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It is frankly unbelievable that the next time the hospital shuts down isn’t because of incel rage or a natural disaster, but because someone in the pathlab clicked on a link in their email.
Robby can't remember the last time he checked his email. Actually, no, It was a few days ago, sitting on the couch in the dead of night, unable to sleep at three am and too brain-dead for case reports or draft rumours, but too wired to chase away the demons without help. Email is boring, and so he looked and yeah, there were things he probably should have read, things that would have been helpful to know before Gloria came downstairs and frowned them at him, but it's a petty part of him that likes when it happens, that the head of the hospital has to come and tell him things in person. Makes him feel things he doesn’t think he should feel, but he enjoys, nevertheless.
Now though, as Gloria explains the situation to the collected staff, he feels vindicated that he just leaves it all unread, waiting to see if the number will top out at 999 or tip over to 1000.
Oh, how they laughed! 2025 and completely paperless and then someone clicks on an offer that's too good to be true and then they're stuck in a 90s techno thriller, like that bit in Jurassic park where the computer locks down because they didn't say please. Computers don’t work like that, or more, they didn’t used to.
The IT department is on it, Gloria reassures them. He didn't think much of it at the time, but he should have read something into how rumpled she was at 9am, should have taken note of the creases in her lavender jacket and around her eyes.
By 12, the extent of the crisis is more than obvious. The lab isn’t just backed up or running slow, they’ve completely ground to a halt. The machines aren’t responding. The old microscopes and manual machines had been donated and written off for tax reasons, extra dollars eked from resources thought to no longer be needed.
The crisis plan is deployed, but by two, they've lost their first patient from it. The woman was fine, laughing and making jokes until suddenly she wasn't, and they pumped her full of what they had, but it was too late.
By three, Jack appears at his elbow, and they're talking battlefield medicine again for the second time in less than a year because they still aren't entirely sure what happened to the laughing woman, and they have no idea when they will know.
The microbiology attending, Freeman, comes down, grey faced and with sweat stains on his shirt, and they make plans for which antibiotics to give and hope and pray that they can cheat the resistance gremlin for a while. It should just be a few days, Freeman says. Eventually this one too will be an anecdote and memory.
It isn’t like the last crisis. For one, state-wide cost savings mean that it's not just them affected. It's all of Pittsburgh's public hospitals, to various extents, and it's not an ER problem as a whole hospital problem, a problem that flows downward more than it does up.
One email. One little email and a bunch of Russian or North Korean fuckers can make all the demands they want, for amounts of money that could bankrupt the city or the state, that no one is going to be negotiating with terrorists, not even after all the data appears on the dark web, as if anyone cares about Mr Carter’s Amikacin levels but his team.
There's no blood either, but that is more of a problem for upstairs. This is a them-problem; they had a fancy blood dispenser installed, and the reports are that it has just...gone dark. Won't respond to commands, and there's no way to tell which bag is which, because it's all barcodes and computer lookup tables and most crucially, sorted by expiry date rather than type and antigen. Ironically, the ER is the only place that has a separate supply, thanks to the aftermath of the shooting, but by 5pm they've been picked over by the surgeons to the point there might as well be nothing at all.
Still, it's not as bad a crisis as last time. The team pulls together, does some miracles, and he doesn't end up on the roof. The gallows humour and the wide range of ailments mean they keep going, triage remaining the backbone that bends but never breaks.
At the end of the first shift, they handover to nights and have a beer in the park, and go home and sleep.
But the next day came and the problem hadn’t improved. The computers in the lab are still dead. The machines refuse to run. The blood still sits in its refrigerated tomb, unable to be identified and disseminated to the needy.
By the end of the first week the situation feels like a toothache that is burrowing into the brain. It feels like they're operating with one hand tied behind their back. No, like both their hands are cuffed. They keep ordering tests as a reflex, and then remembering. They haven't seen a blood gas in days. The phone rings, but it only seems to dispense apologies. The results of all the tests are just regret.
