Chapter Text
“Tier 1 Trauma, ETA three minutes.”
Ten minutes after two in the morning, the city of Pittsburgh should be at its quietest, the people of its city asleep, most hours away from their alarms, or others hours away from getting off shift. Traffic is at its lightest, nearly all of SEPTA’s transport vehicles still snuggled away in depots and yards.
At a level one trauma center, none of that ever matters.
“Alright, we’re gonna put that in Trauma 1” Nightshift charge nurse Lena calls out as heads snap towards the desk.
Dr. Jack Abbot along with nurse Kim Tate put on isolation gowns as the residents and medical students scramble into the room.
“Okay, Whitaker, you get the head for primary assessment and airway, Santos, you do the EFAST, Mohan, you’re gonna check the back when we roll them. Javadi, you’re gonna make sure they don’t miss anything. Welcome to your six weeks of nightshift. We’re gonna have a great time.” Abbot says, a smirk crinkling his eyes as Javadi still struggles with her gloves. The sliding door is open, the room buzzing with anticipation. Respiratory and social work mill by the door, but someone walks in, leaning onto one of the cabinets and crossing their arms. Abbot doesn’t recognize them, with their hair in a colorful scrub cap, a surgical mask tied to their face and their scrubs not the emergency departments black or grey. “Hey.” He says, his brow furrowed at them. “Who are you?” He points from the back of the room.
“I’m Cam. I’m from the O.R. Waiting on the trauma, just following the new S.O.P.” She says, tearing her mask off of her face and putting her hands up.
“Why do we need a nurse from the O.R?” Javadi asks, her safety glasses askew and foggy.
“Ooh. Don’t call her a nurse. She hates that.” Garcia says, marching into the room and grabbing a gown. Cam arches an eyebrow in Garcia’s direction, silent.
“What are you then, a medical student?” Abbot asks, crossing his arms.
“Scrub tech. I’m just the messenger. Miller and Underwood’s new grand plan.” Cam sighs. Abbot stares at her confused. “There’s been too many emergency cases with no warning. I was sitting at the desk last month when someone comes rolling by with a guy with an eleven inch chef knife sticking out of his chest. No warning.” Cam says, staring down Garcia as she focuses on putting on a pair of gloves. “So now, I call the desk, make sure we know if any tier 1 or tier 2 traumas are coming up or not.”
“That’s your whole job? Just…calling the desk?” Whitaker asks. Cam turns to him, brow furrowed, her lip beginning to upturn with mild disgust. Whitaker flushes, his eyes wide, and turns back to his intubation supplies.
“Did his mom drop him off? These kids get younger every damn year.” Cam mumbles.
“We’re just getting older.” Abbot says, putting on a mask.
“What’s this ‘we’ shit? Did you just call me old? After asking if I’m a med student? Good, God.” Cam says, shaking her head.
“I’m just trying to figure out who’s rubbernecking in my trauma bay.” Abbot says, crossing his arms.
“And I’m just wondering how a guy your age had the balls to ask for the curly broccoli hair cut all the twenty year olds have.” Cam replies.
“My hair grows this way.” Abbot replies, pointing to his silver and blonde curls.
“Whatever you say, bro.” Cam says, smirking at him. Whitaker, Javadi, Mohan and Santos gape at the two of them, eyes flashing to everyone in the room who’s staring at the two of them.
“Don’t worry, if you rotate through surgery, you’ll get to enjoy her all the time.” Garcia says haughtily, desperate to break the awkward silence in the room. She turns to Santos, who is putting ultrasound gel on the probe. “You get to do the EFAST? Super fun. I’ll help you.” Garcia smiles, sidling up to Santos. Cam raises an eyebrow, her eyes locking briefly with Dr. Abbot’s as they both witness the display. Before any more words can be uttered, Lena calls out.
“Trauma 1, in room now!” The patient rolls by, groaning.
“27 year old male, GSW times two to the abdomen, GCS 15, packed the one in the flank that went through and through, last BP was 97 over 58. Hung a pack of RBCs, access is an 18 in the AC and a 22 in the hand.” The paramedic reports casually. No one in the room is startled by the patients groaning.
“Thanks, guys. Whitaker, on your count.” Abbot says, his eyes flashing again to Cam before they move the patient.
“Right, uh, My count. One, Two, Three.” Whitaker calls softly, moving the patient over onto the ER stretcher. The patient cries out again, despite the soft landing.
“Uh, sir? Sir? Can you tell me your name?” Whitaker asks, the patient still moaning. The patient doesn’t answer, and Whitaker grows nervous as everyone stares at him. “Sir! You need to tell me your name!” Whitaker demands, shocking the trauma room, the patient included.
“John. My name is John.” The patient croaks out, his writhing lessening on the stretcher.
“John, I’m Dr. Whitaker. Do you know where you are?” Whitaker asks. The patient is interrupted by Santos pressing the ultrasound probe to his stomach, making him cry out again.
