Archive of Our Own

Chapter Text

When Langdon walked past the automatic doors and out into the sweltering July heat of the ambulance bay, he hadn’t decided yet whether he planned on texting his sponsor, bumming a cigarette off anyone that would spare him one like he did on his worst days in rehab, or simply getting some fresh air.

There was no one out there smoking, which eliminated that choice for him. Which was fine; it was probably best he didn’t pick up anymore bad habits, and he liked not having to decide. The bay was not only devoid of smokers, but completely, blessedly empty for a change. No EMTs or paramedics prepping their ambo for the next call, no colleagues stealing a break, no phone calls so loud he couldn’t hear himself think.

Which also meant no one to perform for, no microscope to be under, no Robby. Whatever happened on that helipad could stay up there.

It was a relief. Just him, the thick humidity of mid-summer, and the occasional spotted lanternfly. There was one creeping along the sidewalk a couple feet away; he approached slowly, raised his foot, and stomped. The stupid bug leapt, fluttered, and landed a couple feet away again. He’d read, somewhere, that spotted lanternflies could only jump forward, so it was best to mount your assault from the front; he wasn’t sure how true that was, but he still never came from the rear.

He gave up when he tried again, only for it to flit another couple feet away, and glared at it instead. It was a stupid distraction, but a good one; the weight in his chest had loosened some, and his mind had returned to the present, to his body. His therapist was really going to love this particular exercise in mindfulness. For the meantime, though, he should be responsible. And being responsible, in this case, meant bothering his sponsor in the middle of the afternoon.

His sponsor was an older firefighter named Ray, from his healthcare and first responders meeting. When he told Ray he was going back to work, Langdon promised he’d try not to bug him unless it was an emergency. Ray had laughed, and told him that between the cravings, the amends, and every temptation and trigger particular to him under one roof, he’d be calling a welfare check if he didn’t hear from him by the end of the day. It was a joke, but Ray had also knocked at his front door the one time Langdon forgot to give a heads-up before missing a meeting, and when Langdon answered the door wrapped in his comforter with a fever of 101, Ray told him he’d show up with the rig next time. He didn’t care to test that promise.

He hadn’t even finished pulling up Ray’s contact when the screech of tires had him nearly dropping his phone and leaping out of his skin. His head shot up in time to watch the backseat of a gray sedan open, and a kid no older than twenty-one get shoved out. The car sped off before the door was closed again, leaving behind a puff of dust, the stench of burnt rubber, and an unconscious patient in its wake. He made a mental note to ask Ahmad to pull the plates from the security footage, shoved his phone away in his pocket, and sprinted over.

His knees burned the second they touched asphalt as he knelt beside the patient, and he had to fight the reflex to move. It was no different, in theory, than a polar plunge, or working in a level-1 trauma center’s ED; Langdon had plenty of experience overriding adrenaline.

His cursory visual assessment was simple, and simultaneously ruled out a lot and told him nothing: no blood, no visible trauma. Which led him to his first priority, pulse, which he did not find on the radial or carotid. He was rolling the patient onto his back and adjusting his own positioning before it was even a conscious decision. He laced his fingers together—left over right—and crossed his ankles. The heel of his palm found the kid’s sternum. His elbows locked. He rocked forward and back like a lever.

The mental soundtrack Langdon summoned during CPR had changed a few times over the years. In medical school, it was the classic Stayin’ Alive, until someone told him All Star by Smash Mouth was 104bpm. There was a brief stint where it was Dancing Through Life, because they saw it on Broadway for their anniversary, and Abby insisted he reminded her of Fiyero and kept singing it at him. But when Tanner was around two years old, it became Baby Shark, and hadn’t changed since. It was, actually, the perfect tool for CPR; thirty compressions slotted perfectly with each new shark, and the whole family lined up with five cycles per round before switching out.

Daddy Shark had just arrived when something a little more intentional than sheer instinct returned. The empty bay was no longer the blessing it had been a couple minutes ago; he needed more hands, more tools, more brainpower. Without skipping a beat on compressions, he turned to face the sliding doors.

“I need some help out here!” he called out, loud enough it made his throat burn. And then, a bit dilatory but just as forcefully, “I need someone on airway!” He needed a bag-valve mask, and someone to squeeze it, and preferably a few more people to manage the situation so he could focus on keeping blood circulating through the patient’s body.

