Chapter Text
It was nearing the end of his shift and while he had made it through the worst part of the shift, the period between 3am to 4.30 am, he longed for his bed. And when the weather was like this it was extra nice to go home at the same time as the rest of the city woke up, knowing his job was done.
Outside the freezing temperatures had the city in a iron grip and the merciless wind and icy rain left everyone coming from outside shuddering. The waiting room was filled with coughing people and people that had slipped and broken a wrist or cracked their skulls open. He had treated a couple of elderly people with broken hips and they had handled a small pile up on the highway earlier during the night but had sent the last patients off to surgery a while ago.
The night was rounding off nicely and in less than an hour the day shift would begin to drop in and soon after he would be on his way.
He’d get to greet his wife before she left for work and then he would take a shower, brush his teeth and go to bed while everyone else began their days.
He decided to go prepare some coffee in the break room for everyone coming in but as he opened the door one of the nurses called for him from the charge station. She had the phone in her hand as he turned around towards her.
“Dr Abbott, they are bringing in a hypothermia victim, suspected mugging, critical condition. ETA 3 minutes.”
“Okay, prepare the trauma room for external and internal re-warming, thanks Georgia,” he replied.
The coffee would have to wait, he thought as he went to prepare his team for the incoming trauma.
He could feel the adrenaline start to pump in a familiar way, making him alert and on his toes and taking him out of that end of shift slumber.
Roughly three minutes later the doors swung open and the relative calmness erupted as he sprung to action walking up to the gurney. The patient was wrapped in heating blankets and one of the paramedics was squeezing an ambu bag that was attached to a tube in the person’s throat.
“What do we have?” Jack asked as he approached the gurney.
“Male approximately 25 years old, hypothermic trauma, suspected mugging, was found unconscious outdoors soaked, rectal temperature is 72, no shivering, heart rate 31 but irregular, BP 62/40, sat 74%, respiratory rate 6 but intubated at the scene. GCS 5. No phone or ID on him.”
Poor kid, he had time to think before his eyes traveled from the body covered by the heating blanket to the young man's face.
His heart dropped in his chest and his whole body turned cold with fear.
“Oh god…Whitaker?” he said as his eyes landed on the very familiar face.
The young man was deathly pale, skin waxy and lips blue, but there was no doubt in his mind that this was their former med student that he hadn't seen in months lying lifeless on the gurney, body covered in blankets, c-collar around his neck and breathing tube in his mouth and secured to his face.
“Do you know him? The paramedic asked and gave Jack a surprised look as he squeezed the ambu bag.
Jack looked at Whitaker's face in confusion and shock, dread filling his body.
“Yeah…he was a med student here last year…” he said without taking his eyes away from Whitaker's colourless face.
~
He can’t believe he’s made it through his rotation at the Pitt. It’s all gone so fast, but in a way it feels like he’s always been here. Like he belongs in these corridors. With these people.
He refuses to think he won’t come back. He wants to come back so badly—for his residency. As a real doctor. As someone people can look up to one day. As someone who can make a difference.
He has a period of interviews and preparation to go through first. An away rotation at a different hospital. Match day.
But first, his very last day as a med student at PTMC.
It’s nearing the end of his shift when Robby approaches him.
“Do you have a minute?” he asks.
“Sure! Is everything okay?” Dennis asks.
“Why do you assume it’s something bad?” Robby says, smiling amusedly.
His mentor is quiet for a second or two.
“I just want to say that I’ve enjoyed teaching you. You’ve worked hard, and I’m proud of how far you’ve come.”
He can feel his ears heat up slightly but hopes it’s not visible.
“You’ll become a wonderful doctor,” Robby says. “You are a wonderful doctor.”
He feels himself blush.
“Well, I still need to graduate,” he says with a small smile. “But thank you. I had the best mentor!”
Robby smiles and shakes his head.
It feels like he should say something. After all Robby has made his experience here so much better than he could ever have hoped for.
“I mean it,” he says. “Thank you for everything.”
