Chapter 1: Forty-Eight Hours
Emma Swan was never late for anything. In fact, she liked to pride herself on being punctual for everything. So choosing today, of all days to be late was not something she had planned.
The first shift as an intern is basically make or break; if you shine during your first forty-eight hour shift, the residents and attendings will make your career, and if you even for a second look like you’re stumbling, they will break your career as a surgeon into tiny little pieces and scatter them across the OR floor. Dr. Swan came first in her class at Stanford and she sure as hell was not about to get crushed by one of the best surgical internships on the East Coast. She was determined to shine – not that she had much choice but to do so, she was still determined to stand out from the crowd.
And also kind of determined not to get chastised for being late on her very first day.
She sprinted across the wet parking lot, already feeling puddles spraying up the back of her jeans, praying on her luck that she wouldn't slip and break something. In five minutes, her surgical resident would be wandering into the locker room calling out her name and if she wasn't there then she would more than likely get kicked directly off the programme before it even began. She had to be there on time.
Her feet splashed and skidded across the linoleum reception floor, sending her flying into one of the nurses' stations with a painful crash. Politely providing rushed apologies and smiles she didn't have time for, Emma managed to catch her foot between the closing doors of one of the elevators and clambered inside. She tapped the button for the third floor and used the time it took for the elevator to travel upwards to catch her breath. She tried to pay as little attention to the raised eyebrows she was receiving from the other people that had already been crammed into the stuffy elevator.
Once the doors opened on the third floor, her race began again. Left out of the elevator, right at the first hallway, left at the second, left again, then the third door on the right. She threw the door open to find a large group of terrified looking people in light blue scrubs staring back at her. Clearly they had all managed to arrive early, or at least on time. If she hadn't been behind schedule, Emma probably would have felt relieved that there was no sign of a surgical resident in the vicinity, but with at least twenty people watching her every move, she didn't have time to feel anything other than anxious.
With her pride kicking in, Emma dropped her duffel bag on the end of a bench between two rows of lockers and began to strip. She ignored the few childish wolf whistles that came from several other interns, opting to focus more on putting her scrub top on the right way around instead. Once her scrubs and shoes were on comfortably, Emma stuffed her civilian clothes into her bag and went in search for her stethoscope that she assumed had found its way to the bottom of her bag when she couldn’t find it immediately.
"Good morning, people." Came a voice from behind her, making Emma's focus change completely. "My name is Dr. Whale. I will be the elected resident for a lucky few of you," he paused to flash a glimpse of his pearly-whites behind a sleazy smile. "The rest of you have been assigned to some of the other residents waiting at the end of the hallway. Now, when I call your name, I expect you to leave immediately to find your resident. Understood?"
There was a low rumble of murmurs from the interns, even though most of them, including Emma, were too preoccupied hoping to whatever gods they believed in that they would not be stuck with Dr. Whale as their surgical resident. Multiple employees of Storybrooke Memorial Hospital had already handed the interns some sort of opinion on some of the attendings and almost all of the residents during their welcome party the week before. From that moment, Emma knew that the last person in this hospital that she wanted to be stuck under was Dr. Whale. His sexist and derogatory attitude hadn’t seemed to get him very far with most of the attendings and any of the nurses, and it sure as hell wasn’t going to stand with her either.
"Okay; Bell, Watkins, Morris, O'Donnell, and Adams, you're with Dr. Howells." Five gracious looking interns all shuffled towards the door, leaving only fifteen others behind. "Blanchard, Lucas, Jones, Cassidy, and Swan, you're with me." Emma's stomach dropped. "Stewart, Thomas, Wilson, Stevens, and Jacobson, you’re with Dr. Williams. And the rest of you are with Dr. Watson."
Emma Swan, the girl with the M.D from Stanford was stuck with Dr. Manwhore. She didn't need to know who he was or what his personality outside of work was like to know that her surgical resident liked spending more time flirting with the nurses, interns, and attractive patients than actually spending time cutting in the OR. Even the Chief of Surgery had warned her about his concerning behaviour. This was perfect. Absolutely perfect.
As soon as the other groups of fortunate interns rushed out of the locker room, Dr. Whale got down to business and flashed a politician-like smile at his interns with his overly bleached teeth.
"I have five rules. Remember them; abide by them and you won't get caught out. Follow me." He turned on his heel and swiftly left the room with three of his five interns in tow.
"Hey, you dropped your stethoscope when you pulled out your scrubs," came the voice of one of Emma’s fellow interns. Emma looked up from the position she had resumed halfway into her bag to see a dainty, pixie cut, brunette woman by her side. The other intern reached beneath the bench and pulled out Emma's yellow stethoscope before offering it straight over. "I'm Mary-Margaret, by the way."
Emma graciously took the tool and swung it around her neck. "Thanks. I'm Emma." She nodded towards the door, where they could still hear Dr. Whale's obnoxious voice talking with the leggy intern that Emma had noticed was too busy making eyes at their resident to even listen to him. "Shall we?"
The brunette nodded and followed Emma as she stalked out of the locker room with a little more confidence than she had before she had skid into the room, and that confidence only grew as Dr. Whale mumbled through his introductory spiel.
“Rule number one,” Emma managed to hear Dr. Whale begin at the end of the corridor. “Don’t bother sucking up. I already hate you; that’s not gonna change. Except for you… We could probably make some sort of compromise.” He winked at the flirtatious intern that had previously been making eyes at him. The rest of the group of surgical interns rolled their eyes, but Dr. Whale seemed to have missed it completely as he picked up a box from the nurse’s station. “Number two: trauma protocol, phone list, pagers. The nurses will page you, and you’re to answer every page at a run - and I mean that. You run.”
He handed the box over to a handsomely ragged male intern with thick, dark hair and continued walking as the rest of his interns tore a pager from the cardboard box like wild animals. Fortunately for Emma, she was the first to grab one and found herself directly behind Dr. Whale as he continued with his third rule of survival. She didn’t want to suck up to him, but if she could worm her way into his good books, like one of her fellow interns already seemed to have accomplished, Emma hoped she would have the chance to take her pick of surgeries straight away.
“Your first shift starts now and lasts 48 hours. You’re interns, grunts, nobodies, bottom of the surgical food chain. You run labs, write orders, work every second night until you drop, and don’t complain.” He came to a sudden stop and pushed the door to his right open. “On-call rooms. Attendings and residents hog them for things other than sleep.” He winked again at the flirtatious and lanky intern, which was caught with an incredibly coy smile. Emma bit back a groan as she rolled her eyes at the unprofessional scene that was unfolding before them. “Sleep when you can, where you can, which brings me to rule number three: if I’m sleeping, don’t wake me up unless your patient is dying. Rule four: the dying patient better not be dead when I get there; not only will you have killed someone, you would have woke me for no reason. Are we clear?”
The entire group of surgical interns nodded, until the lanky brunette intern stepped forward with her hand slightly raised and her lip pulled between her teeth.
“Dr. Whale, you said five rules, that was only four...”
Whale hummed for a moment, as if to wait for something to happen, and much to the interns’ surprise, his pager buzzed loudly. Dr. Whale grinned and winked again. “Rule number five: when I move, you move.”
He pushed his way through the group of interns, who were too busy gawking at each other over the coincidence of his pager beeping at the opportune moment to even realise what the situation was. As their assigned resident sprinted out of sight, the interns clicked onto what was happening and scrambled away from the on-call room to chase their resident through the corridors and hallways that led to the only elevator in the hospital that travelled from the basement to the helipad on the roof. When they finally reached the silver elevator, the doors slid open to reveal a paramedic straddling a seizing patient as she tried to hold the teenager down by his hips and his wrists. With the help of his interns, Whale pulled the metal gurney from the elevator and into the corridor.
“What have we got?” Whale asked as they wheeled the bed into an empty room and pulled the paramedic back onto her feet. They transferred the teenager from the gurney onto the larger bed that took up most of the space in the room before awaiting instruction from their resident.
“Adam Young, 15 years-old, new onset seizures, intermittent for the past week.” The paramedic that had been pulled off the boy had explained as she handed over the scribbled chart she had created in the copter. “IV lost en-route, started grand mal seizing as we descended.”
Dr. Whale nodded and instructed his two male interns to his side, “Get him on his side,” he looked up at the lanky brunette over the table; this time there was no wink or any form of flirtation. “You – 10 milligrams of Diazepam IM.”
She nodded to him and fiddled around in the draws of medical supplies that had been wheeled in with the bed as she pulled out a vial and needle. She extracted the liquid into the syringe and pushed the needle into the boy’s spine as he shook atop of the bed. His shaking began to slow as Emma was instructed to go with her gut instinct to do what was expected next. And she did. She successfully connected the boy’s heart rate to one of the machines, and his brain activity on another, all before the attending sauntered into the room.
“A wet fish on dry land, huh?” Asked a strong voice in the doorway of the room. The attending folded her arms across her chest, looking slightly impressed with the efficiency of the newest batch of interns. Emma looked up from the monitors that she had been cautiously checking was on the right track before anyone could check them for sufficient data, when she noticed the stunning brunette. The attending seemed to hold the entire room with just one sentence and a cocky attitude. The sight of the woman that seemed to rock dark blue scrubs and a scrub cap better than anyone Emma had ever seen made Emma’s heart unintentionally falter in her chest. The attending glared at Emma when she noticed the blonde watching her every move. It should have made Emma flinch, but she couldn’t find it in herself to look away from the stunning sight before her.
“Whale, shotgun him.” The attending insisted as she began her work up on the teenager who had now stopped seizing. She lifted the boy’s eyelids and flicked her flashlight back and forth, tracking his eye movements. She ‘hm’ed for a second before pulling the heart monitor and brain function monitor from Emma to take a look for herself. She nodded to herself and pushed the screens back to the blonde intern. “Whatever intern you choose for this case, I need them to keep me updated. Dr. Nolan will be in surgery for the next 18 hours and doesn’t need to be disturbed by a group of idiotic interns.”
Whale clapped his hands together once as the attending sauntered back out of the room. “Okay, you heard Dr. Mills. We need every test in the book: CT, CBC, chem-7, tox screen,” He glanced around his interns and pointed at them one by one as he handed out their duties. “Blanchard, you’re on labs. Jones, patient work-ups. Cassidy, you’re in for a fun morning on rectal exams. Swan, get Adam for a CT; he’s your responsibility now. Report to me before you report to Dr. Mills unless we’ve got a serious problem.”
Emma tried her hardest to hide her smirk, especially since she would now be reporting to Dr. Mills too. She nodded and began unhooking Adam from his machines as he slowly began to come around. She charted his last reading on the monitors as three of her fellow interns stalked out of the room – one more reluctantly than the rest.
“Dr. Whale, what about me?” Emma heard Whale’s favourite intern ask as she released the break from the bed.
“Don’t worry, Lucas. I didn’t forget about you.” He winked at her. “You’ve got the pleasure of being with me all day today.”
Emma had been lugging the oversized bed around the corridors of the hospital for at least thirty minutes before Adam sat up and laughed at her.
“You have absolutely no idea what you’re doing, do you?” He asked her after he realised they were circling themselves down the same corridor for the fourth time.
“I know what I’m doing – I’m just a little lost.” Her patient narrowed his eyes at her, looking more than unimpressed with the intern he had been stuck with. “Look, kid. It’s my first day. Just cut me some slack, okay?”
He scoffed at her. “Sure, I’m a whole world more forgiving than my parents, who will actually be paying for all of this.” He groaned when he saw the same elevator for the fifth time. “Why don’t you just ask someone before my seizures kick in again? You don’t exactly want a dead future soccer star on your hands on your first day, do you? You’re literally worse than the nurse that I got stuck with when I twisted my ankle a few weeks ago, and that’s saying something.”
Emma rolled her eyes at the teenager and gave in. She found the nearest nurses’ station and was finally given directions to CT, where she was aided in transferring Adam from his bed and onto the table for the scan by a male nurse who seemed to smile at her far too much for her liking. She left the nurse to inject a sedative into the teenager’s newly attached IV and wheeled the bed back into the corridor before dropping herself into the chair beside the CT technician. They sat in a comfortable silence as the machine beeped and developed scans of the teenager’s brain on the computer screen. As each scan came onto the screen Emma observed and noted down everything she saw; clear cerebellum, clear optical lobe, clear temporal lobe, clear parietal lobe, clear frontal lobe… Everything was clear.
“Why are we only now at this point?” The same strong voice announced their presence in the doorway, making Emma’s stomach flip as she turned in her chair to see Dr. Mills. She fought the urge to point out the obvious that the attending was flawless in every physical way possible. Instead she guiltily smiled at her and fidgeted with the notes she had taken from the scan.
“We had a few difficulties getting here, but the scans are developing and from what I can tell, there’s nothing to suggest an explanation for Adam’s consecutive seizures.” Emma said as confidently as she possibly could. She had spent far too much time looking at brain scans during her time in medical school to be able to spot any sort of obvious abnormality. Adam had none, and it only made her more suspicious.
“Dr. Swan, is it?” The attending asked, seeing the blonde’s badge hang from the top of her scrub pants as she stood for her to take a seat and observe the scans for herself. Emma nodded at her. “A verbal confirmation would have been nice, Dr. Swan.” She bit before taking the offered seat. She glanced at the screens as she skimmed through the scans with a pensive look on her face. “I’m not the neurosurgeon, but I hate to admit it, I agree with you. We’re just going to have to continue these scans and wait until Dr. Nolan gets out of surgery. Nice work.”
“Thank you, Dr. Mills.” Emma tried not to blush at the compliment as Dr. Mills stood and sauntered past her towards the door, leaving a waft of sweet apples in her midst.
The brunette paused in the doorway before turning back to the intern. “Oh, and you should probably find yourself a map for next time.”
Once Emma had finally completed every scan available to them, she returned Adam to his temporary room on the neurology ward and found herself wandering towards the cafeteria. It had, after all been six hours since she started her shift, and her stomach had started to grumble after the second hour. She grabbed a tray and helped herself to a greasy grilled cheese, fries and a large drink, painfully ignoring the doctor side of her brain that seemed to be yelling at her to choose something healthier and something that might actually give her enough energy to get through the next few hours. As she glanced around the busy cafeteria, she spotted her group of interns as they huddled around a table whispering amongst each other.
“Do you mind if I join you?” She asked, with her tray already on the table. Mary Margaret pulled out the chair beside her with an overly perky grin as Emma took it and sat down.
“I can’t believe you’ve actually been put on a real case straight away,” Mary Margaret sighed, clearly not impressed with being a lab rat for the day.
The lanky brunette shook her head and laughed in near hysteria. “I spent all morning flirting with that idiot and I still haven’t seen a single medical procedure since that kid’s seizure.”
“Ignore Ruby,” the pixie-cut said with a hand on Emma’s shoulder. “She’s just jealous because she’s stuck fetching Dr. Manwhore’s coffee all day.”
“Yeah, well I’d rather be fetching coffee than sticking my fingers in places no one wants fingers to be stuck.” Cassidy groaned. “Have you found anything on the case yet?”
Emma shook her head as she sipped her soda. “Nope. His CT was clear, so were his toxins, and everything else you can think of. So I’m stuck with a medical mystery and a kid that seems to think he knows more than we do.” She chuckled and leaned closer towards her fellow interns. “Does anyone know anything about Dr. Mills?”
“Cardiothoracic Dr. Mills? The one that you’re supposed to be reporting to with this case?” Emma nodded at Cassidy, who raised his eyebrows at her apparent ignorance. “Did you actually read a book in medical school…? She’s the daughter of the greatest cardiothoracic surgeon in the world. Dr. Cora Mills is a legend, and apparently this Dr. Mills is continuing the family legacy.”
“Wait. Her mom is the Dr. Cora Mills? The Dr. Cora Mills that invented the Mills Method ?” This time, it was Cassidy who nodded at her. Emma’s jaw fell slack as she stared back at him in disbelief. “I…But…I thought this Dr. Mills was just a coincidence – I didn’t realise she was already practicing – and practicing at Storybrooke Memorial! Oh my god… She already thinks I’m a complete idiot.”
“Don’t get too far ahead of yourself, love.” Jones told her with a toothy grin that made Emma wince a little. Sure, he was handsome, but everything about him screamed sleaze. She internally rolled her eyes, knowing that without a doubt that he would attempt to lure her into bed with him after a few drinks at the only bar in town, much like she had found herself doing during her years at medical school with many other complete sleaze balls. It was easy, but it got the job done. “Regina Mills thinks everyone is an idiot. That’s why all the residents call her the Evil Queen; she thinks everyone’s an ant, and she’s the boot. She’ll rip your surgical heart out of your chest and crush it before you can even show her how handy you are with a scalpel.”
“Oh, come on, Killian. She can’t possibly be that bad.” Ruby rolled her eyes. “I heard that the best way to get in her good books is by impressing Dr. Nolan.”
Emma seemed to deflate at that point. Mills had already discussed Dr. Nolan multiple times in conversation, but she hadn’t thought much of it – she had simply assumed that they were both nothing more than work colleagues that seemed to work well alongside one another. She hadn’t expected them to be a thing . For some unbeknownst reason, Emma found herself jealous of a man she hadn’t even met yet over a woman that she had barely two encounters with. But she bit her tongue out of pride and nodded. She took Ruby’s advice on-board and convinced herself that when she was later expected to report to Dr. Nolan about Adam’s case, she would prove her worth tenfold.
“Talk of the devil,” Cassidy coughed into his soda, attempting to be as discreet as possible. He failed epically, but the entire group of interns all sat to attention as Dr. Mills approached their table with a sadistic smirk.
“Good afternoon, interns.” She said, instantly sending shivers down Emma’s spine. ‘Great – you’ve got the biggest crush on the greatest surgeon in this hospital ’, Emma thought to herself. ‘How the hell do you expect to learn anything now?’ The blonde internally chastised herself as she barely heard Dr. Mills address their table. “As you all know, the honour of performing the first surgery is reserved for the intern with the most promise. As I’m running the OR today, I get to make that choice. Dr. Neal Cassidy, if you can find it in yourself to stop pretending to have a coughing fit at inappropriate moments, I would like you to scrub in for an appendectomy this afternoon. Congratulations.”
Neal’s cheeks flared a deep said of red as he shook his head in disbelief. He maintained his composure until Dr. Mills had turned on her heel and glided out of the cafeteria, when he jumped to his feet and cheered. “Reserved for the intern with the most promise,” He recited multiple times as he circled the table, trying his very best to piss everyone off with his incessant bragging.
“You don’t actually get those bragging rights until you complete the surgery, mate.” Killian reminded him with a smirk. He was the only intern that seemed to be able to see through the idea of the first surgery – sieve out the weak to reveal the strongest. “Let’s just hope you’re not the next 007.”
“007?” Emma asked.
“007 – Licence to kill.”
When Emma finally made it back to Adam Young’s room, she found his parents frantically patting the side of his face and cooing over him. They didn’t notice her presence in the room until she picked up his chart to check that everything had been recorded correctly since the last time she saw him. She scribbled a few notes on the bottom of his chart after reading his EKG before stuffing it under her arm.
“They gave him a sedative for the CT scan, so he’s still going to be a little drowsy for a while,” Emma told them with her hands deep in her white coat pockets.
“Will he be okay? Our doctor said he might need an operation – is that true? What kind of operation is he going to need?” The boy’s mother asked, completely overwhelmed and on the verge of tears.
Emma opened her mouth for a moment, as if to say something. She snapped it shut as quickly as she had opened it and waited again before trying to say something. “I…Uh… You know, I’m not the doctor. I am a doctor, but I’m not your son’s doctor… I’ll just…” She started backing out towards the door. “I’ll get you Adam’s doctor.”
She spun on her heel and whizzed out of the child’s room, feeling her legs carry her directly to Dr. Whale, who seemed to be mulling around the nurses’ station with Ruby sulking behind him.
“Dr. Whale,” Emma said almost breathlessly. “The parents of the kid with the seizures are here. They want to speak with Adam’s doctor – they have questions. Do you talk to them or do I ask Dr. Mills?”
He waved off her suggestion. “No, Mills has been called into a consultation. Dr. Nolan is out of surgery early, so you’re going to have to brief him on the case and let him deal with it – it’s his case now.”
Emma nodded and tried to ignore the glare that she received from Ruby over Whale’s shoulder as she hastily crossed the hall to the tall, handsome surgeon that seemed to enjoy flashing every passer-by with his charming smile. Just the sight of the neurosurgeon made Emma laugh – he was the complete embodiment of everything she had found that Mills wasn’t. He was polite and cheerful; he clearly seemed optimistic and positively level headed. ‘Maybe that’s why they’re together – they balance each other out.’ Emma thought to herself as she approached him with her own lopsided smile, remembering what Ruby had told her at lunch.
“Dr. Nolan? I’m Dr. Emma Swan – I’m one of Whale’s new interns.” She said, offering the surgeon her hand to shake. As he took it, his charming smile dropped to a pitiful observation. Trying to ignore it, she handed over Adam’s casefile. “I’ve got a patient – or you have a patient – called Adam Young. He’s fifteen and visibly healthy, but he’s been brought in with new onset seizures. He’s been intermittent for the last week. Dr. Mills ordered shotgun, so we’ve got every test results possible, but nothing we have explains the seizures and his parents have just arrived with questions… for you.”
He nodded and skipped through the file page by page. He paused for a moment on the boy’s CT scan and shook his head. “So why do they have questions for me?”
“Because you’re the doctor on his case now.”
“I understand that, but why couldn’t you have just told his parents what you told me?” He asked her with a pensive look as he returned the casefile to her hands. “Everything you told me, is everything we already know, so I’ll just be reiterating everything you said.”
Emma furrowed her brow, not entirely sure whether or not the surgeon was being serious or if he was chastising her in the most polite way possible. “I didn’t want to tell them any wrong information – and I thought that if they had any more questions, you would be the man to answer them.”
The charming surgeon smirked at her and nodded. “Good, I like an intern that actually thinks about their actions before they do anything too gung-ho.” He took off towards Adam’s room with Emma matching his strides and hanging off of every word he uttered. “If you want to remain on this case and under my service, I suggest you tell the parents what you told me, then they can ask me whatever they want to know.”
Twenty-three hours into her first shift, Emma found herself a front row seat in the OR gallery to watch Neal Cassidy perform the first surgery of their internships. Ruby and Mary Margaret had saved her a seat while she ran to the hospital library to dig out a book on seizures. Dr. Nolan had suggested that Emma spent a few hours researching the onset and causes of consecutive seizures after their discussion with Adam’s parents, but she still hadn’t found anything that could have given them an adequate reason for his series of seizures.
“Ten bucks he can’t even hold a scalpel right,” an intern behind Emma muttered as they all stared down on Neal, who was fidgeting more than an anxious kid waiting for his talk with the principle. It was comical, but it wasn’t exactly fair.
“Fifteen, he cries,” another added.
“No, way. Twenty says he has a complete meltdown.” Ruby offered as she pulled out four bags of chips from her pocket, handing one each to Emma, Mary-Margaret and Killian.
Mary-Margaret scoffed and elbowed Ruby in the ribs. “Fifty says he pulls the whole thing off.” The brunette’s fellow interns glanced over at her in utter confusion at her optimism and confidence in Cassidy. “That’s one of us down there. The first one of us. Where’s your loyalty? This may be a cat fight, but he’s down there with the lions.”
Emma rolled her eyes and matched Mary Margaret’s scoff. “I’ll take that action.”
The interns peered over the balcony to get a closer look of their fellow surgical intern with baited breath. No one really wanted to see Cassidy fail, they simply hoped that they wouldn’t be the first to be titled ‘007 ’. Emma’s research book on seizures lay forgotten at her feet, which was then joined by her chips when Dr. Mills walked into the room with the professionalism that Emma had seen from the original Mills in some of her recorded surgeries.
“Okay, Cassidy. This is a routine procedure – you should have seen this a million times in your textbooks. Let’s see what you can do.” She ushered him towards the operating table, and waited for a moment to see if he would crack even before he made his first cut. “I hope you’ve done your research, because I haven’t performed an appendectomy in a while.”
Mary-Margaret groaned in the balcony as they watched tentatively. “Oh, come on. That’s not fair – she’s making him sweat before he’s even picked up the scalpel.”
Neal nodded nervously and held his hand out to the scrub nurse. “Scalpel.” He accepted the scalpel and gently pressed it against the skin, barely making a tear in the flesh of the patient that lay sedated on the table before him.
Regina tutted under her breath. “More pressure on the scalpel.” She instructed and Neal tried again, this time, successfully cutting through a few layers of flesh. “The human flesh is a tough shell. You really have to dig in to get the result you require.”
She leaned over the table slightly, to get a better look at what the intern was doing with the scalpel. For a few minutes, he spent his time carefully cutting through the thick layers of skin and fatty flesh before holding out his gloved hand again to accept a pair of pick-ups that he instinctively attached to a piece of flesh in his view. He held his hand out again to accept a clamp this time. Regina nodded as he clamped the peritoneum.
In the balcony, Ruby threw her hands in the air out of disappointment and grumbled under her breath. “I can’t believe he even got to the peritoneum without creating a code brown. That’s me out, anyway.”
“He hasn’t finished yet – there’s still time for a 007.” Emma laughed, earning herself a high-five from the lanky brunette.
“Stop it, you two. He’s going to pull it off. He’s actually going to do it.” Mary Margaret chided as she leaned forward in her seat in an attempt to tune out the childish behaviour of her fellow interns.
“Appendix is out.” Neal said aloud with a huge sigh of relief as he dropped the organ into a sterile silver bowl.
“Not bad, Cassidy.” Dr. Mills observed, ignoring the muffled cheering sounds coming from the balcony above them. “Now all you have to do is invert the stump into the cecum and simultaneously pull up on the purse strings, but be careful not to break th- You ripped the cecum.” She watched as Cassidy began to panic at the sight in the open surgical field. This was what it was about – this was where the strong shone or the weak fell to pieces. “You’ve got a bleeder. You’re infecting the area. What do you do, Cassidy?”
Neal looked up to her with wide eyes and shook his head, not knowing what to do in that very moment, other than panic.
“Start the suction and you start digging for those strings before she bleeds to death.” Neal nods and holds out his hand to the scrub nurse in a stunned silence. “Give him a clamp.” He attached the clamp to a random spot inside the surgical field, making Regina groan with irritation at his complete stupidity. “Today, Cassidy. Get your head out of fairy tale land and actually think about what you’re doing. What are you waiting for?”
The intern didn’t move – he couldn’t. He simply stared back at Dr. Mills like a deer in headlights. He heard everything that Dr. Mills was telling him, but couldn’t actually contemplate what was happening before him. Nothing registered for a long time, and before he knew it, a scrub nurse was pulling him out of the way, and Mills was sticking her hands into the surgical field, effortlessly trying to fix the dire mess that he had made inside his very first patient.
“007,” Killian whispered in complete astonishment. “Cassidy is 007.”
“Don’t you dare let him hear you call him that,” Mary Margaret warned with a pointed finger in his face. “That will knock his confidence so much more than this has already done. He doesn’t need you making fun of him.”
Emma bit back her laughter at Mary Margaret’s motherly tone as she wagged her finger and continued to rant at the scruffy looking intern. The blonde grabbed her research book and tried to clean up the mess she had made when Regina had appeared in the OR, before patting Mary Margaret on the shoulder. “You owe me 50 bucks, M&M. I will take my payment in cash or in the form of hard liquor.”
This time, when Emma returned to check on her patient, Adam Young, she found Dr. Nolan standing over him, checking his stats and any physical changes in his physique.
“Where the hell have you been?” He barked at the intern as soon as he heard her sneakers squeak on the linoleum flooring.
“I…Watching the first surgery.” She stumbled over her words as she received the chart from one of the nurses. “My pager was on – what happened?”
He ripped the chart from her skinny hands and ushered her outside into the corridor. His voice lowered into a hiss that she would have expected from Dr. Mills instead. “He seized and his heart stopped, that’s what happened. And where were you? Too busy laughing at one of your own failing, when you were miles away from your own failure.” Dr. Nolan took a deep breath and straightened slightly. “I suggest, if you want to remain on this case and remain on my service, that you dig deeper into your research Dr. Swan, because next time, we might not be so lucky. If we don’t find what’s causing his seizures, he’s going to die. If you do find what’s causing his seizures, I’ll let you do what no other intern gets to do: scrub in to assist on an advanced procedure. But you’re going to have to seriously wise up.”
Emma’s eyes widened at the very thought of being the first intern to actually assist on something bigger than a routine procedure of an appendectomy. If she could solve this medical mystery, she would be in every attending on the board’s good books. Now that was sucking up to the boss, but Emma couldn’t even find it in herself to give a damn. She would be succeeding in ways her fellow interns would never imagine. She watched as Dr. Nolan returned to Adam’s room before excitedly speeding off to the library.
For hours, she sat on the floor, beneath the bookcases searching for an answer; searching for something that would at least hint to why Adam was experiencing his seizures. He wasn’t responding to his meds. His CT was clear of tumours; he didn’t have anorexia, renal failure or acidosis; there’s no white count that would suggest an infection; he had no CT lesions, no fevers and nothing in his spinal tap. It wasn’t an aneurysm because there hadn’t been any blood in his CT, and he hadn’t complained about headaches.
She slapped her forehead in utter frustration with the palm of her hand. There had to be something that explained his seizures; but what?!
Then it clicked.
The blonde pushed all of the books from her lap, grabbed her notepad and pen, and raced out of the library faster than she had ever run in her life. She sped through the hospital corridors in search of Dr. Nolan, when she finally collided with him on the surgical floor.
“I’ve got it,” she panted, pointing at the notepad she gripped tightly in her hand. “He’s a soccer player. He has no headaches, no back pain and his CT is clean. There’s no medical proof that he had an aneurysm, but what if he had one anyway?”
Dr. Nolan furrowed his brow at her before he shook his head. “It's not possible - there are no indicators that would show an aneurysm.”
“He twisted his ankle during practice. He twisted his ankle and fell. It wasn’t a big deal, but he had it checked and because it was so minor, his doctor didn’t mention it when I took his history. But he did fall.”
“Oh come on, Swan. You’re wasting my time. Do you know what the chance is that a fall could burst an aneurysm? One in a million. Literally, there is a one in a million chance that Adam’s fall could have burst an aneurysm.” He tried to barge past the blonde intern before stopping in his tracks and mulling over the case in his head once more. He glanced back at the intern and flashed his charming grin again. “What if Adam is one in a million?”
“So, how has your ‘ intern with the most promise ’ handled their first day?” Nolan asked as he leaned back in the chair behind his desk.
“Exactly how I had expected.” Mills smirked as she leaned on the opposite side of his desk. The amusement of the situation swam deep in her eyes at the idea of seeing an intern break on the first shift. “Cassidy crumbled during the appendectomy. He had the right idea, but once it got down to the nitty-gritty part of the surgery, he completely bottled it. I don’t think I’ve ever seen an intern botch an appendectomy in the way he did today.”
Nolan sighed and shook his head at the brunette before him. “I can’t believe that you actually enjoy doing this, Regina… No, I can believe it, I’m just deluding myself into believing that you aren’t that cruel to interns.”
It was Regina’s rich laughter that made the whole outlook on the situation worse for the Neuro surgeon. “Well, they have to learn, David. Who else was I going to choose?”
“Someone with at least a remote idea as to what they’re doing. Swan has a lot of promise.” He told her confidently. He had spent over twelve hours with the intern after she enlightened him with what she was so determined to believe caused Adam’s seizures. “She solved that aneurysm case this afternoon and scrubbed in on the surgery in her first forty-eight hour shift. She’s got the making of becoming a fantastic surgeon, no matter what specialty she chooses. She kept a level head, and even pushed through fatigue enough to sit in the library to research every possibility. She’s already proved herself to be one of the most valuable players in this year’s batch.”
