Chapter 5 Mia #2
Before I can respond, the door opens again and Sebastian enters, carrying a stack of files that he places on the table. The room immediately falls silent, the air shifting as everyone sits up straighter.
"Good morning," he says without preamble, his gaze sweeping over each of us before lingering briefly on me. "We have three new cases to review this morning, plus updates on our existing patients."
He begins discussing a case involving a teenage athlete with unexplained joint pain, but I find my focus drifting as he speaks.
My eyes keep betraying me, drawn to his hands as he flips through the file, to the way his jaw tightens when he emphasizes a point, to the slight furrow between his brows as he considers a question from Naima.
Fragments of my dream flash through my mind—those same hands on my skin, that mouth against my neck, that voice whispering things that would make me blush even harder than I already am. I shift in my seat, crossing my legs tightly as heat pools low in my belly.
"...which is why Dr. Phillips and Dr. Langston will take the lead on this case."
I snap back to attention at the sound of my name, realizing with horror that I've missed whatever case Sebastian has just assigned to me. Harper looks at me expectantly, a slight smirk playing at the corners of his mouth, like he knows exactly where my mind has been.
"Do you have any questions about your assignment, Dr. Phillips?" Sebastian asks, his tone making it clear he too has noticed my inattention. "Or shall I repeat the pertinent details for your benefit?"
Every eye in the room is on me now. Naima's cool assessment, Jonah's sympathetic wince, Harper's barely concealed amusement, and Sebastian's penetrating stare that seems to see right through me.
"No need," I say, straightening my shoulders and meeting his gaze directly. "Thirty-two-year-old male, unexplained seizures, respiratory distress. I've got it."
Sebastian's eyebrow lifts slightly, the only indication that he's surprised I caught that much. "Good. I expect a preliminary differential by this afternoon."
Relief floods through me that I managed to grasp enough details to not completely humiliate myself.
As Sebastian moves on to the next case, I force myself to focus, taking detailed notes and asking relevant questions.
By the end of the meeting, I've almost convinced myself that I've recovered from my momentary lapse.
Almost.
"Well, partner," Harper says as we gather our materials after the meeting. "Shall we go meet our patient?"
I nod, grateful for the chance to throw myself into work and away from my inappropriate thoughts about Sebastian. "Lead the way."
Marcus Ellis lies propped up in his hospital bed, his skin carrying the gray undertone of someone whose body is fighting a losing battle.
He's thirty-two but looks older, exhaustion etching lines around his eyes and mouth.
As Harper reviews the chart at the foot of the bed, I notice Marcus's phone on the bedside table.
Its lock screen shows a gap-toothed little girl with pigtails, maybe five years old.
Must be his daughter. I see the way his eyes keep drifting to the photo, and something twists in my chest, a feeling I know too well.
"Mr. Ellis, I'm Dr. Phillips and this is Dr. Langston," I say, stepping closer to the bed. "We're going to be taking over your case. Can you tell us how you're feeling today?"
"Like shit," he says, then offers a tired smile. "Sorry. Not your fault. The breathing's worse today. Feels like someone's sitting on my chest."
Harper continues his review of the chart with the detached efficiency that seems to be his trademark, barely looking up as he asks, "Any changes to the seizure activity? Frequency or duration?"
"Had one this morning," Marcus says, his fingers fidgeting with the edge of his blanket. "The nurse said it lasted about two minutes. I don't remember it, just waking up afterward feeling like I'd been hit by a truck."
I reach for my stethoscope, moving to the side of the bed. "Mind if I listen to your lungs?"
He nods, sitting forward slightly as I place the cool metal against his back. The raspy crackle I hear isn't promising; fluid’s building up where it shouldn't be. This isn't good.
"Any other symptoms you've noticed?" I ask, moving the stethoscope to different points on his back. "Anything new, even if it seems unrelated?"
"My hands shake sometimes," he says. "And I get these headaches that make it hard to see. That's why I had to call my sister to take Emma for a while. Couldn't trust myself to take care of her properly, you know?"
The mention of his daughter makes his voice crack slightly.
I know that tone, the fear of a parent who might not be there for their child.
Dad had the same tremor in his voice when he finally admitted he needed to go to the hospital, when he looked at me and said, "I don't think I can fix this one, Mimi. "
Pushing the memory away, I force myself to focus on the present. "We're going to run some additional tests," I tell Marcus. "And adjust your medication to help with the breathing. Dr. Langston and I will be monitoring you closely."
Harper and I step out into the hallway to discuss our approach. His assessment is all science and no soul as he rattles off potential diagnoses.