The last couple of hours go by too quickly. Too quickly he finds himself ready to leave, saying goodbye to people he’s grown so used to seeing every day. People who feel like his friends.
“I hope we get to see you again,” Dr. Abbott says, and it feels like he means it.
“I would love to!” Dennis says with a nervous smile.
“I know Robby wrote a great letter for you,” Dr. Abbott says. “I would have too!”
Dennis feels his cheeks heat up again but can’t help the smile that grows on his lips.
He hugs everyone goodbye, earning a friendly but firm pat on the back from Dr. Abbott and a hand on the cheek from Dana.
He takes one last look around the place as he follows Trinity outside.
Come July, he hopes to be back.
~
“His name is Dennis Whitaker,” Jack said, eyes still locked on the young man's face, his gut twisting painfully.
The shock of seeing his med student after so many months was fading, quickly replaced by hundreds of questions, anger and fear.
He shook his head and forced himself to snap out of his trance. If Whitaker was going to have a chance they needed to act now and his life depended on Jack and the rest of the team.
“Okay! Trauma 1!” he directed as he walked along the gurney.
Whitaker's hair was plastered against his milky white skin and full of ice crystals and his eyes were closed. His lashes stood out against his ghostly pale face and were rimmed with frost.
Jack swallowed against the nausea in his throat as they made it into the trauma bay which had been prepared for the incoming trauma. The team of nurses and residents gathered around the gurney.
“What are his injuries?” he asked, heart racing inside his chest.
“Suspected concussion with laceration to the temple. Suspected fractures to the left wrist and ribs. Possible internal bleeding,” the paramedic replied. “OI in the right tibia, warm fluids running.”
It was bad, Jack realised, as he listened to the EMT listing off Whitaker's injuries. Really really bad. He didn’t even remember the last time he had a hypothermia case this bad before. But he didn't have time to think about that.
“Careful, we want as little movement as possible,” he instructed. “On my count…one, two, three”
They very carefully transferred Whitaker to the bed, making sure they didn't jostle his body as any movement could cause his heart to stop.
“Dennis, it's Jack, can you hear me?” he said and placed a light hand on Whitaker's chest.
“We are taking care of you. I need you to hang on for me, okay?”
He didn’t allow himself to think about anything as they began their work. Nothing else mattered. Every second was important. All his questions, all his anger and emotions would have to wait.
“I want an esophageal probe in. We need an accurate temperature reading before anything else.” he said firmly as the team began cutting off
Whitaker's clothes leaving his pale skin exposed
before his legs were covered again.
“Temperature 71,8” nurse Georgia said after a few seconds.
“Okay, let’s start rewarming, internal and external, minimal movement,” he ordered and the team set to action hooking Whitaker up to warm IVs and connecting him to a ventilator with warmed oxygen as well as wrapping his torso in heated blankets.
He quickly moved to examine the young man's head. There was a bleeding wound near his temple. It wasn't deep but a blow to the head was still serious and his profound hypothermia made it more complicated to assess the head injury.
He opened Whitaker's eyes one at a time and shined his pen light into them, finding that they barely reacted to lighting.
“Pupils are mid-dilated and sluggish but equal” he reported. “We’ll keep the C-collar on for now. He needs a CT scan.”
To his left one of his residents was listening to Whitaker's chest.
“Diminished breath sounds on the left side…possible pneumothorax” she said.
Whitaker's rib cage was badly bruised and the dark, purplish blue bruises extended further down his side.
There were definitely broken ribs under Jack's finger tips as he examined his chest before his fingers moved down his side, following the bruising. The abdomen was hard and rigid and Whitaker's' face scrunched up in pain as Jack palpated the distended area.
“I'm sorry buddy,” he said before ordering a portable X-ray and FAST scan.
He didn't like it at all. Whitaker was seriously injured and coupled with his extremely low body temperature they could have disastrous consequences.
“Fast scan shows free fluid around the spleen. No pericardial effusion.”
It was like he feared. Whitaker was bleeding internally. He took another steadying breath, grounding himself.
