Chapter Text
that boy from Georgia was so sweet, his voice was honey and his mom loved me // and he’d do anything for me, there every night when I’d fall asleep // but never showed up in my dreams
never been in love – Gatlin
The world spun at different speeds for different people.
The frequency of rotation and the axis was always the same, the tides of each ocean controlled by one moon and a constant balance of forces, and everyone was given the same 24 hours per rotation and 365 days to circle the sun. But when it seemed everyone else had something to look forward to, their worlds spun more quickly, pushing forward to that future and the optimism it promised.
The passage of time was heavier, and interminable, when it was only experienced by one.
The engagement party had been a night that everyone needed, without question. And for Billie, the celebration of two people who deserved their happy ending was a visible reminder that even when time moved slowly for her, the future could still hold hope and love no matter how distant it seemed. Kit and Bell were getting married, AJ was on the verge of fatherhood, and Devon was committing to his future in Atlanta. Once the crowd began to trickle down, Billie made herself scarce before she would have to confront anything or anyone, returning to the solemn comforts of her dark apartment.
She hung her coat in the closet and took a shower, letting the shampoo wash the rest of the day away, then turned her attention to the kitchen. After turning on the news in the living room, she washed the dishes, emptied the trash, and cleaned the stove, not once registering what the anchors were reporting. The television was on as background noise, ambient voices to drown out the silence. It was on more and more these days.
The past year had been difficult for Billie. The agony of losing Nic took months to recover from, but she was grateful to have the support system of Chastain Park Memorial Hospital to allow her to feel again afterwards. The past year, however, had opened so many wounds that she had dealt with alone, and the only way to get through it all was to numb herself to everything before it became overwhelming. She spent the past year working under the same roof as Trevor, hiding the truth from him, and standing tall when that horrible truth came out and brought with it a hail of gunfire. Facing Porter had been a turning point of sorts, yet nothing seemed to change once it passed. She had her friends, she had her work, and she had what seemed to be the first sparks of a relationship with the one person who knew her better than anyone, yet time moved slowly.
The sparks she supposedly felt were never right. Billie could see the way Conrad looked at Cade in the hospital or across the bar, and then the way he looked at her. Neither were close to how he looked at Nic, which was why she allowed herself to read into the nuances of his smile and his eyes, but at the end of the day it never felt right. She never felt exhilarated or captivated, the thrill of being pursued and the desire to be seen were absent. When Conrad looked at her she felt no attraction. She just felt known. Billie had known him for decades and trusted him with a certainty that she had abandoned before her fourteenth birthday. He knew her. But being known and being loved were not the same thing.
Standing in her kitchen at eleven o’clock with only the news anchors to keep her company, she felt neither known nor loved. She felt lonely.
The sparks were not right, the feelings they brought weren’t true, and it was clear that whatever draw she did feel had nothing to do with romance. It was too late in the day to rationalize the manufactured crush on Conrad, but as soon as she accepted its fallacy, all feelings for him beyond friendship dissipated. They were lost to the clouds with one flourish of her wrist, effortlessly disappearing into the night like they were never there to begin with.
Unlucky in love and lonely, Billie did what she did best. She operated on the brain and the nervous system, and fixed. It was what she had always done. It was her whole life. It saved her life.
Even though time was passing slowly, it was passing. Business returned as usual to Chastain, including her afternoon cortado on the terrace. Conrad was attuned to the break and had been waiting for a moment to interrupt, she could see from the way he approached the table with his own to-go cup shortly after she sat down.
He drummed his fingers against the side of the cup. “You’ve been quiet this week,” he offered. “Is everything alright?”
Billie took a sip of coffee. “Fine.”
“Are you sure?”
“Yes.”
“I’m asking because I care about you,” he said. “I care about you a lot.”
The apprehension in his voice was stinging. For months they had been nearing the line between friends and more and Billie was sure he had noticed it, too. He was gentle and concerned while she felt nothing, and every time he said something like that, she felt worse.
She was tired of putting so much energy into maintaining the distance between friends and more when she knew what side of the line she wanted to remain on.
“Can I buy you a drink after work? We can talk about whatever’s on your mind, or we can not talk at all.”
