Participants:
| Scene Title | Must Be A Full Moon |
|---|---|
| Synopsis | … or the week of a bad anniversary. The ER is always full on both. |
| Date | November 4, 2018 |
Elmhurst Hospital
The emergency room at Elmhurst is usually pretty steady, but there are days when shit really hits the fan. With the news of animal attacks in the tenements, uneasiness among those who are at the lowest end of the Safe Zone's population has blossomed into a deeper fear. Between food shortages, the weather getting colder, and now an unknown threat that has moved above ground from the Down Below, tempers are wound a little tighter.
Today's mess started with a disagreement about some salvage between two of the more colorful street folks. A bottle of rotgut created in God only knows what kind of conditions was smashed over the head of the offending party, and given that the location in which they were squatting houses around 20 people, by the time the conflict was over there were four stabbing victims and eight more with significant lacerations. The entire situation is somewhat exacerbated by the fact that no one will own up to who started it, and it's not like there are actually police to deal with this low-level shit anyway, so there's been shouting in the waiting room among those not as badly hurt. Several orderlies have had to be placed there to separate people who won't shut up.
It's a madhouse.
The waiting room, the emergency room itself, and the corridor that connects the emergency department to the rest of the hospital are filled with people bleeding. Triage has already taken two upstairs to immediate surgery and put the four next-worst injuries into bays.
It's here in the chaos that people almost always find her. "Helen, take Bay 1," Megan Young calls out calmly as she skims the list of injuries. Helen points out three other people and jerks her thumb — they're her team for now, and they're already in motion. "John, take Bay 2; Kelly, Bay 3; I've got Bay 4." It's the worst injuries. She points, grabbing Jim, a female trainee whose name she doesn't know, and a male orderly. Already in motion without checking to see they're on her heels, the redhead snatches a set of gloves from a box as she passes it and is snapping them into place even as they move.
"Let's do it."
These are the nights they live for, right? Or is it the nights they hope they live through? Something like that. Whatever. In any case, Jim knew what he was signing up for when he started this gig, so it’s really his own fault and he can’t complain. Not that he’s complaining. Definitely not.
ANYWAY.
He doesn’t resist the pull from Megan, turning his quick steps easily in that direction and handing her the chart he’s holding. “28-year old male,” he says, “stab wound to the chest that nicked the brachial artery. Possible collapsed lung as well. Second patient head trauma, likely concussion, possible bleed. He’s slurring his words, but he’s also off his face, so that could be part of it.” His voice is calm despite his quick movements, and his mouth pulls to the side in a wry almost-smile. Almost, but not quite. It’s not the smiling kind of night. “Kids.”
"Off his face, hmm?" Megan flips the chart pages, scanning briefly, and then nods. "Let's handle that nicked artery before we worry about the rest. Slanting him a glance, the blue-eyed redhead looks like she's right in her element… and maybe having fun too. She hands him the clipboard back. "You ever reached into a chest and sewn it up? The surgeons have their hands full upstairs, so we're on our own down here." She's genuinely seeking out his experience level — it's not going to be the simplest procedure.
The trainee with them blanches. A nurse is going to sew up a potential nicked artery? That's not what they teach you in nursing school! That's supposed to be the trauma doctor! Only, despite the fact that there are technically two functioning hospitals in this zone, the manpower is still woefully low at this one. Megan quirks a brow at the speaker. "Deep breaths!"
“Yep.” Jim meets the glance, taking the clipboard and tipping his head just a little bit to one side. “Not since the war,” he says, “but I think I remember.” He catches the look from the trainee, though, and then he does smile — and a little snort of amusement escapes him. “It’ll be okay,” he says. “Whatever happens, you’ll know a little more tomorrow than you did tonight, right?”
He turns back to Megan then, gesturing for her to precede him. “Let’s do this thing.” There’s still that calm that seems unshakeable — at least generally. Certainly right now.
