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7:00 a.m.
There were rumors all over the hospital about the still unknown new pediatric surgeon who had been hired recently and was finally starting today.
Robby told us that a couple of days ago Gloria had sent him an email informing him about this new “addition” to the staff.
The hospital had never had a pediatric surgery department. It still doesn’t, actually. But apparently this new doctor was going to join the general surgical team first, and Gloria didn’t really have the rest figured out yet. She was just going to see where all of this would lead.
So Robby’s instruction was that if we had a pediatric patient with a probably surgical case, we should call this new doctor so she could come down and take a look.
Everyone kept talking about her; that was literally the only thing we knew, that the new surgeon was a woman.
Ahmad even started another bet: age, previous hospital, and hair color.
And I really wanted to win that bet, so yesterday I decided to ask the only person I knew who might actually know something.
I was finishing up with a patient when I saw García going over some labs at the nurses’ station.
“Heeey, by the way, do you know anything about the new peds surgeon?”
“Why?” she asked, without even looking up from the papers in front of her.
“Oh, there are bets going around: Age, where she trained, hair color… I want to win.”
She finally looked at me, and I don’t think she liked the question.
“We don’t need a peds surgeon,” she said, turning her attention back to the labs.
I scratched the back of my neck, trying to read the tone of her response.
“Well… they already hired her.”
“We don’t even have a peds surgery department.,” she said.
“I know.”
“And they shouldn’t be hiring more staff when they can’t even cover minimum wage for the people already working here.”
Without looking at me, she grabbed her pen and wrote a few notes on the papers in front of her.
And that’s when I realized it wasn’t really the new surgeon that bothered her. She felt like someone was invading her space. And since I’ve become something of an expert at invading García’s space, I decided to push a little more.
“Does it bother you that she might take some of your surgeries?” I asked with a teasing smile.
“We’ve been operating on kids here for years,” she said, finally turning to look me straight in the eye.
“Yeah, and internists manage ventilators too, but that doesn’t make them intensivists.”
Oh. Maybe I shouldn’t have said that.
I could clearly see her jaw tighten, irritation written all over her face. Because she knew it, she knew it wasn’t the same.
After a second of silence, she sighed.
“She did her residency at Johns Hopkins.”
“Fuuuuck.” The word slipped out before I could stop it.
Her eyes narrowed and her eyebrows pulling together slightly.
“What?”
“I mean… it’s THE Johns Hopkins.” I looked at her like she had just told me they had hired a celebrity.
There was another moment of silence while we held each other’s gaze.
“And?”
“I don’t know… it’s impressive.”
“It’s just a hospital, Dr. Santos,” she replied, her tone suddenly sharper than before.
That was the end of the conversation. She put the papers back where she had taken them from and walked away.
9:00 a.m.
My final bet ended up being: 32 years old, Johns Hopkins, and redhead (I decided to trust my gut).
It was barely 9:00 a.m. and I was already seeing my fourth patient.
“What do we have?” I asked Donnie as he wheeled a patient straight from triage.
“Eight year old male with an acute abdomen, he got here about an hour ago, vomiting, fever, abdominal pain that started periumbilical and now it’s in the right lower quadrant… but it’s not localized anymore.”
That last part made me walk even faster.
I glance at the kid, Ethan, as we enter his assigned room, he’s pale, lips dry, breathing shallow.
“How many hours since it started?” I ask, pulling on my gloves.
“Since yesterday… um, more than twenty four hours, I guess,” his mom, Anna, answers. “But we thought maybe something he ate upset his stomach, until it got worse in the middle of the night.”
I barely place my hand on his distended abdomen and involuntary rigidity, diffuse guarding, Ethan can barely tolerate even the lightest palpation.
This isn’t just appendicitis
“Vitals?” I ask Donnie
“Fever 39.2. Heart rate 138. BP 78 over 42.”
Luckily, the labs are already up on the screen: marked leukocytosis with a left shift, C-reactive protein through the roof. The ultrasound shows free fluid in the abdomen and a very ugly-looking appendix.
I exhale slowly. It’s perforated, probably already peritonitis.
I look over at Anna, who’s trying to hold it together next to her son’s bed: “He needs surgery, urgently,” I say, keeping my voice firm but gentle.
“Surgery?… oh god, is it serious?” she asks, her voice breaking at the end.
“It is serious. The appendix has most likely already ruptured, and that’s causing infection in his abdomen.”
“Is he going to be okay?”
I allow myself a second before answering.
“We got here in time to operate, we’re going to stabilize him and take him to the OR as soon as possible. We’ll take care of him.”
