Chapter Text
Tav woke with a start to an insistent beeping that did not sound like her usual alarm. What the hell? As she blinked her eyes open, the groan of the woman lying in the hospital bed next to her makeshift sofa bed reminded her where she was.
“Ughhh. Hey, soldier, do you mind getting that for me?” Karlach grunted, eyes still closed, gesturing at her beeping IV pole. Tav chuckled at Karlach’s perpetual habit of calling everyone “soldier”, a remnant of the time she’d spent in the military to pay for her schooling.
“Ok, ok, Kar, let me just get untangled from these luxurious hospital linens.” Tav examined the alarm, saw that the bag of fluids was finished, and pressed “channel off”. No need to call the nurse for something this trivial. She hated bothering the nurses for dumb stuff while working, and wasn’t trying to make their lives harder while off duty, either.
“Thanks nurse,” Karlach teased with an impish grin.
“Hah! Asshole.” Tav softly punched her friend’s arm. The two of them used to keep a running tally of how often they’d been mistaken for a nurse by a patient just minutes after introducing themselves as their doctor, but after just a year or so the tally ran up so high they’d stopped keeping track.
It was reassuring to see Karlach in good spirits despite the circumstances.
Karlach had always seemed unstoppable. They’d met on the first day of medical school, introduced by a mutual friend, and Karlach had scooped her into a crushing hug and then squeezed her biceps admiringly – a surprise to Tav, since Karlach was the one with the admirable physique. The two of them had been gym buddies and study buddies ever since.
Tav had never met anyone with Karlach’s boundless energy and stamina, both in the gym and in the operating room. In their third year, on surgery clinicals together, she had watched with shock and pride as Karlach, who’d already been impressing the ortho attendings all month, deftly played first assist on a hip replacement for a rather hefty patient without even breaking a sweat. By then, Tav already knew that she preferred internal medicine to surgery and was happy to play second fiddle and watch Karlach shine. After that month, it was pretty much guaranteed that Karlach would match to her orthopedics residency of choice, and they celebrated together on match day when they found out they were both staying at their home institution for the next few years. While they no longer got to work or study together as much as they used to, being in separate training programs, and the merciless residency work schedules meant they hit the gym together less frequently than before, they remained housemates and best friends and caught up with each other whenever they could, whether that was at home in front of some Netflix or in the hospital cafeteria for a mid-shift coffee.
Tav might’ve never picked up that something was wrong if she hadn’t been home yesterday evening and heard an almighty thud from their shared bathroom. Her friend had been getting ready for a night out together, since the two of them finally had the same golden weekend, and they’d been looking forward to blowing off some steam at their favorite wine bar all week. She thought Karlach must have slipped coming out of the tub, but when she got no response to her knock, she opened the door and saw her friend passed out on the ground. Trying to subdue the panic, she slipped on her doctor hat, only to remember that her doctor hat was useless here without monitors, medications, and nursing staff. So she fell back on her basics. Airway: open, and she made sure Karlach’s head was tilted and chin lifted. Breathing: she saw even, regular chest rise and fall, check. Circulation: Oh. She had a pulse, but it was fast . Really fast. Probably in the 150s? But regular and strong, and her extremities were warm. At this point her ABC only took 15 seconds or so, and meanwhile used her other hand to dial 911 on speaker. Tav described the situation to the dispatcher as concisely as she could, and once they hung up and assured her they were sending a truck right away, she briefly stepped away to make sure their front door was unlocked and then stayed at Karlach’s side with two fingers on her pulse until the paramedics arrived.
The rest of the evening–the ride in the EMS truck, being triaged in the emergency department, and eventually getting admitted to the cardiac floor, was a blur. Tav hated pulling the doctor card, and in fact preferred to be recognized as such as little as possible when she wasn’t at work, but was infinitely grateful that her position as a resident physician allowed her to stay at Karlach’s side through it all.
After an urgent cardioversion, Karlach had woken up pretty quickly, to Tav’s relief. And she stayed awake, which made for two heads to remember and make sense of what was going on, and all the updates that had been volleyed at them overnight, but they hadn’t had a chance to talk about it yet.
