Archive of Our Own

1, 2, 3, 4, 5 –

His eyes are on him. Hot and dark and depthless. 

Megumi’s arms hurt. Palms overlapped, fingers locked together. Elbows straight as iron pumping rods. Up, down, up, down, up, down – to the imaginary beat of the Bee Gee’s Stayin’ Alive – sink two inches in, thrust back out, two inches in, thrust back out – his whole weight recoiling up and off the stretcher, already in the thick of it. The crash cart is ripped open, the pads are placed. He’s up on the bed, and his knees are shaking, twitching like a jackhammer is drilling into his bones, like every bad memory, like trying to run but having nowhere to go.

6, 7, 8, 9, 10 –

It’s hard. Really hard. Tiring. Sweaty. Easier once the sternum and ribs break; the crackling and crunching of each compression, like pressing down on a bag of potato chips, human bubble wrap. If the bones ain’t crackin’, he remembers laughing with his co-residents, the compressions are lackin’! His stomach roils. Feels his phone screaming at him in his back pocket: someone’s dying, someone’s dying, hey, did you know, someone’s dying.

His hands keep slipping. His palms are too slick. No time to wipe them off. Nothing is safe. Everything is sticky with sweat down here. A pressure-cooker of heat and tension, boiling, and boiling, and boiling, paint on the wall peeling, broken AC units with their ribbons and rusty vanes, and labyrinthine corridors of windowless rooms. It’s only sound and flashing lights and more sound. Monitors blaring, phones calling, people crying. He told Megumi once that this place was like being in a casino, with endless noise and endless fluorescent lights and no telling whether it’s day or night. A trip to Las Vegas with no jackpot and no winner. He used to tell Megumi – this might be hell.

10, 12, 13, 14, 15 –

His nape is hot. A fat bead of sweat slips down his back, down his spine, soaking through his scrubs. He breathes in and out, tries to remember pranayama, whatever crap his therapist prescribes him, and the room is full of fire, he can’t stop breathing in the smoke; a hot mess of activity, heavy panting, not a single full breath. No one dares to breathe in the flames.

A shadow shifts behind him. Someone moves close, preparing to switch. 

No. Not yet. His heart beats quickly. 

Look up.

His eyes on his, like they hadn’t ever left. 

(Looking at you. Always. Watching. Waiting for the fuck-up. Worse, waiting for perfection. He won’t even talk about it to you after. He’ll just give you that stern, deep-brow look, jaw set, nostrils flared on a heavy sigh, like the weight of the world is on his shoulders and it’s all cause of you. That look of disappointment. The one thing you can’t stomach. Not from him. He’ll be the team leader and stand at the foot of the bed – cool, casual, calm – and he’ll instruct and command and run the code, and he won’t have the slightest idea of how your world is imploding in on itself. Of how crushing one person’s gaze can be.)

Look down.

16, 17, 18, 19, 20 –

The bed shakes. At the head, they are working on an airway. One flick out the corner of his eyes, Megumi knows – it’s a difficult one. Too much edema. Too much blood and vomit; saliva bubbling over onto their fingertips. The laryngoscope slides, the endotracheal tube is next to follow. Two-large bore IVs and fluids are running. He hears his voice. Epi. 1 milligram. IV push. Megumi keeps up the compressions, fingers twitching and cramping, a life unspooling, a last-ditch attempt to thread the needle to stitch it back together. Hears his own heartbeat, the ugly lub-dub of it, background noise. How long will this go? Hours, months, years? He’s going to grow old here. He’s going to die doing this. The tale of Sisyphus, trapped in Tartarus to eternal punishment, forever pushing a boulder up a hill that is always destined to roll back down. It can’t be for nothing, can it? This has to be for something, right? 

21, 22, 23, 24, 25 –

Look up. 

Gasp a breath. Pitch into the fire of his eyes. 

Look down.

26, 27, 28, 29, 30 –

A pause, and Megumi rests. Cold sweat and his chest is post-asthma-attack tight. Someone taps his elbow, ready to take over. The advanced airway is in. Two bagged breaths. Pulse check. That deep voice. No pulse. That low, focused register, clarity behind every syllable. Shockable rhythm? The AED monitor flashes in a series of chaotic wavy lines, like a child took a crayon and is scribbling like there’s no tomorrow; like jelly on a wobbly plate. Pulseless VF. Charge.

Clear.

Megumi lifts his hands, closes his eyes, and maybe, he prays.

Shock. 

The defibrillator blares. The patient’s torso rockets to the sky; a 1,000-volt fist going straight through their chest, a brush of Zeus's fingertips to myocardium and flesh. A look at the monitor; the child continues to draw. Refractory VFib. Megumi prepares and sets his hands. Time to roll the boulder again. 

Behind him, he hears the daughter in the hallway screaming.

Megumi meets him on the first day of his intern year. 

It's 6:00 AM sharp on a Monday. The busiest day of the week in any ED, least of all July, when all the new residents officially start their training, and inevitably clog up the medical system with ineptitude and first-day jitters. The waiting room is already a circus: crying toddlers and drippy vomit bags and slumped postures. 

He stands in the glass doctor box in the center of the department. Four thick glass partitions to see out of. Computers and chairs and patient tracking boards lining the edges. Cans of Celsius and RedBull and coffee thermoses at each keyboard. It’s one giant doctor fishbowl, with enough sprinkled caffeine to launch any swimming physician into AFib. Outside, nurses flit around the computers and phones, in and out of patient rooms, to and fro the Pyxis machine. Everything moves, nothing stops. The air is heavy with the scent of antiseptic lemon foam soap. 

Rubbing at his nose and sniffing, Megumi takes a look around. 

Guess this is his home for the next three years. 

He shifts on his feet, a slight squeak against the linoleum floor. He’s as ready as he can ever be. A stethoscope around his neck, attached with a bunny charm, the kind they use on Peds. His late mother’s necklace for good luck. A pair of “new” black Hokas and matching Figs; graduation gifts from Toji, with whatever money he managed to scrape up. Badged clipped on his neckline, in big blocky letters: 

Megumi Fushiguro

Emergency Medicine 

DOCTOR 

He’s rubbed his thumb over the title so many times, he’s started to rub the ink off the R. Baby doctor’s first day. Toji sent him a singular picture of a thumbs up. Big, big day.

Megumi hopes he looks okay. Presentable. He hopes he looks like he knows what he’s doing. Like he’s not totally winging it. Like imposter syndrome doesn’t actually exist. He’s smart, and he knows things, and he’s going to save lives. And if he says it enough times, he’ll believe it. 

The swallow in his throat runs down peanut-butter-and-jelly-thick. 

It’s a hard sell.

“First day?” someone asks. It’s a young guy in bright blue hospital scrubs, a tattoo sleeve on one arm. He’s slipping a fresh EKG into the stack awaiting reading, and he’s got a wide bright smile on his face, perhaps a little too happy for an early morning in the emergency department. A quick flash of his eyes to the badge on his neck; Yuuji Itadori, RN. “One of the new interns?”

“Hm?” Megumi blinks, gaping down at the badge before looking back up. “Oh, uhm, yeah,” he reaches out his hand. “Megumi. Nice to meet you.”

“Likewise,” he grins, taking his hand and shaking it in a surprisingly tight grip. “I’m Yuuji. One of the RNs. Who's your attending today?”

Another swallow. A twinge of a coronary artery around his heart. 

“Dr. Ryomen.”

“Oooooooooooh. First shift with Head of the Emergency Department?” Yuuji whistles low. Megumi gives him a deadpan look; he doesn’t need the reminder. “It’ll be fine, don’t worry.” Wink and toothpaste-brand commercial smile. “I’ll be here all day. Moral support.” 

The medical students in the corner watch with raised brows, before they burrow their noses back in their phones, thumbs flying – undoubtedly texting each other. Nobara is at one of the computers near them, and she kicks back from the desk with a sigh. 

“Where is he anyway?” she complains. “I nearly hit a mother of two and a grandma crossing the street to get here on time. Joke, by the way. Kinda.” She nods her head to Yuuji. “Nobara, the other intern. I’m much less nice than Megumi.”

“Heh.” Yuuji chuckles. “Well. Good thing you don’t have to be nice to be in the ED.” He glances around. “He usually comes in a little late. He gets sign-out on the way. Perks of being chief, I guess. If you guys have any questions, let me know. This is my third year down here.” 

Megumi gives a small smile. His nose scrunches and the little stud scrunches with it. Yuuji seems nice. “Thanks, I appreciate it.”

Yuuji’s grin grows a centimeter more. 

“No problem.” He cocks his head with a chuckle. “What the hell made you guys choose this whole mess?”

It’s a question Megumi has been asked more times than he can count. Interview sessions, family dinners, advisory meetings, offhandedly to strangers on the street. Why Emergency Medicine? What made you decide? You like EM? So tell me, what’s wrong with you?

“I like the idea of getting to be there for people on the worst days of their lives, when they need it the most,” he states, as easy as breathing, as basic as muscle memory. “I think that has to be one of the most rewarding things there can be.”

“That is, until they’re upset they haven’t gotten their food yet and start bitching at you from across the department because their nuggets are still frozen,” a deep voice says, low and rolling. “Who cares about the pulmonary embolism in their chest, they haven’t had their lunch yet.”

Dinner-plate eyes, Megumi whips his head around.

Oh.

“I like the thought,” he continues. “Saving as many lives as you can. Doing the most good. If you can ignore the fact that we’re living in a dumpster fire of preventable death, everyone’s sick and dying, our healthcare system is taking on water, and we’re the first to drown. You see,” and Megumi has to stop himself from gaping, he must have just walked in, “for our patients – every day is the worst day of their lives.”

Dr. Sukuna Ryomen does not look like his pictures. 

He’s somehow…more. For the first time, Megumi thinks he might finally understand the meaning of larger than life. Dr. Ryomen eats up the height of the room. He takes up space like it belongs to him, and it probably does. He’s older than the pictures they have of him on the hospital website, the ones last taken in the early 90s; there’s grey in his hair, and bags under his eyes, fine-lined and wrinkled, jacket half-zipped, and he’s bigger and broader than any headshot could ever really capture.

There’s a sterile styrofoam cup in his hand, steaming with some black coffee he must have just grabbed from the break room. He stands there, staring, and takes a sip. Watching as the medical students sit upright and quickly shove their phones into their scrub pockets, as Nobara swivels her chair to full attention. 

“Morning chief,” Yuuji greets, saluting with two fingers at his brow, and Dr. Ryomen nods to him. Yuuji backs out of the room, not before meeting their wide eyes with a grin and wave. “Welp. Back to it.” 

He’s out the door. There, then gone.

Megumi stands there, uneasy. A leaf in the wind. Feels weird and out of place and directionless. 

“You’re all bright-eyed and bushy-tailed,” Dr. Ryomen says, grazing his eyes over them, over him. “Something tells me you already drank the Koolaid.” Megumi’s brow crunches; what does that even mean? The man scratches at his jaw, the scritch-scritch of it indicating a dire need for a shave, before he runs his hand over his mouth and the dark hair over his lip, and sighs. “Dr. Ryomen.” Megumi already knows who he is. Everyone knows who he is. A name on a hospital plaque. A recommendation for a resume. A friend in a high-up place. The signature on his check. “Welcome to the team.”

Megumi forces himself to look at his face, to meet his eyes, because, well, Dr. Ryomen’s just a man, and sure, he’s not just any man, he’s his attending – but he’s a person, maybe not a regular person, but still – a person. And Megumi can’t show fear. There’s some narrow-eyed study the man is doing, looking at them, at him. Like he’s looking to spy out hidden capability but also weakness, like he’s predicting which bone will crack first, which patient will become the statistic.

“I’m Nobara Kugiaski,” Nobara says politely from her swivel chair, trying as she might not to be intimidated. “Intern.” She looks at the students next to her, and nods her head at them: Go, idiots.

“Hi. Yuuta Okkotsu. M4.”

“Toge Inumaki. M3.”

Eight pairs of eyes slide over to Megumi, and his pulse trips. He’s thankful his voice doesn’t shake when he speaks.

“Megumi Fushiguro. Intern.” 

Dr. Ryomen stares at him. His eyes are very deep, like Megumi might fall into them and never come out, his own center of gravity, and Megumi’s been dragged into his center, and Megumi is –

“In my ED, I got three rules,” the man states. A finger goes up. “Ask if you don’t know something.” Second finger. “Don’t take on too much.” Third finger. “If someone’s sick, come get me. Capeesh?” 

They blink at him. Blink. Blink. Blink.

“Ah, and one more.” Brow lowered, Dr. Ryomen rubs a thumb against his forehead. “Don’t ever lie to me. Didn’t ask or examine that part? Tell me that. Interns don’t make mistakes. Only mistake you can ever make is not letting me know something. Down here, lies kill. Understood?”

They nod like dumb bouncing bobbleheads. 

Sighing, he places his half-empty coffee cup on the desk. “Alright,” he points at the two med students. “You two. What do you want to do?”

Toge is quick to reply. “Radiology.”

Dr. Ryomen makes a shrugging sort of face, as if to say Hm, Not Bad. “Good choice. That is if AI doesn’t take all the jobs.” Looks at Yuuta.

“I’m not quite sure yet. Still exploring my options.”

“Oh, good,” he dryly says. “Don’t make my mistake. There’s still time for you to run far, far away.”

Mistake? Run far away? Megumi can’t help the downward cut of his mouth. Sure, maybe it’s a joke. He hopes he’s joking. He has to be. Dr. Ryomen is the best emergency medicine doc in the field, and he loves his job. Surely. 

The med student, Yuuta, laughs loudly, albeit a bit awkwardly. He must want Honors. 

“Dr. Ryomen,” Megumi says, “sir, are you –”

Ring. 

Ring. Ring. Ring.

