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Samira was suffocating.
The last thing she wanted right now was another panic attack, yet she could sense the breath shortening in her lungs as she ran out into the ambulance bay. She placed a steadying hand on her chest to try and quell the pain, but it was no good. Nothing was ever good enough.
Samira rounded a corner where she could be safely hidden from the eyes of lingering EMTs and leaned against the brick, the hot air no real reprieve for the heat in her veins. Her phone buzzed again. With a trembling hand, she took it out and finally glanced at all the texts her mother had been leaving her. Will you come visit before I leave? What do you want me to do with your old clothes? Your old books? Your old photos? Why won't you answer? Is something wrong? This decision has nothing to do with you, understand that. Samira, are you okay?
Are you okay?
Are you okay?
Samira's heart clenched at the texts. Was her mother truly worried, or did she just not want the guilt of having caused a sudden panic in Samira over the change in plans? Did it really matter what the answer was?
She thought about Mr. Green, waiting to watch the fireworks with his son. Mr. Diaz, burdened under the weight of pain and debt. Mrs. Diaz and the children, their lives irrevocably changed. 13-year-old Samira Mohan, praying her father would be okay. Samira couldn't save any of them.
In a strange, sick way, after the shitshow of a shift she'd been having, Samira found she didn't really care anymore what the root cause of her mother's texts were. Maybe it was nice to just feel wanted. To know there was someone still watching out for her.
She couldn't handle another phone call, but she texted back a quick response: I'm okay. Don't throw anything out yet. The ED is busy so I am turning off my phone but I will call you later tonight after my shift ends or tomorrow morning.
Hopefully that would suffice. Now technically, Samira's shift had ended. It was past 7:00 pm; she could be long gone by now. But there was still charting to do and continuity of care for Orlando and an empty apartment she didn't particularly want to crawl into just yet, even though four white walls sounded a whole lot better than what was behind her right now.
Samira tried to get her breathing under control, but her mind was spinning in a thousand different directions and she couldn't stop it. The breath caught in her lungs turned into a lump in her throat which was rapidly turning into tears pricking at the corners of her eyes. Get it together, Mohan. How embarrassing. And how funny that the voice in her head so often sounded like Robby and not herself.
She was under no illusion about her relationship with Robby. Samira wasn't expecting a miracle every time she walked through the doors of the Pitt, for Robby to magically transform into the kind, if somewhat stern mentor he had been when she first met him years ago. Though it wasn't like he had ever truly extended the grace he used to give Langdon and now gave to the likes of Whitaker to herself. No, it had always been an uphill climb to get his approval. It had just been a lot easier when he was more receptive to seeing other ways of climbing, and when Collins was still here in Samira's corner.
Samira missed Heather more than she cared to admit. She was starting to realize it was not just that she had been a guiding hand in the department, but she had perhaps been a friend. Samira was on friendly terms with most everyone she worked with, but that didn't mean they were friends. Or maybe they were, maybe they were trying to reach out to Samira, maybe she had never taken the extended olive branches offered to her, maybe she had missed her window. Maybe she had wasted her time. Maybe she should still take the Jersey job even if her mom and home weren't there anymore, because it wasn't like she had that here either. Maybe she was just destined to be alone, ever since age 13.
Fuck. Samira rolled her eyes at herself as she felt a tear leak out of one eye. This was a fucking pity party, and it was unprofessional, and it was upsetting. Samira could—and frankly, did—blame Robby all she wanted for her declining confidence, for feeling iced out in the ED, for second guessing if she was meant for emergency medicine, but she was only really beginning to understand just how deeply his words had taken root inside her. He was the spark, but she’d been tending to the self-effacing flame.
Ultimately, the only person who could really have the final terrible word about herself was herself, and she'd been letting these words ruin her life. The sharp pinpricks of inadequate and slow and overly emotional and not cut out for this were burrowed so deep under her skin they were like maggots crawling. And she was just so tired of it all.
Something had to change.
