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John Carter was ten years old when he first hurt himself. Following the death of his brother, he locked himself in his room. His parents were too stuck in their own grief to pay attention to him, and, without the necessary supervision, John dragged the jagged edge of a model plane across his skin.
It was small and healed over in just a few days without leaving a scar. It didn't even bleed beyond a pearl or two forming at the line. But he still did it. The grief consumed him until his mind told him that the best way to cope was by hurting himself.
The next time John hurt himself, he was eleven. It was only a few months after Bobby died, so his grief was still clouding his head every single day. His parents were still stuck in it too. They were gone most of the time, but when they were there, they didn't really exist. His father was cold. Mean. He scolded John and pushed him around for silly things that never used to matter. His mother was a shell of her old self. She never even looked at John for more than a few seconds, and certainly never spoke to him. So big things like birthdays just passed without a second thought and, before John knew it, he was eleven and spending his free time alone in his room.
His parent's hired a new maid. Her name was Sylvia and she was a young twenty-five-year-old freshly graduated biology student. When they first met, she crouched down to his height and smiled brightly, introducing herself as his new maid. Just a day later she told him that she was trying to save up money before making a big move across the country. The next day she told him that she was lonely.
"You must be lonely too, huh?" She asked him, voice dripping in pity. She knew about Bobby and would often ask John how he was doing with that. "Your parents seem really upset…are you close with them?"
Two weeks after she started, Sylvia snuck into his room one night. She told him that she could make him feel better and all he had to do was be quiet and keep it a secret. When she left, John grabbed his model plane and pressed the jagged metal into his unmarred skin. He pressed hard enough that the skin split and the little beads of blood collected in the wound before slowly dripping down his arm. He pressed harder and harder until the blood was flowing freely from the cut and he was crying silently.
The cut was small, no more than an inch in length, but it took time to heal. John didn't even bother thinking of an excuse because no one cared enough to ask what happened. He still had a thin one-inch scar at the top of his wrist. It had faded over the years and existed as a small white sliver that only became visible when he got a tan.
For years, anytime something traumatic happened, John relied on pressing something sharp into his skin. Sometimes when he had nightmares about Bobby's death or Sylvia's wandering hands, he woke up in a sweat and blindly reached for his model plane. He always told himself that he had control over his urges, so it really wasn't a bad thing, but that control slowly slipped away. Soon, he upgraded to pocketknives and blades, his model plane and its jagged edge that took effort to do any real damage was forgotten. His new tools required minimal effort and the deep aching pressure that satisfied John's urges took longer to get as the blade only created a sharp sting with each cut.
Soon, he lost control.
Although he refused to admit to himself, he slipped into something close to addiction where every problem, no matter how minor, was solved with a new cut. John watched the blood bead at the line and slide across his skin, mesmerized. He trailed his finger through the blood and dragged his blunt fingernails over the fresh cuts just to increase that deep stinging sensation. He pressed his thumb over the cuts as they began to heal until bruises formed behind them.
Once his control started slipping, John moved his cuts to his hips and thighs. Places he could easily hide no matter what season. With the new location and the extra layer of secrecy, John got more brutal with his body. He pressed harder, deeper. He carved line after line in quick succession until the pain was overwhelming and left his hands shaking.
In college, things got better. They weren't great and the urges never completely went away, but John didn't reach for his blade nearly as often. His cuts healed and formed white scares across his skin that weren't all that visible despite the large number of them. He would go days, weeks, and, eventually, months without cutting himself. He did press a bruise into his skin every so often and track the coloration as they went from a deep purple to a sickly yellow-green. Sometimes when the stress of med school became too much, he shook with the effort of repressing his urges and opted for a quick few smacks to the side of his head over the stinging of a cut or the ache of a bruise. The headaches were instantaneous and it left him rattled for a few minutes, but it was a quick, easy way to calm himself down and satisfy the urges.
