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bough broken, broken back

Summary:

Although there’s no snow and ice to make the steps slippery, Chicago isn’t known for taking care of their crumbling infrastructure. John isn’t known for being steady on his feet.

The world becomes a tilt-o-whirl and John hasn’t fastened his seatbelt. He rolls down the metal steps, body aching as he tumbles. He claws at the handrail, the steps, desperately seeking something to catch onto. It’s no luck - John doesn’t remember making it to the base of the staircase.

-------

A tag, and whumpier alternative, to Season 4, Episode 4: "When the Bough Breaks"

Notes:

Damn, the ER fandom has really caught me. I've been admitted.

Thank you to those on the discord who gave me the idea and kept cheering me on. It's much appreciated :)

Work Text:

There is an anger pulsing, thrumming in his veins, that John doesn’t think he’s felt before. Just this once, one freakin’ time, John would like his former teacher to recognize him. To give him praise - none of the wordless ‘attaboys or hidden plaudits. To share one brief conversation about what Johns’ been feeling - had been feeling for weeks before he decided to drop surgery and redo a part of his education for months now.

Johns’ tried asking. He’s had doors slammed in his face - both metaphorical and literal. He’s going to demand it now.

He takes off like a shot.

John nearly falls on his way to the train station, his feet moving fast and his brain moving faster.

He catches up with Dr. Benton when he’s nearly on the platform; narrowly missing him. John wheezes, slightly, when he slows to a stop, the cold air rattling around his lungs. “Dr. Benton,” he yells. “Hang on a second, I want to talk to you.” One of his hands goes, reaching for his mentor's arm.

It’s shrugged off. “Not now Carter.”

John walks with him, stung by his mentor's physical rebuff. He speaks again, increasingly agitated, “No, wait. You know, for a long time, I bought into your abuse and your humiliation because I thought I was learning something.”

Benton doesn’t even look up when he replies, his footfalls moving faster and faster. “You were.”

John continues, voice nearly cracking: “But, okay, even if there was a point to it then, there's no point to it now.” For one second, John thinks his mentor will pause. He nearly imagines it: Peter heel turning around, a sigh just passing through his lips, seemingly cowed by his former students' indignation.

John couldn’t have been more wrong.

“Good night Carter.” It’s a dismissal.

[For a moment, John is transported back in time. He’s seven, maybe six, trailing along behind Bobby like a static cling. I want to play. I jus’ want to play with you. Bobby, eight years old and not yet saddled with the diagnosis of his disease, whirls scowling. “I don’t want to play with you Johnny!” His voice is loud and the tone is angry. He sounds like Gamma when Johnny accidentally knocked over a vase in the hallway. Johnny wilts, all little boy energy fading. Tears well in his eyes. “Wh-why not?” he asks, trying to swipe at his face and pretend he’s not crying. “‘Cause you’re being a baby.”]

John shakes himself out of it. He’s a grown man - he’s completed medical school, his first intern year as a surgeon - he’s saved lives - he’s not following along like a lost ducking behind his brother anymore. He’s demanding the respect that he’s earned..

--

Peter spends more time arguing with Carter, a back-and-forth dance that he was sick of the moment it started. He has better things to do, more important.

The final nail in the coffin, something to close out this mess of a conversation needs to happen. Carter needs to be pulled off his apron strings, fully, pushed to stand on his own two feet. “Carter, you don’t want to be treated like my student anymore? Stop seeking my approval.”

--

John hasn’t felt this way in a long time. He swallows, spit thick and cloying, like the words from Benton have become lodged in his throat. He squeezes his eyes shut, takes one deep breath to try and rally the responsible and authoritative adult within him.

He follows Benton up the stairs. He’s not going to let him get the last word.

John forces his mentor's name out of his mouth one final time; “Dr. Benton!” He goes to grab at him, he needs just one more moment to reason with him… and he falls.

