The Osteopathic Difference
Nadia rubbed her eyes, trying to push past her exhaustion. Promising to build a heart for Singh’s patient meant she was spending twice the usual time in the lab. She was sleeping even less than usual, and the deprivation made it harder to focus on ignoring her silly and inconvenient crush on Rylan.
“Dr. Keating?”
Jack stood tentatively at the doorway. She gestured for him to come in. Since they had last met to go over Williams’s CABG case, Jack’s knowledge had improved, but his suturing skills were still lacking. It didn’t matter if he wanted to be a psychiatrist, a pathologist, or an astronaut. If he was in the OR, he should know how to suture.
“Have you been practicing?” Nadia asked.
“I have.” He pulled out a small silicone skin pad that was falling apart around the incision sites.
Nadia watched Jack shakily guide the curved needle through the fake skin. She frowned as Rylan’s words echoed in her mind. It wasn’t nice of her to help Jack; it was necessary. Nice didn’t earn respect in the world of surgery. It didn’t save patients. And it was not a quality she often saw in her colleagues.
Except in the chief. A warm feeling rose in her chest. Despite Nadia’s efforts to concentrate, Rylan stubbornly refused to leave her thoughts.
Attempting to distract herself, Nadia stepped closer to the table, silently judging Jack’s suturing technique. His shaking worsened, making her question her methodology. Maybe Rylan had a point. Maybe Jack would respond better to encouragement. She could give it a shot. “Good job getting here on time this morning.” Even to her ears, the words were stilted and forced.
And as soon as she said them, the instruments flew out of Jack’s hands and clattered on the ground. He looked at her as if she might set him on fire.
Nadia pinched the bridge of her nose, her hand hiding her amusement. Silently, he picked up the needle driver and forceps and resumed his work.
No, she was nothing like Rylan, and there was no point in admiring her for the qualities Nadia so clearly lacked. The thought brought unease that spread through her chest, formed knots in her stomach, and added tension to her muscles. Since when did she even entertain the idea to be anything like Rylan?
She cleared her throat and focused on Jack again. “Stabilize your upper arms against your body and keep the lateral part of your hypothenar eminences on the table whenever possible. It will help steady your hands. Right now, you look more like a Parkinson’s patient than a doctor.”
What bothered Nadia most was that she had never shared so much about herself with anyone else but Rylan. She didn’t quite understand how she could have allowed it. There was nothing unique about Rylan that justified such a lapse. Sure, she was attractive, but so were a lot of other people. Appearances hardly accounted for Nadia’s interest in Rylan, and Nadia refused to entertain the possibility that it was Rylan’s compassion that encouraged her to open up.
So what was it then?
Reminding herself again she should quit asking questions she had no desire answering, Nadia reached forward to hold the suture line away from Jack’s field of work. Her mind rebelled against her, recalling that it was the same thing she had done for Rylan a few days earlier. Her heart jolted at the memory of Rylan’s mere proximity back then. Unlike the spike in her blood pressure because of Jack’s clumsy execution, back then her heart had raced because of the fine movements Rylan’s delicate fingers made and the inherently melodic sound her voice carried. Even when she had been stammering about sex in a delightful fluster.
Nadia shook off the memory. It was wrong. All of it. It didn’t matter how her body reacted to Rylan. She was in control of her emotions, not the other way around. Gritting her teeth, she told herself to ignore all thoughts of Rylan’s delicate scent, soft skin, or piercing blue eyes.
Abandoning her assisting duties, Nadia dropped the suture and crossed her arms tightly as if she could hold onto her fleeting resolve. Her emotions toward Rylan felt like an unresectable cancer—when it was impossible to recognize where the tumor ended and the normal anatomy began, there was little hope for recovery.
Ignoring the grim realization, she looked at Jack. He still held the instruments, but he had stopped working. His clueless eyes were wide enough to warrant a workup for brain damage.
She pinched her lips to hide a mixture of displeasure and amusement. “You have no idea what a hypothenar eminence is, do you?”
* * *
As Ashley drew closer to the coffee counter, her breathing rate sped up as if she were on the verge of a panic attack. This is embarrassing.
She had just finished giving the talk on surgeons who had won Nobel Prizes, and it had been so well received that she wanted to get Nadia a coffee as a thank-you. Except she had no idea what coffee to get.
“Hi, Ashley. The usual?” asked the girl behind the counter.
“Hi, Janet. Uh, yes.” Ashley smiled warmly. “And…one more drink.”
Janet waited as Ashley scanned the menu. What does Nadezhda like?
“Are you familiar with what other doctors drink?” Ashley asked. “The one I’m thinking of is about my height with brown hair. And she looks angry most of the time.”
Janet shrugged. “Sorry, not a regular.”
What were the chances this would work, anyway? Nadia probably made one of her minions in the lab fetch her coffee.
Ashley sighed. “I’ll take your four most popular coffee drinks.”
She made her way to Nadia’s lab juggling a four-cup carrier tray in one hand and an extra cup in the other. The liquid in the cups sloshed back and forth, reflecting Ashley’s mind. Torn between thinking coffee was a terrible idea in one instant and a great one in the next, she trudged to Nadia’s lab.
