Twice Upon a Train

CHAPTER ONE

Lisa caught sight of movement in her peripheral vision. Premeds—stepping closer to anesthesia, lifting onto their toes, peering wide-eyed over the drapes. Thank God NYC General's policy prevented them from scrubbing in. "Alright, that's it," she barked. "All of you, move right now, move to that perfect position, the one you've obviously been searching for, and stay there until I say you can move again. This patient deserves better than to have her surgeon distracted by the constant shuffle of your feet." It was a routine gallbladder operation, one that she should have been able to do in her sleep. But she'd lost her edge, lost what top surgeons took for granted, the ability to remain cool under pressure. Distractions—an unexpected movement, a loud noise, a negative thought—in recent days, maybe weeks, they'd gotten the best of her. "If my hand slips," she continued, "even by one millimeter, I'll pierce this patient's bile duct. Is that what you want?"

"No."

"No, Dr. Manoban."

"No, Doctor."

Smooth move, Sherlock. Let everyone know you're worried about making a beginner's error, that's the way to build confidence. She returned her attention to the hot gallbladder, thinking about the stress of her new position—Chief of Trauma Surgery. From there, her mind wandered back to her students. You were just like them, you know, eager to learn, determined to change the world, to make a difference. Like them, you wanted to help the less fortunate, to be better than the doctors who served as your teachers, to repair a broken system. She removed her skull cap, making her way to the family waiting room, trying to remember the precise moment when she'd lost her passion for medicine.

"The surgery went well," she said, sitting next to the husband. "She'll be in recovery for a couple of hours." She answered his questions, providing an appropriate amount of detail. As she stepped off, wanting nothing more than to slip back to her office unnoticed, an attractive brunette joined her.

"Are you okay?" Naomi asked. "Because you seemed stressed in the OR, short with the students, not yourself." This familiarity, this crossing of boundaries, it was why doctors should never sleep with their nurses, not even once.

"I've been working around the clock for days," Lisa responded. "I'm exhausted and dehydrated. Other than that, I'm good as gold." If only that were all it was.

"We're through the worst of it," Naomi said, referring to the Interstate pileup that had filled the ER with mangled limbs and head-traumas. "You should take some time off. You never take time off." She brushed Lisa's hand with her fingertips. "Come on; it'll be good for you." It had been a year since that night, the one where their ethical boundaries had blurred, and still, there were times she acted as if they were lovers.

"Maybe so," Lisa answered. "I'll think about it." It'd been five years since her last vacation; maybe a trip would be helpful. God knows she needed to do something.

"So, do it then," Naomi persisted, playfully bumping into her. "What's stopping you? Surely, it can't be the money. I mean, with all the surgeries you do; you must be rolling in dough. In the grand scheme of things, what's a week or two off?"

"I said I'd think about it," Lisa responded, entering the ICU.

Twelve hours and three grueling surgeries later, she stepped outside, fatigued to the bone.

"Looks good, doesn't it?" a colleague greeted, crossing paths with her on the sidewalk that ran in front of the hospital.

Lisa wrinkled her brow, looking up.

"The new facade, it looks good."

"Oh, yeah, yeah it does," Lisa answered, surveying the updates to the main building. "Nothing screams cutting-edge medicine like shiny glass, lush landscaping, and bluestone tiles." Walking toward the parking garage, she experienced irrational jealousy—of the building, and of the young doctor who'd just gone inside. At thirty, she felt old. Maybe Naomi was right; maybe she did need some time off. Driving home, she considered how she might carve out two weeks without causing hardship. If she rescheduled her elective surgeries, it was doable. But if she did go somewhere, where would she go? She parked in the lower deck, crossed the checkerboard floor, and rode the elevator to her building's rooftop lounge.