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Robby was slated to make it home in record time. If he could finish out this last note and hand off with night shift, he’d be in bed by 9 pm, latest. He had already seen night shift slowly trickle in and noticed a steady flow of day shift leaving. In his periphery, he swore he saw Jack’s head of hair passing by him.
Robby and Jack’s official relationship was relatively new. They had been in a sort of situationship for years but after his sabbatical, and a lot of therapy, Robby found himself going back to his one constant in life. Jack. And to his credit, Jack only said ‘I told you so, once…a day.
“Dana, could you please wrap up whatever you’re doing so we can finally get day shift out of here?”
“Aye aye captain,” she saluted from her spot. Just as she was about to release new grad nurse, Emma, the sliding doors opened.
“Curtis Larson, 42. Combative adult male. We responded to a police call from the golf course, friends said he was acting strange. No trauma.” the EMS team rattled off.
The patient was clearly upset, attempting to push himself up and off the gurney. He was edging towards frantic, as he tried to pull the oxygen out of his nose.
“Trauma 1 is open.” Dana called out. Robby followed the EMS team, beckoning Jack to follow him.
“Should I be going in there?” Emma asked, her hands nervously twisting the end of her braid.
“Yeah, let me come with you.” Dana answered, looking around for another nurse to cover the station. “Perlah, you’re in charge until I get back.”
“Pagbutihin mo!” Good luck!
Dana headed towards Trauma 1, Jack held open the door for her and Emma before following closely.
“Sir, you’re at Pittsburgh Trauma Medical Center, my name is Dr Robinavitch. Can you try and relax for me?” Robby tried to explain, fighting with the patient’s hands.
“He was confused at the golf course, just as we pulled into your ambulance bay, he started to turn combative.” The EMT offered.
“Lucky us,” Dana muttered as she pulled on a pair of gloves.
“His blood pressure is stable.” Emma called out from the end of the bed.
“Good. O2 is 99% on two liters of oxygen. We can take it from here, thanks.” Robby dismissed the EMS team after a successful transfer from gurney to bed.
“Curtis, I’m Dr. Abbot. Did you take anything? Any drugs or alcohol?” Jack tried again.
Jack’s stethoscope briefly touches Curtis’ chest before it’s being shoved off.
“I need to leave, I need to leave. I don’t know you people. Get off!” Curtis yells after Robby tries shining his pen light in his eyes.
Dana’s eyes narrowed and she focuses on his demeanor. He was staring down his nose, right into her eyes. Check.
“Mr. Larson, we cannot help you if we don’t know what is going on. You smell like alcohol, do you drink? Did you drink today?” Jack persisted.
He pulled the gown open on the chest and nodded to Emma. She started places the EKG stickers along his 4th and 5th intercostal space between his ribs.
“What the fuck are you doing?!” Curtis yelled. He was pulling off the stickers as fast as Emma was putting them on. Robby stopped her, gently pushing her behind him.
Tone of voice. Anxious. Aggressive. Check. Check. Check.
Jack looked over his shoulder, made eye contact with Dana, and nodded imperceptibly. That’s all she needed. She walked over to the locked medication cart and opened the drawer with versed. When she glanced at Jack, he was holding up four fingers on his right hand. 4mg.
She drew it up and kept it behind her back, face neutral.
“You fuckers, you’re trying to take it away from me!” Curtis started again, kicking out towards Robby and Jack. Impressive considering they were on opposite sides of the bed.
Dana inched closer. The EMS team had been unsuccessful getting an intravenous line in. That meant the medication would have to be given intramuscularly. Firstly, requires a big muscle like the buttocks, thigh, or arm. Secondly, it’s slower acting, meaning it could take up to 15 minutes for it to affect the patient.
“I assure you, Mr. Larson, we are trying to help. We are not going to take anything from you, promise. Do you have anyone we can call for you?” Robby was near yelling at this point.
Jack’s hands were on Curtis’ ankles, as he tried to find a good vantage point for Dana. Robby switched sides with Emma, so he was closer to the head, and she could try and pin down the legs. Big mistake.
