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The rumours about John Carter are, to the staff at County General, a most irresistible and mutable form of gossip. Ever since Jerry pulled out that magazine and pronounced Roland Carter’s name, everything about their new medical student’s background has been a topic of discussion, from the tailor that ensured his white coat was the right length (Lydia insists it must have been Burdi’s) to the ridiculously expensive preparatory school he attended as a boy (its fees equaling the average nurse’s salary).
The parental kindliness they all bestowed upon him during his first few weeks and months has been lost somewhere among the speculation. Carter has become an object of intrigue. Though his demeanour has hardly changed, they can no longer see him as a lost lamb in need of instruction: for many, it's not even a conscious decision. The knowledge of his wealth simply lingers in the recesses of their brains as they watch him fumble in a trauma, and their command comes out snappier than usual as a result.
He is a wonder, yes, but he is also fundamentally different. They cannot connect with him like they once thought they could. He is the glittering gemstone in the shop window, perfect to point at and create hopeless daydreams about, yet ever out of reach.
All this is to say that the staff at County General (Mark included) believe they have Carter and his kin firmly figured out.
Six months into his working there, though, they realise they're greatly mistaken.
“Dr Greene?”
“Mhm?”
The ER is slow today, so Mark has dedicated some time to the almost meditative act of suturing, tucked away with a drunkard who makes no complaints about his needlework. For a while, he's been left to his own devices here, but Lydia's presence in the doorway surely means he's going to be pulled away imminently.
“Carter’s here.”
Mark hums again, still distracted by the rhythmic motion of thread through flesh. “He's a little early. His shift doesn't start ‘til eight.”
In his peripheral vision, he sees the nurse shift uncomfortably on her feet. “No, I mean- he isn't here to work. Apparently he fell down the stairs? He's with his father.”
Each word is uttered with a hint of incredulity, and Mark can't avoid the intrigue himself. He pushes the rolling stool he's sitting on away from the drunkard’s gurney and pulls off his gloves.
“He alright?”
Lydia makes an odd face, like she's swallowed something unpleasant. “I'm… I'm not sure. I think you ought to come and check for yourself.”
It has all the trappings of one of Doug’s practical joke setups: he's being drawn away, egged on by the prospect of a spectacle that can't be explained but must be witnessed. When he does leave the suture room, therefore, he half anticipates a childish jumpscare as a reward for his foolishness.
Instead, he finds an angular, cold-looking man at admit, his hand tightly clasping the shoulder of none other than-
“Carter.”
The medical student glances up, a brief flash of surprise giving way to relief when he recognises the one calling his name. He doesn't look particularly ill, but his skin is a little paler than usual, and his eyes have a certain glassiness to them that Mark can't be sure is all down to the lighting.
The man standing beside him- Carter’s father, presumably- clears his throat. Smiles. It's faintly crocodilean, but Mark allows for the possibility that he’s being influenced by the stern propriety of the man’s suit.
“Hi.” He greets, gaze flicking from student to father. “My name's Dr Greene, I'm the chief resident here in the ER.” Back to Carter. “Lydia said you fell down the stairs?”
The boy flinches a little, flushing with embarrassment. His hand creeps up to rub at the back of his neck.
“I… yes, I did. It was ridiculous, really, I was just coming down and-” He looks up briefly at his father, as if to gauge his reaction, stumbling over his words when his gaze returns to Mark. “Well, I lost my footing. I’m fine, but Father insisted I get checked out here. Y’know how parents are.”
It's… odd. Mark knows now why Lydia wore that expression, why she couldn't quite explain her discomfort but felt it all the same. The words Carter speaks are perfectly reasonable on paper, and yet something about the way he speaks them makes Mark’s stomach turn. There's a desperation in them, in the breathiness of his voice.
Or is this just another attempt to find intrigue where none exists?
“Sure.” Mark says, gesturing towards one of the empty exam rooms. “Why don't you come over so I can take a look? Better safe than sorry.”
Obedient as ever, Carter follows.
As does his father.
In the exam room, the boy hops up onto the bed, fingers curled around the edge like he's ready to make a quick exit whenever required. His father hovers nearby, casting a shadow over the whole affair as Mark steps forward.
