I'm sorry I haven't updated this for months. Here's a brief recap of what's happened so far.
The Story So Far: Cal became very distressed when his father was brought in as a patient and confesses to Ethan that while their father loved and was proud of Ethan, he physically and mentally abused Cal throughout his childhood. Ethan is supporting Cal, but his brief reunion with his father is causing Cal to doubt his ability and after losing a patient, he's come to the conclusion he'll never be a good doctor and he should quit.
westlife4ever80, it must be very hard for any doctor to lose a patient, even for someone who's completely confident in their ability and firmly believes they did all they could. But Cal has so little confidence in himself... Thank you for your review.
Bonnie Sveen Fan, thank you for your review. It was actually quite heartbreaking for me too, reading back and finding out how much I'd made Cal suffer! But at least he's still alive.
bronny9, thank you for your review. I'm sure a nice cuddle with Ethan would help Cal - I think that's something we'd all like to see. It might take a while, but I'm sure Ethan will do everything he can.
TanithPanic, I'm glad you liked the addition of Lofty! I'm sure I put him in the story for you. I think even in the past, Cal was right sometimes and Ethan was wrong sometimes, though it didn't happen very often. Thank you for your review.
bronwen100, thank you for your pm. I'm really glad you're enjoying this story and I hope I'll finish it now I'm writing Casualty stories again, but who knows when the inspiration will disappear?
Ethan stared at Cal in horror. "No, Cal! You mustn't quit. You're a great doctor and you did really well. You did nothing wrong. If anyone needs to take responsibility for this, it's me. I was the lead doctor; I made the decision to call it."
Cal shook his head sadly. He loved his little brother for wanting to do everything he could to make him feel better, but he knew he didn't deserve it and it obviously didn't change anything. He'd messed up again. Just like he always did.
"Oh, Cal…" Ethan sounded like he might cry too. He wrapped his arms tightly around Cal. "Come on. Come here. I've got you. I promise you, you didn't do anything wrong."
Cal could feel the tears and sobs waiting to pour out of him in a flood, but he knew he couldn't let it happen now. He couldn't stop Ethan from doing his job. He'd done so much to harm Ethan's career already. "No, Ethan. I'm fine. Let's go back to work."
Ethan didn't let go of him. "You really think I'd let you go back to work?"
Ethan's words seemed to penetrate Cal's chest. He gasped at the shock, then the pain began. The terrible pain of guilt: the proof that he wasn't good enough to be here with Ethan. He never had been.
Cal had done so badly, Ethan didn't want him to work with him anymore.
"Cal?" Ethan sounded anxious. "Cal, what is it?"
Cal wasn't sure why he was asking. Ethan must know what he'd said. Maybe Ethan thought that what he was saying was so much a fact, it was stupid for Cal even to think about objecting.
Yes. That must be it.
"You're right, Ethan," he said, and although his voice was calm, the rest of him felt a long way away from the words he was saying. "You need to go back to work, but I'll stay here and rest for a while."
The relief on Ethan's face only twisted the knife further. "I think resting sounds like a good idea. But there's no need for me to go back to work just yet. I can stay with you for a while."
"Ethan, I think you do need to go back to work and to be honest… well, I could do with a bit of time on my own," said Cal.
Ethan flinched. "Yes. Yes, of course. I… I'll go back to work now. It's fine." He smiled a bit unconvincingly and patted Cal's arm. "Call me if you do need me, okay?"
I've hurt him, Cal realised as he watched Ethan go. I hurt my little brother. He was trying to help me and I pushed him away.
Cal waited till he was sure Ethan wasn't coming back. He went to his locker and took out his bag, then he went to the door of the staff room and peered out cautiously. He could see a few figures in scrubs, but he knew none of them was Ethan.
Cal knew he'd be less likely to attract attention if he got changed, but it was too much effort. He just wanted to get out of there. He walked out of the staff room and kept walking, his eyes fixed ahead of him.
No-one called out to him. No-one seemed to notice him go.
It only proved what Cal already knew. They didn't want him there and they were glad he'd finally realised how useless he was and left.
"Dr Hardy?" said Robyn hesitantly. "Ethan?"
Ethan turned to face her, his mind still partly on Cal. "Yes, Robyn?"
"Is there anything you'd like us to do?" asked Robyn. Her voice was gentle, but she was clearly concerned. "Would you like me to take some bloods? Get a line in?"
Ethan blinked at her, then he looked at the patient. Penetrating chest injury above the umbilicus. Suspected injuries to the lungs, heart and great vessels. "Okay, let's put a line in and get a chest x-ray, please. We'll put her on high-flow oxygen and commence fluid resuscitation."
He began his examination. Respiratory distress. Distension of the veins in the neck. No tracheal deviation. He used his stethoscope. No decreased chest expansion on either side. No hyper-resonant percussion note. A tension pneumothorax was unlikely; a simple pneumothorax was possible, but the distended neck veins were a more immediate concern.
