Chapter Text
The rural ER where you work doesn’t get much action on a good day. A handful of hypochondriacs, a few cases of the flu or food poisoning. Maybe a farmer with an MI if things really get moving. Besides, all the really interesting traumas have to get flown out of here anyway-- having the chopper around usually counts for a few minutes of excitement, though.
It’s not the worst thing in the world-- you can get to know the community, develop relationships you probably wouldn’t get elsewhere, really take your time with patients (usually). The unfortunate side effect is that the days become… well. Repetitive at best. Painfully boring at worst.
Today the scale has been tipping toward boring of the mind-numbing variety. There’s only so many times you can check up on Mrs. Renwick before geriatrics finds a bed for her.
“What do you think about this storm?” She chitters as you flip through her chart again. No change in vitals, which you can live with, but what she really needs is a private bed that’s not in the emergency department.
Your brow furrows. “What storm, Diane?”
She gestures out the window, and you follow her gaze. Grey, cold, snowing a little. Standard November. “It’s coming!” she insists, and you shrug, replacing her chart with clack.
“I didn’t hear anything about it on the news this morning,” you reply, dusting off her blankets and re-fluffing her pillow. This is completely unnecessary. Andi, the charge nurse, was just in here, because she also doesn’t have much to do.
Mrs. Renwick flips a hand dismissively. “Oh, what do they know,” she says huffily, folding her arms over her chest. “They’re all a bunch of dumbasses anyway.”
You laugh a little in surprise-- you’ve never heard her swear in any capacity before, and ol' Diane is a bit of a frequent flier in your neck of the woods. “Tell me how you really feel, Diane!” you tease over you shoulder as you walk back to admit, and she laughs too.
An hour later, you do feel like a dumbass, because you are getting absolutely shitsmacked by a winter storm that’s seemingly come out of nowhere. It’s not like you were going anywhere anytime soon-- you’ve been on 24 hour shifts since you became an attending. The hospital point blank refuses to hire any more attendings, so you remain, tragically, short-staffed. Not all bad, because of the nature of the work here, but it can lead to some long shifts. You’ll take the overtime-- those student loans aren’t paying themselves.
Andi groans, head in her hands instead of watching the snow come down-- fat, fluffy flakes that make the line of sight outside the ER bay doors almost nothing. Not to mention the wind-- it howls around the old bones of the hospital, competing with the steady beep of the heart monitors attached to your handful of patients. “What’re the odds of this clearing up by the time I need to leave?” she mumbles, and you frown at the weather app on your phone.
“Slim to none,” you reply grimly, and she makes a half-hearted whimper in response. There’s also an unspoken understanding between the two of you that next week is going to be a fucking circus-- the first big snowstorm of the year always ushers in the first wave of flu season, which is always a joy.
“Sacred Heart, how do you read? Over.”
The two of you snap your heads toward the radio as it crackles to life. The first snowstorm of the year also means either total quiet around the hospital or a shitshow of epic proportions-- if the night really doesn’t go your way, it could definitely be the latter.
Andi shoots across admit on her rolly chair toward the radio. “Read you loud and clear, dispatch, over.” Andi has always been able to snap into a professional phone voice at the drop of hat, and it’s something you greatly appreciate about her.
“What’s your trauma status Sacred Heart? Over.” That’s not usually a promising question from dispatch. You mentally brace yourself for a long night.
“Full open availability for trauma dispatch, over.”
“Incoming GSW, ETA ten minutes, but could be delayed due to the storm. Airlift is unavailable-- you’ll have to handle it on your own, over.”
Gun-shot wound.
Andi blinks several times in rapid succession. “10-4, dispatch, over,” she manages, and the two of you share a look, frozen for half a minute before leaping into action.
“Kendra, Evan, prep trauma!” you shout, hurtling into the supply closet. Safety glasses, masks, gloves, gown. “Let’s get a crash cart and intubation tray ready, prep epi and fluids, call the blood bank for 4 of O-neg, and let’s get ready to move people!”
Your mind races. You’ve gotten the odd gun-shot wound in the years that you’ve been here-- mostly hunting accidents, the occasional self-inflicted. But opening day isn’t for another week, and something tells you this is different. Get it together , you tell yourself, and crack your knuckles.
For being largely unused to any sort of excitement, your ER staff kicks into gear with impressive speed. The trauma room is prepped and the trauma team is suited up with two minutes to spare. The seconds tick by agonizingly slowly as you bob on your toes in the entryway. Part of you knows that if this guy is really, really hurt, he probably doesn’t have a shot in hell-- if dispatch says there’s no airlift availability he’s really fucked. Andi’s panicked sideways look at you confirms that she’s reading your mind.
It’s eerily quiet in the moment before the paramedics burst through the doors; you see the lights of the rig out in the bay, and you offer a firm nod to Andi before the ER explodes in a flurry of activity.
“Gimme the bullet, Trey,” you greet the paramedic team with limited pleasantries, grabbing the gurney firmly and guiding it quickly to the trauma room-- the wheels are packed with snow despite not being outside for longer than 30 seconds. The coppery scent of blood fills the air-- the victims chest is a fucking mess.
