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Come on, come on
Put your hands into the fire
Explain, explain
As I turn and meet the power.
One, two, three, four… Amelia counts in her head as she scrubs in, the rhythm and familiarity of it comforting her. The water running over her hands, the pure adrenaline in her veins, this surgery more than ever before.
She glances around the scrub room, taking it in. She’s stood in this very spot countless times. So has her brother and her sister and many other surgeons before them.
What sets me apart from all of them? She wonders.
She looks up when she hears the door to the operating room slide open, and sees David walk in, stubborn as always. Soon he’s on the table and she can see the nurses preparing anesthesia and draping him properly. Getting him ready.
Getting him ready for her to drill into his brain and inject their stem cells, in the hopes of creating modified, dopamine producing cells. Wow, this is terrifying. Before Amelia can get too lost in her thoughts the scrub room door opens.
Kai. The past several hours come flooding back to her. They had kissed. They had kissed. But a nurse had interrupted them and pointed them towards David's room. He went into surgery, and everyone got a few incredible hours of sleep before he was awake again and demanding brain surgery.
Kai and Amelia hadn’t even been in a room alone since the kiss. They hadn’t discussed it, hadn’t had the chance to. Everything was so incredibly crazy and fast and like a whirlwind.
They push open the door and stare at Amelia, pulling her back to reality. Their hands are in their pockets and their eyes are curious as they watch her. Finally she looks up to meet their gaze.
“So um, I just wanted to say good luck.” They definitely feel out of place here, rocking back on their heels and glancing around the room. Despite this, they still give her one of those smiles that makes her knees weak.
“Yeah, thanks.” Amelia genuinely doesn’t know what else to say, instead focusing on her hands and the water. Anything to get away from the tension quickly building in this very small room.
“You can watch from the gallery if you‘d like.” She offers, trying to be kind even though all she can think of in this moment are their hands on her and their mouth and- Shepherd, this is extremely inappropriate.
“Yeah, that sounds good, thanks.” They nod and then they’re gone. Amelia sighs and turns the sink off, pushing her back against the door, trying to forget what just happened. Trying to forget the neuroscientist who had stolen her heart over takeout food and lab reports.
Immediately the cold air of the operating room hits her and everything is gone. Everything but this very moment and the patient in front of her. It’s an invigorating and life-giving cold, the kind that makes you feel alive.
She hears a chorus of “Welcome back Dr. Shepherd” and nods, smiling at everyone standing around the table. “It’s good to be back.”
“Shepherd.” David is on the operating table, his hands at his side.
“Yes?” She walks over to him and her favorite scrub nurse moves to stand beside her, sliding gloves over her hands.
“Try not to kill me.” He sounds as cocky and arrogant as ever, but Amelia hears the uncertainty, the fear. She knows that feeling intimately. She’s felt it herself.
“I’ll do my best.” She smiles, trying to disguise the nervous energy inside of her. The anesthesiologist places a mask on David’s face and in just a few moments he is unconscious.
Amelia sees Kai enter the gallery, sees them sit down in the very back row and her heart swells. But that’s not important right now.
The air around her feels charged, electric. It’s alive with the thrill of new discoveries and she can’t help but smile. She moves away from the table to stand above David’s unmoving head. She holds her hand out.
“Scalpel.” Amelia’s voice cuts through the gentle silence of the operating room and wow, she’s missed this.
Her breath is slow as she makes the first cut. Okay, not too deep. She keeps an ear out for the monitors, wanting to ensure nothing goes wrong, especially this early on.
Steady. She grabs a bit of gauze, soaking up the blood, and checks for clots. Negative. Swelling? Negative.
“Okay. I’m ready for the injector.” The cold metal feels good in her hands and she stares at it, remembering the moment they came up with the idea. Tom in the lab, flashing them questioning looks and scribbling in his notebook.
She balances her scalpel in one hand, taking the injector in another and leaning back to slide it in the incision. One wrong move and it’s over.
Her muscles tense and she does her best to slow her breathing, lowering the device with the most grace she’s capable of. Once it’s in place, she puts her scalpel down and rests her hand on the top of the injector, near the control buttons.
Unbeknownst to Amelia, Kai sits in the gallery, completely in awe. They’ve seen surgery before, watched from the gallery countless times, but never before have they watched someone like Amelia. She moves around the room like she has it memorized, like she knows how it moves and breathes and is. She holds her scalpel like it's an extension of her own hand.