Once he got to County, he continued to rely on bruises and headaches to fulfill his urges. Working in the ER almost seemed to benefit in some ways because the highs were so high that John felt like nothing could bring him down. Even Doctor Benton's harsh criticism and lack of encouragement wasn't enough to make his urges flare. Unfortunately, the lows were also extremely low.
After Rena Carleton, John's urge to slice open his skin and watch the blood pour down his leg was so strong he shook with it. His knee bounced as he sat on the padded chair, his jaw clenched and fingers moving rapidly in his lap. He flexed his fingers and twisted them harshly to try and repress his urge that hadn't been that strong in years. All he could think about as he stared at the shiny floor was the feeling of the sharp sting of his skin being split open and the sight of hot, red blood spilling over his pale skin. The way the cuts would slowly heal over becoming bumpy scabs before the once severed skin would slowly patch itself up. How the scar would start as a deep pink before gradually fading more and more until they became the sliver of white he was familiar with.
He envisioned what he would use. Perhaps a kitchen knife or the blade from his razor or a nail in the forgotten toolbox that lived in the garden shed. How many cuts would he make before he was fully satisfied? How much blood would he lose? How deep would he have to press to wash away the guilt he felt over not treating Ms. Carleton with the respect he should've?
"Carter." John looked up and made eye contact with Peter despite wanting nothing more than to hide away in some dark corner and carve away at his own skin as he stared blankly at the blood that oozed from his body.
John ended up going to Peter's for Thanksgiving. He met the Benton family and ate their food with a smile as the warm atmosphere of a loving family pushed his urges away until he almost felt normal. He still had that itch in the back of his mind that called out for pain, but it was suppressed among the company of a family that John pretended was his own for just a few comforting hours.
After that, John managed to remain clean of cuts for a couple years. He still relied on his other methods of harm to muffle the stress that terrorized his mind at times. As his surgical residency became more and more stressful, he found himself pressing more and more bruises into his skin. He played them off by complaining about bumping into just about anything and, given his track record of being quite clumsy, no one questioned him. Mark did catch him hitting himself on the side of the head, but he simply claimed he had water lodged in his ear canal.
Then Dennis died.
Despite their efforts, Dennis died in the trauma room. The chest tube, the compressions, the Epi, the Atropine. It didn't matter. He flatlined and they couldn't bring him back.
John stumbled back from Dennis's body as the time of death was called out and the beeping monitors were shut off. His eyes lingered over his friend's mangled face, taking in the last time he would ever lay his eyes on his physical body. The chest tube was still sticking from his body and John wondered if he could've done a better job. Maybe if he did it faster Dennis would be alive. They would be wheeling him up to the OR before he got settled in the ICU. Then again, maybe this all could've been avoided if John was there for Dennis these last few weeks. The paramedic suggested the possibility of this being a suicide. If John had been there, really been there, then maybe he would've seen the signs.
Feeling sick to his stomach, John stumbled back a few more steps. Deep in his chest, the felt the pressure that came with the overwhelming emotions that flooded his body. Then came the urge. It didn't start as a small itch in the back of his mind that grew stronger and stronger but rather hit him full force. The all-consuming urge to shred his skin and rip it off his bones almost made him fall over. He saw a lavage blade out of the corner of his eye and grabbed it with shaking fingers before swiftly leaving the room.
The guilt and fear and sadness ate away at him until the only thing he could think of was stabbing at his body and bleeding out.
—
Peter watched Carter stumble away from Gant, eyes wide. He was shocked, no doubt. Peter was too, enough that it had him lingering in the trauma room even as the nurses started to begin the process of cleaning up the room for the next unfortunate soul who was hurt enough to find their way in this room. He wasn't close to Gant, not like Carter was, but the resident's presence had grown familiar to him. Even though he didn't say it much, Gant was a very promising resident who could turn out to be a great surgeon in the future if he worked on his focus and removing his personal struggles from the OR. But he had potential and Peter wanted to see him succeed.
