Chapter Text
He took a deep breath before walking through the front doors to the Emergency Department. His brain felt clearer than it had the last time he walked in, his heart beat in a steady thrum and not the panicked patter that he vaguely remembered seizing his chest in the past. His heart, though. . .that felt heavy, cautious. He knew that walking through the doors wasn’t the difficult part. It wasn’t gthe place, or the medicine that had caused his panic attacks, caused the ceaseless worry and frustration that had plagued him for half a decade – it was the people. It was all of the people, and although he’d put them on hold – mostly – for the past three months or so, he was about to encounter them.
First, he knew, there would be the people in the waiting room – the unwashed masses, with running noses, with broken bones, with heart palpitations and wheezing in their chests and strange sores that they should really take to a dermatologist except that they don’t have insurance. First it will be the worried mothers, the anxious fathers, the drug-seeking and the homeless and the thousand of other people that Pittsburgh would cough up and spit out in the early fall weather. First it would be the faces that he didn’t know, but that would still cause his chest to ache when he wasn’t able to save them, that would give only the slightest flutter of joy when they could.
But then it would be the people of the Emergency Department – the medical students and residents who looked up to him, the nurses who depended on him, the other attendings who variously pitied and admired him. The people he was responsible for.
The thought of seeing them again hurt.
He walked through the doors anyway.
It was the smell that hit him first – the sour, acrid fumes of body odor and wet wool. There was a vague, antiseptic undertone to it, the unique smell of hospital that would soon cling to his own skin, but here in the waiting room it fell beneath the acrid scent of fear, pain, sweat, and body odor. Robby’s lips twitched in a smile. Home sweet home.
As he made his way through the waiting room, he caught Lupe’s eyes from where she manned the front desk. She raised one eyebrow at him.
“How’s it been, Perez?” he asked, as he sauntered by.
“Nice to have you back, Dr. Robby,” she answered. “Dana know you’ve back today?”
He shrugged. “She gets the same schedule we all get.”
“Good luck with that,” she said, before turning and calling another person to the desk to retrieve an insurance card. Robby allowed his lips to quirk as he pushed his way into the ED.
It was quiet, which was a little unnerving. There was the normal bustle – environmental services personnel mopping the floor, the hurried rush of nurses and residents across the floor – but overall it was quiet. No panic, at least not yet. He shrugged his backpack off, held it with one hand. Decisions, decisions – whether to stop at the front desk, or head immediately to the lockers. While he was still deciding, his eyes made contact with Dana, standing beside Lena at the front desk and clearly in the middle of handover. She crossed her arms deliberately. Robby sighed.
“Hi, Dana.”
“Hi, Dana,” she scoffed, before turning to Lena. “You hear that? Hi, Dana. Three months with nothing more than the occasional text message and some photos of sunsets and then he greets me with a ‘Hi, Dana.’”
Lena rolled her eyes and handed over a tablet. “No way that I’m getting in the middle of whatever this is,” she said. “Dr. Robby, it’s nice to have you back. Dana, enjoy the clean board we left you with.”
With that, Lena quickly ducked out of the way. Robby shrugged, a little shame-faced. Dana wasn’t entirely telling the truth. For the first week he’d sent her several emails, detailing where he’d been on the bike, what he’d been doing. He knew she’d worry, and he hoped that the responsible updates would allay some of that. As the trip had gotten longer – as he’d gotten better – the emails had tapered off, replaced by photos of the breakfasts, lunches, and dinners he was eating. Proof of life, but also proof that he was healing. Dana had always shown a piece of her heart through food – sticking a protein bar in his pocket, sidling up with a cup of coffee unasked. She’d fretted about how often he’d skipped lunches. The photos were supposed to be a sign to her that he was taking care of himself.
Dana sighed, and stepped out from around the desk. Robby flinched a little, uncertain whether she was going to shove him or hit him. To his surprise, she did neither, instead flinging her arms around him. “Lena’s right,” she muttered into his shoulder. “It’s good to have you back.”
Almost immediately, she disentangled herself, coughing a little to clear the emotion from his throat. Robby let out a long breath. One greeting down, only about a hundred to go. But at least there were only a handful that he worried about the way he’d worried about Dana’s reaction.
