Disclaimer: Characters, backstory, and settings belong to Shonda Rhimes and her team of lawyers. This story is meant to be for entertainment purposes only, constituting acceptable borrowing under the fair use doctrine. Please don't sue me, I have no money anyway. Please place all trays in the upright position for landing. Do not use in the bathtub. Always know where your towel is. If you hear guttural moaning in the basement while home alone in the dark, don't go down there.

A/N: I am not an expert in, well, anything legally, practically, or medically relevant to this story, so please forgive any errors you might encounter – my information comes from amazing sources like Google and Wikipedia. I wrote the bare bones of Commitment in a twelve-hour overnight writing marathon in September, so it's something I'm very fond of; please be kind with your hate mail. It starts off canon, and veers into my madness after the events of 7x09. Some events (and even lines) will be vaguely recognizable from canon, but nothing is set in stone and I've definitely fiddled with timelines. A lot. Mwahahaha. Hold on, ye scurvy dogs, thar be angst ahead! Don't abandon ship!

X-X-X-X

PROLOGUE

Quantum physicists tell us about the possibility of parallel universes. That two universes might be exactly the same except for one butterfly flapping its wings on a particular Tuesday. Or maybe one where a World War went differently, or England spoke French. In some of those different universes, the changes were more subtle than a war and more profound than a butterfly.

In one universe, Arizona Robbins is named in honor of her beloved, alive grandfather, who saved eighteen men at Pearl Harbor before being pulled from the warm waters of the Pacific barely breathing. With his grandfather alive and encouraging him, Tim Robbins follows his dream. After college, he serves his country by joining the Army Corps of Engineers and lives until the age of eighty five. With both his best friends alive, Nick deals with his cancer much earlier, and survives. The two men are enthusiastic and doting uncles to Arizona and Callie's children.

In another, Arizona doesn't take the position at Seattle Grace, but rather goes to Shriner's in Massachusetts. She meets Callie Torres at a pediatric orthopedics conference two years later.

In another, Callie Torres and Owen Hunt married a year before Arizona Robbins set foot in Ellis Grey's Seattle Grace and have three children together. The two women become unlikely friends, and eventually lovers. Callie divorces her husband, and Arizona becomes an adoring stepmother to three tiny humans.

In another, Erica Hahn doesn't disappear into a parking lot after fighting with her first girlfriend. They continue their argument for much of the next month, both out of work and in the halls of Seattle Grace, while having angry sex at every opportunity. Erica does end up splitting with Callie, but they work hard to regain their friendship, and it is Erica that pushes Callie at Arizona Robbins several months later. When Arizona wins the Carter-Madison, Erica calls Callie out on her whining. Arizona and Callie talk after Erica locks them in an on-call room for three hours, and amicably split, though both are heart broken. Erica keeps Callie from any embarrassing drunken sorbet episodes, and Arizona returns in time for Christmas, running her clinic from Seattle Grace. Erica is a bridesmaid at their wedding a year later.

In another, Arizona breaks down after being told Callie is pregnant with Mark's child. She returns to Malawi and doesn't run into Callie again until ten years later, when they are both nominated for a pediatric medicine award. Still in love, and both single, they fall into bed together. Mark having died in a plane crash shortly before Sofia turned two, Callie is free to move her and Sofia across the country and spends the next year wooing her ex girlfriend before they reunite permanently.

In another, Gary Clark shoots Callie in the lower abdomen once she hands him the bandages. Extensive damage to her uterus requires an emergency hysterectomy amongst other surgeries. Three years later, Callie and Arizona adopt their first child.

In another, Arizona doesn't win the Carter-Madison. Instead, she wins the Harper Avery five years after Wallace's death for her work on short-gut syndrome. The next year, Callie wins it for her artificial cartilage. They bring their two small children to both award ceremonies, and married after the people of Washington State voted to legalize gay marriage.

In another, despite her heartbreak, Arizona stays in Malawi until her commitment is complete. This is the story of that universe.

