Open Heart One Shots (Choices)

Old Habits

Summary: Ethan drops by the Diagnostic Team's office one too many times after becoming Chief of Medicine, and Cassie puts him to work.

If Dr. Cassie Valentine had known how much paperwork she'd have to deal with as Head of Diagnostics at Boston's Edenbrook Hospital, she would likely have declined the role when her mentor, Dr. Ethan Ramsey offered it to her.

Between timesheets, department budgets and performance reviews, the time she spent with actual patients was much less in comparison. She really shouldn't complain. But if she couldn't gripe to herself, what was the point?

No wonder Ethan, who had held the job before her, was often grumpy. A slow death by paperwork could be a diagnosable condition, reserved for department heads and chiefs of medicine, she thought.

She knew that Ethan's workload had increased tenfold since being promoted to Chief. He had a plan, however, to split the role and give his deputy all the administrative headaches while he did what he did best: focus on improving patient care and physician training.

She might be biased as his girlfriend and former mentee, but there was no one more suited to being a teacher and mentor than Chief Ethan Ramsey.

The sound of the glass doors swishing open had her raising her head at the interruption. A huge smile broke out on her face when she saw who it was.

"Thought you might use a coffee break," said Ethan, placing a to-go cup from their favorite Derry Roasters on her desk.

"What about..."

"Got you covered," he said placing a paper bag next to the coffee cup.

"I love you," said Cassie, reaching for the chocolate caramel cupcake that she'd become addicted to ever since Derry's had added it to their menu a few weeks ago.

"You're talking to the cupcake, aren't you?" teased Ethan as he took a sip of his café Romano.

Cassie only smirked as she took a bite. She might have been talking about the cupcake or him, but it was always best to keep Dr. Ramsey guessing. He knew her too well otherwise.

"What are you working on?" he asked, settling into the visitor's chair.

"Performance reports," she bit out, her good mood from the cupcake souring quickly. "I swear, I don't know how you did this job without tearing out your hair."

"I had interns to terrorize," he quipped. "Keeping you lot in line always put me in a good mood after."

"Glad I could be of service," she grinned, toasting him with her coffee cup.

The ping of the notification on his phone had him sighing.

"I need to head to my next meeting," he told her. "Can we have dinner tonight? I miss you."

"Meet you in the parking garage end of shift?"

"I'll be there," he said, throwing her a small smile before heading out.

-----------------

A few days later Cassie entered the Diagnostic Team's office to find Ethan scrutinizing their latest patient's scans on the large LCD screen against the back wall.

She placed the stack of folders in her hand on the conference table before joining him. As much as she loved him, she needed him gone. The team meeting was in thirty minutes, and she wanted some alone time to prepare.

"Can I help you, Chief Ramsey?" she asked, giving him her best disapproving stare. Not that he noticed.

"Hmm," he said absently, tapping his fingers against his lips as he was wont to do when he was in deep thought. "Could be autoimmune, maybe lupus or multiple sclerosis."

"Earth to Ethan," said Cassie, waving her hand in front of his face.

"Did you need something, Rookie?" he asked, turning towards her, his gaze slightly unfocused.

"My office back?" she said, folding her arms across her chest.

He flushed, realizing that he'd been so focused on the mysterious lesions in the brain scans that he'd forgotten this wasn't his job anymore.

"Ethan, what's going on?" asked Cassie, her voice soft as she saw the abashed expression on his face.

This was the third time this week that he had dropped by. It had her wondering what was going on. He looked away, fiddling with his tie, a clear sign of nerves as she knew quite well.

"I miss this," he said finally, waving his hand to indicate the surroundings before taking a seat at the conference table.

"I miss looking at patient records and figuring out what could be wrong. I miss the mystery of it all. And Cassie," he continued, "I miss working with you."

Cassie sat down next to him and reached for his hand, lacing their fingers, needing that connection.

"I hadn't realized that you were struggling like this," she said, contrition in her tone. "I'm sorry that I didn't notice. Some diagnostician I am."

"It's not your fault," he said, squeezing her hand in gratitude. "I didn't want to burden you with this, so I tried to hide it. You have enough to contend with leading the team."

"Can I get your help with something, since you're here?" she asked as the silence stretched.

"You're far too capable to need my help, love," he beamed, knowing she would try to find a way to soothe his concerns.

"There we have to disagree, Dr. Ramsey," she said with all seriousness but with a sparkle in her eyes. "There's still a lot that I have to learn, and I know that I don't want anyone but you to teach me."

"This is your lucky day!" he said, matching her tone. "I appear to have some free time in my calendar right now and I'd be happy to share my wisdom with you, Dr. Valentine."

Cassie reached for the folders in front of her, handing him the top one.

"Here are the latest case files I received for the team's consideration," she said, switching her gaze to the tablet where she had a summary of the case list.

"We can't take them all of course, but I'm struggling to come up with a system to efficiently filter out the ones that need us versus those that don't," she explained. "It takes me way too long to read up on each before bringing the most critical ones to the team. You always made it look so easy, but I honestly don't know how you did it on top of everything else."

"You need to create an evaluation checklist based on where you want to prioritize the team's time and efforts, matching it to the individual team member's specialization," he advised. "This way, you can quickly scan the case notes against the criteria and decide if you have the right composition of resources to help the patient."

"But won't that preclude patients that we could help?" she asked, eyebrows snapping together.

"Possibly," he nodded. "But your focus needs to be on getting the diagnosis right as efficiently as possible as opposed to taking on too many cases where the team doesn't have the expertise to help and prolonging the patient's stay in the hospital."

Crossing her legs, she propped her elbow on one knee and rested her chin on her upturned palm as she thought about his advice.

"I hear you," she said finally. "I need to stay focused on the mission to help those who don't have anywhere else to go."

"Exactly," he said, looking pleased as he thought of Naveen's legacy continuing on in Cassie.

He reached across the space between them to lightly brush his lips against hers. But Cassie slid her hands around to the nape of his neck, holding him close as she deepened the kiss.

They normally kept things professional at work so as not to feed Edenbrook's gossip machine. But as he felt the love between them flow in that kiss, Ethan thought that there were some things that were worth any risk.