Start the pasta water: Fill a large pot with water, season it generously (it should taste like the ocean), and bring it to a boil. While it heats, grate your cheese.
Sear the shrimp: Pat the shrimp completely dry with paper towels. Season with salt and a pinch of black pepper. Let them rest for 5 minutes after salting – it helps the seasoning penetrate. Heat 1 tbsp of the butter in your skillet over medium-high heat. Add the shrimp in a single layer and cook for 1-2 minutes per side until pink and just opaque. Don't crowd the pan or they'll steam instead of sear. Transfer them to a plate.
Cook the garlic: Reduce the heat to medium. Add the remaining 1 tbsp of butter to the same skillet. Add the sliced garlic and cook for 30–60 seconds until fragrant. Don't walk away from it. The second it smells fragrant, move on to the next step.
Make the cream base: Pour in the heavy cream. Stir it into the garlic butter. Let it simmer gently for 2–3 minutes, stirring occasionally, until it thickens just enough to coat the back of a spoon. Season with a pinch of salt, a few cracks of black pepper, and a tiny grating of nutmeg.
Cook the pasta: By now your pasta water should be boiling. Drop the fettuccine and cook it 1 minute less than the package directions say. Reserve 1 cup of the pasta water before you drain it.
Finish the sauce: Add the drained pasta directly to the skillet with the cream sauce. Toss it with tongs to coat. Add the Parmesan cheese and 1/2 cup of the reserved pasta water. Toss continuously over low heat for about 2 minutes. The sauce will tighten around the pasta. If it gets too thick, splash in another tablespoon of pasta water.
Add the shrimp back: Nestle the seared shrimp into the pasta. Toss gently just to warm them through, about 30 seconds.
Serve immediately: Divide the pasta into warm bowls. Finish with a scattering of fresh parsley, more black pepper, and an extra grating of Parmesan if you're feeling generous.