And Michael You Would Fall

O0O0O0O0O0O0O

He knew he was dying. He had treated enough patients to recognize the symptoms. He just wished his body would hurry up about it.

As he pressed his left hand to the knife still lodged in his body, his right reached into his hoodie pocket. The desperate attempt to pull out his phone was hindered by the slickness of the blood covering his hand and the phone slipped from his grasp, landing with a sharp crack onto the asphalt of the alleyway. He let out an aborted giggle at the irony of his position, half seated against the alley wall next to the massive hazardous waste bin. How many times had he thought he should be thrown out like so much garbage?

He slumped forward, his shredded abdominal muscles finally failing to keep him upright. The movement jostled the knife and he let out an airless scream, scrabbling uselessly at the blacktop beneath him, the pain of the pads of his fingers being rubbed away was a drop in the ocean of his agony. He shoved his sneakers into the pavement, managing a few inches of forward movement. He tried again, hot tears mixing with the bloody spit leaking from his lips, gaining ground, before collapsing onto his side, the movement jarring his bleeding head and his vision going black, a trail of red life left behind him.

30 minutes earlier

“What do we got?” Robby called out to the paramedics who were already moving toward the open glass doors as the wheels of the gurney unfolded, hitting the ground with a clatter.

“Male, late sixties, covid positive, satting at ninety-two on five liters, alert and oriented” the paramedic reeled off, his tone bored.

Robby looked down at the black man on the gurney, oxygen tubing sneaking out under the disposable mask covering his nose and mouth, assessing. “Alright, trauma one is open,” he directed.

He worked it like any other case. Told himself it was just another case, but his body said otherwise. His hand shook, just slightly, as he tapped orders into the portable computer. “You should be feeling better very soon, Mr. Logan,” Robby assured the patient as he slipped out of the room. “We’ll start getting you admitted and then move you to a room upstairs.” The man nodded, breath coming a little easier, but his eyes slid closed with exhaustion.

Robby sat at the computer, the digital chart pulled up on the screen, his glasses slipping incrementally down his nose. Other than a patient name and date of birth, the chart was still empty.

“Robby.” Dana said from behind him, her voice gentle. Robby spun his chair around, taking off his glasses and rubbing a hand through his short cropped hair.

“Yeah, what’s up?” He said back, slipping his folded glasses into his pocket.

“You know what’s up. Go get some air, we’ll survive without you for five minutes.”

“I’m fine, Dana.”

“Yeah, and I’m a mermaid. Go on,” she slipped behind him, shutting down the computer screen and giving his wheeled chair a nudge away from the desk. He stood up obediently, making it two steps toward the door before feeling a sharp slap on his rear end.

“Hey!”

“I just love watching you walk away, honey cheeks. Keep going,” Myrna crooned lewdly. Shaking his head, Robby continued, rubbing a rough hand down his face to idly tangle in his beard. The linoleum floor squeaked under his extra traction work sneakers as he waved a hand to the guard standing near the door to the ambulance bay before stepping out into the cooler air and lower light of the evening beyond.

Reaching into his worn hoodie pocket, Robby pulled out his phone, shooting a quick message to Jake. He liked to check in on him, even if just to remind Jake that he was thinking of him. He was thinking of him, every second his brain wasn’t consumed by the frantic push-pull puzzle that was the ED he was thinking about Jake, and today was no exception.

“Hey, doc.” Robby’s head snapped up at the unexpected words. He couldn’t see who had said them as he glanced left and right. “Over here. I need to talk to you.”

“David?” Robby questioned, rounding the corner of the ambulance bay to take in the dishevelled kid standing with his hands in his over-large jean pockets.

“You know, you didn’t have to do it.” David said, his eyes fixed on the ground.

“Do what, David? Why don’t you come inside and we can talk about this. Does your mom know you’re here?” Robby said, extending a hand, palm down, supplicating.

“You told my mom I should be committed. You got her to sign those papers. I was already a loser, now I’m a freak!” David’s voice rose, spittle flying from his mouth on the last word.

“No, David. You’re not a freak. You just need a little help, that’s entirely normal. This isn’t your fault.” Robby didn’t see what hit him, just saw David move, fast, his hand coming out to strike Robby in the chest. His breath fled with the impact. Eyes moving down his own body, shakily taking in David’s hand, wrapped around the hilt of a knife. A knife whose blade was buried up to the hilt in his body.