Megan studies him and nods once, apparently approving of what she sees in him. She slants a look at the trainee. "Get us a suture tray, the anesthetics tray, and when we get in here, you make sure you can see what we're doing." Her eyes turn to the orderly. "Your job is to make sure that no one, but no one, comes through that curtain until I tell you we're done in this man's chest."
She grimaces slightly. "If we actually have to crack the ribcage, we're screwed. That's gotta go upstairs." Pushing aside the curtain, they troop in to see their patient. "Jim, right?" she asks the other nurse as she pulls her flashlight and flashy-things the patient right in the eyeballs. Because what else do you do with them?? "Where were you in the war?" she asks. The patter keeps everyone in the room calm, makes it feel 'normal' instead of heavily adrenalized.
“Jim,” the man confirms as he goes about getting the things she’s asked for, passing through the curtain once he’s done so and setting them quickly within easy reach of them both. “Started in South Dakota,” he says as he hands her the first tool that she’ll need without being asked — apparently he wasn’t lying. He’s done this before, or at least enough to know what he’s going to need to do. “Then made my way to Chicago, and ended up in Virginia at the end. You?” He’s making assumptions, but it’s probably a pretty safe one to make, all things considered.
"Ferrymen," is Megan's short answer as she works on assessing the patient on their table. "After Afghanistan, I retired from the Air Force and came here to New York. Started seeing a lot of things I didn't like and some like-minded friends and I got together to start helping people. So I was still doing battlefield medicine even before the war. During the war, we initially evac'd out of here to the west, but a couple of friends and I teamed up and wreaked some havoc from here down through the lower Great Lakes region for a bit."
Her hands, he might notice, never stop moving. She's taking a pulse, checking breath sounds, feeling for cracked ribs. She injects a local anesthetic into the area while they're talking. "When we slit the stab wound on him, we should be able to see the temporary clamp they've got on the artery. Are your hands steady enough to sew him?"
“Ah, gotcha.” Jim listens as he works, his hands as though they were drinking coffee and talking about the weather, and not about to perform a procedure that, were it still in the times before, would get them their licenses pulled for the trouble at best, and at worst…well, no need to think about that.
He’s watching her as she works, too, and though it’s hard to tell what he thinks, he does look like whatever it is is on the approving side. “Can do,” he says with a nod, turning away to begin getting the stitch ready. If they’re going to do it, it needs to be quick, otherwise there’s no point to any of this.
Looking up at the trainee, Megan says, "All right, kiddo. We're going to slice through and expand the knife wound a little bit. I need you to get a retractor in there to get it open enough. Once he's sewn up the bleeder, I'll set the lung to drain. You ready?"
The young nurse looks absurdly young in that moment — this is clearly her first ER rotation. But she firms up her chin, nods gamely, and wades in. "Atta girl," Megan encourages with a small smile.
She looks at Jim, picks up the scalpel, and says, "Okay, team…. Ready, set, go." There's a slice, a retraction, and a bunch of sewing that all need to be done quick fast and in a hurry.
And go they do. Necessity is the mother of invention, after all. Or, if not invention, then at least doing what you have to do as well as you can do it. And it seems, in this case, that Jim can do it pretty well. Once the nurse retracts, he goes in without hesitation, leaning over the chest cavity as he says, “The trick here is to keep a good visual, yeah?” However, it’s pretty clear that he’s talking to the trainee, not to Megan. “So try not to let anything move around while I’m doing this.” His voice is calm, and instructive, as though they were working on a cadaver and not someone whose life clearly hangs in the balance right now.
“Then you have to move quickly,” he adds, and he does that, too, his eyes narrowing as he pulls the needle through with one deft motion. “All right,” he says with a nod as he finishes, “there.”
Megan's watching not merely the deft hands but also the patient. Sure, she can do it herself. But better to let the younger ones do it and get better at it with someone watching them! She won't always be around! She is impressed with Jim, and it shows. As soon as he has the artery fixed up and is sure of it, she simply checks his work briefly and nods. "Okay… let's get that lung suctioned." She glances at the trainee. "Wanna stitch up a knife wound?" Because Jim seems to have the same mindset — getting the newbies trained well.
