Chapter Text
12:09 AM | Wednesday | Mid July | Nurse’s Station
As a physician, it is my duty to inform the patient to keep a healthy lifestyle after their operation - get enough sleep, with proper nutrition and exercise. However, as a physician myself I am begging all the gods, if there is one, to achieve that level of health and wealth in life. When was the last time I saw the sun rising aside from the hospital premises? Because why am I once again on call? I love my work, I really do, but being overworked all the time takes the fun out of it and I can’t help but spite.
“You know I can hear you typing from another room,” Nurse Janet, the head nurse, said as she came out of the nurse office, carrying her water bottle and took a swig on it. I did not even notice that I was typing so loudly. I’ve been running on autopilot lately and it sometimes surprises me how I can still survive.
“Nurse Janet, it’s already midnight, any noise IS loud,” I said as I tried to finish charting, conscious about my fingers hitting the keyboard. I looked at the clock only to see that I still have 6 hours left before my duty ends.
“Well, to be fair, Nurse Janet, it is pleasantly quiet tonight,” Dr. Jenner, a 1st year resident under general surgery, said, stretching her arms and legs. I can see Nurse Janet’s eyes get bigger while Dr. Rhea, our innocent Dr. Rhea, is confused about the matter.
“Nurse Janet, I did not peg you to be superstitious,” Dr. Jenner teasingly said.
“Oh dear, you don’t know the horrors I’ve seen every time that word is spoken” she replied. Personally, I do not believe in superstitions. I believe reliable sources, evidence, and science. That’s what makes me thrive in this field. Everything is about scientific research.
I did not pay any attention to their conversation when my phone suddenly rang.
Caller ID: Emergency Room
“Hello, this is Dr. Cuffley”
“Doc, we have a TA patient, 45, male, GCS 8. We already ordered the labs and scans. Can you take a look?” I stood up and rushed through the door as the nurse told me more about the patient. I was taking mental notes for my attending later in any case this will lead to surgery.
“I’m on my way,” I ended the call and pushed the buttons down to the first floor. We ran in the empty lobby, my shoes making rhythmic thumping sounds on the floor reaching my destination.
I have seen many things in the ER, some weird, but it's mostly the overwhelming presence of quick and efficient work that these professionals do under immense time pressure that I can never seem to conquer. Mad respect for that. Hence, it didn’t surprise me when the ER attending was there giving orders to stabilize the patient, but the presence of another person who seemed way out of place in this hospital did in fact flick my curious mind.
“Dick Grayson?” I whispered, seeing him standing in the middle of the room looking at one of the beds where the nurses are busy going in and out. He did not see or hear me since he was fixated on what’s happening. I walked past him and finally got to see who the patient was. Bruce Wayne.
“Dr. Cuffley, you’re here. We did not see anything from the ultrasound as of the moment but we’re waiting on the other labs and scans for further details,” Dr. Cho, an attending on call, said showing me the scans from the ultrasound.
“So far his vitals are stable. Thankfully, Mr. Grayson knows first aid enough to actually bring him in here with a neck brace,” he nodded towards him with a hint of amazement, because, let’s be honest, not everyone who knows first aid can immediately give a neck brace. But I guess there’s an exception from a billionaire family. Mr. Wayne’s education for his children is not failing in any way shape or form at least.
I immediately looked at Grayson then was met by his calm demeanor. It’s like he knows Bruce will be alright. However, he seemed surprised to see me. Well, it has been awhile since we last crossed paths. I was genuinely astonished to see him in my shift.
“Ah, you’re here.” I refocused my attention on Dr. Cho who recognized the neurosurgery residents to address his brain injury. He then led them inside so they could also check on his vitals.
I went to the other side of his bed to check on the vitals myself. He is currently intubated but everything was in order. I looked further on his chest and saw no seatbelt injury, but I can see some healing bruises on his arms and ribs, maybe some minor fracture? But he’s not having a hard time breathing so a pneumothorax is out of question. However, for someone who has recently been in an accident, those bruises and scars should not be there. Was he in a fight? Did he get hit or something? I wanted to ask these questions to also rule out any possible internal injuries that may cause his bruising.
“Hi, Dr. Cuffley,” I was mildly startled by his presence. I did not even hear his footsteps walking in.
