Cristina Yang stood by the nurse's station, her eyes locked on Dr. James Blackwood as he conferred with Bailey about Clay Bedonie's piggyback transplant. Cardio was her domain, and Blackwood was an intruder—a brilliant one. She waited for a pause, then approached, her stride confident.
"Dr. Blackwood," she said, voice crisp. "Cristina Yang, third-year resident. I've specialised in cardio since my internship and trained under Burke and Hahn.."
James turned, his hazel eyes appraising but neutral. "Dr. Yang. I've heard of your reputation."
Cristina lifted her chin. "Good. I've studied your work—your minimally invasive techniques and your mortality rates. Impressive. But I'm not here to flatter you. I want in on this surgery. I've logged more cardio hours than anyone here, and I'm ready to prove it."
James's lips twitched with faint amusement. "The Chief assigned Dr. Karev and Dr. Stevens to the case."
Cristina's jaw tightened. "Karev's a cowboy, and Stevens is… distracted. I'm focused. I live for cardio. You need someone who can keep up."
James studied her, his gaze steady. "You've got the drive, Dr Yang. That's clear."
"Drive? I've got skill," she corrected. "I've assisted on three piggybacks, closed a chest solo at 2 a.m., and memorised every major cardio trial since '95. Do you want trust in the OR? I'm it."
James nodded slowly. "Skill's only part. This case requires cultural sensitivity, discipline, and knowing when to refrain from cutting. Show me that—not with words, in the hospital. I'll be watching."
Cristina opened her mouth, but James's attention shifted. Across the hall, Lexie Grey stood, her chart slipping as their eyes met. Her face was a mix of shock and longing. Her band-aided arm was a silent confession of her intern struggles. James's expression softened as a flicker of something personal broke through his professional façade.
"Excuse me, Dr. Yang," he said, already moving toward Lexie.
Cristina stared, incredulous. "Unbelievable," she muttered, spinning on her heel.
Lexie's breath caught as James approached, his stride purposeful but gentle. She turned, hurrying down the corridor, her heart pounding. She needed privacy and somewhere to process this. She pushed open the door to an on-call room, the dim light casting shadows as James followed, closing the door behind him.
"Lexie," he said, his voice low, laced with the warmth she'd missed.
She faced him, her eyes wide and her voice trembling. "James, why are you here? You were in Boston two days ago. We talked about my intern drama, and you didn't say a word about Seattle."
He stepped closer, his hands twitching to reach for her, but he held back, mindful of the hospital walls. "I missed you, Lexie. Every day in Boston, I was counting the hours until I could see you again. When Webber called with an offer—position, research funds, and a chance to build something, I saw a way to be closer to you. I flew out to visit, to see you, but I haven't agreed to stay."
Lexie's brow furrowed, confusion mingling with relief. "You haven't said yes?"
"Not yet," he said, his gaze steady. "I wanted to talk to you first. This is your hospital, your world. I won't make a move that affects us without your input."
Her shoulders sagged, but new worries surged. "James, if you stay, you'll be my boss. An attending. I'm just an intern, scraping for OR time. If people find out we're together, they'll think I'm sleeping my way to surgeries. I can't be that person."
James's jaw tightened, but his voice was gentle. "I'd never let that happen. We'd keep it professional—separate our work from our personal lives. No one would know until we're ready."
Lexie shook her head, pacing. "It's not that simple. This place is a fishbowl. Gossip spreads faster than MRSA. And I'm already fighting to prove I'm more than Meredith Grey's little sister. You know I told you about her—she's a rock star here. I'm in her shadow, and now you're this Harper Avery winner? I can't handle another spotlight."
James's eyes softened, a memory sparking. "You mentioned Meredith, yeah. Over Skype, you said she's tough but brilliant, and you wanted to make her proud. Lexie, I'm not here to overshadow you. I want to support you like you've supported me through every late-night call, every case that kept me up."
She stopped pacing, her eyes glistening. "I want that too, but I'm scared, James. I love you, but this changes everything."
He closed the distance, his gaze intense, searching. "Lexie, I love you. That's why I'm here, why I'm asking you. If you say no, I'll walk away from Webber's offer. Boston's still there. But if you say yes…" He trailed off, his eyes locked on hers, a silent promise.
