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CHAPTER FORTY-TWO
a change is gonna come.
season four, episode one.

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"Miller, Rogers, Campbell, Emerson, Keys."

The five interns emerged from their chairs and immediately walked up to the man in front of them, who held a clipboard with all the names of the new interns.

"You're gonna be with Dr. Black. She's over there," he said, turning towards a woman who completed a chart by a nurses station.

The five interns immediately began walking towards her.

"I already like this place." John Rogers smirked proudly, heavy Posh accentuating his speech.

"Why? You've been here for, like, five minutes," Cassie Campbell retorted, rolling her eyes.

"Look over there." He beckoned towards Billie. "We got the hot resident."

Jay Emerson, a short girl with Asian features and a green beenie on her head, rolled her eyes at the crass statement. "Ugh."

"Tell me about it," Cassie agreed just as they came up to Billie.

The woman didn't notice them at first, eyes fixed on the chart in front of her, but soon, Cassie cleared her throat and caught her attention. The resident eyed them swiftly, shut the chart closed and placed her hands on her hips. Her eyes landed on Jay.

"Lose the beenie, it's not cool and you're in a hospital." She grimaced.

Jay's eyes widened and she didn't waste a second in taking off the beenie and tucking it hastily inside the pocket of her lab coat.

"My name is Billie Black, Dr. Black for you. Before you say anything," she raised her finger, causing Cassie to stop her incoming sentence beforehand, "I have five rules, memorize them. Rule number one: don't bother sucking up. The only intern who'll get to hold a scalpel is the one who deserves it, and as much as you kissing my ass may be great for my ego, a surgery is something you earn, not bribe."

The interns looked at each other excitedly. Billie turned towards the station and pointed towards to a bunch of stuff laid out on top of the counter.

"Trauma protocol, phone lists, pagers. Every page is answered at a run, no matter if it's emergent or not. I don't care if you're sleeping or having the best sex of your life; you answer immediately, or else I'll make sure you don't see the inside of an OR for a month. That's rule number two, understood?" she said. The interns scurried to take their pages and then followed her when she began walking away. "Normally, I will be the one paging you, but the nurses also will. Which brings me to rule number three: respect the nurses. They've been here longer than you have, they know more, and their job is much harder. Intern I see so much as glaring in a nurse's direction, intern I'll assign every rectal exam I come across for the rest of the year."

They shared fearful looks, making Billie smile under her breath triumphantly, knowing she was nailing the first impression. She made her way down the hall with her intern class in tow and, as they crossed the strip, she continued her speech.

"Rule number four: you're interns, grunts, nobodies, bottom of the surgical food chain, which means you write labs, run orders, and not complain." She nodded. "I want all of you working every second night until you drop, but if you feel like you've worked to exhaustion and it causes any distraction or interferes with your job, please let me know and I'll arrange you a few hours for you to rest. No tired intern will get surgeries, so don't overwork yourselves for OR time because that won't do it. Now, does anybody have any questions?"

A short girl who stood in the very back and Billie would soon learn was called Robbie Keys, raised her hand sheepishly.

"Yes?"

"You said five rules. That was only four."

Billie arched an eyebrow just as her pager went off in perfect timing. "Rule number five: when I move, you move."

☆

"How's my favorite resident doing?" Mark smiled widely once she saw Billie walking in through the doors, followed by her five interns. She reciprocated the grin.

Billie chuckled. "Interns, this is Mark Sloan, head of plastics. Mark, these are my interns."

John leant into Cassie, much to her dislike. "You think they're sleeping together?"

"What do you care?" she retorted in a whisper.

Mark eyed them all, expressionless. "I hate interns."

"I know." Billie rolled her eyes playfully. "What do you got for me?"

"Billie, meet Lucas. Lucas is a thirteen-year-old that was in his karate class when he took a nasty fall and ended up with a three-inch lac on his forearm. He's sedated, we got him on oxycodone and wound is already clean and disinfected, but he needs to have done a running subcutaneous suture." Mark handed her the needle and the string, which he had already prepared beforehand. "You think you can handle that?"

"Oh, I can." The girl smirked, then retrieved the supplies from his hand.

