Michelle's Fanfiction

Title: The Madhouse
Author: Michelle
Email: michelle [at] waking-vision.com
Fandom: LotRPS
Summary: Viggo is a consultant in one of the busiest A&E departments in London. Orlando is just starting out as a resident and quite obviously Viggo hates his guts. Or does he?
Pairing: Viggo/Orlando
Genre: slash
Warnings: AU. This story takes place in a hospital, so please expect needles, monitors that beep and the occasional blood-splatter. And yes, patients might die. If it’s any consolation: This is more “Grey’s Anatomy” than it is “The Pitt”.
Rating: Explicit
Disclaimer: I’m sure many people are called Viggo or Orlando. But I can promise that I don’t know any of them. (And that’s a shame.)
Author’s Note I: This is a very late entry for 2025’s Medwhumpmay. The prompt sheet can be found here. And while this story contains a bit of whump and h/c the main focus is the character dynamics. I started writing this having no more than the premise for the first chapter and the authorial voice. I love to research and I love to make the backdrop of my stories as realistic as possible. But maybe it’s better if you imagine that my evil twin wrote this story. The idea here was to explore a different version of V/O. I never planned on the story getting this long and elaborate. Initially, this was simply a palate cleanser that I wrote in-between; research and accuracy weren’t exactly at the forefront. Which is to say: I apologise to everyone working in the medical field. I know this is not how foundation training works. And I know this has basically zero in common with the inner workings of the NHS. Just roll with it. This one was written for funsies!
Author’s Note II: This story was heavily inspired by me binging “24 Hours in A&E”. That show is actually where the title comes from. Some episodes inspired chapters in this story. And even if the story doesn’t come with my usual level of research the medical facts and procedures are as accurate as I could make them (as an ordinary person without – and I say it again – any background in medicine). I’ve added a cheat sheet with terminology/definitions for everyone who likes that sort of thing. However, all explanations necessary to make sense of the plot are within the story. The cheat sheet is a bonus, you don’t have to use it. And anyways, the hospital is only the backdrop of the story, the boys are the main attraction. Feel free to let the medical language wash over you without understanding a word of it.

ALT. PROMPT: CATHETER

The x-ray didn’t take long. The unit could be moved between bays, which meant there was no need to relocate patients for a simple chest x-ray. After that was taken care of a porter showed up to take Viggo away for his echo. Orlando stayed behind, not feeling like he had any right to tag along. Viggo was a big boy, he didn’t need Orlando to nanny him.

When Viggo came back and the porter pushed the bed back into Bay 7, quite a bit of time had passed. Orlando knew that finding a diagnosis and treating patients could come with a lot of waiting around for other people to do their job. But he’d never felt it so keenly. Usually, he was on the other side of the invisible wall and had lots of things to do.

All this sitting around didn’t agree with him.

In contrast to the paramedics Katie had been less shy with the morphine and Viggo spent the rest of the wait dozing as much as he was able with his heart beating double speed.

Orlando, on the other hand, sat in the bay biting his lip and not really knowing what to do with himself. He felt a bit superfluous and like he had overstayed his welcome. Somehow, he was under the impression that he wasn’t needed, but at the same time he had no idea how to make a strategic exist.

“They’re talking about me,” Viggo said at some point and it drew Orlando out of his musings. He must have spaced out for a moment. He hadn’t even noticed that Viggo was paying attention to what was going on.

“What?”

Viggo nodded in the direction of a knot of doctors staring in concentration at a computer monitor. Katie was among them, pointing out things for her colleagues.

“Might be,” Orlando agreed. “But you like being the centre of attention, so I don’t see the problem.”

The blood pressure cuff on Viggo’s upper arm was cycling and Orlando looked at the monitor to see the result. Viggo was hypotensive and had been ever since Katie had put that cuff on him. Orlando just hoped the wad of doctors crowding the monitor would come to a decision soon.

“Could do without that sort of attention,” Viggo admitted. “I just want to get out of here.”

Orlando looked at Viggo in surprise. He didn’t seriously think they’d just let him go? They still had that MI to take care of.

Katie came over to them. “Hey, boys,” she greeted. “How are you feeling, Viggo?”

Viggo looked at her. “Like I’m having a fucking heart attack.”

Apparently, Viggo was done with ignoring the facts. Blunt as ever.

She nodded, approving of his sudden acceptance, but didn’t seem particularly happy about what she was about to say. “That’s because you’re having one. Just as we assumed. I’m sorry.”

“What about the troponin?” Viggo asked.

“2.8,” Katie answered.

