"Oh, don't," Sam said, tilting her head so that her hair fell away from Dylan's outstretched hand. "I didn't have time to wash it this morning. I'm sure it still smells like a Tequila Sunrise."
Dylan smirked. He kissed her neck, just below her left ear. "Really? And why would an F2 be anywhere near a Tequila Sunrise on a Wednesday early shift?"
"Give me some credit!" she protested, stepping neatly out of his embrace. She yawned as she readjusted her scrub top and pulled it back down, over the strip of her stomach that had become exposed when he'd put one electrically-charged hand under the fabric covering her back. "Some old school friends were in London last night and wanted to go out for drinks. I wasn't the one drinking the tequila, I might add."
"Out on a school night? I never would have believed it of you, Dr Nicholls," Dylan teased. "Dare I even as how your hair ended up smelling like a cocktail?"
Sam ran her hands through her hair. In seconds, it was secured in a bun, with a biro wedged in for safe-keeping. "Over enthusiastic dancefloor action – from the tequila drinkers, before you start getting any ideas!"
Her saving grace was the necessary secrecy of her deepening relationship with her mentor. Outside the safety of his office, he treated her with the same gruff deference afforded to everyone else. Otherwise, she was sure she'd be needled all day, not just when she went home with him to his flat in Clapham that evening.
"So what time exactly did you make it to bed last night?" he asked, when she yawned a second time. He checked his watch before removing it in preparation for the shift. 7.11am.
Sam pursed her lips, thinking. "About two, maybe?"
"Accounting for the Tube ride in, you're operating on about four hours' sleep, then?"
"At best."
"Tut tut, Dr Nicholls, you'd better hope your mentor doesn't find out..."
It was Sam's turn to smirk. She may have been tired but she could still hold her own. "I believe he's aware of the concept of Mutually Assured Destruction. I think I'm safe."
She left a chaste kiss on his lips, straightened his collar and departed the office, yellow stethoscope swinging proudly.
She was more concerned about Dylan discovering just how worn down she was feeling lately. Her week's leave seemed a very long time ago. Spending the first night with him had been glorious, but the rest of the time had been less than ideal. Why she'd had to go home she didn't know - it wasn't as if her father paid her any attention under normal circumstances, much less when he and the stepmonster were preparing for their next MSF trip to central Africa.
Since then, she'd woken up nearly every morning as if she hadn't slept at all and dragged herself through the day to collapse into bed again. Night shifts threw her even more out of whack than usual, though she kept her mouth tightly shut on the topic because she refused to be seen as weak in any capacity. Worse though, and harder to conceal, were the low rumblings of abdo pain that refused to leave her alone. It was perfectly placed to be explained away as period cramps, especially as she'd never had perfectly regular cycles to begin with, but she'd never had constant pain either. With all the busyness of F2 life though, she pushed it to the back of her mind.
"Anyone would think you were failing the year, all the early meetings he has you do!"
Sam rolled her eyes at her acquaintance. Marnie was ballsy, brasher than Sam but no less determined to do the job right. She was a good few inches shorter than the rest of the King's F2 cohort, but more than made up for it in personality and volume.
Sam didn't particularly mix with her contemporaries, preferring the company of non-doctors when socialising. Her sights were set higher than an NHS consultancy, not that there was anything wrong with that. But as soon as she was free of the shackles of training, her presence was required by the British Army, a fact she largely kept to herself. For now, her days were occupied by civilian trauma, A&E timewasters and a certain Dr Keogh.
During the morning briefing, Sam received some news she had been waiting a long time for.
"Dr Nicholls, you're spending the shift in General Surgery. They're expecting you to scrub in immediately after briefing."
She tried hard to conceal triumphant feelings, attempting not to look smug. There was a low hum around her; a mix of admiration and jealousy.
Later that morning, Sam came down from theatres, shadowing the surgeon assessing a complex shoulder dislocation.
Dylan could not help himself thinking that she looked so much more alive somehow, like she was on cloud nine with her day in a new setting, putting her knowledge and skills to good use. He desperately wanted to ask her about the day, hear her brim with excitement and see her appear to literally sparkle with her new experience. However, the patient in considerable pain before him may have something to say about it, not to mention the rest of the department wondering which alien had abducted and replaced him, suddenly taking an interest in and a shine to another human being.
He reeled off the notes to the surgeon, who nodded through the commonplace injury and was about to explain the process of surgery to the burly rugby player on the bed, when Sam cleared her throat.
All eyes shot to her at once. This was not how medical hierarchy worked – Dylan wouldn't interrupt a surgeon and he'd already worked well past his own foundation rotations, climbing a few measly steps up the pecking order. Sam's excellence had nothing to do with her position in the hospital equivalent of the feudal system.
"You haven't tried a traction technique," she stated. It wasn't a question, and yet somehow she posed it as one.
