#nosdecember

“Ava!” Connor’s voice was barely audible over the chaos of the emergency department. It didn’t help that Ava was majorly overwhelmed, trying her hardest to focus on the task at hand so she didn’t have time to panic. It took a gentle nudge from April’s elbow meeting her ribcage before she was able to look up from the central line she had been doing.

“Go help him,” April ushered her out of the treatment room, “I can get a student to do this.”

Ava nodded, too much going on for her to be comfortable to respond. She slipped out of the crowded treatment room, pulling off the pair of gloves that had been making her increasingly uncomfortable. The ED was packed, chaos unfolding as Maggie tried to get the disaster protocol in place. A train accident had all hospitals in the area absolutely swamped with patients and Gaffney was getting the brunt of it due to its proximity. Ava and Connor had been called down to help with the traumas and assess any cases that would need surgical intervention. Connor was pleased; well, as pleased as a trauma surgeon is in such a morbid situation. He enjoyed the chaotic, fast-paced environment of the emergency department when it was experiencing a mass trauma. Ava, however, disliked that exact environment completely. She preferred the predictable, familiar OR where she was in charge and the only thing she had to worry about was finishing the procedure she could often do completely from muscle memory.

To say Ava was uncomfortable was an understatement. She hadn’t seen Sarah in a few hours, since the psychiatrist was jumping between the ED, the waiting room, and upstairs. Connor and her hadn’t been on great terms since their altercation in the CT lounge, especially after Ava had emerged from the room with makeup streaked down her red cheeks and other evident signs of a major panic attack. He didn’t apologize for making her meltdown and she didn’t ask for it; they just fell into some kind of silent cold war. No conversations had come up between them unless it involved work or faux-pleasantries to avoid confusing Latham. Since then, Ava had been increasingly more uncomfortable in Connor’s presence, so the last thing she wanted to do was go help him with a trauma. This meant she didn’t have a single person in her general vicinity to give her some semblance of security, which only worsened her anxiety.

“Finally,” Connor didn’t look up when Ava walked into Baghdad, which meant he missed the death glare she halfheartedly directed at him. He motioned for her to come closer, making her realize how much of a predicament this patient was in.

A large metal rebar was protruding from the upper chest of a teenage boy, whose clothing was bloodied and the rest of his body didn’t look much better. This was unfortunately something Ava had seen more than once since moving to Chicago. From the placement of the bar it looked like it would be a tricky surgery, though not one that Connor couldn’t do with the help of a resident. She wasn’t needed, not really, so why did he call her in here?

“Rebar to the anterior chest cavity, not through and through, pretty sure the bar snagged the left subclavian.”

“Where do you need me?” She tried her best to settle into her surgical mindset, ignoring the way the erratic beeping of the heart monitors was getting to her.

“I don’t think he can make it upstairs,” he was saying as he looked over the labs that Monique handed him, “You’ll need to go to the hybrid OR.”

“That doesn’t answer my question, Connor,” Ava gently lifted the gauze packed around the bar to check the wound, “You don’t need me, not for this. I could be helping with the other surgical candidates.”

“You’re going to do this, Ava,” Connor looked at her for the first time, “I have other patients already prepped upstairs.”

Ava’s heart sank. Not only was he forcing her to operate in an unfamiliar OR, he wouldn’t even be there for it. Usually Ava hated sharing her surgeries, especially with Connor, but today was just not a day for that. She hated traumas, was uncharacteristically unsure of things like this, so the thought of doing it without a trauma surgery assist sounded like a bad idea.

“Connor, no.”

“Ava, you’ll be fine,” he was already taking off his gloves and heading to leave the room, “The team’s already prepping, just get the bar out and repair the artery.”

“Connor!” He was already halfway past the nurse’s station by the time she had tried to stop him. Ava was painfully aware of the amount of eyes on her, the staff around her looking to the surgeon for clarification. She tried to take a deep breath but her lungs felt like they were in a vice, panic slowly setting in. She shouldn’t be this nervous, she tried to reason with herself, it was just another surgery. Everything was too much though; this was too much change at once.

“Doctor Bekker?”

