A/N: Inspired by Emily Owens M.D.
by streams that never find the sea
"And take the hidden paths that run
Towards the Moon or to the Sun"
- The Road Goes Ever On (JRR Tolkien)
He's four years old when he first tells his mother that he wants to become a doctor.
The memory is one that Esther Mikaelson remembers fondly. Between setting plates of scones for tea and reading the catalogue raisonne for Carl-Heinz Kliemann, she pauses for a moment one mid-afternoon in March when her son comes home with a letter from the kindergarten administrator about the school's coming Career Day event.
"…We encourage the pupils to participate in the occasion by attending class in an attire which represents 'what they want to be when they grow up'."
She's not sure why she even asks Niklaus what he wants to go as. At four years old the only activity he has shown enthusiastic interest for is crayon drawing (catching grasshoppers in the garden with Kol doesn't count), a fact that she's very proud of as an art adviser (never mind that they once had to repaint a bedroom wall), and she assumes that he'd want to go as a painter. But Esther does ask, and an answer she is given.
"A doctor."
"A doctor?"
"Like Daddy."
Esther smiles in confused surprise. Dr. Mikael Mikaelson, renowned cardiothoracic surgeon, doesn't really tell his four young children about his work, so she's puzzled about her son's sudden medical aspirations. "Why do you want to be like Daddy?"
Klaus beams – sweet, innocent, childlike. "Because he makes sick people feel okay again. Jane-Anne says her baby sister was sick and Daddy gave her a new heart and now they can play outside."
He never ends up wanting to be anything else.
-o-
Klaus thinks, for a short while, that his Daddy can fix everyone.
After all, he grew up to streams of gifts from grateful patients during the holidays, and people coming up to his father for thanks or praise whenever he's out in public, and new plaques or plates added to the wall where Dr. Mikaelson's hundreds of recognitions are already hung. He never sees the grief-stricken families of the people his father is unable to save, never hears the sobs and screams that Mikael has to brave through after every unsuccessful operation, never feels the sting in the doctor's chest each time he has to answer the question "Time of death?"
To Klaus, his father can fix everyone, because he has never seen Mikael been unable to do so.
The picture changes a few months later when Lillian Salvatore passes away from a car accident. The Salvatores are close friends to Mikael and Esther and Damon is Klaus' own kindergarten best friend, so the entire family attends the service. Four year-old Damon doesn't really understand the loss of his mother, and so over their snack of cookies and apple juice he tells Klaus the very same thing that his father told him.
"Mom got very sick so now she needs to go to heaven where the angels can take care of her."
The statement troubles Klaus. He keeps his silence throughout the service just as a good boy should, but he asks his father about it as soon as they get home.
"Damon said Auntie Lily is sick so she has to go to the angels in heaven. Why don't they just bring her to the hospital to see you?"
A sad smile is painted on Mikael's face as looks at his son. He has broken down complicated heart procedures to a thousands of patients and taught the technicalities of cardiothoracic surgery to hundreds of fellows and residents, yet he can't find the words to explain death to child who's too young understand the transience of life and the permanence of its loss.
So he ends up following his friend's suit. He puts a light hand on the boy's shoulders and tells him that there are some sicknesses that only angels know how to cure. "So when a person gets those illnesses, he has to go to heaven to get well again."
"Okay... so when will Auntie Lily back?"
"Her sickness takes a while to treat, so she has to stay there for a very long time..."
"Can't angels just go to the hospital to treat people so they don't have to go away?"
"Sadly not, son. Angels can only cure people when they're in heaven. That's why a doctor has to do everything he can so his patient doesn't have to go to heaven."
Klaus peers at his father curiously. "Have you had patients who went to heaven?"
"Yes." Mikael answers honestly. "It's sad because I know their families and friends will miss them, but that's just how things are. Doctors can't save everyone."
It's a lesson that stays in Klaus' mind for a very long time.
-o-
Their childhoods pass by too quickly, Esther thinks, smiling as her 'baby' daughter Rebekah gleefully declares that she can finally go out with all the boys she wants to date now that Klaus and Kol are going to college. Mrs. Mikaelson turns to her husband, who smiles back at her as she lets him pour her a glass of merlot.
