Chapter 17 #2
“I see,” Tay said slowly, with an odd quirk to his mouth. It wasn’t until I found Jesse and handed over his coffee that I realized I’d slipped up—the cup had ‘Jesse’ scrawled across one side, obvious like an exclamation mark. Fuck.
Tay didn’t mention it, so neither did I.
They looked tired.
That was my first thought. They looked tired and scared and a little hopeful—like people who were trying their damned hardest to treat each day like a gift because they couldn’t be sure there’d be another.
Mr. and Mrs. Jackson. Their babies were asleep in an extra-wide stroller, curled into each other with a blanket tugged over them.
Tiny hands, rose-pink mouths parted in sleep, pale lashes against peach-smooth cheeks.
Like this, you’d never know they shared a liver.
“Mrs. Jackson. Mr. Jackson.” Novak folded her hands on the conference table.
She didn’t smile, but her tone was gentle.
“Thank you for coming in today. This is to meet the full team and walk you through the steps once more, just to ensure that everything is clear.” She lowered her voice. “Nothing starts without your say-so.”
The mother nodded quickly, jaw tight. “We’re ready.”
“We are.” The father’s voice was low, as if afraid he might wake his daughters. His hand clutched his wife’s like they were each other’s lifeline.
How could they possibly be ready? How could anyone be?
“Good,” Novak said, “then so are we.” She gestured at the man seated beside her, his face serious, blue-rimmed glasses the same color as his scrubs.
“You already know Dr. Lee, who’ll be leading the second team.
You’ve also met Dr. Carter”—she nodded at Tay, just next to Dr. Lee—“who will be his first assist.”
Tay sent the parents one of his easy, reassuring smiles, which earned him a faint one back from the mom.
“Dr. Maddox,” Novak continued, “will be mine, as you know.”
Jesse inclined his head, quiet and steady, and my chest gave an odd tug. Secondhand pride, tangling with sharp awareness of the distance between us.
Novak introduced the others in order of importance—two anesthesiologists, a vascular specialist, two surgical nurses. “Supporting on either table,” Novak said then, “will be Dr. Ruiz and Dr. Hayes.”
Me. My stomach dipped. I wasn’t important here, could be swapped out at a moment’s notice.
Still, when the Jacksons’ eyes flicked to me, I tried to appear trustworthy.
Most likely, I just looked young and inexperienced next to everyone else—even compared to Jenna Ruiz, the other resident, who had a whole two years on me.
“The surgery will go in phases,” Novak said.
“We start by separating shared blood vessels. Then the liver bridge. Once both circulations are independent, closure.” She gave the parents a moment to process.
“You’ll hear us talk about clamp times—that’s how long we cut off blood flow while we work. We’ll keep those as short as possible.”
The father’s throat worked. “What are the odds?”
Sixty to seventy percent that both made it, and only because Devon Memorial was a top pediatric surgery center—that’s what Jesse had told me. God, but how do you explain to a parent that they might outlive their child?
“We’ve spent weeks studying the scans and running simulations.
” Novak’s voice was calm, steady. She leaned forward, her full attention on the Jacksons.
“The most important thing is that each of your daughters has her own heart and lungs. As you know, that’s what makes separation possible.
However, they do share a large portion of their liver and some of the structures in the lower abdomen. ”
The mom nodded to show she was following, eyes a little wet in the stark brightness of the conference room.
“The good news”—Novak cleared her throat—“is that the liver can actually be divided. It regenerates. So as long as there is enough blood supply, we’re optimistic.”
“Optimistic,” the mom echoed, like someone had tossed her a rope she could cling to.
“Optimistic, yes.” Novak nodded slightly.
A pause stretched, weighed down by words she’d yet to say, words we all knew were coming.
“That said,” she continued, her voice quiet yet clear, “this is still one of the most complex surgeries we’ve ever attempted.
It will take many hours, with two full surgical teams working side by side. The risks are significant.”
Mr. Jackson inhaled sharply, gaze sliding to his girls. “How significant?”
No way to sugarcoat this, Jesus. I held my breath as the room seemed to shrink in on itself.
“There’s a real possibility that one twin could do well while the other struggles.
” Novak’s head tilted just the slightest hint.
“It depends on how the blood vessels divide or if there are complications during surgery. There’s also a small but very real risk that neither survives.
But I want to be clear: in a center like ours, with the resources we have?
Survival is not just possible, but much more likely than not.
We cannot promise that outcome, though.”
Mrs. Jackson blinked a couple of times, her voice thick. “We understand.”
My gaze slid to the twins. One of them twitched in her sleep, tiny fingers curled against her sister’s pudgy arm. It hadn’t seemed real before—abstract scans and medical terms, glossy photos, simulations. Now? It was so real it made my teeth ache.
“What we can promise,” Novak added after a second that thrummed in my bones, “is that we will prepare for every scenario. Our job is to give them the best chance at independent, healthy lives. If all goes as planned, your daughters can go on to live much like any other children—playing, running. Growing up together, but separately.”
Fuck. And this, this was why Novak headed the department. I ducked my head to hide emotions I should be able to control much better, awe crawling over my skin, hot and cold at once.
I was part of this, part of the chain that decided whether these two babies got a real shot at life. Even if all I did was read out vitals and hold suction, Jesus, worth it. All the nights I’d crashed face-first into bed, all the skipped meals, the marrow-deep exhaustion—worth it.
The mother’s eyes were wet, the father’s shoulders dropping by the barest margin. “Tuesday,” he said, like a prayer, and Novak nodded.
“Tuesday.”
An answer.
I spent the weekend in a frazzled state. What if I messed up? What if I forgot how to use my hands and dropped stuff just when it was needed? What if Novak asked for something and I didn’t know what she meant?
More than once, I reached for my phone and started typing a text to Jesse. Then erased it again because he’d be evaluating me after this, one final time, and it felt wrong to bring my own anxieties to the party.
Fortunately, Khai and Tessa dragged me to some open-mic event on Saturday night, sticky floors and a dozen beers on tap, musicians that ranged from truly talented to “oops, sorry, I just stepped on my cat’s tail.
” On Sunday, Neil, Sam, and I painted our kitchen in a happy sunshine yellow, leaving me to scrub dried paint out from under my nails, and by the time I ran to work on Monday, I felt…
not settled, no. But ready for the week—ready for tomorrow.
The OR held a chill that kept minds sharp. I knew I’d be grateful twenty minutes in, but right now, I tried not to shiver as I entered the sterile area, following a couple of steps behind Novak and Jesse.
God. The twins looked so small. Lights pooled over their tiny bodies, placed on a specially built surgical table that would split in two once they separated. They were dwarfed by frames of blue fabric, warming mattresses underneath so they wouldn’t get cold in the hours ahead.
“Treat it like choreography,” Novak said. “Step by step, just like we practiced. Call deviations the second you see them.”
The team divided—two twins, two ballet troupes. One story.
I stepped into my place and took a slow, deliberate breath.
Another. Jesse glanced at me—just for half a second, as if checking in on a frequency only we could hear.
Above the mask, his eyes were focused and sure, calm in a way that settled something in my blood.
I steadied my hands and gave him a nod so tiny it barely counted.
The opening move felt like a prologue: a scalpel cut, deliberate and slow.
Skin and tissue, every step double—double checks, double monitors, double glances at vitals.
Each twin had her own heartbeat, painting lines.
I positioned the retractor and caught a tremor in my elbows.
Lock them. Breathe. Listen to the steady beeps, two whole futures in our hands.