Waiting On An Angel

Chapter 1 9/12/05

It's just another night. Just another boring shift. Just another slow crawl into the daylight hours, as the night passes you by and your body once again falls into that unnatural, nocturnal rhythm. You can almost feel the cogs groaning and reversing. You can almost feel the care slipping away.

It scares you sometimes, you realise, as you wander along bland ivory corridors and attempt to look busy and occupied in a patient file. Scares you, as you pass a waiting room full of patients, and relatives, and the expectant eyes of a bored child reach your own. You can remember those long years ago, not long ago at all but oh, how it feels it sometimes. When you first qualified, that face would have stirred you, and the cumulative pain that filled that room, pulled on the strings tying your heart down and maybe 0ne or two would have severed. You wanted to help them all, all at once and fix every cut and hear each untold story. You wanted to be the very best doctor you could be, more than that. You wanted to be your father. The best doctor in the world… or so you had thought.

Things are clearer now.

You wonder when the change began. When too many heart strings had been broken, and that empathy and compassion no longer found the surface quite so easily. When you could walk past a waiting room without even glancing up from your notes, or catching an eye, or even managing a smile. You know it happens to all doctors, that it has to to some extent to remain sane in a job where there will never be enough time for each patient. But you still wonder when you became the exact kind of doctor you always said you wouldn't; not that you didn't care but that somehow, the reflex had become blunted. There had been too much pain, both professionally and personally, to dare allow yourself to let anymore in willingly. Too much pain. Too much spread across the grey faces you now sometimes catch yourself looking straight through, and not really seeing… and those shards of pain gradually frayed that cords holding your heart down, and let it float away altogether.

Sometimes you feel empty. Sometimes… sometimes you look to the heavens and try to track it down again, as though feeling and emotion and happiness could float back down again to settle in that cavity in your chest. Float down on angel's wings. You stand and feel the first fall of snow of the tip of your nose, hold out your tongue like you did when you were a kid, and wish endlessly that things were that simple now. That swallowing that first unique edge of winter, that white fleck of frozen rain, could somehow be equivalent to swallowing your angel. The one who, somewhere you cannot find, sits and holds your heart dear until you can find it again.

IWaiting

On an angel

One to carry me home

I hope you come

To see me soon

'Cause I don't wanna go alone/I

It's been a couple of months since you started your sabbatical in the ER. There was an incident, one of those indefinable things you're not really allowed to talk about to anyone; another surgeon was called to the General Medical Council to answer a patient's accusations, and it fell to you to give the minor circumstantial evidence against your colleague. Trouble was, of course, was that that colleague was your father, and those words you had to speak helped to get him suspended pending further investigation. You can remember forcing them out, feeling like a Judas. You can remember of betrayal on his face… You can remember ripping colourful paper from your first stethoscope. Oh, you were five, and it was plastic, but those thuds of a heart beat you heard in your ears were still so real. And the look of pride in your father's face, now thirty years replaced with something like disappointment. Disappointment he'd go bury in the bottom of a bottomless whiskey glass.

And so you were sent down here, just until things cooled off upstairs, and those old school men who have worked with your father his whole professional life, realise this isn't your fault. You did what you had to do.

It's funny. You thought you wouldn't fit in… that maybe they'd be expecting a real ER doctor and you'd have forgotten all but that endless jangle of nerves in that thin sheaf of tissue, and the irreparable consequences even minor damage to that bundle of fibres could cause. But it slowly comes back to you every day, and a lot of the time it's little things like triage they put you on, because you are precise and efficient but still manage to put the patients at ease. You remember ER rotation in fifth year of med school, and how you went home each day citing your enthusiasm for the discipline; and how your father shunned it, I"God damn ER docs, ripping the patient to shreds and then sending him up to us to do the real work…"/I. And so you agreed, and fell into a life of surgery… because you liked it too, but mainly because it was easier to just agree.

"Eli." You speck the name aloud as you enter one of the small examination rooms, scan the notes in your hand. A small boy sits atop the gurney, that bed that is far too big for him, in a room that is far too adult for him. A older, slightly greying nurse holds his hand… Madison? Matigan? You're learning names, but it's a slow process in such a large department, and you swear it seems the shifts are conspired against you to ensure you work with as many different people as possible.

You close the door behind you, flip the blinds, exhale. And you turn. And smile like you mean it.

The nurse - Matigan, she mouths to you, you knew one of those was right - stays for the consultation. Eli's mother is apparently out in the ambulance bay trying to calm clients she's supposed to be with; Eli explains through tousled blonde curls that Mommy is an interior designer. Or an intewiowr designewr. Eli Peyton is five years old, and all intermittent shyness and boyishness, and raves about how he managed the nice greenstick fracture you suspect he's suffered. Apparently, as he stood aboard his Bart Simpson skateboard and held tight to Custard the German Shephard's lead, he forgot the dog didn't know to just run Islowly/I. Wrist met sidewalk, as did forehead, and the rest tails off as you set up the portable X ray machine.