Regina hummed at her colleague as she moved to sit on the edge of his desk. She had recalled reading the intern’s application and her references prior to the interns flooding through the front doors of the hospital. It had been the only application that she would be happy enough to admit she was impressed with. Emma Swan had the advancement in education that very few of the greats had. She was ahead of her time and Regina was intrigued by it; not very many interns were all that willing to prove themselves in the way that Emma had gone out of her way to do.
“Page her. I want to discuss the case with her.” She instructed him, taking his water bottle from the table and swigging from it. She ignored David’s warning tuts and sighs. They were way past caring about each other’s annoying and dirty habits by now. “I want to discuss the case with the intern that actually ran the entire thing without killing someone on their first shift.”
“I’m on it.” He said, pulling his water from Regina’s hands and sending through the page to his intern. “Oh, and you should probably know that they named your promising intern 007 .”
“I hate to admit it, but I think they’re right. He was reckless. I don’t want an intern in my OR that will spend the entire time in there sweating himself unsterile. It was disgusting and totally unprofessional.”
“Oh, come on, Regina. You remember how nervous we were on our first surgeries.”
“Like it was yesterday, yes, but neither of us looked like we were going to faint or sweat into the patient. We were calm and collected, with an excitement that made us determined to prove how prepared we were. I can already see it; these interns are going to be a bunch of idiots.” Regina smirked at him and elegantly managed to cross her legs in the tight pencil skirt she had changed into for her consultations. “Why do you actually think I do the first surgery choices?”
Before David could confirm everything she was asking him to tell her, a confident knock on the door interrupted them. As the door opened and a blonde head popped out around the door, David smiled.
“Dr. Nolan, you paged?” Emma asked, fully opening the door when she spotted Dr. Mills with him. She bit back her smile and averted her eyes from the brunette sat on the corner of the desk.
“Ah, yes. Swan. Come in, come in.” He waved her over to the seats in front of his desk, allowing Emma to choose the seat furthest away from Dr. Mills. Emma knew that if she had taken the seat closest to the cardio goddess, she would have spent the entire time in Dr. Nolan’s office staring at Regina’s legs. “I have just been telling Dr. Mills about how successful you were today with our little medical mystery case.”
With a gentle smile that Emma had yet to see, Regina leaned from her perch closer to the blonde. “I’m pleasantly surprised, Dr. Swan. Remind me, where were you when you last updated me on the case?”
From her slouching position in the chair, Emma pulled herself into perfect posture and tried her hardest to recall when and where she had last bumped into Dr. Mills, all while trying not to include the times she had seen her throughout the hospital or the times that she had thought-up conversations that they never had.
“Uh, I had just gone through all of the tests for Adam’s case. There was nothing in any of his results that would have explained his seizures. There was nothing on his first CT either, but after some extensive research and remembering what Adam had told me about a fall he had during a soccer practice, it was obvious. It seemed impossible that his fall could have triggered it, but since there was nothing else that could have explained it, I knew that it wouldn’t have hurt if we looked into the possibility. So we did. We performed a second CT and induced another seizure, so we could see the aneurysm, where my diagnosis was proved correct.”
“That was a brave decision, Swan. Not many interns are willing to defend themselves in front of an attending, especially on a case like this one.” Regina didn’t want to blow the intern’s trumpet, but she had to admit, she was impressed. “From what I can gather, Dr. Nolan is incredibly pleased with your efficiency and capability of holding your own. I for one, would very much like to see your capabilities first hand. Therefore, I’m putting you on my service for the rest of the week. You will be working under Dr. Whale with Dr. Lucas, so I expect you to prove to me that you’re capable of upholding your newest expectations.”
Emma stared at the cardio surgeon with wide eyes and nodded with exaggeration. “Yes, of course. Thank you so much, Dr. Mills.” As she opened her mouth to blab some crap about making sure to prove herself, she was saved by the buzzing of her pager. She looked down at the piece of tech attached to the top of her scrub pants and cringed. “I have to take this…”
“Yes, of course. Thank you, Swan.” David said to her and held his hand up for her to leave. The blonde grinned at them before hastily making an exit and speeding away to her call.
“Don’t you dare crack her on your service, Regina.” David warned as soon as Emma closed the door behind herself. “Neuro needs some fresh meat, and the only others that are showing any slight interest are O’Donnell and Bell, and neither of them are capable of forming sentences with words longer than four letters.”
Chapter 2: Saviour
A/N: Wow! What an amazing response for the first chapter - thank you for your reviews! I'm so glad you have all enjoyed it so far. So, as requested and apparently, highly anticipated, here is Chapter 2.
Regina had spent her entire night off planning her dual surgeries for the following day. Stupidly, she had jumped the gun by requesting Emma Swan to join her on her service for the day. There was something about breaking in a new, overly confident, Stanford University graduate of an intern that she just couldn’t resist. It almost felt like she had been handed the greatest gift any self-centred, power hungry cardiothoracic surgeon could ask for. And it was her time to finally prove to some idiotic intern that her speciality wasn’t for the faint hearted, nor could ‘medical mysteries’ be solved by a small amount of guess work and a ballsy attitude. Sure, she agreed that Swan’s success on her very first case under one of the best neurology attendings Storybrooke Memorial had ever seen was a fine achievement, however, there was more than just a little temptation on Regina’s behalf to want to play around with the young and gullible intern.
When the head of cardiothoracic surgery arrived at the hospital to begin a whole new shift, she took it upon herself to do her resident’s rounds on her unit, just to make sure that every one of the patients under her department were just as she had left them the day before. From what she had been able to muster from charts and the word of her residents, everything had gone according to plan in her absence and even her larger cases with scheduled surgeries were just as she had expected. The simple, sadistic looking smile that seemed to have become her ‘resting face’ at some point, helped as she gracefully glided through the corridors without the need to move or dodge around any oncoming traffic. ‘Power and authority’, was what she had called it, but everyone else in the hospital seemed to refer to it as ‘arrogance and entitlement’.
As she rounded the corner to the main lobby of the surgical floor with a stack of charts strategically balanced between her arm and her hip, Regina paused to watch with amusement as one of the newest surgical nurses clung onto every egotistical word that came tumbling out of Dr. Whale’s mouth as he leaned over the nurses’ station with a piping hot cup of take-out coffee in his hand. How on earth the man had come so far in life without being walloped in the face by a very strong, independent woman for his derogatory remarks was beyond her. If she wasn’t so strung up on her own social trajectory, Regina knew that she would have gladly been the woman to offer him a piece of her mind.
She stalked across the linoleum flooring and dropped her stack of charts onto the counter between Whale and his nurse-of-the-day with a severe crash, causing the resident to flinch and drop his coffee onto the dainty redhead’s work space. He muttered a few choice words towards the ‘idiot who thought that was clever’ before looking up to make eye contact with the unimpressed attending, whose hands were now pressed firmly into her hips. Her dark, unapologetic, brown eyes swam with mirth and amusement with his stunned expression. Even dressed in her skin tight pencil skirt and white blouse beneath her lab coat she looked terrifying. Somehow, the woman had managed to successfully transform herself to look exactly like a villain from every child’s fairy tale nightmares. In fact, she even successfully managed to turn herself into every surgical intern and resident’s nightmare too. She was, in every way, the Evil Queen in which she was depicted, and every other employee at Storybrooke Memorial was subjected to her unfair reign and brutal wrath.
“If you are quite finished, Dr. Whale.” Regina gave him a warning look through a glare that would have made any man quake in his boots. “I have assigned you, and two of your misfit interns, to my service today. There is only so much self-absorption and stupidity that I can handle for one day.”
Whale smirked at her and slid the charts that she had so rudely dropped onto the nurses’ station back towards her. “Thanks, but no thanks.” Unimpressed that a second year resident wasn’t actually willing to drop everything just to please her, Regina blinked at him and hummed a deadpan ‘hmm’ through pursed lips. “Booth is doing a facial reconstruction today, and fortunately for the both of us, he has asked me to assist.”
“Yes, how very fortunate.” Regina gibed, still feeling bitter that the resident had chosen to chase the path of breast implants, nose jobs and glute observations instead of continuing his success through her speciality. She had spent far too much time investing in his hand at cardiothoracic surgery not to be. “Either way, Chief Hopper has given me permission to loan two of your interns on their second shift, so if you don’t mind, I will be taking Swan and Lucas for the next forty-eight-hours. I’m sure they would much rather spend time observing a real speciality than one produced merely for vanity.”
“Whatever you say, your majesty, but I don’t think you’ll get much use out of them.” He hypothesised with a curled lip in distaste of discussing his interns.
Regina scoffed at his own personal arrogance. He would have been perfect as her shadow resident. “And why would you say that?”
Whale chuckled and leaned onto the nurses’ station with his elbow. “I don’t know… I think Lucas is a dud, and don’t even get me started on Swan.” He scoffed, much to the attending’s concern. “Swan is already an irritating know it all. If she spent less time chasing some of the big surgeries, she might actually realise that she isn’t as amazing as everyone seems to be making her out to be.”
“For once, Dr. Whale, I don’t think that’s the case.” With a dismissive hum, Regina shook her head in disapproval. She didn’t think that was the case. From what she had already seen from Swan, the intern was already much more advanced in her knowledge than Whale cared to admit. Whether she defended the blonde intern because she saw her own determination and ambition in the woman, or if she had just gained a little faith in their newest batch of interns, Regina wasn’t sure.
“Well, whatever the case is; they’re all yours.” Whale pointed to the five eager interns behind her. “Assign whoever you don’t want to the clinic or trauma. Or you could just make them all your scut monkeys – it’s not like you haven’t done that before.” With a grin, he sauntered off to the elevators down to ORs.
Victor Whale was one of the most arrogant men Regina had ever met in her life, but he could also be a damn good surgeon when he wanted to be. At the time, taking him under her wing had been a good idea, but with hindsight and eventually figuring out the man’s surgical intentions, she should have known from the beginning that he would follow his sexual appetite by choosing plastics over cardio. It was a rookie mistake that Regina still had difficulty trying to shrug off. Alas, she pushed her disappointment to the back of her mind with all of the other thoughts that she didn’t wish to divulge in and spun on her feel to face his interns with a masochistic smile plastered over her face.
“Swan. Lucas. You’re both on my service today.” She told the interns, who had all straightened and hung off her every word like they were being preached pure gold. Swan and Lucas, however, had to visibly hide their grins and the obvious excitement that something about being on her service seemed to enthral in them. “The rest of you will be alternating between the clinic with Dr. Gold or Dr. Midas and the trauma unit with Dr. French. If you are paged to a trauma while in the clinic, page me and assure that there is someone to cover you before you run to it. Understood?”
Blanchard, Jones and Cassidy all nodded with a hit of their own excitement that she had never actually seen from a group of interns that had been put on clinic duty for an entire shift. Suspiciously, she watched them practically skip and race each other to the elevators before they shared a round of high-fives. Regina rolled her eyes and sighed. They hadn’t even left her sight and she already knew that she would be answering annoyed pages from French or even Gold. Receiving them from Midas was a daily expectance, so waiting for those wasn’t something she needed to be worried about.
“I have a few preparatory consultations with a few patients this morning.” She started as she finally broke her glare on the back of Whale’s three other interns’ heads to face Swan and Lucas. “There are a few cases in which I would like for you both to see, so expect to be questioned on your knowledge throughout your shift. I will also be training you, Dr. Lucas on the art of bedside mannerisms. According to some of your references, yours are atrocious.”
Lucas’ eyes widened before her head dropped in utter embarrassment, forcing Regina to fight through every ounce of control she had not to smirk at the reaction. Before leaving the hospital the night before, she had requested a second copy of the applications from Whale’s interns that they had submitted to get onto the surgical programme. The only ones in the pile that she had been impressed with happened to have been submitted through Swan, Lucas and Jones. She already knew that Cassidy’s wasn’t great, especially since his references were his only selling point and he had already proven that he couldn’t hold his nerve under pressure, and Blanchard’s application was much too cheerful and perky for Regina to even get past her cover letter, so that got tossed aside right away. Lucas, on the other hand, had seemingly aced through college and med school, but flunked entirely on her application of patient care. Somehow, the intern had thought it appropriate to use her body and sexual prowess to ensure that her practice patients had the best experience possible.
“I don’t wish to be signing off any harassment claims from family members of patients who have received your special treatment during their stay at this hospital. We already have one misogynistic surgeon at this hospital that uses their attractive appearance to gain himself a few extra brownie points, and we surely do not need another.” Regina’s stern and authoritative tone was enough to make Lucas frantically nod her head in understanding. “As a surgeon in this hospital, you will need as much respect from your fellow surgeons – specifically your male colleagues – as you can possibly muster, and flirting with your patients won’t get you anything other than an STD.”
Lucas cringed at her and accepted the three charts that Mills handed her, while Swan had to visibly bite back her laughter at her friend as she accepted her own charts. From the moment they met, Emma knew that Dr. Ruby Lucas would be trouble. Any surgeon that was willing to kiss up to their resident was a fool – kissing up to the attendings was the only way to succeed, and fortunately for Emma, she had learned that immediately. But Lucas also had an attitude around her that was exciting; she wasn’t as peppy and chirpy as Mary Margaret, but she always seemed to radiantly glow in a way that Emma knew she would never understand.
“I’m sure Whale gave you my intern introductory speech on your first shift,” Regina continued before spinning on her heal and sauntering off towards the cardio wing. When she couldn’t hear the sound of her interns shuffling behind her, she threw over her shoulder: “When I move, you move.”
Regina stepped back from her patient as she hung her stethoscope over her neck and crossed her arms over her chest. She gave Emma a pointed look, motioning her over to the bedside. “Any ideas, Dr. Swan?”
Without hesitation, Emma stuffed a free hand into her lab coat pocket and smiled coyly. She had been listening to Regina intently and occasionally observing the patient’s clear and steady EKG, which she had noticed was a bluff from the get-go, and remembered exactly what the patient’s chart had noted and observed over the last week. But the blonde only needed to pay close attention to the uneven rise and fall of the patient’s chest to see what was going on beneath his chest.
She spoke confidently. “Double arrhythmia.”
Ignoring the impressed scoff from Lucas in the doorway, Regina hiked up an eyebrow in question, hiding every ounce of surprise behind her authoritative glare. How in the hell Emma Swan knew of the diagnosis was beyond her. Most attendings across the country couldn’t even call that one after hearing the rhythm of his heart beat, never mind attempting to call it from across the other side of the room. In fact, it had taken her years to be able to call an arrhythmia from nothing more than a few respiratory checks and an ECG. And now, here the little, blonde intern, Emma Swan, stood with a cocky smirk plastered all over her face, knowing how right she was. Someone needed to take her down a peg or two, and that challenge wasn’t one that Regina was going to back out of willingly.
“Would you like to check that one on the patient? Or would you just like to throw around accusations and untested diagnoses?”
“Of course not. I’ll check....” Emma agreed, pulling her stethoscope from around her neck to fit it comfortably in her ears. She pressed the cold instrument into the crook of her elbow to take the sharp cold from the metal, then pressed it to the patient’s chest with a little fair warn. She listened for a moment and smirked. She moved the instrument across the patient’s uneven rising and falling chest before agreeing that her predictions had been correct and moving her stethoscope back to her neck. “Double ventricular arrhythmia. Steady, so it’s not too concerning, but any more pressure could cause atrial fibrillation. Fitting an ICD would even out the abnormalities and healthily steady the rhythm.”
“Good, Dr. Swan.” Regina offered the blonde intern a genuine smile, only now hoping to convey how impressed and pleased she was to have someone in her company as dedicated and enthusiastic to the cause as she was. It was received with her own crooked smile from the blonde that inadvertently made Regina’s own heart skip to the rhythm of her patient’s. Distracting herself from even the consideration of thinking about how one tiny smile made her feel so giddy, she placed a hand on her patient’s arm and smiled at him with her perfected reassuring smile.
“Thank you for allowing Dr. Swan to revaluate your symptoms, Mr. Roberts. But, as I suspected, nothing has changed since the last time I saw you, and our scheduled surgery this afternoon will proceed with the planned surgery to fit your ICD, and then we will have you back on your feet in no time at all! Dr. Swan will now be the lucky intern that will have a front row seat to observe your surgery in the OR. I’m sure that the two of you will become quickly acquainted when she performs your pre-op later today.”
“I’m sure we will,” Mr. Roberts winked at Emma, who was already blushing in a deep shade of red for some unbeknownst reason to anyone else in the room. Dr. Mills dismissed her team and lead the interns out of the room, and into the corridor.
When Emma closed the door with a click behind them, Regina pulled the blonde to the end of the corridor by her wrist, with Lucas scurrying behind them sporting the most concerned and excited look on her face.
“How did you know that was a double arrhythmia without listening to it?” Regina interrogated, not fully intending for her questioning to come out in a hiss. Her smile had gone and her defensive system had risen to a level that even surprised her. “How could you even think it was appropriate to throw diagnosis accusation to the wind without even performing a patient work up?”
“I’m sorry… I – uhh…” Emma stammered as she tried averting her eyes from Regina’s powerful glare. “It’s just…”
“Spit it out, Dr. Swan.” Regina stepped forwarder, into Emma’s personal space. Almost chest to chest, and nose to nose, Regina could feel the blonde’s sharp and nervous exhalations against her plump lips. It was an intimidation tactic she had used on many an intern and resident, but when her deep, hazel eyes caught onto Swan’s sea green and dilated ones; her breath trapped involuntarily in her throat.
“I… uh… I may have a brief and partial photographic memory… a-and when you mentioned that I would be on your service today after our meeting in Dr. Nolan’s office, I studied… a little.” Emma pushed a strand of fallen blonde hair behind her ear as she tried to take her eyes away from Mills’. Never had she felt this intimidated by a human being in all of her adult life. She felt bashful. Dr. Regina Mills made her like a bashful teenager and it was ludicrous. It was almost embarrassing – and she was right in her face.
Regina pursed her lips and narrowed her eyes as she took a step back to mentally evaluate the blonde’s claims. “Things like that don’t crop up in textbooks with a step-by-step guide, Swan.”
“That’s why I prefer medical journals and personal research.” Emma rubbed the back of her neck and winced slightly under Mills’ observant stare that remained, even after she had stepped out of her personal space. “Your mother, Dr. Cora Mills… She has published some of the greatest research any cardiothoracic surgeon has ever created. Dr. Mills writes about everything she sees regarding her patients – even down to the rise and fall of their chest in correlation to their EKG’s, cardiographs and everything else in between.”
Regina hummed. She hated it when interns referred to her mother’s work, especially when her own contained far more extensive research on matters. She shrugged it off, however, hoping to dampen the thought that her mother may have inspired one of the most enthusiastic surgeons of their generation.
“Hmm. However, when you are an intern on my service, I would prefer you to perform a full patient work up or at least read the patient’s full chart prior to assuming a solid, medical diagnosis.” She looked her interns up and down for a moment before taking off again in the direction of another patient’s room, this time, with her interns following closely behind. “You won’t need your diagnostic skills this time, Dr. Swan. Our next patient already has their diagnosis and they shall be receiving their treatment within the next forty-eight hours. You’ve got the chart – you can present.”
After quickly recovering from Mills’ severe intimidation skills, Emma opened the last chart she had in her hands and scanned the patient work up notes before coming to a halt in the hallway. She read the notes again, scanned through the EKG levels, cardiographs, LVAD readings, nurses’ notes, and even glanced at some of the scan results that had been safely organised within the file. When her understanding of what she had read came alight, her eyes bulged. Dr. Regina Mills had handed her the case file to one of her dream surgeries as if these types of surgeries came and went like a recurring bus.
“A-are you kidding me?” Her question had made Regina chuckle and tempted Ruby to glance over her shoulder to see the file. Even she gasped when she read the treatment plan and schedule. Emma’s nervous stutter was gone and replaced with a confident and determined attitude. “You’re doing a heart transplant today?”
“Correct me if I’m wrong, but am I missing something?” Ruby asked Emma as she handed over her cash to pay for their lunches in the hospital cafeteria. After spending five solid hours traipsing behind Dr. Mills, the attending had called time and fled to meet Dr. Nolan for lunch, giving Emma and Ruby ample opportunity to take their own break to relax for just a moment.
Emma slid her tray onto their newly claimed table and took the seat opposite to where Ruby like to sit. “What do you mean?”
“Is it just me, or am I some sort of third wheel with you and Mills?”
Green eyes widened at her friend’s accusation. “I have no idea what you’re talking about.” Emma stuffed a few fries into her mouth, hoping that her disgusting table manners would prompt a change of subject for the lanky brunette. It didn’t, and Ruby’s unimpressed smirk was enough to tell her so, but it seemed to be worth a try. “Really, Rubes. I don’t know what you’re talking about.”
“No? Well, your serious blush begged to differ in Mr. Roberts’ room. I’ve never seen someone go purple after being smiled at…” Ruby taunted as she played with her own food. Anyone with a pair of eyes – or even one eye – could see that Emma had something for the cardio surgeon. “Oh, and let’s not forget to mention that she got completely up in your space after that. For a second, I thought she was going to kiss you.”
“Stop, Ruby.” Emma warned her. Regina Mills was never going to kiss her. That was a ridiculous delusion that Emma outwardly refused to entertain even for a second.
“You still want her in your bed though, don’t you?”
Emma choked on the handful of fries that she was still trying to chew down and glared at the lanky brunette for causing such a reaction with a crass comment. “I don’t want her in my bed…”
“What, are you just star-struck by her capabilities or something? Because that bush was horrendous and you should be ashamed.” Ruby shrugged and beamed at the table between them, not wanting to catch Emma’s eye as she spoke. “I’m also kinda disappointed that you didn’t go in for the kiss though…”
“Oh my god, can we please stop talking about how I blushed because she complimented me and stepped in my personal space?” Emma shook her head and stuffed another few fries in her mouth, which she tried to swallow before continuing her argument. “And besides, she’s a rock star. I just wanna impress her while I can. Otherwise, I’ll lose too many opportunities and then I may as well have just gone to some average hospital in the middle of nowhere to do my internship.”
Ruby raised her hands in a mock surrender and suppressed a chuckle. “I just wanted to let you know that she’s a free agent if you were planning on asking her out, or whatever.” Frivolously, Ruby ducked her head over her lunch again and tucked in, patiently waiting for a reaction from the blonde. She bit her cheek when Emma gasped to ensure that her suppressed chuckle didn’t escape.
“That’s so not true.” Emma insisted. There was no way that was true – she had seen Mills and Nolan’s connection in his office. No one could have denied that the brunette’s positioning on the neuro surgeon’s desk was under friendship terms. And even if that wasn’t the case, no woman like Mills was single. “She and Nolan are a thing. Everyone knows that.”
“Loads of people think they’re together, but according to the nurses, Dr. Midas used to be Dr. Midas-Nolan – married to the same Nolan that you’re accusing of being in a relationship with Mills.” Emma’s eyes widened at her in surprise. Jackpot. “Apparently their divorce went through about a month ago.”
“Let me guess, Mills is living up to her Evil Queen standards and became a homewrecker?” The blonde dropped her shoulders dejectedly at the thought and pushed her fries around her plate, refusing to look at Ruby any more than she had to. The woman was dangerous and Emma sure as hell didn’t need her spreading false gossip.
“Nope! They’re like siblings apparently. There’s no romance between the two of them. That’s just the way they are around each other.”
“How the hell do you know all of this stuff?”
“I love gossip just as much as the nurses. Besides, every good surgeon needs a few nurses on their side to do their dirty work. I’ve already got a few of the surgical nurses wrapped around my little finger.” She winked at Emma with a smile and patted her hand across the table. “If I had known you were batting for the same team, I would have upped my game earlier.”
“Ruby – no. I’m not crushing on Mills. She’s hot, sure. But I’m not crushing on her. And I am not looking to date anyone around here.” Emma shook her head and retracted her hand from the table like it had been burnt. She had spent her entire night off convincing herself that she wasn’t actually attracted to Mills in that way, and somehow, she had managed to believe it for a moment as she sat alone in her room at the B&B. The idea flew out of the window though, when she saw Mills that morning. Then she had to convince herself all over again. Goodness, no. She didn’t have a death wish, nor did she want her heart to be broken and shattered into a thousand tiny pieces on the OR floor. Regina Mills was intense, stunning in every way possible, intelligent, beautiful, and every other complimentary words for the woman, but Emma didn’t want Regina Mills. She didn’t want Ruby either, but she was more than flattered by the offer.
“Sure…” The lanky intern nodded in her disbelief. “You keep telling yourself that one, kiddo. I’m sure one day someone will believe it.”
Emma rolled her eyes in agitation. She didn’t need this. She really didn’t need this idea that she was attracted to the attending in any way, shape or form. She already accepted that she had acknowledged Mills’ sheer physical perfection. Just because the woman like to stride around the hospital like the owned the place in her slacks or skin tight pencil skirts with a white shirt that seemed to struggle to remain closed around her ample chest, didn’t mean that Emma wanted to bed her. It was a ridiculous accusation and Emma wouldn’t stand for it. It was also a dangerous accusation. If anyone knew that she was attrac… No. If anyone heard that she may be attracted to Mills through the rumour mill, she would be done for.
The two women sat in a momentary silence as they awkwardly stabbed a few fries on their plates. Neither wanting to break the tension between them nor choose to make it even more awkward than it already was. It wasn’t until Mary Margaret strolled into the cafeteria with a sandwich in her hand that Emma could even bare to look at Ruby without cringing.
“Good afternoon!” Mary Margaret practically sang as she dropped into the seat beside Emma.
“Hey,” Emma and Ruby mumbled between them.
Their exhausted greeting was overlooked by the pixie-haired brunette as she began unwrapping her sandwich like it was the greatest thing in the world. She literally looked excited to devour a turkey club. After a bite, she tapped her leg against Emma’s beneath the table to grasp the blonde’s attention.
“So, I was wondering… Since you’re not from around here and all… Where are you actually living?” From Emma’s slouched position at the table, she tilted her head in question at the puppy-like woman next to her. “Because it’s so difficult to find someplace to live around here. Houses only go on sale when people die or when there isn’t anyone to hand the property on to… And as far as I’m aware, there haven’t been any sales or rentals in Storybrooke for eight years.”
Emma scoffed. She had learnt about Storybrooke’s residential market a long time ago after spending weeks and weeks scouring the internet looking for an apartment or even a room to rent for the time being, shortly after her application onto the internship at Storybrooke Memorial was accepted. “I’m staying at Granny’s B&B… It’s not practical, but there’s a bed and a bathroom, so it’ll do for now.”
With a beaming grin, Mary Margaret dropped her sandwich onto its wrapping and gripped Emma by the shoulders. “Come live with me.” She stated, earning herself a confused, and almost terrified look from the blonde. “My father has just given me his apartment on Main Street and moved permanently into his town-issued house for his reinstating as mayor. Which means, I’ve got spare rooms and an entire apartment to fill!”
At Mary Margaret’s words, Ruby finally perked up and grinned at Emma, who seemed to be mulling the offer around her mind. Ruby, like Mary Margaret, had lived in Storybrooke her entire life. Her parents grew up there, her grandparents grew up there, and even her great grandparents had grown up in the quaint little seaside town in Maine. It wasn’t exactly a New England hotspot, and the housing market had less to offer than one of the most desirable neighbourhoods in New York City, but it was home. So, after living with her grandmother from the young age of eight, then tasting the bittersweet lifestyle of living alone at college and med school, Ruby had already began craving it when she returned home to Storybrooke. Like Emma, Ruby needed a fresh start and a place to call her own. Even if that did mean worming her way into a rental with two of her fellow interns.
“How much room do you actually have to fill…?” She asked, almost as if she wasn’t at all interested in Emma’s offer.
Mary Margaret finally let Emma’s shoulders go and beamed at Ruby. “Well, in addition to my room, there’s three bedrooms and a loft conversion, so I’m trying to fill the space, otherwise it’ll be too much for me. And I know you’re living with your grandma, so you’re obviously not going to want to move out…”
“I was looking for a place, actually.” She replied, trying her damned hardest not to sound too enthusiastic or even sound like she was practically begging the woman to offer her a room in the apartment.
“Why on earth didn’t you say anything? The three of us could happily coincide together!” Ruby wanted to laugh at the pixie-haired brunette’s overly cheerful and perky attitude, but thought against it and matched the woman’s grin out of pure relief that she was finally getting out of her grandmother’s old fashioned home and into something much more central in town. It was Emma’s severe wince that made her laugh in the end. “What do you think, Emma? Do you want to move in?”
Regina kicked off her black stilettos beneath the coffee table and curled into the armchair in the attending’s lounge. Her feet hurt, her head hurt and she was exhausted. And it had only been a few hours into her excruciatingly long shift. David had been kind enough to buy her lunch, so that had been one less thing to worry about when she dismissed her attentive interns for an hour. They were exhausting, both mentally and physically.
“So, how are you getting on with your interns?” David asked her once she settled into a comfortable position in the chair, still looking as regal as ever with her feet and tucked beneath her bottom.
“I can’t tell if I feel like I’m a resident with two annoying interns, or if I feel like an attending with two residents that have spent their entire residency living in cardio.” Regina laughed into her salad bowl, unconsciously shaking her head at the absurdity that was Emma Swan and, surprisingly, Ruby Lucas. “It’s insanity. One minute, they’re questioning me about the most basic things that they should have learnt during their first year of medical school, and the next, Swan is diagnosing a double ventricular arrhythmia and providing a treatment plan without even having the patient’s full work-up. And do you know what annoyed me the most? She did it from across the other side of the room.”
If Regina wasn’t certain it was impossible, she would have been convinced that David’s eyebrows raised high enough to hit his hairline. His own surprise, matched her’s at the time it happened. Emma Swan had been confident in her diagnosis enough to not actually require an actual confirmation through a routine check-up - he was consulting patients in ways most attendings could never dream of doing. Somehow, the blonde intern was finding more and more ways to impress her in ways that no other intern had ever done.
“Was she right?”
“As loathe as I am to admit it, she was exactly right.”
David’s back straightened on the couch, from where he watched her every move. They had known each other too long not to know the other’s personal tactics of understanding. He thought she was lying. “Then what’s the problem? Shouldn’t you be celebrating that? You could barely do that at the end of your residency!”
“That’s exactly my point, David.” She emphasised, hoping that the neuro surgeon would actually use his own brain to realise that she was actually praising an intern for finally doing something right. “She’s already too far ahead of herself and she knows how good she is. She knows she’s a valuable player. She’s narcissistic and I won’t stand by and watch her develop a god complex on my watch.”
“It’s a good job you’re not a narcissist either, then. Right, Regina?” He playfully winked at her in an attempt to waiver the woman’s distress under his charm.
“I’m not a narcissist. I’m just fairly confident in the things I know.” She raised her chin in denial. She was a cardio surgeon. It came with the job to be a narcissist, but for interns to share the same type of attitude – well, that just wouldn’t happen under Regina Mills’ watch.
“Of course.” He raised his hands in surrender at her before digging into his own salad bowl that Regina made sure he ate at least twice a week. After fifteen years of knowing one another, David still liked to drive Regina crazy by pretending that he detested every mouthful of his salad. “I’m just reiterating what everyone says around here.”
“Don’t get shirty with me, Nolan. And, I know you’ve been sneaking around behind Kathryn’s back.” She spat out. Rumours spread around Storybrooke Memorial faster than a plague, so when she heard the juicy gossip regarding her closest friend, she couldn’t keep it to herself. “You have to let the divorce file before you start running around with other women. You’ve made your bed, now you’ve got to lie in it, no matter how uncomfortable it is.”
