Chapter Text
Shift 0. Thursday, 08:22pm
"Have you heard?"
Iván, as usual, does not get straight to the point after Marek shakes his head. Instead, he goes on a long winded explanation that starts somewhere in the nineties (something about health insurance and the amount of doctors to cover all patients) and ends with personnel shortage.
"So this new administrative system," Iván says without moving an inch to help Marek disinfect the stretcher, "basically spit out a number of doctors and nurses the hospital needs to be covered. And surprise, the numbers are down to like, seventy or eighty percent."
Marek gives him an unimpressed stare. "I could have told you that without a fancy new IT toy."
"Uh-huh. Not the point," Iván waves disnissively. "The ER's got two new residents and like, six nurses."
"Two residents?" Marek pauses. He's slightly out of breath after scrubbing the stretcher clean from blood splatter and checking up on the medication they carry on the ambulance. His shift is about to end - in eight minutes, to be exact - and if they aren't alerted until then, he might actually make it home on time for once.
"Yup," Iván says. "James MacCormack from anesthesiology. And a new guy."
"Truly groundbreaking. New residents and nurses in a hospital."
"You're no fun," Iván huffs. "Hello? Hospital gossip? The only way to stay sane around here?"
Marek rolls his eyes and tosses his gloves into the trash bin next to the ambulance. "Work relationships are nothing but trouble. You should know that."
"Trouble?" Iván nudges his shoulder painfully. "We're great. Me and Martin. Perfect. Couldn't be better."
Marek is about to reply when the phone clipped to his belt beeps, and he knows they're not going home on time tonight.
"What do we have?" Iván asks. As annoyingly chipper as he can be, when it's time to get serious, he is. Marek could - and would probably trust him with his life in a crisis.
"Altered mental status," Marek mutters, glancing at the phone, "male, forty-five, neighbors made the call because he's wandering through the area. Come on."
"Bet he's drunk," Iván says and climbs into the ambulance. Marek slams shut the door and types the address into their navigation.
"Can you give me that redbull?" He motions towards the driver's seat. Iván reaches for the drink and hands it over.
"Sirens?"
Marek checks the tablet clipped to the dashboard. "Nope. It's only ten minutes away."
And his shift is over. Great.
"Do you know that I already have sixteen hours of overtime this month?" Marek groans and resists the urge to bash his head against their tablet. Instead he downs his can of redbull and slips on a new pair of single use blue gloves.
"Maybe you should take a day off?" Iván taps the steering wheel and shakes his head, "oh, wait. You don't have a life outside of work."
"That's not true," Marek says. "I go to the gym. And stuff." Okay, maybe Iván isn't wrong, if he's already blanking on other activities.
"You go to work or to the club. Which is like, fine," Iván continues, "for somebody who just turned 18."
"Fuck off. Unless you want to become hospital gossip."
"How would I ever become -"
"People have seen you hanging around that cute little exchange student from Korea. They're talking," Marek says. "About you and him. If things are okay with your lovely boyfriend."
"La puta que te -" Iván slams the breaks at a red light. "They think I'm cheating on my long-term partner because I'm friendly with an exchange student?"
"Can you be friendly without putting your hand on his waist?"
Iván's death glare is enough to shut Marek up.
He pulls into a small neighborhood. Neat family houses, well-kept gardens and fences around each property.
"I could afford one of those in approximately two hundred years of full time work," Iván says. "Do you see anybody?"
Marek squints. The sun is starting to set beyond the horizon, but nobody is waving them down outside. "Nope... Oh, wait. A guy next to the fence. On your left."
"Alone?" Marek nods and Iván scoffs.
"Neighborly love ended after the call, huh?"
"Guess so. Pull into that driveway," Marek points ahead.
"Bet we'll get a complaint about that, too."
"Yeah. Well, not my problem."
The second the ambulance stops, Marek opens the door. He grabs their jump bag, shoulders it and heads across the street.
The man is holding onto a stone pillar with a particularly ugly angel atop and makes a sound of acknowledgement when Marek approaches him.