Their eyes fly to the nurses’ station. Megumi’s words go dry in his mouth. The Bat Phone is going off. Red and ringing on its grand pedestal. Striding over, Dr. Ryomen picks it up and puts it on speaker. He leans against the desk, crossing his arms. Megumi and the rest flock around him. His sleeves are pulled up, business-hands; enough to see the light dusting of hair. Hairy man: facial hair, arm hair, peek of chest hair. Megumi doesn’t know why he notices.

Peeling his eyes away, he stares at the red phone as if it’s a horror flick. Half expects to hear heavy breathing on the other line and a Hello, Cindy. 

Instead, a tinny voice comes through, and in the back, the sound of an ambulance siren.

“Medic 5 inbound with a stroke alert.”

Dr. Ryomen clears his throat. “Go ahead.”

“69-year old male, sudden onset left-sided facial droop and slurred speech. Unable to use his left upper and lower extremities. Blood glucose 145. Blood pressure 180 over 90. Heart rate in the 60s. Satting 98 on room air. ETA 10 minutes.”

“Last known well?” Dr. Ryomen asks, jotting the vitals and ETA in the EMS report log.

“Daughter…” the voice muffles, comes in and out, “found him in his chair at 5:00 AM. Says he was fine last night.”

“Any blood thinners?”

“Negative.”

“Copy that, BAT called.”

He hangs up. Rolling his eyes, he turns to them, all staring like guppies. “Strokes are given out like candy down here. You’ll be sick of them by the end of the week.” He points to Megumi, and it might as well be as if he’s pointing a gun at him. Megumi looks right down the barrel. “What do you want to do?”

“What do I want to do?”

Dr. Ryomen stares at him blankly. 

Megumi blinks. 

What?

Then, it clicks. At first, he almost can’t get his mouth to work. 

“Oh, uhm, I – I think I would –”

“You would? I asked what you want.”

The tips of Megumi’s ears flame. Okay. Cool. This is how it’s going to be, huh. Dr. Ryomen is that kind of attending. “I would,” he starts, before cutting himself off, a quick glance at Nobara and the two medical students watching, and starts again, “I want to get a non-contrast CT to rule out hemorrhagic versus ischemic stroke. CTA with perfusion to look for salvageable tissue. No clear last known well, so no tPA. Thrombectomy if eligible.”

“Why does time matter so much?”

Somehow, someway, he pulls it from the recesses of his brain like an Uno reverse card. 

“2 million brain cells die every minute without treatment, sir.” 

“Very good.” Oh. Megumi’s throat shrinks itself dry. The corners of Dr. Ryomen’s gaze are crinkled. It’s kind of like a smile. “Easy first patient. Dr. Fushiguro. This one’s yours. Go and meet them.” He nods to the two students, lingering there; lost ducklings. “Med students. Follow him. You’ll learn a thing or two.” 

Follow me?

Me? Megumi blinks owlishly. Two pairs of eyes snap onto him like two large magnetic pacemakers. I was a medical student two months ago. Yuuta and Inumaki move closer, clutching their pens and mini-H&P notebooks to their chests, pleading their loyalty. What the hell are they going to learn from me?

Dr. Ryomen doesn’t seem as perturbed. He stares at him evenly, picking up that stale old coffee cup and drinking from it. 

Stiffly, Megumi nods. Fake it till you make it. He’s been doing it throughout med school. He supposes he can do it throughout residency too. “Okay,” he replies, turning to the students, “let’s head to the BAT. They should be arriving at the ambulance bay any moment. Remember: ABCs, NIH-Stroke Scale, and a rush to CT.”

They nod in agreement and spill away, or at least, the medical students manage to.

Megumi is not so lucky. 

Spinning around, making his grand escape, a large hand wraps around his elbow and reels him back, stops him right there in his tracks. It’s not hard or painful or rough, but the way it makes him feel – it ruffles him down, plucks him unfeathered. Adjusting the long-sleeves of his grey undershirt, he looks up on a hard swallow. 

Did he do something wrong? Already? The I’m sorry, sir is already on the tip of his tongue.

“Careful,” Dr. Ryomen’s voice murmurs, and fingers leave his elbow to take a tug at his chain – at his mother’s necklace around his throat, a lucky jade gemstone. It’s light, a gentle pinch at the beat of his jugular vein. Time crystalizes to a standstill. The moment holds in his lungs, right before an exhale. “Someone’s going to try and choke you with that.”

July is a slow crawl, but Megumi starts to think he’s getting the hang of it. Maybe.

The first two weeks he cries every day. There’s a lot to learn, and a lot of it isn’t even medicine: admin, work flow, evaluations, feedback, performance reviews, social work. Getting yelled at by patients. Getting yelled at by nurses. Battling constant, ever-present imposter syndrome. (Don’t call me a doctor. I’m not a doctor. What even is that? I don’t know how to do that. Someone tell me what I’m supposed to do.) Spending two weeks learning Epic and how to make orders and how to navigate the MAR. All of which will change six months from now, when he inevitably goes to the VA and is forced to squint at CPRS as it loads on an archaic 1980s internet loading screen. 

The medicine stuff comes easier. A kitchen burn, an asthma attack, a stray popcorn kernel stuck deep in a kid’s nose. Farmers coming in with a “little chest thing” and sent to the cath lab thirty minutes later with a massive LAD occlusion. Old people found wandering, dazed, confused, and very septic. Tooth infections, pneumonias, assaults, the occasional suicide attempt, lots of overdoses. 

By the end of the month, at least, it begins to click.

Megumi starts to move like clockwork: meet patients, write notes, change gloves, smile, provide a tissue when needed. His feet ache and his compression socks ache even more, but he pushes and pushes and pushes till the glory hour arrives and the night team appears and sign-out is over. Time passes strangely down here. There’s no windows or sunlight. It’s not Tuesday, Wednesday, or Thursday. It’s a limbo of how many patients you saw, how many patients you patched, how many lacs you repaired, how many seizures you stopped, how many discharges, how many admissions, and of course, how many fives on those lovely patient satisfaction scores. 

The overhead fluorescents buzz, constant, constant, constant, a power line vibrating the air, no stillness, no pause, and Megumi waits and listens to the buzz, day in, day out, as his fingers click-clack against the keyboard, as the defibrillator charges, as the bedside alerts go off, as the security guards wrestle a patient into four-point restraints, buzzz, buzzz, buzzzzzz, he waits on the edge of some precarious cliff, looking down at the drop-off, waiting for the crash and burn, that fiery MVC, the 10-car-pile-up. For the fucking ball to drop.

Because that’s just what happens with him.

Sooner or later.

Something has to happen.

“Ah, no, noooooo.”

Megumi cocks a brow, cheeks puffy with a half-bite of granola bar. One thing he’s learned from working in healthcare is any chance you get: stuff your face. They just endured a riveting Grand Rounds’ Antibiotic Stewardship in the ED lecture and Megumi’s stomach growled for the last twenty minutes like it was actively trying to become human. 

Beside him, Nobara sinks down in her seat, staring down at her phone. The glow of it reflects off her lead-paint stare. 

“What’s wrong?” he asks, muffled through chubby cheeks.

“Well, I’ve just received terrible news. Next month I have ten shifts with Dr. Ryomen. Ten. God, my life sucks.”

Megumi frowns and swallows down his mouthful of oats and chocolate chip pieces. He glances around the auditorium; no one is paying attention during the break – either going to the bathroom or grabbing some more coffee. He returns his gaze to her.

“And?” he replies, even though he gets the feeling he already knows. “What’s wrong with that? He’s an excellent teacher.” 

“Don’t even,” Nobara scoffs. “He’s such a hard-ass. Every time I staff a patient with him, he chews apart my presentation. Then proceeds to pimp me the entire shift. Why can’t it be Dr. Gojo or something? He never cares.”

And that’s why Gojo’s on night-shift, Megumi thinks but doesn’t say. Two different breeds. Which is the one you’re going to learn the most from? 

He casts his eyes around the auditorium once more. Usually, Dr. Ryomen sits – no, stands – in the back, at the wall. One step out the door. He doesn’t see him. Is he working right now? Is he off? What does he like to do when he’s off? Does he have hobbies? A family? What does his life look like outside of work? 

Megumi looks down at his phone.

Silently, he unlocks it and checks his email. 20 new inbox messages. His thumb taps [IMPORTANT, PLEASE READ] AUGUST ED SCHEDULE. Scrolls, scans. Wavers there.

Four.

Four shifts. Only four with him next month.

Nobara rubs her forehead, at the invisible make-believe stress lines that will one day imprint. “My evals are going to look like shit.” 

“Careful, Nobara. You’re talking about the Department Chair. Wanna get kicked out of the program?” Megumi warns, because she talks a little too loud and comfortably to be any bit smart. It wouldn’t be the first time Nobara’s been pulled into a meeting for professionalism concerns. “He isn’t that bad.”

“Yeah, well, maybe for you.” 

“What’s that supposed to mean?”

Nobara lifts her eyes and looks at him very slowly. Stares at him for a moment. Like he’s slow.

“What?” Megumi asks, again.

“Dude, you're his favorite.”

“Fav –” he sputters, his ears instantly going hot, “what are you talking about? He’s pimped me too. Remember my first shift? Remember that? I wanted to cry.”

Megumi’s thoughts race.

Sure, it’s a nice idea. Really nice. In his dreams, maybe. Some make-believe fantasy idea. It would be nice to be a favorite. He’s always been too painfully average and unextraordinary for any award or distinction, least of all to be a favorite. Ever since he was a little boy, he’s been a withdrawn, unspecial person. And Megumi knows himself. He knows at his core, his personality clashes with every stereotype of an Emergency Medicine physician there can be. He’s not a gunslinging cowboy, or adrenaline junkie, or ADHD bicyclist, or a Myer-Briggs’ ESTJ or ENTJ, not in the slightest. He’s shy and meek and insecure and sometimes, he doesn’t even think he’s good enough to breathe. He messes up once, answers a question wrong, forgets to ask the patient one thing, has an awkward interaction – he thinks about it all day, in the shower, at night, as he’s rolling over and over in bed, brain snagged on that singular little hiccup till it tears a hole in the cloth of the thought, and he thinks about the next day and what will happen, playing out the scenarios, your patient is female and short of breath and tachypneic, tell me Virchow's triad, endothelial injury, stasis, hypercoagulability, sir, show me the EKG, S1Q3T3, sir, what do you want to order, D-dimer, ABG, CTA, sir, what are you going to tell me, what does she have, how are you going to present to me, what is your assessment and plan, be confident, succinct, i want, not i would, i WANT, not i would –

Pulling his sleeves over his wrists, he touches the blank space around his neck. That’s certainly not changing any time soon, and Megumi won’t get his hopes up otherwise. 

Eyes alighting, Nobara flashes a wild grin, and she lurches over her seat for emphasis, like she’s got him – hook, line, and sinker. “But you didn’t cry. And you know what he did? He told you good job. Do you know how many times he’s told me that? Zero. Zilch.” 

It’s impossible to stop his blush, or from stammering like a nervous school girl. 

“You’re being ridiculous. I’m not. He’s not – he doesn’t have – he doesn’t pick favorites.”

“Did he tell you that?” She crosses her arms, and bends her knees to rest her pink orthopedic clogs against the back of the seat in front of her. “Way I see it – I’ve never seen him yell at you, not once. Nah. Instead, I’ve seen him crack an actual fucking smile at you. Face it, you’re the golden child. He probably handpicks you for every shift. Optics don’t matter for someone like him.” 

Well, no, Megumi thinks then, maybe a little sourly, I only have four shifts with him next month. You have ten.

Nobara laughs, and the sound carries down the aisle as attendings and residents file back to their seats for the next presentation. “If you don’t see it, then, well, I don’t know what to tell you. You might be a lost cause.”

Nobara is ridiculous. 

He walks Megumi through his first intubation. His hand, hot and huge, spread wide, cupping just around the back of his knuckles on the GlideScope, guiding him as the camera shakes. He moves him, tells him what to do, never lets him the chance to do the wrong thing. Watch one. Do One. Teach one. A glimpse up at him, maybe two: at how big his palm is, how much space it takes up over his, his sleeves rolled up past his elbows, blue nitrile exam gloves pulled tight, jaw set in that singular concentration. Body behind him, towering, the sudden awareness of his hips pressed against his spine, so close, Megumi smells his cologne, and underneath that, the scent of smoke. The sheer heat of him. Hot, heavy. Steady, not too far now, sweep the tongue, that’s it, there you go, atta boy. Megumi bursts into nervous laughter. He’s never laughed like that before. He makes him nervous, Megumi realizes, maybe, probably.

Lift the epiglottis, expose the glottis. Try some cricoid pressure. See the cords? Slip the tube. Stylet. 

Good waveform. Good breath sounds.

Good.

It happens as a series of warning signs. Quick, small triage decisions. Level 5 to Level 3 to Level 1. Urgent to emergent to resuscitation. Firm bellies and diaphoretic skin and tracheal tugging. He should have seen the flatline coming. He should have felt the first tell. He should have known. Should’ve. Didn’t. The one indomitable truth:

Everything is clearer in hindsight.

“Are you kidding me?”

Megumi turns his head. A middle-aged woman walks out of Room 37 and shuffles her sandals, making a beeline for them. Uh-oh. One glance at the board, a quick reminder, she came in with a chief complaint of tooth pain. Another glance, at Dr. Ryomen this time, standing next to him outside a closed patient room – he’s distracted, busy – the night team is in the middle of an early AM code and might need the extra hand. 

“I’ve been waiting an hour for a single cup of water.”

Squaring his shoulders, as best as he can, to some semblance of an authority figure, Megumi takes a step forward. Prepares himself to take the heat of it. Listen, woman. Read the room. Now’s not a good time. “Miss, I’m sorry to hear that. If you ask your nurse, she’ll be able to –”

“No, no, no, I’ve been asking her. My room is hot as hell, there’s no AC, and you’ve been depriving me of food and water. I’m dying of thirst.” 

Monitors go off inside the room. Wheels shriek against tile. Loud voices. A nurse runs in with two units of blood. 

