"Sarah. Sarah!" Despite her headphones, she heard her name being called and looked around to see where the voice came from. Her eyes settled on Dr Charles standing by the ED doors a few feet ahead of her, a mixture of worry and annoyance all over his face.

"Dr Charles, I am so sorry I'm late. I woke up feeling really ill and I wasn't sure if I should come in and then I felt fine but I couldn't find any pants that fit me and-"

"Hey, hey, hey. Sarah. Sarah, listen to me. It's okay, okay? I'm not mad at you. I was just worried. That's all."

Dr Charles, the head of Psychiatry at Chicago Med, and Sarah Reese's attending, was confident in her abilities, but at the same time well aware of her insecurities surrounding her ability to perform as a psychiatrist; as a result, he was often having to go out of his way to reassure her that she was doing well and that there was nothing to be worried about.

"Are you sure?"

Despite his constant reassurances, she still felt as if she didn't measure up to his abilities as a psychiatrist, and being late didn't help to quell this fear, even though it was a one-off incident.

"Of course I'm sure. Now, we have a patient in treatment four that we need to see soon, but before we do take some time to calm yourself down, okay?" He smiled at her, and she nodded weakly, then made her way over to the break room to dump her bag and jacket.

As she was leaving, she bumped into Nat Manning, a regular ED doctor, on her way to check on a patient.

"Sarah! Are you okay? You look a bit pale." The concern was evident in Dr Manning's voice, but Sarah ignored it.

"Yeah, I'm fine! Just a little tired, that's all." She smiled at Nat, then made her way over to treatment four, where Dr Charles filled her in on the details of the patient.

Nat stood watching her for a minute, then went to find Maggie, reminding herself to check on the patient when she was done; it was just a broken arm and could be handled by the nurses until she was done.

"Hey, Maggie."

"Hey, Nat! What's up? You look worried."

"It's nothing, I just- Sarah seems a bit off today. Could you keep an eye on her for me? Just make sure she's okay?"

"Of course, that's no problem at all." She paused for a moment. "What makes you think something's wrong?"

"I don't know, it's just a hunch, it could be nothing. But she looked really pale just now, and I overheard her telling Dr Charles that she didn't feel that great when she woke up. I don't know. Maybe I'm overreacting."

"Maybe you are, who knows. I'll keep an eye out anyway, just in case."

"Thanks, Maggie."

"No problem at all Nat. You take care of yourself as well, yeah?"

"Yeah. Of course. Thanks again."

"So what are we thinking?"

"Well, the patient presents with rapid speech, agitation, insomnia, and of course the self-harm that brought her here in the first place. Do we have a history?"

"Uh, not really - P.D. brought her in about an hour ago after she was found bleeding on the side of the road."

Dr Reese paused for a moment, considering the evidence in front of her.

"I'm thinking bipolar? This sounds like a mixed episode to me."

"That's what I thought as well. The best course of action at this point seems to be a 72-hour hold, by which time she should be more stable, and hopefully, we'll have got in contact with a friend or relative."

"Sounds good." Sarah smiled at Dr Charles, pleased to have made a correct diagnosis, then walked off to start the transfer papers.

Although it was only a small win, it meant a lot, and Dr Charles could tell that from the complete shift in her attitude; she was suddenly more upbeat and confident, and it was a change Dr Charles was always happy to see.

Just as he was finishing his checks on the Jane Doe, a commotion erupted outside the treatment room. Curious, he stepped outside and found Maggie and Nat crouched on the floor around someone, a few nurses standing behind them.

"Is everything okay?" Maggie turned to look at Dr Charles, anxiety written all over her face.

"Sarah just fainted."

Before he could even respond, she was already regaining consciousness, and Maggie and Dr Manning were trying to help her into a wheelchair.

"Maggie, I really don't think this is necessary - I'm fine. Nat, tell her I'm fine." Sarah, now almost fully alert, looked pleadingly towards Dr Manning.

"I'm sorry Sarah but fainting is never a good thing. We're just going to give you some fluids and let you rest while we run a few tests. It won't take long, okay?"

"I'm fine."

"If you're fine, a few tests won't matter. Let's just get this over with, okay?"

Accepting that her resistance wasn't going to get her anywhere, the young psychiatrist settled into the wheelchair and allowed Maggie to take her to a treatment room.

Half an hour later and Sarah was sitting, attentive and upright, in her hospital bed, an IV attached to her right arm, waiting for Dr Manning. She'd ordered all sorts of unnecessary tests, which Sarah had obviously protested against, but eventually, she'd given in and let the doctor do what she wanted. A doctor herself, Sarah felt there was no reason for concern - she hadn't picked up on anything in the last few days or weeks that immediately rang alarm bells; from her point of view, she was simply tired and dehydrated, and probably going down with the flu. Nothing too serious, and definitely nothing that would require such extensive testing.