Anything that wasn’t basically zero was bad news. Orlando looked at Viggo’s rhythm again, at the ST-elevation that was the cause of all the trouble. At least, now they knew for certain what they were dealing with. It meant they could do something about it. Finally.

“PCI?” Orlando asked.

Viggo looked less than thrilled at the suggestion, but he didn’t exactly look surprised.

“Yeah, that would be our course of action,” Katie agreed.

There was a commotion in the hall and then one of the nurses brought in Chris.

His arch nemesis.

Truth be told, the thought of calling Chris hadn’t even crossed Orlando’s mind. So far, he’d been very successful at ignoring Chris’ mere existence. Katie must have called her or maybe one of the girls at Registration had. Someone around here was bound to have her number. Maybe Viggo had used the time away from Orlando to get in touch with Chris. Traitor.

Chris breezed into the bay looking like she had just gotten up – which probably was the case. Her hair was a mop of something dark and curly and she was in a baggy t-shirt (mostly orange) and leggings (bright green). Either her fashion sense was on par with Viggo’s or she had simply grabbed what was topmost in her drawer. She was lugging a handbag around that both didn’t fit with her outfit and looked large enough to carry a piano around in. She zoned in on Viggo and gave him a quick kiss. On the mouth. She couldn’t keep her lips to herself, not even when Orlando was standing only an arm’s length away.

This was her territory and she was letting everyone know.

“Hey, hon,” she said and took Viggo’s hand.

Orlando tried not to feel any resentment towards her but failed spectacularly.

Yes, Viggo had spent the night with him and not with Chris. Maybe that meant something, but it didn’t feel like it right now. She was possessive towards Viggo in an absolutely natural way that quite clearly came from long acquaintance. Orlando wanted to throw things at her. Hard and unyielding things, preferably with pointy edges.

It was entirely possible that his feelings towards her weren’t fair. But a lot of things in life weren’t fair. Like being rudely awakened in the middle of the night because the gorgeous hunk of a man you shagged had a heart attack.

Orlando definitely could have done without that experience.

Katie took up the thread of their conversation. “Your timing is perfect, Chris,” she said.

Chris looked at McNamara, then at Viggo. She was still holding on to his hand.

Orlando felt left out, like he’d just been dismissed of this whole situation. He didn’t like the feeling one bit.

“What’s going on? What happened?” Chris asked.

“Viggo came in with chest pain,” Katie explained.

Chris’ eyes got big. “You’re not having a heart attack, are you?”

Well, Orlando might not like her but he had to admit that she was a quick thinker.

“Sorry to disappoint,” Viggo replied.

“I told you you should quit smoking,” Chris chastised, but there wasn’t any heat in her voice. She sounded like she was recounting an argument she’d had with Viggo since the dawn of time.

“I’ve been trying,” Viggo defended himself.

“Okay,” Katie said to bring them back on track. “First, I suggest we make sure that Viggo gets another chance to try and quit. As I was just saying before you came in, I’ve scheduled a PCI for him.”

Chris looked lost.

“An angioplasty,” Katie explained. “It’s a minimally invasive procedure where a catheter is inserted into the artery, usually from the groin or the wrist. The catheter is then used to open up the blockage that is causing the diminished flow of blood to the heart.”

“Minimally invasive?” Chris asked hopefully.

“Yes. There’s a local anaesthetic to numb the area where the catheter is inserted. It’s likely that Viggo will have to spend the day here just so that he can be monitored. If things go according to plan he’s home by tomorrow at the latest.”

“And if they don’t go according to plan we’ll be dealing with allergic reactions, strokes and thrombosis,” Viggo lectured.

Katie rolled her eyes. “Doctors really make for awful patients. What form of treatment would you suggest instead?”

That successfully shut Viggo up.

“Then we’ll go for it, right?” Chris asked.

“Right,” Viggo said. “Let’s get this over with, okay?”

“Wonderful,” Katie said. “I’ve already arranged everything. They’re waiting for you at the Cath Lab. Sounds good?”

“Yeah, marvellous,” Viggo said, his voice dripping with sarcasm.

Orlando felt forgotten. No one needed his expertise and nobody was interested in his opinion. (He agreed with Katie, just for the record.) He should probably simply leave. He wasn’t needed here. Chris stood next to Viggo like she had every right and Orlando should leave them to it. This wasn’t his problem, not his fight. It was no more than coincidence that this had happened on his watch.

He cleared his throat. “I’ll better…” He pointed in the general direction of the exit. “Now that everything is taken care of I better leave. Take care, Viggo. See you around.”

Orlando didn’t give anyone the chance to say anything. He just told his feet to move and suddenly he was walking. Out of Bay 7, out of Resus.

