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It scares Mark how easy it would have been to miss it. To dismiss his urge to check on the medical student as unnecessary hypervigilance and keep on walking past the suture room.
If he hadn’t just been on the phone with Rachel, perhaps his protective parental instincts might not have been strong enough to force his hand. Perhaps he would not have paused to hear the muffled thump that set alarm bells ringing in his mind. Perhaps, he would have walked in later to a much, much different scene.
As it is, though, Mark does decide to poke his head in, and he's met with a tableau that pulls all the breath from his lungs.
Standing with his back to the door is a behemoth of a man, grunting and snorting like a wild boar in a trap- and in the man’s grasp, pinned against the wall by the paws around his neck, is John Carter. Dead-eyed and slack as he dangles there like a marionette.
Mark's brain short circuits. He stumbles back. Yells for security, his own voice strangled, yet doesn't wait for the reinforcements to come, because the boy’s lips are tinged blue, and he isn't fighting like he should be. There isn't time. Instead, he darts inside again and places his hands on the attacker’s shoulders, yanking backwards as hard as he can, all to no avail. The patient- because it is a patient; now that Mark is able to catalogue details other than the immediate horror, he can see the gown and the toppled IV stand- may as well be a mountain. He resists every attempt at movement, barely flinching, and it feels like a miracle when the security guards that flood through the door manage to tear him away.
Relinquished from his attacker’s chokehold, Carter crumples. Mark's stomach drops. He shoulders past the mess of moving limbs, the roaring and the kicking, and drops down in front of the terrifying stillness instead.
“Carter? Alright, buddy, I got you. I got you.”
He rearranges the boy’s broken pieces, laying him out flat on the floor and searching desperately for some reassuring sign. The flutter of eyelashes, a groan. But aside from the red marks already blooming around his throat, all Carter’s usual vibrancy is gone. He's pale, utterly unresponsive, those dead eyes so heavy-lidded they're almost closed. When Mark jostles him, he emits no sound. For a moment, it seems as though he isn't even breathing.
When the resident presses his stethoscope to the boy’s chest, though, he's given at least one comforting piece of information. Carter is breathing- for now, at least. Whether he will be once the swelling kicks in is another story entirely.
“You're okay, Carter.” Mark soothes, before glancing behind, voice rising in barely restrained panic. “Can I get a little help in here?!”
The cavalry soon come tramping in, unaware of the carnage until they, like Mark, lay eyes on it: the giant restrained by security and the lifeless boy barely metres away, neck red, face pale.
“Oh my God.” Carol.
“Mark? Mark, what happened?” Doug.
He blinks, and the pediatrician is at his side, hands on either side of Carter's jaw, doing his best to keep the student’s head stabilised. Carol is kneeling a short distance away, her own hands stretched to the student’s temples.
“Guy was choking him.” Mark manages, the words rising like bile in his throat. “He's still breathing, but he's not going to be able to maintain his airway for much longer.”
“Unresponsive?”
As if on cue, Carter shifts at last. The hands at his sides leap up, then flop back down again, too weak to remain lifted, though his nails still claw unsuccessfully at the tiles. His chest heaves. His eyelids lift enough to reveal bloodshot sclera, before his irises roll down and his gaze slides left and right, dazed but evidently frightened. A cracked cry escapes his brutalised throat.
Carol leans closer, smoothing back his hair as he shudders in their grip. “Shh, it's okay, baby. It's okay. Just stay still, Carter.”
Doug, meanwhile, is just slipping his stethoscope from under the boy’s shirt, eyes sharp with concern. “Airway’s getting tighter. I don't think we have long before it closes up.”
Mark curses under his breath, nausea spiking again. They both know what Doug’s assessment means. When he looks back to the door this time, he's unsurprised to find he has a multitude of staff at his disposal.
“I need an adult intubation tray now. And somebody get a gurney.”
Several nurses dart away. Mark turns back to his patient, finding new tear tracks on otherwise colourless cheeks and a low, weak moan rising every so often into the air.
“Carter?” He says, palm rubbing soothing circles into the boy's chest. “Hey, it's- it's Mark. We're looking after you, bud. You're going to be just fine.”