It takes time. It takes attention to detail. To those in the room it might seem to be forever or it might seem to fly. But eventually the man is stable and heading to a room. The chaos in the halls has dropped to a dull roar of the normal hustle and bustle by the time they emerge. And Meg grins at the people who went into that room. "Very, very well done. Laney, go check in with the floor nurse, okay? Finalize the report with her." The young trainee finally has a name. Megan looks to Jim and asks, "Coffee? I could use a couple minutes outside."
The weariness didn’t show on Jim’s face while they were doing it, but now that it’s over, there’s a few telltale signs — a few of the wrinkles around his eyes more pronounced, just a slight dipping of his shoulders, and speaking a little more quickly than he probably needs to when Megan suggests the coffee. “That sounds good,” he says with a nod, and he smiles a little wryly. “That one took me back a little bit,” he admits. He tips his head toward the direction of the cafeteria, eyebrows raising just slightly, and once she starts, he’ll go along. “Could’ve gone a lot worse, though.”
"Most assuredly could have," Megan agrees quietly. Outside of the craziness, the redhead still retains that same calm as in the ER but she also seems a little less… stern. She reaches up to push a strand of pure white back into the swathe of it that cuts from above her eye back into her ponytail and sighs. "The shoestring around here is a little tight. I knew it when I took the job, but… " She shrugs a little. "I hate it when it's stuff like that. Where we should have a doctor in there handling it and we can't." The admission is difficult — they know what they're doing, obviously. But it's not really their responsibility to do what they did.
As they walk down toward the cafeteria, she smiles faintly. "You did good. I like working with people who've seen a thing or two. I don't mind teaching, but when you don't have to, things just move smoother."
Jim sticks a hand into the pocket of his scrubs — Captain America, today, sticking with the ironic superhero theme as he generally does, which she may or may not have noticed previously — and he glances over at her as they walk, nodding once. “Yeah,” he agrees. “It’s hard when it doesn’t seem like it’ll ever really resolve. I don’t think there’s ever going to be enough doctors to go around anymore. At least not in my lifetime.”
His own smile mirrors hers, though, at the compliment. It’s small, but genuine, and it lingers in a way that none of the slight ones exhibited earlier did. “Thanks. I bet I could learn few things from you, though. I’ve seen you work a little bit.” The tone is obviously impressed, in what seems to be his generally understated sort of way. “I thought that trainee was going to faint on us and then we would’ve had another head injury to deal with.”
There's a grin, and Megan chooses not to answer until she's bought Jim a cup of coffee and asks, "Do you mind if we step out onto the porch?" The easygoing shrug is answer enough and she heads toward the outer door of the cafeteria despite the chill outside. Once they're outside, off on the side where no one else will be bothered, she pulls out a pack of cigarettes and makes a face. "I've been quitting for 20 years. Don't mind me. The vice must occasionally be indulged."
It's only after she's lit her cigarette and blown the first inhale of smoke free away from him that she answers him. "I think we all always have things to learn from one another. I don't assume I know everything. I've seen a lot of things and I had to learn some by necessity — I never in my life wanted to be a combat medic, but that's basically what I became over the years. You've got good hands, and I definitely like the way you handled Laney. If she'd cracked her head, I'da had to be mean to her." Megan's reputation is of sternness and a demand for excellence, but she's rarely mean — she is, however, harsh when calling out behaviours sometimes.
There is an easygoing shrug, as well as a nod, and Jim follows her out after he’s snagged a cup of coffee. No cigarette for him, though he does wave away any concern there might be that she does. “I get that,” he says. “I know some people in the same boat.”
