Chapter Text
𝐏𝐢𝐭𝐭𝐬𝐛𝐮𝐫𝐠𝐡 𝐓𝐫𝐚𝐮𝐦𝐚 𝐌𝐞𝐝𝐢𝐜𝐚𝐥 𝐂𝐞𝐧𝐭𝐞𝐫
𝐒𝐞𝐩𝐭𝐞𝐦𝐛𝐞𝐫
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Pittsburgh was a furnace compared to Seattle, especially with September in full swing.
The humidity was horrible, and turned her hair into a frizzy coup the second she stepped outside. It was a stellar start to what was shaping up to be one of the most legendary first impressions in medical history. At least she wasn’t like the fresh-faced interns or the wide-eyed med students, strutting around in their pristine, stiff scrubs and blindingly white shoes. Poor kids. PTMC was bound to be crawling with them, the classic learning facility frenzy. The place had all the markings of a typical inner-city EC. It was high-volume and high-stakes, exactly the kind of mayhem she was used to.
She took in a deep breath as she pushed through the revolving door, and was immediately met with the stale antiseptic funk of the packed waiting room. It was the same grim atmosphere as her old stomping grounds. Chin up, she walked through the metal detector and pressed her freshly-minted badge at the door scanner. To her relief, it gave a small beep and flashed green.
She charged in, and the electricity of the ER hit her like a freight train. Since when was the graveyard shift this high-octane? Everything was an overlapping roar swallowed by the sound of monitors and the sudden strobe of a trauma alert. Moot point for identifying individual voices. She barely had time to register the alarm before a gurney came flying through the double doors, flanked by a cluster of EMTs.
“Twenty-four-year-old male, MVC, rollover,” a paramedic rattled off to a few nearby nurses as they moved. “Unrestrained. Ejected partial. Found about ten feet from the vehicle. Altered on scene. BP dropping en route, last was seventy over forty. Heart rate one-forty. Pelvis unstable, left femur deformity, abdomen distended—”
She hissed a breath through her teeth, wincing sympathetically. Sounds like this one was chewed up and spit out.
“Any airway compromise?” one of the nurses, a woman wearing a grey hijab, asked.
The paramedic shook his head. “Protecting for now. GCS twelve-ish. He keeps trying to sit up.”
She flattened herself against the wall as they rushed past. Her eyes flicked to the patient, who was both extremely pale and diaphoretic. The monitor numbers were bad, worse than bad, and the EMTs didn't seem to have much hope either from the way they were shaking their heads. It was that moment when a lightbulb went off in her brain. It was a horrible idea, perhaps. She hadn't even made it to the locker room yet. Her badge still hung loosely from her hand, her coffee still hot in her other.
And yet, her feet began moving.
She rushed after the group into the trauma bay. She set her coffee down on the nearest flat surface outside the doors, then clipped her badge randomly onto her shirt. The nurses cut away what was left of his clothes, which revealed that the man's abdomen was indeed rigid and distended with bruises already blooming across the lower belly. His pelvis was shifted at an unnatural angle as they moved him and his left thigh was visibly deformed, rotated out. Not to mention the blood that was spattered and soaking through his clothes.
The laundry list was merciless: a shattered pelvis, a hemorrhaging gut, and a massive side of shock. This guy was in for a hell of a ride.
“Pressure’s dropping,” the hijabi nurse called out frantically. “We’re losing him.”
A different voice, belonging to a stern-looking but beautiful South Asian woman to her left, “Two large-bore IVs, now. Get O-pos. Activate MTP.”
The man tried to lift his head, his eyes unfocused as they moved around the room. "Where—" he started, but then his face pinched together and he dropped his head back down.
“Sir, don’t move,” one of the other nurses instructed firmly. “You’re in the hospital.”
“FAST,” a brunette woman with bangs ordered, and the ultrasound probe was pressed into the right upper quadrant. The screen flickered, and the woman grimaced. “Free fluid.”
“Trauma surgery paged?” another nurse asked as people ran in and out of the room.
“In the OR,” the brunette woman replied. “They’re tied up.”
Well shit, maybe the only difference between PTMC and UWMC was the zip code.
The patient’s eyes rolled slightly, not fully losing consciousness, but drifting toward it. His pulse was thready under her now gloved fingers, circling arrest. The brunette woman started to speak again, “Mohan, we should intubate—”
“Not yet,” the South Asian woman, Mohan, interrupted, cutting the woman off. “He’ll crash.”
