Chapter 3

The following morning, the post-surgical ICU was quiet save for the steady beeping of monitors. The patient in bed six had just undergone aortic arch replacement. The risk of hemorrhage was high, and anticoagulant dosages required double verification from the pharmacy. Maya sat at the computer entering orders, dark circles carved deep beneath her eyes.

During routine rounds, one glance at the numbers on screen was all it took. I reached over and stopped the submission.

"Maya, step away from the computer."

She looked up, dazed.

"You entered the wrong unit. The dose is double what it should be."

By a stroke of luck, the pharmacy hadn't cleared it yet. The medication hadn't reached the patient. I immediately called in the clinical pharmacist and the charge nurse, retracted the order, and locked down the medication protocol. Maya stared at the red error alert on the screen, her hands shaking too badly to grip the mouse.

"I didn't sleep well last night. I couldn't focus." She clutched my sleeve. "Don't file an incident report. It'll affect my residency evaluation."

I pried her hand away.

"The person who needs protecting here is the patient, not your evaluation."

"The medication never entered the patient's body."

"The pharmacy review and my intervention are what stopped a disaster. That doesn't mean your error wasn't potentially lethal."

Graham arrived after hearing the news. Maya was huddled in the break room, crying. After hearing the full account, the first thing out of his mouth was, "No actual harm was done. An internal reprimand should be enough. There's no need for a formal record."

I looked up at him. "What's the first rule you teach your residents?"

He fell silent.

"All procedural deviations must be documented accurately. The medical system relies on protocol as a safety net, not on hoping for the best." I finished the sentence for him and opened the report form on screen. "The rule doesn't stop existing just because you choose to forget it."

He lowered his voice. "You're bringing your personal bias against her into this."

"I have personal feelings about you and Maya, but not about medical protocol. The report documents the time, the incorrect dosage, the personnel who intervened, and the outcome. If you think any part of it shouldn't be there, point it out now."

Graham's expression darkened by degrees.

I hit submit.

That night, the hospital launched a formal review. After Maya left the compliance office, she asked me to meet on the rooftop garden. This was the spot Graham and I had once used as our private escape from the rest of the hospital. She stood before the glass door, her eyes rimmed red.

"I'm not like you. You can withstand anything. But I get scared. I make mistakes. I need someone on my side."

"So you went to Graham to make this record disappear?"

"I just want someone who'll stand by me no matter what."

"But you can't make a patient pay for your insecurity. Do you have any idea what your error would have done to that patient?"

Tears rolled down her cheeks.

"You've helped me so many times, but we're even now. When you helped me back then, it wasn't so I'd owe you forever. Why have you become like this?" Her voice wavered between pleading and disbelief.

I looked at her. "I never asked you to repay me."

"Then why won't you let me off the hook?"

"I can let you off. I will never let a medical error slide."

Graham pushed the glass door open and walked in. He'd heard every word of the second half. He stopped one step away from me, his voice heavy with exhaustion. "You never need anyone. You handle everything on your own. You keep score on every favor. Half the time, I don't even know what I am to you. Maya is different. She tells me straight out that she needs me."

I managed a thin smile, cold spreading through my chest.

"So you mistook dependence for deep love and read my independence as indifference. Graham, you don't want an equal partner. You want someone who'll look up to you forever."

He had no rebuttal.

I turned and left without looking back. As the elevator descended to the first floor, a forwarded email appeared on my phone. The subject line read: Temporary Protection Order Violation Notice. The recipient was Maya. Derek had surfaced again, and she had never told me.