4. Shep

FOUR

Shep

1:49 am

I ease into the soft leather seat of my Audi, the weight of the day settling into my bones. The dashboard clock blinks 2:47 AM. I still haven't changed my dash clock to spring forward for Daylight Savings.

My mind drifts to Elizabeth, the brave 15-year-old who is the reason I had to come in tonight. It seems like a lifetime ago that I performed her surgery. Her vitals are stable, and her prognosis is good. I call that a good night's work.

As I pull out of the hospital parking lot, my thoughts inevitably circle back to Elle. Seeing her after all these years... it's like a ghost materialized. I can't shake the image of her that is flashing in my mind on repeat. Our brief interactions have conjured a flood of memories I've spent a decade trying to suppress.

Our college days come roaring back—her laugh echoing across the quad, stolen kisses between classes, the shag contest we drove out for in St. Augustine, the way her eyes lit up when she talked about her dreams. We were so good together so in love.

I grip the steering wheel tighter, forcing myself back to the present. My life is complicated enough without dredging up old heartache. Being a father to Opie is a full-time job on top of my already demanding career. Between emergency surgeries and t-ball games, there's barely time to breathe. The last thing I need is to let my mind wander back to another lifetime.

Most of the women I spend time with want something more, but I'm never in it for more than the night. I'm a single dad and a workaholic. That combination doesn't leave a lot of time for anything more, not to mention that I have no desire for a relationship.

And yet... seeing Elle today stirred something that is an anomaly. A spark of possibility, a dangerous "what if." I shake my head, trying to dislodge the thought. It's been a decade. We're different people now. We both have our lives in different states.

Hell, for all I know, she is married.

After the initial cold stare from her, it felt like I chiseled through some of her icy wall. I can tell she still hates me. But she was somewhat confined due to the circumstances, and I took advantage of the opportunity to somehow make amends.

I feel like we have so much to catch up on, and my curiosity to know more about her is winning out over my practical brain, which is telling me I should stay as far away as possible.

The draw to her is still there for me. Perhaps it's just the newness of seeing her after so long. It doesn't hurt that she is drop-dead gorgeous, even in the hospital setting. Her laugh still gives me a giddy shiver.

Or maybe it's guilt that I didn't do more back in the day. Perhaps this is my chance to at least forge a friendship by making things up to her, whatever that means.

2:01 am

I unlock the front door, trying to be as quiet as possible. The living room is bathed in the soft glow of a single lamp down the hall. Cason's curled up on the couch, textbook open on her lap. She stirs as I enter.

"Hey, Dr. Duncan," she whispers, rubbing her eyes. "Rough night?"

I nod, dropping my keys quietly on the side table. "Thanks for saving me at the last minute and staying late. How was Opie?"

"Quiet as a mouse. I checked on him after I got here, but he didn't stir."

A wave of gratitude washes over me. Cason's been a godsend since Opie was born. She started as a bright-eyed college senior, and now she's juggling her master's in education while still being the most dependable nanny I could ask for.

"You're a lifesaver, Cason. Seriously."

She grins, gathering her things. "It's my pleasure. I love working for you and Ari. You guys rock the co-parent thing, and Opie is the best kid because of it."

Ari, Opie's mom, is one hundred percent better for me as a co-parent than she was as a romantic interest. We were never meant to be long-term—just two people who enjoyed each other's company for a few months. I was upfront about my commitment intentions, and she knew my reputation. When we called it quits, it felt mutual and drama-free.

Then came the pregnancy bombshell.

We handled it like adults - no messy emotions, just practical discussions about raising our child together but apart. It's been surprisingly smooth sailing.

Ari's schedule as a respiratory therapist is almost as chaotic as mine, but we make it work. Opie splits his time between us, and Cason fills in the gaps.

This is my weekend, but she usually takes Opie when I have to go in for on-call. But she is out of town for the holiday weekend, which puts me in a bit of a pinch. Thankfully, Cason is probably the most dependable person in the world.

"Are we still on for tomorrow?" Cason asks, putting her bag on her shoulder and pulling her key fob from her shorts' pocket.

"Yeah, if that works for you. I've got a follow-up with a patient, but I shouldn't be there for too long."

She nods, stifling a yawn. "No problem. Night, Dr. Duncan."

