Reposted with a few tense corrections. Slightly expanded.

It’s a regular Tuesday night in St. Mungos ER. The broom accident that came in at six has been relocated to the Artifact Accidents, stable and improving.

The time between dinner and the evening news is a hazy time. It’s either packed, or it’s empty in the ER waiting room. I see a kid with a rash that turns out to be a clothes detergent allergy. Sign off. I see a woman who mistook morning sickness for the flu. Congratulations. Sign off. Four-year-old boy choking on a piece of dinner roll. Anapneo. It’s amazing how many mothers don’t know that one. I assure the mother her son doesn’t need to be admitted for a cleared tracheal block. Administer lollipop. Sign off.

Around ten, the night-time accidents start to file in. A cut on the hand from a kitchen knife, mishandled during dish-washing. Seal it, bandage it. Sign off. A kid who’s dizzy after slipping and hitting his head in the bathtub. Cranial scans are clear. Send home with hydration and observation instructions for mum. Sign off.

Around twelve, the Three Broomsticks and Leaky Cauldron begin transferring certain customers to us. Lacerations resulting from bar fights. Seal it, bandage it, notify Law Enforcement. Sign off. A case of mild alcohol poisoning from a recent divorcee so freshly single that he still wears his wedding ring. Admit him to detox. Hydrate and monitor. Post the chart. A woman in labor. Page Obstetrics and spare a nurse to take her upstairs. Sign off.

Around two in the morning, things get hairy. More bar fights, more accidents. A boy, barely nineteen, is brought in on a crash cart and wheeled into resuscitation bay 3. Found in the river, floating on his back. He’s hypothermic. He reeks of filthy river water and firewhisky. Secure an airway. Warming charms. Secure an IV. Push saline. He’s in shock. Has been for some time. Check responsiveness. Almost none. Heart rate is erratic. Scratch that, he’s flatlined. Start chest compressions. More warming charms. Ennervate. More chest compressions. I bark orders to push various fluids into the kid’s arm. How long had he been in that fucking river? Twenty minutes, and I call it. Two forty-six. First casualty of the evening.

By three I spend half my time running from examining room to examining room, sealing lacerations and ordering cranial scans. I set broken limbs and administer skele-grow. Admit the worse breaks until the potion takes effect. Send the minor breaks home to rest. Sign off. Sign off. Sign off. Post a chart. Sign a requisition. Fill out a prescription. Count heads in the waiting room. The number dwindles at 4 AM. The nurses change shifts, and I have four fresh bodies at my disposal. My energy starts to flag. Gulp a black coffee between sealing a drunk’s cheek laceration and writing an Infacol prescription. No, Sir, colic is not life-threatening.

At four I find a moment to speak to the parents of the kid they pulled out of the river. I have no explanation. He was beyond our help from the moment he came in the door. He’d been out too long. I have no idea how he ended up in the river. I don’t know why he didn’t drown. Until I met his parents, I didn’t even know this kid’s name. Refer psychological counseling.

It’s not quite five when the worst of the night presents itself. The floo grate glows green in the waiting room, and more people stumble into the crowded room. The welcome witch pages me – it’s urgent. I leave an insomniac with a minor OD to the nurse at hand and rush to resuscitation bay 2.

I know a Cruciatus when I see one, and I see them often enough. It’s 1980, after all. It’s no statistical blip that most cases we see of it are pure-bloods. The board of directors tells us not to ask questions. It’s the donations of these prominent people that keep our doors open. It’s also no statistical blip that most of the DOAs these days are muggle-borns. I stopped thinking about it a long time ago. It's only the Hippocratic Oath that compels me; nothing more.

Sure enough, there’s a black mark on this kid’s forearm. And they usually are kids. A nurse has her fingers over the mark, taking a pulse at his wrist. Another is doing the same at his neck.
“Where was he found?” I stand behind his head and lift his eyelids. I shine a light in each eye. Left pupil slow to respond. Breathing shallow, but not dangerously so - yet. The tremors are starting.

“Brought in by a relative,” the nurse at his wrist says. She reaches behind her for an IV kit and taps for a vein. She leans on his wrist to still his shaking arm.

“Page the OR, this kid’s gonna need a full work-up.” I fit a foam ring around his neck as a stall. If he’s hurt his neck, the shaking will only do more damage. Got to protect him until I can get in place for a full diagnostic work-up. The kid’s legs are spasming all over the place. One nurse hangs a saline IV while the other straps his legs down. We each take up a pair of scissors and start to cut his clothes off. Vanishing is easier, but with Cruciatus cases we have to save the clothing as evidence for Law Enforcement.

“Start a morphine drip. Minimum dosage.” Green light for the OR. The nurse throws a blanket over him for the short trip. We pop the breaks on the gurney and start to move him. We pass the waiting room, and I see two familiar faces. Shit, this kid must be really young, if it’s the Hogwarts matron and headmaster bringing him in.

We three rush past the waiting room in a blur. The kid is still shaking and bucking. His jaw is clenched in a spasm. There’s a gurgling noise. Shit.

