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Someone was punishing him. That’s the only excuse for his body aching the way it did so early in the fucking morning. Jesse pulled a pillow over his face, trying vaguely to suffocate himself, because he was still a little drunk and a hangover the size of Texas was trying to melt his brain into goo. He blindly reached for his phone on the nightstand, but his hand hit the lamp instead, and suddenly his right arm was on fire. It felt like he was being electrocuted. The pain splintered up his arm, through his elbow and all the way up his shoulder. “What the fuck?” he whimpered, cradling his hand to his chest.
He sat up with a new abundance of caution and flicked on the lamp with his left hand to examine his right. The outside of his wrist was stained blotchy purple, and the swelling was making his fingers look like sausages. Jesse poked it experimentally, and the pain made him throw up a little in his mouth…or maybe that was the hangover. He swallowed it down again and held his breath for the next stage of examination, slowly moving his wrist side to side. He groaned. The pain was so bad that he couldn’t breathe, and he rolled back onto the bed.
There was one thing left to test. With his other hand, he drew his fingernail over the pads of each finger. When he got to his middle finger, it was numb. That…wasn’t good. He pinched the nailbed hard, hoping to feel something, but there was nothing. His ring finger and pinky were dead too.
He couldn’t for the life of him remember what happened. But he remembered…he remembered having a few beers in the park last night with Mateo. Then going home and having a few more. Then opening the bottle of vodka he had steadily been working through…maybe finishing it. That’s when things got fuzzy.
His stomach rolled again, sending him careening towards the bathroom. He threw up three times, then a fourth when he accidentally used his injured hand to brace himself against the toilet. Fuck. Whatever had happened, the hand was almost surely broken, and if the swelling was compressing the nerves, he was risking permanent damage. There weren’t a whole lot of options.
Jesse checked his phone, it was around 4 AM. So night shift would still be on; Maybe he could sneak in and have Jack call in a favor to get his x-ray back quickly, and then he’d be home and back in bed before any of day shift even woke up—he could avoid the badgering that would come from anyone seeing the bruises.
He was in his boxers, so he pulled on a pair of joggers and a flannel shirt, struggling to do up the buttons with only his non-dominant hand, and topped off the look with a baseball cap and some sunglasses. The lights outside were already making his head throb. He was still like…40% drunk? So he contemplated his options and ordered a lyft, then leaned against the wall, letting his head fall backwards. The bottle of vodka was still on his counter, and there were still a few measures of spirit in the bottom.
He could remember drinking to forget last night; that was for sure. To forget his racist-ass family that he had cut out of his life, the homophobic patients that hate-crimed him daily in the ER, and the idiot parents that made their kids feel depressed, and unlovable, and hopeless, and useless, and…and if the price of forgetting all of that was a broken hand and feeling like death warmed up, he’d do it again in a heartbeat. Jesse leaned forward to grab the bottle, and tipped the last lukewarm shot of vodka slip down his throat. 45% drunk.
His lyft pulled up outside, so Jesse shoved his feet into a pair of ratty Sambas and pocketed his wallet, keys, phone, and at the last minute, some pirated emesis bags. Better safe than sorry. His driver was a young Hispanic man, who looked over his shoulder at Jesse, pale and rather green under the streetlights. “Hospital?” Jesse nodded. “No puke. Entiendes?”
“Sí,” Jesse said tiredly. “Solo en la bolsa.”
“No, ninguno.”
“Please just drive,” he begged. He sat ramrod straight, trying not to sway. The kid squinted at him suspiciously, but turned around and took off into the night regardless. Jesse felt every bump and swerve in his hand, which was throbbing relentlessly, and in his head, which was somehow equally bad. A sudden acceleration brought another wave of vomit into his mouth, but he kept his lips pressed firmly together and swallowed it again, wincing at the burn in his throat. His good hand was cold and clammy, and he held it against his forehead to try to stabilize himself. God, please just let this end.
Jesse didn’t say a word to the driver as he stepped out in front of PTMC, then slunk into the waiting room. There were a few patients in line, so Jesse joined the queue and took a second to test his fingers again. Still numb.
Fati, his favorite triage nurse, was working the desk. “Name and birthday, please.”
“Jesse Van Horn,” he murmured. “December 15, 1978.” He pulled the sunglasses off and squinted against the fluorescent lights.
“Jesse? What the hell?”
“I…uh, my hand. I think it’s broken. Fingers are numb, thought someone should take a look.”
“Jesus,” she said, seeing the hand. Her eyes wandered upward. “You look like shit.”
