TRIGGER WARNING: GRAPHIC DEPICTION OF SEXUAL ASSAULT, MEDICAL PROCEDURES, DRUG USE
Protect yourself and your health. Don't read this story if it will be harmful for you.
National Sexual Assault Hotline (USA): 8006564673
Chapter 2 – The ER (Carlisle POV)
Stacks of charts line my desk – everything from a mild case of the flu to favors former colleagues called in from around the world. No one had met a better diagnostician, though I would have to retire my name and license soon. Some of these relationships have bordered two decades now. Many hadn't seen me in half as many years. A consequence of having to hide my immortal face.
The scans that were the subject of my focus line my computer screen. I filter through the stacks of papers, finding the respective patient.
Male. Twenty-four.
I exhale slowly, willing the heaviness to dissipate at one positive outcome.
"Difficult patient?" Esme, who had been sketching, sets darn her charcoal as she speaks.
"Fortunately, one that will be fine." I shake my head at the tumors that had been invading this man's brain for months.
The emails of requests had piled up during my absence from Forks. Between seeing patients and catching up on consultations, my time was spread thin.
I shoot off a quick email to my former colleague with the fortunate news that, with rigorous and immediate treatment, his patient would live. I offer some words of regret at my delay in response and compliments of his newest award-winning research on brain tumors.
"Almost done?" Esme asks after I've sent out a few more responses to former colleagues around the world. She sets her charcoal down, joining me as I stand to put files away. Her eyes scan over the piles of paperwork I have worked through in the last few hours, a small frown on her lips.
"Not remotely."
"You should take a break." Esme scoots closer to me, her hands running over my shoulders. She steps up, pressing her lips to my jaw.
"I certainly should." I agree. I reach for her waist, pulling her against me.
Esme's smile is soft, her eyes burned molten gold with hunger different than the one she spoke of. "The kids are gone – perhaps some lunch?"
The sweetness of venom pooling in Esme's mouth warms me. A testament to her desire. A reflection of mine. Her hands slip over my chest, the buttons of my shirt coming undone as her fingers glide by. Her touch was fire against my skin.
"My colleagues might get suspicious if I'm not eating regularly." My hand reaches out shoving the files away to give Esme more space against my desk. She doesn't need it – her legs seem fine bent around my hips.
"We couldn't have that." Esme whispers. My fingers trail down the sides of her hips, hating the fabric that divides me from her skin.
"I've been feeling . . . off." I offer, biting her bottom lip between my teeth. "I may have to call out for today." My hands trace up her thighs, grateful for the shorter dress Esme opted to wear today.
"Human health is so fragile." Esme breathes as I find the base of her throat. I press my lips to her aorta, her voice vibrating where a pulse once was. "It's best you aren't around them."
I clear my throat, trying to force my mind back to the hospital we were in.
"Finish up your work. . . I'll be waiting, Dr. Cullen." Esme whispers, her fingers tugging at my hair. She slips off my desk, her walk slow as she saunters back to her place across the room. The quiet scratching of her pencils against paper fills the room as she takes up her prior pastime.
"You destroy me." I say quietly. My inability to focus on work with Esme sitting in front of me suddenly felt comical.
"Don't keep me waiting."
I move to her side, wrapping my hands around her face. "I'm worse off than I thought. It would be utterly irresponsible to see patients now." I return to my desk, intent on ordering the madness when commotion breaks out elsewhere in the building.
Esme looks up at me, her expression concerned by what clearly sounds like a critical in-coming patient. "You should check on that, Carlisle."
I shake my head, continuing to stack folders for another doctor to take tomorrow when I inevitably call out sick. "Snow is covering the ER today. He prefers I don't intrude." I close the folder I had been previously working on, tucking it beneath some private files. My colleagues shouldn't see correspondence from a relationship formed over twenty years ago.
Esme grins. "Do you have a prior commitment?"
