Chapter Text
Ethan rolled over to put his arm around Casey, but his bed was empty. He found her sitting alone, wrapped in a blanket on his balcony. The twinkling lights of the Boston skyline sparkled in her eyes, but the expression on her face made it clear that she was carrying the weight of the world on her shoulders.
He knelt next to her and lovingly took her hand in his, “Casey, what’s the matter? How can I help?”
She remained silent, vacantly staring out into the city she had grown to love. “I’m not sure you can,” she said, her voice no more than a whisper.
“I’m sorry, Casey, I didn’t mean to….”
She cut him off. “You didn’t do anything wrong, Ethan. What you said tonight, that’s just reality that I’ve been pushing out of my head for too long. You did me a favor by forcing me to accept it and, now that I have, I….” she trailed off.
Ethan took her in his arms, “Would talking about it help? Or I can just hold you, whatever you need.”
“Remember the night in the hospital when we were not sure if I would survive?”
“As if I could ever forget.”
“Remember when I told you that I wished I had loved more? That I was always so fixated on the next step that I never took time to enjoy where I was. I avoided love because I knew I would be moving on in the next few years, so why bother becoming attached?”
Ethan nodded slowly. “Well,” she continued, “I didn’t do that here. I opened my heart, my friends, they’re the best I’ve ever had, they’re family.” She turned to look at him, her eyes brimming with tears, “Then there is you….” her voice broke and she couldn’t contain those tears any longer.
Ethan held her tightly, rocking her in his arms and repeating, “It’s OK, Casey, it will be OK, I’m here.” He raised his eyes to the sky in an attempt to stop his own tears from flowing. He believed that she needed him to be strong and supportive, and he was determined to be that for her, even if he was crumbling inside. As he reassured her that she would be alright no matter what path she chose, he questioned how he would be able to go on if she decided to leave Boston, and him, behind.
“I almost died, Ethan! How could I be so stupid to not learn the lessons it taught me?” her voice became angry as she pulled back from him.
“What do you mean? You did learn, you said it yourself, you have your friends, you have me….”
She stopped him cold, “Do I, Ethan? Did I ever?“
He pulled back, a stunned expression on his face, “What are you talking about, Casey?” his voice conveying equal parts of confusion and hurt, “You know how much you mean to me, of course, you have me.”
“To a degree, perhaps I do,” she said as her tone softened, “but no matter what we feel for one another, we can never take that next step, and, right now, I just keep thinking…why? I mean, in my head, I created this idea of a future here, working at Edenbrook, getting a little place in Boston… with you by my side. But I never thought to ask if you wanted the same thing. Did I just assume? Was I afraid of what your answer might be? Or, deep down, did I know it was just a fantasy and that, once again, I would be moving on.”
Ethan noticed Casey was shivering in the cold night air; he wrapped the blanket around her. “Casey, I…” he stammered, “I have never had a relationship like this… I honestly don’t know how to do a relationship like this…but I am trying. I’m sorry if I have not been able to give you what you have needed.”
She turned and looked at him starkly, “Do you want me to stay?” The words darted out of her mouth involuntarily. She didn’t realize they left her tongue before she heard them with her own ear. They were direct and demanding as if she had been holding them back forever and could not bear to keep them in a moment longer.
Ethan’s eyes glazed over as he swallowed. He cupped her cheek in his hand, he tilted his head to look at her, “More than anything,” he said, “but, Casey, you have the ability to be the best doctor this field has ever seen! Better than Naveen, better than me! I see that in you, and I couldn’t live with myself if I held you back. It would be … so selfish.”
She looked directly ahead and hugged her knees tightly against her chest. The silence that followed lasted moments, but it felt like an eternity.
“Can we stop talking about it right now?” she asked, “I just can’t anymore. I want to go back to bed. I want to make love to you and sleep in your arms just one more night. It’s not avoidance. It is just having one more night before I have to face the weight of the choices before me.”
