Chapter Text
The breakroom became your centre of command; you nursed a to-go cup of stale coffee from the machine as your eyes drifted toward the screen of your laptop. It was silent here, way more silent than the small station Dana had set aside for you, the birds nest she had called It you her chick, she had been far too sweet afraid the Pitt would swallow you right up. You wondered why you hadn't been placed in the psych ward, that is where you should have been doing your rounds, but Gloria had seen your sweet nature and clamped her jaws around you before you could even run.
She'd said It was a good learning opportunity, if a med student, resident or attending thought a patient was in active psychosis or suffering from any mental health issue that you'd be of help that you could bridge the gap between Psych and the ER. You pushed your glasses up when the door opened, he was handsome, and you swore yourself for thinking It dressed in a zip up hoodie and scrub pants his stethoscope over his shoulders, he was about to reach for his first cup of coffee when he saw you from the corner of his eye. You were too well dressed to be a medical doctor from his floor; you were wearing a pair of powder-blue figs too clean eyes still too bright to be working in trauma.
"Hi there." You smiled something pinched and nervous the sweat already accumulating around your palms. “Can I help you?” he asked, not unkindly, but with the barest undertone of wariness that said: please don’t need anything from me before coffee.
You scrambled for composure, your name catching on your tongue. “Oh—sorry. I’m—uh, Dr. (l/n). Psychiatry. Resident. Gloria sent me down for… ER liaison?” You winced. Why did that sound so fake?
He blinked at you. Once. Then again.
A beat passed, his coffee forgotten. “She did, huh?” His eyes dropped briefly to your ID badge, flicked back up to your face. “And how long have you been here?”
“Few weeks,” you said, too brightly. “But this is my first shift in the ER. I set up back there—” You gestured vaguely toward the breakroom table, where your laptop sat open beside a stack of psych consult notes and a very earnest-looking binder. “I’m just here to help if anyone’s flagged with a misdiagnosis or, you know… needs de-escalation or evaluation. Or company.”
He stared at you like you’d grown a second head.
“Company?”
“I mean—like. If someone’s agitated or waiting on inpatient psych, I can… sit with them. Talk. Not as a friend, obviously, like—clinically.”
His mouth twitched. Barely. Not quite a smile. Something more sardonic.
“You planning to counsel the Pitt?”
You deflated a little but straightened your spine anyway. “I’m hoping to be useful. I’ve got crisis training, I worked CPE in Chicago last year, and I did rotations through forensic psych at Riker’s. I’m not afraid of yelling or spitting.”
He reached for the coffee then, poured himself a cup like this conversation needed caffeine more than courtesy. “Yelling’s not what I’m worried about.”
You blinked. “What are you worried about?”
“That you’ll be in the way,” he said bluntly, lifting the cup to his lips. “Not personal. This place eats newbies.”
You nodded slowly. You had been warned. You were still here. “Then I guess it’s a good thing I’m not crunchy.”
He gave you a look then. Not approval. Not warmth. But something closer to curiosity. His gaze dragged over you—not inappropriate, more clinical. Assessing.
“Well, Dr. (l/n),” he said, voice dry, “you don’t get a welcome gift, but you might want to invest in a second pair of shoes. Blood’s not coming out of those.”
You looked down at your sneakers, pristine and navy and oh-so-naive.
You looked back up. “Duly noted.”
He turned toward the door, coffee in hand, and just before slipping out, he muttered, “Don’t let Dana make you cry.”
You blinked. “Why?”
“She cries too sometimes. It’s exhausting.”
And then he was gone.
You sat back down slowly, heart hammering a little faster than necessary, your coffee now cold but your cheeks a little warmer.
You opened your laptop.
This was going to be fun.
✞
It was the kind of arrival that changed the rhythm of a trauma bay.
The man came in thrashing; his wrists bruised from zip-ties the paramedics had replaced with soft restraints. There was blood caked under his nails, a split lip, and his eyes—wild, glassy, blown wide with something that wasn’t just fear or pain—darted around the trauma room like he was seeing things no one else could.