"No," the surgeon said, with a tone of voice that suggested he was talking to someone very stupid. "Look at the body composition of the patient, Dr Nicholls. Don't you think it's unlikely to be possible to reduce this shoulder when such muscles are in spasm?"
"Well, are they in spasm?" she challenged, looking past the surgeon completely and directing her question to Dylan alone.
"No," he conceded. "But having tried two rotational methods which were unsuccessful, I deemed it necessary for surgical intervention to prevent further distress to the patient."
"There! Can I try a traction technique then?"
"Dr Nicholls," the surgeon bristled, "once a surgical consult has been called, I hardly think it's appropriate –"
At this point, the patient forced himself slightly more upright, eliciting a grunt of pain in the process. "Don't I get a say in this? You lot keep fighting over me and it's my shoulder, so I should get to put in!"
Dylan, Sam and the surgeon suddenly looked back to the patient, having somewhat forgotten his centrality to the whole issue as their conversation grew more heated.
"Like I said to Dr Nicholls here," the surgeon said, "it's likely with your body composition, and the method of injury, that non-surgical reductions will be unsuccessful. Considering the method of injury, you're likely to have torn ligaments which may require surgery to repair –"
"Key word there being may," Sam continued to argue. "If the patient would prefer a non-surgical reduction and there are still options for that, which there are, then his choice should be taken into account. You can still scan for ligament damage afterwards if your precious theatre slot is so important to you."
Dylan's eyes widened. He didn't know whether to be furious with her contrariness and drive to prove herself right, or impressed by her sudden burst of patient advocacy.
"I'm happy for you to try. You have more than adequate supervision, as I see it," he said, before the surgeon had a chance to explode due to his usurped power in the cubicle.
The two men stood back, one's eyes burning with suppressed rage and the other's looking on in pure wonder.
Sam took a breath, hardly daring to believe that she was getting a chance rather than a telling off. She took off a shoe and narrated herself as she went through the process of the Hippocratic reduction. No complaint came from either supervisor, so she persisted. It was harder than she expected (the surgeon had not been wrong about the rugby player's muscles proving problematic for a non-surgical reduction) but eventually, with an ear-splitting roar from her patient, she felt the offending shoulder slide back into place.
Dylan's jaw dropped. "You did it," he said incredulously. "Bloody hell, I don't think I've seen an F2 your size do that with any success."
She stood up to her full height. "If that's your way of saying 'Well done' then I accept, Dr Keogh. Thank you," she said with a strained smile. "If you don't mind, excuse me a moment."
She left the cubicle and retreated swiftly to a toilet cubicle, breathing hard. Needle-sharp pain had erupted in her own shoulder as Dylan was giving his roundabout congratulation, and she'd been hard-pressed to keep her mouth shut. Leaning against the back of the locked door, she tried to stand tall and ease out whatever muscle was complaining. She'd dislocated a shoulder once herself, in some sports match at school, pulled muscles too, but this pain wasn't like either of those. It reminded her somewhat of toothache: the kind of raw pain that nothing could touch.
It was enough to make her feel dizzy for a moment, enough for her to rush and sit on the closed lid of the toilet and put her head between her knees. She tried to work out the time, or when she'd last seen a clock. She hadn't eaten since half five, so that was her dizziness accounted for. Sugar level taking a nose-dive after the exertion of reducing a shoulder. Fat chance of there being time to stop for anything resembling a meal – she'd be lucky to find her way back to theatres via a vending machine.
Lucozade would have to suffice for a quick sugar hit, and a vehicle for her next dose of ibuprofen for the cramps that refused to ease. In some way, it was a relief: at least it meant her sketchy-at-best period was finally making an appearance after far too long.
In the middle of the afternoon, Dylan was in the queue for coffee when he overheard a conversation between two A&E consultants. He listened in, realising it was about the F2's.
"...got to choose which one would be a good fit for a day out with HEMS," one said thoughtfully. He re-rolled the sleeve of his pin-striped shirt.
The other sighed. "It hardly seems fair, now there's one out of the pool." She took a long drink of her latte. "Shame about her, she'd have been an easy pick."
The hairs on the back of Dylan's neck prickled. It wasn't his conversation, he shouldn't be listening, not when his brain seemed hard-wired to jump to an unpleasant conclusion that they were talking about Sam.
The second consultant looked up and noticed that Dylan was a few feet away, paying for his coffee. "Dr Keogh, she was one of yours, any ideas on another F2 to send out with HEMS next week?"
He looked at the woman with confusion. "Have I missed something? I'm sure you know which one of my F2's I'd send," he said bluntly.
"Haven't you heard?" the male consultant said in surprise. "What's her name… Sarah?"
Dylan's heart rate picked up. When he replied, his voice was flat and gave away nothing. "Sam."
