Chicago Med fic: Suckerpunched (2/10)
Dec. 23rd, 2021 04:50 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
faye_dartmouthPART ONE
PART TWO
PART THREE
PART FOUR
PART FIVE
PART SIX
PART SEVEN
PART EIGHT
PART NINE
PART TEN
-o-
In reality, Archer knew his functional role in Halstead’s care had hit its maximum. If he could successfully repair a brain bleed with any amount of confidence, he wouldn’t have wasted his energy with Abrams. Since that wasn’t the case, Halstead officially became a neurology patient, and Archer could go downstairs, finish the paperwork and be done.
That was an overly naive approach, however. The bleed in Halstead’s brain was caused by Archer’s fist, and all the hows and whys didn’t mean anything if he died.
Therefore, by a matter of necessity, Halstead was his patient. Even if Archer wasn’t in the operating room, the outcome was still on Archer’s head, and there was no way in hell he was leaving that chance.
He was careful to stay out of the way, but he wasn’t going to be an idle presence. While Abrams scrubbed in -- gamely readying for another long surgery back to back with his last one -- Archer made sure that everything else was in order. He found April sitting with Will in the room. “How is he?” he asked.
“Alive,” she said. “Is this happening, then? No one was happy when I insisted on the room.”
“It’s happening,” Archer reported, and almost as if on cue, the door opened again, and the scrub nurse came in.
“Everyone else out,” she said.
April stood up, but she didn’t budge from Halstead’s side. “He needs to be monitored.”
“And I will,” the scrub nurse said. She was followed by another nurse and the anesthesiologist. Any further concerns people had about Archer’s lapse of protocol were quickly silenced when they finally saw Halstead.
For once, Halstead was working with him.
That, of course, was irony at its finest.
Somehow, Halstead looked worse than the last time Archer had seen him. His lifelessness was accented by the increasing gray hue of his skin. Archer thought about the scans he’d seen. The blood was building by the second, killing brain cells slowly but surely.
For all that Archer had ramrodded this through, they all had to know the odds were still not quite in their favor. Halstead might already be a vegetable. Archer might have already killed him.
Abrams opened the door next, coming inside. “Out,” he ordered. “This is a sterile environment.”
April seemed willing to comply, and Archer followed her to the door, but he turned back. “No complicating history, but his GCS has been three since the accident. O2 levels are stable with intubation, but his BP isn’t great. He had one seizure, but it’s been well controlled with meds.”
Abrams turned from the table, and he looked back at Archer with dispassion. “We won’t know anything until we clear and stop the bleed,” he said. “Until then, we’re just playing a waiting game to see how many brain cells he loses.”
“Then you better get to it,” Archer said soberly.
Abrams inclined his head. “For once, we agree,” he said, and he turned back to the table. The anesthesiologist was already prepping for full sedation, and the scrub nurse was preparing the necessary trays. Someone touched his arm, and he turned to find the circulating nurse.
She looked a little less hostile to him this time.
“Come on,” she said, taking him gently by the arm and leading him from the room. “It’s time for the surgery to start.”
-o-
As a military man, Archer had plenty of experience taking orders. He also had plenty of experience hating the orders as he took them, especially when they were too often linked to not saving lives. He tolerated the order to leave the OR for the opposite reason.
Abrams was Halstead’s only chance.
He hated to admit it on every level, but there it was. Archer had nearly killed Halstead, and now he needed Abrams to make sure he didn’t. In short, Archer had done everything he could do. Now, it seemed, he had to sit and wait.
He had a thought to go back to work. It was what you would normally do as a doctor. It wasn’t like ED docs ran around following their patients all day long. You wouldn’t get anything done that way. And it would be a good show of solidarity. He was in charge of the ED, and he couldn’t lead the damn place by not being there.
That said, he couldn’t lead it very well when he’d nearly killed everyone’s favorite redheaded attending.
Which still didn’t make any sense to him.
Halstead wasn’t all that likeable. He was an adequate doctor sometimes, but when he got himself emotionally compromised, it was just kind of a crap shoot. It still galled him that no one seemed to care that he had willfully ruined a trial -- a mistake that had cost the hospital future trial opportunities going forward.
Sure, Halstead was trying to be penitent, but there were some things you couldn’t salvage. He had to believe that Halstead’s career was one of those things.
He would prefer to think differently regarding the asshole’s life.
Going back to the ED now would be a mistake. Not only would he be hounded incessantly about Halstead’s condition, but he would be asked pernicious questions about how it happened. Archer wasn’t stupid; he knew that would come into account sooner or later. But he’d prefer to know if murder was on the table or if he could get away with nothing but a workplace incident.
That said, he was staying. He allowed himself to be ushered from the OR, but he made his way directly into the gallery and planted his feet in front of the window to watch Abrams and his team continue prepping. Nearby, April had had the same idea.
He glanced at her, wondering if there was some way to order her back to work without sounding like a total heartless bastard. He couldn’t kill Halstead and make April cry all in the same day without being branded as a monster.
He wanted to be a hard-ass, but he wasn’t going for all out monstrosity. At least, not on these terms.
April glanced back his way, and Archer looked back to the surgical space. “I let Doris go back down to the ED,” she said, offering up the information unprompted.
Archer raised his eyebrows, mostly unimpressed. If this confession was supposed to get her some credibility, he wasn’t sure she’d succeeded. “I told you to both stay.”
“I made sure I was with him the whole time,” April said. “I didn’t stop tracking his vitals for a second. There was no need for both of us.”
“But if something had gone wrong--”
April scoffed, and when he gave her another cursory glance, she was staring him down hard. “We’re in a hospital. The second I call a code, everyone comes,” she said. “And you didn’t think that maybe this was a little hard for Doris? For both of us?”
“Yet, you’re still here,” Archer said coolly. “So I’m not sure what point you’re proving.”
“I’m just proving the point that I stayed for Will,” she said, lifting her chin defiantly. “I let Doris go. I know I’m the one with my foot out the door, so I just want to be sure you don’t take this out on her.”
The point was possibly valid, but Archer didn’t much care. He would sort out his issues with the nursing staff later. Doris’ failure to perform in this situation was lower on his list of concerns. He shook his head a little, eyes forward once more.
“You got it done, at least,” he said. “Abrams didn’t even have to wait.”
April looked forward, too. “20 minutes, just like you said.”
There was a note of pride in her voice, but he refused to indulge it. He won’t compliment her. Following orders was part of her job. Besides, he knew from experience, it wouldn’t do any good to stroke her ego. She was too inconsistent to foster.
Besides, things were progressing in the OR. Someone had shaved away a portion of Halstead’s hair, the red locks falling to the floor. Once the area was prepped, Abrams had his position shifted to give him better visibility of the cranium. It was only several moments longer before Abrams called for a blade and went to make the first cut through the thin layer of scalp.
April, for all her defiance, drew a sharp breath and looked down.
Archer watched as Abrams expertly sliced through the skin layer, gently starting to pull back the scalp to reveal the bone underneath. He called for the drill needed to break through the skull.
Not a pleasant thing to watch, to be sure.
For a moment, he was almost drawn to pity. For her. For him.
He had nothing to offer Halstead, but he looked at April again with a sigh. “You can leave, you know. I asked you to stay until the operation started. You don’t have to stay.”
His intentions were good at this point, but April looked up again, shaking her head even as she wiped away tears from her eyes. “No, I’m fine.”
The lie was a little exasperating at this point. She clearly wasn’t fine, and now he was going to have to debate that with her? “There’s nothing you can do by staying,” Archer pointed out, opting for logic instead.
Logic that she did not heed. Stubbornly, she shook her head again. “Neither can you,” she said, and she looked at him levelly. “But you’re not leaving.”
Well, that time she had a point. She’d had the wherewithal to see that there was something to what he was doing, even if she couldn’t have put all the pieces together yet. If she was more amenable, they really could have gotten on. As it was, it was a relief to think of her as leaving. “He’s an ED attending -- not to mention, my patient.”
She didn’t flinch, though. And she didn’t seem at all impressed. “And he’s my friend.”
As if she thought that sentiment was going to hold sway here -- and now. In the OR, Abrams had marked his drill points to create a series of holes. It was going to be a bigger section of the skull that Archer had expected. Clearly, for all that Abrams said this was possible, he was preparing for the worst.
April was pale across from him, and he could hear the uneven rhythm of her breathing. Sparing her another glance, it was clear that she was heartbroken. Archer was pissed off and annoyed, but the swells of pity were increasingly difficult for him to ignore.
This had been an accident.
This whole thing.
All of it.
He wasn’t sure how they’d ended up here -- in brain surgery -- but it was untenable to say the least as Abrams made the first hole.
April had gone ramrod straight, stiff as could be.
“He’s actually doing really well,” Archer pointed out, trying to be sympathetic for a moment. “I mean, look at his vitals? For the amount of blood that he lost, that’s a really positive sign.”
She looked disgusted but transfixed, face twisted uncomfortably even as she seemed unable to look away from the surgery as Abrams directed his drill to the second location. Several spots would need to be drilled. Then, the piece of the skull would pop right off and stay in refrigeration until Halstead--
Well, until he was ready for it again.
“Optimism?” April asked, sounding more than somewhat skeptical. She didn’t look at him even as she scoffed. “You’re actually going to pitch optimism right now?”
Archer watched as well with a growing sense of detachment. His ability to disassociate was pretty well honed since his time in active service. He’d found it to be an essential coping mechanism. He found that it played here, too.
He shrugged, almost with a sense of honed indifference. “Maybe.”
Optimism wasn’t blind, after all. Optimism was a purposeful choice. It was a choice of facts to coerce reality into your preferred version. Optimism was a manipulation of reality, and Archer preferred that to the pessimism of resigning yourself to it.
April, though. She seemed to be stuck in realism. That frustrating place where you saw things just as they were and not how you could make them be.
Across from him, she was still transfixed. “This is bad, though,” she said. “I mean, I saw his scans. The odds of survivability, even with fast intervention, they’re low. And the odds are even lower that he’ll be himself when he wakes up -- if he wakes up.”
Archer wrinkled his nose, and he turned his gaze toward her. “You’re a nurse,” he said. “How would you know any of that.”
She looked at him coolly, and her demeanor was unphased. “A nurse who’s really good at what I do,” she said. “I’ve been working this ED for a long time.”
“But you’re not a doctor,” he said, and he wasn’t trying to be cruel, but he couldn’t help it if his tone was condescending. If she were a doctor, she would have been a much better help when Halstead actually needed her -- instead of her dithering. He’d tried to foster something more out of her. He’d tried -- and she’d crumpled. He raised his eyebrows at her, expectant. “Remember?”
“But I’m not stupid. I know how to read a scan just as well as most of the residents,” she said, coming up with defiance. “It is a hemorrhage. A bad one.”
