Chapter Text
“Hey heads up.” Santos heard from above her. With a groan she creaked her head up, the ache in her neck only growing the further she got into her shift. Though she was greeted with an oh so pleasant sight.
Huckleberry. Well not him but what he was holding. Celsius. Her beloved.
“This is exactly why I keep you around.” She said to the intern before cracking open the can. It wasn’t as cold as she would have liked but it's been sitting in her locker for hours so beggars can’t be choosers.
The caffeine was exactly what Santos needed. She had just done a few stints on the night shift, and this was her first one back on the day shift. Safe to say her body clock hadn’t completely reworked itself yet.
“That’s all I am to you?” Whitaker looked almost hurt, but after a year of knowing each other, Santos has quickly learnt the difference in tones. She can’t believe she would ever say this but she actually is very grateful for Dennis. He was her first friend here, and sure they bickered and squabbled and Santos regrettably would take her anger out on him on days where it became too much, yet they formed a bond that surprised the both of them.
“And your ability to clean.” she says between gulps, but that was actually genuine.
Whitaker shook his head but there was a smile on his face. “Hey good catch with the mesenteric ischemia, surgery just took him up.”
“All in a day's work Huckleberry.” Santos said finishing off the last of her chart. But as one ends another comes.
“Multiple inbound.” Dana called out, one ear to her phone, already gesturing to anyone in her sight to the ED doors “RTC. Three-car pile-up. Two priority.”
The department was always one fluid body, it was never not moving. Though a MVI had a way of quickening steps, gowns were hastily thrown on, gloves were clumsily ripped onto fingers.
Santos loved this part of her job. It’s why she got into medicine, what made her fall more and more in love with the emergency department. The chaos. The broken. The morbid. Her biggest fear when she was younger was getting some desk job like her father, bored out of her mind day in and day out. Now, she can pretty confidently say she very rarely has the same day twice.
“Incoming,” One of two paramedics announce as they bring in the first stretcher. Dr Robby gets there first. “24 year old female, front seat passenger, ejected through windshield. Unresponsive in the field. Tachycardic, hypotensive-”
“Whitaker, Mel, with me.” Robby calls out as they whisk the patient into trauma one.
That’s okay, Santos thinks, didn’t get that one but there's another around the corner.
“Mid fifties male, driver. Heavy front-end impact. Found unconscious, not responding. Reduced breath sounds on the left, abdomen distended. BP dropping, pulse thready.” That makes Santos perk up. Reduced breath sounds sure sounds like a chest tube to her, and lord knows she loves putting in chest tubes.
Dr Al-Hashimi assesses the patient briefly, then looks up while walking alongside the stretcher “Mohan, Langdon gown up.” She says to the senior residents. Well that's no fair, Santos was already gowned up and ready, Mohan doesn’t even have gloves on yet.
Santos tries not to pout, really actually tries, but being the only one left out of the trauma cases is a bummer.
“Hey, quit moping. We’ve got another en route.” Dana chastises Santos, who clearly was not doing a good job in hiding her disappointment.
Santos looked around to see who was left at her disposal aaaandd, damn. Typical. Seems none of the attendings wanted to teach right now. The two new med students it is.
They weren't the worst med students the Pitt has ever seen, but it’s clear neither of them had their heart set on emergency medicine. Clark had outright told her. She was not his biggest fan, she didn’t gel amazingly well with talkers.
“Guess you two are with me,” Santos points to Clark and Hassan.
The EMT’s wheel in another stretcher, “Terry Callahan, 33 year old male, driver of the third vehicle, rear-end collision. Brief LOC on scene, came around quickly. Complaining of headache, vitals stable.”
“Thanks, Dana?” Santos only has to ask before being pointed to a room.
Barely lifting her head, Dana says “Central seven is free.” Before trailing into one of the trauma rooms.
“Hi there Mr Callahan, how are you feeling?” Trinity asks, deliberately looking in the man's eyesight, checking how he's reacting to the things around him. The cut on his head seems to be the immediate issue. He doesn’t look anywhere near as bad as the previous two patients.
“Terry please, I’m okay mostly I think. Hit my head on my steering wheel.” He says reaching up to the wound and wincing at the touch.
Herself and the med students transfer him onto the empty bed in central seven and Trinity begins her evaluation.
“The one day I don't bring lunch from home and decide to get takeout. Must be the universe's way of making sure I stick to my diet.” Terry jokes, shooting the people in the room a trying smile. At least he’s not in bad enough condition to make light of the situation.
Trinity lets her lips slip up, thinking of her patient satisfaction score “The universe has a funny way of working.” And wasn't that the truth.
She hands the ultrasound machine to Clark “Check for fluid in the abdomen.” Always eager to impress, Clark snaps into action, gelling the man's stomach. No free fluid, that's good.
“All clear in the abdomen.” Clark announces and looks to Santos as if he deserves a round of applause for stating the obvious. Trinity just decides to ignore that and walks around to Terry’s head, beckoning Hassan over.
She places her hand on either side of his head, lightly proding the skull. “What am I checking for Hassan?”
