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Patrick squints at the computer screen as he charts on what feels like his thirtieth patient of the night, click-click-clicking away on a mouse that sticks when you press too hard. He smacks it against the desk, the only reliable solution he’s found since his IT requests have repeatedly gone unfulfilled, and sighs regretfully after a glance at the clock.
It’s nearing the last two hours of his third consecutive 7PM-7AM, and each minute that drags by only adds to his misery. Patrick doesn’t know what exactly came over him, but he’ll think twice before volunteering to fill any needs in the night schedule again. Next time they can fend for their fucking selves, because Patrick is not cut out for this life: watching the sun rise at work and getting shitty sleep during the day, only to get up for a repeat.
Thanks, but no thanks. The last 72-hours are already seriously kicking his ass as it is.
Patrick’s head is pounding, feeling heavy and congested as he sags in his chair. Each shrill ring of the phone cuts through his already-fleeting concentration, the constant beep of the monitors an annoyance he’s usually capable of tuning out completely. Everything—the people, the patients, the environment—is worse on night shift, he’s decided, even with the limited sample size.
Despite the mental hurdle though, Patrick’s almost caught up, ready to sign off on his last few pending charts from the untimely influx of patients around midnight. He vows to grab some Tylenol once the deed is done, maybe down an Emergen-C to make the remainder of his shift a little more bearable. If he can just manage to stay awake and avoid distractions for another twenty minutes...
“Hey!” Steeger blurts in a stupidly loud whisper, announcing his presence directly in Patrick’s ear and effectively ruining the second of his goals. It was a tall order in the ER, land of never-ending interruptions, Patrick will admit. “New doctor’s coming in soon.”
“Fuck,” Patrick replies with a jolt, shocked that Steeger was capable of sneaking up on him since he’s typically rapping or humming or being generally noisy. It’s a true testament to how out of it Patrick is. “You scared the shit out of me.”
“Not all of it, most likely,” Steeger remarks, and Patrick looks up, blinking at him with faux-irritation. Not that he’d ever admit it aloud, but having Steeger work these shifts with him has been a saving grace. The night crew is pretty incompetent, and Steeger’s goofy as fuck, but he’s a good nurse, not to mention one of Patrick’s closest friends at the hospital. Still, he keeps a bitch face when he asks:
“Is there something I can help you with, Kris?”
“The new doctor is coming for the five,” Steeger slowly repeats, and Patrick shrugs; everybody knows that, it’s all the department’s been talking about for days.
“What’s your point? We’re only here for like, two more hours,” Patrick says, and he can’t say he’s upset about it. Of course the curiosity’s there, but it’ll have to wait for his normal schedule. The faster he gets out of here and in bed, the better.
“I knowww,” Steeger groans. “I’m pissed we won’t see what’s up on his first day. Heard he’s still pretty wet behind the ears.”
“Still probably knows more than you about how this place runs,” Patrick deadpans, pointedly turning back to his charting to ignore Steeger until he goes away.
“Show some respect, Peeksy,” Steeger scolds with a flick to Patrick’s ear. “Who showed you the ropes around here, eh?”
“Motherfucker,” Patrick says threateningly, swatting at him. “Not you.”
Steeger musses his hair as he turns to go back to the front, finally showing some mercy. “Denial’s not a good look,” he calls, and Patrick takes the opportunity get up and head in the opposite direction—to the back to raid the M.D. closet.
Since Steeger’s just doubled his headache, it’s even more necessary than before.
Patrick rounds the corner into the doctor’s breakroom on a mission, eyes trained to the cabinet where he knows the bottle of 500mg acetaminophen is hiding. He shakes two out into his hand—one for now, one for later—and quietly browses for anything else he might want to stash in his pockets. They keep all sorts of amenities stocked for the doctors. Patrick’s just reaping the benefits of being one of the lucky nurses who knows where to look, and reaches in to claim his prizes—a mini bottle of Purell and a Twix bar.
“Good morning,” comes a firm, low voice from behind, and Patrick’s effectively scared shitless for the second time in less than twenty minutes.
