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Chapter Text

A Hard Day's Night

The alarm blared, and Clementine Hart's hand shot out from beneath her comforter, slapping around blindly until she found her phone. She groaned, squinting at the time: 4:30 AM. First day as a surgical intern at Seattle Grace Hospital.

Her temporary sublet in Capitol Hill was a nightmare—the roommate she'd found online, Tara, had conveniently forgotten to mention her boyfriend practically lived there too, or that they both played in a garage band that practiced until 2 AM. The walls were thin enough that Clem could hear every argument and reconciliation. But it was all she could find on short notice after moving to Seattle just two weeks ago.

Forty minutes later, showered and caffeinated with black coffee strong enough to strip paint, Clem walked through the hospital doors. Her dark brown hair was pulled back in a neat ponytail, her new navy scrubs still stiff with newness. She clutched her white coat, name embroidered in blue: "Clementine Hart, M.D."

The orientation room buzzed with nervous energy as interns found seats. Clem noticed a blonde woman looking particularly exhausted slumped in a chair nearby.

"Mind if I sit?" Clem asked, gesturing to the empty seat.

The blonde looked up, offering a small smile that didn't reach her tired eyes. "Go ahead. I'm Meredith."

"Clementine. Clem." She settled in beside her. "You look like you had as rough a night as I did."

Meredith raised an eyebrow. "That would depend. Did you wake up on your living room floor because you were too busy overthinking your entire life to make it to bed?"

Clem's lips quirked into a half-smile. "No, but I did spend half the night trying to drown out my roommate's boyfriend's drum solo with a pillow over my head."

"Dark and twisty meets sleep-deprived. We'll get along fine," Meredith replied with dry humor.

Their conversation was cut short as a sharp-featured Asian woman dropped into the seat on Meredith's other side.

"Anyone sitting here? No? Good." She didn't wait for an answer. "I'm Cristina Yang. Stanford."

Before Clem could respond, a stern-looking resident entered the room, her presence immediately commanding attention despite her petite stature.

"I have five rules. Memorize them," the resident barked. "Rule number one: Don't bother sucking up. I already hate you. That's not going to change."

Clem exchanged glances with Meredith as their resident—Dr. Bailey, the "Nazi," according to whispers—continued outlining exactly how miserable their lives were about to become.

---

Six hours later, Clem's neat ponytail had loosened, wisps of hair framing her face as she rushed down a hallway, nearly colliding with a tall man in dark blue scrubs and a lab coat.

"Whoa there," he said, steadying her with a hand on her shoulder.

"Sorry, I—" Clem looked up, momentarily caught off guard by startlingly blue eyes. She straightened, collecting herself. "Dr. Bailey's looking for me, and apparently standing still for more than thirty seconds is grounds for execution."

The man chuckled, warm and genuine. "Ah, the Nazi claims another victim. First day?"

"That obvious?" She tucked a loose strand of hair behind her ear, noticing his attending badge. "Dr. Shepherd, is it?"

"Derek," he corrected with an easy smile. "Neurosurgery."

"Clementine Hart. Intern... and currently, professional coffee retriever." She tapped her badge. "The brain, huh? That's where all the interesting stuff happens."

"A neurology enthusiast?" His expression brightened with professional interest.

"My mother—she's an ER nurse—always said it takes a special kind of arrogance to cut into someone's brain," she said, unconsciously fidgeting with her amethyst pin.

Rather than take offense, Derek laughed. "Your mother sounds wise. And she's not wrong."

Their exchange was interrupted by the shrill beep of Clem's pager. "That'll be Bailey. Looking for her coffee, no doubt."

"Better run then. The Nazi waits for no one." His eyes lingered on hers a moment. "Good luck, Dr. Hart."

"Thanks." She hurried away, throwing over her shoulder, "I make my own luck, Dr. Shepherd."

---

The cafeteria buzzed with frantic energy as Clem balanced her tray—a sad-looking sandwich and what the hospital claimed was coffee—while scanning for somewhere to sit. She spotted Meredith at a table with Cristina and two other interns she recognized from orientation.

"Mind if I join?" she asked, approaching the table.

"Brooklyn!" It was the guy with the cocky attitude—Alex. His eyes did a not-so-subtle sweep of her figure. "I was wondering when you'd show up."

"It's Clementine, actually." She sat down next to Meredith, who was picking at her salad disinterestedly. "Or Clem. Not Brooklyn."

"Whatever. You sound like Brooklyn." Alex shrugged, taking an aggressive bite of his apple.

The baby-faced guy across from her smiled nervously. "I'm George O'Malley. And that's Izzie Stevens," he gestured to the tall blonde who looked runway-ready despite eight hours into their shift.

"So," Cristina said without preamble, not looking up from her medical journal, "anyone seen anything good yet? I've been stuck doing post-ops all morning."

"I got to observe an appendectomy," George offered enthusiastically.

"Fascinating," Cristina deadpanned. "I'm here for cardio. If it's not a heart, I'm not interested."

"Speaking of specialties," Clem said, unwrapping her sandwich, "anyone know about that neurosurgeon—Dr. Shepherd? He mentioned a corpus callosotomy tomorrow."

Meredith's fork paused halfway to her mouth.

"McDreamy?" Izzie smiled. "That's what the nurses call him."

"With good reason," Cristina added. "But I hear he's hardcore about neurosurgery. Total career-first type."

"Fine by me," Clem said. "I'm not here for the dating scene."

"Smart," Meredith muttered, resuming eating.

Their conversation was interrupted by all five of their pagers beeping simultaneously.

"Bailey," they groaned in unison, gathering their trays.

"Back to the salt mines," Clem sighed, grabbing her half-eaten sandwich. "Guess dinner's not happening."

---

The ER was chaos. A bus had overturned on the highway, and casualties were streaming in. Clem found herself assigned to Trauma Room 3, where a man with a severe head laceration was being prepped.

"Hart, pressure here," Dr. Bailey instructed, guiding Clem's hands to the bleeding wound.

The doors burst open as another doctor entered—tall, confident, commanding presence. "I heard we have a possible epidural hematoma?"

"Dr. Koracick," Bailey acknowledged. "Yes, patient's pupils are unequal. CT's backed up."

Dr. Tom Koracick—the neurosurgeon whose reputation preceded him—stepped to the bedside, addressing her directly. "You're new."

"Clementine Hart, first day," she replied, maintaining pressure on the wound.

"Well, Dr. Hart, what are the signs of an expanding epidural hematoma we should be monitoring?"

Despite the pressure of the moment, Clem felt her mind snap into clinical mode. "Lucid interval followed by rapid deterioration, ipsilateral pupillary dilation, contralateral hemiparesis, and Cushing's triad: hypertension, bradycardia, irregular breathing."

Koracick's eyebrows raised slightly. "And treatment?"

"Immediate burr holes to relieve pressure, followed by craniotomy."

"Very good." He turned to Bailey. "Your intern knows her neuro."

"My interns know everything," Bailey replied matter-of-factly. "Hart, go see if you can expedite that CT."

As Clem headed for radiology, she nearly collided with Alex, who was wheeling a patient toward the elevator.

"Watch it, Brooklyn," he snapped.

"Sorry," she replied automatically, then noticed his patient—a young woman, clearly in pain. "Need help?"

"I've got it," he said defensively, then hesitated. "Actually... can you check her chart? Bailey's going to quiz me."

Clem took the chart, scanning it quickly. "Nineteen-year-old female, abdominal pain, elevated white count. Appendicitis?"

"That's what I think," Alex said, then added reluctantly, "Thanks."

"No problem. That's what teammates do," she replied, handing back the chart. "Even teammates who call me Brooklyn."

Alex smirked. "Whatever, Hart."

---

Three hours later, Clem found herself in a supply closet, searching for more gauze. The door opened, and Izzie slipped in, looking frazzled.

"Hide me," Izzie whispered. "I just messed up an IV stick three times on the same patient."

"Join the club. I dropped a tray of instruments earlier." Clem reached past her to a box on the shelf. "Here's your gauze."

"How are you so calm?" Izzie asked. "I feel like I'm constantly one mistake away from killing someone."

Clem's expression softened. "My mom's been an ER nurse for twenty years. She used to come home with stories that would curl your hair. The point is—everyone makes mistakes. We learn, we improve."

"I just don't want to be the one who breaks first," Izzie admitted. "You know they have bets on which intern will cry first."

"My money's on George," Clem said with a smile. "But not you, Stevens. You've got this."

Their pagers went off simultaneously. With synchronized sighs, they headed back into the fray.

---

Night had fallen, and Clem found herself in the dimly lit hallway of the ICU, checking vitals on a post-op patient. Her feet were killing her, and she'd given up on her ponytail hours ago, her wavy brown hair now in a messy bun.

"You still standing?" came Meredith's voice as she approached, chart in hand.

"Barely," Clem smiled tiredly. "You?"

"Running on caffeine and stubbornness at this point." Meredith leaned against the counter beside her. "So... you mentioned Shepherd earlier."

"Just professionally," Clem clarified, noting something careful in Meredith's tone. "His corpus callosotomy tomorrow sounds interesting."

Meredith nodded slowly. "He's supposed to be brilliant. One of the reasons I chose this program."

"You're interested in neuro too?"

"Maybe. Still deciding."

They were interrupted by the appearance of George, looking shell-shocked. "Bailey just made me do a central line insertion while she watched and didn't say a word."

"Did the patient survive?" Clem asked.

"Somehow," George replied, collapsing into a nearby chair.

"That's Bailey's way of teaching," Meredith explained. "Traumatize you into competence."

"It's effective," George admitted. "Terrifying, but effective."

Clem checked her watch—3 AM. "Twenty-one hours down, twenty-seven to go. Who needs sleep anyway?"

"Sleep is for the weak," Meredith agreed. "And attendings."

"Speaking of attendings," George began, his voice dropping to a whisper, "I heard Shepherd asking about you, Clem. In radiology."

"About me?" Clem's eyebrows rose. "Why?"

"Something about you being interested in neuro."

"Oh." She wasn't sure why that made her feel both flattered and wary. "Professional interest, I guess."

"Or maybe you've got your own McDreamy situation brewing," George teased.

"Not interested," Clem said firmly, but couldn't help glancing in the direction of neurology. "I've got enough complications without adding an attending to the mix."

As they dispersed to continue their rounds, Clem found herself wondering about that corpus callosotomy tomorrow. Professional curiosity, nothing more. After all, she wasn't here for romance—she was here to become a surgeon.

Day one was nearly halfway done, and somehow, despite the exhaustion, the chaos, and the steep learning curve, Clementine Hart knew she was exactly where she belonged.

---

The break room was deserted at 5 AM, which suited Clementine just fine. Her twenty-minute power nap on a gurney had done little to refresh her, and she desperately needed coffee. She was filling a mug with the questionable brew when the door swung open.

"Please tell me that's not the last of it," Derek Shepherd said, gesturing to the coffee pot.

"Your lucky day," Clem replied, sliding the pot toward him. "Though I make no guarantees about drinkability."

Derek chuckled, grabbing a mug. "Hospital coffee. An acquired taste."

"Like enjoying thirty-hour shifts?" She leaned against the counter, suppressing a yawn.

"You get used to it." He studied her over the rim of his mug. "George O'Malley mentioned you were asking about my corpus callosotomy this afternoon."

Clem felt a flash of annoyance at George's apparent inability to keep a conversation private. "Professional interest. I've only seen one during med school rotation."

"You impressed Tom Koracick earlier. Not an easy feat." His tone was casual but evaluating.

"Dr. Koracick?" Clem straightened slightly, instinctively touching her father's amethyst pin on her scrubs. "The neurosurgeon?"

"One and the same. He mentioned an intern who rattled off epidural hematoma symptoms without hesitation." Derek took another sip of coffee. "Said you might have a future in neuro."

Clem felt unexpectedly pleased by this information. "I just answered his questions."

"That's more than most first-day interns manage with Tom. He can be... intimidating."

"I grew up with a mother who quizzed me on medical terminology during breakfast. Takes more than an attending with an attitude to throw me."

Derek smiled, something approving in his expression. "Gallery's open at 2 PM if you're interested. Might be educational."

"If Bailey releases me from scut work, I'll be there." She checked her watch. "Speaking of which..."

"Back to it," Derek nodded. "Good luck, Dr. Hart."

"Thanks for the intel about Koracick," she said, heading for the door. "Always good to know when you've impressed the right people."

---

By mid-morning, Clem found herself in the pit with Cristina, treating minor injuries from a multi-car fender bender.

"Laceration, left forehead, needs sutures," Cristina said, handing her a chart. "I've got the broken wrist in bed three."

"On it." Clem grabbed a suture kit and headed to the patient—a college-aged woman texting on her phone despite the blood trickling down her face.

"Hi there, I'm Dr. Hart," Clem introduced herself, setting up her supplies. "Looks like you need a few stitches."

"Whatever," the patient replied without looking up. "Can you hurry? I have class at noon."

"I'll do my best," Clem said evenly, preparing the local anesthetic. "This will sting a bit."

As she worked, Cristina appeared beside her. "Need any help?"

"I'm good," Clem replied, carefully placing her first stitch. "Your wrist?"

"Boring. Simple fracture." Cristina observed Clem's technique with clinical interest. "Not bad. Where did you learn to suture?"

"My mom's an ER nurse in Brooklyn. She brought home practice kits—pig skin from the butcher."

Cristina raised an eyebrow. "Gruesome childhood bonding."

"Better than playing catch," Clem replied with a small smile. "You're from Beverly Hills, right? Little different."

"How did you—"

"Heard you talking to Burke about growing up in California. The way you carry yourself. The subtle but expensive watch. It's not hard to connect the dots."

Cristina studied her with newfound interest. "Observant."

"Comes with the territory when you grow up where I did. You learn to read people quickly."

Their conversation was interrupted by Alex, who appeared looking smug. "Ladies, guess who's scrubbing in on an emergency appy with Bailey?"

"You?" Cristina's tone was acid.

"That's right," he grinned. "While you two play nurse in the pit."

"Congratulations," Clem said flatly. "Your lifelong dream of removing an inflamed organ the size of a finger has come true."

Alex's smirk faltered slightly. "Better than stitching up sorority girls."

"Depends on your perspective," Clem replied, finishing the last suture with precision. "Some of us value technical skill over bragging rights."

Cristina snorted appreciatively as Alex walked away, clearly irked.

"He's going to be insufferable now," Cristina muttered.

"More than usual?" Clem asked, applying a bandage to her now-complete suture work.

"You're all set," she told the patient, who had never once looked up from her phone. "Keep it clean and dry. Come back in a week to have the stitches removed."

As the patient left without a word of thanks, Cristina shook her head. "Why do we do this again?"

"The joy of healing?" Clem suggested dryly. "The prestige? The crushing student debt?"

"The surgeries," Cristina corrected. "Speaking of which, you mentioned Shepherd's corpus callosotomy?"

"Thinking of branching out from cardio?"

"Keeping my options open," Cristina said with practiced casualness. "Gallery's usually packed for his procedures."

"Planning to fight me for a spot?" Clem asked, cleaning up her supplies.

"I don't fight. I strategize," Cristina replied with a hint of a smile. "May the best woman win."

Chapter Text

The afternoon found Clem running labs and updating charts—mind-numbing work that was making it difficult to stay awake after nearly twenty-four hours on her feet. She was at the nurses' station when she felt someone watching her. Looking up, she found Tom Koracick leaning against the counter, observing her with analytical interest.

"Dr. Hart," he said by way of greeting. "How's the first day treating you?"

"Like a punching bag, Dr. Koracick," she replied honestly.

He chuckled. "Honesty. Refreshing." He picked up one of her completed charts, scanning it quickly. "Thorough work. Most interns cut corners by hour twenty."

"Not how I was raised," Clem said simply.

"So I gathered. Shepherd tells me you're interested in my specialty."

"One of several I'm considering," she replied, not wanting to commit too early.

"Smart. Keep your options open." He set down the chart. "That epidural hematoma patient from this morning—he's stabilized. Pressure's relieved, no signs of permanent damage."

Clem felt a genuine rush of satisfaction. "That's good to hear."

"Since you helped diagnose him," Koracick continued, "thought you might want to check on him. Room 3118."

"Thank you," Clem said, surprised by the gesture. "I will."

"Good instincts should be encouraged," he said matter-of-factly. "Even in Brooklyn-bred interns."

Before she could respond to the unexpected compliment, Koracick was walking away. Clem shook her head slightly, bemused by the encounter.

"What did Koracick want?" Meredith appeared beside her, looking exhausted but determined.

"Apparently, I've been granted permission to visit a patient," Clem replied. "Like it's some kind of royal decree."

"That's Koracick. God complex like you wouldn't believe." Meredith leaned against the counter. "Though if he's noticing you on day one, that's something."

"Just answered some questions correctly." Clem shrugged it off. "How are you holding up?"

"I'm fine," Meredith said automatically, then reconsidered. "Actually, no. I'm exhausted, my feet hurt, and I just spent an hour listening to a patient tell me his life story when all I needed was his medication list."

Clem smiled sympathetically. "The glamorous life we chose."

"Speaking of choices," Meredith began, her tone shifting, "I saw you talking to Shepherd this morning."

"Just about his surgery," Clem clarified, noting the careful way Meredith brought up Derek. "Professional interest."

Meredith nodded, seeming relieved. "Good. It's just... complicated. Attendings and interns."

"You don't have to explain," Clem assured her. "I've seen enough workplace disasters to last a lifetime. Not looking to create my own."

"Smart," Meredith murmured, just as both their pagers went off. "Bailey again."

"Does she ever sleep?" Clem wondered aloud as they headed toward the surgical floor.

"Legend says she feeds on the tears of interns," Meredith replied with dry humor. "Sustains her."

As they walked, Clem hesitated, then said, "Hey, this might sound weird, but... my roommate situation is a nightmare. Garage band practice until 2 AM, boyfriend who doesn't pay rent but uses all the hot water. Any chance you know someone looking for a roommate? Someone who respects sleep and basic hygiene?"

Meredith looked at her with sudden interest. "Actually, I have this house. It's too big for just me, and I've been thinking about getting roommates. Quieter than a garage band, I promise."

"You're serious?" Clem asked, surprised by the fortuitous timing.

"Dead serious. It was my mother's house. Now it's mine and... it's empty," Meredith explained. "I could use the company. And the rent money."

"Let's talk after shift," Clem said with genuine relief. "You might be saving my sanity."

"That's what teammates do," Meredith replied with a small smile, echoing Clem's earlier words to Alex.

As they hurried to answer Bailey's summons, Clem felt the first real connection forming—not just professional allies but potential friends. Maybe Seattle wouldn't be so lonely after all.

---

At precisely 1:55 PM, Clem slipped into the gallery overlooking OR 2, having barely finished her assigned tasks in time. She spotted Cristina already there, strategically positioned in the front row.

"You made it," Cristina observed as Clem took the seat beside her.

"Barely. Traded coffee privileges with the third-floor nurses to finish my charts," Clem said, unconsciously humming a low jazz melody as she settled in.

"Amateur. I brought cookies from the cafeteria this morning specifically for nurse bribes."

Clem laughed softly. "Now that's a Brooklyn hustle I can respect."

The gallery was filling up quickly—residents, other interns, even a few attendings had come to observe Shepherd's procedure. Below, the surgical team was prepping the patient—a 30-year-old woman with intractable epilepsy.

Derek Shepherd entered the OR with confident purpose, exchanging a few words with the anesthesiologist before looking up at the gallery. His eyes scanned the rows, pausing when he spotted Clem. Their gazes locked for a moment longer than necessary before he turned his attention to his team.

"He's good," Cristina admitted grudgingly. "Not cardio, but good."

"High praise coming from you," Clem teased, trying to ignore the flutter in her stomach from that momentary connection.

Their attention shifted fully to the surgery as Shepherd began the procedure, his movements precise and deliberate. Clem found herself completely absorbed, watching how he navigated the complex anatomy of the brain with what appeared to be intuitive ease. Her fingers absently traced the outline of her father's amethyst pin as she focused.

"Fascinating, isn't it?" came a voice from behind them. Both women turned to see Dr. Koracick taking a seat in the row behind them.

"The corpus callosum contains approximately 200 million axonal connections," he continued. "Shepherd's about to sever them to prevent the spread of seizure activity between hemispheres."

"Will the patient experience split-brain syndrome?" Clem asked, genuinely curious.

"Good question," Koracick nodded approvingly. "Some disconnection effects are inevitable, but the brain adapts remarkably well. Most patients experience significant seizure reduction with manageable side effects."

As the procedure continued, Koracick occasionally offered insights on technique or anatomy. Clem found herself mentally taking notes, impressed by both Shepherd's surgical skill and Koracick's teaching moments.

After an hour, Cristina leaned over to whisper, "Bailey's looking for us. Third floor."

Clem sighed, reluctant to leave but knowing better than to ignore a page from Bailey. As they stood to go, Koracick caught her eye.

"Neuro rounds, 7 AM tomorrow, if you're interested, Hart," he said casually.

"I'll be there," she replied without hesitation.

As they exited the gallery, Cristina gave her a sidelong glance. "Looks like you've got an attending fan club starting."

"Hardly," Clem scoffed. "Just professional interest."

"Mmm-hmm," Cristina hummed skeptically. "Just be careful. Attendings playing favorites creates waves."

"Says the woman who's been following Burke around like a cardio-obsessed shadow," Clem countered good-naturedly.

Cristina didn't deny it. "All's fair in love and surgical specialties."

---

By evening, the fatigue had settled into Clem's bones like cement. Thirty-six hours into her shift, and everything hurt. She was checking on her epidural hematoma patient—now awake and stable—when Izzie found her.

"There you are," Izzie said, looking remarkably fresh considering how long they'd been working. "Conference room in five minutes. George brought food from the deli across the street."

"Real food?" Clem asked, perking up slightly. "With actual nutritional value?"

"Sandwiches, chips, the works," Izzie confirmed. "Better hurry before Alex eats it all."

The conference room had been commandeered by the five interns, with food spread across the table and chairs arranged in a circle. Meredith was already half-asleep in her chair, while George was distributing sandwiches with the careful attention of someone operating on very little rest.

"Brooklyn lives!" Alex announced as Clem entered. "Thought maybe Koracick had kidnapped you for some bizarre neuro experiment."

"You wish," Clem replied, grabbing a sandwich and collapsing into a chair. "Then you'd have one less person to compete with."

"Please, like you're competition," Alex scoffed, but there was less edge to his tone than earlier.

"Thirty-six hours," George said, a note of wonder in his voice. "We've been doctors for thirty-six hours."

"And haven't killed anyone yet," Cristina added. "Day one success metrics."

"I assisted on three surgeries," Izzie shared, unable to keep the pride from her voice.

"I helped diagnose an epidural hematoma," Clem offered.

"I did an appendectomy," Alex countered.

"Assisted," Cristina corrected. "Bailey did the actual procedure."

"Whatever, I was there with my hands in a body cavity. What did you do, Yang?"

"Impressed Burke enough to get on his cardio rotation next week," Cristina replied smugly.

They all looked to Meredith, who had been quiet. She shrugged. "I survived. Sometimes that's enough."

There was something in her tone that resonated with all of them—the simple achievement of making it through when everything seemed designed to break them.

"To survival," Clem raised her water bottle in a toast. "First day down, thousands to go."

They all clinked bottles, a moment of camaraderie in the midst of competition and exhaustion.

As they finished eating, the conversation drifted to patients, procedures, and the hierarchy of Seattle Grace. Despite their differences, there was something binding them together—the shared experience of day one, the collective baptism by fire.

When Bailey appeared in the doorway, they all startled like guilty children.

"Lunchroom's over, children," she announced. "Grey, Yang, O'Malley—you're with me for discharge rounds. Karev, the ER needs sutures. Hart, Dr. Koracick is looking for you in Neurology."

As they dispersed, Clem felt a second wind coming on. Twelve more hours to go, but somehow, in the strange bubble of time that was a hospital shift, she felt like she could make it. One day down—the rest of her career to go.

Chapter Text

The neurology floor was quieter than the surgical wing, the lighting softer, the pace more deliberate. Clem found Dr. Koracick reviewing charts at the nurses' station, his focus intense.

"Dr. Hart," he acknowledged without looking up. "Patient in 3422. Post-op craniotomy, complaining of new-onset visual disturbances. Differential?"

No greeting, no preamble—straight to medicine. Clem appreciated the directness.

"Assuming the craniotomy was recent," she began, "possible causes include cerebral edema near the visual cortex, medication side effects, post-surgical inflammation, or a complication like small hemorrhage or infarct."

Koracick looked up, evaluating her. "And your first step would be?"

"Neurological exam focusing on visual fields, then imaging—preferably MRI—to rule out structural causes."

"Do it." He handed her the chart. "Page me with results."

As Koracick walked away, Clem allowed herself a brief moment of satisfaction before heading to the patient's room. This was why she'd chosen surgery—the directness, the challenge, the trust implicit in being handed a task without hand-holding.

The patient, an elderly man named Walter Jenkins, was sitting up in bed, his wife anxiously holding his hand.

"Mr. Jenkins? I'm Dr. Hart. Dr. Koracick asked me to check on you." She smiled warmly as she entered. "I understand you're having some vision issues?"

"Yes," he replied, voice steady despite his obvious concern. "Started about an hour ago. Like someone drew a dark line through everything on my right side."

Clem pulled out her penlight. "I'd like to perform a quick exam, if that's alright."

As she worked through the neurological assessment, Bailey appeared in the doorway, arms crossed and eyes narrowed.

"Hart," she barked, voice low but sharp. "What are you doing without supervision?"

"Dr. Koracick assigned me to this case," Clem explained, continuing her exam. "Post-op craniotomy with new visual symptoms."

"Did he now?" Bailey's eyebrow arched dangerously high. "And did anyone think to inform the resident responsible for you interns?"

"I was just about to page you with the findings, Dr. Bailey," Clem replied, maintaining her composure despite the intimidation factor Bailey carried with her five-foot frame.

Bailey gave her a look that could freeze lava before turning to the patient with a completely transformed, gentle smile. "Mr. Jenkins, how are you feeling today?"

After Bailey finished her own brief assessment, she pulled Clem into the hallway. "You page me before you do anything. You don't make a move without my knowing. Are we clear?"

"Crystal clear, Dr. Bailey."

Bailey's eyes narrowed. "Page me after imaging. I want to know what Koracick finds."

"Yes, Dr. Bailey."

As Bailey marched away, Alex appeared, leaning against the wall with his trademark smirk.

"Day two and already on the Nazi's hit list," he said, clearly enjoying her predicament. "Nice work, Brooklyn."

"Don't you have patients to see, Karev?" Clem replied, refusing to be rattled.

"Just finished a central line. That's a real procedure, by the way. Not just shining lights in people's eyes." He pushed off the wall. "Have fun with your neuro consult. Some of us will be doing actual surgery."

"With that bedside manner? Good luck keeping your patients conscious," she shot back.

Alex just grinned, unfazed. "Least I'm not playing teacher's pet with the attendings."

Before Clem could respond, he was already walking away, the swagger in his step unmistakable. She shook her head and returned to Mr. Jenkins' room, determined not to let Alex or Bailey distract her from the task at hand.

---

The MRI revealed a small area of bleeding near the optic radiation—not immediately life-threatening, but requiring intervention. Clem stood beside Koracick as he explained the situation to the worried couple.

"We'll need to go back in," he said matter-of-factly. "Small bleed, minimally invasive procedure. Dr. Hart will prep you for surgery and assist."

Clem maintained her professional composure, but inside, excitement flared. Assisting on a neurosurgical procedure less than 48 hours into her internship was unprecedented.

"Dr. Koracick," she began once they were in the hallway, "thank you for the opportunity, but are you sure—"

"You diagnosed it correctly, you get to help fix it," he interrupted. "That's how I teach. Problem?"

"No, sir," she replied quickly.

"Good. OR 3 in thirty minutes. Don't be late."

As Koracick strode away, Clem felt a mixture of exhilaration and nervousness. She was heading to prep when she nearly collided with George in the hallway.

"There you are!" he exclaimed. "Bailey's looking for you."

"Koracick assigned me to his case," Clem explained. "Tell Bailey I'm assisting on an emergency craniotomy and I'll report to her after."

George's eyes widened. "Craniotomy? On your second day? How did you—"

"Right place, right diagnosis," she said with a small smile. "Gotta go."

In the locker room, Meredith was changing into fresh scrubs.

"Craniotomy with Koracick," Clem explained before Meredith could ask. "Patient from earlier developed complications."

"On your second day?" Meredith looked impressed despite herself. "Bailey's going to kill you."

"Worth it," Clem replied. "Wish me luck."

"You don't need luck," Meredith said with surprising sincerity. "You've got this."

The unexpected vote of confidence bolstered Clem's resolve as she headed to scrub in.

---

The OR was a different world—focused, intense, with an almost sacred atmosphere. As she scrubbed alongside Koracick, Clem was struck by how calm she felt despite the enormity of what they were about to do.

"Nervous?" Koracick asked, methodically cleaning beneath his fingernails.

"Appropriately concerned," she replied honestly.

He nodded approvingly. "Good answer. Arrogance kills patients. Healthy respect for the brain keeps them alive."

In the OR, Clem was hyper-focused, anticipating instruments and maintaining clear visualization of the surgical field. She caught herself humming softly—a jazz melody—and quickly stopped, but Koracick seemed amused rather than annoyed.

"Don't stop on my account," he said. "Music steadies the hands. Why do you think we play it during surgery?"

For two hours, the world narrowed to the exposed brain tissue, Koracick's precise movements, and the steady beep of the monitors.

When they finally closed, the bleed successfully evacuated, Clem felt a profound sense of accomplishment. She'd just helped save not just a life, but someone's vision—their ability to see their grandchildren, to read books, to maintain independence.

"Not bad for your first craniotomy," Koracick commented as they scrubbed out. "You have steady hands."

"My mother always said I should've been a watchmaker," Clem replied, the fatigue of her extended shift suddenly catching up with her.

"Ah yes, the ER nurse mom." Koracick dried his hands. "Smart woman. But the world has enough watchmakers. Good neurosurgeons are harder to find."

Before Clem could respond, the door swung open with force. Bailey stood there, arms crossed, foot tapping, her entire five-foot frame radiating controlled fury.

"Dr. Hart," she said, her tone dangerously quiet. "A word."

Koracick interceded. "She was following my direct orders, Miranda. Take it up with me if you have an issue."

"Oh, I have several issues," Bailey replied, her jaw tight. "Starting with attendings poaching my interns without proper notification. These fools barely know how to hold a scalpel, and you've got them diving into brain surgery?"

"It was an emergency case," Clem explained. "I should have paged you directly. I'm sorry, Dr. Bailey."

Bailey's eyes narrowed, taking Clem's measure. "Patient status?"

"Stable. Bleed evacuated without complications. Post-op neurological exam showed immediate improvement in visual fields."

Bailey nodded curtly, seemingly satisfied with the clinical information if not the protocol breach. "Report to the pit when you're done here. We have a multiple MVA coming in."

As Bailey left, Koracick shook his head with a hint of amusement. "The Nazi's bark is worse than her bite. Usually."

"Thanks for backing me up," Clem said, genuinely grateful.

"I protect good doctors," he replied simply. "Now go save more lives before your shift ends. God knows when you'll get to sleep."

---

The ER was controlled chaos when Clem arrived. Nurses rushed between beds, residents barked orders, and the trauma bay doors kept swinging open with new arrivals from a multi-car pileup on the interstate.

"Hart!" Bailey called, gesturing her over. "Trauma bay three. Now."

Clem grabbed a trauma gown and rushed to where Bailey was already assessing a middle-aged man with multiple lacerations and a possibly fractured skull.

"History?" Clem asked the paramedic.

"Nathan Woods, 42, driver of the second vehicle. Unrestrained. GCS was 14 at the scene, dropped to 13 en route. BP 140/90, pulse 110."

Bailey was already palpating the patient's abdomen. "What's your first step, Dr. Hart?"

"Establish airway, breathing, circulation, then assess for life-threatening injuries," Clem recited, already reaching for the necessary equipment.

"And?"

"Head CT to rule out intracranial hemorrhage, given the mechanism of injury and declining GCS," she added, shining her penlight into the patient's eyes. "Pupils equal but sluggish."

"Get him to CT, then. Move!"

Across the ER, she spotted Alex working on a teenage girl, roughly checking her abdomen while snapping questions at the frightened patient. His technique was efficient but brusque, lacking the empathy Clem had been taught was essential in emergency medicine. She caught his eye briefly as she wheeled her patient toward the elevator. He gave her a competitive nod, as if to say "game on."

For the next three hours, the interns worked frantically, moving from patient to patient as Bailey and the other residents directed. Clem found herself handling everything from minor lacerations to a tension pneumothorax that she recognized before the attending did. Each successful diagnosis, each procedure completed, felt like another step toward becoming the surgeon she wanted to be.

As dawn approached, signaling the end of their first forty-eight-hour shift, Clem found herself in the hospital chapel. She wasn't particularly religious, but the quiet space offered a moment of reflection. She'd come to check on the family of a trauma patient who hadn't made it—a 32-year-old mother of two who'd suffered catastrophic internal injuries in the pileup.

"First loss?" came a voice from behind her.

Clem turned to find Derek Shepherd in the doorway, his expression sympathetic.

"That obvious?" she asked, too tired to maintain her usual composure.

"It never gets easier," he said, sitting beside her in the pew. "If it does, you should quit."

They sat in companionable silence for a moment before Derek spoke again. "I heard about your assist with Koracick. Impressive first day."

"Thanks," she replied simply. "I got lucky."

"Koracick doesn't let people assist based on luck," Derek countered. "He saw something in you."

"Maybe," Clem conceded, too exhausted for false modesty. "I like neuro. The precision of it. The way a millimeter can make the difference between speech and silence, memory and emptiness."

Derek nodded, understanding in his eyes. "That's why I chose it. Every case is a universe unto itself."

Clem found herself wanting to say more but held back. There would be time for personal revelations later.

"I should finish my charts before shift change," she said, standing up.

"Get some rest, Dr. Hart," Derek said with a gentle smile that reached his eyes in a way that made her pause momentarily. "You've earned it."

As Clem headed to the locker room, she felt the weight of the past forty-eight hours—the triumphs and failures, the lessons learned, the lives saved and lost. It was overwhelming and exhilarating all at once. And beneath it all was a growing certainty that Seattle Grace—with its challenges, its competitions, and yes, even its complicated relationships—was exactly where she was meant to be.

Chapter Text

The locker room stood eerily quiet when Clem trudged in at 6 AM. Meredith was already changing, looking like she'd been hit by the same freight train Clem felt had flattened her. Forty-eight hours of hell wrapped in scrubs and bad coffee. Forty-eight hours of life-and-death decisions made by people too sleep-deprived to choose breakfast cereal.

"We survived," Meredith said, voice raspy from exhaustion.

"Barely," Clem muttered, yanking open her locker. "And just so we're clear, 'survived' is a generous term for whatever the hell that was." She pulled her scrub top over her head, wincing as her muscles screamed in protest. Every inch of her body ached like she'd gone ten rounds with a cement mixer. "Heard about Martinez in bed two?"

"Construction worker with the crushed pelvis? Bailey whisked him off to surgery about an hour ago."

"Hope he makes it." Clem shoved her stethoscope into her bag with more force than necessary. "His wife kept showing me pictures of their kids. Three of them. All under six." The words hung in the air between them—the unspoken weight of what it meant to hold someone else's entire world in your exhausted, trembling hands.

"So," Meredith began, closing her locker with a metallic clang that echoed through Clem's pounding head, "craniotomy with Koracick, personal pep talk from Shepherd... not bad for someone who claimed they just wanted to 'keep their head down and learn.'"

Clem snorted. "Right place, right answers, and a mother who drilled neurological assessments into me since I was twelve." She ran fingers through her tangled hair, wincing as they caught in knots she was too tired to care about anymore. "Trust me, it wasn't personal. Shepherd probably has some quota of interns he needs to inspire each week."

"Don't sell yourself short," Meredith advised. "You impressed two Attendings in one shift. That never happens."

"Yeah, well—" Clem started, but was cut off when Izzie and Cristina burst in, followed by George and Alex. They all looked like extras from a zombie apocalypse movie—eyes bloodshot, movements jerky, skin the gray-green color of old hospital Jell-O.

"Is it over?" George whimpered, slumping against a locker. "Like, legally over? Can we sleep now?"

"For approximately six hours," Cristina replied, checking her watch with surgical precision. "Then we return to this circle of hell."

"Drinks at Joe's first?" Alex suggested, his usual cockiness dimmed by exhaustion but still irritatingly present. He stretched, deliberately flexing as he removed his scrub top. "I need alcohol to erase whatever the hell just happened to my brain stem."

Clem rolled her eyes. Karev had spent half their shift either ignoring her completely or challenging every observation she made. It was like dealing with a territorial tomcat with a God complex.

"I'm in," Izzie agreed with that sunshine enthusiasm that somehow survived two days without sleep. "One drink, then hibernation."

"Mer? Brooklyn?" Alex looked at them expectantly, his eyes lingering on Clem with a challenge she couldn't quite decipher.

"Do that again," Clem warned, her Brooklyn accent thickening with irritation.

"What, Brooklyn?" Alex smirked, leaning against the lockers with calculated casualness.

"Call me 'Brooklyn' one more time and I'll suture your nostrils shut while you sleep." The threat rolled off her tongue with practiced ease, the same tone she'd used on handsy customers at the bar.

Alex's smirk deepened. "You'd have to get close enough first."

Something electric and dangerous crackled between them. Not attraction—more like two predators circling the same territory.

"Fine. One drink," Clem conceded, zipping her bag with finality. "But if anyone talks about surgical techniques, I'm pouring my beer on them and leaving."

"What about you, Mer?" George asked, eyes hopeful, like a puppy seeking approval.

Meredith hesitated, then nodded. "Why not? We survived day one. That deserves tequila."

As they shuffled toward the door, Dr. Bailey appeared in the hallway like a tiny, terrifying apparition, surveying her disheveled interns with what might have been the microscopic ghost of pride.

"Congratulations," she said, her sternness barely softened. "You all survived. Some of you—" her eyes flicked briefly to Clem, then to Meredith "—even managed not to embarrass me completely."

"Does this mean you like us now?" George asked hopefully.

Bailey's expression hardened faster than setting cement. "Did your brain cells die from oxygen deprivation, O'Malley? Go home, get some sleep. Tomorrow you'll need to be smarter than that."

As Bailey marched away, the five interns exchanged looks of exhausted solidarity. For all their differences, they'd survived the trial by fire together. There was something in that—something none of them were ready to admit mattered.

"Joe's?" Alex prompted.

"Joe's," they agreed, sounding like a cultish chant of the sleep-deprived.

At Joe's

Joe's already buzzed with hospital staff when they arrived, a collection of similarly hollow-eyed doctors seeking liquid comfort before surrendering to unconsciousness. They claimed a booth in the corner, collective exhaustion creating a bubble of reluctant camaraderie.

"To surviving day one," Izzie proposed, raising her beer with excessive cheer that made Clem's teeth hurt.

"To not killing anyone," George added nervously.

"To actually saving people," Cristina amended with pointed emphasis.

"To forty-eight hours of hell," Alex contributed, already halfway through his beer, eyes challenging as they met Clem's over the rim of his glass.

"To doing it all again tomorrow," Meredith finished, raising her tequila shot.

"To Seattle Grace," Clem said, clinking her whiskey against their glasses. "Where apparently sleep is for the weak and coffee is a food group." She took a deep swallow, the burn in her throat more pleasant than the ache in her muscles.

As the alcohol worked its magic, Clem felt her Brooklyn armor softening just enough to appreciate the moment. Seattle was three thousand miles from everything familiar—her mother's cramped apartment with its perpetually broken radiator, the neighborhood bodega where Mr. Patel still called her "little doctor," the bar where she'd paid her way through med school one craft cocktail at a time. Yet somehow, in the span of forty-eight chaotic hours, she'd carved out a tiny space for herself here.

"So Brooklyn," Alex began, emphasizing the nickname with deliberate provocation, "what made you cross the country for this torture program? Couldn't hack it in New York?"

Clem felt the table tense slightly at Alex's tone, but she refused to give him the satisfaction of seeing her irritation. Instead, she leaned back, taking another slow sip of whiskey.

"Couldn't afford it," she answered honestly, surprising herself with the admission. "And Seattle Grace has the best surgical program that wasn't going to saddle me with another hundred grand in debt." She spun her glass between her fingers, watching the amber liquid catch the light. "Plus, my mother threatened to disown me if I didn't get out of New York and 'see something besides the Brooklyn Bridge.'"

"Your mom sounds like my kind of woman," Cristina commented.

"She'd eat you alive and use your bones for soup stock," Clem replied with genuine affection. "Twenty years in a Brooklyn ER makes Bailey look like a kindergarten teacher."

Alex studied her with new interest. "So mommy's an ER nurse and you're following in her footsteps? How sweet."

"Careful, Karev," Clem warned, the edge in her voice razor-sharp. "I know seventeen ways to break your finger using only a reflex hammer."

"Children, play nice," Meredith interjected, though her lips twitched into something dangerously close to a smile.

The conversation flowed easier then—Cristina describing a valve replacement she'd observed, Alex grudgingly admitting a diagnostic mistake, George recounting a patient who'd proposed marriage to him while high on fentanyl. Clem was about to share the story of her run-in with Koracick when she noticed Derek and said neurosurgeon entering the bar, deep in conversation.

Both looked over at the interns' table. Koracick said something that made Derek frown slightly before Derek approached their booth, his fatigue-lined face somehow still unfairly handsome.

"Celebrating survival?" he asked, that half-smile making an appearance.

"Medicating for post-traumatic stress," Cristina replied dryly.

Derek chuckled. "Well deserved." His gaze swept the table before landing on Clem. "First forty-eight is always the hardest."

"It gets easier?" George asked, hope blooming on his face like spring flowers after nuclear winter.

"No," Derek answered with startling honesty. "But you get better." His eyes lingered on Clem a moment longer than necessary, something unreadable in them. "The synapse reorganization was textbook, by the way. Patient's already showing improved coordination."

Clem felt a flutter of professional pride mixed with something she refused to examine. Something warm and dangerous that had no place in a teaching hospital. "Good to hear."

Alex shifted beside her, his body language suddenly tense. He drained his beer and signaled for another, eyes narrowing almost imperceptibly as he watched the exchange.

Derek nodded to the group. "Get some rest. Tomorrow's another day." As he turned to leave, he added quietly to Clem, "Looking forward to seeing what else you can do, Dr. Hart."

As he returned to the bar, Meredith cast a curious glance at Clem.

"Anyone else feel like we just enlisted in some bizarre medical bootcamp?" Clem asked, deflecting whatever Meredith might have been about to say.

"Complete with career-ending booby traps and impossible challenges," Meredith agreed, signaling for another tequila.

"I don't know," Izzie mused, her enthusiasm somehow intact despite their collective exhaustion. "I think it's kind of amazing. A couple days ago we were students. Today we saved lives."

"Today you observed while the real doctors saved lives," Alex corrected, his mood souring visibly. "Don't confuse watching with doing, Stevens."

"Ignore him," Cristina said, standing up. "Tomorrow we might be unemployed if we don't get some sleep. I'm out."

One by one, they finished their drinks and departed, the pull of sleep too powerful to resist. Clem lingered, nursing the last of her whiskey, acutely aware that Alex hadn't left yet either.

"So," he said when they were alone, his voice softer than she'd heard it before. "Shepherd seems interested in your... skills."

Clem met his gaze coolly. "We worked well together on a case."

"Right." Alex leaned forward, invading her space just enough to make a point. "Just remember, Hart—attendings play favorites until they find new toys. Don't mistake professional interest for something else."

She recognized the warning for what it was—part genuine advice, part territorial marking. "Worried about competition, Karev?"

"Please," he scoffed, though something flickered in his eyes. "I'm just looking out for a fellow intern."

"How generous of you," she replied, voice dripping with sarcasm.

For a moment, something honest passed between them—a recognition of similar hunger, similar ambition. Then Alex's cocky smile returned.

"See you tomorrow, Brooklyn," he said, tossing cash on the table as he stood.

"Not if I see you first," she retorted, but there was less venom in it than before.

Outside, Meredith was waiting by her car. "Thought you might need rescue," she explained.

"My hero," Clem said dryly. "Karev's... intense."

"That's one word for it." Meredith dangled her car keys. "So, I've got the extra room cleared out. Just needs sheets. You can move in tomorrow if you want. Beats whatever hellscape sublet you described."

Clem hesitated only briefly. "You sure about this? I talk in my sleep. Sometimes in Spanish, which I don't actually speak."

"My mother's house has five bedrooms and more issues than a psychiatric journal. Your sleep-Spanish is the least of my concerns." Meredith's smile was genuine, if tired. "Besides, carpooling means one of us can nap."

"Deal." Clem felt a genuine smile break through her exhaustion. "But fair warning—I make industrial-strength coffee that may violate several FDA regulations."

"Sounds perfect," Meredith replied. "See you tomorrow?"

"Bright and early," Clem confirmed.

As she trudged to her car in the early morning light, Clementine Hart's mind cycled through the past forty-eight hours—the patients she'd helped, the surgeries she'd witnessed, the connections beginning to form. Derek's approving smile. Alex's challenging glare. Meredith's unexpected friendship. This was just the beginning of the hardest journey of her life.

For the first time since arriving in Seattle, it felt like she might actually belong here.

---

Clem kicked off her shoes and collapsed onto her unmade bed without bothering to change her clothes. Every muscle in her body screamed with exhaustion, but her mind continued cycling through cases, procedures, and faces—especially one face with unfairly perfect hair and a smile that seemed reserved for her.

As she drifted toward unconsciousness, her phone buzzed. With a groan, she fumbled for it in her pocket, squinting at the screen.

A text from her mother: How was the first day, sweetheart? Show those Seattle doctors what Brooklyn's made of?

Despite her exhaustion, Clem smiled. Kit Hart had worked triple shifts to help her daughter through med school and never once complained. The least Clem could do was reply.

With eyes already closing, she typed back: Hard. Terrifying. Amazing. Saved some, lost some. I'm exactly where I'm supposed to be.

She added after a moment: Miss you.

Her mother's reply came immediately: Miss you more. Now sleep. You can't save lives if you're dead on your feet.

Sleep claimed her then, dreamless and deep, as Seattle's morning light filtered through her blinds. The first 48 hours were complete. The rest of her life as a surgeon had just begun.

The Things We Can't Control

The ambulance doors burst open as paramedics rushed in with a small bundle wrapped in blood-soaked towels. The controlled chaos of the ER stuttered for just a heartbeat as everyone registered what they were seeing.

"Newborn female, approximately two hours old, found in a high school bathroom trash can," the paramedic announced, his voice clinical but his eyes betraying horror. "Temperature 94 degrees, respiratory distress, possible hypothermia."

Dr. Bailey intercepted the gurney, her expression hardening into the mask she wore when cases cut too close to the bone. "Page peds and neonatal, stat!" She glanced at the interns hovering nearby. "Grey, Hart, you're with me."

Clementine and Meredith exchanged quick glances before falling into step behind Bailey as they raced toward the trauma room. The baby was impossibly tiny, her skin a concerning shade of bluish-gray that made Clem's stomach twist.

"Hart, start a warmed IV of D10, Grey, get warming blankets," Bailey commanded, her hands already moving with practiced efficiency over the newborn.

Clem worked quickly, her exhaustion from the previous day's shift vanishing as adrenaline kicked in. She found a vein in the baby's thread-like arm—thankful for the pediatrics rotation where she'd insisted on doing every infant IV herself despite her supervisor's eye-rolling.

"Got the line," she announced, securing it carefully with the smallest piece of tape she could manage.

"Respiratory rate's improving with oxygen," Meredith reported, gently wrapping the infant in warming blankets.

Dr. Arizona Robbins, the pediatric surgeon, burst into the room in a whirl of blonde hair and determined energy. She quickly assessed the situation. "How long was she in the trash?"

"Unknown," Bailey replied tersely. "School janitor found her when he heard crying."

As they worked to stabilize the baby, Clem noticed Meredith's intense focus, her expression softer than usual. The infant's tiny hand had wrapped reflexively around Meredith's finger, creating a moment of connection that was impossible to miss.

"Temperature's coming up," Clem reported, checking the monitor. "95.2 and rising."

"Good," Robbins nodded with cautious optimism. "Let's get a full workup—CBC, blood cultures, chest X-ray. Any word on the mother?"

Bailey stepped back slightly, watching her interns work. "Police say they've identified her—a 16-year-old junior. She's on her way in."

"Should I prep for a social services consult?" Clem asked, already thinking three steps ahead—a habit drilled into her by her mother. Kit Hart's voice echoed in her head: In emergency medicine, you're always fighting the clock. Think now about what you'll need in twenty minutes.

"Yes," Bailey confirmed with an approving nod. "And Hart, you'll stay with the baby. Grey, you'll handle the mother when she arrives."

"Me?" Meredith looked surprised, something vulnerable flashing across her face.

"Problem, Grey?" Bailey challenged, that familiar steel entering her voice.

"No, Dr. Bailey." Meredith's professional mask slipped back into place with practiced ease.

As Robbins and Bailey discussed treatment options, Clem checked the baby's vitals again. "She's a fighter," she said quietly to Meredith, who still hadn't moved away from the infant. "Temperature's almost normal already."

"How could someone just..." Meredith began, her voice uncharacteristically raw.

"Fear makes people do desperate things," Clem replied, her tone matter-of-fact but not unkind. "My mom saw cases like this more often than you'd think. Girl probably delivered alone, terrified out of her mind."

"Still," Meredith said, gently stroking the baby's arm with a single finger.

"You're good with her," Clem observed, a hint of surprise in her voice. There was something about Meredith Grey—something guarded and complicated that Clem couldn't quite figure out.

Before Meredith could respond, a nurse appeared at the door. "Dr. Bailey, the mother's arrived. She's in exam room three."

"Grey, you're up," Bailey directed. "Hart, stay with the infant until peds takes over."

As Meredith reluctantly left, Clem focused on the newborn, whose color was improving by the minute. "You've got this, little one," she whispered, checking the IV line. "First day on the planet's not supposed to be this hard."

Later - NICU

Clem was double-checking the baby's vital signs, humming a soft jazz tune her father used to play, when Derek Shepherd entered, chart in hand. The baby had stabilized, but Clem had found herself reluctant to leave, even after her shift technically ended.

"That's Coltrane, isn't it?" he asked, catching her by surprise. "My Favorite Things?"

Clem straightened immediately, feeling inexplicably caught out. "Dr. Shepherd," she acknowledged, her professional mask slipping back into place. "I didn't realize neuro was consulting."

"Dr. Robbins requested it," he explained, approaching the incubator with that easy confidence that seemed to follow him everywhere. "Wanted to rule out neurological damage from the hypothermia." He studied the infant before asking, "How's she doing?"

"Stable. Warming protocol's working well. She's responding appropriately to stimuli." Clem stepped aside to give him access, hyper-aware of his proximity. "No seizure activity noted."

Derek nodded, conducting his own examination with meticulous care. "And the mother?"

"Sixteen, terrified," Clem replied, her edge softening slightly. "Grey's with her now."

"This can't be easy for Grey," Derek observed, his tone suggesting simple professional concern.

Clem studied him for a moment, curiosity piqued. "She's handling it well. Professional, but compassionate."

Derek seemed satisfied with this assessment. As he completed his examination, he commented, "Your assessment was spot on, Dr. Hart. No signs of neurological damage." He looked up at her with that half-smile that seemed to transform his entire face. "You have a good eye."

"Thank you," Clem replied professionally, though she couldn't quite suppress the warmth that spread through her chest at the compliment.

The door opened and Meredith entered, her expression revealing the emotional toll of her conversation with the teenage mother. Her eyes went immediately to the baby.

"How is she?" she asked Clem.

"Stable. Dr. Shepherd just cleared her neurologically."

Meredith nodded, acknowledging Derek with a brief, professional glance. "The mother—Sarah—she's scared and alone. Parents are divorcing, boyfriend broke up with her when she told him about the pregnancy. She hid it from everyone."

"That's why observation and social history matter as much as vital signs," Derek said quietly. "Context changes everything."

The three of them stood in contemplative silence around the incubator, the beeping monitors and whirring machines creating a strangely intimate soundscape.

Bailey appeared at the door, breaking the moment. "Rounds in five minutes," she announced briskly. "Hart, Grey—handoff to peds and join the others."

As they prepared to leave, Meredith lingered by the incubator. "She needs a name," she said softly. "Everyone deserves a name."

"Sarah mentioned she always liked the name 'Hope,'" Clem offered, recalling her brief interaction with the young mother when she'd come to see the baby.

"Hope," Meredith repeated, looking down at the infant with an expression Clem couldn't quite decipher. "It fits."

Derek watched them both, his experienced eyes gentle with understanding. "The first cases that get under your skin never really leave you," he observed quietly. "They become part of who you are as a doctor."

As they filed out of the NICU, Clem glanced back at tiny Hope, so fragile yet so resilient. Twenty-four hours ago, she'd been part of someone else, hidden away in secret. Now she was her own person, fighting for her place in the world.

Not unlike the surgical interns finding their way in the maze of Seattle Grace Hospital—competing, connecting, and somehow becoming more than they were before.

In the hallway, Derek fell into step beside Clem, his voice pitched low enough that only she could hear.

"You've got good instincts, Dr. Hart," he said, his tone carrying something more than professional approval. "That's not something that can be taught."

"My mom always said medicine is three parts science and one part reading the room," Clem replied, surprised at how easily the personal detail slipped out.

Derek's smile deepened. "Your mom sounds like a very wise woman." He paused at the junction of hallways where they would need to part ways. "I'm scheduled for an acoustic neuroma resection tomorrow. Gallery's open, if you're interested."

Clem felt her pulse quicken at the invitation. "I'll be there."

As he walked away, she couldn't help but notice the way his confident stride drew the attention of nearly everyone in the hallway. Including her own.

Chapter Text

ER - Mid-Morning

"Multiple dog bites, owner tried to intervene when his pit bull attacked a neighbor's child!" the paramedic called out as they wheeled in a middle-aged man covered in blood.

"Karev, Yang, Hart—you're up!" Bailey directed from across the ER. "Dr. Shepherd will supervise."

Clem reached the patient first, already pulling on trauma gloves as she moved. She immediately assessed the numerous lacerations across his arms and face, mentally cataloging them by severity. "Sir, can you tell me your name?"

"Martin... Edwards," he gasped through pain, his face contorted. "My dog... is he okay? Caesar didn't mean it."

"Let's focus on you right now," Cristina interrupted, already cutting away his blood-soaked shirt with clinical efficiency. "Multiple deep lacerations to the forearms, defensive wounds."

"Facial lacerations need debridement," Alex added dispassionately. "Possible nerve damage to the left cheek."

Derek arrived, pulling on gloves as he moved to examine the patient. "Mr. Edwards, I'm Dr. Shepherd. We need to check for nerve damage in your face. Can you smile for me?"

The patient attempted a grimace that revealed the extent of his injuries—a deep tear along his left cheek had clearly damaged the facial nerve.

"Dr. Hart, your assessment?" Derek prompted, his eyes meeting hers with an expectant look.

Clem leaned in, focusing on the facial wound with calm precision. "Laceration extends approximately seven centimeters along the left cheek, likely involving the buccal branch of the facial nerve. Will need layered closure and possible nerve repair."

"Good," Derek nodded, a hint of approval in his voice. "You'll assist me with the facial repair. Yang, Karev—clean and close the extremity wounds."

"But I'd like to assist with the facial nerve repair," Cristina protested, her competitive nature impossible to disguise.

"I assigned Dr. Hart," Derek replied firmly, his tone leaving no room for argument.

Alex smirked at Cristina's obvious disappointment while Clem maintained a professional demeanor, though she couldn't help feeling a flash of satisfaction. She caught Cristina's glare and responded with a small shrug that said, *Not my call.*

As they worked to stabilize the patient, a police officer entered with information. "His dog attacked a four-year-old at the park. Kid's being transported to Children's Hospital. Animal Control has the dog—standard protocol is euthanasia after an attack like this."

"No!" Martin cried out, trying to sit up despite his injuries. "Caesar didn't mean it—he was scared! The kid was throwing rocks at him!"

"Sir, you need to stay still," Clem advised, her Brooklyn directness tempered with genuine concern as she maintained pressure on his bleeding wounds.

"This is my fault, not Caesar's!" Martin insisted, becoming increasingly agitated.

Cristina moved methodically, seemingly unaffected by the patient's distress. "BP's rising. He needs to calm down before we can continue."

"Mr. Edwards," Clem said, stepping into his line of sight. Her voice was steady and direct but with an underlying warmth that her fellow interns often missed. "I understand you're worried about your dog, but right now, we need to take care of you. The more agitated you get, the harder that becomes. Can you work with us here?"

Something in her tone reached him, and Martin relaxed slightly. "You don't understand—Caesar's all I have left after my wife died."

"I do understand," Clem replied simply, surprising both Cristina and Alex with her candor. "But right now, my job is to make sure you don't bleed out. So let's focus on that first, okay?"

Derek gave Clem an approving nod as the patient settled, allowing them to continue treatment. As she worked, she felt Derek's eyes on her occasionally, watching her technique with interest.

ER - Afternoon

The trauma doors burst open as paramedics rushed in with a man in his forties, a kitchen knife protruding from his chest at a sickening angle.

"Paul Statham, 43-year-old male, knife wound to the left hemithorax following a mugging," the paramedic reported. "BP 90/60, pulse 120, respiratory rate 28 and labored. Wife's behind us in the second ambulance with minor injuries."

"God almighty," Bailey muttered, then raised her voice. "O'Malley, Hart—with me! Page cardio and prep Trauma One!"

George froze momentarily at the sight of the knife handle jutting from the man's chest, but Clem was already moving, yanking a trauma gown from the nearby rack.

"O'Malley!" Bailey snapped. "Today!"

George jumped into action, following Clem and Bailey to the trauma room. As they transferred the patient to the hospital bed, Dr. Burke arrived, his calm presence immediately taking command of the room.

"Nobody touches that knife," he ordered. "Get me a portable chest X-ray and an ultrasound. We need to see what we're dealing with before we even think about removing it."

"On it," Clem replied, already moving toward the equipment with practiced efficiency.

George hovered uncertainly. "Should I—should I start another IV line?"

"Yes, O'Malley," Bailey directed, her patience wearing thin. "Large bore in both arms. This man's going to need blood, and lots of it."

As they worked to stabilize the patient, the man grabbed George's arm with surprising strength. "My wife," he gasped. "Is Sarah okay?"

"She's being treated in the next room," George assured him. "You saved her, sir."

"Had to," the man whispered. "Couldn't let him hurt her."

Clem positioned the ultrasound as Burke directed, her focus intense as she revealed the knife's position in relation to the heart. "It's penetrated the pericardium," she observed, keeping her voice steady despite the gravity of what she was seeing. "But there's minimal fluid. The knife itself might be tamponading the wound."

"Which means removing it outside an OR would be catastrophic," Burke concluded. "We need to get him upstairs immediately."

"O'Malley, you're with Burke," Bailey decided. "Hart, the wife came in with lacerations and possible concussion. She's in Trauma Two with Torres."

"But I—" Clem began, disappointment flashing across her face before she could hide it. This was exactly the kind of high-stakes case she'd come to Seattle Grace for.

"Now, Hart," Bailey said firmly, fixing her with a look that brooked no argument. "Every patient matters, not just the exciting ones."

Clem swallowed her protest and nodded. "Yes, Dr. Bailey." As she left, she caught George's eye and gave him a small nod that said, Don't screw this up

Locker Room - End of Day

The interns gathered in the locker room, exhaustion etched into their faces but with the unmistakable energy that comes from surviving another intense day at Seattle Grace.

"Baby's stable," Meredith reported, mechanically changing out of her scrubs. "Mother's agreed to counseling and her parents are stepping up to help."

"Dog bite guy's facial nerve repair went well," Cristina added, a hint of envy in her voice. "Hart apparently has 'naturally steady hands' according to Shepherd."

Clem rolled her eyes as she stuffed her scrubs into her bag. "He said that to be nice. I nearly dropped the nerve approximator."

"No, you didn't," Alex countered unexpectedly. "I was watching. You didn't even flinch when the patient sneezed."

"Knife-in-chest guy survived," George said with quiet pride. "Burke said the repair was textbook."

"Look at us," Izzie marveled, her perpetual optimism somehow intact despite forty-eight hours of medical chaos. "Actually saving lives instead of just reading about it."

Alex snorted. "Plenty of time left to kill someone tomorrow."

"Always the optimist, Karev," Clem remarked dryly, tying her shoes with more force than necessary.

"So," Cristina began casually, a dangerous glint in her eye, "anyone else notice Shepherd seems particularly interested in our Brooklyn girl?"

Clem rolled her eyes. "Professional interest. Same as Koracick."

"Two attendings?" Cristina pressed. "That's not just professional."

"It's because she doesn't chase after them like some people," Alex suggested with a pointed smirk in Cristina's direction.

"I don't chase," Cristina defended indignantly. "I strategically position myself for optimal learning opportunities."

"Whatever helps you sleep at night, Yang," Alex replied.

Meredith caught Clem's eye with a knowing look. "Attendings notice competence," she said simply. "Clem's good at what she does."

"Thank you," Clem said, genuinely touched by Meredith's support.

"Besides," Meredith continued, closing her locker with a decisive click, "we should be supporting each other, not competing over every little thing."

"Says who?" Cristina challenged.

"Says the reality that we're all we've got," Meredith replied. "Forty-eight hour shifts, life and death decisions, impossible standards—we need allies, not enemies."

A thoughtful silence fell over the group as they absorbed this perspective.

"Drinks at Joe's?" George finally suggested.

"God, yes," Izzie agreed immediately.

As they filed out together, Clem found herself walking beside Meredith.

"That was nice of you," she said quietly. "What you said back there."

Meredith shrugged. "It's true. And after today—the baby, the knife, all of it—I'm starting to realize there are more important things than hospital politics."

"Like actually being decent surgeons?" Clem suggested with a small smile.

"Exactly," Meredith agreed. "Though I still want the good surgeries."

"Oh, absolutely," Clem laughed. "I'm not that evolved yet either." She hesitated before adding, "So, about that room... the offer still stands?"

"Definitely," Meredith confirmed. "My car's big enough for whatever you need to bring. We can head to your place after Joe's."

Together they left the hospital, the weight of the day's cases—the abandoned newborn, the loyal dog owner, the brave husband—following them into the Seattle night, shaping the surgeons they were gradually becoming.

Joe's Bar - After Shift

The familiar smoky warmth of Joe's greeted them as they pushed through the door, like a well-worn blanket for the emotionally exhausted. Hospital staff had already claimed their usual territories—nurses gathered near the jukebox, attendings maintaining a respectable distance at the far end of the bar.

"First round's on me," Alex announced, surprising everyone as he headed to the bar.

"Did Karev just offer to pay for something?" Cristina asked, her eyebrows raised. "Did he get a head CT I missed?"

"Don't question miracles," George advised as they claimed a booth in the corner.

Clem slid in beside Meredith, feeling her body practically surrender to the worn vinyl seat. "I might actually fall asleep right here," she murmured, the day's adrenaline finally dissipating.

"Not before we toast surviving another day without killing anyone," Izzie insisted, her energy somehow still intact despite everything.

Alex returned with a tray of drinks—beer for himself, George and Izzie, tequila for Meredith, and whiskey for Cristina and Clem.

"You noticed I drink whiskey?" Clem asked, eyebrow raised.

Alex shrugged.

"To not killing anyone," George proposed, lifting his glass with exaggerated solemnity.

"To saving people," Cristina corrected.

"To becoming actual surgeons," Meredith added.

"To Seattle Grace," Clem finished, "where apparently no one sleeps and everyone has boundary issues."

They clinked glasses and drank, a momentary silence falling as the alcohol did its work.

"So," Izzie ventured, "did anyone else notice Shepherd watching Clem during the facial nerve repair?"

Clem nearly choked on her whiskey. "He was supervising," she responded, perhaps too quickly. "That's literally his job."

"There's supervising," Cristina noted with clinical precision, "and then there's... whatever that was."

"Can we not?" Clem pleaded. "I've been here all of three days. I'd rather not start collecting hospital gossip about me before I even finish unpacking."

"Speaking of unpacking," Meredith interjected, shooting Clem a look of solidarity, "we should probably head out soon if we're going to move your stuff tonight."

"You're moving in with Mer?" George asked, surprise evident in his voice.

"Just temporarily," Clem clarified. "Until I find something better than my current place, which features a roommate who practices death metal vocals in the shower at 4 AM."

"Temporarily?" Izzie perked up. "So there's more rooms available?"

Meredith looked momentarily caught off guard. "I—well, yes. It's a big house."

"How big?" George inquired, suddenly interested.

"Five bedrooms, two and a half baths," Meredith replied reluctantly. "But it's old and—"

"I need a new place," Izzie interrupted. "My apartment's getting renovated and I'll be homeless by next week."

"My lease is up at the end of the month," George added hopefully.

Cristina glanced between them with amused disbelief. "Are you all seriously angling to be roommates? That's like voluntarily signing up for more dysfunction."

"Says the woman who lives alone with surgical journals for company," Alex retorted.

"Mer?" Izzie pressed, eyes wide with hope. "It would be perfect. We already spend every waking hour together."

"Which is exactly why we shouldn't live together," Cristina muttered.

Meredith looked to Clem, a silent plea for help in her eyes. Clem recognized the expression of someone who wasn't great at saying no but desperately wanted to.