Amria steps closer from the other side of the bed, “A fracture or swelling…?” She offers, unsure. It kind of pisses Santos off. Every time she asks the med student a question, she is normally always given the right answer, but it’s always given in the form of a question.
“Yep.” She says while feeling around and there it is. “Palpable bony deformity over the temporal region. 5cm head lac.” Santos takes the flashlight from her pocket, “Look straight ahead for me Terry.”
Terry does do that, with some degree of success. His eyes are a little slow to follow but that's understandable after hitting your head like that. That's not what Trinity flags. His pupils aren’t right.
“Slight pupil asymmetry.” She speaks aloud and goes over to the chart to do a quick medical history check.
“Is that bad? It doesn’t sound great.” Terry asks, looking a little paler than before.
“Nothing unexpected, but I’d like to get a CT scan of your head to be safe.” Santos says, and nothing is glaringly obvious about Terry Callahan’s previous trips to hospital. A broken hand a decade ago wasn’t going to give them much info.
“My head's feeling a little worse now,” Terry says while squinting and Santos looks over at the man. He does seem to whiter by the minute, “A bit fuzzy.”
“Let’s get you some pain meds, can we push 50 of fentanyl?” She asks nurse Olive, who nods and goes to get the drug.
“Let's get you set for CT then Terry.” Santos begins to put the rails on the bed, just quick enough to notice Terry’s gaze drifting, his head going limp. “Terry?”
First the hands twitched. The rest of the body came soon after. The rails immediately came down. “Help me turn him.” Santos looks to the med students on the other side of the bed as they push his body towards her so he's on his side.
“Tonic clonic seizure, what do we do?” Santos asks the students as they try to keep his body stable, while Santos also checks his mouth to make sure he's not bitten off his tongue. She's seen it happen and it's really not a fun sight.
“Wait till it's over.” Clark answers immediately.
Santos only has the strength to nod. And they do wait, but the seizure lasts past the threshold of it being manageable.
“Ok, this is longer than I’d want it to be, go get 10 of lorazepam for me.” Santos tells Hassan, who wasn’t really doing much lifting anyway.
It takes another minute but the seizure eventually stops, and Terry’s body relaxes, going slack.
“Go get an attending.” She tells Clark, needing some more help with this. Seems this wasn’t as simple as she was anticipating.
Left alone in the room she does some minor checks, pupils not any better, but not any worse. Makes a note of everything she's seen so far in the patients chart. Wonders where on earth the three people she sent for stuff are.
She does hear some kind of commotion from outside, raised voices and rushed feet, but her attention is drawn away from that when she sees Terry moving. And not only moving but trying to stand. How he has the strength for that after a seizure is beyond her.
“Hey Terry, lay back down for me.” Santos asks, placing a halting hand on his arm. All she gets is a grunt as a reply. She pushes lightly with her other hand, only for it to be swatted away, the groans getting angrier.
“Terry you can’t be up, please lay back down.” She tries again pushing back a little, but this only irritates him more.
His hands now clasp around Santos’s forearms in a tightening grip. And all of Santos’s defence systems fire up. She yanks down, desperate to free her arms from being restrained, but the grip Terry has on her is crushing, impenetrable.
While still holding her, he throws her backwards and blinding searing pain runs from her head to her back as she collides with the wall.
“Get off!” She grits out and she is able to slip her hands out of his to push him back but that just gives him the opportunity to grab ahold of her shirt, bunching it in his fists. And he uses the opportunity to slam her back into the wall again, and again, and again. Her side collides with the medical equipment sticking out of the wall, expelling all the air out of her body in a shuddering gasp. Her head throbs, the white hot sensation expanding.
His grip shifts and although it's getting harder to see, Santos thinks finally it’s stopped. The hands on her retreat off her chest. She tries to breathe, but it feels as if she has needles in her lungs. She doesn't need to be a doctor to know that's not good.
But it wasn’t the end, because that would just be too fortunate for Trinity Santos. The hands left her chest, only to find her throat instead, wrapping around the neck, crushing her windpipe. If she was struggling to breathe before, she certainly was now.
She wills the strength inside of her to front, chasing the adrenaline, the fight never flight instinct she's always had. She kicks out hard, heel first, hoping it lands. It does. Mr Callahan stumbles backwards, the grunting and groans sounding even further agitated.
It gives her space though, an opening. Her vision has started to go fuzzy, but she can just about make out the door. She just has to reach it, just has to open the door. She's so close.
Two strong hands pushing her forward stop her. She was already stumbling, now over her own feet, landing wrist first, immediately protesting, agony shooting up her left arm.
She can’t even cry out in pain, her stupid lungs still not filling back with enough air. The onslaught doesn’t stop. Mr Callahan seems set on destroying every piece of Santos’s body.
It’s ironic in a way she thinks, which is getting harder and harder to do. All those self defence classes she’d signed up for in college, the endless hours learning the most effective martial arts, were pointless. She had all the tools she needed, all the knowledge, but when it came down to it she had failed. She wasn't good enough, she’s never been good enough, she never will be good enough.
