Chapter 17: American Academy of Neurology Conference
"A Grade 4 astrocytoma with complex vasculature," Amelia began her keynote speech. "Grade 4. Six surgeries in one 18-hour procedure. Six methods of attack in one sitting…or one standing, as it were." An edited film of the surgery, showing all the procedures briefly as an overview, flashed onto the screen.
In the past, AAN presentations were known for their dry, droning, and monotone discourses intended for the elite specialists in the neurological medical community. The speeches relied upon language spoken only among brain surgeons. The audio-visual, if a speaker offered any projections to accompany his address, had been limited to bullet pointed, unpronounceable words. Only on rare occasions, when the conference attendees had been particularly lucky, a still photo here and there had been interspersed between the drab words. Yet Amelia, a one-of-a-kind surgeon and first female keynote at an AAN conference, chose to break the boundaries of boredom. Amelia's presentation was different, just like Dr. Herman's brain surgery had been different.
Amelia continued her med-speak after the overview was shown, proving with her words that she had the knowledge and wherewithal to accompany the complex graphics. By this point, even Owen was concentrating intensely to garner meaning from the intricate descriptions. Mrs. Shepherd, a retired nurse, and Amelia's sisters, all doctors, experienced varying degrees of total comprehension. For the first time in all of their eyes, Amelia was no longer the baby of the family in need of tending and concern. Instead, she was a brilliant, state-of-the-art, and daring neurosurgeon. Amy was now the elite of the elite rather than the little five-year-old girl who had been in her father's store the day he was shot.
Continuing her presentation with her radiating charm, Amelia explained, "The plan, after painstaking hours of pre-op analysis, was to dissect around the fornix by passing the hypothalamus. Yet, as has happened to us all, the CT and MRI images were not exactly what I encountered once the skull lay open and the brain sat exposed in front of me."
Revising her feelings of the actual moment, Amelia made light of Derek's inaccessibility at the turning point where she had truly yearned for his expertise. "Now with such a situation, what is a neurosurgeon to do? I could have - oh, I don't know - called my brother, Dr. Derek Shepherd, known to many of you for his great skill and as the NIH guru of all things neuro. Surely someone sought after by the President of the United States could help. And after all, younger sisters notoriously run to their older brothers when they find themselves in a pinch that appears impossible to face, right? At least, I know there have been times when that has been my circumstance." Amelia's next sentence unveiled just a hint of sibling rivalry and created a chuckle among the crowd, "But, sorry Derek, this tumor was mine."
Amelia continued, using words similar to those Richard Webber had offered to her during the surgery, "I knew its complexity like nobody else, having studied and memorized its angles and irregular edges. I could nearly predict its seemingly unpredictable and rapid growth patterns. The tumor and I were foes in a battle. Rather than run to the phone or hand my American Express card to a resident so she could purchase a plane ticket for the other Dr. Shepherd, here is how I chose to proceed…" The neurosurgeons actually chuckled, partly because of her everyday candor and partly because this young woman was perhaps one of the most skilled surgeons in the room. Suddenly, the sexist male doctors interspersed among the other male doctors were face-to-face with brilliance housed in a body with breasts. Owen sat like a cat that ate the canary, bursting with pride and thinking, that is my wife.
After completing her presentation, the first female keynote speaker at an AAN conference was treated to the AAN's first standing ovation. The President of the AAN stepped to the podium to thank Amelia and to once again encourage applause not only for the first-ever surgery of its kind but for the captivating method with which she presented it. As she stood in front of this crowd, knowing the elite surgeons who had tried and not been able to help Nicole Herman were in her midst, Amelia locked her eyes on only one person: her new husband. Owen mouthed, I love you and, in a gesture, she'd recently witnessed at the Rose Gardens, he patted his right hand over his heart and grinned. She nodded slowly in response.
As the President quieted the crowd and shared closing announcements, he surprised Amelia by asking if she could make herself available to individuals wanting to meet her after the session. Further, he asked if she would be willing to conduct a Question and Answer session about the surgery the following day in place of another presentation he had intended to chair. The crowd applauded in support and Amelia agreed. Internally, the moment felt profoundly surreal.
She approached the President, who turned to her for a brief side conversation. He nodded in agreement with a smile and motioned his arm toward the podium. Amelia stepped back into the spotlight, only to receive further applause and another standing ovation. Derek, Owen, and Addison were yearning to run to Amelia, hug her, and shower her with love. Her mother, sisters, and Meredith stood impressed and joyous as well.
