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ladywolfmd · 7 years

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Ars Longa Vita Brevis

Summary: "The Art is long. Life is Short." - Hippocrates Jon is a fresh board certified Trauma Surgeon, attending conventions and workshops in between looking for a hospitals and moonlighting to start on a real practice. On one convention hosted by The Emergency Medicine Department of Casterly Rock Metropolitan Hospital, he chances upon seeing Dr. Sansa Stark, a fifth year Neurosurgery Resident. The last time Jon saw Sansa, she was a first year med student while he was a third year and were both attending a summer suturing workshop in Highgarden.

(You can read this in AO3 too: http://archiveofourown.org/works/11545893

"Attention passengers, this is your captain speaking. We are just about to touch down at Lannisport Airport in about 10 minutes, and we are on time. The weather around Lannisport is clear and sunny and will remain throughout this summer solstice. Thank you for flying with us today."

Jon had just woken up with a start, the weight of sleepless nights after taking on extra shifts from two hospitals he was moonlighting in at Storm's End, still weighed heavy on his lids. Ever since he passed the oral boards - the final frontier before he could officially call himself a licensed Trauma Surgeon - five months ago, he's been busy scouting hospitals that would take him on so he could start his practice. So in between applications and waiting, and of course, after a well-deserved, long overdue vacation he took, (He went sandboarding in Dorne, with his co-residents, Ed and Ned. Namely, Edric Storm, and Edric Dayne), he was moonlighting in different ERs, joining medical missions, and of course, attending many conventions and workshops to keep sharp.

And this time, he would be going to a postgraduate course in Casterly Rock.

While waiting for the plane to land, he lazily looked out his window and marveled when he saw the outline of the famous Rock come to view even from still high up. The massive stone hill was the second tallest structure in Westeros, second only to the Hightower Castle in Oldtown, while The Wall rounded up the three as the third highest.

The unmistakeable rock indeed looked like a lion staring up the sun, and much as I wasn't a fan of the Lannisters in general (because frankly who is?), the Rock was indeed looking beautiful the closer we approach. Jon thought. Especially the ostentatious castle, which looked like a golden beacon on top of the hill - like an offering to the gods.

As the plane descended, Jon watched as even the waters of the Sunset Sea gleamed ochre, proving its namessake with the sun setting over it while red sails with golden lions dotting over the bay, signaling that they were now approaching the famous docks of Lannisport.

As more of the walled city showed itself, more reds, golds and lions as adorned by the uniforms of the men of the City Watch were everywhere, making Jon fight the urge to roll his eyes.

At least you had to hand it to the Lannisters. Spare no expense indeed and this will only get more grand and obnoxious in an in-your-face-you-are-in-Lannister-territory obnoxious, the closer we enter the lion's den.

Jon suddenly thought of his uncle Viserys and aunt Dany - and this time he didn't hold back from rolling his eyes.

Dragonstone wasn't better. He shook his head and chuckled, the view of the runway coming closer and closer as they approached.

Dragons and Lions and too bold colors. He shook his head again.

I prefer Direwolves.

This time he smiled more genuinely.

Once they landed in LanX, Jon was impressed with the service, for indeed, it was truly one of the world's best, never mind that Jon has never seen as many blondes in his life and he was just at the airport.

It only took Jon barely ten minutes through luggage and the checks when he was already on a shuttle to his hotel in Casterly.

The twenty minute ride went without issue. Jon was thanking the old gods that his cabbie wasn't chatty so he was able to enjoy the view of the Sunset Sea as it stretched out from up the skyway.

He took a moment to pull out the brochure and program souvenir they mailed him after he registered.

"The Emergency Medicine Department of Casterly Rock Metropolitan Hospital, welcomes you to its 78th Annual Postgraduate Course with this year's topic: "Breaking Brains and Bones" An Update on Head Traumas and Fractures, Approaches in the E.R."

Venue: The Lann Regency Hotel

July 12-13, 2012

The course was open to all specialties and even general practitioners and all allied health professionals but most of those who were going were, of course, Emergency Medicine specialists, General Surgeons, Trauma Surgeons - like me - Internists, and of course, with the topic, Neurologists, Neurosurgeons, and Orthopedic Surgeons.

Neurology was always a waterloo of Jon since medschool and since he won't be able to avoid head and spine traumas in the E.R., he quickly grabbed the opportunity to attend when Rhaenys, his older sister by his father, showed the ad for it when she visited him in Storm's End while she was attending an Obstetrics convention held there.

"Try and explore The Rock while you're there. For all the pride the Lannisters have, it's well founded there. It's honestly beautiful once you get past the sea of blondes," Rhaenys chuckled. "Anyway, you'll see Dr. Tyrion there and maybe Sarella."

Jon smiled. Dr. Tyrion Lannister was one of his favorite professors at Dragonstone University where he studied. He was a Neurophysiologist but was more famous for being a Bioethicists. He was also scheduled to do a lecture for the course and he'd be sure to attend.

Sarella Martell, however, was his sibling's cousins from their mother. She was an Anesthesiologist who specialized in Orthopedic cases as well as a Toxicologist like her father, Dr. Oberyn Maryell.

His thoughts were broken his phone rang. Dany. Daenerys Targaryen, Jon's aunt.

"Hello?"

"Jon! Are you in Casterly already?" came his aunt's cheerful voice.

"Almost. Still in the cab. How'd you know?"

"Drogo saw your name on the listings. He's asking if you're also staying at the Regency."

Drogo was Aunt Dany's husband. They met when she was assigned as a diplomat in Pentos. Drogo, in turn, was an Ortho jock there and it was no surprise that he would also be attending. Why didn't I think of this earlier?

"I'm staying at the Regency. Give me his number, I'll call and maybe we'll get drinks later," Jon always liked Drogo. Sure he could easily murder an army with his bare hands, but he was actually a decent guy - and putty in Dany's tiny hands. He smirked.

"Great! I'll send it. We've actually been there before so he could show you around. Tomorrow's the start of your thing, right?"

"Aye,"

"Perfect. I"ll tell him. Enjoy your time there - but not too much! Remember, dragons are better than puny lions," she giggled. "And you are still a dragon no matter what."

He snorted. "Okay." I changed my name, okay! Move on.

"The next responsible thing to do is to tell you to go meet a girl while you're there but I don't think I could stomach you bringing a Lannister to join our bloodline," she gagged. "Soooo... the compromise is to say, have fun and don't forget to use protection!"

Jon hung up, embarrassed, before he could hear her cackling on the other line.

Trust Dany to take a jab at my on-again, off-again relationship with Ygritte Ryder, an EMT I met in Skagos where she lived. Sure we weren't labeled or constant, but long-distance would do that to you. She's still my first love or infatuation or whatever worked and we talked and met up as we could, but we both knew that we were just each others 'in-betweens' until 'the one' comes along. I was nothing but fond of her and we did try more seriously but we both knew there was something that was amiss.

Before Jon could think further, the cabbie alerted him.

"We're here sir."

Jon stepped out the cab, grabbed his bags, and paid the driver before turning around and facing the entrance of the hotel.

The entrace of the Lann Regency was just as lavish as most everything was at Casterly. It was fronted by a giant fountain with the bottom filled with golden coins as part of the decoration, while the red tinted double glass doors were framed with a pair of pouncing lion statues made of gold of course.

