Peel all of the shells including tails from the shrimp and pat the shrimp dry with a few paper towels.

Bring a large pot of water to a boil.

While the water comes to a boil, place a large heavy skillet over medium high and add two tablespoons of butter and once melted, start cooking the shrimp in three batches, making sure they do not touch each other while cooking. Cook one minute, turn and cook for 30 seconds more then remove with tongs or a slotted spoon to a plate or platter. If they get a little browned while cooking, great, if not, no worries.

Repeat for the other two batches, adding more butter as needed. Remove each shrimp as they cook and lay flat to stop the cooking.

Reduce heat to medium and add any remaining butter, then add the garlic and cook one minute.

Add half the cream, let it come to a fast simmer, then reduce to low and let it bubble away while you cook the fettuccine. This cream should reduce by a third, about 10-15 minutes.

At this point, the water should be boiling. Add a teaspoon of kosher salt to the water and add the fettucine and cook just short of fully cooked. If using fresh fettuccine, this process should be very quick.

Save one cup of the pasta water and drain the rest into a colander.

While the pasta drains, add the remaining cream, salt, pepper, nutmeg and parsley to the pan with the reduced cream and cook over medium heat for five minutes.

Add the drained fettuccine and a quarter cup of the pasta water, stir and add the grated Parmesan cheese and cook just long enough for the fettuccine to get tender.

Add the cooked shrimp along with any liquid in the dish and stir to combine.

Add more pasta water and/or cream or milk if the mixture needs to be thinned a bit and heat to serving temperature.

Serve with additional Parmesan cheese.