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Every day John Carter comes to work and feels like he’s descending into the bowels of hell, which is an odd feeling, considering surgery is on the eighth floor.
County General has a staff entrance, and as a surgical resident he is entitled to park in the cool refuge of the parking structure, the ugly concrete keeping the cars cool through the long hot summer days, but despite this he always parks on the street and steps into work through the double doors of the ER, dodging traumas and the walking unwell, nodding greetings to everyone who is on. There’s something that feels like home, even if it is nothing like how he grew up. The faces, the fact that all life is here, bubble up and boiling over, drowning and waving at the same time. It isn’t against the rules for him to linger there. He is a resident surgeon, a member of staff, and he is thinking about specialising in trauma anyway, chasing the dragon every time he is down in the ER and he gets roped into the thrilling push-pull dance of where surgery and emergency medicine overlap.
Two years ago he was made an offer of the ER sub-I, but he’s a wilful person, he loves to set goals high. Getting into medical school could have been easy had he said he wanted it to the right family member, but he chose to tell his father first on purpose, chose to fight the disapproval, to prove himself right. Did all the tests, got top marks, a scholarship that he turned down once his father begrudgingly accepted this wasn’t a whim, or if it was, it was something he was willing to work for. His father who never worked much at anything, who sailed through Wharton and who never cut the cord at all, tethered to the name and the money. John took the money, went to Penn, but instead of returning and following in his father’s footsteps, he went to Northwestern, did his internship at County General, and took the grime into his skin, all the smut and grease of the real world under his nails, let it dull some of that Carter buff and polish.
Surgery was the only option from the moment Deb wrinkled her nose at him, and he pursued it, chased it, wanted it from that moment on. He wanted Benton to pick him, even if Hicks and Morgenstern and every other resident told him he was doing well, he wanted what he couldn’t get, battled and fought until he got it. He checked after that no large donations had been made from the foundation, that he was clean. He walked into the alligator’s mouth and gave a big smile and let it sink its teeth into him, giving it the next seven years of his life willingly.
The thing is, he’s a good surgeon. He has steady hands and solid concentration, a good memory and is calm under pressure. He has always thought in three dimensions, effortlessly able to rotate anatomy in his head and think on the fly. He is good at it. His stitches are neat and he knows them all. His affable nature suits the egos of the surgical suites, but he isn’t a pushover. He has steel under his skin, and can show it if he needs to.
The problem is he doesn’t want to do it. He’s got a voice in his head that won’t let him sleep, the little demon that he entertains each day he walks through the ER and thinks about the counterfactual of his life where he’d told Benton no, accepted Mark Greene’s proposal, and set down roots where he has a horrible feeling he belongs.
John originally majored in economics at Penn, and so the sunk cost fallacy is something he was taught early and took to heart like it was new gospel. It's the only one everyone knows but yet everyone still falls for, but there are complications when it comes to the theory and practice. Sometimes the costs are too great, the barriers too high, and all the case studies he read never touched the complexities of medical residency. Maybe it is by design. Maybe this is all on purpose, that the whole medical education system in the United States is predicated on making it impossible to leave once you start. The matching system is too carefully balanced, too enormous and lumbering, a giant that only wakes up once a year to tell the futures of the fourth year medical students. A genie that does not come out the bottle for just anyone, and no amount of money can force it to reconsider.
There are options, but they all involve a great sacrifice. One can always double-board, if you are insane enough, but to do seven years and then another four, eleven years of training…maybe if it was the other way around. If he could do ER first, and then cross over to the other side…maybe he would be able to stomach that, with a few years of perspective.
The thing is he still wants everything he came here to do. He wants Benton to see him as an equal, to accept him, to want him rather than see him as a burden. To choose him. He wants to save lives and he likes the way surgery makes him feel, the thrill, the skill and dexterity of the discipline. He likes the cool feel of the surgical floor, the sterile air and the blue scrubs and the time he gets Shirley to laugh despite herself. He likes surgery.
But he loves the ER. And at the end of the day, no amount of logic or fumbled proofs can disprove the fact that the heart wants what it wants.
