Chapter Text
The sounds of the ER are constant: the beeping of cardiac monitors, the puffing of ventilators, squeaky wheels of moving beds and the sharp voices of very unhappy patients. It’s a chorus Robby has grown used to in his days of shadowing, clinical experience, being a med student, and now in the middle of his residency, a grating tune of blips and hums that lets him know the ER is working as it should. When the rhythmic clicks of machines move in tandem with the bustling of nurses, soft steps down the hall and scratching pens, it means he can finally take a few precious minutes to get caught up on his charting.
It’s midday on a Friday, halfway through his shift, and though Robby would never say it aloud, the day has been oddly quiet. It’s been a rare reprieve from the usual days of stitches and frantic parents, people shoved through the ambulance bay and the wail of vital sighs plummeting. The resident might even call this one of the calmest days he’s had in a long, long while, and he’s grateful for the lull in demands from both his patients and attending. He’s been behind on his charting for weeks, piling up at the nurses' station and hanging from the beds of those who have been waiting on for consults or surgeries or discharge papers. His attending has been breathing down his neck and threatening an extension of his second year if he doesn’t get caught up.
An empty threat, he knows, Dr. Isla Knight is a hardass that likes to spend her time handling her frustrations through dramatics, but even a joking threat is enough to light a fire under his ass and take any free time to jot down a few words to lessen the load. Staying after, even after an easy shift like today has turned out to be, is never fun.
He scrawls out some notes for a patient in Room 8. A young girl waiting on Radiology for a suspected distal radius fracture of the wrist. She came in with steely eyes and a lip between her teeth, scraped palms and a skinned knee with her wrist swollen and painful to the touch. The girl didn’t even flinch when Robby poked at the sore limb, a tough little thing that made him chuckle when she asked if she’d be able to see her own bones. Robby promised she would.
With good vitals and bloodwork, the young patient is low on the priority list and being bumped by more pressing matters. She’s been there far too long waiting on her results, but Robby can only page Radiology so many times, despite her mother’s pestering, before he gets an earful from a technologist. Thankfully, the mother’s friend seemed to be the voice of reason, keeping everyone quiet enough to listen to Robby’s attempted words of assurance.
The mother wasn’t pleased, but Robby can’t blame really blame them. No one wants to spend a Friday stuck in an ER accosted by the smell of antiseptics and glaring white lights. Tucking the girl’s file under the mental hinge of the clipboard, letting it snap shut with a break, Robby tears off a prescription pad for another set of painkillers for the girl and another page to Radiology.
Just in case the mushrooms loitering in the dark haven’t seen the first four he’s sent.
A green light flickers above him, someone pushing a call light for a nurse, and Robby hands the clipboard with the newly ordered meds to Nielson as he passes, gesturing to Room 8 with a flick of his head. The charge nurse gives him a wide grin and a mock salute before darting off, and Robby spins back around in his chair to flip through another stack of messy files. A heavy sigh leaves him, and he rubs his eyes, fingers catching on the frames of his rounded lenses.
Fucking hell.
Already, he can feel the headache building up behind his temples and the dull ache of his writing callus on his right ring finger. He’s much rather be elbow deep in someone’s ribcage or guiding a tube down a throat than spend so much time charting. The resident can’t wait until they switch over to the electronic health records that some of the bigger, better hospitals have been trying their hand at. It’s not perfect, rudimentary systems that bug out and glitch, but the idea that he could type everything up instead of mindlessly scribbling out shorthand only he can read sounds blissful. However, Nebraska hasn’t quite caught up yet, and Riverstone Medical Center still runs on chicken scratch.
Riverstone itself sits in a small corner of Omaha, a few minutes' drive from the University of Nebraska Medical Center where Robby spent his med school years. It’s a partner hospital to the school, and part of the new Nebraska Medicine system that formed a few years back, and Robby matched into their Emergency Medicine residency program right after he finished. Nebraska was not his first choice of state for schooling, but with medical school applications, you take what you can get when you can get it, and it was one of the cheaper programs with the added bonus of ease of transition in residency. Instead of panicking about matching into a random program across the states and moving with zero money in his account and crippling debt, this let him stay and get straight to work.
And while not making quite the amount of money as a fully-fledged doctor, his bank account has much more of a cushion than when he was a half-starved medical student, having sleep for dinner.
Robby doesn’t mind Nebraska. Not really. It was an adjustment at first; Nebraskians lived up to the common term of ‘Nebraska Nice and the general approachability of them was a bit off-putting, but there was a nice Jewish population that brought him a bit of comfort when he first showed up. Robby doesn’t consider himself active in the religion, grappling often with his belief in God, but the vestiges of familiarity in a new home offered a semblance of security. The Star of David still remains around his neck and the touch of prayer on his tongue.
