The fluorescent lights of Seattle Grace flickered faintly above the operating room, casting a cold glow over the intense scene below. Dr. Mark Sloan stood at the surgical table, his hands steady as he skillfully reconstructed a patient's throat with effortless confidence. From the gallery above, Lexie Grey and Sadie Harris watched the surgery unfold.
Sadie leaned toward Lexie, her voice low but fierce, carrying the edge of a woman fed up with being sidelined.
"I'm not sorry for what we did. It was extreme, maybe even foolish, but this program? It's broken. You should be down there in that O.R., not stuck up here in the nosebleeds. And I shouldn't be wasting my day transcribing Karev's illegible charts. How is that teaching?" She shook her head, her dark hair cascading over her shoulder in a wave of frustration.
"They only pay attention to us when they want to get us into bed."
Lexie frowned, her eyes fixed on Mark, whose hands moved with a confidence that made the complex surgery look almost effortless.
"That's not true," Lexie said, a bit too quickly. "Dr. Sloan took the time to teach me today, and it wasn't about that."
Sadie gave her a look—half smug, half pitying. "He likes you, Lex. Don't pretend you haven't noticed how he looks at you. His eyes practically undress you every time you walk by."
Lexie's breath caught, and her heart stuttered as Sadie's words sliced through her defences. She shifted her gaze to Mark, and for the first time, she truly saw it—the subtle tilt of his head as he glanced up at the gallery, his eyes finding hers through the glass. A flicker of warmth softened the sharp edges of his usual cocky demeanour. This wasn't just a professional interest; it wasn't merely a mentor guiding a promising intern. There was something else, something unguarded in the way his gaze held hers—a quiet intensity that sent a shiver down her spine. Maybe Sadie wasn't wrong. Maybe Mark did like her.
But she loved someone else, a man whose brilliance and kindness had captured her heart in a way that Mark's charm never could. She could still picture him—his hands a blur of precision in the operating room, his voice steady and commanding yet warm with compassion that made her feel seen. His rare smile was her anchor, and his presence a promise she held close. She loved him with a certainty that both terrified and grounded her, and no fleeting attraction could shake that.
"Lexie?" Sadie's voice snapped her back to reality, and her smirk widened. "You're blushing. Don't tell me you're into Sloan."
Lexie shook her head, her cheeks burning, but her voice remained steady and resolute. "No, Sadie, I'm not. I... I love someone else." The words spilt out, raw and unguarded, a confession that hung in the air like a fragile truth.
Sadie raised an eyebrow, her tone playful but tinged with respect. "Someone else, huh? Keeping secrets, Grey? Fair enough, but Sloan's not going to like hearing that." She leaned back, crossing her arms, her smirk softening. "Whoever he is, I hope he's worth it."
Lexie managed a small, shaky smile, but her mind was already elsewhere, tethered to the man she loved. "I... I need to go," she whispered. She turned, her sneakers squeaking against the gallery floor, and pushed through the door, leaving Sadie and the O.R. behind. The hallway stretched out before her, a quiet reprieve from the storm of emotions she had left in the gallery. Mark's gaze lingered in her mind, a spark she couldn't fully extinguish, but it was her love for another that guided her steps.
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The hospital room was calm, hushed like a chapel at dusk. Soft overhead light cast a gentle warmth across Holly Anderson's still form. She lay silent beneath crisp white sheets, her chest rising in a steady rhythm with the ventilator, tethered to life by wires, machines, and the unwavering hope of those who loved her. Monitors ticked along like a heartbeat, steady and sure—a quiet assurance that she was still here, still fighting.
Dr. Alex Karev stood at her bedside, unusually subdued. The edge in his voice was gone, replaced by something steadier—compassion, maybe. He guided Emma, Holly's younger sister, to the side of the bed with surprising tenderness.
"She's gonna wake up, right?" Emma's voice was a fragile thread, barely more than a whisper.
Alex nodded, crouching slightly to meet her eyes. "Yeah. She's tough. We've got her."
Dr. Derek Shepherd stepped forward with quiet confidence. "Mr and Mrs. Anderson, Emma—" he paused just long enough to let his words land, "—I'm Dr. Shepherd, and this is Dr. Underwood, the cardiothoracic surgeon who operated on Holly."
James Underwood gave a single, respectful nod.
Derek continued, "Holly's heart was struggling when she came in, and there was some swelling in her brain. But we took care of it. She's stable now. The coma is medically caused, to let her body rest. And based on how she's responding, we expect her to wake up soon."
James stepped closer, his tone grounded and sure. "Her vitals are strong. No signs of distress. We'll keep monitoring her, but everything right now points in the right direction."
Mr Anderson gripped his wife's hand. "So… she's going to be okay?"
Derek allowed himself a small smile. "She's a fighter. Just like her sister."