“He was trying to jump out of a moving car,” the EMT said breathlessly. “Says the nurses from 'inside' are trying to poison him. He punched through a window on 28th.”
Langdon was already grabbing Haldol from the RSI drawer.
“Vitals?” Dr. Robby asked sharply, glancing toward the monitor as they rolled the patient to bed.
“BP’s 160 over 90, HR 118, RR 24, O2 sat 97. Temp’s elevated—maybe 100.8.” The medic glanced at the patient, who was still fighting against the soft restraints and shouting slurred curses at someone who wasn’t there. “He said they’re inside his blood. The bugs. Keeps saying we’re not real.” Langdon hesitated with the Haldol in hand. “What’s his tox?”
“Pending,” the Princess called. “Urine sent. No track marks. No obvious trauma.”
“Okay,” Robby muttered, stepping in closer, voice pitched low. “Listen to me, sir, you’re safe. You’re at a hospital. My name’s Dr. Robinovitch, and—”
The patient let out a raw, guttural sound and spit toward Robby’s shoes.
Robby stepped back without flinching. “Alright. Let’s hold off on meds a sec. He’s febrile. Could be infectious, could be NMS, serotonin syndrome, hell, even anti-NMDAR. I don’t want to sedate him before we rule those out.”
“Jesus,” Langdon muttered. “Then what do we do? He’s losing it.”
“We get labs, get head CT, blood cultures, ammonia. LP if needed.” Robby reached for the call bell. “And get psych—”
Langdon froze. “You’re not gonna call her?”
Robby’s hand paused mid-air. His jaw flexed. “No,” he said tightly. “She doesn’t need to be here for this she isn't familiar with the way things work here yet.”
“But she is the psych resident,” Langdon hissed, panic rising as the patient thrashed again, knocking the IV tray to the floor with a clatter. “And we don’t even know what he’s on. He could be schizoaffective, manic, meth, anything. We need help before he tears the room apart.”
“We’ve got this.”
“We don’t, Robby—he nearly bit me. You want someone getting stuck?”
Robby glanced at the patient again, his eyes storm-dark, torn between control and realism. The man was now screaming into the void—begging the ceiling lights to shut up.
“Fine,” he growled. “Whitaker get her. But she doesn’t come in alone. And she stays behind me.”
Whitaker was already on his way desperate to leave the hell this room had become.
Robby turned back to the patient, his hand steady on the bedrail as he said quietly, “Let’s get your demons figured out, pal. Hang tight.”
✞
Your day was calm so far, the only person that really needed you was Dr Mohan, you two got along well a silent professionalism a respect for each other, you understood her need to want to be more than a doctor to the patient and she got your need to want to listen. "Could be early signs of depression, sometimes It manifests as physical symptoms, stomach cramps, fever." Dr Mohan was just about to speak when Whitaker seemed to appear out of thin air sweat forming around his temple. "Uh-trauma 4 I think he-he's in active psychosis, It's bad." You nodded slowly excusing yourself.
"Ok Whitaker two large breaths- and stay out here the last thing we need is the patient being triggered by others strong emotions." He nodded not in a rush to enter the room as you slowly and gently opened the door. the trauma bay felt like it was vibrating. Not from noise — though the man’s shouts still echoed off tile and glass — but from something more oppressive. Like panic had been bottled up in the corners, waiting to spill.
You could feel it in the way that Dana was hovering. In the stiffness of Whitaker’s posture from outside the door. In how Dr. Robinovitch didn’t look at you when you slipped inside, even though you knew he’d heard the ding of the doors and your soft, automatic “Hi.”
“Vitals are stable. We’ve held off on sedation,” he said, like he was talking to the air instead of you. “Temp’s still up. CT’s pending. No trauma signs.”
