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Tim was no stranger to sickness.
Before getting diagnosed with cystic fibrosis at age eleven, he’d always been sick. His lungs had been so full of crap that he’d constantly felt like he was drowning. The slow yet steady decline had continued in a downwards spiral until finally, he’d had to call 911 on himself. The rest, of course, was history.
With miracle drugs like Trikafta and proper care, Tim had gotten better. Trips to the hospital became more and more rare, doctors’ appointments got spaced out to every few months, and Tim had been able to lead a mostly normal life.
Then, he’d lost his spleen.
Before the car accident eight months ago, a fever was no big deal. Bruce would watch him closely, of course, as he did any of his children when they were sick, but as long as his lungs and oxygenation remained stable, Tim had been allowed to ride out most minor illnesses from the comfort of his own bed.
Not anymore.
As Bruce and Leslie had explained it, Tim’s immune system now sucked. Like, even more than it already had. Cystic fibrosis made him more susceptible to lung infections, but not having a spleen made him vulnerable to everything. And to make matters worse, every single fever was now treated as a medical emergency. Every. Single. One.
Since his splenectomy, Tim had already been sent to the ER three times for fevers and admitted twice. The last time had been because the entire Wayne household (save for Cass, because apparently her immune system was flawless) had contracted the flu. His brothers had spent the week getting coddled by Alfred in the Manor while Tim had been forced to stay in the hospital for three days. He was over it.
Of course, the universe didn’t care about his feelings.
He woke up with a deep, terribly familiar ache in his bones. His muscles throbbed despite the fact he hadn’t moved yet, and he found himself shivering underneath his thick blankets. Part of Tim was tempted to go back to sleep and try again, but he’d already snoozed his alarm twice.
No, he pleaded with his body. Not today. Any day but today.
He was supposed to take Stephanie to the aquarium for their first date. The entire day was planned out to the minute: first, he was going to pick her up and take her to her favorite coffee shop for breakfast; then, they’d spend a few hours at the aquarium before heading to the pier so they could watch the sunset from the top of the ferris wheel. It was going to be perfect.
Which was why he couldn’t be sick. He simply ~refused~.
With a determined huff, Tim forced himself out of bed, inwardly cringing at how his limbs protested the movement. Maybe if he ignored the icky feelings and went about his day, his body would eventually get with the program. After dressing in a t-shirt, jeans, and cardigan (because he was freezing), he started his morning airway clearance routine. As always, he started with two nebulizer treatments: albuterol to open up his airway and hypertonic saline to loosen up the gunk in his chest. When he was finished with them, he threw on his vest and turned it on. His CPT vest usually ran for twenty minutes. Fortunately, it was wireless, so Tim could still move around and finish getting ready while getting his treatment. He had just finished brushing his teeth when he got a text from Conner:
Dude, good luck today! I wanna hear EVERYTHING when you get home tonight. Also, remember not to use too much tongue right out the gate ;)
Tim rolled his eyes. Conner had it easy when it came to girls. Not only did he had zero health issues, but he was also over six feet tall with perfect skin and the confidence to back it all up. Meanwhile, Tim was seventeen-years-old and had never even kissed a girl. And this wasn’t just any girl, either. It was Steph. Steph, who had been his best friend just as long as Conner had. Steph, who was the most beautiful human being Tim had ever lain his eyes on. It had taken him years (and lots of teasing from his siblings and friends) to garner the courage to even ask her out. A part of him was still in denial that she had accepted.
A coughing fit interrupted his musing. It was normal for him to cough during his vest sessions (as getting the mucus out of his chest was pretty much the whole goal). What wasn’t normal, however, was the way the coughing left him dizzy and struggling to catch his breath. His mucus was also much, much thicker and yellower than usual (which, ew). Despite his better judgement, however (because better judgment often lost when put up against a pretty girl in a teenage boy’s mind), Tim continued with his vest therapy as if nothing were amiss. Nevermind the growing tightness in his chest and dizziness developing in his head. He could get sick tomorrow, after he blew Steph’s mind with the best first date ever.
When his vest finally cut off, Tim took a minute to catch his breath. His cough was still wet and grossly productive. He wiped his mouth with a tissue for what felt like the hundredth time that morning before heading downstairs. If he could just get past his family without anyone noticing he was off, then he’d be in the clear.
Everyone was in the kitchen. Jason, Damian, Cass, and Bruce were sitting in the breakfast nook eating while Alfred stood washing dishes over the sink.
“Morning, Timmers,” Jason greeted cheerfully, his mouth full of pancakes and bacon. “Today’s the big date, isn’t it?”
