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Jennifer Margaret Abbot passes away in late January in 2012. It’s a gloomy morning when she succumbs onto the floor in their shared apartment in Philadelphia, dropping the overly sweet coffee she’d been making on the white tiles, shattering one of the beige mugs they’d received as a wedding gift.
Or that’s what Jack assumes. He hadn’t been there. He’d been in the medical tent in Kandahar, a full day of travel away in normal conditions – which were anything but.
He lost his leg a day earlier when his squadmate stepped into an IED. A simple mistake hundreds of soldiers had made before turning deadly. His brain hadn’t managed to catch up with him in the split second between the explosion and losing consciousness, so the moment he wakes up in a Landstuhl hospital on a whole another continent with the strong smell of antiseptic and clinical walls all around, his mind is filled with more questions than answers.
Nothing makes sense. He feels more like an inanimate, shapeless blob than the guy who’d once run marathons and gone hiking on the weekends with his wife.
Dr. Walsh, the rookie surgeon who had signed up on her third year of residency, is sitting next to him on a foldable chair. Her hair is falling out of the bun in the nape of her neck and sticking to it with sweat. Her eyes are closed but her expression is tight, lips pressed into a thin line, indicating that she’s not really asleep.
When she does notice he’s awake and busies herself with handing him a cup of lukewarm water and checking on the dressing on his leg instead of confronting the topic head-on in her usual style, he knows something is wrong. Emery Walsh was nothing if not straightforward and rough around the edges in the way the army surgeons usually were, and Jack Abbot knows better than to think it was all about the leg.
The headmaster at the elementary school Jen had taught at had gotten worried after she didn’t show up for work, but by the time the EMTs got to her, there was nothing they could’ve done. Her pale skin had long since turned blue, the pupils of her soft brown eyes had blown. A heart attack, the medical examiner ruled. Jack was a doctor himself, he knew how random those could be. Especially in women of her age.
It didn’t make it any less clear how there could’ve been no symptoms whatsoever. Had she been unusually tired? Had she had pain in her limbs or shortness of breath? Had she vomited, thinking it was just one of the common stomach bugs that roamed around with voracity through any institution with three hundred kids?
If Jack had been there, he surely would’ve noticed it. He’d seen a thousand heart attacks, treated at least a few hundred STEMIs. It had been one of the first cases he’d been pulled to during his first rotation in emergency medicine.
His wheelchair is pushed to the front row of the church for the funeral. He hadn’t been fitted for a prosthetic yet and with the lingering weakness from an infection, he’d become frustratingly dependent on others. Well, dependent on Robby, a Louisiana native he’d met while assisting in the aftermath of Hurricane Katrina, who’d rushed from Pittsburgh the second he heard where Jack had been airlifted to. Now he sits next to Jack on the pew, looking awkward and out of place in the way non-practicing people raised in other faiths did. Same God, different hymns.
Or maybe there was no God. Jack was slowly beginning to suspect it, the guilt and pain of it gnawing on his soul like he was in the Garden of Gethsemane.
Anyway. That didn’t matter, really. He wasn’t in South Carolina anymore, in his grandmother’s tiny house outside of town where he’d been brought up, where crosses decorated every wall, mass was attended on Sundays with the regularity of a swiss watch and prayer was the solution relied on.
Robby leaves after a couple of days and Jack’s baby sister, Julia, takes his place. She’d been a self-proclaimed California Girl since buying a one-way ticket to university back in ‘99, strongly opposed to spending time in a cold environment for longer than a few days, or taking care of sick relatives. They had never even been that close, not in the way he knew some siblings were. She’d barely been thirteen when he left for college.
But Julia comes when he calls, which Robby had practically twisted his arm to do when they’d sat in his truck after a debilitating appointment of re-learning how to walk in physiotherapy.
In a way, her presence in the apartment, the scene of the crime, was the exact thing he needed. She doesn’t cook for him, which forces him out of bed in the worst moments of his spiraling to ensure they don’t starve to death, even if their choice of nutrition ends up being blue box mac & cheese. When he stops to stare at the beige-mug sized empty hole in their glassware cupboard, she bullies him to come to the couch to binge The Nanny instead.
On the days the phantom limb pain is too much and he can’t wear his prosthetic, she curls up next to him on the bed the same way she used to do with their mother, a long time ago in a different world, and massages his stump with lotion. It’s sweet, familiar. Afterwards she pushes his wheelchair to the Starbucks around the corner to get sugary frappuccinos, which she makes him pay for, and they sit in comfortable silence at the park across the street to sip at them while peoplewatching.
