I do not own TVD or TO.

This is my first ever Saving Hope Crossover.

A few notes. The cure as the show knew it did not find it's place in this crossover, and Jeremy never became a hunter. That means Kol is alive in New Orleans and Jeremy's ring still works.

Also it's been a while since I've seen Saving Hope and really only remember the first season when Charlie was in the coma so that's where the story picks up and diverges from the canon.

Definitely seeing potential here.

She had been working at the hospital for two months when they went head to head. Up until that point they had been on reasonably friendly terms. She enjoyed the light flirtation, and the way her body came alive in his presence. She'd even seek him out during particularly long shifts because he had a way of waking her up and leaving her refreshed if not a little tense.

If there was one thing she hated about being a surgeon it was the long shifts. She was good up until hour eighteen at which point she was likely to curl up on the nearest flat surface and fall into a deep sleep.

She was on hour twenty now and couldn't even be bothered to look for a space she could lie down. She'd barely made it to the nurse's station before crossing her arms and laying her head on the counter. Her compassion was a gift, but so was being able to fall asleep anywhere.

She scrunched up her nose and wiggled it. Something light was tickling the end. It took her a moment to track the movement, but when the finger grazed her cheekbone and sent a jolt of electricity through her body she began to feel a strand of her hair moving.

She squinted through one eye and felt her lips lift in a small smile.

"Do you think that's a good idea?"

"Probably not," Joel shrugged and let go of her hair, "but I think you'll take me waking you up over Maggie."

"Why," Elena arched her back and stretched before standing up, "what was Maggie going to do?"

Joel watched her for a moment and reached out to straighten the chain of her locket. Her soft skin electrocuted him in the same way as her eyes.

"There was talk of dumping cold water down your back," he whispered.

"Is that some sort of hazing thing?" She tilted her head. "Douse the new surgeons in liquid."

He chuckled and set a cup of fresh coffee in front of her. "I get the feeling you would have retaliated."

"I would have," Elena inhaled the rising caffeine and took a dainty sip. "There would have been a wet-t-shirt contest on the surgical floor."

"Damn," Joel shook his head and smirked, "I should have let her wake you." His eyes slid down Elena's body slowly.

"My eyes are up here Dr. Goran," she teased while rolling her shoulders back. She smirked when her motion drew his eyes to her chest once more before returning to her face.

"You started the visual," he held up his hand.

"I suppose I did," Elena drew her lip between her teeth. Her sparkling eyes drifted down his chest.

"My eyes are up here Dr. Gilbert."

Two months of back and forth before she called him into her OR. She needed an ortho consult, except she really didn't like what he had to say about her case.

"No," her scalpel gleamed in the bright light. A few years ago the sight and smell of the blood would have made her gums ache, but now it tugged at her heart strings. "Absolutely not."

"Why would you page me if you weren't going to listen?" Joel tilted his head. Currently all he could see of her was her eyes, and they were glittering with anger. "Her leg needs to come off. Look at the bone."

Elena didn't have to look to know what he was trying to show her. She had seen it herself. The tissue was dying, but he was telling her what she didn't want to hear.

"She is eight years old," Elena choked on her rage. "She loves to run and dance and play. I don't want to cut off her leg."

"You don't have a choice," he shook his head. "This is going to spread, and it's going to spread rapidly until it reaches her heart and kills her. It sucks Elena but flesh eating diseases work down and spread. Now you can stand here and spend time scraping, but I'd say you've got an hour at most before it's too late."

"I will not cut off this child's leg," Elena gritted her teeth. The last thing she wanted was to do that. Lily had been playing by the water when she scraped her foot and like all children she didn't want to take the time to clean it up; she was just a kid. She didn't deserve to lose her leg.

"Fine," Joel turned to the scrub nurse. "Bone saw."

"No," Elena snapped, "don't you dare."

"There's no other method of treatment," he met her eyes again, "bone saw." Joel held out his hand to the nurse.

Melissa looked between the two attending physicians standing over the table.

"Do not give him that saw, Melissa," Elena pointed at the nurse. "Get my phone and press redial then put it to my ear."

"Now's hardly the time for a third opinion," Joel frowned.

"I'm not getting a third opinion," Elena snapped. "I'm getting an alternate treatment. It's been known to work wonders."

"And if it doesn't?" He challenged.

"Then I'll cut it off myself." She set down her scalpel. Elena inhaled sharply when the call connected. "It's me. I need you in OR6 now… great I'll see you in ten minutes."

Elena exhaled and turned back around and scanned the operating room: an anesthesiologist, two scrub nurses, a resident, two interns, two scrub techs, and her and Joel.

She looked at the interns before coming to a decision.

"Rogers get upstairs and close the gallery," she nodded to the room where a few residents were watching, "I want it locked and then I want you back down here. Green at the scrub room door; a woman is coming this way. I want you to get her a surgical gown, mask and a scrub cap. Nobody else leaves this room, and you two speak to nobody."

"You're closing the gallery on ground breaking medicine?" Joel cocked a brow.

"I am," Elena nodded.