Billie held her breath, releasing it as discretely as possible. She sensed the offer would be coming but now that it was out there, she focused all her attention on not hurting his feelings. Perhaps there was a time when a part of her did feel that spark, and would have wanted to go to drinks, but that time had passed and pursuing it would not be worth it for either party.
“No,” she answered.
“Oh. Um, okay.”
She covered his hand with hers and softened her voice. “Conrad, you and I should not get involved.”
“This is because of Nic, isn’t it.”
“No. This is because of you and me.”
With every word, Billie’s approach became more active. She wanted to let him down gently, with reality and not optimism or pessimism. Now that she had his attention, she let compassion lead.
“You should be with someone who loves you the way you deserve to be loved. That person isn’t me.”
His brow furrowed as he nodded along, following the thinly veiled rejection. “I… thought there was something building between us. A spark.”
“For weeks, I thought so, too. And the truth is that I do love you,” she admitted. “Only… I love you in the same way that I loved Nic.”
The honesty in her responses was surprising, almost as surprising as how little she felt drawn to the man who had been a part of her life for years. The water under the bridge had settled and their strained, complicated history was buffered by mutual friends and Nic. When Nic died, they needed each other more than ever before.
Gigi was lucky to have a father like him and every day Billie was fortunate to be a part of that little girl’s life. But the earth was always turning, and anything between her and Conrad would never evolve into something worthy of their time and energy. Life was too short to pretend.
“That is not how you deserve to be loved,” she finished.
Conrad put the coffee cup back on the table and sighed. It was a hard conversation to be having on the terrace, but her hand was still over his and every word of the rejection had been sympathetic. It was surprising, considering how much they cared for each other, but Billie seemed genuinely sorry to not reciprocate any of those feelings.
He squeezed her fingers and asked, “We still be friends, right?”
“Oh, god, absolutely. Please. Please. My life is richer with you and Gigi in it, and the last thing I want to ever do is lose you. Conrad, I want for you to be happy, but I cannot give that happiness to you.” She looked across the terrace to the doctor with the distinct burgundy scrubs and sneakers. “I think there is someone else that can.”
After a long, tense pause, Conrad squeezed her hand again. He had not looked up to the person that she saw, instead he focused on Billie.
“I want for you to be happy, too,” he said.
…
Four weeks of returning home to turn on the news in hopes that familiar voices would fill the space with noise did little to remedy the loneliness that had settled in her bones. All around her were reminders that few others were feeling this way. AJ would not stop talking about baby clothes and furniture, Kit and Bell were planning a wedding, and Conrad and Cade were doing a terrible job hiding their new relationship.
The more Billie thought about her friends, the more she thought about her future. About dating, and a future, and a marriage, and a family… and how badly she wanted an ounce of their happiness for herself.
To make matters worse, she had no one to blame but herself. She had not been unlucky in love, but she had never actively pursued a life beyond work, much less a love life beyond work. Every night she came home to a sink full of dishes and the white noise of the television. After watching so many of her friends get married she felt that time had passed her by, but watching Randolph Bell fawn over his fiancée after and despite everything that tarnished his past, Billie began to wonder whether there really was such a thing as too late or hopeless when it came to romance. “Lost time” lost its meaning as long as you met the right person eventually, even if it took years.
But right now, all she felt was lost.
She had lost so much time, and so much more than that. Despite never avoiding men on purpose, it was difficult to trust and let men into her life, and through the long hours of medical school and the beginnings of a career in neurosurgery, dating was secondary. The few relationships that could have brought happiness were to satisfy a physical craving or because she felt she was supposed to be dating. The connection that was absent with Conrad was absent with them, too. She knew it well.
Dr. Billie Sutton saved lives. That was what mattered. She rebounded from the mistake in her residency and thanks to the good people in this hospital, she now held the role of Chief of Surgery. She had ended up exactly where she knew she would always be.
So why did she feel so lost?
Delaying the return to leftovers and reruns, Billie absentmindedly watched the patrons of the hospital depart for the day. The second floor landing was one of the most under-appreciated spots in the hospital, a way to connect with those in the world from afar and share the sense of movement beneath their feet. Billie heard the footsteps approaching, and one glimpse of meticulously maintained beard in her periphery told her who they belonged to.
