Chapter 5 #2
"I improvised," I correct him. "I will book the OR for tonight. You will assist."
"Max," he says. His voice breaks. "Why?"
I look at him. I see the soldier who is tired of fighting a war he can't win. I see the man who I covered with a sweater because he was cold.
"Because," I say, checking my watch to hide the fact that my own hands are shaking, "Mr. Henderson is a human being. Not a line item."
I turn to walk away.
"And Jax?" I add.
He looks up.
"Do not ever yell at the Chief of Surgery again. It is unprofessional. And it wrinkles my coat when I have to step in front of you."
I walk toward the elevators.
I don't look back, but I can feel his eyes on me.
I enter the elevator and press the button for the top floor. The doors close.
I lean my head back against the metal wall and exhale a breath I didn't know I was holding.
A physiological error.
That’s what I told him.
But as I think about the look in Jax’s eyes when I stood up for him, I realize the complication is much worse than I thought.
The infection has spread. And it’s going straight for my heart.
Lying is exhausting.
Physiologically speaking, deception triggers the same stress response as physical danger. Elevated heart rate. Dilated pupils. The sudden, desperate need to vomit.
I am currently experiencing all three.
"Dr. Sterling wants the abstract by 5:00 PM," my assistant says, placing a sticky note on my desk. She looks apologetic. "He said something about 'verifying the grant eligibility window.'"
I stare at the note. 5:00 PM. It is currently 1:00 PM.
I have four hours to invent a revolutionary surgical protocol that does not exist, for a robotic arm we do not have, to justify a surgery we have already performed.
"Thank you," I say, my voice sounding hollow.
I look across the blue tape line.
Jax is eating a burrito. He is currently dissecting it, pulling out the jalapenos with surgical precision and flicking them into his trash can.
"We have a problem," I announce.
Jax looks up. "We're out of coffee? That is a problem. I can make a run to the cafeteria, but I can't promise I won't punch the barista if he burns the milk again."
"Sterling wants the abstract," I say. "For the Henderson study."
Jax pauses. He drops a jalapeno. "The fake study?"
"The theoretical study," I correct. "He wants a five-page summary of our methodology, hypothesis, and expected outcomes. By end of day."
Jax whistles low. "Short notice. Classic Sterling power play. He’s trying to catch you in the lie."
"Obviously," I snap. "I need to write it. Now."
"Okay," Jax says, wiping his hands on his scrubs. "So write it. You’re the word guy. I’m the knife guy. Use a lot of syllables. Throw in 'synergy' and 'paradigm shift.' He loves that crap."
"I cannot simply throw words at a page, Jax. It has to be medically sound. If I propose a robotic approach that is anatomically impossible, he will know."
I open my laptop. The blank page blinks at me. Cursor. Blink. Blink.
"I need your help," I admit.
Jax raises an eyebrow. "My help? I thought I was 'clutter.'"
"You are a trauma surgeon," I say, desperate times calling for desperate measures. "You improvise. You hack things together in the field. I need... hacking."
Jax grins. It is a slow, predatory grin that makes my stomach flip.
"Alright, Princess. Let’s hack."
He rolls his chair over. Squeak. Squeak. He stops right at the tape line.
"Type this," Jax orders. "Title: Adaptive Kinetic Algorithms in High-Velocity Cardiac Trauma."
I type it. "That sounds... plausible."
"Of course it does. I read Wired magazine," Jax says. "Now, the hypothesis. We believe that the robot can compensate for the chaotic movement of a beating heart during trauma surgery, right?"
"Technically, we utilize cross-clamping to stop the heart," I correct.
"Boring," Jax says. "And risky. If the patient is unstable, stopping the heart kills them. What if we didn't stop it?"
I look at him. "Beating heart surgery is extremely difficult. The motion artifact makes suturing impossible."
"Not for a robot," Jax counters. He leans forward, his eyes lighting up. "The robot has sensors, right? It can track motion. If we program it to sync with the EKG rhythm... it moves with the heart. Like a sniper breathing with his target."
I stare at him.
It is insane. It is reckless.
It is brilliant.
"Active Motion Compensation," I whisper. "We could reduce the ischemic time to zero."
"Exactly," Jax says. "No bypass machine. No cardioplegia. Just plug and play."
I start typing furiously. The ideas flow. My academic rigidity merges with his chaotic creativity. I supply the anatomical constraints; he supplies the tactical solutions.
"What about the haptic feedback?" I ask. "The surgeon can't feel the tissue tension through the console."
"Visual cues," Jax suggests. "Color mapping. If the tissue turns white, you're pulling too hard. Like a video game health bar."
"Tissue ischemia indicators," I translate, typing rapidly.
We work for three hours straight.
