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The Emergency Department, affectionately known as The Pitt by all those who work there, was a fragile balance of fast and slow, calm and chaos, loud and quiet. Right then, however, the balance was tipped rather dramatically into the loud, fast, and chaotic category.
A team of nurses were assembling outside one of the boarders’ rooms. This patient was a man suffering through drug induced psychosis and paranoia and while had initially been somewhat calm, the situation had rapidly changed. Dana eyed her team, needing one more person to do the injection. Last time, it had been poor Whittaker with the Kraken and it had resulted in the med student being peed on. Who was on Dana’s shitlist today?
Just in time, Dr. Langdon passed unsuspectingly past the gaggle of nurses. Dana quickly caught his attention and just crooked a finger, beckoning him towards her. His shoulders slumped and Dana smirked as he obeyed her. After all, even ER Ken knew better than to face off against Dana.
“Alright, now that Dr. Langdon has deigned to join us, let’s go over the game plan. Now this guy is about as big as the Kraken, maybe a little bigger, but he’s not near as agitated so hopefully this will go smoothly. I’m taking right arm, Perlah is taking the left arm. Donnie is taking the left leg and Princess is taking the right. Dr. Langdon here, will inject for us. Dr. Robby ordered Klonopin as well as Haldol as he does have some resistance to benzos due to his drug use. Any questions?” Without pausing, she continued. “Good, let's do this”
“Please just don’t let me get bit.” Dana rolled her eyes.
“Thanks for the color commentary, Dr. Langdon.” He smiled and shrugged.
“You’d miss it if I wasn’t here!” Before Dana had a chance to reply, Dr. Langdon skipped away to prepare the meds. She grinned and shook her head. While she’d rather die than admit it, and certainly not to his face, Langdon did bring a certain charm that the ED would be worse off without.
Dana checked in with the nurses as Langdon returned with the syringe. She made sure everyone had emptied their pockets and gotten rid of anything else on their uniforms before clapping her hands. “Alright everyone, it's go time!”
The struggle that ensued upon entering would go down in the history books of The Pitt as one of the most ass-backwards, cartoonish sequence of events ever seen in the Emergency Department. The man they were attempting to chemically restrain, while not a bodybuilder, was still a man of larger stature and could pack quite a punch. While Langdon was happy, even ecstatic, to not have been peed on, it would have been much preferable to what actually happened.
Upon entering the room, the man, previously in soft physical restraints, had managed to worm his way out of them, sitting bolt upright. With no one to help secure his head, Dana and Perlah were left with the challenge of trying to get him flat on the gurney again. When they were unable to succeed, Donnie abandoned the left leg to use his weight to force the man’s shoulders flush to the bed. Princess, left to battle the patient’s flailing legs alone, slipped and somehow managed to unlock one of the wheels on the gurney. Already shaking from the patient’s thrashing, the gurney skittered several inches to the side.
Frank, who thought he had been far enough away to avoid the man’s flailing legs while the nurses restrained him, was now right in the path of destruction. He was kicked right in his ER Ken face, sending his head snapping violently backwards. Frank cried out and staggered to the floor at the foot of the gurney as blood streamed down his face from his nose and his split eyebrow.
Dana made an aborted move to assist Princess with the man's legs, but that one hesitation was enough for the man to break free and launch himself off the gurney. The bed went flying into Dana and Donnie, taking Princess with it. The man landed directly atop Dr. Langdon, who, while still flat on his back on the floor, had managed to keep a hold of the medication. The syringe loosely held his hand was immediately dislodged and rolled away when over 200 pounds of hysterical patient landed directly on Dr. Langdon’s stomach, chest, and legs. He could be only distantly glad that everyone was too distracted to hear he wheeze he let out, which sounded like a whoopee cushion that had just been sat on.
Frank weakly reached up to try and calm the man, vision spinning and body aching. What he hoped would be a soothing gesture had the opposite effect. The patient seeing Frank reach up, scrabbled for anything to use to get away and unfortunately his hand landed on the syringe. He grabbed it and immediately jabbed the needle into Frank’s chest like he was trying to stab him before scrambling up and away, pressing the plunger down in his attempt to escape the room.
The patient sprinted into the hallway, leaving the door open to all the other staff to stare in befuddled amazement as Perlah looked around her in stunned shock, the last one standing. Langdon let out another wheeze. The room was silent.
