Series Premise: Ethan and Cassie are first-year residents at Edenbrook Hospital, competing for the coveted prize of being mentored by Dr. Banerji.
Chapter Premise: Cassie and Ethan are not sure what to make of their truce after Clinic Day.
Fandom: Open Heart
Pairing: Ethan Ramsey x F!MC (Cassie Valentine); feat. Sienna Trinh, Tobias Carrick
Rating/Category: Teen. AU
Words: 1,250
Series Masterlist
They called it the season of giving and good cheer. But for the interns working the Christmas Day shift at Boston’s Edenbrook Hospital, there was a lot of giving and very little cheer. Unless one counted the overly cheerful Christmas music pumping from the overhead speakers and the tinsel hanging across the nurses’ station.
Patients were either morose or frustrated at being stuck inside the hospital during the holidays. A skeletal staff meant there weren’t enough hands to go around. And the cafeteria food left a lot to be desired.
Cassie Valentine briefly thought of her family in Newport. Home was a roaring fire in the family room and her mom’s special cider. The traditional roast duck for dinner would easily win against the dry turkey and cranberry sandwiches she was nibbling.
She absently glanced around the near-empty hall, her eyes falling on Ethan Ramsey. He was sitting by himself (as usual), holding half a sandwich in one hand and frowning as he read something on his tablet.
They had called a truce ever since Dr. Banerji had admonished them for their competitiveness during Clinic Day last week. Cassie tried not to needle Ethan just because, while he made an equal effort to listen to her opinions.
They both kept up the façade in front of patients and their attendings. They smiled (okay, so his looked more like a grimace at times) and were solicitous, but inside, Cassie felt bored out of her mind.
She wondered if he felt the same.
Arguing with Ethan had been the best part of her day. She’d always come away invigorated from their interactions, and also just a little bit smarter.
Not that she’d ever tell him that. His ego was already the size of Alaska.
A lock of hair fell across his forehead, transforming him from severe to almost boyish.
It was taking her way too long to get over this stupid crush on Ethan, especially since he’d never given her any indication that he felt anything but annoyance at her presence.
“… anyway, you should come, Cassie.”
Cassie flushed when she realized Sienna had been talking the whole time and she hadn’t heard a word her friend had said.
Sensing her distraction, Sienna turned to see what Cassie had been staring at. A mischievous smile spread across her lips.
“Is the Great Armistice of Edenbrook still holding?”
Cassie rolled her eyes. “Aren’t residents supposed to have each other’s backs?”
“Residents, sure. But you and Ethan? A dolphin and a shark aren’t exactly a match made in heaven.”
“We’re just colleagues, Si,” she scoffed.
“Hey, if I looked at my ‘colleague’”—she used air quotes—“the way you were just staring at Ethan….”
She pretended to fan herself, making Cassie laugh.
“Saved by the bell,” Cassie said as her pager’s beep demanded her attention.
She checked the message before gathering up the remnants of her lunch to dispose of on her way out.
“We’re so dissecting this back at the apartment,” Sienna called out.
Cassie simply lifted her hand in response without looking back.
----
Ethan watched Cassie rush off, his attention briefly diverted by the way her silky, blonde ponytail swung behind her.
Did it have a mind of its own, he wondered, or did she deliberately turn her head this way and that so that one couldn’t help but pay attention to it, and her?
And did it smell as sunny as it looked, or was that just the scent of the perfume she spritzed in the locker room at the end of each shift?
And why was he sitting here pondering the mysteries of his co-resident’s grooming habits?
“Whatcha looking at?”
Tobias Carrick slipped into the seat across from him, his lips briefly twisting into a grimace at the sight of the sad little sandwiches from the hospital cafeteria.
He glanced at Ethan’s lunch.
“Those look nothing like mine,” Tobias complained. “When’d you have time to make them?”
“My dad dropped them off last night,” Ethan said, shrugging as he took a bite. “He knew I was working today and thought I’d appreciate a taste of home.” He peered at his friend. “You were busy, as I recall.”
Tobias grinned. “Ah, yes, the lovely Tina.”
“Spare me,” Ethan griped.
“You know, she has a friend,” Tobias said. “Might help you get over the Ice Princess.”
“I’ve told you before not to call Cassie that,” Ethan said angrily.