Viggo was in good hands, that’s why Orlando had insisted on going to the Madhouse. Orlando didn’t need to be here. None of this was his responsibility and his presence didn’t make any difference.

And he wanted to leave. Yes, dammit. It was the right thing to do.

Why then did the spot between his shoulder blades tingle when he walked out of the bay? Why did it feel like Viggo was staring a hole in his back?

Viggo wasn’t. He had no reason to. Chris was there, he was being taken care of.

Surely, Viggo wasn’t staring at him as he left. Surely, this was only Orlando’s imagination.

~*~

Orlando went home. Suddenly, he was bone-tired and longed for his bed. But once he was in it, his body refused to find rest. Maybe he’d been awake for too long. Maybe his body didn’t quite remember how to fall asleep. Everything seemed possible at this point.

Or maybe he was worried for Viggo.

Bullshit.

He wasn’t. Why would he be? There really was no reason. A PCI was a routine procedure that actually didn’t take all that long. It should be finished by now. At the moment, Viggo was probably sleeping off the sedative, the local anaesthetic and the general excitement.

Orlando should do the same. Why could he not? Why was he lying awake? It couldn’t be the fact that the bed still smelled of Viggo. He had barely been in it, after all. Orlando took a whiff of the pillow and seriously considered changing the sheets.

That he had a hard time falling asleep was unheard of. Over the last months, Orlando had learnt to fall asleep under any and all circumstances: He had just worked through the night and morning sunlight was slanting into the room? No problem, he slept. He was working through a patient’s story in his mind and was trying to decide whether another route of action would have yielded a better result? As soon as his head hit the pillow the question took a back seat and he fell asleep. Adrenaline was still coursing through his body? No matter, he had learnt to simply switch off his body and get some rest.

Not now, though. Now his mind was going through the last hours on repeat and Orlando was unable to switch out of that loop. He knew A&E wasn’t for everyone. Working A&E was like reading nothing but the first few chapters from every book he picked up. The story might be fascinating, but he put it to the side and never picked it up again. It could be frustrating, but in Orlando’s mind it was an invaluable chance. He could imagine how the story went on. He could give every story a happy ending.

Whenever they came to the most devastating conclusions or faced hopeless situations, he could send patients to the next point in their journey and imagine that somewhere down the line there was a happy ending for them, however unlikely that might be.

It kept him motivated and made the hard times bearable. Which was to say: It worked. Until it didn’t. He wanted to know how the story ended for Viggo. Orlando didn’t want the cheap cop-out. He didn’t want to imagine things. He wanted to know for certain.

He would, Orlando tried to calm himself. Viggo would call at some point. And even if he didn’t, they’d see each other at work. And then they could pick up where they had left off. It was as simple as that.

Nothing had changed.

~*~

The ringing of his phone rudely woke him. Orlando blindly reached for it and held it in front of his face. It was mid morning, quite a bit of time had passed but not enough that the little sleep he’d gotten so far felt in any way refreshing.

The call came from Viggo.

He looked at the display for a while and counted to ten, simply to not give Viggo the impression that he was in any hurry to pick up. He wasn’t that desperate. And anyways, from the looks of it Viggo had taken his sweet time to call Orlando. The PCI should have been finished hours ago. Leave it to Viggo to be such a dick that he couldn’t even be arsed to send Orlando a quick text to let him know that everything had gone according to plan.

Orlando tried to decide how he should play this. He was miffed that Viggo had left him hanging for so long. They weren’t attached at the hip but somehow Orlando had assumed that Viggo had at least the decency to say thank you in a timely manner.

Eventually, he took the call and said the first thing that came to mind. “You’re timing is off, you should have called hours ago. Why do I even put up with you?”

His tone was long-suffering and annoyed. Basically, it was the tone of voice he almost always assumed when talking to Viggo.

His statement was followed by silence. Orlando rolled his eyes. Leave it to Viggo to act all histrionic.

“Viggo, you jerk. Say your piece and then let me get back to bed. You’re not the only one who didn’t get any sleep last night.”

“Orlando Bloom?”

What the hell? That definitely wasn’t Viggo’s voice. Or maybe it was because they had cut off his dick during the PCI and he was now talking an octave higher. Served him right.

Orlando decided that this theory was unlikely. Anyway, Viggo without a dick would be a tragedy. “Who’s this?” He looked at the phone again, just to make sure that he hadn’t been mistaken the first time around. But no, whoever was calling was doing it from Viggo’s phone.

“Hi, this is Chris. We met briefly?” She sounded a bit shaky.

Chris of all people. Why would she call him and obviously behind Viggo’s back, no less? To gloat? To be bitchy?

