"Hey Amelia, I need your help with something," Dr. Robbins said as she saw Amelia Shepherd looking at an iPad at the nurse's station.
"Yes?" Amelia responded while she finished adding the final details on her patient's chart.
Arizona handed Amelia her tablet with the patient's chart pulled up as she said, "I know that there's not really anything you can do, but I thought maybe if you talked to her, she would better understand her situation. Since you're a neurosurgeon."
Amelia looked down at the chart and she only had to read the first few lines when her heart fell out of her chest and smacked the floor below her. She closed her eyes and took a deep breath, "I can talk to her," Amelia replied so quietly Arizona almost didn't hear her.
Amelia knocked on the outside of the patient's door, "Hello, I'm Dr. Amelia Shepherd. I'm a neurosurgeon; Dr. Robbins asked if I could come and talk to you."
"Yes, of course. I'm Alexa Hanson. Please come in," the woman was about twenty-five. She had the blanket pulled up just below her waist but she was obviously pregnant.
Amelia began, "Well, Ms. Hanson,"
"Please," the woman interrupted, "Call me Alexa. I know you're not supposed to, but it would make me feel so much better."
Amelia smiled, "Alright, Alexa. Do you mind if I sit next to you?"
"Please go ahead. I'm sure you're tired of standing all day." Amelia pulled the chair up and sat down. She was about to speak to Alexa when the woman began to speak again. "I'm so sorry for interrupting, but I would feel much better if I knew a little bit about you. I hope you don't mind."
"Not at all," Amelia replied.
"I see you have a wedding ring," Alexa inquired.
"My husband is a surgeon at the hospital too."
"Any kids yet?"
"No, we got married about a year ago and we're working our way out of a rough patch, so not yet," Amelia replied with a slight smile.
"Are kids in the cards for you guys?"
"I hope so, but it's complicated."
"I know complicated," Alexa began. "I had a boyfriend. He was great; well I thought he was. The second I told him I was pregnant, he bolted. Then my baby…" Alexa trailed off without finishing.
"I wasn't entirely truthful with you about not having kids," Amelia admitted. "I do have a kid, a son actually. He would have been five later this year. He would have been going into kindergarten this fall. He's in heaven."
"What happened?" Alexa asked with genuine concern in her voice.
"I was about 25 weeks pregnant when I got my first ultrasound. I didn't find out I was pregnant until I was about 20 weeks along; that's why it was so late.
"My best friend was my OB/GYN and she gave me the ultrasound. She told me it was a boy and then a horrible look came across her face. After a few more tests she told me I was carrying an anencephalic baby. My baby had a brain stem but no brain."
The woman began to cry and Amelia stopped her story. "I know what you're here to tell me Dr. Shepherd, and I don't want to hear this story. I want to hold onto this a little while longer. Please."
Amelia stopped and let Alexa cry for a few minutes. Eventually, she spoke, "Dr. Shepherd."
"Amelia please."
"Amelia," the woman said as she regained control. "Please continue."
"I was so angry. I didn't speak to anyone for over a month. I mean I'm a neurosurgeon and my baby didn't have a brain. It's so ironic that I would have laughed if I wasn't resisting the urge to break out in tears and scream at the universe for how utterly and completely terrible it was.
"Eventually, I found hope. I decided that my baby's life would have meaning. I decided to donate my baby's organ; my baby was going to save at least twenty other babies so their mothers would get to keep them. My baby's life would have meaning for twenty families that deserved it. I have never regretted that decision. I got to hold my baby and that baby was a miracle because he got to help so many others even though he only lived for forty-three minutes."
Alexa couldn't hold back the tears anymore and she began to sob and sob and Amelia just sat there and held her hand.
About five minutes later, Alexa began to speak. "Call me crazy, Amelia, but I had a hope that you would come in here and you'd say you could pull off some kind of miracle with my baby. Then you started talking and all I could think was 'my baby will die; she has no brain and there's a neurosurgeon telling me that she can't do anything'. Then low and behold, you actually tell me that my baby is the miracle I was looking for."
Alexa breathes in and then breathes out and says, "Who do I talk to about donating my baby's organs?"
Amelia smiled and replied, "I can get some people in here to talk to you."
"Thank you," Alexa replied.
It was only a few hours later when Amelia found herself in a room with the members of the board as well as the other surgeons that had been called in to work on Alexa's case.
"I can't believe you even gave her this option Amelia. This is insane!" Arizona said very loudly. "I trusted you to tell the patient what was happening and lead her to a final decision about what to do."
"And that's exactly what I did Arizona!" Amelia replied.
Arizona opened her mouth to say something else when Jackson interrupted. "Okay, everybody. Let's calm down and talk about this."