“Oh ho,” Tobias teased. “So, it’s Cassie now, not Valentine. When did that happen? And how long can you two keep it going before one of you explodes from excessive politeness?”
“That’s not a thing,” Ethan retorted, ignoring the rest. “Are we still on for pool after shift?”
“Always happy to take your money, Ramsey.”
Later, he made his way to his patient’s room on the fifth floor, scanning the notes he’d made during morning rounds.
Mr. Arbuckle was in his seventies and a bit of a self-declared opera nerd with strong opinions on just about everything.
Ethan liked him.
“...how anyone can be so wrong-headed is beyond me!”
Ethan heard Mr. Arbuckle’s raised voice from down the hall and hurried. What, or who, had gotten the old man so riled up? The stress was not good for his heart.
“Oh, please. Soap operas have all the elements of classical opera,” he heard Cassie argue. “And they have more mass appeal than Puccini.”
“Then why is a performance of Tosca always sold out at La Scala?”
“What’s a few thousand compared to the millions that tune into Days of Our Lives daily?” Cassie shot back dismissively.
Ethan stood in the doorway, his brows furrowed at the sight of Mr. Arbuckle smiling and the strange argument taking place inside. Cassie had pulled up the visitor’s chair and was leaning forward earnestly, her face animated.
He missed arguing with her, he thought with a sigh.
The rest of their resident class either drifted off when he started spouting medical research or gave him dirty looks when he was quick to answer the attending’s questions during morning rounds.
It wasn’t his fault he knew more than they did. Maybe if they didn’t spend so much time drinking at Donahue’s instead of studying...
Of course, Cassie seemed to join the others for Happy Hour and also managed to go toe to toe with him on anything their attendings threw at them.
Tobias had been right. The excessive politeness was just not natural for either of them. But Dr. Banerji had been clear. They either learned to work together or lost his respect.
And that was one thing Ethan wasn’t willing to compromise on.
“Ah, Dr. Ramsey,” Mr. Arbuckle called out. “Would you please explain to this one”—he nodded pointedly at Cassie—“the life-affirming qualities of a good aria?”
“I would,” Ethan began. “But I’m afraid Valentine is too stubborn to admit when she’s wrong.”
He didn’t realize what he’d said until the words were out of his mouth.
Dammit.
This was exactly what Dr. Banerji had warned them about. Arguing in front of patients. The topic wasn’t medicine, but still.
“Ha!” Cassie retorted, turning her head from Mr. Arbuckle to him, mischief in her green eyes. “I’d rather watch Bobby and Tiffany argue over who cheated on whom first than listen to a woman in Viking pigtails caterwauling on stage.”
Amused and enjoying himself immensely, Ethan folded his arms and leaned against the wall. “You have no taste, Cassie.”
“Right back at ya, Ethan.”
----------
All Fics & Edits: @bluebelle08 @lady-calypso @potionsprefect @quixoticdreamer16
The sound of chanting and loud music fills the outdoor patio of Donahue's, Brynlee twirls the ends of her newly dyed hair as Bryce and Raf sing off key to the Jason Aldean. She laughs at their attempt as Jackie and Aurora slip into their chairs on either side of her; both holding trays of shots.
“Okay everyone! We’re 30 seconds from midnight!” Sienna says excitedly as her and Elijah hurry over to the table.
We all grab a shot glass off of the trays now placed on the table. We hold them up and as the time ticks closer, we begin counting.
“5, 4, 3, 2..1!” We all take the shot.
Sienna, Elijah, and Aurora choke as the rest of us down it with ease. We laugh at the three and they roll their eyes.
“Next time, pick something other than tequila Jackie!” Elijah says
Jackie simply laughs and shakes her head. She then elbows me.
“Damn girl! Your hair looks good! And your killing that fit tonight, really went all out for the country theme.”
I laugh and smile at her. “Thanks Jackie, I just..I wanted a change, ya know?”
The table all shares a glance with one another and Brynlee looks at them all with confusion. “What?”
Sienna reaches her hand out across the table and grabs Brynlee’s. “I know things have been…different. Especially when Dr. Ramsey just up and left to the Amazon after everything that happened between you two, and we just-”
Sienna doesn’t get to finish as a tall, tan man walks up behind Brynlee, resting his hand on her shoulder. “We’re not talking about that dumbass tonight.”
