AN: USUK and Gerita Hospital AU.

So this is my new story and it's my NaNoWriMo novel this year so hopefully it will be updated in a timely fashion. (I hope-fingers crossed). It's a hospital setting and full of drama and steamy hookups and all that stuff. (A little Grey's Anatomy/Private Practice like, just FYI)

So WARNING for NSFW and for some injury and illness related things. There will be drama, there will be hook-ups in inappropriate places...This is going to be a little more like a soap opera than my usual fare. I'm trying something new...

If you have trouble understanding the medical terminology, you can always drop me a line. I'll try to explain things the best I can in layman's terms. This story is primarily focused on USUK with a side pairing of Gerita. I'll try to leave warnings at the beginnings of chapters for anything trigger worthy. Wish me luck!

I do not own the characters or Hetalia or anything pop culturey mentioned in this story. If I did then Alfred and Arthur would totally be married in canon and spend their days cuddling...

Chapter One: Loathing

"Are you a complete and utter moron from the Isle of Morons? Is that it?" The harsh English accent spat out yet another insult. Alfred had to do everything in his power to not flinch away from those angry green eyes staring at him from behind the surgical mask.

It was his first day at a new job and things were not going too well. Alfred F. Jones, RN was having a horrible first day of work. He had just moved to town and taken a job at International Memorial Hospital. It was the best hospital in the area and he had fought tooth and nail to secure a position there. He had plenty of experience behind him and excellent letters of recommendation but he was still surprised when he received the job offer. He had actually figured that working at Memorial was a pipe dream. Something that he would always hope to achieve but never actually do. Luckily for Alfred he was hired on and he had spent a happy week filling out paperwork, getting a background check and taking a picture for his ID badge. The entire time he was walking on air, scarcely able to believe that this was actually his life now.

Unfortunately, the high wore off as his first official day of work turned into a nightmare. He had been assigned a preceptor, a happy go-lucky Italian nurse named Feliciano. The two men seemed to hit it off right away, discussing their favourite foods and television shows as they prepared for the day's surgeries. Alfred was excited to be able to scrub for a case, he didn't get the chance very often at his previous hospital and he was eager to begin his day. That was until he met Dr. Arthur Kirkland.

Dr. Kirkland was one of the worst surgeons to work with in all of International Memorial Hospital. He was only surpassed in horrid behavior by Dr. Ludwig Beilschmidt, his counterpart. Both surgeons were absolute tyrants who ran their ORs with an iron fist. No one ever wanted to be assigned to their rooms because they knew that their day would be an awful one. Alfred waved off the sympathy he received from his new coworkers when they all saw that his first day, he was assigned to Kirkland's room. Alfred wished that he would have listened to everyone.

No matter what Alfred did, he received nothing but scorn from the handsome British surgeon. He couldn't pass instruments fast enough, he didn't have the right supplies that Kirkland insisted he used "every day" even though they hadn't been included on his preference card. Poor Alfred couldn't do anything right to save his life. He had been fending off snarky comments and outright yelling the entire day while Feliciano sat on a stool in the corner and gave him 'thumbs up' signs. It was exhausting.

"Are you even listening to me?" Kirkland yelled out, snapping Alfred out of his reflections.

"Yes," Alfred nodded, his eyes bright behind his glasses. "I'm listening."

"Obviously not," Kirkland muttered. "I said 'clamp,'" he spat, holding out his hand.

Alfred fumbled around on his sterile mayo stand for a moment before he located the proper instrument and slapped it into Dr. Kirkland's hand. He may have used a little more force than necessary, but he was getting a bit sick of being yelled at and talked down to.

Dr. Kirkland took the instrument and leaned back over the patient without a second glance at Alfred. The nurse sighed in relief. At least he didn't get reprimanded this time. He chanced a glance at Feliciano who waved at him, his eyes crinkling behind his surgical mask, betraying that he was smiling.

Alfred was surprised at how light-hearted and positive his preceptor was in the face of all the animosity in the room. Nothing seemed to faze Feliciano. Even when Dr. Kirkland yelled at him for Alfred's "complete incompetence," Feliciano just smiled and said, "Sorry Doctor." He didn't lose his bubbly demeanor or snap back or anything. It was incredible. Alfred was biting back retorts with every word uttered by the pompous surgeon he was assisting. He had never before been treated like this. At his old hospital, there were rules regarding surgeon behavior and no one was exempt. It didn't seem as though the same codes of conduct were in place at International Memorial. Alfred hoped that he could make it through the day without cracking.

