Author's Note: Oh my dears – this chapter. So much research involved – more than a dash of theoretical science. I know it's shorter than you've been getting used to, but I hope it's full of wonderful for you anyway. If any of you reading this ARE familiar with the Josephson junction and the Kuramoto model for synchronization of biological oscillators, please feel free to tell me how wrong I have it. I'd like to get a better grasp on those ideas. If you have no idea what I'm talking about, that's good. Lance will explain it as best he can seeing as Pidge is at home and unavailable at the moment. I hope you enjoy.
Chapter Eleven: Scope of Practice
Once an ambulance arrives at the emergency room, there is a transfer. Not just of the patient. Everything switches. The paramedics let down the stretcher, wheel it inside, and shift the patient to a waiting bed and team. Paperwork is torn from a clipboard and tucked into a folder. Information goes back and forth between the ambulance staff and the ER staff.
Lance had always remained on the ambulance side of an emergency room. Bring the patient in, pull the paperwork, return the blood pressure cuff to its waiting hook, answer questions and stay out of the way. Once the ER people had everything they needed, he'd go back to the ambulance to wait for the next call. Staying here afterward was new, unusual, and to be honest, demoralizing.
Keith's condition required a team on high alert, and Stefany had done a good job on the radio before they'd arrived assembling the proper people. There was someone from cardiology, from phlebotomy, two techs, and a nurse – all people that Lance did not know who crowded him and Shiro away from Keith almost as if they weren't there at all. Lance wanted to fight them, cling to Keith's hand and refuse to move, but Shiro pulled him back like an irresistible force of nature, physically restraining him and tugging him into a corner. A powerless place, watching the lab-coat-covered backs, hearing from a distance a few vague words here and there.
"Let them do their job," Shiro told him, and while he hated it, Lance had to admit that he would be out of his league among them. He submitted and stood quietly anxious at Shiro's side, arms folded tightly across his ribs, his backpack on the floor leaning against his leg, watching with grudging admiration how the ER team worked together.
The nurse was amazing, stepping in immediately with the techs on her sides. Between the three of them, they moved Lance's quilt to the only chair in the room and had Keith stripped of his clothes and into a gown in seconds. Then they began efficiently hooking him up to everything they had - another blood pressure cuff, a pulse oximeter, the portable D-size oxygen tank from the ambulance was replaced with the permanent flow attached to the wall. And Lance blinked in amazement as the nurse secured in place all twelve electrodes for an EKG machine with a kind of skill that he could only compare to the embellished and non-realistic precision of old martial arts movies. Stats appeared on the black and green screen to Keith's side, a continuous line of data showcasing Keith's rapid heartbeat, a frightened spike popping up hard every time someone unfamiliar touched him. His oxygen level had increased to ninety-two, but that was the only improvement Lance could see.
The only snag in the entire admissions procedure came when the phlebotomist was temporarily tripped up to discover that Keith already had an IV site. Lance watched him check it, turning Keith's hand this way and that, examining it from several angles. He said something to one of the techs, shrugged with only one shoulder, and began to hook his own apparatus into Lance's cannula to start putting fluids back into Keith's system.
After a few minutes, the energy in the room died down slightly, the phlebotomist leaving altogether, taking one of the techs with him. The cardiologist left shortly after with the remaining tech, and Lance watched the nurse sort of bow out of the room as the ER doctor on call came in. The whole thing seemed a sort of choreographed performance – the team acting as the cast to set the stage for the main actress. Lance felt his muscles constrict, unconsciously standing straighter as he recognized the doctor coming purposefully to Keith's side, a woman who moved like a warrior of the Amazon, like some sort of African priestess. Dr. Angelique Delacroix.
She was covered in royal purple scrubs, gloves, and mask, with almost none of her dark skin visible, but he knew it was her. Knew from the deep brown hair, steaked with gold, that had been plaited in hundreds of tiny braids that normally fell to her waist, but were now pulled into a large knot at the base of her neck. He knew from the confidence in her stride, and the sharpness of her eyes, also dark and streaked with gold, as she took in everything around her in an instant. Lance had only seen her twice before, but he knew her well.
She'd turned up unexpectedly during one of Lance's EMT classes, asking permission to sit in and listen for a while. No one knew why she was there or why she had taken a sudden interest in this particular instructor or lesson. Lance didn't even know who she was then, though she'd been introduced before she'd taken a random seat. She sat there, silently, until Lance answered a question that seemed to surprise her and suddenly Lance found himself the object of her tiger-eyed stare as she continued to drill him about who he was, where he came from, and how he would handle case after case until she'd completely exhausted his soul and his knowledge, turning him into a stammering, uncertain mess in a matter of minutes to the tune of the other students nervously giggling all around him – all of them secretly relieved that they weren't in his shoes. When class dismissed and she left the room, Lance stayed in his seat for a long time feeling slightly violated.
