Late Night
The 18th hour of the interns' first shift.
The group of interns had moved past their initial excitement or nerves and were starting to feel the exhaustion creep in.
Adam, Cristina, and Meredith had just finished a mini-session with Ellis Grey. As they stepped out, they started joking about it.
"Watch me catch someone napping right now—I'll make them regret it," Cristina said with a wicked grin. "Back in our day, the first shift was 48 hours straight. These kids have it easy with just 36, and here I am, their boss, still not resting."
"Oh, come on," Meredith said, trying to calm her down. "We've all been interns. Don't mess with them."
"Mess with them?" Cristina replied, dead serious. "This is teaching them! Besides, I'm about to crash soon, and the last thing I want is them waking me up mid-snooze over something dumb. Better warn them now—stay sharp, don't slack off, and turn a tiny problem into a big one that drags me out of bed. Right, Adam?"
"Me?" Adam chuckled, waving it off. "Don't drag me into this. You two figure it out."
"Wait a sec," Cristina said, raising an eyebrow. "You've got something up your sleeve, don't you?"
"Not really," Adam said with a laugh. "It's their first shift, though. You know how it is—the first time always sticks with you. So I'm planning to stick with them the whole way, make it extra memorable and fulfilling."
"The whole 36 hours?" Meredith's mouth twitched.
"See?!" Cristina jabbed a finger at him. "Compared to Adam, I'm a saint! At least when I'm asleep, as long as they don't bug me and no one's dying, I don't care if they sneak a break. But with Adam? They're in for a nightmare!"
"Alright, time to check on them," Adam said, giving Cristina and Meredith a quick goodbye before heading to the ER.
Tonight's session with Ellis Grey had been deliberately short—Adam's way of giving them a breather to grab some food and recharge. But the real grind was about to kick off again.
---
Emergency Room
Nurses' Station
"How're they doing?" Adam asked, not going straight to his interns but checking in with the nurses first.
"They're all working hard," one nurse said, nodding toward them. "Especially that Dr. Melendez—he's been nonstop since he got here, and he's good, too.
Carter came back, apologized to us, and started focusing on the small stuff, not chasing big dreams anymore.
O'Malley's the same as always.
And little Grey? She's got a nice personality, but she might be too soft-hearted. Not sure if she'll hold up."
"Let's wait and see," Adam said with a nod.
The nurse's observations lined up with his own guesses. The three guys? He wasn't too worried. Whether they were seasoned, tough-skinned, or just rational enough, they'd be fine.
But Lexie? Sweet and kind-hearted. That's great for being a person, but tricky for being a doctor. Too much kindness means too much emotion. When that crashes into life-and-death moments, you either toughen up and push through, or it breaks you. Until it happened, no one could predict how Lexie would handle it.
Bang!
The ER doors slammed open.
"What's the situation?" Adam strode forward quickly.
Shorty, Carter, George, and Lexie all rushed over too.
"Forty-year-old speeding driver, flipped in an MVC. Lost vitals on the monitor. We couldn't intubate," the paramedic said in a hurry.
"How long's he been out?" Adam asked, already checking the patient.
"Twenty minutes to load him, fourteen to get here," the paramedic replied. "We've given two rounds of epinephrine."
"Little Grey!" Adam called out.
"Yes!" Lexie stiffened.
"Intubate him!" Adam ordered. "You know how to do it?"
"I've never done it…" Lexie said, voice shaky.
"But you've seen it!" Adam barked. "Grab the tube—move fast!"
A nurse handed the trembling Lexie the intubation kit.
"Dr. Duncan…" Lexie took it with shaky hands. "You sure I should do this?"
"Are you a doctor or not?" Adam snapped. "Stop stalling! Listen to me—picture the airway, focus on the tube, and go straight in!"
"I can't see the tube!" Lexie fumbled, half-inserting it into the patient's mouth before panicking and looking up. "Can't you do it? Or let George or someone else?"
"Melendez, take over CPR!" Adam shot a glance at the three guys, signaling Shorty to step up. Then he moved to Lexie's side, softening his tone. "This is your shot. Deep breath, follow my lead. It's simple—you've got this. Watch! Don't hit the teeth, just slide it in!"
"I did it! I got it in!" Lexie exclaimed, shakily completing the intubation under Adam's guidance. She looked up, beaming—only to freeze when she saw George, Carter, and the others looking less than thrilled.
"Good job," Adam said, nodding at her before gesturing to Shorty. "Melendez, you can stop."
Shorty eased off the CPR.
"What are you doing?!" Lexie yelped. "Why aren't we saving him?"
"No need to save him. He's already gone," Adam said, meeting her eyes. "You did great. I don't think you've ever called a time of death before, right? You can do it now."
"What?" Lexie blinked, stunned. "He's dead?"
"He was dead when he got here," George muttered.
"It's been this long, with epinephrine and everything already tried. You should've known he was gone," Shorty Melendez said, giving her a look.
Harvard Med? This is it? Johns Hopkins still reigns supreme.
"Then what were we just doing?" Lexie whispered.
"Fulfilling what the law requires," Adam said gently. "And following teaching hospital tradition—making his death mean something by using it to train you. Next time, maybe you'll save someone who still has a chance."
"That's so cruel…" Lexie murmured, staring at Adam in disbelief. She glanced at George and Carter, who nodded, confirming it was standard practice. Tears welled up as she looked back at Adam.
"We're doctors," Adam said, holding her gaze. "Every day, we face life and death. If you can't first cut a piece of your own heart—slice away some of that kindness, carve out the fear and emotion—how will you ever have the guts to cut into a patient and take responsibility for whether they live or die?"
Tears slipped silently down Lexie's cheeks.
"Time of death: 01:35…"
(End of Chapter)