These nurses and their overinflated sense of worth. They were the grunt workers of the ED, and Archer knew they were important. But to watch them preen, and to have doctors fawn all over them -- it was still something that he couldn’t stand about Ethan’s management approach. He knew Ethan had a thing for April, and maybe that was part of the problem. He couldn’t see it.
Turning back to face forward, Archer sighed in exasperation. “Well, he’s still alive, so it could be worse,” Archer reported, wiggling his toes anxiously. He’d always had a hard time standing still, but it had gotten worse in recent years. He didn’t like to be still; he didn’t like to be alone. Too much time alone with his own thoughts never yielded worthwhile results. “Abrams just successfully removed the skull and seems to be zeroing in on the bleeders.”
Even as he said it, he could tell she wasn’t fit to handle it. April could be surprising sometimes. All the times she seemed to be the strongest of the bunch, and then she would go unexpectedly soft. It was frustrating, to say the least. He hated that she was so close to being someone great, but she let sentimentality slow her down.
And she’d made it this far -- but barely.
More than that, she was at the end of her rope.
Looking back to the surgery again, she was nearly morbidly engrossed now. “It doesn’t seem right,” she murmured, her animosity giving way to her fear once more. “It doesn’t even seem possible. I was just talking to him this morning, and now he’s lying on the table with his brain exposed.”
“Yeah, well,” Archer muttered in return. “Surgery isn’t always pretty, but it’s the only shot Halstead has.”
“I know,” she said. “I have just always hated brain surgery. So much can go wrong, so fast.”
“And a lot can go right,” Archer returned, feeling his ire start to raise. He spared her a scathing look, wishing that she’d not bothered to give a two-week notice. “This surgery is Halstead’s only chance. Literally, the only option if he still wants to practice medicine or tie his own shoelaces.”
“I know,” she said again, but her eyes were still fixed on the surgery. Abrams was adjusting Halstead’s volume, increasing his oxygenation. Marty didn’t look thrilled. April sighed. “We need to call Jay Halstead.”
Eyes back on the surgery, Archer shook his head. “Who the hell is Jay Halstead?”
She was looking at him, earnestly now. He refused to make eye contact out of principle. “Will’s brother,” she explained anyway. “His next of kin -- medical proxy, all of it. Things were so crazy downstairs, I didn’t even think of it before, but Jay would want to be here. We should have called him already.”
That was such a nurse thing, to think of the family. No wonder she never became a doctor. She didn’t have the guts for it. “We didn’t need a medical proxy -- it would have just slowed us down,” Archer argued. “The situation was emergent, and with Halstead incapacitated, we had to act fast in order to give him any chance of preserving brain function.”
Somehow, she looked confused. “I know. I’m not arguing it with you. We did what we had to do to save Will’s life, and I’m pretty sure that Jay would have agreed with us if he were here,” she said. “But he should be here. We need to call him.”
Archer made a face to show his general disdain. One thing he missed about the military is that there wasn’t so much damn red tape in treatment. Of course, he’d spent too much time nearly getting blown up, but no job was perfect, clearly. “Why?” he asked, unapologetically callous. “It doesn’t change our treatment plan, and, frankly, it seems like a distraction none of us need right now.”
She looked at him as though he’d just suggested kicking a puppy. “Because Will’s in surgery for a brain bleed and he might never wake up the same even if he does somehow survive,” she said, putting into words what the rest of the ED had been too scared to say. Maybe she did have guts, he had to give her that. If only she could use that energy toward more productive things. “I know I’m not a doctor, but I also know the odds here. No one wants to talk about them, but I’m not naive. His brother deserves to be here just in case.”
Despite the fact that she was talking frankly, she was also underestimating Archer’s control of this situation. It pissed him off, really, and he bristled at the insinuation. Frostily, he turned to her. “Halstead’s not dying.”
Somehow, she looked indignant. She did pick the strangest things to fight him on. “You don’t know that. Not really. We have an obligation to the patient.”
Oh, and now she was going to quote ethics to him? Or, more laughably, protocol? He stared at her tersely. “I do know that,” he said, growing in confidence as she waffled. He made an errant gesture with a facetious shrug. “But, I mean, do what you have to do.
He was daring her to contradict him, and low and behold, she did. Nodded abruptly, she drew a breath. “Okay,” she said, and then she stopped. Looking back at the operating room, she sighed and shook her head, finding enough doubt to hesitate. “What happened again? I mean, how did he get here? You said you were fighting?”
Her gaze had diverted back to him, and he bristled, refusing to look back at her. “Yeah.”
He offered no further explanation, and most people would take it at that, given his position. But April already had one foot out the door. The foot she still had in the door was not afraid to stand up for the things she thought mattered. Her gaze didn’t leave his face. “About?”
Patience would have been the preferable route here. He could have used a deft touch to put her off with no red flags.
But that was the whole nuance problem for Archer.
Namely, he didn’t have it.
“You know, I don’t have time for this now,” he said, turning on her abruptly. “One of my staff members is currently undergoing brain surgery, so excuse me for not making chitchat right now.”
April might have recoiled a few months ago. Most of the other nurses would have caved. Her eyes only narrowed.
He shook his head with a huff, crossing his arms over his chest and looking back to the operating room where Abrams had opened Will’s skull. “You know, just go get the brother here,” he snapped. “I’m sure that’s what Halstead would want.”
Sharp and to the point, but he was actually agreeing with her. She looked like she wanted to argue, but with his consent and encouragement, she had no grounds. Without a word -- and one last look at Halstead’s open skull -- she turned and left.
Good riddance.
Archer didn’t need her any longer. She’d served her purpose. Her utility had been exhausted.
Now he just needed Abrams to have a steady hand.
And Halstead just had to cooperate for once in his damned life.
-o-
From a distance, it was hard to tell exactly how things were going. Everything from his vantage point was blood and brain matter, and Archer wasn’t especially well qualified to judge. However, Abrams seemed calm and in control. There were no signs of patient distress, which meant that Halstead was either doing quite well for himself or he was already brain dead.
Either way, his heart was beating and his vitals remained stable. You probably could ask for more, but with an acute brain bleed, you probably wouldn’t get it.
Especially not from an idiot like Will Halstead.
Damn it, Archer hated him. He hated him. With an absolute, unadulterated passion.
And now here he was, obsessing over his every heart beat.
He needed to live.
Damn it. Archer needed him to live.
The thought was so pervasive that it was actually somewhat consuming. He followed the movements of the surgery with such intensity that he didn’t hear the door open behind him. He didn’t even realize someone else had entered until someone came up beside him into his field of view.
He startled -- you didn’t want to mess with someone who had an undiagnosed case of PTSD -- but he’d learned to cover it well over the course of his career. That probably wasn’t good in the sense that Dr. Charles would drone on about his emotional stability, but it was good in the sense that he didn’t freak out when he saw Ms. Goodwin next to him.
You know, his boss.
The boss.
“Ms. Goodwin,” he said, straightening reflexively. “I didn’t expect to see you.”
Her attention wasn’t on Archer, though. Brow creased, her eyes were drawn to Halstead. “I just heard, but I didn’t believe it,” she said, standing forward anxiously at the window. She made no pretense at small talk. “What’s going on?”
“Abrams has evacuated the blood,” Archer said, keeping it fully technical. The last thing he needed was an overly emotional response from Goodwin to top this mess off. She was better than most, but she had a soft spot when her staff members were in trouble. It was a fine line to walk between appropriate concern and sentimentality. Archer was banking on her keeping it. “He’s started working on the bleeder now.”
A frown deepened on her face as she continued to watch. “And his condition?”
“He’s tolerating the surgery so far,” Archer said. “And we did get him in here quickly.”
“But his contraindications?” she asked, falling back into the mode of charge nurse she’d left behind years ago. “What are the risks for damage?”
Archer shrugged, not sure he was willing to commit an answer to that. “It’s impossible to say,” he said. “His GCS was low, and he suffered from a seizure, but I think we were able to minimize hypoxia. His oxygenation levels have been good, so there’s reason to think that if the pressure was relieved quickly enough -- and if Abrams is half as good as he says he is with the bleeder -- there could be a chance of significant recovery.”
That was an apt medical analysis, but they both knew what it meant. At this point, it was a bit of a crapshoot. Even if everything else went right -- and everything else would have to go right -- Halstead’s chances for a full recovery were no guarantee.
She continued to watch for a moment, engrossed in silence while Abrams completed another series of intricate moves in the procedure. Despite the stakes at hand, the scene was a little placid. It made the inherent sense of urgency seem somewhat surreal.
“What happened exactly?” she asked, almost sounding reluctant. She spared Archer a glance, hesitant and calculating. This wasn’t a casual bit of chitchat here. She wet her lips, gaze just slightly keen. “I heard there was a fight between the two of you.”
Of course she’d heard this. Because gossip spread like wildfire in this hospital, and there was absolutely no sense of professional courtesy. Archer tried not to show just how pissed off he was at this, working his jaw to minimize his frustration. The last thing he needed was to look angry when Halstead’s life was in such a precarious position. He had to keep his focus. If Halstead died, this whole thing would fall apart.
“Uh, there was,” Archer said, invoking enough regret to make him sound plausible. He drew a breath and sighed, forcing a weak smile at Ms. Goodwin. “I’m afraid Dr. Halstead and I don’t always see eye to eye.”
This didn’t seem to surprise her, but there was a flash of pain across her face. She looked from Archer back to the operation. She looked not quite disappointed -- but sad. There was regret. “He’s always been somewhat brash. Deeply impulsive,” she mused. “But I’ve never known him to take a swing at someone before.”
She paused, drawing a long, slow breath as she shook her head.
Archer braced himself for the worst of the questions, when his role was brought to the foreground.
“And yet, I can’t say that it surprises me,” she continued. “Obviously, as our head of the ED, you should not be returning physical punches, but I do understand how things can escalate.”
He looked at her, suddenly dumbstruck.
For the first time all day, he was floored.
See, in that second, Archer realized something brilliant. This might not fall apart. In fact, in creating the worst problem ever, Archer had also created the easiest out.
See, Goodwin wasn’t looking at him as the instigator. In her mind, Halstead was already at fault, and with Halstead unconscious, there was no one to contradict him.
And Halstead had made it too easy. By pitting himself against Archer, he’d created the natural tension. And with his extremely questionable decisions as of late, he was going to be the easy fall man.
He had a pang of guilt about that. Halstead hadn’t fallen as much as he’d been suckerpunched.
But Dean Archer was a survivor.
First and foremost, when put in a dire situation, he found his own way out, no matter what.
The thought froze him to his spot, and he wondered if he could do this. If he could throw Halstead under the proverbial bus -- after literally punching him under the knife. Part of him rebelled at the thought -- he wasn’t a monster, after all -- but he was running out of options and he was running out of time.
Halstead had both options and time right now.
Archer exhaled and nodded his head. “Things have been unusually tense lately,” he said, and the admission was a careful version of the truth. There was no lie involved, and it wasn’t his fault if Goodwin took it as an affirmation of her assumptions.
If anything, that was Halstead’s fault. He was the one who had formed those assumptions.