Lexie's breath hitched, his proximity overwhelming. "What's wrong?" she whispered, noticing how he stared, his eyes tracing her face like he memorised her.
"I missed you," he said, voice rough with emotion. "Every second away from you felt wrong."
Before she could respond, he leaned in, his lips capturing hers in a kiss that was both desperate and tender, a release of months of longing. Lexie melted into it, her hands finding his shoulders, the chaos of the hospital fading away. The kiss deepened, urgency overtaking restraint. As they stumbled toward the on-call room's narrow bed, James's hands brushed her arm, pausing at the band-aids covering her scratches.
"Lexie," he murmured, pulling back, concern etching his handsome features. "What are these?"
Her cheeks flushed, guilt and embarrassment surging through her. "It's… the interns. We've been practising procedures on each other for the solo surgery competition. Sutures cuts—it's stupid and reckless. Cristina thinks I'm a cutter because I lied about it."
James's brow furrowed, his thumb gently grazing the band-aids, careful not to press too hard. "You're hurting yourself to get ahead? Lexie, you're better than this. You don't need to carve up your own skin to prove you're good at your job."
"I know," she whispered, eyes downcast, voice small. "It got out of hand. I'm trying to stop it, but I just… I want to be good, to be seen as more than a good intern."
James lifted her chin, his gaze firm but kind. "I see you. Always. And you're already good—better than good. Stop practising on yourself, Lexie. It's dangerous, and you deserve better. I'm here now, and I'll teach you properly, in the OR, with real cases. You don't need to risk yourself like this."
Lexie's eyes widened, a mix of relief and gratitude washing over her. "You'd do that? Teach me, even if you're not staying?"
"Whether I stay or go, I'm not letting you learn this way," he said, voice resolute. "You're too important to me, to this hospital, to yourself."
Their lips met again, fiercer this time, the weight of his promise fueling their connection. Clothes fell away in a frantic blur—James's scrub top, Lexie's sweater, the band-aids stark against her skin, but no longer a barrier. They collapsed onto the bed, passion drowning out her fears, their bodies reconnecting with an intensity that erased the distance between them. The scratches on her arm were a fleeting concern, overshadowed by the urgency of their reunion.
(Do you want to add lemons in future?)
After, they lay tangled in the sheets, breaths slowing. James propped himself on an elbow, his fingers tracing her arm. "Lexie," he said softly, "should I tell Webber I'll take the job?"
She hesitated, her mind a storm of love and logic. "I need to think about it, James. It's a lot—us, the hospital, everything."
Before he could reply, her pager blared, shattering the moment. She glanced at it, sighing. "It's Cristina. I have to go."
He nodded, brushing a kiss against her forehead. "We'll talk later. I'm not going anywhere until you're ready."
She dressed quickly, stealing one last look at him before slipping out, her heart a battlefield of hope and uncertainty.
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The operating room at Seattle Grace Hospital hummed with the sterile precision of a well-oiled machine, its bright lights casting sharp shadows over the draped figure of Clay Bedonie. The Navajo patient lay at the centre, his chest open, his failing donor heart exposed as the team prepared for a piggyback heart transplant. Dr James Blackwood stood at the head of the table, his navy scrubs crisp, his hazel eyes focused through protective goggles. His lean frame exuded calm authority, hands steady as he surveyed the field. Dr Miranda Bailey flanked his left, her expression a mix of vigilance and quiet approval, while Alex Karev stood to his right, his usual bravado tempered by the complexity of the case. In the gallery above, Izzie Stevens watched, her fingers gripping the railing, Denny Duquette's ghostly presence a shadow at her side.
The OR was a symphony of controlled chaos—monitors beeping, the ventilator hissing, and the soft clink of instruments as the scrub nurse passed tools. James's voice cut through, steady and clear. "Dr. Karev, confirm the donor heart's status."
Alex glanced at the sterile container nearby, where the new heart rested in preservation solution. "Viable, oxygenated, ready to go. No signs of rejection risk."
"Good," James said, his tone even but commanding. "Dr. Bailey, let's review the anastomosis plan. We're attaching the new heart to the existing one, maintaining circulation until we're ready to remove the old."
