Chapter 2

Chapter 2 — Exes in the Operating Room

At half past five in the morning, Alya was already in the doctors' changing room when her phone vibrated on the bench beside her. She had just finished tying her hair back when a message from Naya appeared on the screen, informing her that they needed to gather at the nurses' station before the morning rounds began. Alya sent a brief reply, slipped her phone into the pocket of her white coat, and checked her belongings one last time.

She had not slept particularly well the night before. Apart from still adjusting to her new rotation schedule, her conversation with Raka the previous day kept replaying in her mind. She was irritated that he had dared to ask whether she was still angry, as though the passage of several years should have been enough for old wounds to heal on their own.

Alya knew they could not keep avoiding each other while working at the same hospital. Nor did she intend to resign simply because she had been assigned to the same team as her ex-boyfriend. However, accepting the reality that Raka was now part of her daily routine would require far more patience than she cared to admit.

Her phone vibrated again.

Naya: Are you here yet? I'm at the nurses' station. Hurry over. There's a new patient we need to discuss.

Alya immediately left the changing room and headed toward the nurses' station. When she arrived, she found Naya discussing something with Rafi in front of a computer, while Raka stood near the desk reading a report from the emergency department.

Alya paused briefly in the doorway before approaching them.

"Morning," she greeted Naya and Rafi.

"Morning," Rafi replied.

Naya glanced at Alya before pointing at the computer screen. "A fifty-eight-year-old male patient was admitted to the emergency department last night with severe abdominal pain. The attending physician suspected a gastrointestinal problem, but the initial examination results suggest that it might be something more serious."

Alya placed her folder on the desk and moved closer to the computer.

"Any previous medical history?"

"Hypertension and diabetes. According to his family, he also underwent abdominal surgery about ten years ago."

Alya reviewed the available examination reports, then studied the laboratory results and the patient's vital signs. Several findings made her want to examine the patient in person as soon as possible.

"We need to assess him now. If there are signs of an acute abdomen, we can't afford to delay treatment."

Raka nodded. "I've already asked the nurse to prepare his records. We can go straight to his room."

Alya turned toward him. "I'll examine the patient first. After that, we can discuss the findings."

"All right."

Raka's brief response surprised Alya slightly. She had expected him to argue or make an unnecessary comment, but he simply picked up the patient's records and headed for the door.

Alya followed behind him with Naya and Rafi.

The patient had been placed in the observation unit because his condition still required close monitoring. When they entered the room, a nurse was checking his blood pressure, while a middle-aged woman sat in a chair beside the bed, her face filled with worry.

"Good morning, sir. I'm Dr. Alya, one of the doctors responsible for examining you today," Alya said as she approached the bed. "I'd like to ask you a few questions about the pain you're experiencing."

The patient nodded weakly.

Alya began asking about the location of the pain, when it had started, whether it radiated to other parts of his body, and whether he had experienced nausea or vomiting. She also asked about his previous surgery, as that information could influence the diagnostic assessment.

While Alya conducted the physical examination, Raka stood on the opposite side of the bed, observing the patient's condition and comparing the findings with the earlier report.

"The pain is worst right here, Doctor," the patient said, pointing to his abdomen.

Alya carefully examined the indicated area. The patient's expression changed when she pressed on a particular spot, and his abdominal muscles visibly tensed.

Alya slowly withdrew her hand.

"Sir, I'll request some additional tests to determine what's causing this. For now, please don't eat or drink anything until we've assessed the condition of your gastrointestinal tract."

The patient's wife immediately stood up. "Doctor, does my husband need surgery? He was in so much pain last night that he couldn't sleep."

"We can't be certain until all the examination results are available, ma'am. However, we'll address this as quickly as possible and explain every step we need to take."

After giving her a brief explanation, Alya left the room with the rest of her team. They headed to the discussion room to consider the possible diagnoses and determine which additional tests were necessary.

Raka opened the patient's chart on the table.

"Given his surgical history and physical examination findings, we need to consider the possibility of an intestinal obstruction. I recommend immediate imaging."

Alya nodded. "I agree about the imaging, but we also need to determine whether there are any signs of compromised blood flow or perforation. His condition could deteriorate if we take too long to make a decision."

"That's why we need to get the tests done immediately."

"I know. I just want to make sure we're considering every possibility before deciding on the next step."

Raka looked at her for a moment before nodding. "All right. Let's present our initial findings to the attending physician and request the tests as soon as possible."

Their discussion proceeded smoothly until Raka mentioned a finding in the emergency department report that Alya believed needed to be reassessed.

"The report says his pain decreased after he was given analgesics," Raka said. "That might explain why he appeared calmer when he arrived in the observation unit."

"Pain relief after analgesics doesn't mean the underlying problem has been resolved," Alya replied. "We still need to assess his overall clinical condition."

"I didn't say the problem had been resolved."

"But you're using it as one of the reasons to assess his condition."

Raka placed the chart on the table. "I'm only sharing the information from the previous report, Alya. We haven't made any decisions yet."

Alya realized that her voice was beginning to rise. She took a breath and looked down at the notes in front of her.

"Fine. We'll reassess him once the imaging results are available."

Naya, who was sitting beside Rafi, glanced between the two of them. She chose to remain silent because their discussion was still related to the patient's condition, although she could sense the tension between the two doctors.