Tim forced a smile. He could do this. He could act normal – he'd had a lifetime of practice pushing through illness. No one needed to know. “Sure is.”
Damian glanced up from his plate. It looked like he’d been cutting his pancakes into small, symmetrical squares. “Is that what you’re wearing? Where’s the decorum? I know Brown must not have high standards, seeing as she’s agreed to court you, but what even is My Chemical Romance?”
There was no venom behind his little brother’s words, but Tim couldn’t help but feel defensive. “It happens to be our favorite band. She’s actually the one who bought me this shirt.”
His voice was a little (okay, maybe a lot) hoarse, but he could blame that on the vest if anyone said anything. Now, he just needed to grab his keys and get out of there before –
“Tim.”
Bruce materialized right in front of him. When his father had gained the ability to teleport, Tim didn’t know.
He cocked his eyebrow. “Yes? May I help you?”
His dad narrowed his eyes at him. Tim’s heart dropped into his stomach. He knew that look. It was the look that reminded him that Bruce Wayne had been an ER physician for twenty years and could spot a fever from a mile away. With his eyes closed.
“You’re pale.”
“I just had a rough vest session,” Tim waved off. “I’m fine.”
He knew the hand was coming, but in his groggy state, Tim was too slow to dodge it. Bruce’s palm settled onto his forehead, and that’s when all of his hopes and dreams were crushed.
“Buddy, you’re burning up,” the doctor informed gently. “Alfred, can you grab the thermometer, please?”
Internally, Tim was screaming. He’d been so close. “I’m fine, Bruce. Really. I don’t even feel that bad.”
Bruce took the thermometer from Alfred. “Then prove it by letting me take your temperature. If you’re really as fine as you say, the number will reflect that.”
Ugh. Tim hated it when his bluff was called. With a huff of defeat, he accepted the probe from his dad and tucked it underneath his tongue, praying to every deity out there that the number would be less than 100.4.
“102.8.”
Dammit.
“Maybe it’s just a fluke,” Tim tried, even though he already knew it was futile. “How about we check it again tomorrow, and if I still have a fever, then I’ll go in.”
Bruce set the thermometer down on the counter then put both of his hands atop his son’s shoulders. “Tim, sweetheart, I know you were excited for your date today, but you know a fever means we have to get you checked out. I’m sorry, but your health is my number one priority. I’m sure Stephanie wouldn’t want you to put yourself in danger on her account.”
He was right. Of course he was right. But that didn’t mean Tim had to like it.
“I shall go ready the hospital bags,” Alfred volunteered.
“I’ll help,” Jason offered, pushing himself to stand.
Bruce led Tim over to the table and got him settled into one of the chairs. Tim didn’t protest. He knew there was no use fighting it anymore. Beside him, Cass grabbed his hand and squeezed it encouragingly.
“Shall I go fetch your satchel, Father?” Damian asked, glancing worriedly back at Tim.
Their father nodded. “Yes, please, Habibi. Now, Tim, why don’t you tell me a little bit about how you’re feeling? Honesty would be preferred.”
Tim winced. He was definitely going to get lectured about trying to hide a fever later. “I, um, just woke up like this. All achey and sweaty and such. I coughed a lot more than normal during my vest, too.”
“What does your mucus look like?”
Normal parents asked their kids how their math test went. Bruce Wayne, however, was no normal parent. The man always wanted to know gross things about his children.
Even still, Tim answered his question. “Really thick and yellow.”
“Any shortness of breath?”
“Some, but not as bad as it was during my vest.”
“Nausea? Vomiting?”
He shook his head.
Damian came back with the bag Dr. Wayne carried with him to the hospital and clinic. Bruce thanked his youngest then dug through satchel until he found the pulse oximeter and his stethoscope. Tim allowed the device to be placed onto his finger then sat still while his dad listened to his lungs. Maybe if he was extra cooperative now, it would make Bruce go easier on him later.
“You sound pretty junky,” the doctor observed before glancing at the oximeter, “and you’re only at 90%.”
“That’s not bad enough to need oxygen,” Tim pointed out.
“Normally, no, but you’re breathing pretty fast, kiddo. Are you honestly going to tell me you’re not struggling right now?”
He was. Tim could feel his poor lungs working overtime just to scrape by.
“I can manage.”
Cass frowned at him. “Stop being stubborn. Let Dad help.”
Tim sighed, blinking away the tears of frustration that threatened to spill from his eyes. “I just don’t wanna go.”
