The ER was a cacophony of sirens and shouting, the familiar soundtrack to Christopher's daily life. He stood by the ambulance bay, hands deep in his pockets, watching the clock.
"Dr. Wright, you can't possibly know a patient's diagnosis before they've even cleared the doors," Meredith said, trailing behind him. She looked exhausted, her "post-Der-sex" glow replaced by the frantic energy of a first-day intern.
"Watch me, Grey," Christopher said. "And for heaven's sake, stop looking at me like I've joined a cult. I just read the signs. This city is predictable."
The doors burst open. Paramedics rushed a gurney in. "Katie Bryce, fifteen-year-old female, rhythmic seizure activity, non-responsive to diazepam!"
"Get her to Trauma 1," Christopher barked, moving with a grace that made the older residents look clumsy. "Grey, get a CT scan ready. Not a standard neuro workup—I want a high-resolution angiogram. Now."
"Wait!" A voice like velvet-wrapped sandpaper cut through the chaos.
Derek Shepherd stepped into the fray, his dark curls perfectly tousled despite the trauma. He looked at the girl, then at Christopher. "A seizure in a fifteen-year-old doesn't automatically mean a hemorrhage, Dr. Wright. It's likely a simple febrile seizure or a complication from a fall. Let's start with a basic metabolic panel and a standard MRI."
Christopher felt the familiar itch of superiority. He knew exactly what Derek was thinking: I'm the world-class neurosurgeon, and this kid is just a parlor trick.
"Dr. Shepherd," Christopher said, his voice dropping an octave into a cold, clinical sharp edge. "While you're busy looking for a hoofbeat and thinking horses, I'm looking at the way her left pupil is lagging. It's a subarachnoid hemorrhage from a tiny, leaking aneurysm. A standard MRI will miss it. She'll be dead before your 'metabolic panel' comes back from the lab."
Derek stiffened. The surrounding nurses went quiet. "I'm the Attending here, Christopher. We follow protocol."
"Protocol is a safety net for people who can't see the finish line," Christopher retorted, leaning in closer. "I'm not interested in being safe. I'm interested in her surviving her sixteenth birthday. Grey! Why are you still standing there? Get her to the scanner!"
Meredith looked between the two men—the "God" of the hospital and the prodigy who seemed to be reading the patient's soul. She chose the prodigy. She grabbed the gurney and pushed.
Derek turned on Christopher, his blue eyes flashing. "That was out of line. You're a resident. You don't override an Attending in front of the staff."
"Then be right next time," Christopher said, adjusting his glasses. "It saves us both the breath. She has an aneurysm in the anterior communicating artery. If I'm wrong, I'll spend a month on scut. If I'm right, you let me lead the clipping."
Derek scoffed. "You're twenty-one. You shouldn't even be holding a scalpel near a brain stem."
"And you're a man who moved across the country to escape a wife who cheated on her husband with his best friend," Christopher whispered, his tone terrifyingly casual. "We all have things we shouldn't be doing, Derek."
Derek's face went bone-white. The color drained from his lips as he stared at Christopher, a chill running down his spine that had nothing to do with the hospital's air conditioning. "How did you—"
"I'm a very fast reader," Christopher interrupted, turning his back on the most famous neurosurgeon in the country. "Now, are you coming to see the scan? I hate to say 'I told you so' without an audience."
As Christopher walked toward the imaging suite, his heart hammered against his ribs. He was playing a dangerous game. He'd just dropped a nuclear bomb on Derek's personal life to win a medical argument. But as he saw Meredith waving him over with a look of pure shock at the glowing screen, he knew he'd won.
The aneurysm was there. Exactly where the script said it would be.