something med school didn't cover
part 2 wc: 8.9k (oof) pairing: jack abbot x wife!reader summary: when the doors of the pitt swing open to reveal you on the gurney, dr. jack abbot’s world shatters, forcing him to fight for two lives he didn't know were at stake. c.warning: angst with happy ending; established relationship (married); major medical trauma; graphic depictions of injury; mentions and discussions of abortions in the past; mentions of pregnancy/pregnancy loss scare; jack abbot crashing out; mentions of car accident; near-death experience; never mind the medical accuracy or lack thereof (i tried my best but i’m still not a doctor) a/n: this got out of control. it was supposed to be a usual 3k one-shot but then i kept writing and well here we are now. also shout out to my friend paula that helped me do all the medical research for this one so i didn’t embarrass myself with all the inaccurate doctor talk. love u girl <3
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the fluorescent lights of the hospital always seem to hum a little louder when the er is quiet. it’s a sterile, buzzing vibration that grates on jack’s nerves more than the usual cacophony of sirens and shouting.
he leans against the nurse’s station, a lukewarm cup of bitter black coffee forgotten in his hand. he checks his watch. 2:14 pm. the numbers blurring slightly from sheer exhaustion. his shift was supposed to have ended hours ago, but the universe had other plans.
first, a multi-car pileup at dawn bled into a series of critical post-ops. then, every time he had tired to reach for his coat, another “one last thing” tethered him back to the floor. now, nearly ten hours into a forced double, the walls feel like they’re closing in. all he wants right now is to be through his front door, to shed the smell of antiseptic and the weight of the hospital, and to finally disappear into the quiet comfort of his home, where you were probably already waiting for him.
“it’s too quiet,” dana mutters as she organizes a stack of charts.
jack offers a ghost of a tired smile. “don’t say the ‘q’ word. you’ll jinx us.”
his mind drifts, as it often does during these rare lulls, back to you. he thinks about the way you looked when he left. half-asleep, tangled in the duvet in your hared bed, grumbling about the warmth leaving you as jack got out of the bed. he’d kissed your forehead, whispered that he’d be home by eight, in time to share breakfast with you, and headed into the belly of the beast. as he walked into the hospital, he felt a rare pang of guilt; he’d been working so many double shifts lately that your shared home felt more like a hotel.
i’ll make it up to her, he thinks. maybe he can take you out to that new sushi bar you showed him on your phone the other day. no, you’ll probably prefer thai. you’ve always loved-
the thought is cut short by the sharp, rhythmic chirp of the trauma radio. the sound like a physical blow to the silence.
“dispatch to mercy trauma, we have a level 1 activation. multiple vehicle collision, pileup on the i-579. initial reports suggest a jackknifed semi and at least six passenger vehicles. multiple red-tags. first eta is four minutes. lead bus is carrying a female, blunt force chest trauma, unstable vitals, gcs of 6.”
the er transforms in a heartbeat. the “slump” dies instantly, replaced by the practiced, frantic choreography of a trauma team who’s been through this million times.
robby, that was contrasting the lab results from one of his patients jumps into action.
“abbot, i need you in trauma. we need to get bays 1 and 2 ready. i want respiratory on standby. grab the o-neg. if this is a pileup, we’re going to be drowning in ten minutes.”
“let’s go!” jack barks, his voice dropping into that authoritative, calm register that defined him as he signals some of the residents to follow him,
the coffee is now discarded and forgotten on dana’s desk as jack pulls on a pair of gloves, the snap of latex echoing against the white, bright walls of room. here, in the chaos of trauma 1, he’s in his element. he’s dr. abbot, the man who’s used to holding the line between life and death. he feels the familiar rush of adrenaline, the narrowing of his world until only the patients matter.
“eta one minute!” someone shouts.
robby stands at the ambulance bay doors, peering through the glass. a faint rain has started. a cold, miserable drizzle that blurs the red and blue lights of the approaching sirens.
the first ambulance screeches to a halt and the back doors swing open. immediately, a paramedic jumps out, already pumping a manual respirator. “female, trapped in the driver’s side for twenty minutes. we had to use the jaws. bp is 80 over 40 and dropping. she’s trending toward traumatic arrest!”
robby’s breath catches for a fraction of a second. his eyes scan the familiar face, noticing all the blood, the cuts and bruises.
no, he thinks. please, let it not be true.
“get her to bay 1!” he orders, returning to reality as he steps forward to catch the side of the gurney as it flies past.
as robby pushes the gurney, he refuses to look at the patient’s face. but when he walks past dana’s desk, he looks devastated, and she notices. rounding her desk, she walks next to him, matching his quick step.
“i need abbot out of that room,” he says. “now.”
frowning, dana walks next to him.
“what? why?”
robby just shakes his head. “i need you to take him to trauma 2. anywhere, really. just… away from…”
but it’s already too late.
jack’s eyes are locked on the gurney, tracking the way the patient’s body jolts with every bump of the wheels, noticing the blood-soaked bandages on her chest.
“on three! one, two, three!”
the paramedics help slide the patient onto the trauma table. and it’s only then, as one of the them pulls away the oxygen mask to swap it for the hospital’s ventilator, that the world truly stops spinning.
the air leaves jack’s lungs as if he’d been punched.
“jack…” robby tries, but he doesn’t look at him. he can’t react at all.
the female with blunt force chest trauma and unstable vitals isn’t a stranger.
it’s you.
your face is ghostly pale under the smears of blood and road grime. your hair, which he’d smoothed back just hours ago in the quiet of your bedroom, is matted with glass shards. you lay limp, your chest barely moving, a hollow shell of the person he loves.