It wasn’t just missing his date with Steph (though that definitely hurt the most). It was everything being taken in entailed: long hours of waiting in the ER, constantly being poked and prodded, being woken up incessantly throughout the night, and – perhaps worst of all – the constant feeling of being watched. There was no such thing as privacy for a hospital patient. Doctors and nurses and respiratory therapists and dietitians and a million other different people rotated in and out of his room in a never-ending cycle. Not to mention morning rounds, which involved a crowd of medical students and residents circling his bed and presenting on him like he was a freaking zoo animal. For an introvert like Tim, the hospital was an absolute nightmare.
Bruce placed a hand on his shoulder. “I know, honey. I wish more than anything that there was another way to keep you safe, but I want you to live a long, happy life. And right now, that means getting you to the hospital so we can nip this in the bud before it gets worse.”
Any resistance he had left crumbled. There wasn’t any point, anyway. Bruce wasn’t going to back down, and Tim was too tired to keep fighting.
He sagged against his seat. “Okay.”
The next ten minutes went by in a blur. Alfred and Jason loaded the car with their luggage while Bruce gave Tim a dose of his emergency oral antibiotics and put him on some oxygen via his portable concentrator. As much as he hated the feeling of the nasal cannula in his nostrils, Tim couldn’t deny that it helped, at least a little bit. Cass promised to call Steph and let her know the situation as soon as he and Bruce left for the hospital. It made him feel like a coward, but he was glad he wouldn’t have to hear the disappointment in her voice.
“All right, Timmers, you should be good to go,” Jason announced as he re-entered the kitchen with Alfred. “I put your laptop, headphones, and Nintendo Switch in your backpack. It’s in the front seat along with your pillow and weighted blanket.”
Tim allowed Bruce to pull him to his feet. “Thanks, Jay.”
Cass hugged him tightly. “Feel better, Little Brother. We will visit when you’re ready. I love you.”
“I love you, too, Cassie,” he said, returning the embrace. His sister knew Tim preferred as few people as possible with him in the ER. It was such an overstimulating place already. He’d allow his siblings to come see him later, after he was settled into a room.
As he walked out of the kitchen towards the front door, Damian caught his hand.
“I’m sure Brown will understand your circumstances and allow you to reschedule,” he assured, “so you needn’t waste your energy fretting. You’ll need your strength to recover.”
Tim ruffled his little brother’s hair. For once, the youngest Wayne didn’t protest. “Sure thing, Dames. You needn’t waste your energy fretting, either. I’ll be fine.”
Damian narrowed his eyes. “You better be.”
They got on the road pretty quickly after that. Tim put his headphones in and blared his music (MCR, in honor of Steph) so he wouldn’t hear Bruce call ahead. One good thing about being a Wayne meant Tim never had to sit in the waiting room. He was triaged like anyone else, of course, but if the ER was super busy (and he was stable enough to wait), he just hung out in Bruce’s office until they had an open bed for him. Though even if his father hadn’t owned the hospital, his asplenia and cystic fibrosis were typically enough to get him to the front of the line anyway.
Bruce pulled into Wayne Memorial Hospital’s ER drop off area. He jumped out of the car and ran inside to grab a wheelchair. Normally, Tim would’ve fought him on it, but he was just so tired. Just in the twenty minute drive, he’d gotten noticeably worse. His coughing fits were stronger and almost constant. Even when he wasn’t coughing, he felt like he could never fully catch his breath. He’d been hypoxic enough times in his life to know the portable concentrator simply wasn’t cutting it anymore. It terrified him to think how quickly he had gone downhill.
“Donna’s taking you today. She’s waiting for us inside,” Bruce informed him as he ushered Tim into the chair.
Good. At least Donna was nice. She was a close friend of Dick’s.
After locking up the car, Bruce wheeled Tim into the ER past the main waiting area to where Donna was posted.
“We got room three ready for you guys,” she said, holding the door to the department open for them. “Respiratory’s already in there setting up the high-flow. Figured we might need it.”
The High-Flow Nasal Cannula was the bane of Tim’s existence. It was so dang uncomfortable, like having two leaf blowers shoved up his nostrils. Still, he’d take anything over the feeling of intense suffocation he was currently experiencing, so he didn’t complain.
Once they were in the room, Bruce helped him get onto the stretcher so Donna could start taking his vitals. Luke Fox, a first-year attending and the son of WE’s CEO Lucius Fox (whom was basically family to Bruce), joined them moments later.
“Good morning, Tim,” he greeted, waving his hand under the sanitizer dispenser. He then nodded to Bruce. “Dr. Wayne.”
Bruce helped Tim adjust the pillow behind his back. “Just ‘Bruce’, today, Dr. Fox.”
“Whatever you say, Boss. Donna, how are our vitals looking?”
