Chapter 1 Terrible First Impressions
TERRIBLE FIRST IMPRESSIONS
NAVYA
The operating room smells like a lie. Honestly.
It’s clean, sterile, and controlled—as if the human body isn’t a wet, complicated disaster waiting to happen.
I’m an OR nurse. Have been for two years. I’m good at what I do—but every time I scrub in, gown tied, gloves snapped, hair sealed under a cap that makes me look like an egg—I’m anxious.
The overhead lights are bright, and everyone looks just a little villainous because of them. They give you sharp cheekbones, hollows under the eyes, and shadows on your face that make you look…well, up to no good.
Now, granted, I look at the world through a Bollywood-movie lens because that makes the world more palatable, and my internal melodrama ensures that, outwardly, I offer no drama at all.
In a world of rules and regulations, and keeping up appearances, I’m always glad that my mind is private because the shit that goes on in there…
whew, it’d get me fired or sent to the funny farm… or both.
Probably both.
“Time-out,” Dr. Klein says at the head of the bed, like we’re about to open a grocery bag, not a skull. “Patient: Thomas Avery. Procedure: craniotomy for tumor resection. Left temporal.”
“Confirmed.” My eyes flick to the chart, then to the patient’s pale face. He’s anesthetized, intubated, wrapped in drapes like the world’s saddest burrito.
And that’s when I feel a crackle in the air, like right before a main character—hero or villain—is about to step into the scene.
The circulating nurse, Deanna, leans closer to me. “New attending’s in the room,” she murmurs.
The plot thickens. “Vincenzo?”
Deanna nods, eyes wide like she’s whispering a ghost story at a sleepover. “You heard of him?”
Obviously.
I don’t live under a rock. He’s some neurosurgeon wunderkind.
But then they all are. I think it’s how Bayview Summit Medical Center handles its PR every time it brings in a new doctor.
And the new doctors, all of them, drive real fancy cars because I figure they have small dicks and they need the car to feed their ego.
Behind Deanna, the doors swing open, and the room’s temperature changes like the music going from subtle to dun, dun, dun.
I can just read the scene’s script.
The hero walks into the operating room.
He’s wearing navy scrubs, and they look like they’re tailored for him, not bought online at Scrubs & Beyond for twenty-five ninety-nine.
His surgical cap is low over dark hair, and his mask hangs loose around his neck so we can see his arrogant face.
He looks at us. Hai Bhagvan*, his eyes are so blue they look like contacts. But he doesn’t look like the kind of guy who’d wear contacts, but then who knows with these small-dick big-ego God-complex surgeon types.
“He’s so handsome.” Deanna fans herself with her hand.
Seriously? This woman needs to lower both her hand and her voice because I’m pretty sure he heard her, which would explain why he’s looking at us with those piercing blue eyes full of…disdain. I think that’s the word for when someone looks at you like you’re beneath them.
Except his flared nostrils suggest something stronger, like…disgust. The visceral kind.
Either way, the new neuro doesn’t like us. Or maybe he just doesn’t like Deanna, because she was far too vocal about how hot he is. As if he doesn’t already know.
Men like him always know.
Dr. Klein turns slightly. “Dr. Vincenzo. Good to have you.”
“Mm,” Dr. Vincenzo replies, like Klein just informed him oxygen exists, and what a waste of time that was.
He steps toward the table, and for a second, I forget my own job because I’m busy noticing that the man moves like he’s never once doubted himself in his entire life.
Must be nice. Must be really nice because I wake up in the morning and the self-doubt begins all the way from: Did I brush my teeth right, to, am I about to accidentally kill someone in the OR today?
Dr. Hot Stuff scans the setup.
Instruments laid out.
Sponge counts.
Suction.
Bovie.
The cranial set gleams under the lights.
Everything is in order, right?
His gaze lands on me. “Who are you?”
No hello. No good morning. Not even a nod.
God, he’s such a chutiya*!
“Navya Rana.” I keep my voice neutral.
His eyes flick over my badge. “You’re scrub?”
Ouch! “Yes.”
“And you set this up?”
“Yes.” I want to say with Deanna, but I don’t because he looks angry, and I don’t want to throw her under the bus. She gives me a grateful smile. She knows whatever is coming next is not going to be pleasant.
His mouth twitches. Not a smile. More like an…allergic reaction?
He turns back to Dr. Klein. “Are we really letting new nurses scrub on cranials now?”
My face goes hot under my mask.
Deanna freezes.
Dr. Klein pauses, hand hovering over the drape.
I keep my eyes down because I’ve learned a long time ago that, in hospitals, pride is a luxury. You can’t afford it if you want to keep your job.
“Evan, Navya is an experienced OR nurse. One of my best.” Dr. Klein uses his first name, I think, to disarm him.