After convincing the crowd to be seated and to quiet their applause, Amelia began with a quip, "President Nelson, yes, I would be happy to be available to those who would like to chat. I had originally planned to do so for free, but given the response, I'm guessing a donation of $100 per interaction to the AAN might fit the bill." The crowd laughed as Amelia continued, "Of course, I am joking. We neurosurgeons are allowed to do that, you know?" The youngest child in her was on a roll. "But seriously," she continued, "I would like to take just a moment to embarrass my mother, Carolyn, by asking her to be recognized. Mom, I've put you through loads of ridiculous challenges over the years. This surgery and my career would have never occurred without your persistence as a parent. Thank you." Everyone clapped as Carolyn stood. For many years, Carolyn would have never predicted that this would be the child of the five Shepherd offspring to be lauded by colleagues.
Amelia continued, "My siblings and loved ones surround my mother at our table, but I'm going to simply thank them as a group without inviting them to stand. They too can make themselves available for conversation, but each sets their own AAN donation rate." The crowd chuckled as Amelia put her right hand over her heart, "However, the person I am thrilled to recognize and would like to introduce you to is Grey Sloan Memorial Hospital's Chief of Surgery and, as of this week, my husband, Dr. Owen Hunt, an accomplished trauma surgeon and gifted leader. Without his faith in my abilities and without his encouragement and support, this surgery would have never happened. Owen?" Owen stood and blushed, touched by Amelia's words but really not wanting to be put on the spot. The audience applauded and stood for Owen as he motioned his hands downward and then extended them toward Amelia.
When the session concluded, Owen walked briskly toward the stage to gain access to Amelia before the others. A line of people wanting to meet Amelia was already forming near the stairs of the stage as she posed for pictures with those who had sat up front during her presentation. After the pictures were taken, Amelia approached Owen and they hugged. He whispered in her ear, "You're amazing, but more on that later. What can I do to help right now?" Amelia flashed her blue eyes toward his face and whispered, "Stand with me." Owen nodded and smiled, "Absolutely." The self-assured, talented neurosurgeon in her that had just stood before a supportive crowd was coupled with the little girl deep inside who wondered if the last few hours had been a dream.
In the conversations that occurred throughout the next 90 minutes, Amelia and Owen stood side by side chatting and laughing with various individuals. Owen's hand was consistently curled around her with his hand on the small of her back. Amelia's cheeks began to hurt from all the photos people asked to take with her. Some of her professors from med school had been in the audience and came to tout her accomplishments. Colleagues who had never had the time of day for Amelia were now her fans.
Derek, his ego just slightly impacted, tried his best to work the room and be charming. Addison and Meredith ended up being the only ones left sitting at their table, and they found themselves unexpectedly engaged in deep conversation about Derek, Amelia, and the Shepherd family. As they talked, Meredith realized that Addison had many more years of experience with the Shepherd's than she did. The insights and stories Addie shared were helpful and compelling. Only Addie, though, dared to name aloud what both of the women saw, "Poor, Derek, this must be killing him. Not only was he not the star speaker, his little sister hit it out of the park."
One neurosurgeon, Dr. Jean Paul Agarde, and his daughter, Julianne Moreau, asked Owen to step aside for conversation. Dr. Agarde was the President of the World Federation of Neurosurgeons and Julianne was his daughter and a literary agent. Knowing Amelia was busily engaged with others, Dr. Agarde asked Owen to give Amelia his contact information. He was hopeful that she might be interested in speaking at the upcoming WFN conference in Victoria, B.C. in the summer. The two surgeons discussed the possibilities and Owen assured Dr. Agarde that he would pass along the invitation and information. Then, Julianne asked if Amelia had ever considered writing a book about her experiences as a female neurosurgeon. "I…I'm really not sure that she has," Owen stuttered. "Maybe we could meet for dinner tomorrow night?"
A full hour later, the line had finally ended. While touched by the accolades, Amelia told Owen that her cheeks hurt from smiling and her feet hurt from wearing heals. Owen joked that perhaps she could wear scrubs and tennis shoes the next time she spoke. Walking hand-in-hand, the couple left the room.
By that point, Owen's mother, Jake, Addison, and the group of Shepherds had made their way to the hotel bar. The group were the only patrons besides two small tables of neurosurgeons catching up with other neurosurgeons from medical school days. The space was quiet and dim with comfortable sofa and chair seating and a lovely view of the city. Meredith had sent a text to both Owen and Amelia encouraging them to stop in once they were finished with their meet and greet.
"What do you say?" Owen inquired as he looked at the text on his phone. "It's completely up to you."