“Mr. Grayson,” I formally greeted.
“Ah, Mr. Grayson. Of course,” he said with a tinge of hurt in his voice. I bit my lips as I observe Mr. Wayne.
“I’m working,” I reminded him. Feeling bad about the indifference. It doesn’t necessarily help that we met again in my workplace during my shift after all these years. After more than a decade.
“I know,” he said defeatedly.
“How did he get into an accident?” I turned to see him looking at me. I can see how he immediately composes himself before meeting mine with that same facade he had worn throughout those years.
“He was coming home from work and I was calling him from the manor when I suddenly heard a crash on his end. It was the final turn before home and I guess he miscalculated it with the speed he was going,” he said, rather cautiously, as if choosing the right words to say. I looked at his expression and I can see he’s pretty worried by the possible outcome of this accident.
“What about these scars and bruises?” I asked him cautiously, pointing at the parts where he had them. “They’re healing, but may I know how he came up with them?” I followed. His eyes looked at it closely trying to figure out the how as well.
“Oh, uhm… I’m not sure. Never really saw them myself. He likes to keep in shape and he also does boxing with Luke sometimes so maybe that’s it?” Dick answered. It checks the box but just to be sure, I need to see the x-ray scans to know that these are healing even on the inside. I looked at Dick again and saw how he looked at his adoptive father.
“Don’t worry, we’ll try to do everything we can,” I gave him a reassuring smile, the kind I usually give to the guardians to put their minds at ease.
“Dr. Cuffley, scans are here,” one of the neuro residents called me to check on Mr. Wayne’s condition.
“Injuries are mainly on the neck from whiplash and some fractures on the spine and skull ,” Dr. Cho was pointing out his observations from the scans
“That’s a subdural hematoma at the back of the head. We need to treat that immediately,” the resident said. “I’ll call Dr. Elliot,” he added and left while the other residents stayed to observe some more.
“Now for the abdomen… this is his right?” asked Dr. Cho. I checked the name of the file and it was Mr. Wayne’s but the scan does not seem to fit with what we were expecting.
”Hmm… seems like nothing major on his abdominal cavity,” I voiced, noticing how there’s almost nothing wrong. I checked further into his CT scans, the spleen and liver was intact, hence no issue for internal bleeding. His kidneys and intestines are also clear. For a car accident his organs don't seem to be that affected.
I also checked his X-rays just to clear out the bruises that I saw earlier and I was right about them healing so nothing much to worry about.
“So far, we don’t need to undergo surgery in his case. This will be all on the neurosurgery department,” I said, still looking at his scans in case I missed something. Dr. Cho is also beside me staring at the screen in front of us.
“Dr. Elliot is on his way,” The resident came back after calling the head of the neurosurgery.
“That’s a great coincidence that he’s on call,” Dr. Cho said. It’s not a secret that Dr. Thomas Elliot and Bruce Wayne go way back. It’s just that, head of departments rarely go on call, they mainly participate in lectures, check-ups, and occasional surgery. I guess Dr. Elliot is different from the other heads.
“Let’s talk with the guardian and you guys can proceed with the surgery” Dr. Cho stated. The residents called in Dick to explain to him the current situation of Mr. Wayne, how the operation will go and the consent form he needed to fill before proceeding with the surgery. I also explained to him my observations and what we really need to worry about is his brain injury.
He seemed to have fully grasped the urgency of this situation and proceeded to give consent on the injury. They will provide him the forms in a while but his verbal consent is enough for them to call the needed departments to start the surgery.
I, on the other hand, read through Mr. Wayne’s lab results one more time. Something is definitely not adding up.
“His CBC and blood chem are all in order. Alcohol and drug screens are also negative,” Dr. Cho voiced, who seems to be as surprised as I am.
“Dick said he got into an accident on the way home. Crashed at the final turn before the manor,” I informed Dr. Cho, checking his reaction but he remained still.
”Don’t you think it’s weird that usual TA injuries are not present at all?” I asked but he wasn’t looking at me anymore but the doctor who just arrived walking towards us.
“Dr. Cho,” the person nodded. “Where is he?” he asked.
“Ah, Dr. Elliot. This way please,” he moves past me and shows Dr. Elliot towards Mr. Wayne where he greeted Dick with a hug. Of course Dr. Elliot is close with the Wayne Family. It makes so much sense that he needs to be the attending present for his close friend’s operation.
