Izzie – POV
I did not come to Seattle Grace to spend my first day with my finger up a stranger's ass.
But here we were.
"Rectal exams," Dr. Bailey had said, her voice flat like a death sentence. "All of them. Every one the ER has been saving."
So now I was in a tiny exam room, fluorescent lights buzzing, latex gloves snapped tight around my wrists. A middle‑aged man in a thin gown lay on his side, knees pulled up, trying not to die of embarrassment.
Join the club.
I squeezed a line of clear gel onto my gloved fingers, the cold weight of it making my stomach twist. It smelled faintly sterile, faintly wrong.
"Okay, Mr. Jenkins," I said, keeping my voice gentle. "I'm going to insert my finger now. You might feel some pressure, but it shouldn't be painful. If it hurts, tell me, okay?"
He nodded into the pillow, ears bright red.
I took a breath.
I'd seen this done. I'd practiced on models and mannequins and in simulation labs where the "patient" was plastic and never flinched. But this was different. This was a real person, with real fear and real dignity hanging on by a thread.
I hated that it grossed me out even a little.
You're a doctor now, I reminded myself. Doctors do the messy things so patients don't die from the glamorous things.
"Deep breath," I said, and guided my hand forward.
The gel was cold, the resistance awkward, the angle clumsy. A part of me wanted to recoil; the rest of me forced my face to stay calm, eyes on his back, voice steady as I talked him through it.
"You're doing great," I said quietly. "Almost done."
As I palpated, I focused on what mattered: texture, masses, tenderness, blood. Not the smell, not the fact that I wanted to shower for an hour later. Just the findings. Just the medicine.
There was nothing alarming. No hard nodules, no obvious blood.
I withdrew my hand carefully, wiped away excess gel, and pulled off the gloves with a snap that sounded louder than it should have.
"All done," I said.
He exhaled shakily.
"Was it…okay?" he asked.
"You did really well," I said honestly. "I know it's not pleasant. But it's important."
He gave me a small, grateful smile. The kind that made the whole thing feel a little less disgusting.
Outside, I tossed the gloves, washed my hands like I was scrubbing for a transplant, and stared at myself in the mirror.
Izzie Stevens. Former model. Now rectal exam queen.
"Welcome to surgery," I muttered, and headed for the next patient on the list.
Cristina – POV
Labs were boring. Necessary, vital, life‑saving, yes—but also boring.
I jogged from floor to floor with a stack of tubes and printouts, chasing down numbers like a glorified courier. Every time a printer spit out a result, I snatched it and checked one name in particular.
Katie Bryce.
Fifteen. Multiple seizures. No obvious cause—yet.
Her labs were clean. CBC normal. Chem‑7 unremarkable. Tox screen negative so far. Viral titers pending. It was like her body was laughing at us.
"No metabolic reason," I muttered, flipping through the sheets. "No infection screaming at us. Nothing obvious."
I made my way to the OR level, pausing in front of the big glass window that looked into one of the operating rooms. Dr. Bailey stood inside, mask off, talking with a scrub nurse as they prepared for the next case.
Surgery. That's where I belonged. Not in corridors. Not babysitting lab results.
I pressed closer to the glass, nose almost touching it.
Bailey glanced up, saw me, and her eyes narrowed. A second later, the OR door opened with a hiss, and she stepped out into the hallway.
"Dr. Yang," she said. "What exactly are you doing?"
I straightened.
"Dr. Bailey," I said. "Katie's labs are back. So far, nothing explains her seizures. CBC, Chem‑7, tox—normal. I thought you should know."
She took the sheets, scanned them quickly, lips tightening.
"Okay," she said. "So labs don't give us the answer. That's why we have brains and scans."
I hesitated.
"I heard…" I began. "Every attending chooses one first‑year intern to scrub in, during the first shift. Their 'one' for the year. I just—wanted you to know I'm interested. Very interested."
Bailey stared at me so hard I almost checked myself for burns.
"Go away, Dr. Yang," she said.
"But—"
"Go run more labs," she cut in. "You want to impress me? Stop hovering like a lost puppy and bring me data I can use. When I want someone in my OR, they'll know. Now move."
My jaw clenched.
"Yes, ma'am."
I turned and walked off, fighting the urge to punch the nearest wall.
Fine. She didn't want to see me at the window?
I'd force her to see me in the OR—eventually.
But first, more labs.
Kiyotaka – POV
"Hey, Katie," I said as I pushed her gurney down the hall toward radiology. "That's your name, right?"
