Chapter Text
For the last couple days since his moment of weakness in front of Robby, Jack wanted to avoid him. On his way home from work he had been overtaken by a warm, calm feeling, mixed with a sense of gratitude and affection for Robby for being there like that for him. After he had gotten home that night, however, the sheer embarrassment from what had come over him had been horrifying. Jack had the distinct feeling of being like a molted animal, completely soft and vulnerable, acute enough that it made his eyes sting.
Robby had been completely understanding and kind, of course, warm and receptive and calm throughout what must have looked like a babbling, miserable rant on his part, but he never seemed like he wanted to back away. Of course, he had been perfectly patient and understanding about the entire thing, making unwavering, encouraging eye-contact through most of it. Something about that had just made him want to give up more of himself, to keep talking.
Their exchange came to an end when Jack was sobered up by the realization that Robby was supposed to be at work right now, instead of devoting his time solely to Jack. Robby had asked to meet up with him later, but Jack brushed it off in favor of a quick exit.
The day before his next shift, he realized that totally avoiding Robby was a bit of an immature fantasy. He was a fully fledged attending doctor, and he would interact with his fellow doctors and not give into the temptation to hide from them after oversharing.
If anything, Robby had better get ready to see just how well-adjusted and friendly Jack could be. He was gonna lay the brotherly companionship on extra thick until Robby forgot about what had happened.
Showing up at work, Jack is grateful that Robby has seemingly not told anyone else at work about the incident. No one else had tried to ask him if he was “ok”, or tried to force him into a psych hold. No weird looks from the nurses while they whisper to each other.
Partway through the shift Jack had a minute of downtime and his leg was killing him, so he covertly leaned on the desk to take some weight off his leg and give it a break, playing it off like he was just looking up at the board.
He hears the footsteps coming up behind him and tries his best to stay neutral when Robby copies his posture, leaning his elbows on the desk beside him.
“Someone’s staying up late. Haven’t seen you on a day shift for a while.” Robby has his normal affable smile, but his eyes are moving over Jack’s face, gauging.
“What can I say, I wanted to try being awake at the same time they air all the good soap operas.” The corners of Robby’s eyes crinkle.
“Maybe I’ll trade you for night shifts. I’m sure the 4am walk-ins are very fun and relaxed.”
“Night shifts are chaos, but it’s like I said, I like some chaos. Makes things more fun.”
“That board is fun all the way down, I don’t think I could handle anymore.” Robby flicks his head towards the screen.
“Hey, I’m sure you’re plenty of fun once I get to know you.” Jack actually considered the contents of the board for a moment. “Also, dibs on the tibial fracture coming in hot.”
“Hey, we don’t know it’s a fracture for sure. That’s presumptive.”
“‘Deformation’ doesn’t happen spontaneously, Dr. Robinavitch.”
Robby paused for a moment, his eyes flicking down to Abbot’s feet, “Speaking of legs..” he asks, lowering his voice a bit “Yours bugging you? I noticed you’re leaning.”
Jack’s not against talking about his leg with people, but he will backtrack on that once they show signs that they're gonna be weird about it. “No more than usual when I’ve been on my feet for a while. Probably not much worse than yours.” He shrugged, redirecting away from himself. “Or are you just trying to convince me to take a break so you can steal my patient?”
“I can’t pull the wool over your eyes.” Robby goes to bump him on the shoulder with his fist, pausing for a second halfway there before connecting, like he was stopping to think if it would be ok. Jack appreciated the pause, as well as the follow-through.
—---
The lull in their day was soon interrupted by the sudden appearance of a non-standard patient with a possible surgical complication who had taken a turn for the worse soon after he and his wife had shown up in chairs.
Robby took point as they set up with the patient in the trauma bay, taking stock of the situation. Nurse Dana had already delegated for prepping the room. The patient was a larger middle-aged gentleman with an incredibly swollen tongue, dark purple and smooth with pressure. His tongue held his jaw wide open and stuck more than an inch out of his mouth. He had some swelling around his jaw and neck as well, adding to the effect that his mouth was inflated.
Robby also noted a fairly obvious facial difference that looked to be pre-existing and mostly healed; a cavity in his right eye and cheekbone, he had had some sort of surgical removal of his eye socket in the recent past. The man was semi-responsive, his other eye blinking slowly but not reacting otherwise.
Jack prodded gently around his lips. Testing the area for any give, but the ballooning flesh held tight.
Dana, thank god, was already on top of set-up and brought them up to date.
“Patient’s wife says the last few days he’s been having jaw pain and headaches, lightheadedness and shortness of breath. He had an orbital and zygomatic exenteration several months ago for an aggressive infection, and CT scan shows an aneurysm in his tongue that’s burst.”
“When it rains it pours.” Jack said acerbically.
