Page 18

Chapter eighteen

D amien

The girl’s name was Ava. Fifteen. Pale, trembling, and barely holding on beneath the wires and blinking monitors. Her mother clutched her hand like it was the only thing keeping her grounded to the earth.

They rushed her in an hour before closing. Chest pain, dizziness, a fainting spell. I scanned the vitals, the ECG, and then the history. It was all there—quiet and subtle like a whisper in a crowded room. But I’d heard it before.

My fingers hovered above her chart.

Congenital. Rare. Often missed until it was too late.

Until someone didn’t come home from gym class.

I swallowed hard.

The staff looked to me like they already knew. Not just because I was the senior physician on call—but because they’d seen the shift in me the second I read her file.

Because this wasn’t just any case.

This was the kind of diagnosis that took my career skyward in New York. The one that filled headlines and journals. The one that had made my hands famous.

And here it was again, blooming in Cedar Springs like a ghost I never asked for.

I stepped out into the hall and dialed the number I hadn’t used in over a year.

He picked up on the second ring.

“Damien,” came the gravelly voice of Dr. Philip Ross. “Never thought I’d hear from you again, son.”

I didn’t waste time. “Fifteen-year-old female. Intermittent syncope. Fatigue. Ejection murmur confirmed. Suspected anomalous origin of the left coronary artery. Echo pending. But I already know.”

Ross didn’t ask how I knew. He trained me. He knew how my gut worked.

“How stable?”

“Marginal. We’ve got time. Maybe.”

There was a long pause. Then: “You need to lead it.”

My grip tightened on the phone. “I’m not in an OR anymore.”

“I don’t care if you’re in a wheat field, a back-alley barn, or a fancy clinic with fairy lights. You’re the only one in the region who’s done this. You know the anatomy, the rhythm, the pressure gradients. You saved five kids in New York with that defect.”

I leaned against the wall, the cool paint grounding me. “That was before.”

“Before what?” Ross snapped. “Before you got burned out? Before you ran away to find peace?”

I didn’t answer.

Ross’s voice softened. “Look, Damien. This isn’t about proving anything. This girl—this kid —she doesn’t need peace. She needs you. There’s no one better equipped to save her. Not here. Not even in the city.”

I stared through the glass window into the clinic hallway. A little girl in a tutu skipped past, clutching a juice box. Ava’s mom was sitting with her head bowed like she was praying to every god she could name.

“I’ll need a surgical team,” I said quietly.

“I’ll make calls. But you take point. We both know it’s what you’re wired for.”

I ended the call and stared at my reflection in the glass.

Not the gruff ex-surgeon in flannel, the small-town healer with a flower-loving girlfriend and dirt under his nails.

The man beneath all that.

I felt it again. The spark. The clarity.

The terrifying, exhilarating rush of purpose.

When I walked back into the room, the nurses snapped to attention. My voice was steady, my words direct. I ordered labs, called in a specialist to confirm imaging, and instructed the team on prep for transfer and surgery planning.

It was automatic. Not because I didn’t care—but because I cared so much, I couldn’t afford hesitation.

Later, when the room calmed and Ava was asleep, I sat at my desk and stared at my hands.

Steady.

Strong.

Hungry.

I’d walked away from the OR because I thought the pressure had poisoned me. That it cost me every personal connection I ever had.

But in that moment, I realized something far scarier.

I hadn’t left because I hated it.

I left because I loved it too much.

And because it made me forget to love anything else.

I took out my phone and stared at Ruby’s number.

I didn’t call her.

Not yet.

How could I tell the woman I’d just promised to build a life with that a teenage girl’s broken heart had reminded me of who I really was?

That I didn’t just want to help Ava—I needed to?

That I felt more alive in the last four hours than I had in a year?

I set the phone down and covered my face with both hands.

I was in trouble.

And I had no idea how to tell the woman I loved that my purpose might be bigger than the life we’d just started building.

…

The house was dark except for the flicker of a single candle on the windowsill. The storm had knocked the power out an hour ago, leaving everything hushed, cloaked in shadows and the rhythmic patter of rain on the roof.

Ruby was curled up on the couch in one of my flannel shirts, her knees drawn to her chest, a blanket wrapped around her like armor. She looked up when I stepped in from the porch, her eyes finding mine even in the low light.

“You’re late,” she said softly, not accusing—just knowing.

I nodded and dropped my keys into the bowl by the door. My shoulders ached. Not from fatigue, but from everything I hadn’t said yet.

She patted the space beside her, and I sat down, the quilt falling over both of us like a quiet surrender.

For a while, we didn’t speak.

The candle danced in the breeze sneaking through the cracked window, and I stared at it like it might offer the answers I didn’t have.

“I need to tell you something,” I said finally, my voice low.

She turned toward me, calm but alert. Like she knew the weight of the words before I even spoke them.

“There’s a girl. Fifteen. Emergency case. Rare defect—one I’ve seen before. One I’ve treated before.” I exhaled. “They don’t have anyone else here who knows how.”

Ruby blinked once, then twice, before asking, “Did you take it?”

I nodded slowly. “Yeah. I didn’t even think. I just... did.”

She was quiet for a beat. Then: “Do you miss it? That adrenaline?”

I leaned back, pressing my head against the couch, and let the question hang in the air.

“Sometimes,” I admitted. “But it’s not just the adrenaline. I miss being the guy who knew exactly what to do. In that room, with that chart, with those monitors—I didn’t doubt myself.”

Ruby turned toward me, the candlelight catching the gold flecks in her eyes. “And here?”

I let out a hollow laugh. “Here, I second-guess everything. Whether I’m enough for this life. For you. Whether I’m pretending I can leave that world behind when deep down, I know I never really did.”