What had started as pinpricks of sweat at the base of his neck were starting to roll down his back. The fringe of his hair stuck to his forehead. Sharks came and went, like a carousel. A dull ache had settled into his lower back, and he already knew his knees were going to be killing him for the rest of the day. He looked forward, dully, to spending his evening post-shift flat on his back, ice packs on his knees, half-watching the Pirates game.

Mommy Shark was making a reprise when he finally heard the pneumatic whoosh of the doors and the scuff of shoes against pavement behind him. Some of the excess tension in his shoulders bled away as Whitaker appeared in his periphery and started sealing a bag-valve mask over the patient’s nose and mouth before Langdon had a chance to even fully process he was there.

“What’s going on?” Robby’s voice asked from somewhere above him. Langdon chose, very deliberately, not to look up at him; if he focused on the patient, Robby could just be an attending, and not Robby, which would be a better arrangement for Langdon’s psyche and probably also for the patient’s outcome.

“Dumped from a car,” he explained, distantly surprised by the quality of breathlessness behind his voice. He took in a deep, intentional breath. “No pulse on arrival.”

“Fuck,” Robby muttered. Then, louder, “We need defib.” Footsteps slapped against the sidewalk—whose, Langdon had no idea—and the doors whirred open and clicked shut.

“Overdose?” A second voice from overhead, this one belonging to McKay. He went to respond with something equivalent to probably, but what nearly came out instead was Grandma Shark.

“That’s what I’m thinking,” Whitaker replied before Langdon could quite get the words to cooperate. He shook his head side-to-side to clear out the cobwebs; it helped only marginally.

“Narcan,” McKay declared, immediately echoed by the scrape of her footsteps as they disappeared back towards the doors. She would be quick, which meant this would be over soon. Which was good, because the muscles in his arms were starting to burn. His scrub top clung to his back like a second skin.

“How long?” Robby asked. Short, clipped, unsurprising from a man whose interactions thus far that shift had consisted of very few complete sentences. His voice was closer this time than it had been previously.

“Don’t know,” Langdon replied, which was honest. He’d need to reverse-engineer an estimate from the tempo and the rounds, but that required math, which required a certain degree of working memory he didn’t have to spare in the moment. He could feel the stare he just knew Robby was fixing him with bore holes in him; he continued to not-look.

The sharks had taken on a sort of fluid quality, as if they were actually swimming. The pavement at the horizon shimmered and waved with the illusion of a heat mirage. It was the kind of thing that, when he was little—when he was just Frankie and not Dr. Langdon—meant ice pops from the cooler and a trip to the community pool. Somewhere out there Tanner and Penny were taking a dip in Abby’s sister’s backyard pool, with ice pops in the freezer and plans to see the fireworks. He couldn’t be happier for them.

Robby appeared at the horizon of Langdon’s field of view, reached his arm under Whitaker’s, and lifted one of the kid’s eyelids back. Then released, pulled back the other one. Fixed, pinpoint pupils stared up at nothing.

“Miosis,” Robby called it aloud, even if they could all see it. Then he moved down to the arms, pried the patient’s sleeve up. Langdon knew, remotely, that he was looking for track marks. He also knew he didn’t find them, because a Robby who found what he was looking for would’ve pulled the kid’s sleeve back down, but instead he was moving on, lifting his hand and staring at the blue beneath his fingernails.

It wasn’t the first code he’d ran with Robby that day. A few hours ago, they were at Louie’s bedside, and he couldn’t get the tube in, and blood outpaced the suction. He’d never really taken stock of how many addicts and overdoses passed through the ED before. An uncomfortable pressure settled in the back of his throat, and he swallowed against it.

He was back to Mommy Shark again. His hands were slick with sweat, and for a split second his palm slipped over the back of his other hand. He adjusted between beats, tightened his fingers until his knuckles were white. The grip held.

He didn’t even hear the door when Princess arrived, AED in hand. She landed next to Robby, who was immediately reaching to pull the patient’s shirt up in the spaces between Langdon’s compressions. The transition from cotton to bare skin was jarring; it made the rebound between compressions, the crunch beneath his palms more visceral. Robby’s arms snaked around him to place the left pad; Langdon still managed not to look at him.

The whoosh-hiss of manual ventilation and the steady cadence of compressions competed against each other in a polyrhythm that was nearly hypnotic. Daddy Shark made its third appearance on what was starting to feel more like a tilt-a-whirl than a merry-go-round.

