Chapter Text
JANUARY 16TH, 2027 — 2:23PM
TRINITY
The obstetrics ward is colder than usual this afternoon, even for the middle of January. Trinity pauses for a second as she passes by one of the large windows at the edge of the ward, taking in the snow rapidly piling up on the cars parked below. She sighs as she thinks about her own journey home tonight; a swing shift of midday to midnight means driving back to her apartment, and she'll have to make it especially carefully today. The sigh deepens when she catches sight of herself. Two hours into her shift, and already her hair's beginning to fall out of the tight french braid she pulled it into this morning, wisps framing the new pair of helix piercings she got over Christmas. Not to mention there's a small stain on the left sleeve of her scrubs, and pale pink isn't exactly as forgiving as the black she's used to wearing in the ED.
But still; it's been almost two weeks since she started working in OB—part of the alleged "Triple Threat" rotation of her second year of residency, made up of ultrasound and anesthesia in addition to this one—and she hasn't killed anyone yet. In fact, she's been having a pretty good time. She gets to observe surgeries, and she appreciates how the patients are less violent than the ones in the ED. Well, to her, anyway. She's pretty sure she saw a laboring mother break her partner's hand the day before yesterday, and it might not have been on accident.
She drags herself away from the window, bemoaning the weather and the crazy accidents she's undoubtedly missing in the ED by being up here, and flops down at one of the computers to get an early start on her charting. Another benefit of OB; much fewer patients, and a lot more doctors to go around. Although again, she does kind of miss the rush and the lack of time to think about her own shit that she gets when she works her usual job. Too much time for introspection up here.
But because the universe loves her today—or so she thinks—she gets interrupted before she starts thinking, again, about how she needs to call her brother back about their mom, and about how she really needs to start preparing for her step three exams, and about how she'll be on another new ward in a week and have to learn the ropes. Again. For the fifth time in the past year.
R2 is… a lot.
Her interruption comes in the form of a warm hand clasping down on her shoulder and a husky voice in her ear. Trinity applauds herself internally on how she doesn't jump when Dr. Callahan (PTMC obstetrics attending, 40-something years old, Seattlite, Doctors Without Borders legend, extremely hands on) does this anymore. She turns in her seat, watching as the woman's well-groomed hand falls off her shoulder and comes back up to the iPad she's holding in the other.
"Dr. Santos!" The weathered blonde says with an easy smile. "New patient for you."
Trinity leans back in her seat, mimicking the attending's relaxed posture. "What's up?"
"38 year old woman, 35 weeks with her second pregnancy. Complaining of intermittent vomiting for the last two days," Callahan recites without looking down at the screen.
"Past medical history?" Trinity's used to Callahan's game by now after shadowing her every shift for ten days; the attending begins by only presenting the bare bones of a case, leaving it to Trinity to prove her OB knowledge with her questions. It works annoyingly well.
"Uncomplicated first pregnancy, but she's a type one diabetic."
"How's her blood sugar?"
"Been within normal range."
Trinity frowns slightly. "No other symptoms, just the vomiting?"
"Headache since this morning, but that's it. Normal fetal movement," Callahan purses her lips. "Time's up. What do you suspect?"
"Probably not DKA if her blood sugar's normal, but we should still check her ketone levels to be sure," Trinity starts, tapping her foot on the floor as she thinks through differentials. "More likely it's a viral infection or preeclampsia. Check her blood pressure, and do a urine dip and get a CBC?"
Callahan hums, pleased. She taps something on the screen before she turns away from Trinity, speaking over her shoulder as she walks in the opposite direction. "Sounds like a plan. I'll be with them in room six, you finish up with Mrs. Jacobs then come and find me when you're done."
"Will do."
Trinity finishes what she's documenting quickly, before getting up to discharge Mrs. Jacobs, admitted via the ED a few hours ago for unexpected bleeding following an amniocentesis. Fifteen minutes later, she knocks softly on the door to room six, stepping inside only once Callahan opens the door for her.