I looked at his chart again. I just have to input my observations from earlier and after that, I’m good to go back to my station. However, I can feel from deep within me that there’s something wrong. Obviously a lot from this accident does not make any sense. From the pristine condition of his organs to the minute details of his supposed crash. I’m glad that Mr. Wayne is one less patient to take care of but nothing from this seems to ease my mind.
My thoughts were interrupted when Dr. Cho showed Dr. Elliot Mr. Wayne’s chart through the monitor that I’ve been using.
“Dr. Elliot, this is Dr. Cuffley, a resident from general surgery,” he introduced.
“Dr. Elliot, pleasure to meet you,” I reached out for his hand which he accepted. “I’m just finishing up some notes on his chart. Nothing much from my end, don't worry.” I said in defense as he looked through what I’ve been repeatedly checking out. But he did not know that. For all he knows is I’m reviewing my observations from earlier making sure I’m not missing anything.
“Good, then it’s out of your hands,” he said with a tone that could send shivers down your spine, but not for me. It only made me feel more irritated. I just faced the monitor instead. It was like he was leaving me with a warning not to look into this matter any further. But I shook my head on it. Maybe I’m overthinking it that’s why. However, the fact that everything about this so-called car accident that is not adding up is what keeps on bugging me.
I looked at Dr. Cho who then tilted his head at me. I can’t read minds but he gave me a nod agreeing to what Dr. Elliot said and it just irritated me. I’m just doing my job making sure that nothing is wrong on my end, my license will be on the line in any case there’s a mistake here. Honestly, I’m glad it’s out of my hands now.
“I’ll be prepping for surgery. My residents can get Mr. Wayne later when everything is ready,” Dr. Elliot said and left immediately to the operating room.
I followed him with my eyes as I felt Dr. Cho’s gaze linger on me. I looked back at him irritatedly.
“Look, he’s right, okay? It is out of your hands,” he said leaning his arm on the counter of the center station.
“I know, but does he really have to say it like that? I’m just finishing up some notes on his chart. It’s not like I’m prying into it because the accident does not match his injuries” I whispered, realizing we’re not the only people in here.
“This has become a high profile case and whoever can help with Mr. Wayne’s injuries will be making headlines. That's why he’s trying to set boundaries for his friend,” he whispered back closely.
“I wasn’t even interested in the politics of this case!” I whispered and grabbed the monitor and proceeded to finish the chart so that I can leave here and leave all of this behind.
“I know, Aya. But I’m definitely interested in something else. I didn’t know you were close with hot shot over there?” he pried, nodding towards Dick Grayson.
“The guy is worrying about his father and you want to hear gossip?”
“You got one of the billionaire’s sons in your roster, how come you never talk about it?” because it’s not something to talk about.
“Look, Terry,” I clicked ‘enter’ to officially finish the chart before facing that smirk plastered on him. “It’s none of your business,” I said walking past him and out of the emergency room as I found my way back to our floor.
“Give me the deets about it soon!” He shouted before the elevator got a chance to finally close. I just rolled my eyes and leaned back.
I can definitely feel a headache coming as I began to unpack what just happened in the emergency room. I can’t believe I met Dick Grayson once again. A much more mature Dick compared to the last time I saw him at school. Not just physically, his overall demeanor screams that he’s been through a lot throughout those years. I can’t exactly point where or how but the way he stands and looks at Mr. Wayne tells me something as if he will be shouldering all of his burdens.
More importantly, that accident. It checks everything in the neurosurgery department but it’s impossible for a brain injury like that to occur without causing harm to the abdominal and chest cavities, that’s one inconsistency.
Number two, I did not even see a seatbelt burn that should appear even as a light bruise. If he was not wearing a seatbelt there is a possibility of his body being thrown over the steering wheel, or worse, over the dashboard that could crash into the windshield, but there were no injuries on his face or even a tiny hint of glass on his hair.
Number three, his toxicology reports came back clean so that means he was not under the influence or in any substance and as Dick said he was on call with him when the accident happen so I’m assuming that he is of sound mind and who in their right mind of 48 years old with sons waiting will be driving recklessly in the night without a seatbelt on?