While Robby was aware of Dana working to help chemically restrain a patient, he certainly wasn’t expecting that very same patient to come tearing out of the exam room, slip on the tile, and bowl headfirst into the nurses’ station. Robby shot out of his seat, his stool flying across the room. When he saw some nurses crowded around the groggy patient on the floor, he sprinted for the exam room only to pause in the doorway. Dr. King skidded to a stop right behind him, narrowly avoiding plowing into him.
Robby could only stare at the ridiculous tableau in front of him. Dana, Princess, and Donnie were pushing a gurney away from them while Perlah blinked at the side of the room. Langdon was flat out on his back, panting on the ground. His resident's face was covered in blood and he was holding something to his chest. Dr. King glanced over his shoulder and gasped before pushing her way past him to kneel at Langdon's side.
It was then Robby noticed what Mel had noticed. He hadn’t been able to see exactly what Frank was holding. The syringe of medication was lodged in his chest, to the left of his sternum. He quickly called for more help, not sure who else was injured. Robby lurched forward, sweeping his eyes around the room. “Dana, Donnie, Princess, Perlah, you guys alright?” He barely registered their affirmative responses before he was with Dr. King at Frank's side.
Mel was taking Langdon's pulse, staring determinedly at her watch. “He’s brachycardic.”
“How are we feeling, Frank?” He asked.
“Oh, you know. Great!” Robby couldn't help but be relieved. While the situation was not ideal, Langdon was still joking around, although his voice was breathy and the words were starting to get jumbled. “I love getting kicked, crushed, and then drugged by patients. Really makes my day.” Robby gently bopped him in the head in admonishment, taking care to avoid the bleeding wounds on his face as most of the nurses filed out of the room. Donnie stayed behind, staying out of the way but ready to assist.
“That's enough of that. How are you feeling? That's a pretty high dose of drugs you just got hit with.” Robby glanced to Dr. King, who looked worried. Robby looked at Frank and saw his eyes had gone somewhat glassy. Frank just hummed in response. The medication was definitely kicking in. Robby put his hands on Langdon’s chest and gently removed the needle, which prompted a groan. Dana, one of the only other people remaining in the room, reached a hand out for the syringe before leaving.
“I'll be back with another gurney to get him out of here.” Robby nodded distractedly.
“His heart rate was in the 120s at first, but seems to have slowed. His breathing was fast as well, about 22 respirations but that's slowing as well.” Dr. King rattled off her observations, fingers still planted in Frank's carotid. Robby nodded.
“That medication was dosed on weight, plus the location it was injected, it's going to hit him pretty hard.” Dana was just arriving with the gurney. His call for assistance was finally being answered, with Dr. Santos following quickly behind the gurney. Donnie came further forward as well, ready to help lift Langdon onto the gurney. Robby gave Frank a firm sternal rub, trying to get him closer to consciousness. Frank tried to swat at him but missed.
“Tryna sleep, Robby. ‘M dizzy.” Robby let out a small chuckle, trying to hide his mounting anxiety.
“I know, Frank, but you’ve got to try and stay awake as long as possible.” Frank whined but stubbornly kept his eyes open.
“I don’t like your ‘patient’ voice.” Robby just rolled his eyes but didn’t say anything. He looked to the people around him. “Alright, let’s get him onto the gurney and into another room. His breathing and heart rate are slowing from the medication, so we’re gonna need to get him on oxygen support and monitor his cardiac activity.” Everyone gathered around to lift Frank up, Robby at his head with Dana at his feet, the others on either side. “One, two, three!” With Frank situated on the gurney, Robby waved away Dr. Santos and Donnie, allowing Dr. King and Dana to help him steer the gurney through the halls.
When they left the room, all eyes were drawn to them immediately. Robby saw that the patient who had smashed into the nurses’ desk had also been placed on a gurney and was being whisked away by Dr. Collins and Dr. Mohan. “No gawking! Get back to work!” He snapped. The last thing Frank would want is people looking at him while he was in distress. Robby looked back at Frank’s face and saw his eyes still open. “You’re always the center of attention, aren’t you Langdon?” Frank made a face, his eyes blinking very slowly.
“It’s my speciality, you know that!” Dana snorted. Langdon was clearly not all there.