Her eyes were half‑open, pupils still a little wide from everything we'd given her. But there was awareness there now, a teenage impatience that said she was used to being in control.
"You're…very pretty," she slurred.
I huffed a soft laugh.
"Hey, hey, thank you," I said. "But I heard you were the beauty queen around here. Pageant girl, right?"
"Yeah," she mumbled. "Missed it, though. 'Cause, you know, seizures."
"Yeah," I said. "That part sucks. But we're on it."
Her lashes drooped.
"You're sure?" she asked. "I can't have my brain explode before I win something. That'd be lame."
"Extremely lame," I agreed. "Which is why I need you to tell me everything, okay? Any other weird things before the seizures started? Headache? Vision changes? Falls?"
She frowned.
"During practice," she said slowly. "I fell. On my ankle. It got all swollen. They put ice on it. It hurt, but I danced through it. I'm fine."
"You fell," I repeated. "Hit your head?"
"Dunno," she said. "Everything was fast. Music, lights, heels. My coach yelled at me. That's normal."
We reached CT, the big machine waiting like a giant white donut ready to eat her.
"Excuse me," I called to the techs. "We've got Katie Bryce here for a CT, possible intracranial cause of seizures."
One of the techs, a woman in her late thirties with curves in all the right places and a name badge that read "Nina," glanced up.
"Roll her in," she said. "We'll get her on the table."
I helped lift Katie onto the CT bed, careful with her lines, careful with her neck. Nina and I worked in sync: head positioned, straps in place, foam pads to keep her from moving.
"First day?" Nina asked, eyebrow raised.
"Is it that obvious?" I asked.
"You've still got hope in your eyes," she said. "Give it 48 hours."
"Optimist," I said.
She chuckled.
We slid Katie into the scanner. Nina went to the console; I squeezed into the narrow space beside her, eyes on the screen.
We watched slice after slice appear, grey and white, shadows and shapes of her brain.
I leaned in, shoulder brushing Nina's.
For a second, I felt the warmth of her body, the weight of her gaze flicking sideways to my face. A faint blush touched her cheeks.
Okay, not the time.
I focused on the images.
No obvious mass. No huge bleed. Ventricles looked normal. Hippocampus on both sides looked okay on CT—though CT wasn't the best for that anyway.
"Nothing big," Nina said. "Looks clean to me."
"Maybe," I said. "But CT can miss smaller hippocampal lesions. Might show up better on MRI. We should also make sure this isn't some weird vascular thing that only shows with better contrast or different cuts."
I pointed at one slice where, if you squinted, there was a subtle variation—maybe artifact, maybe nothing.
"Ask them to add a helical sequence," I said. "Just to be safe."
Nina raised a brow.
"You a radiologist now, too?" she asked.
"Just paranoid," I said. "And I read too much."
She rolled her eyes but keyed in the adjustments.
When we were done, Katie was a little drowsy from the sedative we'd used to keep her still, but stable. We got her back onto the gurney, lines intact, monitors beeping steadily.
Back on the floor, her parents arrived—wide‑eyed, panicked, clinging to each other.
"She's going to be a little sleepy for a while," I explained, adjusting her blankets. "We gave her something to help keep her still for the scan. Her vitals look stable right now. We're running more tests to figure out why the seizures started."
"What's wrong with her?" her mother demanded. "Is it a tumor? Is she going to die?"
"We don't know yet," I said honestly. "But we're not going to stop until we find out."
On the way out, I flagged down a passing nurse—a guy in his thirties with tired eyes and a sympathetic smile.
"Hey," I said. "Do you know where I can find the neurosurgeon on call? Dr. Shepherd?"
He jerked his thumb down the hall.
"Neuro bullpen or OR level," he said. "He's new. You'll recognize the hair. Or the ego."
"Great," I said. "Thanks."
I started toward neuro, flipping the CT images in my mind, fitting them into everything I knew and everything I was afraid we'd missed.
Halfway there, I spotted George in a room, struggling with an IV line, brow furrowed, lips pressed tight.
"Hey, George," I called, pausing at the door.
He jumped, nearly dropping the catheter.
"Kiyo," he said. "Oh, hey. I'm just—this vein keeps rolling. I can't…get a line."
The patient looked nervous, bruised from too many failed attempts.
"Can I give you a tip?" I asked. "Not trying to step on your toes."
George swallowed.
"Please," he said.
I stepped closer, pointed at the arm.
