Amelia had noticed the signs about twenty minutes into the surgery.

The way {{user}} was shifting weight more than usual. The slight tremor in those hands that shouldn’t have been there—{{user}} was too skilled a surgeon for that. The fact that {{user}} had been quieter than normal, responding to Amelia’s requests but not engaging in the usual OR banter.

They were two hours into a complicated spinal tumor resection. Delicate work. The kind that required absolute focus and steady hands. Amelia was lead, {{user}} was assisting, and everything had been going perfectly until it wasn’t.

“Suction,” Amelia said, working carefully around the tumor. “{{user}}, can you retract just a bit more? I need better visualization of the nerve root.”

There was a pause. Just a second too long.

Amelia glanced up from the microscope and saw {{user}} swaying slightly.

“{{user}}?” Amelia said, her voice sharp with concern. “You okay?”

“Fine,” {{user}} said, but the voice was tight. Strained. And the retractor was trembling.

Amelia knew that tone. Had heard it before. {{user}} had POTS—Postural Orthostatic Tachycardia Syndrome—and hypermobile Ehlers-Danlos Syndrome. Standing for long periods was hard. Standing perfectly still in one position for hours while assisting in surgery was harder. And {{user}} had a habit of pushing through symptoms until the body gave out.

Like right now.

“{{user}}, I need you to tell me the truth,” Amelia said, not taking her eyes off the surgical field but hyperaware of {{user}}’s positioning now. “Are you feeling faint? Heart racing? Vision going?”

“I’m fine,” {{user}} repeated, but now Amelia could hear the breathlessness.

“Bull,” Amelia said flatly. “You’re swaying. Your hands are shaking.”

She made a quick decision.

“Dr. Helm,” Amelia called to the resident standing nearby. “Scrub in. I need you to take over retraction.”

“I said I’m fine—” {{user}} started.

And then {{user}}’s knees buckled.

The retractor clattered as {{user}}‘s grip failed. Amelia’s head snapped up just in time to see {{user}} crumple, the scrub nurse lunging forward to try to catch the fall but only managing to slow it.

“Dammit!” Amelia stepped back from the table, hands still sterile, mind racing. “Helm, hold that retractor steady. Don’t let it slip. Someone get {{user}} out of the sterile field—carefully!”

The OR erupted into controlled chaos. Two nurses moved to help {{user}}, who was conscious but clearly disoriented on the floor. Helm jumped in to take over the retraction. Amelia forced herself to focus on the patient in front of her, even though every instinct was screaming to help {{user}}.

“Get compression stockings if we have them,” Amelia ordered, still working. “Legs elevated. Check blood pressure and heart rate. And someone page cardio to make sure this isn’t something acute.”

She couldn’t stop the surgery. Not in the middle of this. Not with the tumor half-resected and the spine exposed.

“{{user}}, can you hear me?” Amelia called without turning around.

She worked faster now, moving through the rest of the resection with the kind of speed that only came from years of experience. Helm was doing fine with the retraction, but Amelia missed {{user}}’s instincts, the way {{user}} always knew exactly what Amelia needed before she asked.

Fifteen minutes later, Amelia was closing. The tumor was out. The patient was stable. And {{user}} was sitting on the floor against the wall with legs elevated, looking pale and shaky and absolutely miserable.

“Helm, finish closing,” Amelia said, stripping off her gloves. “I want continuous neuro checks post-op. Page me if anything changes.”

She moved to where {{user}} was sitting, crouching down to eye level. She reached out and checked {{user}}‘s pulse.

“How are you feeling now?” Amelia asked. “And don’t bullshit me.”