Her gaze snapped from the brunette to scour the room, her internal radar pinging for whoever was running the room. An attending she didn’t recognize yet strode in, and he snapped on gloves while a nurse called out the vitals. For a heartbeat, her eyes locked with his, right as the pelvic binder was cinched tight and the patient flatlined into dead weight. A bag of units finally arrived, but the clock was running out. They were hemorrhaging time this guy didn't have.
Words tumbled out before she could even second-guess the impulse. Judging by the deer-in-the-headlights looks from the nurses and residents, she’d been essentially invisible until she opened her mouth.
“Get a REBOA kit.”
The closest nurse blinked. “What? Who—”
“REBOA,” she repeated, more sure of herself this time, but no less rushed. “Endovascular balloon.”
The nurse hesitated, and her eyes flitted around the room to gage reaction. The brunette woman appeared incredulous, all but snapping, “Who are you?”
She shook her head. “We don’t have time to wait for OR,” she explained, moving toward the patient’s right groin. “He’s exsanguinating. We need proximal control.”
The attending's gaze snapped to hers, then flicked down to the badge dangling crookedly from her scrubs. For a microsecond, a spark of intrigue flared in his eyes, only to be instantly smothered by wariness. Or was it pure irritation? He started to bark a protest, but it was too late; the room was already surging to follow her lead.
“REBOA cart is in the supply bay,” a tech supplied.
“Go,” she ordered, nodding absently.
The patient's monitor began to increase frequency of alerts, and his lips began to pale.
“Massive transfusion now,” she called out, then added, half under her breath, “If he arrests, we lose the window.”
She shed her jacket, and in that moment, she realized she wasn't even in scrubs. She was about to be the only legend on record to drop an arterial sheath while rocking scuffed jeans and a Seattle Kraken tee. A Hall of Fame first day.
Someone slapped chlorhexidine onto the right groin while she palpated for a femoral pulse.
“No pulse,” Mohan stated.
“Hang on...” she muttered, then reached for the ultrasound. The probe slid into place, and grey imaging appeared on the monitor...there. A compressed circle; femoral artery, small and collapsing, but present.
“Here,” she muttered, and guided the needle. She advanced it, and was met with a flash of dark arterial blood.
“Wire,” she instructed.
The wire slid in smoothly, thank god. The sheath followed, pushed into place, and then the REBOA catheter.
“Measure,” she murmured, eyes flicking to the markings. “Zone one. Xiphoid to groin...advance to forty-five.”
She moved further, then stopped and confirmed. “Initiate inflation.”
The nurse holding the syringe hesitated for a fraction of a second, and her eyes glanced toward the attending.
“Now,” she repeated, tilting her head, growing frustrated. The balloon inflated slowly and the monitor numbers stuttered, then began to fall even.
“He’s back,” Mohan commented, disbelievingly.
She could feel everyone's eyes on her, staring as if she was Victor Frankenstein himself.
“Keep transfusing,” she instructed. “Call OR again. He needs definitive control."
She stepped back, and her hands hovered for a moment over the sterile field as she assessed that everything was in place. That’s when she saw him properly, the attending who’d been trying to bore a hole through her earlier. He was hovering at the foot of the bed, and his gaze flickered between the catheter and her face. She scrambled to read the room, hunting for any tells, but the guy was a total vault. She mentally replayed his simmering, pissed-off expression and hit a snag. He hadn’t actually greenlit the REBOA. And since she’d just DIYd a somewhat invasive procedure without a mother may I, she was officially flying without a parachute.
She hitched a breath, then leaned into the plummet.
She locked eyes with him.
Isolated, they were actually striking; nice, warm, doe-eyed pools of brown. But right now, that softness was buried under a landslide of semi-controlled fury and something that felt dangerously close to judgment. The room continued to move as she stepped back. Nurses and docs gunned the gurney and monitors toward the elevators for the waiting OR. Mohan shot a look back at her and the attending as she headed out. The bay emptied in their wake, leaving her standing alone in the wreckage, spattered in a mosaic of blood and ultrasound gel.
Silence.
The attending pivoted, and she caught a jolt of pure adrenaline as she realized he was suddenly right in her orbit, barely a foot away. She tilted her chin up and dug her heels in to keep from recoiling. But fuck, he looked absolutely livid.
“Help me understand why you thought that was your call."
His voice was a gravelly monotone, flat enough to be neutral if she was feeling optimistic, though it reeked of contempt if she wasn't. For a split second, she felt like a preschooler caught drawing on the walls. But then she caught herself; he was just an attending, which put them on the same damn level. Maybe he was nursing a superiority complex, or a whole collection of complexes, or maybe he just had control issues. Probably all of the above.