“jack?” dana’s voice comes from a distance, sharp and concerned. “jack, what are you doing? we need to intubate!”
jack abbot, the man who never flinches, who doesn’t shake under stress, no matter how hard or critical the case, now stands frozen. his hands, usually as steady as stone, are shaking so violently they seem to rattle against the metal railing of the bed.
robby glances at dana over his friend’s shoulder, shaking his head.
“no,” jack whispers, the word catching in his throat. “no, no, no…”
“okay, “robby mutters to himself. “abbot, i need you to get out. now.”
but jack still can’t react, he doesn’t even flinch when dana closes her hand around his forearm, trying to pull him out of the room.
robby pushes past him. “she’s crashing! i need a central line now! jack, get out of the way!”
robby grabs a scalpel, his movements clinical and fast. he doesn’t stop to consider who is on the table. to him, right now you are just a ‘red tag.’ he can’t allow himself to think of anything else.
right now, you can’t be the woman who has quickly become one of his closest friends, one of the main supports on his hardest days. the woman he proudly considers family, the same one he shared secrets and past anecdotes with when he came by to yours and jack’s house for dinner every month.
dana is still trying to get jack out of the room, threatening to call security on him when the attending’s weak whisper makes her stop in her tracks.
“stop,” jack rasps, his voice cracking. he lunges forward, shaking dana’s hand off, too desperate. “stop. that’s… that’s my wife.”
the room goes dead silent for a heartbeat, save for the screaming of the heart monitor. robby looks up, nothing but pity for his friend boring in them.
“jack… you can’t be in here, brother. you know the protocol.”
“i am not leaving her!” jack roars, his voice echoing off the trauma bay walls, raw and heartbroken. “my wife is dying. i am not leaving her!”
“you’re making it worse!” robby hisses back. “you’re compromised! you’re going to kill her if you don’t let us work!”
jack looks down at you. he sees the blood. he sees the way your heart rate is flickering on the screen like a dying candle. a cold, terrifying clarity suddenly washes over him. the panic doesn’t disappear, of course it doesn’t, but he forces it down into a small, dark box in the back of his mind.
he steps back slightly, chest heaving. but his hands stop shaking, the roaring in his ears slows to low hum, enough for him to hear his own thoughts again.
“fuck the protocol. i’m staying,” jack said, his voice now terrifyingly low and steady. “robby, get the chest tube. and i need 10 of epi. now!”
he doesn’t look at his colleagues as he works. he looks only at you.
“stay with me,” he whispers, so low only you could have heard it if you were awake. “don’t you dare leave me, do you hear me? stay with me.”
and so the chaos begins in the trauma bay. robby and jack, along with a couple of residents and some extra hands work together, in synchronicity.
“i need a fast exam, now!” jack’s voice cuts through the noise, steady but edged with desperation, focused on the monitors, on the jagged green lines of your heart rate, the terrifyingly low oxygen saturation. he tries not to look at you, knowing that if he did he’d see your eyes, closed and bruised, and he would shatter.
“jack, i’ve got the ultrasound,” rabby says, his voice softer now, cautious.
he moves the probe over your abdomen, eyes flicking between the small screen and your still form.
you’re so still. the woman who loves dancing in the kitchen to grainy jazz records is now buried under layers of medical plastic and blood-stained gauze.
“we’ve got internal bleeding,” robby mutters, his brow furrowing. “she’s bleeding out into her peritoneum. jack, we need to get her to or immediately.”
“wait,” jack says, eyes falling to the darkening bruise on your lower belly. “check the pelvis. i want a full sweep. if there’s a pelvic fracture we didn’t see—”
“i’m on it,” robby replies. he moves the probe lower, his movements clinical.
the room seems to go silent, though the machines are still screaming. jack watches the ultrasound screen, his mind already three steps ahead, calculating surgical approaches, estimating blood loss, praying to a god he hasn’t spoken to in years.
then, the image shifts.
robby freezes. the probe stops moving.
on the grainy, black-and-white screen, nestled deep within the shadows of your body, is a small, unmistakable flicker. a pulsing light.
jack’s breath hitched. his world, already tilted on its axis, began to spin violently.
“jack…” robby’s voice was barely a whisper. “is that…?”
“no,” jack breathes, the word a plea. “no, it can’t be.”
he grabs the probe from robby’s hand, his fingers slick with ultrasound gel. he presses it down again, his eyes wide and frantic as he searches the screen. and there it is. a gestational sac. maybe ten weeks. perhaps older. a tiny, fragile life tucked away inside the chaos of your broken body.
a life he didn’t know about. a life you hadn’t told him about.
“she’s pregnant,” robby breathes from the bedside, his hand flying to his mouth.
the realization hits jack like a physical blow to the chest. this isn’t about just you anymore. it’s about both of you. every choice he makes in the next ten minutes will not just decide the fate of his wife; it would decide the fate of their child, too.
“we can’t use the standard protocol, jack,” robby says, his voice rising in panic. “the meds we were going to use for the induction, the ct scan, the radiation…”
“i know!” jack roars, the sound raw and guttural. he drops the probe and it hits the floor with a dull thud.
the “doctor mode” he has spent years perfecting, the emotional armor he wears like a second skin, cracks wide open. the image of that tiny, flickering heartbeat burned into his retinas. he sees you then; not as a patient, not as a ‘red tag,’ but as the mother of his child, dying on a cold metal table because of a patch of ice and a moment of bad luck.
the room begins to tilt. the bright fluorescent lights turned into blinding white spots. the sound of the ventilator—hiss-click, hiss-click—is like a ticking time bomb.