"Dr. Gilbert?" Melissa watched the woman carefully. There was a fierce determination in her dark eyes. "What are you doing?"

"Saving my patient's leg."

How come I get all the new attendings?

The deafening silence was only interrupted by the constant beeping of the heart monitor as it counted Lily's heart. Elena watched the monitor and waited with bated breath. Nine minutes had gone by since she had sealed off the room. Nine minutes had been spent in still quiet.

She knew they all thought she was crazy, but it didn't matter. Their thoughts could be taken care of easily. The heart was not easily changed, but the head could be persuaded, and she knew someone who was a master of the craft.

"How much longer are we going to wait?" Joel watched the spread of the disease. It had moved a quarter of an inch up the girl's tibia.

"No time at all," Elena turned to face him. Through the window into the scrub room she saw Caroline coming in with Dr. Green. "She's here."

Joel turned and glanced over his shoulder and felt his brows lower in confusion.

"Your friend," he turned back to Elena with an incredulous look, "how the bloody hell is she going to help?"

If she had doubted the fact that he was not Elijah at any point his confusion would have chased it from her mind. She chose to ignore him in favour of her friend.

"You must be really desperate," Caroline held a mask over her face and eyed the table. It didn't take long to realize why. Elena hated it when it was a kid on her table.

"She's eight years old Care," Elena flexed her fingers.

"I bet you miss being able to do this yourself," Caroline laughed.

"It's one of the only things," Elena smiled behind her mask.

"Are you sure it'll work?"

"Positive," Elena reached over and pointed. "You see here? The tissue is necrotic; it's dying from a bacterial infection. All of this could have been prevented by proper care, but…"

"She's eight years old," Caroline deduced, "and wouldn't stop playing long enough to do it. Her parents probably didn't even notice until it started to spread."

"She's a foster kid," Elena sighed, "in a house full of foster kids. It's fair to say they weren't paying much attention either."

"Alright," Caroline nodded. "First thing to do is clear out the room."

"I'm sorry, but who the heck is this?" One of the interns pointed to Caroline. "What authority does she have?"

"Mine," Elena snapped. "I've got a process for this Care. They need to think surgery passed in a blur, and all that they'll remember is that she was not as bad off as we thought."

"Got it," Caroline lowered her mask.

Elena waited until Caroline had compelled everyone in the room to forget and leave. She stopped her before she could do the same to Joel and the anesthesiologist.

"I'm going to need their help," Elena started reaching for the clamps.

"What are you doing?" Joel frowned. "She'll bleed out in minutes."

"No she won't," Elena looked up to meet his eyes. "Trust me." She waited until he nodded before pulling the metal free. "Caroline."

Caroline stepped up beside Elena and brought her wrist to her mouth. She bit down with an audible crunch and ignored the aghast expression in Joel's eyes.

"What the hell?" He moved as if to push her back and found his wrist held by Elena.

"Wait and watch," she gave a pointed look at Lily's leg.

Joel followed her gaze to the stream of blood flowing from Caroline's wrist into the open wound on Lily's leg. For a moment nothing happened and then before his eyes the bone regained its colour and the flesh began to pink up.

"Start lining up the vessels," Elena let him go. "Don't worry about irrigating. We won't have time."

Her fingers moved at the speed of light with his and in a matter of moments Lily had two whole legs.

"Caroline, can you take care of Dr. Haines?" She nodded to the anesthesiologist. "And then Dr. Goran?"

"Take care of?" Joel watched as Elena instructed their dazed co-worker to take the child to recovery. He held up his hand to hold Caroline at bay and tore off his mask. "What did she do to everyone? What did she do to the patient?"

"Am I taking care of him?" Caroline crossed her arms.

"How about answering some questions?" Joel snapped. He had heard of cellular regeneration, but never on such a scale as what he had just seen.

"Okay," Caroline nodded. "I made them forget what happened in this OR, and I'm going to do the same to you."

"Why don't you give us a minute?" Elena sighed and turned to her friend. "Unless we get slammed with a major trauma nobody is using this room again tonight."

Caroline looked between Elena and Joel for a moment before nodding. She told the brunette she would be back in a flash when she needed her before vanishing into thin air.

Elena felt a bead of sweat trickle down her spine as she tugged off her gown and gloves. Tearing the mask from her face she dropped it into surgical waist and turned to face him.

One of the many things she hated about vampires was compulsion and the thought of compelling Joel felt inexplicably wrong. Unless it was absolutely necessary it didn't have to happen.

"You've never seen anything like it," Elena pulled off her scrub cap and tucked it in her pocket. Strands of hair slipped free from her hastily tied bun.

"Obviously," he discarded the medical gown and pulled the unblemished mask to hang around his neck. "Lily will have to be screened for any number of infections now."

"No she won't," Elena shook her head. "She will make a full recovery. The only scars will be psychological from my idiot interns gloating about a possible amputation."

"She said you used to be able to do that yourself," Joel followed her into the scrub room and began washing his hands.

"You caught that huh?" Elena watched the lather form on her skin. He was sharp she'd give him that much.

"What exactly did she do?"

