DASHIELL
I stood in the small neurology conference room, staring at the MRI images displayed on the large screen. The lights were dimmed exactly how I liked them, just enough to see the scans clearly without the harsh overhead fluorescence burning my eyes.
Dr. Patel, one of the top pediatric neurosurgeons, stood beside me with his arms crossed, studying the images with a serious expression. We had been going over Sophia's case for the past twenty minutes.
"She's only four," I said, tapping my fingers steadily against the side of my tablet. "The lesion is in the left temporal lobe, close to eloquent areas. Motor regression is progressing slowly but noticeably. The seizures are increasing in frequency despite the medication we started."
Dr. Patel nodded. "I agree. This isn't a classic benign lesion we can watch and wait on. The focal features on EEG and the regression suggest it's causing real disruption. We need to operate."
I exhaled slowly, my left foot rubbing against my right ankle under the table.
"Surgery," I repeated, almost to myself. "How soon?"
"Within the next two weeks if the mother consents," Dr. Patel replied. "I'd prefer sooner rather than later. The longer we wait, the higher the risk of further developmental delay. I'll need you in the OR for intraoperative monitoring. Your input on the functional mapping will be critical."
I nodded once, precise and professional even as my fingers tapped faster.
"I'll speak with the mother today. She wanted a second opinion, I already arranged one with Dr. Martin at Children's National. But I think she's leaning toward proceeding here."
Dr. Patel gave me a respectful nod. "You've handled this case well, Dr Astor. Most neurologists would have sugarcoated it. You didn't. The family needs that honesty right now."
I didn't know how to respond to the compliment, so I just adjusted the alignment of my papers on the table until they were perfectly straight.
After Dr. Patel left, I stayed in the room for a few extra minutes, staring at the bright image of Sophia's brain. A small, abnormal mass sitting in her left temporal lobe, quietly disrupting her life.
I tapped my fingers rapidly on the table.
Four years old.
I hated this part of the job. The part where I had to look a mother in the eyes and say her child needed brain surgery.
I gathered my files, arranged them in perfect descending order, and headed toward Sophia's room. My foot-rubbing had intensified. The familiar static was building in my head.
I was almost at her door when I heard quick, sharp heels behind me.
"Dr. Harper-Astor."
I turned.
Dr. Calliope Langford was walking toward me, white coat perfectly pressed, elegant features set in a cool, professional mask. But her eyes… her eyes were sharp.
She stopped a few feet away, smiling in that way that didn't feel warm.
"I heard you're handling the neurology side for the temporal lobe mass case," she said smoothly. "The little girl who's going to need surgery. Poor thing."
I nodded once. "Yes. We are coordinating with neurosurgery."
Calliope tilted her head, her smile staying fixed but not reaching her eyes.
"Alexander must be so proud," she said lightly. "Having such a… dedicated little husband working alongside him."
My fingers froze mid-tap.
I didn't like the way she said that. The tone was sweet on the surface, but there was something sharp underneath it, like a scalpel hidden in silk.
I blinked at her, processing.
"He is proud of my work," I replied honestly. "We are both professionals. It is good when we can collaborate on cases."
Calliope let out a soft, almost pitying laugh.
"Oh, sweetie. Of course you think that." She took one graceful step closer, her heels clicking sharply on the floor. "You know, Alexander has always been… particular about the people he lets close to him. Especially in this department. He used to rely on me quite heavily for complex cases. We made an excellent team."
She paused, letting the words hang in the air.
I tilted my head slightly, my left foot rubbing against my right ankle.
"Are you saying you no longer work well together?" I asked, genuinely confused by her point.
Calliope's smile thinned.
"I'm saying some things changed very suddenly," she said, voice dropping. "One day he's completely unattached, the next he's married to a pediatric neurologist he barely mentioned before. It's… quite the plot twist, don't you think?"
My fingers started tapping again, faster now against the side of Sophia's file.
"I don't understand why that matters," I said plainly. "Our marriage has nothing to do with patient care. Sophia needs surgery. That is what we should be focusing on."
Calliope's eyes flashed with something cold.
"You really are adorable," she murmured. "So straightforward. So… innocent." She leaned in slightly, lowering her voice. "Just be careful, Dr. Harper-Astor. Like I said before, Alexander gets bored easily. And when he does… well. Let's just say not everyone survives the fallout intact."
She reached out and lightly brushed a piece of lint off my white coat, a gesture that felt far too familiar and invasive.
My whole body tensed. I stepped back immediately, foot-rubbing intensifying.
"Please don't touch me," I said, my voice firm. "I don't like that."
Calliope raised an eyebrow, clearly surprised by my directness, but her smile returned quickly, sharper this time.
"Of course. My apologies." She glanced toward Sophia's room. "Best of luck with the little girl. I hope your… unique approach doesn't delay her care."
With that, she turned on her heel and walked away, her steps confident and elegant.
I stood in the hallway for a long moment, fingers tapping rapidly against my thigh, trying to process what had just happened. My skin felt itchy where she had touched my coat. The static in my head was louder now.
I didn't like her.
I didn't like how she talked about Alexander.
And I really didn't like the way she looked at me.
I took a slow breath, adjusted the strap of my tablet case until it sat perfectly level, and stepped into Sophia's room.
Work first.
I could figure out Dr. Langford later.
*****
I stepped into Sophia's room, the familiar weight of the files in my hands grounding me slightly. The lights were dimmed, I had asked Nurse Kim to adjust them earlier because I remembered how sensitive Sophia got with bright overhead lighting.