"Press here," I said, placing my fingers firmly proximal to the site. "Hard, for a minute. Trap the blood, let the vein fill. Then tap it, gently, like you're waking it up. Angle shallow, watch your bevel, and don't chase it if it runs. Commit."
He did exactly that.
The vein plumped. The catheter slid in smooth, almost too easy.
The flash of blood appeared in the chamber. George's eyes went wide.
"I…got it," he said. "I got it."
"Told you," I said. "Nice work."
"Thanks, Kiyo," he said, relief all over his face.
"Anytime," I said. "See you."
As I walked away, I caught a glimpse of Preston Burke at the far end of the corridor, watching. His expression was unreadable.
Great. Another attending with eyes everywhere.
Meredith – POV
Rounds were a blur of feet and fear.
Chart after chart, room after room, Bailey's voice in front of us, firing questions like bullets.
"Vitals?"
"Med list?"
"Plan?"
George stuttered. Izzie tried too hard. Cristina snapped out answers like she wanted to beat us to the punch. I kept my head down and my notes legible.
Every patient was a test.
Every mistake felt fatal.
By the time I finally escaped to the nurses' station to breathe, my feet hurt and my brain felt like mush.
That's when I saw him.
The guy from my living room floor.
Standing in the hallway, in a white coat, with a chart in his hand and nurses orbiting him like planets, was my one‑night stand.
Derek.
Of course his name would be something like Derek.
My stomach dropped.
No. No no no no.
He spotted me. His eyes lit up with slow recognition.
"Well," he said, walking over, that stupid smile on his stupid beautiful face. "This is a small world."
I swallowed.
"You're—"
"Dr. Shepherd," he said. "I'm a neurosurgeon. You must be—"
"An idiot," I said. "I slept with my attending."
He blinked.
"You slept with your attending?" he asked lightly. "I thought you slept with a charming guy from a bar."
My face burned.
"This is wrong," I said. "You're my boss. We can't—we can't do this."
"We're not doing anything right now," he pointed out. "We're standing in a hallway. Fully clothed. Talking."
"That's not the point," I hissed. "There are rules."
"I'm very good at breaking rules," he said. "And I'm very interested in…coffee."
"No," I said. "Absolutely not. We're not dating. I'm not dating an attending. It's wrong. It's—unsafe. Professionally. Ethically. Everything‑ally."
He tilted his head.
"So you don't want coffee?" he asked.
"I didn't say that," I muttered. "But I'm saying no anyway."
He smiled.
"I like a challenge," he said.
Before I could argue with him—or myself—another voice cut in.
"Excuse me," Kiyotaka said, stepping up with a chart in his hand. "Sorry to interrupt, Dr. Shepherd. Kiyo, first‑year surgical intern. I have an observation about a CT scan I think you should see."
Derek glanced at him, then at me, then back.
"Wow," he said quietly. "I've never seen a guy so pretty in this hospital. Is this some kind of casting upgrade?"
Kiyo stared at him, unimpressed.
"I'll take that as a compliment," he said. "Anyway, Katie Bryce—fifteen, recurrent seizures, CT mostly clean. But there's a subtle area I think we should look at closer. Might be nothing, might be something hippocampal that CT's not great at catching. I'd like your opinion."
Derek held out his hand without really looking at the chart.
"Just give me the file," he said. "I'll take care of it."
"I think you should know my reasoning," Kiyo said. "If we miss—"
"I'm an attending," Derek cut in, voice cooling. "I know how to interpret a scan. That's why I'm the neurosurgeon."
There it was. The wall.
I saw Kiyo's jaw tighten just a fraction, then relax again.
"Of course," he said evenly. "I'll let you get to it, then. Have a good day, Dr. Shepherd."
He nodded at me—a brief, polite acknowledgment—and walked off toward the elevators.
I watched his back disappear down the hall, a prickle of annoyance in my chest that wasn't quite mine.
It wasn't lost on me that Derek dismissed him faster than he'd dismissed me, and I'd just told him I didn't want to go out with him.
I didn't know what bothered me more: the disrespect, or the fact that Kiyotaka didn't look scared at all.
He just looked…done with it.
Cafeteria – Group POV (anchored on Kiyo)
The cafeteria smelled like overcooked vegetables and desperation.
I carried a tray with something that claimed to be food and scanned the room. The other interns were already gathered at one of the tables—Cristina, George, Izzie, plus a guy I hadn't properly met yet: tall, cocky posture, smirk like he'd been born in an OR.
Alex Karev.
"Hey, guys," I said, dropping onto the empty chair.
