Chapter Text
Among the multitude of other feelings Jack Abbot was in the midst of, one significant one was nervous. If taken into account the last time he would consider himself truly nervous, this would be a new feeling. Anticipatory, feeling the adrenaline of a critical case, caught off guard before he could execute appropriate actions, sure of course he’d felt these feelings as well as nervousness or anxiety in his life before and had been familiar with them. But the true sense of being nervous like this had not struck him for quite a while. Rarely did things catch him unprepared to have some answer for. He didn’t want to classify it as anxiety in his thoughts because Samira herself could not cause him anxiety. The thought of her disappointment most certainly could though, so he remained nervous, not anxious. So be it. He still had a chance and he was determined to push through.
Along with being nervous he was embarrassed. He berated himself internally, this was not cracking up to be his day. Both feelings he knew were completely subjective yet made no difference.
The feeling he was trying his best to dutifully ignore was his pain.
It had been too long since this had happened. And it wasn’t Samira’s fault per se of course. Jack knew better, but he had been distracted, complacent, if not almost definitely lazy. For lack of better example it was similar to when men gained their partners “baby weight”. Jack was happy, and he was savoring it. His therapist insisted that he allow himself the peace that he deserved. And he definitely was, its not that he wasn’t appreciative. He didn’t believe it was possible for him to take Samira Mohan for granted. A small but observant part of his brain was savoring their relationship for when he would inevitably have to surrender it.
He knew Samira cared for him, loved him even. And he was not a “simp” as the kids called it (he had to watch more than one youtube video to accurately gauge that definition). He truly believed she deserved the best and if someone offered more than he could he would fight but he would never hold her back from more than she deserved or could achieve without him.
Knowing all this Jack was nervous for his faults and what might become of them. Letting Samira down in any way was a strike that he may not recover from in his mind. There were no chances.
This was not true, but this is what he led himself to believe. Samira of course could not count on her fingers the number of ways or reasons why she loved Jack Abbot. She knew early on Jack had some sort of sense of “duty” towards her and their relationship and how others could perceive his intent.
Before this she started out feeling a sense of fraud. Jack Abbot had been an army doctor. She could not flirt with him. He had many years of experience above her own. Obviously he would think she was simply trying to get an edge at PMTC and had seen this behavior before from others with the appearance and status he carried, widower or not. Also confessing your genuine interest in your nightshift attending was not a suggested intervention.
Despite all these things Jack and Samira did find eachother. And Jack was about to fuck it all up.
Jack was a victim of a traumatic amputation, he was uncomfortably familiar with pain and discomfort. He had years of practice managing it, along with the anguish when he didn’t take his body’s warnings seriously. Flare ups were part of the territory, inevitable. Nerve and phantom limb pain, weather, mental setbacks, just plain soreness, he was an expert nearing two decades of personal experience at this point. He had learned quickly, so it had been at least 10 years since he had suffered a flare up this bad. He was exceptional with his stretching (modified when it had to be), med regimen, and prosthesis care. Not to say that he definitely did not push his limits at work. But at home he was very conscious of his routine to be able to push himself the way he desired in his profession without much thought. At home he would do what was necessary to not have to sacrifice his mobility at work and temperament that he knew could suffer from his neglect. The worst part was he really had no excuse for this.
Like he said “baby weight”. As a doctor and now dedicated girlfriend, which seemed like an immature term to both of them but with no other alternative at the moment, (Jack had other plans but was determined to not overwhelm Samira), Samira was concerned.
Jack had taken for granted Samira’s massages to his lacking limb. Starting off with some self-consciousness and discomfort, Jack had grown used to Samira’s attention to his BKA. She was if anything overly attentive, at work or not always observing his gait and face for discomfort. He assured her that despite other habits of his he was exceptional at listening to his body in this area, and of his strict routine to keep his comfort and skills at work effective. Unfortunately he had grown used to accepting her offerings of masseuse therapy after long days, easing into her pliant hands on his couch during movies or reading case studies to her while they discussed. And she so much enjoyed being a comfort and help to his fixed pain. It was now a known and established intimacy.
