Archive of Our Own ^beta

Chapter Text

Hey, so I comissioned crowshaped on tumblr to do an art piece for this series! Check it out Here!

Frank knew it was going to be a shitty day the moment screaming broke out in the Pitt.

He was only a few days back from his leave, and he’d hoped to ease into things. But of course, the universe had other plans. Thirty days in rehab, NA meetings multiple times a week, and all he'd wanted was a little peace and quiet. Just a few days to catch his breath.

So much for that bullshit.

Screaming isn’t uncommon in the ER, but what is uncommon is the screaming happening is loud and in foreign language.

Frank pushes out from behind the counter and heads straight for room seven, where the sounds is coming from.

McKay and Princess are trying to calm down a guy who looks like he’s time-traveled from the 1800’s. He’s wearing a dark suit and has a thick beard and, and he’s arguing loudly at full volume with McKay, gesturing wildly with his hands in what sounds like to be angry German.

On the bed behind him sits a younger man, similarly dressed, cross-legged, holding a blood-soaked cloth to his head. He's shouting back at his friend in German, and motioning with his free hand between himself and his coworkers.

“Hey, hey, what’s going on?” Frank asks, sliding himself between McKay and the yelling man.

"Bit of a language barrier, Dr. Langdon." Princess says, eyeing him up and down. Great. He's been back just a few days and he's already getting sized up by the nurses. It's not like he's going to steal a needle full of morphine out of her hand or anything.

“Shit," because it really was all shit. "You don’t know German, do you?” Frank asks McKay.

“If I did, Frank, we wouldn’t be having this issue.”

“Shit.”

“You said that already.”

“I can call a translator,” Princess offers, flipping through her clipboard. Apparently for now it appears she trusts Frank enough to take her eyes of him. “But it’ll be a few hours.”

“He’s freaking everyone out!” McKay snaps. “We can’t just have some Amish guy screaming bloody murder in the Pitt all day.”

The older man barks something else, even louder. The younger guy mutters back, clearly trying to calm him, but they just start arguing again, their volume getting louder and louder.

 “He’s not Amish,” says a quiet voice behind them.

Frank nearly jumps out of his skin. He’d been so focused on the yelling in front of him that he hadn’t noticed the student doctor creeping up behind him.

“How do you know that?” Frank asks, eyeing him.

“Because he just said he’s not Amish. He’s Mennonite.”

“You speak German?”

“Huh? No.” Whitaker’s cheeks go pink, and he shifts a little on his feet. “It’s, uh… Pennsylvania Dutch.”

“Can you translate?”

“I think so?” Whitaker says.

“You don’t sound sure,” McKay shoots back.

“I mean, I-I can. Do you want me to?”

“Yes, Whitaker.”

“Okay,” the younger man says. He walks through the doorway to join them.

The place is a mess. Frank can only imagine what it looks like to an outsider. Two doctors and a nurse trying to calm down a guy who looks like he’s from the 1800s and tend to his bleeding friend.

“Hello,” Dennis says, giving a small wave. The student doctor is avoiding eye contact with everyone except the patient. “Er, Guder Mariye.”

“Kannscht du Pennsilfaanisch Deitsch schwetzer?”

“Ya.”

The older man visibly relaxes. His shoulders drop, and he exhales in relief, reaching out to shake Dennis’s hand. Dennis gives him a small, awkward smile that tries to be reassuring, but mostly looks nervous.

“Ich ghees Dr. Whitaker. Wie kann ich Ihnen helfen?" 

Dennis nods and turns back to the patient, muttering something.

The man looks between Frank and Dennis, cloth still pressed to his head. After a moment, he sighs.

“Ich bin zimmlich schlecht.”

Dennis glances back. “He’s not feeling well.”

“No shit, sherlock. He’s bleeding. Can you ask his name?”

“Was iss dei Naame?” Whitaker asks.

The language is odd- almost like German, but slanted and looser. Like someone doing a bad German impression of English. After a few exchanges, Dennis leans back on his heels.

“His name is Jacob. Here, I’m sure I can just-,”

He launches into a rapid-fire string of questions. He and the patient go back and forth, tone more relaxed now.

“Uh, Whitaker?” McKay says carefully.

But Dennis ignores her, pulling out his penlight and shining it in the patient’s eyes. He says something that sounds like another question.

“Kotze,” the patient replies. His friend mimes gagging.

Dennis frowns and flicks the penlight again. The patient blinks, startled, but calm. It's a total 180 from earlier.

“Schusslich?” Dennis asks.

The friend shakes his head. “Dappich.”

“Ya, well,” Dennis says with a shrug. Jacob huffs out a laugh.

“Wu iss du her?” the friend asks.

“Nebraska,” Dennis replies. He glances over at Frank and McKay who stare at him. Princess has paused mid-note, pen hovering in the air.

“Uh,” Dennis says awkwardly. “So, this is Jacob and his brother David. They were in town delivering furniture and Jacob got hit on the head unloading the truck. He’s been vomiting, but it seems more like it’s from seeing blood than a concussion.”

“Can they speak any English?” McKay asks.

“They both understand it better than they speak it. If you explain what you're doing, it should be fine. Jacob says he doesn’t want a CT scan, just some stitches.”

“We need to rule out intracranial bleeding.” Frank says.

“I told him that. He’s not interested in machines. He’ll sign an AMA form.”

“Huh. I thought the Amish couldn’t go to hospitals.” Frank mutters.

“He’s not Amish” Dennis insists “He’s Mennonite. It’s different.”

Franks and McKay stare at him. He keeps going, oblivious.

“Besides the Amish aren’t prohibited from getting medical care. Lots of Amish people get vaccines and go to doctors, it just depends on how conservative the community is. Most of ‘em try folk remedies first and then got to the doctor as a last resort, Mennonites vary too, but they’re generally more open to modern medicine and modern society.”

