“Check for additional damage,” I ordered, examining the surrounding tissue.
Mireya adjusted the retractor to give me a better view and I found a second small tear near the apex. I sutured it closed andreinforced both repair sites. My lower back had started to ache somewhere around hour four. I ignored it.
"Bleeding's controlled," the perfusionist confirmed.
"Keep going," I said. "We're not close yet."
The next two hours moved the way long surgeries always did. Slow and relentless. The team stayed sharp because I expected them to. Mireya stayed sharper than any of them.
We finished up in the OR hours later. My neck ached from hours bent over the table. My eyes felt gritty with exhaustion. But the patient was stable, alive, heading to ICU with a genuinely good prognosis for full recovery.
That was all that mattered.
I stripped off my gloves and gown, tossed them into the biohazard bin, and headed for the scrub sink. Mireya was already there, water running over her hands. Even from behind, I could see her exhaustion—the slump of her shoulders, the way she leaned against the sink, the slight tremor in her fingers she was trying to hide.
“Go home,” I said, stepping beside her.
She glanced sideways at me. "I have an administrative meeting at eight."
I checked my watch. Six-forty-three. "You have time for a couple hours' sleep."
“Barely.” But she didn’t move. She just kept scrubbing, her movements almost compulsive.
I almost asked if she was okay. She was a competent professional and an exceptional surgical nurse. She could manage her own well-being.
Then she reached over without a word and pressed something into my palm. Two white tablets.
I looked down at them.
"You've been rolling your neck since the third hour," she said simply, eyes still forward, rinsing her hands. "There's a water bottle in my bag."
I didn't say anything. I wasn't sure I could.
This was the part I never let myself think about. Not in the OR, not in the hallways, not in the three seconds between closing my eyes and falling asleep. The part where she was just like this. Quiet and certain and so unbearably perceptive that it felt, sometimes, like an accusation.
I had been careful. Cold when I needed to be, which was often. Short with her in ways I wasn't short with anyone else, because distance was the only architecture I knew how to build fast enough. Half the floor probably thought I didn't like her.
I had done nothing to correct them. It was easier that way. Cleaner.
Her fingers had already pulled away, but I could still feel exactly where each one had rested against my skin. A ghost of warmth in the center of my palm. I closed my hand around the ibuprofen slowly, like I was trying to hold onto something I had no right to keep.
No right. That was the phrase for it. She worked under me. Trusted me to be exactly what I had always presented myself as. Professional. Detached. Unreachable. The kind of surgeon who didn't blur lines because he understood what lines were for.
When I finally looked at her, she was already looking at me. Just for a moment. Just long enough.
She held out the water bottle and our fingers touched at the handoff. Briefer than brief. The kind of contact that meant nothing between colleagues.
My exhausted, traitorous heart didn't seem to know that.
Through a two-hour surgery and bone-deep fatigue, she had noticed my neck.
I wondered, not for the first time and hating myself a little for it, whether she felt any of this the way I did. Or whether I was simply a difficult attending she had learned to read the way you learn to read weather. Not out of feeling. Out of survival.
I almost hoped it was the second one.
"Thank you," I said. My voice came out quieter than I intended.
The corner of her mouth curved. Not quite a smile. Just the suggestion of one.