Eyes meet his, and they swim with confusion as well as moisture. Mark tries to imagine what's going through Carter's mind- the pain, the discomfort, the terror- and hasn't even breached the perimeter of that gulf when the intubation tray he requested is thrust towards him, and he must refocus his efforts on the task at hand: keeping the boy alive. After that, he can… well, Benton will have to be informed, and- and Carter will-
“Mark?” Doug calls, voice pitching up at the end in urgency.
“I know, I’m- I’ll assemble the scope, but someone needs to prep the meds.”
“I’ll do it.” It's Haleh, already plucking the vials and syringes from the tray.
“Okay. Doug, Carol, just- keep him calm, alright? Let him know what's going to happen.”
His orders are received without rebuttal. He busies himself with the laryngoscope, forcing his slightly shaking hands to snap the equipment together and prepare a tube while he tries to ignore Doug’s achingly soft words, Carol’s ministrations.
“Alright, Tiger, I know. I know. We’re gonna fix it, but you need to go to sleep for a little while, okay?”
They get an IV into his floppy forearm, and by the time the Propofol and succinylcholine is being injected into the line, his breathing has deteriorated even further. His lips are bluer, his gaze less coherent. When Carol strokes his hair, his head lolls lifelessly beneath her touch. Mark finds himself glued to the steady disappearance of the milky fluid in the syringe, watching it flee through the tubing into the crook of Carter's elbow until at last there is no more to be given, and he must turn his attention to the boy’s draining consciousness instead.
“We’ve given you some medicine that's going to make you sleepy.” Carol explains quietly. “You don't need to be afraid, sweetheart. We’re gonna take real good care of you.”
The glazed expression on Carter's face deepens, blinks slowing along with his wheezing breaths. His eyes, heavy-lidded as they are, track slowly between the faces in front of him, losing momentum every second. Doug gives his hand a gentle squeeze.
“That’s it, bud. Just let yourself drift, we got you.”
His eyelids dip completely. His lower lip falls to reveal a sliver of front teeth.
“Good boy, Carter. Good boy.” The pediatrician takes a moment to run the tip of his index finger underneath the student’s settled eyelashes, and, after finding no movement, turns to look at Mark. “He's out.”
At once, the urgency kicks back in. Carol shifts to the side, hands still keeping Carter's head steady while allowing space for Mark to move in with the equipment. Scope. Tube. Syringe to inflate the cuff.
“BVM?” Mark asks. Haleh passes one to Carol. “I want you to start bagging as soon as I’m in.”
“Got it.”
“Good. Alright… tilt his head back a little. Great, thank you. Let's try to make this as gentle as possible.”
He presses his thumb to Carter’s chin and eases his jaw open, painfully aware of the contusions around the boy’s neck. The ones that likely mean there's swelling and damage within his throat, too.
Thankfully, the blade of the laryngoscope slides in without much resistance, and Mark manoeuvres to get a better view (God, how painful would this be if Carter were awake?), peering down the barrel of the scope like the sights of a rifle. His own breath is yet again drawn from his lungs. There's inflammation- a lot of it- and the swelling is encroaching ever further on Carter's ability to breathe. They have a couple of minutes before his throat closes up entirely.
“Jesus.”
Doug winces. “That bad?”
“Carol, squeeze a little more lubricant onto that tube, or I've got no chance of getting it in.”
He stretches out his hand for the ET, and within a few seconds he’s holding it. His eyes briefly meet Carter’s, the tiniest sliver of iris still visible beneath his unconscious eyelids, but he doesn't allow himself to linger. Slowly, carefully, he guides the tube in.
Through the mouth. Into the throat. Pushing past the resistance, wincing at the tissue he's scraping past, calling out for someone to give him cricoid pressure, going and going until-
“I’m in, bag him.”
The tubing is connected, and as Mark fumbles to inflate the cuff, Carol informs him that the CO2 is yellow. Correct placement. Thank god for that.
Hands slightly shaking, he allows himself just a second to survey the scene. Discarded plastic and Haleh’s meticulous hands as she tears off pieces of surgical tape to secure the tube. The decimation of the room around them, the IV stand still on the floor, papers scattered. No sign of the man who caused the incident- security must have taken him away while they were assessing Carter.
And, of course… the boy himself. Laying there flat on his back, surrounded by medical equipment that he should be learning to use, sweaty and pale and slack-jawed and looking no older than eighteen as the nurses fuss over him.
“Want me to call ICU?” Doug asks.
Mark should say yes.
“No, thanks. We can… we can keep him down here til he wakes up. At least that way he’ll be somewhere familiar.”
