summary: you and frank langdon have had a tumultuous professional relationship for as long as you could remember. it seemed as though he took every chance to challenge you since the very first day of your emergency medicine residency at the pitt. conflict has intensified even more since you were crowned chief resident of the department, and as the race to the single EM fellowship spot comes to a close. set over the course of an unorthodox shift at PTMC, this story follows you as you navigate the chaos of the ED, take a struggling med student under your wing, and try to keep your footing as your tension with langdon threatens to boil over. in a place where adrenaline runs high and emotions run even higher, rivalry becomes something far more complicated.
disclaimers: rivals to lovers, angst, VERY slow burn, no use of y/n (reader goes by "chief"), mostly follows the plot of the show closely (all credits given to the creators and writers of the pitt for these plot lines and dialogue), incorrect medical terminology
disclaimers: rivals to lovers, angst, VERY slow burn, no use of y/n (reader goes by "chief"), mostly follows the plot of the show closely (all credits given to the creators and writers of the pitt for these plot lines and dialogue), incorrect medical terminology
masterlist
Word count: 5.8K
--------------------------------------
September 5th, 2025 - 11:00 AM
“Chief, Langdon, we need you both on this case,” McKay shouts from across the emergency room, diverting your attention away from a conversation about the betting board with a couple of medical assistants. “Trauma One!”
Holding your stethoscope around your neck with both hands, you jog over to the trauma bay. You fumble with a box outside the room to grab a pair of gloves before you enter the doorway. Langdon rudely bumps his shoulder against yours as he steps in front of you to slide past and enter the trauma bay before you.
“Excuse you,” you mutter and roll your eyes dramatically.
“Any longer struggling with those gloves and the patient would have croaked before you even made it inside,” Langdon insults.
You fight the urge to bite back as the two of you flank the patient on either side of the gurney. You take a spot beside Javadi, and Langdon is opposite of you next to Cassie.
“Seizure in chairs,” McKay informs, eyes flicking between you and Langdon.
“Thank you. How is it out there?” Langdon asks as McKay and Javadi prepare to head back over to triage.
“Chaos, we’re never gonna catch up,” McKay shouts over her shoulder as she removes her gloves.
“Oh the joys of emergency medicine,” you drawl as you engage the guard rail on the gurney and hold the patient up on his side.
Langdon smirks as he mirrors your actions and raises the rail on his side. “Can’t take the heat?” Santos rushes in with a vial of antiepileptic meds and prepares the injection.
You chuckle dryly, “Don’t think I’d be Chief Resident if I didn’t thrive in the kitchen.” You catch a glimpse of Langdon biting his lip through a smile and shaking his head while he typed his login information on the desktop in the room.
“Lorazepam on board,” Santos interjects after pushing the medication through the patient’s IV.
“Draw up another 4,” you suggest, struggling to physically stabilize the patient through his spasms.
“Yeah, no history. Doesn’t look like he’s been here before.” Langdon’s brows furrow as he takes in the information on the screen in front of him.
Santos struggles to open the following vial of lorazepam. “Satting low 90s on 5 liters.” The vitals monitor starts to blare out an unsettling tone.
“Another 4 milligrams,” Langdon echoes your words from earlier when he notices Santos still hasn’t pushed the next dose.
“I can’t get the top off,” she communicates, continuing to attempt to flick off the plastic ring protecting the medication.
“It’s just the plastic, not the metal,” Langdon notes, turning around to evaluate her technique.
“Need a hand, Santos? We can switch off,” you offer. You were hoping to relive the pressure that she probably still felt from crossing Langdon just a half hour ago.
“No, I got it,” she insists frantically, finally flicking off the plastic and drawing up the next dose.
“Ordering CBC, CMP, and a straight cath for a urine tox,” Langdon voices the notes he is typing into the computer.
“Pushing the second 4,” Santos declares. “If this doesn’t work we need to prep Keppra.”
“No, we’ll give more lorazepam. It’s already ordered,” Langdon rebuts.
“But, he’s already had 8 milligrams. He’ll stop breathing,” she objects.
“Then we’ll intubate. Sometimes a patient needs a little more,” he argues back.
Langdon and Santos both look over to you, expecting you to be the tiebreaker vote. You look up at the ceiling, taking a moment to fairly consider both options. “I’m hesitant to give him more lorazepam than we already have but I think it’s our best option. We don’t have any history on him, he could be allergic to Keppra, and we already have more here ready to draw up. We have to work quickly,” you say with a single nod.
Langdon ambles back over to the gurney, this time standing next to you. He grips onto the side rails tightly and exchanges a stern look with Santos. You tilt your head to look up at him. Your lips part slightly as you admire him. How his hair is slightly more tousled than the last time you saw him, the messiness accumulating as more strands flop in front of his face. How his jaw clenches when he’s frustrated, making it even more defined than usual. How his striking eyes pierce into someone’s soul when he wants to tell him off.
You’re snapped back to reality when Robby enters the room. “How long has he been seizing?” he inquires, slipping on a fresh pair of blue gloves.
“Four minutes. McKay found him in chairs and brought him over to us,” you state.
“Pushing another 2 of lorazepam, for a total of 10, per Dr. Langdon’s orders,” Santos grumbles with a bit of sass in her voice. You lay the patient on his back now, expecting he might need to be intubated at any moment. Robby grabs the patient's spasming hand to prevent him from unintentionally striking someone.
“I’m well aware,” Landgon persists. Your eyes slowly drag between the two of them, already formulating ideas to diffuse the tension. You grab your stethoscope and place the diaphragm on the patient's chest to examine his breathing.
“He’s still seizing,” Santos exhales, clearly getting frustrated. She pauses for a beat, expecting a response from one of you. “Call respiratory,” she orders the nurse working the room. “I’m setting up an intubation tray.”
“Which we won’t need,” Langdon declares confidently.
“Dr. Santos, what is the definition of status epilepticus,” Dr. Robby quizzes and looks up at her from his position being hunched over the patient.
“A seizure lasting more than five minutes or at least two seizures without full recovery in between.” Santos rips open an intubation kit and spills the contents onto a tray that is handed to her by the nurse.
“Excellent,” Robby praises. Suddenly, the patient goes limp. Sighs are heard all around the room as everyone begins to relax.
“Seizure activity has stopped,” Langdon chimes.
“Also excellent.” Robby nods.
You continue to move your stethoscope around as you monitor the recovering patient. “Spontaneous breathing, good tidal volume.” The monitor's violent blaring calms to a steady, intermittent rhythm.
“Sats up to 98,” Santos announces in defeat.
“Welcome back, Mr. Marino.” Robby snaps off his gloves.
“Now, we can do a Keppra load slowly and safely,” Langdon smiles tightly and diverts his gaze back to Santos.
“Nice work, guys. I will be at Central if you need me,” Robby informs and exits the trauma bay.
“This must have been a bad vial. 8 milligrams should have worked,” Santos mutters as she inspects the writing on the glass packaging of the medication. Your brows furrow as you slowly tilt your neck to get a look at the information.
“According to your textbook of emergency medicine,” Langdon snaps. “Sometimes they need a little bit more. You’ll learn that with time.”
“Well, why couldn’t I open the vial?” she retorts.
“Because you’re an intern,” Langdon says, as if it explains everything.
Anger begins to build inside of your chest at the unnecessary dig. “Dr. Langdon-” you begin before he cuts you off.
“Who also needs to learn to trust her senior residents, especially in front of an attending. You had both Chief and I telling you this was the right call but our combined six years of experience didn’t seem to cut it for you.” You weakly look over to Dr. Santos with a pained expression on your face, hoping his words didn’t cut too deep. “Now check his labs. Babysit him until he goes to CT. And get some blankets on these side rails as a seizure precaution.” Langdon taps the rails of the bed before exiting the bay dramatically.
“You okay, Dr. Santos?” you ask, watching her continue to examine the vial of lorazepam in her hands.
She shakes her head but hesitates to form words. “The vial…it just didn’t feel right. It was, like, super-sealed shut.”
You nod your head and take a step closer. “Why don’t you talk to Dana. She can help you figure out how to report a quality control issue with medications.” Santos bites the inside of her cheek and shoves the vial into her breast pocket. Before she can walk out, you say one more thing. “The patient is okay now, Dr. Santos. That’s what matters. Don’t overthink it too much. Let me know when his CT results are back.” You give her a faint smile before exiting the trauma bay.
You slowly pad over to the nurse’s station, preparing to confront Langdon yet again about his harsh teaching style that borders on hazing before you hear his voice cut through the ER.
“Hey, look who’s in the house!” Langdon exclaims before embracing Jake, Robby’s son.
“Oh my God,” you say as you stop short, surprise breaking through your irritation. “Jake? I thought you were done growing by now, I swear you get taller every time I see you.” You chuckle and give him a quick hug.
“Jake the Snake!” Dana grins as she swoops in next, arms wide. “It’s 11:00 AM. Aren’t you supposed to be in school?” Dana asks as she approaches the teenager, arms extended for her own hug.
“Mom let me ditch for Pittfest,” he explains with a smile.
You stop beside the counter, arms crossing loosely. “Wow,” you say dryly, eyeing him. “And here I was thinking I’d have to write you a truancy note.” Jake perks up slightly, as if to ask if you could actually do that for him sometime before Dana interjects.
“How’s your mama?” Dana asks lovingly, placing a hand on Jake’s shoulder.
“Oh, she’s restoring some house in Squirrel Hill, so, you know she’s pretty busy.”
“That’s cool. You looking for Robby?” Langdon asks.
“Yeah he’s got our festival passes.”
Langdon tilts his head, curiosity flickering across his face. “Oh, you’re going together?”
“We were supposed to, but I decided to go with a friend.” He swallows and looks between the three of you, clearly aware of the unspoken judgment hovering in the air.
“What’s her name?” Dana interjects, prompting a blush to spread across Jake’s face.
“Leah,” he murmurs, the word barely audible at first, before shrugging and giving a shy, almost guilty smile. He scratches the back of his neck nervously, like saying her name aloud makes it suddenly real.
“Okay, okay,” Langdon teases, gently patting him on the back to congratulate him.
“Jake going on a date. Oh my gosh, I feel old,” you giggle, turning around to face Jake who nearly ran away from all the impending interrogations.
“We need details. Where’d you meet? How long have you been together?” Dana probes, folding her arms behind her back.
“We met at junior lifeguards this summer. And we’ve been dating for two months,” he reveals with a grin. He leans up against the counter, torso slightly leaning away as if he is scared of what we’ll ask next. “She’s pretty great,” he smiles and stares at the ground longingly.
You lace your fingers in front of you, fidgeting absently. The thought of him being so giddy about her prompted something in your chest to flip. You hadn’t really thought about how long it had been since the last time you were in love, or even infatuated with somebody. Your hectic schedule didn’t allow you to think about it often, but when you did, it was a feeling you really yearned for.
Without thinking, you tilt your head up to where Langdon is standing, only to realize he was already watching you with an unreadable expression on his face. A brief pause settles between the two of you, somehow feeling alone in the moment even with Dana and Jake right there. Suddenly, he looks away, clears his throat, and shifts his weight. The moment snaps, like it never happened.
“That’s sweet. I’m happy for you, kiddo,” Dana gushes. She places one hand on either of his biceps and gives him a squeeze. “I’m gonna go find Robby, let him know you’re here.” She trots off across the ER, glancing into each room she walks by to find the chief attending. The space she leaves behind feels suddenly smaller.
“Hey, Langdon says, stepping closer to Jake, voice dropping into something more conspiratorial. He circles around to stand on the other side of him. “A little advice, man to man.” You furrow your brows slightly as you observe the interaction. “Always compliment her outfit,” Langdon continues. “Hold her hand in front of your friends.” He pauses, then adds, “And always wrap it before you tap it.”
You let out a sharp breath. “Jesus Christ, Langdon.”
He doesn’t even look at you as he discreetly presses a condom into Jake’s hand.
Jake laughs, cheeks red, rolling his eyes as he pockets it. “I’m leaving now,” he says quickly, already backing away. “Before this gets worse.”
“Smart choice,” you call after him. Once he’s out of earshot of your remaining conversation, you shoot Langdon an annoyed look. “Unbelievable.”
“Relax. That was preventative medicine,” he mocks, a grin tugging at the corner of his lips.
“Back to work, Gandhi,” you tease, trying not to laugh as you shake your head.
You hesitate for a moment before passing him. “Try to keep up.” His grin says he will.
As you’re walking away you nearly run over a frantic Whitaker who is wearing a johnny rather than scrubs. Come to think of it, you weren’t sure if you had seen him not frantic this entire shift. It reminded you a lot of yourself during your first EM rotation before you realized how much you loved emergency medicine.
“Whitaker?” you ask in confusion.
His head is tilted toward the floor, his body going still at the sound of your voice. He moves a hand up to cover his face swiftly. “Uh-uh, Chief! Hello. Can I help you with something?”
