Bye and bye, bye and bye

The moon's a slice of lemon pie

The mice have got the other half

They've scattered star-crumbs across the sky.

Bye and bye, bye and bye

My darling baby, don't you cry.

The moon is still above the hill.

The stars still shine against the sky.

When you're standing at the window at night, it sometimes comes back to you. What you've given up – what you've lost. And maybe it's not exactly the best time to think about it, but night has this way of being peaceful and scary, all at the same time. Strange dichotomy, but night's made for people who are hurt. And despite the fact that you sometimes go out of your way to hurt others, you have been hurt. So maybe it's fine – the light from the land up on your face and the faint glow from the stars above, only visible near the water – maybe it's okay to let the tears go, and to remember it, because it's a part of a history that you just can't forget.

Sometimes, the forgetting is worse than the remembering.

It starts on a Monday morning; your eyes are sandy with lack of sleep (insomnia's playing up again) and you make your way to Oceanside for a meeting regarding the Safe Surrender program. You really wish this could happen over the phone, but this is something you feel strongly about, so you go anyway.

They're all sitting around the table; they all have no idea what it's like to actually give up a child. You clear your throat. "This is an important part of what my hospital does for the community. We need to provide young mothers with the option of surrendering their baby safely to people who will look after it."

Addison nods slowly; of all of them, she probably understands the most about the fragility of newborns. Naomi nods, too, and you share a glance with Violet, who looks like she really doesn't care. "You all signed up for this," you remind them, and her face turns resigned.

You give out the instructions and they all nod, and then when everyone is filing out, you catch at Addison's arm. "Do you have time for an appointment sometime today?" Your voice is lowered, you cast a look around, and she nods, although she looks confused.

"Yeah," she replies. "I have an appointment actually right now, if you want to come in. Is everything okay?"

You don't get into it – you refuse to see the gynecologists at the hospital and you're tired of trying to explain your sudden tiredness; the fact that you can't sleep – the pain that's always there in the background. "I just need you to check something."

You have a little trouble letting her look, at first. She straightens up. "Charlotte, I can't look if you won't let me."

You frown. "I'm sure it's not that important, anyway."

"Only you won't let anyone at your hospital look." She parts your legs quietly and examines you. She's very gentle, but as soon as she palpitates your abdomen, you cry out.

Addison's face is sympathetic. "Okay, okay. I'll be quick." She feels around carefully and you grit your teeth.

"Jesus, Montgomery, can't you make it quick?" You've got tears in your eyes and she sighs. "I want to do an ultrasound."

"Why?" You sit up and she frowns. "Lie down, Charlotte."

"Why?"

"Because I want a better look at your uterus and ovaries." She pauses, and then looks at you, blue eyes incredibly sympathetic. "How long have you had this pain in your abdomen?"

"I don't know." You shrug, averting your eyes, staring at the ceiling. "A month or two?"

Addison sighs. "Charlotte, I need more information than this. You're a doctor. You know yourself if it's serious or not."

You look back at her and clench your jaw. "I've had it for a month, give or take. Since my last period." You clear your throat. "I've had some constipation; bladder problems. It gets worse in the evenings and when I stand up."

Addison gives you a bottle of water. "Drink this – we'll do the ultrasound in about half an hour." She pauses. "What do you mean by bladder problems?"

"I have to . . . go, more often. Sometimes very . . . urgently." You can hear your voice harden, and you swallow hard. "It's not that big of a deal. The pain is worse."

Addison nods and pulls down your gown. "You can wait in my office, if you like. I'm going to do this ultrasound immediately so I can see what's going on." She gives you a bit of a crooked smile. "Don't worry. No one has to know anything about any of this."

You feel your face unfreeze a bit; you give her a little smile. "Thank you."

A half hour later, you're cursing at her again. "Dammit, Montgomery! You don't have to press so hard on my very full bladder!"

"You know yourself that a pelvic ultrasound requires a full bladder so I can see your uterus and reproductive organs clearly," she replies without preamble. She slides the transducer around your abdomen and peers at the screen. "Are you prone to kidney or bladder stones?"

You remember an excruciating night in the ER, about five months ago. "I've had kidney stones, yes."

She turns off the ultrasound machine and sighs. "Charlotte, I think you know what this means."

"That I have them again?" You sit up and cover your abdomen with the gown. "I can get them lasered before they become a problem."

"That's not what I mean." Addison looks at you levelly. "You need to be tested for bladder cancer."

It's during the waiting period; during your time of frantic flipping through your medical textbooks and reading up on bladder cancer, that the toddler comes in.

The ER is a busy place; it's full of blood and gore and crying people, and you really don't want to go down there, but you've been paged and you're going, if only to scream at the person who decided to disturb you from your mountains of paperwork. You stomp down from the elevator and stop dead.

The two-year-old girl is covered in blood. Her arm is hanging at a strange angle; she has a distended abdomen and her face is completely lacerated. As she blinks her eyes slowly, you gently brush a lock of hair from her forehead and she lets out a weak cry.

It's like a punch in the stomach. You turn away.

"Dr. King? Dr. King?" The resident in charge is trying to get your attention. "The person who brought this child in asked for you specifically. I told her you were busy, but she insisted." Her voice is confused and you blink, feeling the room lazily spin around you.