He pauses for breath, then adds, “Still, it’s weird they speak so little English. Most Mennonites use English day to day. I wonder if they’re from a more conservative offshoot community.”

“How on earth do you know all of this, Whitaker?” McKay asks.

Dennis’s face flushes again, pink creeping up from his collar.

“Um. Internet? You ever start on Wikipedia and just kinda get lost? I was looking up jam recipes and… I lost the plot a little. Besides, it's important to know a few languages, yeah? Most people just want to be understood, not just heard.”

It’s obviously a lie, relatively harmless, but still a lie. Not to mention that nice little Mr. Rogers moment Whitaker tacked on at the end there. Frank has seen people lie like this before, especially in rehab. Lie about something and try to squeeze it in-between sayings or slogans.

Frank narrows his eyes. He could call him out on it, but he’s been working real hard not to be an asshole since his stint in rehab. So instead, he just sighs.

“Yeah,” he says. “I get it.”

From behind her clipboard, Princess mutters, “You would.”

Frank chooses to let that one go, too.

It’s quick work to stitch up their new Mennonite friend, Jacob.

Frank has Whitaker do it while he watches, occasionally reminding him not to pull the stitches too tight. In the end, Jacob gets seven neat stitches just above his eyebrow and a bandage for his trouble.

Dennis apparently tries a few more times to convince him to get a CT scan, but Jacob declines every time, polite but firm. At least he sounds polite. His words have none of the bite that were there before.

Princess prints out the discharge paperwork, and Dennis walks the brothers through each section carefully, switching between English and Pennsylvania Dutch where needed. It’s remarkable about how well Dennis flows from one language to the next. He’s apparently very good at it, because an hour later they’ve gone from yelling in the ER to shaking hands and thanking Whitaker and Frank in broken English.

The brothers head out with one bandaged forehead and a manila folder full of discharge instructions.

As the doors close behind them, Frank turns to Dennis, who’s carefully cleaning up the suture tray.

“You’re weird as hell, Whitaker,” he says, not unkindly.

Dennis glances up, startled. “Thanks?”

Dennis finishes with the suture tray, disposes of everything with almost exaggerated care, then slips out of the room before anyone can ask him any more questions or make any more comments.

Princess clacks off toward the desk to log vitals and finish charting, leaving Frank alone with Dr. McKay in the empty room. Frank picks up the paperwork the brother had left behind, some of the discharge instructions.

Cassie leans over to Frank.

“So do we add ‘horse-and-buggy whisperer’ to his chart, or…?”

Frank rolls his eyes. “Wikipedia my ass. He’s hiding something.”

Cassie smirks at him, dimples flashing. She’s been one of the only ones who treated him like normal since he came back.  The day he returned, she just punched his upper arm, said “Welcome back, Frankie,” and went right back to triage. It was the kindest thing anyone had ever done for him in a long, long time.

He knows she’s had her own issues with addiction, though he’s never asked the extent of it, and he’s not going to. Her past issues and how public she is about them turns some people off her and makes them wary or whisper behind her back. But for Frank, it’s kind of the opposite. He likes her more because of it.

There’s a no-nonsense way she carries herself, like she’s done pretending to be anyone she’s not. Even if she can be a little brash, he appreciates it. Especially now when he’s feeling countless eyes on him.

“How long you think before everyone in this damn hospital knows Dennis can speak Pennsylvania Dutch?” he asks, crumbling up the papers into a ball. They really should have a recycling program here. Even rehab had a recycling program.

“Ten minutes, tops.” Cassie says. Why, want to bet on it?”

“Hell no.”

A machine starts ringing down the hall. Its sharp, insistent tone makes his ears buzz. His heart skips a beat, and he feels his blood rush through him from the top of his head through his fingertips.

This. This is what he missed while he was in rehab. The rush, the urgency, the crackle of things happening all at once and how his brain can go a million miles a minute and people around him can actually keep up.

He shoots the crumpled paper ball into the trashcan. It swirls around the edge before falling into the bin. He straightens, already heading toward the sound.

 “I only make bets I can win.”

___

Here's the translations for Pennsylvania dutch!

• 
  Wie bischt du heit? Wie fiehlscht?- how are you today/how are you feeling?
•  
• Ich bin zimmlich schlecht.- I’m not doing well
• 
  Was iss dei Naame?- what’s your name?
• 
  Kannscht du Pennsilfaanisch Deitsch schwetzer?- Do you speak Pennsylvania German?
• 
  Kotze- vomiting
• 
  Schusslich- Clumsy (with things, usually due to hurrying)
• 
  Dappich- clumsy with oneself
• 
  Wu iss du her?- where are you from?

Chapter Text

Trinity’s day goes from pretty good to pretty bad in the span of about fifteen minutes.

She’d matched with a very pretty woman on Tinder, a tattoo artist who kind of looked like Rhea Ripley, and they’d spent half last evening chatting. The woman had agreed to meet for late-night drinks tomorrow, which fit perfectly into Trinity’s weird, patchwork schedule. She’d been riding that high all day.

The man in Four called her a stupid cunt and asked for a white doctor? No problem. Trinity was too busy imagining getting lost in Ms. Tattoo’s biceps over cosmos and tequila sunrises.

The anti-vax mom in Seven threatened to call the police if her ex-husband gave the kids MMR? Trinity offered her a tight-lipped smile and told her, “We can loop in our hospital attorney if needed, ma’am,” all while wondering how far those tattoos went down.

Not even the news that Dennis apparently speaks Amish or, well, Pennsylvania Dutch, could bring her down.

She liked Dennis well enough. He was a decent roommate. Quiet and tidy and mostly in his own world. It’d only been a few months of cohabiting, and neither of them was pushing for a sitcom-style friendship.

