DIRECTORY!
call me ajay! .✦ ݁˖ they/them. ✦ ݁˖ 8teen. ✦ ݁˖ infp .✦ ݁˖ sagittarius .✦ ݁˖
amateur writer! chronic oc maker! film student! david bowie enthusiast!
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below are my rules + tag directory:

roma★
TVSTRANGERTHINGS
Jules of Nature
Keni
No title available

PR's Tumblrdome
Peter Solarz
I'd rather be in outer space 🛸
art blog(derogatory)
Acquired Stardust
Aqua Utopia|海の底で記憶を紡ぐ
Sade Olutola

JVL
wallacepolsom

No title available

⁂
i don't do bad sauce passes
No title available
dirt enthusiast
cherry valley forever

seen from Canada

seen from United States

seen from Türkiye

seen from Singapore
seen from Poland

seen from India
seen from Canada

seen from Malaysia
seen from United States
seen from Netherlands
seen from United States
seen from United States

seen from Germany
seen from Canada
seen from United States

seen from United States
seen from United States

seen from Pakistan
seen from United States
seen from Brunei
@witch-aj
DIRECTORY!
call me ajay! .✦ ݁˖ they/them. ✦ ݁˖ 8teen. ✦ ݁˖ infp .✦ ݁˖ sagittarius .✦ ݁˖
amateur writer! chronic oc maker! film student! david bowie enthusiast!
letterboxd serializd pinterest ao3 wattpad
below are my rules + tag directory:
RULES!
be kind!! writing is my hobby, and my fics won't be perfect! i'm doing this for fun, so please!! be!! kind!!
my requests are always open, i write for my ocs + reader insert! i write at my own pace, and i am a college student, so please be patient!
i'm okay with nsfw asks/requests, but i will decline them if i feel uncomfortable writing it. i do write smut though!
no maga fucks, no antisemites, no racists, no zionists, no homophobes, no transphobes, no terfs, no misogynists, etc!! fuck ice and free palestine!!
i do not condone the posting of my writing onto other websites or blogs. my writing is MY writing.
i DO taglists!! if you want to be on one, send me an ask!!
do not send me any pro-ai bullshit. i do not want to see your chatbots. do not feed my work into any form of ai or chatbot.
TAG DIRECTORY!
#ajayaps -> me yapping/talking about something
#maddie pierce -> things relating to my oc maddie pierce (the pitt). it will have the fics in this tag, and also other things for the oc!
#vienna waits for you -> fics in the series involving all seasons of the pitt!
#you got your passion -> fic following the first season of the pitt!
#lilliyan pyre -> things relating to my oc lilliyan pyre (asoiaf). it will have the fics in this tag, and also other things for the oc!
"nobody likes a complainer" you say, like an idiot, as if thriving ecosystems of friendships aren't blossoming every day based solely on people vocally disliking the same things in similar ways
*reaches out my hand in love & friendship* come be a Hater with me
one day you too could be a fanfic author who updates a decade later
samira mohan whose father died when she was young due to racial inequality and medication mismanagement. who dedicates her life to trying to be a good, compassionate, kind doctor in a specialty where it is hard to form connections with your patients. samira mohan who was belittled by both her peers who called her slow-mo, who thought that just because the reason they picked emergency medicine is because they can't sit still and need the stimulation, that her reasoning wasn't as valid.
samira mohan who was bullied and torn down by her attending at every possible moment purely because he saw himself in her. samira mohan who never had a father figure and never got to see her mother in love who now has to watch her mom jet off with some guy she's never met and sell the only place samira has left of her dad. samira who watches every single one of her coworkers soul bond with another but none of them even know that about her, to the point where they don't even ask her medical history when she thinks she's developing the same thing that killed her father.
samira never wanted to do literally anything other than emergency medicine and anyone pretending like she did because she was floating the idea around out of insecurity did not watch the show properly. she wanted everyone she pitched the idea to leave to tell her no, this is where you belong. you are an emergency medicine doctor. don't move to psychiatry, you want to be here.
samira mohan who genuinely looks up to robby despite all his misgivings, who wants him to tutor her, to teach her, to guide her. only for all of his efforts to be focused on his white male suboordinates, and (one of) their mismanagement of medication.
Words hold weight..
on nostalgia
the handmaids tale, margaret atwood// @firstfullmoon // @stigmatawife // @jb-blunk // forever winter, taylor swift// @an-attempt-at-living // the memory of a memory, katie maria // erica jong // secrets from a girl whos seen it all, lorde; poster by mlgrsdesign// ? // @n1ntendos // @fairycosmos // @inanotherunivrse //@robertszombie // @notbigthief
The crazy thing about the Pitt is that there are like five Chekhov’s guns and they are shooting different mirrors and bouncing off them all around that damn hospital and they all are going to hit Robby in the head.
three things can be true:
Langdon's behaviour towards Santos in s1 was inexcusable, and he owes her an apology which she is not obligated to accept
Santos needs to be able to conduct herself professionally when working alongside him in front of patients regardless
Garcia was out of line for the manner in which she reprimanded Santos publicly, though she was right to draw a line in the sand
my take on every pitt character btw
Would it be possible to add me to the tag list of the Pitt fanfic your doing with the character Maddie please
of course! adding u rn!! thank you for the support! <333
HBO: Hey try to be neutral about the ICE topic ok
The Pitt: Our virally successful hot silver fox who is white as the driven snow is arrested by ICE because he was trying to protect his patient from further injury because ICE are animalistic bullies and we want to show that to the wider HBO audience that won't recognize brown pain.
you got your passion, you got your pride
summary: maddie pierce is a doctor. a good doctor? she isn't sure. maddie pierce is a big sister. a good sister? she isn't too sure about that either. maddie pierce is completely and utterly lost in her own life. she also has strange underlying sexual tension with her coworkers! can maddie make it through her shift at PTMC without having a mental breakdown or have HR involved? find out here! follows season one of the pitt! each chapter is one episode!
prologue
CHAPTER ONE - 7:00 AM
Maddie steps through the hospital doors and veers immediately toward the stairwell, her sneakers squeaking faintly against the polished floor. She takes the steps two at a time, her hand barely grazing the railing as she descends, the fluorescent lights flickering overhead. She emerges into the waiting room and slows instinctively, her momentum bleeding away as the space unfolds before her. Families cluster together in tight knots. Couples whisper with their heads bent close, fingers intertwined or gripping plastic cups of bad hospital coffee. Individuals pace shallow paths worn into the tile, their eyes distant. Someone laughs too loudly at a phone screen, the sound jarring and out of place. Someone else stares straight ahead, unmoving, their hands folded so tightly in their lap that their knuckles have gone white.
She exhales softly and threads her way toward the ED doors, weaving between chairs and abandoned magazines. She scans her ID against the reader. The doors buzz open with a mechanical click, and she slips inside, the sound of the doors closing behind her sealing her away like an airlock.
She spots Robby almost immediately.
He's standing near the wall of framed doctors, his broad shoulders slightly hunched, eyes fixed on a face that will never leave him. Dr. Adamson. The weight of the anniversary of his death hangs around him like a heavy coat. He looks distant, like he's somewhere else entirely—somewhere Maddie can't follow. His first time working this day since Dr. Adamson died during COVID.
"Hey," she murmurs as she approaches, her voice soft enough not to startle him.
He towers over her, as always. A full foot taller, maybe more. She has to tilt her head back just to meet his eyes. He smells like coffee and the city: warm, faintly bitter, with an undertone of some sort of woodsy soap and something distinctly him, grounding in a way she didn't realize she needed.
Her voice reaches him.
Robby turns, the distant look fading as his eyes settle on her, sharpening with recognition and something softer beneath. "Hey yourself," he says, his smile slow and easy as he runs a hand over his salt-and-pepper beard. His brown eyes meet hers and linger, just a fraction too long, enough to make something in her chest flutter.
Maddie swallows hard and drops her gaze to her Converse—scuffed, breaking down at the sides, the laces fraying. She keeps meaning to replace them and never does. Another thing to add to the list.
She's suddenly hyperaware of the space between them, specifically the lack of it. She tips her head awkwardly toward the center desk, a half-formed suggestion. Robby catches it, something soft flickering across his expression, before he falls into step beside her.
They cross to the center desk together, movements synchronized. Dropping her messenger bag onto the counter with a dull thud, Maddie slips her stethoscope free from where it's tangled with her keys and hospital ID, and settles it around her neck. The familiar weight presses lightly against her collarbone, cool metal against warm skin. She closes her eyes briefly, letting out a slow breath. Drop it here, Maddie, she tells herself. The overdue electric bill. Milo being weird. Dad’s constant calls. This isn’t the place.
“Gloria’s looking for you,” a voice calls from behind the desk, cutting through her thoughts.
Maddie opens her eyes to find Dana looking up at them, one brow already arched, as if she’s been waiting.
Robby groans theatrically as he pulls out his own stethoscope, the sound rumbling from deep in his chest. "No guts, no Gloria. Must be time for my weekly spanking."
Maddie snorts before she can stop herself, pressing her lips together to hide it. Dana shoots her a look that's half warning, half fond, the corner of her mouth twitching.
“Try to behave, for all our sakes,” Dana says, smiling despite herself. Her gaze shifts back to Robby, softening just a touch. “You sure you’re okay being here today?”
“Yeah,” Robby replies suspiciously easily, “Why wouldn’t I be?” His eyes slide past hers, already finding something else to focus on, his jaw tightening almost imperceptibly.
Maddie notices. Dana does too. They exchange a look.
“Well,” Dana says gently, “if you need to talk—”
“I won’t,” Robby cuts in, eyes lifting to the board above her head. “But thanks.” A beat. “Where’s Abbott?”
“Getting some air,” Dana answers, her mouth tightening as she nods toward the stairs. She gives them both a look that says more than she does.
Maddie and Robby sigh at the same time. Robby turns toward the stairwell without hesitation. Maddie follows, then stops short when a hand catches her arm.
Dana’s touch is light, but firm.
“Make sure they’re okay, yeah?” Dana says softly. “Both of them.”
Maddie swallows around the sudden thickness in her throat, nods once, and offers a synthetic smile that doesn't quite reach her eyes, before turning back to the stairs.
—
The roof door creaks shut behind them with a metallic groan, and the cold bites through Maddie's scrubs instantly, bitter and unforgiving. She sucks in a breath through her teeth, her arms crossing instinctively over her chest as goosebumps ripple down her skin. Maddie had always hated the cold.
Jack Abbott stands beyond the safety rails, facing the city. A siren wails somewhere below, weaving through the low rumble of traffic.
"Morning, Jack," Robby says, stepping closer, hands buried deep in his pockets, shoulders hunched against the cold.
Maddie drifts to the opposite rail, mirroring him. She observes Jack in silence—the slump of his shoulders, the way he shifts his weight onto one leg as if the other aches. She knows the prosthetic wears on him after a while, especially during long shifts. Her brow furrows. He shouldn't be up here alone.
Jack glances at Robby, then flicks a look at her, his hazel eyes tired and rimmed with red. "What are you doing here?"
"Working," Robby replies easily, "And you?"
Jack shrugs, eyes still on the city. “Had a guy come in. Hit by a drunk driver in a crosswalk. Thirty-nine-year-old vet. Survived three tours without a scratch. I spent the last two hours coding him.”
Something tightens in Maddie’s chest. She looks down at her shoes, the familiar ache of loss settling in quietly. "That's always a rough way to end the night," she says, voice low, barely audible over the wind.
Jack leans a little further over the edge, “I must’ve had a reason to keep coming back once…can’t think of it right now.”
Robby’s voice cuts in, calm but firm, “Because this job…it keeps on giving. Nightmares. Ulcers.”
Maddie adds, “Suicidal tendencies.”
Jack lets out a small, dry laugh. The sound is rough around the edges, but real. Something stirs inside Maddie at the sound, something warm and fluttering that she has no business feeling right now. She pointedly ignores it, pressing her lips together and refocusing on the skyline.
“Besides,” Robby says, smirking, “if you jump on our shift, that’s just rude, man.”
Jack exhales, then ducks back under the railing to stand safely on the other side, “Hope I’m never one of your patients,” he says, a faint grin tugging at his mouth, softening the harsh lines of exhaustion on his face.
“That makes two of us,” Robby replies, clapping him on the back. The two exchange a soft look, one that comes with years of knowing and understanding each other.
