Work Text:
Frank has only been back at PTMC for two months when Javadi asks him for help with a patient who got hurt on the job.
After the chaos of his first day back, he feels as though he’s settling in again well. There’s still the occasional odd moment when someone references something that happened while he was away or the wary looks he gets from members of staff when he’s at the med dispenser for more than a second. But all in all, he can’t complain.
Well. He could complain and has in the past, but his sponsor likes to argue that it negates the point of making a gratitude list at the end of each day. Sometimes it’s annoying when he’s right.
He’s just getting off the phone with CT regarding his bowel obstruction patient in north three when Javadi walks over with a pinched look on her face.
“Lance Weis, thirty two year old male. He keeps saying that he fell at his construction site and hurt his ribs, but every time we try to examine him or reach for him, he backs away from us,” she tells him, tablet in hand. “Jesse’s in with him currently. Patient is satting at 98 percent on room air and his pulse is holding at 83, but his BP is elevated. 146 over 102.”
“Elevation could be a response to the pain. Fell how?”
“Faulty scaffolding, by his account. He keeps insisting he just needs a script for Percocet then he'll be fine.”
Ah. One of those cases.
The doors are shut as they approach central ten, but the curtain is pulled back enough to leave the patient visible. If this man truly works construction, he must have the cushiest gig of all time as far as Frank is convinced. There’s no sunburn scarring on his face or neck, no weathering of his skin from chronic exposure. His dirty, tattered tennis shoes have clearly seen better days, nowhere close to the steel toed boots a typical construction site would require for safety. His right hand is tucked in his tan jacket, but his left-hand laying on his thigh isn’t the least bit calloused or worn from repetitive use.
Elaborate but poorly thought-out stories from patients almost make Frank miss the days when he believed something like this.
Almost.
The familiar smell of hand sanitizer stings his nose as it dispenses into his palm, the door shutting behind him. “Hi, Mr. Weis, I’m Dr. Langdon. Dr. Javadi tells me you were hurt at work.”
Lance nods, exhaling stiffly through his nose. “I fell while I was on the scaffolding, landed on my side funny.”
Frank nods carefully, linking his fingers together. “What project is your team working on?”
“The new apartments over on West Brook.”
Frank knows those apartments; he passes them on his way to work each day. He keeps meaning to call and check if there’s anything available. That building was finished weeks ago.
“What floor were you on?”
“Huh?”
“The floor. How high up on the scaffolding were you when you fell?”
Lance’s mouth opens and shuts, shaking his head after a beat. “I wasn’t up on the scaffolding; I missed the last step coming down. My ribs caught the bar on the bottom.”
Frank spares a glance at Javadi over Lance’s shoulder, receiving a shrug. He’s not budging from his story, Frank will give him that.
“Understood. Let’s get you into a gown, and we can get X-ray in here to see what we’re working with.”
Lance sighs. “I’ve been here a while already; can’t you just give me the pills so I can head back to work?”
Frank feels like he just checked off the last number he needed on a bingo card. “Mr. Weis,” he says carefully, “Until we examine your chest and abdomen, I can't prescribe you anything, same goes for Dr. Javadi. We need to see the extent of the injury.”
“I already told you the extent of it; I fell and now my ribs are broken. Why do you need to look at them?” His voice is tight, pitched higher like each breath is costing him.
“The severity of the break is important,” Javadi interjects. “If it’s more than just a hairline, it could need surgery depending on if it’s a compound fracture or you could have a fragment puncture your lung, which would require immediate attention.”
“She’s right. Believe me, I wouldn’t be pushing this if it wasn’t vital to your recovery.”
Lance is undeterred, shifting on the edge of the bed and his eyes skirting between Frank and the door like he’s feeling backed into a corner.
Not knowing what else to do, Frank tries pulling out his old South Carolina charm. “You know what, it’s real warm in here today. How about we get you out of this jacket and get some ice on those ribs for now. Jesse, would you crack a new-”
Frank reaches for Lances left shoulder, hoping to get even a glance as to what might be going on under that thick jacket that’s too heavy for September. Lance lurches away from him suddenly with a loud wince. His right arm spasms suddenly where it’s been lamely guarding his ribs, and the silver handgun he had cradled in his side pocket comes clattering to the floor in front of all of them.