“If the divorce papers are signed, I’m free, and guess what? They’ve been signed for a month and I can do what I want.” He scraped together the last few leaves of his salad and stuffed them in his mouth before leaning back into the couch. He had been married to Kathryn Midas-Nolan for six years - six of the worst years of his life, he claimed once he filed for divorce. After meeting the apparent woman of his dreams, David proposed a few months later, and much to Regina’s disbelief, he married her within six months. It was fast and lust filled, and everyone but them saw right through it. “But seriously, I’m not sneaking around behind her back. I’ve not even had a date since the papers went through.”
“I’m not buying that.” She shook her head.
“You don’t have to because it doesn’t actually concern you, Mills.”
“Oh, I wish you had told me that a few months ago when you needed someone to talk through the divorce with you, Nolan.” She growled at him and dismissively pulled a nail file from her lab coat. She didn’t want to end their conversation there, she just wanted to use her decades old tactics of intimidation to make her friend crack. It worked every time.
He looked at Regina and quivered under her signature heavy glare over her busy hands on the file. They both knew that he had never been able to lie to the woman, and this time was no exception. “Look, I met a girl at the bar, we had a few drinks together, I got her number, and that’s it. Nothing more and nothing less.”
“And who was she? Storybrooke is a small town, David. Everyone talks and nobody is a stranger.”
“I didn’t know who she was. I’d never seen her before.”
“Oh, charming. And you didn’t even think to get her name?” The neuro surgeon cringed under Regina’s watchful eye and shook his head. At the time, the last thing on his mind was to ask of the little brunette’s name. Firstly, he was wasted, and secondly, he had been too busy referring to the woman as Snow White to even want to ask for her actual name. “You are abysmal.”
“Jealous?” He asked, receiving a scoff from the brunette. “At least I’ve had a little bit of interest in the last few weeks. Have you started collecting cats yet?”
“Ha-ha. You are so funny.” Regina snarled at him before lobbing the spare scrub cap she kept in her pocket at him. “I’m not looking at the moment and you know that. I’m focusing on my career and I really don’t want to get involved with the messiness of dating again.’
“You sound just like your mother, you know that?”
Regina cringed at him. It was a crafty hit and David knew how much it hurt whenever he compared her to her mother. This time, however, he had used it skilfully, but Regina refused to take the bait and stood to return to the surgical unit. “Well, she’s been right about everything else. Why wouldn’t she be right about this too?”
With the patient’s chart in hand, Emma rounded the corner into her first official solo pre-op patient’s room. Dr. Nolan had kindly walked her through the very first examination, but now, she was on her own with incredibly high expectations to be met by Dr. Regina Mills. Everything had to go perfectly and as smoothly as physically possible, just so she could continue to prove herself on every front. Mills had already been more than impressed with her diagnostic skills and bedside manner, so ensuring a smoothly run surgery from the get go would only add a string to Emma’s bow and she knew it.
“Ah! My elected new best friend has arrived.” The patient in the bed exclaimed the moment he saw her blonde high ponytail come swishing into the room.
She smiled at the elated look on his face and organised the charts at the end of his bed. “You’re in a good mood this afternoon, Mr. Roberts.”
"You’ve got to be when you’re stuck in these beds, Dr. Swan.” He told her with a wink. “And when you know that you’re about to get the gossip from a young and impressionable surgical intern, it’s impossible not to be!”
For a moment, Emma paused and looked at her patient before realising what he meant. She scoffed at the absurdity and moved to the side of his bed to chart his most recent EKG. “Please don’t tell me that you’re looking for gossip from me?”
“I am, indeed.” He nodded, simultaneously agreeing to allow the young intern to press her cold, yellow stethoscope to his chest. “My doctor – Dr. Mills. What’s going on with you and her? Is there a bit of something-something going on that shouldn’t be happening in the hospital or is it deeper than that?”
Emma’s eyes widened at the sixty-seven-year-old man in the bed. Hearing such an accusation for the second time that day still hadn’t gotten any easier for her to digest. The first time had been absolutely ridiculous coming from Ruby Lucas, of all people. But with the second one coming from a patient? Emma was almost embarrassed at her inability to douse her slight attraction towards the brunette attending.
“You are beginning to sound like Dr. Lucas.” She nervously laughed and rehung the stethoscope over her neck to make note of her relieved finding that nothing had changed since that morning. “But no, Dr. Mills is my boss. Well… my boss’ boss. There’s nothing going on between us.”
“What difference does it make if she’s your boss or your boss’ boss? If she’s giving you butterflies when she smiles at you, why are you letting the hospital’s hierarchy dictate your dating pool?”
Emma winced as she took her patient’s blood pressure. Regina Mills didn’t give her butterflies. Regina Mills made her nervous, not sexually enthralled in such a way that would make her stomach flip excitedly. “Don’t you think that’s a little inappropriate to ask, Mr. Roberts?”
“Maybe, but I’m about to go into heart surgery and I’m a sucker for romance. Indulge me in your deepest secrets, Dr. Swan!”
“There is no romance between Mills and me. Trust me, that woman would need a miracle worker to keep her down.” Emma fully laughed this time. From what she had already seen and the reputation that Regina held around the hospital, the woman would need more than a miracle worker to keep her happy.
“So… you? You’re technically a miracle worker. You’re a surgeon; you cut people open to save them for a living. You’re a saviour – why can’t you be hers too?” He wagged his eyebrows at her, which she missed as she pulled open the Velcro of the strap attached to the digital blood pressure monitor and stuffed it back into its elected drawer.
“I’ll give you two reasons why that won’t happen: number one – I don’t like her like that.” Emma stood at the patient’s bedside with her hands on her hips. She ignored Mr. Roberts’ disbelieving grin and continued. “And number two – you’re living in a fairy tale land, Mr. Roberts.”
“Can I tell you something, Dr. Swan?” Reluctantly, Emma nods at him. She doesn’t entirely want to hear him attempt to convince her that she was attracted to a woman she had barely known for three days. “When my wife and I met, I hated her. I couldn’t stand the sight of her because she annoyed me so much, but you know what? I looked forward to seeing her every few days. I would always get jealous whenever I saw someone with her, and I never understood why. It wasn’t until we married that I realised it had been love at first sight. I always held a light to her beauty and even though our personalities were complete opposites, we fit together like a two piece puzzle.”
A faint smile graced her thin lips in appreciation of his story telling. She had always believed in the idea that some people were lucky enough to meet the person of their dreams and fall head over heels in love with them in mere minutes. But that was a fantasy Emma knew she would never be lucky enough to experience. She had never been lucky enough to experience any kind of love – parental or romantic, nor did she ever expect to. Her personal idea on the situation was what she like to refer to as the ‘System’s Justice Service’ – to her love and a family was a birth right, but once you were handed over to the foster care system, you lost every right, like it was a payment for survival.
She smiled and shook her head. “That sounds like a fairy tale to me, and I’m afraid to tell you, sir, I have never believed in fairy tales.”
Mr. Roberts shrugged at the blonde, but smiled knowingly at her – almost like he could read every thought that had crossed her mind over the duration of their conversation. She ducked her head and resumed her pre-operative examination notes. Everything on her check-list had been happily signed off with the results they desperately needed for Mills to perform the surgery to the best of her abilities. She tried to focus on the notes as much as she possibly could, but after every sentence or moment in which she paused for thought, Emma found her mind wandering to thoughts of the brunette. She hadn’t had these thoughts before Ruby or Mr. Roberts had tried intervening.
It only really began to concern her, when she glanced up to see her mind playing tricks on her. Dr. Mills stood in the doorway with her arms folded across her chest and a delicate smirk on her lips. Emma rolled her eyes and returned to her notes until she heard the surgeon’s stilettoed heels clip and clop on the linoleum flooring. Shit. Her mind wasn’t playing tricks on her, and she had willingly and outwardly rolled her eyes at the attending. When the gentle blush pinked her cheeks, she looked up to the patient in the bed, just in time to catch the wink he had directed straight to her.
“How are you doing this afternoon, Mr. Roberts?” Dr. Mills asked as she joined Swan at the foot of her patient’s bed, painfully ignoring the crimson blush that had grown from the intern’s chests to her hairline.
For Emma, her second shift seemed to keep a running theme of second times. It was, of course, her second shift as a surgical intern; she had performed her second pre-op; she had been on Regina’s service for the second time (even though the first time was only temporary); and here she was, standing for the second time in a live OR. Only this time, she wouldn’t be touching the instruments. Instead, she had simply been given clearing to observe Dr. Mills’ heart surgery from inside the OR with a small group of residents, and a few observing scrub nurses. Emma had been huddled in the corner of OR three and expected to remain there out of obedience and simply observe. Prior to her admission to the OR, she had been given a ‘say nothing, do nothing’ speech from the resident that Mills had chosen to assist, giving her no other choice than to note everything she saw during the surgery with every intention of asking the attending following the surgery.
Once Mills had scrubbed in and sashayed into the OR in her deep, navy scrubs, a black scrub cap accented with little, red apples and an immaculate pair of Sketchers on her feet, the entire OR fell into silence. The only noise that seemed to fill the surgically tiled room was the sound of the Mr. Robert’s steady heart monitor and the occasional mumble of a request for instruments. It was fascinating, the silence that had filled the room. It was a professionalism that Emma had never expected from the attending. Sure, she had expected everything to be perfect, but she had assumed, that much like Dr. Nolan, Mills would have enjoyed the steady rhythm of music or even the low rumble of chattering voices.
That all changed when Regina had finally found opening through a median sternotomy, giving her ample access to the beating organ. She began to quiz Dr. Herman on his knowledge of their procedure and how they were to proceed after every step. Somehow, Herman barely reeled off information that Emma knew off the top of her head. This had been a procedure that she ensured she knew inside and out before her intern year – not because she wanted to be a cardiothoracic surgeon, because she still wasn’t sure if that was the case, but because of something else entirely.
It livened up again an hour later, when Mr. Roberts’ heart monitor hit the roof.
“Atrial fibrillation,” one of the scrub nurses pointed out as she read from the monitor as it beeped loudly and obnoxiously.
The entire room had expected Dr. Mills to immediately rush into action in a panic and a fluster, just as her resident had done. Instead, she simply remained at her own pace, and even slowed for a moment to call over her shoulder. “Dr. Swan, would you like to come and walk us through what should happen in this situation?”
Emma stared at the back of the brunette’s scrub cap that sat neatly atop of her head for a second before dragging herself into action and handing her notebook and pen over to the observing resident at her side. “Atrial fibrillation… steady suction around the atria – don’t let it pool, then put him on cardiopulmonary bypass to steady the rhythm or even slow it for a moment.” Regina nodded and motioned her hand for her resident to do exactly as the intern instructed. When Mr. Roberts’ heart rate reduced to sinus rhythm, Emma let out the breath that she hadn’t even considered she was holding. “Use beta blockers to reduce the risk of Atrial Fibrillation post-op and a carotid endarterectomy should be performed to reduce the heightened risk of a stroke.”
Beneath her mask, Regina grinned.
Chapter 3: Holding a Heart
A/N: Hi everyone! Thank you so much for your wonderful reviews and the faves/follows that have been bounding into my email inbox. I'm thrilled that you're all enjoying this story. This chapter is more of a filler chapter for the things to come - I just couldn't find a way to cut it out, so it's here. Hopefully you'll all enjoy it because SQ is happening. It's coming and I'm super excited for you to eventually read what I have planned! Enjoy, and have a great week!
Disclaimer: I am not a surgeon, nor do I own Once Upon a Time or any of its characters - which is unfortunate on both ends.
Holding a Heart
"Wait, you did what?" Cassidy asked Emma as he jumped up onto one of the surgical beds that lined an empty corridor. Four of Whale's five interns had found momentary solace in a small part of the hospital that only seemed to be used for overflow – and that never happened. "Why would Mills let you scrub in on heart surgery?! You're an intern."
"Yes, thanks for that reminder, 007." Emma grumbled as she threw a purple Skittle at his head from her comfortable perch on one of the beds. "She let me scrub in because I'm not a compete idiot and I actually know what I'm doing."
"Woah, hold up." Ruby interrupted from a wheelchair she had long ago commandeered. She wheeled the chair towards Emma's bed and frowned at her. "You got to scrub in on a surgery because you were invited to observe, then you saved the resident's ass. That's the only reason why you got to scrub in and I didn't. Not all of us are miniature prodigies with the ability to stay calm all of the time."
Emma shook her head. That wasn't how it happened. After Herman's miniature panic attack, wrist deep in a patient's chest, Mills had invited her to walk through what was to happen to save the patient and continue the surgery, and Emma had succeeded. Externally, she had strolled through it without a care in the world and even managed to impress the Cardio Attending into inviting her to scrub in and assist at Herman's side. On the inside, however, hiding her anxiety was her biggest feat, and the only ass Emma saved by doing so, was her own.
'Atrial fibrillation. Steady suction around the atria – don't let it pool, then put him on cardiopulmonary bypass to steady the rhythm or even slow it for a moment. Use beta blockers to reduce the risk of erratic A-Fib post-op and a carotid endarterectomy should be performed to reduce the heightened risk of a stroke. Once he is stable again, proceed with caution to insert the ICD.'
Technically – she hadn't really done anything more than suctioning the fluids from the surgical area, but she had still scrubbed in on her second surgery in just two forty-eight hour shifts.
The blonde smirked. She knew of her own capabilities, but hearing her fellow interns reiterate it only made her smug. "I'm not a miniature prodigy. I'm just doing my job and trying not to panic."
"Everyone panics at some point, love," Killian offered, taking a seat at the end of Emma's bed. He received a glare and a shove on his leg from the blonde's foot, but he smiled at her and made himself comfortable. "You can't be perfect all the time. Give it time – you'll crack eventually."
Ruby frowned at him and shook her head. Anyone who knew anything about surgery, and anyone who knew anything about Killian Jones knew that the ragged-around-the-edges man would more than likely be swaggering into a career in plastics for the very same reasons Whale had; he wasn't a hard-core surgeon enough to take his mind out of the gutter. Killian Jones wanted to be a make-up artist in the world of surgery, not a hard-core surgeon. Ruby pointed at him and wagged her index finger. "Hard-core surgeons don't panic. If you're a hard-core surgeon, you can't afford to panic."
"Patience and a calm attitude don't come overnight, Ruby." Mary-Margaret warned her friend in the wheelchair as she practically skipped over to them after hearing their entire conversation travel through the adjoining hallway. She looked chirpier than usual – a little overworked, but chirpy. "And congratulations, Emma. Dr. Nolan told me what happened in Dr. Mills' OR today."
Emma opened her mouth in question for a moment before slamming it shut and opening it again, this time actually asking the question that seemed to be lingering on everyone's lips. "How did Dr. Nolan know? I literally walked out of the OR five minutes ago…"
Mary Margaret blushed and ducked her head slightly, trying her hardest to hide whatever embarrassment she had in the top of her scrubs. "Dr. Mills called him straight after."
"Okay… but how do you know?" Emma raised an eyebrow at her.
"We were… um… mid-conversation when she called."
"I'm kind of tempted not to believe that…" Emma and Ruby shared knowing smirks across the corridor. They had seen the obvious flirtatious spells between their fellow intern and the neuro attending as they passed in corridor, which had given them ample reason to suspect anything out of the norm. And now that Emma knew Nolan and Mills weren't an item, she had all the more reason to believe her speculations. "But thank you, M&M, all the same."
Mary Margaret sheepishly smiled at the blonde and took the offered bag of candy from Ruby, not entirely understanding why the woman constantly had bags of junk food in her pockets for everyone. She hid behind the bag and nibbled away in the hopes that someone – anyone – would change the subject to a distraction for them.
Taking the obvious hints that Mary Margaret seemed to be throwing at him from the foot of Emma's bed, Killian cleared his throat and looked between the two lucky interns that had managed to worm their way onto the Evil Queen's service. "Let me guess, you guys are scrubbing in on Mills' heart transplant this afternoon too?"
"Yeah, right." Ruby scoffed. "She would never let two interns scrub in on a heart transplant. Apparently there was an incident with an LVAD wire and a couple of interns a few years ago, and she doesn't want to let it happen to her patient too. She was reluctant to even let us in the patient's room on rounds, so we're stuck in the gallery like everyone else."
Regina stormed through the hallway. The sound of her sneakers squeaked on the linoleum floor and the rustle of her scrubs echoed in her ear. She didn't look the slightest bit as scary as she would have done had she been in her usual get-up of heels and formal slacks, but the scowl on her face would have been enough to burn down an entire village, so she unenthusiastically settled to work with it. She was seething and close to the edge of flipping her lid. No one in the entire hospital had the same audacity as Dr. Gold to even attempt to rearrange her schedule without her permission, so when she heard from her favourite scrub nurse that her surgery had been pushed back for another two hours, Regina knew exactly who was to blame.
The brunette rounded the corner and into the lobby of the surgical unit to find Gold observing the surgical board with a smug look on his face that Regina would pay good money to see violently wiped off.
"You are not moving my transplant for a bit of general surgery, Gold." She barked at him, feeling the irritation bubble beneath her skin. As he hobbled around to face her, the anger inside her grew even stronger. She hated him – everything there was to hate about a human being, Regina hated when it came to Gold. "Look at the board – there are free slots in every other OR in this hospital. Any of them would give you plenty of time to do your routine surgery without it impacting mine. So, I suggest you erase your surgery from my time slot and find somewhere else to perform your intern level procedure."
Gold smirked at her, showing no sign of ignorance towards her incredibly unimpressed scowl. "Just because you have a powerful name, your majesty, it doesn't mean that you run the OR board. I won't have you dictating who performs what, where, and when." On his unsteady feet, he wobbled a step towards her and protruded a long, bony finger towards her face. "If I want to be in OR One, as previously scheduled, I shall. No flashy, experimental heart transplant surgery will ever govern you to the top of surgery here, Mills. Some of us have been here since before you were born, and I'm sure that your mother would be none too pleased with your vile attitude to your superiors either."
"You are no more superior than I am, Gold, and I couldn't give a damn what my mother thinks." She batted his hand away with the anger that was now over flowing from her body. Any comparison to her mother or even connection with the woman that gave her life was enough to make Regina heave. She had worked damned hard to make a name for herself without the help of her award winning mother, but there would always be people like Gold who was so determined to belittle her by bringing her mother into the conversation. It infuriated her, and he knew every single annoying little way to get to her. "Now, I have an abundance of interns and residents that wish to overlook this surgery for research and experience, and my patient has been waiting for over a year to receive this heart. Today will be the day that she gets it if it is the last thing I do."
"Of course, but you will have to do it when my surgery is over."
"I think you heard me perfectly well, dearie."
Regina ground her teeth and internally fought for as long as she could to not lash out at the man. "I heard you perfectly well, Gold, but I wasn't overly fond of what you had said. And so I'm going to tell you once more: move your surgery."
"We could always ask the Chief if he thinks your little bit of general surgery is more important than a heart transplant for a woman on an LVAD." Regina said with a smirk. Playing the Chief of Surgery card was always plucked straight from her arsenal when things weren't going her way. Everyone in the hospital knew that Dr. Archibald Hopper had the biggest soft spot for Dr. Mills, especially when it came to her surgeries. She brought money and clientele to the hospital more than any other department head at Storybrooke Memorial. And who was she to turn down perfect opportunities like that?!
A deep grumble of a voice being cleared startled Regina into spinning away from her little dispute with Gold. She was more than ready to scream or chastise the fool that thought interrupting a very important conversation. But her eyes widened in relief when she turned to face Nolan with his hands resting firmly on his hips, looking more entitled and powerful than she usually did. The look on his face was enough to inform anyone that he was definitely not impressed.
"The chief isn't coming down here to review your pissing match." He rounded Regina and stood between the dainty brunette and general surgeon that should have retired years ago. "I'm in charge of the board this week, and I've already agreed that the transplant happens in OR One. It's a big surgery and your gall bladder removal isn't a priority surgery, Gold. You're just going to have to bow out and take another OR."
Gold scoffed and folded his arms over his chest, as if he wasn't at all phased by the neurosurgeon, who stood at least two foot taller than him. "Surely a surgery that will most likely kill a very alive patient isn't actually worth the effort, is it?"
"Regina's success rate for this surgery is higher than anyone else in the country." David told him with a tone that left no room for argument. His statistics were true, but that didn't mean she failed to have any fatalities in the OR with this surgery, because she had – on multiple occasions. "We can't guarantee a survival rate, but she is doing everything in her power to save her patient. With or without the surgery Mrs. Gilson could die within the week, Her LVAD is failing and the transplant is her only hope at recovery and survival."
"I am thoroughly disappointed in you, Nolan. I've always known that favouritism has been a strong suit between the two of you, but to stoop low enough to kick a man out of his OR – that's disgraceful." Gold tutted. "And what happens if French needs an OR for a trauma? You're just going to block up every OR for a surgery that your patient will never recover from."
"Lacey has already been informed of the OR board. She's agreed to work her magic in the ER unless she's in dire need of an OR, and if that's the case, we'll have to evaluate which ongoing surgery can be cut short. It's the only way this is going to happen. Belle has even offered up the birthing centre as an overflow, should we need it. You're the only surgeon in this hospital refusing to cooperate."
"You mark my words, every little experimental surgery where you're playing God like this comes with a price." He told them with a pointed finger before finding the strength beneath his prosthesis leg to carry him away through the corridors while muttering: "This is ridiculous. Two children running the entire surgical unit… It's obscene. Wait until Cora Mills hears about this one…"
David and Regina watched the man hobble out of sight and out of earshot, deep into the surgical wing of the hospital before either of them said anything. Regina could barely even dampen the anger and irritation she felt for the man who always seemed to find it in himself to taunt her to the point of complete aggravation. He had been her mother's mentor during her own intern year – they had performed dozens of surgeries together as a team, and many who knew them together argued that they were even romantically involved for a short while. The argument was never proven true, but Regina felt it in herself to attempt to detach herself from any reputation her mother had built up between her internship, right through to the four years she spent as an attending at Storybrooke Memorial Hospital. Everyone had their own story about Dr. Cora Mills, and Regina was the only person to not give a damn.
With a quick flick of the board eraser, Regina watched her friend wipe clean Gold's changes and adjustments to the surgical board. Everything had previously been perfectly organised down to the last second, until Gold managed to get his hands onto it. David rescheduled her transplant surgery to its original time slot and took a step back behind Regina to eye his handiwork.
Time: 1500 – Surgeon: Dr. R Mills – Procedure: Cardiovascular Transplant – Patient: Mrs. Alice Gilson – Lead Scrub Nurse: Ellie Thropp – Assisting Surgeon: Dr. S Herman – OR: 1.
"You have to stop getting into fights with him, Regina." David told her as he found purchase for his chin on the top of her head. He could feel the irritation of his action glow from the dainty brunette, which prompted him to bring his elbows up to her shoulders and slouch on her. Beneath his perch, a light growl emitted from Regina's chest, but much to her own reluctance, she didn't pull away. Instead, she simply folded her arms against her chest and looked up to the surgical board looking exactly the way she planned it.
"It wasn't a fight. It was a discussion for a negotiation."
"Oh, really? Is that what you're calling it now?" He teased, earning himself an exasperated tut. "I was checking in on Humbert's ortho surgery in OR Three, and I could hear your voice. Regina, you were practically screaming at him."
In hindsight, Regina knew she was likely to have been shouting at the man. There was nothing that could have convinced her to remain calm when he meddled in things he had no right to be meddling in. Somehow, he always managed to get under her skin and irritate her in every possible way. "The man drives me crazy. Just looking at him makes me want to live up to what the residents are calling me and actually rip his heart out of his chest to crush it with my bare hands."
"Don't stoop to his level because you know too well that your mother will always side with him." He reminded her. They both knew it was true, but it always made Regina sulk or her heart pang with disappointment. Being her mother's only child, she had expected to have been the favourite, but in her mother's most difficult ways, she was always second best to everyone and anyone. "He's always going to grind your gears, because he knows that the day you let him get the better of you will be the day you say bye-bye to your surgical career and maybe even hello to a prison cell – that's if you're lucky, anyway."
Letting out a sigh, Regina allowed her body finally slouch from her usually perfect posture. Up keeping her straight and narrow demeanour was exhausting, and thinking about how much Gold annoyed her was even more tiring. She didn't need to compete with his vile arrogance on top of his irritatingly large ego because he was already doing it to himself, but the man needed to learn to respect his fellow co-workers. There was no way Regina was going to stand aside for another year and allow him to treat her, and every other attending, like interns without a brain.
"Are your interns any better?" David finally asked her, ultimately breaking the silence between them.
"They're still annoying know-it-all's. Swan is getting worse. I'm fairly certain that she walks around here like she owns the place."
David charmingly smirked from atop of her head. "So, like you, you mean?"
"No. I have power and authority in this hospital. Swan is an intern. She's like a child that thinks they know more than anyone else around them." Regina sighed beneath David's arms and shook her head, simultaneously moving David's. "I don't know. Maybe she'll wise up once she makes a mistake. Once she tumbles down from her high horse and realises that she is not, in fact, greater than any of the others partaking in this internship, I'm sure she and I will get along fine."
"Hmm. And Lucas?"
"I haven't seen anything from her that has impressed me yet. I can't quite tell if her head is out of the game, or if she's too busy staring at Swan to even think about the job at hand." Regina unceremoniously shrugged. She had caught Lucas stating at the blonde on countless occasions, and something in the pit of her stomach made her feel… well, she didn't know what she felt, but it was something. "They both need to reconsider the places her have so fortunately been handed. Because you and I both know how many people would kill for an internship with us."
David hummed his agreement. He and Regina had fought damned hard to even get considered for their own internships, and their interviews and screening processes had been more than gruelling. They had been two of the lucky twelve med students accepted onto the programme that year. And they had done it by themselves. Regina's mother had insisted her own input in their acceptances to the programme, but after Regina's persistence and their incredibly public screaming match for all of Harvard University to hear, Cora Mills stepped back from her daughter's education and allowed her, for once in her life, to take control. They were, however, instantly given unconditional offers into the internships from their academic achievements alone.
It had been a proud moment for the two of them, to say the least, but then they faced the struggle of actually performing and doing as well as they possibly could to succeed at the Storybrooke Memorial Hospital. It was tough, but they managed to make it through together.
Drawing them both from their thoughts of their exhausting intern days, the delicate sound of a throat being timidly cleared behind them prompted them back to reality, even though they both refused to move from their apparently comfortable stance in front of the surgical board.
"Dr. Mills," the voice followed, Regina and David instantly recognising it to belong to Dr. Emma Swan. "Dr. Herman performed the pre-op on Mrs. Gilson and everything is a go for her transplant. He's bringing her down now."
"Thank you, Dr. Swan."
"You were wrong by the way – about Mills and Nolan." Emma muttered to Ruby as she took the offered bag of chips from the brunette and took her seat in the OR gallery. She still had half of the bag of Skittles in her pocket that Ruby had given her hours ago, with every intention of finishing them too. "They're definitely together."
"Why do you say that?"
"I saw them when I gave Mills the update on Mrs. Gilson." Emma tucked her feet up onto the seat of her chair and wrapped her arms around her shins. "Nolan was giving her some sort of weird, from behind hug. Don't get me wrong, they looked relaxed and all, but just looked… odd."
"Oh, so you are jealous of him," Ruby smirked behind her own bag of chips and nudged the blonde.
"No, I'm not." Emma tried not to bite, but her words came out in a sharp and pointed snap. "I'm just proving a point. Which also means that we were wrong about Mary Margaret."
Emma shrugged and stuffed her hand into the rustling bag of chips, trying to hide any sense of jealousy or disappointment that she felt on her new discovery. Well, it wasn't new. She had spotted their relationship from the moment the three of them sat in Nolan's office together. There was a spark and some sort of comfortability that could have convinced anyone that they were in a committed relationship with one another. Maybe her speculations were right – maybe Mills was a home wrecker. Maybe she did break up Nolan's marriage by playing the innocent mistress. 'Innocent, yeah, right.' Emma thought to herself with a smirk. Regina Mills was definitely not an innocent woman.
"We might not be right about Mary Margaret, but I am definitely right about you." Ruby nudged Emma's arm as she spotted Dr. Mills sauntering into the OR with her hands raised and ready to accept her gown and surgical gloves. Emma's eyes were already fixated on the attending's every move. "You are definitely crushing on Mills."
The first several hours of Mills' transplant surgery consisted solely of preparing the patient to receive their donor heart. The scrub nurses and anaesthesiologist had already inserted the IV, the several catheters and drained the stomach clear of fluids once they had put the patient under general anaesthesia, all before Mills had even finished scrubbing in. When she finally took her position at the operating table, a clean incision from the clavicle to a few inches above the navel was expertly cut by Regina's trained and steady hands like she was performing a perfected routine. Somehow, Dr. Regina Mills could make any surgery look like an elegantly planned and prepared dance. She knew how to guide her hands to crack the sternum and remove the LVAD with precaution and precision as she simultaneously connected the patient onto cardiopulmonary bypass. With the help of her carefully chosen surgical team, they formed a well-oiled machine; each of her five scrub nurses, the two cardiothoracic attendings beneath Regina and the surgical resident all knew their places around the focused head of cardio. Half of them were merely there for the sake of it. In reality, Regina knew she only needed three scrub nurses and an assist from a resident to perform the transplant, yet under hospital guidelines, she needed the attendings to ensure she was following the right course of treatment – like they knew any better than she did.
Everything was silent as the scrub nurses handed and received instruments to and from the surgeon with pure grace. The only noise that emitted from OR One was that of the patient's EKG and the steady beat of the bypass machine. It was clinical, yet the most intimate thing any of the observing residents and interns in the gallery had ever seen. There was an unspeakable calmness that Mills seemed to glow with as she instructed one of her specially chosen nurses to suction the unnecessary fluids that had pooled around her surgical area when she had transferred the patient's diseased heart onto bypass. There was nothing in Mills' OR that could have ever suggested any sort of anxiety for any of them. Unless they saw resident and cardiothoracic shadow, Dr. Sean Herman. He looked like he was almost ready to throw up behind his mask.
"Irrigate," Regina instructed her resident after three hours of preparation inside the surgical field. She glanced up at the observant gallery of interns, residents and interested attending surgeons with a smile. This wasn't the first time that people had been queuing up for seats in her OR gallery, and she knew that it most certainly wouldn't be the last either.
Surgeries had been pushed and consultations had been cancelled, all because it was Dr. Regina Mills that had the magic surgical hands to perform one of the most trying surgeries that the hospital had ever agreed for her to do. It wasn't that she had never performed a heart transplant before, because this was her fifteenth in three years, but she and the Chief of Surgery both knew that she was the only one who remained at the hospital with the capability of performing such a surgery without the constant assistance of any other surgical attending. And with the success rate from her previous surgeries, who could even think to deny her of such a privilege?
Regina had given Storybrooke Memorial Hospital one of the biggest names in cardiothoracic surgery. She had become one of the greats in no time at all, and she was just as arrogant as anyone could be. With her talent and skill, there was no use questioning why she believed that she was God's surgical gift to the world. In the eyes of the surgical world, aside from her mother, she was the best young surgeon the East Coast had ever seen.
With notification that her replacement heart was twenty-minutes out, Regina looked up at the gallery once again. Her eyes flickered through the crowd before settling on Dr. Emma Swan. Oh, how she had questions for the intern. She had prepared a list of questions that had the capability of tripping the head-strong intern up in front of the entire hospital. That would bring her down a peg or two, Regina had thought to herself sadistically.
"Dr. Swan. Can you please confirm some of risks that a cardiovascular transplant can pose for the patient, should she make it through the surgery?" She asked with a smirk behind her surgical mask. She watched the blonde in the gallery blanch at the request, but she nodded and made her way over to the intercom in the corner of the gallery.
