Malpractice of the Heart

Clara’s prized protégé, Leo, loved to brag he could crack a chest one-handed.

When his performance failed, he stared at the patient’s unclosing thoracic cavity, dropped the bone saw with a clatter, and ran.

I got the call in the dead of night. I was the one who rushed to the hospital and, against all odds, saved the man’s life.

In the aftermath, Leo was crucified online, his career facing total annihilation. Clara, my girlfriend, wanted to defend him, but I held her back, my grip tight on her arm.

“If you speak up for him now, at this exact moment,” I warned, my voice low, “you can kiss the Whittaker Grant goodbye. And they won’t just come for him. They’ll come for you, too.”

Leo couldn’t handle the vitriol. He threw himself into the river.

His suicide note was a testament written in blood and tears, each line a furious accusation against Clara for not taking his side.

Clara said nothing.

She simply held the note to a flame and watched it turn to ash.

In the years that followed, she ascended. From the Whittaker Grant to a full fellowship, she became a titan in the medical world, a name spoken with reverence.

The day of my own surgery, she insisted on being the one to wield the scalpel.

She did it one-handed.

As I lay there, my own chest gaping open, she angled a mirror so I could see the reflection of my own undoing.

“See?” she whispered, her voice a cold, smooth stone. “A chest can be opened with one hand.

“Why did you have to make it so hard for Leo?

“If I had just stopped you that night, he would be the one standing here right now. Not me.”

A surge of rage and betrayal choked me. I felt a final, hot burst in my chest, and then, darkness.

When I opened my eyes again, I was back. Back to the day of Leo’s disastrous performance, watching Clara ready herself to charge into the fray for him.

What she didn’t know, what she couldn’t possibly understand, was that the man on the table was Arthur Richmond.

And his sister, the matriarch of the Richmond family empire, was protective of her brother to a terrifying, absolute degree.

1

The moment I realized I had returned to the day of Leo’s one-handed stunt, the very first thing I did was turn off my phone.

I slept until the sun sliced through my blinds.

The next morning, I powered it on. Ninety-nine-plus missed calls, just as I expected.

In my last life, the second Leo knew he’d screwed up beyond repair, he’d blown up my phone, begging me to come clean up his mess. And I did. Despite having just finished a triple-header of surgeries, despite having slept for less than an hour, I had dragged myself out of bed. I’d driven through a blizzard, racing back to the hospital to spend the entire night wrestling a man back from the brink of death.

I saved his life.

And because I did, his sister—Sloane Richmond, the iron-willed CEO of one of the country’s most powerful private equity firms—showed a sliver of mercy. She didn’t obliterate Leo. She simply allowed him to face the standard medical board review and disciplinary action.

If Leo had just weathered that storm, he could have eventually returned to his post, maybe even salvaged his career.

But he had spent his entire life sheltered and adored by Clara. He’d never known real hardship. The tidal wave of online hate was more than he could bear. He jumped.

This time, when I walked into the hospital, the scene was one of controlled chaos. Leo was slumped against the wall outside the OR, his face a mask of vacant horror. My colleagues were a blur of motion, their scrubs stained crimson.

“This is on you!” one of them hissed at Leo, his hands trembling with adrenaline and rage. “We told you it was reckless! A one-handed crack? Are you insane?”

“Just because Dr. Pierce fast-tracked you into this residency doesn’t give you the right to play God!” another snapped.

“Well, look where it got us! We’ve barely got a thread of a pulse. He’s circling the drain. If he dies on our watch and his sister finds out, none of us—none of us—will ever work in this city again!”

An alarm shrieked from inside the operating room, a high, flat-lining keen.

One of the nurses sank to the floor, her face ashen. “It’s over… We’re all done for…”

A younger resident, fresh out of med school, started to openly sob. “Why wasn’t Dr. Hayes on call last night? If he were here, he’d know what to do…”

“It’s too late now. It’s over.”

Leo’s head shot up. His eyes, vacant moments before, locked onto me. A flicker of something predatory sparked in their depths.

“It was him!” he shouted, pointing a shaky finger.