Without a word, he scooped her up into his arms and carried her back to his bedroom. He was eager to give her everything she needed except, perhaps, the one thing she needed the most.
One month later
Casey sat at her kitchen table with several offer letters scattered before her. Jackie walked in and poured herself a cup of coffee, “Have you made a decision yet?”
Casey shook her head, “No, I haven’t.”
“Are you even leaning toward anything?”
She sighed, “Well, Cleveland Clinic, UCLA, and NYU Langone are the top contenders. They all have excellent programs, but so does Edenbrook, and they presented an excellent offer to keep me on.” She shrugged, “What about you?”
“I’m hoping to stay here. If Edenbrook makes me an offer, I am staying put.”
“How do you know that’s the right choice?”
“I love the work I have been doing and, despite the challenges of the past few years, I love the hospital, the staff, and the city. I’ve made a home here personally and professionally. In fact, if Edenbrook doesn’t work out, I’m inclined to take the offer from Brigham so I can remain in Boston.”
“Well, I am happy for you, and I really hope I get that same clarity soon. But for now, I better get to work.”
Casey arrived early and found Tobias already in the office. “Hey there, Sunshine!” he said, handing her a cup of tea.
“How did you know just what I needed?”
“I’m just that kind of a guy. So, how you doing?” he said as he took a seat and gave Casey his full attention. “Have you made up your mind? Will we still be colleagues in the fall?”
“I haven’t. I mean, clearly, I would have a great future here, but Cleveland….”
“It’s pretty much the best in the world.”
“It is. But NYU Langone is dedicating major resources to expand its diagnostic team. They want to be the world leader. If I can get in on the ground there, I could launch my career in ways I never imagined.”
“All true.”
“You’re not helping.”
He laughed. “Case, can I give you some advice? I am confident that you are going to have a phenomenal career wherever you land. Every offer you have received is top-notch, including the one here at Edenbrook. You just have to look inside your heart. Do any of these places offer something radically different than the others? Then, there are other factors,” without realizing he looked to Ethan’s desk, “you have a life here. Are you happy with it? Or is this the right time to start anew?”
She took a sip of her tea, “Do you realize you looked at Ethan’s desk when you said that?”
He smiled, “No, I didn’t realize. But I would take it he is a factor too.”
She turned to Tobias, “Yes. But…will you keep this between us?”
“Of course.”
“In all this time… and I know I mean the world to him… but do you know he has never once told me he loves me?”
Tobias tried to hide his shock, but the look on his face gave it away. “Well, I love the guy, but he has always been a bit of a jackass. For someone so smart medically.….” He stopped and shook his head. “Casey,” he said with total sincerity, “that doesn’t mean that he doesn’t love you, but that still does not make it right. But, I have to ask, have you ever said it to him?”
“No.”
“Then I think you need to ask yourself why and, until you can answer that question, I would not factor him into making your choice.” He stood up and patted her on the shoulder as he walked to the door. “Don’t worry, kid, I know you will make the right decision in the end.”
Casey turned to look out the window. The early summer sun was shining brightly. Its warmth felt so comforting, the comfort she desperately needed as Tobias’s question lingered in the air. She felt a bit of an ache in her heart. Why hadn’t she ever told him? Was she unsure of her own feelings? Or was she afraid to hear how he would respond?
Two weeks later
Casey sat alone at the bar in Donahue’s. It was early and she was one of the few patrons there. She rested her forehead on her hands as she stared at the glass of scotch sitting before her. She needed to decide what offer she would accept within the next couple of days, yet she remained no closer to making her choice.
She finished her drink and waved goodbye to Reggie. “Have a good afternoon, beautiful!” he yelled as she grabbed her purse.
As she took in the empty bar, memories came crashing back, and it was as if she was transported in time. Suddenly, it was the first night she ever stepped foot in Donahue’s, sitting next to Ethan at this same bar as her friends laughed in the background seated in what would become "their booth.” How did the time go so fast yet also feel like a lifetime ago? A wan smile crossed her lips as she turned to leave.
