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Mark has never much believed in the phrase, “It’s so hot you could fry an egg on the sidewalk.” However, June in Chicago this year may finally prove the adage right. He’s willing to bet Jerry would test the theory if he leant into the childlike curiosity. A steady stream of sweat drips down his forehead, despite the surgical hat and headband he’s been wearing non-stop since the heatwave began.
“Randi,” He starts, heading to the board to update some patients that are being seen. “Can you adjust the…” His next words are swallowed by a sudden hiss, pop, and gurgle. As Mark gestures towards the vent, it gives one final heave of cool air. Then, there’s silence.
Randi blots at her face with a handful of tissues. She raises one eyebrow and dryly responds to his aborted suggestion. “I don’t think I can do anything to the AC, Dr. Greene.”
He heaves out a sigh, closes his eyes, hoping that when he opens them he’s magically transported out from the ER and onto a beach in Maui, but when he opens them it’s the bland shades of white, green, and pink he’s used to seeing everyday. He hopes his voice is only tinged with disappointment, rather than dripping with it, when he gives his next order: “Call maintenance.”
She holds up the receiver with one hand, while dialing with the other. Her painted nails, dark against the pale plastic of the phone, clack as she dials. “I’m already on it.”
—
Carol hears the dying cry of the ER’s AC and lets out her own resigned sigh in a response. She takes one moment to let her head dip back, eyes closed, and say a silent prayer for the AC to kick back in. The AC stays silent, mocking her.
A thin voice pulls her from her stupor. “Well…”
Carol opens her eyes to see another nurse dressed in pink scrubs next to her. She’s short and thin, relatively pretty for an older woman. Carol’s eyes rest for a moment on her gnarled fingers, twisting her necklace of the cross. “Sorry Debbie - just taking it all in.”
The look Debbie gives her is soft but tinged with impatience. “No worries hun.” The words are meant as a reassurance to Carol but they fall flat. “I don’t think a full tour of the ER will be necessary. Remember,” He smile turns saccharine as she repeats the mantra she’s been quoting to Carol since they first met this morning, “I’ve been working here in the hospital for twenty years, just a few floors up in OB.”
Carol only just bites her tongue. “Well the ER can be a different beast.” She swipes one hand across her forehead as she says it. Her eyes flit towards the busted airconditioning. “Especially in these kinds of conditions.”
—
Mark turns his attention to chairs. He scans the three rows; not shocked at the conditions he sees or the fact that they’re overstuffed with patients and their family members. The summer heat brings about illness and injury. There’s a collection of minor injuries - head lacs, an array of sunburns in various peeling stages and possible sun poisonings, and one kid resting on a pair of crutches with a foul look on his face. He’s about to call for the kid on crutches, one glance at the chart in his hand providing the name “Sam Richardson” when the doors to the ER burst open.
Instead of the EMTs he’s expecting, it’s a petite woman; a baby in her arms. “Help me!” She screams. Her face is red, both from the blazing sun and her heightened state of panic, a possible state of mania. “I need help!” She repeats, crazed eyes scanning the room.
She must be looking for someone wearing a doctor's coat and looking authoritative because her eyes lock on Mark. He assumes he fits that description more than the amalgamation of desk staff, nurses and harried medical students zipping through the corridors.
In one smooth motion, he puts down the chart for Mr. Richardson, saying a silent apology, wipes a fresh wave of sweat from his brow, and starts towards the woman in what he hopes is a calming manner. “Ma’am, please, we can help you–” She cuts him off, barreling towards him.
“My baby, my baby! He’s not well.”
Suddenly, Mark’s arms are chock-full of a baby boy. She’s not wrong; he’s splotchily flushed and warm to the touch. His little chest, visible through the thin linen shirt he’s wearing, goes up and down frantically. His breathing is rushed, like he’s sucking oxygen through a straw. “Ma’am,” and Mark can hear that his own voice is tight in regard to the severity of the situation. He has a brief flash of Rachel as a baby, Jenny crooning to her after a long day at the public pool. “How long has your son been like this?” The baby has stopped sweating, glands overworked and underprepared to cool down his little body.
