23rd Note

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As I scrubbed in, the suspense in the sterile OR air was palpable. I never imagined that this day would actually arrive. That was the day I had to bring this very familiar patient to the surgery table. Dania. The patient who always waits for me to tell her about Haira.

I tried to calm down as the soothing sound of the water washed away the anxieties of the day.

"Sudah siap, Dok?" I was given a clean robe and gloves by a nurse. With a mere nod, I was prepared to greet Dania.

"Scalpel," I murmured, my voice calm amidst the symphony of beeps and the rhythmic whir of the heart-lung machine. I could feel the cool metal grounding me as the instrument was placed on my palm.

With the help of a heart-lung bypass machine, I cautiously opened the chest and avoided the still-beating heart. The crucial move was a careful rerouting of the two main arteries, akin to rerouting a stubborn river.

Slowly, the memories of my conversation with Dania came back to my head.

"Why did you call her Queen, Dok?"

I thought for a moment, choosing the right reason for the seven year old girl. "Because she will later become the Queen at her company."

"Is she rich?"

I nodded, then laughed. "Yes, you could say so."

"Is she richer than you?"

I shrugged my shoulders. "Why so?"

"You must be richer than the Queen, so that you can be a qualified King to marry the Queen."

"Doctor, there's a pressure drop," the anesthesiologist who accompanied me warned. Suddenly my eyes darted to the monitor, indicating that something wasn't quite right — a drop in blood pressure. My thoughts were racing. Was it a leak? A hidden anomaly?

"Okay, team," I said, maintaining a steady tone despite the adrenaline prickling my skin. "We need to hold the bypass." With a calm yet firm voice, I gave an order. Time stretched out. As we studied the anastomosis, the newly formed connection between the arteries, every second seemed to go on forever.

I couldn't let anything bad happen to Dania. Not when I was a pediatric cardiac surgeon.

"Hold *sutures," I commanded. "Suction." The rhythmic whoosh of the suction machine helped clear the field. We needed a better look. The nurse, anticipating my next move, dimmed the lights, focusing a beam on the heart.

There! a tiny pinprick leak.

Time seemed to distort. Sharpening my senses, adrenaline shot through me. "Suture, **Prolene ***6–0, now!"

I knotted the stitch with accustomed ease once I had it. The alarm's howl faded to a gentle thrum as the bleeding eased. "Damn," I muttered, more to myself than anyone else. We labored with fresh determination. The tear was patched and slowly, the pressure crept back up. My hands began to tremble slightly as a wave of relief overcame me.

"We're good," I finally said as my shoulders began to relax. The team exhaled a collective breath, the tension dissipating like smoke.

The surgery continued, with the latter stages carried out with expert ease. I felt a surge of satisfaction when the final suture was tied. It was about giving Dania a chance — a chance to run, laugh, enjoy a life free of a malfunctioning pump, and perhaps even meet Haira, her favorite queen — rather than merely mending a heart.

Exhaustion slammed my body as I exited the operating room, yet the rush of adrenaline kept going since I had been holding a tiny heart in my hands, coaxing it back to life for hours. I peeled off the mask and gloves, feeling the cool air against my scrubbed face when I realized there was a familiar figure waiting for me there.

"Rough one, huh, Dr. Jendra?" Rara, who had been waiting for me, drawled, her voice laced with amusement.

Rough? Try dodging rogue scalpels and internalizing the weight of a child's life for the better part of a day. "You could say that," I mumbled as I tried to wipe the fatigue from my eyes.

There was an unpleasant silence between us, a dense hush full of unsaid words. Rara cleared her throat at last. "So, how about the symposium prep?"

"Right, the symposium." I feigned a laugh. "Everything is proceeding as planned. Venue reserved, speakers confirmed. We'll get to it," I responded, sounding more assertive than I actually felt. "Just need to organize my thoughts first for now."

Rara's smile faltered for a second, then returned, a touch more subdued. "Right, of course. Long night after the surgery, huh?"

"Yeah, long enough," I admitted, forcing a smile. We lapsed into another silence, the sterile hallway stretching between us. "Listen, Rara," I started, my voice low. "I need to say something to you." I openly stated what I meant. The situation during the operation just now and my mind being filled with Haira made me have to do something between us. "I appreciate your friendship, but this closeness, it's not good for either of us."

Her smile faded completely, leaving behind a glint of pain in her eyes. "Jendra, is this about Haira?"

"It's always about her." I answered without the slightest hesitation.

With a hesitant nod, she looked away. "I understand. It's just..." she trailed off, then sighed. "I guess I was hoping for something more."

"I'm sorry but you can stop hoping now. I don't think anyone could ever truly replace Haira." I took a deep breath. "I was also wrong because I know how you used to feel about me. I thought that it happened in the past and I never thought it was something I needed to think about because I've been with Haira for a long time."

We stood there for a moment longer, the unspoken hanging heavy in the air when finally, Rara spoke, her voice quiet but firm. "Okay. I hear you. But know this, Jendra: my feelings for you aren't going to disappear overnight."

I nodded.

"I know, I can't control other people's feelings." The image of Haira's smile lingered, a reminder of the love I cherished and the line I had to walk, carefully, to keep it safe. "I couldn't afford to play along with those feelings of yours. Not when my heart truly belongs elsewhere. So I want to make everything clear here."

I turned my gaze to the woman before me. Her expression was one of disbelief, but I had already made up my mind and it would not change.

"I hope we can be professional in the future. We're colleagues first, and that's what matters."

Exhaustion finally caught up after I finished my words and said goodbye to Rara. I knew things wouldn't be the same between us. But maybe, just maybe, this was the right call. For her, for me, and for Haira, the woman I loved and who truly merited my wholehearted devotion.

When I finally made it to my office and sank into my chair, I closed my eyes and her warm, genuine smile came to mind — a guiding light amid the whirlwind of feelings I was struggling to control.

"Damn, I missed her."

*****

*Surgical suture (commonly called stitches) is a medical device used to hold body tissues together after an injury or surgery. Application generally involves using a needle with an attached length of thread. A number of different shapes, sizes, and thread materials have been developed over its millennia of history.

**Prolene Sutures are non absorbable, sterile surgical sutures composed of an isotactic crystalline stereoisomer of polypropylene, a synthetic linear polyolefin. Indicated for use in general soft tissue approximation and/or ligation, including use in cardiovascular, ophthalmic and neurological procedures

***The suture material smaller than the USP size 1, is 1–0 which is pronounced as 'ought' and smaller yet is 2–0, meaning 00 (pronounced 'two ought' or 'two zero'). The more zeros, the smaller the material, so 6–0 is actually size 000000, and is pronounced 'six ought' or 'six zero'.

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