Their days went: carpool, dinner, separate bedrooms for the rest of the night.

Once they had watched Casino Royale because Dennis had never seen any James Bond film, ever, a fact which Trinity could not let stand. He’d declared Daniel Craig was hot and, in the same breath, that Eva Green was also hot. Which…fair. It made sense that Whittaker swung both ways. He probably had a sexually repressed childhood or something.

Besides that, they didn’t talk much.

Well. She had told him about the date. Just in case she didn’t make it home at a reasonable hour, or at all. Dennis had blinked when she mentioned it was with a woman.

“Why, Huckleberry? You got a problem with me dating girls?” she’d asked.

“No. I just can’t believe anyone would want to date you,” he replied, deadpan.

She flipped him off, and he scrambled to dodge the pillow she lobbed at his head and then they’d carpooled to the hospital.

So yeah. That was the extent of their relationship. Dennis being bi (lingual or sexual) wasn’t her business.

When Jesse had asked her if she knew Dennis spoke Pennsylvania Dutch, she’d just snorted and went on with her day. Because who cared if he did or not, she had a hot date tonight and nothing could bring her down.

She should have known it was going to go wrong. Stupid universe, never letting her have anything.

It starts with the radio.

Things are oddly calm in the ER. Almost too calm, she tries very, very hard to not think about the Q word. Robby is leaned against the nurse’s station, trying to chart something while Gloria stands beside him, clearly on the warpath.

“Your Press Ganey score is very poor,” she tells him, arms crossed.

Robby doesn’t look up. “Those things are bullshit, and you know it, Gloria. Now really isn’t the time. I’m trying to catch up on the paperwork you claim I’m behind on.”

“Dr. Ro-”

The desk radio crackles to life, cutting her off.

The radio on the desk crackles to life.

“PTMC Hospital, this is EMS 50. We are transporting a 45-year-old female with sudden-onset nausea, vomiting, and blurred vision, beginning approximately 2 hours ago.
Patient reports difficulty swallowing and describes generalized weakness, currently unable to walk unassisted. No fever reported.
Suspected foodborne illness per bystander. Patient is alert, but speech is slurred. O₂ saturation is 96% on room air. BP is 142/86, pulse 94, respirations 20 and shallow. IV established, no meds given at this time.  Ten minutes out.

Okay, they could handle that. Sounded like food poisoning. Gloria huffs and crosses her arms. Robby snaps his chart shut.

Then the radio sparks again.

“PTMC, this is EMS 13. We are en route with a 38-year-old male found minimally responsive. Per family, he began complaining of dry mouth and muscle weakness about 2 hours ago.
Patient now has profound descending paralysis, unable to move arms or legs, respirations are shallow and ineffective. Currently on BVM assist. O₂ sats are 89% without support. Pulse is 74, BP 138/72, respiratory rate assisted at 10. Pupils sluggish but reactive. GCS is 9, IV established, no meds administered yet. ETA is 11 minutes.

Robby lifts his head. Dana’s already looking at him with that oddly blanky look that means she’s worried and doesn’t want anyone to know it yet.

“Santos, let’s get an intubation team ready-, he starts to say.

Then the radio crackles again.

“PTMC, this is EMS Command. Be advised we are on-scene at a mass casualty incident. Current count is approximately 20 patients, symptoms ranging from mild GI upset to respiratory paralysis. Incident appears to be linked to a shared meal event. Triage is underway. At least 4 patients are critical, 7 are moderate, remainder are walking wounded. Transports will begin in 10 minutes. Expect multiple incoming units. Stand by for distribution and resource requests.”

There’s a beat of silence.

Then Robby says, “Oh, shit,” staring at the radio like it might start spitting smoke.

It doesn’t, but it does erupt. five, ten EMS crews begin flooding the channel, each giving breathless updates to a dozen different people, ranging from

“Gloria,” Robby says, without looking at her, “we’re putting a pin in this conversation. Call the board. We need a meeting. Now.”

Trinity sighs and leans on the counter.

So much for her pretty good day.

The staff gather in the belly of the Pitt within minutes of Dana’s page. It feels eerily reminiscent of Pitt Fest, when she hadn’t known what to expect and Robby had dropped a bomb in the middle of everything.

Just like before, Robby claps to get the attention of the room.

“Alright, everyone. We’re about to get an influx of patients from what we’re calling a mass casualty incident. It looks like foodborne illness, but we don’t have confirmation yet. As such, we’re initiating hospital-wide emergency protocols. We need every bed cleared! Patients either go upstairs, go home, or get routed to family med. We’re expecting at least twenty incoming. First arrival is in seven minutes. Let’s move.”

He dismisses them with a wave like he’s starting a fire drill and not announcing that they were about to be in ankle deep-shit for the next few hours.

Trinity scans the room and finds Mel and Victoria near the back.

“What do you think happened?” she asks, falling into step with them instead of saying hello.

“I really, really hope it’s just a bad case of food poisoning,” Victoria mutters. His voice it tight, “I can’t handle another pandemic.”

Yeah. Trinity’s not sure she can handle another pandemic either. Or a mass shooting. Or a chemical spill. Or a plane crash.

She glances at the clock.

Six minutes now.

“I’m gonna pee before I get a UTI,” Trinity mutters, more to herself than anyone else. That’s all she can do right now; pee, wash her hands, and wait.

The first patient arrives ten minutes later, which takes longer then projected by the radio.

It’s a woman in her forties, maybe but it’s hard to tell. Her face is pale and slick with sweat, hair plastered to her cheeks in damp clumps. She’s covered in vomit, her dress soaked through, and she’s retching so violently the EMT has one arm across her chest, trying to keep her from falling off the stretcher.

“She’s been puking for over an hour,” the EMT says as they wheel her in. “Can’t feel her arms or legs. Slurred speech, reactive pupils but slow. Started right after lunch.”