“Yes, I remember.” Understatement of the century. “Why are you calling?”

There, Orlando Bloom – the perfect picture of polite conversation. He expected the conversation to go downhill soon, but he was determined that it wouldn’t be his fault. His conscience was clear.

“It’s Viggo,” she started. “I thought you should know.”

She didn’t sound like a woman calling to gloat. She sounded all business – short, to the point, serious. Suddenly, Orlando was on edge. Like, really and seriously on edge.

“Know what?”

“Viggo’s in surgery right now.”

Now it was Orlando who was silent, but only for a moment. That was not the downhill he had expected. “Surgery? What do you mean? What surgery? He was supposed to get an angioplasty.”

“Yes, he did.”

“What happened?”

“I didn’t understand all of it,” Chris admitted. “But something went wrong during the angioplasty. He had another heart attack and … and his heart stopped.”

“What?” Viggo had gone into cardiac arrest? This wasn’t happening. This just couldn’t be happening.

“Briefly,” she cut in. She sounded like she was repeating what she’d been told herself. Like someone had downplayed what had happened for the sake of things not sounding so dire. Don’t scare the relatives to death.

It’s not so terrible if the heart stops. If it does so briefly.

As if.

Chris continued. “The doctor said they got him back right away. But they decided on operating. I just got a call telling me he’s on the heart-lung machine now. He’s getting a bypass. I thought you should know. I mean, you are …” She searched for an appropriate word and the silence stretched. She settled on: “Close.”

If she meant close as in sporadically attached at the nether regions then yes, they probably were close.

“Christ,” he couldn’t help but saying. They were doing an emergency CABG surgery on Viggo? Right now? That was open-heart surgery, a major procedure. If surgeries were cars then the PCI was a Mini Cooper – the old, tiny one that Mr. Bean drove. And a CABG was a fucking Maserati. Only that in this case, every sane person would prefer the Mini Cooper because it was the more sensible car.

Viggo was supposed to get a silly little catheter inserted into an artery in his groin. This took two hours, tops. Generally, patients were allowed to go home the same day. And yes, maybe the catheter wasn’t exactly silly or little but the procedure was certainly minor. And instead they were cutting him open from chest to navel? This was massive.

Orlando didn’t quite know how to deal.

“Thanks for letting me know.” What else was he supposed to say?

“Of course. He’d want you to know.”

Did he?

“Are you at the hospital?” he asked.

“Yes, I stayed for the angioplasty. I had planned to take him home afterwards, pamper him a little.” That sounded reasonable and was exactly the reason why Orlando had left in the first place. It had been clear that Chris had meant to handle the situation.

“Is someone there with you?” Yes, Chris was the woman Viggo slept with – or at least had slept with – and that made her Orlando’s least-favourite person. But he wasn’t a monster. He didn’t wish this on anybody.

“I’m on my own,” she said. “Don’t feel like going home right now.”

It took Orlando only a second to come to a decision. “I’ll be there in a bit.”

Maybe he was offering this more for his own peace of mind than for Chris’. But he just knew that he would go up the walls if he stayed at home. And getting any more rest was totally out of the question.

“Thanks, Orlando.” After a pause she added. “Viggo says you’re quite abrasive. I can’t say that I agree with him.”

Orlando wanted to throw a curse in Viggo’s direction but he stopped himself. It wasn’t the right moment, maybe it would never be again.

Fuck this, Bloom. Don’t turn morose now!

“It’s going to be okay,” Orlando said, even though he couldn’t quite believe his own words. “I won’t be long.”

~*~

After aimlessly running around the hospital Orlando eventually found Chris in front of the CVICU. She sat on one of the three chairs that had been placed in the hallway. Orlando wondered what he was supposed to do now: Shake her hand? Hug her?

“Hi,” he said. They didn’t know one another and he was pretty sure that he didn’t like her. Touching was out of the question.

He let himself fall into the chair next to her.

“Thanks for coming,” Chris said. She gave him a wry grint that suggested she had just lost a bet. “Viggo said you would.”

Cocky bastard.

Out loud he said: “You talked to him?”

“Only for a few minutes. It was all a bit … well, rushed.”

Orlando glanced at her. She looked a little worse for wear. She certainly gave the impression of someone who hadn’t slept a wink and her rather terrible outfit didn’t help much. Orlando had seen all kinds of reactions to bad news – shell-shock, hysteria, non-stop crying, stone-faced indifference. Chris’ expression was serious, but she didn’t look liked she was about to fall apart any moment now.