They head toward the door together, their footsteps echoing across the empty rooftop. Maddie follows, the knot in her stomach loosening. Jack glances at her as they go, something softer in his eyes, and a faint smile pulling at his lips. Warmth spreads through her chest in response, quiet but unmistakable, like sunlight breaking through clouds. She returns the smile, lets it linger just a beat longer than necessary, then falls back behind them, giving them space. She keeps her gaze on her shoes as they move toward the elevator. Stop it, Maddie, she tells herself again, tightening her jaw. Now is not the time.
The elevator doors slide shut with a soft hiss. Maddie naturally settles between Robby and Jack, like she's always done, her shoulder brushing Robby's arm, the heat from Jack's body radiating through her skin. She can smell Jack's cologne, something warm and citrusy, mixing with the lingering scent of Robby's coffee.
Jack speaks first, his voice softer now, breaking the silence. "How's your brother? Milo? Kid doing okay?"
Maddie's smile falters just slightly before she steadies it, muscle memory kicking in, the same smile she's been using since she was old enough to lie convincingly. "Yeah… yeah, he's alright. Acting a little weird, but… probably just school stress."
Probably. The word tastes like uncertainty. Like the knot that's been sitting in her stomach for the past week. The one that tightens every time Milo comes home and goes straight to his room without saying hello. Every time he picks at his food instead of eating. Every time she catches him staring at nothing, his dark eyes distant and unreachable.
Maddie's eyes look everywhere but at the two men beside her; the floor numbers ticking down, the dents on the metal walls, her own reflection distorted in the polished surface. Jack nods once, his gaze drifting to Robby. Robby's eyes flick to Jack's, then back to Maddie, something passing silently between them. They know I'm lying. Of course they know.
"I'm sure… he's just being a dumb kid," Robby says softly, his tone deliberately casual, giving her an out. "Nothing else going on, right?"
Maddie shakes her head, though her brow creases, doubt etching itself across her features. "No… no, not that I can think of—"
Her phone buzzes against her hip, the vibration sharp and insistent. The sound feels louder than it should in the enclosed space. She checks it reflexively, sees another missed call from her dad: Padre flashing across the screen with a photo she’s been meaning to delete, and huffs a breath, before tucking it away without answering.
Jack tilts his head, “Important call?”
"N-No, no. It's just… my Dad. He's been calling for a little while. Nothing major." The lie tastes bitter on her tongue. Discomfort radiates through Maddie's body, crawling under her skin like insects, making her squirm in her skin. Now he's calling me at work, she thinks, her jaw clenching involuntarily. Asshole. She hasn't spoken to him in eight months, not since he banged down her door that night. And now he's bleeding into her job, into the one place she's supposed to be able to focus on something other than the mess of her personal life.
Robby shifts his weight, drawing her attention. Jack's fingers tap once against the railing, then still. The two of them allow a moment for Maddie to say something else, to elaborate, to ask for help. She doesn't. She never does.
"I've got a pregnant teen coming back today for Mifepristone," Jack says, shifting gears, knowing when to drop a subject. "And a small bowel obstruction that's been waiting for surgery for the last three hours."
They both nod, absorbing it.
“Oh, and unfortunately… the Kraken is still boarding in BH.”
Maddie groans, tipping her head back against the cold metal wall, “Still?”
"Guy's been here a week waiting for the psych ward," Robby says, stepping aside as a nurse pushes an empty wheelchair into the elevator, the wheels squeaking softly. He presses himself against the wall to make room, his arm brushing against Maddie's.
“Yep. He’s only getting worse,” Jack adds, mouth pressing into a grim line. “Catching some Zyprexa Z’s at the moment, but when he wakes up… God help you all.”
Maddie chuckles under her breath. Robby’s mouth curves briefly before flattening again.
“I wrote a note for the family of my dead vet, if anyone shows,” Jack continues, handing Robby an envelope. “Oh, and the med students and new interns start today. Good luck with that.”
“Lucky, lucky me,” Robby mutters, his breath heavy with resignation.
"Hey, they might not be so bad!" Maddie says as the doors open with a cheerful ding, a bounce in her step as she moves forward.
Both men groan.
“You just see the absolute best in people,” Jack says, sarcastically, “And you like making new friends.”
Robby snorts. Maddie rolls her eyes, crossing her arms over her chest, “Whatever. I wasn’t bad my first shift.”
They both pull skeptical faces.
“What?! I wasn’t!”
“You told a patient’s father that he was ‘an experiment in artificial stupidity’ if he was being ‘this dumb’ not to let you operate on his son,” Robby says dryly.
Heat floods Maddie's cheeks. "I was just saying what everyone was thinking! And it worked, didn't it?"
“Yeah, yeah, whatever, kid,” Jack mutters, rolling his eyes and rubbing his face.
Maddie frowned slightly as Jack's words settled over her like a wet blanket. Kid.
Jack wasn't wrong. She did like meeting new people. Liked being friendly. That was part of why she did this job, right? Seeing new faces, connecting, helping people… it wasn't wrong to care.
But… what if it was? What if it just made her look… naive? Childish? Like she didn't belong here, like she was playing doctor instead of being one? Her stomach twisted, anxiety coiling tight. Usually, she could keep it together. But sometimes she… didn't. Sometimes she snapped. Sometimes she lost her temper and said things she probably shouldn't, let her emotions bleed through the careful walls of professionalism she had built. Did that mean she wasn't good enough? Did Robby and Jack think less of her? Think of her as a kid? Was that all she was to them? Should she even care what they thought?
You're twenty-two, Maddie. You're a second-year resident. You're allowed to not be perfect.
But the voice in the back of her head that sounds suspiciously like her father whispers back: Why aren’t you? You're supposed to be perfect. I made you to be perfect.
She opened her mouth, half-formed words hanging there—some kind of defense or explanation or maybe just a joke to deflect—but before anything came out, chaos hit like a freight train.
A naked man bursts out of a nearby room, slamming the door behind him with enough force to rattle the frame. His skin is pale and blotchy, covered in a fine sheen of sweat, his eyes wild and unfocused.
“Sir! Get back here!” a nurse shouts.
"No needles! No needles!" the man screams, his voice cracking with genuine terror, bare feet slapping against tile as he tears down the hall, his hospital gown nowhere in sight.
Perlah is already in motion, security right on her heels.
The three of them freeze mid-step, watching the chaos disappear around the corner like a tornado moving through the ED, leaving stunned silence in its wake.
Jack turns slowly to Robby, “You sure you wanna work today?”
—
The trio make their way over to Jack's workspace, weaving around a gurney being steered toward imaging. The orderly pushing it nods at them as they pass, and Maddie returns the gesture automatically.
Jack leans over his chair and wakes his screen with a tap of the spacebar, shoulders squared. His fingers find the keyboard and begins working on last-minute charts. The faint crease between his brows doesn't ease.
He looks exhausted, Maddie thinks, her chest squeezing with concern. When's the last time he actually slept?
Robby claims the adjacent station, setting his coffee down within easy reach, before logging in. Maddie takes the station beside him, slipping her messenger bag beneath the desk where it won't be in anyone's way, and smoothing the wrinkled edge of her scrub top with both hands before pulling up her charts. The blue glow of the screen reflects in her eyes. Familiar. Constant. Consistent. The rhythm of charting, checking labs, reading notes left by the night shift calmed her down.
Her phone buzzes again in her pocket, insistent against her thigh. She groans quietly. This did not.
The ED carries on around them: keyboards clacking, a phone ringing at the nurse’s desk, Collins and Langdon talking nearby. Maddie catches only fragments of it, the words dissolving into background noise as she settles in, pulling up her last chart:
Patient: Marcus Thompson, 67M, chest pain, possible MI, awaiting cardiology consult—
A woman approaches from the desk, slowing as she reaches them. She’s blonde, hair pulled back into a slightly too-tight braid, not a single hair out of place. Glasses sit high up on her nose. She stands straight, hands clasped tightly in front of her, practically buzzing in place.
New intern, Maddie thinks immediately, recognizing the bright-eyed look. Looks like she’s gonna vibrate out of her skin.
“Dr. Robinavitch? Melissa King. I will be joining you today. I just came from two months at the VA,” the woman says excitedly.
Robby turns toward her, and he offers his hand. “Hey, welcome to the Pitt,” he says. “This is Dr. Jack Abbot and Dr. Madeline Pierce.”
Maddie steps forward before Jack can look up—saving him from having to engage when he's clearly running on fumes—smiling softly as she extends her hand to shake Melissa's. Her grip is firm but warm, something she'd learned to get right over time through repeated practice. A good handshake matters, Madeline, her father used to say, standing too close, his breath smelling of whiskey and cigarettes. Too strong and you're aggressive. Too soft and you're weak. Never be weak. She pushes the memory away, focusing on the woman in front of her instead.
“Nice to meet you,” Melissa says, practically vibrating with excitement, breaking Maddie out of her thoughts, “I can’t tell you how excited I am to be here today, so…”
Maddie grins as she nods along. There’s something sincere about Melissa, and Maddie can’t help but feel a quiet pull of affection. It’s been a while since she’s seen someone who’s this genuine. This…present. It’s a nice change.
"Talk to me at the end of the day," Abbott says from his workstation, not bothering to look up, casting Melissa a sideways look from the corner of his eye before returning to his screen. "See if you're still excited then."
Robby lifts his coffee mug as he steps away from the desk, "Ignore him. He had a rough night."
Maddie follows, falling into step beside him, glancing back over her shoulder at Jack. "And is having an ongoing existential crisis," she adds, tone teasing but not unkind, eyes flicking briefly to Jack's profile; the tired lines around his eyes still concerning her.
“Don’t worry, you’ll get there soon enough,” Jack says, his eyes following them.
Maddie glances back again, unable to help herself, giving him a playful glare that doesn't quite hide the concern underneath. Are you okay? Really? she wants to ask, but doesn't. Not here. Not now. She can’t let herself fall so easily.
Instead, she catches the faint lift at the corner of his mouth. Their eyes meet for a moment—quick, almost accidental, charged with something she can't quite name—and she turns away a little too quickly, swallowing hard, heat creeping up the back of her neck.
Robby signals to Maddie that he’s going to check on Dr. Mohan, and she nods, staying behind with Melissa.
"Uh, I go by Maddie, by the way," she says, turning back to Melissa with a friendly smile, tucking a stray strand of dark hair behind her ear that's escaped from her ponytail. “Nobody really calls me Madeline.”
“Yeah, same! Well, not the same. I don’t mean that I go by Maddie or that nobody calls me Madeline—” Melissa stumbles over her words, twisting the ends of her stethoscope. Maddie can’t help the small smile that creeps across her face, the corners of her eyes softening. Oh, she’s adorable.
“I-I, uh, I go by Mel. Not Melissa. Nobody calls me Melissa,” she finishes, glancing to the side, cheeks faintly pink. Maddie lets out a short laugh, the sound warm, not mocking. She nods, tilting her head to the side to deliberately catch Mel's averted gaze, waiting patiently until their eyes meet again.
“Cool. Guess we’re nickname twins now,” Maddie says, a grin tugging at her lips. She lets her posture relax, leaning on the counter. See? I’m chill. You’re chill. We’re chill.
Mel lifts her gaze, meeting Maddie’s. She tilts her head, squints slightly, and then her smile spreads, hesitant, but relieved. Her fingers stop fidgeting, resting loosely at her sides, though her foot taps once against the floor before she catches herself. Cute.
“So, you’re a resident, then?” Maddie asks, leaning a little forward, her elbow brushing the counter, eyes scanning Mel as if trying to get a read without looking too obviously.
“Uh, yeah. R2. You?” Mel studies her back, eyes flicking around Maddie’s face.
"Same. R2," Maddie says, already anticipating where this is going due to Mel’s scrutiny. She tucks her hands into her pockets for a moment, adjusting her scrubs, "And, yeah… I'm young. Graduated at twenty. I'm twenty-two now."
She says it matter-of-factly, like it's just another piece of information, but her jaw tightens. She's had this conversation hundreds of times. Sometimes it goes well. Sometimes it doesn't.
Mel’s eyes widen slightly, “Twenty? Like… twenty twenty?”
Maddie suppresses a laugh, the corner of her mouth twitching as she glances down at her shoes. Here we go, Maddie sighs internally, bracing herself for the usual line of questioning. How? Why? Are you some kind of genius? Were you homeschooled? Did you skip grades?
