Chapter Text
Trinity started to feel the squeeze in her chest ten minutes into the case.
The patient was a man with a gunshot wound to the shoulder, which had earned him a trip straight to a trauma room, but hadn’t turned out to be too serious. Trauma surgery had shown up in the form of Garcia, laid eyes on him, and subsequently rolled those eyes because of how stable he was. Trinity did what she was expected to do, generally attempting to be helpful when she could and getting out of the way when she couldn’t. It had been going pretty well, by her standards. She hadn’t dropped a scalpel on anyone’s foot, hadn’t made a major fool of herself, and had learned and contributed something. Probably.
Anyway, it had been a straightforward case. That was, right up until a pair of invisible hands had started to crush her ribs.
They were all too familiar, and she knew from experience that she couldn’t ignore them for long if she wanted to keep breathing. The man had come in smelling strongly of marijuana, which was a common enough occurrence to not even count as a drop of water to be plonked in the sloshing bucket of notableness that was the Pitt, except that Trinity was pretty damn reactive to airborne allergens and secondhand smoke. And she knew it.
Shit.
Suppressing coughs was hard. It took mental and physical energy, which she poured into the task for as long as she could. She breathed in slow through her nose, trying to let the warmth of the bubble within her surgical mask heat the air by proximity, and she let it out in measured, tiny increments. She stood. She tried to be helpful. She squeaked out words when she could. Then, when she couldn’t take it anymore, she ripped off her mask and rocketed from the room and crumpled to a kneel a few paces away, crunching forward to hack her lungs out.
The door slammed shut behind her. She leaned forward until her elbows hit the ground and dropped her forehead to the cold tile, heaving for air. It was all consuming, the fight for it, but the removal of the mask and the eyes and the heat had her pressing her face to the floor for just a moment of peace. The scent clung to her, faintly, and she fumbled to try and rip off her gown. The door slid open and slammed shut once more, just a whisper over the hands on her shoulders and the shout in her ear.
“Santos?” That was Garcia’s voice, and all in a moment, there was a hand being slid under Trinity’s cheek and another taking her by the shoulder, trying to roll her onto her side with a strong shove. “Shit. I need-“
“No, no,” Trinity said, throwing her weight the opposite way and wrenching herself upright in a dizzying swirl of her head and her half-gone, streamer-like gown. More people were popping their heads out to look at her. Garcia’s hand was still on her cheek.
“No,” Trinity said again, breathless. It came out as just an exhale, no sound. She coughed and tried to tuck the wheezing quality of it away into her elbow, bracing her free hand across her knees. “I—ugh.”
Garcia’s grip shifted to something more supportive, a hand behind Trinity’s shoulder and another braced center on her chest, pushing back against her as she tilted forward not of her own accord. There was a deep furrow to Garcia’s brow. “Hey,” she said, searching for Trinity’s gaze. “You alright?”
Trinity bobbed her head once, trying to find a breath that didn’t fail on the exhale or the in. She settled on something a little squeaky and tossed her shoulders in a high shrug, going for uncaring. “Asthma,” she said, flapping a hand as though to dismiss the worry. She was uncomfortably close to being encircled in Garcia’s arms. “Happens sometimes.”
“Hmm,” was all that Yolanda dignified that with. “Okay, we’re getting you off the floor. Do you have an inhaler?”
Trinity let herself be hauled to her feet and dumped in a chair that someone pushed their way, head still spinning. She nodded and lifted the hem of her scrub top, exposing the belt bag that she kept her EpiPens and inhaler in, a slim zip pack with a red medical symbol on the side. “Probably more allergy than asthma,” she mumbled under her breath, but dutifully took two puffs of the inhaler in quick succession anyway. It wouldn’t hurt.
“What do you mean, more asthma than allergy?” Garcia’s brow was furrowed, her eyes holding a squinted kind of concern. She was close, and she was seeing what was happening, and she was getting that look people did when things didn’t add up, and those things were bad for all of Trinity’s purposes but getting physical help.
Well, shit. This wasn’t how she had thought today would go. This wasn’t how she had wanted anyone to find out, much less the one person in this place who seemed to see her promise and was willing to mentor her. The fewer who knew, the better. That had always been what she stuck to, and Garcia was by no means the first person she would have chosen, But, fuck it. Here went nothing.