"Hello," Marek says, "I'm Marek Brazda with emergency services. Your neighbors alerted us. They were worried you weren't feeling well."
He sets down the jump bag and offers the man an arm. "We are going to walk over to the ambulance together, okay?"
The man just stares at him. Definitely disoriented, Marek thinks, although he can't smell any alcohol. His silver hair is kempt, he's wearing a dark suit and carrying a briefcase. He fits the neighborhood. Wealthy. Upper class.
He's wobbly on his feet, needs both Iván's and Marek's help to make it to the ambulance and onto the stretcher.
"Okay, get me a blood glucose real quick," Marek says. If the man is diabetic, he might be low on sugar. That could explain the disorientation. "What's your name, Sir?"
The man stares at him. "Dylan."
The response is delayed.
"Very good. Airway free." Marek clips the pulse oximeter to the man's finger. "Oxygen is good. Do you know why we're here, sir?"
"Neighbors... Yeah."
"Glucose is normal," Iván murmurs. "Doesn't appear to be intoxicated. Pupils uneven and sluggish to react."
"Dylan, do you take any medication?" Marek asks. Their patient lifts one shoulder. "Any blood thinners?"
The man shrugs again.
"Heart rate is 102, BP 140 over 100," Iván says and Marek nods. That's high. Not a hypertensive emergency, though.
"Sir, look at me," Marek says. "Can you smile?"
Dylan frowns and smiles. More or less.
"Close your eyes. Sir, close your eyes please. Good." Marek gives Iván a small nod, "lift your arms and keep them up."
They both watch while Dylan's left arm drifts down after a few seconds.
Fuck.
"I'll finish the assessment. Go call the hospital," Marek orders. Iván nods wordlessly.
"Alright, Dylan. We're taking you to hospital now. You're gonna meet a lot of new people, but they're all trying to help you."
The rest of the assessment is mostly formality. Luckily, rush hour is over by the time Iván pulls out of the driveway. The sirens cut through the near empty streets and they turn corners with screeching tires. With practiced ease Iván parks outside the ER, right behind a second ambulance with blinking blue lights.
When they wheel the stretcher into the emergency department, it's backed out into the hallway. There's a line at the reception desk, a line out the triage room and even a line at the goddamn women's bathroom. Marek glances at the display mounted above the open winged doors. Every single room is either occupied, or without a medical bed. The waiting room doesn't look any better. People are sitting on the floor, standing in groups with or have curled up on the ground.
"Both trauma bays are occupied," Iván whispers and flags down a nurse for help. Marek furrows his brows. "Let's bring him straight upstairs to the stroke unit. Time is -"
"Brain matter, yeah, yeah. Let's go." Marek unclips the break on the bottom of the stretcher and starts pushing their patient towards the elevator. He's young. Not even fifty. He looks healthy, too, in shape, like he moves his body. He strikes Marek a health freak. Somebody who eats clean and barely drinks and doesn't smoke and counts the coffee cups he's allowed a day. And he's had a stroke. It's not fair, and Marek can't dwell on it. He has to stay moving. Always stay moving. Don't process. He'd go insane, if he tried to actually let the feelings in. If he allowed himself to think - to really think about what he sees everyday.
They don't get far before a man in scrubs interrupts them by blocking their path. Marek barely stops the stretcher before they run him over.
"And where do you think you're going?" The doctor says sharply.
Marek doesn't recognize him. He's about his height, slender, with dark curls, glasses and washed out blue eyes. That must be the new resident Iván had told him about. Marek decides right then and there he definitely doesn't like him. Arrogant bastard, that one.
"Stroke unit," he says. "Can we get by?"
"Are you a doctor, Mr. Brazda?" The resident asks. He speaks good English, with a distinctly familiar accent. Eastern European. Marek narrows his eyes, but he's too far away to read the name on his badge.
"No. But -"
"So you thought protocols don't apply to you? And your patient doesn't need to be assessed by a professional?"
Okay, wow. Things are tense between doctors and the rest of the staff at times, but most doctors pretend to respect first responders and nurses, at least.