"The fluid in his lungs has increased since yesterday's X-ray," I point out. "And the tremors in his extremities suggest peripheral nervous system involvement too. What about an atypical presentation of Guillain-Barré?"
Harper gives me a look that's just short of an eye-roll. "Guillain-Barré doesn't typically present with seizures."
"I said atypical," I counter. "And we should test for mycoplasma pneumonia. The respiratory symptoms could be primary, with the neurological symptoms secondary to—"
My argument is cut short by the sharp wail of a monitor alarm from Marcus's room. We both whip around, rushing back through the door to find him gasping for breath. The oxygen saturation monitor plummets as his lips take on a bluish tinge.
"Get a crash cart in here," Harper shouts to a nurse passing by.
I'm already at Marcus's side, elevating the head of his bed further as he struggles to breathe. "Mr. Ellis—Marcus—try to stay calm. We're going to help you."
His eyes are wide with panic, his fingers clutching at the front of his hospital gown. The monitor shows his heart rate spiking and his oxygen levels dropping dangerously low. A nurse rushes in with the crash cart as another calls a code over the intercom.
"Let's get him intubated," I say, already reaching for the laryngoscope. "His airway's compromised."
Harper moves to the other side of the bed as we work in tandem, the choreographed urgency of emergency medicine taking over.
The room fills with medical staff—a respiratory therapist, more nurses, and an anesthesiologist who takes over the intubation as I step back to assess what else might be happening.
That's when Marcus's body goes rigid, his back arches off the bed in a seizure more violent than any documented in his chart.
"He's seizing!" I call out.
A nurse draws up the medication I asked for as I help roll Marcus onto his side to prevent aspiration. The seizure continues, his oxygen levels dropping further despite the respiratory support.
Everything speeds up after that. The seizure gives way to something worse—cardiac arrhythmia, then asystole.
I lose track of time as we work, the rhythm of CPR, the push of medications, the shock of the defibrillator.
One minute blurs into five, into ten, into twenty.
My arms ache from taking over compressions, but I don't stop, can't stop.
In my peripheral vision, I see the photo of the little girl on his phone.
"Another round of epi," I demand, even as I register the flatline that hasn't changed despite our efforts. "And push one of atropine."
"Dr. Phillips. He's gone." Harper's voice cuts through my focus.
I shake my head, continuing compressions. "Not yet. His daughter needs him."
A hand lands on my shoulder—the anesthesiologist, her eyes are gentle but firm above her mask. "Dr. Phillips. It's been thirty-eight minutes. There's no cardiac activity."
Reality crashes back in as I look around the room, seeing the resigned expressions on every face. I step back, my arms trembling from exertion, and watch as Harper calls it.
"Time of death, ten-forty-seven."
The words echo in my head as the room slowly empties, equipment being removed, monitors silenced.
I stand there, staring at Marcus's still form, at the phone with his daughter's picture.
A nurse gently places a sheet over his face, and I feel that familiar hollowness spreading through my chest, the unique emptiness of losing a patient.
"I'll inform the family," Harper says, his clinical detachment finally showing a crack of humanity.
Not trusting my voice, I barely manage a nod.
I make it through the necessary documentation, the preliminary death certificate, all with a composed exterior that threatens to shatter with each passing minute.
Only when everything is handled do I allow myself to step away, walking with measured steps down the corridor until I find what I'm looking for—a supply closet, something small and private.
I slip inside, closing the door behind me, and finally let the mask drop.
The tears come hot and fast, burning trails down my cheeks as I slide down until I'm sitting on the floor with my knees pulled to my chest. In the darkness among shelves of gauze and antiseptic, surrounded by the clinical smell of alcohol wipes and latex, I break.
It's not just Marcus. It's Dad all over again—the helplessness, the failure, the knowledge that all my training and determination couldn't save someone who needed to be saved.
I press my hand against my mouth to muffle the sobs that wrack my body as memories flash behind my closed eyelids.
Dad in his hospital bed. The flat line on his monitor. The way his hand grew cold in mine.
I don't hear the door open, it's the sudden shaft of light that makes me look up. Blinking through tears, I see a tall figure silhouetted in the doorway. For a moment, I don't recognize him. Then he steps forward, and my breath catches.
Sebastian stands there, his imposing frame filling the entrance, those dark eyes taking in my crumpled form on the floor.
"Dr. Phillips," he says.
I quickly wipe at my face, attempting to recover some dignity, but it's far too late for that. He's seen me—really seen me—at my most vulnerable, my most broken. I wait for the dismissal, the clinical reminder about professional distance, the lecture about emotional involvement.
Instead, he steps inside and closes the door behind him, plunging us back into darkness.