Emma's badge beeped green at 6:18 a.m. The sliding doors sighed open and the familiar brightness of St. Luke's rushed at her—cool air, antiseptic tang, the muted thunder of a hospital waking up. Residents skimmed charts while walking, nurses did handover in low tones, monitors chimed their indifferent music. She tied her hair back, changed into scrubs, looped her stethoscope like a necklace, and breathed once—deep and steady—before stepping into the stream.
"Magandang umaga, Doktora." ("Good morning, Doctor.") Nurse Alyn pressed a clipboard into her hands outside DR 2. "Bed eight: twenty-six-year-old, primigravida, blood pressure flirting with the red since 4 a.m."
"Labs?" Emma asked, already moving.
"Pending repeat, first set shows rising uric acid. Proteinuria positive."
Emma slipped the curtain aside. The young woman's fingers clenched the rails, eyes shiny with fear. "Hi, I'm Dr. Emma," she said, tone even, palms visible. "You and baby are okay right now, but we're going to keep you both safer." She gave crisp orders without raising her voice—IV, magnesium sulfate, continuous monitoring, anesth on standby just in case—and the small team flowed around the bed like a practiced dance. The woman's husband hovered, useless with love.
"Breathe with me," Emma said, counting in fours. The mother copied, shoulders loosening one notch at a time. Pressure ebbed down; the baby's tracing steadied into a stubborn, reassuring line. By 7:40, they had room again to hope. Emma nodded once to the husband; the relief on his face cracked her chest a little, the good kind.
Case two was next door: a thirty-four-year-old on her second child, labor stalling after long progress. Emma checked, coaxed, repositioned, murmured encouragement. "Kaya mo 'to." ("You can do this.") She coached the partner, re-coached the breathing, watched the monitors like a hawk. Ninety minutes later, a slick, furious baby protested the world; the mother cried from relief, laughter, exhaustion. Emma placed the tiny bundle to the chest and watched the mother's whole body reset around the small weight. There it is, she thought—the reason I keep returning to these rooms.
At 9:20, an intern nearly ran into her. "Dok, ER consult—possible ectopic, left lower quadrant, guarding, beta hCG positive."
"I'm five minutes behind you," Emma said, already pivoting. "Start fluids, call radiology for a stat scan. And breathe." She caught the intern's panic with eye contact and pinned it to the wall for them. "What's your name?"
"Jessa, Dok."
"Okay, Jessa. You're going to brief me while we walk—short, accurate, no drama."
They moved together, shoes skimming tile. Jessa summarized, steadier now; Emma nodded. In ER, the scan arrived fast, surgeon-friends faster. A quiet, efficient "let's go" and the patient was on her way to OR; Emma's hand squeezed Jessa's shoulder once: good work, that's how we keep people alive.
By 10:45, she finally swallowed coffee that had cooled from hot to merely serviceable. She checked messages, returned two calls, signed three forms that probably required five more signatures because committees existed to multiply paper. Then clinic.
Clinic was a different kind of marathon: the teenager with irregular cycles, embarrassed but honest when Emma made space for honesty; the woman with three miscarriages whose voice trembled on the word "again" until Emma anchored them both with a plan; the forty-nine-year-old with hot flashes who laughed, "Ay, Dok, I thought I was dying," and Emma laughed with her, "Hindi po, nag-a-apoy lang," ("No, you're not, you're just on fire,") and then explained everything in the kind of careful, normal words that gave power back. She loved this too: not the drama of crisis, but the slow rebuilding of someone's sense that their body was theirs.
At noon, in the tiny window between clinic sets, she sat with two residents eating food from the cafeteria trays balanced on their knees. Miguel, half-asleep with rice mid-fork, asked, "Dok, paano niyo alam agad 'yung gawin sa DR 2 kanina?" ("How did you know what to do so quickly in DR 2 earlier?")
Emma smiled. "I didn't. I just did what the patient needed in front of me. Then the next thing. Then the next thing."
He nodded like she had told a secret. Maybe she had. She washed down the sentence with water and a second coffee because sometimes courage was also caffeine.