He'd almost refused to go when he received an email from her the following morning asking him to come have coffee with her in her office at the hospital, but in the end, he'd been too intrigued not to accept. He even bought and brought the damn coffee – though he hadn't been able to drink it during what seemed like an impromptu hiring interview with dashes of autobiography and a quasi-history lesson thrown in at seemingly random intervals that kept Lance perpetually knocked off balance. He sat there, stunned by her voice, which was deep, intense, and full, rooted into the very core of the earth. She asked him about sucking chest wounds and then turned around and asked what he knew about voodoo. He'd done his best to keep up, but in the end, he accidentally spilled coffee all over himself, his hands shaking incredibly hard at the twists and turns and just the strange intensity of the conversation that he just lost his grip on the cup completely, staining his clothes and damaging some of her notes.
That had caused her to sigh and pull back, slowing down, thanking him for coming and suddenly he was out in the hallway with several napkins, the bitter coffee, and a sense that he had just failed an exam, that he'd missed his chance to do something incredibly special. It felt like being passed over by an undercover deity. Unworthy. In revenge, he'd asked Pidge to pull up everything she could find on Dr. Delacroix.
"I'm surprised she didn't eat you," Pidge told him as they sifted through the information. Angelique was forty-five, had spent her childhood in the French Quarter of New Orleans before attending college at Harvard and later made Chicago her permanent home after her residency there. She had never married and had a reputation for bringing most of her students to tears on the rare occasion she taught a class. "Did you notice if she stole any of your hair?" And Lance had shoved Pidge's shoulder, rolling his eyes, but then that night he sat up in bed worried about that very thing. That had been four months ago, and since he didn't appear to be cursed by anything other than being a sort of awkward nineteen-year-old boy, he'd forgotten all about her until now.
As Dr. Delacroix approached Keith's bedside, Lance couldn't take it anymore. He broke away from Shiro's hand on his shoulder, meeting her on Keith's other side as if he'd protect him from her somehow, though he couldn't bring himself to look her in the eye and Keith actually needed her quite badly at the moment. Angelique didn't acknowledge him; she was devoting her full attention to Keith, slipping one hand into his and placing the other gently on his forehead.
"Hello, baby," she crooned at Keith with so much actual affection in her voice that Lance was startled. He'd never heard her talk like that; she certainly had never spoken to him that way. "My name is Dr. Delacroix, and I'm going to be looking after you while you're here in the ER. Looks like you've got quite a lot going on, huh?" Keith lay on the bed, breathing like fish do when they're out of the water, out of his element, staring at this tiger woman standing at his side. "We're giving you fluids and some pain medication in your IV there, and it seems you've already received a good dose of heart medication in the ambulance. We'll give you a little more time to see how it's working for you before we try anything else. So far, everything seems to be holding steady, so I hope to have you feeling more comfortable very soon. I know you're hurting right now; please stay patient." She paused, conspicuously turning her gaze to Lance, who had to remind himself a little too late to close his stupid mouth. He couldn't tell if she recognized him or not, and he wasn't sure if he'd be insulted or relieved if she had forgotten him completely.
"Is this your friend, darling?" She continued to talk to Keith. Instead of answering, Keith did his normal trick of reaching over to Lance, intending to attach himself to his clothes, but Lance cut him off before he could, gently encasing Keith's hand with both of his, careful of the IV. "I see." She moved her exquisite head over to where Shiro still stood in the corner. "And you?" She asked.
"Takashi," Shiro said, and Lance admired how strong he kept his voice. "I'm . . . was . . . Keith's social worker."
"Ah," Angelique breathed in response, seeming a little disappointed with the selection of outcasts who had followed Keith into her triage room. "Could you tell me who has legal custody of Keith currently? Does he have a living will or advance directive?"
"No, nothing like that," Shiro responded, and Lance could tell he was ashamed of himself for some reason. "And he's eighteen. He has legal custody of himself – no known relatives." Lance knew why she was asking these questions. If Keith blacked out, if he flatlined, if something bad happened here, Dr. Delacroix wanted to know who was allowed to speak for him, to make medical decisions on his behalf. Since neither Lance nor Shiro could legally do so, she would assume that right if the situation came to it. Lance didn't know if he liked that, but it was out of his hands now. This wasn't like the ambulance; he wouldn't be able to get away with anything. He had no authority in this room at all.
Angelique nodded, accepting the answers and assimilating them into her master plan. She moved the hand on Keith's forehead to his chest, as if holding his heart.
"All right, love," she spoke again to Keith. "I'm going to give you five minutes for the medicine to bring your heartrate down before we try something else. You just lie here quiet, just like this. Don't be scared. Your friends are here with you to help you relax, but I am going to borrow Lance for a few moments to ask him some questions. We'll be right outside the door." So she did remember him after all.