The woman, now that her arms have been freed from their burden, breaks down, like the baby was acting as a tether to reality. She falls to the floor of the ER, landing on her knees, sobbing with head in her hands. Her fingers thread through her blonde hair, thick strands within her grasp, and she pulls; sobs wracking her body. A few more pleading words make it to coherency, the rest of them stammered or swallowed by her wailing.
Carol swoops in, her face flushed and wild curls barely contained by a headband. “I’m ready to give five of haldol, Mark.” Mark, internally singing her praises, is so caught up doing his work up on the baby, that he nearly forgets to give the verbal confirmation. Carol’s sharp, “Mark!” is the only reason he remembers to officially permit Carol to administer the medication to the mother.
—
It takes another twenty minutes, but eventually mother and baby are settled into a secluded trauma room; where two plug-in standing fans have been dragged from the depths of the basement. Mark watches as the nurses do their jobs efficiently; with it all leading to the baby being cross crossed by wires and tubes. He’s intubated, little chest moving up and down mechanically, with an IV embedded in the dorsum of his foot, held down with a little bandaid someone must have absconded from the pediatric unit; it has little blue teddy bears dotting it. Another one of the same bandage is notched in the crook of his elbow, where Mark knows the nurses took blood - running a gambit of tests that will assess his electrolytes, kidney and liver function, as well as his blood sugar. Cooling packs are nestled into the appropriate places, carefully swaddled to not cause freezer burn on his sensitive skin.
“Ms. Valeri,” Mark starts, crouching down so he’s eye-level with the boy’s mother. Her eyes are slightly dull, shiny only from the tears and dimmed by the haldol. His voice is like a trigger. Immediately, she goes from softly stroking her child to clasping Mark’s hands, her grip tight.
“I’m so thankful,” There’s a hitch in her breath, like she might start crying again, but she holds the tears at bay. “Thank you for saving my boy. My little Tommy.”
Mark re-routes his speech, beginning with the obligatory ‘no thanks necessary, just doing my job’ spiel that every doctor has said over and over since the day they slipped a white coat over their shoulders for the first time. “Ms. Valeri, your son is going to have to be moved to the PICU, our pediatric intensive care unit, for one or two days.” He swallows, his mouth tasting sour. “I do need to ask, because of how severe his condition was when you first arrived…” He trails off, swallows again despite being parched - this is always his least favorite part of being a doctor, the mandated reporting responsibilities and basic investigation that comes along with it. “I need to ask where your son was and how this condition developed.”
While Ms. Valeri doesn’t break down into heaving sobs again, tears do fall from her eyes and trail down her cheeks, clearing make-up as they fall. As she pulls her hands away to cover her face - suddenly embarrassed and awkward despite Mark having seen her collapse in the ER earlier - Mark grabs some tissues and holds them out to her.
She takes them with thanks, and begins to blot at her face and blow her nose. “My husband and I… we just, we lost track of time.” She sniffs, trying to will the tears to stop, but they continue to roll. “Y’know, the sun's good for babies. The outside…” Ms. Valeri raises one arm, gestures to the windows like Mark’s never heard of leaving the four walls of the hospital. “The fresh air, it’s supposed to do them good.”
He makes a few affirming noises, despite wheels turning in his head that scream negligence, forgotten child, lost track of time. He’s about to thank her for her honesty, tell her he’ll be back to speak with her before her son is transferred, when she speaks again. “And, y’know… he wasn’t crying. Not for long. He was peaceful. For once. Not crying, not screaming, not…” The tears begin to fall in earnest, and Mark remembers sleepless nights with Rachel and Jenny and wishing he had hair to rip out from his head in frustration. “He was finally quiet.”
—
Mark leaves Ms. Valeri with permission to sit by Tommy’s bedside and how-to instructions so she can use the wall phone to call her husband and update him on their son's condition. Before he leaves the room entirely, he pages Jeanie to meet him by the admit desk - the social worker will definitely need to be involved - her calm demeanor will hopefully act as a salve; cooling down tense and defensive emotions.
