Chapter 2
CHAPTER TWO
RIVEN
My mind never fully shut down, even when exhaustion pressed on me like a heavy blanket. So when my phone buzzed against the nightstand at three in the morning, it almost came as a relief.
“Dr. Cross,” I answered, voice steady, controlled."
“This is Jason from ICU. We’ve got a multi-vehicle pileup coming in. One patient has a severe blunt force trauma, possible cardiac contusion. Could be myocardial rupture. ETA thirty minutes.”
I was out of bed before he finished speaking, crossing my room in the dark and pulling clothes from the closet by muscle memory alone.
"Who's available to scrub in with me?"
"Miller's in another case. I can try to pull someone else—"
“Page Mireya Rosen. Tell her I need her immediately."
The line went quiet for a moment. “Dr. Cross, she just finished a thirteen-hour shift. She left about an hour ago.”
"I'm aware." I grabbed my keys and headed for the door. I paused at the end of the hallway and glanced toward my sister's closed bedroom door. Asleep. Safe. I pulled it shut with a soft click before heading for the elevator.
The penthouse was quiet at this hour. It usually was.
"Page her anyway. Tell her it's critical."
Because it was critical.
When someone's heart was failing, when every second meant the difference between life and death, I needed hands across from me that I could trust without question. Mireya Rosen had those hands—they didn't shake, didn't miss, and didn't hesitate when it mattered most.
The drive to the hospital usually took twenty minutes with traffic.
At three in the morning with empty streets, I made it in ten, speeding down the 405 and running every yellow light that threatened to turn red.
The ER was frantic when I arrived, nurses prepping trauma bays and techs shouting updates to each other as word of the incoming pileup spread through the floor.
I cut through the chaos toward the surgical wing, nodding at a few familiar faces but not stopping to talk.
My mind was already running through the procedure before I even reached the doors.
Cardiac contusion from blunt force trauma could deteriorate rapidly—progress to tamponade, arrhythmia, even cardiac arrest. Depending on impact severity, we might be looking at myocardial rupture, valvular damage, or coronary artery dissection.
I pictured the heart bruised and swollen, struggling to keep pumping.
The image settled into my brain as I scrubbed in alone, letting the hot water wash over my forearms. It made my skin red, but it didn’t matter.
I thoroughly worked the betadine foam up to my elbows, the way I'd done a thousand times before.
The OR doors swung open behind me.
“Patient’s two minutes out,” one of the nurses called. "Dr. Cross, your first assist just arrived."
Mireya walked in looking like she'd been pulled straight from sleep. Her hair fell loose around her shoulders, but her eyes were sharp, alert, and already assessing. She stepped up beside me at the sink and started scrubbing, water running over her hands in the same rhythm I'd just finished.
Professional. Reliable. Exactly what I needed. I kept my eyes on my hands and not on the way the surgical light caught the amber in her eyes above her mask. That observation was irrelevant. I filed it away and didn't examine it.
She didn't complain or ask why I'd called her specifically. She just got to work.
"Twenty-eight-year-old male, unrestrained driver. Steering wheel impact, anterior chest wall," I said, keeping my focus on my hands. "Vitals unstable. Suspected cardiac contusion, possible progression. We need to move fast."
“Understood,” she replied, voice even and firm. Calm as ever.
Not a trace of resentment at being called back in.
The patient arrived on a gurney with paramedics and ER staff calling out vitals and trauma assessments. I blocked out the noise and focused on the monitor showing the erratic heart rhythm, the irregular chest movement, and the bluish tint to his lips.
Oxygen wasn't reaching where it needed to go.
We transferred him to the operating table. Sarah helped me into my gown and gloves while Mireya took her position across from me, already gloved and gowned. The anesthesiologist called out numbers that didn’t sound promising.
“Let’s open him up,” I said.
I cut clean through skin and tissue. Mireya had the retractor ready before I asked, holding it with the right tension while I worked deeper. The heart was swollen and bruised from the impact, fighting to keep beating despite the damage.
“There.” I pointed to a small tear in the left ventricle that was leaking with every struggling beat. “We need to repair that before he arrests.” —
“Suture,” Mireya said.