Cars and shuttles and even limousines with flags came and went, with people, some in business suits, some in more casual travel ones, mostly went up looking to check in. Like Jon, most of the doctors opted to fly in a day or night earlier.

With one last look behind him, Jon started walking up.

"Here we go."

Day 1

After two of three sessions in the morning, they were given a fifteen minute coffee break. And breaks like these usually meant making the rounds on the different booths of the sponsors, set outside the plenary halls which included, for the majority, the different pharmaceutical and medical equipment companies, promoting and selling old and new products.

Jon was looking at one booth that sold surgical instruments from the brand he favored. While he was comparing the different pocket minor sets, Drogo came up behind him holding two black coffees.

Jon accepted one and thanked the hulking doctor with the long pony tail to match his long beard. "Thanks."

Drogo nodded. "Minor sets?" He looked at the table Jon was examining.

"Aye. Can't have enough of them," Jon half-smiled.

Drogo answered with a nod again, moving towards the drills and rods. Like Jon, he wasn't much of a talker - well, a sober Drogo anyway. Jon almost smirked at the memory of Drogo slurring along last night and drunk calling Dany. Almost because he also remembered his wake up call this morning with Dany telling him off for not keeping Drogo in check.

He looked him over and was impressed that there was not a trace of drinking on him. "So, Dany woke me up this morning."

Drogo leaned back as he laughed boomingly, his ponytail almost knocking out a guy behind him. He slapped Jon's back a little too hard then that if it weren't for all those long hours in basic army training he had, he'd have flown across the room.

Jon glared at him but Drogo just shrugged at him sheepishly. "The moon of my life is a woman of many words."

Just then we heard a girly voice. "Jon! Drogo!"

The two of them turned around and saw a short young woman with olive skin, dark curly hair and equally dark eyes. Sarella. She grinned when she finally reached them. "Hi."

"Hi Sarella."

Drogo, again, just nodded but at least he was smiling.

"Rhaenys told me you two would be here. I was just talking to Tyrion when his bitchy aunt Genna cut me off and shooed me away," she grumbled.

Dr. Genna Lannister was another famous Lannister, and like all Lannisters who were doctors, her field was neurologic as well. She was a Pediatric Neurologist and like most Pedia Neuros, she was a cutthroat bitch.

"Where are they now?"

Sarella's eyes brightened then. "Oh! I saw them going to the Research presentations from the Neurosurgery residents in Hall B." She eyed me then. "You should come, Jon. I saw your cousin's poster presentation, and she's one of the presenters - also the highly favored to win at that."

Cousin?

She noticed my confusion and exchanged a glance at Drogo who just shrugged at her. "Your cousin, Jon? Sansa Stark?"

Sansa - Sansa Stark...

She sighed impatiently. "You know. Tall. Very Pretty. Blue eyes. Red hair."

Oh.

"Seven hells, right, right. Of course. She's on her," Jon paused and did a mental math, "Fifth year?" How could I forget?

Sarella threw her hands up. "Finally! Yes. Honestly Jon, and to think that Rhaenys told me you were more Stark than Targaryen. You forgot your own cousin."

Jon felt a little guilty then. But among his Stark cousins, he wasn't particularly close to Sansa even though she was the only one who joined the medical field among them. He knew her as the pretty one or the doctor one. Between her attending boarding school at Highgarden and training at Oldtown, they really didn't get to meet each other often enough. Just a couple of times and mostly never went beyond polite greetings. Frankly, Jon didn't know how to talk to her.

"Come on, lets show our support!" Sarella all but linked one arm each with Jon and Drogo.

Drogo looked amused as Sarella, petite as she was, was leading two broody men to the hall.

Sansa.

Jon tried to remember the last time he saw her. And then he felt even more guilty when he remembered it was roughly nine years ago. But to his credit, he practically lived in the hospital ever since he started his residency and he was sure it was the same for Sansa. Residency meant missing family occasions, social gatherings - everything that entailed you have a life, basically.

He knew that, he swore he did. He knew she was on a neurosurgery residency at the Citadel Hospital. If there was one thing he remembered at the top of his head, it was this one because her entering the program drew attention. First because everyone assumed that she was going to Plastics with her delicate almost invisible stitching skills or maybe even Dermatologic Surgery for her natural beauty and genius-level IQ. But no. She wanted Neurosurgery. The "top of the totem pole" in the surgical elite - Jon rolled his eyes muttering 'god complexes' - but also the specialty that was sexist, continuing to be the most male-dominated field. Robb, her brother though, cleared that up after he told Jon that she was doing it for their brother Bran who was crippled at an early age after a freak accident near The Wall.

Nine years though.

July 2003

Jon was practicing his knot tying when he heard a frustrated huff from the table next to his on his right.

He looked to his side and saw a girl with red hair tied in one long braid, who was also practicing her knot tying - her brows were drawn together in concentration as she started undoing the knot she made - a clear indication that she did it wrong because a good knot was one that held but could easily be undone with one strategic pull or cut.

He looked around and he wasn't surprised that there were no other people who are practicing. After the morning session, most were still out for lunch. They were in a two-day basic suturing workshop at Ashford.

After another sigh, Jon worked up the courage to walk up to the girl who, from the looks of it, was definitely younger than him, but somehow was oddly familiar though he couldn't place her. He was lucky that he already mastered knot tying last year when he was still a second year medical student. But that took many frustrating moments such as what she was experiencing now. He was only able to master it because he looked for someone to teach him better and figured maybe that's what she needed too.

"Um, excuse me," he tried to smile through his nerves.

She looked up at him then and Jon saw the bluest eyes he's ever seen, rendering him mute for a moment.

Seven hells, a pretty girl. What am I doing?

But the girl blinked and looked at him as if she was trying to place him too but she didn't say anything and that was when he remembered that she was probably waiting for him to proceed.

Jon rubbed the back of his neck nervously and tried to smile. "Hi. I'm sorry. I - I, uh, doyouneedhelp?"

Her cheeks colored as she looked down, biting her lip, muttering an embarrassed and slightly defiant, "I'm good. Thanks."

Jon was tempted to go back to his seat but something pushed at him to keep talking to her. Struggling for words, he looked down instead to her knot tying kit and guessed where she was having trouble. On the dummy was one perfect square knot. His guess would be she was having problems with tying the second knot.

"One hand or two?" Jon tried again.

She reddened some more and sighed before looking up at him and admitting in a small voice. "Both actually."

Jon smiled kindly then. "The second knot is always the hardest. Especially if you have two left hands," he tried to joke. Cursing himself right after for how corny it was but her reaction encouraged him to continue.

A corner of her lips turned up and her eyes were warmer, never mind that there was a raised brow at that. "You know how to do it then?"

Jon nodded. "I know how to do it...I can teach you, if you want."

She smiled at him more genuinely then and motioned for the seat beside her.

Jon took his own set and placed it beside hers. "Okay, I'll show you how to do it first and then we'll do it together, sounds good?"

She nodded. "Sounds good."

"We'll start with one hand," he said as he started on tying the first knot. "Now for the second," he made the mistake of looking at her to see if she was watching and saw that indeed she was. She was watching alright, and watching very very closely, he could feel her breath on him.

Her eyes met his then and she frowned. "Why'd you stop? Go on."

Jon's neck turned pink and he swallowed before showing her how to do the second knot. "See? The trick is to know the position of the thumb. Wanna try it now?"

She nodded and quickly went to her own kit, while waiting for Jon to undo the knots. Step by step, Jon taught her while she mirrored perfectly on her own and after a couple of doing it on her own she beamed up at Jon.