The intercom cracked throughout the OR as the blonde pressed the button and cleared her throat. "Like any other surgery, there is always the risk of infection, excessive bleeding, kidney failure or blood clots that may cause a heart attack or stroke. Then there is also the risk of coronary allograft vasculopathy or even rejection of the donor heart."
"And for those who don't know what coronary allograft vasculopathy is?" Regina raised a questioning eye brow at the blonde, praying to catch her out. She had given a good but clearly revised answer that could have been plucked out of any book or journal on heart transplants. It was, however, very that arrogant surgeons, like herself, would divulge in the mundane task of explaining every medical term used in their writing.
Swan stuttered into the intercom, squeezing her eyes shut in frustration before finally spitting out her answer. "Coronary allograft vasculopathy is an issue with the vessels that carry blood to the heart. They can become thick and hard as they reach the muscle and cause severe damage that increase the chances of rejection, stroke or cardiac arrest."
Damn it. Regina nodded at the blonde. Her answer was perfect; CAV literally caused blood clots either in or around the heart during transplant. They had been her mother's downfall in her first few transplant surgeries, yet Regina had only faced them on her very first surgery, and had been lucky enough to catch them, remove them and save the patient from one of the biggest risk factors proposed to the surgery.
"And how would the heart have been prepared to travel from the donor in Boston to Storybrooke?"
Swan's eyes widened like golf balls. The blonde woman froze as she kept the intercom button pressed down and stared at Mills in the OR. Her mouth opened and closed a few times before she slammed it shut and cringed. She didn't know. She had no idea. There hadn't been a time in her education that she had ever studied heart transplants from the removal to the end stage of recovery – just the surgery and post-op care. She shrugged her shoulders and tried to find and answer for the attending.
"It's over cut from the donor… then it's added to ice and transported by the fastest form of transport…?" She managed to let out. It was wrong. She knew it was wrong, but it was an answer and that was better than nothing.
"Wrong!" Mills deadpanned, using her stern voice to hide her amusement. That should do it for a while, she thought to herself. "A dose of potassium chloride is injected into the donor heart to stop the heart from beating or attempting to regain rhythm once it is out of the donor's chest. Then it is put on ice and sealed in a sterile cooler box and transported."
She saw Swan frown at her for a moment, before she requested the intern to take her seat again, and called up Dr. Ruby Lucas to the intercom.
"Dr. Lucas, what are our next steps in this surgery?"
Lucas' eyes synched shut at the question. She blanched more than Emma, but her voice didn't stutter as she pressed the intercom button. "When the, uh, donor heart arrives and the blood has fully been diverted through the bypass, remove the diseased heart and sew the new one into place."
"Obviously," Regina almost groaned. Anyone without spending years in medical school could have guessed that one – it wasn't rocket science. It was common knowledge and what Regina was requesting was so much more than that. "Can anyone please enlighten Dr. Lucas on the actual following steps of the surgery – preferably someone that attended medical school?"
Sheepishly, Dr. Whale raised his hand and stepped down from his chosen seat at the back of the gallery, prompting Ruby to rush back to her seat beside Emma with her tail between her legs. Her usually pale cheeks had flared a dangerous red with pure embarrassment at her incapability of answering a question for which she knew the answer. The pressure had squeezed everything she knew out of her mind and the only thing she could think of to say was the most obvious thing that came to mind.
"When the heart arrives, put it on ice." Whale paused and cleared his throat. "Cut the pericardium of the diseased heart and cut around the left atria to allow the donor heart to merge with the rest of the system. Once the diseased heart has been removed, the donor heart needs to be attached through the orthotopic procedure, connecting to the aorta, the pulmonary artery and the remaining part of the atria. Slowly begin to attach blood vessels and allow the patient's blood to begin flowing again. If there are any leaks in the sutures, they will become apparent, and the sutures will have to be redone to prevent any further leaks."
"Thank you, Dr. Whale." Cutting off her former shadow resident, Regina raised a gloved hand from its tentative position in the surgical field. "Dr. Lucas, I hope you were taking notes. I expect you to know what the orthotopic procedure is the next time I ask you."
Lucas nodded at the attending from the gallery and quickly whipped out her notebook from her pocket and scribbled a few reminders for a session in the hospital's library. She still had no idea about anything to do with cardiothoracic surgery and she didn't expect to be able to pick up a few journals or study cases to understand it either. She had Emma to turn to as a study buddy, she supposed.
Mills dropped her head from the gallery again, just in time to catch two of her elected scrub nurses releasing the OR's sealed door with the donor heart in a cooler box. Ever the pair to make an entrance, Gail Upland and Mulan Fu, were two of the best scrub nurses ever to fall to her word and never failed to stand their ground whenever they were required.
"We had to bat off a couple of New Yorkers to get this one," Fu laughed through her own mask as she delicately slid the red cooler box onto one of the surgical trays, where Ellie Thropp, Regina's favourite scrub nurse, was waiting to treat the heart prior to the transplant. "Apparently a failing LVAD and early stages of kidney failure isn't a good enough reason to take the heart."
Regina simply rolled her eyes and instructed her anaesthesiologist to start her timer. She had an hour and thirty minutes between cutting the pericardium of the diseased heart and replacing it with the new one. If this woman's body faced anymore stress of being on bypass alone, her kidneys would fail and their surgery would be unsuccessful. Skilfully, she pressed her scalpel against the membrane and exposed the fascinating organ, checking between the donor heart and the diseased heart of how much the new one needed to be sized and trimmed to fit perfectly in Mrs. Gilson's chest. When she was satisfied with her mental mapping of the organs, she started the first cut of the transplant along the left atria and the great vessels, releasing the muscle from her patient's chest.
She handed the heavy organ across the patient and into the hands of her shadowing resident, who took it with shaking hands and a nervous disposition. She ignored his anxious tremors and accepted the donor heart in her solid and focused hands. Regina took her final measurements and performed a few precise trims of the muscle, she carefully placed the heart into its empty and reserved position in the chest cavity. Perfect.
The cardiothoracic surgeon smiled to herself and glanced up at the clock. Fifty-three minutes down, thirty-seven minutes to go. Holding her expecting hand out to Thropp, Regina received her polypropylene suture kit and instantly got to work with her tight sutures using the bicaval anastomoses technique she had perfected long ago. It was close to impossible to not feel the tens of eyes watching her every movement and every breath as she pulled the pulled and tied off the sutures. The OR and gallery watched with baited breath as she waited for the muscle to pink in the chest cavity. For a second, even Mills had to hold her breath and pray to a God she stopped believing in some time ago.
After what felt like forever, the muscle darkened into its appropriate pink shade and Regina allowed her shoulders to drop in ease as she let out the breath she had been holding for far too long. She couldn't even resist the temptation to smile when the people around her, and watching her from the gallery, began to applaud and cheer in her success. What they didn't know, however, was that this was simply the beginning. She had succeeded in suturing the heart into place, but it was still a guessing game whether the heart would actually take.
She connected blood vessels to the surrounding area of the sutures and instructed the scrub nurses to slowly retract bypass to regain a heartbeat.
"Paddles," she requested, taking the offered defibrillation paddles from Herman. She lined them up to the sides of the pink muscle and nodded to Fu, who had taken over the patient's EKG monitor. "Charge."
The baited breaths were back as the electrical charge travelled through the paddles and echoed around the chambers of the heart. After her third transplant, Regina had developed a forty-five second rule between each defibrillation charge. If nothing happened within the first forty-five seconds of the shock, they would charge again. By the forty second mark, Regina panicked.
"Charge?" Thropp asked sensing that the organ wouldn't respond on the first round.
Regina shook her head and waited.
Fifty-seconds – thump-thump.
"I have a heartbeat." Fu confirmed, much to Regina's relief. It was steady and faint, but it was there.
Pulling the paddles from the cavity, Regina handed them over to a waiting nurse, and called to the anaesthesiologist. "Push two of adrenaline and we'll close."
The anaesthesiologist nodded and pushed the drug through the patient's IV, instantly gaining a positive reaction on the EKG. Steady atrial fibrillation, perfect blood pressure and positive results in urinary samples. The applause was deafening this time throughout the gallery and OR. But Regina didn't smile. She couldn't. This was still just the beginning of the journey for this patient. She had spent over a year and a half with Mrs. Gilson, finding her a solution to her heart's declining health with is powerful disease. The only solution that seemed to work for a while was the LVAD, and even that eventually began failing. When Mrs. Gilson's health began declining faster and faster, Regina knew that she needed to be bumped directly to the top of the transplant waiting list.
A confirmation of a donor heart was the most overwhelming feeling Regina had experienced in a while. They had worked so hard to find a solution while they waiting for a heart that never seemed to come. It was almost emotional to finally be closing up with a brand new, beating organ in her patient's chest.
Emma and Ruby were called directly to the ICU to meet with Dr. Mills once the surgery was over. They were joined by several other residents and a few scrub nurses under the attending's request into the empty ICU room. The entire set up was prepared for an intensive over watch; multiple EKGs, generators, defibrillation crash carts, oxygen tanks – everything. The only things missing, were the patient, the bed and the operating surgeon.
"Move." Came Regina's voice through the corridor as she was followed by an abundance of nurses and a nervous looking Dr. Herman pushing the oversized bed through the corridor. They manoeuvred the standard hospital issued patient bed into the room with precision and made quick work of hooking the patient up to all of the necessary machinery. "I have a proposition for you all. This is where I expect you to prove your worth to your programmes and to prove why you should be seen as some of the best surgeons or nurses in this hospital." The entire content of the room shared looks between one another. Regina Mills was scary as hell, especially when she expected nothing less than extraordinary measures to be taken out, and everybody knew it.
She smirked at the worried looking faces before her and folded her arms across her chest. "This patient has been in my care for eighteen months. We fought damn hard to get her this far and I sure as hell will not be losing her now. Over the next seventy-two hours, Mrs. Gilson will need to be observed and monitored second by second. Any fluctuation or change in any of her charts or scans or anything else will need to be reported directly to me. I may not be on call for the next three days, but I will be in the hospital for another seven hours today, I will be at home for twenty-four hours, then I will be back for another forty-eight hour shift. In that time, I need committed surgeons and nurses to work in pairs and shifts to ensure that my patient makes it through the next three days. The first twenty-four hours are crucial and I am handing her over to you."
The interns, residents and nurses remaining in the room all stared back at her, looking more and more terrified by the second. None of them had death wishes, but Dr. Regina Mills didn't care about that. No, she was more than happy to hand them their own death sentences. Taking care of one of her most important patients ever could be nothing short of a life sentence for any surgeon or nurse that made even the slightest slip up.
"I have organised a schedule around your work hours and your assigned surgeries for you all to follow. For the first six hours, I have Dr. Swan and Dr. Lucas." Regina bit her lip to stop herself from enjoying the terrified look on Dr. Swan's face. She was too focused on watching Swan cringe to notice how petrified Lucas had become. "The two of you will need to check up on Mrs. Gilson on the hour, every hour. I expect a full report written on the chart and for someone to keep me updated after every check-up."
The two interns nodded and accepted the patient files from Herman, who still hadn't seemed to have relaxed in the slightest. They clutched the charts to their chests and listened to Mills reel off her instructions for the rest of the residents and nurses, even though they could barely hear above their own worried thoughts of failure or even the slightest mistake. They were the only interns on the case, and Emma was almost certain that Mills was setting them up for a fail with her most sought after patient. Just the thought of it made the blonde want to vomit.
Once Mills had made her point clear, she dismissed the residents and nurses around her and performed the first post-operative check up on her patient, carefully walking through a step-by-step guide that her interns were required to follow. Clear optical reactions, steady atrial fibrillation, clear kidney dialysis, normal blood pressure, no immediate or apparent sign of infection, even ventilation stream, clear electrocardiogram reading, and clear neurological readings. Everything was checked and double checked before the brunette attending handed her interns her newly completed chart and a sports timer.
"When this resets, repeat the post-op and start the timer again. Send one of the nurses to find me with a detailed update on everything, and thirty minutes before your last check-up, I expect Herman and Clarke to be present for your handover. They need to know everything that has happened, so note it down for them to refer back to, should they need to." Reluctantly, Dr. Mills handed over the schedule for her patient check-ups and dismissed herself from the room.
She didn't want to leave her patient in the hands of two interns for her first six hours, but they were her only choice. She needed extra hands on the case, and she needed, more than anything, to be somewhere in the hospital when someone made a slip-up. And Regina didn't have a shadow of a doubt that Swan and Lucas would be the ones to quickly slip up on their shift.
Over an hour had passed and Emma and Ruby were already bored with listening to the steadily improving beeping of the EKG and the even exhalations from the ventilator pipe that had been threaded into the patient's throat. The sounds were almost haunting and most definitely lethargic. The longer they listened, the sleepier they became.
"Okay, since we are going to be stuck in here for hours." Ruby finally said with a dull and unimpressed tone, "Let's get down and dirty."
Emma's eyes widened as she hissed. "Excuse me?!"
"Woah. That is not what I meant, but whatever." She chuckled, realising that Emma had caught the opposite end of the stick she seemed to be offering out. There was nothing more she would rather do that get up to no good with the blonde, but with the situation they had been forced into, it was also the last thing she wanted to do. "I think we should get to know each other - personally. If we're going to be living together with Mary-Margaret for a while, I think we should know a little bit about each other."
"You know, I think I've got you down to a tee." Emma smirked as she rolled the desk chair she had borrowed from the nurses' station away from the EKG monitor and towards Ruby. She needed a distraction and since the woman with the wolfish smile seemed to be offering her one, Emma couldn't find it within her tired mind to turn her down.
"Why do you say that?"
Emma worried her lip a little before delving into some of the premade assumptions she was riding on when it came to Ruby Lucas. The woman was simple to read, but Emma wasn't entirely sure she was ready to hear about it. The pressured look and expecting smirk was enough to make the blonde throw caution to the wind and actually spill about some of her assumptions. "I don't know – I just think you rely on your sex appeal as a support system because you lack the confidence that you think you should have as a surgeon. I also think that you're not really as straight talking as you make yourself out to be – that's just a front to make friends here. And lastly, I think you're going to be a shark. You know your stuff, yet you act like you don't, just so you can remain under the surface and just play this whole surgical intern game until you find the right moment to pounce." Emma bit down on her bottom lip and shook her head as she scribbled on her notebook. She caught the stunned look on Ruby's face from her honestly and retracted. "I'm sorry – I shouldn't have said that."
Blankly, Ruby stared at the blonde with her mouth ajar for a moment as she allowed Emma's words to sink in. "There's a lot more to it than that, but yeah. I suppose you right." The brunette cringed, but chuckled, easing off and knowing that Emma was more than right.
"And the rest?"
"Are you sure you can't guess any more?"
Emma smirked and confidently straightened her back. "The only other thing I can get from you is that you've got a crush on me."
"Ha! That is rich." Ruby laughed loudly, making Emma cringe this time. Damn it. "Where did you get that from? Oh… no, I know. I told you I wish I'd upped my game to get in your pants, didn't I?"
"Yeah, and you also got jealous because you think I've got some delusional crush on Mills." Emma rolled her eyes, still irritated that the brunette had called her out multiple times on a crush that she most definitely didn't have on Dr. Regina Mills.
"Your crush on Mills isn't delusional – it understandable because, like you said, she is hot. But I don't actually have a crush on you. I wanted to see how you'd react."
Emma narrowed her eyes and creased her brow. She had made far more assumptions about Ruby Lucas than she cared to discuss. "So you're not gay?"
Noncommittally, Ruby shrugged with a smile. "I'm literally just down for a good time." She leaned down onto her knees with her elbows and let out a suppressed chuckle. "You're totally gay though. I saw those white tank tops and the irresistibly skinny jeans – don't think I missed that."
"Actually I wear those tank tops because they're comfortable, and I don't believe in labels."
"Well I'm glad you made an excuse for being able to see all your loose change in those jeans you wear to and from here." She paused for a second and winked at the blonde. "I'm sure Mills would appreciate them too if she caught a glimpse."
"Can you please stop with the Mills thing?" Emma hissed through tight lips. "If the nurses hear you talking like that, it'll get back to her one way or another and I'm definitely not ready to have my ass handed to me on a plate by a woman I don't have a crush on."
"You keep telling yourself that one, Swan."
Chapter 4: Double Trouble
Disclaimer: I'm not a surgeon, nor am I a nurse. Every piece of medical jargon in all of these chapters has been researched, but that doesn't mean its true or accurate. I do try my best, however, to be as accurate as possible!
Regina hadn’t slept again.
Relaxing in her own home after a grueling cardiovascular transplant always seemed to provide Regina with a great feat. It was difficult enough to leave the patient’s room shortly after the surgery, but leaving the hospital to be several miles away for twenty-four hours? That was the hardest part of Regina’s job. Leaving her patient in the hands of capable attending surgeons put her mind slightly at ease, but leaving them with residents and interns – that was a whole other ballgame.
After her first few transplants, Regina had set up camp at her patient’s bedside for the first crucial three days. She would continuously monitor her patient’s stats for the first twenty-four hours, then and only then, would she allow herself to take and hour nap when she needed to. It was pointless and ridiculous. There was never anything she could do, should there have been an issue post-op, but it was a comfort for her to know every rhythm of her patient’s new heartbeat and it felt like she was actually doing something by being at the hospital.
After her fifth transplant, Dr. David Nolan had to carry the tiny brunette out of the hospital over his shoulder and halfway across town to her over-sized house on Mifflin Street. When he eventually learned that she was practically living at the hospital for three days after any transplant surgery, he knew he had to intervene for his friend’s own health and well-being. Much to Regina’s reluctance, he waited with her for the immediate six hours post-surgery before he dragged her away from the patient’s bedside. His first two attempts had been proven difficult with the cardio surgeon eventually needing to be carried out of the hospital with her limbs flailing and curses flying everywhere. She had thrown the biggest tantrum David had ever seen from a grown woman.
The brunette hated him for it for weeks after. She refused to talk to him; she threw shady comments around the hospital, and even attempted to sabotage his research projects. It was petty and she didn’t need to do it, but the anger he had caused in her dainty little body should have been enough to make her implode. Four weeks into her vendetta against the neurosurgeon, David found himself more than bored of her childish attitude. He had dragged her into an on call room for her to completely have it out with him. She screamed for a little while, but once the anger was out, and the heavy vein in her forehead reduced back to a less than concerning size David patted her on the back and told her to ‘Get used to it’. Ten transplants later, and David was still escorting her out of the hospital after her shift was over, just to ensure that his friend made it home to attempt to get some sleep.
David had even become accustomed to moving into 108 Mifflin Street for twenty-four hours after her bigger cardiovascular transplants. The brunette had a tendency of either drinking herself to the bottom of a bottle of tequila, or critiquing her every move from the surgery by watching the recording on repeat in the living room, or in her home office. And annoyingly enough, Mrs. Gilson’s surgery apparently called for a re-watch. Or three.
Through the heavy mahogany floorboards and winding staircase, David was abruptly brought back to reality from his silent extra-curricular activities by the sound of Regina’s rough voice shouting abuse at the television screen. He threw back the covers and apologised to his top-secret bed mate before creeping down the polished staircase and into the living room. He stood in the doorway for a moment, cautiously observing every annoyed outburst from the brunette wrapped tightly in a thick, fleece blanket in the couch as she watched a third re-run of her recorded surgery.
“Regina,” David said in a warning voice after having waited long enough for her to notice his presence. It was a little after midnight, and the attending was more than ready for a little break from his friend’s aggressive yelling. “Turn the DVD off and get to bed.”
Regina practically growled deep in her chest at his intrusion and interruption of her very important research session. Her eyes were still fixated on the recording as she continued to analyse every step, every movement, and every choice she made during the six hour surgery. She critiqued her own practiced and perfected technique, calculated the possibilities of bad outcomes and occasionally found herself weighing up the possibilities of any positive outcomes too. She couldn’t bear to look away, far too concerned that she might miss the slightest mistake that she hadn’t noticed during her two previous observations of the recording. Regina Mills was a woman that thrived on perfection – she was a perfectionist and there was no use denying it, but this surgery was not something that could be tweaked and edited after a few revisions. In Regina’s worn-out and exhausted eyes, this surgery was a murder case. She had made many mistakes during surgery in her past, and in her reign of self-loathing, this surgery was filled with some of her most rookie slip ups.
She had been trying to wrack her brains for the last hour, attempting to find an answer to why the donor heart had taken longer than expected to regain it rhythm in Mrs. Gilson’s chest. There was nothing wrong with the heart before it was extracted, and there was nothing wrong with the organ as it was transplanted, but something, somewhere along the line had stalled it for just a few seconds too long, and it was what made Regina truly worry. From her intensive research prior to the surgery, she had expected and planned for the heart to regain rhythm between twenty-five and thirty seconds after. Dr. Mills wasn’t a woman that could handle being wrong.
“I swear, Regina. If you don’t turn that off now and get to bed, I’ll snap the disk and carry you to bed myself.” David huffed in his irritation. He loved his friend with every fiber of his being, but sometimes, her ambition turned into addiction, and that became fuel to her fast-growing ego, and it was often too much for anyone to handle.
“It’s fine. I’m just observing.” She muttered dismissively, before throwing up her arms in despair and growling at the television screen. “You idiot! You absolute idiot. That suture was far too tight. It’s going to tear the atrium and that will be what you’ve done wrong – that will be what has killed the poor woman. Not only could you not calculate the expected EKG, but you can’t even tie a suture correctly.”
David shook his head and stormed into the living room. Ignoring Regina’s warning curses and threats, he pushed the power button on the TV and forcefully pulled the DVD out of the player. For a moment, he twirled the disk between his fingers before addressing the fact that Regina had lobbed a scatter cushion at his head. “If you get up now, I won’t break it. Otherwise, you’ll see it shattered in a million pieces in the recycling box by sunrise. And you’ll have things thrown back at you.”
“I am trying to work, David. Put it back in the player. Now.” The exhausted cardiothoracic surgeon narrowed her eyes at him, in an attempt to look slightly threatening. It didn’t work, however, when it mixed with her messy, tired up-do, panda eyes from her non-waterproof mascara and her over-sized college colours t-shirt that hung limply on her frame. She looked like a tired college student that had just been tossed around after a brutal finals week with a hangover to match.
“Nope.” He flexed the disk between his hands menacingly, trying to tease her into submission. He knew it would work – so much, in fact, that he didn’t need to hear the deep growl from Regina’s chest to confirm that she was well and truly irritated with him. He smirked. “Get up and go to bed, and you can have it back tomorrow. Or I’ll snap it.”
Regina pushed herself off the couch, leaving the blanket she had had draped over her shoulders to fall onto the floor and stepped right into David’s personal space. She was still at least a foot shorter than the neurosurgeon, but her external demeanour stood ten foot taller. She should have been terrifying, but her curled lip and quiet snarl did nothing but make David laugh. “You wouldn’t dare.”
Regina raised an eyebrow as David brought the DVD high above her head. No matter what she stood on in her living room, she would never be able to pull it from his meaty, man-hands. “Nolan, give me the DVD now,”
“Or what?” David’s charming smirk did nothing to distract Regina’s watchful eyes on her surgery disk. “Are you gonna bite my ankles?”
The brunette glared at her best friend as she tried her damned hardest to jump and reach for the disk. He was infuriating. He was constantly getting in the way of her long-term patient care. She had to dissect the entire surgery second by second before she could face her patient again. She had to ensure that she had done everything by the book – which she already knew she hadn’t done. She had done it her way – a way in which she had tried and perfected on multiple cases. It was a method that should have been perfect for Mrs. Gilson, and here David was, trying to be charming by insisting she rested before heading back to the hospital, when she really needed to be observing everything to be able to fix any mistakes she might have made. The upcoming twenty-four hours were just as crucial as the thirty hours after the surgery.
“Just give it to me.” She reached one more time and stretched no further than the crook of his raised elbow.
“I can’t. You have to get some sleep and go into the hospital with a fresh and well rested mind. Or you’re not going to get anywhere with the case.” David looked at his friend with a solemn smile and nudged her backwards by her shoulder. “I spoke with Ellie, and she told me that the surgery was perfect. She knows the procedure inside and out – just like you do. Ellie would have seen if you had slipped up.”
Regina shook her head and sighed. “Ellie Thropp is a nurse, David. There is no way she would have any idea if I had made a mistake or not.”
“That’s crap and you know it.” David lowered his arm a little to test the waters if the brunette would attack again. “Just get to bed, and I’ll come with you for your morning round straight away, okay?”
In a sigh of defeat, Regina’s head drooped to an innocent nod. There was no room to argue with him over the situation. She was too exhausted to fight with him, especially when she knew that he was probably going to be right in the long run. He always seemed to be right in situations like this. In order to actually keep the rest of her patients alive during her multiple planned surgeries for the following day, Regina knew she should at least attempt to get a few hours’ sleep and clear her mind from any unnecessary anxiety over the transplant.
She took her own step backwards before swiftly turning on her heel and stalking out of the living room. David suppressed a chuckle when he heard Regina’s bare feet inelegantly flap against her incredibly expensive staircase as she made her way up to her bedroom. In all the years he had known Regina, there had never been a time that he hadn’t found her childish tantrums anything less than entertaining. The usually elegant, independent, and well put-together woman should have been the most unlikely to ever fall into an immature strop, but whenever she had passed the point of exhaustion, Regina Mills turned into the six-year-old she claimed she never once was.
He followed the brunette closely up the stairs and waited for her door to slam behind her before returning to his own set-up across the hall. Little did he know, as he hid the surgical recording in one of the drawers that lined a wall of the room, Regina sat in her queen-sized bed with her hand written surgical diaries and a few of her favoured pieces of research on cardiovascular transplants. There was too much time between that moment and the minute she could stroll back into the hospital and perform a full post-operative check on her patient. There was too much time to think about everything and anything revolving around the surgery – including the idiot interns she had allowed on the first watch.
Six hours later, found Regina storming through the corridors of the hospital and into the ICU to track down her transplant patient with David hot on her heels. She had managed to pass out for a few hours the night before, once she stopped thinking about the transplant. Somehow, her mind had wandered in her thoughts of the irritating and insufferably intelligent Dr. Swan. Her mind became enthralled with the running idea of the intern’s luscious blonde hair, her crooked smile and perfect, athletic physique. Mills had allowed her imagination to run wild at the thought of the intern – so much, in fact, that she had no other option but to take an ice-cold shower when her alarm clock rang loudly at 5am, stirring her from the vivid dream she had been experiencing.
The door to Mrs. Gilson’s ICU room was closed shut when Regina and David arrived outside. The two residents Regina had scheduled for the shift just so conveniently happened to be Dr. Kathryn Midas-Nolan and Dr. Jim Frederickson – their favourite people in the world. Throwing he door open, in the most professional way Regina could think possible, she sauntered in to catch the two residents jolting awake from their apparent nap-time.
“Please do not tell me that the both of you were fast asleep in my patient’s intensive care room.” She hissed between gritted teeth. As much as she knew that the two residents on the case hated both her and David, she thought that neither of them would do as much as become so lax when it came to patient care on her watch. “Because if I find out, and I will, that the two of you have spent the last six hours watching the back of your eyelids, I will see it that neither of you see the inside of an OR for a month.”
The two guilty residents looked choked as they hastily rushed around the room to collect the sheets of paper for the attending that had been carelessly strewn around the room. Dr. Midas-Nolan refused to take her eyes away from the grey tiled flooring as she collated all of her data into a manila folder and handed it over to Mills. She nervously fidgeted under Regina’s glare and shuffled away from the doorway, to allow the attending enough space. What the resident didn’t see, however, was the man that followed the cardio surgeon into the room. When she did spot the tall, handsome and incredibly charming man step though the doorway, she resisted the urge to roll her eyes. Of course the Evil Queen had to bring her loyal guard dog to do her bidding, Dr. Midas-Nolan nastily thought to herself. She shook her head and fixated her eyes onto Dr. Mills as she wandered around the patient’s bed, taking her own notes, bit by bit, machine by machine, and number by number.
Regina hummed and occasionally tapped her pen on the top of her notepad before finally slapping it shut and swiveling quickly on her heel to face the residents. Her patient was holding steady and showing a few promising results, yet something didn’t see right. Her blood pressure was slightly elevated, and there was a gap in the note from the previous watch. “I want to know every detail you learned from your hand-over. Tell me every element that you intend telling the surgeons who are taking over the final shift.”
Midas-Nolan stared back at Regina with an attitude that made Regina’s skin crawl. She never liked the woman, even when David proposed and asked his friend to be his best (wo)man. There was never any jealousy on Regina’s behalf – it had always been nothing more, and nothing less than mutual dislike between the two of them. Kathryn was an entitled fool born with a silver spoon in her mouth, and Regina simply despised her. They clashed in ways that made Regina hate her all the more. In the beginning, she had tried to be supportive, but when Kathryn finally came out of her shell and showed her true colours to the world, it only made Regina realise all the more that she wasn’t the right woman for her closest friend.
“Steady sinus tac for the last twelve hours,” Frederickson started, earning himself an alarmed and heavy stare from Dr. Mills. Only twelve hours? “Heart-rate elevated slightly around 7pm last night. It was brief, and it cleared as fast as it came on. Prior to that, we have no recorded history of any elevation in her heart-rate or blood pressure. The tracheotomy will likely require removal in the next few hours as she’s been trying to breathe through it, but the patient’s strength hasn’t managed to overtake it just yet.”
Regina nodded and scribbled a few more messy notes at the bottom of her chart. She pulled her purple stethoscope, which so happened to be a graduation gift from David, from her neck and fitted the apparatus into her ears. “How has her chest been sounding?” She asked as she pressed the cold, metal instrument to the patient’s chest.
“Clear and steady.” Dr. Frederickson confirmed with a nod.
“Any brain activity?” David inquired from the doorway. His arms folded across his chest as he leaned against the wooden door frame, doing everything he could to control himself from treating the residents any differently to the others. The snarl on his face directed to both Midas-Nolan and Frederickson was completely unprofessional, however. “She may be having reactions, but is there any neurological activity?”
Dr. Midas-Nolan rolled her eyes again and huffed. “Dormant, but there’s activity slight activity. She’s responding to sound and light. We won’t know until she wakes.”
David tilted his head down to face his ex-wife. She had been glaring at him from the moment he stepped into the room, as if he had been the bad guy in their relationship. He hadn’t been the one to exclusively cheat with one of their co-workers around the hospital. Nor was he the one in their relationship that wanted nothing more than what he could get out of it – he had been in it for the long-haul. He had been in love.
He rolled his eyes and bypassed the blonde to make his own checks on Regina patient’s reactions and perform the briefest neurological exam in the history of his career. David didn’t need the reminder that the woman he had shared a large chunk of his life with was still so incredibly open about her home-wrecking relationship with the other man in the room by staying any longer than he needed to.
As much as he hated to admit it, Kathryn had been right. Mrs. Gilson’s responses were clear and showing no signs of neurological damage, but with the woman still being deep in a medically induced coma, there was nothing he could say for certain on the matter.
“She’s clear,” David announced to his fellow attending, tucking his pen-sized flashlight into the pocket of his lab coat. “Keep me updated on her coma, and when you wake her, I want to do a full neuro work-up.”
Regina nodded to him and motioned for their departure, just as Dr. Whale and Dr. Clarke stumbled into the room. Finally, someone she could actually rely on to ensure that the job was done right. Whale could be lazy and wrapped up in his own little world most of the time, but from the beginning, Regina drilled into the man that cardio was more than hard-core – it was everything, and the slightest mistake could kill the patient immediately. Technically, she had terrified him into performing in cardio; it got the job done, so the brunette couldn’t care less.
