Chapter Text
It started on the 6th of July.
Mel flagged him down “Dr. Langdon! Dr. Langdon!”
He turned ready to rush to an emergency, “What we got?”
“Oh no.” Mel corrected. She seemed slightly breathless, but not worried. She had a grin on her face. “I just wanted to tell you about this case I was on - a STEMI. Door to balloon time was 48 minutes. You remember, my first day we had one, and you taught me to target under 51 minutes. We made that target. He has an exceptionally good chance at full recovery.”
“Yeah, I remember,” he smiled. That had been a good moment before everything went south that day.
Over the next few weeks, it became a habit for Mel to excitedly beckon him over to share good news.
Every day at a hospital has many wins - big and small - and many losses. It was easy for the losses to feel like they outweighed the wins. But here Mel was, every day, shifting his focus to the wins. Doubling his wins with her own. Before he knew it, he came to expect good news when he saw her. Against his will, a stupid grin would creep up on him the second she entered a room. She was so bright, and so talented, and so positive it took him a while - too long, really - to notice she was struggling.
Langdon saw it as his duty to understand the residents and med students under him. He didn’t have to be their best friend or know their deepest secrets - that would certainly be crossing a line of professionalism. But he needed to understand his team so he could help the whole emergency room function.
He didn’t know too much about McCay’s personal life; she had a kid, an ex, and – as he had just learned – an addiction that she had firmly and solidly under control. She was good at teaching, even with difficult students like Ogilvie and Santos.
Santos was difficult. Langdon knew that his opinion was colored by her turning him in. And he had feelings about that. He had been through enough counseling to accept he was responsible for his own actions. Santos had not been wrong to turn him in. He might even thank her for being a catalyst for change if she weren’t so goddamn self-righteous about it. And his personal baggage aside, she was reckless. She put patients at risk half a dozen times in as many hours on her first fucking day. She wasn’t a team player. And she didn’t have an ounce of professionalism when he came back. He had been the one going through hell for the past 10 months and she acted like his addiction was a personal affront.
But, he forced himself to acknowledge, her cocky attitude wasn’t all bluster. She was smart. Quick on her feet. She cared about the patients. And she seemed to be trying, at least, to work better with everyone except for him. Despite her attachment to the shitty nickname, she seemed to be genuinely friends with Whitaker.
Whitaker, Robby’s golden boy. Eager to please, impressionable, easy to mold. Just what Robby liked in a protegé. Langdon should have known he was never going to last in that spot. Even if the addiction didn’t get him, he was always going to burn out trying to be everything Robby expected him to be. It was an unsustainable position. He had seen his predecessor flame out. He had blamed it on the stress of Covid. Now he oscillated between blaming Robby for all of it, and blaming himself for projecting. Maybe he was trying to get out of taking responsibility for his own failures. Failures Robby had looked past or coached him through in the past, but now seemed to be all Robby saw.
Anyway, Langdon viewed it as part of his job as a senior resident to pay attention to the other residents and notice when something wasn’t right. And within the hospital walls, at least, it was his job to do what he could to help his colleagues. He wasn’t sure if it made him a better mentor, or a fucking hypocrite, to extend that help outside of the hospital walls.
___
On Mel’s first day, Langdon learned that she had an autistic sister - her best friend. And that she had a way with autistic patients. He took what she taught him, and applied it. He tried to listen to his patients more. Understand them.
On his first day back, he got to practice with the blueprint herself, the woman who had taught Mel the tricks she had in turn taught Langdon. Becca King. He also learned that Mel wasn’t just Becca’s sister, but her primary caretaker. He didn’t get the full story right away. Mel let him know that she had DPOA, but was not a guardian. He saw her overstepping. Wanting to protect Becca in a way that undermined her autonomy. He got the sense that Mel had been taking on an immense amount of responsibility - more than she should, more than Becca needed, even - for a long time. He didn’t know how long.
He asked about it in the staff lounge a few days later. He and Cassie ended up grabbing a quick bite at the same time. He wouldn’t quite call it lunch, but it was as close as they got on a shift. “You’ve been working with Mel for ten months - do you have the story on how she became sole caretaker for her sister, Becca?”
