Chapter Text
A humid July morning, the kind where the air already felt like wet gauze clinging to skin, with Pittsburgh's skyline barely visible through the haze. The sun hadn't reached its zenith yet, but already the temperature had climbed to uncomfortable levels, the kind of heat that made even breathing feel like work.
Heather Collins stood on the shoulder of the Boulevard of the Allies, arms crossed, ankle-deep in weeds, and surrounded by the unmistakable scent of burnt rubber and betrayal. Sweat trickled down her spine beneath the crisp white button-down she'd ironed twice this morning. Her 2006 Honda Civic—a car that had survived med school, three cross-country moves, and a breakup with a boyfriend who had proclaimed cars "environmental disasters"—chose this day, this exact goddamn morning to overheat and die. The Civic had been her constant companion through night shifts and panic attacks, impromptu road trips to clear her head when the pressure of medical training became too much. Now it sat defeated, steam still whispering from beneath the hood.
She had twenty-three minutes until she was expected for her first shift as a new ER resident at Pittsburgh Teaching Medical Center. After years of grueling study, mountains of debt, and countless sacrifices, today was supposed to be the beginning of her real career. And she was going to be late.
Heather shoved her curls back with one hand, already regretting the choice of hairstyle. The carefully styled pixie-bob she'd spent forty minutes perfecting in front of her bathroom mirror, the one she'd thought looked "professional but still me," was now plastered to her forehead, humidified into chaos. She kicked the tire, her pristine black heel connecting with rubber in a satisfying thump. The tire did not respond, indifferent to her mounting anxiety.
"Okay," she muttered, her voice tight with the effort of controlling panic. "No big deal. No big deal, it's fine. First day. Can't be the first intern to show up late, right?" The words hung in the humid air, unconvincing even to her own ears. She'd always been the early one, the prepared one, the one with backup plans for her backup plans.
From behind her, the sound of a car slowing, tires crunching on gravel. She turned to see a matte black Jeep with roof racks—dusty, a little battered, like it belonged to someone who didn't give a shit about appearances but was prepared for the apocalypse—rolling to a stop on the shoulder. The vehicle wore its scrapes and dents like badges of honor, stories etched into metal.
The driver's window rolled down, revealing a silhouette backlit by morning sun.
"Trouble?"
Heather blinked, momentarily forgetting her predicament as she took in the man behind the wheel.
The man looked like he'd been plucked from an ER drama and dropped into her morning meltdown. Salt-and-pepper hair, cut close but tousled in a way that looked annoyingly deliberate, as if he'd simply run his fingers through it after a shower and called it styled. Five-o'clock shadow that leaned toward ten-o'clock, giving him that perfect balance between rugged and refined. Button-down shirt—light blue, wrinkled just enough to suggest he didn't fuss with an iron—rolled to the elbows, exposing forearms with faded scars and veins like a roadmap. Around his neck, a small Star of David on a simple silver chain caught the morning light, resting against the hollow of his throat. The kind of arms that spoke of competence, of knowing how things worked. Sharp brown eyes assessed her from behind frameless glasses, carrying the weight of someone who had seen too much but hadn't lost their curiosity.
Definitely older than her. Definitely judging her. Definitely hot in that infuriating way that made her simultaneously want to impress him and pretend she didn't care what he thought.
"Uh—yeah. Overheated. Coolant light came on like five seconds before smoke started pouring out like I'm in a Michael Bay movie." She tried for casual, but her voice betrayed the underlying panic. Every minute that passed was another minute closer to being officially, embarrassingly late.
He arched a brow, a slight crinkle forming at the corner of his eye. "Pop the hood." His voice carried a hint of gravel, like someone who either drank too much whiskey or not enough water.
Heather hesitated, years of city-girl caution warring with desperation. "You a mechanic?"
"Close enough." The corner of his mouth twitched upward.
"Doctor?" The question slipped out before she could stop it, a product of her tendency to categorize people quickly.