Amelia finally glances up towards Kai, her hand still hovering on the injector. She sees that the gallery is nearly empty, aside from Meredith, Richard, and a few others she doesn’t recognize. This surgery is considered secret, so only a few are allowed in.
Kai is smiling at her and Amelia has to look away, focusing on keeping her hands steady. This is David Hamilton’s brain after all.
Taking a deep breath, she returns her gaze to the gallery, scanning over the people there and then those in the O.R. with her.
This is exactly what she imagined as a child playing with a toy stethoscope, as a med student spending late nights in the library, and as a doctor, dreaming of a breakthrough.
This was it. This was her breakthrough.
It only seems fitting to quote her brother, she thinks. The man whose shadow she has walked in up until this very moment.
Her hand on the injector, she raises her voice. “Everyone, we’re standing on the moon.” Amelia’s voice carries through the speaker in the gallery. Meredith gasps, looking over at Richard, who obviously understands. Kai is confused, but they write it off as a “Seattle thing” until they hear one of the doctors next to them speak.
“Isn’t that what the other Dr. Shepherd said? When he tried to cure Alzheimer’s?”
His colleague just nods, and it sends Kai into a spiral of questions. The other Dr. Shepherd? Their mind flies back to a few weeks ago, when they were sitting with Amelia in the lab.
“They always assume it’s because I wanted to be like my brother.” She had smiled, but looking back, Kai realizes that there was a sadness there.
Her brother. The other Dr. Shepherd.
“Injecting the stem cells.” Amelia’s voice pulls Kai back to the present. She presses a few buttons, sliding her finger across the cool metal and hoping beyond hope that this works.
Soon a low hum fills the operating room. Amelia steadies the motorized injector and it’s as if the air in the room freezes with anticipation.
Her heart is pounding and she tries to remember feeling like this before. Very few things have compared. In the gallery, everyone holds their breath, including Kai.
Finally the injector beeps and she lifts it up with a grace and dexterity that they can see from the gallery, setting the tool down on a tray next to her.
“Injection complete.”
The few people in the gallery clap and Amelia relaxes, moving to close the tiny incision in David’s head and call this surgery a success. They did it. The surgery is done. They might really cure Parkinson’s.
She places her hand against David’s skull to close the incision and immediately alarms go off in her head. Of course it couldn’t be this easy.
Her eyes snap to the scrub nurse next to her and then to the monitors. She scans them for any abnormalities, any flaws. She doesn’t find any, but she knows this. This is what she does. She has rested her hand against countless skulls, prepared to close countless brain surgeries. This is not what it feels like.
She racks her brain, trying to tune out the chatter and buzz of the room around her. What is this? Blood clot? Lack of oxygen? Her mind goes back to the scrub room with Kai. How such palpable tension was building in that tiny room. What had she felt? Stress, tension, anticipation— and finally it hits her. Pressure.
“Everyone, I need you to listen.” All eyes go to her and the room falls completely silent, the excited energy of success quickly dying. They can all sense the urgency and anxiety in her voice, even though she does her best to hide it. Kai watches from the gallery, confused. Everything was going well, right?
“This man is about to experience a deadly rise in intracranial pressure. I need you to put him in reverse trendelenburg, administer mannitol, and prep for a craniotomy.” The room is still, and incredibly quiet. Kai just stares, their eyes flicking back and forth between Amelia and the ICP monitor.
An intern breaks the momentary silence. “Dr. Shepherd, there’s no indication of a rise in intracranial pressure.” Everyone looks to the monitors and sure enough, everything is normal.
Amelia feels like she’s on fire. Her mind is racing and her heart is pounding in her chest. This man is going to die if we don’t do something.
“Did I stutter?” Her voice is ice, and it makes even those in the gallery flinch.
The room jumps into action, and so does Amelia. “30 degrees. Open flow. Lower that dosage. Yes, now.” She moves quickly, instructing nurses and consulting with the anesthesiologist.
In the gallery, Kai hears the neurosurgeons next to them whispering.
“What does she think she’s doing?”
“How could she possibly know that? There’s no way.”
Amelia takes her place at the head of the table and lifts her scalpel, resting it against David’s skull.
