Since it looks like it's going to be pretty unanimous, I decided to get started the Pride and Prejudice AU, which is actually something I thought up after seeing 27 Dresses. I won't specify the timeline or Jack and Kate's backstories because that will give too much away, but if you read between the lines you should be able to guess. The only real differences I will point to at this stage are that I made Marc an oncologist because he makes such a good wingman for Jack and Kate's relationship with Diane a little better for reasons that will become clear as the fic goes on... ;)
Chapter 1.
"How are you doing today, Diane?" Dr. Marc Silverman asked as he skimmed over her chart.
Kate had only known the redheaded oncologist for a few days but already she liked him and she knew that her mother felt the same. He was charming and funny with a warn nature and an easygoing personality: the exact opposite of most of the doctors she'd met.
And she'd met a lot since her mother was diagnosed with breast cancer two years earlier.
"Fine, thank you, Dr. Silverman," her mother said, eyeing the man who entered on his heels with a curious look. "Is this the specialist you were talking about?"
After taking some chest x-rays on the day that her mother was admitted, and discovering what he believed to be an abnormal growth on her back, Dr. Silverman had suggested bringing in an expert, a spinal surgeon he assured them was a brilliant doctor and an old friend.
"Indeed he is," he agreed, clapping the taller man on the shoulder. "Dr. Jack Shephard is one of our most promising young surgeons here at St. Sebastian's."
He was younger than Kate had imagined, and more attractive, with dark, close-cropped hair and eyes so intense that they sent a shiver through her as he scanned the room, taking in his surroundings. There was no doubt that he was the handsomer of the two.
"Dr. Shephard, I'd like you to meet Diane and her lovely daughter, Kate," he continued with an impish grin; any fears she'd had of him trying to hit on her had been put to rest when she realised that flirting with the patients and their families was all part of his exceptional bedside manner. "They flew in all the way from Iowa just so they could come to this hospital."
"It's so nice to finally meet you, Dr. Shephard. We've heard such wonderful things about you," her mother said, pulling herself up straighter in bed.
Instinctively Kate got up to help her but she pushed her hands away gently.
"We were actually really impressed by that surgery you did on that paraplegic woman a couple of years ago," she told him as she returned to her seat. "How everyone said she would never walk again, but you fixed her. All the medical journals are calling you a 'miracle worker'."
She meant it as a compliment, a testament to his superior skills as a surgeon, but to her surprise, he looked almost angry at being reminded of this. "You shouldn't believe everything you read, Miss…?"
He glanced down at the file in his hand, but before he could locate the answer she cut him off.
"I prefer 'Kate'," she announced, fixing him with a cool look. What kind of person got upset when someone said something nice?!
"Kate then," he finished with a sigh, and when he smiled it was strained, tapering off before it could reach his eyes.
He returned his attention to her mother, consulting the file again without looking at her. "I went over your the x-rays, and it appears that your back pain is the result of an extradural tumour located between your second and third thoracic vertebrae," he confessed with a stiffness that made it sound as though he were reading from a script. "Based on—"
It took Kate a moment to digest what he was telling them and then she felt sick to her stomach. "Wait, are you saying that not only does my mother have cancer, but she has a tumour as well?" she insisted, momentarily forgetting her hostility towards him.
"Well the tumour was caused by the cancer, yes," he agreed in the same disinterested tone. "As I'm sure Dr. Silverman has told you, late stage breast cancer can be aggressive. Once it metastasises to the lymph nodes, it can also spread to the spine where—"
His efficient manner was starting to annoy her. Her mother was dying and he was treating her condition with the same level of enthusiasm as an ingrown toenail?!
"Extradural? Thoracic? Metastasises? I know you're a doctor, so these words probably make sense to you, but do you think you could put it in English for those of us who don't have a medical degree?" she retorted, losing patience with all his complicated double speak. Why couldn't he just spit it out?!
Both he and Dr. Silverman, who had moved to the foot of the bed when he started his spiel, looked taken aback by the venom in her tone. He blinked at her, furrowing his brow in confusion before explaining, "Basically, your mother has a tumour in the chest region of her spinal column that is eating away the healthy bone. If we allow it to grow, it will continue to compress her spinal cord, creating weak spots which may result in her being confined to a wheelchair for the rest of her life."
Now that she was beginning to understand his prognosis, she almost wished that she still didn't. "Wow, this just keeps getting better," she complained, dropping her head into her hands, sneaking a peek at her mother who had lapsed into silence at the first mention of the word 'tumour'.
Her pale face had turned a shade paler, but other than that she appeared calm.
Too calm.
If she'd had her way, she would have checked herself out and returned to her home in Cedar Rapids to die. It was Kate who was determined to fight this; sometimes it seemed like she was the only one.
"Can you cure her?" she pressed, massaging her temples with her fingers. It felt like years since she'd had a decent night's sleep: the last few months had consisted of camping out in hotels and hospital rooms, waiting for some sign of hope.
"At this stage the cancer is treatable but no longer curable," he confessed, and even though Dr. Silverman had already told them as much, Kate wanted to slap him for putting it in such blunt terms.
Could he even hear himself?! She'd never had any medical training, so there was a chance that she could be wrong, but she was pretty sure that that wasn't how you told someone their loved one was going to die!