Goodwin sighed, drawing her lips together sadly. “I can’t help but feeling sorry, but I don’t think there’s much I can do. If he survives this, my hands will be tied. The timing is just sensitive,” she said, clearly distressed at the notion. “With the amount of recovery he has ahead, and quality of life questions, I don’t want to talk about firing him yet. I want to be sure we can support him through the recovery as much as we are able, but there’s no way I can keep him as an attending in this hospital after violating his probation like this.”
For a moment, Archer could merely stare at her while he made sense of what she was saying exactly. He’d been open to accepting the defense she was offering him, but he’d never really considered the full context. The implications. That he would be exempt for punishment, and that Halstead would carry the blame.
That, if Halstead survived, he might be fired for a fight he didn’t start.
Archer fancied himself a survivor: no matter what.
No matter what, though?
Really?
Did that have any limitations?
Like lying about the order of operations when Halstead had no way to defend himself? Could he put the blame on Halstead and hope he died before he had the chance to refute it? Would he maintain the misconception if Halstead’s brain was mush when this came out? Suddenly, the best case scenario wasn’t saving Halstead. Suddenly, the easiest way out was letting Halstead die.
But Archer was still a doctor.
Halstead was still his patient.
If Halstead died, it would salvage Archer’s career, but Archer wasn’t sure he wanted to know the cost. He wasn’t sure how much of his soul he had left, honestly, and he wasn’t ready to forfeit it on account of Halstead’s pathetic life.
“This is premature for me to discuss -- I’m so sorry, Dr. Archer,” she said, turning toward him with sudden concern. “My intention here is not to make you feel guilty. You have no reason to blame yourself for what happened. Whatever the repercussions Dr. Halstead will face, I want to focus on getting him through this first. Will you please keep me updated on his progress?”
He mustered up a smile, perfunctory and professional. “Of course, Ms. Goodwin,” he said. And, for good measure, he added, “Thank you for your support.”
She smiled at him, but it was small and sad. Her gaze lingered back on Halstead for another second before she shook her head and left the gallery.
Save a life.
Save himself.
Archer closed his eyes, clenching his fingers into fists as he tried to remember how to breathe.
Easy outs.
He opened his eyes again, looking back at the surgery beyond this glass.
It turned out they weren’t so easy after all.
-o-
The problem with neurosurgery was that it just took too long. The brain was too delicate, the anatomy was too complex. Even simple fixes took hours to navigate, and the margin for error was slim to nonexistent. Honestly, Archer probably had the technical skill to pull it off, but he found it too tedious.
And neurosurgeons were generally assholes.
Standing there, his legs started to ache, and he could feel the muscles threatening to spasm in his back. His head was starting to pound -- dehydration, maybe, stress, definitely -- and he was feeling his hold on self control stretch to its breaking point.
Yet, he couldn’t leave.
How was he supposed to leave.
Halstead’s brain was open -- and that was Archer’s fault. The brain matter that had already died -- that was Archer’s fist.
The idea of absolution from Goodwin -- it was appealing.
But how could he even pretend?
Letting Halstead died was easier in one sense, but he didn’t need to be haunted by some idiot redhead ghost after everything else. No, he had to get Halstead through this -- and then he had to disprove his credibility the real way. He wanted to fire Halstead, not kill him.
There was a difference there.
A difference that mattered.
Archer wasn’t the bad guy here.
He wasn’t.
He wasn’t going to be the villain of this story. He was saving this hospital. He was saving himself. At this point, he was saving Halstead, too.
He was the hero of this story.
He just had to aim his punches better. He had to craft the narrative. He had to direct the treatment. This time, he would land the punch right. This time, the knockout blow would have the desired effect. He could control this narrative. He could will this into the outcome he wanted. He was still in control here. He was.
Halstead would live.
Archer would prove he was right.
It would all work out.
Archer rocked on his heels, shaking out the tension in his legs. From his vantage point, he watched Abrams ease carefully through the brain matter, checking the area for possible leaks or bleeders. One of the nurses leaned over to provide suction, and Archer could hear the anesthesiologist over the intercom, reporting Halstead’s vitals.
He was stable, at least. For invasive emergency brain surgery, Halstead seemed to be tolerating it okay. That didn’t guarantee that he wasn’t a turnip already, but at least it meant he wasn’t dead yet.
Small victories, Archer decided.
Even the small ones when you had to cheer for someone you couldn’t stand to live.
He allowed himself to be engrossed in Abrams’ progress, tracking the movements with the best of his knowledge. It was a mere illusion of control he was working with now, but if this went south he wanted to know.
He needed to know.
This time, when the door opened, he heard it at least. He looked back, inwardly holding in a groan. It was Dr. Charles. Their unhelpful psychiatrist who thought he knew everything. Doctors tended to be smug bastards -- that much Archer could accept -- but shrinks just had theory and touchy-feely nonsense to fallback on. It made their smugness lack justification.
And Dr. Charles was worse than most.
Archer found he disliked a lot of people in the ED, but Dr. Charles was the only one he actively did not trust. You couldn’t trust a shrink. They were always listening to what you weren’t saying, and they sure as hell would use it against you.
It was marginally mollifying that Dr. Charles seemed more concerned with Halstead at the moment.
That at least meant he was fixating on Archer for once.
“I heard people start to talk, but I didn’t want to believe it,” he said, coming up close to the glass. His eyes were wide with concern, face drawn in shock. “And I didn’t think it could really be this bad.”
That was a stupid thing to say, given that they were watching brain surgery right now.
Archer, though, wisely kept any sarcastic comeback to himself.
“How long ago did this happen?” he asked. “I mean, I didn’t even know about it, that anything had happened -- much less that he was in surgery.”
Hurried and flustered, people kept blustering in like this was some kind of sideshow or that Archer should have announced it immediately. Goodwin and Charles were the two biggest names that had stopped by, but there had been others. Attendings, residents, students, nurses, techs -- hell, the whole damn hospital seemed to have gotten the memo.
These people had no appreciation for patient privacy. Archer found the legalities tedious as well, but he saw their merit in times like these.
“Well, we’ve been kind of busy,” he said, and he was aware that his attempt to find the moral high ground here was tenuous at best. Still, all this pearl clutching was more than he could tolerate. “I didn’t think stopping to make an announcement would be the right choice.”
Dr. Charles remained steadfastly concerned. “Of course,” he said obligingly. “But what happened?”
Stupid questions. And this was one of the most tenured doctors on staff.
Archer nodded to the operation in front of him, which made for an obvious tableau. “Brain hemorrhage,” he said simply. “Abrams is chasing the bleeders.”
There was more to it than that, but the idea of talking it through was exhausting -- and that was assuming that Archer remembered enough of his neurology rotation to do it justice. In the army, he’d operated under a simpler set of precepts. Brain injuries were a big no-no, and you had to transfer those patients as quickly as you could. To the neurosurgeon ideally, but the morgue was usually the second choice.
Dr. Charles looked increasingly distressed. “No, I mean how.”
In truth, Archer had probably known that was what the question was really about. Maybe he chose willful naivete. Maybe he just wanted to piss the guy off.
Or maybe it was just that question.
It was so damn reductive, so impossible.
Archer had to grit his teeth, and he curled his toes in some strained attempt to hold his temper. He didn’t have the luxury of putting Dr. Charles off like he had so many others. “A fight,” he said, keeping his answer clipped. He rocked back on his heels and watched the surgery with purpose. “It got out of control.”
The answer was honest and to the point. So, it was probably no surprise that it wasn’t enough for good old Dr. Charles.
“You and him?” he asked, as if he hadn’t heard this all through the grapevine already.
Archer dug deep, finding the vestiges of self control. “Yes,” he said. Unflinching. Unwavering.
And still. The man had questions.
Always with the questions. “A physical fight?”
There was definitive proof, then, that there were, indeed, stupid questions. It was getting harder to keep his temper in check, and it really wasn’t his fault this time. “Seems so.”
Dr. Charles looked back to the surgery taking place, almost as if the answer vexed him. “That doesn’t make sense, though,” he said, as though this was some kind of revelation. “I’ve never known Will to be violent. He has some issues with impulse control, and he’s far too likely to take a stance without being open to outside criticism, but never violence.”
This was probably meant to be some valid analysis, mostly because Dr. Charles, the psychiatry god, had spoken it. “Well, you know, he’s been under a lot of stress,” Archer said flatly.
Archer wasn’t trying to be openly combative, but he also wasn’t making much effort to be conversational. You’d think a shrink would pick up on the cues that Archer didn’t want to talk right now, but either Dr. Charles was incompetent -- a likely conclusion -- or he was purposefully rude -- a foregone conclusion. Either way, he was going to subject Archer to this conversation whether he liked it or not.
And telling him to piss off right now probably wouldn't go over well. Dr. Charles wasn’t his boss, but he was good friends with Goodwin, so that didn’t seem like a risk he should probably be taking at the moment.
“I guess,” Dr. Charles said, wholly noncommittal in his commentary. “But even so. We all deal with stress, and he’s never manifested control issues in any kind of physical way.”
“Sure, but he has a history of reckless behavior,” Archer said. He gave the shrink a cursory look, because he at least knew enough to make this point. It was easier to crap your way through psychiatry than neurosurgery, as psychiatry was borderline quack medicine anyway. “I’ve read the literature. There are plenty of examples of PTSD manifesting in unusual ways when under duress. And, I mean, Dr. Halstead has been under a lot of stress lately. Maybe he just snapped.”
Dr. Charles hummed for a second. “I am curious, though,” he continued, even though no one had asked him a direct question. “What exactly were you two fighting about?”
The bastard suspected. Without any background or knowledge of anything, Dr. Charles was inclined to take Dr. Halstead’s side -- and it made him a biased source. It made Archer want to dismiss him outright, but he couldn’t dare to be so bold -- not yet. He was still technically an interim chief. This psychiatrist had the medical know-how of the Pillsbury Doughboy, but he was also Ms. Goodwin’s longtime friend. Archer had to play the game a little bit or it would tip the man off -- and Archer didn’t dare lose Goodwin’s favor now, when it mattered most.
Therefore, Archer shrugged, a diplomatically vague gesture. “Well, I don’t know the guy well, but it’s no mystery that Halstead’s been unhappy lately.”
“Well, I’m not sure about that,” Dr. Charles said, sounding thoughtful. “I’ve been talking to Will on a regular basis, and he’s seemed very eager to get back to normal.”
“Easier said than done,” Archer said shortly, rocking back on his heels. “I mean, he was fired -- he basically tanked his career. It makes sense to me that he’d be a little, you know, stressed.”
“But that’s the thing. It just doesn’t make a lot of sense,” Dr. Charles continued. For a soft, old guy, he could be like a dog with a bone. “I mean, for him to get so upset about something that he’s picking a fight. It would have to be a case or a patient or something.”
Archer sighed, letting his breath catch. It threatened to give him away or break his composure, but he reeled it in just enough. “And why’s that?”