As I close the door behind her, I can't help but marvel at how well our unconventional family functions. It's not perfect, but it works. I'm super grateful that Ari and I can do this right, for Opie's sake.

7:07 am

I arrive at the hospital fairly quickly, missing the worst of morning traffic. My mind is still buzzing from last night's events. Seeing Elle again was more jarring than I imagined it might be. She was in my dreams, and my brain kept conflating the dream version with the reality.

Right now, I need to focus on my patients and do my best to put her out of my mind.

The attending ICU physician, Dr. Kazim, greets me with a nod as I join him and the team for rounds. Elizabeth's room is their next stop. I let him do the initial introduction since he is the doctor running the floor. Once I have an opening, I speak up.

"Good morning, Elizabeth," I say, stepping inside. "How are you feeling?"

She manages a weak smile. "I've been better, but I feel pretty good considering everything. I can wiggle my toes." She smiles proudly as I see the sheet rumple at the foot of her bed.

I smile and give a slight nod to her parents, who have come to stand beside the bed and hear our run-through.

"I'm glad to know you were listening to me last night. That is a great sign."

Relief washes over me. Her case is textbook, and I'm grateful for the positive outcome. I explain to both of them that a physical therapist will be visiting today. My hope is to have her up and out of bed, if even for a short time.

After a second conversation with Elizabeth's mom in the hall, I can't help myself. I make my way to the surgical floor to pull up Elle's chart on my tablet. She's in surgery right now with Charlie Hampton.

I study her scans, my stomach tightening. The damage is extensive, worse than I initially thought from her intake form. There's definite nerve involvement. She's looking at months of therapy, maybe longer.

I lean against the wall, running a hand through my hair. Should I be the one to tell her? We have history, sure, but would that make it easier or harder? I pull out my phone, debating for a moment before typing out a message to Charlie:

Hey, it's Shep. The hand laceration patient, Eloise Klass—I know her from way back. Mind debriefing me after her surgery? Thanks.

I hit send, then stare at the screen, wondering if I've overstepped. But I can't shake this feeling of responsibility. I need to know she'll be okay.

10:16 am

My phone buzzes, and Charlie's name appears on the screen. I answer quickly, eager for news about Elle's surgery.

"Shep, it's Charlie. Just got out of surgery with Klass."

"How'd it go?" I ask, trying to keep my voice neutral. I'm hopeful nothing unexpected came up, and it was smooth, in and out.

"Surgery went well, but it was more complicated than initially thought. We had to call in Dr. Reeves due to the extent of nerve involvement."

I knew it.

I exhale slowly. Reeves is good, one of the best, actually. "That's... good. At least she had Reeves."

Charlie continues, "The laceration was deep, affecting multiple tendons and nerves. We repaired what we could, but she's looking at extensive rehabilitation. The nerve damage is significant—it'll take time to know the full extent of recovery."

My stomach knots as I listen. I've seen cases like this before and know the long road ahead. "What's your take on her prognosis?"

"Best case scenario, with intensive hand therapy and time in a rehab facility, she might regain most function. But it's going to be a long haul, Shep. We're talking months of work, as you're aware."

I lean against the wall, closing my eyes. "Poor thing. I was hoping it was less involved. You going to put her in rehab in Birmingham or let her go back to Florida for that?"

"At least a week here before I'd consider releasing her. I want to see how she does these first couple of days post-op."

My heart sinks. She is not going to be happy with this news. I'm not sure I'm the best person to deliver it. I don't need to give her any more reason to resent me. "Thanks for letting me know, Charlie. I appreciate it."

After hanging up, I stand there for a moment, processing. The weight of what Elle's about to face settles heavily on my shoulders. I want to help, but I'm unsure how or if she'd even want me to.

2:29 pm

I finish up the last of my rounds, my mind still churning over Elle's situation. As I head towards Elizabeth's room for my last visit of the day, I can't shake the urge to check on Elle, too. It's not just a professional concern at this point. It is bordering on obsession.

Elizabeth's dad greets me with a tired smile as I enter. "Dr. Duncan, thank you for coming back."

"Of course. How's our star patient doing?"

Elizabeth, propped up in bed, gives me a weak thumbs-up. "Therapy sucked, but I sat on the edge of my bed and stood and walked about a hundred feet."

I chuckle, checking her chart. "That's the spirit. Pain levels?"