Once he leaves the treatment room, he’s expecting to see chaos spread amongst the ER; a horde of sunburnt men and women, feverish small children with scrapes or a summer cold, or a pair of elderly lovers suffering from long-earned pain or complaining of chest pains. Instead, it’s blissfully quiet. The noise, instead of complaining patients and moans of pain, are ones that play on repeat in the ER: squeaking wheels of rolling gurneys, nurses chatting while they scuttle from room to room, student doctors, medical students, or young residents flipping pages in charts or textbooks, the beeping of machines, or the hiss of oxygen.
It’s not a beach in Maui, but it’s pretty damn close at the moment. Mark will take it.
“We cleared the board?” Mark asks, incredulous, eyes darting to Randi with disbelief. “And we found more of those fans from the basement?” He looks around to see four or five of the standing fans dotting around the ER, each spitting out cool air with varying degrees of success, the little paper flags attached to them flapping.
The front desk clerk doesn’t look up from her magazine, simply turns the page and responds with a simple: “Yes.”
Mark, wiping sweat from his brow, is about to pay her a compliment when the stillness of ER dissipates. The double doors fling open and unleash chaos. A man - Mark’s height, maybe a few inches taller, and double in width - storms in, face beet red. His shirt is drenched with sweat, a thick V snaking down towards his navel. Mark doesn’t have a chance to calm him, though he doubts the typical platitudes would be enough to quell this man's anger - he looks like a bull, ready to chase and charge the clowns at the rodeo.
His words aren’t a roar, but instead a growl that carries barely concealed violence. “I want my wife and my boy and the paperwork to get out of here.” It’s punctuated by an echoing open-palm slap on the admission desk. Mark even thinks he sees Randi flinch.
He takes it as a call to action. “Sir, sir, are you Mr. Valeri?”
“Yes. And my family and I would like to leave.” It’s terse, but it’s a non-violent response. He sounds like he chews rocks.
“Mr. Valeri, I’m Dr. Greene. I treated your son, Tommy. He’s going to be okay, and you will be able to take him home, he has to spend some time in the PICU though.”
Mark barely gets the words out before Mr. Valeri interrupts. “We can watch him at home.” It’s insistent and his body is restless. His hands twitch at his sides, hung limply, now that he’s finished his display of masculinity by assaulting the admittance desk. His next words nearly come out as one: “I know how to take care of my boy.”
Mark nods as he speaks, trying to reassure and keep the situation calm. “Nobody is saying that you don’t sir. However, your son came in in a condition that was very worrying. He was very sick.” Mark swallows, heat suddenly catching in his throat; the little fans dragged from the depths of the hospital basement seemingly doing nothing. “He needs to stay in the PICU.”
“We’re taking our boy home, now, and there’s nothing you can do to stop us.”
It’s clear to Mark that this isn’t working; his calming tones and soothing phrases - pulled directly from the professional development seminar given weeks ago that somehow proudly used the slogan “Stay Steady, Keep Patients Peppy!” Even during the presentation, Mark had wondered how the harried woman had managed to say it with a straight face. “Sir, you need to keep calm. Otherwise, we’ll have to call security to escort you out.” The follow-up part of his sentence is swallowed by a roar of anger from Mr. Valeri - Mark never gets to say the words: “Then, you won’t see your son.”
The scream of irritation calls Randi to action. She shouts for security, follows it up by muttering a few choice words of displeasure under her breath.
Mr. Valeri, the words seemingly stuck in his craw, hisses out “security” with disdain. His eyes dart around the room in a panic, and Mark stares - suddenly aware of their dilation - and another piece of the puzzle clicks in. Much of what he’d attributed to the heatwave and anger over his family's sudden circumstances is consistent with amphetamine drug use.
Mark is pulled from his thoughts by a soft “Dr. Greene.”
Deb walks into the admit area, nose buried in a stack of papers. Normally, Mark would hazard a guess that it’s a mix of xeroxed textbook pages and printed studies. Today, circumstances lead to no estimations, only the knowledge that Deb has been buried in a stack of academia in the lounge for hours and hasn’t noticed the howling from the ER is different than the usual standard. “Dr. Greene, I’m curious about this new procedure that was used last year in California… I’m hoping it can be used…”
“Dr. Chen!” Mark yells for her, his voice sharp.
