Chapter Two

Hermione

"Let's get started. Anesthesia, are we ready?" I inquire, getting into position. I flex my wrists briefly, both of my hands raised.

"Yes, Professor. Patient is under general anesthesia and stable."

I glance at the surgical team, which comprises Doctor May, my mentee and first assistant in today's surgery, Doctor Charles, a junior resident assisting as well, Dr. Smith, the anesthesiologist, Ms. Johnson, the perfusionist, and finally, Mrs. Rodriguez, the scrub nurse.

"Let's begin," I say, looking at the patient's exposed body on the OR table.

The patient, Chairman Bernard Gonzalez, a 65-year-old man, requires an emergency heart transplant. His current heart is failing, and the mechanical assist device is nearing its expiration date, so he needs a new transplant. Today's procedure is an open-heart surgery aimed at replacing his failing heart with a donor heart.

"We'll start with the median sternotomy," I announce, stretching out my hand. "Scalpel."

Dr. Charles hands the scalpel to me, and I get to work with Dr. May. As I make the incision, the scalpel glides smoothly through the skin, revealing the gleaming white of the sternum.

"We will dissect the pericardium; be careful not to damage the phrenic nerve," I say.

"Yes, Professor," Dr. May murmurs, focused on the task at hand. We carefully dissect the pericardium, exposing the heart.

"Retractor," I call, and I feel its weight on my hand, using it to pull back the tissue. "Suction.... Now, let's cannulate the aorta... Clamp." We work in a coordinated silence, our hands moving in tandem.

"Let's initiate cardiopulmonary bypass and get the patient on pump," I instruct.

"On it, Prof," Ms. Johnson responds, activating the machine. The CPB machine hums as it pulses to life, settling into a rhythmic whoosh-whoosh, and taking over the patient's circulation and oxygenation.

"Starting bypass now," Ms. Johnson says.

"Suction," I demand. "Remove the blood from the surgical site."

Dr. May steps forward with the suction tubing, washing the site thoroughly. The water spurts out, cleaning off fluid and blood, revealing the grayish-pink flesh underneath.

I request the aortic cross-clamp, extending my hand sideways. After the blood flow to the heart is stopped, I instruct, "Induce cardiac arrest."

The patient's heart stops pumping blood, and the cardiac monitor flatlines. The ECG monitor flatlines too as the heart stops generating electrical activity.

This is the most critical part of the procedure. "We must complete the implantation quickly to minimize potential complications," I emphasize. "Focus," I order. "We will remove the dysfunctional heart now. Ensure you don't damage the surrounding tissues."

"Yes, Prof."

"Please prepare the donor heart," I instruct. The team quickly moves to carry out my order in the dimly lit operating room. We carefully remove the dysfunctional heart and replace it with the donor heart.

"Prolene 5-0," I request. "Suture... Cut... Suture..." I provide brief instructions, my fingers moving skillfully with Dr. May's assistance.

After the donor's heart has been sown in place, I direct, "Let's complete the anastomosis." This connects the donor heart to the patient's circulation.

"Wean off CPB," I instruct, and Ms. Johnson promptly acts upon it.

The OR falls silent as we wait for the donor heart to begin beating. The air is thick with tension, not because my team doubts my skills, but because Mr. Gonzalez is a crucial VIP member of the hospital's foundation; that's why his surgery was assigned to me.

I operate mainly on VIP patients, most of whose health conditions often entail complex surgical procedures like Mr. Gonzalez's.

Becoming a professor at 25 is no easy feat. I worked hard to get to where I am today. Precisely, I was pressured into giving my best until I reached this spot. Nobody can deny that my position is partly due to my standing as the future heiress of the foundation. My skills prove to the world that my title is fully deserved.

I narrow my gaze, my confidence never faltering, as I check for the slightest indication of a pulse. I massage the heart gently, prompting it to yield. And then, suddenly, it does – a strong, steady rhythm that elicits a relieved exhale from the team.

"We've got a heartbeat!" Dr. Smith announces with glee, his eyes crinkling at the corners.

I remain expressionless, giving the next instructions. "Let's close the chest incision. Suture... Cut..." I dictate intermittently as we work until the suturing is neatly accomplished.

"Vital signs are stable," Dr. Smith announces.

I nod briefly in acknowledgment. "Let's get the patient stable and into recovery. Reverse anesthesia."

"Okay, Prof," Dr. Smith responds.

After the last process has been undertaken, I step back from the patient, my bloodied hands held upward. "Good job, everyone," I commend my team, my voice muffled through my nose cover, and I step out of the OR.

I catch sight of my mom through the screen connecting the OR to the observation gallery as I walk out of the parting doors.

She's the current director of the hospital foundation. There are a few older professors who came to watch, as they often describe it – my outstanding surgical performance.

I avert my gaze as soon as our eyes meet for the briefest moment. My mouth flatlines at the sight of her, and an uneasy sensation pools at the center of my stomach. She rarely watches me operate on patients. I'm sure her presence has nothing to do with the fact that the patient is a VIP and key figure in the hospital's foundation. She's here for a reason, and I have a bad feeling about it.

Ezra Watson Pierce only seeks my attention when I'm needed for a purpose. Questions filter through my mind about what task she has for me this time.

That's the relationship I've had with my mother through the years growing up. I have never felt an emotional connection or bond with her since I was a child; she isn't bothered either.

It took me years of yearning for her acknowledgment and attention before I accepted the painful reality: I was only a tool at my mom's disposal, like everyone else's.

And since then, I have also guarded my heart. I have stopped expecting frivolities like love and attention from others. I merely follow orders to the letter, living in the shadows of myself.

Although I received accolades from my peers and everyone, I didn't depend on those for my validation.

I have adopted an ascetic lifestyle, depriving myself of leisure to groom myself into perfection. This is the lady my mother conditioned me to be.

Despite all I have accomplished, she has never uttered a word about her pride in me. I doubt she is. I don't care if she is. Her opinions no longer define me. Nobody's does.

I hit the shower, scrubbing the stains off my hands first in the basin, before taking a full-body shower.

Exhaustion rolls off my body as the water runs down my head. The surgery lasted for eight hours. Eight hours of intense concentration will take a toll on the average human's body, no matter how agile and fit the person is.

Although there is satisfaction that comes with saving lives, I would have preferred to be a ballerina or a dancer. But when it comes to my family, my desires don't matter.

Mama knows best! I huff, turning off the tap. I change back into my clothes and drape my lab coat over it. I apply a faint spray of perfume and check my reflection in the room. Satisfied with my look, I step out to check on my patients.