Doing a once-over of the state of the man’s face, Robby hypothesizes: “Seems like the infection and surgery weakened the walls of the lingual artery. That’s fed directly from the carotid into the head, so his tongue is under a lot of pressure right now, we gotta avoid agitating it.”
Dana checks his O2 monitor “Blood ox is falling a bit, his tongue’s gotta be blocking his airway.”
Robby claps his hands together. “Alright, we are going to need to get this guy sedated and intubated so he’s stable enough for the OR and they can drain the hematoma.”
“Already hitting the propofol.” Dana confirms, winking at Robby, always the wind beneath Robby’s wings.
“Distorted anatomy, so might be a little tricky. Don’t want to burst it.” Jack added in.
Robby gently tried sweeping his finger into the guy’s mouth, but the seal was tight. His teeth were already digging into his tongue. The idea of shoving a scope in there seemed too dangerous, let alone the intubation tube as well.
“Yeah I'm not shoving a scope in there.” Robby moved his hands down to prod gently along the patient’s slightly swollen open jaw. A small dent remained momentarily in the man’s neck where he had pressed down. Robby felt the time tick by as he searched for the notch along the throat, and felt a flash of frustration for time wasted. His eyes flicked up to his back-up in the room.
“Dr. Abbot, see if you can find an anatomical landmark on the throat for a cricothyrotomy. The edema’s making it tricky.”
Robby waited for Jack’s input, hoping he’d have better luck. Jack prodded pensively for a second. “Yeah, no, especially with the jaw trismus, we’re not doing a blind crike on this guy.”
Moving onto the next best option, Robby shined a penlight up the man’s nose. At least on the surface, the man’s nasal anatomy seemed like it might be untouched by the surgery. “Alright, gonna try for a nasotracheal intubation.”
Robby wasn’t extensively familiar with the technique outside of the odd mouth trauma case, and he really wished Adamson was on shift right now. He swallowed the feeling. He was attending, he’d handle it.
After they’d gotten the tools together and fully tranquilized the poor guy, Robby got started introducing a thin, flexible fiberoptic video laryngoscope through the nostril furthest from the cavity in his face.
Jack whistled. “Fancy toy. Wish we had those in the field hospitals.” Jack said, staying out of Robby’s space so he could work, but keeping careful track of what he was doing.
“Gold standard for tricky intubations.” Robby smiled for Jack, but didn’t take his eyes off the video feed.
Dana looked on critically from the monitor “I don’t wanna tell you to focus, but blood oxygen and pressure are still falling.”
“Feeling the pressure.” Robby quipped. He was having trouble navigating the turn of the nasal passage. What looked to be a turn would transition into tight folds, and Robby was starting to feel a nagging uncertainty of what he was looking at.
He took a harsh, frustrated breath. “Distorted anatomy.”
“I’m calling down anesthesiology. They’re the big leagues for intubating.” Dana said, getting on the phone.
Robby pulled back on the scope, re-introducing it into the other nostril, even though this one was even closer to the excision site. An acidic feeling was building in his head that he swiftly put aside. Now was not the time.
He fed the scope into the other side of his nose, hoping for clearer results. “I really don’t want to crike this guy.” He reminded himself, looking at his distended throat. He’d figure this out, because he had to.
“Robby.” Jack said.
Robby didn't look away from the video feed. “Yeah.”
“Let me take a shot at it.” Jack implored.
Robby was about to say no, that’s he almost had it, but he could feel himself wasting time. His attempts so far had been useless. It would be a relief to stand down, leave it to someone else.
“Yeah, ok. Impress me, Dr. Abbot” he implored. He let Jack gently take the scope from his hands, and stepped back. The weight off his hands makes him feel lighter. Robby felt the pressure off his chest as Jack took over, movements wholly competent and confident.
Jack got to work the moment Robby let go, retracting the scope out of his nose. “Sometimes the best option, Dr. Robby, is the coolest one.”
Jack looked critically over the patient’s face and started feeding the scope into the void of the patient’s eye socket.
“Woah! Hey, you have no idea how sensitive the vessels in the area are!” Robby stepped back in again, ready to take the reins away from Abbot.
“No amount of trauma is worse than death. One of the first things I learned as a doctor. I just want to see if…” he trailed off, locked in on the feed.
Following the void in and down, Jack was proven right.
“Holy shit, I’m good. The cavity goes all the way through, I knew it. The interior distortion in his nose made me think he had to have an alteration in the route to the back of his nasal passage, so he could still breath out of his nose. There's a canal clear through the bone in his cheek straight through to the back of his nose.” Jack was jazzed about this, smiling like a maniac.
The tube was passed through. The patient was bagged and ready for the OR, just like that.
Robby patted Jack on the back, “Incredible work, Dr. Abbot” he said with a weak smile, and moved out of the room before he could get Jack’s reply.
He couldn’t look him in the eye right now.
—--
After the situation was wrapped up Jack tried to find Robby, but the man had done a pretty good job of disappearing. Eventually Jack stumbled on him in the employee lounge. The last place he would have looked for him.