“Maybe try to take a break from that for a while. I don’t know how much more your poor wife can take.” Frank winced and reached a hand to his face. Dr. King quickly caught it and brought it back to rest on the gurney before he could smear more blood everywhere, as they locked the wheels in one of the empty bays. Robby quickly drew the curtains to keep people from snooping.
“Aw man, my wife is gonna be pissed. It wasn’t even my fault!” Robby absentmindedly brushed a hand over Frank’s forehead.
“She knows that, Frank.” Frank sighed and stared up at the ceiling, his eyes slowly slipping closed again. Robby dug into his sternum again, but the reaction was less immediate. He tamped down the dread that flared in his stomach. “Alright, let’s get him on monitoring and oxygen now.” Dana wasted no time taking a pair of trauma shears to Langdon’s scrub top. In no time at all, Dana had put monitoring stickers all over Langdon’s chest, as well as stickers on his wrists and ankles for an ECG. Dr. King slipped an oxygen mask over his face. Robby went to the computer nearby and opened up the psych patient’s chart to see how much Klonopin and Haldol had been used. He winced. The patient was easily 30-50 pounds heavier than Langdon. No wonder he was experiencing the beginning of possible overdose symptoms.
Dr. King urgently called Robby’s name, drawing him away from the computer. Langdon’s arms and legs were jerking weakly against the bed. His symptoms had progressed, as he began to have muscle spasms. Frank was making groaning sounds and Robby could see the jumping and twitching muscles beneath the skin. Robby cursed and grabbed his pen light. He checked Frank’s pupils and found they were much more dilated. His eyes were also rapidly moving back and forth. “Shit, he’s got muscle spasms and nystagmus. He’s definitely overdosing. What are his vitals like, Dr. King?”
“Blood pressure 100/60, heart rate 40 bpm. Respirations 12 and slowing.” Robby cursed again.
“Alright, let's get IV access stat. I’ll go draw up some atropine. Dr. King, switch the mask for a BiPAP, then grab an intubation tray. I’m hoping to avoid that, but let’s be ready just in case.”
“Do you want flumazenil?” Dr. King asked, looking rapidly between Frank and Robby. He shook his head.
“Frank has a prescription for benzos he takes as needed. I don’t want to send him into seizures. We’ll use it as a last resort.” Dr. King nodded, a wrinkle forming between her eyebrows. Dana quickly got IV access while Robby left to draw up medications.
When he returned, Frank was on the BiPAP. The mask was fixed tight to his face and increased his oxygen levels and breathing rate. His heart rate had continued to drop, as well as his blood pressure. Robby quickly administered the onboarding dose of atropine, starting at the monitors. Robby winced as Frank’s muscles continued to cramp and spasm. He wanted to give a muscle relaxer but with two CNS depressants already on board, he didn’t want to risk it. Frank had also broken out in a cold sweat, another symptom of the overdose. Langdon’s muffled groans could still be heard despite the BiPAP mask sealed on his face. His face kept pinching in distress. Dr. King grabbed his hand, holding the spasming limb in her grip in an attempt to comfort him.
Robby had his eyes glued to the monitor as he saw Frank’s heart rate start to climb. He didn’t want to have to use the reversal agent for benzodiazepines, but he would if Frank’s vitals didn’t start to improve. Luckily, his breathing was stable in the BiPAP. Frank’s vitals climbed far enough into “normal” for him to be comfortable without giving the reversal agent. “Alright. He seems to be doing okay. Dr. King, I want you to push atropine in the next 30 minutes to an hour. If an hour after that, his vitals stay steady, hold off. If not, administer again. He seems to be doing well on the BiPAP. Check his sats without it every time you push atropine. Dana, if you could also check in periodically, I’d appreciate it.”
Robby sighed and looked at Frank’s face. While the tremors had slowed from what they were when they’d first started, it still wasn’t ideal. “Hook up a saline drip to keep him hydrated and push 600 mg of IV ibuprofen. He’s going to be sore.” He made eye contact with both Dr. King and Dana. They both nodded at him and he nodded back. Frank was in good hands. “I’m going to work on his facial injuries. Let me know if anyone needs me.”