Time comes to a standstill. No one breathes or even says a word. Frank is closest to the door; he has the best chance at shouting for help, for figuring out how Ahmad can get his ass over here without drawing too much attention to the issue-
But Frank can’t even lock eyes on Javadi and Jesse in time before Lance Weis dives to pick up the gun with his left hand and clocks Frank over the head so hard that his world bursts into a portrait of shooting stars.
It feels like seconds have gone by when Frank groans and finds himself hunched against the crash cart in the corner. There’s a throbbing coming from his cheek bone radiating up to his right eye. A wet, sticky sensation is moving across the top of his head and down over his ear. Frank blinks rapidly, trying to clear the double vision in front of him, but it won’t go away.
On either side of the room, Jesse and Javadi look horrified when he finally focuses his eyes enough to look at them. He doesn’t understand it until he remembers why he was in here and realizes there’s a nine-millimeter pointed inches away from his face.
His mouth goes dry in a way that muscle relaxers could never compete with.
Frank pushes himself to sit up against the crash cart, the dust and dirt from the floor collecting on the palms of his hands as Lance Weis’ stocky frame looms over him. There’s a commotion outside the glass door. Or maybe that’s just the blood rushing in his ears. Frank grits his jaw, his head swinging to lock eyes on Jesse and Javadi who look equal shades of petrified. Jesse keeps his hands palm out in front of his chest, his eyes locked on the patient while Javadi stares at Frank like she regrets ever asking him for help.
He opens his mouth to reassure them, but Lance beats him to the punch, the barrel of the gun thumping against his forehead briefly.
“Don’t!” He shouts. “Don’t say shit to them!”
Frank holds his hands up, his knuckles brushing his shoulders. If he listens closely enough, he swears he can hear the chatter of radios coming from the hub alongside the rush of trying to get all the other patients out as quickly as possible.
Across the room, at Lance’s back, Javadi turns and opens a drawer with one trembling hand, pulling out a pocket of gauze and a roll of tape.
The disturbance doesn’t go unnoticed. Lance whirls to look at her but the gun never changes its lock on Frank. “What are you doing?”
Her face pales. “He has an open head wound. I need to treat him.”
“No. No one is getting treated here but me. You’re not touching him!”
“He’s bleeding, he needs-.”
“Just toss them to me, Victoria.”
Frank doesn’t think he’s ever called her that before and the shock shows on her face. Her eyes remain wide; with Lance not looking at him briefly, Frank takes his chance to mouth it’s okay at her before dropping his palms into his lap.
Javadi under hand tosses the items to him, the gauze landing on top of his legs while the tape catches the top of his arm and drops to the floor on his right. With Lance’s beady glare on him again, Frank rips the gauze open and pulls out half of the stack. Unable to see where the blood is coming from, Frank smacks the gauze where his head aches the most, three inches back from his temple, taping it down loosely.
A bead of sweat slides from Lance’s brow and down the side of his face. His right arm remains tucked against his side like that’s going to distract from the fact that he’s begun to wheeze audibly in the past few minutes. He narrows his eyes at Frank, his mouth curling into a scowl.
“Just get me the pills and this can be over.”
Frank shakes his head, the room tilting around him. “I can’t do that. Not until you’ve been examined. Even if I wanted to, all the drugs you claim to need are locked up out there. If I open that door, the room will be swarmed with people and this whole operation will be over in seconds. You’ll have gained nothing out of this.”
It’s not entirely true, his remark about the drugs; but Lance doesn’t know that. Frank wants to keep it that way.
All of them fly damn near a foot in the air when the phone behind Javadi rings, the shrill noise breaking the careful tension in the room.
Lance locks eyes on Javadi, shouting at her, “Answer it!”
Javadi flinches, her hand trembling as she clicks the accept button. “T-This is Dr. Javadi; you’re on speaker.”