Cristina looked up, eyes flicking over me, remembering the rooftop and the CT and the seizure that had bent to my will.
"Hey," she said. "So. You're a nerd?"
Alex laughed, stabbing his food.
"Big time," he said. "Did you see him jump on that chopper case? Dude's got 'teacher's pet' written all over his face."
I tilted my head.
"I don't know," I said. "I just…do what feels right. I like helping people. And I like not watching them die if I can help it."
Izzie smiled, tucking a strand of blonde hair behind her ear.
"Nice to meet you properly, Kiyo," she said. "Izzie."
"Nice to meet you too," I said. "You look nice, by the way."
Color rose to her cheeks.
"Thanks," she said.
Alex snorted.
"He's got game," he muttered.
George cleared his throat.
"Thanks again for the IV tip," he said. "Seriously. You saved me from poking that guy into a lawsuit."
"It's okay, dude," I said. "You'll get the feel of it. Everyone does."
Cristina leaned in.
"Do you guys know," she said, eyes gleaming, "that Meredith is Ellis Grey's daughter?"
Izzie nearly dropped her fork.
"The Ellis Grey?" she asked. "Like—Harper Avery, legendary surgeon, that Ellis Grey?"
Cristina nodded.
"I would kill to be her daughter," she said. "She's lucky."
I glanced toward the line where Meredith was grabbing her lunch, shoulders a little hunched, eyes somewhere far away.
"Maybe," I said quietly. "But Meredith is her own person. I don't think we should disregard her efforts just because of her mother. The name opens doors, sure. But staying in the room? That's on her."
Everyone looked at me.
Cristina tapped her fingers on the table.
"Damn," she said. "I guess you're right."
"That's annoyingly reasonable," Alex said.
Before I could answer, Meredith dropped her tray at the end of the table and sat down with a sigh like the air had given up on her.
"Hey," she said. "Shit day."
Before anyone could offer sympathy or sarcasm, a shadow fell over the table.
Preston Burke.
"Interns," he said.
We all straightened.
"As you may have heard," he went on, tone precise, "each attending chooses one intern during the first shift to scrub in. Their 'one' for the year."
Our hearts collectively stopped.
"The intern who will scrub in on an appendectomy this afternoon is…" he paused just long enough to make it dramatic—
"Kiyotaka."
The table went silent.
"There is an appendectomy scheduled in OR Two," Burke said. "You impressed Dr. Bailey. Let's see if you can impress me. Be there on time. Scrub properly. Don't embarrass yourself."
Cristina exhaled sharply.
"Damn it," she muttered under her breath.
Izzie's face brightened.
"Congratulations," she said.
George grinned.
"Yeah, man. That's huge."
Meredith looked at me, something complicated in her eyes.
"Best of luck," she said.
"You too," I replied, and let the corner of my mouth twitch into a quick wink.
Her eyes widened just a fraction.
Everyone else looked between us like they'd just noticed a spark and weren't sure if they liked it.
Burke walked away, and the cafeteria noise rushed back in.
Appendectomy.
First day. First scrub‑in.
No pressure.
Meredith – POV (short checkups + Derek again + Kiyo comment)
The rest of the shift blurred into vitals and charts.
"Hi, I'm Dr. Grey," I introduced myself over and over. "I'm just going to listen to your heart."
A post‑op cholecystectomy patient. A guy with a simple hernia repair. An older woman recovering from bowel resection.
Check incisions. Check drains. Check pain. Check the lines. Check the charts. Try not to drown.
In one room, a frail man clutched my hand and called me "doctor" like it meant salvation. In another, a younger woman rolled her eyes and asked when a "real doctor" would show up. I smiled through both.
When I finally stepped into an empty corridor to breathe, Derek appeared from the other end like the universe hated me.
"Dr. Grey," he said, smile already loaded. "Busy?"
"Yes," I said. "Very."
He moved closer, voice dropping.
"You know, we could—"
"No," I said. "We can't. You're an attending. I'm an intern. Dating you would be wrong. And stupid. And probably against several policies."
He leaned against the wall, unbothered.
"Policies are guidelines," he said. "Not laws."
"Tell that to HR," I snapped. "Anyway, what would we even be? A cliché? 'Neurosurgeon sleeps with intern, film at eleven'?"
He considered this.
"I prefer 'two consenting adults take a chance on something interesting'," he said.
"I prefer 'not getting fired'," I shot back.
Before he could respond, Kiyo appeared again, chart in hand, expression serious.