Matigan, or Mattie, as she tells you to call her, steps out the room as you fire off the X ray, trying to bribe Eli into keeping still for five minutes. Clearly the idea of having a 'cool neon cast' and getting all his mates to sign it, is worth the pain of a snapped radius. You have to smile as he squirms right up to the point of snapshot. You are becoming so used to people unconscious, or in severe pain, or just too broken by life to bother making conversation anymore. You ease the injured arm from the wooden block used to stop the rays from passing out the other side, and wait as the film develops. Mattie re-enters, jots down the procedure in the patient chart, hands Eli a cup or cordial to his good hand. Slyly, knowing all the while you can seem slips him a mini pack of Oreo's. Slowly the picture comes through as you examine the lump on the child's head, and test his light and progress reflexes.

"So Doctor Shephard, do I get to chose the colour of my cast? How long do I get to wear it for? Do you guys use a chainsaw to cut it off again?…" That excited singsong voice rises and falls, as Mattie somehow manages to get two child ibuprofen down his throat.

"sure thing. Huge one like the lumberjacks use. We've gotta be careful with them, ya know, one slip…"

Eli looks at you with serious blue eyes. And then he sees your joking expression, and that boisterousness cuts through.

"We should probably check your X-ray first mind you…" You look over to his excited face. "How's about you help me find what's up with you?"

He is off the bed and over to the X ray machine before you know it, cradling his right arm gently. You whip the film out, flick the switch on the light box; it is, of course, what you suspected. Classical presentation. Eli's right radius bone in his wrist has snapped, but only half the way through; a green stick fracture. Uniquely found in children before puberty hits, like the way a green branch from a spring sapling is so hard to break entirely in half; young bones, still that extra bit of give and elasticity as they grow.

"Right, Dr. Peyton…" You kneel down beside his agile form. "What do ya reckon's wrong with that?"

"Gweenstick fwactuwre." He replies, copying the words and grinning mischievously.

"Now he can't say I didn't get a second opinion." You say to Mattie, and the older woman smiles.

Eli squeals excitedly, and listen as he runs through the colour options for casts. You smile too, but this time you actually do mean it.

The door bursts open, and you turn, expecting to see Eli's mom to explain the procedure and gain consent to start making preparations for Eli to get his arm bandaged and put in plaster.

"Dude, they need you in Trauma Room 2..." It is Hurley, the somewhat overweight receptionist. He makes you laugh, so easy going, so full of life. You stand immediately.

"What we got?"

"I don't know the full story, but the paramedics said white female, late twenties, some kind of blunt chest trauma and…" He turns away, signalling to move off from the child. "Suspected rape."

You swallow. "Eta?"

"Two minutes."

You turn back to the bed as Hurley plods from the room, absentmindedly mutter thanks for the heads up. Your mind is running through all the drugs, all the legal technicalities, all the things you're frightened to fk up; and you turn back to that mass of dirty blonde curls.

"Okay, Eli…" You make a note on the chart Mattie holds out for you. "I think together we might have just solved the mystery of your floppy wrist, so now as soon as your mom's back we'll get her to sign something and then whisk you off to get that yellow and blue polka dot cast on, k?" You smile as you subconsciously assess his vital signs. He seems pretty okay for a kid with a splintered bone.

"Okay, Dr. Shephard." He seems to have found the shyness again. You grin. He's a sweet kid.

"Make sure you come show me before you rush home to show Custard his handiwork, alright?"

The yellow tangles bounce as he nods, and Mattie smiles that she's okay to stay with him. You roll up your sleeves, let the door swing shut behind you, grab a disposable apron as you make the walk along linoleum floor to the trauma room. Maybe thirty seconds of peace left. You really need a piss. You really need a sleep. But then you think of your dark apartment, and the Chinese takeout from two nights ago that's gonna walk out to the trash itself soon, and the lonely wail of sirens as they drown into the night. And you know where you'd rather be.

The commotion is sudden and controlled, planned route from bay to trauma room, planned spiel of information to rattle off. The rest of the team, the two nurses and senior and junior house officer all grab the gurney as the paramedics crash through the glass doors. Miriam, a woman who's name you do somehow know, steps aside with you ever so briefly to give you the run down.