Dr. Charles looked at him like he was surprised by the question. “Because that’s what Will is passionate about,” he said. “Yes, he can be brash and abrasive, but it’s never unless he feels like he’s doing something to save a patient. Every other instance he’s gotten himself into trouble, his desire to help people has always been at the core of it. He cares too much sometimes, and he doesn’t always know how to scale back his need to help. I’ve known Will a long time, and I feel quite safe in that assessment.”
The irony was that Goodwin was an easy sell. He wasn’t sure how he’d won her over so easily, but he had. As his boss, she was the critical ally that he needed -- and she would provide a lot of protection from other doubts and inquiries.
But Dr. Charles was a tricky bastard. He never took an answer completely at face value, even when he pretended like he did. Sure, he liked to acknowledge what people said -- even while he was undermining their entire thought process at the same time. There was no good reason to trust a shrink. Diagnosing a body was clear-cut and dry. Diagnosing a mind? Archer didn’t see the point.
The mind was shot. It played tricks on you. It was the most unreliable narrator around. A good cop knew that, and Archer had spent too many years in a war zone to pretend otherwise.
Ethan had always seemed to mean well, and everyone thought Dr. Charles was some stand up guy, but it didn’t matter. Dr. Charles was just like everyone else in the world, pitching his ulterior motives. And Archer had too much other stuff going on today to play nice.
“Look, I don’t know what set him off,” he said, just barely keeping his tone in check. He flitted his hands through the air. “We were talking one second, and the next -- who knows. He was off -- and the next thing I knew, he was on the ground. You’ll have to ask him about it.”
Dr. Charles nodded again, which was even more frustrating than before. Then, in a turn Archer should have seen coming, the psychiatrist fixed his gaze on him anew. “It sounds like a pretty stressful turn of events -- for both of you,” he said. It was impossible to tell with Dr. Charles what was sincere and what wasn’t. Archer’s suspicions were confirmed when he followed up with another question, “And how are you doing?”
Those were the kind of questions that psychiatrists asked. Dr. Charles could pretend to care all day long, but that kind of thing gave him away. The only reason to ask how someone was doing was if you suspected they weren’t doing well.
Archer wasn’t about to be psychoanalyzed by a glorified counselor who enjoyed far too much unearned seniority in the ED -- Archer’s ED, for that matter. He pressed his lips flat and glared back at the man. “Well, honestly, I’ve been better.”
Nonplussed, Dr. Charles made a noise of affirmation. “I’m sure,” he said. Then, with all the audacity in the world, he rocked back on his heels. “Do you want to talk about it? After these kinds of traumatic events, it can be hard to process everything on your own.”
Archer managed to not roll his eyes -- but only just. He forced a smile at the other man, but there was no way to hide his utter contempt. “You know, I think I just want to be left alone, thank you,” he said. “I’m sure when Dr. Halstead wakes up, though, you can talk to him to your heart’s content. There’s your sob story, right there. Will Halstead and his epic fall from grace. And look at him now.”
They both looked, through the glass to the operating room. Abrams had shifted position, using a magnifying tool to get a closer look at the vessels in the brain, exposed in the craniotomy. For a moment, they were silent, watching as the neurosurgeon continued his intricate work.
“Yes,” Dr. Charles intoned quietly. “I’m sure Will is going to need plenty of support. Head injuries like this -- are pretty intense. What did you say his prognosis was?”
“Better with immediate surgery,” Archer said, snapping the words this time. “Better with quick intervention. From me.”
He enunciated the words as clearly and plainly as possible.
Dr. Charles remained unimpressed. He glanced back to Will, then to Archer once more. “From you,” he repeated, and he nodded thoughtfully. “You’ll let everyone know, then? When he’s out of surgery?”
Archer kept himself turned toward the theater, crossing his arms over chest. “Of course,” he said, refusing to make eye contact again. “He’s a part of my ED staff, right? My responsibility.”
“Responsibility is important,” Dr. Charles agreed, starting to the door. “Very important.”
Archer didn’t give him the satisfaction of a second look, and he was still braced, holding his breath, when the door shut behind the psychiatrist and he was plunged back into silence. He shook his head, working his jaw.
“Just don’t screw this up, Halstead,” he muttered. “For both our sakes, do not screw this up.”
-o-
Just when Archer was sure he’d entertained, comforted and ultimately turned away every member of the hospital staff, the door to the gallery opened again. He was about to tell this person off as well, but when he turned around it was Maggie.
She was with someone he didn’t recognize.
Someone who looked suspiciously Irish.
And that was how Archer learned that Will Halstead was actually the more reasonable brother.
Yes, that was the truth.
Irony at its absolute finest.
Archer had not been openly provocative, but he ended up with a punch to the face anyway. Which, to be fair, he probably deserved -- and, more helpfully, would probably help sell the story that none of this was Archer’s fault.
The punch smarted a little, but it solidified Archer’s choice in his gut. He wasn’t wrong here. He wasn’t a bad guy for letting this play out. In some ways, it justified everything. Halstead had had this coming.
Well, not this, but the punch had been unlucky.
That was all.
Bad luck.
He’d comforted himself with that notion, still nursing his throbbing jaw, when Maggie came bustling back in. She looked perturbed, somehow. And she seemed to be perturbed with him.
“Okay, out,” she said.
She was direct and to the point, he would give her that.
She was also entirely out of line. Archer didn’t budge an inch. “I’m the one who just got assaulted.”
She wasn’t buying it, and she beckoned him to the door again. “Seriously, out. Now.”
“No,” Archer said firmly. “Halstead is my patient. I’m going to stay right where I am until I’m confident in the quality of his care.”
Maggie had always been deferential on the job, having a clear understanding of the ED pecking order, but she was soft on Halstead. She was going to paint this as a patient’s rights issue, which was inane in the best of times. Now, the idea of kicking him off the case when it was his quick thinking that had given Halstead any chance was laughable.
His role in the injury notwithstanding.
This was his case.
Halstead was his responsibility.
Archer was an asshole but he always got results.
Yet somehow, this was the hill Maggie was choosing to die on. “Jay wants you off the case,” she said, just as firm as before.
Archer made a face, giving an off handed shrug. “And he’s, what, a cop? He knows nothing about continuity of care. His opinion is, frankly, irrelevant.”
“He’s Will’s medical proxy,” Maggie said with a little indignant scoff.
People put way too much weight on crap like that, and it bogged down the medical system and limited the effective care patients received. It was really mind boggling that no one else saw it but him.
As it was, this day had been way too long. He rolled his eyes. “Oh, please.”
His indifference only seemed to stoke Maggie’s ire. “You know how policy is on this kind of thing. I respect Jay’s call -- because I know Will would respect Jay to make it. I will go to Goodwin on this one if I have to.”
There was some kind of threat there, but it was silly. Not that he didn’t think Maggie would do it, but because the whole thing was pointless. Goodwin was on his side here, and even if she toed the line, he had a pretty strong feeling where her sympathies would be.
She would want the best treatment for Will.
And she was smart enough to see that Archer had provided that treatment -- while everyone else flailed and clutched their pearls at the thought of Halstead being braindead. He was the problem solver. Everyone else just made problems worse.
Including Maggie and her medical proxy policy nonsense.
At least he had nothing to prove here, and he wasn’t going to tread lightly with Maggie. “So you’re going to coddle them? With this much on the line?”
He made a gesture back to the operating room. The scene could not be ignored, and with Halstead’s brain still exposed, Archer knew he had a point -- and a good one at that.
Maggie drew her mouth into a sober line. He could shame her, but it wasn’t going to be nearly as effective as he wanted it to be. “I’m going to do what’s best for the patient,” she said, as if they could separate that out from the red headed doctor under sedation in the next room.
It wasn’t just her over-reliance on policy. It wasn’t even that she was using it to cover up how emotionally compromised she was right now. It was her holier-than-thou attitude. As though she had some moral high ground that made her uniquely qualified to make these calls.
Archer’s calls had given Halstead a fighting chance.
Archer’s -- and no one else’s.
“No, you’re doing what feels best,” he said, lip curling somewhat. He shook his head, feeling disgusted. “I’m Halstead’s doctor.”
She really was too far gone. “Not anymore,” she said, with a cold look in her eyes. “You want to object, bring it up with Goodwin.”
With that, she stalked off. He wanted to stay, if only to put her in her place, but additional scrutiny was probably not what he needed right now. He still wasn’t sure how he’d gotten this situation to turn in his favor, but he needed to maintain that edge as much as he needed to keep Halstead alive. They didn’t have to be contradictory goals, not if Archer played this out the right way.
He would have preferred to do it playing point.
But he’d done the hard part. With Abrams on board, Halstead’s brain would at least have some chance of viability. Archer could monitor things from a more reserved position.
Sometimes it wasn’t a question of following the rules.
Sometimes it was just a question of breaking the rules in a way that didn’t get you caught.
Archer was pretty good at that. Halstead needed to work on it, though.
Hence why Archer was the ED chief and Halstead was on probation.
It still miffed him to leave, but he spared the surgery one more glance. Abrams was hard at work, and Halstead appeared stable. It wasn’t much, probably, but Archer had been through too much crap in his life. Sometimes -- most of the time -- you just had to take what you could get. That was how he’d ended up at Med in the first place.
And look how well that had turned out.
-o-
Archer left the gallery, but he didn’t go far. Halstead’s brother was a cop, which he might have thought made him impressive, but he didn’t know the ins and outs of the hospital. Maggie would have her hands full with him as it was -- clearly, the guy was not coping particularly well -- which meant that Archer had to go -- but he didn’t have to go far.
In fact, all he had to do was navigate over to the other side of the OR department. It didn’t give him a clear view of the procedure, sure, but this hallway was used to transport patients in and out. While the brother fretted about the gallery and the waiting room, Archer could keep himself right in the line of action, technically satisfying Maggie’s ridiculous mandates and his own need to see this through.
Of course, waiting here afforded him less to do. Not that he’d had anything to actually do while in the gallery, but tracking the course of the surgery had least been preoccupying. Standing in the hallway afforded him no such luxury. Here, he was forced to keep his own company.
And that had never been something Archer enjoyed.
It was funny to think about it, sometimes. The army had given him discipline and mettle. It had tested him under pressure and shown just how capable he was. He had honed himself into making the hard calls, and he’d become the doctor that as needed -- not always the one patients wanted. He got results, though.
That had always been the thing.
He got results.
Patients who had him as a doctor lived.
Even when they were too stupid to know what they wanted.
They lived.
Survival was the thing, after all. That was the crux of it. You couldn’t guarantee happiness or success. You couldn’t give them meaning or purpose. But you could get them back out there with a beating heart and a second chance.
Medicine these days had it all backward. It had become too evolved for its own good. They had all strayed from their foundation mission: save the life.
You always saved the life.
Even when they were too stupid to want it.
Even when you were the one who had hurt them in the first place.
