It turned out not to be a bad decision. The rest of her day was exhausting, trauma after trauma after trauma. April was far from a pessimist, but by the end of her shift in the ER, she was about ready to concede the game to Fate. There was only so much even a first-rate medical team could do for someone for whom destiny had written a tragedy.
The next day was the same, and April barely made it through. After her shift, she found herself leaning against the nurses station in defeat, filling out forms with a sense of hopelessness, wondering if this is what the rest of her life would feel like.
"Dr. Kepner," said Dr. Stark stiffly, acknowledging her as he walked up, reaching for a chart. He, too, leaned against the counter in fatigue.
"Dr. Stark," she replied with similar formality. Unbidden, her mind recalled the memory of telling Jackson that she was considering peds as a specialty, and she realized Robert - Dr. Stark - would be the person to whom she'd submit an application.
Her mind scoffed at the very idea. Dr. Stark had never expressed any particular interest in having her as a pediatric fellow, and with their history... well, suffice it to say that she couldn't imagine them having a good mentor relationship. She studied him obliquely as she pretended to read, wondering if he'd even entertain the idea. Maybe, she thought dubiously. In weariness, she went back to her paperwork.
She was with Hunt the next day, too - and the day after that, all at his request. She was beginning to suspect that he and the chief were in conspiracy to give her a taste of how great a trauma fellowship would be, but despite Dr. Hunt's gratuitous respect and thoughtfulness, it was having the opposite effect.
It wasn't the statistically depressing outcomes that bothered her, she thought, at the end of her fourth trauma shift in a row. It was that she didn't even get a chance to know someone as a person before they were... gone. Either not a person anymore but instead a sack of biomaterial to be buried or burned, or a chart of symptoms and treatments that was shunted off into some other department for follow-up care.
She could do it, she knew. Given time, she would adjust, as she always did. What she didn't know was whether she wanted to. Jackson was right - there was a part of her that wanted this simply because her bosses wanted it for her. At times like this, she hated that part of herself. How could she be sure she was making the right decision, and not just the decision that someone else had pushed her into?
April sighed. She had no idea how to go about deciding. What should her criteria be? There was no checklist to determine how to diagnose the rest of your life. The image of Dr. Stark rose in her mind, and she didn't push it back down.
She missed talking to him. He was one of the few people from whom she'd felt no pressure. They had actually touched on her future in medicine on one of their dates - she'd laughed off his question about her career goals, saying that her main objective was just to survive residency. Unlike her other colleagues, his face hadn't immediately registered scorn for her lack of ambition. He'd smiled, nodded, and said that there was no point in rushing.
She did need the advice of someone more experienced, April reflected. Even if she didn't, there was no point in asking any other resident for advice. Jackson had already proven worthless, and she was sure Meredith and Christina would be even less helpful. She realized she'd left someone out, and for half a second, she tried to imagine asking Alex for career advice, then laughed the thought away. There were bad ideas and then there were horrible ideas, April told herself sardonically.
But maybe asking Dr. Stark's opinion wasn't a bad idea. April wondered at that for moment, but there was no way to say for sure unless she just approached him about it. There had to be a way she could catch him at a good time...she resolved to try.
Two weeks later, despite having been on Dr. Stark's service twice, that perfect moment still hadn't materialized. The deadline the chief had set was looming, and April realized she would just have to bite the bullet. She was standing outside his office now, pretty sure he was inside doing post-ops from having peeked at his schedule earlier in the day.
April took a deep breath, and knocked on the door.
"It's unlocked," came the muffled, disgruntled reply. Not exactly an invitation, April thought, but she turned the knob and pushed the door open anyway.
Dr. Stark looked up from his desk, his irritation at being interrupted mixing with surprise as he saw April standing in the doorway. She wasn't on his service today, he thought.
He waited for her to speak, but she just hesitated in the doorway, looking as if she regretted coming in. After a beat of silence, he said dryly, "Something I can help you with, Dr. Kepner?"
"Ahh - well, yes, I - is this a bad time?" Her brown eyes were wider than usual, and he sensed that she was searching for a reason to bail on whatever she'd come here to do. Perversely, that made him determined not to provide her with an excuse.
He put down his pen and leaned back in his chair. "No, not at all," he said in a milder tone. "Have a seat," and he gestured toward the chair in front of his desk.
April finally moved further into the room, closing the door behind her a little too carefully. He continued scrutinizing her, wondering what was up, as she took the few steps toward his desk and perched nervously on the edge of the chair.
Just as he was about to prompt her again for the reason she was here, she spoke up.