"Yeah, she would insist."

"Why, Dr. King?" The resident's face goes blurry and you try to hold onto consciousness as the room goes black.

"Because she's my daughter –"

And you know nothing more.

When you come to, you're lying in a curtained alcove, off the main ER. It's normally given to patients who are quite severely ill and need a little more privacy. You feel weak, but you get up anyway and yell at the attending nurse. "Why the hell did you put me here? This is for patients. I don't need to be taking up a bed."

You sweep out and back into the chaos of the ER, where the resident comes up to you again. "Are you okay, Dr. King?"

"What's going on with the toddler?"

"Your daughter" – the resident looks quickly at you and then changes her tactic – "the little girl came in with multiple injuries, lacerations, broken bones and incredible internal injuries." She looks at you carefully. "It was apparently a car accident."

You turn away. "Where is she?"

"They've taken her up for an MRI. She'll be in the Ped ICU."

"Thanks."

As you walk, your mind insists on pulling forward the thoughts you've pushed behind; the thoughts you successfully suppressed two years ago, when you gave her up for adoption and never expected to see her again.

It was hard enough to carry her through your residency, to spend fourteen-hour days on your feet, but you did it because aborting yet another child was against your own personal code. You dealt with the looks and the comments and for awhile, you even changed your mind – you even thought about keeping her. And then you scrubbed in on several surgeries that turned you into someone who wanted a high-flying career. And you knew – you couldn't do it with a child. You called the adoption agency the next day. Three months later, you had her and it was the worst pain you'd ever experienced. You almost took it back. Almost. But when the time came, you refused to see her and you put the fact that she exists out of your mind.

The last you'd heard, she was adopted by a family that loves her dearly. And you stopped worrying. There aren't enough blonde infants in the world that she wouldn't be wanted. You didn't want to know who had her – but they apparently knew your name. You turn in at the door of the MRI room and watch her, crying weakly, as she's left alone on the table and the doctors conference in the room behind her.

You suddenly snap. "Why isn't someone in there with her?"

They all look up; you grab the door handle and pull it open. She can't even move – she can barely breathe, and you know in your heart that there's no way she's going to be able to make it. Kneeling beside her, you stroke the blonde hair, red with her blood, from her face, and stare into her eyes that are so much like your own.

"Bye and bye, bye and bye, the moon's a slice of lemon pie . . ."

It's the lullaby that you were sung as a child; your mother's gin-scented breath and her cool hands, but somehow it was comforting. The baby in front of you – your baby – doesn't stop crying, but she doesn't take her eyes away from you.

She codes on the table and just as you expected, she's too hurt to stay. She slips away at 16:34 and you blink back tears, instructing a resident to tell the family.

You spend the rest of the night upstairs in your office, slumped in your chair. Somehow, your problems don't seem as bad.

Addison calls you in two weeks later. "I heard what happened at the hospital."

"Yeah." You don't really want to talk about it. The hardest part of being a doctor is knowing you can't save everyone. And you find, even now, that you don't care if you have the cancer. You just don't care.

Addison puts a hand on your shoulder. "I'm so sorry, Charlotte."

"Yeah, well. It happens. Can't save everyone."

Addie nods, you sit there and then your face suddenly crumples. "I gave her away so that she could have a better life than she could with me. And she died, anyway."

Addison puts her arms around you and you lean into her shoulder, feeling the soft satin of her blouse against your cheek. She sighs gustily and you listen to her heartbeat. "It doesn't mean that if you had kept her, she would have lived, Charlotte. It was an accident."

You cry until you feel your stomach heave, and not wanting to throw up on Addison's floor, you choke a little until she hands you some water. "I just . . . I deserve to be punished. Because I could have looked after her and I gave her up so I could have this. And what has this gotten me?"

Addison hands you your test results without another word and you look at the answer without really seeing it.

"It's gotten you life and health. So that you can keep trying to save everyone else."

"I don't have it?"

"You don't have it." Addison smiles at you and you smile back, feeling the flood of relief, anyway. She regards you for a few minutes. "Charlotte."

"What?"

"You spearhead all these programs – parenting classes, Safe Surrender, all of these wonderful things. You do a lot of good."

"Yeah."

"You did it for her?"

You look down at your hands. You remember her tears, her bloody face, the fact that she died anyway. "If I can't save her . . ."

"You may as well try to save someone else's child."

"Yeah."

The stars are bright on the beach; Addison's swirling a glass of wine and you are humming to yourself, quite uncharacteristically.

"If you could have said anything to her, what would you have said?"

"I said it already."

"Oh."

You clear your throat. "I like to think that I gave her a little comfort at the end of her life, something that maybe her own mother couldn't give her. Maybe it was meant to be."

"I think things are meant to be."

"That I'm healthy and she died?"

"You can't look at it like that."

You sigh and look out over the sea. "Maybe she's at peace now. I don't have to worry about her anymore."

Addison squeezes your hand. "There wasn't anything you could do to help her than what you did."

"Just keep going, now."

"Right."

The moon is still above the hill.

The stars still shine against the sky.