“jack, look at me,” robby says, stepping into his line of sight, grabbing jack’s shoulders. “jack, you’re hyperventilating. you need to step back.”
“i… i didn’t know,” jack stammers, his legs suddenly turning to lead. “she didn’t… we couldn’t…”
he looks back at you. your face is a mask of trauma, but in his mind, he sees you the way you were hours ago when he left you cold on your shared bed. the way you smiled at him. did you know then? maybe you were waiting for dinner to tell him.
the grief and the shock collide in his chest, stealing the air from his lungs. jack’s knees buckle.
“he’s going down!” robby cries, catching him under his arms before he hits the floor.
jack doesn’t fight him. he can’t. his strength is gone, evaporated. he slumps against the wall, his head in his hands, the bloodied plastic of his blue gown crinkling as he collapses.
“get him out of here,” robby orders, his voice firm as he takes over the lead position at the bed. “now! someone, please, get him to the breakroom. i’ll take her up. i promise you, jack, i will do everything. just go!”
jack feels hands on him, a strong grip pulling him up, guiding him away from the bed. he tries to resist, tries to reach out for you, but his body simply won’t obey.
as he’s led through the swinging doors, the last thing he sees is the team swarming around you, the red light of the blood bags hanging over your head, and the ultrasound screen, displaying that tiny, flickering heart once more.
the doors click shut, leaving him in the hallway, the rapid beat of his heart a deafening roar in his ears.
he’s a doctor. he’s a husband. and now, he’s a father.
and he might lose everything before the sun went down.
jesse lets go of his arm when they arrive at the breakroom, and with a quiet “i’m sorry” and a gentle nod he leaves jack behind and returns to the room where the rest of the team is still fighting to save you.
you and the baby.
god, the mere thought raises tears to jack’s eyes.
a baby.
his baby.
biting the inside of his cheek, jack thinks of the previous times when he heard these news. of the sound of your excited, cheerful voice the first time you came up to him with a positive test.
unfortunately he also remembers your heartbroken wails as he hold you tight to his chest, both of you sitting on the bathroom floor at home. he remembers how he bit his lips, forcing himself to stay strong for you but wanting nothing more but to crumble into pieces right there.
you had stopped trying after the second miscarriage. a decision none of you wanted to made but that you needed in order to protect your own hearts and your sanity.
and now… now you’re laying on a cold, metal exam table, closer to death than you’ve ever been and jack has everything to lose.
the breakroom smells of stale coffee and industrial-strength floor cleaner. it’s a room designed for brief reprieves, for five-minute naps and hurried meals, but right now, for jack, it feel like a cage.
he seats on the edge of a vinyl chair, his elbows on his knees, staring at his hands, at dark, shiny band on his left hand.
you are pregnant. the thought keeps looping in his mind, a frantic, broken record. how could he miss it? he’s a doctor, for god’s sake. he is trained to notice the smallest shifts in physiology, the subtle cues of the human body.
he thinks back to the last few weeks; your sudden preference for tea over coffee, the way you’d been falling asleep on the couch before the 11 o’clock news. he’d chalked it up to stress, to the gray pittsburgh winter, to his own grueling schedule and the fact that he didn’t seem to have time to spare, time for you.
he closes his eyes and sees you in the kitchen three days ago, laughing at the ridiculous apron he usually wears when he cooks. you looked so vibrant, so incredibly alive. now, you have been reduced to a series of vitals on a monitor, a problem to be solved by people who don’t know the sound of your laugh or your favorite movie from your childhood.
“god, please,” he whispers into the empty room. now, jack abbot is hardly a religious man, but the silence of the hospital is demanding a sacrifice. “take me. just… don’t take them. please.”
the door creaks open and jack bolts upright, his heart hammering against his ribs. dr. robby, his best friend, his brother, stands there. he’s stripped off his bloody gown, but his scrubs are darkened with sweat. somehow, he looks older than he did twenty minutes ago.
“jack,” robby says, his voice level, cautious.
“tell me,” jack demands, his voice cracking. “please, tell me. is she… are they-”
“she’s still on the table,” robby says, stepping into the room and letting the door swing shut behind him. “we’ve stabilized the splenic bleed, and the chest tube is draining well. but jack…” robby let’s out a long, heavy sigh. “ the situation is complicated. you know the physiology as well as i do.”
jack slumps back into the chair, the “doctor” part of his brain forcing its way through the grief. he does know.
in a trauma patient, pregnancy changes everything. the blood volume increases by 50%, which means a woman can lose a massive amount of blood before her blood pressure even begins to drop. by the time you see the “crash,” it’s often too late.
“her vitals are brittle,” robby continues, leaning his back against the vending machine. “because of the pregnancy, her heart is already working overtime. and we’re struggling to keep her map high enough to perfuse the placenta without blowing out the repairs we just made.”
“and the baby?” jack asks, the word feeling foreign and heavy on his tongue.
“the fetus is roughly twelve weeks,” robby says. “at this stage, there’s no ‘saving’ the baby independently. the only way to save the pregnancy is to save the mother. but the vasopressors we’re using to keep her pressure up… they cause vasoconstriction in the uterus. we’re effectively starving the baby of oxygen to keep her brain and heart alive.”
it’s the ultimate medical catch-22. to save you, they had to risk the baby. to save the baby, they might lose you.
