Chapter Text
Most people in the Pitt when asked about Jack Abbot would say that he was one of the calmest doctors under pressure they had ever witnessed, that he could talk anyone through a difficult procedure with ease, that he was steady after a 12 hour shift when everyone else gave the impression that they were about to collapse. He was able to command a trauma room with such ease, even when the stakes were high, or family members screamed out for their loved ones. He was perfectly able to confer with people about their research, even when he was exhausted, brain lagging slightly, but still interested enough to concentrate and listen, giving advice when needed.
This was the person that Jack abbot had managed to become every day for the last 10 years, ever since being discharged from the Army, with a missing limb and a psych so screwed he wasn’t sure how to make it from one day to the next, just the knowing that he had to, that it was his duty to do so in remembrance of those he had lost along with his leg. When he was at work, he was a stable presence, providing structure and support to his shifts. He was a person his colleagues could go to for help and a person the patients could rely on to help them when it was possible.
However, when he got home, no matter how good or bad the shift was, he was reminded of the sadness and loneliness that blanketed his life, the terrors he had seen and what he had done to survive, and the people he had lost in doing so. He would shuffle to his room after his nights spent in the ER and his sleep, when it eventually came, would be filled with dreams of his time in Afghanistan, scenes from trauma rooms where he lost soldiers, of the patients he lost out in the desert and of the fateful day where his leg was blown off by an IED, this particular nightmare resulting in him waking at the sound of his own screams filling his bedroom, sweat running down his back and tears streaming down his face.
When his dreams weren’t filled with his time in Afghanistan, images of his childhood came to him, of which he could only ever remember the bad parts. His father screaming at him to get out of his house as he confessed that yes, he had been kissing a guy out in the bleachers, and no, he was not sorry. Memories of his father hitting him around the face as a small child for speaking up at the dinner table, ran rampant when he slept, leaving him to wake up confused and remember that no he isn’t there anymore, he’s home, far away from what he finds difficult to call his childhood, because he never really remembers having it, not a stereotypical one that is.
It wasn’t just in sleep that he struggled. He had vivid flashes of memories during the day, which often paralysed him on the spot, unable to move or think of anything else until the memory passed, until it stopped running circles around his head, until he convinced himself that he wasn’t there anymore and only then could he go back to what he was doing. These memories plagued his everyday, even now at 47 years old, when he had to play the role of attending physician, who had it all together, at a top trauma centre, when he seriously couldn’t be dealing with them and needed to be as functional as possible.
He had been managing for a while, he saw his therapist once a week, he was only having flashbacks in the safety and comfort of his apartment, and they weren’t happening as often as they used to and the daily nightmares were manageable. However, it was inevitable that his carefully constructed routine that allowed him to manage his life this way, would fail at some point.
It was coming up on the 10-year anniversary of losing his leg, and things were beginning to slip. His sleep was more interrupted than ever by nightmares of desert sands and gun fire, explosions all around and so much blood than he woke up grasping at his right leg, and violent tears streaming down his face. During the days he was off, when his brain was no longer distracted by the hum of the Pitt, he would be thrust into a flashback which left him stuck for hours on the floor, completely unable to control his own mind and body, until he fell asleep and woke up delirious and confused. He knew that he needed to call his therapist, he was falling back into old habits that he hadn’t relied on since he first returned from his last tour and his childhood, but in the moments after one of his nightmares or episodes which left him curled up under his bed or in a dark corner of his living room, hands over his head and the sound of bombs and gunfire in the distance, it was the only thing he felt he could do to dampen the terror he felt so deeply.
That’s how he found himself on the floor of his bathroom, with one of his many first aid kits at his side and a razor blade in his palm. He had just woken from what felt like only an hour’s worth of sleep after a brutal shift, which had taken so much from so many people and had left him feeling rung out when it was over. He had tried so hard to remain calm and present throughout, but at times he could feel his concentration wavering and the ringing in his ears, which he gets before a flashback, making its presence known. He had stumbled to the bathroom after waking in a cold sweat, clothing drenched, breathing coming rapid and a mind that couldn’t quite remember what he had been dreaming about but not quite able to grasp yet that he wasn’t there anymore.
He was so used to the act of cutting that it no longer came as a shock to drag the blade across his upper thigh; he simply breathed and watched as the small droplets of blood bloomed onto the surface, before running onto the surrounding skin, which carried the evidence of his almost four-decade-old habit. He often felt ashamed of his inability to give up on this adolescent habit, which had helped him through his teenage years and which his younger self thought he would grow out of eventually. However, this was never bound to happen as his life hadn’t turned out like how his younger self had thought it would.
