Chapter Text
When John starts developing flu-like symptoms in the middle of his shift, he keeps it to himself.
The headache that pounds behind his eyes, making the bright fluorescent lights of the ER feel like knives. Nausea that churns in his stomach, so bad that on multiple occasions he has to sit on an exam room bed with the curtains closed around him, head between his knees, trying to quell the queasiness. A chill that permeates his bones. Aches that dig their claws into his muscles, pulling and scraping and squeezing.
It's the flu. Plain as day. And a bad one. But John can’t say anything. He can’t complain. He knows this. After last week’s monumental fuck-up, he knows he has to keep his head down and soldier through.
Getting drunk with Harper on shift after finding out about his residency placement at County.
God. How could he have been so stupid?
His future at County General is tenuous, at best. John knows it. He can feel it in the judgemental stares, the lingering looks. The way Hicks had told him that if it were up to her, he’d be out of the program entirely.
They’d let him stay on for now. But his future here is hanging by a thread. No one says it. But John knows.
So, no. He’s not going to make a fuss over a little bit of flu. He’s come so far. He’s not going to fuck this up now.
So, when John finds himself leaning against a doorframe, clutching his stomach and battling another wave of blood-curdling, head-spinning nausea, and Benton turns to him with a faint frown and asks him if he’s alright, he blows him off. Turns his grimace into a smile. “Me? I’m fine,” he lies.
Don’t cause any problems, he tells himself. Don’t draw attention to yourself. Just grit your teeth and bear it.
It is in this way that, when John is changing his scrub top in the locker room an hour later and sees the beginnings of a rash forming on his abdomen, he ignores it.
And, fifteen minutes later, when he notices that his muscle aches and pains have spread to his neck, he ignores that too.
Every symptom, every sign. Ignore, ignore, ignore.
To his horror and great anxiety, however, he seems to draw attention to himself anyway. In the trauma room, Mark asks for a bag of A positive, and John brings him B negative. When presenting a case to Benton, he forgets the word for cholecystitis. He stammers. He stutters. His head pounds. He feels their stares. He feels their judgement.
His head hurts. God, his head hurts. He’d felt fine this morning. Fuck, these symptoms came on fast. He excuses himself from rounds with a mumbled apology and lurches into the men’s bathroom, promptly losing the contents of his stomach. For a minute, he just stays there, kneeling on the tiled floor, sweaty, hot forehead pressed against the cold of the toilet seat. Saliva dribbles out of his mouth and into the sullied water below. He’s dizzy. The light hurts. He… he can’t bring himself to open his eyes. He’s feverish. There’s no doubt about it. Time passes.
Then, a voice.
“Carter, where the hell are you?”
It’s loud. It pierces his brain. It takes everything he has to swallow the sob of pain that threatens to escape his throat. Benton.
John scrambles to his feet. Or, at least, he tries to. A wave of dizziness crashes over him, so intense it sends him tottering against the wall of the bathroom stall with a loud thud. He has to brace both his hands against the wall to steady himself as the world spins. As his head pounds. As he manages, only barely, to stop himself from vomiting again.
“Carter?” Benton’s voice again.
John swallows thickly. “I’m good,” he rasps, hastily batting at the flusher with shaking hands. “Just… just needed a minute.” His stomach contents swirl away as he fumbles with the lock on the door.
Benton is standing on the other side, arms crossed, eyebrows knit together. He looks John up and down. God, the lights hurt.
“What’s wrong with you?” he asks, frowning.
“Nothing,” John insists.
But Benton doesn’t relent. He walks right up to Carter, studying him.
“You’re diaphoretic,” he snaps.
“No, I’m not,” John says automatically.
And then Benton is reaching his hand over, placing it across John’s forehead, which is weird, and his scowl deepens. John jerks away, trying to escape. But he moves too fast, and the searing pain that lances through his brain has him emitting a choked, agonized gasp. The world tilts, then goes white.
Distantly, a panicked voice. “Jesus, Carter??”
Everything goes dark.
Pain. It’s the first thing he registers when awareness returns. His head. His head. It’s going to split open. It’s going to explode. He’s dying. He must be dying.
Hands. Hands all over him, pulling and squeezing. On his arms, his chest, his face. Poking, prodding. Someone peels his eyelid open, and the light that pierces his brain sends a sob tumbling out of his mouth.
Voices. So many of them. Loud. Far too loud. Talking over one another. Talking to him. Panicked, urgent. It hurts. Oh god, it hurts.
“What happened?”
“What’s wrong with him?”
“He’s febrile as hell. Christ. He was working like this?”
“He’s been acting weird all day.”
“What do you think it is? The flu?”
John moans. It’s too much. It’s all too much. This… this is bad. This is wrong. This is a disaster.