"Wait, running subcutaneous sutures?" Cassie stopped them with a frown. "Isn't that a little advanced for a second-year resident?"

"Not for her, it's not." Mark shook his head. "Dr. Black over here completed a five-month program in plastics while she was still in med school, tutored by myself, obviously. She learnt from the best."

"Yeah, whatever. Go away, Mark, I'm supposed to teach them." Billie pushed him away playfully, to which he smiled at her before he left the room. She took his spot on the chair. "Okay, can anybody tell me what a running subcutaneous suture is used for?"

Jay raised her hand. "To close the deep portion of surgical defects under moderate tension. It's used in place of buried dermal sutures in large wounds, if you want a quick closure."

"Good. Observe and feel free to take notes."

They proceeded to each take out their notebooks and pens and analyze Billie as she maneuvered the instruments and the string over Lucas' wound, stitching him up flawlessly. Jay leant into Robbie discreetly.

"I heard Dr. Black's only twenty-four. Can you imagine? I'm older than her," she said in disbelief, completely impressed.

"I think they called her something... what was it? McBeauty, maybe?" Adrian nodded with his head. "Pretty sure it was McBeauty."

"Fits." John smirked. "Listen, if she wasn't my boss, I'd get in there."

"Are you guys-" Billie drawled, eyes fixed on her work. "-paying any attention to what I'm doing, or are you too busy gossiping?"

The interns mumbled out a few apologies quickly.

"Good." She nodded. "Also, Rogers, speak about me that way again, and I'll show you a few very interesting places for you to get in there."

☆

The now resident class (excluding George, who Billie had found out had failed his intern exam) sat in the gurneys in the tunnels, discussing their day so far. They all seemed to be pretty tired already.

"I hate them." Cristina huffed.

"You don't hate them. You hate you," Meredith corrected.

"That was hideous. I feel like a fraud." Izzie shook her head, staring at the ceiling with disappointment.

"Maybe you are a fraud." Billie smiled in mockery as she sipped from her carton of apple juice, a little too pleased to get a reason to hate on Izzie without it sounding too degrading. "Maybe you have no authority in this place and your interns already hate you. Maybe you're a joke."

"I rocked it. I think I'm the new Nazi." Alex nodded proudly, ignoring Billie's statement.

"Oh, you are not the new Nazi." Cristina scoffed.

"What's up with the haircut?" Billie squinted at Alex's moustache and he glanced over at her with a frown, but she simply shrugged. "Whatever. I made those interns my bitches, and they know it. Just wait till you see me get mad at them. They'll be so dead."

"Yeah, she's the new Nazi." Cristina nodded, confident in her prediction.

Just then, George walked into the tunnels and stood in front of the residents. "Meredith, I need to talk to you."

"George, hi," Izzie called out longingly at the sight of him.

"Hey," he replied wryly.

"How was your vacation?"

"Uhm... fine. Meredith, could we-"

"'Cause mine was... I didn't do much. Hung out alone. For seventeen days. Which is the last time that I saw you. The day of Cristina's wedding, which was, well..." Izzie hesitated when she saw Cristina's glare. "And then Mer, Bil and Cristina went on Cristina's honeymoon, without me."

"Dude," Billie chuckled, "literally nobody wanted you there."

"Girl-on-girl-on-girl honeymoon." Alex laughed devilishly. Billie glared at him.

"And Alex took a roadtrip to see Ava, without me." Izzie huffed..

"I did not go to see Ava!" He immediately became defensive. "And her name's Rebecca, and I didn't go see her. I just drove in that direction."

Billie frowned. "What's up with you and Ava?"

"Rebecca," Alex corrected again, but his expression fell. "Nothing."

"Why is everyone so tingly and hurt? I mean, I'm the one who was left at the altar," Cristina said, but her friends eyed her worriedly. "I'm fine, by the way. I honeymooned in Hawaii... and I snorkeled."

Izzie looked at the man standing in front of them. "What did you do, George?"

"Uh, Meredith, I really need to talk to you." He ignored her, but just then, a few interns walked into the tunnels, chatting amicably and carrying their snacks with them.

"Hey, uh, this is for residents only, no interns." Cristina waved them off, prying them to go away.

"Yeah."