It's one of those rare family dinners when the entire family is actually present, and Esther cherishes the moment because she knows that times like this will be even rarer in the future. Many things have changed in the last fourteen years – she's a trustee of the National Gallery of Art now, and Mikael himself is chief of surgery at Leventhorpe-Rath, the top-ranked hospital in the country. Bekah is fourteen and will stay home for two more years, but Finn is twenty three and will leave again soon to start his second year at Wharton. Klaus and Kol, both eighteen with eleven months between them, are headed for college in a few weeks.
Kol – ever blithe, ever free, ever unpredictable - throws a curveball: after twelve years of being hailed a musical prodigy and receiving an invitation to train classical violin at the Royal College of Music, he suddenly declares, to his parents' speechless surprise, that he wants to become a biomechanical engineer. His 170 IQ gets him into MIT as easily as he can play Vittorio Motti's Csardas while the National Symphony Orchestra wails in the background lamenting the loss of the musician who could have been the next Itzak Perlman.
Klaus is no longer their little boy either. He's old enough to understand what death is, knows that people who go to heaven never come back (if they did then life would be called The Walking Dead) and that medicine is a system of precise scientific disciplines more than merely 'making people feel okay'. He doesn't have Kol's genius IQ, but he has a head for the sciences as much as he has hands for fine art, and with diligence it's enough for a place at Harvard.
Many things have changed, true; but there are some things that haven't. Klaus still remembers the look on Jane Ann Deveraux' face when she told him twelve years ago that his father saved her sister, still wants someone to look at him that way one day. He still wants to be a doctor – a cardiothoracic surgeon – still wants to be like his Dad.
"You can go out with them, yes, but the question here is… do they want to go out with you?" Kol teases his forever baby sister, the same way he has always teased her. And just as they have done for the last thirteen years, Rebekah scowls, and everyone breaks into hearty laughs.
Some things will always stay the same, Esther tells herself with a smile.
-o-
He works his way through college and graduates medical school at the top of his class, so when he enters the doors of Leventhorpe-Rath Medical Center a few months later to begin his internship, Klaus feels as though he can conquer the world.
At the outset he's known because of his family name ("You're Dr. Mikaelson's son, right?"), but it doesn't take long for him to make a name for himself. To patients he's Dr. Mikaelson, approachable and patient and knows what he's doing and Oh my God those dimples!; to fellow interns (except for Damon, to whom he will always just be Nik) he's Klaus, workhorse in scrubs and B-52 drinking game runner up out of them (Damon's the champion, of course); to surgeons in the hospital he's Mikaelson, the younger one, if you want something answered or done right then assign it to him.
For his surgical internship he's placed under the supervision of Dr. Isobel Flemming, an attending from cardio notorious for her intimidating personality, and after he claims the honor of being the last intern standing in Flemming's first after-rounds pop quiz, she tells Klaus the words that every intern wants to hear.
"You've earned your first cut, Mikaelson. Here's your front row ticket to Elijah Stowe-Pidmouth's bypass tomorrow. The rest of you watch and take notes in the gallery."
He really feels as though he can conquer the world.
-o-
Klaus makes his first cut, and then everything abruptly falls apart.
He doesn't even like Elijah Stowe-Pidmouth, really – the man does almost nothing other than yap about the love of his life, some random wench who got knocked up by Stowe-Pidmouth's younger brother - and yet Klaus finds himself unable to stop from shaking with the sickening horror of helplessness when the patient suddenly starts to slip away near the end of what should have been a fairly routine bypass.
He stands frozen in his place as he watches everything unfold in front of him in blurred slow motion, as if it's a scene in a movie rather than a moment in real life. One second Dr. Flemming is telling the team that they did a good job, and then all of a sudden Elijah crashes.