Jackson began to review the case with everyone else to catch them up. "Dr. Robbins has a case with a mother, Ms. Hanson, who is carrying an anencephalic baby. She is currently twenty weeks along in her pregnancy. Dr. Robbins, would you please explain the course of treatment that you recommended to the patient."
Dr. Robbins began, "This is one of those impossible cases. The ones where you cannot do anything; I hate to say things like that but it is true. I recommended for Ms. Hanson to be induced for labor and deliver a baby that would be too young to survive outside the womb in order to save her from the pain of delivering full term and then losing the baby after an hour."
"Now," Jackson began, "Dr. Shepherd, please share your course of treatment."
Amelia stood and spoke with great confidence, "I recommended for Ms. Hanson to carry the baby to full-term and then deliver. She would be able to hold her baby and then she would donate the baby's organs."
"Dr. Shepherd, do you have any case studies that we can look at?" Dr. Avery asked.
"Yes," Amelia said as she pulled a file out of a stack. "Here's a case I worked on personally at St. Ambrose Hospital in L.A." She handed it to Jackson who flipped through it.
Everyone was silent and Amelia finally took the chance to look at who was around her. There was the board: Jackson, Meredith, Richard Arizona, and Miranda. Then there were the surgeons who were called in to help on the case: Owen was there for general, Alex was there for peds, and Maggie was there for cardio. Usually, Owen would not represent general since he was technically a trauma surgeon, but he was the highest member of the team besides the three that were on the board and there needed to officially be a representative of general surgery.
After a few minutes, Jackson passed the file to Arizona to look at and said, "I have a few questions." Amelia waited as he continued. "Why did the patient choose not to follow a plan like Dr. Robbins? Dr. Addison Montgomery diagnosed her at twenty-two weeks."
"The patient cut herself off from her doctor, friends, and family," Amelia replied.
"How did the patient come to the decision to donate her baby's organs?" Jackson continued.
Amelia took a deep breath, "She saw people who had been affected by organ donation and decided that it was what she wanted to do."
"It says in the file that the baby lived a total of forty-three minutes from the time he was born until his heart was removed. Did the patient ever doubt or change her mind as she held her baby?"
"No," Amelia replied quietly as she looked down at her hands. She felt Owen looking at her. He was over on the other side of the table, but she could feel him looking at her. She took a deep breath and finally had the courage to look at him. He had pain in his eyes, but it wasn't the pity she was expecting. It was understanding. He obviously knew and she gave him a meek smile.
Jackson continued with his questions. "St. Ambrose Hospital almost didn't give permission to perform the organ recovery and Dr. Sam Bennett didn't agree to assist in the heart-lung removal until the last minute. Do you know why?"
Amelia began to explain, "With anencephalic babies, since they only have a brain stem and no brain, you can't declare death until the lungs stop working since technically the brain stem is still active until then. The hospital almost didn't give permission because technically they had to begin operating before the baby actually died. If the surgeons were to wait until an official time of death the organs wouldn't be viable.
"The decision was pushed through by Dr. Charlotte King. Dr. Sam Bennett was reluctant to do the surgery because of not being able to declare the time of death, but he changed his mind." Amelia finished and took a deep breath.
"That's all of the questions I have," Jackson said. "Dr. Robbins do you have any?"
"Yes. Dr. Shepherd, I'm confused," Arizona said with her brow furrowed. "You said you were personally involved in this case, however, your name is nowhere in this file. Did you know the patient? I'm just not sure of your involvement."
Amelia looked down at her hands. She didn't want to answer. No one in Seattle even knew about her baby; she had wanted to keep it that way. She breathed in. She knew that she had to give some answer. She didn't want to lie. This case was hers and she wanted to help Alexa with what she needed. She closed her eyes, took a deep breath and looked up.
"Yes," she said as she was studying Arizona's face. "I was the mother to the baby. I am the patient in the file."
A few people took sharp breaths, but no one said anything for a moment.
No one spoke so Amelia decided to speak. "I had to push to have this done, but it was the only thing that gave me any hope for the situation. The only reason St. Ambrose agreed to do the organ donation is because I had people in my corner pushing for this to happen. If I had not been able to donate his organs, I would be dead. The utter despair in what was going on would have killed me. It gave his life meaning. And I'm going to push for Alexa to be able to do the same. She needs someone in her corner. So, I'm not going to stop pushing until she gets what she needs." Amelia took a deep breath and excused herself. She quietly exited and the door clicked softly.
Arizona gave a small chuckle. Everyone looked at her. "How messed up is that?" She asked. Everyone was very confused until she continued. "She's a neurosurgeon and she had a baby that didn't have a brain." Everyone was very quiet as they all stared out into space thinking about what had just happened.