"See? It wasn't that hard," Jon laughed nervously but felt some pride that he made her smile happily. She was a quick study, this student of his. He was right in thinking she just needed better instructions and to be honest - the instructions for this workshop was too complicated.

"Thank you," She grinned at him.

He blushed. "You're welcome. It's Jon by the way."

Her smile fell a little and Jon panicked.

She eyed him curiously before breaking into a smirk. "You don't remember me at all, do you? I mean, we met just once before but still."

Jon's eyes bulged and he wracked his brain but came up blank. He was sure he'd remember someone as beautiful as her.

She giggled then and arched a brow. "I'll give you a clue since you were kind enough to help me. My name is Sansa. Sansa...Stark." She grinned and Jon cursed.

"Fuck. Of course! Seven hells, you're one of Robb's little sisters." Red hair. Blue eyes. She could pass as Robb's twin and she looked like Aunt Catelyn. Was this really the prissy little girl in pigtails?

She giggled again. "Took you long enough. But to be fair to you, we never really 'met' met, did we?"

He smiled sheepishly. "I guess not, but still, I should've known. I'm sorry."

She chuckled. "It's okay. Between boarding school and starting right away at Citadel, I wasn't home much, more so with my parent's functions." She shrugged. "We're not allowed to have lives, remember?" She winked conspiratorially.

He laughed back and nodded. "We don't have lives so we can save yours, and all."

She blinked at him then and grinned. "I want that tattooed on my body!"

"Sorry, but I already got you beat on that," he winked.

She pouted.

"I'm kidding," Jon grinned.

"Then we'll get a matching set when we both pass the MLE. Do you promise?" She held up her pinky.

"That means I'd have to wait - When do you start med anyway?"

"I'll be a freshman come September," she said proudly.

His forehead crinkled. "Aren't you in college still?"

"I skipped two grades and I went for the straight program, just like you," she said smugly.

"Oh! So you're the Know-it-all-Stark!"

She smacked him then. "That's Bran but I'm pretty smart too."

He rubbed his arm. "Right. Sorry. First year huh? Isn't it too early to learn suturing?"

She raised a brow again and her smile fell. "Too early?"

Great, I insulted her. "I didn't mean it that way, I meant, I - they teach you that on your second year."

That seemed to placate her. "You're studying in Storm's End, right? So you're...a third year?"

"Incoming," I nodded.

"Any sage advice then?" she leaned closer.

Jon thought for a moment before answering with a smile. "Take as many vacations as you can. Better yet, don't waste anymore of this summer. After tomorrow, fly off somewhere - anywhere. Start medschool when you start medschool. Either way, no matter how hard you prepare, at the beginning, you know nothing."

Her forehead puckered. "Really?"

Jon regarded her, and remembered being as excited as she was when he was finally going to medschool but quickly got a dose of cold water over how very unglamorous it was. It was a sleep when you're dead situation every day. "Well...not to ruin your excitement and all but... I mean, I love it despite how hard it is but... I just - I would've appreciated it if someone told me how hard it really is, you know? Not put it up in a pedestal and such. Everywhere there is a hierarchy even in the smallest way. Fuck - I'm sorry. Don't listen to me, I'm just rambling," he tried to backpedal when he saw the light in her eyes dimming.

He stopped when he felt a hand on his arm. He looked up and Sansa was smiling at him warmly. "It's okay...Jon. I kind of get what you're saying. I mean, I had an idea it's going to be tough but I had no idea it's like that. I mean, I was only worried about lack of sleep and missing out on family occasions but that's not all I'm in for, is it?"

He examined her. "You want the whole truth?"

She looked at him pleadingly and felt a squeeze on his arm - a reminder that she hadn't taken off her hand from him then. "Please. I...I'm not exactly from a family of doctors. Well...you're my only hope as my only medical relative, it falls to you then."

Shit. Right. Both of us would be the first Stark to be doctors. Well, more her than me anyway. "Okay. Why don't we get lunch first?"

She started beaming at him then. "Sounds great - so you know all these stuff already?"

Jon nodded uneasily. "Uh, somewhat. I want to be a surgeon."

"Yay! That means you are the best teacher! I want to be a surgeon too. Teach me when I get stuck again?" She asked looking up at him hopefully.

"I'll do my best," Jon agreed. As if anyone can say no to that look. Was this what Robb was telling me about? Bambi eyes? Or was that his youngest brother?

Once she was comfortable enough, Sansa talked Jon's ear off halfway through their lunch at a nearby diner they went to and he did his best to keep up and true to his promise, gave her all the tips he could think of to help Sansa adjust once she starts formal medschool while Sansa soaked it all up and asked many questions and hung on to his every word.

Jon thought her smart and witty, a fast learner, and of course, stubborn like the rest of the Starks, but she was also very passionate.

As he watched her wave goodbye at him before driving off the following day, Jon thought that Sansa would be fine.

As long as she holds on to that passion, she'll be a great doctor.

Jon blinked back at the memory of that one summer he got to know Sansa a little bit and wondered why that was the last they saw each other in person. Well, last that they actually interacted face to face anyway.

Sure he got the occasional messages - mostly her asking him about some subjects and topics and yes, he'd check in on her - he was, after all, her only relative in the field and he took that role seriously, well at first.

At first because, their medical lives really did get in the way. He couldn't check on her as much as he could - he could barely even take care of himself!

And he really believed that she was doing more than well and would only need him on her first year tops and barely even. At most, they'd message each other on holidays and occasions, asking if one was as stuck as the other - wishing each other a happy hospital/school holiday. But that stopped too by Sansa's third year - Jon's internship year. And from then on, nothing from both ends.

Robb always talked about her proudly, especially Uncle Ned. I only heard good things about her, surely she was doing fine - more than fine. I heard she graduated from Citadel at the top of her class and she did get into their Neurosurgery program - one of the toughest to get into.

Surely, she'd still be the bright-eyed go-getter girl she met that summer right?

Jon couldn't be any more wrong.

The Sansa that he saw was no longer the slow to warm, shy at first girl with her long red braids, curious blue eyes, and always with a ready smile girl he met that summer - filled with dreams and brimming with excitement for starting those dreams.

The first thing that he noticed was the hair.

Her long wavy hair that curled at the ends and shone with the prettiest shade of red he's ever seen (yes even better than Ygritte's and gods knew how much he liked hers too) was now cut so short, the back looked cropped - shaved even and though the tips still curled, they barely went past her ears.

Jon couldn't understand why but seeing Sansa's hair like that really took him back. But he shook that off and tried to see - hoped to see if that was the only thing that she'd have to change. But it wasn't.

Her hair only made her features sharper, her high cheek bones were more pronounced, and higher - her eyes - her eyes that were so warm and honest before, looked impassive, cold and firm just like the rest of her.

She was sitting with all the poise of a queen with ankles tucked into each other at the side instead of legs crossed, and her hands were primly set on top of her lap while she kept her chin slightly lifted as she watched the current presenter silently.

The only sign of hope for the girl he met was that underneath her long white coat - a requirement for some residents to wear to presentations like these so they could show their hospital logos - she was wearing a dress the same color as her eyes.

"Wow, Jon. Your cousin is gorgeous!" Sarella elbowed me. "But... oh her hair! She had such beautiful long hair then but she can pull this pixie cut too."