Her fingers found mine under the blanket. “You still are that guy, Damien. The one who knows what to do. You’re just using those instincts in new ways now.”

I looked down at our hands—hers small and warm, mine still stained faintly with ink from Ava’s charts. I hadn’t scrubbed it off. Part of me didn’t want to.

“But it doesn’t have to be at the expense of everything else,” she added gently. “You’re allowed to still love that part of you. To need it. As long as you don’t forget the other things that matter.”

I turned to face her fully, taking in the curve of her jaw, the worry etched subtly around her mouth. “You matter.”

“I know.” Her lips curved, soft and sure. “And so does that girl. So does every life you touch.”

I swallowed the knot in my throat. “It scares me—how much I still want it. That world. The control. The certainty.”

Ruby reached up, brushing my hair from my forehead. “That’s not weakness, Damien. That’s passion. And it’s okay to have more than one.”

I kissed her then. Not because I had the answers, but because her presence made the questions bearable.

We lay down on the couch together, our bodies tangled beneath the patchwork quilt. The wind howled outside, but in here, there was only the soft cadence of our breathing and the tiny snap of the candle’s wick.

“I don’t know how this is all going to work,” I said, voice thick.

“We’ll figure it out,” she whispered. “Even if we have to draw the blueprint ourselves.”

I pulled her closer, resting my chin on her head. She fit against me like a promise I didn’t know I’d made until I found myself keeping it.

And as the storm rolled on and the night deepened around us, we drifted—not into sleep, but into a quiet where dreams stirred gently. Flickering. Fragile.

But still alive.

The sun wasn’t even over the trees when I stepped out onto the porch, two travel mugs in hand and a knot twisting in my stomach.

Ruby was already at her car, stuffing one last box of florals in the backseat.

Her hair was braided down her back, stray petals tangled in the strands like they'd refused to be left behind.

Her excitement pulsed beneath the nerves.

I could feel it; same way I could feel my chest tightening with every second closer to goodbye.

“Morning,” I said, passing her one of the mugs. “Hazelnut with too much cream. Just the way you like.”

She grinned and took a sip, then wrinkled her nose. “You always say too much, but really, it’s just enough.”

“Debatable,” I teased, but my voice didn’t quite match the smile.

Ruby leaned against the car door, watching me with that gaze that could see through everything. “You’re quiet.”

“I’ve been loading vases and stress dreams into this car for the past hour. I’m allowed to be quiet.”

She didn’t push. Just sipped her coffee and waited.

I walked over and tugged her suitcase into the trunk, tucking it next to her flower crates. Then I reached into my pocket and pulled out the small envelope I’d been carrying all morning.

Her brow lifted. “Is that a love note? Or an invoice for all your packing labor?”

“Open it when you get nervous,” I said, pressing it into her palm. “Not before. I mean it.”

“Cryptic. Very Nicholas Sparks of you.” She smirked, but her thumb ran over the edge of the envelope with care.

I took a breath and cupped her face, brushing my thumbs along her jaw. “I’m proud of you. No matter what happens out there. You belong on that stage.”

Her eyes shone, and for a second, she looked like she might say something deep—then she scoffed lightly, “Better not make me cry before I hit the highway. I’ve got ten miles of winding road and zero waterproof mascara.”

I kissed her. Not just because I didn’t want to say goodbye—but because she deserved to leave knowing exactly where my heart stood.

Her hands slid into my jacket as she leaned into me, her lips warm and familiar and bittersweet. When we finally pulled back, she whispered, “I love you.”

“I know,” I said, brushing my knuckles down her cheek. “Now go show them what sunshine in human form looks like.”

She laughed, wiping under her eyes, then climbed into the driver’s seat. “Tell Hazel I left emergency chocolate in the fridge. And if you burn the house down trying to cook without me, I’m haunting your ghost with passive-aggressive notes.”

“I’d expect nothing less.”

The car rumbled to life, and with a final wave, she pulled away—sunlight catching the window, the petals on her dashboard fluttering like confetti.

I stood on the sidewalk long after she disappeared from view, hands in my pockets, the wind rustling petals from the garden we’d planted together. Some floated down onto the grass, soft and sure. Others danced in the breeze like they didn’t care where they landed.

That was Ruby. Unpredictable and untamable, but always beautiful in motion.

I was just turning toward the porch when my phone buzzed.

Unknown number.

I hesitated, then picked up. “Dr. Cole speaking.”

“Dr. Cole, this is Melissa from St. Julian’s Cardiac Center in New York. I’m reaching out on behalf of Chief Graham. He wanted to personally thank you for the consult on Ava Langston.”

My chest tightened. “She’s doing well?”

“Better than expected. Your notes were brilliant. We’ve reviewed your old case files, your success rate… Honestly, sir, it would be an honor to have you here. Chief Graham was hoping you'd consider joining us temporarily. Six months, surgical lead. Flexible scheduling. Competitive compensation.”

The breeze stilled.

Six months.

Not permanent. But not nothing.

“We understand you’ve built something new in Cedar Springs,” Melissa continued gently, “but we also believe your skills are rare. There are lives that only someone like you can change.”

My throat went dry. Ruby’s car was long gone down the winding road. Her dreams blooming in one direction. My past tugging from the other.

“I—can I think about it?” I managed.

“Of course,” she said. “We’ll hold the offer open for a week. Take your time.”

I ended the call and stared down at the screen, my heartbeat steady—but my pulse racing like I was back in the OR.

It had always been easier to walk away from the noise. From the pressure. From the responsibility of being the one people counted on.

But now?

Now I had something worth staying for.

And something worth risking again.

As the morning sun burned through the mist and lit the petals at my feet, I realized—maybe it wasn’t about choosing one life over another.

Maybe it was finally time to figure out how to carry both.