Brynlee doesn’t have to look up to know it’s her little brother, Dallas Altuve of the Tampa Bay Rays, that's behind her. She turns anyway though; examining his black button up and cowboy hat; matching her black western dress, brown boots, and black hat. His hand tightens on her shoulder.
“Tonight better not be the night he shows up.”
And as if Dallas had summoned him; Dr. Ethan Jonah Ramsey walks out onto the patio. The whole group exchanges a worried glance between Dr. Ramsey and Dallas. Brynlee grabs Dallas’ arm before he can walk over to Ethan.
“Don’t Dallas. I still have to work with him; he’s going to be my boss as of tomorrow.” She hisses at him, keeping her voice quiet to prevent Ethan from looking over.
Dallas lets out a breath, before removing his hand from her shoulder. “Fine. That spineless bastard-”
“Okay that’s enough, Dallas. Just give it a rest.” Sienna snaps at him, seeing the sadness in Brynlee’s cold eyes.
“Sorry Bryn.” Dallas says as he kisses her forehead.
No one but Brynlee notices when Ethan’s head turns at the sound of her name, and their eyes lock for the first time in 2 months. His gaze washes over her in a way that sends chills down her spine, taking in her appearance. When he meets her eyes again; she looks down and grabs her glass of whiskey off the table. She downs the drink and gets up; heading straight inside.
The others look at each other, Dallas locks eyes with the back of Ethan’s head cursing him under his breath. The group pulls Dallas away, taking him to the dance floor to ensure he doesn’t go to jail.
Inside, Brynlee slides straight into a barstool. The bar itself is empty; everyone else is occupied playing darts or dancing. Reggie walks over and gives her a knowing look
“Get me another bourbon Reg, no ice.”
He nods and refills her glass. She downs it in one go.
“Easy there doc. You do have work tomorrow, no?”
“I’ll be fine Reg, I got something that sobers me up at the house.”
He nods, before leaning over the corner.
“You know..maybe you should just talk to him.”
Brynlee looks up at Reggie, trying to see if he’s serious or not. When it’s clear that he is, she laughs.
“And say what Reg? ‘Hey, I know we were never like actually together; but you really fucking hurt my feelings when you just vanished to the Amazon without so much of a text, and then you ghosted me; now you’re back and you’re my boss.”
When Brynlee finishes her rant, she looks up to see that Reggie isn’t staring at her; rather he’s looking at no other than Ethan Ramsey. She turns back and looks in front of her.
“Fuck you Reggie, just give me the whole damn bottle.”
Reggie just laughs and shakes his head at her. Ethan slides into the seat beside her, and she lets out a sigh of frustration.
“Can I help you Dr. Ramsey?” She says, not even looking up at him as Reggie refills her drink.
He doesn’t say anything at first, and Brynee can feel his eyes scanning her up and down. Finally, she turns to look at him; and the normal harshness in his eyes softens.
“Hey Rookie.”
“Actually, you're about 10 minutes too late with that.” She says looking back down at her drink.
Brynlee can see him nod in her peripheral, but she doesn’t acknowledge it.
Before he can answer, Brynlee's head turns to the side as a woman's voice raises.
"I'm not interested."
Brynlee is up in the blink of an eye, already walking over to the tan skinned woman and the pale white man.
"Oh come on baby, I'll-AHAGH."
Brynlee blinks as the woman twists his hand back, a load pop coming from it. The woman quickly grabs her hand and darts out the door.
"That bitch! I'll-"
"You won't do anything Thorne besides call a cab home." Ethan says, stepping in between Brynlee and Thorne
Brynlee turns to Ethan, and he nods; before turning his focus directly onto Thorne. She heads out the door, and turns down the side towards the alley. Altuve finds the woman leaned back against the wall, bandaging her hand.
"Hey, are you okay?" Brynlee asks softly as she crotches down beside her.
"Yeah I'm good, I didn't need anyone to step in."
Brynlee smiles at her, "I saw that you didn't, but let me help you; I'm a doctor at Edenbrook, I can get you bandaged here and then we can go make sure you don't need stitiches."
The woman shakes her head at Brynlee. "Alright...well at least let me help you banadage it; I take it your right hand is your dominant?"
Brynlee gives a pointed look to her injured right hand, and the girl nods. Reluctantly, the woman extends her hand; and Brynlee quietly wraps the hand.
