Chapter Text
Bruce is on the tail end of his shift, and so beyond ready to go home. He’s had three scheduled surgeries, plus two emergency ones for kids caught up in nighttime car accidents, and he’s been here since seven the previous evening, and it’s almost eight a.m. now. And Dick has a gymnastics meet that starts this evening, and Jason needs help with some pre-calc, and Bruce would like to be actually functional for both of those things.
As far as night shifts go, he’s had worse, but that doesn’t stop his eyes from feeling mildly on fire.
“Dr. Wayne,” Selina’s smooth voice calls, as he’s speed-walking past the pit.
“Dr. Kyle,” he returns, smiling. “Stunning as always. Please tell me you’re not about to hand me a toddler with first-time parents who possibly needs emergency surgery when I have half an hour left till the end of my shift.”
Selina falls into step alongside him as he slows slightly, and passes him the tablet she’d been holding.
“No toddlers,” she promises. “Timothy Jackson Drake, fourteen years old, passed out in first period and got brought in by one of the wee-woo wagons a little bit ago.”
Bruce snorts. “Wee-woo wagon?”
“What can I say? Toddlers rub off on you. Figured I’d see if it would catch on.”
“Toddlers, huh? You sure it wasn’t drunk teenagers?” Bruce asks. He frowns. “His temperature is elevated. EMTs give any more info?”
“Lower right quadrant pain,” Selina says, and Bruce groans quietly. “Which he’s incessantly trying to brush off as not a big deal.”
“But he passed out?”
Selina nods, grinning slightly. “Like a sack of potatoes, right out of his seat, or so the teacher told EMS.”
Bruce rubs the bridge of his nose for a couple seconds. “Okay,” he says. “Okay. I got him. Hopefully this is just a run-of-the-mill appendix case. Parents?”
“The school couldn’t get a hold of them. We’re still trying, but the kid says they’re currently on a dig in Egypt and probably won’t be near a phone again till the evening. He doesn’t know of any other adults authorized to consent to medical care for him, no nannies or anything.”
“Hm,” says Bruce. “We may not be able to wait, but I’ll know after the eval. Is Pete in yet?”
“Nope,” Selina says, as she breaks off down a side hallway. “But I’ll page you as soon as he is, and let him know he’ll need to scrub in.”
“Thanks, Selina,” Bruce calls after her. He skims the file one more time, then turns and heads for one of the ER hallway spots. The quicker he checks the kid over, the quicker he can go home and sleep. Easy peasy, hopefully, and then both of them will be on their way.
The kid, Tim, is unfailingly polite, and frighteningly good at acting like he’s not in pain, even while Bruce can see his pale skin, flushed cheeks, and stiff posture where he’s leaning back against the gurney. They quickly run through the usual introductions, but Bruce can tell the boy doesn’t want to be here. He doesn’t blame him.
The nurse is finishing getting a pulse ox and blood pressure cuff on Tim when Bruce pulls on a pair of gloves and steps up to the mattress, and when he gives her a nod, she tugs the curtain shut behind her and heads off.
“How would you rate your pain?” Bruce asks. “On a scale of zero to ten, if zero is no pain at all anywhere, and ten is the worst pain you can possibly imagine.”
“Uh,” Tim says. “A three?”
Bruce stares at him. He looks at the pale tinge of Tim’s skin, his pinched eyes, the numbers on his blood pressure reading.
“Are you sure about that?”
“Yes?” Tim says.
Bruce pulls up a pain chart on his phone, and turns it around for Tim to read. “Here, I want you to look this over really quick and tell me which description you think fits best, okay?”
Tim is silent for several seconds while he reads the description of each number, and then he looks back up at Bruce. “I guess...a five?”
A five. Bruce will write it down, but this kid is definitely higher than a five. Clearly he doesn’t have a lot of practice rating pain. Which Bruce supposes is a good thing, in a way, but definitely not the most helpful in this particular situation.