Meanwhile, I’m already calculating fluid resuscitation in my head based on his weight and age, adjusting boluses for the orders.
Time is running. And so am I.
Then I remember what Robby said, this is exactly the kind of case for the new peds surgeon.
I step out and ask Dana for her extension.
“1130,” she says, while I’m already dialing.
As soon as the call connects, I start talking. I’m not expecting greetings or phone introductions.
“Santos here, second year ER resident. I have an eight year old with probable perforated appendicitis and signs of peritonitis. I’m taking him to the OR as soon as he’s hemodynamically stable. I need you to come down.”
And I hang up without waiting for a response.
___
Not even ten minutes passed before the elevator doors opened, and it felt like the entire hospital held its breath.
And I noticed it before I even saw her; the gossip.
Nurses who suddenly “needed something” in the trauma area. McKay and Mohan pretending to review charts a little too close to my room. Dana peeking out from the nurses’ station.
God, gossip moves faster than any surgeon.
Then I saw her.
Blonde hair.
Not red. Not ginger. Not auburn.
Blonde.
Whitaker was going to be unbearable.
The new surgeon walked with a steady stride, not rushing, but not wasting time either, like the hospital already belonged to her, at least a little. Her coat was immaculate, no wrinkles, and the ID badge was brand new.
And she stopped right in front of me.
“Dr. Santos?” she asked.
“That’s me. Nice to meet you.”
She stepped forward and held out her hand. “Nicole Johnson. Pediatric surgery.”
Good handshake. Firm. Professional.
Maybe it was my imagination, but I think her gaze held mine a second longer than necessary.
“Thirty two years old and I still think mondays should start with scheduled consults, not a case of peritonitis,” she said, quickly glancing at the ultrasound screen like she just needed to confirm something she already knew.
Thirty-two.
I was so close. Whitaker really only won because of the damn hair color.
“Perforated appendicitis, more than twenty four hours of evolution, free fluid in the abdomen, tachycardic, but responding to fluids,” I briefed her on the case.
“Good call bringing me in when you did,” she said, pointing at the heart rate on the nursing chart. “Another couple of hours and this would’ve been a very different conversation.”
She didn’t smile, but she didn’t look away either when she finished the sentence.
“Let’s see him,” she added. As she walked past me, her shoulder almost brushed mine. “I want you to walk me through how you’re managing him.”
And the entire damn staff was still watching.
Right when we disappeared behind the curtain of the room, I’m pretty sure I could hear the collective gossip start, loud enough to reach the Internal Medicine floor.
____
Later, when Ethan was already on his way to the OR, I finally managed to breathe again.
Whitaker showed up next to me with an unbearable grin: “Blonde, thirty two, Johns Hopkins. Told you.”
I looked at him, defeated: “Yeah, yeah, hatever. You won.”
He raised an eyebrow.
“And you owe me dinner tonight. You won, but only because of the damn hair color,” I muttered. “Lucky bastard.”
Whitaker let out a laugh, and I just thought that, beyond the whole spectacle her arrival had caused, the new peds surgeon clearly knew exactly what she was doing. And in this job, that’s everything.
12:00 p.m.
By noon, Mohan had been walking around with the most worried expression I’d seen on anyone all morning.
I understood why when Johnson walked back into the ER.
She studied the ultrasound in silence. Ileocecal intussusception.
Mohan wanted to try pneumatic reduction. Johnson wasn’t convinced. The kid had sixteen hours of symptoms, elevated lactate, free fluid, and was vomiting bile.
The debate lasted less than I expected.
“If you take him to an enema and there’s vascular compromise, you’re going to lose time,” Johnson said calmly, but with complete certainty.
Because she knew she was right.
Mohan tried to defend his position, but in the end he agreed, and they took the kid up to the OR.
And once again, surgery won.
I had been listening to the whole thing from my desk, pretending to work, nodding to myself like anyone cared whose side I was on in that debate.
From across the room, McKay noticed. Of course she noticed.
She walked over to me with a smile that was a little too wide for my liking.
“So, what do we think about the new doctor?”
I didn’t look up from the chart in front of me. “I don’t know. I think she’s very competent.”
McKay let out a quiet laugh.
“By the way, have you seen García down here? I need to talk to her about a patient,” she asked, smiling like she had just told a joke only she understood.
“Mm, no, haven’t seen her,” I replied.
Right then, Johnson and Mohan walked over to the nurses’ station to adjust some orders.
McKay didn’t miss her chance. “Dr. Johnson,” she said, glancing sideways at me. “Did you know my resident is considering doing a double residency in surgery?”