X-X-X-X

CHAPTER 1

Callie Torres awoke with a start and a fervent need to get to the toilet. Jumping up from Mark's couch, where she'd been living for several weeks, she high-tailed it into the bathroom. Luckily the seat was up, which made vomiting easier.

Callie Torres, unless she was forced to speak in public, almost never threw up. She had none of the other symptoms of a stomach flu, she hadn't had any alcohol since that night at Joe's…

Shit. Scrambling up from the bathroom floor, she flushed the toilet and quickly cleaned her teeth. She stumbled into the living room and grabbed her phone. With a quick flip through her contact list, she dialed, even as tears began to streak down her face, "Addie? I need you."

Luckily it was her day off. And Addison's as well. Six hours later, Addison dragged her to the Archfield, and shoved Callie into her suite's bathroom with a home pregnancy test.

An hour later, the tears hadn't stopped, though Callie had made her way from the bathroom to the oversized bed. Curled up into a ball, she was uncharacteristically silent, Addison fearfully watching her.

"Do you want to go to the clinic tomorrow?" was the first, quiet inquiry.

Callie shook her head. She didn't want Mark's baby, she wanted Arizona's. She'd always desired kids, planned to have them, but she'd only been able to picture them in her mind once she was with Arizona. And despite how many friends she'd brought to Planned Parenthood over the years, often even paying, she couldn't manage to avail herself of that option.

Her faint, desperate hope of Arizona maybe returning and eventually rebuilding their relationship died in the moment she came to the conclusion her ex would never forgive her for not only sleeping with Mark – the one man Arizona had always been uncomfortable around – but for also a lifetime shared with Mark even if he was only a part-time father. And after Sloan Riley, Mark would never settle for being a part-time parent. It was then that Callie truly broke down. She had a baby on the way, but with an immature friend instead of with the love of her life. The tears quickened, and sobs wracked her body.

Addison, who had been perched next to her on the bed, wrapped Callie in her arms as her friend disintegrated before her eyes. Mentally, Addison's mind was whirling. As soon as Callie drifted off into an emotionally exhausted sleep, Addison made several phone calls, clearing her schedule for the next week. Callie couldn't stay on Mark's couch. She'd find her best friend somewhere to live, and help her cope.

X-X-X-X

Arizona Robbins stared at her computer screen. She was temporarily in Lilongwe, coordinating the building of her clinic while also diving into surgeries at the city's main hospital. The medicine was phenomenal, and her fellow surgeons were fascinated by the cutting edge techniques she was sharing with them. She could see the difference she was already making, and that was about all that kept the tears at bay during the day. Arizona Robbins was a strong woman. A good man in a storm, as she was raised to be, as she had once promised Carlos Torres she was. But she fell apart every night, sobbing herself to sleep when she even could manage to rest. The storm swirling around in her personal life had battered her into a pulp.

The email she was currently reading was not helping with her self-control. Emails, mostly to Teddy, were about all that kept her afloat – a mix of gossip, personal chat, medical cases (including informal consults), all much like their hurried chats over a cup of coffee or glass of wine – interspersed with the occasional very professional-yet-fond emails from Miranda Bailey. Having moved so often as a child, she rarely fostered ties to places she had previously lived. But Seattle had been different. Seattle had been home, her friends ones she had expected to keep for a long time.

Teddy's email was apologetic. She tried to soften the blow with "We all got really really drunk. Cristina makes this drink, it's blue, and I think I forgot a year of med school because of it, and I didn't even start off with tequila like Callie." But that couldn't take away from "Callie and Mark ended up in bed together. She doesn't seem happy about it, at all."

With silent tears running down her face, Arizona switched to another browser tab. She was logged into the airline's site, everything waiting on her credit card information to book the trip from Lilongwe to Sea-Tac, with many layovers in between. Shaking her head, she logged out of the site and closed the tab.

She would stay. There was nothing for her to go back for anyway, now. She had made a commitment – to the Carter-Madison committee, to the doctors, nurses, and orderlies she'd already hired, and most importantly to the children of Malawi. She had made a commitment she would honor. Even as inside, she broke.

