CATEGORY: JC Angst
RATING: PG (I think)
SPOILERS: Season 6
DISCLAIMER: I don't own or receive profit from the
characters of ER (nor from Anne Rice's Queen of the
Damned..see part 3 of this fic). I'm just borrowing
everyone for a little while.
SUMMARY: This fic takes place where the end of Season
6 left off. A severely depressed Carter is admitted
to the rehab center in Atlanta. The story follows his
time there as well as how his friends at the ER
respond to his depression and drug use.
Peter looked over the paperwork which the nurse had given him. On these sheets of paper, Carter's entire history would be documented. But would the doctors at the rehab center truly understand the depth of Carter's problems by looking at paperwork? He, himself had not understood the danger Carter was in until it was nearly too late, and he was living in the three-dimensional world of reality along with Carter. How would a few scribbled words sum up Carter's distress and the actions which had gotten him there?
Peter and Carter had arrived in Atlanta at an obscene hour, and despite a few hours rest Peter was still exhausted. During the plane trip Carter was quiet and non-communicative, and Peter had been anxious about this break from Carter's normal garrulous, and slightly goofy personality. But Peter had forced himself to concentrate on getting both of them off the plane and into a hotel room. He had yet to think further than getting Carter to the rehab center, but now reality was beginning to set in for Peter. He found that he was having a hard time believing the circumstances surrounding their journey to this place.
Carter was still quiet, and Peter decided to spare him by filling out as much of the paperwork as he could. As Peter did so, he shot quick glances at Carter who was seated beside him. There was something in Carter's face that made Benton pause, something he had never seen there before. Carter looked resigned, despairing, and broken. Peter looked sharply at the younger doctor but withheld any comment. He simply continued filling out the paperwork which Carter did not have the strength to do.
Carter did not notice Benton's concern. He sat quietly in the chair despite the physical pain he felt. He willed that pain to fade, but predictably it would not. He leaned his head against the office wall and closed his eyes. An overpowering lethargy was creeping through his body and joining the pain in its attempt to make him uncomfortable. He longed for a quiet place where he could curl into a ball and fall asleep. He didn't even care if a bed was included in this quiet place; he could easily disappear if he curled up to sleep on a floor somewhere.
"Carter. Hey, Carter. C'mon man. You have to help me with this." Carter suddenly realized that Benton had been trying to get a response out of him for a few moments. He slowly opened his bleary eyes and felt disorientation hit him.
"Carter?" Benton looked closely at the young doctor and didn't like what he saw.
"Carter? You okay?"
Carter ignored the question. "What? What were you asking before?"
Benton hid his alarm at Carter's disorientation and instead asked him the original question.
"Who should they call in case of an emergency? I have to write it on this form."
It was a good question, and Carter had no answer. If he had one, he would have called the emergency contact a long time ago and then he wouldn't have ended up in this mess.
Carter gave up looking for an answer and closed his eyes again.
"I don't know," he said uncaringly. "Nobody."
A rush of anger engulfed Peter so suddenly that it took his breath away. He was so angry with himself for not being available to Carter these past months. He was angry at Carter's other colleagues from work who had also neglected to notice John's distress. And he couldn't even thing about the Carter family without yelling, so he didn't reflect on this anger. But he realized suddenly that he was also angry with Carter for not asking for help when he so obviously had needed it.
But anger would not help John now, and Benton knew it. He hastily wrote his own name and contact numbers in the empty space on the form. He scanned the remainder of the document and was relieved that he could answer the general questions about Carter's occupation and work environment without aid. One glance at Carter told Peter that the defeated man next to him was in no condition to answer any further questions. Carter was quietly dozing and that scared Benton more than anything else had yet. He preferred Carter's previous fist fighting to this current attempt at escape.
After filling out Carter's work information, Peter handed the paperwork to the nurse and walked slowly back to his younger colleague. Carter looked sound asleep, and he did not move when Peter sat back down. Peter silently and subtly monitored John until a nurse called Carter's name.
Carter did not respond, and Peter gently shook him awake.
"Huh?" Carter mumbled.
"C'mon Carter. They're calling your name. They probably want to do your intake now." Peter grabbed Carter's arm to help him up.
"Ah. The intake." Carter croaked sarcastically. He flinched visibly as his back flared with pain when he stood.
"Carter, are you okay?" Peter asked anxiously.
Carter glanced sideways at his mentor but could not bring himself to look directly at him. He still couldn't find the words to answer Benton's question and instead focused on making progress toward the intake room.
Peter watched as Carter heavily limped towards the nurse. Carter had stopped this pronounced limping two months ago, and Peter was shocked to see it now. That Carter was obviously in so much pain only showed how dependent he had become on his pain medications.