Trinity moves automatically. She’s got her gown and gloves on in record time, and she’s placing an oxygen mask over the woman’s face in moments. There’s someone calling out vitals over her shoulder, but she’s barely registering it.

“Let’s get her on the monitor. I need a line, fast,” she says, stepping to the head of the bed. The woman gags again, sharp and empty. Trinity smells bile and acid and something metallic- blood. She’s puking blood.

The vomiting stops just long enough for the woman to rasp, “Can’t… breathe.”

“I know,” Trinity says. “You’re doing great. Just hang on.”

Because she’s talking, and if she’s talking, she’s breathing.

But then it shifts.

The woman’s chest starts rising slower and shallower. There’s too much strain in her neck, like she’s pulling air through a straw. Trinity glances at the monitor- her oxygen is dropping. The waveform looks wrong, less like a worm and more of straight line..

“She’s tiring out,” she says. “We need to intubate. Now.”

“Let’s go,” Robby says, already gloving up behind her. “Santos, you’re up?”

“I’ve got it.”

Everything moves fast after that. Suction ready. Someone passes a scope into her hand. Robby hands her a prepped tube. The woman’s eyes flutter and her body going slack beneath them.

“Alright,” Trinity says, gently prying the woman’s jaw open. “Deep breath if you can.”

The cords come into view, faint and pale and spasming,

She doesn’t hesitate. As carefully as she can, she’s shoving a tube down her patient’s throat.

“Tube’s in,” she says, and someone’s already bagging. The oxygen number creeps back up, slow but steady.

Trinity steps back, tugging her gloves off with a snap. Sweat clings to her neck. Her heart’s thudding in her chest, but her hands never shake.

One down.

God knows how many more to go.

The ER is chaos.

Patients are doubled up in beds, slouched in wheelchairs, or sprawled on gurneys in the hallway. The air reeks of antiseptic and something worse- death. They’ve lost two people already, and they’re too busy to move them to the morgue that their bodies are laying in an empty room side-by-side.

Trinity’s lost count of how many hours she’s been working. Twenty patients so far- some have been intubated and sent up to the ICU, others stabilized with fluids and anti-nausea meds, and the two dead ones. She’s still moving, side by side with Mel and Victoria, but her arms ache and her brain feels like it’s buzzing under static.

Robby is stalking between rooms with his gloves half-on, eyebrows furrowed deep. “Twenty-one patients from the same reunion,” he says. “Six of them are kids. The symptoms aren’t adding up.”

“Cranial nerve palsies. Bilateral descending weakness…proximal before distal. Some of them can’t swallow,” Victoria says, ticking the signs off on her fingers.

“Guillain-Barré? Or Miller-Fisher?” Mohan suggests, standing near the dry erase board they’ve been using to keep track of who’s where.

“On a massive scale?” Trinity scoffs. “There’s no way this many people suddenly developed an autoimmune disease.”

“It could be anthrax.” McKay says. “That would explain the cranial nerve palsies.”

“But not that bilateral weakness.” Langdon mutters, tossing his gloves into a bin. “Is there a chance that this is some kind of bioterror attack? This is not just food poisoning. It’s like they’ve all had strokes at the same time.”

Trinity’s about to say something stupid, like calling Langdon a name for thinking that twenty-one people could all have strokes at the same time when she glances over and spots Dennis standing by the counter, staring at a tablet. He’s not even looking up at the chaos in the hallway around him.

“Uh, Huckleberry? Now’s not a great time to be playing Angry Birds.”

He ignores her, lips moving under his breath. “Stomach pain… dysphagia… diplopia… ptosis…”

“Dude, what are you-,?”

But before she can finish, Dennis abandons the tablet and crosses the hall. He kneels beside a woman curled on a gurney, moaning softly. One hand is pressed to her stomach, the other curled uselessly near her chest.

“Hi,” Dennis says gently. “Can you look at me for a second?”

The woman lifts her head slowly. Dennis cups her face, steady and careful. He looks her in the eyes, using his penlight briefly.

“Ocular palsy,” he breathes. He lets go, stands up straighter. He’s streaked with bloody vomit, drenched in sweat, but he looks surer of himself than Trinity’s ever seen. It’s weird seeing a wet cat look so determined.

“I think I know what this is,” he says, so quietly she almost doesn’t catch it.

“You what?”

“I think I know what this is,” he says again, louder this time. “I’ve seen it before. Back home. It’s botulism.”

Dennis puts a hand on her shoulder and jogs over to Robby. He whispers something into his ear. Robby pulls away, looking a little stunned.

“Botulism?” Trinity echoes, loud enough to draw the attention of the people nearby.

McKay frowns and cuts her a glance. “Botulism? Do you know how rare that is?”

“It makes sense,” Dennis says, voice growing steadier. He pulls away from Robby and face the small group of doctors and nurses gathered by the board. “They all got sick at the same time. Same cookout. This is textbook.”

“You sure?” Robby asks, gaze sharp.

“Yes,” Dennis says. Then again, firmer: “I’m sure.”

Dr. Langdon makes a face. “Hold on. These symptoms could also be-,”

“Botulism is often misdiagnosed,” Mel interrupts, standing beside Dennis now.

Frank shoots her an annoyed look, which is impressive, because if Trinity had interrupted  him like that, he probably would’ve decked her.

“It gets confused for Guillain-Barré, myasthenia gravis, even stroke.” Mel goes on. "But all of this…. cranial nerve palsy, descending flaccid paralysis, alert mental status? It does fit.”

Robby goes quiet, mouth set as he thinks.

“Has anyone said what they ate at the reunion?” he asks finally.

Victoria raises her hand. “One of my patients doesn’t eat meat and only had the sides. She’s sick, too. Could be a contaminated veggie dish or maybe cheese.”

