"Yes, ma'am. Ready to assist."
I start scrubbing beside her, the familiar ritual calming my nerves. The bristles bite into my skin as I work methodically up my forearms.
"I've done about thirty of these. Clean cases, mostly. One complicated by adhesions from previous surgery."
Dr. O'Brien gives me a curt nod. "Good."
Tracy appears at the next sink, already half-dressed in surgical gear. "Appendectomies were our bread and butter at Good Sam. Though I bet they used the fancy laparoscopic equipment for everything, right, Sam?"
The comment sounds casual, friendly, even. But underneath lurks something sharper.
Here we go.
"We used whatever was appropriate for the case."
My voice stays level despite the heat crawling up my neck. I scrub harder, focusing on the mechanical motion.
In the OR, everything is wrong. The lights are dimmer, the equipment older, but somehow more intimidating. The ventilation system hums louder than I'm used to. Even the surgical instruments feel different in my hands—heavier, less refined.
The patient is a nineteen-year-old construction worker. His abdomen is swollen and tender, but his vitals are stable. Classic presentation.
"Scalpel."
Dr. O'Brien makes her incision with surgical precision. I anticipate her needs, handing her instruments before she asks. My movements are smooth and confident.
I know what I'm doing. I belong here, I keep telling myself.
"Metz, please."
I pass the scissors without hesitation. Dr. O'Brienexamines the appendix, which is inflamed but not ruptured.
"Tracy, what's your assessment of the inflammation level?"
Tracy peers over the surgical field. "Moderate inflammation, no perforation evident. Standard removal should be straightforward."
"Neil, thoughts on antibiotic protocol?"
"Prophylactic cephalexin should be sufficient given the lack of complications."
Dr. O'Brien nods approvingly at both responses. I wait for my turn to contribute something, anything, but she continues working.
I'm invisible.
My hands remain steady as I retract tissue and suction blood from the surgical site. But inside, frustration builds like pressure in a sealed container.
"Taylor, suture."
Finally, she acknowledges my existence. I thread the needle and begin closing the peritoneum with precise, even stitches. My technique is flawless—exactly like my father taught me during those summer afternoons in his home office.
Dr. O'Brien watches but says nothing. No criticism, but also no praise.
The case wraps up efficiently. Twenty-eight minutes from incision to final suture. The patient will recover completely with minimal scarring.
"Good work, everyone."
Dr. O'Brien strips off her gloves and heads toward the door without another word.
In the scrub room afterward, I wash my hands methodically. The water runs pink from microscopic traces of blood under my fingernails.