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“That’s common,” Vivian remarked.

“I know. So we did a scan and found a tumor. My question is, Dr. Maguire, can we get it out and if so will the patient come through? She was in a bad car accident. She survived surgery, but can she survive another one?”

“Can I see the scans?”

Dr. Brigham motioned for them to follow him into a room, where the patient’s scans were brought up. Reece peered close. A routine scan in the ER had missed it, but it was there in the brain stem. A brain-stem glioma. Small, barely noticeable and a delicate place. If unsuccessful it would render the patient brain-dead.

“How did the ER doctor misdiagnose this woman as brain-dead? The glioma is preventing her from waking up,” Vivian asked in disgust. “It’s very rare and they’re practically impossible to find at this stage. It’s barely begun. I’ve removed two successfully. They weren’t in adults and weren’t this small.”

“Do you think you can remove it?” Dr. Brigham asked.

“We’ll tell the patient’s next of kin the options. Send home the transplant team. They should never have been called in in the first place. She does have a shot and that’s better than nothing.”

“So glad you’re here with us, Dr. Maguire.” Dr. Brigham left the room.

“Do you think you can remove it?” Reece asked. He stepped closer to get a look at it. Dangerously close, so he took a step back, remembering she was off-limits. He’d forgotten himself for a moment there.

“I’ll have a good shot. Frankly it’s her only shot. This tumor will kill her eventually. Sooner rather than later. And she’ll never come to in her present state with this tumor pressing here.” Vivian sighed. “It’s horrible, but whatever sent her to the ER might’ve saved her life. Do you want to scrub in with me?”

The question caught him off guard. He should say no, just go home for the evening after getting her mother settled, but this was a once-in-a-lifetime tumor.

“Yes. I would.”

Vivian smiled. “Great. I need a surgeon I can trust in there with me.”

He was shocked. “You trust me?”

“You’re a fine surgeon, if my memory serves me correct. I need a good surgeon to help me. I don’t know the other surgeons on this floor. I know you.”

The compliment caught him off guard. “Okay. I’ll get your mother settled and meet you in the scrub room.”

She nodded and turned back to the scans as Reece left. He’d tried to push her away and the last place he wanted to be was in an OR with her for hours while they did brain surgery, but he wasn’t going to walk away from a once-in-a-lifetime surgery.

He’d be a fool to turn his back on her and this opportunity.

And when it came to his career he was no fool.

* * *

Vivian hadn’t felt this much pressure to perform a surgery since her first solo surgery. Funnily enough, Reece had been at her side then too. And she felt as nervous as she had that day long ago. Dr. Brigham had meant her first solo surgery as a test. She’d always been shy and quiet. He’d wanted to intimidate her. See if she’d crack under the pressure and quit the program.

And she almost had.

Except Reece whispered in her ear.

“You can do this. You’re stronger than they think.”

You can do this.

Dr. Brigham had been a little put out that she hadn’t asked him to join her, but she didn’t want her old teacher breathing down her neck. When she got to Germany Dr. Mannheim had given her freedom and flexibility.

And with this surgery she needed to remain calm. Where she was working was a delicate part of the brain. One wrong move and the patient would be gone, but this was the patient’s only chance.

It was also her first surgery back here at Cumberland Mills in front of her colleagues. Colleagues who were after the same position as her.

The pressure was on, to say the least. Which was why she’d chosen Reece. She needed him. Needed him to calm her down. Root her and keep her focused.

Reece walked into the scrub room in his blue-green scrubs, his scrub cap still the same from seven years ago. It was a piece of fabric with a forest in the fall. It reminded her of the trips she used to take with her mother—east to Knoxville or south to Chattanooga. They would drive through the Smoky Mountains. She loved it so much Reece once took her north to Kentucky. They’d spent the night in a cabin in the woods. Never once leaving the bed.

“We’re the same,” he had whispered against her neck as he’d spooned her in bed.

“No, we’re not. We’re decidedly different. And right now I’m extremely happy about that.”

He had chuckled and run his hand over her bare shoulder. “I do like that difference, but that’s not what I meant.”

She’d rolled over to look at him, tucking her arms under her head. “I know what you meant.”