The chances were high that Samira would feel a lessening of the pressure during Robby's sabbatical. She'd worked under Dr. Al before, and she truly respected her. What was more, Baran seemed to truly respect Samira, which was in pretty rare quantity these days. But the chances were higher that Robby either wouldn't actually leave for three months, or that when he returned he could be in an even fouler mood. The chances were also looking higher and higher that Samira wouldn't get a fellowship at PTMC, not with the deadlines looming and competition growing.
Samira's brain started whirring. This was what she was good at, this was where she thrived: seeing a problem from all sides, offering differentials, logically and emotionally parsing out a solution. She could feel her breaths lengthening, the heat on her face easing so that it was only the setting July sun beating down on her, not the turmoil roiling within.
There were four treatment options for Samira's self-proclaimed diagnosis of Professional Disillusionment and Resident Punching Bag-itis.
1. Carry on as is, operating under the assumption that there will be three months of bliss where Baran will treat her with more professionalism and care than is in Robby's pinky finger. After the three months, Robby will be so spiritually healed from his travels that he won't notice Samira at all, or will be so impressed with her developing skills that he will have to acknowledge how poorly he'd behaved towards her.
Side affects may include Robby not returning in a joyful mood and instead punching down harder once he sees all the ways Baran will have changed the ED in her style. Cue nine months of misery and no fellowship recommendation.
2. Request a transfer to a new residency program, wherever will take a senior resident. Presby, New Jersey, California, Antarctica...literally anywhere. She can finish out her residency in peace with the support of a new team that wholeheartedly wants her there.
Side affects may include the near impossibility of transferring in the final year of residency, especially without the approval of one's supervisor, i.e. Robby. Prepare, again, for no fellowship as why would anyone hire someone who could not even finish out one measly residency.
3. Drop out of the residency program entirely. Pack up her things, reapply in another year for a different program, become a lab tech or a PT or a geriatrics primary care physician. Run away as fast and far as she can.
Side affects may include temporary freedom from a toxic workplace, but neglect of lifelong ambitions and emergency medicine skills will lead to further atrophying of confidence and the eventual conclusion that Robby, and the inner voices that sound like him, was right.
4. Join the night shift.
Side affects may include...
Well. Now there was a thought. The night shift was already rather top heavy compared to the day shift, though. Two attendings—why Robby always seemed so adamantly against that during the day, Samira didn't know, since it seemed to work out ideally with their nocturnal counterparts—and two senior residents. Samira had been picking up practically every shift imaginable since Langdon had left after PittFest, so she'd been the only senior resident on days. With a jolt, Samira realized that may be contributing to her truly debilitating case of burnout right now. Chronic workaholic admitting to being overworked? Samira laughed to herself. She really had broken apart this time.
Langdon was back now, though, presumably for good, easing some of Samira's caseload burden. (Though Samira couldn't ignore the cold shoulder Robby had been giving his former favorite all day. She and Langdon wore matching prodigal child signs on their foreheads, now, she supposed.) That left a bit more breathing room to rearrange schedules.
Samira, unlike most of her daytime compatriots, actually liked the night shift. There were usually less patients, which meant more time to care for each individual. And she'd picked up enough doubles that she was probably more comfortable with the timing of it than any of the other day shifters, but it was more than just the circadian compatibility: it was the people. She realized she truly wanted to be friends with them. There was something so noble about a person who willingly chose to work in the dark, when some of the worst cases came through the doors, full of patients who were equally as scared of the light as the team treating them were. Samira respected them all deeply. Parker's nonchalant efficiency, Shen's gallows humor, Crus's welcoming demeanor, Walsh's no-nonsense methods, Mateo's easy reliability.
And then there was Jack.
Samira didn't always know what to make of Dr. Abbot. At first he was like a ghost, only seen at handoff and usually with that brooding look on his face, like he was holding the weight of the world on tight shoulders. Then suddenly he was no longer translucent, but a living, breathing figure before her, donating blood from his leg and trusting her with the most precious thing of all, someone's life. And she came alive in front of him too.