"...Thank you." Is all she says before getting up and leaving. Brynlee sighs and heads back inside; where she is greeted with the sight of Reggie sweeping up the broken glass.
“Alright! It’s closing time, everybody out! You don’t have to go home, but you can’t stay here!” He then walks around to the counter as he finishes, and pulls out a bottle of vodka.
“Not you two. Take this and go out back.” He says, making Ethan look back to see Brynlee standing at the door.
Ethan grabs the bottle from him, and gives Brynlee a small smile. She looks up at him; anger and sadness fights in her eyes; but she nods. And as they go to walk out to the patio, Dallas and everyone else comes in.
His eyes flare at the sight of her and Ethan, and he goes to march over; but Brynlee puts her hand on his chest.
“It’s okay Dallas…we’re going to talk. I’ll meet ya’ll back at the apartment, okay? I won’t be too long.”
Dallas’ eyes soften as he looks down at his big sister; but he looks up and gives Ethan a look that even makes the famous Dr. Ramsey a bit nervous.
“Okay…Don’t be too long or I’m coming back in.”
Everyone else gives her soft smiles before following after Dallas. Bryn turns back and watches them leave before continuing out the door. Ethan and Brynlee sit down at one of the tables on the patio; the cool air hitting their noses.
“Listen..Bryn, I..I shouldn’t have just left like I did.”
Brynlee snorts and looks up at him. “No shit Sherlock. You could’ve just texted me; it takes 5 seconds.”
Ethan nods at her, before pouring his glass of Vodka and taking a sip.
“I didn’t want to just text you that I’m leaving; that’s wrong. I should have told you in person, I was…I thought that if I had, I would stay. And we needed distance, as of tomorrow; I am your boss. I will not let my feelings for you get in the way of your career.”
Brynlee looks at him for a long second.
“I get your reasoning Ethan. But I don’t need you to protect me. I appreciate that you want to protect my image, but that is mine to worry about. I am an adult and I can handle the truth. What’s pissed me off so bad these past few months, is that you slept with me; and then fucking vanished. I knew that we had to stop seeing each other romantically Ethan, I’m not a teenager living some romance novel. But you just left, like I was nothing.”
Bryn can see the pain in his eyes, and while she knows that in his mind, he did the best he could for her…drunk Brynlee didn’t care. Ethan takes another sip from his glass.
“You mean more to me than I can admit Brynlee…but I won’t be selfish. Your career, the life you want, comes first. It has to come first. You’re not nothing to me Brynlee. I’m sorry, I wish I could change how I left.”
“I appreciate that at least you can prioritize my career and residency over whatever we had, but…I need to go, before I say or do something I regret. Goodnight Dr. Ramsey.” Brynlee gets up in a flash, darting for the door
“Goodnight…Dr. Altuve.”
She doesn’t even say bye to Reggie as she bolts out the front door, where Dallas is waiting for her outside. She stops when she sees him, and he wraps his arm around her shoulder; not saying anything as they head towards her apartment.
Note: In my universe, the lawsuit doesn’t exist. I don’t agree with how PB wrote the end of Book 3, nor how they write the Ethan/Naveen relationship and Ethan/MC relationship. Both Ethan and Naveen should have lost their medical licenses for what they did; so I’ve just decided to do them justice by removing that subplot.
Word Count: 1220
The lights of the city shine through the open windows of Dr. Ethan Ramsey’s apartment. Wrapped in the sheet, Dr. Brynlee Altuve stood pressed against one of the bedroom windows; restless from the burden on her mind. Now that she was finishing her third year of residency; she had a decision to make. Was she staying at Bloom Edenbrook, or accepting an offer from another hospital?
Because of all her publicity from saving the Senator of Boston to helping diagnose Leland Bloom’s wife, Dr. Altuve had created quite a name for herself; in the US and aboard. She had job offers from the Mayo Clinic, John Hopkins, UCLA Medical Center, Singapore General Hospital, and a ton more. But she had made her home in Boston, with her friends and a certain doctor. Brynlee turns and glances at the bed, where Ethan is sleeping peacefully. He had pointed out to her just earlier that she was going to have to decide soon where she would continue her career.
And as much as Brynlee wanted to just stay at Edenbrook, getting a job offer for an Advanced Medical Diagnostics fellowship at the Mayo Clinic was a huge deal. But it was a little over 1,300 miles away. Her and Ethan had finally just begun their relationship; what would that mean for them? Would they survive 1300 miles apart constantly for two years?
