Chapter Text
LATE 113 AC
Ethan Carter was halfway through dictating notes for a patient’s chart - something about blood pressure, mild dehydration, and please stop Googling your symptoms - when the world suddenly decided it had other plans.
The fluorescent lights above him flickered.
The floor tilted.
Then everything melted into a spinning mess of colors, noise, and the deeply uncomfortable feeling of falling without actually knowing where you were falling to.
“Wait - what - ”
Thud.
He hit the ground face-first.
Hard.
Wet grass pressed against his cheek. Cold. Real. Very unpleasant. His clipboard somehow survived the trip and was still clutched in his hand like it, too, was confused about what just happened.
“Ow. What the hell - ?” Ethan groaned, rolling onto his back and staring at the sky. “Okay. Nope. I definitely did not consent to this.”
He pushed himself up, wincing as his knees protested. The air smelled wrong - salty, smoky, heavy, like a bonfire by the sea. That alone was concerning. St. Mary’s Hospital did not smell like this unless something had gone very, very wrong.
He blinked.
Once.
Twice.
Still not New York.
Towering over him was a massive stone fortress, dark and jagged, like someone had taken a castle and decided it needed to look angrier. Storm clouds churned overhead, dramatic enough to deserve their own background music.
Ethan swallowed.
“…Okay,” he said slowly, turning in a full circle. “Either I finally snapped from residency hours, or I’ve been aggressively kidnapped by my own imagination.”
Something moved in the distance.
He squinted.
Something big.
Something with wings.
The shape rose above the clouds, scales catching the light as it glided across the horizon with all the grace of a flying apocalypse.
Ethan’s mouth fell open.
“Oh,” he breathed. “…that’s a dragon.”
He stared a little longer, because sometimes if you stared hard enough, things stopped being real.
It did not stop being real.
“Cool,” he muttered weakly. “Cool, cool, cool. So this is happening. Fantastic. Love that for me.”
He dragged a hand down his face. “Either I’m hallucinating from sleep deprivation, or I just got isekai’d like some anime protagonist. And if it’s the second one, I would like to formally complain about the lack of tutorial screen.”
That was when cold steel pressed against his throat.
“Speak, stranger,” a sharp, commanding voice said. “Who sent you?”
Ethan froze so hard he barely remembered how breathing worked.
“Okay,” he said carefully, hands lifting in surrender. “Before anyone stabs anyone, I just want to say - this is not how I usually arrive places.”
He turned his head slowly, painfully aware that one wrong move could end his medical career - and his entire life - in record time.
Two people stood before him.
Very regal.
Very armed.
The woman looked like she’d stepped straight out of a nightmare wrapped in royalty. Silver-gold hair framed her face, her violet eyes sharp enough to cut glass. Her expression clearly said I have killed people for less.
The man beside her had similar silver hair, though his gaze held more curiosity than fury. He looked mildly entertained, like Ethan was a strange animal that had wandered into the wrong enclosure. Still, his hand rested on his sword, just in case the animal turned feral.
Ethan’s brain stalled.
Then crashed.
Then rebooted incorrectly.
“Uh,” he said, because his vocabulary had temporarily abandoned him. “Hi. I’m Dr. Ethan Carter. Human. From… not here. Also - quick question - where the hell am I?”
The woman’s eyes narrowed.
That was not a good sign.
“You stand in the presence of Princess Rhaenyra Targaryen,” she said coldly, “and her consort, Ser Laenor Velaryon. Explain yourself, stranger, before I feed you to Syrax.”
There was a pause.
A long one.
Ethan stared at her.
Then at him.
Then at the castle.
Then back at her.
And just to be thorough - the dragon still circling far overhead like it was waiting for dinner.
Slowly. Horribly.
His fingers went numb.
His clipboard fell from his hand
Targaryen.
Velaryon.
The words echoed in his head, slotting neatly into place like the final pieces of a very cursed puzzle.
Somewhere in the universe, every bad life decision he had ever made nodded in solemn agreement.
He had not been emotionally prepared for this crossover.
Oh.
Oh no.
Negotiations (Or: How to Not Get Burned Alive)
Convincing a medieval princess that he wasn’t a threat, a spy, or a demon personally sent by her enemies turned out to be significantly harder than Ethan had hoped.
Mostly because she had a dragon.
Rhaenyra Targaryen studied him like he was something unpleasant she’d scraped off her boot. “You claim to be a maester,” she said coolly. “Yet you wear no chain.”
“Because I’m not a maester,” Ethan replied. “I’m a doctor.”
Both of them stared at him.
He sighed. “Okay. A physician. I heal people. Sick people. Injured people. People who are actively dying and would prefer not to be.”