She looks up just in time, her question fading from her lips, Mark’s voice likely lost to her, for Mr. Valeri’s arm to snake around her, scattering her papers across the linoleum, and tugging her close to his chest. She’s dwarfed by him, looking small and fragile. Her hair, messily pulled back due to the heat, bobs at his throat.
“I’ll kill her!” The irate husband spews spittle as he talks. Chen flinches, struggles in his arms to get away, and it only makes him grasp tighter. “I’ll kill her!” He repeats his threat, keeping her secured with one arm and digging in his pockets with the other.
He shuffles in the small area, like a tiger in a cage, dragging Deb along with him in the place of prey. Mark locks eyes with Randi - his face impassive but his brain screaming out the message: Where the hell is security?
Randi, like she’s telepathic, can only bite at her bottom lip and give a small shrug of exasperated uncertainty. Mark watches as she tugs the phone by its cord, slowly, towards her. One of her hands drifts into the universal signal for a phone: pinky and thumb stretched out with all other fingers tucked in towards her palm. He takes it to mean that she’s going to try and call 9-1-1. Mark makes a mental note to upgrade his unspoken compliments from earlier to include a box of chocolates or an additional PTO day.
All of Mr. Valeris’ fumbling in his pockets produces a gun - it’s small, black, and it causes Marks’ heart to beat quicker. Chen lets out an undignified squeak at its appearance. “Now, everybody listen to me.” He cocks the gun, keeping the muzzle directed at the floor, but tugs Chen’s head up at an awkward angle. “Or the girl gets it.”
“Nobody wants that. Mr. Valeri,” Mark is falling back to the lame words from the seminar, hoping they keep the situation calm long enough for Security to appear or the cops to be called. “Please, put the gun down. We just want everyone to be safe.”
The next words leave his mouth like they're on a tear. “My son is safe with me! An’ none of you are takin’ him from me.” He tightens his grip on Deb, who has her eyes clenched shut like it could prevent this scenario from being real. “I’m taking my boy home. And my wife. And none of you are stoppin’ me.” He uses the gun to gesture at a nurse, on loan from another department, nameless in Mark’s mind, hugging the wall in terror. “You - go get them.”
Her eyes darted towards Mark. He nods, neck stiff. Go. Play along.
Her non-slip shoes squeak as she skitters far from the admin desk.
—
Debbie May Whisk has worked in County General Hospital for twenty years. In that time, she’s delivered countless children, coached numerous mothers through childbirth, and comforted fathers in dire need of reassurance. If she were to be asked to describe herself at work, she’d say - very much in a tone that declares her humble - that she’s capable and confident in situations of high stress.
Debbie May has never had a gun pointed at her.
She hugs the wall of the ER, silent tears streaming down her face. The bullish man, Mr. Volturi-Valerio-Valeri, waves the gun in her direction. Debbie’s eyes drift towards Dr. Greene, wide and unsure. She watches as he nods, minutely, and she scuttles off away from the violence unfolding in the ER.
—
The OBGYN ward at County has never looked more inviting. Debbie rushes into the admit area, letting the double doors clatter behind her, and grabs for the phone like a woman on fire reaching for water. Her fingers shake as she dials 9-1-1.
Her typical co-workers, doctors and nurses alike, crowd around her. They’re hands are on her, trying to soothe her, and whisper words meant to comfort her.
Their attempts to pacify her - really just commotion in the midst of her horror - stops when, in response to the operator's calm and encouraging tone, she manages to sob into the receiver: “There’s a man with a gun in County’s ER. He’s holding a doctor hostage.” The last words are a wail.
The receiver drops from her fingers the second the words spill from her mouth. Instead, she uses both hands to clutch at the cross hanging from her necklace. Her eyes close, her lips purse, and she gives a silent prayer.
—
Later, Mark will see this moment as a minute distraction. The nameless nurse - Darla, Denise, something with a D - draws the attention of Mr. Valeri enough that he loses his control, the gun hangs loose in his grip.
All hell breaks loose in the ER. A series of things happen in quick succession, so rapidly that Mark will need to write them down and number them later when he recounts the story to the police.
First, a slim figure tackles Mr. Valeri. In the same moment, Deb slides from his grasp, one of her feet coming down hard as she stomps on his well-worn sneakers, angling to pay back a bit of the hurt she’s felt from this ordeal.
