Andres remembered seeing on the list Devon had showed him. The hospital listed was Policlinico A. Gemelli University Hospital.

Location: Rome, Italy (Serving Vatican City)
Specializations: General Medicine, Surgery, Cardiology, Neurology
Policlinico A. Gemelli University Hospital is one of Italy’s largest and most renowned hospitals. It specializes in general health services, cardiology, neurology, and surgery. It is affiliated with the Catholic University of the Sacred Heart.

Why Choose Policlinico A. Gemelli University Hospital?
This hospital is a great choice for individuals seeking specialized surgery or treatment in cardiology and neurology, combining world-class medical technology with skilled professionals.

Andres pulled the Bronco into the ER entrance and assisted Devon into the ER Lobby. He helped him sit down in one of the chairs. He told a shell-shocked Jennie that he would tell the ER desk nurse what happened, then he would have to leave them so that he could go back to their house and call the cops. Jennie nodded numbly as she held Devon’s good hand.as she sat on the chair next to him.

Andres went up to the Main desk to inform the charge nurse that his friend Devon Howard had been shot twice in the left shoulder. He further added that, “The bleeding was controlled, but there looked like a lot of damage had been done to his shoulder, because his arm was limp and he had no control over it. I will leave him with his wife, Jennie, because I have to notify the police and go back to the scene of the crime at his house, so that I can explain what happened there.” Santuzza DeFilippis, the ER charge nurse, nodded as she went around to check on Devon after confirming that he had been shot. She told Jennie, “I am going to get a wheelchair and bring Devon, your husband, into ER Trauma Bay One, where the trauma doctor and staff will take care of him.

The charge nurse was assisted by Leozio and Eliseo, the two orderlies, to help Devon get up on the examination table in the trauma room. While Gisella and Allgeria, the two trauma nurses, prepared Devon for his examination. They unwrapped his shoulder, cut his shirt off, and cleansed the wound. They also prepared a suture kit just in case the Trauma doctor could do the repairs in the trauma room. When they were finished, Michele Pisani, the ER trauma doctor, entered the room and asked Devon a few questions, then examined the wound with a magnifying light. He then instructed the two nurses to insert two IVs and start administering 2 grams of IV ceFAZolin and two liters of IV Lactated Ringer’s solution. He also ordered 2 liters of Oxygen via nasal canula and 200 mg (20 ml) of lidocaine 1% or 10 ml of lidocaine 2% for a local IM injection. He finally ordered a sterile drape with a basic surgical pack that included sterile syringes, needles, scaples, forceps, and hemostats. “Mr. Howard will also need 4mg of Morphine to be administered q4rs PRN for breakthrough pain.”

Dr Pisani quickly debrided the wound and removed all the shrapnel and bone fragments that were in the wound. When he was finished, he wrapped the wound with sterile gauze. He then called for the ER Charge Nurse DeFilippis, “The damage to his soft tissue, ligaments, tendons, and nerve tissue is too extensive for me to repair. He is stable for now, but we are going to need to contact D. Buratti, the trauma surgeon, and Dr. Sabbatini, the Neurosurgeon, and begin the preparation of Operating Room #2 for surgery as soon as possible.”

After taking off his sterile gown, gloves, and disposing of them, he went out into the waiting room to tell Devon’s wife, Jennie, how he was doing. “Mrs. Howard, your husband, Devon, is stable. I have cleaned up the wound and removed all of the bullet fragments and bone fragments. He is getting antibiotics and IV fluids. However, the damage he has suffered is substantial, and he is going to require immediate surgery if there is any hope that he will be able to regain use of that arm. I have requested the services of two top-notch surgeons to perform the reconstructive surgery on Devon. We also have certain gels that may help repair damaged nerve tissue. These hydrogels can be used as a potential therapy to stimulate nerve tissue regeneration. These hydrogels can act as a scaffold for cell growth, deliver therapeutic factors, and provide a supportive environment for nerve repair. Injectable hydrogels, in particular, are promising for treating nerve injuries due to their biocompatibility and ability to be delivered precisely to the site of damage.” 

The following list is for the readers’ edification and was not relayed to Devon at the time of his stay at the hospital. Here’s a more detailed look:

• Hydrogels as scaffolds: Hydrogels can mimic the natural extracellular matrix (ECM) of nerve tissue, providing a 3D structure that supports cell adhesion, migration, and proliferation. 
• Promoting nerve regeneration: Some hydrogels are designed to promote axonal growth, functional recovery, and myelination (the formation of a myelin sheath around nerve fibers). 
• Delivery of therapeutic factors: Hydrogels can be engineered to encapsulate and release growth factors, neurotrophic factors, and other bioactive molecules that are crucial for nerve regeneration. 
• Examples of hydrogels: Researchers are exploring various types of hydrogels, including those based on chitosan, alginate, collagen, hyaluronic acid, and peptides. 
• Conductive hydrogels: These hydrogels are electrically conductive and can be used to stimulate nerve cells or restore disrupted electrical signaling pathways. 
• Examples of applications: Hydrogels are being investigated for treating spinal cord injuries, peripheral nerve injuries, and injuries caused by ischemic stroke. 
• NeuroGel: One study showed that NeuroGel implants facilitated spinal cord reconstruction and functional recovery after chronic injury. 
• PeriPulse™: Epineuron’s PeriPulse™ is a bio-electronic therapy designed to accelerate the regeneration of damaged peripheral nerves. 

