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It's the single mother and her eight-year old that do him in.
It would be easy to call the pair the straw that broke the camel's back. To blame his response on being twenty hours into a twenty-four hour shift.
If Carter is being honest with himself, their deaths would have hit just as hard if they’d been his first patients of the day. At least they passed relatively closely together.
Carter gets through the logistics of the proceedings without complications – certifying the deaths, notifying the extended family, filling out the paperwork. The pain is in the rote nature of it all. It's not the first time he’s handled a case like this and it won't be the last. He's known that since his first med school rotation, accepted it as part and parcel of specializing in emergency medicine. It's only every once in a while that the wave of grief comes in over his head.
Tonight is one of those nights.
He slips out to the ambulance bay with a sandwich he doesn't feel much like eating, brushing off Jerry's attempts to update him on the war between the ortho resident being floated from upstairs and the entirety of the nursing staff.
It's cold enough outside that he can see his breath, a puff of white with each exhale as water droplets from his lungs condense in the air. A reminder that despite everything, he still breathes; he's had reason of late not to take that for granted.
“Evening, Carter.”
Carter glances up to see Dr. Greene standing under the neon lights of the EMERGENCY sign above the entrance doors, hands shoved casually into the pockets of his open winter coat.
“Hey, Mark.”
“Cold out here.”
“Gotta love Chicago.”
Mark laughs. “You know it's one of the things I like most about the city? Actual seasons.”
“...I'll save the next frostbite case for you, then.”
“It's a reminder that nothing lasts forever. The good or the bad.”
Direct hit. Carter focuses his gaze somewhere in the vicinity of Doc Magoos and does not think about the kid holding on to his mother's hand like a lifeline. It's okay, Mom; I'm here.
Mark closes the distance between them in slow, ambling steps.
“I heard you had a rough night,” he ventures casually.
“You could call it that.”
“You been out here awhile?”
Mark's standing close enough that Carter can just about feel the body heat coming off of him. It stands in stark contrast to Carter’s own icy skin, the thin fabric of the scrub top providing very little in the way of an insulating layer.
“I don't know, maybe.” Carter rubs a weary hand over his face. “Board's pretty quiet tonight. I'm waiting on some labs.”
“You want some company?”
“I'm fine, Mark. You don't need to babysit me.”
“That's not what I was doing.”
Carter disagrees, but doesn't pick the battle; Mark's not only his boss but also his friend. It's not his fault that Carter’s feeling particularly uncharitable this evening.
“When are you off?”
“Not for another three hours.”
“You eaten anything?”
Carter waves the half-eaten sandwich in Mark's general direction. “Couple bites of a BLT. I'm really okay, Mark, I'm just…tired.”
“Go take a nap, I'll cover you.”
“It's not that kind of tired.”
Mark nods as if he'd been expecting that. Shifts so that he's standing beside rather than facing Carter, both their backs to the wall. Safe, protected. They have a perpetual awareness of that in common, now. The trauma from their respective attacks might have healed, but it's left scars; for them, it's a first-hand understanding that they are equally as capable of ending up on the gurney as the patients they're treating. “Yeah, I figured as much. But I had to ask.”
Carter laughs, sharp and derisive in a tone that he doesn't think he possessed let alone would have used five years ago. Mark's eyes stay on him, focused and intent like Carter is a code he's running. After a minute, Mark asks, “You want to talk about it?”
“Not really.”
“Okay.”
Mark tosses a basketball to him that Carter catches without thinking, dribbling it once or twice to get a feel for how it bounces in the just-above-freezing temperatures against the salted-six-ways-to-Sunday pavement of the ambulance bay.
He wonders what a bad day at work would look like if he'd taken over the family business like he'd been expected to. If his ability to handle stress is a skill he's been training this whole time or an inherent trait he always had. It used to be that he couldn't remember a time when he hadn’t wanted to be a doctor. He can't say that anymore. It was an hour ago.
Carter misses the basket and lets Mark catch the rebound off the backboard, setting up for a screen instead.
“Your first few years on the job,” Mark starts, pausing only to jump for a shot. Carter catches the ball coming out of the net and passes it back to him, resetting. “...you see more tragedy than you ever thought possible. You power through by focusing on the learning opportunities – ordering the right tests, performing the right procedures, arriving at the right diagnosis.”
“Yep.” Carter spots an opening and slips in to steal, changing places with Mark when he's successful in his efforts.
“Your next few years, you see just as much tragedy but the assumption is that you've learned to cope with it better. Or gone numb.”
“I think that's just called burnout.”
“Nowadays, sure.”
“What did your cohort call it, then?”
“Nothing. We pretended like it didn't exist – culture of ‘man up.’”
Carter sinks the shot and holds on to the ball when it drops neatly into his waiting hands. “I'm sure Dr. Lewis must have loved that.”
Mark smiles – a real one this time, fond and amused. “Oh, yeah. Lydia's got some stories.”
