Page 20 of Crossing the Line
Carmen made her way back toward the surgical wing, where Harper would be waiting for instruction. There was no escape. Just professional obligation and the growing certainty that this would be the longest rotation of her career.
Carmen spent the next hour buried in paperwork, using administrative tasks to avoid thinking about Harper. In her office, Carmen was still reviewing post-operative protocols when the trauma alert pierced the afternoon quiet. The announcement crackled through the intercom system with the particular urgency that made every medical professional stop what they were doing and listen.
"MVA, Emergency Department. All available surgical staff to trauma bay one. MVA, Emergency Department."
Multi-vehicle accident. Carmen's analytical mind automatically catalogued the implications: multiple casualties, potential for complex injuries, all hands needed. She abandoned her paperwork and moved toward the emergency departmentwith the controlled urgency that years of trauma response had ingrained.
The emergency department buzzed with organized chaos. Dr. Hassan coordinated triage with practiced efficiency while nurses prepared trauma bays and surgical teams assembled. Carmen counted at least four ambulances outside, their red and blue lights painting the windows in urgent color.
"What do we have?" Carmen asked Dr. Hassan, falling into the familiar rhythm of emergency medicine.
"Three-car collision on the interstate. Four casualties, two critical." Dr. Hassan's voice carried the calm authority that made her exceptional at emergency medicine. "I need you on trauma bay two—chest trauma, potential cardiac involvement."
Carmen nodded and moved toward the assigned bay, but her attention was caught by movement in trauma bay one. Harper stood beside Dr. Parker, not observing from the sidelines but actively participating in patient assessment. Her hands moved with confidence as she examined a patient's respiratory function, calling out observations that Dr. Parker incorporated into treatment decisions.
This wasn't the careful intern behavior Carmen expected. Harper was functioning like an experienced trauma surgeon, reading vital signs and injury patterns with the kind of intuitive understanding that usually took years to develop.
"Dr. Méndez?" A nurse's voice pulled Carmen's attention back to her own patient, a young man with obvious chest trauma and labored breathing. Carmen forced herself to focus on the immediate medical crisis, but part of her awareness remained tuned to trauma bay one.
Carmen's hands moved through their familiar dance of trauma assessment: airway evaluation, breath sounds, cardiac rhythm assessment. The patient needed immediate surgicalintervention, and he had damaged lung tissue, possible cardiac contusion, and internal bleeding that required surgical repair.
"Prep for emergency thoracotomy," Carmen called out, her voice carrying the authority that made trauma teams respond without question. "Get me a surgical suite and cardiac monitoring."
As her team moved to transfer the patient, Carmen caught fragments of conversation from trauma bay one. Harper's voice, calm and controlled, described arterial damage with the kind of detail that spoke to genuine surgical understanding.
"Arterial integrity compromised at the brachial junction," Harper was saying. "Recommend immediate vascular repair to prevent limb loss."
Dr. Parker's response was approving. "Excellent assessment. Take point on the initial suturing while I handle the thoracic injuries."
Carmen felt something unexpected twist in her chest. Harper wasn't just observing or assisting; she was leading aspects of trauma care with the confidence of someone who belonged in that environment. Her surgical instincts were evident in every movement, decision, and interaction with the medical team.
Carmen's own patient was moved to surgery, but the image of Harper in trauma bay one lingered. The way she'd moved with purpose and authority, the calm competence in her voice, the obvious respect she'd earned from Dr. Parker within minutes of working together.
This wasn't the behavior of someone playing a role or trying to impress supervisors. This was genuine surgical aptitude in action.
The thoracotomy took two hours of intense focus, but Carmen's mind kept drifting to what she'd witnessed in the emergency department. Harper's natural command of trauma procedures, her intuitive understanding of complex injuries,the way she'd stepped into leadership without hesitation or uncertainty.
By the time Carmen finished surgery, the emergency department had returned to normal afternoon operations. She found Dr. Parker completing post-trauma documentation, looking satisfied with the day's outcomes.
"How did your patients fare?" Carmen asked, though she already suspected the answer from Dr. Parker's expression.
"Excellent outcomes across the board," Dr. Parker said, her voice carrying genuine enthusiasm. "That new intern—Harper Langston—has exceptional instincts. She’s a natural trauma surgeon and handled the vascular repair with precision I don't usually see in first-year residents."
Carmen nodded, trying to maintain professional interest despite the emotional complexity churning in her chest. "She seems capable."
"More than capable. She's gifted." Dr. Parker's assessment was unequivocal. "If she's interested in trauma surgery, she'd be a valuable addition to our program. Her spatial reasoning and crisis management are already at resident level."
Each compliment felt like validation and betrayal simultaneously. Carmen was proud of Harper's abilities—the same pride she'd feel watching any promising student excel. But it was complicated by the personal history that made every professional interaction feel like navigating a minefield.
"I'll keep that in mind during her cardiac rotation," Carmen said.
"She mentioned cardiac surgery is her primary interest," Dr. Parker continued. "Lucky for you. She'll be an asset to your program."
Carmen managed appropriate responses and made her way back to the cardiac wing, but her mind remained focused on what she'd witnessed. Harper's competence wasn't an act or aperformance designed to impress supervisors. It was genuine surgical talent that would have been evident regardless of personal complications.
She found Harper in the cardiac wing, reviewing case files with the same focused attention Carmen brought to her own work. Harper looked up when Carmen approached, and for a moment, something beyond professional courtesy flickered in her expression.
"Dr. Méndez," Harper said, her voice carefully neutral. "I was reviewing the cardiovascular complications from today's trauma cases. The intersection between emergency medicine and cardiac surgery presents interesting learning opportunities."