“Mid-thirties male, GSW to the abdomen, BP 180/110, heart rate 102 bpm, elevated resps. No LOC on the scene but lost consciousness on the way here. He’s had two of saline already but the bullet was a through and through, it’s all I can do to keep his pressure up.” You know Trey’s never responded to a trauma like this-- he’s barely out of high school, but you detect only a faint tremor in his voice.
“What happened?” Andi gasps at the same time you yell, “On my count!” You transfer him smoothly and you finally get a good look at the patient.
His face is slack with unconsciousness, weathered in a way that suggests a career outdoors. Short brown hair is stuck damply to his forehead-- whether it’s from sweat or the snow, you can’t tell. Though his shirt has been mostly cut away from his torso, what remains is soaked in blood. There’s so much blood, an amount that doesn’t feel promising for the work you’ll have to do to keep him alive. You can see where the bullet pierced through-- just a hair beneath his heaving ribcage. Liver lac, at best, most likely, which doesn’t spell success for you, but you can’t let yourself sign his death certificate yet. He’s lean, muscular, athletic, and even through the blood matted hair on his chest you can tell his torso is littered with scars. Something glimmers between his pecs— are those dog tags? Who the fuck is this guy , you think for half a second, before you snap back to the situation at hand.
“I don’t know, we got the call from someone who saw him walking down the highway 30 minutes ago. Guy let him stay in his truck to get warm but he wouldn’t say anything. No weapon recovered at the scene, so I’m not even sure what did it.”
It’s not self inflicted-- you can tell that much right away, and the caliber is too small to feasibly be a hunting accident. Somebody tried to kill this fucking guy.
The knowledge sends a chill through you, and you nearly jump out of your skin when the man groans, eyelids fluttering. “What’s your name, sir?” you ask firmly, sinking back into your trauma headspace. “Sir, can you tell me your name?”
He groans again, and his eyes drag open for half a second. “John,” he gasps, and his voice is a low rasp. “My name is John.”
--
The trauma is brutal. But he lives.
An hour and a half on the table before he was stable enough for surgery to take him up. He’d coded once already-- most of the codes you see here are the elderly, half with DNRs. It’s been a while since you’ve run anything close to this.
But still. He lives.
You snap off your gloves and sink slowly down the wall next to the trauma room, holding your head in your hands. You reek of copper and iodine, and you know your gown is soaked in blood, but can’t manage to pull it off.
Andi sags down the wall next to you. “Nice save,” she says tiredly, and you slap her knee. The two of you sit in a comfortable silence for a long minute. Sometimes there aren’t any words you can say.
“Isn’t it time for you to go home?” You manage finally.
“An hour ago,” she sighs, clambering back to her feet. “Just have to dig out my car.”
Your eyes drift close for a moment-- just resting. “I think Trey’s still here. Maybe if you bat your eyes he’ll help you shovel.”
“There’s an idea,” she calls over her shoulder. “Don’t work too hard!” You flip her off, and she laughs.
The rest of your shift passes in a blur. Thankfully, nothing major comes in the rest of the night-- looks like people were wise enough to stay off the roads. Minor victories.
McGovern, the trauma surgeon (as close to a trauma surgeon as you have here anyway-- he’s the Chief of Surgery, but a twenty year veteran of Chicago area hospitals, with a skillset that can prove invaluable in times like these) comes down in the last hour of your of shift, cap still on, blood on his scrubs. You sit up a little straighter as he offers you a weary smile.
“Is he…?” you start, but can’t bring yourself to finish the question.
McGovern nods, corner of his mouth ticking up again. “He coded on the table again,” he says, and your heart falls through your ass. “But he’ll pull through. He’s in the surgical ICU.” He squeezes your elbow. “You did good. He wouldn’t be doing half as well as he is if you hadn’t been here.”
“Thanks,” you breathe. McGovern squints at you, calculating.
“You okay?” he asks, and you don’t know how to answer that. He squeezes your elbow again. “You can go see him if you want. I don’t think he’ll wake up for a while, but. It might make you feel better.”
Absurdly, it feels like you’re going to cry. “I’ll be okay,” you manage. “It’s just. It was a lot.” A lot . The traumas you see are almost 100% accidents-- it can be intense, but they’re still accidents. This-- this was purposeful. Malicious. You don’t know what that means for this town, this community that you’ve come to care about. You’re not sure you want to find out.
“C’mere.” McGovern pulls you into a gentle hug. “I know. It’s hard to get used to, especially in a place like this.” You make a half-hearted noise and he laughs, pulling back to look at you again. “I really think you should see him. Wait until he’s awake and alert if you want. Would give him an opportunity to thank the gal who saved his life.”
“Okay. Alright. My next shift, I’ll… I will.”
“Good.” McGovern smiles at you again. “I called Chambers, he’s coming in early. As soon as he gets here, I want you to go home.” He winks at you. “Already made Evan dig you out.”
“Thanks, McGovern.”
“Don’t thank me,” he tosses over his shoulder as he heads for the stairwell. “Thank you . This is the most action I’ve seen in years.”