"Over the last year I've noticed a strange pattern. Every so often a patient will come in needing our help, but on the flipside, will end up helping us in one way or another, whether it be by offering an open ear to talk to, relationship advice, or general encouragement, and even in the most stressful situations I can take the time to really appreciate these select few people . . ."

"J.D …"

"Take Ms. Mitchell for example. She's been in and out of the hospital for two months, and after her first two hours here at Sacred Heart everyone was babbling on and on about her, and how nice and insightful she was . . ."

"J.D …"

"Even though I've become friends with Ms. Mitchell, I tried to close myself off in the beginning. I thought to myself, "nope, I'm not getting close to this one," because getting close to a patient is like being in a relationship with someone who you know for a fact will break up with you later on. Yeah, whether it's through the front doors of the hospital, or passage into the afterlife – if you believe in such things – patients will leave no matter what, and it hurts every time."

"J.D!"

"Carla!" JD snapped, half playfully but also in genuine frustration, "I completed my rounds, spoke with Dr. Kelso about Mr. Webber's insurance fraud that poor Ted has to deal with now, had a five minute standoff with the Janitor which ended with me having to rinse Scrubbing Bubbles out of my hair, and changed Mr. Morris' catheter for Dr. Cox in less than a half hour, so to say the least, I need a little inner monologue time. Can it wait for five minutes?" "I was almost proud of myself – I sounded like Dr. Cox except not nearly as mean or degrading."

"Ms. Mitchell is checking out."

"This is exactly why I try not to build friendships with patients anymore."

Carla's announcement stung JD's heart like a bee, and not the kind Dr. Kelso enjoyed imitating the buzzing of. No, an angry bee, and with every passing second he felt it weighing heavier on him like a continuous flow of venom. He hoped that it wouldn't cause his emotions to swell, but could only assume that it would. It always did with people like Ms. Mitchell. He made his way down to the first floor tp see her off, rushing at times out of desire to get it over with, but going peculiarly slow at others, afraid of the emotional turmoil that was to come. After a long walk he rounded the corner and stepped into the lobby. When he saw Ms. Mitchell standing tall next to the front door he couldn't help but let a sad smile creep across his thick lips.

"Way to go, Ms. Mitchell, you're healthy again!" J.D praised as he came closer to her. "How dare that nasty pneumonia try to keep you down."

"I showed that ailment who's boss, didn't I?"

"You did!"

Though he spoke with enthusiasm, he was growing terribly sad, and it showed in a small falter of his voice. "You know, you showed me a lot too . . ."

"Oh, Dr. Dorian," Ms. Mitchell sighed, waving her right hand as if to dismiss his words, "I showed you how to make chicken pesto pasta; that doesn't deserve an encomium."

"I know but . . . wait, an econo what?"

She laughed. "An encomium. It's a formal expression of high praise."

"But you do deserve that!" J.D exclaimed. "I feel like after every conversation you and I have I'm a better, smarter person."

"I'm an old woman," she began, cooing almost as if J.D was a baby, which he didn't mind. "I have a lot of wisdom and experience, and it's only the right thing to pass it all on to youngsters like you."

There was a short pause.

"Dr. Dorian, it's been an honor, and thank you again for everything you've done to help me get better."

"You're welcome. It's the least I could do for someone like you."

There was another short pause, and then J.D spoke up once more. "What are you looking forward to getting back to most?" He asked curiously. Ms. Mitchell was a busy woman, and seemed to always be doing something exciting.

"Going back to school and being with my students." She replied proudly. "I've been to many places, but Northern University is my home."

"Well, I hope you have a great time there. Take care of yourself."

"You too, Dr. Dorian."

Then came the hard part – walking away. J.D turned around and hastily made his way out of the lobby, yet even in the midst of his haste it still felt like slow motion to him. "When you say goodbye to someone who has inspired you for a while, you almost feel like a bird trying to fly for the first time, but then when you look back . . ."