He smirked, a flash of white teeth against tanned skin. "Close enough."
Something about his confidence, or maybe just her complete lack of options, made the decision for her. She popped the hood.
The man got out, moved past her with the confident stride of someone used to fixing things—or maybe just pretending he could. He carried himself with the easy authority of someone who had earned their place in the world, not bothering to prove anything to anyone. A faint scent of cedar and coffee followed him as he passed.
He propped the hood and whistled low, the sound cutting through the background noise of distant traffic. As he leaned over the engine, the sleeve of his shirt rode up further, revealing the edge of what appeared to be tattoos on his bicep—geometric patterns in black ink that disappeared under the fabric, hinting at a personal history far more complex than his professional demeanor suggested. Heather found herself wondering about the stories those tattoos might tell, what parts of himself he kept hidden beneath pressed shirts and medical authority.
"Jesus. You try to kill it?" He leaned in, seemingly unbothered by the lingering heat from the engine.
"It's dramatic. We have that in common." Heather crossed her arms, feeling the damp fabric of her shirt stick to her skin. She'd spent an absurd amount of time picking this outfit—professional enough for a doctor, comfortable enough for a twelve-hour shift, and still somewhat reflecting her personality. Now it was just another casualty of this disastrous morning.
He glanced at her, amusement dancing in his eyes. "You headed somewhere?" The question was casual, but there was something assessing in his gaze, like he was piecing together a puzzle.
"PTMC. I'm supposed to start my ER rotation this morning." She glanced at her watch—eighteen minutes now. The knot in her stomach tightened.
"Name?"
Heather hesitated again, years of stranger danger seminars flashing through her mind. But what was he going to do with her name on a busy highway in broad daylight? "Heather Collins."
The man wiped his hand on a rag from his back pocket—seriously, who carried those anymore? Was he born prepared or just affecting a persona?—and turned back to her with a crooked grin that transformed his entire face, making him look younger and more approachable. As he moved, his shirt stretched across his chest, the Star of David necklace catching sunlight again. She wondered if it was a family heirloom or a personal statement of faith, another layer to this man who had appeared out of nowhere like some roadside guardian angel.
"Robinavitch," he said. "Chief attending. Welcome to the chaos, Dr. Collins."
Her stomach did a slow, mortifying flip, like she'd missed a step on a staircase. Of all the people to find her stranded on the side of the road—her new boss. The man who would evaluate her, critique her, potentially make or break the career she'd spent a decade building.
"Oh. Shit." The words escaped in a breathless whisper, heat rising to her cheeks that had nothing to do with the July temperature.
"Not that I didn't want to make an impression," she added quickly, words tumbling out in that nervous way they did when she was flustered. "I just...wasn't planning on 'smoking car' as the opening act." She gestured vaguely to the Civic, which chose that moment to make a pathetic hissing sound, as if agreeing with her assessment.
"Well," he said, straightening and wiping his hand on the rag again, movements economical and practiced, "you've definitely accomplished memorable."
She groaned softly, pressing her fingers to her forehead where she could feel a stress headache forming. This was not how today was supposed to go. In her mental rehearsals, she'd been poised, prepared, perhaps even impressive. Not disheveled and panicking on the shoulder of a highway.
"I had a whole plan. Be early. Look calm. Make a good impression. Not...break down on the highway and get rescued like I'm in a Lifetime movie." The admission came with a self-deprecating smile that didn't quite reach her eyes.
"Could be worse," he said, his gaze dropping briefly. "You could've worn heels."
She lifted one foot, revealing the black pumps she'd chosen after trying on seven different pairs. They were her power shoes, the ones that made her stand taller, both literally and figuratively.
He laughed, a genuine sound that crinkled the corners of his eyes. "Jesus."
Heather flushed, embarrassment mingling with defiance. "I didn't know how formal first days were! And I figured I'd be on my feet all day anyway, so I should—" She stopped herself, realizing she was rambling, a nervous habit she'd never quite outgrown despite years of practice presenting cases to attending physicians.