Curtis suddenly folded forward, his arms coming around Emma’s neck, and squeezing her in a headlock. She immediately tried to pry his hands off but from her angle could not get a strong grip. Robby himself was pulling at Curtis’ arms to try and release his hold.
“Anytime now Dana!” He ordered.
Dana tried to move Emma’s body out of the way, finding space on his thigh. She pressed down and depressed the entire syringe before pulling it out.
“In.” She announced. Dana took a half-step back breathing a sigh of relief. Curtis should weaken in his drugged state and would be able to be pulled off. But that didn’t happen.
As Dana looked up she noticed Robby was still straining against Curtis’ arms. Emma had started to panic, pulling harder at his arms. Jack was uncharacteristically not present.
Dana turned and saw the problem. There was a small puncture wound in Jack’s hand, a tiny spot of blood growing. His hand had been on Curtis’ thighs to try and still him and somehow Dana had managed to inject him with the full 4mg dose.
“I’m okay.” He reassured her quickly. “Get another 4mg. Now!”
Dana dug into her pocket, an already full syringe ready, and she stuck Curtis in his thigh. Jack swayed towards the door to the main hub and barely pushed it open, “Code Hula Hoop!”
Ahmad and several other security guards rushed in. Perlah dropped whatever she was doing and followed in quick pursuit.
It took probably two minutes or less but it felt like agonizingly long. Curtis was finally subdued, movements uncoordinated and slow, his hold on Emma released. Robby quickly pulled her over to the side.
“Soft restraints. Now. Every single person in here is giving a statement.” Robby commanded. There was no room for arguments. Sweat was beading down his forehead and he was breathing heavy. His scrub top was tight across his shoulders and belly.
“Are you okay?” He asked as he gently prodded Emma’s chin and neck. It was already turning red.
“I’m fine I promise. It doesn’t even hurt.” Emma assured quietly, briefly touching a spot on her cheek.
“I still want you to get a full work up. Is there a resident free?” Robby called out to the room. Mel stepped up, pulling her stethoscope off her neck, and ushering Emma away.
♡
Robby rubbed at his brow. It was hot with everyone in here.
“Dr. Abbot, I’d order some labs on him if-“ Robby was mid sentence when he turned around and saw Jack leaning heavily against the wall.
“Hey, hey, Abbot. Hey man.” Robby rushed over to him, taking on some of his weight. His eyes were a little unfocused, he almost looked scared.
“Jack, hey what’s going on, brother?” Robby took on a little more of his support.
“Accidental needle stick, 4mg of versed.” Dana stated, apologetically.
“What? When?” Robby was already feeling the strain of Jack’s dead weight. “Gurney in here, now!”
A gurney materialized. With the help of Dana, Parker, and John, they were able to lift him and placed him supine.
“Central 17 is open.” Perlah notified them.
“His hand caught on the needle for the first dose, Robby I am so sorry-“ Dana started.
“Not now, let’s hook him up to a monitor. I need to know his stats now.” Robby interrupted. His stethoscope already pressed against Jack’s chest, listening to his heart and lungs.
“Nauseous.” Jack mumbled, his head dropping down towards his chest.
“Turn him, recovery position.” Robby ordered, pushing him to his side.
“Oxygen is 94%. Blood pressure 100/64.” Parker announced. Dana walked around the bed, holding an emesis bag close to Jack’s mouth, suction within arm’s reach.
“That’s low for him.” Robby muttered, almost to himself.
“Those are normal vitals.” Parker tried to reassure him.
“They’re low for him, I take his blood pressure every morning.” Robby bit out.
Every head turned to look at him. Robby could feel a subtle flush crawling up his neck and his cheeks.
Jack started to gag, Dana held up the bag for him, but nothing came out.
“I’m tired,” Jack slurred, “I don’t feel good.”
“What meds does he take?” Parker asked pointedly. “Robby, focus!”
“He’s on a beta blocker, metoprolol 25mg for the blood pressure. I’m not sure if he’s still taking the baby aspirin.” Robby knew what that meant. They all did. The combination of the versed and metoprolol could negatively interact, his breathing and heart rate needed to be monitored very closely.
“Heart rate’s 57.” John notes aloud. It’s getting low.