Her eyes were on fire when Lance finally met her gaze, and he wondered how she could keep her expression so fierce like that when her voice was so soft. He looked away as quickly as possible, turning behind him to gesture for Shiro to come take his place at Keith's side. Shiro seemed more than happy to do that, stepping up immediately and leaning with concern over Keith.
"I'll be right back," Lance promised, though he absolutely did not want to follow Dr. Delacroix out into the hall. But it was like he was already gone, no one acknowledged his departing comment. Angelique held the door open for him to go out first, and he walked past her as if to an execution.
It turned out not to be that bad, but it was close.
"Well, Lance," Angelique began, tucking Keith's chart into the slot by the door. "McClain, wasn't it? Still in the med program then?" The way she said it made Lance wonder if she thought he would have been kicked out by now. Though, he supposed he hadn't made that great of an impression on her the last time they'd been together. He hoped she hadn't brought him out here just to ridicule him about that.
"That's right," Lance responded, though he felt that she hadn't expected an answer. "Nice to see you again, Dr. Delacroix."
"Hmmm," she replied, ambiguously, no trace of the gentleness he'd just seen in her remaining outside of Keith's room. "Do you want to explain yourself?"
Now he was confused and not sure where to start. Did she mean the stuff he'd pulled on the ambulance? Letting Shiro carry Keith? He stood there deliberating, leaning a little against the wall, listening to the bustle going on all around them. Carts being pushed, typing, footsteps, monitors going off, murmurings of conversations happening outside of triage rooms just like the one he was having right now, all private discourses though they were right in the open. And out of the corner of his eye, Lance saw Officer Guist just arriving through the main entrance. Great.
"Maybe you tell me what I did and then I can explain why I did it," he suggested, not wanting to give her more than she had on him already. Mostly he wanted to get the lecture finished so he could go back inside with Keith.
"I heard from the ambulance team that you placed that IV on the drive over here," she said, her tone so dangerously neutral that Lance wanted to sit down on the floor. "Is that true?"
"Yes, Ma'am," he confessed, not seeing any point in denying it, wondering how much more the ambulance team had told her. "I thought it would save time."
"You know that's out of your scope of practice, don't you? I could have your status revoked?"
"I . . do know that, yes." Lance could practically feel the discomfort of the coffee spilling on his lap; he was right back in her office again, stuttering under her scrutiny. Geeze, this woman.
"And you did it anyway. Why?" Ah, what the hell? He was already in trouble.
"Because I'm better at IVs than Grayson," he said, very simply, no trace of arrogance involved. "The cephalic vein was the best location, and I wanted to get the medication into his system via IV as soon as possible because an injection would take two hours to work and an IV would take twenty minutes. And I didn't want to wait until we got here because even the two minutes we were away from the hospital was almost three hundred and fifty beats of Keith's heart and thirty liters of oxygen and I just . . .that just seemed like too long when it didn't have to be." He hung his head, wanting to disappear.
"Well, forgive me, but I'm surprised," Angelique finally said, truly sounding that way. Lance risked looking up at her, seeing her standing with her hands on her hips, head tilted to one side, looking at him as if he had suddenly pulled a face mask off of himself, revealing a secret identity that she'd never known about. "I didn't think you had it in you."
That sort of stung, but Lance wasn't in a position to protest.
"And in a moving vehicle on icy roads, no less," she finished, very quietly.
Lance wasn't sure where to go with that. Did she sound . . . impressed? At least she didn't sound mad. He thought it might be safe to change the subject.
"What's going to happen to Keith?" Lance asked, not really caring about anything else. He knew he'd done the right thing, maybe not the legal thing, but the right thing, and if the absolute worst happened and he ended up right back in Cuba in his mango orchards because of it, he thought he could live with that.
"If he's lucky, his heart will start slowing to a normal pace in the next few minutes. If it doesn't, we'll have to use the manual defibrillator." Angelique answered his question as though speaking to a comrade, to an equal. Lance didn't know how, but it seemed she'd gained a new respect for him during their conversation. That didn't mean he liked her answer, though. The defibrillator was a last resort, the ultimate in turning it off and turning it back on again for human hearts. If Keith's heart couldn't return to a normal rhythm on its own, Angelique was planning on using an electric shock to stop it in its tracks with the idea that it would then correct. Or just stay stopped.
"But he's awake," Lance whispered, almost to himself. He's conscious. He'll feel all of that. It'll hurt. It'll hurt so much. Officer Guist had made his way over to them, standing a respectful, but expectant distance away, as if waiting in line for his turn.
"He's awake right now, but if we let him keep going like this for much longer, his heart is going to fail. You know that," Angelique went on. "I don't want to do it either, but if I have to choose, that's what we're going to do. So I suggest you get back in there and calm him down as much as you can."