"Stop explaining," he said. Not unkindly, his tone carrying the weight of someone who had seen countless nervous residents stumble through their first days. "You're just digging deeper."
She sighed, shoulders dropping slightly. "Fair." Sometimes surrender was the better part of valor, especially when standing on the side of a highway with smoke rising from your car.
He nodded toward the Jeep, keys jingling in his hand. "Come on. I'll get you there."
She looked back at her Civic, still making low, dying noises like a wounded animal. Her life was in that car—emergency snacks in the glove compartment, a change of clothes in the trunk, the collection of audiobooks that had kept her company through lonely nights.
"You sure?" The question was as much about abandoning her car as it was about accepting a ride from this man who was no longer a stranger but now occupied the much more complicated position of "boss."
"I'm not leaving you out here. And besides—if you show up after orientation, Dana Evans will eat you alive." There was something in his tone, a mixture of warning and camaraderie, that suggested he'd seen it happen.
"Dana Evans?" Another name to memorize, another person to impress.
"Head charge nurse. She once made a med student cry just by making eye contact." His expression was serious, but there was a glint in his eye that suggested either exaggeration or amused respect.
"Oh god." Heather's stomach dropped further. First impressions were everything in medicine, where reputations could follow you through entire careers. Being late on day one was not the foundation she wanted to build on.
He opened the passenger door for her, a gesture that seemed both old-fashioned and natural coming from him. "Better the devil you know, Dr. Collins."
Heather hesitated only a second before grabbing her bag and coat from the backseat of her Civic. The leather satchel contained everything she thought she'd need—extra pens, a small notebook, granola bars, her stethoscope polished to a shine. As she climbed into the Jeep, she looked over at him again. Something about the way he carried himself, the way he talked—casual, but watchful—unsettled her. Not in a bad way. In the kind of way that made her very aware of how fast her heart was beating, how this unplanned encounter was altering something fundamental about her day, perhaps more.
The interior of the Jeep was unexpectedly tidy, with only a travel mug in the cupholder and a worn paperback tucked into the side pocket—Murakami, she noted with surprise. The vehicle smelled of leather and something faintly antiseptic, as if he'd cleaned it recently but couldn't quite erase the hospital that had seeped into his pores.
He pulled back onto the road like he'd done it a thousand times, hands resting lightly on the wheel, comfortable in the space between crisis and resolution. As he reached to adjust the air conditioning, his sleeve rode up again, revealing more of the tattoos she'd glimpsed earlier—what looked like Hebrew letters intertwined with geometric designs, disappearing beneath his sleeve. A story written on skin, making Heather wonder what other surprises Dr. Robinavitch might hold. Pittsburgh's industrial skyline loomed ahead, the morning sun gleaming off glass buildings.
"So," he said, eyes on the street, voice casual in a way that suggested the question wasn't, "you always this dramatic, or just on Tuesdays?"
She rolled her eyes, the familiar banter territory helping her regain some equilibrium. "Only on landmark life days. Ask me again on my wedding."
He smiled without looking, a quiet expression that softened the hard lines of his face. "I'll hold you to that."
The words hung in the air between them as they merged into traffic, heading toward the hospital where Heather would begin the next chapter of her life—not as planned, but perhaps more memorably. Sometimes the universe had its own ideas about first impressions.
The Jeep rumbled into the staff lot behind PTMC just as the sun began to tip above the skyline, gilding the upper windows of the hospital in a soft, ironic glow. The place looked almost peaceful from the outside—all clean lines and reflective glass, a modern cathedral of medicine promising order and healing. The reality inside those walls, Heather knew, would be far messier. Nature always found ways to disrupt humanity's attempts at control, and nowhere was that more evident than in emergency medicine.
Heather stared up at the building through the windshield, heart pounding against her ribs like a trapped bird. This moment—this threshold between student and professional—was one she'd imagined countless times during sleepless nights and grueling study sessions. Now that it was here, the reality felt simultaneously too large and too mundane.
