Chapter Two
Dr. Ava Davenport was having an unexpectedly smooth evening at work.
As a resident in the emergency room, nights were usually filled with shouting orders, fluids flying everywhere, and a lot more jogging than she ever expected.
Tonight, though, she lounged on a break room bench, sipping coffee from her travel mug and hoping it would carry her to the end of her shift at six a.m.
Eleanor, another ER resident, sat with her, using her coffee cup to conduct an invisible orchestra of frustration.
“It’s ridiculous,” she continued. “I’ve dropped every hint short of skywriting ‘Eleanor likes Zach’ over the hospital, and he—” She threw her free hand in the air. “Nothing. The man has the emotional intelligence of a tongue depressor.”
Ava laughed. “He’s just oblivious.”
“Oblivious?” Eleanor twirled a black curl around her finger. “Ava, I literally asked him if he wanted to get drinks last week. You know what he said? ‘Oh, are a bunch of people going?’ A bunch of people?!”
“To be fair, we usually do go out in groups—”
“I said ‘just us,’ and he was like ‘cool, I know a good sports bar.’” Eleanor slumped against the bench. “A sports bar. He spent an hour explaining the Titans’ defensive line while I was wearing my good mascara.”
Ava tried to suppress her grin. “Maybe he’s just really into football.”
“He’s really into being dense is what he is.” Eleanor pulled out her phone. “I’m this close to texting him: ‘Hey, I think you’re hot, want to make out?’”
“That would certainly be direct.”
“Right?” Eleanor looked up, eyes bright with mischief. “No room for misinterpretation there.”
Before Ava could respond, her own phone buzzed on the table. She cursed when she saw the name Henry.
Eleanor scooted closer, curiosity instantly overriding her dating woes. “Ooh, you two still do phone calls?”
“We try, but the conversations are…flatlining.”
Eleanor exhaled a laugh. “Yeah, all you ever talked about was medicine and sex. Take away the sex, and it’s just work.”
Ava and Henry had met early in medical school, instantly bonding over shared classes and ambition before tumbling into bed.
She thrived in the frenzy of the ER while he buried himself in cancer research, and though they were both residents at Vanderbilt, they rarely crossed paths.
Four months ago, Ava ended it, and their attempts at maintaining friendship, though mostly her effort, felt strained.
Ava dismissed the call and set her phone to Do Not Disturb.
“I’d rather hear more about Zach,” Ava said. “Have you considered that maybe he thinks you’re out of his league?”
A commotion erupted outside, and shouts for backup followed suit.
Ava and Eleanor immediately switched into their doctor personas, rushing into the hallway.
Their attending, Vickie, was wild-eyed as she spoke to a nurse, her scrubs splattered with a dark, wet spray of red.
As soon as she spotted the two of them, she thrust clipboards their way.
“Dr. Davenport—room 211. Dr. Hampton—room 217. Family car crash. Drunk driver hit them head on. Mom’s DOA. Dad and son are critical. Go.”
“Shit,” Eleanor breathed, jogging toward room 217.
Ava followed, turning into room 211 and throwing the clipboard aside at the sight of the mayhem.
She hadn’t looked at the patient’s date of birth, but she hadn’t expected such a small boy on the gurney.
His cheeks, soft with baby fat, were stained a dark red that matched the splotches on his clothes and in his hair.
Pushing past nurses hooking him to oxygen, Ava checked the pulse oximeter on his finger: eighty-nine percent. Hypoxemia.
Not good.
She sidestepped the nurse putting in an IV and went to look at the extent of his head injury.
Definitely qualified as a TBI. The laceration was deep, and she could tell without a scan that his skull was fractured.
Pulling each eye open, she shined a flashlight and noticed that one pupil was bigger than the other: increased intracranial pressure.
Worse.
When she glanced at the oximeter again, she was startled to see that the nurses were taking his blood pressure. The reading had dropped to seventy-eight percent: critical hypoxemia.
Ava pressed her fingers to his wrist to check his pulse, and when she felt nothing, she screamed for a crash cart. He’d slipped into cardiac arrest.
Her hands moved automatically, pressing hard and fast into the boy’s chest. She felt the sickening give of his ribs under her palms.
Voices buzzed around her, fading to a hum. She focused on compressions.
The nurses managed to connect the ECG. The monitor answered with a flatline, telling her nothing she didn’t already know.
