Page 15 of Obeying

Two of them stand with their arms crossed, pretending they aren't taking mental notes.

Brennan isn't pretending. He's writing everything down.

Then she finds it.

A detail buried deep in the history that everyone else overlooked.

The patient mentions having brief episodes of his heart racing over the past few weeks. He assumed it was anxiety and never thought it mattered enough to mention.

Kristen immediately pulls up the monitor readings and orders an ECG.

A few seconds later, she studies the tracing.

Atrial fibrillation.

She looks back at the labs. The elevated lactate. The severe abdominal pain that doesn't match the physical exam. The pieces finally align.

She looks up.

"I think this is acute mesenteric ischemia caused by an embolic event from previously undiagnosed paroxysmal atrial fibrillation. His pain is out of proportion to his abdominal findings, and the elevated lactate suggests intestinal hypoperfusion. I want a CT angiogram to evaluate the mesenteric vessels, specifically the superior mesenteric artery."

The room goes quiet.

Two of the residents glance at me, waiting to see if she's right.

She is. To the letter. It's a diagnosis most attending physicians would need a beat to piece together, and she did it standing at a bedside as a third-year resident working through it in real time. Because Kristen Portland is a pattern reader. She sees the whole picture while everyone else is still looking at the frame, and it took everything in me to keep my face neutral as I watched her do it.

I nod. "Order it."

She moves to the computer, puts in the order, and as she types, the tension leaves her shoulders, replaced by something that makes her look a lot like the person she used to be. Confident, sure, and present.

And watching her work, I stop pretending this is just professional interest. Because it's not. I don't watch other residents like this. I don't look for the shift in their shoulders when confidence comes back, or notice the way their voice changes when they stop second-guessing themselves. I'm doing that with her, and I need to stop.

So naturally, twenty minutes later, I go find her.

She's at the nurses' station, charting on one of the computers, focused enough that she doesn't notice me until I'm standing right behind her.

"Good call there. The detail you caught in the history. Most people miss that."

She looks up, then glances down the empty station like she's checking for someone else I could possibly be talking to. When she turns back to me, there's a crease between her eyebrows. "Are you talking to me?"

"No, I'm talking to the wall."

Her face drops into that annoyed expression I know too well, and I have to stop myself from smiling because I didn't realize how much I missed it. The flat look, the slight jaw clench, the way her eyes narrow like she's calculating whether what I just said warrants a professional response or a thrown chart.

"Well, excuse me for clarifying. Since all you seem to do lately is grill me in front of everyone."

"I'm not grilling you. I'm asking questions you already know the answer to." I cross my arms.

She doesn't respond. She just stands there, guarded, her pen still in her hand, like she's waiting for a punchline that's going to cost her something. And I hate that this woman who would have told me exactly where I could put my compliment and my glasses and my ego is standing there silent and bracing.

"I'm serious, Portland. You did good work in there. Keep it up." I hold her gaze. "We both know you're better than you let on. Show it."

Surprise runs across her face, like she forgot what it sounds like to have someone say that to her and mean it. Her eyes search mine, and then she looks away.

"Thank you."

It's quiet. Almost careful.