He knew that he was a talented nurse and that he was a decent surgical assistant, but the constant barrage of insults was beginning to grate on him. He sighed softly and hoped that Dr. Kirkland didn't hear him.

The rest of the surgery passed quickly and he made sure that he had everything that he could possibly think of ready to go when it was asked for. Kirkland didn't insult him as much after that. He seemed to be going out of his way to ignore Alfred.

When the doctor finally scrubbed out and threw his surgical gown in the trash, Alfred finally relaxed. He could hear the crisp British accent coming from the corner of the operating room as Dr. Kirkland began to dictate the case into the phone hanging on the wall. He tried to ignore it. It was difficult. He'd always had a thing for English accents.

Kirkland finally finished and hung up and stalked toward the door of the room. As he pushed it open, Feliciano called out, "Have a nice day Dr, Kirkland!" in a cheery voice. The doctor grunted and left the room without a backwards glance.

One of the residents, a pretty girl with brown hair tucked into her scrub cap smiled behind her mask at Alfred once the surgeon was out of the room and said, "You did really well. Don't let stuffy old Kirkland get to you. He's an ass."

Alfred was somewhat taken aback. "He seemed…grumpy."

"That's his usual demeanor," the girl said as she sewed the wound on the patient closed with precision. "He's grumpy and anti-social and unforgiving. In one word…he's an ass." She looked up at Alfred in between stiches and smiled again. "Really, don't take it personally. He's like that to everyone."

"Yes," Feliciano had joined them at the field and was standing far enough away to not contaminate the sterile area. "He's awful to work with, no one ever wants to come into his room. But you did really well Alfred."

"Thanks, I guess," the nurse mumbled. He felt odd receiving praise when he felt so shitty about how he had performed. It was comforting to know that it wasn't just him though. If Dr. Kirkland was hard on everyone then at least it wasn't personal when he was screaming at Alfred. Still, he didn't relish working with the short, British doctor again.

Doctor Arthur Kirkland sat behind the desk in his office and shuffled a few papers on his desk. He angrily glanced at them before tossing them down unceremoniously onto the desktop and glared at nothing in particular. He was feeling very short-tempered today. He hadn't slept very well the night before since he had been on call and he was feeling the effects of a bad night's sleep.

Rubbing his eyes, he looked at his door which was cracked slightly open and wondered if he could risk taking a kip on the couch in his office. He knew he didn't have time. He had another surgery scheduled in an hour and he still needed to find time to eat something for lunch.

If he had to admit it to himself, he really and truly loved his job. It was fast-paced, demanding, and very difficult. Arthur had graduated in the top of his class from Harvard Medical School and had quickly risen through the ranks of residency to become a stand-out among his peers. He had always been chosen first to participate in surgeries and his attendings had given him effusive praise throughout his training. When he finally graduated, he had his pick of jobs in both the United States and his home of England. He had chosen International Memorial because they paid well, had a well-respected trauma program, and would allow him to shape the young minds of the country's next physicians. He jumped at the chance, especially when he found out that his friend, Dr. Ludwig Beilschmidt would also be working at Memorial.

The two doctors had been inseparable in medical school after they began to compete for the top spot in their classes. Arthur had beat Ludwig out by a single point in the end and he still held the notion over his friend's head to this day. Ludwig was also a general and trauma surgeon who was well-respected and excellent at his job. They even had adjoining condos in town and would make time at least once a week for dinner together.

Every once in a while Arthur wondered what would happen if he and Ludwig would ever 'hook up,' seeing as they were both gay and had fun together. But the spark just wasn't there. For either man. They just didn't see each other that way. So they spent their time competing and comparing conquests of the romantic and sexual nature, always ready to lend an ear and staying the very best of friends.

As if on cue, Arthur's office door creaked open and Ludwig stepped into the room. He had absolutely perfect posture as he gazed down at his seated friend. "Arthur, how are you today?" he asked in a crisp German accent.

"Tolerable, I suppose," replied Arthur. He rubbed his eyes again. "I got called for three consults last night so I didn't sleep very well."

"I'm sorry to hear that," Ludwig sympathized.

"And I had a terrible surgery this morning," Arthur groused. "The scrub nurse was completely incompetent."