Just as she was starting to drift off - she hadn't been sleeping too well recently, but blamed that on the extra night shifts she'd taken on - Dr Manning returned with some test results from pathology.

"Hey, Sarah. How are you feeling now?"

"I'm fine, better than before. Am I allowed to leave yet?"

"Not quite. I've got some results here I'd like to talk to you about if that's okay."

"Yeah, sure, go ahead."

"So your sodium and calcium levels were lower than we'd like, but hopefully the IV will have sorted that out. Your blood sugar's 3.8, which is also too low for comfort. However, the IV should also have managed that and you should be okay in about an hour."

"Is that it? So I am fine?"

"Well, sort of. Why don't you take a look."

Dr Manning handed a confused Sarah the results from her blood tests, which she took hesitantly.

Her eyes scanned the list, before settling on one line near the bottom.

"hCG - Present"

Her breath caught in her throat.

"Wha- no. No, it's not, it's-" She could feel her heart racing, and her breathing quickened. How could this have happened? She had been so so careful with Joey, every single time. Joey. She started trying to do the maths in her head, but couldn't concentrate on it. How had she not noticed? She didn't have an exact date, but it had been a while...

"Nat-"

"Hey, Sarah, it's okay. Did you not know?"

"I, uh, no…"

"Do you have any idea how far along you might be?"

"I don't know, I- I…" Her voice trailed off as the reality of her situation sank in.

"Well, there are lots of things we can offer here, both medically and as support at work. You know about the nursery don't you?"

"Yeah." Her voice was quiet, and she suddenly seemed a lot smaller, almost like a child being thrown in at the deep end.

"I think what's best right now is for you to have an ultrasound to check on the baby and-"

"No, I don't- I don't want that. Can I be alone for a bit?"

"Oh. Sure." Nat smiled at Sarah, then reluctantly left the room.

Maggie was waiting just beyond the doors for Nat and was disheartened to see her leave the room so soon.

"What happened?"

"She didn't take the news well - didn't even want an ultrasound."

"Do you know why?"

"No idea."

The two women looked towards Sarah, who was curled up on her side in bed, her shoulders shaking gently.

"Should we get someone? Dr Charles?"

"Let's wait a bit. She said she wanted to be alone."

"Okay. I'll speak to her in a bit, and let you know if anything changes."

"Thanks, Maggie."

10 minutes passed, then 20 without a word from Sarah. It was only half an hour later that she appeared at the doorway of her room, desperately trying to catch Nat or Maggie's attention, and leaning on the wall for support. She was about to give up when Nat finally appeared.

"Dr Manning!" She turned around when she heard her name, and smiled at the sight of Sarah out of bed.

"Dr Manning, I was wondering if I could talk to you?"

"Of course." She smiled at her and motioned for the two of them to return to the room. Sarah repositioned herself in bed, and Nat took up the seat next to it.

"So what's going on?"

Sarah took a deep breath and smiled nervously at Nat.

"I want the ultrasound."

"Oh. That's good! What made you change your mind?"

"I don't know. I just want to get it over with."

"Of course. Are you okay with me doing it?"

"Yeah, that's fine."

"Great!"

Nat brought the ultrasound machine round and set it up; all the while Sarah was getting more and more anxious, and beginning to regret her decision.

"Are you ready?"

"Yeah." Her voice was shaky, but she was determined to do this; she couldn't make any decisions until she had more information.

Nat squeezed the gel onto Sarah's stomach, then began moving the probe around. The two women looked towards the screen, and Nat began to assess the image on it.

"It seems you're around 16 or 17 weeks pregnant at this point, and baby and placenta both look healthy."

"17 weeks?"

"I know it seems scary, but it's very common to not know for the first few months."

"I should have known though. I'm a doctor. How did I not pick up on this?"

"I don't know, Sarah, but it doesn't matter. You and baby are both healthy and there don't seem to be signs of any complications-"

"But I should have known."

Eager to move on from Sarah's perceived failings as an expectant mother, Nat continued to move the probe around until she had a clearer picture.

"Do you want to know the sex?"

Sarah looked up from where she was anxiously picking the skin around her nails and nodded.

"Okay, gimme a sec." Nat readjusted the image one more time then turned to Sarah and smiled.

"It's a baby girl!"

"Oh. Wow. Thank you. Can I keep this?" She motioned towards the image on the screen.

"Of course! I'll get that sorted for you." Nat smiled and turned back to the machine; less than a minute later she presented Sarah with a few printouts of the ultrasound images.

"If you need anything else, let me know, okay?" Sarah nodded.

She wasn't going to say anything for fear of appearing needy, but as Nat was leaving the room she spoke up.

"Actually, Nat, could you page Dr Charles, please? I need to talk to him."

"Sure!"