“So…how did this not come up in the military at all?”
“Beats me, soldier. It’s not like they didn’t work me hard! They don’t always do an EKG as part of the entrance examination. And I’d never had any issues with physical activity as a kid so there was no reason to suspect anything.”
“God, isn’t it so fucked up that your heart tolerated all the physical wear and tear of your army years no problem but the stress of freaking residency is what set it off?” Tav chuckled, and Karlach roared with laughter, which just set Tav off, and next thing they knew they were both doubled over with tears leaking out of their eyes.
“Ooh, boy, I probably shouldn’t be laughing like this, what with my fragile condition and everything!”
“Oh, fragile my ass, you know if any of your coresidents ever called you fragile you’d beat their asses.”
“Yeah, well, I can bench more than half of those boys, so they’d better be scared!”
“ Goddd , Karlach, you’re such a freaking ortho resident, it makes me sick.”
They lovingly bickered back and forth for a while, trying to make light of what in reality was no small thing. In the two years since Tav started residency, she’d told countless patients that they had far worse diagnoses, and needed far more invasive and far less effective procedures than the one Karlach needed. She’d done so with heart, and compassion, but also with stoicism, because you have to keep a certain professional distance to survive this gig. Now, though? When it was her best friend? Her Karlach? She found it harder to keep that objectivity about it.
“Are you hungry?”
“I’m actually ok for now. Good thing we ate such a big dinner last night so that we would last longer at the wine bar, eh?”
Tav smacked her forehead with her palm and laughed. “Well, so much for that golden weekend kickoff, huh?”
“Oh gods, Tav, you’re right! Dude, seriously, I’m fine here. You should go and actually enjoy the weekend and not spend it here, basically at work! You won’t get another one for a month!”
“Don’t be ridiculous, Kar, I’m staying here with you until you get discharged. Do you actually think I’d be able to enjoy my weekend knowing you’re in here? I’d just be sitting at home picking my cuticles into oblivion and you know it. Besides, I shudder to think of the fate of the nurses on the unit if you’re left unattended and unentertained.”
"Fine. But promise me you’ll go and get food to eat that isn’t the hospital cafeteria food. We suffer those hot trays enough when we’re working.” True, the hospital cafeteria was cheap and solid enough but not necessarily where you wanted to eat on your day off.
“I can order in.” Tav waved her phone at Karlach. “But I’ll wait until after your procedure. I’ll be NPO with you in solidarity,” she said cheekily. “I ate a lot last night, too. I probably won’t be hungry until dinner.”
“Well, here’s hoping they get to me soon, then, and I don’t get bumped until the end of the day.”
“Ah, we’ll see. I feel like the cardiology suite is usually pretty on time. Plus it’s Saturday, so they’re not doing as many procedures today.”
“I’ll take your word for it. Hey, by the way, did you know the cards fellow who was on last night?”
“Oh yeah! Amy! She’s a first year fellow, so she was an upper level resident when I was an intern. She’s really cool. You probably won’t see her again today, though, cause she was just covering nights last night. They usually have the first year fellows on nights and then we’ll have a more senior fellow during the daytime. But that person still won’t be the one actually doing your procedure, it’ll be an EP–electrophysiology–fellow. You probably won’t meet them until you get rolled back, since they usually get the general cards fellow to do the floor work and the consent forms.”
“Got it. Thanks, by the way. For being here. It’s helpful to have someone who knows the landscape over on the internal medicine side of things. Gosh, it’s so siloed between departments and I have no idea. But it’s also helpful to just…have someone here. At all.” A somber look that Tav rarely saw on Karlach’s face appeared now. Tav squeezed her hand. When the two of them first got to know each other better, they’d realized they shared more than just a love of working out. Karlach grew up with loving parents, but they’d both died suddenly of a freak accident while she was in the army, and she was an only child. Tav’s parents were still alive, back in her home country, but they’d always worked so much just to support the family that she never really felt like she had parents . She’d basically raised her younger siblings, and she hadn’t seen her parents in a few years, what with the cost of flights and the inadequate time off. They both felt alone in the world for different reasons, but could relate to each other’s drive to find their own purpose, and their own chosen family.