She swallowed, and her pulse continued to race despite her mind rationalizing the situation.
"I—” she began, and then somehow managed to keep going. “He was in hemorrhagic shock. Pelvic instability, positive FAST, no surgical availability, systolic in the sixties. Binder and blood weren’t going to catch up fast enough."
"He was about to arrest.” she added, now thankfully sounding more clinical than defensive, “It was a temporizing measure. He needed perfusion long enough to get upstairs.”
After hearing the words out loud, the reckless insanity of the stunt finally hit her. But against all odds, he was actually tuned in, or at least decent enough not to cut her off. A small mercy, or maybe just the eerie quiet before he decided to unleash holy hell. When she finally ran out of air, the silence felt way more suffocating than the last.
“That’s not how we run trauma here,” he responded, rather elusively.
What the hell was that supposed to mean? Was this not an ED? Perhaps a circus?
She exhaled through her nose, blatantly frustrated with the man. “Then what would you have done?”
He dissected her for a beat longer this time. His gaze was stripping, very plainly weighing her worth. Maybe he was deciding how much triage-duty he could dish her, or perhaps a whole shift of rectal examinations. Either way, scut.
“Binder. Blood. Pressors if I had to,” he replied, with a borderline-toxic amount of confidence, which she translated as arrogance. “Intubate early. Push harder for the OR.”
“And if they still weren’t available?”
He didn’t answer immediately, still staring her down.
“It's my call,” he responded, firmer than before. “Waiting versus escalation. We don’t make irreversible moves unless we've exhausted everything else.”
She nodded slowly, weighing his words. “I didn’t think we had the minutes.”
He blinked a few times, then scrubbed a hand down his face, nodding toward the floor.
She flicked a look at the empty space where the REBOA cart had stood, then snapped her gaze back to him. The gears ground, then locked into a terrifying alignment. Oh. Oh, hell no. His overwhelming sense of authority, the way the entire room seemed to treat his word as law, and finally, that lethal: "It’s my call." This was him, the urban legend from Gloria’s exhaustive, read-this-or-die welcome email.
“You’re Doctor Robinavitch,” she stated, and her eyes went slightly wide. It was more of an observation than question.
“In the flesh.”
She straightened absently, brushing at her shirt where it had bunched at the waist of her jeans. “I should introduce myself properly.”
“I know who you are,” he responded, already turning back toward the charting station, signaling the end of the conversation.
“We’ll talk later." A beat. "After you've changed.”
Right. Dammit.
She stood still for a moment longer, then grabbed her jacket and bag and barreled through the trauma doors and back into the EC command hub. She kept her expression neutral, professional, even, despite her pounding pulse and the perspiration now forming on her hands and the back of her neck. She found a bank of lockers and sagged against the cool metal, squeezing her eyes shut.
What a fucking mess.
She had managed to tank her first impression with the one man whose professional validation was the only thing standing between her and a successful tenure.
She downed the dregs of her coffee, which was lukewarm and bitter, before tossing the cup into the bin on her way out. Finally, she was armored in her black PTMC scrubs. Her pulse settled, and the adrenaline burn receded. The EC was still a beehive, but now the glances hitting her were a little too pointed to be accidental. It was the classic ER grapevine, the same town gossip she’d been delusional enough to think she could leave behind in Seattle.
She was halfway to what she assumed was the charting station when a voice spoke through the background roar, calling her name. She pivoted, only to find Doctor Robinavitch, looking less like a trauma-bay surgeon and more like the grim reaper, looming near the central desk. His posture had shifted, gone from a closed-off wall of ice to something almost accessible. Friendly? No, that was impossible. A loose semi-circle of student doctors had already coalesced around him, some white-knuckling clipboards, others clutching tablets like life rafts. An assortment like a chocolate box, that group, but the common denominator amongst them was the usual: wide eyed and terrified.
Robinavitch gave a slight, feline tilt of his head as she approached. His hands now hung loosely at his sides in some kind of deceptive, predator-at-rest kind of ease.
“Alright,” he began, stepping forward and lifting his voice just enough to pull the small crowd into focus. “Quick reset. Listen up.”
The students snapped to attention like a row of toy soldiers. She held back a smirk.