Footsteps sound in the background, soft and padded, and Robby pulls another manila folder from the stack at the nurses' station. It lands in front of Robby with a muted thump, and he licks his fingers to start swiping through the pages of records with a lazy gaze. A full workup of CT scans, ultrasounds, and bloodwork for a man complaining of severe abdominal pain in the lower left quadrant. He sits in Room 14 with an IV drip of morphine and an allergy to penicillin listed, and the resident starts to glance over the unremarkable results.
A shadow falls over his paper, and a quiet voice cuts through the mindless drabble of the ER.
“Excuse me?”
Biting back a sigh, Robby looks up as he fights a kind, professional look on his face, ready to come face to face with the mother from Room 8 or another anxious patient waiting on a doctor, but any sort of polished script dies on his throat when he takes in who stands before him.
Not the frantic parent from Room 8, nor her friend. Not another checked-in patient or someone with a visitor's sticker slapped to their chest. Instead, a woman stands, looking pale with flushed cheeks, shaky, hair sticking to her face with a thick sheen of sweat that contrasts with the typical chilled air outside of Nebraska in November. Hollow eyes hung in a gaunt face blink at him, a hood pulled over her face as if to block it from anyone who might be around them.
She breathes like she’s just run a marathon, chest heaving underneath the baggy jacket she wears, puffed into ragged gasps that curl slightly with the chill she still carries from being outside. There is a smell of something in the air, thick and palpable even through the wash of antiseptic, but Robby can’t quite pin it down other than being strongly metallic and slightly musky. But even after Robby looks at her, takes in the fragile state she’s in, that’s not what makes shock seize his heart.
No, it's the baby clutched to her chest, wrapped in something patched and cooing softly.
Robby blinks.
“Doctor?”
“Ma’am,” Robby gets out, pushing himself to his feet as he shakes back the shock as her pitched voice. Already, his mind starts to run through every possible scenario and the subsequent path to follow. His first concern is the mother, and though she shows no signs of blood or fluids, the shakiness of her body and overall twitchiness make him worry. She resembles those he’s seen when assisting in births, that tremble to the frame and the still swollen belly that suggests the body has just suffered something traumatic.
Domestic abuse? Failed homebirth? Too old to be a teen, maybe homeless, maybe…
“Are you-”
He’s cut off as the woman darts forward, and before he can think, that little bundle of baby and blanket is shoved into his arms. The weight is warm and heavy, and Robby gapes like a fish out of water as he frantically readjusts his arms to support the infant's head. The baby gives a whine, but settles at once.
“I can’t keep him,” the woman says, hands working to tuck the blanket around her baby as Robby cradles him, and her palm lands on his forearm. Her fingers are cold, too cold, and he can feel her skin ripple as she looks up at him with glassy eyes. “Please take him. I chose you because you look kind.”
“Ma’am, wait,” Robby tries again, taking a stumbling step forward as the woman steps back. The infant squirms in his arms, letting out another sound, of distress, annoyance, he can’t quite tell, and his eyes dart frantically back to the baby before going back to the woman.
She’s already a few feet away from him, feet turned towards the triage doors. Robby reaches out to grab her, to try and pull her back to safety.
Postpartum Hemorrhage, she could have vaginal tearing, his mind starts to spin, cycling through all the postpartum complications he saw during his OB-GYN rotations. The pallor of her face and the smell of iron only add to that fear. A pulmonary embolism could explain the shortness of breath, and…
“Let us check you out, let us-”
“No, please,” the woman resists, pushing his hand away as she trembles on unsteady legs, curling in on herself like a wounded dog. Her voice cracks at the end as words come out in a rush. “Please just take him, I can’t keep him. I came all this way, I have too many, my husband, he won’t….”
She cuts herself off with a ragged breath before giving a sharp shake of her head.
“I can’t have another. I just can’t. I’m okay, just take care of him.”
Robby feels his heart rate start to kick up as she insists, and he balks at her words. The resident can’t just take him. He can’t just let her leave. Nebraska hasn’t enacted the newly founded Baby Moses Laws that just made history down in Texas, the hospitals providing Safe Haven zones as fire stations and medical centers for babies under 60 days. In Texas, she could remain anonymous and safe from the law, but here, leaving puts her at risk of prosecution for child abandonment. Robby can’t take her baby.
But his concern isn’t the law. His concern is the mother in front of him, still smelling of afterbirth, with the eyes of a hunted deer. Her words of traveling all the way here, the lack of local alerts from the nearby hospitals about a missing patient, the anonymity she tries to hold with that hoodie, all paints to a woman giving birth alone in a room, and there could be all manner of complications with a situation like that.