“the ultrasound showed some subchorionic hemorrhaging,” robby adds softly. “with the impact of the steering wheel, the placenta might be starting to detach. if that happens, she’ll bleed out from the inside faster than we can pump blood into her.”
jack buries his face in his hands. he knows the statistics. he knows that in maternal trauma, fetal demise is as high as 40-50% depending on the severity of the crash.
“i should have been there,” jack groans. “i should have driven her. she told me the brakes felt ‘soft’ last week and i told her i’d look at them on my day off. i didn’t… i didn’t look at them, robby.”
“jack, stop,” robby says firmly, walking the few steps separating him from his friend and crouching in front of him. “the police report said a semi hydroplaned across the median. it wouldn’t have mattered if she was driving a tank. don’t do this to yourself.”
jack looks up, his eyes bloodshot and raw. “how can i not?i’m the one who’s supposed to fix people. i spend twelve hours a day stitching strangers back together, and the one person who matters,” his voice breaks. “i didn’t even know she was carrying our child.”
robby sighs, his expression softening. “she’s a fighter, jack. we both know that. she’s held on this long. but i need you to stay here. if you go back in there…. i can’t worry about you too. i need to focus on them.”
“i can’t just sit here, man,” jack says, his voice rising. “i’m going crazy in this room.”
“then go to the chapel. go for a walk. or go home. but do not come back to that room,” robby warns. “i’ll send dana or jesse out when we have another update.”
as robby turns to leave, jack calls out, “wait.”
robby pauses at the door.
“the heartbeat,” jack whispers. “was it… was it still there when you left?”
robby hesitates for a fraction of a second, a beat that feels like an eternity to jack.
“it was,” robby says. “faint. but it was still there.”
and with that, the door clicks shut, leaving jack alone again.
the breakroom remains too quiet for far too long. jack paces the narrow strip of linoleum between the coffee machine and the round table, his mind a minefield of memories. he keeps seeing you in the passenger seat of his car, laughing at some stupid joke he told, the sun reflecting the stars in your eyes. he keeps thinking about the baby, whose existence had already rewritten the map of his future, even if they haven’t met yet.
then, the overhead speaker crackles. it’s a sound jack hears a dozen times a shift, a sound he usually meets with professional focus.
“code blue, trauma 1. code blue, trauma 1.”
the world doesn’t just tilt; it shatters.
trauma 1. your room.
jack is moving before his brain can even process the command. he throws open the breakroom door, the heavy wood slamming against the wall with a bang that echoes down the corridor. he doesn’t care about protocol. he doesn’t care about robby’s orders. he doesn’t care about his own career.
he runs.
the hallway feels miles long, the floor slick under his clogs. he passes a group of residents who scramble out of his way, eyes wide as they see night shift attending sprinting with a look of pure, unadulterated terror on his face.
he bursts through the double doors of the trauma bay, his lungs burning.
“jack, wait!” a nurse shouts, trying to grab his arm as he reaches the scrub sinks.
he doesn’t even look at her. he pushes the doors open with his shoulder, crashing into the room like a storm.
the scene inside is a nightmare rendered in high-definition. the rhythmic, mechanical hiss-click of the ventilator has been replaced by the frantic, high-pitched scream of the heart monitor. a flat, unwavering ekg line that slices through the air like a blade.
robby’s standing on a step-stool over your body, his hands locked, his weight throwing everything into the rhythmic compressions of your chest. crunch. crunch. the sound of ribs giving way under the pressure—a sound jack has heard a thousand times—feels like it’s his own bones that are snapping.
“jack, get out!” robby yells, not breaking his rhythm. his face is drenched in sweat, his eyes fixed on the monitor.
“what happened?” jack screams, stumbling toward the foot of the bed. “what the fuck happened?!”
“she went into v-fib, then pea,” dr. santos shouts over the noise. she was at your side, her hands pressed firmly against the left side of your abdomen, pushing your pregnant belly toward the left.
jack’s medical brain registered it instantly. in a pregnant woman in cardiac arrest, the heavy uterus compresses the inferior vena cava, blocking blood from returning to the heart. if they don’t push the baby aside, the compression robby is doing will be useless. there’s no blood to pump.
“charging to 200!” the tech shouts. “clear!”
robby jumps back. your body jolts off the table as the electricity surges through you. jack watches your hands, the same hands he loved to hold while you both were cuddling on the couch on a slow saturday, flop lifelessly back onto the sterile drape.
the line stays flat.
“again!” jack roars, stepping up to the bed, his voice raw. “increase to 300! charge it again!”
“jack, she’s lost too much blood,” robby pants, resuming compressions. “the acid-base balance is gone. her heart is too tired.”
“don’t you say that! don’t you dare say that!” jack lunges forward, grabbing the paddles from the tech’s hands. his eyes are wild, his breathing ragged. “move, robby! move!”
robby hesitates for a second, then steps aside, hands raised in surrender, letting jack take over.
jack looks down at you. this close, he can see the gray tint creeping into your skin. he can see the way the light in the room seems to be fading out of you.
“you do not leave me,” he hisses, the words a jagged prayer. “you hear me? you stay. you stay for me, and you stay for this baby. do not do this to us.”
“charged!”
“clear!” jack slams the paddles against your chest.
thump. your body arches. the monitors wail.
silence.
one second. two. three.
then, a tiny, erratic blip on the screen. then another.
“i have a rhythm!” dr. santos cries, her fingers pressed to your carotid artery. “i have a pulse! it’s weak, but it’s there!”
the room seems to exhale all at once, but the tension doesn’t break. it just shifts.