Elena licked her lips and rinsed the soap from her hands. She turned to find him drying his hands at the same time she started. Both of them were blind to the man in the corner.

"Caroline is my best friend," Elena pursed her lips. "We grew up together. She's the same age as me: thirty-one."

"She doesn't look a day over seventeen," Joel threw the towels in the laundry.

"Because she's not," Elena turned to meet his eyes. She hadn't told him anything about how familiar she was with his face, or where she had come from, but she found she didn't want to lie to him. She mentally crossed her fingers and hoped he was open minded.

"Caroline is eternally frozen at seventeen, and for the longest time I was frozen at eighteen, but then I started aging again. That's a whole other story though."

His brows knit together as she lost herself in a long forgotten memory.

"Elena," he reached out and took her elbow.

The electric jolt drew her out of her trance.

"Sorry," she offered a small smile. "Let's go with the short version."

"Why: what's wrong with the long version?" Joel tilted his head. His free hand tapped the metal sink.

"Nothing," she shook her head, "it's just really long. It's so long that if I were to produce it as a television show it would be five seasons."

"That's long." Joel agreed. He forced himself to hold in his laugh. He was still confused and angry and in desperate need of answers. He had also been all but undermined in the OR by a fellow who he outranked by two years.

"Short version it is," Elena sighed. "I don't know how open you are to the supernatural but Caroline is part of that world. She's a vampire," she slapped her hand over his mouth to keep him from interrupting her. "Caroline is a vampire and vampire blood has healing properties. It restores dead tissue by making the live tissue multiply at a rapid rate. I only use vampire blood when I see no other choice."

"You realize how insane that sounds?" He spoke slowly. For a moment he feared she needed to be committed.

"You just saw something you can't explain," Elena looked up into his sceptical eyes. "I've explained it to you."

"Vampires?" Joel scoffed. "That's crazy Elena."

"Ludicrous," she agreed, "but no less true," she pressed her lips together and sighed. "There is a whole other world out there Joel. One you know nothing about. It's dark and dangerous, but there is also light and hope in the midst of it. Fourteen years ago I was standing in your position when my boyfriend first introduced me to a world that had been surrounding me my whole life."

Joel saw the truth in her eyes; she wasn't lying, but he wasn't ready to listen. He held up his hands to keep her from coming any closer and took a step back.

"You're hiding something else," he shook his head. "What is it?"

"If you don't want to hear about vampires than you don't want to hear about this," she gave a wry laugh.

"About what?"

"You," she shrugged, "and the place you've got in it."

"You're right," he brushed around her for the door, "I don't want to hear that because like I said it's insane."

"Joel…"

"Don't Elena," he paused and glanced over his shoulder. "I don't want to discuss this anymore and I really don't want to talk to you right now."

A vampire had once tried to rip out her heart. She had never forgotten the feeling of his fingers curling around the pumping organ. They had squeezed and tightened and stolen her breath in a crushing wave of pressure. She hadn't thought herself capable of feeling that now that she was human again, but watching him walk away came close.

The post-op report was easy enough. She'd written such documents before and the fact that Lily was a foster child meant few people were going to come sniffing around anyway, but even so she had taken her time.

By the time she made it the on-call room three hours had passed. Two o'clock in the morning was generally a quiet time unless a major accident was rolling in. She would have been there sooner but she kept thinking about the look in Joel's eyes.

She looked up from where she was sitting on the couch with her head in her hands as the door opened to reveal the last person she thought she would see.

She stood up slowly and pushed her messy hair back from her face.

"I thought you didn't want to talk to me," she swallowed.

"I don't," he pushed the door shut and watched her tug her lower lip between her teeth as she stepped towards him

"Then what are you doing…" Elena's breath caught in her throat.

Joel grasped the back of her neck and lowered his head to catch her lips in a bruising kiss.

She parted her lips for the strong sweep of his tongue. His left hand stole under her scrub top and splayed across her ribs.

Elena gasped for breath when he broke from her mouth to lick and nip at her throat. She tugged on his hair and moaned; his teeth tugged at her sensitive skin to leave a wet mark that would form a bruise by morning.

"Joel," she closed her eyes and pressed her lips together.

"Elena," he pulled the blue fabric at her hips so she was pressed to his chest and nipped at her ear.

"I get it," she hummed, "no talking." She used all of her strength to plant her hands on his chest and pushed him back.

"Elena?"

Elena moved around him to the door and flipped the lock. She took a ragged breath before turning back to face him. With a quick movement she crossed her arms and pulled her top over her head. The material hit the floor and puddled.

She moved silently and tugged his scrub top over his head before pushing him to sit on the couch. She met his lidded eyes and reached up to unhook her bra with one hand. The straps slid down her slender arms before the black material fell with a soft thump.

"No talking right now," she placed her hands on his shoulders and knelt on either side of his thighs to straddle him. "Right?"

"Right," he swallowed before sucking her bottom lip into his mouth and running his hands over the smooth expanse of her back. By the time his mouth reached the tops of her breasts he had flipped them so he was lying between her legs.

They could talk later.

So this is what that M rating was for.