Carter practically collapsed in the chair in the intake room. He settled back into its strong support and closed his eyes again. He placed one arm on the desk in front of him and bowed his head.
Peter remained standing and started when a doctor abruptly entered the room.
"Oh, I'm sorry," the man said kindly. "I didn't mean to startle you."
Peter smiled. "No, it's okay." He offered his right hand to the small, balding man. "I'm Dr. Peter Benton. This is Dr. John Carter." Benton placed his other hand on Carter's shoulder by way of introduction.
The doctor smiled warmly and shook Peter's offered hand. "I'm Dr. Blair. I'll be doing John's intake." Dr. Blair adjusted his glasses and took a close look at his new patient.
"How long has he been so unresponsive to his environment?" Dr. Blair asked Peter quietly.
"It just started this morning. I think it's becoming worse."
Dr. Blair nodded and patted Peter's shoulder. "It's okay, Dr. Benton. We won't let any harm come to him. I need to do his intake, but I was hoping you would wait in the reception area until we're finished here. I understand that you brought John into the clinic, and so I'll have questions for you after."
Peter nodded in agreement and looked toward Carter again.
"I'll be right outside, okay Carter?"
Carter did not respond, and Peter reluctantly left.
It was half an hour later that Dr. Blair found Peter pacing restlessly in the reception area. When Peter saw the other doctor, he abruptly stopped his pacing.
"How is he?" the helpless surgeon asked Blair.
Blair motioned for Peter to sit down and then joined him.
"Well, he's pretty hard to assess right now," Blair rubbed his eyes behind his glasses. "I was hoping you could fill in some holes."
"Sure, sure. Anything you need," Peter assured.
"I understand that he was stabbed at the hospital. Suffered serious injuries and almost died, correct?"
"Yes." Peter simply said.
"How long after being stabbed was he was discovered?"
"We're not sure. From his blood loss, it was about 15 minutes."
"Okay, okay." Blair nodded and made a note in Carter's record.
"And he mentioned someone named Lucy. I didn't quite understand Dr. Carter's relationship with her."
"She was Carter's med student. She also was stabbed just prior to Carter. Dr. Weaver, one of our Attendings found both of them in an exam area. Lucy was handling the patient who ultimately stabbed her, and Carter was supervising."
"Where is she now?" Blair asked.
Peter, who had been looking at his hands, jerked his gaze to Blair.
"Carter didn't tell you?"
"No, he became very evasive and did everything he could to escape the subject. I ended the intake when he put his head down on the desk and completely ignored me. I think he might have even fallen asleep. What happened to Lucy?"
Peter ran a hand over his head. "Her injuries were severe and complicated by a pulmonary embolism. She died."
Peter bowed his head and suddenly remembered the destroyed look in Carter's eyes when he had figured out that Lucy had died. Peter cursed himself for not anticipating Carter's reactions to Lucy's death.
"Ah, I see. And how did John's family respond to the attack?"
Peter became bitterly angry again. "His grandmother visited once the whole time Carter was in the hospital. His parents were out of the country and never came to visit their son." Peter spat the words out.
"Okay," Blair made another note. "Dr. Carter mentioned three other individuals, but also refused to talk to me about them." Blair consulted his notes. "Who are Bobby, Gant, and Chase?"
Peter sighed but explained Carter's complicated relationships with these individuals as simply as possible.
"Bobby was Carter's brother. He died of leukemia when Carter was a young kid. Gant was another of my students and a friend of Carter's." Peter bowed his head. "Gant was hit by an El train and died in our ER. Carter blames himself for Gant's death because he believes it was a suicide that he could have prevented. Chase is Carter's cousin. They're very close. Recently Chase overdosed on heroin, and Carter worked on him when he came to the ER. Chase was down over 40 minutes, but Carter brought him back anyway. Chase was severely brain damaged, and Carter's family blamed Carter for his cousin's drug use."
Blair nodded again. "Okay, that clarifies some things for me."
"Can I see Carter now?"
"Well, right now he's in a room sleeping soundly. I'm hoping that sleep will energize him a little bit. I also was hoping that you could stay in Atlanta for a few days. It's uncommon for us to let our patients have access to friends or family for the first week they're here. However, I'm willing to make an exception in John's case."
Peter was relieved that he would be allowed to see Carter, but was worried as well.
"Why the exception?" he asked.
"Well, John does have a drug problem, but I don't believe it's a full blown addiction yet. There's no doubt he's in a lot of physical pain, so he does have a justification to remain on a low dose of painkillers. But I'm not saying that he went about getting those painkillers in the right way.
What I'm particularly concerned about is this depression. I believe he's been moderately depressed since the incident you mentioned with Gant. His history with his cousin, this stabbing, and the loss of his med student probably has severely amplified that depression. John's been trying to handle it alone, but understandably he hasn't been doing so well. Work has been a major distraction for him, but he doesn't have that right now."