She had never seen anyone work the way he did. Dana called him an ER cowboy like a joke but she hadn't fully understood the truth of it until she saw the way he swooped in, with his go bag and unconventional methods and a raging fire in his spirit.
That terrible night, after the dust had settled, and the manic high had given way to melancholy, they were the only ones left in the park across from PTMC, and they had spoken. About what, Samira could hardly remember. Maybe swapping stories from the shift from hell. Asking him about the craziest procedures he'd done in the field. Asking her about the most satisfying diagnosis she'd ever discovered. She mostly remembered how easy it all felt. Sitting in comfortable silence. Her hair down, his leg off.
They'd fallen into a rhythm in the year following, when Samira took on more double shifts and Abbot sent her case studies she might be interested in and they danced around each other while they handed off scalpels and differentials and coffees and small smiles.
Samira had...an intellectual crush on him, nothing more. She admired his teaching and leadership methods, admired even more that he genuinely sought her opinions. Admired how he often told students that slow was steady and steady was smooth—once with a subtle wink in her direction, as if he knew that just earlier that morning, Robby had brought back the Slo-Mo nickname in front of a respected visiting surgeon. And then there was that one time she was demonstrating for a scared six-year-old what a pulse oximeter measured on herself, and the screen showed her heart rate literally jumping as she glanced Abbot performing a tracheotomy in Trauma 2.
If Samira had baggage, Abbot was carrying a full cargo hold's worth. There was a reason he'd relegated himself to the night, a reason he insisted on running straight into danger during the day. The evidence of that danger was as plain as the bloody mark on his back that she'd cleaned up this afternoon.
Samira worried about him, the way she assumed anyone might worry about a flight-risk friend, but she also got the sense deep down that he was steadier than he appeared. That he'd been in the game of managing grief and pain and the shouting in his head for a long time and now had the routine pretty down pat. Even if the routine could use a few more safety nets.
And besides, his thrill seeking didn't come at the expense of others. It was his to bear alone, and she was sure he liked it that way. He didn't lash out the way Robby did, the way Samira felt like she'd been doing lately too. No, Abbot had done something far rarer with his own impulses today: he had cared for Samira.
Samira felt a little silly, even a little ashamed, when she thought about how warm his smallest gesture of kindness had made her feel. Paying for an Uber was no (bullet-grazed) skin off his back, but to her it was utterly monumental. That someone understood the way she wanted to help her patient, that someone wanted to help her in turn. That someone listened to her with dignity. That someone trusted her to care for him in turn.
It was almost too much to bear. Samira's crushing loneliness, her guilt over the patients she could not save today, the blurred edges between the father she would not see grow old and the surrogate parent who wanted her gone, her own inability to stand up for herself after being so beaten down, and the disproportionate feelings that the tiniest gesture on the worst day had arisen in her. Samira wanted to push it all away. Brush the brick dust off her scrubs and walk back inside and keep her head down and clock out and start again tomorrow. Deal with fellowship applications tomorrow, make a game plan for her future tomorrow.
The pain inside of her demanded to be acknowledged, though. The awful events of this shift had thrust everything to the surface, and now it wouldn't go away. Impatiently clawing at her conscience; hence her treatment options.
Option #3 to run away was looking increasingly promising as Samira marked another minute safe from any texts or beeps on her pager. She could steal away under cover of night, not even tell anyone.
But Samira was no quitter. She couldn't be. Despite what Robby suggested, despite the mistakes she'd made, despite the very real desire to just get in her car and drive until she ran out of road.
No, there was only one true solution, at least at this present moment. Maybe she'd change her mind in a week or in three months, but right now, Samira had to protect herself preemptively. She had to fight to preserve even the tiniest spark of faith in herself as a doctor, and hold on to one of the only good things that happened to her today outside of treating patients, take that one iota of kindness and extend it inward to herself. She deserved to be treated well too.
And so with an idea in mind, Samira pushed herself off the wall, wiping at the stray tears that had dried on her face in the heat, and took out her pager. She didn't really need to have this conversation tonight, especially not while she was running on such adrenaline, but she didn't want to lose momentum. Just as soon as she began to dial, a face peeked around the corner of the ambulance bay: the very person she was about to page.
