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He’s barely made it home when he gets the call. Just pulled into the driveway that’s more of a glorified parking spot, just turned off the car.
“Come back,” Dana says, voice clipped. “An ambulance exploded in the bay. I don’t know what’s going on, the fire department just got here. They’re working on Samira now. You gotta come right back.”
Jack remembers nothing about the drive back, cannot recall a single stop sign or traffic light. Doesn’t know how many laws he breaks or accidents he nearly avoids. He drives past the entrance to the ambulance bay getting to the parking deck. Voluminous plumes of smoke wash out towards the street, and ten or so feet from the entrance he sees a rig engulfed in tall orange flames. Three engines from the fire department sit in the lane, firefighters trying to contain the inferno. Jack Abbot knows about thirty ways to devise an IED or explode a vehicle. He’s operated on the bloody aftermath of them all.
Reaching into the center console for the tag he rarely uses, he parks in one of the ADA spots near the entrance. They’re working on Samira now. Dana didn’t have much more information than that. Samira was helping the EMTs unload the patient—white male in his nineties on oxygen, transported from an assisted living facility, chest pain and agitation—when there was a pop, a whistle, and then an explosion. Samira was thrown backwards fifteen or so feet, unconscious. They’re working on her. Robby and Mel are working on her.
It’s Collin who stops him from entering Trauma One. “You can’t go in there, Abbot. You know you can’t go in there.” Why not? He has operated on friends while under enemy fire. He has held their hands while they died, looked them in the eye and promised to tell their families that they love them. He has been to too many funerals for a man his age. “Abbot—Jack. No.”
Trauma bays are warm. They have to be, just like how Emery keeps her perpetually stocked, perpetually ready-to-go, perpetually on operating room at 76 degrees Fahrenheit. Trauma bays at the Pitt have hermetic doors and blowers to keep the rooms warm, so that when they strip their patients of their dignity and just about everything else when they cut their clothes off of them, they don’t become hypothermic. So that when the blood pours out of them and onto the shoes of their doctors and nurses and techs, they don’t become hypothermic. So that when the shock sets in, they don’t become hypothermic, which can make them become acidotic, which can lead to coagulopathies. Which leads to death.
He feels the hot, pressurized air from Trauma One as the door hisses open, then closes without him stepping through. Jack lets himself be led. Collins drags him by the wrist to the Hub, shoving him down into a chair. “Just—stay here. I have to get back in there. So—stay here.”
Nodding dumbly, Jack blinks at the chaos behind the glass. He can’t see her. Collins stopped him before he could. His voice chokes off into a rasp. “How bad?”
“Second and third degree burns on fifteen percent of her body. Tympanic membrane rupture. Traumatic brain injury. Penetrating trauma to the abdomen caused by flying shrapnel and debris. We are most concerned about blast lung.” Collins roots around in her pockets. She has eight. Four on her pants, two in her sweater, two more on the front of her scrub top. Whatever she’s looking for is in her fifth pocket. Taking Jack’s hand in hers, she closes it inside. He knows it from touch alone. “I’m sorry,” she whispers, voice strained. “I’m so sorry. I got it off her before anyone else noticed. This isn’t—I’m so sorry.”
Samira’s engagement ring, on the necklace he gave her. The chain is plain and practical, eighteen inches long in eighteen karat gold. The ring is less so—a three carat emerald cut diamond solitaire in a bezel setting, sitting atop a delicate gold band. They bought it a week ago, the night after he proposed at the end of a deliriously awful shift. After up on the roof, covered in blood and crystalloid and the stench of death and failed codes and sweat, she barked a manic laugh and said that at the end of a shift like this, she still wanted to marry him, and so maybe they should get married. And he, hunched over the railing, thinking about the screams of the distraught mother who smothered the infant she’s brought into bed with her, thinking about the father of two who flatlined three times on his table, thinking about the eight teenagers brought in after being drugged at a party on campus—asked her to marry him.
They went home. They showered and slept, naked in each other’s arms. And when they woke up in the afternoon, he put her in the car and drove them to Tiffany’s. He bought her a ring. He bought her this ring. And decided to keep it private until she finished her residency.
He can’t see her, not from this vantage point. But he can see everyone working around her, pressed in around the bed. He knows that Samira isn’t breathing on her own. He knows when pulmonology comes down that they’re doing a bronchoscopy but can’t see past burnt tissue and blood. He knows that when the perfusionist arrives from the ICU that they’re putting her on ECMO to stabilize her for surgery. He knows that when Emery comes down herself, minutes later, that she won’t look at him because it means she will have to acknowledge that the patient she’s taking upstairs is her best friend’s girlfriend. Because she doesn’t know. She doesn’t know that he’s asked Samira to marry him.
Jack holds Samira’s ring on its chain in between the palms of his hands until the metal warms. She is young, and healthy, and strong. He will not lose her. He has to believe this, or he will stop breathing. He has to believe this, or it will be like she is already dead.