“Of course, Kar. You know I’ll always have your back.”
“I love you.” Karlach squeezed her hand.
“I love you, too.” Tav squeezed back.
“Good morning!” Tav and Karlach both whipped their heads toward the door. The long white coat, scrub cap, and list in hand were the first things Tav noticed. This was probably the cardiology fellow. The strong jaw, piercing yet kind blue eyes, and strong forearms revealed by pushed-up white coat sleeves were the second things Tav noticed. Oh dear .
“Morning, soldier!” Thank goodness one of them retained their verbal faculties. Tav released Karlach’s hand gently and sat down in the chair by the bed to try and regain her composure.
“I’m Dammon, the cardiology fellow on service this weekend. And you must be Karlach!”
“Damn right! Are you going to be the one zapping my heart today? You’re not one of the mean ones who yells down the phone when Tav calls a consult, are you?” Oh my god . Did she really just say that? She shot a wide-eyed look of panic at Karlach but it was too late. To Tav’s relief, he threw his head back and laughed heartily. God, he has a nice smile. “I sure hope not, although I can’t lie, I’m not always at my most chipper in the middle of the night. If I’ve ever been terse with you on the phone, my apologies.” He gave a deferential nod in Tav’s direction.
Tav actually knew which kind of fellow he was even before he answered Karlach’s question. She made a habit of saving everyone’s numbers in her phone, and she meant everyone . You never know when you’ll need to get a hold of someone from a given department, so why deal with the neverending phone tree if you can find out who’s on call and then just call them directly? Plus, if anyone made a particularly deep impression, she saved their number with a little note. See: “ED resident full of shit,” “neurosurgery resident helpful,” and “cardiology fellow scary.” “Cardiology fellow scary” referred not to Dammon, but one of his co-fellows, who during Tav’s intern year had interrogated and then berated Tav so hard for a consult that she hadn’t even wanted to call in the first place, that she’d ducked into the stairwell and cried for a good ten minutes. They say the stairwell cry is a rite of passage for all medical trainees, but that didn’t make it sting any less.
Dammon, on the other hand, was actually already saved in her phone as “cardiology fellow lovely”, because the few interactions she’d had with him over the phone on nights were so remarkably pleasant that she wanted to make sure she remembered. Despite sounding unmistakably sleepy, he’d been kind and helpful, and even taught her something! Suffice to say it was unique to have this kind of consultant conversation on nights. Of course, she was now too embarrassed to tell him the extent to which she’d noticed him previously. Especially confronted face to face with just how physically lovely he was as well. Slightly red in the face, Tav responded, “No apologies needed. I think I’ve actually called you in the middle of the night before and if I remember correctly you were much kinder than most.”
Now slightly red in the face himself, Dammon seemed to address the list in his hands rather than the room, “Well, thank you. I try my best.”
“So who’s the scary one, then, Tav?” Karlach cut in. Tav sputtered. She was really going to have to have a talk with Karlach later about outing her like this. Karlach’s lack of filter was one of the most endearing things about her, but boy could it get her in hot water right now.
Graciously, before Tav could blunder her way to a sufficiently diplomatic answer, Dammon saved her. “I can come up with a few guesses, myself.” He grinned at her, eyes twinkling, as though they already had an inside joke between them. “No need to say their names out loud. They might hear us and start yelling all over again.”
“Phew,” Tav said, jokingly wiping fake sweat from her brow. “Bullet dodged.”
“Always happy to help,” Dammon joked. And then he winked at her. Holy fuck. “You never said what year you were, by the way.” Tav felt like she was going to have a heart attack, and even this cardiologist wouldn’t be able to save her.