"That's the one. Collapsed in an appendectomy around lunchtime. Think she's in a spot of bother." He exchanged glances with his colleague before becoming aware that Dylan was making swiftly for the exit of the cafeteria. "Where are you going?"
The question fell on deaf ears.
The journey from the cafeteria to his Clinical Lead's office took approximately half the time it usually did. He did not take the time to knock, before barging his way in.
He usually got a telling off at that point, a reminder of the social necessity to knock. That Miriam Turner wore a grave expression and invited him to sit, instead, sent a shiver down his spine. She did not ask him to close the door, instead getting up to close it herself.
"Dylan, sit down."
"I'll stand," he contested, hands on his hips. It kept his hands still, and avoided any embarrassing leg-bouncing. "I've just overheard a conversation about one of my F2's," he said briskly. "And I want you to tell me the facts, not whatever's on the hospital grapevine."
Miriam sighed. "You know I wouldn't dare."
"Samantha Nicholls."
"Yes," she said slowly. It did not escape her notice that he used the girl's full Christian name when no-one else did, thinking that this put more distance between them. To the rest of the department it might have done – they probably saw it as his obtuse way of ignoring Sam's preference for a diminutive. Miriam was more perceptive. She wasn't in full possession of the facts but didn't think for one second that there was purely a professional relationship between them. He'd softened somewhat since knowing her, not that most people would have noticed.
"They're spouting all sorts of rubbish out there – what's going on?"
It was difficult. He was so clearly trying to put on a pair of blinkers and ignore what he had heard. "I dare say some of it is true, Dylan. This is why I asked you to sit; it might be a bit of a shock to you." She watched him, and once again he staunchly refused, this time non-verbally. "She collapsed in theatre this afternoon, assisting on an appendectomy. They didn't have time to bring her down here, they had to assess her up there. She went downhill quite quickly from what I heard, and she's in theatre now."
Dylan's mouth went dry. He'd seen her this morning, she was fine. For a brief moment he thought of his office, and his teasing about her hair that smelled of tequila. "Why is she in theatre?"
Miriam dropped her gaze. She was fairly sure she knew exactly what had happened, beyond the three words she was about to relay to him. The secret would stay safe with her, but she couldn't control it if others connected the dots.
"Ruptured ectopic pregnancy."
Silence descended upon the office and his reaction confirmed all of her suspicions. Though he said nothing, his face conveyed shock, horror and confusion. She felt sorry for him: in his early thirties he might be, permanently causing friction between himself, colleagues and patients, but away from the rest of the world he had the curious habit of retreating momentarily to being a boy. A damaged, innocent boy, at that. She knew very little of his upbringing because that was the way he kept it, but sometimes she wondered.
"I'm going up to recovery," he said with finality, as though he had used the time spent in shocked silence to formulate some kind of plan.
"Excuse me?" Far aside from being on shift, did he want all and sundry to contribute to the rumour mill?
He shrugged. She knew him better than to see nonchalance in this action. "Her mother died when she was eight. Father's away with MSF, and barely gives her the time of day to begin with. There's no-one else. I'm only her mentor, but she shouldn't wake up alone after this."
Miriam nodded sincerely. That was a reasonable explanation that wouldn't arouse any misconceptions. Some might wonder why the usually abrasive registrar was suddenly displaying human qualities, but they'd move on soon enough, she was sure. "Go," she said.
He didn't go straight to recovery, instead making a beeline for theatres. It didn't take long to find her, and enter the viewing gallery unseen by the operating team. It felt forbidden to see her like this, laid out in the most primal vulnerability possible. Out of respect for her dignity, he kept his eyes firmly on her face, although he listened intently to the surgical dialogue happening over her. It made him wince: he shouldn't be privy to all this information but he could never explain why, not if he wanted to keep his job.
Later, he gave the same explanation he'd reeled off to Miriam, which saw him allowed into recovery to see her. His curiosity got the better of him and he buried himself in her notes while she slept on.
"Jesus Christ," he murmured, throwing all caution to the winds as a lapsed Roman Catholic.
She seemed at peace as she slept – he wondered if she'd been in pain, if she'd been scared. She'd certainly been surrounded by strangers. He couldn't decide if it was for the best, that her contemporaries hadn't seen her moment of ultimate weakness, or if she'd rather have seen at least one friendly face as she became unwell.
Had she known she was pregnant at all? Surely she didn't. Of all the ways to find out…
A nurse overlooked the desk in front of her, her eyes focusing between the blinds of the side room occupied by the two junior doctors. She'd heard all sorts about how abrupt Dr Keogh could be, his fierce temperament and exacting standards. But that wasn't what she saw as evening descended on the ward: she observed a tired mentor keeping vigil over his student, refusing to give in to rest himself. Every slight movement of hers saw him snap to attention once more until he was sure there was nothing untoward happening. He seemed genuinely concerned for her, something the hospital grapevine would have anyone believe he wasn't capable of.