Dr. Pisani finished, by adding that the charge nurse would bring her to see her husband, Devon, as soon as he was presentable. He wished her and her husband well and politely dismissed himself as he continued with his rounds.

Approximately 10 minutes later, Jennie was escorted back to see Devon. Gisella, the ER Trauma nurse attending to him, said that he would be a little groggy because she gave him morphine for his pain. When Devon saw Jennie, he gave her a sloppy grin, as he said in a slightly slurred voice, “How are you doing, my love?”

Jennie said in a somewhat subdued voice, “I am OK, honey. Dr. Pisani, the ER Trauma Doctor told me that you are going to have to have another surgery on your shoulder. He is hopeful that you will be able to regain the use of your left arm. Even if you don’t, it won’t matter to me….I love you very much.”

Allegria, another ER Trauma nurse came by to see if there was anything that Devon or Jennie needed. Jennie asked the Trauma nurse what the visiting hours were. She informed Jennie that she could visit her husband for 30 minutes every four hours.

Over the next few hours, the consulting surgeons, Dr. Sabbatini, the Neurosurgeon, and Dr. Bugatti, the Ortho-Trauma Surgeon, came by to examine Devon and to talk not only to him but also to Jennie. After doing a close inspection of the wound, checking his reflexes, and his ability to move the arm. They discussed his prognosis. Neither doctor sugar-coated his prognosis. While Dr. Bugatti, the Ortho-Trauma Surgeon, was a little more upbeat about being able to repair his damaged shoulder, Dr. Sabbatini, the Neurosurgeon, did not sound too optimistic about him gaining control or feeling in his left arm. Dr Sabbatini said, “I can surgically reconnect the severed nerves, but the nerves that the two bullets have shredded are another matter entirely. I will, of course, utilize the hydro gels to help facilitate the healing. There is only so much that modern medicine can do. If this had happened just 10 years ago, I would have said there was no chance of you gaining control of your left arm. Dr. Bugatti and I will operate on you as soon as the operating room is ready. We have both cleared our schedule for the surgery, because the sooner we operate and repair the damaged tissue, the better your chances are. You are lucky that there was no vascular damage done, because that might have necessitated an amputation of your left arm just below the shoulder.”

By the time the two surgeons had finished their “pep talk” to Devon and Jennie, Fontana and Auriemma, the two orderlies came in to transport Devon to the operating room. When he was rolled into OR, Bettino Albanp, the Surgical scrub tech, Giulietta Baroffio, the Surgical nurse #1, Pietrina Fazio, the Surgical nurse #2, and Silvio Capuano, the CT tech, were all waiting for him. They effortlessly transferred him to the operating table and began to prep his shoulder for the surgical repairs. I won’t bore you with all of the surgical procedure jargon; suffice it to say that the operation lasted several hours, and while his damaged ligaments and tendons were repaired, with physical therapy, they would be as good as new. It was the control mechanism or the nerve tissue that was the wild card. While Dr. Sabbatical was a gifted surgeon, only time would tell what the prognosis would be. This was because the nervous system healed at a glacial pace, if at all.

When the surgical procedure was completed, Devon was placed on a gurney and moved into the adjoining recovery room, where Adona Mazzi and Rosalba Romano, the recovery room nurses, would continue to monitor his recovery. Once he was awake and stable, he would be transferred to the Medical-Telemetry unit, where he would remain until he was deemed fit for physical therapy. At that time, he would be transferred to the in-hospital rehabilitation unit. Thanks to Devon’s age and the incredible physical condition he was in, the time he spent in the recovery room was brief, to say the least. In just an hour post-op, he was in his hospital room, where Jennie was impatiently waiting for him. She greeted him with a beaming smile and a chaste kiss. “I hate to do this to you, honey, but I am beat, this has been a day from hell, and our little Amelia needs me, so I am going to call it a day. I will be back to see you tomorrow after I have breakfast and have taken care of Amelia. I love you.” Jennie kissed him one more time as she left him under the care of RN Riccarda Zetticci.

Thanks to the Vatican’s deep pockets, Devon remained in the hospital for over two months, where he was put through a rigorous rehabilitation regimen. Unfortunately for him, he never regained the use of his left arm, so when he was finally discharged, it was with a sling. Dr. Sabbatini Devon’s neurosurgeon finally conceded defeat as he spent a little time with him before he released him from the hospital. “I am sorry, Devon, the nerve damage was just too extensive. I am afraid that you will never regain the use of your left arm. While all hope is not lost, it will take a miracle for you to be able to use your left arm.”

The biggest regret Devon has is not the loss of the use of his left arm; he would have gladly given up his life to save his family. It was that he missed the funeral of his best friend and faithful partner, Thomas. Jennie, Andres, and Samiya, along with an honor guard of the Gendarmerie and even the Pope, attended his funeral. He was granted the privilege of being buried in the Vatican Grottoes, an honor typically reserved for Popes.

The following day after returning home from his two month stay at Policlinico A. Gemelli University Hospital

Devon tendered his resignation to his boss, Gianluca Gauzzi Broccoletti, the head of the Gendarmerie Corps. While his boss was unhappy with his decision, he understood. He even offered him a job as an instructor, but Devon replied that if he couldn’t return to work without any limitations, he didn’t want to come back at all. It was just the standards that Devon set for himself; if he could do it right, he always lived by this motto. Besides, he wanted to spend time with his family, and he knew that he had been neglecting them entirely too much. He didn’t want to miss any more of the milestones in Amelia’s life.