Been kicking this around in my head for a long time.  Hope you like it.

It was a typical Saturday evening the in ER in the summer.  She could see the fading sun through the ambulance bay doors as they opened bringing in the usual chest pains and abdominal pains.  Putting down her dictation software, she tuned in to the familiar sound of the EMS radio: more business.  This call was different though, an 8-year-old girl hit by a car on her bicycle.  From the tone of the paramedic’s voice, even before vitals and GCS were given, she could tell it was bad. They called a Level 1 and people anxiously began to assemble.  Children always made it harder.  She watched from her computer as the trauma surgeon arrived.  Inwardly, she was thankful it was him.  She would have trusted him with her own family.  He caught her eye and called her name.  It was wordless, but he was asking her for help.  Taking a deep breath, and steadying the fear she always felt before resuscitations, she stood and joined him in the trauma bay.
They talked strategy in the moments they had before she arrived.  Airway set up, chest tube set up, Xray at bedside, ultrasound at bedside. Charge readied the blood bank and called the OR, while she meticulously set up a tube for a child that size. She checked and double checked her equipment.  Suction, double set up, glidescope, LMA all within reach and she positioned herself at the head of the bed.
EMS arrived almost at a run. She only needed one look to know this young girl was in bad shape.  They were bagging her and there was more blood on the stretcher than she thought a young girl that size could bleed.  Her light brown curls sprawled on the gurney as they positioned her for intubation.  As she slipped the tube through the cords, she looked up briefly and caught the trauma surgeon’s eyes.  She saw something there she had never seen before; fear.  It was only for a split second before he replaced his mask, but it was unmistakable.  She wouldn’t leave him to do this alone.  Setting up the vent, she changed her gloves and nodded imperceptibly waiting for his instructions.
They worked on her for an hour and a half.  Bilateral chest tubes, 14 units of blood, a grossly positive FAST, but just as they readied her for the OR, she lost her pulse.  They exchanged a glance and he opened the chest. 7 more units of blood and 30 minutes later, they were on their 7 round of intracardiac epi and he had cross clamped the aorta.  Still they couldn’t get a pulse back. A repeat FAST showed a significant increase in free fluid and they both knew.  She caught him gently stroking her hair while they performed the next two minutes of chest compressions.  A pall came over the room as the pulse check came.  No one could feel one, the monitor showed asystole.  They had lost.  She had never heard the room so silent as he whispered the time of death.  Some of the staff cried, she could hear quiet sobbing from some of the nurses.  She just felt numb. Tamping down her own emotions, she busied herself with covering the girl as best she could, so her family could see her.  She still had to lead, she would process things at a later time.  She had to be strong for her team.  He placed a hand on her arm as he walked past her towards the room where the family was waiting.  She nodded gravely.  This was the worst part.   She stood in the back of the room, in solidarity as he broke the news to the distraught parents.  Those screams never left you. She watched as he helped hold the mother upright as she sobbed, and they both silently retreated to the door, unwitting voyeurs to unimaginable grief. 
After a period, they brought the family back to see their daughter.  The nurses and techs had removed as much as possible from the room and despite the equipment still present, the young girl looked like she could have been sleeping.  Her parents and her younger brother said their goodbyes.  They closed the door and waited.  Neither said anything, lost in their own thoughts.   The grandparents arrived to bring the boy home.  When he passed the trauma surgeon, he gently tugged at his coat.  He squatted so he was at the boys level. 
“Thank you for working so hard to save my sister,” he said in barely a whisper with huge tears glistening on his eyelashes. The boy then threw his arms around the trauma surgeon in a gesture that seemed to catch the surgeon off guard.   He let go, and was led by the hand out of the ER by his grandparents.  Everyone else watched the boy, but she watched the surgeon.  She saw it before anyone else.  His mask slipped and she watched a sudden rush of grief and failure crash over him. His jaw line hardened and his muscles clenched furiously.  She watched as his nostrils flared and he pursed his lips in a tight line in a desperate attempt to regain composure.  She thought for a moment he might succeed, but quickly realized as his eyes began to sparkle that he would lose his battle here in the middle of the trauma bay.  She acted quickly, guiding him by the arm in the opposite direction down the hall. No one would have judged him, but she knew he would not want to be a spectacle.  She badged them into the ER physician’s locker room, and slid her hand down his arm to squeeze his hand.  Out of respect, she did not look at him, and keeping one hand on the door, she turned to give him his privacy.   He did not let go of her hand.  Locking eyes with his brimming ones, she knew he needed someone who understood, someone who had been where he had. He could not bear this alone.
He led them to the single bench where he sat and she lowered herself carefully.  She wasn’t sure why but she was ginger and quiet as if she moved too quickly she would spook him and he would bottle things up again.  Wordlessly, she waited.  He took in a long hitching breath and let it out in a sigh that held the weight of the world.  He bowed his head and closed his eyes, the tears now with nowhere else to go sliding down his cheeks.  He still held her hand in his and made no attempt to hide them.   They hung briefly on his chin, catching the light and then painted tiny dark spots of grief on his scrub pants next to her blood.  He looked almost surprised by them, as if they were something he hadn’t seen in a long time.  When he spoke, she barely heard the whisper. 
“We did everything we could, right?”  His chin and lower lip quivered as he finished with a sigh, trying to stifle a small sob.  He knew the answer as well as she did, but she nodded gently, and gave his hand a tiny squeeze.  “I know.” He nodded, raking his other hand over his face.  He laughed mirthlessly.
“And I thought the parents were the worst part,” he choked, shaking his head as his smile reflexively turned downward and his laugh turned more into a sob.  Her eyes still downturned, she watched his chest move up and down as he fought with his emotions.  Abruptly he stood and walked to the other end of the room, one hand rubbing the back of his neck.  
“Sorry, you probably have patients,” he apologized, as if suddenly embarrassed by his lack of control.  She stayed seated, but assured him,. 
“My shift is over. I don’t have anywhere else to be.”  He turned around to face her though kept his head bowed and leaned heavily on the locker behind him.  He brought one hand up to hide his eyes as his breath caught in his throat and she watched his face fall.  She crossed the room, and placing a hand on the back of his neck and the other on the small of his back, she drew him softly to her.  He kept one hand over his eyes, it pressed firmly against her shoulder.  The other he snaked around her waist.  He was gentle, but he held her in a way that she knew how badly he needed her strength.  She felt rather than heard him sob as he shuddered under the weight of their loss.  After a few minutes, he pulled back, studying the floor. He pinched the bridge of his nose and took several heavy breaths.  The memories of tears hung on his cheeks and a few changed directions as his chin quivered with each inhale.  At that moment, the overhead speaker interrupted them. 
“Code Yellow Level 1, ER room 3. Code Yellow Level 1 in ER room 3”  He touched his fist to his mouth closed his eyes and drew a long breath.  She watched as he scrubbed his face and with great effort slid the mask back in place.  He looked for all the world like a confident unflappable trauma surgeon, a jarring and stark comparison to the man she had shared the last few moments with. 
He cocked his head slightly and gave her a resigned smile. Squeezing her hand, he moved past her and said,
“Duty calls.”  With that, he opened the door and left.   For some reason, watching him pull himself back together to go save someone else broke the last of the composure she had.  The weight of what had happened and the weight of him shouldering his grief for another time was too much.  Unable to stop it, she sat on the bench, put her head in her hands, and cried.