Brynlee took a breath. Her father would tell her to chase her dreams, and if it was meant to be; they would find their way to one another again. Maybe that’s what scared her about making that decision; that after everything they had been through they still weren’t meant to be. She couldn’t run from the decision she had to make; she would have to make it soon.
As if hearing her thoughts, Brynlee gasps lightly as Ethan wraps his arms around her waist, kissing the top of her head.
Brynlee stares at their reflections in the window, as Ethan strokes her hair.
“What’s going on in that head of yours Bryn?” He says so softly it almost sounds like a whisper
Altuve turns slightly, so she can look in his eyes.
“I was thinking about what you said…about having to choose soon where I continue my career. I’ve gotten a ton of offers…but the Mayo Clinic has invited me to complete the Advanced Medical Diagnostics fellowship.”
Ethan nods thoughtfully “That’s an incredible opportunity Brynlee… do you want to go?”
She freezes slightly, and Ethan knows then what her answer is. She bites her lip, and Ethan puts his hands on her face; gently encouraging her to face him.
“Answer the question Altuve.”
“...Yes, I do…but-” She begins, but Ethan cuts her off.
“No buts Brynlee. If this is what you want, then go get it. Don’t let anything hold you back. You are the future of medicine Brynlee Jean Altuve, you are going to incredible things; you already are.”
She looks up at him, her eyes filled with a sadness that feels like weights on Ethan’s heart.
“...What about us?”
Ethan pulls her forehead next to his, placing a kiss to her lips. He pulls away to look straight into her eyes.
“I meant what I said when I told you that I was done pretending you weren’t the most important thing in the world to me. If you decide to go to the Mayo Clinic, I’ll follow you there if that is what you want. If you want us, I will not make you pick between me and your career…I love you Rookie.”
Brynlee’s eyes begin to water, she places her hand on his cheek.
“You mean that…you really mean that?”
He answers by kissing her again, and Brynlee wraps her arms around him.
“Oh Ethan..I love you…but what about your life here?”
“The only people I’m concerned about leaving are my dad and Naveen; and both will be okay.” He says, and Brynlee can see in his eyes that he means it
“And your mom?..I know that you haven’t gotten close yet, but-”
“That relationship doesn’t get priority over us. You are my priority Brynlee. So if you chose the Mayo Clinic, I will be right there with you.”
Brynlee holds him tightly, Ethan wraps his arms around her, lovingly stroking her hair. They stay there for a while, before Ethan gently raises her head, placing his finger on her chin as he does so.
“Let’s go back to bed, you need your rest for tomorrow.” Brynlee nods in agreement, and Ethan picks her up bridal style and carries her to bed.
—-
The following night, Brynlee sits outside on the curb in front of Edenbrook with her friends. They laugh at the memories they have made in that hospital, the things they overcame and learned. The night turns quiet as everyone breaks into their own discussions.
Bryce and Raf talk about sports, while Elijah and Aurora laugh about something. Jackie and Sienna turn to look at everyone.
“So…we haven’t discussed where everyone is going to be after next month.” Sienna says
“Well, I still have another year of my residency; so I’ll be here!” Bryce says, and Raf nods in agreement
“Yeah, I’ll still be here.”
“I took a job back at Mass Kenmore, they’re asking me to lead one of the new teams.” Aurora says
“That’s awesome! I’m so happy for you babes.” Brynlee says, everyone nodding in agreement.
“I’ll be right here continuing my research!” Elijah says excitedly, everyone claps
“And I accepted the Senior Attending role here, I’ll get to manage next years interns.”
Everyone laughs, before turning to Sienna and Brynlee.
“I will be doing a fast track residency through pediatrics!”
“I’m so happy for you Sienna! You’re going to be the best Peds physician!” Brynlee tells her, and everyone nods in agreement.
They then all turn to Brynlee, who gives them a sad smile.
“...I accepted a fellowship with the Mayo Clinic. Today was my last day here at Edenbrook.”
Sienna gasp, and everyone stops for a moment.
“That’s awesome Brynlee. You deserve it.” Aurora says breaking the silence.
Everyone nods before they all share a look. A group hug is formed not long afterward.