"Dr. Shepherd," he said. "About Katie Bryce—"
Derek sighed.
"You again," he said. "Look, I looked at the scans. There's nothing obvious. We'll keep her here, monitor, run more tests."
"I think there might be a missed lesion," Kiyo said calmly. "CT isn't perfect for hippocampal sclerosis or smaller cortical malformations. Her history—fall during practice, ankle injury, seizures—suggests there might be something subtle we're not seeing if we only rely on the initial cuts."
"I know how to read a CT," Derek said, a little sharper now. "I am a neurosurgeon. I've done this longer than you've been in med school."
Meredith winced internally.
Kiyo's expression didn't shift much.
"I understand," he said. "I just don't want us to regret missing something if she crashes later. That's all."
Derek's jaw flexed.
"Thank you for your concern," he said. "I'll take it from here."
There it was again—that invisible line between "attending" and "intern" cutting through the air.
"I'll get going then, Dr. Shepherd," Kiyo said quietly. "Dr. Grey."
He nodded to both of us and walked away.
I watched him go, then looked back at Derek.
"That was unnecessarily harsh," I said.
"He's an intern," Derek replied. "They all think they see things no one else does. Part of the process."
I didn't say anything, but a small part of me filed it away under "things to remember about Dr. Shepherd."
OR Gallery – Meredith POV
The gallery above OR Two was packed with interns and a few residents on break, all pressed against the glass like kids at a candy store.
Down below, the scrub nurse and techs prepped the room. Burke stood at the table, calm as always. And beside him, in a sterile gown and cap and goggles, was Kiyo.
He looked different in OR gear.
The pretty‑boy edges were still there—the jawline, the eyes—but the cap and mask made him look sharper, more focused. All business.
"I bet the pretty boy chokes," someone behind me whispered.
"I bet he panics and Bailey bans him from the OR for a month," another muttered.
Cristina crossed her arms.
"I bet he doesn't," I said suddenly.
Everyone looked at me.
"We should support him," I added. "He's the first of us to get in there. If he does well, it means one of us can actually impress them this early."
Cristina's eyes flicked between me and Kiyo, then back.
"Fine," she said. "I bet he nails it."
Below, Burke turned slightly toward Kiyo.
"Show me, Dr. Kiyotaka," he said, voice muffled through the mask but still authoritative.
Even from up here, we could see Kiyo inhale slowly, shoulders rising and falling once.
Then he spoke, calm and clear.
"Scalpel."
The scrub nurse placed it in his hand.
Kiyo's grip was perfect—firm, not too tight. He made the incision with a smooth, decisive motion, cutting through skin, then subcutaneous tissue, down toward the fascia. No hesitation, no jagged edges. The line was neat, controlled.
He traded the scalpel for pick‑ups and a clamp without fumbling, fingers knowing where everything was like he'd done this more times than he possibly could have.
"Retractors," Burke ordered, but Kiyo was already anticipating, helping open the field.
He identified the cecum, gently explored, found the swollen appendix with the certainty of someone who'd memorized every diagram and then some.
"Clamp," Burke said.
Kiyo clamped and cut with clean motions, isolating the mesoappendix, cauterizing vessels as needed. No shaky hands. No wasted movement. No theatrics.
He ligated the base, careful not to leave a stump too long or too short.
"Convert the stump into the cecum," Burke said.
Kiyo placed purse‑string sutures with precise spacing, pulling the knot down just right, burying the stump smoothly into the cecal wall.
No torn tissue. No messy bites.
Even from the gallery, you could feel it: the quiet competence, the way the OR staff's tension eased just a fraction.
In the seats around me, the commentary shifted.
"Holy—" someone breathed. "That's textbook."
Cristina leaned forward, eyes shining.
"He's good," she whispered, half to herself. "He's really good."
I felt a strange mix of pride and jealousy twist in my chest.
Kiyo wasn't just handsome. He wasn't just lucky.
He was prepared.
Down below, Burke watched him, eyes narrowed in what looked dangerously close to approval.
"Not bad, Dr. Kiyotaka," he said. "Not bad at all."
Kiyo didn't look up at the gallery, didn't show off, didn't even smile.
He just nodded once, hands steady as he moved to close.
Up here, the room had gone quiet.
For the first time that day, none of us were joking, complaining, or gossiping.
We were all thinking the same thing:
On day one, in the first surgery, one of us had walked into the OR and proved he belonged there.
And if we didn't catch up, Seattle Grace was going to remember his name a lot sooner than it remembered ours.