With a harsh exhale, Trinity pulled the collar of her shirt to the side, exposing her accessed port. “I have a blood condition, okay? Systemic mastocytosis, it was probably the…the fucking weed,” she said, waving at the trauma room they had just emerged from. “This happens sometimes.”
Garcia stared at her for a moment, eyes darting down to and lingering on the port. “You’re serious,” she said. It wasn’t really a question, and she was already backing away, getting to her feet. “Can I…I’m going to go get Robby,” she decided aloud, and then she was off, dashing across the ED.
“Don’t-“ Trinity tried, but there was no point. Garcia was gone, disappeared down a hallway in the blink of an eye. “Do that,” she finished, letting her voice trail off to a whisper. With a wide roll of her eyes, she slumped down in the chair. This definitely wasn’t how she had wanted it to go. “Great.”
“Robby! Robby!”
Robby looked up from the mobile charting station and arched one eyebrow. “What is it, Dr. Garcia?”
“Come on,” she hissed, snagging him by the elbow and yanking him back in the direction from which she had come.
He tried to protest, but she wouldn’t let go, so he tapped his badge to log out of the computer and went along for the ride. “What’s the issue?” he asked.
She pulled him off to the side into an alcove and scanned the hallway, waiting until there were no immediate passersby. Then, hushed, she said, “Did you know Santos has a port?”
He blinked at her. “A what?”
“A port. Like a central line? Says she has a blood disorder and is having an allergic reaction. Did you know about this?”
“No. Where?”
“Come on.”
This time, he followed with no resistance, kicking his pace up a notch. “How bad?” he asked.
“Hell if I know. This is your specialty, not mine. She’s coughing hard and just used an inhaler.” Garcia jogged alongside him. He wasn’t running, he never ran, but his purposeful clip was quick for a reason. She added, “I made her sit and went to get you.”
As they turned the corner, his hands came out of his pockets and he reached for his stethoscope. “Good,” he said with a curt nod. He was content to leave it at that, running the steps. Epi, benadryl and maybe Solu-Medrol. Airway took precedence. Point five on a syringe was slower, but a bigger dose more likely to stop anaphylaxis than an auto-injector’s point three. Then there was albuterol, and there was always racemic epi-
“Should I get anyone?”
He shook his head and made a little gesture, interrupting his own train of thought and telling her to hang back all in one. “Not yet.”
Dr. Robby approached Santos at a quick clip, stethoscope in hand. “What’s going on?” he asked as he crouched down in front of her. He took her wrists and dug in for pulses, then squinted for a moment, like he was sizing up the situation. “Dr. Garcia told me-“
“That I have a port?” Trinity freed one of her hands and yanked her shirt to the side, exposing a curl of IV tubing hanging from her chest, covered with a clear dressing that had the edges tacked down with strips of white. “I have systemic mastocytosis,” she said, locking eyes with him. “I need it to treat reactions before they get bad.”
He arched an eyebrow. “Systemic mastocytosis?”
“It’s a blood disorder where you have too many allergic cells. Mast cells. It’s-“
“I know what it is,” he interrupted. “What are you feeling right now? Tell me in your own words.”
“My mouth is itchy and my throat’s tight, and I have the, like…stuff in the back of your throat feeling. I need benadryl, I have some in my locker. When I take the meds early, it doesn’t get so bad.”
With a grunt, Robby stood from the ground and picked up his stethoscope, moving to stand behind her. “Lean forward.”
She did, bracing her forearms on her knees and dutifully taking measured, deep breaths. She was shaking. Robby set a hand on her shoulder, helping hold her up, and listened for a minute, shifting the bell of the stethoscope around on her back and cueing her to take breaths. After a couple iterations of that, he circled back around to be in her field of vision, sticking his hands in her pockets.
“Lungs are clear,” he said, “I don’t hear any wheezing.”
“I know,” she replied quickly. “That only happens when I let it go on too long, and I just did albuterol. I need benadryl,” she said again.
Robby pressed his lips together in a thin line. “IV benadryl?”
“I don’t have the port for shits and giggles.”
Slowly, he shook his head. “I don’t know if I see the need right now,” he said. “I believe that you’re feeling something, but clinically, you’re fine. There’s nothing to suggest that you’re having an allergic reaction that could turn severe.”
