23. Shep

TWENTY-THREE

Shep

2:37 pm

Randy, Buster, and I are hunched over cups of coffee, discussing the latest case that brought us all three into the OR.

"That was a doozy," Randy says, shaking his head. "Never seen a tumor wrapped around the optic nerve quite like that before."

"Tell me about it," I reply, refilling my cup. "For a minute there, I thought we might lose vision in the left eye entirely."

Buster chimes in, "But you pulled it off, Duncan. As always."

We discuss the case in detail, dissecting each step and decision made in the OR. This ritual helps us decompress and learn from each challenging surgery.

Mid-sentence, my phone buzzes. I glance down, and my heart skips a beat when I see the Houston Methodist number flash across the screen.

"Sorry guys, I've got to take this," I say, already heading for the door. I leave my piping hot cup there as I want to be able to give my full attention as I walk to my office.

I answer as I hurry through the stark hall, wanting to get to the solace of my office. "Dr. Duncan speaking."

"Dr. Duncan, this is Dr. Patel from Houston Methodist. I'm calling about Ari Black's condition."

My pace quickens, and hope and anxiety are warring inside me. It's been a week of minimal progress, each day lessening the likelihood that she would wake up with no residual complications. As I know all too well, with a brain injury, a lot of it is wait and see and hope for significant signs of improvement.

"Yes, Dr. Patel. How is she doing?" I ask, my voice steady despite the tumult of emotions inside.

I push open my office door, shutting it behind me for privacy as I listen intently to Dr. Patel's update.

I sink into my chair, the weight of Dr. Patel's words hitting me like a freight train.

"I understand, Dr. Patel. Can you walk me through her latest EEG results?" I ask, my voice barely above a whisper.

My mind races as he details the minimal delta wave activity and absence of alpha rhythms. I know what this means. We're looking at a Glasgow Coma Scale score of 3 or 4 at best.

"And the latest CT?" I inquire, though I can already guess the answer.

"Significant hypodensity in the bilateral frontal and temporal lobes," Dr. Patel confirms. "We're not seeing any reduction in the cerebral edema despite aggressive mannitol therapy."

I close my eyes, picturing Opie's smiling face—my son, who might never hear his mother's laugh again or feel her arms around him.

"What's her intracranial pressure?" I ask, grasping at straws.

"Holding steady at 25 mmHg. We've maxed out on barbiturate coma therapy, but..."

"But there's no meaningful change," I finish for him.

The silence on the line speaks volumes. We both know what comes next—comfort care, making her final days or weeks as peaceful as possible.

"Thank you, Dr. Patel," I manage to say. "I appreciate your efforts and thorough care."

As I hang up, the reality crashes over me. Ari, the mother of my child, is slipping away. And Opie... my sweet, innocent boy. How do I tell him that mommy might never come home?

My chest tightens, and the air suddenly becomes thicker and suffocating. I lean forward, elbows on my desk, head in my hands. For the first time in years, I feel utterly helpless. All my medical knowledge, all my surgical skills—none of it can fix this.

I stare at my phone, Elle's name highlighted on the screen. My finger hovers over the call button, but I can't bring myself to press it. What would I even say? "Hey, Elle, just calling to let you know my son's mother is probably going to die"? The words stick in my throat, refusing to form.

Dropping the phone on my desk, I lean back in my chair, feeling hollow and numb. How am I supposed to process this? More importantly, how am I going to help Opie through it?

A small voice in the back of my mind whispers that miracles can happen. I've seen it before in my career—patients defying all odds, waking up when everyone had given up hope. The rational part of me knows the chances are slim. The statistics aren't in Ari's favor. But there's still a possibility, however remote, that she could turn a corner.

I take a deep breath, trying to ground myself. The hospital isn't giving up entirely. They're just shifting focus, ensuring Ari remains healthy and comfortable while nature takes its course. It's a waiting game now, one with incredibly high stakes.

My eyes drift to the framed photo on my desk—Opie's gap-toothed grin beaming back at me. How do I prepare him for the possibility of losing his mom? How do I support him through this when I can barely keep myself together?

I pick up my phone again, scrolling past Elle's name to find my son's favorite babysitter. I need to see Opie, to hold him close and cherish every moment we have. The rest— Elle, work, everything else—can wait. Right now, my boy needs me more than ever.

