Chapter Eighty one

Lena's POVI went back to surgery on Monday.Two valve repairs scheduled. Both routine. Both successful. By six I was done and went home.Adrian was already there with food."How was your first day back?" he said."Good. Normal. Two surgeries, both went well.""Are you caught up from Hopkins?""Mostly. Ademi scheduled three meetings this week about the other institutions asking for implementation timelines.""How many institutions?""Five. Two in California, one in Texas, one in Boston, one in Chicago.""That's significant.""It is. But Hopkins goes first. March first. Then we'll see what the implementation data shows."We ate and I told him about the surgeries. He told me about the Paris expansion—Chen had the facility secured and was hiring staff."April fifteenth launch?" I said."Yes. Two months after Hopkins.""We're both expanding at the same time.""We are."At eight Ademi called."The California institutions want to meet next week," he said. "Both of them. Stanford and UCSF."

Chapter Eighty Two

Adrian's POVSunday evening Lena called from Baltimore."I'm at the hotel," she said. "Tomorrow morning at six the protocol goes live.""How are you feeling?""Ready. The implementation lead sent the final checklist. Everything is in place. Staff trained, systems configured, documentation ready.""You sound calm.""I am calm. I've done everything I can do. Now I just watch it happen.""Call me after the launch.""I will."She hung up. I sat in the apartment thinking about tomorrow morning. Six AM Baltimore time. Hopkins would start using Lena's protocol for cardiac screening. Three years of her work becoming standard care.If it worked, eight other institutions would follow.If it failed, it was just research.I went to bed at eleven. Set my alarm for five-thirty so I'd be awake when the launch happened.Monday morning I woke at five-thirty.Made coffee and checked my phone. Nothing from Lena yet.Six AM Baltimore time was in thirty minutes.I tried to work and couldn't focus. Checked

Chapter Eighty Three

Lena's POVThe institution calls started Monday.Stanford first. Video call at ten with their cardiology department head and four senior staff."The Hopkins data is compelling," the department head said. "Three days, twenty-three patients, perfect execution. We want to implement.""What's your timeline?" I asked."June first. That gives us eight weeks for training and systems configuration.""That's realistic if you start training by April fifteenth.""We can do that. I'm allocating budget this week."The call ran ninety minutes. They asked the same questions Hopkins had asked—training requirements, institutional support, cost projections. I answered everything.Ademi was on the call taking notes."Stanford is committed," he said after we hung up. "That's two institutions.""UCSF is tomorrow. Texas on Wednesday."Tuesday UCSF committed. July first implementation. Eight weeks of training starting May.Wednesday Texas committed. August first. Ten weeks of training starting mid-May.By F

Chapter Eighty four

Adrian's POVI landed in New York Wednesday at two in the afternoon.Paris had launched successfully. Chen was running it independently. The facility was operational and performing above projections.But all I could think about was Lena.She'd sounded exhausted on every call from Paris. Not just tired—fundamentally drained in a way I hadn't heard before.I went straight to the apartment. She wasn't home yet. Surgery scheduled until five.I unpacked and made dinner reservations for seven. Somewhere quiet where we could actually talk.She came home at six looking exactly as exhausted as she'd sounded."You're back," she said."How was surgery?""Successful. Complex valve repair. Took four hours.""Sit down.""I need to review the Stanford training materials.""Lena, sit down."She sat.I sat beside her. "We need to talk about your schedule.""I know. But I don't know how to fix it.""Let's start with what you're actually doing. How many surgeries this week?""Three. Two yesterday, one t

Chapter Eighty five

Lena's POVThe reduced schedule started working immediately.Two surgeries instead of four. One institution call instead of three. Ademi handling Hopkins follow-up and sending summaries.By the end of the second week I was sleeping better and thinking clearly again.Ademi noticed first."You seem different," he said Thursday morning before surgery."Better rested.""It shows. Your focus is sharper.""I didn't realize how depleted I was until I stopped.""That's usually how it works."I had surgery at nine. Complex aortic valve replacement. Four hours, clean outcome, patient stable in recovery.At two Ademi sent the Hopkins follow-up summary. Three pages of data review he'd handled independently. Clear, accurate, everything I needed.I sent back two clinical questions and he handled those too.That was delegation working correctly.Friday I had one institution call. Boston, sixty minutes exactly. They were training in July, wanted clarification on the simulation protocols.I answered t

Chapter eighty six

Adrian's POVParis sent first week numbers on Monday.Chen called at seven in the morning Brussels time."Week one is strong," he said. "Client acquisition ahead of projections. Facility running at full capacity.""No issues?""Nothing significant. One regulatory query we resolved in forty-eight hours. Otherwise clean operation.""Good work.""It's the Brussels model replicated correctly. Same structure, same execution standards."He hung up. I forwarded the numbers to Marcus.He appeared in my office at nine."Paris is exceeding projections in week one," he said. "That's faster than Brussels.""Chen learned from Brussels. He built Paris more efficiently.""The board is going to want Paris data at the next meeting.""Schedule it. Chen can present.""Harland will question the Paris timeline.""Harland questions everything. Chen will have the answers."Marcus left. I worked through the morning. The company was running well across all divisions. Singapore stable, Brussels profitable, Par