#Their barely there eyes | Explore Tumblr Posts and Blogs

moondirti · 3 months

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jigsaws

— surgeon! simon riley x resident! reader

angst. anxiety. panic attacks. neurosurgical procedures. medical setting. mean simon. d/s undertones. 3.3k wc

There's a reason no one likes working with him.

Tough. Censorious, or hard to please – whispered wearily by nurses with permanent distaste etched into their crow's feet. He scathes anyone not accustomed to his abrasive exterior; a talus pile of whetted rocks, poised to flay you open should you take the plunge so confidently. Rubs your skin raw, brutally worms his way into your flesh, infamously bars rescue, allowing only saltwater to cradle your open wounds in the aftermath. Nothing about his criticism is comforting, not in the way an attending's support should be.

It sounds inflated. Excessive. Your intern year, you let the horror stories float you by as though they were nothing more than dust motes in an old room. To be expected, no? Hospital's are brutal for even the briefest of visitors, let alone a man who's worked here twenty years. In hindsight, you see that it's a type of discredit only the very fortunate can claim; inaugural residents and medical directors, those who do not have to deal with the virulent terror himself. You know better, now. Really.

Still, it feels as though you're being punished.

The air in the operating room is heavy. Clotted by a thick sense of unease. It's never like this, usually. Though the smell of burnt bone, blood, and remnant antiseptic is always a force to be reckoned with, you've gotten very good at shunning your nose for favour of your other senses. To tune into the vital monitor's beep, or the distinctions between this lump of amorphous tissue versus that lump of amorphous tissue. Reinterpreting them based on the plans you revised while scrubbing up, focused fingers around delicate tools prodding. Cutting.

Reliable perception is fine work. You've honed your personal ability the best you could.

The first lesson Dr. Riley teaches you, and rather gratuitously at that, is it takes just one person to throw it off kilter.

There's an impossible itch right where your mask hooks over your ears, latched nastily onto your scalp. Nothing you can address physically (sterility before comfort), though you're aware that its source isn't so easy as to scratch away. Figurative, then. An unwavering neg, pointed by a pair of cold eyes in your periphery. You're tempted to look up, throw off his stare with one of your own, but you think he wants you distracted.

So, you shift your weight and centre the electrocautery to another portion of abnormal growth. It comes apart like stale bread.

You haven't felt this micromanaged since medical school, when professors would loom over your shoulder and mark the clumsy way you sutured incisions shut. But where your grade had been on the line then, it's a person's life now. You seem to be the only one privy to that fact, or perhaps the one surgeon who cares.

Because Dr. Riley watches you over his wire-rimmed specs, grunting ambiguously under his breath like you can't hear him standing just a foot away. Maddening in that it's quiet, idle. To question it would be putting the burden of critique on yourself. To let it continue–

Sweat pools beneath your collar. The spotlights don't help, either, heat lamps on your roasting nerves, highlighting the wet sheen of your temple to whoever cares enough to notice (just him). Focus feels a vain pursuit, attention zeroing in and out of control. You're caught in the violent dance, swept away, water beneath your feet, between the operation and everything else. Everything else, like the ground that suddenly pushes too hard beneath you. The walls, stretching further and further away. There'd be nothing to catch you should you fall – a possibility that gains traction by the second, your vision spotting with exhaustion.

You almost lose it before a flash of green reels you back in.

It's instinctual. Entrenched response to a colour that only ever means one thing. Looking up at the neuronavigation, you watch as the silhouette of your apparatus veers dangerously close to the patient's motor cortex, highlighted in nausea-inducing neon for maximum visibility. Dr. Riley's presence darkens the space next to the screen, a point of singularity that consumes anything within its event horizon. Though it's the last thing you want to do, you coast a hesitant look over to him.

A surgical gown is meant to be ill-fitting. You find he fills the fabric in a manner antithetical to that design, shoulders stretching it tight across his neck, tree-trunk arms drawing tense pleats around his joints. Even his cap, wrapped smoothly around his forehead, ripples with every shift of his brow. Doubled-up gloves warped to the contours of his hands, thick fingers and knuckles. You watch the way they twitch, distorting the latex like a swift fish underwater, and swallow the stone lodged in your throat.