Mel and Dana seemed to get the hint and left the room while Robby got out supplies to clean and stitch Frank's face. He gently wiped the blood away from Frank’s eyebrow and over the bridge of his nose. He cleaned up the rest of the blood from Frank’s bloody nose as well. The cuts weren't too deep and would only need 2 or 3 stitches each. The tremors had slowed to just the occasional twitch so Robby wasn't worried about his stitches being uneven.
“You always seem to find trouble in my emergency department, and I don’t really appreciate it.” Robby said as he disinfected around the cuts and began to lay down draping. “I’m sure your wife doesn’t appreciate it either.” He fell silent as he began to methodically seal the cuts, falling into an almost meditative state as he did the stitches. “I don’t do simple stitches on just anyone, you know.” He looked at his mentee’s face, which was still scrunched in mild discomfort. “Just don’t let it get to your head.” He tied off the last suture and removed the draping. He cleaned everything once again and put his supplies away.
He stared at Frank’s vitals for a solid minute, watching as his heart rate, breathing, and blood pressure, while on the lower side of normal, stayed steady. He then stared at his resident’s face, watching for any additional discomfort. He was shocked out of his thoughts when the noise of the ED grew louder and Dana shouted for him. He shook himself, allowed himself one last glance, and went back to work.
Waking up on a gurney, while not a common occurrence, still happened more than Frank would like to admit. However, he normally remembered what happened to get him in that gurney.
Dr. Langdon swam to consciousness slowly. He felt bone tired, not even having the energy to try to pry open his eyelids. His skin felt tight and claustrophobic. There was a deep ache that permeated his entire body. He let out a quiet hum as he shifted uncomfortably on the gurney. He tugged the thin blanket draped over his legs further up to his shoulders as he shivered. He heard muted voices around him, even felt a gentle touch on his shoulder as someone straightened his blanket for him and laid another one over him. He wanted to thank them but quickly slipped back into unconsciousness, unable to even utter a noise.
The second time waking was much better. Frank squinted as the lights in the ED seemed to burn his retinas. He had a massive headache, and his back was killing him. He looked around groggily, but didn’t see anything that might clue him in as to what happened. He had an IV in his left hand (which itched like crazy) and oxygen under his nose. He was hooked up to a heart monitor and blood pressure cuff, the former of which was beeping reassuringly in the background. He even had a pulse oximeter clipped to his finger. He fiddled with it as he tried to straighten out his scrambled thoughts. His scrub top was gone, replaced with a thin hospital gown. What the hell.
He tried to think back to the last thing he remembered. He’d gone to work for sure, so it had happened while he was in the ED. Not necessarily reassuring. He thought harder. He'd helped Dana with something. What was it?
He groaned loudly as it hit him, sinking into the gurney in shame. How humiliating! He could never show his face again. He'd had to sneak out a window or something, transfer hospitals. He'd never live this down. Fuck!
His groan seemed to have attracted some attention. Mel stuck her head in the cubicle he was sequestered in, grinning when she saw he was awake. “Dr. Langdon!” He winced at the volume but gave a reluctant smile in return.
“Hey Mel. What the hell happened?” Mel shifted on her feet as she stared at the monitors hooked to him.
“You accidentally got hit with a tranquilizer meant for a psych patient. You had some overdose symptoms but they resolved with time after a couple doses of atropine and oxygen support.” Frank nodded as Mel wordlessly handed him his chart. He knew there was a reason Mel was his favorite. He quickly skimmed the chart but was relieved to see that she was correct. He shifted and winced. His entire body felt like one giant bruise, with his back pulsing with sharp stabs of pain. Even his fingers were sore! Memories slowly trickled in and he cringed. God, he hoped Garcia or Santos hadn’t seen anything. However, something told him Santos had seen at least something, and he was not thrilled.
“You were having some muscle spasms as a result of the overdose. I can get you some more IV ibuprofen if you’d like?” While Frank would normally try to tough it out, he knew Mel wouldn’t look at him any different, and would in fact prefer if he took the offer. Plus, he did feel incredibly shitty. He nodded and she shuffled away to grab it. He put his chart down and scrubbed his hands over his face. He didn’t feel right, but couldn’t pinpoint why. He just wanted to sleep.
Mel came back with his ibuprofen, and trailing behind her was none other than Robby. “Langdon. How are you feeling, man?” Frank gave him a weak smirk as Mel injected the meds into his IV.
