"Make the incision here," Rebecca said, pointing to a critical junction near the artery. "And be careful of the adjacent vessels. The margin for error is small."
Lillian’s hands moved slowly, carefully. She knew this was delicate and one wrong move could lead to a cascade of complications. She felt the gaze of everyone in the room on her, but most of all, she felt Rebecca’s eyes watching closely. It was a test, one she couldn’t afford to fail.
As she made the incision, her breath caught slightly. She hadn’t realized she’d been holding it until it escaped. She followed Rebecca’s next instruction, but the air in the room felt thicker now. The pressure was mounting, and Lillian could feel it in the quickened beat of her own heart.
"Good. Now continue with the bypass graft. Carefully," Rebecca instructed, her voice sharp but neutral.
Lillian nodded again, focusing on the task at hand, determined not to let her nerves get the best of her. She was prepared for this, she reminded herself. She had trained for this exact moment. But knowing that Rebecca was watching her every move—it made her hands feel heavier, the stakes higher.
The room felt colder as the next critical phase of the surgery loomed. Lillian was determined, but the weight of expectation pressed down on her harder than it ever had before.
The next phase began smoothly. The patient lay under anesthesia, and the steady rhythm of the heart monitor filled the room, a constant reminder of the stakes at hand. Lillian’s pulse echoed in her ears as she followed Rebecca’s lead, her hands carefully mirroring each movement the attending instructed.
"Make sure the incision is clean and precise. Any deviation here and you risk damaging the vessels," Rebecca said, her tone crisp and controlled as she pointed to the critical junction where Lillian would begin.
Lillian nodded, swallowing the lump in her throat. She adjusted her grip on the scalpel, her hands steady but her nerves firing. This was it. Her moment to prove she could handle this level of pressure and responsibility.Stay calm, she told herself silently.Just follow Rebecca’s lead.
With a deep breath, she made the incision, focusing on keeping it clean, smooth. The tissue separated as expected, and the heart was exposed. The initial phase of the surgery had gone well, but the more complicated parts were still to come. Lillian tried to focus only on the task in front of her, but she could feelthe tension in the room, the silent expectation that she would handle this flawlessly.
Rebecca watched her every move. It wasn’t obvious to the rest of the team, but Lillian could feel the weight of Rebecca’s gaze, measuring her performance, judging her capabilities. It made the air thick, every action heavier.
"You need to handle the bypass graft carefully," Rebecca continued, her voice neutral, though Lillian could sense the tension simmering beneath the surface. "Watch for bleeding when you connect the conduit."
Lillian nodded again, her hands tightening slightly around the instruments as she prepared for the next step. The graft had to be secured without damaging the surrounding vessels, which meant she needed to be precise—no shaking, no hesitation.
Her fingers trembled slightly as she worked, but she quickly adjusted, trying to steady her nerves. The graft slipped into place, and she could hear the faint approval in Rebecca’s tone as she spoke again. But the pressure wasn’t letting up. Every move felt scrutinized, every second longer than the last.
And then it happened. A brief, almost imperceptible hesitation as Lillian reached to clamp a vessel. It was only for a split second, but it was enough. The clamp slipped, and a small spurt of blood escaped, staining the sterile field. Lillian’s heart dropped as her stomach twisted. She froze for just a moment, unsure of how to fix it.
"I-I can fix it," Lillian stammered, reaching quickly to correct the clamp.
Rebecca stepped in, her movements swift and controlled, overriding Lillian’s. "No. I’ll handle it," Rebecca said, her tone cold, but not harsh. It was the tone of a surgeon who didn’t have time for mistakes. "Just focus on your next step."
The bleeding was under control in seconds, but the shift in the room was palpable. Lillian’s cheeks burned withembarrassment, her hands suddenly feeling clumsy and wrong. She had hesitated—just for a second—but it had been enough for Rebecca to have to step in. The surgical team was still focused, but she could feel the unspoken judgment hanging in the air.
The pressure mounted. Every movement felt heavier now, more critical. Lillian’s hands were steady, but inside she was unraveling, second-guessing every step, every decision. She could barely focus on the rest of Rebecca’s instructions as the weight of her mistake settled like a stone in her chest.
The steady rhythm of the heart monitor that had been the backdrop to the operation began to falter. Lillian’s focus, already stretched thin by her earlier mistake, snapped back to the patient as the beeping sped up, then slowed unnervingly. Her heart seemed to mimic the erratic pattern, tightening with each irregular sound.
“BP is dropping rapidly, doctor,” the scrub nurse announced, her voice tense but professional.
Lillian’s stomach lurched. She knew immediately that something was wrong, and her eyes darted to the site of the graft. Had she missed something? Her mind raced through the possibilities, but nothing seemed to add up. She hadn’t seen any signs of complications—at least, none that she’d recognized.
Rebecca’s voice cut through the tension, sharp and demanding. “Lillian, check the anastomosis. Quickly.”
Lillian’s hands moved automatically, but her mind was swirling with panic. She searched the graft, her breath quickening as she struggled to find the source of the problem. Then she saw it: a small tear near the sutures, just where she’d worked earlier. The tear was leaking blood, pooling dangerously. Her heart slammed against her ribs. It was her fault.
For a split second, Lillian froze. Her training screamed at her to move, to fix it, but all she could hear was the erratic beepingof the heart monitor, the rustle of movement around her, and Rebecca’s unrelenting gaze burning into her.
“I—” she stammered, trying to regain control, her hands fumbling as she reached for the clamp. She had to stop the bleeding. Now. But in her panic, she clamped the wrong vessel.
Everything exploded at once. The blood surged from the site, bright red against the sterile field. The alarms blared, a shrill scream that filled the room. The controlled rhythm of the operation dissolved into chaos as the team sprang into action.
Rebecca’s voice cut through the mayhem, cold and furious. “Lillian, what have you done?!”
Lillian’s hands trembled, her breath catching in her throat as she tried to stammer out a response. “I-I thought?—”
She couldn’t think. The walls of the room seemed to close in on her, the sound of the alarms mixing with her own panicked thoughts. She knew she had made a catastrophic mistake, but she couldn’t fix it. She couldn’t move fast enough.