He takes a sip from his cup, watching her above the little lipped styrofoam rim, and there’s a nod and a little sound of agreement. “None of us planned on that, I guess,” he admits once he’s swallowed, and he has to chuckle at her last words. “Yeah. I saw you one time when one of the newbies was trying to place a central line, and I thought he was going to melt right into the floor. I was sure glad it wasn’t me.” His tone is teasing, though, some more of the stress from earlier ebbing away with the humor.
A brow quirks and Megan grins. "Yeah, yeah… I know my reputation. I cultivate it purposely." She's totally amused. "I'm not nearly as hard on the kids inside the hospital as I've been on people outside of it," she admits. "But inside or out… what they do matters. They hold someone's life in their hands. And there are some mistakes that you can't come back from. They need to know it." She shrugs a little, taking another long draw off her cigarette before lowering it to hold it between her knuckles. Making sure to keep her smoky exhale downwind of him, she asks, "What brought you into the city? I mean… there are a lot of places that can use good medical personnel. Why here specifically?"
“You won’t hear me arguing,” Jim says, lifting the cup to her before he takes another sip. “I just hope I never step over onto that side of you, that’s all. I don’t know if I can take it. I’m very sensitive.” His smile widens at that, and he leans back against the wall, looking out for several moments. “I wanted to help with the revitalization efforts,” he says after a thoughtful pause. There’s another one, even slightly longer, before he admits, “And I wanted a fresh start. Lots of memories other places. Good and bad, but too many to move forward. You know what I mean?” He looks back at her then with slightly raised eyebrows.
Megan nods slightly. "I do," she replies thoughtfully. Although she doubts he's so sensitive that he couldn't take a reaming were it deserved. It makes her smile that he teases. "She can come back better than ever, this city. If enough people love long enough and work hard enough." It might be a strange sentimentality coming from someone as pragmatic as she tends to appear.
"I used to think that I'd seen the worst the world had to offer over those third-world desert hellholes," she comments quietly. "Even right up to a few years ago, I wouldn't have believed the US could come to this." Her coffee is cradled against her chest while she considers. "Do you ever get tired of what you're seeing here? Does it look better to you than it did, say two years ago?"
The smile fades as Megan goes on, and Jim takes another sip from his cup, and the nod he gies now is a little more resigned. However, at her question, his tone doesn’t sound dire when he replies. “Oh, it does,” he says decisively. “It does look better. If it didn’t, I don’t know whether I’d be able to keep doing what we’re doing. I get tired sometimes, but I think about how it was, and it helps me feel better.” There’s a brief pause, before he adds, “What about you?” He studies her, his gaze a little more incisive, as though he could read her thoughts. Though he cannot. Don’t worry, Megan.
"Most of the time, I think so," Megan agrees. "We won." Glancing at him, she grins a little. "We got what we were fighting for. Just occasionally when I see the cost and I'm feeling weary, it doesn't look quite like what winning should like like, yeah?" She sips from her coffee and then admits, "Nights when the ER is overrun tend to make me get a little morose. Sorry about that. I'll feel better after coffee." Hey, there's even real coffee. That's not always the case!
“Yeah,” Jim says after a moment with a little nod, and his voice is a bit quieter as he does. “I get that.” He glances away, before a little amused huff escapes him at her last words. “Don’t worry about it,” he says, lifting his cup toward her as he looks back to her again. “We all get that way. Comes with the territory, right? As long as we don’t let it get us all the time, I think it’s okay.” He finishes the coffee, and tosses the cup into the garbage nearby. “Ready to brave the craziness again?” He tips his head toward the door, but his smile widens a little bit as he does. Despite the reality of those words, they must not want it any other way, or they wouldn’t be doing it, would they?
She chuckles quietly and toasts him with her coffee cup. A brief, quick last drag on her cigarette and she snuffs it out and disposes of it in the receptacle, then takes a moment longer out in the cool air to let the resulting smoke waft away from her before reentering the building. "Once more into the breach," she replies with a wink. "I'd love to see you in my rotation more often." Competent, calm, and good at the job is always in demand.