Three striking inconsistencies to one patient and no one seems to be bothered by it.
All of these thoughts have been bugging me ever since I saw his charts and I know that my brain would not be giving me peace about this anytime soon.
I reached my floor and walked up to the nurse’s station, like my brain is on autopilot reliving everything that happened that I barely noticed Nurse Janet walking up to me.
“Hey, Dr. Cuffley, I was about to call you. The patient in room 408 has a low-grade fever, temp 38.1, vitals stable, incision clean and dry. I just need a prescription.” She was walking beside me back at the station.
“Is the patient awake?” I asked. I need to further assess this and not just blatantly administer medicine without even checking in.
“No, but I checked everything out,” she said with confidence and I don’t doubt that.
“Thanks, Nurse Janet. I’ll just take a quick look and prescribe that for you.” and with that, we entered the room together.
Yeah, right. I got a job to do and this also requires my mental and physical attention. I’ll deal with Mr. Wayne’s case later but for now I have a night shift to finish.
5:52 AM | Wednesday | Waiting Area
I looked at the clock and heaved out a sigh. I just finished an appendectomy and it seems that I won’t be leaving this shift on time again. One can definitely feel the change in the air, the quiet halls of the night slowly drifting to the warmth of the early sunrise.
The vending machine whirred to life as it spits out my drink of choice. I don’t know how many coffees I had for this shift nor how many waters I had today. The first sip woke my eyes wide open as if it rewired my whole system. My favorite coffee spot never fails to disappoint.
“Is this the best place for coffee around here?” I turned to my right to see Dick Grayson walking up to me.
“If you’re tired enough to taste the coffee then yes, I guess this is the best place around here,” I replied.
He chuckled and moved to face the coffee vending machine, checking the options.
“You know, there’s a convenience store up front that would serve better coffee than this one,” I suggested. Honestly, I can’t seem to fathom billionaire’s son Dick Grayson drinking coffee from a vending machine.
Back in high school, he was always surrounded by the most influential families’ kids. They hang out in private clubs, yachts, and mansions that you can never see in public. These kids were snobs, maintaining their circle intentionally among the rich and wealthy. To us, the scholars of the academy, they were insufferable. No blatant actions of distaste, but you can see it from their gaze. The way they mockingly look down on us, condescending comments on our clothes. How they can afford the food in the cafeteria and smirk on our tables with our lunch boxes.
Not Dick though. He was different. He was open to everyone. He may be with the richest kids in Gotham but he also hangs around with us. There’s no discrimination in his actions. Just pure adolescent fondness.
Maybe the kids were trying to be nice to him because he is still the adoptive son of Bruce Wayne but it was evident that his charisma has pushed its way to everyone’s… heart.
“You think I can’t handle a vending machine coffee?” He smirked, pressing the buttons for his drink of choice. “It’s like you don’t know me at all.”
“It’s been years, Grayson. A lot has changed,” I reminded him. Been over a decade since the last time we talked, personally.
“I know,” he said defeatedly. I sighed and walked towards the nearest couch, his back still on me. The silence grew as the skies shade turned from blue to yellow, Dick, looking around the empty hospital waiting room.
I sipped my coffee holding it with my cold hands in contrast to the hot beverage, following Dick’s movement. There’s nothing much to this area, really. Except the floor to ceiling windows that give you an exemplary view of the sky.
“How’s your father?” I asked, still not forgetting about the unusual case. The question made him stop pacing around and settle in front of the windows.
“Dr. Elliot told me that the operation was a success. He’s in the ICU for now. They said he’ll be transferring to a regular room by tomorrow though,” He narrated.
“I wasn’t able to ask you earlier but the accident must’ve shocked you as well,” I watched his shoulder rise up and down, sighing.
“Bringing him to the hospital certainly shocked me,” he turned to me “I haven’t seen him since the operation but I know he’ll push through,” then smiled, full of assurance that this incident would not knock Bruce Wayne down.
Huh… bringing him to the hospital shocked him?
He’s surprisingly calm for someone who had just gone through this ordeal. Usually guardians would only feel relieved once they see the patient.
“Dr. Elliot is known to be very thorough in his surgeries so rest assured that he’s definitely in good hands,” I replied now looking at the empty cup on my lap, my mind buzzing again. I breathed in deep. He’s here and we’re alone. Should I ask him?
