A/N: Hello guys! I don't know about you, but the ALS story was really touching in last weeks episode, so it features heavily in this chapter, and a little Jackson and April moment we didn't get to see. Not sure what to think is upcoming with Japril, but it looks like this week's episode will be interesting. Not sure how I feel about this chapter, but thanks for reading and let me know what you think!

"Ross!"

Shane stopped short his brisk pace down the hallway, so abruptly that his sneakers squeaked on the shiny tile hospital floors.

A scowling Stephanie jogged up to his side from the far end of the hall, resting a hand on one shoulder, "Are you busy?"

Technically no. He'd just gotten himself removed from Dr. Bailey's service for talking to much, and all he had left to do before his shift ended was to finish up charts and do a final round on his patients. That could be done on any schedule.

"No, why?"

"Dr. Kepner wants you."

"I thought you were on her service?" Shane asked, ignoring the lingering awkwardness that he still felt around his friend...well...yeah.

Stephanie was only ever his friend. He could not compete on the level of Jackson Avery. Especially now that the plastics fellow was chairman of the hospital board. It was foolish of him to ever think he could compete.

That development had made things even more strange between Shane and Stephanie. Really it had even made things strange between her and all of their intern group. She was all proud, and genuinely believed that the plane crash survivors and the Harper Avery Foundation buying the hospital was a good thing. And maybe it was. It sure was hell beat getting taken over by Pegasus. Or being closed.

But there was still a lot of uncertainty surrounding it all. Not all t's had been crossed, nor had every i been dotted. No one from above was really talking much, so interns like Shane knew little about what was going on. The ER still hadn't reopened, and word from the nurses was that Dr. Hunt had either quit or been fired. Hardly confidence instilling.

But Shane had to admit that for Stephanie it was. Jackson being a part of it was somehow enough for her. Not that Shane was sure what Avery's new position meant for any of them. Himself, the rest of the interns, the attendings who weren't on the board. April Kepner. Stephanie.

He'd honestly never expected her 'thing' with Dr. Avery to last this long, but she seemed to be happy, despite everything. Maybe Shane would just have to accept that. He would only ever be a friend to Stephanie. It was just hard to make the feelings go away.

"Well I was," Stephanie explained quickly. "But then our ALS patient kind of fired us, because Kepner advised against doing a DD, so I asked if I could go assist Dr. Webber on his lap-appy, and she said it was fine, but then the guy let us back on his case, and I couldn't go assist, and...the patient...expired. They are doing the transplant extraction now. She asked for you."

Shane frowned. That was a little odd. Not that it was odd really for his mentor to want him on her service (though lately she'd been encouraging him to diversify his rotations, instead of sticking mostly with her general cases, and Shepherd's neuro ones). It was just strange that she should want him now. After all, if the transplant team was already doing there thing...there really wasn't that much left to actually do for the patient. Considering he was deceased.

But for whatever reason, Dr. Kepner had asked for him, and Shane wasn't about to refuse. She probably just wanted to test his stitching abilities while they closed the patient up. She certainly knew it had been an issue for him back when those biker's came through the ER. Shane nodded to Stephanie and said, "Okay, where I am I going?"

"OR 2."

Shane nodded and waved stiffly to his friend before he quickly made his way to the OR level. He shook his head when he thought of the lame gesture. Real smooth, Ross. Real smooth.

As he walked town the hallway toward his destination, Shane dodged several transplant teams as they rushed away from the operating theater, carrying the precious coolers. They were taking life saving organs on the beginnings of their journeys to new bodies. And new lives. Saving peoples lives. He counted at least 7 that he passed, and couldn't help but marvel at the fact that medical science made a thing like transplant surgery possible at all. To imagine that living organs could be passed from one person to another was just...it was too big. Too mind blowing. It was one of many wonders that pulled Shane to the world of medicine in the first place.

Shane opened the door to the scrub room, and winced as he nearly ran head long into a very angry Dr. Karev. the peds surgeon was pretty intimidating on a good day, and positively terrifying on a bad one. Now he seemed to be somewhere in the middle, fuming, but not quite ready to come to blows. He was leaning against the door frame with one arm and peering through to the operating room.

"Kepner, get a move on! Dude is dead."