Laenor Velaryon scoffed, clearly unimpressed. “With what? That wooden slab in your hands?”
Ethan glanced down at his clipboard like it might betray him. “First of all, rude. Second, this is for notes.”
Rhaenyra’s eyes narrowed. “Enough. You appear out of thin air wearing strange garb, speaking nonsense, and insulting my consort. You could be a spy.”
“I absolutely could not,” Ethan said quickly. “I don’t even spy competently in my own time. I once got lost in my own hospital.”
That did not help.
“I swear,” he added, hands raised, “I have no idea how I got here. One second I was at work, the next - poof - Dragonstone.”
Laenor paused. “So you do know where you are”
Ethan winced. “Yeah, about that. I’ve… heard of it.”
Rhaenyra’s gaze sharpened. “From someone who ask where you were earlier seem to know more than you let on”
“Uh - ” Ethan hesitated.
Because saying I watched you on TV felt like a terrible idea.
Explaining House of the Dragon to the people actively living it felt worse.
“I - my sister watches things,” Ethan said, then winced and tried again. “Okay, no. Bad explanation. Let me rephrase before I die.”
He cleared his throat. “You’re a Targaryen princess. From the only surviving dragonlord family. People know who you are. Even people who are very, very not from here.”
Rhaenyra’s expression tightened, suspicious but listening.
“And you,” he added, gesturing vaguely between her and Laenor, “are a Velaryon. With dragons. I didn’t exactly need a map and a name tag to put that together.”
Laenor frowned. “Yet you didn't regonised us at first, especially the princess in the beginning”
Ethan shrugged helplessly. “I didn't realise at first. You’re the Realm’s Delight. I’ve heard the name before. Repeatedly. For hours. Against my will.”
Rhaenyra blinked.
“By whom?” she asked coolly.
“My sister,” Ethan said. “She’s… passionate. About history. And books. And very pretty Targaryen women.”
He paused, realized what he’d just said, and hurried on.
“Which - I mean - that came out wrong. You are beautiful, obviously, but that’s not relevant to the espionage allegations - ”
Laenor snorted.
Rhaenyra crossed her arms. “You flatter boldly for a man with a sword at his throat.”
“I cope with stress through honesty,” Ethan said. “And mild panic. There is a sword involved.”
Her eyes narrowed, though there was something thoughtful there now. “You know too much for a common man.”
Ethan spread his hands. “I promise, if I were dangerous, I’d be doing a much better job of it.”
She turned slightly. “We should take him to the dungeons.”
Ethan’s soul attempted to leave his body.
Nope. No. Absolutely not.
His brain latched onto the word dungeons and immediately supplied images he did not want: dark stone cells, chains, rats with personalities, and a smell that could legally be classified as a weapon.
He had never even been to jail.
Jail was clean. Jail had lights. Jail had rules.
This was a dungeon.
Grimy. Damp. Dark. Probably haunted.
At least in his world, dungeons were something you binge-watched on a couch with snacks and the comforting knowledge that you could pause at any time. This? This did not come with a pause button.
“WAIT,” he yelped, panic fully unlocked. “Please don’t dungeon me. I bruise easily. I have sensitive skin. I get rashes.”
Both of them stared.
“I can prove I’m a physician!” he blurted, words tumbling over each other. “Ask me anything - medicine, anatomy, injuries, diseases
Rhaenyra considered him for a moment, then smirked faintly. “Very well,” she said. “Tell me, then - how does one treat greyscale?”
Ethan blinked.
“…Oh. You went hard immediately.”
Rhaenyra arched a brow.
“Okay,” he said quickly. “Isolation first. You don’t want that spreading. Vinegar washes can slow it down, and you’d have to cut away infected tissue. But honestly?” He grimaced. “That’s medieval.”
Both of them stiffened.
“Medieval?” Laenor repeated.
Ethan coughed. “I mean - traditional. Very traditional. Respectfully traditional.”
Rhaenyra’s eyes bored into him. “And you would do better?”
“Yes,” Ethan said automatically, then froze. “…I mean. Hypothetically. With tools I do not have. In a world that does not have antifungals. So maybe emotionally better.”
Silence.
Wind howled dramatically, because of course it did.
Finally, Rhaenyra sighed. “You are either a liar… or the strangest man I have ever met.”
“I get that a lot,” Ethan said.
She straightened. “Very well. We will not kill you.”
Ethan sagged with relief. “Oh thank God.”
She leaned closer, violet eyes sharp.
“Yet.”
“…Fair,” Ethan said weakly.
Somewhere above them, a dragon screeched.