“Who’s here for handoff?” he asked her, as if he hadn’t pored over the scheduled last week. He’d taken the sabbatical to heart – hadn’t look at anything from the hospital for almost ten straight weeks – but he’d needed to know what he was walking into on his first day back. Shen should be here somewhere, for handoff. Frank wasn’t working, thank goodness for small favors. And other than that, it was the normal mix of day shift personnel, with the added bonus of Howard filling in as a second attending.
Al-Hashimi had called him about that, the Monday after he’d left. Confirmed that she’d alerted the hospital to her condition, and confirmed that they’d approved her plan of two attendings on every shift. She was going to move to night shift, she told him – a little quieter, if a little weirder, but a better place for monitoring. With a little distance, Robby had to admit she’d been right. Two attendings was a good call. While it was a bit of a hit to his pride, she’d also been right that he shouldn’t have been doing it all alone.
“Shen,” Dana said, raising one eyebrow as if she knew he’d already looked at the schedule, had it practically memorized. “Why, disappointed that it isn’t someone else?”
“Shoot, Dana, I only met Al-Hashimi for a day, it wasn’t that deep,” he said, a playful tone in his voice. Dana rolled her eyes again, her universal prayer to God to give her the patience to deal with Michael Robinavitch. “Let me go throw these things in the locker, and then I’ll be back. Any idea where Shen is right now?”
“Trauma 2,” she responded. “But you better drop that stuff fast – that boy is out of here at 7 am sharp. He doesn’t like to dawdle and flirt like Abbot.”
A little zing in his stomach at that, but he forced himself not to react. “Can’t blame him for not wanting to flirt with Howard,” he said. “He may change his mind when he learns I’m back on the floor.”
“Trust me,” Dana muttered, “everyone in the Department knows you’re back on the floor today.”
The locker room looked the same as usual, except that a few pieces of masking tape had moved around. He quickly looked for some familiar names, disappointed but not surprised that he didn’t see Mohan’s name anywhere – a bit confused that Ellis had stuck masking tape on a locker apparently shared with Shen. No Javadi, which made sense – she’d probably had to move on to another rotation. Santos, McKay, Langdon, King, and Whittaker’s names were on the same lockers they’d been before he left. The nurses seemed more or less the same, as well – a few new names, a few old-timers gone, but pretty consistent.
He dumped his things in one of the unclaimed lockers, as usual. He didn’t technically have a right to any of the lockers down here – he was supposed to put his things in his office. The office that he avoided using at even the best of times, and one he definitely wasn’t ready to return to on his first day back. He wondered if Al-Hashimi had started putting her things in there, wondering if she had been using it in his absence. He hoped she had. It was quiet, which was nice. And it could use a little redecorating.
After slinging his stethoscope around his neck and taking a deep, steadying breath, Robby headed back into heart of the ED. He skirted by the charge nurse desk and ducked into Trauma 2, catching what appeared to be the end of a procedure, as Shen was snapping off his gloves and nodding at two apparent med students that Robby didn’t know.
“Dr. Robby!” he exclaimed, his eyebrows shooting back up. “I didn’t know you were back today.”
“I did,” Ellis said, her tone a little dark. Robby turned to her in surprise, but she was busy organizing the instrument tray. He’d probably just misinterpreted the tone of her voice – he’d never been able to read her dry humor the way Jack did.
“Doesn’t anyone read the schedule?” Robby asked drolly. Shen shrugged and patted him on the back.
“Just enough to see if I’m on weekends or holidays,” Shen said. “Not like some of the busybodies around here.” With that, he shot a pointed glance at Ellis, who was still studiously avoiding Robby’s gaze. Shen sighed, clapped Robby on the shoulder. “Come on, man, I’ll update you on the beds.”
“Still more bodies than beds?” Robby asked. Shen chuckled.
“The more things change, the more they stay the same.”
Handoff was as easy as Shen and Lena had promised – several boarders, still waitin g on beds but overall stable. An MVA waiting on a CT, but otherwise uncomplicated, and a pair of overdoses with a few hours left on monitoring before they could be released. Other than that, Shen warned him, it was a horde of people who should be going to urgent care or their PCM for minor ailments.