"Yeah, get outta here!"

"Babies."

"Go away."

"007s in training."

"Seriously!"

George's face fell. "I guess I should be going too."

"No, George, we didn't mean you!" Meredith called out for him, but to no avail.

"No, I'm an intern!"

"Wait, what did you wanna tell me?"

"George!" Billie yelled as he got lost down the hallway, although she got no response, to which she huffed out and plopped back down on her seat, staring at her carton of apple juice that she no longer wished to drink.

"Is this how it's gonna be all year? 'Cause Bambi has got to learn how to deal." Cristina scoffed.

"At least he came back. Cut him some slack." Billie shrugged.

"Dude, he failed his exam and got left back in kindergarten," Alex interrupted.

Izzie shook her head sadly. "He wouldn't even look at me."

"Yeah, I wonder why." Billie flashed her eyebrows. The brunette then shrugged her shoulders and hopped off the gurney. "Anyway. I'm gonna go find my suck-ups, 'cause I don't want them killing anybody's uncle or sleeping around with married men, right?"

Izzie, who was taking a sip off her water bottle, immediately choked on the beverage and nearly spat out everything, causing Cristina to grimace at her in disgust. Billie smiled innocently before she walked out of the tunnels, to which Meredith glanced over at the remaining residents.

"That was oddly specific."

☆

"Where have you been? We have multiple MVC's due any second!" Callie, now assigned chief resident, yelled angrily as the starring resident class walked into the pit, each followed by their own interns.

"We're here, aren't we?" Alex retorted.

"Just get ready, okay? And monitor your interns."

Callie proceeded to walk away, leaving the residents to manage their own classes by themselves. Immediately, Cristina turned towards her interns and began handling out instructions.

"Okay, uh... One, Two, go get stat packs. Three, Four, go meet the ambulances," she demanded.

Billie and Meredith laughed. "One and Two?"

"I know. I can't remember their names." The third one waved them off.

The crowd began dispersing, so Billie turned towards her interns. "Okay, this is what's called incoming trauma. There will be a lot of activity, a lot of patients to take care of, and more than likely, a lot of doctors running around. Do not, and I mean it when I say it, ever get in the way of a doctor if they're faced with an emergent case. You do so, you might kill a patient. Okay?" The interns nodded. "Usually, it's a first-come-first-serve type of thing, so if you see a patient and you get to them first, they're yours." She paused. "What are the two most important ER rules?"

Jay raised her hand. "Don't block the ER doors and don't neglect any of the patients."

"Sort of. Yes." Billie nodded. "Let's go."

She demanded them all to put on their trauma gowns and did the same thing, then proceeded to walk into the ambulance station. Her interns followed her out excitedly due to the adrenaline that the first day entailed. Outside, the ambulances were already pulling up, flashing every-colored strobe lights.

"What do we got?" Billie asked the paramedic as the stretcher was offloaded from the ambulance.

"Nancy Walters, thirty-four-years-old, thirty-five weeks pregnant. Complete upper arm amputation. Pressure dressing applied, two large-bore IVs started," he said.

Billie immediately used her stethoscope to listen to the woman's heartbeat while the patient spoke. "Did he say arm? My arm is gone?"

"Ms. Walters, you're gonna be okay. Black, check the wound." Bailey, who was also there, demanded, to which the now second-year resident hung her stethoscope around her neck and removed the bandage from her arm, where a clean cut was shown to have completely amputated the limb.

"It's a clean cut," she informed.

"I really need my arm," Nancy mumbled.

"Ms. Walters, you're gonna be fine. We're gonna take good care of you." Billie nodded, then turned to her interns. "Rogers, Campbell, you're with me on Trauma One. Miller, Emerson, Keys, go to the supply closet and bring me disinfectant and gauze, lots of it, now."

☆

Standing in the trauma bay with her interns lined up behind her, Billie brought in the ultrasound machine to check on Nancy's baby, but soon caught sight of all of the younger doctors doing nothing in particular.

"Well? Don't you just stand there!" she scolded. "Which one of you can tell me potential complications of a traumatic amputation?"

The interns immediately raised their hands, frantic to be picked, to which Billie pointed at who she knew to be called Adrian Miller.