Ethan swallowed.
“Just to be clear,” he added, “burning me will ruin my credibility.
The Awkward Explanation of Modern Medicine
Under heavy guard, Ethan was escorted into a chamber that was slightly warmer, slightly cleaner, and only mildly less intimidating than the dungeon. Rhaenyra and Laenor waited for him there, seated like they were about to decide his fate - which, to be fair, they probably were.
“So,” Laenor said, leaning forward with interest. “You claim to be a healer from another land. What exactly can you do?”
Ethan hesitated.
This was the part where he usually handed out pamphlets and spoke very gently.
“…Well,” he said slowly, “I specialize in fertility and reproductive medicine.”
Rhaenyra’s eyebrows shot up.
Laenor immediately choked on his wine.
“You what?” Rhaenyra demanded.
Ethan coughed. “I - uh. I help people have babies. Through science.”
Laenor stared at him. “That is not helping.”
Rhaenyra, meanwhile, leaned forward, eyes suddenly sharp with interest. “Can you… help us?”
Ethan blinked. Once. Twice.
“You mean,” he said carefully, “with… conception?”
Laenor rubbed his temples. “Gods be good.”
Rhaenyra waved him off. “We’ve been wed a month. The court grows restless. If we do not produce an heir soon, they’ll start whispering. Loudly.”
Ethan nodded. “Right. Political pressure. Expectations. Everyone staring at you like a ticking clock. Yeah, that tracks.”
He hesitated, then asked gently, “Just to be clear… is the issue… compatibility?”
Laenor gave him a flat, deeply tired look. “I prefer the company of men.”
“Oh,” Ethan said. Then, immediately after, “Ohhh.”
He nodded slowly. “Okay. Yep. That would make traditional methods… complicated.”
Rhaenyra sighed. “Precisely.”
Ethan rubbed his chin. “Well. Good news. I can help.”
Both of them straightened.
“But,” he added quickly, “it’s going to sound completely insane.”
Laenor smirked. “More insane than a man appearing out of thin air wearing trousers that tight?”
Ethan ignored that. “I can extract an egg from you, Rhaenyra. Take sperm from Laenor. Combine them in a lab. Then place the embryo back inside you.”
Dead silence.
Rhaenyra stared at him like she was trying to decide whether this was treason or witchcraft.
Laenor looked like he might pass out.
“You wish,” Rhaenyra said slowly, “to take parts of us… remove them… and then return them?”
“Yes,” Ethan said, nodding. “In a very controlled, very sterile environment.”
Laenor whispered, “What in the Seven Hells is a lab?”
Ethan opened his mouth.
Closed it.
The Isekai Doctor’s Cheat Skill
There was just one small problem with Ethan’s very confident medical plan.
He had absolutely no equipment.
No lab.
No sterile tools.
No machines.
Not even a decent sink.
Just stone walls, suspicious torches, and two dragon-riding nobles staring at him like they were seconds away from deciding he was a very articulate lunatic.
“…Damn it,” Ethan muttered.
His mind raced. IVF without equipment was impossible. Hell, basic medicine without equipment was a nightmare. He was a doctor, not a miracle worker. If this was truly a medieval world, he was going to last about three days - five, if he avoided open wounds and raw milk.
Unless.
A horrifying thought struck him.
He slowly raised a hand.
Rhaenyra watched him warily. “What are you doing?”
Ethan swallowed. “Okay. This is going to sound stupid.”
“That has not stopped you before,” Laenor said.
Ethan took a breath. He thought about every isekai anime he’d ever half-watched in the background. About cheat skills. System menus. Convenient divine intervention that existed purely to keep protagonists alive.
Please, he prayed silently, if someone summoned me here, they’d better have given me a cheat code. Because other than modern medicine, I have nothing. I cannot swordfight. I cannot farm. I cannot survive on vibes alone.
“…Uh,” he said aloud, feeling ridiculous. “Summon IVF kit?”
For half a second, nothing happened.
Then the air shimmered.
Light bloomed out of nowhere, bright and humming, and a full set of modern medical equipment materialized neatly on the table -monitors, sterile trays, syringes, instruments, all exactly where they should be.
Ethan stared.
Then grinned.
“Oh hell yeah.”
Rhaenyra and Laenor stared back.
Laenor slowly stood. “You’re a sorcerer.”
“Nope,” Ethan said cheerfully. “Just a guy who apparently unlocked weirdly convenient anime logic.”
Rhaenyra approached the table, cautious but curious. She poked a syringe with one finger like it might bite her.
“And this,” she said slowly, “will help us conceive an heir?”