She needed to clear her head and taking the T to the Seaport would probably be the best way to do that. Ever since she arrived in Boston, that was the one place that consistently brought peace. As she strolled along the Harborwalk, she knew she had made the right call. Her anxiety dissipated almost instantly as she spent the afternoon doing some of her favorite things. She bought a cone from her favorite ice cream shop, listened to street musicians, and delighted in watching young children as they chased seagulls on the promenade. It was such a peaceful day, precisely what she needed! But the setting sun served as a reminder that time was running out and she could not put off her difficult choices any longer.
She reflected on her time in Boston and how it had become her home. She thought about Dolores, the first patient she lost, and how the pain of that night haunted her to this day. Casey wanted to keep Ethan out of her thoughts, but it was impossible to recall that night and not think of him, just as it was with so many other things. Together they drove to find the stuffed frog Dolores bought for her unborn baby. Together, they sat vigil over his incubator when his mother lost her life shortly after his birth. While losing patients never became easy, Casey now understood the lesson Ethan taught her that night. Sometimes, even when everything is done right, death may still be the outcome. A doctor merely delays the inevitable. She thought about Mrs. Martinez. She remembered the days when she and Ethan clandestinely treated Naveen and the bond that formed between them as a result. She dabbed a Kleenex against her eyes. Ethan was right, Edenbrook was her foundation and all these lessons made her the doctor she was today but was there more to gain by remaining here? She believed the answer was yes. Casey knew she could help bring the team to a new level. She had big ideas, like creating specialties within the diagnostics department: pediatrics, oncology, and more. It could be revolutionary, and she would be a pioneer in creating this new vision. What’s more, the relationships she already built at Edenbrook would ensure that her voice would be heard.
But the other offers she had received were too impressive to dismiss. As she mulled them over, she quickly realized that the only option she wanted to consider was New York. She always dreamed of living there and her recent visit only served to reinforce that desire. As she strolled on the Highline, jogged through Central Park, and took in the museums and Broadway, she knew she would be happy there. Also, NYU Langone would be an incredible place to land. They were building a state-of-the-art wing for the diagnostic department. Their commitment to its growth was unparalleled, and their top-notch staff, headed by Dr. Peterson, were among the best in the world. She already learned under two of the best doctors in her field, and the opportunity to work with another could be invaluable.
Finally, Tobias was right; she needed to figure out why she never told Ethan that she loved him, and she needed to understand that before she made her final choice. Did she really love him? Her answer came instantaneously, God, yes, I love him! I love him like crazy, she thought. So why didn’t she share that with him? It came down to fear. His ambivalence still haunted her; his ability to push her away was still painful and impossible for her to understand. Even at their start, she knew they shared something special and that it was worth taking a risk on, and he… he did not. Or did he? In the end, he wasn’t able to fight what he felt for her. He broke his own rules and went against his own ethics because he couldn’t let her go, no matter how hard he tried. Yet here they were, three years later, and he was willing to watch her walk out of his life without the slightest effort to get her to stay. What did that say? Why was he unable to finally take the next step with her? Why, in all this time, did he never manage to say those three little words?
Given their history, she couldn’t be the first. She felt too vulnerable, and she certainly didn’t want him to feel obligated to say it in response to her. It needed to come of his own volition. But it never did. Not even to this day, after all they had been through together, and that was a sad fact that she finally had to accept. At that moment, she realized, no matter how much she longed for him to be, Ethan could not be a factor in her decision, and that hurt her more than she could have ever dreamed possible.
Casey let out a shaky breath as she stood up and walked over to the railing overlooking the bay. She had made her choice. Tomorrow, she would make her announcement and begin the next phase of her life. But tonight, she wanted to enjoy the tranquility of the evening before she headed back to her home and the reality that awaited her. As she backtracked her steps on the Harborwalk, a wistful smile remained on her face. There were more emotions than she could name welling up inside her, but the greatest two were relief and determination. For the first time since that night on Ethan’s balcony, she felt at peace.