He startles, spinning away from the cabinet to see who’s caught him, and sure enough, it’s the new doctor. He’s sitting casually at the table with a tall, steaming coffee in his hand, dressed in M.D. green scrubs that fit him like a dream: the slight V-neck giving just a tease of his thick chest and muscled shoulders, a peek at his collarbones, and the bottoms stretching obscenely over his splayed thighs where he’s shifted to look at Patrick. He immediately becomes the top contender for hottest doctor in the emergency room, in Patrick’s humble opinion.
His expression is controlled at first, but as Patrick takes him in, it turns gentler, to something soft and open when he gives a slight grin. “I’d offer to help you look, but I don’t know where anything is yet,” he adds, taking a sip from his cup. His eyes are so dark, Patrick can already feel how simple it’d be to get lost in them.
“I can show you where everything is,” he offers without thinking, a little dazed from exhaustion and the weight of that gaze on him, then recovers, clearing his throat. “I mean, uh, you’re the new doctor, right?”
“Correct, I’m Jonathan. Toews.”
“Hmm, wasn’t expecting it to sound like that,” Patrick admits, repeating the last name, thankful he didn’t botch it before hearing it. He walks over when Dr. Toews stands, discreetly adjusts the thin material of the scrubs down his legs, and politely extends his hand. “I’m Patrick, one of the nurses.”
“Patrick,” Dr. Toews echoes, taking Patrick’s hand in his, warm and solid and strong. Patrick can feel the confidence and control through his grip, and for the first time in three night shifts, he seems to settle, all the while his pulse kicks up a notch when Dr. Toews doesn’t let go for a moment. Up this close, Patrick can see just how attractive he really is—the softness around his eyes, the genuine kindness in his smile when he says, “It’s nice meet you.”
“Absolutely, the department’s happy to have you, Dr. Toews,” Patrick replies, very careful to say it right and a little unsure of what to do with his hands after they part. He shoves them into his pockets to find they’re still devoid of his target items, which reminds him— “I really can show you were they keep the goods though. There’re mini hand sanitizers in there.”
“And who wouldn’t want a mini hand sanitizer?” Dr. Toews smirks, and Patrick thinks he’s being sarcastic, but it’s too early to tell. He grabs two bottles, anyway.
“See anything else?” Patrick asks, and Dr. Toews shakes his head.
“I’m alright, thank you,” he replies, voice light with amusement. Patrick’s not sure why. Mini hand sanitizers are dope, and after working in the emergency room this long, he’s learned to appreciate the little things—like a stocked M.D. cabinet. Dr. Toews rotates the bottle between his fingers, looking contemplative for a second. “You’re on night shift?
Patrick tries and fails to mask his disdain for it. “Yeah, unfortunately. I’m just picking up extra to help out, though. I’m off at seven when my usual crew comes in.”
“Almost at the finish line,” Dr. Toews says encouragingly, and Patrick blows out a breath.
“Let’s just hope these last couple hours keep quiet. Gets nuts around here sometimes.”
“I look forward to it,” Dr. Toews grins, and he actually sounds like he means it, which Patrick can’t believe.
“You say that now, but—”
‘Patrick, you’re needed in 1210. Patrick, 1210,’ they hear from the overhead, and Patrick groans to himself. Mr. Cannon and his wife have been a nightmare, and apparently plan to continue that trend until his bed is ready upstairs and Patrick can pass them off to someone else.
“Duty calls?” Dr. Toews chuckles.
“Never stops,” Patrick sighs, retreating toward the door to go tend to his patient, and gives a little wave, slightly ticked about the interruption. “See you around, Dr. Toews.”
“See you,” he says, and just as Patrick’s shutting the door behind him, he hears, “Hey—”
He sticks his head back in to find Dr. Toews looking at him like he’s figured something out. “Sir?”
His resolution morphs into a grimace.
“Oh, c’mon, easy with the ‘sir,’ eh?” Dr. Toews admonishes with a teasing edge. “You can call me Jon.”
Patrick’s cheeks flush, and he nods, chewing on his bottom lip. Jon. Jonathan. He likes the sound of both, and decides to go for the latter on a whim.
“Yes, Jonathan?”