The nurse wrote down the numbers on the monitor with a slight frown. That was never a good sign. “His temp’s up to 103.1, and his heart rate is in the lower 130’s. BP is 100/58. He’s tachypneic at 36 breaths per minute with an O2 sat of 86% on five liters. I just switched him from his portable concentrator to the wall.”
“I’ve got the HFNC set up here,” the respiratory therapist (Tim believed her name was Harper) informed. “What settings would you like to start him on?”
“Forty liters and 50% FiO2. Adjust from there as needed to keep him at least 94%. Donna, go ahead and trigger the sepsis protocol. I’d like to get blood cultures, CBC, CMP, lactate, and a blood gas. I also want to swab him for a full respiratory PCR and get sputum and urine cultures along with a STAT chest x-ray. Do we have a weight on him yet?”
The nurse nodded. “50 kilos.”
“Perfect. Let’s give him a liter NS bolus and start him on 2 grams of cefepime, 750mg of vancomycin, and 500mg of tobramycin.”
Donna scribbled the orders down on her notepad. “How about some Ofirmev for the fever?”
Dr. Fox nodded. “That’s fine. Do 1000mg.”
While the two women got to work, the doctor started his assessment. He asked Tim all the usual questions, like how long he’d been feeling sick, what his symptoms were, etc. Tim answered the best he could, but it was hard to talk with how out of breath he was. Luckily, Bruce automatically picked up the slack and finished what he couldn’t.
“Yeah, your lungs sound pretty gross,” Luke observed, “and you’re retracting pretty hard. I’m going to page Dr. Holt and let him know you’re down here. It sounds to me like you’ve got an exacerbation that’s been made worse by pneumonia.”
“L-lucky me,” Tim wheezed in between breaths. “Do…do I hafta go to the ICU?”
The doctor frowned. “Right now, you’re in pretty significant respiratory distress. If you improve on the HFNC and we're able to wean the flow some, then you may be able to get away with going to the step-down unit. But we’ll have to see how things go. For now, let’s focus on getting you stable.”
And with that non-answer, the doctor took his leave.
Since she’d had time to prepare for his arrival, it only took a of couple minutes for Harper to finish setting up the HFNC. The first blast of warm, humidified air up his nose hit him like a truck and made him jerk.
Bruce rubbed his hand up and down his son’s back. “It’ll get better, bud,” he assured, “just try to relax and let the flow do its job.”
Tim gave a shaky thumbs up.
When Donna returned with her cart of meds and IV supplies, Crystal followed her. She must have been in charge today.
“Timothy Drake-Wayne, what are we going to do with you?” She sighed, shaking her head as she donned some gloves.
He huffed. Now that the HFNC had been on for a few minutes, his world had started to clear. He found himself able to breathe easily enough to speak in full sentences. “Trust me, this is not how I planned on today going. Do you think Steph’ll forgive me?”
The nurse rolled her eyes. “Don’t be silly. Cass called her and told her what going on. She’s worried sick. Now, let us take care of everything for now, okay? I’ll have Steph call you later, once you’re stable and feeling up to it.”
Tim sagged against his pillow. He was exhausted. “M’kay. Just please don’t put my IVs in the bends of my elbows. The pump always beeps when I move.”
“I think we can make that work,” Crystal smiled as she inspected his veins. “If I remember correctly, you usually have some pretty good ones in your forearms… Yep, this one will work beautifully. Donna, how’s it looking on your side?”
The younger nurse nodded. “Oh yeah, I’ve got a really good one right here.”
This was why Tim loved nurses.
After his IVs had been inserted and fluids and antibiotics hung, the nurses cleared out, leaving Bruce and Tim alone for the moment.
“Do you think they’ll send me to the ICU?” He asked shakily. The PICU afforded him even less privacy than the floor did, and most of the rooms didn’t have windows. It made him feel claustrophobic and trapped. On top of all that, the visitor restrictions were more strict, meaning his friends and family would have to come see him in shifts.
His dad glanced at the monitor. He hadn’t moved from his post beside the stretcher. “Honestly, bud, I think it's a high possibility. Right now your O2 is at 91%, so it’s going up, and your work of breathing has improved a bit, but it's still not where it needs to be. Beyond that, you need to be monitored very closely for any signs of deterioration. Dr. Fox and Dr. Holt will probably want you in the PICU just to be safe.”
Tim bit his lip. “What would you do if you were the doctor?”
“I’d pawn the decision off on your pulmonologist,” Bruce replied, rubbing his hand over his face.
“Dad,” Tim complained, rolling his eyes. “I asked a serious question.”