“You okay?” He asked quietly.
“I’m fine,” she replied.
A pink and green backpack bounced through the foyer, drawing a smile from Billie. Gigi had a distinct laugh, especially when running towards her father, and when the third member of the small party came into view, her shoulders sank just enough for AJ to notice.
“It’s okay if you’re not.”
“AJ, I’m fine. Really. I’m happy that he’s happy.”
“Even if it’s with someone else?”
AJ had been paying more attention lately, assuming the role of an archetypal big brother who would do harm to anyone and anything who hurt her. He had commented on some of the building tension months ago and had seen Conrad move on just as she had. Billie was grateful to have him, no matter how much she hated knowing he could sense her loneliness, and how much she hated talking about her decision to not pursue a romantic relationship.
She craned her neck and turned back against the banister, facing the other direction. “I told him that he should be,” she started. “I was the one to let him off the hook.”
He stayed silent, watching the trio out the door, and dropped his chin to his chest. Watching someone you cared about walk away, no matter how correct the decision was, brought with it heartache.
“I didn’t have feelings for him,” Billie admitted, barely loud enough to hear. “I thought I did, but it was never romantic, and it never would be. I told him to move on, and I am doing the same.”
There was sincerity alongside sadness, another tone he knew well. AJ was surprised by the admission, and because it was said so quietly it was likely to be the truth.
Her hand raised to cover his shoulder, a silent appreciation and request to leave. “You are a good friend, AJ.”
He covered her hand for a moment and cleared his throat. “If you’re ever not fine, you can always tell me,” he said.
“Only if you promise to do the same.”
Billie turned down the hallway quickly, leaving before the lump in her throat had a chance to materialize and cloud her words with sorrow and loneliness.
…
“Dr. Sutton! I’m glad I caught you.”
Kit rounded the corner and jogged a few steps to match her stride.
“Kit. Hi. What can I do for you?”
“I want you to assist in my laminectomy this afternoon.”
Billie paused at the desk and furrowed her brow. “You need my help for a routine surgery? I know the cord is involved, but…”
“I don’t need your help with the procedure, I would like you to be in the OR with me as Chief of Surgery. I am in the process of hiring a new anesthesiologist and while she is phenomenal on paper and interviewed well, I need to see how she performs during an operation. The procedure will be a practical evaluation, of sorts. I’d like you to be a part of it; not only to help me get a read on her, but because you should be involved in the hiring of all surgical team members.”
A swell of pride bloomed in her chest and Billie put the chart away. It was always nice to be needed, especially by the CEO, but even more so when it was an invitation to advance her career. Kit took an active approach to mentorship, and every week she found a new opportunity to make sure that Billie had the support she needed to grow. This week, it was a hand that brought her to the table to shape the hospital.
“I — wow. Yes, of course. I appreciate the consideration,” Billie said. “Is there anything else I should know beforehand?”
“No, she has already demonstrated competence. In fact, I would prefer if you were blind to her qualifications so you can have impartiality, if you don’t mind.”
“Of course. When d—”
“Excellent. The surgery starts at 1:00. OR three!”
Kit ducked away with a final thanks, leaving Billie with just enough time to grab a sandwich and settle herself before the procedure.
Twenty minutes into the laminectomy, it was obvious why Kit Voss emphasized a practical interview. A resume and an interview with human resources was no substitute for how one handled the pressures of an operating room, and the rapport one could develop with the rest of the surgical team. The three-hour procedure required attention and care, something any seasoned anesthesiologist should have been able to handle with ease. Kit was interested in the candidate’s responses to unexpected events and criticism.
Surgeons loved to be right and loved even more to blame others when things went south. The first target was the assistant or surgical nurse, followed shortly by the anesthesiologist. When the blood pressure spiked near the end of the laminectomy, Kit and Billie worked furiously to address the surgical field. There was no bleeding and no damage to the vascular tissue; no interventions had any effect to silence the blaring monitors that announced the dangerous hypertension.