“Mr. Weis my name is Dr. Baran Al-Hashimi, I’m an attending at this hospital. I need to know if anyone with you is injured.”
Lance only scowls at the phone, shouting. “I’m not talking to you!”
Javadi tries and fails to keep her voice steady. “Just the patient and Dr. Langdon are injured. He has a head wound and a probable orbital fracture. Mr. Weis hasn’t been examined yet.”
Oh. That explains why Frank can’t see for shit out of his right eye.
“Mr. Weis, we can help you, but I need you to let my staff come out of that room. No one else needs to get hurt today.”
“No, no one is leaving. Not until I get what I need!”
“We will get you the help you need, but-.”
“I’ll stay.” Frank says forcing himself to his feet. He’ll blame the decision on the head injury later. “Let the two of them leave, and I’ll help you.”
Jesse speaks up finally, disbelief in his eyes. “Dr. Langdon, you can’t-.”
“I can. I will. Dr. Al is right, no one else needs to get hurt today.” Frank locks eyes on Lance again, saying. “It’s me that he’s pissed off at anyway. No sense in keeping you two here.”
Lance weighs his options carefully, his gazing shifting between the phone and the door, then back to Frank. He lowers the gun briefly, turning his back to Frank just long enough to spit out, “Both of you, get out. Before I change my mind.”
Frank feels his palms begin to sweat as Jesse and Javadi shuffle cautiously towards the door, reaching for each other as they pass the stand-off happening between Frank and Lance. Neither of them looks back at Frank.
That’s probably for the best.
“Dr. Langdon, what do you need from me?” Dr. Al-Hashimi asks.
Frank does a quick scan around the room, his stomach churning from each change in movement. “A portable X-ray; I need to locate where the injury is. I already have pneumothorax and thoracentesis trays, and an intubation kit on standby. Is everyone else on staff accounted for?”
“Yes, the ED has been evacuated.”
“Good.” Frank says, his voice heavy. “Keep it that way.”
Without hesitating a second longer, Frank silences the phone, cutting off Al-Hashimi’s protest.
Frank takes a second to himself to breathe, turning back to Lance, the gun hovering closer to his chest now. “I meant what I said before. I need to examine you before I know what drugs I can give.”
“And if I don’t let you?” Lance spits.
“Then this will have been a waste of your time, and plenty of very sick people won’t have received the help they needed.”
Though he hardly looks ashamed by the remark, Lance concedes. There’s a knock on the glass door behind him, and Frank turns slowly to face Ahmad with the portable X-Ray machine. He keeps one hand face up towards Lance, the other one reaching to open the door. As soon as the machine is within Frank’s reach, he feels the barrel of the gun thump against his shoulder.
“Hurry up, shut the door.”
He yanks the machine inside as best he can, shifting it over to the right side of the bed and lining everything up. Lance sits back on the bed finally, a loud, rough cough coming out of him as he settles in.
“I need you to hold your breath during this part so I can get a clear picture.” As the exposure is finishing, Frank finds the bravado to ask, “How long have you been without the use of your right arm?”
“Excuse me?”
“You haven’t voluntarily moved it since I walked in here; I know a brachial plexus injury when I see one. How old were you when it occurred?”
Lance’s chest heaves, a bluish tint forming around his lips. “In college, football. I got… got caught at the bottom of a dog pile. Helmet came loose and my… my neck and shoulder were crushed.”
“And what? You thought holding up a hospital would be a good way to get the drugs you wanted? Was faking an injury really worth it?”
Lance shakes his head, breathing harder this time. “I didn’t fake shit. Insurance stopped covering my prescription for nerve pain a year ago. Dealer kicked my ass when I didn’t have the cash. It’s… it’s getting real hard to breathe.”
“I’m sure it is,” Langdon says, his eyes swimming as he tries to focus on the X-ray in front of him. “You’ve got two bone fragments pushing on your lung.”
“Wh-what the hell does that mean?”