“I’m sorry, ma’am, but we can’t help you right now –” 

She’s walking up, hands on her hips. For someone with tooth pain, she sure is able to talk. “Well, you better help me. I’ve been asking for hours now, and all you guys are doing is just standing there.” 

Megumi’s eye twitches. An uptick in his blood pressure. What the –

“Listen, ma’am –”

A large hand clasps over the thin bone of his shoulder. Megumi blanks, freezes, blinking up. Dr. Ryomen is looming. He’s mad, Megumi can see it. He doesn’t get mad, he doesn’t lose his cool, but right now – he might be. A tension in the corner of his eyes. At the stubble on his jaw, as a tendon tightens, pressing his teeth together. 

Dr. Ryomen takes one look at her, and says, “Lady, with all due respect,” and his voice is cold, cutting, a false sense of pleasantry, all shadows and narrowed-down space, “a family is currently losing a loved one.” Her mouth shuts, and he points at the door, “This isn’t a hotel. It’s a hospital. I don’t care if you’re not getting five-star service and I don’t give a damn about your water, so go sit in your room and shut the fuck up.”

The look on her face: like he slapped her bright-red.

Like he hooked a finger in her panties and tugged it to her ankles, as she walks and waddles away. 

There’s a heavy breath out from his nose, a sigh. His hand doesn’t leave him. His thumb does a wide sweep over his shoulder. As if to say, now that that’s over. 

Like an inside joke.

Megumi’s stomach does absolutely nothing.

“Remind me how old are you again?” Green eyes bounce over to him, carefully practiced in the art of looking now. Watches him toggle over a chest X-ray, and sees it reflected in his glasses, in noir black and white. His shoe tapping out a rhythm Megumi instinctively tries to decipher. “Heard you were the youngest person in your class.” 

Megumi’s fingers pause over the keyboard, in the midst of typing up a discharge summary. 

How old are you? He nearly wants to ask back.

“Twenty-three.”

Dr. Ryomen does a double-take, near owlish in his round glasses. “You skipped some years?”

He nods. “Yes, sir. I graduated high school early on an advanced track, got my B.S. at nineteen, went straight through to medical school, and got my M.D. at twenty-three.”

“Should’ve known you were a genius.” 

Megumi blinks at genius – and tries to ignore the surge in his pulse, choking on air, flash-pulmonary-edema. He pushes out a breath and forces a laugh. “Yeah, I don’t know about all that.” Dr. Ryomen gives him a certain look. Megumi licks his lips and feels obliged to explain. “Whatever you think I am, I'm really not.” He shrugs. “I don’t have a string of accomplishments to my name or anything.” Not like you. “I didn’t score a 270 on my STEP. I don’t have a first author publication under my belt. No grants or awards. I’m not going down to Washington on weekends to help change legislation. Or doing mission trips across the world. I’m…I’m just here.”

“Yeah. You're here. Your whole life you’ve been going into rooms where 90% of the herd gets culled based on intelligence or merit or whatever the fuck, and you’re here. Think that might be the biggest accomplishment there is, Dr. Fushiguro.”

Another trip of his heart, a too-quick, annoying thump. He rubs a thumb over his badge and fights a smile. He gets too worked up, he knows. 

“Understood, sir.”

“What I really wanna know,” Dr. Ryomen casually switches topics, again, “do all the kids your age get that thing in your nose? Is that the new thing now?” 

Megumi cocks a brow. Touches the little bump of his metal piercing. Surprises even himself when he says, “A stud? You can’t be that old.”

Thankfully, Dr. Ryomen looks amused. “Mhm. You weren’t even in your mother’s womb when I was in medical school. We used to use these things called books to study.” Something cinches tight, like a one-hand surgical tie to Megumi’s lower belly. Oh. “You must’ve been born in, what, 2003?”

“Yes.”

“Jesus Christ.” He blinks like he’s realizing his own mortality. “You know studies have shown that patients perceive physicians with facial piercings as less competent and trustworthy.” 

Megumi quirks a brow. “What do the studies say about animal socks?”

“Animal socks?”

Grinning ear-to-ear now, Megumi plucks at the fabric of his scrubs and moves to lift his right leg, to show the bulk of his compression sock around his ankle. Tiny little hedgehogs with strawberries do the cha-cha up and down his leg. “See? I’ve got one for each day.”

Please like it, he thinks, pleads, I’ll have to crawl into a hole if you think it’s silly.

Dr. Ryomen looks, his eyes sinking over leg to his ankle before he looks away, back to his screen; logged out due to inactivity. “Cute.”

Megumi pushes out a breath, shaky and stuttered, like he just got away with something – something, of some kind, but what it is, he doesn’t know.

He is stepping out of a patient room when he is hit by a truck.

A forty-ton semi with a license plate that reads DOCTOR RYOMEN.

As his legs come out from under him, and his body flies backwards, Megumi starts to make a catalog of injuries: whiplash, broken ribs, pneumothorax, TBI, double pelvic fracture, ruptured spleen, herniated disc, rotator cuff tear…it’s black ice during a snowstorm, it’s hydroplaning on the highway, it’s hitting passenger air bags at seventy miles per hour with how hard he faceplants into the man’s hard chest. 

Hands tether him back by his elbows.

Megumi’s knees wobble.

The first thing he notices: Dr. Ryomen’s hands are coarse – from gloves and cold air and labor, fingertips split with small healing cracks. Megumi’s are the same; dry, raw, punished by the constant scrubbing, one step closer to being a real doctor. He swallows as he feels the texture, the desert in his skin. Dr. Ryomen is always touching him at his elbows. Those soft, vulnerable divots of translucent spider veins. Antecubitals. If he presses that rough pad of his thumb down, he’ll feel his brachial, feel his life force pulsing, the hard stick scars that litter it.

“Oh, I’m – I’m sorry!” For a solid second, Megumi just stands there, blinking, big and wide, his face ripening to a tomato-red. He feels it on his cheeks like a sunburn, and curses his bedeviled sympathetic nervous system. Reminds him of being a med student again – following his attendings to the bathroom, never knowing where to put himself, having to side-step and find a corner to station in so as to not be a nuisance, never wanting to be in the way, because he’s always in the way. “I’m so sorry,” he repeats. “I didn’t see where I was going. I’m sorry, sir.” 

Dr. Ryomen’s head cocks, and he lets go of him.

“You good?”

Megumi brushes his bangs out of his eyes. He wonders how messy his hair is today, what Dr. Ryomen sees when he looks down at him like that, what he’s looking for, as his eyes move over his face. He wonders if he were a med student again, if he would follow him into the bathroom on accident, or willingly.

“Y–yeah,” a quick swallow, “why?” 

Dr. Ryomen’s mouth quirks. His eyes are raised just enough, that Megumi fears he’s noticing far more than he wants him to. 

“Just checking on my walking HR violation,” he says. Megumi’s mouth parts into an ‘o’, taken aback; a million and one thoughts, a violation – what did he say – what did he do – i’m sorry, sir, i’ll do better next time, just give me another chance – “I heard you caught a dissection last week,” he says, just as easily, nothing amiss, and touches his shoulder. “Keep it up.”

His hand squeezes, one thumb slotted over his clavicle, thump-thump-thump, and falls away. Something unbottles inside Megumi; something bright and fizzy in his stomach, like cherry pop-soda, shaken up and down, up to the brim and overflowing. Something that makes him want to walk around the unit in a daze, scrunching his face, scraping his teeth over his lip to fight the stretch of his smile. It doesn’t mean anything. It can’t. He’s just…happy. It’s nothing but that.

Dr. Ryomen walks off.

Megumi realizes what exactly is wrong with him about three months into his intern year. Like how most things go, he’s a little late to the jump, but he catches up eventually.

Across the department, Dr. Ryomen is sitting at his computer, speaking into the little handheld dictaphone. This is a 54-year-old male who presents to the emergency department…two hours of substernal chest pain...past medical history significant for…period…concerning for…comma…must-rule out diagnosis of acute coronary syndrome…He’s mumbling to himself, and his glasses are round, sitting on the bridge of his nose, his chin tilted a little to squint at the screen – like the text is still too tiny even though it’s maximized at the 110% setting. Half-heartedly chewing on some nicotine gum, parking it between his teeth.

A nurse comes up to him and hands him an EKG slip, and he pauses. Takes it in hand to look over, a quick one-two, so proficient it just takes a single glance, no ST elevations or peaked Ts or AV blocks, and he’s pulling the pen from his pocket to roughly mark his initials, S.R., and the thought – I wonder how deep he would get inside me – smashes through Megumi’s brain, as intrusive as a bull in a china shop, hitting him like another Dr. Ryomen-sized truck. 

“Earth to Megumi, earth to Megumiiiiiii,” a familiar voice croons, “Hello? Is anyone there?”

Blinking, half-mortified, afraid to even be in his own skin, Megumi cranks his head over to Nobara like a rusty gear. 

“Huh.”

Nobara is looking at him with a raised brow. She frowns. “Are you okay? You look a little pale.” Megumi nods numbly. I think I just fantasized about our attending’s dick, but that’s neither here nor there. “What’s up with you? You’ve been going in and out all day. Having absence seizures we don’t know about?”

“No,” Megumi replies, perhaps a little gruffly, “and that’s mainly in children.”

“Yeah, yeah. I was wondering if you’re going out with us on Friday. We’re hitting Little Havana for drinks. All the residents are going. Come! Stop ignoring my texts and try to be a person for once.”

Megumi glances behind his shoulder; Dr. Ryomen is still dictating his notes, idly pushing a hand through his hair, leaving a grey trail under the fluorescent lights. There’s a strange twist between Megumi’s ribs, pleuritic and painful, like the feeling of a fuck-up – misdosing an order, missing an abnormal lab, inserting a nasogastric tube in the airway, a needlestick through double gloves and a Hep C positive patient, forgetting to eat the whole shift and passing out in Trauma One. Fuck, fuck, fuck. 

Quickly, he tears his eyes away, realizing he’s sort of just…staring. Again. He must’ve hit his head. Encephalopathic. The neural synapses in his brain wiring in wrong, opposite ways. He needs to go see his psychiatrist. He needs to up his Zoloft. He needs to not think this way. 

The bad, wrong, not good way. 

He’s going to get in trouble, and everyone will know, and Dr. Ryomen will know, and he will never –

“Maybe,” he manages after a very, very long beat. “I have to see if I’m in the mood.”

As if expecting that, Nobara wiggles her brows and sing-songs. “You knowwwwww, I think our favorite male nurse wants to ask you ouuuuuuut. You should get someeeeeee.” She elbows him in the ribs and nods her head across the way. A flick of his eyes, Megumi follows the direction.

Yuuji is in the middle of pushing an old woman in a wheelchair around the corner, and he waves when he sees Megumi, a bright, bursting grin unfurling on his face. Only a little awkwardly, Megumi cooks up a smile back, waving the tips of his fingers, before turning away. All the while, his heart sinks and buoys in the despair of his gut.

“He’s so hot it’s annoying. People would kill to get some of that.” She sighs. “You know, he has a TikTok account? He’s got like…600k followers.” Megumi is already acutely aware. He blocked his account after the second time Yuuji appeared on his timeline. He can’t deal with being in bed and seeing a familiar face from work pop up on his screen like a whole jumpscare. The videos are harmless enough, mostly funny skits about ridiculous ED situations Yuuji’s been in, though it’s clear with one look at the comments – it’s mainly content for women. It doesn’t help that Yuuji decides to film the videos in such a way that they become a thirst-trap with the way he keeps flexing his biceps over and over. “He probably makes more money making content than he does here at this point. You could be rich and famous.”

“No thanks.” Megumi’s face screws up. “I’ve got no interest in dating a medfluencer.” And, well, he’s not really my type.

“What? Why not? He’s super sweet. Don’t let the TikTok fame deter you.”

Megumi rolls his eyes, unable to help his smile. “Yeah. Until he films a HIPAA violation and gets his license revoked. That or make some problematic joke that pisses off the entire internet. I’m good, Nobara. He’s my friend, and I want him to stay that way.”

“Fine, whatever. Don’t go with him, who cares. Still come on Friday. It’s $3 dollars off nachos and $20 bottomless mimosas.”

“I’ll let you know,” he shrugs, a little apologetically. “I’m usually too tired after work.”

“You’re no fun. It’s karaoke night.”

“Oh, then I’m really not going.”

“Stop it! Do I have to tie you up and –”

“Hey Nobara,” Maki, the charge nurse, barks from the nurses’ station, and they turn. “Your patient is trying to leave AMA.” She points down the hall at a man who desperately looks like he needs to be hooked up to two liters of supplemental oxygen, trying to be talked down by his nurse from leaving. He’s already halfway down the hall to the automatic door exit. 

“Ah, shit,” she curses under her breath, and flees to catch up with them, shouting, “Hey sir, hey! You’ve got endocarditis! You need IV antibiotics for at least a week! If you want to leave, you need to show that you understand the risk of…”

Megumi sighs.

He turns back to his walking workstation, parked outside his patient’s room. He was in the middle of putting some quick panel orders before he sort of…forgot. Totally not because of distraction or anything, of course. Someone clears their throat. What now? He flicks his eyes over, and meets Maki’s deadpan gaze.

Her brow is raised, and her arms are bent on the nursing station counter, leaning, ankles crossed. Casual as can be.

“Ten minutes by the way.”

That gives Megumi pause. “What?”

“You were staring for ten minutes.”

“Huh?”

“Oops. Ten minutes and 32 seconds, I mean.” She lifts her phone and flashes the timer on it; 10:32. The flock of nurses behind the counter giggle behind bowed heads. “We’ve been placing bets. You’ve got it bad.”

“What?” he repeats, again.

“Those bedroom eyes you’ve been making. Believe me, I get it,” she chuckles. “You’re not the first and you won’t be the last. Every intern goes through it.” Smiling, she pretends to zip her lips. “Your secret’s safe with me.”

Megumi stares and stares and stares.

