MATT

“I’d like to put in my two weeks’ notice.”

I glance up from the mountain of paperwork on my desk to see Kirt, my brand-new surgical assistant, standing at the door of my office. He’s wringing out his hands. A bead of sweat rolls down his forehead.

“Why?”

His gaze jerks to me and his eyes widen in fear. “Why?”

He didn’t think he’d have to explain himself. He’s about to lose his bowels on my carpet.

I toss my pen onto my desk and lean back in my chair. This is the last thing I was expecting him to say. I thought we had a good thing going. I’ve only made him cry twice.

“I know you’re a great surgeon.” My expression must harden because he amends his statement. “The best surgeon! Truly! It’s why I took this job. I figured if I stuck it out with you for a few months, you’d give me a good letter of recommendation for my next job. Honestly, I thought this was a Devil Wears Prada situation—”

“A what?”

His cheeks redden. “The Devil Wears Prada…the movie?” My face doesn’t change. “Sorry, my girlfriend made me watch it the other day and it really helped me put some things into perspective.” His hands start waving as he explains the plot. “There’s this terrible boss who basically terrorizes the whole office. The main character thinks if she toughs it out as her assistant long enough, she’ll be able to work anywhere she wants.”

He’s too stupid to realize he’s just implied I’m a “terrible boss” who “terrorizes” people. If he wasn’t already quitting, I’d fire him.

“Get to the point.”

“Oh, well, yeah. The point is…I can’t do this. The stress of this job is more than I can handle. I have a stomach ulcer. I’ve started to develop nervous bowels.” I’m now more concerned than ever that he’s going to soil my carpet. “I’m not sleeping. My girlfriend gave me an ultimatum: either I leave New England Medical Center or she leaves me. I thought I’d be able to make it until the new year, but that’s still a few months away. So…” He pauses and glances down at the ground. “I’m giving my two weeks’ notice.”

My secretary appears behind him, holding a file, which means my next patient is here: a seven-year-old girl named Fiona. In a few minutes, I’ll join her and her parents in the conference room for a consultation about a complex procedure that will relieve the pain and suffering she’s endured from being born with a severe curvature of her spine.

I don’t have time for Kirt and his stomach ulcer.

I stand to receive the file.

“They’re already in the conference room,” she says with a no-nonsense tone.

“Thank you, Patricia.”

She straightens the glasses on the bridge of her nose and aims daggers at the back of Kirt’s head, which tells me she likely heard part of his speech and she didn’t like it. Unlike him, she’s loyal. She’s been working for me since I first started here.

Kirt scrambles as I leave him standing there and head for the conference room. “Dr. Russell. Dr. Russell! You’ll still give me a good rec letter, right?” he shouts down the hallway. “I’ve been a good surgical assistant, haven’t I?!”

I don’t answer him because I’m already flipping through Fiona’s file, reacquainting myself with the x-rays and CT scans I’ve been studying for the last few days. She’s been turned away from four other doctors. The curvature in her back is severe enough that the procedure would prove difficult even for the top pediatric spinal surgeons in the world. Fortunately for her and her parents, I’m one of them.

I push the door open and see Fiona’s parents sitting at a table wearing expressions of fear and apprehension. Her mother has dark circles under her eyes. Her father’s hand is clasped over his wife’s on top of the table and he squeezes twice in an act of reassurance as I walk in. Fiona sits beside her mom, tucked in the oversized leather chair, making a little doll dance on her lap. At first, she leans awkwardly against one of the chair’s armrests, but when she sees me, she tries and fails to sit up straight. A deep frown cuts across her chubby-cheeked face. Seeing that small struggle ensures I’ll go through with this procedure even if it kills me. She deserves to have someone fighting for her, and if Kirt is too much of a pansy to do it with me, I’ll find someone who will.

I’ve been at New England Medical Center for five years now. When I first started, I’d just come off of not one, but two fellowships—one in complex spine and the other in pediatric scoliosis. Even after all that training, I had a lot to learn. Some would say I still do. Most of my colleagues think I’m naive to take the kind of cases I do. There are four other spine doctors in our department, and I’m the only one who specializes in peds. The rest of them—the ones sitting together at a table in the doctors’ lounge as I walk in for lunch—do routine adult spinal fusions, the kind of cases that take two hours, the kind that allow for a four-day work week and extra time on the golf course.

