chapter forty-one ━ the return of amelia shepherd
( season eight, episode fifteen )

❝I told you to stop calling me
that.❞

WHEN ELLIE WAS six years old and in kindergarten, she was asked to present her family tree. Even at a young age, she knew it was not normal for her parents to be as distant as they were. Her classmates' parents would volunteer to be the 'classroom parent', but her parents never did.

Mark did whenever he could.

But she never understood while doing the assignment how the Shepherd family never fit into the tree. They were her brother and sisters as much as Mark was. But they never fit into the tree.

That was when Mark sat her down and explained that they were family friends who were like siblings.

As she grew up, she understood that, and she never tried to step on the Shepherd sisters' toes when it came to Derek. They had their brother and she had hers.

But that didn't stop how much it hurt when Amelia snapped at her for being Derek's 'favorite sister' when she was in LA. The one thing she never wanted to do, she had done—unintentionally, of course.

Ellie was sitting in her office, figuring out the OR schedule when she heard her pager go off. With a small sigh, she looked down at it.

Dr. Derek Shepherd — 911, x-ray room

She let out a breath and stood up from her desk, making her way to the scan room. Just as she was about to walk inside, she heard Derek's voice. "Amy, I am telling you, it is unresectable." Ellie paused. "Let it go."

"I came all the way from LA to show you this," Amelia replied and Ellie peered around the doorframe, her eyes landing on the youngest Shepherd sibling; she looked to be doing better. "You could spend more than thirty seconds looking at it."

"I am looking at it," Derek retorted with a frustrated groan. "It's a gliosarcoma that has invaded the carotid artery. You try and remove it, she will stroke out."

Amelia scoffed. "Stop being a jackass."

"Dr. Grey." Derek looked at Lexie who had awkwardly been put in the middle. "Excuse us."

"Dr. Grey," Amelia countered, still looking at her brother. "Stay here. I need backup."

Ellie shook her head and walked inside the room. "Dr. Grey," she said, clearing her throat and everybody looked at her. "Give them a moment, please." Lexie nodded and hurried out of the room, grateful to escape the tension. "Thank you." The blonde looked at the younger neurosurgeon. "So... you're in town. Does that mean you're doing better?"

Amelia nodded. "I am."

"Good."

"That's a good point," Derek said, pointing at Ellie who frowned. "You just got out of rehab. I want you to get on your feet. But you can't help her."

Amelia stared at him before pulling out her phone. "Look at his face," she told him, holding up a photo. "His name is Mason. This gliosarcoma belongs to his mother, Erica. He's a great kid. I don't know him that well, but he seems great. I do know his dad well—his name is Cooper. You met him, Ellie." Derek glanced at her. "He works with me and he is a good guy. He is a good dad, which means that he is the one who is gonna have to tell Mason that his mom is dead. That he doesn't have a mom anymore because we didn't do anything."

"You tell Cooper that you're sorry," Derek replied, opening the door. "You tried. Let it go. I have a surgery."

Ellie watched him walk away just as Amelia turned to her. "Ellie?"

"I'm sorry," she said, glancing back at her. "I have an OR to schedule. You tried, Amy. I'm sorry for Mason. And Cooper. Really."

She pressed her lips together and started for the door. "Wait, Ellie, I—" She paused and Amelia let out a breath. "I'm sorry."

"For what?"

"For what I said when you were in LA," she said and Ellie sighed. "That you had to see me like that. I know you were just trying to help."

Ellie ran a hand through her hair. "Is that actually how you felt?" she asked her quietly. "Do you actually feel like Derek prefers me over you?"

Amelia paused before slowly shrugging. "Sometimes."

"Why?"

"Because!" Amelia exclaimed, throwing her hands up in the air. "Because you haven't done anything that would make him disappointed. You don't drink, you don't do drugs, you—you're perfect! And he doesn't get annoyed by you."

"Amy—"

"I'm sorry I said those things," Amelia said and Ellie let out a breath. "But everybody knows it's true. We all know it, Ellie. Because you're also my favorite sister. And I shouldn't have used it as an insult."

Ellie closed her eyes and rubbed her lips together. "It's okay," she whispered before pulling her into a tight hug, burying her head in Amelia's dark hair. "It's okay."