Emma's tears slipped free, but she grinned through them, brushing Holly's hand with her fingers. "You hear that, Holly? You're coming back. You better wake up soon."
Mrs. Anderson's voice cracked with emotion. "Thank you. Thank you both."
From the back of the room, Cristina's eyes shifted briefly to Alex—catching the quiet strength in his stance, the way he stayed grounded for the girl beside him. Growth didn't always shout. Sometimes, it stood still and steady.
Alex met her glance for half a second before turning his attention back to Emma. He rested a hand gently on her shoulder. "Keep talking to her. She knows you're here."
Across the room, James's gaze drifted toward the hallway beyond the open door. A subtle movement—clear but quiet—caught his attention.
It was Lexie Grey.
She walked by with her scrub cap tucked under her arm, her hair loose and her face unreadable. There was something about her gait—quiet yet composed, burdened but determined—that held his breath.
"I'll check in again soon," he told Derek, already on the move. His voice remained calm, but his pace revealed a sense of urgency. He slipped out of the room and into the corridor, following the fleeting silhouette before it disappeared around the corner.
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The door to the on-call room slammed shut behind them.
James stood silently at first, jaw clenched, shoulders tense with restrained fury. He had pulled Lexie inside with a gentle yet firm grip on her wrist, his eyes blazing with a rage that made her heart lurch. Lexie remained frozen, clutching her scrub cap in both hands, her pulse racing as his intense gaze held her in place.
"You operated on Sadie?" His voice was low but sharp—controlled rage fueled more by fear than ego.
Lexie hesitated before answering. Her lips parted, but no words came.
"I asked you a question."
She nodded slowly, her eyes dropping. "Yes."
"Lexie, what the hell were you thinking?" James's voice was still low, but laced with an anger that pierced the silence. "You performed an appendectomy—without supervision—with a bunch of interns playing surgeon. You broke your promise to me. No more reckless stunts, no more practicing on yourself or anyone else. Do you have any idea what you've done?"
Lexie's breath hitched. Her mind flashed back to the chaotic moment in the skills lab: the scalpel trembling in her hands, Sadie's bravado, the adrenaline drowning out every warning bell. Now, with James in front of her, shame rushed in like a wave.
"I… I didn't mean for it to go that far," she stammered, her voice small. "We thought—"
"You thought you could play doctor?" James cut in, stepping closer as frustration overtook him. "What if Sadie had died? Peritonitis, sepsis, a nicked artery—any of those could have killed her. You would've been expelled, Lexie. Your career would've ended before it even started. All of this… to prove a point?"
His hands clenched at his sides, the weight of his own hard-earned discipline fueling the fire. "I trusted you to keep your word."
Lexie's eyes stung. Her throat tightened. She had promised him—after he caught her stitching a cut on her own arm—that she'd stop taking reckless risks. She'd meant it then. But now, standing in the wreckage of that promise, the guilt was too much. The tears came—silent, uncontrollable—as she turned away, unable to face him.
James's anger wavered. His breath caught at the sight of her breaking. The fire in his chest twisted into something else—worry, protectiveness, affection. He couldn't look at her like this and stay mad.
"Lexie," he said, his voice softer now, stepping forward. "Hey… look at me."
He touched her shoulder gently, coaxing her to face him. "I'm angry because I care. You're too good to throw this away."
Her sob caught in her throat. Slowly, she met his eyes—shame, guilt, and something else flickering in her expression. Trust.
"I'm sorry, James," she whispered, voice raw. "I swear I'll never do anything that reckless again. I… I didn't want to let you down."
He exhaled, his anger dissolving into something steadier. "I know."
He pulled her into his arms. She folded into him, her tears soaking into his scrubs, and he held her close—his grip firm, protective. The steady rhythm of his heartbeat grounded her as they stood together, wrapped in silence that said more than words could.
Then came the sharp beep of a pager, slicing through the quiet.
Lexie pulled back, quickly wiping her cheeks. Her voice was steady now, even with tear stains on her face. "I have to go."
James nodded, his hand lingering on her arm. "We're not done talking, Grey. Be careful out there."
She managed a faint smile, then turned and slipped out the door, the urgency of the hospital pulling her back to reality. James stood still, watching her disappear down the corridor—his chest full of pride, fear, and the unspoken vow to help her keep that promise.
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The operating room board stood like an impending verdict, its blank surface ready to declare a victor. The air buzzed with tension as the residents gathered, all eyes fixed on Cristina Yang's marker. Dr. Richard Webber and Dr. James Underwood shared an unspoken anticipation. James's hazel eyes narrowed slightly as he recalled the advice he had once given her in the operating room: choose the prepared, not the proud.
Cristina stepped forward, her hand steady, and scrawled in bold strokes: Alex Karev.