Glancing through the windows, Shane could see April hovering just beyond the body of her patient, as the last transplant team placed his liver into a cooler and left the OR. Deftly avoiding Dr. Karev's elbows, Shane made his way to the sink, and began to scrub in, because...well that's what you did before entering an OR. Even if the patient is dead.

"I'm here, I'm here!" He called out catching is mentors eye. April nodded at him approvingly before answering Alex.

She was glaring at Karev, "Go find another OR! I'm taking as long as this needs and I have permission to do that. Ross and I still have to close."

Alex rolled his eyes, "This could be done way sooner. Just stitch him up and send him downstairs. Let those guys worry about making it look pretty! You're not a freaking mortician."

Something flashed in Dr. Kepner's eyes and she snapped, "Shut up, Alex!"

"Look, I gotta kid kidney transplant to freaking coordinate, and the damn transplant coordinator quit, and so did freaking Hunt and the stupid OR's are all full," Alex grumbled.

"I know!"

"Uh," Shane stammered awkwardly, gesturing behind him.

"What?" Alex demanded, turning his fiery gaze to Shane and making him wince.

"I know OR 3 is free. I saw them clearing out of there on my way down here."

"There! See?" April said triumphantly. "Go bother them Karev. They're done before we are."

Without another word, beyond muttered cursing, Dr. Karev brushed past Shane and into the hallway. Shaking his head and pulling on his surgical gloves, Shane chuckled nervously. Dr. Karev was a top notch fellow. Best in the pediatric department by a landslide. But the guy also had a reputation for being difficult and for sometimes handling himself in a manner that was more suited to be exhibited by the patients he treated, rather than by the surgeon himself.

"He's sure in a hurry..." Shane commented as he reached the side of the gurney.

"Yep," April replied flatly.

It was only when Shane got up close, standing directly across from April with the patient between them that he noticed the slight tremor in his mentor's hands. She held the stitching implements in her hands just above the open body cavity of her patient. For all her snark and bravado with Dr. Karev, up close Dr. Kepner seemed a little freaked out. Casting around for an explanation, Shane noticed that the someone, likely the last transplant team had forgotten to cover over the dead man's face with a towel. It was a customary thing to do with the dead, and Shane could understand his mentor being a little unnerved by seeing her patient's face.

Shane sure knew he was, so he reached out for a towel to pull over the man's head, only to have April reach out one hand, "No...it's...leave it."

"Are you sure?"

"Yes," she said more firmly. "Leave it. He's still a person. We need to keep thinking of him that way."

"Okay," Shane responded tentatively before he picked up his own set of threads and looked up at Dr. Kepner expectantly. "So, are we're just doing a standard close?"

She sniffed, "Actually, I...I wanted to see if we could do the, uh close with a continuous stitch. Have you done one of those before?"

Shane was momentarily taken aback. That kind of stitch was harder, more complex and less visible on the skin than other techniques they might have done. It was usually reserved for visible parts on a living patient to avoid scarring. He'd never heard of it being used on a deceased patient. But based on the tight lipped and quiet mood of his mentor, Shane could tell that using this stitch meant a lot.

"Only on fruit," he quipped after a moment.

April smiled faintly at his joke, "Well, I know you are a quick study so...I need...you to help me do this."

Nodding Shane moved his hands into position and began following her instructions and closing up the open wounds on the man's torso. It was clear, from the way Kepner was operating that she wasn't quite herself. They took care and reverence for each motion over the body. The OR was eerily quiet as they worked. Normally the sound of monitors and the chatter of nurses and doctors filled the room. But the patient had no vitals to monitor, and there were no nurses to monitor them. Normally, April herself was one to fill silences. But not tonight. So, Shane didn't push it. He understood. Dr. Kepner might not be tearful or distraught, but he could tell she was upset. She'd just lost a patient.

After several moments work in silence April sighed, "I know you think it's weird."

"What?"

"This technique. It's supposed to...well...prevent scarring."

Neither of them chose to comment on the futile goal of preventing scars on a dead body.

"It's very clean," Shane said simply, gazing down at the half finished job.

The stitching was very neat and precise. Not choppy and hurried, like some normal closes on dead people ended up. The cut pieces of skin were drawn back together nearly perfectly, reforming what had once been a living breathing abdomen and chest as though someone had only taken a pencil on some illustrated body and drawn out the incisions. If you squinted it would be hard to tell that a surgery had been done at all, let alone one that had vacated this body of most of it's internal organs.