“Right, uh,” Ava blinked rapidly as she looked over at the nurse, “Get him to the hybrid OR then. I’ll go scrub.”

She could do this.

She had to.

Five minutes later, she was scrubbing in. She didn’t like this at all, the OR in the emergency department was so different. It was new, yes, and very nice but it wasn’t her ORs. The huge glass windows looking into the ED only worsened it for Ava. She felt like a changed animal being watched at a zoo, except she couldn’t even pace to make herself feel better. She was on display and could see the chaos outside too, it was too much.

“Ready, Doctor Bekker?” some resident whose name she suddenly forgot asked from beside her. The young woman didn’t like Ava very much, probably because she thought she got in her way of Connor, but Ava could not care less. Residents were the least of her worries, especially now.

“Uh, yeah. Give me a second.”

She left the scrub area, going to get her gown and leaving Ava in silence. She got distracted by staring out the window, eyes tracking Natalie as she ran across the ED when a code blue sounded over the speakers. Ava didn’t realize how hard she had been scrubbing her hands until she looked down and saw how red her skin had become. Her anxiety was getting the better of her, making her revert to old compulsions in an attempt to soothe herself. She hadn’t been so obsessive about cleaning since med school, but she found herself washing her hands for a second time because something just felt off.

By the time Ava nudged the door to the OR open with her hip, her adrenaline was so high she wanted to run. Somehow it felt like her heart was going to jump from her chest, as anatomically incorrect as that might be. She was focusing on deep breaths while the scrub nurse helped her into her gown, but when she held open the first glove Ava knew this would be a problem.

Nitrile gloves were a sensory nightmare when she was anxious, as ironic as that was. Yes she was a surgeon and yes surgical gloves and the consistent beeping of heart monitors could trigger sensory meltdowns. Ava didn’t know for sure why and she had spent years forcing herself to ignore the anxiety that ate away at her stomach whenever she felt those gloves touch her skin.

Today was different though.

The second she had both gloves on she wanted to scream, the feeling of the material tight against her hands more uncomfortable than ever. She couldn’t stop herself from immediately reaching to touch her collarbone, a self-soothing stim she had since she could remember, subsequently breaking her sterile field when her hand brushed her neck. Cursing under her breath, Ava apologized and explained to the staff that she would need to go rescrub.

She ran to the sinks without thought, ripping the gloves and gown off her body the second she was out of the operating area. Her mind was a jumble of thoughts, heart rate probably above 160 if she had to guess. Everything was too much and even after tossing the offending gloves into the waste bin she felt like they were still there. The awful feeling of bugs crawling along her wrists and the powdery residue left behind from the nitrile made her want to gag.

Before she could stop herself, Ava clapped her hands over her ears. The yelling from the ED, the hum of the air conditioning, and the constant beeping of different machines was finally getting to her. The gloves had been her last straw though, bile rising to her throat at the thought of having to put them back on. Even when she scrubbed at her hands roughly with the harsh anti-microbial soap again she still felt them, the sensation making frustrated tears pop up without consent.

The next thing Ava knew she was on the floor. She couldn’t handle it anymore; everything was so much. She was crying, she knew it, but she couldn’t hear herself or anything else over the flood of thoughts that suddenly hit her. The rough texture of her scrubs was at the forefront of her mind, a constant reminder that she couldn’t exist without one thing touching her. Every tactile sensation was too much in that moment and a harsh sob left her throat.

All she could think about was what Connor said in the lounge that day. All of the intrusive, hateful thoughts that morphed themselves out of his words erupting in her head. Even though most of them weren’t ones Connor had actually said out loud, Ava’s anxiety took his anger poorly and had a hayday with the self-deprecation fuel.

All you do is get in the way, Ava.

Were you even thinking about the patient?

You’re so selfish.

This is so childish.

You’re not cut out to be a surgeon.

Ava was so far in her head she didn’t hear the nurses yelling, trying to get her attention. She didn’t hear Connor’s voice as he was asking her what the hell she was doing and what was wrong. All she could do was sob, short nails digging into her biceps with as much force as she could muster. She was so overwhelmed and everything was too much. She was hyperventilating, the room starting to spin, she was supposed to be doing a surgery. Why wasn’t she in surgery?