She gaped at him. “I don’t start wheezing until it’s bad,” she said, almost desperately. “I need benadryl and more albuterol now, or it’ll get to a point where I need epi later.”
“And you never made me aware of this…why?” he asked.
“It’s in my paperwork,” she muttered, dropping her gaze. “Didn’t want to make a deal of it.”
“We don’t get any of that.” He sighed, long and drawn out. “Alright. Well, right now, benadryl doesn’t seem indicated,” he said, the picture of calm even as she bristled. “If someone came in with your symptoms, I would give them a second-gen antihistamine and maybe albuterol. What did you say you were reacting to?”
“Probably the weed smoke,” she said, flinging a hand out in the direction of the trauma room. “The last patient, it was just everywhere. I know I react to that.”
Robby and Garcia traded a glance. Robby rubbed at his forehead. “I can get you a Zyrtec,” he said, lifting his shoulders high, hands still crammed in his pockets, “and you can sit in the staff lounge and cool off for a while, and use your inhaler again if you think it’s needed. With a pulse ox, if it’d make you feel more comfortable.”
“Don’t bother,” she said, shooting to her feet. The world swam around her and she had to do an awkward sidestep to catch herself, bouncing off a wall. There was panic in her eyes, and she knew it. How was she supposed to stay calm when he was telling her to disregard everything she had ever done? “I take four a day. Fuck, do you want me to call my immunologist? Or my hematologist? Either will tell you exactly what I’m saying. I’m taking benadryl now or I’m going to need epi later. That’s what we’re talking about here.”
“Let’s move this out of the hallway.” Robby took hold of Trinity’s elbow, and the only reason she didn’t shake him off was because she wasn’t sure she could stay upright without someone’s steadying grip. He guided her away from the trauma rooms and towards the staff lounge, walking her to the door before letting go. “I’ll be there in just a minute.”
With a scoff, she made like she was going to wrench her arm from his hold and disappeared inside. The table was three paces away. She aimed her steps for it and just managed to get herself into a chair before dropping her head onto the wood and taking deep, wheeze-tinged breaths to try and control her heart rate. This was how it started. Fuck him for making her go through this, but he would see.
Trinity threw him a scathing look and launched herself into the room. He sighed and rubbed at his face with the inside of his sleeve.
Garcia trailed behind. She had stayed silent, just a shadow throughout whatever had just happened, but she was still present. She glanced at Robby and raised an eyebrow. “Do you think she’s exaggerating?”
“I don’t know.”
“She’s a good kid, but she pushes, hard. Remember the whole Langdon business?”
Robby exhaled through his teeth. Trinity had gone to Garcia first, who told him about it after the fact. Nothing here was a pretty picture. “Fuck, like I could forget that. What would you do?”
“Oh, no. You’re the emergency medicine doctor here. I do surgery, not allergic reactions.”
“You’re close with her.”
Garcia snorted. “I didn’t know she had a port, let alone some sort of blood disorder. Not that close, apparently.”
He offered a wan smile. “Rock paper scissors?”
“No.”
“Rock paper scissors and I’ll let you have the next procedure?”
“Still no.”
He held his hands up in defeat. “Fine,” he said, reaching for the door handle. “I tried. Come for emotional support?”
“Bullshit,” she said, but followed him anyway. “You’re doing the talking.”
Robby opened the door, holding it open so Garcia could slip inside. Trinity was slumped forward, sitting with her head on the table, pillowed on one arm. She was staring at the watch on her wrist with squinted eyes, observing something, but she dropped her arm down to her knee when they entered.
“So?” she said tightly, making no move to sit up.
Robby sighed and pulled out a chair. Garcia mirrored him, keeping her mouth shut.
“Let’s start from the beginning,” he said, propping his elbows on his knees. “What do you think you’re reacting to?”
Already, it was visible that Trinity was growing frustrated. “I just told you,” she said. “The mariujana. I-“ She broke off to cough, tilting her face down into the table. When she caught her breath, she continued, “It’s like the one airborne thing I still react to, except lavender. I know it’s an issue.”
“Hmm. What makes you think that this is going to turn severe?”
“Because I know myself. I’ve lived with this for half my life and have had a name for it for ten years, and when it starts respiratory like that, it always escalates. Always,” she said with emphasis. “So. Benadryl?”
Robby was quiet for a beat. “I’m sure you know that the standards of care have changed,” he said. “We don’t give benadryl for allergic reactions now. It’s Zyrtec or epinephrine for two systems, which you don’t have right now. Right?”
