It seemed innocent at the time.

"Ad libitum," he'd say with a wink––His go-to refrain when discussing plans to eat, drink, or indulge in light debauchery. As a resident intern at the Pitt, you've scrawled the abbreviation "ad lib." on the charts of countless patients to indicate they could drink, move, or eat freely without restriction. Robby said it with a warmth that caused the clinical frigidity of the phrase to melt away.

On your first day at the ED, an elderly patient of yours sent her friend down the block to smuggle in some greasy takeout in spite of her low-sodium diet. You caught the two scrambling to hide their fried chicken and fries as the doctor rounded the corner behind you, carrying her CT results. "The scan was unremarkable, which means we didn't find any acute or dangerous abnormalities explaining your symptoms—" He paused, noticing the salty food strewn about and the guilty look on their faces. You braced yourself for impact, but instead, Robby just smiled. "Ladies," he chuckled, "recovery is ten-percent science and ninety-percent spirit. Please, don't hold back on my behalf." He removed his readers, then leaned in closer. "Though I may need a little something to keep me quiet." He swiped a single fry from their basket. It got a giggle out of the woman on one of her worst days. From the start, he had a certain way about him you found impossible to ignore. You were awestruck at how he managed to put each of his patients at ease. His stupid dry sense of humor would get old quickly if it weren't so irritatingly charming. When he winked and told the woman that he'd see if the hospital would accept crinkle-cuts as copay, you wanted to groan, but a sappy pit of fondness had nested itself in your chest and would only infect you further. You followed him out of the room, raising a finger to question him about the sodium. "Ad libitum," He gave you a smirk, popping the fry into his mouth before hustling toward the ambulance bay. It won you over on day one. Little moments like those, you had to shake yourself from looking at him as more than a mentor.

You started paying attention to more than his medical lessons. Sometimes you could catch a glimpse of the real Robby. On his good days, he left you pieces of a clearer picture. He seemed fun-loving. Or at least like he used to be. Like he had a bit of a reckless streak that never fully faded. You had hardly any evidence to support that theory, as you'd never seen him touch a single vice. Not even a cigarette. Sex, however… There was a charge in the atmosphere that a certain handful of names brought into the interactions between them, and it fogged up the room like smoke rising from a flame that had since been diminished. Robby was fully capable of being messy. He had the unmistakable air of a seasoned sinner, yet in practice, he lived with the austerity of a saint. Well, he tried to, anyway. You were wishing he'd practice what he preached and loosen up once in a while. Enjoy himself. Start taking care of himself a little, at the very least. "Ad libitum." Yeah right. Something you'd soon learn was that Robby is shit at following his own advice.

Ch. 2

Occasionally, a box of donuts will turn up in the break room. Usually sent by a grateful patient, they gradually disappear over the course of a 15-hour shift as tired and hungry staff members find time to nab a treat or two amidst the chaos. A few minutes of sugary contentment. Something to tide them over til they can eat a real meal. It's the least they deserve.

You've been keeping tabs on Dr. Robinavitch. You've never once seen him touch the donut box. In fact, you never see him eat much at all. For a leader who preaches self-care, he lacks the mental wherewithal to do any sort of meal prep at home. He relies solely on the convenience of hospital food during the workday - Aside from the emergency protein bar he carries in his pocket to keep himself from going dizzy between surgeries. Robby is spread so thin caring for others, he's struggling to meet his most basic needs. Eating for sustinance only. Without pleasure. The bare minimum.

The next time the box of donuts returns, you decide to save one for Robby. If he won't take a break, at least you can pack some sweetness into his shift. It's a beautiful selection; powdered sugar, cinnamon-dusted, vanilla with sprinkles, chocolate glazed… And one long john. Sitting there, fresh and pillowy, its frosting glistening beneath the flourescent lights. Without thinking, you pick that one. You're well aware that it's the densest option in the box. Something about the idea of it going toward Robby, he who cannot indulge, puts a spring in your step. You don't stop to analyze the feeling. You're just excited to do something nice. And Robby loves when you go the extra mile.