Bailey nodded, her voice precise. "We'll connect the new heart's aorta and pulmonary artery to the patient's, keeping the old heart functional during the transition. It's delicate, but we've got the imaging to guide us."
James's eyes flicked to the monitor displaying Clay's vitals. "His pressure's holding, but we're on a clock. Let's move." He extended his hand, and the nurse placed a scalpel in his palm. With practised precision, he began the incision to prepare the chest for the new heart, his movements fluid, almost surgical artistry. "Dr. Karev, keep an eye on the bypass machine. Any fluctuation, I want to know."
"Got it," Alex said, his focus sharp despite the faint smirk that lingered, a nod to his competitive edge.
In the gallery, Izzie's breath hitched, her eyes darting between the OR and Denny, who leaned casually against the glass. What's that gooey thing they're taking out? He asked, his voice teasing as if they were watching a movie and not her patient's open chest.
"Stop it," Izzie whispered, her voice barely audible, her knuckles whitening on the railing. "I thought you were going to be quiet."
You're acting like you don't want me here, Denny said, his tone soft but piercing. Izzie, I'm as real as you.
She shook her head, tears pricking her eyes. "You're not real. I can't hope for that."
Touch me, he urged. I'm here for you.
She refused, her voice breaking. "Why are you here?"
I'm here for you, Izzie Stevens.
Below, James's voice pulled her attention back to the OR. "Dr. Bailey, I'm ready to position the donor heart. Clap the aorta."
Bailey moved swiftly, her hands steady as she applied the clamp, slowing the blood flow. "Aorta's secure. Vitals stable."
James carefully lifted the donor heart, its pinkish hue stark against the sterile drapes. He positioned it beside Clay's failing heart, his fingers deft as he began suturing the new heart's vessels to Clay's. The room was silent save for the rhythmic beeps and James's calm instructions. "Dr. Karev, suction here. I need a clear field."
Alex complied, his movements precise, though his eyes flicked to James, sizing up the newcomer. "You've done a lot of these, huh? Piggybacks aren't exactly routine."
James didn't look up, his focus unwavering. "Enough to know every patient's different. Mr. Bedonie's beliefs make this one unique. We're respecting his ritual—old heart goes to his medicine man post-op."
Bailey's lips curved faintly, approving. "Speaking of, Dr Blackwood, there's an official rule—that if a patient requests their organ back for cultural reasons, we honour it."
James's brow rose slightly, a glint of curiosity in his eyes. "Is that so?"
"It's the Chief's rule," Bailey said smoothly, her tone leaving no room for doubt. "Declared it myself."
James nodded, a ghost of a smile tugging at his lips. "Noted. Dr. Karev, ensure the old heart is prepped for return to the patient's family after we're done."
"On it," Alex said, his voice clipped but professional.
The surgery progressed, and the team worked in sync as James completed the anastomosis, connecting the new heart's vessels. The monitors showed stable vitals, and the new heart began to take on some of the circulatory load. James stepped back slightly, his eyes scanning the field. "We're ready to remove the old heart. Dr. Bailey, confirm bypass is holding."
"Bypass is solid," Bailey reported. "Pressure's steady, oxygen saturation's good."
James nodded, reaching for the old heart, his hands moving with surgical precision to detach it from Clay's chest. The failing organ, scarred and weakened, came free, and he placed it carefully in a sterile basin for pathology—and, per Clay's wishes, for his ritual. But as the scrub nurse took the basin, a faint movement caught James's eye. The old heart, disconnected and resting in the basin, twitched.
"Hold on," James said, his voice sharp, calm, fracturing for the first time. He leaned closer, goggles fogging slightly as he stared. "That's not possible."
Bailey's eyes widened, her voice low. "Is that… beating?"
Alex craned his neck, his usual smirk gone. "How's his heart beating on its own? It's out of his body!"
The heart pulsed faintly, a slow, erratic rhythm that defied medical logic. James's mind raced, years of training clashing with the anomaly before him. "I've read case reports—rare instances of myocardial recovery after prolonged rest—but I've never seen it."
Bailey shook her head, a mix of awe and disbelief. "It's remarkable. Like it's fighting to stay."