“We’re going to miss you Bryn!” Sienna says with tears in her eyes
“I know it won’t be the same, but I’m still going to call and text and facetime everyone. Plus I’ll be coming back to visit.”
“Yeah, to see Dr. Ramsey no doubt.” Jackie says with a smirk
“Actually…Ethan has also accepted a position at the Mayo Clinic.”
That catches everyone off guard.
“Wait…are you going because of him, or is he going because of you?” Bryce asks, the concern in his voice is evident
“He’s going because of me.”
Now it’s everyone else's turn to gasp. Sienna smiles and wraps her arms around Brynlee’s neck. “I’m so happy for you Bryn. You deserve this; truly. You and Ethan have been through so much together; just promise you’re not going to forget us.”
“I could never forget you all. You’re my best friends, actually scratch that. You’re family.”
A wave of awes is heard before they all hug again.
Dr. Brynlee Altuve might not know exactly what the future holds; but she knows that she will always have a home in Boston.
Series Premise: Ethan and Cassie are first-year residents at Edenbrook Hospital, competing for the coveted prize of being mentored by Dr. Banerji.
Chapter Premise: Dr. Banerji takes notice of Ethan and Cassie, but for all the wrong reasons.
Fandom: Open Heart
Pairing: Ethan Ramsey x F!MC (Cassie Valentine); feat. Naveen Banerji
Rating/Category: Teen. AU
Words: 1,750
Series Masterlist
Dr. Naveen Banerji hadn’t always been a teacher. When he first became a doctor, it was all about showing his colleagues that a brown man from Kolkata with an accent could out-diagnose any of them.
That had changed, though—somewhere between the accolades for his research and his name appearing in The New England Journal of Medicine so often that they joked it should just be called the Banerji Journal of Medicine.
He chased the flashiest cases, took risks that netted the biggest rewards. Then, one day, he realized that all his medical prowess couldn’t save the one person who mattered more to him than any case.
After his sister’s death, he had taken a long, hard look at his life and decided it was time for a change.
Now, as the interns (his fourth cohort) filed into the hallway outside Edenbrook’s community clinic, coffee cups in hand, clipboards tucked beneath their arms, he thought this might just be the strongest crop of residents in recent years.
Ramsey and Valentine, in particular, had all the makings of one day becoming excellent diagnosticians. They just had to stop fighting each other long enough to realize it wasn’t about them, but the patients.
“Good morning, doctors, and welcome to Clinic Day,” Naveen said, scanning the faces before him.
“As you can see,” he nodded to the waiting room behind the glass doors, “we have a full house. So, no more sitting on the sidelines as observers.”
Naveen grinned at the excited murmurs that rippled through the group. Normally, residents were allowed to treat patients only after intern year. But Naveen didn’t see why interns couldn’t handle the run-of-the-mill cases that came through the clinic.
He’d won the argument, and here they were. In the days leading up to Christmas, the clinic’s patient load always ballooned. Today wasn’t an exception.
“You’ll be working in pairs,” he announced, raising his voice to get everyone’s attention before looking down at his notebook where he’d already written down the pairings.
The excitement quickly dissolved into groans.
“Medicine isn’t a solo sport,” he continued without looking up. “If you intend to become diagnosticians, learn to use every resource available to you. Including each other.”
“Carrick. Varma.” He began reading names. “Greene, you’re with Emery. Ramsey. Valentine—”
“Actually, sir,” Ethan interrupted, throwing Cassie a frown. “I’d work more efficiently alone.”
“I don’t bite, Ramsey,” Cassie said with an amused smirk. “But, hey, if you don’t want to work with me, that’s your loss. I certainly don’t need you.”
Naveen peered at them above the rim of his glasses. “It’s either pair up or finish your shift in the morgue.”
Silence.
“Excellent.” He smiled inwardly at the matching looks of confusion on their faces. “I’m sure today will be a valuable learning experience for both of you.”
Ethan waited until after Dr. Banerji finished with the assignments before stomping over to Cassie. She folded her arms across her chest, tilting her head back to stare suspiciously at him.
“Let’s just get this over with,” he bit out, ignoring the way her green eyes narrowed in steely-eyed determination.
“I don’t know why you hate me, Ethan, but I won’t let you ruin today for me.”
Ethan stared in shock at the hurt in her voice.
“I… I… Cass—”
She held up one hand. “Forget it. Let’s just get to work.”