Mel swallows visibly, her throat working, and straightens her spine, fingers twisting lightly in front of her as if trying to channel her surprise into something resembling professional composure. "I-I mean, wow. Yeah. That's… really impressive. I-I thought you looked young, but… wow. N-No biggie, though! Sorry, I'm just impressed."
There's no condescension in her voice. No skepticism. Just genuine admiration that takes Maddie by surprise.
“No worries,” Maddie says, letting her smile linger, softening her shoulders as they drop from their defensive hunch. Huh. “A lot of people react that way. I just don’t like it when people assume I’m unqualified.”
Which happens more frequently than I would like, she adds silently, thinking of past attendings who dismiss her input, patients who would ask to speak to a "real doctor," the way some nurses would treat her like she had no clue what she was talking about.
Mel nods, eyes steady and earnest. “Yeah. Totally get it.”
Maddie smiles again, gentler now, warmer. But not from you. There's something about the way Mel looks at her—respectful, curious without being invasive—that feels different.
She straightens before she can think too much about it, checking the clock on the wall. "It was good to meet you, Mel. Dr. Robby's probably gonna call rounds in a few minutes, and I just need to check in with someone real quick."
Mel’s shoulders lift slightly, her smile widening just a touch, “Good to meet you, too! See you in a bit!”
She seems…thoughtful. Kind. Friendly. That’s good. She smiles again to herself. Jack can suck my balls.
—
Maddie drifted over to where Langdon and Collins stood reviewing the board. The board glowed with color-coded names and room numbers, a visual representation of the chaos they'd be navigating for the next twelve hours. She came up beside them and rested her elbow on the edge of Langdon's desk, settling into a comfortable lean.
"Morning, you two," she chirped, her voice deliberately bright, trying to inject some positivity into the pre-shift tension that always hung in the air.
“Morning, sunshine,” Langdon said without looking up, mouth slanting into a smirk as he typed.
Sunshine.
Maddie's smile faltered—barely, just a tiny flicker, a microscopic crack in the facade—and a small crease formed between her brows before she could smooth it away. Langdon’s nickname for her always landed a little… wrong. A little patronizing. A little kid-sister, like she was the ED's child instead of an actual doctor. She knew Langdon didn't mean it that way, at least, she didn't think he did, but it still made something in her chest tighten uncomfortably, made her want to prove herself time and time again.
She smoothed her expression before either of them could notice, forcing the smile back into place, wider this time, more convincing.
"You ready for today? New interns," she said brightly, redirecting, pushing past the discomfort.
"Yup. Thrilled," Collins deadpanned, her gaze still glued to the board, not even pretending to be enthusiastic. Her voice was flat, exhausted.
A beat of silence passed, heavy and awkward. Collins blinked slowly, like she was processing on a delay, then sighed, a deep, bone-tired sound, "Sorry. Rough morning."
“All good,” Maddie said gently, studying her face. “You okay?”
"Yep," Collins answered too quickly, already stepping back from the desk. "Just tired. I'm gonna go prep before Robby starts rounds."
Maddie watched her go for another moment, concern tugging at her, then turned back to Langdon, "You know what's up with her?"
He lifted a shoulder in a shrug, still typing, "No clue."
He finally pushed away from his desk with a squeak of chair wheels and came around to face her properly, stretching his arms above his head until his back cracked audibly. "But you—" he pointed at her with a pen, "—better be on your A-game. Heard this batch of newbies is… something."
Maddie raised a brow, half amused, half intrigued, crossing her arms over her chest. "Something how? And when have I ever not been on my A-game?"
Langdon gave her a slow, knowing look, "Mmm-hmm," he hummed, the sound dripping with sarcasm.
"What?" Maddie demanded, but he was already turning back to his computer, effectively ending the conversation with a dismissive wave of his hand.
She rolled her eyes and pulled out her phone, checking her messages. Three texts from Milo's school about an upcoming parent-teacher conference she'd already scheduled. Another missed call from her dad. Her thumb hovered over the notification before she swiped it away.
After a moment, Langdon nodded toward her phone. “Your dad still calling?”
Maddie slipped the phone back in her pocket. “Yeah. Still calling. I’ll…deal with it eventually.”
Eventually. Maybe never. Preferably never.
Langdon hesitated, his fingers stilling on the keyboard. "Maybe you should do it sooner rather than later. Give him a chance. If he's trying this hard, he must have something he needs to tell you."
Maddie froze, her whole body going rigid. She turned fully toward him, pivoting on her heel, an incredulous look spreading across her face like a storm cloud. Is he serious right now?
He knew her past with her father. She'd told him—over drinks one night after a particularly brutal shift, when the alcohol had loosened her tongue, and the exhaustion had stripped away her usual defenses. He knew about the bruises, about the drugs, about the years of broken promises and empty apologies.
"You're joking," she said, her voice flat, disbelieving.
His brows knit together, "No? I just mean, he told you he's been working on himself. Maybe it's worth hearing him out."
She let out a humorless laugh, the sound sharp and bitter. Her hands clenched into fists at her sides, nails digging into her palms. "I've given him a second chance. And a third. And a fourth."
Her voice was rising slightly, emotion bleeding through despite her best efforts to keep it contained. "When he says 'working on himself,' that means he found a new wife to disappoint, checked himself into rehab just long enough to get the completion certificate, and bought a self-help book he'll never open. It doesn't matter. He was a shitty dad before the drugs. They just made it easier to pretend that was the only problem."
The words came out harsher than she intended, raw and unfiltered. She watched Langdon's expression shift. Something tightened behind his eyes, something unsettled by her bluntness.
Good, part of her thought viciously. Be uncomfortable. You should be.
But another part of her—the part that hated conflict, that wanted everyone to like her, that spent her childhood learning to read rooms and defuse tension before fists started flying—immediately felt guilty for snapping at him.
Maddie frowned at his reaction, her anger cooling into confusion, about to ask what his deal was, when Robby reappeared at the end of the hallway with McKay and the new interns following behind him in a nervous cluster, effectively cutting off their conversation.
Saved by the bell, Maddie thought, forcing her hands to unclench.
“As you can see, we have some new faces with us this morning,” Robby starts, “Good morning, good morning. Come on over.”
Maddie's eyes drift over the group almost immediately, her body shifting into assessment mode without conscious thought. A habit she's utilized to her advantage since she was young. Old habits die hard.
Let's see what we're working with here.
He moves to Mel. “Starting with second-year resident Dr. Melissa King, fresh from the VA.”
Mel's hands are clasped tight in front of her, knuckles white with the pressure, and her smile is wide—almost painfully wide, like she's trying to physically manifest enthusiasm through sheer force of will. "Everyone calls me Mel," she adds quickly, her voice a touch too loud in her nervousness. "I'm so happy to be here."
Maddie shoots her a small smile, which Mel immediately returns. Something warm flickers in Maddie's chest at the exchange. We're gonna be friends. I can feel it.
Robby nods at the taller woman beside Mel, signaling her forward.
“Trinity Santos, intern,” she says, arms tucked behind her back, chin high. Maddie studies her more carefully, noting the small smirk playing at the corner of her mouth. Confident. Good. We need confidence here. But maybe a little too confident. That could be a problem. Especially when working with others.
“Victoria Javadi, MS3,” the next woman says. Maddie turns to her, noting her younger appearance. She looked nineteen, maybe twenty. Huh. Similar to me. She gives Victoria a knowing nod with a smile, which the girl hesitantly returns.
"Uh, Dennis Whitaker, MS4," the guy standing next to Victoria says, and immediately Maddie's attention zeroes in on him.
Oh, honey.
Small frame, maybe 5'7" if he's lucky. Pale, like hasn't-seen-sunlight-in-months pale. Mousy brown hair that’s definitely not in style. Maddie notices the dark circles under his eyes. Chronic sleep deprivation? Or just one bad night? His hands fidget constantly at his sides, fingers twitching, adjusting his stethoscope, never quite settling. His eyes dart around the room, as if sustained eye contact is physically painful.
She wonders if he's always that tense, or if it's just first-day jitters amplified by the intensity of the ED. Dude looks like he's about to cry. She can see the shine of moisture at the corners of his eyes, the way he blinks repeatedly like he's trying to keep his composure.
Cute, she thinks. Hope he’s actually cut out for this.
"Welcome to the Pitt, I'm—" Robby starts, but Dana cuts him off mid-sentence, appearing at his elbow with a phone raised up to her ear.
“We’ve got two traumas from the T. Five minutes out,” she says, sharp, all business.
“Okay, copy that,” Robby replies, calm as a river. “Actually, this is the most important person that you’re gonna meet today. This is Dana. She’s our charge nurse. She is the ringleader of our circus. Do what she says when she says it.”
Maddie watches as he gestures to Dana. She throws Maddie a small wink, and Maddie returns it with a small smile.
“As you can see, our house is always packed, and our department is mostly clogged up with boarders. Those are admitted patients waiting for a room upstairs, sometimes for days. Beds are a very precious commodity around here, so please be quick and efficient with your workups.”
The interns nod. Maddie studies them, mentally rating their survival odds. Mel—90%, she's got the VA experience. Santos—75%, confidence will either save her or kill her. Victoria—60%, she's young but seems clever enough. Whitaker—40%, unless he gets out of his own head.
“What else…” Robby continues, “We treat the sicker patients back here, but please keep your eye on that waiting room, make sure nobody’s gonna die out there.” He gives them a serious look, drilling it into them.
"Your senior residents are Dr. Collins and Dr. Langdon." Both nod on cue, Collins having returned from wherever she'd disappeared to. "You report to them, they report to me. Your other residents are Dr. McKay, Dr. Mohan, and Dr. Pierce." The interns nod again.
“Great. Senior residents, you got your sign-outs?”
“Yep,” Collins replies. Langdon nods.
“Okay. Let’s do this,” Robby says, leading the group down the hallway.
Maddie falls into step behind them, her earlier conversation with Langdon still sitting uncomfortably in her chest. Her phone buzzes again in her pocket. She ignores it.
—
“Virgil Straker,” Langdon starts as the group shuffles into the room, his tablet already in his hand, “9mm GSW to the left shoulder. CT angiogram negative. Surgery wants to admit for overnight observation.”
Maddie gives Straker a warm smile as she checks his vitals, “Good vitals,” she reports, angled toward Robby.
"They repeat a crit?" Robby asks without looking up, his attention focused on carefully peeling back the edge of Straker's shoulder dressing, checking for any signs of fresh bleeding or infection.
“Stable crits every two hours times three,” Langdon says.
Robby nods, satisfied, re-securing the dressing. "Discharge on Ceftin, recheck tomorrow. He'll get more rest at home." Then he drops into that gentler mode he reserves for patients, the one that makes Maddie's heart do something strange, leaning down with a half-smile that crinkles the corners of his eyes. "Good morning, Mr. Straker. Feel like going home?"
“Hell yeah,” Straker says, glancing up from his phone with a grin. Robby laughs under his breath.
“Okay,” Robby says, amused, giving the shoulder wound one more glance before stepping back and motioning them toward the hall.
They’re halfway down when Collins picks up the thread. “All right, Murphy Rottenstein. Forty-eight-year-old woman with cirrhosis and upper GI bleed. Intubated and stable after one unit. Waiting on an ICU bed.”
Maddie nods, and before the group steps into the room, a cheerful voice calls out.
“Hey, Doc!”
She doesn’t even need to look. The grin is automatic. “And we all know Louie Cloverfield,” she says, detouring toward him with the others following. “Blood alcohol of four hundred-twenty at eleven last night.”
“I’ve been cutting back,” Louie beams up at her from his wheelchair.
"How is he still breathing?" Collins says, shaking her head, but she's smiling too—it's impossible not to smile at Louie, who should be dead a dozen times over but somehow persists through sheer stubbornness and a liver that apparently defies medical science.
“That’s a lethal dose for you and me,” Robby says as he crouches down, smiling softly, “that’s happy hour for Louie.”
Maddie catches herself watching Robby's profile—the way his eyes soften when he talks to patients, the lines that appear at the corners of his eyes when he smiles—and forcibly redirects her attention back to Louie's chart. Jesus, Pierce. Get it together.
“Sobered up. Had two rounds of lorazepam,” Maddie adds.