George's jaw dropped, disbelief flooding his expression. "Is she kidding?"
Meredith forced a smile, her lips tight, feeling the sting of both ambition and disappointment stirring within her. "Congratulations, Alex."
Alex shrugged, his typical guarded bravado masking a flicker of pride. "Whatever."
James nodded subtly, a spark of approval lighting his expression. Cristina had made the right choice—Alex's performance on Holly's graft had proven his readiness. Turning to her, James spoke crisply: "Yang, prepare Ethan Carter for his septal myectomy. O.R. 3, one hour. Adjust his beta-blockers and confirm the echo."
Cristina met his gaze resolutely. "On it, Dr. Underwood."
Webber's brow lifted, a glint of respect in his eyes. "We'll make it happen, Underwood." Then he turned to Cristina. "Interesting choice, Yang."
"He made the best case," she replied firmly, recalling James's words.
Meredith stared at Alex's name—stark and final—an emblem of a chance slipping away. The solo surgery was her shot at stepping out of her mother's shadow. But now, the weight of the decision loomed heavy in her chest, ambition pulsing like a second heartbeat.
George muttered under his breath, still stunned. Izzie's eyes flicked between them, sensing the silent fractures forming.
Cristina capped the marker and turned away, already shifting her focus to Ethan Carter. James's directive had set a new challenge in motion.
The board held its ruling: one name, one opportunity.
The residents drifted apart, their rivalries unspoken but simmering beneath the surface. James moved toward the O.R. with brisk steps.
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The operating room was a crucible of cold light and relentless precision, where every second thrummed with purpose. In O.R. 3, the team moved like a well-oiled machine—scrub nurses arranged scalpels and retractors with surgical care, their gloved hands glinting under the fluorescents. The anesthesiologist adjusted the ventilator, its rhythmic hiss echoing the heartbeat Cristina Yang could feel pounding in her chest. Monitors blinked, their green lines primed to chart Ethan Carter's fate. The air was sharp with antiseptic, chilling the sweat on Cristina's brow as she stood near the sterile field, her scrub cap snug, eyes razor-sharp.
Across from her, Dr. James Underwood surveyed the scene, his hazel eyes scanning every detail—suction ready, cautery primed, team alert. He adjusted his scrub cap, a nervous tic he hid from most but couldn't quite suppress, and locked eyes with her.
"Positions, people," James called, his voice slicing through the OR's hum.
Nurses snapped into place. The anesthesiologist gave a quiet nod. Cristina's pulse spiked.
James stepped closer and locked eyes with her. "Yang, you're not assisting," he said calmly. "You're performing the septal myectomy. I'll be right here. You'll do every step."
Cristina blinked. "Wait—me? The whole procedure?"
She hesitated—just for a second. "Are you sure?"
James didn't flinch. "I'm sure. Don't let the nerves fool you. I'm here. If you need me, I've got you."
Cristina inhaled deeply, her expression shifting from doubt to steel. The OR's glare sharpened, the monitors' glow casting shadows on James's face. She could do this. She had to do this—not just for Ethan, but for herself, for every time she'd been overlooked.
"Hell yeah, I'm ready."
She stepped forward. A nurse placed the scalpel into her palm. The lights above sharpened to a clinical glare.
"Focus," James said, a glint of encouragement in his voice. "Incision at the left ventricular apex, three centimeters, shallow. Avoid the conduction system. Now."
"Three-centimeter incision," she repeated under her breath. "Shallow. Avoid conduction."
She leaned in. "Starting incision... now."
The scalpel met the skin—steady, controlled.
"Depth?" James asked, watching closely.
"Sub-epicardial," Cristina answered. "Easing through the muscle fibers."
The monitor gave a reassuring beep. Ethan was stable.
"Excellent," James said. "Now retract gently. Don't crush the myocardium."
Cristina adjusted. "Retractor in. Field's open."
"The outflow tract's exposed," a nurse confirmed.
Cristina leaned forward. "Visualizing the septal bulge. Gradient's confirmed at 60 millimeters."
"Begin the core resection," James said. "Use the metzenbaums. Don't tear."
Cristina took the scissors. "Beginning resection. First millimeter coming out… tissue's thickened but clean."
"Watch the chordae tendineae," James reminded. "You're close to the mitral valve."
"I see it," Cristina said, adjusting. "Redirecting slightly posterior. Still in the safety zone."
A pulse of blood welled up suddenly.
"Small vessel breach," she muttered. "Clamping."
"Cautery ready," James said instantly. "Steady—don't cauterize into the septal wall."
Cristina moved quickly, sealing the bleed with laser focus. "Bleed controlled. Vessel sealed. Suturing."
"Breathe," James said gently.
Cristina let out a tense breath, her eyes locked on the heart. "Resuming resection. Two millimeters total. Clear of conduction path."
