17. Lillian
LILLIAN
L illian stood just outside the operating room, adjusting her mask and trying to calm the growing tightness in her chest. The weight of today’s procedure hung heavy in the air.
It wasn’t just any surgery; it was a high-stakes cardiothoracic operation, and she was assisting Rebecca Not just her attending physician, but the woman she had come to care about more than anyone else.
The patient, a middle-aged man, had a complex case involving severe coronary artery disease.
The procedure required precision, expertise, and flawless execution—everything Lillian had spent years training for.
But this time, it felt different. This time, the stakes weren’t just professional; they felt personal.
All eyes would be on her, especially Rebecca’s.
She took a deep breath and stepped into the operating room.
The scrub nurse and other residents were already prepping, their movements efficient and practiced, but there was an unspoken tension that always accompanied major surgeries.
Lillian approached the scrub sink, scrubbing in alongside a few familiar faces.
"You’ve got this," Benji said from beside her, offering a supportive smile through his mask.
Lillian nodded, though her stomach churned with nerves. "I know," she replied, her voice steady but thin. "It’s just…a big one."
"Yeah, but you’ve handled worse, right?" he said, trying to ease the tension with his usual casual demeanor. "And hey, at least we’ve got Lang in there with us. Nothing goes wrong with her around."
That didn’t help. If anything, it made the pressure worse. Exactly , she thought. Rebecca’s reputation was flawless, and here she was, desperate not to be the one to tarnish it.
The door to the OR swung open, and there she was—Rebecca Lang, in full surgical gear, her posture as rigid and controlled as ever.
The moment she stepped into the room, the air seemed to cool.
The chatter quieted. Everyone turned their attention to her, waiting for instructions and for her to take charge.
Lillian's heart skipped as Rebecca gave her a brief, calm nod. It was professional, distant, but there was something more in her eyes—a flicker of expectation and pressure. Lillian straightened her back, reminding herself that she was capable. She had worked hard to get here.
"Everyone ready?" Rebecca’s voice was crisp, cutting through the quiet hum of the equipment.
The scrub nurse and other residents confirmed, and Lillian’s throat felt dry as she nodded along with them. She caught Rebecca’s eye for a moment before the surgery began, but there was no warmth there, just the same cool professionalism Rebecca always carried into the OR.
"You’ve assisted with procedures like this before," Rebecca said as she turned to Lillian, her voice steady but cold. "Just follow my lead and don’t second-guess yourself."
Lillian nodded, trying to hide the slight tremble in her hands as she prepared to assist. "Got it," she replied, her voice stronger than she felt.
The patient lay on the table, draped and prepped, the monitor’s steady beep filling the room.
Lillian took her place beside Rebecca, her heart pounding as they began.
Rebecca’s hands moved with the kind of precision Lillian could only hope to master one day.
Each instruction Rebecca gave was clear, firm, and without room for error.
As they opened the chest and exposed the heart, the tension in Lillian’s body grew tighter. She could feel Rebecca’s presence next to her—commanding, flawless. Every move Rebecca made was calculated, and it reminded Lillian just how high the bar was set.
"You’ll handle the next part," Rebecca said, her voice leaving no room for hesitation.
Lillian swallowed, nodding as she carefully took the instruments handed to her by the scrub nurse. This was her moment to prove herself. She couldn’t afford a single mistake.
"Make the incision here," Rebecca said, pointing to a critical junction near the artery. "And be careful of the adjacent vessels. The margin for error is small."
Lillian’s hands moved slowly, carefully. She knew this was delicate and one wrong move could lead to a cascade of complications. She felt the gaze of everyone in the room on her, but most of all, she felt Rebecca’s eyes watching closely. It was a test, one she couldn’t afford to fail.
As she made the incision, her breath caught slightly. She hadn’t realized she’d been holding it until it escaped. She followed Rebecca’s next instruction, but the air in the room felt thicker now. The pressure was mounting, and Lillian could feel it in the quickened beat of her own heart.
"Good. Now continue with the bypass graft. Carefully," Rebecca instructed, her voice sharp but neutral.
