To my wonderful Elle anon- this is for you!
Chapter 5
Ethan's head is a mess.
He's been doing it all wrong.
That shouldn't be much of a surprise, not really. He hasn't exactly been under the impression up until now that he's been doing an incredible job of being a source of support, but even so, his brief conversation with Duffy while agonising over Alicia's results has hit home some uncomfortable truths and he's such an idiot, he can see that now.
This kind of situation is admittedly a minefield at the best of times but still he's managed to get it all just about as wrong as it gets.
He's taken Duffy's words to heart. He truly has. If friendship is what she needs then of course that's exactly what he'll give her; exactly what he would have given her anyway, he likes to think, but then he's been so awkward with her lately, everything has been a mess…
This is his fault. This is all his fault. If he hadn't gotten involved with Leigh-Anne, if he hadn't been so cold with Alicia until so relatively recently, if only he hadn't stood her up that night, then perhaps…
No, he tells himself. No, this is exactly what Duffy was trying to tell him, he can't think like this. It's not helpful, it achieves nothing bar wasting his energy and Alicia needs him to be there for her, Alicia needs…
He's no idea what she needs. He takes Duffy's point, of course. She needs someone to be there for her, a friend, but there's going to be so much more to it than that for her. There's so much she's going to have to work through to come back from this, so much to confront, to accept…
He just can't stop thinking about those samples Mrs Beauchamp had him take off for bloodwork.
Alicia's samples… shit…
He watches from the doctors' station, helpless. The nurses have left her alone now, and he knows of course that it's a good sign, that he should be pleased, but somehow all Ethan can focus upon is how small she looks, how fragile, how broken.
How can his friendship ever be enough to fix this?
He's dreading getting her bloods back. Mrs Beauchamp has told him nothing, nothing but her order to get Alicia's bloods rushed through as a priority, and Alicia hasn't acknowledged them at all, barely uttering a word since he got her out of resus, but Ethan knows enough from the tests Mrs Beauchamp has ordered. She's been hiding symptoms, he'd only realised in that moment. It hadn't even occurred to him back in resus that she was in more pain than she was letting on, he was so stupid…
This could change everything.
Those blood results could break Alicia, there's no denying that.
And Ethan doesn't know if he can bear it.
He needs to pull himself together. He has to, she needs him, she needs his friendship and something about Duffy's tone told him that she knows more about this horror than she's comfortable admitting; he values her opinion above all else.
Anything.
Anything to help Alicia.
But how can he be of any use to her when he can barely cope with this himself?
Resus is empty. The worst of the RTC patients must be through by now, Ethan realises.
The calm before the storm, whatever this next storm might be.
He finally finds her in her office. He doesn't knock, doesn't even look properly to check she isn't in the middle of a meeting, spots her through the glass pane in the door and barges his way in, frantic, distraught, desperate for answers.
"Dr Hardy, as you can see, we're in the middle of something," Mrs Beauchamp snarls.
Ethan blinks, startled.
It feels as if he's arrived here on autopilot, completely and utterly controlled by rage.
Mrs Beauchamp and Elle stand beside the filing cabinet, Elle still studying a hospital printout, grimacing, Mrs Beauchamp shooting him a death glare.
"If you want to speak to me, you'll have to wait outside," she reiterates. "We're busy. I'll be with you in a moment, but as it's the end of your shift…"
"Why didn't you tell me you were running a pregnancy test?" The words tumble out of Ethan's mouth before he's quite aware of what he's done. "She's my patient! I'm treating her, you should have told me…"
"Well, because you've just shown a complete disregard for patient confidentiality, for one."
He falters, stares at Elle, takes in her expression, the enormity of his mistake slowly sinking in. "She doesn't know?"
He had assumed, in the remnants of his blind rage having stormed into Mrs Beauchamp's office to find her and Elle already preoccupied, that she already knew, that Mrs Beauchamp had deemed him incapable, deliberately kept him in the dark because she has no faith in him whatsoever any longer to treat Alicia.