"He should look nice," April continued, eyes narrowing as she carefully threaded a surgical needle over through the patient's chest.

"Did you treat him for a long time?"

"No," she answered. "But I knew him back at Mercy West when I was a resident."

Shane swallowed, unable to prevent himself from thinking about his own friends and acquaintances in the Seattle Grace Mercy West residency program. It was hard to picture what it would be like to have to treat one of them as patients someday. Shane couldn't help but wonder a bit about how his mentor must be feeling, since this guy was a physician assisted suicide and in a way directly facilitated his death.

"Did you know him well?"

"Well enough. We...got coffee a couple of times. Knew the same people. Studied together. He told me in person about his diagnosis."

"ALS."

"Yes," April nodded. "He...wasn't fully advanced, yet, but he wanted to be sure his organs where..."

"He could have gotten an infection. The risk increases the longer..."

"Exactly."

They were both doctors. They knew the risks associated with the long, slow, and painful decline that ALS patients had.

"He d-did a..noble thing. I don't know If I could ever..."

"Me too," Shane agreed with wide eyes. "Talk about brave."

He didn't know if he could. Shane was always one to look forward in his life. In high school he'd longed for graduation. In college, he'd focused on his future in medical school. In medical school, Shane had envisioned his triumphs as a surgeon. As an intern he flattered himself with day dreams of winning a Harper Avery. It was hard to imagine how it would feel to know that no matter what you did, or how much you fought, your body would betray you and you would die.

Washington was a state that allowed Death with Dignity to be an option for patients like this. Hell of a decision to have to make.

"That's why...he should...that's why we're closing this way, Ross. For his family. For...his mother."

Shane understood that. Not only because she'd known the patient, or because she knew his family. It was something that could be done. It wouldn't ease the pain of the loss in anyway, but it would show them that care was given to a man who had done a wonderful and selfless thing. A sign of respect. Your patient never really stopped being your patient even when they died.

April laughed stiffly. "I'm a trauma surgeon. I'm not supposed to have cases like this."

"Bit of a departure from car crashes and sex injuries, huh? And lump and bump day."

"God, I need an ER," April moaned. "And board certification."

Shane only nodded. Hoping that his mentor would achieve these things, hoping that Seattle Grace Mercy West Hospital could give her what she wanted. He'd hate to lose her advice. Shane hoped it could give him the opportunity to learn in a Level 1 trauma center too.

It didn't take long before all their stitching was finished, and the close was complete. April sent Shane back into the scrub room to get some wet cloths and they carefully wiped the blood off of the man's chest. Again, it wasn't standard for a fellow and a surgical resident to do this, there were people downstairs in the hospital morgue who's job it was to make bodies look presentable, in case the family wanted to see their loved on again. But Shane didn't question it.

In the silence of the room, both Shane and April were startled when a voice was heard in the far corner of the room. When both he and his mentor jumped, Jackson winced and cleared his throat. He was looking at Dr. Kepner tenderly, despite the continued tension between them, which as far as Shane could see had only increased since Avery had been made 'king of the board' (as Dr. Bailey had snarkily described things before she'd kicked Shane out of her OR).

Poor Avery was on the outs with almost everyone now. Or so it seemed. Shane kind of felt bad, even if he was never Jackson's biggest fan. From the other members of the board, to attendings like Bailey, to fellows like Karev, Jackson Avery was not the most popular person right at this very moment. Only Stephanie seemed to have fully embraced the transition. And an interns opinion didn't amount to much.

He'd heard from Nurse Mandeeb that Hunt has resigned because he'd found out that the Harper Avery Foundation (with Jackson as its mouthpiece) had wanted to fire him. And Shane was pretty sure that, on top of all the other complications that existed between them, April was probably a little resentful of the fact that Hunt, her mentor, had left the hospital in a sense because of Jackson.

"Are you done in here?" Jackson asked quietly. "Not to rush, but space is limited and-"

"Yes," April looked up from the table and over Shane's shoulder, so he assumed she was looking the plastic surgeon right in the eyes. He felt slightly uncomfortable, because the energy in the room had definitely changed. For all the denial and pretensions, Shane knew he was the odd man out. There was something between them, large and unresolved.