“Yeah.”
“Give me your insurance card and your ID and head on back.” He finagled them out of his wallet one-handed and put the sunglasses back on as he pushed through the doors. The stark whiteness—the walls, the floors, the sheets—was blinding, burning his corneas and sending pain like an icepick through his brain.
Bridget intercepted him and saw through his makeshift disguise immediately. “You’re not on for another three hours, Jess.” He would have snarked back at her if the room hadn’t started to spin. “C’mere.” Bridget took him by the elbow and led him into one of the north cubicles, where things were always a tad less hectic. She deposited him on the bed and immediately went for his vitals, taking a second to rub warmth into his good hand when the pulse oximeter didn’t get a reading. “What happened, doll?”
In the back of his mind, Jesse knew that questions were going to be asked, questions he wouldn’t be able to answer, and really didn’t want to answer…not truthfully, at least. “Tripped,” he shrugged. “Thought it was just a sprain until I woke up and things were numb.”
“Well, that’s why God made hospitals,” she said breezily, stroking his arm kindly. “Your heart rate and your BP are a little high. Take some deep breaths and lie back. I’m gonna grab you an ice pack and send Jack in.”
“Bridge—can you…the lights. Off?” The sentence didn’t make any sense, but Bridget understood and tapped the switch to turn the automatic lights off before pulling the curtain.
Jesse sighed. It was a point of pride that he’d never been a patient in this department before. He had dodged punches, diffused tempers, and followed sharps protocols to the letter, and it wasn’t fair that a night of alcoholic stress-management had put him in this position. His head pulsed again, and he tried to stay as still as possible to quiet the rising nausea. Just when he thought he had it under control, Dr. Abbot flung the curtain back, turned the lights back on at full strength, and tossed an ice pack on the bed. “Well, look what the cat dragged in.”
Jesse promptly puked. He had kept the emesis bag that he brought from home and managed to contain most of the mess, but there were a few splatters that had made it onto his pants, and a string of saliva clinging to his shirt. He spat into the bag again, and Jack offered a box of tissues. “I’m, uh…one-handed tonight,” Jesse said lamely, holding up his bad hand.
“I got you.” Jack took the bag and twisted it off before chucking it into the biohazard bin, then changed his gloves and took Jesse’s hand delicately in his own. “Fati said your fingers were going numb?”
“Last three. Middle, ring, pinky.”
“How long have they been numb?”
“Dunno. Woke up that way.”
“Going to poke around a bit. You need another bag?”
“Yeah, probably.”
Jack stared at him calculatingly. The sunglasses at 4AM were admittedly pretty conspicuous. “Is the nausea from the hand or the headache?”
“Little of both.”
“What exactly happened?” Jack was indeed poking around, prodding the swelling closer and closer to the bruise until Jesse hissed and tried to pull away.
“Tripped, I guess. Hit it on something.”
“When?”
“Uh, last night.”
“What time last night?” Jack’s gaze was piercing. When Jesse hesitated, Jack let go of his hand and wheeled closer, bringing out a penlight. “Sunglasses off. Did you hit your head?”
“No, fuck. I’m hungover, not concussed.” But he took the glasses off anyways, so Jack could see for himself.
“You sure?” Jack flashed the penlight in his eyes and Jesse groaned, pushing it away. Jack acquiesced and put it down, then moved to gently feel for bumps or tenderness on Jesse’s head. “Do you remember what happened last night?”
Fuck. He looked away from Jack, trying to find some shred of dignity in the patterned curtain. There was a point where respect for his colleagues outweighed respect for himself, and he had just found it. “No,” he admitted quietly.
“Do you know how much you had to drink?”
“That has nothing to do with my hand, Abbot. I didn’t come here for a lecture.”
Jack picked up his hand again, delicately moving fingers and shifting it side-to-side to test mobility. “It’s broken,” he said plainly. “If that’s all you want to talk about, I’ll get you in the x-ray queue, and I’ll call up an ortho consult. If you’re done with the bullshit, I’ll take you up myself so we can jump the line, and we can chat.”
Jesse licked his lips, chapped from the vomiting. “Just give me some pain meds and send me up.” He knew he was being a bitch, but he didn’t have the energy for anything else right now.
Jack looked disappointed. “Sure. Tell me how drunk you are so I can responsibly prescribe you some.”
“I’m not…it’s just residual. From last night.”
