Chapter Text
Dr. Jack Abbot has no patience for anyone from billing. They’re all vultures, as far as he’s concerned, all bloodsucking leeches that should be ashamed of themselves. People having the worst days of their lives, tired, in pain, being poked and prodded and shaken awake and sternum rubbed, listening to the maddening beeping of heart monitors and oxygen alarms and screaming, and there’s billing. Fucking billing. Asking clearly unhoused patients about insurance information, bothering parents of dead children with the home address they can send the fucking bill to.
So yeah, Jack has no sympathy for the vampires from the billing department, but that doesn’t mean that any of them should get stabbed in the lung with a scalpel.
He’s sticking his hand under the hand sanitizer dispenser outside of Trauma 1 when he hears the commotion; he looks towards the ambulance bay first, then towards Chairs, but his ears take him to… outside BH 1, where two paramedics are helping to lift a young woman onto a stretcher and Dr. Ellis is stabilizing the scalpel in this woman’s chest.
“What the fuck happened?” Jack snarls, snapping rubber gloves on as quickly as he can while they wheel her into Trauma 2. One of his new med students, Borgen, is sobbing, and he’d known that Borgen wasn’t cut out for emergency medicine the moment he’d seen them, but this is only confirming that Borgen will be finishing out this rotation in Pedes or Psychiatry before long.
He had been expecting someone other than the woman with a scalpel in her lung to answer, and she doesn’t really, but she does crack a joke. “That’s what-“ she coughs, her voice a rasp- “I get for… working in billing,” she says, her lips curling in something resembling a smirk. Jack rolls his eyes and gets Bridget to push ketamine and roc. Her eyelids flutter a few times before they close.
“Fucking Borgen-” Dr. Ellis starts when Jack asks again, and Borgen sobs loudly again.
“I didn’t mean to!” They shriek.
“I know, Borgen. Just go sit in the staff lounge for a bit, okay?” He says, forcing a softness into his voice that isn’t there. Borgen begins to wildly shake their head, and he glances at the vitals. Not great. He grimaces.
“I can- I can help-“
“No,” Jack says. Somebody must’ve told Lena, or maybe she heard Borgen’s shrieking, but either way, she pokes her head in and coaxes Borgen out. Bridget has already cut away her shirt, and Ellis is working on her. “What did Borgen do?”
“Left a fucking scalpel next to the combative patient in Behavioral 1,” Ellis snarls. Lily, a newer night nurse, is fluttering around the bed with Bridget, both of them taking care of things before Ellis or Jack can ask. Jack doesn’t pinch the bridge of his nose, mostly because he’s got blood on his gloves and he’d have to change them after touching his face, but it’s a near thing. “This one came in for patient info, and the guy got pissed at her and stabbed her.”
“Fucking Christ,” Jack says. Her sats begin dropping. “Ellis, what’s happening?” He asks, trying to turn this absolute shitshow into a teachable moment.
“Um, blood in the lung, most likely,” Ellis says, doing her job with the grace and efficiency he expects from a senior resident. Shen wanders in, pulling his blue gloves on, and Jack gladly hands the case over to him; they can handle her while he tries to handle Borgen.
Lena is sitting with Borgen in the staff lounge, and Jack rubs a tired hand over his face. “Borgen,” he says, and the kid wails. “Borgen, breathe, buddy. Breathe.”
“I- I- I didn’t- I didn’t-“ Borgen is hyperventilating, and he lets Lena touch the med student, pull them into a gentle, careful hug. Jack does the talking.
“Borgen, it was an accident. Everyone knows that. It was a really stupid mistake that you never should have made-“ Lena sends him a harsh glare, but he’s never been one to sugarcoat anything- “but it was just that: a mistake.”
He doesn’t say that he definitely needs to speak to the hospital’s lawyers, because both him and Shen could be named on the lawsuit, and he’s pretty sure that any reasonable person would not leave a sterile surgical kit within reach of a combative psych patient in psychosis. Med students are pretty damn protected, but that is just common sense, and he really doesn’t want to pay more for the fucking medial malpractice insurance he has, so he needs to see what they’re going to say, but he’s fairly sure he already knows. Borgen is probably fucked, and him and Shen’s premiums are going up.
Shit.
Borgen is calming down now. He weighs his options: it’s been the q-word, he has other, more competent med students who won’t get a hospital employee stabbed with a scalpel, and Borgen is clearly not doing well. “Go home,” he says, trying to sound soft and comforting. He thinks it just sounds angry, which is entirely unintentional. Borgen looks up at him with wide, tear-filled eyes.