“What comes through those doors is unstable until proven otherwise. Triage is up front. Trauma bays one and two are priority; if they’re full, you wait for me to tell you where to put the next patient. Radiology’s down the hall on your left. You don’t send anyone anywhere without clearing it with an attending on duty.” he gestured toward the central hub. “Charting lives here. If it’s not in the chart, it didn’t happen. If it didn’t happen, it’s your problem.”
There was a beat of silence, long enough for the students to trade nervous glances.
“Attendings run the rooms. Fellows and senior residents manage flow and supervise procedures. Ask questions if you're unsure. Stay with your assigned teams unless told otherwise.”
He paused for another beat before introducing her, throwing her a quick glance, “our new attending transfer from UW Medical Center. A few years of experience, apparently.”
She funneled every ounce of restraint and patience to her eyes to stop them from rolling. It was a Herculean effort. Gloria hadn't been exaggerating when she'd labeled the man as "irascible". She huffed through her nose and offered the group a small smile despite her irritation.
“Hello,” she greeted. “I promise I don’t bite."
They returned with a few smaller smiles and nods.
Robinavitch continued. “She’ll be working the block with Langdon today. Doctor King, you’re with them.”
Standing a few paces back was a doctor who could only be Langdon. He looked up, raked a hand through a mess of mahogany-dark hair, then flashed her a grin.
“Welcome to the circus,” Langdon chirped from the sideline, shifting his weight as he leaned against his charting desk.
So she was right about that, too.
She fought a smile, relieved to find a kindred spirit in the room. Nearby, Mel hovered. She was younger, more alert, and clearly trying to configure her messy surroundings. Definitely fresh-out-of-the-box. She caught the blonde’s eye and gave an encouraging nod, causing a layer of tension to melt from the girl's shoulders.
Robinavitch finished assigning roles, and when he was done, he looked back at her briefly. “You ready?”
“Yep,” she replied with a short nod. “Bring it on.”
He gave a single, curt nod, and his eyes narrowed in that trademark critical squint of his. He then pivoted toward whatever the hell was next on his chopping block. She watched his departure for a heartbeat, then shook him off, turning back to Langdon and Mel with a clap of her hands.
“Alright,” she beamed. “Show me what we’ve got.”
And so they started down the hall with Mel in tow.
“So, new-girl,” Langdon began, glancing sideways as they passed the supply alcove. “You want to tell me why half the department looks like they just watched someone juggle knives?”
She groaned, even though she anticipated it. This grapevine was highly efficient. “How subtle of you, Langdon.”
“I try,” he replied with a cheeky smile. “But I was stuck with a lac repair when the fun stuff went down, so now I’m living off scraps. What happened?”
Her eyes locked onto the pattern of the tiles beneath her feet as they walked. “I dropped a REBOA.”
Langdon stopped walking, and Mel ran into him, letting out a small yelp.
She took two more steps before she noticed and turned back. Langdon stared at her for a second, then broke into a grin, absolutely tickled. “On your first day?”
“Technically before my first day,” she corrected with a huff. “I wasn’t even in scrubs yet.”
“Jesus Christ,” he scoffed, shaking his head. “Robby must love you.”
She barked out a laugh, nodding theatrically. “Oh yeah. We’re best buds. Matching friendship bracelets and everything." she sighed, shaking her head. "He basically called me reckless.”
Langdon winced sympathetically.
“I asked him what he would’ve done,” she continued. “And he gave me the whole binder-blood-pressors speech.”
Langdon sucked in a breath through his teeth, saying somewhat solemnly, “For what it’s worth, if he didn’t think you were capable, you wouldn’t be standing here right now. He keeps competence.”
She raised a brow. "You know what, yeah, I was competent as shit in there. That guy would've died." she chewed the inside of her cheek. "But Robinavitch still looked ready to murder me."
“Well, he hasn't thrown you out—yet,” Langdon responded with a shrug. “Many have gone down for less.”
She nodded, sighing. “I’ll take it, I guess.”
They reached their first patient, who was a middle-aged woman clutching her wrist, clearly in a lot of pain.
“Alright,” Langdon began, slipping into work mode. “Let's see here...FOOSH injury, X-ray shows a distal radius fracture, nondisplaced, neurovascularly intact.”
She nodded. “Easy peasy. Splint and pain control.”
Langdon turned to Mel. “You want to walk us through your plan?”
Mel straightened, blinking up at him with wide eyes. “Uh...immobilization with a sugar-tong splint, oral analgesia if tolerated, ortho follow-up in a week?”
“Good,” she replied, smiling encouragingly. “What are you checking before you splint?”