“I was calling him all night! Over and over! But his phone was off! We’re not the ones who killed this patient! He is! The man who could have saved him but deliberately shut his phone off!”

Every head whipped in my direction.

“Dr. Hayes!”

“Lucas… is that true? Was your phone really off on purpose?”

“Of course it was!” Leo scrambled to his feet, shoving his call log in everyone’s face. Ninety-nine calls. He stalked toward me, his eyes red-rimmed and wild. “Dr. Hayes, a life was on the line. We’re doctors. Our phones are supposed to be on 24/7. You knew there was a major cardiothoracic surgery scheduled for last night. You knew you’re the best we’ve got. To turn your phone off at a time like this… Lucas, what the hell were you thinking?”

Crack.

The sound of my hand striking his cheek echoed in the corridor.

I stood over him, my voice ice. “Have you lost your mind, Leo?”

The commotion had drawn staff from other departments. They were gathering, watching.

I raised my voice, ensuring they could all hear. “The on-call roster is posted in black and white. Last night’s surgery was your responsibility, Dr. Sterling. Not mine. Yes, it seems my phone died. But the person who signed the chart, the person ultimately responsible for that man in there, is you.”

Leo’s face went pale. “You can’t hide behind a schedule when a man is dying! Your phone is never off. It was only off yesterday. You were targeting me, weren’t you, Lucas? That’s fine. But you don’t get to gamble with a patient’s life to prove a point!”

He was so righteous, so utterly convincing, that some of the patients and families lingering in the hallway began to murmur. They were buying it. They were starting to believe I’d intentionally left a rookie to fail just to watch him burn.

Before I could speak, one of my colleagues stepped forward.

“Shut up, Leo! Just shut your damn mouth! Do you have any idea that Dr. Hayes performed three back-to-back marathon surgeries yesterday? He survived on two bites of a protein bar and a bottle of glucose water!”

“Exactly!” another chimed in. “While you’re sitting in the resident’s lounge complaining about paperwork, he’s putting in the hours. He didn’t get home until after midnight. Forgetting to plug in a phone that’s been running nonstop for 36 hours isn’t a conspiracy, it’s called exhaustion!”

Family members of a patient I had operated on yesterday nodded in agreement.

“Besides,” the first colleague added, his voice firm, “Dr. Hayes fulfilled his duties during his shift. Last night was his time off. He wasn’t on call. This wasn’t his responsibility.”

The murmuring crowd fell silent. The truth settled over them.

Even the residents who had been in the OR with Leo looked away, unable to meet my gaze. “He’s right, Leo. This one’s on us. We just got dealt a bad hand.”

Leo staggered back, slumping to the floor again. His lips were white.

“What is all this commotion!”

The hospital director, Dr. Wallace, appeared at the end of the hall, her voice sharp with authority. Behind her, her face a mask of cold fury, was Clara.

I started to speak, but she walked straight past me without a glance. She went to Leo, kneeling down and helping him gently to his feet.

“It’s okay,” she murmured, just for him. “I’m here. I’ll find a way to fix this. You’re going to be okay.”

Dr. Wallace’s glare dispersed the crowd. Then, she jerked her head toward her office. I followed her.

The second the door closed, her stern facade crumbled. Panic flooded her eyes.

“Lucas! I know you’re not officially involved, but you have to save him! You have to! That man is Arthur Richmond. If he dies in our hospital, Sloane Richmond will burn this place to the ground, and every single one of us, you included, will be caught in the fire!”

I let out a slow breath.

The truth was, the only reason I’d dared to turn off my phone was because I knew my team. They were good. They were good enough to keep a patient stabilized, to keep him alive long enough for me to get a full night’s sleep. Long enough for me to arrive this morning with leverage.

I looked Dr. Wallace dead in the eye. “The responsibility for what happened today doesn’t just fall on Leo. It falls on Clara, too.”

The director stared at me, confused.

I slid a document across her desk. It was a formal proposal for an experimental surgical technique. At the bottom was Clara’s signature, authorizing Leo to perform it.