“Lacey, I need interns.”
“Funnily enough, I do too.” Lacey muttered in her robust Australian accent as she leaned back on the nurses’ station in her outwardly butch stance. “Whale’s given me all five of his for the day. Apparently, he and Booth are becoming chums and doing a partial facial reconstruction today.”
“I need two of them.” Regina insisted, handing over a fresh coffee from one of the vendors conveniently set up around the hospital to the trauma attending. “I need Swan and Lucas to observe my critical heart-transplant patient for a couple of hours.”
“No can do, Regina. I need those two. They’re to only ones in that bunch with the intuition to do the right thing, and they need to spend some time in the ER and the clinic. Chief Hopper seems to think that they’ve spent far too much time on big cases and that’s a no-go when there are plenty of residents in this hospital that need cases for their residency exams.”
Noncommittally, Regina took a sip of her coffee and spoke honestly to the Australian attending. She smirked over the rim of the plastic lid. “The residents are idiots.”
“Yeah, and so are the interns, but someone’s gotta help me run the ER at some point.”
“You’ll still have Jones, Cassidy and Blanchard.” Regina offered, like it would even begin to sway the woman into agreeing to give up two of the best interns in the hospital. “Cassidy might be titled as 007 for now, but I don’t think that’s going to last very long. Those three adequate enough, don’t you think?”
“Sure, but I need people covering the pit, the ER and the clinic. Three interns aren’t going to be able to handle that on their own. I need two in the ER, two in the clinic and someone in the pit, and the last time I checked, that means I need five interns, and Whale has kindly given me his five interns. Take one of Howells’ interns – they’re dying to get some cardio action with you.”
Regina glared at the trauma attending, more than ready to fling a hypothetical ball of fire at her head. Sure enough, they were friends, and Regina most certainly wouldn’t turn down a few drinks with the Australian at the Rabbit Hole, remembering how their last night out had found them both in her bed for the umpteenth time. But Regina needed interns that weren’t complete idiots and Lacey had already nabbed up the only ones she had her eye on. “Fine. But if they’re horrific, I’m dropping them in your lap.”
“That’s fine, mate.” Lacey drawled with a look of success plastered on her face. She flirtatiously winked at the head of cardio. “The more the merrier in my lap.”
“Swan, Lucas. Gear up.” Dr. Lacey French instructed through her energetic Australian accent, as she tied her ER gown around her neck. She stormed off towards the doors to the ambulance bay, with a hurried Swan and Lucas following close behind. “Incoming trauma. Cyclist with severe head wounds after collision with a trucker. Expected multiple broken bones, fractures and internal injuries. Neurology and orthopaedics have been paged. A couple of other attendings have been cautioned too. We’re two minutes out.”
Emma and Ruby nodded as they helped each other tie the backs of their gowns to prevent them from falling off their shoulders when their patient came flying into the Trauma Unit. Neither of them had been fortunate enough to actually experience the excitement of the ER yet, so when everything began to feel real as they waited for their actually dying patient to arrive, Emma couldn’t stop bouncing on the balls of her feet with the adrenaline that coursed through her veins. Sure, she had experienced a few practice ones during medical school, but this was the real thing. There was a real person’s life on the line and she had the skills and resources to save them in completely different circumstances than being in the OR. She felt a rush that no words could describe. Or at least that’s what she thought, anyway.
Once they were gowned and gloved, and waiting in the biting cold, Maine breeze, Ruby narrowed her eyes and looked at their young attending. “How the hell does a cyclist get into a collision with a trucker…?”
“Most likely by being an idiot, Dr. Lucas. But that doesn’t mean that we can’t treat him all the same.” French chuckled and double checked her pager. She had an intern missing. She needed three interns for a case this size, and somehow, she had only managed to find two of the three she had been looking for, and it infuriated her. “Where the hell is Blanchard?”
A concerned glace was shared between Swan and Lucas. They hadn’t actually seen Mary Margaret for hours. She had been assigned to the clinic with Cassidy for the day, who hadn’t seen her since their first few consultations together, and that was three hours ago. The day before, when Emma and Ruby were lugging their possessions across town to move in with the pixie-cut brunette, she had gone AWOL then too. For some unbeknownst reason to everyone, so it seemed, the woman had a fascination with randomly disappearing for hours on end. It was more than concerning, but Emma couldn’t keep her mind focused on her friend when they spotted the flashing lights of the ambulance quickly approaching them with the sirens blaring.
Lacey signaled for the interns to follow her as she raced towards the back of the vehicle, where they pulled the doors open to reveal a frantic looking paramedic and a bloodied body wrapped in hospital issued insulating blankets. The heavy smell of burned flesh and ironized blood wafted from the sanitised area as Lacey and her interns hoisted the gurney from the back of the ambulance. Even the smell of tire rubber filled their senses as it swirled in the air with every other stomach wrenching smell. When the gurney reached the floor with a crash, the surgeons pushed it through the doors and into their prepared trauma room.
Pulling away some of the excess blankets around the patient’s chest, Lacey called to the paramedic holding her scribbled chart. “Give me stats. Give me details. Tell me everything you know.”
“John Doe. Wild trucker on a murderous rampage.” Although the paramedic’s exterior screamed with anxiety, her voice was strong and confident enough to reel through the information that she had collated between the accident and their arrival at the hospital. She stood at the foot of the patient’s new bed as the interns aided by a few nurses with transferring the patient from the rickety ambulance gurney. “Hit our cyclist clean off his bike with the front of the truck and managed run him over with four wheels before he was stopped. Tire tread has been indented into the abdomen, assumed burst lung, broken ribs and pelvis.”
French didn’t have the time to react to the paramedic’s assumed diagnosis. Instead she handed multiple instructions to her interns to insert fresh IV’s into the patient’s hand, push multiple doses of morphine, and several rounds of fluids through the gauge, allowing herself enough time for a quick observation of the patient. She pulled the last few blankets from the convulsing man on the bed as he reacted to the medication the interns had injected him with. It was more of a shock than anything else when French pulled a bloodied blanket from his mangled legs. She stumbled back on shaking legs as her eyes flickered from exposed bone and the paramedic.
“You didn’t mention that his legs were practically destroyed!” French all but screamed, drawing the entire room’s attention to the patient’s exposed femurs. “Someone page ortho again stat. And can someone please page Double Trouble?!”
“Double Trouble?” Emma asked with a furrowed brow as she hooked up the patient to the EKG monitor that instantly showed a declining atrial fibrillation. He was almost in cardiac arrest.
“Mills and Nolan.” French told her, confirming the immediate speculation Emma had drawn once she realised that this was quickly becoming a cardio case. French pulled out an intubation kit from one of the many drawers that lined the back wall as the patient began seizing again. She threw it up to bed to the blonde intern with a pointed look. “Get him intubated, Swan.”
Catching the intubation kit perfectly, Emma tore open the packaging and quickly pulled out the tube and laryngoscope, successfully discarding the packaging somewhere on the floor. She positioned the patient’s head enough that would prevent any more damage should there be any injuries to the patient’s spinal column, and opened his mouth wide to press the aiding apparatus between his teeth. Skilfully, and with a precision that very few people had, Emma thread the tube through the scope and through to the back of the patient’s throat. When the tube failed to even make it to the larynx, she shook her head and called over to her attending.
“His airway is blocked completely.”
“Smaller tube.” Lacey pointed at one of the nurses at Emma’s side to hand over a smaller tube for the intern to try. With efficiency, she pulled out the larger tube from his throat, and replaced it with the smaller one. Again, the tube failed to pass any further than the top of the larynx.
“I can’t get anything in…” Emma pulled out the smaller tube and accepted the smallest tube the trauma room had to offer. It managed to travel further into the patient’s throat, but failed again to reach its assigned distance. She pulled it out and looked up to French, who was trying her hardest to prevent the patient from bleeding out onto the trauma room floor, while her fellow intern was pressing even and precise compressions to the patient’s chest.
“Then trach!” The Australian yelled over the chattering voices of the nurses and pulsing sound of the EKG monitor.
Emma stared at her wide-eyed and thrust the laryngoscope into the hands of her assisting nurse. Emma Swan had only ever observed a few tracheostomies in her life, and half of them had been on TV. She had never even had the opportunity to test it out on a cadaver either. “I’ve never done one.”
“Then now’s your chance. I’ll talk you through it.” The attending stepped down and allowed the man Emma instantly assumed was Dr. Humbert, the attending orthopaedic surgeon, and pushed a tray over to the blonde at the head of the patient’s bed. She injected a syringe of lidocaine into the column of the patient’s neck, and handed over a bottle of iodine to the blonde, who effectively sprayed the liquid over the patient’s exposed neck before accepting a ten-blade scalpel. “Use your fingers to find the top of his larynx, then make a small vertical incision between three and four centimeters.”
The blonde intern nodded and pressed the scalpel onto the patient’s neck and broke through the skin. Much to her own relief, she missed the cricoid artery and made a perfect incision above a crease in the patient’s neck. Using her knowledge of the procedure, Emma followed the next step and dissected a minimal amount of the pretracheal tissue to push the thyroid isthmus downward. She reiterated the procedure in her head as she had read it in so many of her medical journals. Half of the words had stopped making sense by the time she had done exactly as she had needed to.
“Perfect,” Dr. French observed, and aided the blonde in stabilising the larynx into position. “Finish your bronchoscopy, but be sure to avoid the posterior tracheal wall, otherwise, its game over.”
Carefully, Emma followed the remainder of Dr. French’s instructions for the tracheostomy and successfully managed to perform the procedure with very few mistakes. She had struggled to find placement for the tube in their John Doe’s tracheal lumen, but with the aid of her attending, successfully managed to secure the tube in a prime position to attach to the ventilator, all before his EKG began screaming and echoing around the ER again.
“He’s in V-fib!” Dr. French called, pushing the trach tray away from her and handing Swan the trach pump to attach to the pipe in their patient’s neck. “Where the hell is cardio?!” In a fluster, she glanced around the room, in search for Mills, or at least someone from cardio. “Swan, slow and steady on the pump – only let go when I say, okay? Lucas, back up.”
The trauma attending called for a crash cart and efficiently exposed the John Doe’s chest as she called Dr. Lucas to push two of EPI once she had cleared herself from the patient’s chest. She called a charge on the defibrillation paddles and quickly pressed them onto the patient’s chest, shocking his heart into an instant A-fib before it dithered back to V-fib.
“Charge to a hundred and go again.” She called for, as Dr. Mills rushed into the room, accepting a gown and gloves.
“I’m here! Move.” She bumped French out of the way and took the paddles in her own hands before shouting, “Clear!”
Everyone surrounding the bed, aside from Swan and Mills stepped back from the bed and watched the patient’s chest convulse off the bed before collapsing back down. An erratic beep on the EKG rang through the room as Mills handed over the paddles to a nurse. The patient was already out of V-fib and instantly into an intermittent A-fib. His blood pressure sky rocketed, and his body shook with the tremors of aftershock from the powerful defibrillation.
Mills shook her head and contemplated her surroundings. She spotted the blonde evenly squeezing a trach pump – his breathing was steady but his heart rate was anything but. She had no other option but to call for drastic measures.
“Keep steady on the trach pump, Swan. Watch the clock if you have to. I’m going to have to crack his chest, so don’t you dare miss a beat.” Swan’s eyes widened, but she nodded in understanding. She didn’t, however, look up at the clock. Instead, her eyes remained glued on the cardiothoracic surgeon’s professionalism as she prepared for her specialty's most dangerous procedure. Dr. Regina Mills was an art form and Emma Swan was most certainly a confirmed admirer. “Can someone please find Nolan? I’m going to need his help and someone page the OR and tell them I’m going to be in his chest before we even get there.”
Comically, the entire ER scattered around to their expected places. Regina Mills held an authority over any room in ways that even dictators could never accomplish. She was powerful, and everyone around her knew it. One of the nurses lowered the bed enough for Regina to gain ample access to the patient’s chest, prior to giving Swan the heads up that she would need to duck with the bed, and prepared a sterile tray for the surgeon’s procedure.
As Mills prepared to press her scalpel to the patient’s chest, with a silent ER, Nolan skidded into the room with a flushed and flustered pixie-cut intern that had previously been AWOL hot on his heels. Swan and Lucas shared knowing smirks over the patient’s bed at the sight before them. When Mary Margaret had gone missing for a second time on their day off, after receiving a hurried phone call, the pair had made bets that she wouldn’t be returning to the apartment for the rest of the night. And they were right; she strolled into the apartment an hour before they had planned to leave for their assigned third forty-eight hour shifts with a smug look on her face.
Pulling Swan and Lucas away from their knowing looks, David snapped on a pair of gloves and pushed his way through the crowded trauma room. “Sorry, I was a little preoccupied. What’ve we got?”
“Roadkill.” Regina deadpanned, pulling her scalpel away from her surgical field. She needed to get in his chest before he arrested on the table again and died before they could even do anything. “Check his responses, then I’m going to need a hand when I’m actually in his chest.”
“That’s stupid, Regina! Don’t even think about cutting into his chest before I’ve even done a basic neuro.”
“Then do it now before we lose him! If you weren’t so busy faffing around with your little intern, we wouldn’t be worrying so much!” Regina glared at the pixie-cut brunette, who was already being lectured by the trauma attending for going missing while on shift. The Australian’s already strong accent almost became incomprehensible through her anger as she pointed her finger to chastise the woman.
“He’s responsive, but unconscious from his extensive injuries.” David announced as he passed his flashlight over the patient’s eyes. He let go of one of John Doe’s eyelids and stepped back from the table. “Regina, get him on bypass and a ventilator – he’ll stay steady until we get to the OR. You can do what you have to do when we’re in there. His injuries won’t sustain your weight if you’re in his chest.”
Regina contemplated the idea for a moment, before nodding her head. It was their safest option, and the only option they really had if they wanted any chance of saving him, but that didn’t mean that she wanted to bow out like that. She still wanted the chance to stabilise his erratic heart before they left the ER, but with the glare that David was dishing out to her left no more room for argument. She hated the hold he seemed to have on her. He kept her grounded and damn, it irritated her.
“Fine,” She sighed, gripping the scalpel in her fist. She pressed it against the patient’s chest and quickly made work of hooking him up to the bypass machine instead of cracking his chest bone. Simultaneously, she carefully instructed Swan and Lucas to connect the trach to the ventilation machine and ensure that both the ventilator and bypass machine were ready to be moved. Between the three of them, they had successfully transferred the patient from hanging on by a thread to a full set of life-support machines in mere minutes.
When the ER was prepared, French released the break on the bed for the surgeons and nurses to begin pushing the bed directly to the OR.
“Swan, Lucas, you’re scrubbing in.” Regina called over her shoulder as they manoeuvred the bed into the corridor.
David frowned and shook his head “What about your other interns?”
“They’re idiots, and they’re monitoring my transplant patient. I need someone.”
“No.” David asserted to his friend as they wheeled the bed into the elevator. “We don’t need interns for this, Regina. Call in Herman and Feinberg to scrub in. Lacey needs Swan and Lucas to cover for her!”
The elevator doors slowly began to close, leaving Mills staring back at Swan and Lucas with an almost apologetic look on her face.
“We don’t need interns for this, Regina, he says.” Regina mimicked as she took a clamp from one of the scrub nurses. It had already been a messy surgery, and they were only an hour in. The brunette had found herself performing more procedures from general surgery than she had done in years, and she had yet to even see to their patient’s heart, where some of the real damage was. She tutted at the surgeon across from her and nodded her head towards the pixie-haired intern behind him. “Yet, here he is with an intern at his beck and call. What game are you playing, Nolan?”
David chuckled at her, and took the ten-blade offered to him by one of the scrub nursed drafted onto the case. “The ‘you-can’t-pick-favourites’ game. You had Swan and Lucas at your beck and call for their last shift, now you’re trying to nab them again? I don’t think so.”
Regina paused for a moment and glared at her friend. She wasn’t picking favourites. She was using surgeons with the capabilities of doing the advanced surgeries, and Swan was the best intern she had seen in a while, not to mention she was a world easier on the eyes than any other intern she had ever seen. Having the blonde on her service simply made her day easier, and much more appealing to the eye. But David didn’t need to know that. Hell, Regina didn’t even want to know that. But it was a fact, and Regina knew that she had to face the music of it at some point.
She stared at the timid intern over his shoulder again and smirked behind her mask when she saw her shudder. “Isn’t your intern over there the one that went completely M.I.A from trauma this morning? Because Lacey is furious.”
And Lacey was furious. The Australian had almost refused to scrub into the surgery, simply because the intern was casually let off the hook for going missing for hours on end. She didn’t care about her reasons for going M.I.A, but she had still disappeared. She abandoned her post in the clinic just because there was something far more interesting to do elsewhere in the hospital. She wouldn’t have been so mad if someone had given her the heads up prior to her little walkabout, but when Cassidy came running to her, complaining that he was the only one trying to run the crowded clinic, she couldn’t help but be angry.
“No intern is permitted to run off onto their own cases and abandon the position that they had been assigned to.” Dr. Lacey French spoke with authority as she forcefully tied a suture below the patient’s pelvis. “My clinic is now overrun because one idiotic intern didn’t think her post was adequate for the day.”
“Actually, Blanchard was on an errand for me.” He told her, with an overly confident attitude that Regina saw straight through.
“Really? And where were you at the time of this errand?” Regina asked with a raised eyebrow. She already had a few reasons to believe that David had most definitely moved on from his ex-wife, and if random disappearances with an intern weren’t enough to raise a few red flags, then nothing was.
“Working.” He deadpanned.
Regina’s rich laugh echoed through the busy OR. “Oh, is that what you’re calling it now?”
“Regina, I was busy. Bleeder.” He pointed out the blood trickling into their surgical area from a cut or tear somewhere in the field. Regina was quick to react and took the suction pipe to clear it.
“I’ve got it.” She silently got to work dealing with the bleeder deep in the patient’s abdomen, occasionally calling for a few instruments from the scrub nurses around her, before continuing their conversation as if nothing had interrupted them. “Of course you were working. I wouldn’t expect anything less from you.”
“Snarky, snarky.” David tutted, trying to hide his embarrassment of clearly being caught out.
“You’re really irritating. Did you know that?”
“How could I forget? You tell me every day, remember?”
Chapter 5: Assumptions and Personal Intuition
Disclaimer: I'm still not a surgeon.
Assumptions and Personal Intuition
The atmosphere throughout OR Three was blissful. The peaceful and serene working conditions of the operating theatre were a stark contrast to the actual work in hand. Their John Doe from the Roadkill case lay open on the cold, metal table that divided the operating theatre, while trays and sterile instruments lay scattered around the surgical field. Pliers, clamps, scalpels, bone saws, suture kits, and an abundance of other tools and instruments were juggled between surgeons and nurses. The sight was something straight out of a sadistic horror movie, and yet Dr. Mills loved it. Traumas and surgeries like this one made her heart race and adrenaline flood through her veins. She lived for the chaotic surgeries like this one. And even though Regina loved organisation in her OR, when challenges like this one arose, the thrill of the pandemonium destroyed any desire she had of being an anal-retentive in her work.
“Clamp,” David would request occasionally to break the silence that had lulled around them. He was one of the many surgeons on the case that hated the silence, except, he was the only one who really didn’t care about testing Regina on it. For him, trauma surgeries were like a college party; it was messy unorganised and completely wild. And no college party was without a carefully selected playlist to be blasted throughout. David’s surgical playlist had been wisely selected, with contributions from almost all of the surgical staff at the hospital. After some convincing, even Dr. Mills had included two songs, despite the fact that she preferred the steady and reliable rhythm that came with the surgery. The baseline of the patient’s EKG monitor, the shuffling of scrubs, and even the sound of the metal instruments slapping gloved hands created a song that Regina would happily listen to on repeat for the rest of her life.
As they battled with the medicine and sciences that they had all practiced for so long, each surgeon faced their own hurdle to jump. Dr. Humbert had stood at the foot of the patient’s bed for three-quarters of an hour before making his final decision to perform a double leg amputation – each cut just above the knee. It was a vicious decision, but Dr. Graham Humbert knew that the only option he had to keep his patient alive was to amputate. It would avoid infection, and actually keep the patient alive, but he couldn’t help but question whether or not their cyclist John Doe would be mentally able to survive without both of his legs.
It was a tough decision to make, but someone had to make it.
For Dr. Lacey French, her hurdles were just getting higher from the moment their patient arrived in the trauma unit. It wasn’t until they had arrived in the OR and stabilised the patient that Dr. French was able to actually map-out the injuries that their John Doe had sustained. His heart had started failing before they could get him on bypass, he was losing more blood than they could pump back into his body, and several of his vital organs had started failing. It was a nightmare of epic proportions until he began to settle and stabilise. And just when they thought they were out of the clear, the entire surgical team on the case found themselves falling into a deep, downward spiral.
Five hours into the surgery, and Double Trouble were already causing arguments.
“David, stop it.” Regina had snapped, removing the clamp that he had unnecessarily attached in the surgical filed. “You’re going to kill him from adding needless pressure when you could be suctioning the field so I can actually see what I’m trying to do.”
“Oh, and clearing the surgical field by clamping won’t aid that?” He snarled back at her, earning himself a few shocked gasps from some of the trauma nurses. It still stunned far too many people that he had the audacity, and death wish, to actually retort whenever the head of cardio flipped. “Just because you don’t have your precious cardio squad to read your mind throughout surgery, doesn’t mean you can yell at me, Mills.”
Regina pursed her lips behind her mask in annoyance and clumsily dropped the bloodied clamp onto a surgical tray with a clatter. “If I wanted your assistance in such a way, I would have asked for it. Would I not?”
“If you spent more time watching what you were doing than picking petty holes in everything I do, you would have noticed that you needed the clamp to see that his blood has haemolysed.” David commented, glancing over to the patient’s EKG monitor for a moment to confirm his queries while Regina cringed at her constant need to be right. It never seemed to play in her favour. “Pressures dropped.
“Okay, suction.” Dr. Mills ordered as she pressed surgical lap pads into the field to soak up the haemolysed blood and cells surrounding the area. “I’m actually going to have to get to his heart this time."
“Impossible. You’ll kill him straight away,” Dr. French chirped in as she added her own lap pads to the surgical field at David’s side.
“It will kill him either way! His heart is already severely damaged. If I don’t get to it now, all of this would have been for nothing.” Regina warned as she motioned for the anaesthesiologist to slide across a step-stool for her to access a prime position to make an incision in the patient’s chest. She stepped up and exposed the patient’s chest and clavicle, before glancing down to David, Lacey, and Graham who had offered his services to keep their patient from falling under. It was dangerous to cause any more damage, but without the procedure, their hours spent trying to save his life would have been for nothing. “Stabilise the area, stop the bleeding, and for god sake, do not let him collapse.”
The four surgeons surrounding the first cavity nodded and proceeded with packing and lapping the surgical field, ensuring that the organs were reacting in each right way as Regina pressed her ten-blade scalpel into their patient’s skin. The cardio attending made quick work of cutting through the flesh and splitting the breast bone to reach the organ that had been completely transferred over to the bypass machine. Her body was ridged as she assessed the damage and reached for her required instruments, until the OR was filled with the irritating and echoing sound of a pager buzzing and beeping. She flinched and bit back a growl as she caught Blanchard rushing across the OR floor to dismiss the lousy piece of plastic. Only when the OR fell back into a complete, hushed silence did she return to her task in hand.
In the newly rediscovered calmness in the theatre, with the occasional verbal update from her assisting surgeons or panicked mumbling when one of the idiots managed to make a mistake, Regina was able to repair the damage that had been caused to the aorta. A valve had ruptured early in the surgery, and without relying heavily on bypass, Dr. Mills knew they would have had no chance to attempt to save his life. If he even made it out of the surgery alive he would have to trudge through and keep fighting during his post-op recovery period. It was a feat no one should have had to have faced alone.
As she successfully reconstructed his breastbone to being her series of stapling, the vibrations and shrill buzz of the same incessant pager rang through the OR. In sheer frustration, Regina slammed the surgical stapler down onto the metal tray beside her, essentially shaking and even toppling multiple instruments onto the linoleum flooring. Beneath her mask, her usually plump lips pursed together in the thinnest of lines. Had she not been biting her lips, the brunette would undoubtedly have ground her teeth at the complete ignorance that some of the surgical staff at Storybrooke Memorial seemed to have for surgical requests. At the beginning of the surgery, she had made it incredibly clear that they needn’t be interrupted by interns and residents who had multiple other attendings to annoy the life out of, and that included the interruption of their pagers that lined a table beneath the window to the scrub room. They were unnecessary distractions that they didn’t need during such an intense surgery.
“How many times do I have to ask?” She practically growled through gritted teeth. Her eyes narrowed to the same shape as her lips as she watched Blanchard – the only person in the entire OR to react – as she scurried towards the pagers again.
“I’m sorry, Dr. Mills,” Blanchard fretted as she dismissed the pager for a second time. “Actually, Dr. Mills… it’s your pager again. It’s… uh….”
Regina’s head snapped towards the intern with raised eyebrows and an expecting stare for her to continue. “Spit it out, woman.”
“Uh… There’s a 9-1-1 for your patient in ICU-34,” She blurted in a rush, causing Dr. Nolan and Dr. French to snap their heads up to look at each other over their John Doe before their gazes shot to Regina. The intern fiddled with the pager a little while longer until her eyes lit up. “Wait… Isn’t that the transplant patient?”
In a quick moment, Regina felt the air slam from her lungs in a fleeting rush. Her mouth fell open under her mask, her heart raced ten to the dozen in her chest, and her sternly square shoulders drooped to create a posture that Regina Mills had never been one to wear in public. This wasn’t happening. This couldn’t be happening. There was nothing from her morning check-up that could have suggested anything drastic would happen before her patient woke from her medically induced coma. But it was happening, and it was happening too far away from her. She stepped down from the operating table, still staring out into the distance as her mind wandered to every possibility when she heard David and Lacey’s voices bring her sharply back to reality.
“Go!” They had shouted together when she remained firmly on the spot once she stepped down from her stool.
“Regina, go. We’ve got this.” David told her as she slowly backed towards the airtight door. “Someone page Feinberg!”
Before she could even register where her legs were carrying her, Regina had torn off her surgical gown, gloves, and face mask, discarding them somewhere as she pushed her way through the surgical floor and towards the ICU. A high, inaudible pitch rang through her ears louder than any of the chattering voices around her as she barged through the collectives of surgeons, nurses and even a few families of patients. There was nothing that could have stopped her from running directly towards ICU-34 – the very same room with the red code siren ringing on the wall outside the room.
As she pushed the door wide open to the room, the sight before her was the last thing she needed to see. It was the sight she had witnessed in countless nightmares about countless patients she had operated on. And it was more certainly not something she was prepared to see after such a successful sixty-four hours post-op.
“No…” She breathed, gaining everyone in the room’s attention almost immediately as her patient’s chest dropped back onto the bed after the defibrillation shocks erupted through her chest. She watched the EKG monitor with baited breath, in the hopes to see some possibility that Mrs. Gilson would regain sinus rhythm. When the flat line on the EKG monitor continued through the screen and the crash team began hanging up the defibrillation kit, Regina’s head began shaking from side-to-side. “No, no, no.”
Her stride across the room would have been impressive if the brunette hadn’t looked as psychotic as she practically pounced onto the crash cart and tore the paddles out a nurse’s hands. With shaking hands and anger bubbling in her veins, Regina pressed the paddles back onto her patient’s chest and looked over her shoulder to her favourite scrub nurse – the only other person on her surgical team that knew the ins and outs of the entire case – and pleaded with crestfallen eyes.
“She’s been down too long, Regina. There’s no coming back from this,” The nurse told her, gaining herself the usual glare that Regina was always so willing to hand out. There was nothing they could do, and in her heart, Ellie Thropp knew that Regina could see it too. She was too late.
“Yes there is! There is always a chance. Charge the paddles to 200.” Regina barked as the other nurses in the room began to step back. She was infuriated. Every damn idiot in the hospital was too afraid to try, and if they didn’t try, they would definitely lose her patient – the very same patient she had spent far too long trying to find a solution for. “I said charge the damn paddles!”
“Regina, she’s gone.” Ellie placed a gentle hand on her superior’s elbow and tried to pull the woman away from the patient’s bedside. “Her pressure dropped. She’s been down for well over an hour.”
“Impossible.” Regina whispered. She shook her head in disbelief. It wasn’t possible; this never should have happened. Mrs. Gilson should have made it out alive. She should have been there to meet her first grandchild in a few short weeks. She never should have gone in to an arrest. This should have been her second chance, not her death sentence. Regina tugged her arm away from nurse Thropp’s ever tightening grip on her elbow. “That heart was perfect, and so was the surgery. Now, I suggest you let me go so I can do my job and actually save my patient!”
Managing to pull her arm free, Regina charged the defibrillation machine herself and pressed the paddles firmly to Mrs. Gilson’s chest. The shock travelled through the connecting wires and into her patient’s stationary heart. Unconsciously, Regina held her breath and tentatively watched the EKG monitor for even the slightest slither of rhythm. The flat line spiked for a moment before falling flat again.
“She’s been down for well over an hour. There’s nothing any of us can do, Regina.”
“You haven’t even tried to save her.” The attending snarled at the nurse this time. Her entire surgical team had done nothing to save her patient. They had just stood around watching the monitor, whinging about the fact that there was nothing they could do, when in fact, they could have done so many things to bring her back. They could have put her on bypass; someone could have massaged her heart – hell, someone could have even called to put in her LVAD again. They did nothing.
“We did. You were just too late. Her pressure dropped. She went into V-Fib – we got her back into sinus for around seventeen minutes, then she went down again. It was too much pressure on her body and the donor heart. We did everything we could.” Ellie timidly pressed her hand on top of Regina’s incredibly pale one that gripped onto the handles of the paddles. She waited for a moment as she apologetically glanced up at the attending. “You have to call it, Dr. Mills.”
It felt like a kick in the ribs. Her lungs felt as though every bout of air had been violently pulled from them, like she had been winded by a force. Her heart raced in her check like it would never stay in its prime position for much longer. Bile rose in her throat before it became strapped in her oesophagus. She couldn’t breathe. She couldn’t think and she most definitely couldn’t stand to be in the same room as her apparently reliable surgical team for any longer. She shook Ellie’s hand from hers, and thrust the paddles into the nurse’s grip.
“Time of death: twenty-three, forty-eight.”
Dr. Emma Swan and Dr. Ruby Lucas had been stuck in the ER for three whole hours without even a treating a broken arm. Not a single person had come through the doors, and not even an ambulance had called to announce an emergency anywhere in vast areas between Storybrooke and Augusta. They had been lumbered with a job that was apparently worse than scut. At least on scut duty, they were actually doing something more than spinning around on the desk chairs behind the nurses’ station and humming show tunes. Even the trauma nurse had gone off into the office to take a nap.
“The Trauma Attending may be smoking hot with her Australian accent, but I swear, if I’m asked to work trauma again, I’ll organise a mass accident so I’ve actually got something to do.” Ruby had groaned as she spun around on her chair. She kicked her feet off the desk and pushed her chair into the middle of the empty trauma unit. For a hospital with one of the biggest and most successful trauma departments in the country, it was amazing how empty it got on occasion.
“We should have been allowed to scrub in on this.” Emma agreed and slumped further into her chair. “We should have at least been allowed to observe in the gallery until our pagers went off.”
Ruby scoffed. “It was your girlfriend’s bestie that stopped us. If not for him, we would have been fine.”
“She’s not my girlfriend. And besides, he was technically right. Someone needed to cover this place.”