Mel's eyes squinted for a second before she responded. “Cap refill, sensation, and motor function.”
“Exactly,” she agreed, nodding.
They moved around the bed, and Langdon drew up meds while Mel prepped the splint under their watchful eyes. It felt natural, correcting when needed and letting Mel do the work otherwise. She missed mentorship, a muscle she hadn't been allowed to flex much during the final stretch at UWMC. Another two years and she would’ve stepped into her old mentor's shoes as senior attending, commanding a whole fleet of students. But life had dealt a different hand.
As Mel pushed the meds, Robinavitch materialized at the foot of the bed, further proof of her grim reaper theory. She shot him a wary glance, then promptly looked away, opting for the irritatingly difficult task of pretending he didn’t exist. It was a losing battle. He stood so close that his shadow bled into hers on the floor. His gaze flicked from the patient to the monitor, then finally locked onto the syringe in Mel’s hand.
“Dose?” he asked, and the sound of his voice had her briefly glancing toward him, then away again.
“Ketorolac, fifteen IV,” Mel answered quickly, more nervous than before.
He gave a single, perfunctory nod as his eyes raked over the splint setup, traveling from Mel to her. For a fraction of a second, she braced herself, certain he was finally going to break his silence and deliver a verdict.
“Page me if there’s neuro changes,” he instructed Langdon, even though she was closer, already stepping out of the room.
The silence he left behind lasted all of two seconds. She groaned dramatically as soon as the door shut behind him, dragging a hand down her face. “I told you. He absolutely despises me."
Langdon bit back a smirk. “Guess you really did make a great impression this morning, maybe even better than mine.” he paused, shivering, "Which says a lot."
Mel glanced between them, confused. “Is he usually that...detached?”
“No,” Langdon replied with a sigh. “Trust me, silence is neutral, and neutral is good. He's a great teacher, really, I think he's just having a rough week.”
She exhaled, rolling her shoulders. “Love a man of mystery.”
Langdon tsked. “Give it time. He’ll warm up, he's a big teddy bear at heart.”
It wasn't bad. Manageable, even.
She cycled through the rest of the student rotation in a blur of passing introductions. Trinity Santos was the immediate standout, her favorite by a mile, and they managed a brief moment in the lounge to trade numbers. Dennis Whitaker was a sweetheart, earnest enough to be genuinely endearing; he put her in mind of a nervous but well-meaning barn mouse. Then there was Victoria Javadi, the daughter of Doctor Shamsi, if the rumors were right, who was smart as a whip and twice as eager. She was almost intimidatingly brilliant, though she carried a certain stilted social frequency that hinted at long-term tutoring or homeschool.
The Pittlings were exactly what she remembered being at that stage. Exhausted, overwhelmed, and trying very hard to hide it behind large cups of coffee and Redbulls. She met Dana Evans too, finally, who was stationed at the command center hub. She immediately took a liking to Dana, who was somehow both tough as nails and the most compassionate person in the room.
A few of the other residents and surgeons floated in and out over the course of the day. They had quick introductions of firm handshakes, and she managed to file some of their names for later, including Garcia, Shamsi, and the night shift: Walsh, Miller, and Shen. No one treated her like a novelty or questioned her being there, which was a huge relief, and helped more than she wanted to admit.
And Robinavitch...or Robby, as everyone called him, though she didn't feel like she'd earned the right to call him that yet. He remained a complete enigma, exactly as incomprehensible as he’d been at the start of the shift. He’d drift in once or twice, drop a few brief observations, and then vanish. A total apparition.
This was unsettling for her, as Langdon had run off on multiple occasions throughout the shift to meet up with his best bud Robinavitch. She could've guessed they were friends from the way that Langdon had defended him earlier, but it was still frustrating to watch how Robinavitch showed actual emotion, and dare she say happiness, when him and Langdon would fuck around by charts. Then Langdon would come back and Robinavitch would be wiped of all humanity. Maybe that was a bit dramatic, but the point stands.
By the time the shift ended, she was exhausted, feeling like she earned the right to be from the amount of people she helped and all the names she'd learned. And maybe Langdon had been right, maybe first days were just like this. Maybe tomorrow would be easier.
»»»
It was not.
She drifted downstairs early the next morning, mostly out of old habit. Also nerves, if she was being honest with herself. But this time she was better prepared. She was wearing clean scrubs, her hair cooperated for once, and her bag was packed with everything she’d forgotten the day before. She was level-headed and determined not to make any more first-day legends. The plan was simple. She'd get a jump on charting and maybe poach a patient or two so the night shift could catch an early break.