There was no other way to measure success. There was no other way to structure his life.
All Archer could do was save the life.
PART TWO
PART THREE
PART FOUR
PART FIVE
PART SIX
PART SEVEN
PART EIGHT
PART NINE
PART TEN
-o-
In reality, Archer knew his functional role in Halstead’s care had hit its maximum. If he could successfully repair a brain bleed with any amount of confidence, he wouldn’t have wasted his energy with Abrams. Since that wasn’t the case, Halstead officially became a neurology patient, and Archer could go downstairs, finish the paperwork and be done.
That was an overly naive approach, however. The bleed in Halstead’s brain was caused by Archer’s fist, and all the hows and whys didn’t mean anything if he died.
Therefore, by a matter of necessity, Halstead was his patient. Even if Archer wasn’t in the operating room, the outcome was still on Archer’s head, and there was no way in hell he was leaving that chance.
He was careful to stay out of the way, but he wasn’t going to be an idle presence. While Abrams scrubbed in -- gamely readying for another long surgery back to back with his last one -- Archer made sure that everything else was in order. He found April sitting with Will in the room. “How is he?” he asked.
“Alive,” she said. “Is this happening, then? No one was happy when I insisted on the room.”
“It’s happening,” Archer reported, and almost as if on cue, the door opened again, and the scrub nurse came in.
“Everyone else out,” she said.
April stood up, but she didn’t budge from Halstead’s side. “He needs to be monitored.”
“And I will,” the scrub nurse said. She was followed by another nurse and the anesthesiologist. Any further concerns people had about Archer’s lapse of protocol were quickly silenced when they finally saw Halstead.
For once, Halstead was working with him.
That, of course, was irony at its finest.
Somehow, Halstead looked worse than the last time Archer had seen him. His lifelessness was accented by the increasing gray hue of his skin. Archer thought about the scans he’d seen. The blood was building by the second, killing brain cells slowly but surely.
For all that Archer had ramrodded this through, they all had to know the odds were still not quite in their favor. Halstead might already be a vegetable. Archer might have already killed him.
Abrams opened the door next, coming inside. “Out,” he ordered. “This is a sterile environment.”
April seemed willing to comply, and Archer followed her to the door, but he turned back. “No complicating history, but his GCS has been three since the accident. O2 levels are stable with intubation, but his BP isn’t great. He had one seizure, but it’s been well controlled with meds.”
Abrams turned from the table, and he looked back at Archer with dispassion. “We won’t know anything until we clear and stop the bleed,” he said. “Until then, we’re just playing a waiting game to see how many brain cells he loses.”
“Then you better get to it,” Archer said soberly.
Abrams inclined his head. “For once, we agree,” he said, and he turned back to the table. The anesthesiologist was already prepping for full sedation, and the scrub nurse was preparing the necessary trays. Someone touched his arm, and he turned to find the circulating nurse.
She looked a little less hostile to him this time.
“Come on,” she said, taking him gently by the arm and leading him from the room. “It’s time for the surgery to start.”
-o-
As a military man, Archer had plenty of experience taking orders. He also had plenty of experience hating the orders as he took them, especially when they were too often linked to not saving lives. He tolerated the order to leave the OR for the opposite reason.
Abrams was Halstead’s only chance.
He hated to admit it on every level, but there it was. Archer had nearly killed Halstead, and now he needed Abrams to make sure he didn’t. In short, Archer had done everything he could do. Now, it seemed, he had to sit and wait.
He had a thought to go back to work. It was what you would normally do as a doctor. It wasn’t like ED docs ran around following their patients all day long. You wouldn’t get anything done that way. And it would be a good show of solidarity. He was in charge of the ED, and he couldn’t lead the damn place by not being there.
That said, he couldn’t lead it very well when he’d nearly killed everyone’s favorite redheaded attending.
Which still didn’t make any sense to him.
Halstead wasn’t all that likeable. He was an adequate doctor sometimes, but when he got himself emotionally compromised, it was just kind of a crap shoot. It still galled him that no one seemed to care that he had willfully ruined a trial -- a mistake that had cost the hospital future trial opportunities going forward.
Sure, Halstead was trying to be penitent, but there were some things you couldn’t salvage. He had to believe that Halstead’s career was one of those things.
He would prefer to think differently regarding the asshole’s life.
Going back to the ED now would be a mistake. Not only would he be hounded incessantly about Halstead’s condition, but he would be asked pernicious questions about how it happened. Archer wasn’t stupid; he knew that would come into account sooner or later. But he’d prefer to know if murder was on the table or if he could get away with nothing but a workplace incident.
That said, he was staying. He allowed himself to be ushered from the OR, but he made his way directly into the gallery and planted his feet in front of the window to watch Abrams and his team continue prepping. Nearby, April had had the same idea.
He glanced at her, wondering if there was some way to order her back to work without sounding like a total heartless bastard. He couldn’t kill Halstead and make April cry all in the same day without being branded as a monster.
He wanted to be a hard-ass, but he wasn’t going for all out monstrosity. At least, not on these terms.
April glanced back his way, and Archer looked back to the surgical space. “I let Doris go back down to the ED,” she said, offering up the information unprompted.
Archer raised his eyebrows, mostly unimpressed. If this confession was supposed to get her some credibility, he wasn’t sure she’d succeeded. “I told you to both stay.”
“I made sure I was with him the whole time,” April said. “I didn’t stop tracking his vitals for a second. There was no need for both of us.”
“But if something had gone wrong--”
April scoffed, and when he gave her another cursory glance, she was staring him down hard. “We’re in a hospital. The second I call a code, everyone comes,” she said. “And you didn’t think that maybe this was a little hard for Doris? For both of us?”
“Yet, you’re still here,” Archer said coolly. “So I’m not sure what point you’re proving.”
“I’m just proving the point that I stayed for Will,” she said, lifting her chin defiantly. “I let Doris go. I know I’m the one with my foot out the door, so I just want to be sure you don’t take this out on her.”
The point was possibly valid, but Archer didn’t much care. He would sort out his issues with the nursing staff later. Doris’ failure to perform in this situation was lower on his list of concerns. He shook his head a little, eyes forward once more.
“You got it done, at least,” he said. “Abrams didn’t even have to wait.”
April looked forward, too. “20 minutes, just like you said.”
There was a note of pride in her voice, but he refused to indulge it. He won’t compliment her. Following orders was part of her job. Besides, he knew from experience, it wouldn’t do any good to stroke her ego. She was too inconsistent to foster.
Besides, things were progressing in the OR. Someone had shaved away a portion of Halstead’s hair, the red locks falling to the floor. Once the area was prepped, Abrams had his position shifted to give him better visibility of the cranium. It was only several moments longer before Abrams called for a blade and went to make the first cut through the thin layer of scalp.
April, for all her defiance, drew a sharp breath and looked down.
Archer watched as Abrams expertly sliced through the skin layer, gently starting to pull back the scalp to reveal the bone underneath. He called for the drill needed to break through the skull.
Not a pleasant thing to watch, to be sure.
For a moment, he was almost drawn to pity. For her. For him.
He had nothing to offer Halstead, but he looked at April again with a sigh. “You can leave, you know. I asked you to stay until the operation started. You don’t have to stay.”
His intentions were good at this point, but April looked up again, shaking her head even as she wiped away tears from her eyes. “No, I’m fine.”
The lie was a little exasperating at this point. She clearly wasn’t fine, and now he was going to have to debate that with her? “There’s nothing you can do by staying,” Archer pointed out, opting for logic instead.
Logic that she did not heed. Stubbornly, she shook her head again. “Neither can you,” she said, and she looked at him levelly. “But you’re not leaving.”
Well, that time she had a point. She’d had the wherewithal to see that there was something to what he was doing, even if she couldn’t have put all the pieces together yet. If she was more amenable, they really could have gotten on. As it was, it was a relief to think of her as leaving. “He’s an ED attending -- not to mention, my patient.”
She didn’t flinch, though. And she didn’t seem at all impressed. “And he’s my friend.”
As if she thought that sentiment was going to hold sway here -- and now. In the OR, Abrams had marked his drill points to create a series of holes. It was going to be a bigger section of the skull that Archer had expected. Clearly, for all that Abrams said this was possible, he was preparing for the worst.
April was pale across from him, and he could hear the uneven rhythm of her breathing. Sparing her another glance, it was clear that she was heartbroken. Archer was pissed off and annoyed, but the swells of pity were increasingly difficult for him to ignore.
This had been an accident.
This whole thing.
All of it.
He wasn’t sure how they’d ended up here -- in brain surgery -- but it was untenable to say the least as Abrams made the first hole.
April had gone ramrod straight, stiff as could be.
“He’s actually doing really well,” Archer pointed out, trying to be sympathetic for a moment. “I mean, look at his vitals? For the amount of blood that he lost, that’s a really positive sign.”
She looked disgusted but transfixed, face twisted uncomfortably even as she seemed unable to look away from the surgery as Abrams directed his drill to the second location. Several spots would need to be drilled. Then, the piece of the skull would pop right off and stay in refrigeration until Halstead--
Well, until he was ready for it again.
“Optimism?” April asked, sounding more than somewhat skeptical. She didn’t look at him even as she scoffed. “You’re actually going to pitch optimism right now?”
Archer watched as well with a growing sense of detachment. His ability to disassociate was pretty well honed since his time in active service. He’d found it to be an essential coping mechanism. He found that it played here, too.
He shrugged, almost with a sense of honed indifference. “Maybe.”
Optimism wasn’t blind, after all. Optimism was a purposeful choice. It was a choice of facts to coerce reality into your preferred version. Optimism was a manipulation of reality, and Archer preferred that to the pessimism of resigning yourself to it.
April, though. She seemed to be stuck in realism. That frustrating place where you saw things just as they were and not how you could make them be.
Across from him, she was still transfixed. “This is bad, though,” she said. “I mean, I saw his scans. The odds of survivability, even with fast intervention, they’re low. And the odds are even lower that he’ll be himself when he wakes up -- if he wakes up.”
Archer wrinkled his nose, and he turned his gaze toward her. “You’re a nurse,” he said. “How would you know any of that.”
She looked at him coolly, and her demeanor was unphased. “A nurse who’s really good at what I do,” she said. “I’ve been working this ED for a long time.”
“But you’re not a doctor,” he said, and he wasn’t trying to be cruel, but he couldn’t help it if his tone was condescending. If she were a doctor, she would have been a much better help when Halstead actually needed her -- instead of her dithering. He’d tried to foster something more out of her. He’d tried -- and she’d crumpled. He raised his eyebrows at her, expectant. “Remember?”
“But I’m not stupid. I know how to read a scan just as well as most of the residents,” she said, coming up with defiance. “It is a hemorrhage. A bad one.”
These nurses and their overinflated sense of worth. They were the grunt workers of the ED, and Archer knew they were important. But to watch them preen, and to have doctors fawn all over them -- it was still something that he couldn’t stand about Ethan’s management approach. He knew Ethan had a thing for April, and maybe that was part of the problem. He couldn’t see it.