“Okay, okay,” the doctor placated. “Truthfully, it really would be a team decision. I would ask Dr. Holt his opinion and probably reach out to the PICU doctor as well to get theirs. But as the ER attending typically gets the final say, I’m honestly leaning towards the ICU. I know that’s not what you would prefer, but you're on a lot of oxygen right now, and if your condition were to worsen any further, I’d want you to be where they can escalate care quickly and safely.”
That was not what he wanted to hear. Tears pricked his eyes once again, and this time Tim was too tired to fight them.
Bruce immediately wrapped his arms around his son. “I’m so sorry, bud. I know this sucks.”
“I hate this,” Tim sniffled against his dad’s chest. “I hate being the sickest one in the family. I was finally starting to feel like a normal kid.”
“It’s going to get better,” Bruce assured. “I know it doesn’t feel like it right now, but your body is adjusting to not having a spleen. Eventually, you won’t get sick as often. It just takes time.”
Tim wiped his eyes and let out a shuddery breath. He needed to get himself together before the next person came in (which would probably be way too soon). “Y-yeah. Sorry, I didn’t mean to get overly emotional.”
His dad pressed a kiss into his hair before pulling away to look into his eyes. “Don’t apologize, sweetheart. I know this is really hard, especially since you don’t feel well. I promise to be here for you no matter what ends up happening.”
Tim shivered, pulling his blanket closer. He just hoped the meds made him feel better soon.
A few hours later, Tim finally got settled into a room.
Despite his begging, the doctors had admitted him to the PICU. Dr. Holt had promised to try to transfer him after a day or two, but for now, Tim was simply requiring too much oxygen for the step-down unit to take him. On the up side, he felt a bit better than he had earlier, now that he could actually breathe (and had lots of drugs in his system). He’d even managed to take a short nap while waiting on transport.
“Hey, buddy, are you feeling up for a visitor?” Bruce asked gently, pausing in the doorway. He’d stepped out a few minutes prior to call the Manor to update everyone.
Tim furrowed his brows. His siblings weren’t supposed to come until later (Dick had already offered to bring him dinner). “Who?”
In lieu of a verbal answer, his dad stepped aside.
Stephanie.
His girlfriend (they hadn’t technically gone on a date yet, but he was going to go with it) looked beautiful. She was wearing an oversized purple sweater and a black skirt with tights and a matching bow tied back in her flowing, blonde hair. In her hands, she carried two full, plastic cups and a white paper bag.
“Hi,” she greeted gently, coming fully inside the room. “Bruce told my mom you were starting to feel better and had been cleared to eat, so I brought you some iced coffee and pastries. I thought maybe, if you’re feeling up to it, we could still have our date.”
Tim was suddenly very aware of how horrible he must look. He’d been sweating on and off for hours as his fever went up and down, leaving him feeling very sticky in the process (because of his CF, his sweat was extremely salty and therefore even grosser than a normal person’s). Not to mention the thick nasal cannula taking up most of his face and the sickly, pale tint to his skin.
“Steph, I’m so sorry,” he lamented, his voice hoarse from all the coughing he'd been doing. “You deserve much better than… this. I feel like I ruined everything. Please forgive me.”
Stephanie sat the bag and cups down on Tim’s bedside table then pulled a chair up to his bed. Bruce, Tim noticed, silently snuck out of the room, shutting the door behind him.
“Tim,” Steph began, taking his hand in hers. Her skin was warm and soft. “You didn’t ruin anything. You got sick. It happens. There’s no need for apologies or forgiveness. We can go to the aquarium another time.”
“But you shouldn’t have to deal with this. You’re amazing, Steph. You could have any guy you wanted. I just don’t understand why you wouldn’t want someone else. Someone normal.”
“Timothy Jackson, get the fuck outta here with that shit,” Steph ordered. “I don’t want anyone else. You’re my person. No one gets me like you do. Yes, you have your struggles, but my life hasn’t exactly been sunshine and roses, either. My dad’s in prison, for crying out loud! But you don’t judge people by the shit they have to carry. You judge them by how they treat you in spite of it all. And no one has ever treated me better than you.”
He perked up. Her words seemed to good to be true, but that could be said about anything pertaining to Steph. She herself was too good to be true, yet here she was. “Really? You mean that?”
She smiled at him. “Hey, if Grey’s Anatomy has taught me anything, it’s that hospitals are the best places to develop a budding romance. Just don’t tell my mother I said that. She hates that show on account of their unrealistic portrayal of nurses. So, what do you say? You feeling up for a coffee date, hospital-style?”
His heart felt all gooey (in a good way, like freshly baked chocolate chip cookies). How on earth did he manage to snag a woman like Stephanie Brown? “I would love nothing more.”