"We can go say 'hi' for a spell. How often do we all get together like this?" Amelia winked, "I'd hate to miss the opportunity to remember why we seldom get together like this," Owen laughed and put his arm around her.
When the couple entered the bar, Derek stood and began applauding. The others followed suit. Amelia smiled at Owen and alleged while barely moving her lips, "He's trying too hard to convince himself that he's not bothered by all this."
Owen grinned and assured her, "He means well."
Meredith, who had consciously decided to praise Amelia right away and then offer little more for Derek's sake, observed, "Amelia, you were wonderful." Derek forced himself to shake his head in agreement. It wasn't that he didn't agree. His struggle was that he had always been the Dr. Shepherd and he was experiencing a new and unfamiliar role. A little part of him deep inside most certainly yearned for similar opportunities, and his internal dialogue had many observations regarding what he would have said and done differently. He simply couldn't help himself.
At the same time, he maintained the role of big brother and asked, "Has anyone offered you something to eat, water, or anything, Amy? What can I get you?" Amelia thanked him and agreed to some water and whatever appetizer he decided upon.
Owen's mother told Amelia that she was overjoyed to have been treated by such an intelligent and fine neurosurgeon at the ER a while back. "You're in the big leagues, Amelia, and my daughter. How lucky am I?" Debra beamed with a giggle.
Nancy, being the oldest and perhaps the most arrogant of the Shepherd children, couldn't resist commenting on Amelia's age and new notoriety. Knowing exactly which buttons to push, Nance offered, "Amelia, you're so young to be at this level in your field. Tell us the truth. You did call Derek for assistance, didn't you?"
Amelia tightened her grip on Owen's hand to the point that he almost asked her to remember he needed the hand for surgery. Now counting her lucky stars for both not having called Derek and for Richard Webber convincing her not to make the call, Amelia was able to look at Derek and confirm, "Derek, did you consult on this case? At all?" Derek pursed his lips, raised his eyebrows, and shook his head. Amelia continued with just an edge of sass in her voice, "What do you know, Nance, your little sister is actually a skilled surgeon who can hold her own."
"Oh, I know, Amy. I'm simply so accustomed to you living in Derek's shadow," Nancy retorted as the practiced bitch that she was.
Derek, playing the role of peacemaker, interjected, "That hasn't been the case for some time, Nance. I admire Amelia's surgical skill and abilities." Then returning to role of brother and without even attempting to keep a serious expression, he blurted, "Unlike the time she tried to operate on the family dog."
Amelia buried her head in her hands while the other Shepherd's rolled with laughter. Owen howled, turned toward Amelia and questioned her with shock in his voice, "You did what?!"
Responding with a strong defense, Amelia pointed out, "The dog lived. You guys never tell that story with the important fact that the dog was just fine."
"How much damage could you really do with a Sharpie and a butter knife, Aims," Kate asked jovially. Everyone laughed as Amelia simply rolled her eyes and grinned.
Lizzie added gently with a warm smile, "I'm just glad I walked in when I did. Otherwise, poor Charlie might have bitten off your hand and permanently ruined your surgical hopes." Lizzie leaned over and side-hugged her little sister. Meredith observed the family dynamics and confirmed that Lizzie was among her favorite Shepherd family members and Nancy among her least.
All of the Shepherd's who had flown in would be leaving the following day. As the gathering came to a close, Derek, Meredith, Amelia and Owen offered their goodbyes. Each sister and Mrs. Shepherd prodded Owen to make sure the couple came out east the following Christmas. Owen wisely responded that such a visit would be nice, but they'd just have to wait and see. In his own mind, he was hopeful that Amelia would be nearing the end of a pregnancy by then. The future remained a mystery.
Back in their room, Owen lay in bed as Amelia washed her face. He stared at the ceiling, simply thinking about the last few days. Slowly, his blinks were fewer as his eyelids weighed their way down toward his cheeks. Amelia climbed into bed and caressed his shoulder, unsure if he was already asleep. Owen grinned and groaned, "Mmm."
"Thank you for your support tonight," Amelia related. She snuggled onto his broad, muscular chest as he positioned his arm around her shoulders and back. Their legs intertwined naturally as had become habit.
Without opening his eyes, he murmured, "Mia, you were brilliant tonight. Charming. Captivating. Brilliant."
Amelia lightly sighed, "Thank you, O. Knowing you were there made all the difference for me." She reached over to his left arm and stroked it with her right hand.
"Mrs. Shepherd-Hunt," Owen offered sleepily, "I am proud to be your husband."