“A five,” Bruce echoes. “But you passed out in class?”
“Only for a second,” Tim says. “It was a one time thing. I probably just didn’t drink enough water, right? It’s an exam week, I haven’t been sleeping much and everything. You know.”
“Hm,” says Bruce. “Maybe. We’ll find out, okay? You’re sure there’s no one we can call for you right now, besides your parents?”
Tim shakes his head. “No relatives on this side of the country,” he says. “It’s fine. I’m good. I can handle things fine. I’m used to it.”
Bruce aches for this kid.
“Tim, do you mind pulling the gown up for me so I can check out your abdomen? That’s where you’re having pain, right?”
“Yeah,” Tim says. He sounds wary, and a little bit tense. “Uh, sure.”
Bruce leans in a little to get a good look, as Tim is bunching up the thin star-covered fabric in his hands to get it out of the way, and in two seconds flat Bruce knows that this isn’t going to be a garden-variety appendicitis case.
“Tim,” he says, very calmly, eyes locked on a stark line crossing the kid’s skin. “How’d you get this scar here, bud?”
“Uh,” says Tim. “I lost my spleen?”
Oh, this complicates things. This complicates things a lot.
“You lost your spleen?”
“Yes.” Tim looks a little sullen now, and Bruce can tell he’s trying not to hunch over protectively while Bruce prods the edges of the long scar down the center of his abdomen. Definitely an open splenectomy, so either no time or no ability to do it laparoscopically. That’s a major surgery. Why was this not in the kid’s chart?
“Do you have antibiotics?” Bruce asks. He’s fighting to keep the urgent tone out of his voice. “You have a fever. Have you taken any since that started?”
Tim shakes his head. “My parents didn’t get the prescription refilled after the last time I needed them.”
Dishonor on his parents! And their cow! Bruce’s fingers are moving steadily, palpating each quadrant, and Tim is clearly miserable. He can see Tim’s leg twitch when he starts creeping over towards the lower right quadrant of the kid’s abdomen, and if the situation were less serious, he might have allowed a laugh at Tim needing to keep himself from straight up kicking Bruce away.
“How did you lose it?” Bruce asks.
“The Joker.”
Bruce’s brain and fingers both stutter to a momentary halt.
“The J--”
“Remember when he shot that bazooka into traffic last year?”
Bruce’s voice goes a bit strained. “Yes.”
“My bus was in that.”
“Your--”
“And yet,” Tim continues, scowling fiercely, “we still don’t have seat belts on the bus. Unbelievable.”
Bruce presses gently, so, so gently, feather-light on Tim’s lower right abdomen, reeling from that unexpected answer. And as he lets up the pressure, he asks by sheer muscle memory, “Is this where--”
Tim goes gray . His entire body tenses, then relaxes, and his eyes roll up while a cut-off shout of pain bounces around the air for a few moments longer.
“Oh, bud,” Bruce says, quietly. One hand rests, steadying, on Tim’s stomach, his thumb rubbing circles on Tim’s now-sweat-soaked skin, and his other hand reaches to brush Tim’s bangs back while the kid blinks his eyes open again, clearly fighting off involuntary tears.
Pale as the inside of an oyster, Jason would declare if he were here. Tim is shaking slightly now.
“I’m so sorry,” Bruce says. “Breathe, Tim. Deep breaths, nice and slow.”
Tim does his best to follow the instructions, closing his eyes and hanging on to Bruce’s hand while he evens back out.
“I’m fine,” Tim says, rushed and a little frantic, the second he can speak again. “I’m fine, I’m fine, sorry--”
“You’re not fine,” Bruce says, voice gentle. “That’s okay. You don’t need to apologize. I’m sorry you’re in so much pain, Tim. I think you’ve got appendicitis. If you do, your appendix is going to have to come out.”
The look Tim turns on him is a lot more panicked than Bruce expects.
