Archive of Our Own ^beta

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."

Chapter Text

Shift 1. Saturday, 7:43 am.

Marek hates useless calls. Mostly people who call emergency services for nothing, because they decide they have to see a doctor about their week-old back pain at two in the morning. Low grade unmedicated fevers are a close second in his personal least-favorite-tierlist.

The thing he hates more than anything? That would be working with kids.

It's tragic if something bad happens, hauntingly tragic, but mostly Marek just hates kids. Sick kids, especially.

Come on - that doesn't make him unequipped for the job, he just has a least favorite demographic.

And for good reason.

Currently, they're chasing down a kid through his classroom until he's backed into a corner.

He holds out a ruler as if it were a sword and shouts at the top of his lungs: "I'm not coming with you! I'm calling the police!"

"Yeah, let's," Marek mutters. Psychiatric emergencies aren't rare, but with kids, it's even more precarious. They can barely touch them without a court order, much less give medication.

"Hey, come on, have you ever been in an ambulance? It's really cool," Hyli tries.

"No way that works," Marek pants, "come on, let's just grab him. We don't have all day. And he can't stay here if he keeps threatening to kill himself."

The boy, predictably, kicks a chair in response. It clatters to the ground and Marek can see the principle wince from the corner of his eyes. "Not coming! You just want to drug me!"

"Alright, let's go. You grab his legs, I've got his arms," Marek says. The two teachers and headmaster who, in their desperation, had called paramedics, stand back instead of helping. Figures.

Cautiously, Marek steps around a table. Hyli rounds the other side so they can pinch him and make an escape nearly impossible. After a silent nod, they both reach for the boy. He kicks Hyli's shin, screams and bites and scratches, but their uniforms protect them from actual harm. Well, until the boy sinks his teeth into Marek's hand and bites straight through his glove.

"Ow! Dammit!" Marek curses. He finally manages to grab ahold of the boy's wrist and wrestles him out of the corner with Hyli's help. He twists and writhes like a snake, trying to escape their unrelenting grip or at the very least sink his teeth into Marek's skin again. This time, he's more cautious; they carry the kid onto the stretcher. While Hyli holds him down, Marek calls the on-duty emergency doctor to meet them on-route.

"Hey, kid, can I let you go?" Hyli murmurs. "We don't want you to get hurt, you know?" The boy nods, and he doesn't try to kick Hyli when he releases him onto the stretcher. Hyli has always had a way with kids - hell, he has a way with all patients. While Marek doesn't consider his bedside manner to be atrocious (after all, as a paramedic, his job involves communicating with patients all day), he thrives in a crisis. The more pressure he's under, the calmer he is. He's not bothered by vomit, feces, blood, guts, bones, brain matter - he doesn't tend to dwell on past cases, either. That'd just make him burn out. And he's seen that happen to plenty of other paramedics.

"Marek," Hyli says, "you're bleeding."

Marek looks down at his gloved hand. The boy's tiny little milk teeth had actually pierced the fucking latex and his skin somehow, leaving it stained red.

"You've gotta be kidding me," he breathes and follows that up with a string of Czech curse words the boy is sure to miss. The bite itself isn't bad, he's barely bleeding, but the paperwork is atrocious. This counts as a workplace accident, after all.

And then there's the matter of...

"Do you know who's on call right now in the ER?" He asks.

Hyli raises his eyebrows. "New guy and Mac."

Fuck my life.

He grabs a disinfectant wipe and inspects the damage. Not deep. Not dangerous. He definitely won't need stitches for that. Honestly, he'd much rather just ignore it completely. 

Impatiently, they wait for the doctor to arrive. Without him, they won't be able to administer medication, and their patient still seems quite upset. Once the doctor arrives, he climbs into the back with the boy, while Marek and Hyli get in the front. Marek breathes a sigh of relief when they escape the boy's obnoxiously loud voice and threats to call the police.

"What have I done to deserve this," Marek groans once he's buckled himself into the passenger's seat. "I'll go see somebody later. Or never. It's a fucking kid, he's not gonna transmit hepatitis."

Hyli rolls his eyes and starts the engine. "That's why they say doctors make the worst patients. Doctors and paramedics, I guess. Go get your blood test, Marek."

"You know," Marek says as Hyli backs out of the school parking lot, "I really hate your perfect rule-following moral ass."

Hyli shakes his head, amused by the frankly lame insult. "How's new guy, anyways?"

"The worst," Marek says. "Such an ass. When did you start caring about hospital gossip, Mr. Work-Life-Balance?" 

