“I’m not worried about that,” Charlie said. He stopped himself before he was too tempted to admit to everything.

Dr. Ralter set down his glass. “What’s wrong? You should be elated. You got the fellowship.” Then he narrowed his eyes and cocked his head. “Unless this isn’t a surprise to you, Charlie. Is it?”

Charlie didn’t answer. He didn’t want to lie, but he didn’t want to admit to the truth either. Regardless, he didn’t have to. Dr. Ralter saw through everything. In fact, he actually looked a little like he was expecting this outcome.

“This isn’t a surprise to you, is it?” Dr. Ralter said with a sober expression.

Slowly, Charlie shook his head.

“Did your father have something to do with this?”

Charlie stared down at his napkin. “I asked him not to.”

“But he wouldn’t listen, and now you don’t want to give up the opportunity.” Dr. Ralter wasn’t even guessing anymore. He had to be some kind of seer.

He called over a server. “My friend here would like to order,” he said, smiling when Charlie scowled at him. “He doesn’t think he’s hungry, but he’s wrong. Bring him the most delicious item on the menu, can you? He needs to be in tip-top shape for the rest of the day.” When the server had gone, Dr. Ralter turned back to Charlie. “You’re aware that Megan has also applied for the fellowship?”

Again, Charlie nodded.

“Ah. It’s all coming together.”

“Or falling apart,” Charlie said.

“You need to tell her.”

That snapped Charlie out of his daze. He nearly spit out his water, he was so startled by the suggestion. “Absolutely not. Are you kidding? That’s the worst idea anybody’s ever had. She’ll hate me for the rest of her life.”

Dr. Ralter shrugged. “You think you can maintain a relationship without her finding out? I mean, assuming you do want to maintain your relationship. We’ve all seen the way you look at her, young man.”

Charlie shook his head with a sad smile. “Now you sound like my father. Look, Dr. Ralter, I’m not in the kind of place where I canjust allow a relationship to affect my career like this. I like her. I really do. But I have to prioritize?—”

“Your patients.” Dr. Ralter finished for him. “You were going to say that, weren’t you? Well, let’s just pretend that you were.” He took a casual sip of his tea. “Let me give you a piece of life advice you’ll probably never get from a man like your father. And yes, I am familiar with him — I haven’t been living under a rock for the last twenty years. Charlie, taking care of yourself is taking care of your patients. Looking after the health of your relationships is looking after them. Physicians who are distracted by the messes they’ve made of their personal lives rarely give the best possible care. Don’t neglect your own mental health and assume it’s somehow in the best interest of your patients. It isn’t. I promise you.”

“So you’re saying…”

“I’m saying tell her the truth. At least tell her that she never had a chance, or she’ll always wonder whether there was something she could have done differently. She’ll second-guess herself for the rest of her life. I know how ambitious she is. She’s going to act like she doesn’t care, but it’ll be a lie. She’s going to be angry, but if I know her half as well as I think I do, she’ll understand why you can’t turn the position down.”

“And if you don’t know her at all?”

“I guess that’s a risk you’ll have to take. But isn’t it better than the alternative?”

“Which is?”

“Lying to her for the rest of your life.”

Later that evening, Dr. Ralter announced to all the residents that Charlie had gotten the fellowship. Charlie watched Megan’s face fall, and his heart actually broke for her. Before she could go hide in the locker room, he found her and laid a hand on her shoulder.

“Megan?” he said, and when she turned to see him, he could easily read the tears she was holding back. “Are you going to be okay?”

“Of course I am,” she answered with an obviously fake smile. “It was always a fifty-fifty shot, right? I just wasn’t the best candidate, that’s all. I just…” She bowed her head. “I just wish I’d gotten a chance to interview, you know? I don’t understand why they chose a resident before interviewing everyone. I was hoping my winning personality would cancel out any inadequacy.” She tried to laugh, but it was about as convincing as her smile. “I mean the best resident won, right? By a landslide, apparently. They didn’t even need to interview. My inadequacy shined through, even if only on paper.”

“You’re not inadequate,” Charlie said. “Listen. Let’s get a coffee, huh? We haven’t had much of a chance to talk, and I think we should. I know you’re sore, but you shouldn’t be. You’re more than qualified. It should have been you. I mean that.”

“Then…” She paused and glanced up at him. “Then why wasn’t it?”

Charlie sighed and hated himself a little. “Because the system isn’t fair. I doubt it ever has been. Come on. Let me buy you a coffee, and I’ll explain everything.”

They walked together to the closest café, a little place that looked like it would be more appropriate on the West Coast. It had a rustic interior, warm lighting, and paintings from local artists on the walls. Charlie hoped the coziness would soften the blow he was about to deal. He had decided to take his attending’s advice this time. The truth was weighing him down too much, and he couldn’t stand the idea that Megan might doubt her own abilities because of this — not when her abilities had absolutely nothing to do with it.