She listens when he talks about Jen. Pretends she doesn’t hear him crying in the middle of the night when she knows he doesn’t want company. Drives him to get Jen’s ashes from the crematorium, and when he decides they should be spread along her favorite hiking path in Wissahickon Valley Park, she packs snacks and ibuprofen for his leg.
When the true realization that Jen was gone hits him on the bench in the park, the small urn between his hands, surrounded by lingering snow and families with kids, Julia lets him hide his face in the shoulder of her obnoxiously pink coat.
Her commanding presence didn’t leave space for the guilt of forcing her to take care of him. If anything, she acted like it was an all-inclusive vacation from her job at an advertising firm in Los Angeles.
Philadelphia becomes suffocating when Julia leaves, when there’s nobody left to keep tabs on him except for his peppy physiotherapist and her immediate contrast of his Vietnam vet therapist, both of whom he saw twice per week.
Nights are the worst and they all follow the same pattern.
He sits in the living room, staring at the television television screen rather than watching whatever was playing on it, before his eyes start drooping just enough to lull him into believing that tonight would be different. Gets into bed, falls asleep. Relives the explosion and Emery’s face when she’d told him Jen was gone. Somehow manages to stumble to the bathroom with only one leg to empty his guts. Doesn’t get up until his cheeks feel tight from the salty tears and the sun is rising behind the curtains.
Robby, during their semi-regular calls, gives him a less-than-subtle suggestion to apply to work at Pittsburgh Trauma Medical Center and Jack almost laughs him off the phone.
Leaving Philadelphia would be to leave the life of his entire adulthood so far behind. Where he’d gone to medical school, matched into residency and worked as an attending. To leave would be to leave the hospital Jen, a native Philadelphian, had been born at, and the courthouse he’d married Jen in, which had conveniently been on his way to work. To leave would be to leave behind the apartment they’d shared, the bed they’d slept in, and the park Jen’s earthy remains resided in.
He suffers through two more nights of the sleeping-sweating-vomiting-crying cycle, and right there, on the cool bathroom floor with his forehead resting against the rim of the toilet, he thinks that there has to be something else for him out there. Knows there has to be a deeper purpose to his life, that there must be a reason he survived the explosion when so many didn’t.
His stiff and shaky fingers find Robby’s contact. Does the offer still stand?
Robby’s affirmative reply comes five minutes later. A week after that, Jack’s all packed up and ready to make the five hour drive to the city that would supposedly be his new home.
He throws himself into work. None of the other attendings at the PTMC seem to prefer the nightshift, so he takes almost all of them. First reluctantly, accepting his fate that as the new guy, he was going to be tested. Then more eagerly, when the realization that you won’t sleep badly at night if you don’t sleep at night hits.
The fear of panicking in the middle of a shift melts away as May progresses and the nights get shorter, even when the shifts don’t.
He falls into a routine. Walks to work, works a shift with menial viruses and challenging traumas, tries to teach whatever resident has been unlucky enough to be hoisted onto him, and walks home. Once a week they had the attendings’ meeting at half-past six in the morning, at the end of his shift, which would often stretch to last longer than it should with administrative bullshit.
If it gave him an excuse to avoid home longer, he wouldn’t complain about it.
On most of his off-days he doesn’t get out of bed. Gets a police scanner to listen for possible MVAs or MCIs, just in case there would be an excuse for him to go back into work, and stores it on his bedside table.
His new therapist sends him to a psychiatrist, who gets him on SSRIs. It takes a while but slowly, one nightshift at a time, he starts to feel more stable. Starts going to the veterans’ support group in July and to the bar afterwards, where they could swap stories and complain about the VA without supervision.
Then he and Robby both work New Year’s Eve, one of the two holidays notorious for explosion-related injuries. Technically, Jack knows he should be fine. The surroundings are far from the sandfields and he’s heard many fireworks before without reacting, but he also knows that PTSD didn’t exactly function on technicalities.
Robby finds him curled up in one of the bathrooms with vomit covering the front of his scrub shirt, and no matter how he tries to comfort him, it feels like a million steps backwards.
At some point, around three years after Jen’s passing, he comes across an online article about widowers. He knows he shouldn’t click it, knows that nothing good comes out of giving way to the masochistic part of yourself that wants to know every gory statistic.
He clicks it anyway. Reads that widowers live approximately 9.5 years after the death of their spouse. After that, the days he’d previously counted to know how long he’d lived without her turn into a countdown to the exact moment he knows he should die.
While that would’ve been something his therapist should definitely know about, he keeps it to himself – doesn’t even tell Robby, who, as his emergency contact, would be the first one to be called.