Robby can’t leave her unchecked. He wants to help her. The mother is trying to help her baby, and all Robby wants to do is put her in a hospital bed and make sure she’s safe, give her a pamphlet of resources or counseling or something to keep from disappearing. The baby wiggles, kicking his tiny legs against his arm in the makeshift swaddle.
“Just let me help you,” Robby repeats uselessly. It’s a weak attempt to get her to stay, and the mother is already one foot out the door. He’s well within his rights to call security and force her to stay, but her helpless words rattle about his mind.
My husband won’t let me.
I came all this way.
I have too many.
Please take care of him.
Her eyes meet his, desperate and broken and watery in a way that makes his gut clench, and Robby can see the exhaustion. The pain. The utter hopelessness of it all. Her shaking hands as she pulls away entirely, the anguish that overlays her voice as she gives a final glance to her baby.
“His name is Dennis,” she whispers to him, and Robby finds himself nodding as his heart races, shoes rooted to the ground. “Just keep his name for me. Please keep him safe.”
With that, before he can try and reach for her again, the woman is gone, limping back into the controlled chaos that exists beyond the triage doors and in the waiting room of Riverstone Medical Center.
Jesus Christ.
Robby lets out a shaky exhale, mind still swirling with convoluted thoughts as they dance between right and wrong, choice and consequence, the oath he took upon graduation. The legality and morality of the decision he holds, the power he has as the easy day morphs into sudden complexity.
Fuck, fuck, fuck--
The baby squeals in his arms, and finally, Robby jerks his head down to get a real look at the infant.
At Dennis.
Despite the turmoil running rampant in his head, the resident finds time slowing down for just a moment.
Robby’s first thought is that the baby is scrunchy. A little scrunched nose, scrunched hands, closed eyes, a tiny bottom lip sticking out between chubby cheeks. Robby has never thought newborns cute, wrinkled faces that only a mother could love hyped up on oxytocin until they start to resemble something vaguely human after a few months, and while physically, Dennis seems is no exception, Robby can’t help but think that this crinkled little baby is just a little endearing. Ever so slightly adorable with those pudgy cheeks and long eyelashes.
Dennis is still covered in vernix, lathered between the folds of his skin, mottled with pinks and reds, and he has that typical newborn scent that can’t be described. Bits of light, wispy hair are damned and flattened to his head, a soft blondish white in color. He’s all wrapped up in an old, ratty blanket with faded swirls of color, with holes and patches and discolored fabric, bunching out as Dennis tries to kick his legs again. Tiny fitness peek out of the blanket, reaching up and out.
He really is just a few hours old.
Then, the baby makes a little whining sound, mouth opened in a wide yawn, and his eyes flutter open as he blinks blearily at Robby with brilliant blue irises.
The very sight of it makes his heart stutter in his chest.
Dennis seems to regard him with something scrutinizing, if its possible for an infant to make such an expression. He blinks at Robby with those long eyelashes, one little hand thumping against his chest as tiny fingers reach for his beard. They curl into the bits of hair on Robby’s chin, and a soft grumble garbles from Dennis' throat as he tugs with that telltale baby strength. It stings, and Robby grunts, trying to turn his head away, but those little fingers seem determined to yank at him. Dennis coos with seeming delight as Robby winces.
Instead of lifting a hand to detangle tugging fingers from his beard, Robby finds himself drawing a finger across his chubby cheek. Dennis is warm, skin soft to the touch, which is good; newborns lose heat fast, especially with weather like today and not knowing how long his mother traveled with him to the hospital. The warmth that radiates from the infant, like a little sun curled to his chest, is just a testament to the care his mother swaddled him with. There are no injuries on the babe, no blood or bruises.
Dennis coos as Robby’s finger brushes his cheek, head turning to gnaw at the end of his finger as he remains holding tight to the resident’s facial hair.
Good rooting reflex, is all Robby thinks with a chuckle, despite it all, and he adjusts his hold on the baby to hold him closer to his face to lessen the tension on his beard
“Hi Dennis,” he murmurs softly to the newborn, rubbing his cheek with soft sweeps, and the baby nuzzles into his fingers as he looks up at Robby with those big blue eyes. “It’s good to meet you.”
Dennis blows a raspberry at him in response, smacking his lips together. Robby’s eyes crinkle at the edges as his face splits into a smile.
Robby thinks he could stare at his little scrunchy face all day. Nevermind other newborns, sticky and wrinkled and crying, this one, Dennis, is different. The longer Robby takes in every little feature, every wrinkle of his nose or tiny gurgle, the way his fingers find their place on his face, the resident thinks he might be the cutest thing in the entire world. The cutest thing wrapped up in a ratty blanket, determined to yank the hair from his face.
