The decisions. Right. Because that was the core of it, wasn't it? The impossible choices that defined who lived and who became another statistic in my personal ledger of failure.
"Limited supplies," I said. The clinical language felt safer than emotional truth. "Inadequate medical equipment. Multiple serious injuries. I had to triage."
"Triage means choosing who gets treatment first. Who has the best chance of survival."
"I know what triage means."
"I'm sure you do. But knowing the definition intellectually is different from living with the consequences emotionally." Dr. Senna's voice stayed gentle, but her questions were scalpels cutting through protective tissue. "You chose who to treat. Who to prioritize. And some people died because of those choices."
The words hung in the air like smoke from a fire I couldn't put out.
"Sarah Chen," I whispered. "Internal bleeding. I could have tried surgery with the equipment we had, but the odds were terrible and we didn't have the supplies to waste on a procedure that would probably fail. So I focused on the patients I could save. Made her comfortable. Gave her pain medication from our limited stock. Held her hand while she bled out over three hours."
My vision blurred. I blinked hard.
"Marcus Rodriguez. Crushed pelvis, compound fractures, developing sepsis from wound contamination. He needed antibiotics we didn't have, surgery I couldn't perform without proper tools. I kept him sedated so he wouldn't suffer. He lasted four days."
"And you blame yourself for their deaths."
"I made the choice to let them die."
"You made the choice to save six other people who would have died without your care." Dr. Senna leaned forward slightly. "Bea, you were in an impossible situation with inadequate resources and no good options. You did triage exactly as you were trained to do—prioritize those with the highest likelihood of survival. That's not murder. That's medicine."
"It felt like murder."
"I imagine it did. But feeling guilty doesn't make you guilty."
The logic was sound. I was a surgeon—I understood resource allocation, probability, the brutal mathematics of crisis medicine. But logic and emotion occupied different territories, and grief didn't care about reasonable arguments.
"I dream about them," I admitted. "Sarah and Marcus and the others who didn't make it off Earth, who died in the crash, who I couldn't save in the cave. They're there every time I close my eyes. Asking why I chose someone else. Why they weren't worth saving."
"What do you tell them?"
"Nothing. I just apologize and apologize and apologize until I wake up."
Dr. Senna was quiet for a moment, her expression thoughtful. "Have you considered that maybe they're not accusing you? That maybe your subconscious is trying to process trauma by creating these conversations?"
"Psychology isn't my area of expertise."
"Medicine isn't mine. But I know trauma when I see it, and you're carrying weight that would crush most people." She set down her datapad, gave me her full attention. "You survived the Liberty disaster. You saved lives in impossible circumstances. You were rescued and brought to an alien ship where you've continued healing people across species barriers. Those are remarkable accomplishments."
"They don't balance out the ones I lost."
"No. They don't. But Bea, and I need you to really hear this, you're not responsible for balancing the cosmic scales. You'renot required to save enough people to make up for the ones you couldn't save. That's not how healing works."
The words hit somewhere deep in my chest, cracking something that had calcified around my heart.
"Then how does it work?" My voice came out smaller than intended, almost childlike in its confusion.
"You save the people you can save. You mourn the ones you couldn't. You forgive yourself for being human and finite and unable to fix everything." Dr. Senna's expression was kind but unflinching. "And you allow yourself to live instead of just surviving. You're allowed happiness, Bea. You're allowed rest. You're allowed to build connections without feeling guilty that you're alive when others aren't."
I wanted to argue. Wanted to defend the punishment I'd been inflicting through overwork and isolation and relentless forward motion. But the exhaustion was too heavy, the grief too raw, the truth too obvious.
I'd been punishing myself. Using medicine as penance. Destroying my health in some misguided attempt to atone for surviving when others didn't.
And it wasn't working.
"I don't know how to stop," I whispered.