“The sutures go from out to in and not the other way around. This won’t do.” Nadia was criticizing Sarah, her lab assistant and a first-year medical student, in a sterile area at the far end of the lab.
“I’ll redo the anastomosis, Dr. Keating.”
As Sarah picked up the required instruments, she knocked down a vascular stapler.
“My grant isn’t intended to cover expensive mistakes,” Nadia said with ice in her voice. “Scrub out and get me another stapler.”
Ashley wanted to shake her head and laugh at the same time. Nadia’s reaction was excessive, but it was also funny how she always had something intimidating to say. Still, the chances of Sarah finding any humor in the sharp remark were slim. The girl scrambled out of the sterile gown and headed toward the exit. On her way out, she met Ashley’s eyes.
“I’m glad she’s not my boss,” Ashley teased, trying to calm the tensed girl.
Sarah’s eyes got even wider before she scurried away.
“Do you have to be so hard on the poor girl?” Ashley frowned, despite amusement still dancing on her lips. “She’s still learning.”
“If you were the patient, you wouldn’t want some clueless medical student practicing on you. Some mistakes are harder to tolerate than others.”
Ashley chuckled. “You just love being the bad guy, don’t you?”
“It’s a welcome bonus,” Nadia said with just a hint of a smirk. She stepped toward Ashley, tearing off her sterile gown in one motion. “I’m busy. What do you want?”
“I got you coffee,” she said, though the sudden closeness made her breathe a little harder.
Nadia looked at the tray. “Which one is for me?”
“I’m not sure.” Ashley’s cheeks heated. “I had no idea what to get you.”
Nadia took her time washing her hands, then gestured for Ashley to set the drinks on the bench closest to the exit.
Ashley complied, relieved to put the tray down. But now she had nothing to shield her from Nadia’s assessing stare, and she shifted her weight from side to side.
Nadia didn’t even bother examining the drinks. “I don’t drink coffee.”
“Ever?” Ashley’s mouth dropped. Surgeons loved caffeine, but maybe Nadia preferred tea instead of coffee.
“No tea, cola, guarana, or whatever caffeine nonsense people have come up with these days.” Nadia quickly disabused her of that thought.
Ashley frowned. “But you’re here all the time. I’ve seen you pull double shifts without batting an eye. You mean to tell me you keep going out of pure stubbornness?”
Nadia shrugged. “I don’t like stimulants. They create physical dependence. And I don’t like to be dependent on anything.”
The “or anyone” was left out, but Ashley heard it just as loudly. Disappointment wiggled through her and she reached out to retrieve the coffees. Well, this was a stupid idea.
“Leave them.” Nadia touched her hand. “I’ll give them to my staff.”
Ashley’s heart jumped at the contact, and she looked up with her eyes wide. Nadia quickly withdrew her hand, leaving a longing sensation from Ashley’s skin all the way to her core. Ashley cleared her throat, ignoring the feeling. “I thought nice went against your nature,” she teased.
Nadia visibly cringed. “I’m not…that.” She picked up one of the coffees and examined it. “You guessed Sarah’s drink.”
Ashley smirked. “For someone who doesn’t drink coffee, you know a lot about other people’s coffee preferences.”
Nadia’s nonchalant shrug made Ashley wonder if she was allergic to compliments. “I’d say it’s nice of you to know something about her, but I’m afraid you might go into anaphylactic shock.”
Nadia scoffed and turned the cup to show Ashley where the barista had scribbled “soymilk” on it. “There was a study that looked into how what kind of coffee someone drinks can tell you about their personality. I decided to figure out if the data applied to my staff.”
Ashley grinned. Of course, there was research involved. “And does it?”
“People who drink their coffee with soymilk tend to be detail-orientated. It’s spot-on for Sarah.” Nadia glanced in the direction of where Sarah had been working. “That is if she remembers to suture the graft the right way.”
Ashley chuckled at Nadia’s dry tone. “And the rest?”
Nadia picked up the remaining drinks one by one. The PhD graduate student working with her was creative and motivated, which was reflected by his preference for cappuccino’s rich and sophisticated flavor. The straightforward general surgery resident drank black coffee. The Frappuccino drinker was more likely to take risks in life, as evidenced by the fact that he was the only staff member who ever argued with her.
“It also means he doesn’t make healthy choices, but I don’t need a study to tell me that, given the amount of sugar he consumes.”
Ashley laughed, thoroughly enjoying Nadia’s masterful ability to balance humor and discipline. For someone who rarely engaged in chitchat, her ample knowledge of her staff filled Ashley with addictive curiosity. “And what about this one?” Ashley placed the fifth cup on the table. It was Ashley’s drink, a latte.
Nadia’s face stiffened as she stared at the cup.
“What?” Ashley asked.
“Nothing. I have to get back to work.”
Ashley grabbed her hand. “What just happened?”
“It’s nothing. It was a dumb study conducted by an armchair psychologist. It hardly qualifies as science. Forget it.”