There are shards of hope that cut through the stymie and swamp. Management make a deal with a private lab from another hospital which restores some movement, but they're not used to the volume, they're not used to Doctors yelling at them, not used to any of this. They didn't even have a night shift until yesterday, for god's sake, and anyway, the lab is two miles away in shitty downtown traffic. But it is something. It can be done, but slowly. Everything is slow. Everything nonessential upstairs gets cancelled, which means that as they turn essential they swirl down the drain and into the ER, where everyone ends up eventually, sure as taxes.
The emotional break sneaks up on him, this time. Before he knew like the dread before a heart attack, but this time it's six weeks in and they lose another kid to the vagaries of sepsis and it's too much. It's too much. It's too much, but there's nowhere out but through, but he feels it, the shatter, the chip in the screen that starts to creep across his frame of vision.
They cope. They learn how to do without. They lose a few more, but fewer than they expected. It isn't like the other times, the big crises. The problem with long crises is that they fade from even the most attentive public view, even from their own view, dwarfed by the trees up ahead.
During the worst of it though, the patient satisfaction rankings are published, and the thing that makes him crack is the smile on management's face when they tell him that they've improved.
They changed triage, you see, and because the serious patients are in an altered pathway, the usual churn are being seen faster and are therefore happier. It's the first time he’s seen Gloria happy in six weeks, and it makes him want to die.
All the focus on patient satisfaction is hiding that the centre is failing who it should be serving, who it has always served, the truly desperately unwell, the dying, the lost. That they keep losing them because the chain has a weak link, and yet no one can fix it. They can't even get a new chain, and now they're saying that the chain was holding them back. That, maybe they were better off without the chain at all.
The mixed metaphor makes his head hurt more than usual, but the insult has already slipped between the ribs like a knife and reminds him of something Jack once said to him, that no one breaks the same way twice.
He starts to climb, but half way up he stops, and instead sits on the floor, pulls out his phone, and writes an email.
Jack comes in for the night shift and hears the news that Robby has quit.
“Can you even do that?” one of the new kids asks. “He had tenure.”
“It's not a slave contract,” Collins scolds. “It's a free country.”
“I wouldn't say that,” Jack says drily. “It's more a deal with the devil. How do you think I got my magnificent golden fiddle?”
“Not to mention your good looks,” Dana says, sarcastically, and he rolls his eyes.
“Did he go home?” Jack asks the kid quietly, once they go back to work.
“I don't think he's in the building”, he says, quietly. “I think they told him to go and think about it.”
“Great, thanks,” Jack replies, patting the guy, Whittaker, that’s it, on the shoulder as he reaches for his phone with his other hand, already scouting for a quiet room, but then there's a holler that a four car pileup is on its way, unseasonable black ice on the freeway, and they are all go. He doesn't forget, but needs will always take priority over musts.
The needs resolve themselves, and then Robby appears at 1AM like an omen in the dark. He looks normal, by which Jack realises means ‘terrible’ in the language of normal people. He finds Jack bent over a microscope in the makeshift lab that is fast becoming permanent, staring at some atypical cell borders that Morgan, the tech, had asked for a consult on.
“Didn't you quit?” Jack asks, beginning a dance he’s been mentally choreographing for the last few hours.
“Like you can quit this job”, Robby says dismissively. “Where do you need me?”
“I don't,” Jack replies, but then Doctor Francesco appears at the door, and Robby's out of there before Jack can yell at him.
Robby’s good at hiding in plain sight, good at playing the game of running from crisis to crisis, but for Jack's life it's a blessing it is a quiet night between the crises. Eventually there isn't enough for two attendings, and Robby can be caught in a subtle trap and herded somewhere quiet and enclosed, and the door clicks shut on them.
He is so still it's like he isn't breathing, and Jack thinks of the PHQ-9 checklist, of the signs he’s been ignoring for too long.
The argument is just a repeat of earlier, of Robby avoiding his gaze, of him trying to catch the eye of anyone walking past through the small window in the door.
Eventually, with a frustrated groan, Robby thrusts his phone at Jack, shows him something. In the periphery it looks to be his resignation email, but Jack’s played this game before. He isn't going to read something preplanned.
“Explain it to me. Read it to me,” he asks.
“You can't read?” Robby scoffs, and Jack softens his jaw, looks at him calm and slow and a little too long.
“Indulge me. I don’t have my glasses on me. Make me get it.”
