CHAPTER 1 #2
Instruments. Exits. Breath. Long, on the third.
"Because somebody was on the wrong side of a window once," I say. "Because I know exactly what that costs, and I am done paying it blindly."
He is very still.
He files the answer with a surgeon's care for a vital that he is going to look at later in the chart and know what it means.
"You ran the pediatric medication dosing protocol at St. Margaret's for the surgical recovery unit," he says.
"You wrote the second revision. The Wednesday conference opens with a five-minute nursing-quality report before the morbidity-and-mortality cases.
You will present there. I will call on you third. "
"Yes, Dr. Romanov."
"You will hand the protocol to my office by five tomorrow."
"Yes."
"Do you take tea?"
The question is out of register and on register at the same time. The kettle has worked the bergamot out of the tin and the bergamot is in the room. He has not made a cup for me; he is offering to.
"I take it when it is offered, Dr. Romanov."
He stands. The standing is the slowest thing he has done since I came into the room — not slow because of weight, slow because nothing about him is hurried.
He goes to the credenza. He pours from the small electric kettle into a cup.
The leaves are loose-leaf; the tea is darker than I take it.
He sets the cup in front of me. He does not pour a second.
"Drink," he says.
I drink. The cup is hot at the lip. The tea is over-steep by a count of forty seconds — Earl Grey, slightly bitter, with the bergamot at the front of the tongue and the malt at the back. I do not say it is over-steep. He knows. He poured it that way.
"Don't call me Rossi like I'm a chart, Dr. Romanov."
It is out of my mouth before I have planned the sentence.
The chamomile cup at eleven, the M his eyes narrow one degree, the closest he has come to a tell in a quarter hour. The watch answers before he does. His right thumb moves on the crown of the watch — a touch a fraction of a second long — and then he is still again.
"Rossi," he says.
The word is precise. The word is filed.
I take a second sip. The bergamot has settled into the back of the cup. I file the word back.
"Understood, Dr. Romanov."
"Make the protocol legible. Hand it in. Be on time. Five minutes Wednesday. Three slides. No apologies. The case is the case."
"Yes."
"You are dismissed, Rossi."
I set the cup on the desk. I stand. I walk to the door and do not look at the third shelf on the way out.
He does not say anything to my back.
In the corridor I do not lean against the wall.
I mark the stretch from the door to the elevator. Forty-two steps. The same number as the locker room. The hospital has built itself around the number forty-two for me today and I am not going to argue with a building.
---
At one o'clock I am in the cafeteria and there is a small white bag on my tray that I did not put there.
I lift it. Earl Grey teabag — loose-leaf, the same bergamot, the same brand as the cobalt tin in the chief's office. A small folded note on the inside layer in a hand that is not Sister Mary Catherine's and not Beatriz's. The hand is lyrical and right-leaning and Russian-trained.
If you would. The brand is the chief's. The taste is mine.
No signature.
I look up. A man in hunter-green scrubs is leaving through the far doors with a takeout container, sandy-haired, light beard, six-foot-one, a four-strand braided leather cord visible at his left wrist above the cuff of his coat. The doors close behind him before I can be sure.
I sit. I put the bag at the corner of the tray. I eat the pasta. I touch the medallion at the V of the scrub top once, the second time today, and let the hand drop.
---
At two o'clock I am in the OR-3 gallery and I am alone.
The chief is not in his office; Beatriz told me at the door — Mija, if you've never seen the gallery, the chief uses it for teaching; you can sit in on a mitral repair at fourteen-hundred. The implication being that the chief had said so. I do not test the implication.
The gallery is twelve feet by twenty, glass front overlooking the OR floor twelve feet below, brass rail at waist height running the length of the glass. The rail is cool to the touch. I have my right hand on it before I think about it.
Below me, OR-3 is open and lit. The OR lamp is on. Three articulated arms folded out into operating position. Four bulbs running, four arms, four shadows over the table that is no longer empty.
A draped patient lies under the lights. Mitral valve repair, Beatriz said.
The surgeon at the head of the table is in hunter-green scrubs, his hands inside the chest. His sandy hair is up under a green cap and his light beard is hidden under the mask, but the cord at his left wrist — four-strand braided leather, dark cognac brown, the brown of a saddle stitched by hand — is visible above the glove cuff.
I watch his hands. I have been counting hands at operating tables for four years; counting hands is how I do not count the patient.
His are precise. They tap the cord with the index finger of the right against the thumb in a pattern of four — one, two, three, four — every minute and a half between maneuvers, a rhythm he keeps to himself and not for the room.
The instrument tech reads him before he speaks.
The room runs on him. The four shadows under the lamp move when his hands move, and they are the same four shadows that were quadruple-cast over an empty table at nine in the morning.
At fourteen twenty-three he sets a retractor. He lifts his eyes. He finds the gallery. He finds me.
The mask is up; the cap is on; the hazel of the eyes is the only thing I can read across the glass and twelve feet of vertical air and the brass lamp. The eyes find me, register me, and go back down to the chest in the same four counts.
I do not move my hand off the rail. The brass is no longer cool against my palm.
He has placed an Earl Grey teabag on a stranger's lunch tray today, and the hands he is operating with are the hands that placed it. I am being seen, and the seeing is being done at a tempo I have not heard before.
---
At three thirty I am in the Floor 8 pharmacy signing the controlled-substance cabinet log for the daily-witness rotation.
The cabinet is along the north wall. Double-key, biometric, ledger signed by the on-shift pharmacist and witnessed by the charge nurse.
The pharmacist — sixty-some, bifocals on a chain, gray cardigan — turns the page of the leather-bound ledger.
The signature beside hers from the prior shift is precise and right-leaning and matches the hand on the note in the cafeteria.
I do not say so. I sign my own name as observer in the column the pharmacist points to.
"Pull sign-off Thursday," she says. "Your print is already in the witness field. Until Pharmacy clears the competency, you cannot pull alone."
"Understood."
"Also. " She closes the ledger. "If you go past trauma bay six tonight, the emergency oxygen rack is leaking at the regulator. Slow leak. You can hear it if the room is quiet. Maintenance flagged it two months ago. Maintenance has flagged maintenance back. Do not lean on it."
"Two months."
"Two months. " She looks at me over the bifocals. "Welcome to St. Jude's."
I walk past trauma bay six on the way to the freight elevator. The third regulator hisses, just barely — a thin sustained note at the edge of audible. I listen from the doorway for four beats. I do not lean on the cylinder. I file rack 6-C and the two months of unanswered maintenance.
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