Amelia was in a bed in an on-call room, laying on her back with her arms behind her head staring up at the bunk above her. She heard a small knock at the door but she didn't answer. She stayed where she was and didn't move.
Owen poked his head in the door and said, "It's me." Amelia didn't respond. Normally he would have crawled in next to her and hold her, but he had a feeling that wasn't what she needed, so he sat on the floor next to the bunk and didn't say anything. He sat facing the wall but he could see her out of the corner of his left eye.
About five minutes passed before she said anything. "I didn't tell anyone. Not Derek. Not my mom. Not anyone. The only people that knew were in L.A. and I had left that life behind. I wanted a fresh start because I was tired of everyone looking at me with pity. I had left it behind… I thought I had left it behind."
She paused and then sighed. "You know the last conversation that Derek and I had was about running. I told him that we're both runners; when things get complicated, we run. I congratulated him for running back to Meredith after he ran to D.C. because he was the first one of us to return after we ran." Out of the corner of his eye, he caught her smile. "Then I told him that I was falling in love with you. He was so excited." They both smiled at that one.
He wasn't sure where she was going but he waited for her to finish.
She sighed and continued. "I ran," she said. "That night we took the pregnancy test; we were both excited. Then as we were waiting, I began thinking about losing another baby and I knew I couldn't do it again. Then I started to think about everything that could go wrong and I was relieved when the test was negative." He winced a little at that remark but was glad when she didn't see. "Then I felt absolutely terrible because I was so relieved and you were so crushed, so I ran." She was finally done.
It was silent and Owen finally made his bold move. He got up and laid down in the bed next to her. She scooted into him and as soon as he wrapped his arms around her, she began to cry. It wasn't an all-consuming sob that either of them expected; it was a cry of relief that she had finally told him. She had finally accepted what had happened to her. She felt as though a weight had been lifted off her.
After a few minutes, Owen finally spoke, "I can't promise you anything. I can't promise that our baby will be perfect. I really wish I could, but I can't. All I can say is that I will be here with you no matter what. We will do it together every step of the way."
Amelia smiled and looked up as he kissed her gently.
Four Months Later
Amelia had given Alexa her personal phone number and they talked quite frequently. Alexa needed the support and Amelia got to see the situation from a third-person point of view this time. It gave her a completely different perspective.
The night came when Alexa came in for delivery. The team was assembled: Arizona would deliver the baby and Alexa wanted Amelia in the room, Alex would lead the organ delivery; Owen and Meredith volunteered to be the general surgeons, while Maggie would procure the heart and lungs, and Richard volunteered to assist as needed.
Alexa decided to not to have drugs because she wanted to be able to have a clear mind as she held her daughter for those few minutes. It was a long labor: twenty hours. Amelia stayed for the whole thing, offering support and being the person that Alexa needed then. After it was over, Alexa got to hold the baby for ten minutes. She cried and Amelia watched and remembered her own unicorn baby. The baby started to squeak and Amelia sadly told Alexa that it was time.
Somehow Alexa managed to hand the baby over to Alex who took her to the operating room. Alexa balled as soon as they left. Amelia held her hand and said, "You just did the hardest thing you will ever have to do. Trust me. I've been through a lot of crap; nothing is as bad as this. I'm so sorry."
Alexa barely managed to say, "She is a miracle."
"Yes, she is," Amelia agreed quietly as she comforted Alexa.
The next day, Alexa was ready to be discharged. Amelia and the team that assisted in the organ recovery came to see her off. Arizona, Alex, Meredith, and Maggie said a quick good-bye and thanked her for all that she had done and said they were so sorry for her loss. Amelia and Owen stayed a little while longer.
Alexa looked around the room and then quietly said, "I knew that I'd be going home without her. I prepared myself, but I can't get over the feeling that I'm forgetting something."
Alexa smiled to herself, "I read about losing a baby. They said to wait at least a year before trying for another; so you can make it past all of the milestones that you would have had with the baby you lost…" She smiled and said, "I guess that gives me some time to find the right man to have my next one with."
Amelia and Alexa gave a little laugh at that one. "At least I will get a chance to tell my rainbow baby about the miracle that their older sister was," Alexa said distantly with a slight smile.
She walked over and hugged Amelia really tight and said, "Go have your rainbow baby. They'll want to hear about their miracle brother."
"I will," Amelia responded. They let go and Amelia said, "Call me if you need anything."
"I will," Alexa responded as she walked to Owen. "Thank you, Dr. Hunt," she said as she held out her hand. "You take care of my girl over there," Alexa said in a small whisper.
"I will," Owen responded with a smile. Alexa sighed and walked out of the room.
Neither of them said anything for a moment and then Amelia walked over and Owen gave her a hug. "How do you feel?" he asked.
"I feel like I've finally got closure," Amelia responded with a small smile.