Beepbeepbeepbeep -
He staggers away from Elijah as the team of doctors he operated with races to save the patient. Klaus' world swirls into a mire of terms and numbers, all predictably familiar - yet suddenly meaningless. In his mind he can enumerate all the things he should be doing – check ACT elevation, push 300U/kg heparin if needed, calculate if SVR is between 1000 to 1200 units, assess inotropic state of ventricle – but all he can seem to do is listen to the frantic pounding that suddenly fills his head.
" - Blood pressure's 66/39 and dropping - "
"What's happening?"
"V-fib, get me the paddles now -"
"Did we miss any bleeders?"
"No, surgical field is clear –"
"Dr. Flemming, we're not getting a carotid pulse –"
"Charge to 200 –"
"Charged –"
"Clear!"
"Still not perfusing -"
"Start compressions! Amiodarone 300, one epi, one atropine –"
"He's going into cardiogenic shock!"
"Charge me up again, 300!"
"Charged -"
"Clear!"
"Resume compressions – give me two epi -"
"We're still not getting a response –"
"Is there a heart reading?"
"Rhythm is agonal -"
"Dr. Flemming…"
"Give me 360!"
"Beeeeeeeeeep –"
He doesn't even wait for the attending surgeon to call it – the inimitable sound of the EKG flatline rings loud and jeering in Klaus' head, as though taunting him and his helplessness. Elijah Stowe-Pidmouth is gone, and no one in the room full of multi-awarded doctors could do anything about it.
He doesn't even remember how he gets out of the OR. The next thing he knows, he's in front of a sink in a restroom, head spinning painfully, the retching sound of his own nausea echoing mockingly throughout the cold, empty hall each time he throws up.
"Nik? Nik, are you – Nik!"
Damon catches him just as he crumples to the floor.
-o-
"How do you…"
It's the first words that leave his lips when he goes to his father's office at the end of the day. He doesn't even have to finish the sentence, because Mikael, having read Isobel's report earlier that afternoon, already knows what his son wants to say.
"Do you remember what I told you when you were four and asked me if I ever had patients who went to heaven?"
"…Doctors can't save everyone."
Mikael smiles faintly, a pensive expression swimming to the surface of the doctor's blue eyes. "You'd have heard that ten thousand times throughout medical school, and each time you heard it you'd have thought to yourself that you know what it means and you accept what it means. But you'll never really understand it until the day you lose a patient."
"Does it get easier with time?"
"I wish I could tell you that it does. But the truth is, it doesn't. As long as you're human, it will be painful every time."
Klaus closes his tired eyes. He tries not to think of Elijah Stowe-Pidmouth, but the weight in his chest makes it difficult. All he did, at that, was cut up the man's chest – he wonders how much more painful it must feel if he were the operating surgeon.
And for the first time in his life, he thinks that maybe he should have chosen to be something else.
"But you know what happens with time, Niklaus? You become wiser. You begin to truly accept that there are limitations to what you can do, that sometimes even your best is not enough. What's important is that you learn how to let the past go and move on.'"
The son looks reflectively at his father, and the father looks back kindly at his son.
"Losing a patient is painful, and it should be – because they day it stops being painful is the day you stop caring about this person you're trying to save. Just be strong enough to go back to the hospital the next day, face a new patient and tell him 'I will do my best to save you."
-o-
The days bloom into weeks, the weeks blossom into months, the months bleed out into years. After taking part in 564 operations - 513 lives saved and 51 lost – over the course of his six year cardiothoracic residency and fellowship, Klaus becomes an attending surgeon.
He comes to understand that everything that Mikael said is true. Losing a patient doesn't become easier with time - but finding the strength to go on does.
The first time he gets over Elijah Stowe-Pidmouth's death is two weeks later when he assists in a kidney transplant that saves a sixteen year old girl's life. The moment Davina Clare smiles and says thank you to her doctors after the operation that allows her to go a week without dialysis for the first time in three years - the expression on her frail young face all too similar to Jane Anne's when she told Klaus that his father saved her sister - Klaus realizes that no matter how painful it is to lose a patient, another day brings another chance to save another life.
And he finally comes to truly accept the truth that doctors can't save everyone.
