It was a long line for coffee this morning like it nearly always was. I had overslept. When April had been here, that was something that I didn't have to worry about because I knew that she would be up and drag me out of bed if she had to. She'd been gone for two months now, occasionally FaceTiming me from halfway across the world and clearly, based on the enthused attitude that she had since she had left, whatever she was doing over there really was making a difference in her life and her healing process after Samuel.
The same couldn't be said for me.
Falling asleep at night had become difficult but what was harder than that was waking up to an empty bed and trying to force myself out of it each morning. It'd been months. There was an expectation for me to behave normally now. I was sure that was because there was no one left who understood what April and I had been through. Now instead of dealing with our loss together, she had left me to handle it on my own. Except I wasn't handling it. I just pushed through every day and focused on my work, hoping that it would get easier or less painful to deal with. Walking past an empty nursery every night was wrecking me. But there was nothing else for me to do at this point.
I missed her. I missed our son. At least April would come back eventually, but it was getting harder and harder to wait for her with each passing day. When she did call, I didn't want to let her know how hard all of this was on me. She seemed so much better, there was finally some light back in her again. I couldn't be the one to ruin that for her.
Reaching the front of the line, I ordered a black coffee and breakfast sandwich. Our kitchen had been virtually untouched in the past few months, only cleaning up the takeout food and washing the cutlery used for it. Cooking for one was just depressing. Ordering takeout was a hell of a lot easier. The same applied to breakfast. I knew April would have insisted upon making our own coffee and taking it in, but alone, I had no motivation.
It doesn't take long to get the order and I scarf down the egg and bacon sandwich as I walk, scrolling through patient charts. I had a breast reduction scheduled for the afternoon, but other than that, it was a pretty light day.
My pager buzzed and I let out a sigh, shoving the last bite of my sandwich into my mouth to free up my hand and take a look at it. It was a non-emergent page from the trauma surgeon who was taking care of things in the emergency room with Owen and April both gone. It was weird, things down there without her. Without the both of them, really. It felt like an entirely different place now.
"What's going on, Jones?" I questioned as I arrived downstairs in the emergency room, pocketing my pager again and taking a sip of the coffee now that it had cooled off some.
"Need you for ENT today. We've got a teenager here with osteogenesis imperfecta, type four. Looks like he's developed some hearing loss as a result of the disease." He explained calmly, handing over the tablet in his hand.
The simple explanation hit me like a train, bulldozing through me without taking any account to how I felt at that moment. How could he know? At the same time, how could he not know? The word about what April and I had been through had traveled through the hospital beyond our control, damned HIPPA and any sense of decency, apparently. It seemed unlikely that he didn't know. My chest tightened and I clenched my jaw, not wanting to put any part of how I felt on display. I hadn't let April see the depths of my emotion when she had fallen apart, needing to cover and keep it together for her, so there was no way that I could spill out like that in front of anyone else I knew.
But at the same time, I had a job to do.
All of those feelings that I had been keeping buried away have to stay inside. Swallowing thickly, I gave a nod of my head to indicate that I had heard him and forced my gaze down at the tablet in my hands to review the information in front of me. Hearing problems were common in people with O.I. among other things. I was going to have to suck it up and handle this patient just like anyone else would.
No amount of prepping myself was going to make this any less difficult than it would be, though. There was nothing that I could do on that particular regard. I force my feet to move, heading over toward the bed that the patient was located on.
"Jordan Byrde?" I questioned, waiting for the boy to look up and nod. "Hi, I'm Dr. Avery."
Introductions are exchanged and his mother offered me more background information about his case. It took every ounce of strength that I had to keep my face straight. I wanted to call someone else to handle the case – anyone else with the same ENT certification that I did, even if it meant making them wait. But I don't.
This could have been my kid. This should have been my kid, one way or another. I knew that April had prayed for a miracle in the situation, no matter how unlikely it was given what her ultrasounds and the test results had said, and there had been a part of me that wanted her to be right. I hadn't wanted to encourage her, to give her more hope that would eventually be shattered, but I had wanted it to. I would have given anything for our son to be able to be here, to have a life, even if it was far from normal and far from the life that I would have wanted my son to have. But it was too late now. There was nothing I could do to change the past. I just had to live with it.
I do all of the testings that were necessary – an audiologic assessment that includes a hearing test with air and bone conduction and speech reception threshold, taking all of the notes necessary for a case like this. But I knew I couldn't be his doctor.
