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The neurosurgery floor was too quiet for 2 a.m.
Not hospital quiet- nothing in a hospital was ever really quiet- but muted. Dimmed lights. Distant monitor alarms. The hum of ventilation in the walls. Enough silence for Nagisa to hear the scratch of his pen and the ache forming behind his eyes.
His office door was open a crack.
That was the mistake.
“You look haunted.”
Nagisa didn’t look up from the angiograms spread across his desk. “Go away, Akabane.”
Instead, Karma leaned against the doorway with a coffee in each hand like he owned the place. His tie was gone, sleeves rolled up, white coat wrinkled from a shift.There was probably formaldehyde somewhere on him.
“You’ve been up here for four hours.”
“I know.”
“You forgot dinner.”
“I know.”
“You’re muttering.”
Nagisa finally glanced up. “You autopsy people are disturbingly observant.”
“Occupational hazard.”
Karma walked in anyway.
Nagisa immediately regretted acknowledging him because now he was circling the office like an overfed cat. Looking at scans pinned to the board. Picking up papers. Sitting on the edge of the desk.
Nagisa snatched a chart from his hand. “Don’t touch that.”
“Ooh. Sensitive.”
“I’m serious.”
Karma took a long sip of coffee instead. “What’s got you spiralling?”
Nagisa rubbed a hand over his face. “Post-op complication. Forty-three-year-old male. AVM resection three days ago. Surgery went clean. Imaging looked fine. Then suddenly right-sided weakness and aphasia.”
“Stroke?”
“That’s what it should be.”
“But?”
“But it isn’t acting like one.” Nagisa gestured sharply at the scans. “There’s edema, but not enough. No hemorrhage. Perfusion’s strange. Labs are weird. He keeps deteriorating in intervals instead of progressively.”
Karma hummed thoughtfully, like this was casual dinner conversation and not someone’s collapsing brain function.
Nagisa stared at another scan, jaw tight. “I’m missing something obvious.”
“You haven’t slept.”
“I slept.”
“When?”
“…Tuesday.”
“It’s Thursday.”
Nagisa ignored him.
Karma swung slightly where he sat on the desk. “You know, normal people have hobbies.”
“I do have hobbies.”
“Medical journals don’t count.”
“They absolutely count.”
Karma grinned. “You’re one bad case away from becoming the guy who keeps string maps on his wall.”
Nagisa pointed at the door without looking at him. “Leave.”
“No.”
“Karma.”
“You get mean when you’re thinking.”
“You get annoying when you’re alive.”
“Aw. You do care.”
Nagisa exhaled sharply through his nose, trying very hard not to smile because that would encourage him.
Unfortunately, Karma noticed anyway.
“There it is,” he said smugly.
“Please go bother literally anyone else.”
“I tried. They said I’m your problem.”
"I hate everyone in this hospital"
Karma slid off the desk and wandered behind Nagisa’s chair before Nagisa could stop him. Warm hands settled briefly on his shoulders.
Nagisa stiffened automatically.
“You’re tense,” Karma said.
“I’m working.”
“You’re turning into a fossil.”
Nagisa shrugged him off half-heartedly. “Some of us contribute to society.”
“Hey, I contribute. I tell dead people secrets.”
“That’s not forensic pathology.”
“It is spiritually.”
Nagisa pinched the bridge of his nose.
Karma leaned down beside him, chin nearly on his shoulder now, both of them staring at the scans. Nagisa could feel the warmth coming off him, annoyingly distracting.
“Okay,” Karma said after a moment. “Explain it to me like I’m stupid.”
“You are stupid.”
“Explain it slower, then.”
Nagisa should not have indulged him. He knew that. But he also knew the weird trick of talking through a problem out loud sometimes helped untangle it. So he started explaining. Surgery timeline. Symptoms. Imaging progression. Differential diagnoses. He talked with clipped irritation at first, but gradually slipped into the focused rhythm he used during conferences.
Karma listened more carefully than anyone expected him to.
That was the dangerous thing about him.
He acted careless, but he noticed everything.
Nagisa was halfway through describing inflammatory markers when Karma interrupted.
“Wait.”
Nagisa frowned. “What?”
“The deterioration intervals.”
“Yes?”
“And the inflammatory response started before the weakness?”
“…slightly.”
“And you said his blood pressure spikes happened first?”
Nagisa went still.
Karma pointed lazily at one of the scans. “Could it be vasospasm?”
Nagisa blinked once.
Then twice.
“…No,” he said automatically. Then paused. “Wait.”
He grabbed another chart fast enough to nearly knock over his coffee.
Karma watched him with unbearable satisfaction.
Nagisa flipped through notes, scanning medication timings, transcranial Doppler results—
“Oh, you have got to be kidding me,” he muttered.
“What?”
Nagisa sat back hard in his chair. “Delayed cerebral vasospasm secondary to inflammatory response.”
Karma grinned slowly. “So I solved neurosurgery.”