The trance didn’t lift until Robby spoke again. “Hold compressions.” Langdon obeyed, hands hovering a few inches over the patient’s chest, waiting. His eyes wandered from the pads, along the leads, to the monitor. “PEA.”

A non-shockable rhythm. He resumed compressions as Robby opened his mouth to speak before the doors slid open again and the heavy thud of running feet carried McKay back into frame. Whatever Robby was going to say, he rose to his feet, and the two swapped as Whitaker let go of the bag and peeled the mask off the patient’s face. She braced the patient’s head with a hand on his forehead, inserted the nozzle into his nostril, and pressed down on the plunger with her thumb.

He did not stop compressions. Naloxone would take time to work. He continued. The endless cavalcade of sharks continued—Grandpa and Baby and Mommy again. He could no longer feel his knees, and he wasn’t sure exactly when that had changed. That sensation in the back of his throat took on a distinctly acidic quality.

“I’ve got spontaneous respirations!” Whitaker announced, and only then did Langdon realize he’d stopped tracking conversation somewhere along the way. The sharks were gone, only the ghost of their melody remaining. He blinked a few times in rapid succession before surveying.

Whitaker had the mask off, and now that he was listening for it, he could hear the faint whistle of returning breath. McKay and Princess had disappeared somewhere. Robby’s eyes were fixed on the patient, though they occasionally flickered over to Langdon.

“Hold compressions,” Robby ordered, and Langdon again obeyed. His arms trembled slightly as they hovered over the patient. Robby’s pointer and middle finger found their way to the patient’s neck and pressed lightly. The slightest hint of a smile ghosted the corners of his lips, and Langdon knew before it was said aloud that it must be good news. “We’ve got ROSC.”

Which meant two things simultaneously: the kid was probably going to be okay, and this nightmare was finally about to be over. He released his hands from their death grip, flexing his fingers to get the blood circulating through them again, and glanced around to orient himself.

McKay and Princess reappeared, accompanied by Ogilvie and a stretcher. The sun was brighter than he’d remembered it being. Robby clapped Whitaker on the back as he stood up. The kid’s fingers were starting to twitch, eyes moving beneath his lids. A faint, lopsided smile crossed Langdon’s face.

The act of standing up was its own endeavor. The world tilted slightly as he pressed his hands against his knees and pushed up, pressure settling behind his eyes and between his ears. He swayed before steadying himself. His scrubs stuck to his skin like Saran Wrap.

He took an awkward step back to make room, and bodies immediate swarmed the gap he’d left open. He watched, as if from underwater, or somewhere far away, as Robby counted to three, and his colleagues carried out the choreography of hoisting the patient onto the gurney, landing him with a familiar thud.

“You coming?” Robby, eyes landing on Langdon and scanning him up and down. Langdon couldn’t even begin to parse what the question or attention translated to. The heat’s oppressiveness hadn’t gotten any better now that he was off the dark asphalt, thoughts trudging through molasses to reach him.

“I’m—” He broke off, swallowed against a throat that felt like sandpaper, tried to wet his lips. It didn’t really work, but at least he could speak. “I’m going to take five. Cool down.”

Robby gave him a short nod before turning back to the stretcher and the ensemble gathered around it. “Right, Whitaker, Princess, Ogilvie, stay on this with me. McKay, you’re good to go back to your patients.” A pause, a glance back over his shoulder; Langdon was suddenly very interested in another spotted lanternfly creeping up the building’s exterior. “Langdon, take ten, cool off.”

His head picked back up, surprised, but Robby was already disappearing into the building with everyone else. He sighed, tilting his head back and raking his hair back from his forehead before heading inside on legs that were, he noted vaguely, unsteadier than he’d expected.

The air conditioning was not the relief he was anticipating. Walking through the sliding doors was more like stepping into a walk-in freezer than the comfortable, climate-controlled ED. A fine shiver worked its way down his already-aching spine. The scrubs clinging to his skin felt claustrophobic; he’d probably have to grab a fresh pair from the dispenser before getting back to work. He kept his head down and made eye contact with no one as he maneuvered to the break room, grateful that the ED’s layout was so familiar he could probably navigate there with his eyes closed if he had to.