She pushed through the staff entrance and immediately spotted the man that had been sitting in the back of her mind for the past twenty-four hours. Robinavitch was already dug in at the central hub, completely engrossed in the nightshift charts. He was wearing his glasses, which, for whatever fucking reason, actually looked damn good on him, framing the focused intensity of his gaze. A half-drained coffee sat at his elbow, the only sign he wasn't a robot. Did he actually beat me here? It was technically impossible, yet he looked like he'd been there all night, running the place in his sleep.
It was the prime window to attempt a peace treaty, or at least a ceasefire. She didn’t think she could survive another twelve hours with her boss skating around her like she was carrying a highly infectious strain of the plague. It was a total shot in the dark, but a necessary one. She desperately scraped her brain for any shred of common ground, but the man was a locked vault; he didn't have a single tell at his workstation or on his person that hinted at a hobby, a favorite sports team, or even a life outside these walls.
She narrowed her eyes, zeroing in on his zip-up. There, embroidered on the chest, read, Beers of the Burgh. She hesitated. Asking her superior about a craft beer festival at six in the morning felt like a fast track to being labeled the department alcoholic. Or maybe he was one. Either way, definitely not a viable option. She pivoted, thinking harder. He was a guy, and guys usually liked things that went fast and made too much noise, right? There was that insanely sexy Triumph Bonneville parked right outside in the staff lot.
Fuck, whatever, this was probably going to implode in her face, but she was going in.
"Did you see that a Bonneville out back?" she asked, keeping her tone breezy as she drifted toward the board to eye the patient list.
How she managed to not cringe at the god-awful line was beyond her comprehension. That said, if he actually took the bait, it was the perfect opening to then mention the bike’s aesthetics, the engine, or whatever the fuck, anything to serve as a bridge over the obvious gap between them.
Robinavitch let out a noncommittal hum, but he didn't even grant her a sympathetic glance, let alone a smile. At this point, he had to know she was fishing for a conversation, and he was clearly refusing to bite. She waited a beat, then another. Still nothing. Defeated, she shifted her weight and leaned in slightly, squinting at the chart he was currently dissecting. If he wasn't going to talk to her, she’d just have to hope she could absorb his expertise through osmosis.
“Hyperkalemia on the guy in bed four?” she asked, nodding toward the screen.
It was a blatant move to shop talk, but sure enough ding-ding-ding his head finally lifted.
“What do you want to know?”
It was a reasonable question, but the delivery was loaded with attitude. This took form in the slight curl of his lip and that judgmental arch of his brow that rubbed her the wrong way. She stopped dead in her tracks, and she blinked up at him. She could feel her ass-kisser mask slipping.
“Are you—why are you acting like this?” she blurted out, her annoyance finally outstripping her nerve.
He stared at her for a beat, and his expression was blank, maybe even a bit entertained. Oh fuck off, Robinavitch. Then he said, irritatingly calm in its delivery, “Do you want to see the chart?”
That wasn’t even in the ballpark of an answer. Not even close. It definitely wasn't the olive branch she’d been aiming for. She let out a tired breath through her nose as her carefully curated morning zen was officially starting to fray.
“No,” she replied, a few degrees icier than she meant. She shook her head, stepping back and giving him the distance he so obviously craved. “Whatever. I’ll just ask Frank."
It was a total power move to drop the first name of a guy she’d known for all of twelve hours, but she was desperate to pry some kind of reaction out of Robinavitch.
Bingo.
He glanced up again at the mention of Langdon. She nearly doubled down with a snarky parting gift just to return the favor, but she managed to bite her tongue. She fled before she could stand waiting for something he clearly wasn’t offering. Score one for her being the bigger person. Pissy-pants Robinavitch, or Rabbit-bitch, as Garcia so eloquently put it, would be the death of her. Between the rancidly bitter black coffee and that "thou art weary" expression he wore like a shroud, he was too much.
She didn't even have to look back to know he was already buried in his precious charts. The world according to Robinavitch would resume another cold rotation.
She headed down the hall, and irritation buzzed under her skin. So much for he’ll warm up. Langdon was either a terminal optimist or in a state of deep-seated denial. Robinavitch remained exactly this. Closed off, curt, and professionally impenetrable. And yet, a thought gnawed at her. She still wanted him to see her, to acknowledge that she was more than just a body filling a position. She didn't have anything to prove, objectively speaking; she had the degrees, the certifications, and the awards to back up her ego. She was good at this, great, even. But in the shadow of his silence, all those accolades felt like participation trophies. To him, she was still an unvetted variable in his domain.