Hyli snorts. "You think every resident is an ass."

Touché. But also, Marek is objectively right, okay? So many new residents arrive with an ego the size of Jupiter and the arrogance of somebody who's convinced they're on top of the world. They don't give a fuck about what he thinks, what the nurses think, the only authority they might actually consider is that of an attending or department leader.

"Is there actually a single resident you like?" Hyli nudges his shoulder painfully.

"Mac," Marek says immediately. Precisely because Mac, unlike Dr. Med. Kněžinek is not arrogant. Instead he's calm, kind and has an aura that instantly puts everybody - Marek included - at total ease. Honestly, he's wasting his talents in anesthesiology, where he barely even interacts with patients. He'd be so much better suited for the ED. Maybe he'll take a liking to it after this rotation. "I hope new guy changes his mind and goes into pathology instead. Or radiology. Hell, maybe he can get a fat paycheck as one of those useless administrators instead."

"He's Czech," Hyli says casually. Marek sees him peering over, as if he were waiting to see a reaction.

"And?" Marek thrums his fingers against the steering wheel. Just before they'd been able to cross the intersection, the traffic light had turned red. "Do you think I know every Czech person in the world? Did you know one of the janitors is Bulgarian, by the way?"

"I didn't," Hyli replies and revs the engine when the light switches green. "But now I'd like to talk to him. Because I miss home, you know? I thought you might, too."

"Go home if you miss home," Marek shakes his head. "I don't."

There was a reason he left, after all, without ever looking back. He doesn't particularly miss the language, either. The only thing he does miss is the beer, and the price of everything. Germany is expensive as shit. Especially Berlin.

"Well maybe you'll be lucky," Hyli snickers, "and you'll see Mac instead."

Obviously, Marek is not that lucky.

First he spends nearly an entire hour waiting on a chair just outside one of the exam rooms, then he spends another hour waiting inside the exam room.

He seriously considers leaving just as the door opens, and Dr. Kněžinek walks in. He nearly drains the dispenser of disinfectant, cleanses his hands meticulously up to his elbows and adjusts the mask above mouth and nose. His pale eyes narrow when he recognizes Marek in his paramedic uniform.

Now that he's closer - only a few feet from Marek's face - Marek can tell he's about thirty, so a few years older than himself. He looks tired. His curls are disheveled, he's pale, which makes the dark bags beneath his eyes stand out like a sore thumb. Marek wonders how many hours he's been on call for. Considering they work residents to the bone here, probably way too many. That's about as far as his empathy extends towards Kněžinek.

"What's up?" The doctor asks in Czech without looking up from the tablet he's holding. Not wasting any times with pleasentries, then.

Marek bristles instinctively. "A kid bit me."

"A kid bit you," Kněžinek says. Finally, he raises his gaze. He sounds a little bemused. "And you let it?"

"Haha. Funny." Marek holds out his hand. "I'm legally required for you to take a look and tell me it's fine. For documentation. Otherwise the insurance won't cover it or whatever."

Kněžinek raises his eyebrows. He points at the blue exam bed in the corner. "You're on my chair."

"Are you actually for fucking real?"

"Sit."

Marek scoffs, gets up off what is apparently Kněžinek's own personal chair and climbs onto the bed instead. Kněžinek rolls closer with the chair and examines the wound.

"You've lost way too much blood. You've got minutes at best. Any last words?"

"Yeah," Marek says. "Fuck. You."

He starts getting up, but Kněžinek shakes his head. "I've gotta take a look at your blood. And you need a tetanus shot. Just a sec."

He rolls his chair over to the locked drawer and puts a tray on top of it, then he returns to Marek's side and disinfects his arm. Marek glares when he pinches him with the needle. Either he's terrible at drawing blood, or Marek has made an enemy.

"I'll have this tested for hepatitis and HIV."

"Just hepatitis," Marek says.

"But -"

"I'm on prep." For an instance, Marek recognizes surprise in the doctor's eyes and braces himself for an inevitable comment about his sex life. Which exists. Flourishingly. Only not only with people he actually knows, or he'll ever see again, so better safe than sorry, right?

Sex is a better coping mechanism than drinking or smoking, anyways. Maybe he should be having more sex instead of losing half of his paycheck on cigarettes. 

"Right," Kněžinek just says instead, "and as a medical professional you should know pre-exposure prophylaxis is not a failsafe."

"Oh, I bet you feel so good when you can show patients how many big words you know," Marek bites back.