No, that would only cause confusion. Mr. Wayne is already in a stable condition and Dr. Elliot particularly told me that it is out of my hands. But my curiosity really craves answers. My heart is pounding hard on my chest, but instead of backing down, the excitement fuels me. This thrill, oh how I’ve missed this feeling.
“How have you—”
“You know, Mr. Wayne was really lucky,” I turned to him with such conviction. I need answers.
“What do you mean?” He asked, eyeing me with curiosity.
“I am speaking from a medical perspective…” I started.
“But usually, with traffic accidents involving the driver there would be multiple gastrointestinal issues that we need to watch out for, sometimes leading to surgery,” I paused, keeping it as vague as possible, not diving deeper into the details. I watched his reaction, checking if he knew anything about the case but he just looked at me intently.
“Worst cases tend to have multiple departments collaborating in the OR. It’s usually us, the Orthopedics, and Neurosurgery. Thankfully, it was just one department.” Let’s mask it as something lucky. Although, of course, I know it’s not.
“I see…” He said hesitantly, still his gaze on me. “You didn’t think it’s weird?” he followed, squinting his eyes. I looked outside the window as the buildings in front of us were being slowly enveloped by the morning sun. It’s such a nice view from up here on the 5th floor.
“Well… for someone who did not wear their seat belt. It was rather surprising that the injury was at the back…” I immediately paused, realizing something.
“... a fall,” I whispered. What if it had been a fall on the back? From a low story building? Maybe 3rd or 2nd floor? That changes everything.
“What?” he said. I snapped my head to face Dick, eyes bulging as my brain racked through different theories about this new found thought.
“Yeah, uhm, I didn’t find it weird. Fascinating, but not weird,” I said deflecting.
If he was in a fall why did they try to hide it as an accident? Was it an attempt? Is that why they were trying to hide it? What if it wasn’t an accident but intentional? I stood up wanting immediately to get away and clear my head and I can’t really ask these questions right now. They’re all speculations. I need to recheck his charts.
“I should go. I still have some charts to finish before I can go home,” I stood up and was about to walk away but then he called to pause me.
“Wait,” he said. “Can you tell when the driver has been wearing their seatbelt or not?” he continued, wearily. I faced him with wonder, my mouth slightly agape. That question alone confirms one big thing about this whole ordeal. I pursed my lips, trying to prevent a smile.
“Yes,” I replied as I looked in his eyes trying to catch anything. Although this is not the exchange I mapped out in my head, I am still satisfied with the outcome.
He nodded with hesitation as he stood in front of me.
“I’ll see you around then, Dr. Cuffley,” he smiled, not fully but with the usual politeness.
“You too, Mr. Grayson,” I replied and went on my way.
8:34 AM | Wednesday | Adam’s Breakfast Diner
“Well, that’s reckless billionaire Bruce Wayne for you,” I rolled my eyes as Karina read through the headline article of today’s Gotham Gazette. Of course he’s a reckless billionaire. I was only able to finish the charts for my shift and the operation from earlier. I did not even get a chance to peek onto Mr. Wayne’s chart because of the emergency calls from the ER.
I’m currently having breakfast at a diner with my friends from college. Karina is reading the newspaper across from me while Miles is beside her and across from him was Jalen. Adam is busy at the counter serving customers in his diner because one of his waitresses bailed out last minute.
I walked over to him to top up my coffee. This won’t affect my sleep anyway. At this point, I just drink it for sustenance.
“Sorry I can’t join you guys today. We’re understaffed right now,” Adam apologized as I poured in my drink.
“Don’t be, it’s out of your control. Is there any way I can help around?” I asked out of courtesy. I was already out of my scrubs and can probably man the cashier or wait around.
“Are you kidding me, Aya? You’re beat up. Go eat your breakfast over there,” He said, shooing me back into our booth which I simply obliged. We do help around in his diner sometimes, especially back when he was still starting up. I’m glad it boomed into a full-blown breakfast diner.
“I can’t believe the big boss is out again,” Jalen said, sipping his mug. He works for the Wayne Enterprise in their finance department, right under Mr. Wayne’s chain of command. So I get his frustration knowing that his paperworks will be awaiting approval from the CEO himself.