Amelia smiled to herself. "I love you, baby Sloan."

Ellie rolled her eyes. "I told you to stop calling me that."

"I know." A small smile tugged at the corners of the blonde's mouth as she pulled away from the hug. "So... can you try and convince Derek to do this surgery? Use your favorite sister powers."

"You know that it has to be you," Ellie replied, sighing to herself. "I can try, but I think you have to prove yourself to him. And you brought the case. You know it the best."

Amelia nodded. "You're right."

Ellie patted her on the cheek before leaving the room and towards the surgical board. She saw Jackson and April already in front of the board, flashcards in the plastics resident's hands.

"Sixty-five-year-old woman enters the ER in shock," he read as Ellie took hold of her marker. "Presents with a pulsatile, expanding abdominal mass. Go."

"Ruptured triple-A," April answered, confidently. "I would take the patient straight to the OR and access the peritoneal cavity through a vertical midline incision."

Jackson nodded. "Nice."

"You guys are studying for the oral boards in the middle of the day?" Meredith asked, walking up to the group.

April smiled. "Just another benefit of having a study buddy," she replied brightly. "You should get one."

"I have one," Meredith said sulkily. "It's just that my stupid study buddy's too busy trying to save her stupid marriage to actually help me study."

"Well, you know what's better than a study buddy?" Alex asked them and Ellie glanced at him. "A study lackey. Check it. Hey, you! Brown-haired girl, you're up."

"Uh, trauma incident or a surgical situation?"

Ellie groaned to herself. "You made your interns come up with study questions?" she asked and he smiled back at her.

"Surprise me," Alex said to the intern and the blonde shook her head.

"A twelve-year-old boy fell off his bike, hitting his abdomen against the handlebars," she read off the card. "Complains of progressive abdominal pain and is short of breath."

Jackson looked down when he heard his pager go off. "Sloan. 911. Do I really have to go?"

"Yes!" Ellie exclaimed, pushing him in the direction of the ER. "I get to break some bones today. Yay!"

☀️

ELLIE WALKED TOWARD the ER with Callie. "How would you like to be my assistant teacher today?" the ortho surgeon asked her resident.

"Uh—why?" Ellie asked when Meredith came up to them.

"Dr. Torres, Dr. Webber suggested—"

"Uh-uh," Callie interrupted, shaking her head. "Here's how this is gonna work—I talk and you listen. You're here because you and your little pals are all freaked out about the oral boards—well, except for Ellie—and Dr. Webber suggested that Callie Torres might have a special secret study method, right?"

"Mm-hmm."

"Yeah..." Callie nodded. "Dr. Webber's correct. Callie Torres does have a study method—an excellent study method—but she's not about to just give it away. Callie Torres' study method has to be earned. Frankly, she doesn't think that Meredith Grey has what it takes. Ellie Sloan, meanwhile, is bound to succeed because she remembers every detail of every surgery she's ever done."

Meredith furrowed her brows. "I think she does?" she replied, though it sounded more like a question. "I think Meredith Grey has what it takes?"

"Ellie Sloan is wondering why we're all talking in the third person," Ellie piped up before starting to walk through the crowd that had gathered around her patient.

Callie shrugged and looked back at the general resident. "For her sake, Meredith Grey better hope she's right, 'cause today? Today is gonna be a grind."

Ellie glanced at the two who had joined her and smirked at Meredith's face. "Welcome to ortho." She looked back at their patient, his arm stuck in a meat grinder. "Are you ready?" She nodded at Callie. "I'm in."

☀️

ELLIE AND CALLIE were both examining the arm that was stuck in the meat grinder while his friends stood around him. "Hang in there, Dom."

"Yeah, you're looking good, bro, real good."

"You're lying, Tommy," Dom said to him. "I look like Sopressata."

"Don't worry, Dominic," Ellie told him, trying to reassure him. "We just gave you some drugs for the pain. You're gonna start to feel better real quick."

Meredith looked at the orthosurgeon. "What do you think, Dr. Torres?" she asked and Ellie glanced at her. "Is this an amputation?"

