Chapter Text
Just like every winter, a flu virus had ravaged the Pittsburgh Trauma Center ER. Over the course of a week it had taken out 3 residents, 5 nurses, and the entirety of the intern class. Charlie had managed not to get it the first time around, but by the end of her last shift, when everyone had finally returned from their sick leave, Charlie felt the tickle start in the back of her throat. The other nurses were constantly teasing her about her extra-vigilant hand-washing, masking, and sanitizing, but her diligence had allowed her to survive her first year as a nurse without any infections…until now.
She jogged to catch up with Perlah on the way out of the ER, bumping her with a light elbow. “Perls, I have a bad feeling about this…I think the ER is finally taking me down.”
“Ach, finally!” She said with a gentle, teasing smile. “We were betting on how long it took you to take your first sick day. You think you got the flu going around?”
Charlie grimaced, “Yeah, and at the rate it took down everyone else, I’m not going to make it in Monday.”
Perlah squeezed Charlie into a quick side hug before they split to go to their cars. “Do you have everything you need? Fluids, Kleenex, Tylenol?”
“I think so! Just going to hunker down and do my best not to die,” Charlie laughed.
“I’m going to text you and see how you feel this weekend, and if you don’t answer I will come and kick your door down,” Perla threatened with another smile.
Charlie gave her a parting smile, but when she got to her car, she just sat for a minute to try to contain her anxiety. She had been inspired to become a nurse after spending a lot of time in hospitals in college, battling and beating breast cancer as a young 22-year-old. She had actually met Dr. Robinavitch for the first time when an infection was ravaging her immunocompromised body and she had collapsed in the waiting room, “causing wholly unnecessary drama,” as Robby had joked. The cancer treatment had left her with radiation-scarred lungs that tended to flare up with any common infection, so Charlie lived most of her life dreading getting sick.
Being a nurse was maybe not the best career choice for someone in her condition, but for Charlie, there was never a second option. The nurses that had cared for her were the strongest, kindest, hardest-working people she had ever met, and joining their ranks was the most natural transition in the world. Robby did his best to keep tabs on her, checking in during shifts and trying to keep her away from infectious patients where he could—although of course, that wasn’t always possible.
By the time she got back to her apartment, Charlie had a pounding headache, and she immediately wrapped herself in a blanket and passed out on the couch. The cough started around 3 am, and the fever followed a few hours later, so by noon the next day Charlie was feeling like absolute shit. She was trying to force down liquids to stay hydrated, chasing cough syrup with bottles of gatorade, and like any good nurse, she kept a record of her fluid intake and med schedule. That was the extent of what her brain could accomplish in this state—the cold had taken over, filling her brain with cotton and making time go slipping and sliding outside of its normal bounds.
Perlah texted her Sunday morning, as promised, and Charlie sent back a single poop emoji. It wasn’t much, but it communicated quite effectively how she was feeling. The fever had reached the triple digits, and the cough had gotten painful—like her lungs were being torn open alveoli by alveoli. She slept most of the day again, somehow remembering to text Dana that she wouldn’t be coming in—Charlie wasn’t sure her voice would hold out for a proper conversation.
Around midnight, Charlie woke up with a coughing fit so bad that she couldn’t catch her breath. Her anxiety spiked as she desperately rummaged in her bedside drawer for an emergency inhaler, and it took two doses of bronchodilator for her breathing to fully relax. Falling back on her pillows, Charlie was exhausted, but also on high alert. She analyzed each breath, trying to detect any hint of a wheeze and swallow down each cough before it ripped out of her.
The radiation from breast cancer had burned out the cancerous tissue, but also burned part of her lung that had been in the way. It was unavoidable, but the consequences had been brutal. Even clearing her throat could bring on a coughing fit so bad it felt like her lungs were trying to leave her body. Now this cold was running rampant in her body, and Charlie was well-aware what could happen if it got worse.
She hauled her pillows and blankets to the couch, bringing her inhaler with her, and just…sat. There wasn’t much else to do when you were miserable and agonizing over every breath. It was infuriating that normal people could settle in and muddle through, but she lived on the knife’s edge of wondering if her lungs could take the abuse. She clutched her inhaler in one hand and phone in the other, just…waiting.
