After hanging up the phone, Adam headed to the VIP ward. Today, he was in charge of a patient with a Rathke's cleft cyst.
"Mr. Martin! Mr. Martin!" Nurse Violet—the sharpest of the bunch—was anxiously knocking on the bathroom door inside the ward.
"Dr. Duncan, Mr. Martin's locked himself in there and won't open the door," she said, turning to Adam.
"Mr. Martin, please open the door. I know you're feeling awful, but you need our help," Adam called, giving the door a few firm knocks.
"I don't need help! I don't need anyone!" Mr. Martin yelled from inside. "I'm an island—a beautiful little island, surrounded by water!"
"Shit!" Adam's face darkened.
"Dr. Duncan, I'll get security," Nurse Violet said instinctively.
"No need," Adam replied. With a hard twist, he forced the lock open.
Nurse Violet froze on the spot. There was Mr. Martin—a successful guy who could afford a VIP ward—sprawled by the toilet, his face plunged into the water. When he saw them barge in, he lifted his head for a second, then dunked it right back in, chugging desperately.
Adam marched over, grabbed him by the collar with one hand, and hauled him out.
"No!" Mr. Martin thrashed wildly. "Let me go! I need water!"
"Violet, get the restraints," Adam ordered.
"Yes, sir!" She bolted out of the room.
"Don't look at me! I don't want anyone seeing me like this—so pathetic!" Mr. Martin roared as he struggled.
"This isn't you, Mr. Martin," Adam said, pinning him to the bed and trying to calm him. "You're sick. There's a Rathke's cleft cyst in your pituitary gland causing hyponatremia—low blood sodium. That's why you're so thirsty.
"But we can't let you guzzle water. It has to be an IV drip. Drinking too much will mess with your sodium levels even more and drive you into delirium.
"That 'beautiful island surrounded by water' you saw? It was just a toilet. And I'm not your in-flight attendant on some vacation—I'm your doctor."
"No! I don't believe you!" Mr. Martin screamed, completely unhinged.
Adam had seen him in his normal state before: a reclusive, proud businessman with a male assistant always at his side. According to the assistant, Mr. Martin had no friends—well, except maybe the assistant himself, who'd been with him for three years.
Though, honestly, that was probably just the assistant's wishful thinking. When he followed Adam's orders and restricted Mr. Martin's water intake, the guy's desperate thirst got the better of him—and he fired the assistant on the spot.
Adam had tried to talk him out of it.
"You're just a doctor—what do you know?" Mr. Martin had snapped back. "Come talk to me about this when you have an assistant." His words dripped with disdain and arrogance.
Adam didn't bother arguing further. But Nurse Violet couldn't hold back—she shut him down in a few sharp sentences. Sure, there are plenty of successful businessmen, but not one in a hundred is a billionaire. Mr. Martin had to eat his words.
This doctor might actually understand the dynamic between a boss and an assistant. Still, he didn't take Adam's advice and call the guy back. In his mind, the assistant had seen him at his lowest, and that respect was gone forever. No way he'd keep someone like that around.
Adam got it. It was like the old days—knowing too many royal secrets could get you in hot water.
You know too much.
The king doesn't want to see you.
You've got to disappear…
"Dr. Duncan," Nurse Violet called, snapping him back. She'd returned with the restraints in record time.
"Tie him down," Adam instructed.
She expertly secured Mr. Martin's wrists and ankles to the bed.
"Start him on a 3% hypertonic saline IV drip—500 milliliters over four hours," Adam ordered. "Repeat that back."
"3% hypertonic saline IV drip, 500 milliliters over four hours," she echoed.
"Good," Adam said, then added, "Be careful with this. Too much saline can permanently damage his brain. Make sure it's 500 milliliters total over four hours—no more."
Nurses are great for routine stuff—they can handle it without a doctor hovering. But for rare, tricky cases like this, their experience falls short. If she'd misheard and thought it was 500 milliliters per hour for four hours, Mr. Martin's brain would be toast. Not dead, but paralyzed for life.
Adam had just told Liz that "every great doctor has lost a patient they shouldn't have due to a mistake." What he didn't say was that applied to average great doctors. For a cheat-code genius like him, a patient dying from his error might never happen. And the longer he went—skills and expertise piling up—the less likely it'd ever be.
He wasn't about to let his first screw-up be something this basic. Even if it did happen, it wouldn't tank his career. Seasoned doctors could still rattle off every detail of their own slip-ups years later—it haunts them forever. Adam's brain had an encrypted folder for that kind of thing, but a mistake he could avoid with one extra word? No chance he'd let it slide.
"Got it, Dr. Duncan," Nurse Violet nodded seriously.
"Dr. Shepherd," Adam said later, tracking her down after settling Mr. Martin. He filled her in.
"Alright," Dr. Shepherd replied, glancing at her watch. It was past 2 p.m. The IV drip would take four hours, pushing them past regular hours. "Keep a close eye on him tonight. We'll operate tomorrow."
That's a big difference between attendings and residents: attendings have set schedules. Aside from rotating hospital duty or emergencies, they work seven-to-five with weekends off—normal life stuff. It's why residents grind so hard to make attending. It's not just the money—it's the free time. Money and leisure? That's the dream.
"Cristina, your favor's cashed in," Adam said, finding her later and handing off Mr. Martin's overnight watch.
The nurses could handle it, technically, but since he was Adam's patient, he didn't feel right without a dedicated doctor on it. Might as well burn Cristina's favor now—otherwise, she'd keep obsessing over it. Plus, if they bet again later and the favors stacked up, she might just give up and ghost the debt entirely. Better to keep it clean: owe, pay, owe again.
As expected, Cristina was thrilled to agree. Owing someone a favor weighed on a proud, principled person like her. Adam hadn't given her a chance to clear it before, but now? Just a night shift and some extra patient duty to wipe the slate clean. Way better than handing over a surgery.
He trusted Cristina enough but still drilled the instructions into her three times before clocking out, changing, and driving off to New Jersey.