Lance nodded, feeling the weight of responsibility for Keith being returned to him, wondering if that would have been the case if he'd somehow displeased Angelique with his explanation of the IV. He gripped the handle of the triage room door, intending on going on, but Officer Guist spoke up behind him.
"Actually, I'd like a word with you first," he said, breaking into the conversation now that it was practically finished. Angelique lowered her mask specifically to scowl at him.
"Oh no," she snipped at Guist. "You're going to have to wait, Officer. I just gave this boy a job to do and someone's life is at stake waiting for him to do it. You can have your say when his patient is out of danger and resting."
Guist didn't look very happy about that, but there wasn't a whole lot he could do. He didn't have a warrant for the triage room. "Can I ask you some questions, then?" He compromised.
"That's fine," Angelique agreed. "You go on now, Lance. Go talk him down. I'll be there in a few minutes to check on your progress."
Never in his life did Lance believe that he would be pulled out of a room for violating medical rules only to be later defended from an officer of the law and sent back into the room to continue. He would have never thought that Angelique Delacroix would turn over a patient in her emergency room into his care. But he certainly wasn't going to question anything Dr. Delacroix said to him. And if she thought, even just a little, that he might have a chance to help Keith not need electric defibrillation, then he was all for it. But what the hell was he supposed to do?
Shiro looked serious when Lance returned to them. Both he and Keith had their eyes closed, and Shiro held onto Keith's hand, bowing over him a little in defeated pain, self-admonishment almost radiating from him. Lance checked the screen with Keith's numbers displayed on it. Oxygen up to ninety-four, which was considered just shy of normal. Heart rate .. . . still fluctuating between 160 and 170. Lance had no idea what he was going to do to help that, but he'd be damned if he disappointed Angelique again, damned if he allowed Keith to be put through any more trauma without thinking of something.
"Hey there, guys," he greeted softly as he joined them at the bedside. Keith opened his eyes at the sound of Lance's voice, and Lance put a hand on his head. "Miss me?"
"Wh. . Where did you go?" Keith wheezed, just that tiny sentence dropping his oxygen level to ninety-two again.
"Shh, Lobito," Lance shook his head at him. "I was just outside with the doctor. You're in luck, Keith, she is legendary."
"She is?" Shiro asked, as if he'd nominated himself to speak for Keith.
"Oh yeah," Lance assured, hoping to ease Keith's fear about being here, hoping to make it clear that he was in good hands now, trying to lighten the weight that was on Keith's heart. "Highest survival rate of any doctor on the floor, and I heard a rumor that she took out her own appendix. Don't know if that's true, though."
"You. . . you're my doctor," Keith protested, resistant, not wanting to be here and hating that there had been nothing he could do about it. Lance smiled, a little bitterly.
"No, I'm not," he admitted, ashamed. "If I hadn't been pretending to be, you wouldn't be here right now, Keith. It wouldn't have come to this." Keith's heart performed a frightening little shudder, the read out on the screen looking like a dog shaking itself dry. It made Keith whimper, eyes closing again. Lance needed to try a little harder. Five minutes was not a long time, and Keith was still terrified, which was impeding the medication's effectiveness. Lance put a hand on Keith's chest, as Dr. Delacroix had done, not feeling it. The pulse was rapid, but not strong, unperceivable under his palm.
"What did she say?" Shiro asked, gaze heavy on Lance. "The doctor. What's the plan?" Oh no, don't ask me that, Lance inwardly groaned. I don't want to tell you; it won't help. There is no way to ease that news and no way to prepare for it if you know in advance. He pressed harder on Keith, pushing down, searching for the feel of the heart under his hand. If only he could calm it, physically hold it still. If only he could match it to . . . wait a second.
"Synchronization," he heard himself say, remembering walking through his door, late, to find Pidge there with Hunk and about five metronomes, all pulsing out of rhythm with each other, different start points, different speeds. Hunk was so close Lance wondered how he wasn't getting knocked in the face by one of the pendulums, a stopwatch in his hand. "We're going to try synchronization." You're going to what, Lance? You're saying this out loud, you idiot.
"What's that?" Shiro sounded unsure, and Lance didn't blame him. He was certainly winging it with this, but mostly he needed to give Keith something to do, something more physical and focused than lying there struggling to breathe, waiting on the invisible assistance of the drugs. Something to calm him down like Dr. Delacroix had told him to do. "A procedure?"
"No, physics," Lance answered, looking only at Keith, noting that the glimmer of almost trust that had been in his eyes when he'd taken him from his apartment had turned into something that resembled blind faith. Though Lance wasn't sure how that could have happened when he'd done nothing to improve Keith's condition since the beginning. This would be his absolute last chance. He did not want to watch him be shocked. That couldn't happen.