“You are going to need to manage the hemodynamic perturbations without my direction if you want a place in my OR, Dr. Moore,” Kit finally said.
“Dosing eighteen of Precedex,” Dr. Moore announced. The blood pressure returned to a stable range and silenced the alarms as she returned the vial to the other medications. “If you had given me three extra seconds to convert 132 pounds to kilograms so I could calculate the dose of dexmedetomidine instead of labetalol, we could have all avoided the awkwardness of me not killing the patient because of her documented sensitivity to beta blockers while also saving your ass in the process.”
A silence fell over the operating room and all eyes turned to Dr. Moore, who had frozen in place. The anesthesiologist looked up slowly, sheepishly, and gulped.
“Um. Dr. Voss,” she finished quietly.
Dr. Moore held her breath. Her eyes darted between the CEO and the Chief of Surgery, grateful that the mask obscured the drop of her jaw. The mortified look in her eyes, however, was impossible to hide. She was seconds away from kneeling and begging forgiveness when a single, bright laugh filled the room.
“Well,” Kit said. She turned her attention back to the spinal cord. “Alright then.”
“That was unexpected,” Billie added.
“I —”
Kit shook her head and removed another section of the patient’s spine. “Don’t worry, Dr. Moore. Everyone is allowed one of those moments. In fact, I welcome the passion and candor.”
“I am so, so sorry, Dr. Voss. I should not have spoken out of turn like t—”
“That much is true. When you report to work on Monday, we can discuss the specifics of your contract and where the line for conduct unbecoming is. I’m not sure you are past it yet, but that was certainly close.”
Billie winked in her direction, and Dr. Moore let out a deep, relieved breath. “Yes, ma’am,” she apologized.
“Don’t call her ‘ma’am’,” Billie corrected with a smile. She turned to the monitors and the stable blood pressure, then to the intravenous medications on the table. “Did you really do that math in your head?”
“At 2.2 pounds per kilogram, Mrs. Diaz weighs 60 kilos, and at 0.3 micrograms per kilogram… it nets out to 18 of Precedex.” The anesthesiologist shrugged. “It helps when they’re round numbers.”
Kit laughed and finished the removal of the damaged lamina, returning calm and normalcy to the operating room. The practical evaluation ended without event, and the two surgeons answered questions about the position and what to expect from supervisors, and welcomed Dr. Moore to the team permanently.
…
The operating room was a sacred space. One that required attention, focus, and bravery to enter. When working on the brain and nervous system, one wrong move that was a fraction of a millimeter away from perfect could leave a patient permanently impaired or worse.
Like most surgeons, Billie had developed a ritual to prepare for such pressures. She visualized the procedure, regulated her breathing, and scrubbed her right hand for twice as long as her left. Sometimes, when time allowed, she would enter the scrub room early to see how the room would be set up and visualize everything beyond the nerves and vessels, and to watch the rest of the team prepare.
Surgeons were known for their egos; like the striker on a football pitch, the one player who got the glory if the ball went into the net and the patient survived. The truth was that there were dozens of others who made any survival possible. Sometimes there was a resident or another surgeon to provide the assist, but every surgery included a scrub nurse, a circulating nurse, and an anesthesiologist to play defense. Without their help, nothing a surgeon did would be possible. Dr. Chu was Chastain’s attending anesthesiologist and assisted most operations, but for specialized neurosurgeries, Billie requested the most recent addition to the matchday squad. Dr. Moore was the only other person in the hospital who shared her appreciation for and specialization in the brain.
Her interview was weeks ago, but the anesthesiologist’s bravado had become a trademark and topic of conversation. Not every surgeon enjoyed working with Dr. Moore because of that feistiness, but Billie appreciated having someone to spar with. Rarely about medicine and never about anesthesiology, the snipes were easy and fun and confined to the operating room. When she scrubbed out the joking stopped, but it would return hours or days later when Dr. Moore’s name was once again next to hers on the board.
The patient was wheeled in and Billie was greeted by a smile behind the mask. Sometime during their work partnership, a friendship had begun to blossom. It was one formed organically, separated from Nic and Conrad and Kit. The proximity of sharing an operating room had helped, but not as much as knowing that Dr. Moore would always come prepared with a story or a joke or something as simple as a smile to make the day brighter.