Turning back to face forward, Archer sighed in exasperation. “Well, he’s still alive, so it could be worse,” Archer reported, wiggling his toes anxiously. He’d always had a hard time standing still, but it had gotten worse in recent years. He didn’t like to be still; he didn’t like to be alone. Too much time alone with his own thoughts never yielded worthwhile results. “Abrams just successfully removed the skull and seems to be zeroing in on the bleeders.”
Even as he said it, he could tell she wasn’t fit to handle it. April could be surprising sometimes. All the times she seemed to be the strongest of the bunch, and then she would go unexpectedly soft. It was frustrating, to say the least. He hated that she was so close to being someone great, but she let sentimentality slow her down.
And she’d made it this far -- but barely.
More than that, she was at the end of her rope.
Looking back to the surgery again, she was nearly morbidly engrossed now. “It doesn’t seem right,” she murmured, her animosity giving way to her fear once more. “It doesn’t even seem possible. I was just talking to him this morning, and now he’s lying on the table with his brain exposed.”
“Yeah, well,” Archer muttered in return. “Surgery isn’t always pretty, but it’s the only shot Halstead has.”
“I know,” she said. “I have just always hated brain surgery. So much can go wrong, so fast.”
“And a lot can go right,” Archer returned, feeling his ire start to raise. He spared her a scathing look, wishing that she’d not bothered to give a two-week notice. “This surgery is Halstead’s only chance. Literally, the only option if he still wants to practice medicine or tie his own shoelaces.”
“I know,” she said again, but her eyes were still fixed on the surgery. Abrams was adjusting Halstead’s volume, increasing his oxygenation. Marty didn’t look thrilled. April sighed. “We need to call Jay Halstead.”
Eyes back on the surgery, Archer shook his head. “Who the hell is Jay Halstead?”
She was looking at him, earnestly now. He refused to make eye contact out of principle. “Will’s brother,” she explained anyway. “His next of kin -- medical proxy, all of it. Things were so crazy downstairs, I didn’t even think of it before, but Jay would want to be here. We should have called him already.”
That was such a nurse thing, to think of the family. No wonder she never became a doctor. She didn’t have the guts for it. “We didn’t need a medical proxy -- it would have just slowed us down,” Archer argued. “The situation was emergent, and with Halstead incapacitated, we had to act fast in order to give him any chance of preserving brain function.”
Somehow, she looked confused. “I know. I’m not arguing it with you. We did what we had to do to save Will’s life, and I’m pretty sure that Jay would have agreed with us if he were here,” she said. “But he should be here. We need to call him.”
Archer made a face to show his general disdain. One thing he missed about the military is that there wasn’t so much damn red tape in treatment. Of course, he’d spent too much time nearly getting blown up, but no job was perfect, clearly. “Why?” he asked, unapologetically callous. “It doesn’t change our treatment plan, and, frankly, it seems like a distraction none of us need right now.”
She looked at him as though he’d just suggested kicking a puppy. “Because Will’s in surgery for a brain bleed and he might never wake up the same even if he does somehow survive,” she said, putting into words what the rest of the ED had been too scared to say. Maybe she did have guts, he had to give her that. If only she could use that energy toward more productive things. “I know I’m not a doctor, but I also know the odds here. No one wants to talk about them, but I’m not naive. His brother deserves to be here just in case.”
Despite the fact that she was talking frankly, she was also underestimating Archer’s control of this situation. It pissed him off, really, and he bristled at the insinuation. Frostily, he turned to her. “Halstead’s not dying.”
Somehow, she looked indignant. She did pick the strangest things to fight him on. “You don’t know that. Not really. We have an obligation to the patient.”
Oh, and now she was going to quote ethics to him? Or, more laughably, protocol? He stared at her tersely. “I do know that,” he said, growing in confidence as she waffled. He made an errant gesture with a facetious shrug. “But, I mean, do what you have to do.
He was daring her to contradict him, and low and behold, she did. Nodded abruptly, she drew a breath. “Okay,” she said, and then she stopped. Looking back at the operating room, she sighed and shook her head, finding enough doubt to hesitate. “What happened again? I mean, how did he get here? You said you were fighting?”
Her gaze had diverted back to him, and he bristled, refusing to look back at her. “Yeah.”
He offered no further explanation, and most people would take it at that, given his position. But April already had one foot out the door. The foot she still had in the door was not afraid to stand up for the things she thought mattered. Her gaze didn’t leave his face. “About?”
Patience would have been the preferable route here. He could have used a deft touch to put her off with no red flags.
But that was the whole nuance problem for Archer.
Namely, he didn’t have it.
“You know, I don’t have time for this now,” he said, turning on her abruptly. “One of my staff members is currently undergoing brain surgery, so excuse me for not making chitchat right now.”
April might have recoiled a few months ago. Most of the other nurses would have caved. Her eyes only narrowed.
He shook his head with a huff, crossing his arms over his chest and looking back to the operating room where Abrams had opened Will’s skull. “You know, just go get the brother here,” he snapped. “I’m sure that’s what Halstead would want.”
Sharp and to the point, but he was actually agreeing with her. She looked like she wanted to argue, but with his consent and encouragement, she had no grounds. Without a word -- and one last look at Halstead’s open skull -- she turned and left.
Good riddance.
Archer didn’t need her any longer. She’d served her purpose. Her utility had been exhausted.
Now he just needed Abrams to have a steady hand.
And Halstead just had to cooperate for once in his damned life.
-o-
From a distance, it was hard to tell exactly how things were going. Everything from his vantage point was blood and brain matter, and Archer wasn’t especially well qualified to judge. However, Abrams seemed calm and in control. There were no signs of patient distress, which meant that Halstead was either doing quite well for himself or he was already brain dead.
Either way, his heart was beating and his vitals remained stable. You probably could ask for more, but with an acute brain bleed, you probably wouldn’t get it.
Especially not from an idiot like Will Halstead.
Damn it, Archer hated him. He hated him. With an absolute, unadulterated passion.
And now here he was, obsessing over his every heart beat.
He needed to live.
Damn it. Archer needed him to live.
The thought was so pervasive that it was actually somewhat consuming. He followed the movements of the surgery with such intensity that he didn’t hear the door open behind him. He didn’t even realize someone else had entered until someone came up beside him into his field of view.
He startled -- you didn’t want to mess with someone who had an undiagnosed case of PTSD -- but he’d learned to cover it well over the course of his career. That probably wasn’t good in the sense that Dr. Charles would drone on about his emotional stability, but it was good in the sense that he didn’t freak out when he saw Ms. Goodwin next to him.
You know, his boss.
The boss.
“Ms. Goodwin,” he said, straightening reflexively. “I didn’t expect to see you.”
Her attention wasn’t on Archer, though. Brow creased, her eyes were drawn to Halstead. “I just heard, but I didn’t believe it,” she said, standing forward anxiously at the window. She made no pretense at small talk. “What’s going on?”
“Abrams has evacuated the blood,” Archer said, keeping it fully technical. The last thing he needed was an overly emotional response from Goodwin to top this mess off. She was better than most, but she had a soft spot when her staff members were in trouble. It was a fine line to walk between appropriate concern and sentimentality. Archer was banking on her keeping it. “He’s started working on the bleeder now.”
A frown deepened on her face as she continued to watch. “And his condition?”
“He’s tolerating the surgery so far,” Archer said. “And we did get him in here quickly.”
“But his contraindications?” she asked, falling back into the mode of charge nurse she’d left behind years ago. “What are the risks for damage?”
Archer shrugged, not sure he was willing to commit an answer to that. “It’s impossible to say,” he said. “His GCS was low, and he suffered from a seizure, but I think we were able to minimize hypoxia. His oxygenation levels have been good, so there’s reason to think that if the pressure was relieved quickly enough -- and if Abrams is half as good as he says he is with the bleeder -- there could be a chance of significant recovery.”
That was an apt medical analysis, but they both knew what it meant. At this point, it was a bit of a crapshoot. Even if everything else went right -- and everything else would have to go right -- Halstead’s chances for a full recovery were no guarantee.
She continued to watch for a moment, engrossed in silence while Abrams completed another series of intricate moves in the procedure. Despite the stakes at hand, the scene was a little placid. It made the inherent sense of urgency seem somewhat surreal.
“What happened exactly?” she asked, almost sounding reluctant. She spared Archer a glance, hesitant and calculating. This wasn’t a casual bit of chitchat here. She wet her lips, gaze just slightly keen. “I heard there was a fight between the two of you.”
Of course she’d heard this. Because gossip spread like wildfire in this hospital, and there was absolutely no sense of professional courtesy. Archer tried not to show just how pissed off he was at this, working his jaw to minimize his frustration. The last thing he needed was to look angry when Halstead’s life was in such a precarious position. He had to keep his focus. If Halstead died, this whole thing would fall apart.
“Uh, there was,” Archer said, invoking enough regret to make him sound plausible. He drew a breath and sighed, forcing a weak smile at Ms. Goodwin. “I’m afraid Dr. Halstead and I don’t always see eye to eye.”
This didn’t seem to surprise her, but there was a flash of pain across her face. She looked from Archer back to the operation. She looked not quite disappointed -- but sad. There was regret. “He’s always been somewhat brash. Deeply impulsive,” she mused. “But I’ve never known him to take a swing at someone before.”
She paused, drawing a long, slow breath as she shook her head.
Archer braced himself for the worst of the questions, when his role was brought to the foreground.
“And yet, I can’t say that it surprises me,” she continued. “Obviously, as our head of the ED, you should not be returning physical punches, but I do understand how things can escalate.”
He looked at her, suddenly dumbstruck.
For the first time all day, he was floored.
See, in that second, Archer realized something brilliant. This might not fall apart. In fact, in creating the worst problem ever, Archer had also created the easiest out.
See, Goodwin wasn’t looking at him as the instigator. In her mind, Halstead was already at fault, and with Halstead unconscious, there was no one to contradict him.
And Halstead had made it too easy. By pitting himself against Archer, he’d created the natural tension. And with his extremely questionable decisions as of late, he was going to be the easy fall man.
He had a pang of guilt about that. Halstead hadn’t fallen as much as he’d been suckerpunched.
But Dean Archer was a survivor.
First and foremost, when put in a dire situation, he found his own way out, no matter what.
The thought froze him to his spot, and he wondered if he could do this. If he could throw Halstead under the proverbial bus -- after literally punching him under the knife. Part of him rebelled at the thought -- he wasn’t a monster, after all -- but he was running out of options and he was running out of time.
Halstead had both options and time right now.
Archer exhaled and nodded his head. “Things have been unusually tense lately,” he said, and the admission was a careful version of the truth. There was no lie involved, and it wasn’t his fault if Goodwin took it as an affirmation of her assumptions.
If anything, that was Halstead’s fault. He was the one who had formed those assumptions.