“It’s collapsed. You’re not getting enough air.” The room around him rocks suddenly as he turns to grab the oxygen mask, grasping the nearest IV pole until everything around him stops spinning. Frank inhales forcefully through his nose and out of his mouth, desperately trying to pull himself together.
Lance’s grip on the gun goes loose while he struggles with each inhale, his eyes falling shut. “You’re not… not gonna let me die.”
“Oh, believe me, we didn’t come this far to only come this far.” Frank replies, fitting the mask over Lance’s nose and mouth then lays him flat in one fell swoop. He cranks the oxygen up to one hundred percent, hoping to buy himself some time. Turning back to the phone, he unmutes the device, asking warily, “Dr. Al, are you still there?”
“We’re here, Frank. How can I help?”
“I need you to put Dr. King on the phone.”
There’s a long pause. “Dr. Langdon, if it’s another doctor that you need, we can send someone in. You don’t have to-.”
“No, no one is coming in,” he forces it out, pain pulsing in his head as he tries to locate the shears to cut Lance’s shirt open. “I just need to talk to her, please.”
There’s another pause on the other end, the rustle of the phone being passed around. Quietly, a nervous voice comes across the line. “Frank?”
He allows himself a single second to sit in the relief of having someone he trusts with him, even from a distance. “Mel, listen to me. The patient is unconscious, but he has a pneumothorax resulting from flail chest; I need you to talk me through the procedure before he codes.”
“Wh- you’ve done them a thousand times, why would you-?”
“Because my vision is doubled; I can’t see straight.” He’s fairly certain that there’s blood dripping into his eye making it worse. He opts not to scare her by voicing that. “I need you to be my eyes. Talk to me like you’re teaching a med student who’s never dealt with a chest wound before.”
“Are you sure?”
“I asked for you, didn’t I?”
Frank pauses in his haste to line everything up, his cheek turned towards the phone. His heart races as silence follows, fearing he’s being left to his own devices, but then-
“Okay… okay, we can do this,” Mel says. The swarm of noise around her dulls, her voice coming in clearer. “Do you have the tray ready?”
“Yes, patient is prepped.” Frank flexes his hands once to keep them from trembling. “He’s on high flow O2, satting at ninety-one. Pressure is at 136 over 97, pulse at 72 and falling.”
“Alright, you need to locate the second intercostal space between his second and third ribs; count down from his collar bone applying pressure if you need.”
Franks vision doubles again as he stares at the expanse of skin over Lance’s sternum, feeling carefully with deft fingers to locate the right bone. “Alright, I’ve got it!”
“Identify the mid clavicular line. The intersection of the two spaces is where you’ll aspirate. First, you need to administer the lidocaine.”
“Right, right, okay,” Frank reaches for his needle, tossing the cap blindly into the room. “Now for the catheter?”
“Yes, you’ve got it. Make sure to connect the tubing so no other air gets into the pleural space, then draw the excess air out using the large syringe.”
His hand smacks heavily against the tray, fumbling for the syringe to connect it to the port. Frank shakes his head once, trying and failing to compete with the spinning sensation consuming him. It’s growing hard to focus on the procedure and staying upright at the same time.
He doesn’t realize he’s been quite for too long until Mel’s gentle reaches his ears again. “Frank? Are you alright?”
That feels like a loaded question right about now. Even so, Frank licks his lips once, squaring his shoulders as much as he can manage. “I’ve got it. Aspirating now.”
As he draws the air out of the cavity, Frank watches with bated breath as Lance’s chest reinflates and his oxygen levels slowly tick back up where they belong.
There’s no time for being relieved. Frank doesn’t think twice about shedding his gloves, quickly turning back to the phone and speaking clearly into the receiver. “It’s done. He has two bone fragments pushing on his right lung, he needs to be in surgery an hour ago. Get him out of here.”
On instinct, Frank’s hands go in the air again the second that the door opens, standing still as stone while multiple officers coming in to secure the scene. The surgery team comes in hot on their tails to whisk Lance away, shouting orders as they leave. The second that the doors are shut, leaving him alone in the room for the first time in what feels like a decade, Frank feels his whole-body shutter as it catches up to no longer being in immediate danger.