Your brows knit together, and your lips part slightly. “You can start by looking at me when I’m speaking to you,” you reply with a chuckle, half joking and half concerned that something had happened to him.
After a brief moment of silence and his stance not changing, he slowly moves his arm down to his side and simultaneously lifts his head up to face you. His face and neck are covered in blood streaks.
You try, but fail to prevent the smile that’s already creeping up. “Who Jackson Pollocked all over your face?” you ask, taking a step closer to inspect the damage.
Whitaker exhales through his nose, half-laughing despite himself. “Arterial bleed,” he responds quickly. “It was hiding behind a monster blister on a patient’s leg.”
“That’s one way to learn,” you reply, eyes scanning him automatically. Pupils equal. Breathing steady. No blood soaking through his scrubs that doesn’t belong to someone else. Good.
“What happened after?” you inquire, wanting to ensure that the patient was taken care of prior to helping the med student change.
He shrugs, then straightens, clearly trying to sound more confident than he feels. “Once it started spurting, we used a BP cuff as a tourniquet to stop the bleeding. Mel helped me get it stitched up.”
“Good,” you say, nodding. “You stayed in the room.”
“Yeah,” he admits. “I wanted to step out, but… I didn’t.”
“That instinct passes,” you tell him, reaching for a pack of wipes and handing it over. “Eventually.”
He lets out a breath, wiping at his cheek. “It was kind of a lot.”
“They always are the first time,” you say evenly. “Blisters lie, arteries don’t.” That earns a real smile. You tilt your head, eyes flicking to the still-speckled collar of his gown. “Any of that blood yours?”
“No,” he assures. “Promise.”
“Good,” you reply simply.
“I like big butts and I cannot lie,” you hear an ominous voice creep up as Myrna rolls up behind Whitaker in her wheelchair. He turns around to face her which is when you get a view of his fully exposed boxers. You bite back a smile.
“Whoa. You scared me there,” Dennis laughs.
“Want a pony ride, big boy?” Myrna attempts to seduce him.
“What?” Whitaker is left speechless, clearly feeling violated at the interaction.
“Okay,” you drawl, breaking up the awkwardness. “Come on, Myrna, let’s get you out of here. Dr. Whitaker and I have some important confidential patient information to discuss.” You grab the handles of her wheelchair and begin to wheel her away from Dennis.
Before you fully walk away, you turn over your shoulder to say one last thing to him. “Go scrub up. Fresh scrubs, then come find me. I want you on my next case with me.”
He straightens up after learning you hadn’t fully given up on him after his third scrub change in five hours. “Really?”
“Yes,” you say without hesitation.
He nods, energized now. “Okay. Thank you.”
You watch him turn toward the scrub dispenser before turning back into the controlled chaos of the ER, already scanning for the next thing that needs you.
“You always snatch the cute ones away from me,” Myrna scolds, shaking her head.
-
“Travis Johnson, 17, had a tonsillectomy ten days ago at St. Michaels. Started spitting blood an hour ago. Good vitals,” a paramedic informs you as you rush over to get the new patient settled.
“Hi Travis, I’m the chief emergency medicine resident here. How much blood are we talking?” you query as you prepare a pair of gloves.
“Couple mouthfuls,” he informs.
“Okay,” you falter, fumbling at your breast pocket to grab your pen light. “Open up for me,” you request and shine the light in his mouth. You examine the damage at the back of his throat before putting the light away.
You turn around, looking for backup to help you on this case. “Dr. Whitaker, Jesse, I could use some hands here.” They both nod and promptly shuffle their way through the moving parts of the ER to reach you. “I got a post-tonsillectomy hemorrhage. Nebulized TXA ASAP,” you request of Jesse, and he gives you a thumbs up as he runs off to grab the supplies. “Let’s get him to trauma two,” you order, looking around at the two paramedics and Whitaker.
As the paramedics and Jesse wheel the patient inside the trauma bay, you quickly halt your motion and hold out an arm to stop Whitaker as well. You take in the fact that he’s now wearing the wrong colored scrubs, a light blue hue, but decide against commenting. “This could go south very quickly. You up for this?” He opens his mouth to answer but before he can you interject again. “Great! I knew you would be. Let’s do this.” You guide him into the bay with a hand lightly brushing the back of his arm.
You all huddle around the patient on the stretcher and grab a hold of the sheet he is laying on. “Ready?” you ask, eyebrows raised and look around at the huddled group. “Here we go. One, two, three.” You all carry your weight to get the teenage boy moved to the gurney that belongs to the trauma bay. Nurses work to transfer all the tubing and fluids already hooked up to the patient from his ambulance ride.
“Alright, Travis, I need you to take a few long, slow deep breaths of that TXA. It’s gonna help your blood clot to stop the bleeding,” you advise. The patient nods with the nebulizer now being held in his mouth by Jesse.
“Any medical problems?” Whitaker asks breathlessly, earning a nod of approval from you. You unravel your stethoscope from your neck and insert the earpieces.
“No, just a ton of strep. That’s why I had the surgery,” the patient answers. Lifting the patient’s shirt slightly, you place the diaphragm of the stethoscope at various landmarks on his chest to hear his breath sounds.
“You take aspirin? Any other medications?” Whitaker asks, earning a shake of the head from Travis.
“Lungs are clear bilaterally, no stridor,” you announce, removing the stethoscope from your ears.
“You feel like throwing up? Any pain in your belly?” Whitaker continues to inquire. He takes a step closer to the patient and begins to examine his abdomen, pressing down firmly.
“No,” he replies shortly.
“What labs are you ordering, Dr. Whitaker?” you quiz.
“Uh, CBC, BMP, maybe coags?” he half asks, half answers.
“Add a type and screen, just in case we need to transfuse,” you nod.
Nurse Jesse turns around to check the patient’s vitals. “Good sats at 98%. BP is 115 over 80,” he reveals, twisting his torso to look over at you.
“Beautiful. Four by four on a ring forceps, let’s take a look.” You hand the forceps pinching together a square of gauze to Whitaker for him to complete the inspection.
“Okay. Head back, open wide for me,” Whitaker requests. Jesse removes the nebulizer from the patient’s mouth. You shine a pen light into the patient’s oral cavity while Whitaker uses the forceps to sop up some of the free floating blood.
“What do you see?” You crank your neck to the side so that you’re able to see exactly what he’s seeing.
“No active bleeding, but there’s some white and dark brown stuff where the tonsils used to be,” Whitaker observes, looking to you for approval at the end.
“That’s good. That’s a fibrinous clot. It means the TXA is working,” you assure. “Are your parents on the way, Travis?” You divert your gaze back to the patient.
“They’re in Baltimore for a wedding. I didn’t want to bother them,” Travis replies before shoving the nebulizer back in his mouth.
You give him a soft smile, not breaking eye contact. “Travis, you’re in the emergency room. They’re your parents. They want to be here for you.” You grab a pen and notepad from a table nearby and hand it to the patient. “Write down their numbers for me, and I’ll be the one to bother them.” He nods and begins jotting down the numbers.
You turn back towards Whitaker. “Dr. Whitaker, you call Head and Neck with the phone in here, and I’ll inform the parents.” Before giving him a chance to respond, you scurry out to use a landline at the nurses station.
You dial the first number written down on the notepad to no avail. The line rings three times and you’re sent straight to voicemail. You sigh before leaving a concise voicemail to inform the parents that their son is receiving emergency care. You’re about to attempt the second number that Travis provided to you before Whitaker’s voice grabs your attention.
“I need a little help in here!” he yells out from the door of the trauma bay, prompting you to slam the phone down and run back over to the room. Langdon trails behind you as soon as he spots you running from across the ER. You take note of the blood spattered across Whitaker’s scrubs, more obvious this time that he’s wearing a lighter color. You immediately clock that the patient coughed up more blood.
“Post-tonsillectomy hemorrhage,” you explain breathlessly to Langdon once you see him run in the door after you. “Get us a Yankauer and sponge stick.” You grab the aspirator and attempt to vacuum up the blood gurgling around in Travis’s mouth.
“He was stable, then it just opened,” Whitaker informed, standing behind the patient and propping his head up.
“Call the blood bank! Two units, whole blood. Get a second line,” Langdon orders to the nurses assisting the case.
“What did Head and Neck say?” you ask Whitaker.
“They refused to come down to see him,” he informs.
“Assholes,” you and Langdon both mutter simultaneously. Both of you turn and lift your heads to look at each other, and fully bump foreheads in the process as you’re both hunched over on each side of the patient.
“Ouch,” you whimper, rubbing your forehead with your free hand. Langdon curses under his breath and does the same. You let out a short, frustrated huff and wipe your own brow, meeting his eyes for just an instant. Langdon blinks first, a half-smile tugging at his mouth. Chaos continues around you, but for a heartbeat, the world narrows to the two of you.
“Tachy to 120. His sats are down to 90%,” Jesse shouts from the end of the bed.
“Okay, get a high-flow nasal cannula,” Langdon asserts.
“Give him 100 of ketamine,” you tack on. “Set up the GlideScope.”
“Hold suction,” Langdon meets your gaze, “I’m going to try for direct pressure.” You nod and promptly remove the Yankauer from Travis’s mouth.
Langdon carefully slides a pair of forceps holding gauze into the patient’s oral cavity and pushes it against the back of his throat.
“Call Garcia,” you request of Jesse.
You turn back to face Travis and observe his eyes darting around at all the different faces in a panic. You place your hand on top of the patient’s for comfort. “You're doing great, Travis, we’re gonna get you all patched up in no time,” you speak quietly.
While your eyes stay on Travis, you catch Langdon’s glance. He’s focused on the bleed, but you know he’s noting how you handle the chaos while remaining gentle with the patient. You meet his eyes only for a heartbeat before returning to the patient.
“Let’s lie him down,” you instruct, already shifting position as you hear Robby enter the room.
“What happened?” Robby asks, snapping on a pair of gloves as he takes in the scene in a single sweep.
“Bleeder opened up,” Whitaker says quickly.
“Ketamine on board to intubate,” Langdon adds, preparing the tubing and GlideScope. You exchange positions with him without a word, sliding into place as he steps aside. Your hands close around the forceps, muscle memory taking over.
“Sats holding at 97,” Jesse reports from his spot by the monitor.
“Can you get an airway?” you ask Langdon, your tone calm but watchful.
He scoffs lightly, “Come on.” You raise your eyebrows, still preparing yourself to jump in if necessary. He begins to lower the scope down into the patient’s mouth. “Nothing but blood. Can’t see the cords.”
“Sats 94,” Jesse updates.
“Not sure we have room for the tube with the sponge stick,” Langdon informs you as he shifts his movement.
“If I pull out,” you counter, tightening your grip, “we’re gonna get a lot more blood.”
“Doesn’t look like you secured that airway,” Garcia chimes in as she enters the room donned in her PPE, sliding on a pair of safety glasses into place.
“He’s working on it,” Robby defends and gives her a stern look.
“Bougie,” Langdon requests, not taking his eyes off the screen.
“Open a crike tray and prep the neck,” Garcia asks a nurse off to the side.
You glance at her sharply. “What’s with you and all the criking today, Garcia?”
She smirks, “Efficiency.”
“Hold on,” Langdon interrupts. “I’m going in blind with the bougie. I might be able to feel the tracheal rings.”
“And I might have a three-way with Madonna. Move,” Garcia commands as she finishes setting up a crike tray.
“Not happening. Pressure.” Langdon locks eyes with you desperately and you nod, applying more pressure to the wound. You nod and lean in, applying more force. Your hands begin to tremble, but you don’t ease up.
“Make room for the grown-ups,” Garcia continues to badger.
“Okay, okay. Hold on. We can try a retrograde intubation,” Robby suggests after another failed attempt from Langdon to get the tube in. “There’s no obstruction, we just can’t see what we’re doing. We take a needle, and we put it in the cricothyroid. We run a guide wire up and out the mouth, and we slide the ET tube up over the wire.” Robby begins to prep the patient for the procedure by placing a sterile drape over his chest.
“Never seen one before,” Langdon mutters.
“Me either,” you admit. “First time for everything.”
“Sats 90,” Jessie updates again.
“No time to play MacGyver with this kid. It’s time to crike,” Yolanda presses.
“It’ll be quick,” Robby assures her.
“You get one shot,” she replies, loosening her stance just enough. “Then I cut.”
You observe as Robby inserts a catheter into the patient’s neck and then smoothly slides the guide wire through the entrance. “Let me know when you start to feel it up top,” Robby states.
“Nothing yet. More suction,” Langdon orders.
“I’m trying,” Whitaker groans, panic creeping into his voice.
“Mm. Still can’t find it.” Langdon’s tongue sweeps across his lips as he focuses in on the patient even more.
“Well, keep feeling in there. It’s gotta be there somewhere,” Robby persists. You catch Garcia’s stare burning into the back of Robby’s head.
“Sats down to 89,” Jessie says.
“Guys, this is not working,” Garcia says firmly.