Although there’s no snow and ice to make the steps slippery, Chicago isn’t known for taking care of their crumbling infrastructure. John isn’t known for being steady on his feet.

The world becomes a tilt-o-whirl and John hasn’t fastened his seatbelt. He rolls down the metal steps, body aching as he tumbles. He claws at the handrail, the steps, desperately seeking something to catch onto. It’s no luck - John doesn’t remember making it to the base of the staircase.

--

Peter has no intention of turning around. He said his piece, tugged loose the knot of his tie, and washed his hands of his former student. Carter’s just going to have to learn to live with that.

A loud thump, the rattling of metal being hit, changes everything.

He turns, and watches with horror, as John tumbles down the staircase and lands with a thwack onto the concrete.

Carter lands face down and Peters’ mind races. Check his neck, his spine. Determine if he’s breathing. Assess - possible head trauma, facial fractures, internal bleeding. Could be broken ribs, arms, legs… shock.

Peter takes the stairs down, two at a time, and goes to kneel by his students’ side. As he does, his hands fumble for the cell phone in his pocket. He flips it open and dials three numbers with a shaky hand: 9-1-1.

--

Peter is relegated to the sidelines once the ambulance arrives, the EMTs taking command of the scene in seconds. Peter can only bite out “He fell down the steps,” and stand there, feeling like a lump on a log and no better than the dirt on the bottom of someone's shoe.

He’s thankful the ride back to the hospital is short. His eyes stay locked on Carters’ prone form the entire time - unconscious, bleeding, neck wrapped in a collar… A layer of guilt settles in over him. He did this. He may not have pushed him, god no, but he did this.

When they burst through the doors of County Generals’ ER, an EMT he’s only half-confident in knowing her name bellows out Carter's stats. “Approximately twenty-six-year-old male, unresponsive, fell from the steps leading up to the el. His airway is open, but his breathing is shallow. RR 10, SPO₂ 88%, assisted ventilation with BVM. Cuts to face and forearm, significant facial deformity—possible mandibular fracture. Multiple contusions on chest and extremities. Suspected thoracic spine fracture. No obvious paralysis, but patient unresponsive so unable to fully assess neuro.”

It’s both worse than Peter expected and far better. For a moment, watching Carter nosedive from where he’d been chasing him, Peter had thought him dead.

The ER responds to the stats instantly, snapping into gear.

--

The first thing that alerts John he’s awake is noise. The lights of the ICU hum, the ventilator pushes air in and out, a slight hiss of oxygen, and there’s soft footsteps padding around the room. John tries to move, adjust ever so slightly, and is immediately met with resistance. Every inch of him was immobile, strapped and braced to something hard beneath him. He begins to panic, can feel his heart race - hear the tick tick tick on the monitor - and although his head feels stuffed with cotton, he tries to think.

A collage of scenes flick and flitter. Him and Dr. Benton. Anger welling. The stairs of the el. A sudden burst of pain.

Oh. He opens his eyes to take stock of his injuries, hoping that he’d scathed by with nothing more than a few bruises or contusions.

He’s being fed oxygen through a mask, forcing him to inhale in shallow, controlled breaths. There are a number of tubes running into his arms, a number of bandages swaddling him. He swallows, which produces a soft tug. He comes to the conclusion he’s been intubated, and it remains down his throat. These last few breaths had been his first independent in a while, or maybe the ventilator was still helping.

John doesn’t try to speak, not really, more to gather the attention from anyone in the room. Whatever sounds he does produce, alert him to more injuries: his jaw ached horribly. He scans the rest of his body, eyes closed, from the swelling around his face, to determine whatever other areas he may have injured. He finds a dull, constant throb running through his mid-back.

He makes whatever sounds he can; a moan, a whimper… anything to alert someone he’s awake.

He’s met with an unfamiliar nurse. And although she’s unknown to him, she takes care of him with softness, like he’s delicate. “Hey, take it easy,” she said softly. “You’re in the ICU, Dr. Carter. You’ve got a spinal fracture, so you can’t move much yet. Your face is bruised, your jaw isn’t broken, just bruised, but you’re stable.”