He needs to treat her. Perhaps that's selfish, perhaps this is exactly what Duffy was trying to tell him, but Ethan needs to treat her. He needs to know she's alright, he needs to protect her, he knows gossip spreads like wildfire in the ED and that's the last thing Alicia needs right now, she needs someone who cares about her, someone who is going to be discrete…
She needs someone who is on her side in this whole mess, and after his conversation with Rash, Ethan isn't convinced that's going to be completely guaranteed unless he treats her himself.
This is such a mess. And to think he was so excited to be working with Eddie. He'd come into work on his day off, for god's sake, especially to see Eddie, especially to hand him the research papers he'd dug out for him in a bid to get him onto a course akin to Bea's, he'd liked Eddie…
It was already a mess, but he's just gone and made it even worse, Ethan realises with a sinking feeling.
He's made it ten times worse, because it's so clear from the shock visible in Elle's features that it wasn't Alicia's results she and Mrs Beauchamp had been discussing at all.
At yet there's clearly going to be no doubt in her mind now that he's talking about Alicia, that this is all about Alicia, his angry outburst, his blurting out about the pregnancy test…
Why does he keep making everything worse?
"Dr Hardy, Dr Gardner has just been running by me the CT results of one of the RTC patients she's about to discharge." Mrs Beauchamp's tone is cold.
"I… I…"
Elle gathers up the results printouts, awkward, holds up her hands. "I should go…"
Mrs Beauchamp shakes her head. "No, you stay, Dr Gardner, I was about to come and find you anyway. Dr Hardy has been treating Alicia, but as it's coming to the end of his shift, I'd like you to take over, please. I already collected Alicia's bloodwork, but…"
"I know," Ethan blurts out. "I went to get it after I got her transferred up to the ward, they told me you'd taken them. I don't understand, I'm her doctor…"
"And you're about to finish shift," Mrs Beauchamp finishes. "It makes far more sense for Dr Gardner and I to handle this part, then you can complete the handover and…"
"It doesn't explain why you hid this from me!" Ethan protests. "I've been treating her for the last hour, for god's sake! You don't think perhaps I should have known there's a possibility she's pregnant! You could have warned me in resus, if she'd developed complications upstairs and I hadn't looked at your blood request…"
"I didn't warn you in resus because Alicia doesn't know, and unless the bloods confirmed it I thought it best it stayed that way, given the circumstances."
His heart stops, and he has to fight back the urge to vomit, to scream. "What? Alicia doesn't know?"
"Dr Hardy, will you close the door, please, seeing as you seem to be in this for the long haul? We don't have time for this, we're at maximum capacity as it is." She brushes past him, swipes Alicia's remaining notes from his arms in one swift movement, hands them to Elle. "Dr Gardner, your next patient. Involved in the RTC earlier while already en route to the ED by ambulance, initially being brought in with a severe laceration to the brachial artery on the right side, dislocation to the elbow on the left side, after falling through a window. Paramedics in attendance at the scene reported she was pushed, the patient had reported the assailant to the police in the early hours of yesterday morning, for a rape that took place ten weeks ago. Primary survey was completed in resus where the patient complained of severe abdominal pain- you were booking CT, Dr Hardy," she snaps, as Ethan attempts to interrupt her. "None of the patient's injuries account for the pain reported, but there's significant abdominal distension consistent with a pregnancy of approximately ten weeks she's suffered uterine bleeding since admission and she can't tell me the date of her last period, so given the circumstances…"
"You think she's miscarrying?"
"Dr Hardy, if you'll allow me to speak, please," Mrs Beauchamp snaps. "I considered the possibility, yes. However, her bloods have come back negative, and while I'm sure we can all agree that's good news given the circumstances, that leaves our patient with…"
"Alicia, we all know it's Alicia, I don't understand why you won't…"
"… Unexplained abdominal pain, bleeding and significant distension, Dr Hardy I am not going to tell you again! But her bloods have come back confirming gonorrhoea and chlamydia."