“Then what are they all doing here?” Robby asked. “Has Gloria been advertising again?”
“No insurance,” Santos said, breezing by. “Hey boss, welcome back.”
“Good to be back,” Robby muttered. He turned to Shen. “She right?”
“Seemingly,” Shen shrugged. “Way above my paygrade, man.”
“Fair enough.” Robby glanced at the board. “Anything else I should know about?”
Shen paused a moment, looked up at the ceiling thoughtfully. “I don’t think so,” he said. “Gloria hired some more security personnel – Ahmad is trying to hide the bet on how long they last, you should get in on that. We have another disaster training coming up next week – holding it during swing shift to get as many attendings as possible. Oh, and Donnie’s pregnant again – make sure to congratulate him.”
Robby’s throat itched to ask additional questions. Had anyone missed him? Dana had seemed okay, but was she, really? Had things run smoothly in his absence? Had Jack managed things? Who had met him on the roof in the dark, predawn hours after a rough night? Was Al-Hashimi holding things together? Was Gloria more pleased with his interim replacement than with his own work? Did Jack tell anyone about the late night phone calls – not so many, not really, not when compared against the ten weeks, a half dozen calls wasn’t so many. . .
He forced himself out of the endless cycle of his own thoughts. Don’t perseverate, he reminded himself, though the reminder strangely seemed to have the tones of his therapists voice. He gave Shen a thumbs up.
“Great work last night,” he said, instead of asking the questions that were now just a steady, low level thrum at the back of his head. “Catch some Zs.”
“Catch some Zs?” Dana snorted, and Robby jumped a little. He’d forgotten about her uncanny ability to sneak up on him. “Hey, cap, before you jump into everything, I think there’s someone who wants to have a word with you.”
Another sharp zing through his belly before he turned in the direction she was gesturing, spotted Whittaker standing there, his Bambi eyes huge as he held both hands on his stethoscope, fidgeting back and forth. This time, when Robby’s face broke into a grin, it was genuine.
“Hey kid,” he said, clapping one hand on the other man’s shoulder. “Thanks for looking out for my place. It looks great.”
“Yeah?” Whittaker looked oddly, desperately hopeful. “The mail wasn’t too messy? You didn’t notice anything. . .out of place?”
“Not a thing, appreciate it,” Robby said. It wasn’t true – he’d walked in and immediately spotted the replacement spider plant on the windowsill. In fairness to Whittaker, when he’d left the thing had been half dead, the victim of neglect. It had probably been a mercy when Whittaker put it out of his misery . . . whatever had happened that resulted in the covert attempt at a replacement. “Couldn’t even tell that you’d had a few orgies while I was away.”
“Orgies?” Whittaker’s ears went up in flames. “What? No, I didn’t . . . what. . .did Santos say something”
Robby chuckled, clapped him twice more on the shoulder. “I’m just joking with you. The place looked great. Seriously.”
It had been the first relief in returning from the Sabbatical. Strange, that it had been so scary to him, to send that first, simple text. To tell someone he was coming back. Just Whittaker – just the resident, but even so, his fingers had trembled over his cell phone for what felt like hours before finally managing to type: “I’ll be back tomorrow night. Sorry for the short notice.”
In no time at all, Whittaker had responded with a thumbs up, and then, a little longer, an almost-funny message detailing how often the plants had been watered, how they had been rotated for maximum sun exposure, notification that the mail was on his kitchen table, there were two packages that had been placed in the closet, he hadn’t slept there, he’d stayed at Santo’s, but he’d change the bedding so Robby could sleep in fresh sheets, and would he like the Roomba run in the morning, or the night, like Whittaker had been doing it. Robby had closed his eyes and laughed. It had been too much – too much care, too much caution, just too much after weeks on the road, alone with his. Thoughts. He’d sent back a thumbs up, and hadn’t answered any of the questions embedded in the middle of Whittaker’s long, rambling message.