In the afternoon lounge, the background hum of gossip grew louder than the AC. An older consultant with a voice like velvet and a mouth like a blade leaned in: "Narinig mo? Dr. Santos might step down." ("Have you heard? Dr. Santos might step down.")
Emma felt a small, almost childish balloon lift in her chest. Finally.
"Board meets later," someone else murmured. "Sabi nila…" ("They say…") A shrug, a look, a tilt of chin that whispered the word they didn't say: connections.
"Board will never pick outsiders," one of the radiologists said, meaning people not born on certain floors, to certain parents, into certain circles.
Emma offered nothing but neutral air, an expression you could pour any meaning into. Inside, the balloon faltered, bobbed again. She was not an outsider—she was the Assistant Head. She had earned and re-earned her chair at the table. Her performance evaluations were boring in their praise. The residents asked for her on nights they were scared. The nurses listened when she didn't raise her voice. She told herself the balloon could stay.
By three, she returned to clinic. A patient in her late thirties sat straight-backed, lipstick perfect, eyes glassy. "My IVF failed," she said, looking at the window instead of Emma. "I told my husband I didn't care. I care."
Emma did not reach for a script. She told the truth gently: grief is part of this, you are not broken, we can try again or step sideways, both are brave. The woman looked at her then, really looked, as if searching Emma's face for permission to be human. She found it. Sometimes that was all medicine was: granting permission to feel.
Between patients, Emma washed her hands and stared at the water slipping away. She saw, superimposed, the small town street where she had walked last week, the bakery windows fogged with sugar air, the vendor's aluminum buckets balanced on bamboo. Taho. She almost smiled. Soy allergy, she remembered, and frowned at herself for remembering the smallest things about the strangest man.
At 4:57 p.m., a message pinged: Dept meeting at 5:15. Attendance required. She turned her head toward the clock and felt that odd balloon again, stretched thin as skin.
The conference room was bright and cold. Dr. Santos—kind eyes, sad mouth—stood at the head of the long table. Around him: the hospital director, board liaisons, four senior consultants, two fellows, Emma among them, spine tall for no reason but this—rituals have their own posture.
"Effective next week," Dr. Santos began, voice even, "I will be resigning my post as Head of OB-GYN." He paused. "It has been an honor."
The room rustled with the polite noises people make when pretending news is not news. The director folded his hands and smiled like a photo.
"We thank Dr. Santos for his years of service," he said. "And we are pleased to announce the new head of the department."
Time acquired edges. Emma watched the director's mouth, felt her heartbeat there.
"Dr. Alexandra Uy."
There was a second of no sound at all. Then chairs moved, someone clapped, someone else made a small surprised oh that wanted to be a cough. A young woman stood up from the far end, lab coat too new to have stains that tell stories, eyes bright and wide and a little terrified.
"Thank you, sir," Dr. Uy said. "I—I'm honored."
Emma's face did what faces are trained to do after enough years in institutions. She smiled, small and firm, and clapped with everyone else. In the periphery, she heard the whispers dress themselves as facts:
"Pamangkin ng board member." ("Board member's niece.")
"Magaling daw." ("They say she's good.")
"Pero ang bilis." ("But so fast.")
"Politics." (No translation necessary.)
The balloon popped without sound. Inside, something else did not pop; it fractured, cleanly and with precision, like glass cut by a practiced hand. She felt the moment land in her body in three places: the base of her throat, the center of her chest, and that spot below the ribs where breath goes to bargain.
Dr. Uy made a little speech—gratitude, teamwork, vision. The words were not offensive; they were just not for Emma. The director's smile did not shift. Dr. Santos sat the way men sit when they have decided to be replaced by whatever comes next and will not be ugly about it. Emma watched all of them with the calm of a surgeon's hand and none of the calm of a human heart.
The meeting adjourned. People milled with that busy-lazy purpose of after. Emma walked out on steady feet and straight down the hall to the restroom, where the mirror kept its secrets like a good friend.
She pressed both hands to the sink's edge and looked at herself the way she looked at patients when searching for what hurt without being told. There she was: capable, thirty-four, Assistant Head, the person younger doctors turned to when the night got mean. There she was: not chosen.