"I—I don't know," she said. "Is it? Don't answer, Sloan."

Meredith paused. "What?"

"No, you tell me, Dr. Grey," Callie told her. "Does this look like an amputation to you?"

She looked down at the fingers that were crushed by the meat grinder and nodded. "I mean... yeah."

"Amputate?" Dominic repeated, shaking his head. "No, you can't. I need my hand. Tommy, don't let them take my—"

He suddenly fell asleep and Tommy's eyes went wide. "Whoa. Is he—"

Ellie shook her head. "No. Those are the drugs. They work quickly."

"Just like we have to," Callie added.

Mike, another of his friends, looked at them. "But you're just gonna cut off his arm?" he asked. "I mean, I—"

"No." Callie shook her head in response. "This is a teaching hospital, Mike, okay? I'm doing a thing." She looked back at Meredith. "Grey, here's how it's gonna work if you want my help on the boards. You're gonna run this. Ellie already has my teaching strategy which means that she'll assist. You're going to decide our course of action. You're going to be the person that stands between Dominic and a hook for a hand. You in or out?"

"I already said that amputation is our best option."

"Ooh." Callie tilted her head. "Best?"

Meredith nodded. "Yeah, best."

"Okay." Callie shrugged. "So book an OR and fire up the bone saw," she said. "Let's move him out, people. Grey wants to amputate."

"Woah."

Ellie nudged Meredith on the shoulder and motioned to his hand. "Feel," she whispered and she looked at the ortho resident.

"What?"

"Feel for fingers," she elaborated.

Meredith looked at her weirdly before examining the hand. "Dr. Torres, wait." Ellie smiled to herself. "I have a finger here."

"I knew that already, Grey."

"No, a viable finger," she continued before squeezing it. "Look at the cap refill."

"I—Is that good or bad?" Mike asked and Callie shrugged, looking back at Meredith.

"Is that good or bad, Dr. Grey?"

"It's good," Meredith told them.

Callie nodded. "Alright. So what do you want to do?"

She wanted to take apart the meat grinder. That was what Meredith Grey wanted to do. And let Dominic's friends do it. Callie sent Ellie to take a break and come back when they had made more progress.

"You're not gonna hear me complain..."

☀️

ELLIE WALKED INTO her office for lunch and saw Jackson sitting on her couch. "What are you reading?" she asked him, taking out a Diet Coke from her mini fridge.

"Sloan and I have a patient who is a former patient of Bailey's," Jackson replied with a sigh, looking up. "And the only way she'll agree to let us do the surgery on him is if I read all of this." He held up a thick booklet of information and her eyes widened. "So, that's what I'm doing."

Ellie nodded and sat down beside him. "Hmm. Fun. In other news, Amy is here."

He paused and looked back up at her. "Isn't that the first time you've seen her since—"

"LA," she said with a nod. "Yeah."

"Oh." He nodded. "Well, how is she?"

She shrugged, opening her can. "She seems fine," she replied. "At least, that's what I'm hoping is true. She's trying to convince Derek to do a surgery."

"And I imagine that did not go well?" he asked.

"Of course not," she said and he chuckled to himself. "Lots of yelling. But, hey, how's the studying going?"

"Could be better," he replied. "You?"

She nodded. "I have everything logged. I think I'll be fine. So long as I don't short circuit at the worst time."

"I wish I had a photographic memory," Jackson said, leaning back on the couch. "That would make studying so much easier."

Ellie shrugged. "It's a blessing and a curse. Blessing—I remember everything. Curse—I remember everything." She looked down at her watch. "Oh, I gotta go watch Meredith get a hand out of a meat grinder."

"Wait." Jackson stopped her from standing up and she looked back at him. "You have an eyelash." He brushed it off her cheek with his thumb and her blue eyes found his green ones.

"Uh..." She blinked and cleared her throat. "Th—Thanks. I gotta go." She hurried out of her office and brought a hand up to her cheek, her face turning red. "What just happened?"

☀️

CALLIE WANTED TO test Meredith's knowledge of ortho, which was how she ended up in the observation deck of their surgery, sitting beside Alex who was laughing at the resident's misfortune. "There she goes again," he said, pointing at her. "She's gonna yack."

