Chapter Text
The ER was loud, which wasn’t surprising, but it always took you a minute to adjust to. The bright lights and constant chaos were familiar, but at first, it was always the world’s loudest static. You found a place near the central desk, not so close as to be a nuisance but out of the way of the beehive-like flow of the ER.
“You the newbie?” A blonde woman with bright hazel eyes and a sweet smile asked you as she shuffled papers, managing to peer at the paperwork down her glasses while somehow still clearly looking at you.
“Yeah,” you cleared your throat and extended a hand over the counter, which she shook quickly, “yeah, I’m Dr. Bones.” Her eyebrows raised, her smile growing. “I didn’t pick it!”
She had a good laugh, deep and warm as she shook her head. “Well, at least you come with a built-in nickname, I’m Dana—Hey Robby!” She looked past you, balancing a clipboard between her hip and left hand, waving with her right, “Found your new R3!”
You turned and found a man, tall, brown eyes, with a thick, but neat beard with scattered grays that matched those at his temples, warm brown eyes, and when he smiled at you, the world narrowed just a little. A black blur at the edges, that staticky chaos softening to a more distant roar. Fuck.
He passed by a sanitizer dispenser, reaching out to it reflexively and rubbing his hands together. Large hands, strong, with long, nimble fingers. Fuck fuck. “Hello!” He extended his hand to you, and you took it gladly, warm palm pressed to yours, “I’m Dr. Michael Robinavitch, but everybody just calls me Robby.”
You dropped his hand and felt the warmth of it still, “Nice to meet you, Dr. Robby. I’m Dr. Bones.”
“Little bit of nominative determinism huh?”
You shrugged, smiling up at him, “Only if I go into ortho.”
He leaned against the desk, and you did your level best to ignore the way Dana’s head seemed to bounce between the two of you like she was watching a tennis match. “That the plan?”
You snorted, stuffing your hands in your pockets, “Not if I can help it.” He cocked his head to the side, a clear question, “ER is the plan, maybe critical care long term.”
“You were at…”, his tongue clicked, eyes looking up at the ceiling as he tried to remember, his expression endearing. Fuck fuck fuck. He snapped his fingers, “U of M, right? Before here?”
You dug the toe of your shoe into the linoleum, “Yep!”
“How’d you end up here at PTMC? Sort of a weird time of year for a new residency.” His face was warm, bedside manners impeccable, as you got the startling impression he cared.
“Oh, it just uh,” you cleared your throat, hoped your face wasn’t too red, “wasn’t the right fit, teaching environment wise.”
His eyes narrowed, but then he straightened, “Got it. Well, time for the quick run down, you know me and Dana, do whatever she says.” She rolled her eyes and tapped his shoulder with a near painful amount of fondness before blurring past him. “Those two behind me pretending not to listen are Perlah and Princess,” without turning back they waved, “your fellow students are Javadi,” he pointed across the room at a young woman in one of the exam room, “Whitaker,” a young man on the other side of the clinic who seemed to talk to a patient with alternating fear and confidence, “Dr. Santos,” a woman with a high pony tail and laser focus on what appeared to be an exposed femur, “Dr. King,” a tall, willowy blonde with a strangely peaceful expression as she seemed to glide from one part of the ER to the next, “Dr. McKay,” a redheaded woman who was charting and also talking to one of the other nurses just as quickly as she typed, “Dr. Langdon,” a tall man with a beautiful smile and the squarest jaw you had ever seen, “Dr. Mohan,” just through the glass of one of the rooms he pointed at a woman who was nodding slowly, shining a pen light in a patient’s eyes, "And Dr. Collins." Robby's eyes seemed to linger on her face as she looked at him from across the ER, before stepping into an exam room. “If you’re thinking critical care, you should talk to Dr. Abbot; he works night shift, but you’ll end up meeting him eventually. He’s our go-to guy for any major traumas, mass casualties.”
“Army vet?”
“How’d you know?” He looked bemused, his smile made him look 10 years younger. Shit fuck goddamn.
You managed a shrug, “Aren’t they all?”
“That mean you’re a vet?”
“No.” Your smile was tight, guarded. “But I think anybody who works in here by choice has battle scars.”
“Dr. Robby,” it was one of the nurses, Princess, holding a phone to her chest, “we’ve got at MVA, 21-year-old female, potential OD, three minutes out. Restrained driver, hit a tree.”
“We’re on. Follow me.” It was easy to do; there was something about him that made you believe you’d follow him into hell and that he’d get you right back out. “What are we looking for? Gloves and gowns on your right.”
“For the MVA, head and trunk traumas; broken ribs, skull fractures, pneumothorax, splenic rupture, burns from the airbag, potential breaks to the hands and forearms.” You had your gloves on and started to pull the gown over your scrubs, but before you could start tying it on, Robby was at your back, fingers working quick knots.
“And for the potential OD?” His voice was so close, quiet, it rumbled in your ear. Bastard, motherfucker, shit.
“If Pittsburgh is anything like Ann Arbor, most likely fentanyl, they’ll have given her Narcan on the way over. If she’s still not responding, it might be head trauma, but we won’t know that until we see her. If it is a head trauma, worst-case scenario is burr holes in the trauma bay. I’ve done it, but not my favorite. More likely concerns for seizure activity, particularly with an OD, really hate seizures on intubated patients.” His hands rested on your shoulders, a solid squeeze that you felt race into your toes.
“One of the surgeons, Garcia, she will jump in on those burr holes if Santos doesn’t tackle you for them, though she and Garcia have been more or less attached at the hip.” He shook his head, “Surgeons, they’ll get in the OR one way or another, you can either let them or get out of the way. Plan of attack for when the rig pulls in?” He walked around in front of you now, his hands working behind his own head, and you wished more than anything he’d turn and let you do it. Let you feel the heat radiate from him. Fuck fuck fuck shit fuck.