Kněžinek scowls. "Let me do the damn test, Mr. Brazda. Don't be an idiot and refuse appropriate treatment because you have a bone to pick with me."

Marek stays silent for a few heartbeats. He may not like Kněžinek, but at least he hadn't been an asshole about him taking PreP. He's met other healthcare workers who had been. Plenty of them, in fact.

"Fine."

"Good." It looks like Kněžinek might be smiling underneath his mask for the first time.

He's probably gloating.

"Did the guy have a stroke?" Marek asks while Kněžinek digs around for the tetanus vaccine.

"Of course. Ischemic stroke. He has a good prognosis, it was caught within the golden hours."

Of course. Marek pinches his brows. "If only somebody had suspected that."

Kněžinek offers him an unimpressed stare. "If I had sent him up to the stroke unit without a CT and it'd have been sepsis or ketoacidosis or anything else, it would have been on me. The rules exist for a reason."

He tosses the needle into the trash along with the wet wipes. "You'll have the results by tomorrow. Just give me a call."

Marek nods and rises to his feet. He sticks a bandaid on his arm and glances at the clock. His shift isn't even half over yet - he better get back to work.

Marek ducks before the fist hits him square in the face. He feigns a punch, then he wrestles his sparring partner to the ground with little effort and pins his arms against the gym mat.

"Ow! Get off me, you big oaf!" Matyáš complains. Marek obeys, and Maty rolls onto his back, chest rising and falling with effort. His unruly curls are tied back in a messy bun, his forehead is glistening with a sheen of sweat.

Marek is certain he doesn't look much better after an hour of boxing. His t-shirt feels damp and he's still out of breath by the time Maty sits up and dries his face with a towel. Marek inspects his upper arm and grimaces. Maty may not look very intimidating, but he's quick and doesn't pull his punches. That'll leave quite the bruise.

"Have you met the new guy yet?" Maty asks curiously. Maty is the masterful conductor of every and all hospital gossip. There's little he doesn't know - somehow, he has that way on people. The way that makes you open up and spill your innermost secrets without hesitation.

"Yup." Marek pulls himself to his feet and offers Maty a hand. Together they make their way through the gym and back to the lockers on the first floor. At this time of day, it's busy. Marek had come straight off his shift, but he's grown used to carrying around a change of clothes.

Maty showers and slips into blue scrubs instead of his usual sweatshirt and sweatpants. Ah. Night shift it is, then. Maty is a registered nurse and right now, he's working on his trauma certificate. His shifts are either at the ICU or in the ED. Marek hasn't seen him down there in weeks, though.

"Everybody hates him," Maty says and clips his badge to his chest.

Marek looks at him with a touch of disappointment. If Maty hadn't been headed to the hospital, they might have gone home to his place. It's not like they're together (not for a lack of trying, it had just always ended in screaming matches and tears), but just the sex is good, too.

Maybe Marek just isn't made for a real relationship. Maty definitely is, and that had been most of the problem: He had wanted commitment, stability, long romantic date nights and Marek had wanted sex, fun, drugs and parties. Marek doesn't hide that he's gay, but Maty wears it as a badge of pride, his stupid ugly rainbow pin on his gym bag and the "Love is Love" sticker on his workplace locker. They're just not fucking compatible like that.

"Hm," Marek makes. "Yeah. I see why."

Maty runs his fingers through his auburn curls and tilts his head. His eyes are so remarkable, Marek thinks, one is hazel, the other forest green. He has long lashes and mischievously curves lips, moles you can only count if you get close enough. Maty is beautiful. Although Marek knows they can't ever be together, he dreads the day Maty will tell him about the man he loves.

"Do you know what he told me?" Maty says. A rhetorical question, because he doesn't even give Marek a second to reply. "It's a miracle you haven't killed a patient yet, because your triage skills rival those of my niece. And she's a toddler."

Marek snorts.

"And that's like, super unfair by the way," Maty continues and tugs at his hair angrily until he's pulled it into a somewhat neat ponytail. "Because he didn't order an EKG for a guy with upper abdominal pain. 'cause he found a gallstone and completely forgot the heart exists, apparently."

Marek's lips quirk upwards involuntarily. "Good to know."

"Don't get yourself in too much trouble," Maty boxes his bruised arm playfully.

Marek winces.

"Have a good shift. Call me soon," he says.

Maty leans up to kiss his lips and puts his hand on his cheek for a few seconds.

"I will," he says and shoulders his work bag.