Langdon piped up before you could even open your notes. “He’s textbook psychotic. Could be excited delirium, meth-induced, hell, maybe even first-break. He keeps calling us nurses from the bugs.”
"Ok, let's all just, let's give him a moment." You spoke it specifically to Langdon, urging him to stop with the remarks as you slipped on a pair of gloves.
You stepped forward gently, eyes already scanning the patient. Mid-thirties, muscular build, soaked in sweat and stinking of adrenaline and fear. He was still talking — rapid, breathless, fractured — about how they’d put wires in his skin, how he’d seen it happen, how they were trying to “smoke out his memories.”
You took a single step closer, just one, voice calm and clear. “Hi. My name’s Dr. l/n. I’m just here to talk, alright? I’m not going to touch you.”
He didn’t look at you. But he stopped talking.
That was something.
“Can you tell me your name?” you asked.
Still nothing. But his breathing had changed—shallower now. Watching you.
“I’m not here to hurt you,” you added, softer this time. “I Just want to understand what’s going on. You said they put something in your blood?”
His eyes flicked to you. Then to Robby. Then to you again.
“Don’t listen to them,” he rasped. “They’re not real. You’re not real either.”
You glanced at Robby, who nodded once. You knew his look; you'd seen it earlier on in your career from other healthcare professionals: He’s not safe. Don’t push it.
You stayed put. “I know it feels that way. That must be terrifying. Do you think something’s controlling your thoughts?”
His face twisted, then cracked—like a fracture spreading through porcelain.
“Yes,” he whispered. “The nurses in the walls.”
You turned back to the team. “Paranoia, auditory hallucinations, disorganized thinking—yes, this is likely psychotic. But it’s too early to rule out substance-induced or organic. I want a urine tox, ammonia, thyroid panel, and head CT read stat. If they’re clear, we’ll talk antipsychotics. But not Haldol yet—he’s febrile and tachy.”
Langdon blinked. “So… now what?”
“Supportive care. De-escalation. Cooling measures if the fever climbs. Let me stay and talk to him.”
Robby finally looked at you.
His expression was unreadable, but his voice was quieter than before. “You sure?”
You nodded. “He’s scared, not evil.”
There was a beat. Then he stepped back, hands sliding into his pockets.
“Okay,” he said, and for the first time all day, he said it to you. “He’s yours.”
They cleared the bay slowly, like pulling teeth.
Robby was the last to leave, lingering at the threshold as if some part of him didn’t trust this setup — you, in your stupid clean scrubs and soft eyes, facing down someone who’d been spitting bile and screaming minutes ago. But he didn’t protest. Just gave a single nod and let the door close behind him. "Come find me when he's calmed down yeah?" You nodded and looked away.
You sat on the edge of a rolling stool, keeping distance, hands in your lap. The patient — later you'd learn his name was Devante — was curled in the corner of the gurney like a wound-up spring, knees tucked to his chest, pupils blown wide.
“Devante,” you tried, voice level, tone gentle. “I’m still here.”
His head twitched, eyes snapping toward you. “Don’t say my name.”
“Okay,” you said easily, “we don’t have to use names.”
You didn’t ask any more questions — not yet. Just sat with the silence, letting it stretch. It made most doctors twitchy, that quiet. But you’d spent time in inpatient units, you’d seen what happened when people were forced into conversation before, they were ready. Sometimes you just had to let the brain cool off, let the fear bleed out.
He started murmuring again after a few minutes — not to you, not at first. Just muttering about the skinwalkers in the ceiling tiles and the smell of blood in the air.
“You’re in a hospital,” you said, not correcting him, just anchoring. “There are doctors here. Nurses. We’re not here to hurt you.”
He laughed — a jagged sound. “That’s what they always say. Right before they open my skull and feed the wires in.”
Your pulse fluttered — not from fear, but from the terrible ache of recognition. Psychosis wasn’t just a clinical bullet point. It was devastation wrapped in the skin of a person.
“I believe you feel that way,” you said. “But I also think you’re really sick right now. We want to help.”