"It's Meredith's house," Clem said firmly. "Her choice. And maybe we can discuss it when we're not all half-dead from exhaustion."

"Fair point," George conceded, though the hopeful look didn't quite leave his face.

"I'll think about it," Meredith promised, clearly grateful for Clem's intervention. "But tonight is not the night for major decisions."

Alex checked his watch. "I'm out. Early shift tomorrow with Burke."

"Wait, how did you get Burke?" Cristina demanded, instantly competitive. "I requested cardio."

"Life's unfair, Yang," Alex smirked as he stood. "Get used to it."

As Alex left, the energy shifted, the five remaining interns settling into a more relaxed conversation. They swapped stories from med school, compared nightmare attendings, and for a brief window of time, weren't competitors for surgeries but simply five people at the beginning of the same impossible journey.

Eventually, Meredith touched Clem's arm. "We should go if we want to get your stuff moved tonight."

Clem nodded, suppressing a yawn. "Right. My mattress is calling my name, and I'd prefer it to be in a death-metal-free zone tonight."

Moving Scene

Meredith's car pulled up in front of a shabby apartment building in Capitol Hill, its aging facade oddly charming despite the peeling paint.

"Home sweet home," Clem remarked dryly, "at least for another hour."

"How much stuff do you have?" Meredith asked, eyeing the building with mild concern.

"Two suitcases, some books, and a mattress," Clem replied. "I traveled light from New York."

They climbed three flights of stairs to reach Clem's apartment, where muffled but distinct death metal could already be heard through the door. Clem sighed as she inserted her key.

"Brace yourself," she warned before opening the door.

Inside, the small apartment was dimly lit and cluttered with takeout containers, scattered magazines, and mismatched furniture. A tall woman with purple hair was headbanging in the kitchen while chopping vegetables, her boyfriend sprawled on the couch with a guitar.

"Tara," Clem called out over the music. "TARA!"

The woman looked up, registering Clem's presence with mild surprise before turning down the music. "Hey! Didn't think you'd be back tonight. Hospital stuff runs late, right?"

"Usually," Clem confirmed. "This is Meredith, my colleague. I mentioned I was moving out, remember?"

"Oh, right," Tara nodded, though her expression suggested this was news to her. "Cool, cool. Need help?"

"We've got it," Clem assured her, already moving toward her bedroom—the smallest in the apartment, barely large enough for a twin mattress and small dresser.

Meredith followed, taking in the space with a quick glance. "You weren't kidding about traveling light."

"Minimalist by necessity," Clem explained, already pulling clothes from the dresser and stuffing them into a duffel bag.

They worked efficiently, Meredith packing books while Clem gathered toiletries. The death metal resumed in the background, providing a surreal soundtrack to their task.

"So," Meredith ventured as they carried the first load down to her car, "what made you choose Seattle Grace?"

"Wanted a fresh start," Clem replied, securing her mattress to the car roof. "Seattle Grace has one of the best surgical programs in the country, and I needed..." She hesitated, searching for the right words. "Space to become whoever I'm going to be as a surgeon without anyone's expectations following me."

Meredith nodded, understanding in her eyes. "I get that. Really."

When they finally packed the last of Clem's belongings into Meredith's car, Tara emerged from the apartment to say goodbye, her boyfriend mysteriously absent.

"So, doctor life, huh?" Tara said awkwardly. "That's, like, intense."

"It is," Clem agreed.

"Well, good luck and stuff. Sorry about the death metal."

"You're not," Clem said with a smirk, "but I appreciate the sentiment."

They hugged briefly, and then Clem and Meredith were driving through Seattle's nighttime streets, the car filled with the few physical possessions that defined Clementine Hart's life.

"So," Meredith said as they approached her house, "about the other rooms..."

"You're considering Izzie and George?" Clem guessed.

"I don't know," Meredith admitted. "It's complicated. Having people around means less space to...exist. But also..."

"Less silence," Clem finished for her. "I get it. Big, empty houses have their own kind of noise."

Meredith glanced at her with surprise. "Exactly."

"For what it's worth," Clem offered, "George seems like he'd be tidy, and Izzie would probably bake. There are worse roommate qualities."

Meredith laughed—a genuine, unguarded sound. "I'll think about it. Tonight, it's just us."

They pulled into the driveway of a beautiful old house that somehow managed to look both impressive and slightly neglected. Meredith killed the engine, and for a moment, they sat in companionable silence.

"Welcome home," Meredith said finally. "At least temporarily."

"Home," Clem repeated, testing the word. It had been a while since any place had felt deserving of that label. "Let's see if it sticks."

Together, they began unloading the car, carrying pieces of Clem's life into Meredith's inherited house—two surgical interns at the beginning of a journey neither could fully anticipate, forming a fragile bond that felt, against all odds, like the start of something significant.

When they finally collapsed on Clem's bed, exhausted but satisfied, Meredith turned to her new roommate with an expression of mock seriousness.

"Just one house rule," she declared. "No death metal before coffee."

"Deal," Clem agreed, extending her hand for a formal shake. "But fair warning—I've been told I hum jazz when I'm concentrating."

"I can live with jazz," Meredith decided, smiling despite her exhaustion. "It's practically medicinal compared to what I've been hearing in my head lately."

As they dissolved into tired laughter, Seattle's night rain tapped gently against the window—a soft percussion accompanying their first night as roommates in what would undoubtedly be a complicated symphony of surgical aspirations, personal demons, and unexpected friendship.

Chapter Text

The alarm blared at 4:30 AM, and for a moment, Clementine wasn't sure where she was. No death metal. No sounds of her roommate's boyfriend raiding the fridge. Just... quiet.

She blinked in the darkness, remembering. Meredith's house. Her new room.

Clem rolled over and silenced the alarm, stretching in bed. She'd barely had time to unpack last night, just enough to find her toothbrush and scrubs for today. The rest of her meager belongings sat in suitcases against the wall, shadowy outlines in the pre-dawn light.

She padded quietly down the hallway, the old wooden floors cool beneath her bare feet. A floorboard creaked under her weight—the same one she'd mentally noted last night. The house was old but solid, with character that her previous apartment had lacked. She flicked on the kitchen light and jumped when she saw Meredith already sitting at the counter, a steaming mug between her hands.

"Jesus," Clem whispered, hand over her heart. "How long have you been sitting in the dark?"

Meredith smiled tiredly, dark circles underneath her eyes suggesting she hadn't slept much. "Couldn't sleep. Coffee's fresh."

"You're an angel," Clem said, reaching for a mug from the cabinet. "Though possibly a creepy one who sits in dark kitchens."

"First-day roommate jitters," Meredith admitted, tucking a strand of hair behind her ear. "I haven't had a roommate since... well, ever."

Clem poured herself coffee and leaned against the counter. "Me either. Not counting Tara, which I don't, because she was more like a hostile squatter who collected rent."

They sipped in comfortable silence for a moment, the clock on the wall ticking softly.

"So," Meredith said finally. "I was thinking about George and Izzie."

"The roommate situation?"

"Yeah. What do you think? Honestly."

Clem considered, blowing on her coffee. "I think they're good people. George is... sweet. Awkward, but sweet. And Izzie's intense but genuine." She shrugged. "Plus, help with the bills wouldn't hurt, right?"

"Right," Meredith nodded thoughtfully. "It's just... this was my mother's house. I grew up here. It's weird to think about filling it with people."

"People who understand what we're going through," Clem pointed out. "People who won't complain when we come home at 3 AM covered in someone else's blood."

Meredith laughed softly. "There is that."

Clem glanced at the clock. "Shower's free?"

"All yours. I'll make toast."

Heading upstairs, Clem paused at the door to her new room, looking at the suitcases. For the first time since leaving New York, she felt like she might have made the right decision coming to Seattle.

Twenty minutes later, they were in Meredith's car, speeding toward the hospital as the street lights blinked out one by one.

"You think Bailey will be in a mood again today?" Clem asked, applying mascara using the visor mirror, trying not to stab herself in the eye as they hit a pothole.

"Bailey's always pissed about something," Meredith replied, swerving around a delivery truck. "Just pray it's not directed at you today."

"Fat chance," Clem muttered, snapping the mascara closed. "I swear she has it in for me."

"Bailey has it in for everyone. It's how she shows she cares."

"Then she must care about me a whole lot," Clem said dryly.

They pulled into the hospital parking lot just as dawn was breaking over Seattle, painting the sky in shades of pink and gold that reflected off the puddles from last night's rain. Clem took a deep breath, mentally preparing herself for whatever the day would bring.

"Ready?" Meredith asked.

"Let's do this."

---

The locker room was already buzzing when Clem and Meredith arrived. Cristina was tying her shoes with surgical precision, while Izzie pinned her hair back, chattering about a patient she'd been following.

"Morning," George said, looking nervous as always as he buttoned his lab coat. "You guys hear about Bailey?"

"What about her?" Clem asked, opening her locker.

"Apparently," Cristina started, lowering her voice conspiratorially, "she was pulled into an emergency bowel resection at midnight. Patient crashed twice on the table. She's been here all night and word is she's on the warpath."

"Great," Clem muttered, changing into her scrubs. "Just what I needed today."

The door swung open with a bang, and Alex Karev strutted in, looking annoyingly well-rested and sporting that cocky grin that made Clem want to throw something at him.

"Morning, losers," he greeted them, eyes lingering on Clem for a moment too long. "Brooklyn, you look rough. Tough night?"

"Not everyone can roll out of bed looking like a jackass, Karev," Clem retorted, tying her hair back in a tight ponytail.

"You've been thinking about how I look in bed? Interesting," he smirked, moving unnecessarily close as he reached past her for his stethoscope.

Cristina rolled her eyes. "Get a room."

"I'd rather get hit by a bus," Clem said sweetly, shutting her locker with more force than necessary.

The door burst open again, and Bailey stood there, dark circles under her eyes, clipboard in hand, the exhaustion on her face immediately silencing the room. The interns straightened instinctively, conversations dying mid-sentence.

"I've been here for sixteen hours," Bailey announced without preamble, her voice sharp with fatigue. "I spent all night cleaning up another surgeon's mess. I'm tired. I'm hungry. And I have absolutely zero patience for any of your nonsense today. Understand?"

"Yes, Dr. Bailey," they chorused.

"Good. Grey, Yang, you're with Burke on the cardio floor. O'Malley, you're in the pit. Stevens, you're with OB today. Karev, you're running labs for Dr. Shepherd's meningioma case."

Clem waited, but Bailey turned to leave without assigning her.

"Dr. Bailey?" she called hesitantly. "What about me?"

Bailey turned back, fixing Clem with an unreadable look. "Hart. You're with me today."

The other interns exchanged glances. Being assigned directly to Bailey was either a blessing or a curse, and from Bailey's mood today, it seemed like the latter.

"Move, people!" Bailey barked, and the interns scattered like startled birds.

As Clem moved to follow Bailey, Alex brushed past her. "Good luck, Brooklyn," he murmured, a hint of genuine sympathy in his voice. "You're gonna need it."

Bailey led Clem to a large cart filled with patient charts, the stack nearly as tall as Clem herself. "Post-op notes," she explained curtly. "All need to be updated, filed, and entered into the system."

"All of them?" Clem asked, looking at the towering stack, her heart sinking.

"Is there a problem, Dr. Hart?" Bailey's eyes narrowed dangerously.

Clem straightened her shoulders. "No, Dr. Bailey."

"Good. When you're done with those, the lab results in the basement need to be organized. Apparently, some incompetent intern—" Bailey paused meaningfully, "—mixed up the filing system yesterday."

Clem bit her lip. That had been Alex, not her, but she knew better than to correct Bailey.

"I expect precision, Dr. Hart. Every patient deserves accurate records. Every. Single. One."

"Yes, Dr. Bailey."

Bailey's expression softened fractionally. "Finish by noon and maybe—maybe—I'll let you observe Dr. Shepherd's surgery this afternoon."

Clem's heart skipped a beat. "The meningioma resection?"

"That's the one," Bailey confirmed. "But only if these charts are perfect. Understand?"

"Yes, Dr. Bailey. Thank you, Dr. Bailey."

Bailey snorted. "Don't thank me yet, Hart. You haven't seen the mess in the basement." She turned to leave, then paused. "And Hart? I heard you moved in with Grey."

"Yes, ma'am."

"Hmm." Bailey eyed her critically. "Just remember, I don't care who you live with or who you're friends with. In this hospital, you're my intern. That means you represent me."

"I understand."

"See that you do." Bailey walked away, leaving Clem with the mountain of paperwork.

Clem sighed, pulling up a chair. If doing scut work was what it took to get into Shepherd's OR, then that's what she would do. She grabbed the first chart and got to work.

---

By some miracle—and the sacrifice of her lunch break—Clem managed to finish the charts and the basement filing by 11:45. She found Bailey in the ER, stitching up a nasty laceration on a teenage skateboarder's arm.

"Dr. Bailey," she said, trying not to sound out of breath from running up four flights of stairs. "I've completed all the charts and reorganized the lab files."

Bailey glanced up briefly, then returned to her suturing. "Double-checked the allergies section on the Morris chart?"

Clem nodded. "Yes, and I noticed his medication dosage was off by 5mg, so I flagged it for pharmacy."

Bailey's hands paused for the briefest moment, and Clem thought she saw the ghost of approval cross her face.

"Operating Room 3," Bailey said finally. "Shepherd's just starting. Tell them I sent you."

"Thank you, Dr. Bailey!" Clem said, already backing toward the door.

"Don't make me regret it, Hart!"

Clem practically flew to the elevator, jabbing the button repeatedly as if that would make it arrive faster. When it finally opened, she came face to face with Cristina.

"Where are you running to?" Cristina asked suspiciously.

"Shepherd's meningioma resection."

Cristina's eyes narrowed. "But Karev's running labs for that case."

"Bailey's letting me observe," Clem explained, checking her watch anxiously.

"Must be nice being the favorite," Cristina muttered, crossing her arms.

"Bailey had me doing post-op charts all morning," Clem retorted. "I wouldn't exactly call that favoritism."

The elevator arrived at their floor, and Clem hurried out, Cristina following close behind.

"I've got ten minutes before I need to be back with Burke," Cristina said. "I'm coming with you."

Together they rushed up to the gallery, which was already crowded with residents and other interns eager to watch the renowned neurosurgeon at work. Clem scanned the rows for an empty seat, her heart sinking when she saw none available.

"Brooklyn!" a familiar voice called.

She looked up to see Alex Karev in the front row, patting the empty seat beside him. Cristina shot her a look, but Clem was too grateful for the seat to care about appearances.

"Thanks," she said, sliding in next to him.

"Finished Bailey's torture assignment already?" Alex asked, raising an eyebrow. There was a hint of actual respect in his tone, though he'd never admit it.

"I'm efficient," Clem replied, eyes already fixed on the OR below.

Derek Shepherd stood at the operating table, his posture relaxed but focused as he made the initial incision into the patient's skull. Even from the gallery, Clem could see the precision in his movements, the confidence in each gesture. The bright OR lights gleamed off his surgical loupes as he worked.

"He's good," she murmured, almost to herself.

"Yeah," Alex agreed. "But don't tell him I said that. His ego's big enough already."

Clem smiled despite herself. "Your secret's safe with me."

"So," Alex said, leaning slightly closer, his voice lower, "you and Grey are roomies now?"

"News travels fast."

"It's a small hospital," he shrugged. "You gonna let O'Malley and Stevens move in too?"

Clem glanced at him curiously. "Maybe. Why do you care?"

"Just making conversation," Alex said defensively. "It's a long surgery."

Below, Shepherd was directing the resident assisting him, his voice carrying through the speakers into the gallery.

"See that? The tumor's adhered to the facial nerve. We'll need to be extremely careful with the dissection here. One slip and we risk permanent facial paralysis."

Clem leaned forward unconsciously, completely absorbed. This was why she'd gone into medicine—these moments of delicate precision, where skill and knowledge meant the difference between recovery and permanent disability.

"You really like this stuff, huh?" Alex observed, watching her.

"Neurosurgery? Yeah," she admitted. "My dad used to say the brain is the last great frontier."

"Your dad a doctor too?"

"No," Clem said quietly, her eyes still on Shepherd's hands. "He was a soldier. Died when I was eight."

Alex was silent for a moment. "That sucks."

It wasn't eloquent sympathy, but it was genuine, and Clem appreciated that more than platitudes.

"Yeah, it did," she agreed.

They fell into silence, both focused on the surgery below. Shepherd was now carefully separating the tumor from the facial nerve, his movements methodical and precise. The tension in the OR was palpable even from the gallery.

"Beautiful," Shepherd murmured, his voice carrying through the speakers. "See how the nerve fibers run just beneath the capsule? That's why we take our time here."

Clem found herself unconsciously leaning closer, her eyes never leaving Shepherd's hands. This was artistry as much as medicine.

Below, Shepherd successfully removed the tumor intact, holding it up briefly for the OR team to see. A ripple of appreciation went through the gallery.

"Clean margins," Shepherd announced. "Now let's check nerve function before we close."

"He makes it look so easy," Clem murmured.

"That's why he gets paid the big bucks," Alex replied. "That and the hair."

Clem laughed softly. "The hair doesn't hurt."

Alex gave her a sidelong glance. "So you've noticed the hair, huh?"

"I have eyes, Karev."

"Yeah, and I've seen where they go when Shepherd's around."

Clem felt her cheeks warm. "I don't know what you're talking about."

"Sure you don't," Alex said, but his tone was more teasing than accusatory. "Just don't come crying to me when you get your heart broken. Attending and an intern? That won't end well."

Below, Shepherd was wrapping up the procedure, instructing the resident on the final steps of closure. The gallery began to empty as people returned to their duties.

"I should get back to the pit," Clem said, standing.

"Yeah, I need to run his post-op labs," Alex agreed.

They walked out of the gallery together, an awkward but not uncomfortable silence between them.

"Hey, Brooklyn," Alex said as they reached the stairs. "If you want to see more neurosurgeries, Shepherd's doing a corpus callosotomy tomorrow. I could save you a seat again."

Clem looked at him suspiciously. "Why would you do that?"

Alex shrugged, a hint of his usual cockiness returning. "Maybe I just like watching you get all excited over brain stuff. It's kind of cute. In a geeky way."

Before Clem could respond, Alex turned and jogged down the stairs, leaving her standing there with a mix of confusion and something else she wasn't ready to name.

---

By 8 PM, Clem was exhausted. After the surgery observation, Bailey had assigned her to the pit, where she'd spent hours suturing minor lacerations and diagnosing stomach flus. Her back ached, her feet were killing her, and all she wanted was fifteen minutes of quiet before her next round of patients.

She pushed open the door to the on-call room on the surgical floor, praying it would be empty. The room was dimly lit, and she nearly cried with relief at the sight of the empty bunk beds. She fell face-first onto the lower bunk, not even bothering to remove her shoes.

"Long day?"

Clem jerked upright, heart racing. Derek Shepherd was sitting in the corner chair, a medical journal open on his lap, watching her with amused eyes.

"Dr. Shepherd!" she exclaimed, hastily sitting up and smoothing her scrubs. "I'm sorry, I didn't see you there."

"Clearly," he said, his smile causing little crinkles at the corners of his eyes. "You looked like you were about to pass out."

"Bailey had me on scut all morning and the pit all afternoon," she explained, feeling strangely self-conscious under his gaze.

"Ah, the Bailey Special," Derek nodded knowingly. "I saw you in the gallery for the meningioma resection."

"It was amazing," Clem said, her exhaustion momentarily forgotten. "The way you preserved the facial nerve—I've read about that technique, but seeing it in person was incredible."

Derek's smile widened. "Most interns fall asleep during the nerve dissection part."

"Are you kidding? That was the best part."

He laughed, setting aside his journal. "You're not like most interns, are you, Dr. Hart?"

"I don't know," Clem replied honestly. "I'm just trying to learn as much as I can."

"That's a good answer," Derek said, studying her with interest. "Your focus reminds me of myself as an intern. Never could get enough of the OR."

"My mom says I've always been obsessive about the things I care about," Clem admitted.

"Your mother's a nurse, right? That's what you mentioned before."

Clem nodded, surprised he remembered. "Twenty years in Brooklyn Methodist ER."

"She must be proud of you."

"She is," Clem said, then added with a small smile, "She was really excited for me to get out of New York."

"New York has its charms," Derek agreed, his expression momentarily distant. "But Seattle has... other advantages."

His eyes met hers, and Clem felt a flutter in her stomach that had nothing to do with exhaustion. The air in the small room suddenly felt charged, intimate in the dim light.

"I should—" Clem began, not sure what she was about to say.

Derek leaned forward slightly. "You know, I meant to tell you earlier. Your observation about the patient's subdural bleeding yesterday was spot on. Not many first-year interns would have caught that."

"Thank you," she said, warmth spreading through her chest at his praise.

"I have a craniotomy scheduled for Monday," he continued, his voice lower now. "If you're interested, I could use an extra pair of hands."

"I'd love that," Clem replied, too quickly perhaps.

Derek smiled, and she realized he had moved closer, or maybe she had. They were only a few feet apart now, the dim light of the on-call room casting soft shadows across his features.

"You have a natural talent for neurosurgery," he said softly. "It would be a shame not to nurture that."

Something in his tone made Clem's breath catch. There was professional interest there, yes, but something else too—something that made her pulse quicken.

"Dr. Shepherd," she began, not sure what she was going to say but feeling like something needed to be said.

"Derek," he corrected gently.

Their eyes locked, and for a moment Clem forgot they were in a hospital, forgot she was an intern, forgot everything except the intensity in his eyes and how the space between them seemed charged with possibility.

Derek moved closer, so close she could smell his aftershave—clean and expensive. She wasn't sure if he was going to say something more or if he was going to—

The door to the on-call room burst open, flooding the space with harsh hallway light. Dr. Preston Burke stood in the doorway, eyebrows raised at the scene before him.

"Shepherd," Burke said, his tone neutral but his eyes moving between Derek and Clem with obvious curiosity. "The Chief is looking for you. Something about tomorrow's board meeting."

"Right," Derek said, standing up quickly. "I'll be right there."

Burke nodded, his gaze lingering on Clem for a moment before he stepped back into the hallway, leaving the door ajar.

An awkward silence fell between them.

"I should go," Derek said finally, gathering his journal.

"Of course," Clem agreed, mentally kicking herself for... what exactly? Nothing had happened. Nothing was going to happen. He was an attending, for God's sake.

At the door, Derek paused, looking back at her. "Monday morning, 7 AM. Pre-op on Mrs. Rodriguez."

"I'll be there," Clem promised.

He nodded, his professional demeanor firmly back in place. "Get some rest, Dr. Hart. Bailey won't go any easier on you tomorrow."

"I know," she said, offering a small smile. "Goodnight... Derek."

A flash of something—satisfaction, perhaps—crossed his face at hearing his first name on her lips.

"Goodnight, Clementine."

As the door closed behind him, Clem fell back onto the bunk, staring up at the ceiling. What was she doing? Developing a crush on an attending was exactly the kind of complication she didn't need in her life right now. Especially one who clearly knew exactly what effect he had on women.

But as she closed her eyes, trying to steal a few minutes of rest before returning to the pit, she couldn't help replaying the moment in her mind—the way Derek had looked at her, the warmth in his voice when he praised her work, the strange electricity she'd felt in the room. The way he'd said her name, like he was tasting it.

Monday, 7 AM. She'd be there, ready to learn, ready to impress.

Just for the medicine, she told herself firmly. Nothing more.

But even as she drifted into a brief, exhausted sleep, she knew she was lying to herself.

Chapter Text

The next day

The thing about being a surgical intern is that time becomes elastic. Days stretch into endless cycles of rounds and scut work and rare, precious OR time. Nights compress into stolen moments of sleep and caffeine and trying to remember who you were before you became this creature who lives on adrenaline and ambition. Sometimes, you forget what day it is. Sometimes, you forget your own name.

Clementine Hart hadn't forgotten her name. But she had forgotten to set her alarm.

"Clem! Get up! We're going to be late!"

Meredith's voice pierced through her dreamless sleep, and Clem shot upright in bed, heart hammering. Sunlight streamed through the window at an angle that was all wrong, too bright, too high in the sky.

"What time is it?" she croaked, fumbling for her phone.

"Six-fifteen," Meredith called from the hallway. "Rounds in forty-five minutes!"

"Shit!" Clem leapt from bed, nearly tripping over her unpacked suitcase. Late on her third shift. Bailey would eviscerate her.

She showered in three minutes flat, threw on clothes, and stumbled downstairs with her hair still dripping. Meredith stood in the kitchen, holding out a travel mug of coffee and a banana.

"Breakfast of champions," Meredith said dryly. "Car's running."

"You're a lifesaver," Clem said, grabbing both. "Literally."

"Save the gratitude for when we actually make it there on time," Meredith replied, already heading for the door. "Bailey has a special place in hell for tardy interns."

The drive to the hospital was a blur of Seattle morning traffic and Clem attempting to pull up her hair with one hand while sipping scalding coffee with the other. By the time they screeched into the parking lot, she'd managed to pull herself together enough to look semi-professional, her damp hair scraped back into a neat ponytail.

"Six forty-eight," Meredith announced as they sprinted through the hospital entrance. "We might actually make it."

They raced up the stairs, taking them two at a time, dodging bewildered patients and annoyed orderlies. They burst into the locker room just as Bailey walked in from the other entrance.

"Grey, Hart," Bailey said, eyeing them suspiciously. "Cutting it close this morning, aren't we?"

"Traffic," Meredith offered.

"Alarm malfunction," Clem said simultaneously.

Bailey's eyebrow rose fractionally. She turned to address the whole group. "Pre-rounds. Five minutes. Don't make me wait."

As soon as she left, Clem collapsed against her locker, exhaling sharply.

"That was close," George said, already fully dressed in his lab coat.

"O'Malley, have you been here since yesterday?" Clem asked, quickly changing into fresh scrubs.

"I got here at five," he admitted. "I wanted to check on my post-ops."

"Suck-up," Alex coughed into his fist, not bothering to hide his smirk.

"How's that different from you practically drooling over Shepherd yesterday?" Cristina challenged him.

"I wasn't drooling. I was observing," Alex shot back. "Some of us actually want to become surgeons instead of just playing doctor."

"Guys, please," Izzie interrupted. "Can we save the fighting for after rounds? I'd like to make it through one day without Bailey making me do rectal exams on the entire geriatric floor."

"She doesn't actually make people do that," George said uncertainly. "Does she?"

"Ask Izzie's finger," Alex laughed. "It's seen things."

Clem finished buttoning her lab coat and grabbed her stethoscope. "Let's go before we're all doing rectals until retirement."

---

Rounds were brutal. Bailey was in rare form, peppering them with impossible questions about rare complications and obscure anatomical variations. By the third patient, sweat was beading on George's forehead, and even Cristina looked rattled.

"Hart," Bailey barked as they approached the fourth room.

Clem stepped forward, flipping open her small notepad, "Samuel Walters, 56-year-old male, post-op day two following an anterior cervical discectomy performed by Dr. Shepherd. Patient reports pain at a 4, down from 7 yesterday. Neurological exam shows improving grip strength bilaterally and resolution of paresthesia in the C6 dermatome. Labs are within normal limits, and he's tolerating a regular diet."

Bailey nodded, seemingly satisfied. "Plan?"

"Continue current pain management protocol, physical therapy consult this morning, and if all goes well, possible discharge tomorrow."

"And if the pain increases?" Bailey pressed.

Clem hesitated, mind racing. "Assess for signs of infection or hematoma formation, potentially order a CT to rule out post-surgical complications, and consult neurosurgery."

"Good," Bailey said, her expression giving away nothing. "Grey, why might this patient develop dysphagia post-op?"

As Meredith launched into an explanation of potential esophageal injury during anterior neck surgery, Clem caught Alex watching her from across the patient's bed. He gave her a small nod of acknowledgment – not quite approval, but something close to respect. Clem felt a tiny flare of pride. Praise from Bailey was rare. Recognition from competitive peers like Alex was almost as valuable.

The moment was broken by a familiar voice from the doorway.

"Good morning, everyone."

Derek Shepherd stood leaning against the doorframe, chart in hand, eyes scanning the room before landing on Clem. Something flickered in his gaze – recognition, perhaps, or memory of their interaction in the on-call room.

"Dr. Shepherd," Bailey acknowledged. "We were just discussing your discectomy patient."

"And how is Mr. Walters doing this morning?" Derek asked, moving into the room with that easy confidence that seemed to part the air around him.

"Improving neurological function and decreasing pain," Clem replied before she could stop herself.

Derek smiled at her, the corners of his eyes crinkling. "Excellent. Dr. Hart, isn't it? I believe you're scheduled with me on Monday's craniotomy."

Bailey's eyebrows shot up, and Clem felt five pairs of eyes swivel toward her.

"Yes, sir," she managed, ignoring the burning sensation in her cheeks.

"Good. I look forward to it." His eyes held hers a beat too long before he turned to Bailey. "Dr. Bailey, when you're finished with rounds, I could use one of your interns to assist with a lumbar puncture."

"Take Yang," Bailey replied. "She needs the practice."

A flash of disappointment crossed Cristina's face, quickly replaced by determination. "Yes, Dr. Bailey."

As they moved on to the next patient, Clem could feel Alex's eyes boring into her back. She didn't have to look to know his expression – suspicion mingled with competitive fire. She'd been singled out by Shepherd twice now. In the volatile ecosystem of surgical interns, that made her both lucky and a target.

---

By mid-morning, Clem found herself in the pit, suturing a nasty gash on the forearm of a surly teenager who'd tried to catch a falling knife. Her concentration was absolute, her stitches small and precise.

"Nice technique," a voice said from behind her. "Your mom teach you that?"

Clem glanced up to see Alex leaning against the exam room doorway, arms crossed over his chest.

"Yes, actually," she replied, returning to her work. "Practice sutures on pig skin she would bring home. Most kids got toys. I got surgical skills."

"Explains a lot about you," Alex said, moving into the room to watch her work more closely.

"Meaning?"

"Meaning you're wound tighter than those perfect little stitches." His voice held more curiosity than malice.

"I'll take that as a compliment," Clem said, tying off the last suture. She turned to the teen. "All done. Keep it clean and dry, come back in ten days to have the stitches removed."

The boy slid off the exam table without a word, ducking past Alex with typical teenage surliness.

"You're welcome," Clem called after him, shaking her head. She turned to Alex. "Did you need something, or did you just come to critique my suturing?"

"Actually," Alex said, "I came to show you something. If you're not too busy being Shepherd's favorite."

Despite herself, Clem felt intrigued. "What is it?"

Alex's smirk was almost friendly. "Something better than suturing moody teenagers."

Five minutes later, they were riding the elevator to the basement, Alex maintaining a mysterious silence despite Clem's questions.

"If this is where you murder me and hide my body, just know that Bailey will know I'm missing," Clem said as they stepped out into a dimly lit corridor.

"Please," Alex snorted. "If I wanted to kill you, I'd make it look like a medical error. Untraceable."

"That's... comforting?"

Alex led her around a corner and through a set of double doors, into a long, quiet hallway lined with gurneys.

"Welcome to the secret intern hideout," he announced with a flourish.

Clem looked around, confused. "It's... a hallway full of gurneys."

"It's not just any hallway," Alex explained, flopping down onto one of the gurneys. "Nobody comes down here except delivery guys, and they only use it twice a day. Perfect for catching sleep, avoiding Bailey, or..." he waggled his eyebrows suggestively, "other activities."

"Gross," Clem said, but she couldn't help smiling as she sat down on the gurney opposite him. "How did you find this place?"

"Followed a third-year resident who looked way too well-rested," Alex admitted. "Best decision I ever made."

Clem leaned back against the wall, surprised at how comfortable the gurney was. "So why show me? I thought we were supposed to be enemies or something."

Alex shrugged, his usual cockiness softening slightly. "Think of it as professional courtesy. We both know what it's like growing up on ramen noodles and mac and cheese dinners."

"You too?" Clem asked, surprised.

"I get you. The chip on the shoulder, the something-to-prove thing. It's familiar."

Before Clem could respond, the doors at the end of the hall burst open and Meredith, Cristina, Izzie, and George tumbled in, laughing about something.

"You told them too?" Clem asked Alex.

"Nah, they found it on their own," he replied. "Unfortunately."

"There you are!" Meredith called, spotting them. "We've been looking everywhere. It's lunchtime, and we have news."

The group crowded onto the gurneys, Cristina and Meredith squeezing in beside Clem, George and Izzie joining Alex.

"What's the news?" Clem asked, accepting half a sandwich from Izzie's outstretched hand.

"Burke is doing an open-heart transplant this afternoon," Cristina announced, eyes gleaming with excitement. "And guess who's scrubbing in?"

"You?" George guessed.

"Me," Cristina confirmed, practically bouncing. "After the lumbar puncture with Shepherd, Burke saw me in the hall and asked if I wanted in. Obviously, I said yes."

"Congrats," Clem said sincerely. "That's huge."

"Yeah, well, not all of us can get personally invited to surgeries by department heads," Cristina replied, a hint of edge in her voice.

Clem felt her face heat. "That was just—"

"Speaking of," Meredith interrupted, "what's the deal with you and McDreamy? He was definitely giving you the McDreamy eyes on rounds this morning."

"There's nothing going on," Clem insisted, though the memory of the on-call room made her cheeks flush. "He's an attending. I'm an intern. End of story."

"Right," Alex said dryly. "And the special invitation to his craniotomy is just because you're such a talented surgeon in the first week."

"Maybe it is," Clem shot back. "Some of us get by on more than just attitude, Karev."

"Children, play nice," Meredith chided. "We're all going to get surgeries eventually. Some sooner than others."

"Says the one with the surgical legend for a mother," Cristina muttered.

"Hey, I haven't been in an OR in days," Meredith protested.

"At least your resident doesn't hate you," George sighed. "I'm pretty sure Bailey has a special look of disappointment she saves just for me."

"Bailey has a special look of disappointment for everyone," Izzie reassured him, patting his knee. "It's how she shows affection."

"So who's moving in?" Alex asked suddenly, looking between Meredith and Clem. "Heard you're taking in roommates."

"News travels fast," Meredith noted, raising an eyebrow.

"Well?" Alex pressed.

Meredith and Clem exchanged a glance.

"We're thinking about it," Clem said carefully. "George and Izzie have expressed interest."

"And what about me?" Alex asked, his tone casual but something vulnerable flickering behind his eyes. "Too good to live with Evil Spawn?"

The nickname – clearly one he'd heard before – was spoken with practiced indifference, but Clem caught the slight tension in his jaw.

"You never asked," Meredith pointed out.

"I'm asking now."

An awkward silence fell over the group.

"We'll think about it," Clem said finally, surprising herself.

Alex seemed equally surprised but nodded, his expression unreadable.

Their impromptu lunch was interrupted by the simultaneous beeping of their pagers. Five pairs of eyes widened in unison.

"911 to the ER," George read aloud. "All available personnel."

"Mass casualty?" Izzie asked, already on her feet.

"Only one way to find out," Cristina replied, a hint of eagerness in her voice that only surgeons would understand.

They sprinted toward the elevator, lunch forgotten, the promise of surgical opportunities outweighing everything else. As the doors closed, Clem caught Alex watching her, his expression thoughtful.

In that moment, she realized she was becoming part of something – this strange, competitive, dysfunctional family of surgeons-in-training. For better or worse, these were her people now.

---

The ER was organized chaos. A school bus had overturned on the freeway, sending twenty injured children and two adults to Seattle Grace. Nurses rushed between beds, doctors shouted orders, and the air smelled of antiseptic and fear. Bailey stood in the center of it all, assigning cases with military precision.

"Yang, you're with Burke in Trauma 1. O'Malley, help Dr. Torres with the fractures in beds 3 through 5. Stevens, pediatric assessment in the waiting area. Grey, assist Dr. Webber with the abdominal trauma in Trauma 2. Karev, you're on the collapsed lung in bed 6. Hart—"

"I need an intern," Derek interrupted, appearing suddenly beside Bailey. "I've got a ten-year-old with a possible basilar skull fracture."

Bailey's eyes narrowed slightly. "Take Hart, then. The rest of you – move!"

Clem followed Derek to a trauma room where a small girl lay immobilized on a gurney, her face ghostly pale except for the blood matting her blonde hair.

"Lily Chapman, ten years old," the nurse reported as they entered. "Found unconscious at the scene, GCS of 9 on arrival. Pupils equal but sluggish. BP 90/60, heart rate 110."

Derek moved to the bedside, his demeanor immediately shifting to a gentler version of his usual confidence. "Lily? I'm Dr. Shepherd. Can you hear me?"

The girl's eyelids fluttered but didn't open.

"Let's get a head CT, stat," Derek ordered.

As they rushed Lily toward the CT scanner, Derek brought Clem up to speed. "Bus driver lost control on the overpass. This one was sitting by the window that shattered on impact. Paramedics found her three rows from her original seat."

"Ejected during the roll," Clem murmured. "Not good."

"No," Derek agreed grimly. "Not good at all."

In the CT room, they carefully transferred Lily to the scanning table. As the machine whirred to life, they watched the images appear on the monitor, slice by slice revealing the delicate structures of Lily's brain.

"There," Derek pointed to the screen. "See it?"

Clem leaned closer, studying the image. "Epidural hematoma. And... is that a fracture line extending into the middle cranial fossa?"

"Good eye," Derek confirmed. "The question is, is it compromising the middle meningeal artery?"

"If it is, she'll need immediate decompression," Clem said, the urgency of the situation making her stomach tighten.

"Page the OR," Derek told the technician. "Tell them we're coming up now." He turned to Clem. "Ever assisted on a pediatric craniotomy?"

"No," she admitted.

"First time for everything," he said, already moving toward the door. "Unless you'd rather sit this one out?"

"No!" Clem said quickly, too quickly perhaps. "I mean, I'm ready."

Derek's eyes met hers, and in them she saw not just the attending assessing his intern, but something more personal – trust, maybe, or faith in her abilities. "Good. Let's go save this little girl's life."

Twenty minutes later, Clem stood at the operating table, watching Derek make the initial incision into Lily's scalp. The OR was quiet except for the steady beep of the monitors and Derek's occasional requests for instruments.

"Craniotome," he said, extending his hand without looking up.

The scrub nurse placed it in his palm, and he began the delicate work of removing a section of Lily's skull. Clem watched, fascinated, as layers of protection were peeled away from the brain beneath.

"Suction," Derek ordered, and Clem moved in with the instrument, clearing the field of blood to reveal the swelling hematoma beneath.

"Good," Derek murmured. "Now hold this retractor. Exactly like that. Don't move."

For the next hour, Clem stood perfectly still, arms beginning to tremble with the effort of holding the retractors exactly as positioned, while Derek meticulously evacuated the blood clot and repaired the damaged artery.

"Almost done," Derek assured her, noticing her struggle. "You're doing great. Most interns would have asked for relief by now."

"I'm fine," Clem insisted, though her shoulders burned with fatigue.

"Stubbornness is a valuable trait in neurosurgery," Derek said, a smile evident in his voice despite the surgical mask. "Within reason."

Finally, he stepped back. "You can relax now. We're ready to close."

As Derek placed the final sutures in Lily's scalp, Clem flexed her cramped fingers, relief mixing with a profound sense of accomplishment. They had potentially saved not just a life, but a future – all the birthdays and Christmases and first kisses that this little girl might now live to experience.

"Thank you," she said quietly as they scrubbed out together. "For letting me assist."

Derek looked at her curiously. "You earned it. Your focus in there was impressive. Most first-years get distracted, especially in pediatric cases."

"I just..." Clem hesitated, searching for words. "I kept thinking about her parents. What they must be going through."

"That's the difference between a good surgeon and a great one," Derek said, his voice softening. "Technical skill matters, but it's caring about the life on the table that makes you push beyond your limits." He paused, studying her face. "You have both."

The compliment warmed her more than it should have. "I'm just an intern. I have a lot to learn."

"We all do," Derek replied. He dried his hands, his eyes never leaving hers. "Even attendings."

Something in his gaze made her pulse quicken – that same electric connection she'd felt in the on-call room. For a moment, they stood in silence, the air between them charged with unspoken possibilities.

Just as Derek opened his mouth to speak, his pager went off. He glanced down at it and sighed. "I have to take this." He paused at the door. "You did good work today, Dr. Hart. Really good."

After Derek left, Clem finished changing out of her surgical gown, still riding the high of the successful surgery. As she exited the OR area, she nearly collided with Alex.

"Hey, watch it," he said, steadying her with a hand on her shoulder. "How was the craniotomy?"

"Amazing," Clem admitted. "We got the hematoma before permanent damage."

"Lucky you," Alex said, but without his usual bite.

They fell into step together, heading toward the surgical floor. Their pagers beeped simultaneously.

"Bailey," they both said after checking.

When they arrived at the nurses' station, Bailey was waiting with a grim expression.

"The bus driver just arrived," she informed them. "Massive MI en route. He's coding in Trauma 1."

Clem and Alex rushed to Trauma 1, where they found a team already performing CPR on a middle-aged man. The cardiac monitor showed a flat line.

"Hart, take over compressions," Bailey ordered as soon as she spotted them. "Karev, push another round of epi."

Clem moved to the patient's side, placing her hands on his chest and beginning compressions. The man's skin was cool to the touch, his lips already tinged blue.

"How long has he been down?" she asked, counting rhythmically in her head as she pumped.

"Twenty minutes," Bailey replied grimly. "He arrested as soon as they brought him in. Massive MI, from the looks of it."

Clem continued compressions, sweat beading on her forehead with the effort, but the monitor remained stubbornly flat.

"Come on," she muttered to the patient. "Don't do this."

But after another ten minutes, Bailey finally shook her head. "Time of death, 16:42."

Clem stepped back, her arms aching, a hollow feeling in her chest. This was the part of medicine they couldn't teach in textbooks – the weight of failure, the lives that slipped away despite your best efforts.

"You did everything you could," Bailey told her, unusually gentle. "Sometimes, they're gone before they even get here."

Clem nodded, unable to speak past the lump in her throat. It wasn't her first death – she'd seen patients die during med school – but it hit differently now that she was responsible, now that the hands attempting to save lives were her own.

"I'll... do the paperwork," she offered.

"Do it later," Bailey said. "Go take a break. That's an order."

Surprisingly, Alex stayed with her as she walked slowly out of the trauma room, his usual arrogance replaced by quiet understanding.

"First one?" he asked as they reached the relative quiet of the hallway.

"Second," Clem admitted. "You?"

"Same." Alex said. "Old guy with pneumonia on the first day."

"How did you deal with it?" Clem asked, genuinely curious.

Alex was quiet for a moment. "You remember that for every one you lose, there are ten more waiting for you to save them." He paused. "And sometimes you get really drunk."

Despite everything, Clem laughed. "Is that a prescription, Dr. Karev?"

"Professionally speaking," Alex replied, the ghost of a smile touching his lips.

They walked in companionable silence to the vending machines, where Alex bought two candy bars and handed one to Clem.

"Sugar helps," he explained with a shrug.

It was such an unexpectedly kind gesture from someone who worked so hard to appear uncaring that Clem felt a rush of gratitude.

"Thanks," she said, meaning more than just the candy.

Alex nodded, understanding in his eyes. "Don't mention it. Seriously. I have a reputation to maintain."

---

By evening, the chaos had subsided. Most of the bus crash victims were either admitted or discharged, the hallways were quiet again, and the interns had gathered in the locker room, exchanging stories from the day.

"I held retractors for three hours in a spinal fusion," George groaned, rotating his shoulders. "I can't feel my arms."

"I got pulled into an emergency C-section," Izzie countered. "The baby wasn't breathing when it came out. Scariest two minutes of my life."

"But the baby made it?" Clem asked.

Izzie nodded, a smile breaking across her face. "Perfect Apgar scores by minute five. It was amazing."

"I helped save a ten-year-old with a brain bleed," Clem offered. "Shepherd let me assist on the craniotomy."

"Of course he did," Cristina said, rolling her eyes. "Meanwhile, I got to watch Burke transplant a heart into a 40-year-old father of three." She couldn't keep the excitement from her voice. "I actually got to touch the donor heart. It was... transcendent."

"Transcendent?" Alex snorted. "It's a muscle, Yang."

"Says the guy who spent all day inserting chest tubes," Cristina shot back.

"Three chest tubes, two central lines, and I reduced a shoulder dislocation," Alex corrected. "Plus, I kept Brooklyn here from crying after we lost the bus driver."

"I wasn't going to cry," Clem protested, though she had been close.

"Sure, Brooklyn," Alex said, but his tone was teasing rather than cruel.

Meredith emerged from the shower area, toweling her hair dry. "Anyone else feel like they've lived a month in one day?"

A chorus of exhausted agreement went up from the group.

"Joe's?" Izzie suggested hopefully. "I could use a drink. Or five."

"I'm in," Cristina agreed immediately.

"Me too," George added.

"I'll go if you're buying," Alex told Izzie with a grin.

Izzie threw a scrub cap at him. "In your dreams, Evil Spawn."

They all looked at Clem and Meredith.

"I'm so tired I might fall asleep in my beer," Meredith admitted. "But what the hell. Let's go."

"Clem?" George prompted.

Clem hesitated, thinking of the mountain of unpacking waiting for her, the calls she should make to her mother, the sleep she desperately needed. But looking at these faces – already becoming familiar, already starting to matter – she found herself nodding.

"One drink," she agreed. "But someone else is driving. I've been on my feet for fourteen hours."

As they filed out of the locker room, laughing and bickering about who would drive, Clem caught sight of Derek standing at the nurses' station, charting. He looked up as they passed, his eyes finding hers in the group. He smiled – not his professional smile, but something more personal, more private.

Clem smiled back, feeling that now-familiar flutter in her chest.

"You coming, Brooklyn?" Alex called from ahead, holding the elevator door.

"Yeah," she said, breaking eye contact with Derek. "I'm coming."

As the elevator doors closed, cutting off her view of Derek, Clem found herself surrounded by the other interns, squeezed between Meredith and Alex in the small space. Cristina was arguing with George about cardiac output measurements, Izzie was texting someone with rapid-fire thumbs, and Meredith was leaning tiredly against the wall, eyes closed.

They were competitive and exhausted and sometimes cruel to each other. They were also brilliant and passionate and frighteningly alive. They were becoming surgeons together, stumbling through these early days, making mistakes and saving lives and forming bonds that would shape them in ways none of them could yet imagine.

And somehow, improbably, they were becoming her family.

The elevator dinged, doors sliding open to reveal the hospital lobby. As they stepped out together into the evening, Clem felt something settle inside her – the certainty that whatever happened next, whether it was surgical triumphs or personal disasters or complicated entanglements with attractive attendings, she was exactly where she was meant to be.

Sometimes, life surprises you. Sometimes, you travel across the country thinking you're running away from something, only to discover you've been running toward something all along. Sometimes, you find your people in the last place you expected to look.

Chapter Text

The Following Monday

The alarm went off at 4:15 AM, and for once, Clem was already awake. She'd been staring at the ceiling for twenty minutes, mentally rehearsing procedures and reviewing neuroanatomy. Today was her craniotomy with Shepherd, and her stomach fluttered with equal parts excitement and nervousness.

She slid out of bed quietly, careful not to wake the house. The weekend had been a blur of unpacking, on-call shifts, and catching up on sleep whenever possible. George and Izzie had moved in Saturday afternoon, filling the once-empty house with boxes and laughter and the smell of Izzie's stress-baking. Alex had been conspicuously quiet about his housing situation after his initial inquiry, and Clem found herself wondering if his question had been genuine or just another way to get under her skin.

The kitchen was dark and peaceful as she made coffee. She leaned against the counter, cradling the warm mug between her palms, and closed her eyes. Focus. Today mattered.

"You're up early," came a sleepy voice from the doorway.

Clem opened her eyes to find Meredith shuffling into the kitchen, hair tousled, wearing an oversized Dartmouth t-shirt.

"Big day," Clem replied, pushing a second mug toward her roommate. "Craniotomy with Shepherd at seven."

Meredith poured herself coffee and studied Clem's face. "Nervous?"

"Terrified," Clem admitted. "But in a good way."

"You'll be fine," Meredith said, adding an obscene amount of sugar to her coffee. "Shepherd wouldn't have picked you if he didn't think you could handle it."

"I know," Clem said, though the reassurance helped. "It's just... I don't want to mess up. Especially not with him."

Something flashed across Meredith's face—concern, perhaps, or recognition. "Just remember, he's your boss. Nothing else."

Clem felt heat rise to her cheeks. "Of course. What else would he be?"

Meredith gave her a knowing look but didn't press further. "I'm heading to the shower. Izzie wants to leave by five-fifteen. Something about checking on a patient before rounds."

After Meredith left, Clem stood alone in the kitchen, sipping her coffee and trying to ignore the implications of Meredith's warning. Yes, Shepherd was attractive. Yes, there was something there—a connection, a spark, whatever you wanted to call it. But she hadn't come to Seattle to fall for an attending. She'd come to become a surgeon. Everything else was a distraction.

---

The pre-dawn hospital had a different energy—quieter, more serious, like a theater before the curtain rises. Clem strode through the still-empty corridors toward the neurosurgical wing, a second coffee in hand. She'd arrived forty-five minutes early to review Mrs. Rodriguez's chart one more time.

"Dr. Hart," called a voice as she passed the nurses' station. "Eager to get started, I see."

Derek Shepherd stood at the counter, already in navy scrubs, hair perfectly disheveled in that way that seemed both effortless and deliberate. He smiled at her, that warm, crinkly-eyed smile that made her suddenly conscious of the fact that she hadn't put on makeup that morning.

"Dr. Shepherd," she greeted him, aiming for professional but feeling her pulse quicken. "I wanted to review the case again before pre-op."

"Thorough," he approved. "Mrs. Rodriguez's scans are in Conference Room B if you'd like to take a look. I was just about to review them myself."

The small conference room was dim, the light from the view boxes casting everything in a bluish glow. Derek pinned up the MRI scans, the ghostly images of Mrs. Rodriguez's brain appearing in stark relief against the illuminated background.

"Quiz time, Dr. Hart," Derek said, standing close enough that Clem could smell his cologne. "What are we looking at?"

Clem studied the scans, grateful for the distraction from his proximity. "Grade II astrocytoma. Right frontal lobe. Approximately 3.2 centimeters."

"And what's our approach?"

"Craniotomy with awake mapping to preserve speech function, followed by complete resection if borders are clear," Clem recited, remembering her late-night study session. "The tumor is dangerously close to Broca's area, which is why we need to keep the patient conscious during the critical portion of the procedure."

Derek nodded, looking impressed. "And what's your greatest concern with this particular case?"

Clem hesitated, then decided honesty was best. "The proximity to the language center means even a slight mistake could leave Mrs. Rodriguez unable to speak. Plus, as a professional translator, her livelihood depends on perfect language function."

"Good," Derek said softly. "That's very good, Dr. Hart. Most interns focus only on the technical aspects. You've considered the human element."

His approval warmed her more than it should have. For a moment, they stood in silence, the air between them heavy with something Clem wasn't sure she should name. Then Derek cleared his throat and stepped back, breaking the spell.

"We should check on our patient," he said, his voice professionally brisk again. "Pre-op begins in twenty minutes."

They walked together toward Mrs. Rodriguez's room, discussing the case in technical terms. By the time they reached the patient's door, Clem felt centered again, the momentary awkwardness forgotten in the face of the work ahead.

Mrs. Rodriguez was sitting up in bed when they entered, a petite woman in her early fifties with salt-and-pepper hair and intelligent eyes that betrayed her nervousness despite her calm demeanor.

"Good morning, Mrs. Rodriguez," Derek greeted her with warm confidence. "This is Dr. Hart. She'll be assisting with your procedure today."

"Please, call me Elena," the woman replied with a slight accent. "And it's nice to meet you, Dr. Hart, though I wish it were under different circumstances."

"How are you feeling this morning?" Clem asked, checking the IV line as she spoke.

"Like someone who's about to have her head cut open," Elena said with gallows humor that Clem immediately appreciated. "But I trust Dr. Shepherd, and now I trust you too."

"We're going to take excellent care of you," Clem assured her, meaning every word.

Derek proceeded to explain the procedure once more, his manner both professional and comforting. Elena asked several precise, intelligent questions, and Clem found herself admiring the woman's courage.

"One more thing," Elena said as they prepared to leave. "My daughter's flight was delayed in Chicago. She won't be here until this afternoon. If... if something happens to me, there's a letter in my purse."

"Nothing's going to happen," Derek reassured her. "But I'll make sure your daughter gets your message if she arrives while you're still in surgery."

Outside the room, Derek paused, his expression serious. "That's the hardest part, you know. Not the surgery itself. It's carrying their fears, their hopes, their final messages just in case. That's what weighs on you."

Clem nodded, understanding exactly what he meant. "How do you handle it?"

"You acknowledge the weight," he said simply. "And then you do everything in your power to make sure those messages never need to be delivered."

---

At 7:30 AM, Clem stood in OR 2, watching as the anesthesiologist administered the initial sedative to Elena Rodriguez. The room hummed with the quiet efficiency of a well-orchestrated team preparing for a complex procedure.

"Dr. Hart, you'll be monitoring neurological responses once we wake Mrs. Rodriguez for the mapping portion," Derek explained, his voice muffled slightly by his surgical mask. "Until then, you'll assist with the craniotomy."

"Yes, Dr. Shepherd," Clem replied, focusing on keeping her hands steady despite her racing heart.

The surgery began methodically. Derek made the initial incision with practiced precision, and Clem watched, fascinated, as layer after layer was carefully retracted to reveal the glistening surface of the dura mater, the protective covering of the brain.

"Drill," Derek requested, and the high-pitched whine of the cranial drill filled the room.

As bone flaps were carefully removed and the dura folded back, Clem got her first glimpse of Elena's brain. No matter how many cadaver dissections she'd performed, nothing compared to this—the pulsing, living organ that contained everything that made Elena Rodriguez herself.

"Beautiful," Derek murmured, almost to himself. "Absolutely perfect exposure."

The first two hours passed in focused intensity, with Clem assisting as needed, her admiration for Derek's skill growing with each precise movement. His hands never hesitated, never trembled, moving with the confidence of thousands of hours of practice.

"Alright, let's begin the wake-up," Derek announced. "Dr. Hart, prepare the language cards."

This was the most delicate part of the procedure. With Elena's skull still open, her brain exposed, they would wake her to ensure that speech centers remained intact during tumor removal.

As the anesthesiologist decreased the sedation, Clem moved to Elena's side, ready to engage her in conversation while Derek carefully mapped the brain tissue with a small electrical stimulator.

"Elena," Clem said gently as the woman's eyes fluttered open. "Can you hear me?"

Elena blinked, momentary confusion giving way to awareness. "Yes," she whispered. "Is it... happening now?"

"Yes, we're in the middle of your surgery," Clem explained calmly. "You're doing great. I'm going to show you some pictures, and I'd like you to tell me what they are."

Clem held up a card with a simple image. "What's this?"

"A house," Elena replied.

"Good," Clem said, watching as Derek applied the stimulator to a small area of brain tissue. "And this?"

"A... a..." Elena frowned.

"Try again," Clem encouraged, noting the spot where Derek was currently stimulating.

"I know what it is," Elena said, frustration evident in her voice. "It's a... car."

Derek made a small mark on the brain tissue with a sterile pen. "That's our boundary," he murmured to Clem. "We don't go beyond that line."

For the next forty-five minutes, they continued this delicate dance—Clem showing images and asking questions, Derek mapping the precise borders where language function resided, ensuring they would preserve Elena's ability to communicate.

"You're doing beautifully, Elena," Clem reassured her. "Just a few more minutes, and then we'll put you back to sleep for the rest of the procedure."

Once the language mapping was complete, the anesthesiologist administered sedation again, and Derek prepared to remove the tumor.

"Would you like to assist with the resection, Dr. Hart?" he asked, surprising Clem.

"Yes, absolutely," she replied, trying to contain her excitement.

"Good. You'll help me with the microscopic dissection. The key is to go slowly and respect the borders we've just established."

Under the surgical microscope, the tumor appeared as a slightly discolored region against the healthy brain tissue. With Derek guiding her hands, Clem helped separate tiny blood vessels and delicately tease away the abnormal tissue from the surrounding structures.

"Excellent," Derek murmured as she successfully removed a small section of tumor. "You have naturally steady hands. That can't be taught."

The compliment sent a warm flush through her, and she was grateful for the surgical mask hiding her smile.

The procedure continued for another three hours, Derek and Clem working in seamless coordination, removing the tumor piece by meticulous piece until finally, the resection was complete.

"Beautiful work," Derek announced to the OR team. "Clean margins all around. Let's close her up."

As they began the process of replacing the bone flap and suturing the layers of tissue, Clem felt a profound sense of accomplishment. They had removed a tumor that could have eventually killed Elena, and they had preserved her ability to speak, to translate, to continue her life's work.

"You did exceptionally well today, Dr. Hart," Derek said as they scrubbed out together afterward. "Not many interns could have handled that level of responsibility."

"Thank you for the opportunity," Clem replied, scrubbing her hands with perhaps more vigor than necessary, trying to focus on the clinical aspects of what they'd just shared rather than the way her skin tingled when his arm brushed hers.

"You earned it," Derek said, his eyes meeting hers in the mirror above the sink. "I meant what I said in there. You have a gift for this work."

Before Clem could respond, the door to the scrub room swung open, and Alex Karev entered, still wearing his scrub cap.

"Hey, Brooklyn," he greeted Clem, nodding respectfully to Derek. "Dr. Shepherd."

"Dr. Karev," Derek acknowledged. "Did you need something?"

"Just wanted to check if Hart's free for lunch," Alex said casually, though his eyes darted between them with undisguised curiosity. "Cristina's hogging the cardio cases, and I need someone to complain to."

"I think we're finished here," Derek said, a hint of something unreadable crossing his face. "Mrs. Rodriguez should be waking up soon. Dr. Hart, perhaps you'd like to check on her in recovery before your lunch?"

"Of course," Clem agreed quickly.

After Derek left, Alex raised an eyebrow. "So, how was it?"

"It was incredible," Clem admitted, unable to keep the enthusiasm from her voice. "We did an awake craniotomy for language mapping. I actually got to help remove the tumor."

"Lucky you," Alex said, but his tone wasn't unkind. "Beats the hell out of what I've been doing. Webber had me in the pit all morning."

"Aww, poor baby," Clem teased, finding it easier to fall into their usual banter now that Derek was gone. "No one let you cut today?"

"Yet," Alex corrected, a competitive gleam in his eye. "Day's not over, Brooklyn. And I hear Torres has a hip replacement this afternoon that needs an intern."

They walked together toward the recovery area, their conversation shifting to the day's cases and the latest hospital gossip. Clem was grateful for the distraction, for the normalcy of complaining about assignments and joking about Bailey's latest impossible demands.

But as they passed a nurses' station, Clem caught sight of Derek speaking with Dr. Torres, and her step faltered, her mind instantly replaying moments from the surgery—his hands guiding hers, his voice low and encouraging in her ear, the way he'd trusted her with tasks no other intern would have been given.

"Earth to Brooklyn," Alex said, waving a hand in front of her face. "You still with me?"

"Sorry," Clem said quickly. "Just thinking about post-op orders."

Alex followed her gaze to where Derek stood and rolled his eyes. "Right. Post-op orders. That's definitely what you were thinking about."

"Shut up, Karev," Clem muttered, quickening her pace.

"Just saying," Alex continued, easily keeping stride with her. "Guy's got half the nurses and a quarter of the doctors in this place ready to drop their pants for him. You might want to take a number."

"It's not like that," Clem insisted, though the words sounded hollow even to her own ears. "It's professional respect."

"Is that what they're calling it these days?" Alex smirked.

Clem stopped walking and turned to face him. "What's your problem, Alex? Jealous that an attending thinks I have potential?"

Something flashed in Alex's eyes—annoyance, maybe, or something deeper. "I don't get jealous, Brooklyn. I get even." He paused, then added more seriously, "Just be careful. Mixing business with pleasure never ends well."

Before Clem could respond, Alex's pager went off. He checked it and swore under his breath. "Gotta go. Bailey's looking for me." He started to walk away, then called over his shoulder, "Save me a seat in the cafeteria. I'll buy you a pudding cup if you're lucky."

Clem watched him go, confused by the conflicting signals. Was he warning her as a friend? Needling her as a rival? Or was there something else behind his concern?

She pushed the thought aside and continued to the recovery area, where Elena Rodriguez was just beginning to wake up. As Clem checked her vitals and performed a quick neurological assessment, she was rewarded with a groggy smile.

"Dr. Hart," Elena murmured. "Did it work? Did you get it all?"

"We got it all," Clem confirmed, gently squeezing the woman's hand. "And your language function is completely intact."

"Thank you," Elena whispered, tears forming in the corners of her eyes. "Tell Dr. Shepherd thank you too."

"I will," Clem promised. "Your daughter should be here soon."

As if on cue, a young woman in her twenties rushed into the recovery area, her face tight with worry. "Mom?"

The tearful reunion that followed reminded Clem why she had chosen this path. For all the politics and the exhaustion and the complicated feelings, moments like these made everything worthwhile. This was why she had come to Seattle. This was what mattered.

---

Hours later, Clem was finishing her post-op notes at a quiet nurses' station when she sensed someone approach. Looking up, she found Derek leaning against the counter, jacket on and clearly heading out.

"Nice work today, Dr. Hart," he said, his voice low enough that the nearby nurse couldn't hear.

"Thank you, Dr. Shepherd."

He hesitated, then: "I was thinking about grabbing dinner at Emerald City Bar on Fourth - not Joe's, somewhere quieter. I'd be interested in discussing your potential in neurosurgery." His smile was casual but his eyes held something more. "Around eight, if you're off by then."

The invitation was delivered with perfect balance - professional enough to seem innocent, personal enough that they both knew it might not be.

"I should be done by then," Clem replied, trying to match his casual tone.

"Good." He nodded once, then straightened. "See you later, Dr. Hart," he added before walking away, leaving Clem to wonder exactly what she was getting herself into.

As she watched him disappear down the corridor, Meredith's warning from that morning echoed in her mind: Just remember, he's your boss. Nothing else. But even as she told herself this was just about her career, just about learning from the best, she couldn't ignore the flutter of anticipation in her stomach—or Alex's warning that seemed to come from a place of genuine concern.

She returned to her notes, trying to focus on the medical facts rather than the way Derek had looked at her, or the way he'd said her name, or the prospect of seeing him outside the hospital for the first time.

It was just dinner. Just shop talk.

Nothing more.

But even as she thought it, Clem knew she was lying to herself.

Chapter Text

Later That Evening

The locker room buzzed with end-of-shift energy as Clem changed out of her scrubs, trying to appear casual while checking the time for the third time in five minutes. 7:25 PM.

"So, Joe's in ten?" Cristina asked, slamming her locker shut. "I need tequila after the day I've had."

"Count me in," Meredith sighed, slipping into her jacket. "I spent six hours in the pit with nothing but sutures and drunk college students."

Izzie leaned against the lockers, already dressed in street clothes. "George is meeting us there. He's still finishing charts."

Four expectant faces turned toward Clem, who was deliberately taking her time folding her scrub top.

"I think I'll pass tonight," she said, aiming for nonchalance. "I'm exhausted after that craniotomy."

Alex snorted, his expression hardening slightly. "Whatever. More tequila for me." His dismissive tone barely masked something deeper—disappointment, perhaps, or suspicion.

Clem shot him a warning look. "Some of us actually need sleep, Karev."

"Some of us don't make excuses to ditch our friends," he countered, but there was no real heat behind the words. Just that trademark Alex Karev challenge, like he was daring her to admit something.

Meredith studied Clem's face a moment too long. "Everything okay? You've seemed distracted since the surgery."

"Just tired," Clem insisted, pulling her hair from its elastic and letting it fall around her shoulders. "I'll probably grab something to eat and head home. Maybe do some reading."

"Reading. Sure." Alex rolled his eyes, his cocky smile not quite reaching his eyes. "Don't hurt yourself with all that excitement."

Clem rolled her eyes, but felt heat rising to her cheeks. "Don't wait up," she told Meredith pointedly.

After her friends left, Clem took her time getting ready, applying a touch of mascara and lip gloss she kept stashed in her locker for emergencies. She switched her practical work flats for the leather ankle boots she'd worn that morning, unbuttoned the top two buttons of her blouse to reveal the delicate curve of her collarbone, and tried to quiet the voice in her head listing all the reasons this was a terrible idea.

At 7:50, she slipped out of the hospital through a side entrance, avoiding the lobby where she might run into someone she knew. The cool Seattle evening wrapped around her as she walked the four blocks to Emerald City Bar, her pulse quickening with each step.

The bar was dimly lit and mercifully free of Seattle Grace staff. Derek sat at a small corner table, a glass of scotch in front of him, jacket draped over the back of his chair. He looked different outside the hospital—more relaxed, slightly less polished. When he spotted her, his face broke into that smile that made her stomach flip.

"Clementine," he said, standing as she approached. "You made it."

"Derek," she replied, the use of his first name still feeling illicit on her tongue. "Sorry I'm a little late."

"Worth the wait," he said, pulling out a chair for her, his eyes lingering on the exposed skin at her neck. "What are you drinking?"

"Whiskey. Neat."

His eyebrow raised slightly. "A woman who knows what she wants."

"Usually," she replied, meeting his gaze directly.

When the waitress arrived with her drink and menus, Clem was grateful for the momentary distraction. The tension between them was palpable, charged with everything unsaid since that moment in the on-call room earlier that week—when he'd almost touched her face, when their bodies had been close enough that she could feel the heat radiating from him, when they'd both realized simultaneously that the door wasn't locked.