“Alright, where does it hurt, bud?”
Carter smiles sheepishly. “My head, I guess. And my wrist. I was concerned about a distal radius fracture but my range of motion isn't too bad so maybe I just bruised it?”
“Let me see.”
The boy allows Mark to take his wrist in hand, but remains oddly wary throughout the whole examination. When the resident concludes that it isn't broken, Carter sighs with relief and withdraws it immediately.
“Good… good.”
“Now for your head. Whereabouts is the pain?”
“Roughly occipital.”
Mark runs his fingers through the student’s hair to check for injury and stumbles upon a rather large bump right at the back of his head. The moment he reaches it, Carter cannot help but hiss, and Mark doesn't miss the way that his father’s hand tightens a fresh grip on his shoulder.
“Sorry.” The boy murmurs, though to whom it isn't clear. “It's a little tender.”
“I bet… Did you lose consciousness at all?”
Carter opens his mouth to speak. The words come from his father’s lips instead.
“Briefly.”
Mark glances at the terse man still hovering, then back at Carter, frown wavering on his face. “Right. How long?”
“A few seconds.” The father again.
“Carter, is that right?”
The boy doesn't have to share a look with his father this time. He simply nods.
“Any dizziness? Nausea?”
A shake of the head. With each second, it seems Carter is withdrawing more, and the man at his side growing larger in stature.
“Is this going to take much longer? We have a family dinner this evening and John must attend.”
“We'll be as quick as we can. I'd just like to make sure Cart- John is well taken care of.”
The man huffs. Evidently, his son's care is little more than an irritating detour from everyday life, a chore that needs to be attended to. Carter, meanwhile, is looking down at his own feet, kicking his legs back and forth like a bona fide child. His cheeks have flushed a fiery red.
“I'll be back in a sec.” Mark tells him. “Stay put, alright?”
“Yes, Sir.”
When Mark returns, Carol Hathaway at his side, he's surprised to find that Carter's father is no longer in the room.
“Where’d your Dad go?”
The boy looks up, blinking curiously as though he's only just coming to the realisation himself. “Oh. I think he had to take a call.”
“I see. Do you mind if I let Carol take a look at the bump on your head?”
A small nod. The charge nurse moves closer, standing behind the bed and running her fingers through Carter's hair just as Mark had done prior. When she hits the same bump, the frown that settles on her face is one of deep concern, and Mark knows she's considering the discussion they'd had before entering.
Something isn't quite right.
Why'd you say that?
I don't know. It just doesn't add up. Kid’s got a goose egg on the back of his head but he's injured his wrist pretty badly too. Did he break his fall with his hand or not? If he did, when did he bump his head?
Could’ve been at the bottom, I suppose.
Maybe, but this isn't a minor hit. He knocked himself hard, Carol. I just… I don't like any of this.
“Ouch.” Carol says gently. “Looks pretty sore.”
Carter nods.
“How did you do it?”
He freezes. Blinks. Screws his face up gently, like he's trying to remember the answer to a quiz question, then seemingly relaxes when he finds it.
“I tripped. Knocked it on the, um, edge of a table.”
Carol meets Mark’s eyes, frown deepening. She doesn't have to speak for her question to be deciphered.
That wasn't the story, right?
The resident shakes his head as subtly as he can manage.
No. No, it wasn't.
He pulls a stool over from the corner of the room and settles into it in front of their unlikely patient, hands on his knees, voice unthreatening, unaccusatory.
“I thought you said you fell down the stairs, bud.”
Carter looks to him, and the eyes that Mark meets are so awash with confusion it breaks his heart.
“Oh. I… maybe…”
“You can't remember?”
“N-no, I-” The boy scrubs frustratedly at his face and inhales sharply. “I fell down the stairs, and then when I- at the bottom of them there was a table. I went right into it.”
It feels almost cruel to push him any further, but Mark has to discern the truth, and right now everything seems far too tangled up.
“And what about your wrist?”