“No, no, I can-“
“I have to speak to the hospital lawyers, and you need to sleep. You’re of no use to me right now, and you need to go home and take care of yourself,” he says. Borgen’s eyes get even wider at the mention of lawyers.
“Am I gonna get sued?” Borgen asks, and Lena sends him another scathing look.
“Maybe,” he says, because he’s not in the business of sugarcoating. “That was a really stupid thing you did. Reckless and dangerous and she might have lung issues for life. It would be well within her right to sue.”
“Oh my God,” Borgen chokes, then flees and he hears the staff bathroom door bang shut. Lena sighs.
“You didn’t have to tell them that,” Lena mutters, and Jack shrugs.
“Better that they know now so they can prepare rather than be surprised when they get served,” he says. Lena looks up at him, and he raises a brow.
“They’re not gonna win, huh?” Lena says, sounding genuinely mournful. Borgen’s just a kid, and certainly not cut out for ER medicine. Although, after that display, Jack’s not sure that they belong in medicine at all.
“Doubt it. Any reasonable person wouldn’t leave sharp objects with a combative psychosis patient,” he says. Lena grimaces.
“I’ll get them to go. You should check on little miss billing,” Lena says, and Jack nods.
He’s bombarded by the other resident and the two med students the moment he leaves the staff lounge.
“Is it true?” His resident, Valada, asks, and he raises a single brow.
“Did someone from billing really get stabbed?” His other M3 med student asks, and he fixes Washington with his best unimpressed stare.
His M4, Azizi, wisely doesn’t say anything. Jack slips gloves on and walks into Trauma 2 with the fanclub right behind him.
“She’s stable,” Shen says casually, like he’s talking about the weather. Ellis is covered in blood up to the elbow, but the girl’s vitals are stable. She’s intubated, and Lily is taking ‘little miss billing’s hospital badge off of her scrubs to look up her name in the system. Shen gives him the rundown, and Jack nods once.
“Good job, Ellis,” he says, and Shen looks offended that he’s been left out. “You too, Shen. Now, the rest of you, out. You have patients,” he reminds them. Valada huffs, but they all break off. “She goin’ up?”
“They’re ’prepping the OR now’, which means she’ll be down here for the next four hours,” Shen responds. Jack huffs out something that sounds a little bit like a laugh. “Did she really say ‘that’s what I get for working in billing’?”
“Yes,” Jack mutters, walking up behind Lily to see her file. There’s an emergency contact on there, and Lily is already calling, but it’s after 1am, so he’s not sure they’re going to get anyone to pick up. He scrolls through her history, his eyes catching on the epilepsy diagnosis. “She’s got epilepsy. Make sure we get some seizure pads on the rails, and park her in the hall so we’ll see if she starts seizing,” he says. Ellis nods and Shen begins rolling her out, Bridget rolling her many accoutrements out with her.
“Nothing,” Lily says in her little voice, and he nods.
“Just try one more time, leave a voicemail asking to call us back the moment they get the call,” he instructs, and she nods, dialing the number again. He can hear a female voice floating through the phone as he looks at her past medical history: appendicitis at 17, no complications, wisdom teeth out at 15, no complications, first seizure at 6 months and the next at 7 years, diagnosed with epilepsy after a one-day EEG, started with Keppra but it caused mood changes so they went to 300mg of extended release Lamictal and bumped up to 600mg before the seizures were under control.
Lily points at the Lamictal dosage. “That’s the max, isn’t it?” She asks, and Jack nods.
“Yeah, which doesn’t bode well for her not seizing out in our hallway,” Jack grunts. “I’m calling Walsh to tell her to hurry up.”
Lily snorts, and she sounds a lot like his wife when she does that, so it makes him blink twice before he picks up the phone.
Walsh does not give a single fuck that this woman could seize in his hallway and fuck up the very precarious stability she has, and it makes Jack want to strangle her a little. He grabs the ring hanging right beside his dog tags for strength.
He briefs Lena. “Assuming she takes it before she comes into work, that’s probably 5 or 6pm,” he says. Scrubs a hand down his face. “Is there someone else in billing down here?”
“Yeah, girl named Jadyn. I can go get her, if you want to talk to her,” Lena says, and he nods. The PA announces an MVC 5 minutes out, and he sighs. “Where is she? I’ll get her myself.”
“South 16,” Lena says, and maybe luck is on his side, because Jadyn is just finishing up with South 16 when he gets there.
“Hi, do you know when your coworker from billing takes her seizure meds?” He asks, straight to the point. Jadyn’s eyebrows shoot up.
“Six,” she answers. “Her alarm always goes off at six and pisses off whoever she’s with. Is she okay?”