Of course he could massage his own leg, but he just hadn’t unless it was aching. He did his stretching, took his medications, and followed strict advice on the suggested time allotment for his prothesis before risking pressure injuries (been there done that), and absolutely passed out with it off after a grueling shift. Or laid awake listening to his police scanner. (They were both the same to his leg if his prothesis was absent).
So despite this wealth of knowledge and experience Jack Abbot was about to learn a lesson. With a cold front moving in his whole body had been particularly more sore this week. His back and right hip were both compensating for a knee that was on its last leg. Samira was due back this morning at shift change from visiting her mother in New Jersey over the past long weekend.
If Jack had not been so guilty he would be ecstatic. Samira knew Jack took a dose of gabapentin twice a day, toradol as needed, usually at least every other day maybe two, maybe daily, pain didn’t have a routine. And an oxy prescription for exacerbation that he preferred to stay clear of but was smart enough and had the experience to keep around.
What Samira didn’t know was that Jack had not called for his refill of gabapentin Thursday, his toradol was not where he remembered leaving it last, and he refused to take his oxy on any working days. Also maybe since working the Friday she left, he took advantage of her absence and stayed for a double, slept as needed in the on call room Saturday and was still wiped enough Sunday to Monday that he would be getting his prescriptions Monday morning. Really not a big deal. Besides the fact that his pain had been steadily increasing and he was on his third day of not listening to his body, this was going to be a doozy.
Jack knew the mental solace he took in his and Samira’s new found routines but the physical benefit was more than he had now belatedly realized. He could do nothing now but chastise his own far gone stupidity until he could get to the pharmacy near his house after greeting Samira back Monday morning. He was going to promptly pick up and take his prescriptions, most likely lay in his shower completely forgoing the bench (his arms were strong enough for the grab rails if he could just lay down), add his rarely used trazodone to the mix, and later drowsily greet Samira at his home for his evening off admitting to some discomfort. That was the plan anyways.
He knew he could call his provider to pick up his prescriptions here at PMTC and she would oblige. He also knew he was getting to the point of really truly being in desperate need of relief. Between traumas and some invisible line he had drawn for himself he was going to greet Samira and he was going to make it to his pharmacy, his inattentiveness had done this to himself and that was that. Even though this logic would never fly applied to a patient of his, this is what stuck.
Samira had sent Jack a few text messages offering her excitement to see him at shift change after her short trip even if she couldn’t be over his place until the next evening. Jack had done his best to offer his shared enthusiasm hoping his responses weren’t as clipped as his nerves felt.
It was now 7am, hours since he heard from Samira and minutes until he would see her. He was completely and utterly shot and he was far from hiding it well. Shen and Ellis had both cornered him into calling Robby in early themselves. He had conclusively pulled rank and refused, the strained voice he used left room for doubt but was enough that they didn’t argue. He knew he was absolutely tachy and had been for a while. He had been in so much pain he had been nauseous and unable to eat, forcing saltines and sips of water down his throat, he was shaky and dehydrated, along with taking tylenol and ibuprofen that didn’t even touch the pain. Trying to appear casual had forced his back to compensate for his would be pronounced limp. Everything was aching. This pain felt years in the making.
He was so close, all he had to do was handoff, greet Samira genuinely (and also kind of like liar he hated to admit) quickly and be on his way right? Medications, a hot shower, rest.
Wrapping up to hand his patients off in around 15 minutes, he involuntarily gulped. He knew he had been warm and tachy before, but he now felt clammy. The sweat which had been dampening his back was now on his brow that he had to swipe away. The shakiness he had felt was now more visible with the escalation of his pain. His hands holding the ipad were visibly tremoring.
Jack took quick stock of the staff around him, he had to sit now. Shen and Ellis who he knew had been honed in on him were now too absorbed in preparing for handoff. Luckily Jack honestly had been too exhausted his whole shift to even be snappy and let his attitude portray his situation to any other staff unless they truly took their time to observe his clearly obvious state.