“we need to get the bleeding under control now,” robby says, his voice shaking. “jack… she can’t take another arrest. if she codes again, we won’t get her back. the fetal heart rate is in the 60s.”
robby doesn’t finish the sentence, but jack hears is loud and clear.
you’re both dying.
jack stands there, the paddles still in his hands, staring at the flickering green line of your heart. he’s covered in your blood, his gown torn, his soul laid bare in front of his entire team.
he looks at robby, and for the first time in his career, michael sees the “great jack abbot” looking utterly broken.
“save them,” jack whispers, his voice barely audible over the hum of the machines. “whatever it takes, i don’t care. just… don’t let them… save them. please.”
robby nods slowly. “we’re going to try a high-risk embolization to stop the deep pelvic bleed. it’s the only way to avoid more surgery, but the radiation… it’s dangerous for the pregnancy.”
jack looks at your stomach, then back at your face. the choice is impossible.
life or life.
“do it,” jack says, his voice hardening into a cold, desperate resolve. “save her. save my wife. we’ll deal with the rest when she wakes up.”
as they begin to prep the specialized equipment, jack doesn’t leave. he backs into the corner of the room, his back against the cold tile. he watches them work, his eyes never leaving the monitor, counting every single beat of your heart as if he could keep it moving through sheer force of will.
the icu is a different kind of purgatory than the er. in the er, death is a screaming, bloody predator you could fight with a scalpel and a shout, something loud and violent. in the icu, death is a shadow. something silent, patient, and impossible to pin down.
it’s 11:45 p.m. hours have passed since you were moved up from the er.
now you lie in the center of a web of plastic tubing and wires, the steady, rhythmic hiss-click of the ventilator the only thing keeping the room from falling into a grave-like silence. a cooling blanket draped over your legs to keep your temperature regulated, and a specialized fetal monitor strapped across your bruised abdomen, its screen showing a jagged, persistent little line
142 bpm.
jack is sitting in the hard plastic chair pulled flush against your bedside. he hasn’t changed out of his scrub bottoms, though someone forced him to put on a clean gray hoodie to cover the bloodstains on his undershirt. he looks older, tired. devastated. the harsh overhead led lights catch the new lines of exhaustion etched around his eyes.
he’s holding your hand, the only part of you that isn’t covered in bandages or sensors. your skin feels paper-thin and cold.
“i’m here,” he whispers, his voice a dry rasp. “i’m not going anywhere.”
he checks the fetal monitor. that sound, the rapid thump-thump, thump-thump of the baby’s heart, is the most beautiful and terrifying thing he has ever heard. it’s a ticking clock. every beat a miracle, but also a reminder of how much he stands to lose.
“why didn’t you tell me?” he asks softly, his thumb tracing the line of your knuckles, the stone crowning you ring finger cold and harsh against his skin.
were you scared? were you waiting for the ‘right’ moment? god, he would have given anything for that moment to have been over dinner, or in bed, or literally anywhere but on a trauma table.
he leans his forehead against the metal railing of the bed, his eyes closing.
“i went through our messages while i was waiting for you to come out of the or,” he admits, a ghost of a self-deprecating laugh escaping him. “i looked for clues. i looked for a hint. and all i found were grocery lists and you telling me to come home early because you missed me. but i didn’t come home, did i? i stayed for that extra shift. i stayed to fix people i didn’t even know while you were… you were growing a life.”
his guilt is a physical weight, a cold stone in his stomach. he’s dr. jack abbot. he’s supposed to be the one with all the answers, the one who sees the things no one else notices. but he has been blind to the most important thing in his own world.
a nurse slips into the room, her movements practiced and quiet. she checks the bags hanging from the iv pole, her eyes lingering on jack with a mixture of pity and professional concern.
“the baby’s heart rate is holding steady, dr. abbot,” she says softly, nodding toward the fetal monitor. “and her map is at 70. she’s stable for now.”
“for now,” jack repeats, the words feeling like ash. “stable is just another word for ‘waiting for the next crisis’ in this building, and you know it, claire.”
“from what i’ve heard, she’s a fighter, jack,” the nurse replies, mirroring robby’s words from earlier. “and so is the little one. i’ve seen people come back from worse.”
“not many,” jack mutters, but he squeezes your hand a little tighter.
when the nurse leaves, the silence rushes back in. jack stands up, his joints popping, and leans over you. he carefully places his hand on your stomach, right over the sensor. closing his eyes, he tries to feel through the layers of skin and muscle, trying to connect with the tiny being inside you that he had only just met through a grainy ultrasound screen.
“hey,” he whispers to your belly. “i’m your dad. i’m… i’m a bit of a mess right now, but i’m here. and i need you to do me a favor. i need you to keep fighting. i need you to give your mom a reason to wake up. because i don’t think i can do this without her. i know i can’t do this without her.”
before he can realize what’s happening, a tear escapes, tracing a hot path down his cheek and landing on the sterile white sheet.
“i’ll be better,” he promises, his voice cracking. “i’ll be home. i’ll fix the brakes. i’ll learn how to be whatever you both need me to be. just… don’t let go. please, don’t let go.”
outside, the rain continues, now heavier, fiercer. but inside the room, time remains frozen. jack abbot, the man who usually held the city’s lives in his hands, now seats back down and waits for the only life that truly matters to come back to him.
from time to time, doctors filter into the room, checking vitals, checking on jack. robby comes up from the er a couple of times to share a sympathetic smile with him, to promise that everything will be fine.
jack sighs, “i’m a doctor too, robby. you can’t lie to me.”
“and i’m your friend and i know that a bit of hope is what you need right now.”
he stays for a while, keeping jack company until his pager calls him back to action.