"Heart's tolerating it," the anesthesiologist confirmed. "Pressure's holding."
Cristina gave a small grin behind her mask. "Resection complete."
The monitor flickered—gradient now 45 mmHg.
"You just dropped the pressure by 15 points," James said, pride rising in his voice. "You did it, Yang."
Cristina's eyes gleamed. "We're not done. Closing now."
She sutured with smooth, practiced hands, sealing Ethan's heart. The monitors sang of stability. The surgery was over.
Cristina stepped back, chest heaving, eyes shining. Her hands trembled slightly—not from fear, but from the magnitude of what she'd just done.
"Ethan's stable," the anesthesiologist said.
"Beautiful work," James murmured. "Everyone—nice job."
The O.R. exhaled as one. Tension gave way to awe. Cristina caught James's eye.
"Did that really just happen?"
"You just fixed a heart, Yang," he replied. "And you didn't flinch."
Cristina grinned behind her mask. "I could do that again right now."
James chuckled. "Let's save your ego for the scrub room."
After Surgery
The sound of rushing water filled the scrub room. Cristina scrubbed out hard, adrenaline still buzzing through her limbs.
James stood beside her, calm and composed, sleeves rolled to the elbow.
"That was unreal!" Cristina said, spinning to face him. "I cut into a heart. I handled a bleed. Resection, sutures, closure—nailed it."
"You did," James said simply, his voice steady but warm.
Cristina's brow furrowed slightly, sincerity breaking through the adrenaline. "I was terrified. At first. Ten seconds in, it all just… clicked. Like my hands remembered something my head hadn't caught up to."
"That's what I saw in you," James said, his voice quiet but firm. "Not just talent. Control. Instinct. You've got what it takes to outshine anyone in that program."
"You know," she said, quieter now, "Burke never let me near a solo cardiac case."
James shrugged. "Maybe he wasn't watching close enough."
Cristina's grin returned, slow and dangerous. "You staying?"
"I signed the contract this morning," James said.
Her chest lifted, pride creeping into her voice. "Then I guess I'll just have to keep showing off."
James headed for the door, pausing. "Just don't forget—even the best surgeons need to breathe."
"I'll breathe when I'm done changing the world," Cristina shot back.
James glanced over his shoulder. "Just don't forget to sleep."
He left, the door swinging shut behind him.
The door swung shut, leaving Cristina alone in the scrub room. She stared at the empty sink, her heart still racing, already imagining the next heart she'd conquer. The fire in he
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The corridors of Seattle Grace were nearly silent, bathed in the dim glow of overnight lights. The end of the shift left the air still, punctuated only by the occasional squeak of sneakers on linoleum. James Blackwood strolled down the hall, his hands tucked into the pockets of his slightly wrinkled scrubs, eyes scanning until they landed on a familiar figure.
Lexie Grey stood by the nurses' station, flipping through a chart. Her ponytail was loose, scrub cap forgotten, her face lit by the monitors behind her. James smiled to himself before calling out, "Lex."
She turned, eyebrows lifting in surprise—and something warmer—when she saw him. "Hey," she said, cautious but curious.
"I've got a surprise for you," James said, stepping closer, his voice low and teasing. "Come with me."
Lexie glanced around instinctively, wary of who might see. "A surprise? Now?"
"Our shift's over," he said with a grin, gently brushing her elbow. "No excuses."
Still unsure but unable to resist, she followed. They walked in silence, tension melting away with each step until he pushed open the door to an empty procedure room. The overhead lights were dimmed, casting a soft glow over a metal table—on it, neatly arranged, were a bowl of oranges, a banana, a gleaming scalpel, needle drivers, and suture kits.
Lexie blinked, then laughed. "You brought me fruit?"
James shut the door behind them and leaned against it. "Not just fruit. Surgical fruit. It's time I kept my promise.Oranges for suture practice. Banana's for knot-tying. No pressure. No patients. Just you, me, and the fruit bowl."
Lexie bit her bottom lip, touched. "This is… kind of perfect."
James picked up a needle driver and handed it to her. "Start with the orange. Straight, even stitches. I'll guide your hand."
Their fingers brushed as he positioned hers, the moment charged, intimate. She focused, clumsy at first, but gradually finding rhythm as James coached her with quiet encouragement.
The room fell into a quiet rhythm, interrupted only by her soft laugh when a stitch pulled crooked, or his subtle smile when she corrected herself. The tension of the day faded away, replaced by quiet closeness and the sound of sutures threading through skin-like citrus.
As she leaned over the orange, focused and glowing, James murmured, "This is what I meant back then. Teaching you. Properly."
Lexie looked up, eyes shining, breath caught between gratitude and something deeper.
The scene faded to quiet, their hands side by side under the surgical lamp, the promise fulfilled—at least, just beginning.
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