Dr. Toews blinks a couple times, smile creeping back to his face. “That was all, Patrick,” he replies, and Patrick quickly closes the door before he makes a stuttering fool of himself.
After a moment of reflection on the other side, filled with deep breathing and a little denial, he gets it together and goes to see what Mr. Cannon wants—more pain meds if he has to keep waiting, obviously. Oh, and another pillow.
The encounter brings Patrick back down to earth, and by then he’s convinced himself that Dr. Toews was just being nice. Who isn’t nice on their first day at a brand new job? He’ll look at everyone the way he looked at Patrick, because he’s personable. He’ll tell everyone to call him Jon, because he’s approachable, and Patrick will laugh at himself for getting all flustered over a handsome face in the first place; especially one that’s most likely married—even if he didn’t notice a ring—and straight.
Patrick chalks his drama up to watching too many episodes of Grey’s Anatomy when he should’ve been sleeping this week. The moniker suits him perfectly, but Dr. Toews probably isn’t his McDreamy, and he can be cool about it.
In fact, nobody does cool better.
He isn’t intentionally watching for Dr. Toews, but of course, he notices him appear from the breakroom around 4:50. Everyone notices. Patrick can practically feel the chatter stirring around him. He’s thankful to be a safe distance away though, peeking around the corner where he can remain unseen but close enough to spy.
Dr. Toews has a fresh cup of coffee in his hand, and seems hesitant to put it down as all the nurses come up to say hello, as if holding it solidly in front of him will prevent some of them from standing too close or touching his forearm. He smiles politely and briefly shakes their hands, but his demeanor is different; he looks weirdly…taller, more upright and focused in a way he wasn’t before, which Patrick understands. It’s his first day, and being bombarded with new people isn’t always the most comfortable thing on its own, especially an awkward bunch like the night crew.
Patrick notices him glancing around, sort of over the heads of those speaking to him, but he never seems to miss a word they say, moving his mouth in all the right places. When he’s satisfied with his survey of the place and people stop swarming him, Dr. Toews turns to sit down at the desk next to the 10PM doctor, and Patrick nearly swallows his own tongue. Never in his life has he seen an ass look so good in scrubs; between that and his thighs, Patrick’s not even sure how he found ones that fit, to be honest.
“Creepin’ on the new doc already?” Steeger asks from behind, and Patrick nearly jumps out of his skin again. The bastard must’ve snuck through the supply room.
“Would you fucking cut it out, man?” Patrick scolds. “And I met him already, I don’t need to creep.”
“Ohhh, you did, did you?” Steeger drawls suspiciously. “Well, so did I. He’s a little uptight.”
“He’s been here for like, ten seconds, Kris, and you were probably being ridiculous, if I had to guess,” Patrick says, inexplicably defensive of Steeger’s initial read of him. The Dr. Toews he talked to wasn’t uptight.
“Ridiculously awesome and easy to get along with,” Steeger amends. “Let’s go talk to him.”
“Let’s don’t and say we did,” Patrick suggests instead, and Steeger punches him in the shoulder.
“Peeks, I’m bored, dammnit! I just wanna—”
‘We need a stretcher to the ambulance bay, STAT—We need any available nurse and a stretcher to the ambulance bay, please,’ comes a rushed voice over the loudspeaker, and Patrick rocks Steeger back.
“Oh, look what you did, genius! You know we don’t fucking say that word!”
“Just shut up and get a bed,” Steeger says flatly, rubbing his arm, and Patrick moves quickly, adrenaline snapping him into focus as they head outside.
The scene is much of what he expected: The triage nurse is bent over into the back of a private vehicle, with the family—an older woman, a wife, and a younger guy, a son or brother, Patrick guesses—circling around and giving a frantic, tearful report of what happened.
“What we got?” Patrick asks when he gets there, slinging open the back driver’s side door to find another male in his late fifties, maybe, lying unresponsive.
“No pulse, that’s what,” Kristy mutters under her breath, and Patrick glances over his shoulder to see Steeger lowering the stretcher. Bet he’s not fucking bored now.