Dylan wasn't refusing to give in to sleep, though he might have preferred it if he'd had the option to choose. He was tired, like any registrar, but his mind was in overdrive. Thoughts circled around and around in his mind, spinning up like a cyclone and getting bigger and worse with every rotation.
If Sam's baby had been his, and this news got out, it would be a GMC hearing and being struck off for gross misconduct, possibly for them both. The very thought made him feel sick. Medicine had been his ticket out of the life that had come before, but for Sam to lose it too… She was so dead set on joining the RAMC. He wasn't sure he could bear seeing her lose that.
There was no-one he could approach for advice, no-one he could share the burden of thoughts with.
And why should he automatically assume it had been his baby, anyway? Sam was a beautiful woman; he had no right to assume she couldn't have slept with someone closer to her own age rather than her grumpy bastard of a mentor.
When Sam woke up, she felt spacey and confused. It took a moment to regain control of her body enough to make a sound. Her throat was sore. Scratchy, like the beginning of a cold.
"Dylan," she mumbled clumsily. He was in the chair beside the bed, his chin rested on his fists and elbows planted on his knees, staring into space.
On hearing her voice he snapped back to reality. "You're awake, that's good," he said.
She would have laughed, if only all her synapses were up to responding at a normal pace. "Good?" she said instead.
He looked abashed. "Yes," he said, looking away. "As in, I am pleased to see you come round at last."
"What happened?" she asked. "Why am I here? I can't remember… I was assisting in theatre, and..."
"That was a while ago, Sam." He knew full well why he couldn't just spit it out, but that didn't make it easier on his rational brain.
"What time is it?"
He checked his watch. "Nearly eight in the evening. You've been through quite a lot, today." He bit his lip. "Samantha," he said quietly, "did you know that you were pregnant?"
Her eyes turned wide in shock and a hand shot down to her stomach. It hurt. "No, I'm not – shit, ouch!"
This was too much to take in. She was horrified. Her stomach rolling, she wondered if she was going to be sick.
It was the first time he'd ever seen her cry, and he hadn't broken the worst of the news yet. He extended a hand out to hers but missed, instead awkwardly grasping her wrist. All of a sudden, they were miles apart from the mentor and F2 who'd kissed in his office that morning.
"Sh, sh, Sam, don't cry," he soothed. He rubbed his thumb on the inside of her wrist.
"But I'm not supposed to be –" she sobbed. "I can't… The Army… My training!"
"Please wait, I haven't told you it all yet," Dylan said softly. He should have blurted it all out in one, saved her this in-between turmoil. "You're not pregnant anymore. It was ectopic, and it ruptured while you were assisting in theatre this afternoon."
"Oh."
The single despairing syllable was worse than her tears.
"They did their best, but the damage was too severe – they couldn't save the fallopian tube. I'm sorry. Your fertility in the future might be affected: it might be harder to conceive in the future and –"
She held up her hand to stop him. "I really, really don't want to hear that right now." She stared up at the ceiling, her vision blurred with tears.
They sat in silence for a few moments.
"I have to ask, Samantha – do you… do you need someone to call the father?"
Despite the obvious pain this caused her, she sat straight up and looked at him with eyes like fire. "Fuck, Dylan! What kind of woman do you think I am, sleeping around with half the city?!"
He regretted his question immediately. "You mean – it was – mine?"
"Well done, Sherlock," she said grimly, tears shining down her cheeks. "One forgotten pill does matter, it would seem." She lay back down and faced away from him, curling up like a child. Little whimpering sounds escaped at irregular intervals, before she mumbled something that cut Dylan to the quick. "I get it, if you want to get out of here and pretend this never happened. You don't have to get in trouble with Miriam, the Trust or the GMC, over me. I can work this out on my own."
While he was reeling from the confirmation that he was very much implicated in this dire situation, he was astounded by Sam's reaction. He thought for a few seconds, before getting up to close the blinds. Hopefully any onlooking ward staff would assume it was for Sam's privacy, not to cover up a morally questionable decision of his.
Crossing the room back to her, he stood beside the bed, facing her turned back. He put a hand on her upper arm, as gently as he could. She still flinched in surprise.
"You do not have to do this on your own," he whispered firmly. "You are not going to do this on your own. Absolutely not. You're not absolving me of all responsibility and soldiering on alone. If you'll have me, then I will be here. We may have to keep it quiet, but I will absolutely take care of you."
He felt her arm relax under his touch. She shifted on the bed, turning back to face him. Her breath caught as she did so, and he made a mental note to check her painkillers as soon as possible.
"Do you mean that?"
He nodded. "I'm a lot of things, but a liar is not one of them." It was a risk worth taking: he closed the space between them, crawling into the bed beside her and holding her as she cried.