You set it on his desk as you pass by. A quiet offering, perfectly placed onto a white napkin. You've got to move on to your next patient. Still, you keep looking back, watching from the periphery to see if he's touched it yet.

He rounds the cubicle and the pastry catches his eye. He slides to a halt, backtracking his steps. Hello, what do we have here? He raises an eyebrow and looks over his shoulder, immediately questioning who is responsible. The man just can't accept a simple act of kindness. No, he's probably searching for some sort of angle. Someone must be buttering him up because they have a favor to ask. Or it's a weak attempt at an apology for one of the first fuck-ups of the day (like that narrows it down any). Or… Someone could be flirting… The phone rings, and he blinks, reshifting his focus. Doesn't matter. Not right now. There's a perfectly good long john with his name on it and he isn't going to waste any time on it. You watch him hover over it for a moment, flicking a finger or two before he closes in.

He lifts the donut to his face. You catch a flicker of something you never expected to see. Longing. Raw, unmasked longing. A smile curls at the corners of his lips before it's lost to the introduction of a truly shameless amount of pastry. Suprised by the amount of filling, he throws an open palm beneath his chin to catch any custard gone astray, teasing it out from the center with the searching curve of his tongue. God. He eats like no one's watching. It sticks to his beard in drabs as he savors the mouthful, eyes rolling to the back of his head. Good choice, y/n. His expression melts into utter bliss, and you watch as he lets the toil of the hospital momentarily fade into the background. You feel a sudden surge of pride. It's the first time you've seen him experience pleasure—real pleasure. And fuck, it looks good on him. It's a ride for you to witness the old stickler let himself come undone, just for a moment. Watching him chew, swallow a swig of coffee. Wipe the custard from his beard. He finishes the whole thing in about four hefty bites, then licks the glaze from his fingers before hitting the hand-sanitizer. He straightens his posture, snaps on a new pair of latex gloves, and just like that, the doctor is back.

The scene rips through you like a twister. You're left speechless in his wake, your mind running wild with saccharine fantasies of a pot-bellied, silver-haired variety. You've very quickly come to terms with the fact that your unwavering urge to impress him was about more than your performance. Let's face it, you wouldn't have brought him the donut if attraction weren't at play—but seeing him revel in it really cemented it for you. Shit. You've got a whopping crush on your attending. You want to be the reason he feels like that again. It takes every ounce of restraint not to fetch him another. Two more. Get him alone with the entire box. You don't even have a second to collect yourself before his hand claps down against your shoulder.

"We've got a vertical decel hitting the door in five. Scrub in, I'll need your hands on this one." You jolt upright, straight as an arrow. "A window washer took a three-story fall. EMS is reporting hypotension and JVD, so we might be looking at a bedside thoracotomy." His voice is all logic and ice. Yet, there’s a smudge of stray frosting right at the corner of his jaw that he missed, mocking his own self-control. It's incredibly distracting. You're barely listening. Your mind is still stuck on the way his eyes rolled back mere seconds ago. He tilts his head, searching your face for a diagnostic reason for your silence. "You okay? You look flushed."

"What?"

"If you're coming down with something, I need to know before we scrub in."

"Oh!" You exclaim, "I'm fine, just overdid it on the caffiene this morning," you feign, shocked that he can sense your unbalance without any hesitation. Not only is he hot, he's eerily perceptive.

He isn't totally convinced. He steps closer, the scent of coffee, cream and sugar still on his breath. You do your best to hold it together as he raises a gloved hand, hovering it just an inch from your forehead as if to check for a fever. You swallow at the near-physical contact. "Hm. Pupils are blown. Any tremors in your hands?"

"Not that I've noticed."

"Alright. Drink some water and meet me in Trauma One."

"Yes sir," you blurt. He smirks and lifts an eyebrow on his way out. Sir? That would be the first time those words have ever left your mouth. He seems amused. Maybe you really aren't feeling well.

