The call came on a Wednesday afternoon, ordinary in its timing and disruptive in what it carried. James was at the outpatient lab, halfway through a stack of consults, when Henry Bassman appeared at the door. “Do you have a minute?”

There was something in the way he said it that made clear this was not about one more case. James set his pen down. “Of course.”

Peterson was already in the conference room, one ankle crossed over the opposite knee, a folder resting on the table in front of him. He looked less like a hospital director than a man about to explain why someone else’s week had just become his problem.

James took the empty chair. “What happened?”

Peterson slid the folder toward him. “One of the dermatology groups in San Diego owns its own lab,” he said. “Their dermatopathologist is out. Serious illness. No clear return date.”

James opened the folder. The numbers told the story quickly—steady volume, established referral base, physicians accustomed to consistency. “They reached out to us?”

Bassman nodded. “Specifically.”

“How?”

“They asked Alex first.”

James’ eyes shifted slightly. “And?”

“He said no,” Bassman said. “Couldn’t make the commute.”

Peterson leaned back. “Then he gave them your name.”

That landed differently. James didn’t respond right away. Alex had every reason not to make that recommendation. James joining SCPMG had cost him something real, even if neither of them had ever said it out loud.

“That was generous,” James said finally.

“It was,” Bassman replied.

“They need coverage immediately,” Bassman continued. “Sign-out, oversight, stability. The technical lab is still intact. What’s missing is confidence.”

“For how long?” James asked.

“Temporary,” Peterson said. Bassman glanced at him.

“How temporary?”

“Two months. Maybe three.”

It was said cleanly. No one challenged it. James looked back at the numbers. “You want me in San Diego every week?”

“Enough to keep it from slipping,” Bassman said. “Sunday night down. Friday back. We’ll manage the rest here.”

James closed the folder halfway. “And my cases here?”

Bassman didn’t hesitate. “We’ll distribute what we can.”

“What about the consults asking for me?”

A brief stillness. “We’ll triage them,” Bassman said.

“How?”

“Routine work gets covered,” Bassman replied. “Anything that needs Dr. Deetan—we hold.”

James nodded. “That’s going to slow things down.”

Bassman met his eyes. “Yes.” A moment passed. “You’ll be off call while this is going on,” Bassman added. “No overnight coverage. No weekends.”

James looked at him. “That’s not nothing.”

“No,” Bassman said. “It isn’t.”

Peterson leaned back slightly. “This won’t go beyond two months.” The room accepted that. No one confirmed it. “They also want the reports in their system,” Peterson added.

James looked up. “Their system?”

Peterson nodded. “They’re not going to accept outside reporting long-term. Everything has to land in their records.”

“And we can’t do that from here,” James said.

“Not yet,” Peterson replied.

A brief silence. “So until that’s built,” James said, “I have to be there.”

Bassman nodded once. “Yes.”

“We’ve handled things like this before,” Peterson continued. “If we set it up correctly, it won’t require you on-site forever.”

James looked at him. “How?”

“That’s where Jake comes in.”

James leaned back slightly. “Jake.”

“He knows our lab system,” Peterson said. “Not just how to use it—how to work around it.”

“That sounds unstable.”

“It’s effective,” Peterson replied.

Bassman added quietly, “And necessary.”

By the time the meeting ended, the plan had already begun to take shape. James would start the following week. The rest would follow.

He drove home with the folder in the passenger seat and Alex’s name still carrying more weight than San Diego itself. The traffic blurred into something indistinct by the time he reached Palos Verdes. The house stood quiet when he walked in, the late light settling across the floor in long, even lines.

Deanna was in the kitchen. She looked up and knew immediately. “What happened?”

“San Diego.” She waited. “One of the dermatology groups down there lost their dermpath coverage. They want help.”

“For how long?”

“They said temporary.”

She smiled faintly. “So not temporary.”

“Probably not.”

“Why you?”

“They asked Alex first.”

