Chapter Text
Dr. Abby Griffin raced from her car in the Buffalo General Hospital parking garage to the nearest elevator. Resting her head back against the metal wall, she let out a heavy sigh. What a morning, she thought to herself.
It all started when she slept through her alarm, waking more than 45 minutes late. Scrambling out of bed, she stubbed her toe on the dresser and then hobbled into the shower only to discover that her hot water tank was shot. After taking an agonizingly cold shower, she dressed and woke her daughter, Clarke. At 14, getting the girl out of bed in the morning was becoming more and more difficult.
The duo didn’t pull up to Clarke’s school until well into 2nd period, where the high school freshman hopped out of the passenger seat, barely uttering a goodbye and slamming the door behind her.
Throw in a speeding ticket on the 33 Expressway as she raced to the hospital and Abby was officially having the morning from hell.
“This day couldn’t possibly get any worse,” she said aloud to no one as the elevator reached its destination.
Stepping onto the Emergency Room floor, she was greeted by the smiling faces of Dr. Eric Jackson and Nurse Harper McIntyre.
“Rough morning?” Jackson asked with a raised eyebrow.
“You have no idea. Did I miss anything?”
“It’s been pretty quiet so far,” replied Harper.
“And no sign of our fearless leader yet,” added Jackson with a smirk.
“Let’s hope it stays that way.” Knowing she meant it, Jackson and Harper chuckled as Abby headed down the hall to drop her belongings into her locker.
Abby had been at Buffalo General for the whole of her career and she genuinely loved it. Not only did it mean she was able to stay in her hometown, but she had also formed several long lasting friendships with her colleagues. The only negative to working at Buff General was the hospital’s CEO, Marcus Kane. Since the day he started 5 years ago, he and Abby were constantly butting heads over everything from patient care, to insurance, to hospital policy. He was arrogant, cold, and completely black and white, insisting on following the letter of the law at all times. It was clear that sentiment and empathy were two emotions he was devoid of. To make matters worse, it irritated Abby that the man possessed no medical background. Sure, he earned his MBA from Stanford, but he wasn’t a doctor, he was a businessman.
Despite already being late, Abby couldn’t bare the thought of facing her 12 hour shift without her morning coffee. Heading into the main lobby, she hopped in the Starbucks line, her mouth already watering at the thought of a Venti Caramel Macchiato.
“Dr. Griffin,” a voice said from behind moments later.
Fuck! She’d know that damn voice anywhere. Steeling herself, she slowly turned to see none other than Marcus Kane staring down at her, a smug look permanently plastered to his face.
“Kane,” she said coolly before turning back around, hoping he’d take the hint and leave her the hell alone.
“Didn’t your shift start almost 45 minutes ago?”
Turning her head just enough to glare at him over her shoulder, “Yes, it did. Feel free to dock my pay.”
“Well, apparently someone woke up on the wrong side of bed this morning. Have a good day, Doctor.”
Abby couldn’t stop her eyes from rolling, but she refused to give him another glance, keeping her back to him. It wasn’t until she heard retreating footsteps on the marbled floor that she finally turned to see Kane heading down the hallway. “Ugh!”
**********
Late that same afternoon, Abby was updating a patient’s chart on her iPad when Harper appeared at her side. “Dr. Griffin, you have a patient in 7. He was pulled from a house fire, possible smoke inhalation.”
Abby hurried across the floor to find one of the other nurses putting an oxygen mask in place. “Maya, order a chest x-ray, please.”
The nurse scurried out of the room and Abby turned her attention to the young man in front of her. “Hello, Isaac,” she said, reading his chart. “My name is Doctor Griffin.”
With the oxygen mask, Isaac was unable to speak, but he nodded.
“We’re giving you oxygen and we’re going to take you upstairs for a chest x-ray shortly.”
He nodded again and Abby left the young man to rest while she went to check on another patient.
**********
An hour later, Abby returned to Isaac’s room with Jackson, x-ray in hand. “How are you feeling?”
“Better.” His voice was hoarse when he spoke and he started to cough.
“The hoarseness and coughing are expected, but it will pass. You’re lucky.”
“Thanks,” he replied. “Can I go home now?”
Abby studied the young man before pulling up a nearby stool to his beside. “Isaac, this is Doctor Jackson. We’d like to discuss the results of your chest x-ray. It shows a pulmonary pleb on the right side, which means you have air trapped in the lining of the lung.”
Isaac nodded. “I know. They found it about a year ago, but I’m doing fine.”
Abby and Jackson shared a surprised look. “That may very well be but now you’re also dealing with the smoke inhalation. That, along with the pleb, is putting too much pressure on your lungs. If it ruptures, your lung will collapse and you could die.”
The young man looked nervous for the first time. “Ok…” he said quietly.
“I need to operate.”
“No, I can’t have surgery. It’s not an option. Isn’t there another way?”
“Isaac,” Jackson said. “I’m afraid surgery is your only option.”
“Then I refuse.”
“What?” Abby was confused. As a doctor she was used to delivering bad news and trying to calm frightened patients, but this was different. Isaac was obviously scared, but blatantly refusing life saving treatment?
“I’m 19, so I’m still on my mom’s insurance,” Isaac started. “Her policy sucks and it only covers emergency surgery.”
“And this is considered a pre-existing condition,” Abby finished.
“Yeah. Look, my mom already works 2 jobs. We can’t afford something that isn’t covered.”
“Isaac, I’m not sure you understand the consequences of refusing treatment.”
“I understand. You’re not operating,” he said firmly, his jaw set. “I’d like to be discharged, please.”