John… John doesn’t like this news. She’s taking care of him like he’s delicate, frail and fragile, because he is. Against his will, tears flood his eyes. They drip down the sides of his head, his prone and vertical position leaving them no other escape route.

The nurse's voice is soft when she tries to comfort him. One of her hands is petting his head, featherlight touches so as to not provoke pain from his facial injuries. As the tears fall, he can feel her gently swipe at them with an errant tissue. John feels a rush of warmth flood through him, like the world's most warm and softest blanket has covered him. He knows the hand not consoling him has just delivered him a heavy dose of drugs.

They have the desired effect. John drifts back to unconsciousness.

--

 

When he awakes again, blissfully, John feels fine.

I’m…I’m high. His eyelids droop, and he pushes for some sort of coherency.

“Stay awake for me, Kid.” John squints, tries to find some defining features in the pink scrubs. He knows that voice. “Keep those pretty brown eyes open, Carter.” John groans and as he does, he learns that the tube that had been in his throat has been removed. At least that’s a blessing.

He thinks for a moment about moving his jaw, trying to determine if he can parse out a sentence, enunciate so the words are clear. Immediately, pain blooms.

--

Carol notices the moment Carter awakes from his drug-induced nap. He’s not nearly as panicked as last time, she assumes - she’d gotten an update from Rita, one of the friendlier ICU nurses. She watches as a myriad of emotions, thoughts, involuntary reactions flicker across his face. He’s never had much of a talent for masking and the haze of drugs isn’t making it easier on him.

There’s a low moan.

She pushes closer to his bedside, stands from the rolling stool she’d been sitting down on - so he can see her from his prone position, his body trapped at a 180 degree flatline. Her hands go to the top of his head, gently touching the brown strands that are thick with grease and dried blood and the remainder of iodine. “Shhh… Baby…” She whispers, and the pet name is instinct. She’s called Carter lots of things - kid, bud, John - one memorable time she’d called him Johnny - but never “baby.” It’s a term some of the other nurses will whisper, ever so often, when Carter arrives for a shift looking particularly zapped.

He moans again, and although his eyelids are dropping, she sees the way they move - up and down, up and down - like he’s trying to message her with his eyes. Look down he seems to scream.

So Carol follows his instructions. His right hand is sloppily curled in a manner similar to how one would hold a pen or pencil. Carter moves it sporadically, gently, left to right. Her eyes snap back towards his face. His big, brown eyes - she’s heard others call them puppy dog-like before, and they’re not wrong - look up at her with woe. Please? He looks vaguely like a dog she had as a kid, sitting tableside, begging for scraps.

“You want to write something?”

He blinks once, hard. His face spasms in pain. It’s a clear yes.

“I’ll be right back, Carter. I’m just going to get you some paper.”

Carol rifles through the ICY nurses station desk, briefly flipping through papers and charts, until she finds a small white writing pad. She snags it, and a pen, and hurries back to her charges’ bedside.

--

It doesn’t hurt when Carol guides the pen into his hand, but it’s an unfamiliar sensation. Her hand is a gentle chaperone to his, not forcing him in any which way, but keeping his wrist steady enough that his writing won’t look like random lines on a page.

--

She watches Carter write with all the grace and elegance of a toddler holding a crayon. The words slowly do begin to appear, a combination of chicken-scratch and an attempt at hieroglyphics. When she pulls the pad away from Carter, to get a better look at his message, a breathy laugh pushes past her lips unbidden..

Despite the drugs, despite the pain, he only has one thing written: ‘Dr. Benton?’

--

Being paged to the ICU is nothing new, nothing unusual for Peter. He’s been called to review charts post-op, assess whether incisions have become infected, and a multitude of other things. However, when Peter hears “Dr. Benton, please come to the ICU” echoing over the PA system, his heart drops.

Carter.