“Just give me a second,” Langdon snaps.
“Until he arrests?” she challenges.
“Oh my god, I’m gonna lose another patient,” Dennis whimpers, tears welling in his eyes.
“Whitaker. Cut. It. Out,” you seethe through your teeth like a stern mom when her toddler acts up in a grocery store. His face firms up immediately.
“Sats down to 87.” Jessie starts peering over in a panic.
“I’m gonna redirect the wire,” Robby updates.
“Sats still dropping. 86.”
“You got this,” you encourage, looking between Langdon and Robby.
“Sats 84. We need to bag him,” Jessie urges.
“Still not seeing it,” Langdon sighs.
“I’m suctioning like crazy,” Whitaker interjects.
“Pressure still firm,” you say, hands burning now from the force.
“Okay we’re done playing doctor. Lose the wire. I’m criking this kid,” Garcia announces, scalpel in hand.
“All right, we tried. I’m sorry,” Robby admits defeat.
“No, wait. Wait. I’ve got it,” Langdon says, sudden certainty in his voice as the wire bites against resistance.
“You still don’t have an airway,” Garcia badgers.
“Keep the laryngoscope in place so the tube passes easily,” Robby guides. “Pass the T, the T tube over the wire. Hang on to that wire. Do not let go of that wire.”
“25 centimeters at the lips,” Langdon announces.
“That ought to do it. Pull the wire, bag him.” Robby prepares his stethoscope to examine the breath sounds.
“Balloon’s up,” says Jesse.
“Yellow on CO2. That’s good,” Whitaker exhales with wide eyes.
Your shoulders finally drop. “It’s fucking fantastic,” you say, a giggle escaping your lips at the adrenaline rush reaching a peak.
“Good breath sounds bilaterally,” Robby notes, softening his tone.
“Sats coming up,” Jesse adds.
“Guess you’re gonna have to save that scalpel for another day,” Langdon mocks Garcia with a toothy grin.
“You guys got lucky,” Garcia admits, peeling off her gown in defeat.
“No, we got skills, baby. We got skills!” Langdon shouts out behind her. “Ordering propofol and fentanyl drips.” Langdon gleefully saunters over to the desktop to type in his orders. You laugh and hand off the forceps and blood-soaked gauze to Whitaker. The room finally exhales around you.
“Nice of you to join us, Dr. Flores,” Robby greets the ENT attending who just entered the room.. They always did seem to arrive just a moment too late to be useful.
“Sorry,” Flores replies easily, unfazed as he surveys the scene. “Got stuck in a nasty radical neck dissection.” He glances toward the bed. “Still bleeding?”
“Not with direct pressure,” you answer, moving to stand beside the two attendings.
“We’ve got the airway,” Robby adds, crossing his arms. “You get the bleeder.”
Dr. Flores wraps his stethoscope around his neck. “OR’s standing by.”
“So I can cancel the Uber?” Whitaker drawls, earning a few tired chuckles from around the room.
“Fresh sponge stick for you, Whitaker,” Jesse says, already pressing forceps into his hand. Whitaker swaps them out with more confidence than he’d had an hour ago.
“You need me to stay here?” he asks, turning to Dr. Robby.
“He’s your patient now. You did a good job,” Robby praises. You shoot Whitaker a big smile and give him two thumbs up from behind Robby. “It’s only until the anesthesiologist takes over. You got it?”
“Yeah, I got it,” Whitaker says confidently, nodding at the two of you.
“Get yourself a fresh pair of scrubs on your way back down,” Robby orders and begins walking out. You and Langdon fall into step behind him, the three of you pausing outside the trauma bay. You can practically feel each other still buzzing from the rush.
“Where’d you get that move?” Langdon asks. The three of you pump the hand sanitizer dispenser in succession and huddle around the outside of the trauma bay.
“Retrograde intubation. That’s an Adamson special. I learned that from the best,” Robby replies, looking fondly into the distance.
You had been trying to avoid the topic of his late mentor’s death anniversary today, opting to distract Robby with your charm and optimism. “That was fucking awesome,” you beam, nearly jumping up and down.
“You’re not too shabby yourself, Professor,” Langdon adds.
Robby’s mouth curves, though his eyes stay thoughtful as he looks between the two of you. “Yeah, that got kind of rough in there. You both kept your composure though. Exactly the kind of candidate they want for the ED Medical Education Fellowship,” Robby smiles tightly and looks between the two of you.
“Well that’s great but there’s probably like a million people competing for the one spot,” you exhale with a weak smile. Langdon shifts beside you. You feel it more than you see it. When you glance at him, he’s already looking back, something guarded passing between you before either of you can name it.
“Yeah probably. But I know that they like to go with someone that they know from firsthand experience has the skills to be successful.” He takes in both of your confused expressions. “At least that’s what I told them in my recommendation letters for both of you. It’s gonna be a fierce competition, but you guys are used to that with each other right?” Dr. Robby flashes a grin at each of you. He doesn’t wait for an answer, peeling off down the hallway and leaving the tension humming in his wake.
You and Langdon stand there, shoulder to shoulder, the hum of the ER filling the space where something else wants to be said.
He opens his mouth, and then closes it, deciding against whatever he was about to say.
You turn toward the nurses station and walk toward your next endeavor of the day. The unspoken conversation is left lingering in the hallway.
disclaimers: rivals to lovers, angst, VERY slow burn, no use of y/n (reader goes by "chief"), mostly follows the plot of the show closely (all credits given to the creators and writers of the pitt for these plot lines and dialogue), incorrect medical terminology
masterlist
Word count: 5.2K
--------------------------------------
September 5th, 2025 - 10:00 AM
Once your phone call with the local police department wraps up, you return the landline to its docking station and scan the nurses station for someone to spread the news to. You spot Cassie and Victoria having a catch up and approach them quickly.
“Dr. McKay, Javadi,” you greet with a smile. “I hope I’m not interrupting anything important.” They both shake their heads.
“Oh not at all,” McKay assures, tucking the iPad in her hand between her torso and her arm. “Do you need a hand with anything?”
“Well, yes, sort of,” you sigh. “Someone stole an ambulance from the bay just a few minutes ago. We have no idea who it could have been, so I just wanted to gauge if maybe you guys had seen anything suspicious?” You raise your eyebrows hopefully and fiddle with the pen in your hand by clicking it in an erratic pattern. It always felt inappropriate involving junior residents in the petty administrative drama that came with being chief resident, but occasionally there was no way around it.
Javadi’s jaw nearly drops to the floor, and McKay’s eyebrows raise as her eyes widen. McKay looks to Javadi before answering. “I don’t think it would have been anyone we’ve come across today, but we can definitely keep you in the loop if anything comes to light.”
“Thank you, McKay. I can always count on you,” you grin and shoot her a wink. You’re suddenly reminded of the incident with Mr. Bradley in Jenna’s room prior, and realize you hadn’t gotten the chance to update them about their patient. “Oh, by the way, have you guys heard what happened with Mr. Bradley earlier?”
“Yeah, Dana actually was just telling us about that. I’m so sorry that happened while you were there, are you okay?” McKay asks concerned. Javadi simply nods behind her and gives you an apologetic look.
“It was definitely frightening in the moment, but I’m good now,” you state with a confident nod.
Before you can say more, Dr. Mohan approaches the group with a peppy smile. “Hey, girls! Is it alright if I steal you, Javadi? I have a sickle cell patient that I think would be really great for you to see,” she requests. Both Javadi and Mohan look to McKay for approval.
“Of course, go nuts guys,” McKay approves and gives them a smile before they trot off to a patient room across the hall. Her neck extends a bit to make sure they’re out of sight before taking a step closer to you with a smirk plastered on her face. “So, back to Mr. Bradley. Langdon really bailed you out of there, huh?”
Your brows furrow and you remove the pager from the waistband of your pants, suddenly very interested in a page that didn’t even exist. “Yeah. He loves to make it clear to everyone that I can’t handle a situation by myself,” you mumbled, fiddling with the pager in your hands.
“I don’t think it’s like that at all,” Cassie laughed. “You guys seem to be getting along better than usual lately. To me, it seemed like he was being protective.” She shrugs casually.
You reflected a bit on the state of your relationship with Langdon. On the number of friendly interactions to argumentative blowouts. Although the arguments probably had not decreased at all, there definitely were a few more wholesome moments being sprinkled between you both the past few months. Especially today. You ignore the feeling that there’s something tugging at your heart when you think about it.
“As if Langdon would ever be protective of me. He relishes in my despair,” you dramatize and take a look at the triage board.
McKay takes a beat without looking away from you. “You don’t have to like him,” she begins. “But he has a lot of respect for you, whether you realize that or not. And…I think he’d lose it if something happened to you.”
“Hey, Dr. McKay,” a voice interrupts from a few feet away, prompting you both to find nurse Mateo striding over cooly. “Mind giving me a hand with Mrs. Davis? She’s trying to split but I don’t think she’s good to go just yet.”
McKay nods to Mateo then looks back over to you. “See ya later, Chief,” she acknowledges with a smile, already walking away next to Mateo.
-
You’re in the midst of debriefing the ambulance heist with a pair of police officers and the paramedics when you’re interrupted by a piercing screech that echoes throughout the emergency room. You all attempt to ignore the potential bloody murder happening just feet away from you, and the conversation turns back to everyone scolding the paramedic that left the keys inside of the ambulance.
Dana checks in with you to inform you that a trauma is coming in at the same time that Langdon approaches the group and tells everyone to clear the doorway. You promptly grab a gown and a pair of gloves to slip on as a new pair of paramedics wheels in the gurney with the new patient.
“Wendell Stone, 52, chief rigger from Pitfest. Isolated trauma to the left chest. Speaker tower came down on him. Looks like multiple rib fractures. Pulse 110, BP 130 over 85. Decent sats at 96. 50 of fent in the field,” a lanky paramedic with tousled hair informs you, Santos, and Langdon as you follow them to the trauma bay. Simultaneously, the patient is throwing orders at his seemingly coworker who came to accompany him.
“How we doing Mr. Stone?” Landon inquires as you enter the trauma bay where the patient is parked.
“Mr. Stone was my dad. Just Stone,” the patient insists.
He is cut off by yet another patient screaming from a nearby room, this time a much deeper voice. “Who the hell woke the Kraken?” you utter knowingly as you begin to untangle some of the wires and tubing connected to Stone.
Langdon and Santos begin to examine the patient in parallel. “4 of morphine,” Langdon instructs the nurse when he notices the patient wincing in pain from the contact.
“No abdominal tenderness,” Santos shouts.
Dr. Garcia and Robby enter the room shortly after. “What have we got?” they both inquire at the same time.
“Jinx, you owe me a coke,” Garcia teases with a laugh.
“Isolated chest trauma with-” Langon begins, before Garcia cuts him off mid sentence.
“Stop. I want to hear from Dr. Santos,” she orders and looks over at Trinity. Robby awkwardly looks between the two of them and exchanges a confused look with you while he adjusts the overhead lamp.
“Isolated chest trauma with obvious flail chest. No hemopneumo on POCUS. Good sats and vitals,” Santos presents without missing a beat. You begin to prep the patient’s belly for a FAST ultrasound to test for internal bleeding. You evenly apply the jelly all over his stomach.
Dr. Garcia smiles, “Excellent presentation.” She turns to the patient before continuing. “Sir, I’m Dr. Garcia from surgery.” Garcia palpates Stone’s abdomen to examine for distention. You press the ultrasound probe into his stomach and scan the area.
“I need surgery?” Stone questions in surprise, riddled with anxiety.
“We’re not quite sure yet, Stone,” you falter as you make eye contact with the patient. “No blood in the belly on FAST,” you inform the staff around you.
“You guys got this together?” Robby looks between you and Langdon, already starting to walk out of the room.
“Do I have a choice?” you tease as your gaze meets Langdon’s eyes. With a clean towel, you begin to wipe the excess jelly off of the patient’s abdomen.
“Fortunately for you, Chief, you’re stuck with me,” Dr. Langdon shoots you a forced smile and returns his eyes to the patient. Stone groans when Garcia touches his bruised chest.
“Abdomen is benign,” Yolanda announces, “CT chest, abdomen, pelvis with contrast to rule out any internal bleeding. And more morphine for Christ’s sake.”
“No, no, no. Don’t knock me out,” the patient protests. “I gotta stay on top of the crew doing the put in.”
“The what?” Garcia asks, puzzled.
“The festival. He’s working Pitfest,” you state. “Stone, we’ll block the nerves going to your ribs to help out with your pain without impairing you.”
Langdon nods in agreement. “Let’s roll him to the right.” You swiftly pull up on the same side of the patient as him, your sides nearly touching. On a count of three, you and Langdon push him to face the same direction as you while Garcia and Santos pull him towards them on the other side of the bed.
“That’s a ton of intercostal blocks,” Garcia protests.
“Nope–” you and Langdon begin at the same time.