After a beat, he nods woodenly, and like a robot, not saying a word, turns on his heels and walks off. A curtain falls over his face, dark and blank. He makes a straight line for the staff bathroom. There’s only two on the floor and they’re always busy. A small stroke of luck, Megumi yanks on the door handle and it gives. It’s empty when he walks in. Recently cleaned too. You never know what you’ll find in a bathroom down in the ED – between feces smeared across the walls, people actively fucking, someone’s severed thumb in a Ziploc bag, a pet chicken named Honeybear, a patient purposely clogging the toilet with their own clothes, or suitcases with giant dildos inside – he is glad to walk in and find a perfectly normal, perfectly clean bathroom for him to make into a confessional.

“Fuck,” he mutters, locking the door behind him and stumbling to the sink. He puts his face in his hands and breathes, in and out, and tries not to scream, his body a cathedral of ache. It’s alright. It’s not that big of a deal. Not everyone knows. Dr. Ryomen doesn’t know. It’s not like Megumi seriously thought that – anything could happen between them. Not that. Never that. “Fuck,” another groan, letting his skull thunk against his hands. “Fuck, fuck, fuck.”

Where’s Dogtor Peanut when you need him? He needs a licensed, health-professional, emotional support therapy dog. Dogtor Peanut comes in every week with his badge and vest, making his rounds, licking smiling teeth, helicoptering around the room with his fluffy German Shepherd tail. Megumi needs an appointment, and he needs it fast. 

Save me Dogtor Peanut, he thinks miserably, as he stares into his frazzled round eyes. Save me.

He can name all the cranial nerves, recite the Krebs Cycle forward and backwards, calculate a Wells Score in his head on pure memory, slot in an IV with his eyes closed, but for some reason – putting his fingers on his pulse, auscultating his own heart, hearing that irregular rate and rhythm – it’s a hard diagnosis. An impossible one. The rare zebra. 

“I think I have a crush,” Megumi says out loud, nearly spitting it. A ugly, malformed one at that. Terminal, maybe. 

It’s…disgusting. A crush on Dr. Ryomen. It makes Megumi want to throw up, realizing it. The fixation of each moment; a sentence here, a look there, a hand on the bedrail. The guilty pleasure of finding this man attractive – older and handsome and smart – how pathetic Megumi is, seeking his approval, his undivided attention, wanting to make him proud, thrilling at each innocent good catch and nice job, delighting in his secretive warm smiles. The fact that he’s fifty-something, and Megumi is just twenty-three. The fact that he’s his attending, Department Head of the ED, physician-in-chief, the man with a hospital wing in his name – a man who’d never be caught dead with the fresh-out-of-med-school intern. It’s awful, despicable, frankly embarrassing. Megumi doesn’t just need an up in his anxiety meds; he needs electric shock therapy, a lobotomy, a snip of this dopamine circle called love. If Dr. Ryomen knew –

He would be so ashamed.

Splashing cold water on his face, wiping at the crust at the corner of his eyes, Megumi takes a hard look at himself in the mirror. 

He’s pale. His hair is a mess of unruly dark. Forehead shining with the faintest sheen of sweat. There’s the long, fluffy fringe of his lashes, and the heavy bags under his eyes, and a perpetual frown on his lips, an expression frozen between anxious terror and despair. Plain, average. So invisible, that his own dad forgot. He’s empty space, a fill-in-the-blank.

And who could ever want a thing like that?

He shuts off the water. He walks outside.

He does not look at Dr. Ryomen for the rest of the shift. 

“21-year old male, GSW to anterior chest, GCS 14, bleeding controlled with an occlusive dressing. Airway patent, breathing shallow. BP 118/72, HR 124, satting 93% on room air. IV NS running. ETA 6 minutes.”

Megumi shifts on his feet, reciting the EMS call, over and over in his head.

21-year-old, GSW to the anterior chest…

Tachycardic at 124…

Breathing shallow, in acute respiratory distress…

21-year-old, GSW to the anterior chest…

Tachycardic at 124…

Breathing shallow, in acute respiratory distress…

According to the literature, 90% of patients with penetrating thoracic injuries die before ever reaching the hospital. Megumi’s agonizing over the fact when Dr. Shoko Ieiri, attending trauma surgeon, bursts through the trauma bay doors. The bedazzled pager on her hip vibrates with a priority alert. “My team is aware,” she states, one hand reaching down to silence the device. “OR 1 will be ready in 5 minutes. What’s the story?”

“GSW to chest. Hemodynamically unstable,” Dr. Ryomen replies, his arms crossed. Megumi stands close next to him, his heartbeat in his throat. They’re wearing their yellow protective hazard gowns. Face guards and masks at the ready. “Possible internal bleed and cardiac injury.”

He looks at Megumi then. 

“You’re on primary. I’ll take the tube, if we need it.” Megumi nods. That’s fine by him. Dr. Ryomen is the fastest intubator in the whole wild west; positioning, visualizing, and securing the airway with such economical precision, he makes it look as easy as, well, breathing. Megumi still shakes too much. “This won’t be pretty.” He darts his eyes down to Megumi’s shoes in a glance. In the distance, he hears the ambulance sirens. “Tie your shoes and don’t trip. We’re running.”

Megumi looks down.

His tennis shoes are untied. Floppy laces tendriling on the floor. 

He’s down on his knees, shakily tying his laces, all the while he can hear the sirens get closer, and closer, and closer, circling like some overhead hawk. Suddenly, a blaze of red lights flash and scatter down the hall. The ambulance bay doors swing open and the EMS crew is wheeling a stretcher towards them, him, fast. 

Dr. Ryomen was not wrong. 

It’s a sprint.

They’re grabbing the rails and pushing the patient to the trauma bay, so quick, Megumi nearly does trip over himself, trying hard not to hit the walls or run into one of the charging WOWs or ultrasound stations. Megumi takes the quickest of glimpses. At first glance, the patient looks fine. He’s a little pale, a little diaphoretic, but he’s looking around with wide eyes, mentating appropriately when they ask him if he knows where he is. Good. Still perfusing his brain, that fast young heart compensating for any current blood loss. No other obvious injuries other than the bandaged wound around his chest. 

“Drive-by-shooting on the corner of a 7-Eleven,” one of the medics reports, clutching the steering rails, as they bring him around the corner. “Patient found down on the sidewalk with apparent GSW of the right chest. Bystanders reported multiple shots, but no further details. GCS 14 in the field.”

Once in the bay, they move as a unit to pick up the backboard, heave the patient onto the bed, and unclasp the straps holding him in place. Nurses flit around the sides; Yuuji works on getting another IV in, Maki takes the nearby computer to start recording, another prepares the fentanyl drip.

The patient’s face is held in a grimace, shutting his eyes to a tight lemon-squeeze. Blood runs wetly along his neck. Not flaky or dried, new and fresh and bright-red – the thick, iron-heavy stench of it tangible in the air.  

“Hurts,” he mumbles, in a daze. 

A mess of blood steadily trickles from the emergency dressings – a very obvious bullet wound in his right chest. Distracting injury. Like an Anki flashcard from his med student days, his brain supplies him with the route memorization. What could be damaged? It’s Dr. Ryomen’s voice in his head. The lungs, sir. The heart and great vessels. Thoracic wall and bones. Diaphragm. Liver. Esophagus. Spinal cord. 

“Two lines in,” Yuuji says. A mask goes over the patient’s face with a low hiss of oxygen. “Non-rebreather at 15 liters.”

“Get etomidate and roc on stand-by,” Dr. Ryomen instructs.

“Sir,” Megumi stands at the head of the bed, and calls out to the man. Meanwhile, Dr. Ryomen takes out his trauma shears and slices off his shirt in one clean stroke. “Can you open your eyes, sir? Sir, can you tell me your name?”

His eyes open, inky pupils constricting to the bright alien lights. 

“K-Kamo. Kamo Noritoshi.” 

“Airway intact.” Ripping the stethoscope from his neck, mind flying a mile a minute, Megumi puts it over the man’s breast, then the other side, covering both lung fields. “Diminished breath sounds on the right.” His eyes track his fast breathing. “Asymmetric chest rise. Trachea deviating slightly to the left.”

“Why won’t we intubate first, Dr. Fushiguro?” asks Dr. Ryomen.

“Suspecting tension hemothorax, we need to decompress before positive-pressure ventilation, or else –” Megumi swallows, feels his own trachea obstruct at the thought, “or else, we’ll make it much worse. Sir.” 

Dr. Ryomen nods in agreement with his assessment. “Correct.”

It’s hard to feel pleased, or savor that small thrill of praise – Megumi doesn’t know how Dr. Ryomen stays so calm, how he can instruct and teach when there’s a fire rising in the room. Moments like these, Megumi feels like the biggest fraud there is. 

Nobara is already on the ultrasound. Cold liquid gel and probe, she’s sticking it to the patient’s right upper quadrant, to Morison’s pouch, to the pelvic bladder, to the peristernal and apical window. Megumi watches the fuzzy black and white screen with wide eyes. Around them, the nurses move like a well-oiled machine: taking the patient’s cut-off clothes, storing it into a plastic bag, attaching the pulse ox and blood pressure cuff and getting him on the monitor. It’s like a theatre play. 

“Positive e-FAST,” Nobara announces, and there’s a jump in her voice, there’s fear. “Anechoic fluid between the diaphragm and lung.”

Well, shit. There it is.

“Right hemothorax,” Dr. Ryomen states. “Nothing we didn’t expect.” Eyes sharp under the harsh lights. The monitor screen beeps in input. “Tachycardic. Pressures getting softer. Satting 98 on 15 liters.”

“What – what does that mean?” Mr. Norotoshi asks underneath them. He’s speaking slow, slower, raspy-like. He doesn’t realize it, but blood is rapidly accumulating in the sac around his lung, slowly collapsing it and shifting his heart across his chest. “Am I going to die?”

“No,” Megumi says, quickly, grasping his hand and squeezing. Glimpses the numbers on the monitor: HR 145. Breathing fast. They just need to evacuate the hematoma, give his lungs the space to breathe and his heart the space to work. “There’s blood in your lungs. We’re going to have to release the pressure. You’re not – you’re not going to die. We’re not going to let –”

“What are you going to do, Dr. Fushiguro?” 

Megumi looks over. Dr. Ryomen is looking right at him. His face is unreadable.

“Needle decompression. Finger thoracostomy. Chest tube.”

The man hands him the 14-gauge needle. “Go.”

Megumi’s eyes bulge. 

Fuck. 

Fuck, fuck, fuck. 

“I need a 36 French,” Dr. Ryomen barks, and he crowds over Megumi’s left shoulder as he bends over Mr. Norotoshi’s flank. Megumi pinches the edge of the 3-inch needle through his gloved fingers. Tries not to shake as he sees a nurse rip the packaging off a fresh chest tube. Dr. Ryomen is taking lidocaine and injecting deep into the rib space as the patient hisses underneath. “Quick. Where are you going?” Between the fourth and fifth intercostal space. Mid-axillary line. Rapid-fast answers. “Above or below?” Above the rib, as to not hit the neurovascular bundle. “Good. Do it.”

Megumi does it. Feeling the ridge of his ribs, puffy with the numbing lidocaine. Finds the spot and pushes the tip of the needle in, and there’s a pop, as it punctures – into the interpleural space, the thin sac covering the lungs, and – a trickle of blood starts to leak. He pulls it out. When he looks up, Dr. Ryomen is handing him a scalpel.

His voice is deep and rich and precise. “Cut.”

Megumi cuts. 

“Incision,” he announces, and presses in – to the sound of beeping monitors and rustling feet and his own heartbeat. More blood spills out from the cut. It’s a tiny one, just enough to push his finger in. He does. He pushes his finger in and keeps going, into the intercostal muscles, to the ridge between the ribs. Okay. “This good?” he breathes, his breath hot under his mask. 

He looks up with a tremble in his eyes, along his jaw, and Dr. Ryomen looks back. The man leans just enough to move over his shoulder, caging him in. He’s right there, his face hovering next to his ear. A presence on his shoulder, to his back. His arm reaches over and he’s sticking his finger into the side of the patient’s chest with his gloves, feeling around, into the space. “Good. Go.” And Megumi clamps the end of the chest tube, and with another Kelly clamp, shoves the cylindrical tube in, following the path of his finger –

It slips in.

A whistle. “That your first chest tube?” Dr. Ieiri says. “Nice one. You didn’t go through the liver. Maybe you’ll be a good ED doc yet.” 

“A great one,” Dr. Ryomen emphasizes quietly, from next to him, like it’s to him, and it sounds warm. 

Megumi almost misconnects the tube to the canister at that. Clearing his throat, he tries again, and snaps it on, and watches as a wash of bright blood bursts into the chamber.

“Oh. That’s – that’s a lotta blood,” Nobara comments, gaping at the onslaught of blood gushing from the tubing, into the drainage. 

“Too much,” Dr. Ieiri says. “He needs the OR.”

Suddenly, the monitor alarm goes off; numbers dropping fast. Blood pressure of 90/60 to 80/50 to 60/30. Heart rate steadily dipping. One look at Mr. Nortoshi’s face, and he’s paler than before, eyes closing and his mouth opening as if half-asleep.

“Mr. Nortoshi?” Yuuji is there and he reaches out to do a sternal rub. Hard. “Mr. Nortoshi?”

Megumi is working on securing the tube in place with a figure-eight suture, when Dr. Ryomen barks, “Forget the OR, he’s crashing. He won’t make it there. Dr. Kugisaki, man the airway. Initiate mass transfusion protocol. We’re going into his chest and stopping the hemorrhage at bedside. I want –” The overhead monitor starts to go crazy, strobing red and yellow and resounding alarms over the unit. Another glance at the vitals. The EKG tracings fluctuate, slow, then suddenly, bounce around with no discernable pattern. “Decompensating fast. Possible cardiac contusion from ballistic impact force.” Then, Dr. Ryomen is over and on the bed, one foot on a stool, other knee on the frame, and he’s doing chest compressions. Megumi hasn’t finished the sutures yet. Blood has filled up the canister. The patient’s skin feels cold. “He’s going into VFib. Get the fucking AED pads on.”

