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Mount Auburn Hospital

Mount Auburn Hospital is a community teaching hospital located at 330 Mount Auburn Street in Cambridge, Massachusetts, serving the Cambridge and greater Boston area as an affiliate of Harvard Medical School and, since 2019, part of the Beth Israel Lahey Health system. Founded in 1886 as the first hospital in Cambridge, the facility provides emergency services, acute care, and a range of inpatient and outpatient medical programs. Within the Faultlines universe, Mount Auburn became the site of Alastair Hargreaves's near-fatal medical crisis on February 15, 2011—the day he fainted during a Harvard lecture, fell from his wheelchair, fractured multiple ribs, and experienced blood pressure crashes so catastrophic that the Emergency Department called a Code Blue. For Siobhan Hargreaves, the hospital was where she watched strangers work on her husband's body while pressed against a wall, unable to breathe, whispering "please" to no one and everyone. For their four-year-old twins, Charlotte and Catherine, it was the reason Lily O'Shea came to stay—the first time their father's fragility became visible enough to disrupt their world. The crisis at Mount Auburn became the turning point that convinced the Hargreaves family that Harvard was unsustainable and that Alastair's survival required choosing a smaller stage over a prestigious one.

Overview

Mount Auburn Hospital operated as Cambridge's primary community hospital, providing the emergency and acute care services that a university-adjacent population required. Its proximity to Harvard University made it the natural destination when Alastair collapsed during a lecture, and its Emergency Department was equipped to handle the acute cardiac monitoring and resuscitation that his crisis demanded. The hospital was not, however, equipped for the specific constellation of challenges that Alastair's case presented—a patient with suspected hypermobile Ehlers-Danlos Syndrome, autism, osteoporosis, chronic pain, and a communication profile that shifted to British Sign Language under extreme stress. The gap between what Mount Auburn could provide and what Alastair needed defined much of his experience there.

Within the Faultlines universe, the hospital represented both lifesaving intervention and institutional limitation. The ER staff who responded to his Code Blue saved his life. The nurse who reported his extensive bruising to social services—well-intentioned but wrong—added trauma to trauma. The hospital that stabilized his body could not provide BSL interpretation, could not accommodate his sensory needs during recovery, and could not prevent the investigation that forced Siobhan to explain, while her husband lay in critical condition, that his bruises came from a connective tissue disorder and not from her.

Physical Description and Layout

Mount Auburn Hospital occupied a campus in the West Cambridge neighborhood near Harvard University, its architecture reflecting over a century of expansion and renovation from the original 1886 facility to a modern community hospital with approximately two hundred beds. The Emergency Department was configured for rapid assessment and intervention—trauma bays and examination rooms arranged for acute care, cardiac monitoring equipment positioned for immediate access, and the spatial organization that emergency medicine demanded: triage area, treatment bays, imaging access, and the ability to call and assemble a Code Blue team within minutes.

The ER bay where Alastair was treated featured the standard equipment of an acute cardiac monitoring station: blood pressure cuffs, EKG leads, IV access points, and the cardiac monitoring displays that tracked the catastrophic descent of his blood pressure from critically low to unreadable. The space was functional and clinical—designed for saving lives rather than accommodating the particular needs of a patient whose body was failing in ways the standard diagnostic framework did not anticipate.

Sensory Environment

The Emergency Department's sensory environment presented the challenges common to all hospital acute care settings—fluorescent lighting, constant noise from monitors and medical equipment, overhead pages, the controlled urgency of staff moving between patients, and the antiseptic smell that permeated every surface. For Alastair, whose autism made sensory processing difficult even under ideal circumstances, the ER constituted sensory assault layered on top of physical crisis. The bright lights, unpredictable noise, multiple staff members entering and exiting his space, the pain from fractured ribs, and the overwhelming disorientation of his blood pressure crashes combined to shut down his verbal communication entirely. He signed in BSL—trembling, fragmented: "Faint. Can't talk. Hurts. Please help."—because spoken language had become inaccessible.

The hospital's sensory environment during Alastair's extended observation period continued to challenge his neurological needs. The lights could not be dimmed to his preferences, the bed was unfamiliar and disrupted already-compromised sleep, institutional food offered no comfort, and the constant awareness of being monitored by strangers created the particular claustrophobia of hospital stays for autistic patients—surrounded by stimulation they cannot control and unable to access the environmental accommodations that make daily functioning possible.

