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If she had to pick a single word to describe PTMC's surgery department, it would have to be sloppy. Not chaotic, unpleasant, confusing (well, maybe), but sloppy.
She had honestly expected it to be strict, no nonsense, considering that's what her mom and Presby had prepared her for. But as she stood next to Dr. Mosley on standby, she wondered if she should've stayed and gone into surgery somewhere, anywhere else instead.
She grinds her teeth as Dr. Mosley's pager goes on and on and on, off tempo as "Your Woman" by White Town blares through the OR. She watches, catches, and learns, keeping her lips tight shut as Dr. Mosley sloppily sutures the guy back together and then stops abruptly. "Jesus Christ, Dr. Javadi, can you please check what they want?"
She leans back and looks down at his hip. 25F GSW L1. "You're getting paged for a PAT immediately."
"Your time to shine, Nepo," Dr. Garcia says as she finishes digging in a big bite near the guy's navel. "The big kids got it up here, unless you think you can't handle it?"
"I'll scrub out," Javadi says, annoyed to the wazoo as she makes her way out of the OR. It was a waste of time, and they both knew it.
"Who are you? I called surgery for a consult," Dr. Robinavitch says, exasperated. While an older doctor with bangs that have seen better days is pressing an ultrasound wand along the bruised skin on the patient's chest. "I wanted Garcia, hell, I'd have taken Dr. Shamsi."
"Victoria Javadi, intern, not one of yours thankfully," Dr. Javadi says as she rubs sanitizer deep into her palm and carefully looks at the wall for her glove size. "Would you like me to get Dr. Mosley?"
"G-d, fuck it, you'll have to do," Dr. Robinavitch says with a groan. "Elaine Grey. Neighbor reported a gunshot, but she's only complained of neck pain and headache. Landed hard on the ground, and possible chest trauma due to a fall. No loss of consciousness. Happened probably less than 3 hours ago, so time is of the essence."
76 percent chance of mortality, a 90 percent chance if she were left there. Javadi can't help but wonder if there was any family to notify.
"What is, eough," Victoria groans, and notices the blood seeping from the girl's eye and nose, and keeps her mouth shut. Blood, too much blood fuck, not good. "Sorry. Is she—"
"Can you stop touching my boobs? I have a fucking bullet in my eye, not my chest!" The patient hollers as Javadi steps up to their side, gently stepping around Dr. Bangs.
"She's aware, hairline fracture though," Dr. Bangs teases, pulling back the equipment she was using. There is no apparent trauma to the chest, but there is bruising, and they'll need to send for an X-ray to see if there's more than a fracture, just in case, for when they put the patient under to prevent complications.
"Where the fuck am I, whuh- how did I get here!" The patient says, yanking on her restraints. Javadi fights back the flinch, but feels an arm on her shoulder keeping her steady. "Why can't I fucking see?"
"You got this," Dr. Bangs whispers in Javadi's ear. Javadi hates that it feels like liquid luck in her veins as she goes back in for more.
"Ma'am, can you keep your eye open for me?" Javadi asks, lightly prodding the wound as the patient holds back a blink, but she blinks reflexively as Javadi gently touches the eye for a reaction. Good, she'd give that a solid 13 on the GCS scale. Also responds and obeys commands, but shows signs of short-term memory loss, as she yells at them once again that she can't see. Very good, chances are looking better, disability rather than mortality.
Javadi then asks, "Can you lean forward for me, ma'am? I just need to see if there's a penny behind your ear."
"Huh?" The patient then leans forward and tilts her head in confusion, fighting against the restraint as if she wants to scratch the back of her ears. Javadi lays a hand on the back of the girl's head and neck, but no bloodied hair or sheets. No exit wound then. Looking at the loss of an eye, maybe go in through the side of the head? Too risky due to eye damage.
"Must've been my imagination."
"Diagnosis, Dr. Javadi?" Dr. Robinavitch asks.
