"You want me to build the case against her."
"I want you to present the facts." Alexandra's gaze was steady and fixed. "The facts you have been meticulously documenting since you arrived. The facts that demonstrate this hospital has been aware of the risks Dr. Bennett represents and has taken appropriate steps to address them."
The implication was clear. Marianne's audit would be used to show that Oakridge had tried to contain Isla's recklessness. That the hospital had done its due diligence. That when disaster inevitably struck, it was the fault of one maverick surgeon rather than institutional failure.
They were going to sacrifice Isla to save themselves.
And they expected Marianne to hand them the knife.
"I need to see the surgical records." Her voice came out steadier than she felt. "Before I can present anything, I need to understand exactly what happened."
"Of course." Alexandra nodded. "Shaw will provide you with full access. The board expects a preliminary report at seven."
The next four hours were the longest of Marianne's life.
She locked herself in her office with the surgical records and a pot of coffee that grew cold as she worked. The bitter smell of it filled the small space, mixing with the sterile scent of paper and ink from the endless files. Page after page of documentation. Vital signs charted minute by minute. Medication logs. Procedural notes. The meticulous record of a surgeon fighting an impossible battle.
She read Isla's own notes, written in the aftermath of the death. They were clinical but clearly haunted. Patient presented with acute abdominal pain and hypotension. Imaging revealed ruptured abdominal aortic aneurysm with significant hemorrhage. Emergency surgical intervention indicated despite poor prognosis.
The words were professional, detached. But Marianne knew Isla well enough to read the devastation underneath. She had lost a patient. For a surgeon who poured everything she had into every case, that loss would have been devastating regardless of whether it was anyone's fault.
She reviewed the surgical records in minute detail, looking for anything that might exonerate Isla. The sequence of decisions. The reasoning behind each deviation. The outcomes that had preceded each choice.
What she found was exactly what she had expected.
Isla had done everything right. Every deviation had been justified by the rapidly deteriorating situation. Every unauthorized choice had been an attempt to save a life that was slipping away. She had fought with everything she had, using every tool at her disposal, refusing to give up even when the odds were hopeless.
But Robert Hendricks had died anyway.
Some patients couldn't be saved. Some damage was too severe, some bleeds too catastrophic, some hearts too weak to keep beating no matter what a surgeon did. This was one ofthose cases. The outcome had been determined before Isla even touched a scalpel.
But the documentation didn't show that. The documentation showed a surgeon who had made repeated unauthorized decisions. A pattern of deviation that matched exactly what Marianne's audit had identified. Evidence that could be twisted into negligence by lawyers skilled in the art of medical malpractice.
At six-thirty, Isla finally texted back.I'm okay. Don't know what's happening yet. They told me to stay away from clinical areas.
Modified duty. They were already moving to restrict her practice while the investigation proceeded.
Marianne stared at the text and felt her heart breaking. She should tell Isla what was coming. Should warn her about the board meeting, about the way her audit was going to be used, about the fact that Marianne herself was being positioned as the architect of her destruction.
But what would that accomplish? It wouldn't change anything. The board would still meet. The lawyers would still circle. The outcome would be the same regardless of whether Isla knew it was coming.
So Marianne typed back:I love you. We'll figure this out.
And then she went to the board meeting and presented the evidence that would destroy the woman she loved.
The boardroom was packed. Twelve board members in expensive suits, their faces grim with the knowledge that their hospital was about to face another lawsuit. Alexandra Vale at the head of the table, her composure firmly in place. Victor Shaw at her right hand, his expression holding barely concealed satisfaction.
Marianne stood at the front of the room with her slides and her documentation and the careful words she had prepared. Shecould feel the weight of what she was about to do pressing down on her chest. Alexandra's gaze remained steady and fixed on her, waiting.
"Ms. Cole." Alexandra's voice was cool. "Please present your findings."
Marianne took a breath and began.
She presented the audit data. The pattern of deviations. The documentation that showed Isla consistently choosing unconventional approaches over standard protocols. She was meticulous, professional, thorough. Everything the board expected.
She also tried to present context. The outcomes data that showed Isla's survival rates far exceeded departmental averages. The specific cases where protocol deviations had saved lives that standard approaches would have lost. The medical realities of trauma surgery that made rigid adherence to protocol sometimes deadly.
The board wasn't interested.