Function and Services

Mount Auburn Hospital provided the emergency cardiac care that Alastair's crisis required: immediate blood pressure monitoring that tracked his catastrophic hypotensive episodes, EKG assessment of cardiac function, IV fluid administration, emergency resuscitation when he coded, and the intensive monitoring that followed. The facility coordinated chest CT scanning to evaluate potential internal bleeding from his rib fractures—a genuine clinical concern given that fractured ribs near intercostal arteries in a patient with fragile connective tissue could produce slow hemorrhage into the thoracic cavity. Serial blood tests monitored hemoglobin and hematocrit for signs of active blood loss, and the results—no active major hemorrhage, though hemoglobin was low suggesting either minor bleeding or chronic anemia—provided some reassurance amid the ongoing crisis.

The hospital's social services department also intervened, though not in a way that served the patient. A nurse observed the extensive bruising covering Alastair's arms, chest, and legs—bruises of varied ages that did not match the pattern of his fall—and reported concerns about potential domestic abuse. The bruises were, in fact, the characteristic presentation of his connective tissue disorder: his skin bruised from the gentlest contact, bumping into a desk leaving marks that looked like violence. Social services asked Siobhan careful questions about how Alastair sustained injuries at home and whether she felt safe—well-intentioned inquiries that nonetheless required a woman in the worst crisis of her life to prove she was not abusing her critically ill husband.

History

Mount Auburn Hospital was founded in 1886 as the first hospital in Cambridge, Massachusetts, establishing a community healthcare institution that would serve the city and surrounding area for over a century. The hospital developed as a teaching affiliate of Harvard Medical School, connecting it to one of the world's premier medical education institutions and ensuring access to physicians and specialists trained at the highest levels of academic medicine. In 2019, Mount Auburn joined Beth Israel Lahey Health, a major healthcare system formed through the merger of Beth Israel Deaconess Medical Center, Lahey Hospital and Medical Center, and several other institutions, positioning the hospital within a larger network of medical resources and referral capabilities.

The hospital's location near Harvard University shaped its patient population and institutional identity, serving faculty, staff, students, and the broader Cambridge community. For the Hargreaves family, Mount Auburn's proximity to Harvard made it the default emergency destination when Alastair collapsed during a lecture—a geographic convenience that placed him in a competent community hospital rather than the academic medical center that his complex condition might have warranted.

Relationship to Characters

Alastair Hargreaves

Alastair's February 2011 crisis at Mount Auburn represented the moment his body delivered an ultimatum that could not be negotiated. He had been pushing himself beyond his physical capacity at Harvard—marathon grading sessions, packed lecture schedules, relentless research demands—and the accumulated toll manifested catastrophically during a Shakespeare lecture when he fainted, slumped forward from his wheelchair, and fell to the floor. Students gasped, someone called 911, and paramedics Danny and Jules from Somerville immobilized him carefully after noting his medical alert bracelet indicating bone fragility and connective tissue concerns.

In the ER, Alastair's verbal communication shut down entirely—the pain, overwhelm, and sensory assault combining to make spoken language inaccessible. He signed in BSL, trembling: "Faint. Can't talk. Hurts. Please help." His blood pressure, already unstable, began its catastrophic descent: 73 over 42, then 68 over 38, then unreadable—the monitors unable to register what had become too low to measure. His eyes rolled back. His body went limp. The Code Blue alarm sounded—"Code Blue, ER bay four!"—and the crash team responded with fluids, oxygen, multiple IV lines, and the intensive resuscitation that pulled him back from the edge. "Got a carotid pulse—weak but present—he's coming back."

The social services investigation added institutional trauma to medical trauma. Alastair's extensive bruising—the visible evidence of a connective tissue disorder that made his skin mark from the gentlest contact—triggered a domestic abuse inquiry that required Siobhan to explain, while her husband lay in critical condition, that the marks came from his body's own fragility. The nurse's concern was well-intentioned, but the investigation left Siobhan shaken and furious, and added another layer of institutional failure to a crisis already defined by the gap between what Alastair's body needed and what systems could provide.

When Alastair could speak again, days into his hospitalization, his first coherent words were soft and broken: "I didn't know... I didn't know I mattered like that." Siobhan's response was fierce: "You've always mattered like that. You just never believed it." The crisis taught both of them that Harvard was unsustainable—that the prestige came at a cost his body could not pay—and within months the family relocated to Baltimore, choosing Alastair's survival over academic ambition.