Chapter Text

Shift 2. Saturday, 7:40 pm.

Marek lifts the aluminum foil off the oven proof dish and inspects whatever dinner their team had concocted tonight. Reheated chicken wings, fries with a side of nuggets. Fatty, lukewarm and with enough cholesterol to raise his blood pressure to dangerous levels.

In other words: exactly what he needs after having no opportunity to eat all day.

He shovels half of the leftovers onto a plate and doesn't bother with the microwave, instead, Marek starts wolfing it down bent over the counter. The breading is slightly soggy and stale, but it does the job. Hyli watches him from the couch and grins, sipping his hot cocoa and scrolling through social media.

It had been a calm night so far (although they'd never say that word aloud), with only three alerts from dispatch. One baby with a slight fever, an elderly man with trouble breathing and a collapsed homeless guy they'd given narcan to. As far as evenings go, it's almost relaxing.

Marek is about to raid the fridge for dessert when his and Hyli's pagers go off simultaneously. He grimaces and glances down at the message.

"Teen against glass door," Hyli reads. "Emergency physician alerted. Sirens and lights."

Marek rolls his eyes. "The last bit of cake is gonna be gone by the time we get back."

"Didn't you say you were on a cut?" Hyli teases back while they walk to the ambulance bay. Hyli grabs the keys and hops into the vehicle, Marek follows him after checking the back.

"That was last week, and I changed my mind when Iván brought cake."

Hyli flips a switch and the sirens howl to life. They cut through the quiet of the evening and they speed down the street towards one of the many suburbs a few miles out.

Marek types the address into their navigation system and grabs the tablet, scrolling through the information dispatch has provided. It isn't a lot. Teen against glass door can be just about anything from a simple cut to dangerously deep gashes.

What Marek isn't expecting is the absolute nightmare they walk into.

The door is open. A neighbor is waving them inside, he shoulders the BLS bag and follows him. Inside the house - a simple family home, two floors, tiled hallways, neat, inviting - is utter pandemonium.

Somebody is screaming. An older man, maybe around fifty, is crying. They're crowded in the living room, the parents, a young girl, neighbors.

The living room is large. When it's sunny outside, it must be a lovely space with huge glass windows overlooking a neat back yard. There's a mahagony coffee table, a flat screen TV mounted to the cream colored wall and a huge leather couch in the same color. A platter of half eaten cookies lays on the table, along with two empty mugs of coffee and a remote control. A pile of books is balanced precariously next to a French press.

What had once been the door leading to the back yard is shattered. The pane has burst into a thousand shards of sharp deadly glass, and amidst the shards lies a teenage boy. Half of his body is inside, but his head and shoulders are outside, past the doorframe. There's blood everywhere, on the glass, on the bricked floor, on the linoleum inside, on a desperate neighbor's hands.

"He fell!" Somebody screams. "He fell!"

Marek drops the jump bag and sprints through the broken door. He can tell immediately that the worst injury is on the boy's neck. Blood is spraying from his side.

Fuck. Oh, fuck.

"Shit," Marek curses. The teen is gasping for air, writhing, with blood squirting from his fucking carotid artery. Immediately, Marek clamps a hand over the cut to the side of his neck and presses down hard.

"Somebody let in the emergency physician! Hyli, I need an IO and one gram of TXA and 200 micrograms of fentanyl." 

Paramedics can't administer medications, unless the patient will die without intervention. This is definitely one of those cases. 

The teen is deadly pale. Marek's hands aren't free, he can't even reach for his wrist to get a pulse, much less a BP reading, but he's sure he's crashing. Hypovolemic shock. He's losing too much blood. If they can't get this under control, the teen will be dead before they even reach the hospital.

"What's happening?" His mother screams. She tries to squeeze through the door, somebody holds her back.

"IO placed," Hyli says, "TXA and fentanyl administered. Hypotensive and tachy at 150. Starting on high-flow oxygen."

"Fuck," Marek breathes. When is that damn doctor arriving? "He needs an RSI if he deteriorates."

At least the opioids are starting to work. The teen stops thrashing, his face goes slack. Marek tunes out the sounds of sobbing and screaming.

He tastes blood everywhere, heavy, bitter, and turns his head. Finally, after what feels like an eternity, but what couldn't have been more than two minutes, an emergency physician joins them. Marek knows her, he's seen her around. She's small and fierce and highly competent. She takes one look at the boy and says "prepare to intubate".