The next thing Ava knew she was waking up, disoriented because she didn’t remember falling asleep. It took her a few minutes of confused staring at the white ceiling before she realized she was in a patient room. Panic set in almost immediately, concern for the patient flooding her more than any concern for herself. She felt an immense wave of guilt; what had she done?

The rapid beeping of a heart monitor signaled her increasing tachycardia and that immediately caught someone’s attention. Sarah was there in seconds, hands landing cautiously on Ava’s cheeks to soothe her. Ava didn’t resist because she knew immediately that it was Sarah, relaxing into the touch but unable to make eye contact. She was still overwhelmed, despite the amount of sedatives undoubtedly circulating her system. The mental toll was just as bad as the physical and all she wanted to do was melt into Sarah’s arms and weep.

There was a pool in his apartment building, and a gym, but no garden, so he’d had to make do with what he had. His balcony was a good size, and he’d filled it with so many plants he was sure it was going to fall down. It had started with just a couple of ferns, something to add a bit of green to the otherwise bleak view out of his window, but had quickly turned into something more. Within a few months he had a little herb garden, growing almost everything he needed to cook with, and a strawberry planter in one corner that he took care of the way his mother had taught him. The rest of the space was filled with an assortment of random plants - fuschias, roses, petunias, and a series of succulents that somehow kept dying despite everything he did.

The balcony was his happy place.

Then Lolly had been born, and he only had time for her. Every waking moment was spent feeding or rocking or changing her. He slept when she did, and if by some miracle she was awake and happy to just lie on his chest or in her crib, he’d spend that time making arrangements for his move back to New Orleans. 

There was almost no time left for his balcony, and it broke his heart watching it slowly die back, knowing he couldn’t do anything. He tried to water the plants when he could, and pruned them once or twice, but he didn’t have the hours to dedicate to them like he used to.

Their new house had a garden though - he’d made sure of it. It wasn’t as big as the one he’d grown up with, but it was enough. Lolly would be able to run and play as she got older, and there was space on the lawn for a swing set or a climbing frame, if she wanted one. He had plans for a new herb garden, bigger than the one on his balcony, and if all went well, he wanted to try his hand at growing vegetables as well. 

Once the two of them were settled, his mom and Jo came round to help with the garden. It took them a couple of afternoons, but he couldn’t have been happier with the results, and he sent both of them wine and a tin of homemade beignets as a thank you.

From then on, whenever he had free time, he’d take Lolly out to the garden with him so she could watch as he planted and watered and tended an ever growing collection of herbs and vegetables. When she was still little, she’d lie on a blanket and play by herself while he gardened, but as she got bigger and learned to walk, she started wanting to help. He’d dress her up in her little sun hat and denim overalls, and the two of them would spend the day in the garden together.

There was nothing he enjoyed doing more, and every time she’d toddle over to him and produce an assortment of herbs from her pocket, his heart would swell with pride. 

They’d warmed up after a couple of minutes, and Ava began the short drive back home. The sky was darker than it had been even an hour ago, and heavy in the way that said snow was coming. She hoped it would be during the night, because neither she nor Sarah had work in the morning, and a day spent building snowmen in the park and drinking hot chocolate in bed was exactly what they both needed right now.

Their apartment was on the second floor, at the front of the block, and as Ava walked from her car to the door of the building, she could see Sarah’s silhouetted figure dancing in the kitchen. She hadn’t done much of that recently, not the way she used to, so seeing her looking like her old self was a good sign, and Ava couldn’t help the grin that spread across her face as she made her way upstairs.

Her keys were buried in the bottom of her bag, as they so often were, and she struggled for a minute or so trying to find them before the door opened in front of her. Sarah was standing there in leggings and one of Ava’s baggy sweatshirts, her curls pulled up in a messy topknot, and she looked more at peace than she had for a long time.

     “I saw you pull up outside,” Sarah explained, before taking Ava’s coat and bag from her and placing a gentle kiss on her cheek.