Robby shakes his head. “You do, don't you get it, you do, you always do,” Robby says like a prayer, and then he's got his tongue in Jack's mouth and pinning him in place against the sterile walls. Jack feels the stuttering strength in him and diagnoses as a reflex, before giving in, giving in and getting selfish and taking it for himself because it matters. It all matters. You can say that it doesn't, you can explain it but it can't hide the truth that they're in a slow motion train crash that is breaking everything, two hundred miles an hour and every day another piece of wreckage accordion shunting through failing infrastructure, lurching from one crisis to another, another death that should have been avoided, another shift that was worse than it needed to be, another well meaning stab in the heart.
The kiss breaks as hard as it began, and then begins again, and then for Jack it's a hand in Robby's hair, staring him down like he's back in Iraq in pain, his nurse spiralling into the sand that’s covered in Jack’s blood, and he has a gun and a decision to make, and he makes the other one, because to do it like that would be impossible.
Over Robby’s shoulder Jack can see that there's light on the horizon; the day shift will be here soon. He opens the door, a hand on Robby’s back. He doesn't let go as he explains to Shen a censored version of the problem, and with a subtle nod they are free, stepping into the predawn onto uncertain ground.
Jack's a soldier though, he has made harder decisions than this in colder lights, so he takes Robby to his car and throws it into drive without saying anything and they go near the speed limit through the silent streets until they're parked, and then through the door, and he takes Robby to bed and lets Robby take him apart.
Robby’s the mild mannered control freak who has lost control, and Jack can take it, has taken it, can take it better than anyone knows, just another superpower demurred as experience.
He learns the secrets of Robby almost all at once, and locks them away, marks them top secret. He sees how the battles have ravaged him, how he's got a new tattoo on his ribs that tastes of iron underneath Jack's tongue. How his dick is slow to wake but once standing is impressive, long and unbending like its owner. How it feels in the hand and against the roof of his mouth. How he leaks that addictive amine tang because it's all desperation, all the way down. How he swears and exclaims the names of Gods Jack knows Robby doesn't believe in, has never believed in, and how that says a lot about what he holds holy, what he holds dear. How he says Jack's name like a prayer, a mantra, long and slow and sweet and reverent, all borrowed vowels and a strangled click at the end. How when he slides into Jack's ass once he's satisfied his inner gentleman, both of them made a mess by lube and latex and thick fingers with ragged cuticles, Robby makes a noise like a choke start, like a flooded engine finally turning over once he is in and up and inside.
It wasn't planned, none of this was planned, but it couldn't have been more perfect if it had been, just that strong upright man coming apart against Jack's body, under his mouth, a foot deep in his guts it feels like, or close enough.
It'll get better. Or maybe it won't. Maybe this is the decay that will take them, that all the good people who care a lot will go and be replaced by inferior copies, who teach with heresy and hearsay and who mourn the days when good men passed on knowledge with tired eyes.
Maybe the lab will reopen and they'll never take a twenty minute blood gas for granted ever again. Maybe this will fade like the rest of the crises. Maybe the wounds will just become the kind of scars you use to pick up babes in bars. Maybe this is the time they walk away from the rot.
But he doesn't think so.
Robby's not a nasty fuck, he's got his sharper side but it's easily worn away with the fine sandpaper jack wears as skin. They're gasping into each others mouths soon enough, the pace slow and intimate and Robby's got his hand over the edge of jack's stump like he's in love, like he has done this a thousand times before, holding him exactly where it works the very best to drive Jack to sputter and swear and say the filthiest things only a former soldier can say with a straight face, and Robby's eyes come alive, finally, mirth and understanding and love and that and the relentless pummelling of his prostate by a dick worthy of a sonnet, is enough that Jack closes his eyes and comes with a single luxurious stroke of his dick, coating his hand and belly and a bit hitting Robby's cheek like a nascent kiss. it's enough, and what Jack thought would be at most a friendly hand job and an awkward conversation ends with come stains and tears, because Robby is still coming when his face crumples, and he drops, and cries for all they've lost and have yet to lose into the sweat slick aftermath on Jack's skin as the sun rises, bright and sure, and they fall into another day.