"Looks calm," she said, fingers unconsciously gripping the coffee mug he'd handed her, seeking warmth despite the July heat.
Robby shifted the Jeep into park and cut the engine, the sudden silence emphasizing the gravity of the moment. "It's lying to you." His voice carried the weight of someone who had seen the facade crumble too many times to be fooled by it anymore.
She turned to him, eyes scanning his profile—strong jaw with a day's worth of stubble, faint scar just below his right temple that looked like an old suture line, a little grey in the stubble along his chin catching the morning light. He looked exactly how an attending should look in her mind: exhausted, cynical, and unreasonably good under pressure. He also looked like he was about to throw her into the deep end and watch how she swam, with that particular mixture of clinical detachment and hidden concern that seasoned doctors perfected.
"Anything I should know before I walk in?" Her voice came out steadier than she felt, a skill honed through years of pretending confidence during rounds.
Robby leaned back in his seat, hand resting casually on the wheel, the edge of one tattoo visible beneath his rolled sleeve as he moved. His other hand absently touched the Star of David at his neck, a gesture that seemed unconscious, perhaps a habit formed through years of self-reassurance. "Don't take anything personally. Especially not from Dana."
"You mentioned Dana. Is she really that bad?" Heather tried to picture this woman who could apparently reduce med students to tears with a glance.
"She once stabbed a guy with a butterfly needle for calling her 'sweetheart.'" His deadpan delivery made it impossible to tell if he was serious, his eyes focused on the hospital entrance where staff members were streaming in for the morning shift change.
Heather raised her eyebrows, uncertain whether this was some sort of first-day hazing ritual.
"Just kidding," Robby added, the corner of his mouth quirking upward. Then after a beat: "Mostly."
The subtle humor did little to calm the nervous flutter in her stomach. This was the real test—not the board exams or simulations, but the actual trenches where decisions had real consequences and where the hierarchy was as rigid as it was unspoken.
He reached into the backseat and pulled out a worn travel mug with "Doctors Do It With Patience" printed on the side in faded letters, handing it over. The mug was scuffed around the edges, clearly a longtime companion.
"What's this?" She stared at the offering, momentarily thrown by the casual gesture of kindness.
"Coffee. Black. I figured you looked like someone who forgot breakfast." His tone was matter-of-fact, but there was something in his eyes—a flicker of recognition, perhaps, of another morning long ago when he'd been the one standing beside a broken-down car, late and panicking.
She blinked at the gesture, wrapping her fingers around the warm mug. "Thanks...that's weirdly thoughtful for someone who looks like he lives on adrenaline and saltines." The words slipped out before she could filter them, a nervous habit of deflecting genuine moments with humor.
He smirked, unlocking the doors with a click that felt oddly final. "Get moving, Dr. Collins. We're already late." There was no real censure in his voice, just the practicality of someone who knew that time in an ER was the most precious commodity.
6:29 a.m.
The ER at PTMC hit like a wall of sound.
Phones rang in discordant symphony. Monitors beeped with various levels of urgency, each tone signaling a different vital sign requiring attention. Voices overlapped—orders, updates, questions, complaints—creating a cacophony that Heather knew she would eventually learn to parse but now just washed over her in overwhelming waves. The scent of antiseptic warred with sweat, burnt coffee, and something metallic that Heather didn't want to identify but recognized instinctively as blood. The fluorescent lights hummed overhead, casting everyone in a slightly sickly pallor that made it hard to tell who was staff and who was patient at first glance.
The moment she stepped through the automatic doors, someone shoved a chart into her hands—a blue clipboard with papers already dog-eared and a pen attached by a chain that had seen better days. The plastic clipboard was worn smooth at the edges from thousands of handoffs.
"Collins?"
She turned, coffee sloshing slightly in the borrowed mug.