Jon nodded dumbly, unable to tear his eyes off of her. She was still beautiful. Even more to be honest. She'd be bald and still be beautiful. And Sarella noticed the change because she was three years Sansa's senior in Citadel U where she went too before going back to Dorne for her residency, he briefly remembered.

"Tough. She looks like she's ready to fight," Drogo added. "Fierce eyes."

I couldn't agree more. Jon nodded again. There was a toughness in her that screamed intimidation despite the cool and calm exterior.

And when she stood to take her turn at the stage, Jon started to understand quickly how the change came about.

A hush went over the crowd as she was introduced and remained while she walked towards the podium. She walked - no - almost floated so gracefully yet there was a confidence in her Jon hadn't seen before.

It was there that he heard the voices - all from guys while the moderator continued listing off Sansa's credentials.

"Oh she's up."

"Yes. The Ice Princess is next."

"More like frigid snob."

Jon's brow ticked and he was about to turn around and beat up whoever the voices belonged to when he felt a hand gripping his arm and saw Sarella shaking her head then giving the same look to Drogo whose jaw was clenched so tightly.

"I don't care how smart she is. I still don't think she's a good fit for the program," continued the airy voice. "There's only so far book-smart can get you. I mean, sure, she has skills yes, but if one has to work double time - give that much effort to do the job then maybe that extra effort would be better off in a...less critical field."

"He's only saying that because she was praised and he was scolded on one of Dr. Jaime Lannister's ORs they were both assisting in," the other voice pointed out.

A snort, probably from the arrogant one. "Please. Everyone knows he's only being sweet on her to get access to that ass."

Jon's jaw clenched while Sarella held back a disgusted sniff and Drogo was starting to get scarily silent more than usual.

"And now, he's just saying that because he tried and failed in tapping that ass too."

The assholes chuckled.

"I'm just saying that a woman is not cut out to belong in Neurosurgery."

"Shhhhhh!" Jon craned his neck at the direction of the angry shushing and saw a tall bearded guy with long red hair glaring at them. "Will you cunts shut up? We all came to listen to her not to you pricks gossiping like hens with cocks." A Northern accent. Jon smiled. Northern loyalty right there. He then glanced Jon's way and noted their tight expressions and glared back at the rude men. "Shut up, listen, and clap for your co-resident or get the fook out. Fooking cunts."

Who are you and can we shake your hand or give you a medal? Wait. Co-residents?

Jon looked behind then and saw that the seats two rows behind them were occupied by residents - Citadel Hospital Neurosurgery embroidered with the lighthouse logo on their coats. That only served to tick him off more.

Sansa was presenting for them! I mean, I knew neurosurgery was competitive as fuck but with each other and at home base at least! Not in fucking contests like these. Jon bristled.

Thanks to the redhead, they finally shut up and remained that way like good residents did when reprimanded by an attending and great timing too because Sansa was just about to start on her presentation. Still Jon couldn't get over it.

"Stop it," Sarella hissed. "It's just the jealousy talking - that and being threatened by a woman nonetheless," Sarella hissed in his ear. "Sexist pigs."

"Fine." Jon focused instead on the girl he thought to have a crush on that two-day summer they had and saw the woman she'd become the more he watched her speak.

"Good morning doctors. I'm here to present to you my research entitled: Invasive versus Non-invasive approach to treating CPSP or Central Post-stroke Pain, a Meta-analytic review..."

Jon couldn't believe the transformation. Sansa exuded a quiet confidence that was the right amount of pride and grace. Her presentation was clear, to the point, and though there were many technical stuff she discussed that he wasn't familiar with, she was able to present it in a way that anyone, no matter what specialty, could get unlike the first who didn't care about the audience as he kept dropping flashy jargons simply said to impress. Sansa didn't need any embellishments. Her topic alone was attention worthy. Neuropathic pain or nerve pain was the hardest pain to treat.

And this was also where Jon saw some of the old Sansa he met. When he realized that Sansa didn't just present a case to win, she was presenting a topic that she resonated with and something she wants to both educate and call more attention from for its importance and impact not just for her colleagues, but across the different specialties. It was the sincerity in her voice and the thorough research she put in that would win this for her and true enough, at the end of this event, she did.

As she received her certificate and the ten thousand dragon check for her department's choice of charity foundation, all three of them stood up and applauded her first before everyone else joined in.

Her eyes found Jon then and she grinned briefly before settling into a simpler and humbler close lipped smile.

She was still in there. Jon grinned in relief. They haven't transformed her truly yet.

He looked back to gloat at her less than supportive co-residents who were clapping either half-heartedly or just simply politely. Well, at least, half of them. Some were clapping more enthusiastically with actual pride in their eyes. There was hope for them too.

"She won. As if there was anyone else," Sarella said loudly while she nudged at me.

Jon puffed out his chest and agreed loudly too. "It was hardly a competition."

Drogo grinned wickedly directly at the residents.

"Now you see, you fooking greenboys. That's how it's done," came the redhead.

Drogo called him over and they grabbed each other's hands and pulled themselves together for the manliest hug Jon's ever seen. Somehow I'm not that surprised that they know each other.

"Drogo, you shite, how've you been? Heard you got yourself whipped by a woman," the redhead bellowed before taking note of Sarella. "So are you the woman who finally whipped the Khal's giant horse arse?"

Sarella only laughed and shook her head. "That's my aunt you're talking about and she does hold the whip for this one," she poked Drogo who didn't look one bit ashamed as he shrugged. Sarella offered her hand then. "Sarella Martell, by the way. Anes and Tox for Dorne." He shook her hand and introduced himself. "Tormund Giantsbane - don't ask. Trauma surg in Eastwatch Veterans." He leaned down then and whispered loudly while looking at Drogo. "And I'll only believe he's whipped when I see it," he winked, making her laugh and Drogo roll his eyes.

He then looked at Jon and offered his hand to him too. Jon took it and gave Tormund a firm shake. "Jon Snow. Trauma too, no affiliations yet."

"Ah. Fresh off the boards? Wanna consider taking it up North?"

Jon was about to say that he was in fact, looking to work in the Northern peninsula where he could be far away from being the political son in King's Landing - also, the same reasoning for changing his last name, when Sarella interrupted.

"He's also the cousin of the presenter you defended," she piped up.

Tormund grumbled then. "Couldn't let them get away with that. Where I'm from, women and men don't matter. As long as you can do the job, then by all means, do it. Besides, Northerners stick together and I wasn't about to let them badmouth a fellow redhead." He then punched Drogo and Jon. "Just as we bearded men need to stick together."

Jon winced a bit as Tormund belly laughed while Drogo raised his brows and crossed his arms before he looked at me. "Shouldn't you go to her?"

He reddened. "I - yes. Of course."

Sarella flashed a knowing smile at Jon that Tormund caught. "Why don't you go on ahead?" she suggested.

"Yeah, go try and steal her away from the horde," he grinned wickedly for someone Jon just met. "Little miss here needs to show me a picture of the woman whose got Drogo's balls in her hand."

Sarella's eyes lit up. "Ooh wait!"

Drogo gave Jon a knowing smirk before he whipped out his phone and showed Tormund pictures of Rhaego, his and Dany's two-year old son. "This is the Stallion that will mount the world," he said proudly.

"Good pecker on that one. Nice job, for Khal Drogo," Tormund looked up at Drogo impressed.

Shit, I didn't even ask about Rhaego and he's a cousin too. Wait - cousin. Right.