She brushed past him toward the exam rooms.
Ethan watched her go.
Christ.
She actually thought he hated her. The realization sat like a stone in his chest.
He couldn’t say why, but her stubbornness was a large part of her appeal. And her just walking away rather than calling him out didn’t sit well with him.
“Hey, Ramsey. Shouldn’t you be in Exam Room Three with your partner? Or has Valentine already figured out you’re dead weight?” Tobias called out in a mocking tone.
Ethan flipped him off in response, earning a laugh from Carrick before marching off to see his first patient.
Cassie didn’t turn around as he entered the room. A woman in her early sixties sat on the exam table, a thick winter coat beside her.
“I’ve had this cough for weeks,” she was saying, waving one hand toward her chest. “Probably just another Boston winter.”
Cassie smiled. “Tell us about it while my colleague, Dr. Ramsey, listens to your lungs.”
Looks like he was second chair on this, thought Ethan, reaching for his stethoscope.
Cassie settled onto the stool beside the patient. “When did it start?”
“Any fever?” Ethan asked briskly.
“Thanksgiving, and a little, mostly at night.” The woman nodded and then her eyes softened. “My grandson’s coming for Christmas. He’s a teacher, and I don’t want him catching whatever I’ve got.”
Cassie leaned forward. “Any weight loss?”
“Maybe a few pounds, but I’ve been so busy getting the house ready for the holidays. I haven’t had time to eat a proper meal, and….”
The woman’s voice broke off as she started coughing into her hands.
“Thoughts?” Dr. Banerji prompted. He had quietly slipped into the room midway through the exam.
“My leading diagnosis is pneumonia,” Ethan said without hesitation.
“How would you confirm it?”
“Chest X-ray. CBC. Pulse oximetry.”
Cassie frowned. “Maybe.”
“What do you mean ‘maybe’?” Ethan countered.
“Would you excuse us a minute?” Dr. Banerji said pleasantly to the patient. “Valentine, Ramsey, let’s step outside to discuss.”
Outside the room, Ethan whirled around to glare at Cassie.
“Productive cough. Fever. Crackles in the right lower lobe,” he listed the symptoms on his fingers. “It’s pneumonia.”
“I don’t think she’s telling us everything,” Cassie said. “She mentioned her grandson before she mentioned herself.”
“So?” he shot back.
“So,” Cassie said slowly, enunciating each word as if talking to a child, “I think she’s minimizing her symptoms.
“It’s textbook, Valentine.”
“Ahem.”
Ethan and Cassie both turned to face Dr. Banerji, who was watching them with an exasperated look on his face.
“If you two are done arguing?” Dr. Banerji raised an eyebrow.
Cassie looked down, while Ethan felt the tips of his ears turn red.
“Valentine, get more of the patient’s history. Ramsey, order a chest X-ray and blood test. I agree it’s most likely pneumonia, but let’s rule out RSV just in case.”
Their next few cases were simpler and they both agreed on the diagnosis for the most part. Remembering how Dr. Banerji had chastised them, Ethan was careful to include Cassie in his thinking. And she did the same.
By Ethan’s count, they were neck and neck.
They both played nice until their next patient, an elderly man in a threadbare coat who looked somewhat embarrassed to be here.
“The clinic is free, right, doctors?” he asked, wheezing slightly.
“Absolutely,” Cassie replied, smiling gently. “Now, what brings you here today?” she looked down at the chart. “Mr. Gray.”
“Charlie’s fine,” he said. “Well, doctor, I can’t seem to walk without falling over. Almost got run over by a car the other day.”
Ethan pulled Cassie aside after the man finished answering their questions.
“Could be neurological,” he said, keeping his voice low.
“I don’t know,” she said, staring at the man’s feet. “Something isn’t adding up for me.”
“What’s not adding up?” he prodded. “You and I both know falling over repeatedly is usually a precursor to neurological issues.”
“Let’s run a test,” Cassie said, turning toward the patient. “Charlie, can you walk in a straight line from there to here?”
Charlie took a few steps before he started wobbling. Ethan rushed to catch him before he could fall.
“Satisfied?” he frowned at Cassie, helping their patient settle back on the exam table.
“Not quite,” she said. “Now, Charlie, please take off your boots and walk toward me.”
He did without wobbling, back and forth, twice.