My phone rings on my desk. Alice's name flashes across the screen. "Of the highest importance." I smile at Esme before accepting the incoming call.
"Carlisle!" Alice's voice is frantic. "It's Bella."
"Isabella Swan." I hear the voices of my colleagues echo several floors below me.
Esme's eyes meet mine instantly. The worry pounding in my mind echoes in her eyes. I'm on my feet moving, faster than I should, to the ground floor. My phone was forgotten in my office, though Alice's warning having come uncharacteristically late does not evade my thoughts.
The fuss and questions get louder as I approach. Bella's name is uttered more than once. I recognize the other voice – Jacob Black. Her new werewolf friend. He's yelling.
I force my body to slow as I enter the ER. My eyes swerve, looking for Bella. Her blood intoxicates the room – bitter to the smell, the sweetness evaporating instantly as it spills from her body.
Nurses have circled Jacob. He's holding Bella against him. They're trying to convince him to lay her down, but he's not giving in.
"Sir, are you hurt? Are you injured?" A nurse is spying the blood covering Jacob's clothes.
"Jacob, put her down." I step in – past Dr. Snow. He shoots me an annoyed look that I ignore.
Jacob recoils instantly, his arms tightening around Bella. She's unconscious. I can smell her wounds, though she's not bleeding profusely. My jaw tightens as I spy the bruises shadowing her jaw and neck.
"Put her down so we can take care of her." I repeat, indicating to the gurney someone has moved over. My eyes wash over the tight hold he had on her body – he'd harm her more holding her this way. "She needs help."
Jacob's expression morphs into raw anger, his arms tightening around the frail girl as they shake with the throes of his emotion. "No! Get someone else! No, no, no!" Jacob's voice is so loud that the nurses around me cringe. "It was him! He did this!"
Pondering eyes turn to me. Murmurs of voices I wouldn't hear had I been human shoots anger through my veins.
"She's dating his son."
"You think it was Dr. Cullen's boy?"
"He was in the system. Those sorts of kids have all sorts of issues."
I breathe deeply, the sharp scent of Bella's blood hitting me again. "He is not here right now. He's out of town." I snap, half to Jacob, but mostly to my colleagues gossiping around me when there are more pressing issues. "Jacob, put her down, now. She needs help."
Jacob meets my gaze for the first time, and, finally, his arms go slack as he complies with my orders. His body shakes ferociously as he relinquishes Bella, laying her flat against the bed. "Take care of her."
"Thank you." I tell him. "I'm going to help her, Jacob." I vow, hoping to ease his fear. "If you leave your number at the desk, I'll call you with an update."
He glances down at Bella's unconscious form, his jaw locked. "Don't bother." He spits out, turning and disappearing through the doors of the ER.
"Who was that? Do you know him, Dr. Cullen?"
"Doesn't matter." I growl at the nurse. She was newer. Younger. Obsessed with the gossip of the small town we lived in.
She recoils from the ferocity of my words.
The irregular beat of Bella's heart pulls my focus away from the nurse. I move to her side. She's waking up – the sign of consciousness present in the tears leaking from her eyes.
"Bella," I squeeze her hand in mine. "I'm going to take care of your sweetheart. I know it hurts. I'll give you some medicine to help."
"Did that man do this to her? Do you know him, Dr. Cullen?" The same nurse – Jennifer – was saying.
I turn to the others. "Move her to room one."
They comply easily, but I pause, motioning for Jennifer to stay.
"What are you doing?" I ask. Her eyes flash as they rake over me.
"That's Chief Swan's daughter, isn't it?" She licks her lips, her arms crossed over her chest. "Someone needs to call him."
"Yes, I'm well aware of that. However, you have a specific job to attend to now."
"That boy was pretty suspicious. We should inform the police."
"I can vouch for his character." I was getting frustrated by her disregard for Bella's health. "Leave the investigation to the police, won't you?"