“shouldn’t you be home already?” jack asks. “your shift was over hours ago.”
robby only shrugs. “people need me around here.”
at that, jack’s eyes regain that teary shine. nodding, he promises robby to call him if anything changes and waves his fiend goodbye before leaning back again on the chair, his eyes fixed on the slow rise and fall of your chest.
the world doesn’t come back all at once. it returns in fragments. first, the rhythmic hiss of a machine, the smell of antiseptic, and a heavy, weighted warmth on your left hand. your eyelids feel like they had been leaded shut, but the persistent, low hum of the icu finally pulls you toward the surface of consciousness.
you groan, the sound catching in the back of your throat, dry and scratchy from the tube that has only recently been removed.
then there’s the faint scratch of a chair scraping against the floor.
“hey… hey, look at me. open your eyes, sweetheart.”
that voice. you know that voice better than your own heartbeat. it’s the same voice that whispers sweet nothings into your ear at night, the same one that you hear in your warmest dreams. except now it sounds rough, exhausted, and trembling with a hope so fragile it feels like it might shatter any moment.
you force your eyes open. the light blinding at first, a sterile white haze, but then it focuses. jack. he looks like he hasn’t slept in a week. his hair is a mess and his eyes, usually so sharp and clinical, are now swimming with tears.
“jack?” you rasp, your voice coming out as barely a breath.
“i’m here. i’m right here.” he leans over, his hand cupping your cheek with a tenderness that makes your chest ache. he kisses your forehead, his lips lingering there for a long moment as he takes a shuddering breath. “you scared the hell out of me, love.”
you try to move, but a sharp pang in your abdomen makes you wince. memories start to bleed back in. the rain, the blinding headlights, the screech of metal. you instinctively try to reach for your stomach, but your arm feels like lead.
“the… the accident… jack, i…”
“it’s over,” he whispers, his thumb stroking your temple. “you’re safe. i’ve got you.”
a few minutes pass by until the door pushes open quietly. robby walks in, followed by an ob-gyn specialist you didn’t recognize. robby looks at you, a genuine, relieved smile breaking through his professional mask.
“welcome back,” robby says, checking the monitors. “you’ve had a hell of a day, but your vitals are finally starting to behave.”
the ob-gyn, a woman with kind eyes that introduces herself as dr. pauline , steps forward. “we need to talk about why you’re feeling so much pressure in your abdomen, besides the surgical repairs.”
jack’s grip on your hand tightens. he looks at you, his expression a complicated map of wonder and fear.
“you’re pregnant, dear,” dr. pauline says softly. “about twelve weeks. the accident was severe, and the trauma to your body was significant. we had to perform some emergency procedures that were high-risk for the pregnancy, but as of twenty minutes ago, the fetal heartbeat is steady.”
the world stops right there and then.
you look from the doctor to jack, your mouth falling open. “pregnant? are you sure?”
dr. pauline nods and you have to bite your lip to keep it from trembling. jack’s grip on your hand tightens.
“it’s going to be a long road,” dr. pauline continues, her tone turning serious but encouraging. “you have a lot of healing to do. your ribs and the internal repairs, plus the blood loss. and for the baby, we’re going to have to monitor you both every hour. there’s some bruising near the placenta, so it’s going to take hard work, absolute bed rest, and a lot of time before we can say we’re completely out of the woods. but right now? right now, you’re both winning.”
“thank you, doctor,” you whisper, voice so small it makes jack’s chest squeeze. “and thank you, michael. jack told me you were the one who took care of me when i arrived.”
robby gifts you with a small, soft smile. grabbing your free hand, he gives it a squeeze.
“i’m glad i could help. but i don’t think i could’ve done it without my team. or without dr. abbot’s aid.”
that has you snapping your attention back to jack.
“you were there?” he simply nods, eyes glued to your hand, to the ring on your finger. “i thought you guys had protocols for that kind of thing.”
“we do,” says robby, nodding.
“fuck the protocol,” barks jack at the exact same time. “my wife was dying. what was i supposed to do? go home? i did what i had to.”
when your eyes finally connect with his again you see it, the utter exhaustion, but behind that there’s something more. something raw and vivid.
“i’m so sorry,” you whisper. “i’m sorry you had to see that, jack. i can’t even imagine…”
“shh…” leaning forward, jack offers you the safe space of his shoulder to cry. “what matters is that you’re alive, love. you both are.”
after the doctors finish their checks and leave the room, a heavy, comfortable silence settles over the two of you. jack doesn’t let go of your hand. he seats on the edge of the bed, staring at you as if you were a ghost that might vanish if he blinked.
“jack,” you whispered, your voice a little stronger now. but you still feel the pressure of your tears threatening to spill at any given moment.
the thought of jack having to bring you back to life, your blood covering his gloved hands… knowing that he had to find out about something you had been suspecting for a couple of weeks through a scan in a trauma room in the er…
“twelve weeks,” he says, his voice thick with his own tears. “and you didn’t… you didn’t tell me.”
there’s no accusation in his voice, only a profound, echoing confusion.
you look down at your hands, the plastic hospital bracelet stark against your skin. “i didn’t know, jack. not for sure.”
jack doesn’t speak, he holds on tight to your hand, dropping a feather like kiss on your knuckles.
“i was suspicious,” you admit, a small, tired smile tugging at the corners of your mouth. “but i told myself i was just imagining it. that my brain was playing some twisted tricks on me. but then i started feeling so tired. then there was the coffee. god, the smell of it started making me nauseous about two weeks ago. i’ve been drinking tea ever since.”
jack lets out a short, wet laugh, rubbing his face with his free hand. “i’m a doctor, i should have seen it. i should have known.”