She takes over monitoring, the pulse ox, the BP cuff, the EKG. Just as Marek has predicted, they need to do an RSI. Hyli administers atomodite and sux and she inserts the tube down the boy's throat.

"Good breath sounds bilaterally," she says, "we need to move him."

Marek's hands are slippery and soaked with blood. Cautiously they lift the teen onto the stretcher and Marek presses his finger against what is likely to be a nicked carotid. Standing to the side of the stretcher, he can barely apply enough pressure to keep the blood from jetting out.

"I'm getting on the stretcher," Marek decides in a split second. With Hyli's help, he climbs atop the stretcher without letting go. He straddles the boy's waist and clamps his hands around the injury on his neck.

"Pulse weak and thready," Hyli announces.

"What's happening?" The mom sobs, "please - please, somebody tell me, please! Please!"

"We're taking him to the closest trauma center," the doctor says, "I promise we're doing everything we can."

But there's no time to reassure the mother her kid will be alright, and even if there was time, it's no guarantee. Not when Marek can feel his heart flutter against his hands, fighting to pump what little blood there is left to all vital organs. Ambulances don't carry blood.

Sometimes he wishes they did. 

While on route to the hospital, the doctor calls the ED. She holds the phone between shoulder and ear, bagging the boy with her free hand.

"Teen with a penetrating neck wound, suspected carotid involvement, ETA eight minutes," she says. She puts down her phone and slips back into gloves. "Can we get a hemostatic dressing on that?"

Marek winces. "I can't let up the pressure to get it."

She reaches over to their supplies with one hand. "Here you go."

Marek glances over at the cardiac monitor. "He's in hypovolemic shock."

Familiar routine sets in. When others panic, Marek is calm, almost eerily so. 

"Pushing saline. Get that damn QuikClot on."

"I can't open it." The monitor beeps and Marek glances over again. His hands are slippery, when they hit a pothole, he lets up pressure slightly. Immediately, the injury starts leaking blood. Marek curses. No chance of applying the gauze.

"Okay, just keep your hands on it."

The kid is white as a sheet of snow by the time they roll him into the trauma center with Marek still sitting atop him.

"Trauma bay two is open!" Somebody shouts.

A trauma team is waiting inside. Apparently, Kněžinek is the on-call trauma surgeon with a team of four nurses.

"Seventeen year old fell through a glass door. Penetrating neck wound and uncontrolled hemorrhage, fentanyl and TXA given on-site, tachycardic at 140, systolic at 70 and dropping. Intubated in the field." 

"Thank you." Kněžinek points at Marek. "We need to get you off the patient without losing pressure. Activate massive transfusion protocol and hang two units of O negative."

Marek grits his teeth. He can barely move without letting go of the injury.

"I need somebody right here," he says.

"Orság, take over," Kněžinek says. Maty steps next to Marek, another nurse helps the resident into a blue gown so he can remain sterile. Apparently, there's no time to get the patient up to an OR.

"Let go on three - two - one."

Marek removes his hands from the patient's neck and slides down the other side of the gurney. Blood starts gushing from the laceration and Maty stills the bleeding with a quick clotting bandage.

"Alright, I need all hands on deck. Galabov, keep bagging. Get me arterial access and push calcium chloride."

Marek stands a few feet aside. The hospital is so understaffed Kněžinek is the only surgeon - the anesthesiologist hasn't arrived yet, there's no attending, not even a med student. 

"Saturation is 78 and falling," a nurse says.

Kněžinek says nothing. He stares at the teen, then at the monitor. The moment seems to stretch endlessly, do something, dammit.

"He'll never make it up to the OR," he says. "I've gotta open him up here."

"Are you insane?" Marek replies. "Put in a catheter and call the vascular surgeon!"

"There is no goddamn vascular surgeon!" Kněžinek barks. "I need a surgical field."

Marek knows his way around the trauma bay enough to find the blue surgical drapes in one of the drawers. The other trauma nurses move in unison, within two minutes, they've set up lights, suction and drapes the patient's neck.

"Assess him for additional injuries," Kněžinek turns to Marek.

Marek cuts open the boy's shirt. He's covered in small laceration, but none of them are bleeding profusely.

"All clear."

Kněžinek bends over the surgical field and makes an incision, widening the cut slightly to visualize the extent of the injury. "Suction."

The tube whines, can barely keep up with the amount of blood drenching the drapes. The doctor is evidently struggling to see anything, but when he does, he pauses.