At this, Carter's story unravels. He stares down at his own wrist like it's foreign to him, twisting it carefully this way and that as though the circumstances of his fall will be written on the underside. He comes up empty. His mouth opens and closes, throat working, eyes still blinking in confusion, until Mark rubs him on the shoulder.
“Hey, it's alright. Look, Carol and I need to make sure we haven't missed anything. Can you unbutton your shirt for us, bud?”
It's almost scary how soon he complies. When he arrived, Mark could've sworn he was more coherent and put together, but with every moment that goes by he seems to lose some of it. Shock, perhaps?
He struggles to unbutton his shirt, so Carol wordlessly steps in to help. By the time she’s aiding him in getting his arms out of the sleeves, he's totally pliant beneath her touch. It's enough to bring Mark to the door, poking his head out and gesturing for the nearest nurse (it happens to be Haleh) for assistance.
“Could you get Carter lined up for a CT? Soon, if possible.”
Haleh’s face falls. “Oh. That bad?”
“I don't know yet,” Mark says with a weary sigh. “But something isn't quite right with him and I want to be on the safe side.”
“Sure, sure.”
“Thanks, Haleh.”
“No problem. I'll let you know when they're ready for him.”
It's a matter of seconds that he's not looking at Carter, but somehow, when he turns back, everything has changed. Carol is trying her best to maintain normalcy, folding the boy’s shirt slowly and methodically despite the shaking of her hands, and Carter is…
Carter is covered in bruises.
They begin at his collarbone, just below the neck of a scrub top, and do not end until his bare skin does. Some are small, more vibrant purple pinches that appear recent, while others paint murky swamps of green and yellow across several inches of skin in one brush stroke. They're all in various stages of healing. They're certainly not the result of a single fall, nor any simple fall, for that matter. The ones that sicken Mark the most outline the boy’s ribs. They quiver with each breath, and are undoubtedly excruciating, not to mention the work of brutal force.
Jesus Christ.
So many questions swirl in Mark's mind, and yet he can find the courage to utter none of them. It takes the realisation that the absence of Carter's father is bound to be temporary for the words to at last break free. He crouches in front of the badly beaten boy, and murmurs,
“Who did this to you?”
Carter is quiet. His gaze is growing more detached by the second, drifting this way and that without settling.
“Carter? John?”
He blinks again, then finally meets Mark’s eyes. The lack of coherence in them is frightening.
“D’y’know when… when m’Mom’s coming t’get me?”
The chief resident feels sick to his stomach, and it takes all his energy to tear his attention away for even a moment to address Carol.
“We need a rush on that CT.”
“Got it. I’ll go- Mark.”
He barely has time to register her warning before Carter is toppling forwards, his eyes rolling back, his limbs heavy and limp. It’s only by luck that the boy’s head meets Mark’s hands instead of the solid metal railing, that Mark is able to hoist him up and lay him on the gurney without further injury.
This isn't a temporary faint, either. When his name is called, Carter does not stir, and a sternal rub accomplishes nothing but a weak curling inward of his shoulders. Carol has enough initiative to call for assistance and drag the crash cart closer- just in case- while Mark peels back the student’s eyelids in turn and lets his flashlight beam dance over unseeing eyes.
“Carter? Wake up, bud. Come on, Carter, come on.”
The result only confirms his worst fears. One pupil is noticeably larger than the other, and neither react to the light as they should. All at once, it's no wonder that the boy isn't waking up.
He has a bleed on the brain.
Mark kicks up the brakes on the gurney and rapidly pulls up the railings.
“Alright, Carol, we're moving.”
“Where to?”
“Trauma one, two, it doesn't matter. When we get there, I need as much O negative blood as we can get, I need neurosurgery down here, and I need as many hands in that room as possible.”
And then they're out, bursting through the doors of the exam room and barrelling along the corridors towards the trauma rooms. Inevitably, they don't go unnoticed, especially not when nearby staff realise who it is they're transporting.
“Carter? What the hell happened?”
“Jesus Christ.”
“What do you need?”