“I bet.” Carter fakes Mark out when he makes a move, spinning around Mark's back. The regret is nearly instant, the move pulling at muscles that are still knitting themselves together after being sliced open and repaired.
“The worst thing about emergency medicine is that you never get used to it. The best thing is the same.”
“You know I gave that speech recently? The night that–.” Carter cuts himself off as the rest of the memory hits him. The night that Lucy died. That Carter ended up the recipient rather than the practitioner of said emergency medicine.
He doesn't talk about that night.
“See one, do one, teach one,” Mark says.
Lucy never got the chance to teach one. Hopefully Abby will.
Carter's shot goes wide, and Mark dives to catch the rebound as it bounces off the corner of the backboard. Mark slows the pace down shortly after, keeping his distance as he dribbles back and forth in a wide arc.
“Has it ever happened to you?” Carter asks.
Mark catches the ball on its next bounce, holding it still. “What, burnout?”
“Whatever you want to call it. This – this feeling.”
“For me, it's not a presence or absence kind of thing. It's a level that fluctuates over time, sometimes minute-to-minute.” Five minutes after Carter wrapped up in trauma one, he'd been showing Abby a new technique for reducing a dislocated shoulder and trying desperately not to think of Lucy doing the same for him in an abandoned building. Five minutes after that, he'd narrowly avoided being roped into Chuny's revenge against Dr. Bonehead, as they've taken to calling their ortho floater. They not only treat whiplash in the ER, they inflict it.
“What about you?” Mark asks softly.
“I don't – I haven't–.”
Carter's lungs are working hard now – the combined efforts of the exertion and the pain making it hard to catch his breath. That's what he tells himself, at least.
“I have to go.”
Mark's call of Carter! isn't actually that loud, but still manages to echo in his ears as he heads back into the building. He finds the labs he'd been waiting for ready for him at the desk and is halfway down the hall with both them and the corresponding patient charts before Mark returns.
An incoming multi-victim trauma threatens the relative quiet of the board but removes the possibility of non-work-related conversations in any of their immediate futures. Carter picks up the victims in need of sutures like he's a med student again, feeling the weight of Mark's eyes on his back as he exits the trauma bay without jockeying to get in on the action. Lets Jing-Mei handle the fasciotomy with Benton shouting instructions from the adjacent room, hands deep in another patient’s chest.
Peter pokes his head in the door of the suture room twenty minutes later. “What was that?”
“What was what?”
“You know how to do a forearm fasciotomy. Dr. Chen didn't.”
“Got to learn sometime.”
“Carter.”
“You talked her through it. You did the same thing for me the first time, too.”
“The first two, if I remember correctly.” Carter does. Peter isn't a particularly patient teacher but then again, neither emergency medicine nor surgery are fields which allow them much room for such a thing. He is a better teacher than he gives himself credit for, though – high standards, but applied equally to all. Peter's as hard on himself as he is any of his students, and Carter's always respected that.
A quiet click of the door informs him that Peter has left without a word, and Carter busies himself with tying off the last suture on his unconscious patient and cleaning up. He's unsurprised when Peter returns not two minutes later, a can of Sprite and a bag of Skittles in hand, dropping both on the counter beside Carter in a wordless instruction.
“Not coffee?” Carter asks.
“You never drink coffee in the last two hours of your shift.” Carter is oddly touched by the fact that Peter knows this. It's true, of course – the caffeine poses too much of a problem for falling asleep after work – but there's still a warmth in the knowledge that Peter remembers his rhythms as much as Carter remembers Peter's.
“You do this for Reese when he's in a mood too? Sugar rush?”
“Reese doesn't eat sugar.”
Carter laughs. “That's what you think.”
“No, he doesn't – Carla and I are on the same page about this.”
Carter tips a handful of Skittles into his mouth and follows them down with a mouthful of Sprite, the acidity tickling the back of his throat. “The nurses keep a stash of candy in one of the drawers at admit for winning the hearts and minds of Chicago's youth as needed. They sneak him squares of chocolate whenever you bring him in.”
“What?”
“His favorite is cookies and cream.”
“Oh, my God.”
“Do you know the sign for chocolate?”
Peter's silence is his answer. His gaze could bore a hole clean through Carter's head and out the other side when Carter cups his left hand into a small C and moves it in a circle on the back of his right, grinning all the while.
“...you're a bad influence already,” Peter mutters, but John is watching for it and spots the reluctant uptick at the corner of his mouth that indicates he's secretly amused.
They make their way back out to the hub, Carter showing him the signs for sugar and soda as they walk. Peter's pager goes off just as they're passing the elevators. He squeezes Carter's shoulder just briefly before taking off at a run up the stairwell, diving back into the fray.
“Dr. Carter, you have a minute?”
Carter glances over his shoulder to see Kerry working her way towards him determinedly and slows down to let her catch up. “I'm picking up another patient just as soon as I discharge this rule-out MI.”
“Good. But that's not what I wanted to talk to you about.”