John’s parents separated when he was thirteen. It happened fast, there was a lot of yelling, a lot of crying, and John was old enough that it hurt but that it didn’t make much material difference to his life. He was away at school most of the year, and his parents both still lived in the mansion, even after they couldn’t stand the sight of each other. His father would call him and update him on the process, but his mother would never say anything, not in her weekly calls or the long letters she would write him, the bottom smudged with her lipstick, sealed with a kiss.
Most of his friends’ parents were divorced, so by the time he came home, the summer he turned fourteen, he was resigned to it, buoyed by the promise of double christmas presents, of playing each off against each other, the way his friends had taught him were the benefits.
In the end, he came home and found them kissing in the kitchen, his father bent over his mother, his hands up inside her blouse.
“Oh,” he says, and his father doesn’t even move, just breaks the kiss and glares at him. “I thought you were back tomorrow.”
“I thought you were getting divorced,” he says, shocked.
“Things change, John,” his father says, witheringly. “Sometimes adults change their minds. There’s nothing wrong with it.” His mother had laughed and ducked her head into the crook of his neck, the blush making her look sweet and girlish.
It didn’t solve anything, though. They would have been happier if they had got divorced, even though they were perfect for each other. Even though they lived a codependent life. Even if Gamma’s astrologer said they would never find anyone better.
The next summer, his father flies home from their holiday in the Maldives a week early. John barely notices, spending the entire time face down in the water, looking at the fish on the reef. When it is time to go home, though, a storm rolls in, huge and heavy, and he and his mother get stuck in the first class lounge for ten hours waiting for it to pass.
“You know, I fought so hard for your father,” his mother says, sometime in the middle of the night. The lounge has a lot of champagne to drink, the butler had said, and his mother had risen to the occasion. She’d even let John have a glass, and he can feel it in his blood, the bubbles different from the ones in soda, somehow.
“He was very, very popular,” she says, wistfully. “There were a lot of girls at Penn who had their eyes on him from the start, and he was definitely dating a lot of them.” Her voice is dreamy, and she looks at him like she’s not even there, not really. “Do you know why I won, darling?”
“I don’t,” John admits.
His mother smiles like the sphynx, leaning back, her eyes closing as she recalls the memory. “Because I made the chase worth it.”
Now, John would leave it, understanding that his mother is a lush who enjoys nothing more than being luscious on someone else’s wine, but back then he still didn’t know all the family secrets, so he gives into curiosity, into the irresistible pull of his own mythology. “What does that mean?”
“You’ll know when you’re older,” she said, with a laugh, but the truth is that John is 27 now and still doesn’t know what she meant.
He doesn’t think it has anything to do with sex. He learns later that his father flew home because his mistress told him she was pregnant. He doesn’t know what came of that baby, or whether his mother knew, but he’s seen the way his father looks at his mother, a kind of begrudging respect that he usually only reserves for his business rivals. Someone who is playing the game better than him.
Maybe that is what she meant. That there is always a way to win the game, even when it's rigged against you.
John was a dinosaur kid, his favourite was diplodocus, if you asked, but like all younger brothers he had a soft spot for the Tyrannasaurus Rex, but Bobby was a mythology kid, as was Chase. Chase loved Egypt, which is why John knew about the sphynx, but Bobby loved gods and monsters, Greece and Rome, the mythology of how the world worked before anyone even conceived of science. The spring came because Persephone came back from Hell, and the fall came because she went back to her husband. Everything was Zeus’ fault, because if there’s one thing everyone can agree on, is that the world needs a father figure as much as a young boy does.
When Bobby died, they had a funeral. John had said they should bury him as the ancient Greeks did, but his father told him to keep his stupid thoughts to himself. It was the first time his father called him stupid. It was not the last.
When he looked up ancient Greek funerals, they didn’t seem that different from the Episcopal one they’d had. It seemed a pity. When Chase found him at the funeral, he told John about the ancient Egyptian burial rites with the enthusiasm of someone who had learned that bodies were gross on the inside. They both privately decided that they’d prefer to be buried viking style, pushed out into Lake Michigan on a raft and set on fire. Better to go out like that than to be slid into the ground, watered with tears, forgotten but for words in stone that claimed you were loved.