The nurses don’t stop moving the gurney. I hop on and kneel over the kid’s skinny frame, one knee on each side, and pull out a laryngoscope from my pocket. He’s swallowed his tongue. I’ve got to charm his jaw to get it to relax, or I’m going to lose a finger intubating him. A nurse hands me a kit from a cart as we pass. I bite the plastic packaging and pull out the endotracheal tube.
“I’m in.” I attach the bag and begin pumping with my hand. The kid’s eyelids are fluttering. He’s finally getting sufficient oxygen. His eyes open fully, and I don’t doubt he’s conscious now. His back arches in pain, and the tube nearly slips. I smell the sharp scent of urine. He’s lost himself.

“Up the morphine,” I bark, and the nurse on my left does it on the move. Through the OR doors with a bang.

The OR is the magic-neutral zone. Filters clear the air immediately of all spell residue. It’s the area of least energy-contamination in the hospital. Essential to most magical medical operations, but especially in spell-damage cases like this. We wheel the gurney up beside the table, and I climb off.

“One, two, three,” I count us in for the lift. We three hoist him from one bed to another using the blanket underneath him.

“Page Anesthesia.” The fever is starting. Cruciatus affects the nervous system so suddenly, so abruptly, that the after-effects of extended or repeated exposure are the extremes of an overwhelmed, confused body. Core temperature skyrockets to kill germs, in case the cause is viral or bacterial. The kidneys go into overdrive, expelling all waste in case it’s a poison. Diarrhea and vomiting are common, for the same reason. Tremors, from a reeling nervous system. Respiratory arrest, for the same reason. Heart palpitations, when the adrenaline and cortisol levels rise dangerously high. Hallucinations, from neuron misfires. Hemorrhages, from CNS damage, trauma, or hematomas.

I do a cranial scan. No sub-durals, but he’s shaking like a leaf and probably hallucinating. His eye movement patterns are erratic. He’s breathing fine now. In fact, he’s hyperventilating. I pull the tube as the nurses strap his arms down. We lost the IV in his thrashing. Slap a square of gauze on the torn butterfly and apply pressure. Tap the other arm. Priority one is to restore morphine and saline.

I remove the tube and he starts spewing nonsense. One minute he’s apologizing and the next he’s professing undying love for some girl. Or boy, who am I to judge? I half-expected him to cry out for his mummy. He screams as they strap his arms down.

I’m performing diagnostic charms to check for breaks. Skull and jaw are clean. Clavicle and scapula check out. Ribs, arms, vertebrae are good. Small pelvic fracture. Make a note. Femurs and tibia are fine. Two small bones in left foot broken. Make a note.

The kid vomits, and we roll him onto his side so he won’t choke. Nurse One holds a basin under his chin while the other struggles to replace the IV. His arms are shaking too badly. She tries the groin for a good vein. Cleansing charms to remove the urine. Needle stick; quick and fast. She’s in.

Intravenous skele-grow for the fractures and breaks. Beta blockers for the tremors. I go up and down his body casting charms to relax his spasmed muscles. Bit by bit he relaxes, like a rag doll going limp.

Pages are going off overhead for more Healers to the ER. Two more have come to us in the same condition. I look at the clock. This kid was twenty minutes ahead of them. The other two weren’t brought in by Hogwarts.

“Green!” Healer Blass pokes his head in and barks at me. “Got a second?”
“No.” The kid’s a train wreck, of course I don’t. Being a senior physician on call bites when disasters occur in unison.
“We’ve got two civilians in. Worse than him. Cruciatus to the point of brain damage.”
“Page a neurologist.” The kid has stopped vomiting. Roll him over and check his heart rate. He’s just moaning under his breath now. Not enough energy to scream. The morphine must be tiring him out. I hear the page go off overhead for a neurologist. The glowing sign above the OR door changes as they wheel in the other two. This kid's just been bumped to Charlie position. Alpha patient is in OR Two. Bravo is across the hall in OR Three. Pray we don't get a Delta.

“The male has a GI bleed.” Blass again.
"Alpha or Bravo?" I take the kid's ankles in my hands and pull his legs straight for more relaxing charms. The nurses lean on his knees.
"Bravo." Then how bad is Alpha? I wave him in to keep an eye on the kid and rush next door to the second OR. One catastrophe at a time. Stop the bleed. Stop the tremors. Get a complete work-up on his head. Smethwick finally gets his ass downstairs and takes over for me. I move on to the woman in Alpha position. Cranial bleed. Too late for decompression charms. I have to bore a hole in her dura to relieve the pressure. She'll be lucky if she doesn't go blind. My patient in OR One is stable. I call Blass back to switch places. The woman is his to deal with now.

On the fourth floor, the young man lays resting with gauze patches taped over his eyes. The cocktail of drugs he’s on causes photophobia. He’s out for the night, thanks to heavy sleeping draughts. I check his vitals again. His temperature is returning to normal. He’s stable; improving. I won’t sign off until I’ve talked to the headmaster.