Trinity pressed her lips together and gave a little nod. “Just,” she coughed, “tight.”
“How much albuterol so far?”
“Two puffs.”
“Let’s have you sit with Dana in central,” he said, starting to get to his feet. “Take a break, repeat the albuterol if you have to. Have someone come find me if it gets worse.”
Looking hurt, she got to her feet in an uncoordinated shove and steadied herself on the table. She was still coughing. “Fine,” she said tightly, then booked it. Garcia and Robby watched her go.
“That went well,” Yolanda said dryly.
Robby made a face. “Too harsh?” he asked.
She shrugged. “Guess you’ll see. If she goes into anaphylaxis, that’s your answer. At least we’re in an ED.”
“Can’t believe she didn’t tell anyone,” he muttered, getting to his feet. “And has a central line. Jesus.”
Trinity could have told anyone that the reaction was going to get worse. (And she had, actually. They just didn’t listen.)
Predictably, it got worse.
Trinity walked herself to the Hub, mumbled something to Dana about asthma and needing a break when she was looked at with concern, then dropped into a chair and took another two puffs of her inhaler robotically, like it was just a step to be checked off of a list. She sat there, fidgeting and twisting from side to side in the chair, trying to burn off some of the nervous energy, to feel like she was doing anything but waiting for her throat to close. When her throat started to feel tight, like there was a lump in the back of it that all the aggressive coughing in the world couldn’t clear away, she made a face at the bitter garlic-onion taste of the albuterol in her mouth and resolved to find a water fountain to rinse it out. At least that was something she could do.
So, she stood from the rolling chair on shaky legs and headed for the fountain, swishing away the sour aftertaste on her tongue with mouthful after mouthful of water. The tiny bit that she tried to drink didn’t go down the way it should have, like she hadn’t swallowed right, and really, that should have been her first indicator that things were going to shit, but she was lightheaded and things were starting to gain fuzzy halos and to be frank, she had passed that boundary long ago.
In a second flat, it wasn’t a question anymore.
Anaphylaxis wasn’t predictable. Trinity knew this like the back of her hand, had experienced it more times than she could count, and even still, she messed up sometimes. Her fuck-up today? Daring to think she’d be able to stand for long enough to get back to the Hub.
The pre-syncope hit hard enough that she started to operate on autopilot. Her head was starting to spin in earnest. She spit the water back into the sink. She made it halfway back to the nurse’s station before her heart started to thud even harder and her vision blurred from fuzz to grayness at the edges, and then, the choice had been made for her. She slid down a wall and reached for the ever-familiar autoinjector tucked into the belt she wore at her waist, a bright yellow device protected by a clear case that she struggled to free it from with shaking hands.
Should she have yelled out for help first? Maybe, but she was somewhere visible enough, and she was in an emergency department, and some part of her brain must have figured those two things would work in her favor. Epi first, epi fast had been drilled into her ever since she was a little girl, so now, she didn’t hesitate.
She finally got her thumb to pop the lid of the case and she slid the autoinjector from it on muscle memory alone, then pulled the blue cap off with her teeth and stared down at the yellow pen in her hand.
Blue to the sky. Orange to the thigh.
With a deep, steadying breath, she lined the orange tip up over the side of her thigh, and after a practice swing, jammed it down into the muscle as hard as she could.
Thousand one, thousand two, thousand three. Done.
Somehow, she didn’t think that taking the initiative and doing the damn epi would be the hardest part of this today. Not here. Not with these people, with how they were handling it.
Fuck that Zyrtec.
Trinity took a breath. In, out. No tighter, but no looser either, not that epi worked that fast. Real life wasn’t like the movies. So, she let the pen clatter to the ground through cold fingers and forced herself to inhale, to prepare.
“Hey!” she shouted, lifting an arm in the air. She had to pause to cough as her throat squeezed tighter, a warning shot over the bow. She fumbled for the second EpiPen, trying to dig it out of her belt bag. It didn’t feel like a question, not now. “I need help!”
“Dr. Santos?” Dana was the first to notice. She jogged over, eyes flicking up and down Trinity's slumped form like she was already assessing the situation. “What’s goin’ on?”