The match opens in January, and John thinks about applying to switch. He thinks about it through the whole month and the next, all the way into March when the match closes, his application never more than half-filled in, and only when the date passes that he truly realises he can’t do it anymore.
He is in hell now. Trapped and captured. He is Persephone, making the best of it, taking every shift down in the ER like he can eke out another day in the sun. Benton is distracted and dismissive; he has other things on his mind, a baby, a faltering career, personal problems that bleed professional. He is John’s personal Hades, someone who keeps him captured but doesn’t really care for him, not really, not as anything but a gasket, a trophy, a pet. He cares more for what John represents than what he can give.
Let me go, John begs, through everything but words. His actions scream, but it is all too subtle. He could do something else, but his hands are tied. He would never compromise patient care. He loves his patients. He wants to do his best for them. He can help them, so he does, he lingers by their bedside, dotes on them, treats them like his children. Benton doesn’t notice at first, but then when he does, he still doesn’t grasp what it means that John is rebelling. Doesn’t ask why his disciple is wandering away from him, circling another star.
“I want to quit surgery,” John says, in the mirror. His own face stares back at him. “I want to quit surgery. I need to quit surgery. I’m sorry, but I have to quit my residency.” Says the words until they feel familiar on his tongue. Says them like a mantra, like a prayer.
“I’m going to quit,” he jokes everywhere. He makes the joke in the resident’s lounge, while scrubbing in, every time something is hard, and his peers laugh and ignore it, agree, commiserate. “Can you do it soon?” Dale says, not looking up from where he’s bent over a book. “I think Anspaugh is going to ask you to assist him on the Whipple, and I need it more than you.”
“I want to quit,” he tells Anspaugh, the next morning, after the whipple goes perfectly.
“Everyone wants to quit their residency at some point,” Anspaugh replies, dismissively. “You’re a talented surgeon, Doctor Carter. You should not throw it away.”
So John goes to Benton, intending to throw himself on the rocks. He goes to him at home, and is rebuffed. He corners him after a surgery, in the locker room, and Benton just strips and steps into the shower and tells him to leave him alone.
So John writes a letter and puts it in his locker. It feels like a suicide note. He doesn’t feel better after, and even worse when Benton doesn’t say anything.
“Did you get my note?” he asks, when they pass in the hall.
“There wasn’t anything in my box,” Benton shrugs.
“I put it in your locker.” John says, urgency grabbing his tongue and Benton’s wrist. “It’s important.”
“I spilled coffee in my locker, Carter. Everything’s in the trash.” Benton looks at him shrewdly. “If there’s something you need to say, just say it.”
“I want to quit,” Carter says, blatantly, openly. “I want to quit the surgical residency program.” Three people pass them in the hall and look at him. He realises he’s shouted it, that he’s vibrating with anger. His fist clenches around Benton’s wrist, and he sees the wince on his face.
Benton takes him by the arm and leads him into the nearest empty room, locks the door and stands in front of it.
“Don’t be stupid,” Benton says, serious as a heart attack, and John’s vision flashes red.
“I’m not stupid,” Carter says, and he means to spit it but it comes out broken. Benton shoots him the most disappointed, brutal, withering glare.
“What’s this about really, Carter?” he sighs. He folds his arms, giving John the facsimile of his full attention. Outside, John sees people gossiping, pointing their way. He steps in and closes the blinds. Benton does not move.
The room is quiet. Quiet and still. They are very close.
“I don’t want to be a surgeon anymore,” John says, simply, quietly. “I made a mistake. I got caught up in the competition of it all, on proving I could, but I don’t want it.”
His mouth is very close to Benton’s ear, whispering it like a secret. The room feels hot, close, like it is boiling over with their tension.
“Your evaluations are good,” Benton says, equally quietly, his face frowning, turning his head so he can look at John. His voice is low, calm, the way he’s only heard it twice before, on the worst days of his life. “You get the first choice of surgeries. You are technically the best surgeon of the last two cohorts. You should be happy.”
“It’s not enough,” John says. He fists his hands in Benton’s scrubs. “It’s never going to be enough.”