Evan snarls.
Dude, Dr. Klein, I don’t think it’s working.
“Is something wrong, Dr. Vincenzo?” I step in because we have a patient on the table and we have to, you know, get to work.
Dr. Vincenzo’s gaze snaps back to me. “Why are your clamps arranged like that?”
My brain blanks for half a second.
What? I’ve done cranials with Dr. Klein dozens of times, and they are arranged correctly.
I glance at the mayo stand, a reflex of self-doubt. The clamps are where they should be—organized by size and type, clean order, muscle memory.
“They’re arranged per preference card.” I make sure I don’t sound defensive. In my experience, that gets you nowhere.
He takes one step closer, and I swear the air thins.
“Preference cards are for people who need reminders,” he grinds out. “Not for competent staff.”
Oh!
So, we’re doing this today.
It’s Dr. Chutiya’s first time in the OR at a new hospital, and he wants to show who is boss. Excellent. Let the games begin.
“Would you like them arranged differently?” I ask politely, because I am a professional. And also, the bigger person, you absolute dickhead.
He leans in just enough so that only I can hear him. “I’d like you to stop arguing and start thinking.”
As in, shut up, lady, and start using that puny brain of yours.
My throat tightens.
This guy is way out of line. I have about a thousand responses to his stupid remark. Sharp ones. Smart ones. The kind my bestie, Latika, would say with her whole chest.
But I keep my mouth shut, because this is a hospital, and this man is a famous surgeon, and I am a nurse who lives in a building where the stairwell smells like pee.
“Understood.”
I don’t bother to smile because thanks to my mask, he wouldn’t be able to see it anyway. Plus, he doesn’t deserve a smile.
His eyes narrow slightly, like he expected more fight. Like he wanted it.
Take that, gandu*.
He turns away and speaks to the room again, voice louder. “Suction tubing.”
I hand it over before he finishes the words.
He takes it, inspects it like he’s looking for a reason to be displeased, and then tosses it back on the field with a little too much force.
The tubing slaps against metal.
I flinch before I can stop myself and draw his attention.
Got you, that look says.
Haraami*!
Dr. Klein clears his throat. “We’re ready to proceed.”
Dr. Vincenzo doesn’t answer. He steps up, takes the scalpel like it’s an extension of his hand, and proceeds.
Incision begins. The skin opens. Blood beads. Suction hums.
The room settles into a grim, focused hush.
This is where I’m good. This is where I know what to do without having to think.
Hemostat.
Retractor.
Suction tip.
Irrigation.
Sponges counted.
Instruments passed with quiet efficiency.
I hand Dr. Klein a Kerrison. He nods. We move. We flow.
Then—
“Navya.”
Dr. Douchebags’ voice cuts through the rhythm like a snapped thread.
“Yes, Doctor?”
He extends his hand without looking. Palm up. Expecting.
I glance at the field. He hasn’t asked for anything specific. There are fifteen options that could fit that hand.
“Which instrument would you like?” I stay calm.
He finally looks at me. And in his eyes, I see it.
He’s enjoying this.
“A dissector.” His tone is sharp. “Obviously.”
Of course! Now, he’s behaving like Miranda Priestly. Any minute now, he’s going to say, “That’s all.”
I reach for the Penfield.
He slaps his hand down on the field—gloved fingers tapping the air like a metronome of impatience. “Not that.”
My brain scrambles. #4? #1? He said dissector. He could mean a Woodson. He could mean a Freer. He could mean he wants—
“A Woodson?” I ask because asking again is better than guessing wrong.
His eyes go cold. “Do you not know the difference between a dissector and a probe?”
The barb hits. Actually, they all do. I just pretend, even to myself, for the sake of my mental health, that they don’t.
“I do,” I say, softly.
“Then why are you making this difficult?” he growls.
The whole room feels it. The shift. The tension. Deanna’s eyes dart. Anesthesia holds still like a statue. Dr. Klein’s hands pause mid-motion.
I feel the humiliation crawl up my neck like a heat rash.
Because you’re not asking for what you want, I want to say. Because you’re testing me. Because you think you’re God.
But instead, I take a breath and remind myself: Don’t cry in the OR. Don’t cry in the OR. Don’t cry in the OR.
I locate the instrument he means—an instrument that was, in fact, on the field, right where it should be. He just wanted to watch me scramble.
I pass it into his hand.
He takes it without a word.
Whew! Small mercies.
Dr. Klein resumes, voice careful, and he’s looking at me. “Let’s keep going.”
“Yes, doctor.” That’s me telling him that I’m good to go. No harm, no foul.
Because that’s what people like me do.
We swallow our pride.
Silence falls.
The tumor is partially exposed now.