Ava nodded and returned the kiss, then allowed Sarah to lead her through to the kitchen. The whole apartment smelled of garlic, and something else Ava couldn’t quite put her finger on, and Carly Rae Jepsen was playing from the speaker on the countertop. It was unlike Sarah to be listening to something this upbeat, but with the way things were at the moment, she was doing whatever she could to bring her mood up. If that meant listening to LA Hallucinations on repeat while she chopped potatoes, then that was what she was going to do.

Sarah had set out their meal on the kitchen table, instead of leaving it on the side so they could grab what they wanted and eat on the couch, and she’d even gone as far as to light some candles and open a bottle of red wine. (Technically she wasn’t supposed to drink with her antidepressants, but if they hadn’t stopped her from chugging half a bottle of vodka when she was seventeen, she wasn’t going to let them stop her from enjoying a glass of wine with her girlfriend at twenty-seven.)

Everything looked perfect, and Ava snaked her arms around Sarah’s waist as she told her exactly that. 

She’d started cooking properly during her suspension, and now that she was on medical leave she had even more time to indulge in her new hobby. It was relaxing (despite the meltdowns she’d had the few times things had gone wrong), and it managed to ground her more than any of the techniques she’d learnt in therapy. The repetitive motions - stirring a pot, dicing vegetables, sieving flour - were what helped most when she was stressed, and by the end, she had something to show for it.

     “I hope you like it. I found the recipe online, so I’m not sure if it will be okay, but-”

     “Shh. It smells and looks wonderful, my love. You’ve done a great job.” She pressed a kiss to Sarah’s temple, then sat down and took a sip of her wine. 

The food did look good - rosemary and garlic butter steak, with crispy little roast potatoes and grilled vegetables - and Ava was so proud of Sarah for it. She’d come a long way in the last couple of months, in almost every sense, and even though she still had a way to go, things were looking up again.

They talked while they ate, Ava updating Sarah on all the hospital drama she was missing out on (although she managed to avoid repeating the things some of the nurses had been saying about the crazy psychiatrist), and Sarah telling Ava about her day. She didn’t do much, save for her cooking and some mindfulness Dr Charles had insisted she try, but she always seemed to have funny stories about their neighbours, who, Ava had to admit, were some of the weirdest people she knew.

Once they’d finished eating, Sarah grabbed two spoons and a pint of chocolate ice cream from the freezer, and the couple made their way over to the couch. They had a collection of blankets and throws, and as soon as they’d sat down, Ava pulled the fluffiest one on top of them and snuggled up to Sarah. 

It turned out to be Nat, a math teacher Sarah had only seen in passing, and Maggie was more than happy to help Sarah choose a gift for her (while remaining completely silent about who her own Secret Santa was.) Ava and April were the same - they both refused to reveal who they were buying for, claiming that it would “ruin the magic”, and it wouldn’t be secret if they told her.

     “You’re exempt, because you don’t know anyone and you need us to help you,” Ava had explained, and April simply nodded along in agreement.

All the gifts were left in a basket on one of the tables in the teachers’ lounge to be handed out on the last day, so a couple of days before that, Sarah had arrived earlier than usual to drop hers off without being seen. With Maggie’s advice, she’d chosen a scented candle simply named “Winter”, that cost more than any candle should, and a little bottle of what was, according to Maggie, Nat’s favourite champagne.

It was all wrapped up neatly in brown paper covered with tiny Christmas trees, a feat that had taken Sarah well over an hour to achieve. Every other year before now, she’d managed to wrap each gift in just under five minutes, but Olivia was one now, and constantly wanted to see what her mom was doing; she’d grab and pull at all the paper, and put bow after bow in her mouth, no matter how many times Sarah took them off her. 

In the end, Sarah had decided to wait until Olivia was asleep, but by that point she was willing to shove the presents in a little gift bag with some shredded tissue paper and call it a day. That felt wrong though, so she’d forced herself to wrap the gifts the way she wanted to originally, with the promise of an early night once she was done.

On the day of the gift exchange, most of the staff had gathered in the teachers’ lounge after school - not just those who’d participated, but others who wanted to come along for the fun of it. Jimmy was standing on a table, looking like a completely different person in an ugly light-up sweater instead of a suit as he announced each person’s name, and a couple of people managed to get pictures before he noticed.