J.D turned around and looked to where Ms. Mitchell stood. All he could see was the outside door closing. The woman nowhere in sight. ". . . it's like the mother bird was never even there." With that, he lifted his chin and pressed onward. "I tried not to let it get to me. After all, I still had people – my friends, and the other mother bird; the stricter, more terrifying, and sometimes downright cold mother bird . . ."

"Newbie!" Dr. Cox barked.

"Ahh, there's the sweet chirp now!"

"Yes mother bir– I mean, Dr. Cox?"

Dr. Cox's brow furrowed in an angry-like look of confusion at J.D. "I'm not even going to begin to ask what you came close to calling me there, but I need you to cover the nightshift for Dr. Henderson."

J.D's face was instantly wiped clean of all expression, yet in his eyes Dr. Cox could see much aggravation. "Can you handle that, Monica?"

Every fiber of J.D's being wanted to say no. He was looking forward to having a night off after working all but one day that week, yet he knew that he couldn't refuse. Reluctantly and forcing a cheesy smile, he nodded his head. "I can handle that."

"Aww, don't feel so bad, Moni." Dr. Cox began sarcastically. "All you have to do is tend to your patients, Dr. Henderson's patients, who for the most part need almost constant care, while assisting me in the emergency room all night, which really shouldn't be that bad. I mean, it's just Friday, so we'll only have to deal with victims of senseless violence, drunkards, druggies, car accidents, stupid teenagers who have nothing to do but hurt themselves and make our lives that much more complicated. Really, it won't be all that terrible." He cringed. "Ugh, who am I kidding, I'm getting sweaty palms just thinking about it."

"At least you don't have the butterflies yet."

"Now don't you start worrying that pretty little face of yours, too. Your entire little posse will be here with you, so you can all pull yourselves through this purgatory of a night to come in the most annoying of ways possible like you always do. Now come with me, I've got charts for you."

The butterflies J.D felt fluttering around in his gut seemed to be going to waste as the night was perhaps the quietest of Friday nights the hospital had seen in months. Even the emergency room maintained a reasonably low level of commotion. J.D's patients were all asleep, Dr. Henderson's patients were all asleep, and his pager hadn't gone off in nearly an hour, so he decided to check in with Turk and Carla and see how they were doing.

"I just wanna go home, baby." Turk groaned tiredly, burying his face in Carla's shoulder.

"Yeah? Well, so do the people who are gonna come in here needing surgery. I'm sure they'd rather be home on the couch watching TV than going under the knife." Carla paused and softly caressed the back of Turk's bald head, lightening her tone of voice. "But I want to go home too."

J.D cut in. "Right about now I'd be visiting Ms. Mitchell. I'd understand her advice more easily at night for some reason."

"I'm happier that she's gone." Turk said, only to receive bewildered (and almost offended) looks from his wife and best friend. "I mean, she's gone which means she's healthy. Isn't that what we were going for?"

"I guess so . . ."

J.D felt a wave of vibrations shake his hip which could only mean one thing – Dr. Cox needed help. Carla was paged as well, so together they zipped down to the ER. It was still abnormally quiet, but there was definitely a situation brewing. Two ambulances had just arrived. Dr. Cox was near the doorway walking alongside a stretcher, on which was a man who was clearly panicking, and his right hand was grotesquely swollen and mangled. Two of his fingers were dislocated, and a large cut stretching from his palm to the top of his wrist leaked much blood, but he didn't appear to be in immediate danger.

"Newbie, I need you to get him into a room and assess him, like now, now, now."

Without a word, J.D rushed over and placed his hands on the stretcher, failing to notice that Dr. Cox was gesturing in the opposite direction. With that he attempted to roll it forward, but Dr. Cox gave resistance. "Not him, you idiot!" He barked. He then pointed over to the right where there was another stretcher that J.D hadn't even seen yet. On this one was another fellow, this one much smaller in stature, and clearly in much more need. J.D hustled over to his side. A closer view made J.D's heart sink. This one was nothing more than a kid, and overall looked as though he was already dead . . . or soon to be. J.D placed two fingers on the side of the boy's blood-covered neck. He felt a small murmur that he wouldn't even consider to be a literal pulse. This kid needed help. Nervousness flooded into J.D's system, and to make matters worse, the man who Dr. Cox was tending to started to cry frantically.