The quiet moment does not last.
Despite the brief moment of solace the resident has found with the newborn, he’s still standing in an ER, and a shrill sound from another room and the patter of footsteps interrupts them. Dennis whimpers at the sound, sucking in a deep breath as if he might start wailing, and panic flares hot in Robby’s belly. He tries to soothe him, tucking him closer to his chest, tiny ear over his heart as he forces himself back to reality and the task at hand. He knows somewhere, in the haze that is his mind, that the sound of a heartbeat can ease a baby.
Now, he needs Dr. Knight. He needs his attending. While Robby is a second-year resident and can hold his own with numerous things, a fully fledged doctor in his own right, a situation like this needs his attendings full observation and supervision. They need to get Dennis charted, start an exam, notify social work and law enforcement, and start the procedure for an informal infant surrender.
A pretty term for child abandonment. The mere term makes Robby’s throat tight, and his stomach twists uncomfortably as Dennis fusses in his arms, snuggling into his chest. The image of his mother, such a fleeting interaction but forever cemented in his mind, flashes briefly.
Sick, scared, exhausted. Trembled and broken and very much alone. The idea of child abandonment is simply not conducive to what had taken place, with what action she had taken. The tears in her eyes and the raggedness of her voice was palpable as she pushed her baby into Robby’s arms, a stranger, and stumbled away.
You look kind.
Damn Nebraska from the lack of Baby Moses Laws.
“Dr.Knight!”
As he shouts, Robby brings a hand to cup Dennis’ head on instinct to muffle the sound of his voice, trying to keep the fussy babe calm. He ignores the confused looks from the other nurses or patients loitering in the corners, head on a swivel as he looks every which way for wherever his attending might have slipped off too. Or his charge nurse.
“Dr. Knight!”
“Jesus Robinavitch, what?” He hears her snap from the left, and the resident whips his head around to see her crown of hair poking out of a patient's room. A clipboard is clutched to her chest, expression strewn up in a combination of irritation and bafflement as she looks him over. It makes sense. Robby isn’t one to shout.
When her gaze lands on Dennis, he feels an odd tug in his chest that makes him want to curl his body around the baby like a shield.
“I have a baby,” he says dumbly.
The door to the patient's room shuts with a pointed click, a bit too harsh as Dr. Knight approaches him. “Yeah, I can see that,” she grumbles at him, scrubbing a hand over her face. “Why the hell do you have a baby? Where’s the mom?”
Robby swallows, avoiding her gaze. “Gone.”
“What do you mean, gone?” his attending snaps. Dennis lets out another whimper at the rise in tone, and Robby fights the sudden urge to scowl at her. He’s never had a desire to get pissy with his attending, and the protectiveness that curls in his chest confuses him. “You just let her leave?”
“She handed him to me,” and he keeps the explanation vague. He doesn’t want to get the mother in trouble. This is already a murky area, and while leaving a baby in a hospital is illegal in the state of Nebraska, the chances of tracking the mother down are slim to none if Robby stays quiet. If he acts like he didn’t see her face, didn’t converse with her, see what she was wearing or that she said she traveled a ‘long way’, the mother is likely in the clear.
Unless, of course, she ends up dead or hospitalized from some untreated postpartum complication.
“Said she couldn’t keep him.”
Instead of more grousing, Dr. Knight actually pauses at that. Her expression goes from annoyed to something contemplative, eyes narrowed. Her lip worries between her teeth as her steely eyes flit from Robby to the baby cradled in his arms.
“Did you get a good look at Mom?”
“No,” Robby lies at once. The image of her will always be burned into his memory, but that is not information he will reveal to anyone. Not CPS, not Social Work, not his attending. “She left right after she handed me the baby.”
Dr.Knight stares at him. Robby feels like squirming, fighting to keep his expression neutral so Dr. Knight doesn’t catch him in his little lie.
Then she gives a curt nod.
“Good,” his attending says resolutely. Robby is sure she can see the utter shock on her face, though she doesn’t comment on it beyond a snap of her fingers. “When CPS and the cops ask, we didn’t see her. Gone before we could get a single word from her.”
Robby feels his shoulders sag in relief as he nods in agreement, his protective grip on Dennis loosening as Dr. Knight turns away. “Nielsen!” She calls, waving her hand as a head pops up from the nurses' station. “Come help Robinavitch with a Baby Doe! And Robinavitch,” she adds as Nielsen heads their way. “That baby is your responsibility now. See to it that he’s safe.”