"Dr. Mohan? Whitaker said you'd gone out this way." The ease of his words belied a slight undercurrent of—was that worry? Samira didn't think so, but she'd gotten fairly good at reading his emotions and she could tell there was something more underneath his skin. (Selfishly, so deep down inside of herself she could barely even grasp it, Samira preened at the idea that he might be worried about her. That he might be checking on her just because he wanted to, and not because he needed her for a second hand on an incoming trauma.)
"Hi, Dr. Abbot." She gave him a little smile, one dimple stubbornly peeking out. It couldn't help itself around him.
Instead of gesturing her to return inside as she suspected, he propped himself against the wall next to her, crossing his arms, biceps popping under the scrubs. "Was that your DKA patient you were working on?"
In Samira's daze of the past few minutes, attempting to emotionally regulate and figure out what the fuck she was going to do next, she'd forgotten that other people knew of Orlando too. And that Abbot's Uber was not going to be particularly useful anymore, in light of the new circumstances. "Yes," Samira sighed. "He fell at his second job. It wasn't related to his diabetes. I don't know if it was a faulty railing, or heat stroke, or..." she trailed off. She didn't want to name the other possibility.
"Ah. I see." Abbot nodded, voice low. "I'm sorry, Samira. You know you did everything you could for him—are doing everything."
"I know." Did she know that? Did she really feel like that? It was hard to parse.
As if Abbot could sense that Samira wasn't able to carry a full conversation about Orlando right now, he pivoted. "Dana said you were looking for me earlier. About a fellowship recommendation? I didn't know you were looking for something new. I thought New Jersey was all lined up."
Samira chuckled. "Change of plans. I thought it was all lined up too, believe me. It's been a...day of changing expectations."
Abbot smiled knowingly, leaning his head back against the wall, exposing his sunkissed neck. "That bad, huh?"
"You have no idea," Samira muttered.
"So tell me." There was that soft voice again, same he'd used when he said he'd pay. Quiet and assuring.
"I don't want to go to New Jersey anymore, since the only reason I was going to take that job was to be near my mother, who's just declared she's going on a yearlong cruise with her boyfriend. So I was thinking of looking at fellowships here, even though I know they're practically full, and Crus is definitely getting the ultrasound one, so Dr. Al and Robby suggested geriatrics, but now I don't even know if I want to be here at all, and—"
"Whoa, whoa. Slow down." Abbot raised his hand up to stop Samira's quickening voice. "Geriatrics? Really?"
"All that and that's what you're focusing on?" Samira raised her brows.
"Humor me."
"Robby thinks I'm...predisposed to the pace." Samira couldn't help the grimace that came out.
Abbot frowned, the corner of his lips curling. "You know that's bullshit, right?"
Samira shrugged, not looking at him. Abbot lifted his head off the wall and craned his neck down so he was directly in her field of view, giving her the famous Jack Abbot Eye Contact. "Samira. Dr. Mohan. You're the smartest person in that entire goddamn department. And if you want to go for a geriatrics fellowship—if you want that—then I will write you a shining recommendation and every senior citizen who walks through those doors will be the luckiest patients alive. But something tells me you don't want that, do you?"
Samira felt exposed, like she was caught on flypaper. "No. No, I don't want that. But I don't know what I want right now. Well—" she stopped herself. Now was the time. Rip the bandaid and treat the underlying wound. "I know that I can't continue here in the way that I have been."
"What do you mean?" Abbot grew uncharacteristically still.
"I mean this isn't sustainable. Not for me, not for Robby, not for our patients. Something has to give."
"You worked with Al-Hashimi at the VA, right? I like her. I think she'll be a good addition here, and I think she'll be good for you when Robby's gone."
"I know, and I like her too. But I'll be waiting for the other shoe to drop as soon as Robby gets back." Samira paused, studying his wide hazel eyes. They were so bright, shining with—with something. "I don't want to put you in a bad spot, I know Robby's your best friend. But I want to run an idea by you."