“Carter? Hey, Carter? You with us?”
It’s a familiar voice. Really familiar. But… the name escapes him. He can’t think of it. His brain feels like mud.
He opens his mouth and forces the words out anyway. This is bad for him. This is bad for his future at the hospital. This he knows. He has to… he has to mitigate the damage. “ ‘M okay,” he manages to get out. “Jus’…. just leave me. Jus’ gimme… a minute…”
More voices talking over each other.
“What is he talking about?”
“He’s not making sense.”
“Okay, let’s get him on the bed.”
More hands. He’s moving, he’s in the air. His stomach jolts, and then he’s choking, choking on something hot and putrid gushing up his throat…
“Shit! Get him on his side!”
“Get me some suction!”
And then John must lose time again, because the next thing he knows, cool fingers are stroking the sides of his face. A woman’s voice, familiar and kind. “Small scratch, Carter,” her voice says.
And then something sharp and painful is pinching his arm, and John whimpers. Something is wrong. Something is wrong with him. He doesn’t understand. He doesn’t understand.
“Shhh, baby, you’re alright. We’re gonna fix you up.”
“H-h-hurts,” he chokes out.
Another voice. Different. And unlike the others, this one’s name he knows. Benton. “What hurts, Carter? Tell me. Tell me what’s wrong.”
John just moans. Something wet is on his face. He shudders. “…head…” is all he is able to say.
More voices. The words are familiar, but they don’t make any sense. He doesn’t know what they mean.
“I want a CBC, a chem panel, and a blood gas. Hopefully this is just the flu. But I don’t want to take any risks.”
“This isn’t just the flu, Mark. It can’t be. This… this isn’t normal.”
The voices begin to fade out. A buzzing is taking over his brain. It’s loud and it hurts and it spreads from his head down his neck all the way down his spine and into his legs. Louder, louder, louder… until suddenly, everything is gone.
Mark watches, nauseous, as the pale boy on the bed in Exam 2 squirms and whimpers. Standing several feet away, he can still practically feel the fever that blazes underneath Carter’s skin.
104.7, the thermometer had read. How, how, how had this happened?
Haleh strokes John’s hair, murmuring in his ear as Carol moves around him, quick and efficient, setting up IVs and drawing blood. Occasionally, she glances back at him. Her expression is grave, her eyes wide and a little fearful. She bites the inside of her cheek.
She’s worried. Benton, crouched by the bedside, is worried. The surgeon’s got a look on his face Mark has never seen before. His eyes are laser focused on his med student. He doesn’t look away from Carter’s face, not for a second. When people try to talk to him, he responds, but he still doesn’t look away.
“Did he say anything to you?” Mark asks Peter. “Before he passed out. Did he say anything?”
For a second, Peter’s eyes close, his face twisting. “No,” he says, when he opens them again. “No. He just… he just kept saying that he was fine.”
Mark sighs, scrubbing his face with his hand. On the bed, as Carol sticks a needle in his arm, the boy lets out another whimper. A shuttering gasp. Face white and so, so sweaty. Eyes clenched tight. Marks’ stomach twists.
And then, for a moment, Carter stills. Completely. Everyone in the room pauses, eyes fixed on the boy. A second of silence. A strange, gurgling, choking sound escapes his mouth. And then…
“Shit!” Mark curses, lunging forward as Carter begins to shake and thrash. Foaming spit is bubbling out of his mouth. His limbs lurch, his back arches off the bed. His eyes half-moon, only the whites exposed. “Hold him steady!” Mark cries. Peter is already there, cradling Carter’s head between his two large hands, holding it in place, holding it secure, keeping it from banging against the rails of the bed. The surgeon looks stricken. “Get me two of Ativan!” Mark calls out to Carol as he tries to hold Carter down. Peter talks quietly and urgently into Carter’s ear, words that Mark cannot hear.
Then the syringe is being pressed into Mark’s hand, and he’s depressing the plunger into Carter’s IV port.
After a few moments, the convulsions weaken as Carter’s body relaxes. Shakes turn into tremors, and the tremors fade into shivers. The boy’s breathing is ragged. His oxygen sat reads 92.
“This isn’t the flu,” Peter says again, slowly releasing Carter’s head. “Something is wrong.”
Mark knows it. They all know it. Mark turns to Carol and Haleh, both nurses looking shaken. “Get him in a gown,” Mark says quietly. “And put a rush order on those labs.”
Mark is in the lobby, updating Kerry on the situation over the phone, when Carol sticks her head out of Exam 2. “Mark,” she calls out. “You’re going to want to see this. Right now.”
Mark hurriedly tells Kerry he’ll call her back, then jogs over. “What’s wrong?” he asks, approaching the bedside, coming up beside Benton, who looks slightly sick.