“Hey Jack,” Robby turns him back supine, rubbing gently on his sternum. His eyes flutter for a moment before opening fully. He smiles.
“Hi.” He’s barely audible at this point.
“I want to intubate you. Your oxygen and blood pressure are getting low.” Robby bent over the rail of the bed so Jack could see and hear him better.
“No Robby,” Jack shook his head. “I don’t want to,”
It would’ve been endearing had his life not been on the line.
“Okay,” Robby nodded in agreement, “But if you stop protecting your airway, I’m going to do it. For your safety.” He added.
“I’m so cold,” his eyes closed again.
“Dana, can we talk outside for a second. John stay with him. The rest of you back to your patients.” Robby dismissed to the room. Dana followed him to the nurse’s station. He sighed and locked eyes with Emma, who seemingly got a clean bill of health. She was sitting behind of the computers, juice box in hand, as Mel spoke to her.
“Robby, I don’t know how it happened-“
”How did you get another dose so fast? I didn’t see you go to the cart a second time.”
”I had one in my pocket. It was wasted from another patient.” She replied calmly.
“Dana.” He wasn’t looking at her. His eyes were trained on the ceiling.
“What do you need, anything at all?” She asked, kindly.
“I need…” A stuttered breath. “I need you to tell me he’s going to be fine.”
“He will be.” She said it like she was sure. “He’s tough, you can’t get rid of him that easy.”
That got a laugh out of Robby. He glanced at his watch, 8:59pm.
♡
He finished herding up the day shift and sending them home. His last boulder, Dana. He was Sisyphus and getting Dana to go home was his boulder.
“Dana, please go home. You’ve already filled out your incident report, there’s nothing else you can do.” Robby pleaded.
“It’s my fault.”
“It’s not your fault. It was an accident.”
“Still my fault.”
“Fine, yes it was your fault.” Robby relented. Dana’s eyes shifted towards him.
“It’s your fault for poking him. It’s his fault for putting his hand there. It’s my fault for being in your way. It’s Emma’s fault for getting choked.”
Dana scoffed and a hint of a smile broke by the ends of her mouth.
“I will text you updates, please just try and get some rest.” Robby sent her away. It was only moments after she passed through the threshold and left the hospital, John grabbed Robby.
“2 liters of oxygen via nasal cannula. Still only 89%, blood pressure dropped again 94/60. His respirations are shallow.”
“Bag him.” Robby ordered. There was a blink of hesitation from John before he nodded and nurse Kim stepped in. She held the mask tight against Jack’s face, slowly pushing oxygen in. Robby was satisfied only when he saw Jack’s chest rise with each breath.
“Did you put a line in him?” Robby asked. Kim nodded confirmation.
“Jack,” Robby called. His eyes didn’t even twitch this time.
“Jack, I need you to wake up.” Robby tried again. His lips had a blue tinge to them.
“O2 is dropping a little.” John reported. Robby was chewing the skin of his cheek inside his mouth, he knew he was going to get hell for this.
“Matteo, can you drop 80mg of ketamine?” Matteo moved quickly, attaching it to Jack’s Iv.
“Dr. Shen, let’s see what you got!” Robby clapped, pushing the intubation tray towards him.
Kim pulled the bag away from his face, the O2 immediately dropping dangerously low. The monitor started beeping incessantly. Robby checked twice to make sure the heart was still beating in normal sinus rhythm.
“Okay, here we go.” John struggled for a minute, the laryngoscope not finding purchase. Robby’s hands twitched where they were down at his sides. He wanted to do it.
“I’m in,”
Finally. Robby’s stethoscope was already in place.
“Good breath sounds bilaterally. Good end tidal.”
“ICU can take him. They can have a bed ready in 15 minutes.” Matteo said, the wall phone up to his ear. Robby gave him a thumbs up and removed his gloves.
“Robby, you should go home.”
♡
Jack felt good. In fact for the first five seconds he was awake, he was completely free of any worries, pain, stress, anger. It was only when his brain caught up, he felt panic.
He could feel the air being pushed mechanically, robotically, forcefully into his lungs. His first instinct was to pull it out. One feeble attempt and his hand was immediately stopped by the restraints on his wrists.