"I didn't cause it! I didn't cause it!" he repeated through tears.

"Car accident?" J.D asked.

"More like a vehicular massacre," Dr. Cox replied, "and this one's drunk. So that kids' blood is gonna be on his hands unless we, meaning you, can do something to keep him alive, so get a move on it!"

"I didn't cause it! It wasn't my fault!" the man continued to wail. "I swear, I didn't do anything wrong!"

"To be a doctor, you need to be able to withstand the most gruesome of sights. It used to be that whenever I saw something gross, like a grade school classmate vomiting on the playground or a shot of mid-surgery while channel surfing on the TV, I would gag and cry. Although I can now meet this need, I still feel terrible, physically and emotionally when I see anyone hurt or sick."

J.D further inspected the boy and his many injuries. His forehead was split open from the tip of his left eyebrow to the tip of his right, and it was a deep wound. His eyes were shut, but his lids were swollen and taking on a light purple tint. Small pieces of glass were shimmering under the ceiling light – the problem was that they were embedded in his skin along the right side of his face from his temple to his lips which had a slash running diagonally through the left side. As he continued to inspect, J.D tried to assume what had happened to the boy in the accident.

"The driver-side window shattered . . ." he mumbled upon seeing the glass.

The boy's nose was crooked, was also turning purple, and blood was pouring from either nostril. The general misshapenness of his nose caused J.D to wonder if he could even breathe through it.

"He was thrown forward, but the airbag should've kept him in better shape than this."

"Maybe it didn't deploy fast enough, or at all." Carla added.

Carla tried to open the boy's mouth but there was too much blood to see anything. "Bambi, suction please!" She ordered.

While J.D worked, Carla gently places her hands on the sides of the boy's neck. She could feel internal swelling, leading her to believe that his airways were constricted, soon to be shut off entirely. She swept a finger along the outer front of his throat where the swelling was worse. Even upon applying pressure she could not feel his Adam's apple. A red flag went up.

"Oh goodness, we need airway access ASAP." She said. "Hurry, we're losing our window. If we don't get through it now he's a goner. J.D, did you get that suction?"

"I'm trying, but there's blood coming up his throat."

"Oh god, Dr. Cox!"

The elapsed time at this point was only twenty-five seconds, and already J.D, Carla, and everyone else in the room were feeling exhausted, relying on adrenaline alone to keep them functioning, but ultimately to keep the boy alive.

"What is it?" Dr. Cox asked, clearly displeased about being called in.

"We need your help gaining control of his airway – there's too much blood coming up into his throat. I think his neck might be broken."

"I'll bet money on it. Someone get me a ventilator."

...

Nothing happened and no one said a word. Cox whistled loudly. "I said a ventilator!"

"There isn't one in here!" one of the assisting doctors exclaimed.

J.D watched in fright as Dr. Cox's face turned from its normal complexion to a fiery red. He gritted his teeth as his bushy brow furrowed. It was the sheer essence of frustration seen on a man's face. "I'll deal with whoever did not stock this room with a ventilator later, but if you don't find me one in the next sixty seconds then you'll be the one to call the time of death, now go! Carla, bag him."

"There's too much blood in his throat!" J.D opposed. "If you bag him the air pressure will just push it down into his organs."

"Newbie, if he's not drowning now he'll be suffocating soon if we don't do something. Whatever blood we force in we'll get out. If we can keep him alive long enough we'll get him right up to surgery, but we're climbing this case one stair at a time so we gotta get past this one before we can proceed. Carla, bag him."

J.D stepped aside and took a deep breath, trying to clear his mind for a brief moment. One of the many things he disliked about the emergency room is that five minutes could pass and leave you feeling more tired and weary than an entire nightshift. This was a perfect example of the madness of the emergency room.