Within minutes, the trauma bay explodes into motion. The automatic doors hiss open and a paramedic rushes a woman on a gurney towards you. She appears as if she's choking. "We have a 32-year-old female, fell from three stories washing a client's windows," the paramedic shouts over the rattle of the wheels. The woman is panicking and can't quite seem to get enough air.

"Ma'am, we're gonna take care of you quickly. Can you tell me your name?" Robby asks, guiding the gurney down the hall. Javadi and Whitaker catch up to join you in Trauma One. She can barely manage to wheeze out a word. She's on the verge of blacking out. The paramedic answers for her.

"This is Erin Gable, we found her with a crushing chest injury. En route, she started crashing. BP is 72 over 40, heart rate's 128 and thready. We’ve got distended neck veins and her heart sounds are muffled."

"Beck’s Triad," you say. You recognize those symptoms as the three pillars that indicate fluid surrounding the heart. "We need to relieve the tamponade."

"Prep for a thoracotomy?" Whitaker asks, pushing up his sleeves with haste.

Robby is already in motion, dropping the bed height to match the stretcher with a quick tap of his foot on the hydraulic pedal. "No. Y/n. Tell him why." You feel your own heart skip a beat at the sound of your name, Robby's trusting gaze allowing you a moment to shine.

"We start with pericardiocentesis using the subxiphoid approach. A chest incision is too invasive if we can resolve the tamponade with a needle first."

Robby nods approvingly in your direction. "Can always tell which of the interns stayed awake during cardiology." You hold back a smile, trying not to let the praise take up any meaning in your over-occupied mind. "Okay. Let's get her up, then prep the chest for aspiration. Starting with 20ml of lidocane."

Dr. Javadi stands at the head of the bed, her hands firmly cradling the patient's neck and the top of the drawsheet. You and Whitaker position yourselves on the far side of the trauma table. "On my count. One, two, three—" With a synchronized surge, the team uses the sheet like a hammock, pulling the woman laterally across the slider board in one swift motion.

Robby shoves the ultrasound probe into your hands. "Y/n, I'll need a subcostal view."

You slide the probe into place, revealing the fluid-filled sac squeezing the heart. "There. Looks like significant effusion."

Robby rounds the table to make eye contact with the patient while he preps the lidocane injection. "Ms. Gable, I'm Dr. Robinavitch. Your heart lives in a little protective pouch, and some extra fluid has leaked into that pouch. There's so much fluid that it’s putting pressure on your heart and preventing it from pumping enough blood to the rest of your body, which is why you feel like you can't breathe in enough oxygen. I'm going to make a small opening right at the bottom of your sternum," he places two fingers at the barrel of her chest, "Right here," then positions the needle. "A pinch from the numbing medicine…" He injects the lidocane. "And in a moment, some pressure as I use a needle to drain the fluid. As soon as I do, that pressure will vanish, we'll get your heart pumping normally again." He holds out his hand, and Whitaker places an 18-gauge needle and syringe into his palm. He looks to you. "Y/n, grab the syringe and attach the stopcock. When I go in with the needle, make sure you maintain constant negative pressure. You feel a pop, you pull. Understood?"

You reach out, your fingers brushing his as you grip the syringe. You are so close you can see the individual lashes behind his glasses… and that distracting, sugary smudge on his jowl. It’s a maddeningly soft detail in a room full of sharps and stainless steel. You try to keep your head above water, but your mind is practically flooding with imagery of the surgeon before you gulping down calories as if it were the only mercy he'd ever allow himself.

You hesitate, your pull on the plunger faltering. He shifts his attention from the monitor, eyes peering at you over his frames, sharp enough to pin you in place. "I asked you a question. Why are you looking at me like I’m the one on the table?"

"Sorry. You pop, I pull. Got it."

Robby's hands steady the needle at the sternum with painstaking accuracy. He aims it toward the left shoulder from a 45-degree angle, the tip of his tongue peeking through his lips in an unconscious quirk of focus. It's impossible for you to forget that minutes ago, he was wielding that tongue to extract the heart of a pastry with the very same efficacy he brought to his precision tools.

