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Jack finds Langdon in the ED waiting room, exactly where Lee Ann said he would be, when she’d told him four hours ago that Langdon had registered himself at the admit desk. It’s just past one in the morning now, but it’s already been a shitty, hopeless Friday night, and the wait time is hovering around eight hours for non-urgent patients.
The only reason Jack’s out here, sneaking in a personal visit to chairs between ODs, drunk drivers, and bar brawls, is that Langdon’s latest pulse ox reading is low enough to bump him up on the priority list. That, and Santos told him the bullheaded idiot (her words) was sitting in chairs doing his own triaging. Apparently, he’d told her to admit a kid with a broken tooth ahead of himself and wouldn’t take “get your ass up, already” for an answer.
The mom looks up hopefully as Jack approaches, with her arms full of sleeping, blood-spattered toddler. The little boy’s chest is rising and falling peacefully. The blood on his clothes and face is dry, and his complexion is golden and healthy. Nothing suggests Santos’ assessment of urgency was incorrect.
“Just a little while longer,” he assures the mom, who smiles thinly and nods, readjusting the toddler’s weight in her lap. Jack thinks the kid’s probably about the same age as Langdon’s youngest.
Meanwhile, Langdon hasn’t stirred. He’s hunched over, huddled up under a blue ski jacket that’s zipped all the way to his chin. His cellphone is clasped between his hands but the display is black and his eyes are closed. The part of his face that shows above his mask is greyish.
“Langdon,” Jack calls, brusquely, and shakes the man by the shoulder.
Langdon’s eyelids reluctantly flutter open. It takes him a long moment to pull his head up and look at Jack. “Hey, Dr. Abbot,” he says, and stops there to catch his breath. Rapid and shallow. Not good.
“Hey, yourself. I’m putting you in Central 8. You need a wheelchair?”
Langdon’s shaking his head. “There’s a kid—“
“Yeah, I see him. He’s doing a lot better than you. So, are you going to be a doctor today, or a patient?”
“He—”
“In case it wasn’t clear, that was a rhetorical question, and it has exactly two possible answers. Either you’re a doctor, in which case I’m your attending and you’re going to do what I say. Or you’re a patient, in which case I’m your doctor and you’re going to do what I say. Any questions?”
In lieu of response, Langdon coughs, harsh and deep, into the sleeve of his jacket.
“That’s what I thought,” Jack says, and waves Santos over with a wheelchair. “Come on. Up. On your feet.”
Langdon casts a long look across the aisle at the toddler and his mom.
“We’re okay,” she encourages him, rubbing gentle circles on her son’s back. “You go on in.”
And Langdon seems to accept that, because he helps Jack pull him up to standing, but he’s both tall enough and unsteady enough that Jack has to widen his own stance to stop the both of them from toppling over as Langdon turns and maneuvers himself into the wheelchair.
Privately, Jack thinks Santos hit the nail on the head – “bullheaded idiot” is about right.
–
Another trauma gets called in just as they arrive at Central 8, so Jack turns Langdon over to Jesse to get him set up on supplemental oxygen and reupped on acetaminophen. By the time he gets back, the labs and chest film Santos ordered are ready.
“Well, that’s pneumonia,” he confirms, reviewing the film.
“Gee, no kidding,” Langdon huffs, and then breaks out into a deep, wheezing cough. “God, that hurts.”
“I bet. How long have you been sick?”
“Since Tuesday.” He’s fiddling with his nasal cannula.
“Leave that alone, come on,” says Jack, and pushes his hand down. “When was your last shift?”
“Monday. And I’m supposed to be on tomorrow, but Mohan agreed to pick up for me.”
“Okay, let’s go with doxy and cefepime for 7 days. I’ll let Robby know you’re going to need coverage for the week at least.”
“Don’t tell him it’s pneumonia,” Langdon asks. Jack raises his eyebrows and relies on the power of his piercing stare until Langdon continues, “It’ll freak him out. I don’t need to give him any more reasons to worry about me.”
Which is both not wrong and also somehow entirely wrong-headed at the exact same time.