Jack sighs. The MVC is pulling up to the ambulance bay. “No. Long story short, she was stabbed by a patient with a scalpel. Go find Lena and she’ll point you to her bed if you want to see her, I’m sorry, I have to go,” he says, already shuffling sideways, eyes on the ambulance bay. Jadyn waves him off, and Jack barely slows down to call out her med timing before he’s skidding to a stop beside the stretcher, gloves in place.
He hands her off to Robby in the morning, which pisses him off to no end. She kept getting bumped from the OR by other traumas, and they’d given her the 600mgs of ER Lamictal, but he is wildly unhappy with this development. Robby sighs.
“She’s still sedated and intubated, and Walsh said she was next in line, but that’s assuming no more traumas come through,” he says irritably.
“Can’t believe your med student did that,” Robby scoffs out a laugh.
“My fuckin’ premium is gonna go through the roof,” he grunts, swinging his camo backpack onto his shoulder. “Shen’s too, probably. And Borgen is just fucked.”
“Yeah,” Robby agrees. “See you tonight.”
Jack groans. “Don’t remind me,” he grumbles, walking through the ambulance bay towards the staff lot.
He has an odd dream. At first, it’s just reality, what happened to his wife, what happened to Rachel. He arrives before the ambulance, tearing his hair out. Robby had known there was a pedestrian vs motor vehicle coming, but he hadn’t known it was Jack’s wife. Things are blurry, and Jack knows it’s a dream, but his body still reacts like it’s not, like Rachel is dying all over again, like she is paralyzed and brain dead, like he has to pull the plug on her again.
But when he’s signing the forms, he looks back to Rachel, and it’s not her. It’s… it’s the girl from billing. Robby is saying something, how sorry he is, how horrible this is, but Jack’s fear and anger fade into just… confusion.
She starts to seize, which is antithetical to the words ‘brain dead’ but apparently his mind doesn’t know that in his sleep, and he watches her seize and seize and seize while the room stays in place, exactly where it is. Robby doesn’t react, no one comes in, Perlah doesn’t push Keppra, no one does anything. She just seizes until she dies, and Jack doesn’t move either.
He wakes up confused, clutching at the ring. It’s been a long time since Rachel’s death, but he still dreams about it sometimes. Seven years is long enough for his heart to mostly heal, but the scars still hurt when it rains, still ache when it gets cold. He glances at the clock and realizes he has about two hours before he should get ready for his shift and head in.
He checks his phone first, just in case Robby texted him an update on the girl from billing. He knows it’s silly, because Jack handed over so many patients and Jack’s never really cared before, but, well, he wasn’t going to get sued before, is what he tells himself, at least.
After the second shower of the day and some breakfast at five-thirty pm, Jack pulls into the staff lot around six fifteen. He knows he’s early by a long shot, but he had nothing else to do, and he’s unsettled from his dream. He needs a crisis, needs the chaos, needs the shouting and beeping and screaming. He feels at home there, safe.
“You’re early,” Dana says the moment he walks in the staff entrance. He doesn’t know how she knows everything; she didn’t even look at him.
“Nothin’ better to do,” he grunts.
“You’re just wondering about that girl from billing,” Dana says, following him to his locker. He frowns at her. She has to be a witch, really, because how the fuck does she know that?
“She get up to the OR?” He asks instead of reacting, and Dana nods.
“Not long after you left. In ICU step-down now. Probably discharged in a day or so. Back at work with you in-“
“You’re early,” Robby says, and Dana scoffs at being interrupted. Jack grunts.
“Amazing observational skills, there, Doc,” he says dryly.
“Your billing girl-“
“Not my billing girl,” he grumbles. “And Dana filled me in. Now can we hand off the actual patients still in the ED, maybe?” He asks. Dana holds her hands up in surrender, slinking away to gossip with the day nurses about Jack’s supposed interest in the fucking girl from billing.
Why would he be interested in the girl from billing? He isn’t. He just wants to know when she’s going to wake up so that he can call his lawyer. He tucks his dog tags and the ring under his scrubs as Robby begins to discuss the patients, and Dana winks at him.
Jack Abbot doesn’t speak Tagalog, but he hears the word ‘billing’ in the middle of Perlah and Princess talking and bites back a groan. There better not be a fucking betting pool on this, he thinks. I just want to know when to call my damn lawyer.
Dana, that little witch, leaves the girl from billing’s chart open. He closes it without looking, because he doesn’t need to give these vultures any more ammo.
Christ, he thinks as Perlah and Princess mutter in Tagalog to each other, and I thought billing were the vultures.