Then, a little later. . .”I saw the letter on your nightstand. I didn’t do anything with it. Do you want me to do anything?”
This time, Robby had sent a real response – “No.”
When he’d gotten home, the very first thing he’d done – well, the first thing after doing a second glance at the new-old spiderplant – was head to the room and pick up the letter. It was in an envelope, that was good. Nobody had seen the words inside it, not unless Whittaker had opened it. Robby doubted that he had. He ran one hand over the name on the front of the letter, felt the small divots that his pen had left. He wasn’t entirely sure what he wanted to do with the letter, wasn’t sure whether he wanted to make sure nobody ever read it, or if he wanted, desperately, for one people to set eyes on it. In the end, he had opened the drawer to the nightstand and put it back inside, chalking it up to decision fatigue. He’d deal with it later. Or not.
Now, standing in the middle of the ED, looking down at Whittakers’ oddly nervous face, he wasn’t sure whether he should mention it again or not – whether he should ask if the resident had read the words, thumbed through the tear-streaked pages. Before he had a chance to decide, he heard a short yip of delight.
“Dr. Robby!” Mel King ran over to him, bouncing a little. She had her arms extended, as though for a hug, before pulling them back in and clapping a little. “You’re back! You’re alive!”
“Uh. . .” Robby didn’t know how to respond to that. Santos sidled up.
“Smooth, Mel,” she muttered. “Way to remind him about his suicidal ideations.”
“No, not that. . .we just missed you,” Mel said. “Not to say that things weren’t good while you were gone – I mean, they weren’t as good as when you’re here. . .but Dr. Abbot was really great, I see why you like him so much. Does this mean that he’ll be back to working Night Shift?”
“I. . .” Robby shifted a little, not quite sure how to respond to the onslaught.
“I think what she means to say is, does this mean you’ll be back to full-time and we won’t have to Hoo-ah every morning?” Santos asked.
“Hoo-ah?” Robby’s voice was, frankly, fainter than he expected. His brain was spinning a little, because it almost sounded like Jack had been a principle attending on the day shift- not just picking up a shift here or there, occasionally handling a double, but rather regularly being here with his day-shifters.
“I like the chant!” Mel said perkily.
“You would,” Santos replied.
“I think what everyone is trying to say,” Dana now, cutting in, reclaiming some semblance of order, “is that it’s nice to see you doing so well, Dr. Robby, and we are eager to continue running the ED with the same stability and competence with which we’ve managed to run it in your absence. And that we are all eager to return to the patients we were handling.”
It was a clear dismissal, and to their credit, the residents heard it for what it was, quickly scrambling back to their various patients. Ellis edged in, her face still closed off, her arms still crossed. “I’m going to handle triage,” she informed Robby and Dana, before nearly stalking off to chairs.
“She on day shift now?” Robby asked. Dana sighed.
“She followed Abbot when he came over. I think he was glad of it, honestly. It wasn’t exactly. . .easy. . .when you were out.”
Shit. Shit, shit, shit. A hole was opening in Robby’s gut, that feeling returning of your fault, your fault, your fault, not good enough, not good enough, not enough. Dana seemed to almost read his thoughts, looking at him with a mix of compassion and exhaustion.
“It wasn’t easy, but it wasn’t bad,” Dana said. “Two attendings was a good idea. But with you out. . .someone had to take some shifts on alone, and as the most senior attending. . .it wasn’t anything you haven’t been handling for years.”
She wasn’t wrong, but Robby knew the weight of handling it alone. He knew the cost.
Dana patted him on the shoulder. “Buck up, cap,” she said lightly. “You know Abbot. Wasn’t anything he couldn’t handle. Though I have no doubt he’ll be glad to hand over the paperwork.”
“Yeah,” Robby chuckled automatically, before pausing. “Wait. . .what?” Because Abbot wasn’t a fan of paperwork – no doctor was – but he was diligent about his charting, never one to have to hang around after shift to add to his notes or dictation.
“You know,” Dana said. “All the admin bullshit. The scheduling, the performance evals, the budget. . .the boring stuff.”
“I thought Al-Hashimi was handling that?”