"I wanted to ask you for advice," and she folded her hands in her lap, looking prim and serious. He suppressed a smile, suddenly not wanting to spoil her determination. "About my career."
"Oh," he said, caught off gaurd. "Well, the most common career advice given out is 'be a doctor', so I think you're doing fine." He smirked at her, but the sarcasm in his voice was more playful than biting. She relaxed her posture a bit, and gave him a small smile in return.
"No, I mean - about my fellowship options. Chief Webber is concerned that, as a chief resident, I haven't applied to a specialty program yet."
"Well, then, apply to one," Stark said, swinging his hand, palm up, to the side and wondering why she felt she needed advice. "Surely there are a number of departments here that would be happy to have you."
"It's not that, it's - I don't know how to choose. It's a big decision, picking a specialty." Her eyes filled with doubt. "I don't want to make the wrong decision, or for the wrong reasons."
Stark's eyebrows furrowed. "What are the wrong reasons? Money? You'll make plenty of money in whatever specialty you choose."
"No, not money," April said, wrinkling her nose a little in distaste. He still found that incredibly endearing, he noted absent-mindedly. "That's not - I'm not worried about that. Chief Webber suggested trauma surgery. Dr. Hunt told him that I've showed great promise as a trauma surgeon, and the chief said that it would be a wise decision, but..."
"But what?" Stark asked, not understanding her hesitation. "You would make an excellent trauma surgeon, and it would be a fine choice." He paused, trying to find a reason for her reluctance. "Don't give any weight to what people say about cowboys and ambulance chasers, it's a very respectable career, trauma surgeons save lives." He frowned at her suddenly. "Why are you asking me about this, why not talk to Dr. Hunt? I'm not a trauma surgeon."
"I know that," April said, flustered. "I don't want - Dr. Hunt would just pressure me further to become a trauma fellow, and I don't want to be pressured. I came to you because," April swallowed, "because I wanted to know...what you...well, what made you choose pediatrics?" Her last several words came out in a rush.
Stark paused, taken by surprise, watching her face carefully for a moment. "Is that something you're considering?"
April's mouth opened and closed, and then she said, almost babbling in that way she had, "I know you've never said anything about me showing promise in pediatrics the way that Dr. Hunt has with trauma, and it does seem foolish to disregard the chief's advice -"
"April," he raised his voice a little to cut her off in exasperation. She started a little, and he realized belatedly that he'd used her first name without thinking, for the first time since she'd rejected him. He pursed his lips, unwilling to apologize for or even acknowledge his slip. Instead, he shook his head just slightly, and made an effort to even out his voice. "You didn't answer my question. Again," he enunciated pointedly, "is that something you're considering?" He stared at her face, a little uneasy about the flicker of emotion that had passed over it a moment ago.
She replied slowly, hesitantly. "I've thought about it. It's such challenging and rewarding work - well, on good days. I - I'm not like you, the bad days are harder, I wish -" she paused, reorganizing her thoughts. "Even Dr. Robbins, she's so cheerful and playful with the kids," April winced, feeling like she was insulting him for not having the same demeanor, but plowed forward, "but she's still so much better than I am at maintaining distance from the patients. And I know...I know you've said that's my biggest weakness, as a doctor, that I get too involved." She fell silent, her mental struggle plainly visible.
Stark sighed. So that was it. "I haven't always been like this," he said, saving her from the impossible task of finding the right words to say next. "Stoic and cranky," he elaborated, letting his lips twitching upward at the corners to reassure her that he wasn't offended by her earlier implication about his demeanor relative to Arizona's. "And I guarantee you," this dryly and with an eyebrow raised in contempt at the very thought, "that Dr. Robbins wasn't always so good at staying professional and detached either. It's something we all work for, something that you'll have to work for no matter what sub-specialty you choose, although, you're right, it is harder in peds. It's not just bad days, it's years and years of watching kids die, and a lot of people can't handle that."
He paused. She opened her mouth to speak, but he held up a finger, and she closed it again.
"To answer your question," he said, leveling his gaze at her, "I chose pediatrics because out of all the patients I'd had as a resident, it was the kids I remembered best. The pediatrics cases I'd had were the cases I cared the most about." She nodded slowly, and he realized he shouldn't have been surprised that she would feel the same way.
"So you think," she said timidly, "that I might be better off in trauma, where there's less risk of getting emotionally involved in my cases."
"I said no such thing," Stark replied irritably. "I think you'd be an excellent pediatric surgeon." He saw that she looked unconvinced, so he leaned forward, propping his elbows on his desk. "Emotional involvement is dangerous, but sometimes it makes you better at your job. I gave you only criticism then - and you deserved it, for not listening to your attending - but your behavior with Asha demonstrates that."