A loud pop echoes throughout the ER, reverberating in the silence. The gun skitters across the floor, patients and nurses alike sliding away from it like it’s radioactive. It lands nearby the vending machines nested amongst dust the janitor has long forgotten.
Before Mr. Valeri can do anything but scream in anger - or pain - a trio clamors through the entry way. Two of them, the police officers, are holding their guns and scanning the room for any more danger. They shout “Chicago PD! Drop your weapons.” The third of them, looking much more harried, is Alden - an aged security guard that Mark could’ve sworn had put in his papers years ago. He’s clutching at his weapons belt with both hands, slightly wheezy when he announces “Hospital Security.”
As the police officers do their job - Mirandaizing Mr. Valeri, cuffing him, securing the scene - Mark’s eyes darted back to the tackler, laying still on the ground. A hollow feeling blooms in his gut. He’d assumed it was the security guard - but now, looking at the remnants of their encounter and disarray amongst the chairs, he notices the flaws in his assumption.
The most glaring? The person who tackled Mr. Valeri had been wearing a white coat.
Mark only knows one doctor in the ER that’s stupid, reckless, dumb, heroic, good-hearted to do that. “Dr. Carter!” He yells, suddenly springing into action, racing towards the prone body on the floor. His yowl alerts the nurses, mid-examination of Deb who's struggling to shrug off their fervid care, and they divide to conquer.
—
The chaos of the ER is normally comforting. John loves the liveliness of his workplace, even though he certainly experiences the drawbacks (sleepless nights, bad food, sour patients, etc.). John doesn’t find the chaos of today - the oppressive heat, the howling of a madman, and one of his best friends being held at gunpoint - particularly charming.
“Deb.” Her name is nearly silent as it falls from his lips. Mr. Valeris’ hissed directions to a nurse on loan - “You go get ‘em!” - swallows her name.
John doesn’t watch an unnamed and unseen nurse skitter off, only hopes it’s someone smart who will ignore Mr. Valeris’ directions and instead phone the police. John’s eyes stay locked on Deb, locked on the gun, and locked on the source of the unsettling clamor. He sees thick fingers loosen on the gun. His tongue darts out to wet his lips.
John lunges.
—
Mark is getting too damn used to seeing John Carter, medical student, resting on gurneys in his ER. They roll him into Trauma 1 and immediately the air is thick and stifling. No little fans in here…
Mark begins to feel sweat bead on his skin and talks with his stethoscope still hooked in his ears. “GSW to the chest - located in the upper abdomen. BP 70, HR 150… his sats are in the 80s.” The words seem to fall flat in the room as he speaks, like they can’t permeate the heat and humidity. The nurses and other doctors are bustling around the gurney. “His breath sounds are on the right only - diminished on the left. He needs fluids.” As he says the words, Haleh snaps into action.
Her voice is nothing but smooth when she says: “Two liters,” and gently slides an IV into his prone arm.
The monitors, only just hooked to Carter by Lydia’s delicate fingers, begin to wail. “His pressures’ tanking,” Lydia warns, wiping one frail arm across her forehead. “He’s losing his airway.” She begins gathering the equipment for an intubation. “He needs to be intubated - Mark.”
Mark takes the offered tubing and prays that nobody in the room notices his hand shaking ever-so slightly. It’s the adrenaline, the little doctor in his brain supplies. It’s Carter, another voice argues. He’s notching the scope, when the monitors let out another screech. “Sats still falling; he’s at 75!” Lydia calls, breaking the warring mini-Marks in his brain, urgency lining her tone.
“It’s a tension pneumo,” Mark provides, uselessly, like the others don’t have medical training. He drops the intubation kit and instead begins to do a needle decompression. When he pulls it, the hiss is loud in the trauma room, like a geyser breaking the silence.
The hiss of air brings about palpable relief for all. Carter's numbers begin to tick up on the monitor. Mark finishes the intubation he’d only just managed to start. After those tools leave his hands, Haleh’s replacing them with the portable ultrasound.
When Mark blinks at her, she simply raises her eyebrows in response.