He didn’t respond. But he didn’t escalate either. His eyes flicked to the corner of the room, then back to you. You waited. The silence went long again. He began to rock slightly, rhythm building. You stayed still.
Finally, he asked, “You ever hear voices?”
You didn’t answer right away. Then — softly — “Not in the way you mean. But I think we all hear something, sometimes. Even if it’s just the voice in our head telling us we’re broken.”
Devante stopped rocking.
He stared at you like he was trying to see if you were mocking him.
You didn’t blink.
“You’re not broken,” you added. “You’re not evil. You’re sick. And we can treat sick.”
When the door finally hissed open again — Whitaker and a nurse coming back in with cooling blankets and blood vials — Devante didn’t flinch. He didn’t scream. He let you place a damp cloth gently on his wrist.
And he didn’t look away from you. You smiled. "Can we put one on your forehead, to help with the fever?" He swallowed. "But-you-can you, do It?" You nodded and grabbed the ice pad from princess. "Here this should help." He sighed in relief as he leaned back his muscles relaxing.
"Ok, I will be back, Princess monitor his fever, when It's gone down you and Whitaker can just keep a distant eye on him make sure he doesn't hurt himself." They both nodded and you shot one last smile before you gently clicked the door shut.
It was nerve wracking, never knowing the next move with a patient you'd been spat at, bodily fluids thrown at you, scratched and sworn and yet that shake never disappeared. it felt like you’d been holding that breath for years. The cool air of the hallway met your sweat-dampened scrubs like a slap, and for a moment, you just stood there — eyes closed, heart still thudding in your chest like you hadn’t just come out of a win.
When you opened your eyes, he was there.
Dr. Robby leaned against the nurse’s station like he belonged to the drywall, arms crossed, face unreadable. You hadn’t heard him walk up. Of course you hadn’t.
“You okay?” he asked.
Not how’d it go. Not what did you give him. Not are we going to need restraints.
You swallowed and nodded. “Yeah. Stable. He’s… calmer. Still a little guarded, but not combative.”
Robby tilted his head a little, like he didn’t quite believe you. “You didn’t sedate him?”
“No. I just talked to him.” You shifted your weight, hugging your iPad close like it might shield you from the way he was looking at you. “Tried to ground him. He was paranoid, not violent. Thought we were feeding wires into his brain.”
A long beat passed.
Then, flatly: “Sounds like textbook psychosis.”
“Maybe,” you said. “Could be drug-induced. We’ll see once tox comes back.”
His mouth twitched. Not a smile. Something more thoughtful.
You waited for the lecture. The dressing down. You shouldn’t have gone in alone. You don’t know the Pitt. This isn’t a psych ward. But it didn’t come.
Instead, Robby looked down at the ground and muttered, “I wouldn’t have handled it like that.”
“I know,” you said, voice gentler than you meant it to be. “But that doesn’t make it wrong.”
That got his eyes back on you. Dark, sharp, assessing. But not unkind.
“You’re… different than I expected,” he said after a moment.
“Let me guess.” You tucked a strand of hair behind your ear, trying to defuse the knot building in your chest. “You thought I’d be delicate.”
“I thought you’d be a liability,” he said bluntly. “No offense.”
“None taken.” You smiled, dry. “I’m getting that a lot.”
He watched you for a second longer, then ran a hand through his hair — frustrated or tired or maybe just unsure what to do with you. “Langdon made the right call. You helped.”
You blinked. That was… the closest thing to praise you’d gotten since stepping foot in the ER. Not that you wanted It, but he seemed to give it to everyone here but you
“I’m just here to bridge the gap,” you said. “That’s all.”
“Yeah, well,” Robby pushed off the wall. “Keep standing in the middle of things like that, eventually someone’s gonna fall on you.” You stood for a few seconds before you nodded. 'Is that all?" He nodded.
