Chapter Text
The night shift was coming to an end. Outside, a cold November morning had settled over Pittsburgh. Most of the trees were bare now, their last rust-colored leaves scattered across damp sidewalks. The first light of day reflected off the dark water where the three rivers met, but inside the Pitt, very little had changed. Handoffs were underway, monitors kept beeping, another consult was called, and the day shift filtered in. Different faces came in, but the work never stopped.
Jack Abbot stood across from Michael Robinavitch, finishing the last of the morning handover. There was a patient waiting on cardiology. Another transferred upstairs. Labs still pending on a more critical case. Business as usual.
It was Robby's first day back after his sabbatical, but he'd already reached out to most of the staff before returning. By now, there weren't many people he hadn't already talked to, and the questions had mostly been asked and answered. The morning felt surprisingly ordinary. Three months ago, he'd have been waiting for something to go wrong. But now he felt different, more grounded.
Al-Hashimi stood at a desk across the room, already buried in a case. Robby found himself wondering why he'd ever disliked her. He couldn't remember. She wanted the same thing he did. A better ER. For the first time, he caught himself thinking she might be someone he could lean on.
Robby firmly believed he'd changed. Liked to think he was quicker to listen now, not so fast to jump to conclusions. Therapy had just started but had already given him a place to start to untangle some of the things he'd carried around for years. Little by little, he was going to learn how to build healthier relationships. Even so, some people still seemed to matter more than others, and he couldn't have said why.
Jack closed the last chart, exhaustion seeping into his voice: "Good to have you back, brother."
Robby answered with a quick smile. "Good to be back."
Then Jack's whole face brightened as he glanced over Robby's shoulder.
Robby turned. Dennis Whitaker was making his way quickly toward them with a paper cup of coffee. He looked like he'd only just rolled out of bed, but his face softened into a smile as soon as he spotted Jack, not seeming to notice Robby beside him.
"Hi, Jack."
"Well, good morning, Dennis," Jack said, his gaze traveling across Dennis's face.
Robby tossed the chart onto the desk. "Since when are we on a first-name basis, exactly? Professionalism isn't optional."
Dennis's smile faltered as he noticed Robby. "Dr. Robby. Sorry. I didn't even see you. Won't happen again, promise. I'll stick to the proper titles."
Jack kept his eyes on Robby: "Oh, don't beat yourself up about it, Dennis, I'm not sure this guy is the best person to be giving lectures on professionalism."
Robby rolled his eyes.
Jack turned to Dennis again: "You get any sleep?"
"Yep."
"Uh-huh." Jack leaned in and plucked a fleck of glitter from Dennis's hair. "Care to explain this?"
Dennis eyed the glitter between Jack's fingers for a second. "So what? It was her birthday."
Jack smiled and went on to study a chart. Robby glanced from Jack to Dennis, trying to make sense of the easy familiarity. It didn't fit.
He turned as Dana approached. "It's good to have you back, Captain."
"Thanks. What've you got for us?"
"EMS just called."
The three men turned their attention to her. "We've got an inbound patient. Respiratory distress. The crew asked us to be ready," Dana continued.
Jack glanced toward the exit. "Well… my shift's over. I'm getting out of here."
Dennis tilted his head innocently. "What, you've got somewhere better to be?"
Jack gave him a look that was equal parts warning and amusement. "You'll survive without me."
Dana cut in, her voice all business. "Abbot, I really need you to stay for this one."
"Why?"
Dana shook her head. "Gloria just rushed in here saying something about an incoming trauma, possible police escort, international case. Administration wants everything by the book. She said we need someone steady on this one."
"I'm steady," Robby said, irritation creeping into his voice. "I'm here. I can handle things."
Dana looked at him apologetically. "I know. Definitely. I just thought Abbot could stick around and back you up. Just for a little while."
Robby sighed. "Can't say I understand that."
Jack smiled. "Give me a chance. I grow on people. Ask Dennis."
Robby snorted despite himself. As they headed for the ambulance bay, his eyes drifted toward Jack and Dennis, who were leaning slightly toward each other.
"Happy now?" Jack gave Dennis a gentle nudge with his elbow.
Dennis didn't even try to hide his smile. "So, what if I am?"
Before anyone could say another word, the distant wail of approaching sirens echoed through the ambulance bay. The ambulance had arrived and the ambulance bay doors flew open. Two paramedics rushed inside, pushing a gurney. On it lay a fairly short and completely bold, well-dressed man in his late fifties. His suit jacket hung open, his tie loosened. He was heavyset and visibly out of shape, now lying perfectly still, one arm dangling over the side of the gurney.
At first sight, it looked like any other arrival: a gurney carrying a patient who was critically ill. There wasn't a police officer in sight, despite what Gloria had been babbling about. The only unusual thing was that the two paramedics appeared to be having a heated argument as they pushed the gurney inside.