She tilts her head in the direction of exam three and he follows her into the room reluctantly. “I wanted to commend you on how you handled the Castillo case this afternoon. I know it wasn't easy.”
In the ER, they use precise terms for the anatomy but never for the emotion. ‘Wasn't easy’ instead of ‘depressing on a level that you'll still be thinking about at 2 AM weeks later.’
Carter isn't technically supposed to have favorite patients, but he does a lot of things he's not technically supposed to. The rules are fluid down here, they have to be when lives are on the line. Families who visibly and deeply care for one another are always going to count among his favorites. That familial bond is something he doesn't take for granted – it doesn't come for free as a byproduct of a blood relationship, it's something that's earned by showing up and giving a shit.
“Mmhmm,” Carter acknowledges, unable to put any of this into words and unsure if it would be a good idea to anyways.
“There are resources available if you want to talk–.”
He cuts her off. “I know. Thank you, Dr. Weaver.”
“There's no shame in caring about your patients.” He grits his jaw and nods in lieu of saying anything. “You know, a lot of residents–.”
He doesn't really pay attention to the rest of what she's saying, mind already elsewhere half out of self-defense. He got to see the softer side of Kerry when they lived together, knows that whatever the face she keeps up at work, it's always there just under the surface. He wonders how she does it. Even now, years into his residency, the wall between the personal and the professional still has gaping holes that the right case can just slip right through.
“John.” A touch to his arm draws him back into his head and he looks up into concerned eyes.
“Sorry,” he says. “Long night.”
“Why don't you take a break? We're not that busy.”
“No, I'm good. Just took one.”
The door opens to reveal Malucci, clearly on the hunt for an attending to consult. Carter leaves the two of them to it. He's not proud of the small smile that crosses his face as Kerry exclaims, “You did what ?” in a tone of barely-contained frustration, but smile he does all the same.
They're a team down here. They spend more time with each other than they do anyone else in their lives. Carter knows more about Haleh’s teenager's college application status than he does what grade any of his younger cousins are even in. Malucci hasn't exactly expressed an interest in being a team player.
A whispered, “Carter, c’mere a second,” leads him to Chuny hiding behind a set of supply shelves in the back hallway.
“Need help with something?”
“No.”
He peers around the corner to see Dr. Bonehead exit the men's washroom and knock a precariously placed bucket of yellow liquid off the top of a nearby shelf and onto his head. “Just didn't want you to get splashed.”
“Please tell me that wasn't urine.”
“Banana bag. But he doesn't know that.”
The laugh that garners from him is genuine. The guy brought it on himself when he tried to throw Carol under the bus for one of his own mistakes.
He sidesteps neatly around the puddle of dripping, grumbling resident on a path back to the main desk, glancing up at the board to double check what’s come in while his mind and his heart have been elsewhere.
Carol looks up from the computer, a slight smile crossing her features when she spots him. “Hey Carter, there you are.”
“Here I am.”
“Someone was looking for you earlier.”
A small figure emerges from behind the desk, barreling into him at full speed. Tiny hands wrap around his legs and squeeze tight. “Dr. John!”
His back complains when he bends over to pick the kid up and settle him on his hip, but Carter doesn't know what the point of all the physio was if not being able to comfort a child in need. “Little John!”
“I'm not little.”
“I'm sorry, I forgot. Big John! Where's your Dad?”
He glances over at Carol, who points in the direction of exam room two where Carter can see Malucci and Kerry talking to a guy Carter recognizes from earlier this afternoon.
When he looks back Carol mouths ‘wound reopened’ at him. “Ah.”
“Dr. Dave glued his gloves into Dad.”
Carter's lips twitch. “Did he now?”
He puts the kid down and watches as he runs off. “Did you ask him to share that little tidbit?” he asks Carol.
“I can neither confirm nor deny.”
“Thanks,” he says.
“No problem.” She heads off with Jing-Mei in the direction of Trauma Two, leaving just Carter and Mark alone at the desk.
“Sorry about earlier,” Carter says, rubbing a sheepish hand along the back of his neck. “Just one of those nights.”
“That's okay,” Mark says. “Family makes allowances.”
“I wouldn't know, I'm not close with my family.”
“That's not what it looks like to me.”
“How's that?”
“Your family's right here, Carter.”
“...you think so?”
Carter thinks about each of the colleagues that have taken time out of their day to pull him aside and check in. The confidence he has that if he were to approach any of them right now and say, “Hey, I'm having a hard time”, they would drop everything to help.
It doesn't take away from the fact today was difficult. For all he knows, tomorrow might be even worse; the universe can be cruel like that. But it still counts for something. It has to, doesn't it? Otherwise, what has it all been for? He's not just twenty years worth of education poured into a lab coat; he has a heart, a brain, and a soul.
A family, too. It looks a little different than the one he pictured when he was a kid, but it's just as good.
“Could’ve fooled me,” Mark says.
Yeah, Carter thinks. Just as good.