“You must’ve had a hell of night with this one, Aya” Miles commented nodding towards the newspaper Karina is reading with the picture of a crashed car. It reminded me again of all those thoughts I had throughout the shifts.
“My head aches thinking about it,” I said as I took a bite on my sausage with its fatty juices melting all over my tongue. I nearly rolled my eyes. It’s been awhile since I had a hearty breakfast and it always hits close to home. We don’t usually meet that often so we try to eat out whenever we’re available and today is one of those days. For the four of them, it's usually before they go to work since I’ve been on call for today, well, technically, yesterday.
“You know I’m surprised that man is still alive. It says here that he was going 45 miles per hour,” Karina announced as she hovered through the article while taking a bite of her eggs.
“Must’ve been a lot of damage huh?” Miles said nonchalantly.
“To the car? Oh yes. His body must’ve suffered as well,” Karina eyed me waiting for me to confirm whatever she’s thinking about.
“HIPAA guys,” I reminded them. Although as much as they want to think it was bad for Mr. Wayne, I know for a fact that he actually was a very lucky guy. A term that reminded me of my encounter with Dick Grayson earlier.
“It says in this article that the neurosurgery department, headed by Dr. Thomas Elliot, led the surgery of Mr. Wayne to its stable condition,” Jalen read the news aloud through his phone.
“Huh, why were you guys not mentioned? Wasn’t your department involved there, Aya? Usually with traffic accidents there must’ve been some injury in the abdominal area, especially if he was wearing a seatbelt,” Karina, a forensic professor at Gotham University, wondered as well.
I badly want to share my sentiments with them but I can’t have my license risked, considering how this is a high profile case for our hospital.
I just looked at her knowingly. She knows I can’t talk about this.
“Okay, okay. But… hypothetically… was the general surgery department there?” Karina pushed. So, I gave in. A little.
“Hypothetically… no,” and that’s it. I waved my head to stop her from asking questions. Now it’s my turn.
“Hypothetically…” I started, and I’ve been thinking about since this morning “is there a possibility that a fall accident may be mistaken as a vehicular crash?” I asked her.
“Depends, how did they fall?” and that made me think… a 2 or 3 story fall and a bleeding at the back of the head. “Fell on their back?” I answered.
She hummed thinking while Miles and Jalen are focused on their own conversation.
“Well, both accidents can be different depending on the trajectory and orientation of the body during the descent or crash. It can also be based on the severity and location of the injuries and even the patient’s age and comorbidity,” she stated.
“Oh!” She exclaimed. “I remember this one study I’ve read about distinguishing injury patterns between fall from heights and pedestrian impacts!” she scrolled through her phone to search for the article. She always has a back-up copy of those papers in case she needs them to cite in her classes.
“Here it is!” she was reading through it and I did not feel the need to correct her that it in fact was not a pedestrian but the driver themselves. But this paper would definitely help elevate some questions in my head. Or so I thought.
“So basically, it says that injuries like skull fracture, liver and lung injuries, are more common with fall victims compared to pedestrians and what the latter have are mainly external injuries to the head and legs,” she continued.
“If they fell on their back, then most likely fractures will be at the back of the head,” she finished but was still scrolling through the research paper.
“Does that answer your questions?” Karina asked, looking at me.
It does answer the question of him maybe falling on his back but how come he doesn’t have any injuries on his lungs and liver or in any of his internal organs? It still doesn’t make sense to me.
“Yeah, thanks. I might use that in one of my papers,” I smiled as I lied through my teeth. But she didn’t need to know that. Nonetheless she still sent the article for me to read through later.
In every accident that we try to heal, it is best to look into the mechanism of the injury to find the best treatment method for the patient. It makes it easier, more efficient. In every reaction there’s an equal and opposite reaction, that’s what Newton said. So how come the injuries he acquired does not match the accident that they try to portray?
“Why did you suddenly ask about it? Is it one of your patients?” Karina pried as she finished up her food.
“No, like a told you, it might come up in one of my papers,” I replied because I cannot say that the headline car crash does not make sense to me, at all, but I can’t let anyone know that I’m looking into the accident of Mr. Bruce Wayne, the reckless billionaire he is, or maybe that’s what they want people to believe.