Nat seemed to like her gift, which was a big weight off Sarah’s shoulders, and she thanked Maggie for her help. Ava unwrapped a wicker basket filled with bottles of hot sauce, and Sarah wasn’t sure she’d ever seen her this happy. It wasn’t what she’d expected from her, but she had to remind herself that despite their near-constant flirting, they didn’t know all that much about each other.

Sarah was one of the last people to get her gift, and was so distracted by Ava and her hot sauce that it took her a moment to register Jimmy calling her name for the third time.

She didn’t hesitate opening her present, and she could feel Ava’s eyes on her as she peeled back the wrapping paper to reveal a pair of suspenders and a bow tie. They were both dark green, the suspenders not too different from a pair she already owned (and loved), and the bow tie was covered in tiny white chromosomes. 

They were perfect, and she told Ava this as she tried to separate the bow tie from the cardboard it was attached to.

People started filing out of the room once everyone had their gifts, and Ava followed Sarah back to her class, as she so often did after school. It had become their little routine by now - fifteen minutes (sometimes more) spent in one of their rooms at the end of the day, catching up over coffee before they went their separate ways.

The last day was no exception, and Ava was almost giddy as she perched herself on one of the front row desks. This was the last time they had together until school came back, unless one of them was brave enough to invite the other somewhere, and Ava wanted to make the most of it.

     “Are you going to try it on?” She motioned towards the bow tie that had been set down on Sarah’s desk, and the other teacher nodded.

     “I can help, if you want?”

It was a pre-tied bow tie, one that Sarah could put on with her eyes shut, but she somehow found herself saying yes, and handing it to Ava.

What came next was something she didn’t think she’d ever be prepared for.

She was leaning on the very edge of her desk, her legs slightly apart, and within seconds Ava was standing between them, closer than she ever had been before. Sarah’s breath caught in her throat as Ava lifted the collar of her shirt and removed her Christmas bow tie, carefully setting it down on the desk to Sarah’s left before bringing the new one up to her neck.

     “This really suits your skin tone,” she told her as she fiddled with the clasp at the back. It was harder than she’d thought, doing it on someone else, but after a couple of attempts it finally seemed to have worked.

She pulled back, admiring her handiwork, then quickly reached forward to straighten the bow tie. Sarah’s cheeks were slightly flushed, an adorable rosy colour that made Ava want to lean in and kiss her, and it was all she could do not to. 

     “Does it look okay?”

     “It looks perfect,” Ava said with a smile. “Have a nice Christmas, Miss Reese.”

The use of her title instead of her first name caught Sarah off guard, and she tried to ignore the warmth pooling between her legs as she watched Ava leave. She wanted to believe that she knew what she was doing - getting close to her like that, fingers gently brushing her skin as she struggled with the clasp, then calling her Miss Reese in a tone she hadn’t heard for well over a year - but she couldn’t help thinking that Ava was just like that.

"Ava," Connor was mad, Ava could hear it in his voice even before she saw his face. She was just trying to make coffee, back turned to the door as she fought with the machine that wouldn’t cooperate. The way the door closed less than gently and the footsteps coming up behind her made her stomach drop a little. She hated that tone, hated the way her name sounded when someone said it with hostility. It made her want to run, but this was real life and she couldn’t do that.

"Connor," Ava tried to keep her tone level, pretending her voice wasn’t trembling a little as she turned to look at him.

He was mad, tablet in hand as he glared daggers at her. Ava hated that look, when his ego was clearly seeping through and one little thing that didn’t go his way made him act like this. He was about to throw a tantrum, she was sure, and usually that would make her more annoyed than anything. However, the way he had her borderline backed up against the counter made her feel more intimidated than she liked.

"Why was my surgery postponed and my patient allowed to break her fast?"

Ava raised an eyebrow, "Latham asked me to cover your pre-ops since you didn’t bother to show up for rounds this morning."

"That doesn’t answer my question, Ava."

"I’m not here for you to demand things of me, Connor," she retorted as she forced herself to stand her ground, "She’s diabetic."

"So?"

"So her white count and blood sugar were low," Ava rolled her eyes, "A bloody med student would be able to tell me why we had to postpone her surgery."