The brunette intern rolled her eyes. There was nothing to cover and there was nothing to do. They had already spent the first hour completing a few charts that Dr. French had given them, and completed their own paperwork in the pure, unadulterated silence of a sad and empty trauma unit. Somehow Blanchard, Jones and Cassidy had come out of this sunny-side up. Emma and Ruby thought they had been given the better job out of the lot for the day, but apparently not.
Ruby came to a stop on her spinning chair and looked over at Emma. “Wait. I thought you said that Nolan and Mills were together?”
“Yeah… Why?” Emma shrugged dismissively. She didn’t want to think about Mills being in a relationship with someone other than her. She didn’t even know the woman, but she couldn’t help but feel jealous of anyone who got to spend so much time with her.
“Well, I just find it weird that Mary Margaret went missing, and Nolan didn’t answer his pager immediately.” Ruby told her with a shrug. “I mean, it’s just strange that they both turned up at the same time. And to make it even stranger, she had sex-hair and a blush that could have put any of us to shame. It was just too perfect to have been coincidental.”
“Oh, come on. They could have just been working a case together.”
“Yeah, right.” Ruby scoffed and shook her head. That definitely wasn’t what was going on between their roommate and the head of Neuro. “But you know what that means? It means that you, my friend, still have a chance to get n Mills’ pants.” She winked at the blonde.
Emma rolled her eyes and threw her pen across the trauma unit, successfully flying through Ruby’s fast hands and hitting her directly in the forehead. The blonde smirked and leaned back into her chair. She sighed loudly and tucked her hands beneath her armpits, resisting the urge to act like a nine year old and shout ‘I’m bored!’ at the top of her lungs. Instead, she allowed Ruby’s taunting suggestion seep into her mind. They already knew that Mary Margaret was sleeping with someone, and her reactions of a woman with a school-girl crush was enough to tell anyone that she was getting some. But after what Emma had seen with Nolan and Mills before the transplant surgery, she could have sworn that they had been together for years, and if that was the case, someone had to warn Mary Margaret before she got herself hurt.
By the fourth hour, the trauma nurse had re-joined the two interns, baring coffee and cookies with a smile. Clearly an empty trauma unit was a recurring theme for there to be home-baked cookies and freshly ground coffee at the ready. But before Emma could actually take a moment to enjoy her mug of Joe, Cassidy skid into the trauma unit looking more than flustered. He was out of breath and bright red in the face.
“What’s wrong with you?” Emma asked with an amused smirk behind her mug.
“Are you guys busy?”
Ruby raised an eyebrow and took a big bite of her cookie before mumbling through a full mouth. “Do we look busy to you?”
He paused for a moment, long enough to take deep breath and glance around the empty unit. It was almost comical how he reacted to the sight of its emptiness. “I need help. The clinic is overrun and Mary Margaret got to scrub in on the roadkill surgery, so it’s just me… 007.”
Feeling more than slightly guilty for encouraging Killian with the ‘007’ nickname for their fellow intern, Emma cringed and dropped her own cookie back into the paper bag they had been brought in. “So you want our help?” Frantically, Cassidy nodded as his pager violently beeped. “Fine, but you gotta give me and Rubes the best cases.”
Emma could see Ruby’s wolfish grin out of the corner of her eye, but Cassidy’s reluctant fidgeting held her utmost attention. He twiddled his thumbs before reluctantly agreeing. Throwing back the last mouthful of her coffee, Emma thanked the trauma nurse and followed Dr. Cassidy out of the trauma unit and into the overcrowded clinic with Ruby hot on her heels. The brunette intern, who was trying to stuff the last part of her cookie in her mouth scoffed.
“So that’s where all of our emergency patients were sent…”
Another few hours came and went as Ruby took the first few patients together, diagnosing a kid with tonsillitis, an elderly gentleman with a migraine and a teenager with a broken arm. Graciously enough, ortho resident, Dr. Frederickson, came to their aid while Dr. Humbert was still in surgery with the Roadkill case, providing an x-ray and organising for one of the nurses to cast it straightaway. From that moment onwards, Emma and Ruby took to their own cases, while Cassidy ran around like a headless chicken, panicking about everything and anything he could possibly panic about. He was like a kid that had eaten too much sugar before bedtime. He didn’t have an off-switch, and from what Emma could see, he didn’t have an on-switch for his brain either. She had been slightly concerned that the 007 stint had been too much for him, but when she saw how little he did know, she couldn’t find it in herself to care anymore. He wasn’t helping himself in any way.
By the time the clinic had calmed to a quarter of its original size, Emma noticed how much Cassidy had calmed. He had successfully diagnosed and treated a few of his patients and admitted those who needed further treatment or examinations. He had, however, come to a fumbling stop in the middle of his successful string of patients. Emma was stitching up a gash on the bridge of a skateboarder’s nose when Cassidy timidly approached her with his hands stuffed deep in the pockets of his lab coat.
“Hey, Ems,” He muttered from over her shoulder. “I need a consult on a patient in bed 9.”
The blonde glanced over her shoulder and around Cassidy to get a glimpse of the middle-aged woman sat in the bed. “Read me her chart while I finish up here.”
He nodded and produced the chart he had tucked under his arm. “Jayne Carter. 46. She had surgery a few days ago and now she’s got chest pains and a shortage of breath.”
Emma tied her last suture on the boy’s face and called over a nurse to give him a final once over before they discharged him. She stood from her stool and followed Cassidy over to his patient. She already knew what the woman’s diagnosis was, but she had to make sure to see for herself before calling any unnecessary shots, like Dr. Mills had taught her during her second shift. It was a lesson she knew she could never afford to forget, no matter how many times she had been right on the diagnoses.
She smiled at the woman in the bed and introduced herself before pressing her cold stethoscope to the woman’s chest, listening for a moment before nodding in confirmation. As she brought her yellow stethoscope back around her neck, the patient in bed nine let out a violent cough into the tissue she protectively clutched in her hand. As she brought her hand back into her lap, Emma had to fight the urge not to throw her hands in the air in success. Her mental diagnosis was right. The tissue had been full of blood and a strong confirmation that the woman did indeed have a postoperative fever.
“Post-op fever.” Emma confirmed aloud to Dr. Cassidy. He looked at her with a sigh of relief before she continued. “Admit Mrs. Carter and get her in for a Spiral CT, VQ scan, provide O2, dose with Heparin, and consult with Dr. Mills, Dr. Fienberg, or Dr. Gold for an IVC filter.”
Dr. Neal Cassidy nodded with a grateful smile as Emma left the patient’s bedside to sign off her skateboarding patient at the nurses’ station. As she handed the clipboard over to nurse Fu, a smartly dressed man stood at her side and clapped a hand on her shoulder.
“I’m impressed, Dr. Swan.” He said.
Emma glanced up at the man and felt her eyes widen at the sight of him. “Chief…” She spluttered. “Thank you.”
He smiled kindly at her. “How did you know it was a post-op fever?”
“The five W’s: wind, water, wound, walking, wonder drugs. Most of the time it’s wind, splinting or pneumonia. Pneumonia’s easy to assume, especially if you’re too busy to do a thorough check up. Dr. Cassidy’s patient came in five days postoperative and presented with the fourth W: walking.”
He grinned at her and pushed up his tiny spectacles on his nose. “Good. Most interns miss it, and in fact, it’s one of the most common misdiagnoses. Did you know that?”
She shook her head and blushed. “I didn’t actually.”
“That doesn’t seem to be something you have to worry about, Dr. Swan. Not after what Dr. Mills and Dr. Nolan have been reporting about you.” His hand dropped from her shoulder as she cringed. “You’re obviously a talented surgeon, Swan. Don’t be coy about it, because this is your time to shine.”
Regina had stormed out of ICU-34 with tears pooling in her eyes that threatened to spill. Her heart ached in her chest, so much in fact that she would have been more than willing to plunge her hand into her own chest to rip out her heart to sew it into her patient’s chest. She had never quite felt so personally connected to a case in her entire career. This one was her biggest project. She had already performed ground breaking surgery with Mrs. Gilson over the last eighteen months by incorporating an LVAD in with her treatment plan, developing a bypass machine that could carry her long enough to find the best possible fit of a donor heart, and countless other procedures. They had even trialled a few things while they were waiting, and nothing had been successful. The donor heart should have been their breakthrough.
She stormed through the corridor with a thunderous glare on her face that only made her teary eyes look terrifying under the florescent lighting of the Intensive Care Unit. The rubber soles of her scuffed converse sneakers that she usually kept for emergencies squeaked on the linoleum flooring, and her back up, purple scrub cap that was covered in white feathers and regal crowns did nothing to maintain her startling presence. At the end of the corridor, she threw herself into one of the supply closets and slammed the door before a gut-wrenching weep escaped her lips.
The brunette crippled over at the waist and roughly pulled off her scrub cap, throwing it halfway across the room. Beneath her skin, her blood felt like it was doing the impossible and bubbling over. Every drop of humanity she felt flowed through her veins was replaced with an animalistic rage as her stomach flipped and twisted uncomfortably. The lump in her throat thickened as her body forced out another ragged weep in consolation for her inability to hyperventilate. Her lungs felt heavy, like they had been filled with asphalt in the short space of time between leaving her patient’s bedside and hiding herself away. She couldn’t breathe. She physically couldn’t find the strength in her healthy lungs to inhale enough to keep her conscious.
When her head began to feel alarmingly light, Regina stormed further into the supply closet, tearing scrubs, bowls and surgical instruments onto the floor as she dug around for something – anything – that would aid her breathing. Spotting a brown paper bag filled with gauze, she pulled it from the sliver rack, successfully pouring out its content and pulling the opening to her lips. Into the bag, she let out a heavy exhale before forcing herself to pull back and take a deep breath into her reluctant lungs. It was painful, exhausting and nauseating. Her head spun and whirled as her breathing began to regulate and the thought of Mrs. Gilson’s family came back to mind. Deep in her chest, her own heart beat and ricocheted off her ribs at a dizzying speed. If she hadn’t known so well the symptoms of an anxiety attack, the brunette would have sworn she was having a heart attack.
Regina dropped the brown paper bag to the floor once her breathing regulated and followed it down with a slump. Her clammy hands found a perfect grappling purchase around the side of her face and along her hairline, where she had essentially began pulling out her short hair from its restraints at the back of her head. She tucked her legs to her chest and allowed her back to fall against one of the tall shelving racks, leaving her head to lull even further backwards to rest on a stack of towels.
She couldn’t think straight. Her head swam with questions and scenarios of possibilities about Mrs. Gilson’s death. The brunette knew she could play the blame game all day, but when she truly thought about what had happened, all fingers should have been pointed at her. It was her fault that Mrs. Gilson had died. Regain had performed the risky surgery and given her a new heart when she was perfectly fine living with the LVAD. The head of cardio had killed a patient in a surgery that she could have lived without. It was a stupidly rookie mistake, and it had been done for all the wrong reasons.
It was an unnecessary death. She could have saved the woman. She should have saved the woman. She should have questioned the pager the first time it rang out instead of snapping at the intrusion. She should have been more attentive to her other patients. She had been neglectful and essentially, she had been the one who had caused her patient’s death.
With a ragged and sharp intake of breath, Regina’s body shook and heaved. She cursed herself as she crawled across the floor to reach out for one of the paper bowls she had ripped from its home on the rack and brought it beneath her mouth in time to catch the bile that came splashing up from her stomach.
An hour after her anxiety attack had begun, Regina had managed to calm herself back into a much more humane and approachable state. Not that anyone on the ICU unit wanted to approach her while she was cooped up in the supply closet. But still, she had calmed and found herself pacing the between the mess of supplies she had made when she first got in the room. Her knuckles were red raw from her second bout of anger, where she ended up in a fist fight with the wall. He head was still chaotic, but it was a chaos she could control.
The pager she had reattached to her scrubs while racing to ICU-34 had beeped and buzzed on several occasions from David, who had obviously been trying to find her once his surgery was over. Yet, she had given him no such luck in his search until it buzzed again for the eighth time in thirty minutes. The sound echoed through the supply closet and into the corridor of the ICU unit.
When the door cracked open, Regina had to force herself not to throw her god-awful pager at her intruder.
“Need a hug?” David’s deep voice asked through the small gap between the door and the frame. When she refused to answer, he pushed it open enough for him to slide through and lock the door behind him. “I heard about Mrs. Gilson.”
Regina grunted and glared at her friend across the room. She didn’t need his sympathy, and she sure as hell didn’t need him to be looking at her like she was broken and fragile.
“I’m sorry, Regina,” he told her, crossing the room and pulling involuntarily pulling her into a hug. She squirmed and pinched beneath his arms to let her go, but the well-built surgeon held her tighter and tighter until she finally gave up and allowed him to hold her. He cradled her head to his chest and swayed between his feet as his thick, beefy hands traced the length of her spine until she finally broke into ragged tears again. “Please don’t blame yourself for this. You battled this case for months before the donor heart came in; nothing else worked and there was something that definitely made you question whether this would work or not.”
“But that’s not the point, David!” She punctuated with a heavy and ragged snuffle into the surgeon’s scrubs as he continued to hold her close to him. “This heart should have worked. She should have been okay.”
He nodded in understanding against her head before kissing the parting of her hair, where it had fallen when she tore out her hair tie. “I know, but now you have to be okay. The heart didn’t work, but it’s over. She’s gone and you did everything you physically could.”
She knew he was right. He was telling her aloud the things that she had been trying to convince herself for the entire time she had been hidden away in the closet. She was constantly in need of reassurance that everything would be okay, and David was always the one that knew she needed the support. He was always the one that could comfort her in the times that she didn’t even know she needed it. He was her safety net from herself.
“Ellie and I informed the family,” he whispered against her head, “but, as you can imagine, they want to speak to you to thank you for everything you did.”
Her voice was small and weak as she mumbled beneath her breath. “I can’t…” She shook her head against his chest. “I can’t tell them I killed her. I can’t tell them that I let them down like that. They trusted me.”
“And they still trust you. They trust that you made every right decision. They know that this was out of your hands.” David let his arms fall to Regina’s sides and pushed her out at arm’s length to look at her face. She looked physically and mentally exhausted. There had only ever been a few occasions in which he had seen her look the way she did in that moment, and it always worried him for her own health and well-being. Without a doubt, she would be sat with a bottle of tequila when she finished her shift. “You have to go back out there and be a doctor. If we hid ourselves away every time we lost a patient, we would spend more time hiding than actually being a surgeon. These things happen. You just have to pick yourself back up and get back on the horse. If it’s any consolation, you saved our roadkill case. He pulled through and the police identified him. You saved a new father, a loving husband, a beloved son… You gave him his life back.”
At 7am, Emma clocked out of her third shift at Storybrooke Memorial Hospital. Her roommates, Mary Margaret and Ruby, had already left and gladly taken the keys to her yellow Volkswagen classic beetle. She had offered them her keys the moment she heard from one of the nurses that the bar across the street stayed open twenty-four hours a day, seven days a week for the abundance of medical staff that constantly worked unsociable hours and still wanted a drink after an exhausting shift. Emma was exhausted, and ideally, she should have been heading straight home with the others, but after a tough first week, Emma couldn’t resist the longing idea of holding an ice-cold beer in her hand before she went home to crash for the next twenty-four hours.
She had officially made it through her first week of forty-eight hour shifts, and if that wasn’t something to celebrate, then Emma didn’t know what was. It had been the most grueling week of her life, but the blonde would have been lying if she had said that she didn’t enjoy it. She had met some of the best people she had been given the pleasure of meeting in a long time, and she had found a woman that had her head over heels. Not that the woman knew, however. Because that would be far too unprofessional for an intern to do. It was even unprofessional for her to even play with the idea in her mind, alas, she couldn’t physically drag her mind out of the gutter when it came to Dr. Regina Mills.
The side door to the Rabbit Hole was propped open cynically with a breeze block that had been shoved inside an empty box of surgical gloves. Even the décor inside the bar resembled that of a hospital themed dive-bar. Emma smiled at the sight of a med-school standard skeleton sat in the corner dressed in light blue scrubs as she took a seat at the sticky bar. For 7 in the morning, Emma was slightly surprised with how busy the bar seemed to be. A few interns she recognised from her first day mulled around in front of the dartboard cradling their own bottles of beer, while a few nurses seemed to be already pretty half-cut as they threw back shot after short, jeering each other on to get one last drink in the back of their throats. There were even a few attendings that she recognised lingering around.
Emma motioned over to the bartender, who seemed to be casually enjoying leaning against the bar, watching over his patrons without a care in the world, or even any intentions of actually moving to serve her. She ordered herself a beer and finally allowed herself to relax. For the entire week she had been tense with nerves and the anxiety of failing to make herself stand out from the crowd of interns, but from the successful feedback from the chief of surgery the night before, Emma knew she had been doing something right.
She rolled her shoulders and tilted her head side to side, loosening out any knots or tense pulling’s of her muscles before she let herself succumb to the soothing taste of her bottle of Bud. Curiously, she glanced along the bar, observing all of those who chose to sit alone than with any of their other colleagues when her blue-green eyes landed on the brunette that seemed to have run through her mind all week. Dr. Regina Mills, Head of Cardiothoracic Surgery at Storybrooke Memorial Hospital was sat alone at a dive-bar at 7 in the morning. It was a sight Emma never thought she would see. She bit back her excitement and the grin that seemed to be threatening to cover her lips and took a mouthful of her beer before stepping down from her stool and taking the empty seat next to the attending.
“Dr. Mills…” Emma said quietly, not hoping to startle the brunette out of her daze as she stared at the liquor optics on the wall. “I wasn’t expecting to see you here.”
The attending scoffed as she looked at the blonde intern beside her. “You weren’t expecting to see me at the only bar in town open at this time of day, that is also just so conveniently situated opposite the hospital that we just so happened to have finished a forty-eight hour shift at?”
Nervously, Emma took another swig of her beer and rubbed her hand against the back of her neck. “Now you put it like that, it sounds stupid. But yeah – I didn’t think you would be the kind of girl to sit at a bar after a long shift, cradling a drink.”
“I am a woman, Dr. Swan.” Regina picked up her glass of a clear liquor tilted her glass pointedly at the blonde. “I am a woman trying to relax before going home.”
“Do you have to correct everything people say to you? Or do you just do it to me because you enjoy driving me crazy?” Emma laughed as she signaled for the bartender to bring them over another round drinks. She raised her eyebrows when she spotted him push a tumbler under a bottle of tequila. “I wouldn’t have pegged you for a tequila kind of woman, either.”
Regina smirked as she accepted her fresh tumbler of tequila with lemon and lime soda. Little did the intern know, Dr. Mills was more than partial to the taste of tequila – straight or with a mixer. She tried to ignore the excitement that bubbled in her stomach at the idea of the blonde actually going out of her way, in her free time outside of the hospital, to talk to her. She bit her bottom lip and turned her stool to face the blonde.
“You seem to make far too many assumptions about people that very rarely seem to be entirely accurate.”
”Yeah? Well maybe I just need a closer inspection, because you, Dr. Mills...” Emma let out an amused sigh and flashed her crooked smile at the brunette, who seemed to be attentively watching her every move. “Well, you’re a complete mystery to me.”
Hiding her smile in her glass of tequila, Regina crossed her legs on the stool and allowed her body to lean closer to the younger woman. She quickly began to feel the effects of the alcohol from her previous few drinks. When she took a moment to actually think about it, she realised that the drink in her hand was actually her sixth in an hour. She had gone out of her way to attempt to drown her sorrows over her difficulty in discussing with the Gilson’s about their mother and wife’s sudden passing after her successful surgery. But sitting in front of Emma Swan – Regina couldn’t even think about the hospital. She couldn’t think about anything other than the blonde. The woman had the capabilities of sending a throbbing sensation to the pit of her stomach with the simplest of smiles.
“Good. Because I would much rather remain a mystery to you.”
“Are you sure?” Emma tapped her foot against Regina’s ankle and winked. “I have already made plenty of assumptions about you that I’d like to know if they’re right or not.”
Raising an interested eyebrow, Regina spoke through her smile. “Really? Like what?”
As she visibly gained some confidence at her confirmation to continue, Emma jumped straight in. “I think that you decided to pursue cardio because of your mom. You know, she’s the best of the best in the business, and I think you wanted to prove you could do it. Or you had no choice but to follow in her famous footsteps because of high expectations. I can’t quite decide between the two.”
“Neither are correct.” Regina snapped like a knee-jerk reaction. She hadn’t meant to be so snappy, but any mention of her mother instantly clicked in her defensive. She took a deep breath and looked at the woman in front of her to attempt to bring herself back to the conversation. “My mother is indeed claimed to be one of the greatest cardiothoracic surgeons in the country, but no. She isn’t the reason I became a cardio surgeon. She had nothing to do with it, actually.”
“Okay…” Emma pursed her lips and thought for a moment, trying not to pay too much attention to the fact that the brunette had barely taken her eyes from her in the entire time they had been talking. “How about this one: I think that you’re not here to relax. I think you’re here because you want someone to talk to you about anything other than work, just so you can take your mind off it.”
“You’re terrible at this.” Regina’s thick, husky laugh was like music to Emma’s ears, especially after following her previous harsh answer. It was soothing and completely open to whatever sarcastic battle she seemed to be internally facing. “I’m here because I wanted a drink after losing a patient. I had spent the last two years trying to find a solution to her lousy heart, and just when I thought we were in the clear, she kicks the bucket and rejects her perfect, new heart.” The brunette ran her hand over her face in exhaustion. Her entire shift had been too much for her to handle, and now she was going to relive it with her intern. She closed her eyes and shook her head, hoping that her emotions would attempt to stay hidden this time.
“Wait… Is this your transplant patient?” Dr. Swan reached across the small space between their legs and rested her hand on Regina’s knee in support without thinking of the possible consequences. The brunette flinched at the contact, but she didn’t pull away. Instead, Emma could visibly see the woman rebuild the walls she had allowed to slip for just a moment. Her defensive was strong, and so was her attitude in response.
“Yes, well apparently I do have a heart that is capable of feeling something when a traumatic event happens to someone I was so close to saving, much to the disbelief of many at the hospital.” With a bitter scoff, Regina called over to the bartender and ordered them another round of drinks after noticing that the blonde was peeling off the label of her second empty beer bottle with the hand that wasn’t sat on her knee. “The heart was a perfect match. It should never have rejected, but it did and I still can’t find the reason why. I spent the last five hours researching and trying to get some idea.”
“How did it happen?” The blonde squeezed her knee, involuntarily making Regina’s heart skip a beat in her chest.
Regina shrugged uncharacteristically, and her eyes fell onto the blonde’s hand on her leg. She tried to ignore the delicate smile that graced her lips, but the comfort of the blonde’s thumb ghosting over her leg involuntarily made her want to grin with excitement “She arrested after sixty-three hours of near perfect sinus rhythm. She arrested again after being brought back. The crash team did everything they could, but when I got there, it was too late.”
“I’m so sorry, Regina.” Emma sighed with pure and genuine sympathy for her case. “There was nothing you could have done to have changed the outcome of that. Everything you did in surgery was perfect – I saw it with my own eyes. Her family couldn’t have asked for a better surgeon on her case.”
“Hmm…” Regina muttered dismissively, making Emma slowly retract her hand, much to Regina’s dismay. She looked up at the intern and smiled before taking a mouthful of her tequila. “Humour me just a little more. What else do you assume of me?”
“I think you’re probably a shopaholic with a bank balance that allows you to be.”
Regina feigned offence with a shocked gasp before rolling her eyes and chuckling. “Partially true since I don’t usually have the time. Although, I’m more than certain Dr. Nolan would argue that it is entirely accurate after he cleans out my browser history.”
Emma grinned. “Okay, so that’s one I got right. But I feel like that one was common knowledge.”
“Then give me another.”
Deciding to test her luck, with the bit of liquid courage she had received from her three incredibly quick bottles of beer, Emma straightened her back and smiled knowingly. “I reckon that you and Nolan are in some kind of secret relationship.”
“That’s a little more personal than I usually care to divulge, Dr. Swan.” Regina confessed, trying, and failing, to hide her smile and the sheer excitement that continued to buzz through her veins. “However, Dr. Nolan and I went through medical school together. Our relationship is purely platonic.”
In that very moment, Emma wanted to jump from her bar stool and dance like a child. If she could have succeeded in a mini celebration with her newfound information, she would have. But behind Regina’s nervous blush, she knew not to push the woman too far in that direction. Dr. Mills was most certainly a woman that enjoyed the chase, and Emma was signing up for a marathon.
“You know, I’m actually quite shocked at that one.” She admitted truthfully. Emma paused for a moment to think, and without actually thinking as the words came tumbling out of her mouth, she spoke openly to the other woman. “Okay, I’ve got one last one off the top of my head, but I don’t think this one is common knowledge.”
Regina raised an expecting eyebrow, waiting for the blonde to attempt to distract her from the ever changing feelings that rippled in her chest and the pit of her stomach.
“I don’t think you’re anything like the person you show to the world.” Regina furrowed her brow, but Emma continued. “I can’t help think it’s a front so you can protect yourself by scaring everyone off, but I think it hurts you more than a little heartbreak ever would. I just think that you need to let yourself be… you for a little while and let someone in. You wear your heart caged on your sleeve for the world to see, and I don’t think it works for you.”
“We’re done here, Dr. Swan.” Regina threw back the last of her tequila and slammed the tumbler on the bar before elegantly stepping down from her stool with a scowl. The intern’s assumptions felt like a kick in the teeth. They may have reflected a little truth, but the surgeon wasn’t even in the right mind to be called the Evil Queen again, let alone be called out on her deepest inner demons.
“What?” Emma said as she stepped down from her own stool and reached out to the brunette. “I’m sorry, Regina – I didn’t mean to upset you or anything – I just-“
“You just made yourself sound like a complete and utter idiot.” Regina tugged her arm out of Emma’s tight grasp and pointed her index finger straight in the blonde’s face. “And it’s Dr. Mills to you – not Regina.”
In a world wind of emotion, Regina spun on her heel and stormed out of the Rabbit Hole, leaving an incredibly sullen and slightly confused Emma Swan in her wake.
Chapter 6: An Apple a Day
I am so sorry that this is so late. It has been an incredibly rough few months for me and I feel like I've kinda lost my flow - hence the reason why it took so long to get this chapter out. I'm going to be working incredibly hard over the coming weeks and months to ensure that this story is updated regularly and actually completed.
Not to mention I also think that SWEN needs to stick together now that the show is practically obsolete. Swan Queen will always live on in our hearts and fan fiction.
Anyway, this chapter is gonna be a little familiar to Grey's fans. I totally stole one of the biggest cases from season two and made it my own, Storybrooke style - I just couldn't help it. There's a little bit of medical jargon that I 'borrowed' too, since I'm still not actually a surgeon. If you squint, there's Swan Queen - this is just a filler because the next two chapters are going to be worth the wait - I hope!
An Apple a Day
Regina Mills hated romance. She hated those little meet-cute stories that patients always seemed to find the need to tell her whenever she asked about their history. What they never seem to realize is that wasn't quite the history she was looking for. Nor did she appreciate the endless streams of couples and lovers that would sit side by side in her office, or on a patient bed holding hands and reassuring one another that everything would be okay - that no matter what, they would get through whatever the world was going to throw at them. That blind faith that almost everyone in a romantic relationship seemed to have made her feel physically sick.
She wasn't jealous. Gods, no. Regina Mills was not the jealous type. She was especially not jealous of the idiots that always seemed to utter ridiculous words of how they were soulmates, and how no matter what obstacle was put in front of them, they would always overcome it to find one another again. It actually made her nauseous. How any two people could be so deluded as to be so blind to the world around them baffled her.
Even as a child, Regina was never the type that would lie awake at night imagining her perfect white wedding and how wonderful her future betrothed would look, standing at the altar waiting for her with their hand held out for her to take. Instead, the little latino girl and daughter of one of the greatest female surgeons in the country, was the type of child that would lie awake at night imagining the endless possibilities of her future career as a surgeon. Almost every night, she would sneak down the staircase from her bedroom just to dig through her mother's endless collections of VHS recordings of surgeries from ground-breaking medical research to routine procedures that her mother could undoubtedly achieve blind-folded. Through the years, she had binge watched surgeries over and over again until finally, she could perform the majority of each surgery in mid-air with her hands while being in perfect synchronization with the lead surgeon on the screen.
That was why she hated romance. Because she had fantasized about her career too much to allow someone into her life that could stand in the way of her success. Success came for Regina like it had been waiting for her to come out of the shadows and stand in the spotlight - like it was her right of passage. From Regina's point of view, any person she could ever claim to love would only stand in her way and block out the light. She was a narcissist and her successful career would always come first. That's why she hated romance.
It didn't necessarily help that her mother had drilled into her absorbent mind from an incredibly young age that love is weakness, or that her career would never wake up one morning and tell her that it didn't love her any more. And even at ten-years-old, Regina wasn't even remotely shocked or upset when her father finally packed his bags and walked out of them. In fact, she was more surprised that he hadn't done it sooner. He kept in touch, of course, sending his mija gifts on her birthday, at Christmas, and those occasional moments just because he wanted to spoil his precious little girl.
And it wasn't necessarily her mother’s constant drivelling about how unfortunate it was that another fellow surgeon had fallen down the path of marriage and subsequently ruined their successful career that had made Regina grow to despise the idea of romance and love. Instead, it was her own heart-breaking mind that set her on the path of social self-destruction.
In her heart and in her mind, nothing could possibly convince her that someday, somehow, someone could ever fall in love with her and her endless amounts of emotional baggage. The only things Regina could cope with, were lust filled nights that dragged her far away from her own painful reality.
That was why Regina Mills hated romance.
She didn't deem herself worthy of it.
Her best friend and irritatingly annoying colleague, however, believed he was the single most charming man on the planet, thus making him a ‘love magnet’, as he had once confessed during one of their late night tequila sessions in med school. It had made Regina snort aloud with laughter, but even she, in her inebriated state, knew he was right. David was always surrounded by women claiming that he was always in love with at least one of them. He was never a man whore in such a sense, but he was a serial lover, as Regina liked to think of him. David Nolan was a sucker for true love, and after a few months of one of his more serious med school relationships, he was ready to scream from the rooftops that he had finally found his 'true love'. Two years later and he was ‘happily married’. Even from standing on the side-lines, Regina knew her friend was the furthest thing from finding happiness in his marriage. So when his marriage broke down, she wasn't in the slightest bit surprised at that one either.
She was surprised, however, when her suspicions about her friend and his apparent new toy were swirling around the hospital faster than a penny could sink in a fountain. The rumours had started a little over a week ago, conveniently a few days after her run in with Dr Swan at the Rabbit Hole, when she heard nurses gossiping about spotting the neurosurgeon leaving an on-call room, then followed by a tussled intern not two minutes later. She had tried calling him out during their roadkill case before the rumours had even emerged, but his warning stare warded her off for a little while. Or at least, a week until he decided to bail on their usual weekly plans without warning.
Regina had already been in the hospital for twelve hours when she stalked through the corridors of the surgical wing, revelling in the sound of her expensive custom made Louboutin's as they clicked against the tiled flooring. It was like music to her ears that only sounded sweeter when she heard several nurses, residents and interns almost squeal to get out of her way. Her chin was raised high, her back perfectly straight, a three foot stride that should have been impossible for her quaint height, and a sanguine look on her face made Dr Regina Mills look like the most powerful woman in the hospital. Her black pencil skirt, stockings and white blouse that was barely held closed with a struggling button over her breasts were merely accessories to her power.