Robby grabbed the handle of the knife over David’s hand, desperate to keep the blade of agony still as the kid tried to pull the knife back out. He was so close now, and through his blurring vision Robby could see the curls falling over David’s forehead. His mind was sluggish, the only thought rising to the top of the maelstrom was who broke you so badly? Acting on pure instinct, he pulled his head back before slamming it with all the force he could into David’s face. His vision whited out, a high pitched ringing filling his ears and he smelled blood, tasted blood.

As the static slowly cleared from his vision, sensation hit anew, the stabbing pain in his head almost unbearable. Robby found himself half laying, half seated against the rough wall of the alley. David was gone.

O0O0O0O0O0O0O

“Hey, Dana, have you seen Doctor Robby?” Javadi asked, pushing her hands into her scrub pockets. “We have a case of intractable vomiting, I-I think the patient is an addict, but he’s not really talking so I could be wrong. I’m not sure if that changes the treatment, and Doctor Robby said to ask if I had any questions. About a patient I mean, and questions about a patient. I mean, even if he was talking he’d probably lie about something like that, right? I remember the case last week-”

“No worries, hun,” Dana says, stopping her words midstream, “I’ll find him for you. It’s about to be my break anyway.” Grabbing her jacket, she moved toward the exit, waving a dismissal behind her as Javadi started to follow.

Dana strolled out, the movement of her hand to her pocket retrieving her lighter and a cigarette as automatic as the huge glass door she walked through. Leaning against one of the huge stone facade support pillars, she lit the cigarette, pulling in a grateful breath as she returned the lighter to her pocket and removed her phone with practiced ease. Finding Robby’s number took her a little longer, she made a point of never contacting him unless it was absolutely necessary; being the cause of the look she saw cross his face far too often when his personal phone rang was not on her list of things she wanted to do today.

As she tapped his name and held her phone up to her ear, she blew out a smoke laden breath, watching the wisps lift into the air. She pulled her phone away from her ear. The outgoing ring sounded funny, echoing slightly. She lowered her phone, checking that the outgoing call screen looked normal, and she realized the odd cadence was coming from another phone ringing nearby. Walking slowly toward the sound, Dana rounded the corner that led to the huge red hazardous waste dumpsters that lived in a wide alley next to the ambulance bay.

She was going the right way, the ringing getting louder before stopping entirely, her phone letting her know her call had gone to voicemail. The light was getting low with the setting sun, and she strained to see past the comforting external lights that lit the area outside the door. Her foot landed in a puddle, which was odd, it hadn’t rained in a few days. This city really needed to get control of the water drainage. She slid her foot along the ground, trying to avoid any garbage that might be laying around, but it impacted something soft. She paused, pulling up her phone flashlight to see what it was.

Not what. Who. Robby.

He was laying prostrate on his side on the asphalt, blood covering his face and forming a small pool beneath his still lips. A much larger pool had congealed under his torso and was now coloring the toe of Dana’s shoe. Dana screamed, but there was almost no air in her lungs and the sound was strangled before it could be born. She kneeled next to his limp body, shaking fingers connecting with his neck, just under his jaw. There. His blood still pumped through his body, perfusing his precious tissues along with the ground.

Dana stood, running back to the bright lights of the bay. There was one ambulance parked, a paramedic she didn’t recognize just starting to fold the stretcher wheels up into the box. “Hey, I need help over here!” Not getting an instant response, Dana switched to her nurse voice, “Now!”

After everything, after they had scooped up Robby’s lifeless body, after she had yelled about pressure and head trauma and be gentle, Dana was left standing stunned outside the ambulance bay, her hands covered in his blood, the knees of her scrubs saturated with the sticky wetness of the puddle that had been beneath him.

“Ooh, big trauma incoming,” Langdon shouted, responding to the whoosh of the automatic door like a dog to a bell. He pulled on a pair of non-sterile gloves, “trauma two is open, gentlemen! What’s on the menu today?” The paramedic looked green, both in the face and in his manners, his movements jerky as he pulled the gurney toward the indicated bay.

“Umm, m-male, forties, maybe fifties, massive penetrating trauma to the abdomen, weapon still lodged in the wound. And-uh, his head… He’s got a head injury.” He gratefully let go of the rail as his charge was transferred to the hospital stretcher before retreating quickly, pulling the ambulance kit along in his wake.