Not long afterward, their attending physician arrived to review the initial findings. After listening to Alya and Raka's reports, he approved the imaging studies and instructed the team to continue monitoring the patient while preparing for possible surgery if his condition warranted it.

Alya immediately contacted the radiology department to confirm the examination schedule. Raka helped coordinate the patient's transfer, while Naya prepared the necessary documentation.

They worked quickly because the patient's condition left no room for unnecessary delays.

---

Shortly before eight o'clock, the imaging results finally became available. Alya and Raka reviewed them alongside their attending physician, who then requested a consultation with the surgical team to determine the next course of treatment.

The suspicion of an intestinal obstruction had grown stronger. The patient required further evaluation, and the possibility of surgery could not be ruled out if his clinical condition continued to deteriorate.

Alya checked the patient's latest vital signs before informing his family of the situation. She explained that the team was considering the safest course of action based on the examination results and that the final decision would be made after the surgeon had evaluated him.

The patient's wife looked worried when she heard that surgery might be necessary.

"If he needs surgery, will my husband recover, Doctor?"

Alya understood that the woman needed reassurance, but she did not want to make promises she could not guarantee.

"We'll do everything we can to treat your husband's condition, ma'am. We'll explain the risks thoroughly before any procedure is performed. For now, the most important thing is to identify the cause of his symptoms and prevent his condition from getting worse."

The woman nodded slowly, although her eyes remained moist with tears.

After finishing her explanation, Alya returned to the doctors' lounge. Raka was already there, entering the patient's progress notes into the medical record.

"Have you explained everything to his family?" he asked.

"Yes. They're still worried, but at least they understand why we need to conduct further evaluations."

Raka nodded and continued working.

Alya sat at the desk opposite him to complete her examination notes. For several minutes, the only sounds between them were the tapping of computer keys and the faint conversations drifting in from the corridor.

"Alya," Raka called eventually.

She kept her eyes on the screen. "What?"

"Do you think there's anything else we should find out about his surgical history?"

The question was professional, and Alya answered in the same tone. They discussed the patient's previous surgery, the possibility of adhesions forming between tissues, and several other details that needed to be clarified through further examinations.

Their conversation proceeded without any issues until Raka handed her the notes he had just completed.

Alya read through them before pointing to a particular section.

"This part needs to be clarified. You wrote that the pain started decreasing early this morning, but according to what the patient told us earlier, the pain actually intensified again before he was admitted to the observation unit."

Raka leaned closer to examine the section she was referring to.

"You're right. I'll correct it based on his latest account."

Alya slid the chart toward him. "Make sure the timeline is accurate. Information like this is important when assessing the progression of a patient's condition."

"I know."

His response made Alya look up.

Raka seemed to realize that his tone had sounded unpleasant. He exhaled softly before continuing, "I mean, I'll correct it now."

Alya returned her attention to her computer screen. "All right."

Although the exchange had been brief, Naya, who had just entered the room to collect some documents, noticed the two of them. She said nothing until they left the doctors' lounge a few minutes later.

As they walked toward the nurses' station, Naya moved closer to Alya and spoke quietly.

"You two actually work pretty well together when you're discussing patients."

Alya turned toward her. "Did you think we couldn't?"

"That's not what I mean. I'm just surprised because you seem so different when you're discussing work compared to when you're dealing with each other outside of patient care."

Alya sighed. "Because work has to be kept separate from personal problems."

"Then just keep working the way you did earlier."

"That's exactly what I intend to do."

Naya smiled faintly. "Good. At least I won't have to act as a mediator every time you two run into each other."

Alya let out a small snort before quickening her pace toward the nurses' station.

---

By late morning, the patient in room 318 had been transferred to an appropriate unit for further monitoring and evaluation. The surgical team had provided its initial assessment, while Alya and Raka were asked to complete the documentation and follow the patient's progress.

After finishing those tasks, Alya went to the doctors' lounge to retrieve her water bottle. She had just sat down when Raka entered, carrying two sheets of examination results.

"Dr. Bagas wants us to report the patient's progress before the shift change," Raka said.

Alya nodded. "I've already prepared the notes. I just need to add the evaluation results from the surgical team."

"I'll complete the section on the interventions and monitoring plan."

They began dividing the work without arguing. Alya prepared the summary of the patient's condition, while Raka documented the examinations that had been performed and the proposed follow-up plan. Once all the paperwork was complete, they reviewed it together before submitting it to their attending physician.

As Alya was about to leave the desk, Raka called her again.

"Thank you for this morning."

Alya turned, furrowing her brows. "For what?"

"For staying focused on the patient even though we have personal issues between us."

Alya was silent for a moment before slipping her pen into the pocket of her white coat.

"I won't let personal problems interfere with my work."

"I know."

"Then there's no need to thank me."

Raka accepted her response without arguing. He straightened the documents in front of him while Alya picked up her bag and walked toward the door.

"Alya," he called once more.

She stopped with one hand still resting on the doorknob. "What now?"

Raka hesitated before finally speaking. "I hope we can continue working together without any problems."

Alya looked at him for several moments. There were plenty of things she wanted to say, but in the end, she simply replied, "As long as you do your job properly, we won't have any problems."

With that, Alya left the room and headed toward the elevator to continue her duties in another unit.

Inside the doctors' lounge, Raka remained standing near the desk, staring at the door that had just closed behind her. A moment later, his phone vibrated with an incoming message from his mother. He opened it, read the few lines on the screen, and then sat back down to finish the patient notes still open on his computer.