He started to gag, the tube moved slightly when he tried to cough, he could feel tears in his eyes. His fingers scrambled on the bed for the call button, he knew it had to be somewhere close by.
Why was he in the hospital? Was this the medical unit for the army?
His left hand pressed it, weakly. Someone rushed quickly into room. He couldn’t see their face from where he was lying and that annoyed him.
“Hey Jack,” The voice was unfamiliar.
“Let’s up the sedative, please.” That command wasn’t directed at him this time.
That was the last thing he wanted. He tried to pull harder at the restraints.
“Can you page Dr. Robby….again?” Another voice was on his other side.
Why would Robby intubate him? He knew better than that.
Jack almost finished his thought before his eyes shut again.
♡
“We’re going to pull the tube out, okay?” Dr. Cameron from respiratory, gently held his face. The sedatives had been weaned off, Jack could feel his gag reflex respond.
The pull was worse. His whole insides felt irritated from his belly to his tongue.
“Deep breaths,” Dr. Cameron reminded him. He coughed and gagged, nodded he was okay.
“Fuck,” Jack rasped out. It had been years since he was last intubated, complications with the leg. He took a deep breath.
“O2 is holding up.” Dr. Cameron smiled, “You keep this up and you’ll be eating dinner at home.”
Jack smiled politely. A big stuffed elephant sat in the chair next to him. He nodded questionably at it.
“That from Robby?” He asked.
“Umm…no. Dr. Shen I believe. Something about you being old.” Jack laughed.
“The basket over there is from the Emergency Department, there’s a separate card from Dana. Dr. Robby hasn’t been here yet, I can try paging him again.”
“Do you have my phone?” He asked the nurse. She nodded, pulling a bag of personal belongings to the bed.
His phone, his watch, his ring.
His leg was propped up in the corner.
He called Robby.
“Can you come pick me up?”
♡
Jack was a patient man. He knew that people coped in different ways. He let Robby coddle him like a little baby bird. He didn’t protest when Robby insisted on listening to his lungs every half hour. He didn’t fight the bath that Robby insisted on monitoring him for. He even let Robby tuck him into bed with extra blankets and that dumb stuffed elephant in their bed.
Where he drew the line was Robby trying to spoon feed him soup like he was on his deathbed. He pulled the spoon from Robby’s grasp and set the bowl down on the coffee table.
“I’m okay. What I could really use is company, do you want to sit for a second?”
Robby shook his head no.
“Please.” Jack wasn’t above begging. Or using his big puppy dog eyes. He even put on his sad boy pout just for extra measure.
Robby relented. He moved the stuffed elephant from the spot next to Jack so he could sit beside him.
“Whatever guilt you’re holding, I need you to let it go.” Jack said, turning so his legs were in Robby’s lap. Robby immediately, mindlessly started rubbing Jack’s stump.
“I don’t feel guilty.”
“Okay, then whatever anger or frustration or resentment. I’m alive and right here. I’m right here and I need you.” Jack stretched a little, pushing himself deeper into Robby’s hold.
“I-It’s not that either. I feel powerless.” Robby looked at Jack.
“You feel human.” Jack corrected gently. “It’s normal, it’s good. Healthy even.”
“I want it to go away.” Robby was getting uncomfortable, unable to look Jack in the eyes. His hands fidgeting and picking at the skin next to his cuticles.
“Sometimes we need a reminder that we’re human. Keeps us grounded. Keeps us thankful for what we have.” Jack put his hand on top of Robby’s.
Robby looked and he swore he could see the tiny scar of where Dana poked him, even though he knew that wasn’t likely.
“Hey,” Jack said getting Robby to look at him, “Can you get me one of those chocolates from the basket?”
Robby cracked a smile, reaching over past the arm rest and digging into the get well soon basket. He tossed it gently to Jack.
“Did you like it? The basket and everything?”
Jack nodded, unwrapping the chocolate.
“I was slightly surprised to see in the card everyone writing Robby ♡’s Jack.” The lines by his eyes crinkled.
“Yeah I might have accidentally let the cat out of the bag with that one.” Robby scratched the back of his head, taking a chocolate for himself.