"Bihemispheric Gunshot Wound with minimal bleeding, potential clotting issue during transport," Javadi pulls out her pager and sends one out for any available neurosurgeon and Dr. Conley, just in case. Not her wheelhouse, but who is she without a good challenge? "Needs a CT immediately, see if the gunshot caused severe brain swelling. Keppra, Cefazolin for now until an OR is ready. Débridement for skull fracture, keep an eye on her, uh, well, her eye specifically, and get her intubated as soon as we know the fracture in her ribs won't cause a problem under anesthesia."
15 percent chance of mortality, odds that she'd be willing to perform on. Maybe even publish a case report due to the high mortality rates of GSW's. With consent, of course, she's not a monster.
"Dr. McKay, differential?" Dr. Robinavitch asks as he turns to Dr. Bangs, McKay. McKay, a pretty name for a hot doctor.
"I can do an ultrasound on the eye to see if there are any skull fragments pushed forward due to impact, and prevent exenteration, maybe enucleation too?" Fat chance. Patients like these are lucky if they regain their bihemispheric multilobar involvement, much less vision. Going back to her old daily life is now, unfortunately, nearly impossible.
Not like the girl wanted to. A self-inflicted shot in a dark room, if she'd ever seen one.
"Good. I would also recommend sedation, save upstairs a headache until surgery." Dr. Robinavitch says as a nurse steps past her to find a vein and grumbles about having to give an IM injection.
"Be my guest, Dr. Bangs, send her up to neuro and we'll go from there," Javadi says, tamping down her excitement. She likes working with Dr. Conley, the perfect mixture of patience and fear of failure when working with her. Probably a surgery that'd keep her away from trauma surgery til the end of the shift if anything, no Dr. Garcia. "I'll also page for an ophthalmologist to get a better look, too."
Which means a Dr. Shamsi-free environment for the remainder of her shift.
"Dr. Bangs?" Dr. McKay says with a wroth exhale as she throws her bloodied gloves onto the floor.
Ah shit. "I didn't mean anything by it, I just didn't know your name and your bangs y'know very cool. Very chic…" McKay looks at her with a raised eyebrow, which makes Javadi want the earth to just take her now. While Robby looks like he's fighting a good laugh himself.
"Very French!" Javadi chirps, and it's just the cherry on top as Dr. B—McKay glares at her, great going, Victoria, you did it again. First time doing a consult for the ER, and she's stepped on their toes; maybe she shouldn't focus on trauma surgery. Neuro would take her; neuro loves her and her steady, arthritis-free wrists. "Sorry, just forget I said anything."
"Uh-huh," Dr. Robinavitch says as they push the patient out into the hall. Then he claps his hands together as they sit outside the elevator, and she tries to hide the flinch as he does it so close to her ears. Get it together. She's a surgeon; she's better than this. "You said you were an intern?"
"Yup," Javadi says, avoiding meeting Dr. Robinavitch's gaze and ignoring the side eye Dr. McKay is giving her. Counting down the number that was going down at a snail's pace, and leans back and forth on her heels as she waits.
"Huh, interesting," Dr. Robinavitch says, and Javadi sees the exact moment he makes the connection. "Are you by chance related to Dr. Javadi from Endo?" …And there it is. There goes trying to keep it under wraps; it's barely been a week.
Maybe she can just say that it's a common last name. That he's a racist, or something. But her parents didn't raise a liar, an avoidant person, though? Unfortunately. "It's internal medicine, not family medicine, for a reason."
"Interesting." Dr. Robinavitch says as he taps the bars, checking again on the sedation that was administered. "I'm horrible with connecting faces to names—"
Crisis averted.
"—But last time I checked, his daughter was supposed to be 22. Never met a surgeon that young in years." Literally jinxed it, someone get her out of this conversation please. Please.
"Still 21, but I am turning 22 soon, in July, actually."
"Really?" McKay chimes in.
"I got here by merit." Her mother has recently been taking that as a challenge since she moved out as soon as she started her residency. "Plus, I'm used to messy," Javadi adds with finality, making direct eye contact with Dr. McKay.
