Incision of the Heart

Chapter 5: The Game Changer

Emily woke up the next morning feeling more rested than she had in days. She’d gone to bed early, the thrill of yesterday’s success still buzzing in her veins.

For the first time since arriving at Johns Hopkins, she felt she had a genuine foothold in the shadowing program.

She’d proven herself in the OR, and while she wasn’t about to let her guard down around Liam, there was a glimmer of hope that perhaps they could coexist—at least professionally.

The hospital was already buzzing with activity when she arrived.

Nurses bustled through the hallways, medical students clutched clipboards like lifelines, and residents argued softly over-diagnoses.

Emily walked briskly to the morning briefing, her coat flapping behind her, determination etched into every line of her face.

As she entered the conference room, she spotted Liam sitting in his usual spot near the front, leaning back in his chair with an air of casual confidence.

He was flipping through a patient file, his brow furrowed in concentration.

Emily ignored the slight flutter in her chest as she made her way to an empty seat across the table from him.

Dr. Reynolds entered moments later, a folder in hand and a gleam of excitement in his eyes. He placed the folder on the table and glanced around at the group of eager premed students.

“Today, we’re tackling something unique,” he began, his tone commanding attention. “We have a 35-year-old male patient presenting with recurrent syncopal episodes and chest pain. He has a complex congenital heart defect that wasn’t fully corrected during childhood. It’s been causing significant complications. Our job is to assess, plan, and execute a solution.”

The room buzzed with anticipation.

A congenital heart defect was not only rare but also challenging—a case that required precision, creativity, and teamwork.

Emily’s pulse quickened. She could feel the excitement rising in her chest.

“Carter, Grant,” Dr. Reynolds said, his sharp eyes landing on them. “You’ll take the lead on this one. I want a detailed presentation of the case by noon. Think of it as your chance to prove you can handle a real-world challenge.”

Emily’s stomach tightened.

Leading a case was a huge opportunity, but doing it with Liam?

That was a different kind of challenge altogether.

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By mid-morning, Emily and Liam had secured a small conference room to review the patient’s file.

The walls were lined with whiteboards, and Emily wasted no time filling one of them with notes as Liam organized the imaging scans on the computer.

“Alright,” Emily said, tapping the cap of her marker against her palm. “The patient has a history of Tetralogy of Fallot that was partially corrected in childhood. Looks like there’s a residual ventricular septal defect and pulmonary regurgitation causing right-sided heart strain.”

Liam nodded, his eyes scanning the echocardiogram results. “The tricuspid valve is under significant pressure. If we don’t address this now, it’s only a matter of time before he develops full-blown heart failure.”

Their words came quickly and efficiently.

Despite their differences, both were sharp, detail-oriented, and unrelenting when it came to solving a problem.