"What the hell happened?" one of them demanded, looking at his partner.
"How the fuck would I know, he was talking just minutes ago."
"I know he was talking!"
"You gave him the—"
"Yeah, I gave him the neb. Everything by protocol."
"Trauma One!" Robby said firmly, already pushing the gurney toward the trauma bay. "Let's move!"
Jack stepped in front of the paramedics, holding up a hand as they all followed the gurney. "Hey, hey, hey. What the hell are you two fighting about?"
"This guy... this doesn't make any sense." He frowned. "He was short of breath, but he kept yelling. He kept talking. British accent. Saying weird things. Something was just off. Then, just like that..." He snapped his fingers. "Dead."
They were all in the same room now.
"Transfer on my count. One, two, three."
"No pulse. Start CPR."
Jack stepped up to the bedside as Dennis started compressions. Around them, the rest of the trauma team got to work.
Robby turned to the paramedics. "Start from the beginning," he said. "Talk to me."
"British male. Mid-to-late fifties. Severe respiratory distress when we picked him up. He was really agitated, fighting for air. Kept thrashing around, waving his arms, yelling at us. We could barely get him to sit still long enough to treat him."
"Yeah, he wouldn't stop talking," the other paramedic interrupted.
"Saying what?" Robby asked.
The two exchanged a glance. "He kept repeating the same thing. 'I'm not supposed to be here.' Over and over again."
"We treated him per protocol," the younger paramedic replied. "Oxygen. Nebulizer. Monitors. He was still conscious, still talking..."
"He was terrified, like he was being chased or something," the older paramedic added quietly.
"And then?"
"He just... dropped. One second he was talking, the next he was gone."
"Bag him."
Dennis sealed the bag-valve mask over the man's face as another nurse squeezed the bag. "One milligram epi, IV."
Jack scanned the monitor, then the patient. "Any reversible causes? Tension pneumo? Massive PE?"
"Equal breath sounds. No obvious signs of tension."
Robby leaned over the patient, listening briefly before stepping back.
"Continue compressions," Robby said.
For just a second, Dennis glanced up, only long enough to catch two figures standing beyond the glass doors. They weren't wearing hospital scrubs. One of them stood very still with his hands clasped behind his back, watching through the glass.
His eyes flicked to Jack and he realized Jack had seen them too. Their gazes met for the briefest moment, a silent exchange passing between them. Jack's attention snapped back to the patient. "Another round of medication. Continue compressions."
Dennis immediately refocused on the man beneath his hands, pushing the strangers from his mind.
Dennis completed another cycle of compressions before frowning. "Jack..."
Jack looked over to him. "What is it?" Dennis kept his hands moving.
"I think this guy's had a sternotomy."
Jack stepped closer to the bedside. "What makes you say that?"
"I'm not sure." Dennis shook his head. "I can feel something under the sternum."
Jack glanced down at the patient's chest. "Sternal wires?"
"Maybe."
Robby finally looked over, his tone sharpening. "It doesn't matter right now. Previous cardiac surgery changes absolutely nothing. Keep the compressions going."
Dennis nodded. "Right."
Jack lingered for another second, looking at Dennis. "Still... let's remember that. Good catch, Dennis."
Dennis gave Jack a faint smile. Robby observed the two of them for a moment, his expression unreadable, before turning back to the patient. "If we get this guy back, we can worry about his surgical history."
Jack gave a small nod. "Fair enough."
"One milligram epi, IV."
Another cycle. Another dose of epinephrine. Still no rhythm, no pulse.
Dennis glanced from the monitor back to the patient. "Come on..."
Jack caught Robby's eye. Robby gave the smallest shake of his head.
Dennis noticed the exchange. "No." He reached for the patient's wrist again, as if he might somehow find something everyone else had missed. "Let's keep going."
"Dennis," Jack said gently.
Dennis didn't look up. He searched for a pulse one more time, then let his fingers linger against the man's wrist. There was nothing. Dennis's shoulders sagged. Slowly, he withdrew his hand and stepped back from the bed.
"I think it's time to call it," Jack said.
"Yeah." Robby glanced at Dennis, lingering on him for a moment. "You did everything you could. We've still got patients who need us."
The monitor went silent. Dennis pulled off his gloves as someone draped a sheet over the body. Jack let out a quiet sigh while Robby stood with his arms folded, his eyes still on the patient. Over the next few minutes, the room gradually emptied. The paramedics were the first to leave, followed by the nurses, until only the three doctors remained. Finally, Robby turned toward the door, leaving Dennis and Jack to call the time of death and wrap things up.
He had barely reached the doors, however, before someone stepped into Robby's path. It was a tall dark-haired man in a long black coat and behind him stood a slightly shorter, grey-haired man who appeared considerably more apologetic about the interruption.
"I'd rather you stayed," the taller man said in a crisp British accent. Looking thoroughly taken aback, Robby stepped back into the room.