"So," Derek began after they'd ordered food, "tell me why neurosurgery."

The question caught her off guard. She'd expected something more personal, less professional.

"Honestly? The complexity." Clem took a sip of her whiskey, letting it warm her throat. "The brain is the last frontier of medicine. Everything that makes us who we are lives there—our memories, our dreams, the essence of who we are. There's something profound about working with that."

Derek watched her with an intensity that made her skin tingle. "Most surgeons would talk about the technical challenge."

"That too," she admitted. "But that's not really why we do it, is it? Not the good ones, anyway."

"No," he agreed softly. "It's not."

Their conversation flowed easily through dinner, moving from cases to medical school experiences to favorite procedures. Clem found herself laughing at his stories about residency mishaps, sharing her own struggles through med school while bartending nights.

"So that's the source of your jazz humming in the OR," Derek said, leaning forward. "I wondered about that."

Clem felt herself blush. "Sorry. Bad habit."

"Don't apologize. It's charming. Distinctive." His eyes crinkled with his smile. "It suits you."

Two hours passed like minutes. Their plates had been cleared, their drinks refilled twice. The professional pretense of the dinner had long since evaporated, replaced by the unmistakable chemistry that had been building since they first met.

"I should probably head home," Clem said finally, though she made no move to leave.

"Probably," Derek agreed, his eyes never leaving hers. "Or we could have one more drink."

"Where?"

"My place." The invitation hung between them, deceptively simple.

Clem's breath caught. This was the moment to say no, to thank him for dinner, to maintain the professional boundary that was already blurring dangerously.

Instead, she heard herself ask, "Where's your place?"

"I have land in the woods. Peaceful. Private." His voice dropped slightly on the last word. "I live in a trailer there. It's not much, but the view is spectacular."

"A trailer in the woods?" Clem couldn't help but smile. "That's not what I expected."

"I'm full of surprises, Dr. Hart." The return to her surname was playful now, teasing.

"I'm beginning to see that," she replied.

The decision crystallized between them, unspoken but clear. Derek paid the bill despite her protests, and they walked out together, careful not to touch until they reached his car.

As they drove through the darkening Seattle streets, Clem stared out the window, watching the city give way to suburbs and then to forest. Was she really doing this? Crossing this line? The professional complications alone were enough reason to turn back. Not to mention the fact that they barely knew each other.

And yet, there was something undeniable between them—something that had been there from the first moment, an understanding that went beyond physical attraction. A recognition.

The trailer appeared suddenly in the headlights, silver and solitary in a small cleared area. Beyond it, the land sloped down toward what Clem assumed was a lake or river, invisible in the darkness.

"You weren't kidding about being in the woods," she said as they stepped out of the car.

"I told you," Derek replied, unlocking the door. "Peaceful and private."

The trailer was surprisingly spacious inside—compact but thoughtfully arranged. A small kitchen area, a dining nook, a living space with a comfortable-looking couch. And at the far end, partially visible behind a half-drawn curtain, a bed.

Derek gestured for her to sit while he opened a bottle of wine. "Still want that drink?"

"Yes," Clem said, suddenly nervous now that they were here, alone, the pretense of a professional dinner completely shed.

She accepted the glass he offered, their fingers brushing in the exchange. The brief contact sent electricity up her arm, a current of desire that settled low in her belly, warm and insistent.

"To new beginnings," Derek said, touching his glass to hers.

"New beginnings," Clem echoed, taking a sip to steady herself.

They sat on the couch, close but not touching, the air between them charged with anticipation. Derek's eyes never left her face as they talked, his gaze occasionally dropping to her lips when she spoke, making her increasingly aware of her own body—the quickening of her pulse, the heat building beneath her skin.

"You know," he said finally, setting down his wine, "I've been wanting to do this since the moment I saw you in that hallway."

His hand found hers, fingers interlacing slowly. The simple touch felt more intimate than it should have, his thumb tracing small circles on her palm that sent spirals of pleasure up her arm and across her chest.

"Do what?" Clem asked, her voice barely above a whisper.

Instead of answering, Derek leaned forward, his free hand gently moving a strand of hair from her face. The gesture was achingly tender, his fingers lingering against her cheek, tracing a path down to the sensitive spot beneath her ear. This time, there was no pager to interrupt, no unlocked door to worry about.

When their lips finally met, it was soft at first—tentative, exploratory. Then Clem's hand found the nape of his neck, fingers threading through his hair, and the kiss deepened with a sudden urgency that took her breath away. His mouth was warm and demanding against hers, tasting faintly of expensive scotch and desire.

Derek pulled her closer, one hand at the small of her back, the pressure of his fingers igniting trails of sensation along her spine. His other hand slid up to cradle the back of her head, tangling in her hair. His touch was confident but gentle, each movement deliberate, as if he was memorizing every curve and angle of her body.

Clem felt herself responding instinctively, arching toward him as the kiss intensified, a soft moan escaping her throat. Her entire body felt electrified, hyper-aware of every point where they touched—his hand at her back, his chest against hers, his thigh pressed alongside her own.

When they finally broke apart, both slightly breathless, Derek's eyes had darkened to stormy blue, pupils dilated with desire. "I've been thinking about that all day," he admitted, his voice husky.

"Just today?" Clem teased, though her own voice trembled slightly.

"Longer," he confessed, his fingers tracing the line of her collarbone, dipping just below the open neckline of her blouse, sending shivers across her flushed skin. "Much longer."

This time when they kissed, there was no hesitation. His hands moved with the same precision he displayed in surgery, finding exactly the right places to touch, to caress. The top buttons of her blouse came undone beneath his fingers, exposing the delicate skin beneath. When his lips followed the path his fingers had traced, Clem gasped, her head falling back as he explored the sensitive hollow of her throat, the curve where her neck met her shoulder.

"You're beautiful," he murmured against her skin, each word a caress that vibrated through her. "So beautiful it hurts to look at you sometimes."

Clem's fingers worked at his shirt buttons, eager to feel his skin against hers. When her hands finally made contact with his chest, she felt him inhale sharply. She explored the contours of his shoulders, his chest, committing to memory the way his muscles tensed beneath her touch, the way his breath quickened when her nails grazed lightly down his stomach.

"Your hands are cold," he whispered, smiling against her lips.

"Warm them up," she challenged.

Derek's smile turned wolfish as he guided her hands upward, pressing them against his chest, his heartbeat strong and rapid beneath her palms. "Better?"

"Getting there," Clem breathed.

They moved together with growing urgency, discovering each other by touch and taste in the dim light of the trailer. Clothes were discarded piece by piece, each new expanse of skin explored with reverent attention. Derek took his time, his surgeon's hands mapping every curve and plane of her body as if committing it to memory, finding places she hadn't known could be so sensitive, drawing gasps and sighs from her that she couldn't control.

His lips traced a path down her throat, across her collarbone, lower still. Each kiss was more intoxicating than the last, each touch more electric. Clem arched beneath him, her fingers tangled in his hair, guiding him even as she surrendered to his exploration. The feel of his mouth on her skin was exquisite torment, setting every nerve ending ablaze.

When he lifted her, carrying her the few steps to the bed at the back of the trailer, Clem wrapped her legs around his waist, her lips never leaving his. They fell onto the bed together, a tangle of limbs and breathless laughter that quickly gave way to something deeper, more intense. The feel of skin against skin was divine—the heat of him pressed against her, the weight of his body a delicious anchor.

"Clementine," Derek whispered against her skin, her name becoming a litany as his mouth continued its torturous journey across her body. His hands seemed to be everywhere at once, stroking, teasing, drawing her inexorably toward a place where thought was impossible and only sensation remained.

They moved together with increasing intensity, finding a rhythm that felt both new and somehow familiar, as if they'd known each other's bodies for years instead of hours. Derek's touch was at once gentle and commanding, guiding her toward a precipice she was eager to fall from. When she reached for him, he captured her wrists, pinning them gently above her head.

"Not yet," he murmured, his voice dark with promise. "Let me taste you first."

And when he did, it was with a hunger that undid her. He feasted on her slowly at first, teasing her with flicks and circles that had her writhing. Then faster, deeper, until she was crying out for him, trembling on the edge. Derek seemed to know exactly how to touch her, how to bring her to the edge and keep her there, suspended in exquisite torment.

He teased her mercilessly with lips and tongue, coaxing sounds from her that she’d never heard herself make—raw, breathless, desperate. When she gasped his name like a plea, he moved over her again, eyes dark and intent.

Her skin felt hypersensitive, every nerve ending alive with pleasure as his hands and mouth worked in tandem, building a tension within her that was almost unbearable. When she thought she couldn't take anymore, when she was certain she would shatter from the sheer intensity of sensation, Derek finally moved back up her body, his eyes locked with hers.

He rocked into her with a depth that made her cry out, and again, this time softer, a moan laced with surrender. He moved like he knew her—every tilt of her hips answered by a deeper thrust, every intake of breath matched by his own low groan.

"Look at me," he murmured as the tension built between them. "Stay with me."

Clem did, fighting against the urge to close her eyes as pleasure washed over her in waves. The intimacy of that shared gaze was almost too much to bear—more exposed, more vulnerable than the physical act itself.

Their movements became more urgent, more primal. Derek's hand found hers, fingers interlacing, anchoring her as the world narrowed to just this moment, just this connection. Their bodies moved in perfect synchrony, every thrust, every touch bringing them closer to release.

When it finally came, it was simultaneous and shattering, their bodies arching together as if choreographed, her name on his lips, his on hers. The intensity of it left Clem breathless, trembling, clinging to Derek as waves of pleasure continued to pulse through her.

Afterward, they lay together in the quiet darkness, limbs entwined, skin cooling in the night air. Derek pulled a blanket over them, tucking Clem against his side. She rested her head on his chest, listening to his heartbeat gradually slow, feeling the gentle rise and fall of his breathing.

The only sounds were the distant lapping of water against the shore and the occasional creak of the trailer settling. Outside, a light rain began to fall, pattering softly against the metal roof.

"So," Derek said finally, his fingers tracing lazy patterns on her bare shoulder, sending pleasant aftershocks through her still-sensitive skin. "About that neurosurgery career we were discussing..."

Clem laughed, burying her face against his chest. "Is this how you mentor all your promising interns?"

"Only the ones who hum jazz in my OR," he replied, his fingers moving to trace the curve of her spine, each touch rekindling the embers of desire.

The caress sent a shiver of renewed wanting through her, and Clem raised herself on one elbow to look down at him. In the dim light, his eyes were dark and knowing, his lips curved in a satisfied smile that made her heart race all over again.

"In that case," she murmured, leaning down to brush her lips against his, "perhaps I need more... mentoring."

Derek's eyes darkened again as he pulled her closer. "I think that can be arranged, Dr. Hart."

This time, their coming together was slower, more deliberate—a thorough exploration rather than a desperate rush. They took their time learning each other's bodies, discovering what made the other gasp, what made them tremble. Derek showed her exactly how sensitive the back of her knee could be, how a certain touch along her ribcage could make her writhe with pleasure. Clem discovered the spot on his neck that made him groan, the way he shuddered when she ran her nails lightly down his back.

When dawn finally broke over the Seattle woods, they had mapped each other completely, charting territories of pleasure neither had fully known existed. The morning light filtered through the window of the trailer, painting Derek's skin in golden hues as he slept beside her, one arm still wrapped possessively around her waist.

Clem watched the play of morning shadows across his face, tracing his features with her gaze. She knew they had crossed a line that could never be uncrossed—that the day would bring complications and consequences. Their colleagues, their careers, their futures—all now complicated by what had happened between them.

But for now, feeling the steady rhythm of his heartbeat beneath her cheek, the gentle weight of his arm around her waist, the pleasant ache in her body that reminded her of everything they'd shared, she couldn't bring herself to regret it.

The Next Morning

Sunlight streamed through the small windows of the trailer, painting warm patterns across the rumpled sheets. Clem stirred slowly, her body deliciously sore in unfamiliar places. Before opening her eyes, she registered several sensations at once: the steady rise and fall of Derek's chest beneath her cheek, the weight of his arm draped across her waist, the mingled scent of his cologne and something uniquely them lingering on the sheets.

She allowed herself a moment of perfect contentment, eyes still closed, savoring the warmth of him against her. The previous night replayed in fragments—his hands on her skin, her name on his lips, the way he'd looked at her as if she were something precious and rare.

A faint smile curved her lips as she finally opened her eyes, taking in the sight of Derek still asleep beside her. In repose, his face looked younger, the tiny lines at the corners of his eyes softened. One dark curl fell across his forehead, and Clem resisted the urge to brush it back.

This feeling—this quiet intimacy—felt dangerously comfortable.

The thought slipped in unbidden, and with it came a flash of memory: morning light through Venetian blinds, the smell of expensive coffee, a deep voice murmuring "just between us" while straightening a tie.

Clem's contentment evaporated, replaced by a creeping anxiety that tightened around her chest. She carefully extracted herself from Derek's embrace, sliding out of bed with practiced stealth. Standing naked in the unfamiliar space, she suddenly felt exposed in a way that had nothing to do with her lack of clothes.

What was she doing? This wasn't some college fling—this was her attending, her boss. Someone who held power over her career, her future. Someone whose recommendation could make or break her residency.

She began gathering her scattered clothing, pulling on each piece as if assembling armor. The fabric of her blouse felt cool against her flushed skin as she buttoned it with trembling fingers.

"Leaving so soon?" Derek's voice, husky with sleep, startled her.

Clem turned to find him propped up on one elbow, hair tousled, eyes still heavy-lidded. The sheet had slipped down to his waist, revealing the chest she'd explored so thoroughly the night before. Her body responded traitorously to the sight, a warm curl of desire unfurling despite her rising panic.

"I should get home," she said, aiming for casual but hearing the strain in her own voice. "It's my day off, and I have... things to do."

Derek studied her face, his expression shifting from sleepy satisfaction to concern. "Everything okay?"

"Fine," Clem replied too quickly, searching for her left boot under the small dining table. "Just remembered some errands I need to run."

She found the boot and sat on the edge of the couch to pull it on, avoiding his gaze. The silence stretched between them, heavy with unasked questions.

"Clementine," Derek said gently, "look at me."

She did, reluctantly, steeling herself against the warmth in his eyes.

"We should talk about this," he said.

"This?" Clem echoed, feigning ignorance.

"Last night. Us." He gestured between them. "What happens when we go back to the hospital."

"Nothing happens," Clem said firmly, rising to her feet. "Last night was..." She paused, searching for the right word. Amazing? A mistake? Career suicide? "...last night," she finished lamely.

"I see." Derek's voice cooled slightly. He wrapped the sheet around his waist and stood, moving toward her. "And is that what you want? For last night to just be last night?"

Clem took an instinctive step back. "It's what makes sense."

"That's not what I asked." He was close enough now that she could smell his skin, feel the heat radiating from him. Her resolve wavered.

"I should go," she repeated, more to herself than to him.

Derek sighed, running a hand through his disheveled hair. "At least let me drive you home."

The thought of being trapped in a car with him, with all her conflicted feelings, was almost unbearable. But the alternative—calling a cab out to the middle of nowhere, explaining to the others how she'd ended up stranded in the woods—was worse.

"Okay," she conceded. "Thank you."

Derek disappeared behind the curtain to dress, giving Clem a moment to collect herself. She found her purse, checking her reflection in a small compact mirror. Her lips were slightly swollen, her hair a tangled mess. She quickly worked her fingers through the worst of the knots and applied a touch of lip gloss, trying to look less like someone who'd spent the night being thoroughly ravished.

When Derek emerged, dressed in jeans and a gray henley that hugged his chest in a way that made Clem's mouth go dry, he offered her a steaming mug.

"Coffee for the road," he said. "Black, no sugar."

The small, thoughtful gesture nearly undid her. She accepted the mug with a murmured thanks, careful not to let their fingers touch.

Outside, the morning was crisp and bright, the forest around them vibrant with spring green. Under different circumstances, Clem might have found it beautiful—might have lingered to admire the way the sunlight filtered through the trees or the glimpse of sparkling water down the slope. Instead, she hurried to Derek's car, clutching her coffee like a shield.

The drive began in silence, tense and awkward where last night's journey had been filled with anticipation. Clem stared out the window as the woods gave way to suburbs, then city streets, sipping her coffee and trying to ignore the man beside her.

"You know," Derek said finally, "we're both adults. Whatever this is or isn't, we can handle it professionally."

Clem glanced at him, then back at the passing buildings. "Can we?"

"I'd like to think so." He paused, then added more quietly, "I'm not in the habit of pursuing interns, Clementine. This isn't... a pattern for me."

The statement was clearly meant to reassure her, but it only reminded Clem of her own past mistake—of allowing herself to be swept up in the attention of someone who held power over her academic future. She wasn't sure she'd survive that a second time.

"That's good to know," she said neutrally.

Derek sighed, his knuckles whitening slightly on the steering wheel. "Where exactly am I taking you?"

Clem gave him the address to Meredith's house, then added,

As they approached the house, Clem gathered her purse, preparing to make a quick exit. But before she could reach for the door handle, Derek pulled over and turned to face her.

"Last night was incredible," he said simply, his directness catching her off guard. He looked at her with an openness that made her chest ache.

She met his gaze, fighting the pull she felt toward him. "It was," she admitted. "That's what makes this complicated."

"It doesn't have to be."

"But it is." Clem sighed, suddenly tired. "You're my boss, Derek. You evaluate my performance. You help decide which surgeries I scrub in on. You write my recommendations. The power imbalance alone makes this a terrible idea."

"And if I weren't your boss?" he asked. "If we were just two people who met in a bar?"

"But we're not." Clem reached for the door handle. "Thank you for the ride. And for... everything."

Derek looked like he wanted to say more, but instead he simply nodded. "Enjoy your day off, Dr. Hart."

The return to her surname stung more than it should have. Clem slipped out of the car with a final, tight smile and closed the door behind her. She stood on the sidewalk, watching as Derek's car pulled away, disappearing around the corner.

Only when he was completely out of sight did she allow her shoulders to slump, exhaling a breath she hadn't realized she'd been holding. The weight of what had happened—what she'd allowed to happen—settled heavily on her as she walked the remaining distance to Meredith's house.

She was halfway up the driveway when the front door opened and Meredith appeared, still in her pajamas, coffee mug in hand.

"There you are," Meredith said, eyebrows raised. "I was beginning to wonder if you'd decided to move out after one night."

Clem forced a smile. "Just got an early start to my day off."

"I saw a car drop you off," Meredith remarked casually, stepping back to let Clem into the house.

"Just... someone I met." Clem replied evasively.

Meredith studied her face for a moment, then mercifully changed the subject. "Izzie's making pancakes. George is still asleep. We were thinking about having a movie marathon later if you want to join."

The normalcy of the offer—the simple, uncomplicated pleasure of hanging out with friends—was exactly what Clem needed. "That sounds perfect, actually."

Inside, the house was warm and smelled of coffee and maple syrup. Izzie greeted her from the kitchen with a cheerful wave of a batter-covered spatula.

"Walk of shame?" Izzie asked with a grin, taking in Clem's rumpled appearance.

Clem rolled her eyes but couldn't suppress a small smile. "I prefer to think of it as a victory lap."

This earned a laugh from both Izzie and Meredith. Clem felt herself begin to relax for the first time since waking up in Derek's arms. Here, in this house with these people who were rapidly becoming friends, she could almost forget the complications waiting for her back at the hospital.

Almost.

"I'm going to grab a shower," she announced, heading for the stairs. "Save me some pancakes."

In the privacy of the bathroom, Clem finally allowed herself to really look at her reflection. Her hair was a mess, her eyes slightly puffy from lack of sleep. There was a small mark on her neck, just above her collarbone—evidence of Derek's attention that she hadn't noticed in the dim light of the trailer.

As she stepped under the hot spray of the shower, she tried to wash away not just the physical remnants of the night but the lingering sensation of Derek's hands on her skin, his mouth against hers. But even as the water sluiced over her body, she knew it wasn't that simple.

Whatever had started between them wouldn't be so easily rinsed away. And tomorrow, when she returned to the hospital, she would have to face not only Derek but the reality of what they'd done—and what it might mean for her future.

For now, though, she would eat pancakes with her roommates. She would watch movies and laugh and pretend that her life wasn't suddenly infinitely more complicated. She would take this one day of normalcy before facing the consequences of a night she couldn't bring herself to regret, despite everything.

Tomorrow would arrive soon enough. And with it, all the complications she was trying so hard to outrun.

Chapter Text

The hospital corridors buzzed with the usual morning chaos as Clem pushed through the main entrance, coffee clutched in one hand, dark circles carefully concealed beneath a layer of concealer. She'd spent most of her day off alternating between overthinking her night with Derek and determinedly not thinking about it at all—neither strategy particularly effective.

"You look like crap," Cristina greeted her cheerfully in the locker room, already changed into her scrubs.

"Thanks. Couldn't sleep," Clem replied, opening her locker with more force than necessary.

"Day off insomnia. Happens to the best of us," Izzie chirped, tying her blonde hair back. "Your body forgets how to relax."

Meredith shot Clem a curious look but said nothing, for which Clem was profoundly grateful. She changed quickly, avoiding eye contact with her fellow interns, especially Alex, who'd been watching her with unusual intensity since she walked in.

Bailey burst through the door exactly on time, clipboard in hand, expression stern. "Rounds in two minutes, people. Move it."

The interns scrambled to follow her, falling into the now-familiar formation behind their resident. Clem kept her eyes fixed on Bailey's white coat, dreading the moment they'd inevitably cross paths with a certain neurosurgeon.

That moment came sooner than expected. As they rounded the corner toward their first patient's room, Derek emerged from the elevator, looking frustratingly well-rested and handsome in his navy scrubs. His eyes found hers immediately, a flicker of something warm passing over his features before his professional mask slipped into place.

"Dr. Bailey," he greeted, nodding to the group. "I was hoping I might borrow Dr. Hart for a consult on my post-op craniotomy patient."

Bailey's eyes narrowed almost imperceptibly, her gaze flicking between Derek and Clem with laser precision. "Dr. Hart is assigned to cardio today. Dr. Stevens can assist you."

Derek's smile didn't quite reach his eyes. "Mrs. Rodriguez specifically asked for Dr. Hart. She was quite impressed with her pre-op care."

"I'm sure Mrs. Rodriguez will appreciate Dr. Stevens' excellent bedside manner just as much," Bailey countered smoothly. "Dr. Hart, report to Dr. Burke after rounds. He's expecting you in the cath lab."

"Yes, Dr. Bailey," Clem murmured, relief and disappointment warring inside her.

As the group continued down the hall, Clem felt Derek's eyes on her back but didn't turn around. Beside her, Alex leaned in slightly.

"Trouble in neurosurgery paradise?" he whispered, just loud enough for her to hear.

"Shut up, Karev," she hissed back.

"What was that, Dr. Karev?" Bailey asked without turning around.

"Nothing, Dr. Bailey," Alex replied innocently.

"That's what I thought. Now, our first patient is Mr. Jenkins, post-op day two following cholecystectomy..."

---

The cath lab was blessedly busy, giving Clem little time to dwell on her complicated personal life. Dr. Burke was demanding but straightforward, expecting precision without the emotional minefields that apparently came with neurosurgery.

By mid-afternoon, she'd assisted on two cardiac catheterizations and was reviewing charts at the nurses' station when a paper cup appeared in her peripheral vision. The rich aroma of dark roast coffee—not the watery hospital cafeteria version—wafted toward her.

"Thought you might need this," Derek's voice, low and casual, sent an unwelcome shiver down her spine. "Black, no sugar."

Clem glanced up, careful to keep her expression neutral despite the curious looks from the nurses nearby. "Thank you, Dr. Shepherd, but I'm fine."

"It's just coffee, Dr. Hart," he said, setting the cup down beside her chart. "Not a marriage proposal."

His tone was light, but his eyes conveyed a deeper message. He lingered a moment too long before adding, "When you have a moment, Mrs. Rodriguez really would like to see you. She's being discharged tomorrow."

"I'll try to stop by," Clem replied stiffly.

Derek nodded, maintaining his professional demeanor. As he turned to leave, he added quietly, "The view was particularly nice this morning. Clear enough to see all the way to the water."

The comment—innocent to anyone listening but laden with meaning for her—made Clem's cheeks warm. She stared fixedly at her chart, refusing to watch him walk away.

"Well, well," drawled a familiar voice once Derek was out of earshot. Alex leaned against the counter beside her, arms crossed. "Special coffee delivery from the head of neurosurgery. Should I be impressed or concerned?"

"Neither," Clem snapped, closing her chart with unnecessary force. "Don't you have patients to see?"

"Just finished with Burke's valve replacement. Guy's a machine," Alex replied, studying her face. "So what's with you and Shepherd?"

"Nothing's 'with' me and Shepherd," Clem said, lowering her voice. "He's my boss. End of story."

"Right," Alex said skeptically. "That's why he's bringing you coffee and making weird comments about views."

Clem's head snapped up. "You heard that?"

"I hear everything, Brooklyn," Alex smirked, but then his expression hardened slightly. "Look, I get it. Attendings are hot. Power is sexy. But trust me, it's not worth it."

"There's nothing going on," Clem insisted, gathering her charts.

"Good," Alex said, his tone unexpectedly sharp. "Because guys like Shepherd—they've got all the power. When it crashes and burns, you're the one who ends up reassigned to Scut City while they move on to the next intern."

The accuracy of his assessment hit too close to home. "Speaking from experience?" she deflected, uncomfortable with his insight.

"I'm just saying, be careful," Alex replied, his momentary concern quickly giving way to his usual smug expression. "You're too good to get sidelined by hospital politics."

The compliment, backhanded as it was, caught Clem off guard. Before she could respond, Alex straightened up, his familiar cocky grin returning.

"Besides, if anyone's going to battle you for surgeries, I want it to be a fair fight. Not you getting special treatment because you've got McDreamy making moon eyes at you."

"McDreamy?" Clem repeated, arching an eyebrow.

"That's what the nurses call him," Alex shrugged. "Not my invention."

Their conversation was interrupted by a page for both of them—multiple traumas arriving in the ER. Alex pushed off from the counter.

"Saved by the bell," he said. "Race you to the good cases?"

Despite everything, Clem found herself smiling. "You're on, Karev."

They hurried toward the elevators together, the tension momentarily broken. As they waited for the doors to open, Alex glanced sideways at her.

"For what it's worth," he said quietly, "I think Bailey knows something's up. She doesn't randomly reassign interns unless she's got a reason."

"There's nothing for her to know," Clem insisted as they stepped into the elevator.

Alex gave her a long look but mercifully dropped the subject as the elevator filled with other staff members. Clem stared at the illuminated numbers, trying to focus on the trauma cases ahead rather than the complicated web she'd unwittingly woven.

---

The ER was controlled chaos when they arrived—multiple victims from a construction site accident. Bailey stood at the center of the storm, rapidly assigning cases.

"Karev, you're with Torres on the crush injury in Trauma 1. Hart, help Grey stabilize the head lac in 3 before Shepherd gets here."

Clem froze. "Shepherd?"

Bailey's eyes narrowed dangerously. "Yes, Dr. Hart. The neurosurgeon. For the head laceration. Is that a problem?"

"No, ma'am," Clem replied quickly.

"Good. Now move!"

Clem hurried to Trauma 3, where Meredith was already assessing a middle-aged man with a significant scalp laceration and possible skull fracture.

"CT's ordered," Meredith told her as she entered. "Help me get him stable for transport."

They worked in tandem, inserting IV lines and checking vitals. Clem was applying pressure to the bleeding wound when Derek entered, pulling on trauma gloves.

"What have we got?" he asked professionally, though his eyes lingered on Clem a beat longer than necessary.

"Construction worker, fell two stories," Meredith reported. "GCS 14, pupils equal and reactive, complains of headache and nausea. Significant scalp laceration with possible skull fracture."

Derek nodded, stepping forward to examine the patient. His shoulder brushed against Clem's as he leaned in, the brief contact sending an unwelcome jolt through her.

"Good pressure technique, Dr. Hart," he commented, his voice neutral but his eyes conveying something more personal.

"I'll go check on that CT," Clem said quickly, needing to escape the suddenly too-small trauma room.

"Actually," Derek countered, "I need you to continue holding pressure while we transport. Those steady hands of yours are perfect for this."

The comment—professional on the surface but loaded with subtext—made Clem's cheeks warm. Meredith glanced between them, her expression unreadable.

"I can hold pressure, Dr. Shepherd," Meredith offered.

"Dr. Hart has already established the technique," Derek replied smoothly. "Better not to switch midstream."

And so Clem found herself trapped in the narrow confines of the CT scanner corridor with Derek, maintaining pressure on their patient's wound while Meredith went to check the incoming images.

"You're avoiding me," Derek said quietly once they were alone.

"I'm being professional," Clem corrected, eyes fixed on her patient.

"We need to talk about what happened."

"No, we don't," Clem insisted. "It happened. It was a mistake. End of story."

Derek's expression tightened. "Is that really what you think? That it was a mistake?"

Before Clem could answer, the patient groaned, drawing their attention back to his care. By the time they had reoriented him and checked his vitals, Meredith had returned with the CT results.

"Depressed skull fracture," she reported, handing the films to Derek. "No significant bleeding."

Derek studied the images. "He'll need surgery to elevate the fragment. Book an OR, Dr. Grey." He turned to Clem. "Dr. Hart, you did excellent work stabilizing him. I'd like you to scrub in."

The offer was professionally appropriate—she had been first on the case—but Clem caught the strategic nature of the invitation. Working with him in surgery would make avoiding him impossible.

"Actually, I'm assigned to cardio today," she reminded him, grateful for Bailey's earlier intervention. "Dr. Grey can assist you."

Derek looked like he wanted to say more, but Meredith's presence prevented it. "Very well," he conceded. "Let's get him prepped, Dr. Grey."

As they wheeled the patient toward the elevator, Clem slipped away, heart pounding. She needed air, space, perspective. The hospital suddenly felt too small, the corridors too narrow, the possibility of running into Derek around every corner too high.

She found momentary refuge in the basement corridor—the intern hideout Alex had shown her days earlier. Leaning against the wall, she closed her eyes and took several deep breaths.

"Hiding from someone?"

Clem's eyes snapped open to find Alex watching her from a few feet away, his expression more smug than concerned.

"Just needed a minute," she replied, straightening up.

Alex leaned against the opposite wall, arms crossed. "Surgery got canceled. Guy's wife mentioned he was on blood thinners they didn't tell us about."

They stood in silence for a moment, the distant hum of the hospital barely audible.

"You know," Alex said finally, "whatever's going on with you and Shepherd—"

"Nothing is going on," Clem interrupted automatically.

"—it's your business," he continued as if she hadn't spoken. "But Bailey's not stupid. If you keep dancing around each other like this, the whole hospital will know by the end of the week."

Clem let her head fall back against the wall with a soft thud. "There's nothing to know."

"Sure," Alex said skeptically. "That's why you look like you might have a panic attack every time he walks into a room."

"I didn't ask for your opinion, Karev," Clem snapped.

"No, but you're getting it anyway," he replied, pushing off from the wall to stand closer to her. "Because contrary to popular belief, I'm not actually an asshole one hundred percent of the time."

Despite everything, Clem felt her lips twitch toward a smile. "Just ninety-five percent?"

"Eighty-five, max," Alex countered, his own mouth curving slightly. "Look, I'm just saying—be careful. This place runs on gossip. And gossip can kill a career faster than malpractice."

The genuine concern in his voice surprised her. "Why do you care?"

Alex shrugged, suddenly looking uncomfortable with the question. "Maybe I don't want to lose my competition. You're the only one who makes things interesting around here."

Before Clem could respond, both their pagers went off simultaneously. The basement hideout had been discovered—Bailey was summoning them.

"Busted," Alex groaned. "How does she always know?"

"She's omniscient," Clem sighed, pushing herself away from the wall. "We should go before she adds another hour to our shifts."

As they walked toward the elevator together, Alex bumped his shoulder lightly against hers, the gesture less friendly and more challenging.

"Just watch yourself with Shepherd," he said as the elevator doors opened. "Pretty boy attendings are nothing but trouble."

Clem caught the edge in his voice – something that sounded suspiciously like jealousy. "I can handle myself, Karev."

"Whatever you say, Brooklyn," he muttered as they stepped inside.

The doors closed, carrying them back to the chaos of the surgical floor, where Bailey waited with crossed arms and narrowed eyes, looking remarkably like a disappointed parent who'd caught her children sneaking cookies before dinner.

"Dr. Hart, Dr. Karev," she greeted them coldly. "So nice of you to rejoin the land of the working. I believe there are post-ops that need checking, charts that need updating, and labs that need running. Unless you think your time is better spent hiding in the basement?"

"No, Dr. Bailey," they replied in unison.

"Good." Bailey handed each of them a stack of charts. "I expect these completed before either of you even thinks about going home tonight."

As they accepted their punishment, Bailey fixed Clem with a penetrating stare. "And Dr. Hart? Whatever's distracting you today—fix it. I need my interns focused on medicine, not personal drama. Understood?"

"Yes, Dr. Bailey," Clem murmured, feeling heat rise to her cheeks.

Bailey nodded once, then turned on her heel and walked away, leaving Clem with the uncomfortable certainty that her mentor knew exactly what—or rather who—was causing her distraction.

"Told you she knew," Alex muttered.

"Shut up and do your charts, Karev," Clem replied, but there was no real bite to her words.

They settled at the nurses' station, spreading their paperwork between them. Across the surgical floor, Clem caught sight of Derek exiting an OR, still in his scrub cap, deep in conversation with another surgeon. As if sensing her gaze, he looked up, their eyes meeting briefly across the distance.

Clem looked away first, focusing determinedly on her charts. Beside her, Alex said nothing, but pushed a candy bar from his pocket toward her—a small, unexpected gesture that seemed at odds with his usual demeanor.

She accepted it with a nod, unwrapping it as she turned to the first chart. Whatever storm was brewing between her and Derek would have to wait. For now, she had work to do, a career to protect, and apparently, a complicated friendship forming with the last person she'd expected.

It wasn't until much later, as she was finishing her final chart, that Clem realized something had shifted. For the first time since arriving at Seattle Grace, her thoughts had been more occupied by her growing friendship with Alex than by her complicated attraction to Derek.

Perhaps that was progress. Or perhaps it was just the beginning of an even more complicated triangle than she'd bargained for.

Either way, as she finally signed off on her last chart and prepared to head home, Clem knew one thing for certain: Seattle Grace was changing her, challenging her, connecting her to people in ways she hadn't anticipated. And despite the complications, despite the risks, a small part of her wouldn't have it any other way.

Chapter Text

The On-Call Room

Clem pressed her forehead against the nurses' station counter, feeling the cool surface against her skin. Twelve hours into her shift, and the relentless pace of Seattle Grace had finally hit a lull. She glanced at her watch and calculated she had maybe twenty minutes before Bailey would track her down with another assignment.

Twenty minutes. Just enough time to close her eyes.

She spotted an empty on-call room down the hall and made her move, slipping away from the bustling corridor. As she walked, she didn't notice Derek Shepherd standing at the far end of the nurses' station, his eyes following her retreating form.

The on-call room was mercifully empty. Clem sighed as she sank onto the lower bunk, kicking off her shoes and stretching out. The scratchy standard-issue blanket felt like luxury against her exhausted body. She closed her eyes, willing herself to power-nap efficiently.

Two minutes later, the door opened and closed with a soft click. Then came the distinct sound of the lock turning.

Clem's eyes shot open. Derek Shepherd stood with his back against the door, his expression unreadable in the dim light.

"Dr. Shepherd," she said, sitting up quickly. Her heart hammered against her ribs.

"Dr. Hart." His voice was low, deliberate.

Clem swung her legs over the side of the bed, planting her feet on the floor.

"You're still avoiding me." Derek took a step forward.

"I wasn't avoiding you, I was—" Clem started, then stopped herself. "Fine. I was avoiding you."

Derek moved closer. "You said we needed to be professional. I'm trying to respect that."

"By following me into an on-call room and locking the door?" She raised an eyebrow.

"That... wasn't exactly professional," he admitted, a hint of a smile playing at his lips. "But I needed to see you. To talk."

"Talk. Right." Clem stood up, arms crossed. The room suddenly felt much smaller. "Look, what happened the other night—"

"Was incredible," Derek finished.

"Was complicated," she corrected him. "I'm an intern. You're an attending. This—" she gestured between them, "—shouldn't have happened."

"But it did happen." His voice dropped lower. "And we both wanted it to."

They stood facing each other, the tension between them nearly visible in the half-light. Clem could smell his cologne—subtle, expensive. She remembered how it had clung to her skin.

"This is a terrible idea," she whispered.

"Probably the worst," Derek agreed, not moving away.

Something snapped between them. Clem wasn't sure who moved first—maybe they both did—but suddenly her hands were in his hair and his mouth was on hers. The kiss was hungry, desperate, all the restraint of the day evaporating in an instant.

She pushed him backward until his legs hit the edge of the bunk. With surprising strength, she shoved him down onto the mattress. Derek looked up at her, surprise and desire mingling in his expression.

"You're full of surprises, Clementine," he murmured.

"Shut up," she said, climbing onto his lap. "Just shut up."

His hands found her waist as she straddled him, pulling her closer. Their kisses grew more urgent, breath mingling, hands exploring with increasing boldness. Clem tugged at the hem of his scrub top, and he obliged by raising his arms so she could pull it over his head.

"Your turn," he said, his fingers finding the bottom of her scrub top.

She let him remove it, leaving her in just her simple cotton bra. Derek's eyes darkened as he traced the constellation of freckles across her collarbone.

"I couldn't focus all day," he admitted, his voice husky. "Kept thinking about the other night."

"Same," Clem confessed. "And I hate myself for it."

His hands moved to her back, drawing slow circles over her skin. "We could stop."

"Do you want to stop?"

"God, no." His laugh was quiet, almost pained.

She leaned down to kiss him again, rolling her hips against his. Derek groaned softly into her mouth, his hands tightening on her waist. With a sudden movement, he flipped them both, pressing her back against the narrow mattress.

"You're a hazard to my self-control, Clementine Hart," he said, trailing kisses along her jawline.

"I thought surgeons were supposed to have excellent self-control," she gasped as his teeth grazed her earlobe.

"Not around you, apparently."

Their remaining clothes were shed with urgent efficiency. In the close quarters of the on-call room, they moved together with a chemistry that surprised them both. Clem took control, pushing Derek onto his back again and straddling him. She moved above him, setting a rhythm that had them both struggling to stay quiet.

"Look at me," Derek said, his voice strained.

She did, meeting his intense gaze as they moved together. There was something raw and honest in that moment of connection—something that scared her far more than the physical act itself.

Afterward, they lay tangled together on the narrow bunk, the reality of what they'd done settling over them like a heavy blanket. Clem's pager, discarded with her scrubs, buzzed insistently from the floor.

"That'll be Bailey," she sighed, making no move to check it.

Derek's fingers trailed lazily up and down her bare arm. "This complicates things."

"You think?" Clem laughed without humor. "Sneaking around, on-call room hookups—I didn't come to Seattle Grace for this."

"What did you come for?" His question was genuine, curious.

For a moment, Clem considered telling him the truth—about what happened in New York, about running away from scandal rather than toward opportunity. But the moment passed.

"To become a surgeon," she said simply. "Not to become a cliché."

Derek nodded, understanding. "For what it's worth, you're the furthest thing from a cliché I've ever met."

The pager buzzed again, more insistent this time. With a groan, Clem extracted herself from Derek's arms and began gathering her scattered clothes.

"We need rules," she said, pulling on her scrub pants. "If this happens again."

"When it happens again," Derek corrected, watching her dress.

She shot him a look. "Rule one: not at the hospital."

"Agreed." He sat up, reaching for his own clothes. "Rule two: nobody knows."

"Especially not Bailey." Clem shuddered at the thought.

"Or Karev," Derek added, a hint of something like jealousy in his voice.

Clem paused in the act of putting on her top. "What's that supposed to mean?"

"Nothing." Derek shrugged. "Just noticed how he watches you when you're not looking."

"Alex Karev is not watching me," Clem scoffed. "He's competing with me."

Derek didn't look convinced but didn't push it. "Rule three," he continued, "this doesn't affect work. I don't show you favoritism, and you don't avoid my service."

"Fine." Clem tied her hair back into its messy bun. "And rule four: either of us can end this, anytime, no questions asked."

Derek held her gaze as he buttoned his shirt. "Does that mean you're not ending it now?"

The pager buzzed a third time. Clem grabbed it, checking the message. "Bailey's looking for me." She moved toward the door, then paused with her hand on the lock. "I should end it. We both know that's the smart thing to do."

"But?" Derek prompted.

Clem turned back to face him, her expression a mix of resignation and desire. "But I'll probably see you tonight. Your place."

She slipped out the door before he could respond, straightening her scrubs as she hurried down the corridor. As she rounded the corner, she nearly collided with Alex Karev.

"Whoa, Brooklyn," he steadied her with a hand on her arm. "Bailey's on the warpath looking for you."

"I know, I got the page." She tried to move past him.

Alex didn't let go of her arm. His eyes narrowed slightly as he took in her flushed face and hastily tied hair. "You okay?"

"Fine. Just fell asleep in an on-call room."

Something in his expression told her he didn't believe her, but he released her arm. "Whatever you say. But a word of advice? Next time, make sure your scrub top isn't inside out."

Clem looked down in horror to see the seams of her top exposed. She glanced back up to see Alex walking away, hands in his pockets, whistling what sounded suspiciously like "It Had to Be You."

She quickly ducked into a supply closet to fix her top, heart racing. Four simple rules, and she'd already broken one of them—somebody knew.

As she emerged from the closet and headed toward Bailey's voice echoing down the hall, Clem wondered just how complicated her life at Seattle Grace was about to become.

The Basement Hideout

Clem finally escaped Bailey's wrath with a stack of charts that would take the rest of her shift to complete. She needed space, food, and maybe a moment to sort through the chaos of her own making.

She grabbed a sad-looking sandwich from the cafeteria and made her way down the service stairs. The basement corridor was dimly lit and smelled faintly of disinfectant and old books. Halfway down the hall was the abandoned storage room that had become an intern sanctuary—complete with mismatched chairs, a small table, and a vending machine that still worked if you kicked it just right.

Clem pushed open the door, hoping for solitude, only to find Alex already sprawled in one of the chairs, feet propped up on the table, unwrapping a protein bar.

"Brooklyn," he acknowledged with a nod. "Bailey let you live, huh?"

"Barely." She hesitated in the doorway. After their earlier encounter, she wasn't sure she wanted company—especially his. But the alternative was the crowded cafeteria where Derek might be.

She took a seat at the far end of the table, unwrapping her sandwich.

Alex studied her for a moment. "You know, for someone who just got laid, you look pretty miserable."

Clem nearly choked on her first bite. "Excuse me?"

"Please." He rolled his eyes. "Inside-out scrubs? Sex hair? Not exactly subtle."

"I don't know what you're talking about," she said automatically, but her cheeks betrayed her with a flush.

Alex snorted. "Whatever. Your business who you hook up with." He paused, then added with deliberate casualness, "Even if it is an attending."

Clem set down her sandwich. "What makes you think—"

"I'm not blind, Brooklyn." He leaned forward, lowering his voice even though they were alone. "Shepherd's been watching you like you're a particularly interesting tumor sample." He mimicked Derek's intense gaze, making it comically exaggerated.

"You're imagining things," she insisted, but her heart wasn't in the denial.

Alex shrugged. "Like I said, your business." He took another bite of his protein bar.

Before Clem could respond, the door opened again and Cristina strode in, followed by Meredith, Izzie, and a tentative-looking George.

"So this is where you two have been hiding," Cristina said, dropping her tray on the table. "I've been looking all over for you."

"Why? Miss us?" Alex smirked.

"Hardly. I need someone to cover my post-ops. I'm scrubbing in with Burke on a valve replacement."

"No way," Alex said, at the same time Clem responded, "Not happening."

Meredith sat down next to Clem, glancing between her and Alex with curious eyes. "What were you two talking about so intensely when we walked in?"

"Nothing," they said in unison, then exchanged an annoyed look.

"Right," Meredith said, not believing them for a second.

"We're thinking of having a housewarming thing. You know, christening Meredith's house as the new intern crash pad."
Izzie added, settling into a chair with her salad.

"Great," Clem muttered, imagining how she'd juggle secret trysts with Derek while living with three other interns.

"You don't sound thrilled," George observed.

"No, it's fine," Clem said quickly. "I'm just... tired. Been a long day."

"A long night, too, from the looks of it," Cristina commented, eyeing the barely concealed hickey on Clem's neck.

Clem's hand flew to her collar, pulling it higher. "I don't know what you're talking about."

"Oh please." Cristina rolled her eyes. "Someone got lucky. And not in a surgical way."

"Can we talk about something else?" Clem pleaded.

"Like what?" Izzie asked. "The fact that Evil Spawn here—" she jerked her thumb at Alex, "—was asking again if there's room for one more at Meredith's?"

All eyes turned to Alex, who suddenly looked uncomfortable.

"You want to move in too?" Clem asked, momentarily forgetting her own discomfort.

"My place is being fumigated," Alex said defensively. "I just need somewhere for a few weeks."

"Uh-huh," Cristina said skeptically. "I'm sure that's the only reason."

Alex scowled at her. "What's that supposed to mean?"

"Nothing." Cristina smirked. "Just observing that certain people seem very interested in certain other people's comings and goings."

"Speaking of comings and goings," Meredith interjected, clearly trying to change the subject, "did anyone else notice Shepherd coming out of the same on-call room Clem was supposedly napping in?"

The basement fell silent. Clem felt the blood drain from her face.

"What? No," she stammered. "I was alone. Definitely alone."

Five pairs of eyes stared at her with varying degrees of disbelief.

"Oh my God," Izzie whispered, a slow grin spreading across her face. "You and Mcdreamy?"

"No!" Clem protested, but the denial sounded weak even to her own ears.

"Clem and McDreamy," Cristina mused, looking almost impressed. "Didn't see that coming."

"Stop it," Clem hissed. "There's nothing going on."

"Your neck says differently," Meredith pointed out, not unkindly.

Clem buried her face in her hands. "This can't be happening."

"Hey." Alex's voice cut through the chatter, unexpectedly serious. "Leave her alone."

Everyone turned to look at him, surprised.

"Since when are you the defender of anyone's honor?" Cristina asked.

Alex shrugged. "I'm just saying, if she doesn't want to talk about it, back off."

"Thank you," Clem said quietly, giving him a grateful look.

"Besides," he added with his usual smirk, "when Bailey finds out, she'll be in enough trouble."

"Bailey can't find out," Clem said, panic rising in her voice. "None of this can get out. Promise me."

"Relax, Brooklyn." Alex's tone was surprisingly gentle. "Your secret's safe with us." He looked around the table. "Right?"

One by one, the other interns nodded, though Cristina added, "As long as you give us details later."

"There are no details to give," Clem insisted, even as her mind flashed to Derek's hands on her skin just hours earlier.

"Sure there aren't," Izzie said, waggling her eyebrows. "But when there are, we want to hear them."

"Can we please talk about literally anything else?" Clem begged.

George, who had been quietly observing until now, cleared his throat. "So... about this housewarming thing. Are we inviting people from the hospital, or keeping it just us?"

Clem shot him a grateful look as the conversation shifted to party planning. She caught Alex watching her, his expression unreadable.

As the lunch break ended and they gathered their things to head back upstairs, Alex hung back, letting the others leave first. When it was just the two of them, he turned to Clem.

"You know," he said, keeping his voice low, "there are easier ways to advance your career than sleeping with an attending."

Clem bristled. "That's not what I'm doing."

"No?" He studied her face. "Then what are you doing?"

"I don't know," she admitted, surprising herself with her honesty. "Making a mistake, probably."

Alex nodded slowly. "Been there." He hesitated, then added, "Just... be careful, Brooklyn."

"Why do you care?" Clem challenged.

He shrugged, already heading for the door. "Maybe I don't."
As he reached the doorway, he paused and looked back at her. "Besides, if anyone's going to make your life miserable around here, it should be me."

There was a gleam in his eye that Clem couldn't quite interpret—something between humor and genuine concern.

"You're doing a pretty good job of it right now," she replied, but there was no real heat in her words.

Alex grinned. "Just getting started, Brooklyn." He held the door open for her. "Coming?"

Clem gathered her half-eaten lunch and joined him at the door. As they walked back toward the elevator together, she found herself wondering about the complexities of Alex Karev—and how, in less than two weeks, her carefully ordered new life in Seattle had become hopelessly, thrillingly messy.

Chapter Text

Morning at Derek's Trailer

The first light of dawn filtered through the thin curtains of Derek's trailer, casting a soft glow over the tangled sheets. Clem lay on her side, watching Derek's chest rise and fall as he slept. They'd been up most of the night—talking, laughing, and doing everything but sleeping. She traced a finger along his collarbone, surprised by how quickly this had become familiar in just two weeks.

The alarm clock suddenly blared to life, shattering the peaceful moment. Derek's eyes flew open, momentarily disoriented before focusing on her face.

"Morning," he mumbled, voice thick with sleep.

"Morning," Clem replied, glancing at the clock. "We got maybe two hours of sleep."

Derek reached over to silence the alarm, then pulled her closer. "Worth it."

His lips found hers in a lazy kiss. Clem allowed herself to sink into it for a moment before reluctantly pulling away.

"We're going to be late," she warned, though her body contradicted her words as she pressed closer to him.

"We're already late," Derek countered, his hands sliding down her bare back. "What's another few minutes?"

Clem laughed, placing her palms against his chest to create distance. "Bailey will have my head if I'm late again. And unlike you, I don't have the luxury of being an attending who can waltz in whenever he wants."

"Is that what I do? Waltz?" Derek asked, propping himself up on one elbow, the sheet falling dangerously low on his hips.

"You definitely waltz," Clem confirmed, trying not to stare. "With that hair and that smile. It's obnoxious."

"You weren't complaining about my hair last night," he teased, running a hand through his famously perfect locks. "In fact, I distinctly remember you—"

"Okay!" Clem interrupted, slipping out of bed. "That's enough memory lane for this morning."

Derek watched appreciatively as she gathered her scattered clothes. "I'm just saying, if we're talking about things that are worth being late for..."

"Stop looking at me like that," Clem said, feeling herself blush despite their intimacy.

"Like what?" Derek asked, his expression deliberately innocent.

"Like I'm some rare surgical case you can't wait to get your hands on."

He laughed, finally getting out of bed himself. "Can you blame me? You're extraordinary, Clementine."

The way he said her full name still sent shivers down her spine. She quickly pulled on her underwear and reached for her jeans.

"Last night was actually pretty great," she said, trying to sound casual. "You know, the conversation part."

"You mean the parts where we weren't tearing each other's clothes off?" Derek chuckled, pulling on his boxers. "I agree. Though I still don't know much about you."

"You know I grew up in Brooklyn, my father was military, my mom's a nurse." Clem ticked the facts off on her fingers. "You know I bartended through med school and that I make a Manhattan that would make you weep."

"Surface details," Derek countered, buttoning his shirt. "I still don't know why you really came to Seattle."

Clem froze momentarily before continuing to dress. "I told you—great surgical program, fresh start."

"Running from something in New York?" His tone was light, but his eyes were perceptive.

"Aren't we all running from something?" she deflected, pulling her hair into a ponytail. "Where are my shoes?"

Derek pointed under the small dining table. "Under there. And yes, most of us are. I left New York because..." He paused, seeming to reconsider. "Well, that's a conversation for another time."

Clem retrieved her shoes, curious about what he'd stopped himself from saying, but equally relieved he wasn't pressing her about her own secrets.

"We need to take separate cars," she said, changing the subject. "I can't show up at the same time as you."

"Agreed." Derek handed her the travel mug of coffee he'd quickly prepared. "Though I'm not sure who we think we're fooling."

As they hurried through their morning routines, Clem caught herself watching Derek—the efficient way he moved around the small space, how he seemed completely at ease with her presence in his private domain. It was becoming dangerously comfortable.

"What?" Derek asked, catching her staring.

"Nothing," she said quickly. "Just... this is getting complicated, isn't it?"

His expression softened. "It was complicated the moment I saw you."

Before she could respond, both their pagers went off simultaneously.

"911," Derek read aloud.

"Multiple trauma," Clem confirmed, looking at her own pager. "Mass casualty."

Their eyes met in understanding. The intimate bubble of the morning had popped. It was time to be Dr. Shepherd and Dr. Hart again.

"You leave first," Derek said, grabbing his keys, "I'll give you ten minutes before I follow."

He kissed her quickly as she paused at the door. "For what it's worth, Clementine, complicated doesn't always mean bad."

"Says the brain surgeon who likes puzzles," she retorted, but couldn't help smiling as she headed for her car.

Hospital Chaos

The ER of Seattle Grace was pandemonium. Stretchers lined the hallways, nurses rushed between patients, and the air was filled with shouts, moans, and the metallic clink of medical instruments.

"What happened?" Clem asked as she joined Meredith and Cristina at the nurse's station, trying not to look like she'd just thrown on yesterday's clothes and raced across town.

"Dead Baby Bike Race," Cristina explained, thrusting a chart into Clem's hands. "Annual underground bicycle race. Bunch of bike messengers racing through traffic for a trophy and some cash."

"They call it the Dead Baby Bike Race?" Clem asked incredulously.

"Yeah," Meredith added, "and from the looks of it, they take the name seriously. Half the staff got called in."

"Where have you been?" Cristina asked, eyeing Clem's slightly rumpled appearance. "We've been handling this mess for forty minutes."

"Car wouldn't start," Clem lied smoothly. "What do we have?"

Before Cristina could answer, Bailey appeared, her expression stern. "Nice of you to join us, Dr. Hart. I was beginning to wonder if you'd forgotten where you work."

"Sorry, Dr. Bailey," Clem said, feeling her cheeks flush. "It won't happen again."

"It better not." Bailey handed her another chart. "Trauma 2, possible open tib-fib fracture. Go."

As Clem moved toward Trauma 2, she caught sight of Derek striding through the ER doors, looking every inch the composed attending despite having left his trailer ten minutes after her. Their eyes met briefly, and he gave an almost imperceptible nod before turning his attention to the chief resident.

Inside Trauma 2, Clem found a young man with a mangled leg, his cycling shorts torn away to reveal a gruesome fracture where bone had punctured through skin.

"I'm Dr. Hart," Clem introduced herself, pulling on gloves. "Kevin, is it? Can you tell me what happened?"

"Some idiot cut across three lanes," the cyclist groaned through gritted teeth. "I went over my handlebars and landed on a parked car."

Clem nodded, carefully examining the wound. "You've got a compound fracture here. We'll need to get you to X-ray and then probably surgery."

"Am I going to lose my leg?" Fear crept into the man's voice.

"Not if I can help it," Clem assured him, reaching for the irrigation solution to clean the wound. "I'm going to page orthopedics. Dr. Torres is the best there is."

As she was irrigating the wound, the trauma room door opened, and Derek walked in. "Dr. Bailey said there might be some nerve involvement here," he explained, his tone entirely professional.

"Dr. Shepherd," Clem said formally. "This is Kevin Alder, 32, involved in the cycling accident. Open tib-fib fracture with possible peroneal nerve damage. He's reporting numbness in his foot."

Derek nodded approvingly at her assessment before approaching the patient. "Let me take a look."

As Derek conducted his examination, Clem watched his hands—the same hands that had been exploring her body hours earlier now moved with clinical precision over the patient's injured leg. The contrast was jarring.

"Good catch on the nerve involvement," Derek commented. "We'll need a thorough neurovascular workup before orthopedics takes him to the OR."

"Yes, Dr. Shepherd," Clem responded professionally, though she couldn't help but notice the hint of a smile playing at the corner of his mouth.

As they prepared to transport the patient, Derek leaned close to check the monitor, his arm brushing against Clem's. "Nice work, Dr. Hart," he said, just loudly enough for the patient and nurse to hear, then added in an undertone, "You left your earring on my nightstand."

Clem's hand instinctively went to her ear, confirming that indeed, one earring was missing. "Thank you for the feedback, Dr. Shepherd," she replied evenly, willing her face not to betray her.

As Derek left the trauma room, Bailey appeared in the doorway. "Hart, once you've transported him to radiology, I need you in the pit. We're short-handed."

"But Dr. Shepherd mentioned the neurovascular workup—" Clem began.

"Did I stutter?" Bailey cut her off. "No specialties today. Everyone rotates through the pit. Shepherd has a whole department at his disposal."

"Yes, Dr. Bailey," Clem sighed.

After transferring Kevin to radiology, Clem returned to the ER to find it even more chaotic than before. Alex was suturing a nasty gash on a cyclist's arm, while Izzie argued with another resident about pain management for a patient with multiple fractures.

"About time," Alex called when he spotted Clem. "Your boyfriend's been asking for you."

"He's not my—" Clem started, then realized Alex was referring to a patient, not Derek. "Very funny, Karev."

"Seriously though," Alex continued, tying off his suture, "Bed four has been complaining about no one checking his vitals for the past twenty minutes. I'd do it, but I'm about to take this guy to CT."

Clem headed to bed four, finding a middle-aged man in cycling gear with a bandage wrapped around his head. "Sir, I'm Dr. Hart. What happened to you?"

"Got clipped by another rider," the man explained. "Hit my head pretty hard. The helmet split in two."

Clem checked his pupils and ran through the neurological exam. "Any nausea, dizziness, memory issues?"

"I can't remember the accident," he admitted. "And I'm pretty dizzy when I try to sit up."

"We'll get you a head CT to be safe," Clem decided. "Possible concussion, maybe worse."

As she was writing orders, she heard a commotion across the ER. George was attempting to insert a chest tube into a patient with a pneumothorax, and from the looks of it, things weren't going well.

"I can't get it in," George was saying, his voice rising in panic.

"Move," Bailey ordered, taking over. "O'Malley, step back and observe."

Clem winced in sympathy as Bailey smoothly inserted the tube, releasing a whoosh of air as the collapsed lung re-expanded. George stood there, looking defeated.

"Don't worry, O'Malley," one of the residents called out. "Not everyone can handle trauma. That's why they call you 007, right? Licensed to kill?"

A ripple of uncomfortable laughter spread through the ER. George's face flushed red.

"Hey," Clem said sharply to the resident. "Like you never struggled with a procedure."

"Mind your own business, Hart," the resident replied. "Unless you want a nickname too. Shepherd's Shadow has a nice ring to it, don't you think?"

Clem felt her face grow hot, but before she could respond, Bailey's voice cut through the tension.

"If you people have time to stand around making up childish nicknames, then clearly we don't have enough patients," Bailey said loudly. "Last I checked, there were at least fifteen more waiting to be seen."

The resident slunk away, and Clem returned to her patient, acutely aware that her connection with Derek might not be as secret as she'd hoped.

Lull in the Storm

Three hours later, the chaos had finally begun to subside. Most of the cyclists had been admitted, sent to surgery, or discharged with minor injuries. Clem stood at the nurses' station, helping Tyler, one of the nurses, reorganize the charts that had been scattered in the frenzy.

"Thanks for the assist," Tyler said, gratefully accepting the stack of organized files. "Most doctors wouldn't bother."

"My mom's a nurse," Clem explained, sorting another pile. "She'd kill me if I didn't help."

"Well, she raised you right. Unlike some of these other interns who think we exist to fetch them coffee."

Clem smiled. "Let me guess—Karev?"

"Among others," Tyler confirmed with a roll of his eyes.

As they continued working, Clem felt someone approach from behind. The faint scent of familiar cologne reached her before she turned around.

Derek stood there, two cups of coffee in hand. "Thought you might need this," he said, offering her one.

"Thanks," Clem replied, taking the cup and trying to maintain a professional distance despite the knowing glint in his eye.

"Rough morning?" he asked casually.

"You could say that," she answered, taking a sip.

Tyler glanced between them, clearly sensing the undercurrent, and discreetly excused himself with the reorganized charts.

"So," Derek continued once the nurse was out of earshot, "I hear I have a shadow."

Clem nearly choked on her coffee. "What?"

"Word travels fast around here," Derek said with a hint of amusement. "Apparently I've been showing favoritism to a certain Brooklyn-born intern."

"That's ridiculous," Clem protested, though she could feel heat creeping up her neck.

Derek leaned slightly closer, lowering his voice. "Is it? Because I've been trying very hard not to favor you. In fact, I think I've been harder on you than anyone."

"Oh really?" Clem raised an eyebrow. "Is that what you call last night? Being hard on me?"

A slow smile spread across Derek's face. "Well, if you want to get technical about it—"

"Dr. Shepherd!" Bailey's voice cracked like a whip, causing both of them to jump back slightly. She approached with purposeful strides, her expression unreadable. "I need to borrow Dr. Hart for a consult."

"Of course, Dr. Bailey," Derek said smoothly, stepping back. "We were just discussing the neurovascular assessment of the tib-fib fracture in Trauma 2."

"Uh-huh," Bailey said, clearly unconvinced. "And does that assessment require you to stand quite so close to my intern, Dr. Shepherd?"

Derek cleared his throat. "I'll check on those CT results," he said, making a tactical retreat.

As Derek walked away, Bailey turned her laser focus to Clem. "Dr. Hart."

"Dr. Bailey?" Clem tried for innocent but suspected she wasn't pulling it off.

"Let me make something very clear," Bailey said, her voice low and precise. "I don't care what attending thinks you hung the moon and stars. You are my intern. That means you answer to me first. Is that understood?"

"Yes, Dr. Bailey."

"And whatever is going on between you and Shepherd—"

"There's nothing—" Clem started to protest.

Bailey held up a hand. "Save it. I'm not blind or stupid. Just be smart about it. This hospital runs on gossip, and right now, you're providing the day's special."

Clem swallowed hard. "I understand."

"Good. Now go help Dr. Torres with the pre-op on the tib-fib patient. She requested you specifically after Shepherd sang your praises."

As Clem headed toward orthopedics, she glanced back to see Derek watching her from the end of the corridor. He gave her a small smile before turning away.

In the background, as Derek and Clem headed in opposite directions, Alex emerged from an on-call room, discretely adjusting his scrub top. A moment later, one of the attractive nurses from the ER floor followed, smoothing her hair and checking the hallway before slipping away in the other direction. Cristina, passing by with a stack of charts, caught sight of the scene and rolled her eyes dramatically.

"Typical," she muttered, continuing on her way. "At least some people are having fun during this disaster of a day."

Chapter Text

One week later

The key felt heavy in Clem's hand as she unlocked the front door of Meredith's house. After working a brutal 24-hour shift, she'd finally told Derek she needed a night away from his trailer, away from him. Just one night to remember who she was outside of whatever this thing between them was becoming.

Laughter spilled from the kitchen—Meredith and Izzie's familiar voices, George's tentative chuckle, and a fourth voice that made Clem pause. Distinctly male, cocky, and unmistakable. She dropped her bag by the stairs and followed the sound.

In the kitchen, Meredith, Izzie, and George were gathered around the island with pizza boxes spread between them. And there, looking entirely too comfortable on one of the stools, was Alex Karev.

"Brooklyn!" Alex called out, raising his beer bottle. "Finally decided to grace us with your presence?"

Clem arched an eyebrow, her exhaustion momentarily forgotten. "Since when are you part of the welcoming committee, Karev?" She reached for a slice of pizza, her stomach reminding her she hadn't eaten in hours.

"He's moving in," Izzie said flatly, not bothering to hide her displeasure. "Tomorrow."

Clem glanced between them, taking a bite of pizza. "Didn't realize it was decided."

"His apartment got condemned for toxic mold," George explained through a mouthful of pizza.

Alex shrugged. "Building inspector said it was 'uninhabitable.' Like that's news."

"And nobody thought to include me in this decision?" Clem asked, leaning against the counter rather than joining them at the island.

"We would have," Meredith said pointedly, "if you'd actually been around."

"I've been around," Clem defended, brushing a strand of hair behind her ear.

Izzie snorted. "Please. You haven't slept here in four days."

"Three," Clem corrected automatically. Then, realizing she'd walked right into the trap, she added, "I've been on call."

"Right," Alex smirked. "On-call at McDreamy's trailer. Must be some fascinating cases out there in the woods.

Clem met his gaze directly, refusing to be rattled. "Careful, Karev. I've performed sutures on less deserving patients."

"The whole hospital knows," Izzie said, reaching for another slice. "Bailey gave me this look yesterday when I mentioned your name."

"Like we were harboring a criminal," George added.

"Perfect," Clem sighed, finally sliding onto an empty stool. "So I'm what, the hospital pariah now?"

"More like the hospital entertainment," Alex replied, his eyes flickering with something unreadable. "The nurses are running a pool on how long it lasts."

"Of course," Clem said dryly, her accent more pronounced with fatigue. "Seattle has a surprisingly active gossip mill for a city that's perpetually caffeinated and sleep-deprived." She turned to Alex. "So you're really moving in tomorrow?"

"Yep. Fifth bedroom. End of the hall."

"It's barely bigger than a supply closet," George added.

"Still better than toxic mold," Alex replied with a shrug.

"Oh," Izzie said suddenly, brightening, "we're having a party this weekend."

"A party?" Clem repeated, quirking an eyebrow.

"Yeah, Izzie's idea," Meredith clarified, not looking thrilled. "A small get-together. To unwind."

"It's gonna be awesome," Izzie insisted. "We need to make some friends outside the hospital."

Clem was about to respond when Cristina appeared in the doorway, dropping her jacket on a chair. "I don't need friends outside the hospital," she announced, heading straight for the pizza. "What did I miss?"