"Ok thank you." You turned on your heel and walked away, Robby tapped his nail against the nurse's station looking at the room where Devante was being held. "Would you look at that, she's not as weak as you think." He rolled his eyes at Dana. "Guess she's not."
✞
the results arrived about three hours after Devante was admitted a ding on your iPad. You scanned them quickly, mouth tightening.
Positive for methamphetamines. Elevated creatinine kinase. Slight hyponatremia. Head CT clean. No bleeds, no infarcts. No masses. Nothing to explain away the delusions.
You let the iPad fall into your lap as you sank into the worn plastic chair near the nurse’s station. It wasn’t textbook schizophrenia, but it wasn’t just drugs either. He wasn’t faking it, and he wasn’t just high. He was falling through the cracks — the kind of patient the Pitt saw a dozen times a week and couldn’t hold on to long enough to save.
“Results?” The voice came from over your shoulder — low, quiet, like he’d been waiting to catch you in the lull.
Dr. Robby stepped into your space without asking, reading over your shoulder. You cleared your throat as he's smell evaded your space.
“Meth positive,” you said, without turning. “But I don’t think that’s the whole story. His history’s messy. Childhood trauma, previous psych hold two years ago, no follow-up care. He’s got signs of a thought disorder, but nobody’s tracked it long enough to say for sure.”
“You think he’s sick,” he said, not as a question.
You nodded. “I think he’s sick and using, and every time someone chalks him up to just another addict, he gets further from help.”
Robby exhaled through his nose. “You want to 302 him?”
“It’s not about what I want,” you said. “He’s not actively suicidal, not homicidal either. I can’t hold him just because he’s sick. But I can try to talk him into a voluntary hold. Maybe buy him a few days of safety.”
Robby leaned a hand on the counter beside you. You could feel the warmth of him, close but not touching. "Ok lets do it." You stood up ready to enter Devante's room again, but Dr Robby stopped you. “You can’t save all of them.”
“I know,” you said, though your throat went tight around it. “But I’m going to try anyway.”
A beat of silence. Something unspoken stretched between you — not judgment, not quite admiration either. Something heavier. Something complicated.
“You want me in there when you talk to him?” he asked, finally.
You blinked.
He wasn’t offering backup. He wasn’t trying to take over. He was offering presence. Presence from a man who rarely gave it when it wasn’t required.
You looked up at him, met those storm-gray eyes, and for a moment, the ER noise faded.
“No,” you said gently. “But thank you.”
Robby straightened, shoved his hands in his hoodie pockets. “He turns on you, you scream or grab something,” he muttered. “I don’t care how calm he seems.”
“Yes, sir.” You smiled — Then you were gone.
✞
The room was still except for the rhythmic beeping of the monitor above Devante’s head and the low, mechanical hum of the vent overhead. He sat slouched on the gurney, his hoodie clutched around him like armour, eyes flicking toward you with suspicion and exhaustion in equal measure.
You pulled the curtain halfway closed behind you, giving the illusion of privacy without total enclosure — a small trick you’d learned in psych rotations. Enough to lower the temperature without escalating paranoia.
“Hey, Devante.” Your voice was soft, neutral. Not sugary. Not patronizing. “Mind if I sit?”
He shrugged, noncommittal, so you eased down onto the chair by the foot of the bed and rested the iPad on your lap.
“You got my blood,” he said, eyes narrowing. “You gonna tell me I’m crazy now?”
“I’m going to tell you what we found,” you said evenly. “And then I’m going to tell you what I think. After that, it’s up to you.”
His jaw twitched. He nodded once.
“Your labs show some methamphetamine in your system. It’s affecting how your body’s working right now — your muscles, your kidneys. But it’s not the only thing that explains what’s happening.”
You kept your voice low. Calm. You weren’t here to scare him.
“We also looked at your brain — no bleeding, no stroke. But Devante… I’ve read your chart. This isn’t the first time you’ve felt like people were watching you.”