"I'm all ears, Dr. Mohan."
"I want to switch to the night shift."
A millisecond went by that felt like a lifetime. If possible, Abbot's eyes widened even further, just for a moment, before he reined them back in. His arm muscles flexed. "Are you serious?"
Samira nodded. "I've thought through my options. It's either night shift or literally leave Pittsburgh right now."
Jack—no, Abbot, she reminded herself, smiled. "Whoa, don't trip over your enthusiasm for my shift, now."
Samira couldn't help her own smile slowly growing. "That's not what I meant. Listen, I work with your team all the time anyway, we get along. The cases are interesting on the night shift. And I like speaking with patients who come in then. They're scared, they're usually in dire need. We're their last resort, and it feels good knowing we've helped people in their darkest hour. We've taken the time to know them when they had nowhere else to turn." Until she said it out loud, Samira hadn't realized how much she meant those words. It wasn't that she was only good with elderly patients—it was that she cared so much, too much, about all her patients, and at night they were at their most vulnerable. In most need of someone to listen and care.
"That's how I feel too." Abbot said. He took his time with his next words before saying, "I don't want you to feel like you're being pushed out of the day. And you certainly don't have to make this decision final right now. But I would welcome you to the nightshift in a heartbeat. But you probably already knew that, didn't you?"
Samira felt her cheeks burning. She did know Abbot liked her in some capacity, trusted her work, gave her the good cases at handover. She didn't dare consider anything further. "Lucky hunch, I guess."
"Hm." Abbot grinned. "So who're you thinking you want to ask to swap? Which vampire has to go into the light?"
Samira considered the question. "Parker, maybe? She's almost definitely got a better social life than I do."
"Yeah, she probably could use a reprieve from being stuck with me and Shen," Abbot joked. "Alright, why don't you sleep on it for a day or two and then we'll all talk? This has been a nightmare shift for you, I can tell."
"Gee, was it that obvious?" Samira groaned.
"Can't let the future of medicine burn out on us just yet." Abbot put a hand on the back of her shoulder, nearly spanning to her neck. It didn't feel patronizing though—it felt like a comfort. "Actually, speaking of, have you ever thought about a teaching fellowship?"
"I don't really think I should be passing along my work habits to anyone else."
"Come on. Personally, I think most of this department could stand to take a page out of your book. Look, if you're serious about a fellowship here—though I don't think you need one, I think you could apply straight for an attending position next year and get it—why don't you look into the Medical Education Fellowship? I'm not trying to influence you one way or another. And definitely not to stay at the Pitt if you don't want to. I'm just saying, you've got more options than you think you do."
Samira considered his words. She'd thought about that fellowship track before, had put it aside last year when she'd heard Robby had put Langdon up for it instead of her. Of course, Langdon wasn't doing it now, but she assumed the position was filled anyway. "I have to imagine that's pretty competitive. Or already taken. I appreciate the advice, Dr. Abbot, but I've wasted a lot of time on this New Jersey job, so now I think I'll just have to take what I can get."
"Never thought I'd have to tell you this, but you deserve to take all the time you need. This is a big decision. You don't need to waste it on something you don't want to do." There was that eye contact again. Samira didn't know what she had done to warrant his attention like this, but it was like a balm to the festering wounds in her heart telling her she wasn't good enough, telling her she didn't belong. "And I don't see why we couldn't take two fellows, even if it is filled. Lucky for you, I've been known to fast track applications straight to the upper echelons of management."
"Isn't that cheating?"
"That's making sure you and this hospital both know what you're worth."
Samira lifted a hand to the one on her shoulder, grasping it in hers before lowering it down. She didn't let go, though, their two hands swinging gently between them. She didn't want to ever let go. "Thank you, Dr. Abbot. For seeing me."
Samira didn't want to burn out. She didn't want to crumble the way she did today. She didn't want to lose her breath or her will to practice medicine. She didn't want to be made to feel alone and translucent, passed through by everyone around her.
Jack made her feel like flesh and bone and heart. Made her feel like she belonged, even in the darkness.