It becomes a selfish thought he relies on more than he should. Not a threat, but a promise. It keeps him going, gets him out of bed. He’s a thirsty man crawling across a desert for the promise of an oasis waiting for him at the end of it.
During a particularly bad shift when everyone seems to be keen on dying on him: six years more until I can die.
When Robby makes him take a few days off during the anniversary of Jen’s death and the loss of his leg, and he makes the drive back to Philadelphia to rub salt on the wounds: five more years until I can die.
Emery starts working at the hospital, now a full-fledged surgeon with an impressive reputation, and they end up working on a young marine who had been t-boned by a truck for hours before he succumbs to the injuries and simultaneously sends Jack into a PTSD episode: four more years until I can die.
Sometimes he stands on the roof on the wrong side of the railing and tempts fate, wondering if waiting was actually worth it if he was going to die regardless.
He does some research, co-authors papers about discrimination of veterans in healthcare with a few old friends he’d been stationed with. Not exactly the most marketable topic in the journals or the media, but he goes to the conferences just for the sake of getting out of Pennsylvania every once in a while.
In Orlando, he sleeps with a medical device rep, a tall, dark-skinned woman with a witty tongue. She asks him about the wedding ring he hadn’t even realized was still on his finger. Does it again in Vegas with a blonde cosmetologist on a bachelorette trip. From a set angle, him behind her with her head bent forward, in the dim light of the bedside lamp, she looks like Jen. He kicks her out, neither of them finishing, and spends the night crying in the bathtub.
Even hooks up with Emery once, in a moment of weakness for the both of them. They’d been sent to the same trauma conference to listen to hours and hours of panels and presentations about triaging and effective treatment during the worst MCIs in the United States. The two of them, the only ones in the whole hospital who had seen the horrors of a combat zone. It was slightly ironic, definitely bad planning from the administration.
Emery had skipped the fancy dinner, three courses and two drinks with an uncomfortable side of small talk, so he’d knocked on her door. She’d opened in a robe with a bottle of wine in hand. Afterwards they had mutually decided to never talk about it again.
He never starts anything serious with a woman. It would be unfair to them when he was going to die, he knows. He knows, because he’s been through it.
Half a year before his death, January 2021, he researches all the possible burial options and what could be done with his ashes. He gets a lawyer and updates his will, assigning half of the money on his bank account, which had been collecting quite nicely along the years, to a charity for unhoused veterans. The other half he leaves to Julia. Feels good about it. That high alone carries him through a few shifts in the COVID hellhole.
He doesn’t tell anyone, but he knows exactly the moment that his promised 9.5 years would be filled. The day when he is sure that if a brick doesn’t fall on his head, and a particularly violent patient doesn’t happen to attack him with a knife, and the pandemic wouldn’t send him into a spontaneous cardiac arrest, he’s going to hang his stethoscope on the railing and jump off the roof of the hospital.
It’s July and he’s working a rare day shift he’d picked in hopes of giving him more time to die, or at least make the final decision on dying. He hasn’t met the new batch of interns and medical students before, since they rarely worked the night shift, and has made a decision that he doesn’t need to learn their names either.
He’s sure of it. What would he do with them as the last new neural connection in his brain before his ultimate death?
They filter in, still a little unsure in their surroundings. A man whom he vaguely recognizes as an intern, a woman with ginger hair definitely in her late 30s who introduces herself as an MS3.
Then–
The moment he knows he’ll be able to recall for however long he’d continue to live.
Samira Mohan, MS4, is the most gorgeous woman he’s ever laid eyes on in his forty-five years of roaming planet Earth. Her dark curls are neatly gathered on a ponytail at the back of her head, her skin practically glows under the bright fluorescent lights. The way her scrubs flatter her body makes it look like she was born to wear them. He can’t even see her full face from behind the mask she’s wearing, but he doesn’t have to either.
And then she’s walking towards him, her step steady and confident, and introduces herself with her soft voice.
And–
And time slows down. The timer in his head, counting down the hours, sputters like an old engine before coming to a full stop. It huffs and puffs, refusing to restart for the final moments it would’ve been needed for.
She revolves in his vicinity, skillful and attentive, through the whole shift. Like she’s his moon, revolving around his trajectory, keeping him balanced, filling in for him when he needs it.
The thoughts come later that evening when he’s back at home, again, eating Thai takeout in his underwear. His fridge was empty, he hadn’t wanted to leave any perishables. Hadn’t left a single beer either, to his bitter realization when he has to wash the noodles down with plain water.
How fucking dare she?
