Chapter Text
“MVA incoming, at least one critical,” One of the triage nurses relates to Hayley as she comes through the ER doors in response to a page, “5 minutes out.” Hayley sighs, hurrying to put a gown on over her scrubs.
“So much for a quiet night,” She throws her brown hair up into a bun to keep it out of her face. She had just finished checking on her patients and was trying to get some much needed sleep in an on-call room when she got the page. Despite her exhaustion, she’s looking forward to an incoming trauma. Their smaller, rural hospital didn’t get many exciting cases. Half the time people wandered into their emergency room to have a warm place to sit.
She stands outside with another doctor and a nurse, slipping on some gloves while they wait for the ambulance.
“John Doe. Car vs semi, GCS 6 at the scene, head trauma with positive seatbelt sign, B.P. is 85/50. He had a unit of saline en route.”
“Take him to trauma 1 and get him up on the monitors,” Hayley walks next to the gurney, “What the hell happened?”
“The other driver lost control of the truck, could have fallen asleep at the wheel, or he could have been drinking,” The paramedic says, “I don’t know. The other driver was conscious, police will do a breathalyzer, but I had to get this guy here.”
“You did the right thing. On my count, one two three,” They heave the patient onto the exam table, hurrying to start an IV and get his vitals, Hayley makes note of the tattoo on his chest as she attaches the leads, characteristics like that can help get an ID, “He’s tachy and hypotensive, let’s hang another unit of saline. We don’t know his name?” Hayley directs the question to the paramedic.
“No, he was outside of the car and we couldn’t find his wallet. There was a fire, I think he was able to get out before he passed out. His phone was completely shattered in the accident, the police are working on figuring out who the car is registered to,” The paramedic nods to them, “It’s a damn shame, a young man like that. Good luck.”
“Sir? Can you hear me?” Hayley shines her penlight in his eyes, “His pupil response is low, order a head CT stat. Sir, can you tell me your name?”
“Nick...” It’s half a name, half a groan as he fights unconsciousness, Hayley almost doesn’t catch it.
“Stay with me Nick,” She grabs the ultrasound probe and squirts some gel onto his stomach, “Looks like his spleen took some damage, he’s bleeding into his abdomen.”
“Nick, I- ugh,” He lets out a low groan, the monitors start to blare.
“Damn it,” Hayley holds her stethoscope against his chest, “His left lung collapsed. Get me a chest tube now.” She grabs the betadine, rubbing it on his skin.
“10 blade,” She takes the scalpel from the nurse and makes the incision with practiced ease. She inserts the tube, hearing the desired puff as the trapped air is expelled and the lung is able to expand. She watches the monitors, his readings low but steady.
“Get him on oxygen. He’s stable enough for CT,” Hayley says, “Page surgery and neuro, I’m concerned about a possible brain bleed.” She meets the surgeons in imaging, the trio wait anxiously for the results to display on the monitors.
“There,” Dr. Grant points to the scan of his brain, “Subdural hematoma. Good call, Lewis.”
“Looks like there’s damage to his spleen,” Dr. Turner concurs with Hayley’s earlier assessment, “Let’s get him to surgery.”
It’s out of her hands now, Hayley goes back to the ER to see if she’s needed. But the other guy came in with a broken wrist and one of the PA’s had already set it and all she had to do was sign off on his exam. He has a mild concussion but other than that and the wrist, he’s fine (and very clearly drunk). Unfairly lucky. She debates with herself over whether she should go try to get some sleep, but she knows she won’t be able to. She goes to the gallery to watch her patient. She feels sorry for him, they have no way of identifying him and he’s all alone. At least she knows his name. Nick. It’s a nice name.
He came in with nice jeans and a tight-fitting cotton shirt that unfortunately they’d had to cut off him. With all his hip bracelets, he seemed more a city type. She wonders what he was doing in Douglas, three hours south of Atlanta and two and a half west of Savannah. What was he doing driving in the middle of the night? Maybe he was on the run from the law, or maybe he was driving through the night to interrupt the wedding of his love before she gets away from him. Hayley chuckles, running her hands through her knotted hair. She needs to get out more. Maybe it’s a little childish (she is the youngest doctor at the hospital, by quite a margin) but she likes making up stories about the people around her. Maybe it stems from childhood shyness, or a flair for the dramatic, but she does it all the time. In coffee shops and on planes and when she has a John Doe in the ER she can’t identify, apparently. She has to remind herself that her patient is not the character she makes up in her head, but a person with a life and probably some family or friends who love him.
The surgery is long, there's some damage to his kidneys as well that wasn't seen on scans. He codes once on the table, and Hayley thinks she holds her breath for the full two minutes it takes to bring him back. Dr. Turner manages to repair the damage to his spleen without removing it, and Dr. Grant’s craniotomy is successful. Now it’s a waiting game, it’s impossible to tell how severe the damage to his brain is. And even if he wakes up, there’s no telling what sort of deficits he may have. It'll be touch and go for the next several hours, Hayley doubts she'll be getting any sleep.
“Any progress on an ID?” Hayley asks the social worker outside of Nick’s ICU room.
“No, and we’re not likely to get any until the morning at the earliest,” It was around 3:30 am, no one at the precinct to run the plates, “The car is the best bet, if that comes up empty we’ll look into missing persons reports matching his description. But since you can’t report an adult missing for over 24 hours, that will take some time too.”
“He said his name was Nick in the ER,” Hayley says, “If that helps.”
“It does,” The social worker makes a note, “We’ve temporarily labelled him Tallahassee.” Hayley nods. Every hospital has a different method for naming unidentified patients, they use state capitals.
“Let me know when you hear anything, will you?” Hayley asks.
“Sure thing, thanks Dr. Lewis.”
She enters Nick/Tallahassee's room, scanning over his most recent labs. His red blood cell count is improving after his transfusion, and his platelets are good. His EKG also looks positive considering the amount of stress his heart had been under in the last few hours, this guy had something to live for. She checks over the monitors and orders some repeat labs to be drawn in a few hours. His post op scans of his brain look promising, the next 24 hours will be crucial in determining whether he will wake up, and in what state. Satisfied the vent settings were appropriate, Hayley takes a seat in the chair next to the bed, keeping him company while she finishes up her notes. She finds herself studying him for the first time, now that she isn't busy saving his life. He's handsome, even with the bruises and cuts on his face. What hair she could see poking out from his bandages is a dark blond, his bone structure giving him the chiseled look seen on actors in movies and TV.
“Don’t worry handsome, I’m sure we’ll ID you soon,” She adjusts his IV, noticing for the first time a tattoo on his right forearm, Annabeth, “Looking like you do, I bet there’s someone missing you.” She vaguely remembers another tattoo on his other arm, but she can’t remember and it’s currently bandaged from his radial fracture.
The belongings he had on his person are in a bag at the bedside, having been removed prior to his surgery. She eyes the items through the plastic, wondering if any of them will give her a clue to his identity. A watch, two bracelets (one a thick leather and the other a thin string of wooden beads), a long chain necklace and a chunky silver ring. Nothing remarkable, no wedding band, no ID. She opens the bag and takes out the watch, checking for an engraving.
Ships Passing, says the back. That’s it, no name or salutation or any other hints to who this man is.
“You’re very mysterious, you know that?” The steady rhythm of the vent is her only answer.