"Miller."

"Uh, well, people with diabetes or heart disease have a higher risk for complications. Some of these include joint deformity, hematoma, infection, necrosis, blood clots in the deep veins of the limb or lungs, bleeding, shock, and death." He nodded proudly at his statement.

"Good... maybe we should work on your facial expressions a bit." Billie frowned in concern, but then shook her head. "Come over here and clean the wound."

Adrian smiled excitedly and mocked his friends, then proceeded to walk over to the opposite side of the bed and grab the gauze in order to disinfect the cut. Meanwhile, Billie began performing the ultrasound.

She analyzed the image on the screen. "Keys, what am I looking for here?"

"Fetal heartbeat," she replied sheepishly, but instantly.

Billie nodded just as none other than Mark Sloan walked into the room, to which they smiled at each other.

"What do you got for me?" he asked immediately.

"Nancy Walters. Complete amputation. Baby looks fine, but she's having some contractions."

"Hey, Nancy, I'm Dr. Sloan. Mind if I take a look?" Mark walked up to the patient on the bed, urging Adrian to move over to leave him space. He immediately left the seat and crowded together with his intern class.

"It's a clean cut. Beautiful." Billie glanced over at the severed arm.

"Impressive." Mark nodded in agreement. "Hang antibiotics and put a sterile moist dressing. There's a chance of a good recovery here. Do we have an arm?"

"Campbell, Rogers, you're on it," Billie ordered, then looked at Mark. "They're looking for it."

Nancy looked up. "My baby has no father. He's already down two arms, so he really needs me to have an arm."

Mark nodded. "Billie, since you brought the babies with you, why don't you make them do something useful and get them to find that arm?"

☆

An hour went by in which the interns worked hard to find Nancy's arm. In the end, a man came in through the ER doors carrying it, to which they took it to Mark and Billie to verify the state and, once they were sure they were able to reattach it, the attending sent his resident to debride the arm before surgery.

As she did so, sitting by Meredith in an empty exam room, Cristina walked into the room.

"Still no sign of Burke." She sighed. "Oh, you've got a severed arm."

"My arm. Mine. Get away from it." Billie hissed back.

"Maybe he's not on today," Cristina ignored her words, talking inwardly, as if internally trying to figure out where Burke could be.

"Maybe you should just see him and get it over with." Meredith shrugged.

"Oh, no, no, no. If I never see him again, I won't care." She covered her face with her hands, sighing into them.

"Well, I've seen Alex. I've also seen Mark. I've seen all of my boys." Billie nodded. "The one I still haven't seen is my brother though."

Cristina looked up. "Oh, he's in a case with me."

"Wait, he is?"

"Yeah. Internal decapitation. He's actually kinda cool, I like him much better than Shepherd." She groaned.

"No! Cristina, that's not how this works! We're supposed to be in this together!" Billie whisper-yelled, horrified at the thought of her brother bonding with her best friends. "You can't like him! We hate him! Ian LeBlanc hate club, right?"

"Yeah, okay. You're weird."

Meredith shrugged. "I've seen Derek and Derek has seen me."

"And?"

"Awkward. Plus, he seems to know Lexie."

"And?"

"More awkward. Your intern is my half-sister. How weird is that?" Meredith shook her head.

"Your half-sister is kinda hot." Billie shrugged nonchalantly, recalling the moment earlier that day where she'd caught sight of the younger Grey.

The blonde glared at her. "Don't."

Just then, Izzie walked into the room. "I'm trying to save Bambi's life. My interns think I'm a loser." She looked down at Billie's work. "Severed arm."

"Callie's a bitch." Alex sighed as he strode into the room as well.

"Word." Izzie rolled her eyes.

"She won't let me off my patient and there's nothing wrong with him. Except he's a nut job." He looked down. "Severed arm."

"Does anybody know anything about deers?" Izzie then asked. They all turned towards her.

"They taste good." Alex raised his eyebrows.

"Evil," she glared at him.

"Wait, when you said Bambi, you meant like an actual deer?" Billie held back her laughter.

"Yeah."

A chuckle escaped her lips and she looked back down at the severed arm she was supposed to be debriding. She couldn't believe how extra Izzie could be, taking upon tasks that had absolutely nothing to do with her actual job.