“You absolutely did not.”
“You’re welcome.”
Nagisa was already reaching for the phone. “I hate you.”
“Mm. Buy me breakfast first.”
Nagisa pointed at him again, but there was no force behind it this time.
Karma just looked delighted with himself.
Five minutes later, Nagisa was coordinating new orders with the ICU team while scribbling notes at alarming speed.
Karma remained in the office the entire time. Feet kicked up on the desk. Drinking Nagisa’s untouched coffee. Smiling like he’d won something.
Eventually, Nagisa hung up the phone with the ICU and finally leaned back in his chair.
The adrenaline was starting to settle now that there was an actual plan in motion. Orders entered. Consults called. Medications adjusted. The problem was solvable again. Which meant his brain had enough free space to remember Karma was still there.
Still in his office.
Still drinking his coffee.
Nagisa narrowed his eyes. “That was mine.”
Karma looked down at the cup in his hand. “Ah. That explains why it tastes miserable.”
“You put six sugars in everything.”
“Life is cruel enough already.”
Nagisa snorted softly despite himself and returned to rearranging the disaster spread across his desk. He stacked scans into neat piles with the aggressive precision of someone trying to regain control of his surroundings.
Karma watched him for a moment.
Then, quieter, “You okay now?”
Nagisa paused.
“…Yeah,” he admitted. “I think so.”
The answer seemed to relax something in Karma’s posture too, though he disguised it immediately by stretching dramatically across the visitor chair like a cat claiming territory.
“You’re welcome for saving your patient, by the way.”
“You made one suggestion.”
“A brilliant suggestion.”
“A lucky suggestion.”
Karma gasped. “Unbelievable. This is how geniuses are treated.”
Nagisa rolled his eyes, but his mouth curved faintly.
Silence settled for a minute after that. Comfortable this time.
Outside the office, someone hurried past with squeaking shoes. A distant overhead page crackled through the hall. The hospital never really slept.
Nagisa glanced over eventually.
Karma looked exhausted.
Not visibly, not to most people. But Nagisa knew him well enough to catch it in the slight droop of his shoulders and the slower blinking.
“You’ve been here almost as long as I have,” Nagisa said.
“Mhm.”
“What did you even do today?”
Karma made a face immediately. “Do you want the HR-approved version or the pathology version?”
“The pathology version.”
“Dangerous choice.”
Nagisa set his pen down fully now, turning slightly toward him. “Tell me.”
Karma spun the coffee cup idly between his hands. “Three autopsies. One suspected overdose that wasn’t actually an overdose. One drowning.”
His tone stayed casual, but Nagisa noticed the way his gaze unfocused slightly. Cataloguing.
Compartmentalizing.
“And?” Nagisa asked gently.
Karma sighed theatrically. “And one guy who exploded.”
Nagisa blinked.
“…What?”
“Industrial accident.”
“Karma.”
“I’m serious.”
Nagisa stared at him flatly.
Karma held eye contact for exactly three seconds before grinning. “Okay, partial explosion.”
“That is not better.”
“There were pieces.”
Nagisa rubbed his face. “Why do I ask you things?”
“Because you love me.”
“You’re deeply irritating.”
“Yet here we are.”
Nagisa shook his head, but there was no real bite to it anymore.
Karma continued, voice lighter now, “Anyway, the overdose case was weird. Guy had enough fentanyl in his system to kill two people, except toxicology timing didn’t line up with lividity.”
Nagisa frowned automatically, drawn in despite himself. “Body moved?”
“That’s what the detectives thought.”
“But?”
Karma pointed at him. “See? This is why we’re friends. You get it.”
Nagisa ignored that part entirely. “So?”
“Insulin.”
Nagisa’s brows lifted slightly.
“Tiny injection site between the toes,” Karma said. “Someone tried to stage the fentanyl after he was already dead.”
“…That’s actually clever.”
“I know. Murderers are getting creative. Very rude of them.”
Nagisa huffed out a quiet laugh.
For a second neither of them spoke.
Then Karma tilted his head at him. “You know this is incredibly unhealthy, right?”
“What is?”
“This.” He gestured vaguely between them. “Our conversations.”
Nagisa frowned. “Why?”
“Normal people don’t relax by discussing cerebral vasospasms and homicide.”
Nagisa considered that seriously for a moment.
“…Maybe that’s why I like talking to you.”
Karma went unexpectedly still.
Not dramatic. Just a tiny pause.
Then he smiled, smaller this time. Realer.
“Yeah?” he said softly.
Nagisa realized, a second too late, how that sounded.
He immediately looked back down at his paperwork. “Don’t make it weird.”
“Oh, I’m absolutely making it weird.”
“Karma.”
“You basically confessed.”
“I did not.”
“You practically proposed.”
Nagisa grabbed a folder and threw it at him.
Karma caught it effortlessly, laughing loud enough that someone passing the office glanced in with concern.