Johnson turned toward me, not surprised, more… intrigued (?)
“Oh, really?”
Before I could answer, McKay added: “Yeah. Seems like there’s something about surgery that’s been attracting her lately,” she said, giving me a quick wink.
The reference to García was subtle, but I caught it.
Because McKay knew exactly what she was implying.
Johnson held my gaze a second longer than necessary.
“Good to know,” she finally said before walking away.
McKay was enjoying this far too much.
4:00 p.m.
I was just about to open my energy bar when I heard the ambulance sirens getting closer. As I got up and headed toward the entrance, Dana shouted from the nurses’ station: “A pedestrian struck, nine year old girl, a few blocks away, not sure how bad she is.”
Out of the corner of my eye I saw García stepping out of room 12, already heading toward the ambulance bay beside me.
We didn’t speak, we just waited.
As the ambulance doors opened, the paramedic was already giving report: “Nine year old female, high speed vehicle strike. Unresponsive at the scene. BP 68 over 35, heart rate 162. We attempted field intubation but couldn’t get a view, satting 88%. Abdomen distended and tense, no obvious massive external bleeding.”
García started walking alongside the stretcher with me.
Whitaker stepped closer: “Need anything?”
“Yeah, please take care of the mom, we’ve got this.” I glance at García, looking for confirmation and she nods.
We reach the trauma bay.
“GCS seven. I’m intubating,” I say. I’m not asking for permission, just thinking out loud.
There’s blood in the oral cavity (probably a laceration somewhere) but I manage to pass the tube. Not easy, but it goes in.
“Good,” García says beside me, meeting my eyes for a second before turning back to the patient.
As I secure the airway, both of us turn toward the door when we hear it open.
Johnson walks in already wearing gloves.
First thing she asks: “Estimated weight?”
Without looking at her, García answers: “Not sure. thirty kilograms, maybe.” Then adds, “We didn’t exactly have time to weigh her, as you can see.”
Johnson ignores the passive-aggressive comment, she just nods and starts calculating doses and volumes.
“BP still 68 over 35, heart rate 170, sat barely holding,” I call out.
García grabs the portable ultrasound.
“FAST positive in Morrison’s pouch. Free fluid.”
García and Johnson exchange a quick look. Same conclusion, Intra abdominal bleeding.
I turn to Perlah: “Give twenty per kilo of crystalloid… uh, six hundred.”
Johnson looks up at me, she doesn’t contradict me. Just asks: “Did you order blood yet?”
García answers: “Let’s stabilize her first.”
“And what if she bleeds out before you stabilize her?” Johnson replies.
The tension fills the entire room.
García doesn’t get the chance to answer.
The monitor alarms. Heart rate dropping.
García turns to me.
“Pulse?”
I reach for the girl’s neck.
Nothing.
“Starting compressions.”
Suddenly everyone moves in sync around the bed.
“0.3 milligrams epinephrine,” Johnson says.
“Epinephrine in,” Perlah answers.
“Keep compressions going,” García says, already positioning herself on the other side of the bed.
I count out loud, trying to keep rhythm.
One, two, three…
The monitor still shows asystole.
“Prepare for transfusion,” García says calmly.
Johnson is already on the phone with the blood bank: “Activate pediatric massive transfusion protocol, estimated weight thirty kilograms.”
Second cycle.
I check for a pulse again and pause.
There it is
“Weak pulse… but it’s there.”
The monitor comes back with a barely stable rhythm.
But all of us are still holding our breath.
The crystalloid bag is almost empty. “First bolus almost done,” Perlah says.
“Hang another,” García replies immediately.
But Johnson steps in, not aggressive. Precise.
“She already got twenty per kilo. Another full one makes forty.”
García doesn’t look at her. “She’s in shock.”
“Yes, hemorrhagic shock. She needs blood, not more crystalloid.”
The tension in the room is thick enough to cut with a scalpel.
I look at the monitor: Systolic BP 72. Heart rate 160 again.
García speaks: “I need enough pressure to get her to the OR.”
Johnson answers just as firmly: “And I need her to get there without dilutional coagulopathy.”
The silence that follows is uncomfortable.
I stare at the monitor, silently begging for the pressure to climb.
And there it is.
“Pressure’s up to eighty… but falling again. She’s only transiently responding to fluids.”
Johnson considers it for a second.
“Okay, start blood now, five more minutes of targeted resuscitation and we move.”
García looks at her. Then nods.
Just in time the blood arrives, and Perlah already has the orders ready.
As the blood starts running, the girl loses pulse again.