Jon scanned the hall and found her talking to his great-uncle Aemon who was a Neuropsychiatrist.

He gathered his courage and started walking over to them. It was his uncle who saw him first. "Ah, Sansa, have you met with my great-nephew, and if memory serves me correctly, your cousin?"

She turned around then and gave Jon a bright but shy smile. She's even prettier up close. "Jon," she said, his name a soft whisper on her lips.

Jon chuckled nervously. "Sansa, hey." Should I go for a hug? Wait, we haven't done that before, have we?

Sansa stepped closer but hesitated like Jon did before she finally went in for a brief hug. She smells great. Jon's first thought before remembering to hug her back. They pulled away quickly, looking at each other awkwardly with Sansa tucking her hair behind her ear twice and Jon rubbing at his neck.

Man up, Jon. "Congratulations, Sansa. You were great up there."

She smiled shyly. "Thank you Jon."

He cleared his throat. "You look great. I mean, how are you?" He cursed inwardly.

Sansa's corner lip quirked but she didn't call him out. "Thanks and oh you know. Alive and surviving," she lifted a shoulder yet Jon caught something briefly in her eyes but before he could say anything, she shifted the topic to him. "I however am unforgivably late with my congratulations. I saw you in the top ten for your specialty boards. Congratulations, Jon." She reached up and gave Jon a quick kiss on the cheek before pulling away and giving an apologetic smile. "Forgive me?"

"There's nothing to forgive," he immediately answered.

She pouted. "Well, forgive me for not keeping contact since - it's been too long and I've been rude."

He shook his head. "It's okay, for that I'm equally to blame. But how are you - really? You're almost at the finish line."

She blinked then and tried to give a too bright smile. "It won't be long now, yes."

We heard a cough behind us and to Jon's horror he forgot his great-uncle was still there and Sansa looked equally ashamed too. "So I take it you've met then."

"Of course. Jon helped me adjust for my first year in med school and he taught me how to stitch my first suture," she recovered quickly while Jon shifted uneasy with praise.

"I hardly helped. She would've done great with or without me," he shrugged.

Sansa was about to protest when we saw her co-residents approaching. Immediately, Sansa's demeanor shifted.

Her back stiffened and her face smoothened into her neutral mask.

There were five of them, all with closely cropped or completely shaven heads that was the signature of most neurosurgery residents across most programs - a sign of solidarity for their patients that they'd have to shave as part of the OR preparations as they say, but really it was just one more form of soft hazing. It didn't apply to female residents but Jon guessed Sansa parted with her long locks to prove a point. One of them was always flanked, moving ahead of their assembly like geese in the air - another show of hierarchy.

That one, had unfeeling violet eyes he trained at Sansa. "Congratulations, Dr. Stark," he managed but Jon couldn't see the sincerity and he also recognized that voice as being the arrogant one. Finally a face for the voice.

Sansa gave a nod and a small smile. "Thank you Dr. Dayne." Finally a name for the face.

She then turned to Jon and Dr. Aemon and introduced them. "Dr. Aemon, Jon, these are my seniors. This is Dr. Gerold Dayne, our chief resident," she motioned to the leader. "And this is Dr. Humfrey Hightower the deputy chief, Dr. Lyman Darry, and Dr. Horas Redwyne. Doctors, of course, you know Dr. Aemon. And this is Dr. Jon T-Jon Snow, Trauma Surgeon and my cousin." She almost slipped on Jon's name but it touched him all the same that even without communication, she was updated making him feel doubly guilty.

They of course, greeted Dr. Aemon readily and only politely regarded Jon who didn't really mind. Dr. Aemon excused himself and that was when Dr. Dayne started on Sansa.

"I hope I wasn't interrupting anything important, but I have need of you Dr. Stark," he raised a brow at her and Jon once again felt his brow twitching.

"Of course, Dr. Dayne," she nodded at him and shot me the subtlest apologetic look. "I - " she started.

Jon cut her off and smiled kindly. "Go. I'll see you around later or tomorrow. Sarella and Drogo said to say congratulations too but they're busy over there."

She looked where I pointed and for a moment Jon could see the look of longing in her eyes but was quickly gone when her seniors started leaving. With a final wave and a quick smile, she went and followed them. "Tell them thanks and I hope to see them too."

"I will." There wasn't much Jon could do. It was an unfair world but Sansa had to follow an order from her senior.

Groveling, kissing ass, humiliation, unfair hours, and underpaid work - that was residency.

There were stages and there were steps in medical hierarchy. It gets better eventually on the way up but the way up is often dark and full of terrors.

There was nothing to do but just stick it out because like all ladders, eventually you get to the top.

Jon found Sansa later that night at the rooftop.

The rooftop of the Regency as converted to a VIP rooftop bar which was open for the delegates these two nights though they closed the bar at exactly midnight. By quarter, the staff would lead the guests down the VIP lounge instead where it was open all day and night citing that it was unseemly to catch guests falling asleep or getting drunk at the rooftop - safety reasons as well as snobbish pursuits. But guests may still stay as long as they are not inebriated and remain awake.

Drogo, Tormund, and Sarella went ahead while Jon chose to stay and enjoyed the quiet.

It was half past one and he was leaning on a rail, puffing on a cigarette while he watched the view of the still lit docks of Lannisport they could still see from this high up the Rock.

He thought he was alone when he saw a flash of red from the shadows.

He snuffed out his stick and threw it before walking over to investigate and almost jumped when he saw it was Sansa.

She had her back to him while she sat on top of her coat on the floor, still in her dress with her legs pressed together and tucked to the side, typing away on her laptop while she leaned against the wall.

"Sansa?"

She jumped - almost dropping her laptop but she failed in catching the glasses she was wearing when she surged forward. She recovered quickly while I crouched down, picked up her glasses that I've never seen her wear before, and handed it to her.

"Jon!"

"Sorry, I didn't mean to scare you. I'm as surprised as you are," offering her glasses once more.

Even in the dark Jon could tell she was blushing. She took the glasses from him and wore it back but she didn't look up at him muttering an embarrassed thanks.

Jon thought she looked cute with her silver frames. He bet it made her eyes looked bigger, if only she'd look at him.

"Working late, I see," Jon said before sitting down next to her.

"Yes - but, oh Jon, you don't have to sit down. You'll get your pants dirty!" she frowned.

Jon chuckled. "Says the girl sitting on her white coat."

She pressed her palms to her forehead, dislodging her glasses a bit. "I know. It's gross but can I get a pass tonight?" she tried to say cheerfully but Jon could tell she was exhausted.

"Anytime. Why aren't you in your room?"

She frowned again. "My bosses are on the same floor and I need the peace and quiet or I'll never finish," she sighed.

"What floor is that?"

"45th."

"Mine is at the 50th. You're welcome to stay there."

Sansa gave him a wry smile. "At least buy me dinner first."

It was Jon's turn to flush not realizing how he sounded. "I didn't mean - I

Sansa waved him off and chuckled. "A joke, Jon. I am still capable of it."

Jon ran a hand down his face and shook his head. "You're mean and here I was doing a -

Sansa cut him off with a kiss to his cheek. "Sorry. Thanks for the offer Jon, but I'm good here. I'm actually just polishing the report I have to hand over bright and early today," she rolled her eyes.

"Sorry," Jon could only offer.