The time between Nat leaving and Dr Charles arriving was long, too long for Sarah to be comfortable with. It allowed her mind to wander to places she didn't want it to, for her to become overwhelmed with anxiety at the decision she had to make. And at the end of it all, everything led back to Joey. He'd been through a lot with her, but towards the end, they'd slowly drifted apart. There was no way this could fix things; if anything, it would make the whole situation more complicated. At the moment, there were no hard feelings - it was a mutual breakup on both of their terms, and they'd remained civil since. However, adding a baby to the equation would only make things worse, and there was no way she could go through with this without him finding out; for all she knew, he was the one that ran her tests, which would make him the first to know.
And, on top of everything, she wasn't ready for a baby.

"Sarah?" Dr Charles knocked on the doorframe of her room, and she looked up, pleased to see him.

"Dr Charles!"

"How are you doing? I heard you fainted earlier. What's that about?"

"Actually, that's what I wanted to talk to you about."

"Oh?" Making himself comfortable in the bedside chair, he motioned for Sarah to elaborate on her previous statement.

"Nat ran some tests, and uh… They came back-" Her breath caught in her throat and she could feel her eyes welling up.

"It's okay, take as much time as you need."

"I think it's, uh, easier for me to show you." She took a deep breath as she handed him the ultrasound pictures from earlier.

"Wow, Sarah, this is…" He looked up from the pictures at her, taking in her tear-filled eyes, the raw, bleeding skin around her fingernails from where she'd picked it all off, and the anxiety written all over her face.

"How do you feel about this?"

"I don't- I hate it. I'm too young for this and there's no way I can handle a baby. The father isn't in the picture, and even if he was, he's not exactly cut out for parenthood. I've never wanted children, and yet here I am, meanwhile April desperately wanted her baby and she lost it. I have no options and I just feel so, so trapped."

"How far along are you? If you don't mind me asking?"

"17 weeks, and I only found out this morning. How am I fit to be a mother when I couldn't even pick up on the most basic of things? I'm a doctor, this should be second nature to me."

"Is it possible that you may have known, at least for some of this time, but instead ignored it, maybe hoping it would go away?"

She thought back over the last few weeks and months - she'd been a lot more tired than normal, but blamed it on the extra shifts she'd taken on, and none of her clothes fit properly anymore, but she'd blamed that on her decrease in exercise. Now that she looked back, she realised she'd found some excuse or arbitrary explanation that didn't involve tying the symptoms together. Even when she'd found herself heaving over her toilet every morning, she still managed to blame it on anxiety or work stress, rather than taking a step back and looking into it properly.

"I guess…"

"You also mentioned something about feeling trapped? Would you like to elaborate on that?"

"I just- I'm stuck with this baby now; I don't have a way out of this. Joey? He doesn't even know. He won't have to deal with the consequences of our mistake."

"Wait, Joey-from-pathology Joey?"

"Shit ." She hadn't realised she'd slipped his name into the conversation.

"It's okay, it's none of my business. And you do realise there are 'ways out of this', don't you?"

"If you're talking about an abortion… I can't."

"Why not? It's legal up to 23 weeks here."

"I don't want to hurt her. But I don't want her either." For the first time since receiving the news, she placed a hand on her stomach, which now that she looked was raised, and gently drew circles with her thumb.

"I guess what I'm saying is - I don't want any of this. I wish this hadn't happened, because now that it has, I can't see a way out of it."

"There doesn't have to be a way out of it, just a way you can cope with. If you can't cope with an abortion, that's fine - no one is forcing you to have one. I know you don't want to carry this baby, but adoption is always a possibility."

She looked at him uncertainly; they'd had too many kids from the foster system come into the ED, refusing to go back for fear of the abuse they undoubtedly would face, either from their new parents or from the people put in place to try and prevent it. No. There's no way she'd put her daughter through that.

Dr Charles realised the problem with his suggestion and immediately tried to backtrack, but to no avail. Both he and Sarah knew there were only three realistic options here, none of which seemed adequate.

The two sat in silence for a while, both considering the options. As far as Sarah was concerned, adoption was a no-go; she'd seen too many kids failed by the foster system and despised the idea of putting her own baby through that. Instead, she had just two other options: terminate the pregnancy and move on, or continue with it and accept motherhood.
She knew that she only had a few weeks to decide - after that the baby was considered viable and abortion would no longer be an option; she'd have to go through with it.
Dr Charles, on the other hand, was more concerned for Sarah than the baby. He wanted it to be okay, of course, but not at the expense of Sarah's happiness. However, he couldn't see a decision that could accommodate both Sarah's and the baby's needs.

"Dr Charles, can I be alone for a bit?" He was drawn away from his thoughts by the sound of Sarah's voice.

"Huh? Oh yes, of course." He stood up to leave then turned to face her.

"I know how difficult this must be for you. If you need anything just let me know okay? We'll get through this."
"Thank you. Really." She smiled at him, but he could see the worry in her eyes.

Poor thing, he thought to himself. She's so young.