"Your son is dating her, isn't he?" Jennifer questions, her head tilted with interest. "That's – "
"Go to Dr. Snow and get another assignment." I snap, fury covering my words. "And do not breathe a word about this patient to anyone, in this hospital or out of it."
"What?" She demands, eyes wide.
"You heard me." I force myself to speak slowly. "Trust that the doctors remaining on her case will care for her and alert those necessary."
I leave the nurse spluttering angrily behind me as I move towards Bella. It takes a second to push past the crowd that has gathered to help.
I had seen the fragility of the human body in my two centuries as a doctor. Still, the sight of the girl I'd come to know as my daughter caused my chest to constrict painfully. She lay hauntingly still as staff moved around her.
Her skin, bright beneath the harsh hospital lights, was marred with dark bruises. As cloth was cut from skin, more bruises were revealed. They trailed over her arms, down the sides of her chest and stomach, disappearing towards her back. The patches of black against her side made it clear her ribs were broken. The thick bands of bruises over her wrists and arms unnerved me – she was restrained. Brilliant red blood was smeared along her skin, the origins unknown, hiding injuries I was sure existed. Blood masked the long, slender bruises on her hips and thighs.
Anger flares in my body as I took in the pungent smell of the scent she carried alongside her own.
She was harmed in a way significantly different than I had previously assumed.
Doctors and nurses are crowded around her, trying to tally her injuries. Their chaotic strategy rendered them inefficient as they attempted to triage her injuries.
"Isabella, can you open your eyes?"
I push past them, quietly demanding order in their action. "Rose," I call the nurse I once worked with regularly. "Get me an ultrasound. Her stomach is badly bruised – internal bleeding is my first concern."
Bella's movements were small, but indicative of her rousing.
"Isabella, can you open your eyes? Can you hear me? Squeeze my hand if you can hear me."
"She's not yet conscious. Do a neuro exam instead of trying to rouse her." I order the nurse trying to awaken Bella. "Is the IV in yet? I need that IV faster!"
I start at her head, instantly feeling the heat of pooled blood contained within her scalp. "Give me an update."
A resident answers me, his voice low against the chaos. "Unresponsive and pupils dilated. Blood pressure is ninety over sixty, and pulse is weak and thready."
"Insert an arterial line. Keep an eye on her pulse ox." I order.
"Here's the ultrasound, Dr. Cullen." Rose hands the portable monitor to me.
"She has a head contusion, closed." I point Rose to her head, showing her the injury. "We need a head CT. Call ahead for it."
"Got it." She makes note of the injury on some papers.
Bella's moans softly as I massage her neck.
"I'm sorry, honey." I whisper to her. "I know it hurts."
The skin around her throat was dark. I force my hands to loosen, taking a step back to breathe deeply before speaking. "Neck is bruised and swollen. Evidence of strangulation. She needs an airway evaluation."
"I'll do it." Rose whispers, peering over my arm to see the bruises. "Who would do this to the chief's daughter?"
"Someone with little fear." I growl. I force Bella's eyes open, seeing the splotches of red covering her sclera. Whoever had blocked her airway had done it long enough to burst her blood vessels.
"Charlie Swan will put the fear back into him." Rose responds.
Charlie would likely never see the man who did this. The one that harmed Bella in such a violent and vicious way was not long for this world.
A cry of pain pulls me from my furious thoughts. She was much more awake, but certainly not present.
I shake my head, almost frustrated by those around me. If I was on my own, I would be able to act faster with the knowledge I already had. I could smell the Rohypnol in her blood, feel the heat of misplaced blood in her abdomen, hear the struggle of her lungs in her chest.
"Do a trauma panel for a drug analysis and crossmatch." I hiss.
If I could put an ounce of her blood on my tongue, I'd know exactly how much of the drug was in her system. I wouldn't have to wait for the lab results to relieve some of her pain.
A quiet whimper pulls my attention.
"Isabella, it's okay. You're at the hospital."
"Arterial line going in. Pulse ox is down to eighty-eight."