“No,” Tim says. “No, I can’t, it’s fine, I’m just sick, or--even if it is appendicitis, I was reading about that, you can just give me a lot of antibiotics, it’ll heal--”
“Tim, you don’t have a spleen. And we don’t know how badly infected your appendix is, if that is what’s going on here. This is a medical emergency, it can’t wait.”
“I can’t,” Tim repeats. “No, we were having a test, I have to finish--”
“Your teacher will let you take it later,” Bruce tries to soothe, and a different nurse--Molly, Bruce remembers, pretty new, very sweet, good with little baby veins--is poking her head around the curtain, a question on her face. He nods furtively, and she steps away, over towards where they keep medication.
“It’s worth 26% of our grade,” Tim blurts out, breathing picking up. “I’m not--I can’t do this again, please just let me go home, please, I promise I won’t mess up this time, I thought it was just the stomach flu or something, I’ll take antibiotics, I’m fine.”
“Tim,” Bruce says, firmly, gently taking both of the boy’s hands in his own broad ones. “Tim, listen to me. Everything is going to be okay, but we need to check your appendix as soon as possible, and if it’s infected, it has to come out. I promise your school will understand. And if your teacher gives you trouble, you can email me and I’ll talk to him myself. I'll write you the best doctor's note ever. Okay?”
Tim just stares at him wide-eyed as the nurse comes back over with supplies.
“This isn’t your fault,” Bruce adds, registering what Tim said. “You didn’t do anything to cause this. It happens. You haven't messed up, kiddo.”
Tim just swallows hard and grips Bruce’s wrists in return. Bruce sees Molly waiting patiently a few feet away out of the corner of his eye.
“I can’t,” Tim says, quieting now, closing his eyes, and this is worse . “Please, Dr. Wayne, there’s got to be something else to do. I don’t want to do this again.”
Oh. Oh. Bruce thinks he gets it, or at least kind of. Enough.
“Tim,” he says, gentle and steady. “Molly is going to give you a small amount of morphine to help with your pain, to get you more comfortable. I’m going to order a CT scan of your abdomen so we can find out what’s going on for sure, and then we’ll make a decision from there. I’m sorry that this is happening so suddenly, and I know it’s terrifying and you’re in a lot of pain right now, but listen to me. This surgery is not going to be like when you lost your spleen. We have time to do this laparoscopically, not with an open incision that’s big and takes a lot longer to heal. You’ll just have a few little incisions, and a much faster recovery.”
“You’re sure?” Tim asks.
“I'm sure,” Bruce says. “Your poor spleen was injured from blunt-force trauma, and I’m guessing you had internal bleeding going on, and the surgeon then couldn’t spare time. He had to do emergency clean-up of the damage. But what's happening today is a lot more controlled, because you’re already here and pretty stable. We do routine appendix surgery all the time, Tim. It’s quick and straightforward, and even with things being a little more complicated because of your missing spleen, you’re going to have a much easier time.”
Tim looks doubtful, but seems to be taking Bruce as much at his word as he can.
“Okay,” he says. “And I, uh...you said I have to have a scan first?”
Bruce nods.
“And if the scan shows that it’s, like, not that bad? Or--”
“If it’s not your appendix making you sick, we won’t need to take it out,” Bruce says. “But if it is your appendix, we can’t risk leaving it in with your immune system being compromised. I promise we will only do the surgery if it’s necessary, okay?”
Tim sighs, and Bruce can see the resignation the boy suddenly wraps himself up in like a coat.
“Can Molly give you some pain medication now?” Bruce asks. “I want you as comfortable as possible.”
“Yeah,” Tim mumbles. “Sure.” He looks away as Molly twists the plastic syringe into place in one of the ports on Tim’s IV catheter and carefully pushes the morphine, but his entire body relaxes noticeably after only seconds.”
“I’m going to get your scan set up,” Bruce says, peeling off his gloves and tossing them in one of the bins. “Molly, will you stay with Tim for a few minutes and get his vitals again? I’ll be right back.”