"Would you quit with that?" Jackson asked from the other side of Ellie while she gave Alex an amused look. "I gotta finish this thing before I go into surgery." She glanced at the papers he was still reading. "Hey, where is your study lackey?"

Alex sighed. "Of course the one competent intern in the whole program just so happens to be pregnant and needs surgery for a coronary artery dissection."

Ellie frowned just as Lexie and Amelia walked into the gallery. "Morgan needs surgery?" she asked him.

"How do you know about Morgan?"

"Everybody knows about the pregnant intern, Karev," Jackson replied and Ellie nodded in agreement just as his pager went off. "And that's the surgery. Here we go."

"You got this!" Ellie called out to him. "Just don't freak out!" He gave her a thumbs-up as he left the room and she looked back at Alex. "Wait... So if Morgan needs surgery, then why aren't you with her?"

"My attending gave me a job," he said in annoyance. "Call the boyfriend. I left, like, six messages."

Ellie shrugged with a small sigh. "Well, Chris is a fourth-year at Cleveland Clinic. I mean—You know how busy it gets."

Alex glanced at her. "How do you know his name?" he asked.

"She's always known random facts," Amelia answered for her. "If she's read it somewhere, she remembers it."

Lexie looked down at her sister's surgery. "They're not just amputating and fitting him for a prosthetic?"

Alex shook his head. "No. She thinks she's gonna be able to salvage the finger bits and reattach, but she's cracked."

"Callie is also testing Meredith," Ellie added, giving Alex a weird-slash-concerned look; she wasn't entirely sure what emotion she should feel for him.

"That's gonna be so much harder," Amelia said.

Ellie glanced at the woman. "Alex, have you met Amelia yet?" she asked. "Amelia Shepherd, Alex Karev."

"Oh, Shepherd's sister," Alex said with a nod. "Nice to meet you."

"You, too."

Lexie straightened up suddenly as though an idea was coming to her. "You know what else would be harder? Going through the carotid."

"For fingers?" Alex asked.

Ellie shook her head, still watching the surgery. "They're not talking to us. I've learned to just tune out the talk of the brain."

"It would be harder," Amelia agreed with a nod. "But there'd be better control than going through the femoral."

They shared a smile and hurried out of the room. "Good luck!" Ellie called out to them before standing. "Alright, I'm gonna go watch Jackson's surgery."

"You're blushing."

"Shut up."

Ellie walked over to the OR next door and sat down in the observation deck. "Oh, that's a good-looking lymph node," Mark said. "You got it?"

Jackson nodded. "Yep. Oop."

"Did—Did he say 'oops'?" Ellie furrowed her brows at the sound of Miranda Bailey's voice and found her standing in the back of the OR.

Mark tensely smiled, not looking up from his work. "Dr. Bailey," he said. "What a pleasant surprise."

"The man said 'oops'!"

Jackson shook his head. "I didn't. Actually, Dr. Bailey, I said 'oop'."

Ellie chuckled to herself in amusement and Mark looked up at the general surgeon. "He was picking up a lymph node, almost dropped it, but didn't," he told her. "Let's make some room so Dr. Bailey can get a better view of our every move. How's the view from up there, Ellie?"

Jackson followed his gaze, not knowing the blonde was up there. She nodded. "Crystal," she replied. "Keep going."

Mark nodded. "As you were, Avery."

Jackson glanced back at Ellie who gave him an enthusiastic thumbs-up making him smile to himself as he looked down at the procedure in front of him.

"Y—You—You don't want a little more suction, Avery?" Bailey asked him with a frown.

"Dr. Bailey," Mark interrupted. "While I'm always glad to hear your perspective, I'll instruct the resident."

"But your instructions result in 'oops'," she countered. "We don't 'oops' in my OR."

Mark took in a breath. "Let's try a little more suction."

Jackson took the opportunity to look back up at the gallery and she noticed the annoyance starting to creep into his features. She gestured for him to take deep breaths which he did, starting to feel better. As the surgery continued, both Mark and Jackson were becoming increasingly annoyed by Bailey.

"I'm ready for the transfer, Avery," Mark said.

"Dr. Sloan."

