Power with a Capital P

Author: Jennifer Lycette, MD

This excerpt was adapted from the novel The Algorithm Will See You Now, a speculative thriller by JL Lycette, MD. It has been republished here with permission.

Keywords: medical fiction, medical thriller, book excerpt, medical science fiction

Hope blinked and adjusted to the interface, welcoming the familiar adrenaline rush at the start of a case. The AR overlay showed her a 3-D map of Brayden’s blood vessels, highlighting the malfunctioning port’s location. Yesterday’s events faded from her mind, replaced by a new augmented reality. 

A soft whoosh of air behind her signaled the outer doors had swung open. Finally. 

But it wasn’t the attending, only another nurse, who Hope didn’t recognize.

The new nurse glanced between her, Jacie, and Lincoln, clearly unsure who was who under the surgical attire, even though Hope wore the surgeon’s smartglasses. The nurse’s gaze settled on Lincoln. “Um, Dr. Kestrel?”

Hope rolled her eyes, then realized the nurse wouldn’t be able to see her expression behind the glasses. She raised a gloved finger. “Here. What is it?”

The nurse hesitated, her glance darting back to Lincoln for a second, then waved behind her toward the door leading out of the O.R. “There’s someone here for you.”

“We’re about to start the case.” If the attending ever bothered to arrive.

The nurse shifted her feet. “But, it’s Dr. Maddox. She said it can’t wait.”

Hope swore under her breath, then turned to Lincoln with a helpless shrug. If the Director said it couldn’t wait, she didn’t have a choice, even if she was fully scrubbed.

Lincoln sighed in resignation. “You’ve got to be kidding me.”

He gestured to her face, and Hope leaned forward to allow him to remove the smartglasses. That was a waste. They’d have to be re-sterilized now.

She yanked off the gown and deposited it in the recycling. The gloves followed. 

Jacie started to lower her hands to do the same, but Hope stopped her before she contaminated her gloves. “Don’t. Stay scrubbed. When the attending comes, introduce yourself as the intern, and you’ll observe the case.”

“Without you?” Jacie squeaked.

“You’ll be fine.” Hope glanced back into the O.R., where the equipment around Brayden swallowed his slight form. She’d made a promise, damn it. “Keep an eye on him for me, okay?”

Not waiting for Jacie to answer, she exited the O.R. and crossed the red line painted on the floor to demarcate the sterile zone. A crowd of suits filled the hallway, and a half-dozen heads swiveled at her arrival, Maddox at the front of them.

Hope tried to cover her surprise at the entourage of VIPs, recognizing among them the CFO, COO, and a few of the various department heads. Behind them lurked an imposing, red-headed resident dressed in scrubs. Leach, again.

What was he doing here?

Just then, her attending finally showed. He slowed and gave the group a curious glance.

Before Hope could say anything, Maddox spoke. “I’m afraid I need to borrow Dr. Kestrel. If you can manage without her.”

The attending nodded and hurried onward through the O.R. doors. Hope wondered how much of his rush was because he was late to start the case versus wanting to avoid Maddox.

Maddox’s gaze swiveled to Hope.

On casual observation, an outsider might take PRIMA’s Director for a schoolteacher or a librarian. Hope guessed Maddox to be in her mid-sixties but a very fit mid-sixties. She kept her silver hair in a stylish pixie cut, dressed in classic cardigans and tailored slacks, and accessorized with tasteful jewelry.

But upon a second glance, one noticed the details. The heels—designer, sable-black. The sweater—cashmere, pinot-red. Hope caught a whiff of perfume she couldn’t quite place, not floral but sharp. Power, she decided. It smelled like Power, with a capital P.

Hope drew her posture up straighter. Out of the corner of her eye, she spotted several others doing the same. 

She shifted her gaze past the group to the two people flanking them. The guards in the identical suits. She’d been right, then. They must be some new higher layer of security.

Maddox fixed a laser focus on Hope. “Quite a situation we had yesterday. Wouldn’t you say, Dr. Kestrel?”

Yesterday. Her heart hammered in her chest, and her eyes darted back to Leach, who now sported a snide grin. 

“Is Cecilia with you?” Maddox demanded.

Hope gestured behind her in confusion. “I just came from the O.R.”

Cecilia was a researcher, not a surgeon, and had a bad habit of forgetting things outside her lab, like meetings. But this hadn’t been a prearranged meeting, had it?

Maddox tilted her head back and projected her voice upward. “Osler, begin recording.”

“Yes, Doctor Maddox. Beginning recording now.”

About the author: JL/Jennifer Lycette MD is a rural community hematologist/oncologist, novelist, award-winning essayist, wife, and mom (three of the human sort, two of the dog persuasion). Mid-career, she discovered narrative medicine on her path back from physician burnout and has been writing ever since. Her essays can be found in Intima, NEJM, JAMA, and other journals; and online at Doximity, kevinMD, and Medscape. Her published speculative fiction can be found in the anthology And If That Mockingbird Don’t Sing: Parenting Stories Gone Speculative (Alternating Current Press). Her first novel, The Algorithm Will See You Now, a speculative medical thriller, is out 3/2/2023 (Black Rose Writing Press). Connect with her on her website https://jenniferlycette.com.