"Dr. Santos, perfect timing. We're just waiting for some results from the lab," the attending smiles, sitting back down on the stool at the side of the bed.
On the bed is a tan woman with wavy dark hair cut into a sharp bob. She's extremely pregnant, an astute observation that Trinity would have been able to make even without Callahan having filled her in, one hand rubbing her bump through the flimsy white and blue hospital gown while the other lies on the bed next to who Trinity assumes is her husband. He has similar brown hair but is almost as pale as Trinity, one hand gripping the edge of the bed instead of his wife's hand, likely nervous about disrupting the pulse oximeter where it's sitting on her index finger. Behind him, in the shitty faux leather 'armchair' that furnishes most of the patient rooms up here, a little girl is sitting and reading a book. She's maybe seven or eight years old, hair pulled back into two pigtails, and below her thick bangs Trinity can see the clear resemblance in her round face to the patient.
"Erin, Matthew, Izzy, this is Trinity Santos, she's on loan to us from the emergency medicine department for a while to learn some more about obstetrics. Is it okay with you if she asks some questions?" Callahan asks gently.
Trinity sends her best approachable smile at them, pulling a stool up to the end of the bed so she can see both Erin and the monitors clearly.
"Of course," Erin breathes out, shifting slightly on the bed.
"Great." Trinity runs down her checklist quickly but thoroughly, knowing that Callahan—Emma, as the patients refer to her—already went over everything with them, probably twice. But Callahan's buying time until the lab results get in. And giving Trinity a learning opportunity, of course. Since the fall, when she finally gave in and started going to regular therapy (and lasted almost two full months), Trinity's been trying to be less jaded.
Sometimes she's successful. Being out of the ED helps.
While she finishes up in getting a history of Erin's diabetes (diagnosed at eleven years old, generally good management of her bloods, no previous diabetic ketoacidosis, or DKA), the phone in the corner of the room rings and Callahan goes to pick it up. Her face is serious as she listens to them, checking what Trinity assumes are lab values on the patient's chart on her tablet. After a few seconds, she hangs up and sends Trinity a look that she takes as her cue to finish with her questions.
"That was the lab," Callahan speaks up, looking between Trinity and the little girl Trinity noticed when she first came in. "Dr. Santos, maybe you could take Izzy to the cafeteria to get a snack for fifteen minutes while I spend some time with her parents? Would that be a good idea, Mom and Dad?"
"Yes, I think so. Come here, baby—" Matthew says, pulling his daughter in closely and smacking a kiss on the top of her head. "Be good for the nice doctor, okay? We'll see you when you come back."
Izzy hesitates by her mom's bedside, one hand wrapped tightly into the sheets.
"Go on, honey," Erin says, smiling weakly despite her ashen face. "Get a snack. I want to hear about how the cafeteria is for after I have the baby."
"Izzy, do you like cookies?" Trinity speaks up from where she's moved back towards the door. Matthew smiles at her gratefully as his daughter perks up slightly, turning to look at Trinity and nodding hesitantly. "Well, they have great cookies. Trust me."
She neglects to mention that it's pretty much the only edible thing that they cook up there. Trinity 2, Cynicism 0.
"Okay," Izzy agrees, walking over to her hesitantly. Her pigtails swing as she walks, brushing the pink hoodie she has zipped up over a pair of jeans. Hopefully she's warmer than Trinity is; it's not as bad as in the ED, but up here the ward is kept at a glacial temperature.
"Let's go," Trinity says softly, reaching one hand out to the girl. "Bye Mom, bye Dad, see you soon!"
"See you soon," Izzy echoes, taking her hand.
Izzy stays quiet the whole elevator ride down to the cafeteria, twisting her feet in front of her and staring at the ground. Only perks up slightly when they're in line at the cafeteria and she sees the collection of baked goods the hospital has to offer, pointing out the one she wants (Chocolate chip. A girl after Trinity's heart). She goes silent again while they find a table by the window, her with her cookie and Trinity with a green tea (her new new year's resolution is to consume less caffeine, after her first one didn't even last until the end of New Years' Day).