A second later, the door opened and they all caught sight of George, who stood under the sill expressionless. Cristina turned towards him.

"Oh, George, severed arm." She hooked her thumb over her shoulder, pointing at the limb on the table. "Plus, Mer's half-sister is my intern. Izzie's playing Dr. Dolittle. Billie's still hating on her brother. Oh, and Alex hates your wife."

George simply looked at them, deadpan. "Dr. Sloan's ready for the arm."

He proceeded to walk away, leaving the rest of the interns to grimace at his sudden wryness. Billie raised her gloved hand.

"I'll say it. George is being an ass."

"I think it's my fault. I said some things and now, he's not talking to me." Izzie shrugged sadly, making Billie stare in her direction.

"You're always the one who fucks up, aren't you?"

"I don't know what he's got to complain about. Those new chick interns are hot." Alex dismissed her words with a smirk.

"Alexander Michael Karev, you get your crusty junk anywhere near my interns, I'm gonna gut you." Billie threatened, causing Alex to frown in slight fear.

"He's married, Alex," Meredith reminded.

"Yeah. He's married," Izzie chorused.

"You know who's seriously hot? That Lexie girl." Alex then nodded, causing Billie and Cristina to burst out in laughter under their breaths.

Meredith glared at him. "Get out before I hurt you."

He began walking away. "I'm going over Callie's head to Bailey."

Cristina frowned. "Uh, Callie is over Bailey's head."

"Spiritually, Bailey's over everyone's head," Billie said. "Hey, did I mention? There's an Alex Karev wannabe in my intern class."

"Oh, I would very much like to see that." Cristina laughed amusedly. "If you know what I mean."

Billie laughed. "Oh, I bet you would."

☆

"Okay, people, I'm going into surgery with Dr. Sloan right now," Billie said as she stood in front of her interns, who awaited her words with palpable excitement. "I'm gonna ask four questions that, if you're competent enough, you should know. Whoever gets more correct answers will scrub in with me."

The five interns shared exhilarated looks and prepared themselves for the game, knowing it could possibly result in a chance to their first surgery.

"Okay, let's go. Question number one," she began. "What drug is used to treat overdose?"

All of their hands immediately rose up frantically, to which the resident chose Jay. "Naloxone!"

"Correct. Jay, one. The rest of you, zero. Question number two," Billie nodded in excitement. "What is the procedure done on patients with pectus excavatum to fix the depression of the chest?"

This time, only Jay, Cassie and John's hands shot up, and the chosen intern was the latter, "Aortic repair, scoliosis treatment, breastbone corrections and eye surgeries!"

"Incorrect. Those are all procedures that can be used in the treatment for Marfan syndrome, which is usually associated with pectus excavatum, but they're not the same thing. Sorry, John." Billie clicked her tongue and shrugged. "Uh... okay, Cassie."

"The Ravitch procedure!" she yelled out in eagerness.

"Correct. Jay and Cassie, one. The rest of you, zero. Third question," Billie continued. "What is intravenous gentamicin?" This time, it was only Jay who raised her hand. "Emerson?"

"It's an antibiotic prophylaxis."

"Correct. Last question." She smiled, leaving a little silence for suspense. "What's my second name?"

This time, nobody raised their hands and they were flooded by silence. The interns shared disappointed looks, knowing they wouldn't be able to scrub in on their first ever surgery, but Billie simply chuckled.

"Just kidding. What is the triangle of death?"

"Acidosis, acquired coagulopathy and hypothermia!" Jay yelled out at the top of her lungs in a very Cristina-like fashion before anyone could say anything else, to which her smile faded and she shrank back. "Sorry."

"That's okay. Emerson, you're scrubbing in with me." Billie smiled, then proceeded to walk off in order to get ready for surgery.

"So I'm just better than all of you?" Jay mocked her friends once she was sure her resident was out of earshot.

☆

Freshly out of a surgery in which they had managed to reattach Nancy's arm and, to top it all, George had singlehandedly delivered her baby on his own, Billie walked out into the hall, wearing the post-surgical gown. She came up to the nurses station in order to update her patient's chart, but as she did, she didn't notice Ian approaching her discreetly, two coffees in hand.