Carter moved back again, his hands trembling. He kept his eyes on Gant the entire time until they quickly glanced to his right before his hand slowly reached out to grab something. Peter shifted his weight to try and get a look on what he was taking but was unable to see it. Frowning, he watched as his resident basically fled the room.
Peter might not have the best bedside manner or be a particularly cozy person, but he wasn't stupid. He knew what grief could do to a person and Carter was kind with a soft soul that was easily affected. Losing a patient was hard for everyone, but this wasn't just a patient. This was Gant. This was Carter's roommate. His friend.
He followed Carter out of the room and just barely caught sight of him tumbling into the bathroom. When he entered the bathroom, he stepped over the trail of Carter's discarded bloody gown and gloves. He heard faint rustling and heavy breathing coming from the first stall.
"Carter," he said as he knocked on the door which creaked open with the pressure since it was never locked. "What the hell are you doing?"
Peter stared wide-eyed at an equally shocked John Carter who had his scrub bottoms pooling around his ankles with one hand pulling up the bottom of his boxers to reveal his upper thigh and the other clutching a blade.
Carter made an unintelligible noise that echoed through the otherwise silent bathroom before slamming the stall closed. Peter pushed against it before his resident could trap himself in there. Although Peter was more than willing to crawl across the dirty bathroom floor if it meant keeping Carter from cutting himself.
"Go away!" Carter managed to get the door locked but dropped the blade in the process. Hearing the clink of the metal, Peter dove down and snatched the blade before Carter's shaky fingers could reach it.
Peter took a few steps backwards, blade clutched in his hand and chest heaving from how quickly everything just happened. His usually quick mind faltered as he tried to understand what he saw. He almost felt like his eyes played a trick on him and he didn't actually just see surgical resident John Carter seconds away from dragging a blade across his thigh. The worst thing Peter thought he was about to walk in on involved nothing more serious than a bit of vomit and tears.
The room fell into an uncomfortable silence that was soon broken by the rustling of Carter's scrubs being pulled up. Peter struggled with what to say and he couldn't keep his eyes off the blade for more than a second before they moved back.
Finally, he spoke without much of a plan, but the knowledge that he needed to say something. "Carter, can you come out here?" He kept his voice as soft as he could, utilizing the tone of voice he only ever let his younger patients hear. "Come on," he said when there was no response for a minute. "Please, Carter. Just come here."
There was silence on the other side of the stall for ten, twenty, thirty seconds before the lock clicked at the door creaked open to reveal Carter who stood with his head down and arms hanging limply at his side in defeat.
Peter sighed. "What the hell, man?" He breathed out sadder than intended.
Carter's shoulders hunched and one hand covered his face as he began to cry. Choked, ragged sobs were half-muffled by his hand as he dug the heel of his other hand into his thigh. Tears dripped onto the floor before Carter moved his hand to roughly rub at his eyes while biting his cheek to try and stop the sobs.
Peter placed the blade in the sink closest to him before tugging Carter to his chest. He wrapped an arm around him and held him close with one hand on the back of his head, his fingers lightly threading through his hair. "It's okay," he whispered, unsure of what else he could say.
Carter clung onto him, hands fisted in his scrub top and face resting on his shoulder. He cried more openly but still kept himself quiet. Whether out of habit or out of embarrassment, Peter didn't know.
He did know that he would need to have a serious conversation with Carter though. Or someone did. If Carter preferred to see a counselor to talk about his desire to hurt himself, that was fine too. He just needed to talk to someone. Whether this was the first incident or if he had a history of turning toward self-harm, Carter needed support. Peter wanted to voice that in some sort of way amidst the soothing, but he struggled to think of a way to say it. Everything felt too harsh or impersonal which wasn't what worked with Carter. He needed support and Peter didn't know how to give that.
But as Carter cried against his shoulder and held onto him like his life depended on it, Peter thought that this was all the support Carter needed at the moment.