“Sorry, sir, we just have to check your abdomen.” Garcia says, nodding to encourage Santos to keep looking. Santos and Garcia keep exchanging glances as they scan the quadrants required for an EFAST, Dr. Garcia’s voice taking on a different tone than usual.
The exam continues, but the only thing Cam focuses on is the ultrasound, and how little Garcia seems to be paying attention to the scan. Dr. Mohan checks the patient’s back, the only thing of note was the already known exit wound, fraying the tissues in John’s flank.
“Well, call me if the CT shows anything. Good job, Trinity.” Garcia says, taking her gloves off and slingshotting them into the garbage can. Cam’s brow furrows deeply, her eyes scrutinizing Garcia. She looks at the vitals displayed on the screen, the blood pressure cuff just now deflating and providing a new reading. Her eyes flash to Abbot’s before looking back at the screen.
“You got the look.” Abbot says, coming around past Whitaker toward the side of the bed.
“What look?” Whitaker says, turning to follow Abbot as he grabs the ultrasound.
“Your spider-senses tingling?” Abbot asks, flashing his eyes to Cam, who pushes herself off the wall while still staying feet away, but closer than before, her eyes still glancing between the patient’s vitals and the ultrasound machine. “Blood pressure is soft, we got a bullet running around somewhere in the body...” Abbot says, as if he’s reciting eggs and milk off his grocery list, his eyes glancing at Whitaker, Mohan and Javadi, who stare anxiously at him. Santos is behind him at the door, freezing when Abbot grabs the ultrasound again. The ultrasound picture on the left hand side just below the ribcage shows on the screen, and Abbot flashes a look to Cam.
“Always listen to your instincts.” Abbot says, cracking a small smile. “You see a lot of EFASTs before?”
“A few. I thought I saw a space, but I wasn’t sure. Just felt…off.” Cam says, pulling out her cellphone. “Hey, it’s me. Open up the trauma room, we got a spleen that needs to be taken out. Yeah, it’s usually a couple of prolenes. Just…open the room. I’m oscar mike.” Cam hangs up, jamming her phone in her back pocket. “Well, no rest for the wicked.” She says, heading towards the door.
“Nice meeting you, Cam.” Abbot says, taking off his gown and throwing it away.
“Nice meeting you…uh.” She pauses in the doorway grimacing when she realizes she doesn’t know his name.
“Jack Abbot. You can call me Jack.” He says, putting hand sanitizer on from the wall dispenser before holding out a hand for her to shake.
“I don’t call doctors by their first names, but it’s nice to meet you Dr. Abbot. I guess someone will send Garcia’s dumbass back down to transport this patient.” Cam scoffs, heading down the hallway toward the stairs that lead up to the surgical department.
“And I guess Santos is presenting the clinical indications of an EFAST exam during rounds in the morning.” Abbot calls into the room, much to Trinity’s horror. “Hey!” Jack calls out to her. Cam turns, hands in the air again. “Did you serve?” he asks.
“My brother.” She replies. “I gotta go help these kids get this party started.” Cam shrugs, hustling down the hallway. “Hey, you know I’ve got some really good mousse if you want to add a little volume, by the way.” She calls, turning back once more to him, gesturing like she’s fluffing her hair despite the cap covering it. Cam pops the stairwell door open and charges up before Abbot can reply, leaving him with his hands on his hips, staring down the hallway.
“Tier 1 trauma, ETA 15 minutes”
It’s just after seven in the morning, the sun beginning to crest above the tall buildings in the city. Dr. Robby slides in through the ambulance bay doors, past a patient on a gurney transported by paramedics.
“Good night?” Robby asks Abbot, setting his backpack down under the desk as his eyes lock onto the board.
“Not bad. Santos and Garcia almost missed an EFAST doing…whatever it is they think they’re doing.” Abbot says, leaning onto the desk as they both stare at the screen full of people that probably could be almost anywhere else besides stuck in the hallways of the emergency department.
“You want me to talk to her?” Robby asks, turning to look at him a moment.
“No, she’s sufficiently humiliated I think. Guy went up to the OR around 0230. We got a trauma coming in about…12 minutes.” Abbot says, looking at his watch.
“Why don’t you get out of here, before it comes in?” Robby says, rolling up the sleeves of his hoodie and nodding at Dana as she gets done getting report from Dana. “Which room, Dana?”
“Trauma two sounds good to me.” Dana answers, slamming back some coffee and putting her reading glasses on to check her computer.
“Sounds wonderful. Seriously, Abbot, you should get out of here.” Robby says, heading toward the trauma room.
“What am I going to do? Sleep?” Abbot says with a small chuckle, following him into the trauma room.
“Good morning, everyone. You guys wanna get out of here, or are you taking a page out of Dr. Abbot’s book and stick around?” Robby says, putting on a gown. The younger residents and students don’t answer, grabbing gowns, gloves and putting on safety glasses. “I guess that answers that.” Robby says with a slight smile at Abbot.
Cam rounds the corner into the room, taking her spot from this morning back, sidling between the cabinets on the wall near the door.