4:19 pm

I sit on the park bench, watching Opie race up the ladder of the giant slide structure. His laughter carries across the playground, mingling with the shouts and giggles of other children. My heart aches as I observe his carefree joy, knowing the devastating news I'm holding back.

The weight of Ari's condition presses down on me, threatening to crush my composure. I wrestle with the impossible decision of when and how to tell our son. Should I shield him from the harsh reality or prepare him for what's coming?

My mind keeps circling back to the idea of flying Opie to Houston. He deserves a chance to see his mother while she's still alive. I know that if I don't give him this opportunity, he may resent me when he's older. The thought of that potential regret gnaws at me.

But then I picture my four-year-old son standing beside Ari's hospital bed, surrounded by beeping machines and tangled tubes. Is that the final image I want him to have of his vibrant, loving mother? The doctor in me understands the clinical aspects, but as a father, I'm lost.

I've guided countless families through similar situations, offering advice and comfort. Now, faced with my own crisis, all that experience seems to evaporate. I'm adrift, second-guessing every potential choice.

Opie waves to me from the top of the slide, his face beaming with excitement. I force a smile and wave back, my heart breaking a little more. How do I protect him while also being honest? How do I balance his need for closure with his innocence?

The playground suddenly feels suffocating. Children's laughter is drowned out by the constant chatter of indecision in my head. I need to make a choice, but every option seems wrong.

I'm lost in thought, watching Opie play, when Elle's voice startles me.

"Hey there, stranger," she says softly, sliding onto the bench beside me.

I turn to her, surprised. "Elle, I didn't expect you to come."

She smiles, but I can see the concern in her eyes. "You seemed off in your text. I wanted to check on you."

I nod, grateful for her presence but unsure how to explain. "Thanks for coming."

Elle reaches out, her hand resting lightly on my arm. "What's going on, Shep? You look like you're carrying the weight of the world."

I take a deep breath, struggling to find the right words. "I got a call about Ari today," I begin, my voice barely above a whisper. "It's... it's not good."

Elle's grip on my arm tightens slightly. She doesn't push; she just waits for me to continue.

"They've moved to supportive care," I explain the medical terminology and how they come to these decisions. "Basically, they're out of options. They'll keep her comfortable, but statistically, she won't come out of this."

I trail off, unable to voice the grim reality. Elle leans closer, her shoulder pressing against mine in silent support.

"Oh, Shep," she breathes. "I'm so sorry."

We sit in silence for a moment, watching Opie chase another boy around the playground equipment. His laughter floats back to us, a stark contrast to the heaviness I feel.

I hold back tears. I know she knows it is more about Opie than anything else, but it still feels odd to get emotional about someone I dated to the person I am now dating.

I did care for Ari. We made a really good team with Opie. Fuck, I'm already thinking about her in the past tense. We make a good team. And if I'm being completely honest, she did all of the hard work. She is an amazing mom.

"I don't know how to tell him," I admit, coming back to the present and Elle. My voice cracks, betraying my resolve. "He's so young. How do I explain that his mom might not..." I can't finish the sentence.

Elle's hand moves to my back, rubbing gentle circles. "There's no easy answer," she says softly. "I wish I could be more help to you. Know that I'm here, though."

7:59 pm

I close Opie's bedroom door quietly, my heart heavy. Tonight's bedtime routine felt different, more poignant. I linger over our goodnight hug, breathing in the scent of his hair and savoring the warmth of his small body against mine. The weight of the news about Ari presses down on me, making each step down the stairs feel like a monumental effort.

As I reach the bottom, I spot Elle through the patio doors. She's sitting outside, two glasses of wine on the table in front of her. The sight of her waiting for me brings a small measure of comfort, but I'm not ready to talk just yet.

I step out onto the patio. "Hey," I say softly.

Elle looks up, her eyes full of understanding. "Hey, yourself. I poured you some wine."

I nod, appreciating the gesture. "Thanks, but... I think I need a shower first. Today was... rough."

"Of course," Elle says, her voice gentle. "Take your time."

I run a hand through my hair, suddenly feeling the day's exhaustion. "Bedtime with Opie was tough tonight. I just need to wash the day off, you know?"