Carter is splayed out, tube-laden arms at his side. An oxygen mask has been fitted to his ghostly face. His scrub top is gone, revealing a pale expanse of chest and abdomen.
“Look,” Carol says quietly, pointing.
Mark does. He swallows. It’s a rash. Purplish red bumps, spreading across the right side of Carter’s abdomen. In some distant part of his brain, alarms begin to sound off. “Carol,” Mark says stiffly, “hand me some gloves.”
She does, and Mark puts them on. He leans forward, studying the rash. It looks almost like a bruise. Gently, Mark presses down on it. It does not fade.
Something clenches in Mark’s gut. A terrible feeling. A horrible suspicion.
“Look at his arms,” Carol says now, voice small.
The skin is mottled. Faint, reddish webbing under the skin, spread up and down Carter’s limbs like distorted honeycomb.
Oh, fuck.
Peter is staring at him, eyes boring into the side of his head. The surgeon takes a step back, runs a hand through his hair. “…Mark…” Peter says hoarsely, his voice cracking.
Mark nods, his throat tight. “I know,” he says faintly, trying to work through his own shock. His horror. “I know. Carol, we need… God. We need to get set up for an LP right away.”
Peter watches from the corner as Mark and Carol prepare his student for a lumbar puncture.
Carter is pale. He’s feverish. He’s sick. Unconscious. He had a damn seizure.
And he probably has goddamn fucking meningitis.
All the signs point to it. Now they just need confirmation.
Fast. They need confirmation fast.
Peter swallows his nausea. It might already be too late.
For the millionth time, he replays the events of the entire day in his mind. Every interaction with Carter. He’d seemed fine in the morning. But at some point, somewhere along the way, he’d started acting weird. Shaky. Spacey. Slow. Sick.
God. Peter lets out a long breath, trying to calm himself. He wants to tell himself that everything will be fine. But it’s not. It’s not going to be fine. Not if Carter has meningitis. Not if Carter has meningitis and started displaying symptoms hours ago and said nothing and Peter did nothing and now, and now… now it might be too late.
That’s the thing about meningitis. You have to catch it early. You have to start antibiotics right away. Otherwise… otherwise…
Peter remembers a case from when he was in med school, when he was on his ER rotation. A college-aged girl came in with a rash on her stomach, a stiff neck, and debilitating head pain. She’d been camping with friends when the symptoms started. It had taken them three hours to drive to the nearest hospital. It had taken them too long. She died thirty-six hours later. Sepsis.
When had Carter’s symptoms started? How long ago? Two hours? Three? Too long. Too long.
He looks at the boy, floppy and unresponsive on the bed. Carol undoes the back of his gown, revealing the long, bumpy curvature of his spine. His slight, slender frame. The faint protrusion of ribs underneath pale skin. So thin, the boy is practically skeletal. A smattering of brown moles.
Mark helps Carol get the boy into a fetal position for the tap. They turn him on his side. They pull his knees to his chest. They tuck his chin down.
He looks so small.
He’s so still.
Not a shiver. Not a shudder.
Peter wants to be sick. This is his fault. He knew Carter was lying. He always knows. Carter is a terrible liar. He kept saying he was fine, and Peter could tell that he wasn’t, but he let the kid carry on anyway. Why? Why had he done that? Fuck. Fuck. Fuck!
This was bad. This was really bad. He’d let this happen. God. Even if they save the boy, a million things could go wrong. The fever would cook his brain, give him permanent brain damage. Sepsis, eating away at his organs. Losing his hearing. Bacteria spreading through his body as they speak, rotting away muscle and tissue. Amputations.
Fuck. Fuck. Fuck. Peter feels his breath quickening. He digs the palms of his hands into his eye sockets. This is all his fault. This is all his fault.
He watches, as if outside of his own body, as Carol scrubs the pale, sweaty, feverish skin of Carter’s back with antiseptic. “It’s alright, sweetheart. You’ll be alright,” she murmurs to him.
They drape a sterile blue sheet over Carter’s exposed back. Mark injects the lidocaine right between L4 and L5. John doesn’t flinch, doesn’t react. Peter wants to move forward, wants to comfort, wants to hold his student’s hand…
He doesn’t, though. He can’t bring himself to move. And besides, a voice whispers from the darkest part of his brain. What’s the point? It’s too late to comfort him. He’s too far gone…
Carol hands Mark the spinal needle. It’s four inches long. Relatively thin. About the width of a paperclip wire. Long and straight. It glints, briefly, beneath the fluorescent lights. It disappears into Carter’s back, right where the lidocaine went in, and Peter visualizes its progress, moving through skin and fat and ligaments and the dura mater around his spinal canal. Deeper and deeper and deeper. God. God. Carter.