"Alex is moving in, and we're having a party," George summarized.

"Great," Cristina said sarcastically, grabbing a slice. "Sounds like a perfect weekend."

"I can invite Shepherd if you want," Alex offered Clem with a challenging look. "Make it official."

"Don't," Clem said, her tone leaving no room for discussion. She paused, seeing Alex's surprised expression at her sharpness. "Please," she added, softer but still firm.

Alex studied her for a moment, then nodded. "Your dirty little secret's safe for now, Brooklyn."

"It's hardly a secret," Cristina muttered, rolling her eyes.

"Can we please talk about literally anything else?" Clem asked, "Anybody die today? Any good surgeries? Car crash? Decapitation? Anything?"

"Fine," Izzie conceded. "But you're helping with the party. No hiding in your room or disappearing to McDreamy's forest love shack."

"It's not a—" Clem started, then shook her head with a small smile. "Fine. I'll help with the party."

As the conversation shifted to party planning, Clem sat back, watching her fellow interns bicker and laugh. For the first time in weeks, she felt strangely at home. Despite the teasing and Alex's knowing smirks, there was something comforting about being here, being just another surgical intern instead of Derek Shepherd's secret girlfriend.

She found herself absently tracing patterns on the countertop as she reached for another slice of pizza. Just for tonight, she was Clem Hart from Brooklyn—surgical intern with attitude to spare—not the woman sneaking around with an attending. And despite missing Derek more than she wanted to admit, it felt good to remember who she was on her own.

The Party

By Saturday night, Izzie's "small get-together" had morphed into what could only be described as a full-blown house party. The living room furniture had been pushed aside to create a makeshift dance floor, the kitchen counter was lined with bottles, and people—most of whom Clem didn't recognize—were spilling out onto the back porch.

"So much for making friends outside the hospital," Clem said to Meredith over the music as she surveyed the crowd. "I count at least twelve nurses and half the residents from our floor."

"Izzie invited a few people from work," Meredith explained, nursing her tequila. "Then they invited a few people, who invited a few more people..."

"Is that Joe from the bar?" Clem asked, spotting the familiar bartender mixing drinks in their kitchen.

"Izzie thought it would be 'classier' to have a real bartender," Meredith confirmed with an eyeroll.

Clem spotted George in the corner, awkwardly hovering near an ER nurse who was clearly looking for an escape route.

"Should we rescue him?" Clem asked, nodding toward George.

"Nah, he needs to learn," Meredith replied. "Survival of the socially fittest."

Across the room, Alex was holding court, surrounded by a group of giggling nurses. He caught Clem watching and raised his beer in a mock toast before whispering something that made the nurses laugh harder.

"Where's Cristina?" Clem asked, scanning the crowd.

"Out back, last I saw," Meredith answered. "Complaining about the music and threatening to leave."

Clem smiled. "Sounds about right."

She was about to suggest they join Cristina outside when she felt it—that shift in the atmosphere, the subtle change in energy that only happened when Derek Shepherd entered a room. She didn't need to turn around to know he was there, but she did anyway, her pulse quickening despite her best efforts.

Derek stood in the doorway, unfairly handsome in dark jeans and a navy button-down, his hair perfectly tousled as if he'd just stepped out of a photo shoot rather than his trailer in the woods. His eyes scanned the room until they found hers, and that confident half-smile she'd come to know so well spread across his face.

"You've got to be kidding me," Clem murmured, taking a large gulp of her drink.

"What?" Meredith followed her gaze. "Oh. That's... unexpected."

"Did you invite him?" Clem asked, already knowing the answer.

"Of course not."

"Izzie?"

Meredith shook her head. "Maybe someone else told him about the party."

Clem's eyes found Alex across the room. He was watching the scene unfold with undisguised interest, a smirk playing at his lips.

"Karev," Clem said under her breath, her eyes narrowing slightly.

Derek was making his way through the crowd toward them, stopping to greet people he knew. By the time he reached Clem and Meredith, he'd acquired a beer from somewhere.

"Dr. Grey," he greeted Meredith with a nod. "Nice place."

"Dr. Shepherd," Meredith replied, amusement playing at her lips. "Didn't expect to see you here."

"I heard there was a party," he said simply, his eyes never leaving Clem's face. "Hope it's okay I dropped by."

"It's basically a hospital party at this point anyway." She glanced between Derek and Clem. "I should go... check on Izzie."

As Meredith disappeared into the crowd, Derek took a step closer to Clem.

"Surprise," he said quietly, his voice carrying that hint of playfulness she'd grown accustomed to.

"You crash all your interns' parties, or am I special?" Clem asked, her accent slightly more pronounced despite her attempt at a casual tone.

"You're avoiding me," Derek replied simply, his eyes searching hers.

"I'm not avoiding you," Clem corrected him, meeting his gaze steadily. "I'm trying to convince my roommates I actually live here."

Derek's expression grew more serious. "Bailey cornered me yesterday."

"Great," Clem sighed, her expression a mix of concern and resignation. "What did she say?"

"That she's not blind, and neither is the rest of the hospital staff."

Clem absently fidgeted with the watch on her wrist. "Just what my residency needs."

"Relax," Derek said, his hand briefly brushing against hers before pulling back. "Bailey's... pragmatic."

"And what does our pragmatic resident think about you showing up at her intern's house party?" Clem asked, raising an eyebrow.

"I didn't ask," Derek replied with that characteristic confidence. "Dance with me."

"What? No." But there was no real conviction in her voice.

"Why not? Everyone's dancing."

"Everyone is our colleagues," Clem pointed out, gesturing around them.

"One dance," Derek pressed, leaning in slightly. "Then I'll behave. Professional distance all night."

Clem looked around. The music had shifted to something slower, and couples were pairing up on the makeshift dance floor. In the corner, Alex was watching them with open curiosity.

"Fine," Clem conceded with a slight shake of her head. "One dance. But then you're pretending you barely know me for the rest of the night."

"Scout's honor," Derek promised as he led her to the dance floor.

He placed his hands appropriately on her waist, keeping a respectable distance between them.

"See?" he said. "Perfectly innocent."

"Nothing about you is innocent, Derek," Clem replied, but there was warmth in her voice as she placed her hands on his shoulders.

"I missed you," he admitted quietly.

"I missed you too," she admitted quietly. "It's stupid."

"It's not stupid," Derek murmured, his thumb tracing small circles where it rested on her waist.

The song ended, and as promised, Derek released her. "Thank you for the dance, Dr. Hart," he said formally, though his eyes held a warmth that was anything but professional.

"You're welcome, Dr. Shepherd," Clem replied, matching his tone.

"Now, I believe I promised professional distance," Derek continued, his eyes still locked with hers. "I'll just get another drink and leave you to your party."

As he walked away, Clem felt Alex's presence before she saw him.

"So," Alex said, sidling up next to her. "That was subtle."

"About as subtle as you inviting him," Clem replied, giving him a knowing look.

"Me?" Alex feigned innocence, then shrugged when Clem's expression didn't waver. "Fine. I might have mentioned the party during rounds yesterday."

"You're pushing your luck, Karev," Clem said, though there was no real anger in her tone.

"He showed up, didn't he?" Alex said. His tone shifted slightly, becoming less teasing. "Admit it, you're glad he's here."

Before Clem could respond, Izzie appeared, grabbing both their arms.

"Shots!" she announced, dragging them toward the kitchen. "Everyone's doing shots!"

The next hour passed in a blur of tequila, laughter, and increasingly bad dancing. Clem found herself loosening up, actually enjoying the party despite the awkwardness of having Derek there. She kept catching glimpses of him throughout the night—talking to Joe at the bar, laughing with some of the residents, always keeping a respectful distance from her while somehow making her feel like she was the only person in the room.

After her third shot, Clem decided she needed some air. She slipped away from the group and headed upstairs to her bedroom, intending to grab a sweatshirt before going out to the porch.

She had just pulled a worn Columbia Med sweatshirt from her dresser when her bedroom door opened and closed quickly. She turned to find Derek leaning against it, his eyes dark with intent.

"This isn't professional distance," she pointed out, though she made no move to increase the space between them.

"I lasted an hour," Derek replied, stepping closer with that confident stride. "I think that deserves some credit."

"Derek, there are people everywhere," Clem said, though her body betrayed her by not moving away.

"I know," he said, his voice dropping to that low register that always made her skin prickle with awareness.

"You're drunk," she suggested, raising an eyebrow.

"I've had two beers," he countered. "I'm completely sober."

"I'm not," Clem admitted, her hazel eyes meeting his steadily. "Three tequila shots in, and I'm already making questionable decisions."

"Like what?" Derek asked, closing the distance between them.

"Like letting you in here," Clem said, but her hands were already reaching for him.

Derek's hands found her waist as he backed her toward the bed. "We can stop," he said, though his actions contradicted his words.

"Five minutes," she whispered, "Then we go back downstairs. Separately."

"Five minutes," Derek agreed, his lips finding hers.

The kiss was electric, charged with the tension of avoiding each other all night. Clem's hands slid into his hair as they fell onto the bed in a tangle of limbs, their kisses growing more urgent.

Derek's hand slipped under her shirt, his palm warm against her skin. Clem gasped as his fingers trailed higher.

"I missed this," he murmured against her neck.

"It's been two days," Clem laughed breathlessly, then gasped as his teeth grazed her collarbone.

"Two days too long," Derek replied, his hand moving to the button of her jeans.

They were so absorbed in each other that neither of them heard the footsteps outside the door or the knock that followed. It wasn't until the door swung open that they registered they weren't alone.

"Excuse me, I'm looking for the—" Bailey's voice cut off abruptly.

Clem froze, Derek's hand still at her waistband. They both turned to see Bailey standing in the doorway, her expression cycling rapidly through shock, embarrassment, and finally, stern disapproval.

"Dr. Bailey," Derek managed, sitting up quickly. "This isn't—"

"Don't," Bailey held up a hand, cutting him off. "Just... don't."

Clem scrambled to sit up, her face flushing with mortification but her posture remaining defiant.

"The bathroom," Bailey said stiffly. "I was looking for the bathroom."

"First door on the left," Clem supplied, her voice steadier than she felt.

Bailey nodded once, her lips pressed into a thin line. "I'll be leaving after that. I suggest you both consider your choices more carefully in the future." She paused, then added pointedly, "Perhaps with a locked door, at minimum."

With that, she closed the door, leaving Derek and Clem in mortified silence.

"Oh my God," Clem whispered, dropping her head into her hands. "That did not just happen."

"It did," Derek confirmed, running a hand through his disheveled hair. "That definitely happened."

"My career is officially on life support," Clem said, smoothing down her shirt. "And Bailey just pulled the plug."

"It's not that bad," Derek tried to reassure her, his usual confidence momentarily shaken. "Bailey's... reasonable."

Clem gave him a look that was equal parts amusement and disbelief. "Bailey just caught us making out like teenagers. There's nothing 'not that bad' about this situation."

"When you put it that way," Derek winced.

"I have to go talk to her," Clem decided, standing up and straightening her clothes.

"Now?" Derek asked, surprise evident in his voice.

"Yes, now. Before she leaves thinking—" she gestured between them, searching for the right words.

"Thinking what?" Derek asked, a hint of his usual confidence returning.

"Thinking I'm sleeping with you to advance my career," Clem said bluntly. "Stay here. I'll be back."

She slipped out into the hallway, relieved to find it empty. She could hear the party continuing downstairs, apparently unaware of the drama unfolding above. Clem made her way to the bathroom just as Bailey was emerging.

"Dr. Bailey," Clem began, her voice low but steady. "I wanted to apologize for... that."

Bailey regarded her for a long moment. "Dr. Hart, what you do on your own time is your business."

"I know, but—"

"I'm not finished," Bailey interrupted, raising a hand. "What you do on your own time is your business, but when it affects your work, it becomes my business."

"It hasn't affected my work," Clem said, meeting Bailey's gaze directly.

"Hasn't it?" Bailey raised an eyebrow. "You were late twice last week. Your mind wanders during rounds. And let's not even discuss the fact that you've been on Shepherd's service more than any other intern."

Clem opened her mouth to protest, then closed it, knowing Bailey was right.

"I'm not going to report this," Bailey continued, "because despite everything, you're a good doctor. You have potential. But hear me clearly, Dr. Hart: I will not stand by and watch you throw away your career for a man. Any man. Even one with hair like that." She gestured vaguely toward Clem's room.

"I understand," Clem said quietly, her posture straightening slightly.

"Do you?" Bailey challenged. "Because right now, it looks like you're making the same mistakes countless female doctors have made before you. Letting a relationship—particularly one with an attending—define your medical career."

Clem's Brooklyn edge emerged as she responded. "That's not what I'm doing. I didn't put myself through Columbia just to throw it all away."

"No?" Bailey's expression softened slightly. "Then prove it. Show me I'm wrong."

With that, Bailey moved past her toward the stairs.

"Dr. Bailey," Clem called after her. When Bailey turned, Clem said simply, "Thank you."

Bailey nodded once, then continued downstairs.

As Clem watched her go, she felt a strange mix of embarrassment, gratitude, and determination rising within her. Bailey was right—she needed to be better than this. To prove that whatever was happening with Derek wouldn't define her career.

She returned to her room to find Derek sitting on the edge of her bed, looking concerned.

"How bad was it?" he asked, his usual self-assurance tempered by genuine worry.

"Bad," Clem admitted, sitting beside him. "But also... maybe good? She's not reporting us."

"That is good," Derek agreed cautiously.

"But she made me realize something," Clem continued, turning to face him. "I came to Seattle Grace to become a surgeon, not to fall for my boss."

Derek was quiet for a moment, studying her with that intense gaze. "And now?"

"Now I need to prove—to Bailey, to myself—that I can do both. Be a great surgeon and..." she gestured between them, "whatever this is."

"What is this?" Derek asked, his directness catching her off guard.

Clem fidgeted with her watch, a habit when thinking. "I don't know yet. But I do know I can't let it overshadow why I'm here."

Derek took her hand, stopping her fidgeting. "I respect that. And for what it's worth, I think you're going to be an exceptional surgeon, Clementine Hart."

The sincerity in his voice was unmistakable, and Clem felt some of her tension ease.

"Even if it means less time at the trailer?" Clem asked, studying his face.

"Even then," Derek confirmed with the same decisiveness he showed in the OR. "Though I reserve the right to sneak into inappropriate rooms at parties."

Clem laughed, the tension breaking slightly. "Next time, lock the door."

"Deal," Derek agreed, his expression growing more serious. "Bailey's right, you know. You have incredible potential."

"We should probably get back to the party before someone else comes looking for us," Clem said, standing and pulling her sweatshirt on.

"Separately?" Derek asked, standing as well.

"Definitely separately," Clem confirmed. "I'll go first. Wait at least three minutes."

She paused at the door, turning back to face him. "And Derek? This doesn't mean I'm ending... whatever this is. It just means I need to remember who I am outside of it."

With that, she slipped out the door and back to the party.

Chapter Text

Morning Rounds - One month after the party

The early morning light filtered weakly through the windows of Seattle Grace as Clem hurried down the corridor, balancing a coffee cup in one hand and flipping through patient charts with the other. She'd overslept after spending the night at Derek's trailer, and while she wasn't technically late—yet—Bailey had made it clear that "on time" meant "early" on her service.

She rounded the corner to find the other interns already gathered, Bailey standing before them with her characteristic stern expression. Alex caught her eye and smirked, clearly noticing her rushed appearance.

"Nice of you to join us, Dr. Hart," Bailey said without looking up from her clipboard.

"Sorry," Clem muttered, sliding into place between Cristina and Alex. She caught Meredith's knowing glance but ignored it.

"Now that we're all here," Bailey continued, "we have an interesting case coming in from the ER. Annie Connors, 43-year-old female with what appears to be a massive abdominal tumor." She fixed each intern with a stern look. "And I mean massive. So let me be clear: there will be no gawking, no staring, and absolutely no treating this patient like a circus attraction. She is a human being seeking medical care, and you will all act accordingly. Understood?"

A chorus of "Yes, Dr. Bailey" echoed through the group.

Just then, the elevator doors opened, and the interns turned to see what could only be described as an extraordinary sight. Annie Connors was being wheeled in on a reinforced gurney, her abdomen distended to a size that seemed impossible. The tumor appeared to be the size of a beach ball, maybe larger.

Despite Bailey's warning, every intern stared for at least a moment. Cristina's eyebrows shot up, her clinical curiosity clearly piqued. George's mouth fell open slightly before he caught himself. Izzie's expression shifted immediately to compassion, while Meredith maintained a controlled, professional demeanor.

Alex leaned closer to Clem and whispered, "That's not a tumor—that's a carry-on passenger."

Clem elbowed him sharply in the ribs. "Shut it, Karev," she hissed, though her own eyes had widened momentarily at the sight.

Bailey gave them both a warning glance before addressing the group again. "Alright, assignments for today. Grey, you're with Dr. Shepherd. Stevens, you'll be with him too. O'Malley, you're with me—I need a central line placed in Mr. Peterson in 2214." She paused, glancing between Clem and Alex. "Dr. Hart, Dr. Karev, you're running post-op rounds on the surgical floor. Yang, Dr. Burke requested you specifically for one of his consults."

Cristina tried unsuccessfully to hide her pleased expression.

"Questions?" Bailey asked, looking around at the group. When no one spoke, she nodded. "Then get moving."

As the group dispersed, Clem caught Derek walking down the hallway. He glanced at her, a subtle smile playing at his lips before he turned his professional attention to Meredith, asking about Annie's chart.

Alex noticed the exchange and rolled his eyes. "Subtle, Brooklyn. Real subtle."

"Like you're one to talk about subtlety," Clem retorted, falling into step beside him as they headed toward the post-op wing. "Pretty sure that supply closet incident with Nurse Olivia last week set a new hospital record for lack of discretion."

Alex grinned, unrepentant. "Jealous?"

"In your dreams, Karev," Clem replied, though there was no real bite to her words. Their antagonism had somehow shifted into something more complicated—not quite friendship, but a grudging mutual respect that neither was ready to acknowledge.

"First patient," Clem said, reaching for the chart outside the first room. "Mrs. Lenore Franklin, post-op day two following appendectomy. You want to take this one or should I?"

"Ladies first," Alex said with a mock bow.

Clem rolled her eyes but pushed the door open, her demeanor shifting immediately into professional mode. "Good morning, Mrs. Franklin. I'm Dr. Hart..."

Annie's Case

Meredith stood at Annie's bedside, reviewing her charts while Izzie helped the patient get settled.

"I know it's a lot to take in," Izzie was saying gently, adjusting Annie's pillows. "But you're in good hands here."

Annie nodded, her expression a mix of embarrassment and relief. "It's just—I never thought it would get this big. It started so small, you know? Just a little bump. By the time I realized something was really wrong..." She gestured helplessly at her abdomen.

"How long have you been living with it?" Meredith asked, trying to keep her tone neutral.

Annie looked down. "Almost two years."

Izzie's eyes widened. "Two years? Annie, why didn't you come in sooner?"

"I was embarrassed," Annie admitted quietly. "And scared. Every day I told myself, 'Tomorrow. I'll call a doctor tomorrow.' Then one day I couldn't button my pants. Then I couldn't see my feet. Then I could barely breathe when I laid down." She attempted a smile that didn't reach her eyes. "Guess I ran out of tomorrows."

Derek entered the room then, his calm confidence immediately filling the space. "Good morning, Annie. I'm Dr. Shepherd, head of neurosurgery. I'll be consulting on your case along with Dr. Burke from cardio."

Annie looked confused. "Neurosurgery? Is something wrong with my brain too?"

"No," Derek reassured her. "But a tumor of this size affects multiple systems, and we need to ensure we have all perspectives covered before proceeding."

He smiled warmly at Annie before turning to Meredith. "Dr. Grey, let's get a complete set of scans. CT, MRI, and ultrasound. I want to know exactly what we're dealing with."

"Yes, Dr. Shepherd," Meredith replied professionally, though Izzie noticed a slight tension in the air. Ever since Derek had started coming around the house, there was an awkwardness whenever he worked directly with the other interns.

As Derek left the room, Annie sighed heavily. "They all look at me the same way, you know. Doctors. Like I'm some kind of freak show."

"No one here thinks you're a freak show," Izzie said firmly, sitting on the edge of the bed. "We just want to help you."

"Dr. Stevens is right," Meredith added. "We see all kinds of medical conditions here. Your tumor is large, yes, but it's a medical condition that needs treatment—nothing more, nothing less."

Annie's eyes filled with tears. "I just want my life back. I want to be able to walk into a room without people staring. I want to be able to breathe when I lie down at night."

Izzie squeezed her hand. "Then let's make that happen. One step at a time, okay?"

Clem and Alex on Rounds

"Mrs. Davison is recovering nicely from her cholecystectomy," Clem reported as she and Alex left the patient's room. "Minimal pain, good appetite, bowel sounds present."

"Bet you can't say that five times fast," Alex quipped, reaching for the next chart.

"Very mature," Clem replied, though her lips twitched. "Who's next?"

"Mr. Collins, post-op day three after femoral-popliteal bypass," Alex read. "Let's see if his foot's still pink."

They worked their way through the post-op floor with surprising efficiency. For all his faults, Alex was thorough and clinically sharp. When he wasn't trying to impress anyone or being deliberately antagonistic, he was actually a decent doctor.

"So," Alex said as they paused at the nurses' station to update charts, "you and Shepherd seem to have survived the Bailey incident."

Clem glanced up, her pen pausing mid-sentence. "We're fine."

"Just fine?" Alex pressed, leaning against the counter. "He's been at the house twice this week."

"You counting, Karev?" Clem asked, returning to her charting. "I didn't realize my love life was so fascinating to you."

"Just curious how long before the chief gets wind of it," Alex shrugged. "Administrative policy on attending-intern relationships is pretty clear."

Clem felt a flicker of unease but kept her expression neutral. "Thanks for your concern." She raised an eyebrow. "Though I'm surprised you'd worry about professional ethics considering your rotating schedule with half the nursing staff."

"Hey, I'm just looking out for my fellow intern," Alex said with exaggerated innocence. "Wouldn't want you to miss out on surgeries because you're too busy playing house with the boss."

Before Clem could respond, they heard raised voices from the imaging department across the hall. They both looked up to see Annie Connors being wheeled in for her scan, with Meredith and Izzie accompanying her.

"Damn," Alex muttered, his eyes fixed on Annie's enormous tumor. "That thing's the size of a beach ball."

"Have some respect," Clem said quietly, though she understood his reaction. The tumor was truly massive.

They watched as the transport team struggled to position Annie on the CT scanner. Her tumor made conventional positioning impossible, and the technical staff seemed at a loss.

"They're going to need a bigger boat," Alex said under his breath.

Clem shot him a warning look, about to reprimand him when they heard Annie's voice, suddenly loud and clear.

"I can hear you all, you know!" Annie called out, her voice trembling with anger and embarrassment. "The whale, the blob, the carry-on passenger—I hear everything you say!"

Clem and Alex exchanged a look, realizing Annie must have overheard similar comments throughout her stay. Meredith was attempting to calm the patient while Izzie looked furious, scanning the room for the culprits.

"Nice," Clem said to Alex, her voice heavy with disapproval. "Real nice."

"I didn't say anything where she could hear me," Alex defended.

"That's not the point," Clem replied sharply. "The point is—"

"Dr. Hart! Dr. Karev!" Bailey's voice cut through their conversation like a whip. "Unless post-op rounds now include standing around gossiping, I suggest you get back to work."

"Yes, Dr. Bailey," they replied in unison, quickly gathering their charts.

As they walked away, Clem glanced back at Annie, who was now lying on the scanner, tears streaming down her face while Izzie held her hand. Something twisted in Clem's chest—a mixture of sympathy and shame for being, however peripherally, part of the problem.

George's Central Line

In room 2214, George was preparing to place a central line in an elderly patient, Mr. Peterson. Bailey stood beside him, arms crossed, watching his every move with hawkish intensity.

"Dr. O'Malley, explain the procedure as you go," Bailey instructed.

George swallowed hard. "Um, I'll be inserting a central venous catheter into your subclavian vein, Mr. Peterson. This will allow us to administer medications and take blood samples without having to stick you with needles repeatedly."

The patient, a frail man in his seventies, nodded wearily. "Whatever you need to do, Doc."

George prepared the insertion site, his hands shaking slightly. Bailey had been particularly hard on him lately, and the pressure was getting to him.

"I'm sterilizing the area," George narrated, swabbing the patient's chest with betadine. "Now preparing to locate the subclavian vein using ultrasound guidance."

He positioned the probe, squinting at the screen. "I can see the vein... I think."

"You think?" Bailey repeated, her eyebrow arching dangerously.

"I mean, I can see it," George corrected quickly. "Definitely the subclavian vein, right there." He pointed to a dark space on the screen.

"And how do you know it's not the artery?" Bailey pressed.

George hesitated. "Because... the artery would be... pulsing more prominently?"

Bailey sighed. "Perhaps you'd like to try again with the ultrasound, Dr. O'Malley. This time, actually identifying the correct vessel before you stick a needle into it."

George repositioned the probe, his face flushing with embarrassment. This time, he took more care, and eventually pointed out the correct vessel with more confidence.

"Good," Bailey said, her tone allowing no room for celebration. "Now proceed."

George prepared the needle, took a deep breath, and began the procedure. His first attempt missed, causing the patient to wince.

"Sorry, sorry," George muttered, withdrawing the needle.

"Dr. O'Malley," Bailey said calmly, "you're overthinking it. Trust your training. You know where the vein is. Just place the line."

George nodded, took another steadying breath, and tried again. This time, he hit the mark, threading the catheter into place with a growing sense of confidence.

"Good," Bailey said when he'd completed the procedure. "Now secure it and dress the site."

As George finished, he couldn't help but feel a small surge of pride. It wasn't a glamorous procedure, but he'd done it correctly, under pressure, with Bailey watching his every move.

"Thank you for your patience, Mr. Peterson," George said, patting the elderly man's shoulder.

As they left the room, Bailey stopped George in the hallway. "You did well in there, once you stopped second-guessing yourself."

"Thank you, Dr. Bailey," George replied, surprised by the rare compliment.

"Don't let it go to your head," Bailey warned. "You've got a lot more to learn. Now go check on my post-op cholecystectomy in 2118."

Clem and Derek

After finishing rounds, Clem headed to the research library to review some material on a complicated post-op case. The library was mostly empty this time of day, with just a few residents hunched over textbooks in the corners.

She was deep in concentration, making notes on the recovery patterns for complex vascular surgeries, when she felt someone sit down next to her. The faint scent of familiar cologne told her who it was before she looked up.

"Dr. Shepherd," she said formally, though her lips curved into a small smile.

"Dr. Hart," Derek replied, his voice equally professional despite the warmth in his eyes. "Studying up on vascular recovery protocols?"

"Just reviewing some literature for a post-op patient," Clem explained, keeping her voice low. "Mrs. Jacobs is showing some unusual swelling patterns after her bypass."

Derek nodded, genuinely interested. "The femoral-popliteal case? I heard about that from Bailey."

"That's the one," Clem confirmed, impressed that he was keeping track of cases outside his department.

Derek leaned slightly closer under the pretense of looking at her notes. "You left early this morning," he said quietly.

"Some of us can't roll in whenever we want, Dr. Shepherd," Clem replied, though there was no edge to her words. "Bailey expects punctuality."

"Dinner tonight?" Derek asked, his fingers brushing against hers briefly where they rested on the table.

"Can't," Clem said, genuinely regretful. "I promised the roommates a movie night."

"Tomorrow, then," Derek said, that confident certainty in his voice that both irritated and attracted her. It wasn't really a question.

"Maybe," Clem replied, purposely vague just to challenge his assurance. "If I'm not on call."

Derek smiled, recognizing the game. "You're not on call tomorrow. I checked the schedule."

"Of course you did," Clem said, shaking her head slightly, unable to suppress her smile.

"My trailer, eight o'clock," Derek said, standing up. "I'll cook."

"Last time you 'cooked,' we ended up ordering pizza," Clem reminded him.

"I'll order pizza at eight, then," Derek amended with a grin.

As he turned to leave, Clem called after him, keeping her voice low, "Derek?"

He turned back, eyebrows raised in question.

"Annie Connors," Clem said, her expression growing serious. "Is there any hope?"

Derek's expression sobered. "Burke and I are reviewing her scans this afternoon. It's... complicated."

"That's not an answer," Clem pointed out.

"No," Derek agreed. "It's not." He hesitated, then added, "I'll let you know what we find."

As he walked away, Clem noticed Alex standing in the doorway of the library, watching their exchange with an unreadable expression. When he saw her notice him, he smirked and disappeared down the hallway.

Cristina and Burke

Cristina entered the cardio lab to find Burke reviewing echocardiograms with focused intensity. He glanced up as she approached, acknowledging her with a slight nod.

"Dr. Yang, good. I want your opinion on something." He gestured to the screen, where a heart valve was clearly malfunctioning. "What do you see?"

Cristina stepped closer, studying the images carefully. "Mitral regurgitation, severe. The valve isn't closing properly, causing significant backflow into the left atrium."

Burke nodded, impressed but not showing it. "And treatment options?"

"Surgery is indicated," Cristina replied without hesitation. "Valve repair if possible, replacement if necessary. Though some cases can be managed medically if the patient is a poor surgical candidate."

"And what makes a poor surgical candidate?" Burke pushed, testing her knowledge.

"Advanced age, multiple comorbidities, poor overall health status," Cristina listed. "Basically, if the risks of surgery outweigh the potential benefits."

"Like our tumor patient," Burke mused, almost to himself.

Cristina's interest was immediately piqued. "Annie Connors? Are you consulting on her case?"

"I am," Burke confirmed. "A tumor of that size affects cardiac function. I need to assess whether her heart can withstand the stress of a complex, lengthy operation."

"Can I assist with the assessment?" Cristina asked, trying not to sound too eager.

Burke studied her for a moment. "You're direct, Dr. Yang. I appreciate that." He nodded once. "Yes, you can assist. We'll be meeting with Dr. Shepherd in an hour to review all the imaging."

Cristina couldn't quite hide her satisfaction. "Thank you, Dr. Burke."

"Don't thank me yet," Burke warned. "This case is... challenging, at best. Insurmountable, at worst."

"I don't believe in insurmountable medical problems," Cristina replied confidently. "Just surgical puzzles waiting to be solved."

A flicker of something—perhaps approval, perhaps amusement—crossed Burke's face. "We'll see if you maintain that optimism after reviewing her scans."

Alex's Patient Crisis

Alex was checking on his last post-op patient, Mr. James, a 35-year-old recovering from a minor surgical procedure for kidney stones. As he entered the room, he found the bed empty and the patient's belongings gone.

"Where's the patient?" Alex demanded of a nearby nurse.

"He said he was checking himself out," the nurse replied with a shrug. "I told him he needed doctor's clearance, but he wasn't interested in hearing it."

Alex cursed under his breath and headed for the elevators. He caught sight of Mr. James at the hospital entrance, clearly preparing to leave.

"Mr. James!" Alex called out, jogging to catch up. "You can't leave yet."

The man turned, looking irritated. "Look, Doc, I feel fine. I've got work tomorrow, and I can't afford another day off."

"You haven't completed your antibiotic course," Alex argued. "And we need to make sure there's no post-procedural infection before you're discharged."

"I'll take the pills at home," Mr. James insisted.

"It doesn't work that way," Alex said firmly. "You need to be monitored for at least another 24 hours."

Mr. James shook his head stubbornly. "I can't afford another day here. My insurance barely covers what I've already racked up."

Alex ran a hand through his hair in frustration. "Look, man, I get the financial thing, but if you leave now and develop complications, you'll be back with bigger problems that cost even more."

"That's my risk to take," Mr. James said, turning to leave.

"It's AMA then," Alex called after him. "Against medical advice. You'll need to sign forms acknowledging you're leaving despite medical recommendation."

Mr. James hesitated, then reluctantly turned back. "Fine. Whatever. Get me the forms."

Alex led him back to the nurses' station, where Bailey happened to be reviewing charts. She looked up questioningly.

"Mr. James wants to sign out AMA," Alex explained, reaching for the appropriate forms.

Bailey studied the patient with a shrewd expression. "Mr. James, may I ask why you're in such a hurry to leave our fine establishment?"

"Work," the man replied shortly. "Not all of us have fancy jobs with sick leave."

Bailey nodded thoughtfully. "I understand that. But Dr. Karev is right—leaving now significantly increases your risk of complications."

"I'll take my chances," Mr. James insisted.

Bailey considered him for a moment, then turned to Alex. "Dr. Karev, what's the absolute minimum time we need to observe Mr. James to ensure basic safety?"

Alex looked surprised at the question but thought quickly. "We could potentially discharge him tomorrow morning if his vitals remain stable overnight and his blood work comes back clean."

"And the antibiotics?" Bailey prompted.

"We could switch him to oral meds to complete at home, provided he understands the importance of finishing the full course," Alex admitted.

Bailey turned back to Mr. James. "Here's what we can do. You stay until tomorrow morning—just one more night. We'll expedite your final checks, and if everything looks good, you'll be out of here by 8 AM. That should get you to work with minimal disruption."

Mr. James hesitated, clearly torn. "I don't know..."

"Additionally," Bailey continued, "I'll have our financial services department visit you today to discuss payment plans and assistance options. Seattle Grace has programs for patients in your situation."

The man's shoulders relaxed slightly. "You can do that?"

"I can," Bailey confirmed. "So do we have a deal? One more night, and then you're free to go—properly discharged with medications in hand?"

After a moment's consideration, Mr. James nodded. "Alright. One more night."

"Excellent," Bailey said briskly. "Dr. Karev will get you settled back in your room."

As Alex led the patient back to his room, Bailey called after him, "Dr. Karev, a word when you're done."

After getting Mr. James situated, Alex returned to find Bailey waiting with a stern expression.

"You almost lost that patient," she said without preamble.

"He was determined to leave," Alex defended. "I tried to explain the risks."

"Yes, I heard your medical explanation," Bailey said, unimpressed. "What I didn't hear was any acknowledgment of his actual concerns."

Alex frowned. "His medical needs are what matter."

"His medical needs exist within the context of his life," Bailey corrected. "These aren't case studies in a textbook, Dr. Karev. They're people with jobs and families and financial worries. Understanding that is part of being a good doctor."

Alex shifted uncomfortably. "So I should have... what? Ignored medical protocol because he has work?"

"No," Bailey said patiently. "You should have heard his concerns and found a compromise that addressed both his medical needs and his practical realities. Like we just did."

Alex nodded slowly, processing her point.

"Think about it," Bailey advised. "Now, go help Dr. Hart with the post-op notes. And try to remember your patients are humans, not just interesting medical puzzles."

The Scan Review

In the imaging conference room, Derek and Burke stood before multiple screens displaying Annie's scans, their expressions grave. Meredith, Izzie, and Cristina observed from the back of the room, while Clem, having finished her rounds, had slipped in quietly to listen.

"The tumor has integrated with her abdominal wall," Burke was saying, pointing to various areas on the scan. "And here, it's encroaching on the inferior vena cava."

"Not to mention the compression of multiple organs," Derek added, shaking his head slightly. "Her right kidney is practically non-functional due to the pressure."

"But surgery is still possible?" Izzie asked hopefully.

Burke and Derek exchanged a look that spoke volumes.

"Technically, yes," Burke answered carefully. "But the risks are extraordinary. A surgery of this magnitude, with this level of complexity..."

"What are her chances?" Meredith asked directly.

Derek sighed. "Based on these scans, even with the best surgical team and perfect conditions... maybe 10% survival rate."

A heavy silence fell over the room.

"And without surgery?" Cristina asked, always practical.

"The tumor will continue to grow," Burke explained. "Eventually, it will compress her lungs and heart to the point where they can no longer function. She probably has a few months at most."

"So we're just going to give up?" Izzie challenged, her voice rising slightly. "Tell her to go home and die?"

"No one's giving up, Dr. Stevens," Derek said firmly. "We're assessing the reality of her situation."

"The reality is she came here for help," Izzie insisted. "She finally worked up the courage to face this, and now we're telling her it's too late?"

"Izzie," Meredith said quietly, placing a hand on her friend's arm.

From her position near the door, Clem spoke up. "What about partial debulking? Even if we can't remove it all, could we reduce it enough to improve her quality of life for whatever time she has left?"

All eyes turned to her, and she felt a momentary self-consciousness at inserting herself into a case she wasn't officially assigned to.

Burke considered her suggestion. "It's possible. Risky, but possible. It wouldn't cure her, but it might buy her some time and comfort."

"It's an option worth discussing with her," Derek agreed, giving Clem a subtle nod of approval.

"I'll set up a meeting with Annie to discuss her options," Burke decided. "Dr. Yang, you'll assist me since you've been working on the cardiac assessment. Dr. Grey and Dr. Stevens, you'll continue to monitor her pre-op."

As the group dispersed, Derek caught up with Clem in the hallway.

"Partial debulking," he said quietly. "Good thinking."

"Just trying to find a middle ground," Clem replied with a small shrug. "Sometimes that's all we can do."

"Sometimes it's enough," Derek said. He glanced around to ensure they were relatively alone, then added in a lower voice, "Still on for tomorrow night?"

Clem nodded, a smile playing at her lips despite the gravity of the case they'd just discussed. "Eight o'clock. Don't forget the pizza."

"I wouldn't dare," Derek replied with a grin before heading off to his next case.

As Clem turned to leave, she nearly collided with Alex, who was approaching with a stack of charts.

"Nicely done in there, Brooklyn," he said, nodding toward the conference room. "Didn't know you were on the case."

"I'm not," Clem admitted. "Just observing."

"Right," Alex drawled. "Just happened to slip into a high-profile case discussion where your boyfriend was presenting."

"He's not my—" Clem began automatically, then stopped herself. "Whatever. What do you want, Karev?"

"Bailey wants these post-op notes completed and filed before the end of shift," Alex said, handing her half the stack. "Apparently, we're being punished for gossiping earlier."

"Great," Clem sighed, taking the charts. "Just how I wanted to spend my afternoon."

"Could be worse," Alex said with surprising equanimity. "Could be rectal exams."

Despite herself, Clem laughed. "True enough."

They walked together toward the nurses' station, settling in for the tedious work of completing paperwork.

"So," Alex said after they'd been working in silence for a while, "the tumor lady. You think she has a chance?"

Clem considered the question seriously. "With the partial debulking? Maybe. Not a cure, but some relief, some time."

Alex nodded slowly. "Sometimes that's all you can hope for."

Clem looked at him curiously, surprised by the philosophical tone. "That's... unexpectedly reflective of you, Karev."

Alex shrugged, immediately retreating behind his usual bravado. "Just saying. Medicine's not always about the cure. Sometimes it's just about making the crappy situation slightly less crappy."

"Very poetic," Clem said dryly, but she was smiling slightly as she returned to her charting.

The Surgery

The OR was tense the next morning as Burke and Derek prepared for Annie's surgery. Meredith and Izzie were scrubbed in to assist, while Bailey supervised from the side. The gallery above was packed with residents and interns, including Clem, Alex, George, and Cristina, all eager to witness this rare and complex procedure.

"It's enormous," George whispered as Annie was prepped and draped, her massive tumor exposed under the surgical lights.

"The vasculature alone is going to be a nightmare," Cristina observed clinically, leaning forward for a better view.

Below, Burke made the first incision, beginning the long and delicate process of separating the tumor from Annie's body. Hours passed as the surgeons worked methodically, clamping vessels, cutting through adhesions, and carefully freeing the mass bit by bit.

From the gallery, the interns watched with a mixture of fascination and growing concern as complications began to arise.

"Her pressure's dropping," Clem noted, watching the monitors.

"They've hit major bleeding," Alex added, pointing to where Burke was working rapidly to control a sudden hemorrhage.

Down in the OR, the situation was deteriorating rapidly.

"Suction here," Burke ordered calmly despite the crisis. "More lap pads."

"BP's down to 80/40," the anesthesiologist reported.

"She's losing volume faster than we can replace it," Meredith observed anxiously.

"The tumor's invaded the vena cava more extensively than the scans showed," Derek explained, his face grim behind his mask. "We're hitting bleeding that we can't control."

Despite their best efforts, Annie's vital signs continued to decline. The monitors began to alarm as her blood pressure plummeted further.

"V-fib!" the anesthesiologist called out.

"Starting compressions," Izzie immediately moved into position, beginning CPR while the team prepared the defibrillator.

"Charge to 200," Burke ordered. "Clear!"

Annie's body jerked with the shock, but the monitors showed no improvement.

In the gallery, the interns watched in tense silence as the team below fought desperately to save their patient.

"They're losing her," George whispered, his voice tight.

After thirty minutes of resuscitation efforts, with multiple shocks and rounds of medications, Burke finally looked up at the clock.

"Time of death, 14:17," he announced quietly.

In the sudden stillness of the OR, Izzie's voice broke the silence. "We can't just stop. We have to try again."

"Dr. Stevens," Bailey said gently but firmly. "It's over."

The gallery slowly emptied as the interns dispersed, each processing the loss in their own way. Clem lingered for a moment, watching as Derek removed his surgical gown, his posture betraying his exhaustion and disappointment.

After the Loss

Clem found Derek in the attendings' lounge, staring out the window with a cup of coffee gone cold in his hands. She hesitated in the doorway, unsure if she should interrupt his solitude.

"You can come in," Derek said without turning around. "I'm just... processing."

Clem slipped inside, closing the door softly behind her. "It wasn't your fault."

"I know that," Derek replied, finally turning to face her. His eyes were tired, the confident surgeon momentarily replaced by a man carrying the weight of a lost patient. "Intellectually, I know that. But..."

"But it still feels like you should have been able to do more," Clem finished for him.

Derek nodded, setting down his cup. "We knew the risks were astronomical. I told her that. Burke told her that. But she wanted to try anyway."

"Because the alternative was certain death," Clem said quietly, moving to stand beside him at the window. "At least she had a chance."

"A ten percent chance," Derek corrected bitterly. "Which turned out to be zero percent."

"You gave her hope," Clem argued gently. "For someone who's been hiding in shame for two years, that's not nothing."

Derek looked at her, a small smile finally breaking through his gloom. "How is it you always find the right perspective?"

"Brooklyn upbringing," Clem shrugged, returning his smile. "When everything's a disaster, you get pretty good at finding silver linings."

Derek set his cup down and reached for her hand, lacing his fingers through hers. It was a small gesture, but intimate in the context of the hospital.

"Still on for tomorrow?" Derek asked eventually.

"As long as food is involved," Clem confirmed. "And no talk of work."

"Deal," Derek agreed. He checked his watch. "Don't you have a movie night to get to?"

Clem groaned. "God, I forgot. It's Izzie's turn to pick. Last time it was some three-hour period romance where everyone died at the end."

Derek laughed. "Sounds riveting."

"Hey, at least I get beer and wings out of it," Clem said, pushing off from the railing. "You heading home soon?"

"Paperwork," Derek grimaced. "The glamorous life of an attending."

"Don't stay too late," Clem said, moving toward the door. "You need your beauty sleep."

Derek smiled. "Good night, Dr. Hart."

"Good night, Dr. Shepherd," Clem replied, matching his formal tone, a hint of a smile playing at her lips as she headed back inside.

Roommate Movie Night

The living room of Meredith's house was in comfortable disarray—pizza boxes stacked on the coffee table, chicken wings arranged haphazardly on paper plates, and beer bottles claiming every available surface. The TV was queued up with Izzie's movie selection for the night.

"If this is another one of those weepy historical dramas, I'm leaving," Alex warned, grabbing a slice of pizza.

"You'll watch what I pick and you'll like it," Izzie retorted, though without real heat. "Besides, it's my turn."

"What did you choose?" George asked cautiously as he settled into the armchair with a plate piled high with wings.

Izzie grinned triumphantly. "Die Hard."

Alex nearly choked on his beer. "Seriously? Stevens, I might have misjudged you."

"What?" Izzie shrugged innocently. "I contain multitudes."

Meredith laughed, curling up on one end of the couch. "I thought for sure we were in for another Jane Austen adaptation."

"That was last month," Izzie reminded her. "I'm mixing it up."

Clem entered the living room, fresh from a quick shower, her damp hair pulled into a messy bun. She wore an oversized Columbia Med School sweatshirt and leggings.

"Please tell me you saved me some wings," she said, eyeing the rapidly disappearing food.

"Bottom box," George said through a mouthful. "We hid them from Alex."

"I resent that," Alex said, reaching for another beer. "I would never steal a woman's wings."

"You absolutely would," Meredith countered. "And have."

The doorbell rang, and George jumped up. "That'll be Cristina. I'll get it."

Moments later, Cristina swept in, looking slightly disheveled and carrying a six-pack. "Sorry I'm late. Got caught up with... hospital stuff."

"Hospital stuff?" Izzie repeated skeptically, noting Cristina's rumpled appearance and the fact that her shirt buttons weren't aligned properly.

Cristina avoided eye contact, setting her beer down with perhaps more force than necessary. "Yes. Complex, boring, hospital stuff. What are we watching?"

"Die Hard," Alex reported, still sounding pleased by this development.

"Thank god," Cristina sighed, flopping down between Meredith and Clem on the couch. "I was afraid it would be another costume drama where everyone gets consumption."

"That was last month," everyone else chorused.

Cristina grabbed a beer and settled in. "So did I miss anything good? Any hospital gossip?"

"Nothing you don't already know," Meredith replied. "Annie's surgery..."

The mood in the room sobered momentarily.

"Yeah," Cristina nodded. "Burke was pretty torn up about it."

"I'm just saying, it's got to be weird for Dr. Shepherd," George said, changing the subject. "First major case loss since becoming head of neurosurgery here."

Clem focused intently on her chicken wing, not wanting to reveal that she'd just seen Derek processing exactly that.

"Speaking of McDreamy," Izzie teased, glancing at Clem, "he didn't want to join movie night?"

"He's busy," Clem said simply, reaching for her beer.

"Too busy for his favorite intern?" Alex smirked.

Clem threw a wadded-up napkin at him. "Shut up, Karev."

"Ooooh, touchy," Alex laughed, dodging the projectile.

"Can we just start the movie?" Clem pleaded, glancing at Izzie.

"Yes, please," Meredith agreed. "Before Alex gets himself murdered."

"Fine, fine," Izzie relented, grabbing the remote. "But don't think you're off the hook, Clem. We want details eventually."

"There are no details," Clem insisted as Izzie started the movie.

"There are always details," Cristina muttered under her breath.

They settled in as the opening credits rolled, the familiar rhythms of friendship temporarily drowning out the day's difficulties. Despite the teasing, Clem felt a warmth that had nothing to do with the alcohol—this unlikely group had somehow become her people in Seattle.

As Bruce Willis appeared on screen, Clem's phone lit up on the side table. The name James Callahan flashed across the screen, causing her stomach to drop. Without hesitation, she jabbed the end call button forcefully.

"Whoa, who pissed you off?" Alex asked, noticing her aggressive reaction.

"Nobody," Clem said too quickly, tossing her phone face-down onto the couch cushion beside her.

The others exchanged curious glances, but a notification sound indicated a voicemail had been left. Clem pointedly ignored it, reaching for another slice of pizza.

"Ex-boyfriend?" Izzie guessed, unable to help herself.

"I said nobody," Clem repeated firmly. "Are we watching this movie or not?"

"We're watching," Meredith assured her, giving the others a look that clearly said to drop it.

The group reluctantly returned their attention to the screen, but Clem remained tense, her eyes occasionally darting to her silenced phone. The voicemail notification glowed faintly against the cushion, an unwelcome reminder of the past she'd left behind in New York.

Chapter Text

**Flashback**First Meeting - Cardiothoracic Surgery Rotation - Final year of Medschool

Clementine Hart adjusted her white coat nervously as she waited with the other medical students outside the cardiothoracic surgery department. It was her first day of this rotation, and she'd heard Dr. Callahan was both brilliant and demanding.

"Dr. Callahan doesn't suffer fools," whispered one of her classmates. "He's one of the best cardiac surgeons in the country, but he expects perfection."

Before Clem could respond, the door swung open, and a tall man in pristine surgical attire emerged. Dr. James Callahan had the confident bearing of someone entirely comfortable in his expertise. His blonde hair was perfectly styled, and his pale blue eyes held an intensity that immediately commanded attention. Unlike the casual scrubs most attendings wore, he was dressed in crisp khakis and a pressed button-down shirt under his white coat—every inch the polished academic physician.

"Good morning," he said, his crisp British accent giving additional weight to his words. "I'm Dr. James Callahan, Chief of Cardiothoracic Surgery." His eyes scanned the group methodically. "You're here because cardiac surgery requires the highest level of precision and dedication. I'm here to determine which of you possesses those qualities."

Clem felt herself straighten instinctively under his scrutiny.

"Today, you observe," he continued. "Tomorrow, those who demonstrate genuine understanding might be permitted greater involvement. Follow me."

The students fell into line behind him as he strode down the hallway, his gait measured and purposeful. Clem found herself taking notes as he explained the day's cases in detail.

"You," Dr. Callahan said suddenly, stopping and turning toward her. "What's your name?"

"Clementine Hart, sir," she replied, hoping her voice sounded steadier than she felt.

"Ms. Hart," he repeated, his accent making her name sound somehow more sophisticated. "Describe the pathophysiology of mitral valve regurgitation."

Without hesitation, Clem explained the condition, including its hemodynamic effects and surgical options. Dr. Callahan's expression remained impassive as she spoke, but she caught a flicker of interest in his pale eyes.

"Adequate," he said simply, though something in his tone suggested this was high praise from him. "Carry on."

One of her classmates nudged her as they entered the cardiac catheterization lab. "That was practically a standing ovation from Callahan," he whispered.

Clem tried to suppress her smile, already knowing this rotation would be different from the others.

Teaching Moments

Two weeks into the rotation, Clem found herself staying later than the other students, reviewing echocardiograms and cardiac catheterization films in the department's reading room. She'd developed a habit of using the quiet evening hours to study cases and perfect her interpretation skills.

"Still here, Ms. Hart?" Dr. Callahan's cultured voice came from the doorway.

"Yeah, just going over tomorrow's case," she replied, straightening up.

Instead of leaving, he entered the room, setting down his ever-present cup of perfectly brewed tea. "What do you see?" he asked, nodding toward the images.

"Severe aortic stenosis," Clem said confidently. "Valve area's less than one centimeter squared, big gradient across the valve."

Callahan moved to stand beside her, his movements precise and controlled. "Surgical approach?"

"Aortic valve replacement," she answered, then paused, studying the images more carefully. "Though this guy's pretty old and has a bunch of other issues. Maybe TAVI would be less invasive?"

"Interesting," he said, his tone warmer than usual. He leaned closer to point at a specific area on the screen, and she caught the faint scent of expensive cologne. "But consider this—what does the annular anatomy tell you about TAVI feasibility?"

Clem focused on the measurements, trying to ignore how close he was standing. "Oh, the annulus looks oval instead of round," she realized. "That could make device positioning tricky and increase leak risk."

"Precisely," Callahan said, genuine approval in his voice. "Most students only see the obvious pathology. You consider the surgical implications." He studied her for a moment. "You have excellent clinical intuition, Ms. Hart. That's not something that can be taught."

"Thanks, Dr. Callahan," Clem replied, unable to hide her pleasure at the compliment.

"James," he corrected with a slight smile. "When we're discussing cases privately, formality seems rather unnecessary."

Clem nodded, feeling a small thrill at this gesture of collegiality from someone she already respected immensely. "James, then."

He stayed for another forty minutes, walking her through the nuances of the case, his teaching style more relaxed and engaging in this intimate setting than during formal rounds. When he finally left, Clem realized with surprise that it was nearly midnight.

The Research Opportunity

"I'm selecting a research assistant for my clinical outcomes study," Dr. Callahan announced after rounds one morning, a month into Clem's rotation. "The position requires meticulous attention to detail, analytical thinking, and a willingness to invest significant time in meaningful research."

Several students exchanged hopeful glances, but Callahan continued, "I've already identified the most suitable candidate. Ms. Hart, please see me in my office after rounds."

Clem felt the weight of her classmates' stares—some envious, others speculative. Research with Callahan would be huge for her residency applications, particularly given his international reputation.

Later, in his immaculately organized office, he outlined the study. "We're looking at long-term outcomes for minimally invasive cardiac procedures," he explained, handing her a leather portfolio of materials. "The data could change surgical standards worldwide."

"Why me?" Clem asked directly, genuinely curious.

Callahan leaned back in his chair, studying her with those pale blue eyes. "You think systematically. You question assumptions rather than just accepting them. And you have the intellectual rigor needed for real research." His smile was slight but warm. "These qualities will serve you well in surgery too."

"I won't let you down," Clem said, feeling a flush of professional pride.

"I'm quite certain you won't," he said, his British formality lending weight to the statement. "We'll be working closely together. I think this will be good for both of us."

As she left his office, portfolio clutched carefully to her chest, Clem felt like she'd just taken a major step toward her future as a surgeon.

Crossing Professional Lines

The first time Callahan suggested dinner to discuss the research, Clem figured it was just professional. The second time, when he chose some fancy restaurant in Manhattan's Upper East Side, she started to wonder.

"Is this okay?" she asked as the sommelier presented a wine that probably cost more than her monthly rent.

"It's just dinner, Clem," he replied smoothly. "Colleagues discussing important research somewhere more comfortable than the hospital cafeteria."

And they did talk about research—along with surgical techniques, patient outcomes, and Clem's plans for residency at Mount Sinai. The conversation flowed easily, Callahan treating her like an equal in a way that was both flattering and kind of intoxicating.

It was past midnight when they got outside. The city was quieter now, and Callahan's hand found the small of her back as he guided her toward the waiting car.

"I really enjoyed tonight," he said, his voice different somehow. "Your insights are... refreshing."

"Thanks," Clem replied, suddenly very aware of how close they were standing. "For dinner and everything."

He studied her face in the streetlight, then stepped back slightly. "Shall we continue our work next week? The preliminary data needs detailed review."

Clem nodded, telling herself the flutter in her chest was just excitement about the research.

The First Transgression

The research was going really well. Clem's analysis had found patterns in the data that backed up Callahan's theory about better outcomes with minimally invasive techniques, and they were both pumped about it as they worked late in his office one evening.

"This could actually change cardiac surgery," Callahan said, looking over her latest analysis. "Your work on the secondary endpoints is brilliant."

"It's cool to be part of something this big," Clem agreed, organizing her notes. The hospital was quiet around them—most people had gone home hours ago.

"You should be proud," he told her, his pale eyes warm as they met hers. "Most medical students couldn't have found these patterns, let alone analyzed them like this."

"I'm just lucky to be working with you," Clem said, though his praise still made her feel warm.

Callahan stood, moving around his desk smoothly. "You know you're exceptional, Clementine. Your mind, your dedication..." He stopped right in front of her chair. "Your passion for excellence."

Something shifted between them, charged with tension that had been building for weeks. Clem knew she should leave, keep things professional, but when Callahan reached out to touch her cheek, she didn't pull away.

"This is probably a bad idea," she whispered as he leaned closer.

"Probably," he agreed, his thumb tracing her jaw.

Neither of them seemed to care as their lips met, soft at first, then more intense. Papers scattered as Callahan pulled her to her feet, pressing her against the window overlooking the city.

Later, as she picked up her scattered notes with shaking hands, Clem told herself it was just once—a moment of weakness from working so closely together.

She was wrong.

The Affair

What started in his office became a pattern—intimate dinners at discrete restaurants, weekends at his country house in the Hamptons, stolen moments in empty conference rooms when the hospital was quiet.

"You're incredible," he would tell her as they lay together in expensive sheets. "You see things others can't even imagine."

The combination of respect and desire was addictive. Being wanted by someone she admired so much validated everything—not just her attractiveness but her worth as a future surgeon.

There were red flags, of course. How he insisted they always arrive and leave separately. How he dodged personal questions about his life. How little she knew about him outside the hospital.

"Why do we have to be so secretive?" she asked once as they shared dinner at his country house.

"Hospital politics," he explained smoothly. "Relationships between faculty and students are technically allowed but professionally problematic. I won't have your reputation damaged because of me."

It sounded protective, even noble. So the affair continued, a secret that felt both thrilling and increasingly important to who she was.

The Cardiothoracic Society Gala

The annual Cardiothoracic Society gala was the department's biggest event—a fundraiser with prominent surgeons, researchers, and select students who showed exceptional promise. Clem, as lead researcher on Callahan's groundbreaking study, was invited.

"You look stunning," Callahan murmured as they passed each other near the silent auction, his eyes appreciating her navy silk dress. "Meet me in the library in fifteen minutes. I want to show you something."

Clem nodded discretely, her heart racing at the thought of a private moment during such a public event. It was risky, but after months of secrecy, there was a thrill in dancing so close to getting caught.

She was heading toward the library when a commotion at the entrance caught everyone's attention. A woman in her early forties, elegant in emerald green, was making an entrance—fashionably late and owning the room.

"James!" the woman called out, her voice carrying across the space.

Clem watched, frozen, as Callahan turned with a smile that suddenly looked fake. "Victoria," he said, moving to greet her with a kiss on both cheeks. "I wasn't sure you'd make it."

"Wouldn't miss it, darling," the woman—Victoria—replied, slipping her arm through his like it was the most natural thing in the world. "You know I love seeing you dressed up."

Around Clem, conversations continued, but she couldn't hear anything. The woman looked familiar—Clem had seen her photo somewhere. And then it hit her like a punch to the gut. The silver-framed photo on Callahan's office desk, the one he'd said was his sister when she'd asked.

Not his sister. His wife.

As if she could feel Clem staring, Victoria's eyes found her across the room. There was no anger there, no surprise—just a tired, knowing look.

Clem ran to the bathroom, barely making it into a stall before the tears came. God, she was so stupid. All the signs had been there, and she'd ignored them all, thinking she was special enough to justify the lies.

When she finally came out, trying to fix her makeup with shaking hands, Victoria was there by the mirrors, touching up her lipstick like nothing had happened.

"You must be Clementine," she said, her tone surprisingly gentle. "James has mentioned your research skills."

Clem stared at her, mortified and confused. "I—"

"Please," Victoria interrupted, not mean but firm. "You don't need to explain. You're not the first smart medical student to catch my husband's eye." She capped her lipstick with a sharp click. "Though you've lasted longer than most. That's... interesting."

The casual way she said it was somehow worse than if she'd been angry. This wasn't shocking news to Victoria—it was routine.

"I didn't know," Clem managed to whisper.

"Of course you didn't," Victoria replied, turning to face her. "That's kind of the whole point." She moved toward the door, then paused. "Piece of advice? Look at that research data more carefully. James gets... creative when his career's on the line."

With that warning, she was gone, leaving Clem alone with her shame and growing worry.

The Unraveling

Victoria's warning ate at Clem over the next few days as she avoided Callahan's increasingly frantic calls and texts. When she finally went back to the lab, she started going through the raw data with fresh eyes.

The problems were subtle at first—patient response numbers that seemed too consistent, baseline measurements that had been "corrected" after the fact, follow-up data that painted an impossibly rosy picture. But once she started looking, the pattern became obvious.

The data had been systematically altered to support what Callahan wanted to prove.

"You've been avoiding me," Callahan said from the doorway, his usual control cracking. She hadn't heard him come in.

"I've been going through the research," Clem replied carefully, closing the laptop where she'd been comparing the original and modified data.

He came closer, his familiar confidence now seeming calculated instead of natural. "Victoria shouldn't have talked to you at the gala. That was completely inappropriate."

"Inappropriate?" Clem repeated, incredulous. "What about lying to me for months? You're married, James."

"I didn't lie," he said smoothly. "I just didn't volunteer information that would complicate things unnecessarily."

"We don't have 'things,'" Clem said firmly. "And there's something else we need to talk about. The data—"

His expression went cold instantly. "What about the data?"

"It's been changed," she said quietly. "I found the original files. The outcomes aren't nearly as good as what we've been reporting."

For a second, real fear flashed across his face before he got his composure back. "You're wrong. Those must be preliminary numbers before proper adjustments were made."

"No," Clem insisted, finding courage in her anger. "I checked everything. You changed the data to support your hypothesis."

All pretense dropped away. "Be very careful, Clem. You're making serious accusations that could destroy careers."

"I know what I'm risking," she said, standing up despite her racing heart. "That's why I'm pulling out of the study. Now."

His laugh was cold and unfamiliar. "You think it's that easy? Your name is on everything. If there are problems, they implicate you just as much."

The threat was clear, and it scared her. "You wouldn't."

"I don't want to," he said, his voice softening in a way that might have seemed genuine once. "We've done important work together, Clementine. Don't throw that away over a misunderstanding."

"It's not a misunderstanding," she replied, grabbing her stuff with trembling hands. "And I won't be part of fraud."

As she got to the door, his words followed her: "You'll regret this, Ms. Hart. I promise you that."

The Fallout

Callahan moved fast. By the next morning, rumors were flying that a medical student had faked data on a major cardiac surgery study. No names were mentioned officially, but anyone in the department could connect the dots.

"He's saying you manipulated patient data to show better outcomes," Clem's classmate Sarah told her quietly over lunch. "That he caught you during a routine review."

"That's completely false," Clem said, keeping her voice steady despite the panic.

"I believe you," Sarah said quickly. "But he's this internationally famous attending, and you're..."

"Just a student," Clem finished.

The ethics committee hearing was set for the following week. Until then, Clem was suspended from all clinical work—potentially career-ending in her final year.

She called her mom that night, finally breaking down as she explained everything. Kit Hart listened without interrupting, her steady presence an anchor through the phone.

"This man," Kit said finally, her voice tight with controlled anger, "isn't the first doctor to abuse his power, and sadly he won't be the last. But he picked the wrong student to mess with."

Kit Hart had over twenty years as an ER nurse. She knew doctors, hospital politics, and most importantly, who to call when justice needed help.

Vindication

The ethics committee hearing should have ended Clem's career. Instead, it ended Callahan's.

Victoria Callahan showed up unexpectedly with organized files documenting similar data problems in her husband's previous research. Two former students gave sworn statements about inappropriate relationships and professional retaliation afterward. The head nurse submitted a formal complaint detailing years of ethical concerns about Callahan's research practices.

Most damning was Clem's evidence—the original data files with timestamps clearly showing where and when changes had been made to support Callahan's desired conclusions.

"Based on this evidence," the committee chair announced after hours of testimony, "we find Dr. Callahan's accusations against Ms. Hart completely without merit. We also recommend immediate investigation into all research published under Dr. Callahan's supervision over the past seven years."

Relief flooded through Clem, though she knew her final year would always be marked by this mess.

As she left the hearing room, Victoria Callahan was waiting in the hallway.

"Why did you help me?" Clem asked quietly.

Victoria's smile was sad but determined. "Because I'm tired of cleaning up his messes. And because you did something many others couldn't—you wouldn't go along with it."

Aftermath and Moving Forward

Despite being cleared, the experience left scars. Callahan was put on administrative leave pending investigation, but whispers followed Clem—the student who brought down a department chief, the girl who slept with her mentor.

"Your evaluations are excellent," the residency advisor told her during her final assessment. "Your grades are outstanding. This incident doesn't have to define your career unless you let it."

Clem nodded, grateful but still unsure.

When match results came in, she was just relieved to match anywhere—many programs might have been scared off by the controversy. Seattle Grace wasn't her top choice, but it was across the country from New York, from Callahan, from all the whispers.

"Seattle's a good program," her mom said when Clem called with the news. "It's a fresh start."

A fresh start was exactly what she needed. As Clem packed her apartment, deciding what to keep and what to leave behind, her phone rang and the name flashed: Callahan.

She let it go to voicemail, listening later with detached curiosity. He was sorry things had gotten "so complicated." He still believed in her potential. Maybe when things settled down, they could find a way to "fix their professional relationship."

Clem deleted the message without responding. Seattle was waiting, and with it, the chance to be known for her surgical skills instead of her mistakes. She wasn't looking back.

Chapter Text

A Not-So-Quiet Morning

The early morning quiet of Seattle Grace's surgical floor was interrupted only by the squeak of rubber soles on linoleum and the occasional beep of monitors from patient rooms. Clem leaned against the nurses' station, reviewing charts before rounds began. She'd arrived thirty minutes early, determined to stay ahead of whatever the day might throw at her.

"Good morning, Dr. Hart."

Derek's voice carried that distinctive blend of professional courtesy and intimate familiarity that made Clem's stomach flutter, no matter how many times she told herself to get it under control. She looked up to find him extending a coffee cup toward her.

"Black, no sugar," he said, his eyes crinkling at the corners.

Clem accepted the coffee, brushing his fingers with hers. "Thanks," she replied, keeping her voice neutral despite the warmth spreading through her chest. "You're here early."

"Full day today." Derek leaned against the counter beside her, leaving a professionally appropriate distance between them that somehow felt more conspicuous than if they'd been standing closer.

"How's the Morrison case going?" he asked, referring to one of Bailey's post-op patients Clem had been monitoring.

"Good. Labs came back clean, and his incision site looks—"

"Well, well," came a voice from behind them. "If it isn't Seattle Grace's most obvious secret."

Tyler, the night shift nurse with perpetually disheveled scrubs and kind eyes, approached with a patient chart. He handed it to Clem with an exaggerated wink.

"Mrs. Jenkins needs her discharge papers. Figured I'd give them to you before Bailey sends you running for the rest of the day."

Clem rolled her eyes. "Thanks, Tyler."

Tyler glanced between them with amusement. "Don't worry, your coffee dates are safe with me." He tapped his name badge. "Switzerland."

"We're not—" Clem started.

Derek smiled diplomatically. "Good morning, Tyler."

"Morning, McDreamy," Tyler replied with a grin before heading back to his station.