Elle nods. "I understand completely. Go ahead. I'll be here when you're ready."

"Thanks," I murmur, grateful for her patience.

I turn and walk back inside, heading for my bedroom. The promise of hot water and a few moments alone to process everything is calling to me. As I close the bedroom door behind me, I let out a long, shaky breath. The shower can't wash away the decisions I need to make, but maybe it can help clear my head enough to face them.

I stand under the shower, letting the hot water pound against my face. My eyes are closed, the steady stream washing away the day's tension. For a moment, I can pretend that everything is normal, that I don't have to face the harsh reality waiting for me outside this sanctuary.

Suddenly, I feel a presence behind me. Soft arms wrap around my waist, and I instantly recognize Elle's touch. She doesn't say a word, holds me close, her body pressed against my back.

The tenderness of her embrace breaks something inside me. All the emotions I've been holding back come rushing to the surface. A sob escapes my throat, and then another. I can't stop it now. The tears mix with the shower water as I finally let go of the sorrow I've been carrying since I got the call.

I cry for Opie, for the innocent child who will likely lose his mother. I cry for Ari, lying in a hospital bed with a life cut too short. I cry for myself, for the weight of the decisions I must make and the fear of being unable to do it alone.

Elle doesn't try to quiet me or offer empty platitudes. She just holds me tighter, her presence a silent comfort. Her hands stroke my chest gently, grounding me as I let out all the pent-up grief and worry.

I turn in her arms, burying my face in her neck. She runs her fingers through my wet hair, murmuring soft sounds of comfort. We stand like that for what feels like hours, the water cascading over us both as I embrace the vulnerability.

The water from the showerhead is like a warm embrace, enveloping us both as I turn to face Elle. Her eyes meet mine, filled with understanding and a silent promise of support. At this moment, I need her more than I've ever needed anyone.

I back her up against the cool tile wall, the contrast of temperatures mirroring the intensity of our connection. My hands trace the gentle curves of her body, every hill and valley familiar yet new as if I'm discovering her all over again. She yields to my touch, her body pliant and willing under my command.

I kiss her fiercely, a desperate attempt to convey all the emotions I can't put into words. She responds with equal enthusiasm, our tongues dancing in a rhythm that speaks of raw need and shared desire. My hands tangle in her wet hair, pulling her closer as if trying to merge our very souls.

I spin her around so her back is to me, the water cascading down her slender form. I take a moment to admire the view, the way the droplets cling to her skin, tracing the lines of her body like a lover's caress. I lean in, my breath hot against her ear. "Just let go, Elle," I whisper, my voice husky with desire. "Let me take care of you."

My hands explore her, sliding over her slick skin, claiming every inch of her as mine. I cup her breasts, teasing her nipples into stiff peaks before moving lower, my fingers slipping between her thighs. She gasps as I find her center, her body arching against mine as I stroke her with practiced precision.

I position myself behind her, the tip of my erection teasing her entrance. With one hand on her hip, I guide myself inside her, both of us moaning as I fill her completely. The sensation is overwhelming, a mix of pleasure and the need to possess her utterly.

I set a demanding and tender rhythm, each thrust a silent plea for connection, for solace in the midst of chaos. Elle braces herself against the wall, her cries of pleasure echoing off the tile, mingling with the sound of the running water.

I can feel her tightening around me, her body coiling like a spring as she nears the edge. I reach around to stroke her clit, the added stimulation pushing her over the precipice. She cries out, her orgasm washing over her in waves as I continue to drive into her, chasing my release.

With a final, desperate thrust, I find my climax, the intensity of it threatening to knock me off my feet. I hold onto Elle as if she's my anchor, the only thing keeping me from being swept away by the storm of emotions raging inside me.

As our breathing slowly returns to normal, I turn Elle back around to face me. I kiss her gently and softly thank her for the sanctuary she's provided me in this moment of vulnerability.

We stand there, holding each other under the steady stream of water, finding comfort in the silent understanding that passes between us.

I know that the road ahead will be difficult and filled with challenges and uncertainties. But in this moment, with Elle in my arms, I feel a glimmer of hope. Together, we've found a connection that transcends the pain and the fear, a bond that might be strong enough to weather any storm.