Partly because it was a quick explanation and partly because she was running out of breath, Trinity pushed the used EpiPen in Dana’s direction for proof. “Anaphylaxis,” she said, forcing down a cough. “Just used epi, already took albuterol. My throat and chest are tight.” Then, in a mumble, she added, “Should have just taken the benadryl.”
“Epi and albuterol,” Dana repeated back as she dropped to a crouch, leaning forward to inspect the EpiPen. “Okay, honey. What was that about benadryl?”
“Robby didn’t want me to take benadryl,” Trinity said, squeezing the unused autoinjector tight between her hands like a lifeline. For the millionth time that day, she shifted her shirt to the side to reveal her port. “Told him, but he didn’t believe that I was reacting. I have…” she paused to breathe. “Systemic mastocytosis. Could have prevented this with a push dose.”
“Oh, kid,” Dana murmured. “Are you lightheaded? How’s your breathing?”
Trinity exhaled hard just to hear the wheeze. She was tiring out, fighting to keep herself sitting. Not that she should have been. “Yeah. Not great.”
Dana gave the room a quick glance, then focused in on Trinity. “This needs treatment, honey,” she said, gripping Trinity’s shoulder. “Who do you want?”
Trinity didn’t think twice about it. “Mel. Or Dr. Collins.”
“Okay.” Dana gave her shoulder a squeeze. “I’m saying with you,” she said gently, then switched straight to a shout. “Mateo!”
“Yeah?” he yelled back.
“Anaphylaxis,” Dana called. Mateo jogged in to stand behind her, appearing from somewhere outside Trinity’s field of vision. She craned her head up to look at him, then dropped it just as quickly when it made everything spin more. Dana continued, “She just used an EpiPen, and she has systemic mastocytosis and a central line. Can you get a doctor, please?”
“Oh, shit.” Mateo booked it. Dana frowned at Trinity.
“How long since the first epi?” she said, skipping the wrist and going straight for the neck to count a pulse. “I don’t like how you’re breathing.”
Trinity held up three fingers, then wiggled her hand to mark the time as approximate. She had managed to hold onto the second EpiPen, but she didn’t feel like it was worth trying to respond aloud. Her throat was too tight for that.
“Okay. Give me that,” Dana said. She plucked the autoinjector from Trinity’s hand and, with practiced motions, pulled the cap off and pressed it to her leg. “There’s that,” she said. “I’m thinking you’re going to need a third, hon.”
“Maybe.”
“Okay. Keep breathing, kid. I’d rather not need to call a code for you.”
Trinity snorted, starting to slump to the side. It was getting marginally easier to breathe, the wheezes coming just a little quieter now, but the world was still blurry and everything sounded like it was fuzzing in and out. “Might need to…flat,” she murmured, bracing one hand against the cold tile to keep herself from tilting further. “World’s…”
The next words didn’t come. Dana moved anyway, darting in to get her hands on Trinity, controlling the descent. “Okay. Alright, that’s fine,” she said. “Let me help you. Don’t want you to hit your head.”
Everything was easier horizontal. Trinity tucked her knees up and held onto them, assuming the approximate position of a ball. People were standing over her, saying things, but they were so far away and her eyes wouldn’t focus and she couldn’t make out the shapes that their mouths made. She caught some things, but not all, responding when she could and making faces when she couldn’t. Eventually, there was a word of warning in her ear and she was being lifted onto a gurney, floating in their air before thudding down. She closed her eyes.
Mel hadn’t expected to need to treat a coworker for anaphylaxis while on shift, but her time in the Pitt so far had been full of surprises. As she walked alongside Mateo, being led towards the Hub, she nodded along as she took in the information that was offered up rapid-fire, trying to not look too taken off-guard by the news.
“She’s having an anaphylactic reaction, she has systemic mastocytosis and a central line,” Mateo was rattling off, like he was repeating from a script. “Dana’s with her, she’s sitting on the floor near the Hub. She seemed like she was having trouble breathing, and she just gave herself an EpiPen.”
“Oh!” Mel said, tuning back into the conversation in a hurry. Making mental notes, she tried to summarize aloud. “Anaphylaxis, mastocytosis, EpiPen. Okay. We should get her a room.”
Mateo nodded in agreement. “I’ll get a wheelchair,” he said, jerking his thumb over his shoulder. “She’s just up there. Are you good from here?”
“Um, sure.”