“You’re hiding it well, I’ll give you that,” Jack said. “But you’re definitely still under the influence.” He entered some notes in the chart, putting in orders probably. “Bridget’s gonna take some blood. We can start you on some low-dose ket and get a banana bag in to help sober you up. Then we can talk about getting some Zofran and morphine in.” He hesitated. “You sure you don’t want some company?”
“Just wanna sleep.”
“Yeah. Good luck with that.” Jack slipped out of the room without another word. Bridget was back soon, and Jesse thanked his lucky stars that she was on shift and not Dana…Dana would have given him an earful.
Bridget didn’t push, probably because he was her go-to to cover nights, and that was too valuable a resource for her to risk. She nailed the blood draw and came back a few minutes later with the ketamine, a banana bag, and two pillows that she fluffed and stuffed under his hand to elevate it. “I’ll take you up to x-ray in about 20 minutes, babe. I already told Dana that you’re off shift, and Lindsey’s going to take a double to cover you.”
So, he might still be in for an earful today. He should have known that the nurses’ network would be humming the second he walked through the door, disguise or not. “Thanks, Bridget,” he said weakly. The ketamine worked fast, already smoothing out the rough edges. The ice pack Jack had brought in was already halfway warm and kept sliding off his wrist, so Jesse slapped it over his eyes instead.
It was lonely to be in a cubicle by himself, but he didn’t for one second wish he had taken Jack’s offer. He had spent months avoiding an uncomfortable conversation with himself, and it would be a hundred times worse to have it with Jack.
A small part of him knew that the drinking was a problem. It had gotten bad after PittFest, but if he was being honest with himself, it had really started during covid. Something about the grueling cycle of a ward teeming with desolate patients, and an apartment empty of life. He couldn’t remember when the worst days of his patients’ lives started becoming the worst days of his life too, but yesterday was one of the bad ones.
It didn’t take much, at this point. A fourteen-year-old attempted suicide had come in, whose parents didn’t support their child’s “choices”. They saved him, of course. But then they sent him upstairs for monitoring, and the only people that went with him were the parents who put him in that bed in the first place.
So yeah, he drank. It was warranted.
Someone wheeled him up to x-ray, and he let them arrange him on the table like a ragdoll. Bridget was there again when he was returned to the ED, and took more blood. Dr. Abbot was through the curtains next, followed closely by Dr. Walsh. “You need surgery,” Jack said bluntly. “Fifth metacarpal’s got a displaced shaft fracture, Walsh needs to put in a pin to stabilize it.”
“It’ll take me fifteen minutes,” she said confidently. “We’ll have you out of here by noon. We’re gonna move you to pre-op, then Anesthesia’s going to give you some pain meds so you’ll be comfortable while we get everything going. Any questions?” Jesse shook his head. The headache had receded a bit, and the room had stopped spinning, but Jack’s knowing glare still made him feel queasy. “Great. Hang in there, we’ll see you soon.”
Two night-shift orderlies he recognized but didn’t know were already kicking the bed’s brakes off, getting ready to move. Jack stepped back and watched, arms crossed over his chest. “Good luck, Jesse,” he said finally, without any real warmth. “Let me know how things turn out.”
Three days post-surgery, Jesse was pleasantly floaty. He wasn’t stupid enough to drink while he was on oxy, so he had replaced the opioids after the first two days with the max dose of Tylenol, and downed a bottle of IPA he had ordered with some groceries on doordash. He was watching the Pirates game, a second bottle in hand, when there was a knock at his door. He grimaced—maybe Dana had finally gotten tired of him ducking her calls. The knock came again, sharper and louder. Probably not Dana, then. Jesse wrenched the door open, and regretted it instantly.
“I come in peace,” Jack said. He held up a bag of takeout from the restaurant by the hospital.
Jesse considered him for a moment, but stepped aside to let the man in and closed the door behind him. He’d hear about if he didn’t. Jack had never been to his place, so he was looking around curiously. Jesse saw his eyes land on the beer bottle, so he grabbed it and finished it in a long swig, staring Jack in the eye as he did it. “Did Dana send you to come to check up on me?”
“Maybe I wanted to check on you myself.”
“I didn’t know PTMC made house calls now.”
“Guess they do. How’s the hand?”
“Fucking hurts. Itchy too.” He held it out so Jack could take a look at it. The swelling had gone down, but the purple bruising peeked out from the edges of the cast. Jack nodded in satisfaction.
“Do you remember what happened yet?”