"The artery is nearly transected," Kněžinek says. "I - I need to -"

They're all looking at him expectantly, monitors beeping, blood pressure dropping.

"We're waiting, doctor," Hyli says.

Kněžinek swallows. "Vascular clamp."

Marek watches in horror as Kněžinek attempts to clamp the artery that is nearly split in two. With each heartbeat, blood spurts from the long cut. Maty hangs bag after bag of transfusions, but by now, Marek feels as if they were knee-deep in blood. In reality, it's only a dark puddle on the floor, but it's growing rapidly.

When the instrument touches the delicate artery, the cut splits further. It splits vertically, travels up the membrane and Kněžinek slips again. Ligation is failing - he can't interrupt the profuse blood flow. 

"Fuck, I - fuck. Graft kit."

"We don't have a graft kit here."

"Uh, we could try a shunt, or -" Kněžinek is reeling for composure and ideas. 

"Pressure is dropping. He's crashing," Hyli warns, "systolic at 40."

"Hang another unit of blood!" Kněžinek barks. "Somebody get me a goddamn vascular surgeon, stat!"

"Patient is not clotting."

"Sats down to 50 percent, we -"

"I've lost pulse," Maty says. "PEA. Starting compressions."

Kněžinek stands, vascular clamp in his hand, and stares at their patient. His glasses are splattered with blood. It's a miracle he can see anything.

"Should we push epi?" Marek asks urgently, and he startles and nods.

"First round of epi."

Maty kneels over the patient and compresses his heart over and over. But there's no blood to pump. The blood is everywhere but where it's supposed to be; on the floor, on Marek's hands, staining the blue drapes dark red, splattered across scrubs and shoes.

"I'll take over," Marek tells him after a few minutes. Maty's forehead is glistening with sweat and he nods, they trade places.

Marek counts to the beat of Stayin' Alive.

One. Two. Three. Four. One. Two. Three. Four.

Ribs crack beneath his hands.

The injury has stopped bleeding. There's nothing more to give.

"Second round of epi," Kněžinek orders and pushes the epinephrine. It's so fucking futile and cruel. "Hold compressions."

Marek pauses. He's out of breath, and the air inside trauma bay two is hard to breathe. He tastes iron on his lips.

"Asystole," Hyli says quietly.

"Your turn," Kněžinek says. Hyli raises his eyebrows, but he obeys. He glances at Marek as if to say this is pointless. They're giving CPR to a corpse. To somebody who was never going to survive, to somebody whose day had been today, as unfair and horrific as it may be.

"Third round of epi," the doctor says three minutes later. "Come on, do proper CPR!"

"Doctor," Marek says sharply, "call it. No ROSC after three rounds of epi. He's gone."

He can say what the nurses can't, it won't have any repercussions. Kněžinek can't fire him, after all, can't make his life hell at work. There's a look in the doctor's watery eyes Marek doesn't like, something dangerous, something crazed.

"Let me," Kněžinek says. His scrubs are bloodied. He pushes Hyli aside and gives CPR until he looks like he might collapse.

After the seventh round of epinephrine, he slows. Everybody is watching. It's like a train wreck, impossible to take your eyes off. 

Finally, he stops. Even though Kněžinek is still wearing his surgical mask, Marek can tell his face is white. He stares at the body on the stretcher and looks like he's about to pass out. Blood is splattered across his scrubs. He's holding his hands up as if he were frozen in time, frozen in the code he'd just run unsuccessfully.

The monitor is still flatlining, a steady sinus tone that rings in Marek's ears until a nurse reaches up and switches it off.

"Time of death," Kněžinek chokes out, "uh, ten - yeah, ten thirty six pm."

Then he flees the scene. He leaves trauma bay one through the winged doors and Marek watches him disappear behind a corner. So much for the debrief.

A nurse stares at the floor shellshocked. Blood is dripping from the gurney, forming a pool of dark red. Red handprints are left everywhere. The suction tube is stained, the instruments are red, the air smells saturated and heavy. Somebody starts gathering up the soaked dressings.

"I'll take this back to the ambulance," Hyli says after a few seconds of silence. He points at the stretcher and Marek nods automatically.

The adrenaline that had kept him calm and functioning is starting to wear off, he can feel his hands tremble and his heart race. In spite of the gloves, his skin is covered in dried blood. He's fairly certain some of it is smeared across his face, painting a gruesome image of death.

"I've gotta wash this off first," Marek gestures to his bloodstained uniform. "Go ahead, I'll be right there."

