Chapter 3 – The Gauntlet
Bellevue Hospital, Surgical ICU – 05:27 a.m.
The SICU smells like bleach, death, and the particular kind of fear that only happens when the sun still hasn't come up.
Noah Kim strides ahead of the four interns like a runway model who moonlights as a dictator. His blond hair is somehow still perfect at five-thirty in the morning. He doesn't look back.
"Keep up, babies. If you fall behind, I leave you for the nurses to eat."
Leo's legs feel like overcooked ramen. Asher is limping from standing eighteen hours straight. River's eyes are glassy. Ezra is humming "Sweet Caroline" under his breath (probably delirium).
They stop outside Bed 7. A sixty-two-year-old post-op Whipple, septic, on max pressors.
Noah spins, arms crossed. "Present."
Silence.
He raises one perfect eyebrow. "Did I stutter? Kang, you're up. Make it fast, make it pretty, make me believe you've ever opened a textbook."
Leo swallows. His voice is hoarse. "Mr. Alvarez, sixty-two-year-old male, post-op day two from pancreaticoduodenectomy for adenocarcinoma. Last night he spiked to 39.8, became hypotensive—"
"Stop." Noah's voice slices clean. "When you say 'hypotensive,' do you mean his pressure was low, or do you actually know the numbers?"
Leo's face burns. "Uh… 78 over 40 on Levophed 30 mics."
"Better. Continue."
"—lactate climbed to 9.2, urine output less than 10 cc an hour. Cultures pending, broad-spectrum antibiotics started—"
Noah cuts him off again. "Which antibiotics, genius?"
"Vanc, Zosyn, and fluconazole," Leo fires back, heat rising.
"Wrong. We added meropenem at 0300 because the prelim Gram stain showed rods. Do you live under a rock?"
Leo opens his mouth. Closes it.
Asher snorts quietly behind him.
Noah's eyes snap to Asher. "Something funny, Cohen?"
"No, sir," Asher says, but his mouth twitches.
Noah steps so close his mint gum breath hits Asher's face. "You think sepsis is comedy?"
"No, I think you're a drama queen with a God complex."
The SICU goes dead quiet. Even the ventilators seem to pause.
River makes the tiniest "oh shit" noise.
Noah smiles (slow, terrifying). "Excellent. Cohen, you just volunteered to recap every central line in this unit today. By yourself. With me watching."
Asher's bravado flickers. "Yes, sir."
Noah pivots to River. "Park. Bed 12. The post-op AAA repair. Go."
River straightens, voice soft but steady. "Mrs. Washington, seventy-one-year-old female, post-op day one from open infrarenal aneurysm repair. Graft is patent, lower extremities warm. She was extubated two hours ago but now she's altered, GCS 13, complaining of flank pain—"
"Stop. Flank pain after AAA repair means what, intern?"
River doesn't hesitate. "Retroperitoneal bleed until proven otherwise."
Noah looks almost disappointed that they got it right. "CT stat?"
"Already ordered. And type and cross for six units."
"Good. Don't fuck it up."
Finally, Ezra. Noah barely glances at him. "Miller. You're ortho. You don't get to talk on my service unless a bone is literally sticking out of the skin. Understood?"
Ezra grins, slow and Texan. "Yes, sir. But just so you know, I'm real good at making things stick out."
Noah stares at him for three full seconds. Ezra doesn't blink.
Noah turns away first. "Disgusting. I like you."
Then he freezes.
Matteo Rossi and Sebastian Wolfe are leaning against the nurses' station ten feet away, sipping coffee like they're watching Netflix.
Matteo lifts his cup in greeting. "Morning, Kim. Breaking the new toys already?"
Noah's entire posture changes (shoulders back, chin higher). "Just teaching them how the world works, Dr. Rossi."
Sebastian doesn't look up from his phone. "Try not to make them cry before breakfast. It's unbecoming."
River whispers under their breath, "Too late."
Noah hears it. His eyes narrow.
He spins back to the interns. "All of you. Listen carefully. Rule number seven (I just made it up): if Dr. Rossi or Dr. Wolfe speaks to you, you answer like your life depends on it. Because it does."
Matteo pushes off the counter, walks over until he's right in front of Leo again. He's close enough that Leo can smell his cologne (something expensive and dangerous).
Matteo's voice is soft, almost kind. "Kang. You still have that patient's blood on your shoes."
Leo looks down. Dried brown flakes. He nods.
"Good," Matteo says. "Wear it like a badge until you stop shaking. Then wash it off and come find me in the CTOR at 0700. We're doing a CABG on a thirty-eight-year-old dad. Try not to faint when I ask you to hold the heart."
He walks away.
Sebastian follows, murmuring without looking back, "Park. Pituitary tumor at 0900. Don't be late or I'll drill your skull myself."
The two attendings disappear around the corner.
Noah exhales like he was holding his breath for a year.
He turns back to the interns, voice suddenly quieter. "You just met the two scariest people in this hospital. And they both already know your names. Congratulations. You're either going to be legends or cautionary tales."
Asher raises a hand. "Can we get breakfast now?"
Noah checks his watch. "You have nine minutes. Then we preround again. Move."
They scatter.
But in the hallway, Leo catches River by the sleeve.
"Hey," he whispers. "You okay?"
River's smile is small and razor-sharp. "I once spent six hours with my hands inside someone's brain while the patient recited poetry to me in French. I'm fine."
Ezra jogs past them, yelling, "Last one to the cafeteria carries Noah's pager for a week!"
Asher is already sprinting.
Leo laughs (an actual laugh) for the first time since July started.
It sounds foreign in his throat.
But it feels like the beginning of something.