He doesn’t wait for the elevator, instead he takes the stairs two at a time, briefly flashing back to his hurried gait when he’d first turn to find his student crashing down toward concrete, hand only lightly gripping the railing as he does.

When he arrives at the ICU, pushing open the swinging doors, he expects to hear the blaring of monitors and to see a rush of action. He expects to see his former student swarmed by Doctors and nurses, fighting to survive a complication. The sight that greets him is much different.

Carol is standing, stool kicked aside, and speaking to Carter in a soft voice - like she’s speaking to a patient of Dougs’. He can pick out a few words, amongst the silence - only cut by beeping machines, of their one sided conversation - and it takes only a few seconds to register she’s giving him updates about the ER.

Carter looks… as expected. His jaw is mottled black and blue, and there are a number of stitched lacerations across his face, including one particularly nasty looking one under his right eye. He’s unkept in a way that Benton assumes Carter would hate - hair limp with grease, dried blood crusting in a number of places, and the leftover vestiges of medical care marring his face. Peter knows there’s leftover tacky bits from the medical tape that had been holding his tube in place. He can see the slight discoloration of orangey yellow that iodine leaves. Worst of all, Carter is pinned. Safety restraints have been laid across his body, tight enough to keep him immobilized and prevent him from causing more damage to his spine.

Benton blinks, pushes away all the thoughts that make him the center of attention - I did this. I can’t believe. If I’d only given him the courtesy. If I’d listened. - and focuses wholly back on Carter.

As he approaches Carters’ bedside, Carols’ smile is wide. “And look who's arrived!” Her tone is teasing. “We’ve been waiting.”

Carter makes a noise, low in his throat. Carols’ smile wavers.

Her voice lowers when she speaks to Peter, like she’s whispering a secret.“He can’t speak really, his jaw is just too painful.” One of her hands pats him delicately. “He’s been writing. Just a few words.” She gestures to the writing pad; a few choppy words written in ink. “He was asking for you - first thing.”

Another noise, like a frog croaking.

Peter steps in, close, despite his own trepidation. Last time he was this close… Carter was chasing him up the stairs, Carter was sprawled on the concrete, Carter was getting carefully rolled onto a backboard, Carter was being worked on in Trauma 2…

The words slip out of him unbidden: “Hey, kid.”

They sound choked.

His former students hand flaps, trapped by the restraint, and Peter watches as Carol moves - with practice - to give Carter the support he needs to coherently write. Peter sees the scratchy letters develop but he’s stunned by the final result.

Carters’ written, in his finest attempt at penmanship, a shaky “sorry.”

--

County General ER has been witness to a lot of emotion; the grief and sadness that blooms with death, the swell of elation and happiness from birth, the fear that leeches from family members in their worst movements… Carol could go on. Carol has witnessed most of it, generally passing by with a raised eyebrow and an inner monologue. She’s not ready for the emotional bout that is going to happen between two of the hospital's finest doctors.

She slaps her hands together, probably too loud for a place that begs to sanctity like the ICU, as a clear tension breaker. “I need to check on some patients.” Her words are matter of fact, everyday. “Peter, do you think you can help John write when he wants to speak?”

Carol fixes him with a look that says: You can. You will.

She watches as Peter nods, dumbfounded, still paused by Carters’ most recent scrawl.

--

The door clicking shut with a soft snick shakes Peter out of his stupor. His first instinct is anger - how can Carter possibly think any of this is his fault? But he pushes it down, jaw clenched, stubbornly reminding himself that Peters’ anger is the reason they’re in this mess in the first place.

He’d been angry at Carter - furious - for wasting his time. He can remember the words he’d hurled in response to his student claiming he was egotistical: “Yeah, yeah, right, Carter. I'm egotistical. You know what? I got a lot of people that worked that damn hard to make sure I am; and for them, I’ve got to be self-centered. I don't take time for anything. But, you... man, man. I did for you, Carter. I did, man.”