The room is heavy with the cluttered noise of active resuscitation: monitor alarms and suction and packages tearing and the stick of pads and voices working in tandem. Yuuji retrieves the first unit of uncrossed blood, spiking and hanging it and wrapping a fist around it to push it faster. Maki works the defibrillator; the automatic voice prompting – stay clear of patient, analyzing, shock advised, charging, stand clear, deliver shock now –

“Clear!”

All hands off. 

She hits the electric bolt button.

Mr. Nortoshi’s shoulders twitch to his ears, a punch of an electricity walloping through his chest. The robotic voice continues from the AED. 

Shock delivered. Resume CPR.

“Still in VFib,” Dr. Ryomen shouts, arms resuming their position. “Keep going.”

It all happens so fast. 

Dr. Ryomen is above Megumi’s head doing chest compressions, and Dr. Ieiri is cutting into the young man with Mayo scissors and a scalpel, shearing across muscle and fascia, using a bone saw to cut across exposed sternum, then handing Megumi the rib-spreader, having him pull open his ribs with a high-pitched click-click-click, and a crunch as the last ones break to make way for her incision. Fuck, oh fuck. They’re going for a clamshell thoracotomy, he realizes, belatedly. They’re doing a fucking clamshell. He can see the patient’s heart, can see his two inflating, deflating lungs. Red spills out onto the starched bed sheets. There’s a lot of it. Megumi dissociates, hard. There, but hardly, as he scoops heaps of blood from the patient’s chest, suctioning the pooling blood as fast as he can, Nobara holding traction on the vital organs with her gloved hands. Fuck, he thinks again, oh, fuck. He feels so utterly fucking useless. He can’t think. Can't do. This is insane. Utterly fucking insane.

This patient is going to die. 

He knows it. They all do. Yet they try anyway.

He watches as Dr. Ieiri puts a vascular clamp around the aorta, the great vessel leaping out of the heart, and jumps when Dr. Ryomen’s deep voice goes, “Megumi,” – not Dr. Fushiguro, Megumi – “get your hands in there. Now.”

Dr. Ryomen tells him to. So he does.

Megumi sticks his hands into the open cavity of the man’s chest, and he has his palms around his heart, grasping it in his hands like a giant grapefruit. A bloody, ripe pomegranate. And he’s pressing the heels of his palms in and out, in and out, fast, rapid, approximately a hundred beats per minute. In, out, in, out, pump, pump, pump, pretend to be alive, pretend to work, pretend to be. Can hear the blood squeak like a chew toy between his latex gloves, a soft gurgle as some blood spurts through a hole in the right ventricle – evidence of the bullet’s path. 

Like throwing down a dart on a dartboard, Dr. Ieiri sticks a 14 gauge into the myocardium, into the red beefy muscle, directly into the right atrium of the heart. “6 units of pRBCs,” Yuuji shouts, and he’s squeezing another blood bag on the hook, mass transfusing directly into the heart through it. Megumi watches, in part horror, in part fascination, as the heart turns from a flaccid sack in his hands to a blood balloon. Dr. Ieiri is quick to put some cardiac staples over the site and the bullet wound; patching up holes in a sinking ship.

He blinks and Dr. Ryomen has the defib paddles, and Megumi’s backing up, letting go for him to spatula the heart between the two pads. Charging. Stand clear. Deliver shock now. Megumi goes back to massaging. Then again. Charging. Stand clear. Deliver shock now. When his fingers wrap back around the organ for the third time, he gasps, realizing. 

It’s twitching in his hands.

Beating. It’s beating. The heart is beating. Lub-dub. Lub-dub. Lub-dub. And –

It dies right there in Megumi’s hands.

Charging. Stand clear. Deliver shock now. Cardiac massage. Charging. Stand clear. Deliver shock now. Cardiac massage.

The arrest goes on for another twenty minutes. 5 mg epi. 10 units of packed red blood cells. He massages, Dr. Ryomen shocks, he massages, Dr. Ryomen shocks. They never bring the heart back again. Megumi never sees another beat. 

For a moment, the hospital feels unnaturally still. There’s a monitor sounding somewhere down the hall, an environmental tech pushing a cart to the bay, an overhead voice calling a rapid response on another floor – yet, quiet. Megumi stares at his bloody hands, holding this human heart, as the room slows, as the movements come to a stop, as everyone reaches a certain understanding. Suddenly, a strange, horrible feeling bowls Megumi over, like an ice-pick chipping cartilage from his rib, leaving him exposed and fragile. 

There’s a fine tremor in his palms. 

“Time of death,” Dr. Ryomen’s voice echoes in the room, in the loneliness of a flatline, “11:35 PM.”

Finally, Megumi gasps, takes that breath in, and it sits painful under his diaphragm. A gut-punch of an inhale. He sees it stain the inside of his face shield. The monitor beeps, beeps, beeps. No one bothers to shut it off. Soon, the red-lined bio bin will be in. 

Mr. Noritoshi’s face still holds warmth, but his eyelids have fallen apart, and his eyes are locked at the ceiling, his stare frozen in time. He’s about Megumi’s age. Looks like a normal guy he’d see at a party or in a class. Except, his chest is open and he’s been peeled apart like an onion. He woke up this morning like it was a regular day. He couldn’t have known it would be his last day alive. Someone places a sheet over his face, covering it.

Out of the corner of his eye, he sees Dr. Ryomen rip off his bloody hazard gown, and with it, his gloves. His hands emerge slick with sweat. Megumi does the same. He dumps the stained garments into the disposal. His skin feels grainy.

Megumi does not meet his eyes.

Or anyone’s for that matter.

Stepping away, shoes squeaking in pools of blood, Megumi walks off to the bathroom. Perhaps it’s unprofessional. Perhaps they need to debrief. He can’t bother to care. He’s becoming more aware of his body by the second; the adrenaline in him having nowhere to go now, but buzzing around inside of him like a loud thought, hyperaware of the sweat cooling beneath his scrub top, the soreness between his shoulders, the cramps in his calves. He washes his face. His arms, his hands. Blood is dried along his forearm like a paint smear, flaking at his elbow creases, darker where it pooled through the personal protective gear. He doesn’t know how long he sits there, watching the water run, the blood swirling pink over the porcelain before it disappears. He breathes fast in and out, darkness tinging along the edges of his vision. Some sense of impending doom creeps, a beat in his chest that sounds like i’m-going-to-die-i’m-going-to-die-i’m-going-to-die, and he braces his hand against his chest and against the sink. Tries to center himself with his breaths. Air. He needs it bad. Get outside, to open space. Breathe.

He bursts out the bathroom door, through the backdoors of the ED. Takes a sharp breath and stands there for a minute, in the round-about of the ambulance bay, trembling where he stands, about ready to be run over. Tears bud in his eyes. He wipes underneath them, feels them start to tip over and spill hot down his cheeks. Oh boy. He’s crying. He’s going to really cry now.

To his right, he hears a flint spark, a lighter struck.

Wide-eyed, Megumi turns his head.

In a patch of errant moonlight, Dr. Ryomen is there. Zippo in his fingers, leaning against the brick with a weary look. Smoke curls from his nose. Megumi didn’t know he smoked, but perhaps, he should have. He smells it on him, sometimes, on particularly bad shifts; knows he chews on nicotine gum to get through the day. He’s looking right at Megumi, watching, quietly observing him – and something about his expression carves Megumi’s chest wide-open, thoracotomizes him, displays his heart for all to see, all that blood, and red, and beeping bombs, and Megumi tries not to make a noise in his throat – a sob – the way Dr. Ryomen looks smoking alone in the shadows, shoulders lowered, eyes far away, like he’s hardly there at all – like the weight of the world sits there on his shoulders and he knows it’s his cross and his alone to bear. 

He’s the attending after all. Megumi’s just an intern. 

Am I still your favorite? Megumi wonders. Even now? 

Please just tell me I was good for you today.

A splatter of dried blood sits on the cuff of his sleeve. A dark blotch.

Megumi turns away, sniffing. Stupidly, dumbly, he wonders how he looks. He brushes some hair from his face, feels the soft frizz of his unruly hair curling in his peripheral vision. Stethoscope dangling around his neck like a noose.

“You know, one of the hardest things about being a teacher is to sit and watch.”

Megumi sniffs again, eyes flickering like faulty bulbs. “What?” His voice is soggy.

“Don’t ever promise a patient they’re not going to die.”

At that, Megumi’s fists curl. He wants to scream and sob and scream. This – this isn’t what he wants to hear, this isn’t what he needs right now, what is he – why is he saying that to him? “I didn’t – I thought he – I wanted to make him feel –”

“Better?” Dr. Ryomen sighs, speaking around smoke. “I know, kid. It’s hard.” He looks at him, and it’s such an achingly sympathetic, pitying look. Kid. Megumi’s fists tighten. “You did good back there.”

Megumi blinks at him, dripping tears, almost can’t believe it. He must have misheard. 

“But – but the patient still –” he swallows, “the patient died.”

“Try as we might believe, we aren’t god. Sometimes, people come to us on paths that aren’t able to be changed, a train there’s no stopping. Sometimes, being there and trying is all you can do.”

Megumi looks at him, underneath his lashes. He doesn’t know much of anything about him. Emergency rooms aren’t best for conversations. No quiet corners for favorite TV shows or weekend hobbies. It’s glances and short sentences, heartfelt moments shattered, swallowed by the next call, the next heartbeat that needs them more than they need their own. He thinks about all those articles he’s read about him, past interviews, and keynotes, and ACEP conferences, and AAEM talks – his expeditions with Médicins Sans Frontiers, to warzones and natural disasters, fabled stories of relief and aid. He’s probably seen much worse than Megumi. Much, much worse. Megumi will probably see much worse than today.

“That was the first patient I ever lost.”

Dr. Ryomen studies him for a moment. 

He sighs.

“The first patient I ever lost was a three-month-old infant who was smothered by her father. He was asleep and didn’t know. They were co-sleeping.” He rubs a hand over his face, like it’ll smooth away the lines and the years and the tired. It doesn’t. “He brought her in,” and he takes another drag, “crying and screaming and in hysterics, two nurses had to hold him outside the room, and I remember putting this baby girl on the bed, pressing two fingers to her chest, doing tiny chest compressions, because she was just that small – and she was just…” he shrugs, “blue. She was dead on arrival. There was no way I could’ve ever brought her back. I still tried. We ran the code for an hour. You try a little harder when they’re young. Makes you feel a little less guilty, I guess. Now, I’m not trying to compare tragedies or anything. Point is, sometimes, we can’t change a damn thing, and we have to accept that. You’ll always remember your first,” he says, and his voice is soft and measured, like laying soil over a grave, “and you won’t ever remember your last – because there will never be a last.”

Megumi…bursts into tears.

He starts crying.

Hard.

Crying like a fucking child. Hiccuping, ugly sobs. Crying so hard, it’s like drowning in air, gulping on sorrow, the air too thick to breathe. A harsh suck in, a long willowy wail out. Tears dripping and leaving dark bruises on the pavement. A vein in his forehead pulsing, pressure bursting at the seams of his skull. He can’t help, can’t stop it. Dr. Ryomen’s looking at him and he’s shaking his head, and then his cigarette is discarded, and he’s reaching across, bringing his palm across Megumi’s back, pulling. Megumi doesn’t fight it. He curls into him, caught in a hug, burying his wet face in his chest. 

“It’s okay, honey, shhh, it’s okay, it’s all okay,” it really isn’t, nothing is okay, nothing about what just happened will ever, ever be okay, “you’re good, you’ve got it, you’re okay.”

Okay, okay, okay.

“I’m starting to think I’m not cut out for this,” he squeaks. His ears are red, and one is pressed to Dr. Ryomen’s chest, and inside he can hear – thud, thud, thud, thud, thud – a beating muscle, red and strong, can picture it inside his ribcage, how it might look in his hands, and he listens to his pulse, searches for his existence in those systoles and diastoles, one by one, comforted, half-expecting it to stop. No one should see the things he just saw. No one should experience the things he just did.

“Shhh. You’re young,” Dr. Ryomen is murmuring softly, at the crown of his head. “You’re still young. You’ve got good instincts, and a good heart, and we need more people like you in this field. Don’t burn yourself before you even start. You did good. You tried. Believe in that.”

That’s really, really hard to do.

Megumi isn’t sure how long he cries for, only that his face is hot and his eyes are heavy, and his chest hitches on every breath. Dr. Ryomen’s jacket is wet, Megumi’s tears soaking into the polyester-cotton. The scent of tobacco lingers in the fibers, and it brings an old comfort – the memory of long car rides with his father, from one state to the other, and a breeze through open windows. God, I’m such a loser, he squeezes his eyes, breathing tight, god, I’m such a loser.

He pulls away, wiping at his eyes, at his stuffed-up nose, sniffing hard. “Thanks,” he mumbles, and tries his best not to be embarrassed. Shoving his face into his attending’s chest and bawling his eyes out, feeling like he’s alone and twelve, and wanting to be held again. He’s not a baby or anything. He has what it takes. At least, he thought he did. Now, it feels like…he’s just crossed some invisible line. Dr. Ryomen knows this about him now. Seen the crack in his exterior and watched him break. 

Dr. Ryomen looks down at him, their eyes meet, the quiet stretches…

Megumi looks away.

“I’m sorry – for – all that. I didn’t mean to freak out, or freak you out, or anything. I’m just – emotional, right now, I don’t – I don’t know why. Sorry.”

“Don’t be.”

The outdoor fluorescent lights hum and moths flutter. On the horizon, the night sky is dark with ominous thunderclouds, foreboding rain. Megumi takes a step backwards. He needs to put some distance. Up close like this, he notices things he’s never let himself notice – the glints of silver in his hair catching in the light, the bump in the bridge of his nose like he’s broken it once before, the faint scar on his chin like a crater in the moon. “I’m gonna…” Megumi points his thumb behind him, “finish up some notes, and – find and talk to the family, I guess. They should be –” he takes a shaky breath, “coming in now.”