“It was my next step.” Mark offers, trying to sound authoritative.
“Get stepping.” Haleh counters.
The small screen is dark. Blackness appears, all the organs a dim grey in comparison to the blood. “He’s bleeding internally,” Mark announces to the room. “Someone call surgery; someone alert Benton.” He peels off his latex gloves - sticky with sweat - and drops them to the floor.
His order is useless: Lydia is already on the phone, notifying surgery of their newest expeditious patient. Haleh is already prepping the gurney for transportation, hauling up the drug box and making sure all the various wires and tubes hooked into their injured doctor are accounted for.
—
John wakes to monitors beeping, a thumping pain in his sternum, and a whining groan echoing in the room. It takes him a moment to recognize that the noise is coming from his mouth. “Ergh…” It’s muffled by the high-flow oxygen mask that’s strapped to his face.
He’s about to return to the warmth of drug-induced sleep when someone speaks. “You’re awake.” He forces his eyes back open and squints, trying to gain clarity through the haze. It’s Deb, looking mussed and flustered and red faced. John doesn’t think he’s ever seen her so imperfect. He tries to respond in the affirmative, tries to ask her how she’s feeling, but his throat gives nothing but a low moan.
Deb must take his noise as a signal to continue because she does. “You’re an idiot.” Her words are clunky with unshed tears. “You got shot.” She lets out a shaky breath and John watches as more tears spill down her face. He tries to lift a hand, a silent offer to wipe them from her cheeks, but the limb is shaky and weak. She doesn’t notice. “And I’m not going to say it’s my fault John.” Her eyes are harsh. “‘Cause you made a reckless and stupid decision.”
John, lips and throat dry and brain muddled, can only muster a “hnhh” in self-defense.
Deb reaches towards him, and for a brief moment his hazy brain thinks she’s going to slap him. He slams shut his eyes, preparing himself for a sudden increase of pain, but instead her fingers are soft on his cheeks. She’s petting him, letting her finger’s caress him in a way that would make him flush and stammer and rub at the back of his neck if he was coherent enough. She sits like this for a moment or two, both of them silent. The machines beep and there’s hisses of air from his oxygen mask. Her words are soft when she finally does talk again. “Thank you.”
One of her hands drifts from his face and down towards the pain management pump that rests in the bed. She presses the plunger and John feels a flood of warmth enter his system. He sinks deep into it.
—
Mark finishes out the shift from hell by signing off on his statement to the police, shooing Deb out of Carter’s room; instructing her to head home and not return until she feels well-rested and safe, and calling Jen and Rachel from the phone in Carter’s hospital room. He whispers into the phone, eyes locked on the youngest of the ER doctors, and doesn’t share an iota of the panic or pain he witnessed in the ER with his family. Instead, he praises Jen for her legal drafts and agrees with her when she complains that one of her co-workers is an incompetent schlub. He congratulates Rachel on her spelling and promises that when he gets home they can color together.
Long after he’s hung up, and long after he’s due to leave the hospital, Mark sits and stares at John Carter. He watches his chest move up-and-down. He counts his breaths. He adjusts tubes and wires that don’t need to be adjusted. He straightens blankets and wipes out imaginary wrinkles.
Through it all, Carter doesn’t so much as twitch.
“You’re brave.” Mark says to the sleeping doctor. He gives this as praise, thankful it won’t fully register with Carter and won’t be an endorsement of his behavior.
“You’re an idiot.” Mark reminds him. It’s a falsehood because he’s watched Carter master techniques and answer difficult questions. It’s the truth because Carter never seems to recognize the value he has to others.
“You’re never going to do anything that reckless ever again.” Mark insists, words steady and impossibly fond, like it’s not a lie.
—
Mark does eventually leave the hospital. He has things he needs to do - basic self-care, human necessities - and promises to follow through on with his daughter. He’s nearly silent as he leaves the ER, only waving goodbye to the few overnight shift workers loitering in the admit area. He’s near the double doors when the impossible happens.
There’s a low hum, a few groaning and wheezing noises, and the air conditioning unit that had released its death knell this morning kicks back on.
He bites back a hysterical laugh and hurries through the double doors, hands already digging in his pockets for his car keys.