“Of course,” she says, sparing him a quick smile before focusing entirely back on Tim, and as Bruce walks away he can hear her starting to gently ask about Tim’s hobbies, and family, and what he was going to do this weekend.
With Tim in good hands, Bruce pulls out his phone and texts Selina, letting her know the situation, and that he’s happy to cover it. Then he sends Alfred a quick text as well-- Sorry, last minute case. Won’t be home till later. Update when I can.
And then he gets to work.
Over the course of an hour, Bruce learns a lot.
It’s definitely Tim’s appendix. It definitely needs to come out. Tim’s splenectomy isn’t in his records because the boy hasn’t been to the family doctor since he was five, and he was triaged and treated over at Gotham Memorial since it was closest to the accident last year, and since Gotham Memorial is part of the region's other major medical system, his records never got transferred to this one. And his parents never scheduled the recommended follow-up visits with a normal pediatric or family doctor, so it wasn’t recorded that way, either.
The splenectomy is sure in his file now. Bruce just made sure of that.
Tim’s parents are definitely in Egypt, and they still haven’t been reachable. Nor, apparently, did they set up an actual caretaker for Tim during their absence, aside from weekly cleaners and a system of scheduled grocery deliveries. Some teenagers can be very independent, and lord knows he was one of them, but even teenage Bruce understood that some supervision was necessary. Now Tim is about to have surgery without parental consent, because it’s an emergency and they’re unreachable. And when he wakes up, he’s going to probably be a ward of the state.
Bruce already texted Alfred to ask if their case worker in the Department of Children and Families could look into it and see if there's any way the Waynes can help. Bruce has experience, after all, from both Dick and Jason, and Tim apparently is their neighbor, after all. It’s at least worth a check.
And as for Tim himself, Bruce has tried not to leave him alone for more than a few minutes. As much as the kid seems independent, and sharp as anything, he’s scared. More scared than patients usually are, even for emergency surgery. The only thing that seems to help is Bruce calmly explaining, step by step, exactly what he’ll do during the surgery, to distract Tim while in pre-op.
And now Bruce is ready, standing in the OR, scrubbed in and gloved up and raising his head just in time to see Tim being rolled through the doors, pale and determined.
Once Tim is secure on the table, and the anesthesiologist is just waiting for the okay to have Tim start his countdown, Bruce leans over and smiles big enough that he knows his eyes are crinkling above the mask.
“Hey, bud,” he says. “You ready?”
“No,” Tim snorts. He manages to shoot Bruce a quick smile, even if it’s small. “But I have to be.”
“Tim,” Bruce says. “You’re going to be okay. Don’t worry. I’m very, very good at what I do.”
He can see amusement warring with nerves across Tim’s face.
“That should really sound pretentious,” Tim says, “but for some reason it doesn’t, from you. Thanks, Dr. Wayne. I’m sorry I’m being such a pain about all of this.”
“No,” Bruce says firmly. “You’re not being a pain at all. You’re doing great. It’s completely okay to be scared, and I promise I’m going to get your poor appendix out as smoothly as possible, and then you'll wake up and eat as much ice cream as we can spare.”
“That doesn’t sound too bad,” Tim says, even as he’s eyeing the approaching mask nervously. Bruce hears the heart rate monitor pick up slightly.
“Hey. Tim,”
Bruce says.
Tim looks back up at him, and the anesthesiologist gently settles the mask over Tim’s nose and mouth.
“What music do you want to hear?” Bruce asks. “I’ve got anything you want.”
Tim’s eyebrows pinch together. “Thought the surgeon chooses music?” he says, slightly muffled.
Bruce laughs for a second. “Usually, yeah. But I always ask my kids what they want to hear. You’re the one who’s doing the hard work here, and I like to think that music might help a little. My only rules are no baby shark and no death metal--I have to be able to tune it out.”
“Exactly how sick did you get of Let It Go?” Tim asks, and there. That’s a real smile, finally. Bruce fights down the urge to cheer.