“Serratus anterior blocks down to T-9,” he adds before you can finish your sentence.
“You kids and your crazy regional blocks,” Garcia mocks, presumably getting deja-vu to the Nepalese woman from earlier this morning. She examines a message on her pager. “Dr. Santos, call me with the CT results. Extension 1121.” She smiles and exits the trauma bay. Instinctively, you and Langdon basically break your necks to look at each other, having clocked Garcia’s blatant favoritism to Santos.
“Alright, Santos. Looks like you’re the chosen one taking Stone to CT. Keep us updated with the results, and let me know if you need help with anything,” you snap off your gloves and give her a nod.
Langdon peels off his gloves and gown in tandem and follows you towards the door. “You don’t actually hate it,” he comments ambiguously, stuffing his gown and gloves into a nearby biohazard bin. You’re now presumably out of Santos’s earshot.
You keep your back to him, fingers working at the knot behind your neck a second longer than necessary. “Hate what?” you question, slowly untying the gown before slipping it off, buying yourself time.
Out of your peripheral vision, you feel that his gaze lingers on your face in a way that prickles along your skin. “Being in it with me,” he reveals, almost too casually.
Your fingers tighten around the edge of the gown. For a heartbeat, you forget to breathe. “Don’t flatter yourself, Langdon,” you scoff, pretending to ignore the impact his words have on you.
You finally glance at him, and he’s already backing away, the faintest curve to his mouth, like he’s said something true and knows it. The curtain falls shut behind him, but the words stay, unsettling and warm in your chest, long after the trauma bay resets around you.
You busy yourself with resetting the bay long after it’s no longer necessary. You straighten linens that are already smooth, wipe down a counter that’s already clean. Anything to keep your hands moving so your thoughts don’t. This is stupid. He’s stupid. You’re better than letting a single, half-muttered line rattle you like this. You’ve worked with him a hundred times. You’ve traded jabs sharper than scalpels. So why does today feel different? Why does your chest still feel tight, like something unspoken lodged itself there and refused to move? You shake your head, annoyed at yourself.
Get it together. It was nothing. He’s nothing.
And yet, as you step back into the noise of the ER, you can’t quite convince yourself of either.
-
You rush back to Mr. Stone’s trauma bay when the frantic wail of monitors slices through your small talk with Mateo. You’re already moving before you register Langdon and Santos breaking off from their stations and falling into step behind you.
“What’s going on?” Langdon demands as you reach the bedside. You and Landon approach the gurney on one side. Santos circles to the opposite side, putting herself directly across from the two of you.
“Hypoxic to 78. BP’s crashing. Systolic’s 82,” Jessie rattles off numbers from the various monitors surrounding the patients. Langdon removes his stethoscope from around his neck and begins to listen to the patient’s lungs.
Santos places her fingers to the patient’s carotid pulse. “Pulse is thready. I should intubate. Does he need a massive transfusion protocol?” She speculates as she stumbles to lower the side rail of the gurney on her side.
“No. Absent breath sounds on the left. Tracheal deviation to the right,” Langdon snaps.
Your stomach drops into focus. “Grab a 14 gauge angiocath, now, and get him on a non-rebreather” you order.
“What are we doing?” Santos asks as she wildly grabs supplies from Jessie and shoves them over to you and Langdon. Langdon grabs the angiocath and preps to relieve the pressure.
“Tension pneumothorax from the BiPAP’s positive pressure,” Langdon informs flatly. He doesn’t look at her as he drives the catheter into Stone’s chest. Air hisses free. The room exhales with it.
“Who the hell put him on BiPAP in the first place?” you mumble, slightly relieved that Langdon has bought you some more time now.
“Was it Garcia?” Langdon points, looking towards Jessie for guidance. Jessie opts not to speak, but shoots a look towards Santos.
Santos confesses, “No his-his sats were down. I did.” She lowers the patient’s head back onto his pillow carefully.
“You did?” Langdon begins slowly and you brace yourself. His voice is quiet in a way that’s dangerous. You could already sense he was about to blow up at Santos. “Without running it by either of us?” Langdon points a finger between you and him.
“Can I put in a chest tube?” Santos asks breathlessly, ignoring Langdon’s confrontation.
“He doesn’t need a chest tube. He needs a pigtail catheter. And Chief is going to be doing it while I keep my eye on you,” he chastises. His words land hard. You feel Santos stiffen across the bed.
“Sats and pressure both coming up,” Jessie reports. He sets up the field with clipped precision. You pull on a gown and sterile gloves, your movements steady even as the air in the room tightens.
“Draw up 75 of ketamine,” Langdon orders, heat still simmering beneath every syllable.
You catch his eye. “Dr. Langdon,” you voice quietly, eyeing him with your brows raised. His gaze snaps to yours. “Take a breath,” you suggest, keeping your voice quiet. Not as a command but a reminder.
His chest rises once. Twice. He exhales through his nose and reaches to help you drape the patient, hands controlled again. You notice the effort it takes as he reins himself back in. “We all want the same thing,” you say, calm and even, holding his gaze long enough to make the point land. “Let’s get him there.” Langdon nods once, sharp and clipped, and then turns back to the field.
Langdon and Santos quickly don their PPE and assist you in prepping Stone for the pigtail catheter insertion. The room settles into a familiar rhythm. You deliberately keep Santos close, give her something useful to do. It’s easier to learn when your hands are busy.
“Whoa, what did I miss?” you hear Robby query as he enters the room again.
“A little drama from a tension pneumo,” Langdon responds. You don’t look up as you mark your incision site, but you feel Robby’s attention swing between you, Langdon, and the intern standing far too stiffly across the bed from the three of you now.
“Drama aside, he’s still breathing. Let’s keep it that way,” you say and lay out the sterilized equipment on the metal table by the bed.
“You could have called me,” Robby assures.
“We got it under control,” Langdon replies. “And Dr. Santos learned what can happen when you put a patient with a small pneumothorax on BiPAP.” You bite back the urge to sigh. Teaching moment, sure. But the patient is still right there.
“Ah,” Robby trails, suddenly understanding the predicament.
“Thumb scalpel,” you request and hold your hand out, deliberately keeping your tone neutral, grounding. It’s an olive branch of sorts. Back to the work, back to the point. Santos gently places the scalpel in your hand, fingers brushing your glove before she pulls away.
“He was hypoxic. I thought it would help,” she defends. You keep your eyes on the incision, steadying your breathing, hoping the room doesn’t tilt back toward blame.
“But you didn’t discuss it with Chief or me. And he almost died,” Langdon crosses his arms while he watches you make the first incision. You feel the weight of his words even without looking at him. Too sharp. You decide to step in before this calcifies into something Santos carries for years.
“Dilator,” you request and collect the instrument from Santos. “Dr. Santos,” you add quietly, just for her, “watch the angle here. This part matters.” She leans in from across the bed to witness the procedure.
“You need to run every order by a senior resident or attending,” Langdon scolds, continuing to dig into Santos. You were starting to feel a bit bad at this point. It was clear she had gotten the hint and learned her lesson.
“That’s why it’s a four year program,” Robby adds, taking Langdon’s side.
You glance up. “She gets it,” you say evenly. “Let’s focus.” You keep moving, sliding the wire in with care, narrating every step so Santos has something concrete to hold onto instead of the heat of the moment. “When you do this procedure, make sure to never lose the guidewire. If it gets sucked into the chest cavity, it’s game over,” you instruct as you begin to slide the wire into the cut you made by Stone’s ribs. “Ready for the pigtail.” You grab the catheter from Santos and prepare for the insertion.
“What the hell are you doing,” a new voice snaps you out of your zone. Your shoulders tense for a split second before muscle memory takes over. You look up to see Garcia speed walking into the trauma bay, her presence instantly shifting the temperature in the room. “Pneumo is tiny. It’ll resolve spontaneously.”
You open your mouth to respond, but Langdon beats you to it. “It was tiny until the patient went on BiPAP,” Langdon jumps in to defend you. Or berate Santos further. You couldn’t really tell.
“Are you fucking kidding me?” Garcia swears.
“Guidewire out,” you interject, your voice firm, professional, reclaiming the room as you remove the apparatus. You make a point of narrating it, anchoring everyone back to the patient.
“His sats were down. I-I gave the order,” Trinity sighs, defending herself again.
You feel her spiral starting and step in before it goes too far. “We’re here now,” you say calmly. “And he’s stabilizing. That’s what matters.” You quickly fumble with the Heimlich valve that came with the kit and connect it to the now inserted catheter.
“Without clearing it with us,” Langdon badgers.
Garcia smiles and crosses her arms, looking at Santos fondly. “Honest mistake from the rookie. That’s how we learn.” Garcia responds. The room stills.
Langdon nearly breaks his neck from cocking it sideways to look at Garcia. The movement is sharp, reactive, like he can’t decide whether to be offended or impressed. Garcia doesn’t flinch. She meets his stare head on, chin tipped slightly upward, arms crossed but loose. It isn’t just authority she’s holding. It’s confidence, and something a little more personal.
They exchange blank stares for what feels like forever, neither willing to blink first. You keep your head down, finishing the catheter setup, but you register every second of it. The territorial tension is obvious, the unspoken hierarchy battle playing out in silence. Santos stands caught between them, frozen. Her eyes flick back to Garcia without thinking, not fearful so much as searching.
Eventually it draws Robby’s attention. He looks from them to you as you finish connecting the drain. You don’t comment. You secure the line and give a small nod. The patient is stable. Everything else can wait.
You straighten slowly, peeling your gloves off and letting the snap break the silence. When Langdon turns toward you and Robby, you all exchange a knowing look.
“If she knew everything she’d be your attending, not an intern,” Garcia continues to defend. Her tone is casual, but there’s warmth under it. Santos feels it. You see her shoulders ease slightly, see the way her gaze lingers on Garcia before darting back to the floor. She still looks like she wants to disappear, but she’s standing a little taller now.
“That is very true,” Robby adds. You nod once in agreement and shift subtly closer to Santos, close enough to be reassuring without making a show of it.
“Besides, it could have happened on its own without the BiPAP,” says Garcia.
“Wow. Beautiful moment. A lot of love in the room,” Langdon mocks.
“If you’ll excuse me,” Robby says, prompting his exit. “Nice save,” he pokes his head between you and Langdon.
You clear your throat. “While Dr. Langdon could definitely work on his delivery,” you begin, making it clear you don’t approve of his teaching style, “he’s pushing because the stakes are high in emergency medicine. We’re extremely lucky we were able to catch this in time. Let’s try to make sure the next teaching moment doesn’t involve putting people’s lives at risk.”
Silence settles in the wake of your word. He looks at you, really looks at you this time, eyes sharp but thoughtful. You’ve challenged him in front of everyone, but you didn’t undercut him. He recognizes the difference.
Garcia studies you next, one brow lifting slightly. There’s something like reluctant respect there, mixed with the faintest edge of irritation. You didn’t give her the opening she wanted. You didn’t take her side either.
Santos stands very still between the two of them. Then she nods once, small and serious, like she’s committing the lesson to memory. Her eyes flick to Garcia again, softer now, something unspoken passing between them. Gratitude, maybe. Or something more complicated.
Langdon moves first, stripping off his gloves and tossing them aside with more force than necessary. As he passes you, his shoulder brushes yours, not quite an accident. He doesn’t stop, but you hear him exhale, slow and controlled, like he’s forcing himself back into line.
Garcia lingers, just long enough to murmur something low to Santos that you don’t catch. Santos’s mouth twitches, tension easing from her shoulders as she follows Garcia out, close enough that their arms nearly touch.
The bay empties. You stand there for a moment longer, hands braced on the bed rail, the adrenaline finally bleeding off.
Behind you, Langdon pauses at the threshold. You don’t turn, but you feel his attention settle on you anyway.
“Chief,” he says, low and controlled.
You glance up, looking at the wall in front of you, not turning around to face him just yet. “Yeah?”
He steps closer to you, deliberate, careful not to cross the line. The weight of him presses in anyway. “You let her off easy.”
“I didn’t,” you reply evenly, starting to organize your tools. “We corrected the patient’s course, Langdon. That’s the priority.”
“She risked someone’s life,” he snaps, voice taut. “And you… you just stepped in and fixed it. She needs to feel it. Learn it. Not just survive it.”
You finally turn around to face him. The calm in your expression is deliberate, almost icy. “And you think screaming at her in front of the patient and the rest of the team would teach her better?”
“I think she needs to know the stakes,” he says, jaw clenched. “And she needs to know you mean them. You should have been harder.”
You tilt your head slightly, not breaking eye contact. “Being harder doesn’t mean losing control. If I humiliate her, she won’t learn anything. She’ll just fear me. And fear is useless in a crisis.”
He takes a breath, sharp and slow. “Fear isn’t the point. Respect is. Authority. She has to understand consequences. I trust her skills, but not her judgment yet. And I expect you to make sure she does.”