A strange sigh leaves his chest, his eyes drooping shut in exhaustion. The top of his head and cheekbone throb in time with the overactive beating of his heart. Frank leans back on his heels, tipping his head towards the sky subconsciously, and finds that he can’t fight back when his knees quit altogether, sending him cascading towards the floor in seconds.
He barely notices when he hits the ground, a dull ache spreading down the left side of his body. Frank makes no effort to move; the will power escapes him. Sound rushes in again suddenly as the doors open behind him and someone is on him immediately. Warm hands grasp his neck and shoulders, rolling him carefully onto his back.
“Frank?” Knuckles drag roughly across his breastbone. “C’mon, kid, open your eyes. I need you to look at me.”
It can’t be true, Frank tells himself. He wouldn’t be here, he’s still…
Frank forces his eyes open, met instantly with the blurred figure of Robby hovering over him, looking as worried as he’s ever seen the man. Or at least, Frank thinks he’s worried. It’s hard to focus with the way it feels like he’s been tossed in with the dryer cycle.
“R’bby?” Frank tries reaching for him, his arms barely making it off the ground. His voice fails him, no sound coming out no matter how much he works his jaw. It strikes him distantly that Robby is in his civies; a loose black jacket and jeans, a faded t-shirt beneath them. How far away was he when he heard about the hostage situation?
Did he come knowing that Frank was at the heart of it or in spite?
Robby holds Frank’s head precariously still, saying, “It’s alright now, Frank. We’ve got you. Just hang on for me, alright? You hear me, huh? Frank?”
He means to answer Robby, he really does. In a matter of seconds, consciousness is throwing Frank into that familiar dark pit once again, uncaring of the shouting of his name surrounding him on his way out.
He tells himself it’s just the adrenaline leaving him. As if that makes any of this less frightening in the slightest.
Frank only gets a few minutes of peace before people are shining a light in his eyes and moving him every which way while they yell across him.
He can’t tell what room he’s been moved into. Everything is still spinning too much to tell. Someone slides a pulse ox over his finger. It’s growing unbearably loud in the tight space, so many of the voices are impossible to make out except for Robby saying:
“Somebody page CT. Do we have pain meds on board?”
Frank’s eyes spring open fully for the first time in ages. The way his heart begins racing in fear doesn’t go unnoticed by the monitors or any of the doctors standing over him. He rips his arms away from the poor nurse trying to stick his IV, yanking close every body part as much as he can manage.
“Don’t,” he struggles, trying desperately to project his voice. “Don’t administer anything, I don’t want any narcotics. I don’t need them.”
Robby’s hand plants in the middle of Frank’s chest as he tries to get up. “Frank, you have an orbital rim fracture. I can’t in good conscience leave you in pain like this.”
“I don’t care. I don’t want them, they’re not… I can’t do it.”
He doesn’t have the right words to say that it’s not the meds that he’s wary of; it’s finding out if he’s strong enough to start over again when things go sideways. Frank is days shy of his first year, he’s not ready to surrender, not like this. Not when he spent so long thinking he would never get here in the first place.
A whine works it’s way to the surface, barely audible over the sound of Dr. McKay to his left, saying:
“Can’t we at least give him the option to try a less aggressive option before forcing narcotics? He could respond well with an alternate.”
In this moment, Frank has never loved her more. He doesn’t doubt that she knows where he’s coming from. Cassie has been honest with him about her own struggles since he came back, she even recommended a few meetings for him to check out. It’s been such a relief to have someone in his corner who understands what he’s been dealing with, someone who has ached in the same shades as him.
“Please, Robby. Don’t make me.” Frank begs. “Please.”
Though the wariness shows on his face, Robby shakes his head once and laments, “Plain acetaminophen, as much as his kidneys will tolerate. Re-evaluate in two hours.”
Frank sighs in relief, his shoulders relaxing into the bed again. His head lolls, watching as Robby moves towards the door, shedding his gloves in a rush. Frank forces his head off the mattress once more, working around a heavy tongue as he forces out: “Thank you.”