“Yeah, really kind of tragic.” She sighed, her voice gentle. “Her father died when she was thirteen...” she looked up as if trying to remember the exact age. Langdon tensed, suddenly nervous to know the truth. To have to incorporate it into his perception of the strong, empathetic, smart doctor he was just starting to know. “...maybe fourteen,” Cassie continued. “And then her mom died when she was in college. She worked full time to support herself and her sister all through med school with no parental support.”
“Shit…” Langdon breathed. He didn’t know what to say, so he went to fact-finding. “How’d they die? Do you know?”
“Her mom died of cancer - a pheochromocytoma I think. She’s very open about that. As for her dad… I should let you hear that from her. I don’t really think it’s my place to share.”
“You make it sound like she confided in you. You friends?”
“I like her, but I wouldn’t say that.” He looked at her with enough intensity to compel more out of her. “We were put on a case together where it became… pertinent. I don’t think she wanted me to know, and I don’t think she would have told me if it weren’t for the circumstance.”
Langdon had the sudden urge to review every chart signed by McCay over the last 10 months. He wouldn’t, of course. That would be a waste of time at best, a gross violation of privacy at worst.
__
He didn’t pry. Honestly between the rush of the job, and his stupid, ceaseless, distracting pain, he didn’t have time to pry. But he paid attention. Listened, when Mel talked. He was trying to be better at that, listening. He remembered a conversation he and Mel had on her first day. Where she revealed that her big secret for getting through to an autistic patient was just listening.
He had taken it as a joke, a dig, even, at first. But it wasn’t. She wasn’t being humorous or passive aggressive. She was just being straightforward, honest, direct Mel. And she was right about him. He didn’t always listen. Especially when someone wasn’t like him. When they didn’t react to things in the way he expected.
Mel wasn’t like him. She was probably autistic, but he got the sense she herself had never been assessed. She always spoke about autism like it was something she understood, but apart from her. He had never done a psych rotation; he certainly wasn’t qualified to diagnose her. But he had learned the signs, and he was pretty sure. So he took her advice and he just listened. And it worked. It seemed like she had just been waiting for anyone to listen.
And he learned. He learned that Mel worried about Becca. Constantly. She worried about herself, too. But for all the responsibility she took on, he thought she could stand to worry about herself more than she did. She worried about lots of people - the girl who had come in with a broken bone, bruising, and too much emergency room history, the frequent fliers, him. He didn’t like when Mel worried about him. He did appreciate the little pep talks, the smiles, the terrible attempts at jokes. But her worrying about him was backwards. He was the mentor. He was supposed to be helping her. And it was slowly becoming more clear that beneath the smiles, and the happy-go-lucky veneer, she needed help.
Langdon was aware Mel had a thing with siblings. After they had a case with siblings, he prompted her to take a break, or put her on something simple to reset - glass out of a wound, stitches, staples - something basic she could do in her sleep. He came to expect the blinking back of tears, or the distraction after one of those cases. However, this wasn’t a sibling case. There were no kids involved. There was no caregiver being overworked. He was blindsided by the tears as they left the room.
It was a suicide - a veteran. Self inflicted GSW to the head, but somehow still alive, conscious on arrival. He seemed like he might want to survive after all, although it was hard to make much sense of anything he tried to say between the wound and the fact that he was absolutely loaded. For a good minute there, it seemed like he was going to pull through, against all odds. And then the odds caught up with him. This was the type of case that would certainly get to Abbot, but he didn’t peg it as a trigger for Mel.
She was certainly attentive to PTSD. There was that woman with PTSD after Pitt fest - even amid the rush of the ER she had clocked it. And they ran into it again with a patient this past week - a veteran, as it turned out, but that wasn’t on his intake form, so it did take some sleuthing - or then again, maybe it was just listening - to figure it out. She seemed to catch the symptoms faster and more frequently than other residents. He had attributed that to her time at the VA. Maybe it was. Maybe her reaction here, too, was just a reflection of her experience at the VA.
But, no, he didn’t think so. He had seen her deal with trauma after trauma in the emergency room without developing new triggers. This was different, something deeper.