Bella's face contorts in pain, her eyes squeezing tight as she slowly rouses. "No." She whispers. "No. Please."
"Bella," I drop closer to her, "You're safe. You're with me in the hospital. I know it hurts. We're going to make it better."
Her eyes open, unfocused as they take in the light and movement. She makes no other indication of awareness of my voice.
"Bella, can you hear me? I'm going to do an ultrasound." I press the probe onto her stomach. "It won't hurt." I tell her, though she pulls away regardless. Her movements are slow and weak.
"Isabella, you're okay." Rose tells her gently, soothing her hair back. There's blood in her hair. From which injury, I'm uncertain.
"Her chest is badly bruised. She must have some broken ribs." It was an Ortho resident who spoke. "Her wrist is also broken. I'm not sure the extent of the damage without an X-ray."
"Get x-rays of her chest." I snap. "Check for pneumothorax."
Bella's slurred pleading makes my chest tighten.
"She is hemorrhaging internally. She's going to need surgery." I say, dropping the ultrasound prob on a table behind me. I move toward her wrist, assessing the damage to it. "We need to stabilize her and get that CT."
Bella's scream pains me as I shift her injured hand into mine. She is more alert now, twisting unhappily on the examination table. Some nurses hold her, trying to ease her movements to make our jobs easier.
The resident is right – her wrist is swollen and discolored. The nails of her hand are broken and caked in dried blood. I scape my finger against her nails, the dried blood flaking into my hand. Turning quickly before my colleagues can see, I wrap my glove around the blood, depositing it in my pocket.
"Stabilize her wrist for now." I say, pulling a new glove onto my hand. "We need x-rays left wrist and left hand."
The ortho resident is prodding at Bella's side, making her cry out in pain.
"You're okay, Isabella." Rose is saying.
"Bella, you're safe." I tell her, squeezing her shoulder gently. "You're okay. You're at the hospital."
"I can't breathe." Her eyes search for me, trying to place my voice. Her breaths are sharp, rattling in her chest.
Rose has her stethoscope at Bella's side, but I can hear her difficulty. I already know the problem.
"Decreased breath sounds on the left, Dr. Cullen."
"Bella, it's going to be okay. Take slow, deep breaths for me. I'm going to put in a chest tube to help you breathe." I abandon her wrist, moving towards her chest instead. "Get me a thirty-six tube tray, betadine."
A nurse returns quickly. I don't glance over to see who is opening it up, pulling the contents out for me to use.
"You're okay, Bella." I tell her, though I'm unsure if she can hear me over her distressed cries.
The orange iodine mars her blotched skin. "Hold her still."
"This is going to pinch a little, darling." Rose tells Bella. She's holding Bella's shoulders down, keeping her in place as I inject the lidocaine.
"It hurts. Carlisle. . . No." She slurs, her body twisting away from me. Hands reach down to hold her still as I inject the last of the medication.
"I know, sweetheart." I whisper. "I'm almost done." The lie escapes my mouth before I can stop it.
I barely make out my name uttered in Bella's pained voice.
"You're doing so well, Bella." I tell her. "Just a little longer."
"Dr. Cullen, there's evidence of sexual assault." Rose tells me.
"I know." I growl, scraping the scalpel across Bella's skin. She jerks away from my touch, grotesquely silent in her agony. "Hold her!"
Three sets of hands respond, grasping the limbs of the girl before me. Bella's body stills in shock for a moment, and her resulting screams freeze everyone around her.
"We need to get the police here to report this, Dr. Cullen. Should I at least call the Chief?" I'm not sure who said it – I'm not paying enough attention.
"That is not your job right now." I snap. "She's injured with an unreliable airway. She needs surgery. Call the OR and get a room prepped now."
"Please stop." She whispers. "It hurts."
"I know, Bella. I'm sorry."
Her unfocused eyes are on me, though I'm unsure if she actually sees me or is following the sound of my voice. It's enough recognition that I'm sure her head injury is minimal.