The Seaport was bustling with activity, waterside restaurants and bars were busy, music and chatter filled the air as joggers and runners whizzed by. It was so loud that Casey didn’t hear the booming voice coming from behind until it was almost upon her. “Casey!… Casey!…CASEY!” She turned around and saw Ethan, several yards away, running toward her.
“Ethan, what are you doing here?”
He momentarily leaned over, hands on his knees, as he caught his breath. Ethan was in top shape, so Casey knew he had to be running frantically to be in this condition.
“Are you OK?” she asked.
“Yes, yes,” he said as he caught his breath and stood up straight, “Oh, thank God I found you. We were all worried.”
“Worried? Why? No one called me…” she went to take her phone out of her purse as Ethan handed her the very phone she was searching for.
“You left it behind at Donahue’s. Reggie gave it to me when I passed by looking for you.”
“Oh, God, I’m sorry I worried everyone! But… how did you know to find me here? I didn’t tell anyone where I was going?”
“Well, I do know a thing or two about you, and being at the Seaport always brought you peace. Knowing how much you have on your mind right now, my gut told me you would be here.”
She offered a small smile and placed her hand on his chest as he pulled her into his arms. “I guess you have been paying attention,” she said. While that pleased her, it did not stop her heart from aching as she reflected on the realizations she had come to about their relationship today.
“Wait a minute, why aren’t you at work? You’re on the schedule today. You said you were looking for me. Is everything OK?”
Ethan let out a soft breath as he took her hand and gently led her to a nearby bench.
“Casey, I was sitting at a red light heading to work when it hit me. I have been such an ass because while I knew it to be true, I never let you know, and I needed to rectify that right away.”
“What, what are you talking about? Wait… you didn’t go to work? You never call out of work, Ethan, what’s going on?”
“Casey, work isn’t important right now. You are. You are the most important thing in my life.”
Her eyes opened wide and her heart began to race as she gazed at Ethan, perplexed and anxious. He gently turned her head to face him. She realized she never saw his eyes like this before, a combination of earnestness, vulnerability, hope, and fear boiled together, giving her just a glimpse into his soul. Taking both of her hands in his, he spoke,
“Casey, Casey Rose MacTavish, I love you. I love you with all my heart and I have for so long. I’ve been a fool for not telling you, for not admitting what has been in my heart and I couldn’t let another second go by. Before you came into my life, I never believed that love like this existed. I thought soul mates were some ridiculous concept created by people who needed to live in a fantasy, and now, now I know that’s not true. I don’t think everyone is lucky enough to find that person, but I have found mine, and, Casey, I’ll be goddamned if I am ever going to let you go.”
“Ethan,” she muttered, but he put a finger gently to her lips.
“I know you have a big decision to make, and I want you to make the one that is best for you and your future, but Casey, I want to be a part of that future. If you chose to stay at Edenbrook, then I want us to build a life together here. If you decide to leave… well, I am one of the top doctors in the world, Case, I can get a position anywhere… so, if you choose to leave, I want to go with you. I will be happy to start our life together wherever you land because, frankly, a life without you in it is not an option to me. A life without you is not a life worth living. So, if you will have me, I will follow you to any corner of the world because… because I love you and I could never let you go.”
Casey sat quivering in stunned silence. She bit her trembling lip as a single tear slowly rolled down her cheek, glistening in the moonlight. Ethan raised his thumb to brush it away. He looked into her eyes, and he was certain she never looked more beautiful than she did at this very moment.
“Casey, will you have me? Will you let me spend the rest of my days by your side?”
Choking back tears, Casey threw her arms around his neck and held him so tight it took his breath away.
“Oh my God, Ethan! Oh my God! Yes! Of course, I want you with me. I love you!! I love you so very much, and…” she stopped as a realization of what he just said came over her, “Ethan,… you, you would follow me?”
“Casey, I would do anything for you.”