He dashed off and she continued onward. Every doctor learned fast that the nurses should be respected, trusted, and listened to, but Mel was still surprised as she rounded the corner and found Trinity laid out on the floor, feet up. Mateo hadn’t been kidding. She looked bad.
“Hey,” Mel said, dropping down onto one knee. She traded a look with Dana, who freed one hand from where she had been supporting Trinity’s head to point to the two EpiPens on the ground. Trinity was flat, breathing fast and hard, with a pallor that should have been reserved for ghosts. She really didn’t look good.
“What are the meds so far?” Mel asked as she took Trinity’s wrist, feeling for the pulse. She pressed her index and middle finger to the radial artery along the inside of the thumb, and counted the beats against the ticking hands of her watch. It was pretty fast and it was hard to count, dipping and dodging away from her fingers even when she pressed them in deep.
“Albuterol and two EpiPens, last dose about two minutes ago,” Dana listed off. She reached down to shift Trinity’s collar to the side, drawing attention to an accessed port. “She has mastocytosis and a port. Not sure if there’s a definite trigger.”
“Okay,” Mel said, reaching for her stethoscope. She leaned over Trinity, bringing herself closer. “I heard you used an EpiPen,” she said. “How are you feeling?”
Trinity blinked hard. “Shitty,” she said, pressing her eyes shut. “Need,” she broke off to cough, “a neb. Benadryl. Maybe steroids.”
Mel bobbed her head. She was making observations about Trinity’s work of breathing and audible wheezing, and she didn’t like them very much. “I can see how hard you’re breathing,” she agreed, pausing for a moment to slide her stethoscope around on Trinity’s chest and sides. “I hear wheezing and stridor, and you’re diminished. You’re going to need more epinephrine, not just steroids.”
“Fucking fantastic,” Trinity mumbled. “I’m not moving.”
“I’d prefer if you didn’t,” Mel said. She felt for Trinity’s pulse again, lips tugging down. “Okay. Someone needs to call a code,” she said, quietly enough, but with as much force as she could muster. She looked to Dana. “This needs an attending.”
Dana dipped her head just once, agreeing. Setting Trinity’s head down gently on the ground, she sprang to her feet and planted her hands on her hips, looking around the ED. She was already moving, heading for the Hub as she called out, “Where the hell is Robinavitch?”
They got Trinity off the floor. They found her a room. Robby was nowhere to be found, having disappeared like he tended to do, so Mel dealt with it, ordering repeat doses of epi and a slew of other meds. An RT stood at the head of the bed, managing the oxygen and breathing treatments. Trinity already had the port, so they didn’t bother trying to get an IV in her, going with the straight-shot central access for benadryl and Solu-Medrol and famotidine.
It worked. She improved. Her sentences got longer and more coherent, and they were able to sit her up some without her blood pressure plummeting. She started to come back to herself, getting chatty, just in time for Robby to show up.
“What the hell happened?” he demanded, striding in and going straight for his stethoscope. He kept his attention on the monitor as he listened, eyes taking in the numbers and tracking the beats.
“Anaphylaxis,” Mel said helpfully. She pointed at the screen, then clasped her hands, rocking back on her heels. “Sats were low nineties, but are coming up with a DuoNeb. Her blood pressure is a little better, but she’s getting a bolus now.”
Trinity stayed quiet until he stepped back, tucking his stethoscope away. “What did you think happened?” she snarked, pulling the mask down for a moment. A cloud of medication mist escaped through the gap she had created. Her face was unnaturally red, flushed a neon pink that spread down her neck and diffused across her chest. Her scrub top had been cut off and sat where it had been tossed in the corner, replaced with a gown. “I needed benadryl. Can’t say I didn’t tell you.”
“Hmm.” Robby moved on, feeling her pulses at her wrists, then her neck. “What meds so far?”
“Three doses of epinephrine, fifty of diphenhydramine, a hundred twenty-five of Solu-Medrol, and twenty of famotidine,” Mel said. “Two of those were EpiPens, so point three milligrams. The third was point five from a vial.”
“Okay. Draw a CBC and tryptase.”
“Got it,” Perlah said, turning to rummage through a drawer.
It sounded like Trinity was suppressing a laugh. It came out as a mix between a scoff and a cough, and the respiratory therapist nudged the mask back over her nose. She pulled it down again.