"Dr. Cullen," Rose motions to the monitors on the wall. "Her vitals are dropping"
I lighten my pressure on her chest, hoping it might ease her pain. I know nothing will truly help until the tension in her chest is reduced. I thread the tube into the incision, forcing it toward her lungs. Her body jerks violently as she coughs against the tube.
"Easy, honey. It's almost done." Rose is murmuring.
"Bella, breathe." I beg of her, holding her steady as she trembles and coughs. "Breathe. You're okay. This will be over soon." I tell her, though I'm unsure of how much she's processing. "The chest tube is in."
Rose presses her stethoscope to Bella's side, confirming that her breaths are easing.
"Dr. Cullen, the OR is ready."
"Get the midazolam and intubation prepped."
"We don't have the results from the lab yet." The new intern tells me.
"We don't have a choice." I tell him, not revealing that I am certain the Rohypnol in her body is not concentrated enough to cause serious harm when mixed with a sedative. The intern nods, and a nurse reaches for the cart with vials of medicine. "I'm sorry, Bella. Sedate her."
"No." Bella's voice is slurred with pain. Her confused eyes, swirling around trying to understand. "Carlisle."
"I'm right here, Bella." I offer. Her red eyes are unfocused, shifting with no destination.
"Pushing midazolam." I watch as nurse push the clear medication into Bella's IV. Within seconds, Bella's body loosens on the gurney as the medicine sluggishly travels.
"No." Bella's eyelids flutter, fighting the medicine. So very typical of her.
"Sleep, Bella." I squeeze her hand in mine. "Let me take care of you now. No one is going to hurt you anymore."
Her eyes drop shut as I speak, her cries quieting until nothing remains but her shallow breaths.
"Secure her airway before taking her up." I watch as another resident reaches for the intubation kit, sneaking up to Bella's head to work over her. "Watch her blood pressure and other vitals until the anesthesiologist can monitor her. Stabilize her wrist, and we need a Jason for a neuro consult. I need two residents scrubbed in for surgery."
I slip out of the exam room, escaping quickly to my office as they wheel Bella for her CT and to prepare her for surgery. Esme is pacing around, her hand gripping my phone.
"Carlisle!" Her eyes search mine for answers.
My previously white shirt is stained with Bella's crimson blood. I yank off my clothes, pulling on scrubs I hadn't intended to use today. "She was . . . assaulted. Someone attacked her."
Esme exhales sharply. A thousand emotions cross her face paired with just as many thoughts I'm sure she wants to verbalize. Esme composes herself quickly. "How is she doing?"
"We'll take care of her." I'm not sure what else to say. Time was not allowing me the opportunity to comfort Esme in the way I wanted. I pull the glove of dried blood out of my pocket, handing it to Esme. "Whoever did this is human. I'm sure Jasper can get someone to run a DNA test."
Esme nods. "Edward knows she's here." Esme murmurs mournfully. "Alice is bringing him back – I assume she will have a story spun before they get here. She asked that you call immediately after you finish with Bella, unless she gets here first."
I pause, casting a glance at my wife. She was pacing again, her expression filled with concern. I wavered for a moment, wanting to offer her more than I had already. But Bella's weakening pulse needed to be the point of my concern.
"Alice and Edward will want updates." She whispers to me. "I'll stay so you can relay them through me."
"Leave if you need to . . . They will understand why you couldn't be here."
Esme sobs quietly, her head falling into her hands. "Why? Why would someone do this to Bella?"
My arms cover Esme, holding her to me for just a moment longer than I should have.
"No, go." Esme pushes me away, her ocher eyes terrified. "Bella – she needs you. I'll be fine."
The words I offer Esme are insufficient as I leave my office, rushing toward the ORs.
"Carlisle," Ben Gerandy walks over as I'm scrubbing my hands.