"Someone new?" Ludwig raised a brow.

"Yes," Arthur nodded. "Well, actually he was fine. But he pissed me off."

"How so?"

"I'm not sure," Arthur admitted. "He was just irritating. And he was being watched by that horrid nurse Feliciano, you know I can't stand him. He's so chipper."

"I think Feliciano is an excellent nurse," Ludwig sat down in the empty chair opposite Arthur.

"He's very good at his job," Arthur acquiesced. "He's just so…happy. All the time. It's exhausting."

"Yes," Ludwig agreed. "It can be grating. I never know how to respond to him when he's working with me. Half the time I just stare at him silently."

"Because you're attracted to him," Arthur pointed out.

"I am not," Ludwig's voice was a little gruff.

"You are," Arthur countered. "You said so yourself, three weeks ago when you'd had too much beer."

"I did nothing of the kind," Ludwig insisted, but his cheeks went a bit red.

"Whatever," Arthur waved his hand.

"So this new nurse…?" Ludwig trailed off and left the conversation open for Arthur.

The young English surgeon leaned back in his chair and touched his fingertips together. "He was just like Feliciano. Bright and chipper and eager to please. It was annoying."

"So you were extra hard on him," Ludwig said, making a statement.

"Yes," Arthur agreed. "I had to be. He was distracting me." Arthur's face coloured as he realized what he had said.

"Distracted you?" Ludwig's eyes glinted. "How?"

"Nothing," Arthur looked down at his desk and tried to avoid the question.

The German surgeon looked hard at his friend for a moment before standing up abruptly. "I have a surgery, I should go."

"Have fun," Arthur waved at Ludwig as the other doctor left his office. He glanced back down to the stack of papers on his desk. They could wait. He needed to get something to eat and prepare for his next case. And he had to do rounds before then as well. This was going to be a busy and tiring day.

Alfred balanced his plate of tacos in one hand as he used his other to badge himself into the operating room's break area. Finding an empty place at the table he collapsed in the seat next to Feliciano and turned to the other nurse. "How in the world did you get through the line in the cafeteria so fast?" he asked.

"I didn't," Feliciano smiled at him. "I brought my spaghetti from home. I only eat in the cafeteria on Fridays. Helps save money and all that."

"Oh," Alfred nodded. He had waited for most of his lunch break to just get his lunch. Now he was going to have to scarf down his six tacos in the next ten minutes so he wouldn't be late getting back to his room. He immediately poured some hot sauce on them and began to devour his tasty lunch. "So Kirkland is really just a jerk to everyone?" he asked Feliciano with his mouth full.

The Italian nurse nodded silently for a moment. "He seemed unusually harsh this morning though. I wonder why?"

Alfred contemplated that while he ate his tacos. They were pretty good for hospital food, he thought. He was going to have to try some of the other food before he was convinced to use the cafeteria every day though. He didn't know if he'd have enough time anyway. It might be better to start bringing his own lunch.

When his phone alarm went off signaling his break was over, Alfred shoved the last taco into his mouth in one large bite and threw away his garbage before joining Feliciano in the hallway. They walked the short distance back to the operating room and began to prepare for their next case.

It was an easy procedure for them, a laparoscopic appendectomy. A relatively short case, that didn't require a ton of instrument sets, so the set-up was quite quick. Alfred scrubbed in and began to set up his back table to his specific likings. Feliciano watched him carefully and occasionally made suggestions. Alfred would usually nod and take the other nurse's advice. He hadn't scrubbed for quite a while and any help was appreciated.

Glancing at the board on the wall with the information pertaining to their current surgery, Alfred internally groaned when he saw the name, 'Kirkland' next the surgeon's space. He really didn't want to work with that guy again.

Feliciano popped up from his stool and grabbed a sterile container of towels, popping them onto Alfred's field saying, "Dr. Kirkland likes to drape with towels to begin. I almost forgot."

"Good thing you didn't," Alfred nodded. "I don't want to get yelled at any more."

"You won't," Feliciano said with confidence. "Maybe he was just tired this morning. I'm sure by now he's had lunch and will be better with some tea in him."

"Maybe," Alfred said unconvinced. "I just wish I knew what his problem with me was. I did everything right this morning and he still called me an idiot every chance he got."

"Don't take it personally," Feliciano advised. "He's just like that, remember?"