She watches the clock now, counting the seconds in her mind. Five, four, three, two…
As if on cue, alarms start going off, blaring and beeping and flashing. She just smiles, shaking her head. She knew it. The person closest to the monitors turns to read them off. “High ICP and climbing even higher. His heart rate is also increasing.”
Amelia doesn’t waste a second. She nods, lowers her hand, and cuts. The feeling of the scalpel in her grip is exhilarating. She twirls it in her hand, cutting and spinning and trimming. She moves with a focus and grace that is unmatched.
Everyone in the gallery is shocked, their mouths wide open, especially the neurosurgeons. Meredith finally meets Kai’s eyes and sees the question there.
“No, I don’t know how she knew that.”
Amelia glances up at one of the surgical nurses, who throws her a questioning grace, and she nods.
“It seems like we’ll be here a while.”
She gets up and slides in a CD. The sound of calm classical music fills the operating room, and Kai swears they can see Amelia moving her scalpel to the soft rhythm of the music.
After almost an hour of cutting and adjusting medications, one of the nurses speaks, and Kai looks up at the noise. “ICP is returning to normal. If we had waited even a moment later, I don’t think we could have saved him.”
Amelia smiles slightly, still swaying to the music. “Good job everyone. I’ll close from here.”
Soon David’s skull is safely closed and Amelia steps in the scrub room, glancing at the clock. It’s been hours. She rips off her gloves and mask and runs her hands under the cool water.
Once again, the door swings open and there stands Kai. They come to stand next to her and after a moment of heavy silence they speak.
“That was incredible, what you did in there.” Amelia looks up to meet their eyes and smiles.
“Honestly, I didn’t realize just how much I missed surgery until today. I forgot how much I love it.”
Kai stands still, toying with what to say next. Should I risk it? Ah, screw it. “I didn’t know him, but I think your brother would be proud.”
Silence. It seems like forever they stand there, the only sound running water.
When Amelia finally speaks her voice is quiet and… fragile? It’s not something Kai has ever heard from her, and they’re stunned.
“I appreciate that.” Amelia meets their eyes, and for just a moment, her walls crumble. Sadness and grief. Anger and despair. Pride and joy. Everything mixes into a storm and then it’s gone.
She returns her gaze to the operating room in front of her. Nurses and doctors moving about, cleaning and preparing for their next patient.
Kai nods, understanding the need for a subject change. They rub their hand over their eyes and then squint against the lights, a tiredness hitting them suddenly. “How are you not exhausted?”
“Well I am, but you learn to manage it. Most surgeries are longer than this. Honestly, the pure adrenaline keeps you going.” Amelia chuckles, drying her hands and untying her scrub cap.
“Come with me.” Amelia motions for Kai to follow and leads them to one of the on-call rooms that she typically crashes in.
They lean against the door frame and try to read her expression. “What about David? What if something goes wrong?”
“First of all” Amelia steps closer to them. “I’m a really incredible surgeon, so he’ll be great. Second” She unclips her pager and waves it around in the air. “We have this. Third.” She steps even closer, and Kai’s heart jumps. “I’m asking you to stay.”
Don’t do it Shepherd.
Her hand moves up the side of Kai’s face and before she can control it, before she can even think about it, her mouth is on theirs. They react immediately, their arms coming up to cradle her against them.
Somewhere in the back of her mind Amelia registers that this is the most gentle and loving kiss she thinks she’s ever had.
It’s not intense. It’s not rushed. It just is. They fit together like two pieces of a puzzle and it just feels right.
They finally break apart and Amelia looks up at them. “So?”
Kai nods, and Amelia lays down on the bed, tossing her phone and pager on the table next to her. She reaches her arms out and they go willingly, letting her pull them into bed next to her.
She wraps her arms around them and lays her head on their chest. She hasn’t had this in years, maybe ever.
They stay that way for a while in gentle silence until Kai breaks it.
“Shepherd?” Their voice is low and incredibly tired, tinged with something deeper.
Amelia is almost asleep, and she has to force her eyes open. “Yeah?”
“How did you know that today? What was going to happen?” They finally ask the question that has been on their mind for hours.
“I don’t know. I just knew.” She absentmindedly laces her fingers in their hair and for a moment everything is completely silent.
“I’m in awe of you.”
Amelia’s reply comes without hesitation. “I’m in awe of you too, Dr. Bartley.”