Her phone buzzed. A message from an unknown number: This is Monette's husband. BP is good today. Salamat ulit, doktora. ("Thank you again, doctor.") He added a photo of a hand—Monette's—on a blanket, a blood pressure cuff loose around the upper arm, the digital screen smug with normal numbers. Emma's breath left and returned, the basic miracle.
She did not cry. It wasn't pride; it was practice. She washed her hands again even though they were clean. She sat on the closed toilet lid until the cold pressed into her hip bones and gave her an anchor. Then she stood, fixed her hair, and walked back into the hospital that had just told her a truth she already knew somewhere: there are rooms you can own, and rooms you can only borrow.
At her locker, she changed into a fresh blouse, the kind you wear when you intend to absorb compliments or insults and pretend both are water. She pulled out her bag; a small metal clink sounded at the bottom. The compass. She had forgotten it was there. She turned it in her palm; the needle trembled and then settled in a direction that was not north so much as not-here.
Tucked into the side pocket, a different rectangle: a card, white with embossed letters.
Ronald D. Alonzo, MD
Head, OB-GYN
St. Therese Medical, Daet
She remembered the way he had leaned on his father's desk, half-grin hiding something that did not need hiding. We need you, he had said. And then, without shame or fanfare, the other truth: My parents would be thrilled if you stayed. They always thought we made a good pair. It had been easy enough to file under small-town politics and childhood pairings parents invent. It had been easy enough to refuse in her head.
Easy, before today.
Her phone lit again—this time a message from a senior mentor who had texted before she could. Heard the news. Politics, hija. Emma stared at the words until the edges doubled. Then another: Take a breath. Take a break. Your talent doesn't shrink because a title went elsewhere.
She typed, Thank you, Doc, and deleted it, typed again: Kaya pa, ("I can still manage,") and deleted that too. She put the phone face down on her thigh and held the compass in both hands like prayer.
The hallway outside held its constant traffic: wheels, whispers, the soft panic of people trying not to show it. Emma listened to the hum of this life that had been hers so completely she forgot to imagine any other. She could stay. She could keep doing the work that mattered regardless of who was introduced in front of a mahogany table. She could be the person residents called at three a.m. because she answered, because she always answered.
Or she could drive six hours south again. She could walk past the bakery window that fogged with sugar and heat. She could accept coffee thick enough to stand a spoon in. She could ignore the vendor calling Taho! and remember not to buy an extra cup that would go undrunk. She could see a man with a man bun who said things like fate with a straight face. She could stand at the edge of a forest that had once swallowed her whole and kept her safe while the world called her ridiculous. She could be where her grandmother's name still lived in other people's mouths like a blessing. She could start over somewhere that had never asked for her resume, only her presence.
It wasn't that she wanted to run. She had never been a runner. It was that something was moving in her peripheral vision, steady and certain, the way dawn arrives even on days you hope it will forget to. She realized then that the strange pull she had felt since stepping foot in Panganiban wasn't a rope on her ankle dragging her backward. It was a tide, and tides do not negotiate; they simply keep the moon's promises.
She tucked the compass back into her bag and stood. Outside, the city pressed its forehead to the glass. Inside, the hospital made a sound like breathing.
She told herself, as honestly as she could, that she would not make any decisions tonight. She would go home, cook something simple, lie down, and let sleep attempt what competence could not. She would show up tomorrow, because that was what she did. She would be kind to patients because that was who she was. She would answer the interns' questions and not let her voice crack where they could hear it. She would keep the promise she made to herself at twenty-three: that she would be a person who did not lose herself where the system was broken.
She lifted her bag to her shoulder. The card inside didn't weigh much, but she felt it anyway, like a coin sewn into a hem for luck. She took one step toward the elevator, then another, and the building did not crumble; it only stayed itself.
In the glass of the elevator doors, her reflection looked back: composed, tired, unwilling to be smaller because a younger woman with a different last name had been positioned above her. The elevator chimed. The doors opened. The afternoon moved with her.
Panganiban, she realized—not for the first time and not for the last—was not a place she was trying to run back to.
It was a place walking toward her.
And she was finally standing still enough to feel it arrive.