“Get her stable, check for signs of neurological impairment, respiratory, and cardiac impairment. Run a tox screen, CBC, blood gas, and a chem-7, get her on plenty of saline, .5 of naloxone if indicated, ultrasound the abdomen to look for free fluid and blood, CT for other internal injuries.”
“Well,” Robby turned to you, smiling and nodding, “I can’t speak to the environment there, but Michigan’s got you well trained.” Before you could flinch, he barreled forward. “Speaking of, been in a few rough fits myself; we don’t run that sort of show here. If you have any—,” the sirens that had been distant suddenly became shockingly close and he ushered you a few steps forward, “any concerns you bring them to me right away.”
He just had time to see you nod when the ambulance pulled into the bay and the doors swung open, “Just lost her pulse, GCS of eight before she went down, now we’re at five.” One of the EMTs shouted as the other and Robby started to pull the bed out of the rig, and you took over bagging until the other EMT could take it. “She’s been unconscious but reactive since we arrived in the field, she was breathing on her own—,”
You stepped a foot on the edge of the bed, “Switch off compressions to me on three,” you stepped up onto the edge of the gurney, standing on the bar at the base for leverage, leaning over the rail, “one, two, three.” You took over compressions quickly, “Pulse, rhythm, and respirations in the field?” You could feel the bed being wheeled in. Robby was talking, but you knew it wasn’t to you, leaving you to run some pretty grim math.
The young woman was beat to hell, she’d hit the tree around 50 miles per hour at best. Her forearms were bruised and burned from the airbag; too out of it to move them off the steering wheel. Probably fractures in her wrist and fingers. Hopefully, her ribs were okay; she had at least been sober enough to put on her seat belt. They got you back to the trauma room double time, but you were short enough that you still needed to stand on the bar of the gurney to use enough force.
“Stop compressions.” Robby’s voice cut clear, a hand on your hip, then to your lower back as both your heads turned to the monitor, “still asystole, resume compressions. Bones, what’s the plan?”
“Pupils are reactive but sluggish, no obvious facial fractures or skull deformities,” you rattled off, running a checklist, visualizing anatomy, “let’s push .5 of naloxone, and let's get an amp of atropine and epi onboard once we move her over.” The beds were lined up, and you moved off the stretcher, letting Robby take over compressions as you got your hands on the board, “On my count, one, two, three!” The team lifted the young woman onto the bed, and you needed that leverage for compressions. That was really your only thought as you stuck your knee into the side of the bed and swung yourself over.
“Jesus, okay, Bones!” Robby called with a slightly manic laugh, like a deranged owl. “Atropine and epi, let’s go, people! I’ll get her intubated, ET tube 7.0, laryngoscope, and a bougie.”
There was a moment, a split second, when Robby was placing the laryngoscope where you met eyes—and for reasons that were beyond you both—you smiled at each other. His smile was soft, sweet. Like a fucked up Lady and the Tramp, except instead of spaghetti you were sharing a person’s airway. “Holding compressions for intubation.” He moved quickly, smoothly, like you expected he always did. Your eyes flicked up to the monitor as he guided the ET tube over the bougie, “Still in asystole, let’s get another amp of epi, please! You guys got a LUCAS?”
“I’m in, check the end tidal.” He stood up, stretching his neck from side to side as he looked at the monitor and then back at you, “You know we do, you heard her folks!”
Before you knew it, you were both guiding the LUCAS into place, and then he was there at the side of the bed, helping you down. His hands were already so familiar as one settled on your waist, the other taking your hands. Someone must’ve walked into the room then, stepping behind Robby, they probably didn’t see you over his frame, and you were stuck now. Chest to chest. You could feel him breathing; you were certain he could feel you. He was so tall, and he felt solid against you, warm. Bitch, tits, shit, fuck.
“We’ve got one too many cooks in this kitchen. If you are not needed, get out!” You’d turned your head to the side so you weren’t yelling in his face, you still flushed a little, as his hand, just a finger or two, brushed against your hip bone. When there was finally room, room to breathe, room to move, you dove to her abdomen. “Belly is soft,” a bit of relief, probably too early, rushed through you, “ultrasound please.”
Robby passed it to you, “Remind me not to get on your bad side.”
“I’ll be sure to keep it in mind.” You slid the transducer over her abdomen, “No blood in the belly. Let’s stop compressions.” The LUCAS whirred to a stop, and there—faint, but there—was a rhythm. “We’ve got brady!”
“Damn right we do.” His hands clapped together once, the sound loud and joyful in the room.
“Let’s get a dopamine drip, five migs per kig per minute over the next hour; we can titrate from there. I want a CT of the torso, neck, and head just to be safe, and an x-ray of the arms, anterior and lateral views, please. And can someone let me know when she starts to perk up and when the results of those blood tests are in?”
“Absolutely,” Perlah—when had she gotten there—said while looking at her iPad, “not bad, newbie.”
You could finally see her now, really see the woman on the bed. Helena, according to the ID in her pocket. She was sweet-looking, with soft red hair. Long, down to her shoulders, pretty, even soaked as it was in sweat. She had a perfect bar of freckles across her nose and cheekbones. She reminded you of your first grade teacher, Mrs. Clark. And today, for now, Helena Sable would live. You exhaled then, wiping the back of your forehead with your wrist.
“Not bad at all.” Those hands again, solid on your shoulders, squeezing so close to the tensed muscles of your neck. Just twice. Just enough to feel your neck and face flush, to feel your hands tingle, palms sparking and warming. “Think you’ll fit in just fine, kid.”
Motherfucker, goddamn, shit, fuck, damn.