He knew, practically, that he should grab something to drink or an ice pack to cool him down, but his legs carried him directly to the table instead. He pulled the chair out, parallel to the table, and all but collapsed into it. The fatigue became a lot louder once he was off his feet, smothering and all-consuming, like a thick fog enveloping him. He tilted his head back, closed his eyes, and breathed.

A minute or two later, the door clicked open, and he cracked his eyes open to find Dana slowly closing it behind her.

“Hey,” she said softly, which he recognized from her talking to Mel earlier and from years of working together as the voice she reserved for when a colleague blurred into the patient category.

“Hey.” He perked up slightly, forced a weary grin, and overall tried to nudge his categorization back in the direction of just a colleague.

“You look wiped,” she said, not unkindly, eyes trailing him up and down with scrutiny. He followed her gaze down towards himself. His scrubs were a darker, sweat-saturated shade of black. His skin was blotchy and bright red, glazed with a layer of sweat that reflected under the florescent lights. He looked approximately, he thought, like how he felt: overheated and damp, like a squirrel that had fallen into a park fountain.

“Yeah,” he sighed, because ‘wiped’ might’ve been the kindest understatement she could’ve found for his present state. “Just ran a full code in the bay,” he annotated, even though she was Dana, which meant she probably already knew. “Robby said I could take ten.”

“So I’ve heard.” Because Dana knew everything, which was either a blessing or a curse depending on the day. “How’re you feeling?”

There it was, the interrogative. He scrubbed a hand down his face.

“Hot,” he opened with, because that was definitely the dominant sensation. “Sweaty, like my arms might fall off.” Like someone who just did CPR for a solid however many rounds on hot asphalt, he figured.

Dana folded her arms across her chest, raised an eyebrow. He sounded like himself, like Langdon, which would do more to assuage her concern if he was anyone else.

She fixed him with the look, one of the most important tools of the nursing trade. “I’m serious, Langdon.”

He sighed. His posture deflated ever so slightly, sinking further into the chair. He knew better than to try to get anything by Dana. “A little nauseous, a little headachey. Mostly just tired.”

“Heat’ll do that to you.” She nodded sympathetically, and finally took her eyes off him, stepping over to the sink. “How long were you at it?”

That, he realized, was a really good question. He tried to do the math while Dana ripped a few paper towels from the roll, folded them, and ran them under the tap. He came up empty-handed.

“...Three rounds?” he offers eventually, the best he could come up with. “Lost count near the end.”

Dana glanced over her shoulder at him. He didn’t meet her gaze, his eyes fixed absently on the ceiling. She wasn’t sure if she most disliked the delay in his response, the uncertainty of his answer, or the sheer fact that he ran at least three consecutive rounds.

“Frank,” she said firmly, and waited until he met her eyes again. “You know you’re supposed to—”

“I know, I know,” he acquiesced immediately, and waved her off with a weak flick of his hand. “Wasn’t a chance to.” It wasn’t a defense so much as it was context. He seemed to understand that.

She still looked unconvinced, but mercifully chose not to press the issue. Which was a relief; he was already feeling the consequences of that particular situation, and he was fairly certain his head might explode if he had to sit through a lecture on it right then.

“Okay,” she said, walking back towards him. “Just, take care of yourself, kid.”

There was a special weight to how that sentiment applied to him now, and a special irony about the fact that taking care of himself was exactly what he’d been trying to do before the universe laughed at that plan.

“I will,” he said, because he had been, and he’d continue to, and he didn’t have much of a choice about that if he wanted to keep his license.

“Well, let’s get you cooled down and then we’ll get you back out there.” She motioned for him to lean forward, and he did, dropping his forehead into his palm. “I’ll tell Robby if you need more than ten.”

He had no interest in needing more than ten minutes, or in anyone having to share that information with Robby. “Okay,” he replied, because he also had no interest in arguing that point with Dana.

She spread the wet paper towel out over the back of his neck, and watched as he sighed with relief and fought off a shiver in response. He looked overheated and exhausted and like the next five hours were going to be especially long for him, but he was conversational and drenched in sweat, which boded well for his prognosis.

She was starting to turn towards the fridge when something slight changed in his posture, his breathing picking up marginally. He leaned forward some, closed his eyes, and pinched the bridge of his nose between his thumb and pointer.

She stopped, and crouched down to his level to get a better look at him. “Talk to me, kid. You alright?”