"Something on your mind?" Trinity asks softly as she watches Izzy pick at the cookie, crumbs falling over the table in front of her.
"Yeah," Izzy mumbles, not looking up at her.
"Want to tell me about it?"
She waits for a second, watching how Izzy stills and frowns slightly.
"It's okay if you don't. But maybe I can help," she offers. She doesn't think there's anything really wrong with Izzy: there aren't any alarm bells ringing now or before when she saw the family together. But Izzy's young and her mom's definitely going to need to be hospitalized for a while. It's not surprising she seems upset.
Izzy hesitates for a second before she looks up at Trinity through her eyelashes, big wet brown eyes blinking rapidly. "Because you're a doctor."
"Exactly."
"…Is my mom going to be okay?"
"I think she is," Trinity answers her honestly. She doesn't want to lie to Izzy and tell her that Erin isn't sick, but given how Callahan reacted earlier and the statistics about preeclampsia if you seek treatment early, which they have, it's likely both she and the baby will be completely fine after the delivery. So she settles for what she's certain of, and what she hopes will make Izzy feel better. "I know that she has some really really smart doctors and nurses looking after her right now. And I know that she has your dad with her, and she knows that you're here supporting her, which is really helping."
"It is?" Izzy asks, her eyes widening.
"Oh, yeah, absolutely."
"Are you lying to me?"
Trinity shakes her head. "I wouldn't lie to you. I promise."
She holds out a hand to punctuate her point, pinky finger extended.
Izzy takes in her offer, reaching out her empty hand to link their fingers and shake. "Okay."
She turns back to eating for a few seconds before speaking up again in a much lighter tone.
"Did you know that I picked the name for my sister when she's born?"
"No way!" Trinity says with a grin. This is one of the things she always appreciates about kids—how resilient they are.
"Yeah!"
"That's so cool. What's her name? Oh, wait, no—let me guess." Trinity frowns deeply, twisting her lips like she's thinking deeply. "I've got it! Izzy!"
Izzy giggles slightly. "No, that's my name!"
"Oh, you're right! That would get a bit confusing."
"Guess again."
"Hmm... Izzah?" She says with a grin.
"That's not a name!"
"Are you sure? I thought it was!"
Izzy shakes her head, smiling properly for the first time since Trinity originally saw her this morning.
"Okay, I get one last guess, then you tell me. Deal?" Trinity asks, taking another sip of her tea.
"Deal," Izzy agrees, her hair shaking as she nods her head.
"Oh, I know. Trinity!"
"No!"
"Are you sure? It's a great name."
"That's not it."
"Shoot. You have to tell me now."
"Cecilia," Izzy says, sounding the name out with concentration. "But we're going to call her Cece, like I'm Izzy but my name's actually Isabella."
"Wow, that's so pretty! You chose a good name, I can tell you're a great big sister already." It's definitely better than what Trinity's brother Daniel would've been named if she had that kind of power at seven years old. With retrospect, Michelangelo Santos doesn't sound as great as she had thought.
Izzy puffs with pride at the compliment, taking a big bite of her snack. She starts telling Trinity about how she's going to help out with the baby when she arrives, including her plans to dress her up like a build-a-bear and take her to her second grade class' show and tell.
When they leave the cafeteria a few minutes later, enough time likely having passed for Callahan to relay the news and Izzy's parents to have some time alone to process it, Izzy is in a much better mood. She skips along to the elevators, dragging Trinity after her, and looks around at the people by them with interest.
Trinity's checking her phone—two new messages, one from Huckleberry asking if she's driving back tonight and if so did she remember her snow chains (rude. She's from California, not the moon), and the other on the ED group chat stating that Robby's in a terrible mood today and to avoid pissing him off (what's new?)—when Izzy tugs on her hand to get her attention.
"Who's that?" Izzy asks loudly.
"Who?" Trinity replies, following the girl's eye line to where an all too familiar figure is standing by the elevators, staring at them both. "Oh."