Shit, Alicia, shit…
"So you're thinking pelvic inflammatory disease?" Elle asks.
Ethan can't read her expression. She's blank, professional, engaged, but there's something else beneath her mask he can't quite place.
"I think it's a strong possibility, yes. Either way, we'll need to get her started on antibiotics, and I want her monitored overnight. Speak to gynaecology, I want someone down to examine her once you've completed obs. Dr Hardy?"
"Umm, CT came back clear," Ethan stammers. He can't focus, not after this latest revelation. He can only see Alicia, doesn't even have to close his eyes to see Alicia in resus, Alicia covered in blood, still, Alicia writhing in pain as they had tried to unstrap her from the spinal board, Alicia lying broken on a hospital trolley, covered in shards of glass, Alicia in pain…
The pain must be significant. It'll be numbed a little now after the morphine, but if pelvic inflammatory disease is looking like the most likely explanation, she must have been suffering for days, not hours. Perhaps it's worsened since they brought her in, too much to cope with on top of her latest injuries, but it would have been bad for days, maybe even weeks…
How long has she been hiding this?
He needs to focus. He needs to focus; he's no use to Alicia like this.
"Resps were raised again after transfer to CT, but she's responding well to oxygen therapy via a nasal cannula. She's maxed out on morphine, I've tried offering her tramadol but she's refusing, though I suspect she's in more pain than she's letting on with the artery repair. Her elbow needs x-raying, I've been waiting on her CT results and her bloods before I moved her down there. The alignment seems to be holding well, but still, given the circumstances I think it should be confirmed. And I think…" he hesitates; it feels like some sort of terrible betrayal, saying this out loud, even though rationally he knows he has to do this, that if Elle is going to take over her treatment she needs to be aware. "I think her respiratory issues are psychological. Panic attacks, PTSD, I don't know…"
"Okay." Ethan envies Elle's calmness, doesn't understand how she can sound so calm and collected when this is Alicia, when they're discussing Alicia, when this is all just so, so wrong. "Okay. Has she been seen by the rape crisis team?"
"I had them on standby when she was first brought in," Mrs Beauchamp answers. So she knew, Ethan realises, she already knew… she must have, of course she must have, she would have been informed by the police of Eddie's bail, suddenly it all makes sense. "I sent them back after Dr Hardy took her up for CT, it was clear she was in no fit state to speak to them."
Elle nods. "I'll book someone to come down and speak to her tomorrow provisionally. We'll see how she responds overnight."
"I can do that," Ethan offers quickly. "I'm back on shift tomorrow morning, I can…"
"Ethan," Elle says gently. "Ethan, I will take excellent care of her, alright? You have my word. You need to go home, you need to rest. Let me handle this."
He shakes his head helplessly, momentarily overwhelmed by it all. "It should never have gone this far," he despairs. "We should have noticed. Why didn't we notice? She's practically been crying out for help for weeks, for god's sake, her behaviour's been so erratic, in the two years she's been here I've never seen her have one completely unprovoked outburst, let alone as many as she's had lately, someone should have…"
"I know." Mrs Beauchamp is quiet, pensive. "If it's any consolation, our staff duty of care policy will be reviewed and should it be deemed necessary…"
"But that's absolutely no use to Alicia, can't you see that?" Ethan snaps. "That isn't going to change what he did to her, it can't take away the fact that she's had to work with him, she's had to come in here every day and watch him…"
"Ethan," Elle says softly. "Ethan, listen to me. You're no good to her like this, this isn't helping Alicia either. Go home. Get some sleep. I'm going to go up and check on her now, I'm going to get a gynaecologist down to look at her tonight even if I have to drag them myself. We'll take it from there. I'll update you at the start of your shift tomorrow, alright? You know the drill, I'll make sure she's monitored overnight, what's left of it. I'll get someone from the rape crisis team down to speak to her tomorrow once she's awake…"
"I don't think she'll speak to them, what if she won't…"
"She's my patient for this shift, let me worry about that. She's in safe hands."
