28. Seamus
twenty-eight
Seamus
A Few Weeks Later
Here goes nothing.
I’m about to pitch a study on female sexual response to one of the most respected doctors in the program—while half the hospital still thinks I’m conducting my own trials in the stairwells.
Smart.
Real smart.
I navigate through the maze of tables, my eyes scanning for Dr. Roberta Madison, one of my supervisors during my OBGYN rotation a couple years ago. Spotting her near the window, I make my way over.
The importance of the impending conversation presses down on me.
“Dr. Madison.” I attempt a smile as I slide into the seat across from her.
“Seamus,” she acknowledges. “It’s been a while since we’ve last talked. What’s going on?”
The hum of the hospital cafeteria surrounds me—a low murmur of conversations. Clinking utensils against plates. The occasional burst of laughter. It’s a familiar symphony, one I’ve grown accustomed to over the years.
Today, it feels distant. Background noise in a world slowly shifting underneath my feet.
Dr. Madison sips her coffee, her sharp eyes studying me over the rim of her cup. As my OBGYN mentor, she always had an uncanny ability to see right through me, to peel back the layers and get to the core of whatever’s on my mind. It’s both comforting and unnerving.
It’s also the reason I’m here.
“I’ve been giving a lot of thought to my upcoming R-5 year and what subspecialty interest I’d like to pursue.” I take a deep breath, steadying myself. “I’m interested in neural mechanisms underlying female sexual function.”
Her eyebrows lift, a mixture of curiosity and intrigue flashes across her face. “What a fascinating area. Not many venture into that territory.”
“Part of the appeal.” I offer a slight nod.
She leans back in her chair and crosses her arms. “Alright, Seamus. Walk me through it. What’s driving this interest?”
“Over the past few months, I’ve felt…off.” I choose my words carefully. “Not with the work itself—it’s the environment. The hospital is tense. Unpredictable. I’m not na?ve enough to think people aren’t talking.”
Dr. Madison crosses one leg over the other, her gaze unreadable. “You’re referring to your situation with Caldwell.”
“Yeah.” I exhale. “I’m sure you’ve heard what happened. The case. Miranda Black.”
“I heard some things,” she says evenly. “Rumors, statements. I’ve read between the lines.”
I nod. “He hasn’t spoken to me since the settlement. Not a word. No eye contact. No acknowledgment. Honestly, it feels like my name has been quietly circled in red ink. I’m not saying I’m being sabotaged. I’m not getting invited to the table either.”
“You're concerned this situation will follow you into R5 and beyond?” She tilts her head.
“Of course it will. Next year I have an opportunity. We're meant to dive deeper into something we care about, right?” My hands are gesturing more than normal because I feel like this is my only chance to salvage things here in Seattle. “The goal is to explore something meaningful to further my studies. Originally I wanted to go into neurosurgery because of my family’s history with alcohol. It’s not what’s driving me anymore. ”
She leans back, still listening.
“I’ve worked hard for over a decade. I’m terrified if don’t branch out from under Caldwell’s shadow—it won’t matter what I do. The doors will still be closed.” I sigh.
“So?” she prompts.
“I want to design a research track.” I meet her eyes.
“Neurosurgical implications of female sexual dysfunction. Brain connectivity, arousal response, regional mapping—what we know, what we don’t.
I want to spend my R5 year working on it.
Clinical data, neuroimaging, maybe even collaboration with OBGYN. ”
I pause. Waiting. I've dangled the carrot.
“Ah.” She steeples her fingers, eyes narrowing with curiosity rather than judgment. “Why this subject, Seamus? Why now?”
I hesitate, only for a second. If I want this to work—if I want her to trust me—I have to be real. Even if this is extremely personal.
“I’ve fallen in love…” Her eyebrows lift, just slightly as I continue, “…with a woman who’s never, until me, been with someone who actually understood how to give her pleasure.
Without going into the long, sordid history, my interest in this subject started a long time ago.
I started reading studies about the neurobiology of female arousal back in med school.
It wasn’t required, I first stumbled across the research after a class on cortical sensory maps.
The variability fascinated me and, as I’ve been thinking about my future, realize it still does.
Humans—mainly men—seem to think sex is a simple binary mechanism.
It's not, especially for women and their desire and ability to orgasm.”
She holds up a hand. “I didn't expect our conversation to go in this direction.”