“Mmm, yeah,” he mumbled. His voice, when he spoke, was thinner, more effortful. “Kinda light-headed.”

Ten minutes was starting to sound particularly ambitious. His eyes, when they wandered to meet hers, were slightly unfocused in a way they hadn’t been.

“Alright, put your head down,” she instructed. “Deep breaths, in through your nose, out through your mouth.”

He complied automatically, bending forward until his head was nearly between his knees. His breaths were metered, intentional, slightly shaky on the exhale. The clinical picture had expanded some to include heat exhaustion and dehydration. He needed water, Pedialyte if she could scrounge any, and maybe a thirty-minute nap if she could sneak him into a room.

“If you feel like you’re going to faint, get down on the floor,” she told him. “I’m going to get you water.”

He gave her an affirmative hum and a slight nod, his breathing still careful, measured. She squeezed him once on the shoulder, noting the heat that was both entirely expected and equally concerning. She straightened up and, with one last glance at him, turned and walked over to the fridge. She’d get him his water, then go find Robby and let him know Langdon was heat sick and would probably be down for the count for a half-hour. Robby wouldn’t be happy, because Robby hadn’t exactly been happy with anything that had happened thus far that shift, but he’d accept it because he was also still, at the end of the day, someone who cared.

There was a sharp, abrupt cry behind her, the sound she’d long come to recognize as the diaphragm tensing and all the air being forcibly, violently expelled from the body. This was not, however, a sound she’d ever associated with Frank Langdon. Her body acted on professional muscle memory before she was even finished integrating those two disparate pieces of information, taking a wide step and pivoting through it to double back. Seconds of distance had a way of outweighing decades of experience in situations like these, and there was a dull thud behind her before she’d even fully turned around. The sound of something unconscious, something without protective reflexes, hitting the floor with all the momentum of gravity.

When she made it to his side no more than a couple seconds later, his limbs were flexed and jerking rhythmically. The clonic phase, in all its violence. She crouched beside him just long enough to roll him onto his side—something temporary, just enough—before scrambling to shove the table and chairs out of his way, metal scraping against the floor. It had been, per her watch, twenty-seven seconds. He was still seizing, but at least the force of it hadn’t rolled him onto his back yet. She crossed the room in fewer strides than she knew she was capable of, threw the door open, and shouted without bothering to look.

“I need a doctor in here!”

She didn’t wait to see if anyone was coming to answer her call; she had a patient to attend to. Gently, she took his right wrist in her hand and abducted his arm, bent at the elbow, his hand twitching palm-up beside his head. His skin was burning, with a thin layer of clammy sweat over top. A split-second observation that told her everything she needed to know. His left arm was harder, flexed at the elbow and curled against his chest; she worked during the spaces between contractions, bringing it across his midline, back of his hand pressed against his cheek. The leg was easiest; she maneuvered the knee and hip into a right angle and, using it as leverage, rolled him towards herself and properly on his side.

Fifty-one seconds and counting. The door opened behind her, footsteps rushing in. McKay was first in the room, Al-Hashimi hot on her heels. Dana could see the calculus behind their eyes, the exact order of recognition: situation, clinical presentation, person. Mel rushed in a beat after the other two, just enough time for McKay and Al-Hashimi to already be on their knees. She stalled a fraction of a moment longer than the other two had, a certain extra weight placed on that third recognition.

“Witnessed generalized tonic clonic,” Dana explained. “One minute.”

“Stertorous respirations. Flushed, diaphoretic,” Al-Hashimi continued, reaching out to lay the back of her hand against Langdon’s cheek. “Febrile?”

“Hyperthermic,” Dana corrected. “He ran the code in the bay.” She let the implication speak for itself.

“Fuck,” McKay muttered, shuffling out of her hoodie. She folded it sloppily, tilted Langdon’s head off the floor, and shoved the hoodie underneath. “He didn’t switch out.”

“Exertional heat stroke?” Mel asked. “From CPR?”

“It’s possible.” Al-Hashimi held her hand up in a gesture Dana recognized as stabilization first, diagnosis second. “Let’s not get ahead of ourselves.” McKay and Mel both nodded. Dana continued to flick her eyes from Langdon, to her watch, and then back up to Langdon. “Could this be benzodiazepine withdrawal? I don’t know his timeline.”

“No,” Dana answered simply. “One minute seventeen seconds.”

“Should I get Ativan?” Mel asked from her position crouched by his legs, closest to the door.