Jack sat slowly, pretending to look down at his charts, kept his head aimed low and attempted quiet box breathing for the few moments he could get. This was it, he was going to make it.
Robby came up and clapped Jack on the shoulder while looking at the rest of the floor, “Show me what you’ve got so you can get the hell out of here.”
“Right”, Jack stood slowly steering them to the corridor outside the inner hub looking focused down at his ipad while he swallowed down repeatedly the now excess saliva in his mouth. Robby followed while continuing to observe the ER rather than Jack.
Jack who had perseverated over seeing Samira and his attempt to put his best foot forward in his façade both in embarrassment and paranoid delusion that he could not fault in front of her (and this was a fault he had caused by neglect), had no room for thoughts other than attempting to read his ipad.
Wait? Attempt? Was this his pain? Hypoglycemia? Exhaustion? No no no no no. He was close he could feel it in his hands, he had been at the finish line. Robby was now expectantly staring at him. Jack wrenched his gaze between Robby and the ipad. His tongue felt heavy.
Jack rasped, “Listen this isn’t-“
“Jack?”
“Just a second- I-“
Jack gripped the edge of the nurses station weakly. Robby’s gaze cut sharply to his grip, now taking in his pallor, sheen of sweat, harsh breathing and trembling.
Grabbing Jack firmly by the bicep, “Woah, hey we’re going to sit-“
“-Fruitcake!” Myrna not stopping, only greeting in passing had clipped Jack from behind with her wheelchair. More specifically clipped Jack’s right leg, and moved on as if it was just morning huddle routine.
Jack’s eyes snapped shut, biting his tongue hard enough that he was sure he was tasting blood. Robby watched his already pale face shade to translucent, his grip on the nurses station attempted to stabilize him only to fall slack.
Besides the all consuming pain Jack’s first feeling was pure mortification along with the thought of, “Didn’t make it.”
White heat rushed up his whole right side. His head felt hot then too light. He could feel his eyes about to roll. The first word he could gasp out to Robby was, “-Sorry-.” Cut off by his body falling limp into unconsciousness.
Robby’s gut had dropped the second he had taken in Abbot, immediately guilt ridden for having only now glanced at his face and missing the case in front of his eyes. Myrna’s oversight had Robby’s fear skyrocket.
Already having physical contact, Robby was at least appreciative for the saving grace that he could make sure Abbot would suffer no other physical harm. Bringing Jack’s limp body in for a strong hug under the armpits Robby called out, “I need a gurney and nightshift doctors NOW.” Jack’s head lolled into Robby’s shoulder, god he was saturated in sweat. “You’re okay Jack, you’re okay.” He murmured before transferring his dead weight with Shen and Ellis who had ran over with the commotion.
Ellis reached for his carotid while he was wheeled to a room calling out, “strong pulse, tachy.”
Shen betrayed his usual calm, “What the fuck happened?”
Robby barked, “That’s what I want my nightshift doctors to tell me, what the fuck exactly happened?”
Dana and Jesse were now expediently hooking Jack up to all the monitors.
Shen and Ellis glanced at eachother, Robby commanded the room, “We need everything basic first, a line in each arm, EKG, CBC, and CMP. No xrays or CT yet, there was no headstrike. Keep his boxers on for now everything else off to asses.”
The room moved fluidly. Robby at Jack’s face performing a HEENT exam, shining a light into his eyes and trying to rouse consciousness, “Abbot, Jack, hey pal time to make your way back.” Jack didn’t stir exactly but there was some movement, Robby was pleased with that he’d give Jack another moment, giving his hand a quick squeeze.
Shen and Ellis performed other bodily assessments, listening to heart and lungs and palpating while they spoke. “He’s too tachy we need to fix that now. I think we both agree that from what we saw tonight this is pain exacerbation right Doctor Shen? Does he have any allergies? Can we get some morphine on board?” Ellis slung her stethoscope back around her neck.
“No allergies,” Robby directed at Dana.