“Hold out your hands for me, Louie,” Robby says. Louie does, and the tremor is still there. "Another two of lorazepam," Robby says, standing fully, his hand briefly touching Maddie's elbow; just a brush of contact, a signal to handle it, gone before she can really register it. But her skin tingles where his fingers were.
“On it,” Maddie nods, stepping away to find a nurse.
She finds Mateo near the med cart, his dark curls bent over a tablet, and relief floods through her. Thank God, someone I can actually talk to.
"Hey," she says, coming up beside him. "Louie needs another two lorazepam. And a Librium script for when we discharge him."
Mateo huffs a laugh, tapping the order into the system. "Back already? He's gonna outlive us all."
"Probably." Maddie forces out a laugh, the sound hollow, trying to seem casual and probably failing spectacularly if the way Mateo's eyes narrow at her immediately on her is any indication.
They've known each other since they were kids; their mothers were friends. Mateo had been there for everything: her mother's funeral when Maddie was seven, the first time her father hit her and she showed up at his house with a split lip at nine, the day she took Milo and left at twenty. He knows her tells, which tends to greatly irritate her.
Mateo gives her a sideways glance, the kind he's been giving her ever since they were kids, the one that says I see right through you, "You good?"
"Yep," she says too quickly, her eyes shifting away from him, focusing intently on the med cart.
He pulls a face, raising one eyebrow that clearly says bullshit.
She groans, her shoulders sagging in defeat. "Fine. No. My dad's still been calling nonstop."
"Again?" Mateo's whole expression morphs into one of disgust, his nose wrinkling like he's smelled something rotten. He knows her father almost as well as she does, has his own collection of memories involving raised voices and slammed doors, with Maddie sharing his bed more nights than he could count.
"Yeah." Maddie rubs at her forehead with the heel of her hand, pressing hard enough to leave a red mark, trying to massage away the tension headache that's been building since she woke up. "He's calling me at work now, too. Literally just as I clocked in. He knows that I hate that," she hisses, her voice dropping low.
"Since when does he care?" Mateo mutters, typing on the tablet angrily. The two have had this conversation hundreds of times, all resulting in the same conclusion. He doesn’t care. He doesn’t care that I hate it when he calls while I’m working. He doesn’t care that I don’t want to speak with him. He only cares about himself. What’s best for him.
"I know." She spreads her hands over her face in a helpless gesture, frustration bleeding through. "Nothing's changed since last time. He's just… doing what he does best. Creating more problems, pretending to solve them, and crawling back to me so that I can fix it for him.”
"Yeah," Mateo says quietly, and she loves him for not trying to fix it, for not offering solutions that won’t help or suggesting she give her father another chance or any of the typical bullshit people usually say. He just creates a safe space, with no pressure. She appreciates it.
She blows out a breath, "And then Langdon—out of nowhere, mind you—tells me maybe I should give him another chance." She squints at Mateo, still genuinely baffled by the interaction. "Like… what?"
Mateo stops typing entirely, his hands freezing mid-motion. He turns to look at her fully, his expression morphing into confusion. "Langdon said that?"
“Right? I get he’s coming from a good place and all, but…he can’t possibly think I’m going to give that fucker another chance.”
Mateo’s mouth twists, “Weird.”
"I know. I wanted to ask what his deal was, but we got interrupted—"
The front doors burst open, and EMTs barrel through the entrance, moving fast, the noise swallowing her words completely.
"Incoming!"
Maddie snaps into motion the second the doors swing fully open, her body responding before her brain fully processes, muscle memory from the hundreds of traumas she’s done. She's moving toward the trio of EMTs with Robby appearing at her side almost instantly. The rest of the team trails after them in a loose cluster, students scrambling to keep up.
"Forty-two-year-old male, Sam Wallace," one EMT reports, his words coming fast and clipped as they roll the stretcher through, the wheels squeaking against the floor. "Blunt head trauma with agonal respirations. Dropped down on the T tracks. Couldn't tube him, LMA in place."
"Suicide attempt?" Maddie asks as she pulls on gloves from the box mounted on the wall, the latex snapping against her wrists, eyes already sweeping over the man on the stretcher.
“Rescue,” the EMT answers. “Good Samaritan. Took a spill helping an elderly woman who fell off the tracks. She’s right behind us.”
Right on cue, the woman’s screams echo through the bay, loud enough that Maddie winces.
"Okay. Trauma one. Go ahead," Robby says, his voice cutting through the chaos with calm authority, directing half the group toward the man with a gesture.
Maddie steps forward, intercepting the elderly woman as the EMTs roll her in.
“Elderly woman, fell from the T platform,” one EMT explains, raising his voice over her cries. “Good vitals, no head injuries. Degloving injury, right lower leg with open fracture dislocation to the ankle.”
Robby lifts the cloth covering her leg. The fabric peels away to reveal a mess of exposed tissue and bone, muscle glistening wet and red, the foot hanging at an unnatural angle. Maddie grimaces at the sight. Jesus Christ.
“Trauma two. Trauma two! Let’s go!” Robby calls out.
He breaks off toward trauma one, while Maddie heads to trauma two, Victoria and Whitaker following behind her.
The room is already buzzing when Maddie steps in. Gloves snap, carts clatter.
The elderly woman is still screaming, the sound piercing through the air.
Whitaker’s stationed at the bedside, eyes wide, hands hovering like he’s not sure where to place them. She slips in beside him, close enough that their arms nearly touch. He stiffens at the proximity, but she catches the way his shoulders drop just slightly, tension releasing incrementally.
Maddie nods towards the woman’s leg, signaling for him to grab it so that they could all lift her onto the table.
He fumbles for half a second, then gets a grip.
“On three,” a nurse says from the head of the gurney.
They lift together, careful and synchronized, easing the woman from the stretcher onto the table. Robby rushes back into the room, snapping on a fresh pair of gloves as he walks.
“Did she faint or did she trip off the platform?” Collins asks.
"Nobody knows," the EMT says, stepping back out of the way as the team swarms the patient. "Guy jumped down, pulled her off the tracks just as the train came in. Isolated injury to the foot."
"The train ran over her foot?" Maddie asks as she grabs trauma shears and begins cutting through the woman's bra and clothing, exposing her torso to check for other injuries they might have missed.
“Caught between the platform and the train,” the EMT confirms.
The woman screams, raw and panicked.
"Ma'am? Ma'am, what's your name?" Collins calls, projecting her voice over the noise, leaning into the patient's line of sight. "Do you speak any English?"
No answer. Just more screaming, high-pitched and frantic, words tumbling out in a language none of them recognize.
"Type three open fracture," Maddie announces to Langdon as she carefully peels back the temporary dressing, exposing the full extent of the shredded tissue beneath.
Langdon nods, already drawing up meds from the crash cart. “Two grams Cefazolin—”
Maddie leaves him to it, stepping toward Whitaker. He’s pale, frozen between the supply cart and the bed, squeezing his hands together.
She positions herself directly in his line of sight, blocking his view of the injury, and keeps her voice low, just for him. "You good?"
He swallows hard, Adam's apple bobbing. "Yeah. Yes. I'm good." His voice cracks halfway through anyway, betraying him.
"You'll get used to it," she says, grabbing a stack of gauze from the cart beside them, "Just gotta get through the first horror show. After that, your brain sorta… recalibrates. Stops seeing it as horrifying and starts seeing it as a puzzle to solve." Baptism by fire.
He exhales a shaky laugh but remains pale.
He'll be fine, Maddie thinks, studying his face. He just needs some time. And maybe a vomit bag.
"Airway and breathing are perfect," Collins reports from the head of the bed, her hands checking the woman's neck and jaw.
"As is circulation," Maddie says, turning away from Whitaker, "BP one-forty over eighty-five."
Robby nods. “Students, what might’ve made her faint on the platform?”
"Uh, TIA or CVA," Victoria says first, her voice uncertain, eyes locked on the cardiac monitors.
"Could be arrhythmia, or a cardiac event," Whitaker adds, stepping forward slightly.
"So she needs…?" Maddie prompts, encouraging them to follow the thread.
"Head CT," Victoria answers quickly, at the same time Whitaker says, "EKG and troponin."
"Good," Robby says, nodding at both of them with approval.
The doors sweep open, and Garcia breezes in. “What do we got, party people?”
“Subway train degloved her foot with an open fracture-dislocation,” Maddie answers, shifting aside so Garcia can see the leg.
"Ooh. And I thought my heels were painful," Garcia mutters, moving closer to examine the injury with a critical eye. She leans down toward the patient, raising her voice. "Ma'am, I'm Dr. Yolanda Garcia. Any pain in your chest or belly?"
The woman keeps screaming.
“Can we please push the morphine?” Garcia snaps.
“No,” Collins says firmly. “It could cloud her mental status.”
“I can’t do an exam like this. Push the damn morphine.”
"We could do a popliteal block," Maddie offers, her voice cutting through the rising conflict. "Numbs the lower leg completely, no systemic side effects. She'll still be alert enough to assess for neurological issues." Maddie catches Robby’s eye, who nods approvingly.
Garcia points at her with her index finger, a grin spreading across her face. "Wonderful. I knew we kept you around for a reason. Where's the other guy?"
"Next door, he's a bit worse," Robby says, already walking Garcia toward the door.
“Pan scan her,” Garcia calls as she leaves. “And let me know when she quits screaming.”
Princess and Maddie set up for the block. Princess positions the ultrasound probe against the back of the patient's knee, angling it slightly, searching for the popliteal nerve bundle on the grainy black and white screen. She steadies the probe, and Maddie begins threading the needle under the ultrasound guidance, watching the bright white line of the needle track through tissue layers toward the target. The needle tip reaches the nerve sheath, and Maddie slowly injects the anesthetic, the medication spreading around the nerve in a dark bloom on the ultrasound. Perfect.
Robby returns just as Princess tapes the dressing. “Nerve block complete?”
“Seems like it’s starting to work,” Maddie says, as the woman begins to quiet down, “Takes ten minutes for the full effect, and the Marcaine lasts a good four hours.”
“She’s next for CT,” Langdon says without looking up from the monitor.
Robby glances at the woman’s face. Her screams have dwindled to heavy, breathy mumblings.
“You have any idea what language that is?” he asks Princess.
“Definitely not Tagalog. Maybe Hindi or Urdu,” she says, as she adjusts the patient's IV line.
"I'll get language services on the phone," Robby says, already pulling out his cell as he heads toward the door.
Collins raises an eyebrow at Princess. “Don’t you speak, like, five languages?”
“Six,” Princess corrects, “But that’s not one of them.”
“Six?” Langdon says, “And here I thought Maddie was the smart one.”
Maddie clicks her tongue. “It is way too early for you to start being an asshole, Langdon.”
"Open hostility? In front of the patient? Really, sunshine?" His tone is teasing, but the nickname still lands wrong.
Maddie stiffens, "Thought I told you to stop calling me that," she mutters, her voice low but sharp. "And she doesn't speak English.”
Langdon smirks, clearly enjoying getting a rise out of her. "Judgmental. Dismissive." He gestures toward the two interns clustered near the end of the table, watching the exchange with wide eyes. "Observe: this is how Dr. Sunshine teaches. With compassion and grace."
“I swear to god, Langdon!” Maddie says, but she’s fighting a smile, “I will file a complaint for workplace harassment.”
"Looking forward to it. I'll wear my best tie to the hearing."
Robby returns before Maddie can formulate a response, his presence immediately shifting the energy in the room back to professional. "How's she doing?"
"Vitals stable," Maddie reports, grateful for the interruption, checking the monitor. "Heart rate's coming down now that the pain's controlled. BP holding steady."
“Unlike these two,” Princess adds, nodding at Maddie and Langdon.
"Ooh, good for you," Langdon fires back immediately. "Princess made a joke. Alert the press. This is unprecedented."
Princess mutters something vicious in Tagalog. Maddie snorts.
Langdon places a hand over his heart. “And I thank you for that beautiful blessing. Namaste.”
Robby scans the woman again, then looks up. “Okay, do we have a phone or anything with a relative’s name on it?”
Maddie shakes her head as she strips off her bloodstained gown, balling it up and tossing it in the biohazard bin. "EMT said the purse got obliterated when the subway ran over it. Total loss. Whatever ID or phone she had is gone."
“Any way I can speak with her?” a police officer asks, stepping into the room, notebook already out.
“Highly doubt it. We don’t know what language she speaks,” Robby says, walking over. “Hey, um, any chance she jumped?”