In the gallery, Izzie's tears spilt over, Denny's voice softer now. Look at that, Izzie. A miracle, right?
"It's not a miracle," she whispered, her voice trembling. "It's science. Or… something." But her heart ached, the sight of Clay's heart beating on its own blurring with her own impossible connection to Denny.
James straightened, regaining his composure. "Dr. Bailey, let's monitor the new heart's function, but we need to assess this. If his original heart is viable, we may not need the transplant. Dr. Karev, get pathology on standby—we're keeping this heart intact for now."
"Got it," Alex said, his tone a mix of scepticism and intrigue.
Bailey's voice was firm. "We'll need to run tests, but if this holds, it's a game-changer for Mr. Bedonie."
James nodded, his focus returning to Clay's open chest. "Let's close the new heart's connections, for now, keep him stable. We'll decide the next steps post-op."
The team worked swiftly, James's hands guiding the sutures to secure the new heart temporarily, ensuring Clay's circulation remained stable. The monitors beeped steadily, a testament to their skill, but the air was thick with the weight of the unexpected. As they began closing, James's voice softened, almost to himself. "Sometimes, the body knows something we don't."
Bailey glanced at him, a spark of respect in her eyes. "You handled that well, Dr. Blackwood. Not many would've stayed that calm."
James met her gaze briefly. "You work in places like I have. You learn to expect the unexpected."
In the gallery, Izzie exhaled, her hands trembling. Are you okay up there? Denny asked him to come closer now.
"I can't do this," she whispered, turning away from the glass, her heart torn between the miracle below and the ghost beside her.
The OR team finished closing, and the scrub nurse covered Clay's chest with sterile drapes. James stepped back, peeling off his gloves, his mind already on the post-op discussion with Clay. The beating heart was a mystery—one that might free Clay from his haunted fears, but it left the team grappling with the boundaries of medicine and belief.
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Later, back in Clay's room, the atmosphere was lighter, calmer.
Clay Bedonie lay in his hospital bed, his dark eyes calm, gazing at the soft light filtering through the window. The monitors beeped steadily, a quiet contrast to the sage-scented air from his earlier cleansing ritual. Dr James Blackwood stood at the bed's foot, navy scrubs slightly creased, hazel eyes warm yet professional. Dr. Miranda Bailey stood beside him, arms crossed, while Izzie Stevens hovered near the door, clutching a chart, Denny's whisper in her mind. He's okay now, huh, Izzie?
"Mr. Bedonie," James began, voice steady, "your surgery took an unexpected turn. When we removed your donor's heart, your original heart started beating on its own."
Clay's brow furrowed. "My heart? The one I was born with?"
"Yes," Bailey said, voice firm but awed. "It's functioning strongly. If it holds, you won't need a transplant or LVAD. It's remarkable."
Clay exhaled, eyes drifting upward, a faint smile forming. "I'm free. Not haunted anymore."
Izzie stepped closer, voice soft. "The hitchhikers? From the donor's heart?"
Clay nodded, grateful. "Gone. This heart's mine. No other spirit."
James's tone was respectful. "Medically, your heart rested for six years, repaired itself—a rare case. But your beliefs matter. If you feel free, that's what counts."
Clay met his gaze. "You kept your word—gave me my heart for the ritual. Now I don't need another."
"We'll honour the ritual," Bailey said. "Your heart's preserved for your medicine, man."
"Thank you," Clay said, voice steady. "You listened."
Izzie's throat tightened, Denny's voice sharper. Burn my sweater, Izzie? She forced a smile. "What's the ritual like?"
"We burn everything tied to the dead," Clay said. "Fire frees the spirit. Nine days, with prayers."
Izzie nodded, thinking of Denny's sweater. Do you want to be free? Denny whispered. She swallowed, voice shaky. "That's beautiful."
James glanced at her, noting her distress, but focused on Clay. "We'll monitor you. If your heart holds, you're on track for recovery. Your medicine man can visit."
Clay's smile grew. "Your science, my beliefs—they met today."
Bailey nodded. "Rest now. We'll check in soon."
Izzie lingered as they left, envying Clay's peace. Let me stay, Denny urged. She hurried out, his presence heavy.