“Aw, fuck,” Dana says, after she strips off her trauma gown and gloves. After she wipes the blood off her face, and comes inside the Hub, dropping into a squat in front of him. After her eyes catch the glint of gold in his hand, and her face goes pale. “Shit—Jack. When?” He tries to answer. He crumples instead, and finds himself pressed into her shoulder, nearly toppling out of the chair when she wraps her arms around him. “Alright,” she says, wiping his tears with her thumbs. “Robby’s gonna come out and tell you what’s going on. Then we’re gonna get you taken care of. No protesting.”
In the end, Robby and Dana’s version of get you taken care of is a gurney shoved in the attendings’ office shunted off one of the old back hallways that rarely sees use since the last renovation of the Pitt, Jack laying down on it, and a drip of versed and clonazepam. He blinks out of consciousness to Dana cocooning him in blankets, incredibly aware of the absence of the tungsten ring that spent a decade and a half on his left hand. He hasn’t worn it in six months. Instead, it has sat nestled in a velvet box, alongside a plain gold band he was handed by a different emergency physician in a different state. It has sat there for six months, on his dresser, next to his watch stand. Six months, two weeks, and three days.
Samira kissed him for the first time in the parking deck, halfway between their cars, six months, two weeks, and two days ago.
Hours later Jack wakes up, groggy and anxious, and with Emery standing over him.
“They’re taking her off ECMO now,” she says, hands clasped behind her, eyes anywhere but his face. “She’s already been moved into the ICU. The plan is to keep her on a vent and high flow oxygen while she recovers. Grade five liver lac. She lost about seven feet of large intestine. Burn team is consulting, but her eyes and airway do appear to be intact…” Her voice trails off. “I’ve gotten out of practice of doing… this.”
They don’t treat people they know here in Pittsburgh. They don’t treat friends. They don’t treat family. They are civilians who live in Pittsburgh. They are not in a warzone. They are not two desperate people, coordinated medevacs and supply lines and blood drops from thousands of miles away. She is no longer the Captain Obvious to his Major Asshole. She made the decision to amputate his leg. She attended his first wife’s funeral. She helped clean out the house in Fort Benning. Anyone but her should have done Samira’s surgery. Emery Walsh is the only person he would have trusted with Samira’s surgery.
“I couldn’t make you any promises,” she mutters, looking at her sensible orthotic shoes.
“You never did before, Em.”
It’s never been their way. There aren’t any promises when you’re both just trying to stop people from dying, trying to make sense of a war that they shouldn’t be fighting, trying to make sense of what they both signed up for in two very different high school cafeterias.
“Sure I did,” she counters, voice cracking like a whip. “I thought I was God.”
Jack snorts, pulling the IV out of his arm. Looks around for something to hold pressure with, and grabs a stack of tissues off Robby’s desk. “You’re not?”
“Fuck off. Do you want me to take you upstairs, or what?”
“I can find my way.”
Emery scoffs. “Astonishing that you managed to convince two women to marry you.”
“I know,” he replies, grinning. The chain is still threaded through his fingers, the ring dangling off of it in plain sight. Always eagle-eyed, his irascible Captain Obvious. The Wicked Witch of West Germany. “And Samira’s so smart.”
“Yeah, but she’s just as bonkers crazy as you.”
And Samira proves that fact less than forty-eight hours later, when she extubates herself not much more than twenty minutes after waking up in her ICU bed. Coughing, forcing her body upwards as she hacks up mucus and coagulated blood, tube in her hand. All Jack can do is groan with fond exasperation, waving off the nurses and CNA’s who pour into the room.
“Hon,” he complains, holding the straw from his water bottle to her lips. “Just because you know how, doesn't mean you should.” Fixing him with a glare, she reaches for his hand. Sees her ring sitting on his pinky finger, and slots it back onto hers. “I kept it safe. Do not—don’t try to talk.”
“Can,” she manages to croak.
Sighing, Jack leans up over the bed, combing back her hair from her face. “Yeah, I’m gonna marry the shit out of you for that little stunt back there.” He presses a kiss to her forehead, burned and peeling, but otherwise unscathed. He’d taken a damp washcloth to it last night, gently cleaned off all the soot. “And for the one you just pulled in here. Jesus Christ, Samira. I know you’re miles beyond the rest of us, but I’m gonna need you to give me a break after this one.”
Her hand fists into the neck of his shirt, fingers holding tight. “Love you too.”
“Yeah,” he murmurs. Her curls still smell like smoke. Now that he’s awake, he needs to stop by the nurses station and ask for a bed bath kit to clean her up. He has a pair of her pajamas in his backpack, her skincare all sorted into a toiletry case. No flowers in the ICU, but at least she can moisturize. “That’s what the ring is for, baby.”