The officer grimaces, his expression darkening. "She may have been pushed." Maddie’s stomach drops.
“Jesus,” Robby murmurs.
“Yeah. Could be looking at a possible hate crime.”
Maddie looks down at the patient’s trembling hands and quietly shakes her head.
“I take it you’re free now?” a grating voice calls from the doorway.
Maddie doesn’t need to look; she sighs before even turning her head. Gloria. Of course.
Robby gives the officer a tight, pained smile, then glances back at Maddie with a kill me now expression that makes her mouth lift in the corner. He follows Gloria out of the room like a man walking to his own execution.
Maddie watches them walk toward Dana's desk through the clear doors, Robby's posture stiffening with each step, his shoulders drawing up toward his ears. Gloria's gesturing animatedly, her mouth moving rapidly, and even from here, Maddie can tell whatever she's saying isn't pleasant.
Langdon bumps her elbow lightly with his, startling her out of her observation. "Step out for a sec," he says quietly, his voice lacking its usual teasing edge. "Go check on him. See what's up."
Maddie blinks. “You sure?”
“Yeah, we’re good here.” He lowers his voice. “Gloria’s a piece of… work. And we both know Robby doesn’t need this today of all days.”
Today. The anniversary.
Maddie nods, understanding settling in her chest, and tugs off her gloves. She slips out of the trauma bay and heads toward Dana's desk.
As she approaches, Gloria’s voice cuts through the hallway like nails on a chalkboard.
“Boarding is a nationwide problem. Your predecessor, Adamson, sure as hell knew that. Or wasn’t that something he taught you?”
Maddie's eyebrows shoot up so fast they nearly reach her hairline. She did not just—
She steps beside Dana, who looks equally unimpressed, her arms crossed over her chest, her expression thunderous.
“Fuck,” Robby says, the word punched out of him, stunned and furious. “Wow. Really?”
“Yes, really. Other hospitals are managing this crisis much more effectively. So you can either step up your game, or you can step aside.”
Gloria spins on her heel and leaves. Robby stays there, shoulders tight, one hand braced on the edge of Dana’s desk.
Dana gives him a thumbs up, a quick sign of solidarity, then pats Maddie’s arm before walking off.
Maddie steps closer. “She’s a bitch.”
Robby huffs out a humorless laugh, shaking his head. “You have no idea.”
Maddie studies his face, “You sure you’re okay today?”
His face shutters instantly. He grabs his tablet like a shield. “I’m fine.”
He turns to leave, walking towards the stairwell.
"Robby—" Maddie follows him, reaching out but stopping short of actually touching him, her hand hovering in the air between them.
He spins back around, sharp and sudden, and Maddie instinctively takes a half-step back, her body remembering before her mind catches up.
"I said I was fine!" he yells, his voice echoing off the concrete walls of the stairwell.
Maddie flinches. Her shoulders come up toward her ears, her head tilts slightly down, and her weight shifts backward onto her heels. All the old defensive positions activating like muscle memory.
For a fraction of a second, she's not in a hospital stairwell. She's thirteen years old, standing in the kitchen doorway of their old apartment. Her father is drunk, the mean kind of drunk, the kind where his words get sharper, and his hands get heavier. She'd just told him that Milo needs new shoes because his toes are pressed against the front of the ones he has, and her father is spinning around from the refrigerator with that same sudden movement.
"I said we don't have the money! Stop fucking asking me for things!"
The beer bottle in his hand, sweating with condensation. The way she'd calculated the distance to Milo's room, mentally preparing to grab her brother and lock the door if the bottle left his hand and came toward her face.
She'd learned to read the trajectory of violence before it happened—to know from the set of someone's shoulders, from the clench of their jaw, from the particular quality of their voice, whether words would turn into fists. Whether she'd need to put herself between her father and Milo again. Whether tonight would be the night he went too far.
She'd gotten good at taking the hits meant for her brother. Good at calculating angles and absorbing impact. Good at making herself a target so Milo could stay safe in his room, oblivious, protected by her body and her willingness to break before he did.
You can hit me, she'd thought so many times, standing in that kitchen, in that hallway, in that living room. Just don't touch him. I can take it. He's too small. He won't understand. So hit me instead.
But, she's not thirteen anymore. Robby isn't her father. This stairwell isn't that kitchen.
But her body doesn't know the difference. Not in this moment. Not when someone she cares about is yelling at her with that same fury, that same desperate need to lash out at whoever's closest.
Her breathing has gone shallow without her realizing it. You're safe. You're safe. He's not going to hurt you. Robby isn’t him.
But the knowledge doesn't stop the fear that floods her system like cold water. Doesn't stop her from seeing her father's face overlaying Robby's for a terrible, disorienting moment.
Robby's chest is still heaving, his eyes wild, but something in her expression must register because his face suddenly changes, the anger draining away, replaced by a dawning realization.
"Maddie—" he starts, his voice completely different now, softer, regretful.
But she's already moving, already pushing past him in the narrow stairwell, her shoulder brushing his chest as she passes. She needs space. She needs air. She needs to not be in this confined space with someone who just made her feel like that scared thirteen-year-old again.
"I'm fine," she says, her voice flat and mechanical, "You're right. I’ll leave you alone.”
"Maddie, wait, I didn't mean—"
But she's already gone, pushing through the stairwell door and back into the ED.
Just keep moving, she tells herself, her vision blurring slightly at the edges, her heart still racing. Keep moving, and you'll be okay. Keep moving. Keep moving.
Don't let him see that he scared you. Don't let anyone see.
Don't be weak.
Maddie spots Garcia and Santos heading toward trauma two.
She breathes out slowly, physically shakes off the moment—shoulders rolling back, spine straightening—and follows them back into the trauma bay.
Focus on the work. What you can control.
Inside, she pulls on new gloves and a fresh gown as Garcia starts briefing, her voice cutting through Maddie's spiraling thoughts.
"Good Samaritan dude has a small left temporal intraparenchymal bleed. Nothing surgical at this point."
"No epidural, no subdural, no midline shift in the brain," Santos adds.
“That’s good news,” Collins says. “He could recover.”
Garcia gestures toward the elderly woman’s leg. “CT can take her in five. Let’s have a look. Bandage scissors?”
Maddie hands them over immediately.
“All right,” Collins says to the interns, sliding into teaching mode. “If an artery is totally transected, the smooth muscle and the tunica media contracts with hemostasis.”
The interns nod.
“But if it’s a partial cut, get out your umbrella,” Maddie jokes, pushing down her anxiety.
“Grab a culture from the open fibula before you reduce,” Garcia says.
“You’re up,” Collins signals to Victoria, handing her the culture swab.
Victoria inhales, steps closer, and carefully takes the sample. Maddie gives her an encouraging nod.
“Dr. Pierce will stabilize the knee for the reduction,” Collins continues. “Dr. Langdon will be distracting distally before moving medially to clear the tibia.”
Maddie shifts into place at the knee, bracing it between her palms. She nods at Langdon, letting him know to start.
Langdon slides lower on the leg, gripping the ankle, maneuvering the tibia, pulling gently but firmly, trying to coax the displaced bone back into proper alignment.
Out of the corner of her eye, Maddie spots Victoria’s face lose color. A beat later, her eyes roll back, and she collapses onto the floor with a dull thud.
Without looking up from the patient, Santos says dryly, “Med student down.”
—
Maddie guided Victoria and Whitaker out of trauma two, keeping a gentle hand on Victoria's elbow—fingers light but ready to catch her if her knees buckled again—just in case she decided to faint a second time. Whitaker trails close behind them.
They reached the central desk, where Robby was hunched over a monitor.
"Dr. Robby?" Maddie says, keeping her voice flat.
He looks up immediately, his eyes finding hers. Something flickers across his face—relief, maybe concern—before his gaze shifts to Victoria.
"She took a fall," Maddie continues, tilting her head toward Victoria.
"No, I–I tripped on the gurney. I'm fine," Victoria blurts out, the words tumbling over each other. Her cheeks are flushed with mortification, her hands twisting together.
Whitaker, standing just behind her, slowly shakes his head.
Robby steps toward Victoria, "Why don't you go get a cold drink in the staff lounge? Maybe sit down for a few minutes."
"I'm fine, really. I swear," Victoria insists, her voice rising slightly with desperation. "I don't need—I can keep working."
"Oh, I know," Robby says kindly, but still firm, "But it's hospital policy. Anytime someone gets a paper cut around here, we have to fill out a workers' comp report."
Victoria nods solemnly, giving up for the moment, going to walk past Robby.
"Other way," Robby calls after her.
Victoria spins around mid-step, her cheeks flaming red, and Maddie automatically points her in the opposite direction, a sympathetic smile on her face. Sorry, girl. It sucks to get benched.
Robby's eyes flick up as Victoria hurries past, trying to meet Maddie's gaze, but she deliberately looks past him, focusing on a point somewhere over his left shoulder.
His jaw twitches. Barely perceptible, but she catches it.
He noticed.
Good. Let him sit with it.
The petty satisfaction of it surprises her; she's not usually one for games, for deliberate cruelty, but the sting of his earlier words is still fresh, still sitting uncomfortably in her chest.
She can't deal with him right now. Can't look at him without seeing that moment of rage, without feeling the echo of old fear.
She turns to Whitaker.
Maddie sighs. “Let’s take a walk.” She hooks her arm through his and steers him down the hall toward trauma one. He stiffens automatically, then relaxes half a beat later.
"You doing okay?" she asks as they walk, keeping her voice low, just between the two of them.
He nods a little too fast. “Yeah—yeah, I’m alright. Just, uh… feel like I’ve been thrown into the deep end with no knowledge of how to swim. And also extremely nauseous.” He lets out a shaky laugh.
Maddie gives him a sympathetic smile, bumping his shoulder with her arm. “Hey. It’s all good. Everyone starts out like that.”
Whitaker looks up at her. “Did you start out like that?”
Maddie presses her lips together, looking vaguely guilty. “Uh… well. Not exactly.”
Whitaker huffs a small laugh and looks at the floor, still feeling self-conscious.
“I had more experience with this sort of thing before,” she adds quickly.
He looks up, brow creasing like he’s about to ask what she means, but Maddie pushes open the doors to trauma one before he gets the chance.
Inside, Mel is stapling the Good Samaritan’s scalp, forehead scrunched in concentration.
"So, what's the plan for this guy?" Maddie asks, stepping into the room, her eyes scanning the monitors automatically: oxygen saturation good, heart rate steady, blood pressure stable. She gives Mel a small smile, catching her eye. Mel returns it briefly before refocusing on her work, placing another staple with a soft click.
"ICU, when we can get a bed," Samaira answers from near the computer, where she's been charting, walking away from the monitor as she speaks. "Admit for supportive care. Repeat head CT in three hours. Or sooner, if he blows a pupil or shows any neurological changes."
Maddie nods. “Want a Keppra load?”
Samaira shakes her head, smiling. “Order’s already in.”
Maddie returns the smile as Samaira heads out. She turns back around. “Nice job,” she tells Mel.
Mel pauses mid-staple, the stapler hovering above the patient's scalp, and looks up at Maddie with worried eyes. There's a faint crease of concern between her eyebrows. "Do you think he'll wake up?"
Maddie sighs softly. “Maybe. Maybe not.” She adjusts the drape over the patient’s shoulder. “No good deed goes unpunished, unfortunately.”
As she gestures for Whitaker to follow her back toward trauma two, Mel calls, “Oh—has anyone, um, notified the family?”
Maddie stops in the doorway, turning back. She shakes her head, "No, I don't think so. Good call, Mel.”
Mel brightens at the praise, her shoulders straightening with renewed confidence.
"Once you're done here, go find Dana; she'll take care of it," Maddie adds. "She's way better at those conversations than any of us."
Mel nods, returning to her staples with renewed purpose.
Maddie and Whitaker slip back into the hallway, their footsteps quick as they head toward trauma two again.
When they walk in, the nurses are already wheeling the elderly woman back into the room, settling her into place.
“Pan scan is negative. That means you can admit to orthopedics,” Garcia says without looking up from her phone.
“But there may have been a medical etiology if she fainted,” Maddie says, scanning the monitor.
“That’s not surgical. Get an internal medicine consult. Or admit to medicine with ortho consulting. Either way, I’m off the case,” Garcia replies, smirking as she exits the room.
Langdon huffs, throwing his hands up in exasperation. “Okay. Thanks for nothing!”