“We grew up the same. Alone.”

Emotions had washed over her and she’d tried not to cry. “We’re not alone now.”

“I know.” And he had kissed her again.

She couldn’t help but smile at the memory, but then her stomach twisted in a knot because that was long gone and she couldn’t let her attraction for Reece interfere anymore. It was too dangerous. She was alone now.

Isn’t that what you wanted?

“How’s my mother?” Vivian asked. She needed to know that was at least taken care of.

“She’s in her room and relaxing. The nurses and residents manning my trial patients will watch her. You don’t have to worry.”

“I do a bit.”

“No one knows you’re related to her. Just like you wanted.” There was a hint of censure in his voice.

“What’s with the attitude?” she asked.

“No attitude,” he replied quickly, but he wouldn’t look her in the eye. She wasn’t an idiot. She knew he didn’t approve.

“I don’t want people to be sticking their noses where they don’t belong. I don’t care if it’s found out she’s my mother, I just don’t want it announced and I don’t want it to affect your trial either.”

He looked at her then. His expression softened as he began to scrub in beside her. “I’m sorry.”

“It’s okay.”

“No, I mean it, Vivian. I’m sorry. I naturally assumed... Well, forget what I assumed. Just accept my apologies.”

Now she was intrigued. “What did you assume?”

“It doesn’t matter.”

“Yes it does!”

“I forgot how pushy you are.” Then he grinned at her and she couldn’t help but laugh with him.

“And I forgot what a stick-in-the-mud you can be. Now, tell me.”

“Fine. Honestly, a lot of surgeons feel like family being sick in their workplace is a sign of weakness in them. They don’t want others to know they are being affected personally.”

“I can see that.”

“And I assumed since you’re going after Dr. Brigham’s job that you would feel the same. I mean, you did your residency here, but you are technically new now. There are a lot of sharks out there vying for that position and I can tell you most of them are in the gallery to watch you remove this brain-stem glioma from the patient.”

Vivian snorted and dried her hands with the paper towel. “Oh, I know. I’m used to living in a shark tank. My seven years in Germany have taught me how to deal with sharks.”

His expression changed, his brow furrowed and the smile wasn’t quite as sincere as it once was before.

“Well, I’m glad you know how to deal with it.” He moved past her and headed into the OR.

Vivian frowned. One minute it felt as if no time had passed and then the next it felt that they were strangers.

You don’t have time to think about it now.

And that was certainly true.

Right now she had to focus on this surgery, on saving this woman’s life. She just hoped that whatever was bothering Reece wouldn’t come up during the surgery because right now she had to depend on the man she’d known seven years ago. The surgeon who had been her partner.

The man she could depend on. The man she didn’t deserve.

She took a deep breath and headed into the OR, where a scrub nurse helped her on with her gown and gloves.

“Where is the resident that noticed that she was decerebrate?” Vivian asked.

“She’s in the gallery, Dr. Maguire,” Reece said. “Dr. Berlin is the one who discovered it.”

Vivian glanced up at the sharks. All the neurosurgeons were up there, scattered amongst the eager residents and interns who were there to learn. This was a once-in-a-lifetime type of surgery.

She remembered seeing her first brain-stem glioma surgery, watching a seasoned surgeon do a delicate surgery to save a life, and what a rush it had been. That had been the moment she knew what her focus would be as a surgeon.

She wanted to work on the human brain.

It was also the moment she’d met Reece, because he’d been just as enthralled as she’d been watching that surgeon perform the surgery.

Vivian motioned and Dr. Brigham pushed the button for the intercom. “Is there something I can help you with, Dr. Maguire?”

She could see the more seasoned surgeons lean forward, anticipation on their faces, hoping that she would ask one of them to come down and help her.

“Can you send Dr. Berlin down? Ask her to scrub in. She’s going to help Dr. Castle and I take out this beast.”

“Are you sure you want Dr. Berlin?” Dr. Brigham asked skeptically. “I have assisted with this surgery before, Dr. Maguire.”

“I know you have, Dr. Brigham, and I appreciate that, but I don’t need another assist. Besides, Dr. Berlin is the one who questioned Dr. Low’s diagnosis of brain death in the ER. Because of her we’re here today and I would like her to join me.”