"White female, late twenties we think, found crawling on the sidewalk outside a pretty grotty apartment down on 103rd. Someone said she ran out the door in kind of a panic, and then just seemed to collapse. Police are down there now." She catches your eye. "Basically she's got an ungent tension pneumothorax caused by what seems to be a Swiss army knide, and pretty substantial vaginal bleeding and associated trauma

and bruising consistent with rape. Naturally with the tension pneumo she hasn't managed to tell us if it is rape, but you know the drill."

You take the information in, register that you do indeed know to work on a rape until told otherwise basis, nod your thanks. The frail body is hoisted to the hospital gurney, and Miriam and Steve leave their part of the job behind.

You approach the bed swiftly, do a visual assessment, the extreme shortness of breath, the obvious building air effusion in her left lung, and those emerald eyes which find yours, and flinch.

"Miriam!" You call after the receding figure. She turns.

"What's her name?"

"Kate Austen."

"You're gonna be okay, Kate." And you can feel the care returning.

There's so much to do. So much to do, and an order in which it must be done. One of the nurses - Claire? - grabs a catheter kit, automatically, from the trolley, and you rip it from her hands. Too harsh. You take her to one side, explain swiftly to eyes which gaze at the floor that all evidence must be preserved. Her gentle Australian accent lilts and flutters as she apologises profusely.

You've already left the conversation before she even begins.

You don't mean to be crude, or too hard. You don't mean to yell. But there's something about the fragments of a life lying before you; the shattered body lying on the hard, generic gurney as you stand tall and strong and undamaged above her. Something about the way, even though you know nothing beyond this patient's name, nothing beyond her hair colour, have no responsibility to her past the authority of a doctor… you feel like you should have been there. Should have been in a place you don't even know, to stop all this happening to the stranger before you.

And because you weren't, there is one thing left you can do. You need to make it better. You need those pieces of DNA he will have left, to be found and preserved and betray his identity.

You need to restore her.

All of this takes seconds. Seconds for you to know, you have to fix her. You have to somehow make this better.

She is scraping for breath, wild panic in eyes which refuse to meet anyone else's. You work on autopilot; thinking of nothing past the present moment, yet somehow all those moments add up into minutes of action and progress. IV in. Pain relief. Monitor attached. Sterilise the area around the wound in her chest, insert the chest drain; watch the instant relief, the sudden whoosh of air escaping, the pressure build up diffusing out.

Those eyes; they meet yours again, somehow a tunnel of vision creating itself despite the exposure of her bloody chest, the numerous clinical items she is attached to, the five other bodies which circulate and make notes and speak in hushed whispers you wish she couldn't hear. She is full of fright and pain, shock, and above all a resounding fear which leaps from her as real as air. She finds you in the chaos… and the inch of peace in her eyes, it's all you need.

You smile weakly at Ms. Austen, as Claire pushes another five of morphine through the IV; you try to forget about the rawness inside her, the other place she will be bleeding from, the images which must be rasping through her head.

Her breathing slowly subsides to normal, the progress achingly gradual. And you hold her eyes, desperate to give her something other than those images to think of.

The phone call is awful. It's too factual, too clinical, too abrupt. You want to tell the woman on the other end about the person she is to come to examine. Abercrombie & Fitch jeans, the aqua green top torn and becoming stiff and brown in the uneven flow of where blood has spilled. The gasp she made in pain, as she was transferred from the paramedic's stretcher to the hospital gurney. You want her to understand there is more than a name and an assault.

"I'll be there within the hour, Dr. Shephard." She's done this a million times. You know she has.

Maybe she's just impatient. Maybe you're quiet too long. "Dr. Shephard?"

"Uhm, yeah, that's fine."

"Do you… know the patient, Dr. Shephard?"

You think of her, Kate Austen, lying sedated and abused behind you… can see the bruising and swelling that flares up as her body tries to begin repair, foolishly believing it is the physical wounds that need healing. And you want to say yes, for you don't want her to be alone. You want for her to know someone, so when she wakes, there is a familiar face to tell her everything will be okay.

"No. No, I don't know the patient."

The line goes dead, and you feel there's something left unsaid.

Other patients are a good distraction for a while; John Locke, with a sudden numbness in his left leg, Charlie Pace attempting to blag some morphine, weakly complaining of headaches. His voice is shaking, hands fidgety and trembling, sweat pouring from his forehead. You return five minutes later with a bottle of methadone and he storms out, stumbling and slamming into people, disgruntled.

It's always the same. He's in every week. He's the kind of patient that makes you question your commitment to the job.

You're filling out the necessary forms for a patient self discharge form when she appears. Young, tall, blonde; looking like the spoilt daughter of a rich city financier. You don't know why, but you were expecting someone older, more experienced, more solid. Hurley escorts Miss Rutherford to where you stand, in the midst of medical trolleys and patients and all chaos imaginable.