She shrugged. "S'not you're fault. It's whoever invented hierarchy," she shivered and that was when Jon noticed that she was just in a short sleeved dress that only came down to just a little below her knees. It was a little longer than what he usually saw women wear but it only made Sansa look even more lady-like which suited her just as well in Jon's opinion.

He didn't ask just took off his coat and handed it to her wordlessly.

When she tried to protest, he raised his brow in challenge while she shivered again, causing her to bite her lip and accept it graciously.

While she shrugged it on, he walked over to the bar area and took a table cloth - the cleanest one and when he went back, he draped it over her legs before settling back beside her.

Sansa looked at him gratefully then. "Thanks Jon." She reached out and gave his arm a squeeze - like she did years ago. He smiled at her fondly then.

She dropped her smile. "You should head back and sleep."

"So should you."

She sighed. "I want to but I really need to finish this."

"Anything I can help with?"

"Do you know anything about deep nerve electrostimulation for sheep versus monkeys?"

"Uh..."

Sansa quirked her lip. "Thought so. Go on, seriously, I'll be okay. I promise I won't tell Robb you left me alone if that's what you're concerned with."

"Didn't think about him. Though that is a good reason to keep staying with you, threat of your brother and the whole Northern army," he grinned.

She sighed. "Fine, suit yourself. I might take another hour."

"Go ahead, take your time. I don't mind. it's nice up here. 60th floor and all."

"I won't be chatty until I finish," she warned.

"Shutting up now," Jon made a show of zipping his lips causing Sansa to laugh once before shaking her head and retrieving her laptop.

Jon tried not to watch her as she worked, briefly contemplating if he should get her something warm to drink since she was going to be stubborn about this.

Eventually after ten minutes, he excused himself to do just that, only earning a half-committed nod.

He came back up after fifteen minutes with two styrofoam cups filled with hot water and a takeaway bag filled with tea packets, condiments, and lemon bars (they were the only ones good to go) he bought from the lounge.

Sansa looked up at him surprised and adorable looking in his too-large coat and those damn glasses.

Jon sat beside her and pushed the bag of lemon bars at her while he took out the tea stuff. "Are you an Earl Grey or a Chamomile person?"

Sansa still looked at him stunned and possibly close to tears that Jon almost panicked. He didn't know a thing about comforting a woman in tears. He coughed and repeated his question.

Sansa looked down and played with the lid of the bag she was still holding, blushing. "E-earl Grey."

"Ear Grey it is," He started making her tea and was about to ask if she took it with sugar or honey when he saw her looking inside the bag with tears silently pouring down her face.

"S-Sansa what - "

Sansa quickly wiped her face but failed to stop the tears. She tried to smile wanly. "Sorry Jon...I don't know what came over me - it's just... it's lemon bars. I love lemon bars."

She started wiping at her face more furiously then looking annoyed at herself. "Ugh. Sorry. I'm okay, I promise. I just - I'm fine - this is stupid."

Jon understood what she's going through. She was tired, she was overworked and likely faced one form of humiliation today despite her win and now someone was being nice to her. He's been there too. Any kindness, no matter how small felt like water in a desert.

So he stopped what he was doing and crouched in front of her, gently taking her glasses off, setting them safely, then he took her hands in his before bringing her to his chest slowly, wordlessly just holding her still. Experience taught him that rubbing the back or stroking the hair only brought more hysterical tears - more less words.

Sansa stiffened at first until finally she relaxed and crumpled into his chest, just the touch of her cheek to his collar and nothing else.

This kind of crying, he knew well. It was the frustrated and tired one. It didn't need the sobbing or the hiccupping - that'll only tire you out more.

Sometimes, you just needed a good cry - just the right amount of silent tears to release some of the tension. Just enough to calm down.

After a solid five minutes, Sansa raised her head, wiped her eyes one last time and took a deep breath.

Jon released her slowly and gently but kept close in case she needed another minute. "Better?" he risked.

She smiled at him then and nodded. "Yes," she laughed nervously. "Thanks Jon. I needed that. Sorry I ruined your shirt."

Jon just shrugged. "A small sacrifice you can make up to me once you become rich and famous. My small contribution to your future success."

She laughed again, for real this time. "I'll add that to the list."

"You do that," Jon smiled. "So, ready to get back to work?"

She nodded. "Yes."

"Good," he reached out and placed her glasses on her. "So. Sugar? honey?"

Sansa blushed and Jon almost did too at her reaction but he managed a smirk. "For your tea."

"Oh. Just h-honey," he heard her utter a tiny fuck that he'll let slip now.

"Honey, it is," he teased while he added it to her tea.

"You're mean."

"Sorry. Tea for apology?" He handed her the cup.

"Thanks. Apology accepted. How'd you know about the lemon bars?"

"Honestly, they were the only ones I could get fast. A lucky move then," Jon admitted sheepishly.

"Well, according to the Alchemist, when you want something, all the universe conspires in helping you achieve it. It must be my lucky break," she grinned while taking a bite.

Or mine. Jon thought and was quickly embarrassed for even thinking it.

What followed was companionable silence as Sansa worked. Before Jon knew it, he had dozed off.

He woke an hour and a half after with a light shake from Sansa. For a moment he forgot where he was but then he quickly adjusted when he felt his back.

"Hey, sorry to wake you but I'm actually done," she was whispering and cradling her laptop, her coat was draped in one arm, while a hand stayed on hid shoulder and from this angle he was able to take her all in better.

Jon just blinked, too caught up in her eyes that looked midnight blue in the dark.

She bit her lip and looked apologetic. "Sorry to wake you from what I saw was a peaceful sleep but you'd probably be more comfortable in your bed than here."

Jon snapped out of it and rubbed his eyes while he stood up. "You're right. Are you really done?"

She smiled and nodded. "Yup. All done and I even cleaned up too."

Jon frowned as he took in everything. "You didn't have to do that."

She rolled her eyes. "Too late. Come on, let's get back."

They started walking back when Sansa stopped for a moment.

"What is it?"

She blinked and smiled again. "Nothing. You go back ahead. I think...I want to look at the port for a little while. I'll follow and sleep, I promise."

Jon eyed her then before holding out his hand.

Sansa looked at it and then his eyes confused.

He changed and offered his arm instead. "Come on. Let's look at the view for a moment."

Likely knowing Jon won't give up, she just smiled wider and held on to his offered arm and followed when he lead her to the view he was looking at earlier.

After watching the water break against the rocks below Sansa wrapped her arms around Jon. "Thanks for tonight, Jon. It's been a while since I've been treated like a human being."

Jon returned her hug. "Sure. Though you won't be thanking me for the many times I wanted to punch your chief today."

She looked up at him then and frowned. "You heard him and the others say nasty things about me."

"Sexist pigs," he spat Sarella's earlier comment.

Sansa chuckled then. "They're just threatened by me."

"The seven hells they should. You're brilliant and tough. Drogo thinks so too."

She grinned. "Yeah?"

"Fierce eyes, I quote."

She grinned.

"It's tough and unfair, but I have faith in you," Jon tucked a strand of her short hair, feeling mad again that she had to cut it just to prove a point.

Sansa noticed but let it slip, closing her eyes instead at the feel of Jon's fingers. "I know. I'm pretty tough too."

Jon chuckled. "I know. I was almost afraid that they've transformed you for good."

She tilted her head then. "Almost?"

"For one, you're still wearing the most lady-like dress ever, and another was your passion resonating with your research presentation," he ended with a shrug.