X-X-X-X

Work kept going after Arizona left Callie in an airport. Surgeries couldn't be postponed so she could cry in a supply closet. And then Stark chopped off a leg she could have saved, and Callie found herself dragged into the drama. She'd ended up in a discussion/argument with the arrogant little man outside the patient waiting room, somehow, and the girl's parents had heard everything – her assertion that he should have waited because she could have saved the leg, Stark's assertion as the "senior attending" that he was right, and even Karev's gruff, profanity laden statement that she knew more about bones than Temperance Brennan and that he'd seen her rebuild worse. Besides the fact that apparently Alex Karev watched TV, she'd noticed the horrified parents listening in.

And then she'd been named as a witness for them in their lawsuit. And after they'd given their statements, so had the other nurses and doctors in the OR. Great. Just what she needed. But she was honest and open with the lawyers – she most likely could have saved the leg, or at least most of it. It would have required massive physical therapy and recovery time, but the girl had been a soccer star and was used to working hard.

She took pity on Karev after Stark blackballed him from the peds floor, calling him for every even vaguely-related peds case she acquired, as did most of the other attendings. While a doctor getting sued, and other doctors being called to testify against him, was a big deal and would generally have the doctors siding with the sued one on principal, unnecessarily amputating a child's limb, after a GSW when shootings were still a sensitive subject at Seattle Grace, on top of Stark's general behavior and angry temper tantrums on the peds floor, led to most of the employees siding with Callie and Alex. The peds nurses, residents, and lesser attendings called in consults for second opinions regularly to double-check Stark's already mediocre work. And the hospital moved on even as the lawsuit cranked through the legal system like molasses in January as the in-house counsel looked for a contract loophole that would let them get rid of Stark.

Except for April Kepner. Who had been working rather closely with Stark, and had been horrified when the news spread around the hospital.

Addison slowly lowered Callie's coffee intake, citing numerous studies regarding caffeine and various birth defects. By the time Callie was down to one cup of regular coffee a day, plus as much decaf as she could drink, the headaches started to appear. She wasn't sure if they were stress or grief or caffeine related, but they hurt. April found her in late December studying an x-ray for an upcoming surgery.

"Doctor Torres?" It was unfortunate the woman's voice was a bit grating when Callie had a headache, but despite her pep, April was a solid surgeon. Callie could respect that even when she wanted to muzzle her.

"Yes, Kepner? And can you keep it down? I have a headache," Callie replied.

"Umm… I was wondering if I could be on your service for awhile. Maybe long-term?"

Callie turned and stared. Usually, residents avoided her service, especially on a long-term basis. Avoided carpentry. There was no glory in ortho, she had realized long ago. Her own ex-husband had used her as a way to avoid people he was angry at, and even Karev was only really interested in the peds procedures. Which she understood, and was glad to indulge him. He was good with the kids, and any peds person who understood her specialty better was a positive given the amazing ways kids tended to injure themselves. Kepner had, as part of her residency at Seattle Grace, spent a particularly boring rotation helping Callie with hip replacements and cleanly-broken bones, and never looked back. "Why?"

"Umm… well." The younger woman turned slightly red. God, she hoped Kepner wasn't coming out and needed advice or something.

"Speak up or get out, Kepner. Choice is yours. Why do you want to hang around the carpenter?"

"I uhhh… I've studied the amputation case of Doctor Stark's. And watched some of your surgeries lately. And I realized I don't know enough about ortho. And it was…" April trailed off as she watched Callie stiffen at the mention of the amputation. "I'm sorry! I'm sorry! Just… it's been really fascinating. And I want to learn more!" she rushed out her explanation.

Callie stared at her coworker some more. "I thought you were into peds, or trauma, or something."

April smiled a little. "I thought I was too."

Callie grinned. "Okay. Well, I'll talk to someone about getting you assigned to my service until you tell me otherwise. Meanwhile, you busy today?" April shook her head. "So… what can you tell me about this x-ray?"