“On it.” Dana responded. Jesse had finished putting all leads on and was working on collecting his labs. The vitals displaying were cause for concern, heart rate and blood pressure elevated. The forced pain management would ease those some.
Shen agreed while down at his residual limb carefully removing the prosthesis. “Definitely pain, I figured it was more than he was letting on, but I never thought he would let himself get to a point like this, this is borderline self harm. Not cool man. We tried to get him to call you in early but he pulled the nightshift senior attending card.” What was left of his leg itself bore no sign of his distress. It looked intact, small miracles.
Robby scrubbed a hand roughly down his face and through his hair, what a way to start his shift. “That’s what it looked like to me too. I didn’t even have a chance to ask him any questions before he went down. I was looking around waiting for him to give me report. Having him walk with me before I noticed. He may have been confused Im not sure, he just looked like he was trying to explain himself but couldn’t get it out. Pale, clammy, diaphoretic, tachypneic. I was having him sit so I could get a better look at him and Myrna clipped his leg with her wheelchair.” The whole room visibly winced.
Looking down at Abbot his face was slack but not peaceful. He was heaving shallow breaths, curls soaked from sweat, leads and lines littering his body.
Jesse interrupted their observations, “Definitely some confusion or the beginnings of it, blood sugar came back at 60, rest of his labs came back normal. Ill get glucose on board.”
Robby rubbed his hands together, “Jesus, so obviously he was not eating lets assume nausea and get some zofran too. Dana can you get crackers, snacks, gingerale whatever you can get for when he comes around.”
“Sure thing cap.”
Robbys attention now at the computer entering orders added more softly, “And Dana please find Samira.”
The rest of the room glanced at one another. Jack and Samira had kept their relationship professional but the way they orbited around eachother was impossible not to notice even before they were a thing. The pining had been nauseating. Especially when everyone’s job was to observe and catalog. And most people who worked at a hospital treated gossip as if it was their second job. Both parties had a new found pep in their step. If they had been good doctors before, the new peace they shared had introduced a level headedness to each of them that people were admiringly envious of. They looked relaxed. In their field that was hard sought after and more rarely found.
Samira couldn’t believe it, she was late. Well not late but late to being early. Jack always liked that Samira held the same sense of time that the army had carved into him. If you aren’t 15 minutes early you’re late. Jack would love Samira even if she was a person who was habitually late but he was loathe to admit that it would grate on him. Fortunately there was no need to consider this. But today Samira had missed her early alarm, unable to shoot Jack a “Good morning hope your shift was eventful in a good way see you soon :)“ As was usual. They didn’t always get a response from one another while working but it was a sweet habit to think of eachother and be thought of, which they seemed incapable of doing anything different. The knowing buzz in their pockets an hour before shift change brought a warm smile to their faces.
When Samira scrambled into the Pitt perfectly on time (late) she had done her customary search for a head of gray curls. She glanced around but knew he would find her before he left, intent on starting her day. She walked by what had to have been a shift change resource consuming trauma considering there was a night and day shift attending and a fourth year resident looking very earnest in their discussion. Wait. Shen had stepped to the side to murmur something to Ellis. There were two nightshift attendings in the room. And the second was Jack Abbot, now in semi-fowlers, pale, naked besides his boxers, hooked up to leads and monitors and unconscious? His curls were plastered to his scalp and forehead.
Samira hadn’t felt real fear for quite some time and it made her sick. Stress and anxiety she was familiar with, she had gone through med school and was nearing the end of residency it was nothing if not stressful. She shared sorrow and disappointment with her patients terminal diagnosis and loss for the ones she couldn’t save. But this feeling of dread made her freeze then stagger. Shen’s eyes locked onto hers making Robby turn. His mouth was tight as he waved her in. Samira would have come in regardless after she found her feet but Robby’s wave had put her into motion. Samira’s heart was racing, eyes trying not to convey the magnitude of her alarm. Jesse was now placing a gown on Abbot.
“Whats going on-“
“Samira he’s okay.”
“He’s unconscious!”
“It just happened, he’s already coming around.”
There was no blood, no bruising that she could see.