"I can't read your mind, Doctor." Your attending snaps when you take too long to elaborate. His voice is rough, a sucking chest wound in the sterile air of the OR – too raw, natural in a way these halls don't see. You squirm uncomfortably in the force majeure. "What's the hold up?"

"Um-" You pull away from the glioblastoma, your patient's head remaining tightly in place by a positioning frame. "I'm concerned about resecting this part. It's all wound up in healthy tissue, right up against the motor cortex. A wrong move could cause permanent damage."

Dr. Riley doesn't move. Instead, his blank stare flicks down to the surgical site, digesting the truth for himself. The anesthesiologist beside you holds her breath. You wish you had it in you to do the same, but your lungs already wheeze for oxygen as it is.

Somewhere, dim and timid in the recesses of your mind, it occurs to you that this isn't normal. No attending should actively foster an environment where help is punished, especially not while being paid a hefty salary to do exactly that. A dour attitude is one thing – everyone has their days – but you know nurses with greater burdens that boast smiles and little stickers on their ID badges, running on three hours sleep while dealing with bedpans and lewd comments all day. Your search for guidance, then, is certainly not the worst thing in the world.

(No matter how stern the look he gives you is.)

"You need to make a decision. Hesitation in the OR can be just as fatal."

Great load of good that does.

But it was to be expected. Pre-op, you sat down with him to discuss the acceptable margins, and got as much out of that conversation as you did this one. Review the imaging. You've been given the functional mapping for a reason. Never mind that it was standard procedure to check-in regardless; he handles you like you're a child playing dress-up, waving around tools too complex for your grubby hands to operate. Asking him anything is validating what he believes, like kindling wood into a roaring fire. Your mouth smacks to the taste of ash.

The discoloured mass growing off your patient's brain seems to glare back at you. Ugly, yellow, and stained in a coating of blood, severed from its sisters that now lay dead on an adjacent table. It kills you to let it stick, to progress to hemostasis with an increased risk of recurrence. Should this individual ever come in again, their pain would be on your hands – a real possibility you cannot reckon with, for all you know how devastating a toll it would have. The last time it happened, you promised yourself you would never allow it again.

(A mistake that even the greenest of medical students know not to make. Promises are null in this field. They'll blow out like bad tattoos, ink smudged under skin. Patients die, families grieve, doctor's bear the guilt – to fool anyone about it would be doing a greater disservice. Conciliation is not your job. It is not a duty you owe.

Not even to yourself.)

"I… I think we should stop here to avoid any potential issues." You resolve, lips pursed painfully tight. Your hands shake, bullet of emotion ricocheting within your ribs. Your nerves are shot, you tell yourself. It'll take time to compose them, time you don't have. Better to shelf this, then. You're doing the right thing by wrapping it neatly for another day, if that day should ever come.

Dr. Riley huffs.

Or, not.

"CUSA," He clips to the scrub nurse, who shakes as they place the tool into his impatient hand. It's all you can do to watch in horror as your attending commandeers your case, addressing the portion of concern with offensive expertise. The activity on the neuronavigation doesn't so much as blink as he emulsifies the target tissue, tumored cells dissociating from the surrounding matter like butter.

And it isn't a learning opportunity – hardly anything at all when he washes the area in saline solution, manoeuvre over as quickly as it started. Instead, your attention sticks to the casual disrespect he felt was necessary. Snubbing your insight like it was dirt beneath his shoes, too competent to even address your error with words. Humiliation rips like a wave up your neck, washing your ears and cheeks in balmy warmth. Underneath it all, settled like wet sand on the shore, you find that it is not your bruised ego that's left, but rather a wilder, darker thing.

Shame at having failed him.

(How obnoxiously redundant.)

"Think you can manage the duraplasty, Doctor?" Derision distorts his expression into something crueller than his usual indifference. You hate to think it suits him.

"Yes."

It's only an hour later that you're granted the chance to break down.

After wound closure, scrubbing out and postoperative discussions with the patient's family, you think you'd have moved on. Things like this happen – it's what necessitates post-graduate training in the first place – and you're certainly not irredeemable for having faltered on the line. At least, that's what the logic delineates. It mutters its assurances like dogma in your head, insisting that because it is rational, it is right. Any other day, you would be inclined to listen to it.