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Outside the hospital, Izzie stood near the entrance, sweater clutched in her hands. It smelled like Denny. Still. Always.
"You heading home?" came his voice.
She looked up at him — at his impossibility — and, for once, didn't flinch.
"I love you," she said. "And I always will. You own a piece of me. And even though you'll be gone, you'll never be forgotten."
He frowned. "Why are you telling me this?"
"I'm trying to let you go," she whispered, "so your soul can be at peace."
Denny stepped closer. "I have peace, Izzie. I'm here for you."
Tears filled her eyes. "Goodbye, Denny."
She turned and walked away.
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In the intern locker room, Cristina found Lexie rolling down her sleeve quickly. She didn't miss the red-stained gauze or the nervous glance from the other interns.
"I can explain," Lexie started.
Cristina looked around, eyes sharp and disappointed. "I didn't teach you the parallel pulley stitch. I can barely do it myself."
She stepped closer. "Whatever this is-whatever you're doing—shut it down. Practising on yourselves is insane."
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Back at Meredith's house, Izzie stood before the fireplace.
Alex approached quietly. "Iz?"
She didn't turn around.
"I see you," he said. "I've seen you all day. Struggling. And I know you don't want my help, but let me. Whatever it is — I can help."
Izzie turned to him slowly, eyes full of grief. She held out the sweater.
"Burn it for me?"
Alex nodded, took the bundle gently, and stepped outside.
She watched through the glass as he dropped it into the flames.
It caught quickly, curling into ash and orange.
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At Joe's bar, Callie sat with Cristina and Mark.
"I hate how hard it is," she said, nursing a drink. "You let people in… and they become a part of your life. And then you can't stop thinking about them."
Mark didn't respond. His eyes were focused on the door — and Lexie, who had just walked in.
Callie stood to get another round, leaving Cristina and Mark in silence.
Cristina's gaze drifted toward the bar, where Owen sat alone.
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That night, Izzie returned to her bedroom. She closed the door behind her, leaned against it, and exhaled.
She had let go. She had burned the sweater. She had said goodbye.
But when she opened her eyes, her breath caught.
Denny was sitting on the bed.
"I said goodbye," she whispered. "I burned the sweater."
He smiled. "Yeah. Thanks for that. I loved that sweater."
She gasped, eyes wide. "Oh my God. You're not real. You're not real!"
"I told you," Denny said, voice tender. "I'm here for you."
"I burned it!" she cried. "I said goodbye!"
"Izzie," he said gently. "Look at me."
She turned.
"Touch me."
Trembling, she stepped closer and placed her hand on his chest.
He laid his hand over hers.
"You see?" he said softly. "I told you I was real."
Her lips parted in wonder. And then — slowly — she kissed him.
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Joe's bar was buzzing — a mess of voices, glass clinks, and the low hum of bad decisions. Lexie sat tucked into a corner booth, shoulders curled inward, nursing a second whiskey she didn't need. Cristina was at the bar with Callie and Mark, laughing about something Lexie couldn't hear. But she wasn't really listening anyway. Her mind was elsewhere — her body in the bar, but her heart still stuck in the hospital hallway where she had seen him.
James.
He hadn't warned her. Hadn't called. Hadn't sent a single message saying he was coming. He had just… appeared. Like a ghost.
Her phone buzzed on the table.
James:I am outside of bar. Need to see you.
Her breath caught. She stared at the screen, pulse quickening. The noise of the bar suddenly felt miles away. She quickly typed back,
Lexie:On my way.
She grabbed her coat, ignoring Mark's glance across the room, and slipped out the side door into the cool Seattle night.
The cool Seattle night greeted her as she stepped out from the bar. James stood under a lamppost, his dark jacket accentuating his lean frame, hazel eyes lighting up at her approach. "Lexie," he said, voice warm, closing the distance. He cupped her face, kissing her softly, a tender spark igniting after months apart. She melted into it, hands on his chest, the world fading.
Pulling back, he smiled. "Come to my hotel? The Archfield's close. Just us, no hospital chaos."
Lexie nodded, eyes bright. "Yes." She leaned in, kissing him again, deeper, a promise of more. They walked hand-in-hand, the city's lights glinting as they headed to the Archfield.