Robby stops in the doorway, his stance tight. He never turns to look at Frank; only hovers, and carries on like nothing was said. Like this is just another day for them in the ED.
Frank doesn’t mind. He knows Robby understood what he meant.
The pain isn’t so much worse later as much as it is unrelenting.
Frank can’t find a position to lay in that doesn’t make something ache. His cheek throbs each time he tries to open his eyes or look around the room. Despite his best efforts to stare at one spot on the wall as much as possible, the dizziness and residual nausea refuses to subside for even a minute.
Mel staples the top of his head shut, pausing between the shot of lidocaine before beginning to let him breathe out heavily out through his mouth and grit his teeth through the discomfort. She takes a wet cloth to the side of his neck, wiping up the trail lines of blood he didn’t realize were there. As soon as she’s done, the gloves are gone and Mel’s cool hands are resting on his shoulder through his scrubs.
“Are you sure I can’t get you anything?”
At least when she asks him this, Frank knows she just means a blanket or some crackers to ease his stomach. “No, I’m okay. Thanks. For the staples, and for being there earlier with,” he gestures lamely to the state of his face. “Y’know.”
“You don’t need to thank me.” Mel says, a note of finality to it. “We have each other’s backs.”
He does his best to smile at her, his fingers grazing the top of her hand as she gets up to go check on her other patients. Frank tries settling in, telling himself that he’ll finally get some sleep, but the machines around him keep beeping every time there’s a small change in his vitals. The too bright lights over his head won’t stop buzzing but he doesn’t trust himself to get up without face planting again and-
A swift series of knocks on the door frame makes him realize he shut his eyes again. Cassie is standing there with her arms crossed in front of her chest and that concerned look on her face that she usually reserves for patients.
“Should I even ask how you’re feeling?”
Frank shrugs. “’M sure you can probably guess. Javadi and Jesse okay?”
“They’re fine. Just worried about you, same as everyone.”
“Sure. Hey, I owe you one, for intervening earlier. That took balls, standing up to an attending.”
Cassie waves him off, stepping into the room. “Robby knew it was the right call; he just didn’t want to admit it. You know how stubborn he is.”
Frank perks up at the mention of his name. “Is he still here?”
She bites her lip, looking over her shoulder and then back at him. “I don’t know. He took off right after we got you settled; I haven’t seen him since then.”
Frank can’t say that he’s surprised. Robby’s last day before leaving for sabbatical wasn’t exactly a walk in the park for anyone. He hardly expected Robby to be willing to stick around and talk after everything that transpired today, or before for that matter.
“Okay, honest this time,” Cassie says. “How’s the pain?”
“Like… a seven with the lights on.”
She reaches for the light switch in a second, killing the overheads and relieving a fraction of the ache behind his eyes. Cassie drops into the rolling stool at his bedside, asking him quietly. “Has anyone called Abby?”
There’s nothing he can say that won’t make him sound like more of a victim. “She’s home with the kids,” he lies. “She’s gonna try and come by later.”
She hums, hardly sounding impressed or like she believed him for a second. “I’ve got a few minutes between patients. Feel up for some company?”
“…really?”
Cassie nods, a familiar gleam in her eye- one that he’s seen in more than a few recovery rooms in the last year- and Frank lets himself bask in the comfort of being understood.
Frank sighs, his head tipping towards her as his eyes shut again. “Thanks.”
“You don’t need to thank me. It’s what we do.”
He doesn’t have to ask what she means. He’s seen it plenty of times before.
Frank crosses his arms over his chest, telling himself that maybe if he holds himself together it won’t feel so bad anymore. An alarm blares suddenly in the next room over, a crescendo of sound building around him much like the borderline unbearable pain in his head from the sudden disturbance.
When he curls in on himself, trying to get away from it- the noise, his own pain, it’s too hard to tell anymore- Cassie’s cool hand covers his forearm, distracting him from all of it. Frank’s hand slides over her wrist, holding on for dear life for as long as he can get away with
Frank only wishes he knew earlier that something so small could make such a difference.