“Ah. Um, oh yes. I’m a PGY2 in the IM program this year.” She put a smile on her face and tried to act normal. Or, as normal as you can when you find yourself inexplicably turned on by an incredibly hot cardiology fellow whose muscled chest you could just start to see in the V of his scrub top.
“Very good! Congrats on being done with the worst year.”
“Oh thank you, thank you, there were times when I didn’t know if I’d survive, but here we are.” He laughed again, a deep but gentle sound that seemed to come from a great sense of ease inside of him. Why is even his laugh sexy?
“I remember the feeling all too well. But time flies when you’re working a lot, doesn’t it? Any ideas of what you might want to do afterward?”
“Oh, I’ve had many ideas over the past few years, but not too many of them stuck. Right now I’m thinking either primary care or doing a palliative care fellowship.”
“Good for you! We need more doctors in both of those fields.” His response surprised her. Most subspecialized fellows usually talked down on primary care, or tried to convince her to pursue their fellowship.
“Thanks, I agree. Cardiology’s really cool, but there’s plenty of people applying to that fellowship each year. Doesn’t seem like y’all need to recruit many more,” she joked.
Karlach cleared her throat, snapping Tav and Dammon out of their banter. He was so easy to talk to, that even though he was distractingly handsome, Tav found it natural to slip into this back and forth with him. She’d almost completely forgotten why they were actually here.
“Well it’s a good thing we’ve got Dammon here to help me out. So what’s the plan for today, boss?” Karlach deftly steered the conversation back to the task at hand, but gave Tav a sidelong glance that told her they’d be talking about that later.
“Right, yes.” Dammon blinked like he was waking up mid-dream. “So. You have Wolff-Parkinson-White syndrome, which is why you went into that supraventricular tachycardia yesterday and passed out. Tav, I’m sure you’re very familiar with the physiology of that.” He shot her a warm smile as he gestured to the relevant parts of her EKG tracing and Karlach smirked. If there’s any way to get on Tav’s sweet side, it’s to compliment her competence, and Karlach knew it. “I know the overnight fellow went over this with you, but I’m just reiterating because I know last night might have been overwhelming. Stop me at any time if you have questions, okay? So, the most effective treatment for this to prevent further episodes is a catheter directed ablation, and that’s the procedure we’re going to do today. I won’t be doing it myself, we have EP fellows here who need their numbers and I’m not going into EP anyway. But I will be getting postop signout from the EP fellow and will be following you primarily until you’re discharged.” Tav perked up, knowing that meant she’d get to see him again. Then he looked right at her, raised one eyebrow, and said, “You haven’t let her eat anything, have you?”
She quickly shook her head. “Of course not! She’s been NPO since midnight.”
“Good.” He was still looking at her, giving her a smile that made her blush and avert her gaze again. “I’ll be back after the procedure to check on you, Karlach. They should roll you back in about an hour! Good to talk to you again, Tav.” And with that, he tucked his list into his white coat pocket and strode out of the room. Both Tav and Karlach exhaled like they’d been holding their breath for hours.
As soon as he was out of earshot a few seconds later, Karlach leaned back in bed, gave Tav her most impish grin, and drawled, “So…what’s the deal with the exceptionally kind, exceptionally handsome cards fellow who was totally flirting with you?”
Karlach knew Tav better than anyone, so the inability to maintain eye contact, flushed cheeks, and forcibly deadpan voice with which she responded told her everything she needed to know, despite her words. “He was not flirting with me. He’s just a really nice guy and was probably glad he didn’t have to explain it all to someone who’s totally clueless for once.”
“Sure, Tav, sure. But I’ll bet you ten bucks you stay until after my procedure so that you get to see him again.”
“You asshole!” A pillow flew through the air in the direction of Karlach’s face. “I was going to stay anyway. I already told you.”
“Well, make yourself comfortable.”
Tav settled into the sofa by the window with her laptop. If she was going to be here for the next few hours, she might as well get some work done instead of just staring out the window feeling anxious about her friend. She opened up Epic and started to prep for her clinic next week, but kept drifting away, to thoughts of bright eyes, warm smiles, and strong hands following an EKG tracing.