The three of them manage to get the guy—Robert Donovan, they learn—onto the bed, and Patrick just hops on top to ride along and start CPR while Steeger pushes them inside. If the family’s story is anywhere near accurate, it’s possible he’s been down for a while—history of COPD; battling the later stages of lung cancer, though they thought he’d turned a corner for the better recently; didn’t wake to his alarm; wife couldn’t get him up. Not a good prognosis, Patrick’s afraid to say. He can feel swelling in his abdomen, most likely fluid on his lungs complicating his airway even further, so it’s pivotal that they establish one—and a fucking pulse—as soon as possible.
As they make their way into the ER through the ambulance entrance, Patrick instantly locks eyes with Dr. Toews at the desk, and even through the building chaos, it’s as if everything slows down. Dr. Toews gets to his feet, gives Patrick a nearly-indiscernible nod, then jerks his head toward room 1204.
“We’ve got a code, page respiratory to 1204 right now,” Patrick announces calmly but urgently to anyone ready to take action. He’s still compressing Mr. Donovan’s chest—down and release, down and release, down and release—but he desperately needs to be bagged. “Somebody get the crash cart.”
Patrick’s aware of Dr. Toews filing into the examination room behind them, but he doesn’t expect him to take over the way he does.
“Talk to me, Patrick,” he calls over the commotion, hovering by the foot of the stretcher after he pulls on a pair of gloves. The first few minutes of running a code are the most frantic, all hands on deck to cut off clothes and attach the necessary wires—blood pressure cuff, SAT monitor, and AED pads and cardiac leads to the patient’s chest. Patrick tells Dr. Toews everything he knows as succinctly as possible—his history, a rundown of what medications he’s on, and that he’s presented with no pulse since arrival.
“Get him on the bag,” Dr. Toews instructs when respiratory comes into the room. Patrick glances up to see Mr. Donovan’s oxygen saturation is low as fuck—less than 60%. If it doesn’t pick up, they’ll have to put a tube in.
“If his SATs don’t go up in two minutes, I’m intubating,” Dr. Toews says, steady and resolved, right there on the same page. “Can someone tap in for Patrick on compressions, please? We need IV access.”
“I got you, Peeks,” Steeger steps in, and Patrick gladly switches so he can get his hands in elsewhere.
“Got your IV. Pass me a start kit and a couple flushes, please,” he tells the tech, then looks to Dr. Toews. He’s still at the foot of the stretcher, and he’s the picture of composed, hands folded in front of him, eyes going from the heart monitor to the patient and back. Patrick looks too. “Still in asystole. You want epi?”
“Yes,” Dr. Toews confirms. “Then another in three. Where’s the glidescope? I’m done waiting for his O2 to improve.”
Everyone stands stuck, like deer in headlights—goddamn night crew—and so he calls again, “The glidescope, where is it?” His tone isn’t harsh, but it commands attention, demands action, and warrants respect. Patrick finds it strangely hot.
“It’s behind 1203, somebody move it for Dr. T,” Steeger answers, and Patrick injects the first round of epinephrine, praying Steeger swallows any jokes about his ‘sick rhymes’ he’s thinking of sharing with the class.
“Epi in,” Patrick announces, and steps over to delegate someone to keeping a running list of what’s going on. This is Patrick’s room, and charting after all this shit will certainly be a nightmare.
Once Dr. Toews has the glidescope and intubation tube, it’s smooth sailing, despite the inflammation. He guides it in on the first try with deft, practiced hands, brows furrowed and face focused, and respiratory resumes respirations after the tube holder is secure. Patrick pushes another epi and alerts the crowd.
“Let’s check for a rhythm and a pulse,” Dr. Toews instructs after another cycle of compression, and the room freezes for a second as everyone stares at the monitor, even those who have no idea how to read what they’re looking at.
“That’s shockable, Jon,” Patrick mumbles, Dr. Toews’ first name slipping from his lips so easily. “Got no pulse, but that’s shockable, yeah?”
“He’s in V-Tach,” Dr. Toews confirms. “Let’s shock it, charge to 200.”
“Charging,” another nurse repeats, pressing the button on the defibrillator.