García slips a hand out of the pocket of her dark fleece jacket, raising it to wave cautiously to them both. She smiles slightly, and Trinity snaps her eyes away from the surgeon. She feels her ears heat up, changing color to what she's certain is firetruck red as she looks away from García and takes in how few people are in between them. It's not enough to fill an elevator. Sadly.
"Is she your friend?" Izzy continues loudly, swinging on Trinity's arm as she looks between the women curiously.
"Not exactly."
It's not that she and García ended things on bad terms.
Whatever was between them ended officially in October, after weeks of awkwardness and things just kind of petering out between them. In all honesty, it had been weird since June.
But she doesn't need to dwell on that right now. They had ended things mutually, Trinity hovering in the doorframe of the surgical on call room before her shift started, the two of them coming to a mutual decision. That because of how busy Trinity was with her R2 year and adjusting to her new rotations, and the same for García and the intensity and long hours of her fellowship, they barely had time to breathe, let alone see each other. And sure, this isn't the entire reason Trinity thought it best to call it quits, but it was a good enough portion of it that she didn't feel bad about using it as her reasoning. And García agreed to it readily.
After that, things actually got better between them at work. Trinity returned to the ED for most of November and December after finishing her rotations in the ICU, toxicology, and pediatric EM. She was initially nervous when she had stepped back into the ED, two and a half weeks after she last saw the surgeon. But to her surprise, García had treated her exactly the same as when they first started seeing each other: making jokes about the lack of talent down here with a wink to Trinity that implied she was the only exception; reassuring their shared patients that they were in good hands with her; she even got Trinity coffee, more than once! It was kind of weird. Maybe more than kind of, in fact. But Trinity reciprocated quickly, always a little too grateful to be given this kind of attention by García (or anyone, her mind corrected before she told it to shut up), and they soon fell into a tentative friendship.
Of course, this friendship didn't extend outside the hospital walls, but she was glad for that. It felt like a healthy boundary. The best possible outcome after you end your casual relationship of over a year with a colleague.
So, things were good! But given what happened the last time that she and the surgeon saw each other, just outside the hospital after Trinity's most recent stint in the ED ended… well. Let's just say that this isn't exactly how she wanted to run into García again for the first time afterwards. She doesn't really want to see her at all.
"Why not?" Izzy continues asking, oblivious to Trinity's barely contained panic.
Trinity snaps her eyes back down to the girl, tugging on her hand to get her to look up at her. Izzy blinks up at her, her light brown eyes noticeably brighter after she got her sugar fix and her worries off her chest. She uses the hand that isn't clutched in Trinity's to push her bangs out of her eyes, rubbing at them slightly.
"Hey, Izzy," Trinity says in a conspiratorial tone, ducking down so that the girl can hear her better. "Do you want to take the super secret shortcut way back to your mom's room? If you're up for it, that is."
"I am!" Izzy replies, her mouth dropping open.
Trinity smiles at her, straightening up and pulling her lightly over to the stairwell. "Okay then, let's go."
This rotation really isn't that bad, she thinks to herself as they start walking up. There's no way she would ever get a break this long in the ED, and it's certainly winning out interest-wise over her first R2 rotation outside of the ED.
That one, starting at the end of August, was in the intensive care unit here at PTMC. Like Trinity had suspected when she asked Mel about her experience there, it wasn't quite her speed. It wasn't bad, not really—intensive care operates at a much slower pace than the ED, but the basic core tenets are the same. Airway, breathing, circulation. The issues is that in the ICU, you want slow. It only gets exciting—scratch that, high-intensity—in the way she had gotten spoiled with in the ED if something goes really, badly wrong. And because there weren't many patients, she had to see the same barely improving faces day after day. If the ED has the ABCs, then ICU has the DEFs. Demoralizing, emotionally exhausting, fatiguing.