You let your fingers brush the bedrail behind you, deliberate and grounded. “I don’t need anyone to tell me how to teach or correct mistakes, Langdon. She’ll learn. Just like you and I did.”
Langdon’s gaze narrows, his jaw tight, arms still crossed. “I’m not telling you how to correct mistakes. I’m saying you’re not pushing hard enough. You let her get away with too much. And if she almost kills a patient again…”
You cut him off. “You want her scared? Go scare her yourself,” you say, sharp. “I run the room.”
“Damn it,” he mutters, his frustration growing. “You always have to prove you’re in charge, don’t you?” He runs his hand through his now messy hair that's flopping on his forehead.
“I am in charge,” you snap back, voice clipped. “And don’t forget it.”
He exhales through his nose, shoulders stiff. “Fine,” he says, just loud enough for you to hear. “Don’t act surprised when I don’t let her off easy. She needs it.”
You watch him walk away, teeth gritted, pulse still buzzing from the argument. Every instinct in you screams at how infuriating he is. How he always has to push, to provoke, to make you feel like you’re not good enough. And the worst part? You can’t believe you’d even started to think maybe you were warming up to each other. Stupid. Completely stupid. And yet here you are, seething at him, and somehow still thinking about him.
-
“Hey Chief,” Dana greets you soon after you exit the trauma bay with Stone. “Need your help with something.”
“Hey, Dana. What do you have for me?” you ponder, taking a few steps toward her to meet her in the middle.
“I collected a squad to restrain the Kraken long enough to inject some IM Haldol to calm him down. I just need you to hang out outside the room and call security if things escalate,” she orders and gives you a tight smile.
“For sure,” you nod in approval and follow her over to a group of people, including Whitaker, Perlah, Donnie, nurse Kim, and Larry, one of the medical assistants on the floor. “Hey, gang,” you acknowledge cooly with a grin as you approach the group. “I’m on backup duty. You guys got this. Dr. Whitaker, you’re injecting?” You felt it important to refer to him as “Doctor” in moments like these.
He nods nervously as he snaps a pair of gloves on. “Lucky me,” he says, forcing a smile that doesn’t quite stick.
You place one hand on either of his upper arms. “Eyes on the prize, champ,” you tease and lightly shake him to perk him up. “Lets do this, people!” You walk Whitaker over to the rest of the group that has assembled outside of the Kraken’s room at this point.
Dana waves us over. You can hear the patient’s muffled screams in the background of the bustling ER through his enclosed room. “Okay, you ready? One, two, three,” Dana counts down before opening the door quickly and rushing everyone inside.
The team works quickly. Donnie and Larry each hold down a leg, Dana and Kim each grab an arm, and Perlah restrains his head. They use all their strength to hold the patient down as he writhes and tries to escape their grasp. You hover by the open doorway, heart ticking up as you watch the chaos unfold, eyes locked on Whitaker.
He hesitates for half a second too long before darting in. “What do I do? What do I do?” Whitaker shouts in a panic when he realizes the patient won't sit still. You gasp in shock and try not to laugh when you realize Mr. Krakhozia is fully urinating on Whitaker as he scrambles to get his bearings. Whitaker builds up the courage to get close enough to block the stream of pee and jab the needle into the patient through his pants. He lets out a strangled sound as the needle goes in, and the patient instantly relaxes.
Everyone sighs in relief and backs away from the patient once they realize he’s gone limp.
“Congrats, kid. You just earned your yellow wings,” Perlah joked through the fabric of her mask.
“Midazolam should take him down in a few minutes. Haldol should kick in after about 20,” you comment from your spot by the door. “Great job guys.” You smile with teeth and give them all two thumbs up.
“Let’s monitor him in the meantime,” Dana says and nods in approval before exiting the room.
Whitaker turns to you, holding his arms out, clearly disgusted with himself. “Do I really need to wait here for 20 minutes?”
“I’ll hang back,” Perlah offers, already checking the patient’s vitals with a cart nearby.
“At least you already know how the scrub dispenser works now,” you chime, trying to lift his spirits.
-
“I just discharged Jenna,” Mohan informs as she walks up next to you at the counter you’re charting at. “She’s so lucky she made it. Not everyone that’s come in today can say the same,” she says as she grabs an iPad off the shelf next to you.
You sigh and turn to face her. “I know. She’s such a sweet girl too. I’m glad she’s able to get home early. Thanks for that, Samira.”
“Mr. Bradley,” you hear a voice behind you choke out as they run by you and Mohan. You both spin around to witness Jenna confronting Mr. Bradley. “I just wanted to apologize for the way I spoke to you. There’s no excuse. I was gonna ask a nurse to give you this, but it’s my number and email. If I can ever be of any help in any way, please.” She hands Mr. Bradley and his wife a small sheet of paper. “I’m so sorry. I really hope he pulls through.” She wipes a few tears away with the back of her hand. Her parents gently guide her away, their arms around her shoulders. She takes one last glance over her shoulder at the bedside she just left, and you see the weight of the day press down on her small frame.
It’s only after she disappears from view that the sting of tears hits you. You close your eyes briefly, blinking rapidly to keep them at bay. You can’t imagine the survivor’s guilt, the helplessness she must be feeling, standing there trying to offer comfort when her friend’s life is hanging in the balance.
You take a deep breath, letting the tension in your shoulders ease slightly. Another life saved today, another narrow escape, and yet the weight of the near-loss still presses in. You glance at the chart you’d been working on, grateful for the routines, the tools, the teamwork that make moments like this possible. It doesn’t erase the fear or the sorrow, but it reminds you why you keep showing up.
disclaimers: rivals to lovers, angst, VERY slow burn, no use of y/n (reader goes by "chief"), mostly follows the plot of the show closely (all credits given to the creators and writers of the pitt for these plot lines and dialogue), incorrect medical terminology
masterlist
Word count: 4.7K
—------------------------------------
September 5th, 2025 - 9:00 AM
The code goes on in near silence. The only sounds that travel through the room are the constant beeping of the monitor, the air wheezing out of the ambu bag, and Dennis’s grunts as he attempts to get Mr. Milton back.
Suddenly, a crackling sound is heard and a look of horror spreads across Whitaker’s face. “Shit, I think I just broke some ribs,” he stammers.
“It means you’re doing it right,” Langdon assures.
“Donnie lets prep that third round of epi,” you voice, seeing that three more minutes have passed on the clock.
Donnie fumbles with the last syringe of epi in his pocket and injects it through the patient’s IV line. “Third amp of epi is on board,” he confirms. He hovers over Whitaker on the other side of the patient bed, knowing Mr. Milton’s fate just as well as you do.
The pace of Whitaker’s compressions speed up again. Droplets of sweat run down the side of his face and cling onto the fabric of his scrub top. “Come on,” he coughed out.
You twist your torso slightly right to look at Langdon, who looks to be just as bummed out as you are. “Langdon, we’ll be good here if you wanna go check on your other patients,” you state. You didn’t want there to be too many people around when you had to break the news to Whitaker that we had lost the patient.
Langdon slightly nods in understanding. “Call me if there’s a resurrection,” he says, already half-turned away, and slips through the small gap in the curtain. The fabric whispers shut behind him.
You hesitate for half a beat before drifting toward the opening, unable to help yourself. You peek your head out of the room, eyes scanning the chaos beyond. Gurneys lining the hall, a trauma team sprinting past, Dana barking orders near the desk. Your pulse spikes with the familiar itch to be in the middle of it, to do something.
Three more minutes, you remind yourself. You force your hands to unclench at your sides. If something truly urgent were happening out there, someone would grab you. They always do.
Inside, the room hums with compressions and monitor tones. Whitaker’s arms tremble as he keeps the rhythm. You step back in fully, refocusing, grounding yourself in the patient in front of you. This is where you’re needed.
Several moments later, the curtain parts again and Dr. Robby enters, eyes immediately sweeping the room, clocking every detail. “Third epi on board?” he asks you.
“Three minutes ago,” you confirm, glancing at the code timer before meeting his gaze.
“How long has he been going at it?” Robby questions, alluding to Dennis.
“10 minutes in here, possibly 30 minutes of prior downtime,” Mel informs, adjusting her stance near the foot of the bed.
Your eyes flick to Dennis. His jaw is set, breathing controlled through clenched teeth. You move closer. “You’re doing great,” you murmur under your breath, just loud enough for him to hear. “Keep that depth. You’ve got this.”
“Don’t suppose you’d let me try a pericardiocentesis,” Santos asks as she enters the room, clearly having been hovering around in the hall for the past couple minutes.
“For what?” Robby asks, barely looking at her.
“For practice,” Santos states matter-of-factly. “In case it’s tamponade.”
You straighten slightly. “None of that seen on the ultrasound,” you inform from across the room, tapping the mental image you still have of the scan. Flat pericardial space. No effusion. No miracle hiding there.
Santos folds her arms. “This is a teaching hospital,” she says firmly. You roll your eyes and scoff at her attempt to get the chief attending to let her use a still-warm body to rehearse an irrelevant procedure on.
“It’s not a cadaver lab,” Robby shoots back.
“What do you call this?” Santos contends. Robby turns toward her slowly, disappointment etched deep across his face.
“We’re not here to practice procedures,” you say sharply. “We’re here to give Mr. Milton his best shot with his integrity intact. You probably didn’t even know his name. Show some respect.” Robby looks at you and nods in approval.
“Do you need a break,” Mel offers, the attention in the room shifting back onto the code. Santos creeps out of the room, presumably to find another near-dead patient to prey on.
Dennis shakes his head immediately. “I’m fine,” he insists, though the words come out ragged, his chest heaving between compressions.
You step closer again, keeping your voice low. “You can switch out for thirty seconds,” you say gently. “It won’t undo what you’ve done.”
“I’ve got it,” he repeats, more stubborn than steady.
“Hold compressions,” Robby commands. The false rhythm on the monitor returns to a natural flatline. For a fraction of a second, the room is eerily still. Dennis doesn’t even realize he’s started again until Robby speaks. “Okay, Whitaker, I think that’s enough.”
“It’s been four minutes since the last epi,” Dennis pleads, finally looking up, eyes glassy. “One more minute, please.” His head tilts toward Robby, hopeful in a way that makes your chest ache.
Robby checks the watch on his wrist as Whitaker continues going through the motions for another moment. “5 minutes since the last epi,” you note quietly, giving the number weight. Finality.
Robby exhales, “Okay, that’s it. Hold compressions.” Relief flickers through you. Not because it’s over, but because you didn’t have to be the one to end it.
Dennis slows, then stops, a beat too late. His hands hover over the patient’s chest, like he’s unsure where to put them now. He looks at you, searching but lost. The monitor continues its long, empty drone until Donnie steps in behind him to silence it.
You move to the bedside. Your hands find the neatly folded blanket at Mr. Milton’s feet. You draw it up over his torso, smooth it once, then gently cover his face. The room feels smaller without the noise.
“He took his wife out for dinner last night,” Whitaker says suddenly. “For her birthday.”
You turn back to him. “That’s a good last day,” you say softly.
“Why doesn’t everyone take a break,” Robby suggests. “Go check on your other patients. We’ll meet back here to debrief with Kiara.” He nods once and leaves.
You linger a moment longer beside Dennis. “You did everything right,” you tell him, steady and certain. “Sometimes that’s all we can do.”
He swallows, nods once, and wipes his face with the heel of his hand before slipping out of the room. The ER swallows everyone back up; monitors, call bells, the churn of patients who are still alive and waiting. A few minutes later, the team filters back in, quieter now, forming a loose semicircle around the empty bed.
“Okay. What went well?” Robby asks. The room is smaller now, emptied of urgency, Mr. Milton’s body is still laying on the bed. Everyone stands in a loose circle, arms folded, hands tucked into pockets, eyes drifting anywhere but the mattress. The adrenaline has burned off, leaving only weight.
“We checked for reversible causes of cardiac arrest on ultrasound,” Mel offers.
Robby nods once, encouraging. “Okay, good. Does anybody have anything that they wish had gone differently?” he probes.
Dennis shifts his weight. You can see him replaying the timeline in real time — hallway, room, hands on chest. “In the hall, he should have been on a cardiac monitor,” Whitaker interjects. “We would have caught the arrest right away.” The words come out carefully, but they carry a weight anyway. Blame that was aimed squarely at himself.
“That’s true,” Robby acknowledges, not dismissing it. “But there was no indication for cardiac monitoring. And we now know that his abdominal pain was not from his gallstones but from unstable angina due to coronary artery disease.”
Whitaker’s brows furrow. “Then we should have admitted him to cardiology,” he rebuts, grasping for a different ending.
You shake your head gently. “We did an EKG, troponin. He had a HEART score of three. He only had a one percent chance of an adverse cardiovascular event in the next thirty days.” The facts hang between you, solid and unforgiving. Not excuses, but truth.
“Standard of care is to discharge with outpatient follow up,” Collins adds. The words settle like a period at the end of a sentence no one wants to finish. Dennis’s shoulders dip, more in acceptance than defeat. The room is quiet enough that you can hear the distant beeping of another monitor through the wall. Another patient, another chance.