"I am a professional," Marek snaps back. "Every FAST sign was positive. And both trauma bays are occupied. You think I can't do a stroke assessment?"
"If you were capable of making diagnoses in the field my job would be obsolete. Instead I'm left picking up behind you doctor wannabes. Trauma bay one. Now."
"Of course, doctor." Marek smiles with gritted teeth, because he doesn't want to be out of a job tomorrow morning, and rolls the patient into the trauma bay.
Who the hell does that guy think he is? First night in charge of an ER and it's gone straight to his ego? Well, the young female nurses may nod and smile, but not Marek. He'll be damned before he lets a resident undermine his experience just because he's a paramedic and not a doctor. What is he gonna do, fire him? He has no jurisdiction over first responders. They don't even work for the hospital.
"I've worked with other residents like you," Marek murmurs when he passes the man. He smells of freakishly expensive aftershave. "Cocky. Arrogant. Right up until they kill a patient because they can't ask for goddamn help."
"You should really learn to keep your tongue in check," the doctor whispers back, "if you don't want me to dig up other regulations you conveniently decide to ignore."
"Let's move the patient," he says, raising his voice above the constant beeping and chatter.
Now that he's closer, Marek can decipher the letters on his badge.
Med. Dr. T. Kněžínek.
Obviously Med. Dr. T. Kněžínek doesn't move a finger to actually help them, so Marek takes the patient's legs, a nurse holds his head and shoulders steady and Iván lifts his waist onto the hospital bed.
Iván gives him a look and Marek shakes his head subtly. Let Iván do the handover. He'll probably get through it without backhandedly (or directly) insulting Kněžínek.
"His name is Dylan Falco, aged forty five. Neighbors called emergency service because he was staggering and appeared disoriented and intoxicated, which they claim is highly unusual. GCS 13, BP 140 over 100, tachy in the 100s. O2 sat at 95 percent, BGA within range, temp 36.5. Dispatch told me the neighbors said he lives alone, they don't know about any family or close friends. No known medications, I couldn't find any in his laptop bag. Presented with extreme disorientation, ataxia, pupils uneven and sluggish to react, positive for the FAST test."
Somehow, Iván manages to say all of that without breathing more than once. It's actually impressive.
"Okay," Kněžinek says and turns to a nurse. "Get him into CT."
Well, waiting for a thank you, have a nice day had been wishful thinking.
Marek turns on his heel and leaves Iván to wheel out their stretcher.
"You just know how to leave a lasting impression," Iván remarks after they've left the ER.
"He won't even last a month." Marek tosses his gloves into a trash bin and follows Iván out of the ER. "Once Eefje has a shift with him. She will eat him alive."
Dusk has turned night, it's crisp and cool outside. Summer is definitely over, with leaves turning red and nights becoming colder. Marek draws in a deep breath of fresh air that's infinitely better than inside a stuffy waiting room. The taste of disinfectant lingers longer, Marek isn't sure he can ever wash it off. He stretches until his joints crack, a painful reminder his early twenties are over and he's slowly but surely inching towards thirty.
Iván laughs. "Five minutes before you offended somebody is a new low. Even for you."
"Even for me?" Marek says indignantly. He reaches into his pocket for the key to his locker. He grabs his backpack from the break room and lights a cigarette, blows a ring of smoke into the night sky.
Iván crosses his arms in front of his chest.
"What?" Marek inhales deeply. "Are you seriously gonna give me the nicotine lecture?"
"Nothing you've not heard." Iván holds out a hand, "I'm giving you the it's rude not to share with coworkers lecture."
Marek snickers and tosses Iván the package and his lighter. "Help yourself."
"Thanks."
Marek acknowledges Iván with a hum. They stare into the cloudy sky for a few minutes, before Iván yawns and snuffs out his cigarette.
"I think I'll head home now. You coming?"
Marek looks back. The lettering of the emergency room glows in the distance, red, bright. Somebody's sitting outside, phone pressed to their ear.
"Yeah. Yeah, I'll be right there."