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Santos sat in the surgical gallery with one leg crossed over the other. Hot coffee steamed under her nose, while a cold compress slowly slid off the cut along her eyebrow arch. She could feel a throbbing pain in her temple, but adrenaline hadn’t fully worn off yet, so she ignored it with stubborn determination.
From the beginning of her shift, Santos couldn’t complain about a lack of work. She had several patients, but everything had been calm and uneventful. It wasn’t until shortly after 11 o'clock that she was assigned a new patient — Arthur Wild. The man seemed visibly anxious, and his behavior from the very start raised her concern.
After a brief history, Santos moved in to examine him, but Arthur suddenly pushed her with considerable force. She hadn’t expected it. She lost her balance and hit her head on a table next to the bed. For a few seconds everything blurred. Only when she felt someone helping her sit up she did realize something warm was running down her cheek.
Through the haze she spotted a worried Robby and McKay kneeling beside her. Robby shone a light into her eyes, checking her pupils, then asked short questions about dizziness, double vision, or nausea. She answered negatively to all of them, though at first she needed a moment to process what they meant.
McKay placed two stitches on her right eyebrow arch, and Robby firmly ordered two hours of rest. Santos immediately protested, refusing to lie in room nine as Dana had suggested. Eventually they reached a compromise — she would rest in the staff room, and someone would check on her periodically.
She agreed, but didn’t last long there. After a dozen minutes she told Dana she was going to grab an early lunch and would be back soon. She left the hospital and headed to a small stand serving freshly ground coffee and the best sandwiches in the area. However, she didn’t return to the ER as promised, instead heading to the fourth floor, telling herself she wanted to check on how her patient with a ruptured spleen was doing, brought in by ambulance three hours earlier.
She now watched the operating field on the monitor with focused admiration.
Down below, behind thick glass, an entirely different reality existed from the ER.
Silence. Focus. The metallic sound of instruments.
And Yolanda Garcia standing at the operating table looked like a fucking queen.
The patient lay open from the sternum to below the umbilicus. The trauma patient had previously been stabilized with packing and transfusion. Only now did Garcia return to the spleen, as suction worked more calmly than before and the monitor above the table finally showed more stable parameters.
Dr. Parker stood opposite Garcia, his back to Trinity, operating the suction with one hand and holding a retractor with the other.
Santos remembered their first meeting three hours earlier.
"And who the hell are you?" she had snapped when he appeared at the patient’s bedside instead of Garcia.
The man didn’t even flinch. He walked to the wall where gloves were stored and began putting them on while looking at the patient.
"Dr. Parker. Third-year resident. Transfer from Chicago," he replied dryly without even looking at her.
"Great. I don't care. Where is Garcia?"
"She’s finishing the operation. So what do we have?"
"Dr. Santos...be nice," Robby said, crossing his arms, clearly seeing Santos glaring at the new surgeon as if she wanted to say something far less polite.
"18-year-old male, hit by a car..."
And she disliked him immediately.
Too confident. Too polished. Too much “I know everything.”
And when Garcia eventually came down, it turned out he knew significantly less than he thought.
She didn’t know who had trained him in Chicago, but here, under Garcia, he would not have an easy time.
He was competent at following Garcia’s instructions, but his knowledge was insufficient for a surgeon as brilliant as Yolanda Garcia.
Now she watched Garcia slowly suturing the injured spleen with a fine vascular stitch while Parker held suction.
"Dr. Parker," Garcia said calmly. "Why are we trying to preserve the spleen instead of removing it?"
"Because… the patient is relatively young, and preserving immunologic function reduces the risk of future infections."
"Which ones specifically?"
Parker hesitated for a second.
"Postsplenectomy sepsis."
"Full name."
"Overwhelming post-splenectomy infection syndrome."
"Mortality?"
"Uhh… fifty percent?"
"In some studies, higher. Which bacteria are we most afraid of?"
"Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis."
"And if you forget vaccinations after splenectomy?"
"The patient can die from fulminant sepsis."
"Exactly. That’s why removing a spleen just because a surgeon is lazy is unacceptable."
Parker swallowed hard.
Santos let out a quiet laugh and bit into her sandwich.
Garcia continued, clearly referencing Parker’s earlier insistence that the spleen should have been removed from the start.
"Anatomy of the vessels," she said.
"The splenic artery arises from the celiac trunk and runs along the superior border of the pancreas."
"Branches?"
"Short gastric arteries, the left gastroepiploic artery, and pancreatic branches."
"Which structure is most at risk during dissection of the splenic hilum?"
"The tail of the pancreas."
"And if you injure it?"
"Pancreatic fistula, enzymatic leakage, abscess. The patient can develop peritonitis."
"How do you know you have a fistula?"
"High amylase in the drain."
"Good. Better. Maybe Chicago didn’t fail you entirely."
One of the nurses snorted quietly under her mask.
Parker tried to smile, but he looked like a man standing in front of a firing squad.
Garcia continued suturing the spleen with absurd precision.
Santos shook her head in disbelief. Most surgeons would have removed the spleen two hours ago.
Garcia was saving it millimeter by millimeter.
"Complications after splenic repair?" she asked.
"Rebleeding."
"What else?"
When he stayed silent too long, Garcia cut in sharply.
"Keep going, Parker. You should be able to list them without thinking."
Santos sighed, stood up with her coffee, and pressed the intercom.
"Delayed hemorrhage, splenic infarction, subphrenic abscess, pancreatic fistula, pseudoaneurysm of the splenic artery. That’s why after this kind of repair you monitor hemoglobin. The patient may look stable… until suddenly he’s bleeding out into his entire abdomen."
Several staff members looked up. Garcia froze for a second, then, without taking her eyes off the field, raised a subtle eyebrow under her mask.
Parker turned sharply, noticing her standing at the intercom with coffee in one hand, a compress in the other, and a bandage over her brow.
"Perfect, Dr. Santos. How nice of you to join us," Parker said.
"Dr. Garcia, the pleasure is mine. Glad to see my patient’s spleen is still in place. I’m impressed," Santos replied sincerely.
Dr. Bulkovitch, the anesthesiologist, removed his glasses and set down the newspaper he had been reading. Santos had worked with Garcia and Dr. Walsh several times before, and Bulkovitch had always been present. She liked him — a good-humored man in his fifties who often talked about his daughter, who had chosen a different career path than he had hoped.
"Dr. Santos, we haven’t seen you on the OR floor in a while," he said.
Santos raised her coffee cup in greeting.
"Well, I’ve been busy saving lives. No time for reading newspapers."
Bulkovitch snorted.
"That’s called high-quality medicine."
"That’s called a paid nap funded by the hospital budget," Santos shot back. One of the nurses chuckled under her mask."In the ER I can barely read a CBC between resuscitations."
"Maybe you should consider anesthesiology. You could also read the press during shifts."
"And where's fun with that?"
"You ER people are always running. Surgeons stand still for hours, and we make sure none of you kill the patient. Everyone has their role."
"Sounds exhausting," Santos laughed.
"That’s why I sit," Bulkovitch said cheerfully, spreading his hands.
Santos glanced at Garcia and was almost certain she was smiling under her mask.
"I have a feeling, Dr. Santos, that I’ve been seeing you more and more often in this gallery… and not only here," Bulkovitch said.
Santos raised an eyebrow.
"I like watching professionals work."
"Good thing Dr. Garcia is the best surgeon in the hospital. At least your excuse holds up," he replied.
It was true — Santos had been coming more and more often lately, usually after shifts, waiting for Garcia to finish so they could leave together. Sometimes she dozed in the chair, sometimes she simply watched the OR in half-lidded silence. Occasionally Garcia let her come down once Dr. Shamsi had left and the OR had quieted. Garcia would talk her through the procedure and ask her questions.
Santos leaned against the glass, hiding her smile behind her coffee.
Without looking up from the field, Garcia finally decided to end the exchange.
"Dr. Santos, have you cured all your ER patients that you keep coming up here?" Garcia asked.
Santos paused.
"I came because I was worried about my patient. But I see that was unnecessary."
"Since you’re here, tell Dr. Parker the most common causes of delayed splenic bleeding," Garcia said, clearly amused.
"Poor hemostasis at the hilum or a missed vascular branch, especially at the upper pole," Santos replied.
"Excellent. But not on my OR and not on my shift," Garcia said. "Management?"
"It depends on hemodynamic stability. Observation if stable, splenic artery embolization if interventional radiology is available, or immediate relaparotomy if the patient crashes."
Garcia set down her forceps.
"What suture do I use for injured parenchyma?"
"4-0 Prolene with Teflon pledgets."
"Why not Vicryl? Parker, listen too."
"Because under tension Vicryl cuts through splenic tissue like a hot knife through wet paper. And then instead of repair, you’ve got a massacre on the table."
Bulkovitch laughed quietly behind his monitors.
" Dr. Santos, you should be down here instead of him. Want to switch places?"
Parker sighed deeply, looking like he was ready to disappear into the floor.
"You will live Parker. I mean...probably."
Garcia finished a key step, secured the field, and lifted her head. Her gaze landed on Santos’s face — and her expression immediately hardened.
"What the hell happened to your face?" she asked.
"Occupational hazard," Santos replied.
"Santos…"
"The patient got aggressive. He pushed me into a cabinet."
"Are you fucking kidding me?? Did you lose consciousness?"
"No."
"Photophobia?"
"Nope."
"Nausea?"
"Only when I look at Dr. Parker."
Bulkovitch laughed loudly.
"Dizziness?"
"Oh for God’s sake, Garcia."
Just answer the question!" the surgeon snapped, visibly shaken by the entire situation.
"I'm fine!" she said a little to loudly. She took a deep breath and add calmer. " Robby did the neuro check earlier. McKay stitched me up. I’m fine. I’m on rest now and will be checked again in an hour and then back to work.”
Garcia stared at her for a long moment, completely losing focus on the patient for the first time...ever. The scrub nurses exchanged looks. Bulkovitch watched both women with interest.
"Relax, and focus on your patient. He’s still alive, so let’s keep it that way," Santos said quietly.
Garcia finally looked back at the field.
"Since you were supposed to rest, why are you here?"
"Technically, I am resting."
"Watching surgery is rest?"
Santos gestured toward the field.
"Watching you save that poor spleen? Honestly? Extremely relaxing."
And fucking hot, she thought.
Garcia chuckled under her mask.
"On a more serious note… downstairs, in the waiting area, his seven-year-old sister is waiting. They lost their parents like six months ago. He’s all she has left. So fix him properly, so I don’t have to go down there and break a child’s heart."
A brief silence fell over the room.
"Well, no pressure, Dr. Santos," Garcia said, but her movements became even more precise.
"I still can’t believe you repaired it. The bleeding was massive," Santos said.
Garcia nodded slightly, then returned to the field.
"These are hands that heal. And I chose to heal this poor spleen."
"You’ve got a god complex, you know that? You and Walsh," Santos laughed.
"Like every surgeon," Victor added.
"It’s not a complex. It’s observation. Don’t ask about our insurance coverage on our hands."
"I don’t want to know," Santos said.
"What suture did you use on the lower pole?"
"Horizontal mattress with reinforcement."
"Risky."
"Only if you don’t know what you’re doing."
"There it is again. God complex."
Garcia glanced at her briefly. Even through the mask, she was smiling.
"Want to scrub in?"
Santos hesitated.
Damn, she did.
Very much.
"Tempting," she admitted. "But Robby would literally kill me."
"Probably."
"Besides, I follow orders."
"Stalking my OR isn’t following orders."
"I brought coffee and emotional support."
We wouldn’t survive without it.”
Santos raised her sandwich, though Garcia’s eyes never left the field.
"And lunch."
"What are you eating?" Garcia asked.
"Turkey sandwich."
"From Mrs. Watson’s stand?"
"Yup."
"You’re lucky. They’re usually sold out by this time."
"When they saw my stitches, they felt sorry for me and warmed it up in the toaster."
"Shit. Now I’m hungry."
"There’s one waiting for you in the staff room too."
Garcia raised an eyebrow.
"Really?"
"Sun-dried tomatoes."
"And goat cheese?"
"Double."
"Seriously?"
"Of course. Who do you take me for?"
A very specific kind of smile appeared on Garcia’s face, one Santos only ever saw in private. Warm. Soft. Her eyes gleamed under the harsh surgical light.
The nurses exchanged glances. They were now certain.
"Thanks," Garcia said warmly, looking at Santos.
Santos smiled back.
"Oh. So that’s what Dr. Garcia looks like when she actually likes someone. Good to know. I thought it was just a hospital myth," Bulkovitch said.
"Dr. Bulkovitch, please focus on the patient," Garcia said warmly.
The anesthesiologist looked at the monitor and leaned in theatrically.
"Patient stable. Surgeon clearly softening in the presence of Dr. Santos."
Santos sat back down and laughed softly, shaking her head like this was her favorite ending to the conversation.
Garcia kept her eyes on the field, but the corner of her mouth twitched upward. The surgeon did not deny it, which led the staff to begin treating the rumors as effectively confirmed, even though nothing had been explicitly stated.
For a second she looked completely unmoved, as if Victor’s comment had never happened. Then, calmly, she returned to suturing, as if placing a period at the end of the exchange.
After a short silence, she turned to Parker.
Dr. Parker,” Garcia said in a relaxed tone. “If we had sudden bleeding from the superior mesenteric artery and anterior access was blocked by infiltration, what alternative anatomical approach would you consider?”
Parker straightened immediately.
“Uhh… you could try approaching from below, through the mesentery of the small intestine, or… use a standard proximal control at the level of—”
Garcia looked at him a second longer than was comfortable.
“And if the bleeding source is distal, just beyond the inferior border of the pancreas?”
Parker hesitated.
“Then… you could attempt to place a vascular clamp or ligate the vessel blindly to quickly control the situation, and then possibly—”
Garcia lifted her gaze from the operative field. Her eyes above the surgical mask narrowed dangerously.
“Blindly? In the mesentery?”
Parker went silent immediately.
Santos snorted with laughter.
“If you want to kill the patient, then why the hell not?” she muttered. “Fucking loser.”
A few people in the OR coughed to hide their laughter.
Garcia didn’t even pretend to be offended.
“Dr. Santos,” she said calmly, “we can still hear you. The intercom is on.”
Santos cursed under her breath.
“Shit,” she said, reaching to turn it off.
But she was almost certain Garcia was smiling.
A few minutes later, the OR phone rang.
One of the nurses picked up.
“OR Block 1.”
She listened briefly, then looked uncertainly at Garcia.
“It's Dana from the ER. She’s asking if Dr. Santos is in here by any chance.”
Santos stiffened instantly.
“Oh fuck.”
Garcia slowly looked up toward the gallery.
She already saw Santos collecting her coffee and compress in a panic.
“Please tell Dana,” Garcia said calmly, returning to suturing, “that Dr. Santos was here a moment ago to check on her patient and has already gone back downstairs.”
The nurse blinked smiling. “Of course.”
Garcia looked up once more. Santos was already gone from the gallery.
Garcia shook her head almost imperceptibly, amused.