He pictures the needle entering the subarchnoid space, the fluid-filled sleeve running from Carter’s brain and down his spine.
Mark removes the stylet and readies the collection tubes as cerebrospinal fluid begins to dribble out. Carol cards her fingers through his sweaty mess of brown hair. Peter turns away. He doesn’t want to watch this. He doesn’t… he can’t… God. He can hardly think straight. Seeing Carter like this. He’s just a kid. He’s just a fucking kid. It’s not right. It’s not fair.
“Fluid is cloudy. High pressure.”
Mark’s voice is hollow. It feels like a death sentence, to Peter. Cloudy means bacterial meningitis. High pressure means severe swelling in the brain. Jesus. Jesus Christ. `
Peter looks over. At Mark. At Carter. At the needle protruding from his back like an impalement. Mark is looking at his hands. They’re shaking.
“Mark…” Peter says. He trails off. He doesn’t know what to say.
“I know. I know.” Mark won’t even look at him. The ER attending’s voice cracks. He looks close to tears. “Fuck,” Mark rasps. He shakes his hands out, steadying them. He screws the caps onto the vials and hands them off to Carol. “Okay. Okay. Carol. Get these to the lab. I want CSF cell count, glucose, protein, and a gram stain. We’re starting on broad-spectrum antibiotics right away. We need ceftriaxone. We need vancomycin. We need dexamethasone. As fast as you can, Carol. Go now.”
The nurse nods quickly. She gives Carter’s shoulder a squeeze before hurrying from the room.
Mark looks up at Peter, now. “This is bad.”
Peter looks away. He can’t bear to make eye contact. He stares at the window, with its shuttered blinds. “I know.” His heart pounds. His skin feels hot and itchy. It feels like an invisible hand is reaching up from his gut and wrapping its fist around his heart and squeezing. Panic.
Mark lets out a long, shaking breath. Steadies his hands. Peter watches as he slides the needle out of Carter’s back. He flinches at the sickening pop it makes as it exits all the way. Mark reaches for the tray and procures a small white bandage, which he plasters over the insertion site.
“Help me get him on his back, Peter,” Mark says quietly.
Together, gently, they uncurl the boy. Mark straightens his legs out. Peter takes him by the shoulders, carefully setting him down so that his head rests on the pillows. He nearly hisses at the heat that radiates off John’s skin as he lets the pad of his thumb brush up and down Carter’s cheek.
Peter reaches for the ear thermometer on the counter and places it in Carter’s ear.
104.8. Jesus.
“We need ice packs. And a cooling blanket,” he snaps.
“Malik is already on his way with them,” Mark replies.
At that moment, Carter moans. Both the doctors freeze.
Shit. Shit.
“Hey. Hey, Carter,” Mark says softly, crouching down beside the bed. He squeezes the boy’s hand. Carter whimpers.
Eyes open. Glazed and unfocused. “D-dad?” he whispers hoarsely.
Peter’s guts twist. “No, no, bud. It’s Doctor Greene. At County.”
Carter whimpers again. Tears leak from his eyes. “H-hurts.”
“I know. I know it does. You’re sick. We’re going to get you something for the pain real soon, alright?”
Carter lets out a broken sob. A shiver wracks his sickly body. Peter feels ill. “Hurts,” Carter chokes out again, and his face is scrunched up in pain, his lower lip trembling, his cheeks glistening with tears, and Peter can’t take anymore. He stumbles from the room, breathing heavily.
God. God. God.
In two months, Carter is supposed to become a doctor. He was going to become a resident, here, at County. He was going to be Peter’s resident. And now… and now…
He feels eyes on him. Concerned and scared and teary. Word has spread of Carter’s condition, then.
“Lydia,” he snaps, and the nurse straightens to attention. Peter’s chest heaves. He needs to get out of here. “We need… we need acetaminophen. Morphine. Naproxen. Stat. And find out where Malik is with those cold packs.” His tone is harsh and aggressive, but he does not care. He waits for Lydia’s affirming nod, and then he is off, pushing through the double doors, lurching into the ambulance bay.
It’s lovely outside. Blue skies, the sun shining. The temperature pleasant and unseasonably warm, hovering in the mid sixties. Early spring. Carter has meningitis. Carter has meningitis and his treatment was delayed. Carter might die. In the distance, Peter can hear music playing. It’s from the radio in that bodega stand across the street. The song is cheerful. Drums and plucky strumming from an acoustic guitar. The lyrics in Spanish, words Peter cannot understand. Probably something about love. Fuck. Fuck.
He stumbles. He presses himself against the wall of the hospital. Lets his back slide down, until his ass hits the concrete, his knees to his chest. He buries his face in them.
And then, against his will, tears begin to flow.