He was scrubbing his face back and forth mindlessly, but turned and smiled tiredly at Jack from where he was sitting at a table, leaning forward in his chair. Something about his hunched posture and sad eyes cut into Jack a little more than he would let himself acknowledge.
“It almost seemed like you were a real doctor in there.” Robby ribbed. “Where the hell did you get the idea to even do something like that?”
“I can read, you know. Saw a journal article about a couple cases a few years ago for trans-orbital intubation for patients with midface trauma, it sounded badass.” Jack pulled his own chair out further from the table to give himself more space to sit down, lean forward and rub at his leg.
“It looked pretty badass.” Robby added.
“You were pretty textbook in there too, went down all the options methodically, narrowed down the options.” He added, because it seemed like Robby needed to actually be told this.
Robby shook his head once, physically dodging the comment in a way. “Nah, I was…” he paused, then started again suddenly “But you, you stepped up and knew exactly what to do.”
Jack noticed Robby was trying to redirect the attention back onto him. He stared Robby in the face for a second. He’d been told he could make intense eye contact sometimes, but he wanted to make a point of actually getting through to Robby.
“You would have moved onto it as an option, I just got impatient. I could have been wrong. Probably the only reason it occurred to me first is I am familiar with how doctors can be hesitant to work on anatomy outside what they’re trained on.”
Robby’s face cinched up like he’s had something sour. “Yeah.” He said, clearly not agreeing. The more Jack said, the guiltier Robby looked, like any affirmation Robby heard was internally rejected.
Jack swallowed a feeling of frustration. How things had turned around so much over the past couple days, he had no idea. Jack had calmed down from his weird state the other day, partly thanks to Robby, but now Robby was being weird and dodgy. Thinking back on it, Robby wasn’t generally that open, except for the few bits and pieces he’d shared the other day to prompt Jack to open up.
“Robby,” he said, leaning forward over the table, catching his eye. Robby turned his face away, crossing his arms. “It’s not like you made an actual mistake, man. You didn’t even hesitate. You just…took longer to come to a solution than I happened to. It’s whatever. Happy ending. You’re still a great doctor.”
Robby sighed heavily. “I don’t-” He did the same gesture as earlier, a single shake of his head, like he was trying to shake off whatever was affecting him. Jack stayed where he was, leaning forward, waiting to see if he’d continue.
Robby’s silence went on too long, making the atmosphere of the room awkward. Jack was gonna need to push him. He wracked his mind for the tricks his old therapist would use to try to get him to open up when Jack was still new to therapy.
He vaguely remembers them making assumptions on purpose. It was kind of a trick, either the other guy would disagree and have to defend why that wasn’t the case, or they would agree and you’d be closer to the heart of the matter.
“I’ve been thinking about your tattoos.”
Robby does look up at that, surprised by the sudden turn.
“Not in a weird way. Don’t get excited. It’s like, the amor one, love your fate, right? Do you think of this job as your fate? Like, the only thing you could ever do?”
“Jack, we both know how much work it takes to get this far. You don’t just turn your back on this. I don’t think any of us could just walk away from this, it’s our whole lives.”
Robby sighs, then scoots his chair back to get up, clearly done with where Jack was pushing the conversation. “Nah. No. I can’t leave this place. I can’t. C’mon man.” Roby trails on.
Jack is starting to realize how compressed Robby is keeping things. He must not let himself talk about this stuff to anyone, and Jack can’t imagine he’s got a therapist at this point. Getting the man to open up would require a slower, more methodical approach and, well, there’s a reason Jack never went into surgery.
His first impulse on seeing Robby’s escape attempt, probably stemming from his time in the military, is to put him into a headlock and tackle him to the floor until he stops fighting back, but his will to not get fired for assaulting a co-worker wins out for now.
Jack goes for a less blunt approach.
“Oh, please. You make it sound like you’re forced, but I know you like your job.” He scoffs at Robby.
The man pauses, standing with his arms still braced on the table, considering whether or not to take the bait. “Do I?” He offers the slightest opportunity to Jack.
Robby is at a low point for now, a process that Jack is intimately familiar with. When you’re there it’s hard to see the things that motivate you, that bring you joy. You forget they exist temporarily, and the whole world is a storm cloud. The only real option, as far as Jack’s found, is to distract yourself or wait to see if it passes.
“I know you do. Because despite everything, I like it too. There is the high that comes from taming the mess and saving lives, of course, but it’s other stuff too. The quiet days, the nice patients, and excuse my ego, the feeling like you matter, because you do.”
Jack gave Robby’s hand a friendly pat, leaving his hand where it is. “A lot of it is the people you work with, too.”
Robby looks down at his hand and makes the same friendly grimace Jack's seen him make the entire time he’s been working here, but Jack hopes he’s gotten through to him at least a little bit.