“Look, I'm not trying to make you uncomfortable. This isn't salacious. It's truly important to me.” I shift in my chair because it sucks this topic feels taboo, even in the medical realm. This is part of why I want to tackle it. “Neurosurgery’s always been my plan and still is. However, this is a chance to explore how brain function plays into something most people dismiss as emotional or behavioral. I don’t want to chase tabloid science. I want to do this with intention. Rigor. Data. Yes, maybe a little fire under my ass, because my back is against the wall right now.”
I stop for a moment to gauge her response.
“Go on.” Dr. Madison settles back into her chair.
“Sure. I’m struck by how little we understand about the neural mechanisms underlying female sexual function.
” I decide to lay it all out there. “Especially given the studies indicating specific brain regions—like the medial frontal gyrus, inferior frontal gyrus, putamen, and entorhinal cortex—play roles in sexual desire and arousal. There’s still so much uncharted territory to explore. ”
Dr. Madison’s gaze sharpens. “You’re referring to the fMRI study on HSDD?”
“For one,” I reply, leaning forward. “In that particular study, women with hypoactive sexual desire disorder were shown to exhibit different activation patterns compared to those without the condition. Understanding these differences could be pivotal in developing targeted treatments.”
She lifts her chin, contemplating. “Do you believe neurosurgical interventions could play a role in addressing these dysfunctions?”
“Well, it’s certainly a possibility worth exploring,” I say earnestly. “If I can pinpoint the neural circuits involved, there might be ways to modulate them, either surgically or through neuromodulation techniques.”
Dr. Madison’s lips curve into a thoughtful smile. “Ambition has never been your shortcoming.” Then her brow furrows. “Let me ask again. Why now? Don’t give me the poetic answer—give me the practical one.”
“Um…” I brace myself. “Despite my situation with Caldwell, I’d rather make something of this moment than sit around waiting for someone to decide my future.”
She hums. “What about the stairwells?”
“Excuse me?” I freeze, mortified.
“You’ve got a reputation,” she says plainly. “You’re smart. Talented. Too smooth for your own good. Plenty of extracurriculars, from what I’ve heard.”
My face flushes. I tamp it down because this is serious to me, so I hold her gaze. “I’m not going to lie. I’ve had consensual sexual encounters with a handful of women at the hospital. Nurses and other residents mostly. I can explain. It’s not what it probably seems like.”
Dr. Madison says nothing—just watches me. Calm. Neutral. A little too quiet.
“It started during med school,” I go on, shifting again in the uncomfortable cafeteria chair as I explain what happened with Tara and Priya.
“When I started my residency, there was a nurse I worked with who was smart, competent and older than me by a few years. We were on overnights together, and one night, we were standing outside the on-call room waiting for a consult when she kissed me. Told me she’d heard about my ‘research’ and wanted to participate. ”
My lips twitch with the memory—how nervous I’d been, how electrified. “We slipped into the stairwell. I used a couple of techniques I’d mastered. Let's just say they worked well. Afterward she told me no man had ever paid attention to her body like I had.”
She purses her lips. I keep going. At this point, I might as well.
“She wanted to keep meeting. Once, sometimes twice a week. Same spot, same rhythm. I thought we were building something—this connection, you know?” I think back to when it was happening.
“After a month or so, she told me the truth. She had a boyfriend and saw a future with him, and wanted to have a secret relationship. Obviously, I ended it.”
I glance down. “She told her friends about me, though. Loose-lipped bragging, I guess. Suddenly, I started getting approached. Women who were curious. Frustrated. Looking for something private, easy, safe. I had more offers than I could keep up with—I never initiated any of this.”
“How come you felt compelled to saying yes?” Madison grimaces, not exactly unkindly. More like…pointed.
“Um.” I look away for a second. “You have to understand, I was lonely. It was an outlet—a pleasurable one. For me it was clinical. Each woman was different. How they responded. What made them unravel. I was careful—consensual, clear about boundaries, always…”
I trail off, eyes flicking up to meet hers.
I sound like a tool. “Look, I didn’t realize the reputation I was building.
Or the nicknames I was given. I didn’t understand or even imagine the women would be confused about my own intentions.
Or, how this shit could follow me. Looking back, it was a little fucked up. ”
Dr. Madison leans back slightly. “Well yes, if you were experimenting with the staff.”
“God…” Fuck . She's right. I nod again. “I should have had better judgment. With the exception of one incident last year, I stopped over two years ago. It started to feel hollow.”