Dana looked at him, again with the eyebrow raised that said Robby, you dumb moron. “She was covering your shift as attending. What, you think she took over your job as Chief? With only one day of turnover. Don’t be an idiot. Abbot handled it, the same way he did when your grandma died and you had to take off that week for the funeral. Now come on, chop chop, we got a waiting room full of dripping noses and weird rashes for you to deal with.”
And that was it for the shift. As Shen had warned him, it was mostly a flood of low-level colds and minor sprains. An occasional MVA came in, but the roads were still clear, Pittsburgh not yet huddled down for the grey slush of winter. Overall, Robby was pleasantly surprised by how smoothly everything went. King and McKay were rock stars, as he’d always expected, but Whittaker seemed to have grown even more in confidence in the weeks he’d been away.
Ellis, on the other hand. . .she’d never been particularly friendly toward him, gravitating more to Jack, but she’d always been professional, if distant. Today, though. . .she’d been talking with King, or Santos, until he walked over and then she’d swiftly turn and head in the opposite direction. When they were working a trauma together she directed most of her words to Santos, Whittaker, or the med students. It wasn’t. . .wrong, exactly, it was a teaching hospital, but it was disconcerting. Robby was used to a level of banter with his senior residents.
Well. . .had been used to, he had to admit. Not so much since Collins had left, and he’d sent Langdon to rehab. Not since before Pittfest, if he was being honest with himself. . .
If you aren’t honest with yourself, you certainly can’t expect anybody else to be honest with you.
Jack had never told him that one of the most annoying things about actually going to therapy was having that little voice ringing in the back of his head throughout the day.
He would have been worried by Ellis’s distance, except that he saw her consulting with Howard. He shrugged it off. Maybe it wasn’t a problem at all. She wasn’t breaking any protocol. Maybe it just took her a while to warm up.
At the end of the shift, Robby was ready to head home, and that was a whole new feeling in itself. He didn’t feel the existential dread that he used to – the endless hours of nothingness that lingered between shifts. He felt pleasantly sore, mildly hungry, and emotionally depleted. He was ready to eat take-out, rot on his couch, and go to bed and it felt. . .it felt nice. Still, despite his desire to head out, he offered to handle hand-off and let Howard cut out a little early, thanking the other man profusely for stepping up in his absence.
“Good evening, Dr. Robby,” Dr. Al-Hashimi’s calm, low voice greeted him. “I hope that your Sabbatical went well?”
Her voice was carefully professional. Robby forced his own face to remain impassive. Their last interaction had been. . .tense, to put it lightly. Still, she’d sent him a terse text message a few hours after he’d exploded at her on shift, telling him that she was reporting her medical condition to the hospital. She’d bcc’ed him on an email to Gloria, confirming that she needed to speak with the administrator as soon as possible. And she’d sent him the conditions that she’d worked out with the administration. That, and the one brief phone call.
“Good evening, Dr. Al-Hashimi,” he responded, just as professionally. “You’re looking well. Night shift treating you well?”
At that, she smiled, a little wryly. “Dr. Abbot’s Nightcrawlers have fully embraced me into their fold,” she said. “It’s. . .different.”
“The weirdest and the wildest,” Robby said, drawing a light chuckle from the other doctor.
“Indeed,” she said, inclining her head.
He told her a few short stories about his sabbatical as they rounded. Told her about the mugginess of Florida, the genuine shock and joy of spotting alligators in the everglades. He showed her a photo of his visit with an old friend in New Orleans, the two of them clinking pints of beer together. In turn, she filled him in on the hospital – as much as a newcomer could. He appreciated it, appreciated that he didn’t have to be circumspect with her, the way he did with Dana, and the day shift doctors.
She did look better, he realized, which was a strange thing to think about someone he’d only known for a day. It might just be the start of a shift, whereas his mind remember her with her wide eyes, make-up cracking on her skin, hair unbound and slightly wild. He vaguely remembered his first impression of her, as an incredibly competent, put together, restrained woman. The doctor who stood before him mirrored that woman – not the one from the end of shift who was bowing under her own stress and sense of duty.