Sophia was sitting up in bed, drawing with crayons on a large sheet of paper. Her mother looked exhausted, eyes red-rimmed like she hadn't slept properly in days.
"Good afternoon," I said directly, arranging my papers on the rolling table in their usual perfect order. "I spoke with Dr. Patel, the neurosurgeon. We reviewed the MRI together."
The mother straightened immediately, fear flashing across her face.
"What did he say?"
I kept my voice calm and honest, the way I always did.
"The lesion in Sophia's left temporal lobe is most likely causing her seizures and the regression in her movement. Dr. Patel recommends surgery to remove it. The sooner we do it, the better the chance of stopping the seizures and protecting her development."
Sophia looked up from her drawing, clutching her stuffed bunny.
"Will they cut my head open?" she asked in a small voice.
I turned to her and gave her a small, direct smile.
"Yes. But you will be sleeping the whole time. You won't feel anything. And when you wake up, the bad part in your brain that's making you have staring spells will be gone."
Her mother's eyes filled with tears.
"Is it dangerous?" she whispered.
"All brain surgery has risks," I answered honestly. "But Dr. Patel is very experienced with children. Because of where the lesion is, there is a small risk of affecting speech or memory, but we will use special monitoring during the operation to protect those areas. I will be in the room too, watching the brain waves."
I paused, my fingers tapping a steady rhythm against the side of the tablet.
"I know this is scary. You asked for a second opinion, I arranged one with Dr. Martin at Children's National. They can review the scans tomorrow if you want. But I believe surgery is the best option."
The mother wiped her eyes and looked at her daughter, who had gone back to coloring quietly.
"I… I don't want her to suffer anymore," she said, voice breaking. "The staring spells are happening more. She's falling behind other kids her age."
I nodded once.
"Then we should move forward. I can schedule the surgery for next week if you agree after the second opinion."
I stayed in the room for another twenty minutes, answering every question the mother had, no matter how small or repeated. Sophia even asked if her bunny could come to the hospital on surgery day. I told her yes.
I had just stepped out of Sophia's room when my pager went off.
Urgent Neurology Consult – Elias Grant, 16 y/o
Cardiothoracic Floor – Room 812
Chief Astor requesting
My fingers tightened around the pager. Alexander was requesting me specifically. That wasn't unusual when our departments overlapped, but after everything last night, I felt a small flutter of nervousness mixed with something warmer.
I adjusted the strap of my tablet case until it sat perfectly level, took a slow breath, and headed toward the elevator.
When I reached the eighth floor (Cardiothoracic wing), the atmosphere was noticeably different, more intense, more urgent. I walked down the hallway on the balls of my toes, fingers tapping rapidly against my thigh as I passed several nurses and residents.
I stopped outside Alexander's office door, hesitated for half a second, then knocked twice.
"Come in."
I pushed the door open.
Alexander was sitting behind his large desk, white coat draped over the back of his chair, sleeves rolled up to his forearms. The room was dimly lit, just how I liked it. Multiple large monitors displayed cardiac imaging, MRI, echo, angiograms. He looked focused. Powerful and In complete control.
He glanced up when I entered, and something dark and possessive flickered across his eyes for a brief moment before his usual cold mask settled back in place.
"Dashiell," he said, voice low and calm. "Come here."
I walked over to his desk, stopping beside him instead of sitting. I leaned forward slightly to look at the screens, my shoulder brushing his.
"Elias Grant?" I asked directly. "What happened?"
Alexander leaned back in his chair, one hand casually resting on the back of my thigh under the desk, hidden from view but very intentional.
"Sixteen-year-old male with unrepaired Tetralogy of Fallot. He's been stable most of his life but started deteriorating two weeks ago, syncopal episodes, increasing seizures, and dropping oxygen sats. Neurology was consulted because the seizures are getting worse and he had a focal seizure yesterday."
I studied the images carefully, hyperfocusing on the brain MRI that had been pulled up on the second monitor.
"There's a small area of ischemia in the right frontal lobe," I murmured, more to myself than him. My fingers started tapping rapidly against the edge of his desk. "That could explain the new focal seizures. His heart is probably throwing clots or he's having paradoxical emboli because of the right-to-left shunt."
Alexander's hand slowly stroked the back of my thigh, thumb pressing into the muscle.
"Exactly," he said. "He needs corrective heart surgery within the next few days, but the neurological instability makes it risky. I want you on the case. Pre-op, intra-op monitoring, and post-op management."
I nodded, still staring at the scans.
"I'll need to do a full neuro exam and probably repeat the EEG. He might need anti-seizure medication adjustment before surgery." I paused, then added honestly, "This is complicated. His brain is already stressed. Open heart surgery could make the seizures worse."
Alexander's hand slid higher on my thigh, squeezing possessively.
"Then you'll just have to monitor him very closely, won't you?" he murmured, voice dropping. "I want you in the OR with me."
I turned my head to look at him. My cheeks felt warm.
"You want me in your operating room?"
His dark eyes locked onto mine with that terrifying intensity I was becoming addicted to.
"I always want you close to me," he said flatly. "Especially when I'm cutting open a chest."
I swallowed, fingers tapping faster.
"Okay," I whispered.
Alexander's lips curved into a small, dangerous smirk. His hand squeezed my thigh one last time before he pulled away.
"Good boy. Now go see the patient. I'll meet you in his room in twenty minutes."
I nodded, trying to ignore the way my body reacted to his touch and his words.