“Did we figure out what she’s speaking?” Whitaker asks, from beside Maddie, like he’s unsure if he’s allowed to ask questions.
“Last interpreter thought she might be from Pakistan,” Langdon says, rubbing his forehead.
“There are seventy-seven languages in Pakistan,” Maddie mutters.
"Okay, well, I will buy lunch for whoever figures it out," Langdon sighs, already heading toward the door. "Good luck. If you need me, I'll be saving lives. See ya, sunshine."
He salutes Maddie lazily on his way out, two fingers to his forehead.
Maddie’s eye twitches at the nickname, flipping Langdon the bird as he walks out.
“That was wicked,” Santos says, grinning as she logs into the monitor.
Whitaker stops writing for a moment, frowning. “That was gross.”
“Yeah. Too much for Little Miss Crash and Burn,” Santos smirks. Maddie shakes her head at the dig at Victoria. “What’d you do with her?”
“Nothing. I think she’ll be fine,” Whitaker says, trying his best to sound confident.
“Are you kidding? If that took her out, she’ll be lucky to make it through this rotation,” Santos snorts.
“Hey, easy on Javadi, alright?” Maddie says, giving her a pointed look. “It’s her first day. She’s only an MS3. Cut her some slack.” Whitaker swallows hard, glancing between them like a tennis match.
Santos lifts her hands in fake surrender. “Listen, all I’m saying is that some people aren’t cut out for this. And, anyway, she’s hella young too. She’s like twenty or something. Doubt she even knows what she’s doing.”
Maddie’s head snaps up. “I’m twenty-two, Santos. Do you think I don’t know what I’m doing?” The room goes quiet.
Santos freezes, startled, then laughs nervously. “Twenty-two? Holy shit. Makes you younger than all of us, even baby-faced Whitaker over there.” Whitaker looks startled, eyes widening at Maddie. “Didn’t mean to offend, sunshine. Just teasing.”
The nickname lands differently this time. More barbed, carrying an undercurrent of mockery that makes Maddie's skin prickle with anger. But she forces herself to breathe through it; in through her nose, out through her mouth.
Don’t engage. Don’t give her the satisfaction. Be professional. She’s new. She just needs to be humbled.
“Right. I’m gonna go try to figure out what language this lady speaks. You two have fun,” she says, pushing out of the room before the irritation spills over.
She makes it only a few steps before Robby spots her and heads over.
Of course. Just what I needed.
"Hey," he says quietly, stopping close. "Got a sec?"
Maddie's shoulders tense involuntarily, but she nods, sanitizing her hands at the nearby dispenser.
They stop in a quieter corner, tucked away from the rest of the ED.
Robby turns to her, rubbing his palms against his beard. "Look. I'm sorry. I shouldn't have yelled at you in the stairwell. That was out of line."
Maddie's eyes drop to the floor, her jaw tight. When she finally looks up, her voice is carefully controlled. "I don't deserve to be screamed at. Not when I was just trying to help. I was just worried about you."
"I know, I know," he says, exhaling hard, "I shouldn't have yelled. That was—that wasn't okay. But, uh, I really don't need you to try and fix me, okay?"
There's a subtle edge there, defensiveness bleeding through the apology, and it cuts deeper than his earlier outburst did.
Fix him?
Maddie's brows knit together, confusion and insult flickering across her face, "What? I don't want—I'm not trying to fix you, Robby. I'm just trying to help you. Give you support. Be there for you on a day that I know is hard." Her voice rises despite her efforts to keep it level.
"And I appreciate that," he cuts in, his tone edging toward final. "But I don't need it. Okay?”
Maddie stares at him, her anger draining into something colder.
He doesn't need me. Doesn't want me.
Just like—
She stops the thought before it can finish.
"Heard," she says flatly. Then she walks away before he can see her hands shaking.
Behind her, she hears Robby let out a frustrated breath, hears what might be him saying her name, but she doesn't turn back.
—
Moments later, the doors burst open and EMTs come rushing in through the entrance, transporting the morning's nursing home patients. Every morning after the nurses did their bed checks at the facilities, there were always elders who ended up needing to come to the ED; the predictable wave of bodies that had given up overnight or hearts that had decided to stop.
7:35, Maddie thinks, checking the clock on the wall. Like clockwork.
She walks closer to the EMTs as they bring the patients in, already assessing from a distance. Two gurneys. One patient moving, one patient not. The mechanical thump-thump-thump of a LUCAS device audible as she got closer.
"Eighty-nine-year-old woman from a SNF," the lead EMT calls out, breathless from the rush, rattling off information rapid-fire. "History of emphysema, CHF, MS. V-fib, unresponsive to three shocks. Two rounds of epi already administered." Maddie nods, walking them to room fourteen. Robby appears at her side almost immediately, walking beside her but keeping his distance.
“What is that?” Whitaker asks from behind her.
"LUCAS chest compression system," Maddie responds, pulling gloves from the box mounted outside the room and snapping them on.
“Robotic CPR,” Langdon explains, coming up from behind them.
Reaching the room, everyone surrounds the gurney.
“Everybody, get a hold. One, two, three.” Robby counts off as they lift in unison transferring from the gurney to the table in one smooth motion. Except there's a sudden sharp cry from the foot of the bed, high-pitched and pained. Whitaker jerks backward, pulling his hand free, cradling it against his chest.
Robby and Langdon sigh.
“Students are dropping like flies,” Langdon mutters.
“Take a break,” Robby says, not unkindly, but firm.
“Ice the finger, find someone to help with it after,” Maddie says gently. Whitaker nods, flustered. This is just not a good day for this guy.
“You can count on getting a couple elderly patients every day around 7:30, after the nursing homes and assisted living facilities do their morning bed checks. You can practically set your watch.” Langdon explains. The LUCAS continues pumping at the woman’s chest.
"Was there an advanced directive?" Maddie asks, positioning herself beside the LUCAS, one hand resting on the machine's frame
“No, full code, per the nursing home,” the EMT says.
Maddie’s eyebrows shot up, a sharp exhale escaping through her nose.
"Seriously?" Langdon says, his voice dripping with frustration. "An eighty-nine-year-old with end-stage everything, and she's a full code?"
"LUCAS off," Maddie says, her hand already moving to the power switch.
The sound of a flatline fills the room. “Still V-fib,” Langdon says.
"LUCAS on," Maddie says, flipping the switch back. The machine resumes its work immediately. "One more round of epi, one more shock, and then we call it?"
She directs the question to Langdon, pointedly ignoring Robby hanging by the opposite side of the table. Langdon nods.
Robby exits the room for a moment without comment, and Maddie watches him go from the corner of her eye, tracking his movement even as her hands draw up the epinephrine.
She delivers the woman another round of epi, pressing the plunger slowly, watching the medication disappear into the IV line, and then moves to the defibrillator, her fingers moving across the controls with practiced ease. "Charging to two hundred," she announces, the machine's high-pitched whine filling the room as it powers up. Langdon grabs the paddles. Robby walks back in.
"Charging, and—" Langdon has the paddles positioned, ready to deliver the shock, when Dana suddenly appears in the doorway at a near-run.
"Stop. Call it," she says, slightly out of breath, one hand raised. "Nursing home just faxed us a DNR."
Langdon scoffs, “Are you kidding me?”
Maddie groans, her head dropping forward briefly in frustration before she moves to power down the equipment. "Power off the defibrillator and the LUCAS," she says, her hands already moving to flip switches.
“Complete waste of time and money,” Langdon spits angrily, “Who the hell works at that place?”
Maddie gives Langdon a confused look, her brow furrowing as she strips off her gloves. What' the hell’s his problem? He doesn’t usually act like this.
She makes eye contact with Robby before she could stop herself. He shares the same look.
"A nurse taking care of sixty patients who couldn't find the form," Robby says firmly, his voice cutting through Langdon's anger calmly, raising his eyebrows at the younger doctor in clear warning. Check yourself.
“She called 911 so she could take care of the others,” Dana says, equally unimpressed.
Maddie sneaks a glance at Langdon, who still seems annoyed, especially after getting chewed out. Something's going on with him. This isn't about the DNR.
"Okay, let's move her to the viewing room and notify the family," Robby says. Dana nods, pulling out her phone.
Langdon goes to leave the room, moving toward the doorway, but Robby steps in front of him and slams his hand across the doorframe with enough force to make a dull thud, physically blocking his exit.
Langdon stops short, startled, looking up at Robby with something like challenge in his eyes before it fades into resignation.
"One of the things we do here," Robby says, his voice measured, "is to take a moment of silence when we lose a patient, to respect their humanity. And also to remember that this was somebody's child, or sibling, or parent, or friend."
He directs it to Whitaker, who’s still clutching his finger, nodding.
Maddie closes her eyes, taking a deep breath that fills her lungs completely before releasing it slowly. The silence in the room is heavy, respectful, broken only by the ambient sounds of the ED beyond the walls…and sudden music.
Maddie's eyes snap open, her head jerking up in shock. Whitaker is fishing frantically in his pocket, his face turning red, trying to silence his phone even as the music continues blaring. He hisses in pain when the movement jostles his injured finger. Maddie snorts, immediately slapping a hand to her mouth.
“I am so sorry,” Whitaker says, looking everywhere but at anyone’s eyes. Maddie sees Dana trying to hold in a laugh, and they make eye contact, sending them both into fits of giggles.
“Maybe leave it on vibrate while you’re working,” Robby says, amused but exasperated.
Everyone exits the room, leaving Maddie and Whitaker behind. Robby casts a look at Maddie as he leaves, but she ignores it, turning to Whitaker.
“So…you like funky music?” she teases, causing Whitaker to go bright red.
“Fuck, I’m so sorry,” he stammers, fiddling with his phone in his hands, “I really didn’t mean-”
“Relax, I’m just messing with you,” Maddie interrupts him, “Cheered everyone up though, so there’s that,” she says with a smile.
She nods to the patient, “Get her to the viewing room.” She begins to exit the room, then looks back at Whitaker, “And make sure to get someone to fix your finger, ‘kay? I’ll check back on you later,” she smiles, walking out of the room.
She walks out, walking up to Dana and Robby, who stand observing Javadi.
"How old's that kid?" she hears Dana ask as she approaches.
"Probably around twenty," Maddie responds at exactly the same moment Robby says, "Don't know."
The two share an awkward look, and Dana looks between the two of them, before speaking, “She some sort of savant, like our Maddie here?” Maddie smiles at Dana, who gives her a pat on the shoulder.
Robby begins moving towards Javadi, “I don’t know. Maybe,” he says, voice tense. The two watch Robby walk away, Javadi in tow.
Dana turns toward Maddie the second Robby is out of earshot, her expression shifting from casual to serious. "So, what happened?"
Maddie sighs—of course she noticed—and tries to walk away, but Dana follows her, "Nothing happened."
"Obviously something happened," Dana continued, "The both of you look like someone shit in your cereal this morning."
"Mm, wonderful imagery, Dana," Maddie retorts.
Dana reaches out and grabs Maddie by the arm gently but firmly, stopping her in her tracks. "I'm being serious, kid. What happened?"
Maddie faces Dana fully, shakeing her head, her shoulders sagging slightly. "We just had a disagreement, that's it."
She walks over to her desk, needing to do something with her hands, and begins shuffling things around aimlessly.
“A disagreement?” Dana questions, eyebrows raised, hand on her hip.
Maddie nods, avoiding Dana’s gaze.
"Can you… work it out?" Dana says slowly, carefully, trying to catch Maddie's gaze, but Maddie keeps her eyes determinedly fixed on her desk.
"Sure, yeah. Probably," Maddie says shortly, frustration bleeding through despite her best efforts to contain it. "I'm gonna go check in with Langdon."
She walks away before Dana can press further, feeling the weight of Dana's concerned gaze following her down the hallway.
—
“Language mystery solved yet?” Maddie asks Langdon, leaning forward on the edge of his desk.
"No," Langdon sighs heavily, looking down at his monitor where he's presumably been cycling through different languages. Then he pivots abruptly, his chair swiveling to face her more fully. "Hey, what's your take on dogs?"
Maddie gives him a baffled look, “My take on…dogs? In what context?”
“For kids,” he clarifies.
“Don’t think I’ve ever seen a kid say no to a puppy,” Maddie supplied, “Man’s best friend, you know?”
“Well, you don’t have a dog,” Langdon points out.
“Don’t have a best friend,” Maddie responds, “Closest thing to one is my baby brother.”