“Don’t worry about that. I’ll do it. Finish up your notes and take off. Your shift ended,” and he glances at his wristwatch, “two hours ago.”

Megumi meets his eyes shyly, cheeks flushed and lashes spiky. “Are you sure –?”

“The ED will survive for a couple hours without you, Dr. Fushiguro.”

“Okay.” Megumi’s throat moves, and then slowly he turns, still looking over his shoulder at the man. The corner of his mouth is curled, gaze pulling at him in slow sips. Megumi is acutely aware. “Thanks. Again. I’m – I’m sorry about all that.”

Dr. Ryomen shakes his head.

“Sweetheart.” Oh. Megumi’s heart skips a big beat. Sweetheart. Warm and fond. The word hangs between them, or at least, on Megumi. Dr. Ryomen can’t possibly know what it does to him, is doing to him. “You’re good company,” he says, in that same affectionate way, and Megumi quirks his lips around a smile, and walks away like that, back into the department, his hands clasped in front of himself and his knees shaking – something hot and humiliating unspooling in the pit of his stomach. 

He knows he’ll hold onto it for a very long time.

It happens on a Friday. 

The day starts off fine. Megumi wakes up ten minutes before his alarm goes off, drinks his coffee while riding the bus. In the emergency department, it’s business as usual. Chest pain, abdominal pain, COPD exacerbations, falls, MVCs, and respiratory viruses. Same old, same old.

That is, till a patient withdrawing from alcohol decides to punch him in the face.

Megumi does not see it coming.

You never hear the bullet that kills you.

It’s not even his patient. He’s coming around the corner, notepad in hand, and the next, he’s flat on the floor, seeing stars. White hot sear of dots across his vision, the world going dark, a shade or two cooler, the delirious feeling of his head emptying. Did he hit it? He can’t tell. There’s a warm burst of sensation down his face, and it trickles into his mouth, tastes like liquid penny metal. His palm flies to his face, and it takes him a moment to realize oh, that’s blood. Instantly, he hears yelling and shouting, shuffling, tension, raised voices, the sounds of a situation poorly managed. His hearing goes in and out, like a flash grenade just went off, and remembering safety training – he scrambles backwards on his hands and knees as fast as he can.

He looks up, blinking, senses clearing, and sees the shape of the man towering over him. He’s round and stout, a fat belly with brawny arms and a mean suckerpunch. Megumi can only focus on the man’s hands: outstretched and trembling and telegraphing murder. 

Oh.

Megumi is going to get strangled.

And the patient doesn’t even need his stupid necklace to do it. 

The security guards are too late, his reaction time is too slow. Megumi cowers there stuck in a perfect freeze-frame, paralyzed by fear as the figure staggers forward, swaying hard to the left and to the right, before righting his course, lunging towards him, and Megumi flinches, and –

It happens so fast, it’s like something from a movie. 

The patient is there, and upright, and the next, there’s a deafening echo as his body crashes to the floor. Something cracks in his jaw when he hits the ground, his cheek crushing into white tile. Dr. Ryomen is on top of him, muscles shifting quickly, manhandling his arms behind his back like wrangled livestock. The combative drunk flails, hisses and spits, trying to knock him off to no avail. 

Dr. Ryomen’s breathing hard, frame angled protectively between Megumi and the patient. “Your arm’s about to get broke if you don’t quit,” he shuts down, voice tight, no trace of hesitation, verbal de-escalation protocol gone in the wind. “Don’t ever fucking hit our staff.”

The way his face looks. His expression. His voice. It gets a gasp out of Megumi. Sweat collects underneath his blue polyester sports bra like a water bucket. Suddenly, hands grab him by the elbows and lift him up. It takes him a beat to realize it’s Yuuji and Maki.

“Holy shit, are you okay?” Yuuji is asking. He holds Megumi still. “Your nose. You’re bleeding everywhere.” Then, he’s wrapping the thick of his arm around his waist, keeping him steady, and walking him back to a nearby chair. 

Megumi’s eyes are squeezed shut as Maki shoves tissues into his hands and reaches up to pinch around his nose with one. “Stay still. Does it hurt? Here, hold this there. He got you good.”

She tries to feel around his face, pressing her thumbs to the divots of his nose and cheek, but Megumi swats her hand away. He stretches his body off the chair to peer down the hall. He wants to see Dr. Ryomen. He needs to see what’s happening. His heart is heavy and quick and pounding.

“I’m – I’m fine,” Megumi stammers, pushing her hand away again, as he watches a flock of security guards materialize to descend upon the man. Dr. Ryomen pulls the patient upright for them to lock a pair of handcuffs on. “Really. I’m fine.”

Maki tuts, shooting him a low whistle. “Well, you just got your shiny badge of honor today. It all happens to us sooner or later.” 

Megumi half-heartedly listens. He watches as the security guards take over, dragging the patient to one of the clear glass observation rooms on the unit. The patient will be placed with a one-to-one sitter and constant twenty-four-seven watch. There’ll be a permanent red flag stained on the patient’s chart now. Beware: this patient hits, this patient bites, this patient has a strong personality.

Dr. Ryomen gets rid of him and doesn’t waste a second to lock eyes on Megumi, honing in on him, and next thing Megumi knows, he’s on him, immediately. Striding over, long legs eating up the distance. He looks furious, like he’s full of hollowed-out disappointment and fury, and is it me, Megumi thinks, did i do something wrong – i’m sorry, i should’ve been more careful – i should’ve listened to you – i should’ve –

“Sir, I –”

Dr. Ryomen wraps a hand around his wrist and pulls it away from his face. Bloody paper towel crunching, Megumi doesn’t dare struggle. “Let me see it.”

Megumi’s face throbs. There’s blood in his nostrils and in his mouth, and down his throat. 

“Hold still.” Voice low and close, crouched down to reach his level. “What the hell happened?” he growls, and takes Megumi’s chin in his hand, turning his face this way and that, like he’s one of his patients, and Megumi’s too taken aback by it to protest. Two thumbs square across his nose, pressing, then his cheekbones. It’s a dull ache. “Tell me where it hurts.”

“I– I’m okay.” Megumi is red, head to toe. Embarrassment, nerves, he doesn’t know. He’s red. “He just – I was coming around the corner, and the patient decked me. I don’t – I didn’t see it coming. I’m sorry.”

“I’m getting a CT head on you.” Megumi gulps. The donut of truth. “And we’re filing a report. The police are on their way.”

Police? Megumi’s eyes go big and helpless. “Oh. It's okay, really. I’m okay.” He laughs a little empty. “He’s – the patient was withdrawing. I don’t want to press charges. I want to treat him. He needs lorazepam and a banana bag, not – not a locked cell.”

“He just assaulted you, Megumi.”

“And it’s fine. Please. Nobody died.”

Dr. Ryomen’s eyes narrow. “That doesn’t mean it shouldn’t be taken any less seriously. If EMTALA didn’t exist, I’d make sure he never takes a step in my ED ever again.” His hand hasn’t left Megumi’s face. Instead, it settles on the nape of his neck, thumb stroking over the edge of his carotid, up behind his ear, shivering through him. He tuts. “Don’t look at me like that. He’ll get his fucking Ativan and his banana bag.”

His face goes a little somber. Megumi swallows hard, focusing on the crease between his brows, the way his eyes shift over his face, a quiet, searching look as he holds Megumi’s head to look at him. “Are you okay?” he says, softer then.

Megumi’s lashes flutter.

It feels…intimate. Like they’re the only two people in the department. Like a doctor and his patient.

I want to be seen and taken care of and this man’s going to do it for me.

“Yes, yeah, I’m just a little,” he motions to his nose with the tissue, shrugs, “nothing’s broken, I don’t think. Just some blood.” He knows it’s not what Dr. Ryomen is talking about, or what he wants to hear. He just doesn’t have an answer for him yet. He has to think about it in the shower first. “I should –” he clears his throat, “clean up. Don’t wanna scare any patients. Now, if you’ll…excuse me –”

Megumi pushes up from his chair; Dr. Ryomen lets him go, stretching to his own feet. He looks at him like he’s a problem he hasn’t fully decided what to do with yet, but he says nothing as Megumi turns swiftly on his heels. Not meeting his eyes, Megumi hurries to the staff bathroom tucked in the corner of the ED. Grabs fresh paper towels and wipes at his nose. It’s stopping now, a slow leaky dribble. It’s going to be bruised tomorrow for sure. Behind him, the door opens. He forgot to lock it. 

He turns, ready to pardon himself on a held breath, when his eyes widen. Jerks, like a cartoon, ready to burst out of his skin. Heavy footsteps fall in.

“Dr. Ryomen,” he blurts, “Sir –?”

Dr. Ryomen strides forward, a risk with a pulse. He stops in front of him, close, closer than normal, and a horrible thrill tears through Megumi. An ambulance siren goes off in his chest, his heart pounding so loud he’s sure the whole hospital can hear it. Dr. Ryomen leans in. Megumi’s breathing goes shallow, eyes tracking all over the man’s face, flying to his mouth, to his eyes, to his gaze – because for one wild second, he thinks he might kiss him. Dr. Ryomen’s pupils are fat and dilated. His eyes are trained on his face. His throat flexes as he swallows. 

Megumi stares, transfixed. A strange feeling in his belly rises into his chest, hot and thick. His teeth sink into his lip. 

Dr. Ryomen’s gaze flickers towards the movement. 

He does something strange. 

Lifting his hand, he rubs a fat thumb over Megumi’s mouth, right over the bottom lip of it. Pinches it away from his teeth, releases.

“Oh.” It’s all Megumi can think to say. His knees are weak. Hot in the stomach at the wrongness of it. He feels sick. He feels so turned on he can’t think straight.

“I thought I moved on,” Dr. Ryomen rasps faintly, idly, like he’s talking more to himself than to Megumi. “I’m not some infallible paragon, honey. I’m sorry.”

Megumi opens his mouth to ask  – what, what do you mean sir, how so? – and –

Dr. Ryomen has one hand on his nape and he’s kissing him. 

It’s a…good kiss. The sort of kiss Megumi imagines a woman in a novel would throw her life away for – the type of kiss that’s so thorough, it’s a warning you’re about to be thoroughly fucked, if not eaten. Dr. Ryomen’s not supposed to kiss him like that, he’s not supposed to be kissing him at all. Megumi makes the mistake, eyebrows lifting, and kisses him back, doesn’t even think about it really, just opens his mouth as Dr. Ryomen opens his, feeling the lip of his facial hair. It hits Megumi hard, leaves him breathless, like losing his footing at the top of a hill and he’s sliding down into the dirt. He doesn’t know what he expected Dr. Ryomen to kiss like, but he supposes he should’ve known. He should’ve known it would be like this. All raw certainty and purpose. He wants this. He wants Megumi. Flustered, and beet red, and nervous, and a bloody wreck. 

Dr. Ryomen pulls back for a second, looks at him. 

He seems fascinated by his lips. Continues to press his thumb into them, as if to make sure they really exist. Press, peel away, press again. A pitting test for edema, except it’s a measure of swollen pink.

Something in Megumi’s abdomen goes liquid, pressing his palms to Dr. Ryomen’s hard stomach. For the first time in his short-lived career, he starts to understand decision fatigue, what they mean when they say that – how the long series of decisions throughout the day lead to the poor, rushed decisions at the end of it – when he smiles, lips twitching – when he reaches up, presses up on his tip-toes, and kisses him again. 

Dr. Ryomen indulges. He kisses back. 

Megumi closes his eyes, shakily exhales when he feels his lips against his throat; slow and narcotic, like falling asleep in the snow. 

Do you like me? he thinks hazily, feels his slick coat the inside of his thighs. Am I your favorite? One day, will you pick me to be chief? 

He doesn’t dare open his eyes. He doesn’t dare move.

Dr. Ryomen pulls him against him, big hands gripping the thin frame of his hips, then sliding up behind his back, and Megumi feels it – his hardness; thick and hot, something insistent pressed against his stomach, evidence of his desire. He gasps, squirming, revelation running through him like a lightning strike. Gasping that turns to moaning as Dr. Ryomen’s mouth moves to just underneath his ear. Megumi can’t help it. He rubs against him, rocking forward on his heels to rake his cunt right over the breadth of him in his pants. Hard. “Fuck,” the man says, low and strangled in his throat, “fuck.”

He releases him.

Abruptly. Disentangling from Megumi, pulling away if it takes great effort. 

Megumi stumbles a step back. The sound of their breaths are heavy, echoing in the sterile, dingy bathroom. Megumi looks up at him, mouth tender and bee-stung. It’s quiet. The What Now? clouds the room, the air is heavy with it. An eternity passes, or perhaps several seconds. Megumi looks up at Dr. Ryomen, and the man is already watching him. It’s dimly lit in the bathroom; the white fluorescent light glows muted and blurred in his dark irises. It’s fucked up. It’s all fucked up now. Oh. Oh god. 

For a second, Megumi is incredibly and intensely scared.

“Are you going to report me?” he asks. “Sir?”

Dr. Ryomen looks at him, incredulously, and laughs. 

Locate the iliac crests.

Hot clouds of vapor fog up his mask. A child lays pale and sweating, curled on his side in fetal position. Lateral decubitus. The long line of her spine lays exposed, crooked at the top; a touch of scoliosis. Megumi presses his gloved hands to her hips, feeling the flared wings of her pelvic bones. Reaches his thumbs across to her spine. Her skin is hot with a 103℉ fever. Eyes pinched closed; she’s been vomiting all night and it hurts to look at light. Headache, stiff neck; textbook meningitis. 

What are you looking for?

“The L4 spinous process, sir. Below the conus medullaris.”

Feel the space. Find your mark. 