This woman, who knew nothing about him, just appeared in his life like an angel in PPE, and decided to turn it upside down. The future doctor who did a chest tube with no instruction while he just stood and observed. When he’d asked about it, impressed, she’d told him it wasn’t her first rotation, that she’d done ob/gyn and surgery, which hadn’t had the effect of downplaying her abilities she’d clearly meant it to.
So when he lies down on his bed, alone – alive –
Jack’s a fucking asshole, that’s what he is. Thinking about her like she’s a woman, not like she’s a medical student. Or maybe he thinks about both.
It’s a confusing blend of emotions, mixing work with personal the way he had never done before. Well, not never if it came to purely the physical – this, with Samira, was expanding in his mind like well-yeasted dough.
It would be better to just steer clear of her, he decides. Unfortunately, Samira had definitely not gotten the memo he’d sent her telepathically with multiple miles between them.
Jack had made the mistake of taking Robby’s dayshifts while the man disappeared to the mountains to mourn Adamson, thinking he wouldn’t have to work them postmortem. Instead he has to drag his feet to work at six in the morning daily, his body protesting the lack of sleep. It’s way more than he’s contracted to work but they’re in the middle of a pandemic and physicians kept dropping dangerously often – if he was willing to come, he’s sure Gloria would’ve dragged him in by his collar.
Samira is always there, so close to his side that it feels like he’s grown an extension of himself. One brain, four hands. Jack gives her more autonomy than he would for a typical med student, but she takes it well – responds to instructions and improves at a pace he’d never seen before in a student. That alone was enough to have her operating under Shen, a third-year resident who admittedly wasn’t that great of a teacher.
He still hasn’t seen her face beyond the peek he’d taken at her badge, but the crinkles on the corners of her eyes after he compliments her sutures or nods at her correct dose of intubation meds have him thinking she’s smiling. In the middle of the hellhole, she’s smiling at him. Jesus Christ, this woman.
He gets his confirmation of it three weeks later, when she somehow manages to discover his secret hiding spot on the roof. He’s got a cigarette between his lips, had picked up the old habit sometime in the middle of the first year of their COVID hell. In his defense, he really had thought he’d be dead by now.
The door slams closed behind her back and he briefly opens one of his eyes to glance at the intruder, hoping it isn’t Langdon, one of the overeager interns. But no. It’s her. Samira doesn’t come as close as she probably could, considering they were in open air.
Watching her strip off her mask is the most erotic thing Jack has seen in years. The excitement of it’s finally happening followed by the instant gratification of seeing her narrow jaw, soft lips and teeth so straight she had to have had dental work done.
He’s not even thinking about any illicit things, like her newly revealed lips pressed against his own or around his cock, but somehow, he’s still hard in his pants. Inhaling the smoke, he swears it’s just the combination of nicotinic acetylcholine receptors triggering the release of endorphins in his brain, and the fact that he hadn’t seen any actual nudity in real life in three years. It’s the pandemic that’s got him fucked up.
She leans her back against the railing, around four feet away from him. “Hell of a day, huh. I mean, you’ve probably seen worse. I heard that you’re a vet.”
“Yeah, but this ranks as awful,” he says, his voice rough. “At least people with gunshot victims can be treated.”
Patient after patient dying on their watch. Normal people in good shape, marathon runners and special ops vets and construction workers, torn down by the same illness the former president had called fake only a year prior.
Samira hums, turning her head to look at the Pittsburgh skyline at sunset.
“It’s so easy to lose sight down there,” she mutters, closing her eyes to inhale the fresh air deeply. “My dad used to say we’re one with earth and soil, and that the core of the human experience is to be perceived and remembered for things other than your physical form – since that’s just biology and chemistry, you know? I think I’m starting to get it now.”
He’s speechless, stares at her with the cigarette between his lips like a malfunctioning robot. Jack has spent his life in rooms with a strict hierarchy. The military more obviously, but medicine had one, too. The way Samira was talking to him was as if she’d known him his whole life.
Worst of all? He wants to hear more. After losing Jen, it was as if he’d fallen into a pit of despair and couldn’t comprehend a reality where there was more to living. Then, this brown-eyed girl with hair braided like a crown manages to soldier down his defences like she’s trained to do so.
What a cruel, cruel trick of the universe.
Robby comes back and Jack returns to nights after that, catching glimpses of her at handover. Suddenly, Samira Mohan, MS4, has finished her six-week elective emergency medicine rotation.
And Jack thinks, finally, I can die.
And he thinks, looking through the residency applications over Robby’s shoulder and seeing a very familiar name in the mix, well, I’ve lived this long already.