As far as Marek knows, there are staff bathrooms only accessible with a key he doesn't have, so he heads to the visitor toilet instead. It's lodged between examination room three and four and he pushes the door open with his shoulders so he doesn't leave bloody handprints everywhere. The light is already on, bright and neon-colored.

"What a fucking mess," Marek mutters to himself and flicks on the faucet with his elbow. The water runs red. He scrubs his hands and wrists, then he grabs a paper towel and wipes the blood off his cheek. Once he looks presentable, he turns to leave. He really needs a drink or five, and maybe a night with Maty. He's off tomorrow, after all. 

A quiet groan startles him. Startles is probably putting it light, he nearly jumps out of his fucking skin.

Jesus Christ, he's not alone.

The sound is coming from one of the stall, and it's followed by a raspy gasp for air. A patient, then. Of course Marek could have fucked off, but he's a paramedic and he can't just leave somebody in pain.

"You alright?" He asks. When he receives no response, he walks up to the only occupied stall and knocks. No reply. The stall isn't locked when he gives it a slight push. Ethics be damned. Marek opens the door and - ah.

Shit.

It's Kněžinek, curled around the toilet bowl like a drowning man holding onto a life ring. He lifts his head and squints at Marek, then he waves his hand weakly.

"Piss off," Kněžinek groans. It's not very threatening coming from somebody who looks like he's about to puke his guts out.

"Jesus," Marek mutters. He may hate the guy, but he's not that much of an asshole. The least he can do is make sure he doesn't aspirate on his own vomit. He leans against the doorframe and watches Kněžinek draw in shallow breaths through his mouth, his knuckles turning white when he grips the rim of the toilet. He's fighting it. Beads of perspiration drip down his pale forehead, leaving pinkish trails in the smears of oxygenated blood.

"Fucking... Leave," he chokes out and coughs. "Don't gloat, asshole."

"I'm not." Marek sighs and taps the door impatiently. "You know it won't get better if you just sit here in for an hour, right?"

"Oh, I hate you so much." Kněžinek's breaths are coming in rapid succession. He bows his head and swallows thickly, shakes his head as if to will the nausea (or Marek) away.

"Likewise," Marek mutters. "Can you just get this over with? I wanna go home. I've been on call for fourteen hours."

Of course it's past his shift. When has he ever been done on time?

The doctor is fighting his stupid losing battle and Marek is not about to rub his back. He watches (not entirely without mercy) him finally give up. He retches and coughs and then he throws up until Marek actually fears he might pass out.

He leaves his designated spot next to the door frame and kneels down next to the doctor, feeling for his pulse. Rapid. So fast Marek is surprised he manages to lift his head to look at him. His skin feels clammy to Marek's touch. 

"Okay," he says, "you're okay. Take a deep breath."

It sounds lame even in Marek's own ears. It's not okay. It's not fucking okay. He's already painfully aware the silent film of the boy laying amidst a sea of glass is permanently burnt into his brain. It's like all neurons light up simultaneously to replay the scene over and over, to take him back to the back yard, to the grass shining with fresh arterial blood, to the family torn apart by - by what, exactly? Fate? A God Marek doesn't believe in? Or a cruel coincidence nobody could have predicted?

It requires immense effort to press pause on those images.

"Why didn't I..." Kněžinek shudders and spits out a mouthful of bile, "I should've done the - the stent right away. Why didn't I - fuck. Fuck."

Marek shakes his head. "He was dead when he fell through that door. There was nothing you could have done. Or anybody."

"You were right," Kněžinek murmurs fervently. "If I had called a vascular surgeon - fuck, if I wasn't so fucking arrogant to think I could handle this on my own, I - I could have saved him. I could have saved him. I killed him."

His next breath sounds strangled. He makes a guttural sound in the back of his throat that barely sounds human and buries his head over the toilet once again. This time, Marek does reach out to touch his back, albeit hesitantly. The doctor is only dry heaving; it sounds painful.

When he's done, he buries his face in his arms, trembling. This is too fucking intimate. It's time to leave. It was time to leave like, fifteen minutes ago.

"Can I get you anybody?" Marek asks, "I'll fuck off."

Kněžinek shakes his head and sniffs. He wipes his teary eyes and looks so utterly defeated Marek actually feels bad for him.

"I don't like you," Marek says. Kněžinek makes a sound that somewhat resembles a huff. "But this wasn't your fault. Believe me, if it was, I'd be the first to give you shit, but that boy lost too much blood. It was his day. And that fucking sucks. It's not fair. But it's not your fault, either. It's not your fault the hospital is cutting costs and corners, either. You would have called a surgeon, if there'd been one."