Clem groaned quietly. "I hate that nickname."

"I don't know," Derek said, taking a sip of his coffee. "It's grown on me."

"You would say that." Clem shuffled the charts in her hands, feeling the familiar mixture of attraction and professional awkwardness that had become their morning routine. "I should probably—"

"Last night was nice," Derek said quietly, his voice dropping to ensure only she could hear.

Despite herself, Clem smiled. "It was."

"Dinner tonight? My place?"

Before Clem could answer, the elevator doors opened to reveal Cristina, Meredith, Izzie, George, and Alex, all arriving together in various states of wakefulness.

"Incoming," Clem murmured, taking a small step away from Derek.

Cristina approached first, eyebrows raised at the sight of them. "Morning, Dr. Shepherd," she said pointedly, then turned to Clem. "Where's Bailey?"

"Haven't seen her," Clem replied. "Maybe she's in a meeting?"

Alex joined them, dropping his bag behind the counter. "Morning, Brooklyn," he said to Clem, then nodded to Derek. "Dr. Shepherd."

Meredith and Izzie exchanged looks that Clem had learned to recognize as their "something's going on" faces. George simply looked nervous, as he often did when attendings were nearby.

Derek cleared his throat. "Dr. Hart was just updating me on the Morrison case."

"Right," Cristina said, not bothering to hide her skepticism. "Because you're suddenly interested in general surgery cases."

Izzie elbowed Cristina discreetly.

"Has anyone heard from Bailey?" Meredith asked, changing the subject. "It's not like her to be late."

As if summoned by her name, the elevator doors opened again—but instead of the diminutive form of Miranda Bailey, Chief Richard Webber stepped out, his white coat pristinely pressed.

Derek straightened immediately. "Chief."

"Dr. Shepherd," Webber replied with a nod before addressing the group. "Interns. I'll be taking over for Dr. Bailey today. She's down with strep throat."

A ripple of surprised murmurs passed through the group. Bailey was never sick.

"Dr. Bailey is sick?" George repeated, sounding both concerned and slightly terrified at the prospect of Webber running their day.

"Yes, Dr. O'Malley, even surgical residents get sick occasionally." Webber glanced around at the group. "I'll be running rounds in five minutes. I suggest you all be prepared."

Derek took this as his cue to leave. "I should get to pre-op," he said, nodding professionally to the group. "Chief." As he turned to go, his eyes met Clem's briefly. "Dr. Hart."

"Dr. Shepherd," she replied, hiding her smile behind her coffee cup.

Once Derek was safely out of earshot, Alex leaned in toward the group. "Bailey's out and the Chief is running point? This could be interesting."

"Interesting is one word for it," Cristina muttered, hastily reviewing her charts. "Last time Webber ran rounds, he quizzed everyone on obscure surgical procedures from the 1980s."

"Think he knows?" Izzie whispered to Clem, nodding in the direction Derek had gone.

"About me and—" Clem lowered her voice. "No. And let's keep it that way."

Chief Webber returned, clipboard in hand. "Rounds start now, people. And I warn you, I run things differently than Dr. Bailey." He scanned the group with eagle-eyed precision. "Today's assignments will be shaken up. Karev, you're in the pit. Yang, you're with Burke on his bypass."

Cristina's face lit up while Alex scowled.

"Grey and Stevens, you're with me in general today," Webber continued. "O'Malley, you'll be monitoring post-ops."

Clem waited, realizing she hadn't been assigned. "Sir? What about me?"

Webber consulted his clipboard then looked up at her with an expression she couldn't quite read. "Hart. You'll be with Dr. Shepherd today."

The group went silent. Alex's eyebrows shot up, and Cristina made a small choking sound.

"Is there a problem, Dr. Hart?" Webber asked, his tone making it clear there better not be.

Clem swallowed. "No, sir. No problem."

"Good." Webber nodded sharply. "I'm aware Dr. Bailey has been keeping you away from neurosurgery lately, but I believe in rotating all interns through every specialty. Your education comes first." His gaze swept over the group. "Any other questions?" When no one spoke, he nodded again. "Then let's move. Patients are waiting."

As the group dispersed to their assignments, Cristina sidled up to Clem. "Well, well. Back on neurosurgery with McDreamy. Must be your lucky day."

"Shut up," Clem muttered. "This is the opposite of what I need."

"Why? Afraid you can't keep your hands to yourself in the OR?" Alex chimed in from behind them.

Clem spun around. "Don't you have an ER to get to, Karev?"

Alex held up his hands in mock surrender, but there was something in his expression—was that genuine concern? Before she could analyze it further, he was gone, heading toward the elevator.

George lingered awkwardly. "Do you think the Chief really doesn't know? About you and Shepherd?"

"I don't know," Clem admitted. "But I'm going to do my job today, just like any other day." She squared her shoulders. "It's just neurosurgery, right?"

As she headed toward the neurology wing, Clem couldn't help but wonder what kind of test this was—and whether she and Derek would pass it.

The Chief's Shadow

Clem's footsteps echoed in the neurosurgery wing as she approached Derek, who was reviewing a patient chart outside Room 2214. She straightened her white coat and tucked a loose strand of hair behind her ear, mentally preparing to maintain absolute professionalism.

"Dr. Hart," Derek greeted her, his voice carefully neutral. "Glad you could join neurosurgery today."

"Dr. Shepherd," she responded with a nod, accepting the chart he handed her.

"Sherry Meyers, 16," he began, seamlessly transitioning into attending mode. "Post-op day two following aneurysm repair. She's been experiencing headaches this morning."

Clem skimmed the chart. "Vitals stable, labs normal. Pain scale?"

"Six out of ten, localized behind the right eye."

"Could be normal post-op pain, but worth watching for potential vasospasm," Clem suggested.

Derek's lips curved slightly. "Good. Let's assess."

They entered the room where a teenage girl with blonde hair was scrolling through her phone, looking bored and uncomfortable.

"Good morning, Sherry," Derek said. "This is Dr. Hart. She'll be working with me today."

"Another doctor?" Sherry sighed dramatically. "How many of you are there?"

"Just enough to make sure you get better," Clem replied with a smile. "I hear you're having headaches this morning?"

As Clem performed a neurological assessment, Derek observed her technique. Katie winced when Clem tested pupillary response.

"Light sensitivity?" Clem asked.

"Yeah, it makes it worse."

Clem glanced at Derek. "Could be meningeal irritation."

"My thoughts exactly," he replied. "Sherry, we're going to order a CT scan and check your aneurysm repair site."

As they stepped out of the room, the distinctive sound of dress shoes on linoleum made them both turn. Chief Webber approached, clipboard in hand.

"Dr. Shepherd, Dr. Hart," he greeted them. "How's our aneurysm patient?"

"Post-op headaches," Derek explained. "We're ordering a CT to rule out complications."

Webber nodded. "Good call. Mind if I observe your assessment of the scan?"

Derek and Clem exchanged a quick glance.

"Of course not, Chief," Derek replied. "We'll page you when the results come in."

"No need. I'll just tag along with you two today. General surgery is surprisingly light," Webber smiled. "It's been a while since I've observed neurosurgery up close."

Clem felt her stomach tighten. "That would be... educational, sir."

"Indeed it would, Dr. Hart." Webber's expression revealed nothing. "Shall we continue rounds?"

The CT Room

An hour later, Clem stood beside Derek in the darkened CT viewing room, studying Sherry's brain scans. Chief Webber stood slightly behind them, his presence almost tangible.

"No signs of bleeding," Derek observed, pointing to the repair site. "Surgical field looks clean."

"Could be unrelated migraine symptoms," Clem suggested. "Her chart mentioned a history."

"Good observation," Derek replied. "What would you recommend?"

Clem considered for a moment. "Continue pain management, monitor for changes in neurological status, and consult with her neurologist about adjusting her migraine protocol."

Webber stepped forward. "You seem quite comfortable with neurological cases, Dr. Hart."

"I find neurosurgery fascinating," she answered carefully.

"Dr. Shepherd must be an excellent teacher," Webber commented, his eyes flicking between them.

Derek cleared his throat. "Dr. Hart shows natural aptitude. She's performed well on all surgical rotations."

"I see." Webber's pager beeped, and he checked it. "I need to take this. But I'll catch up with you for your craniotomy at eleven."

After Webber left, Derek and Clem stood in silence for a moment.

"Is it just me," Clem said quietly, "or is the Chief being weird today?"

"It's not just you," Derek replied, his voice low. "But let's just focus on the medicine. We have nothing to hide professionally."

Clem raised an eyebrow. "You believe that?"

"I have to," he said. "Come on, we have pre-op prep for Mr. Lewin's craniotomy."

Pre-Op Assessment

Derek and Clem stood at Mr. Lewin's bedside, reviewing his case—a meningioma pressing on his motor cortex. The sixty-year-old former high school baseball coach listened intently as Derek explained the procedure.

"We'll remove as much of the tumor as possible while preserving motor function," Derek explained. "Dr. Hart, what are the primary risks we're concerned about?"

"Seizures, motor deficits affecting the right side of the body, speech difficulties if the tumor extends toward Broca's area," Clem answered without hesitation.

"Very good," Derek nodded. "Mr. Lewin, do you have any questions before we prep you for surgery?"

The man smiled nervously. "Just one. Will I still be able to throw a baseball with my grandson after this?"

Derek placed a reassuring hand on the man's shoulder. "That's our goal, sir."

"You two work well together," Mr. Lewin observed. "Been a team long?"

Clem felt her cheeks warm slightly. "I rotate through different specialties, Mr. Lewin. Today I'm learning from Dr. Shepherd."

"Best hands in the business," came Chief Webber's voice from the doorway. "Mind if I join?"

"Chief," Derek acknowledged. "We were just finishing Mr. Lewin's pre-op assessment."

"And I was just telling them they make a good team," Mr. Lewin added.

Webber's expression remained neutral. "Seattle Grace prides itself on excellent teamwork. Speaking of which, Dr. Hart, may I borrow you for a moment?"

Clem followed Webber into the hallway, her heart racing despite her outward calm.

"Dr. Hart, I noticed you seem quite comfortable in neurosurgery."

"I try to be prepared for any service, sir."

"Hmm." Webber studied her face. "Bailey mentioned you haven't been on Dr. Shepherd's service for some time."

Clem kept her expression professional. "Dr. Bailey rotates us through different specialties to ensure well-rounded training."

"Indeed." Webber nodded. "Dr. Shepherd speaks highly of your technical skills."

"Thank you, sir."

"Just remember, Dr. Hart—a surgeon's judgment is their most valuable asset. Both in and out of the OR." He glanced back toward Mr. Lewin's room where Derek was completing notes. "Are we clear?"

"Crystal clear, sir."

The OR

Clem stood across from Derek at the operating table, the bright lights illuminating Mr. Lewin's exposed cranium. The rhythmic beeping of monitors provided a steady backdrop as Derek worked methodically to access the tumor.

"Suction, please," Derek requested, and Clem responded immediately, clearing the field.

From her position, Clem could see the gallery above them. Chief Webber sat front and center, watching their every move with unwavering attention. Beside him sat Dr. Burke, which was unusual—Burke rarely observed neurosurgery procedures.

"Dr. Hart, what would happen if we damaged the precentral gyrus during resection?" Derek asked, continuing his teaching despite their audience.

"Contralateral hemiparesis," Clem answered promptly. "The patient would lose motor function on the opposite side."

"And how do we avoid that?"

"Cortical mapping and constant monitoring of motor evoked potentials."

Derek nodded behind his mask. "Exactly. Now, I'm going to remove this section of the tumor. Note how I'm staying within the margins we identified."

As Derek worked, Clem assisted with precision, anticipating his needs before he voiced them.

"Bleeding in the surgical field," Derek announced calmly. "Bipolar, please."

Clem handed him the instrument swiftly. "Small vessel at the tumor margin," she observed.

"Good eye. Let's cauterize and continue."

Two hours into the procedure, Derek began closing while Clem assisted. Up in the gallery, Webber remained watching, even as other observers had cycled through.

"Beautiful work, Dr. Shepherd," Clem said quietly as they completed the final sutures.

"Excellent assistance, Dr. Hart," he replied. "Your hands were rock steady throughout."

As they scrubbed out side by side, Derek spoke without looking at her. "The Chief didn't take his eyes off us once."

"I noticed," Clem replied softly. "Think he knows?"

"If he didn't before, he's definitely suspicious now."

"Because I did something wrong?"

Derek shook his head. "Because you did everything right. You know my techniques too well for someone who's supposedly been kept off my service."

Before Clem could respond, the door opened and Chief Webber entered the scrub room.

"Impressive procedure, Dr. Shepherd," he said. "Clean margins, minimal blood loss."

"Thank you, Chief."

Webber turned to Clem. "And Dr. Hart, excellent assistance. Your anticipation of the next steps showed remarkable familiarity with complex neurosurgical procedures."

Clem kept her voice steady. "Thank you, sir. Dr. Shepherd is very clear about what he needs."

Something flickered across Webber's face—amusement? Concern? It vanished too quickly to interpret.

"Carry on," he said before exiting. "I'll see you both at the post-op assessment."

Intern Lunch

The hospital cafeteria buzzed with activity as Clem dropped her tray onto the table where the other interns were already gathered.

"She lives!" Cristina announced. "We thought McDreamy might have locked you in an on-call room by now."

"Very funny," Clem muttered, sinking into a chair. "I just spent four hours in surgery with the Chief watching my every move."

"Ouch," Meredith winced sympathetically. "That's brutal even by Webber standards."

Alex pushed his pudding cup toward Clem. "Here. You look like you need this more than I do."

Clem eyed him suspiciously. "Are you being... nice?"

"Don't get used to it, Brooklyn," he replied with a smirk. "Just figured brain surgery with your boyfriend while the Chief watches deserves some chocolate consolation."

"He's not my—" Clem stopped herself. "Whatever."

Izzie leaned in. "So, what's the verdict? Does Webber know?"

"If he didn't before, he's definitely suspicious now," Clem said, echoing Derek's words from the scrub room. "He's been following us around all day."

"That's weird," George commented through a mouthful of sandwich. "Webber never follows interns around."

"He does when he thinks they're sleeping with an attending," Cristina pointed out.

Clem groaned. "Not so loud."

"It's weird on the general side too," Meredith added. "Webber kept finding reasons to ask about you—how you're adjusting to the program, whether you seem focused on work."

"Great," Clem sighed. "So he's investigating me."

"Maybe he's just making sure you're learning actual medicine and not just anatomy with Shepherd," Alex suggested with a grin.

Clem threw a french fry at him. "You're disgusting."

"What are you going to do?" George asked, looking genuinely concerned.

Clem pushed her food around her plate. "What can I do? I'm going to finish my shift, be the best damn doctor I can be, and hope Webber realizes I'm here for the medicine, not just..." she trailed off.

"McDreamy's hair?" Cristina supplied helpfully.

Despite herself, Clem laughed. "It is great hair."

"Speaking of great hair," Izzie murmured, nodding toward the cafeteria entrance where Derek had just walked in. His eyes scanned the room, briefly resting on their table before he headed to the attendings' section.

"Post-op notes are waiting for you, Dr. Hart," he called across the room, professional but with the hint of a smile. "When you're finished with lunch."

"Yes, Dr. Shepherd," Clem replied, equally professional.

As Derek walked away, Alex leaned in. "Five bucks says Webber is waiting at the nurses' station to 'accidentally' run into you two again."

"Ten says he's hiding in the post-op patient's room," Cristina countered.

"You're both wrong," Clem said, standing up and gathering her tray. "He's probably hiding in the supply closet on the way to neurosurgery."

"Fifty bucks says I'm escorting you all back to work," came Bailey's voice from behind them, causing everyone to jump. "Strep throat must have cleared up faster than expected."

"Dr. Bailey!" George nearly choked on his water. "You're back!"

Bailey raised an eyebrow. "Disappointed, O'Malley?"

"No! I mean—we're glad you're feeling better," he stammered.

Bailey's gaze settled on Clem. "Hart. I hear the Chief put you with Shepherd today."

Clem nodded cautiously. "Yes, Dr. Bailey."

"Interesting," Bailey said, in a tone that suggested it was anything but. "Well, finish your lunch and get back to work. All of you." She turned to leave, then paused. "And Hart? Professional distance. Remember that term?"

"Yes, Dr. Bailey."

As Bailey walked away, the group exhaled collectively.

"Bailey knows," Izzie whispered.

"Of course she knows. Remember the party?" Meredith corrected. "She just doesn't want the Chief to know."

Clem stood up. "I should go. Post-op notes wait for no intern."

"Good luck with Spy vs. Spy," Cristina called after her.

As Clem headed back toward the neurosurgery wing, she couldn't shake the feeling that the day was about to get even more complicated. Between Webber's surveillance, Derek's proximity, and now Bailey's return, staying professional had never been more challenging—or more necessary.

Chapter Text

The End of the Shift

The rest of Clem's shift passed in a blur of patient assessments, charting, and carefully maintaining professional distance from Derek. By the time seven o'clock rolled around, she was mentally and physically exhausted but satisfied with her work. Mr. Lewin was recovering well, showing improving neurological function with each assessment. Sherry Meyers' headaches had responded to treatment, likely confirming they were indeed migraine-related.

Clem finished her final notes at the nurses' station, suppressing a yawn.

"Long day?" Alex asked, appearing beside her with his own stack of charts.

"The longest," Clem admitted. "How was the pit?"

"Three broken bones, two lacerations requiring sutures, and one kid with a Lego up his nose." Alex smirked. "Standard Tuesday."

Clem laughed despite herself. "Sounds riveting."

"Better than being under Webber's microscope all day," Alex countered, leaning against the counter. "So, did he catch you and Shepherd playing doctor in an on-call room?"

"Contrary to popular belief, Karev, some of us actually came here to practice medicine," Clem replied dryly. "And no, Derek and I maintained complete professionalism."

"Derek, huh?" Alex raised an eyebrow.

Clem realized her slip. "Shut up."

Alex grinned. "Whatever, Brooklyn. Your secret's safe with me."

"Since when are you the keeper of my secrets?"

"Since we became roommates," Alex replied, his expression shifting slightly. "Like it or not, we're in each other's business."

There was something in his tone that made Clem look at him more closely. "Does that bother you? Me and Derek?"

Alex scoffed, focusing on his chart. "Why would it bother me? I've got better things to worry about than who you sleep with."

Before Clem could respond, Derek approached, his shift also ending. "Dr. Hart, done for the day?"

"Just finishing up," she replied professionally.

Alex gave her a pointed look before muttering, "Later, Brooklyn," and walking away.

Derek watched him go, then turned back to Clem. "Everything okay?"

"Fine," she said, closing her last chart. "Just Alex being Alex."

They walked toward the locker room together, maintaining appropriate distance in the hallway.

"I was thinking," Derek said quietly, "maybe we could get dinner tonight? That new Italian place on Fifth?"

Clem hesitated. "After today's Webber surveillance, are you sure that's smart?"

"We're allowed to eat, Clementine," Derek replied with a smile. "Besides, Seattle has about three hundred restaurants. What are the chances we'll run into anyone from the hospital?"

Clem considered this. After the stress of the day, the thought of good food and Derek's company was tempting. "Okay, but if we see anyone from the hospital, I'm ducking under the table and you're eating alone."

After changing into her street clothes, Clem met Derek by the hospital's main entrance. They walked out together, discussing their plans for the evening in professional tones that wouldn't raise eyebrows if overheard.

As they approached the parking lot, a voice called out behind them.

"Dr. Hart, Dr. Shepherd. A moment, please."

They turned to find Chief Webber standing in the doorway, his expression unreadable.

"Dr. Hart, could I see you in my office before you leave?" Webber asked, his tone making it clear this wasn't really a request.

Clem exchanged a quick glance with Derek. "Of course, Chief."

"You too, Dr. Shepherd," Webber added, turning to head back inside.

Derek and Clem followed, a silent current of tension between them. As they walked through the quiet hallways toward the administrative wing, Clem's mind raced through possible scenarios. Had someone reported them? Had Webber been watching them all day specifically to confirm his suspicions?

Webber led them into his office, gesturing for them to sit in the chairs across from his desk. He settled into his own chair, regarding them thoughtfully.

"I wanted to speak with both of you about today," he began.

Clem sat perfectly still, waiting for the axe to fall.

"Mr. Lewin's surgery was exemplary," Webber continued. "Dr. Shepherd, your technique continues to impress. And Dr. Hart, your assistance showed remarkable skill for an intern."

"Thank you, sir," they both murmured.

"In fact," Webber leaned forward, "I've been hearing good things about you from several attendings, Dr. Hart. Dr. Burke mentioned your quick thinking during a cardiac tamponade last week. Dr. Bailey was impressed with your handling of that multiple trauma case in the ER."

Clem blinked in surprise. "I'm... I'm just trying to learn as much as I can, sir."

"The nurses speak highly of you as well," Webber continued. "Particularly Tyler and Olivia. They say you treat them with unusual respect for an intern."

Derek glanced at Clem with a hint of pride in his eyes.

"My mother is a nurse," Clem explained. "I know how vital they are to patient care."

Webber nodded. "It shows. Which is why I was curious about Bailey keeping you off neurosurgery recently."

Clem froze. Here it was.

"I observed you today to see if there was something I was missing," Webber continued. "Some deficiency in your neurosurgical skills that would explain Bailey's rotation choices."

Derek cleared his throat. "Dr. Hart shows remarkable aptitude for neurosurgery, Chief. Her spatial reasoning and technical precision are exceptional."

"I noticed," Webber replied dryly. "Which makes me wonder why a promising neurosurgical intern isn't getting more exposure to the specialty."

Clem found her voice. "Dr. Bailey believes in well-rounded training, sir. I've learned valuable skills in all departments."

"Indeed." Webber leaned back in his chair. "Well, I've spoken with Bailey, and we've agreed that your training schedule should be adjusted to include more regular neurosurgery rotations."

Clem wasn't sure whether to be relieved or concerned. "Thank you, sir."

"Don't thank me yet," Webber replied with a small smile. "Neurosurgery demands exceptional focus and judgment. Both in the OR and out."

There was something in his tone that made Clem wonder if he knew more than he was letting on.

"I understand, sir," she said carefully.

"Good," Webber nodded. "Because this hospital runs on more than just surgical skill, Dr. Hart. It runs on trust, professionalism, and clear boundaries." His eyes flicked briefly between her and Derek. "Am I making myself clear?"

"Crystal clear, sir," Clem replied, her heart racing.

"Perfectly clear," Derek echoed.

Webber studied them for another moment, then nodded. "Excellent. That will be all, then. Have a good evening, doctors."

As they left the office, Clem exhaled slowly. Neither spoke until they were safely in the stairwell, away from prying eyes and ears.

"Do you think he knows?" Clem whispered.

Derek ran a hand through his hair. "I think he suspects. But I also think he just gave us a warning without actually making an accusation."

"Which means?"

"Which means we're walking a very fine line," Derek replied, his expression serious. "One that's just gotten thinner."

Clem nodded, processing this. "Maybe we should skip dinner tonight."

Derek looked disappointed but nodded. "Probably wise. I'll take a rain check?"

"Definitely," Clem agreed, trying to ignore the small pang of regret. "I should probably get home anyway. Early rounds tomorrow."

They parted ways in the parking lot, maintaining their professional facades until safely in their respective cars. As Clem drove home, she couldn't help but wonder if Webber's apparent blessing for her neurosurgical training was also a test—one that would scrutinize not just her surgical skills, but her professional judgment as well.

Either way, she was determined not to let him—or Bailey, or anyone else—doubt her commitment to becoming an exceptional surgeon. Whatever it took.

A Few Days Later

The house was unusually quiet for a Thursday evening. Meredith was on call, Izzie had dragged George to some cooking class, and Alex was covering an overnight shift in the ER. For the first time in weeks, Clem had the place entirely to herself.

She'd taken advantage of the solitude with a long shower, followed by the luxury of wandering between rooms in just an oversized t-shirt and underwear. The simple pleasure of not having to fully dress just to get a glass of water was something she'd missed since moving into the increasingly crowded house.

Clem was curled up on her bed with a medical journal when her phone buzzed with a text from Derek.

Finished early. Heard you have an empty house. Room for a visitor?

Clem smiled, typing back: Depends on the visitor. Medical journals and ice cream already keeping me company.

His reply came quickly: I can be more entertaining than medical journals. Can't compete with ice cream though.

You have 30 minutes before I fall asleep reading about cerebrovascular innovations.

15 minutes. I'm already on my way.

Clem laughed, setting her phone aside. She glanced around her room, quickly tidying the scattered clothes and books. She considered changing into something more alluring than her faded Columbia Med School shirt but decided against it. Derek had seen her covered in blood after a 36-hour shift; a little authenticity wouldn't kill him.

True to his word, Derek arrived fifteen minutes later. Clem opened the door to find him holding a bottle of wine and wearing jeans and a casual sweater.

"You actually made it," she said, stepping aside to let him in.

"I said I would," he replied with that smile that still made her stomach flip. "No emergencies, no traumas, just me escaping before Webber could find something else for me to do."

Clem led him into the kitchen, grabbing two wine glasses.

Derek set the wine down and moved closer, his hands settling on her hips. "I like this look on you," he said, eyes traveling appreciatively over her bare legs.

"Don't get used to it," Clem replied, though she leaned into his touch. "It's strictly a roommate-free house special."

Derek watched her as she poured the wine, his eyes following her movements. "How long do we have?" he asked, his voice lower than before.

"Meredith's on call, Izzie and George won't be back for hours, and Alex is stuck in the ER all night." Clem took a sip of wine, meeting his gaze over the rim of her glass. "So, barring any disasters, we have the place to ourselves until morning."

Derek stepped closer, the kitchen suddenly feeling much smaller. "That's a lot of time to fill."

"I'm sure we'll manage," Clem replied with a quirk of her eyebrow, brushing past him toward the stairs. "But first, I want to hear about your day. Did you finish the Kennedy consult?"

As they settled on her bed, wine glasses in hand, Derek recounted his day—a complex consult, two routine procedures, and a promising new research opportunity. Clem listened, occasionally asking questions or offering observations about similar cases she'd seen.

"You know," Derek said, setting his glass aside, "most people's eyes glaze over when I talk about cerebral aneurysm clipping techniques."

"I'm not most people," Clem replied with a shrug. "Besides, I find it fascinating."

"That's one of the things I love about you," Derek said, his voice softening. "Your genuine passion for medicine."

The word "love" hung in the air between them. Neither acknowledged it directly, but Clem felt something shift in the atmosphere.

She set her own glass down on the nightstand with deliberate slowness. "Is that all you love about me?"

Derek's smile was slow and deliberate. "Not even close."

He leaned in to kiss her, but Clem placed a hand on his chest, stopping him. The thin cotton of his sweater did little to mask the warmth of his skin or the quickening of his heartbeat beneath her palm.

"My turn," she said, her voice taking on a commanding edge that made Derek's eyebrows rise in surprise.

Clem moved forward, pushing Derek back against the pillows. She straddled him, pinning his wrists above his head with one hand while the other traced the line of his jaw. The position gave her a sudden rush of power that she hadn't realized she'd been craving.

"I've spent all week being professional, controlled, and cautious," she said, her voice dropping to just above a whisper. "Tonight, I don't want to be Dr. Hart."

Derek's breathing quickened, his pupils dilating as he looked up at her. "What do you want to be?"

"In charge," Clem replied, leaning down to kiss him—hard, insistent, demanding.

Derek responded immediately, surging against her hold. But Clem tightened her grip on his wrists, pulling back slightly.

"No," she whispered against his lips. "My rules tonight."

A smile spread across Derek's face—part surprise, part unmistakable desire. "Yes, ma'am."

Clem released his wrists but gave him a warning look. "Keep those there."

She tugged at the hem of his sweater, pulling it up and over his head. Her hands explored his chest, fingers tracing each defined muscle with surgical precision, following the trail of dark hair down his abdomen.

"Do you have any idea," she murmured, "how distracting you are in the OR?" Her nails scraped lightly down his torso, making him shiver beneath her. "All focus and control. It drives me crazy."

Derek's hands twitched against the pillow. "Clem," he breathed, clearly struggling to keep them where she'd placed them.

"Patience," she admonished, shifting her hips against his in a deliberate motion that made him groan. "Good things come to those who wait."

She kissed her way down his neck, alternating between gentle touches and light bites that made his breath catch. When she reached the sensitive spot just below his ear, Derek's control slipped and his hands moved to her waist, fingers digging into her skin.

Clem immediately sat up, giving him a stern look. "What did I say?"

"Sorry," Derek replied with a grin that suggested he wasn't sorry at all. "You're making it very difficult to follow instructions."

"That sounds like a personal problem, Dr. Shepherd," Clem replied with mock seriousness. She took both his hands and firmly placed them back above his head. "Try again."

This time, Derek obediently kept his hands in place, though the tension in his arms revealed how much restraint it required.

Clem rewarded his compliance by pulling her t-shirt over her head, revealing she wore nothing underneath. Derek's eyes darkened as he took in the sight of her, his gaze moving slowly over her body with an intensity that made her skin flush.

"This isn't fair," he complained, his voice husky.

"Life isn't fair," Clem retorted, leaning down to kiss him again, her bare chest pressing against his. "Now, are you going to behave, or do I need to get creative with restraints?"

Derek's eyes widened slightly at the suggestion, his breath catching. "As much as that sounds intriguing, I think I can behave."

"We'll see," Clem replied with a wicked smile.

She continued her exploration of his body, taking her time with each touch, each kiss. Her hair fell forward, creating a curtain around them as she trailed kisses down his chest. Derek remained still, as instructed, though his breathing grew increasingly ragged as she worked her way down his stomach.

When she reached for his belt, Derek finally broke. "Enough," he growled, his hands shooting from the pillow to grab her waist. In one fluid motion, he flipped them over, pinning Clem beneath him, his weight pressing her into the mattress.

"My turn," he said, his voice rough with desire.

Clem's laugh of surprise quickly transformed into a gasp as Derek's mouth found her neck, his hands sliding down her sides to grip her hips possessively.

"I thought you were going to behave," she managed between breaths.

"I did," Derek replied, his lips trailing down her collarbone. "For as long as I could."

His hands and mouth moved with the same precision he displayed in surgery, but with an entirely different purpose. Clem arched against him, her earlier dominance giving way to sweet surrender as he discovered all the places that made her breath hitch and her body respond.

"Derek," she whispered, her fingers tangling in his hair.

He looked up at her, his eyes dark with desire. "Yes?"

"More," she commanded, pulling him back up to kiss him deeply.

They moved together with increasing urgency, all playfulness transforming into raw need. The outside world disappeared—no hospital politics, no Chief Webber's watchful eye, no roommates who might return early. There was only them, tangled together in the growing darkness of her bedroom.

Derek's hands were everywhere, exploring, claiming. When his fingers found particularly sensitive spots, Clem bit her lip to keep from crying out, her back arching off the bed. He watched her reactions with a surgeon's focus, learning her body with thorough dedication.

Their remaining clothing was discarded in hurried movements, the need for skin against skin becoming overwhelming. As Derek positioned himself above her, he paused for a moment, his eyes locking with hers in silent question.

Clem answered by wrapping her legs around his waist, pulling him closer. "Don't you dare stop now," she breathed.

What followed was a passionate dance of pushing and yielding, giving and taking. Derek maintained the perfect balance between gentle and fierce, reading her body's signals with intuitive precision. Clem matched his rhythm, her hands gripping his shoulders, her lips capturing his in hungry kisses.

The tension built between them, climbing higher with each synchronized movement. When they finally reached the peak together, it was with a shared intensity that left them both trembling and breathless. Derek buried his face in her neck, murmuring her name like a prayer as they rode the waves of pleasure.

Later, as they lay together catching their breath, Derek traced lazy patterns on Clem's bare shoulder.

"That was..." he began.

"I know," Clem replied with a satisfied smile.

"Where did that come from?" Derek asked, genuine curiosity in his voice.

Clem propped herself up on one elbow, regarding him thoughtfully. Her hair fell in tousled waves around her shoulders, and there was a rosy flush still visible on her chest. "I spend so much time being careful—at the hospital, with Bailey watching, with Webber suspecting. Always measuring my words, controlling my actions." She shrugged. "Sometimes I just need to... not be careful."

Derek nodded slowly. "I like that side of you."

"I noticed," Clem replied dryly.

Derek laughed, pulling her close again. "You're full of surprises, Clementine Hart."

"Good," she said, settling against his chest. "I'd hate to be predictable."

They lay in comfortable silence for a while, listening to the sounds of the empty house. Clem felt herself drifting toward sleep when Derek spoke again.

"Stay at the trailer this weekend," he suggested. "We could have this—" he gestured between them "—without worrying about roommates or pagers or hospital gossip."

Clem considered this. The idea was tempting—a weekend away from the constant navigation of hospital politics and roommate dynamics.

"What about Bailey's weekend rounds?" she asked.

"I happen to know she switched with someone," Derek replied, his fingers combing through her hair. "You're off until Monday."

Clem smiled against his chest. "You planned this, didn't you?"

"I may have checked the schedule," Derek admitted, pressing a kiss to her forehead. "Is that a yes?"

Clem didn't answer immediately, weighing the professional risks against her personal desires. After everything with Callahan in New York, she'd promised herself she would never again let a relationship affect her career. But this felt different—Derek treated her as an equal, respected her ambitions.

"Yes," she finally said. "But I'm bringing actual food. I've seen what you keep in that trailer's fridge."

Derek laughed, the sound vibrating through his chest beneath her ear. "Deal."

As they drifted off to sleep, Clem pushed away the small voice in her head that warned about Bailey's disapproval or Webber's suspicions. For once, she decided to be just Clem, not Dr. Hart—at least for the weekend.

Chapter Text

Friday Night

The gravel crunched under the tires of Clem's car as she pulled up beside Derek's Land Rover. The trailer gleamed silver in the late afternoon light, nestled in the clearing surrounded by towering pines. She cut the engine and took a moment to appreciate the stillness, so different from the constant hum of the hospital or the bustling energy of Meredith's house.

Derek emerged from the trailer, wearing faded jeans and a simple blue sweater that made his eyes look impossibly bluer. His face broke into a wide smile when he saw her.

"You made it," he said, approaching as she climbed out of her car.

"I said I would." Clem reached into her backseat for her overnight bag and a large grocery sack. "I also said I was bringing actual food."

Derek took the grocery bag from her. "I have food," he protested mildly.

"Cereal and beer is not food, Derek." Clem slung her bag over her shoulder. "Besides, I thought we could cook together."

"Together?" Derek raised an eyebrow. "Is that safe? I've heard stories about your kitchen adventures from Izzie."

Clem pointed an accusatory finger at him. "That fire was not my fault. Who puts dish towels that close to a stove?"

Derek laughed, the sound warm in the cool evening air. He leaned in and kissed her, a soft greeting that quickly deepened. When they finally pulled apart, Clem was slightly breathless.

"Hi," she said softly.

"Hi back," Derek replied, his eyes crinkling at the corners.

Inside the trailer, Clem was struck as always by how the small space somehow managed to feel spacious and comfortable rather than cramped. Large windows framed views of the forest, and the clean, simple design reflected Derek's organized mind.

"So," Derek said, setting the grocery bag on the counter, "what are we making?"

Clem unpacked the ingredients: fresh pasta, tomatoes, basil, garlic, a bottle of good red wine. "My mom's pasta pomodoro. Simple but perfect."

"Your mom's?" Derek asked, opening the wine. "Is she a good cook?"

"The best." Clem smiled, washing her hands at the small sink. "She worked crazy shifts, but she tried to make sure I ate real food."

Derek handed her a glass of wine. "She sounds impressive."

"She is." Clem took a sip, letting the rich flavor wash over her tongue. "What about your family? You don't talk about them much."

A shadow crossed Derek's face briefly. "Big family. Four sisters. They're all back East."

"Four sisters?" Clem's eyes widened. "That explains so much about how you handle the nurses at the hospital."

Derek laughed, the momentary darkness lifting. "I learned early on that women run the world."

They worked side by side in the small kitchen, bodies brushing against each other in the confined space. Derek chopped garlic while Clem sliced tomatoes, their movements falling into an easy rhythm. She found herself humming unconsciously—something her father used to do while cooking.

"What's that song?" Derek asked, looking up from his chopping board.

Clem paused, realizing she'd been humming Steely Dan's "Reelin' in the Years." "Just something my dad used to play. He had this weird mix of jazz and classic rock he'd listen to when cooking. My mom said it drove her crazy, but after he died, she'd play his records while making dinner."

Derek watched her with soft eyes. "You don't talk about him much."

"Not much to say." Clem shrugged, focusing on the tomatoes. "He was a military doctor. Died when I was eight. Peacekeeping mission gone wrong."

Derek's hand covered hers, stilling her knife. "I'm sorry."

"It was a long time ago." Clem took a deep breath. "Anyway, that's why I binge-watch medical documentaries and can't cook without music."

Derek smiled gently. "Well, I have a solution for one of those." He moved to a small speaker on the counter and connected his phone. A moment later, the trailer filled with the opening notes of "Brown Sugar."

Clem laughed. "Stones? Not exactly what I expected from you."

"What did you expect? Classical? Opera?" Derek's eyes twinkled. "I'm full of surprises, Dr. Hart."

They cooked and ate to a soundtrack of classic rock, swapping stories about their medical school days and outrageous ER cases. The pasta was perfect—simple but bursting with flavor. They finished the bottle of wine on the small deck outside the trailer, wrapped in blankets against the cool evening air, watching stars emerge in the clear night sky.

"You can't see stars like this in the city," Clem observed, leaning back against Derek's chest, his arms wrapped around her.

"That's why I bought this land," Derek murmured against her hair. "After New York, I needed... space. Air. Quiet."

There was something in his voice—a thread of old pain—that made Clem turn to look at him. "What happened in New York, Derek?"

His arms tightened around her slightly. "Life happened. Sometimes you need a fresh start."

"I know that feeling," Clem said, thinking of Callahan and the scandal that had followed her through her final year of medical school.

"Let's not talk about New York," Derek said, pressing a kiss to her temple. "Not tonight."

Later, in the narrow bed that somehow felt spacious enough for both of them, Clem traced the contours of Derek's face with her fingertips. The moonlight filtering through the window cast silver shadows across his features.

"What are you doing?" Derek asked, his voice soft in the darkness.

"Memorizing you," Clem replied simply. "This version of you that nobody at the hospital gets to see."

Derek caught her hand, pressing a kiss to her palm. "Is that so different from the surgeon you work with?"

"Very." Clem smiled. "Dr. Shepherd is brilliant but intimidating. Sometimes arrogant."

"And this version?"

Clem pretended to consider. "Still brilliant. Less arrogant. Definitely better taste in music than I expected."

Derek laughed, pulling her closer. "I'll take that as a compliment."

"You should," Clem murmured, settling against him. "Not many people get my seal of approval on their music choices."

They fell asleep to the sound of the wind in the trees and the steady rhythm of each other's heartbeats, work and hospital politics momentarily forgotten.

Saturday

Clem woke to the scent of coffee and the sound of rain pattering on the trailer's roof. She stretched languorously in the warm bed, savoring the rare feeling of waking naturally instead of to an alarm or pager.

Derek appeared in the doorway, holding two steaming mugs. "Morning."

"You're dressed," Clem observed, sitting up and accepting the coffee. "Please tell me you haven't been up for hours."

"Only one," Derek admitted with a smile. "Old habits."

Clem took a sip of the coffee—strong and black, exactly how she liked it. "At least you remember how I take my coffee. That earns you some forgiveness for being disgustingly functional in the morning."

"I'll take it." Derek sat on the edge of the bed. "I thought we could go for a hike today, but..." He gestured toward the window, where rain was steadily falling.

"Rain check?" Clem suggested with a smirk.

Derek groaned at the pun. "That was terrible."

"You loved it." Clem stretched again, the sheet slipping down to reveal her bare shoulders. She noticed Derek's gaze following the movement, his eyes darkening slightly.

"I did have other ideas for today," he said, taking her coffee mug and setting it on the nightstand.

"Is that so, Dr. Shepherd?" Clem asked, her voice deliberately innocent. "And what might those be?"

Instead of answering, Derek leaned forward, capturing her lips in a kiss that quickly banished any remnants of sleep. His hands slid beneath the sheets, finding warm skin and eliciting a soft gasp from Clem.

"I think I approve of your rainy day plans," she murmured against his mouth.

Later, they braved the rain to visit a small farmer's market in a nearby town. Huddled under an umbrella, they wandered between stalls selling local produce, artisan bread, and handcrafted goods. Clem found herself thinking how ordinary it felt—how normal to be shopping for food with Derek, discussing dinner plans, choosing wine—all without the constant awareness of hospital hierarchies and watchful eyes.

"You're miles away," Derek observed as they walked back to the car, bags of fresh produce in hand.

"Just thinking how nice this is," Clem admitted. "Being regular people for a change."

Derek nodded, understanding in his eyes. "No Dr. Hart, no Dr. Shepherd."

"Exactly." Clem bumped her shoulder against his. "No Bailey watching our every move, no Webber giving us cryptic warnings."

"No Alex making inappropriate comments," Derek added with a grin.

"God, don't remind me." Clem rolled her eyes. "He's gotten worse since moving into the house."

Derek's expression shifted slightly. "Does it bother you? Him being there?"

"Alex?" Clem looked at him curiously. "No. I mean, he's annoying as hell sometimes, but he's also..." she searched for the right word, "predictable. In a weirdly comforting way."

Derek didn't respond immediately. They reached the car and loaded their purchases in silence.

"Derek?" Clem prompted once they were inside, the rain drumming on the roof.

"I just wondered if there was something there," he said finally, starting the engine. "Between you and Karev."

Clem stared at him, momentarily speechless. "Me and—Alex? Seriously?"

"You have a certain... dynamic," Derek replied, not looking at her as he pulled onto the road.

"Yeah, it's called mutual irritation," Clem said, trying to process this unexpected turn in the conversation. "He calls me 'Brooklyn' specifically because he knows I hate it. I call him out on his crap because someone needs to."

Derek's hands tightened slightly on the steering wheel. "So there's nothing there?"

"No," Clem said firmly. "Absolutely not. Where is this coming from?"

Derek shook his head slightly. "Just something I've noticed. The way he looks at you sometimes."

"Alex looks at anything female," Clem pointed out. "It's his default setting."

A small smile tugged at Derek's lips. "Fair point."

"Besides," Clem added, "I'm not interested in Alex. I'm here with you, aren't I?"

The tension in Derek's shoulders eased visibly. "You are."

They drove in silence for a moment, the wipers beating a steady rhythm against the windshield.

"Are you jealous, Derek Shepherd?" Clem asked finally, a hint of amusement in her voice.

"Of Karev?" Derek scoffed, but there was a touch of color in his cheeks. "Absolutely not."

"Uh-huh." Clem couldn't help but smile. "For the record, if I were interested in someone at the hospital besides you, it definitely wouldn't be Alex."

Derek glanced at her. "Good to know."

Later that afternoon, as they prepared dinner in the trailer's small kitchen—freshly caught fish from the market, local vegetables, crusty bread—Derek's phone rang. He glanced at the screen, his expression changing in a way Clem couldn't quite interpret.

"Aren't you going to answer that?" she asked, noticing his hesitation.

"It's not important," Derek said, silencing the phone and turning his attention back to the fish he was seasoning.

"Could be the hospital," Clem pointed out.

"If it were the hospital, my pager would go off," Derek replied, his tone a little too casual. "This is just... an old friend. They can wait."

Something in his manner made Clem pause, knife hovering over the vegetables she was slicing. "An old friend you're avoiding?"

Derek looked up, meeting her eyes directly. "This weekend is about us. No hospital, no complications. Just us."

The sincerity in his voice dispelled her momentary concern. "Just us," she agreed with a smile.

They ate dinner by candlelight, the rain creating a soothing backdrop. Derek opened a bottle of excellent Cabernet that complemented the fish perfectly. Their conversation flowed easily, touching on favorite books, travel destinations, medical advances they found fascinating.

"You know," Clem said, refilling their glasses, "for someone who was a bit of a legend at Columbia, you're surprisingly normal."

Derek raised an eyebrow. "I was a legend?"

"Oh, please." Clem laughed. "Like you didn't know. Derek Shepherd, the neurosurgical prodigy who published groundbreaking research on cerebral aneurysms while still a resident."

"And yet you didn't recognize me when we first met," Derek teased.

"I knew exactly who you were," Clem admitted. "I just wasn't about to feed your ego by letting you know that."

Derek laughed, the sound warm and genuine. "Smart move."

After dinner, they settled on the small sofa with the remaining wine. Derek put on a record—actual vinyl on a portable player—that filled the trailer with the rich, lush sound of Miles Davis's "Kind of Blue."

"Impressive," Clem nodded appreciatively. "Maybe there's hope for you yet."

Derek smiled, a hint of nostalgia crossing his features. "My dad loved jazz. He had an amazing collection of records. This was one of his favorites."

"Your dad was into jazz?" Clem asked, genuinely curious. Derek rarely mentioned his family.

Derek nodded, his eyes growing distant. "He owned a small general store in New York. Nothing fancy, but he loved that place. Every evening after closing up, he'd put on a record and just listen." His voice softened. "No matter how tired he was from the day, he'd sit in his chair with a scotch, eyes closed, completely lost in the music."

"That sounds like my father," Clem said softly. "He had eclectic taste—jazz, classic rock, everything. When did your father pass away?"

Derek took a sip of wine before answering. "I was ten. Two men came into his store to rob it. They shot him for forty-three dollars." His voice remained steady, but Clem could see the old pain beneath the surface.

"Derek, I'm so sorry," she said, reaching for his hand.

"It happened a long time ago," he replied, squeezing her hand. "But it changes you, losing a parent that young."

"It does," Clem agreed. "My father died when I was eight. Peacekeeping mission gone wrong."

"What do you remember about him?" Derek asked gently.

"He was larger than life—always laughing, always moving. My mom said he couldn't sit still for five minutes." She smiled at the memory. "Except when he was listening to music. That was the only time he'd be completely still."

Derek nodded in understanding. "It's the small details you hang onto, isn't it? For me, it's the smell of his aftershave. Old Spice. Can't smell it without thinking of him."

"For me, it's his humming," Clem admitted. "He hummed constantly while working. I catch myself doing it during surgeries sometimes."

They sat in comfortable silence for a moment, the music filling the space between them.

"Did it make you want to become a doctor?" Derek asked finally. "Losing him?"

"Partly," Clem acknowledged. "I wanted to save people others couldn't. What about you? Did losing your father influence your career choice?"

Derek considered this. "I think it made me understand how fragile life is, how quickly everything can change. There's something about neurosurgery that acknowledges that fragility while still offering hope."

Clem nodded, struck by the depth of his response. "That's beautifully put."

Derek's arm tightened around her shoulders. "You miss him."

"Every day," Clem admitted. "Especially since starting my residency. I keep thinking about if he would be proud."

"He would be," Derek agreed. "You're an exceptional doctor, Clementine."

Clem looked up at him, surprised by the serious tone in his voice. "Thank you."

Derek tucked a strand of hair behind her ear, his eyes soft in the dim light. "I mean it. I've worked with a lot of residents over the years. You have something special—a combination of technical skill and genuine compassion that can't be taught."

The sincerity in his voice made Clem's chest tighten. She leaned up and kissed him, trying to convey without words what his praise meant to her.

The kiss deepened, slow and unhurried. Derek's hands tangled in her hair as he pulled her closer. The rain continued to fall outside, creating a cocoon of intimacy around them.

"Bed?" Derek murmured against her lips.

"Bed," Clem agreed, allowing him to pull her to her feet.

They moved to the bedroom, shedding clothes along the way. The urgency of the previous night had given way to something more deliberate, more tender. Derek's hands and mouth traced every curve of her body with reverent attention, drawing sighs and whispers from Clem's lips.

When they finally came together, it was with a rhythmic intensity that matched the rain drumming on the trailer's roof. Afterward, they lay tangled in the sheets, breathing in sync, the warmth of their bodies a counterpoint to the cool night air.

"Stay," Derek murmured, his voice thick with approaching sleep.

"Where would I go?" Clem asked, equally drowsy.

"No," Derek clarified, pulling her closer. "I mean stay. Here. With me. More often."

Clem smiled against his chest. "Are you asking me to move in, Dr. Shepherd?"

"Not yet," Derek replied, his voice growing fainter. "But maybe... someday."

Clem didn't respond, listening as Derek's breathing evened out into sleep. The casual "someday" hung in the air, simultaneously thrilling and terrifying. She tucked it away to examine later, letting the sound of the rain lull her to sleep.

Sunday Morning

The first thing Clem registered was the feeling of being watched. She opened one eye to find Derek propped on his elbow beside her, looking at her with an expression of quiet contemplation.

"That's not creepy at all," she murmured, her voice husky with sleep.

Derek smiled, unrepentant. "You scrunch your nose when you dream."

"I do not." Clem rubbed her face, trying to orient herself. Sunlight streamed through the window, suggesting it was later than she usually slept. "What time is it?"

"Almost nine," Derek replied, reaching out to brush a strand of hair from her face. "You were sleeping so peacefully, I didn't want to wake you."

"So instead you decided to watch me like a weirdo?" Clem asked, but there was no heat in her words. The intimacy of the moment—the casual affection in Derek's touch, the warmth of the sun on their skin—felt precious.

"A surgeon's observational skills," Derek corrected with a grin. "Very professional."

"Mmm, definitely feels professional," Clem agreed, gesturing at their state of undress.

Derek laughed, leaning down to kiss her. "Good morning."

"Morning," she replied against his lips. "Coffee?"

"Already made," Derek said. "Want me to get you some?"

"In a minute." Clem stretched, feeling pleasantly sore in all the right places. "This is nice."

"What is?" Derek asked, his fingers tracing lazy patterns on her bare shoulder.

"This." Clem gestured vaguely. "Waking up together. No alarms, no emergencies."

"It could be like this more often," Derek suggested, a hint of seriousness behind his casual tone.

Clem turned to face him fully. "Derek, about what you said last night..."

"About staying here more often?" he prompted when she hesitated.

"Yes." Clem sat up, pulling the sheet with her. "Look, I really like you—"

"But?" Derek's expression was carefully neutral.

"But I'm an intern," Clem said. "I'm at the very beginning of my career. I've worked too hard to risk complicating things."

Derek sat up as well, his back against the headboard. "Is that what I am? A complication?"

"You know that's not what I meant," Clem replied. "But this—us—it already puts me in a difficult position professionally. Bailey watches me like a hawk, Webber's suspicious, the other interns think I'm getting special treatment..."

"Are you?" Derek asked quietly.

Clem looked at him sharply. "Am I what?"

"Getting special treatment," Derek clarified. "Because of us."

"No," Clem said firmly. "And that's because I've been working twice as hard to prove myself. I turn down surgeries with you when I can tell Bailey disapproves. I take on extra cases to show I'm not cutting corners."

Derek was silent for a moment, studying her face. "I didn't realize how much pressure this was putting on you."

"It's not your fault," Clem said quickly. "It's just... complicated. And I've been in complicated professional situations before. It didn't end well."

"What happened?" Derek asked, his voice softening.

Clem hesitated, then decided that if anyone would understand, it would be Derek. "In my final year at Columbia, I worked with a cardiothoracic surgeon named James Callahan on a research project. He was brilliant, respected, charismatic."

"And?" Derek prompted when she paused.

"And we became involved," Clem admitted. "It was stupid and unprofessional, but I was flattered by his attention. It started with late nights reviewing research, then dinner to discuss findings, then..."

"I get the picture," Derek said, no judgment in his voice.

"I thought it was real," Clem continued, staring at her hands. "Until I met his wife at a medical conference. Turns out, he had a pattern of seducing promising female students."

Derek's expression darkened. "That's abuse of power."

"It gets worse," Clem said, taking a deep breath. "When I confronted him, he admitted he'd been falsifying research data for our project. When I threatened to report him, he turned it around, claiming I was the one who'd fabricated results to impress him."

"Jesus, Clem," Derek murmured, reaching for her hand.

"I was suspended pending an ethics investigation," Clem continued. "Eventually, Callahan's wife came forward with evidence that he'd done this before. He was put on administrative leave, I was cleared, but the damage was done. Everyone knew. The whispers followed me for the rest of my time at Columbia."

"That's why you came to Seattle," Derek said, understanding dawning. "A fresh start."

Clem nodded. "And now I'm right back in a similar situation. Dating an attending, trying to prove myself."

"I'm not Callahan," Derek said firmly. "I would never use our relationship to manipulate you or your career."

"I know that," Clem assured him. "But the perception matters too. I need people to see me as Dr. Hart, not as Dr. Shepherd's girlfriend. Does that make sense?"

Derek nodded slowly. "It does." He squeezed her hand. "So what are you saying? That we should cool things off?"

"No," Clem said quickly. "God, no. I'm saying... I need to go slowly. Weekends like this are wonderful, but I need to maintain my independence. My own place, my own career path."

Relief washed over Derek's face. "That's reasonable."

"Is it?" Clem asked, suddenly uncertain. "I'm not good at relationships, Derek. I'm much better at cutting people open."

Derek laughed, the tension breaking. "Fortunately for both of us, I don't need surgery."

"Not yet," Clem replied with a small smile. "But fair warning: I'm complicated and stubborn and probably not worth the trouble."

Derek's expression softened as he reached out to cup her face. "You're worth every bit of trouble, Clementine Hart." The depth of emotion in his eyes made her breath catch. "And for what it's worth, I think you're exactly the kind of complicated I need in my life."

The sincerity in his voice made Clem's chest tighten. She leaned forward, resting her forehead against his. "Thank you for understanding."

Derek kissed her softly. "Thank you for trusting me with your story."

They stayed like that for a moment, foreheads touching, breathing in sync. Clem felt a weight lift from her shoulders, having finally shared her past with Derek.

"I should tell you something too," Derek began, his expression shifting to something more serious. "About New York—"

His pager suddenly blared from the nightstand, making both of them jump. Derek reached for it, checking the display with a frown.

"Emergency?" Clem asked, immediately shifting into doctor mode.

"Multiple vehicle accident on the highway," Derek confirmed, already moving to get dressed. "They need all available neurosurgeons."

"I'll come with you," Clem said, reaching for her clothes.

"No," Derek replied. "You're officially off until tomorrow. There's no reason for both of us to lose our weekend."

"Derek, I'm a doctor," Clem argued. "If there's a mass casualty event—"

"Bailey will kill me if I bring you in on your day off," Derek said, pulling on his shirt. "They'll page you if they need you."

Clem wanted to protest further but recognized the logic in his argument. "Fine. But call me if it gets worse and they need extra hands."

"I will," Derek promised, leaning down to kiss her quickly. "Stay as long as you want. Make yourself at home."

He was fully dressed now, keys in hand, transformed from the relaxed man of moments ago into the focused surgeon she knew from the hospital. Clem felt a pang of regret for the interrupted conversation, wondering what Derek had been about to tell her about New York.

"Derek," she called as he reached the door. "What were you going to say? About New York?"

Derek hesitated, his expression unreadable. "It can wait," he said finally. "We'll talk later."

Before Clem could respond, he was gone, the door closing behind him. She sat in the rumpled bed, listening to the sound of his car starting, then fading as he drove away. For some reason she couldn't name, a sense of unease settled over her, a feeling that whatever Derek had been about to say would change things between them.

Pushing the thought aside, Clem got up and headed for the small bathroom. Whatever it was, it would keep until later.

But as she stood under the hot spray of the shower, Clem couldn't shake the feeling that their perfect bubble was about to burst.

Chapter Text

SUNDAY: RETURN TO REALITY

The rain had finally stopped by the time Clementine's Honda Civic pulled into the driveway of Meredith's house. She sat for a moment, engine off, listening to the last notes of Nina Simone fade from the speakers. The weekend at Derek's trailer felt like a dream now - intimate conversations under blankets, shared confidences about their fathers, and that moment when Derek had almost told her something important about New York before his pager interrupted.

Clem grabbed her overnight bag from the passenger seat and headed toward the house, carefully navigating puddles that reflected the late afternoon sky. As she pushed open the front door, the familiar sounds of her roommates filled the air - Izzie's laughter from the kitchen, the low hum of ESPN from the living room.

"Look who's back from her forest fantasy weekend," Alex called out from his sprawled position on the couch. He was wearing a faded Seahawks t-shirt and had a medical journal open on his chest.

"Miss me, Brooklyn?" he added with that trademark Karev smirk.

"Like a fungal infection," Clem shot back, dropping her bag by the stairs. She noticed George sitting in the armchair, focused intently on a medical textbook.

"Please tell me there's coffee," she said to no one in particular.

Meredith emerged from the kitchen with two mugs. "Just made a fresh pot. Figured you'd need fortification before movie night."

"You're a lifesaver," Clem accepted the steaming mug gratefully.

"So," Meredith lowered her voice, "how was the weekend with McDreamy? Spare no details."

"Later," Clem whispered, nodding toward the others.

Izzie bounced into the living room carrying a bowl of popcorn large enough to feed a surgical floor. "Clem! You're just in time. It's your pick tonight, remember?"

"I remember," Clem said, settling onto the couch deliberately far from Alex. "And before you start lobbying, O'Malley, we're not watching 'Star Wars' again."

George looked up from his textbook. "I wasn't going to suggest—"

"Yes, you were," everyone replied in unison.

Clem's phone buzzed. She pulled it from her pocket expecting Derek, but instead saw her mother's name on the screen.

Mom:Just confirmed my flight for the 17th. Three weeks from now. Can't wait to see where my girl works and meet these roommates I keep hearing about. Love you.

Clem stared at the message, feeling a complex wave of emotions. Her mother visiting meant worlds colliding - Kit Hart would undoubtedly want to meet Derek. She'd have questions about her daughter dating an attending. Sharp, questions that wouldn't miss a beat.

"Earth to Brooklyn," Alex waved a hand in front of her face. "Who's got you looking like you just discovered a surprise tumor?"

"My mom," Clem replied, tucking her phone away. "She's coming to visit in three weeks."

"Mama Hart is coming to Seattle?" Izzie perked up. "I can't wait to meet the woman who raised you to be such a ray of sunshine."

"Very funny," Clem said. "She can smell BS from three counties away, so consider yourselves warned."

"I like her already," Meredith said, dropping onto the couch beside Clem.

"So, movie pick?" George prompted, clearly eager to shift the conversation. "Please, something that doesn't require a tissue box this time."

Clem reached for the remote. "I was thinking 'The Princess Bride.'"

Alex groaned. "Seriously? A princess movie?"

"It has sword fights, giants, and torture devices," Clem countered. "And it's quotable, which matters when you're sleep-deprived."

"As you wish," George said with a grin, earning an appreciative nod from Clem.

As the opening credits began to roll, Clem felt her phone buzz again. This time it was Derek.

Thinking about what you shared today. Means a lot that you trust me. We should talk more about New York soon.

Clem stared at the message, that familiar unease returning. Whatever Derek needed to tell her about New York, it seemed important. But for tonight, she was determined to enjoy this rare moment of normalcy with her fellow interns.

"Hey," Meredith whispered beside her, "you okay?"

"Yeah," Clem replied, setting her phone face-down on the coffee table. "Just glad to be home."

MONDAY MORNING: HOSPITAL CHAOS

The surgical floor of Seattle Grace was chaos incarnate on Monday morning. A multi-car pileup on I-5 had the ER overflowing, and the five interns had been running non-stop since their shift began at 6 AM.

"Hart, take bed three!" Bailey barked as she strode through the ER, clipboard in hand. "Yang, you're with Burke in Trauma One. O'Malley, prep OR 2 for the splenectomy. Stevens, run these labs. Karev—"

"I've got the guy with the handlebar through his abdomen," Alex interrupted, already moving toward the trauma bay.

Bailey raised an eyebrow. "Actually, you've got bed four. Probable concussion with facial lacerations." She handed him a chart. "Suture practice for you, Karev."

Clem caught the flash of frustration on Alex's face before heading to her assigned patient. Bed three contained a young woman in her twenties, helmet still strapped to her head, leather motorcycle jacket cut away to reveal multiple abrasions.

"Jessica Whitman, 26," the paramedic reported as Clem approached. "Passenger on a motorcycle that collided with a sedan. GCS 15, BP 110/70, pulse 110. Complains of right lower quadrant pain and right arm pain."

"Thank you," Clem said, already reaching for gloves. "Ms. Whitman, I'm Dr. Hart. Can you tell me where it hurts most?"

"My side," Jessica grimaced. "And my boyfriend? Jason? Is he okay? He was driving."

"I'll check on him," Clem promised, gently palpating the woman's abdomen. The wince when she touched the right lower quadrant was unmistakable. "I need a portable ultrasound and CBC, chem panel, and type and cross for four units," she called to a nearby nurse.

From across the ER, she could see George with a male patient - presumably Jason - who appeared less injured but was loudly demanding to see his girlfriend.

As Clem worked, she noticed Cristina at the next trauma bay looking unusually pale. When their eyes met briefly, Cristina quickly looked away, focusing intently on the patient chart in her hands.

"Everything okay?" Clem asked when they crossed paths at the nurses' station minutes later.

"Fine," Cristina snapped, her voice sharper than usual. "Just because you had a weekend sex retreat doesn't mean the rest of us are falling apart."

Before Clem could respond, Cristina hurried away, leaving Clem staring after her with concern. Something was definitely off with Yang.

The ultrasound confirmed Clem's suspicion - Jessica had free fluid in her abdomen, likely from a lacerated liver. As she prepared to present the case to Bailey, she spotted Derek across the ER, deep in conversation on his cell phone. His expression was tense, his back turned to the main floor as if seeking privacy.

When he hung up and turned around, their eyes met. He gave her a quick, professional nod before turning his attention to the head CT of another accident victim.

AFTERNOON: TENSIONS AND SECRETS

By mid-afternoon, the chaos had settled into the controlled urgency typical of a surgical floor after a major accident. Clem scrubbed out after assisting Bailey with Jessica's liver laceration repair, feeling the satisfying exhaustion that came from good, focused surgical work.

"Nice catch on the expanding hematoma, Dr. Hart," Bailey said as they left the scrub room. "You've got good hands."

Coming from Bailey, this was equivalent to a standing ovation. "Thank you, Dr. Bailey."

"Don't let it go to your head," Bailey added quickly. "And don't think I haven't noticed you checking your phone every five minutes. Whatever's going on with you and Shepherd, keep it out of my OR."

Clem felt her cheeks flush. "Yes, Dr. Bailey."

As she headed to check on post-ops, Clem passed the nurses' station where a crowd had gathered, snickering at something posted on the bulletin board. When she drew closer, she saw what had captured their attention - a large printout of a lingerie advertisement featuring an unmistakable Izzie Stevens, strategically placed where everyone would see it.

"Who did this?" Clem demanded, reaching to tear it down.

"I believe that would be your buddy Karev," Nurse Tyler replied, not bothering to hide his amusement.

Just then, Izzie rounded the corner, freezing when she saw the crowd and the image. Her face went from shock to mortification to fury in seconds.

"Where is he?" Izzie's voice was dangerously calm.

"Izzie, ignore it," Clem said, finally managing to pull the image down. "Alex is being a child."

"This isn't just here," a surgical resident passing by informed them. "They're in the elevators, the locker rooms, even the gallery."

Izzie's eyes filled with tears of anger. "I modeled to pay for med school. I'm not ashamed of it."

"You shouldn't be," Clem agreed, crumpling the paper. "But Alex should be ashamed of this."

Before either could say more, they heard raised voices from a nearby patient room. Clem recognized George's voice, uncharacteristically confrontational.

"You dismissed his symptoms!" George was saying as Clem and Izzie approached. He stood facing Alex in the doorway of what had been Jason Whitman's room - the motorcycle driver. Now the room was empty except for a stripped bed and equipment being removed by staff.

"The CT was clear," Alex shot back. "No one could have predicted the slow bleed."

"I told you something wasn't right with his pressure dropping," George insisted. "But you were too busy plastering the hospital with Izzie's underwear photos to actually practice medicine!"

Alex's expression hardened. "Watch it, O'Malley."

"Or what?" George stepped closer to Alex, seemingly unintimidated for once. "Jason is dead because you couldn't be bothered to take my concerns seriously."

"That's enough," Bailey's voice cut through the tension as she appeared behind them. "Both of you, with me. Now."

As Bailey led George and Alex away, Clem and Izzie exchanged worried glances.

"Jason died?" Izzie whispered.

Clem nodded grimly. "Must have been an occult injury they missed."

"Jessica's going to be devastated," Izzie said, glancing toward the ICU where their patient was recovering.

"I'll talk to her when she wakes up," Clem offered, already dreading the conversation.

Later, as Clem updated Jessica's chart at the nurses' station, she noticed Cristina leaning heavily against the counter, eyes closed.

"Yang?" Clem moved closer. "You really don't look good."

Cristina's eyes snapped open. "I'm fine. Just need more coffee."

"You need more than coffee," Clem persisted, lowering her voice. "Your color is off, you're sweating in a cold hospital, and you nearly dropped that tray in the OR earlier. What's going on?"

"Nothing I can't handle," Cristina insisted, straightening her posture with visible effort. "And if I wanted Dr. Phil, I'd turn on daytime TV."

Before Clem could press further, her pager beeped - it was Derek, asking her to consult on a case in the neurology department. As she headed toward the elevator, she caught sight of Izzie surrounded by a group of female nurses, all of them laughing together rather than at her. Whatever Izzie had said, it seemed she was reclaiming her narrative.

The elevator doors opened to reveal Derek, looking tired but professional.