April's skills as a surgeon easily adapted to ortho, and her farm-raised body had the hidden strength, built while hauling seed and wrestling pigs, to set hips and break bones. Callie, grateful for both a protégé and a new friend, jumped into mentoring the younger woman with both feet.

X-X-X-X

In mid-January, Arizona received an email from Alex Karev, of all people.

Hey Robbins –

Look, this new department head they brought in to Peds is a total jackass. He's horrible with the kids, ignores the parents, thinks he's god's gift to medicine. Two weeks ago there was a school shooting, and we got this kid with a GSW and major damage to her leg. Stark had one guy stabilizing the GSW and he was going to cut off the leg. I'm not Ortho, and it was bad, but I knew it was salvageable, especially if I could get Torres in there. And he was just going to cut it off. I spoke up, loudly, and the guy doing the GSW backed me up that the kid was stable enough for reconstruction work. So I got a nurse to page Ortho, but she didn't put a 911 on it, and Torres had her own patient so she got there after it was too late for the leg, but soon enough that she could see it was an unnecessary amputation.

And that's what the lawsuit the parents are bringing will say. I almost body-blocked him, but I wasn't sure how long I could hold him off before Torres arrived. Anyway, thanks to Stark getting his ass sued and because I stood up for the patient, he's kicked me off the peds floor. A bunch of the other attendings are sneaking me in on peds cases if they can, but it's not going to be enough. I need to switch hospitals if I want to really concentrate on peds. Do you have any suggestions on where will take me this far into residency?

Arizona smiled a little, the honest gesture unfamiliar outside of the reassuring surgeon-smiles she bestowed on patients and parents. It was a horrible situation, but she knew Karev was great at pediatrics, was glad he'd finally figured out it was his field, and there were several programs she could think of that would take him, even as rough around the edges as he was. Yet… she had imagined her clinic as a teaching hospital. And the overall plan included accepting residents once they were settled. She had an email to the Carter-Madison people, and one to the Chief at Seattle Grace, to write.

The Chief, desperate for some good press after the amputation story hit the local news when the irate parents talked, agreed to let her oversee the rest of Karev's residency. He would have to fly back for his boards, but he would be in Malawi as a representative of Seattle Grace for the last year-and-a-bit before his boards and the first year of the fellowship she would surely give him – and had been assured would be recognized at Seattle Grace as well should they decide to return there when her commitment was finished. It was a better result than she could have ever hoped for.

A month later found her at the Lilongwe airport as Alex Karev stepped off the gangway. He gave her that smirking grin she had figured out covered for real pleasure, and she grabbed his carry-on, unexpectedly hugging him in the process.

"Hey, Robbins," he said, letting her lead him towards baggage claim.

"Karev, glad to see you. C'mon, I've got the spare bed all set up for you," Arizona smiled, honest and open. Her first real taste of Seattle – her favored protégé – was in Lilongwe, and it didn't hurt. It made her happy, in fact, to see the resident she thought was the future of peds. And she was bringing him in to be a part of her dream. Others hadn't wanted a part in her dream – she stomped that thought down inside before she pictured Calliope's face as she had walked away in Sea-Tac – but Alex Karev jumped at the chance she offered him.

"I'm living with you?" His eyes were surprised, but he quickly covered it.

"Yeah, space is tight and funding nonexistent for extra rooms at the hotel. So you'll have to tough it out for awhile. I promise I pick up my towels. Once the clinic is actually built, you can have your own room, but you'll still have to share living space. I didn't account for residents for another couple of years," she replied, dimples breaking out for the first time since before Sea-Tac. It was good to see Karev. He had such potential, and her patients could really use his skills.

"Sounds fine," he gruffed. "So the clinic is being built?"