“Would you look at that?” he exclaimed in surprise.
“What are you thinking, Dr. Valentine?” Dr. Banerji asked from behind her.
Cassie lifted one of the boots. “Charlie, what’s your shoe size?”
“I’m a size eleven.”
“These boots are a size thirteen,” she said, looking up at Ethan and then Dr. Banerji. “I noticed your shoes seemed a bit disproportionate for a man of your size and stature.”
“They were the only ones left at the Goodwill,” Charlie explained.
“Excellent observation, Valentine,” Dr. Banerji praised her after Charlie was discharged with instructions to find shoes his size.
And then he looked up at Ethan. “Sometimes, Ramsey, it’s easy to reach for the flashy illness without recognizing that poverty is its own disease. It’s our job to treat the whole patient—not just the disease..”
Ethan nodded slowly, shooting Cassie a frustrated sideways look.
The rest of Clinic Day settled into an uneasy rhythm.
Patients came and went in a blur of coughs, sprained wrists, sinus infections, and winter viruses. Somewhere along the way, Ethan stopped trying to beat Cassie to every diagnosis. She, in turn, stopped treating every diagnosis as a debate to be won.
By the end of the afternoon, he was no closer to figuring out who was ahead.
Later, as the community clinic shut down for the day, everyone gathered in the empty waiting room.
Naveen scanned the tired and hungry faces of his residents, secretly pleased.
“Congratulations on your first proper Clinic Day,” he said pleasantly. “Good news is that you get to do it all again next week.”
The groans, when they came, were as predictable as flu season.
“Contrary to what I observed today, today wasn’t about diagnosing as many patients as possible,” he continued, his voice hard as steel now.
“Anyone can memorize symptoms or build a differential. You’re doctors. If you didn’t have those skills, you wouldn’t be here, and certainly not at Edenbrook.”
He paused a beat, letting his words sink in.
“Curiosity. Compassion. These are skills we can’t teach you.” He looked around the room at some of the worst offenders today. “I don’t care how brilliant your diagnosis is if the patient no longer believes you care.”
His gaze settled briefly on Ethan and Cassie.
“The two of you spent half the day trying to beat each other.”
Ramsey clenched his jaw while Valentine looked abashed.
“And yet—your best work came when you stopped competing.”
“Neither of you noticed because you were too busy keeping score.” He smiled faintly. “Perhaps you two need to figure out why that is before the next Clinic Day.”
He tucked the notebook beneath his arm and walked away, leaving the interns alone with their thoughts.
I’m always refining my headcanons, especially for Ethan and Cassie. I feel like I know them and their relationship better now than I did back in mid-2021. I know their voice, what they’d do and not do, and how their social media presence plays out. This is especially true for Ethan, who we know from canon is not a Pictagram fan.
At the time, I was new to transmedia storytelling and didn’t always know how to show characters when the only media is Pictagram. So, I often had people making comments they wouldn’t have later on, or even having Ethan’s voice not be “him” in a few posts.
In Lia Land, Ethan’s relationship to social media is minimal. He has a Picta account that he uses to check in on what Cassie’s doing and posting. He might comment sarcastically later in their relationship when he sees an opportunity to troll her publicly. But most of the time, he’ll save his comments for private DMs or texts.
When Ethan does comment, it’s usually something dry humor and witty/sarcastic, or coming from a place of gratitude. Likewise, his posts are rare and his captions one liners.
“No personality,” as Cassie would say with a shake of her head.
It’s also an established hc in Lia Land that Cassie co-manages Ethan’s Picta account over time. The description literally says:
Posting only under duress. Account co-managed by Cassie Valentine (@cass_valentinemd)
Case in point. I originally created their wedding fic as told through social media in June 2021. As I read it again, I’m rethinking and revising how I interpret it.
Ethan wasn’t commenting on some of the posts. It was Cassie logged in as Ethan because she knew it’s not his style to do so. Or his interest either.
I mean, Ethan Ramsey using a kiss face emoji? Or being effusive on Picta? So not him. 😆
These are a few Cassie posted. In the first post, Cassie sent him “suggested” text. He copy-pasted it without looking.
The first comment was Ethan. The second comment was not. 🤭
Ps. Ethan absolutely knew what she was doing. And let her. There might have been a few “Christ!” uttered when he saw what she had done. But it was his wedding night and he got distracted 😉