"Keith, we're going to make a closed circuit – your heart and mine. Where's your hand?" He took Keith's right, the one he'd put the IV in, and guided it upwards, towards his chest, then rethought it at the last second and, extremely careful of the IV site, helped Keith reach under his shirt for skin to skin contact. If there was even the slightest chance that this would work, it would be better with as few barriers as possible. There was a tiny shriek from the monitor as Keith's heart spiked up with the movement.
"Lance?" Keith asked as Lance pressed Keith's hand against his own heartbeat. Shiro looked extremely skeptical but kept quiet.
"It's like a calibration," Lance tried to explain, holding Keith's wrist to help keep his hand fixed in place, knowing he wouldn't have enough strength to hold it up there for long, easing himself delicately on the bed close to Keith, hip-to-hip. "Though I've never done it this way before." Lance slipped his right hand through Keith's hospital gown sleeve, reaching through to where his heart would be. This was so out there; he couldn't believe he was even going to try this.
"What are you trying to do?" Shiro encouraged more explanation. Lance tried to think of how best to explain it and have anyone take him seriously. First he wondered what Pidge would say, then dismissed that quickly as he realized he'd never get anyone to understand anything that way. He decided to be as forthright as possible. It wasn't like he had a lot to lose.
"Did you know that if you set five metronomes next to each other on a table and set them off one after the other, all different speeds, that they will continue to keep pace, just as you set them, without ever changing? Shh, Keith, you just breathe now; trust me." Keith's fingers were curling against Lance's skin, as if he were trying to pull away, like he wasn't sure. Lance held him securely.
"Ok," Shiro accepted, sounding confused, but that's because Lance had only given him half the information.
"But if you take those same five metronomes, all different start times and paces, and instead of setting them on a fixed table, you put them on, say, a skateboard, or something that will allow them to oscillate, to rock, even a little, within seconds every single one of those metronomes will be ticking identically."
"And that applies to this situation how? I'm not following," Shiro asked, not condescendingly. His voice had hope in it, as though he couldn't understand what Lance was getting at, but he really wanted it to work. Lance was also hoping. It was such a long shot. Mostly he wanted to provide Keith with a distraction that sounded completely plausible. This could all be an elaborate mind game that worked a treat or it could be a waste of time that broke all of Lance's credibility. Hard to tell at this point, but Lance just didn't have anything else.
"Let's say Keith's heart is one metronome, ticking fast, not keeping time the way it should," Lance laid his experiment out, hoping that it made even a little sense, grateful that Pidge wasn't here to tell him in excruciating detail how many ways he was messing this up. "And now I've put my steady, slower metronome heartbeat next to his. And the position I've just set is what's known as a Josephson junction, which is two superconductors, our hearts, being joined by a weak coupling system, which would be the connection of our hands here, but will result in a joint supercurrent at the same pace due to the Kuramoto model of synchronization." Lance paused in his wild and possibly inaccurate description to glance at Keith's monitor. No change. And the only thing he could feel under his hand was Keith's labored breathing and fever heat. But they weren't moving yet. There needed to be some small movement, oscillation or . . . a rocking of some sort.
"Keith, if you have any energy left at all, try to move with me, ok?" Lance invited as Shiro stood to the side, utterly transfixed. Lance began an awkward shifting, just barely, keeping Keith's hand in place, lowering his head to his chest to concentrate. "Pay attention to everything slowing down. It'll only work if we can move a bit together."
But Keith absolutely could not move. Even with Lance's help, his hand was trembling against Lance's chest with the effort of partially holding his arm up. He'd started blinking fast again, his body worn out and on the verge of giving up. Lance felt defeated, sad, and completely out of ideas. What was he even doing? This was all so stupid. He wasn't even remotely sure he'd gotten the science right. Just because he'd seen it done in metronomes didn't mean anything in this situation. He shook his head, hoping that the five minutes would be over soon, hoping that whatever pain medication was in Keith's IV would be enough to at least block some of what was going to happen to him. Lance slumped a bit over Keith, feeling ridiculous for even suggesting this.
He was about to remove his hands and sit up, tell them to never mind, he had no idea what he was even talking about, when Shiro scooted in close on Keith's other side, slipping his real arm around Keith's shoulders. He moved behind Keith, propping him up and letting him rest against his chest while he wrapped both arms around him, reaching forward in order to hold to their arms on either side. His robotic arm gripped to Keith just above his elbow while Lance felt his organic hand close on his forearm above his wrist. Lance looked up at him, meeting his eyes. He still looked doubtful, but determined too.
"Thanks," Lance told him, several layers of gratitude in one word. "Let's try rocking a little, just back and forth for a bit and see what happens. Keith – you just relax and breathe, ok? We've got you."