“how could you?” you reach out, brushing a stray hair from his forehead. “we stopped looking for the signs a long time ago, jack.”
the air in the room shifts. the “last two times”, two years of hope, two positive tests that ended in heartbreak before the first trimester was even over. they were the shadows that had lived in the corners of your apartment, the reason you both had stopped talking about possible names or color palettes for the nursery. you had both quietly agreed to stop trying, to protect what was left of your hearts.
“i didn’t want to say anything until i was certain,” you whisper, tears pricking your eyes. “i couldn’t handle seeing that look on your face again if it didn’t stay. i was going to buy a test this weekend, i promise. i just… i wanted to be sure before i gave you hope again.”
jack leans down, pressing his forehead against yours. his breath hitches. “hope is all i’ve had for the last few hours, watching you on those monitors. i don’t care about the timing. i’ve got you two now. and that’s all i need.”
he moves his hand, sliding it under the hospital blanket to rest flat against your stomach. his palm is warm, steady, and large enough to cover nearly the entire area where the new life rests tucked away.
“we’re going to do the work,” he vows, his voice low. “whatever the doctors say. whatever it takes. i’m not losing either of you. we’ve fought too hard to get here.”
for the first time since the sirens started screaming hours ago, the tension in jack’s shoulders finally breaks.
you rest your head on his shoulder, the steady thump-thump of his heart syncing with yours. it isn’t the perfect, easy ending. there are months of recovery ahead and a thousand medical hurdles to jump but for now, in the quiet of the icu, the three of you are together.
“i love you,” he whispers into your hair.
“i love you too,” you breath, finally letting your eyes drift shut. “both of us.”
the transition from the icu to the step-down unit was supposed to be a victory. it has been ten days since the crash. your chest tube is out, your color is returning, and jack has finally stopped vibrating with the manic energy of a man haunted by ghosts.
but the “pitt” never let anyone relax for long.
jack is sitting in the armchair, his laptop open as he tries to catch up on charts while staying by your side. you are propped up on pillows, picking at a bowl of fruit, when a sharp, searing cramp radiates across your lower abdomen.
it isn’t like the dull ache of your healing surgical incisions. this is different. cold. deep.
“jack,” you gasp, the plastic fork clattering onto the tray.
he’s at your side before the fork hit the floor. “what is it? where’s the pain?”
“cramping. hard.” you grip his forearm, your knuckles turning white. “it feels… it feels like the last times, jack.”
the color drains from his face, but the doctor in him takes the lead before he can panic. he throws back the blankets. and there it is. a small, terrifying smear of crimson on the white sheets.
“pauline! anyone! i need a fetal doppler in here now!” jack shouts toward the hallway, his voice cracking the quiet of the ward.
minutes felt like hours. dr. pauline rushes in, her face set in a grim mask of professional focus. jack stands in the corner, his hands pressed against his mouth. unfortunately, he knows too much. he knows all the signs, just like he knows that post-traumatic subchorionic bleeds could trigger labor or a final, fatal abruption.
the room is filled with the static sound of the doppler searching.
whoosh. whoosh.
the sound of your own pulse, too fast, too frantic.
then, a silence that feels like a death sentence.
“come on,” pauline whispers, moving the probe. “come on, little one.”
thump-thump-thump-thump.
the sound burst into the room. fast, rhythmic, and stubborn.
“heart rate is 150,” pauline exhales, a visible wave of relief washing over her. “the cervix is closed. it’s a ‘threatened’ event, likely just the hematoma from the accident draining. but we are increasing your progesterone and you are on strict, absolute bed rest. no sitting up, no laptop, nothing but breathing.”
jack doesn’t move for a long time after she leaves. he just leans his head against the wall, his chest heaving. the setback lasted only ten minutes, but it had aged him a decade.
“jack,” you call his name softly, patting the free space next to you on the bed.
he walks over and sat on the edge, taking both of your hands in his. “we almost lost the light,” he whisper. “i can’t… i don’t know that i could take it if it happened again, sweetheart.”
“we didn’t lose it,” you said, pulling his hand to your cheek. “they’re still here. we’re still here.”
jack sighs with relief, nodding. he leas down to press a soft, careful kiss to your lips.
three weeks later, the air in pittsburgh finally shifts from the bitter bite of winter to the hesitant warmth of early spring.
you’re not wearing a hospital gown anymore. instead, you wear one of jack’s oversized soft hoodies and a pair of leggings, sitting in a wheelchair by the large windows of the garden pavilion. you are still weak, and your gait is a slow, painful shuffle, but today is the day the doctors, your husband included, have circled in red on the calendar.
week 14. the beginning of the second trimester. the safe zone.
jack walks into the pavilion carrying two cups of herbal tea and a small, rectangular envelope. he looks different today. he’s actually shaved, and for the first time since the night of the pileup, the haunted look in his eyes has been replaced by a quiet, steady glow.
“happy second trimester,” he says, leaning down to kiss the top of your head.
“we made it,” you breathe, looking out at the budding trees. “i honestly didn’t think we would.”
“i have something for you,” he says, sitting on the bench beside your chair. he hands you the envelope with a bright smile.
you open it with trembling fingers. inside isn’t a medical chart or a bill. it is a high-resolution 3d ultrasound from that morning’s check-up.
the image is vividly clear. you can see the curve of a tiny nose, the miniature perfection of ten fingers tucked near a chin, and the long legs that robby joked would make the kid a track star.