She scowled as she hit the lockers, and shoved her bag into her locker with a thud.
Despite the rocky start, the shift wasn't all too shabby. Mel took the lead on more of the routine rounds, which let her and Langdon hang back. They fell into easy rapport, leaning against the central station’s laminate as they traded notes on the best bagel spots in the city. It was a relief to be treated like an equal, or at least a human being, while they talked shop. Between discussing weaning protocols and vent settings, she even learned Mel had a sister, Becca. For a few hours, the oppressive weight of Robinavitch felt like a problem for a different floor.
Dana’s voice interrupted them mid-triage, breaking the chit-chat: “Incoming. Two minutes out. MVC, high-speed. Five patients total. Three sent to Presby, two here.”
Robinavitch materialized out of thin air, wow, surprising, and immediately ordered all hands on deck. “Trauma One and Two. Split the room.”
His gaze cut to her, and his eyes narrowed briefly, as if surprised to see her. "Your move on critical, let's see what you're made of."
She stood frozen. Her eyes widened momentarily before she shook it off. This was it, a tactical reset. Maybe this was the second chance she needed to finally stick the landing.
“Langdon, with me,” she instructed, rushing over to prep. “Mel, stay with Mister Ansari here.”
The doors burst open less than a minute later.
“Thirty-two-year-old male, driver, T-boned at intersection,” a paramedic explained as they rolled the first gurney in. “Airbags deployed, restrained. Decreased LOC on scene. BP eighty systolic, HR one-thirty. Obvious chest trauma, left-sided breath sounds diminished. Abdominal tenderness...”
Langdon was beside her, snapping his gloves on as his eyes moved over the patient.
She moved to the head of the bed. “On three. One—two—three.”
They transferred him, and the monitor came to life. “Okay,” she began as her eyes read the lines. “Santos, two large-bore IVs. Pressure bags. Type and cross, CBC, CMP, coags.”
Santos nodded, busying herself. Langdon shook his head. “Breath sounds diminished on the left.”
“Agreed,” she replied. “He’s altered and dyspneic.”
Garcia appeared at the edge of the bay, crossing her arms at the scene in front of her, having been paged. “You thinking chest?”
“Chest first,” she responded. “Then airway.”
Robinavitch stood just outside the blast radius of the bed with his hands on his hips. His eyes scanned the room like he was watching a chessboard. He hadn’t said a word yet, but he wasn’t scolding either, which she took as a win. For now, her hope remained high.
The patient gagged as he tried to roll his head to the side.
“Sir, stay still,” Langdon ordered. “We’re getting you squared away over here.”
She leaned closer, and her eyes flicked between the vitals and the mechanism. There was signs of a seatbelt across the chest, presenting as bruises blooming along the ribs, and his hypotension wasn't responding to the first bag of blood Santos had already spiked.
“Tension pneumo until proven otherwise,” she concluded, taking in a breath. “Langdon.”
Already done. The needle went in, and a hiss of escaping air followed. The monitor responded almost immediately.
“Good,” she added. “Prep for intubation. He’s not protecting.”
Garcia tilted her head, scowling. “You want the tube now?”
“Yes,” she nodded, “If he arrests, we lose him.”
Garcia’s scowl deepened. “That’s a pretty bold assumption, Seattle. You planning on running an ICU here?”
She almost laughed at the name, or she would have, if she weren't being openly disrespected in front of her entire audience of peers. Langdon shot her a look, and his brows quirked just enough to signal he was ready to play backup; he usually had a witty comeback chambered and ready. She shook her head, keeping her hands moving at the same breakneck pace.
“He’s hypotensive, vomiting, and altered,” she replied briskly. “He aspirates, we’re chasing hypoxia on top of hemorrhage. He arrests, we’re doing hopeless compressions. I’d rather control the airway now than lose it later. Thanks.”
Garcia scoffed, shaking her head disapprovingly. “Or you paralyze him, tank his pressure, and hand me a corpse.”
Before she or Langdon, whose mouth was open and ready for retort, could utter a word, Robinavitch closed the gap. He looked genuinely pissed, a strong contrast to his usual clinical patience.
"Garcia," he snapped, taking a step forward. "Enough."
The room went dead silent, and every head snapped in his direction, synchronized. Her jaw threatened to hit the floor, but she clamped it shut just in time. He was actually stepping in to defend her? Over Garcia?