“Was he attacked? Did he hit his head? Why is his heart rate 110 if he’s not even conscious?” she glanced at the normal sinus rhythm being displayed from his EKG besides the tachy and tried to take a breath. She placed a hand on his left knee closest to her. No one acknowledged this. She had never seen Jack look so ashen, so sick. She had a fleeting thought that this is what he would look like if he was dead. She rejected the thought as quickly as it came. She was being dramatic, but felt misplaced with how to process all the information that she still didn’t have.
“We believe he collapsed from pain exacerbation at his BKA and hypoglycemia. We were rounding, I caught him, no head trauma or any other. His blood glucose was low, most likely not eating from the discomfort. He’s getting morphine, fluids, glucose and zofran. Its been less than five minutes. He’s already had some twitches and small involuntary movements, id rather let the meds kick in and let him wake up himself so we can further assess him, shouldn’t be long now.”
Samira wracked her brain which was feeling particularly sluggish. Pain exacerbation? That couldn’t be right, Samira knew Jack took regimented care of his body. This wasn’t a simple flare up or one bad shift of discomfort. Would Jack really be in this much pain since she had been gone and not mentioned a single word to her? They had spoken some, she knew he had worked a double and she was surprisingly enjoying the visit to mother’s that she had been dreading. If anything she was just looking forward to seeing Jack this morning and evening. She had not been assessing their short conversations over the phone, but she also had not seen him in person.
She turned on her heel at Shen and Ellis. “You two doctors think this is pain exacerbation and you let him work until he dropped? Look at him!” Samira’s voice steadily rose with tears of frustration now lining her eyes. “You’re telling me he was working five minutes ago? This isn’t a flare up, this kind of pain had to be days in the making!”
“Doctor Mohan! That’s enough. We all know Doctor Abbot doesn’t listen to advice unless he wants to. Doctor Shen and Ellis tried to call me in early and Doctor Abbot ordered them not to-“
“They should have! Why did no one call me?”
The guilt in the room was palpable by all. Every person had a different reason they knew why this was their fault.
Shen and Ellis were ashamed that they hadn’t done more for someone who led the way as an example for advocating for your patients. And they had utterly failed him.
“I think once he’s settled he’s going to have many undesired conversations about how he handles his pain and how unhealthy this stint was. He’s taking the week off non-negotiable and more if needed, and you should take a few days too, we’ll manage. Samira we’re all blaming ourselves, but part of the truth is also that this was idiotic and his fault. Not his pain but after the fact of his clear mismanagement of it. He has friends and…obviously more here, that care about him and he needs to learn to lean on that.”
A low moan snapped everyone’s attention to Jack.
“Hey pal, welcome back take it slow.” Robby said placing a steadying hand on his shoulder. “You’re getting morphine right now, can you tell me how much pain you’re in.” Jack gritted his teeth and shook his head side to side, eyes clenched shut. “Five more milligrams of morphine,” Robby clipped.
Samira moved up to grasp his hand, swiping away tears with her free one she choked out, “Jack I’m here we’ve got you, you’re going to be okay.” There seemed to be a half second of recognition cross his face, it looked like he had tried to nod.
Jack’s entire body was moving in unease clearly trying get away from the pain that was consuming him. His hand clenched Samira’s offered one with desperation. His breaths started heaving, he was going to risk hyperventilation. The monitor blared out his increasing heart rate climbing to 140.
Ellis was signing out and pushing ativan into Jack’s line as the words had left Robby’s mouth demanding it. A nasal cannula was placed.
“Jack you’re getting ativan to calm down but you need to do the work too. You need to take some nice big deep breaths for me. Samira’s going to lead and you need to follow.”
Jack was still making his way into awareness. His leg, his leg felt like it had been ripped from him, ironic. The pain Jack had been concealing was raw and the only thing he was aware of. He was getting bits of conversation around him but none of it was formed enough for it to make a difference to him. He was being crushed, he had to be, he had to be dying. There could be no other explanation right?