Ashley realized what the problem was. “Now I have to know about latte drinkers.”
Nadia crossed her arms. “I’m not going to tell you.”
It was childish and yet adorable how Nadia tried to protect her feelings. Ashley pulled out her phone. “Fine. I’ll find out for myself.” How many studies linking personality traits and coffee could there be?
With a few taps, she found a blog post that referenced the study in question. She couldn’t imagine Nadia ever reading a layman article about a scientific paper, but if any time was appropriate to cut corners, it was now. A summary table contained personality characteristics of the various coffee drinkers. She found the list for lattes: people pleaser, neurotic, indecisive. She snorted. “Yeah, that’s pretty much how you see me.”
“No.” Nadia reached out but then retracted her hand to her side and made a fist. “You also add an extra shot. I think that description is more accurate.”
Ashley looked back at her phone again. The traits for espresso were leadership and hard-working. She smiled. The whole study was silly, as Nadia had said, but it was nice of her to try to make Ashley feel better. And it was totally working.
“I’m changing my coffee drink,” Ashley announced with all the seriousness she could muster.
Nadia chuckled. “I don’t think you should change anything.”
The words made Ashley’s breath hitch. She stared at Nadia. Those intense brown eyes made her entire body flare with want, need, and something that words could never describe. No “friend” had ever looked at her the way Nadia did.
Nadia looked away, breaking the connection. “Except, of course, the way you tie your surgical knots,” she added dryly. “I hope you change that to save some OR time.”
Ashley forced a laugh. Nadia had made it clear they couldn’t be together. She had to guard against emotional lapses like the one that had just happened. “If I do all my knots the way you want, it might save me fifteen seconds,” she said, recovering. “And that is an optimistic estimate.”
The door swung open. It was Sarah, returning with the stapler. Nadia snapped back into rigid aloofness.
“It’s about time. Did you go all the way to India to get that stapler?”
Ashley stepped away. The moment had passed, and it was time for her to get back to work. She turned to Sarah. “Let me know if she’s too hard on you, and I’ll have a stern talk with her.”
“Dr. Keating is a great mentor,” Sarah protested promptly. “It’s a privilege to work with her. She’s inspiring, and her pioneering research is going to change the world.”
Ashley looked at Nadia, who was smiling arrogantly.
“Did you hear that? It’s a privilege to work with me.”
Ashley snorted as she walked out. “I’ll try to keep that in mind.”
* * *
Nadia shifted in her bed. The mattress felt as if it were filled with stones, not made of memory foam. She had made significant progress on her project today, so why was she restless?
Her osteopathic background gave her the framework to build a heart, but the knowledge wasn’t limited to one field. How did Ashley put it? Healers explain the same world from different perspectives. Ideas are bound to overlap.
Ah, boundaries.
Boundaries were good. They helped people operate within preset parameters. Emotions were complicated, unpredictable, and undesirable in a neat universe of rules.
But it is human nature to feel.
Nadia fluffed up her pillow, frustrated at how logic kept slipping through her fingers.
Ashley. When did she start thinking of Rylan by her first name?
She pushed the thought away and forced herself to think about her experiment. A heart, like any other organ, grew within a body. Osteopathy taught that the body functioned as a whole and should only be understood as a unit. The irony was that when it came to her relationships, Nadia had dispassionately compartmentalized her life. But they were artificial walls. What if she broke them down?
Nadia rolled over again. Why couldn’t she have the same clarity in her personal life that she had in her job?
Squeezing her eyes shut, she tried to chase away the moonlight that peeked into through the window shades. She was ready to admit that her insomnia had nothing to do with her experiment. Not her laboratory experiment, anyway.
She couldn’t say the same for her social experiment. Boundaries had been crossed, lines had blurred, and feelings had developed. She could no longer ignore the way her heartbeat quickened every time she saw Ash—no—Rylan.
She turned over again. It was hopeless. Fighting her feelings was a battle she had lost before it began. She was naïve to think she could separate her emotions from her actions. The truth was obvious: Nadia had deep, sappy, gut-wrenching, chest-tightening, butterflies-in-the-stomach feelings. For Ashley. Yes, Ashley. Because no matter how much she denied it, Nadia couldn’t think of her in any other way anymore.
It was never just sex. And if Nadia kept burying her emotions, her heart might break.
Literally.
The only sensible course of action was to allow herself to feel her feelings instead of pushing them away.
The mattress shifted on the other side of the bed, and she fought the urge to slither away as an arm wrapped around her. She gently pushed the arm off and slipped out of bed. She stared at the handsome face in the dim light, guilt rotting inside her. Why couldn’t she feel for him what she felt for Ashley?
Her mind flooded with frustration over her emotional ineptness, and her eyes dampened.
She couldn’t keep going like this. She had to come clean. To everyone. And maybe Ashley would appreciate her honesty. Maybe she would understand—and forgive her.
Even if she didn’t, Nadia could no longer keep secrets from the people she cared about. Telling the truth was the right thing to do. For everyone involved.