Thumbs jamming into the gaps between her spinal column, vertebrae spread open like the pages of an old book. One above, one below. Closes his eyes and presses and feels the space. Here. This is good. The LP kit is open, sterile field peeled back. Gowns and gloves on. Orange chlorhexidine sponges dripping ugly stains onto the bed and floor.

Local.

The shadow at his back watching as he injects the lidocaine in between.

Tap. A low murmur. I want to see you hit it on the first try. 

His needle does not shake. Pushes past skin and subcutaneous tissue and several layers of ligaments – anatomy textbook latin, supraspinous, interspinous, ligamentum flavum, dura – and a pop –

The stylet slides. Cloudy, purulent fluid drips out.

Attach the manometer. Collect.

His hand shakes as he unscrews and holds a tube up to the tap. Watches silently as it drip, drip, drips. Yellow and xanthochromic. Drip. Drip. Drip.

Hm.

Good.

Very good.

In a way, it’s as if none of it happened.

Dr. Ryomen treats him as usual. Teaching and quizzing in equal respect. Guiding his hand in certain procedures, letting him take the wheel in others. A sideways glance, a look, a nod. 

Things don’t change, except they do.

“Please, please, please, sir.”

Dr. Ryomen’s open mouth moves just under his ear, one big hand splayed across his stomach. His lips, slick and hot, a rough nosing, an inhale over his jaw. 

“You got to be quiet.”

It’s the supply closet; their bodies stuck together behind two heavy duty metal racks in the corner. Megumi went in here to search for a suture removal kit, sliding the grated shelves around one after another, bending down to look near the endless supply of gauze packages. The keypad beeped and the door opened and someone walked in with slow, methodical footsteps. Megumi didn’t need to turn around, didn’t need to confirm. He felt the hand on his back and knew. It happened so quickly: his back sandwiching to Dr. Ryomen’s chest and he reaches down to cover the hand on his belly, large and heavy, grabbing it, pushing it further, leading him inside the waistband of his scrubs.

Dr. Ryomen says nothing when he does. Just breathes heavily into his hair. Kisses the side of his neck. Touches him, touches soft cotton, thumb and pinky spread wide, middle fingers cupping between his legs, pressing against his clit. His bulk, physical and metaphysical, eats up the room; Megumi is but a speck. Megumi feels swaddled by him, small in his embrace, but safe. Stays still, and put, as he yanks his scrubs and shoves the elastic band of his underwear down his ass. How he kicks his legs apart so they fall and get stuck around his knees – Megumi jerks hard against him, whining – the thought anyone could come in, at any moment – and see him like this –

It’s embarrassing – how much he wants this. The things he’d let this man do. 

Megumi’s pussy throbs.

His hand thrashes, knocks over a box of medium-sized gloves. The fluorescent light above buzzes. Shelves of saline, rolls of tape, and IV catheters stacked around them. 

“Dr. Ryomen,” he sighs, as the man finds him sopping wet, the bare skin, the damp wiry curls and puffy folds, disregarding it all, and pushing two thick fingers in, like it’s just another Tuesday. “Dr. Ryomen.” He takes his time, makes a meal out of it. Parting his labia, circling the rim, pressing inside, coming back out, dipping back in, fucking him on them. Megumi can feel the sodden mess he’s making, wet and drenched.

Dr. Ryomen grunts. “Unbelievable.”

He’s looking down at Megumi's body, focusing on his entrance. He seems satisfied. Megumi feels more slick drip out of him.

Megumi exhales, a little shaky, as Dr. Ryomen begins to pump, in and out, and in a little deeper. Megumi grips his forearm tightly and covers his mouth with his other hand, biting the heel of his palm, trying to stifle the sound that comes out of him as his fingers move. It’s a devious ache. He wants nothing more than to ride this man’s cock like a coin-operated horse.

“You like it rough?” he asks. His tone is cajoling and sweet. Megumi nods. “Then, let me fuck you up a little.”

Panting, Megumi’s head falls back against his shoulder, and he turns slightly, feeling the bristles of Dr. Ryomen’s facial hair against his temple. He tilts his hips forward and back, fucks himself on his hand. Twitching around his digits when one large arm snakes up his chest to grasp at his throat. Megumi holds his forearm, braces himself on it, swallowing against the pressure on his neck. He owes him a scrap of skin. He owes his attending a taste.

His clit pulses. His body goes rigid. He cries out – a gaspy-needy sound that splits through the room. Tightening, almost painfully, as his orgasm rolls through him, thick and cloying. In the distance, there’s the sound of muffled chaos happening outside. 

There’s tears trickling at the corners of his eyes. 

Dr. Ryomen’s mouth kisses them away.

A bulging, unseeing, doll-eye stares up at him. One fixed and dilated pupil. 

Lateral canthotomies are not for the faint of heart. 

This might be the grossest thing Megumi has ever done, and that’s saying something.

The ends of two scissor blades hover above a blue iris, slipping under the corner of one eyelid, as if tucking it to bed. Megumi holds the shears there, carefully, and bites the inside of his cheek. He’s numbed with local and clamped for thirty seconds, and now – 

He peeks a glance over his shoulder. 

Dr. Ryomen stands there with his arms crossed. He’s not wearing a jacket today. His biceps are flexed. “Where are you now?”

“Inferior crus of the lateral canthal tendon.”

“The what now –?” a voice underneath him asks. The patient grips one edge of the bed to keep himself still, the handcuff around his wrist clanking against the rail. The state correctional facility officers, stationed in the two chairs in the corner, look up from the games on their phones to watch. 

“The tendon at the corner of your eye,” Megumi explains. “By cutting it, we can open up the space and allow your eye to decompress. You have orbital compartment syndrome – there’s too much pressure within your eye socket and it’s constricting the blood vessels to your eye. If we don’t act within the hour, you might lose your vision permanently.”

“Yeah, you explained all that, in the – the consent, but – this is kinda wild, don’t you think?” the inmate swallows, then sighs. “Just do what you gotta do.”

Megumi nods. He looks up at his attending. Dr. Ryomen’s hands are on his hips, akimbo. He tilts his chin. Go ahead.

He snips. 

Pulls away.

Quick and painless. 

Megumi takes the Tono-Pen and taps it against the man’s anesthetized cornea. A number flashes on its digital screen. He smiles and flips it over to show Dr. Ryomen. “Down to 20.” 

“That it?” the man asks, blinking sluggishly. “20? What’s that mean?” 

“It’s a measure of the fluid pressure in your eye. Normal is 10-21. Yours was 42.” 

“It means don’t get into any more fights,” Dr. Ryomen says coolly. He peels off his gloves; left, then right, fingers hooked just beneath the cuff, tugged off in a snap. Not needed. “Whoever punched you nearly took your eye.”

The patient huffs. “Fuckin’ jackass.”

Dr. Ryomen chuckles, like tell me about it. He scrapes his shoulders up by his ears and works a crick in his neck loose. Then, he’s nodding at Megumi and making his exit. Megumi picks up the scraps from the procedure and moves to follow.

The man grabs his wrist. The cuffs clang.

The officers stand up. Dr. Ryomen stops.

Megumi snaps his gaze down the line of his arm to the man. He looks up at Megumi, brows pierced together. 

“Thank you,” he says, “thank you.”

“You don’t have to thank me,” Megumi replies, and he wishes he were eloquent, and charismatic, and not always talking with his foot in his mouth. He puts his hand over the man’s and squeezes back. “It’s no biggie.”

From the doorway, Dr. Ryomen watches. When Megumi looks up, he walks away.

“You should’ve seen yourself.” He’s licking him as if he were a round scoop of cold cream, sugar and strawberry and ice, melting on a hot summer's day. Slow strokes of his tongue, pulling-sucks of his mouth. “When you caught that triple A. I could've taken you right then and there.” 

They’re in the staff bathroom. Megumi clutches one hand against the edge of the sink, his other rooted so deep into his attending’s hair he’s gripping into his skull, and his ass is hanging so far off, he might as well be free-falling. Below him, Dr. Ryomen is on his old-man knees and nose-deep in his vagina. For a moment, but only a moment, he thinks dizzily of how mad HR would be, and how they’re going to have to report this to the head, and how the head is currently giving him head. 

“R-really?” he whimpers. “You didn’t – you didn’t look at me the entire – uh – shift.”

“Is that what you think?” the man chuckles into his cunt, the sensation vibrates through his core, tickling his thighs. Megumi twitches, his legs shaking as he steadies his heels over his broad back. “I always look at you. First time I saw you. When you stood there with your tucked-in scrubs and clean shiny shoes and flashed those big green eyes at me, and called me sir, reciting stroke statistics like you were a walking textbook – I knew you were gonna be a fucking problem.” He lifts his head and spits on his cunt. “I don’t do this, you know. This is a first for me.” A hot sigh from his nose. “We’re not supposed to fuck our residents.” 

He dives back in, licking into Megumi. Eats his pussy like he’s just broken a diet. Dark eyes find his as he looks up. His nose is wet. His mouth and jaw. Megumi watches as he does it again. How he works one, then two fingers inside him. How he watches his fingers enter him and come back out and enter again. His fingers hook inside him brutally, lips suctioned over his clit. It strikes something deep in Megumi. He shakes, with curled toes, socked-feet sliding over his shoulders. Suddenly scared.

“It’s too much, too much – sir – w-wait –”

“Shh, shh, shh, that’s a good boy,” Dr. Ryomen shushes into his folds, a coddling murmur, doling out praise like dessert after dinner. “There you go, Dr. Fushiguro. Just lay there and take it.” A moan leaves Megumi, bruises his throat. “You’re going to go so far. Far beyond me.”

Something bursts and gushes, a hot slick rush out of him, and Dr. Ryomen groans like he’s in pain.

Sir, he thinks, but doesn’t say, as he explodes, liquifying into a sob, whiny and loud, I don’t think there’s anything else beyond you.

Megumi gets moved to nights.

Two long weeks of it. 

Night float is scary. Nothing good comes to the hospital late at night, especially not to the ED.

Between the trauma witching hours of 11:00 PM to 2:00 AM where all sorts of stabbings and gunshots and car accidents walk through the doors, to the skeleton staff, to the absolute fatigue of his circadian rhythm getting fucked several different ways sideways, his goal remains the same: survive to the next morning. See the sunrise, check the day team, fall into his bed the same time most people are getting up. Exhaustion is just part of this line of work. 

Go home. Sleep. Go back several hours later. 

It’s a strange feeling to leave work and to return to work on the same day. At times, it feels like he’s stuck in his own special brand of hell. Limbo. Something straight out of the Twilight Zone. Walking out the doors, closing his eyes, falling into the abyss of sleep, just to open them and find out he’s back where he started – back in those same sterile white walls and neverending chorus of alarms. The ding ding ding of the monitors start to follow him into his dreams.

He bounces between shifts with Dr. Gojo and Dr. Gakuganji, the nocturnists. Dr. Gojo is a hazard to be around; his method of teaching is no teaching at all – letting interns and residents do anything they like, zero-supervision, hands-off, run-the-department-by-themselves and tell-him-about-it-later, all laissez-faire. Dr. Gakuganji is a little less so. He’s old, older than old, and he’s there and doing something, but he’s not particularly inspiring or great as a teacher. Typical letter-of-rec attendings. Easy to get along with, with lower than low expectations. 

He doesn’t see Dr. Ryomen. 

Not for a while.

It's a hard month.

The car rocks tumultuously. The overhead light illuminates him from above. Megumi slaps one sweaty hand to the ceiling to turn it back off.

He’s unused to riding someone. He kneels astride him, trying not to shake. The world spins on a hard shudder as the head of Dr. Ryomen’s dick rubs against his pussy. He’s big. A hot fantasy that came true: he’s big. Huge, really – the good end of the bell curve. Hard iron sheathed in velvet-soft skin. His cock slips in, parting tight rings of muscle like a hot knife to butter. Megumi lets out a heavy, ugly guh.

He sets to bobbing haphazardly, with no real rhythm, bracing his hands on the man’s abdomen, before opting for his wide-set shoulders. Leverages his weight there. He seats himself fully, before circling his hips in a sort of grind. There’s the sticky sound of his slick sloshing, the slap-slap-slap of skin when he lifts himself up and falls back down. There’s no rhyme or reason or method to his movements, just wants to go fast and hard; lets his cunt tighten and flutter, and fucks Dr. Ryomen with sloppy wetness. 

“Slow down, sweetheart,” Dr. Ryomen chuckles, tone nearly endeared. “You got so nice and wet for me.” His fingers circle his clit, casual and unhurried. “Let me enjoy it a little.”

Megumi’s breath hitches, eyes fluttering. Tries to tamper down a spike of anxiety, that part of him that wants to hurry, fuck and get it out of their system. 

Outside the window, he can see the other cars, those lamps out there. Dr. Ryomen has tinted windows, but still. Anyone walking will notice a car bouncing in a physician-parking space. Any passerby can spot the shine of his skin, red and sweaty-faced in the window. They shouldn’t be doing this in the hospital garage, he knows that, they know that, but –

It’s dark out, nearly midnight. The only people out right now are those getting off their late shift or those up to no good.

Dr. Ryomen is pulling his shirt up, letting cold tickle Megumi’s stomach, and a genuine stream of terror tears through him. Anyone could walk by, and see this part of him, this hidden, private thing. See that he’s letting this man, his attending, the man rail him in the back of his car. The utter indecency of it. Megumi doesn’t even have the excuse of being drunk. He’s very, very sober. This is stupid. Idiotic. Where’s his clinical judgement? Where’s his common sense? At least, he has no wife. Or kids. That’s…good. That’s a win.

Slow, open-mouthed kisses slink up his neck. “Want someone to see those tits, huh, baby?” Snagging his sports bra, bringing it up over his head. Wordlessly, Megumi lifts his arms to let him sling it off and away. Bending his head, Dr. Ryomen hunches his back so he can suck Megumi’s nipples to hard points, lapping and licking. “They were in my way,” he says, like an explanation. He rears back to slap them. Megumi shrieks, scandalized, watching his skin turn hot and pink.