Jack knows Langdon desperately wants to earn back Robby’s approval. He also knows Robby is struggling even to consider the idea of ever trusting Langdon again.
Perlah’s taken to calling them Dr. Left Hand and Dr. Right Hand, because at this point they’re not talking to each other, if they can help it.
Like mentor, like student. Two bullheaded idiots.
“If you think the way to win back Robby’s trust is lying or hiding things from him, my friend, you’ve got another thing coming.”
Langdon bristles, but if he was going to say something in response, it gets lost in his next volley of coughing. He draws his knees up closer to his chest.
“He’s going to want to know why you’re out. If you’re telling me not to answer him, I’ll plead HIPAA and hold my tongue. But I won’t lie to him for you, and I don’t envy you the consequences.”
Jack has to give Langdon a minute to catch his breath before he can speak.
“Damned if I do, damned if I don’t,” is what he gets out, finally. His eyes are bright, eyelids blinking rapidly like maybe he might cry. His respiratory rate is at least 60.
“Slow down the breathing, kiddo. If you’re not satting above 92 with resps below 30 when we take that thing out of nose, you’ll still be boarding here on hold for internal medicine when Robby gets in for the day shift and I won’t have to say a damn thing.”
Perhaps not unforeseeably, this advice fails to achieve its intended result. Even then, the severity of Langdon’s reaction is a surprise. His respirations pick up and then he’s coughing again, gasping shallowly, and throwing his hands vaguely in Jack’s direction like he’s trying to push him away. He’s panicking.
“Okay,” Jack soothes, “Okay. Slow down. You’re okay.” He ducks around Langdon’s hands and puts his arm around the man’s shoulders, pulls his body up against his chest. Firm pressure, grounding. “Slow down. In through your nose.”
Langdon’s arms come up to cover his face and there are definitely tears on his face now, but that could be from the force of the coughing. Jack pulls his hand back to rub slow circles into Langdon’s back.
“That’s good,” Jack says, “Nice and slow. In through your nose.”
Langdon turns his body towards Jack and lets Jack wrap him up in his arms. They stay like that for a lot longer than Jack should be staying with one patient, but no new traumas come in, and no one’s paging SOS, so Jack doesn’t move.
Eventually, Langdon pulls away. His breathing is more even now, but he’s ashamed of himself, staring fixedly at his knees. Jack sighs and lets him go.
“I’m going to go check the board,” he says. “You work on the breathing. Deep breath in, hold three, huff out. Cough when you need to. Knock it off when you’re tired, and then try to get some sleep.”
–
It’s another two hours before Jack returns, going on 6am. Langdon’s dozing when he gets there, but he comes to alertness quickly.
“I’m going to turn the oxygen off for a bit, see where you’re at” Jack says. “You ready?”
Langdon nods. “What happened to Matias?” he asks.
“Matias?”
“The little guy with the busted tooth.”
Jack smiles. “Well, he’s going to have a crooked grin until he’s about seven years old, but he’ll be fine. He’s gone home already.”
“That’s good.”
Jack watches the numbers fall on the pulse ox until it holds steady at 91. “If I discharge you this morning, can your wife come pick you up?”
Langdon winces. “That’s not going to happen.”
“Is she going to be at home today to check in on you?”
“She’s at home,” Langdon says, “I’m not.”
Bullheaded goddamn idiot. Jack can read the subtext.
“You living alone?”
“Yeah.”
“Well, congratulations. You just won yourself a cannister of oxygen and a houseguest for the weekend.”
Langdon looks up at him, startled. “You don’t have to do that.”
“No, I don’t, but what are friends for?” Jack cajoles. “The way I see it, the biggest question is whether I send you out in a cab or whether you hold on until I can give you a ride.”
He’s edging around the real question. If Langdon is still at PTMC when the clock turns 7, Robby will know about it. And Langdon knows that.
“I can wait,” he says.
“Good. That’s good. And what should I tell Robby?”
Jack watches Langdon swallow thickly.
“Tell him whatever he wants to know.”