Al-Hashimi and McKay’s replies landed simultaneously.

“Yes,” said Al-Hashimi.

“No,” insisted McKay, and the other three sets of eyes in the room settled on her. “It’ll reset his clean time.” She didn’t have to say what that would do to him, what little thing might break inside an addict just a few months shy of a year.

Mel still watched her with wide, uncertain eyes, an expression that plainly declared “I care more about keeping him safe and alive than keeping him sober” without demanding she speak it out loud.

“It counts unless it’s the only option,” McKay elaborated, because she knew Mel, knew she was someone who needed to understand something completely before she could endorse it. “We haven’t tried a second-line, and we’re still under five minutes.”

“One minute thirty-two seconds,” Dana added, glancing at her watch.

“We’ve still got three and a half minutes before we’re in trouble,” McKay concluded. Something gave in Mel’s expression, her eyes ducking back down to Langdon, still convulsing between the four of them. This was a concession, but she was making it.

“Okay, Dr. King,” Al-Hashimi took over. “Thousand milligrams Keppra, and we’ll try to establish an IV.” A pause, a single beat of deliberation. “Pull the Ativan too, four milligrams IM.” Then, more to McKay than Mel, “Just in case.”

Mel was up and out the door before Al-Hashimi had even finished her directive. Langdon still seized, his back arched, head pressed into the bunched-up fabric McKay’s hoodie, gasping, gurgling breaths punctuating any brief moment of silence in the room.

Dana looked back down at her watch. “One minute fifty-eight seconds.”

There was, objectively, not much for them to do but watch and wait. They’d done what they could—staging him and the room—and would do more when Mel returned. In the meantime, a seizure was the sort of thing that was just going to happen, and they were going to kneel there and watch it and time it, and then it would be over.

And, eventually, it was over.

The thrashing slowed and then stopped, altogether and all at once. His body settled against the floor, relaxed fully into the recovery position, head still tilted at a slightly odd angle. Dana reached over, one hand at the base of his head and the other beneath his cheek, and gently guided it into something more anatomically correct.

“Two minutes forty-one seconds,” she called it. The three of them lingered for just a beat, watching his breathing settle into something full and steady, a heavy sigh on the exhales. The door flew open again to reveal Mel, IV kit and Ativan in hand, bag of Keppra jiggling in her arms.

“I got the stuff, and—” She broke off, something small shifting in the set of her eyes. Relief. “He stopped on his own?”

Dana nodded, stepping around her. The doctors could explain; she was the charge nurse, which meant her actual work was something akin to a stage director, and right now she had a scene to run.

She caught the door before it fully closed behind Mel, scanned the ED, and eventually locked eyes with Jesse. He perked up immediately, moved towards the break room. She held her palm out to pause him.

“Get me a wheelchair, now,” she ordered, simply. He flashed a thumbs up before turning on a dime, disappearing into the bustle of the department.

She stood by the door and waited. Somewhere behind her she could hear the sound of paper and plastic, mumbled complaints about vein quality and the heat of his skin, the particular habit-kindness of McKay announcing “quick pinch” to an unconscious patient.

“Eighteen gauge in the right AC,” McKay called out.

“Line’s patent,” Mel echoed. “Hanging Keppra.”

Dana spared a glance over her shoulder. Mel was standing next to Langdon, holding up the IV bag, eyes fixed on the catheter at the other end of the line. Al-Hashimi was still crouched next to him, pointer and middle finger pressed to the inside of his wrist, counting. McKay had a hand on his jaw, tilting his face towards her, fingers pressing gently around the curve of his eye socket.

“Contusion, right orbital and supraorbital,” she announced to the room. And then, “Did you see the fall?” She glanced up at Dana before returning her focus, swiping the back of her hand under Langdon’s nose. It came back with a small streak of half-dried blood, the dark red stark against the blue of her glove. “Nose looks intact. Dried blood, no active bleed.”

“He had his head between his knees,” Dana replied, because that was more useful than saying no. “He was lightheaded.”

McKay gave a nod of acknowledgement, and made quick work of feeling around the back of his scalp. “No step-off, no lac.”

“Good. We’ll get him into CT once he’s stable.” Al-Hashimi let go of Langdon’s wrist, reaching into her pocket and retrieving her penlight. “Pulse one-nineteen.”

