The heart monitor's flat line screamed through the operating room like a banshee's wail.
Dr. Ethan Graves stared at the motionless chest of the seven-year-old girl on the table, his hands still gripping the surgical instruments that had failed him. Again. The familiar weight of defeat settled on his shoulders like a lead blanket.
"Time of death: 11:47 PM," he whispered, his voice barely audible over the mechanical chorus of machines that had fought so hard to keep little Sarah Chen alive.
The OR fell silent except for the soft hiss of the ventilator that no longer served any purpose. Ethan's surgical team avoided his eyes, their faces hidden behind masks that couldn't conceal their disappointment. This was the third patient he'd lost this month. The third child.
"Doctor Graves?" Nurse Martinez's voice was gentle, but Ethan could hear the unspoken question. What went wrong this time?
Ethan peeled off his bloodstained gloves and dropped them in the disposal bin. "Prep her for the family," he said, turning away from the small form on the table. "I'll... I'll speak with the parents."
The walk to the family waiting room felt like a death march. Each step echoed in the sterile hospital corridor, mixing with the distant sounds of beeping monitors and hushed conversations. Through the glass doors, he could see the Chen family huddled together on uncomfortable plastic chairs. Sarah's mother clutched a stuffed rabbit—the same one Sarah had insisted on bringing to every appointment.
How do you tell parents their daughter won't be coming home?
Ethan had done this dozens of times over his twelve-year career, but it never got easier. If anything, it had gotten harder. Much harder.
He pushed through the doors, and the family's faces turned toward him with desperate hope. Hope that died the moment they saw his expression.
"I'm sorry," Ethan began, the words tasting like ash. "We did everything we could, but..."
Mrs. Chen's wail cut through his practiced speech like a scalpel through flesh. Her husband caught her as she collapsed, and their teenage son just stared at Ethan with hollow eyes that seemed to ask: Why couldn't you save her?
Ethan wished he had an answer.
Two hours later, Ethan sat alone in his office, staring at Sarah Chen's medical file. The words blurred together as exhaustion and grief clouded his vision. Congenital heart defect. Mitral valve prolapse. Surgical complications. The clinical terms felt cold and inadequate to describe the bright little girl who'd told him jokes during her pre-op consultation.
His phone buzzed with a text from his ex-wife: Saw the news about your patient. I'm sorry, Ethan. Are you okay?
Even Linda, who'd left him two years ago because he was "married to the hospital," still cared enough to check on him. That somehow made everything worse.
Ethan closed the file and rubbed his eyes. When had he become this person? The surgeon who used to be confident, precise, unshakeable? The one who colleagues called "Golden Hands Graves" because he never seemed to fail?
That man felt like a stranger now.
His reflection in the darkened window showed the truth: a thirty-two-year-old man who looked forty, with premature gray streaking his black hair and lines etched deep around his eyes. The pristine white coat couldn't hide the fact that he was falling apart.
The office door opened without a knock.
"Rough night?" Dr. Marcus Webb, the hospital's Chief of Surgery, stepped inside and closed the door behind him. His expression was unreadable, but Ethan had worked under Webb long enough to recognize the look. They'd had this conversation before.
"The Chen girl was complicated," Ethan said, not looking up from his desk. "Multiple valve defects, unexpected arterial—"
"That's the third one this month, Ethan." Webb's voice was quiet but firm. "The board is asking questions."
Ethan's hands clenched into fists. "I know."
"Do you?" Webb moved closer, his tone shifting from professional to concerned. "Because from where I'm sitting, it looks like you're drowning. When's the last time you took a vacation? Hell, when's the last time you went home before midnight?"
The questions hung in the air like an accusation. Ethan couldn't remember the last time he'd done either.
"I'm fine," he lied.
"You're not fine. You're exhausted, you're making mistakes, and you're going to lose your surgical privileges if this keeps up." Webb leaned against the desk. "Take some time off. Get your head straight. The OR will still be here when you get back."
If I get back. The unspoken words echoed in Ethan's mind.
"I can't," Ethan said finally. "I have three surgeries scheduled tomorrow, and—"
"I'm not asking, Ethan. I'm telling you. Two weeks. Mandatory leave. Clean up your life, or I'll clean it up for you."
Webb left without another word, and Ethan was alone again with his failures.
The parking garage was nearly empty at 2 AM. Ethan's footsteps echoed off concrete walls as he walked toward his car, his body moving on autopilot. The adrenaline that had kept him functioning for the past eighteen hours was finally wearing off, leaving him hollow and numb.
He fumbled with his keys, his hands shaking from exhaustion and too much caffeine. The BMW's door handle felt cold against his palm—a reminder of all the things his successful career was supposed to provide. Success. Prestige. Satisfaction.
Instead, all he felt was empty.
Ethan slumped into the driver's seat and closed his eyes. Maybe Webb was right. Maybe he needed time to figure out how to be a surgeon again. How to save lives instead of watching them slip away.
He started the engine and pulled out of the parking space, his mind already drifting to the bottle of whiskey waiting in his apartment. Just one drink. Maybe two. Enough to quiet the voice in his head that kept replaying Sarah Chen's last heartbeat.
The rain started as he turned onto the main road, fat droplets splattering against the windshield. The wipers swept back and forth in a hypnotic rhythm that matched his heavy eyelids.
Just stay awake for fifteen more minutes. Home is only fifteen minutes away.
But exhaustion was a patient hunter, and Ethan had been running from it for months.
His eyes closed for just a second. Maybe two.
The truck ran the red light at full speed.
Ethan saw it in the split second before impact—a massive eighteen-wheeler barreling toward his driver's side door. Time seemed to slow as his surgeon's mind catalogued the physics of the collision, the trajectory, the inevitable outcome.
This is how it ends.
The world exploded into noise and pain and twisted metal. Glass shattered, airbags deployed, and Ethan's carefully ordered life disintegrated in the space of a heartbeat.
As darkness closed in around him, his last coherent thought was almost peaceful: At least I won't have to fail anyone else.
Then the world went black.
SYSTEM INITIALIZATION DETECTED
HOST VITAL SIGNS: CRITICAL
MEDICAL PROFICIENCY SYSTEM ACTIVATED
EMERGENCY PROTOCOLS ENGAGED
BEGINNING CELLULAR REPAIR SEQUENCE...
End of Chapter 1