But that's the thing about being strung out beyond measure. The only sentiment with teeth, sharp and stubborn, is anguish. Indignity. Self-turned anger. You replay the scene like something new will come of it, a silver lining or a divot to pin the blame in anything but yourself. The scalp staples back into place, the dressings wrapped tight. The hibiclens soap lathers up to your elbows, your skin itchy as it dries. The family is thankful, little tears dotting their eyes. The storm passes, waters rippling into quiet calm. And still–

In the wake of it all, you're irrevocably changed. Raw.

There's a little closet for occasions like these. You're relieved to find it empty, void of anything but rusted buckets and mildewed mops. It's a welcome crowd, certainly, borderline claustrophobic compared to the wide floors of the OR, and you sink to the floors within the tight, comforting embrace. Immediately, hot tears spring to your eyes, rabbit heart racing along hollowed ribs. Emotion rushes your throat, tumultuous and messy, piling half-formed grievances on top of one another until they form an intricate, prodigious beast.

Impossible to tackle, worse to tame.

Could you have done anything different?

Is there a reason why he hates you?

Are you cut out for this?

Is this worth never getting a good night's rest?

Do you deserve any of the opportunities you've been given?

Would they be better off in the hands of someone more competent?

No answer claims any. Unresolved, they wriggle underneath your flesh, feeding on the muscle keeping you intact. Tunnelling through your marrow, soft matter fattening them up. You feel as though you're shifting to accommodate them, anatomy morphing into an ugly sack of dermis and maggots. True reflection of a degraded conceit.

The dark, at least, remains omnipresent. Clean against your skin, or purifying, in some odd way. If there is no witness to your misery, then perhaps you can pretend it doesn't exist. That it doesn't affect you as much as it does, or how you won't be thinking of it during every case to come–

A knock rattles you out of your reasoning.

"Hey." Kyle's voice is soft on the other side of the door.

You make your best effort to wipe the wetness from your cheeks, warbling a quiet come in to your chief resident. Fluorescent light intercedes on your little sanctum, spotlighting your crumpled frame. The pitying grimace that twists his face is enough indication that you did not do a good job at hiding your affliction. You must look pathetic.

"We missed you at lunch."

"Wasn't hungry." You sniff, taking his hand to pull yourself up.

"That bad, huh?"

"Worse than you could've prepared me for."

He snickers. It alleviates some of the weight off your chest, this. Conversation to remind yourself that there is more to the world than your angst.

(Only some.)

"It'll get easier, I promise. He's harsher on the juniors."

"I think that's not for you to say. Tell me, has there ever been a superior who didn't absolutely adore you?" Your voice sobers to a close resemblance of Laswell's. "Good work on the diagnosis, Dr. Garrick. I'll admit, I wouldn't have caught that myself."

The man in question lightly shoves your arm, wrinkling his nose in distaste. "Okay, hush. I get it. Still–"

"You don't have to do this, you know." You smile until it gets too much to sustain, then turn to gather your white coat from behind the front desk. The note of positivity his companionship brings is fickle. Appreciated, but not enough to balm the sore blisters of Dr. Riley's rebuff. That'll take the weekend, likely, holed up in your room with nothing but a cuppa and old How I Met Your Mother reruns. "I'm fine, really. I'd rather just continue about my rounds and forget he exists."

But Kyle sighs. Sighs, and bites his cheek in that same way he does when he has to deliver bad news to intakes.

You blanch. "Don't–"

"He came looking for you in the mess hall. Something about the report." The unsteady composure you've built within yourself immediately dissipates, as though it were nothing more than an absorbable stitch. "You know better than to skip out on post-op briefs."

Your voice is weak when you speak again. Breathless. "I'm sorry."

"I don't blame you, darl. But he wants to see you in his office, now." Kyle's face is sympathetic. It doesn't do you much good. "I'll cover your rounds in the meantime."

"Thanks."

And despite your true gratitude, the words ring as empty.

"Sit."

Like a marionette suspended on string, you do as you're told.