"I - the artery -" Kněžinek makes another attempt at lifting his head. Marek's hand is still on his back and he pulls it away as if he'd been burnt. "I - I tried to clamp it and it - tore. I - maybe if I hadn't - if it hadn't - he could - and now I need to tell his parents and I don't think I can."

Marek remembers the frail, pale artery pumping blood with every heartbeat. It had been so frayed it had split further the minute Kněžinek had tried to clamp its ends.

Like this, vulnerable, hurt, miserable, he looks so young and afraid. He's lost the air of arrogance, the brashness, the cocky sneer.

"How can you be like this?" He whispers.

"Like what?" Marek asks. He rises to his feet and steps out of the stall, grabs a few paper cloths from the sink and returns to Kněžinek's side.

The doctor shrugs. "Like you don't care. That he's..."

He swallows again and fights an upcoming wave of nausea. Marek can see the battle etched into his features, the way his teeth grind, the way his jaw clenches. The doctor presses a hand against his chest.

"Of course I care," Marek snaps. That's not fair, either. He's been accused of being an unempathetic piece of shit too many times. Never by patients. Only by colleagues, or family. "But I can't care to the point of killing myself. I can't care so much I end up here after everyday. But don't you dare tell me I don't care just because I don't wear it on my face. You need some way to not take the shit we see home."

Like drinking. Or smoking. Or sex.

Kněžinek winces. "Sorry."

He must have misheard that. Marek hands him the wad of paper towels wordlessly and Kněžinek wipes his mouth. He lets himself slump against the stall wall and closes his eyes, chest rising and falling rapidly. He looks like shit. His skin is ashen, he's sweating profusely and he can barely catch his breath.

"I'm having an MI," Kněžinek murmurs.

Okay, now Marek is actually starting to hallucinate.

"You're not having a heart attack," he says.

"Radiating chest pain... Dyspnea..." Kněžinek lists weakly. "Classic heart attack."

"Holy fuck, you're not having a heart attack," Marek repeats. "You're having a panic attack."

"You're a psychiatrist too, huh?" Kněžinek croaks.

Marek rolls his eyes. "If it'll make you feel better, I can get you an EKG in the ambulance. But you'll have to pay me overtime. My shift ended two hours ago."

Kněžinek sighs weakly. "Can you fuck off then?"

"Not a chance in hell."

"You're persistent and annoying as fuck."

"So I've been told many times," Marek smiles briefly. He sits down cross-legged next to Kněžinek. "I'm Marek, by the way. If you ever get sick of calling me asshole. Or Brázda."

"Tomáš," the doctor murmurs and wipes the sweat from his forehead.

Marek hesitates. "Was that... The first patient you lost?"

"No. No, of course not. I'm a fourth year resident," Tomáš says. He doesn't seem quite ready to brave the world just yet.

"So... Has this happened before?"

His silence is answer enough.

"With every code?" Considering he is a trauma surgeon, that would be debilitating. He sees the worst of the worst. He can't save everybody. He can't perform miracles, he's only a man.

"No."

Just when Marek thinks there won't be any follow-up, Tomáš adds: "Just the bad cases."

"You should see somebody."

"Now you can actually fuck off." Tomáš seems a little more alive and little less on the verge of fainting. Slowly, he scrambles to his feet, balancing himself by holding onto the door handle. Marek watches him limp to the sink and rinse out his mouth, then he starts cleaning the blood off his face. His scrubs are a lost cause, but at least he looks vaguely human again.

"I don't need a shrink," he insists.

"Okay." Marek hesitates. "There's somebody in-house, though. A social worker. Who you can talk to."

Tomáš stays silent. Marek doubts he'll show up at the social worker's office. They're similar in that regard.

"I need to tell the parents. They're in the waiting room," Tomáš rasps and leans against the counter. He stares at his ghastly reflection for a few seconds, the scrubs. Blood has soaked through them. It's starting to dry and turn dark brown.

"You don't need to tell them. I will."

"Marek, no, I lead the trauma, I need to be the one to -"

"Look at yourself." Marek motions towards the mirror. "You're in no state. I'll tell them. Nobody needs to know you didn't. I'll send you to the documenting and you put down your name."

"Why would you do that for me?"

"Do I seem like a stickler for rules?" Marek shrugs. "Same reason I'm a paramedic. I just don't like seeing other people suffer."