“It’s going to be two hundred,” she said, staring at Robby. Her eyes were squinted, almost in disbelief. “Probably higher. Whatever you’re trying to prove, you won’t.”
“This is the standard of care for mastocytosis,” he said, still watching the monitor. “Epinephrine, supportive care, draw a tryptase within four hours, ideally two. Unless you don’t want me to?”
She tossed her hands up. Perlah had just paused the fluids and was pulling back on her port with a syringe, getting the amount needed to waste before drawing the labs. “Be my guest. My hematologist will love this. I never get these drawn because I treat at home.”
He fished a penlight out of his pocket and clicked it on. “Open,” he instructed, and shone it in the back of her throat. “Huh. Pretty red.”
She fixed him with a dead-eyed stare. “That’s not a surprise.”
“Hmm.” Finally, Robby tucked his hands in his pockets. “What else? You’ve had epinephrine, benadryl, steroids, and pepcid. Are we missing anything?”
She shook her head. “Observation. Might rebound.”
“Observation it is. Good work, Dr. King. Have someone stay with her until the neb is done.” With that, he backed out of the room. “See you,” he said, then he was gone.
The RT placed the mask more firmly over Trinity’s nose, and she didn’t pull it off this time. She flicked her eyes skyward and looked to Perlah, who had just deposited the used syringe in a sharps bin. “Idiot,” she said in Tagalong, not even bothering to sigh.
“No question,” Perlah tossed back, tucking the tubes of blood into a lab bag. “I’ll get these sent off. Breathe,” she said with a forceful point jabbed towards Trinity’s chest, then stepped out of the room.
Trinity breathed. She went along with the whims of the RT, sitting there as he added more medications to the nebulizer cup and listened to her lungs for the tenth time, and stared up at the ceiling tiles. After an indeterminate amount of time, the curtain swished open. Dana stood there in the gap, a stack of blankets hefted in her arms.
“Hi, honey,” she said, stepping forward and depositing the blankets on the foot of the bed. She squeezed Trinity’s hands. “You’re looking better. Is there anything I can get you? Some water, saltines? Maybe a listening ear?”
Trinity shook her head. “Thanks,” she said, then cleared her throat. Her voice was still raspy, and the arguing hadn’t helped. “I don’t need it.”
“I don’t believe that,” Dana said, moving to unfurl the blankets. She shook one out and draped it over Trinity’s legs, then wrapped another around her shoulders like a cape. Once that was done, she clasped her hands. “How are you feeling?”
“Eh.” Trinity sighed and made a so-so motion. She left it at that.
“You look cold. Sure I can’t get you another blanket?”
“I’m sure,” Trinity said, cracking the tiniest of smiles. “Thanks.”
“I got you. We all look out for each other here.” Dana perched on the edge of Trinity’s bed. “Why didn’t you tell someone you had EpiPens? I wouldn’t want you to drop and us to not know how to help. I care about you, kid.”
Trinity gave a half-shrug, lifting one shoulder. “Didn’t want to be that person.”
“Bullshit,” Dana said, gentle but firm. “You gotta let someone know about these things. I don’t care if it’s me, Robby, Amal, even Gloria.”
“Not Gloria,” Trinity mumbled, but gestured for Dana to continue.
“Someone,” Dana said with emphasis. “Someone, ‘cause next time, I don’t want to find out because you’re on the floor. Capiche?”
Trinity shook her head, but she didn’t fight it. “I guess I don’t have a choice anymore.”
“That’s right.” Dana chuckled and patted Trinity’s hand, getting to her feet. “Shout if you need anything, alright? I’m right outside.”
Trinity said nothing, and Dana headed for the door. Right as she was about to step out, hand on the sliding glass pane, Trinity called, voice very quiet, “Thank you.”
Dana turned back and smiled. “I got you,” she said one last time, and stepped out. In a gentle, slow motion, she closed the door.
Trinity sighed and shut her eyes, all too cognizant of the dry coldness and the chilly prickling and the omnipresent beeping of the oxygen and the fluids and the monitors. These callbacks never ended. They never would end. But she had a blanket, and a Dana, and an EpiPen at her side, and that was enough. It would be enough. It had to be enough.
Amidst the chaos of the ED, the hustle and bustle and loudness that would never stop, she let out a breath. Two EpiPens. Three pokes. One code.
Fuck, did she want to go home.