Her expression changed. “And?”

“He said no,” James said. “He gave them my name.”

She understood what that meant without asking anything further. “That was gracious.”

“It was.”

He rested a hand lightly on the folder. “I think I have to do this.”

She nodded. “Because they need you?”

“Yes.”

“And because you can.”

He looked at her. “Yes.”

“Then the question is whether we can,” she said.

That landed more precisely. They talked through the logistics the way people do when something has already been decided. Travel. Timing. Teaching. The weekly sessions at City Hospital Bassman had already agreed to protect.

“That can’t go away,” Deanna said.

“It won’t.”

“Good.”

“Are you going to resent this?” she asked.

He considered it honestly. “Not now.”

“That’s not the same as never.”

“No,” he said. “It isn’t.”

Her hand moved almost unconsciously toward her abdomen. Neither of them commented on it.

“I don’t want to do this badly,” he said.

“You won’t.”

“You can’t know that.”

She looked at him. “I know you.”

The next morning, James found Devon already moving through the lab, catching things before they became problems. “Do you have a minute?”

“That depends,” Devon said. “Is this one of those minutes?”

“It might be.”

Devon set the papers down. “Alright.”

James handed him the folder. Devon skimmed it quickly. “San Diego.”

“Yes.”

“They want you down there.”

“Yes.”

“For how long?”

“They said two months.”

Devon gave him a look. “Right.”

“They asked Alex Kim first.”

Devon nodded. “And he sent them to you.”

“Yes.”

Devon tapped the page once. “That’s class.”

“It is.”

“And they’re going to hold cases for you,” Devon said.

“Some.”

“That’s going to stack.”

“I know.”

Devon leaned back slightly.

“We can move slides this week,” James said.

Devon shook his head. “Moving them isn’t the problem.”

James waited. “Matching them is,” Devon said. “If their case numbers don’t line up with how we accession in our lab information system, we’re going to spend more time fixing errors than reading cases.”

“How long?”

“To make it clean?”

Devon considered.

“Two months.”

“So even if we move the slides…”

“It doesn’t matter,” Devon said. “Not until everything lines up.”

James nodded. “That’s why I’m talking to you.”

“We’ll need a controlled pickup,” Devon continued. “Daily. Same time. Logged. No exceptions. And whatever Jake builds has to match it.”

“We should probably call Jake,” James said.

Devon nodded once.

“Yes.”

Jake met them that afternoon at Premiere. He looked almost exactly the same—contained, observant, already processing the room before anyone finished explaining it.

“Dr. Deetan,” he said.

“Jake.”

“It’s been a while.”

“Yes,” James said. “I heard you made your way down here.”

Jake nodded once.

“Eventually.”

A small silence passed between them. Measured. Peterson outlined the situation. Jake listened, asked a few precise questions, then looked at the documents. “What system are they on?”

“Clinic side is Mediprompt,” Peterson said. “Lab side is older.”

Jake nodded. “And we need to bring that into our system.”

“Yes.”

“We’re not just mapping orders,” Jake said. “We’re mapping results back into their system. If it doesn’t land correctly, it doesn’t exist to them.”

“And until that’s working?” James asked.

Jake met his eyes. “You’re how it gets in, Dr. Deetan.”

“We can stage the feed first,” Jake continued. “Orders in, results out, manual reconciliation in the middle.”

Devon nodded slightly. “That buys us time.”

Jake glanced down again, pausing briefly before continuing. He didn’t need to stop. But he did. “We’ll make it work, Dr. Deetan.”

By the end of the day, the plan was in place. Not finalized. Just moving.

That night, James stood again at the window, his overnight bag resting near the door. Deanna came beside him, her hand finding his without asking. “When do you leave?”

“Sunday.”

She nodded. “Then we have a few days.”

“Yes.”

Outside, the coastline held its curve in the dark. Inside, something had shifted. Not broken. Not yet. They had taken him off call. It didn’t give him his time back.

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