Mark paused and nodded. "Yes."

"You know that this patient has a history of multiple surgeries in that area," Bailey said, standing directly behind the plastics surgeon.

"She sure does."

Bailey nodded. "Okay, then I don't understand why you think it's a good idea to continue to dissect right there."

"Respectfully, Dr. Bailey, it's not entirely important that you understand everything I do every step of the way," Mark replied.

"Uh, no, respectfully, Dr. Sloan, I disagree," Bailey said and Ellie glanced between them as though it was a ping-pong game. "I think it's extremely important. Now, if you had read the file like you said you did, you would know that she'd have massive scar tissue exactly in the area that you're dissecting, so I think going forward with that dissection is a monumentally stupid course—"

"Respectfully, Dr. Bailey—uh—the bulk of that scar tissue is gonna be found near the axilla," Jackson interrupted the attending and Ellie looked over at him. "So, if Dr. Sloan continues dissecting right there, I really don't think there'll be a problem. And I—I read that in—in—in the file. The file that you—Carrie's file—that you gave me to read. I... I did... I did read it."

Ellie leaned back in her seat, a small, proud smile coming to her face.

Suddenly, the monitors around them started going off. "Damn it."

"Respectfully, doctors," Bailey said and they looked at her. "I told you so."

Ellie rested her arms on her knees, her foot tapping nervously as she watched the two plastic surgeons continue their work and Bailey continued to talk to them.

"One more clamp, please," Jackson said.

"Vascular clamp," Mark added. "It's still oozing. Dr. Avery, how do you want to proceed?"

Jackson paused. "Um..."

"Come on, Jackie..." Ellie muttered to herself, watching him find the answer while Bailey stood behind him, making him more nervous. "Come on... You know it. You know the answer..."

"I—uh—I don't—I don't know."

She hung her head and Bailey frowned. "Oh, he did not just say 'I don't know'. Man, tell me what you see!"

Ellie stood up and began pacing the observation deck. Bailey, meanwhile, had walked around to the other side of the table and Mark was talking to Jackson. "Dr. Bailey..." She paused and looked down. "You need to leave this OR."

"Excuse me?"

"This patient—my patient—developed a subclavian bleed because we misjudged her adhesions," Jackson said and Ellie found herself sitting down once more. "But I am now doing an arterioplasty, which is not an easy thing to do, and you are making it more difficult by distracting me. You are compromising my ability to care for my patient, Dr. Bailey."

"Well, if you're telling me you can't focus in—"

"I'm telling you that you need to get out," Jackson interrupted, looking at her. "Now."

"Oh, Dr. Sloan," Bailey said, still looking at Jackson. "If you let your resident speak to an attending this way—"

"Dr. Bailey, I believe Dr. Avery made it very clear," Mark said, siding with him. "Leave the OR... or I'll have you removed."

Bailey looked over at Mark before leaving the OR in a huff. The plastics surgeon glanced up at the gallery and back down at the surgery. "I think you impressed her," he said making the resident furrow his brows in confusion.

He looked up at the observation deck where Ellie was still sitting and she smiled at him. A faint blush reached both their cheeks, though neither noticed the other. Mark glanced between them as Jackson went back to their surgery and nodded.

☀️

"THAT WAS IMPRESSIVE, Dr. Avery," Ellie said, leaning in the doorway of the resident's lounge. "I didn't think you had it in you."

Jackson turned around at her voice. "I won't lie... that was kinda terrifying."

Ellie laughed lightly and began walking toward him. "But you handled Bailey. Not many residents can do that. Or attendings, actually. And the surgery was successful."

"It was."

She smiled. "Come on," she said. "Let me buy you a congratulatory dinner."

"Yeah?"

She nodded. "Yeah. Unless... you don't want free food?"

"No, no, I do."

"Well, good." She pressed her lips together. "Five minutes. I'll see you outside. Good job, Jackie." He began to turn back to his cubby when she stopped him and wiped his cheek with her thumb. "Eyelash," she whispered. Jackson found her blue eyes and she patted his shoulder, looking away from his gaze. "Five minutes..."

"Right..." He nodded and watched as she left the lounge. "Five minutes..."