It was easy to get lost in a place like the Pitt. Despite the constant complaint of there never being enough rooms, the hospital Amira had spent countless weekend work experiences at as a teen was, if you're being generous, half the size of this place. People were constantly rushing somewhere, patients were littered all over the place.
So, Amira was not as sure here. A little out of her depth. Everyone just seemed to know everything, and she thought she was one of those people, constantly top of her class. But perhaps that was an easy feat considering her class was no larger than 15 at school. Med school had made her doubt her abilities, but the Pitt was making her doubt every single thing she's ever been told. ever learnt. It felt as if there were no rules here. It was chaos.
But, she had achieved her task, lorazepam in hand, and was heading back to central seven when she saw Ethan Clark lingering outside of the trauma rooms. Now Amira didn’t hate, her parents taught her better than that, but good god did Ethan Clark get under her skin.
He was, to be blunt, a douche. For lack of a better word. Perhaps suck up would fit as well, but douche felt more therapeutic to use. He constantly talked over her, bragged about his super fantastic parents who were both chief of surgery at their respective hospitals. Granted he was smart, annoyingly so, but she would bet everything she has that all his life things have just been handed to him. What a shock.
“Aren’t you supposed to be with Doctor Santos right now?” She asks unimpressed.
“Aren’t you?” He questions back childishly. Only two more weeks, two more weeks on this rotation than she’s done with this place and she’s done with him.
“I was just heading back now. I was getting the lorazepam, remember?”
“Okay? And I'm getting an attending.” He says, but it looks more like he's watching two critical trauma patients being treated.
“Doesn’t look like it.” She mutters out.
“Hey, they’ve clearly got their hands full right now, they’d probably just shout at me. And I don't want to piss them off, they write our reports.” God he’s such a loser.
“Well I have to get this to Dr Santos, just get a damn attending.” Amria says sick of him, heading back to central seven.
“Heres the- Dr Santos!” This was truly not a sight Amira was expecting to see.
Two bodies on the floor. One seizing, one barely breathing. Dr Santos laying face down on the ground, murmuring in pain.
“I need some help in here!” Amria shouts out, catching the attention of one of the nurses outside. Perlah, she thinks.
“What happened?!” The nurse asks rushing in, taking the scene in as she rushes to Santos’s side.
“I-I-I don't know. He was seizing when I left. I was gone for like 5 minutes.” Amria says. Genuinely she has no idea how this could have happened. Had someone come through here, thrown Terry off the bed and assaulted Dr Santos? Could Terry have possibly done it?
The nurse bends down, closer to Dr Santos, whispers something not English to Santos, moving a strand of hair out the way. “Go get someone with black scrubs on. Now!” Perlah commands, and Amira is off.
“What did you do to this unlucky soul Robby?” Garcia asks, gloves being pulled on, eyes scanning the patient before anyone speaks.
Robby doesn’t look up.
“Twenty-four-year-old female, ejected through windshield,” he says, voice clipped, controlled. “Came in unresponsive. We secured the airway, got her intubated. Bilateral breath sounds but decreased on the right.”
“Pressure?”
“Eighty systolic, dropping before we got fluids in. We’ve pushed two units, got a third hanging. FAST was positive for free fluid in the abdomen, likely intra-abdominal.”
“Any chest injuries?”
“Possible contusions. No obvious pneumothorax yet but keep an eye on it.”
Garcia nods once, already moving, already in it.
“Alright, we’re not sitting on this,” she says, turning slightly to the surgical intern who has been trailing her for an annoying amount of time. “Let’s prep for OR-”
“Dr Robby!” Cuts Garcia off mid sentence. Everyone in the room pans to whom Garcia vaguely remembers being one of the med students currently at the Pitt. She looks frazzled, like she's seen a ghost. Garcia smirks thinking it's probably just a broken bone instead. These med students were getting weaker and weaker.
“What Hassan?” Robby snaps, the med student struggling to convey her next piece of information, like she doesn’t know how to say it. Probably forgot half of the patient's presentation she was told to rush in here with Garcia thinks. Smiles again. The joys of med students.
“It's… It’s Dr Santos.” The med student gasps out. Garcia’s smile instantly drops.
“What? What about Dr Santos Hassan?” Robby presses.
“She- a patient attacked her. He was seizing when I left and when- when I came back…” The med student can barely finish but she doesn’t need to as Robby rushes out of the room. Whitaker following not too far behind.
The horrified expression on the med student's face makes Garcia’s stomach drop, and it’s any wonder she has half the logic to turn to her intern and say “Page anyone from surgery. Tell them to come take this patient.” She says stripping her gloves off with lightning speed.
“You’re not going to do it?” The intern asks, confused.
But she doesn’t respond, already halfway out the door. She rushes to where all the sound is coming from, the multiple people gathered around one room. Pushes her way to the front. She doesn’t have any right to demand this space, but she needs to see. She needs to make sure Trinity is okay.
Garcia isn’t a squeamish person, never has been. It’s why she excelled in surgery. It took a fucking lot to phase her.
For the first time in her career as a doctor, she feels sick.