She shot a smile at two of the nurses sat at the station opposite the attendings' lounge and disappeared inside, finding the man she had spent the last twenty-minutes trying to track down. The neurosurgeon, who raved to his patients about maintaining perfect posture, was sat on one of the couches with his legs akimbo, his elbows dug into his thighs and his head tilted over the cell phone he clutched in his hands. The smile on his lips disappeared when a perfect red apple ricocheted off the side of his head and bounced onto the couch beside him.
"For a man who got into college on a football scholarship, you're not very talented at catching flying objects." Regina announced her presence in the doorway with a smirk as she bounced her own perfect red apple on the palm of her hand. "Specifically the ones flying directly at your head."
David rolled his eyes and locked his phone to stuff in his pocket before he eyed the offending apple at his side. "How do you expect me to constantly be prepared for you to lob apples at me from across the room when I'm already preoccupied with something else?"
"Maybe if you had considered paying a little more attention to me, you wouldn't have this problem." She took a bite out of her apple as she strode across the room and took up the seat beside her friend. "You should be grateful, dear. I could have easily picked up one of those godawful apples from the trolleys, but no, it was one freshly plucked from my tree this morning."
"Well excuse me for sounding unappreciative. Besides, I wouldn't want to pay much more attention to you – this hospital is already slightly crowded – we don't need your ego filling up the rest of the space."
"Oh, and I'm the one with the big ego." Regina nudged him with her shoulder and turned her half eaten apple around in her hand. "Personally, I would have assumed that the one who was sleeping around the hospital would have had the largest ego."
David was about to bite into his own apple when he realized exactly what it was that Regina was insinuating. He coughed and spluttered slightly before offering the dainty brunette a heavy glare. It had nowhere near the same impact hers had, but it was threatening enough.
"I'm not sleeping around the hospital. Especially not to boost my ego."
Regina hummed. "The more you lie to me, dear, the heavier your privileges to my cider press will be impacted. I could just rebuke them entirely..."
"You wouldn't dare."
David bit his bottom lip and cringed when his cell phone chirped. Actually chirped like he had changed the message tone on the device for it to sound like birds. David hated birds and the only time he had ever changed his message or call tones on his device was for Regina's contact (he had set her ring tone to the Imperial March from Star Wars and an air raid siren for her text messages; he thought it was funny – she thought it was immature). This time, it was Regina's turn to roll her eyes as she peered over his shoulder to catch a glimpse of a text message from a 'MMB'.
"So the nurses are right," Regina accused, sitting back against the couch and crossing her legs with a smug look plastered on her face. "I never thought you would have fallen to the world of emojis, but the snowflake is rather cute."
Before Regina could see much more of the R-Rated text message, he switched the phone into silent mode and rammed it back into his pocket like a teenager who had been caught texting at the table during a family dinner. The aggressive bite he took out of the apple in his huge fist was too out of character for Regina to pass up letting out her rich laughter. It echoed through the attendings' lounge, gaining them both questioning looks from Dr Boyd and Dr Midas (the elder), who seemed to be discussing something rather intensely. Regina offered up an apologetic hand.
"You have to stop gossiping with the nurses, Regina. It's becoming a bad habit."
"At least they don't lie to me, glare at me in surgery because I ask them a question, nor would they, I don't believe, bail on long standing plans without telling me first."
David's entire body stiffened when the realization hit him. Every single Wednesday night since they were in med school was 'their time'. At first, they spent their hours together studying, then it turned into drinks at the bar on the end of campus, until finally they either ended up at one of their homes, cooking dinner and watching a movie, or actually going out to dinner together and unwinding. David even made it a priority during his marriage, much to Kathryn's dismay. The only time their Wednesdays together were cancelled were if they had to work, or if they had something that they couldn't rearrange – and even then their nights together were simply delayed a few hours until they were done.
He ran his hands over his face and huffed in disappointment. "Shit. I'm so sorry I didn't call, Regina."
"It's fine," She shook her head and bit back the smile. She didn't really care that he had bailed on her. She was simply disappointed that for the very first time in their friendship, he seemed to be hiding something from her. "So, are you going to tell me what's going on, or do I have to piece together every bit of information I have already?"
"You're so annoying."
"And you are an idiot."
The neurosurgeon chuckled and leaned back in the couch, ultimately slouching until his head was levelled with Regina's shoulder. "The woman I'm texting is the same woman I met at the bar a few weeks ago."
"So this 'MMB' is your Snow White..." Regina mulled over it for a second before her eyes bugged and her forehead wrinkled into a frown. It looked almost painful the way her face contorted into something David had never seen in all of their fifteen years of friendship. "Mary Margaret Blanchard?! Mary Margaret Blanchard is your Snow White?!"
Regina looked like she was going to vomit even as she hissed through her teeth. Her nostrils flared in irritation, and what David could have sworn looked something like disgust. She never did like any of the women he chose in his life – not that she was any good at choosing the women in her own life either, but Regina wouldn't go there with that one. No, not when the tables were turned on him and her interrogation light was all but blinding his eyes. How on earth could he have picked the single most irritating intern the hospital had ever seen?!
"I didn't know who she was when I met her!" He hissed back at her. "If I had known she was an intern that night, I never would have asked for her number."
"An intern, David," Regina muttered, shaking her head in disappointment. They had seen far too many prominent surgeons fall to their sexual desires by bedding interns and ruining their careers. Falling for an intern was career suicide and they both knew it. And yet here she was, still pretending that her little day dreams regarding one blonde intern meant absolutely nothing.
"You're one to judge!" He bit back; his voice harsher than he intended. For a moment, he paused to look around the attendings' lounge, just to see if anyone else had joined them, or if Boyd and Midas had just remained in the lounge to listen to their conversation. He was relieved, however, to see the paediatric and general surgeons still deep in their own conversation. "The nurses aren't just talking to you, you know. They've been telling me about you and Swan."
"I beg your pardon."
"You heard me." He tilted his chin towards her and lowered his voice quieter than a whisper. "When did you start sleeping with Swan?"
Regina blinked at him blankly. She opened her mouth slightly and closed it again before she shook her head and stared at the man she treated like a brother. "I am not sleeping with that fool." Regina's lip turned into a snarl that only grew when she felt the flutter in the pit of her stomach. "Emma Swan is a vile human being with a horrid personality and a severe attitude problem that seems to go hand-in-hand with her ridiculous god-complex."
"Ah. So you're head over heels and she doesn't know?"
David placed a heavy hand on her knee along the seam of her pencil skirt. It wasn't there for very long, when Regina brushed it off as quickly as it was placed. "Don't be so ridiculous."
"You should tell her."
"Tell her what? That I can't stand the sight of her arrogant little face?"
"No, that you like her."
Out of nowhere, Regina suddenly found her short, cleanly kept nails incredibly fascinating. Never in her life had she noticed so many things about her nail beds and the curves of her nails. The brunette was never the type of person that could allow someone to put words in her mouth, yet here she was, allowing David to do it for her. It was like history was repeating itself, except instead of Dr Swan putting words in her mouth and accusing her of her emotional ineptness, it was David accusing her of having inappropriate feelings for someone completely off limits.
"I'm not doing that." She shook her head.
"Then stop treating her like a doormat."
"I treat her the same way I treat all the other interns." Snapped Regina defensively. She had tried to overlook her conversation with Dr Swan at the bar a few days ago, but every time she saw the damned intern, she couldn't see past the apologetic look in her ocean green eyes or the slight upturn of her coral pink lips in greeting as they passed one another like ships in the night. Regina didn't even know what she was thinking when it came to Dr Swan.
"That's exactly my point." David placed his hand on his friend's knee for a second time and squeezed. This time, it wasn't swatted away, nor did her stocking-clad leg go tense beneath his grip. The only movement she made under his hold was to let out a deep exhale and to run her long fingers through her short, dark locks. "What happened between you two?"
"Nothing." The neurosurgeon raised a disbelieving eyebrow that made Regina huff, turning her into the irritated teenager. "She sat with me at the bar last week and I snapped. She told me that I apparently wear my heart in a cage on my sleeve. According to her, I need to let someone in."
"Funny, that..." David chuckled and received a well-earned glare from the woman beside him. He patted her leg and smiled. "I'm serious, Regina. You like her – I know you like her a lot – I just don’t understand why you have to shut her out because she called you out on your biggest flaw.”
“Being over protective of my emotions and my career is not a flaw.”
“You’re not just over protective, Regina. You’re violently hiding from any chance of happiness. This place isn’t going to make you happy forever.”
“But it won’t. Do me a favour: there’s a huge case on its way in – an hour out – and Lacey has been working with Swan all day. Fienberg has offered up her services because it looks like it's going to be a big cardio case, but I think you need in on this. You haven't worked with Swan in over a week; give Fienberg your cases. Give yourself a little bit of time with Swan without terrorizing her.”
Dr Emma Swan’s cheek vibrated. Then it stopped. Then it vibrated again.
The blonde intern groaned into the flat pillow that she had curled herself into on one of the bunk-beds in the on-call room. She had been on shift for thirty-two hours and spent seventeen of those hours running around the ER after one of the two Australian surgeons at Storybrooke Memorial Hospital. She was exhausted, and for once, in the two and a half weeks she had worked at the hospital, the vibration of her pager was unwelcome.
When Emma finally felt human enough to surface, she peeled the pager from her cheek, already feeling indents of the device and its buttons on her skin. Her eyes crossed for a moment as she tried to work out the number on the pager, until it finally clicked. Her eyes widened and she threw herself down from the top bunk with a slap of her bare feet on tiled flooring. In a second, she had managed to tug on her socks and sneakers and found herself sprinting down the hallway to attempt to find the surgical attending that had requested her presence. Her pager had gone off twice and she was too comatose to even answer it. If the situation was as serious as she believed, Dr Emma Swan was officially done for.
The rubber soles of her classic pair of chucks squeaked on the linoleum flooring of the hospital’s corridors as she skidded around the corner, into the bustling ER. She had spent the whole of her second week following around Dr Whale, who was following Dr Lacey French. She was a shadow’s shadow for an Australian trauma surgeon that always got a kick out of the most gruesome surgeries. Emma couldn’t say the same about her Resident, however, who seemed more concerned with stitching up some of the smallest cuts and gashes anyone came in with, just so he could perfect some of his plastics techniques he had picked up from Dr August Booth. It was almost bitter sweet, the number of times the most exclusive plastic surgeon on the East Coast had come to take over for his shadowing resident. Apparently, Dr Whale still had more than a lot to learn.
Dr French on the other hand, was a complete badass. And almost as much of a hardass as Dr Regina Mills, and Emma had already pissed off the latter. She didn’t need to add another attractive attending to her list by falling into an emergency too late. Her feet were almost losing traction on the linoleum when she called out to one of the nurses manning the emergency phones.
Conversations in the ER seemed far more swift and brief than anywhere else in the hospital. Everywhere else, conversations needed to be precise, conveying as much information as possible, whereas the ER was a whole different ballgame. Everyone already seemed to be on the same wavelength for some reason. An order could be shouted across the room and its receiving surgeon or nurse knew exactly where they needed to be and how to react. An order for diazepam could be hollered from bed one, and someone in the adjoining hall way would hear it and take the order immediately. It was fascinating, and Emma loved it. It came with a thrill and an edge that couldn't be created anywhere else in the hospital. Emma was almost grateful that the nurse was prepared for her near enough demand for information. Almost.
She barrelled into ER Room Three practically panting. Her breathing came heavier as she took in the sight before her. Dr Mills was smiling and cupping the cheek of the female patient on the bed, when Dr French was laughing with the male patient on the same bed. It took her a jealous moment before she saw around the situation. The two patients on the single bed were connected by a single object thrust directly through their midsections. The smell of rotting flesh and other bodily excretions filled the air. The stench was thick enough to make Emma’s strong stomach turn and gag. The sight, on the other hand, intrigued her enough to overpower the desire to vomit.
“Oh my god,” She muttered from the doorway, making her presence known immediately. She didn't take much notice of the surprised stares coming from the several Attendings and nurses that were flitting around the scene like the case was something they saw every day. She couldn't focus on their day-to-day actions, not when she was so fixated by the scaffolding pole that had pierced through not one, but two very alive people. Both of whom were still sitting, talking and laughing.
“Pretty intense, huh?” The young man who had been chuckling away with Dr French said with a wince as his insides shuffled around when he spotted the young intern in the doorway. His neck was stiff and propped up with a brace, while the rest of his body slumped over the scaffolding pole that seemed to have a mixture of two different people’s intestines clinging to it. Intense would be a gross understatement.
“Definitely,” Emma couldn't help but grin when she saw the patient’s own nervous laugh. She shouldn't have - it wasn't the time or place, but the atmosphere in the room was uncomfortable enough. She could feel Dr Mills' disapproving glare burning into her forehead, but she bit the inside of her cheek and ignored it. “So what happened?”
“One minute I was taking my date, Amelia, over here for ice cream,” He stopped for a small ‘hi,’ to come from the girl behind him before continuing his story, “And the next, we’re human shish kebabs. They always say you learn a lot about someone on a first date. I didn't quite realize that this was what they meant.”
Emma stared at the patient for a moment until she could mentally recover and process. She shook her head and blinked at the misfortune. “This was your first date?!”
The front of the 'human shish kebab' grinned this time. The twinkle in his eye could have convinced anyone that the impaling object in his abdomen wasn't actually there; like it was a minor inconvenience in his day, and he was simply sitting around, waiting for the day to simply pass him by with nothing more than a wave.
"Our first date after planning many," He chuckled from low in his belly, making him wince from the movement again. It was subtle, but Emma even heard a delicate hiss from behind him. Mills reacted quickly to the pained sound and pressed a cold compress against the female patient’s forehead. "We had planned around eight, and something always seemed to come in the way of us from actually getting our date."
The woman on the other end of the scaffolding pole, who Emma had learned was called Amelia, scoffed a little as Dr Mills took a step back to read her chart and check her pager. Emma tried her damned hardest not to look at the only woman she had ever met that could rock a pair of navy scrubs and still look a million dollars.
"Like my car crash, and Jamie's car crash." Amelia continued to tell the room while only being able to look at Dr Mills. "And then there was the earthquake, the hurricane, and my favourite one of all was when my apartment went up in flames."
"So you guys are totally defying all the odds, right?" Dr French asked as she flicked a flashlight over Jamie's eyes. From where Emma was standing, she could see his delayed reactions and sluggish movements. In his situation, she wasn't surprised. Nor was she surprised when the Australian Trauma surgeon tutted.
"You could say that. I'd say it's brought us closer together." The entire room let out breathy laughs. The air was filled with anxiety from the actual trained medical staff, and yet the only ones who didn't seem to be worrying were the only ones in the room in mortal danger.
They were positively optimistic, and Emma didn't understand it. How could she understand it? There was nothing in her own life that could ever make her want to be optimistic, but looking at the world from the bottom of a well, they definitely had it worse than she did, and yet they still managed to be optimistic and romantic.
"Glad you could make it, Dr Swan." Dr French's thick Australian accent pulled Emma away from her thoughts as she plunged her fists into the pockets of her white lab coat. "I know you've already had a busy day with us today, but we need the best of the best on this case, and after what I've seen this week from you, I understand why everyone else is already raving about you."
Emma blushed profusely. The pinking of her cheeks only deepened when she felt Dr Mills' eye on her. "Thank you, Dr French."
Dr French clapped her on the shoulder and handed over the entire case file to the intern. It was thick and heavy, clearly documenting every single procedure that they had put the two patients through in the short space of time since they arrived at the hospital. "Okay, Swan, now's your time to shine. Mr Lovis' BP's holding steady at 90 over palp. Miss Samuel has already had two hypotensive episodes to the low 80s. How do you suggest we proceed?"
The blonde thought for a moment, building up a complete plan of everything she would have done had she been one of the paramedics first on the scene. Their necks were already braced, they were clearly not facing any neurological issues that could have caused a problem — at the time being, and they both seemed to be breathing relatively well on their own. She scratched her chin and flicked through the case file before asking: "Did you bolus Miss Samuel with fluids?"
"We're pushing LR wide open through two 16 gauges in the antecubs."
"Hm, okay." She paused for a moment and sized up the patients in her head. Anything they could possibly consider trying could be risky. Even the slightest awkward movement of the bed could cause some severe internal damage worsen or even tear open the wound that seemed to be plugged by the offending object. "They'll never fit in to CT, so I suggest x-ray and labs before any decisions can be made on the removal of the... impaled pole, then a decision on how to remove the pole should be made before surgery, so we know what we're dealing with before we get in there."
"Good." Dr French grinned and clapped her shoulder again. "Take Dr Jones with you and page me the minute you're done."
Emma nodded and stuffed the case file under her armpit.
Emma, with the aid of Dr Killian Jones and two nurses, wheeled the large patient bed through the bustling corridors of the hospital, calling out to anyone in their way. The patients, visitors and doctors all seemed to part like the red sea when they spotted the conjoined patients leaning over their respective sides of the scaffolding pole. For Emma's liking, far too many people stopped and gaped at Amelia and Jamie like they were animals in a circus, only there to entertain them. It bothered her so much about her patients' mental wellbeing that when the four of them managed to roll the bed into the elevator, she draped blankets and gowns over them to further hide the protruding piece of metal in their stomachs. From their appreciative smiles, Emma could tell that it helped somewhat, even if people would just stare at them, wondering what the hell was hiding beneath the wads of material wrapped around them.
Not that Dr Jones seemed to be helping in any way shape or form, either.
"Oh, man. I bet you thought you were going to be in for an entire universe of a different kind of penetration today, am I right?" He joked, mustering a wicked grin from Mr. Lovis and a groan from both Emma and Amelia.
"Really?" She drawled. "You think this is the time and place to be making crude comments to your patients?"
He shrugged and visibly halted himself from giving Mr. Lovis an 'am I right?' nudge to the shoulder. Emma didn't even want to think about what could have happened to the man's insides if he were to be nudged as jokingly as Dr Jones had intended. He could be perfectly fine one moment, and the next he could be paralysed from the neck down, and for what? A crude comment that only made them all cringe?
Emma rolled her eyes again with a sneer. She had already made up her mind that she really didn't like Dr Killian Jones, neither as a doctor, nor as a possible friend. Since the hospital was now going to become her entire life, it became her dating pool, and the only real place where she could make friends, Emma was allowed to be picky. Mary Margaret and Ruby were already forced upon her - albeit, she did rather enjoy their company (and Mary Margaret's rent-free apartment in the middle of town). But being friends with Killian Jones, however, was a big no-no in her books.
When Dr Mills stormed out of the Rabbit Hole a week before, Emma had intended on following the infuriating woman out of the bar to demand to know what the hell her problem was, only to be stopped by the man who seemed to spend the majority of his time dressed like a leather-obsessed pirate. First, he bought her a beer and told her to calm down. He listened to her rants about the cardiothoracic surgeon (even though she missed out some of the major details about her totally unprofessional and unrequited crush on the older woman). He even listened to her drunken slurs about how she needed to make some roots in Storybrooke, but after that, Emma surmised that everything else that came tumbling out of her mouth was like white noise for the man.
It wasn't until he tried ploughing her with endless shots of tequila and overly rehearsed pick up lines, did Emma finally realise what he was trying to do. Had she not spotted Ruby sauntering into the bar, looking around for the blonde who still hadn't arrived home hours after she had promised, Emma knew she would have found herself waking up in a bed at the B&B with a headache and an unwanted bedmate out of the sheer frustration she had over the head of Cardio. From then on, the blonde couldn't stop the look of distain creeping onto her face as her lip curled into something of pure disgust.
It was the same way she looked at him now, as he continued to make sexist and overly suggestive comments to one of their patients, who only seemed to chuckle and cringe at the words unlike his attached counterpart, who only seemed to groan at everything her colleague said. She let out a huge sigh of relief, however, when the elevator doors opened and led them into the radiology department, which ultimately shut the incessant bigot up.
Two hours later, and Emma had never been so relieved to finally see the X-Ray Technician's office totally empty. She dropped into it and groaned at the relief of finally taking her weight off of her legs, even if it were only for a few minutes as she waited on her patients’ second round of X-Rays. Her feet throbbed inside her old, battered pair of chucks that normally hugged her feet perfectly. Usually, they were kind to her soles, but today, after already having spent thirty-five hours running through the corridors or seeing to every need of the Trauma attending, Emma's feet were well and truly agonised. Even the arches of her feet felt like they had dipped under the weight of her body.
She let her head fall back against the wall of the dark technician's room for a mere moment as the scans loaded onto the computers before her. And a mere moment it was when the sound of high heels clipped against the tile flooring until they came to a sudden stop. Emma looked up and visibly shuddered at the sight in the doorway.
"Dr Mills." She nodded, straightening in her seat. The blonde was more than careful not to look anywhere other than the head of Cardio's face. She most certainly did not let her eyes wander down to the fitted black pencil skirt that clung to every flattering feature the brunette flaunted beneath the waist. Her eyes didn't even wander towards the struggling button of the woman's white blouse, where it hardly held the material together over her breasts. The tensed muscles of the brunette's legs as she stood in her ridiculously high heels wasn't enough to make Emma's eyes flutter, either.
But Emma Swan was a liar.
The attending surgeon pursed her lips at the gawking intern, ignoring the fact that she was currently being eyed like a piece of meat and her traitorous heart beat ten to the dozen in her chest. "Where are we, Dr Swan?"
"We're currently waiting on pathology to get back to us with their labs," Emma cleared her throat slightly and handed over the brown folder that she had been clutching tightly in her hands, like it would disappear if her grip loosened for just a second. "After I saw their first x-rays, I didn't think we would be able to make much of a decision from the original pictures, hence the reason why they're back in there."
Emma pointed at the two terrified looking young adults sat together inside the x-ray room through the glass. Much to Emma's relief, Killian had offered to assist the technician for their second round of scans, unlike the first time, when he wandered off to the nurses’ station where he draped his body over it as he flirted with several of the radiography nurses.
Dr Mills hummed at the sight as she opened the folder to skim through the dark x-ray images. She held a few up to the light to gain some sort of perspective on the only piece of information they had on their case. She let out a few more hums and a couple of 'uh-huh's until she slid them back into the folder, which she tucked beneath her arm for safe keeping. "Good idea."
The blonde before her offered a tired grin that still seemed to hold as much weight and excitement as the few she had shared with her on their first shift together. Regina forced herself to bite her tongue and ignore the tugging arousal that grew in the pit of her stomach. How one idiotic woman, whom she couldn't even stand, had the ability to make her stomach flip and her head spin was beyond her. She hated it, and yet her heart ached slightly when the smile fell into a pensive look.
"Could I talk to you for a minute?" She asked, her head dropping to look at her own shapeless legs in her scrubs that held nothing to the sheer perfection of the other woman’s impeccable limbs.
Regina raised a questioning eyebrow. "Is that not what we're currently doing, Dr Swan?"
"Yeah, I mean I wanna talk to you about the other day in the Rabbit Hole." Emma shifted in her seat awkwardly before finally glancing up at the older woman. Had she still been staring at her knees, the blonde would have completely missed the conflicted look that flickered across the brunette's face as she thought for a moment.
Dr Mills bit her bottom lip as she folded her arms over her chest, visibly setting up a defensive wall between them. "We are on hospital time, Dr Swan. I do not wish to discuss things that happen outside of these walls. If you wish to learn anything else today, you will do well to remember that professionalism is key."
"I know, but could you just hear me out?" The blonde intern stood and almost reached out to the other woman to stop her from storming out again. Her arm swung and fell beside her leg, but Regina stayed, much to both of their surprises. "I wanted to apologise. I shouldn't have said the things I did... I just wanted to get to know you."
Regina scoffed and tightened her folded arms across her chest. "By making accusations that are both offensive and entirely untrue?"
"Yeah, it probably wasn't the best way to go about it." Emma cringed, gripping the back of her neck and awkwardly rubbing the skin beneath her hairline.
There was a pause for a moment. A moment of understanding, or at least, that was what Emma thought it was when the attending's features softened for the briefest periods. Her lips pursed and chocolate eyes flickered into an emptiness that Emma hated. She hated how the woman shut herself off from the world so quickly. She hated how there was nothing she could do or say to metaphorically get her foot in the door of Regina's mind palace before she could slam it in her face.
"Hm." Regina hummed dismissively, successfully breaking the silence between them.
"I am really sorry, Regina."
Dr Mills' back straightened like a die as she turned on her heels to leave the technician's office, only stopping and turning back briefly to speak to the intern over her shoulder. "You can bring those x-rays down to the light room on the surgical floor when you're done."
Chapter 7: Playing God
Sorry for the delay! This should have been out last week, but I've been really sick and I can't concentrate when I'm sick.
Huge disclaimer on this one - I'm no more a surgeon than Patrick Dempsey. Even though he played a surgeon on tv for like 10 years, doesn't mean he could give you a play-by-play of a huge surgery, but you know what, that's what I've attempted to do here. Any mistakes or gross inaccuracies are my own fault, but will be changed should someone know more about medicine than me!
I hope you all enjoy this chapter, and I'm certain that you're going to enjoy the next one, anyway. Your comments are like crack, so keep them coming, and I promise to do better at replying to them this time!
Every part of Emma’s body hurt in one way or another. Her back ached, the muscles in her legs had gone stiff and the pounding headache that had crept up on her was heavy enough for her eyes to beg her to let them close, even for just a moment. She fought through it, however, as she aided the two nurses who had accompanied her for the last two hours to push their patients’ bed into one of the pre-op rooms on the OR floor.
Killian had disappeared somewhere on the Radiology floor when he spotted a blonde nurse with far too much sway in her hips as she wandered the halls. It was a relief, Emma thought when he had disappeared long enough to get himself kicked off of the case by Dr Nolan. At least now, she would get a little more recognition for her work, and maybe stand more of a fighting chance at getting the offer to scrub in on the surgery to really prove her worth. It was a spiteful thought, but Emma couldn't care less. It wasn't as if he had done anything to help either. And Emma still had to prove her worth to Dr Mills, who she was still certain probably didn't want her anywhere in the near vicinity of her OR. As much as she was internally chastising herself for being such an idiot, Emma still couldn't forget she had a job to do. She couldn't spend her waking hours thinking of the attending surgeon who had already decided that she wasn't good enough to know anything about her. She couldn't spend her working hours bumping into the woman either, but Emma couldn't help that one - it was like the brunette was going out of her way to sought her out.
Still, Emma bit her tongue and took her scans and pathology report to the Light Room where the attendings and residents on the case had agreed to meet to discuss the next stages of the case. She wasn't even in the slightest bit surprised when Dr Mills and Dr French were standing around the first stack of X-Rays as they tried to decipher something from the blurred images.
"We're not gonna get anything from these, Mills," Emma heard Dr French mutter as she squinted at one of the images over the light boxes. "I can't tell if that's her spine, or if it's the actual pole."
"That's what Swan thought." Regina hummed as she plucked down an image taken over the patients' ribs. "She ordered another round before I took these from her."
With a click, Emma closed the door behind herself, instantly drawing the attention of the two attending surgeons; one of whom offered her a gentle smile, while the other narrowed her eyes and stared at her, like she could figure out everything about the blonde intern with a single look. Emma squirmed under Dr Mills' watchful eye as she offered over her second batch of scans and the pathology report.
"These are better than the first lot. They're still not great, but I think they'll work." She told them as Dr French replaced the first round of scans with the new ones on the light boxes hung on the walls. "Mr Lovis and Miss Samuel are currently stable. Neither of them are experiencing much pain at the moment, but I think they're going to need an intense neurology exam before we proceed with anything else."
Emma bit her bottom lip and dropped her head when she spotted Dr Mills attempt to force herself not to dramatically roll her eyes at her. She swallowed heavily as she stepped around the Cardiothoracic surgeon to stand beside the trauma attending, who was staring at the scans like they were the most horrifying thing she had ever seen. The reaction itself was surprising to say the very least, since the woman had served for her adopted country in the US Army as a front-line trauma surgeon for little over three years before moving to Storybrooke with her twin sister.
"This is... yikes." The Australian muttered.
Dr Mills sighed and traced her finger over the dense white line that pierced through one of the patients' bodies. harshly highlighted by the light it hung over. Her voice sounded deep in thought as she spoke quietly. "It looks like it's going straight through her spine."
"It is. T8's completely crushed."
Emma, from her spot beside the trauma attending, squinted at the scan image in front of her, having already seen the one they were intently looking at. She took in every shadow, every dense line, and every minute crack in places cracks shouldn't have appeared. She hadn't had much experience with X-Rays, but even Emma could see the severity of the damage the accident had caused. Her hand cupped her mouth to attempt to muffle the gasp that escaped her throat. It was fruitless, but Emma needed to hold onto something, if only to allow her mind to process what she was seeing, and apparently, her jaw was the only stable thing she could think to hold on to.
"Is that...?" Emma paused and squinted again as she leaned forwarder. "Oh, wow."
"What are you seeing, Dr Swan?" Dr Mills asked, causing the lack of air already in her lungs to dissipate even further. She didn't know why, but as Mills stepped behind her and glanced over her shoulder, Emma could feel her heart pounding in her chest, ricocheting around her ribcage.
She cleared her throat as she dropped her hand to her chest. "I might be wrong, but it looks like it's transecting her aorta."
Mills hummed as she leaned closer to the light box, her own squint on her face as the front of her body pressed against Emma's back, eliciting a perfect shudder and a sharp intake of breath from the blonde. Her smirk at her successful intimidation tactics, and ever growing arousal, only lasted a second before it fell at the sight before her. Regina didn't know how many times it had happened over the last three weeks, but somehow, she found herself agreeing with one of the idiot interns she had quickly come to despise. Except Dr Emma Swan wasn't just one of the many idiotic interns that proved of no use whatsoever. She was… something else entirely.
"It is," She breathed, letting her hot breath puff against the curve of the blonde's ear. She hesitated long enough behind the intern to see her squirm slightly. The pinking of the other woman's cheeks and neck was enough to send a jolt of pure excitement to the pit of her stomach, which only made the feeling at the apex of her thighs even more uncomfortable. Trying not to squeeze them together to create some kind of pressure was a feat within itself.
"You paged?" A voice interrupted, making Regina step back suddenly to address the new presence in the room with a gentle clearing of her throat. She pursed her lips at the sight of her friend, who was practically bouncing with energy on the balls of his feet. She watched him glance at the over-exaggerated space she had put between herself and the intern as he attempted to discretely wink at her. Regina had learned in the very early stages of her friendship with David Nolan that the man was as subtle as a gun.
"Yeah, check this one out." Dr Lacey French interrupted their little staring contest as she stepped around Regina to take her place beside the blonde intern once more to point up at the image Emma had been so intently staring at. She, like her intern, was fascinated by the images on the walls; so much so that she had taken several photographs with her cell phone and sent them to her sister, Belle, who was trawling her own department for something. OB very rarely had many surgical cases, and Lacey knew her twin-sister well enough to know that she would come running to join them them minute she could.
Behind her, Dr Nolan folded his thick arms against his chest, feeling his white lab coat pull across his back and tighten over his biceps. Just like Regina, he hummed as he glanced over the scans, wincing a few times as he spotted a few of the same injuries that his co-workers had already pointed out. He shook his head and sighed. "Oh, wow."
"That's what I said," Emma chuckled, receiving herself a bright smile from the neurosurgeon.
"These people are still alive?"
"They're still flirting," Lacey told him.
David shook his head again in utter disbelief. He propped his chin up with his fist and tutted as he thought. In all of the years he had worked alongside the trauma department, never had he ever seen injuries like these with the patients still living and awake. It was a miracle - at least, it was a miracle from a medical perspective. He highly doubted the people who had the scaffolding pole speared through their bodies thought the same thing, however.