Sansa shook her head. "The passion, yes. I do love it - every little thing about this even the times I want to kill myself or murder them instead because why should I die when they should instead moments."

"You would've covered that up easy."

"But the dress? Really Jon?"

"Uh, I figured that was another way to prove a point. That they may take away your hair and call you mean things just because you're a woman in their sick man's world they've built up, but you showed them that you can do their jobs better in a skirt and heels too," he said proudly. "That and the fact that you're two years their junior to boot."

"Wow."

"Well, wow to you first. And I'm really glad you didn't transform into a heartless gunner," he said lightly but his eyes were sincere.

"Well the summer before freshman year of med, an incoming junior taught me more than just sewing sutures and tying knots. He told me that entering the medical world was going to be tough and unfair that I must be tougher but fairer and it stuck to me all these years," she eyed Jon impishly.

Jon couldn't hide an embarrassed grin. "Wise friend."

"Mhm," Sansa nodded. "But really, the true lesson was that, he showed me what truly made a difference between a good doctor from the rest."

"And what's that?"

Sansa took his hand and and squeezed. "Kindness," she said so softly.

Jon just looked at her with his mouth open, clearly not expecting that.

Sansa started tugging at his hand. "I'm beat. Come on."

Jon shook his head, and followed, with his heart impossibly full, and a smile he couldn't wipe off from the compliment.

Kindness.

He does know some things after all.

Day 2

When Jon woke up he decided to take a risk and ask her out when the opportunity comes within the day.

He felt that something that summer years ago but thought it was more on her adoring her excitement and zest for medicine. He figured this time, he won't wait nine years to realize it and give it a go.

But unfortunately for him, the opportunity never came.

Jon didn't see her all day and he finally found out where she was from Sarella when he met up with her in the afternoon sessions.

"Sorry Jon. I saw her earlier and she told me that she had to fly back to Oldtown right away according to the shithead boss of hers. No wonder the Daynes all but cut him off the family. Her boyfriend picked her up though and they rode his family's private jet. But before she left, she asked to give this to you," she pushed a small box at Jon's hands before he could process what she was saying.

He broke it down.

One, Sansa was on a flight back to Oldtown.

Two, she was flying with her boyfriend on her boyfriend's family's jet. How did he miss that?

And lastly, there was something in his hand.

"I don't - boyfriend?"

Sarella's eyes narrowed before widening with realization. "Oh shit."

Jon looked to her for answers.

She took his arm and sat him down. "Okay, calm down. Relax."

He didn't.

She rolled her eyes and gave up. "Apparently, it's still new. He works at Citadel Hospital too. He's Dr. Willas Tyrell, one of the Radiologists. I called my dad after I recognized him when Sansa introduced us quickly." Oberyn Martell was also an Anesthesiologist as well as an Acupuncturist among other things and he was friends with Garlan Tyrell, Willas's older brother. Jon tried to absorb as Sarella explained. "Dad said that Garlan was happy that his younger brother was finally dating."

Jon's heart dropped. "Is he...is he decent?" He didn't bother to ask about looks because he knew the Tyrells were generally good looking.

Sarella smiled sadly. "He's smart, charming, handsome, well-mannered, and kind."

Kind.

Jon felt crushed.

"But it's all still new like it's only been a month and they hardly go out with her schedule. They're probably still getting to know each other - "

But all Jon heard was kind. If he was truly kind, then it won't take long at all.

I was nine years too late.

Jon stood up then and sighed, before mustering up a smile and thanking Sarella.

"Wait! Before you go broody, she did leave you something," she pointed to the box I was still clutching.

Jon opened it then and inside was a note and something wrapped in a golden tissue-like paper.

He read the note first.

Jon,

I can't thank you enough for more than tonight. I won't forget it just as I never forgot the kind guy who took pity on me when I couldn't tie my knots. You taught me more than that though, if you recall. You told me that the sign of a good knot was for

1) how it held firmly and

2) how it could be undone by just one strategic pull only the surgeon who made it knows as well as the teacher who taught it

I didn't tell you but I kept the tie I used and stole yours when you weren't looking ;)

Now I'm giving it back attached to something that would always remind me of your knot pulling last night. (I used two handed knot tying!)

Good luck with your next step Jon! Sorry I had to go again.

Until the next time we meet then (Under better circumstances I hope)

Sansa

Jon unwrapped the other gift and held it up.

He smiled when he saw a golden replica keychain of the hotel with the blue practice tie, knotted in a perfect surgical knot twice on the chain.

"See? There's hope still. They're not married yet," Sarella grinned.

Jon rolled his eyes and shushed her when Dr. Tyrion Lannister started talking.

"Okay. Last session for this course, I hope you are still awake and alive. I shall try to make this as short and as entertaining as I can. In short, all my visual aids will be anatomically perfect for everyone and I've spiked the next batch of coffee," he grinned. "Alright, I have your attention now? Well if not at least even before I speak my topic I already have your money in my pocket so we're all good here."

Laughter.

"Let me start with a favorite anecdote especially since I see a lot of residents from all over here with eyebags darker than the balls of an elephant and I could pick out the fresh board passers from the crowd easy as pie. Okay, are you ready?"

Ars longa,

vita brevis,

occasio praceps,

experimentum periculosum,

lucidum difficile

"Hippocrates, our father of Medicine said, 'The art is long, life is short, opportunity fleeting, experiment dangerous, and judgment difficult.'" He paused. "It's a tough challenge, we chose to pursue for a living. And it never ends for we keep on learning. It's hard, and more often than not, as much as we want to save lives, we want to kill our fellow doctors just as much too," he paused again but this time from the laughter that erupted from the crowd.

He raised his hand for silence before he continued. "But in the end, it's still the life we chose and thus we have no choice but to keep on living it for as long as we can. We have failures, we have triumphs, but most of all we keep on trying. But also remember, not to forget the third line. 'Occasio praceps.'

"Some opportunities come once in a lifetime. In the occasion that you miss it once, and it presents itself again, don't be a dumbass and grab it by the balls, tie it up, and never let go."

Jon swallowed and clutched the keychain in his pocket.

"Now then, I can begin."

As Dr. Tyrion went on his lecture, Jon was only half-listening.

As much as he wants Sansa happy and he truly does even if it's with someone else, he'll still hold on and hope.

They were still young.

They still had time.

"Art is long, after all," he muttered as he glanced down at the knot Sansa gave him.

#jonsa #fanfiction #jon snow #Sansa Stark #jon snow x sansa stark #fanfic #doctors AU #modern westeros #ladymdfic

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12 Unexpected Things that Mess With Your Memory http://yourgradgear.com/2017/09/27/12-unexpected-things-that-mess-with-your-memory/

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12 Unexpected Things that Mess With Your Memory

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Surprising memory stealers

You regularly ransack the house to find your keys. You suddenly can’t recall the name of your kid’s teacher. You made your six-month dentist appointment three months late. Sound familiar? Fear not: most forgetfulness isn’t anything serious, says Majid Fotuhi, MD, PhD, founder and chief medical officer of NeurExpand Brain Center in Luterville, MD and co-author of The Memory Cure. Lack of sleep, certain medications, and even stress can impact your memory. “Fortunately, your brain is malleable, meaning it changes and improves,” says Dr. Fotuhi. “Memory can be boosted with simple powerful interventions.” Here are surprising things that impact your memory in both good and not-so-good ways.

