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It’s barely two minutes after hearing about the jumper on the hospital’s roof that Mark watches Carter burst out of the stairwell into the ER and skid toward the exit doors. He’s at his side before he even realizes he’s moved, gripping Carter’s elbow hard enough to bruise, forcing him to stay in place.
Carter whips around to face him, face made almost comically young by the panicked, helpless expression.
“Carter. Don’t go out there.”
“She’s my patient. She’s my—”
“That’s exactly why you can’t go out there.”
The panic finds an avenue, manifests as anger. “I can’t see my own patients when they need help?”
“You can’t do anything for her, Carter.”
It’s the one thing Carter can’t hear. His head snaps back as if Mark had reached out and slapped him, tries once more to get free from Mark’s grip. Mark holds fast. That’s not how we’re gonna run this, buddy.
They remain like that, staring blankly at each other, for another moment. Then Carter implodes. His chest caves in on itself and his head drops, the air punched out of him. Mark grips his arm tighter and drags Carter in the opposite direction of the exit doors, toward the ambulance bay. They round a corner near the basketball hoop out back before Mark stops and puts his hands on Carter’s shoulders. The kid looks up dumbly, as though he hasn’t made up his mind between asphyxiating and screaming until his lungs bleed. Mark pushes down on his shoulders, hard, and Carter half sits, half collapses down on the curb.
Mark crouches beside him, bouncing on the balls of his feet as he waits for something to happen.
He’s watched innumerable interns lose their first patients. He’s doled out tissues, held hands, even been punched on one memorable occasion, but he’s never been stared at, unblinking, like Carter needs this explained to him. As though the world doesn’t make sense without Mark there to teach him how to navigate it. It freezes the air in his lungs, the realization that he can’t explain this. That not everything is the result of something else, some procedure Carter carried out in the wrong order which Mark can point out was incorrect. He takes a breath. Carter is still watching him expectantly.
“I’m so sorry,” is what comes out of his mouth.
Carter’s head is between his knees before Mark has finished his sentence. His fingers grip his ankles, squeezing spasmodically at irregular intervals. Mark puts a hand on the nape of Carter’s neck, unsure of what else he can do. He lets Carter’s stuttered breathing dominate the air between them. He’s said the wrong thing, he knows, but the distant, detached part of him which is always assessing and evaluating wonders if there even is a right thing to say in this scenario. Whether the best thing to do is to just sit with him in the late November air and wish distantly that he’d brought a coat.
Carter’s head snaps up abruptly, and this time his eyes are glassy with tears. His hands fly to his throat, grasping desperately at his tie. He looks to Mark, and the terror in his eyes is so different from the childlike confusion of a few minutes before that it jars him.
“I can’t—I’m not—” Carter wheezes, before it dawns on Mark what’s been happening since Carter sat down. He’s hyperventilating.
Mark reaches out, gently grasps Carter’s hands with his own. Carter flinches slightly, but his hands fall to his lap. Mark loosens Carter’s tie for him, undoes the top button of his shirt, and replaces the hand that was on the nape of his neck.
“Okay, Carter, listen to me. I know it feels like you can’t breathe. But you can. So I want you to just sit here, and listen to the cars going by outside. That’s all. Pay attention to which direction they’re coming from. See if you can hear the El.”
He reaches a hand out to grab hold of Carter’s wrist and take his pulse, but Carter’s hands are already pressed into his face, heels digging into his eye sockets. So instead he pries Carter’s hands from his face and shifts to sit next to him on the curb, close enough to brush shoulders with him. He looks out at the alley around him.
“They haven’t collected the trash down here in forever,” he remarks mildly to the air. He gets no response. Not that he was expecting one. “And it’s fucking freezing.”
This does merit a slight huff of laughter from Carter.
“You got any Thanksgiving plans?” He knows the answer, but waits for Carter to shake his head before he continues. “Me neither. It’s my least favorite holiday, to be honest. I don’t know how to carve a turkey. I don’t even know where to start. You need four industrial ovens just to make everything you’re supposed to make, and you’ve gotta invite Great Aunt Mary even though she says something disparaging about your house or your career and has every year since 1894.” Carter laughs again, and Mark takes it as a sign to keep talking. “And don’t think you can get out of it by working. You know how many grease backsplash burns we had to treat last year? 74. And I went home at 3.”
Carter’s head is back up. He’s smiling, if wanly, elbows braced on his knees, staring at the gutter on the other side of the street. One hand grips the other, and Mark can see that his knuckles are white. He doesn’t speak. That’s fine with Mark. He’s happy to wait Carter out.