At 4:00 PM, I realize I am starving.
"Food," Jax announces, reading my mind. "I’m ordering pizza."
"I do not eat pizza in the office," I say automatically. "The grease risk to the keyboard is too high."
"I’ll get you a fork," Jax says, pulling out his phone. "Pepperoni? Or are you a plain cheese kind of guy?"
"Pineapple," I say.
Jax stares at me. "Get out."
"The sweetness of the fruit balances the acidity of the tomato sauce," I defend. "It is a refined flavor profile."
"It’s a crime," Jax says, shaking his head. "Something the Canadians have yet to pay for, but their time is coming… Fine. One abomination, coming up."
When the pizza arrives, the box is greasy and smells of regret and oregano. Jax dives in immediately, folding a slice in half and consuming it with efficient, terrifying speed.
I, however, retrieve a set of plastic cutlery from my desk drawer. I transfer a slice to a paper plate. I begin to cut.
"Stop," Jax says. He lowers his slice, looking horrified. "Just stop."
"What?" I ask, carefully severing a bite-sized piece of pepperoni.
"You’re performing an autopsy on a slice of Domino's," Jax says. "It’s pepperoni, Max, not a tumor. You don't need clear margins."
"I am avoiding grease transfer to my fingertips," I explain, stabbing the piece with my fork. "My keyboard cost three hundred dollars. I do not intend to lubricate the shift key with rendered pork fat."
"You’re sucking the soul out of the pizza," Jax argues. "You have to fold it. It’s the law. The grease is the point."
"I do not fold food," I say, chewing methodically. "I consume it with dignity."
Jax watches me eat another forkful. He looks like he’s witnessing a crime.
"You are the most high-maintenance human being I have ever met," Jax decides. "How do you even eat a burger? With a scalpel?"
"If one is available," I say deadpan. "Precision prevents mess."
Jax shakes his head and shoves another massive bite into his mouth. "You’re tragic, York. Truly tragic."
"And you," I say, watching a drop of sauce threaten to fall on his scrubs, "are a laundry hazard."
He catches the drop with his thumb just before it hits the fabric. He winks.
"Reflexes, Princess."
We finish eating—him in five minutes, me in twenty.
"Read the conclusion back to me," Jax says, wiping his mouth with a napkin.
I clear my throat. "In conclusion, the proposed methodology offers a paradigm shift in cardiac trauma management, transforming the operative field from a static environment to a dynamic, responsive ecosystem."
Jax nods. "Sexy. Sterling is going to need a cold shower after reading that."
I hit Send.
The email whooshes away.
I sit back. I feel lighter. We didn't just cover our tracks; we actually designed something incredible.
"You know," I say, looking at Jax. "That... actually makes sense. The motion tracking. We could actually do it."
"Why do you think I suggested it?" Jax winks. "I’m not just a pretty face, Max."
"No," I agree softly. "You are not."
I look at the empty pizza box. I look at the blue tape line.
"Thank you," I say. "For the help."
"Anytime, partner."
Partner.
The word settles in the room. It feels dangerous. It feels permanent.
"We should test it," I say suddenly.
"What?"
"The theory," I say. "We have the Sim Lab. We have the robot. We could upload a motion algorithm and see if we can actually suture a moving target."
Jax looks at me. His eyes darken.
"You want to go to the Sim Lab? With me?"
"Yes," I say. My heart rate kicks up. 85 bpm. "For... science."
Jax smiles. "Science. Right."
He stands up.
"Lead the way, Chief."
Jax
There are very few things in this world that terrify me.
I have been shot at. I have defused a pressure plate IED with a pair of rusty pliers. I have eaten sushi from a gas station in Nebraska.
But watching Dr. Maxwell York try to operate a three-million-dollar surgical robot he has just "hacked" with a theoretical algorithm... that is terrifying.
"Initiating start-up sequence," Maxwell announces.
He is sitting at the surgeon’s console of the Da Vinci Xi surgical system. His head is buried in the viewer, his hands gripping the master controls. He looks like he’s trying to pilot a starship while wearing a Tom Ford suit.
"Copy that, Commander," I say, leaning against the doorframe of the Sim Lab. "System is green. Target is..."
I look at the operating table.
Lying there is "Bob." Bob is a high-fidelity mannequin torso made of silicone and nightmares. He has a synthetic heart, synthetic lungs, and a very surprised expression painted on his plastic face.
"Target is Bob," I confirm. "He looks nervous."
"Bob is an inanimate object," Maxwell says, his voice muffled by the console. "He does not feel nervousness. Now, inserting the camera."
The robot looms over the table like a giant, four-armed spider. Maxwell moves his hands. The robot arms whir to life. One arm, holding a camera, dives gracefully into Bob’s chest cavity.