"Fiesty," Dr. McKay says with a hum. "You'll do just fine upstairs soon, then."
Javadi just shrugs and steps away from the duo as the elevator opens, but she hears Dr. Robinavitch mumble to Dr. McKay, "Maybe work on the socialization."
She can talk, but she feels like she's going to die every time she has to socialize. She had tried to force herself to get over it during the latter half of med school, but it felt like concrete had settled in her stomach every time she had a conversation with doctors and wannabe ones. At least on Ao3, she had some anonymity. "I socialize sometimes. Not well, but I can."
"Don't be a stranger then, Vic." Dr. McKay's frown shifts into a smile as she teases her, and Victoria tries not to preen that she amended one of her slights as the elevator opens up. A nickname, nice.
"Sounds a bit too much like Victor Frankenstein if you ask me," Dr. Robinavitch says as Victoria walks in and presses the floor button for the ICU until the OR is ready.
"Beluae Erimus," Dr. McKay says. Victoria doesn't bother hiding the chuckle as the door shuts, giving Dr. McKay a smile in return. Bride of Frankenstein, how quaint.
Independence is weird.
Because she has another paper to her name. Her record of never losing a patient is still held up to boot. But she has no one to celebrate it with.
She could crawl her way home and take in her dad's praise while her mom just passes her the salad as they forced themselves to sit down and acknowledge her. Her dad's words of praise always reminded her of how the beach's waves soothed her during her first clerkship at Berkeley. Rocking her back and forth, soothing her as she took a deep breath of air and let it surround her, the world falling around her as she went down and down.
Suffocating as much as it was calming. Familiar.
So she lies in her bed (if you can even call it a bed, it's just a mattress she ordered online, a pillow she stole from her last sleepover at her parents', and bedsheets from her childhood bedroom), and places her phone on her shoddily put-together bedside cabinet she got from IKEA, and listens to the waves. Hoping that it will be enough.
It's never enough.
She hates that she counts down the days til she's in the ER again for a consult. 2.083 days.
Counts the number of hours even. 50 by the way.
Don't get her wrong, general surgery is fine, an about-to-burst appendix here, laparoscopic cholecystectomy there, sometimes a basic herniorrhaphy, but there's something about going down to the ER and the adrenaline of it all. There was so much room for error, but whenever she went down there, it was like she was the glue they needed. They didn't want the gunners or the inept; they wanted someone who knew what they were doing.
How she proved herself over and over. How Dr. Robinavitch, sorry Dr. Robby, didn't groan and yell at her when he saw her, and trusted her. Didn't hover but did give a push when needed.
The only downside was how they were trying to beat the empathy into her. She's empathetic! But you can only have so much grace, and it sucks when she snaps at patients or family for being too… what's the word?
Distant? One-track-minded? Assholes who don't care that their kid is in an incredible amount of pain due to a torn ACL (Grade 3 ) with visible knee deformity, a kid who might never walk the same again due to this being a re-tear because proper rehabilitation was neglected, and they only care to ask if he can play soccer again—
Unaffected? Careless? Callous Pathetic Cowards. More than one word, but an apt one.
"Jesus, can you care more about your son and less about his career? It's not that hard."
"What is that supposed to mean? I care about my son," Mrs. Davis says, shoving her finger in Javadi's face. "How old are you even, fuck," Mrs. Davis lets out a mirthful chuckle, as she pulls out her phone and begins to record her, "I knew we should've asked for them to take us, Presby."
"They would say the same thing. I did most of my clerkships there," Javadi grits as she takes a step back, and quietly apologizes to Connor. He just looks up at her with gratefulness, not expecting her to be in his corner.
He then sits trying to readjust himself, but winces, "Mom, you need to calm down. She didn't mean anything by it. It's my fault we're here."
"Connor, I don't have to listen to a doctor who, by the looks of it, hasn't hit puberty." Excuse you, too bitch. "This is your life's work, of course, I'm worried about it."