There was a lot of noise he was becoming aware of all at once and trying to distinguish. It was so loud, who was yelling? His throat was burning. Oh? It was him? He was yelling out. He didn’t have much time or concentration to observe this as more than a passing fact. He was dying.
Jack was unable to heed any advice. He had begun howling in pain and actively trying to get away from himself. Robby was losing control of the situation fast. Everyone in the room looked distraught seeing Abbot so vulnerable. Samira had tears pouring down her face, no soothing words making their way Jack’s awareness.
Jack’s chest was heaving, sobs now wracking his chest. “Murphy!” He cried out. His first words since waking up.
Robby’s heart plummeted through his shoes. The room went cold. This was catastrophically worse than he had anticipated. Jack’s pain had launched him into a PTSD episode upon waking. Samira had comforted Jack after more than one nightmare. He had given her advice on when and when not to wake him and things to say to ground him if need be. This was not that. The room was silent, besides Jack’s anguish and blaring alarms. There was one second where everyone recognized the significance of what was happening.
Confident in no head trauma Robby still made sure and pulled Jack’s eyelids back one by one for a second time and shone his penlight. “PERRLA.”
Robby made an attempt with a hand on his shoulder, speaking loud enough to try to gather Jack’s attention but not distress him. “Doctor Abbot, you’re at PMTC in Pittsburgh where you work. You’re safe, we’re trying to get your pain under control. Can you hear me?”
“Murphy! Where is he?” A sob, “We need a nine line! Someone get my tourniquet, please!” Tears leaked from Jack’s eyes and Robby’s were now wet as well.
“This is too much, he’s going to do himself damage, we need to sedate him to get his pain under control.” Robby announced. Samira choked on her relief.
The awareness they had fought so hard to find in Jack had landed on Robby’s word of sedate. His leg, they were going to take it. He needed to stay awake, they couldn’t.
Robby was caught completely off guard. Jack had wrenched his hand from Samira’s grip. And with all the adrenaline he had left shoved Robby away from him hard. He ripped both IV lines out, gaze frantically assessing the room without much recognition behind his eyes.
Robby didn’t fall but he stumbled a few steps back. The atmosphere in the room yet again changed. Robby yelled out, “Samira get back!” Across the gurney at the same time Shen manhandled her.
Samira. He locked his eyes on her. There was relief mixed with his confusion and distress. She would help him. “Samira they’re going to take my leg, they can’t! Don’t let them!” His eyes were wild and pleading his chest still heaving. The air was sucked out of the room. This was sad.
Samira did her best to take advantage of his attention that they had been desperate to get. “Jack look at me,” he nodded frantically. “We’re trying to help you and you need to let us. I promise no one is taking your leg. You need to take some deep breaths.” Her eyes were begging him to trust her.
And he did. Jack stuttered on a harsh exhale. He trusted Samira with his life and would do anything she asked of him, she must know something he didn’t. Samira Samira Samira. Something was wrong. Jack had a flash of Samira being on his couch, him waking up, she had been massaging the leg that he didn’t have.
He looked down to see past his boxers his missing leg. Oh no. Everyone in the room clocked his stare. They held their breath, unable to gauge if this was going to improve or deteriorate the situation further.
“Jack?” Samira tried softly.
“My leg.” He gulped, “Its already gone?” Eyes fixed on the empty spot on the gurney, flexing toes that weren’t there.
“Yes honey it has been for a while.”
“Right, I know that.”
“Jack you need to move your right hand.”
He had gripped his thigh so hard he was going to leave deep painful bruises.
“I need to know whats real.”
Robby cut in, “Jack we’re all here to help you with that.”
Jack glanced sluggishly at Robby. He was already starting to crash and fighting it hard. He was so confused trying to make sense of what he could and put the pieces where they belonged. He was still in so much pain but the morphine was starting to take effect, if not at least the edge off. He took in the gurney he was on, his clothes stripped off, the leads on his chest.
“Im… at work. Im a patient?”
Robby’s eyes gleamed with relief of the recognition in Jack’s eyes he had been trying to will into existence.