Still, Orlando felt like he had to assure her somehow. He was a doctor, his opinion counted in a situation like this. Part of his job was pretending. Pretending that his faith in the medical profession was endless. Pretending that he didn’t know about all the things that could go wrong along the way. He wasn’t supposed to put the fear of god into people. And he wasn’t supposed to instil any unfounded hope.

At the moment, he couldn’t care less what he was supposed to do as a doctor. He said the one thing he wanted to hear himself. “It’s all going to be okay, you know. You needn’t be worried.”

“I’m not worried,” said as if that was the most natural thing in the world.

Orlando threw her another look. “You’re not?”

How could she not be worried? Had no one told her what a CABG actually entailed? Was she the one person in this hospital to not google a procedure for potential risks? Well, lucky her.

“No.” She sounded very convinced. “Viggo’s not a quitter.”

Orlando wasn’t quite sure whether not being a quitter had anything to do with the current situation. She made it sound like any of this was a conscious decision on Viggo’s part – in which case he probably wouldn’t have had a heart attack in the first place. Orlando decided to not point that out. That would be kind of demotivating and that wasn’t what they needed right now.

“No, I guess he isn’t.”

“He’ll be back on his feet in no time, you’ll see.”

That was unlikely. This would take Viggo out of the game for at least two months, maybe more, provided nothing unexpected happened along the way. Like him fucking dying, for instance.

“Well, I’ll take your word for it. You’ve known each other for quite some time,” he said diplomatically.

“You don’t believe me,” she stated but she didn’t sound cross.

He shook his head. “It’s not that. More the fact that I obviously know more about bypass surgery than you do.”

There was no need to tell her that he certainly had googled all the details on his way here. Something this specialised wasn’t exactly his area of expertise and he’d wanted a little more information than what he could remember from his numerous textbooks.

Chris shrugged, taking his answer in stride. “I’m right and you’re wrong, you’ll see. I know these things.”

What things, exactly? “Are you psychic or something?” Orlando asked. Imagining Viggo as the counterpart to one of those new-age witches had a certain charm. She definitely had the hair for it, but so far Orlando had yet to see her in anything tie-dyed. She also didn’t wear any jewellery and Orlando felt witches ought to wear a lot of rings.

“You can decide for yourself once you’ve realised that I’ve been right all along.”

She didn’t suffer from low self-esteem, which was something she had in common with Viggo. Two people with such a constitution was a truly terrible combination.

“Well, I wouldn’t mind being wrong, but don’t ever quote me on that,” Orlando couldn’t help but saying.

“Wouldn’t dream of it.” Chris promised. “Did he ever tell you how we met?”

“No.” Of course not and Orlando wasn’t convinced he wanted to hear the story.

“I was hanging out with a few friends; we were playing pool in a bar. Viggo was there on a date with a guy.” She chuckled like the idea of Viggo being on a date with a guy was hilarious in and of itself. “A bloke started harassing me and my friends. First just cat calls, then he tried to grope us. It turned pretty ugly pretty fast. At one point, Viggo got up and went over to the guy. And without saying anything – no warning, nothing – he decked him. The bloke went down like a log, bleeding like a pig. A broken nose.”

Orlando could definitely see Viggo do something incredibly stupid like that. He’d probably still do that. He was that kind of chivalrous idiot. “Your knight in shining armour?”

“In a way. A few days later the guy with the broken nose brought some friends. They caught up with Viggo on his way home, beat him up pretty badly. Broke his jaw. I’ve never seen skin turn this many colours.”

“Oh, damn,” Orlando couldn’t help but saying.

“Exactly. Do you know how a broken jaw is treated?”

There were several options. He tried the first that came to mind. “Titanium plates?”

“No, not quite as fancy.”

“Wires?” Orlando asked and Chris nodded.

In that case, the upper and lower jaw were wired together. This in and of itself sounded like an extremely joyous experience. But the fun part was the fact that it was all but impossible to eat with an immobilised lower jaw. That meant a liquid diet until the break had healed.

“As I said, he’s not a quitter. He got in touch with me after the surgery and asked me out. I could hardly understand a word he said with the way he was mumbling! I still remember that I had fries and a burger. He had a strawberry milkshake.”

“Poor man,” Orlando couldn’t help but saying. He could see her point, though. Viggo wasn’t a quitter, alright. But he certainly was some unlucky wanker.

“It was the strangest first kiss I ever had,” Chris mused.

Orlando raised an eyebrow. “With the wires? Really?” That couldn’t have been much in the way of a kiss.

“Yeah.” She chuckled. “He didn’t live up to his full potential until later, but I was still hooked.”

Orlando tried to imagine a kiss like that, failed and decided that it was probably for the better.

Any maybe he liked Chris. Just a tiny bit.