Page 26 of Crossing the Line
Carmen checked her watch. Two o'clock. Time for rounds with the surgical interns assigned to her supervision. She gathered her files and moved toward the conference room, where three first-year residents waited with the particular alertness of people determined to prove themselves.
Harper sat with perfect posture, notepad ready, her attention focused entirely on the medical charts spread across the table.Beside her, Brooke Donovan reviewed surgical approaches with the methodical thoroughness Carmen appreciated in interns. Willow Franklin had arranged her materials with obsessive precision, color-coded tabs marking different sections of her notes.
"Good afternoon," Carmen said, settling into her chair with practiced authority. "We'll be reviewing post-operative protocols for cardiac patients, specifically monitoring for complications during the first forty-eight hours."
Three hands moved across their notepads in synchronized efficiency. Carmen began her explanation of arterial pressure monitoring, but found her attention drifting to Harper's careful questions that were intelligent, relevant, and demonstrating preparation that went beyond basic requirements.
"Dr. Langston," Carmen said, testing Harper's knowledge. "What's the primary concern with patients showing irregular heart rhythms twelve hours post-surgery?"
Harper's response was immediate and comprehensive. "Potential for arrhythmia indicating incomplete repair, medication interactions affecting cardiac rhythm, or early signs of infection. We'd want to review surgical site integrity, check medication levels, and consider doing an echo evaluation to assess mechanical function."
Perfect. Carmen felt something twist in her chest, professional pride mixing with personal complication in ways that made concentration difficult.
"Correct," Carmen said, moving to the next topic before her expression could betray anything beyond professional assessment.
The hour progressed with increasing technical complexity. Harper's responses remained thoughtful and accurate, but more importantly, she seemed genuinely engaged with cardiac surgery rather than performing for evaluation. Carmen foundherself explaining advanced techniques with more detail than usual, drawn by Harper's obvious passion for the specialty.
"The key to successful cardiac repair," Carmen was saying, "lies in understanding that every intervention affects multiple systems. You can't approach the heart as an isolated organ."
"Like the intersection between cardiac function and neurological response during surgery?" Harper asked. "I've read about surgeons monitoring cognitive indicators during complex procedures."
Carmen paused, genuinely impressed. That level of thinking went far beyond intern-level knowledge. "Exactly. The brain-heart connection during surgery is crucial for optimal outcomes."
Their eyes met across the conference table, and for a moment, Carmen forgot about professional boundaries. Harper's intelligence wasn't an act designed to impress supervisors. It was genuine curiosity that reminded Carmen why she'd fallen in love with cardiac medicine.
The moment shattered as the hospital's emergency system crackled to life.
"Code Red, all available surgical staff to trauma bay one. Multiple casualties, residential fire, ETA five minutes. Code Red, trauma bay one."
Carmen was moving before the announcement finished, her teaching materials forgotten. Behind her, the three interns scrambled to follow, but her attention focused on the controlled urgency in Harper's movements. No panic, no hesitation—just immediate transition to emergency protocols.
"What are we looking at?" Brooke asked as they hurried through hospital corridors.
"Residential fire means potential smoke inhalation, burn trauma, and possible cardiac complications from oxygen deprivation," Carmen explained, her mind already catalogingtreatment approaches. "Willow, you'll assist with airway management. Brooke, trauma assessment and stabilization."
She turned to Harper, professional necessity overriding everything else. "Harper, you're with me on cardiac monitoring. Fire victims often present with irregular heart rhythms from smoke exposure."
Harper nodded, falling into step beside Carmen with natural ease. "Should we expect firefighter casualties as well?"
"It’s possible. Phoenix Ridge Fire Department responds to everything, and residential fires can be unpredictable."
They reached the trauma bay as the first ambulance arrived, its red lights painting the windows in urgency. Carmen could see EMT teams preparing stretchers, the controlled chaos of emergency response unfolding with practiced efficiency.
"Remember," Carmen told her team, "we work together, we trust each other's assessments, and we save lives. Everything else is secondary."
Harper's steady presence beside her felt both comforting and dangerous. Professional necessity demanded they work as a team. Personal history demanded she maintain distance.
Carmen chose necessity. Lives depended on it.
The ambulance doors opened, and emergency medicine took over.
Carmen assessed the situation with clinical detachment: three firefighters with varying degrees of smoke inhalation, two civilians with severe burns, and a construction worker who'd been trapped during the building collapse that followed the fire.
"Trauma bay two for the construction worker," Dr. Hassan called out, coordinating triage with practiced efficiency. "Dr. Méndez, we need you on the firefighter with chest trauma."
Carmen moved toward the stretcher where EMTs were transferring a woman in her thirties, her Phoenix Ridge FireDepartment uniform charred and torn. The patient's breathing was labored and her skin pale despite the soot covering her face.
"What do we have?" Carmen asked the lead paramedic.