Goodwin sighed, drawing her lips together sadly. “I can’t help but feeling sorry, but I don’t think there’s much I can do. If he survives this, my hands will be tied. The timing is just sensitive,” she said, clearly distressed at the notion. “With the amount of recovery he has ahead, and quality of life questions, I don’t want to talk about firing him yet. I want to be sure we can support him through the recovery as much as we are able, but there’s no way I can keep him as an attending in this hospital after violating his probation like this.”
For a moment, Archer could merely stare at her while he made sense of what she was saying exactly. He’d been open to accepting the defense she was offering him, but he’d never really considered the full context. The implications. That he would be exempt for punishment, and that Halstead would carry the blame.
That, if Halstead survived, he might be fired for a fight he didn’t start.
Archer fancied himself a survivor: no matter what.
No matter what, though?
Really?
Did that have any limitations?
Like lying about the order of operations when Halstead had no way to defend himself? Could he put the blame on Halstead and hope he died before he had the chance to refute it? Would he maintain the misconception if Halstead’s brain was mush when this came out? Suddenly, the best case scenario wasn’t saving Halstead. Suddenly, the easiest way out was letting Halstead die.
But Archer was still a doctor.
Halstead was still his patient.
If Halstead died, it would salvage Archer’s career, but Archer wasn’t sure he wanted to know the cost. He wasn’t sure how much of his soul he had left, honestly, and he wasn’t ready to forfeit it on account of Halstead’s pathetic life.
“This is premature for me to discuss -- I’m so sorry, Dr. Archer,” she said, turning toward him with sudden concern. “My intention here is not to make you feel guilty. You have no reason to blame yourself for what happened. Whatever the repercussions Dr. Halstead will face, I want to focus on getting him through this first. Will you please keep me updated on his progress?”
He mustered up a smile, perfunctory and professional. “Of course, Ms. Goodwin,” he said. And, for good measure, he added, “Thank you for your support.”
She smiled at him, but it was small and sad. Her gaze lingered back on Halstead for another second before she shook her head and left the gallery.
Save a life.
Save himself.
Archer closed his eyes, clenching his fingers into fists as he tried to remember how to breathe.
Easy outs.
He opened his eyes again, looking back at the surgery beyond this glass.
It turned out they weren’t so easy after all.
-o-
The problem with neurosurgery was that it just took too long. The brain was too delicate, the anatomy was too complex. Even simple fixes took hours to navigate, and the margin for error was slim to nonexistent. Honestly, Archer probably had the technical skill to pull it off, but he found it too tedious.
And neurosurgeons were generally assholes.
Standing there, his legs started to ache, and he could feel the muscles threatening to spasm in his back. His head was starting to pound -- dehydration, maybe, stress, definitely -- and he was feeling his hold on self control stretch to its breaking point.
Yet, he couldn’t leave.
How was he supposed to leave.
Halstead’s brain was open -- and that was Archer’s fault. The brain matter that had already died -- that was Archer’s fist.
The idea of absolution from Goodwin -- it was appealing.
But how could he even pretend?
Letting Halstead died was easier in one sense, but he didn’t need to be haunted by some idiot redhead ghost after everything else. No, he had to get Halstead through this -- and then he had to disprove his credibility the real way. He wanted to fire Halstead, not kill him.
There was a difference there.
A difference that mattered.
Archer wasn’t the bad guy here.
He wasn’t.
He wasn’t going to be the villain of this story. He was saving this hospital. He was saving himself. At this point, he was saving Halstead, too.
He was the hero of this story.
He just had to aim his punches better. He had to craft the narrative. He had to direct the treatment. This time, he would land the punch right. This time, the knockout blow would have the desired effect. He could control this narrative. He could will this into the outcome he wanted. He was still in control here. He was.
Halstead would live.
Archer would prove he was right.
It would all work out.
Archer rocked on his heels, shaking out the tension in his legs. From his vantage point, he watched Abrams ease carefully through the brain matter, checking the area for possible leaks or bleeders. One of the nurses leaned over to provide suction, and Archer could hear the anesthesiologist over the intercom, reporting Halstead’s vitals.
He was stable, at least. For invasive emergency brain surgery, Halstead seemed to be tolerating it okay. That didn’t guarantee that he wasn’t a turnip already, but at least it meant he wasn’t dead yet.
Small victories, Archer decided.
Even the small ones when you had to cheer for someone you couldn’t stand to live.
He allowed himself to be engrossed in Abrams’ progress, tracking the movements with the best of his knowledge. It was a mere illusion of control he was working with now, but if this went south he wanted to know.
He needed to know.
This time, when the door opened, he heard it at least. He looked back, inwardly holding in a groan. It was Dr. Charles. Their unhelpful psychiatrist who thought he knew everything. Doctors tended to be smug bastards -- that much Archer could accept -- but shrinks just had theory and touchy-feely nonsense to fallback on. It made their smugness lack justification.
And Dr. Charles was worse than most.
Archer found he disliked a lot of people in the ED, but Dr. Charles was the only one he actively did not trust. You couldn’t trust a shrink. They were always listening to what you weren’t saying, and they sure as hell would use it against you.
It was marginally mollifying that Dr. Charles seemed more concerned with Halstead at the moment.
That at least meant he was fixating on Archer for once.
“I heard people start to talk, but I didn’t want to believe it,” he said, coming up close to the glass. His eyes were wide with concern, face drawn in shock. “And I didn’t think it could really be this bad.”
That was a stupid thing to say, given that they were watching brain surgery right now.
Archer, though, wisely kept any sarcastic comeback to himself.
“How long ago did this happen?” he asked. “I mean, I didn’t even know about it, that anything had happened -- much less that he was in surgery.”
Hurried and flustered, people kept blustering in like this was some kind of sideshow or that Archer should have announced it immediately. Goodwin and Charles were the two biggest names that had stopped by, but there had been others. Attendings, residents, students, nurses, techs -- hell, the whole damn hospital seemed to have gotten the memo.
These people had no appreciation for patient privacy. Archer found the legalities tedious as well, but he saw their merit in times like these.
“Well, we’ve been kind of busy,” he said, and he was aware that his attempt to find the moral high ground here was tenuous at best. Still, all this pearl clutching was more than he could tolerate. “I didn’t think stopping to make an announcement would be the right choice.”
Dr. Charles remained steadfastly concerned. “Of course,” he said obligingly. “But what happened?”
Stupid questions. And this was one of the most tenured doctors on staff.
Archer nodded to the operation in front of him, which made for an obvious tableau. “Brain hemorrhage,” he said simply. “Abrams is chasing the bleeders.”
There was more to it than that, but the idea of talking it through was exhausting -- and that was assuming that Archer remembered enough of his neurology rotation to do it justice. In the army, he’d operated under a simpler set of precepts. Brain injuries were a big no-no, and you had to transfer those patients as quickly as you could. To the neurosurgeon ideally, but the morgue was usually the second choice.
Dr. Charles looked increasingly distressed. “No, I mean how.”
In truth, Archer had probably known that was what the question was really about. Maybe he chose willful naivete. Maybe he just wanted to piss the guy off.
Or maybe it was just that question.
It was so damn reductive, so impossible.
Archer had to grit his teeth, and he curled his toes in some strained attempt to hold his temper. He didn’t have the luxury of putting Dr. Charles off like he had so many others. “A fight,” he said, keeping his answer clipped. He rocked back on his heels and watched the surgery with purpose. “It got out of control.”
The answer was honest and to the point. So, it was probably no surprise that it wasn’t enough for good old Dr. Charles.
“You and him?” he asked, as if he hadn’t heard this all through the grapevine already.
Archer dug deep, finding the vestiges of self control. “Yes,” he said. Unflinching. Unwavering.
And still. The man had questions.
Always with the questions. “A physical fight?”
There was definitive proof, then, that there were, indeed, stupid questions. It was getting harder to keep his temper in check, and it really wasn’t his fault this time. “Seems so.”
Dr. Charles looked back to the surgery taking place, almost as if the answer vexed him. “That doesn’t make sense, though,” he said, as though this was some kind of revelation. “I’ve never known Will to be violent. He has some issues with impulse control, and he’s far too likely to take a stance without being open to outside criticism, but never violence.”
This was probably meant to be some valid analysis, mostly because Dr. Charles, the psychiatry god, had spoken it. “Well, you know, he’s been under a lot of stress,” Archer said flatly.
Archer wasn’t trying to be openly combative, but he also wasn’t making much effort to be conversational. You’d think a shrink would pick up on the cues that Archer didn’t want to talk right now, but either Dr. Charles was incompetent -- a likely conclusion -- or he was purposefully rude -- a foregone conclusion. Either way, he was going to subject Archer to this conversation whether he liked it or not.
And telling him to piss off right now probably wouldn't go over well. Dr. Charles wasn’t his boss, but he was good friends with Goodwin, so that didn’t seem like a risk he should probably be taking at the moment.
“I guess,” Dr. Charles said, wholly noncommittal in his commentary. “But even so. We all deal with stress, and he’s never manifested control issues in any kind of physical way.”
“Sure, but he has a history of reckless behavior,” Archer said. He gave the shrink a cursory look, because he at least knew enough to make this point. It was easier to crap your way through psychiatry than neurosurgery, as psychiatry was borderline quack medicine anyway. “I’ve read the literature. There are plenty of examples of PTSD manifesting in unusual ways when under duress. And, I mean, Dr. Halstead has been under a lot of stress lately. Maybe he just snapped.”
Dr. Charles hummed for a second. “I am curious, though,” he continued, even though no one had asked him a direct question. “What exactly were you two fighting about?”
The bastard suspected. Without any background or knowledge of anything, Dr. Charles was inclined to take Dr. Halstead’s side -- and it made him a biased source. It made Archer want to dismiss him outright, but he couldn’t dare to be so bold -- not yet. He was still technically an interim chief. This psychiatrist had the medical know-how of the Pillsbury Doughboy, but he was also Ms. Goodwin’s longtime friend. Archer had to play the game a little bit or it would tip the man off -- and Archer didn’t dare lose Goodwin’s favor now, when it mattered most.
Therefore, Archer shrugged, a diplomatically vague gesture. “Well, I don’t know the guy well, but it’s no mystery that Halstead’s been unhappy lately.”
“Well, I’m not sure about that,” Dr. Charles said, sounding thoughtful. “I’ve been talking to Will on a regular basis, and he’s seemed very eager to get back to normal.”
“Easier said than done,” Archer said shortly, rocking back on his heels. “I mean, he was fired -- he basically tanked his career. It makes sense to me that he’d be a little, you know, stressed.”
“But that’s the thing. It just doesn’t make a lot of sense,” Dr. Charles continued. For a soft, old guy, he could be like a dog with a bone. “I mean, for him to get so upset about something that he’s picking a fight. It would have to be a case or a patient or something.”
Archer sighed, letting his breath catch. It threatened to give him away or break his composure, but he reeled it in just enough. “And why’s that?”