She placed the suture in my hand before I reached for it. I didn't react. In the OR, I never did. But I registered the precision of her, the way she read me without being asked, and I found I didn't want to examine why that felt like more than competence.
This. This was exactly why I called her in despite the hour or her fatigue. She was efficient and always anticipated what I needed before I said it.
But if I was being honest with myself, it wasn't just her skill that steadied me.
It had been six months of this. Six months of her hands across the table from mine, anticipating every move before I made it. Six months of telling myself it was professional respect and nothing more.
She was my first assist. My employee. The power gap between us was wide enough to make any other truth completely off the table.
So I kept my eyes on the patient and said nothing.
I stitched the tear carefully, each pass of the needle counted and controlled. The room fell into the rhythm I preferred during surgery, only the sound of the monitors and the ventilator's mechanical breathing filling the space.
No wasted words. Just focus.
The heart responded. The tear sealed. The monitor showed improvement—rhythm stabilizing, blood pressure climbing incrementally but steadily.
“Check for additional damage,” I ordered, examining the surrounding tissue.
Mireya adjusted the retractor to give me a better view and I found a second small tear near the apex. I sutured it closed and reinforced both repair sites. My lower back had started to ache somewhere around hour four. I ignored it.
"Bleeding's controlled," the perfusionist confirmed.
"Keep going," I said. "We're not close yet."
The next two hours moved the way long surgeries always did. Slow and relentless. The team stayed sharp because I expected them to. Mireya stayed sharper than any of them.
We finished up in the OR hours later. My neck ached from hours bent over the table. My eyes felt gritty with exhaustion. But the patient was stable, alive, heading to ICU with a genuinely good prognosis for full recovery.
That was all that mattered.
I stripped off my gloves and gown, tossed them into the biohazard bin, and headed for the scrub sink.
Mireya was already there, water running over her hands.
Even from behind, I could see her exhaustion—the slump of her shoulders, the way she leaned against the sink, the slight tremor in her fingers she was trying to hide.
“Go home,” I said, stepping beside her.
She glanced sideways at me. "I have an administrative meeting at eight."
I checked my watch. Six-forty-three. "You have time for a couple hours' sleep."
“Barely.” But she didn’t move. She just kept scrubbing, her movements almost compulsive.
I almost asked if she was okay. She was a competent professional and an exceptional surgical nurse. She could manage her own well-being.
Then she reached over without a word and pressed something into my palm. Two white tablets.
I looked down at them.
"You've been rolling your neck since the third hour," she said simply, eyes still forward, rinsing her hands. "There's a water bottle in my bag."
I didn't say anything. I wasn't sure I could.
This was the part I never let myself think about. Not in the OR, not in the hallways, not in the three seconds between closing my eyes and falling asleep. The part where she was just like this. Quiet and certain and so unbearably perceptive that it felt, sometimes, like an accusation.
I had been careful. Cold when I needed to be, which was often. Short with her in ways I wasn't short with anyone else, because distance was the only architecture I knew how to build fast enough. Half the floor probably thought I didn't like her.
I had done nothing to correct them. It was easier that way. Cleaner.
Her fingers had already pulled away, but I could still feel exactly where each one had rested against my skin. A ghost of warmth in the center of my palm. I closed my hand around the ibuprofen slowly, like I was trying to hold onto something I had no right to keep.
No right. That was the phrase for it. She worked under me. Trusted me to be exactly what I had always presented myself as. Professional. Detached. Unreachable. The kind of surgeon who didn't blur lines because he understood what lines were for.
When I finally looked at her, she was already looking at me. Just for a moment. Just long enough.
She held out the water bottle and our fingers touched at the handoff. Briefer than brief. The kind of contact that meant nothing between colleagues.
My exhausted, traitorous heart didn't seem to know that.
Through a two-hour surgery and bone-deep fatigue, she had noticed my neck.
I wondered, not for the first time and hating myself a little for it, whether she felt any of this the way I did. Or whether I was simply a difficult attending she had learned to read the way you learn to read weather. Not out of feeling. Out of survival.
I almost hoped it was the second one.
"Thank you," I said. My voice came out quieter than I intended.
The corner of her mouth curved. Not quite a smile. Just the suggestion of one.
"Goodnight, Dr. Cross."