The importance of the impending conversation presses down on me.
“Dr. Madison.” I attempt a smile as I slide into the seat across from her.
“Seamus,” she acknowledges. “It’s been a while since we’ve last talked. What’s going on?”
The hum of the hospital cafeteria surrounds me—a low murmur of conversations. Clinking utensils against plates. The occasional burst of laughter. It’s a familiar symphony, one I’ve grown accustomed to over the years.
Today, it feels distant. Background noise in a world slowly shifting underneath my feet.
Dr. Madison sips her coffee, her sharp eyes studying me over the rim of her cup. As my OBGYN mentor, she always had an uncanny ability to see right through me, to peel back the layers and get to the core of whatever’s on my mind. It’s both comforting and unnerving.
It’s also the reason I’m here.
“I’ve been giving a lot of thought to my upcoming R-5 year and what subspecialty interest I’d like to pursue.” I take a deep breath, steadying myself. “I’m interested in neural mechanisms underlying female sexual function.”
Her eyebrows lift, a mixture of curiosity and intrigue flashes across her face. “What a fascinating area. Not many venture into that territory.”
“Part of the appeal.” I offer a slight nod.
She leans back in her chair and crosses her arms. “Alright, Seamus. Walk me through it. What’s driving this interest?”
“Over the past few months, I’ve felt…off.” I choose my words carefully. “Not with the work itself—it’s the environment. The hospital is tense. Unpredictable. I’m not naïve enough to think people aren’t talking.”
Dr. Madison crosses one leg over the other, her gaze unreadable. “You’re referring to your situation with Caldwell.”
“Yeah.” I exhale. “I’m sure you’ve heard what happened. The case. Miranda Black.”
“I heard some things,” she says evenly. “Rumors, statements. I’ve read between the lines.”
I nod. “He hasn’t spoken to me since the settlement. Not a word. No eye contact. No acknowledgment. Honestly, it feels like my name has been quietly circled in red ink. I’m not saying I’m being sabotaged. I’m not getting invited to the table either.”
“You're concerned this situation will follow you into R5 and beyond?” She tilts her head.
“Of course it will. Next year I have an opportunity. We're meant to dive deeper into something we care about, right?” My hands are gesturing more than normal because I feel like this is my only chance to salvage things here in Seattle. “The goal is to explore something meaningful to further my studies. Originally I wanted to go into neurosurgery because of my family’s history with alcohol. It’s not what’s driving me anymore.”
She leans back, still listening.
“I’ve worked hard for over a decade. I’m terrified if don’t branch out from under Caldwell’s shadow—it won’t matter what I do. The doors will still be closed.” I sigh.
“So?” she prompts.
“I want to design a research track.” I meet her eyes. “Neurosurgical implications of female sexual dysfunction. Brain connectivity, arousal response, regional mapping—what we know, what we don’t. I want to spend my R5 year working on it. Clinical data, neuroimaging, maybe even collaboration with OBGYN.”
I pause. Waiting. I've dangled the carrot.
“Ah.” She steeples her fingers, eyes narrowing with curiosity rather than judgment. “Why this subject, Seamus? Why now?”
I hesitate, only for a second. If I want this to work—if I want her to trust me—I have to be real. Even if this is extremely personal.
“I’ve fallen in love…” Her eyebrows lift, just slightly as I continue, “…with a woman who’s never, until me, been with someone who actually understood how to give her pleasure. Without going into the long, sordid history, my interest in this subject started a long time ago. I started reading studies about the neurobiology of female arousal back in med school. It wasn’t required, I first stumbled across the research after a class on cortical sensory maps. The variability fascinated me and, as I’ve been thinking about my future, realize it still does. Humans—mainly men—seem to think sex is a simple binary mechanism. It's not, especially for women and their desire and ability to orgasm.”
She holds up a hand. “I didn't expect our conversation to go in this direction.”
“Look, I'm not trying to make you uncomfortable. This isn't salacious. It's truly important to me.” I shift in my chair because it sucks this topic feels taboo, even in the medical realm. This is part of why I want to tackle it. “Neurosurgery’s always been my plan and still is. However, this is a chance to explore how brain function plays into something most people dismiss as emotional or behavioral. I don’t want to chase tabloid science. I want to do this with intention. Rigor. Data. Yes, maybe a little fire under my ass, because my back is against the wall right now.”
I stop for a moment to gauge her response.
“Go on.” Dr. Madison settles back into her chair.