Frustrated tears sprung to her eyes, and as she tried to brush them away with the back of her hand, she felt her mother's fingers close around hers, squeezing them with as much strength as she could muster.
But he seemed unmoved by her reaction as he continued to read from his notes. "I'd like to schedule a biopsy as soon as possible to determine whether or not the tumour is malignant.
"In the case that it's benign there are steroids we can administer, to reduce the inflammatory reaction around the tumour, and decrease the volume of the mass impinging on the spinal column," he told them and for a moment, Kate felt what could almost be described as hope, until he added, "But given your recent medical history I would say that that's unlikely."
He seemed to have already decided the outcome; she had to force herself to keep listening as he rushed on, careful not to look at either of them as he directed his words at her mother, "If it turns out that the tumour is cancerous, which is more likely to be the case, then I'd say you're looking at surgery to remove it and then possible adjuvant radiation and chemotherapy to try to control the spread."
"You wanna operate on her spine? Isn't that dangerous?" Kate insisted, reluctant to commit to more surgery. Her mother had already had a double mastectomy, but by then it had escaped to her lymph nodes. There was no guarantee that they would get it all this time.
"She could end up worse off than she is now." At least she could still get to the bathroom on her own. That was something to be grateful for, at least.
"There are inherent risks involved," he agreed, rattling them off like a shopping list. "Nerve injury, infection, bleeding and stiffness… In the case of major complications there's also a small chance of paralysis or death."
"How small?" she demanded, dropping her mother's hand, overwhelmed by the knowledge that, no matter what she did or didn't do she could still lose her.
"It's not common, but at the rate your mother's health is deteriorating it's a definite possibility. That's why you should take some time to think about it before we proceed," he told her with what almost passed for a sympathetic smile.
It was the first sign of emotion that he'd shown since he entered the room, and when it faded again, replaced by the clinical expression that she hated so much, she wondered if it was real, or if she'd just imagined it.
"I'll be able to tell you more once we get the results of your biopsy back," he concluded, closing the file and running his fingers through his dark hair. It stood up in tufts where he'd touched it when he let his hand fall back against his side and she couldn't deny the fact that he was pretty darn cute, even if he was a heartless jerk underneath. "If that's all I can help you with for now, I have to go prep for my next consult."
He regarded them each with a curt nod, already halfway to the door as he promised, "I'll get back to you with a time for that biopsy."
"That'll be fine," her mother agreed, recovering her voice now that she'd had time to digest the news that she was in worse shape than either of them had anticipated. "Thank you, Dr. Shephard, Dr. Silverman."
"I'll see you both again this afternoon," Dr. Silverman said with a smile as he stepped out into the hall.
When Kate failed to acknowledge that the spinal surgeon was leaving, picking at her cuticle as she stared at the wall, her mother tapped her arm to get her attention. "Katherine?"
"Yes, thank you for your time, Dr. Shephard," she managed to answer, her voice laced with more sarcasm than she intended. "It's been a real pleasure."
If she never saw him again it would be too soon.
She took a twisted sense of satisfaction from the hurt that passed over his features as he made his exit. After all of the pain he'd just inflicted on her he deserved it and more.
Her mother waited until he closed the door to fix her with a disapproving look. "Katherine! Did you have to be so rude? Honestly, I thought I raised you better than that."
She was twenty-seven years old now and mature enough to be managing her mother's treatment; she wasn't going to be lectured about manners like a child, not when his had been much worse. If anyone was rude, it was him.
"I'm sorry, Mom, but did you see how he kept staring at that file?" she complained, willing her to see it from her side. "He didn't make eye contact with you once the entire time he was talking. And the way he kept throwing medical terms around like he's better than us because he could afford to go to Columbia…"
A fresh wave of anger hit her as she finished, "It's like you're not even a person to him, you're just a piece of meat he can use to win more awards."
"I highly doubt that was what he was thinking, Katherine," her mother scoffed, slumping back against the pillows now that they were alone.
She was beginning to look frail, a fact that scared Kate to no end. Until Jack Shephard had come in and dropped his bombshell she had never really allowed herself to consider the possibility that this might be one fight that they couldn't win.
"He was just doing his job."
"Well maybe he shouldn't!" she insisted, jumping out of her chair so that she could pace the length of the room. "I don't like him, Mom, and I don't like the idea of him cutting you open."
"You wanted the best and according to everyone at this hospital, he's it," her mother reminded her with a touch of what sounded like resentment.
"Maybe he is and maybe he isn't," she agreed, refusing to give up even if her mother already had. "All I know is, I'd feel a lot better if we got a second opinion, from someone less..."
She wasn't even sure how to finish that sentence, what it was that bothered her so much about him. Something about him just got under her skin.
Less Jack, was the best that she could come up with, stunned by how comfortable she was with using his first name, even if it was only in her head.
Dr. Silverman was always just Dr. Silverman…
"We don't have to do this right now," her mother said, closing her eyes with a tired sigh. "Either way he said I'll need that biopsy so let's just wait until your father gets here before we make any decisions…"
This idea is a little strange and different to anything else I've written so I'm not sure how well it worked...
Next chapter: Jack's impressions on Kate as he and Marc discuss the consult, and a chance encounter at the vending machine, but will she accept his apology? ;)