Forcing an infant this size through natural delivery risked catastrophic perineal injury—or worse, a uterine rupture and lethal blood loss.

“Preston,” I forced through clenched teeth, my lungs packed with wet sand. “He can’t fit. My uterine wall… it’s too thin.”

“Elena, for God’s sake, stop throwing your weight around as ER chief.” He slammed a pair of forceps onto the Mayo stand. The clatter made the nurses jump.

His gaze skated past my sweat-drenched face and settled, softly, on the figure beside me.

Khloe Summers. His star intern, the adoring shadow who’d clung to his side for six months. Her eyes were rimmed a watery, manufactured red. She held a tilted medication tray, having just splashed saline down her own chest, and gnawed her lip, shoulders trembling like a leaf.

“Dr. Pierce,” Khloe whispered, breathy and fragile. “Dr. Vance is just in so much pain. She didn’t mean to strike my tray—I stumbled. Please don’t be angry with her.

This is all my fault.”

Sixty seconds earlier, under the guise of wiping my brow, this fragile leaf had buried her sharpened acrylic nails into the tender flesh inside my bicep and twisted.

I’d convulsed on reflex, and my flailing arm had knocked her tray askew. Through Preston’s twisted lens, that clumsy piece of theater was proof of a domineering wife abusing the weak.

“Look at this, Elena. This is my OR. I’m the attending surgeon,” Preston said, his voice dropping, dripping with disgust. “You might play tyrant down in the ER, but right now you’re nothing but a patient.

My student brings you your anesthetic, and you assault her. Where is your basic decency?”

“I didn’t—”