"We didn’t do anything! You ruined my operating schedule."

"She would have gone into hypoglycaemic shock, Connor. She definitely wouldn’t have made it off that operating table and if she did her risk of post-op infection was too high!"

"That’s not the point, Ava!" He spat and the anger in his voice made her jump a little. He was overreacting, she knew that, but this was getting to be too much. She had been overwhelmed all morning, after sleeping through her alarm and having to rush through her routine to get to work on time. This was proving to be yet another change in her schedule that was only stressing Ava out more.

"Then what’s the fucking problem, Connor?"

“You are,” he was clearly referencing more than just her meddling with one surgery, even if she had good reason. He was mad at her, for whatever reason, and was using this as an excuse to lash out at her. Ava just stared at him, both because she was waiting for him to elaborate and because she did not know how to respond. Usually an argument with Connor was no big deal, since they argued on the daily, but since she was already overwhelmed this was way too much already. She wanted to run, to leave and go find Sarah because she would be able to keep her calm, but she couldn’t. Ava never backed down from a fight, especially not when Connor and her job were concerned, and she definitely was not going to let him win now.

“All you ever do is get in the way,” Connor spat, “I have a system and this was an important surgery, now you’ve gone and messed it up. You meddle too much, Ava, and it’s getting ridiculous.”

“Excuse me?” her tone was incredulous because, really, he was making no sense, “Since when do you have a system? You’re the most erratic and trigger-happy surgeon I have had the displeasure of meeting.”

He didn’t validate that with a response, choosing instead to glare at her more, which only made Ava more upset. Him and his goddamn “holier-than-thou” attitude would drive her crazy one day. He was being entirely unfair too, since she had, in this case, done just was what required for the patient’s safety.

“Why are you on my ass about this all of a sudden? Last time I checked you were the one on Latham’s bad side today because you didn’t show for your pre-ops. Besides, I was thinking about the patient here.”

“Were you, Ava?”

The accusatory tone did not sit right with the other surgeon at all, “What are you insinuating now?”

“Were you thinking about the patient?” his question must have been rhetorical because he didn't let her answer, “Or where you just trying to get me back in the doghouse with Latham?”

“What?”

“You heard me.”

“Connor, what the hell? Why would you even accuse me of that?”

He just scoffed, as if her shock was ridiculous to him, “I wouldn’t put anything past you, Ava.”

Ava stared at him in confusion, honestly hurt that he thought that lowly of her. They may have their differences but they have worked together long enough to know when the other was joking or just being difficult. Connor was serious now and it was so frustrating, he knew Ava would not put a patient in danger like that just to mess with his surgery.

“Just stay out of my way, Ava,” he turned to leave and only looked back at her dismissively, “Don’t mess with my surgeries.”

When the door to the CT lounge slammed shut again, Ava found herself shakily letting out a breath she didn't know she had been holding. She set her coffee cup on the counter again, realizing her knuckles had turned white from how tightly she was gripping the mug. Her head was reeling, trying to take in everything that had just happened. Connor’s accusations were ringing in her head, making her question where the hell this thought that she would sabotage him like that for no reason even came from.

Before she was even completely aware, Ava found herself sliding down the cabinet and landing less than gently on the floor. The ugly hospital linoleum was cold through the thighs of her scrubs, making her shiver both out of anxiety and the temperature drop. Her mind was racing, all of Connor’s words hitting her way too hard all of a sudden. She could usually brush off his comments with an eye roll and a reminder that he was just being egotistical, but this time they stung.

Maybe it was because she was already overwhelmed, the morning had been too stimulating and too many things were out of place. Whatever the reason, Ava’s anxiety decided to hit full force the second she was alone. She couldn’t breathe, it was all too much and guilt was hurting her like a rolling wave.

Why was she even guilty? There was no reason for her to feel this way, because she had absolutely done the right thing. She even clarified with Latham afterwards and he agreed that he would have done the same. Ava did what was in the patient’s best interest, Connor’s accusation was completely misplaced and ridiculous.

So why was this hurting her so much?