And he thinks, looking through the list of the upcoming resident class during a departmental meeting, maybe statistics are just statistics.
Shit.
The decision to want to live, to actively lead a better life for the purpose of remaining healthy, is hard. His current therapist, Dr. Halstead, an older man with a calm presence, puts him back on the schedule twice a week, six feet apart and masked but physically in office, instead of the biweekly online meetings they had kept up with semi-regularity. He stops drinking as much and the cigarettes in his backpack go untouched for long intervals.
He swears that the sudden increase in his will to live is not because of her – how could it be? She was just one medical student in the sea of many. Sure, she got under his skin, many people did. Especially recently.
It’s a combination of many things, or at least that’s what he analyzes on the leather couch at his therapist’s office; the pandemic giving him a new perspective on life after seeing a record number of patients die without anyone around to hold their hand (although it also kept him awake at night). Julia and her wife, Sarah, having a baby boy for him to spoil through online Amazon orders of endless diapers and clothes (with zippers, not buttons). Getting a non-work related hobby for the first time in his life (cycling, which had become like a black hole for his accumulated savings).
And – as he presents it to Dr. Halstead – a newfound hope in the future of emergency medicine (Samira Mohan).
There was no telling how Samira had ranked the PTMC and if she would match there, the whole process was very volatile. There was still a possibility, a likely one, that she’d match to a nicer or higher paid specialty like internal medicine or surgery. He almost wishes that were the case. At least then he could find inner peace on his own, or pretend to do so. Keep the version of her he’d cooked up in his mind without the expectation of anything more.
He tries to keep his expectations low, doesn’t want to put the weight of his life on the twenty-something, wicked smart budding doctor. That would account for several HR violations, he was pretty sure. Not that it would be a problem, since he would never actually do anything.
Dr. Samira Mohan starts her intern year at the PTMC exactly one year after ruining every plan he’d had of dying. She lands at the ED with the force of a rocketship, jumping immediately to assist Robby on an incoming trauma at shift change before she’s even properly introduced herself. Jack watches from where he’s finishing his charts at the nurses’ station and wonders if it really could be that easy with her.
The trauma of the pandemic is still fresh on everybody’s minds and overshadows most of the year. Out of the two interns starting in the ED, the other one transfers to family medicine less than a month in. Samira works a lot of nights, trains under Jack, but he settles with watching her from a distance.
He doesn’t see her outside of work until the PTMC Christmas party, a formal event thrown in the ballroom of some nice hotel in the city center. Jack had volunteered to work the night weeks prior, but in rare agreement, Robby and Gloria had for some reason decided that he should be the one in attendance.
There’s only so many times he could rebel against the administration without consequences, and this fight wasn’t worth his energy. So he puts on his suit and drives to the venue with firm intention to remain stone cold sober, spend an hour tops (all at the complimentary buffet), and then disappear, possibly with an excuse about his residual limb being sore.
The excuses leave his mind like dust in the wind the second he spots her in the deep red cocktail dress. She’s nursing a glass of white wine and chats away happily with the doctors and nurses from other departments, trying to build rapport in case she ever needs a favor. He’s so taken aback by her that it doesn’t even cross his mind to be embarrassed by it, until Gloria thanks him for staying for so long, when she’d expected him to leave immediately.
He’s only a man after all, and Samira is so eager to learn, laser focused on her residency. Robby doesn’t see it – his responsibility is to look at the ED as a whole, care about the number of patients seen in an hour. The nights, run by mostly Jack, are the wild west compared to the days. It’s easy for him to become a mentor for her, since he wasn’t under strict expectations from the branch and there were generally fewer patients.
When she starts showing interest in some of the less conventional methods of stabilizing trauma patients, he begins printing out interesting and out-of-the-box case studies and articles of unusual treatment methods, and slips them into her locker through the small gap at the top. Any trauma that comes in when they’re on the same shift, he makes her think through it first.
Sure, it’s plain favoritism, but Samira devours the knowledge like it’s the only source of sustenance in her life, internalizes his teachings like it’s her scripture. Nobody really cares what Jack does anyway during his shifts as long as patients get seen and treated.
With Samira's intern year and her second year of residency passing, he gets to watch her adapt and bloom into a promising young physician.
And he would be happy to be her best friend, even if it was all he’d get from her for the rest of his life – he’d die a fulfilled man, knowing how many hours he’d gotten to spend in her company. She’s his moon, keeping him on his trajectory, no matter if he never became her emergency contact, or got to listen to her breathe in her sleep in their shared bed, or had the chance to see her wear a ring he would pick out for her.
He’s living on loaned time, anyway.