“Can you tell me what happened?” I’ve got a quill poised over his chart.
“A raid.” The reply is curt. Everything is said on a need-to-know basis these days.
“At Hogwarts?”
“At Derbyshire.”
“Why was it you that brought him in?”
“I happened to be present.”
“And he’s a student of yours?” I was scribbling down the facts in point-form. Not that anyone can read my writing.
“No. He graduated. He was twenty in January.” I look at the skinny kid through the windows of the ICU room. He doesn’t look older than sixteen.
“You’re sure?”
“Quite.” I make a note of it. “Will you be his Healer for the duration of his stay?” the headmaster asks. It’s phrased as a polite inquiry, as a matter of simple convenience, but I can hear the broader meaning beneath it. He wants something.
“I’m an ER Healer.”
“Could I persuade you to keep him as your patient?” the headmaster asks in a whisper. I look back at the skinny kid and wonder why he’s so special.
“The spell-damage Healers are wonderful at what they do,” I assure him. “He’s perfectly safe in their hands.”
“You were in Ravenclaw, were you not?” he asks suddenly. I nod. I’m surprised he remembered. I graduated over a decade ago. “It’s not a question of a capable Healer,” he explained. “It’s the fact that loyalty and honesty are hard to come by. And that I fear involving more people than strictly necessary in his case may cause a young man in his situation to…slip through the cracks.” So he wanted my protection and word as a Healer. The patient was already entitled to confidentiality, but more was necessary. He wanted to make sure no one arrested him, tried to kill him, neglected him, or even knew he was in the hospital because of the mark on his arm. The mark in question had been concealed under a layer of gauze, for the security of those not under the Hippocratic Oath. I look at him and realize I don’t even know the kid’s name.

“Mr. Doe will be treated well, I assure you.”
“You’ll keep his case?”
“I will. He’ll be discharged as soon as the fever stops.”

1981

They bring them in to us in the middle of the night, to spare moving the prisoners in broad daylight when ordinary people are out and about. Patients in chains, fresh from the Ministry’s detainee cells. It’s a one-stop-shop between here and the courtroom, and then on to Azkaban. They might as well staple one-way tickets to these guys’ collars.

Some get a physical, to prove they’re healthy enough to stand trial. Some get cuts sealed, either self-inflicted or the result of fights behind bars. Some are so badly damaged from the fight they put up while being arrested that I have to admit them. I dislike having Aurors standing guard outside patient rooms.

I recognize the kid, because he hasn’t gained an ounce of weight since I last saw him. I open his prison-issued shirt and listen to his heart and breathing. Last time I saw that bare chest, I was kneeling over it shoving a tube down his throat. He’s breathing fine now. There are new scars on his chest, just below his armpits. Their healing pattern, length, and precision makes me think they’re self-inflicted. Why be a slave to fashion and slit one’s wrists?

“You were admitted last year for spell damage. Any recurring effects?” I scribble a memo on his chart. There’s no name on the chart; just a prisoner number. The same number is written on a metal tag around his neck, and on two others around his wrist and ankle. In case he winds up in pieces at some point, like the soldiers in Vietnam, they’ll know which limbs are his.

“No.” I take his blood pressure, temperature, and ask for a urine sample. He’s good to go. Sign off. I watch him leave with the Aurors and suppose I’ll never see him again. Azkaban has its own resident physician.

1997

Teenage boy, breathing difficulties. Administer oxygen and a steroid. The kid clutches to the oxygen mask like it’s the only source of air left in the universe. I pull up my swivel chair and sit in front of him. I have one hand on each side of his neck, doing a breathing exercise with him while he puts his head between his knees.

“Nice and slow, feel your lungs pump – one, two, three…” He slowly begins to calm down. I thought it was asthma at first, but he doesn’t have asthma. This is the Malfoy kid. I’ve seen his chart before. Perfect health, regardless of being an inbred pure-blood. This seems to be some sort of panic attack. He’s too distraught to even try to hide the mark on his arm.
“What happened?” I ask, when he seems sufficiently calmed to answer. He shakes his head and begins to hyperventilate again. I repeat the process of calming him.

“Who brought you in?” He points, and I turn to look at the man waiting by the door. He’s wearing a glamour. I can tell because although one eye is charmed blue, the other remains black. I realize I still don't know his name. I'd ask, but he wouldn't tell me. On second thought, I don't much care. Under Oath I don't need to know it, and the Oath is all that's still good and pure these days. It's safe. I wave him in, and he approaches cautiously.
“I’ve paged Psych,” I say. “To keep him calm while I see other patients. If he’s not breathing right in an hour I’ll prescribe a steroid.”
“That won’t be necessary.” I peel off my latex gloves. They snap.
“That eye was lazy when you first came in,” I say casually. It’s the left eye that was least responsive on his visit the ER. The man stiffens. Bluff called. “On second thought,” I reach into the drawer and pull out a generic ten-dose inhaler. They look ready to bolt, now that I know who they are, and want to make sure the kid can breathe when he leaves. “Wait at least fifteen minutes between doses. If you need more, there’s a dealer that works out of the back of Smidges Pub.”

In an instant, they’re gone, and I fudge the chart. Sign off. I drop the clipboard off with the welcome witch, and tell her to post a copy to Azkaban. The Healer there will need it sooner or later.