Because she had trusted her judgment instead of a flowchart.
She allowed herself one moment to feel the relief wash through her, the familiar euphoria of a life snatched back from the edge. Then she looked up and found Marianne watching her with an expression she couldn't quite read. Not disapproval, exactly. Something more complicated. Grudging respect mixed with frustration—and something deeper that Marianne quickly masked.
Their eyes met across the trauma bay. For one suspended moment, nothing else existed except the space between them. The chaos faded. The monitors became distant noise. There was only Marianne, her pen frozen over her clipboard, looking at Islaas if she had suddenly become a puzzle that refused to fit into any of her neat categories.
Then someone called Isla's name and the moment broke. She turned away, back to the work that never ended, but she could still feel the weight of that gaze following her across the room.
The rest of the morning was a blur of surgeries and consultations and the grim arithmetic of triage. The man with the ruptured spleen went into surgery at nine-fifteen and came out at eleven with his abdomen successfully repaired. The woman with the crushed pelvis survived but would face months of rehabilitation. Orthopedics would take over her case now, the long slow work of rebuilding what the accident had destroyed. The teenager was moved to the ICU in stable condition, his mother finally allowed to sit beside his bed and hold the hand that had gripped the steering wheel too tightly on that rain-slick highway.
One of the four critical patients, an elderly man whose injuries had been too extensive to treat, had died before reaching the hospital. There was nothing anyone could have done. Sometimes the damage was simply too great, the body too broken, the timeline too short. Isla had learned to accept that early in her career. Not to be at peace with it, exactly, but to accept it. You couldn't save everyone. You could only save the ones who could be saved, and you had to let go of the rest or the guilt would eat you alive.
Three out of four. Better than the numbers had any right to be.
But as Isla finally stepped away from the trauma bay, pulling off her gloves and trying to let the adrenaline fade from her system, all she could think about was the look on Marianne's face when she had challenged her in front of the entire team.
The staff lounge was quiet when she pushed through the door, exhausted and irritable and desperate for coffee that didn'ttaste like the break room's perpetually burnt offerings. Tamsin was already there, sitting in one of the worn chairs with her own cup cradled in her hands.
"Hell of a morning." Tamsin's voice was warm with understanding. "How are you holding up?"
"I'm fine." Isla poured herself coffee and dropped into the chair across from her friend. "Three saves, one loss we couldn't have prevented anyway. All things considered, it's a good day."
"That's not what I meant."
Isla looked up to find Tamsin watching her with that knowing expression that always made her feel uncomfortably seen. They had worked together for four years. Tamsin had witnessed her worst moments and her best, had seen her hands shake after losing patients and steady themselves before impossible surgeries. There was very little Isla could hide from her.
"The audit is going to be the death of me," she admitted finally. "I can't focus when she's standing there watching every move I make. It's like having a hawk perched on my shoulder, waiting for me to make a mistake."
"Ms. Cole seems... thorough."
"That's one word for it." Isla took a bitter sip of her coffee. "She questioned my tube placement in the middle of a critical situation. Do you know how dangerous that is? How distracting it is to have someone second-guessing you when a patient's life is on the line? Pfft. She doesn’t have a fucking clue. "
Tamsin was quiet for a moment, her expression thoughtful. "She watches you differently than she watches the others."
"What do you mean?"
"I've seen her observe three different physicians this week. With Dr. Hartman and Dr. Chen, she's clinical. Distant. She takes notes and asks questions and maintains professional boundaries." Tamsin paused, her gaze steady on Isla's face."With you, it's different. More intense. Like she's not just evaluating your procedures."
Something uncomfortable stirred in Isla's chest. She pushed it down immediately. "She's probably just more focused on me because I'm the reason she was hired. The board wanted accountability, and I'm the most visible target."
"Maybe." Tamsin didn't sound convinced. "But the way she looked at you today when you saved that kid... that wasn't just professional assessment. I was watching her while you were doing the tube repositioning. When your hands went in and you made that call to ignore her and save him anyway, she didn't look angry. She looked..."
"Looked what?"
Tamsin considered for a moment, choosing her words with characteristic care. "Fascinated. Like she was seeing something she hadn't expected to see. And maybe didn't want to see."
Something about the observation made Isla's stomach tighten. She didn't want to examine why. Didn't want to think about what it might mean that Marianne Cole watched her with fascination instead of clinical disapproval. The woman was here to evaluate her, possibly to end her career. Nothing about that dynamic should feel anything other than adversarial.
"Don't." Isla's voice came out sharper than she intended. "Don't start with that. She's the woman trying to destroy my career. Whatever intensity you're reading into her surveillance, it's not what you think."
"Okay." Tamsin held up her hands in surrender. "I'm just saying what I saw. You can do whatever you want with the information."
They sat in silence for a moment, the weight of the morning settling over them. Isla stared into her coffee and tried not to think about the way her pulse had jumped when Marianne stepped closer to question her. About the way she had beenacutely conscious of exactly where Marianne was standing throughout the entire crisis.
It didn't mean anything. It couldn't mean anything.
She was not going to let herself be distracted by a woman whose entire purpose was to find fault with everything she did. No matter how cool Marianne's gaze was. No matter how her voice cut through chaos with an authority that demanded attention. No matter how something deep in her chest responded to the challenge in those blue eyes.
The audit would end eventually. Either Marianne would find enough ammunition to end Isla's career, or she would realize that protocol deviations backed by stellar outcomes didn't constitute a crisis. Either way, the surveillance would stop. The intensity would fade. And Isla would go back to practicing medicine the way she had always practiced it: on instinct, with absolute conviction, trusting the skills she had spent a lifetime developing.