With that, she stalks away, and Robby glances back at the baby in his arms, who has settled enough to have sleepy eyes and even breaths.
Little Dennis.
His responsibility.
Who still hasn’t let go of his beard.
Nielsen replaces Dr. Knight’s looming presence. His charge nurse, who’s been in the field since Robby was toddling around in diapers. Still, he’s a friendly man with a thick, thick Nebraskan accent that makes him both charming and hard to understand when he rambles out orders when the ER gets a bit intense. He runs a tight ship, and Robby has seen him lie on the floor with pediatric patients to ease a tongue depressor between their teeth, tackle a man to stab a needle in his thigh, and bleed all over the nurses' station after taking a punch to the nose. With wild hair and a frazzled persona, Nielsen has the demeanor of a man who’s been dealing with the public and healthcare system for far too long.
The charge nurse doesn’t look the least bit flustered as he glances over Robby as he holds Dennis in his arms, and his face just splits into a blinding grin with crinkled eyes, giving his cheek a poke.
“Well look at you, with your little bundle of joy there,” Nielsen drawls oh so fondly, though Robby feels his body stiffen as the nurse coos. Dennis himself does not seem happy with the attention, lib wobbling and yanking more harshly at Robby’s beard. Nielsen chuckles, looking back up at Robby. “Room 12 is open for you. Got the warmer bed already in there.”
Nielsen pulls away from Dennis, Robby’s muscles unspooling as the baby settles, following Nielsen towards Room 12. He uses his heel to carefully shut the door behind him to avoid any loud clicks that might upset the infant.
The infant warmer is set up in the corner. One of two in the ER, rolled over from the PEDS floor when OBG-YN doesn’t get down fast enough for the numerous emergency births that happen in the ER. The regular hospital bed lies in the middle of the room with fresh sheets, and Nielsen scrounges around the cabinets, humming thoughtlessly to himself as he starts to pull out supplies.
“I’ll get a chart started,” he muses aloud, tossing a clipboard with empty paper on the bed. “Physical exam, weight, jaundice assessment, heel stick…did you page PEDS or NICU?”
“Not yet.” Robby watches as Nielsen pulls out supplies, blankets and a lancet, a thermometer and pulse ox, alongside a plethora of other things that seem like far too much for such a tiny baby.
“Go ahead and page NICU just in case. Have ‘em on standby.” He tucks a mattress cover over the thin pad in the warmer before clicking the machine on. It comes alive with a hum. “PEDS and Social Work can wait a minute. Morrow’s probably pretty busy anyway.”
Morrow. Robby rolls his eyes at the mention of the oncall social worker that floats between the ER and the PEDS floor. He’s never quite sure how to feel about the woman, not with her brusque attitude, kind but quick to the point. While Dr. Knight is snippy and temperamental, Morrow seems almost bored with her line of work, yet she’s detailed and talented. It doesn’t matter now.
With the infant warmer set up and Nielsen prepping Dennis’ chart for a full exam, Robby takes to unwrapping the baby from his tattered blanket. More mottled skin appears, still white with vernix, reinforcing the notion that the babe is only hours old, little toes half purple in that typical newborn fashion. Dennis' cord has been clipped a bit too close to the skin, likely with shoelaces and a pair of scissors, a bloody stump with flakes peeling off his stomach. Overall, though, he seems quite healthy, and he gives a big stretch as his limbs are freed from the swaddle, a heavy yawn leaving him. Robby gets little fingers detangled from his beard and lowers him into the warmer.
Dennis’ seemingly calm facade of sleepiness breaks, and the moment Robby’s arms leave him, the baby lets out a high-pitched wail, flailing his arms and legs as he starts to cry.
“Well, that’s a good strong cry!” Nielsen says cheerily. Robby winces at the ear-splitting shriek, something primal uncurling in his chest as Dennis starts to blubber, like it goes against his very core to let the baby sob, but Nielsen grabs his wrist with a fond laugh as the resident’s arms dart back in to pick up the baby.
“Ope, hold on,” the nurse adds with a shake of his head, handing Robby Dennis’ chart with the words BABY BOY DOE scribbled across the top. “You can hold the little guy in a minute here. Let's do the exam, and then you can feed him and give him a wash.”
Nielsen doesn’t give him a chance to respond before his hands are on Dennis, smoothing over his skin and thrashing limbs with a gentle touch. Robby pulls a pen from his scrub pocket to jot down whatever stats the charge nurse might give him as he starts his physical examination of the baby.
It’s too late to do an Apgar Test, but they can still get an Infant Physical Examination and a scoring on the New Ballard Scale.