"Yeah, yeah," Alfred grumbled. He glanced over his table one more time and was satisfied that he had everything he needed. Hopefully this case would go better than their previous one.

It didn't.

As soon as Dr. Kirkland entered the room he groused that Alfred didn't have the right gloves on the table. Alfred did in fact have the same gloves he had used the previous case, which the surgeon had accepted. The poor nurse didn't know what to say. He just looked Kirkland in the eye and said, "Do you want a different pair?"

"No," Arthur huffed. "I'll suffer through with these."

The doctor turned toward the patient and began to help his resident's drape the prone figure with sterile drapes so that the procedure could begin. Alfred rolled his eyes at Feliciano and the Italian man giggled softly.

"You there," Dr. Kirkland pointed at Alfred. "Are you going to join us for this case or not?"

Alfred nodded and pulled his sterile things up to the patient. "Yup, coming right now."

Dr. Kirkland blushed at his words and turned away pointedly. He held out his hand and asked for a skin marker so he could make a mock-up of the incision for the trainee surgeons to follow. Alfred handed it to him and began to get all of his things ready for the case. He had a lot to do before they could start. He began to attach sterile light handles to the overhead lamps and throw cords off of the field which Feliciano plugged in so they could actually do the procedure. Dr. Kirkland stared at him the whole time. It was a bit unnerving. Alfred worked as fast as he could and when he was finished Dr. Kirkland rolled his eyes and said, "Well, that took an age. Give me the local."

Alfred grit his teeth and handed over the syringe filled with numbing medication. He announced what kind of medicine it was and made sure not to accidentally stab the infuriating surgeon with the exposed needle. He thought about it though.

Throughout the surgery, Dr. Kirkland made random snarky comments to him and remarked on the speed of his response. Alfred honestly didn't think he could do anything faster than he was, but according to the doctor he was the slowest scrub nurse in existence. Alfred fumed. When the case was finally over, he breathed a sigh of relief and looked to Feliciano for some support.

"Excellent Alfred," the other nurse said. "That went really well. Better than last time, huh?"

"I guess," Alfred began to clean up the mess of instruments on his table. "He didn't scream this time, so that's good."

"It's an improvement," Feliciano nodded. "Well, that's it for today, you can check in with the charge nurse and go home. You deserve it."

"Thanks Feli," Alfred sighed. "I think I'm going to need a beer or two with dinner tonight."

"Oh yes," Feliciano nodded. "I go through wine by the case working here some days." He winked to show he was kidding but Alfred wasn't entirely sure. "Oh Alfred," Feliciano called out as the new nurse was preparing to take his dirty instruments away. "On Friday's we all go out as a unit for karaoke. It's super fun, you should come!"

"I'll think about it Feli," Alfred smiled hesitantly. "Thanks for the invite."

"I hope you come. See you tomorrow, we'll be working with Dr. Beilschmidt." Feliciano's voice rose ever so slightly on the name of the doctor.

Alfred raised his eyebrows and nodded but didn't say anything. "Okay, bye Feli!" he called as he left the room.

"Bye Alfred!" came the chipper Italian voice.

Alfred checked in with the charge nurse and was told he was free to go for the day. He dragged his feet to the locker room and changed out of his dirty scrubs and back into street clothes. As he pulled on his worn jeans, he couldn't keep the bright green eyes of Dr. Arthur Kirkland out of his mind. He shook his head and grunted. He didn't need to be thinking along those lines. Kirkland might be incredibly attractive—and English—but those thoughts were absolutely forbidden to the young American nurse.

Grabbing his messenger bag, Alfred made his way out to the parking lot and got in his car to head home. He stopped on his way at a small Chinese takeout place by his apartment and ordered some General Tso's chicken. Extra spicy. He carried his dinner inside and immediately dug in. As he ate, he reflected on the day. It hadn't went at all like he was hoping. But at least his coworkers seemed nice. He really liked spending time with Feliciano. The Italian nurse seemed like he could become a good friend.

Alfred finished his meal, hopped in the shower and got ready for bed. It was only eight-thirty at night but he was incredibly exhausted after his day. Flopping down on his bed, he lay spread eagled in the dark. His cat jumped up on the bed to join him and beg for cuddles. Alfred held his cat and slowly drifted off to sleep, hoping that tomorrow would be a better day. The last thing he saw before he closed his eyes was a vision of green eyes behind a surgical mask calling him an idiot.