Chapter 8
DESTINY
Albuquerque General did not believe in quiet nights.
People liked to say that sometimes.
Quiet night.
Slow night.
Calm night.
Anyone who worked emergency medicine knew those were curse words wearing scrubs.
The ER had its own weather system, and that night the pressure sat heavy long before the storm broke.
Fluorescent lights hummed overhead. Monitors beeped.
Phones rang. Someone coughed wetly behind a curtain in Bay Three.
A toddler with a fever cried against his mother’s chest while she whispered prayers in Spanish and pressed kisses into his sweaty hair.
It was normal.
Which meant awful.
A domestic violence case came in just after eight.
Woman in her thirties. Split lip. Bruising around one eye.
Two kids in the waiting room with a social worker, both too quiet in the way children got when they had learned that noise made bad things worse.
Lily took one look at my face and stepped between me and the curtain before I could decide I was fine.
“I’ve got this one,” she said.
“I can handle it.”
“I know.” Her eyes softened behind her glasses. “That’s why I’m taking it.”
I wanted to argue.
I didn’t.
Lily was still five-four, still wore thick glasses that slid down her nose when she got tired, still looked like she belonged in a library surrounded by cozy sweaters and highlighters instead of blood pressure cuffs and trauma shears. But people underestimated Lily McCallister exactly once.
After that, they knew better.
She handled the woman with a gentleness that made my throat hurt.
I handled a teenage soccer player with a dislocated shoulder who kept trying not to cry in front of his father.
Then a baby with RSV symptoms. Then a construction worker with a nail through his palm.
Then two overdoses fifteen minutes apart, one breathing when he came in, one not.
We got them both back.
For now.
That was another thing about the ER.
You learned not to confuse back with saved.
I moved through it all the way I had trained myself to move through chaos—steady, methodical, eyes open, hands sure.
Vitals. Lines. Labs. Orders. Comfort when I could give it.
Pressure when blood needed stopping. A sharp voice when someone started spiraling and needed something firmer than sympathy.
People said emergency medicine took nerves.
Maybe.
But I had grown up around club life, old secrets, violent men with soft hearts, soft women with steel spines, and rooms where everyone smiled while calculating exits.
Chaos did not scare me.
Chaos was practically a family member.
I knew how to function when everyone else was panicking. I knew how to read a man’s shoulders before his mouth caught up. I knew when silence meant shock and when it meant danger. I knew blood was not always the worst thing in a room.
It made me good at my job.
That was what I told myself anyway.
By ten-thirty, Lily and I were both running on vending machine pretzels, burnt coffee, and the kind of adrenaline that made your hands too steady and your thoughts too sharp.
She found me at the nurses’ station typing notes with one hand and trying to open a protein bar with my teeth.
“You look feral,” she said.
“You look like you lost a fight with a copier.”
She pushed her glasses up with the back of her wrist. “I did. The copier fought dirty.”
“Did you win?”
“No, but I did threaten to report it to biomedical, so emotionally, yes.”
I almost laughed.
Almost.
Then the radio cracked.
Every head in the station shifted.
Static.
A paramedic’s voice, rough and clipped.
“Albuquerque General, incoming. Two adult males. Multiple gunshot wounds. One critical, hypotensive, abdominal trauma, significant blood loss. Second male GSW shoulder and chest, unstable but maintaining airway. ETA seven minutes.”
The ER changed shape.
Instantly.
No panic.
Not from the people who knew what they were doing.
Just motion.
Fast. Precise. Brutal.
“Trauma One and Two,” charge called. “Clear them now.”
“OR?” someone shouted.
“Already paging.”
“Blood bank.”
“Massive transfusion protocol ready if needed.”
“Respiratory.”
“On the way.”
“Crash cart.”
“I’ve got it.”
That was me.
My body moved before my mind had finished processing the words.
Two GSWs.
Seven minutes.
Critical.
I pulled the crash cart into position, checked drawers, checked suction, checked oxygen, checked everything because checking was prayer when prayer did not have time to kneel.
Lily moved beside me without needing direction.
We had worked together long enough that our rhythm had become its own language.
She cleared lines.
I prepped trauma shears.
She pulled warm blankets.
I set up pressure bags.
Someone stripped beds.
Someone else called imaging.
The trauma surgeon was paged again.
OR called down that they were clearing a room.
Another radio update came through.
“Three minutes.”
The sliding doors opened and closed.
People in the waiting area stared as if staring could tell them whether the disaster coming belonged to them.
I tightened the cuff on my glove.
Breathed in.
Breathed out.