Robby lets the silence breathe before speaking again, “He was your patient, Dr. Whitaker. Would you like to say something before we all take a brief moment of silent reflection?”
Dennis blinks, caught off guard. He opens his mouth, closes it, then tries again. “Uhm…He liked Kentucky bourbon…” A small, fragile detail. Human and real.
A smile tugged at your lips. “And lattes,” you tack on, softly, offering him a thread to hold.
Robby chuckles at your sentiments, “Okay. Good, me too. Anything else?”
He stares at the empty bed, searching for something more substantial than vitals and labs. “I don’t know, I just met him. He seemed nice. He was married. Um… that’s it. That’s all I got.” It’s clumsy. Incomplete. Perfect.
Mel bursts into a fit of applause, instinctive and earnest. She then freezes, hands dropping as she realizes no one else has moved. Her face flushes as she cringes, muttering a quiet, “Sorry.” The moment passes without cruelty.
“I spoke with his wife. She’s on her way here. If anyone needs to talk about this some more, I’m available,” Kiara comments. Her voice is gentle and practiced. It’s the unexpected deaths that rattle people the most in the ER.
Robby folds his arms. “For now let’s harness some positive thoughts here for Mr. Milton.” The room obeys. Eyes close. Heads bow. Some mouths move in silent prayer. Others simply stand still, bearing witness. You keep your gaze lowered, thinking of bourbon and lattes and a birthday dinner that ended too soon.
“Okay,” Robby says at last. “That’s it. Let’s go save some lives.” The spell breaks. The team disperses, one by one, slipping back into motion.
As Dennis turns to follow, you catch his sleeve. “Hang back a second,” you say quietly. “I just want to see how you’re doing.” Robby gives you an approving nod before exiting the room.
Whitaker nods and lets the curtain hang open after the others file out. The room feels hollow without them. It’s just the two of you and the memory of what happened here.
He stares at the floor. “I keep thinking… if I’d asked one more question. If I’d pushed harder about the pain. Maybe I would’ve caught it.”
You lean back against the counter behind you, giving him space while staying present. “That instinct you have? The one that’s already replaying everything?” you say gently. “That’s what’s going to make you a good doctor. But you can’t allow it to punish you.” You take a beat. “Look, Whitaker, I’ve been doing this for three years now. A bit longer if you count the sub-i I did here in med school. I didn’t catch this either. And there’s no version of reality where I would have ever caught this. I don’t even think Robby would have. You can’t beat yourself up over this.”
He swallows, “It felt like he trusted me. And then he just…” His voice cracks. “I was right there.”
“And you didn’t stop,” you remind him. “You showed up for him in the only way that mattered when it counted most. You didn’t walk away. You did everything right.”
“That doesn’t bring him back,” Whitaker sighs.
“No,” you agree. “But it means he didn’t die alone. It means his last moments were spent with someone who cared enough to fight for him.”
Dennis finally looks at you. “How do you do this? Just… keep going?”
You think of the hundreds of losses that live quietly in your bones. Of the people whose names you still remember. “You don’t get used to it,” you say. “You just learn how to carry it. And you don’t carry it by yourself.” He nods slowly, absorbing that. “You’re allowed to feel wrecked by this,” you add. “Just don’t let it convince you that you’re a bad doctor. You’re not.”
A breath leaves him, shaky but real. “Okay.”
You offer a small, steady smile. “Okay is enough for today, Dr. Whitaker.” He finally gives you a soft smile in return. The best form of encouragement for a med student is reminding them that the light at the end of the tunnel is approaching, and soon enough they’re going to be doctors. After giving him a light pat on the shoulder, it’s back to work.
You step back into the hall with that familiar ER whiplash. Grief sits heavy in one room while life is still barreling forward everywhere else. The world refuses to pause. You make it three steps before a familiar voice cuts through the noise, “Chief.” Your shoulders tense before you even turn.
Langdon stands near the med station, chart tucked under one arm, gaze already on you like he’s been waiting. The earlier edge is still there, polished and rehearsed, but something beneath it has softened.
You slow, not stopping right away. You let him wait the extra second. Then you turn. “You stalking me, Langdon?” you taunted.
A corner of his mouth twitches, and he restrains himself from rolling his eyes. “Sorry about Milton.” Your brows furrow slightly, pleasantly surprised that he was offering you a moment longer to grieve the loss.
You angle your body toward him without fully closing the distance. “Whitaker’s first,” you reply melancholically.
His expression shifts. It’s subtle, but you catch it. He knows exactly what that means. “Yeah,” he says. “That one sticks.”
You lean back against the counter at the nurses station, arms folding like armor. “He did everything right,” you add, because the words still need somewhere else to go.
“I know.” Langdon’s gaze flicks briefly toward the room you came from. “I watched him in there. Kid didn’t flinch. He held the line.” You study him, searching for the usual condescension. It isn’t there. Just recognition.
The corner of your mouth curls up into a smirk. “Well, he is learning from the best,” you boast, overexaggerating your influence on him.
He chuckles dryly. “And you handled Santos,” he adds.
You scoff, “You mean when I didn’t let her turn a man into Human Anatomy Lab 101?” As your memory flashes back to the moment where you shut Trinity down, you remember that Langdon had already seemingly left the room at that point. You don’t bring it up, but realize he must have been keeping an eye on you from afar.
“Mm.” He nods. “Robby backed you without hesitation.”
“He would’ve shut it down either way.” You glance past him, toward the moving tide of the ER. You don’t want this to become about you.
“Maybe,” Langdon says. His eyes don’t follow your gaze. They stay on you. “But it mattered that it came from you.”
You feel that land. Feel the way it presses at the space between your ribs. There it is. The thread pulled tight between you.
“It was about Whitaker,” you reply, snapping yourself out of the feeling. “Not me.”
“I know,” he says. Your eyes meet before you can stop them. Neither of you looks away. The ER noise dulls, as if the world has decided to grant you this one fragile pause.
A trauma alert blares overhead.
Langdon steps back first, professionalism snapping back into place. He hesitates, then adds, “You’re good with them. With all of them.”
You tilt your head as you push off the counter and begin to walk over to the recently admitted trauma. “Careful. Sounds like praise.”
His lips curve. “Don’t get used to it,” he teases.
You meet his gaze. “You’re good too. You just hide it behind that attitude.”
That earns you a real, toothy smile. It’s brief and unguarded.
“See you in the trenches, Chief,” he shouts, turning around and jogging backwards to face you one last time before running off.
“Try not to get in my way,” you shoot back, now jogging yourself in the opposite direction. The words are familiar. The tone is not. You can’t help but notice Princess, who is trailing behind Langdon to accompany him on the incoming STEMI, looking between the two of you with a sly smile on her face.
You shoot her a confused smile back before running into a trauma bay that is already filled with staff, working on a patient that got shot in the heart with a nail gun.
“This place sucks. I will destroy you on Yelp,” the patient threatens as Collins begins to place gauze around his closed wound. “Nobody’s ever comin’ to this shithole again, I swear to God.”
You snicker to yourself while Perlah helps you gown and glove up to assist with the removal of the nail. “Alright. Let’s keep him alive long enough for him to leave that review,” you declare.
-
Placing your palm under a sanitizer pump, you lather the foam all over your hands before checking in on McKay’s patient. McKay had called out to you that her hands were full with another patient, so you assured her you would check on Jenna for her.
“Knock, knock,” you announce before opening up the curtain to the patient area. You’re greeted by a brunette college-aged girl scrolling on her phone in bed, while her friend is anxiously rambling to someone on a chair next to her. “Hi Jenna. Dr. McKay is a bit busy with another patient right now, and she asked me to check in on you. I’m the chief resident here at the emergency department. How are you feeling?”
She slowly places her phone down in her lap. She doesn’t smile, and the look on her face spells existential dread. “Hey. Thanks, Doc. Nice to meet you,” she still exchanges pleasantly. She fiddles with the nasal cannula wrapped around her head that is supplying her oxygen. “I’m feeling better, I think. Am I gonna be able to get out of here soon?”
You log into the iPad clutched in your hand to check on the last notes written in the chart by Javadi. Continue to monitor. Discharge once vitals stable for several hours. “It looks like Dr. McKay is okay with you leaving once we get a few more sets of stable vitals on you over the next few hours. But you should be able to get out of here by the end of the day if you’re still doing well. Is it okay if I get another set of vitals to add to your chart?” She nods in compliance and finally gives you a tight smile, presumably relieved at the fact that she’s going to be okay and home soon.
After checking her blood pressure with the cuff and your stethoscope, you check her heart rate, oxygen saturation, and count her respiratory rate. You hang your stethoscope back around your neck and begin entering her stats into her electronic records on the iPad you had brought over with you.
“Where did you get the fucking drugs?” a sharp voice heckles from the entrance to the room.
Your head snaps around to see who the offender is, and you’re faced by the father of Robby’s brain dead overdose patient from earlier this shift. “Who are you?” Jenna spat, looking up from her phone that she was already scrolling through again.
“Did you give them to my son? Did you give my son drugs?” Mr. Bradley continues to accuse from beside the curtain, waving his hands around.
“Mr. Bradley,” you scold sternly. “I need you to calm down, sir. You’re not permitted to be in patient rooms.”
You begin to approach him but flinch when he begins to raise his arms again, stopping you from getting too close. “Tell me the fucking truth,” he shouts, body facing Jenna now and pointing towards her. Against your better judgement, you slide in between the aggravated father and Jenna’s bed, hoping to protect her from his ire. All the commotion in the room has drawn attention from the staff in the hallway. Dana starts dialing the phone number to call security.
“Sir,” another voice cuts in from the hall. The voice is calm, low, and threaded with command. “You need to step back.”
Langdon appears at the opening in the curtain, one hand already lifting it aside. He takes in the scene in a single glance: Mr. Bradley’s rigid posture, Jenna frozen against her pillows, you standing squarely in between them with your shoulders set. He clenches his teeth, but his tone doesn’t rise. “This isn’t your room,” he continues evenly. “You don’t get to interrogate patients.”
Mr. Bradley completely ignores Langdon’s presence and continues to berate Jenna. “Did you drug my son?”
“Your son gave me the drugs, asshole. Ask him,” Jenna retorted, opting to defend herself.
“He’s dead. And you are a fucking liar!” Mr Bradley lunges towards Jenna. “You killed my son! You killed my fucking son!” The movement is sudden. You brace instinctively, heart vaulting into your throat as his weight pitches forward.
Langdon moves at the same time you do. He doesn’t shove you aside. He doesn’t bark orders. He simply steps in, one hand catching Mr. Bradley’s forearm mid-lunge, the other bracing his shoulder.
“Hey,” he says firmly, voice low but unyielding. “That’s as far as you go.” Mr. Bradley struggles against him, breath coming ragged. You feel the rush of air as Langdon’s shoulder brushes yours, close enough that you can sense the heat of him, the tension held tight beneath his calm. He keeps himself between the man and Jenna without ever overtly taking your place. He just widens the barrier you had already established.
Security floods in a heartbeat later. They peel Mr. Bradley away, one on either side, his protests echoing down the corridor as he’s escorted out of the bay. The curtain sways in his wake. The noise of the ER seeps back in around the edges, as if the room itself exhales.
Only then do you realize your hands are trembling. You force them still and turn back to Jenna, grounding yourself in the professional rhythm. “You’re okay,” you tell her quietly. “He’s gone. I’m gonna make sure that doesn’t happen again.”
She nods, wide-eyed. Her friend clutches her arm.
When you turn, Langdon is already stepping away, as if he’d merely been passing by.
“Nice instincts, Chief,” he remarks casually as you both walk down the hallway. “Terrible self-preservation.”
Your brows knit. “I had it handled.” In reality, you weren’t really sure if you would have had it handled had Langdon not been there to physically deescalate the situation. But you would never admit that to him.
He finally looks at you before something unreadable flickers across his expression. “Yeah,” he says. “I know.”
-
As you’re walking by the supply closet, you hear a loud rattling sound coming from inside. You take a step back and peek inside to see someone’s hand struggling to open the drawer of the scrub dispenser. Your gaze shifts to reveal that it’s Whitaker, with some sort of white substance littering his black scrubs. He’s startled when he sees you standing there, holding back a grin.
“Ch-chief-,” he stammers for a second before slowing down and taking a breath, as you have instructed him to earlier today. “I had a bit of an accident with the Mylanta.” He sheepishly looks down and a flush creeps upon his cheeks.
“Rookie mistake,” you giggled and walked a bit closer, crossing your arms.
“Uh, there’s no scrubs in here,” he continues and points to the dispenser.
You nod. “Yeah, kinda a whack system. You have to put your old ones in before it coughs out a new pair,” you inform succinctly. You grab a johnny from the rack nearby you and toss it in his direction. He just barely catches it and looks at you with wide eyes. “You need help changing too?” you tease him with a laugh before he runs off to find a vacant patient room to change in.