Langdon let out a low whistle, “Looks like we’ve got a live one kids,” he glanced at Mel and Princess gowning up in the doorway before turning back to the bloody body, expertly attaching a pulse ox to the patient’s finger and assessing the knife wound quickly before turning to see the extent of the head injury. His knees turned to jelly and his stomach dropped as he took it in. “Oh my- It’s Robby,” Langdon breathed, moving further toward the head of the gurney and digging his knuckles into Robby’s sternum. “Robby, can you hear me? Robby! Michael-”

O0O0O0O0O0O0O

“-Robinovitch. Big name. You might want to think about shortening it if you want patients to remember it. The ED isn’t exactly conducive to name retention.”

“Oh - uh, okay,” Michael replied, “if you think it’s necessary.”

“Hmm,” Adamson hummed, nodding slowly. “Michael… You don’t look like a Mike…” He trailed off, looking Michael up and down. “Ah, got it! Doctor Robby.” He didn’t elaborate, spinning on his heel and heading deeper into the maze of hallways. Michael followed, a little wary, his head on a swivel trying to take everything in.

“Here’s trama one, two, three, and four,” Adamson said, pointing to each one as they moved swiftly past, “locker room, bathrooms are over there, but good luck ever seeing the inside of one. Pedes is right over there, behavioral health down that way. And this is where the magic happens.” He slapped his palms down on the sterilizable wood-look counter of the nurses’ station. “Robby, I’d like to introduce your new boss, Maggie.” He reached over the counter and put one arm around the shoulders of the charge nurse standing behind the desk.

“Oh, nice to meet you, Maggie,” Michael said, reaching out a hand.

“Nope, never shake a nurse’s hand, you truly have no idea where it’s been,” Adamson said, and Maggie playfully slapped him on the arm before taking Michael’s outstretched hand.

“A pleasure. We have two other nurses for this shift, Lucia and Dana. I’m sure you’ll run into them sooner rather than later.”

“Well, that concludes the grand tour,” Adamson said, “find me if you need me. Otherwise, don’t find me.” At that, he turned on his heel and walked off toward one of the trauma rooms, leaving a very confused Michael in his wake.

“Don’t worry, honey,” Maggie says, “You’ll get the hang of it real quick.”

O0O0O0O0O0O0O

“Pupils unequal but reactive, definite head injury,” Mel called, clicking off her penlight and stowing it back on the collar of her scrub shirt. “He needs a CT.”

“He’s not going to make it to CT,” Langdon called back, cutting through Robby’s worn navy blue sweatshirt. “I’m going to catch hell for this,” he muttered, ripping the soft fabric with a practiced hand. Tiny sprays of blood whipped against his legs as he tossed the soaked fabric to the floor. “Volume?”

“Four hundred mls in the cell saver,” Mel called, straightening.

“The knife is keeping most of the blood in, but with his stats still dropping he must have massive internal hemorrhage. Squeeze in another unit of O-neg and I want another two units on standby!” Langdon’s voice was raised, the pitch a little higher than usual. “Who knows how much he left on the pavement.”

“Foley output,” Princess said, holding the bag up for Langdon to see.

“Well, now we know where the blood is going,” he said, taking in the bag filled with bright red fluid, “call up to surgery, tell them we have a penetrating injury with major renal lac who needs an OR yesterday. I’m sure Garcia will faint with joy.” Princess obeyed, rushing over to the phone on the wall, her gloves leaving red streaks on the grey handpiece.

“Portable X-ray, please!” Langdon called. He had to treat this as just another Trauma, stabilize, collect information, then move to surgery. The steps were simple, he could do this. He just couldn’t look at Robby’s face as he passed the ET tube down his throat, couldn’t notice his tattoos as he stuck the adhesive monitor pads to his chest, couldn’t stop when he felt the crunch of Robby’s glasses under his foot.

The heart monitor beat out a steady rhythm as the brakes were unlocked and the gurney pushed toward the elevator, heading to the surgical floor.

Beep

Trauma two was empty now, Dana stood alone in the middle of the chaos. Sterile packaging slowly wicked up the red blood, turning pink in the bright overhead lights.

Beep

Mira walked in then, her cheerful yellow bucket and mop trailing her like a reluctant dog. “Oh, sorry Dana, I’ll give you a minute.” She said, backing up a couple of steps.

Beep

“No, Mira, I was just leaving.” But she didn’t. She kept staring down at the puddle of blood next to her white shoe as Mira quietly left the room.

Beep

Mel looked into the mirror in the women’s bathroom, sluicing water down her arms to wash off the blood the gloves couldn’t stop from reaching her wrists.

Beep

Langdon stared into his locker, pointedly not looking at the baseball cap right at the back that he knows conceals a small sandwich bag of little yellow pills.

Beep

Collins sat at a charting station, her elbows on the desk and her head in her hands.

Beep