“Very,” says Bruce, dryly. “Come on. What music? Pick a genre, an artist, whatever.”
“Are you sure?” Tim asks. “Really?”
“Totally sure,” Bruce assures him. “Pick, and then you get to count down and try to hit zero. If you actually make it to five, I’ll get you a surprise after this.”
“You don’t have to do that,” Tim tells him immediately. “Um...could you do Sleeping At Last? Anything is fine. He’s really good for chilling out.”
“Done,” Bruce says, already typing it in. “Okay, Tim. You’ve got this. Everything’s going to be okay.”
Tim looks back up, over his head at the older anesthesiologist who’s already cracking a joke and instructing Tim to start counting down.
Tim doesn’t even make it to six. (Bruce buys him a stuffed dinosaur anyway.)
Tim wakes up all the way, finally, and manages to make eye hazy contact with Bruce, eyebrows drawing together over the course of several seconds, like he’s stuck in slow motion. He opens his mouth partway, like he’s about to speak. Then his eyelids close and his breathing slows all over again.
Bruce snorts quietly. He’s in one of the recovery room chairs, plastic and hard and shaped to the proportions of absolutely no one’s body. He’s dressed himself in an old set of sweats that he keeps in his locker for emergencies. They’re comfortable, and Bruce is tired as all get out, and ever since he got out of Tim's surgery and off shift, he’s been determined to not spend a minute extra in scrubs. This is his weekend off. He’s earned it.
Tim wakes up again a few minutes later, without opening his eyes.
“H’llo?” he mumbles. “Shakira?”
“Afraid not,” Bruce says gently, trying to keep a straight face. “Just Dr. Wayne again.”
“Oh,” says Tim, and then he lets out a tiny little sigh and doesn’t speak again for a minute. Bruce glances over the monitors, checking once, twice, thinks about grabbing a thermometer and doing the hourly temperature check a little early, just in case--
“Y’know there’re...plants on...the space station?” Tim says, so quietly, Bruce almost can’t hear him.
Bruce does know this. That’s not important right now.
“Really?” he asks.
“Mmhmmm,” Tim gets out. One of his hands drifts up and starts scratching at the oxygen cannula under his nose. Bruce gently catches his wrist and settles it back down against the mattress.
“Plants on the space station?” Bruce prods.
“S’many,” Tim says. “Little plants. Alllll these lil' plants...jus' up there...in space...we grew…”
He’s silent again for a minute, mouth open slightly, and Bruce can’t help smiling and remembering Dick after his first surgery. He’d been the same way. Almost like watching a baby chick fall asleep, fall over, and wake itself up again in the span of one long blink.
“Grew veg't--veget--veg-e-ta-bles,” Tim suddenly says, sounding it out carefully, like he’s trying not to trip over his tongue. “And. Flower. Flowers? A zinnia. So pretty.” He opens his eyes, glances around, and spots Bruce.
“Dr. Wayne?” he asks, tiredly. “Y'r here?”
“I am,” Bruce says, smiling. “No one should wake up alone. I figured I’d keep you company. Your surgery went perfectly, bud, you’re going to heal up just fine.”
“Oh,” Tim slurs. “‘S’good. But...you c’n go…”
“I’d rather stay,” Bruce tells him. “If that’s all right with you. I’m interested to hear more about these space flowers.”
Tim’s eyes blink open again. “Zinnias,” he says, nodding. “Hm. Yeah. Pretty.”
“So you said.”
“D’y think...the plants up there're happy?”
Bruce runs his fingers over the gift bag in his lap. “Are they happy? I never really thought about that before.”
“Yeah,” Tim says. “Y'know. They’re all...up there in a space station...all the ways away fr'm Earth...'n like...they never asked t'go to space? Right? They just were...y'know, planting. Planting around. And...one day...boom, whoa, rocket, oh man...n'then, there’s no gravity? An' no Sun? They can’t get--”
Tim’s breath hitches.
