Medical Center.
Operating Room 2.
"Call Dr. Montgomery and tell her to come over as soon as she's done over there," Dr. Burke instructed.
"Yes, Doctor," the nurse replied, hurrying off.
"The ultrasound equipment still isn't advanced enough," Adam said, shaking his head. "It can't pick this up."
"You'll never get a perfect measurement before going into surgery," Dr. Burke said gravely. "That's why we, as doctors, have to keep sharpening our skills."
Baby Emily had been born underdeveloped. Her atrial septum was split by a thin membrane, and her aorta was narrower than anyone could've imagined—just one millimeter in diameter. It couldn't carry enough blood. No matter how well Adam had prepared or how precise the Norwood procedure was, without a steady blood supply through that aorta, Emily wouldn't make it. Dr. Burke estimated she had about 24 hours left, tops.
Dr. Montgomery arrived soon after getting the message.
"Crap!" she muttered under her breath, closing her eyes. As a seasoned pro, one glance told her everything she needed to know.
"If you've got no objections, we're closing her up," Dr. Burke said.
The Norwood procedure had hit a dead end. All they could do now was stitch her up, give her a little more strength, and buy her a few extra hours.
"Yeah," Dr. Montgomery said, opening her eyes with a heavy nod.
"Let's do it," Dr. Burke signaled to Adam.
Adam nodded back, moving fast but with expert precision to close Emily's chest.
"Get her to the neonatal ICU," Dr. Burke ordered once they were done.
The surgery was over.
"Dr. Duncan, step outside for a sec. I need to talk to you," Dr. Montgomery called.
"Sure," Adam replied. He peeled off his surgical gown, gloves, and mask, then followed her out of the OR to her office.
Man, what an office.
In a hospital—or anywhere, really—a big, private office like that screamed status. It was one of the perks Chief of Surgery Richard had dangled to lure Dr. Montgomery here.
"Dr. Duncan, I don't want you to tell Dr. Stevenson about the surgery's outcome," Dr. Montgomery said once she'd settled into her chair.
"Why not?" Adam asked, caught off guard.
"Emily's not going to make it past 24 hours," Dr. Montgomery said, locking eyes with him. "I want Dr. Stevenson to handle her case from start to finish."
"You mean…" Adam trailed off, piecing it together as he studied her.
"Exactly," she nodded. "Dr. Stevenson's got real talent in pediatrics. I want to mentor her properly. Since Emily's already in this state, I'm handing her over to Liz completely.
"She's going to be scared. She's going to freak out.
"But if she pushes through it, the next time something like this comes up, she'll be able to handle the pressure.
"You can only become a better doctor by letting go of too much emotional attachment to patients. That's Dr. Stevenson's biggest weakness right now.
"I went through the same thing back in the day."
"I get it," Adam said with a nod.
In that moment, he believed Dr. Montgomery was genuine. You wouldn't put a student through something this brutal unless you truly saw potential in them. Most of the time, it's a thankless job.
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"I'm asking you not just to keep quiet, but also to ignore her pages," Dr. Montgomery added. "If Emily makes it to tonight, I want you out of the hospital. Let Dr. Stevenson deal with it all on her own."
"You sure about this?" Adam asked, raising an eyebrow. "Knowing Liz, she's probably not going to thank you for it. She might even ditch pediatrics altogether because of this."
"Then that'd be a shame," Dr. Montgomery said, shaking her head. "But whether it's pediatrics or any other specialty, every great doctor has to face this hurdle.
"If she can't get past it today and gives up on pediatrics, what then? Is she going to quit every time she hits a wall?"
"Maybe she's just meant to be an average doctor," Adam pointed out.
"Maybe," Dr. Montgomery paused, considering it. "But right now, I want to give her a shot. I don't want her talent to go to waste. What she does with it later—that's up to her."
It was a rare opportunity, honestly. If they weren't absolutely sure Emily couldn't be saved, no attending would ever let an intern take the reins like this. Plus, there was the risk factor—hysterical families could easily sue the attending if they found out.
Dr. Montgomery was willing to teach this way. If it were Cristina or Adam on the receiving end, they'd be grateful after the fact.
Of course, Adam and Cristina wouldn't even need this kind of lesson. Call them cold or heartless, but they already had the mindset of top-tier doctors.
"I hope Liz can see Dr. Shepherd's good intentions," Adam said with a nod. "I know what to do."
"Here's hoping," Dr. Montgomery replied with a wry smile.
Adam got it. Beyond the selfless angle, there was a bit of self-interest in it for her too. After he'd turned her down, she had no choice but to groom her own team. Normally, it'd be a slow process, but Emily's case was a sudden golden ticket. If Liz could push through, her mindset would level up big time. Pair that with her natural talent and Dr. Montgomery's guidance, and Liz could rise fast—maybe even become her right-hand woman. So yeah, despite the risks, Dr. Montgomery was willing to roll the dice.
Adam left her office.
During the day, he deliberately avoided Liz. That night, he didn't even stick around to cook up his usual late-night meal. Not that he could've anyway—the quintuplets in the neonatal ICU, courtesy of Mrs. Lusabin, each had a dedicated doctor assigned. Liz was on Emily, naturally, while Meredith, Cristina, George, and another intern each took one of the others.
Left to his own devices, Adam could've chatted with Alice Grey. But since he'd promised Dr. Montgomery, and knowing Liz might actually track him down, he bailed on the hospital entirely. He headed to Robin's apartment instead—perfect timing to change her bandages.
Her wound was on her conscience.
She needed a little extra TLC.
Late that night, Adam's pager wouldn't stop buzzing. Liz was paging him like crazy—desperate, terrified, you name it.
"Why aren't you answering?" Robin asked, groggy from sleep but woken up by the constant beeping. She'd crashed hard after overdoing it earlier.
Adam sighed and filled her in.
"Whoa," Robin gasped, wide-eyed. "You doctors have to go through training like that?"
"Not all of us," Adam shook his head. "Only the great ones need that kind of mindset. You either have it from the start or you build it up. Tonight's a make-or-break moment."
"But isn't that just… cruel?" Robin winced.
"Tonight's cruelty might save hundreds, maybe thousands of patients down the line," Adam said with a heavy sigh.
"Liz probably won't forgive Dr. Montgomery for this. Or you," Robin muttered.
"I don't need her forgiveness," Adam said with a carefree grin. "As long as you forgive me, I'm good~"
"Whoa!" Robin sucked in a breath again—maybe shocked by Adam's sudden flirty vibe, maybe something else. The whole mood shifted in an instant.
Yeah, the harsh reality sucked, but life keeps moving forward…
P.S. Big thanks to "Lost in Mountain" for the tip!