It was his anger, the way he yelled at her and had her cornered like that. Connor wouldn’t hurt her physically, she knew that for certain, but it still scared her. Her anxiety was never rational but when it came to conflict it was inconsolable. She could only hold on to her façade for so long before she broke, which is what this was. She didn’t mean to upset him, didn’t mean to make him angry. It was all an accident; she didn’t mean to.

“S-stupid Connor,” she muttered, “S-stu...stupid God co-complex.”

Her breath was coming out in ragged gasps by this point, short nails digging into her arms to ground herself. Mind racing, she tried so hard to focus on something, anything, but she couldn’t. His words were ringing in her head like a shrill shriek, not letting her ignore them. They began morphing too, into other distortions her brain insisted were real.

All you ever do is get in the way.

You meddle too much, Ava.

You’re the problem.

You.

You’re not worth it.

You’re selfish.

You did this.

Fraud.

Nuisance.

Disappointment.

Her hands clapped over her ears like she could block out the intrusive thoughts from the outside. She was shaking like a leaf, panic overtaking her completely. Stomach rolling, Ava felt like she was going to be sick with how overwhelmed she was. The fluorescent lighting made her feel way too hot and brought tears to her eyes along with the panic. Her head was reeling, too much going on and no Sarah or Ativan or any of her comfort objects to calm her down.

All of her coping mechanisms went out the window in that moment, slumped over knees and breathing rapidly. Her hands were over her ears or on her neck, nails digging in deep because it was the only way she could ground herself. Pain stims aren’t healthy, she knew that, but in that moment all she knew was she felt like she was suffocating. She deserved this, her brain insisted, the pain was the least she deserved in that moment.

“Sarah! Where are you headed?”

The medical student turned to see April running after her, catching up just before she passed the ED entrance. It felt weird not going straight through to put her things in the lounge and ask whose service she was on. Apparently April wasn’t aware that she wouldn’t be down in the emergency department that day either.

“Upstairs,” Sarah stopped so she could talk to her friend, “Cardio rotation starts today.”

“You’re leaving us so soon?”

“Unfortunately. I’m surprised at how quickly the ED grew on me, I thought I’d be happy to leave.”

“Rude,” April’s voice was teasing because she knew what Sarah actually meant, “Cardio is a big jump.”

“It is, I’m honestly nervous.”

“You’ll do just fine. Try to get on Doctor Downey’s good side if you know what’s good for you. Also Connor’s up there, so you’ll have a familiar face.”

The student nodded, “I’ll keep that in mind, thanks, April.”

“Of course. Hey, come visit whenever, okay?”

“I will,” Sarah accepted the hug offered to her, “We still on for drinks at Molly’s Friday night?”

“Absolutely.”

***

“Oh, how nice of you to join us,” a stern, accented voice spoke when Sarah stepped into the skill’s lab, “Miss…”

“Oh, uh… R-Reese,” she stuttered as she took a seat beside one of her classmates, “Sarah.”

“Well, Miss Reese, first impressions are everything, aren't they?” Doctor Bekker’s gaze was unwavering as she watched the student fidget in embarrassment, “Do try to be on time from now on, okay?”

“Yes, Doctor.”

“Lovely. Now, if we’re done with interruptions, I would like to start this introduction before you all waste any of my surgery time.”

Sarah couldn’t help but roll her eyes, already knowing that cardio rotation would be the longest five weeks of her life. April and Doris had already told her all they knew about the other CT fellow and Sarah knew she was a bit no-nonsense, but this was unexpected. She had only had one interaction with Doctor Bekker before and she had seen that she was very case oriented and gruff but she didn’t think too much of it at the time. They were in the ED and she had been called down because Connor was in surgery, Sarah could tell the other surgeon was out of her element in the emergency room. She didn’t blame her, she hadn’t been too fond of the ED either, so she assumed Ava was just trying to get things over with. Still, maybe she did fit the unfeeling, mean surgeon stereotype better than Sarah had hoped. Calling her out in front of her classmates for being late was a bit of a bitchy move, if she was being honest. Especially since it wasn’t Sarah’s fault, some patient had asked for directions to the community lab and she had to help him find his way. She would have tried to explain but something told her the other woman wouldn’t have wanted to hear it anyway.