Lance had never felt so much like a quack in all his life. This was not medicine; this was supernatural nonsense. No, he tried to correct himself. It was science; he had seen this work himself. Just not with hearts. Still, there were worse things he could be doing with his five minutes here with Keith, with what could be his last five minutes. He was supported here in the hospital, with Lance in front of him, whispering assurances, and Shiro behind him, holding him securely, all of them comfortably rocking together in a slow and steady rhythm, quiet, soft. If everything went horribly wrong, if the medicine failed and the defibrillator didn't work, at least in these few minutes, Keith would know that Shiro was here, holding him. That he'd come looking for him.
Lance felt his own chest tighten up as he thought about that, feeling the coming helpless shaking that always happened to him after handling intense situations as he'd just done with Keith. If he wanted to keep it at bay, he'd have to keep moving. If he were to hold still, if things got too quiet while they waited, he was going to break down. And there was nowhere to hide right now if he did. He took another breath, trying to just focus on what he was doing, stay here in this moment with Keith and Shiro. He needed to be Incident Commander in Charge for just a while longer.
"It's working," Shiro whispered, and once he said it out loud, Lance could feel it. Keith's breaths had deepened, getting slower and more effective. His heart also slowing and strengthening, to the point that Lance could feel it throbbing under his palm. Inwardly, Lance was shaking his head. No way. There was no way this was working, but he knew better than to say anything dumb like that. It had been his idea; so he certainly wasn't going to admit that he hadn't had any real faith in it. It's not working, Shiro, he thought. The medicine is working. This was all a smoke and mirrors trick.
But there were lecturers who were keen on the placebo effect, on how powerful a tool the mind could be in things like this. Shifting Keith from a place of unfamiliar terror to being rocked in Shiro's arms might have had something to do with the dropping heartrate, though Lance wouldn't be publishing a paper on the radical effects of the Josephson junction when used to synchronize heartbeats in separate bodies anytime soon. He didn't even think he'd tell Pidge about it later for fear that she would laugh herself breathless and then give him hell about it for months.
"There you go," Lance congratulated softly, as if he'd planned the whole thing, as if he'd been certain of its success. Keith's face had smoothed into quiet exhaustion, into relief. He leaned against Shiro in perfect trust, as calm as Lance had ever seen him. It stirred up a warning flicker of something uncomfortable in Lance, so he turned his face away from them to look at Keith's numbers. So much better than when he'd come in. Keith's heart rate had slowed to a respectable 90 beats a minute, and his oxygen had come up to 98 percent. Blood pressure an almost textbook 105 / 70.
"Oh, that's better. Much better," Lance heard Angelique behind him as she entered the room to check on them. He heard the relief in her cheery tone and realized how much she'd wanted the medication to work too. "Well done, everyone. I see you're all very cozy here, but can I get you two to back up so I can check on our boy here?" Lance extracted his hand from Keith's sleeve and then helped him detach out from under his shirt. Likewise, Shiro eased Keith onto the pillows, reluctantly standing up.
"Sorry, I won't be long," she apologized, setting her stethoscope into her ears. "Just need to listen to your heart a moment, darling." Lance tried to stand up and let her get close, but Keith had a tight grip on his sleeve. He had to use his other hand to gently pull him off so he could get out of Dr. Delacroix's way.
"I'm getting your blanket," he offered, relinquishing his place to Angelique. "I'm not going anywhere." Believe me, I know how hard it is to be alone with this woman. Meanwhile, Shiro had seen Officer Guist still standing in the hallway.
"Looks like I need to, though. Keith, I'll be right back," Shiro promised, disappearing out the door to see what Guist was still doing here. Lance hoped he'd tell the officer to get lost; there was no reason for him to still be hanging around. It should be pretty obvious at this point that Keith couldn't keep a court date in this condition. Lance picked up his quilt, the scent of the apartment rushing up to him as he moved it, a little piece of softness in this very not soft space, and he draped it over Keith, pulling it up to his waist protectively and waiting for Dr. Delacroix.
"Has anything like this ever happened to you before, sweetheart? Any other heart troubles?" Angelique was asking Keith as Lance finished fussing with the blanket. Keith shook his head, unable to look at her despite how gentle she was being with him. Lance would have to tell him later how special it was that she was speaking to him so warmly. Maybe he'd even tell him about the coffee episode. He might think it was funny.
"Well, now that we've gotten things under control, we can start figuring out what happened and why so it doesn't happen again. How's that sound?" Angelique went on, her voice coaxing and careful. "I'd like to do a couple tests while you're resting with us here. I'm going to have someone come down with an EKG machine in a few minutes to measure your blood flow and heart patterns, and I'd like to leave you hooked up to it for a few hours just to monitor how things are going. I'm going to take a blood sample from you, and we're going to keep administering fluids; you definitely need them."
"Dr. Delacroix?" Lance spoke up before he had thought much about whether he should. "I . . . already took a blood sample this morning. We, um, we were thinking Keith's arrhythmia could be caused by anemia. It's already in the lab." Angelique looked at him over her shoulder, face mask covering her mouth, but her eyes were hard.