“Compressions.”
No one argues, no one fights for command, we don’t even look at each other, we just work.
One cycle, and the pulse returns.
Now the pressure holds at 85.
“Abdomen’s getting tighter,” I say.
“Yeah,” García replies. “The source is still there.”
“Yes, but she’s perfusing better now,” Johnson adds.
They look at each other.
Something passes between them.
Maybe it’s some kind of surgical language I still don’t fully understand.
“Let’s go,” García and Johnson say at the same time.
Perlah and I start clearing the bed, getting everything ready to move the girl upstairs to surgery as fast as possible.
6:30 p.m.
Thank God the shift was almost over. I had finally managed to sit down, and the energy bar in my bag was still untouched, i opened it and took a bite, enjoying my first real food in… I had no idea how many hours.
I heard footsteps approaching and looked up.
“Are mondays always like this around here?” a voice asked behind me.
Johnson had her blonde hair slightly loose, like she’d taken the hair tie out after leaving the OR.
“Only the quiet ones,” I replied with a faint, teasing smile. “Just the hospital welcoming you with open arms, Dr. Johnson.”
She leaned against the desk in front of me, crossing her arms.
“You can call me Nicole.”
Instinctively, I shook my head.
“Dr. Johnson, I…”
“Nicole,” she repeated.
I looked at her for another second, considering it.
Who would it hurt if I called her by her first name?
“Okay… Nicole.”
She nodded slightly, as if she had just closed a deal.
“How’s the little girl?” I asked.
Her expression shifted a little, more serious now, more professional.
“Grade IV splenic laceration. García got excellent vascular control, we managed to save the spleen.”
I don’t know why (it's something I obviously already knew) but hearing someone else talk about García’s surgical skills like that gave me a small twist in my chest.
“She’s in the ICU, ventilated and on low dose pressors, but she’s perfusing much better than when she left the ER.”
I let out the breath I didn’t realize I’d been holding.
“She’s going to recover,” she said confidently. “That’s my favorite part about working with kids, they bounce back faster and better than almost any adult.” She added it with a small smile.
I nodded, because she was right.
After a brief silence, she looked at me again with that same evaluating intensity from earlier that morning.
“That was a clean intubation,” she said. “With that much blood in the airway, not many people get it on the first pass.”
I already knew. García had complimented my intubation earlier.
“Thanks, I guess, I got a little lucky.”
“No,” she said. “That was skill.”
That was… another compliment?
She glanced toward the patient board.
“McKay mentioned you’re considering a double residency?”
I rolled my eyes, remembering McKay’s grand intervention that morning.
“McKay talks too much,” I said.
“That doesn’t answer my question.”
I took another bite of my energy bar, trying to buy myself time.
“Yeah, I’m thinking about it.”
“Surgery is demanding,” she said. “Not just technically.”
“I know.”
“It means making decisions quickly, defending them, and most of all standing by them when someone else disagrees.”
She didn’t say García’s name, but we were both thinking it.
“I think I can handle it,” I replied firmly.
Nicole held my gaze.
“I think so too.”
And something changed in the way she was looking at me.
It didn’t feel like academic evaluation anymore. It was… interest?
“Okay, it would probably be irresponsible of me not to ask…”
“Ask what?” I said.
“I’ve spent the last few hours considering asking you out, but I’d rather not invest time and interest if there’s already someone else.”
…what?
“Are you dating someone?”
I blinked, frozen, my energy bar halfway to my mouth.
Okay. I definitely did not see that coming.
My brain tried to come up with a logical answer, but the only image that appeared in my head was García.
We had never talked about it. We had never put a name on it.
But I also hadn’t gone out with anyone else since we started… whatever it was we were doing.
Nicole was still waiting. She didn’t look uncomfortable, just patiently expecting an answer.
I opened my mouth to respond…
And that’s when I heard her.
“Yeah, she’s dating someone.”
I didn’t know how long Yolanda had been standing there, but she wasn’t looking at us, not even at me.
She stepped up beside me at the nurses’ station, calmly arranging a few papers she was holding.
My energy bar was still suspended in the air.
García finished aligning the papers, set the pen down on the desk, and walked off toward the hallway as if she hadn’t just dropped a bomb on the two of us… on me.
Nicole raised her eyebrows and watched me in silence for a few seconds.
“Well,” she finally said with a small nod, “I suppose that answers my question.”
I still hadn’t reacted.
“I didn’t mean to make things awkward,” Nicole added: “But I prefer being direct and avoiding workplace drama.”
My brain was still stuck ten seconds in the past.
