"Conference room B. Third floor administration."
Isla nodded once, sharply. "Fine."
She didn't let herself think too hard about what awaited her as she made her way through the hospital's labyrinthinecorridors. Didn't let herself imagine the bureaucratic nightmare of justifying every split-second decision to someone who had never held a dying patient's heart in their hands. She just walked, blood-spattered scrubs and all, and told herself that whatever came next, she could handle it.
The third floor was a different world from the controlled chaos of the ER. Quiet. Carpeted. The air smelled like coffee and paper instead of antiseptic and fear. Isla's sneakers squeaked against the polished floor as she approached conference room B, drawing disapproving glances from a cluster of administrators who scattered at her approach.
She knocked once, perfunctorily, and pushed open the door.
The conference room was all glass and chrome, designed to impress visiting donors and intimidate anyone who found themselves summoned here. Isla had been in this room exactly twice before: once for her initial hiring interview, and once to receive an award for surgical excellence. Neither experience had prepared her for what waited inside.
The woman seated at the head of the long conference table looked up from a spread of documents with an expression of careful neutrality. She was approximately Isla's age, maybe slightly older, with sleek dark blonde hair pulled back in a style so precise it looked architectural. Her suit was immaculate, her posture impeccable, and her blue eyes assessed Isla with the detached interest of a scientist examining a particularly unusual specimen.
"Dr. Bennett." Her voice was cool, modulated. "Please, have a seat."
"I'll stand." Isla remained in the doorway, acutely aware of the blood on her scrubs, the exhaustion dragging at her bones. "I have patients to check on."
Something flickered across the other woman's face: annoyance, maybe, or amusement. It was gone too quickly to identify. "This won't take long."
"Good." Isla crossed her arms over her chest. "Because I just spent the last hour saving a man's life, and I'd rather not waste time explaining it to someone who wasn't there."
"I'm Marianne Cole." The woman rose, smoothing her already-smooth jacket. "Risk and Compliance. The board has asked me to conduct a comprehensive review of our high-risk practitioners, and your name came up rather... prominently."
"I'm sure it did."
Her lips curved, stopping short of a smile. "You have an impressive record, Dr. Bennett. Extraordinary outcomes. Save rates that are well above the departmental average." She picked up one of the documents from the table, Isla's personnel file from the look of it. "You also have a pattern of protocol deviations that would make most hospital administrators break out in hives."
"Protocols are guidelines. Not commandments."
"Protocols exist to protect patients."
"I protect patients." Isla's voice was harder than she intended. "Every day. With my hands and my skills and my judgment. What do you protect, Ms. Cole? Spreadsheets? Insurance premiums?"
The temperature in the room dropped several degrees. Marianne set down the file gently and met Isla's gaze directly.
"I protect institutions from practitioners who believe their judgment supersedes established medical standards. I protect patients from doctors who are so convinced of their own infallibility that they can't recognize when they're putting lives at risk." Her voice remained perfectly level, perfectly controlled. "And I protect hospitals from lawsuits filed by the families ofpatients who died because someone decided that rules didn't apply to them."
The words landed like blows, precise and deliberate. Isla felt her jaw tighten, felt the familiar surge of defensive anger that had gotten her into trouble more times than she could count. This woman knew nothing. She sat in her pristine office with her pristine suit and her pristine files, and she presumed to judge the choices Isla made in moments of life and death.
"The man I just operated on is alive because I made a choice that your protocols wouldn't have allowed."
"The man you just operated on is alive despite the fact that you violated multiple institutional guidelines in the process. Today, that worked out. Tomorrow, it might not." Marianne picked up another document. "I've flagged your recent cases for review. There's a pattern here, Dr. Bennett, and it concerns me."
"A pattern of saving lives?"
"A pattern of recklessness disguised as instinct." Marianne's gaze was steady and direct. "I'm not here to punish excellence. I'm here to ensure that excellence doesn't come at the cost of institutional integrity."
Isla stared at her, this polished, composed woman who had probably never held a scalpel in her life, who had never watched a patient's blood pressure drop and known that she had seconds to make a choice that would mean life or death. The anger that had been simmering beneath the surface threatened to boil over.
"Have you ever saved a life, Ms. Cole?" The words came out sharper than intended. "Have you ever stood over someone who was dying and known that you were the only thing standing between them and the end? Or do you just sit in judgment of those who do?"
Marianne's expression flickered. For just a moment, her composure cracked, revealing hurt and fury. Then it was gone, replaced by a neutrality so complete it felt like a wall.
"Your surgical privileges are contingent on cooperation with this audit process, Dr. Bennett. I suggest you consider that carefully." She gathered the files into a neat stack. "I'll be reviewing your cases in detail over the coming weeks. If there are deviations that you believe were medically necessary, I expect you to be prepared to justify them. With evidence. Not attitude."
"Is that all?"
"For now."