Having a team around her every day had begun to remedy some of the loneliness that had sat deep in her bones. At the very least, it provided a distraction from the emptiness outside of the hospital. Billie had a team that she could count on, and that was more than enough.
The scheduled thrombectomy was meant to be minimally invasive, but an unforeseen complication during the repair required interventions to keep it that way. Dr. Moore expertly balanced both vasopressors and vasodilators to stabilize the blood pressure, and it was this balancing act that enabled the unconventional approach to the procedure. Surgical cuts and sutures would have put the patient at risk of hemorrhage or stroke but because the medications had been managed so well, the patient’s circulatory system was never in serious danger despite momentary drops and spikes in blood pressure.
Billie was able to remove the clot and the pressures stabilized for the final time. The patient’s other vital signs returned to normal and the team could relax for the remainder of the repair. Despite her years in the operating room, Billie had rarely considered how challenging anesthesiology was, and how precise the doctor had to be before, during, and after the surgery. She opted to close the patient and use the time to learn more about her new teammate, Dr. Moore. The practical interview was insightful and while they had worked together for weeks, there was little else that she knew about the woman who had saved a patient’s life at least twice in her OR.
“Did you always want to go into anesthesiology, Dr. Moore?” Billie asked as she cauterized a vessel.
“Avery.”
“I’m sorry?”
“My name is Avery. I appreciate the formality, Dr. Sutton, but it isn’t necessary. You can call me Avery.”
The anesthesiologist sat back in the chair and used the deflection to buy time. Remarkably, no one had asked her this since she began working at Chastain, and she suddenly felt exposed.
“To answer your question, no. I lost my father to a cerebral aneurysm rupture when I was fifteen. He collapsed after school one afternoon and was dead before he even hit the floor. From then on, I knew I wanted to go into medicine, specifically neurology, but I never really wanted to be a doctor… I just wanted to do something to make sure no one else would have to go through what I went through,” Avery answered. “I went to college, then Stanford, and learned about perioperative care around the same time as pharmacokinetics and fell in love with the puzzle of anesthesiology. Now I help behind the scenes, and every day I learn more about the brain from surgeons like you.”
“We wouldn’t be able to do what we do without doctors like you.”
Avery smirked behind the mask and met her eyes. “No, you wouldn’t.”
“Stanford Medical School, though,” Billie said, “With that on your resume, you could have had your choice of residencies. What did you do next?”
“A neuroanesthesiology fellowship at Yale. I was in New Haven for about ten years before moving here.”
Billie whipped her head around. “Damn, girl! No wonder Kit was so impressed by you!”
“Yeah, well…” Avery trailed off and checked the monitors, avoiding the neurosurgeon’s eyes. “I don’t like to broadcast that. It tends to change people’s perceptions of me.”
“How so?”
“The same way you just did. People hear ‘Stanford’ and ‘Yale’ and ‘fellowship’ and think I should have gone into neurosurgery or clinical research — something more than wasting my talents adjusting dosages of drugs. They think anesthesiology is beneath me. I have never been in medicine for the ego or the rush of saving a life, but what people don’t realize is that I am indispensable. No one can dispute that.”
The woman’s path to her specialty was fascinating to Billie. Many doctors had a similar story about losing a loved one or wanting to protect others from their own painful experiences, but few in the surgical suite were motivated by science and learning, and not chasing the adrenaline rush. It was refreshing to hear.
Billie threw the final stitch and said, “Well. I for one am glad that you left Connecticut and found Chastain.”
There was a tension in her statement, one that Billie was not sure was meant to be put there, that dissolved when Avery laughed.
“I hate the snow. Hate it. If Dr. Voss hadn’t hired me, I would have been waiting tables in Atlanta just to get away from that frozen hellscape!”
“Don’t sell yourself short. I’m sure you could make better money using your chemistry background to tend bar,” Billie winked. She double checked that the procedure was indeed finished and backed towards the scrub room with a grin. “See you tomorrow, Dr. Moore.”