Dr. Charles looked at him like he was surprised by the question. “Because that’s what Will is passionate about,” he said. “Yes, he can be brash and abrasive, but it’s never unless he feels like he’s doing something to save a patient. Every other instance he’s gotten himself into trouble, his desire to help people has always been at the core of it. He cares too much sometimes, and he doesn’t always know how to scale back his need to help. I’ve known Will a long time, and I feel quite safe in that assessment.”
The irony was that Goodwin was an easy sell. He wasn’t sure how he’d won her over so easily, but he had. As his boss, she was the critical ally that he needed -- and she would provide a lot of protection from other doubts and inquiries.
But Dr. Charles was a tricky bastard. He never took an answer completely at face value, even when he pretended like he did. Sure, he liked to acknowledge what people said -- even while he was undermining their entire thought process at the same time. There was no good reason to trust a shrink. Diagnosing a body was clear-cut and dry. Diagnosing a mind? Archer didn’t see the point.
The mind was shot. It played tricks on you. It was the most unreliable narrator around. A good cop knew that, and Archer had spent too many years in a war zone to pretend otherwise.
Ethan had always seemed to mean well, and everyone thought Dr. Charles was some stand up guy, but it didn’t matter. Dr. Charles was just like everyone else in the world, pitching his ulterior motives. And Archer had too much other stuff going on today to play nice.
“Look, I don’t know what set him off,” he said, just barely keeping his tone in check. He flitted his hands through the air. “We were talking one second, and the next -- who knows. He was off -- and the next thing I knew, he was on the ground. You’ll have to ask him about it.”
Dr. Charles nodded again, which was even more frustrating than before. Then, in a turn Archer should have seen coming, the psychiatrist fixed his gaze on him anew. “It sounds like a pretty stressful turn of events -- for both of you,” he said. It was impossible to tell with Dr. Charles what was sincere and what wasn’t. Archer’s suspicions were confirmed when he followed up with another question, “And how are you doing?”
Those were the kind of questions that psychiatrists asked. Dr. Charles could pretend to care all day long, but that kind of thing gave him away. The only reason to ask how someone was doing was if you suspected they weren’t doing well.
Archer wasn’t about to be psychoanalyzed by a glorified counselor who enjoyed far too much unearned seniority in the ED -- Archer’s ED, for that matter. He pressed his lips flat and glared back at the man. “Well, honestly, I’ve been better.”
Nonplussed, Dr. Charles made a noise of affirmation. “I’m sure,” he said. Then, with all the audacity in the world, he rocked back on his heels. “Do you want to talk about it? After these kinds of traumatic events, it can be hard to process everything on your own.”
Archer managed to not roll his eyes -- but only just. He forced a smile at the other man, but there was no way to hide his utter contempt. “You know, I think I just want to be left alone, thank you,” he said. “I’m sure when Dr. Halstead wakes up, though, you can talk to him to your heart’s content. There’s your sob story, right there. Will Halstead and his epic fall from grace. And look at him now.”
They both looked, through the glass to the operating room. Abrams had shifted position, using a magnifying tool to get a closer look at the vessels in the brain, exposed in the craniotomy. For a moment, they were silent, watching as the neurosurgeon continued his intricate work.
“Yes,” Dr. Charles intoned quietly. “I’m sure Will is going to need plenty of support. Head injuries like this -- are pretty intense. What did you say his prognosis was?”
“Better with immediate surgery,” Archer said, snapping the words this time. “Better with quick intervention. From me.”
He enunciated the words as clearly and plainly as possible.
Dr. Charles remained unimpressed. He glanced back to Will, then to Archer once more. “From you,” he repeated, and he nodded thoughtfully. “You’ll let everyone know, then? When he’s out of surgery?”
Archer kept himself turned toward the theater, crossing his arms over chest. “Of course,” he said, refusing to make eye contact again. “He’s a part of my ED staff, right? My responsibility.”
“Responsibility is important,” Dr. Charles agreed, starting to the door. “Very important.”
Archer didn’t give him the satisfaction of a second look, and he was still braced, holding his breath, when the door shut behind the psychiatrist and he was plunged back into silence. He shook his head, working his jaw.
“Just don’t screw this up, Halstead,” he muttered. “For both our sakes, do not screw this up.”
-o-
Just when Archer was sure he’d entertained, comforted and ultimately turned away every member of the hospital staff, the door to the gallery opened again. He was about to tell this person off as well, but when he turned around it was Maggie.
She was with someone he didn’t recognize.
Someone who looked suspiciously Irish.
And that was how Archer learned that Will Halstead was actually the more reasonable brother.
Yes, that was the truth.
Irony at its absolute finest.
Archer had not been openly provocative, but he ended up with a punch to the face anyway. Which, to be fair, he probably deserved -- and, more helpfully, would probably help sell the story that none of this was Archer’s fault.
The punch smarted a little, but it solidified Archer’s choice in his gut. He wasn’t wrong here. He wasn’t a bad guy for letting this play out. In some ways, it justified everything. Halstead had had this coming.
Well, not this, but the punch had been unlucky.
That was all.
Bad luck.
He’d comforted himself with that notion, still nursing his throbbing jaw, when Maggie came bustling back in. She looked perturbed, somehow. And she seemed to be perturbed with him.
“Okay, out,” she said.
She was direct and to the point, he would give her that.
She was also entirely out of line. Archer didn’t budge an inch. “I’m the one who just got assaulted.”
She wasn’t buying it, and she beckoned him to the door again. “Seriously, out. Now.”
“No,” Archer said firmly. “Halstead is my patient. I’m going to stay right where I am until I’m confident in the quality of his care.”
Maggie had always been deferential on the job, having a clear understanding of the ED pecking order, but she was soft on Halstead. She was going to paint this as a patient’s rights issue, which was inane in the best of times. Now, the idea of kicking him off the case when it was his quick thinking that had given Halstead any chance was laughable.
His role in the injury notwithstanding.
This was his case.
Halstead was his responsibility.
Archer was an asshole but he always got results.
Yet somehow, this was the hill Maggie was choosing to die on. “Jay wants you off the case,” she said, just as firm as before.
Archer made a face, giving an off handed shrug. “And he’s, what, a cop? He knows nothing about continuity of care. His opinion is, frankly, irrelevant.”
“He’s Will’s medical proxy,” Maggie said with a little indignant scoff.
People put way too much weight on crap like that, and it bogged down the medical system and limited the effective care patients received. It was really mind boggling that no one else saw it but him.
As it was, this day had been way too long. He rolled his eyes. “Oh, please.”
His indifference only seemed to stoke Maggie’s ire. “You know how policy is on this kind of thing. I respect Jay’s call -- because I know Will would respect Jay to make it. I will go to Goodwin on this one if I have to.”
There was some kind of threat there, but it was silly. Not that he didn’t think Maggie would do it, but because the whole thing was pointless. Goodwin was on his side here, and even if she toed the line, he had a pretty strong feeling where her sympathies would be.
She would want the best treatment for Will.
And she was smart enough to see that Archer had provided that treatment -- while everyone else flailed and clutched their pearls at the thought of Halstead being braindead. He was the problem solver. Everyone else just made problems worse.
Including Maggie and her medical proxy policy nonsense.
At least he had nothing to prove here, and he wasn’t going to tread lightly with Maggie. “So you’re going to coddle them? With this much on the line?”
He made a gesture back to the operating room. The scene could not be ignored, and with Halstead’s brain still exposed, Archer knew he had a point -- and a good one at that.
Maggie drew her mouth into a sober line. He could shame her, but it wasn’t going to be nearly as effective as he wanted it to be. “I’m going to do what’s best for the patient,” she said, as if they could separate that out from the red headed doctor under sedation in the next room.
It wasn’t just her over-reliance on policy. It wasn’t even that she was using it to cover up how emotionally compromised she was right now. It was her holier-than-thou attitude. As though she had some moral high ground that made her uniquely qualified to make these calls.
Archer’s calls had given Halstead a fighting chance.
Archer’s -- and no one else’s.
“No, you’re doing what feels best,” he said, lip curling somewhat. He shook his head, feeling disgusted. “I’m Halstead’s doctor.”
She really was too far gone. “Not anymore,” she said, with a cold look in her eyes. “You want to object, bring it up with Goodwin.”
With that, she stalked off. He wanted to stay, if only to put her in her place, but additional scrutiny was probably not what he needed right now. He still wasn’t sure how he’d gotten this situation to turn in his favor, but he needed to maintain that edge as much as he needed to keep Halstead alive. They didn’t have to be contradictory goals, not if Archer played this out the right way.
He would have preferred to do it playing point.
But he’d done the hard part. With Abrams on board, Halstead’s brain would at least have some chance of viability. Archer could monitor things from a more reserved position.
Sometimes it wasn’t a question of following the rules.
Sometimes it was just a question of breaking the rules in a way that didn’t get you caught.
Archer was pretty good at that. Halstead needed to work on it, though.
Hence why Archer was the ED chief and Halstead was on probation.
It still miffed him to leave, but he spared the surgery one more glance. Abrams was hard at work, and Halstead appeared stable. It wasn’t much, probably, but Archer had been through too much crap in his life. Sometimes -- most of the time -- you just had to take what you could get. That was how he’d ended up at Med in the first place.
And look how well that had turned out.
-o-
Archer left the gallery, but he didn’t go far. Halstead’s brother was a cop, which he might have thought made him impressive, but he didn’t know the ins and outs of the hospital. Maggie would have her hands full with him as it was -- clearly, the guy was not coping particularly well -- which meant that Archer had to go -- but he didn’t have to go far.
In fact, all he had to do was navigate over to the other side of the OR department. It didn’t give him a clear view of the procedure, sure, but this hallway was used to transport patients in and out. While the brother fretted about the gallery and the waiting room, Archer could keep himself right in the line of action, technically satisfying Maggie’s ridiculous mandates and his own need to see this through.
Of course, waiting here afforded him less to do. Not that he’d had anything to actually do while in the gallery, but tracking the course of the surgery had least been preoccupying. Standing in the hallway afforded him no such luxury. Here, he was forced to keep his own company.
And that had never been something Archer enjoyed.
It was funny to think about it, sometimes. The army had given him discipline and mettle. It had tested him under pressure and shown just how capable he was. He had honed himself into making the hard calls, and he’d become the doctor that as needed -- not always the one patients wanted. He got results, though.
That had always been the thing.
He got results.
Patients who had him as a doctor lived.
Even when they were too stupid to know what they wanted.
They lived.
Survival was the thing, after all. That was the crux of it. You couldn’t guarantee happiness or success. You couldn’t give them meaning or purpose. But you could get them back out there with a beating heart and a second chance.
Medicine these days had it all backward. It had become too evolved for its own good. They had all strayed from their foundation mission: save the life.
You always saved the life.
Even when they were too stupid to want it.
Even when you were the one who had hurt them in the first place.
There was no other way to measure success. There was no other way to structure his life.
All Archer could do was save the life.