“Especially if something was made with improperly canned vegetables,” Dennis adds.

Trinity watches the gears turn in Robby’s head. She can almost see the moment he starts to believe it.

She hasn’t read much on botulism herself. There’s a guide for clinicians that the CDC posted online in 2021 which she had skimmed during her third year of medical school, but that was it. She barely has time to read the patient charts, let alone brush up on obscure neurotoxins. She also doubts that Robby has been reading anything recently, too. But chances are good that both Mel and Dennis have.

Mel’s too dedicated not to have read every guideline three times, and Dennis is too obsessive with his learning. He’s always bringing up some article from The Lancet or Clinical Infectious Diseases, like normal people talk about the weather.

Robby claps his hands once. “Alright. We treat for botulism. McKay, call the health department. Request the antitoxin. Start the process now. We don’t wait.”

“We still haven’t gotten labs back-,” Gloria starts. Because of course Gloria is still fucking here.

“We don’t wait for lab confirmation,” Robby says firmly. “If I’m wrong, I’ll take the heat.”

“Robby,” Gloria says, voice tight. “Foodborne botulism is a public health emergency. If we notify the CDC, it’s an outbreak. We’ll trigger federal protocols. Quarantines. Media attention!”

Robby doesn’t blink. “And if we don’t, we’ll be triaging body bags. Pick one.”

Gloria opens her mouth like she wants to argue. Then shuts it.

She exhales hard through her nose and mutters, “Fine.”

“Good,” Robby says. “Let’s move.”

Within the hour, a CDC rep arrives with the antitoxin in a cooler stamped EMERGENCY USE ONLY. It feels absurdly small, considering how fucked up the afternoon has been. But it’s here; Botulism Antitoxin Heptavalent.

The only defense they’ve got left.

The treatment doesn’t reverse paralysis. Everyone knows that. What it does do is halt the toxin’s progression. It binds to what’s left in the bloodstream and neutralizes it before it can reach the next synapse, the next breath. It’s a race they can only win if they’re ahead of it.

They’re not ahead of it for everyone.

Some patients already need mechanical ventilation. Others are on the verge of needing it. A few can still speak but can’t swallow, can blink but can’t sit up. Not to mention the now three dead, bodies still cooling in the spare room. A man, a woman, and a ten-year-old boy missing his two front teeth.

The Pitt is quieter now that everyone’s been triaged, but no one’s relaxing. They’re mobilizing long-term care with the rest of the department: speech therapy consults, PT and OT, bowel regimens, bladder care, DVT prophylaxis. It’s not sexy medicine, not like some people think Trinity’s job is. It’s just survival.

She finds herself at the side of Mrs. Windsor, the family matriarch, who’s sitting upright in a chair and visibly exhausted. Trinity and McKay have both checked her. She’s stable, no symptoms, but she looks ill anyway, watching her family lie pale and still in beds down the hall. Her eyes are so red it looks like she hasn’t blinked in an hour.

Trinity doesn’t think anyone’s told her about the deaths yet.

She beckons Trinity and Robby over. “Tell me what happened,” she says, her voice tight.

Trinity glances at Robby, who nods for her to go ahead.

“We’re treating everyone for botulism,” Trinity says carefully. “It’s a rare kind of foodborne illness caused by a toxin. It’s very serious. It can cause paralysis, starting at the head and moving down.”

“But there’s a treatment?” Mrs. Windsor presses.

“Yes. We’re using antitoxin,” Robby says, arms folded. “It doesn’t undo what’s already happened, but it stops the toxin from spreading and potentially  doing more damage. That’s why early treatment is so important.”

“They’ll recover?”

“With the right care, yes. But it’s a long road. Weeks to months, depending on how bad it is. Some of them will need ventilators. We’ll have to watch for dry eyes, dry mouth, pressure sores, UTIs. Many of them will need speech, physical, and occupational therapy as early as possible."

Mrs. Windsor exhales slowly. “You’re testing for it, right?”

“We are,” Robby assures her. “The health department’s already collecting samples. We’ve sent off blood and stool, and they’re taking food from the event site. That’ll confirm it. But we’re confident, based on symptoms and timing.”

Trinity steps in. “Do you remember what you ate? Or what you didn’t eat?”

Mrs. Windsor’s eyes narrow as she thinks. Then she snaps her fingers. “The potato salad. Damnit, I told Judy not to bring it.”

“Potato salad?” Robby echoes.

“Yes. New York style. No mustard. That’s why I didn’t touch it.”

“Do you know if she canned the potatoes herself?”

“She probably did. All of us were raised on canning. Grew up with pressure canners and jars in the cellar.”

Robby drags a hand down his face. “If the potatoes were canned improperly and then served cold…”

“That would explain everything,” Trinity finishes. “Even the vegetarians got sick. Botulism doesn’t need meat, just an anaerobic environment and time.”

Mrs. Windsor looks down the hall again, eyes glossy. “God help us,” she murmurs.

“We’ll take care of them,” Trinity says. It’s the best she can offer.

They step away from Mrs. Windsor, leaving her staring down the hallway again, still as a statue. Trinity feels like her own limbs are moving through syrup. The adrenaline that’s been carrying her for the past few hours is draining out fast, leaving her hollowed out and shaky.

She leans her back against the wall just outside the nurses’ station and exhales through her nose and closes her eyes. She tries very, very hard to not to see the boy with the missing teeth, slack-jawed and blue by the time they got to him. Tries not to see the panicked mother begging someone, anyone, to fix it. Tries not to hear her own voice, snappish and sharp-edged and too calm, telling them there was nothing to be done.

She thinks she might throw up.

Instead, she sits down on the floor.

She’s vaguely aware of Robby still giving orders in the background. He’s calling for vent transfers, confirming the antitoxin doses, coordinating with the ICU. He’s a force of nature when it counts. He always has been.