They reach trauma two, and the gurney hasn't even halted before nurses start hanging blood bags and preparing IVs, plastering EKG stickers on a bruised chest that heaves with uneven breaths. The moment the monitor flashes to life, it becomes evident that Carter is tachycardic, hypertensive, and well on his way to being apneic too. There isn't enough time. All the while they were talking to him, the space between his brain and his skull was filling with blood. Who knows how much he's lost by now?
“He needs a CT.”
“I don't know whether one's available-”
“It doesn't matter. We're going up now.”
And they're moving again. Mark hopes his panic isn't showing, but it certainly feels as though he's running around like a headless chicken. Where the hell is Dr Morganstern? Hicks? Anybody of a higher status to take over, to stop their student from bleeding out?
Somehow, they make it up to CT without Carter crashing. Everyone stands outside while he's engulfed by the whirring machine, nobody quite sure whether they're witnessing a decline that can’t be reversed. The results, when they do come, confirm it.
Aside from the catalogue of previously healed broken bones, the most terrifying finding is an epidural hematoma. More specifically, a posterior fossa extradural hematoma: a large (life-threatening) collection of blood between the occipital bone and the dura mater.
Throughout his career, Mark has only seen a handful. They're rarer than hens’ teeth, because the brute force required to break the occipital bone enough to induce bleeding is staggering. If there were any uncertainty about the situation before, there isn't now. Carter didn't fall down the stairs. Somebody, most likely the man who's been attempting to puppeteer his own son since their arrival, slammed his head into a hard surface. Possibly repeatedly, judging by the size of the hemorrhage.
Now is not the time for retribution, though. The boy is in need of surgery immediately, and with their newfound evidence, he should have an undisputed ticket to the OR.
“Get him out.” Mark says to the CT tech, impatient.
“I'm already on it, Dr Greene. You know as well as I do that these things move slowly when you least want them to.”
He doesn't care. Time is of the essence, and every second they spend out here is one that could be spent evacuating the blood putting dangerous pressure on Carter's brain. They've already wasted enough; any more would be-
“He's seizing.”
Never has Mark been more bitter about being right. Before the machine has even been shut off, he shoulders through the door, and thankfully there are other hands (Carol, Haleh, and Lydia’s) to assist him in getting Carter back onto the gurney. Battered, bruised, and now convulsing, the boy is deteriorating rapidly. It doesn't take much for Mark’s mind to be made up.
“Lydia, get that crash cart over here.”
Carol, trying to maintain Carter's airway by keeping his chin tilted just so, glances up. “What are you doing?”
“Tubing him. If I can sedate and paralyse him, we'll minimise damage and streamline things for surgery.”
She doesn't object. Just keeps a hold of Carter's cheeks until the line in his arm has been established, and the pavulon and sux muffle his movements into nothingness. Mark focuses on the intubation. He tries to convince himself that the lack of gag reflex is a consequence of the paralytic, as it usually is, but in the back of his mind he's aware that this might not be true, that he might have been able to slip a tube down Carter's throat even before the medications.
In the end, none of it seems to matter. Neurosurgery finally arrives to whisk Carter away into theatre, and the ER team are left shell shocked in the aftermath. Something about the lack of blood on their scrubs makes everything feel so much worse. At least after a rough trauma downstairs, there is evidence to scrub away and cleanse oneself of. Gaping wounds on a patient’s body are serious, but they're visible, and the vivid crimson spurting of an arterial tear may not be pretty, but it points to the beating of a heart.
When all is still and cold and pale, where’s the evidence of life?
Mark swallows back bile.
“If anybody needs me, I'll be… I'll be outside.”
Carter's father doesn't return. Perhaps the bastard anticipated that the truth would be revealed, or perhaps he simply didn't care enough to stick around long enough to see whether his son survived the attack. Either way, Mark’s story is unchanging when the police come to take his statement: while he knows it isn't his job to make assumptions, he's certain that Mr Carter is responsible. Carol corroborates.
The boy remains in surgery for hours on end. Peter, who had been operating on another patient when Carter was brought in (and whom Mark was eager to inform the moment he scrubbed out), finds out about his student's condition by accident. According to the nurses’ chatter, he walks into the OR demanding to know where his student has gotten to, only for the patient under the drapes to bear Carter’s face. It renders Peter speechless, apparently. Not that Mark witnesses it. He spends a great deal of the time between simply sitting outside the ER, watching the ambulances roll in and absently waiting for his pager to beep with news of Carter's status.