Squeezing his eyes closed, half-ashamed he likes it, he gasps, “please,” and says it again, pleasepleaseplease, pitching higher, more wobbly. Mouth open and wet and wanting. He rides the man, hard, muscles in his legs burning. He loses time. He’s barely a thought. He’s a slick, clutching sheath. And soon, he’ll have Dr. Ryomen’s cum in him, happy and full and complete.

His lashes flutter, hips rolling. Megumi tightens around the thought; a flex and shiver of his cunt stretched wide around. His cunt stretches sore, drenching him. There’s a sheen of slick wetness painting the inside of his thighs, glistening in the hair at the base of his shaft. Dr. Ryomen’s fingers grip hard enough to bite. 

“– fuck, Megumi –”

Dr. Ryomen thrusts into him. His hands run up and down his back, his hips, his shoulder blades. Then, wrapping a hand under his jaw, drags him in for a kiss, biting at his mouth like he wants to chew him up and spit him out. His thumb digs into his neck below the angle of his jaw. Megumi hopes it bruises.

“Do you want to cum,” he asks him, teeth knocking into his. His breathing is labored, voice hoarse and scraping rough, swallowed up in the cavern of Megumi’s mouth.

“Yes –” he breathes, keens loudly, bright and vivid in the confines of the car, “yes, yes.”

Dr. Ryomen looks at him, eyes molten hot and bright. “Ask me then. Ask me nice.”

Megumi doesn’t blink an eye. “Please, I want to cum. Can I cum? Please? Please just, just, let me cum, please, please.” 

“Nicer than that. Show me some respect.”

It hits him then, suddenly, low and dirty. His whole body shivering on top of him. “Can I cum, sir?”

Dr. Ryomen fucks into him hard. Skewers him right there on his cock. Knocks the wind right out his lungs. Pounds into him, harshly, frenzied. Megumi’s orgasm is a violent thing. Hits him so hard he’s sobbing. Rolling through him in rhythmic pulses, shaking his limbs, fingers clutching at shirt, and hair, and shoulder, anywhere he can get a grip. He hears a tear, the sound of Dr. Ryomen’s Figs splitting in two.

His cum drips down the inside of Megumi’s thigh, vicious. Like blood.

One afternoon, Megumi watches Dr. Ryomen float a transvenous pacer on a patient mid-arrest.

Inserting a catheter straight through the patient’s jugular vein, even as he’s receiving active CPR. Guiding it through the right atrium into the right ventricle of the heart, using nothing but ultrasound and an EKG strip. Suddenly, somehow, the patient is brought back from the dead. 

The residents gather outside the room, all watching, in equal awe and silence. Nobara stands next to Megumi, one arm wrapped around his – her favorite emotional support intern – and she breathes, “Holy shit. How the hell did he just do that?”

“He’s amazing,” he tells her, breathless, pressing a palm to the outline of a bruise on his neck, something tugging and throbbing in his stomach like alchemy. 

Out of the corner of his eye, Nobara looks at him strangely for one long moment.

Prepateller bursitis.

Housemaid’s knee. Megumi foresees it in his future. 

His knees ache down there on the floor, shins rocking back and forth on hard tile; he might as well be scrubbing. He doesn’t care about the pain or the grime or the lack of sanitation. He doesn’t pay much attention. His mouth is slack around a mouthful of cock. Saliva dribbling out the corners, smearing down his chin. The scent of musk and sweat and precum in his nose. Tonguing veins on the underside. Making him make a little noise. Sucking him in balls deep, swallowing, and swallowing, and swallowing, winning that cream. 

Megumi chokes on him as he murmurs ah shit, stroking his hair.

He steadies his palms against the thick of Dr. Ryomen’s thighs. His lips circling his dick, the head nudging the back of his throat. He lets him fuck into the wet heat of his mouth. Sloppy, the small bathroom echoing with the sounds of gulps and gags and squelches. Dr. Ryomen’s fingers are wrapped in his hair, holding him there like a pair of reins. Megumi always forgets just how big his hands are until they’re locked around his skull.

“Put your hands on the floor,” he says, and Megumi obeys, falling forward on his hands, looking up, heavy-lidded and flushed. “Spread your knees farther.” Megumi does. He’s well-trained. A quick study.

On all fours, he whines with his cock down his throat, fingers tugging the roots of his hair to move him back and forth along his length before he pulls out, leaves his mouth red and glistening. Dazed, Megumi tilts his head, lips parted and chin wet. Dr. Ryomen stares down at him. He jacks his cock. Keeps staring down at him as he inhales. Fucking his fist with a brutality Megumi wouldn’t dare to use on his own.

On reflex, Megumi opens his mouth. 

“Please, sir,” he chokes out, and curls his hands into the tile, “I can take it. I’ll be good.” He might be meek about most things, but this isn’t one of them. The first shot misses his mouth and streaks across the tip of his nose before coating a long eyelash. Megumi lets out a squeal. Dr. Ryomen groans, jerks his hips closer, shoving the head of his cock back into his mouth and finishing off, warm and thick, the flavor intense. His cock softens in his palm, and he pulls out.

“Don’t swallow,” Dr. Ryomen says lowly. He swipes his thumb along Megumi’s lip, pushing the rest into his mouth. “Ten minutes.”

The door handle jiggles.

Dr. Ryomen doesn’t lift his head. Megumi doesn’t dare look away from him. 

“Coming,” he says loudly, to whoever is on the other side. He fixes himself inside his scrubs. His gaze stays on his.

“Hey, Megumi.”

Megumi looks up, lifting his thumb from the dictaphone, pausing. His notes sit there on the computer screen, half-finished. He blinks at him. “Hm?”

Yuuji leans his hip against his desk. “How’s it going?” 

Megumi glances around, then back to him. “It’s going. Could be worse, I guess.” He smiles. Dr. Ryomen, from a couple computers away, looks over. “How about you?”

Yuuji lets out a breathy chuckle. “Oh, you know – it’s going.” He sidles a little closer. Megumi doesn’t miss it. “I was wondering, well, if you wanted to go get some coffee some time, or dinner maybe? I know a good sushi place down the street. We could swing by after work.” 

Megumi pauses. “Oh.”

That’s a surprise.

Just then, Nobara passes by with a clipboard and a wink, before disappearing into a patient room.

Oh.

He glances over at Sukuna, again, and finds he’s already watching, clearly trying to listen in,  and something about it, reminds Megumi of the raised dorsal fin of a shark, slowly circling its kill. It takes him a second. Feels like his brain has been made into TV static, everything on a delay. 

“Uhm, that sounds nice. Is this – is this like a…a friend thing?” Yuuji stares blankly. Megumi winces, stumbling over his own words, sort of aware that he’s being weird. “Or is it like, a – you know, a date? Or something…like that.”

Yuuji gawks at him for a moment in a tremendously uncomfortable silence. He scratches the back of his head and forces out an awkward bark of laughter. “Uhhh, well, yeah, a date.” 

“Oh. Okay.” Megumi clasps his hands together on the desk. “Wow. Uhm. I didn’t know you thought of me like that, or anything.” What the fuck does he say here? “Hah, uh, sorry, I don’t really know what to say.”

Yuuji looks at him, something deflating behind his eyes. “So, I’m guessing…that’s not a yes?”

“I…” oh god, this is awkward, just spit it out, get it over with, rip the bandaid, “I don’t know if I feel the same. I’m sorry. I really want to keep you as a friend, you know? It’ll be too messy at work otherwise, right?”

“Right. Yeah. I get it.” Yuuji nods, a stiff sort of smile on his face. He drums his hands on the desk and pushes off from it. “Can’t go mixing business with pleasure.” 

“I’m…I’m sorry –”

Yuuji waves the air, dismissive. When he smiles this time, it’s genuine. “No hard feelings. Just wanted to try, or else I’d never know.” 

Tipping his head, he walks away. Megumi follows him with his gaze, tracking him as he goes down the hall – a flash of a frown on his face as he rounds the corner. Several computers away, Dr. Ryomen meets his eyes, a tic in the corner of his jaw, before turning back to his notes.

Megumi swallows and turns back to his own. His heartbeat thuds in his ears, in the roof of his throat.

Later, Dr. Ryomen breaks a rule and palms his ass through his scrubs when he walks by. Discretely, of course. 

“Get on the bed.”

Megumi does as he bids. They’re in one of the trauma call rooms. On a single cot in an empty white room. Megumi’s legs are spread open like a frog ready for dissection. Dr. Ryomen’s pulled himself free – thick and long. Pulsing red, angry, mean. Filled veins weaving along the length; from the fat mushroomed head down to the dark thatch of hair at its root. It bobs there for a second, fully erect. Dr. Ryomen has zero issues with his body. He’s stretched tall to his full height, towering like an ancient tree, watching him, head tilted to one side. 

He doesn’t say anything when he slips inside his wet cunt. Megumi’s pussy makes it easy, always ready. He starts talking, pumping slowly. 

“Jesus, baby,” he murmurs, in his ear, cupping his hand over his mound, his thumb catching the head of his clit. “How long’ve you been like this?” 

“H-hours,” Megumi pants.

“You need to pay attention on shift, sweetheart. Can’t spend all day daydreaming about getting fucked.” Dr. Ryomen thrusts into him, slowly, carefully at first, getting his cock slick enough to fuck into him with ease, then faster, harsher, enough to make Megumi’s toes curl. “You’re a greedy little thing, you know that? Can’t take you fucking anywhere.” Megumi whines, bucking his hips. “You were wet enough for me to smell you.”

“I-I’m sorry, sir.” Megumi’s face glows red. “Ah, can’t – can’t help it. Did you – oh – did you think about me too?”

“My star resident,” Dr. Ryomen says dryly, looking him up and down. He surprises Megumi. He slips out of him and grabs him by the hips, turning him around on all fours. Hands and knees on the cot. Presses one hand on the small of his back, and makes him bend. “What you’ll find out about me,” he continues, a low murmur, “is that I always want to fuck you.”

Dr. Ryomen slides closer, dipping his dick back into him. Their entire bodies brush as he rocks into him. Megumi trembles, shakes. It’s so good from this angle. It’s such a profound feeling he grabs Dr. Ryomen by the arm, digs his nails into him. He’s going to cum harder than he ever has. 

“Sir, you’re so deep, it’s –”

Dr. Ryomen kisses his cheek, a warm wet press, kisses his ear, his shoulder, his neck. The words fade. Dr. Ryomen groans, and it sounds like he’s in pain, like Megumi is hurting him, but it’s only how good he feels, how fucking good he feels. “Goddamn, you’re fucking tight,” and he lets out a hard, loud, bed-shaking laugh, rocking inside him with it, and Megumi gasps a little oh. “Swear each time you get tighter.” He fucks him faster, almost punishing, as if trying to shove something inside him as deep as it will go and leave it there. “Gonna fuck you so deep it sticks.”

And he’s splitting him open, unpeeling him, making a space for himself in his body, and there’s nowhere to go, flattened like this against the bed. Drool starts to drip from the corner of Megumi’s mouth, a sticky path trailing down his cheek, pooling below his ear. Obscene thing. Dr. Ryomen grunts behind him like an animal, and this is getting fucked, he realizes, and he’s already tensing in his thighs and his knees and his stomach, and Megumi’s going to get fucked until the bed breaks and all Megumi can do is shut up and take it –

“Dr. Ryomen, Dr. Ryomen, sir, oh my god, sir, I – I –”

There’s a loud bang as someone beeps into the call room down the hall. They’re both so smart, it makes Megumi run hot that they’re willing to do something so stupid. Really, what are we even doing? He wonders, feeling like he’s at the edge of something, one foot hovered over a giant chasm. Megumi bites down on Dr. Ryomen’s hand to keep from crying out, but he can’t stop whimpering with each thrust. Can’t help but think how horrible he must sound, wailing like a porn star at the way he fills him up, balls slapping his clit. Half a mind is still too much. He can feel his brain start to atrophy. Wonders if Dr. Ryomen can fuck the genius right out of him. The sticky sound of his cock sliding into his wet cunt is loud, too loud, his pussy making a noise like water, they’re going to get caught – how can anyone sleep next to this in the other room – they’re going to –

“If you don’t keep quiet, they’re going to come in here and find you like this for me –”

Oh god, oh fuck, sir, yes, fuck, sir, muffled under his palm. Tears leak from Megumi’s eyes. Back arching so hard that his hips jerk off the bed, forcing Dr. Ryomen’s cock deeper inside. It’s like a match against kerosene, Megumi pitches blindly into pleasure. Pleasure so deep it’s painful. His knuckles go white on the sheets. His eyes screw shut, body locking tight, and he convulses, wild and wailing, moving so much that Dr. Ryomen shoves him against the mattress, forcing him to go still and suffer through the pleasure. 

He cries out, for mercy, and Dr. Ryomen gives him none. Continues to thrust into him, haphazard and sloppy, and harder than ever, and Megumi knows he’s going to cum too soon. Megumi screams, nothing left to give, a saturated rag of pleasure, wringing itself to death. So good, so good, soooo good, he hears himself saying out loud, over and over. 

When Dr. Ryomen cums inside him, he kisses him on the cheek. Tells him how proud he is of him, his favorite, how he's going to save lives, how he's going to save his life, you’re doing so great, you’re going to be the best, you’re going to be perfect. 

Charging. 

Stand clear. 

Deliver shock now. 

Megumi meets Dr. Ryomen’s eyes across the trauma room, a yawning chasm. It’s up to you, Dr. Fushiguro. It’s all up to you. Hands fluttering over a broken-ribbed chest. Everything inside him crushes. Tensing, coiled tight. Sweat down his back. Panic set. I want it, so I will it, and it shall be.

Pressing his fingers to a carotid artery, feeling, searching for a pulse. 

The silence stretches. The air cools. Stills. The daughter outside stops her screaming.

Their eyes meet.

ROSC

NOUN

“Return of spontaneous circulation, or in other words – the term for when a patient’s heart has resumed beating on its own.”