It had been a busy day for Noah. After the M&M Conference, he’d headed over to the Stanhope and up to the OR along with a good portion of the rest of the attendees. En route he’d had several people compliment him on the program, and even a few had remarked how surprised they were about Dr. Mason’s outburst, which was reassuring.
Despite Dr. Mason’s comment to him after the conference was over, Noah felt very good about how things had gone in general, and he imagined Ava did, too. For Dr. Kumar to have supported her the way he had was certainly a tribute to her standing in the department, and it had to have buoyed her lagging self-confidence about her clinical abilities. And Dr. Jackson had certainly come through in a commendable fashion.
After making certain all was copasetic with the day’s surgical-resident assist schedule, Noah had started his own four operative cases. As his assistant for the day, he had chosen third-year Dr. Dorothy Klim. She was a terrific resident with whom Noah enjoyed working. This was the first time they’d operated together since Noah had assumed his super chief role. They made a good team, as she could anticipate Noah’s technical needs as any good assistant does, so the cases proceeded apace. Such efficiency always made the nurses happy, so it ended up being a pleasant day for all involved, including the patients.
In between each case, Noah dictated the procedure as he always did. Some surgeons put off the dictation until their last case was over, but Noah liked to do it right away to be certain he didn’t forget any details. During each round trip to and from the surgical lounge where the dictating booths were located, Noah kept an eye out for Ava on the rare possibility they could interact on some superficial level, but it wasn’t to be.
Leaving his final scheduled case for the day, an open cholecystectomy, or gallbladder removal, Noah again looked for Ava. Seeing that it was past 3:00 when her shift ended, he checked the PACU, where he had run into her the day they had their first real conversation. But she wasn’t there. Checking the scheduling board, he saw that her last case had finished almost an hour earlier, meaning she’d most likely left the hospital on time.
Disappointed not to have even made eye contact during the day, Noah looked forward to seeing her that evening at her house. Although he’d been staying with her almost every night since she’d gotten back from Washington, he hadn’t the previous night, due to emergency surgery that had kept him in the hospital. As he sat down in one of the dictating booths, he found himself fantasizing about the upcoming evening. There was a wine shop on Charles Street appropriately called Beacon Hill Wine, and he planned on stopping in and getting a bottle of champagne to celebrate the outcome of the M&M. At least she was out of the woods, even if he wasn’t.
Just before Noah began his dictation, he made up his mind to call Ava a bit later to find out her thoughts about take-out that night. He even entertained the possibility of their going out to an actual restaurant, either that night or over the coming weekend. He had no idea how she might respond, but it seemed like a fun idea. And why not? Wasn’t the cat out of the bag? With what Dr. Mason had publicly said at the M&M, it probably wasn’t possible to maintain the secrecy of their affair even if they continued overtly to ignore each other in the hospital.
When Noah was finished with the dictation, he went back into the PACU to make sure everything was fine with the cholecystectomy patient. When he had left the OR, the operation hadn’t been totally over. The six-inch incision in the right upper abdomen was still open. This was standard protocol in a teaching hospital. With the open gallbladder removal, Noah had brought in a first-year resident to provide traction. When the key part of the operation was done, it was standard protocol for the most senior resident, meaning Noah, to leave so that the next senior resident, Dr. Klim, could teach the first-year resident basic suturing technique.
Noah briefly glanced over the postoperative orders, which the first-year resident had written, again under the auspices of the third-year resident. This was par for the course and hadn’t changed in years. Medical education in general hadn’t altered much over the last century, despite everything else involving medical science and technology being drastically different.
Noah hurried back to the surgical lounge to change into his whites. He had an enormous amount of work to do above and beyond work rounds and seeing his private patients. Now that the M&M was over, there was a lot of catching up to be done, which he intended to do and still leave the hospital close to 6:00. If it was at all possible, his hope was to get to Ava’s before she started her workout so that by the time she was finished showering, he’d have their celebratory feast, including champagne, ready to be enjoyed.
Almost at the exact moment he hurriedly pushed into the men’s surgical locker room, Noah felt his phone buzz with a text. Curious who might be texting him on his phone rather than his hospital tablet, which was where he received the vast majority of his messages, Noah pulled out his phone and was happy to see it was a text from Ava. With a mixture of titillation tinged with relief to finally connect with her, he opened it.
Noah stopped in his tracks, his euphoria evaporating. With almost total disbelief, he read over the message multiple times. It was brief: On a business trip for a few days. Will text when I return.
Noah sank down on a low bench, still holding the phone in his hands, staring at the screen in dismay, amazed that Ava would be insensitive enough to send such a short, emotionally unexpressive text. Under the circumstances, it seemed almost deliberately cruel. Either that or she lacked empathy, although either explanation seemed equivalently heartless. Immediately, the question rose in his mind about how long she had known about this trip or whether it was something that had happened that afternoon as a response to a lobbying emergency, if there was such a thing. He hoped it was the latter, because if it wasn’t, she should have told him she was going the moment she’d heard about it.
As Noah thought more about this totally unexpected development, he realized she must have some days off, as she had worked more than a week straight, including the entire past weekend. At the time, Noah hadn’t questioned it, because he worked every day and every weekend as a matter of course. The idea it was rare for her to work more than five days in a row hadn’t even entered his mind. But why didn’t she bring it up last night that she was scheduled to be off tomorrow?