The pediatrician doesn't argue, nodding his head and returning to their stricken student.
“Doug?”
“Yup?”
“I’m going to go find Peter.”
The surgeon is right where Mark expects him to be- elbow deep in a patient with Morganstern and utterly apathetic to everything going on outside the operating room. When Shirley announces the chief resident's presence, Peter barely gives him a cursory glance where he stands at the door.
“What do you want, Mark?”
So weary. So impatient.
Mark presses the surgical mask to his face and rolls his shoulders. Takes a deep breath.
“You need to… you need to scrub out and come downstairs, Peter.”
“Why.”
“It's your student. Carter.”
Peter sighs, pulling a stitch closed. “What's he done?”
“He’s not the problem, Peter, it- look, something has happened and you-”
“What has happened?”
“Some patient tried to strangle him.”
Peter’s hands, midway through pulling another stitch, freeze. He looks at Mark, properly this time.
“... He alright?”
There's concern thrumming beneath his words, not that Peter would ever admit it. Everyone knows that as much as he's prone to complaining about Carter, he has a real soft spot for the buck-toothed student assigned to him.
Mark shakes his head slowly. “I, uh… I had to tube him.”
Peter exhales a measured breath, then steps away from the table.
“Show me.”
When they get down to the ER again, Carter has been set up in curtain two, though he's still flocked by staff making sure he's attended to. They part when they see Peter, murmuring to each other and letting him wander to Carter's side instead.
The boy is just as still as he was when Mark left him. He's been changed into a gown, though, and tucked under a couple of blankets, so that he looks more like a patient than ever. They've also hooked him up to some more lines- Mark notes the addition of corticosteroids to reduce the inflammation in his throat, as well as the expected painkillers, fluids, and sedatives.
“Man.” Peter whispers, gaze flicking from one sign of infirmity to the next. “How did it...”
“Big guy in sutures. I'm guessing he was altered, saw the kid had a needle and freaked out. When I got there, he, uh… he had him pinned up against the wall by his throat.”
Peter swallows, presumably fighting back the same nausea as Mark is. “Was he awake?”
“Not at first, but he came round on the floor before we put him under. I don't think he was aware of much.”
A nod.
“The swelling was pretty severe.” Mark continues, though this is evident by the ever-darkening bruises on the boy’s neck. “I imagine it'll take a while to come down, and I don't think it's a good idea to try extubating until it has.”
“I agree.” Peter murmurs. His hand twitches on the rail, as though he's fighting back the urge to sweep it through Carter's hair.
“I think the plan, then, is to keep him sedated for now, and start waking him when we see improvement. Could be twenty four hours or so, maybe even more.”
Another nod. Peter’s eyes are still fixed on his broken student, and as silence falls again, he lowers himself into one of the chairs beside the bed.
“I’ll… I’ll stick around for now- I assume there's, uh, paperwork I'll need to fill in.” He adds this last element quickly, like he's afraid to appear too soft in his desire to stick around.
As if Mark doesn't know the truth of his affection.
“Alright.” He replies simply. “Let me know if anything changes.”
The inflammation in Carter's throat goes down slowly, and the bruises he's sustained change colour like shifting of the seasons. While Mark's on shift, he checks on the student multiple times a day- often, the boy isn't alone. Peter is a dedicated vigil-sitter, filling in charts and keeping an eye on his charge at the same time, and the rest of the staff are always around too. They comb their fingers through his hair and eat their lunches at his bedside, talking amongst themselves as he sleeps on.
After approximately a day, an ENT specialist and a respiratory therapist come down to consult. Following an exam where they palpate Carter's neck gently and affirm that he's satting well, they give their approval: it's time to wake him up.
It would be an understatement to say that Mark is concerned. He's eager for Carter to be back to his old self, of course, but every time he sees those purple marks around the boy’s throat, his stomach rolls with unease. The pain will be immense, not to mention the psychological trauma of having a patient squeeze the life out of you on what's supposed to be a regular work day.
He's a third year medical student. If this incident shakes him enough, it could be catastrophic for the rest of his career. The rest of his life.
Still, Mark follows the advice of the experts, letting the drip drip drip of Midazolam cease.
And over the ensuing hours, John Carter comes back to them.
His brow furrows and unfurrows. His nose twitches. His head lolls slightly to the left, then to the right. His heart rate creeps up.