And Peter won’t lie - not even to himself - he’s still angry. But he understands; both where he’d gone wrong as a mentor and why Carter had decided to transfer down to the ER.

Peter fixes his gaze on Carters’ eyes - brown connecting with brown - and finally speaks. “Man, you don’t owe me an apology. You don’t owe me sorry.” He watches as Carters’ brow furrows; watches as he winces, stitches pulling.

A heavy sigh slips from his mouth. Damn, this kid. Always admitting fault, even when it wasn’t his - not really. “I may not have pushed you down those steps, but I’m the reason you fell.” His chest feels tight as he speaks, so Peter lets his eyes drift. They settle on the stitches under his eye. Peter absent mindedly counts them as he talks, giving his brain a secondary task so it can’t fall prey to emotion.

“You tried talking to me. We started and never finished conversations about the length of time you’d been spending with patients.” He swallows. “You came to me far before you went to Anspaugh - I didn’t listen to you. I’m the one who is sorry.”

His head jerks, attention driven back to his students’ face, when there’s a noise like a groan. “T-T.” Carter twitches, face spasming as he tries to speak, his tongue useless when his jaw and teeth and face overall are too bruised to function.

Peter grabs the writing pad, does his best to follow the procedure that Carol had modeled earlier in their conversation.

--

John doesn’t finish writing the words fully, feeling weak and tired and exhausted from the length of time he’s been awake - with an onslaught of emotion and the drugs that have been steadily fed into his IV since his arrival. Still, he manages “thank y” and a large vertical line.

He lets his eyes drift close, but he can hear the rush of air that bounces from Dr. Benton unbidden.

“You’re welcome Carter. Get some sleep.”

--

Two Weeks Later

While most of what John says is slurred, he’s thrilled to have the ability to communicate orally. So much of his daily tasks or general caretaking have been impossible due to the injury to his spine, speaking feels like a freedom. As the days have progressed, John has responded to dozens of neuro checks, tests for his spine, and sat through a barrage of CT scans and MRIs and X-Rays. He’s become used to the clinical effectiveness of a sponge bath - welcomed it, horrified at the color of water in the basin the first time. He’s become an expert at log rolling; carefully letting the medical staff swap out sheets and gowns and clothing and other medical equipment that he doesn’t want to consider.

That being said, John is elated for today. Today is the day he’s going to be able to sit up.

He tenses when the door swings open, straining to recognize the person entering the room. He grins when he instantly recognises the voice that says “Good morning, Dr. Carter.”

“G’d Mor’ing.” He offers in return, hoping his voice doesn't sound too much like please let me sit up please let me sit up please let me sit up in the way he fears.

John can’t see Peter as he speaks to him, but he can imagine it in his mind: he’s reading Johns’ chart as he speaks to him, “You’ve been cleared through imaging, neurology… even the physical therapists would like to see you at an angle other than 180 degrees.” He clicks his pen with finality. "Let's do one final spine check.”

John makes a noise that is wholly undignified, even for a person in his situation. It’s a long plaintive sound, thready with what he would like to assume is indignation but that he knows Peter would classify as annoyance. “Evr’yb’dy…” John says, unhelpfully, knowing his argument isn’t going to change anything. [”If everybody jumped off a bridge, would you follow that too? Let’s do our own critical thinking Carter.”]

"Let's be quick about it, Carter. The sooner we do them, the sooner you’re somewhat upright.”

He’s not wrong about that, so John complies. He completes the motor testing with ease - push against my hand, wiggle your toes, see if you can lift your legs - and the sensory testing is a bit of a joke - tell me what temperature this is; hot or cold, do you feel this? The reflex testing happens fast too; he has all appropriate reflexes and his babinski is positive. He doesn’t wait for Benton to finish tracking his notes before he asks, “N’w?”

--

Peter clicks the pen off with finality. “Now.” He agrees, and carefully inclines the bed that Carter’s been living in for weeks so he’s sitting upright.