With her tears now falling freely, Casey jumped up and threw her arms around him. Ethan reached forward and placed his lips on hers. Their kiss was deep, passionate, and filled with a fire they had never felt before. He leaned back, lifting her feet off the ground as he let out a joyful moan. She gazed up at him as he placed her down gently. Her smile was never brighter, and neither of them had ever experienced this much joy.
“It took you long enough!” she laughed as she wiped away her tears.
“I was foolishly delaying the inevitable,” he said smiling. “Do you forgive me?”
“Always,” she said stroking his chin before giving him a lingering, tender kiss. “Now, can we please go to your apartment? I think we need to celebrate this moment properly!“
He gave her a sly grin as he took her under his arm, “Of course we can. Casey, I love you so much.”
Two months later
Casey stood in a large, beautiful room flooded with sunlight streaming in from the floor-to-ceiling windows surrounding it. They provided stunning views of the bay, but more importantly, there was a perfect view of the promenade where Ethan professed his undying love to her just two months before. She lovingly gazed in that direction as she unpacked a box on the dining room table. Ethan walked from behind her and wrapped his arms around her waist, kissing her gently on her neck. As she turned around to stroke his cheek, the sun reflected off of the beautiful diamond ring on her left hand, creating beams of radiant light around them.
“You need to stop unpacking.” He said, “It can wait, your friends will be here any minute now.”
“I just wanted to get these glasses out. We used these for a toast the night we moved into our apartment together as interns. I want to use them again tonight.”
He smiled and kissed her cheek. “Then give me, I’ll wash them while you go and get changed.”
As Casey dressed, the business news was playing on the radio Ethan kept by his bedroom chair. “…In other news, Edenbrook and Mass General Hospital have announced their merger will be finalized by the end of the year. With Bloom Industries divesting all interests in the hospital, Mass Edenbrook is poised to be the premier hospital in the region….”
Casey looked down at the ring on her hand, then to the framed picture of them that Ethan kept on his nightstand, and she smiled. She made the right choice; she was exactly where she was meant to be.
A half-hour later, Sienna, Jackie, Aurora, Elijah, Bryce, and Raf were seated on the ample, plush sectional in the living room.
“This place is just freaking amazing!” Jackie said.
“What made you decide to move?” Raf asked Ethan, “I mean, your old place was pretty incredible too.”
“Well, it was important to me that we have a brand new place where we could begin our new life together,” he replied.
“Plus, it is bigger, so there is more space for us,“ Casey added.
“Yes, for us and anyone else that may come along,” Ethan said while gently kissing Casey’s hand as she blushed.
“One thing at a time, dear,” she said taking his face in her hands, “I think we’ve had enough change for a while.”
She was right; with their residencies now in the past, things were about to change forever. Elijah and Jackie were also offered positions at the new Mass Edenbrook; Sienna decided to start a private pediatric practice in Cambridge. Aurora was leaving for Yale-New Haven Hospital, fortunately just a 2-hour drive away.
“I am so happy that we will still be close to each other,” Sienna said, “Although I wish you weren’t so far away, Aurora.”
“It’s not very far, Sienna. Plus, with Casey and Ethan’s wedding coming up, I will be here all the time. I’m not missing out on all that fun!”
“Well, I think a toast is definitely in order!” Casey poured champagne into the glasses she had unpacked earlier.
“Ohmygod!” Sienna squealed, “These are the same glasses we toasted with when we moved into our apartment!”
Jackie smiled warmly, “We’ve come full circle.”
Everyone raised their glasses, “To the best damn residents Edenbrook has ever seen!” Elijah yelled, “To the best friends anyone could ever have!” Jackie added, “And to the future, may it be as bright and beautiful as the past we shared together!” Casey said beaming. They clinked glasses. CHEERS! CHEERS! CHEERS!
“This may be the best day of my life,” Casey said leaning into Ethan.
He kissed her on the top of her head, “Well, then I am going to have to work harder to make every tomorrow just a little bit better.”