Jesse scraped his good hand across his face. He hadn’t showered in three days, his hand was throbbing, and he’d really rather wallow in self-pity (or self-disgust) by himself. “What are you doing here, Jack? You’re not…we’re not…”
“Came to check on a colleague I thought was having a rough time.”
They stared at each other, and Jesse decided that it was unlikely Jack would ever stand down first. “You want a beer?” He finally asked, grabbing himself a third bottle from the fridge.
“Nah, I’m on shift in a few hours.” Jack started unpacking the takeout, and Jesse popped the bottlecap off with his cast. “Neat party trick.”
Jesse grunted. “I’ve got a lot of time on my hands…hand.”
They ate quietly, commenting only to ask each other to pass the dumplings or soy sauce. The Tylenol was wearing off, and Jack’s presence was making him anxious. Sure, they were work friends, but Jesse had been an asshole to him at the hospital, and for some reason Jack had taken that as a sign to come over? To his apartment?
“I noticed that no one came to visit you at the hospital,” Jack said abruptly, scraping the last of the fried rice from the carboard takeout container.
Jesse snorted. “Yeah, I noticed that too.”
“Not just after your accident. At work too. You never talk about family, or dating, and you’re always the first one to volunteer to cover shifts if someone needs it.”
“This is making me feel real good. Very warm and fuzzy.”
Jack continued doggedly. “And when I notice someone which dives headfirst into work, but seems like he’s withdrawing at the same time, I make sure to keep an eye on them so they don’t end up like me.”
A siren started up outside, long and whining. That third beer might have pushed him to the drunk side of tipsy. “Like you?” Jesse asked.
“Falling, with no support system to catch me.” Jack took the last bite of rice and chewed thoughtfully before beginning to clean up their dinner mess. “It was PittFest, wasn’t it? You were a lot more…present, before.”
The extremely accurate observation was like an arrow, and his heart was the bullseye. He winced as it hit its mark. “It doesn’t affect my work,” he said defensively.
“I’m sorry, but it does. Maybe you don’t realize, but…you used to be the one that everyone went to for help. Calming a patient, or checking med recs…but when was the last time someone asked you to double check a foley placement?”
“Fuck, have you been watching me or something?”
“Yeah. Dana has too. Because we’re worried about you.”
“Then why isn’t she here?”
“If you called and asked her to come, she’d be here in a heartbeat. But she’s got three kids and a husband and an entire ER to run.”
And yeah, Jesse knew that. He was just being petty. Probably because he was a little freaked out. He had noticed that some coworkers who used to rely on him gave him a wider berth, but he figured it was just because they were more confident now, and didn’t need him. Jack made it sound like… “People are scared of me?”
“Not scared, just…respectful. They give you space.”
“I didn’t know I was…I mean, I wasn’t doing it on purpose.”
“We know.”
“I can be better. I don’t know, smile more or something. I’ll bring in donuts.”
“That’s not the point. I came over because I think something’s wrong, and I want to help fix it.”
They were back at the beginning. “It was just a bad night. There was a shitty case in the ED.”
“And now you’re 3 beers deep at 4pm on a Wednesday, and either you’re not taking the pain meds you should so that you can drink, or you’re mixing alcohol with opioids, which is an even worse decision.”
Frustration was growing in Jesse’s chest. “I’m not an alcoholic. I never drink on shift, and I don’t get withdrawal symptoms or whatever. I just…there’s just bad days.” He didn’t mention how the bad days were stringing together lately, one after another for weeks. Maybe months. He wasn’t going to admit that to anyone.
“I’m not here to bully you, brother. Just here to help.” Jack’s voice was the softest Jesse had ever heard it. “Do you want to talk about the bad days?”
“No.” The response came quickly and firmly.
“Do you want me to leave?”
Jesse paused, staring at his cast. “Yes,” he said finally. “…sorry.”
“No worries. I kind ambushed you.” He grabbed his bag and put on his coat, Jesse standing as he moved towards the door. “If you ever want to talk, my door’s always open.”
“Thanks Jack. I…I’ll think about what you said.”
“Good. Feel better.” Jack left.
Jesse stared at the door, feeling numb. Not his hand; that wasn’t numb. He took two more Tylenol, and swallowed them dry. Someone had finally called him on his bullshit, and it felt shitty, and he could really use another beer, but that was only proving Jack’s point, wasn’t it? The third beer was still in his hand. It had a few swallows left. Jesse stared at it, considering what Jack had said.
Maybe he did need a wake-up call. Maybe he needed to get better.
He poured the rest of the bottle down the drain.
Maybe he’d try.