"What are you saying?" Peter asked.
"Well, I'm worried that the depression and guilt are going to intensify. If that's the case, I was hoping someone who cared about John could be with him. So far he's felt alone in this, and I want him to see that isolating himself isn't necessary. He respects you, and it's obvious that he seeks your approval. I think it will be important for his recovery to see that you are willing to stick by him even when he feels as if is existence is intolerable to others."
Peter flinched at the other doctor's words. "Is that how he feels? That he is intolerable?"
"I didn't know."
"Your Dr. Carter is too intelligent for his own good. He knows how to hide well. But we'll take care of him here. Since I'm not sure of his drug use history, we'll keep him in rehab, but I'll be working closely with your psych department. The doctor's here are top notch, and I'll make certain you're apprised of your colleague's condition. Can you stay in Atlanta for a week? I know it's short notice, but I do think it's important that you're here."
"Oh, yeah, sure." Peter said absently. He was still trying to digest the information Blair had just provided about Carter's state of mind. "I can make arrangements."
"Also, can you get in contact with John's family? If John doesn't improve, we may need their consent for some medical options."
"Like what?" Peter asked anxiously.
"Well, let's just see where Dr. Carter is in 24 hours and then we'll discuss options. Like I said, he's sleeping now. I suggest you go back to your hotel room and do the same."
Peter nodded. "Okay. I'll try to get in touch with Carter's family." Peter shook Blair's hand again. "Thanks, Dr. Blair."
Blair nodded. "Thank you Dr. Benton for all your help. Now go get some rest."
Kerri looked on as Mark talked to Peter over the lounge telephone. She didn't like the grim expression on Mark's face as the conversation continued, and she anxiously waited for her colleague to fill her in on Carter's condition.
After an unbearably long length of time, Mark finally got off the phone. He took a moment to gather his thoughts before facing Kerri.
"What is it, Mark? What's going on with Carter?" Kerri could no longer hold her question inside.
Mark exhaled forcefully. "It doesn't sound good." Mark saw no sense in lying to Kerri; she would see right through him. "His pain has increased since he's been off the medications, but Peter is more worried about the depression."
"What do you mean?" Kerri needed clarification; she wanted to know exactly what was happening to Carter. Actually, she wanted to be in Atlanta now with Carter.
"Peter said that Carter seems to be closing down. Apparently he's become lethargic to the point of falling asleep in the middle of the intake. Peter noted that Carter showed disorientation and disinterest in his surroundings and future. He's barely talking, Kerri." Mark said these things in a calm, clinical tone, but Kerri sensed real worry in him. She thought of Carter silent and bottled up and could hardly imagine it. The young doctor had always been outgoing and talkative.
"What are they doing for him?" she asked.
"They're letting him sleep for now. He's exhausted from the insomnia that he's apparently been experiencing these past few months." Mark's tone was bitter, and Kerri understood why. Neither of them had known about Carter's inability to sleep, but if they had looked closely enough, they would have seen the signs. They just hadn't bothered to look that closely.
"Peter said that they'll let him sleep up to 24 hours, but after that they'll try to get him moving again. Oh, by the way, Peter's got some vacation time coming, and Carter's doctor has asked him to stay in Atlanta. Could you talk to Anspaugh about it?"
Kerri nodded. "Of course. Is there anything else we can do on our end?"
"Peter said that the center might need family consent to perform certain medical procedures. I guess I'll try to track the Carter's down."
"What kind of procedures?" Kerri asked.
Mark shook his head. "They're not discussing any possibilities yet with Peter. They're just suggesting this as a precaution. Besides, someone in Carter's family ought to be notified of his whereabouts, don't you think?"
Kerri didn't respond. Secretly she wondered how long it would take one of the Carter family to discover John's absence. Suddenly another thought occurred to her.
"But Mark, he's 30 years old and a doctor. Surely he can give his own consent."
Mark averted his gaze from Kerri momentarily but looked back at her when he began speaking. "Kerri, there's some question as to whether Carter is going to be able to give consent. According to Peter, we really need to contact the family."
"But surely after he gets some sleep, he'll be able to respond better to his surroundings. He just needs some sleep. I mean, yesterday he was treating patients here in the ER. You can't convince me that his condition is so much worse!" Kerri refused to believe what Mark was saying, because if she did she would have to be on a plane to Atlanta within the hour.
Mark looked at Kerri's helpless expression and was surprised. Very rarely did Kerri show such concern so openly.
"Kerri," he said calmly, "you need to talk to Anspaugh about Peter. I'll call Carter's family, OK?"