"They broke ground not long after I got here, but there's still time before they're done. And as my first resident, you also get to be my assistant. More paperwork, sorry, but also the best surgeries! Plus, I just got the extra funding to build a school near the clinic, for the patients and their families. The refugee situation in Malawi means it'll be the first schooling a lot of these kids will have had. You get to help me hire teachers. I hope you can pick up languages quickly. Chichewa is not an easy language for me, and our staff translators aren't always available," she grabbed the second large suitcase he'd pulled from the conveyor belt. "This it?" At his nod, she started to lead him towards the parking lot and the battered truck she'd bought for the clinic's use.

"I was reading about that. Lot of refugees from other countries?" He'd read a good deal about Malawi since Robbins' offer came in his email and was confirmed by the Chief. He read up on the gender violence and anti-gay sentiment in his new country, and had already decided to stick to Robbins like glue.

"Unfortunately. And we'll get a lot of patients referred from the Red Cross refugee camps, stuff they can't handle. It's already been arranged – ambulances, some funding help, that kind of thing. Otherwise they'd either be out of luck or trying to medivac the kid to a city hospital, but that's pretty hard to manage on their budget." She threw his suitcase in the back of the old Ford, and unlocked the door. "C'mon, the hotel's about a half hour away, we'll get you settled, and then you can see where we're working out of temporarily. It's an older hospital, not quite up to… well, it sucks, but I'm doing what I can until the clinic's finished. Kids can't wait." She unlocked his door and climbed into the driver's seat. "Buckle up. Driving through town can be… interesting."

Though Karev's language skills were more along her level – stumbling but enthusiastic – he adapted quickly to the work they were doing. Even with a language barrier sometimes in place, he bonded well with the kids, and she worked with him to smooth the edges of his behavior around the parents.

The clinic was completed by mid-March, and the school soon after, so they moved outside the city to their new location in rural Malawi, a few hundred miles from the border and midway between the Red Cross refugee camps and the nearest city, on the edge of a moderately sized farming village. Housing for the staff was attached to the clinic, and Arizona and Alex decided to continue sharing a small two bedroom apartment, the one set aside in the plans for the permanent clinic director's family.

Like an overprotective brother, Alex didn't leave Arizona alone except to go to the bathroom or when they were safe in their locked apartment. But his surgical skills flourished under her tutelage, and for awhile they were content, functioning, if not happy. He jumped into his new residency with abandon, even the overwhelming amount of paperwork he helped Arizona with, and kept his mentor going by making sure she ate regular meals and drank enough water, which she tended to forget between work and ongoing grief.

When the reality of her breakup with Callie overwhelmed her six months to the day after their fight at Sea-Tac, Alex tucked her into bed, and told everyone that she was sick. That night he made dinner and set a roll of toilet paper by her bedside in lieu of tissues.

X-X-X-X

Callie sighted her prey down the hall. With fluid movements, she grabbed the other surgeon's arm and forcefully directed them into the nearest on-call room.

"Hey, Lexie, we need to talk," she said, shutting and locking the door behind them. At the three month mark, she was just starting to show, and though Mark had been sworn to secrecy until out of the first trimester, the plastic surgeon was practically strutting in the halls.

"Sure, Callie," the younger woman replied. The two had been friends, once, but the stress on their friendship from Lexie's split with Mark had kept them apart since.

"Look, it was a mistake, but I got really drunk one night after… after Arizona left." Lexie nodded. The stories of that night of drinking at Joe's had made their rounds of the hospital. April had tended a smashed Bailey and Altman's drunkenness had been hysterical according to Meredith. "And I ended up sleeping with Mark."

Callie let the other woman absorb her statement. "And I'm sorry, but I got knocked up. I hit the three month mark yesterday, and I wanted to come clean with you before you heard it from a nurse or something. Mark and I are not together, in fact, I'm kind of barely speaking to him right now, but you deserved to hear it from the source. I'm sorry. I'm so, so sorry."

Lexie pulled her arms around her torso, and nodded. "I'm not with Mark, Callie, it's fine," she said.

"Yeah, I know. But you want to be. Which, honestly, I would advise against. He's being a douche right now. I just… you're a good friend, Lexie, and I don't want this to screw us up." She thought of the mornings when she'd cook breakfast for all four of them, a strange little almost-family. Callie liked the younger woman, thought she was great for Mark, even if Mark wasn't the best for her.

