Medical Center
Cafeteria
Lunch ended on a sour note.
Adam's blunt logic cut through the warm fuzzies like a scalpel, exposing the rot beneath the chicken-soup-for-the-soul vibe. Meredith wasn't the only one squirming—Liz felt it too.
George and Cristina, though? They didn't bat an eye. Cristina's all about survival of the fittest—she's gunning to be a legendary female surgeon and has zero patience for screwups like Alex. Plus, she's cocky enough to think she'd never make such a rookie mistake. No personal sting, no offense taken.
George, meanwhile, might be soft as heck, but he's decent at heart with a mostly solid moral compass. He vibed with what Adam said. Alex, with his total lack of ethics—letting him grow as a doctor would be what? A disaster waiting to happen? In just over two months, even with residents and attendings watching him, the guy's already caused this much chaos. Imagine if he actually got good. The bigger the power, the bigger the responsibility—and the bigger the damage.
Green Clinic
"Here's the test results," Adam said, handing the chart to Leonard. "The patient can't get an artificial heart valve."
"No biggie—we can use a pig valve," Leonard replied, glancing at the chart with a smile.
"Not gonna work," Adam said, shaking his head. "The patient, Devo, was up this morning and afternoon, dragging herself out of bed to pray by the window. She's a devout Orthodox Jew— even wants to change her name to Esther. Good luck convincing her to take a pig valve."
Esther's the ancient Persian queen from the Bible—a beautiful, kind Jewish heroine who saved her people with her wits. Leonard's mouth twitched; he clearly knew the reference.
Jews see pigs as unclean. For an ultra-conservative Orthodox Jew, sticking a pig valve in their life-pumping heart? That's straight-up blasphemy.
Leonard rubbed his temple. "Try to talk her into it anyway."
"If the pig valve's a no-go, we could look at a bovine valve," Adam suggested. "Jews don't mind those, and they work better too."
"Bovine valve?" Leonard frowned. "That's newer tech—pretty complicated…"
Adam got it. Medicine's always evolving—new ideas, new techniques popping up constantly. Doctors have to be lifelong learners. But when you're older, the energy and efficiency for picking up new tricks? They tank. Big, complex surgeries can stretch 10, 12, even more hours, and that's brutal on aging docs. Leonard's hesitation screamed one thing: he'd never done a bovine valve surgery, didn't feel confident, and wasn't eager to try.
"We could call in an expert—do a video consult," Adam said with a grin. "There's always a first time, right? I'd love to learn the technique from you too. Of course, it's just a backup plan—better safe than sorry. For now, we'll push for the pig valve option."
"Hmm. Let's go see her," Leonard said, a smile creeping onto his face. He gave Adam an approving nod.
They were old friends, and no one else was around, but Adam's tact—giving him an out while keeping things smooth—meant a lot. Leonard appreciated it.
Patient Room
Devo's—or Esther's—parents were on board, but she blew up the second she heard the plan.
"What?! You actually agreed to this?!" she yelled, gripping her IV pole and glaring at her mom and dad.
"Honey, it's to save your life," her mom said, trying to calm her down.
"Enough!" Esther snapped. "You don't respect my faith—or me! You're seriously okay with them sticking a filthy pig in my body—in my heart?! An animal that breaks every Jewish law! My heart's my life source! If you swap it out with that, what am I even left with?!"
"It's just the valve, not the whole heart," Adam pointed out.
"I don't care!" Esther whipped around to him, unloading full blast. "Putting pig parts in me? I'd rather die."
"See? Told you we shouldn't have let her join the Orthodox crowd," her dad grumbled. "Should've stuck with the Reform crew like everyone else."
"You don't even light candles on Friday nights, and you can't name all ten plagues from Passover!" Esther fired back at him. "You've both lost your faith—and now you're whining about me being devout?!"
Her parents hung their heads, saying nothing. They couldn't win against an Orthodox zealot's verbal onslaught. They'd gone Reform—like most Jews—for the freedom, the lighter rules. By that metric, yeah, they'd ditched the faith hardcore.
"Miss Friedman," Leonard cut in, no choice but to step up. "We respect your devotion, but without surgery, you'll die."
"Then figure something else out," Esther said, still rational enough not to book a one-way ticket to heaven just yet. "As long as it's not snorting and oinking like Wilbur, I don't care what it is!"
Adam stayed quiet, glancing at Leonard. In front of patients—especially with family around—you don't undercut your attending. It's basic. Like how Jia Baoyu, the spoiled brat from Dream of the Red Chamber, got away with murder at home but played the perfect gentleman outside, earning his grandma major street cred. If he hadn't, she'd have had him beaten to a pulp, no question.
Leonard could dote on Adam all he wanted, but Adam wasn't about to get cocky and stomp on the unwritten rules. If anything, he'd double down on propping Leonard up. Even though he knew the bovine valve was the perfect fix, unless Leonard greenlit it, Adam wouldn't breathe a word to the patient or her folks.
"We'll think it over," Leonard said, mulling it over before heading out with Adam in tow.
Office
"Adam, since you brought up the bovine valve idea, I'm guessing you've already done your homework. You know who the experts are, right?" Leonard paced a bit, then stopped and looked at him.
He knew Adam's habits. Back before med school, Adam had bought a cabin in the woods and hunted animals just to practice surgery years ahead of time. Now? The guy was meticulous—thought of everything. When Shepherd once said Adam reminded him of someone, Leonard's first guess was the infamous Dr. House. Not a stretch.
"Yeah," Adam said with a grin. "Dr. Chesney at Cleveland Clinic, Dr. Kens at Johns Hopkins, and Dr. Morton at Mass General—they're the big names for this."
"Great," Leonard said, clearly sold. "Set up a call. We'll study it first. If it's doable, we go with the bovine valve."
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