"Dr. Hart," he greeted formally as she stepped in. Once the doors closed and they were alone, his expression softened. "Hey."

"Hey yourself," she replied, studying his face. "Everything okay? You've been fielding a lot of calls today."

Derek hesitated, that same look from the trailer crossing his face. "Just... some loose ends from New York. Nothing to worry about."

The elevator stopped before Clem could respond, and Derek immediately shifted back into professional mode as others joined them.

Whatever Derek wasn't telling her, it felt increasingly significant. But like everything else in this chaotic hospital day, it would have to wait.

EVENING: RESOLUTIONS AND REVELATIONS

Twilight had settled over Seattle Grace as the interns gathered in the locker room, the collective exhaustion of the day evident in their slumped shoulders and subdued conversations.

George sat on a bench, staring blankly at his locker. Bailey's reprimand had been thorough, but she'd also acknowledged that his instincts about Jason had been correct. The validation seemed to offer little comfort for the loss of a patient.

"Hey," Clem said, sitting beside him. "You were right to push for more testing."

"Doesn't matter now," George replied quietly.

"It does," Clem insisted. "It matters that you trusted your gut. That's what makes a good surgeon."

Alex emerged from the shower area, hair still damp. The locker room fell silent as he made his way to his locker, directly across from where Izzie was changing.

To everyone's surprise, Alex spoke first. "I was out of line with the photos."

Izzie paused, her scrub top half-removed. "Yes, you were."

"But I didn't kill that patient," he added, his gaze shifting to George. "The bleed was retroperitoneal. Nobody saw it coming."

"You didn't take me seriously," George countered.

"I should have," Alex admitted reluctantly. "Won't happen again."

The concession, minimal as it was, seemed to diffuse some of the tension. Izzie finished changing and turned to face Alex directly.

"For the record," she said, her voice steady, "I'm not ashamed of those photos. I did what I had to do to get through med school without debt. But next time you feel the need to share my modeling career with the hospital, remember that I can suture in my sleep and access sharp objects all day long."

A hint of a smile crossed Alex's face. "Noted, Stevens."

Meredith closed her locker with a decisive click. "Anyone else feel like they've aged ten years today? Joe's. Now. I'm buying the first round."

"Count me in," Izzie agreed, slinging her bag over her shoulder.

"George?" Meredith looked to him.

George hesitated, then nodded. "Yeah, okay."

"Brooklyn?" Alex raised an eyebrow at Clem.

She shook her head. "Rain check. I need to check on Jessica before I leave."

As the others filed out, promising to save her a seat at Joe's, Clem noticed Cristina taking longer than usual to pack her things, her movements deliberate as if requiring extra concentration.

"Yang," Clem said quietly once they were alone, "whatever's going on with you, you should get it checked."

Cristina looked up, her usual sharp defenses momentarily lowered. "It's just a bug."

"A bug that's lasted how long?" Clem pressed.

Before Cristina could answer, her pager beeped. "Burke," she explained, checking the display. "I need to go."

Clem watched her leave, still concerned but recognizing the futility of pushing further. Cristina Yang did things on her own terms.

After checking on Jessica, who was still sedated and stable, Clem made her way to the neurology floor. She found Derek in his office, surrounded by patient files and illuminated by a single desk lamp that cast dramatic shadows across his tired features.

"You missed quite a day," she said from the doorway.

Derek looked up, his expression softening at the sight of her. "I heard. George and Alex nearly came to blows?"

"Among other things," Clem replied, stepping inside and closing the door. "Izzie's modeling career went public, Cristina's hiding something medical, and my mother's visiting in three weeks."

"Your mother?" Derek set down his pen. "That's... significant."

"It is," Clem agreed, perching on the edge of his desk. "And speaking of significant things, what is it about New York that you need to tell me?"

Derek's gaze dropped to his desk momentarily before meeting hers again. "Clementine, it's—"

His phone buzzed loudly on the desk. He glanced at the screen and quickly flipped it over, but not before Clem caught the 212 area code.

"New York calling?" she asked lightly, though tension crept into her voice.

"It can wait," Derek said, echoing his words from the trailer.

Clem studied his face—the slight tightness around his eyes, the careful neutrality of his expression. "That's the third call from New York today."

"It's complicated," Derek admitted, rubbing his temples. "Past life stuff."

"Past life stuff that keeps calling?" Clem raised an eyebrow. "Derek, we spent the weekend sharing our darkest moments. I told you about Callahan. Whatever this is—"

"It's not the same," Derek interrupted, then immediately softened his tone. "I just need to handle some things before I can explain. Can you trust me on that?"

Before Clem could respond, both their pagers sounded in rapid succession. Emergency in the ER—all hands.

They exchanged a look that acknowledged the reprieve this interruption provided, even as it escalated the underlying tension between them.

"We're not done with this," Clem said as they headed for the door.

"I know," Derek replied, his hand briefly finding the small of her back. "And I promise, I'll explain everything soon."

As they rushed toward whatever crisis awaited them in the ER, Clem felt a familiar uneasiness settling in her chest. The weekend's intimacy suddenly felt distant, replaced by the growing shadow of Derek's unspoken New York secret.

But right now, there were patients who needed her focus. The mysteries of Derek Shepherd's past would have to wait—though Clem couldn't shake the feeling that whatever he wasn't telling her was already on its way to Seattle.

Chapter Text

TUESDAY MORNING: UNWELCOME SURPRISES

Seattle rain drummed steadily against the windows of Seattle Grace as Clem rushed through the hospital entrance, coffee in one hand and half-eaten bagel in the other. Despite leaving Meredith's house with plenty of time, an overturned truck on Madison had turned her normally quick commute into a thirty-minute crawl.

She spotted Alex leaning against the nurses' station, his face unusually tense as he studied a piece of paper in his hands. When he noticed her approaching, he quickly folded the paper and shoved it into his lab coat pocket.

"You're late, Brooklyn," he said with his typical smirk, though something seemed off behind the bravado.

"Traffic," she replied simply, sliding her bag under the counter.

Before she could inquire further, Bailey rounded the corner with the other interns trailing behind her.

"Nice of you to join us, Dr. Hart," Bailey said, her tone sharp. "Now that we're all here, rounds. Stevens, present."

Izzie stepped forward, flipping open a chart. "Claire Rice, 34, post-op day two from a cholecystectomy. Vitals stable, incision healing well, no signs of infection."

"Plan?" Bailey prompted.

"Continue monitoring, possible discharge tomorrow if labs remain normal," Izzie answered confidently.

As they continued rounds, Clem noticed Cristina seemed paler than usual, her typically sharp focus slightly dulled. When Cristina excused herself abruptly during the presentation of a post-op bowel resection, Meredith shot Clem a concerned look.

After rounds, Bailey assigned the day's cases. "Karev, you're with Burke. Yang, ER. O'Malley, post-ops. Stevens, clinic. Hart, you're with Shepherd today."

As the interns dispersed, Alex brushed past Clem with uncharacteristic force, nearly causing her to spill her coffee.

"What is your problem?" she demanded, grabbing his arm.

Alex yanked away. "Not everything is about you, Brooklyn," he snapped, his voice carrying a bitterness that went beyond their usual banter.

"Fine," Clem released him, watching as he stalked off toward cardio. Whatever was eating at Alex Karev, she didn't have time to psychoanalyze it now.

She walked through the surgical floor, and stopped at the neurology nurses' station where Derek was reviewing a patient's file.

Derek had been distant the past two days, their conversations limited to professional exchanges and brief text messages. Whatever was happening with his "New York situation" remained unspoken between them.

"Dr. Shepherd," she greeted formally, aware of the nurses nearby.

"Dr. Hart. We have a case I'd like your assistance with."

He led her to a patient room where a middle-aged man sat upright in bed, a bandage covering a small portion of his shaved head. The man's eyes lit up when they entered.

"Dr. Shepherd! Back so soon?" the patient greeted cheerfully.

"Mr. Duff, this is Dr. Hart, one of our surgical interns," Derek introduced. "She'll be assisting with your case today."

"Edward Duff," the man extended his hand to Clem. "But everyone calls me Eddie."

"Nice to meet you, Mr. Duff," Clem replied professionally, taking his chart from the foot of the bed. She quickly scanned the notes—Edward Duff, 54, admitted for small temporal lobe tumor removal scheduled for tomorrow morning.

"Dr. Hart, Mr. Duff has an interesting profession," Derek said. "He works as a medium."

"I connect people with their loved ones who have passed," Eddie explained, seeing Clem's skeptical expression. "Don't worry, I'm used to doctors being skeptical."

Clem nodded politely, focusing on the chart. "I'll be preparing you for surgery tomorrow, Mr. Duff. We'll need to run some additional labs and complete your pre-op assessment."

Eddie tilted his head, studying her intently. "You remind me of someone who used to buzz around like a busy little bug, always curious."

Clem's hand faltered slightly on the chart. Bug was her father's nickname for her, something she'd never discussed with anyone.

"Mr. Duff needs a complete pre-op workup, Dr. Hart," Derek said, noticing her reaction. "I'd like you to run his labs and prepare him for tomorrow's procedure."

"Of course," Clem replied, grateful for the redirection. "I'll order those right away."

"And Dr. Hart," Derek added as she turned to leave, "when you're finished, meet me in exam room three. We have another consult."

As Clem hurried from the room, Eddie called after her, "Jazz helps, you know. Keeps the connection strong."

She paused briefly in the doorway, unsettled, before continuing toward the nurses' station. How could he possibly know about her father's nickname? About the jazz? It had to be a lucky guess.

Trying to shake off the encounter, Clem focused on ordering Eddie's labs. As she worked at the computer, Meredith appeared beside her.

"Have you seen Cristina?" Meredith asked, her voice low with concern.

"Not since she bolted during rounds," Clem replied. "Everything okay?"

Meredith hesitated. "She's... I don't know. She won't talk to me."

"Yang? Not talking to you?" Clem raised an eyebrow.

Before Meredith could respond, their attention was drawn to a commotion at the ER entrance. Paramedics rushed in with a teenage girl on a stretcher, her long skirt and modest blouse immediately standing out among the typical Seattle attire.

"Teenage female, collapsed during prayer service," the paramedic reported as Bailey approached. "BP 90/60, pulse 120, respiratory distress apparent."

"Get her into Trauma One," Bailey directed. "Page Burke and get a chest CT stat."

As they wheeled the girl past, Clem noticed Alex already moving to assist, his earlier mood seemingly forgotten in the face of a critical case.

"I should go," Meredith said, eyeing the trauma room. "But if you see Cristina..."

"I'll tell her you're looking for her," Clem finished with a nod.

Clem finished ordering Eddie's labs and headed to meet Derek in exam room three, determined to refocus on her work and push thoughts of psychics and their impossible knowledge aside.

TUESDAY AFTERNOON: FAITH AND SCIENCE

The ER buzzed with activity as Clem made her way toward exam room three. She passed Trauma One where Burke, Bailey, and Alex worked on the teenage girl who had collapsed. Through the glass, she could see the girl was now conscious, speaking animatedly despite her obvious distress. A middle-aged couple—presumably her parents—stood nearby, their anxious expressions contrasting with their daughter's calm demeanor.

Derek was waiting in exam room three, reviewing a CT scan displayed on the lightbox. He glanced up when Clem entered, offering a small smile that didn't quite reach his eyes.

"How did it go with Mr. Duff?" he asked.

"He's..." Clem hesitated. "Different."

"He said something that bothered you," Derek observed.

"It's nothing," Clem said dismissively. "Some people are good at reading others. It's not supernatural."

Derek gestured to the CT scan, changing the subject. "Subdural hematoma. Minor car accident victim who reported headache and confusion afterward. Neurology cleared him initially, but his symptoms worsened overnight."

They discussed the case professionally, the easy intimacy they'd shared at the trailer now replaced by a careful distance. As Derek explained the surgical approach he planned to take, his phone buzzed in his pocket. He checked it quickly, his expression tightening before he silenced it without responding.

"New York again?" Clem asked, unable to keep the edge from her voice.

"It's not a good time to discuss this," Derek replied quietly.

"Is there ever going to be a good time?" Clem pressed, keeping her voice low. "Because whatever this is, it's becoming the elephant in the room, Derek."

Derek's pager interrupted before he could respond. He checked it and sighed. "911 from Trauma One. We need to go."

They hurried to the trauma room where the teenage patient was now surrounded by a full team. Burke looked up as they entered.

"Shepherd, we need a neurology consult. Seventeen-year-old female with severe mitral valve stenosis. Echo shows vegetation on the valve, likely endocarditis. We need to replace the valve immediately, but she's refusing treatment."

The girl, pale but composed, lay propped up on the stretcher. Her long dark hair was neatly braided, and despite her obvious illness, her eyes were alert and determined.

"This is Esther," Bailey introduced. "And these are her parents, Mr. and Mrs. Saulter."

"It's Devo, actually," the father corrected with a sigh. "She was born Devo Saulter. The Esther thing is... recent."

"I chose a Hebrew name when I converted," the girl explained, her voice surprisingly strong. "My soul is Esther now."

Clem studied the girl with growing concern. Despite her youth, she seemed entirely certain of herself, a dangerous combination with critical illness.

"Esther has been explaining that her faith prohibits accepting a pig valve replacement," Bailey informed them. "We've been discussing options."

"There are no options," Esther stated firmly. "I won't accept anything unclean into my body. It's against God's law."

"Sweetie," her mother pleaded, "this is your life we're talking about."

"My eternal life matters more than my earthly body," Esther replied with the conviction only a teenager could muster.

Mrs. Saulter turned to the doctors in exasperation. "We're not religious. We named her after a punk band, for God's sake."

"This isn't about you," Esther told her parents. "This is my faith, my choice."

"You're seventeen," her father countered. "Legally, we make your medical decisions."

"Actually," Burke interjected, "Washington state recognizes the mature minor doctrine. If Esther demonstrates sufficient understanding of her condition and the consequences of refusing treatment, she may legally make this decision herself."

"So we're just supposed to let her die because of a religious conversion?" Clem blurted out, unable to contain her frustration.

"Dr. Hart," Bailey warned, giving her a sharp look.

"I've studied the laws," Esther insisted. "Pig is treif—forbidden. I won't violate Kashrut even to save my life."

"What about a human valve?" Derek suggested, drawing everyone's attention. "There's no religious prohibition against that, right?"

"Human valves are in extremely short supply," Burke explained, clearly irritated by the suggestion. "The waiting list is months long, and this patient needs immediate intervention."

"What about bovine?" Alex spoke up suddenly. Everyone turned to him in surprise. "A cow valve. Cows are kosher animals, right?"

Burke frowned. "Bovine valves aren't ideal for someone this young. They don't last as long as porcine valves."

"But it would work," Alex pressed. "And it doesn't violate her religious beliefs."

"Would that be acceptable to you, Esther?" Derek asked.

Esther thought for a moment. "Cows are kosher animals. If prepared properly..." She nodded slowly. "Yes, I think that would be permissible."

Burke looked skeptical.

After a moment's consideration, Burke nodded. "Fine. We'll use a bovine valve. Karev, prep her for surgery. Dr. Hart, run the pre-op labs."

As the team dispersed to prepare for surgery, Clem found herself standing beside Alex in the hall.

"Bovine valves?" she said. "I didn't know you were an expert in religious dietary laws."

Instead of his usual cocky response, Alex merely shrugged, that earlier darkness returning to his expression. "Sometimes you just need to find a middle ground."

"Is everything okay?" Clem asked, surprising herself with the genuine concern in her voice.

Alex hesitated, his hand unconsciously touching the pocket where he'd stashed that paper earlier. For a moment, it seemed he might actually confide in her. Then his walls slammed back into place.

"Worry about your own problems, Brooklyn," he muttered before walking away.

Clem watched him go, baffled by his behavior. As she turned to head back to neurology, she nearly collided with Cristina, who looked even worse than she had that morning.

"Whoa, Yang," Clem steadied her. "You look like death warmed over."

"I'm fine," Cristina insisted, though she was gripping the wall for support.

"Right, and I'm the Queen of England," Clem retorted. "Look, I won't pry, but maybe you should take a break?"

"I don't need a break," Cristina snapped, her face suddenly taking on a greenish tinge. Without another word, she rushed toward the women's restroom.

Clem hesitated, debating whether to follow, but decided against it. Cristina Yang was fiercely private, and whatever was going on, she clearly wasn't ready to share.

Instead, Clem headed back to check on Eddie Duff, who was due for his pre-op evaluation. Despite her reluctance to face the unsettling man again, she couldn't avoid her responsibilities.

When she entered his room, Eddie was sitting up in bed reading a worn paperback. He set the book aside and smiled.

"Dr. Hart. I was hoping you'd come back."

"I'm here to complete your pre-op evaluation, Mr. Duff," Clem replied, keeping her tone professionally distant.

"I upset you earlier," Eddie observed. "I apologize. Sometimes I speak without thinking how my words might affect people."

"It's fine," Clem said dismissively, taking his blood pressure. "You couldn't have known about the nickname."

Eddie studied her face. "Your father was military, wasn't he? A doctor like you."

Clem's hands faltered slightly. "Mr. Duff, I'm trying to do my job here."

"Of course," he nodded, allowing her to continue the examination in silence. As she listened to his heart, he spoke again, his voice gentle. "You're angry that he left, aren't you?"

Clem froze, the stethoscope pressed against his chest. "I'm not angry," she said automatically, her voice tight.

"Eight years old is young to understand duty and sacrifice," Eddie continued softly. "Young to understand why someone would choose to leave."

Clem pulled back, her professional mask firmly in place despite the churning emotions underneath. "Mr. Duff, with all due respect, my family history isn't relevant to your pre-op care. I need to check your neurological responses now."

She proceeded with the examination, asking him to follow her finger with his eyes, testing his grip strength, and checking his reflexes. Eddie complied quietly, but as she finished making notes in his chart, he spoke again.

"You're afraid of being left again. By that doctor of yours."

Clem's head snapped up, her eyes narrowing. "Mr. Duff—"

"The truth is coming, Dr. Hart," he said simply. "But not all departures are betrayals."

"I'll send someone to take you down for your final scans," Clem said stiffly, gathering her paperwork and heading for the door.

"Keep humming that jazz," Eddie called after her. "He hears it."

Clem hurried from the room, disturbed by how accurately the man had pinpointed her deepest fears. It was nonsense, she told herself. Cold readings and lucky guesses designed to seem supernatural.

She found herself walking toward the hospital chapel, a place she rarely visited. It was empty at this hour, the late afternoon light filtering through stained glass to cast colorful patterns across the simple wooden pews. Clem sat in the back row, not praying, but allowing the quiet space to calm her racing thoughts.

The door opened behind her, and she turned to see Izzie entering, looking surprised to find anyone there.

"Clem?" Izzie hesitated. "Sorry, I didn't mean to interrupt."

"You're not," Clem assured her, sliding over to make room on the pew. "Just... taking a break."

Izzie sat beside her. "I heard you met our psychic patient."

"You believe in that stuff?" Clem asked.

Izzie's expression hardened unexpectedly. "No. My mother spent our grocery money calling psychic hotlines. They're con artists preying on vulnerable people."

"This guy knew things, Iz," Clem said quietly. "Things about my dad that no one here knows."

"They're good at what they do," Izzie replied, her voice softening slightly. "They notice details, make educated guesses, read your reactions. But it's not real, Clem."

"Maybe," Clem conceded. "But he said something about Derek too... it just hit a nerve."

"Because you're already worried about whatever Derek's not telling you," Izzie pointed out reasonably. "That's not psychic ability—that's just playing the odds. Everyone in this hospital knows something's up with you two."

Before Clem could respond, both their pagers sounded simultaneously. 911 to OR 2—Burke's surgery on Esther was experiencing complications.

As they rushed from the chapel, Clem's thoughts remained divided between the scientific medicine she had dedicated her life to and the inexplicable messages from a man who somehow knew her deepest fears about Derek and New York.

TUESDAY EVENING: TRUTHS EMERGE

The observation gallery above OR 2 was packed with staff by the time Clem and Izzie arrived. They squeezed into spots along the back row, watching the drama unfold below. Burke stood over Esther's open chest, his typically steady hands moving with precise urgency while Alex assisted, looking intensely focused despite his earlier mood.

"What happened?" Clem whispered to George, who was leaning forward with rapt attention.

"The vegetation on her valve was more extensive than they thought," he explained without taking his eyes off the procedure. "It broke loose when they were prepping the replacement site. Burke's trying to prevent emboli from reaching her brain."

"Where's Cristina?" Izzie asked, scanning the gallery. "She lives for Burke's surgeries."

George shrugged. "Haven't seen her for hours."

On the OR floor, Burke's voice carried through the speakers. "Karev, suction there. More. Good."

Alex's movements were precise, his focus absolute as he followed Burke's instructions. Whatever was bothering him, he'd managed to compartmentalize it completely during surgery.

"He's not terrible," Clem admitted quietly.

"Don't let him hear you say that," Izzie replied with a small smile. "His ego's big enough already."

They watched in tense silence as Burke worked to repair the bleeding and complete the valve replacement. After nearly forty minutes of delicate maneuvering, he finally stepped back.

"Let's come off bypass," he instructed. "Karev, watch the pressure."

A collective exhale seemed to ripple through the gallery as the heart monitor began showing a strong, steady rhythm. People began filtering out, but Clem remained, watching the methodical process of closing.

"You coming?" Izzie asked, standing to leave.

"In a minute," Clem replied, her eyes still on the OR.

As the gallery emptied, Clem noticed Derek entering the OR floor below, speaking briefly with Burke before glancing up toward the gallery. Their eyes met briefly before he turned away, continuing his conversation with Burke. That familiar sense of unease returned—whatever Derek wasn't telling her about New York was becoming an increasingly palpable presence between them.

Finally tearing herself away from the gallery, Clem headed toward the locker room. The surgical floor was quieting as the day shift prepared to hand off to the night team. As she rounded the corner, she nearly collided with Cristina, who was emerging from an exam room looking even paler than before.

"Yang," Clem steadied her. "Seriously, you look terrible."

"Thanks," Cristina replied dryly, though without her usual bite.

Clem lowered her voice. "You missed Burke's valve replacement. The whole thing. That's not like you."

Something flickered across Cristina's face—vulnerability quickly masked by her typical defensive posture. "Some things are more important than surgery."

"More important than surgery?" Clem raised an eyebrow. "Now I know you're sick."

"Just drop it, Hart," Cristina said, attempting to move past her.

"Look," Clem said, stepping slightly to block her path, "we're not Meredith and Cristina close, I get that. But we're... still friends. Colleagues. Fellow soldiers in the surgical trenches."

For a moment, Cristina's carefully constructed walls seemed to waver. Then she shook her head. "This is my problem. I'll handle it."

As Cristina walked away, Clem noticed her heading not toward the exit but toward OB/GYN. The pieces suddenly clicked into place—the morning sickness, the fatigue, the uncharacteristic absences during surgeries. Cristina Yang was pregnant.

Respecting her privacy, Clem continued to the locker room, finding it empty except for Alex, who sat alone on a bench staring at that same piece of paper from this morning. He didn't notice her enter, his expression a mixture of anger and defeat that made him seem suddenly younger, more vulnerable.

"Evil Spawn actually has feelings," she said, not unkindly.

Alex startled, quickly folding the paper again. "What do you want?"

"You were decent in there today," she said, sitting on the bench opposite him. "With the bovine valve idea and assisting Burke."

He shrugged, his typical bravado notably absent. "Whatever."

An uncomfortable silence stretched between them before Clem spoke again. "That paper you've been carrying around all day. Bad news?"

Alex's jaw tightened. For a moment, she thought he might lash out or simply walk away. Instead, he unfolded the paper and handed it to her without a word. Clem scanned it quickly—medical board exam results. Failed.

"Oh," she said quietly, handing it back. "Alex..."

"Don't," he warned. "I don't need your pity."

"It's not pity," Clem insisted. "It's... I've been where you are. More than you know."

"Right," Alex's voice dripped with skepticism. "Little Miss Columbia Top of Her Class gets what it's like to fail?"

"I had an ethics investigation at Columbia," Clem admitted. "Complete with hearing and suspension. It nearly cost me everything."

"Ethics investigation?" Alex looked genuinely surprised. "What'd you do, Brooklyn? Steal drugs? Sleep with an attending?" His eyes widened slightly. "Wait, is that why you and Shepherd—"

"No," Clem cut him off sharply.

She gave him a condensed version of the Callahan disaster—the affair, the fraudulent research, the whispers and sideways glances that followed her through her final year.

"It wasn't the same as failing boards," she acknowledged. "But that feeling that your career might be over before it starts? I know that feeling."

Alex was quiet for a long moment. "So what did you do?"

"I left," Clem said simply. "Came here for a fresh start. You don't have to leave."

"And in the meantime, everyone will know I failed," he muttered.

"No one has to know unless you tell them," Clem pointed out. "We could study together. For when you retake it."

Alex looked up, genuine surprise crossing his face at the offer. Before he could respond, George and Izzie entered, arguing about a diagnosis they'd made in the clinic.

"Just saying, if you'd ordered the CT first—" George was insisting.

"The symptoms clearly pointed to—" Izzie countered.

They fell silent, noticing the unusual sight of Alex and Clem in what appeared to be a civil conversation.

"What's going on?" George asked suspiciously.

"Brooklyn's critiquing my surgical technique," Alex said, instantly reverting to his defensive persona. "Like she could do better."

And just like that, his walls were back in place. But as he brushed past George and Izzie, Alex caught Clem's eye with a look that might almost be gratitude.

After changing into street clothes, Clem headed for the hospital exit, exhaustion settling deep in her bones. The day had been a whirlwind of strange encounters and unexpected revelations—Eddie Duff's impossible knowledge, Cristina's pregnancy, Alex's vulnerable moment, and through it all, the persistent shadow of Derek's New York secret.

Chapter Text

WEDNESDAY MORNING: UNWELCOME TRUTHS

The rain beat against the windows of Seattle Grace with a steady, familiar rhythm as Clementine Hart finished updating her patient's chart at the nurses' station. Three successful post-op evaluations down, two more to go before she could even think about lunch. She tucked a wayward strand of chestnut hair behind her ear and reached for her next chart.

Tyler, the male nurse who'd taken a professional liking to Clem since she'd shown actual respect to the nursing staff, appeared at her side with unusual urgency. His normally calm demeanor was replaced with something close to alarm.

"Dr. Hart," he said, voice lowered as he leaned in. "You need to disappear. Like, five minutes ago."

Clem looked up, pen hovering over her notes. "What? Why would I—"

"She's here," Tyler interrupted, glancing nervously toward the elevators. "Satan in a designer dress. Coming up from the lobby now."

"Who's here?" Clem asked, straightening up at his obvious distress.

Tyler's eyes widened in disbelief. "You don't know? Shepherd's wife."

The word hit Clem like a physical blow. "His what?"

"Wife," Tyler repeated, looking increasingly uncomfortable. "Tall, gorgeous, redhead. Shepherd has a wife. He is very much married."

Clem felt the floor shift beneath her feet. "That's not... that can't be right."

"I thought you knew," Tyler said, genuine concern crossing his features. "Everyone's been talking since she stormed past the ER demanding to see the Chief."

The elevator doors opened with a cheerful ping that felt grotesquely out of place in Clem's suddenly tilting world.

From the elevator emerged a woman who could only be described as stunning – tall and slender with hair the color of sunset falling in perfect waves past her shoulders. Her tailored Prada suit probably cost more than Clem's monthly rent, and her heels clicked against the hospital floor with confident precision. She paused at the nurses' station, designer glasses perched on her nose as she scanned the surgical floor like a predator seeking prey.

Then her eyes landed on Clementine.

Tyler had already made a tactical retreat, leaving Clem standing alone, patient chart clutched to her chest like inadequate armor.

The redhead approached with a smile that was all teeth and no warmth. "So you're the twelve-year-old who's been screwing my husband."

Clem stiffened, feeling the eyes of everyone at the nurses' station on them. "Excuse me?"

"Dr. Addison Montgomery-Shepherd," she said, extending a perfectly manicured hand. "Double board-certified in neonatology and fetal surgery. And still legally married to Derek Shepherd." She looked Clem up and down with surgical precision. "Though I understand he conveniently forgot to mention that part."

Clem didn't take the offered hand. "I don't know what you're—"

"Oh please," Addison interrupted with a dismissive flick of her wrist. "Let's not insult each other's intelligence. I know exactly who you are, Dr. Hart. The brilliant intern from Brooklyn with the tragic backstory and the naturally steady hands." Her voice dropped to a confidential tone. "Derek has a type, you know. Smart, driven women who worship his surgical brilliance. It's all very predictable."

Clem struggled to keep her expression neutral, professional. Inside, her mind raced through every conversation with Derek, searching for clues she might have missed. The mysterious New York calls. The interrupted conversations. The "past life stuff" he'd been so reluctant to discuss.

"I'm here for a TTTS case," Addison continued, adjusting her glasses with casual elegance. "Twin-to-twin transfusion syndrome. Quite fascinating, actually. But I thought I should introduce myself to the woman who's been warming my husband's bed while I've been in New York thinking he just needed space." Her smile turned razor-sharp. "Silly me."

The practiced casualness of Addison's words carried a sting designed to cut through to the bone. This wasn't just information – this was calculated warfare. This woman knew exactly who Clem was and what she meant to Derek.

"I have patients," Clem managed, proud that her voice didn't shake despite the earthquake happening inside her.

"We all have our patients, don't we?" Addison replied, her tone suddenly almost sympathetic. "It's what keeps us going when we discover the men in our lives aren't who we thought they were." She glanced meaningfully at Clem. "A piece of advice from someone who's known Derek much longer than you have – when he says he needs space or time, what he really means is he's running. It's what he does best."

Before Clem could respond, movement at the end of the corridor caught her attention. Derek had rounded the corner, his expression shifting from routine professional focus to absolute horror when he spotted his wife.

"Addison," he said, the single word loaded with disbelief and fury as he approached. "What are you doing here?"

"Hello to you too, Derek," Addison replied smoothly. "Richard called. Apparently, he still thinks I'm the best, even if you've forgotten." She gestured toward Clem with theatrical flair. "I was just having a delightful chat with Dr. Hart. Filling in some of the blanks in your narrative."

Derek's eyes darted to Clem, filled with panic and something that looked dangerously close to guilt. "Clementine, I can explain—"

"Dr. Hart," Clem corrected coldly, stepping back. The use of her first name in this context felt like salt in an open wound.

She turned to Addison with a professionalism she didn't feel. "Dr. Montgomery-Shepherd, it's been enlightening." Then to Derek, without meeting his eyes: "Excuse me, Dr. Shepherd."

Without waiting for a response from either of them, Clem turned and walked away, her steps measured and deliberate.

"Clementine, wait!" Derek called after her, his voice carrying through the now-silent surgical floor.

She didn't look back, not even when she heard the beginning of what promised to be an explosive confrontation behind her.

"You had no right to come here," Derek's voice, tight with anger.

"I had every right," Addison's reply, cool and unruffled. "You didn't file for divorce, you just disappeared..."

Clem pushed through the stairwell door, letting it close on their voices. Only when she was certain she was alone did she allow herself to run.

THE BASEMENT - INTERN HIDEOUT

The basement of Seattle Grace was a labyrinth of forgotten storage and abandoned equipment, but it had become a sanctuary for exhausted interns seeking escape from the hospital's constant demands. In a hidden corner behind old gurneys and outdated monitors, Clem sat on the cold floor, back against the wall, knees pulled to her chest.

Married. Derek was married.

The word kept repeating in her mind, a terrible mantra that undermined everything she thought they'd built together. Their weekend at the trailer felt like a cruel joke now – his stories about his father, his "understanding" of her past with Callahan, his talk of her "staying more often." All of it happening while his wife was... where? New York? Waiting for him to come clean? Planning her dramatic Seattle entrance?

Clem slammed her fist against the concrete floor, welcoming the sharp pain that shot through her hand. This was Callahan all over again, but somehow worse. With Callahan, she'd been blindsided by the revelation of his wife. With Derek, she'd been vulnerable by choice, had knowingly crossed professional lines because she believed what they had was worth it. She had ignored all the signs.

"Damn it!" she shouted into the empty space, her voice echoing back at her. "Damn it, damn it, damn it!"

She'd done it again – trusted an attending who'd fed her lies. First Callahan with his research manipulation and hidden wife, now Derek with his... what? His estranged marriage he never bothered to mention? His "loose ends" from New York that turned out to be six feet of gorgeous redhead with board certifications and designer shoes?

The door to the hideout creaked open, and Clem quickly wiped at her eyes with the sleeve of her lab coat. "Not now," she called out, not caring who it was.

"Yeah, well, life's full of disappointments," Alex's voice echoed in the dim space.

Alex Karev stepped into view, surveying her with an unreadable expression. Without asking permission, he dropped down beside her on the floor, his back against the same wall, close enough that she could feel the heat from his body but not quite touching.

"So Shepherd's married," he said bluntly. "To Addison Montgomery. She's like the God of neonatal surgery, by the way."

"Of course she is," Clem laughed bitterly. "Why wouldn't she be? She's perfect."

"She's also up there right now tearing Shepherd a new one in the middle of the surgical floor," Alex added. "Bailey had to intervene before they gave the post-op patients heart attacks."

Despite everything, Clem felt a flicker of grim satisfaction at that image. "Good."

Alex reached into his lab coat pocket and pulled out a half-crushed pack of cookies. "Swiped these from the pediatric ward," he said, offering her one. "Cancer kid. Too nauseated to eat 'em anyway."

"Jesus, Alex," Clem muttered, but she took a cookie anyway.

"Got these too," he added, pulling a wad of tissues from his other pocket and dropping them between them. "Mrs. Jablonski in 412 won't miss them. Pretty sure she's hoarding them to build a nest or something."

"You're a terrible person," Clem said, but she took one of the tissues and wiped roughly at her eyes.

They sat in silence for a moment, the only sound the distant hum of hospital equipment and the crinkling of the cookie wrapper as Alex helped himself to one.

"I told you attendings were bad news," he finally said.

"Not helpful, Karev."

"Wasn't trying to be helpful," he replied, but there was less edge than usual in his voice. "Just stating facts."

Clem turned to look at him directly. "Did you know? About Shepherd being married?"

Alex shook his head. "Nah. But I'm not surprised. Guys like that always have something they're not telling you."

"And what kind of guy is that?" Clem asked, anger flaring again.

"The kind who's too perfect," Alex said simply. "Perfect hair, perfect reputation, perfect trailer in the perfect woods. Nobody's that perfect without hiding something seriously screwed up."

The brutal assessment hit close enough to home that Clem couldn't argue. Instead, she took another cookie, crumbling it between her fingers rather than eating it.

"You wanna know what I think?" Alex asked after another stretch of silence.

"Not particularly."

"I think you're too good for this crap," he continued anyway. "You don't need Shepherd's special attention to be a damn good surgeon."

The unexpected compliment caught Clem off guard. She studied his profile, trying to detect any hint of mockery, but found none.

"Didn't know you had such a high opinion of my skills, Karev."

"Don't get used to it," he replied, the corner of his mouth lifting in what might have been a genuine smile. "But I've seen you in the OR. You've got the hands for it. Unlike O'Malley, who nearly passed out during that splenectomy yesterday."

Despite everything, Clem found herself smiling slightly. "George didn't almost pass out. He just... got very pale."

"He was green, Brooklyn. Like actual green."

There was an odd comfort in Alex's brutal honesty. No false sympathy, no platitudes about how everything would work out. Just cookies stolen from sick children and the cold truth that sometimes people weren't who you thought they were.

"So what's your plan?" Alex asked, gathering up the cookie wrappers.

"My plan?"

"Yeah. Your plan for dealing with McDreamy and Satan in Prada up there." He looked at her expectantly. "You're not hiding in the basement forever, are you?"

Clem took a deep breath, feeling a strange clarity emerging from the wreckage of her emotions. "I'm going to do my job. I'm going to be a surgeon. And I'm going to make damn sure neither one of them gets in my way."

Alex studied her for a moment, then nodded with what looked like genuine respect. "Hardcore, Brooklyn. I like it."

As they both stood, Alex hesitated, looking almost uncomfortable. "For what it's worth," he said, not quite meeting her eyes, "Shepherd's an idiot for lying to you. And for having that wife and still messing around with you."

Before Clem could respond to the unexpected support, the sound of footsteps echoed in the corridor outside.

"Clementine?" Derek's voice called out. "Are you down here? We need to talk."

Alex raised an eyebrow at Clem. "Want me to tell him to go to hell?"

For a moment, she was tempted to accept the offer. Instead, she squared her shoulders. "No. I can handle Derek Shepherd."

"Your funeral," Alex shrugged, but he moved to stand slightly in front of her as Derek appeared in the doorway, looking disheveled and desperate.

"Clementine," Derek said, relief washing over his face when he saw her. Then his expression hardened when he noticed Alex. "Karev, give us a minute."

"Not happening," Alex replied flatly, crossing his arms.

"It's okay, Alex," Clem said quietly. "I've got this."

Alex hesitated, then gave her a slight nod. "I'll be right outside if you need me," he said, deliberately loud enough for Derek to hear. As he passed Derek in the doorway, he added in a low voice, "She deserves better than you, man."

When they were alone, Derek took a step toward Clem, his hands raised in a placating gesture. "I know how this looks, but please, let me explain."

"Explain what, exactly?" Clem kept her voice steady despite the storm inside her. "That you're married? That your wife thinks you just needed space? That you've been lying to me since the day we met?"

"I didn't lie," Derek protested weakly. "Addison and I... it's complicated."

"Complicated," Clem repeated, the word bitter on her tongue. "Funny how men always say that when what they really mean is 'I didn't tell you the truth because it was inconvenient for me.'"

Derek ran a hand through his hair, the gesture so familiar it made Clem's chest ache. "I was going to tell you. This weekend, at the trailer. But then the accident happened, and I—"

"Save it," Clem interrupted, holding up a hand. "I don't want to hear your excuses. What I want to know is one thing – did you leave New York because of her?"

Derek's hesitation was answer enough.

"I thought so," Clem said quietly. "Just like Callahan. I'm attracted to men with secrets like moths to flame."

"I am nothing like Callahan," Derek said sharply. "What Addison did—"

"What Addison did?" Clem caught the slip immediately. "What exactly did Addison do, Derek?"

Derek's face darkened. "She slept with my best friend. In our bed. In our home."

The confession hung in the air between them. Under different circumstances, Clem might have felt sympathy for him. Now, it just added another layer to his deception.

"So you ran," she said flatly. "You ran away to Seattle without bothering to divorce her, and then you started something with me without telling me any of this."

"It wasn't like that," Derek insisted. "When I met you, when we started... I wasn't thinking about Addison. I was thinking about you. About us."

"There is no us," Clem said, the words cutting through her own heart as much as his. "There can't be. Not now."

"Clementine, please," Derek moved closer, his eyes pleading. "What I feel for you is real. That hasn't changed."

"Everything has changed," Clem countered, stepping back to maintain distance between them. "You're married, Derek. And maybe Addison did something terrible to you, but that doesn't change the fact that you lied to me by omission. After everything I told you about Callahan, about my trust issues, you still chose not to tell me."

Derek's shoulders slumped, the fight seeming to drain out of him. "I was afraid of losing you."

"Well," Clem said, gathering all her remaining strength, "now you have anyway."

She moved past him toward the door, pausing briefly when she drew level with him. "I'd appreciate it if you'd assign me to a different service. I can't work with you right now."

"Clementine—" he reached for her arm, but she pulled away.

"It's Dr. Hart," she corrected, her voice steady despite the tears threatening to fall. "And I believe Dr. Bailey is looking for me."

As she walked away, leaving Derek standing alone in the basement hideout, Clem felt a strange mix of devastation and determination. Derek had lied—and whether Addison had hurt him or not, that betrayal was something Clem couldn't simply overlook.

She found Alex waiting in the corridor as promised, his expression unusually solemn.

"All good, Brooklyn?" he asked, falling into step beside her as she headed for the stairs.

"No," she answered honestly. "But I will be."

Chapter Text

WEDNESDAY AFTERNOON: THE HOSPITAL BARRICADE

The hospital corridors had never felt longer than they did that afternoon. Each step Clem took felt like walking through quicksand, her white coat suddenly too heavy on her shoulders. The news about Derek—Dr. Shepherd, she mentally corrected herself—had spread through Seattle Grace with the efficiency of a stage four malignancy, impossible to contain.

She rounded the corner toward the surgical board, steeling herself for another potential encounter, when Bohkee, the veteran scrub nurse who rarely spoke but missed nothing, caught her eye. The older woman made a subtle gesture toward the adjacent hallway just as Derek's voice became audible from around the corner.

Without hesitation, Clem slipped into the alternate corridor, nodding her silent thanks to Bohkee, who turned back to her charts with practiced indifference.

"Bohkee," Derek's voice carried clearly, tension evident in every syllable. "Have you seen Dr. Hart anywhere?"

Clem pressed herself against the wall, listening to Bohkee's characteristic silence—the woman could communicate volumes without saying a word.

"If you see her..." Derek's voice trailed off, followed by retreating footsteps.

"He's gone," George's voice came from behind her, making her jump.

"Jesus, O'Malley," she hissed, pressing a hand to her chest. "Don't sneak up on people."

George offered an apologetic smile, his naturally anxious demeanor somehow reassuring in its familiarity. "Sorry. Bailey sent me to find you. She's reassigned you to Burke's service for the rest of the week."

Clem felt a wave of relief wash over her. "Thank god."

"Yeah," George nodded, shifting awkwardly. "So, um, do you want to talk about—"

"No," Clem cut him off firmly. "I absolutely do not want to talk about it."

"Right, of course," George backpedaled quickly. "Totally understandable. Not talking. Got it." He paused, then added with surprising firmness for someone who usually apologized for breathing, "But just so you know, none of us think you did anything wrong. You didn't know."

The simple statement of solidarity threatened to crack Clem's carefully constructed composure. She managed a tight nod. "Thanks, George."

As they walked toward the cardio wing, George kept up a steady stream of nervous chatter about their patients—his usual anxious tendency somehow creating exactly the buffer of normalcy that Clem desperately needed. When they approached the nurses' station where Burke was reviewing charts, George suddenly became overly interested in a bulletin board display.

"The... uh... new hospital infection control protocols look fascinating," he said loudly, positioning himself to block Clem from the view of the adjacent corridor while pretending to study a poster about proper hand hygiene.

Confused, Clem glanced past him to see Derek at the far end of the hallway, clearly searching. Before he could spot her, a commotion erupted from the nearby trauma bay—Izzie's voice calling out urgent medical terminology that drew Derek's immediate attention as an attending.

"Is there some kind of system I don't know about?" Clem asked George under her breath.

George kept his eyes on the infection control poster with the intensity of someone studying for boards. "System? What system? There's no system. I just really care about... methicillin-resistant staphylococcus aureus prevention."

"O'Malley, Hart," Burke's commanding voice interrupted. "If you've finished your continuing education, I have a mitral valve repair waiting."

"Yes, sir," they replied in unison, hurrying toward the attending.

As Burke led them through the case details, Clem couldn't help noticing how he positioned himself between her and the corridor where Derek had been searching. It wasn't obvious—Burke was too professional for theatrical gestures—but the subtle placement felt deliberate.

"Dr. Hart, you'll be assisting me on this one," Burke continued, handing her the patient's chart. "O'Malley, you're on post-op monitoring for the Evans case."

"But I thought—" George began, then caught himself. "Yes, sir."

As George headed off to his assignment, Clem studied Burke's inscrutable expression. "Thank you, Dr. Burke."

Burke raised an eyebrow with that characteristic precision that made every gesture seem choreographed. "For what? Assigning you to a complex surgical case that will require your complete focus and concentration? I'm not doing you any favors, Dr. Hart. I expect excellence in my OR."

But there was something in his tone—a hint of understanding perhaps—that suggested Burke was very aware of the current hospital dynamics.

"Of course, sir," Clem nodded. "Complete focus and concentration."

"Good," Burke replied. "Because in my OR, there's no room for distractions. No matter who they come from." The emphasis was subtle but unmistakable.

---

Three hours later, Clem emerged from Burke's successful mitral valve repair feeling almost like herself again. The focus required by the complex procedure had been exactly what she needed—a reminder that whatever chaos was happening in her personal life, she was still a surgeon. Still capable.

As she washed up at the scrub sink, Bailey entered the adjacent OR prep area, her presence both comforting and intimidating in that uniquely Bailey way.

"Dr. Hart," Bailey nodded. "How was the valve repair?"

"Textbook," Clem replied. "Dr. Burke let me place the annuloplasty ring."

"Good," Bailey said, her tone business-like as always. "You're with Burke for the rest of the week. After that, you'll rotate to Torres in ortho."

Clem dried her hands slowly, recognizing the lifeline being thrown. "I appreciate that, Dr. Bailey."

Bailey fixed her with that penetrating stare that made interns wish for a convenient sinkhole to appear beneath them. "Don't appreciate it. Learn from it. Whatever is happening between you and a certain attending—which I do not want to hear about—is a distraction you can't afford as a surgeon."

"Yes, ma'am."

Bailey's expression softened almost imperceptibly, revealing the protective instinct beneath her notorious exterior. "This hospital runs on two things, Hart. Medicine and gossip. One heals patients. The other just creates casualties."

With that, Bailey turned to leave, but paused at the doorway. "He's been asking the nurses about your whereabouts. If you were heading to the cafeteria, I'd suggest taking the south corridor."

Before Clem could respond, Bailey was gone, leaving her to marvel at the resident's uncanny ability to simultaneously reprimand and protect her interns.

---

The hospital cafeteria buzzed with its usual afternoon energy—staff grabbing late lunches between surgeries, residents debating cases over coffee, the constant undercurrent of hospital life continuing despite personal dramas. Clem navigated through the maze of tables, tray in hand, scanning for a quiet corner where she might eat in peace.

She'd almost reached an empty table by the windows when she heard it—her name being discussed at a nearby table of senior residents.

"—sleeping with an attending and then acting shocked when there's a wife," a female voice was saying with the casual cruelty that hospital gossip encouraged. "Classic intern move."

"Right?" another resident laughed. "Like, welcome to medicine, sweetheart. They don't put 'married' on the hospital badge."

"At Columbia she was involved with some department head too," a third voice added with obvious satisfaction. "Heard there was an ethics investigation and everything. Girl's got a type."

Clem froze mid-step, her tray suddenly feeling impossibly heavy. The urge to turn around, to confront them, to defend herself surged through her chest. But before she could move or speak, another voice cut through the gossip like a scalpel.

"You know what else is a classic move?" Alex's voice, sharp and carrying clearly across the cafeteria. "Talking trash about colleagues because you're threatened by their actual surgical skills."

Clem turned to see Alex standing near the residents' table, his expression radiating the kind of controlled aggression that made people step back.

"Stay out of it, Karev," one of the residents warned, but there was uncertainty in her voice.

"Or what?" Alex challenged, his trademark smirk replaced by something darker. "You'll spread rumors that I'm sleeping with an attending too? Sorry to disappoint, but I'm earning my surgeries the old-fashioned way—by being better than half the residents in this place."

"You're one to talk about ethics," the female resident scoffed, but she was already gathering her things.

"At least I own my mistakes," Alex shot back without missing a beat. "Unlike you people acting like you've never crossed a line in this hospital." He paused, letting his gaze sweep the table with obvious disdain. "And for the record, Hart diagnosed an arterial embolism that Davidson over there missed last week. Maybe worry less about who she's sleeping with and more about the patients you're not saving."

The targeted resident flushed red, but the group was already dispersing under Alex's withering stare.

Without missing a beat, Alex turned away from the now-silent residents and spotted Clem standing there. "Brooklyn," he said, jerking his head toward an empty table by the window. "Let's eat."

Grateful for the escape and slightly stunned by his fierce defense, Clem followed him to the table, setting her tray down across from his. For a moment, neither spoke.

"You didn't have to do that," she finally said.

"Do what?" Alex asked, focusing intently on unwrapping his sandwich with the kind of deliberate casualness that suggested the conversation was over.

"Defend me."

Alex shrugged, not meeting her eyes. "They're idiots. Besides, I wasn't defending you. I was stating facts."

"Right," Clem nodded, understanding the game. "Just the facts."

"Don't make it a thing, Hart," Alex muttered, but there was less bite in his tone than usual—almost gentle, by Alex Karev standards.

They ate in companionable silence for a few minutes before the rest of their group appeared. Izzie slid onto the bench beside Clem with her usual boundless energy, while George settled across from them, and Meredith appeared last, looking characteristically disheveled but alert.

"Burke let you place the annuloplasty ring?" Izzie asked, her eyes lighting up with genuine excitement. "That's huge! Burke never lets interns do the technical stuff."

"Yeah," Clem agreed, grateful for the normal surgical conversation. "His technique is incredible. So precise."

"I heard Satan's wife is taking over the TTTS case," Meredith said with her typical dark humor, then caught herself as everyone turned to look at her. "Sorry. I mean Dr. Montgomery-Shepherd. The brilliant neonatal surgeon who also happens to be stunning and married to McDreamy."

George winced. "Meredith..."

"It's fine," Clem said, surprising herself with how steady her voice sounded. "You can talk about her. She works here now, apparently. Might as well get used to it."

"Have you actually met her?" Meredith asked with characteristic directness.

"Oh yes," Clem replied, stabbing a piece of lettuce with more force than necessary. "We've been thoroughly introduced."

The four other interns exchanged glances, that wordless communication that had developed between them over months of surviving residency together.

"Well, she's supposed to be brilliant," Izzie offered diplomatically. "Double board-certified and everything."

"And hot," Alex added with his usual lack of filter, earning immediate glares from both Izzie and Meredith. "What? She is. It's an objective medical observation."

Despite everything, Clem found herself laughing—a real laugh that surprised her with its genuineness. "Yes, Alex. She's gorgeous. And brilliant. And accomplished. And married to Der—Dr. Shepherd." She shook her head with dark humor that would have made Meredith proud. "I really know how to pick them, don't I?"

"Hey," George said with unusual firmness. "You didn't pick anyone. You didn't know he was married."

"Exactly," Meredith agreed, her voice carrying the weight of someone who understood complicated relationships. "Shepherd's the one who lied by omission."

"Can we please talk about literally anything else?" Clem asked. "Please?"

"Mrs. Patterson in 3187 might need her gallbladder out," Alex offered immediately, switching gears with surprising sensitivity. "Bailey's going to let me scrub in if the scan shows what I think it shows."

"Lucky," Izzie said with appropriate surgical envy. "I'm stuck doing post-ops all afternoon."

Just like that, they were back to normal intern conversation—competing for procedures, complaining about residents, debating treatment protocols. For a brief moment, Clem felt almost normal again.

Until she noticed Derek entering the cafeteria, his eyes immediately scanning the room until they found her table. For a heartbeat, their gazes locked across the crowded space, his expression a complicated mixture of regret and determination that she recognized all too well.

Then, as if choreographed by some unspoken signal, her fellow interns shifted into action. George leaned back in his chair, effectively blocking Derek's line of sight. Izzie immediately launched into an animated discussion about their afternoon surgeries, her voice pitched to demand attention. Meredith turned to face Clem directly, creating a wall of conversation. Alex somehow managed to "accidentally" knock over his water glass, the minor commotion drawing curious looks and forcing Derek to navigate around the small crowd that gathered to help clean up.

"You guys are ridiculous," Clem muttered under her breath, but she couldn't deny the warmth spreading through her chest at their instinctive protection.

"Don't know what you're talking about," Alex replied innocently, mopping up spilled water with napkins while maintaining perfect awareness of Derek's location. "I'm just naturally clumsy."

"Very clumsy," Meredith agreed with a straight face that didn't fool anyone.

"We should go," Izzie announced suddenly. "I want to check on my post-ops before evening rounds."

As they gathered their trays and prepared to leave, Clem caught one more glimpse of Derek across the cafeteria. He was still watching their table, his expression unreadable but intent. For a moment, she felt the familiar pull—the urge to go to him, to hear his explanations, to try to make sense of the mess they'd created.

Then Meredith's hand landed gently on her arm. "Come on," she said quietly, understanding without explanation. "Let's go practice some actual medicine."

For the first time since Addison Montgomery-Shepherd had appeared in her perfectly tailored suit, Clem felt something other than humiliation and betrayal. Here, surrounded by fellow interns who barely knew her full story but had somehow decided she was worth protecting, she found an unexpected sanctuary.

The fallout from Derek's deception was far from over—she could feel his presence in the hospital like a constant low-grade fever. But in this moment, flanked by her fellow survivors of surgical internship, Clem allowed herself to believe that maybe she would survive this too.

After all, if she could survive Bailey's rounds, Burke's expectations, and the general chaos of Seattle Grace Hospital, she could certainly survive one lying attending with beautiful hair and a secret wife.

Even if it felt like her heart might not.

Chapter Text

Monday Morning

The orthopedic wing had always felt like neutral territory to Clem—all broken bones and straightforward fixes, far removed from the emotional landmines that seemed to explode around neurosurgery these days. She'd been looking forward to a week with Torres, whose reputation for no-nonsense directness and excellent teaching made her a favorite among the interns.

"Hart!" Torres called out as Clem approached the nurses' station, her voice carrying that particular blend of authority and warmth that made residents want to impress her. "Ready to learn how to put people back together properly?"

"Yes, ma'am," Clem replied, genuinely smiling for the first time in days. "Looking forward to it."

Torres was pulling up X-rays on the computer when Chief Webber appeared at her shoulder, his expression unreadable in that way that made everyone in his vicinity suddenly question their life choices.

"Dr. Torres," he said, his voice carrying the weight of administrative authority. "I need to make a change to your intern assignments."

Torres frowned, her fingers pausing over the keyboard. "Sir?"

"Dr. Hart will be reassigned to Dr. Montgomery-Shepherd's service for the week. High-risk pregnancy cases require additional support."

Clem felt her stomach drop somewhere around her ankles. "Chief Webber, I—"

"The decision is final," Webber interrupted, though not unkindly. "Dr. Montgomery-Shepherd specifically requested you for her cases."

Torres looked between Clem and the Chief, her sharp eyes missing nothing. "With respect, sir, Dr. Hart was assigned to my service. I had plans for her surgical education this week."

"And now she'll receive surgical education in neonatal procedures," Webber replied smoothly. "The reassignment is effective immediately."

As Webber walked away, Torres turned to Clem with a look of genuine concern. "You okay with this? Because if there's a reason you shouldn't be working with Montgomery-Shepherd..."

Clem forced her most professional expression. "It's fine, Dr. Torres. Thank you for asking."

Torres studied her for another moment, then nodded slowly. "Well, if you need anything—and I mean anything—you know where to find me."

Monday Afternoon: Welcome to Hell

The neonatal intensive care unit occupied an entirely different universe from the rest of Seattle Grace. Everything was smaller, more delicate, bathed in the soft lighting designed to protect developing eyes. It should have been peaceful. Instead, as Clem approached the nurses' station where Addison Montgomery-Shepherd stood reviewing charts, it felt like walking into a beautifully appointed lion's den.

"Dr. Hart," Addison said without looking up from her paperwork, her voice carrying the kind of professional politeness that could freeze water. "How lovely. I was hoping we'd have a chance to work together."

The way she said "work together" made it sound like a threat wrapped in silk.

"Dr. Montgomery-Shepherd," Clem replied, keeping her voice steady. "Chief Webber said you needed additional support."

"Oh, I do," Addison smiled, finally looking up. Even in scrubs, she managed to look like she'd stepped off the cover of a surgical journal. "I have quite a few... educational opportunities for you this week."

Something in her tone made Clem's professional instincts sharpen. "What kind of opportunities?"

Addison's smile widened, revealing perfect teeth that somehow looked predatory. "Well, to start, I need someone to run down to the lab and personally collect the results from all the morning draws for the NICU patients. Then there are about thirty charts that need updating with the latest vitals. After that, the breast milk refrigeration unit needs a complete inventory—we can't be too careful about proper storage protocols."

Clem blinked. These were tasks typically assigned to medical students or first-week interns who needed to learn hospital systems. "Ma'am, with respect, wouldn't my time be better spent observing procedures or—"

"Dr. Hart," Addison interrupted, her voice dropping to that dangerous register that suggested thin ice ahead. "Are you questioning my educational methods?"

"No, ma'am."

"Good. Because I find that interns learn best when they understand every aspect of patient care, from the most basic tasks to the most complex procedures. You'll observe surgeries when I feel you've demonstrated sufficient competence in the fundamentals."

Translation: You'll observe surgeries when hell freezes over.

"Of course," Clem nodded, recognizing a losing battle when she saw one. "I'll start with the lab results."

"Excellent," Addison replied, already turning back to her charts. "Oh, and Dr. Hart? I prefer my lab results hand-delivered with a complete verbal summary of any abnormal values. I find it's a wonderful way for interns to really engage with the data."

As Clem headed toward the elevator, she could practically feel Addison's satisfied smile boring into her back. This was going to be the longest week of her residency.

Tuesday: The Scut Work Continues

By Tuesday afternoon, Clem had personally walked enough miles between the NICU and various hospital departments to qualify for a marathon. Her morning had been spent reorganizing medical supply closets ("Organization is the foundation of surgical excellence, Dr. Hart"), followed by an hour of alphabetizing patient files ("Attention to detail in records keeping directly correlates to attention to detail in surgery").

She was in the middle of transcribing nursing notes—by hand, because Addison believed computer transcription "lacked the personal touch"—when Alex found her in the small resident workroom adjacent to the NICU.

"Jesus, Brooklyn," he said, dropping into the chair across from her. "You look like shit."

"Thanks for the pep talk," Clem muttered, not looking up from the chart she was copying. "Really what I needed today."

Alex leaned forward, studying the pile of paperwork around her. "What the hell is all this?"

"Educational opportunities," Clem replied, mimicking Addison's tone perfectly. "I'm learning the fundamentals of patient care."

"By copying charts?"

"By hand," Clem emphasized. "Because apparently my computer transcription skills are inadequate for neonatal care."

Alex was quiet for a moment, his usual sarcasm notably absent. "She's screwing with you."

"You think?" Clem finally looked up, her exhaustion evident. "What gave it away? The fact that I haven't seen the inside of an OR in two days, or that I've personally counted every bottle of formula in the NICU?"

"She has you doing inventory?"

"Inventory control is essential for proper nutrition management," Clem recited wearily. "Also, I've memorized the proper storage temperature for seventeen different types of breast milk supplements."

Alex's expression darkened. "That's bullshit. She can't use you as her personal bitch."

"She's not," Clem said, though her voice lacked conviction. "She's providing comprehensive educational experiences."

"Brooklyn." Alex's voice was uncharacteristically serious. "I got to scrub in on my first day with Burke. This isn't education. This is punishment."

Before Clem could respond, Addison's voice drifted from the NICU. "Dr. Hart? I need those transcriptions completed within the hour. We have several new admissions coming in."

Clem closed her eyes briefly, summoning what remained of her professional composure. "Coming, Dr. Montgomery-Shepherd."

As she gathered her papers, Alex caught her arm. "You don't have to take this. Go to Bailey."

"And say what?" Clem asked. "That the attending doesn't like me because I slept with her husband? That'll go over real well."

"You didn't know he was married."

"Doesn't matter," Clem replied, pulling free. "She's not technically doing anything wrong. Everything she's assigning me is legitimate. Just... creatively humiliating."

Wednesday: The Syphilis Outbreak

The morning started with the kind of hospital-wide panic that made even experienced staff members look nervous. Clem was in the middle of her latest assignment—personally delivering laboratory results to every attending physician in the hospital because Addison believed "face-to-face communication builds professional relationships"—when she noticed the unusual activity in the corridor.

Nurses were setting up tables and privacy screens with the efficiency of people preparing for a natural disaster. Senior residents huddled in urgent conversations. The usual hospital buzz had taken on an edge of collective anxiety.

"What's going on?" Clem asked Tyler, who was helping set up what looked suspiciously like a screening station.

Tyler glanced around nervously before lowering his voice. "Syphilis outbreak. Started with some of the interns and residents... let's just say it's spread. Now everyone who might have been exposed needs testing."

Clem felt her eyebrows rise. "Everyone?"

"Chief's orders. No exceptions," Tyler confirmed grimly.

As if summoned by their conversation, a steady stream of hospital staff began forming lines near the makeshift testing stations. Clem recognized faces from every department—attendings trying to look dignified while standing in what was essentially a walk of shame, residents whispering among themselves, nurses maintaining professional composure while clearly dying of curiosity about their colleagues.

She spotted Alex in one of the lines, looking characteristically defiant despite the circumstances. When their eyes met, he gave her a sardonic salute that somehow managed to be both embarrassing and endearing.

"Dr. Hart." Addison's voice cut through the corridor noise with surgical precision. "I trust you're not allowing current events to distract from your responsibilities?"

"No, ma'am," Clem replied, hefting her stack of lab results. "Just delivering the cardiology reports to Dr. Burke."

"Good. When you've finished, I need you to personally verify the sterilization protocols for all the NICU equipment. We can't be too careful about contamination during times like these."

As Addison glided away in her perfectly pressed lab coat, Clem couldn't help but notice that even facing a hospital-wide STD outbreak, the woman managed to look like she was walking a runway.

Wednesday Afternoon: The Confrontation

Clem was heading back from the lab with yet another stack of results when she rounded the corner and nearly collided with Derek. He looked like he hadn't slept properly in days—which, she realized with a mixture of satisfaction and unwanted concern, he probably hadn't.

"Clementine," he said, stepping directly into her path. "We need to talk."

"Dr. Hart," she corrected automatically, clutching her lab results like armor. "And I'm working."

"Five minutes," Derek said, his voice carrying that desperate edge she'd heard too often lately. "Please."

For a moment, Clem considered walking around him. The rational part of her brain suggested avoiding this conversation entirely. But weeks of suppressed frustration were simmering just below the surface, and suddenly she was tired of running.

"About what?" she asked, her voice carefully neutral.

"About us. About what happened. About—"

"There is no 'us,'" Clem interrupted, but without the heat she might have expected from herself. Instead, she felt oddly detached, like she was watching the conversation from a distance. "And what happened is that you lied. What's to discuss?"

Derek's face tightened. "I didn't lie. The situation was complicated—"

"Complicated," Clem repeated, glancing past him toward the testing stations where staff members continued to queue up for STD screening. The irony wasn't lost on her. "You know, seeing all this makes me wonder if there were other things you forgot to mention."

It was a subtle dig, delivered with the kind of Brooklyn directness that made it impossible to misinterpret while still maintaining plausible deniability. Derek's face went pale, then flushed.

"That's not fair," he said quietly.

"Fair?" Clem asked, but her voice lacked the anger Derek seemed to be expecting. Instead, there was something colder in her tone—disappointment, maybe, or simple exhaustion. "I told you about Callahan. I told you exactly what that betrayal did to me. And you listened, and nodded, and let me believe you were different."

Derek stepped closer, his voice dropping to that persuasive register she remembered too well. "I am different. What Addison and I have—had—it's not the same thing. We were over long before I came to Seattle."

"Then why didn't you divorce her?" Clem asked simply.

The question hung in the air between them. Derek opened his mouth, then closed it, clearly struggling for an answer that would make sense.

"Because," he finally said, "it's complicated."

"Right," Clem nodded, feeling something settle into place inside her chest. "Complicated."

She started to walk away, but Derek caught her arm—gently, but firmly enough to make her stop.

"Clem, please. Don't give up on us because of this. What we had was real."

For a moment, looking at his desperate expression, Clem felt an echo of the old attraction. But it was distant now, like a song playing in another room.

"What we had," she said quietly, "was based on me not knowing who you really were. That's not real, Derek. That's just... convenient."

This time when she walked away, Derek didn't follow.

Wednesday Evening: Aftermath

The intern lounge was blessedly quiet when Clem finally collapsed onto one of the worn couches, her completed lab deliveries forgotten on the floor beside her. The confrontation with Derek had left her feeling strangely empty—not devastated, as she might have expected, but drained in the way that came after a fever finally broke.

She was staring at the ceiling when Meredith appeared, settling onto the adjacent couch without invitation or comment.

"Heard you had words with McDreamy," Meredith said after a moment.

"Word travels fast around here."

"Hospital's smaller than it looks," Meredith replied with characteristic pragmatism. "Plus, he's been moping around the neuro ward like someone killed his dog."

Clem found herself almost smiling despite everything. "His perfectly coiffed, surgically gifted dog."

"Exactly." Meredith studied her with sharp eyes. "You seem... different than I expected."

"Different how?"

"Less devastated. More..." Meredith paused, searching for the word. "Resolved, maybe?"

Clem considered this. "I think I'm just tired of caring about it. About him." She turned to look at Meredith. "Does that make me heartless?"

"Makes you smart," Meredith replied without hesitation. "Heartless would be if you'd never cared at all."

Before Clem could respond, the lounge door opened and Alex slouched in, looking characteristically disheveled.

"Brooklyn," he said, dropping into a chair across from them. "You look like hell."

"Thanks for the continued moral support," Clem replied dryly.

"How's life with Satan in heels?" Alex asked with his usual tact.

"Educational," Clem said flatly. "Apparently I need to learn proper medical supply organization before I'm ready for actual medicine."

"That's bullshit."

"That's targeted harassment disguised as teaching," Meredith corrected. "But calling it bullshit works too."

Alex leaned forward, his expression more serious than usual. "How much longer do you have with her?"

"Two more days," Clem replied. "Then back to Bailey."

"You can survive two days," Alex said with uncharacteristic certainty. "Hell, you survived today. That's something."

Just then, Izzie and George appeared in the doorway, both looking slightly frazzled.

"There you are," Izzie said, settling onto the couch beside Clem. "We've been looking for you."