“Yes, you’re coming down pretty hard right now. How’s your pain? That’s what we’re trying to gauge to make you comfortable.”
Jack’s right hand still dug into his thigh. He closed his eyes for a few seconds trying to take stock of himself while being so closely observed. Oh god. Jack tried and failed to hold back a gag.
An emesis bag was thrust in his lap. Jack gulped a few times instead, tried to ease his stomach. Opened his eyes again and felt shakiness and unease but less of the nausea, trading one evil for another. He again tried to observe his surroundings.
His eyes searched for her and landed back on Samira. Samira? She was being held back by Shen, and she seemed comforted by this. Why? What had happened? She appeared frightened. Curls askew, lips trembling, eyes bloodshot. Jack was immediately on edge, what was causing her such distress? Jack tried to find the source with no success. “Samira, whats wrong? Are you okay?”
Samira’s mouth opened and closed several times with no answer being given. Jack’s brow furrowed. What was he missing? He was losing the energy he needed for such an important issue.
Robby kept his voice low, “Jack you’re scaring her.”
Had he heard that right? Jack looked between her and Robby several times. Again doing his best to gather facts with the sludge that his brain was currently operating on. He was a patient, everyone was staring at him, cataloguing him. No he couldn't have. Samira was afraid of him? This was Jack’s worst nightmare come true. Jack heard the blood rushing in his ears. He choked out, “Did i- no I couldn’t have- I wouldn’t- are you?” at Samira, “Is she-?” Directed at Robby.
Robby stepped closer, feeling somewhat more confident with Jack trying to sort out what was going on, he gently but firmly removed Jack’s hand from digging into his thigh and held it in his own.
“Jack you didn’t hurt anyone.” For the first time today Jack took a solid deep breath in and out. He leaned his head back and closed his eyes biting into his lip to contain his relief. He clutched Robby’s hand tightly. Robby’s shoulders fell a half inch from his ears. “You passed out during report and haven’t been lucid since you woke up. You had a very distressing flashback and as your coworkers and…friends, we are all very concerned about your wellbeing. Im going to say this as your friend and as a provider. I believe its in your best interest to be sedated for a few hours with pain meds on board. You took a serious toll on your body today. And I’m sure the last few days as well.”
Jack cracked an eye open and murmured, “Thank you but not a chance.”
Samira cut in hard, “Jack this is serious.”
Jack found it difficult to meet her gaze, “Samira…I’m not myself right now. Should you be here?”
Samira wanted the floor to swallow her.
Jack went on unable to meet her eyes, “I-I,” his words starting to tremor, “I want you here, but maybe you aren’t safe. Im sorry that this is how it worked out.”
Samira felt her feet under her again. “You went through something traumatic, I’m only scared for you. I know that you would never endanger me. Jack please listen to Robby’s advice. You need the rest and the monitoring.”
Robby cut in, “Ill make sure you get discharged tonight.” Not above begging, “Please, you need the rest and the day of observation, Mohan will take you home tonight.”
“I don’t think that’s-“
“That’s perfectly fine, that’s what was going to happen if he left now anyways, Jack I need you to stay, please.”
Not now or in any lifetime would Jack Abbot be able to deny Samira Mohan and here she was begging him.
Jack locked eyes with Robby. The most intense and determined he had been so far. Voice pitched low between them, “Is she safe with me?”
“Yes, but not until after you rest, and ill examine you physically and mentally before you leave, I promise. We can call psych too, you can decide that when you wake up. You’ll have to pass a rudimentary exam anyways, only the basics as this was definitely not psychosis, it was PTSD. Just the homicidal and suicidal questions are necessary, but if you want to discuss more with them that will be up to you. You need rest, to call your therapist tomorrow, and you are going to make sure you have and take the medications we or your own doctor prescribe you.”
Jack had closed his eyes again during Robby’s monologue trying to take his words in. Continuously fighting with his mind and body. He was vibrating with anxiety but it appeared as if he was listening.
“Jack?”
“Hmm, i’m thinking, its- difficult right now. But I think I got all that.”