"But you're not worried about me," Connor says, and Javadi wants to reach out and hug him as she notices how his voice sounds clogged. Like he was choking down his tears.
"I just don't want to see your talent go to waste." Talent. It's hard work. Javadi knows that all too well, and so did Connor. And look where it got them, stuck in another surgery.
"Connor, do you want me to get security and escort your parents out as we talk about what's going to happen in the next couple of hours?" Javadi says, looking straight at Connor.
"Are you serious—"
"I was talking to Connor," Javadi snaps at Mrs. Davis and turns back to Connor, who looks like a deer in headlights, stammering.
"Dr. Javadi, can I talk to you real quick?" Dr. McKay asks as Javadi glares at the parents, who sit there stunned in silence.
"Yes," Javadi says as she tears off her gloves and throws them on the floor with a harsh slap.
"We'll be right back, Mr. and Mrs. Davis," Dr. McKay says with a tense smile to the parents, then turns to Dr. Whittaker and Dr. King, who sit there like they're frozen in time. "Make sure to tell Connor what's going to happen and what he wants from the cafeteria since it'll be a bit til his operation if you would. We'll be right back."
"Dr. Javadi—"
"Save the lecture, report it to Dr. Shamsi or Dr. Walsh because frankly, I would do it again," Javadi says as soon as the door shuts, glaring at the couple through the glass.
"Do you talk like this to all your higher-ups?" Dr. McKay says lowly, and Javadi feels her arms and hands shake with anxiety as Dr. McKay waits for a response.
"No, I'm sorry. I just—"
"If a patient gets under your skin, step out. We are here to be of assistance, not to criticize."
Like the public court record and parole she saw due to an aggravated assault case that Javadi found through a simple Google search on a Cassie McKay, and Javadi bites her lip, keeping that retort under tight wraps.
"We are not judges, juries, or executioners. Maybe this is how they manage their anxiety, their worry. Of course, they care about Connor as much as we do—"
"What about Connor then?"
"What about Connor?"
"There was so much trauma to his meniscus and cartilage in his MRI," Javadi says and lets out a wry laugh, "So much damage, I'd question how much they made him practice and play post-op the first time immediately after. It's a known fact that male soccer athletes are under-reported due to the shame they feel, and statistics of psychological and physical abuse have still skyrocketed in recent years."
"He is not abused, just overworked."
"We are mandated reporters," Javadi says, leaving no room for argument. "If no one else wants to address it, I will."
"His mom is just worried."
"There's being a helicopter parent, and running your kid into the ground. Psychological abuse and self-inflicted harm are my concern, and if you don't, I want to call Dr. Mohan, an attending, and Kiara to step in on the case."
"Fine, but you can't be performing the surgery if you want to play that game. I'll ask for your transfer on the case, too."
"This is not some silly power play, Dr. McKay. This is a child."
"A child who's going to be 18 in 2 days."
"Still a child," Javadi pleads.
"Is that your final deduction, Dr. J?" The way she says it makes a shiver of fear run down Javadi's back. She saw everything. She saw the complaints and the corrections of her fans' understanding of peer-reviewed articles. How much?
"I—" Her legs wobble, and she feels like a newborn fawn as she tries to steady herself.
"Well, Dr. J, what do you say?"
Too much. She probably saw the way she giggled over getting a nickname. How she praised her colleagues. Her hands feel numb, it is—Stop—breathe. Get it together.
She is better than this. She is better than her father.
She is not better than. Her mother.
She saw the one complaining about the hierarchy as if it were some feudal system. Complaints about her mother.
"I, uh, excuse," Javadi stammers, shoving Dr. McKay's hands that try to reach out to her, and whoa, her heart is running like a jack rabbit. She bumps into someone as she heads towards the door at the end of the hallway and to the stairwell. She leans against the wall as the world feels like it's pressing down on her til there is nothing left, "Me."