After that was over, she spent two weeks shadowing a toxicologist at Presby. She had considered going into toxicology once, before dismissing it with the knowledge that she might carry too much of a vested interest in the cases that she came across. But luckily her time shadowing Dr. Soto went better than she had expected. More truly accidental overdoses than she had ever seen before even after over a year in the ED (mostly kids, with a good number of elderly dementia patients too). Several potential poisonings, including one person who had been microdosing themselves with hemlock because they were convinced someone would try to poison them. They were very quickly referred to Psych. And unsurprisingly a lot of suicide attempts, only some successful. Including one patient that she really really doesn't need to think about right now, not when she has to focus on stopping Izzy from running too far up the stairs ahead of her, her hand warm where it clasps Trinity's own and her pulse beating steadily. And anyway, Trinity did well there. She even got several rough claps on the back from the attending who reminded her of a love child between Robby and Miller, a thought she would care to never have again.
And finally, the last one she did before spending a few months getting used to the Pitt again, was pedes EM at the Children's hospital. That one was probably the most difficult, as shown by how only one week there drove her to initiating the conversation with García that stopped them seeing each other any way other than professionally.
She just felt like she needed to give all of her attention to her patients. Not that Trinity doesn't try to do that anyway, of course she does, but this was different. The babies were the easiest patients in a way, but spending so much time with the parents was an adjustment. She felt the need to spend her time off making sure she was up to date on all of her reading so that she didn't risk fucking up someone's kid. But still. She learned a lot and came out of it with the knowledge that apparently, kids like her.
And hey, now she knows for certain how to talk to kids better than before, something helpful for her current situation.
"It's this door right here," Trinity says, pointing to the door to the vacant ward. She doesn't come up here often, but it's the quickest route to cut across to OB and the NICU when you come up from the lobby. If of course you take the stairs; the elevator is a lot faster.
"Okay." Izzy steels herself for a second before jumping up onto the top step with both feet, not holding onto the railing.
"Woah, careful there!" Trinity exclaims as she takes a look behind the girl, taking in how dozens of flights of stairs spiral downwards. "Your parents are expecting you back in one piece!"
Izzy grins up at her, gap-toothed and mischievous. "Sorry."
"It's okay. Come on."
She holds the door open for Izzy as the girl walks under her arm, resting a hand on the top of her shoulder to steer her in the right direction.
"It's just down this way."
"Where is everyone?" Izzy asks curiously, peering into one of the empty rooms as they walk past.
"There aren't any patients in this bit at the moment," Trinity explains. "But maybe there will be soon."
"Why aren't there any patients?"
"Umm…" How do you explain budget cuts and the current clusterfuck of a governmental administration to a seven year old, Trinity muses to herself. Maybe this is a time where lying is acceptable. "Renovations."
"Okay!"
"Just up here—oh, hang on a second." Trinity's pager buzzes loudly and continuously where she has it pinned to the waistband of her scrubs. She's still getting used to the feeling of it, but it's useful. And it makes her feel like she's Cristina Yang, which was thirteen year old Trinity's dream, so she can't really complain. Picking it up and staring at the tiny screen, her stomach plummets. It's displaying the code used for a type of hospital emergency, and she instinctively pulls her phone out of her pocket to see what's happening.
A message on the app she was forced to download during her program orientation reads:
PTMC EAS: CODE SILVER, SIP (ALL PATIENTS AND STAFF)
Fuck.
She sends a look down the corridor—empty—before turning back to Izzy where the girl is humming and looking curiously around them, oblivious to what's going on.
"Hey Izzy," Trinity says, squatting down to eye level with the girl. "We have to stay here for a little while, I'm sorry. But we can check out one of these patient rooms while we do that."
Izzy frowns slightly. "Okay."
"Let's go in here," Trinity says, pushing her into the closest room. Before she shuts the door she makes sure to stick her head into the tiny bathroom and under the bed to check they are in fact alone.
"What's going on?" Izzy asks, her eyes wide and scared as she wraps her arms around herself.
"I'm sorry Izzy, I know this is scary, um… do you have to drills in school? For if someone comes in who isn't meant to?"
Izzy nods.
"It's like that. We have to stay here until I get a message that tells me it's safe to leave, here on my phone," Trinity tells her, showing the notification she had received.