“I’ll send her down.” Dr. Brigham motioned to the young resident in the front row. She could almost feel the glares, like knives jamming into her back, but Vivian didn’t care. This was a teaching hospital.

She didn’t need another head surgeon in her OR breathing down her neck, judging her. Frankly, she didn’t need the resident in here either, but Dr. Berlin deserved to be here. Besides, if she did eventually get Dr. Brigham’s job, smoothing the road between her and the residents and surgical interns wasn’t a bad thing.

Vivian didn’t have to be buddies with them. She wouldn’t be, because then they’d never learn, but she wanted them to know that she was fair.

That she would give them a chance in the OR and that she could be a good teacher. And she was. She’d taught many German surgical interns. She’d been Dr. Mannheim’s right-hand man in the last two years working there, so he’d given her the job of overseeing the education program as well as working on his various trials.

That was the key to becoming a successful Chief of Surgery as far as Vivian was concerned. As she glanced up into the gallery she could see that here at Cumberland Mills things had changed. It was a dog-eat-dog world.

“Where would you like me to shave?” Reece asked as he sat down at the patient’s head.

“Just there over the base of the skull. You don’t have to shave her entire head.”

“Okay.”

Reece began to prep the patient as Vivian went over her instrument trays. It was something she did a couple of times, silently to herself. Thinking about each instrument and the role they would play in the surgery. It helped her visualize it all.

She closed her eyes and thought back to the last one she did. It had been a bit different. The glioma was easier to visualize and this patient’s was smaller. It would be no bigger than a strand of hair. So small and insignificant to the human eye, but deadly just the same. One wrong move and she could sever a nerve in her neck.

The brain was a beautiful thing in its intricacy and there was so much about it that they still didn’t know. Especially when it came to things like autism, where people saw the world differently. And then there was Alzheimer’s, which wiped away memories and processes until it eventually claimed the life.

Her mother didn’t deserve to have Alzheimer’s. It wasn’t fair.

Everything I love is taken away from me. And I have no one else to blame except myself.

And as she watched Reece she thought of what she could’ve had with him. Only she didn’t believe in that life. It had destroyed her mother. So losing Reece was her fault, but it was for the best.

Was it?

A lump formed in Vivian’s throat and she pushed that thought away. She couldn’t think about that now. She couldn’t think of how empty her life was. Right now she wasn’t a daughter; she wasn’t hurting. Right now she was a surgeon.

A damn good surgeon.

“Dr. Maguire, I can’t thank you enough.”

Vivian’s thoughts were interrupted by the eager resident who was getting gowned by the scrub nurse.

“Not at all, Dr. Berlin. I want to congratulate you on catching the subtle nuances of this. If it wasn’t for you, our patient here would not have made it.”

She might not even survive this.

No. The patient was going to survive this. She’d worked under a microscope of judging surgeons before. She could do it again.

She
would
do it again.

“Thank you, Dr. Maguire, all the same,” Dr. Berlin gushed. And in the blush on Dr. Berlin’s cheek Vivian saw a piece of herself. Who she used to be. Shy. Withdrawn. Never thought of twice and afraid to stand up.

“No more thanking. Go stand next to Dr. Castle and take a spot at the scope. You’re going to get up close and personal with this glioma and the brain stem.”

You can do this.

Vivian took another deep breath. She watched as Reece washed the newly shaved spot on the patient’s head with betadine. The scrub nurse began to prep the surgical field as Vivian took her place as the head neurosurgeon.

“Scalpel.” Vivian made the incision. She could hear Reece explaining the procedure to Dr. Berlin. She didn’t even have to ask him; he just did it.

It was nice.

Why isn’t he going for Dr. Brigham’s job?

That she didn’t understand, because he had the drive, he had the knowledge and the skill. He was a brilliant surgeon. Dr. Brigham’s job was rightfully his. It should be his. Yet he showed no interest in it.

“I just want to focus on my Alzheimer’s trial.”

And maybe that was so, but Dr. Brigham had his own research going. It wasn’t a one or another situation.