Vickie came from behind, pushing Ava aside and slapping two pads to the boy’s chest. The defibrillator barked instructions, its shrill voice cutting through the room. Ava knew to step aside, predicting the next set of instructions would tell her attending physician to press the shock button.
“Clear!”
A shock jolted through him. Vickie tracked the heart monitor while Ava resumed chest compressions. They continued the cycle until Ava felt like bones would tear through her skin: step back, shock, compressions.
The heart monitor stayed flat, but she couldn’t stop. Someone shouted her name, but the patient wasn’t stable yet. His heart wasn’t beating.
Two gloved hands wrapped around hers, stopping her mid-push. Vickie yanked her back.
“Time of death: 12:05 a.m.”
Ava’s knees buckled, but Vickie held her in silent solidarity.
Ava always saved her patients. Always.
“Dr. Davenport, I’m sorry,” Vickie said, her voice still distant. “Start the documentation and paperwork for me. I need to check on Dr. Hampton. There’s nothing else I can do here.”
The smell of the room—iron and antiseptic—hit Ava all at once, and she shoved past Vickie to vomit into the sink.
In the back office, Ava collapsed into her desk chair and stared at the blank computer screen.
Med school had prepared her for death in the abstract—all statistics and protocols.
No one had prepared her for the specific weight of a child on the gurney or the way time distorted in a trauma bay, expanding and collapsing until she couldn’t say if it had been four minutes or forty.
She had done everything right. She knew she had. It just hadn’t mattered.
After a long moment, she stood and headed for the second-floor locker room.
The shower was methodical, her brain on autopilot.
Her hands moved through the motions while her mind kept stuttering back to the room, the monitors, the rhythm that wouldn’t return, and Vickie’s hand on her shoulder.
She stayed under the spray longer than she needed to, until the heat started to fade and she had no excuse left to stay.
She tied her wet hair into a messy bun and slipped into spare green scrubs, which were technically out-of-uniform but the only ones she had. Her blood-specked set was in a biohazard bag now.
Slinging her shoulder bag on, Ava set her path toward the ER. The paperwork was waiting. Documentation was necessary for every patient, but the death of a child required more.
Walking down the dark hallway outside the locker room, she thought about having to read the boy’s chart. She’d know his name, how old he really was, and she’d eventually find out where his body was sent now that it didn’t need to take up a bed.
She detoured, finding that she wasn’t in a rush to get back after all. Vickie had given her an hour to recover, but it was hard to move on when her mind fixated on the surviving father. His life had been shattered by a drunk driver’s selfish choice.
The driver was likely fine.
A side exit led to a small courtyard between the hospital and a parking garage. Ava pushed through the door without thinking, following the pull of being anywhere but inside.
The night was cool, temperatures finally dropping below sixty degrees. She stood still for a moment just outside the door, letting her eyes adjust.
She thought about the father again and made herself breathe through it. In through the nose. Out slow.
You can’t carry all of it. You carry what you can and you keep moving.
She wasn’t sure who had told her that. An attending, maybe. Or maybe she’d told herself so many times it had stopped having a source.
It didn’t help as much as she needed it to.
Ava closed her eyes, savoring the breeze and the crickets.
Cigarette smoke, however, broke through her calming moment.
A man paced at the courtyard’s far end, smoking steadily. Tall, lean, and dressed in black, he moved with a jagged, nervous energy. He took three steps forward, turned, then three steps back.
Ava considered mentioning the no-smoking rule but held back. The way he moved like he was trying to outpace his own thoughts told her he needed it more than she needed the clean air.
She dropped her gym bag and rolled her shoulders, feeling vertebrae pop. Her neck ached from hunching over patients. She let her head fall back, eyes closed, just breathing for a moment that was hers alone.
When she opened them, the man had stopped pacing.
He was staring at her.
She couldn’t make out his features from this distance—only his silhouette under the dim courtyard lights and the orange glow of his cigarette.
He took a step toward her, moving into the edge of the lamplight, and something snagged in her chest before her brain caught up. The jaw first—that particular set of it.
Her breath stopped.
Jay Wyler looked as tattered and tired as she remembered, stress hanging heavy around him. But it was the pain in his eyes that undid her—that specific, bone-deep exhaustion she had spent years trying to fix. She knew its edges and had watched it swallow him once before.
She had not expected to find it here.
When their eyes met, he sucked in a breath. “Ava?”
The seconds ticked by slowly. She had already thrown up once tonight. Her body seemed ready to do so again.