"I think we're done here." Mrs Beauchamp moves to open the door, gestures to Elle and Ethan to follow. "I need to check in on the RTC victims in intensive care. Go home, Dr Hardy. Get some rest. I need you back in here 8am sharp tomorrow morning."
"Right… yes, of course." He's lost all track of days, the events of tonight having caused what must now be officially considered yesterday to blur into one long continuum with tonight, or this morning, or whatever it is. He's on shift in a few hours, perhaps Elle is right…
Except he has no faith in Mrs Beauchamp to allow him to continue treating Alicia tomorrow, if she's even still the responsibility of the ED by the time he's back on shift, and he can't leave things with Alicia like this.
It's not selfish, Ethan tells himself. This isn't about him.
This is about Alicia, and the fact that he's messed everything up with her, again, just like he always does.
Friendship. Duffy told him she needs his friendship.
He has to tell her that from now on, his friendship is exactly what she'll have, no matter what, as long as she wants it.
He races after her along the corridor, heart in his mouth. "Elle! Elle!"
She pauses, turns back towards him, expression softening with concern. "Ethan, I really think you should…"
"I just need to see her," he pleads. "I can't go home without seeing her, I need to apologise, I didn't know how to… earlier… I just messed it all up, I wanted to support her and I got it all wrong, I see that now, I need her to know… if she wants me to leave, I'll leave, I don't want to make this about me, she's the… the most important… I just… it's so hard, she doesn't deserve this, I need her to know that…"
"Ethan." Elle places her hands on his shoulders. "Ethan, listen. You need to look after yourself too. I know you want to be there for her, and I know Alicia will appreciate that."
He shakes his head adamantly, curses himself. "I seriously messed things up again with her earlier, I've been such an idiot…"
"Let me guess, you tried to be her knight in shining armour and she told you exactly what she thought of that?"
He smiles faintly, in spite of everything. "Am I really that obvious?"
"A little. She'll forgive you, Ethan."
"You don't know that."
"No, I don't," Elle admits. "But I have seen the way you two look at each other. Look, go and get changed, calm yourself down. I'll come and find you when I'm finished with her. She'll be fine, Ethan. She's going to be fine."
It's with an immense feeling of responsibility that Elle begins with her next patient.
It's always like this, of course, always harder when it's one of their own, but there's no denying that this particular instance is an exception even to that.
It's so much. In isolation, perhaps it wouldn't be so bad, it would be manageable, but together…
She can understand why Ethan is so distraught.
Alicia is strong, under normal circumstances. She can completely believe it might not seem that way just now, not to Ethan, and certainly not to Alicia, but she's strong enough to get through this. Elle is sure of that.
Working out where on earth to start to get her through this first stage is the more difficult part.
"Alicia? Alicia, it's Elle, can you hear me?"
She lies propped upright on a hospital trolley, right arm elevated, left hooked up to the fluids drip, outstretched, strapped, her eyes closed, and yet her whole posture is far too tense for her to be asleep.
"Just want to sleep…"
"I know sweetie, I'm sorry. I'm going to leave you in peace soon, okay? You can sleep soon."
"Everyone keeps saying that," Alicia complains, opens her eyes for a moment and promptly squeezes them shut again, as though the brightness of the ward is too much to bear.
Her voice is weak, exhausted, all-telling of the horrors she's encountered tonight.
"Well, I'm not everyone, am I? I promise this will be as quick as we can make it. Now listen, I'm a little worried about…"
"Ethan…?" There's something about the way she says his name; confusion and hurt and guilt and pain and regret and sadness all at once.
"Ethan's gone, sweetie, his shift ended. Technically it ended a while ago, actually, and I'm not sure he was supposed to ever be on at all. You've got me for the rest of tonight, I'm not going anywhere."
"Think I… scared him off."
"No, no you didn't, Alicia. Mrs Beauchamp had to practically drag him off to the staff room. I think he's going to drop in and see you once we've got you sorted, okay?"