The question, when it comes, is not one Mark was expecting.
“Is it always this bad?”
“Is what?”
“Working here.”
“Yes. And no.” He pauses, weighing his words on the back of his tongue before he releases them into the air. “It’s always hard to lose a patient. Especially when you didn’t have to. It’ll always hurt like this. And that’s not a bad thing. It means you still care about people and you want them to continue to live their lives. But all this… uncertainty, all this scrutiny, it lets up after a while. It stops being so suffocating. You’re a smart kid, Carter. We all know that. We just want you to be confident in what you do. Whatever that is.”
“What if I never am?”
“You will be. Because every single one of us here used to be you. We were all high-strung, high achieving kids swimming in debt. We were scared shitless. But experience gives you confidence.”
“Even Dr Benton?”
“What?”
“Was he scared shitless?”
“More than anybody else in our class. If you tell him I said that, I’ll deny it.”
Carter snorts. Mark lets his gaze fall on the opposite wall, waiting Carter out as the cogs that need to fall into place begin to click behind his eyes. Carter chews his lip.
“It was my fault.”
“It wasn’t.”
“It was!” Carter’s up suddenly, pacing. Mark stays where he is, squinting up at him through the weak sunlight. “She told me what was wrong. She told me what was bothering her. But I was so wrapped up in my own shit that I didn’t see it. I didn’t see her. I was blinded by one thing about her and it made me stupid. What kind of doctor does that make me?”
Mark stands now, slowly. “Carter, I wasn’t there. I can’t tell you what you should or shouldn’t have done or seen. But I know you, and I know that you are incredibly attentive and observant, and you care, and that is all that you need to be a good doctor. You’re just young. You’ll know better next time. That doesn’t make this time any easier, I know. But this wasn’t your fault.”
Carter scoffs. “Didn’t stop her from jumping off the fucking roof.”
“She made a decision. People make that same decision all the time. Sometimes there just isn’t anything that you can do about it.”
“I can’t accept that.”
“Then start. ‘Cause it’s not gonna change any time soon.”
Carter looks at him again, lost. One tear, a vestige of his earlier panic, drips off the bridge of his nose. He is so unbearably young in this moment, so completely alone and unguarded and floundering for answers. Mark does the only thing he can do. He pulls Carter in for a hug. Carter’s hands bunch the fabric of Mark’s scrubs and his head drops down onto Mark’s shoulder. He doesn’t seem to be crying anymore, just breathing harshly and wobbling on shaky knees. Mark lets him. He can’t do anything else for him.
Carter pulls away eventually, hands migrating up to his collar to readjust his tie. They’re still tremoring too badly to achieve anything, so Mark reaches out again to fasten the button and tighten the knot.
“I’m sorry,” Carter says, eyes locked on something over Mark’s left shoulder.
“Don’t be,” Mark says simply. “It’s hard.”
“What do I do now?” It’s quiet, and there’s a hint of hysteria in it. Mark clasps Carter’s shoulder and steers him toward the hospital.
“Now we go back inside before our fingers start falling off. You’re going to drink a cup of coffee and eat something, and in fifteen minutes you’re going to be back out there with us.” They reach the doors and Mark stops, rotating Carter to face him.
“You’re going to be okay,” he says, and grips Carter’s shoulder.
Then he turns and plunges back into the chaos of the ER. Out of the corner of his eye, he sees Carter making his way into the staff room, shoulders slightly slumped, avoiding eye contact, but still here. Attaboy.
Benton flies past him in a flurry of scrubs and directives. Mark snags Benton’s sleeve and drags him over to one side. When Benton sees him, sees the look on his face, his expression changes entirely, snapping to attention, eyes boring intently into Mark’s face.
“Did you talk to him? Is he alright?”
“He’s fine now. I sent him for some coffee, and then he’ll rejoin us.” Mark pauses. “Could you give him a ride home at the end of your shift? I think the adrenaline crash is gonna hit him hard.”
“My mother made him promise to be at Thanksgiving dinner with us. I told him there wasn’t a chance in hell he was going.”
“You gonna reconsider?”
He’s expecting a sharp reply, something with enough snark to make a med student quit on the spot. Instead, Benton looks away.
“I might,” he says.
Mark could needle him for this. But with the kind of day it’s been, he doesn’t have the energy to turn up his nose at a show of humanity. He nods, claps Benton on the shoulder, and does his best to disappear into the crowd of staff and patients.