And even that’s been rocky lately.
“So, what am I, chopped liver?” Langdon says, half-teasing.
Maddie rolls her eyes affectionately, “You are definitely my best annoyance,” she says, “Big difference.”
"You know you love me," Langdon retorts, a smirk playing at his lips.
Maddie shakes her head playfully, but she's smiling too. Then the smile fades slightly as she remembers his earlier outburst, the unusual anger over the DNR situation. She looks at him more carefully, noting the tension still lingering in his shoulders, the way his fingers tap restlessly against his desk. "Everything okay?" she says, trying for casual, "You were acting a little… strange before. With the nursing home patient."
Langdon turns towards her, a weird look on his face. His mouth opens to respond, but before any words can form, a voice interrupts from behind Maddie.
“I have a lethargic four-year-old,” a voice from behind Maddie sounds. She turns around to see Mel coming up to Langdon’s desk. Their eyes meet, and Maddie gives her a smile. Mel returns it immediately, her face brightening. “No PMH, no antecedent illness, no fever or vomiting. Parents just couldn’t wake him up this morning.” Mel continues.
“What room?” Langdon asks, already standing up from his chair, their conversation clearly tabled.
“Oh, uh, south fifteen,” Mel says, pointing behind her, “There’s no nuchal rigidity, no skin lesions, no focal neuro. He looks well fed and cared for.”
Langdon nods, pulling some gloves on as Mel does the same. He turns towards Maddie, “You wanna come with?” Maddie nods, pulling on her gloves, following the two.
"DKA from new-onset diabetes?" Maddie questions as they walk, her mind already running through different diagnoses.
Mel shakes her head, “No, BG 85. CBC, BMP, UA, and UDS ordered.”
Maddie nods her head as Langdon opens the door to the room.
Langdon smiles at the parents, “Hi, I’m Dr. Langdon, this is Dr. Pierce, we’re just gonna take a look at your son.” The parents nod, shuffling to make room for the three of them.
"Tyler, can you wake up for me, buddy?" Langdon asks gently, leaning over the bed, one hand on the boy's small shoulder, giving it a light shake. The kid doesn't respond, not even a flutter of eyelids, just that same unnatural stillness.
Maddie looks up from examining the kid's extremities—checking for bruising, needle marks, anything that might indicate injury—and addresses the parents directly. "He's not usually this sleepy?"
The mom shakes her head emphatically, her voice tight with worry. "No, never. And he barely flinched for the blood test.”
“He wakes up at 90 miles an hour and doesn’t stop till he passes out at night,” the dad supplies.
Maddie nods as Mel whips around in concern, “He passes out?”
Maddie quickly shakes her head, catching Mel's alarmed expression. "No, I think they just mean that he goes all day and then just gets really tired at night. Like normal kid tired, not medically passing out." She looks at Mel reassuringly, trying to ease the panic she can see building.
Mel mouths an exaggerated 'oh' and nods, embarrassment coloring her cheeks pink as she looks back down at the young boy.
“Any chance he could have ingested something?” Langdon asks the parents, “Any pills, vitamins, any prescriptions that may have been left around?”
The mom shakes her head firmly, “No, that’s all kept locked in the medicine cabinet. The whole house is childproof.”
“Any alcohol? Anything left out?” Maddie questions.
The dad shakes his head, “No.”
“What about pets?” Mel asks.
The father shakes his head again, “No.”
“So he’s usually, like, quite active?” Mel asks.
“Very,” the mother responds.
“Um, any injuries lately?” Mel asks.
“No.”
"Hasn't bumped his head recently?" Mel asks, as Langdon and Maddie continue their physical examination. Maddie palpates the boy's abdomen, soft, non-tender, no masses, while Langdon listens to heart and lung sounds.
“Not that I’m aware of, but he does love roughhousing with Drew,” the mom responds, pointing to the father.
"But he never gets hurt," the dad says quickly, defensively.
“Oxygen level is normal. Good pulse and blood pressure. No signs of infection.” Maddie says to Langdon, who nods.
“We’re gonna start with blood and urine tests, check for any metabolic abnormalities,” Langdon says to Mel.
The three of them give reassuring smiles to the parents and take their leave, Mel leaving to grab the supplies for the tests.
Langdon heads back to his desk without Maddie getting to continue their conversation from earlier. Damn it. He’s avoiding me.
She sighs, but spots Whitaker sitting at a desk with Santos, his finger out. She heads over to them.
“No anesthesia, or…” she hears Whitaker say nervously.
“I’ll stop before I hit the nail bed. I hope,” Santos says with a grin, tending to his finger.
"Hey, you two," Maddie says, approaching them with a warm smile, deliberately interrupting before Santos can traumatize Whitaker further. "Oh, good, you're getting that taken care of." She gestures to Whitaker's finger, which looks angry and swollen, the nail bed dark with trapped blood.
"Blood's under pressure," Santos explains, her tone shifting slightly more professional with Maddie watching. "Just gotta drain it. Quick procedure, doesn’t hurt."
Maddie nods her approval. "Go ahead." She looks at Whitaker, noting how his eyes keep drifting toward the patient board on the wall behind them, "Eyes down here, Whitaker. Watch and learn what Santos is doing. Might come in handy.”
Whitaker drags his gaze back down obediently, his face scrunching slightly in anticipation of pain. "Sorry, I'm just seeing who's next. Trying to stay on top of the board."
“You’re supposed to take them in the order they arrive,” Santos says, slightly condescendingly.
"Yeah, I know how it works," Whitaker responds, matching her tone with surprising backbone, a flash of irritation crossing his usually anxious features. Woah. Got some fire in him afterall.
“Okay, okay, no need to argue about it,” Maddie says calmly, “Just pay attention.” Whitaker nods again, his cheeks flushing slightly pink—whether from embarrassment or from Maddie's attention, she's not entirely sure. There's something in the way he straightens his posture when she addresses him directly, something almost eager-to-please that reminds her of a puppy trying desperately to impress.
God, he’s kinda adorable in a pathetic sorta way.
Wait, no. No, no, no. No, Maddie. He’s a student. You should not be thinking about him like this!
…I mean, technically, he’s older than you.
Santos finishes the job with practiced efficiency, using the heated needle to puncture through the nail and release the trapped blood. Dark red fluid wells up immediately, and she wipes it away with gauze. "Wow, pain's gone. Thank you," Whitaker says, genuine relief flooding his voice as he takes back his hand, flexing the finger experimentally. Maddie snaps out of her thoughts to look at Whitaker’s finger, nodding at Santos in approval.
Santos nods, looking at her monitor, “All right. How about you take a 20-year-old cough in eight? Should be easy. Probably viral.”
"I don't need an easy one," Whitaker says, and there's a note of defensiveness in his voice, embarrassment coloring his features. He looks at Maddie through the corner of his eye, then quickly looks back down.
He’s embarrassed. He cares what I think of him.
"Suit yourself, Huckleberry," Santos says with a shrug, standing and stretching. "I'm gonna take the splitting headache in six. Maybe I'll catch a subarachnoid hemorrhage or something cool." She shoots a playful salute toward Maddie, who returns it with a slight smile, and then walks off toward the patient rooms.
Maddie turns back to Whitaker, one eyebrow raised in amusement. "Huckleberry?"
Whitaker sighs, “She says it’s a term of endearment. I think it’s bordering on harassment.”
Maddie snorts, “Don’t think she means anything by it. But, I get it, not a big fan of sunshine either.” She studies him more carefully, noting the slight midwestern twang in his voice that he tries to suppress, “Where’re you from?”
“Uh, Broken Bow, Nebraska,” he answers, his midwestern accent emerging as he says the name.
Maddie gives him an amused look, “Where the hell is that?”
“About three and a half hours west of Omaha,” Whitaker replies, slightly defensive.
Maddie nods, her lips pursed, trying to hold in a laugh, “What do you, um, do there?”
Whitaker blushes a light pink, “My parents have a farm, so….”
Realization dawns on Maddie’s face, “Oh, that explains ‘Huckleberry’. You’re a farm boy.”
“Ye-Yeah, I guess,” Whitaker stammers, looking down at his finger again.
"Hey, nothing to be ashamed of," Maddie says gently, nudging his leg with her own under the desk. "Just a lot of us here grew up either in Pittsburgh or in other cities. We don't really get a lot of people from Omaha, Nebraska."
“Broken Bow,” Whitaker corrects quietly.
"Right, sorry. Broken Bow," Maddie corrects herself, smiling sheepishly. She stands up, reaching out to pat his shoulder, her hand lingering for just a second longer than strictly necessary. "Take it in stride, Huckleberry. Take it in stride."
Maddie begins walking away, heading to triage, feeling Whitaker’s on her. Cute little farm boy. What am I going to do with you?
She spots McKay near the triage desk, talking to Kiara, the hospital’s social worker.
"Mom's got a bad burn," Maddie hears McKay saying as she approaches, keeping her voice low. "Needs wound checks and hand therapy. And I got a sneaking suspicion she may be unhoused."
Maddie walks up to the two of them, "Need some help, Cassie?"
McKay's face lights up when she sees her, genuine warmth in her expression. "Sure, hon. I'm wrapping up with this patient for now, then I'm headed to chairs to pick up some new arrivals."
Maddie nods. McKay has been something close to a mother figure since Maddie started her residency. The two clicked easily, and Maddie frequently found herself gravitating towards the older woman.
Kiara smiles at both of them, "I'll talk to her. We can offer some resources.”
"Thank you, I appreciate it," McKay says sincerely. Then her attention shifts, her eyes lighting up as she spots someone approaching. "Ah, you're back!"
Maddie turns to see Javadi approaching the three of them, looking significantly better than she had earlier. Javadi gives a small smile, “Dr. Robby suggested I might be of assistance.”
“Well, the best things comes in threes right?” McKay jokes, Maddie smiles. “Uh, Victoria Javadi, this is Kiara Alfaro. She’s the department social worker, which pretty much makes her an angel.”
Kiara chuckles, "Welcome."
“Thanks,” Victoria says, slightly awkwardly.
“Thank you,” McKay says to Kiara, as she turns to leave.
“Nice seeing you, Kiara,” Maddie says, giving her a warm smile.
The trio begin walking towards the waiting room. “So, what rotation is this for you?” McKay asks Victoria.
“Um, third. I’ve done OB-GYN and pedes.” She replies.
“Any favorites?” Maddie asks.
“Not really,” Victoria shakes her head.
“What are you leaning towards?” Maddie asks.
“I’m not really sure yet.”
“Okay, well, you have time. Uh, can I actually ask you a personal question?” McKay says, turning to face her.
Victoria takes a deep breath, her shoulders squaring, and Maddie recognizes the defensive posture immediately: someone preparing to justify their right to be here, "I'm twenty, and I've earned the right to be here." I so get it, girl.
"Oh. Yeah, I don't... I don't doubt that for a minute," McKay says quickly, genuine surprise in her voice. She gestures toward Maddie. "Maddie here also started at twenty. Though she was a resident then, not a student."
Victoria’s eyes widened, “You—you did?”
Maddie nodded, a small smile on her lips, “Yup. Don’t worry, eventually everyone stops asking those kind of questions. They still underestimate you, though, sorry, girl.” Victoria cracks a smile.
McKay clears her throat, drawing Victoria’s attention back to her, “I…I was actually wondering if Dr. Eileen Shamsi from surgery is a friend or relative of yours. I saw you talking to her in the hall and I thought…”
Javadi’s demeanor changes, annoyance flashing across her face, “Yeah, she’s my mother.”
Both McKay’s and Maddie’s eyes widen, as they share a look. “Oh. Oh, wow. Oh, that's cool.” McKay says.
“And for the record, my... my father also works here. He's an endocrinologist.” Victoria adds.
"Oh, so like a family business," Maddie jokes, laughing, trying to lighten the serious atmosphere, but she stops when she sees Victoria's face, the way her expression closes off completely. "Sorry. Sorry, that was a bad joke. I'm sure that comes with a lot of pressure.”
“And as for the age thing, I'm a 42-year-old R2, so I have my own haters, trust me.” McKay says, walking the trio out the front doors, into the waiting room, “Okay. Um, sometimes when it gets busy, we’ll help the nurses bring back patients.”
Javadi nods, eyes scanning the packed waiting room.