"Yes, we are," Dr. Kepner repeated, as she stepped back and folded her wet towel and set it on an instrument tray. "Ross, you can go." She briefly focused her gaze on Shane instead of Dr. Avery, and smiled a sad smile. "Thank you."

Shane didn't need to be told twice and he folded his towel and rushed past Dr. Avery into the scrub room to wash his hands. Keeping his head down and as focused on the sink and running water in front of him, Shane also couldn't help but monitor his teachers out of the corner of his eye. Dr. Avery had taken several steps, moving closer to Dr. Kepner than he'd ever observed in the past. She seemed aware of this too, and took a step back. Moving his soapy hands under the hot water for a second pass, Shane wondered whether they'd say anything at all, or if they'd just stand there.

As curious as Shane was, he knew he could only stay to wash his hands for so long before it became weird and intrusive. If it wasn't already.

It was Kepner who broke the silence, "Brad's dead."

Avery's brow furrowed and he quickly looked to the head of the bed, realization dawning on his face, "That...that was Brad? Like...Brad Parker, Brad? Our Brad?"

"Our Brad."

Shane hung his head. Avery might be feeling bad too, if he thought about it. Since they were friends at Mercy West. The guy was already having a difficult time, and on top of it all he was unintentionally standing in a room with the dead body of a person he knew. Talk about bad day.

"Oh man," Jackson continued, running a hand across his forehead. "I saw the name on the chart; I didn't even connect. That is Brad."

"Yeah," Dr. Kepner nodded.

Avery swore, and hung his head. He was getting really upset, and was obviously frustrated from his whole shift, "I can't believe I didn't realize it was him. I saw the chart; I've just been so buried with all this...board crap. I should have visited him. I mean, you said he was doing the DD, but you thought he shouldn't and maybe I could have convinced him to wait or-"

"No," April shook her head, tentatively reaching out to Avery but stopping short because of her gloves or something else. "No...it was kind of terrible, Jackson, but...he did a good thing. A very Brad thing to do. No one was going to change his mind. I understand that now. It's okay Jackson."

"Are you okay?"

April swallowed, "Yes."

Jackson lifted his eyes and sighed heavily, "I suck."

"No, you don't."

"I do. I'm not cut out for all this...board politics stuff,," Avery shook his head. "I'm not. They...Shepherd and the rest. They have their interests and agendas and my mother and the Foundation have their own and I don't think that they line up. Shepherd treats me like some sort of child and so does my mother. And I mean, they...Grey and Yang and...they did this to save the hospital. And my family wants to change things and I just can't give them all what they-"

"You don't have to do anything any of them want you to do," April reasoned, pulling off her gloves. "All you have to worry about is doing what you think is right."

Jackson laughed, "That easy?"

"Easy is..." she shrugged. "Easy is overrated. Besides...this is too huge to be easy..."

"I don't know what to do."

An suddenly, for a moment, Shane was certain that they were no longer talking about Jackson Avery's new job. It felt very personal. The words cut deep and meant so much more. If only they could both see the double meaning. Shane didn't think they did. Yet, it was clear that, whatever pain they'd caused each other, and whatever the mess Avery and Kepner had been trying to avoid in the past several months, they genuinely worried for each other. And cared enough to try to help.

Finally, April shrugged, and seemed to cast around for the right words, "This...this is a hospital run by doctors. That's huge. Amazing. Keep that in mind, and I'm sure you'll figure out what to do. I know you will."

Avery shook his head ruefully, "No suggestions?"

"This is all on you Jackson. I know you can do a good job, you just need to...I know you are mad that your mom put you in this situation, but she did and it is what it is. You can't change that. What you can do is stop whining and freaking out about everything. Just suck it up and do it," Kepner replied sternly.

"Right. It's on me."

Shane's hands were definitely clean and he could not drag the process out even more. He turned to the towels and quickly dried his hands off. As he made his way out of the scrub room, Shane looked over his shoulder one last time. As the door closed behind him, he caught one last exchange between Kepner and Avery. It made him sigh. Maybe they were like he and Steph. Maybe they were letting each other go too. And yet? Yet it seemed like they shouldn't.

"But I suppose you wouldn't be opposed to reopening the ER?" Jackson teased.

April smiled and bit her lower lip, "You said it, not me."