“So, who can tell me the reasons an angiogram would be performed?”

Sarah sighed, getting out her notebook as quietly as she could. She didn’t even have an interest in surgery, much less cardiothoracics, so this would be a painful rotation. It was more focused on the process and anatomy, which was a nice contrast to the chaos of an ED trauma, Still, she didn’t feel prepared for this at all, especially since she was stuck with a mentor who probably hated her already.

“Miss Reese? Care to answer the question?”

Looking up from her notes, Sarah knew she must resemble a deer caught in the headlights for the second time that morning. She flushed when she realized everyone was staring at her, though her gaze was stuck on the doctor who was slowly walking towards her table. Why did she have to be pretty and have a dangerously distracting accent? It was downright cruel, especially since it made it hard to hate her. Sarah knew that was foolish of her to even think about, but she figured anyone who looked at Doctor Bekker would have to agree with her. Still, she was insanely intimidating and the way she kept targeting Sarah had her anxiety about this placement rising even more.

“Oh um… An angiogram is done to observe b-blood flow into the heart, pinpointing any problems with coronary arteries. So… angina or suspected CAD would be a reason to perform this exam?”

“Is that a question or an answer, Miss Reese?”

“Answer...” she mumbled, “Coronary artery disease or unexplained chest pain is often the reason for angiography.”

“Better,” she didn’t miss the tiny flash of what must have been a smile before she turned away, “Now, can someone else walk me through the process?”

The morning passed slower than Sarah had hoped. Doctor Bekker didn’t stop calling on Sarah, making sure she was paying attention and actually knew the content. She did her best to answer as confidently as possible but the eyes on her and knowing she had already gotten on Ava’s bad side was anxiety inducing. By the time the doctor dismissed them for their scheduled lunch, Sarah was ready to run down to the ED and beg April to save her from this disaster. She didn’t get the chance though because the second she turned to leave the Skill’s lab, a voice called after her.

“Miss Reese, a word?”

Sarah hated that, the way she addressed her by last name. She knew it was commonplace, since she was still a student and she was, in a way, her new teacher. Still, she disliked how formal it sounded and it wasn’t long before she had persuaded the majority of the ED staff to refer to her by first name. That wouldn’t happen with this Doctor, though, she was sure of it.

“Yes, Doctor Bekker?” Sarah turned and walked back to where the surgeon was standing by the desk, scrolling on her tablet. She didn’t look up at Sarah right away, instead letting herself be distracted by whatever chart she was reading. The student waited quietly, though she really just wanted to leave.

“Apologies, I have a pre-op to get to,” she finally said before setting the device down, “I wanted to clarify, you do understand that punctuality is the most respectful quality in a good doctor?”

“Yes ma’am,” that felt a bit out of place, since the other woman wasn’t much older than herself, but it was probably best when speaking about respect. As much as Sarah had begun to dislike her new mentor due to her attitude, she hated to be disrespectful.

“I know those emergency room doctors may have given you the wrong idea, but we are punctual up here in surgery, understood?”

“Of course, I was simply helping a patient find the lab and lost track of time. It won’t happen again.”

“Good. I will see you after lunch then? I have a CABG surgery scheduled and I’m allowed to have three students observe.”

“I- really?”

“If you would like,” she nodded, “Your intelligence and knowledge put you above some of your peers, miss Reese; it’s obvious. I think you would benefit from observing the practical application of skills.”

“Oh… thank you?”

“Indeed. You do lack any sort of confidence, though, which is a shame.”

Sarah didn’t know how to answer that, it felt like a bit of a backhanded compliment. She knew she was apprehensive and didn’t trust her gut enough, but it still annoyed her to have it pointed out. Observing a surgery wasn’t her biggest wish like some of her classmates would have but she certainly wouldn’t turn down any sort of kindness from her new mentor. She couldn’t exactly get a good read on this woman, as her attitude seemed to switch depending on who was in the room with her. She was going to be quite the person to get along with, Sarah assumed. She just hoped she could fix the ruined first impression she gave, though it seemed like Doctor Bekker wouldn’t be letting go of that any time soon.