His needle pierces the skin. He leans in just a hair closer to you, his presence overwhelming. “Because if something’s wrong—if you can’t focus—you need to step out. Right now." His whisper comes out in a gravelly rasp that vibrates in the small space between you. Better fold or this won't end well.

"It's not me. It's… Um… You've got a little…" you trail off, gesturing to your own mouth. He gets the idea, brow twitching in a poorly masked flush of embarrasment. His knuckles are pressing against the patient's ribs, maintaining the exact millimeter of depth needed to avoid a fatal slip. His hands are sterile. Trapped. He can’t do anything about it now.

"And you waited until now to tell me?" A prickly heat crawls up your neck, one you haven't known since you got in trouble with the adults in grade school.

"I didn't want to interrupt."

His gaze remains fixed on the ultrasound monitor. "Just— Fix it. Before the nurses start taking pictures."

Fix it. The audacity of the command is enough to make your blood run hot. He says it with a furiating level of nonchalance. Without tearing his eyes off of his work, he tilts his head back just a fraction of an inch, offering his chin to you in quiet challenge. God, he's got some nerve. Is he truly expecting you to do this for him in the middle of a procedure? Then again, could you really leave him looking like this, knowing you're technically to blame? There's a nagging sense of clarity that if you don't fix it now, you'll spend the rest of the day wondering how it would feel to have done it. With your free left hand, you turn to your side to feel for a piece of gauze. You knock a scalpel to the floor. Damn it, y/n. Keep it subtle.

"Don't let that plunger slip," he murmurs, his concentration unbreaking. Ohh, fuck him. He's enjoying this, isn't he? Mr. 'maintain constant pressure.' Right. Does he know it was you who left him the donut? Is he just testing to see if you'll have the nerve to touch him while the room is watching––?

The harsh ringing of the heart rate monitor pulls you back to reality, a cold reminder that a life is currently leaking out onto the table in front of you. You suddenly remember exactly where you are. Woah. Knock it off. You are getting worked up over nothing. Robby's your boss. He has a reputation to keep. His hands are occupied and you're the only one close enough to help him out. That's all.

The pad of your thumb grazes his jaw. Somehow, the stakes feel higher than the actual surgery. You pull back before anyone can blink. Don't overanalyze it... You force it down. Try to shrug it off. Pretend it never happened. But Robby's eyes meet yours, holding them for a beat of silent gratitude that makes your stomach drop.

He snaps his head back to the ultrasound screen. "Focus up. I’m at the pericardium. Pop in three... two..."

The needle gives way, and a sudden flash of brown fluid surges into the syringe. The monitor’s panicked chirping smooths into a steady, healthy thrum. "Pressure's coming up! 90 systolic!" Whitaker calls out, breaking the spell you're under.

Robby lets out an adrenaline-fueled exhale, but remains next to you, unmoving. His shoulder brushes yours as he begins threading the catheter. He tells Ms. Gable that you successfully relieved her heart, and that they will be leaving a catheter in her chest to keep the pericardium from refilling. They're getting imaging of her other injuries and moving her up to the ICU to keep a close eye.

You watch him step back, his broad shoulders relaxing slightly as the tension of the procedure drains out of the room. He turns his attention back to the chart, completely unaffected, leaving you trapped in your own head. Does he have any idea how much he shook you just now? You're dying to know what he's thinking behind those sharp eyes, but frustratingly, he remains… Robby. An unreadable wall.

He catches you outside of the doorway as he discards his surgical gloves. "Nice work in there. Not only did you save the patient's life, you also saved me from what could have been a very embarrassing group chat correspondence." He looks at you, his expression warm but firm. "Precision is a requirement of this department, Dr. y/n. If I'm lacking it... By all means. Speak up next time."

As the nurses begin wheeling Ms. Gable out toward the ICU, he gives you one last nod before walking away, leaving you to question whether he’s actually oblivious or just enjoys watching you squirm.