Hypotension. Tachycardia. Ethan looked at the systolic blood pressure: pulsus paradoxus on inspiration. Quiet heart sounds.
"Robyn, can I get a focused ultrasound, please? And can you get-" Ethan stopped. The low blood pressure, fast but quiet heartrate and the marked decrease in systolic blood pressure when the patient breathed in was indicative of cardiac tamponade. Ethan had never performed a pericardiocentesis. He was more than willing to perform one now, but he needed to be supervised by a doctor who had performed it.
Connie, Zoe or Dylan would all have performed one, but so had Cal. Ethan wasted valuable seconds as he wondered if asking for Cal would be a boost to his brother's confidence or if it would make him go to pieces.
"Ethan!" said Robyn urgently.
Ethan looked at the monitor. Jugular venous pressure was elevated. Another classic sign of a cardiac tamponade. "Prep for a thoracotomy, please, and can someone find me a consultant or Cal?" but please not Cal? He added silently and hated himself for it.
Ethan knew Cal could do this. If he couldn't, Ethan wouldn't be here. But his self-esteem was so low and if it went wrong, he would only torture himself further. The fact he'd saved Ethan's life might actually make him feel worse because he might feel it was down to luck alone that his brother had survived.
"Ethan, you needed a consultant?" asked Zoe.
Ethan was so relieved, he came close to hugging her. "The patient has a cardiac tamponade, Zoe, and I've never performed a pericardiocentesis."
"Are you happy to do this?" asked Zoe.
Ethan nodded.
"Then I'll supervise you," said Zoe. She squeezed Ethan's arm. "You'll be fine. I'll be right here."
"Well done, Ethan," said Zoe. "Very good work."
"Thank you," said Ethan, but he felt empty and guilty. He wished Cal could have been here to supervise him and share the moment with him.
Zoe's smile faded slightly. She put her hand on Ethan's arm and rubbed it gently. "It does take a lot out of you sometimes, doesn't it?"
"Yes," whispered Ethan, thinking it was probably easier to agree, but he'd never been very good at fooling anyone.
"Come on. Let's go and have a chat," said Zoe, taking his arm and leading him out of Resus.
Ethan didn't argue. He tended not to argue with the consultants and he thought Zoe would probably take him to the staff room, which was where he wanted to be anyway. He had to be with Cal. "Um, Dr Hanna…"
"Ethan, I told you. It's Zoe."
"Um, Zoe. I don't suppose… can we tell Cal you performed the pericardiocentesis?"
Zoe stared at him for a moment, then said simply: "I think we need to go to my office."
"But Cal-" Ethan remembered his rule of not arguing with the consultants and blushed. "I'm sorry, Dr- Zoe."
"Ethan, you have nothing to apologise for," said Zoe. "But I'm concerned about you. Really concerned." She hurried him along to her office and ushered him inside. "Okay. Sit down." Zoe sat on a chair beside Ethan. "Okay, the first thing I needed to ask you – I didn't ask before as obviously our patient was obviously my main concern – where's Cal?"
"In the staff room," said Ethan, his mood plummeting still further. "We lost a patient. Cal took it very hard. I wanted to stay with him, but he said I should go back to work. And I'm sorry – I'm really sorry – but I think I should get back to him soon."
"I won't keep you long," promised Zoe. "But I need to know, Ethan. Why do you want me to lie to Cal about who did the pericardiocentesis?"
"Because if he doesn't know I've done one, then he's the only one of us who has," said Ethan. "It might give him a bit of a confidence boost to know he saved my life, but I had to ask you to do it for me."
"It might, but we can't lie to him!" said Zoe. "I have been very concerned about Cal lately and I do want to help him, but I'm not prepared to lie to him and quite frankly, I'm shocked you are."
Ethan looked down at his lap.
"Ethan, I know you want to help him," said Zoe, more gently. "We all do. But I don't think lying to him is the answer. We need him to believe all the positive things he's saying to us. He has enough trouble with that already and if he finds out we've lied about something, it'll be even more difficult for him to believe us. Even if we did lie to Cal, we can't lie in the medical notes and that's something Cal could check or something he might accidentally see."
Ethan dropped his face into his hands. He knew Zoe was right. Of course she was right.
He felt Zoe stroking his arm. "I know it's hard, Ethan. It's horrible seeing someone you love suffering so much. But you're doing really well and if you need support, we're here for you as well as for Cal. You don't have to do this all on your own."
Ethan tried not to cry. He had no reason to cry. His dad had loved him. "I just don't want to make him feel worse."
"I know you don't," said Zoe. "And I'm sure you help him a lot."
Ethan wished he could be even half as sure.
"Tell you what," said Zoe. "Why don't you stay in here for a bit, and I'll go and get you a coffee and send Max to go and sit with Cal? He's really worried about him and he'll be happy to help."
"No, I should do it," said Ethan. He took off his glasses and wiped the tears from his eyes. "Thank you for the suggestion, Zoe. And for being so kind. But Cal really needs me and I need to go and find him."