“Leo’s one-handed showboating,” I said calmly. “Clara personally approved it. We are all shouldering an insane amount of risk to pay for their arrogance. So, yes, Director, I can clean up this mess. But Leo can’t be the only one who faces consequences.”

I leaned forward, my hands flat on her desk. “If you don’t handle Clara, something like this will happen again. And next time, I’m not sure I’ll be able to save this hospital.”

Dr. Wallace’s expression hardened. Clara was her star, the protégé she had mentored since medical school. But the hospital’s survival, its very existence, was on the line. And right now, she needed me to save Sloane Richmond’s brother.

“That arrogant little…!” She slammed the signed proposal down on the desk. “After everything I’ve done for her, she pulls a stunt like this!” She looked up at me, her eyes flinty. “Don’t you worry. Her application for the Whittaker Grant? It’s dead on my desk. Her promotion track? Canceled. From now on, she’ll be handling basic consults and paperwork. She will never be trusted with a core surgical position in this hospital again.”

A slow smile touched my lips. I picked up the pen.

With that single action, the glittering path that had led Clara from the Whittaker Grant to medical stardom in her past life had just been severed.

It was a long day. From morning until well past nightfall, I worked. Slowly, painstakingly, Arthur Richmond’s vitals began to stabilize.

My scrubs were soaked through with sweat. The moment I stepped out of the OR, my legs gave out and I collapsed. A colleague forced a bottle of glucose into my hand and I drank it down, the sugar slowly bringing the world back into focus. The same residents who had been in the OR with Leo gathered around me, their eyes filled with tears of gratitude.

“Thank you, Dr. Hayes,” one of them choked out, gripping my hand. “Without you… I don’t know what we would have done.”

“It’s true,” another added. “Sloane Richmond is ruthless. If her brother had died… she might have gone after our families.”

I reassured them as best I could. Finally, I was free to go home, to fall into bed.

I was in the underground parking garage when a footstep behind me made the hairs on my neck stand up. I spun around.

Nothing. Just rows of cars and concrete pillars.

Muttering to myself, I turned back toward my car.

A cloth clamped over my face, and the world went black.

A sweet, chemical scent flooded my senses as my consciousness faded.

When I woke, my right hand was chained to a heavy steel table. In the dim, flickering light of a single bare bulb, I could just make out the silhouette of the person standing over me.

“Clara!”

The hand holding me down flinched. I was bound to a chair, and I thrashed against the restraints.

“Clara, it’s you! I know it’s you, isn’t it? Whatever you’re planning, we can talk about it! Please… just let me go! I saved him! For you, I saved Leo’s ass!”

The figure paused. When she spoke, her voice was a ghost of a sigh.

“No, Lucas. You saved him from Sloane Richmond’s immediate wrath. But you still let him be cast as a villain, a reckless, incompetent doctor. You left him to face the world alone.” Her voice hardened. “I’m sorry. If you truly want to help him, there’s only one way. You have to lose a hand.”

My blood ran cold.

“That way,” she continued, her tone unnervingly calm, “no one will believe you performed the surgery. They’ll credit the miracle to Leo. I’ll talk to the other residents. I’ll delete the surgical logs. Lucas… this time, you have to help him. For real.”

My eyes widened in disbelief. “Clara!”

A heavy cleaver, glinting in the dim light, was raised high above her head. I bucked against my restraints, a primal scream tearing from my throat.

“I’m a surgeon! My hands… how will I live without my hand?!”

The cleaver paused mid-air. The yellow light caught a flicker of something—pity? regret?—in her eyes.

“I’ll take care of you for the rest of your life, Lucas.”

“Wait!” I yelled, my voice cracking. “If you do this, you’ll never practice medicine again either! They’ll find out!”

She shook her head slowly. “Dr. Wallace is my mentor. She would never let it come to that. Don’t worry. I have the power to stay in this world, to protect you forever.”

“She’s already abandoned you!”

Her body went rigid for a second, then she let out a small, dismissive laugh.

“No. She wouldn’t.”

CRUNCH.

“AAGGHHH!”

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