She did manage to doze off, but was woken again around 8:00 AM with a coughing fit bad enough to warrant the inhaler again. It was her third dose, and her nurse’s brain was already raising warning flags—the recommended dosage was no more than four puffs a day, and at this rate, Charlie would hit that before noon. She knew that something needed to change, so she dragged herself to her feet to try and take some more cold medicine and get her body some kind of sustenance. She was lightheaded with fever, but in the back of her mind she recognized it was probably also due to the fact she hadn’t been able to eat anything all weekend.
Her team in the pit would have started their shift by now, and Charlie would have given anything to be there with them. She found an applesauce pouch in the fridge, the only food that she could currently swallow without gagging, and sucked it down, quite proud of herself for accomplishing the small task.
Tired of being vertical, she tossed herself back onto the couch, but when the air was forced out of her lungs, she realized it was a mistake. The coughs came quick and strong, forcing her to roll off the couch onto her knees, bracing against the cushion. To her horror, she tasted blood in the mucus she coughed up, and could see a tinge of pink in the tissue. She took the fourth puff of her inhaler, but it barely made a difference, and she knew the decision was made for her…Charlie was going back to work. Some oxygen, some of the heavy-hitting meds, and an IV, and she would be feeling so much better.
She found her old IV-accessible sweatshirt in the back of her closet, grateful she hadn’t gotten rid of it, and packed a small bag with headphones, her charger, and the massive file of her full medical record…just in case. She was getting jittery about the prospect of being a patient again, and wasn’t sure she could stomach sitting in the waiting room. But what use was being a nurse if you couldn’t take advantage of it?
She texted Dana as she walked to her car, Coming in, flu, hard to breathe. Be there in ten.
And yeah, maybe she shouldn’t be driving, but there’s no fucking way she could afford an ambulance, and even an uber at surge pricing was pushing her budget. She drove at a snail’s pace and gratefully pulled into the last spot in the staff lot without incident. As she climbed out of the car, she had to turn around and brace herself against the door as another cough wracked her body. She had been pathetically hoping that maybe Dana or Perlah would be there to greet her, maybe with a wheelchair, but sneaking in the side staff entrance she was instead met with chaos. Two ambulances were unloading at the same time with gnarly looking traumas, and the board showed every cubicle was full.
Sighing, she was making her way towards the nurses’ desk to collapse when Robby and Dr. McKay rushed by with one of the traumas on a gurney. “Charlie?” Robby asked, his eyes darkening in concern as he took in her uncertain state. “What the hell happened to you?” He let McKay push ahead and grabbed Charlie’s arms gently, supporting her as she coughed and tried to curl in on herself.
“Flu,” she gasped hoarsely, “wheezing.”
Robby looked over his shoulder at the trauma, and took a second to decide. “Can you find yourself a bed? I’ll be there in five minutes, I swear.” Charlie nodded, and Robby squeezed her arms before stepping away. “Get an oxygen mask and a pulse ox on until I can get to you.”
Charlie leaned back against the wall, searching for an open room, but it was making her head spin. The staff lockers were a few steps away, and she found herself stumbling blindly into the hallway, not realizing how dizzy she had gotten. She practically fell onto the bench, immediately leaning forward and holding her head over her knees as she coughed violently again. The coughing had changed in the last hour—it was burning, shredding her lungs into ribbons, and it wasn’t bringing in nearly enough air.
“Holy shit,” she heard from behind her. Glancing up, she eyed Langdon coming around the corner and kneeling in front of her. His fingers briefly found the pulse in her wrist, and then she felt his stethoscope on her back. “Charlie, can you hear me?”
She nodded, tears leaking from her eyes as she fully started to panic. “Can’t….breathe,” she gasped.
Dr. Langdon nodded calmly, “You’re wheezing, I can hear that. We’re going to get you to a bed and get some oxygen on, alright?” She nodded, and started to stand before Langdon gently pushed her back down. “Stay put, I’m going to be right back.” He peeked his head around the corner and called out, “Hey, Matteo, get a wheelchair in here, now!”
He was back at Charlie’s side in a second, as her coughs turned into gagging dry heaves. “Can you hold your breath for me?” His face sobered as he listened with the stethoscope again. “Exhale, then take a deep breath for me?” Charlie exhaled in with a whimper, and could only take in a short, shallow breath before hacking and gagging again.