“Everybody clear?” Dr. Toews checks, and every hand goes up in the air as a shock pulses through Mr. Donovan. “Continue CPR and somebody check for a carotid.”
Dr. Toews steps in to check for a femoral himself, while Patrick does as he’s asked, pressing his fingers to the patient’s neck.
Nothing. There’s nothing. Patrick glances at Dr. Toews, and he knows from the look on his face and his own experience that there won’t be. Mr. Donovan was gone when he got here, his extremities pale and cold.
“Push a dose of bicarb, and another epi in two,” Dr. Toews says, and so they do, a moment of understanding passing between them. When there’s a family down the hall to speak to, doing everything you can sometimes means doing a little more than you know is necessary.
After fifteen minutes, another shock, and nearly thirty cycles of CPR, Dr. Toews calls it.
“Time of death, 5:42,” he says, and the room falls into an uneasy silence before everyone starts moving to pick up the disaster. They’ve all been here before, but that initial empty feeling after a loss always comes. “Nothing more we could do, guys. Too far gone.”
He removes his gloves, and Patrick does the same, walking over to Dr. Toews at the trash can. “I’ll go with you to talk to the family.”
“Fine with me,” he nods, blowing out a breath and scrubbing a hand over his face. He looks tired more than anything, though his day’s just begun, and Patrick feels the urge to touch him nudging at the periphery of his control.
“Let’s go,” Dr. Toews adds, so they do...
Patrick thinks about that conversation with the Donovans later, while he’s gathering his things to leave, after the charting’s been done and the funeral home’s come and gone.
Dr. Toews chose his words carefully, and spoke to the family with such empathy and kindness. He was professional, tactful, and thorough in explaining Mr. Donovan’s critical condition, and when he said his team did everything that could be done, it didn’t feel cheap, it felt true. Despite the outcome, Patrick could tell he had their trust.
He remembers Steeger bringing up his supposed inexperience earlier, but it’s clear to him after just a few hours, that any worries can be put to rest. Patrick’s been here long enough to know on instinct when a doctor can hang in this department. Dr. Toews speaks as though the place is already his, from a position of competence and leadership, not arrogance. It’s nice to see, is all.
Around 6:55, Patrick checks the computer in the comparatively lowly nurses’ breakroom one more time to make sure all his charts are signed and closed, then slings his backpack over his shoulder, ready to make his escape. As only luck would have it, he runs into Dr. Toews in the hallway, another empty coffee cup in his hand.
“Patrick,” he breathes out, corner of his mouth quirking up in a half-smile that doesn’t reach his eyes. “I’m glad I caught you.”
“You drink a lot of coffee,” Patrick notes, and Dr. Toews actually looks a little embarrassed by it.
“I know, I’m trying to cut back.”
“Are you?” Patrick teases, secretly delighted when the tips of his ears turn red to match his cheeks.
“I was thinking about it, but after that…” Dr. Toews shrugs. “Some start, huh?”
He briefly diverts his gaze before making eye contact again, and there’s a hint of vulnerability beneath his confidence that Patrick didn’t hear out there—that he’ll likely never hear out there. This is the Dr. Toews Patrick spoke with before the job started, more open and relaxed.
This is Jonathan.
“Nobody’s doubting you, Jon,” Patrick assures him, just in case that’s what he was thinking. He doesn’t seem like a guy who doubts his abilities much; still, Patrick can’t stop himself from pressing the issue. “You were awesome in there, and with the family.”
“I’ve been practicing,” Jonathan says, waggling his eyebrows as a perfect ender to a classic dad joke. Patrick’s laugh comes easy, regardless of the lame. “Seriously though, I appreciate you coming in there, by the way. It’s not an easy thing.”
“No, it isn’t,” Patrick agrees, trying and failing to hold in a yawn that breaks the tension. “Happy to be of assistance.”
“And even happier to leave,” he finishes. “Go get some rest.”
“Yes, sir,” Patrick says, completely out of habit.
Jonathan levels him with a look that’s much unimpressed.
“See you around, Jon,” Patrick offers in apology, and his answering smile is soft and satisfied.
“See you...”