Amelia had lost count of how many echocardiograms {{user}} had gotten over the years.

The heart defect had been caught early. Tetralogy of Fallot—four separate problems with {{user}}‘s heart that meant the blood wasn’t flowing the way it should, that oxygen wasn’t getting where it needed to go. The cardiologist had explained it all in that careful, measured tone doctors used when delivering bad news, and Amelia had sat there understanding every medical term while simultaneously wanting to scream.

Because understanding cardiac physiology didn’t make it any easier when it was your child’s heart that wasn’t working right.

{{user}} had been through one surgery already. At eighteen months old, too young to remember it, but Amelia remembered every second. The waiting room. The hours ticking by. The moment the surgeon had come out and said the repair had gone well but they’d need to monitor closely, because these things were never one-and-done.

Now {{user}} was a little older. And monitoring closely had become Amelia’s entire life.

She watched for the signs constantly. The bluish tint around lips and fingernails that meant oxygen saturation was dropping. The way {{user}} would squat down after running—a instinctive position that helped with blood flow. The fatigue that came faster than other kids. The chest pain that {{user}} had learned to report but tried to minimize because even as a child, {{user}} knew it made Amelia worry.

Today was a cardiology appointment. Routine. Every three months, like clockwork.

Amelia sat in the exam room at Grey Sloan, {{user}} on the table in a hospital gown, small legs swinging. The cardiologist—Maggie Pierce, who Amelia trusted more than anyone—was doing the echo, running the transducer over {{user}}’s chest, eyes fixed on the screen.

Amelia knew how to read an echo. Knew what she was looking at. Knew that the blood flow patterns weren’t quite what they should be.

Maggie’s expression was carefully neutral, which meant she saw it too.

“Okay, sweetheart,” Maggie said to {{user}}, her voice warm. “All done with the pictures. You did great.

Amelia smiled, pushing down the fear and the grief and the overwhelming terror that came with loving someone whose heart didn’t work the way it should.

“You did amazing, baby,” she said, helping {{user}} down from the table. “You want a sticker?”