Susan’s the one to break him out of his stupor. She settles into the bench beside him, and they sit together, lit only by the intermittent red and blue of the sirens, until at last she decides to speak.
“I’m sorry I wasn't there sooner.” She begins, voice low. “There was an LOL in exam two who just wouldn't stop talking, and by the time I got out, you were already upstairs.”
Mark swallows. “You don't have to apologise for doing your job,” He tells her, when really he’s rankling with injustice. Why was this his cross to bear? Why his guilt, his horror, his fear? Even Peter, the boy’s mentor, didn't have to witness the grunting and rolling eyes of Carter convulsing. Neither he nor Susan nor Doug had to see the boy’s terrifyingly rapid decline.
“The police are out looking for his father.” Susan continues, oblivious to his simmering thoughts.
“I hope they put a bullet in his skull.” Mark grits out.
Next to him, he can feel Susan prickle with shock, maybe even disgust. She has no right to judge him, though, and he won't apologise for his brutality, no matter how much it disquiets her. Perhaps that makes him cruel, but he's seen enough cruelty for one day to know that it doesn't even touch the surface of what's possible.
The thought that anybody could beat Carter is sickening. The thought that his own father could is far worse. Mark tries to imagine what it would be like to lay a hand on Rachel and feels cold sweat on the back of his neck, blood rushing through his head. He couldn't. He just fucking couldn't.
“He'll be okay.” Susan says at last.
Mark doesn't reply.
An hour or so later, when he's alone again, the bell finally tolls in the form of his pager’s shrill shrieking. Carter is out of surgery. He lingers outside another fifteen minutes before biting the bullet and slipping back into the ER.
The boy is, unsurprisingly, in the ICU. Mark has to survive several interrogations to even get close to him, and when he finally does open the door to Carter's room, he's not the only visitor there. Peter Benton is sitting in a chair against the wall, arms folded, eyes fixed on his charge. He gives Mark little more than a perfunctory glance.
Carter himself looks about as rough as can be expected, though it still makes Mark’s stomach drop to be confronted with the evidence of his instability. It's hard, initially, to even discern him beneath the tangle of crossing wires and tubes. Then there's a glimpse of pale flesh, stippled with bruising. The twitch of a finger. The mechanical rise and fall of a chest that's covered in EKG stickers, while a pale blue blanket creeps in like the tide on a tranquil beach.
Higher up, there's more recognition, and yet more machinic disfigurement. His head has been turned slightly on the pillow, or perhaps it fell that way naturally. His closed eyes too speak of sleep, but the illusion is broken by endless protrusion of tubes tethered down with tape. An NG. An ET tube. A central line in his neck that branches out like the heads of a hydra. It's no wonder Carter is pale, and sticky with sweat: suddenly, to Mark, the medical machinery is a hundred-limbed beast, and their student is locked in battle with it.
“Hi.” Mark just about manages.
Peter gives him another glance. Shifts uncomfortably in his seat. “Hi.”
“I… I thought I might find you here.”
“My student nearly died today. I'm not sure there's a more appropriate place for me to be.”
His abruptness shouldn't be surprising. From experience, Peter often becomes snappy when he's stressed: he was a nightmare during med school exams.
Mark, therefore, does not burden him with more empty words. Instead, he moves to the chair on the other side of the student’s sickbed and shakily sits down. Before him, the battlefield of surgery is laid bare. A small, rectangular patch of hair near the base of Carter's skull has been shaved to a close-crop, and within its confines stretches the sickening curve of a fresh scar, the wound only recently closed. There's still another tube for drainage.
It's a grim reminder that perhaps only an hour ago, a surgeon was poking around in the boy’s head. Mark finds himself reaching for a hand, suddenly paternal. He clasps it within his own, rubbing small circles on the back of it as though this small comfort might erase the sensory hell of everything else. If anything, he hopes Carter cannot feel his touch, so that he might be ignorant of everything else too.