-
“Chief, we have a bit of an….issue,” Dana falters, snapping you out of a daze of working on patient charting at the nurses station.
“Oh yeah, don’t worry. I already know about the loose rats. Facilities should be dealing with the issue now,” you assure her and turn your head back to your computer to finish off the sentence you were typing.
Dana pauses as if the news she’s about to deliver will ruin your day. “No, hun. Somebody just stole an ambulance.” You stop in your tracks and swivel your chair to fully face her now. “Was takin’ a smoke break and one of the paramedics almost got their arm torn off by someone driving off with the ambulance.”
You pause for a beat, completely flabbergasted. This is something you have not experienced yet. One thing about working in the ED is that you encountered a unique problem you’d never dealt with almost on a daily basis. “Uh…” you begin, not quite sure how to handle this. “Any leads on who it could be?”
“No leads at all. I’ll let Robby know too but he seems pretty caught up with the Bradleys, so figured we could get a head start on it,” Dana explains.
“Got it. I’ll notify the authorities. Make sure the paramedic gets checked out, and let’s both spread the word to see if anyone else might know anything,” you assert, already beginning to dial the number of the local police station into one of the hospital landlines. Dana pads off to examine the injured EMT on a stretcher in the hallway.
Sighing heavily, you press the phone up to your ear. Rats, cursing patient families, and stolen ambulances and it’s not even lunch yet. Your eyes shift to the time in the bottom right corner of the screen on the desktop you were using.
9:59 PM.
You could already tell you were going to need a miracle to get through this shift.
-
a/n: hi everyone! I just wanted to pop in at the end and say i hope everyone is enjoying the fic so far and is liking the pacing. I don’t want it to feel like I’m giving you scraps with the Langdon interactions but I really want to focus on building and representing the relationship steadily here before jumping into anything too crazy, since this literally all happens in the course of a day. Want to be upfront that i foresee the rival to lovers arc taking a while to flesh out, and i’m thinking of continuing to write into a sequel pairing with season 2 if people like this enough. Just want to emphasize that if you guys do not like a slow burn this is probably not the fic for you haha. I also want this to be an overall “The Pitt” fanfic, not just a Langdon fanfic, and I want the reader to really feel integrated and a part of the universe other than just with the pairing I’m portraying, as I feel that a lot of fics don’t get to dive into that as much! We’re making this fic pass the Bechdel test guys. I’m always open to feedback though and want my readers to enjoy so def let me know what you all think! Thanks for all the support I’ve gotten so far :) let me know if anyone wants to be added to the taglist. see yall soon xo
disclaimers: rivals to lovers, angst, VERY slow burn, no use of y/n (reader goes by "chief"), mostly follows the plot of the show closely (all credits given to the creators and writers of the pitt for these plot lines and dialogue), incorrect medical terminology
chief year masterlist
Word count: 4.7K
-
September 5th, 2025 - 8:00 AM
“Where are we going now?” Mr. Milton inquires, brows knitting together as the bed begins to roll. You and Whitaker are standing at either side of the stretcher, guiding him carefully out of his assigned room and into the humming and beeping of the emergency room hallway.
“We need the room for someone else,” Whitaker explains gently, hands steady on the rail. “But you can rest in the hall until we get your labs back.” He offers an apologetic smile, the kind that makes it hard to be annoyed at him for anything.
Mr. Milton studies him for a moment before breaking into a grin. “Your parents must be proud,” he declares. “Having a son for a doctor.”
Whitaker lets out a soft, almost embarrassed laugh, glancing instinctively in your direction as a faint blush creeps up his neck. “Yeah, I guess,” he acknowledges. “I was the first one in my family to go to college. They sacrificed a lot to get me here.” There’s something earnest in his voice, unpolished and real, and it makes your chest ache just a little. You catch his eye and give him a small, approving nod, so to say, you’re doing great, before he turns back to the patient, professionalism snapping neatly back into place. “How’s your pain, Mr. Milton?” You watch the exchange with a fondness you don’t bother to hide. This is why you love teaching. Seeing it click. Seeing compassion come naturally.
“Ah, I’m fine,” Mr. Milton waves him off. “I could use a latte though.” He raises his eyebrows suggestively.
You bite back a smile. Whitaker opens his mouth, clearly torn between patient satisfaction and basic medical knowledge, so you step in before he can twist himself into knots. “Unfortunately, that could trigger your gallstone pain, Mr. Milton,” you explain, voice gentle but firm. “And then we’d all be having a much worse morning.”
Mr. Milton sighs theatrically, “How about a bourbon?”
“It’s barely 8 AM,” Whitaker jokes back. “How about some ice chips?”
“No, thanks. I prefer my whiskey neat,” the patient declines.
You fold your arms, arching a brow as you begin to back the stretcher into its spot along the wall. “Yeah,” you say flatly, “that’s not happening.” Whitaker grins, quickly neutralizing his expression as he follows you away. As you step back, you glance at him again, pride flickering across your face, and he straightens just a bit, like the approval means more than he’ll ever admit.
You take two steps away from the stretcher before the sense of being watched settles between your shoulder blades. Across the ER, Langdon stands near the trauma bays, chart in hand, posture loose enough to pass for casual. His attention, however, isn’t on the monitors or the patient board. It’s on you.
On Whitaker, lingering at your side a beat too long. On the way you speak to him — low, steady, encouraging. Langdon’s eyes flick away briefly, then return. His jaw shifts, just once, like he’s chewing on something he doesn’t quite want to taste.
Whitaker laughs at something you say and the sound travels throughout the emergency room. Langdon exhales sharply and turns a page in his chart with more force than necessary. He doesn’t look back again right away but his shoulders stay tense, his stance rigid where it hadn’t been before.
You never meet his gaze. And whatever is sitting heavy in the air between you stays there, unspoken.
-
A pair of paramedics burst through the ambulance doors with a gurney between them, breathless and blood-splattered. “Twenty-three-year-old, Ben Kemper,” one of them calls out as they rush toward the trauma bay. “No helmet. Got doored riding an e-scooter. Neck versus handlebar then face-planted to the pavement. Obvious facial fractures, but alert and oriented with good vitals.”
The department pivots in an instant. Conversations cut off mid-sentence. Charts are abandoned. Chairs scrape back as anyone with a free moment moves at once, pulling on gowns and gloves snapping into place. The bay fills with motion and purpose. It’s all hands on deck.
After the team works to transfer the patient from the stretcher to the bed, you swiftly hook him up to telemetry monitoring to assess his rhythm and vitals. “How you doing, Ben? Can you hear me?” you ask as your hands work to finish setting him up.
“Blood, back in my throat,” the patient manages to gurgle out. Mel checks his ears and nostrils with a flashlight.
“That’s probably from the nosebleed,” Langdon informs the patient while he throws a pair of gloves on.
“A and O,” you announce to the team to let everyone know he’s alert and oriented. “Someone get me the suction. I’m just gonna get rid of some of that blood that’s bothering you, Ben.” Santos hands you the aspirator, and you attempt to vacuum up the free fluid floating in his mouth. “Tachy at 120, pulse ox borderline at 90.”
“Neck contusion, larynx shifted to the right, no crepitance,” Santos shouts over a nurse that is reading out more of the patient's vitals.
“4 of morphine,” Langdon points at the nurse. He grabs a pad of gauze and rolls it up. “I’m going to stick something in your nose to stop the bleeding.” He’s now hovering over the patient's face. Still suctioning, you adjust your stance to stand on the side of the patient’s face opposite of Langon, giving him room to work on his nose. You remove the aspirator once you see most of the blood is gone, and Landon backs off once the gauze is inserted. “How about now, Ben?”
“Better,” Ben gasps softly. Dr. Garcia struts in, fully donned in her personal protective equipment, looking around to assess the scene.
“Let’s have a look,” Langdon states, looking at Yolanda as he prepares to examine the patient's injuries. He hooks two fingers under the patient's upper jaw, lifting up slightly to reveal Ben’s maxilla fully detached from the remaining bones in his skull. You shudder slightly at the sight, both amazed and disgusted. Ben gags at the impact. “Floating face.”
“Le Fort III fracture,” you confirm, reporting from the other side of the patient’s head.
“You don’t see that every day,” Robby remarks, face blank. “Okay, let's prep for airway. Double set up just in case.” Robby begins to walk out of the trauma bay and everyone shuffles around to prepare for either an intubation or cricothyrotomy.
The room tightens around you as the patient’s sats plummet, alarms blaring in uneven rhythm. Santos is already at the head of the bed, hands steady on the ambu bag, eyes flicking between you and the monitor as she ventilates. Garcia murmurs about landmarks and scalpel size beside you. Langdon stands across from you, gazing towards you, laryngoscope in hand. You lock eyes with him for half a second, a silent challenge passing between you before you nod and grab the scope. “Okay,” you say sternly, voice cutting through the chaos, “let’s intubate. If we can’t, then we crike.”
The bag rises and falls under Santos’s grip, and the curtains ruffle as Dr. Robby weaves his way back into the room. “How we doing?” Robby presses as he adjusts the new gown he threw on.
“Ketamine and sux on board,” Langdon announces, fiddling with the pillow under the patient’s head.
“Pulse ox holding at 94,” Santos says, hands still working to squeeze the ambu bag.
“Prepping the neck just in case,” Dr. Garcia calls out from behind the new intern.
“Let’s have a look,” Langdon nods to you as you attempt to guide the laryngoscope into the patient’s trachea. The beeping of the machines remains steady and your breathing gets heavier the more you struggle to find the airway. “A little deeper,” Landon insists, making eye contact with you and then turning back towards the monitor. You fight the urge to snarkily tell him you know how to intubate a patient.
“There’s too much inflammation. I can’t see shit,” you struggle as you try to guide the scope both left and right with no success. “I still think I can get it.” You keep attempting to maneuver the apparatus, hoping to get some glimpse of the trachea before either going in blind or ceiling the patient.
“I think we should crike,” Garcia suggests, looking slightly uninterested, now standing behind Langdon. You scoff and turn to Dr. Robby for guidance, not quite ready to give up.
Langdon shakes his head. “You don’t crike a laryngeal fracture. Don’t listen to Edwina Scissorhands,” he turns to you, walking closer, validating your thoughts before you even had a chance to speak up. Although you hated to admit it, you fully had each other’s back on this one. His entire facial anatomy is unstable and you have no idea what the state of his larynx is looking like. “If they can’t cut it, surgery doesn’t know how to fix it,” Langdon mumbles, continuing to take jabs at an unamused Dr. Garcia.
Garcia ignores Langdon and begins to prep for a cricothyrotomy. “The contusion is high at the thyroid cartilage. So you just stand there looking pretty, ER Barbie and Ken, and let me fix this” she mocks both of you as she sets up around the patient. Langdon rolls his eyes and is about to fire back before you interject. You choose not to bite back right now. There’s a life on this bed, and that matters more than pride.
You brace one hand on the rail of the bed, the other still wrapped around the scope. Your eyes never leave the patient as you cut in, sharp and steady, “No. You cut into that, you’re carving through a shattered landmark. You’ll make a false tract and lose him completely.” Your gaze flicks to Robby, then back to Garcia. “We buy time. Keep bagging. I’m going again. If I can’t pass a tube, then we talk trach below the injury. Not a blind crike through a broken larynx.” You shake your head as you re-center the scope, jaw tightening.
“We’re down to 85,” nurse Jesse declares anxiously, watching the patient's oxygen saturation fall steadily on the monitor.
“I-gel, bag, and crike,” Dr. Robby demands, shrugging apologetically. You look at him, eyes wide, in utter disbelief at the fact that he was betraying his two star senior residents.
“Dr. Robby, you can’t be serious,” you almost laugh, continuing to plunge the scope deeper until you’re right before where you expect the airway to be.
“I-gel, please,” Yolanda smirks after getting Robby’s approval. You respected Garcia and her professional opinion greatly; if anything, historically you were more likely to take her side than Langdon’s. But you still believed you could save this patient without cutting into his throat. You look over to Langdon, almost hoping he’d fight with you to intubate. His lips tighten into a flat line, and you both know at this point you’ve lost the battle.
You sigh dramatically and hand the laryngoscope to Jesse, walking towards the end of the patient bed to offer up the procedure to one of the junior residents. You couldn’t help but be a bit of a diva. Switching spots with Santos, she begins to organize the strewn-about gauze on the tray table by the patient’s head. “I’ve never done a crike before,” Santos warns, but still appears confident about performing the procedure.
“Mel’s doing the crike,” Langdon shot her down, putting his hand out for emphasis. A few mumbles are exchanged between Garcia, who insists on doing it herself, Santos who is preparing to cut, and Langdon who is backing Mel.
“Teamwork, please. Let’s focus on the patient,” Robby brings everyone back down to earth, shuffling his way over to stand next to Dr. King, who seemed to win the crike lottery today. She grabs a package of sterile tools from Jesse and lays them out on the table.