He sat on the tiled floor, legs extended out in front of him, and dragged the blade across his right thigh, not caring how many times he did so, until the pounding in his chest slowed and his breathing came easier, until the sounds from his dreams dissipated and he could finally hear the traffic going by outside his apartment. After he was finished, he stared at the damage, from today and that done in the days previous, and sighed heavily into the empty bathroom. He knew what he was doing was harmful, he knew that he should call his therapist, call Robby or Dana, but he couldn’t bring up such a carefully concealed part of himself, something he did in a way that meant nobody would accidentally find out about it, with anyone.
There were 5 new cuts on his thigh, which he only noticed when he finally managed to orient himself enough to look properly. A couple were probably too deep and needed a few stitches but he wasn’t currently in the mindset to care about such tedious efforts on his part, and instead stuck to cleaning his leg of blood, which was slowly leaking from each cut, with antiseptic wipes and placing a wad of gauze on the offended area before wrapping a length of bandage round his thigh and sticking it down with some tape. He sat for a while, contemplating what he had done and when he would likely do it next, tomorrow probably, and when he had last done it, yesterday. With that thought, he looked under the bandage on his left thigh. There was yellow pus covering the surface of the previously white gauze, and a smell which Jack would more commonly associate with dying flesh coming from the wounded area. As much as Jack was a doctor and knew better than what he was about to do, he was also a man currently not in the best state of mind, so he covered the area back up and got on with his day.
After cleaning up and putting away his first aid kit, Jack made his way back into the bedroom using the crutch, which had been resting against the bathroom tiles and sat down on his bed slowly. He pulled on a pair of sweatpants and a hoodie which had been discarded on the opposite side of his bed, before transferring himself into his wheelchair and pushing himself into his living room. He didn’t plan on using his leg today.
The sun was beating down outside, casting rays through the blinds. He got a glass of water from the kitchen, not feeling all that hungry for anything of any substance despite not having eaten in around 20 hours, and set it down on the coffee table and transferred himself onto the couch. He swiped through his notifications, of which there were not many, one from his sister and a couple from Robby notifying him of the status of some of the patients which were left over from his night shift. He always appreciated Robby’s effort to update him on patients, which he and his team put so much effort into trying to help, whether that be in the trauma rooms or those from the waiting room. Robby knew first hand how much each individual patient meant to him, so hearing that they had made it through surgery or were discharged with a survivable prognosis made his day just a little bit easier.
Jack felt a sudden wave of nausea pass over him, feeling lightheaded and slightly breathless, leading him to lay down on the couch, pulling the throw blanket, which was draped over the back of the couch, over himself and snuggling into it, resting his head on a pillow left from the last time Robby had stayed over. He grabbed the TV remote off the table and, after turning it on, picked a nature documentary to watch. However, before long, his eye lids became heavy with sleep, he was so tired after both his shift the night before but also his morning activities that after only 10 minutes of being curled up on the couch, Jack Abbot was asleep.
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Jack could see the sand dunes in the distance, the horizon lined with them, and dust clouds were forming all around them. The ground was rough beneath him, and the smell of burning fuel and metal penetrated his nostrils as he looked around the wreckage of the Humvee, which he and his fellow medics and soldiers had just been riding in, back to their base.
His head was swimming in an ocean of muffled noises, shots being fired and fires forming around the Humvee where fuel was leaking continuously onto the sand, the hum of an engine that was soon to explode and most horrifying, the sound of men shouting, screaming for help, help that was not coming.
Jack moved his hands up from where he had been leaning on them to keep himself up and pulled off his cracked goggles, finally seeing his surroundings clearly. He could make out Charles and barns from where he was, both screaming into the silent and dark desert for somebody, anybody. James was lying to his right, deceased, and the others he assumed were still inside the broken pieces of the Humvee, likely trapped or dead on impact.
Charles must have seen movement as he sharply stopped his shouting and began moving towards him, face covered in ash and burn marks all over his trousers.
‘Abbot, is that you, you with us?’ Charles called, coughing every few steps before dropping down in front of Jack, hands coming up to shake his shoulders lightly.
‘Yeah, yeah, I’m alright.’ Jack said, breathing heavily and trying to focus on the man in front of him. Barns followed shortly behind and came up behind Charles; his face suddenly paled at the sight of Jack.
‘What is it Barns? Spit it out!’ Jack exclaimed at Barns’ unusual silence.
‘Well, I wouldn’t say you were alright Abbot if I’m being honest.’ Barns said as he pointed to Jack's legs, which were stretched out in front of him. The left one was unscathed, however, the ankle and foot as well as part of his tibia and fibula of his right leg were twisted at a 90-degree angle, bones sticking out and blood pouring from the wound.
Jack was frozen, he knew exactly what to do in a situation like this and he had been trained for it. Unfortunately, this was his leg he was faced with, and all his knowledge, experience and training meant nothing when it was his leg that was in shatters beneath him.
‘Oh god.’ was all he could mutter as he stared at the limb. The shock and adrenaline were beginning to recede and instead be replaced by pain, the acknowledgement of the injury bringing this process on much faster than anticipated and Jack knew what had to be done if he wanted to live.