She nods, blinks. "I know he cares… it's just…"
"Tried to smother you?"
"How did you…?"
Elle laughs. "He's a man, and he clearly cares about you a lot. That's how. You haven't scared him off, Alicia, he's just being overprotective, and he knows that, I'm sure he does. Especially if you told him. He'll be back, and if he values your friendship as much as I think he does, he'll have taken it to heart. Now, enough about Ethan, we need to focus on you. Mrs Beauchamp said you were experiencing abdominal pain, that it came on before the crash."
Alicia grimaces, guilty. "I couldn't tell… Ethan…"
She frowns. "Why couldn't you tell Ethan?"
"I'm not stupid, Elle." She opens her eyes at last, glistening, raw. "I know… I know he's… given me something." She shudders. "I meant to… do something about it, just couldn't… in here…"
This isn't the moment, Elle decides, to point out to Alicia the lecture she would have given any patient to dare present in cubicles with her symptoms and then offer up this by the way of an excuse.
It's not exactly a direct comparison, to give Alicia credit. She could have gone to St James's, of course, straight to a specialist, but even then, the Holby medical world is small, and she wouldn't have blamed her for living in fear of anything making its way back to Eddie, too traumatised by this whole mess to remember the safety net of patient confidentiality.
"Hey, it's okay. I understand, it's okay. We got your bloods back, there's no easy way to say this, we need to get you to gynaecology. I suspect they'll want to do a laparoscopy, just so we can rule out appendicitis."
Alicia moans, closes her eyes. "Just tell me, Elle. It's not appendicitis, I know it's not appendicitis… You're thinking PID?"
Clearly, her self-diagnosis hadn't quite made it through to the end stages.
"Gonorrhoea and chlamydia. So yes, I'm afraid it's a strong possibility."
Alicia just blinks, visibly numb, stares at the oxygen tank.
She's still in shock, Elle realises. Of course she's still in shock, why wouldn't she be? Everything else would have been more than enough for her to cope with, enough to send her mind into overdrive. It's no wonder this is more than she can process for tonight.
"I'm going to take you up to gynaecology now, okay? Alicia?"
"Just do what you need to do. I don't care, I'm… I'm beyond caring. Just do it." There's no emotion in her tone any longer. No anger, no pain, no sorrow, nothing.
"Okay. Okay, gynaecology then." Elle turns away, begins gathering together the assortment of monitors and fluid drips. "And then we need to book you into orthopaedics, Mrs Beauchamp said the paramedics reduced your elbow at the scene…"
"Ruby did it," Alicia admits. "She didn't want to, I talked her through it… the door was stuck… it was that or risk… losing…"
"I know, and while I don't doubt you and Ruby did an excellent job under the circumstances, I'll be much happier once we've confirmed the positioning's correct. So, gynaecology, orthopaedics, and then I promise I will let you sleep."
"Should you still be with me? I'm not exactly emergency anymore, if you're transferring me to gynaecology, or orthopaedics, or wherever, shouldn't…"
"Let me worry about that," Elle tells her firmly. "Mrs Beauchamp's orders. You're my patient until the end of my shift."
She's silent until the porters have arrived to take her up to gynaecology, until they're halfway down the corridor, waiting for the lift.
"You're good at this," Alicia breaks the silence at last.
Elle frowns. "At what?"
"I… it's so hard to explain." Alicia shakes her head.
"So, try?"
"I feel bad just saying this… Ethan doesn't get it. He doesn't know what to say to me, he can barely… look at me…"
Elle sighs. "He's only trying to help, Alicia. He's a man. Men aren't great with this sort of situation, it takes them a while to work it out. But he will. Believe me, Alicia, if anyone will, he will. You just need to give him time."
"It's not just him. Even Mrs Beauchamp, she just…" she shudders. "The pity. I don't want her pity, I just want…"
"Everything to go back to normal? I know you do, sweetie, of course you do. And it will. New normal. Old normal is gone, I won't pretend it isn't, but new normal will start to feel okay after a while."