“Been better, been worse. When can I get out of here?” Robby let out a harsh laugh, arms crossed across his chest.
“You can go home in a couple hours. You will have the next 3 days off.” Frank opened his mouth to protest but was swiftly interrupted. “If you don’t listen to me, I’m telling Abby you refused to listen to me and you’re going to have to deal with the fallout.” His mouth snapped shut and he grumbled under his breath. He lifted a hand to his chest and rubbed at a sore spot, wincing at the pressure. Robby’s eyes softened just a bit. “That would be where he got you with the needle. Try to not get bowled over by psych patients in the future?” Frank scowled.
“He kicked me in the face, Robby! My money maker!” Frank brought his hands to his face, probing the neat stitches that now held his nose and eyebrow together. Robby laughed at his annoyed expression and sidled up to the bed, putting his hand on Frank's ankle. Mel's eyes were darting back and forth between the two of them like she was watching a particularly intense tennis match.
“How are you really feeling man? And don't bullshit me.” Robby’s expression was deadly serious and even Frank knew when not to push it. He took an inventory before he answered.
“My chest hurts like a motherfucker and my muscles hurt like I just ran a marathon but my back is surprisingly okay considering… everything. Still hurts though. Face feels like I got into a fight, which I pretty much did. Really, I am doing okay.” Robby gave a curt nod to himself. Frank shook his foot where Robby had a hand resting. “Now stop being a mother hen and get out of here! You’ve got an entire department to tame!” Robby let out a laugh and obeyed, heading for the door.
“I’ll see you in a couple hours when I discharge you. If you leave AMA, I will kick your ass.” Frank waved him away, but Robby froze in the doorway. Langdon looked at him oddly. “You scared me for a second there, Langdon. Don’t do it again.” And with that, Robby hit his hand on the doorframe and swanned back into the department. Frank smiled and rolled his eyes.
Mel cleared her throat.
Frank looked to her. “What’s up, Mel?”
“I am glad you are okay, Dr. Langdon. I would much prefer not to have to work on you as a patient in the future.”
“The feeling is mutual, Mel.” She briefly rested her gloved hand on his shoulder before snatching it away like she had been burned. She smiled and followed Robby back into the ED. Frank got comfortable on the bed, closing his eyes. He was still so tired. He was about to drift off when his phone began going off. He fished it out of his scrub bottoms and cringed. Abby was calling him and to his horror, he had multiple missed calls from her as well. That was not good. This whole situation would be so much fun to explain. He quickly answered it. “Hey babe!”
Having his wife yell at him was probably scarier than the psych patient that bashed his face in and then managed to drug him into oblivion. Luckily, she just let out a disappointed sigh on the other side of the line. “Don’t you ‘hey babe’ me, Franklin Ainsley Langdon. What the f-” She quickly cut herself off. The kids must be in the room, he mused. “What the heck happened? I got a call from Robby like an hour ago telling me you got assaulted and drugged by a patient?” Frank sighed, resigned to his fate.
“Well honey, you see…” As he explained and reached the end of what he remembered, his beautiful, lovely wife who he adored burst out laughing.
Of course. Of course.
She quickly cut herself off. “I know you were hurt and you probably don't feel well, but damn. That sounds like a symphony of catastrophe. Just one thing after another, huh?” Frank nodded.
“Yeah I don't think any of us will be living it down any time soon.”
“Well I will be by to get you in a couple hours when Robby cuts you loose. The kids will be coming with me so warn Robby that his department is going to be invaded by your children.” Frank laughed, wincing as it pulled at the incredibly sore injection site on his chest.
“You had a hand in creating them, if you recall? You did like 99% of it.”
“When they act like they do, they’re all yours.”
“Fair enough.” With that, they said their goodbyes and Frank put his phone down. He sunk into the mattress on the bed, wishing he was in his own. Just as he felt himself start to drift off, he was startled awake by a grating voice from the doorway.
“So I heard you got donkey-kicked and sedated. Awesome. I helped get you in the gurney but man, I wish I could watch the footage of that.” Frank peeled an eye open to glare at Dr. Trinity Santos staring smugly at him from the entrance to his room. He mustered the energy to lift one hand and one finger in reply and went back to sleep listening to Santos laugh as she left.
Over his dead body.