Dana Evans stood like a sentinel in the middle of the nurses' station—elegant yet formidable in navy blue scrubs layered over a light blue long-sleeved shirt. Her platinum blonde hair was pulled back in a neat, low ponytail that emphasized sharp cheekbones and clear blue eyes that seemed to see right through Heather's facade of confidence. A delicate gold cross necklace hung at her throat, and small gold hoop earrings caught the fluorescent light as she tilted her head, assessing. Despite being in her forties, Dana carried herself with the alert poise of someone half her age, her slender arms crossed over her chest as she leaned slightly against the counter. The ID badge clipped to her pocket confirmed what Robby had said—Head Charge Nurse—in bold black letters beneath her name.
"You're late." The words were clipped, final, brooking no argument. Her voice held an undercurrent of authority that didn't need volume to command attention.
Heather opened her mouth to explain about the car, the rescue, the improbable meeting with her attending, but Dana held up one finger—nails short, practical, with clear polish chipping at the edges, a simple gold band on her ring finger catching the light.
"Don't care why. Robby already covered your ass. You won't get that again." Her tone made it clear this was both warning and promise, but the slight quirk at the corner of her mouth suggested that beneath the stern exterior was someone who had seen every first-day disaster imaginable. Behind her, nurses and techs moved with practiced efficiency, giving Dana a wide berth that spoke volumes about the pecking order.
"Yes, ma'am." The words came automatically, Heather's default when faced with authority.
Dana's eyes narrowed, intensifying their already penetrating gaze. "Don't 'ma'am' me. This isn't the military." A flash of something—maybe humor, maybe irritation—crossed her face before disappearing behind professional detachment.
A young woman zipped past with a rolling vitals machine, her ponytail bouncing with each determined step. A man with gauze taped across his head shouted about someone stealing his shoes, his voice slurring slightly from either medication or the head injury itself. A nurse with a clipboard barked something in Spanish over the intercom, her voice carrying the urgent cadence of someone who needed a response now, not later.
Heather turned slowly, scanning the chaos, heart jackhammering against her ribs. It was nothing like her calm rotations on the med-surg floors where patients were already stabilized, their problems catalogued and addressed in orderly progression. This was pure kinetic madness—life and death decisions happening in real time, staff moving in what seemed like random patterns but was actually a complex dance of prioritization and expertise.
Robby appeared beside her like a ghost, materializing from the controlled chaos as if he'd stepped through a hidden door. He'd shed the rolled-up shirt for dark blue scrubs and a lanyard badge that swung slightly with each step. The casual confidence of earlier had transformed into focused intensity, his movements economical and precise.
"Orientation in fifteen," he said, voice pitched just loud enough to carry over the ambient noise. "You'll meet the others then. For now—follow me." The command was gentle but unmistakable.
Heather fell into step beside him, clutching her chart like a lifeline. "The others?" She tried to match his measured pace despite the heels that now seemed like a ridiculous choice, their clicks on the linoleum marking her as an outsider among the soft-soled shoes of everyone else.
"Interns, med students, residents. Yolanda Garcia, Frank Langdon, Samira Mohan, Cassie McKay and Dr. Jack Abbot — he's the night shift version of me." His words were clipped, efficient, already shifting into the shorthand language of the ER where every second counted.
"You mean your heir apparent?" The quip slipped out, another attempt at establishing some kind of rapport in this alien environment.
He glanced at her, amusement briefly softening the professional mask he'd donned. "You've been talking to Gloria already?" A question that seemed to carry more weight than its surface suggested.
"Gloria Underwood?" Heather snorted, the name familiar from hospital gossip networks that transcended individual institutions. "No, but I've heard things." The medical community was small, especially at the top, and reputations traveled fast.
"Careful," Robby said, voice lowering. "She's got spies everywhere. And she loves to remind us we're lucky to even have this department." There was history there, politics Heather didn't yet understand but would need to learn quickly to navigate this place.
He pushed open the swinging doors into Trauma Bay One, the metal cool under his palm and warming under hers as she caught the door on its backswing. The doors made a soft whooshing sound, oddly gentle for what lay beyond.