‘Okay, okay, you’re going to need to cut the rest of.’ Jack said quickly to the men in front of him, their already pale faces becoming whiter and refusal at the request already making its way onto their lips. However, Jack beat them to it.
‘No, you must. I’ll bleed out if we don’t remove it and pack the wound. I’ll talk you both through, it and it’ll be done in minutes.’ Neither man looked convinced, but they agreed that they wouldn’t be able to get out of there with Jack in his current state.
Jack quickly grabbed a tourniquet out of his med bag and placed it on his lower thigh, before removing a pair of trauma shears and a bone saw out of the back pocket of the bag, a place for tools that he rarely had to use and handed each over to Charles. The man looked horrified, already knowing what he was about to do.
‘Okay Barns, you’re going to make sure I don’t fall unconscious and if I do, wake me the hell up. Charles, you’re going to need to first cut through the tissue still attached to the lower limb using those.’ Jack pointed to the trauma shears. ‘Then you’re going to cut through the bone using that.’ Jack said, pointing at the bone saw. ‘I’m going to scream, a lot, but just ignore it as much as you can.’ Jack looked out into the desert, seriously contemplating how the fuck he ended up in this situation and why the fuck he had to be in one of the Humvees that would inevitably blow up during this war.
He looked back at Charles and Barns, too young to be out here, and was reminded that he was once them. New recruits in a war that wasn’t made for the faint of heart or the empathetic, for the people who cared so deeply it hurt to cause people harm, whether that be from just holding a gun with the intent to use it or from the eventual act of firing the bullets. However, those that did possess these traits, like Jack, could compartmentalise and shove it all down, and he suspected that the 2 soldiers in front of him would soon get very good at doing just that.
‘Okay, on the count of three, Charles, start cutting, and Barns, don’t let me faint. If I do, pack the hell out of the wound with as many gauze as possible and scream in my face until I wake up.’ Barns rummaged through the med bag as Jack spoke, pulling out a bundle of fabric and handed it to Jack.
‘You’re not alerting anyone who might be nearby of our position before we get even the slightest chance to get out of here with your screams.’ Barns gestured to the rag. Jack understood immediately and held it against his mouth.
Charles began counting down from 3, and before Jack could take another breath, the trauma shears were slicing through muscle and fat, nerves tangled in it all. His screams were quickly muffled by the rag which had found its way between his teeth, tears streaming down his sand dusted and heat stricken face along with the sweat that had created a sheen over his skin.
Awareness didn’t last long, before Charles even had the chance to get the bone saw out of the med bag, Jack could feel the firm grip of unconsciousness pulling him under until all he could hear was the distant shouts of his name and then suddenly nothing as the darkness took over.
----
Jack jolted awake, shallow breathing coming fast and wetness on his face that felt sticky and fluid at once. He could feel the tremors racking his frame where he lay and sweat covering his back. He was barely awake and didn’t have to open his eyes to know something was wrong. He was burning on the outside, skin clammy and hot, but internally he was freezing, pulling the blanket further up to his chin, where he curled in on himself more. He slowly realised where he was, not in his bed or on the floor like he so often was these days, instead on the couch facing a TV playing a documentary he couldn’t remember putting on. He felt his eyelid begin to close again, but managed to pry them open with the remaining energy he had left, which felt like very little despite being asleep for God knows how long, and glanced at the clock on the wall, which informed him that it was 6:30pm.
He drew a hand up and ran it through his sweat-dampened curls. This was not normal; this wasn’t what he usually felt like after a day like today, even after having a few nightmares that would have him in a similar state to the one he was in now, but never this bad. He couldn’t think, his mind running in circles, trying to grasp onto reasons he might be feeling so terribly, but in his feverish state, he found nothing. He could imagine his temperature was well into the hundreds right now and he could feel the nausea building, threatening to spill over, his breathing was getting worse and his heart rate was increasing by the minute.
He remained on the couch, trying to breathe, trying to delay the inevitable until it was too late and he was retching over the side of the couch, bile and the small amount of food left over from this morning descending to the floor. His stomach rolling and head pounding, he found the hand not currently holding his weak body upright grasping his phone in front of him. He focused as much as he could on the screen, vision swimming as he did so, where he found his contacts and found the name that if he were in a better state, he definitely wouldn’t be calling.
After clicking on the contact sluggishly, his body fell heavily against the couch, arms too tired to hold him upright anymore. It only rang twice before the cheery voice of Robby could be heard through the speaker.
‘Hey man, you ok? I didn’t expect to hear from you today; it is your day off, remember.’ Robby Joked down the line, if only he knew.
‘Robby.’ Jack breathed sharply, with more tears falling as bile rose in his throat again. ‘Something’s wrong, man. I need help.’