Dr. Riley's office is barren of any personal adornment, cast in the same austere template initially given to him. There's a leather couch tucked prim under the window, throw pillow flat on one end. A wire file organiser sits atop his desk, papers fighting for space between the flimsy bookmarks. Pens in a cup, a stapler by his keyboard. All ordinary, inconclusive belongings, that which you sift through like a ravenous creature, slobbering for clues at the life your attending leads.

Ironically, the one thing that offers any inference is an empty photo frame, faced towards the rest of the room, away from him.

You don't like the uncomfortable feeling it inflicts.

"The family." He levels a bored look to you, that which hardens the longer you take to address his ambiguous question. In the harsh lights of the operating room, his eyes looked nearly black. Now, sunlight paints a clearer picture. Taupe and sepia, flecks of various browns brightened by the pale blue underline of his mask. "Doctor."

Floundering, you search for the clouded memory of your discussion with the patient's relatives. It ripples, faintly, between your revels in self-pity. If you needed any censure of your disordered priorities, that is surely enough.

(Funny how he continues to criticise you, even unintentionally.)

"Good. Hopeful. I told them you managed to resect the entire thing, and detailed the plan going forward." It's as though your hands are compelled to move by electric shock, charged full of destructive energy. You rub your face, twiddle your thumbs, scratch the armrests of your chair; trying any measure to defuse the bomb you feel ticking beneath your chest. "They give their thanks."

All the while, he remains steady before you.

A moment of tense silence clears. "I just submitted the operation report." He says, derailing the conversation to what you suspect has always been its purpose. "I mentioned your inability to close the surgery."

You damn near choke on your spit. He notices, of course, and raises a challenging brow.

"I- I'm sorry, but that isn't what... I was perfectly able to complete it." Your protest carries none of the strength you will it to. As is always the case around him, you're made to sound like a defiant student, instead. Pouting and stomping your foot, inflating your strict sense of justice to an occasion that does not call for it.

"Oh?" You know you're not crazy for thinking that way, either. He speaks in faux conciliatory tones, brows knitting together as his argument waters down to one he thinks you can digest. "Would you rather I have said you refused, then?"

You shake your head, staring down at your lap. You really, really don't want to be here. Is it worth it, then? To stand your ground when the worst that will come of his misstatement is an inquiry from above? The strength has long since left you. Now, it is a matter of bloodletting. Leeching the struggle before it festers into something greater, a malady you cannot control.

"No."

"Make up your mind, Doctor." He hums, grabbing a protein bar from his drawer before standing. He doesn't have to round his desk to tower over you, but he does. Heat radiates off him in waves, blushing your neck so that when you look up at him, owlish, your face flares with stockpiled fervor.

You wonder if it could be read as desire.

"You know best." Shutting down has never been so disencumbering. Acquiescence, upending an ivory flag with the knowledge that you don't have to bleed any longer.

His lashes flutter. When you blink, they seem closer than they were before.

"That's right." Dr. Riley practically fucking purrs, chest rumbling thoughtfully at your chosen response. A pressure settles between your legs, bloating desperately into that bundle of nerves that inhibits all reason. "So next time, if you have a problem with the way I do things, you'll address it to me directly instead of snivelling like a bloody prat. That way, maybe I'll explain it to you, too."

A nod is not enough.

"Yes, Dr. Riley."

He cocks his head, fiddling with the wrapping in his hands. His fingers are scarred, brutish, though they tear the foil with all the precision in the world. Your acceptance does not feel nearly as final, expectation thickening the space between you. The title startles to your tongue, then. Novel. Unsure. You haven't called anyone it since secondary. You do not know whether he'll take to it kindly at all.

"Yes, sir."

But his eyes crinkle at the corners, pleased, and it more than fills the hole he harrowed out from you earlier. Your reaction to the approval should be documented, given a name and listed somewhere on the DSM-5.

(Nothing about it feels healthy.)

"Good." He pushes off the edge of his desk, tapping a knuckle to your chin. Instinctively, you open your mouth. The protein bar fits between your teeth, pasty and dry, but his pulse vibrates near your lips and–

You bite down anyway.

(But oh, does it feel good.)

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