She looked confused, so he elaborated. "You went above and beyond thorough medical care to give your patient the best possible chance of responding well to treatment. You told me yourself, you recognized all the things about the case that you couldn't change, and instead of letting that overwhelm you, you did what you could do for her. You need to learn when and how it's appropriate to invest that much, but..." He held her gaze steadily. "You can do this job, if you want to."
She let out a breath, and said, "So...you think I should apply for a fellowship in pediatrics instead of trauma, then?"
He sighed. "Dr. Kepner, that's your decision," he said.
"But, if you could just tell me - " she started.
"No!" he said testily. "The chief and Dr. Hunt may be comfortable telling you what you should do with your life, but I am not." He paused, hating the lost look on her face, remembering how blithe she'd once been about her lack of intention. His desire to stay as detached as possible wrestled with his unwillingness to leave her completely adrift.
Abruptly, he recalled the advice an older doctor had once given him. He sighed again, reluctantly resigning himself to saying what she needed to hear, even if it meant letting down his guard more than usual. "Look - stop it. Just stop asking what you're good enough at to do. Don't apply for a fellowship because of the opinions of other doctors at this hospital," Stark said, staring at her intently as she shifted in her seat.
"I'm not generally the type," he said dryly, "to give speeches about following your heart. But in this case, that's what you should do. Ask yourself what you want to do, and go do that. Regardless of how good you are at it, or how much support you have from the people around you."
She opened her mouth, clearly about to protest. "Because," Stark said, glaring at her until she closed it again, "skill can be learned. And yes, the world needs skilled doctors, but more than that, the world needs doctors who are so animated by their work that -" he paused, searching for the right words, "- that they don't allow themselves to become complacent. Doctors who care enough about what they do to push the standard of care higher and higher." He stopped, staring at her, remembering what he'd told Dr. Hunt. "Caring can't be taught," he said again now.
He fell silent, watching her brow furrow in consideration. After a moment, she nodded slightly. A subtle change had come over her face; the hint of desperation for direction had been replaced by a calmer reflection. She looked more at ease with herself, a stunning contrast to the nervous wreck she'd been when she walked in.
He watched, transfixed, as her eyes first dropped to her lap, and then closed as she took a deep, quiet breath. He was suddenly uncomfortably aware of the way her lips became fuller when she relaxed, the way her lashes grazed her smooth cheeks when her eyes were closed. As much as he didn't want to, he couldn't help but be reminded of how open and - it pained him to admit - how young her face had been when they'd been dating. He hadn't forgotten that she didn't want him looking at her like this, but the weak sunlight filtering through the window blinds made the delicate curves of her jaw and collarbone stand out more, and he let himself stare for a moment anyway, before she opened her eyes again and met his gaze.
"Thank you, Dr. Stark," she said formally, "for taking the time to talk with me. I apologize for interrupting your work, I'll let you get back to it." She stood up and turned to leave, but paused with her hand on the doorknob, looking back at him. "Thank you," she said again. "Really." She smiled, and before he could say anything else, she was gone.
Stark leaned back slowly in his chair, realizing that she hadn't told him if she'd made a decision. With a sudden unpleasant jolt, it occurred to him that if she picked trauma, he would hardly see her anymore once she started her fellowship after residency. He felt cross at the very idea, then marveled at himself for still being so affected by her.
But damn it, he was. Despite the gravity of their topic of conversation, during the last several minutes with her, he'd felt lighter than he had all day. It was bittersweet, the revelation that it was mattering less and less to him whether or not she ever saw him the way he'd once hoped she would. She probably wouldn't, and he couldn't even work himself up into anger over that anymore, all he could do was hope that she wouldn't disappear from his life completely.
He sighed, and picked up his pen again. Whatever she decided, this paperwork wouldn't disappear on its own.
Two days later, sifting through his inbox, he found a pediatrics fellowship application packet, bound in a sleek blue plastic jacket. A spark of electricity hit his chest, and he flipped open the back cover, finding the last page. The bottom was signed and dated in her tidy cursive, and he smiled.
.
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**** The advice that Stark gives to April was inspired by a quote from one of the heroes of history that I admire. A fellow preacher, Martin Luther King, Jr., is said to have carried one of his books with him almost everywhere. "Don't ask what the world needs. Ask what makes you come alive, and go do it. Because what the world needs is people who have come alive." - Howard Thurman.
Please review. ****