The group of residents were gathered in the OR observation room to watch a high-risk coronary bypass.
Ava stood at the front, pointing out key steps as the lead surgeon worked below.
“Notice how Dr. Ramirez is positioning the graft,” Ava said. “This level of precision ensures the bypass will hold under pressure. One mistake here, and the patient could suffer a fatal rupture.”
Ethan’s voice broke in from the back. "Wouldn’t a saphenous vein graft be a better option for a patient with a history of peripheral artery disease? It’d reduce the risk of complications down the line."
Ava turned, her expression unreadable. "Are you suggesting Dr. Ramirez doesn’t know what he’s doing, Dr. Clarke?"
"Not at all," Ethan replied smoothly. "Just pointing out an alternative that might work better. Medicine evolves, doesn’t it?"
Murmurs rippled through the residents. Ava took a measured breath. "Medicine evolves, yes. But we don’t experiment in the middle of a procedure. We follow the plan."
"Plans can change," Ethan countered. "Especially when lives are at stake."
Ava’s jaw tightened. She turned back to the observation window. "Any other questions?"
The room went silent.
After the surgery, Ava pulled Ethan aside.
"What the hell was that? Why the hell do you keep annoying me?" she demanded, her voice low but heated.
"What was what?" Ethan asked, feigning innocence.
"Undermining me in front of the residents," Ava snapped. "You may think you’re some kind of surgical prodigy, but this isn’t the Ethan Clarke show."
Ethan’s smirk faded. "That’s not what I was trying to do."
"Then what were you trying to do?"
"Save the patient," he replied, his tone serious. "Isn’t that the goal?"
Ava stared at him, frustration and something she couldn’t quite name swirling in her chest. "The goal is to follow protocol so everyone knows what to expect. You can’t just throw out suggestions without considering the consequences."
"And you can’t just dismiss new ideas because they’re not yours," Ethan shot back.
The tension between them crackled like a live wire.
"Dr. Clarke," Ava said finally, her voice measured, "if you can’t respect my authority, this is going to be a very long residency for you."
He held her gaze, unflinching. "And if you can’t see the value of thinking outside the box, this is going to be a very long year for all of us."
Ava opened her mouth to respond but stopped herself. She turned sharply on her heel and walked away, leaving Ethan standing alone in the hallway.
That evening, Ava sat in her office, reviewing the day’s cases. Her mind kept drifting back to Ethan. His confidence annoyed her, but she couldn’t deny his instincts were sharp. He’d been right about the graft—technically, at least.
A knock on the door pulled her from her thoughts.
"Come in," she called.
Ethan stepped inside, hands in his pockets. "Got a minute?"
She sighed, setting down her pen. "What do you want, Dr. Clarke?"
He closed the door behind him, his expression unusually serious. "I wanted to apologize."
Ava raised an eyebrow. "For what? Being insubordinate? Undermining me? Or just generally being a pain in the ass?"
Ethan chuckled softly. "All of the above."
"Well, that’s a first," Ava muttered.
He stepped closer, his green eyes sincere. "Look, I get it. You’re the boss, and I need to respect that. But I wasn’t trying to undermine you. I just... I get caught up in the moment. When I see a chance to help, I take it."
Ava studied him for a moment. "You need to learn to channel that energy into teamwork. Medicine isn’t a solo act."
"Neither is leadership," Ethan countered gently.
Ava’s lips twitched, almost forming a smile. "Touché."
They stood in silence for a moment, the tension between them shifting into something less hostile.
"Anything else, Dr. Clarke?" Ava asked finally.
He shook his head, heading for the door. But before he left, he turned back. "You’re a hell of a surgeon, Dr. Grant. I just thought you should know."
Ava blinked, caught off guard. "Thank you for the compliment.”
Ethan grinned and left, leaving Ava alone with her thoughts.