“There’s one more thing.” Robby tensed hoping against all odds this would be taken well. Jack hummed an acknowledgement.
“What happened today… like I said you’ve probably had a rough few days. We think that.. this wasn’t intentional but that its bordering something like that with how neglectful your pain management was, unless there was something else we missed?”
Jack slowly shook his head, “I didn’t get get my refills on time. I forgot to pick them up after my double too, and I don’t like to take my oxy when i’m working.” Jack thought but didn’t add Samira’s missing hands and internally groaned.
Robby bit his cheek, “You’re off for the week Jack.”
“-Wait. But you just said- I swear I wasn’t punishing myself or trying to hurt myself intentionally.” Jack was reeling.
“No nothing like that,” Robby cut back. “This isn’t anything reportable.” Jack’s body language sagged again. “But like I said it was clearly negligent. And you’re in no state to take care of patients. You are a patient and you need to take care of yourself first. Its only concern and doctor’s orders for your wellbeing. Ill be coming by this week to check on you if i’m welcome to.”
Robby looked to the side and softly added “Samira will have a few days too.” He continued on, “You need to take more time if you need it, your mind and body are begging you for it. But the week is mandatory. We’re worried. You also need to talk to your therapist about why and how you let it get this far and refused to ask for help or let anyone help you until you were unconscious and had no choice. Have you had anything this serious happen in the last five years?”
Jack cracked his eyes back open and admitted, “Nothing like this in more than ten.” Robby and Samira winced making eye contact.
His mind going to another place thinking about the times Lauren had to witness the trauma he had taken home with him. His left thumb fingered his empty ring finger while his eyes took stock of the also empty spot his leg would have been in. The rest of the room honed in on Jack seeing both movements and felt sympathy for his sorrow.
Looking back up at Robby, “I think I’ve had a shock.” Jack said it as a statement but it seemed to come out as a question.
Robby kept his eyes fixed on Jack’s trying to keep his attention. “Yes I think so. Jack let us help you. Okay?”
Jack bowed his head and whispered a confirmation. “I- I’m saying yes and I believe this is the right choice but I just-” He lowered his voice to nearly a whisper and Robby had to duck his head to make sure he caught it, “I’m on edge, I cant uhm, I don’t think I can look knowing- I don’t want a countdown or anything.”
Samira jumped in all eyes on her. “Jack would it help-? Can I hug you?”
Jack was the most selfish bastard on the planet. He nodded before she finished what he was saying. “Samira only if you’re comfortable,” Jacks lip wobbled, voice breaking, “I need you to know that I would never-“.
Stepping closer, “Shh nows not the time, I know, of course I know. Everything’s okay and you’re going to be fine. We’re going home soon to rest, as soon as you wake up okay?”
Robby tied off a tourniquet on Jack’s bicep. Samira scooted slowly on the gurney next to Jack facing him, his eyes gleamed and he held both arms out shaking. Samira leaned into his chest and Jack buried his nose into Samira’s neck. Robby alcohol prepped and slid a needle into a healthy vein on Jack’s outer forearm, securing the catheter in place while Jack tethered Samira to himself.
“Is this okay?” Jack was humiliated and desperately trying to control small sobs.
Samira had a hand cradle the back of his head and run through his curls, she pecked a kiss on his cheek, “Jack honey you’re okay, everything is okay, please relax, thank you for coming back to me.”
Jack’s head was heavy with the emotions he couldn’t yet sort though. He had never felt such a mixture of guilt and relief, but he tried to focus only on the relief without much success, just for the moment he was trying to allow it. He melted into Samira.
“Samira I’m so sorry.” He hiccuped.
“Shh not right now Jack. Its okay, you’re okay.”
“Thank you. Thank you.” Jack kept murmuring between them, and then, “I love you. Samira, you’re the best of us.”
These were the last words Jack could get out before his arms securing Samira Mohan to his sweat soaked body fell limp and his head lolled for the second time that day. Robby had pushed the sedative though the tubing for his desperately needed respite.