She was panicking at the lack of oxygen, and hadn’t even noticed Matteo lifting her under the shoulders and into the wheelchair until they were moving. “Tranquila, Charlie,” he murmured in her ear, patting her shoulder.
Dana met the chair at the bed and helped transfer Charlie over, a worried look on her normally stoic face. “Thought you took the day off, babe?” Someone had put an oxygen mask on her, and Charlie felt her lungs relax for the first time since she had arrived. She leaned back, trying to focus her wild eyes on the trio that was intently watching her. She had somehow hung onto her bag, and pulled out the file, weakly shoving it at Dana. The charge nurse picked up the file and was paging through it. “Frank, look at this—radiation induced lung injury secondary to radiotherapy for breast cancer. She’s got scarring.”
Dr. Langdon grabbed an X ray from the file and held it up to the light, looking at the pocket of white in Charlie’s left lung. Charlie craned her neck to look, unfortunately setting off another explosion of coughing, and she felt Matteo’s strong arms holding her upright. At some point, her abdominal muscles had given up, and were barely supporting her. “We’ve got you babe,” Dana said, wiping spit from under mask, “Just relax. We’re gonna take care of you.”
“She’s got a fever,” Matteo reported, still supporting Charlie’s shoulders.
“And there’s blood in the sputum,” Dana said, looking at the gauze she had used to wipe Charlie’s chin. Dana quickly took her temp and frowned, “102. Charlie, have you been taking anything?” Charlie nodded. “Tylenol?” Another nod. “500mg?” Charlie weakly pointed upwards. “1000?” She nodded. “How long ago?” Charlie just shrugged, and Dana rubbed her leg comfortingly. “That’s okay, Charlie, that’s great.” Dana slipped a pulse oximeter onto her finger and stepped back, talking quietly with Langdon and paging through the rest of her file.
Charlie felt her eyes closing as she really began feeling the effects of the hypoxia. Matteo shook her shoulder softly, then harder. “Charlie! Gotta stay awake a little longer, okay?”
When Charlie opened her eyes, Matteo was leaning her forward, and Robby had appeared, holding his stethoscope to her back. “Hey Charlie. Not feeling so good, huh?” Matteo eased her back onto the gurney again and stepped away as Robby moved his stethoscope to her chest, just below her collarbone. “Sats at 86, definitely wheezing, with some crepitus on the left side,” he noted. “Have you used your inhaler today?” Charlie nodded, trying to let her eyes close again. “Not yet, Charlie,” Robby commanded gently, shaking her arm. “Did you max it out? Yeah? Okay, we’re going to get you some relief.”
Relief sounded great. She wasn’t sure her lungs could take any more punishment, and her brain was screaming for either oxygen or something a little less…alert. Charlie couldn’t figure out how things had gone downhill so fast, but she was infinitely glad that she had made it to the pit. Dana started an IV (on her first try, bless that woman), and rubbed Charlie’s arm while some medications were added, trying to relieve the burning feeling. “Hurts,” Charlie choked out, almost a whisper.
Robby leaned over, capturing Charlie’s meandering gaze. “Give it a second, let the meds work.” His stethoscope was out again, still listening. “Inhale for me?” Charlie took in the deepest breath she could, but it got stuck on the way in, and she coughed again…and again…and again. She ended up gagging, her throat exhausted, and spitting blood-tinged phlegm into a basin. She felt Matteo tuck the aspirator into her mouth, trying to help clear her airway. They were all talking to her, touching her, trying to comfort her, but she was about to pass out from the sheer pain that was ripping through her chest.
“Jesus, kid,” Robby said, eyeing what she had coughed up. “You don’t do things halfway, do you?” He was smiling, but couldn’t hide the worry from his eyes. “Alright. Your lungs sound awful, but we’re not going to intubate you just yet. We’re going to keep monitoring. Blood oxygen is still low, we really need to get that back up. And we’re going to get you on some broad-spectrum antibiotics. Dr. Langdon, take some cultures and send them to the lab to see what we’re dealing with.”
Charlie felt a tear slip out of her eye, but Dana was there to quickly wipe it away. “Hey you, don’t worry about a thing. We’re gonna take care of you. Just close your eyes and relax.” Robby was nodding, and Charlie saw that Perlah and Princess had joined Matteo and Frank in the cluster at the end of the bed. “Rest now. We got you.” Charlie smiled slightly, and gladly let herself drift into sleep, surrounded by her team.