She lets herself drop to her knees as the worry runs its course. Fuck up. Half-ass surgeon. She is better than this. She has to be better than everyone if she wants a chance of being taken seriously.
She chose this. She chose this because trauma surgery is the only form of rebellion she could take. Not ER medicine, she's not free like a cowboy. Not psych because how can she help others if she can't help herself? Not family medicine because she never even wanted to be a doctor.
Her old psychiatrist, whom she never told anyone about during the pandemic, asked the one question that still stuck with her. If your parents weren't doctors, what would you want to be?
And she didn't have an answer then. She still doesn't have one right now. She can't be anything but a doctor.
"Victoria?" Cassie whispers, and she squats down to meet Victoria's height.
"Go away."
"I'm. I'm sorry, I didn't know—"
"Go away. Haven't you already done enough? Just go back to Connor, I'll take myself off the case—"
"Do you want anything?" Cassie asks, as she settles down with a wince and sits criss-cross.
"To leave me alone."
"I can't do that. Do you want me to call your dad—"
She lets out a wet laugh at that as Cassie grimaces. "I'm not some kid who had a bad day at school. I just had a moment of weakness."
"Do you…want me to call your mom?"
Javadi turns and glares at Cassie, who just raises her hands in the air as if caught. "No."
"Right."
Javadi lets out a sigh as Cassie looks like she's beating herself up for the constant missteps. So she sits up and wipes at her eyes with her long sleeves and says, "I care about Connor, McKay. Probably too much, but if Dr. Robby or…Dr. Shamsi, were to see the MRI, they would suspect the same thing too."
"You're probably right," McKay says sternly, eyebrows pinched, "I just saw a concerned parent, and I was that parent too once. Or twice."
"You have a kid?"
"Harrison, he's in middle school right now, and just," McKay pauses as if it makes her contemplate how time just flies. Javadi is barely getting intimate with that feeling. In about a year, she'll have been a doctor longer than she was a child. "Growing up so fast, and maybe I let it get to me with the case. Broke his ankle after some accident with his dad, and I got so scared, and when it happens to your kid, you just feel like you need to control it somehow. They need to be safe, but you also need to be logical because you're the parent. And you're responsible for this little life, until you're dead. You love them until you die."
"You sound like a great mom."
"I'm trying," McKay says, rubbing at her forehead with a laugh, "I…," She looks at Javadi with a furrowed brow and an open mouth, wavering but whispers, "I got clean for him. Relapsed when he was young, and barely got custody of him a year and a half ago now. I just want to be there for him."
"He loves you." Kids always love their parents, no matter their wrongdoings; it's a hard tether to cut off, because once you think you've severed it, you crave it again. That love that was once there. That love she could never let go.
"I love him so much."
"You're easy to love, Cassie," Javadi blurts, and backtracks as she feels a blush burn her ears, "Sorry, that's like super unprofessional."
McKay smiles and turns around, looking at the door and down the hall back to the trauma bay. "You say the sweetest things, but if you feel up to it. We can talk together with Connor and his parents about the next steps, and Kiara can be there in case things escalate."
Javadi opens her phone and checks herself in her phone's reflection. She looks tired, but there are no noticeable smears, and down at her stained sleeves. As she rolls them up, she says, "That's fine with me."
McKay eyes her, and Javadi meets her eyes with a tilt of her head, "My son always gets dropped off by my dad after my shift."
Javadi wonders if this is skipping so many steps on the flirting chart, but she's calling an R4 by her first name and had a breakdown in front of said R4, so etiquette has long been thrown out the window. "I would love to meet him. That's if it's fine with you. I don't want to like—"
"I want to get to know you."
"Cool," Javadi says with two thumbs up.
He's as sweet as anything. Really into fun facts about Australian animals, so every time she has a chance, she looks into a fact that he doesn't know about, and they have a back-and-forth as they walk out of the ER, while McKay swayed back and forth til she passed out in the passenger seat while Javadi drove after the first week of concerning driving from Cassie.