"Manageable," she says, wincing slightly as she shifts.

I nod, making a few notes. "Good. We'll keep an eye on that. Any questions for me?"

After addressing their concerns, I excuse myself, my feet carrying me towards Elle's room before I can talk myself out of it. I pause outside her door, heart racing. Through the window, I see her lying there, her bandaged hand resting on a pillow. She looks pale and vulnerable after surgery.

Taking a deep breath, I knock softly and enter. Elle's eyes flutter open, surprise registering as she sees me. I feel bad to have woken her. It's too late now.

"Shep?" Her voice is hoarse, the familiar post-anesthesia growl.

"Hey," I say, awkwardly hovering near the foot of her bed. "I talked to Dr. Hampton after your surgery. We ran into each other on the floor," I lie. "I wanted to come by and make sure you are doing okay."

She attempts a smirk, and I'm confident she wants to tell me to fuck off. "How bad is it, really?"

I hesitate, weighing my words carefully. "It's going to be a tough road, Elle. But you're strong. You've got this. You have a great team handling your case. I know Dr. Reeves personally, and he is an excellent surgeon. I'm certain he did a great job for you."

She looks away, blinking rapidly. "They said I might not regain full function."

My chest tightens. I want to reassure her, but I can't lie. "It's too early to know for sure. But you've got as good of a chance as you could ask for. Now it is the long game."

Elle nods, still not meeting my eyes. The silence stretches between us, heavy with unspoken words and shared history.

Finally, I clear my throat. "Listen, if you need anything…"

"Thanks," she cuts me off, her tone polite but distant. "I appreciate you stopping by, but I think I have it covered."

I nod, recognizing the dismissal. As I turn to leave, I can't help but wonder if I've made a mistake coming here, reopening old wounds that neither of us seems excited to face. Maybe I should leave well enough alone.

They say I'm an asshole, a player. But I beg to differ. I'd say I just keep to myself. I'm not really the type to go out of my way to help someone.

So why now? Why do I feel the need to make sure Elle is taken care of, especially considering that she seems to want nothing to do with me?

I think I want to show her that I'm not the same self-centered jerk I was back then. To prove to myself that I can be a better man.

But the sad truth is, conceivably, an egocentric asshole might be all I am. A mediocre, greedy man. After all this time, even with my blatant attempts to help her, she still seems to want to keep me at bay. Maybe that is best.

As I head toward the elevator, lost in thought, I nearly collide with Hunter Parrish. He takes the resident bad boy general surgeon mantle, so I don't have to. He has a shit-eating grin when I almost knock his coffee out of his hand.

"Whoa there, Duncan," he says, steadying me. "You look like you've seen a ghost."

I force a laugh. "Long morning. You know how it is."

Hunter nods, and then his eyes light up. "Hey, you won't believe this new rehab facility we've got. I admitted a patient there yesterday, and I just left there. That place is how rehab should be done."

I raise an eyebrow, curious despite myself. "Yeah?"

"Man, it's top-notch. Right next to the hospital, state-of-the-art equipment. They've got this VR therapy setup that's mind-blowing." Hunter launches into a detailed description, his enthusiasm contagious. He almost makes the idea of going to a rehab facility sound like an enjoyable experience.

As he talks, a thought starts forming in my mind. Elle. She needs rehab. She's not from here, and no one's looking out for her best interests.

"... and the staff-to-patient ratio is incredible," Hunter's saying. "Seriously, it's like a five-star hotel for recovery."

I nod, my decision solidifying. "Sounds impressive. Listen, I've got a patient who might benefit from that. Needs some pretty extensive hand rehab. Any chance you could put me in touch with the admissions team?"

Hunter grins. "I don't have it, but I will have Marijka send it to you. She hooked my patient up, and I know she will take care of yours. But fair warning, there's usually a waiting list since they started taking patients not even a month ago."

With those words, a heavy doubt settles on my shoulders. She isn't my patient; I shouldn't be butting my nose into this. But if I don't, she could get lost in the process between insurance approval and open beds. When a surgeon gets involved, things happen. I would do this for anyone, right?

"Thanks, man. I appreciate it."

As Hunter walks away, I pull out my phone, already formulating a plan. I might not be able to fix the past, but I can at least make sure Elle gets the best care possible while she's here. It's the least I can do.