“Strong cry, good tone. Clear breath sounds bilaterally, fast and shallow. Strong heartbeat,” Nielsen reports over the wailing, placing the cold knob of the stethoscope over Dennis’ heaving chest. It only seems to upset him further, tears spilling down reddening cheeks in thick droves. He glances to the side of the warmer with squinted eyes. “Weight of eight pounds, seven ounces.”
“Big baby,” Robby adds over the crying as he writes. He tries to keep the edge of restlessness from his tone as Dennis continues to sob, the urge to snap at Nielsen to hurry up as he keeps poking at the baby. It can’t be good to just let a baby be so distressed, right? “Any abnormalities?”
Nielsen doesn’t respond for a moment as he starts to check Dennis’ neuromuscular and physical maturity. Checking his ears, for languo, the creases of his foot and eyes and ears. The charge nurse seems happy with that, giving Robby a number to write down, before moving on to check his muscle tone and flexation. Robby himself thinks that Dennis is probably fine with all the flailing he’s doing, but says nothing as Nielsen goes through the checks.
Flexing his wrists to check for square window, drawing his arms across his chest to check the scarf sign, arm recoil and popliteal angle with flexations of the forearm and knees. Robby holds his breath as Nielsen measures Dennis’ hip flexibility by carefully rolling the joint in the socket and bringing his heel up to his ear. The nurse gives another number, Robby calculates and reports back.
Finally, the charge nurse shakes his head and lets Dennis rest.
“No abnormalities. Cord’s cut a little close, but skin’s warm and good color. Definitely full-term by NBS. At least six hours old. Need a glucose to check for sure, but I’d say this is a real healthy babe.”
While relieved at the report, Dennis himself does not seem healthy with his score, and his crying just seems to increase in volume the longer he lies in the warmer. Robby finally gives into the urge to comfort, if only to save his ears, he tells himself, by offering a finger for the baby to hold.
Dennis hiccups, face blotchy with tear tracks, nose snotty, and though he doesn’t stop crying, he does quiet a little when those strong little fingers wrap around Robby’s larger one, looking up at him with the most devastated expression.
Though Robby knows that logically, babies cannot express clear emotions like anger or fear until around four months of age, or even show preferences for people until nine, he still feels like that chubby face is glaring at him with pure indignation that Nielsen was allowed examine him.
How dare you, he seems to say with those watery blue eyes. How dare you let him manhandle me like that?
Robby tries to give an apologetic smile.
“Just a bit longer,” he finds himself reassuring the baby, rubbing the pad of his thumb over those little fingers.
“Oh, he likes you,” Nielsen croons from the edge of the warmer, holding Dennis’ foot in between his fingers as he presses a lancet to the heel. Dennis whimpers as his heel is poked, a small dribble of blood bleeding into the tube, and Nielsen soothes it with a rub. Dennis’ toes flare in a clear sign of a healthy Babinski reflex.
Robby scoffs at that. “I think he’s unhappy.”
“Yeah, he wants you to hold him. He was pretty content being cuddled up in your arms there,” the charge nurse continues to tease. Robby feels his cheeks flush with heat, and he shoots the man a glare as Nielsen wraps a pulse ox around Dennis’ foot to get a heartbeat and oxygen saturation. “Weren’t you, Baby Doe?”
“Do we need to check for bilirubin?” The resident tries to deflect, jotting down the stats as they flash on the pulse ox. 170 bpm, a little high, but likely because he’s crying, SpO2 levels of 98%. All good levels for a newborn. Thank god.
Nielsen shakes his head. “Jaundice likely would’ve popped up by now. If his skin gets yellow, we’ll check, but I think he’s just fine. All I think this little guy needs is a good wash and a bottle. Hungry, ‘little guy?”
Dennis blubbers in response. His grip tightens on Robby’s finger, and without thinking, Robby gives his fist a gentle squeeze back, as if to say, I’m here.
“Alright, I’m gonna send for some diapers and a bottle, and switch your girl with the broken wrist to Dr. Thornock. Baby Doe’s all yours until PEDS ‘n CPS shows. I’ll page NICU and let ’em know we don’t need ‘em,” Nielsen says as he starts to clean up, tossing the used supplies in the hazards bin and trash can. His hand claps over Robby’s shoulder. “Give me a shout if you need me, Robby. Good luck.”
Nielsen exits then, as casually as he came, and Robby feels giddy that he’s finally able to turn his attention back to the screeching infant in the warmer. Once again, he can’t help but wonder how bad it is to let an infant cry for so long. Like Dennis’ tiny lungs are either going to give out, or he’s going to pass out with how much he’s wailing. His cortisol levels must be sky-high by now. Does he feel abandoned? Forgotten as they touched him but left him to cry? Robby feels sick at the thought.
