Chapter 3 Sienna
SIENNA
Elise was furious.
It was in everything: the rigid set of her jaw, how she held her injured arm cradled against her body with her good hand, the tight, controlled anger radiating from her in waves.
She was sitting on the treatment bed in the medical room, still in her full hockey kit minus the helmet and gloves, and she had not stopped talking since they'd walked through the door.
The room smelled of antiseptic and adhesive and the sharp, cold-air scent of a player fresh off the ice.
Somewhere in the building, a game was still being played.
In here, the world had shrunk to two people and an injured shoulder and the argument between them.
"You didn't even try. You didn't even attempt to assess whether I could play on. You just pulled me off the ice."
"I assessed you on the ice." Sienna kept her voice even as she washed her hands at the sink, scrubbing between each finger with methodical focus.
The water was warm and the soap smelled of eucalyptus and she focused on the sensation of it, grounding herself before she turned around to face the storm.
"I made a clinical judgment that you needed further examination. "
"You made the judgment in about ten seconds."
The tap ran. Sienna rinsed the soap from between her fingers. "Sometimes ten seconds is enough."
"It wasn't a playoff game. You said that. You actually said that to me while I was lying on the ice."
Sienna dried her hands and turned around.
Elise's green eyes were blazing, and the flush along her cheekbones wasn't just from exertion.
The anger was obvious. Beneath it, Sienna recognised embarrassment and fear, the triad she'd seen in every injured athlete who'd sat on that bed.
Anger was always the first response. The fear came later, when the adrenaline wore off and the quiet set in.
"I said it might be different if it was a playoff game.
That's an honest answer." She met Elise's eyes and held them.
The frustration pushed back at her, hot and insistent, but she didn't budge.
She'd had this conversation before, with other athletes, in other medical rooms. The anger was never really about the decision.
It was about the loss of control. "And for the record, I don't question my call.
If I thought you could have played on safely, I would have let you. "
Elise opened her mouth, then closed it. The steadiness in Sienna's tone must have reached her, because some of the fight went out of her shoulders.
"Now. Can I look at your shoulder?"
Elise exhaled hard through her nose. Her nostrils flared. "Fine."
Sienna pulled on a fresh pair of latex gloves, the snap of the rubber loud in the quiet room, and approached the treatment bed.
She stood beside it and began her examination.
Observation first, as she'd been trained: assessing from a step back before touching.
The alignment was off. Elise's left shoulder sat visibly lower than her right, and the swelling was already forming along the anterior joint line, a puffiness that disrupted the clean lines of her deltoid.
The bruising would develop over the next few hours, but Sienna could already see the faint discolouration starting beneath the skin.
She moved to palpation, stepping closer. This was clinical. This was her job. She pressed gently along the clavicle, the acromioclavicular joint, the head of the humerus. Elise was rigid beneath her fingers, every muscle locked against the pain, but she didn't flinch away from the contact.
"Tell me when it hurts."
"It all hurts."
"Tell me when it hurts more."
Sienna pressed along the anterior joint line and Elise hissed through her teeth.
The shoulder was unstable. The joint had clearly subluxed during the impact, and while it had partially reduced on its own, there was significant laxity when Sienna tested the anterior drawer.
The labrum was involved. She was almost certain of it.
But she needed imaging to confirm.
"I need to do a more thorough examination." Sienna stepped back and met Elise's eyes. "I'll need to cut off your jersey and shoulder pads. Just down to your sports bra."
Elise held her gaze. The anger was still there, but layered with vulnerability now, and the awareness that they were alone in a small room and Sienna was asking her to undress.
After a moment, Elise nodded once and Sienna began the slow process of removing her gear.
The jersey came off first, Sienna taking her scissors to it. Then the shoulder pads.
Underneath, Elise was in a stretchy compression shirt that clung to her torso. She pulled it over her head one-armed, her face tightening with pain as the movement jarred her shoulder, and then she was in her sports bra, sitting on the treatment bed and the room was very bright and very quiet.