Kerri paused then accepted it. With a nod she slowly walked out of the lounge door.
Carter slept. And while he slept, he dreamed. Over and over Paul Sobricki stabbed him. Over and over he saw the bloody mess that had been Lucy. He didn't fight the dream anymore. He understood its purpose now. The dream was there to remind him that he was the one responsible for Lucy's death. He was the one who caused all of her suffering. He was the one who caused all the suffering of those he cared about most.
The dream was his own private hell, and he knew that he deserved it. He didn't deserve the help he knew the doctors at this place wanted to give him. But then, he wasn't really sure where he was anymore, and he couldn't understand why anyone would want to help him anyway.
He plunged back into a deep sleep and left these idle thoughts behind. He concentrated on the nightmare which had become second nature to his subconscious. In a second, he would feel it. Ah, yes, there it was. Incredible, indescribable pain blossomed within his back. Another minute and then he would see her. Sure enough, there she was, covered in blood from the mortal wounds he had inflicted upon her. He tried to scream, but no sound came; he tried to move, but he was paralyzed. He begged an unseen force to intercede and give him the strength to help her. He knew he could help her if only he could find the strength.
But he was too weak. He watched as she tried to talk, tried to breathe, tried to live. And this time he watched as she looked accusingly into his eyes and died.
His world shattered again and again.
Peter returned to the rehab center anxious to see Carter. He was still concerned for Carter's well being even though he knew that the doctors at the center were closely monitoring the distraught young man.
Peter talked to the receptionist who said that she would notify Dr. Blair of Peter's arrival. Peter thanked her and sat in the reception area.
Peter was grateful that Blair entered the room only a few minutes after he arrived. Blair approached Peter, and Benton became alarmed by the concerned look on the other doctor's face.
"Dr. Benton," Blair acknowledged Peter and extended his hand.
Peter accepted Blair's hand and shook it. "Dr. Blair. How's Carter doing?"
Blair sighed heavily. "Well, I won't lie to you. I'm afraid Dr. Carter's condition is deteriorating. He hasn't really regained consciousness since yesterday. We can't get him to wake up even after shaking him. The only time he showed any response to his environment was when we tried to give him IV fluids."
"IV?" Peter queried.
"Well, from the information you supplied about his back injury, I saw that his left kidney was severely damaged. John hasn't had anything to eat or drink for over 24 hours now. I don't want to aggravate that kidney anymore than necessary, so I tried to get an IV line into him."
Peter nodded. "I agree with your reasoning. It would be bad if his electrolytes got out of whack. But what's the problem?"
"John won't accept the IV. He keeps pulling it out. We tried four times, and each time John pulled the line out. It was a bloody mess."
Peter sighed and found that he was angry with Carter again.
"You think he's trying to kill himself then?" Peter asked the question simply, but he could not believe that he was actually saying the words.
"I'm afraid so. I think that John feels as if killing himself is a way to take control over what is happening to him. But I'm only guessing at his motives, because he hasn't talked to me yet."
"Well, what are the options? What can we do for him?"
"I want to put him in restraints so that we can keep the line in. But I can only do this for 24 hours, because any further time in restraints needs to be approved by his family. Have they been contacted yet?"
Peter's expression became cloudy. "One of the other doctors in Chicago is trying to contact them. As of this morning, he didn't have any success."
Dr. Blair nodded. "Okay. Well, here's what we do. I'd rather not delay the IV, but I think it can be held off until the end of the day. Do you concur?"
Peter nodded. "His kidney has been healing nicely, but any later than the end of the day and we might run into complications."
"Okay, delaying the IV will give us a few hours for your colleague to locate the family and approve the restraints past 24 hours."
"What happens if we still can't find the family?" Peter asked.
"We'll still put the IV in and hope we locate John's family within a day. I'll give him some antidepressants through the IV as well, but as you know they'll take a couple of weeks to work. How do you feel about becoming John's court appointed guardian, Dr. Benton?"
Blair's question caught Peter by surprise. "What?"
"I'll have to go to the courts to get a judge to assign a legal guardian until the family can be located. Usually the center would become his guardian, but the circumstances surrounding John are a little complicated. I think it would be better if you were assigned his guardian since you are more aware of his physical complications that I am. And John can't wait for his family to contact us. He needs help, and he needs it now. So, would you be willing to be John's guardian?"
Peter nodded. "He'll hate me for it, but yeah, I'll do it."
Blair patted Peter on his back. "Good man, Dr. Benton. I think you'd better see how it's going with your colleagues up North and let me know about the status of John's family as soon as possible."
"Of course. But can I see Carter before I go? Maybe I can get through to him."
"That was my next suggestion, Dr. Benton. I'll bring you to him."
Sequel: Slow Walk