“Alright Dennis, it’s okay,” Robby attempts to soothe awkwardly, reaching for one of the towels Nielsen left for him. The fabric is soft and damp with warm water, and the resident leans down to gently wipe at the dried blood on his belly. Already, the umbilical cord is starting to dry, and soon it will fall off. “Let me get you clean, and then we’ll get some formula in your belly, okay?”
Miraculously, for both his sanity and his ears, Dennis seems to listen as Robby looms over him and wipes him off. He’s not too focused on getting off all the vernix; it’s good for a baby’s skin, but just enough to get all the superficial stuff off to keep the baby more comfortable. While he doesn’t stop in his sobbing, the cries diminish to hitched breaths and soft whines instead of the full-on bawling that filled the room just moments ago. Robby finds himself chuckling as Dennis fights his nose and eyes being wiped, trying to push away the fabric with clenched fingers.
Though Dennis is warm and under a lamp, Robby doesn’t want to risk dropping his temperature with a full bath. He focuses on cleaning the gunk clinging to his nose to keep his airways clean and patting dry the little wisps of blondish hair that stick from his scalp. The ends curl slightly as they start to dry, and Robby wonders, briefly, if he’ll have curly hair when he starts to grow. Will Dennis have blond hair, or will it darken to brown? Somewhere in between? Will his eyes stay this brilliant newborn blue, or fade to green, brown, or hazel?
Robby tries to shake the thoughts from his mind as he moves to carefully clean Dennis’ blotchy cheeks of tears. There is no need to dwell on what Dennis might become. Once the hospital deems the baby fit and healthy, and his bloodwork comes back clean, he’ll move to the pediatric floor before CPS places him in some foster home. A lackluster investigation will be done to attempt to find his mother, and as long as she doesn’t end up in the hospital with any sort of complication, itll be a dead end.
And then Robby will never see the baby again.
His mother asked to keep his name. Robby wonders if he can when he finally hands him off to the state.
Another nurse, not Nielsen, but a student, Robby can tell by the ID tag on her waist that reads Nursing Student drops by with another blanket, a handful of diapers and wipes, a bottle, and an ID bracelet with the name BABY BOY DOE printed across in bold on flimsy plastic. The bracelet is too wide to wrap around a wrist, so Robby fastens it to his ankle. A serial number that matches the one on his chart is written across the bottom, alongside today's date for Dennis’ suspected birthday.
November 12, 1999.
A little winter baby.
“Happy Birthday, Dennis,” Robby murmurs to him.
Dennis gives a hiccuped coo, hand reaching out for him.
The baby fusses as Robby tries to get a diaper on him, not quite crying but squirming and hiccuping like it's the worst thing in the world. Robby finds himself tossing the first and redoing it at least twice when he misplaces the sticky fastenings as Dennis kicks his legs, not wanting to make it too tight against delicate skin, nor loose enough to slip off him when he picks the boy up. Robby wants to find it frustrating, but all he can really think as he wrestles the diaper on is that Dennis has strong little legs and solid hip stability.
He finds himself thinking about Dennis mother as he takes care of her son. His mother, who, by state law, could be charged with child abandonment or neglect. But Dennis is not neglected. He arrived at the hospital swaddled carefully in an old blanket that was clearly loved with all its stitches and patches, warm to the touch and in great health. A nelgcted infant doesn’t sleep soundly in an ER while being held. An abandoned child isn’t handed off by a mother in tears and begging for help and his name to be kept.
You look kind. She had said. I am giving him to you because you look kind.
Robby hopes she’s okay. That wherever she is from, whatever drove her to this, however her family or husband might be, that she will be okay. That her body will recover from giving birth in a room alone with zero help or love, and she will forgive herself for what she had to do.
Dennis whimpers again as Robby tries to get a hat over his wiggling head, pushing at his arm with clawed hands, and Robby accidentally pushes it past his eyes. The resident has to resist the urge to laugh as the baby wrinkles up his face and stops crying for a moment in utter shock.
“Sorry, little guy,” Robby rumbles apologetically as he fixes the hat, revealing those blotchy cheeks and lashes dripping with tears. Dennis looks so very sad, and it makes an amuse,d yet aching feeling twist in his chest. “You’re making this real hard on me with all that wriggling, y’know.”
Dennis simply sniffs at that, hand grasping at the air like he’s trying to grasp at Robby’s beard again, a whine bubbling up between hitched breaths.
“Hold on now. You can yank at me in a second.”