"Shannon Rutherford." The woman extends her hand.

"Jack Shephard. She's… she's right this way."

You lead the blonde girl - she's barely more than a girl - to the side room where Ms. Austen has been moved now she's stable. You think of Charlie Pace, throwing his life away on drugs and lost days, the things he could have achieved if only someone had told him 'no'. And then there's Kate Austen; who you don't know, who you will never know past saving her life… this slip of a girl who exudes beauty even now. You think that no matter what she might have done, she doesn't deserve any of this. No-one does. You swing open the door for Miss Rutherford, finding that fragile form hidden under starched sheets, and wonder if there will ever again be a day where Kate Austen can carry herself through without thinking of the abomination inflicted upon her.

It takes an hour or more to convince Ms. Austen to consent to the procedure. You almost want to tell her not to have it done. It's horrid and invasive and rips away any shred of dignity the patient might have left. It's personal, too personal, when all she will want to do is shower and scrub at herself until all that invisible dirt, the black that no-one else can see, is gone. She doesn't want a smear, a pregnancy test, to pass urine through torn membranes to check for STD's. She wants to be left alone to try and blockade the memories and tears that threaten.

She wants to forget the violation ever occurred.

And that's why, as you leave the room and Ms. Austen turns away from the implements placed in perpendicular lines on a tray; you feel like you've betrayed her.

The side room is finally quiet; all probing and exposure over with, sheets replaced, Ms. Austen made as comfortable as she can be. A single IV hangs from the back of her hand, and she lies with her back to the door as you enter, Matigan accompanying you for the peace of mind of the patient.

From the end of the bed you can see her eyelashes moving in fearful silence. She turns, so slight that at first you think you are imagining the movement.

"Ms. Austen…"

"Kate." Her voice is a whisper… so hoarse, so raw. She doesn't look at you. She doesn't look at anything at all.

"Kate." You begin again. "Miss Rutherford said the results would be back in the next twenty four hours." You say this so quietly, so not wanting to remind her of the invasive procedure she has just undergone.

She blinks, says nothing, blinks again. You want to sit on the end of the bed and say what really matters; IYou're safe now. He can't get you, he won't ever get you again. We'll fix you./I

"If there's anything I can do…" Your heart is thudding against your chest with anger towards whoever did this to her. It's the first time you've felt it in so long, the first time in as long as you can remember you felt truly alive and compassionate towards another. You look at Kate, who you didn't even know existed twelve hours ago… battered and broken, her heart full of only dread and fear of the nightmares to come when sleep beckons. No peace to be found in day or night dreams… and you want to give your heart to her, to try and mend that little part, so the healing might spread and fill her whole.

She doesn't move as you back quietly out the room; Mattie nods that she will stay for a few minutes more, just in case Kate opens up with only a woman in the room. It's at that moment that Eli, the little boy with the fractured wrist, barrels into you, apparently trying to break the other one too.

"Dr. Shephard!" He cries, holding up a fluorescent green arm, his new cast already cluttered with best wishes from hospital staff. "Check it out! It was so cool, they let me do the bit around my thumb myself and they said I could stay off school tomorrow and…" He is full of excitement and adrenaline, stuffed with it, overflowing from him.

You glance from Kate to Eli, round and back again, the contradictions compounding. One quiet, one loud. One on the brink of life, so excited, living each day as if it might be the last… and one too pounded by life, full of the pain and cynicism that comes with adulthood, having just lived through the day that could have so easily been her last. One protected by every measure available; parents and school and curfews and limited sweets… and one who has somehow been abandoned along the way, allowed to slip into the cracks of vulnerability.

Eli whispers to you from the doorway, glancing at Kate's unmoving form with a mixture of curiosity and confusion. He sees her blink, inhale, exhale, blink again.

"What's wrong with her?" He's too young. He doesn't know the horrors that fill the world, not yet. You look into those gleaming blue eyes… place your hand atop his head, nestling into the wild blonde curls which bounce as if animated. Eli looks up to you, all awe and admiration, as you gently steer him away from the things he shouldn't see. And you want to lead him to Neverland, so he never needs to know the horrors the human race is capable of.

"She's… she's just had a pretty rough day, Eli. She just needs some rest." Oh, if it were that easy. If sleep alone could heal those wounds deep within her that no scalpel, no forceps, nothing but time will ever hope to fix.

"But she doesn't look sick."

"Sometimes people hurt on the inside, buddy. Sometimes… sometimes it's not an obvious thing, like your arm."

"Like when you feel sad?"

You look at him, all innocence and daydreams and through the mask of childhood, the first remnants of maturity appearing.

"Yeah, Eli. Something a bit like that."