“Hey, how’s the patient from tonight?” Whitaker asks.
“Fine. Spleen out, put a G-tube in since there was a hole in the stomach too. Just pursestringed the tube into it, extubated in the OR, didn’t even need to go to the ICU.” Cam shrugs.
“Robby, that’s Cam, she’s a scrub tech from the O.R. She’s the one who had the spider-senses about the EFAST.”
“It’s actually Spidey-senses.” Whitaker mumbles. They all turn to him, surprise plastered across all their faces, but Cam can’t help but crack a smile.
“He’s right. And it wasn’t anything special. Like you said, I’ve seen enough EFASTs. I just had a gut feeling.” Cam shrugs.
“I cannot believe Gloria has the O.R staff doing this.” Robby says, putting on gloves as he shakes his head.
“Well, forewarned is forearmed.” Cam shrugs. “I’m nosy, too.” She faux whispers, winking at Javadi.
“How long have you worked at the Pitt?” Robby asks.
“Eight months. Been a scrub tech for…just about six years.”
“You from Pennsylvania?” Robby asks, untangling the cords from the monitor on the wall.
“Pittsburgh born and raised. I got out of scrub tech school and traveled though. Got a job in Chicago, then Detroit, a year in G-Dub in D.C, methodist in Indy, Shock Trauma in Baltimore.”
“Anywhere but here?” Abbot challenges, turning his eyes to her. She shifts under his scrutiny.
“Yeah. Well, back now.” Cam sighs.
“I take it you’re a trauma junkie like the rest of us?” Robby says with a wry grin. Cam huffs out a small laugh.
“Oh yeah. I live for chaos.” Cam says with a smile. The room, teeming with nurses and ancillary staff all murmur with agreement.
“Doesn’t your shift end in like fifteen minutes?” Abbot asks, eyeing the clock.
“What am I going to do? Go home and sleep?” Cam scoffs. Robby raises an eyebrow at Abbot, who looks away from all of them, focusing on a cabinet full of I.V supplies.
“Trauma two, in room!” Dana calls out, the patient slack on the gurney.
“Twenty one year old male, long extrication from single-car MVC, GCS of 5, but that was after 8mg of Narcan. The long extrication was because he was halfway out the sunroof, but too high to get all the way out. 18 in the right wrist, 20 in the left AC.”
“Oh, boy.” Cam mumbles, getting a pair of gloves off the wall dispenser as they move the unconscious adult over.
“Alright, what’s the move, Whitaker?” Robby asks, standing over Dennis’ shoulder.
“Probably eight more of Narcan?” Dennis says, his words dripping with uncertainty.
“Whitaker, is that an order or a question?” Abbot says, checking the patient’s abdomen with the ultrasound, Santos standing shoulder to shoulder with him.
“Mateo, can I get 8 more of Narcan?” Dennis requests with a smattering of authority. The syringe of Narcan goes into the I.V line, and Cam sidles up to the patient's side. Robby’s brow furrows as he sees her close to the patient, until all hell breaks loose. The young man bolts upright, screaming and trying to get out of the stretcher. Cam throws her body across the young man’s knees and hips, her hand locking onto the patient’s to prevent him from tearing out his I.V’s.
“Let’s get some precedex and haldol, see if we can stop this rodeo ride.” Robby says, chuckling at Cam wrestling the patient and Dennis’ stunned expression. “You saw that coming, too?” Robby asks.
“You know how many twenty-somethings and redheads I’ve helped keep on the table?” Cam laughs, still pinning the patient down.
“She really does like the chaos.” Robby smiles, shaking his head at Abbot, who is staring at her. “Go home, you’re tired. I’m tired, and I just got here.” Robby says, putting his hand on Jack’s shoulder to break his trance. “Cam, nice meeting you. Thanks for the extra hands.” Robby says, taking off his gown and throwing it in the garbage.
“Well, let me give you report at least, before you throw me out. Bed one is a THC user with hyperemesis, I think Perlah just got him out of the shower. Probably give him a liter of crystalloid and get him out. Bed two is waiting on ortho to come down and do a surgical consult, hopefully they can find a bed.”
“Have a good day!!” Cam calls, waving to the trauma bay as she heads out. She gives a weak salute to Robby and Abbot, and Abbot cracks a smile at her as she spins around, marching down the hallway toward the surgical department.
“Good God, that's a big girl.” Myrna states, shuffling her wheelchair towards Robby as Cam struts toward the stairwell.
“Hey.” Abbot snaps. Robby turns her wheelchair to face him, taking off his glasses to stare her down.
“Myrna, you don’t comment on staff’s bodies. You want to get banned from here? Where else is going to take you?” Robby asks, raising his eyebrows.
“If I had known the brooding one was into big girls, I would have started working him over years ago.” Myrna mumbles to Robby. He shakes his head with a sigh, pushing her wheelchair further from the desk and locking the brakes when he pushes her into the corner. Robby shakes his head as he walks back towards Abbot, who’s glaring at Myrna, but his ears are flush.
“Where were we on report? Bed 3?”