He would tell her a fact until he eventually started talking about his mom a month into their walks home. How her favorite snack was Skittles, and how she liked bologna sandwiches as soon as she got home. What book she was reading, her favorite kind of bath salts.
She would order it through Amazon to Cassie's place, their place, and ran away every time Cassie tried to confront her about it. Woops.
She doesn't miss the side eyes she gets from the ER staff as she waits for McKay to wrap up charting, holding Harrison's hands as they played thumb war.
"Did you know that pythons have over 80 small teeth rather than the usual fangs that venomous snakes have?" Javadi says as she presses down on Harrison's thumb, as he tries to wiggle out.
"Gross. Ah Ah, Dammit." Harrison yelps as Javadi wins another round. She playfully flexes her arms as Harrison leans against the counter, rolling his eyes at her display.
"It's why their teeth are split like that with a divider in between on the top and bottom," Javadi says, pointing out her index and middle fingers in front of her mouth to make her point.
"Cool…how do you bend your fingers like that?" Harrison says as she curls her fingers til they look like fangs.
As she's about to ask and explain how she's double-jointed, she hears a snort from behind the hub and squints at Dr. Santos and Dana, who are snickering like a couple of school girls.
"Sorry, just an inside joke to myself," Dr. Santos says, waving her hand at them, as she holds in a barely concealed giggle.
"He's like 13," Javadi says, glaring at Dr. Santos. Childish fucking humor.
"Nothing like that, just Whittaker owes me money," Dr. Santos says, looking at Javadi and rolling her eyes. "Had money on something, or someones." To which Dana slaps Dr. Santos' arm.
"Nothing you need us mind, Dr. Javadi, Harrison," Dana says cheerily as her glasses glide down her nose as she looks down at them, "Actually, Harrison, do you want to take a walk with me and getcha a snack? It'll be a bit before your mom's ready. I barely saw her finish handing off North 14."
Harrison looks at Victoria, who just nods, "You can go with Dana, we still have leftovers from Monday if you're still hungry after."
As she watches Harrison walk away and babbles to Dana, she feels Dr. Santos' glare burning the side of her head. "Say what you want to say, you and Dana are not subtle."
"I'm not one to judge, but are you…"
"McKay needed a babysitter."
"Right."
"She's my only friend, and I owe it to her," Javadi mumbles petulantly.
"Is she?" Dr. Santos pauses, logs out of her computer, and leans back, looking at Javadi with concern. "Taking advantage of you."
" Did Dr. Garcia? Or is it Dr. King?" Javadi says with a raised eyebrow as Dr. Santos lets out a soft whistle.
"It's just some fun." Javadi heard all about how Dr. King moved in a couple of months back, while Dr. Whittaker temporarily moved out to live on some farm with a girl named Amy. Javadi has learned to give as much as she can get.
'Right, fun." Javadi says with a scoff, "Fun is when we are young and messing around with dolls and playing house. Not so much when you get older."
"Just be safe about it," Dr. Santos says, knowing she's fighting an enemy she can't win against.
"Harrison is a good, smart kid. And Dr. McKay is a great colleague."
"Whatever you say."
So what if they kiss or fuck when Harrison is at his dad's? They're both adults who know how to keep their work and private lives separate. That's what she thinks, at least, as Cassie is splayed across their bed, fading in and out of consciousness as she plays with Victoria's scalp.
"What happened?" Cassie mumbles into Victoria's neck as she plays with her hair.
"Just thinking."
"Play your white noise, you need to be up at 5."
Javadi pulls back and presses a hand against Cassie's bangs, getting a good look at her as she asks," Can you lie on top of me tonight?"
Cassie wriggles but settles, their legs interlocked and arms pressed so tight together like they were puzzle pieces made specifically for each other. It almost brings her tears.
"Thank you," Javadi mumbles as she opens her phone and loops the video. Putting her phone on the hard mahogany bedside.
Suffocating. Familiar. But Soothing.