-o-
She arrives at Leventhorpe-Rath fifteen months after Klaus becomes an attending surgeon.
He takes no interest in teaching interns – he's never really been the 'mentor' kind of guy – but Damon for some inexplicable reason thinks it's going to be fun and signs up for the job.
The first time Klaus learns about her is during a lunchtime chat with Damon while the latter goes over the information sheets of the four interns he gets assigned to supervise before he meets them for the first time the following week.
"This one's pretty hot." Dr. Salvatore quips with a grin, showing his best friend the papers for an intern named Quinn Fabray.
Klaus mocks a sigh before shaking his head in resignation. After four years in medical school and six in trauma surgery residency you'd think Damon would start acting like a doctor and not a college frat guy… but then again, Damon Salvatore is Damon Salvatore.
"Let's see – five five, one fifteen, looks every inch like a cheerleader, O.C. address. A hundred bucks says Barbie here is gonna go for Plastics."
"Really. I didn't know that you're a part time fortune teller now."
"It's an educated guess, I've been watching Sherlock. Now this guy, Marcel Gerard – he likes cardio."
"Because…?"
"Because his bio says he went to Harvard and was research assistant for Dr. Fell. You know anyone who worked with Dr. Fell and didn't go into cardio?"
Dr. Mikaelson grins. He himself was a research assistant for Dr. Honoria Fell during his final year at Harvard medical school, and no, he doesn't know any med student who worked with Dr. Fell and didn't go into cardio. The elder doctor did studies on reperfusion arrhythmia, a subject of little use to anyone outside of the heart business.
"And then we have Aaron Whitmore… Geez, if this guy doesn't become the runt of the litter." Damon declares. "Just look at him, Nik. No confidence on that face whatsoever. Went to Whitmore College in freakin' Georgia, and I'll bet you a grand his family owns that school. Probably intelligent but with independence issues… I'm gonna have to sort that out."
"The only thing these poor kids are gonna have is PTSD from having you as their attending."
"No, they're gonna be awesome. 'Cause I'm gonna teach them how to be awesome. Like Dr. Camille O'Connell here - did psych at Johns Hopkins, med school there too – wow, she's 26, but she looks like she's at least 35. Poor girl stressed herself all out at JH. I'm adding at least 6 hours of sleep everyday to her requirements or she's going to look older than Dr. Flemming by month end."
Klaus almost spews out his water in an attempt to keep his laughter in.
"And last but not the least, Caroline Forbes. From Park Avenue, New York City. I hope she's not a stuck up little - oh, hello there, she went to NYU and not Columbia."
"And that means…?"
"That she's more likely a hipster than a hyper-intellectual Stepford kid. Although she doesn't really look like a hipster in this picture. Actually, now that I think about it – she doesn't even look like she's from New York."
"Shall I buy you a Netflix subscription so you can watch more episodes of Sherlock? You don't seem to be anywhere close to cracking the Mystery of the Hipster Intern."
"Very funny, Nik." Damon replies dryly. "I'll ask her myself when I take them to Sonny's on Monday after work."
"You're gonna take them. To a bar. After their first day of work. You're not even gonna wait for the weekend."
"Uh-huh. I'm gonna be the best internship attending ever. And because you're such a supportive best friend you're not invited to come with us on Monday."
Klaus just shakes his head.
God help those poor interns.
-o-
A/N
1. So... how are we guys after TO 05x01? I've seen the KC scene and I totally hate myself because despite the gigantic mess that has become TVD Season 5 onwards and TO since its inception, and the handful of things I did't really like about that last interaction, I find that deep inside I am still Klaroline trash. :)
2. This goes out to flipped, one of the many people who've been there for me throughout all these years. Thank you for all the love and I hope I can make this work for you.
3. What can I say, I like Nice!Mikael and Nice!Esther when I write them as Klaus' parents! I do have a couple of oneshots in the works where they are Caroline's parents and are not as nice to Klaus. Hopefully those get posted next month.
4. I'm not active right now, but there's still erica-dreams-in-colour at for my feeble attempts at graphic relevance which I can also hopefully go back to soon. See you guys around!