"See? You're good at this. You aren't looking at me like I'm broken…"
Are you? Elle wants to ask.
"No," she agrees. "No, I don't think that's helpful. But you are allowed to feel like that, Alicia. There's no shame in that."
"I don't really know how I feel, to be honest."
"No, of course you don't. It's too early for that, and that's okay too." She thinks about the woman from the rape crisis team Mrs Beauchamp has on standby for tomorrow morning.
Elle can't call this one. Alicia could be ready to pour her heart out by tomorrow morning, or she could refuse to even allow them to let the woman through the door.
It's far too early to tell how she's going to react to this.
Elle can only hope it isn't as explosively as she's been coping over the last few weeks.
"The laparoscopy confirmed a severe case of pelvic inflammatory disease," the gynaecology consult explains to Elle grimly. "She should have come in for treatment weeks ago. I mean, a registrar, of all people, she should know better…"
"And I've no doubt she does, under normal circumstances," Elle replies coldly. "And I know you're aware of the situation, I know Connie Beauchamp phoned ahead to brief you."
"I didn't mean it like that," the gynaecologist says gently. "I'm aware it's not so straightforward for rape victims. Believe me, I see this every day. But yes, had we caught this sooner, it would have saved her an awful lot of pain, and the recovery would have been much faster. I've drained the abscesses, I've got her on intravenous metronidazole, she'll need at least ten days' worth. Bring her back up if she gets any worse."
Orthopaedics, mercifully, are more sympathetic. Elle leaves Alicia to be taken to X-ray, lurks outside, helps herself to the coffee in the orthopaedics staffroom before quite frankly she needs the caffeine.
"Dr Gardner?" A nervous, uncertain voice pulls her from her only semi-conscious trance.
"Ruby?" She's changed out of her paramedic uniform, pale, shaking, dishevelled. "Ruby, you should have gone home hours ago…"
"I'm fine. I'm fine, I've… I've just come from speaking to the police, actually. About Alicia, about the scene when we arrived earlier. Yesterday, I guess now. Of course, Iain and I didn't witness the assault, but as we were at the scene…" Her eyes are red-rimmed, voice a little shaky. "Just wanted to get it over with, you know?"
"Are you alright?" Elle worries. "Ruby, you look…"
"It's just been a long shift, that's all." Ruby smiles, forced, fresh tears in her eyes. "Honestly. I'm fine. Umm… Mrs Beauchamp said you were treating Alicia?"
"Yes." Elle nods. "Did you want to check on her? I'm hoping to have her back down on a ward soon, she's very tired, she's still in shock, but I'm sure she'd like to see you."
"Are you sure? I don't want to crowd her…"
"Ruby, you won't," Elle tells her gently. "Just between the two of us, I think she could really use a friend. I'm more of a… I don't know… honorary aunt, or something. I think she'd really appreciate it if you dropped in to see her."
"Is she alright?" Ruby asks now. "Mrs Beauchamp wouldn't tell me anything…"
Elle pauses for a moment, contemplating. "She'll be fine," she says at last. "She's strong, Ruby. She'll be fine."
I am so sorry for the delay in getting this chapter up- partly down to this taking forever to write (this one took a LOT of medical googling, I am no doctor!) and partly because of some personal stuff I have happening next week that has taken a lot longer to get organised for than I thought it would. Thankyou as ever for your lovely reviews, I hope it was worth the wait!
As a side note, I also have a new Casualty story, Finding Avalon, and I would love it if you gave that one a try too- although absolutely no pressure!
Please do let me know what you think of this one. I am aiming to have the final Alicia/Ethan scene from episode 1 in the next chapter...
-IseultLaBelle
Edit: I have a two hour flight tomorrow, I will be taking my laptop and I will be using that time to write. Would you guys prefer I work on Atoms, or Finding Avalon (my other Alicia/Ethan story)? Let me know in the reviews. I will be flying at 1pm tomorrow (Monday 3rd) UK time, so I will go with the majority then.