"It's going through her anterior lung..." He thought aloud as he stepped in front of the other surgeons to get a closer look, strolling up and down alongside the wall covered in light boxes and X-Rays. His brow furrowed. "It's going through the aorta and out through the spine." His head shook again as he let out an exasperated and breathy laugh. It wasn't the time for laughter, but even in this moment, Dr Nolan's nerves of steel were beginning to concave. "I don't understand how she's still alive."
Regina's lips pursed again as she tugged on the lobe of her ear in contemplation. Like David, who still hadn't actually seen the patients, couldn't believe how they were still alive. Medically, she knew how they were still alive, but how it was physically possible without infection or organ failure, Regina, for once in her life, didn't know anything.
"Without the pole tamponading the wound, the aortic injury alone should have killed her." Her dark eyes squinted again before she let out a gasp at one of the images she hadn't yet studied. "The pole shot straight through his superior vena cava. God, his lung is a mess."
It was a mess. Even though the pole was creating a perfect blockage through his lung, it had cracked his ribs, which had pierced directly through his right lung, causing it to already begin to fill with fluids. He could drown long before they even had the chance to pull the damn thing out. Then there was her - her heart was already unstable, pumping out at inconsistent variations of A-fib. From Regina's earlier cardiac examination, she couldn't see the young woman's heart returning to sinus rhythm any time soon - no matter how many drugs they gave her. She swallowed down the lump in her throat and listened to the voices in her head that mocked and taunted her about why falling in love was a dangerous thing as if it was trying to prove a point. This young couple who were already so excited to share their first date together, were already being torn apart both literally and figuratively. They had both faced so many situations that could have killed them in their search for love – it was simply ironic that they their lives may come to an end with them joined together in such a way.
"Look at that: it's punctured his diaphragm down to his bowel," David sighed again as he scratched his chin, deep in thought. "So bacterial contamination of the lung is practically inevitable."
"This entire case is a mess." Dr French tutted as she tussled her dark hair in sheer frustration. Never in her life had she felt so agitated by a case before. It wasn't that she hadn't spent much time with difficult cases, because she had; it was more to do with the fact that she, like Regina, didn't have an explanation as to how their bodies were still alive and reacting naturally, nor did she have a solution in mind that didn't kill at least one of them. It was in her oath to do everything in her power to save each and every one of her patients, and that included the ones who were conjoined by a steel scaffolding pole.
The only problem was that Dr French didn't think she could save either of them, never mind the both of them. She didn't even know how they were going to extract the pole without killing at least one of them. That had her mind crawling.
Startling the other surgeons, Dr French pushed her way through them as she searched the desks along the opposite wall for a piece of paper and a pen. The second her hand came into contact with the utensil, she began scribbling and drawing until her chicken scratch turned into something much more legible. She hated the idea, but with her front-line experience, Lacey had learned to become brutal and realistic.
"Here," She handed over the piece of paper to the head of cardio, whose eyes widened momentarily as she glanced at the script and simple diagram. Regina nodded, prompting Lacey to finally breathe out the breath she was painfully holding in her chest. "It's the only way we can do this. If we want to save a life today, this is our only option."
Emma glanced over Dr Mills' shoulder to get a glimpse of the chaotic image Dr French had managed to produce within a few seconds. It shouldn't have startled her in the way that it did as she tried to decipher what the arrows and symbols were supposed to mean. She knew of the Trauma Attending's past with her thorough training and front-line experience in the Middle East, but she had never expected the woman to stand herself on a pedestal and actually play God.
"So you're basically saying that if we extract the both of them from the pole, they're both going to die?" Emma asked, glancing between the three attendings, who each gave her a firm look with the same emptiness in all of their eyes. That was all she needed for an affirmative. She swallowed thickly. "And now we have to test our god-complexes to decide who gets to live, and who has to die?"
"Welcome to Trauma, Dr Swan." Dr French clapped the intern on the shoulder with a grimace. This was the one situation in her job that she hated, and yet in scenarios like this, there was nothing they could do to avoid it. "You're more than welcome to go grab something to eat or take a nap to settle your nerves. I need you on the ball if you're going to scrub in this afternoon."
Emma opened and closed her mouth momentarily, realising that there was no fight, no need to beg, and no other competition to stand in her way of scrubbing in on one of the biggest surgeries of her intern year. It was huge. It was an honour, and somehow, it was being handed to her on a plate. Albeit, it was an unethical plate, knowing that she would be going into surgery to kill one patient and save the other, but it was bitter sweet, and Emma knew that this kind of resilience was something she would have to build if she wanted to be one of the best. It was a resilience no-one wanted to obtain.
She nodded and silently took her leave, only letting out a painful and exhausted sigh when the door closed with a click behind her.
On the other side of the door, there was no time or even space between the three surgeons for any of them to sigh out their own frustrations.
"I want a general surgeon on this case." Dr French dictated as she wandered back over to the scans. A cardiothoracic surgeon, a neurosurgeon, and a trauma surgeon had no chance at fixing this mess alone, and she was pretty damn sure her colleagues knew that. "There's too much internal damage in both patients. With just our expertise, we don't stand a chance at saving either one of them without causing even more damage."
"So we're calling in the chief?" Regina asked, folding her arms defiantly over her chest.
"No, the chief doesn't have time for this. I've paged Gold."
Regina scoffed. "I am not working with Gold on this, Lacey. I don't care if he is your brother-in-law; I can't stand the man, and he highly dislikes me."
"That's fine. I'll page Feinberg down here and you can go back to your patients." The trauma surgeon said with a wave of her hand, not daring to turn to face the woman she knew had a thunderous glare plastered on her face.
"Oh, come on, Lace." David whined as he crossed the room and placed his beefy hands on the dainty Australian's shoulders. He squeezed them tightly for the briefest moment. "You know Feinberg still can't tell her ass from her elbow. Do you really want to trade Mills for her?"
"Of course I don't, but if Gold doesn't scrub in, we're well and truly fucked."
"What is it with you Australians and your desire for vulgar language?" Regina admonished as she pressed her lips into a firm line, ignoring the foreigner as she turned and predatorily stalked towards her with a grin on her lips.
"It gets us what we want," She purred into Regina's ear as she stepped into the woman's personal space, knowing all too well that the uptight woman actually had no real issues with the use of such vulgarity, having seen the brunette throw such utterances around after a few too many shots of tequila while squirming between bedsheets. In fact, Lacey would have gone as far as to say that the woman had a dirtier mouth than anyone in the damn hospital. She also knew better than most that the only way to get through to Dr Mills was by using her sexuality.
If Regina was the type to throw a tantrum and stamp her feet in a public place, she would have. But as she felt Lacey's eyes burn into her own with a teasing smile that she had only ever resisted (and regretted) once, she rolled her eyes and slumped.
"I swear, if he even gives me an ounce of trouble, he'll find my scalpel in his neck and you will be without a cardio surgeon and a general surgeon on your case." She warned.
"Duly noted," She grinned and patted her colleague turned friend on the shoulder. “Now, I've already decided how I think this should go, and I think Regina would agree with me. So David, it's down to you to give your decision if we want a shot at saving either one of them.”
The neurosurgeon couldn't stop his head from shaking again. His eyes glanced between the two women and the wall full of X-Rays before he held Lacey’s gaze. “I need time to examine them both before I can make any type of decision. This is life or death – I won't make this decision lightly.”
Lacey nodded before she collected the X-Rays from the light boxes and stuffed them under her arm to take her leave. “Page me when you've made up your mind.”
Emma was more than a little relieved to see her fellow group of interns sat around their usual table in the hospital cafeteria after she had piled her plate high with the greasiest food the place had to offer. She needed energy, and for that, she probably should have chosen a banana and some protein bars, but instead her body reacted like it was in hangover mode – craving grease, atop of grease, atop of grease. Oh, and she knew her large helping of Mountain Dew wouldn't drink its self either.
She slid her lunch tray onto the table and unceremoniously dropped herself into the empty seat beside Dr Cassidy.
"Here to brag about your taxing case with three of the hottest and most talented surgeons in the hospital again?" Ruby questioned through narrowed eyes that glared at the blonde as she threw a perfectly round cherry tomato in her mouth.
"No," Emma snapped back defensively. "My case is amazing, and you're just jealous that you're stuck working for the Vagina Squad all day."
Ruby shook her head and scoffed. "Mary Margaret is on the Vagina Squad with Dr Belle Gold. I'm on Paeds this week with Dr Boyd and Dr Bell."
"Oh, sure, because being a grown ass babysitter is way more interesting than Gyne." Emma snarked, feeling surprised that she actually gained a few laughs from around the table. Even Ruby's eyes glinted with humour as she bit the inside of her cheek to stop the smile that threatened to take over her scowl. "So, has anyone got anything good?"
"I had two people speared together by a scaffolding pole until that stuck-up asshole kicked me off the case." Killian offered as he took an aggressive bite out of the burger he had been cradling.
"Regina Mills is not stuck-up. She's a little uptight and private, but she's not stuck-up." Emma defended like she had the right to do so; like it would mean anything to her that the intern she couldn't stand the sight of had actually defended her name from getting dragged through the mud by some nameless intern. She ducked her head when she spoke again, hoping to hide the light colouring of her cheeks. "And she's not an asshole, either."
"Would you like to kiss her ass while you're defending it, Swan?" Ruby flashed her roommate a challenging smile that made Emma wish she hadn't even opened her mouth to begin with. With her big, brown eyes, she winked at the blonde and leaned over the table. "Actually, I've got something good going with Dr Boyd."
For the briefest moment, Neal perked up and smiled at the woman sitting opposite him. "You know she's married with a kid, right?"
"Not like that, you moron," Ruby rolled her eyes, throwing one of her cherry tomatoes at his head. "I mean, she's like a badass. She saves tiny-humans while rolling around the hospital wearing those sneakers with the wheel in the heel..."
"Oh! You mean Heelys, right?" Mary Margaret asked dreamily as she propped her chin up with her fists. The woman was the epitome of a nine-year-old with the strangest motherly instincts that Emma had ever come to witness. It was almost like having a younger sister and a mom in the same damn person.
"Uh, yeah, I guess," Ruby smiled but furrowed her brow in concern towards the blonde across from her, trying her hardest not to laugh at their friend's excited tendencies. "Anyway, she's got this kid with a tumour the size of a tennis ball on his liver and she's getting him to help her find a way to cut it out before he needs a transplant. He's so smart – he does rounds with her for all the other kids and the other parents love him. He even takes her daughter, Alexandria, around with him. He's the cutest."
"So you are babysitting?" Killian gave the group a toothy grin and winked at Emma when Ruby huffed in annoyance. The blonde simply rolled her eyes and chuckled at him, seeing right through his second attempt to find a way to lull her into a false sense of security in their acquaintance.
"Will you still be asking me that when I scrub in on the transection of his tumour later?" The lanky intern smirked and nonchalantly sipped at her drink through its straw while the other four interns gawked at her.
"Ah, Dr Swan; you're just in time," David smiled over his shoulder at the blonde intern who had quietly stepped into the pre-OP room. He squeezed Amelia's hands before stepping back and plucking the pathology report from one of the tables beside him. "I've gone over the pathology report, and I've done a brief neurology exam, I just need an extra set of eyes on this reflex exam."
Emma nodded and joined the neurosurgeon at his side, already feeling the pressure of the situation rising in the pit of her stomach. Just looking at the young couple who were already sharing the most intimate details about one another in such a confined space made Emma want to turn and vomit. She wanted to run and hide, yet at the same time, she wanted to do whatever it was that she could to attempt to save at least one of her patients. Had the pole landed even an inch to the left or to the right, they could have been killed instantly, but they weren't. They were given a second chance. They were given an opportunity of survival. Emma was given the opportunity to save them. And that was more than a lot of pressure for an intern three weeks on the job.
She watched as Dr Nolan rotated Jamie's foot round and round in circles. When the young man winced, Emma's eyes involuntarily widened in surprise. From the positioning of the pole through his body, she had expected them both to have been paralysed for life.
"Could you wiggle your toes for me, Mr Lovis?" The attending asked as he let go of Jamie's foot and stepped back to watch for any kind of movement. There was a brief pause since his request, but when David saw it, the grin on his face shone like a thousand light bulbs. Jamie's toes wiggled slightly which resulted in a hiss of pain from him, but the movement was there, nonetheless. And the pain was an even better sign.
"Are they moving?" Jamie asked, trying to peer over his neck brace to catch a glimpse of his toes.
Emma and David nodded simultaneously, both with proud smiles on their faces.
"Yes, they are," Dr Nolan told him as he rounded the bed to rotate Amelia's foot in the same way he did Jamie's. This time, however, there was no wince of pain. There was no recognition at all that the man had even touched her foot. The neurosurgeon stepped back again and repeated his earlier question. "Could you wiggle your toes for me, Miss Samuel?"
Both surgeons held their breath as they tried to watch the reaction on Amelia's face and for any possible movement of her toes. The strained wince on her face showed nothing but sheer determination to have her toes move, showing no signs of pain like Jamie's had.
"Are mine moving?" She asked hopefully, flicking her eyes between Dr Swan and Dr Nolan.
"Yes, they are." David replied with a tight lipped smile as he stepped back, knowing that Dr Swan was standing behind him in befuddlement. Yes, he had lied about Miss Samuel's toes moving during their reflex exam, and no, he didn't need to give his intern an explanation why he chose not to tell a terrified patient that even if she did survive their separation, she would never walk again. He couldn't cause that much pain when he was already agreeing to something that was eating him up from the inside.
He turned slowly and caught Emma's eyes before he tilted his head towards the door. "Can I speak to you for a moment, Dr Swan?"
Emma nodded and followed the attending out of the room, closing the door behind her so they stood in the middle of one of the busiest corridors on the surgical floor. She waited expectantly for the surgeon to begin talking until she spotted exactly who she knew they were waiting for. Dr Mills, ever the beauty, had re-donned her navy scrubs and pinned her hair back beneath her signature black scrub cap that boasted little red apples all over it. Even out of her intimidating pencil skirt the woman was a vision.
It wasn't until the entire group of attendings and residents approached them that Emma realised Dr Mills wasn't alone. Dr Gold, who Emma had had a very brief run in with, was snarling down Mills' neck; Dr Lacey French was still skimming through endless files of paperwork and scans; Dr Belle Gold was briefing Mary Margaret on trauma protocol (since she had almost as much experience in the ER as her twin sister); Dr Whale was too distracted by some of the nurses sauntering past them to pay any attention to the fact that he was about to collide into Dr Humbert's back as they walked.
Had their arrival not revolved around something as delicate as it was, Emma would have scoffed at the sight and muttered something about the 'Storybrooke Memorial Avengers' stalking their way towards them.
"I've got Nurse Thropp and Nurse Upland prepping OR One, I've signed Aurora on as our anaesthesiologist, and we've closed the viewing gallery as per Chief Hopper's request." Dr Mills told the neurosurgeon and the intern whose eyes hadn't once moved from her face. She shrugged off the blonde's abnormal behaviour and raised her chin. "Are they ready?"
David nodded and handed over the charts before addressing the entire group of surgeons before him. "Her vitals are erratic. Pulse is weak. Her spine is severed... I was hoping it didn't hit from the angle it did, it just can't miss the aorta, no matter how we proceed."
"That's what we thought," Dr French said, coming to stand beside Dr Mills. "He has better odds at surviving this than she does. It doesn't mean we can't try to save them both, though."
Dr Swan stared at the surgeons who were all nodding in agreement, silently praising the three lead surgeons on the case. The sight made Emma's stomach turn even more. How could they do this? How could they be okay with this - with giving up? They were supposed to save people, not send them to their deaths!
"They're flirting..." Emma mumbled, yet still catching the attention of the entire group. "They're flirting and she's joking with him. How do you tell somebody that she's gonna be dead in a few minutes when she's sitting up and cracking jokes?"
Pursing her lips and sucking her teeth, Dr Mills took a predatory step into the blonde's personal face and snarled: "If you're not comfortable with trying to save at least one life this afternoon, Dr Swan, then I suggest you turn around and find something else to do with your afternoon because this is the only way we can do this." Terrified of actually getting kicked off of the case Emma opened and closed her mouth several times to argue until Dr mills impatiently raised her hand to stop her. "I don't want your excuses, Dr Swan. There is no other way to go about this. And if we leave it, they're both going to die. Is that what you would prefer?"
She shook her head quickly. "Absolutely not, Dr Mills."
"Hm," Mills hummed as her dark eyes wandered from Emma's swirling green eyes, down to the battered Converse on her feet, back up to the blonde curls that were painfully pulled back into a tight ponytail. "Dr Swan, if you and Dr Blanchard can prep the patients and bring them to OR One, as soon as possible, you can scrub in."
“How on earth do you handle working with Dr Mills?” Mary Margaret asked as they looked into OR One from the scrub room as their hands worked sanitising soap into their skin and between their fingers. Their patients had been prepped and wheeled into the OR by Nurses Thropp and Upland, leaving Emma and Mary Margaret to scrub in while Dr Nolan offered their patients the briefest pep talk and a delicate overview of what would happen during their surgery; including the explanation that their main focus would be ensuring that Mr Lovis would make it out alive.
“She's not so bad when her head isn't a million miles up her own ass.” Emma offered with a shrug as she dragged the soap down to her elbows.
Mary Margaret scoffed. “I find it difficult to believe that.”
“I did too, then she verbally attacked me,” Emma practically cringed as she made eye contact with the attending cardiothoracic surgeon through the glass window. She would have sworn the other woman offered the lightest upturn of her lips, had she not seen the heavy glare beforehand. “I think she's just nice to anyone who isn't a surgeon.”
“Hm.” Mary Margaret hummed as she flicked the excess water off her hand into the huge sink. She held her hands up, avoiding any and all contact with anything else in the room and turned to face her roommate. “Are you trying to justify destroying my toaster the night you came home from the Rabbit Hole?”
“Are you trying to pretend like you're not sleeping with Dr Nolan?”
“I am not!” Mary Margaret snapped back immediately and so defensively she more than likely gave the game away. “I'm not sleeping with Dr Nolan; therefore, I'm not trying to hide anything.”
Emma chuckled and made a scene of repeating Mary Margaret’s action of flicking off the water on her hands. “I'll remember that the next time you both so conveniently go AWOL and you come back with blatantly obvious sex hair.”
“I do not have se-“ Mary Margaret began as Emma laughed even harder and began sauntering out of the scrub room with a smug look plastered on her face. “Emma Swan, you get back in here!”
The blonde intern shook her head with a grin and stepped through the automatic doors into the OR, quickly accepting her gown and gloves from a waiting nurse. She ignored the questioning looks from the attendings and a few of the residents on the case as she turned for the nurse to tie her into the gown. As she turned around, however, to rejoin her attending, Emma couldn't ignore the questioning gaze over her from Dr Mills. Her eyes were soft for a change, and the delicate upturn of her lips were clear to see this time, but the deep lines in her forehead were still visible.
The sight itself made Emma's heart skip a few beats and a feeling in the pit of her stomach rose that really shouldn't have happened in a room full of surgeons that stood around two people that were joined together at the stomach by a scaffolding pole. Nevertheless, it was there.
In return, she offered the smallest smile back and ducked her head as she stepped through a group of residents to take her stance beside Dr French, on the opposite side of the table to Dr Mills.
“Ya ready, Swan?” Dr French asked quietly as Mills and Nolan debated dosages with Dr Aurora Rose, their anaesthesiologist, who looked just as swamped as the rest of the surgeons in the room. It had been quite some time since she had to simultaneously keep two patients asleep under anaesthetic and such intense circumstances.
“I guess,” Emma offered with a shrug.
“You and me, kid, we’re gonna take Miss Samuel, while Mills and Nolan lead with Mr Lovis.” The Trauma Surgeon told her, making Emma's head whip to the side to look at her. She hadn't expected anyone to actually change their surgical plan to attempt to save not one, but two lives this afternoon, but here she stood with a gloved hand on her shoulder and an optimistic attending smiling at her. “Dr Herman, Dr Blanchard and Dr Whale are all going to join us and the five of us are going to do everything in our powers to save her.”
“Do you think she can make it?” Emma asked through a whisper as she watched the young woman’s eyes begin to flutter shut.
“I hope so,”
The steady hum of the OR was as deafening as it was silent in the mere moments after Jamie and Amelia succumbed to the powerful anaesthetic. It cast an eerie atmosphere over the seemingly endless numbers of nurses and surgeons that bustled around the unconscious patients, who were still sat upright, draped over the scaffolding pole that had pierced through their bodies. It only took a few seconds, however, of the heavy silence to be cut short with the frantic screams of the EKG connected to Amelia. Her stats were dropping drastically, her pressure was falling, and her heart was failing.
She was crashing.
The already busy OR turned into something chaotic as surgeons and nurses alike took to their positions, 'team-one' taking to holding Mr Lovis steady, with Dr Mary Margaret Blanchard, the dedicated intern, holding the offending pole steady, while 'team-two' steadily slid the young woman backwards, releasing her from the pole's impalement. The operating table waiting at the ready was instantly covered in the gushing blood that didn't seem to stop pumping from the young woman as she was transferred from the bed she had shared with her date.
It was a rush as Emma and the rest of the team two surgeons wheeled Amelia's table across the OR before they called for supplies. Emma and Dr French instantly took the lead by attempting to pack the gaping wound in their patient’s abdomen, while Dr Herman and Dr Whale busied themselves as they tried to stabilise their patient by getting her onto bypass. Her heart had started to fail the moment she was put under the amnesia, almost as if she knew her time was up. Her body was weak, and declining by the second, unaided by the numerous lap-pads and surgical towels that were being wedged between her remaining organs that were threatening to move in all manner of places.
It was a mess. The entire OR was a mess. And the more they poked and prodded and tried their damned hardest to bring their patient back to sinus tac and in a stable enough position to actually allow them to operate, the more Emma was beginning to think, for once, that Dr Mills had been right in thinking that Miss Samuel would never make it through the separation.
She risked a glance across the OR to see Dr Mills herself standing on a plastic step-stool with her hand inside her patient's chest, calling out orders and almost rummaging to find and plug whatever it was that was causing the excessive bleeding. Even with the now shortened scaffolding pole in his abdomen tamponading the wound, the slightest movement had caused all kinds of disruptions within his body. And somehow, her patient was still alive and stable, despite his dramatic blood loss. Emma was even beginning to think the woman was a miracle worker too.
As tens of minutes passed, team two found no break in the blood that still continued to pour out of Amelia's stomach cavity, nor did they find any success in putting the woman on bypass. Even with Dr Blanchard's extra set of hands aiding with both cavities after her assistance in holding the scaffolding pole firmly in place, there was too much damage for any number of surgeons to fix. It was when Dr Herman accepted a step stool and reached into the chest cavity they had created in preparation for bypass that Emma lost all hope for her patient's survival.
"Her aorta is completely shredded," He huffed behind his masked and slowly pulled his hand out of their patient's chest, leaving the cavity to steadily pump streams of blood into a puddle on the floor.
"Herman, have you thought abou-" Dr Mills started before she was instantly cut off by her shadowing resident.
"I've thought of everything. There's nothing that can fix her aorta to give us enough time to sort the rest out. Even if this was her only problem I wouldn't hold much hope."
"Just pack the wound as well as you can while her heart is still beating." Dr Mills instructed, ignoring French's mutters of 'I know, I know', as she, Dr Blanchard and Emma frantically grabbed fistfuls of surgical towels and laps pads. "If you can stabilise her enough to get some work done on the aorta, that's great, but otherwise..."
In perfect synchrony with Miss Samuel's EKG, the one attached to Mr Lovis rang out through the OR, creating an almost deafening screech as his pressure dropped drastically and his heart began to fail. The surgeons and nurses that collected together to make team one each rushed around the OR grabbing supplies and instruments from the surrounding drawers and cupboards, answering to each and every call for assistance. It was chaos. Pure, unadulterated chaos.
"French! Swan!" Mills shouted across the OR as she found herself forearm deep in her patient's chest with Nolan opposite her and the husband-wife Gold duo strategically working around remaining scaffolding pole in Mr Lovis' abdomen. "I need some extra hands!"
And for the first time in the entire surgery, Dr Emma Swan hesitated. She watched Dr French drop what she was doing, quickly handing over her lap pads and surgical towels to Dr Blanchard and allowing one of the scrub nurses to tear off her blood soaked gloves to replace them with a fresh pair. She was instantly at Dr Mills' side, putting her hands into the surgical field and following instructions from her colleagues, while Emma's eyes flickered between Miss Samuel, her rapidly declining EKG stats, and Dr Mills' frantic reactions. It wasn't until the older woman looked up expectedly to meet the intern's deep green eyes that Emma bit back her guilt for leaving her patient open on the table to aid another and followed Dr French's footsteps across the OR.
In the back of her subconscious, she hardly heard Dr Blanchard shouting and screaming, ordering some of the attendings to actually pay attention to the other patient, who had been abandoned as she bled out on the table. Her shrill voice ordering someone to save her was drowned out entirely when Emma's eyes met with deep, chocolate ones across from her. The sight itself grounded her as she accepted the suction tube thrust into her hand by a scrub nurse. The blonde intern became so focused, in fact, that she barely registered the towering neurosurgeon leave her side to pull her fellow intern away from Miss Samuel, who had flat lined not long after Dr French and Emma joined team one.
"Time of death: nineteen fifty-three." Dr Nolan's voice echoed around the OR as it briefly fell silent when the empty hum of Miss Samuel’s EKG monitor was switched off. Even Dr Mary Margaret Blanchard’s hysterical pleas were silenced as she shook her head and slowly began to back out of the OR.
From what Emma could see without taking her eyes away from Dr Mills and the surgical field around their hands, her fellow intern had backed herself into the washroom, ignoring all demands to return to the theatre to help team one in their attempt at saving Mr Lovis. But in that moment Emma couldn’t even think about her colleague turned roommate, turned friend. She couldn’t dare think about anyone other than the cardiothoracic surgeon that held her gaze across the table and wordlessly communicated the following steps they were intending on taking.
Hours upon hours continued to pass as Emma shuffled her weight from one foot to the other. Her legs and her back had begun aching hours ago, but now that felt like a distant memory. Any past idea of what it felt like to have her weight taken off her feet was nothing more than a pipedream. Even her head had started to hurt from being tilted towards the surgical field at an awkward angle. Not to mention how emotionally exhausting and draining the entire experience had become.
Long before they even began the surgery, Emma had made it clear about how difficult it was going to be to accept that there was only one life that they had any chance at saving. At the time, the mere thought of it disgusted Emma, but when their presumptions became a reality, she bit her tongue and held back any unprofessional emotions that threatened to impact on her ability as a surgeon. Now, however, after such a grueling surgery with the faintest light at the end of a trying day, Emma felt her emotions welling up again.
Later on, she would convince herself that the only reason her mind wandered back towards Miss Samuel was because of her exhaustion. But as the surgeons slowly began to pack Mr Lovis’ wound and congratulate one another on their accomplishment, Emma felt her stomach twist and turn and warp into something incredibly painful; so painful in fact, that her breath hitched the moment Dr Mills acknowledged her presence in the surgery.
“Thank you for your assistance this evening, Dr Swan,”
Emma’s head snapped up to look at the attending with an incredulous look. Dr Mills had never offered her, nor any other surgeon for that matter, any form of gratitude. While everyone else on the case shared their own form of thanks and congratulations, Mills had remained silent and continued her final few sutures along Mr Lovis’ aorta. It was an anomaly and the both knew it.
Behind her mask, Emma’s mouth involuntarily opened and closed for a moment, before her stomach began to rebel against her by churning and threatening to spill its contents within her mask.
“I… I need a moment,” She muttered as she quickly handed over the suction pipe and surgical towel in her hands to one of the OR nurses standing directly behind her. “Please, excuse me.”
And, before Emma knew it, she was sprinting out of the OR, tearing her gown and gloves off of her body. Her surgical mask followed, before her hospital issued scrub cap was torn off her head and discarded somewhere through the OR corridor, leaving her thick blonde curls to fall from their loose hold at the back of her head.
Her hands collided with the cold metal bar across the back of one of the fire exit doors as she pushed her way out into the bitter cold night that Maine seemed to be notorious for. And as the cold air reached her lungs, Emma’s sharp intake of breath turned her stomach again, leaving her with no ability to fight the impending force that pushed a seemingly endless stream of bile from the pit of her stomach.
She wretched and heaved for what felt like forever, until a comforting hand was placed on the small of her back, and another collected her blonde hair from around her face. Emma couldn’t bear to look over her shoulder from her position where she stood keeled over at the waist and involuntarily watching the contents of her stomach splash onto frozen ground beneath her feet.
“Not even a miracle could have changed what happened in there today, Swan,” A raspy voice from behind her verbally announced their presence. The hands holding her hair and drawing comforting circles didn’t falter either when Emma stiffened at the recognition of the voice.
For a moment, Emma had almost expected Dr French, or even one of her fellow interns to have found her heaving outside the fire-exit. But Dr Mills gently soothing her as she sobbed through every expulsion of bile was definitely not what she had expected.
“Your team did everything you could to save her,” Dr Mills continued as Emma cleared her throat and slowly began to stand in an attempt to recompose herself, instantly feeling the loss of the brunette’s warm, comforting hands as they retracted. “Not even a team of the greatest surgeons in this country could have saved her. Your attempts were the reason we can tell her family that we did everything we could to try to save her life.”
Emma nodded and closed her eyes for a moment to ground herself back in the moment. From the second she escaped the OR, to this very instant, her mind had wandered; it had questioned her and her validity of her doctorate title, it had argued that even though she had been on the team that had saved a life that evening that she still wasn’t good enough to be a surgeon, and it even reminded her that while one had survived, they had stood by and watched another die. A life for a life.
“It doesn’t get any easier, choosing who gets to live and who gets to die, but in the long run you become a realist. Whether you like it or not, Dr Swan, eventually, you will be able to look at cases like these and have the ability to decide realistically who can survive, and who will die even with your help.”
Emma nodded again and finally opened her eyes to look at the older woman. She wasn’t much older, but in this light, with the gentle hue emitted from the hospital shining on their faces, Emma saw pure beauty. She saw the effect that stress and nights that never ended had impacted on the corners of her caramel coloured eyes, but behind all of that, Emma saw the surgeon, for the first time, as nothing more than a human being. Behind her tough façade and powerful mask there was a human being – a normal person that Emma could relate to now more than ever.
“Do the deaths get any easier?” Emma asked after a while in a small voice that even she didn’t recognise. She cleared her throat roughly before speaking again. “She was the first patient I’ve ever lost.”
Much like Emma before she sprinted out of the OR, Dr Mills’ mouth involuntarily opened and closed in hesitation. Her words were almost visible on the tip of her tongue, yet somehow they seemed impossible to capture, like they were a million miles away from where she needed them to be.
“No, they don’t,” Dr Mills sighed and ran her fingers through her hair. “Sometimes they become easier to accept or anticipate, but that doesn’t mean the losses are any easier to swallow.” She paused for a moment, catching the exhausted flash behind the blonde’s usually green eyes, that appeared to look like a perfect shade of blue under the moonlight. “If it is any consolation, I had the same reaction when I lost my first patient.”
Emma almost scoffed as she attempted to imagine the put together brunette crying and vomiting over the death of a patient she had no chance of saving to begin with. The scoff seemed to die in her throat when her eyes latched onto the other woman’s.
“It’s not really, but, uh, thanks,” She stuttered through her words and internally rolled her eyes at her inability to remain calm and collected around the other woman.
“Very well.” Dr Mills uttered with a stiff nod and pursed her lips at the blonde, instantly rebuilding her infamous walls around her mind. “I suggest you head home and get some rest. You only have another twelve hours until your next shift begins, Dr Swan. I would hate to see you return without an ounce of sleep.”