"Hiding," Clem admitted. "It seemed like the safest option."

"Smart," George agreed, perching on the arm of Alex's chair. "Did you hear about the Chief calling an all-hands meeting tomorrow about 'professional conduct and hospital relationships'?"

Clem groaned. "Please tell me that's not about—"

"It's not about you specifically," Izzie said quickly. "More about the... general chaos. The syphilis thing has everyone on edge."

"Plus, apparently three different attendings complained about the gossip affecting patient care," George added.

"Great," Clem muttered. "I'm affecting patient care now."

"You're not doing anything," Meredith said firmly. "Other people's inability to mind their own business is affecting patient care."

"Meredith's right," Izzie agreed. "This isn't your fault."

Looking around at her fellow interns, Clem felt something loosen in her chest. Here, in this cramped lounge with these people who barely knew her full story but had somehow decided she was worth defending, everything felt more manageable.

"Thanks," she said simply. "For... all of this."

"All of what?" Alex asked with mock confusion. "We're just sitting here."

"Right," Clem agreed, understanding the deflection. "Just sitting here."

But as conversation drifted to safer topics—upcoming rotations, difficult patients, Bailey's latest impossible demands—Clem allowed herself to believe that maybe this was enough. Maybe complicated attendings with secret wives weren't the most important part of her life after all.

Maybe what mattered was right here: people who sat with you when everything fell apart, who defended you without being asked, who treated your problems like they mattered without making a big production of it.

Everything else—Derek, Addison, the hospital gossip—would sort itself out eventually.

After all, she had exactly two more days to survive, and she wouldn't be doing it alone.

Chapter Text

Friday Evening: Arrival

Clem was pacing the living room of Meredith's house, straightening throw pillows that didn't need straightening and checking the time for the tenth time in five minutes. Her mother's flight had landed an hour ago, which meant Kit Hart would be walking through the front door any minute with her particular brand of Brooklyn practicality and maternal radar that could detect emotional upheaval from three states away.

"You're making me nervous just watching you," Izzie said from the kitchen, where she was attempting to make the place look less like a disaster zone inhabited by overworked medical residents. "She's your mom, not a hospital inspection."

"You don't understand," Clem replied, moving a medical journal from the coffee table to the bookshelf. "My mother has twenty years of ER nursing experience. She can assess someone's entire life situation in under thirty seconds. I need this place to say 'thriving young professional' not 'barely functional intern having emotional breakdown.'"

"What emotional breakdown?" Alex called from upstairs. "You've been weirdly functional lately. It's disturbing."

"Thanks for the vote of confidence, Karev," Clem shot back, though her voice carried the familiar edge of their comfortable antagonism.

George emerged from his room, nervously adjusting his shirt. "Should we, uh, maybe not mention the whole thing with—"

"There is no thing," Clem interrupted firmly. "We're all just friends and colleagues living our best intern lives."

Meredith appeared at the top of the stairs, taking in Clem's manic energy with characteristic directness. "You know she's going to figure it out anyway, right? Mothers have supernatural powers for that stuff."

Before Clem could respond, the doorbell rang. She froze.

"That's her," she whispered.

"It's a doorbell, not a firing squad," Alex said, jogging down the stairs. "Want me to get it?"

"No, I'll—" But Alex was already opening the door.

"You must be Mrs. Hart," he said, his voice taking on uncharacteristic politeness. "I'm Alex. We've heard a lot about you."

Katherine Hart stepped into the entryway, and Clem felt the familiar mix of love and slight intimidation that her mother always inspired. At fifty-four, Kit retained the sharp alertness of someone who'd spent decades making split-second decisions in emergency situations. Her salt-and-pepper hair was pulled back in a practical ponytail, and she wore the kind of comfortable but put-together clothes that suggested someone who valued both function and self-respect.

"It's Kit," she said, shaking his hand with the firm grip Clem remembered from childhood. "And you must be the one who keeps my daughter from taking herself too seriously."

Alex grinned. "That's me. Professional ego deflator."

Kit's eyes swept the room, taking in the controlled chaos of medical textbooks, takeout containers, and the general lived-in quality of a house full of residents. Her gaze lingered on each roommate as they introduced themselves—Izzie with her genuine warmth, George with his nervous politeness, Meredith with her guarded friendliness.

"So," Kit said after the introductions, setting down her overnight bag, "this is where my daughter has been hiding out."

"I haven't been hiding," Clem protested, accepting her mother's hug. "I've been working. There's a difference."

"Hmm," Kit replied, the sound carrying twenty six years of maternal skepticism.

Saturday Morning: Maternal Interrogation

The next morning found Kit in the kitchen at six AM, because some habits die hard, making coffee with the competence of someone who'd survived decades of hospital shifts. Clem stumbled downstairs to find her mother had somehow made their disastrous kitchen look almost functional.

"You're up early for someone on vacation," Clem observed, accepting a mug of coffee that was significantly better than anything they usually managed to produce.

"Internal clock," Kit replied simply. "Twenty years of twelve-hour shifts will do that to you." She studied Clem over her coffee. "You look tired."

"I'm an intern. Tired is my natural state."

"This is different tired," Kit said with the kind of certainty that made Clem's stomach clench. "This is 'something happened' tired."

Clem took a deliberate sip of coffee, buying time. "Nothing happened. I'm just adjusting to life here."

"Seattle treating you well?"

"It's fine. Good program, good learning opportunities."

Kit's expression suggested she was filing away all the things Clem wasn't saying. "Your roommates seem nice. That Alex has sharp instincts."

"Alex is..." Clem paused, considering how to explain Alex Karev to her mother. "Alex is complicated. He's got a good heart buried under layers of aggressive sarcasm and trust issues."

"The best ones usually do," Kit agreed. "And the others?"

"Meredith's brilliant but keeps everyone at arm's length. Izzie's impossibly optimistic and somehow makes everyone feel like family. George is sweet and earnest and probably too good for this place."

Kit nodded, processing. "Sounds like you've found your people."

"I guess I have," Clem realized, surprised by how true that felt.

Just then, Alex appeared in the kitchen, hair sticking up at odd angles and wearing a wrinkled t-shirt and boxers.

"Morning, Kit," he said, making a beeline for the coffee. "Fair warning—George used all the hot water again, so if you're planning to shower, prepare for an arctic experience."

"I've survived worse," Kit replied with amusement.

Alex grinned. "I like you already."

As conversation flowed around the kitchen—Alex complaining about his upcoming shift with Burke, Kit asking knowledgeable questions about the hospital's trauma protocols—Clem felt herself relax for the first time in weeks. This felt normal. Safe.

Saturday Afternoon: The Unwelcome Visitor

Clem had run out to pick up Chinese food for lunch, leaving Kit to get acquainted with the house and its inhabitants. Meredith was at the hospital, George was hiding in his room with textbooks, and Izzie was giving Kit a tour of their makeshift study space when the doorbell rang.

Alex, who was sprawled on the couch reviewing surgical procedures, groaned as he hauled himself upright. "If that's another one of George's study group friends, I'm moving out."

He opened the door to find Derek Shepherd on the front step, looking uncharacteristically uncertain.

"Is Clem here?" Derek asked without preamble.

Alex's expression shifted from mild annoyance to active hostility in the space of a heartbeat. "No."

"Do you know when she'll be back?"

"Why?"

Derek seemed to register Alex's tone for the first time. "Look, I just need to talk to her for five minutes. It's important."

"Important," Alex repeated, his voice flat. "Like it was important when you forgot to mention your wife?"

"Alex, I know you think—"

"I don't think anything," Alex interrupted, stepping into the doorway to block entry. "But I know Brooklyn's been sleeping better and actually eating lunch instead of stress-vomiting in supply closets. So whatever you're selling, she's not buying."

From the living room, Kit's voice carried clearly: "Everything alright out there?"

Alex called back without taking his eyes off Derek. "Just someone who has the wrong address."

Derek's face tightened. "Five minutes, Alex. That's all I'm asking."

"And I'm telling you to get lost," Alex replied steadily. "She doesn't want to talk to you. She's made that pretty clear by avoiding you for three weeks."

"She hasn't given me a chance to explain—"

"Explain what?" Alex's voice was rising now, weeks of protective irritation finally finding an outlet. "That you're married? That you let her think she was losing her mind with all those mysterious phone calls? That you knew about what happened to her in New York and you pulled the same crap anyway?"

Kit appeared in the doorway behind Alex, her nursing instincts clearly activated by the tension in his voice. Her eyes moved from Alex's rigid posture to Derek's face, taking in the expensive haircut, the practiced charm, the air of someone used to getting his way.

She didn't say anything, just crossed her arms and watched with the sharp assessment of someone who'd spent twenty years reading people in crisis.

Derek noticed her presence and seemed to realize he was being evaluated. "You must be Clem's mother. I'm Derek Shepherd."

Kit's expression didn't change. "I know who you are."

The words carried a weight that made Derek shift uncomfortably. Kit's silence was somehow more intimidating than any lecture could have been.

"Look," Derek said, turning back to Alex, "I just need to explain the situation—"

"The situation," Alex interrupted, "is that you're married and she didn't know it. Pretty simple situation."

Derek's jaw worked silently for a moment. "It's more complicated than that."

Kit made a small sound—not quite a laugh, not quite a snort—that managed to convey exactly what she thought of men who described their dishonesty as "complicated."

Derek looked between Kit's narrowed eyes and Alex's hostile stance, recognizing a united front when he saw one.

"Could you just tell her I came by?" he asked finally.

"No," Alex said simply. "I don't think I will."

Derek stood there for another moment, clearly wanting to argue, but Kit's continued silent assessment seemed to drain the fight out of him. Without another word, he turned and walked back to his car.

Alex closed the door and turned to Kit. "Sorry about that."

"Nothing to apologize for," Kit replied, though her eyes remained sharp. "That the attending?"

"That's the attending," Alex confirmed.

Kit nodded once, filing away the information. "Good instincts," she said finally.

Saturday Evening: Secrets

Later that evening, after Clem had returned with Chinese food and the group had settled into the easy rhythm of shared meals and casual conversation, Izzie found herself alone with Kit in the kitchen. Everyone else had migrated to the living room for a night of medical documentaries and competitive diagnosis.

Izzie was washing dishes when she heard a familiar sound—the distinctive rattle of pills in a prescription bottle. She glanced over to see Kit discreetly taking what looked like two small white tablets, chasing them with water.

The movement was practiced, automatic, but something about it nagged at Izzie. Maybe it was the way Kit glanced toward the living room first, or the careful way she tucked the bottle back into her purse.

"Headache?" Izzie asked casually.

Kit paused almost imperceptibly. "Something like that."

But Izzie had worked enough clinical rotations to recognize the gesture. The timing—after eating. The discretion. The specific way Kit had positioned herself to block the view from the living room.

"My mom takes Compazine for migraines," Izzie said carefully, testing.

Kit's hand stilled on the dish towel. "Does she?"

"Yeah. Really helps with the nausea that comes with them."

The silence stretched between them, loaded with understanding. Kit's eyes met Izzie's, and in that moment, both women knew the conversation had shifted to something much more serious than headaches.

"Izzie," Kit said quietly.

"I didn't see anything," Izzie replied immediately, but her voice carried too much understanding for the denial to be convincing.

Kit studied her for a long moment, taking in Izzie's genuine concern and natural discretion. Finally, she sighed.

"How much do you know about oncology?" Kit asked.

Izzie felt her heart sink. "Enough."

"Pancreatic," Kit said simply. "Stage three. Possibly four, depending on which oncologist you ask."

The words hit Izzie like a physical blow. She'd seen enough cancer cases to know what pancreatic cancer meant, especially at that stage.

"Kit..." she whispered.

"The prognosis isn't great," Kit continued matter-of-factly. "Six months if I'm lucky. Maybe less."

"Does Clem know?"

Kit shook her head firmly. "And she's not going to. Not yet."

"But—"

"Look at her," Kit interrupted, gesturing toward the living room where Clem's laughter could be heard over some debate about proper suturing techniques. "She's finally starting to find her footing here. She's building real friendships, focusing on her work, creating a life. I'm not going to destroy that."

Izzie felt tears prick her eyes. "She has a right to know."

"She has a right to finish her intern year without managing my medical care," Kit replied firmly. "She has a right to become the surgeon she's meant to be without feeling guilty about not being home taking care of me. She has a right to be twenty-six and brilliant and focused on her future instead of watching me die."

"That's not fair to you."

Kit smiled, the expression both sad and determined. "Honey, fair went out the window when my husband died and left me to raise an eight-year-old alone. This is just the latest chapter."

Izzie wiped her eyes with the back of her hand. "What can I do?"

"Keep my secret," Kit said simply. "At least until her intern year is over. Let her have this time."

Looking at Kit's resolute expression, Izzie understood that this wasn't really a request—it was a mother's final gift to her daughter. The gift of normalcy. Of time to become who she was meant to be without the weight of impending loss.

"Okay," Izzie agreed quietly. "But if you need anything—anything at all—you call me. Promise?"

Kit reached over and squeezed Izzie's hand. "Promise."

From the living room, Clem's voice called out: "Mom! Come settle a debate about whether Alex actually knows what he's talking about regarding cardiac procedures!"

"Coming," Kit called back, her voice perfectly normal. She looked at Izzie one more time. "Thank you."

As they rejoined the group, Izzie watched Kit slip seamlessly back into the role of visiting mother—proud, interested, gently teasing. No one would ever guess she was carrying a death sentence.

Except now Izzie was carrying it too, and she wasn't sure how she was going to keep that kind of secret without it destroying her.

But looking at Clem's genuine smile as she defended Alex's surprisingly solid knowledge of cardiothoracic surgery, Izzie understood why Kit was asking. Some gifts were worth the pain of keeping them.

Sunday Morning: Departure

Kit's flight wasn't until evening, but the morning carried the particular weight that comes with knowing time is more limited than anyone realizes. She was sitting on the front porch with her coffee, watching Seattle wake up, when Alex joined her.

"Mind if I sit?" he asked.

"Course not." Kit shifted over to make room on the porch steps.

They sat in comfortable silence for a while, watching the neighborhood come to life.

"Thank you," Kit said finally. "For yesterday. With the doctor."

Alex shrugged. "Guy was being a dick."

"Still. You didn't have to stand up for her like that."

"Yeah, I did," Alex replied simply. "She's... she's been through enough crap. And she's finally starting to seem less like she's waiting for the other shoe to drop."

Kit studied his profile. "You care about her."

"We all do," Alex said, but there was something in his voice that suggested the caring ran deeper than simple friendship.

"She talks about you differently than the others," Kit observed. "When she mentions your name, her voice changes."

Alex's jaw tightened slightly. "She's got enough drama in her life right now."

"Maybe drama isn't always bad," Kit suggested gently. "Maybe sometimes it's just... life waiting for the right moment."

Before Alex could respond, the front door opened and Clem appeared, still in pajamas and holding her own coffee.

"There you are," she said, settling on the porch steps beside them. "I was wondering where everyone disappeared to."

"Just enjoying the morning," Kit replied, though Izzie, watching from the kitchen window, noticed the way Kit's eyes lingered on her daughter's face, as if memorizing it.

"So," Clem said, looking between her mother and Alex, "what were you two conspiring about?"

"Your questionable taste in roommates," Kit replied without missing a beat.

"Hey," Alex protested with mock offense. "I'm a delight to live with."

"You left your dirty dishes in the sink for four days," Clem pointed out.

"That was strategic," Alex argued. "I was testing everyone's breaking point."

As they fell into easy banter, Kit felt a deep sense of satisfaction. This was what she'd wanted to see—Clem integrated into a chosen family, defended and cared for, laughing freely. Whatever challenges lay ahead, her daughter wouldn't face them alone.

When it came time for goodbyes later that evening, Kit hugged each of the roommates individually, but saved Clem for last.

"I'm proud of you," she said simply, holding her daughter tight. "Your father would be proud too."

"I love you, Mom," Clem replied, and Kit heard the echo of the little girl who used to bandage her dolls after watching Kit come home from the hospital.

"Love you too, baby," Kit whispered back. "Take care of yourself. And let these people take care of you too."

As Kit's taxi pulled away, Clem stood on the porch waving until the taillights disappeared. She didn't notice Izzie watching from the window, tears streaming down her face, or the way Alex lingered beside her even after the car was gone.

Some secrets, Kit had taught her daughter long ago, were kept out of love. And some goodbyes were too important to know they were final.

Chapter Text

Hospital Hallway

Bailey stood in the hallway outside the patient rooms, her clipboard held with characteristic authority as the six interns gathered around her. The morning light filtered through the windows, casting long shadows across the linoleum floor as she prepared to assign the day's cases.

"Listen up, people. Today we have actual medicine to practice instead of whatever it is you've been doing that passes for patient care." Bailey's voice carried its usual mix of sternness and barely concealed affection. "Dr. Yang, you're with Dr. Burke on the conjoined twins in room 304. This is a complex case involving shared cardiovascular and hepatic systems."

Cristina's eyes lit up with the kind of intensity she reserved for challenging cardiac procedures.

"Shared liver, shared inferior vena cava, complex vascular connections," Bailey replied. "These twins have been planning separation surgery for months. Today's the day we find out if it's possible."

"I'll take excellent care of them," Cristina said, already mentally cataloging the surgical challenges involved.

"Dr. Grey, you're with me on post-operative rounds. We have seventeen patients to check, medications to adjust, and discharge papers to complete." Bailey's tone suggested this was less exciting than cardiac surgery but equally important. "Try to stay focused."

Meredith nodded, though her attention seemed elsewhere. She'd been distracted all morning, checking her phone repeatedly.

"Dr. Stevens, you're covering the ER with Dr. Torres. Dr. O'Malley, you're with Dr. Montgomery on prenatal consultations." Bailey continued down her list with military efficiency. "Dr. Hart and Dr. Karev, you're both in the pit today. Multiple trauma cases coming in, and I need people who can handle chaos without falling apart."

Clem glanced at Alex, who looked pleased. Working the ER together officially was different from their study sessions, but they'd developed an effective partnership over the past few weeks.

"Any questions?" Bailey asked, though her tone suggested there better not be any.

"Dr. Bailey," George raised his hand tentatively, "what's the prognosis for the conjoined twins? Are we expecting—"

"We're expecting to do our jobs, Dr. O'Malley. Surgery is scheduled for this afternoon, and every one of you needs to be prepared for whatever happens." Bailey's expression became more serious. "Some cases don't have fairy tale endings. That doesn't mean we don't fight for them anyway."

As the group began to disperse, Bailey caught Clem's arm. "Dr. Hart, a word."

Alex paused, waiting, but Bailey waved him on. "Dr. Karev, go check in with the ER. Dr. Hart will catch up."

When they were alone, Bailey's demeanor remained firm but carried an undertone of mentorship. "I've been watching your work. You're settling in well, focusing on medicine. That's good."

"Thank you," Clem replied, unsure where this was leading.

"Personal drama has a way of following people around this hospital. The key is not letting it interfere with patient care." Bailey's gaze was direct but not unkind. "You've handled your situation with professionalism. Continue doing that."

Clem nodded. "My focus is on learning to be the best surgeon I can be."

"Good. Now go catch up with Dr. Karev before he finds a way to irritate the nursing staff. That boy needs someone to keep him in line."

Morning - Room 304

Annie and Liz McKenna sat in their hospital bed, connected at the torso as they had been for their entire twenty-three years. Annie was animated, gesturing excitedly as she spoke with Cristina about the surgery, while Liz remained quiet, her anxiety evident in the way her hands trembled.

"We've been planning this for two years," Annie explained, her voice filled with determination. "I want to travel, to date, to have a life that's just mine. I want to know who I am when I'm not half of something."

"Annie, please," Liz said softly, her voice barely audible. "We don't have to decide today. We could wait longer, make sure—"

"We've waited our whole lives, Lizzie. I can't wait anymore."

Cristina observed the interaction with clinical interest while reviewing their chart. The case was medically fascinating – complex vascular connections, shared liver segments, intertwined nerve pathways. It was exactly the kind of challenge she lived for.

"Dr. Yang," Annie addressed her directly, "what are our chances? Really?"

Cristina considered the question with characteristic bluntness. "The surgery is high-risk. Shared organ systems create complications. But Dr. Burke is the best cardiac surgeon on the West Coast, and the planning has been thorough."

"But we could both survive?" Liz asked desperately.

"That's the goal," Cristina replied, though her tone suggested she understood the uncertainties involved.

Dr. Burke entered the room with his usual commanding presence, Derek close behind. Both men carried themselves with the confidence of surgeons accustomed to impossible cases.

"Good morning, ladies," Burke said warmly. "Are we ready to make history?"

Annie nodded eagerly while Liz gripped her sister's hand tighter.

"Dr. Yang, review the surgical plan with our patients," Burke instructed. "I want everyone completely clear on what we're attempting today."

As Cristina began explaining the procedure in detail, neither twin noticed the way she occasionally gripped the bed rail for support or the slight pallor that had developed over the past few days.

Late Morning - ER Break Room

Clem sat at the small table in the corner, a practice quiz spread in front of her as Alex paced nearby, gesticulating as he explained cardiac pharmacology. Their morning in the ER had been steady but manageable, and they'd stolen thirty minutes to continue their ongoing board preparation.

"Beta blockers reduce cardiac workload by blocking sympathetic stimulation," Alex said, his voice taking on the rhythm of someone who'd been drilled on this material repeatedly. "Decreased heart rate, decreased contractility, decreased oxygen demand."

"Contraindications?" Clem prompted without looking up from her notes.

"Asthma, COPD, severe bradycardia, heart block." Alex dropped into the chair across from her. "This is actually sticking. I think your teaching methods might be working."

"Shocking revelation," Clem replied dryly. "Turns out studying actually helps with learning."

The break room door opened, and Nurse Jennifer Walsh entered with what Clem had come to recognize as predatory intent. Jennifer was attractive, confident, and had been making increasingly obvious attempts to get Alex's attention for the past week.

"Alex," Jennifer said with a smile that was all teeth and invitation, "I was wondering if you wanted to grab lunch later. Or maybe meet up after shift? I know this great place downtown."

Alex barely looked up from his notes. "Busy."

"Come on," Jennifer moved closer, leaning against their table. "You've been studying non-stop for weeks. Don't you think you deserve some fun?"

"My idea of fun involves not failing out of this program," Alex replied with characteristic bluntness, though there was less bite than usual. "So no thanks."

Jennifer's expression faltered slightly. "Maybe this weekend?"

"I don't think so," Alex said, his attention already back on his study materials. "Thanks anyway."

After Jennifer left with obvious disappointment, Clem looked at Alex with raised eyebrows. "That was almost diplomatic."

"Don't get used to it." Alex shrugged, not meeting her eyes. "I've got more important things to focus on than random hookups."

"Since when?"

"Since I decided I actually want to be good at this job." Alex's tone was matter-of-fact, but something in his expression suggested there might be more to it. "Besides, most of these nurses just want to say they slept with a doctor. It gets old."

"How very evolved of you."

"I'm full of surprises." Alex returned to his notes, effectively ending the conversation. "Okay, next topic. Complications of acute pancreatitis."

"Pseudocyst formation, splenic artery aneurysm, pancreatic necrosis," Alex began, his focus returning to the material, though Clem noticed he seemed more relaxed when they were studying together than he did during most other interactions.

Afternoon - OR 2

The conjoined twin separation was in its fourth hour, and the surgical team worked with meticulous precision. Burke and Derek operated with the kind of coordinated expertise that came from years of complex procedures, while Cristina assisted with her characteristic intensity despite the increasing pallor and occasional tremor in her hands.

"Careful with the hepatic vessels," Burke murmured, his hands steady as he navigated the shared vascular connections. "Dr. Yang, retraction."

Cristina moved to adjust the retractor, but her vision blurred momentarily. She gripped the instrument tighter, forcing herself to focus, but the room seemed to tilt slightly.

"Dr. Yang?" Burke's voice was sharp with concern as he noticed her slight sway. "Are you all right?"

"I'm fine," Cristina replied automatically, but her voice lacked its usual conviction.

"Step back," Burke commanded gently but firmly. "Nurse Patterson, take over retraction."

Cristina wanted to protest, but the wave of nausea that hit her made argument impossible. She stepped away from the table, one hand pressed to her abdomen.

"Get Dr. Yang to the ER," Burke instructed without taking his eyes off the surgery. "Have someone check her out."

Two nurses helped the unsteady Cristina from the OR while Burke and Derek continued working. They were at the most critical point of the separation, with both twins' lives hanging in the balance.

"Annie's vitals are stable," the anesthesiologist reported. "But Liz is showing signs of cardiovascular stress."

Derek and Burke exchanged glances over the surgical field. They'd known this moment might come – the point where saving one twin might mean losing the other.

"Continue," Burke said quietly. "We save who we can save."

Afternoon - ER

Addison was examining Cristina on a gurney in the emergency department. The younger woman was conscious but obviously unwell, her usual confidence replaced by visible discomfort.

"Dr. Yang, when was your last menstrual period?" Addison asked with professional directness.

"I don't see how that's relevant," Cristina replied curtly. "I just need something for the nausea so I can get back to surgery."

"The combination of symptoms you're presenting – severe abdominal pain, nausea, dizziness, shoulder pain – creates a specific clinical picture." Addison continued her examination. "I need to rule out an ectopic pregnancy."

Cristina's eyes widened slightly. "That's... that's not possible."

"I'm ordering blood work and an ultrasound to confirm," Addison said gently but firmly. "If I'm right, this is a surgical emergency that can't wait."

An hour later, Addison returned with results and a serious expression. "Cristina, you have an ectopic pregnancy in your left fallopian tube. It's beginning to rupture, which explains your symptoms. We need to operate immediately."

Cristina stared at the ceiling, processing the information with uncharacteristic quiet. "Will this affect my surgical training?"

"Not if we address it now," Addison assured her. "I can perform a laparoscopic salpingostomy that should preserve the tube and your fertility. You'll be back in the OR within a week."

"Do it," Cristina said without hesitation. "Whatever needs to be done."

Within two hours, Cristina was in recovery, the ectopic pregnancy successfully removed along with one of her fallopian tubes. Her first question upon waking was whether Burke's surgery had been successful.

"The twins?" she asked groggily.

"One survived," Addison told her gently. "Annie made it through. Liz didn't."

Cristina nodded, already mentally processing the medical complexities that had led to that outcome even as she struggled with post-anesthetic disorientation.

Evening - Surgical Floor

The conjoined twin separation had ended three hours ago with devastating success. Annie McKenna was alive, recovering in the ICU, adjusting to a life in a single body for the first time. Liz McKenna was dead, her heart unable to survive the separation that her sister had desperately wanted.

Burke stood outside Cristina's recovery room, watching through the window as she slept. The ectopic pregnancy surgery had been routine, but he found himself checking on her with an attention that went beyond professional concern.

"She's going to be fine," Addison said, joining him in the hallway. "The procedure went perfectly. No complications."

"Good," Burke replied, though his gaze remained fixed on Cristina's sleeping form. "She's... she's an exceptional surgical resident. We can't afford to lose talent like that."

"Is that what this is about? Her surgical potential?" Addison's tone carried gentle skepticism.

Burke considered the question longer than it should have taken. "She has the focus and dedication to be truly great. That's rare."

"Yes, it is," Addison agreed, noting the way Burke's eyes hadn't left Cristina's room. "Dedication like that should be... valued."

Neither spoke about the careful distance Burke had maintained from his residents, or how that distance seemed to blur when it came to Cristina Yang. Some truths were better acknowledged quietly than spoken aloud.

Late Evening - Hospital Cafeteria

Clem found Alex sitting alone at a corner table, methodically working through a stack of medical journals while eating what appeared to be his third cup of pudding. The cafeteria was nearly empty, filled with the quiet exhaustion that settled over the hospital during evening shifts.

"Stress eating or studying?" she asked, sliding into the seat across from him.

"Both," Alex replied without looking up. "Trying to understand hepatic blood flow patterns. Also, this chocolate pudding is the only thing in here that doesn't taste like cardboard."

"The twins?" Clem asked gently.

Alex finally looked up, his expression more serious than his usual defensive mask. "One made it, one didn't. The survivor's getting everything she thought she wanted – her own body, independence, freedom to make her own choices. But she'll never see her sister again."

"That's what she chose," Clem pointed out.

"Yeah, but did she really understand what that meant? Or was she so focused on what she was gaining that she couldn't see what she was losing?" Alex pushed the journal aside. "I keep thinking about how they argued before surgery. Liz was scared, wanted to wait. Annie was determined to go through with it."

Clem recognized the weight in his voice – the same tone she'd heard when he'd talked about family, about choices that couldn't be undone. "Are you thinking about something besides the twins?"

"Maybe," Alex admitted, then seemed to catch himself. "It's just... sometimes people fight so hard for what they think they want that they destroy the good things they already have."

"And sometimes people stay trapped in situations that aren't good for them because they're afraid of change," Clem replied thoughtfully. "There's no perfect choice. Just the one you can live with."

Alex nodded slowly, some of the tension leaving his shoulders. "Thanks for not making this weird. For just sitting here."

"Sometimes you need someone to think out loud with," Clem said simply.

They sat in comfortable silence, Alex returning to his journals while Clem grabbed a cup of coffee. The hospital's night rhythm settled around them – distant monitor beeps, soft-soled footsteps, the quiet hum of life-sustaining machines. Outside, Seattle's October rain painted the windows with sliding reflections of fluorescent light, washing the day's choices clean while they prepared for whatever tomorrow would bring.

Chapter Text

The Next Day

The basement of Seattle Grace had become Alex and Clem's unofficial study sanctuary. Away from the chaos of the main floors, surrounded by stored equipment and forgotten furniture, they'd claimed an old gurney as their makeshift classroom. Alex sat cross-legged at one end while Clem perched at the other, a stack of medical textbooks between them like a paper fortress.

"Okay, Karev," Clem said, flipping through her notes. "Types of shock. Go."

Alex rubbed his eyes, already looking tired despite the early hour. "Hypovolemic, cardiogenic, distributive, obstructive." He rattled off the list with the mechanical precision of someone who'd been drilling the same material for weeks.

"Causes of distributive shock?"

"Septic, anaphylactic, neurogenic." Alex paused, then added with his characteristic edge, "Also known as the ways this hospital tries to kill me on a daily basis."

"Very scientific," Clem replied dryly, making a note in the margin of her textbook. "Let's try something else. You're in the ER, patient comes in with chest pain. Walk me through your differential."

Alex straightened slightly, his competitive instincts kicking in. This was the kind of clinical thinking that came naturally to him when he stopped second-guessing himself. "MI, PE, pneumothorax, aortic dissection, GERD, costochondritis..."

"Good. Now narrow it down. Your patient is a forty-five-year-old male, crushing chest pain radiating to his left arm, diaphoretic, nauseous."

"Sounds like an MI. Get an EKG, cardiac enzymes, chest X-ray. Two large-bore IVs, oxygen, morphine for pain, nitro if his pressure can handle it."

"Better," Clem said, making another note. "You actually know this stuff, Alex. You just panic when you're being tested."

Alex watched her write, noting the way she chewed her bottom lip when concentrating. Over the past few weeks, these study sessions had become the part of his day he looked forward to most. Not just because she was helping him pass his boards, but because she treated him like he was capable of being more than the screwup everyone expected.

"You know," he said, his voice taking on an uncharacteristically soft edge, "if I actually pass this thing, it'll be because of you."

Clem glanced up, surprised by the genuine gratitude in his tone. "You'll pass because you're smart enough to. I'm just helping you organize what you already know."

"No, it's more than that." Alex held her gaze, something shifting in his expression. "You make me want to be better at this. Not just for the test, but... better in general."

The words hung between them, carrying more weight than either had expected. For a moment, Clem saw past Alex's usual defensive posturing to something more vulnerable underneath. Before she could formulate a response, footsteps echoed down the basement stairs.

"Study party!" Izzie's cheerful voice preceded her appearance, arms loaded with coffee cups and what appeared to be homemade muffins. "I brought sustenance for the brain trust."

"Izzie," Clem said, grateful for the interruption but also oddly disappointed. "You didn't have to—"

"Of course I did. Alex needs all the help he can get, and you need actual food instead of whatever vending machine disaster you usually survive on." Izzie set down her offerings and beamed at them both. "Besides, I made way too many muffins. Stress baking is becoming a problem."

Alex grabbed a muffin with something that might have been relief. The moment of vulnerability had passed, his usual mask sliding back into place. "Thanks, Stevens. Though if these poison me before my retake, I'm haunting you."

"They're cranberry orange," Izzie said, settling onto a nearby crate. "Very wholesome. Practically health food."

"I should go check on my post-ops," Clem said, gathering her notes with perhaps more haste than necessary. "Alex, keep reviewing cardiology. We'll pick this up later."

As she headed for the stairs, she could hear Izzie launching into an enthusiastic explanation of her baking technique, but Alex's earlier words echoed in her mind. You make me want to be better. She'd heard similar sentiments before, usually from men who wanted something from her. But coming from Alex, it had sounded different. Less calculated, more... honest.

She pushed the thought aside. The last thing she needed was another complication.

Afternoon - Cristina's Hospital Room

Burke knocked softly on the door frame before entering Cristina's room. She was awake, sitting up in bed with a medical journal in her lap, looking frustrated by her temporary confinement.

"Dr. Yang. How are you feeling?"

"Like I should be in surgery instead of lying here reading about procedures I could be performing," Cristina replied with characteristic directness. "When can I get back to work?"

"Dr. Montgomery says another day or two," Burke said, taking the chair beside her bed. "The laparoscopic approach was successful, but you need time to heal."

Cristina nodded impatiently, then seemed to really look at him for the first time since he'd entered. "How's Annie McKenna?"

"Stable. Adjusting. It's going to be a long recovery process, both physically and emotionally."

They sat in silence for a moment, the weight of the previous day's events settling between them. Burke found himself studying Cristina's face – the determination that never quite left her expression, even when she was recovering from surgery.

"Cristina," he began, then stopped. How did you navigate this conversation with someone who viewed everything through the lens of surgical excellence? "The pregnancy... do you need to talk about it?"

"There's nothing to talk about," Cristina said immediately. "It was an ectopic pregnancy. It was removed. Problem solved."

"It's not always that simple," Burke said carefully. "Even when the medical solution is straightforward, there can be emotional complexities."

Cristina looked at him with something approaching surprise. "Since when do you concern yourself with residents' emotional complexities?"

Burke hesitated. Since you, he thought but couldn't say. Since somehow your dedication to surgery became something I look forward to witnessing every day. Since your focus and drive remind me why I fell in love with medicine in the first place.

"Since I realized that exceptional surgical residents are... worth looking after," he said finally. "You have tremendous potential, Cristina. I don't want anything to derail that."

"Nothing will derail it," Cristina assured him with fierce conviction. "This changes nothing about my commitment to surgery. If anything, it reinforces how important it is to stay focused on what matters."

Burke nodded, recognizing the steel in her voice that he'd come to associate with her most determined moments. "Good. That's... that's what I hoped you'd say."

As he stood to leave, Cristina called after him. "Dr. Burke? Thank you. For making sure I got help yesterday. For not letting me collapse in the OR."

"Of course," Burke replied, meaning more than just the professional courtesy implied. "I'll check on you tomorrow."

Afternoon - Emergency Department

The ER hummed with its usual controlled chaos when the ambulance arrived. Clem and Meredith were restocking supplies when the paramedics wheeled in a stretcher carrying a woman in her sixties, confused and agitated, fighting against the restraints.

"Where am I?" the woman demanded, her voice sharp with panic and authority. "I need to get back to the hospital. I have surgeries scheduled. My patients are waiting!"

Meredith froze, her face draining of color as she recognized the voice before seeing the face.

"What do we have?" Bailey asked briskly, approaching the gurney.

"Ellis Grey, sixty-three, found wandering outside her assisted living facility," the paramedic reported. "Became increasingly agitated when staff tried to redirect her back inside. Possible UTI, but she's been insisting she's late for surgery."

Meredith stood rooted in place, staring at the woman on the gurney. Ellis Grey was smaller than her reputation suggested, her once-commanding presence diminished by confusion, but her intelligence blazed through the fog of her condition.

"You," Ellis said, focusing on Meredith with sudden clarity. "You look familiar. Are you one of my interns?"

"I... I need..." Meredith's voice came out strangled. Without another word, she turned and fled the trauma bay.

Clem watched her go with concern before turning back to the patient. Ellis was studying her now with the same sharp attention she'd given Meredith.

"Dr. Bailey," Clem said quietly, "I'll take this case."

Bailey nodded, having witnessed Meredith's reaction. "Dr. Hart, room three. Full workup. And page psych for a consultation."

As they moved Ellis to the examination room, the older woman continued her assessment of Clem. "You have good hands," she observed, her voice carrying the authority of someone accustomed to evaluating surgical potential. "Steady. Do you want to be a surgeon?"

"Yes, ma'am," Clem replied gently, beginning her examination while trying to keep Ellis calm.

"Good. Surgery chooses you as much as you choose it." Ellis's eyes were lucid for a moment, almost maternal in their intensity. "Don't let anyone tell you that you're not strong enough. I built a career in this profession when women weren't welcome. It can be done."

Clem found herself unexpectedly moved by the mixture of confusion and fierce determination in Ellis's voice. "What kind of surgery did you do?"

"General surgery. I was going to cure everything." Ellis's expression grew sad. "But then... then I forgot how."

As Clem continued her examination, drawing blood and ordering tests, she couldn't help but think about Meredith's reaction. Whatever history existed between mother and daughter, it was complicated enough to send one of the most composed people she knew running from the room.

Ellis Grey might be lost to Alzheimer's, but in her lucid moments, Clem could see echoes of the brilliant surgeon she'd once been. It was both inspiring and heartbreaking – a glimpse of what medicine could build and what time could steal away.

"Doctor," Ellis said suddenly, gripping Clem's hand with surprising strength. "Promise me something."

"What's that?"

"Don't let them make you smaller than you are. The world will try. Fight back."

Clem squeezed her hand gently. "I promise."

Chapter Text

Hospital Rooftop - Late Afternoon

Clem pushed through the heavy door leading to the hospital roof, the Seattle drizzle immediately misting her scrubs. She'd checked three supply closets, two on-call rooms, and the basement before Tyler mentioned seeing Meredith head upstairs "looking like she'd seen a ghost."

She found Meredith sitting on the ledge overlooking the city, her legs dangling over the side, staring at nothing with the kind of hollow expression that came after particularly brutal emotional hits.

"Your mother's stable," Clem said without preamble, settling beside her on the concrete ledge. "UTI, like we thought. Some dehydration. She's responding well to antibiotics."

Meredith didn't acknowledge the medical update, just continued staring at the gray Seattle skyline with unseeing eyes.

"She asked me if I was one of her interns," Meredith said finally, her voice flat and distant.

"Alzheimer's patients often—"

"She didn't recognize me." The words came out matter-of-fact, but Clem could hear the carefully controlled devastation underneath. "My own mother looked right at me and saw a stranger."

Clem studied Meredith's profile, noting the careful blankness that had replaced her usual guarded wariness. This was shutdown mode – total emotional lockdown to prevent complete collapse.

"She told me not to let anyone make me smaller than I am," Clem offered quietly. "Even confused, she recognized surgical potential when she saw it."

"Yeah, well, she always could spot talent in other people's children." Meredith's voice carried bitter familiarity with disappointment. "Just never seemed to find much in her own daughter."

The rain picked up slightly, adding to the general misery of the moment. Clem recognized the particular ache in Meredith's voice – the special pain that came from loving someone whose approval always felt just out of reach.

"I spent my entire childhood trying to be impressive enough to get her attention," Meredith continued, staring down at the street below. "Perfect grades, early acceptance to medical school, matching into surgery. None of it mattered. I was never going to be Ellis Grey."

"Maybe that's not the worst thing," Clem said carefully.

Meredith finally looked at her, eyebrows raised in tired skepticism.

"I mean, from what I've heard, Ellis Grey was brilliant but not exactly... accessible. Maybe being yourself instead of being her is actually better."

"Right. Because being mediocre me has worked out so well." Meredith's laugh was hollow. "At least if I were like her, the disappointment would make sense."

They sat in silence for a moment, rain pattering around them. Clem knew better than to try to fix this – some pain just had to be sat with.

"She's going to die one day," Meredith said suddenly, the words barely audible above the wind. "And she'll never know who I am again. All those years trying to make her proud, and now she can't even remember having a daughter."

"Maybe she doesn't need to remember," Clem said gently. "Maybe it's enough that you know who she was to you, even if she can't remember being that person."

Meredith nodded slowly – not agreement exactly, but acknowledgment that some truths couldn't be fixed, only endured.

"We should get back," Meredith said finally. "Bailey's probably wondering where we disappeared to."

"Probably." Clem stood, extending a hand to help Meredith up. "For what it's worth, I think you're tougher than you give yourself credit for. And your mom... even lost in her own mind, she still saw something worth encouraging in a complete stranger. That instinct came from somewhere."

Meredith took her hand, pulling herself to her feet. "Thanks. For not trying to make this better or telling me everything happens for a reason."

"Sometimes things just suck and there's no deeper meaning to find."

"Yeah," Meredith agreed, and for the first time since fleeing the ER, something almost like relief crossed her face. "Sometimes they do."

OR 3 - Later That Day

Dr. Bailey stood at the scrub sink, methodically washing her hands with mechanical precision. Through the window, she could see into OR 3 where Jeremiah Tate lay prepped for surgery – twenty-one years old, fighting yet another battle in his ongoing war with cystic fibrosis.

"You ready for this, Dr. Hart?" Bailey asked as Clem joined her at the sink.

"Yes, ma'am." Clem began her own surgical prep, noting the subtle tension in Bailey's shoulders that appeared when cases became personal. "How many surgeries has he had?"

"Lost count after fifteen," Bailey replied tersely. "Kid's been through more procedures than some attendings perform in a year. Cystic fibrosis doesn't give you the luxury of easy fixes."

Dr. Montgomery appeared at the adjacent sink, her presence creating the usual undercurrent of professional awkwardness. The past few weeks had settled into careful courtesy, but interactions remained precisely calibrated to avoid personal territory.

"The patient's young, good surgical candidate aside from the underlying CF," Addison said, focusing strictly on medical facts. "Standard bowel resection should resolve the obstruction."

They entered the OR where Jeremiah lay unconscious, his body showing the toll of chronic illness but retaining the resilience of youth. Bailey positioned herself as lead surgeon, Clem assisting, Addison consulting.

"Scalpel," Bailey requested. "Dr. Hart, what are we dealing with?"

"Intestinal obstruction secondary to meconium ileus equivalent – thickened secretions causing blockage in the small bowel," Clem replied, monitoring both the surgical field and Jeremiah's vitals.

"Correct. This is his fourth abdominal surgery, so expect significant adhesions."

The surgery proceeded methodically for the first hour. Bailey's hands moved with practiced confidence through familiar anatomy, while Clem provided steady assistance. The obstruction was exactly where they'd expected, and initial dissection went smoothly.

"Looking good," Bailey murmured, more to herself than anyone else. "Just like we planned."

But as they worked to free the affected bowel segment, Jeremiah's pressure began dropping.

"BP's falling," the anesthesiologist announced. "Down to 95 over 65."

Bailey's hands paused. "How's his heart rate?"

"Climbing. 110 and rising."

Bailey exchanged glances with Addison over the surgical field. In patients with advanced cystic fibrosis, cardiovascular stress could cascade quickly into full system failure.

"More suction," Bailey ordered, working to maintain visualization as blood began pooling in the surgical site. "There – see that? Splenic vessels are more friable than normal."

"Common in CF patients," Addison confirmed, moving in to assist. "Chronic inflammation affects vessel integrity."

Despite their careful technique, a small tear in the splenic artery opened further under the stress of retraction. What should have been a minor bleeding complication became a race against time as Jeremiah's already-compromised system struggled to cope.

"Pressure's dropping fast," the anesthesiologist reported with increasing urgency. "85 over 50, heart rate 130."

Bailey worked frantically to control the bleeding, but years of chronic illness had left Jeremiah with little reserve. His weakened heart couldn't handle the additional stress of blood loss and surgical trauma.

"Come on, Jeremiah," Bailey said under her breath, her usual professional detachment cracking slightly. "You've made it through worse than this."

But even as she spoke, the monitors began showing the cardiac arrhythmias that indicated impending failure. Twenty-one years old, and his body was simply worn out from fighting.

"V-fib," came the announcement they'd all been dreading.

Bailey called for the paddles, but they all recognized the futility. After twenty minutes of aggressive resuscitation attempts, she was forced to call time of death.

Post-Op - Outside OR 3

Bailey stood in the hallway outside the operating room, still in her surgical gown, staring at the floor with the particular stillness that followed unexpected loss. Clem approached cautiously, recognizing the weight of accumulated grief that attendings carried.

"Dr. Bailey?"

"Four years," Bailey said without looking up. "I've been fighting for that kid for four years. Every surgery, every complication, every setback – we kept finding ways to keep him going."

"You gave him four years he wouldn't have had otherwise."

"His parents trusted me," Bailey continued, her voice flat with exhaustion. "They brought him here believing we could fix whatever went wrong. Now I have to tell them their son didn't make it through what should have been routine surgery."

Clem had no easy answers, no platitudes that could make this kind of loss bearable. Some patients were lost to disease progression, others to surgical complications, but losing young patients to the cumulative effects of chronic illness felt particularly cruel.

"You gave him the best care possible," Clem said finally. "Sometimes that's not enough, but it doesn't mean it wasn't everything."

Bailey looked at her then, and Clem saw something raw and tired in her attending's expression – the accumulated weight of every patient who hadn't made it, every promise that couldn't be kept.

"This job will break your heart repeatedly, Dr. Hart," Bailey said quietly. "The question is whether you let it break your commitment to the next patient."

"Has it broken yours?"

Bailey considered this for a long moment, straightening her shoulders as she prepared to face Jeremiah's parents. "Ask me tomorrow. Right now, I need to go deliver the worst news two people can receive."

She walked away with the measured step of someone carrying an almost unbearable responsibility, leaving Clem alone in the hallway to contemplate the true cost of choosing medicine – not just the long hours and difficult training, but the accumulation of losses that couldn't be prevented, only endured.

A few days later:Hospital Corridor - After the Power Outage

The emergency lighting cast eerie shadows down the hallway as Clem made her way through the hospital, still buzzing with adrenaline from the chaos of the past few hours. The storm had finally passed, but the aftermath lingered - patients stabilized, equipment reset, everyone running on pure exhaustion and caffeine.

She'd heard about what happened in the elevator through the hospital grapevine that moved faster than any paging system. George O'Malley, of all people, had performed emergency surgery on a cop with a bullet wound while trapped between floors. Burke had talked him through a pericardiocentesis via shouted instructions through the elevator shaft, and somehow - impossibly - George had pulled it off.

What she'd also heard, through Tyler's carefully neutral expression and Meredith's worried glances, was that Alex had been there too. And that he'd frozen.

She found him in on-call room three, sitting on the edge of the narrow bed with his head in his hands. His usually perfect hair was disheveled, his scrubs wrinkled from the long shift, and something about his posture - defeated, smaller than usual - made her chest tighten.

She slipped inside and turned the lock behind her, the quiet click making him look up.

"Heard about the elevator," she said simply.

Alex's expression immediately hardened, his defensive walls slamming into place. "Yeah? What'd you hear? That George fucking O'Malley saved the day while I stood there like an idiot?"

"I heard you helped transport a critical patient and got stuck in an emergency situation that—"

"Cut the shit, Brooklyn." Alex stood abruptly, pacing to the small window. "I froze. While that cop was dying and George was actually doing something useful, I just... I couldn't move. Couldn't think. Burke was shouting instructions and George was stepping up, and I was useless."

The self-loathing in his voice was raw, more honest than she'd ever heard from him. It reminded her uncomfortably of her own voice after particularly brutal failures - the way perfectionism turned every mistake into a personal indictment.

"Everyone freezes sometimes," she said carefully. "It doesn't define—"

"Doesn't it?" Alex whirled around, his eyes blazing with frustration and something deeper - shame, maybe, or fear. "You think Burke's going to remember that I'm a decent intern when he's writing evaluations? You think anyone's going to forget that when it mattered, really mattered, George fucking O'Malley had to save the day because Alex Karev was too chickenshit to act?"

"You're being too hard on yourself—"

"Am I? Because it feels like I'm being exactly as hard as I should be." His voice was getting louder, edged with the kind of anger that came from feeling trapped. "You know what the worst part is? I knew what to do. I knew exactly what needed to happen, but when Burke started giving instructions, all I could think about was fucking it up. About making it worse. About proving that everyone who thinks I don't belong here is right."

Clem felt something crack open in her chest - recognition, maybe, of the fear that lived underneath all their confidence. "Alex—"

"And now George - George who can barely start an IV without sweating through his scrubs - is going to be Burke's golden boy because he had the balls to actually try when I couldn't." Alex's hands clenched into fists at his sides. "So don't stand there and tell me I'm being too hard on myself, because I'm pretty sure I'm not being hard enough."

The words hit her wrong - not because they were cruel, but because they were so painfully familiar. Because she recognized the voice of someone tearing themselves apart for being human, for having moments of doubt in a profession that demanded god-like certainty.

"You know what?" she said, her own voice sharpening. "You're right. You should just give up now. Quit surgery, quit medicine, go find something easier where you never have to risk failing or looking stupid or being anything less than perfect."

Alex stared at her, clearly not expecting her to agree.

"Because that's obviously what you want - someone to pat your head and tell you it's okay to be mediocre. Someone to make excuses for why you can't handle the pressure." She moved closer, her own frustration building. "Or maybe you just want to wallow in feeling sorry for yourself because it's easier than admitting that sometimes good people have bad moments and it doesn't make them failures."

"That's not—"

"Isn't it? Because from where I'm standing, you sound like someone who's more invested in being right about how much you suck than in actually trying to be better."

The words hung between them, sharper than she'd intended. Alex's expression shifted from hurt to anger, his jaw tightening.

"Fuck you," he said quietly, but with enough venom to make her take a step back. "Fuck you and your perfect fucking attitude. At least I'm honest about screwing up instead of pretending like I have my shit together when everyone can see I'm just another mess trying to fake it."

The accusation stung because it hit close to something true - the careful facade she maintained, the way she performed competence even when she felt anything but confident.

"Right," she said, turning toward the door. "Clearly you'd rather feel sorry for yourself than—"

She didn't get to finish the sentence.

Alex moved faster than she'd expected, crossing the small room in two steps and catching her wrist before she could reach the door handle. The contact was electric - all the tension and frustration and something else they'd been dancing around for months suddenly given physical form.

"Don't," he said, and his voice was different now, rougher, more desperate than angry.

She turned back to face him, and something in his expression - vulnerable and fierce and wanting - made her breath catch. They stood like that for a moment, close enough that she could see the gold flecks in his dark eyes, could feel the heat radiating from his skin.

Then he was kissing her.

It wasn't gentle or romantic - it was hungry and desperate, months of circling each other finally finding an outlet. His hands fisted in her hair, pulling just hard enough to make her gasp against his mouth, and she responded by pressing closer, her teeth catching his lower lip with enough force to draw a rough sound from his throat.

"Fucking finally," he muttered against her mouth, and the crude honesty of it sent heat pooling low in her stomach.

They moved together with desperate efficiency, hands working with clinical precision to push fabric aside, to find skin. Her back hit the door with enough force to rattle it in its frame, but she barely registered the sound. His mouth was on her throat—hot, wet, claiming—and she let her head fall back with a gasp. Fingers hooked into the waistband of her scrub pants, dragging them down in rough jerks, and she felt air hit her skin like a jolt.

"Alex," she breathed, her fingers digging into his shoulders hard enough to leave bruises, and he responded by lifting her, pressing her more firmly against the door, his hips grinding against hers with an urgency that made her vision blur.

The narrow bed creaked ominously as they fell onto it, a tangle of desperate limbs and discarded scrubs. There was nothing careful or considerate about the way they came together - it was all teeth and nails and the kind of raw need that had been building for months without acknowledgment.

Alex's hands mapped her body with possessive intensity, calloused fingers leaving trails of fire across her skin. When she arched beneath him, her nails raking down his back hard enough to make him hiss, he retaliated by biting the sensitive spot where her neck met her shoulder, marking her in a way that felt both primitive and necessary.

"You drive me fucking crazy," he growled against her throat, and she could only gasp in response because his hands had found exactly where she needed them, and coherent thought became impossible.

When he moved over her, into her, it was with a force that made them both cry out - her back arching off the narrow mattress, his name falling from her lips like a curse or a prayer. The rhythm they found was fierce and desperate, fueled by months of unspoken want and the particular intensity that came from finally giving in to something they'd both been fighting.

The small room filled with harsh breathing and bitten-off curses, the sound of skin against skin, the creak of institutional furniture pushed beyond its intended use. When she pulled him down for another kiss, it was all tongue and teeth, tasting like desperation and something that might have been relief.

The release, when it came, was shattering - her body clenching around his as she cried out, nails digging into his shoulders, while he buried his face in her neck and groaned her name like it was the only word he remembered. They moved together through the aftershocks, clinging to each other with an intensity that spoke to hungers neither had been willing to acknowledge.

Afterward, they lay in the narrow bed, breathing hard, sweat cooling on overheated skin. The silence stretched between them - not uncomfortable exactly, but loaded with the weight of boundaries crossed and the knowledge that nothing would be the same.

Alex traced patterns on her shoulder with one finger, his touch gentler now but still possessive, still carrying the echo of how he'd gripped her moments before. Clem stared at the ceiling, her mind struggling to process what had just happened, the way months of careful professional distance had been incinerated in the space of minutes.

"So," Alex said finally, his voice rough from exertion and something else. "That was..."

“Yeah,” she echoed, but her voice cracked a little. She cleared her throat, as if that might clear the thoughts racing through her head too fast to name.

Before either of them could attempt to navigate the conversation they probably needed to have, both their pagers went off simultaneously - the harsh beeping cutting through the quiet intimacy of the moment like a blade.

They looked at each other and started laughing - the kind of exhausted, slightly hysterical laughter that came after emotional and physical intensity collided with the relentless demands of their profession.

"Duty calls," Clem said, reaching for her discarded scrubs with hands that weren't quite steady.

"Always does," Alex replied, but he was watching her get dressed with an expression she couldn't quite read - satisfied and possessive and maybe a little stunned by what had just happened between them.

They dressed quickly and efficiently, falling back into the professional roles that fit them better than emotional vulnerability. But as they prepared to leave the on-call room and return to the controlled chaos of the hospital, the air between them hummed with new knowledge - of boundaries obliterated, of wants acknowledged and satisfied, of the way months of tension could transform into something that felt dangerously like intimacy.

“This doesn’t have to be complicated,” Clem said, but the words felt brittle in her mouth—like a lie she’d rehearsed without believing. Her hand hovered over the door handle, fingers trembling just slightly. She didn’t look at him when she said it.

"Right," Alex agreed, though something in his expression suggested he knew better. "Just two people blowing off steam."

They both knew it was already more complicated than that - had been from the moment he'd kissed her like he was drowning and she was air - but some truths were easier left unspoken, at least for now.

The hallway was bright and sterile after the dimness of the on-call room, full of the familiar sounds of hospital life continuing despite personal revelations. They walked toward their respective assignments without discussion, but Clem was hyperaware of everything—Alex’s gait, the dull ache between her thighs, the phantom imprint of his mouth on her neck. Her heart hadn't slowed down, and she wasn’t sure if it was because of what had happened, or what came next.

She kept her gaze ahead, shoulders squared, every step a performance. Because if she stopped pretending she had it together, she was pretty sure she'd shatter right there in the hallway.

Chapter Text

Morning After - 6:00 AM

Clem stood in front of the coffee pot, watching dark liquid drip into the glass carafe with the intensity of someone studying for boards. She'd been there for three minutes, which was approximately two minutes and fifty seconds longer than coffee required supervision. The machine gurgled and hissed, filling the silence she desperately needed filled.

Her body still hummed with sense memory from yesterday's on-call room encounter. The way Alex had grabbed her wrist, the desperate hunger in his kiss, the weight of him pinning her against the door. *Fucking finally,* he'd growled, and she'd responded with equal ferocity, months of tension snapping like a surgical suture under too much pressure.

The coffee pot gave a final wheeze, signaling completion. Clem poured herself a mug, added two sugars instead of her usual black, and took a sip that burned her tongue. Perfect. Physical discomfort was easier to process than whatever emotional minefield she'd stumbled into.

Footsteps on the stairs made her freeze. She knew those footsteps - confident, slightly heavy, taking two steps at a time. Alex.

"Morning, Brooklyn."

Clem turned, coffee mug halfway to her lips. Alex stood in the kitchen doorway, hair still damp from his shower, wearing jeans and a faded Pearl Jam t-shirt that clung to his shoulders in ways that made her remember gripping those shoulders while he moved inside her.

"Morning," she managed, grateful her voice came out steady.

Alex moved to the cabinet for his own mug, and for a moment it felt almost normal - until he reached around her for the coffee pot and carefully avoided letting their bodies brush. Yesterday, he wouldn't have thought twice about crowding into her space, probably would have made some sarcastic comment about hogging the good coffee.

"Sleep okay?" The question came out rougher than he'd intended.

The question hung between them, loaded with subtext. Had she slept okay after they'd practically fucked against an on-call room door? After months of sexual tension had exploded into something raw and desperate? After they'd both pretended it was just "letting off steam" while knowing it was anything but simple?

"Like a baby," she lied smoothly. "You?"

"Yeah. Great." Alex poured his coffee black, the same as always, but his movements were more careful than usual.

They stood there for a beat too long, coffee cooling in their hands. Alex opened his mouth like he might say something real, something that acknowledged what had happened between them, but footsteps thundered down the stairs.

"Coffee!" Izzie burst into the kitchen wearing yoga pants and a bright yellow sweater, smile bright enough to power the hospital. "Please tell me someone made real coffee and not that instant garbage George bought."

"Real coffee," Clem confirmed, stepping sideways to make room. The movement brought her closer to Alex, close enough to catch his scent - soap and something distinctly him that made her stomach flutter.

"You're both up early," Izzie observed, bustling around them to grab mugs and the sugar bowl. "Usually I have to drag Alex out of bed with a crowbar."

"Couldn't sleep," Alex said, the same moment Clem said, "Wanted to get to the hospital early."

Izzie paused, sugar spoon halfway to her mug, and looked between them. "Okay, that's weird. You two are being weird."

"We're not being weird," Clem protested, taking a large gulp of coffee that burned all the way down.

"You're standing on opposite sides of the kitchen like you're afraid to get within three feet of each other," Izzie pointed out. "Yesterday you were practically sharing the same chair during studying. Today you look like awkward strangers."

Before either could respond, George appeared in pajama pants and a wrinkled Columbia t-shirt, hair sticking up at impossible angles. "Why is everyone up so early? It's barely six."

"Ask the coffee addicts," Izzie said, still eyeing Alex and Clem suspiciously. "They're acting strange."

"We're not acting strange," Alex said, his jaw tightening slightly. "We're drinking coffee before work. Revolutionary concept."

Meredith shuffled in wearing an old Dartmouth sweatshirt, looking half-dead and completely unconcerned with anyone else's drama. She poured coffee, added enough sugar to fuel a small aircraft, and took a sip before acknowledging the room's occupants.

"What's everyone fighting about now?" she asked wearily.

"We're not fighting," Clem said quickly. "Everything's fine."

"Everything's peachy," Alex agreed, his tone just a shade too defensive.

Meredith looked at them both, then at Izzie and George, then back to her coffee. "Okay. I'm too tired for whatever this is. Just... try not to kill each other before we get to the hospital."

She wandered back upstairs, coffee in hand, leaving the other four in increasingly awkward silence.

"Seriously, what's going on?" George asked, genuine concern in his voice. "You guys seem... off."

Alex drained his coffee in one long gulp and set the mug down harder than necessary. "Nothing's going on. We're fine. Great. Couldn't be better." He grabbed his leather jacket from the back of a chair. "I'm heading in early. See you at the hospital."

He was gone before anyone could respond, the front door closing with a decisive click.

Clem stood frozen, coffee mug clutched in both hands, aware that two pairs of eyes were studying her with varying degrees of curiosity and concern.

"Okay," Izzie said slowly. "That was definitely weird."

Seattle Grace Hospital - Throughout the Day

The weirdness followed them to the hospital like a persistent shadow. During morning rounds, Alex positioned himself on the opposite side of Bailey's group of interns, something that made their resident pause mid-sentence and frown.

"Karev, Hart," Bailey said sharply. "What's the differential for a thirty-two-year-old male presenting with chest pain and shortness of breath?"

Usually, Alex and Clem would exchange glances, some silent communication passing between them before one answered. Today, they both stared straight ahead like strangers.

"MI, PE, pneumothorax, aortic dissection," Clem rattled off.

"Anxiety, costochondritis, GERD," Alex added, still not looking in her direction.

Bailey's eyes narrowed slightly at their sudden lack of teamwork. "What happened to you two? Yesterday you were finishing each other's medical thoughts, today you can barely stand on the same side of the hallway."

Neither answered.

The pattern continued throughout the morning. During their brief crossover in the hallway between cases, they managed polite nods that wouldn't have been out of place between complete strangers.

By noon, the carefully maintained distance was becoming exhausting. They'd been assigned to work together in the pit for the afternoon shift, which meant close quarters whether they liked it or not.

"Karev," Bailey said bluntly when she gathered the afternoon ER team. "You're retaking boards in three days. I don't care what crawled up your ass and died, but figure it out. Hart, trauma bay three needs sutures. Karev, you're with her for backup." Bailey's tone brooked no argument. "And whatever this passive-aggressive dance is? Cut it out. It's affecting patient care."

Trauma Bay 3 - Forced Proximity

The patient was a teenager who'd cut his hand on broken glass while skateboarding. Simple laceration repair, the kind of case Clem could handle in her sleep. Under normal circumstances, she and Alex would have fallen into easy conversation while she worked, him asking questions about technique or making sarcastic observations about teenage invincibility.

Today, Alex stood silently by the supply cart, handing her materials with the mechanical efficiency of a surgical robot.

"4-0 nylon," Clem said, not looking up from her work.

Alex placed the suture in her palm, careful not to let their fingers brush.

"So," the teenager said, wincing as Clem began stitching. "You guys dating or something? Because the vibe in here is super weird."

"We're colleagues," Clem replied automatically, focusing intently on creating perfectly even stitches.

"Right. My sister says that when adults act weird around each other, they're usually either fighting or—"

"Keep your hand still," Alex interrupted, his voice rougher than necessary.

As soon as the patient left, awkward silence descended on the trauma bay. Alex began cleaning up supplies while Clem updated the chart, both moving with careful precision to avoid unnecessary proximity.

"This is fucking weird," Alex said finally, tossing gauze into the trash with more force than necessary.

Clem looked up from her chart. "Incredibly weird."

"We can't keep doing this dance. Bailey's already noticed, and if she's picking up on it, everyone else will too."

"I know." Clem set down her pen, finally meeting his eyes. "We're being ridiculous."

"Complete idiots," Alex agreed. "I mean, what are we, in middle school? We're friends who had sex. It happens."

"Right." Clem leaned against the bed rail. "Friends have sex sometimes. It's not exactly unprecedented."

Alex studied her face. "You regret it?"

"No," she said without hesitation. "Do you?"

"Hell no." His answer was immediate and honest. "But I have no fucking clue how to act around you now."

"Yeah, that's the problem." Clem ran a hand through her hair. "It's like my brain forgot how to be normal around you."

"Same. I keep thinking about..." Alex trailed off, shaking his head.

"About railing me in the on-call room," Clem finished matter-of-factly.

Alex's hands stilled on the supply cart and his eyes snapped to hers, pupils dilating slightly. "Christ, Brooklyn." His voice came out rougher, lower. "You can't just say shit like that."

"Why not? It happened. We both remember it." She held his gaze steadily, though there was a slight flush creeping up her neck.

"Because we're at work," Alex said, but his voice was strained. "And because when you talk like that, I start thinking about doing it again."

The honesty hung between them for a moment. Clem felt her breath catch slightly at his admission.

"Okay," she said finally. "Point taken. Professional boundaries."

Alex took a breath, clearly trying to regain his composure. "Look, we're stuck working together, living in the same house, studying for boards together. This avoidance thing isn't working."

"No kidding. I've been standing on the other side of rooms from you all day like you have some contagious disease."

"And I've been acting like you might spontaneously combust if I get too close." Clem shook her head. "This is stupid. We're friends, Alex. Good friends. I don't want to lose that because we don't know how to handle one night."

Alex was quiet for a moment, then nodded. "Yeah. Me neither."

"So what do we do?"

"Go back to being us?" Alex suggested, though his voice was still slightly strained. "Same friendship, same dynamic. Just... with the knowledge that we've seen each other naked."

"And that you're apparently very vocal during sex," Clem added with a smirk.

"Says the woman who left scratch marks on my back," Alex shot back, but he was almost smiling now despite the lingering heat in his eyes.

"Fair point." Clem felt some of the tension ease from her shoulders. "So we're okay? Still friends?"

"Still friends," Alex confirmed. "Even if you're going to make this impossible by talking like that."

"I'll try to behave," Clem said, though her smirk suggested otherwise.

"Sure you will."

And just like that, some of the weirdness dissolved. Not all of it - there was still something simmering under the surface, especially with the way Alex was looking at her - but enough that they could function again.

Chapter Text

Meredith's House - Evening

The living room looked like a medical school study group had exploded - pizza boxes balanced precariously on stacks of medical journals, someone's stethoscope draped over the back of the couch, and Izzie's collection of scented candles fighting a losing battle against the smell of pepperoni and exhaustion.