“Surgery was a success.” Peter grits out after a while. He still doesn't meet Mark's eyes. “They found the bleed and repaired his skull. Townsend says it was the nastiest occipital fracture he's seen in his career.”
Townsend is one of the neurosurgeons at County. He's seen enough head trauma to know the exact path a bullet has to take to ensure a quick death, and the specific nerve which, when severed, is utterly incompatible with meaningful recovery: which is to say he's seen it all. For his assessment to be so definitive means the injury must have been bad.
“It was his father.” Mark says quietly, watching the droplets of condensation gather on the inside of Carter's ET tube. “I'm sure of it.”
There are a few moments of silence, before Peter lets out a small, wry snort, totally devoid of humour.
“I wonder what he used to think,” The surgeon says bitterly, “Whenever peop- whenever we talked about his family. How great his life must be with all that money.”
Mark considers, but cannot continue for very long. Each memory of the boy’s red-cheeked deflection now makes him want to vomit.
He squeezes Carter’s hand.
I’m so sorry. I'm so sorry, buddy, I didn't know. We didn't know.
It takes four days for him to wake up: four days of penitence, and rumour, and fear. The ER is awash with chatter, and though Mark does his best to quell it, it's like hoping a sponge will soak up a tsunami. Morganstern’s words to him on the third day are eerily reminiscent of Carol’s overdose only months prior. It's up to him to keep the place running. Carter is already being spoken of in the past tense, a lively presence that was but no longer is, a brilliant young man caught in a terrible situation. Mark doesn't have it in him to echo the sentiment to his own team, so desperate as they all are for hope, and, thankfully, it's the right decision.
Because Carter does wake up, in the end. He opens his eyes in the middle of the night, and it's only Peter’s continued presence at his side that keeps him from choking on the vent alone (though later, with a haunted look in his eyes, Peter will tell Mark that he's never seen anybody tolerate a tube like that, as though its discomfort were only a drop in an ocean of experienced suffering). He follows commands, if a little drowsily. When he's extubated, he's able to speak, even if his words are heartbreakingly confused at first.
Where ‘m I?
Is my Mom coming?
Dr Benton? ‘s it time f’r rounds?
When the latter arises, Peter becomes softer than Mark has ever seen him. He shifts closer, settling a hand on Carter’s forehead as carefully as if the boy were made of glass, and speaks in a quiet, comforting rumble.
“No, Carter. You're not working at the moment. You've been badly hurt, but you're okay now. Everyone's here to take care of you.”
His words are a soothing balm, even in his student’s most delirious moments. Carter has looked up to him since the very first moment he stepped in the ER, but when he blinks up at Peter now, doe-eyed and clumsy with drugs, a new reverence settles into his gaze. Of all the people that come to visit him, Peter is the one he trusts best.
Mark thinks it's a miracle that he can trust anybody at all after what happened, and yet, as he's beginning to realise, Carter is a unique sort of soul. Within him there is a potent desire to love and be loved, at all costs. In the ER, it guides his hand to fix what is broken, and at home, he must often have tried the same, stretching out his arms in placation only to be met with the same, unforgiving fists.
Finally, though, the hands that return his touch are equally gentle. The nurses comb his hair and change his dressings. When they drag a washcloth over his face, they always follow it up with a kiss to his forehead. Susan massages his sore wrist until he's so relaxed he falls asleep. Doug squeezes his shoulder and sneaks him snacks from the vending machine, unwrapping the Zagnut bars for him and breaking them into small, easy-to-chew chunks that he presses into Carter's waiting palm. Peter flips through the pages of a medical journal and reads aloud to him. When the boy sleeps, he holds his hand so that he can feel the pulsing of a heartbeat against the pad of his thumb.
Mark is no different. When he enters on the seventh night, he settles down into the same chair by Carter's bedside and gently smooths back the hair that hangs limp over the boy’s forehead. The latter sleeps. The former could not be more awake.
“They got him,” He says quietly. “He’s never going to hurt you again, Carter. I promise.”
None of them can erase what's happened, but they can try to build a better future for him, brick by brick.
God knows he's worth the toil.