“I don’t understand, Carter,” Benton says, and John can feel the frustration coming off him, his hot breath, the sweat on his brow where it presses against his own. “Make me understand. What about this isn’t enough for you?”
John wants to say something, but he kisses him instead, takes Benton’s full lip between his teeth and tries to pour it all out that way. All the feelings, the desperation, the futility, into swipes of tongue, of the graze of teeth, of the movement of lips upon lips.
Benton makes a noise, a grunt, something like surprise but he fists his hands in John’s scrubs and twists, pushing him against the door. He kisses him hard, dominating, like the hot shot surgeon he is, all technique and passion and fury, ego and discipline and skill, so much skill. John’s right leg ends up around Benton’s hip like he wants to bring him inside him, take him as a transplant, and the way Benton’s fingers dig into the scant meat of his thigh makes it feel like Benton feels the same, but just as he thinks it’s going somewhere, Benton drags himself away, pushes himself back, shaking his head.
“No. You don’t get away that easily,” he says, as if that wasn’t the hardest thing that John’s ever done. “I need you to tell me what's really going on.”
“I –” John stumbles.
“Tell me!” Benton snaps. His hands, that had just been on John’s body, are clenched into fists.
Everything at that point boils over, the heat and the passion and the burning. “My parents should have got divorced when I was thirteen,” John stammers, “They separated, began the whole process, but something happened and they stayed together because it was too difficult to give up. It wasn’t one thing, it was everything, the finances, because of me, because of my parents’ jobs, their social standing, the things they had gotten used to having. So they stayed together because it made sense. They were in love at one point! But now they were miserable, and they made everyone around them miserable. They’re still together, going through the motions, but I saw my father with his mistress and I…I don’t want to be him. I don’t want to spend my life wishing I was with someone else. I feel like I’m a hostage of this department, that I can’t escape, even if the door is right there.”
Benton sighs. “That’s just a story, Carter. Not everything has to be like something else. Your surgical residency isn’t the same as your parents not getting divorced, and it certainly isn’t holding you hostage.”
“What options do I have?” John asks. “Either I quit this, walk away, give up on my dreams, become the man my father always said I was, the stupid idiot who will never make it in the real world, or I stay here and wither away, let it take more and more of me until there’s nothing left but surgeon.”
Benton looks at the ceiling. Outside, someone calls his name. They have an audience. Someone probably has their ear pressed against the door. They’re probably debating calling security.
“You can take some time off,” Benton says. “Take a week. See how you feel. Don’t make a hasty decision.”
He doesn’t think this is going to change anything, but then a voice comes from outside, loud and questioning. Anspaugh, asking if they need help.
“Okay,” John says, hastily.
When the door opens, he makes a joke about how many surgeons it takes to unlock a door, but when he leaves, he knows it's for the last time.
And when Benton comes to his door that night, by the time they’re done, he knows Benton finally understands too.
Summer comes during the next week, hitting the city like a sweaty fist, right in the solar plexus, and Chicago buckles.
It had been a cool and pleasant spring, never topping 65 degrees, and then it was 105, a fever that resists all forms of treatment. John buys a fan and sits in front of the window, thinking about nothing and everything, over and over, until his phone rings and Mark Greene, in the ER, slides into his ear with an offer. A bout of gastroenteritis has run through the ER residents, and they are understaffed. Doctor Benton mentioned that Carter might be available. Would he be able to come in?
“I probably should mention, the air conditioning is broken,” Greene says. “It's hot as hell down here.”
“I’ll be there in 20,” John says.
This time when he arrives at work, he takes the space he is entitled to in the parking structure. He walks in through the staff exit, gets a coffee from the surgical staff room, and changes in the surgical resident’s locker room. He puts on green scrubs, the pair he had held onto for nostalgia’s sake, tucked in the back of his locker like a secret, and clips his ID onto the pocket, alongside a pair of fresh pens, his penlight, and drapes his stethoscope around his neck.
In the mirror he looks the same, but he knows things have changed, and with his fate in his hands and without a look back, he eschews the elevator and takes the stairs, one at a time, down into paradise.