“Why don’t you head to the break room, Trinity?”

But Dana’s offering her a hand, and her legs feel like paper, so she takes it.

Dana gives her a firm pat on the shoulder and nudges her in the direction of the staff hallway. Trinity walks. She’s not really sure how. It’s like her body remembered the way before her brain caught up.

She finds a chair in the break room and collapses into it, scrubs crinkling. Her head is buzzing. Her ears too. Like a pressure chamber right before the explosion.

It had been such a good day. The morning was smooth, charts were up to date, everyone got lunch breaks. She’d been joking with Dennis about fake Yelp reviews for the hospital vending machines. She was excited (excited, like an idiot!) for her date tonight

And then everything fell to shit.

How the hell did Dennis clock that it was botulism so quickly? He wasn’t even a doctor yet, but when the first patient started going floppy with their eyes, it was Dennis who asked about botulism. Dennis, who pushed back when there were doubts about it. Dennis who rubbed her shoulder once just once, when she was trying to hold a toddler upright while suctioning out secretions and couldn’t stop her hands from shaking.

He didn’t try to say anything comforting, either. He just stood next to her and did what had to be done.

The door creaks open, and Mel slips inside. Her hair is pulled back messily and she’s holding a bottle of Gatorade, which she tosses Trinity’s way.

“Catch.”

Trinity flinches but catches it, barely. “You okay?” she asks.

Mel sighs and drops into the chair across from her. “Define okay.”

They sit in silence for a beat. Then Mel says, “You know Dennis was right. About the botulism.”

Trinity scoffs. “Don’t remind me.”

“I mean, I read about it in that CDC update last spring. They said to watch for neuro signs, especially in kids. It never occurred to me that it could be botulism, but I backed him up, for what it’s worth.”

“You did,” Trinity says quietly.

Mel eyes her. “You did good, Trin.”

“I feel like I got hit by a truck.”

“Welcome to medicine.”

Trinity snorts and then slumps deeper into the chair. “I don’t think I can go on this date tonight.”

Mel’s eyebrows lift. “Really?”

“I don’t even know what I’d say. Hi, sorry I smell like antiseptic and existential dread, let’s split an appetizer?”

Mel shrugs. “You survived an MCI. You suctioned a toddler while crying on the inside and didn’t drop him. Go on your date. Let someone feed you something hot. You earned it.”

Trinity stares at the ceiling. “Maybe.”

“Not maybe,” Mel says, standing. “Definitely. You can still change your mind later. But for now? Go wipe your face, chug that Gatorade, and finish your shift like the badass you are.”

Trinity squints up at her. “What on earth has gotten into you?”

“What do you mean?”

“How do you stay so… perky?”

“Oh. Well, I don’t know. I just think about the difference I’m making.”

“Wow. Really?”

“No.” Mel admits, grinning sheepishly. “I guess I just keep reminding myself about my why. Because I want to make a difference. That’s what keeps me going. It was a mess out there today, but there are still eighteen people alive because of the work we did. That’s pretty good. A hundred years ago, everyone would have been dead. It’s kind of remarkable, when you think about it.”

Yeah. Trinity supposes it is.

She stands up, Gatorade in hand.  There’s still more work to do. Patients to chart, families to call, more antitoxin to track. Not to mention their still-full waiting room.

Trinity nods slowly. She unscrews the cap of the Gatorade and takes a long swig. Then she gets up.

One step, then another. Her legs are working again.

She doesn’t feel steady.

 But she’s still standing.

Chapter Text

Robby’s always been a patient man.

If you asked anyone who knew him, maybe besides Jack, if he was, they’d probably say no. Robby was a lot of things: an idealist, a little bit of a mess, and  a little terrifying when he was on a roll. But patient? Not usually the first word that came to mind.

And yet, deep down, he is. He can wait when it matters. For the important things. Basically for the things that don’t involve actively bleeding people or someone’s airway closing up.

Even so, when Donnie tells him that his pet project med student was overheard speaking fluent Pennsylvania Dutch to a pair of Mennonite brothers in the ER, Robby is pissed to find out secondhand. And he’s even more ticked that he’s one of the last to find out. 

He catches Santos near the stairwell, already changed out of her scrubs and visibly annoyed.

“Did you know about this?” he asks.

“About what?” she snaps, not needing to ask Robby what he means. “Dennis being a secret polyglot? No. Apparently that’s new information.”

Robby squints. “You live with him.”

“We’ve never said that. I never said that.”

“You carpool every day.”

“Maybe we’re saving the environment,” she says, deadpan. “Or maybe because gas is five dollars a gallon and we’re both poorly paid.”

Robby crosses his arms. “You’re telling me you’ve lived with the guy for months and never once heard him drop a single word in Pennsylvania Dutch?”

“Listen,” Trinity says, tossing her badge in her tote bag, “he’s private. You know that. I found out he’s from Nebraska because he made something called a runza and forced me to eat it. I thought it was a Hot Pocket. We don’t exactly sit around and have heart-to-hearts.”

“Sure,” Robby says flatly.

“I’m serious,” she shoots back. “He talks more to you than he does to me. And that’s saying something, because you’re, no offense, a bit of a jackass.”

Robby smirks. “None taken. Especially from you.  Where is he anyway?”

“No idea,” she says, checking her phone. “We were supposed to leave fifteen minutes ago. I told him if he wasn’t outside in ten, I was leaving his ass behind. I’ve got a date at eleven.”

“With a person?”

“Go to hell, Robby.”

He laughs half-heartedly. Because now that he’s thinking about it…Dennis had seemed fine earlier.  They worked through a particularly tricky lumbar and younger man hadn’t acted any more nervous than usual, and he handled all the pressure from their MCI. The kid had even spoken up when he recognized the symptoms. Dennis three months ago might not have done that. He hadn’t said anything about translating for the Mennonite family. Hadn’t said much at all, really. Dennis was either fine and just had his phone on silent, or he wasn’t fine and was pretending like he was.