Nicole took a step back.
“Anyway,” she said, now with a faint smile “I appreciate the honesty, and I mean it: if you’re serious about the double residency, you can always come by my office. I’m sure you’d be a strong addition to the program.”
“Mm, thanks,” was the only thing my brain managed to produce.
“You’re welcome,” Nicole replied. “See you tomorrow, Santos.”
And just like that, she left without making a scene.
And for my bad luck, McKay appeared beside me with an absolutely insufferable grin.
“Oh my God, Santos. If I had a coin for every time you captivated a surgeon on the first day you met them, I’d have two coins. Which isn’t a lot, but it’s weird that it happened twice.”
And she walked off, laughing to herself.
7:30 p.m.
It took me exactly half an hour to finish my charts and practically run out of the ER at the end of my shift.
I walked toward the lockers to grab my things. I was the last one left; the others were already filled with the night shift’s stuff.
I kept replaying the way Yolanda had practically claimed me in the middle of the ER, but I’d rather not think about that right now. There would be another moment to talk about it.
And apparently that moment was now.
Because I heard a pair of very familiar boots approaching the lockers.
Yolanda was already changed and ready to go home, her bag in hand, standing by the locker room exit, her hair loose, those impressive curls falling around her shoulders, looking effortlessly stunning, as always.
She didn’t say anything. She just looked at me.
I guess it’s now or never.
“Am I really dating someone?” I asked, looking straight at her, my backpack already hanging from my shoulder.
I watched confusion spread across her face as her eyebrows drew together slightly.
“Don’t you?” she said, then sighed. “Because if that’s not the case, you should probably tell me right now.”
Something in her gaze hardened as she crossed her arms.
And I could feel my heart starting to race, my palms getting sweaty.
“I mean…” I shifted my weight from one foot to the other, not really knowing what to do with my limbs at the moment. “We never talked about it… we never put a name on it. I thought maybe, for you, this was still casual.”
Her expression softened a little, just a little.
“Trinity, oh my god. I spend time at your place, you spend time at mine. I stay over even when we don’t sleep together. We cook together, we even feed that farmer you insist on calling your roommate. And besides…” she paused, “I haven’t gone out with anyone else since we met.”
Something shifted in her expression.
“Have you?”
She asked it in such a vulnerable way that my heart flipped all over again.
“Have I what?” I asked, because my brain was clearly not functioning properly during this conversation and these revelations.
“Have you been seeing someone else?”
And then I understood. And I answered as fast as possible, because god knows that ever since I met her, I couldn’t imagine choosing to spend my few free hours outside the hospital with anyone who wasn’t her.
“No. Of course not.”
I watched her let out a breath of relief, like she’d been bracing herself for the worst.
After a second of silence, she asked: “Then how do you label all this?”
And then it was my turn to release a breath I hadn’t realized I’d been holding for months.
“Thank god we’re dating, oh my god, you have no idea how stressed I’ve been for months about asking you this. Because for me, it stopped being casual a long time ago. I don’t want it to be.”
“Neither do I,” she replied with the softest, sweetest smile I’d seen in a long time.
“Listen,” she added, “I’m not good at asking for things, but I’m also not good at pretending I don’t care.”
She crossed her arms again.
“And I hated that she thought she had a fucking chance.”
“Oh, I noticed,” I replied, amused. “I mean, you basically just claimed me in the middle of the ER.”
“I didn’t claim you,” she said. “I just wasn’t going to stand there smiling while someone asked you out.”
“She was thinking about asking me out,” I said, still teasing her.
Maybe I shouldn’t have done that, because I immediately earned a very accusing finger pointed straight at me.
“Careful, Trinity.”
I burst out laughing, “Besides, you could’ve let me answer.”
“Well, next time answer faster.”
“Oh, I think I like jealous Yolanda.”
“Well, I don’t,” she said. “So you better move your ass away from that locker and let’s get out of here, because I left some pasta in your fridge yesterday and I’m not letting it go to waste.”
I stepped closer to Yolanda before starting to walk toward the exit, and when I was very, very close to her, I said; “For the record, I was going to tell her I’m already seeing someone… and that I’m pretty, pretty invested.”
“Oh yeah?” García asked quietly. “How invested?”
“Let’s get to my apartment and I’ll show you,” I said, winking at her.
I didn’t have to say it twice, because Yolanda practically dragged me across the parking lot.
We made it to my apartment in record time.
And somewhere between the ER parking lot and my front door, the thing we’d been dancing around for months finally had a name.
Yolanda García was my girlfriend.
And honestly? That felt pretty great.