“Okay, possible splenic bleed, let's get a femoral central line and give warm O neg. Page the trauma surgeon. Let’s keep handling minimal. We don't want him arresting.” he said.
“...Chest film confirms left 8th and 9th rib fractures. No pneumo. No signs of cervical fractures. Wrist likely distal radius fracture.”
Whitaker's left wrist lay limply at his side. It looked grossly swollen and deformed.
It was also their least priority right now and all they could do was splint it until he was stable enough for further examinations. All that mattered at the moment was treating the hypothermia and even his other more serious injuries would have to wait until he was more stable.
Jack looked at Whitaker's face, eyes locking around the tube in his throat. His skin was ashy grey and lifeless and his lips remained a bluish tint. There was a small cut on his cheek and his uninjured arm was bruised.
“Who did this to you, huh?” he whispered sadly.
Several minutes went by and Whitaker remained severely bradycardiac and hypotensive. His saturation remained in the low 80s despite them ventilating him as his temperature remained dangerously low.
“Temperature 72.5…” Nurse Georgia said.
His temperature was rising slowly but the numbers on the monitors were too low, every beep of the heart monitor slow and irregular.
Whitaker could still die. He was barely clinging to life and he could still die from this. And it was all up to Jack to make sure that didn't happen.
“Come on, kid,” he said impatiently, wanting desperately for there to be signs of improvement.
“Heart rates dropping…24 beats per minute.”
He was dying…
Jack refused to let it happen.
“Don't do this. Not like this!” he said, shaking his head and biting his lip. “Come on Dennis!”
Then the monitor stopped beeping and the rhythmic sound was replaced by a shrill tone.
“He’s in VF, start compressions” he shouted.
~
He does his away rotation at another hospital in Pittsburgh. He has his interviews. He does all the admin. He lists PTMC emergency medicine as his first choice. Trinity tells him that he will certainly get it.
He tells himself he most likely won't. He prepared himself for it. Tells himself it's okay if he doesn't. For weeks he has his fingers crossed but he never jinxes.
When Trinity says of course you'll match with us everyone loves you, he says she doesn't know that. When Mel says the same when he's invited to a random after work he tells her he probably won't.
He wants it so much. More than anyone of them will ever know. He wants it so much his stomach turns into knots and his chest hurts when he thinks about not making it.
But he tells himself that everything will be okay regardless. Of course it will.
Before he knows it Match day. He can't sleep the night before. He's already awake by the time Trinity leaves for work.
He knows he's already matched somewhere.
“Text me as soon as you know,” Trinity says as she walks out the door.
All he does is wait for that stupid email. Alone in their apartment.
Over and over again he tells himself that everything will be okay regardless of what happens.
He'll become a doctor.
But he hopes and he wants so badly to return to the Pitt. His heart and soul wants it. Yearns for it. He prays for it.
He tells himself maybe they are all right. Maybe he has a chance.
And then he opens the email with shaky hands and a racing heart.
It's not PTMC. It's not emergency medicine.
And it doesn't matter that he's spent so much time tell himself he won't get it to prepare himself. It doesn't matter that he's told himself over and over again that it will be fine.
It doesn't matter that he hasn't jinxed it.
It still feels like the ground collapses underneath his feet. He still cries and sobs on their living room couch like a silly child.
He feels so stupid for believing in it in the first place. For making them convince him that he had a shot.
~
They had been doing CPR for almost 10 minutes and Dennis remained stubbornly in VF.
“Come on kid, you can do it!” he whispered as he watched the monitors for a change and felt for a pulse on Dennis' throat.
“Come back to us,” he pleaded.
The seconds trailed by as he waited and fainted, hoping to feel a heartbeat, but there was nothing underneath his fingers.
“Still in VF. Continue compressions,” he ordered.
Then the door burst open and Robby rushed inside.
He stopped in his tracks only a few feet in and his face fell the instant his eyes landed on Dennis' lifeless body on the gurney.
“What the hell is happening!” he screamed.