“Tim?”
“Can’t let the Sun in,” Tim says, sniffing. “Too...radiation...bad? They just have like...lights. Dr. Wayne...they don’t get t'see the Sun...they must be so sad--”
Tears are actually welling up now. Bruce doesn’t know what to do with this. Oh boy.
“D'they miss the ground?” Tim says, sounding positively weepy. “How d'they know how to grow? What if they miss their ” He pauses for a moment. “I miss my mom. Why do moms go away?”
This is above Bruce’s paygrade. This is probably also above the paygrade of the very lovely social worker who’s down the hall, too, but Tim is right here, right now, and this is not the kind of conversation he needs to be having while waking up from his own emergency surgery.
“Did you know you get a teddy bear after surgery?” Bruce interrupts, quickly. He’s slipped into the tone of voice he uses with little kids.
Tim blinks, looks over at Bruce again, as if suddenly remembering he’s there. “What?” he asks. Another blink.
“A teddy bear,” Bruce repeats, smiling gently. "We give out surgery teddy bears." He reaches out and picks the bear off of Tim’s rolling tray nearby, and holds it in the boy’s line of sight. “You did a great job. You earned it.”
“But…” Tim starts, then trails off. He reaches one hand out for the bear and misses by several inches. “It’s got a lil mask on.”
“Yep, sure does,” Bruce agrees. “It’s a hospital bear. Can you read what its shirt says?”
Tim squints for a long second. “Get...well?”
“Good job,” says Bruce. “Yes. Get well. And that’s exactly what you’re going to do. How are you feeling, Tim?”
“Uh,” Tim says. “Rainbow?”
Bruce stares. “Rainbow?”
“The computer screen looks like it’s a ripply rainbow.” Tim frowns. “Don’t think it’s s’posed to do that.”
“That would be the meds,” Bruce says.
“Oh.”
“How’s your pain?” Bruce clarifies.
“Uhhhhhhh...one,” Tim says. Bruce just sighs.
“All right. You’re not too sore? No sharp pains? Don’t feel sick?”
“Nope nope nope,” Tim mumbles. “Sleep. Night.”
And he conks out again before Bruce can say another word. Bruce smiles and tucks the bear in the crook of one of Tim’s limp arms, then settles back in his chair to keep vigil for a while longer. Tim might be alone in the legal system right now, stuck in limbo while the state opens a case, but he’s not going to be on his own. Not while Bruce has any say in it.
When Tim wakes up enough, Bruce will give him the dinosaur, and hopefully some ice cream, and a whole lot of broth. The social worker will explain his situation, and Tim will hopefully get to go to a good, stable place when he’s discharged a few days from now—after they’ve given him plenty of antibiotics and are sure nothing else has taken the opportunity to attack his body while it’s weakened.
Bruce hopes that maybe it’ll be his place that Tim goes to. Possibly. It’s on the table.
And for tomorrow, when Tim is thoroughly awake, on lower meds, and definitely getting bored, Dick and Jason have already agreed to come ply him with Mario Kart and Smash. Bruce is assured this plan will be enough to keep any teenager from getting too antsy and trying to sneak around too much. (Not that his sons would have any firsthand knowledge of that. Of course.)
Tim’s going to be okay. They caught the appendicitis in time, and Bruce didn’t lie when he told Tim he was good.
Tim will heal. And Tim will also hopefully get his home situation sorted out, too, and start healing on that front, too. Even if that’s a much longer process. He won’t be alone through it, at least. Bruce already decided that much. No matter what comes, Timothy Drake is not going to be alone anymore.
For now, Bruce sets the gift bag on the windowsill, leans back, and closes his eyes. He reaches out and makes sure one hand is on top of Tim’s, just in case the boy wakes up soon. He listens to the rhythm of Tim’s soft breaths, the steady beep of his heart monitor, the sound of his heart slow and measured and strong. And finally, finally, Bruce allows himself to drift off to sleep.