Lillian nodded again, focusing on the task at hand, determined not to let her nerves get the best of her. She was prepared for this, she reminded herself. She had trained for this exact moment. But knowing that Rebecca was watching her every move—it made her hands feel heavier, the stakes higher.
The room felt colder as the next critical phase of the surgery loomed. Lillian was determined, but the weight of expectation pressed down on her harder than it ever had before.
The next phase began smoothly. The patient lay under anesthesia, and the steady rhythm of the heart monitor filled the room, a constant reminder of the stakes at hand.
Lillian’s pulse echoed in her ears as she followed Rebecca’s lead, her hands carefully mirroring each movement the attending instructed.
"Make sure the incision is clean and precise. Any deviation here and you risk damaging the vessels," Rebecca said, her tone crisp and controlled as she pointed to the critical junction where Lillian would begin.
Lillian nodded, swallowing the lump in her throat. She adjusted her grip on the scalpel, her hands steady but her nerves firing. This was it. Her moment to prove she could handle this level of pressure and responsibility. Stay calm , she told herself silently. Just follow Rebecca’s lead.
With a deep breath, she made the incision, focusing on keeping it clean, smooth.
The tissue separated as expected, and the heart was exposed.
The initial phase of the surgery had gone well, but the more complicated parts were still to come.
Lillian tried to focus only on the task in front of her, but she could feel the tension in the room, the silent expectation that she would handle this flawlessly.
Rebecca watched her every move. It wasn’t obvious to the rest of the team, but Lillian could feel the weight of Rebecca’s gaze, measuring her performance, judging her capabilities. It made the air thick, every action heavier.
"You need to handle the bypass graft carefully," Rebecca continued, her voice neutral, though Lillian could sense the tension simmering beneath the surface. "Watch for bleeding when you connect the conduit."
Lillian nodded again, her hands tightening slightly around the instruments as she prepared for the next step. The graft had to be secured without damaging the surrounding vessels, which meant she needed to be precise—no shaking, no hesitation.
Her fingers trembled slightly as she worked, but she quickly adjusted, trying to steady her nerves.
The graft slipped into place, and she could hear the faint approval in Rebecca’s tone as she spoke again.
But the pressure wasn’t letting up. Every move felt scrutinized, every second longer than the last.
And then it happened. A brief, almost imperceptible hesitation as Lillian reached to clamp a vessel.
It was only for a split second, but it was enough.
The clamp slipped, and a small spurt of blood escaped, staining the sterile field.
Lillian’s heart dropped as her stomach twisted.
She froze for just a moment, unsure of how to fix it.
"I-I can fix it," Lillian stammered, reaching quickly to correct the clamp.
Rebecca stepped in, her movements swift and controlled, overriding Lillian’s. "No. I’ll handle it," Rebecca said, her tone cold, but not harsh. It was the tone of a surgeon who didn’t have time for mistakes. "Just focus on your next step."
The bleeding was under control in seconds, but the shift in the room was palpable.
Lillian’s cheeks burned with embarrassment, her hands suddenly feeling clumsy and wrong.
She had hesitated—just for a second—but it had been enough for Rebecca to have to step in.
The surgical team was still focused, but she could feel the unspoken judgment hanging in the air.
The pressure mounted. Every movement felt heavier now, more critical. Lillian’s hands were steady, but inside she was unraveling, second-guessing every step, every decision. She could barely focus on the rest of Rebecca’s instructions as the weight of her mistake settled like a stone in her chest.
The steady rhythm of the heart monitor that had been the backdrop to the operation began to falter.
Lillian’s focus, already stretched thin by her earlier mistake, snapped back to the patient as the beeping sped up, then slowed unnervingly.
Her heart seemed to mimic the erratic pattern, tightening with each irregular sound.
“BP is dropping rapidly, doctor,” the scrub nurse announced, her voice tense but professional.
Lillian’s stomach lurched. She knew immediately that something was wrong, and her eyes darted to the site of the graft. Had she missed something? Her mind raced through the possibilities, but nothing seemed to add up. She hadn’t seen any signs of complications—at least, none that she’d recognized.
Rebecca’s voice cut through the tension, sharp and demanding. “Lillian, check the anastomosis. Quickly.”