She explained the absence of Dr. Mohan, which he appreciated – in the end, she’d headed to New Jersey after all, the surety of a job outweighing the desperate search for a fellowship opportunity that didn’t call to her. Henderson had gotten the ultrasound fellowship. He had no doubt that Jack would be happy about that, keeping one of his senior residents around for another year and then, hopefully, a shot at attending. Javadi had, indeed, moved on to a new rotation, now in psychiatry, though she spent as much time with Caleb in emergency psychiatry as she could. She seemed to be enjoying it.
Other than those changes, Al-Hashimi assured him that much was still the same.
“Thanks for the catchup,” he told her, as they returned to the charge nurse desk. Dana had left while he’d been rounding, Lena back fussing over the tablets and updating the board with the names of the night shift doctors who would be taking over the patients care. “Just one other question.”
Al-Hashimi didn’t respond, just continued to watch him, her big brown eyes patient. Robby sighed. “I noticed that Jack. . .Dr. Abbot. . .isn’t on the schedule for this week. Any idea where he is?”
Dr. Al-Hashimi paused a moment before answering, her brows drawn together. “He didn’t tell you?”
“Uh. . .” Shamefaced, Robby nervously brushed at his hair. “I tried to take the Sabbatical seriously. Not too much chatter with anyone at the hospital. You know how it is.”
“Hmmm.”
Robby worried for a moment that he wouldn’t answer at all, but she seemed to take pity on him.
“I don’t know exactly what he’s up to,” she said finally. “But he’s doing well. Truly. When we were out the other night he mentioned being on call for TEMS this week. He was called in during a shift a few weeks ago, and it was a bit of a scramble to find covered for the Pitt. Ever since, he’s tried to schedule his TEMS availability around his shifts.”
Robby nodded. “That makes sense,” he said. “Thank you for again for catching me up. And thank you for. . .well, everything.”
“You’re very welcome,” she said with a smile. He turned to walk away, but paused a moment to hear her say, “You really do seem to be doing well, Dr. Robby. Maybe I should consider a sabbatical myself.”
Robby gathered his things from the lockerroom, putting his earbuds in and picking a playlist to listen to as he walked home. There was a definite bite to the Pennsylvania air already – enough that he was glad for his hoodie and light jacket, slight enough that he didn’t shiver as he walked. Normally he would throw his cell phone back into his bag for the walk home, but today he hesitated, his fingers trembling over the screen.
Before he had time to second guess himself, he pulled up the text message thread with Jack.
Hey, brother. He typed, hitting send before he had a chance to stop himself. Having opened the floodgates, he knew he needed to continue.
You may have heard. I’m back in town. Wanna grab a drink, catch up?
It was a simple enough message. Innocuous. He threw his phone back in his bag, heart pounding strangely. He didn’t want to see the answer on his way home. Didn’t want to see the lack of one, either. He knew that as soon as he was back in his house he would take it off silent, leave it face-up where he could see it, circle it again and again waiting for Jack’s response.
You perseverate on things. When there is action you be taken, you need to take it. . .but you also need to accept that some things are out of your control.
Jack was still volunteering with TEMS. That pissed Robby off. For all of Jack’s talk of going to therapy, and dancing through the darkness, and finding hobbies, he was still spending his off time throwing himself in front of danger and working. That wasn’t a hobby. That was a death wish, if just better disguised than Robby’s helmet.
He was also going out with Al-Hashimi, another part of his brain reminded him – for once, the little voice not sounding a bit like his therapist. He spent enough time with her that she knew how he was doing – knew his schedule. He wasn’t jealous. It was good for Jack to have a friend. Especially a friend who had her head on straight, who didn’t worry him and force him off to the rooftop to talk them down.
Jack has plenty of friends, the traitorous part of his brain reminded him. They never bothered you before.
Robby wished he still had his phone in his hand, that he could switch to a podcast that would drown out the voice in his head. He wasn’t jealous. It was fine. He and Jack were fine. If Jack wanted to go out with Al-Hashimi, that was great. She was a beautiful woman. Smart. They would make a good pair.
He would be happy for his friend. Happy.
If you aren’t honest with yourself. . .
Therapy really was a bitch.