"What does sip mean?" She asks curiously.
"It stands for shelter in place. It means we have to hide here. Is that what you get taught in school too?"
"Um… kind of. Run, hide, fight. That's what we have to do at school," the girl blinks back. Her voice is a little more steady now she knows what's happening, even if Trinity feels her heart break at her words.
"Great. We can't do the run bit first here, because some of the doors lock when this kind of thing happens," she explains, looking straight into Izzy's eyes so that her point gets across. "We hide first. And if someone comes in here, you still need to hide unless they see you. Then you run, then fight. Got it?"
"Got it."
"Good."
Trinity stands back up, looking to see if there's anything in the empty room she could use to barricade the empty door. They don't lock, is the problem, for obvious reasons. So during orientation and the drills that they run through every so often physical barricades are always recommended.
But of course there isn't anything. This room—actually, most of the ones they walked past—doesn't even have a bed in it any more. They're clearly serious about the budget cuts.
It's fine, Trinity tells herself. The odds of a code silver—armed intruder, hopefully with a knife instead of a gun—being on this empty floor are low. And they usually get detained incredibly quickly. Although usually people don't even get through the doors to the hospital with a weapon anymore; it's not just the ED that has metal detectors employed at its entrance, the main lobby has them too. Though now she comes to think of it, when they were at the elevators before it did look like there was some maintenance being done on them…
"Trinity?" Izzy's voice breaks through her thoughts and Trinity realizes that she's been staring at the closed door for a while.
"Right, sorry. You know what, I have a new idea. Take this—" she hands Izzy her phone and, after taking a second to think, unclips her badge and pins it to the front of Izzy's shirt. "And you wait in the bathroom until you hear me tell you to come out, okay?"
Nodding slowly, Izzy raises a hand to touch the badge. "What about you?"
"I'll be right out here."
"Okay."
"Great. And you remember what I said about the doors outside? The ones to go to the other areas and the stairs?"
"They're locked."
"They are. But if you use this," she says, tapping the badge, "and tap it on the locks where there's a big circle shape, it might let you through."
"Okay."
"Can you repeat that all back to me?"
"Hide in the bathroom until you tell me to come out. But run if someone comes and they see me, and then use this to get through the doors."
"That's perfect, Izzy. I need you to lock the door and then sit in the shower, got it?"
"Got it."
"Good girl," she says with a tight smile and a ruffle of Izzy's hair, exhaling slightly as she hears the lock click shut in the door behind her.
She makes her way back over to the door and sits against it, cursing the too lax security she knows has been an issue before. Last year, when a month after the Pittfest shooting someone managed to get a knife into the ED because they came in via the ambulance bay and no one searched them (not Ahmad's fault, of course, and no one got hurt. But the hospital's policies suck). Three years ago too, there was a scare when someone tried to kidnap one of the babies from the NICU according to García and Ellis (who both told her as much on separate occasions; Trinity has never seen them speak more than a sentence to each other).
Pulling her pager back off of her hip, she holds it on top of her knees with one hand. Wills the screen to come to life and it to display the code for all clear.
She must have been staring at it for several minutes when she hears something from the hallway outside.
A crash from further down the hall, something that makes her gasp on instinct, shoving her hand over her mouth to shut herself up. She glances towards the bathroom door but Izzy's still silent. Good.
The sound of footsteps walking up the hall in their direction makes her freeze. She holds her breath as they pass by the door, closing her eyes in relief.
But then she hears a sound ring out from the bathroom. Her phone chimes loudly, before Izzy drops it with a clatter and a gasp.
The footsteps stop abruptly, before walking straight back towards them. Seconds later, Trinity feels a hand slam on the door, the vibrations thrumming through her as she stares straight ahead, too afraid to even take a breath. The clock mounted on the wall next to the window, one of the only things left here, reads three fifteen.
She hears someone take a few shallow breaths on the other side of the door, harsh and strained, before a raspy male voice speaks up.
"Is someone in there?"