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A dysfunctional thyroid

When your thyroid’s out of whack, you may feel too hot, too cold, anxious, depressed—and your memory may also be lagging. “Although the thyroid doesn’t have a specific role in the brain, memory loss is the one thing a person notices when it stops functioning normally,” says Dr. Fotuhi. A butterfly-shaped gland that sits along the front of your windpipe, the thyroid reigns over almost all your body’s metabolic processes. “People with high or low thyroid levels—which are very common in women—may have difficulty with memory and concentration,” he says. Ask your doctor for a simple thyroid test to determine if it’s the culprit behind your memory problems.

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Hot flashes

Every time hot flashes make you you feel like sticking your head in the freezer, you may also feel a fog rolling into your brain. “The more hot flashes a woman experiences during menopause, the worse her ability to remember names and stories,” says Dr. Fotuhi. “Fortunately, hot flashes don’t damage the brain in any way. Memory improves once the hot flashes subside.” Other menopause-related symptoms contribute to memory loss, including insomnia and sleep apnea, Dr. Fotuhi says.

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Lack of sleep

Last night’s late party makes it less likely you’ll remember your new coworker’s name the next day. “While some part of the brain takes a siesta when we sleep, deeper areas involved with memory and emotional response become relatively more active,” says Allen Towfigh, MD, medical director of New York Neurology & Sleep Medicine. “Individuals with sleep deprivation and sleep disorders not only suffer from impaired memory but also daytime fatigue, impaired attention, and reduced reaction time.” The standard recommendation of eight hours of sleep a night doesn’t necessarily work for everyone. If you wake up fatigued and fall asleep unintentionally during the day, then you may need more sleep, says Dr. Towfigh. Related: How to Fake a Good Night’s Sleep

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Anxiety and depression

Worrying about an upcoming presentation in front of the CEO may also hinder your memory, several studies show. “We don’t understand the exact link, but strong evidence indicates depression, anxiety, and bipolar disease disrupts the neural circuitry involved in developing and retrieving memories,” says Dr. Towfigh. “The severity of the memory loss often mirrors the severity of the mood disorder—severe depression brings about equally severe memory loss.” Prolonged periods of everyday stress increase cortisol levels in the brain, which causes our brain cells to lose synapses (the bridges that connect our brain cells to one another), and make it more difficult to create and retrieve memories. The good news is when memory loss exists with a mood disorder (including anxiety and depression), the memory loss is usually at least partially reversible. “As the individual’s mood improves, often so does the memory loss,” says Dr. Towfigh.

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Prescription drugs

Check your medicine cabinet: many common prescription drugs can make you feel forgetful. Anxiety disorder meds like Xanax, Valium, and Ativan (which are benzodiazepines) put a damper on the part of the brain that moves events from the short-term to the long-term memory. Tricyclic antidepressants have a similar effect. Heart medicines including statins and beta blockers have also been linked to memory issues, as have narcotic painkillers, incontinence drugs, sleep aids, and even antihistamines like Benadryl. Bottom line: Don’t stop taking your (potentially life-saving) medications, but talk to your doc if you believe any drug you’re on may be messing with your memory.

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Smoking

If you’re still smoking, that may help explain memory lapses. “Smoking damages the brain by impairing its blood supply,” says Dr. Towfigh. Research published in the Archives of General Psychiatry gathered from data obtained from more than 7,000 men and women found a more rapid decline in brain function (which included memory along with vocabulary and other brain functions) with age than from those who never smoked. “Furthermore, cigarette smoking promotes the accumulation of abnormal proteins which impair the brain’s ability to process and relay information,” says Dr. Towfigh. Related: 15 Ways Smoking Ruins Your Looks

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A high-fat diet

Greasy burgers and French fries pack on pounds and are hard on your heart—and they may also cause memory issues. One study revealed that adolescent mice had poorer learning and memory skills after being fed a high-fat diet for eight weeks, while another study on middle-aged rats found that the hippocampus (the part of the brain responsible for short-term memory) may be particularly vulnerable to the impact of high-fat diets. More research is needed to determine for sure whether or not high-fat diets impact human memory, but here’s what we do know: Calorically dense diets promote type 2 diabetes, hypertension, and cardiovascular disease, which can all do damage to our brains, says Dr. Towfigh. “This holds true earlier in life, too. Studies link childhood obesity with a reduced attention span and impaired concentration and focus.”

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Stress

A sudden emergency can make it tough to recall something as simple as your home address. A rat study published in Neuron shows that stress hormones influence an area of the brain area that controls working memory. Researchers found that repeated stress reduced receptors in the part of the brain that’s connected to thought processes Although this study involved animals, the human brain works similarly, explains Dr. Towfigh. “Repeated or chronic stress can be harmful. Regular exposure to elevated glucocorticoids (a hormone released by the adrenal gland) also causes our brain cells to reduce receptors, making brain cells less capable of responding to neurochemical (brain chemicals) cues.” Finding ways to relieve stress may help: Practicing meditation does double duty by easing stress and helping improve memory, according to a study from the University of California, Santa Barbara. College students who completed eight 45-minute meditation sessions over two weeks increased their average GRE exam scores from 460 to 520 and showed improvement on tests of working memory.

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Germs

A nasty cold sore does more than make you feel self-conscious—it may be messing with your memory, according to a 2013 study in Neurology. Researchers found that people who exposed to many germs, such as herpes simplex type 1 (the cold sore virus), over their lifetimes were more likely to have memory problems than those exposed to fewer germs. Among more than 1,600 study participants, those with a higher “infectious burden” had a 25% increase in the risk of a low score on a cognitive test. Although there is no vaccine for the cold sore virus, childhood vaccinations against other viruses could help prevent problems later in life, the researchers suggest. In addition, regular exercise may help too—doctors think repeated infections may damage blood vessels, since a high infectious burden is also linked to a greater risk of stroke and heart attack.

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Green tea

Now for some good news: chemicals found in green tea may help improve your memory, according to a University of Basel study. “Several compounds, EGCG and L-theanine, in green tea increase neurogenesis (growth of new brain cells) in the hippocampus, the part of the brain used for short-term memory and learning new things,” says Dr. Fotuhi. How much green tea has not yet been determined, says Dr. Fotuhi, who recommends combining green tea with other healthy habits such as exercise for greatest memory improvement benefits.

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Exercise

Regular sweat sessions also help keep memories sharp. “Physical exercise improves mood and sleep and by doing so, it invariably improves cognition and memory,” says Dr. Towfigh. An animal study published in Brain, Behavior and Immunity, for example, showed daily exercise increased brain cell growth after 12 weeks of conditioned running. Dr. Fotuhi recommends 45 minutes of aerobic exercise four days a week for the best memory boost.

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A vitamin B12 deficiency

Vegetarians and vegans are at a higher risk of being deficient in vitamin B12, which keeps the body’s nerve and blood cells healthy and helps make DNA. That’s because B12 occurs naturally only in animal foods: shellfish, meat, poultry, eggs, and dairy. In addition to fatigue, loss of appetite, constipation, and weight loss, a B12 deficiency can also lead to memory problems. If you feel your meatless diet may be affecting your memory, your doctor can give you a blood test that determines whether you should be taking a vitamin B12 supplement. Note: it’s not just veggies who are at risk for a B12 deficiency. Pregnant women, older adults, and anyone with pernicious anemia (a potentially life-threatening lack of vitamin B12 due to an inability to absorb it from food) or gastrointestinal disorders like celiac disease and Crohn’s disease may need supplementation.