The nurses are prepping Bella still. I can hear her heart faltering as her internal bleeding worsens. My frustration surfaces again – if only I didn't have to play by human rules. If I could treat Bella with the speed and agility I had, her prospect would be better.
"Is this Charlie's girl?"
"Yes, it is." I grab a towel, draping it over my sterile hands.
Ben steps in my way, fidgeting with his hands. "Rumor has it she was sexually assaulted."
"Word got around. I suppose dignity is not afforded to our patients anymore." My voice is sharper than I want it to be.
Ben flushes red. "I didn't mean anything by that. It's just what I heard."
"I would put an end to any rumors circulating, Ben." I respond coolly. I glance through the window of the OR, seeing that Bella is fully prepped for surgery. "I need to go."
Ben nods, though he continues to stand before me. "Your boy. . . He's dating her, isn't he?" His heart skips a beat at the silence that sits between us.
My frustration grows as I debate my next words. "Did you want me to respond to those allegations against my son now so Bella's condition can worsen?" I take a step towards the OR, but Ben moves in front of me again.
I can feel the heat as my colleague flushes with discomfort. "I'm not going to throw around accusations. . . But I – I still can't let you do this. She's as good as family to you, isn't she? You shouldn't be operating on her."
"As I said, she's critical." My patience was wearing thin. "You're still wasting my time."
"More of a reason to let Snow take the case." Ben wipes beads of sweat off his forehead. He's not used to confrontation with me. "His judgement won't be so clouded. . . Especially on a case that can be touch-and-go."
I shake my head. "I'm the best surgeon here – we both know that." I can hear Bella's heart. It's waning. We're still wasting time. "Bella's best shot of no complications and an easy recovery requires an adept surgeon."
Ben grimaces at my words, nodding slightly with agreement. "Well, yes – but. . . If anything goes wrong, you could be held liable for operating on her."
"A girl's life is at stake. I'm sure you can imagine my career is not at the fore point of my thoughts."
"You've been at a bigger hospital for a few months now." Ben hesitates. "Remember that this is Forks. We don't have the resources to protect you if this goes south."
That's where this came from. He was worried about a lawsuit.
"Rest assured that nothing will go wrong, and I will take responsibility of anything that does."
"Carlisle – "
"If something goes wrong, consider it my resignation."
Ben freezes at my words, and I sidestep him while I have the change. A scrub nurse steps forward to help me with my sterilized equipment as I step into the OR. I can see Bella over her shoulder – intubated, fully sedated, and prepped for surgery. She looks incomparably small beneath the drapes and equipment.
For a moment, everything feels quite heavy.
I don't have any ability to process the feeling before a resident reads out her vitals, informing me of her deteriorating condition.
"This girl is like a daughter to me. She isn't dying on this table." I say to those around me. "Scalpel."
"Alice,"
"I know, Carlisle." Alice's voice is a buzz of speed. "I'm on my way to her house now. Jasper already went ahead to set up the scene. They're going to ask you to speak to Charlie – tell him Jacob found her in her bedroom, the lock of the front door broken, and the house ransacked. She's going to be fine, Carlisle. I already saw. . ."
"Edward?"
Alice is silent for a beat too long for comfort. "He'll be at the hospital in two minutes. Charlie won't believe Edward is innocent unless he has a solid alibi. I'm working on that now. If he asks, Edward was camping for the last few days with Em and Jazz."
"Good."
"Carlisle." Esme's hand touches my arm. "Ben is waiting to speak with you. Charlie is here. I don't think they told him it was Bella."
"I'll speak with you later." Alice's voice chips and the line cuts out.
"Edward will be here momentarily." I tell her. I wrap my arms around Esme, pulling her close to me. The grief was hitting me now.
"How is she? Tell me honestly, Carlisle." Esme asks, her voice painted.
I close my eyes, trying to force the memories from my mind. "She's stable now. That's what matters."
"If Jacob hadn't brought her. . ."
"She might have died before Charlie got home to find her."