“look at that nose,” jack whispers, his finger tracing the print. “that’s your nose.”
“yeah. that’s your chin, though,” you laugh softly, a tear of pure, uncomplicated joy sliding down your face. “the abbot stubbornness is already visible.”
while you are still contemplating the small piece of warmth and joy that was still growing inside of you, jack reaches into his pocket and pulls out a small, velvet box. you look at him, confused.
“jack? we’re already married.”
“i know,” he says, opening the box to reveal a delicate band with a tiny, shimmering stone on top. the birthstone for the month the baby was due. “but the night of the crash, i realized i’d spent so much time being a doctor and a provider that i forgot to be a good husband. i forgot to celebrate the life we were building.”
he takes your hand, sliding the ring onto your finger next to your wedding band.
“this is a promise,” he says, his voice thick with emotion. “no more double shifts when i don’t have to. no more missed dinners. from here on out, it’s the three of us.”
you lean your head back against the headrest of the wheelchair, looking from the ring to the ultrasound, and then to the man who quite literally pulled you back from the edge of the grave.
the trauma is still there, the scars on your body and the stiffness in your limbs would be reminders for a long time, but as the sun warms your skin, the angst of the past month finally begins to dissolve.
“jack?”
“yeah?”
“i think i want thai food tonight.”
jack laughs. and it’s a real, booming abbot laugh that echoes through the garden. “you heard the boss,” he whispers to your stomach. “thai it is.”
bonus
the spare bedroom at the end of the hall had spent years as a storage space for jack’s medical journals and your half-finished art projects. it had been a room of “maybe someday,” a door you both tended to keep closed, preferring to keep the bad memories on the other side.
now, six months after the rain-slicked pavement nearly took everything, the door stands wide open and the scent of paint lingers in the air. a soft, muted sage green that jack spent three weekends perfecting because he refused to let anyone else touch the walls.
you seat in the newly assembled rocking chair, your hand resting atop the prominent, solid curve of your stomach. the baby is active today, a rhythmic tapping against your ribs that feels like a secret code. you are thirty-four weeks along, a milestone that, for a long time, felt like a destination on a map you weren’t allowed to reach.
“i think the crib is slightly crooked,” jack mutters, kneeling on the floor.
he was wearing an old pittsburgh steelers t-shirt, his hair disheveled, looking less like the formidable dr. abbot of the er and more like… like you husband, who was utterly determined to defeat a piece of furniture.
“jack, it’s perfect,” you laugh softly. “the level said it’s straight. you’ve checked it four times.”
“five,” he corrects, standing up and wiping his hands on his jeans. he walks over to the crib, shaking the railing with enough force to test a bridge. “i just… i need it to be steady. everything has to be steady.”
you reach out, taking his hand and pulling him towards you. immediately, he sinks onto the ottoman at your feet, resting his head against your knees. the fierce, protective energy he carries is a byproduct of the trauma; a lingering shadow of the man who collapsed back in that trauma room. but it was softening, replaced by a deep, quiet anticipation.
“oh. i just remembered. we haven’t opened michael’s gift yet,” you say, pointing to the changing table.
sitting atop a stack of colorful onesies is a beautifully wrapped box with a heavy silver bow. next to it is a card embossed with the university of pittsburgh medical center logo.
according to jack, robby dropped it off at the nurse’s station for him to bring home.
“he said if he had to hear me talk about ‘fetal heart rate variability’ during a trauma shift one more time, he was going to quit, so he bought this to shut me up,” he said as he lay the box on the changing table the other night.
you open the card first. in robby’s cramped, hurried physician’s handwriting, it read:
to my dear friends (and my future favorite abbot),
i’ve known you two for a long time and i truly can’t think of anyone better to take care of each other. i also know that kid will be so lucky to get to call you two mom and dad. i can’t wait to meet the little one.
congratulations on the final stretch!
— robby
inside the box is a high-tech, medical-grade infant vitals monitor, the kind that synced to a smartphone. it’s exactly the kind of gift dr. robby would give: a way to keep watch even when the lights were out. underneath the monitor was a tiny, hand-knitted sweater with a small stethoscope embroidered on the pocket.
“he’s a softie,” you whisper, running your hand over the wool.
“don’t tell him i said so, but he’s the reason we’re sitting in this room,” jack said, his voice drops into that low, honest tone he saved only for you. he looks up at you, his eyes reflecting the soft nursery light. “when i saw you on that table… i forgot how to be a doctor. i forgot how to breathe. he held the line until i could find my way back.”
jack stands up and leans over you, pressing a long, lingering kiss to your forehead before moving down to press his ear against your belly. he waits, silent and still, until the baby delivers a sharp kick right against his cheek.
“hey there,” jack whispers to the bump, a grin breaking across his face. “i hear you. we’re ready for you. everything is ready.”
he stands back, surveying the room; the crib, the sage-green walls, the gift from his brother, the man who helped save your lives, and the woman who was his entire world. the angst of the pitt, the screams of the monitors, and the cold terror of the icu feel like a lifetime ago. they are just scars now. like faded, silver lines that proved they survived the storm.
“do you think the baby will like the room?” you ask.
jack wraps his arms around you from behind, his chin resting on your shoulder as you both look out at the quiet pittsburgh street below.
“she’ll love it,” jack promises.
the sun begins to set outside the window, casting a warm, golden glow over the nursery, turning the sage walls into the color of a new spring. you’re a survivor, jack is a father, and in just a few short weeks, the pitt would be nothing more than a place where jack went to work, while his real life, his whole life, waited for him right here, at home.