Siobhan Hargreaves

Siobhan was at home with four-year-old Charlotte and Catherine when Harvard medical services called. She contacted Lily O'Shea, who arrived within twenty minutes to watch the twins, and drove to the hospital with her hands shaking on the steering wheel, her mind cycling through worst-case scenarios she had feared since long before they materialized. She knew this could happen—had feared it constantly—but knowing and experiencing were different countries entirely.

At the hospital, Siobhan did not leave Alastair's side. She translated his BSL when he could not speak. She held his hand when he woke disoriented. She advocated fiercely when nurses tried to rush him through tasks his body could not manage. She endured the social services inquiry with the particular fury of a woman being asked to prove her innocence while watching her husband die. And she read him the messages that poured in—from Harvard students who had covered his office door with cards, from Oxford alumni who remembered him twenty years later, from the RADA and theatre community that had never forgotten the young man who had cried during Act 4 of The Seagull and sent flowers to the entire cast the next day.

The memory of those days stayed with Siobhan for the rest of her life—the sound of monitors alarming, the limpness of his body, the terror of thinking she might lose him. But she also carried proof that their love had created ripples far beyond what either of them had imagined. When she chose Baltimore over Harvard, she chose without hesitation and without resentment, because love—real love—meant protecting what mattered most.

Community Context and Neighborhood

Mount Auburn Hospital sat in West Cambridge, Massachusetts, near Harvard University and the academic community that defined the neighborhood's character. The hospital's proximity to Harvard meant its patient population included faculty, staff, and students alongside the broader Cambridge community. For Alastair, the hospital's location meant that his collapse during a lecture reached the ER quickly—campus emergency services responding first, followed by ambulance transport across a short distance that geography made easy even as his body made everything impossible.

The community response to Alastair's crisis revealed the depth of connection he had built through decades of teaching and mentorship. Harvard students left cards covering his entire office door, created banners reading "We miss you, Professor Hargreaves" and "Come back soon," and covered the English House lobby windows with sticky notes containing lecture quotes, inside jokes, and expressions of gratitude. Oxford alumni flooded social media with memories spanning twenty years. The theatre community rallied around the family. The outpouring demonstrated that Alastair's impact extended far beyond the lecture hall—that his willingness to show up authentically, disability and all, had created connections that sustained his family when his body failed.

Accessibility and Design

Mount Auburn Hospital met standard accessibility requirements including wheelchair access, accessible restrooms, and elevator access between floors. The Emergency Department's equipment and layout accommodated patients with mobility limitations, and medical staff were trained in standard emergency protocols that included positioning and immobilizing patients with bone fragility.

The hospital's accessibility failures during Alastair's crisis were communicative and sensory rather than architectural. No BSL interpretation was available on staff—Siobhan served as Alastair's translator, a role that placed the burden of communication access on a family member already in crisis. The ER and inpatient rooms offered no sensory accommodations for an autistic patient—no option to dim lighting, no quiet spaces for recovery, no acknowledgment that the standard hospital sensory environment constituted an active barrier to neurological recovery for patients with sensory processing differences. The social services investigation, while procedurally appropriate, demonstrated the accessibility gap that exists when medical systems cannot distinguish between the bruising patterns of connective tissue disorders and those of domestic violence—a failure of medical literacy that added institutional trauma to an already devastating crisis.

Notable Events

Alastair's Fall and Hospitalization (February 15, 2011)

On February 15, 2011, Alastair Hargreaves fainted during a Harvard Shakespeare lecture, fell from his wheelchair, and was transported by ambulance to Mount Auburn Hospital's Emergency Department. He arrived in severe pain from fractured ribs, unable to speak, signing in BSL: "Faint. Can't talk. Hurts. Please help." His blood pressure crashed catastrophically—73 over 42 to 68 over 38 to unreadable—triggering a Code Blue response in ER bay four. The crash team resuscitated him with fluids, oxygen, and multiple IV lines, eventually detecting a weak carotid pulse and stabilizing him. Chest CT revealed severe rib fractures but no active major hemorrhage. Social services was briefly consulted when a nurse observed extensive bruising inconsistent with the fall pattern—bruising actually caused by Alastair's suspected Ehlers-Danlos Syndrome. Siobhan Hargreaves translated his BSL, advocated for his care, and endured the investigation while community support poured in from Harvard students, Oxford alumni, and the theatre community. The crisis became the catalyst for the family's decision to relocate from Cambridge to Baltimore, choosing Alastair's health over Harvard's prestige.

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