They wave me down and I inwardly groan. I know what this is going to be about, and I don’t have the energy to deal with their boys’ club bullshit today.

“Hear you’re losing another assistant, Matt,” Dr. Goddard says. In his late thirties, he’s the closest to me in age, but that’s where our similarities stop. He’s in surgery for the money and the reputation. He wears monogrammed polos. He drives a cherry red Porsche. His wife looks like an inflated sex doll.

“How’d your fusion case go this morning, Jeff? Break any nails?”

His eyes narrow on me.

“At ease, boys.” Dr. Lopez chuckles and then leans toward me. “I heard you might be taking on that seven-year-old. I took a look at her x-rays and they’re not pretty.”

I shrug. In my hand, I have a stack of files containing surgical details from cases I’ve successfully executed in the past that are similar to Fiona’s. If Dr. Lopez weren’t sitting with Dr. Goddard and the rest of them, I’d ask him for his input.

“How are you going to do the case without a surgical assistant?” Dr. Goddard asks, needling me again.

I want to ask him how he manages to look in the mirror in the mornings without punching the glass. We all have our unanswered questions.

“You know they have a picture of Dr. Russell up in the staff lounge?” he continues, turning to the group with a shit-eating smirk on his face. “They added devil horns and a red tail. I’m thinking of asking one of them to give it to me so I can have it framed.”

I offer a wry smile. “As always, gentlemen, it’s been a pleasure.”

I wouldn’t bother with the doctors’ lounge at all, but the gourmet catering is usually pretty good and it saves me from having to worry about lunch. I pile up a plate with grilled salmon, sautéed vegetables, and a cheesy potato dish that has my mouth watering, and then I find a quiet table in the corner.

The lounge operates a lot like a high school cafeteria. NEMC is a private hospital that consists of fifty-four surgeons covering fifteen specialties. Each specialty has its own quirks.

Here’s how to tell them apart:

The beer-drinking sports fans? Those are the general orthopedic surgeons. They do their fellowship in sports medicine and they’ve never met a protein supplement they didn’t love.

The masochists, the men and women who enjoy being woken up at all hours so they can rush in and save the day? Those are the transplant surgeons.

If they like to hit on the nurses and tell everyone they make the most money, it’s a good chance they’re cardiothoracic surgeons.

The Ferrari drivers who want to be popular with the local celebrities, wear shiny suits, and do what we all refer to as “fake surgery”—plastic surgeons.

You catch my drift. We all have our idiosyncrasies, even me. I’m one part masochist, one part perfectionist. I have a little hero complex of my own and an ego that could fill this entire room, but it’s necessary. Who wants to put their kid’s spine in the hands of a simpering fool who buckles under pressure?

“Mind if I take a look?” Dr. Lopez asks.

I glance up from my plate to see him pointing to the files laid out in front of me.

I nod. “Go for it.” Then I think better of it and reach for the third one down—one from a particularly trying case I tackled last year. “Start with that one.”

He pulls out a chair opposite mine and sits down. “You intimidate Dr. Goddard. That’s why he acts like that.” I don’t reply. I didn’t sign up for a therapy session. “I probably shouldn’t be telling you, but he interviewed for the same fellowship as you and the program directors didn’t pick him.”

I muster up a half-interested hum then shove another bite of salmon in my mouth. He won’t succeed in convincing me that Dr. Goddard deserves my pity.

Dr. Lopez chuckles. “All right, I can see that you two won’t ever reach an understanding, so let’s focus on a different problem. How many surgical assistants have you run into the ground in the last year? Two? Three?”

Five, but I don’t correct him.

“I’ve had the same assistant for years and she’s great. She anticipates what I need in the operating room, she’s timely, and she’s sharp as a tack. She makes me a better surgeon. Do you catch my drift?”

I level him with a bored stare. He’s dangerously close to getting asked to leave my table. He might be one of the senior surgeons in this hospital, but he’s not my boss.

He trudges on, unmoved by the daggers I’m aiming at him. “You’re wasting your time training new assistants every few months. Your surgeries are hard enough without having someone green by your side. Think of how much more you could do with a team you trust.”

I’m annoyed to realize he does have a valid point, but it’s nothing new. I’ve come to this same conclusion myself. The problem is, I’ve yet to find an assistant who could last longer than a few weeks.