Excusing myself to get the test results from the lab for them, though, I can't hold it in as long as I want to be able to. Everyone had their limits when it came to pain – that applied to mental agony just as much as it did the physical suffering. I had my limits, a breaking point, one that I could only ignore for so long before it became absolutely too much for me to bear.
The slam of the door to the supply closet behind me is loud and probably drew the attention of people on the other side of it, but at the moment, I couldn't have given less of a damn what anyone else thought. My eyes burned as tears came up, widening my eyes to try and keep them from spilling past the brim. The tightness in my chest made it painful to get oxygen in and out. Wrapping my hand around one of the shelves, I tipped forward at the waist and leaned my head against it. The metal shook loudly underneath my grip, everything on the cabinet vibrating because of it. I could have knocked it over, I could have torn up the entire thing – but no amount of destruction was going to ease the way that my heart was ripping apart inside of me.
A guttural noise left my throat and my hand swiped over a box of gauze, sending it and a few other softer times onto the floor. I don't bend over to pick it up, instead, intentionally rattling the shelf that I was gripping onto. None of it made me feel better but I was losing control of myself.
Two fists slammed against the shelf and I listened to it rattle. The cold metal hitting against the sides of my fists so sharply produces a little bit of pain, but it's hard to process it when I feel like my heart was currently being clawed out of my chest, slow, just to drag out the pain for as long as the universe was capable of. Was everything that I had been through not already enough suffering?
"Avery?" Hearing my name barely drew away my focus.
"I'm fine," I lied through gritted teeth.
"Son, you're clearly not." Webber's voice was much more firm with the words and I tightened my grip, knuckles nearly turning weight, before releasing the metal that I was holding onto and straightening up again, facing away from him.
My head shook and I ran my tongue over my teeth inside my mouth, trying to find enough restraint that I would be able to get through some kind of brief conversation with him. My jaw was tensed so tightly that I could feel my teeth grinding against each other inside of my mouth, arms stiff and hands curled into fists.
"You can't go back out there looking like that," he continued, stepping forward.
"I have patients to take care of." I inhaled sharply through my nose.
"Is this all" –he motioned to me– "about April?"
I scoffed. "No, it's not about April." If it was, I would have been able to keep it together. I wouldn't be having a goddamn breakdown in the middle of a supply closet like my life was falling apart again.
"Then what is it?" He continued.
"A teenager came in today with hearing loss because of the disease that he has. Osteogenesis imperfecta, type four." I explained, wetting my lips as I spoke. Without looking at him, I'm sure that there's a shift in his posture and the understanding that he suddenly has.
"Do you need me to take over?" Richard offered. If it would have made sense, then I might have said yes. I knew that he was experienced with a bit of everything in all of the years that he had practiced medicine and surgery, but he wasn't an ENT or hearing specialist. It wouldn't have been right for me to pass this case onto him, no matter how much dealing it with even for a few minutes was tearing me up inside. I had to conquer this on my own.
"No." I swallowed thickly, shaking my head. "I'll handle it."
Without saying another word or giving him the chance to stop me, I walked past him and out of the supply closet, drying my cheeks with the back of my hands before quickly shoving them into the pockets of my lab coat. I kept my head down, wanting to get the results from the lab as soon as possible, and pass on the teenager and his worried parents to another doctor.
Samuel was gone. There was nothing that I could do to change that.
As much pain as it may have caused me, there were too many thoughts and scenarios that I had imagined with our son that I was never going to be able to get rid of. A lot of them had occurred before April had even spilled out that we were having a boy, but my imagination had spun out thinking about the different things that I would be able to do with our child, the experiences that I would have with our kid that I'd never been able to have with my own father after he had left me and my mother. I had wanted to be a good dad. That's all I had wanted. Now, with April halfway across the world and me on my own, I wasn't that. I wasn't even a good husband. And today, I couldn't even manage to be a good doctor for this patient. I felt like nothing.
Two of those things, I couldn't change. There was nothing that could be done about what had happened to our son. Samuel's short life and tragic death was an agony that I was just going to have to keep living with day after day. April... it could have been different, but she had made her decision without consideration for how it would affect me. I had let her. I hadn't wanted to suffocate her when she was grieving, I wanted to give her the best chance that she could to heal, even if it wasn't what was best for me.
But I could be better for this kid. I could do for him what I would have wanted doctors to do for my son.