"Oh?" Was the only thing she said, all the honey gone from her tone. Yeah, Lance might not have wanted to volunteer that information. But he didn't want Keith to have to do things twice either. The test results could already be available, which meant he could start getting an iron supplement sooner. "You're taking it upon yourself to do blood samples now, are you? But how did you . . . no, wait, it was Dr. Coran, wasn't it?"
Lance hesitated. It was one thing to confess his own sins. He didn't want Coran to get into trouble for helping him smuggle anonymous BSL II samples through diagnostics. His hesitancy quickly turned to confusion. How did she know it was Dr. Coran?
"Oh, never mind," Angelique said, turning away from him. Lance wondered if she were only giving him three words now because she was saving them all for the disciplinary write-up she was going to type up later. It wasn't necessarily illegal – what he and Coran had done this morning. But Keith hadn't signed permission for anything, and he technically was no one's patient, so if something had happened and he'd wanted to, he could sue them for malpractice. "I guess I'll see what I can find out from the lab then."
She stood up, pocketing her stethoscope. "I'll be back with the EKG machine." Then she looked at Lance again, and he couldn't read her expression. Exasperation? Amusement? "You and I need to have a talk later," she said, rather threateningly. He nodded, submissive. "Stay with him until I get back, but for God's sake, don't touch anything. You understand me?"
Oh, yes, Lance understood. It wasn't for God's sake, it was for Lance's. He was on incredibly thin ice, and the only reason he was even allowed to stay in this room was because Keith's numbers were improving.
"Yes, Ma'am," Lance acknowledged, frustrated, depleted and slightly disoriented. Angelique sighed, as if she weren't sure she could leave him alone with Keith, but she was a busy woman, and now that Keith was out of immediate danger, she did have other things she needed to do. She shook her head, waving a hand at him dismissively, and went off to take care of other patients. Lance unconsciously slumped as she left, resting both hands on Keith's bed.
"Did . . . did I get you in trouble?" Keith asked hesitantly, and Lance could feel his gaze on him. He lifted his head to comfort him, seeing the worry in his eyes, emphasized by exhaustion.
"I got myself in trouble," Lance replied, smiling. "It's nothing you have to worry about."
"But . . why? What did you do wrong?" Keith wondered out loud, his voice so endearing to Lance that he paused before answering in order to pull the blanket higher, over Keith's chest. It was so good that he had enough breath again to talk, even if this was what he wanted to talk about.
"I didn't do anything wrong," Lance said, and he heard Hunk snort in his memory because of the slipperiness of his answer. "Everything I've done was technically the correct thing to do; I'm just the wrong person to do it."
"But if you did the right thing . . .?" Keith sounded confused, and as though he were getting upset. There was a catch to his voice that Lance didn't like. "Why is it like that?"
"Hey, Lobito, calm down," Lance eased him, putting a hand on his arm, needing him to stay quiet and restful. Keith reacted by curling towards him and clinging again to his sleeve. "No reason to get all worked up. It's because I'm an EMT. Just an EMT - I should say. And when this all started, I wasn't even on call. Technically, Dr. Coran and I should have had you sign some paperwork before we took a blood sample, and Coran should have taken it, not me. And I wasn't supposed to let Shiro carry you, and I really wasn't supposed to start your IV, and especially not in your hand. I don't really have any authority to do any of that stuff. I did it because I have the training and the practice, but most EMTs don't, so it makes sense that they aren't allowed to."
"But . . Shiro cleared you. He said it was ok," Keith protested.
"That worked for Grayson," Lance explained. "But Shiro isn't your legal guardian or medical power of attorney. He doesn't really have any power to speak for you. Him saying it was ok didn't mean a thing."
"So what's going to happen?" Keith sounded anxious. Lance shifted so he could put one hand on his chest.
"I'm not sure," he answered honestly, keeping his tone light despite the severity of the words he was using. "Maybe nothing? I think the worst that could happen is I get sued for malpractice, stripped of my EMT credentials, kicked out of the med program, and sent back home." Keith clung to him tighter, alarmed.
"Sued? They can sue you?" He asked.
"No," Lance smiled again, leaning closer. "But you can. If that's something you wanted to do?"
"God, no."
"Looks like I'm safe then," Lance responded, though he didn't feel it. Dr. Delacroix could still do plenty to hurt his career. He very well could leave this hospital without his volunteer EMT card if she wanted that to happen. He wasn't sure she did though. Since it looked like Keith was going to be ok, the disciplinary measures taken against Lance were hopefully going to be mild. It would have been a completely different story if something had happened.
"How about you, Lobito?" Lance changed the subject, smoothing invisible wrinkles in the quilt to soothe the tremor that he felt starting in his hands when he allowed himself to think what might have happened to Keith. Not yet. Dr. Delacroix would be back soon; Shiro and Officer Guist were still talking out in the hall. Keith was awake and needed him. He couldn't fall to pieces yet. "How are you doing? Is it easier to breathe?"