George sat cross-legged on the floor, remote clutched in both hands like a sacred artifact, scrolling through movie options with the same methodical precision he used to calculate drug dosages.

"What about this one?" He paused on a romantic comedy from the nineties, complete with a woman in a wedding dress running through an airport.

"Absolutely not," Alex groaned from his sprawled position on the far end of the sectional. "I'd rather watch Burke do heart surgery in real time. Again."

"That's saying something," Clem observed from her corner of the couch. She'd positioned herself with what she hoped looked like casual indifference - close enough to the group to seem normal, far enough from Alex to avoid the weird magnetic pull that kept making her hyperaware of his every movement.

"Come on, it's a classic," Izzie protested, appearing from the kitchen with a bowl of popcorn that smelled suspiciously gourmet. Leave it to Izzie to make movie theater popcorn from scratch. "What's wrong with a little romance?"

"Everything," Alex muttered, then caught himself shooting a glance toward Clem before looking away quickly.

Meredith looked up from the medical journal she'd been half-reading. "Since when do you have opinions about romance movies, Alex? Usually you just complain and eat all the pizza."

"I always complain about romance movies," Alex said defensively. "They're unrealistic and stupid."

"Wow," Clem said dryly, "tell us how you really feel."

The comment earned her a sharp look from Alex - not angry, but something more complicated. Like he was trying to figure out if she was taking a shot at him or just being her usual sarcastic self.

George, blissfully oblivious to undercurrents, continued his democratic movie selection process. "Okay, no romance. Action? Drama? What about a thriller?"

"Something with explosions," Izzie suggested, settling into the remaining couch space. "I need vicarious excitement since my life has become nothing but sutures and studying."

"Since when do you like explosions?" Meredith asked.

"Since I realized watching other people's adrenaline rushes is safer than creating my own."

"Smart policy in our line of work," Clem agreed, then immediately regretted speaking when Alex's attention shifted back to her.

They'd managed to get through most of the day without the morning's level of awkwardness, but there was still something charged in the air between them. Like the moment before a storm when all the hair on your arms stands up.

"You two are still acting weird," Izzie announced matter-of-factly.

"We're not acting weird," Clem protested, though even she could hear how defensive it sounded.

"You're sitting like you're afraid Alex might bite you," Meredith observed without looking up from her journal. "And Alex keeps looking at you like he's trying to solve a particularly complicated medical puzzle."

"I don't look at her like anything," Alex said, his jaw tightening slightly.

"Right," Izzie said skeptically. "That's why there's enough tension in here to power the hospital."

George finally settled on a movie - some action thing with cars and explosions that seemed designed to require minimal emotional investment. As the opening credits rolled, Meredith casually set aside her journal.

"Alex," she said, "I was thinking about room arrangements."

Alex paused mid-reach for pizza, immediately suspicious. "What about them?"

"That room upstairs is basically a closet with delusions of grandeur. The basement has actual space, and it's quieter." Meredith's tone was deliberately casual, but Clem caught the quick glance she shot between them. "Want it?"

Alex straightened, genuinely interested despite his wariness. "What's the catch?"

"No catch. Well, maybe contribute more to the coffee fund since you drink twice as much as the rest of us combined."

"Deal," Alex said immediately. "When?"

"Tomorrow's our day off. We could move stuff in the morning."

Clem found herself staring at her hands, trying to untangle whether the twist in her stomach was relief or disappointment. More physical distance was probably smart. Practical. Good for maintaining whatever the hell they were trying to maintain.

"Excellent," Izzie said, settling back with her popcorn. "Musical chairs, but with bedrooms."

"Your ability to find excitement in the mundane is disturbing," Alex muttered, but there was less bite in it than usual.

As the movie progressed - something about a heist involving cars that apparently defied several laws of physics - they settled into more familiar patterns. Izzie provided running commentary, Meredith divided her attention between the screen and medical journals, George absorbed every plot detail like he might be tested on it later.

Alex and Clem maintained their careful distance, but some of the morning's razor-wire tension had dulled to something more manageable. When Izzie made an increasingly creative observation about the impossibility of the car chase physics, Alex snorted with genuine laughter.

"There's no way that Mini Cooper could outrun those motorcycles," Izzie was saying with complete seriousness. "The power-to-weight ratio alone makes it impossible."

"Since when do you know about power-to-weight ratios?" George asked.

"I dated a mechanic for three months. Worst relationship of my life, but I learned things."

When Alex caught Clem's amused expression, more of the day's weirdness dissolved. For a moment, it felt almost normal - like friends with complicated history instead of two people navigating an emotional minefield.

By the time the credits rolled, the atmosphere had shifted from awkward to simply charged. Still careful, still loaded with subtext, but functional.

"Alright, I'm done," Meredith announced, stretching. "Early morning tomorrow if we're actually moving furniture."

"I should probably pack," Alex said, standing and stretching in a way that made his shirt ride up slightly. Clem's eyes tracked the movement before she caught herself and looked away quickly.

"Need help?" George offered earnestly. "I'm very systematic about packing."

"Thanks, but I don't have that much stuff to move."

As they dispersed toward their rooms, Izzie lingered to collect empty boxes and glasses. Clem was almost to the stairs when Izzie's voice stopped her.

"Clem?"

"Yeah?"

"Whatever happened between you two," Izzie said quietly, focused on stacking pizza boxes, "don't let it mess up something good, okay?"

Clem paused with one foot on the bottom stair. "What makes you think something happened?"

Izzie's look suggested she wasn't buying the innocent act for a second. "I live with you people. I notice things. Just... be careful. Both of you."

2:47 AM - Hallway

Clem moved through the dark hallway like the walking dead, exhaustion making her limbs feel disconnected from her brain. The harsh bathroom light had left spots dancing in her vision, and she was navigating back to her room purely on muscle memory and the faint glow of Izzie's insisted-upon nightlight.

She was three steps from her door when she walked straight into something solid and warm.

"Shit," Alex's voice, rough with sleep and surprise.

"Sorry," Clem mumbled automatically, hands shooting out to steady herself against his chest. He was wearing just boxers and a t-shirt, skin warm and solid under her palms.

They did an awkward shuffle - Clem stepping left as Alex stepped right, then both overcorrecting in opposite directions. Alex's hands gripped her shoulders to keep them both upright, and suddenly they were very close in the narrow hallway.

Close enough that she could smell his soap and something underneath that was just him. Close enough to see his pupils dilate despite the dim light. Close enough to feel the heat radiating off his skin.

"Sorry," she whispered again, but made no move to step back.

"Yeah," Alex said roughly, but his hands stayed on her shoulders.

The hallway was silent except for their breathing. Clem became hyperaware of everything - the way his thumb was absently stroking against her collarbone, the rise and fall of his chest, the way he was staring at her mouth like he was starving.

"Clem," he said quietly, and her name sounded different in his sleep-roughened voice. Raw. Wanting.

She looked up at him, and whatever she saw in his expression made her exhaustion evaporate. Without consciously deciding to move, she rose on her toes and kissed him.

Alex responded like he'd been waiting for permission, one hand sliding to cup the back of her neck as he kissed her back with desperate hunger. This wasn't the frantic desperation of the on-call room - this was slower, deeper, but somehow more intense.

"Your room," Alex murmured against her mouth, voice strained.

"Yeah," Clem breathed, already turning toward her door.

They barely made it through the door before Alex had her pressed against it, hands tangling in her hair as he kissed her like he was trying to memorize the taste of her mouth. Clem's fingers found the hem of his t-shirt, pulling it over his head before her hands mapped the planes of his chest.

"Christ, Brooklyn," Alex groaned as her nails scraped lightly across his skin.

This time was different from the on-call room. Less desperate, more deliberate. They took time - Alex's mouth trailing down her throat while her hands explored the muscles of his back, both of them learning what sounds they could draw from each other in the darkness.

When Alex's hands slipped under her sleep shirt, Clem arched into his touch with a soft gasp that made him smile against her collarbone.

"Bed," she managed, and Alex didn't need to be told twice.

They moved together in the dark, a tangle of limbs and whispered directions and breathless laughter when they couldn't quite coordinate their eagerness. When Alex settled between her thighs, Clem wrapped her legs around his waist and pulled him down for another kiss.

"You sure about this?" Alex asked, voice strained with wanting but eyes serious in the dim light.

"Very sure," Clem replied, then proved it by rolling them over so she was straddling him.

Alex's hands gripped her hips as she moved above him, and the soft sounds of pleasure they drew from each other seemed loud in the quiet room. When she leaned down to kiss him, Alex rolled them again, pressing her into the mattress as he moved inside her with deep, steady strokes that made her gasp his name.

They moved together with increasing urgency, hands and mouths seeking skin, until they both came with muffled cries against each other's mouths.

Afterward, they lay tangled together, breathing hard. Alex's arm was around Clem's waist, her head on his chest, both of them loose-limbed and satisfied.

"We're probably gonna have to talk about this," Clem murmured eventually, though she made no move to disentangle herself.

"Probably," Alex agreed, already drowsy. "Tomorrow?"

"Tomorrow," Clem agreed, exhaustion pulling her toward sleep.

Alex knew he should leave - should go back to his own room, maintain some kind of distance. But Clem was warm and soft against him, and he was bone-tired, and it had been a long time since he'd felt this settled. Like pieces clicking into place.

He'd just rest for a few minutes, he told himself. Then he'd go.

7:30 AM - Discovery

Izzie burst through Clem's door without knocking, scanning the room for her black cardigan.

"Clem, I need to borrow your—" She stopped dead. "OH. MY. GOD."

Clem and Alex were tangled together, clearly naked under the rumpled sheet, Alex's arm wrapped possessively around her waist. Both jolted awake at Izzie's shriek.

"Jesus, Izzie," Alex muttered, sitting up and running a hand through his hair, completely unfazed by being caught naked. "What happened to knocking?"

"FINALLY!" Izzie practically bounced. "Do you have any idea how long I've been waiting for this? The sexual tension was suffocating!"

Clem pulled the sheet higher, more resigned than embarrassed. "Good morning to you too, Izzie."

"This is why you two were acting like weirdos yesterday, isn't it? All that awkward avoiding each other?" Izzie's grin was blinding. "Meredith owes me twenty dollars. I said you'd figure it out before New Year's."

"You bet on us?" Alex asked, sounding more amused than annoyed.

"Everyone did! Well, except George because George thinks people get pregnant from kissing." Izzie grabbed the cardigan from the dresser. "This is amazing! You're perfect for each other!"

"Can we maybe keep this between us for like five minutes?" Clem asked without much hope.

"Please. You two live together, work together, and now you're sleeping together. The whole hospital's going to know by lunch tomorrow." Izzie headed for the door, then paused. "I'm making pancakes! Lots of pancakes! Celebration pancakes!"

She practically floated out, closing the door behind her.

Alex dropped back against the pillow with a snort. "Subtle as a brick through a window."

"Could've been worse. Could've been George. He would've had a panic attack and probably called his mother for advice."

"True." Alex pulled her closer. "So much for keeping things quiet."

"Were we really going to keep this quiet?" Clem settled against his chest. "We're not exactly subtle people."

"No, we really aren't."

They lay in comfortable silence for a moment before Alex spoke again, his voice rougher than usual.

"Look, I suck at this talking about feelings stuff, but I need you to know something." He paused, like the words were hard to get out. "This isn't just messing around for me. It matters."

The blunt honesty hit her square in the chest. Alex didn't do pretty speeches, but when he said something, he meant it completely.

"It matters to me too," she said quietly.

"So what are we doing here? Dating? Friends with benefits? What?"

Clem considered. "Maybe we don't have to define it right now. Just... see what happens."

"You want to not overthink something?" Alex raised an eyebrow. "That's like asking George not to stress about everything."

"Maybe we both need to try some new approaches."

Alex's thumb traced her jawline. "I can work with that."

From downstairs, they could hear Izzie's voice getting louder, probably telling everyone about pancakes and celebration breakfasts.

"We should probably get down there before she comes back," Clem said, not moving.

"Probably." Alex's arm tightened around her. "In a few minutes."

"In a few minutes," she agreed.

8:00 AM - Kitchen

The kitchen smelled like butter and excitement. Izzie stood at the stove flipping pancakes with unusual enthusiasm while George sat with his coffee and newspaper. Meredith nursed her own cup, looking like she was still processing being awake.

"There they are!" Izzie announced when Alex and Clem appeared. "I made enough pancakes to feed a small army because I cook when I'm happy."

"You cook when you exist," Alex said, grabbing coffee mugs from the cabinet.

"Today it's definitely happiness." Izzie beamed at them. "You both look... relaxed. Well-rested."

"Izzie," Clem warned, accepting coffee from Alex.

"What? I'm just making an observation. Medical observation. You seem less tense."

George glanced up from his paper. "You do seem better than yesterday. Yesterday you were acting like you'd never met each other."

"We worked through it," Alex said, settling at the table next to Clem.

Before Izzie could launch into more commentary, the front door banged open and Cristina appeared in the doorway looking genuinely panicked.

"Meredith. Emergency. Now."

"Good morning, Cristina," Meredith said mildly. "Coffee?"

"Burke asked me on a date. An actual date with dinner reservations and conversation about non-medical topics." Cristina's voice pitched higher. "I don't do dates. I do sex and surgery. I don't know how to talk about normal things."

"Since when do you care about dating?" Meredith asked, but she was already standing.

"Since never, which is exactly the problem." Cristina grabbed Meredith's arm. "You own normal people clothes. I need to borrow normal people clothes and get normal people advice."

"I'm eating pancakes," Meredith protested as Cristina dragged her toward the stairs.

"Bring the pancakes! This is a crisis!"

Their voices faded as they disappeared upstairs.

"Huh," George said. "I guess everyone's having revelations today."

---

Alex's current room was small and functional - clothes draped over a chair, medical textbooks in neat stacks, his guitar propped in the corner. Not much, but clearly lived-in.

"This really isn't a lot of stuff," Izzie observed, surveying the space.

"I don't accumulate shit," Alex said, shoving clothes into a duffel bag. "Most of my stuff's still back in Iowa anyway."

"The basement's going to be great," George offered helpfully. "Really spacious once you get used to the whole underground lair thing."

"Underground lair?" Alex paused in his packing.

"It's atmospheric," Clem said, carefully stacking his textbooks. "Very private."

"Atmospheric is George-speak for creepy," Alex translated.

"Not creepy! Mysterious. Like a cool bachelor pad," George insisted.

"A mysterious underground bachelor lair." Alex picked up his guitar case. "This keeps getting better. Come on, O'Malley, make yourself useful."

"Why do I have to help? Moving to the basement wasn't my idea."

"Because you keep talking about how awesome it is down there," Alex shot back. "Time to put your money where your mouth is."

They headed out, George grabbing one of the bags, their bickering echoing down the hallway.

"It really is spacious," George was insisting. "And private. You'll love the privacy."

"Private like a bunker is private," Alex muttered back.

Alone with the remaining books and clothes, Clem braced herself for what was coming.

"Okay," Izzie said immediately, "they're gone. Spill. How was it?"

"Izzie..."

"Come on! I've been watching you two circle each other like sharks for months. All that unresolved sexual tension had to go somewhere eventually." Izzie picked up one of Alex's t-shirts, folding it with unnecessary attention. "Was it worth the wait?"

Despite herself, Clem felt heat creep up her neck. "It was... yeah. Worth it."

"I knew it!" Izzie's grin was triumphant. "You two are perfect together. He makes you less serious, you make him less of a complete jackass."

"He's not a complete jackass."

"He absolutely is. But he's our jackass, and he's totally gone for you." Izzie's expression softened slightly. "You deserve something good, Clem. Especially after all that Shepherd disaster."

A crash echoed from the basement, followed by Alex's voice: "Goddammit, George!"

"Sorry! Sorry! These stairs are really narrow!"

Izzie and Clem looked at each other and headed for the basement to assess whatever damage George had managed to cause.

Chapter Text

Chapter Text

Hi! Sorry, I have been dealing with Anxiety, depression, selling my house...possibly buying a small farm with a 4 year old and one year old..and a lack of motivation to write.

But, the next chapter will be posted this weekend, and I will be back to posting once or twice weekly.

I also am thinking I am leaning towards Derek and Clem making a come back in the future. So let me know what you think!

Thanks for comments and kudos!

Chapter Text

Hospital - Morning Rounds

The morning air carried the familiar hospital cocktail of disinfectant and burned coffee as the interns gathered around Bailey for rounds. Clem appeared at Alex's elbow carrying two cups of coffee - one black, one with cream and sugar.

"Here," she said quietly, handing him the doctored coffee without ceremony.

Alex accepted it with a slight nod, their fingers brushing briefly. "Thanks."

Nothing dramatic, but the easy familiarity of the gesture was impossible to miss. Bailey's pen stopped tapping against her clipboard.

"Well, well. Coffee service now," Bailey observed dryly. "What's next, Hart? Fluffing his pillows?"

"It's just coffee," Clem said with a slight edge.

"Uh-huh." Bailey's tone suggested she wasn't buying the casual act for a second. "Stevens, O'Malley - you're with Torres in ortho. Yang, you're with Burke in cardio. Grey with Shepherd." She paused, consulting her clipboard. "Karev, Hart - you're with me. We have an interesting case that requires your particular brand of stubborn curiosity."

Cristina, who had been unusually quiet, finally spoke up. "This is weirder than yesterday when you two were being all overly professional. Now you're doing couple things without being a couple."

"We're not doing couple things," Alex said defensively.

"You literally just coordinated your coffee routine," Cristina pointed out flatly. "That's domestic."

"Since when do you care about anything besides your own surgical advancement?" Clem shot back.

"Can we focus on medicine instead of analyzing coffee distribution?" Alex asked, but there was no real irritation in his voice - just tired resignation.

"Alright," Bailey interjected sharply. "If this whatever-it-is affects your work, I will separate you so fast you'll think you imagined working together. Now move. We have a patient who's been making the psychiatric department question their collective sanity."

Room 318 - Shane Herman's Room

Shane Herman sat in the hospital bed looking like a man who'd been through an emotional blender. His wife Tina sat beside him, her pregnancy clearly visible, her hand resting protectively on her belly.

"Mr. Herman," Bailey began, "these are Dr. Karev and Dr. Hart. They're going to be assisting with your case."

Shane looked up with exhausted eyes. "You here to tell me I'm crazy too?"

"We're here to figure out what's actually wrong with you," Clem said, pulling up a chair. "Walk us through what's been happening."

"My wife's pregnant. Four months along. About six weeks ago, I started feeling different. Nauseous in the mornings, food aversions, my stomach getting bigger." He laughed bitterly. "I took a pregnancy test as a joke. It came back positive."

Alex leaned against the wall, studying Shane intently. "You took a pregnancy test?"

"Three of them. All positive. My stomach's been growing at the same rate as Tina's." Shane's voice cracked. "The psychiatric department thinks I'm having some kind of sympathetic pregnancy delusion. But the physical symptoms are real. How do you fake morning sickness for six weeks straight?"

"The abdominal distension is definitely real," Bailey confirmed. "As is the positive pregnancy test. Which, in a biological male, indicates something else entirely."

"What kind of something else?" Tina asked quietly.

"That's what we need to find out," Bailey said. "Dr. Hart, what can cause a false positive pregnancy test in men?"

Clem straightened. "Testicular cancer can produce hCG - specifically nonseminomatous germ cell tumors. So can other tumors - stomach, liver, pancreas. Given the timeline and constellation of symptoms, we're probably looking at a tumor producing beta-hCG."

"Good. Dr. Karev, next step?"

"Blood work to check hCG levels. CT scan of the abdomen and pelvis, tumor markers including AFP and LDH," Alex answered promptly.

"Excellent. Get him scheduled for imaging and draw the blood work. I want results by this afternoon."

As they left the room, Shane's voice followed them: "Please tell me you can figure this out. I can't take much more of people looking at me like I'm losing my mind."

Hospital Corridor

"Poor bastard," Alex said as they walked toward the elevator. "Imagine having physical symptoms that mimic your wife's pregnancy, then having everyone think you're having a psychological breakdown."

"If it's testicular cancer, the timing is really shit," Clem observed grimly. "Wife's pregnant, he's potentially facing chemo and surgery."

"Could be something benign. Not everything's a death sentence."

"Since when are you the optimistic one?"

"Since you started being the pessimistic one. Someone's gotta balance this shit out."

Clem glanced at him as they waited for the elevator. "You know, for someone who claims not to give a damn about patients, you're getting pretty invested in this one."

"I'm not invested. I just don't like seeing people get screwed over by doctors who don't listen." Alex's jaw tightened.

"Right. That's why you stayed late yesterday to check on Mrs. Patterson even though she wasn't your patient."

Alex paused, caught. "Shut up, Brooklyn."

The elevator doors opened, and Clem grinned as they stepped inside. "There he is. Evil spawn's back."

CT Scan Results - Later That Afternoon

Bailey gathered Alex and Clem around the viewing computer as Shane Herman's CT images appeared on the screen.

"There," Bailey pointed to a large mass in the abdomen. "Retroperitoneal tumor, approximately eight centimeters. Explains the abdominal distension and the positive pregnancy test."

"Is it malignant?" Clem asked, leaning forward to study the images.

"We won't know until pathology, but the imaging characteristics suggest it could go either way." Bailey scrolled through the images. "Good news is it appears to be encapsulated and hasn't metastasized. Bad news is it's going to require surgical removal."

"How do we tell him?" Alex asked, his voice carrying an unusual note of concern.

"Honestly and directly," Bailey replied. "This man's been told he's delusional for weeks. He needs to know his symptoms were real and that we have a treatment plan."

Room 318 - Breaking the News

"Mr. Herman, we have your test results," Bailey began, pulling up a chair across from Shane and Tina.

Shane gripped his wife's hand. "Just tell me straight. Am I crazy?"

"You're not crazy," Bailey said firmly. "You have a retroperitoneal tumor - a mass behind your abdominal cavity. It's been producing hormones that caused the positive pregnancy tests and contributed to your other symptoms."

Tina's free hand flew to her mouth. "A tumor? Is it cancer?"

"We're waiting for biopsy results to determine that," Bailey continued. "But regardless of whether it's benign or malignant, it needs to be surgically removed."

"Surgery," Shane repeated numbly.

"The good news is that it appears to be contained and hasn't spread," Clem added. "The imaging looks promising for a complete surgical removal."

"When?" Tina asked.

"We'll schedule it for early next week. Dr. Bailey will be performing the surgery."

Shane looked directly at Alex. "How do you deal with everyone thinking you're crazy? When you know something's wrong but nobody believes you?"

Alex was quiet for a moment. "You don't," he said finally. "You just keep pushing until someone listens. Until someone believes you."

As they left the room, Shane's voice was stronger: "Thank you. Thank you for believing me."

Joe's Bar - Evening

The bar was crowded with the usual mix of hospital staff and random Seattle residents. The interns had claimed their usual corner table, medical journals abandoned in favor of drinks and decompression.

"Pool?" Alex asked, nodding toward the tables in the back. "I'm feeling lucky tonight."

"Your funeral," Clem said, standing. "Twenty bucks?"

"Make it the drinks," Alex countered with a cocky grin. "Loser pays."

"Even better. Hope you brought your wallet."

They made their way to the pool table while the others settled in with their drinks. Alex racked the balls with confident precision, clearly expecting an easy win.

"Ladies first," he said, gesturing to the table with exaggerated chivalry.

"How generous," Clem said dryly, chalking her cue. "I'll try not to embarrass you too badly."

"Big talk, Brooklyn. Let's see what you got."

Clem lined up her shot and scattered the balls across the table, sinking two stripes. "Stripes."

"Lucky break," Alex muttered, but he was watching her more carefully now as she moved around the table, calculating angles.

"Luck's got nothing to do with it," Clem said, sinking another stripe with casual precision.

Alex's cocky grin faded as Clem methodically worked her way around the table. She moved with the same focused intensity she brought to surgery, each shot deliberate and controlled.

"Son of a bitch," Alex said when she sank her fourth ball in a row. "Where the hell did you learn to play like that?"

"Bartending in Brooklyn," Clem said, lining up her next shot. "You pick things up when you're working your way through med school."

"You hustled me."

"You hustled yourself. I never said I was bad at pool." She sank the five ball in the corner pocket.

Alex finally got his turn when Clem missed a difficult bank shot, but by then it was too late. He managed to sink two solids before Clem reclaimed the table.

"Eight ball, corner pocket," she called, then proceeded to sink it exactly where she'd pointed.

"Unbelievable," Alex said, but he was grinning despite himself. "You completely sandbagged me."

"I prefer 'strategically underestimated,'" Clem said, handing him her cue stick. "Whiskey sour. And don't cheap out on the whiskey."

Alex shook his head, laughing. "Remind me never to gamble with you again."

"Where's the fun in that?"

Alex headed to the bar to fulfill his debt, leaving Clem to return to their table where the others were watching with amusement.

"Brooklyn just destroyed Alex at pool," Cristina observed. "His ego might not recover."

"He'll survive," Clem said, settling back into her chair. "Besides, free drinks make everything better."

She was explaining her strategy to Izzie when Derek approached, looking carefully casual in jeans and a button-down. Her stomach immediately tightened, but it was anger now, not the old hurt.

"Dr. Hart."

"Dr. Shepherd." She kept her voice neutral, professional.

"I was hoping I could talk to you for a minute." His eyes flicked to the other interns. "Privately."

"I'm good here, thanks," Clem said, glancing toward the bar where Alex was still waiting to order.

"Five minutes. Just to clear the air."

"The air is fine. Crystal clear, actually."

Derek's jaw tightened. "Look, Clem, I know you're upset about Addison showing up, but what we had was real. You can't just pretend it didn't happen."

"What we had was you lying to me for months," Clem said steadily. "That's pretty real."

At the bar, Alex had finally gotten the bartender's attention when he glanced back toward their table. Seeing Derek hovering over Clem, his expression immediately darkened. He grabbed the drinks and headed back, moving with purpose.

Derek's eyes narrowed as he took in the protective way the other interns had shifted around Clem. "I was having a conversation with Dr. Hart."

"Looks like Dr. Hart's having a conversation with us," Alex said as he arrived, setting Clem's whiskey sour in front of her with deliberate care before taking his seat. His body language made it clear he wasn't going anywhere.

"I wasn't talking to you, Karev."

"No, but you're talking to Brooklyn." Alex's voice carried a warning edge. "And she said she's good here. So maybe take the hint."

Derek's gaze shifted between them, clearly noting the easy way Alex had delivered her drink, the protective positioning. "I see. Is there something I should know about?"

"Yeah," Alex said, his tone getting sharper. "You should know that Brooklyn doesn't need to hear your explanations about how complicated your marriage is."

"This isn't about my marriage—"

"Everything about you is about your marriage," Clem interrupted, taking a sip of her whiskey sour. "The fact that you ran away from it without ending it, the fact that you started something with me without mentioning it, the fact that you're still here making excuses instead of dealing with it." She leaned back in her chair. "I'm not interested in being anyone's midlife crisis, Derek. Find another hobby."

Derek stood there for a moment, clearly wanting to push the issue. But the united front of the interns and Alex's increasingly hostile posture made it clear the conversation was over.

"This conversation isn't over," Derek said quietly.

"Yeah, it is," Alex replied, not bothering to look up from his beer. "Has been for weeks. You're just catching up."

Derek left, and the tension at the table slowly began to ease.

"Well," Izzie said after a moment, "that was uncomfortable."

"Thanks," Clem said quietly to Alex, gesturing to her drink. "For this, and for... the rest."

"You won it fair and square," Alex said with a slight smirk. "Besides, someone had to tell McDreamy to back off."

"Here's to pool hustlers and protective assholes," Meredith said, raising her beer.

"I'll drink to that," Clem agreed, clinking her glass against Alex's bottle.

Chapter Text

Thanksgiving

The kitchen buzzed with Izzie's manic energy as she pulled ingredients from overstuffed grocery bags, her blonde hair already escaping from its ponytail. The counter looked like a food magazine had exploded across it.

"Okay," Izzie announced to the assembled household, "I know we're all busy with hospital stuff, but it's Thanksgiving. We're doing this right. Turkey, stuffing, cranberry sauce, pumpkin pie—the whole traditional spread."

"Iz, that's like twelve hours of cooking," Meredith pointed out from her perch on the counter, coffee mug in hand.

"Exactly! Which is why I need everyone to commit. No bailing for hospital shifts, no mysterious emergencies, no 'I forgot I had plans.'" Izzie fixed each of them with her most determined stare.

George shifted uncomfortably by the refrigerator. "Actually, I'm supposed to go hunting with my dad and brothers. It's a family tradition."

"Hunting?" Izzie's voice pitched higher. "On Thanksgiving? That's barbaric!"

"It's not barbaric, it's bonding," George defended. "We've done it every year since I was twelve."

"You're going to abandon me to cook alone so you can kill innocent animals?"

"I'm not abandoning you. I'll be back by evening. And technically, we usually don't actually kill anything. My dad's eyesight isn't what it used to be."

Clem leaned against the doorframe, watching the domestic drama unfold. "I can help when I get off shift, Izzie. But I'm on until six."

"Really? You won't get stuck with some emergency surgery?"

"Just routine floor work today. Should be manageable."

Alex appeared in the kitchen doorway, hair still messy from sleep, wearing jeans and a faded t-shirt. "Coffee," he mumbled, heading straight for the pot.

"Alex!" Izzie pounced. "Thanksgiving. Today. Here. You're staying, right?"

Alex poured coffee into his favorite mug. "Yeah, sure. I'm off at five."

"Perfect! Well, not perfect timing-wise, but we'll make it work."

"Sounds like a plan," Clem said, accepting the coffee Alex handed her without being asked. The easy domesticity of the gesture wasn't lost on anyone in the room.

"Look at you two," Izzie said with a grin. "All couple-y."

"We're not couple-y," Alex protested, but there was no real heat in it.

"You literally just did the coffee thing without her asking," Meredith pointed out.

"It's just coffee."

"Sure it is," Izzie said, already turning back to her ingredient organization. "George, you're on dessert duty when you get back from your murder expedition. Meredith, you're on table setting and general supervision. And when you two get home from work, you can help with whatever's left."

George grabbed his jacket. "I should head out. Dad's picking me up in twenty minutes." He paused at the door. "Try not to burn the house down while I'm gone."

"No promises," Meredith said cheerfully.

Seattle Grace Hospital - Medical Floor

Clem's shift was exactly as routine as promised—post-op checks, medication adjustments, and discharge paperwork. She worked steadily through her patient list, looking forward to getting home to help with dinner.

Around noon, she was updating charts at the nurses' station when her phone buzzed with a text from her mother: Happy Thanksgiving sweetheart. Thinking of you. How are things with Alex?

Clem smiled despite herself. Kit had taken an immediate liking to Alex during her visit, much to everyone's surprise.

She typed back: Things are good. Really good. How are you doing?

I'm fine, honey. More importantly, give that boy my love. I liked him.

You barely talked to him for five minutes.

Five minutes was enough. He's good for you.

How can you possibly know that?

Because you smiled more in those five minutes than you did the entire rest of my visit. Trust your mother's judgment. Life's too short not to be happy.

There was something in that last message that made Clem pause, but before she could think too much about it, her pager went off with another patient to check on.

Meredith's House - Early Evening

By the time Clem and Alex got home around six, the kitchen was in full preparation mode. Izzie had somehow enlisted Burke and Cristina, who'd apparently shown up while they were at work. Burke had clearly taken charge of the more complex dishes while Cristina stood in the corner looking like she'd rather be performing surgery.

"There you are!" Izzie exclaimed. "Perfect timing. Burke's been amazing, but we still need to get the potatoes going and finish the green beans."

"I can handle potatoes," Clem said, washing her hands.

"And I can do whatever doesn't require precision," Alex added, grabbing a beer.

Burke looked up from where he was expertly preparing what looked like an elaborate stuffing. "Dr. Stevens had everything well organized. We're right on schedule."

"Burke basically saved Thanksgiving," Izzie said, beaming. "He's been coaching me through everything."

"This is nice," Cristina observed, though she sounded mildly surprised by her own admission.

"See? I told you Thanksgiving could be fun," Izzie said.

"I didn't say it was fun. I said it was nice. There's a difference."

Around seven, George returned from his hunting expedition with stories of his father's poor marksmanship and several boxes of bakery pie.

"How was the great outdoors?" Meredith asked.

"Cold. Muddy. My dad shot a tree." George held up the pie boxes. "But we stopped at the good bakery on the way back, so the day wasn't a total loss."

"Thank God," Izzie said, accepting the boxes. "I was starting to panic about having enough dessert."

By eight o'clock, thanks largely to Burke's expertise, they'd managed to produce a Thanksgiving feast that would have made Martha Stewart proud. The dining room table groaned under the weight of perfectly roasted turkey, expertly seasoned stuffing, mashed potatoes, green bean casserole, cranberry sauce, and Burke's restaurant-quality gravy.

Dinner

"Okay," Izzie said once everyone was seated with full plates, "I know this is cheesy, but we're doing the gratitude thing. It's tradition."

"Do we have to?" Cristina asked.

"Yes. We have to." Izzie raised her wine glass. "I'll start. I'm grateful for this house, for all of you, and for Burke saving me from a complete nervous breakdown."

"I'm grateful that you allowed me to help," Burke said diplomatically. "It was quite enjoyable."

"I'm grateful for alcohol," Cristina said, taking a sip of wine.

"I'm grateful to be home safe from the Great O'Malley Hunting Expedition of 2005," George added. "And for store-bought pie."

"I'm grateful for people who don't make me talk about my feelings," Meredith said, glancing pointedly at Izzie.

All eyes turned to Alex, who shifted uncomfortably in his chair. "Uh... I'm grateful for this. All of this." He gestured vaguely at the table. "People who don't suck. Food that isn't from a vending machine. Whatever."

"Eloquent as always," Clem said with a grin.

"Your turn, Brooklyn."

Clem looked around the table at these people who'd become her chosen family, then thought about her mother's text message and that odd note about life being too short.

"I'm grateful for second chances. And for people who stick around even when you're complicated." Her eyes met Alex's across the table. "And for my mom, who somehow always knows exactly what to say, even from three thousand miles away."

Izzie's wine glass froze halfway to her lips, her expression tightening almost imperceptibly. She glanced quickly at Clem, then down at her plate, her jaw working like she was biting back words.

Alex raised his beer bottle in a small salute, oblivious to Izzie's sudden tension.

"Now can we eat?" Cristina asked. "All this gratitude is making me hungry."

"Agreed," Burke said, beginning to carve the turkey with professional precision.

As conversation flowed and wine loosened tongues, Clem found herself thinking periodically about her mother. Kit had seemed different during her visit—more focused on Clem's happiness, more insistent about not wasting time. But then again, Kit had always been intense about living life fully.

Izzie remained unusually quiet throughout dinner, picking at her food and offering only distracted responses when directly addressed.

"Pass the stuffing?" Alex asked quietly.

When she handed it to him, their fingers brushed briefly. "This is nice," she said.

"Yeah, it is."

"I mean it. Having people to come home to. People who know all your shit and stick around anyway."

"Don't get all sentimental on me, Brooklyn."

"Wouldn't dream of it."

But as the evening continued with too much wine and competing stories from their various shifts, Clem realized that this was exactly what she'd been looking for when she came to Seattle—not just a fresh start, but a place where she belonged.

"More wine?" Meredith asked, already reaching for the bottle.

"Definitely," Clem said, holding out her glass.

Some holidays were about big gestures and dramatic moments. Others were about good food, decent wine, and the people who showed up when it mattered.

This was definitely the latter kind, and she wouldn't have it any other way.

Later That Night

After everyone had gone home or to bed, Clem and Alex found themselves in the kitchen doing dishes—a task that had somehow become theirs by default.

"Not bad for Stevens' first Thanksgiving production," Alex said, drying a serving bowl.

"Burke saved her ass. Did you see that stuffing? That was not beginner-level cooking."

"That's basically a miracle."

They worked in comfortable silence for a few minutes, settling into the easy rhythm they'd developed over the past weeks.

"You know what was weird?" Clem said eventually, handing him a plate to dry. "A text from my mom today."

"What about it?"

"The way she said 'life's too short not to be happy.' It just... I don't know. Sounded off for her."

Alex paused in his drying. "Off how?"

"Kit's not usually the philosophical type. She's more practical. Direct." Clem frowned, scrubbing at a stubborn spot on the casserole dish. "Maybe I'm overthinking it."

"Maybe she just wants you to be happy."

"Maybe." Clem handed him another plate. "She really did like you, you know. When she visited."

"She seemed cool. Tough, but cool."

"She is. She's the strongest person I know." Clem was quiet for a moment. "I should call her more."

Alex glanced at her. "Everything okay?"

"Yeah. Just... Thanksgiving makes you think about family, I guess." She managed a smile. "Good thing I found myself a decent one here."

"Stevens would be thrilled to hear you call us decent."

"Don't tell her. She'll want to plan a family bonding activity."

"Could be worse though," Alex said, drying another plate.

"How's that?"

"We could be spending the holidays with our actual families. Your mom's cool, but my family's a fucking nightmare."

Clem glanced at him, noting the edge in his voice. "When you're ready to talk about that nightmare, I'll listen. No judgment, no advice unless you ask for it."

Alex looked surprised by the directness of the offer. "Just like that?"

"Just like that. You've heard plenty of my shit. Fair's fair."

They finished putting away the dishes, and Alex tossed the dish towel onto the counter. "I'm beat. All this gratitude wore me out."

"You said like three words during the gratitude round."

"Three more than I wanted to say."

"You're such an ass," Clem said, but she was grinning.

"Yeah, but I'm your ass now."

"Lucky me."

As they headed downstairs, Clem thought that this was probably what contentment looked like—not grand romantic gestures or tearful declarations, but someone who did the dishes with you and made fun of your sentimental moments.

Someone who stayed not because they had to, but because they wanted to.

Even if they complained about Izzie's holiday enthusiasm the entire time.

Chapter Text

Four Days After Thanksgiving - Monday Morning

"Hart, you're with Koracick in neuro today," Bailey announced during morning rounds. "He specifically requested you for a complex AVM case."

Alex, standing nearby with his assignment to run labs and update charts, felt his stomach tighten slightly. While Clem got to scrub in on interesting surgeries, he was still stuck with the basics until he passed his re-test.

"Lucky," he muttered, but he managed a small smile when Clem looked his way.

Tuesday Afternoon - Hospital Lab

Alex was running blood work when he overheard two residents talking at the next station.

"Did you see Hart yesterday? Koracick was actually letting her handle the clip applier on feeding vessels."

"She's got good hands. Hart was retracting brain tissue like a second-year."

"Yeah, some people just have it, you know? Natural surgical instincts."

Alex focused harder on his lab results, trying to ignore the conversation, but the words stuck.

Wednesday Evening

Alex was studying when his phone rang. Iowa area code. He almost didn't answer.

"Alex?" Aaron's voice was rough, agitated.

"What do you want, Aaron?"

"Jesus, hello to you too. Can't a guy call his brother?"

"You only call when you need something. So what is it this time?"

There was a pause, then Aaron's laugh—bitter and familiar. "You always were a smart little shit. Fine. I'm in some trouble. Need to lay low for a while."

"What kind of trouble?"

"The kind where maybe I shouldn't go into details over the phone." Aaron's voice sharpened. "Look, I was thinking I could crash with you for—"

"No."

"Come on, Alex. It's just for a few weeks—"

"I said no. I'm not doing this anymore."

"Right. Because you're too good for your family now. Playing dress-up with the rich kids." Aaron's tone turned vicious. "You think putting on a doctor costume changes what you are? You're still Jimmy Karev's son, little brother. Still white trash from Iowa. And sooner or later, everyone's gonna figure that out."

Alex's jaw tightened. "Don't call me again."

"Fine. But when this whole doctor fantasy falls apart, don't come crawling back home. 'Cause you burned that bridge tonight."

The line went dead. Alex stared at his phone, Aaron's words echoing: You're still Jimmy Karev's son.

Thursday Morning - Hospital Observation Gallery

Alex was supposed to be restocking supply closets on the third floor, but he found himself drawn to the observation gallery overlooking OR 2. Through the glass, he could see Clem working alongside Koracick on what looked like a complex craniotomy.

Her movements were confident, precise. Even from this distance, he could see Koracick occasionally nodding in approval as Clem handled delicate instruments, her hands steady as she worked on actual brain tissue.

"Shouldn't you be somewhere else, Karev?"

Alex spun around to find Bailey standing in the doorway, arms crossed and expression unimpressed.

"Dr. Bailey, I was just—"

"You were just abandoning your assigned duties to moon over your girlfriend." Bailey stepped into the gallery, her tone sharp with irritation. "This is a hospital, not a romance novel."

Alex's jaw tightened. "I wasn't—"

"Save it. Whatever's going on between you and Hart, handle it on your own time." Bailey moved toward the door. "Right now, you have supply closets to restock and a re-test to study for. Focus on that instead of playing lovesick puppy."

"Dr. Bailey—"

"Go. Now. And Karev? If I catch you slacking off again because you're distracted by relationship drama, you'll be doing inventory in the basement for the rest of the month."

After she left, Alex stood alone in the gallery for another moment, burning with humiliation. Bailey thought he was here because he missed Clem, not because watching her succeed was eating him alive.

Somehow that made it worse.

Thursday Evening - Joe's Bar

Alex was on his second beer, staring at the bottle instead of participating in the conversation. Clem sat beside him, close enough that their knees touched, telling the group about her surgery.

"Koracick let me do the dural opening," she was saying, her eyes bright with excitement. "Said my technique was better than some of the third year residents he's worked with."

"That's incredible, Clem," Izzie said.

Clem glanced at Alex, noting his silence. She reached over and squeezed his thigh gently—a small, unconscious gesture of connection.

Alex tensed under her touch, his jaw tightening almost imperceptibly.

"You okay?" Clem asked quietly, leaning closer so only he could hear.

"Fine." But his voice was flat, and he shifted slightly away from her hand.

Clem frowned, studying his profile. "Alex—"

"Just tired," he cut her off, taking another drink. "Long day of running labs."

There was an edge to his voice that made Clem pull back slightly. She'd learned to read his moods, and this felt different than his usual grumpiness after a bad day.

"Maybe we should head home," she suggested.

"You stay. Celebrate your surgical triumph." Alex stood abruptly. "I'm gonna get another drink."

He walked to the bar, leaving Clem staring after him with confusion and growing concern.

"Everything okay with you two?" Meredith asked.

"I thought so," Clem said, watching Alex order another beer instead of coming back to their table. "But apparently not."

When Alex did return twenty minutes later, he sat one seat over from where he'd been, putting George between them. The message was clear, even if he didn't say anything.

Clem tried to catch his eye, but Alex kept his gaze fixed on his beer, Aaron's words still echoing in his head: White trash from Iowa. Everyone's gonna figure that out.

And sitting next to Clem—beautiful, brilliant, accomplished, golden-girl Clem—he'd never felt the truth of those words more acutely.

Later

They'd driven home from Joe's mostly in silence, Alex's mood from the bar still hanging over them like a storm cloud. Once inside, they headed down to the basement together, following their usual routine.

Alex kicked off his shoes and started unbuttoning his shirt while Clem sat on the edge of the bed, watching him.

"You were quiet tonight," she said, pulling her sweater over her head.

"Just tired." He shrugged out of his shirt and tossed it toward the hamper.

Clem stood and moved toward him, her hands settling on his chest. "Maybe I can help you relax."

She leaned in and kissed him, soft at first, then deeper. Her fingers traced the familiar lines of his torso as she pressed closer, and after a moment, Alex responded, his hands coming up to her waist.

They moved to the bed, shedding clothes in what was usually an easy, hungry rhythm. But tonight Alex's hands were clumsy, distracted, like he was forcing himself through familiar motions.

Clem slid her shirt off and reached for him, but she could feel the tension radiating from his shoulders, the way he kissed her without real heat—as if trying to will himself into wanting this.

She kissed down his throat, lingering at the spot that always made him groan, her hands sliding over his chest and lower. When she wrapped her fingers around him with practiced familiarity, stroking with the teasing rhythm that usually had him arching into her touch, his body refused to respond.

"Alex..." she whispered against his ear, shifting to press herself against him, trying to ignite something with the friction of skin on skin. But his fists only clenched tighter in the sheets.

"Come on," he muttered under his breath, frustration bleeding through.

She kissed him deeper, her tongue brushing his, her body moving against his in all the ways that typically drove him crazy. Instead, every attempt seemed to wind him tighter, his mind clearly elsewhere—on Aaron's poisonous words, on his failures, on everything except her.

The harder she tried to bring him back to her, the more his tension pushed against any possibility of arousal. After several long minutes that shifted from heated to awkward to painful, the truth became undeniable.

Alex broke away, collapsing onto his back and staring at the ceiling with defeat written across his face.

"Shit," he bit out, voice raw with humiliation.

"Hey." Clem's hand found his shoulder, her touch gentle. "It's okay. It happens. You're stressed about the re-test—"

"It's fine." The words came out clipped, mortified. "Just... let's just go to sleep."

He turned away from her, his shoulders tense with humiliation.

Clem lay beside him, staring at his rigid back in the dim light. She wanted to say something comforting, but the set of his body told her he didn't want to talk about it.

"Alex?" she whispered after several minutes.

"What?"

"Are we okay?"

There was a long pause. "Yeah. We're fine."

But they both knew he was lying. Clem could feel the distance between them like a physical thing, and Alex's inability to perform felt like a symptom of something much bigger going wrong.

Neither of them slept well, trapped in their own spiraling thoughts. And in the morning, all of Alex's frustration and humiliation would explode in the worst way possible.

Friday Early Morning

Clem woke to the sound of pages turning and the soft scratch of a pen on paper. The basement room was still dark, but she could see Alex sitting at his desk in boxers, hunched over medical textbooks with a cup of coffee that had probably gone cold hours ago.

"What time is it?" she mumbled, squinting at the clock. 4:17 AM.

"Early. Go back to sleep."

But his voice had that edge to it—the one that meant he was spiraling about something. She sat up, pushing her hair out of her face.

"How long have you been awake?"

"Couple hours." He didn't look up from his textbook.

"Alex. The re-test isn't for another week."

"Yeah, well..." He paused, his pen hovering over the page. Aaron's words were still echoing in his head, mixing with the image of Clem in the OR, confident and praised while he sorted through lab results like a glorified secretary. "Maybe if I was sleeping with my attending I wouldn't have to worry about it."

The words hung in the air, ugly and deliberate.

Clem went completely still. "Excuse me?"

Alex saw the shock on her face, the way her eyes widened with genuine hurt. For a moment, something in his chest twisted sharply. The rational part of his brain was screaming at him to stop, to apologize, to tell her about Aaron's call and his fears about being left behind. She was looking at him like he'd slapped her, and part of him wanted to reach for her, to take it back, to—

But then he thought about watching her work with Koracick, about Bailey calling him a lovesick puppy, about Aaron's voice: You're still Jimmy Karev's son, little brother.

"Some of us have to actually work for our opportunities," he said, the words coming out harsher than he'd intended, "instead of just spreading our legs for the right people."

The silence stretched between them, toxic and heavy. Then Clem got out of bed and started pulling on her clothes with sharp, angry movements.

"Fuck you, Alex. Fuck you and whatever bullshit is making you say that."

She grabbed her phone and headed for the stairs.

"Yeah, run away. That's what you're good at," Alex called after her, even as part of him was screaming to shut up, to stop making it worse.

Clem stopped at the bottom of the stairs. "What did you just say?"

Alex opened his mouth to apologize, to explain, but Aaron's words crashed over him again: ...White trash...Everyone's gonna figure that out.

"You heard me. Soon as things get real, you bail. Callahan, McDreamy, now me."

She turned around, her face cold with fury. "Go to hell, Alex."

The basement door slammed behind her, and Alex sat there staring at his textbook, hating himself and unable to take any of it back.

Kitchen

Clem was aggressively making coffee when Izzie appeared in the kitchen doorway, already dressed in jeans and a sweater for her shift.

"You're up early," Izzie observed, taking in Clem's rumpled clothes and obvious fury.

"Couldn't sleep."

"Everything okay?"

"Peachy." Clem slammed the coffee pot back onto the burner harder than necessary.

Izzie moved to the refrigerator. "Want some eggs? I can make us something before we head in."

"Thanks."

Izzie started pulling ingredients out while Clem sat at the kitchen table with her coffee. They were eating in tense silence when Alex appeared in the kitchen, fully dressed in khakis and a button-down, looking like he hadn't slept at all. He moved stiffly toward the coffee pot, not making eye contact with anyone.

The silence stretched uncomfortably as he poured coffee into his travel mug. Clem didn't look up from her plate, and Alex kept his gaze fixed on what he was doing.

Finally, he grabbed his mug and headed for the door without a word.

"Okay, that was ice cold," Izzie said after he left, looking between the door and Clem. "What did you two fight about?"

"Nothing worth discussing," Clem said, stabbing her eggs with unnecessary force.

Hospital - Morning Rounds

Bailey stood at the nurses' station with her clipboard, ready to dole out assignments to the gathering interns. Alex positioned himself on the opposite side of the group from Clem, who was pointedly ignoring his existence.

"Stevens, you're in ortho. O'Malley, cardio with Burke. Yang, you're in the pit with me. Grey, neuro with Shepherd." Bailey's pen moved down her list. "Hart, you're in OB today with Montgomery. Karev, you're floating between services today. Try not to screw anything up." Bailey closed her clipboard. "Move."

Clem's stomach clenched. Working with Addison, of all people, after Alex's vicious comment about sleeping with attendings. The irony was almost too bitter to swallow.

As the group dispersed, Alex finally looked in Clem's direction, but she was already walking toward the elevators, her jaw set with fury.

Hospital Cafeteria - Lunch

Clem was picking at a salad when she spotted Alex at the coffee station, leaning against the counter and chatting with Nurse Olivia. He was using his cocky grin—the one that usually meant he was trying to get something. Or someone.

"Karev's working overtime today," Meredith observed, settling at the table with her tray.

"What do you mean?"

"The flirting. It's aggressive, even for him." Meredith followed Clem's gaze to where Alex was now touching Olivia's arm while she laughed at something he'd said. "And obvious. Like, painfully obvious."

Clem stabbed her lettuce with more force than necessary. "Not my problem."

"Right. That's why you're stabbing your food like it personally wronged you." Meredith took a bite of her sandwich. "What did you guys fight about this time?"

"Who says we fought?"

"The fact that you two haven't looked at each other all day, and he's over there flirting like his life depends on it." Meredith paused. "Also, Izzie said you two were weirdly tense at breakfast."

Before Clem could respond, Alex's laughter carried across the cafeteria, loud enough to draw looks from nearby tables. Olivia was practically glowing under his attention.

"How's it going with Montgomery?" Meredith asked.

"Fine. Professional. Cold, but fine." Clem's voice was clipped. The morning had been perfectly civil—Addison treated her like any other intern, neither friendly nor hostile. Just... nothing. Which somehow made Alex's cruel accusations sting worse.

"That's progress, I guess?"

"Yeah, progress," Clem said flatly, watching Alex lean closer to whisper something in Olivia's ear. She pushed her barely touched salad away. "I should get back."

"You barely ate."

"I'm not hungry anymore."

Hospital corridor - Late Afternoon

Clem was coming out of a patient room after updating a post-op chart when she saw Alex walking down the hall with Olivia, both of them heading toward the on-call rooms. Olivia was giggling at something Alex had whispered in her ear.

"Really?" Clem said when Alex passed close enough to hear.

He stopped, turning back with a challenging look. "Really what?"

"Nothing. Forget it."

"No, go ahead. Say what you're thinking."

Clem glanced around the busy hallway, noting the nurses and other staff within earshot. "I'm thinking you're being
a dick."

"Yeah? Well, at least I'm being honest about what this is." Alex's smile was cold. "We hooked up a few times, Brooklyn. Don't make it into something it's not."

The words hit like a slap, made worse by the public setting. "Right. My mistake."

"Good. Now we're clear." He turned back to Olivia. "Come on."

Clem watched them disappear into the on-call room, her chest tight with anger and something that felt uncomfortably like hurt. A few nurses had clearly overheard the exchange, and she could feel their curious stares.

She lifted her chin and walked back toward the nurses' station, refusing to give anyone the satisfaction of seeing her rattled.

Meredith's House - Evening

Clem was alone in the kitchen making dinner, grateful for the solitude after a day of maintaining professional composure while her personal life imploded. She was dicing onions with perhaps more aggression than necessary when she heard the front door slam.

Heavy footsteps moved through the house, and she tensed, recognizing Alex's gait. She kept her focus on her knife work, hoping he'd go straight to the basement.

Instead, he appeared in the kitchen doorway. His hair was messy and his shirt was wrinkled, making it pretty obvious what he'd been doing for the past few hours.

They stared at each other for a moment, the air thick with unspoken hostility. Alex moved toward the refrigerator, "Don't worry," Alex said, his voice cold as he grabbed a beer. "I'm not staying."

Clem didn't respond, just continued chopping vegetables with sharp, precise cuts.

Alex paused at the kitchen door, beer in hand. "You know what your problem is, Brooklyn?"

"Don't." Her voice was low, warning.

"You think you're better than everyone else. But deep down, you know you're just as fucked up as the rest of us."

Clem set down her knife and turned to face him, her expression ice cold. "Get out of my kitchen."

"Your kitchen?" Alex laughed bitterly. "Nothing here is yours, princess. Just like everything else—you're just borrowing it until something better comes along."

"Are you done?"

"I'm just getting started."

"Well, I'm done." Clem abandoned her cutting board and knife, moving toward the door. "Enjoy your beer and whatever pathetic victory lap you think you're taking."

She pushed past him without another word, leaving him standing alone in the kitchen with his beer and his bitterness.

Alex stood there for a moment, staring at the onions she'd left half-chopped on the counter. The silence felt heavier than any screaming match would have.

He took a long drink of his beer and headed for the basement, hating himself more with every step.

Chapter Text

Saturday Morning - Nurses' Station

The interns clustered around the nurses' station at 6:55 AM, waiting for Bailey who was uncharacteristically late. Clem stood at the counter with a cardboard tray of coffee cups, methodically distributing them to the nursing staff as they arrived for day shift.

"Thank you, honey," said Nurse Patricia, accepting her cup with genuine warmth. "You're an angel."

"Extra shot of espresso, just how you like it," Clem replied, her voice steady but lacking its usual warmth.

Alex lounged against the far wall, pointedly not looking at Clem's coffee distribution.

"That's really nice of you, Clem," Izzie said. "Getting coffee for everyone."

"The nursing staff keeps us alive," Clem said simply. "Least I can do."

Olivia approached the station, her hair pulled back in a neat ponytail despite the early hour. "Morning, everyone."

"Olivia." Clem's voice was perfectly neutral as she handed over a cup. "Your usual."

"You're so sweet, thank you." Olivia accepted the cup with a bright smile, either missing or ignoring the tension in the air.

After the nurses dispersed, Meredith leaned closer to Clem. "You okay?"

"Perfectly fine."

"Right. Because treating your boyfriend's rebound hookup to coffee is totally normal behavior."

Clem's jaw tightened slightly. "He made it very clear yesterday that we were never actually together. So there's no rebound to speak of."

Cristina snorted. "Please. We all saw you two playing house for weeks."

"Apparently Alex didn't see it that way." Clem's voice was ice cold.

Alex, who had been pretending not to listen, went very still. George looked uncomfortable, Izzie looked worried, and Meredith just looked pissed on Clem's behalf.

"That's bullshit and you know it," Meredith said.

"It doesn't matter what I know," Clem replied. "It matters what he said. In front of half the nursing staff."

Alex pushed off from the wall, his jaw tight. "Maybe if you hadn't been acting like—"

"Like what?" Clem turned to face him directly for the first time all morning, her green eyes ice cold. "Like I had any expectations? Don't worry - I got the message yesterday. Loud and clear."

Before Alex could respond, Bailey's voice cut through the tension.

"Sorry I'm late." Bailey appeared around the corner, moving more slowly than usual. Her face was pale with a slight green tinge, and she looked exhausted.

"Dr. Bailey, are you feeling alright?" George asked with genuine concern.

"I'm fine, O'Malley. Just tired." Bailey grabbed her clipboard, steadying herself against the counter for a moment. "Long night."

The interns exchanged worried glances. Bailey was never late, and she certainly never looked this rough.

"Right. Assignments." Bailey consulted her list, her usual efficiency slightly dulled. "Stevens, you're in peds today. O'Malley, post-ops with the residents. Grey, you're covering the pit with Torres. Yang, cardio with Burke."

She paused, pressing her hand briefly to her stomach.

"Hart, you're with Koracick in neuro again. Don't let it go to your head." Bailey's tone was automatic, lacking her usual bite.

"Yes, Dr. Bailey."

"Karev, you're floating. Try to be useful somewhere." Bailey closed her clipboard. "Move."

Neurology Floor - 7:30 AM

Clem found Dr. Koracick at the nurses' station, reviewing charts with his usual intensity. He looked up as she approached.

"Hart. Ready for another day of actual medicine?"

"Yes, sir."

Koracick studied her for a moment, taking in her carefully composed expression and the slight tension in her shoulders. "You look like someone ran over your dog."

"I'm fine."

"Right. And I'm the Pope." He grabbed his charts and started walking. "Whatever personal drama is eating at you, leave it outside the OR. I need your head in the game today."

"My personal life doesn't affect my work."

"Good. Because we've got six post-ops, and Henderson from yesterday is showing new deficits. Your assessment was right about the thrombotic event—CT confirmed small vessel occlusion."

Despite everything, Clem felt a flicker of professional satisfaction. "Treatment?"

"Anticoagulation, started this morning. But I want you to keep a close eye on his neuro function." Koracick stopped outside room 314. "Think you can handle that without getting distracted by whatever Karev did to put that particular brand of ice in your voice?"

Clem's jaw tightened almost imperceptibly. "Dr. Koracick, I can assure you that my personal life has no bearing on my patient care."

Koracick studied her for a moment, noting the steel in her voice. "Fair enough. But whatever's driving that laser focus today - don't waste it on self-pity. Channel it into becoming the surgeon you're capable of being."

"Understood."

He pushed open the door to Henderson's room. "Show me what we're looking at."

Inside the room, Mr. Henderson was more alert than the day before, his wife still at his bedside.

"Good morning, Mr. Henderson," Koracick said. "This is Dr. Hart. She's been following your case closely. How are you feeling today?"

"Better, I think. Less confused."

"That's good to hear. Can you squeeze both my hands?" The patient's grip was stronger, more equal between both sides.

Clem stepped forward. "Mr. Henderson, can you tell me what year it is?"

"2005," he said without hesitation.

"And where are you?"

"Seattle Grace Hospital. Had surgery on my brain." His speech was clearer, more focused.

Outside the room, Koracick nodded approvingly. "Anticoagulation's working. Good catch yesterday."

"Thank you." Clem's voice was still carefully controlled, but there was genuine relief underneath.

"Don't thank me yet. We've got five more patients, and the day's just getting started."

Room 322 - Third Patient

"This one's interesting," Koracick said as they approached their third patient. "Twenty-eight-year-old female, fell down stairs at home three days ago. Initially seemed fine, went to urgent care, got discharged. Came in yesterday with severe headache and vomiting."

"Delayed presentation of traumatic brain injury," Clem said immediately. "Subdural hematoma?"

"That was the initial thought. But the imaging is... unusual." Koracick handed her the chart. "Take a look at the CT results and labs."

Clem flipped through the pages, her brow furrowing as she read. "The bleed pattern doesn't look like a typical subdural. And these coagulation studies..."

"What do you see?"

"PT and PTT are both elevated, but platelets are normal." Clem looked up, her voice dropping. "Did anyone ask about domestic violence history?"

Koracick's eyebrows rose. "Why?"

"Young woman, 'fell down stairs,' unusual bleeding pattern, coagulopathy..." Clem's voice was quiet but certain. "Pattern doesn't fit. And if she's pregnant, miscarrying from trauma could cause DIC."

"That's... actually not a bad theory. Let's find out."

They entered the room to find a young woman lying in bed, her husband hovering anxiously beside her. She had a bandage over her left temple and looked pale and exhausted.

"Mrs. Patterson, I'm Dr. Koracick, and this is Dr. Hart. How are you feeling today?"

"Better, I think. The headache isn't as bad."

"Good to hear. Mrs. Patterson, I need to ask you some questions, and I need complete honesty, okay?"

The woman nodded, but her eyes flicked nervously to her husband.

"When you fell down the stairs, do you remember exactly what happened?"

"I... I was carrying laundry. I missed a step."

"Had you been feeling unwell before you fell? Dizzy, nauseous?"

Another glance at her husband. "Maybe a little. I've been tired lately."

"Mrs. Patterson," Clem said gently, "is there any chance you could be pregnant?"

The woman's face went white. "I... I don't know. Maybe?"

Her husband stepped forward. "Pregnant? You didn't tell me you thought—"

"I wasn't sure," she said quickly. "I was going to wait to see if..."

Koracick held up a hand. "Mr. Patterson, could you give us a moment alone with your wife? We need to do a physical exam."

"I'd rather stay—"

"It's standard procedure. You can wait right outside."

After the husband reluctantly left, Mrs. Patterson began to cry quietly.

"Mrs. Patterson," Clem said softly, moving to sit beside the bed, "did you really fall down the stairs?"

"Yes," she whispered, then after a pause, "but... we were fighting first. About money. Things got... heated."

"Did he push you?"

A long silence. Then, barely audible: "He didn't mean for me to fall. But... yes."

Clem and Koracick exchanged a look.

"Mrs. Patterson, we're going to run some tests. A pregnancy test, and some other blood work. But I want you to know that we're here to help you, and we're going to make sure you're safe. Okay?"

The woman nodded, still crying softly.

Outside the room, Koracick turned to Clem with grudging respect.

"How did you piece that together?"

"The story didn't add up. Healthy young woman doesn't just develop coagulopathy from a simple fall." Clem's voice was matter-of-fact. "When the medicine doesn't make sense, usually means there's more to the story."

"Smart thinking. Order a beta-HCG, full coag panel, and get social services up here."

"Already planning on it."

"Hart?" Koracick paused as they moved toward the next room. "That was solid clinical reasoning. The kind that saves lives. Keep channeling whatever's driving that focus today."

"Thank you, Dr. Koracick."

"Don't thank me. Thank your instincts. And for what it's worth—anyone stupid enough to throw away a surgical mind like yours doesn't deserve to be taking up space in your head."

Clem's expression softened slightly. "I appreciate that. But you're right—he's not worth the headspace."

Joe's Bar - That Evening

Clem sat alone at the bar, nursing her second whiskey and trying not to think about Alex or his rebound or the way her chest still felt tight when she remembered his words in the hallway. The interns had all scattered to their various plans—Meredith on a date with some veterinarian she'd met at the grocery store, Cristina with Burke, George and Izzie claiming they had "roommate bonding" to do.

Which was probably code for avoiding the awkwardness of her and Alex's very public implosion.

The bartender was wiping down glasses when the door opened, bringing a gust of cold Seattle air. Clem glanced up reflexively, then froze.

Derek Shepherd stood in the doorway, scanning the dimly lit bar until his eyes found hers. He looked tired, his hair more disheveled than usual, wearing jeans and a leather jacket instead of his typical surgical attire.

For a moment, they just stared at each other across the room. Then Derek moved toward the bar, settling onto the stool beside her after a moment's hesitation.

"Clem."

"Derek." Her voice was carefully neutral. "Shouldn't you be at home with your wife?"

"Ex-wife. The papers are signed." Derek signaled the bartender. "Scotch, neat."

"Congratulations."

Derek accepted his drink, his fingers wrapping around the glass. "Rough day?"

"They're all rough days. That's the job."

"That's not what I meant."

Clem took another sip of whiskey. "Then don't ask questions you already know the answer to."

Derek was quiet for a moment, studying her profile. "I should have been honest with you from the beginning. About Addison, about everything."

"But you weren't."

"No. I wasn't." Derek stared into his scotch. "I was selfish. I wanted what we had, and I was afraid if you knew the truth, you'd walk away."

"So instead you let me find out from your wife. In front of half the hospital."

"I fucked up, Clem. Completely."

Clem turned to look at him directly, her green eyes hard. "Is that supposed to make me feel better? Your regret?"

"No. It's supposed to be the truth."

"Little late for that, don't you think?"

Derek's jaw tightened. "What we had was real. Whatever else happened, that part wasn't fake."

"Wasn't it? How would I know the difference?"

"Because you felt it too. The way we were together—"

"The way we were together was you lying to me every day for months." Clem's voice was cutting. "So forgive me if I'm not moved by your sudden commitment to honesty."

Derek leaned closer, his voice dropping. "Someone else hurt you today. This isn't just about us."

"Everyone hurts everyone. That's what people do."

"Not always."

"Always." Clem finished her whiskey. "The only question is how long it takes."

Derek studied her face, taking in the brittle edge to her voice, the way she held herself like armor. "Let me take you home."

Clem let out a short laugh. "That's your grand gesture? Your proof that you're different now?"

"I'm not offering to be different. I'm offering to be honest about what this is."

"And what is it?"

"Two people who hurt each other, trying to feel something other than that for a few hours."

The brutal honesty of it hit Clem harder than any pretty promise would have. At least he wasn't lying to her this time, wasn't pretending this was about love or second chances.

"My place," she said finally, leaving money on the bar. "But Derek? This doesn't mean anything. This is just convenient."

"I know."

As they walked toward the door together, Clem told herself this was different because at least this time, she knew exactly what kind of mistake she was making.

Somehow that felt like progress.