So. If he wasn’t okay, where would he go?

“I might have an idea,” Robby mutters.

Trinity raises an eyebrow.

“You go on. Don’t be late for your hot date, Santos. I’ll make sure he makes it home.”

“Suit yourself,” she says, trying to sound casual, but she doesn’t quite pull it off. Her brow is furrowed, and her hand lingers a second too long on the door before she pushes it open.

Attitude problem aside, Robby could tell that Dennis mattered to her. Even though she's probably gouge her own eyes before admitting it out loud.

The first place Robby checks is the chapel.

Because Dennis is a religious guy, and it makes sense that he would try and find some comfort there.

But when he checks, the place is deserted. There’s not even a forgotten coffee cup in sight. Robby exhales through his nose and makes his way back down to the Pitt, where the evening shift’s already clocking in.

He spends awhile checking empty rooms and lounges, and before he knows it it’s become much later than he realizes. He knows it’s late because he nearly collides with Jack coming around the corner near the nurse’s station.

The hell are you still here?” Jack asks, sipping a Sprite like it's whiskey.

“Looking for my bloodhound. You haven’t seen him, have you?”

Jack lifts a brow. “Whitaker?”

“No, the other nervous farm boy who follows me around like a lost puppy. Yes, Dennis.”

Jack snorts. “Haven’t seen him tonight. I had no idea he spoke Pennsylvania Dutch, though.”

Robby stops in his tracks. “How the hell do you know that?”

“Samira texted me.” Jack shrugs. “Said he broke into fluent dialect like he was raised in a barn with no electricity. She also asked me if I wanted a few jars of pickles.”

Robby throws his hands up. “Jesus Christ, I just found out and I’m his damn attending. You people are vultures.” 

“About the pickles? King’s sister has been making them for weeks. She’s got these sparkly ones now that make you shit glitter.”

“No, Jack.” Robby says, feeling a headache coming on.

Jack grins. “Gossip flies around here, Mike. You know that.”

“Yeah, but I expected at least a thirty-minute delay. Or some kind of grace period. What happened to privacy?”

“We work in a glass box. The moment someone farts in the break room, it’s on a group chat. Anything that happens here that’s not medical is considered ER confidential. Which means it’s not."

Robby mutters something under his breath just as Shen joins them, clocking in for his night shift with an iced coffee the size of a newborn.

“Evening,” Shen says in greeting. “Hey, did you hear about Whitaker speaking Pennsylvania Dutch?”

Robby turns slowly, blinking. “You’ve got to be kidding me.”

Shen takes a sip. “What? It’s weird, right? Like, he’s got the Midwest thing going on and I get that, but Pennsylvania Dutch is very niche. What’s next, he churns his own butter?”

Jack laughs so hard he chokes on his Sprite.

Robby just stares. “He spoke to two patients for maybe twenty minutes tops and somehow every person in this hospital has a full backstory for him now.”

“To be fair, no one has speculated on a backstory yet as far as I know.” Shen points out, digging into his pockets. He finds a napkin and gives it to Jack so he’s not dripping soda onto his scrubs.

“I’ll start,” Jack says agreeably once he’s finished wiping up soda. “Was he Amish? I knew a guy in basic who was Amish, but he was one weird little fucker. Not Whitaker weird. He was twitchier.”

The thought had never occurred to Robby but now, honestly… it would explain a lot.

The awkward social instincts, the too-formal thank-you notes, even the weirdly intense work ethic he’s got going on.

Jack must see the thought cross his face because he whistles. “Holy shit. You think so.”

“I’m not saying I do,” Robby says after a moment, “but I wouldn’t bet against it.”

They all stand there for a second.

“Frank said that Whitaker was really uptight about the difference between Amish and Mennonite. Maybe it peeves him off that people thought he was Amish when he wasn’t.” Shen offers.

Robby frowns at that. Jack catches his eyes, squinting a little.

“Whitaker aside, a little birdie told me you still haven’t talked to Frank yet. He’s been back in action for days.”

“Mind your own damn business.” Robby grumbles, because no, he hasn’t yet and he’s not sure If he wants to. The situation with Frank was a whole other thing to unpack. Jack just hums lowly.

“Anyway,” Robby says, trying to change the subject. “Still need to find him. He was supposed to leave with Santos and didn’t show. I’m starting to think something’s up.”

“You want me to check the back lot?” Jack offers. “Sometimes people take calls out there when they don’t want to be found.”

Robby nods. “Yeah. Thanks.”

Jack heads off while Shen leans against the counter, already opening his charting dashboard.

“You really should talk to Frank.” Shen says, not looking up from his computer. “He’s put in the work, you can tell.”

“I didn’t ask you, John. Just shut up and drink your coffee.”

Shen mock salutes him.

“Yessir.”

The only other place Robby can think to check is the spot. His spot. Jack’s spot. The spot half the damn hospital has used at one point or another to breathe.

Sure enough, Dennis is standing at the edge, just past the safety barrier.

Robby approaches slowly, making a deliberate noise so he doesn’t startle him. The last thing he needs is for Whitaker to get surprised and trip. It’s a long way down from up here.

“Hey, man,” he calls. “You’re not gonna jump, are you? That’d be really rude. I’d have to stay late.”

Dennis doesn’t even flinch. He’s leaning on the wrong side of the rail, arms folded, staring out over the city.

“No,” he says, soft and flat. “I wouldn’t do that. It’s just a nice view.”

A hot breeze rolls over the roof, but Robby still shivers.

For a long moment, it’s quiet except for the sounds of the city below them. There’s the distant sound of an ambulance siren from the bay below. Robby can imagine Jack and Shen directing people downstairs.