He flinched. “I’m not paranoid,” he snapped. “People are watching me. They got my name, my social, they know where I sleep. You think that’s not real?”
You didn’t look away. You didn’t interrupt.
“I think it feels real,” you said gently. “I think your brain is working overtime trying to protect you from a world that’s already done you dirty too many times. And I think that’s a hell of a burden to carry alone.”
He blinked at that. Just once. But it was enough.
“You’re not crazy,” you added. “You’re sick. And sick can get better.”
He looked away, jaw tight, his fingers twitching where they gripped the hem of his hoodie.
“They gonna strap me down again?” he muttered. “Make me drool on myself like they did before?”
“No restraints,” you promised. “No forced meds. Not unless you’re hurting yourself or someone else. I’m not asking for a hold. I’m asking you to agree to a short stay — voluntary. Three days. Let’s get you stable, hydrated, clean. Then we make a plan.”
He was quiet for a long moment. Then:
“They just gonna dump me out again.”
“Not if I can help it,” you said. “But I can’t help it if you leave tonight.”
That hit. You could see it in the way his shoulders drooped, in the sudden wet shine to his eyes that he blinked away fast.
“You gonna be there?” he asked roughly. “If I go?”
You nodded. “I’ll check in every day.”
Another pause.
Then: “I’ll stay.”
Relief nearly buckled your knees, but you just nodded again, slowly, carefully, like you hadn’t just held your breath the entire conversation.
“Thank you,” you said.
He didn’t respond. Just curled tighter into himself, a man fighting ghosts with everything he had.
You stood, quietly, and gave him back the illusion of peace.
✞
The hallways were quiet now, the steady clamour of the ER leaving behind only the hum of the fluorescent lights overhead. You’d finished with Devante’s case, and though he was still deep in the cycle of withdrawal and psychosis, you’d managed to get him to agree to stay voluntarily. The first small victory in a sea of struggles.
You walked into the nurse’s station, where Robby was reviewing some patient charts. He glanced up as you approached, his face tired but relieved, like he already knew the outcome of your conversation with Devante.
“Hey,” you said softly, “he agreed to stay.”
Robby’s lips twitched upward in what could’ve been a smile — or something close to it.
“Good. That’s the hardest part,” he replied, setting the charts down. His voice was low, steady, and there was something in it that made you feel like you’d just earned a badge of trust.
You leaned against the counter, glancing down at your hands, suddenly unsure how to continue. There was a lump in your throat, an echo of the weight from the last hour, and you couldn’t quite shake the exhaustion that curled through you. But there was also something else — a feeling that hadn’t been there before, something unspoken between you and Robby.
Your gaze flickered up to him. He was looking at you like he knew there was more you weren’t saying, but he didn’t push. The air around you felt charged, the steady pulse of the hospital’s hum against the silence of the room.
“I’m not used to people actually listening,” you admitted, your voice a little quieter than you meant it to be. “To them trusting me… I mean, I know it’s my job, but it’s different when they really listen.”
Robby nodded, his expression thoughtful. "Sometimes just getting them to listen is the hardest part of all." His tone was soft but there was an edge to it, like he'd been through this himself many times before. “It’s a fine line, though. You gotta be careful not to push too hard. Trusting someone doesn’t mean they’re ready for everything yet.”
You smiled slightly, though there was a tightness to it. You felt it then — the weight of his words, how they lingered between you. And maybe, just maybe, you wanted to know more about the man who spoke like he’d been carrying the same burdens you had, only for longer.
There was a beat of silence. Robby’s eyes held yours a moment too long. Then, to break the tension, he cleared his throat and picked up a chart.
"Uh-Mckay needed help-Uh thanks I'll get Devante up to psych." He nodded shooting you a quick polite smile. "Ok."
You nodded and walked away, your heart felt funky every time you were near him; he was handsome no doubt and driven, but you were young, and he was one of those men who liked serious women, and you were all smiles and powder blue scrubs with a dandelion pin stuck through the shirt.
A child in his eyes.