The First Cut Was His

I held the scalpel with a surgeon's precision, my hand steady above the exposed heart. The patient's life hung in perfect balance, dependent on each careful movement. One slip, one moment of distraction, and...

'Dr. Vance?'

The voice seemed to come from far away. My mind was elsewhere—in Alexander's study, watching Victoria's legs wrapped around my husband's waist, hearing his cold voice telling me to 'take care of' our unborn child.

'Dr. Vance, we need to ligate the artery now.'

I blinked, the operating room coming back into sharp focus. The patient's open chest cavity. The steady beep of monitors. The concerned eyes of my surgical team above their masks.

My hand had drifted dangerously close to the coronary artery. One millimeter more and I would have nicked it, causing a catastrophic bleed.

'Yes, of course,' I murmured, correcting my position. 'Forceps, please.'

I completed the procedure on autopilot, my body remembering what my distracted mind couldn't focus on. When we finally closed, the head nurse gave me a searching look.

'Are you alright, Dr. Vance? You seemed... elsewhere today.'

'Just tired,' I lied, stripping off my gloves and mask. 'Long week.'

In the scrub room, I leaned against the sink, my legs suddenly weak. What was happening to me? I'd never lost focus during surgery before. Never put a patient at risk because of personal problems.

The door swung open, and Sarah Jenkins, a fellow surgeon and the closest thing I had to a friend at the hospital, stepped in.

'Elena, we need to talk.'

Her voice was gentle but firm—the same tone she used with difficult patients. I knew what was coming.

'I'm fine, Sarah.'

'No, you're not.' She crossed her arms. 'You nearly severed Mrs. Rodriguez's coronary artery in there. That's not fine. That's not you.'

I turned away, washing my hands with mechanical precision. 'I had it under control.'

'Take some leave, Elena. Whatever's going on in your personal life—'

'I can't,' I interrupted, my voice sharper than I intended. 'I can't take leave right now.'

If I stepped away from the hospital, even for a week, Alexander would seize the opportunity. Any absence would be twisted into evidence of instability, incompetence. The file he'd compiled against me would grow thicker.

Sarah's reflection in the mirror looked concerned. 'Elena, as your colleague and friend, I'm worried. You're one of the best surgeons I know, but today...' She hesitated. 'Today you were dangerous.'

The word hit me like a physical blow. Dangerous. The antithesis of everything I'd worked to become.

'It won't happen again,' I promised, meeting her eyes in the mirror. 'I just need to compartmentalize better.'

Sarah looked unconvinced but nodded. 'If you change your mind about the leave, I'll support you. Just... take care of yourself, okay?'

The irony of her choice of words wasn't lost on me. Take care of yourself. Take care of it. The language of disposal, of problems to be eliminated.

When I arrived home that evening, the house was quiet but not empty. Alexander's presence was palpable—a heaviness in the air, a sense of waiting.

I found him in his study, the scene of my humiliation. He sat behind his desk, a folder open before him, not bothering to look up as I entered.

'You're late,' he said, his tone conversational but with an edge that raised the hair on my arms.

'Surgery ran long.'

'Hmm.' He finally raised his eyes to mine. 'I hope you were more focused there than you've been at home.'

My stomach clenched. Did he somehow know about my near-mistake? Was he having me watched at the hospital too?

He pushed a document across the desk toward me. 'I've scheduled the procedure for tomorrow afternoon. These are the consent forms. Sign them.'

I didn't reach for the papers. 'Alexander, this is my body. Our child. Don't I get any say?'

'You had your say when you married me.' His voice remained eerily calm. 'When you agreed to be the perfect political wife. A scandal—a messy divorce with a child involved—doesn't fit that agreement.'

'So I have no choice?'

'Of course you do.' He leaned back, steepling his fingers. 'You can sign these papers and continue your career as Dr. Vance, respected surgeon. Or you can refuse, and by this time tomorrow, the medical board will be reviewing evidence of your... instability.'

My blood ran cold. 'What evidence?'

'Today's near-miss in the OR would be a good start.' His smile didn't reach his eyes. 'Did you think I wouldn't know? I have eyes everywhere, Elena. Even in your precious hospital.'

The room seemed to tilt beneath my feet. He'd been watching me, waiting for me to make a mistake he could use against me.

'The papers will be here until sunset,' he said, returning to his work. 'After that, I make the decision for you.'

I stumbled from the study, my vision blurring with unshed tears. In our bedroom—no, my bedroom now—I sank onto the edge of the bed, my hand instinctively moving to my still-flat stomach.

'I'm sorry,' I whispered to the tiny life inside me. 'I'm so sorry.'

The next day passed in a fog. I moved through the hospital like a ghost, avoiding Sarah's concerned glances, going through the motions of my rounds.

At four o'clock, I found myself in a private pre-op room, wearing a hospital gown instead of my white coat. A different kind of vulnerability.

Alexander hadn't come. Instead, he'd sent his lawyer—a thin, severe man with cold eyes—to witness my signature on the final consent forms.

'Mrs. Sterling,' the lawyer said, using the name I never used professionally, 'please sign here.'

My hand trembled as I took the pen. The words on the form swam before my eyes: 'voluntary termination,' 'informed consent,' 'release of liability.'

Clinical terms for the death of hope.

As I pressed the pen to paper, a single tear fell, smudging the ink of my signature. The lawyer pretended not to notice, collecting the forms with efficient detachment.

'The doctor will be with you shortly,' he said, closing his briefcase. 'Mr. Sterling sends his... regrets that he couldn't be here.'

Left alone, I stared at the ceiling, feeling hollow. In just a few minutes, they would come for me. They would take me to a room not unlike the ones where I performed surgeries. They would end the life inside me—the life that, despite everything, I had begun to love.

And somewhere across town, Alexander was probably with Victoria, neither of them sparing a thought for what they had forced me to do.

As the door opened and the nurse entered to prepare me for the procedure, a strange calm settled over me. This would be the last time Alexander Sterling took something from me. The very last time.