Dana returned her attention to the ED in time to watch Jesse moving towards them with a wheelchair. A small crowd had gathered. Not directly—the denizens of the Pitt were smart enough not to be too nosy with Dana right there in the doorway—but adjacently. She watched as Robby appeared, as if from thin air, because the thing about Robby and the Pitt was that it was his, and the people in it were his, and he always managed to land at the scene of every crime.

Behind her, numbers were being called out—2 eyes, 2 verbal, 4 motor—and she didn’t need to do the math to arrive at the sum or the conclusion. A GCS of 8 was considerably alerted, but not unexpected in his presentation. She filed it away and stepped forward to make room for Jesse to get in there with the chair, and to intercept Robby before he walked right in.

“Dana,” he said, voice low. “What’s going on?” He was already craning his neck to try to see into the room; she steered him a few steps to the side. “Jesse just said there was a medical emergency. Who is it?”

“Robby.” She held firm on the eye contact even when he didn’t, waited for him to re-center on her. Finally, sheepishly, he did, bringing a hand up to rub at the back of his neck. She sighed and decided to rip off the band-aid all at once. “It’s Langdon. He had a seizure.”

She watched as a merry-go-round of emotions flickered across Robby’s face, as if he couldn’t settle on a register. She waited until it settled back into something more neutral before continuing.

“It looks like exertional heat stroke,” she explained. “They’re transferring him to Trauma Two.”

His jaw worked for a moment before he replied. His eyes wandered away again, and didn’t return. “How long?”

“Two-forty-one.”

“And did they—” He broke off as the break room occupants paraded through the door.

Al-Hashimi first, moving towards the trauma bay with purpose, the crowd parting around her. Mel next, still holding the IV bag, in lockstep with the chair. Jesse was pushing, McKay walking briskly beside them, one hand on the arm of the chair. Langdon was slumped against the backrest, feet resting at odd, hasty angles against the footplate, head lolled to the side with his chin against his chest. You could barely see him through the people alongside him; Dana had worked in that ED long enough to know it was intentional.

Dana could swear she didn’t see Robby’s chest move until the procession had passed and he sucked in a sharp breath through his nose.

“No,” she replied without waiting for him to pick up the question where he’d dropped it, because she knew what he meant, and wanted to spare him the fate of having to editorialize on that. “It self-terminated. They started him on Keppra.”

“Good,” he muttered before fully committing to speaking. “That’s, uh, that’s good.” His gaze remained elsewhere. He rocked slightly on his feet. Then, mumbled, “He never asked to switch.”

Dana wasn’t a mind-reader, but she was about as close as you were going to find to one at PTMC. She fixed him with a pointed look she knew he could see through his peripheral.

“This isn’t your fault.” It was, objectively, true, at least from every version of events she’d recieved. That was how most things worked in medicine; the kind of things that were bad luck, or wrong place at the wrong time, or a perfect storm. It was also emotionally true, and that was what she needed Robby to grasp.

“Like hell it’s not,” he retorted, predictably, sharper than he probably meant it. “I knew how long he was at it. I saw him, I—”

“Robby,” she said firmly. “I just spent the past five minutes talking to him. I saw the same thing you did: hot and sweaty. Is it my fault, too?”

His eyes flickered back towards her face for a moment, almost betrayed, before returning to the window of Trauma 2.

“No,” he relented eventually, quietly. She knew he meant it; she didn’t know if he also meant the equivalence.

“He’ll be okay,” she said, already shifting her weight. The rest of the ED didn’t disappear when Langdon seized, as much as she would’ve preferred it had. “Kid’s strong.”

“I know.” Robby ran a hand down the side of his jaw, before rubbing his palms together. Over in Trauma 2, Jesse, Perlah, and McKay were hoisting Langdon out of the chair and onto the bed. She could almost hear the sound of his body landing against the gurney in her head.

She took a few steps in the direction of her desk, the direction of the ED, the work, the real world.

“Then what’s got you so wound up?” She knew the answer, she was pretty sure, and it traced back five years and ten months ago.

He didn’t answer, not really. Instead, he stood there for slightly too long of a moment, then said, “I’m going to check in; I’ll keep you updated,” turned heel, and walked away.

Dana watched him disappear into the crowd in the loose trajectory of Trauma 2, before sitting down at the desk and turning her attention to the computer. Above her, a new entry populated the patient tracking board: