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Published:
2026-09-22
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2026-09-26
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Equal & Opposite

Summary:

Six years ago, Agatha Harkness and Rio Vidal were the best surgical team Westview General had ever seen.

They were also married.

Then a patient died, four minutes of hesitation became six years of silence, and Rio left Westview without ever taking off her wedding ring.

Now Rio is back as the hospital's new Head of Surgery.
Unfortunately, Agatha is still there.
Still Head of Cardiothoracic Surgery. Still infuriating. Still devastatingly good at her job. And, inconveniently, still wearing her own wedding ring.

They're supposed to be professional.

Instead, they argue over patients, compete over surgical decisions, accidentally fall back into old habits, and repeatedly insist that whatever is happening between them is absolutely not a relationship.

Meanwhile, everyone else at Westview seems to know exactly where this is going.
Because six years apart apparently wasn't enough to make Agatha Harkness and Rio Vidal stop loving each other.

Unfortunately, everyone else in the hospital figured that out years ago.

Notes:

Welcome, this is an Agatha Harkness/Rio Vidal medical AU centred around two brilliant surgeons, one very complicated marriage, six years of unresolved feelings, and a hospital that seems determined to put them in the same room at every possible opportunity.

Agatha is Head of Cardiothoracic Surgery. Rio is returning to Westview as Head of Surgery. They're still legally married, despite having spent six years living separately and avoiding the conversation about what, exactly, that means.

A note on the medical elements: the surgery and hospital situations in this fic are fictionalised for storytelling purposes and should not be taken as medically accurate advice, because I am not a medical professional.

And yes, the title is doing exactly what you think it is.

Enjoy. ❤️

(See the end of the work for more notes.)

Chapter 1: Reassignment

Chapter Text

The email arrives at 6:47 in the morning, before Rio Vidal has had coffee, before she's fully awake, before she has any of the usual defenses a person needs to survive news like this.

RE: Interim Appointment — Head of Surgery, Westview General Hospital

She reads it twice. Then a third time, because surely she's misunderstanding something, surely the board hasn't actually done what the subject line says they've done.

They have.

Effective in three weeks, Dr. Rio Vidal, formerly of Metro General, formerly of several other hospitals in several other cities she picked specifically because they weren't Westview, will assume the role of Head of Surgery at Westview General. Which means she will oversee every surgical department in the building. Which means, unavoidably, inescapably, that she will be the direct administrative equal of the Head of Cardiothoracic Surgery.

Who is Agatha Harkness.

Her ex-wife.

Still, technically, currently, on paper, her wife. A fact Rio has not thought about in approximately four days, which is a personal record.

She sets her phone face-down on the kitchen counter like that will do anything, like the words will un-arrange themselves if she just doesn't look at them, and pours coffee into a mug that says WORLD'S OKAYEST SURGEON, a gift from a resident three cities and one lifetime ago. She drinks it black. She has always drunk it black. It has nothing to do with the fact that Agatha used to tease her mercilessly about it, you drink your coffee like you live your life, Vidal, joylessly and with excessive discipline, and everything to do with the fact that she simply likes it that way.

She tells herself this. She has told herself a lot of things over the past six years.

By the time she's on her second cup, she's already run through the obvious options. She could decline. She's qualified enough, respected enough, that turning down a department head position wouldn't torch her career. She could ask for a different hospital, wait for the next opening, let some other overqualified neurosurgeon with an ego and a god complex take the Westview job.

But the job is good. The job is, if she's honest, exactly the job she's spent the last six years quietly building a resume toward. Westview's neuro program has needed real leadership for years. The hospital's trauma numbers are strong. The compensation is absurd. And there's something else, something she doesn't examine too closely at 7 a.m. with caffeine barely in her bloodstream, something that sounds, if she lets it, uncomfortably like unfinished business.

She calls the recruiter back at nine. Accepts.

She does not call Agatha. She's fairly sure Agatha will hear about it from someone else first, and some small, petty part of her, a part she's not proud of, a part that has clearly not evolved past the divorce, or the non-divorce, whatever this is, wants that. Wants Agatha to find out sideways, from gossip, the way Rio found out two years ago that Agatha had been made Head of Cardio, from a colleague at a conference who said oh, you must be so proud like it wasn't a knife.

                                       ⟡˙⋆ ⚠︎ ⋆˙⟡

Westview General has not changed in the six years since Rio last set foot in it. That's the first thing she notices, walking in on her first day: the same lobby with the too-ambitious modern art installation nobody's ever liked, the same gift shop selling the same overpriced teddy bears, the same particular hush that hospitals get right before the day shift takes over, when the building is holding its breath.

She'd forgotten how much she loved this place. She'd also forgotten how much of that love was tangled up in a woman with sharp blue eyes and an even sharper mouth, so she supposes some things stayed exactly as complicated as she left them.

Jennifer Kale, CEO, meets her outside the administrative wing with a firm handshake and the weary, competent energy of a woman who has spent the better part of a decade holding this hospital together with sheer force of will and a truly heroic tolerance for chaos.

"Dr. Vidal. Welcome back to Westview." Jen's smile is genuine, if a little assessing, the look of someone doing quiet math. "I read your file. Twice. Very impressive record. Very interesting history with this particular hospital."

"You could say that," Rio says.

"I did say that." Jen starts walking, and Rio falls into step beside her, badge already clipped to her collar, white coat still smelling faintly of the dry cleaner's. "I'll be direct, because I don't have time not to be: I know about you and Dr. Harkness. Everyone who's worked here longer than eighteen months knows about you and Dr. Harkness. It's practically hospital folklore at this point. There's a version of the story where you two performed open-heart surgery on each other's mothers on your first date."

"That did not happen."

"I'm aware. I've also heard the version where you got married in an OR during a code blue."

"Also did not happen." Rio pauses. "We got married in Portugal. It was very normal. It was one of the only normal things we ever did."

"Comforting," Jen says dryly, "and yet you two are still legally—"

"I know what we still are, Dr. Kale."

Jen glances at her sideways, gauging, and apparently decides that's enough digging for a first impression. "Right. Well. I need you to know I didn't hire you to reignite a hospital soap opera. I hired you because your surgical outcomes are some of the best in the country and this hospital's neuro department has been treading water for three years. I need someone who can actually run it. I don't care what happened between you and Agatha. I care whether the two of you can be adults in a boardroom."

"We can," Rio says, with more confidence than she currently possesses.

"Good. Because you'll be attending the same department head meetings. Serving on the same committees. Occasionally consulting on the same cases, given how often cardiac and neuro overlap in trauma. I need this to work, Dr. Vidal. Professionally. I'm not asking about the rest of it."

"There is no rest of it," Rio says, and even she can hear how unconvincing it sounds.

Jen just gives her a long, unimpressed look, the look, Rio will learn, of a woman who has refereed exactly this kind of thing before and has no illusions left. "Sure," she says. "Orientation's this way."

                                       ⟡˙⋆ ⚠︎ ⋆˙⟡

Rio doesn't see Agatha for four days. She tells herself this is fine, even good, time to settle into the role, learn the new EMR system, memorize the names of forty-some surgical residents, figure out where the good coffee is hidden (third floor break room, apparently, guarded jealously by the OR nurses). She tells herself she is not, in any way, delaying an inevitable collision.

She is absolutely delaying an inevitable collision.

It happens on day five, in the surgeons' lounge, at 6:15 in the morning, because the universe has always had a cruel sense of comedic timing where Agatha Harkness is concerned.

Rio is pouring coffee, the good coffee, from the machine she's finally located, when the door swings open behind her with the particular unhurried arrogance of someone who has never once worried about who might be on the other side of a door.

"Well," says a voice Rio has spent six years trying, and failing, to fully excise from her memory. "If it isn't the ghost of Christmas past, haunting my coffee machine."

Rio doesn't turn around immediately. She takes a breath first. Counts to two, not three, she doesn't have three seconds of composure to spare, she's found, and turns.

Agatha Harkness looks, infuriatingly, incredible. Six years has done nothing but sharpen her, new lines at the corners of her eyes that only make the blue of them more striking, hair a little shorter, the same effortless, coiled stillness she's always carried, the kind that makes a room recalibrate around her without her having to try. She's got a scrub cap dangling from one hand, an expression of lethal amusement, and the particular stillness of a predator that has just noticed something interesting wander into its territory.

"Agatha," Rio says. Even. Calm. A voice she's practiced.

"Doctor Vidal, I hear now. Head of Surgery." Agatha lets the words sit there, turning them over like she's checking them for a hidden flaw. "Bold career move. Bold life move. I confess, when I heard, my first thought was that someone in HR had made a truly spectacular clerical error."

"It's not an error."

"No," Agatha agrees, stepping further into the room, heels clicking against the tile with a rhythm Rio's body remembers before her brain fully catches up. "I checked. Twice. Very thorough vetting process, this hospital has. Very thorough, and yet somehow they missed the part where hiring you means hiring a woman who once told me, and I quote, I would rather set myself on fire than work in the same building as you again."

"I don't remember saying that."

"I have excellent recall for the things you've said to hurt me, Rio. It's practically a party trick."

There it is, the flash under the sarcasm, quick and gone, the thing Rio's spent six years trying to convince herself she imagined the first hundred times she saw it. She doesn't reach for it. She's learned, at great cost, not to reach for it.

"For what it's worth," Rio says, setting her mug down, "I didn't know you'd made Head of Cardio until two years after it happened. I found out from a stranger at a conference in Denver."

"Ah, yes. I'm aware. I heard about that conversation. Apparently you excused yourself to the bathroom and didn't come back for forty minutes."

"How do you know that?"

"I know things, Rio. It's part of my considerable charm." Agatha sets the scrub cap down on the counter, crosses her arms, studies Rio with the particular assessing look she used to give difficult cases, the one that means she's already three steps ahead of the conversation everyone else thinks they're having. "You could have called. Congratulated me. Sent a card. Something civilized."

"You could have called me first. You got the promotion. The tradition, as I recall, is that the person with news makes the call."

"I didn't have your number anymore. You changed it. Twice, if the rumors are accurate."

"I didn't change it because of you."

"No," Agatha agrees, mild, entirely unconvinced. "Of course not. Purely coincidental timing, both times, that you changed your number within a month of us finalizing which of our belongings went to storage." She pours herself coffee from the same pot, deliberately, unhurried, like she has all the time in the world and intends to spend every second of it making Rio uncomfortable. "It's fascinating, really. The lengths two people will go to, to avoid admitting they're still furious with each other."

"I'm not furious."

"You're something. I haven't decided what yet. Give me another cup of coffee's worth of observation and I'll have a diagnosis."

"I took the job because it's a good job," Rio says instead. "Not because of you."

"Of course not." Agatha's smile is all teeth, bright and completely unconvinced. "Nothing to do with me at all. Pure coincidence that out of every hospital in the continental United States, you landed in the one where your wife happens to run Cardio."

"Ex-wife," Rio says, too fast.

Agatha's eyes drop, deliberately, pointedly, to Rio's left hand, where the ring still sits, plain gold, worn thin at one edge from six years of Rio turning it around her finger during stressful consults, a habit she has never managed to break. Agatha doesn't say anything about it. She doesn't have to. The silence does the work for her, stretches out just long enough to be unbearable, and then she looks back up, and something in her expression has gone carefully, deliberately blank.

"Mm," is all she says. "Well. Welcome to Westview, Dr. Vidal. I'm sure our little professional marriage will be every bit as functional as our actual one."

She turns to go, heels tapping an efficient retreat, and pauses at the door only long enough to add, without turning around: "Try not to burn my department down in the first month. I have a reputation to maintain."

"Your department's fine," Rio says to her retreating back. "Mine's the one that's going to need work."

"Obviously," Agatha calls over her shoulder. "You always did prefer things that were already broken."

The door swings shut behind her, and Rio stands there for a long moment with her coffee going cold in her hand, heart doing something complicated and unwelcome in her chest, and thinks: four days. It took four days to feel like this again.

She's going to need a lot more coffee than this.

                                       ⟡˙⋆ ⚠︎ ⋆˙⟡

The department head meeting that afternoon is, against all odds, almost professional. Almost. Jen runs the room with the crisp efficiency of someone who has clearly had this exact meeting a thousand times and has learned to move fast before anyone can derail it. Agatha sits three seats down from Rio, reading a chart, saying nothing, contributing exactly two comments, both sharp, both correct, both delivered with the specific bored precision she uses when she wants everyone to know she could dismantle the entire conversation if she felt like putting in the effort.

Rio catches her watching, once. Just once, a flicker of blue eyes over the top of a folder, gone the second their gazes meet.

It shouldn't feel like anything. It feels like everything.

She spends the rest of the meeting very deliberately not thinking about the ring hidden somewhere under Agatha's scrub top, because she knows it's there, has known it for six years, ever since a mutual friend let it slip after one too many drinks at a conference. She still wears it, you know. On a chain. Doesn't take it off. Rio had filed the information away like evidence in a case she wasn't ready to try.

She still hasn't tried it.

Walking out of the meeting, briefcase in hand, she catches Agatha's eye across the hallway one more time. Agatha's expression gives away nothing, bored, faintly amused, the mask fully back in place.

But her hand, Rio notices, has drifted to her collarbone. Just for a second. Just long enough to press something flat against her skin, underneath the fabric of her scrubs, like she's checking that it's still there.

Rio looks away first. It feels, obscurely, like losing.

Six years, she thinks, walking back to her new office, past a wing of the hospital she used to know as well as her own home, past a version of herself she left behind here along with everything else. Let's see how long I last this time.

She doesn't yet know the answer is: not very long at all.