A sweat-dampened strand of dark hair had come loose from Elise's ponytail and was stuck to her temple. Sienna wanted to reach out and tuck it back. She gripped her tablet instead.
Sienna had seen this body in the medical room earlier tonight. She'd noted it from a safe distance, noted the strong shoulders and the lean arms with the clinical detachment she applied to every player on the roster. An anatomy lesson. A professional assessment.
This was not that.
This was inches away. The light was unsparing, and Elise's skin was damp with sweat and flushed from two and a half periods of hockey, pink along her collarbones and across the tops of her shoulders.
The muscles of her upper back and arms were visible in sharp relief, a definition that came from years of training and didn't soften with rest. A bruise was already forming along her left deltoid where the shoulder had taken the impact, a dark bloom spreading beneath the skin.
Sienna's medical brain catalogued it. The rest of her brain took in everything else: the way Elise's stomach rose and fell with her breathing, the small scar on her right forearm, the hollow of her throat where a bead of sweat was slowly tracking downward.
She smelled of cold air and exertion and a scent underneath both of those that was warm and clean and entirely unhelpful right now.
Sienna swallowed. Adjusted her glasses. Pulled the professional mask back into place with an effort that took more than it should have.
"I'm going to test your range of motion. Passive first, so I'll be moving your arm. You don't need to do anything. Tell me where the pain starts and where it's worst."
Elise nodded, watching Sienna's hands with an intensity that sent a flutter through Sienna's stomach. Stop it.
She placed one hand on Elise's scapula, warm beneath her fingers even through the gloves, and the other on her upper arm.
She began moving the joint through its range.
External rotation was limited by pain. Abduction beyond ninety degrees made Elise's breath catch.
There was a grinding sensation, subtle but present, that suggested a labral tear.
The apprehension test was positive: when Sienna moved Elise's arm into the position of dislocation, Elise's whole body went rigid.
"Okay. That's enough." Sienna released her arm gently and stepped back. She pulled off one glove to make notes on her tablet, recording the findings in the clinical language she'd been trained in. Positive apprehension. Anterior laxity, grade 2. Suspected labral involvement. Imaging required.
The tablet screen glowed in her hands. Behind the clinical words was a simpler truth: this was bad, and Elise knew it was bad, and nothing Sienna said next was going to make it better.
"So?" Elise's voice was tight. The anger had drained, and what was left was worse. Dread.
"I suspect a partial tear to your labrum with some joint instability." Sienna looked up from the tablet. "But I can't confirm the extent without imaging. An MRI will tell us exactly what we're dealing with."
"How long am I out?"
Sienna set the tablet on the counter. "I genuinely don't know yet. That depends entirely on what the scan shows."
The silence that followed was thick and heavy.
Elise was staring at the wall behind Sienna's head.
Her good hand was gripping the edge of the treatment bed so hard that her knuckles had gone white, and a muscle in her jaw was jumping.
The muted roar of the crowd pressed through the walls, the game continuing without them, and she knew Elise could hear it too.
"I need to get back out there."
"You can't." Sienna kept her voice level.
Through the walls, the crowd surged with a burst of noise. A goal or a near miss. Elise's fingers curled tighter on the bed's edge.
"It's still the third period."
"Elise." Sienna set the tablet down and faced her directly.
"Your shoulder joint is unstable. If you go back out there and take another hit, or fall on it, or even reach for a puck at the wrong angle, you could turn a partial tear into a complete tear.
That's surgery. That's months of recovery. That could end your season."
Elise didn't flinch, but her breathing quickened, three fast breaths before she brought herself back under control.
The anger was still there, but it was thinning, and underneath it the fear was surfacing.
The real fear. Not of pain, but of time.
Of weeks on the sideline. Of watching from the stands while the team played on.
Sienna had felt that fear once. She'd been nineteen, sitting in an orthopaedic surgeon's office in San Diego with a destroyed ankle and a professional tennis career that had just ended, and the panic had been so total that she couldn't hear anything the surgeon said for the first five minutes.
She recognised the look. Elise had gone somewhere inward, jaw tight, beautiful green eyes fixed on the wall above Sienna's shoulder.