This was what I was good at.
Blood did not scare me.
Bullets did not scare me.
Men making terrible choices and arriving in pieces did not scare me.
Then the ambulance bay doors flew open.
The first stretcher came in hard and fast.
Paramedics surrounding it.
Blood everywhere.
Leather cut open.
Black fabric.
Ink.
A patch.
My mind saw the patch before it saw the man.
Royal Bastards.
For half a second, my body stopped belonging to me.
No.
No, not here.
Not my hospital.
Not my family.
Not—
“Nate Callahan,” the paramedic shouted. “Male, thirties. GSW upper chest and shoulder. Pressure unstable, breathing labored but present. Needle decompression in field not performed. Possible hemothorax. Lost blood en route.”
Nate.
The name hit me so hard the trauma bay blurred.
Nate’s face was pale beneath road dust and blood. His beard was darker with sweat. His eyes were half open, unfocused, but his mouth still twitched like he was trying to insult death and couldn’t find the breath.
“Nate,” I whispered.
Lily’s hand gripped my elbow once.
Not to comfort.
To anchor.
Because the second stretcher was already coming through.
And some part of me knew before anyone said his name.
I knew from the shape of his body beneath the blood. From the way his dark hair stuck to his forehead. From the ink along his arm. From the cut of his jaw even under oxygen tubing and shadow.
I knew.
I refused to know.
“Second male,” the paramedic said, voice rising over the sudden frenzy. “No ID at scene, wallet found in jacket pocket en route.”
He handed it off to one of the nurses, who flipped it open fast.
I watched her face.
I watched the moment she read it.
“Dylan Degan,” she said.
The world went silent.
Not really.
The trauma bay was loud. Violently loud. Orders, wheels, monitors, shoes squeaking against polished floor.
But inside me, everything went soundless.
Dylan.
His name was not supposed to exist in my ER.
Not like this.
Not bleeding out on a stretcher with gauze packed against his abdomen and someone’s hands buried in pressure over a wound that kept trying to take him from the world.
“GSW abdomen,” the paramedic continued. “Possible exit wound, possible internal bleed. Pressure tanked twice en route. Two large-bore IVs. Fluids running. Lost consciousness twice. GCS fluctuating. He’s circling the drain.”
Circling the drain.
I hated that phrase.
I hated it in every patient.
I hated it with Dylan’s face under it.
His eyes fluttered.
I moved without deciding to.
“Nurse Rourke,” someone barked.
I snapped back.
“I’m here.”
That was the lie nurses told first.
I’m here.
As if being there meant you could stop the worst thing from happening.
My hands went where they were supposed to go. Vitals. Pressure. Assessment. Trauma protocol. My voice came out steady because training was merciful and cruel.
“Pressure is dropping.”
“Blood ready?”
“On the way.”
“OR status?”
“Room is clearing now.”
“Keep pressure.”
“I need suction.”
“Cut the shirt.”
His shirt was already mostly cut, but not enough. Trauma shears moved through fabric and blood. His skin beneath was too pale. His body too familiar and not familiar enough. Older than the last time I had seen him. Harder. Stronger maybe. Still Dylan. Still impossible.
His head shifted.
A sound caught in his throat.
I leaned closer before I could stop myself.
His lashes lifted.
Barely.
His gaze dragged through the light, unfocused, searching through blood loss and pain and whatever thin line kept him tethered to his body.
Then his eyes found mine.
Not fully.
But enough.
Enough to break me if I had let it.
“Beautiful,” he breathed. “Is that you?”
My heart cracked open right there in Trauma One.
Lily made a sound behind me.
I swallowed hard, forcing my hands not to shake.
“It’s me,” I said, voice low. “Dylan, listen to me. You’re at Albuquerque General. You were shot. We’re taking you to surgery.”
His mouth moved again.
No sound came out.
I wanted to touch his face.
I wanted to scream at him.
I wanted to ask where he had been for three years, why he had walked away, why he had stayed gone, why his name still lived in me like a splinter no surgeon could remove.
Instead, I pressed harder where the blood was coming too fast.
“Stay with me,” I said.
His pulse beat weakly beneath someone else’s fingers.
Weak.
Wrong.
Unacceptable.
“You hear me?” I said, sharper now. “You stay with me.”
His eyes rolled halfway shut.
“Destiny,” he whispered.
My name.
Not Nurse Rourke.
Not some ghost he imagined.
Me.
The trauma surgeon arrived, and the room swallowed him.
After that, there was no room for feeling.
There was only work.
The OR was ready in less than ten minutes.