"Okay, um, next to come back is Fred Saeta. Knee pain after a fall," McKay tells them, checking her tablet. "Fred Sa—!" she begins to call out, but is immediately interrupted by a man who appears in front of her face, invading her personal space.
“Hey, Doc. Hi. Hi. Doug Driscoll. Any chance someone could see me now? I’ve been here for, like, two hours.”
“Unfortunately, Mr. Driscoll, there’s a lot of patients still ahead of you, some of whom are severely ill,” Maddie says gently, “You can take a seat, and you’ll be called when we’re ready for you.”
Doug gets a little angrier, “Well, I got chest pains that woke me up in the middle of the night!”
“Chest pain,” Victoria says.
“Yeah,” Doug responds, confused.
“No, it’s not plural. It’s just chest pain, not chest pains.” She corrects. Jesus, Javadi, read the room.
Maddie gives her side-eye, silently telling her to cut it out. Antagonizing patients is never a good idea…
“Yeah, and if I have more than one, it’s chest pains! Are you even a real doctor?” Doug’s voice rises as he steps closer to Javadi.
“She’s a student doctor,” Maddie says, quickly tugging Javadi back behind her.
"Yeah, well, keep her the hell away from me," Doug says angrily, his finger jabbing toward Victoria accusingly. "I just need to see someone, okay? Not her. A real doctor. Isn't chest pain an emergency? I don't…"
“It looks here like you got an EKG five minutes after arrival, so it's not a heart attack,” McKay says, checking her list, trying to defuse the situation.
“Yeah, but I'm supposed to get a chest X-ray and blood tests.” He insists.
“Ah, and you are next in line for the lab tech, okay? So listen for your name. Excuse me. Fred…”
McKay stops, noticing an older woman vomiting into a bowl, standing next to a taller boy. “Uh, actually could you get me a wheelchair, please?” McKay says to Javadi, who nods and heads to grab one.
McKay signals Maddie to the woman, both of them making their way over. “Hi. I’m Dr. McKay, this is Dr. Pierce,” McKay says to the woman, “What’s going on?”
The woman can't respond—she's still actively retching, her face grey and sweaty, her whole body trembling.
The taller boy next to her responds, “I, uh, found her on the floor in the bathroom. She can’t stop puking.”
Maddie nods, “What’s her name?” she asks.
“Theresa. She’s my mom.” the boy responds.
Maddie nods as she and McKay guide the woman over to the wheelchair that Javadi brought. McKay grabs the handles, and they rush her into a room.
—
“Four Zofrans on board,” Donnie says, as Maddie nods, smiling appreciatively.
“That should stop the nausea,” Maddie says to Theresa. ”David, have you had any vomiting?” Maddie asks the woman’s son, who’s fully absorbed in his phone.
“No,” he says flatly, not looking up.
“Anyone else sick at home?”
"No, it's just us," Theresa responds weakly from the bed, her voice hoarse from vomiting. "My husband passed away a few years ago, from COVID."
McKay and Maddie frown, “I’m so sorry,” McKay says.
Maddie's eyes drift back to David, studying him carefully—waiting for some reaction, some acknowledgment of his father's death being mentioned. But he doesn't look up from his phone. Doesn't show any emotion at all beyond mild irritation at still being here. Strange.
“Potassium, 3.1,” Donnie says.
“Is that bad?” Theresa asks when McKay makes a slight grimace at the number.
“It can cause heart problems. But we're gonna correct it, okay? Ten in the bag, twenty PO. Javadi, any questions?” McKay asks.
Javadi takes a moment to think before turning her attention to David. "Uh, David, have you two traveled out of the country recently?”
“We never go anywhere,” David says, looking bored, “Is she gonna have to stay here?” he nods towards his mother.
“If the rest of the tests are good, and she responds to treatment, she can go home,” Maddie responds with a tentative smile, but catches McKay's look out of the corner of her eye, a you’re seeing this too, right?
David nods, rolling his eyes slightly, looking back down at his phone.
“Uh, Javadi, could you stay here with Theresa and David please? McKay and I will be right back,” Maddie says, keeping her voice casual.
They step out into the hallway, the door closing behind them with a soft click. The moment they're out of earshot, Maddie turns to McKay.
"So, you caught that weird vibe, right?" Maddie asks, keeping her voice low, glancing back through the window into the room where David is still glued to his phone.
“Uh huh. I’m gonna ask Robby if we could get his opinion on this. He’s pretty good at figuring these things out,” McKay says. Maddie's eyes widen slightly, and she immediately starts backtracking. Nope. Not happening. Too early for another “talk”.
"Um, I actually just remembered I gotta check on another patient!" Maddie calls back over her shoulder, practically speedwalking away. "Keep me updated!"
McKay stands there looking confused, her head tilting as she watches Maddie retreat. "Uh... okay?" she says, bewildered by the sudden exit.
Maddie power-walks through the ED, weaving between nurses and equipment carts, putting as much distance as possible between herself and wherever Robby might be. Mature, Pierce. Real mature. You're twenty-two years old and you're literally running away.
She reaches Langdon's desk at the exact same moment as Mel does—both of them nearly colliding, pulling up short with matching startled expressions.
"Uh, excuse me, Dr. Langdon, Maddie," Mel starts, slightly breathless, her tablet clutched against her chest. "Almost all of our labs are back on sleeping boy Tyler. All 100% normal. White count normal, metabolic panel perfect, urinalysis clean. What are we missing?"
Langdon takes the tablet and scans the results. He leads the two women back to Tyler’s room.
“Is he waking up?” he asks, pulling gloves on, as Maddie does the same.
“No, he’s—he’s still fast asleep,” the father says.
"Most of the lab results are in, and they look great," Mel says, attempting to sound encouraging, a small smile on her face. "No abnormal blood count, no electrolyte abnormalities, no signs of diabetes, no kidney disease, no liver dysfunction, so..."
Langdon moves to the bedside, his hands gentle as he performs another exam, trying to see if there’s anything he missed. Maddie does the same, hands moving closer to his face.
“Good. So—So, what’s wrong with him?” the mother presses.
“We’re still trying to figure that out,” Langdon says.
“Did he, uh, have a playdate yesterday, by chance?” Mel asks the parents.
“No, he had preschool, but he was fine when I picked him up,” the mom says.
“Any kids in his class ill?” Langdon asks.
“No, my phone tree would have lit up if someone else was sick.”
Maddie leans in closer to the boy. She gently opens his mouth, angling his face toward the overhead light to see better, and spots a small green speck lodged between his teeth. Her eyes narrow as she focuses on it. What is that?
She grabs a small Q-Tip from the supply tray beside the bed and carefully dabs at the substance, extracting a tiny amount. "Did he eat anything this morning?" she asks.
“No. Why?” the mother responds, shifting forward in her chair.
“It looks like some sort of gelatin,” Maddie says, bringing the Q-Tip out of his mouth, observing the substance on it, “Any chance he could have gotten into some bath beads or laundry pods?”
The mother shakes her head, “No, there’s no such thing in our house.”
“What about gummies?” Maddie asks.
“No, we’re very strict about candy,” the mom says turning to her husband, who looks very alarmed, “Right?”
“Oh, shit. Danny.” the father says, running his hands down his face.
“What about Danny?” the mother questions angrily, her body going rigid.
“Your brother, he…he gave me some gummies he got in Cleveland. They were in my coat pocket.”
“Are you fucking serious?” the mother asks, enraged.
“Pot gummies?” Mel asks for clarification, looking between the parents.
"Yes," the father says miserably, turning to his wife with pleading eyes. "I'm so sorry. I didn't think—I forgot they were in my pocket, and he must have found them when I hung my coat up, and—"
"Let me call the lab," Langdon interrupts, already pulling out his phone. "Maybe the tox screen is back." He steps toward the corner of the room, phone to his ear. "Hey, this is Dr. Langdon from the ED. Can I fast-track a lab on a pediatric patient, last name Jones, first name Tyler? Tox screen. It's urgent."
“Get the fuck out! I mean it!” the mom screams, shoving her husband back, her face contorted with rage.
Langdon quickly steps between them, “Why don't we step outside, and maybe you can help me figure out how much he may have taken.” He guides the father toward the door with one hand on his shoulder, the door closing behind them, leaving Maddie and Mel alone with the mother.
Maddie clears her throat, "Um, once we know how much your son may have taken and the labs confirm it, we'll be able to treat him appropriately." The mother nods slightly, mechanically, her head dropping into her hands, shoulders beginning to shake with silent sobs. "I'm, uh, sorry. This is... it's going to be okay. Kids metabolize THC differently than adults; he'll wake up. It just takes time."
Maddie reaches out and grabs Mel’s hound, rushing her of the room, closing the door behind them.
Once they’re out, Maddie takes a deep breath, turning to face Mel. “When you’re in a tense family situation like that, it’s always best if you try to get out as soon as possible, after trying to diffuse any physical altercations. Don’t wanna be trapped in a room if things escalate further.” Mel nods, toying with the end of her braid.
Maddie continues, “If you can’t diffuse it yourself and it gets violent, then just call security, and they’ll do it for you. Don’t try to be a hero. We’re nerds, not boxers.”
Mel smiles at that, “Uh, that was a good catch back there,” Mel says, with genuine admiration, “I definitely would’ve missed it.”
Maddie smiles, “Thanks. And, no worries, that’s why you’re still learning, right? I am too. And, if you need another set of eyes on a patient, you can always ask someone else for a consult.” Maddie smiles, patting the side of Mel’s shoulder when she spots McKay, “Uh, if you’ll excuse me, I just have to check on something.” Mel nods, moving to speak to Langdon.
Maddie walks up to McKay, “So, any updates?”
McKay grimaces, nodding, “Yeah. Kid made an 'elimination list' of a bunch of girls at his school. Mom made herself sick to get him here for some help.”
Maddie gapes at McKay, “No kidding. Javadi’s not still in there alone with him, is she?”
McKay shakes her head, “No, Robby’s getting Kiara to talk to him, they’re right over there.” McKay points to where Robby is sitting and talking to David. Maddie nods, watching them.
Suddenly, David stands up abruptly, his chair scraping loudly against the floor. His face is flushed with anger, his jaw set. Without warning, he bolts—pushing past Kiara, dashing for the exit. Robby stands up, rushing after him.
"Oh, shit," Maddie says, her body already moving before her brain fully processes what's happening. McKay quickly calls for security.
"I'll be back," Maddie calls over her shoulder, already jogging after them, her ponytail swinging.
David runs through the ED doors into the waiting room—patients looking up in surprise as he barrels through—and heads straight for the stairwell, taking the steps two at a time. Robby is right behind him, his longer legs eating up the distance, and Maddie follows, her shorter stature making it harder for her to keep up. Fuck, fuck, fuck.
“David! Stop!” Robby yells, but the teenager keeps running. He reaches the doors before either of them could catch up, running out into the street.
"Fuck!" Robby curses loudly, his hand coming up to rub his neck in frustration, the tendons standing out. He turns back around, heading toward the stairs. Maddie follows, looking back a moment, then walks in with Robby. Robby suddenly pauses, stopping in the middle of the waiting room, his eyes going glassy. His breathing becomes heavier, his eyes flicking around the room.
"Robby?" Maddie says, coming up in front of him quickly, positioning herself in his line of sight. She keeps her voice calm, even, trying not to startle him. "Robby, hey, look at me."
Nothing. No response. His pupils are dilated, his face pale, sweat beading on his forehead despite the cool temperature.
“Robby!” ~~~~~~~~~ i hope everyone enjoyed!! sorry for the long wait, this chapter was hella long!! i've already started writing chapter two, so it should be out earlier than this one!! thanks for reading!! <33
taglist: @rufles2
i miss you 2012 avengers. i miss you the avengers tower. i miss you irondad and spiderson. i miss you meme lord shuri and peter. i miss you loki lingering in the tower for no other reason than that he's the main love interest. i miss you poptart-eating thor. i miss you grumpy bucky barnes. i miss you old man, chronically offline steve rogers. i miss you clint in the vents. i miss you girls night with wanda and natasha. i miss you the rare bruce banner feature. i miss you sassy sam wilson. i miss you cheeky reader who always called fury by his first name. i miss you christmas avengers blurbs in the middle of the fanfiction written by an autistic 14 year old. i miss you 😔😔😔
everybody leaves
big shout out to tumblr for being the first major site in like two years to implement an ill-advised "feature" nobody wants, likes or respects that doesn't involve AI