Inside, a teenager moaned on a stretcher, his skin ashen against the stark white sheets. He was flanked by two nurses—one young with vibrant red hair pulled back in a messy bun, chewing gum aggressively (Princess, per her badge, though Heather wondered if that was really her legal name), and one older with sharp eyes behind tortoiseshell glasses and a thick Bronx accent that cut through the medicalized language (Perlah). Both looked up when Robby entered, their expressions showing a mixture of relief and wariness.
"Vitals?" Robby asked, already moving toward the bed, his focus narrowing to the patient with practiced intensity. The room smelled of antiseptic and fear, the particular acrid scent that accompanied trauma.
"BP's low, heart rate's dancing," Perlah said, finger tapping the monitor where numbers flashed in concerning patterns. "He's bleeding somewhere, but we haven't found it yet." Her experienced eyes met Robby's in a silent communication that spoke of dozens of similar cases.
Heather's pulse spiked again, adrenaline flooding her system. This wasn't a simulation or a textbook case—this was a real teenager with real blood loss that needed to be located and stopped. Robby turned to her, expression unreadable beneath the professional mask all doctors learned to wear.
"You want in, Dr. Collins?" The question was casual, but it carried weight—a test, an opportunity, a challenge.
She froze, coffee mug still clutched in one hand, chart in the other. "Now?" The syllable came out higher than she'd intended.
"Better now than after your second coffee break." His eyes held a challenge, but also something else—perhaps faith? Or simply the necessity of all hands in an emergency.
He didn't wait for further response. Just nodded to Perlah, rolled up his sleeves—revealing more of the geometric tattoos that wrapped around his bicep—and stepped in, hands already reaching for gloves from the wall dispenser.
Heather looked at the kid on the gurney—pale, breathing fast, maybe sixteen with a skateboard logo on his torn t-shirt and dirt ground into scraped palms—and felt her hands move on instinct. The chart and mug found their way to a side table. Gloves from the box snapped over her fingers with practiced ease. Gown tied at the back with Princess's help. Monitor leads blinked their urgent message. Her eyes scanning the numbers, the signs, the subtle tells that weren't in textbooks but had been impressed upon her by mentors who insisted she look at the patient, not just the data.
She stepped in beside Robby, and for the first time that morning, everything went still. The chaos receded, time narrowed to the pulse of the monitors and the rhythm of necessary actions. This was what she had trained for—this moment when instinct and education merged into something like muscle memory.
Later, she wouldn't remember what she said or how she handled it. Just the rush, the focus, the way the world narrowed down to vitals, blood loss, pressure, decision. The satisfying moment when they found the bleed—a laceration to the spleen—and the controlled urgency of getting him prepped for surgery. The way Robby's hands moved with certainty but not bravado, efficient without being showy. The way he gave her space to work but remained present, a safety net she didn't need but appreciated nonetheless.
Robby gave her a nod when it was over—brief but unmistakable, a currency more valuable than words in this environment.
"Not bad, Dr. Collins." Coming from him, in this place, it felt like higher praise than any academic accolade.
She exhaled, slow and shaking, heart still in her throat but now from accomplishment rather than anxiety. "I'm not going to throw up." It was both observation and triumph.
"That's the bar, huh?" A hint of that earlier smirk returned, the attending briefly visible beneath the trauma doctor.
"For now." She surprised herself with the confidence in her voice, a seed of belonging beginning to take root.
He turned and walked out, tossing a used pair of gloves into the bin without looking, the practiced move of someone who had done it thousands of times. His tattoos disappeared again beneath the scrubs, mysteries for another time.
And Heather Collins, still buzzing from adrenaline and something more electric beneath it—purpose, perhaps, or the intoxicating knowledge that she belonged here after all—followed him deeper into the ER. Her heels clicked a slightly more confident rhythm on the linoleum, marking the beginning of her transformation from outsider to initiate in this strange, vital world where every second mattered and first impressions could be rewritten in blood and competence.