The other woman nodded, clearly still in a state of shock. She raised her head, meeting Callie's gaze. "Why'd you keep it? If you're not with Mark, if you don't want to raise a kid with him?" The question was honestly curious, not accusing.

Callie laughed bitterly. "I've brought more friends to Planned Parenthood than I want to think about. I've held their hands and never judged and sometimes even paid for it. I believe in a woman's right to choose. But it was never a choice for me. Too many years of Catholic school or something. I mean, I might be single, but I'm not… I've got the money as an attending, and the support system, and I know this kills any chance of Arizona ever forgiving me for… a lot of things, if she ever comes back." Callie let out a little, involuntary sob at that. "But I can support a baby, I like kids, I wanted my own - though not this way, and so far it's healthy, so, here I am. Stuck with Mark as the baby daddy for the next eighteen years or so."

Lexie nodded. It was a personal choice, and she could understand, if not agree, with Callie's position. "It's okay, Callie. And... well, I'm not sure if congratulations are in order, but I know you'll be a great mom." She smiled a little stiffly, obviously processing. "And I think we'll be okay."

"Thanks, Little Grey," Callie smiled back sadly.

X-X-X-X

Two weeks after spending the day in bed, crying, Arizona oversaw the transfer of several patients from a local orphanage to her clinic. The battered bus was full of a mix of children needing everything from basic inoculations to major surgery, as well as a handful of orphanage workers. As the workers and her own staff slowly unloaded the passengers onto stretchers or wheelchairs, she watched closely as Alex took lead on organizing everyone. She found her attention drawn to a screaming baby, no more than six months old. The orphanage worker rocked the little girl to soothe her, but wore the long-suffering look of an adult who knew what they were doing was fruitless in the face of a baby's unhappiness.

Arizona stepped over to her, offering with a gesture to take the little one into her arms. With a relieved sigh, the worker handed the girl over, along with the paperwork she carried on the child's behalf, before returning to the bus to help another of her charges.

"Hello, little one," Arizona soothed, as the girl settled into her arms. Tears continued to stream down her tiny face, but her sobs quieted in Arizona's embrace. Glancing down quickly at the paperwork, she smiled brightly - honestly - at the little girl, the action unfamiliar after so long, "Moni, Zola. It's very nice to meet you." With the baby relaxing in her arms, she stepped back to continue monitoring the rest of the activity around them.

She'd sent Karev to the orphanage a few days beforehand, to do as much organizing as possible, and offer up preliminary diagnoses to help with setting up what amounted to triage at the clinic. Amongst the paperwork in her hand, Arizona saw that Alex thought Zola might have spina bifida. She cursed internally – they had just received their first shipment of latex-free supplies, two months behind schedule, but hadn't everything needed quite yet to hopefully avoid what was a common allergic reaction in children with the condition. She'd have to call and try to rush the next order.

"Karev!" she called, nodding him over to her side.

"Yeah, boss?" he grunted, a toddler quite happily in his arms and playing with his stethoscope.

"You set up any latex-free rooms for these kids?"

"Oh, for Zola, you mean? Yeah, but we're gonna need more supplies soon," he grinned at the little girl curled in Arizona's embrace. "She's the highest priority for latex-free at the moment. Any rashes on her from my gloves? She was fine while I was there…"

"Not that I'm noticing, but let's not risk it," Arizona grinned, pleased at her protégé's comprehensive work and attention to detail. Latex-free hospital rooms for spina bifida patients were the norm on her peds floor in Seattle, due to how common the allergy was, and she was pleased to see he'd taken that instruction to heart.

One of the orphanage workers, a small child in his arms, stopped by Arizona as she rocked Zola, "That baby, she's always crying. I've never seen her stop like that." He grinned, and then followed the other workers and patients into the clinic.

"Huh. Guess you like me, huh, big girl?" Arizona said, getting a gummy smile in return. "Well, I like you too."

to be continued...