With a gentle squeeze to those reaching fingers, Robby attempts to wrap Dennis up in that typical blue and pink striped flannel all infants are swaddled in in the hospital. Not many infants come through the ER, but Robby grew familiar with these exact blankets during his OBG-YN rotation during med school. Arguably his worst rotation with abrasive, cruel attendings and snobby residents (who knew that the baby rotation would have such assholes?), but he assisted in his fair share of delivered and subsequent swaddles of squalling newborns. Part of Robby wants to wrap Dennis back up in the blanket his mother brought him in, still discarded on the hospital bed, but the fabric is sticky and wet and won’t keep him warm for long.
I’ll get it cleaned, he thinks as he tucks Dennis’ limbs into the blanket, though the baby fights like hell to keep his arms free. And make sure it goes with him.
The sound of Dennis’ wailing during his examination had faded to background noise after a few moments of it, Robby has long since learned to block out unnecessary sounds to keep himself sane during his shifts, but the sudden dip into silence the moment Robby scoops Dennis back up into his arms is noticeable. The moment Robby pulls him from the warmer and rests his head in the crook of his elbow, tucked to his chest, his crying ceases at once. The fussing stops, eyes going half lidded as he nuzzles his head into Robby’s scrub top.
It’s a bit shocking, the sudden shift from wailing to contentment, crying so hard Robby was worried his throat would bleed to nearly napping in his arms. It makes the resident pause for a moment as he settles himself into the rickety chair by the hospital bed. Maybe Nielsen was right. Maybe Dennis does like him, and all the baby needed was to be held.
Pediatric guidelines are simply guidelines, after all. Maybe Dennis is the exception to the ‘not showing a preference until nine months old’ rule.
Robby can’t help but plant a little kiss on his head, right where the hat meets skin, before his brain screams at him that he’s going to give the baby RSV, but the quiet satisfaction coo that comes from Dennis makes Robby feel like his heart is going to burst.
“Hungry, Dennis?” Robby whispers as he repeats Nielsen’s early words. He keeps the baby’s name quiet, trying to keep the knowledge of it to himself, like it's something special between the two of them. He grabs the bottle, warm to the touch, and brings it to the baby’s lips. Dennis latches onto it like a dog with a bone.
Once again, that small hand comes up to curl into Robby’s beard as Dennis starts to drink. Robby doesn’t have the heart to push it away as the baby’s eyes go half lidded, making little suckling sounds.
The outside world fades to nothing as Robby watches the baby eat. He’s never noticed how many sounds newborns seem to make until now. His general assumption was that they cried or closed until they started babbling a few months later, but Dennis has made a variety of little noises since he was placed in his arms. Coos, whines, huffs, little grumbles of irritation when Robby tried to adjust him in his arms or untangle those fingers from his beard. Small squeals and chirps when breathing, and now these happy muffled suckles as he eats. Who knew babies were such noisy creatures outside of their distress?
Was this what it was like for his own mother, and then the grandmother who raised him? Did they feel like this when they held Robby in their arms? That powerful, instinctive warmth that rears like an animal caged in his ribs and that protective ember that flares with each little sniffle that comes from Dennis? Was that where his desire came to shield him when Dr. Knight raised her voice, or when Nielsen poked him as he wailed?
Robby has never thought himself a father, but for a moment, as Dennis grows sleepy and content with a belly full of formula and a hand holding his beard for comfort, a heavy warmth in his arms, he wonders if this is what it might feel like.
Too bad that’s not something he can have.
Not in the middle of his residency, where he might be packing up to move in a year and a half’s time and swamped with 80-hour weeks and far too little sleep. Not before, when any relationship he managed to have seemed to end because of issues that were entirely Robby’s own fault. Even now, what he tries to have is fleeting and superficial, pulling away the second it gets a bit too deep. He’s unable to open himself up to others in any intimate sense, any emotional sense, not in the way a child would need.
Fatherhood is certainly not something he can manage now, nor is it something he imagines in his future.
Robby is too burdened. Too busy. Too much baggage he can’t handle, repressive tendencies and avoidance tactics that make him the worst therapy client on the planet. Robby isn’t sure when his life started to spiral into a world of exhaustion, self-loathing, and the horrible habit of intellectualizing yet not feeling, but it's where he sits at the tender age of 28 years old.
Maybe it's when he matched into Emergency Medicine. Maybe it was when he started med school.
Maybe long before that.
Regardless, fatherhood is not something he can manage without fucking up some poor kid beyond belief, and not with a baby that was dropped off in the ER by a broken mother less than 30 minutes ago just because he feels an inkling of protectiveness. Dennis will be handed off to the state, placed with a foster home, and raised by a family desperate to love him.
It’s what's best for him, yet the mere thought of it sits heavy in his chest, clawing at his heart.