I shift my focus back to the field. There’s too much blood. I can’t see. I need to see.
“Suction,” I command, and the scrub nurse is there in an instant, the suction tip clearing away the blood.
But it’s not enough. The vessel I just repaired is bleeding again, faster this time, pooling dark and thick.
Ella’s little body jerks slightly, her pulse spiking.
Her BP is still plummeting.
“Clamp.” My hand is already outstretched, my fingers closing around the instrument before the word has fully left my lips.
I isolate the vessel, working quickly, methodically, my movements swift but controlled.
Cauterize. Suction. Suture. Every second counts.
The monitors are still beeping, but the pitch is changing. The alarms stop. Ella’s BP starts to climb, slowly but steadily.
“Pressure’s coming up,” the nurse reports, her voice edged with relief. “Ninety over sixty.”
It’s not great, but it’s better. It’s enough, for now.
I release a slow breath, unclamping the vessel. My eyes scan the field, searching for any sign of continued bleeding, any potential weakness in the repair.
Once again, six-year-old Ella Bailey finds herself under my care.
A fistula has formed an abnormal connection between her intestine and her skin, leaking infection.
She cannot afford another complication.
“All right,” I say, my voice steady and sure. “Let’s finish this.”
I sit at my desk, hands tangled in my hair, staring at the ceiling as if it might offer absolution for my own negligence. As if somewhere within these stark, fluorescent-lit walls, there exists a god willing to forgive me for something as unforgivable as walking into that operating theater anything less than my best.
There is no absolution. No forgiveness. Just the cold, undeniable truth:
I was too bloody tired.
The surgery was a technical success. Ella is stable. For now. But stable isn’t good enough.
I should feel relief. Instead, I feel nothing but disgust at my own unprofessionalism.
When her blood pressure dropped, when her artery opened up like a goddamn ticking clock, I felt the weight of every poor decision I made last night come crashing down upon me.
There’s a knock at the door, and Lucia pops her head in, smiling. “Hey,” she says lightly. “You okay?”
I smooth my expression into something neutral. Something that doesn’t scream I’m a goddamn disgrace. “Yeah. Fine.”
She hesitates. “You seemed a little off today.”
My shoulders lock tight, a coil of shame twisting low in my gut. She noticed. Of course she did—Lucia’s too sharp not to clock my exhaustion in the middle of surgery.
I suck a breath through my teeth. “I’m just a little tired.”
Lucia smirks, a knowing glint in her eye. “Oh, I see. The young, gorgeous Daisy keeping you up all night?”
I grimace, not seeing any humor in the situation. “No. Not at all. And I apologize for being off during surgery.”
“You don’t need to apologize.” She waves me off. “We all have bad days.”