“Take a break, Dr. King. I’ll meet you in the break room in a moment.” A few weeks ago she may have pushed back, insisting she was okay. But it seemed that he had banked a little trust. Mel would be fine; she wasn’t less of a doctor for stepping out for a moment when she needed to. In fact, in many ways her empathy for the patients was a great asset in the ED. Mel had shown Langdon that she could handle things, and Langdon had shown Mel that he wasn’t going to think less of her when she took 5 minutes to reset.
He took a minute, adding a note to the suicidal vet’s chart - he was definitely going to wrap up this chart himself, not ask Mel to finish the note for him. Mel was usually more willing to talk if she had a few moments completely alone to collect herself.
When he entered the break room, she was tapping her fingers in a repeated pattern. Her thumb tapped against each finger on the same hand from index to pinky back to index. Her eyes were closed and she was saying something under her breath. He closed the door gently, not wanting to interrupt. He thought she might not have noticed him coming in. But a moment later, she stopped her pattern. Her eyes snapped open, and she took a deep breath as she met his gaze.
“How are you doing, Mel?”
“I’m fine,” the high, somewhat breathy voice betrayed that she was not, in fact, fine.
“Do you want to tell me why that case got to you?”
She looked at him, then looked up at the ceiling. Back to him. She opened her mouth, a word caught in her throat. She closed her mouth. He waited.
“It’s personal.”
“Now, I’d like to think we’ve gotten close enough, we can get a little personal with each other.” A faint smile twitched across her face for just a brief moment. Or maybe he imagined it, because a second later, she was looking like she was on the brink of tears.
“The case just reminded me of my dad.”
“Oh.” The dad. Cassie had said he died when Mel was what? Fourteen? And she wasn’t forthcoming with the details the way she was about her mother’s death. He wasn’t sure what to say. So he just waited. That was often the best strategy with Mel. He got the sense that not many people listened to her, and more than the right questions or the perfect response, she just needed someone to listen.
The silence filled the room. It had to have been at least 7 seconds. He almost jumped in and started talking just to break it. He still didn’t have anything worth saying, but if he opened his mouth, something would come out, and the tension would break and Mel wouldn’t be so on the spot to explain if that wasn’t what she wanted to do. Just before he gave in and started babbling, Mel spoke.
“My dad died by suicide. He served in Afghanistan. It was after his second tour.”
Fuck. Against his will, because this was his colleague, not some patient, he started listing the case out in his head. Female in her late 20s. Sole caregiver, new city, no support system to be heard of, likely autistic without accommodations. And now he knew, family history of suicide. That was a significant risk factor. He couldn’t just ignore this. It was his duty as a doctor and as her mentor to do something.
“I’m so sorry, Mel,” the words were meaningless. They didn’t help anything, so he reached for something more concrete. “What do you need?”
She just gave her head a little shake. An idea was slowly forming. She was overwhelmed. She never got a moment where she wasn’t either caring for patients or caring for Becca. He could give her a moment.
“We are leaving work on time today,” he declared, “which surely buys you at least an hour to do something fun before you have to pick Becca up.” They never ended a shift on time. Mel had to have built that into her schedule by now.
“I have to catch up on my charts from the last 4 patients. There’s no way I can finish that by 7 and continue to see patients.” She started to argue.
“You’re not taking any more patients today,” he insisted, "Just focus on the charts, and then we're out of here."
“That’s not fair to the others. I can take another patient. I’m fine.” And her voice was sounding steadier. She seemed more grounded.
“Mel,” he said, softening his voice, not quite pleading. “I’ve had a shit day. I need this, too. Please, just do this for me.”
She looked like she wanted to argue, but they were interrupted. He was needed to sign off on orders for Ogilvie. He started to head out, but turned before going. “Meet me by the lockers. 7pm. Don’t make me wait.”
He was out of the room before she could protest. Langdon managed to keep Mel off of any new cases for the next 45 minutes, allowing her to focus on charting. He had a half dozen charts to finish himself, and was picking up extra cases to keep anyone from noticing or complaining he had benched another doctor. It was fine, he would wrap it up after going out with Mel before sleeping. There was no longer anyone at home to complain about his pajama time charting.