Slowly, he stood by her side next to the counter and slyly slipped the carton cup towards her, causing Billie to stop her scribbling and look up at him, disbelieving.

"What are you doing?" she asked, expressionless.

"Coffee," he mumbled over the rim of his own cup, taking a sip from it and keeping intense eye contact with her.

Billie looked between him and the coffee briefly before she used her hand to knock the cup to the ground, causing the lid to come loose and the caffeinated beverage to spill all over the floor. A few heads turned in their direction, but Billie simply remained unfazed.

"I don't want your stupid coffee," she said.

Ian looked down at the floor and pressed his lips together, trying to hide his strike of sadness at the lost coffee. "I spent three bucks on that."

"Good." She glared at him before she was walking away, leaving him behind with a small crowd of nurses staring at him.

☆

Billie was already changed back into her street clothes and was now making it her job to tie the laces of her boots alongside Meredith, Cristina and Alex, all of whom were also changing out of their scrubs. However, as the brunette was about to head out, Izzie walked in, wearing a big smile on her face.

"I saved Bambi! I mean, not George Bambi, but I saved the deer!" she squealed proudly.

"Uh... congratulations?" Meredith frowned weirdly.

"Oh, please don't tell me you're becoming a veterinarian. We've had enough vets for a lifetime." Cristina rolled her eyes. Alex snorted.

However, Billie's mouth fell open a little. "Wait, when you said all that stuff about the deer you actually meant... a deer?"

"Yeah, why?"

"No, I just-" Billie began laughing softly, soon growing into a prolonged chuckle that lacked decorum, unable to stop. "I just- I- I thought you were joking."

"No, I wasn't joking. The deer got ran over and I saved it, what's wrong with that?" Izzie shrugged nervously, looking over at the rest of her friends, who simply shook their head in lack of understanding.

The brunette kept laughing- "Wow, Iz, you're really- God, you really are a joke after all, huh?"

"Okay, what the hell's your problem?" The blonde shook her head.

"Uhm, you!" Billie's laughter died out along with her good mood and she stood up, walking towards Izzie threateningly. "You come in here, talking about things that nobody gives a crap about, such as, uhm, let me think... maybe the fact that you saved a fucking deer, which really couldn't be more pathetic. Then you make it all about you and you make yourself the victim of every existent scenario, even the ones you're not involved in, and you're so... fucking... dramatic! It's exhausting, Isobel. It makes me want to grab you by the hair and put your head down the fucking toilet. And all that thing with George that you got going on-yeah, I know about that-it's fucking sickening, and it repulses me in such way that somedays, I can't even hold it together and I wish I could just fucking scream it out loud, just so that I could see the look on your face when your sad little life comes crumbling down! So you don't get to be mad at me, when all you've ever done in your life is ruin everything around you!"

The silence fell upon the room. Billie's shouting had called the attention of every resident in the locker room, causing a small crowd to gather up in order to witness what was going on. Her chest was left heaving due to the adrenaline pumping through her veins and she glared in Izzie's direction, then turned around to grab her bag.

"Oh, my God," Izzie whispered under her breath, realization hitting her like an anvil. "You're still mad about Denny."

Billie froze in her step, her back towards the blonde. "Excuse me?"

"You're still mad about Denny." She laughed in disbelief, shaking her head slowly. "Get over it, Billie! It's been almost a year. Get freaking over it!"

Billie took a deep breath, but really, at this point, there was nothing anyone could do to save the situation that was about to happen. She steadied herself, closing her eyes to remain calm, but without anybody expecting, she turned around, swung her arm into the air and ended up punching Izzie straight on her jaw.

At the scene, Meredith, Cristina and Alex immediately bolted to their feet, watching as the blonde stumbled back and held her face in pain. But somewhere, deep down, they all knew she deserved it, so they didn't run to her aid.

"Get freaking over it, Izzie," Billie mocked coldly, then turned around.

She walked over to her locker, which Alex was standing next to, and proceeded to slam it shut. Billie then examined him for a second, eyes squinted.

"I do like the haircut, Alex." She nodded before she walked out of the room.