"Yeah." In fact, if Dr. Delacroix hadn't specifically told him not to touch anything, Lance likely would have fiddled with the oxygen flow. Keith probably didn't need it up so high anymore. However, things being what they were – he thought he'd best leave it alone. Instead, he shifted the blanket a little more, tucking it tighter around Keith, his fingers lingering over some of the fabric patches. His mother had made it using scraps of clothes, old favorites from Lance's childhood. There was a piece of soft cotton from a pair of pajamas he'd loved, the last remaining corner of his baby blanket, the logo of a Tshirt, several sections from his father's old work shirts. A piece of faded flowery print that had been his mother's best Sunday dress. Each snippet a memory, each stitch a tie to his family. Keep it together.
"Lance?" Keith called him, very softly.
"What is it, Lobito? You all right?"
"I'm so tired."
"Well, your heart just ran its own private marathon, you know."
"I don't think I can stay awake for much longer." He did sound tired, but comfortable. The pain medication easing him down. Lance put his hand against his face, running his thumb over his eyebrow. "Is it ok if I . ."
"You don't have to stay awake," Lance gave him permission to sleep, knowing that Keith probably would have drifted off a long time ago if it hadn't been for Lance specifically asking him not to in the ambulance. "You can go to sleep, Keith. It's all right."
"If I do . . . will I," he hesitated, and Lance felt his brow crease under his fingers. "Will I wake up again?" No, really? Now Lance put both hands on either side of Keith's face, forcing them not to tremble. He kissed Keith tenderly on the forehead, not able to help himself.
"Oh, Keith, of course," he assured, quickly, shocked and sad that Keith had even worried about that. He wished he could tell him that it hadn't been that bad, but it absolutely had been. "Your numbers are good; you're safe now. Geeze, you poor thing. I'm sorry." Lance knew that Keith had been scared, terrified even, but for some reason he hadn't thought about that. He touched his forehead against Keith's, wanting to be closer but not sure how to manage it.
"Rest, Lobito," he encouraged. "I'll be here."
"Did . . . did Shiro leave?" Keith asked, sleepy.
"No, he's still here. He's just outside talking to someone. I'm sure he'll be back soon." And there is no way I'm letting him go anywhere while you're sleeping, Keith, Lance promised silently.
"Talking to who?" Keith murmured, but Lance didn't want to remind him about the policeman. Didn't know if he'd even seen him there in the apartment – his entire focus had been on Shiro, it was possible that he'd missed him. He didn't want to tell him about Monday, or the court summons, or that the jury had made a decision that would affect the rest of Keith's life. He didn't want to think about that now, and he didn't want Keith to think about it either. Not when they were just barely recovering.
"I can't see from here," Lance half-lied. It was true that he couldn't see Officer Guist from this angle, but he knew he was out there, waiting. Knew he still had to deliver to Keith the summons. Knew that he still wanted to talk to Lance too. Outside this room, the world was still moving. The snow was still falling. The sun going down. "Quiet, now. Rest your heart. It's going to be ok."
Keith's eyes were already closed, his chest rising and falling slower and slower. Lance straightened, watching him sleep, feeling uneasy. His hand shook when he reached out to smooth the hair away from Keith's face, something else that was coming for him whether he wanted it to or not.
"It's going to be ok," he repeated, to himself as the shivery feeling traveled up his arms and into his chest, all the panic from the afternoon that had gathered quietly in the back of his mind, waiting almost politely for him to finish his duties as an efficient responder, catching up to him now in the stillness, when the emergency was over. Lance grabbed on to the blanket with both hands, feeling lightheaded all of a sudden, too warm. Damn it. His knees were shaking now along with his hands and shoulders, so he went ahead and knelt on the floor, his fists above him, clinging to the blanket, to his family, to Keith. "It's ok," he told himself, firmly. There's no need for this now. Everything's fine. Keith's sleeping peacefully. A tear dripped unexpected and fast from his eye, and a matching sob caught in his throat. He let go with one hand so he could cover his mouth. He didn't want to make any noise here, but he was quickly losing control over things like that. The sob came out in a weird sort of wheeze, followed immediately by another, desperate little wails of anguish from a tragedy that hadn't even happened. He tried to shake it away, shake his head. This was so stupid. Why did he always do this? He heard himself gasp, choking on his own attempts to be quiet, knowing that he was lying to himself.
Nothing was ok.
Author's Note: I wish you guys knew how quickly Angelique just walked out of my head. I wasn't planning on her, but now that she's here – damn I love her. And speaking of walking – who is going to walk in on Lance's little breakdown here first? Shiro? Angelique? Guist? I haven't decided – who do you want? My poor Lance, a good deed never goes unpunished, does it? As you and Keith are well aware.