Garcia opened her mouth, looking affronted and equally shocked, but was cut-off again.
“She's accounted for hemodynamics,” he began, though he was still refusing to meet her eyes, dead-staring Garcia. “If you want to argue airway timing, do it with me, after the patient is stable.”
Garcia held his gaze for a second longer, glaring. She then looked back at the patient with a frustrated exhale. “Fine,” she muttered, holding her hands up as if in begrudging surrender. “Tube him.”
The room resumed motion immediately.
“Pre-oxygenate,” Langdon ordered. Was he smirking? Perhaps a trick of the light. He adjusted the bag.
“Etomidate. Succinylcholine,” she added to that, blinking out of the odd haze brought on by the interaction. Christ, Robinavitch-induced whiplash. “Low-dose push. Santos, be ready with Pressors.”
Santos nodded, swallowing once but looking thrilled for it. “Ready.”
The patient gagged weakly, and his chest began heaving. Medications went in and the patient went still.
“Tube,” she ordered, and Langdon slid it in cleanly.
“CO2 confirmed,” Santos called out. “Chest rise...left still diminished.”
“Chest tube,” she instructed.
Garcia was already there, and her irritation was replaced by focus. “I’ll place it.”
“Go,” she responded, knowing that disrespect wasn't a good enough reason for the patient to be denied the best surgeon in the room. And in a few moments the tube was placed; a rush of air, then blood.
“Output?” she asked, nodding absently to herself.
“Two hundred,” Santos replied, now openly grinning.
Robinavitch stepped closer now, scanning the setup, the blood products, then the vent. “FAST?”
“Positive,” she replied. “Abdomen’s rigid.”
Garcia nodded. “I'll take him. He’s coming up hot.”
“Do it,” Robinavitch ordered. “We’re not waiting.”
The patient’s pressure continued its sluggish crawl upward. It wasn't a victory, but he was breathing, which counted as a win. They hit the floor running as they funneled the bed toward the elevators. She stayed rooted to the spot for a beat, and her fingers twitched at her sides while her brain whirred at max capacity. Nearby, Garcia ripped off her gloves with a violent snap and scorched her with a parting look.
“You better be right,” Garcia called from over her shoulder as she went to follow the gurney, though there wasn't as much heat behind it as before.
She nodded. “I know I am.”
Langdon let out a low whistle behind her, his grin mirrored perfectly on Santos’s face.
“Alright, we're done here." Robinavitch muttered with a nod of his head. Then he turned and walked away, moving on once again.
So much for that.
She finished charting on autopilot. Her shoulders ached now that the adrenaline had worn off. There was dried blood on the cuff of her sleeve she hadn’t noticed, and she scrubbed at it absently with a wipe. She signed off, logged out, and leaned back from the workstation, rolling her neck. She turned to the sound of typing, only to find Robinavitch standing down the hall at the counter near Trauma Two, charting. One of his hips was leaned against the laminate, suggesting he’d been there a while. For the first time, the machine looked human, and absolutely exhausted.
She lingered, caught in an awkward vacuum. She was running on fumes, but this felt like a pivot point, a necessary move if she was ever going to survive working in his orbit. She pushed off her chair and headed down the hall. She kept her footsteps intentionally loud on the linoleum to give him fair warning, or a chance to bolt. When she reached him, she tapped the counter lightly with her knuckles, catching his attention.
“Hey.”
He didn’t look up, though his hands stalled over the keys for a fraction of a heartbeat. Wishful thinking, maybe he’d just hit the end of his rights. She found herself tracking the flex of his fingers, mesmerized by the dance of the cursor across the screen. She had to forcefully clear her throat just to break the spell, and she managed to tear her gaze away from the movement of his hands.
“I just—” she stopped. Rambling was definitely a downward spiral. “Thanks. For back there.”
There was a pause, long enough for her to start taste-testing the regret of opening her mouth. Then, his head inclined in a nod so slight it was almost microscopic. Perhaps another trick of the light.
“Mm,” he hummed.
That was it. No "you did fine," no "Garcia was out of line", not even a consolation prize of a reprimand. She would've settled for a lecture just to feel some friction. She let out a huff and turned, bailing before the silence became awkward. Her pride flared up right on cue; she’d said her piece, and that was supposed to be enough. She headed back toward the treatment area, perhaps to find Santos.
Behind her, Robinavitch’s fingers stilled. He looked up then, just briefly, long enough to watch her walk away.