Abby and Jackson headed back out into the hallway. “We can’t let him do this, Jackson. This is crazy.”
“Abby, I agree with you, but it’s not our choice. If Isaac refuses, our hands are tied.”
“I can operate without his consent…”
“No, you can’t,” Jackson interrupted. “Despite the danger it poses to his health, technically, it’s still classified as pre-existing. If you operate, he can sue for assault.”
“But he’ll be alive,” she said defiantly.
Jackson put a gentle hand on his friend’s shoulder. “Abby, don’t do anything stupid. You’ve done all you can.” He eyed her, knowing that Abby had a history of bending the rules. No, scratch that, she had a history of breaking them, consequences be damned. It was something he loved about her, that she was willing to do anything to save her patients, but sometimes, it got her into trouble. “I’m going to get his discharge paperwork started.”
**********
Deciding to make one final plea to Isaac before he was discharged, Abby entered his room to find him half dressed and perched on the edge of the hospital bed. He was breathing heavily and clearly out of breath. “Here, let me help,” she said as she helped him back into bed.
“Thanks,” Isaac replied weakly.
Abby looked over his vitals, alarmed at what they showed. “Isaac, your pulse ox is only 82. We need to do the surgery.”
“No…”
“The pleb could burst at any moment!” she cut him off.
“No, the insurance…
“Ok Isaac, I have your discharge paperwork,” Maya said as she entered the room. “I need to go over a few things with you and you’ll have to sign.”
Isaac nodded in response as Abby came to a decision. “While Maya goes over everything with you, I want to do one last exam.”
Maya found it somewhat odd that Abby would do that while she was discharging the patient, but she quickly brushed it off, turning her attention to the task at hand.
As Maya and Isaac’s attention was on the discharge information, Abby went around to the other side of the bed, grabbing a scalpel off the tray. Without warning, she made a small incision in Issac’s side.
“What the hell!” he jumped.
“I’m sorry Isaac,” Abby apologized, hiding the scalpel from sight. “But I found a small, but penetrating, wound. If it’s not addressed, it could infiltrate the pleural space.” She locked eyes with Maya who was staring at her in shock. “Maya, call up to the OR, please.”
As Maya left, Abby tended to the wound.
“You cut me!” Isaac said accusingly.
“I didn’t. It’s just something we missed,” she lied.
“You’re crazy! I’m still not having surgery.”
“Actually, you are, since this is considered emergency surgery,” she stated matter of factly. “And, if we happen to find another issue while we’re in there, we can fix that too.”
**********
Hours later, and completely exhausted, Abby emerged from the OR. She had been able to successfully remove the pleb, leaving the young man with two healthy lungs. She let out a heavy sigh as she leaned back against the wall, glad that Isaac would be ok.
“Abby, are you insane?!”
Abby turned her head to see Jackson making a beeline for her. He looked furious. “Not now, Jackson.”
“Yes, now,” he said, taking her by the arm and guiding her into a nearby storage room. He closed the door and then turned his attention back to Abby. “Please, tell me you didn’t do it.”
Abby crossed her arms tightly in front of her chest. She couldn’t look Jackson in the eyes, instead dropping her gaze to the floor.
“Jesus Christ, Abby! What were you thinking?”
“I was thinking of saving a 19 year old boy’s life!” she snapped. “Which I did, by the way.”
“Is that your defense for the Ethics Committee?” he asked, his eyes softening slightly.
“Hopefully, it won’t come to that. I don’t think Isaac or his mother will press charges.” Obviously, there were no guarantees, but regardless, Abby didn’t regret her decision. Isaac was alive and that was all that mattered.
“Maybe not, but they’re the least of your worries right now.”
“What does that mean?” Abby asked, furrowing her brow.
“Maya,” he said simply. “She reported you to Kane.”
“Dammit.”
“You’ll be lucky if you don’t lose your job, Abby. Kane has been looking for a reason to get rid of you for years now.”
Shit. Abby knew Jackson was right. Given the opportunity, Kane would toss Abby to the curb in a heartbeat and she knew it. In her desperation to save Isaac, she hadn’t actually thought of the consequences for herself.
“I made the only decision I could to save my patient’s life. I’ll deal with the consequences, whatever they may be.”
The duo exited the storage room, Jackson shaking his head the entire time. Part of him admired Abby for her dedication and bravery. The other part of him wanted to shake her for being so reckless. God, she was infuriating.
They had just stepped foot into the ER when Harper came running over to them. “Abby, Kane was just here. He’s looking for you.”
“Fantastic,” mumbled Jackson.
“He said if I saw you to send you to his office immediately.”
“Well,” Abby shrugged. “There’s no point in delaying the inevitable.”
With a sad smile, Abby placed a reassuring hand on Jackson’s arm and then headed for the elevator to face the music. On her way up to Kane’s office on the 15th floor, she promised herself that she would not beg for her job. No, she would never give Kane the satisfaction. She may not have followed protocol, but she didn’t regret her decision, no matter the consequences.
Taking a deep breath, Abby held her head high as she crossed the outer office to Kane’s secretary, Gaia. “I was told he wanted to see me.”
Gaia picked up the phone, alerting her boss that Abby was waiting to see him. “You can go in,” she told Abby, almost looking nervous for her.
When Abby pushed open the office door, she noticed Kane standing with his back to her, his hands in his pockets, looking out the window at the city below. He didn’t turn or acknowledge her presence, that is until he heard the click of the door shutting behind her. It was then that he turned on her, his eyes flashing with anger. He was furious and Abby waited for actual smoke to come out of his ears. “What the fuck were you thinking?!”