“You're okay, baby.” Haleh coos, stroking his hair as his expression morphs into one of discomfort yet again. “We’re taking care of you.”
When his eyes eventually open, Mark expects him to freak out, to start pulling at the tube in his throat, to toss and turn and react in all the ways he really ought to, given the trauma of the attack. Instead, when brown irises appear beneath drooping eyelids, the boy is unexpectedly placid. He lifts his hand only once, and doesn't protest when it's held in Carol's warm grasp instead. He forces his breathing in line with the vent, eyes closing, nostrils flaring. Muscles quaking with the force of his endeavour.
“Hey, bud.” Mark greets, placing a hand on the student’s trembling shoulder. “It's Dr Greene. Do you know where you are? One blink for no, two for yes.”
Peter watches intensely from the corner of the room, arms folded.
Blink… blink.
Some of the tension in the room eases.
“That's good. That's good. And do you remember what happened?”
His heart rate spikes slightly, but Carter responds with no more than two watery blinks. Peter averts his eyes.
“Okay, buddy. You're doing really well. Your throat is going to be sore for a while, but you're going to be just fine, alright? And I think it's probably about time we tried to get that tube out.”
Blink blink.
A hitching breath. Eyes quickly squeezed shut against the threat of a gag.
“We’ll be as quick as we can. You just try to relax, Carter. Good boy.”
One of the nurses gently peels the tape keeping the tube in place, rubbing soothingly at the red marks that are left behind. Another helps to prop him up. A third, working in tandem with Mark and the respiratory therapist, extubates. Peter, unsurprisingly, remains close by too, though he spends his time pacing back and forth like a cornered lion.
The whole operation can't take more than a minute, but as the tube is pulled out, Carter goes so white that he has to be lowered back down to the bed, loosing low whimpers of agony all the way.
“We’ll give you some more painkillers, bud.” Mark says, watching the boy shudder with a wince.
It's no use. Before his dosage can even be adjusted, his skin has turned completely ashen, and his eyes are rolling back in his head. All the morphine will do is keep him sedated for longer- but perhaps that's for the best right now.
“Try a warm compress for his throat.” The chief resident suggests, tugging off his gloves. “And just, uh… make sure he doesn't wake up alone, hm?”
There is no shortage of volunteers ready to keep watch.
For almost two days straight, Carter spends the vast majority of his time asleep, or at least curled up on his side attempting to sleep. The morphine keeps the pain from spiking like it had during extubation, but in the middle of both nights, Mark is called in to find the boy inconsolable after a bad dream, clutching his throat, barely able to take in a full breath.
Psych consults. They report that John is an amiable young man, though he isn't very forthcoming. He insists he's alright, and as the days drag on and they have no further reason to keep him in the hospital (the bruises around his throat are green and yellow now, and while he flinches if anybody goes to touch them without explicit permission, they don't appear to bother him as much as they did), there's not much anybody can do.
On the fourth day, he's sitting up in bed doing charts for Peter while the latter watches warily, unsure whether to dissuade him or keep up the hardened facade.
On the fifth day, a black limousine pulls up outside the front entrance, and a dry-spoken man in a butler’s garb explains that he's there to take Mr Carter home.
Mark catches the boy as he's packing up his things in curtain two.
“You sure you're alright to go?” He asks. “It's perfectly understandable if you need a little longer.”
Carter shakes his head firmly. “My folks want me back. I’m alright, Dr Greene, really.”
Mark nods. “Sure, sure… Got your meds?”
The boy retrieves a pill bottle from his pocket and gives it a shake. The chief resident tries not to picture the throttling he witnessed only days ago.
“Great.” He murmurs. “Well, take it easy, Carter. You know where we are if you need us.”
That's the end of that. Carter walks out of the ER and steps into the limousine. The door is closed behind him. The engine rumbles, and the tires crunch against the asphalt, then carry him away.
The simplicity of it all shouldn't shock Mark, really- not when this whole thing began from a chance encounter in the suture room- but he's struck by it all the same. Just days ago, the boy was lying broken on the ground. Now, he's on his way home, and he'll be back for his shift on Monday.
Time will keep on moving, and despite the endless cruelty and injury, they will persist.
Perhaps it's a beautiful thing, this tough exterior they learn to develop, the ability to pick themselves up and keep going in the face of adversity. But Mark’s stomach twists with dormant terror all the same.