“So,” Robby says eventually, tone as neutral as he can make it. “Mennonite?”

“They were Mennonites,” Dennis corrects, awkward. “It’s- I’m not. It’s different than being Amish.”

“You said you were from Nebraska.”

“They have Amish in Nebraska,” Dennis says. “Mostly south of Kilgore. And just outside of Broken Bow”

Robby exhales and leans beside him; his arms folded over the barrier.

“You left?”

Dennis hesitates. “After my rumspringa. That’s… well it’s basically, you’re allowed to go experience the world without your parents telling you wat to do. The idea is you’ll realize how messy and terrible it is, come back home, and tell stories about it for the next few decades.”

Robby sees Dennis bite his lower lip in thought, so he just keeps his mouth shut and lets Dennis think.

“There was this car wreck,” Dennis says after a beat. “I was a few weeks into rumspringa. Some guy hit a pole. I ran over to help, but he was clutching his chest when he came out of the car, and he collapsed. I didn’t know what to do. His heart stopped.” Dennis’s voice softens. “This woman showed up and said she was a doctor. And she just started CPR. Everyone else was frozen, but she didn’t hesitate. I didn’t know what it was at the time. I thought she was just pushing on a dead guy’s chest. But after a few minutes, he started breathing again. It was the most incredible thing I’d ever seen. She literally brought a guy back to life.”

He huffs out a bitter laugh. “That was it. That was the moment. I wanted to do what she did. But education stops after eighth grade, usually. I wasn’t baptized yet, so I got special permission to go to undergrad.”

“Ah,” Robby says. “That theology degree makes more sense now.”

“I told my family it was to study the Bible better. Be a better servant of God.”

“But really, you wanted to be a doctor.”

Dennis nods.  “My rumspringa went on longer than usual, much longer than anyone else’s. From 17 to 21. Everyone was waiting for me to come back and get baptized. And I just… didn’t.”

Robby tries to imagine it. Dennis as a teenager, seeing CPR for the first time. Begging his parents to let him go to college to study Theology under the promise of being a better servant.

“I told my parents on my 21st birthday. They shunned me that same day. My mom gave me some money she’d saved, and I hitchhiked out. There’s this ex-Amish community just outside Broken Bow. They helped me get scholarships, apply for school, that kind of thing. Eventually I landed in Pittsburgh.”

A pause.

“I was staying with this guy, it’s kind of a long story, but we had a falling out. He kicked me out, and I just sort of floated around until now.”

Dennis stares out over the skyline. The golden hour is long gone. Everything’s blue now.

“I really disappointed them,” Dennis says. “My mom, God, she cried so hard. I’ve never seen her cry like that.”

His voice tightens. “They thought a degree would help me stay. That I just needed to get it out of my system. And I threw it back in their faces.”

He swipes a hand across his eyes, tries to laugh, but it comes out twisted. “Did you know 90% of Amish teens choose to stay? To get baptized, join the Church after their rumspringa. For my order, Andy Weaver, it’s 97%. One of my brothers didn’t even do rumspringa. He already knew what he wanted.”

“You’re the three percent,” Robby says quietly.

“I’m the three percent,” Dennis echoes. He leans back; gaze tilted toward the night sky.

“I miss them. I miss home. I miss looking up and seeing stars. I’m homesick for a place I can’t go back to.”

His voice turns reverent. “There’s this idea in the faith called Gelassenheit. It means yielding. Or submission to the will of God. That’s what everything is supposed to be about. That oneness. Like the prayer you were saying after Pitt Fest. The Shema.”

Yeah. Robby remembers saying the Shema on that horrible night, even if he'd rather not.

“I had a shot at that. A chance. And I blew it." His shoulders curl inward. He looks really young. "I just couldn’t keep the faith.”

Robby knows that feeling.

That aching, empty place in your chest that comes when you break something you can’t fix.

He’s known it ever since his dad told him he’d never amount to anything. And Robby had clawed and worked and bled to prove him wrong. Some days he thinks maybe he did. Other days, it still feels like his father’s voice is carved into his bones.

 Dennis is staring at street, thumbs rolling over each other, his jaw tight like he’s trying to keep the rest of the words in.

Dennis’s voice pulls him back.

“I haven’t spoken Pennsylvania Dutch in years,” Dennis says. “Then those brothers came in today and it just…” His voice falters. “It reminded me of home. The botulism thing, too. There was an outbreak in my hometown when I was a kid. Eight people got sick from canned asparagus. No one would touch Esther's food again, after that."

He doesn’t smile at the memory, not even a little. And Robby thinks, yeah. He knows exactly what it’s like to be haunted by where you came from and to miss it anyway.

Robby looks at him, a thought occurring to him.

“But you wouldn’t have been happy if you stayed.”

Dennis finally glances over his shoulder. His eyes are wet but not spilling.

“No. Not in the end.” He chokes a little. “But I’d have my family. I-,”

His voice breaks, thick with emotion, as he stumbles over the words.

“I just miss my mom.”

Robby steps closer and his hand finds the back of Whitaker’s neck. He squeezes lightly, putting pressure on it like he’s holding a kitten by the scruff.

It’s firm enough to be a reminder of some kind of Dennis, and he lets out a single, broken sob. He sucks in a breath of air quickly, trying to keep himself from falling apart, but it seems like it’s not working.

And Robby just lets him.

Over the years Robby has been a patient man. And he’s learned a lot of things because of that.

In these cases, when it all feels like too much, it’s not worth it to try and fix it. There’s no good reason to try and fill the air with platitudes. It sucks and it hurts, but the best thing you can do is just feel it.

So, Robby just stays right there, fingers steady against his neck, anchoring him through the storm. Because when the swell is over, Robby will be waiting on the shoreline.