“I’ll assist in case she screws up,” Garcia muttered, hovering over Mel’s shoulder. You couldn’t help but slightly snicker under your breath at her attempt in hazing the sweetest person that’s ever walked into the ER.
“Yolanda, play nice,” Robby urges as Mel and Jesse continue to prepare for the procedure.
“You ready?” Garcia challenged, only about a few inches away from Mel’s face. “Hello?” Her patience wears thinner and thinner. “Youve done this?” Garcia asks as everyone begins to notice Mel is stalling a bit.
Mel perks up a bit, still looking slightly uneasy. “Oh yeah…” she trails, “in the cadaver lab.” You and Robby look at each other, slightly more nervous now. You both lean in a bit closer to get a good look at what she’s doing. Robby begins to guide her through every cut and step of the procedure, and you add in little tips here and there to help smooth along the process.
“You’ve got this, Mel,” you add calmly. “Just slow it down. Human anatomy doesn’t change just because Madame Guillotine is breathing down your neck.”
“Get ready to bag the crike,” Langdon comments to Santos.
“Nice and gentle,” you add, eyes still on Mel’s technique. “She just built you an airway. Treat it like one.”
She promptly removes the ambu bag from its current position and accidentally bumps into Garcia as she walks over to her new assigned position. “Excuse me,” she says, flustered that she didn’t notice her there in the first place.
“No worries,” Garcia replies smoothly with a grin. You exchanged a blank look with Langdon, not needing to express any emotions to understand Garcia’s treatment of Santos versus Mel was completely different.
“Nicely done. Sew it in,” Robby praises and removes his now bloody gown as he prepares to go scope out the scene in the rest of the ER.
“Does your resident know how to suture or do I need to teach?” Garcia asked Langdon critically, looking right past Mel.
“You’re all class, Yoyo,” Langdon smiles.
“I know, thanks. That means a lot of nothing coming from you,” Garcia teases as she takes her gloves off and shoots Langdon a sly grin. Seeing Langdon direct his snarkiness at someone other than you gave you mixed emotions. You were secretly still reeling from the fact that he actually backed you up earlier, despite everyone else in the room being against you.
Mel is now staring off into the distance, still holding her hands with the sterile gloves on up in the air. “Mel, you okay?” you ask her, noticing her uneasiness again.
“If they’re done fighting,” she sighs and looks between Langdon and Garcia.
“They’re allergic to peace and quiet,” you assure her. “If they stop talking, check their pulses. It’s usually a bad sign.”
Yolanda laughs as she unties her gown, “We’re not fighting. This is playing. Langdon’s too soft to fight.”
“Oh yeah, I have nothing but respect for Dr. Garcia. In fact, I think she would make a wonderful hostess at Applebee’s,” Langdon calls out at Garcia as she exits the room.
“Ouch, not even a waitress?” you muttered softly under your breath as you cleaned up your area, not expecting anyone to hear but earning a chuckle from Santos.
“Later, odds,” Yolanda added cooly, flashing Santos a smile before making her final exit. You glance at Trinity just in time to catch color creeping up her cheeks.
The room exhales with Garcia’s departure. The monitor settles into a steady rhythm as everyone recovers from the chaos of the moment. Santos finally peels off her gloves, rolling her shoulders like she’s just come out of a storm. Mel lowers her hands at last, flexing her fingers like she’s been holding her breath for ten minutes straight.
“You did good,” you tell her quietly, meeting her eyes. “Both of you.” Mel nods, small but grateful, and starts tidying without being asked.
Langdon lingers near the end of the bed, gaze drifting from the patient to you, then away again, like he can’t quite decide where it belongs. The edge is still there, but something underneath it has shifted. He clears his throat. “For the record, Chief,” you look over and lock eyes with him, “given an extra 30 seconds you would have had that tube,” he says, casual, almost careless. Almost kind.
It shouldn’t matter. It does.
You give a single nod in return, professional and contained. Now that the adrenaline has ebbed, clarity settles in: there was probably no version of this where you got that intubation. Not cleanly. Not in time. But he backed you anyway. In front of everyone. Out of the corner of your eye, you catch Santos flick a look at Mel.
For a heartbeat, the ER noise swells back in. Gurneys rolling, voices calling, monitors blaring. Santos bumps your shoulder as she passes. “Not bad for a near-ceiling,” she murmurs.
You allow yourself the ghost of a smile as you step back from the bed, leaving the patient stable behind you.
As you exit the trauma bay, leaving Langdon and Mel to debrief the newly learned procedure, you run into a flustered Whitaker in the hallway, having some sort of confrontation with a patient in the hallway. Whitaker’s eyes light up as soon as he sees you, clearly needing some sort of backup. “Hey, Chief!” he exclaims, prompting you to shuffle over to him standing next to the patient bed. “Can this patient get a sandwich?” he asked and pointed towards Earl.
Your eyebrows furrow together. “Earl, I saw Perlah get you a sandwich like a half hour ago,” you replied, body square towards the patient now.
“I ain’t ate this whole week!” he states his case. Your eyes shift to a confused Whitaker and back to Earl.
“Sure, whatever,” you exhale with a slight laugh. “Be right back. Come on, Whitaker, I’ll show you where the food cart is.” He falls into stride next to you as you head over to the other side of the emergency room. You approach the food cart and begin shifting through the labeled sandwiches in the bing. “We have to make sure it’s not egg salad or he’s gonna kill me,” you mutter, earning a chuckle from Dennis. You eventually find a turkey sandwich and snatch it out of the bin. “Bingo!” You shoot him a wide smile and wave the sandwich in the air.
As you begin walking away, Dennis interjects, “Hey, uh, can I…?” he trails and points over to the food bin.
You smiled, realizing what he meant. “Help yourself, Whitaker.” He beams and shoves a whole sandwich into his back pocket before following you back over to the patient.
-
A few moments later, as you’re eyeing the triage board for a case that needed a senior resident, you hear a male voice shout from one of the patient rooms. Your head snaps over to where the sound came from, you’re startled to see a mischief of rats run across the floor in opposite directions. All you can do is watch, eyes wide in horror as several patients waiting in the hallway start to realize something is wrong. “Nothing to see here!” you exclaim as you run over to the source of the critters. An unnerved Collins runs right past you, looking like she’s about to hurl. You open the curtain to find Whitaker and nurse Donnie, holding their hands up away from the unconscious homeless man laying on the stretcher.
“Patient tested positive for rats,” Whitaker explains to you and Robby, who is now also standing by the opening of the patient room. “If it matters, I only counted three,” he shouts towards Heather, who is already long gone at this point.
You slowly turn toward Robby. “So what’s the protocol for documenting this?” you inquire with a smirk, only half joking.
He ignores your initial question as you walk with him back towards the center of the hallway. “Speaking of protocol,” he begins and you raise a brow. “We’re not taking action yet, but I might need your help on this case with a concerned mom who thinks her son has a kill list.”
Your jaw nearly drops to the floor as you take in the information. “Keep me posted,” is all you can say in response with a shrug. He gives a brief nod, and you peel away from each other, drifting in opposite directions toward the next place the ER demands you.
-
The pitt hums at a manageable pitch for once, the kind of lull that feels borrowed rather than earned. Fluorescent lights buzz overhead as you sit hunched over a workstation, buried beneath charts and half-finished evaluations. A stack of incident reports waits to your left, your inbox blinking with unanswered messages, and your coffee has gone cold somewhere near your elbow. You toggle between schedules and duty hour logs, jaw tense as you try to make a puzzle of coverage out of thin air. Chief Resident work proved to be necessary but thankless and endless.
Around you, the department breathes in a slow, steady rhythm. Monitors beep in distant rooms. Perlah and Princess laugh quietly at a nearby desk. Stretchers roll past without urgency. It’s calm enough that, for a moment, you almost forget where you are.
Almost.
“I need a little help here!” you hear a boyish voice shout from across the ED. Whitaker. You stumble out of your chair so fast you almost spill your coffee all over the keyboard. You run over to the source of the noise and see Whitaker performing CPR on an unconscious Mr. Milton. A frantic Donnie is searching a nearby supply cart.
“Holy shit, what happened?” you query as you grab a nearby crash cart and start pulling it to the nearest room. “Whitaker stay on compressions, Donnie bag him,” you shout out from a few feet away trying to stay calm. Robby and Mel rush over once they notice the commotion. “Robby, King wheel him in here!” You beat them to the room and clear out space for the gurney to slide smoothly into.
Whitaker doesn’t miss a beat, ferverously pushing down onto Mr. Milton’s sternum and simultaneously rushing towards the room. Mel promptly takes over the airway while you and Robby set up the defibrillator. “Hold compressions. Clear,” you command as Robby hands you the paddles. You swiftly distribute the gel along the paddles and place them onto the patient's bare chest. A wave of dread washes over you as the monitor displays a flat line. “Damn it! Asystole,” you confirm and return the paddles back to the cart. You can’t shock zero rhythm.
“Resume compressions, amp of epi,” Robby instructs as he prepares a dose of epinephrine and hands it to Donnie.
“Slow it down, Whitaker,” you guide him. His rate of compressions had gotten quicker the more nervous he got. You looked into his eyes and dramatically motioned yourself taking a big breath, reminding him to stay calm. He nodded and slowed down to the correct pace. You grab the penlight from your breast pocket to examine Mr. Milton’s eyes. You carefully lift up one of his eyelids and shine the light into his orbs to reveal the last thing you wanted to see. Just to confirm, you check the other one only to observe the same thing. Your heart sinks as you look to Robby sadly. “Fixed and dilated.”
“He’s been down a long time,” Robby infers and shakes his head. Several moments go by with Whitaker refusing to halt CPR. Dr. King steadily squeezes the ambu bag still. You’re standing next to Dr. Robby now, exchanging a look with him every few seconds.
“Take a break Whitaker, I can do a shift,” you begin to walk over, noticing the sweat dripping down the side of his face.
“I’m fine,” he insists, dismissing you. You stop in your tracks and back away, throwing your hands up in surrender.
“Hold compressions,” Robby commands. As soon as Whitaker stops, a monotone signal emits from the monitor. “Resume compressions.”
“Still asystole,” you mutter under your breath, fully knowing Mr. Milton’s fate now. Your heart aches. For the patient who had no idea today was going to be his last day. But also for Whitaker – it was clear this was one of the first, if not the first patient he had ever lost. And you knew that he was going to blame himself for it.
“Should we shock him?” Whitaker asks, desperate to come up with a solution. His compressions were getting weaker and shallower by the minute.
“You don’t shock asystole,” Mel informs apologetically from beside him.
“It could be fine v-fib,” Whitaker presses.
“Not a chance,” you and Robby both utter at the same time.
“When was his last epi? ACLS says every three to five minutes right? Let’s push another round,” Whitaker pleads.
To your surprise, Robby acquiesces, “Fine.” He nods and is promptly pulled out of the room by a nurse who got a request from a patient to see him. “Three rounds of epi and then call it. Chief you’re in charge,” Robby calls out as he exits the room.
Hundreds of compressions and a few rounds of epi later, Mr. Milton doesn’t seem to be improving. “Hold compressions,” you voice, carefully eyeing the monitor as you hear the flatline go off again. You hear the curtains behind you rustle and turn to see Langdon entering the room.
“Let’s try calcium. It could be hyperkalemia,” Whitaker urges.
“No, his potassium is normal,” you state and shake your head.
Langdon crosses his arms and looks between you and Whitaker. “Ready to call this?” he inquires.
“Not yet,” Whitaker notes, out of breath. Donnie attempts once more to get Dennis to break from compressions, but he refuses.
And now, just so soon after the seemingly genuine moment you had with him earlier, Langdon was getting on your nerves again. “I got this, Langdon,” you snap and hold your hand out. “Let’s push another round of epi.” You look over to Donnie with kind eyes. He nods and prepares the injection of the next dose.
Whitaker’s arms are trembling now, sweat darkening the collar of his scrubs as he counts under his breath, each compression a little less certain than the last. Mel keeps the ambu bag moving, steady and relentless, though her eyes flick to the screen like she’s aware it’s not going to change. Donnie steps back after the epi, hands lingering in midair as if he’s waiting for something to happen.
Nothing does. The room feels suspended, caught between motion and inevitability. Every sound is too loud. Every second stretches.
You stand near the doorway, chest tight, the weight of the code pressing in on you from all sides. You can feel Langdon beside you, close enough that his presence registers like heat against your skin. He doesn’t say anything now. He doesn’t try to take over again. He just watches the same false rhythm on the monitor, eyes dark and unreadable, hands in his pockets.
You swallow. “Keep going,” you encourage, even though your voice lacks its earlier edge. Even though every part of you already knows. But you want to let Whitaker have the closure and certainty. Whitaker nods and pushes on. Mel squeezes the bag. The clock ticks. A janitor slowly walks past the open curtain, swiffering the vinyl floors.