“Yes,” Ethan said. “Safely. Effectively. With a significantly lower chance of divine punishment than you’re probably imagining.”
She frowned. “What must be done first?”
“I need to track your ovulation.”
Silence.
“My what?” Rhaenyra asked.
“The part of your cycle when you’re most fertile.”
She crossed her arms. “You mean my moon blood.”
Ethan sighed. “Close enough. We’ll start there.”
The Miscommunication
The first extraction went smoothly.
Ethan worked with the intense focus of a man who had decided - against all reason - that this was just another long shift and not a medically impossible procedure taking place in a castle ruled by dragonlords. He sterilized, measured, monitored, and took notes like his life depended on it.
Which, technically, it did.
By the time evening settled in and the torches were lit, Ethan was hunched over his clipboard, scribbling observations and muttering to himself about hormone levels and timing windows.
Rhaenyra watched him from across the chamber, visibly exhausted but thoughtful.
“If only,” she sighed, more to herself than anyone else, “we could have three children at once. An heir for the Iron Throne, one for Driftmark, and a spare.”
She waved a hand vaguely, clearly indulging in royal wishful thinking.
Ethan nodded absently, pen scratching across the page. “Mhm. Got it.”
Rhaenyra assumed he was simply humoring her.
Ethan, however, filed it away as direct instructions
A Weird Way to Take a Sample
Over the next three months, Ethan carefully monitored Rhaenyra’s cycle, tracking ovulation with far more precision than Westeros was emotionally prepared for. Each month, he extracted eggs, documented everything, and reassured her repeatedly that yes, this was normal, and no, she was not being cursed.
Rhaenyra assumed the length of the process was simply how this strange, foreign medicine worked.
Meanwhile, Laenor had questions.
“So,” he said one afternoon, eyeing the sterile cup in Ethan’s hand with open suspicion. “I simply… do this… into that?”
“Yes,” Ethan replied.
Laenor grimaced. “That’s barbaric.”
Ethan nodded sympathetically. “Tell me about it. This is somehow still the best option.”
Laenor stared at the cup. “I hate everything about this.”
“Very common reaction,” Ethan assured him. “You’re doing great.”
By the end of the third cycle, Ethan had three healthy, viable embryos stored and ready.
He stared at his notes, satisfaction blooming.
She wanted three children, he thought.
She’s getting three children.
Problem solved.
Rhaenyra lay on the makeshift exam table - a repurposed dining table covered in clean linens, pillows, and dignity rapidly slipping away - her expression pinched.
“This feels undignified,” she said.
“Medicine often is,” Ethan replied cheerfully, adjusting the speculum. “You should see how it goes in where I'm from.”
“I should not,” she said firmly.
Laenor took one look at the setup and immediately turned away. “I’ll be outside,” he announced. “Very far outside. Possibly in another wing.”
The procedure itself went smoothly.
Which, in hindsight, should have been a warning
The Grand Reveal
A weeks after the embryo transfer, Rhaenyra began feeling… off.
She was exhausted. Nauseous. Irritable in a way that made even seasoned courtiers flee on sight. One unfortunate servant sneezed too loudly and nearly lost their job. Laenor had been banished from her immediate vicinity twice for breathing too loudly.
Ethan checked her vitals, ran his tests, stared at the results, and slowly - very slowly -broke into a grin.
“Well,” he said, unable to keep the excitement out of his voice, “congratulations, it's a success.”
Rhaenyra straightened. “I am?”
“Yes,” Ethan said brightly. “You’re pregnant.”
Relief washed over her face. She exhaled, tension melting from her shoulders. “At last.”
Ethan nodded. Then, casually -
“With triplets.”
The room died.
Laenor’s goblet slipped from his fingers and shattered on the floor.
Rhaenyra blinked once.
“…What?”
“Triplets. Three embryos implanted, three successfully developing. Textbook success, honestly.”
Her face drained of color. “Three.”
“Yes.”
“I am carrying,” she said slowly, “three children.”
“You wanted it,” Ethan said, then stopped. “…You don’t look happy.”
“I WAS JOKING,” Rhaenyra snapped.
The words hit him like a brick.
Ethan paled. “Oh.”
Oh no.
“Oh. Uh. Oops?”
Laenor dragged a hand down his face. “We are doomed.”
“Three babies,” Rhaenyra whispered, staring at nothing. “At once. Inside me.”
Ethan tried to recover. “On the bright side,” he offered weakly, “science works?”
She slowly lifted her head.
Her eyes were blazing.
“You,” Rhaenyra said, pointing at him, “are never. Leaving. Us.”
Ethan swallowed.
And thus, the realm’s most chaotic pregnancy began.