Sometimes, no amount of good planning in the entire world can keep something from happening. Life is inevitable, in a way, and there's an entire series of inevitable moments that can't be avoided. Not by schedules, or calenders, or watches. Sometimes the inevitable was good. Sometimes it was bad. But most of the time it existed somewhere between the two extremes. Neither black nor white, good nor evil, and nobody could really say anything except that it had happened, and that was just the way that life was.

Izzy wasn't a huge fan of this view of life. No doctor was. They were in the business to save lives, not to accept the inevitabilities of fate. So, when she had first met Denny, she'd never considered the possibility of losing him. True, there was that chance—they were, after all, in a hospital, and he was, after all, a patient. But it was her business to make sure that he didn't die.

"Stevens, get Burke and O'Malley in here stat," Bailey ordered, as she stared at the young man, who's eyes were opening and closing rapidly, in a desperate attempt to remain conscious. Izzy stared at the man for a moment, her feet itching to obey Bailey's orders, but some bizarre part of her heart telling her to stay put.

"Now, Stevens!" Bailey barked. The command got the intern's feet in motion, and she hurried down the hallway.

He couldn't die, he couldn't die, he couldn't die

The words were a constant litany in her mind. Of course he wouldn't die. That was what doctors were for, after all. To make sure that the good guys, like Denny, believed.

"Stevens, wanna watch where you're going?" an annoyed Spawn of Satan said when she rammed full on into his chest. Izzy paused for a moment, and brought her fingers up to her aching nose. That man had one very hard chest.

"Look, Alex, I don't have time right now. There's a very sick man who needs a very healthy heart very soon."

"Denny?" he asked. Izzie couldn't be sure whether his change in expression was one of softening, or jealous hardening. Probably the second, she decided. The man wasn't exactly the captain of the warm fuzzies department.

"Yeah," she said, and pushed past him.

After scouring Burke and George's regular haunts and failing to find them, Izzie was running her hands through her hair. Where on earth could they be, and why the hell weren't they answering their pages?

And then she realized that the only reason Burke wouldn't answer his page would be if he was in surgery. She ran to the nurse's station and checked his schedule. He didn't have any planned until eight at night, but then. . .

And it hit her. For the first time she noticed all of the doctors and nurses streaming toward the ER. Something had come in, and it was big.

"Christina!" Izzie exclaimed, reaching out and grabbing the sleeve of one very fast-moving intern. "What's going on?"

Christina's usually dour face split into a wide smile and she clapped her hands together.

"Well," she said. "We've got ourselves a five car pile-up. With casualties!"

"How is that a good thing?" Izzie asked. Christina's smile, if anything, grew wider.

"If there are five cars, and two people are dead, that means it's serious and there's plenty of live ones to start cutting and stitching!" And, on that joyful note, she began practically running toward the ER.

Izzie sighed and rolled her eyes. Her job was here to fix people—unlike some people, who seemed to get all of their kicks out of the dissection aspect. Maybe Christina should consider a career in pathology.

But, as much as she disdained joining the throngs of well-wishers, the fact was that her best bet to find Burke lay somewhere within those walls.

The ER was a mess, as nurses attempted to dash patients off to open rooms, paramedics yelled at the doctors and surgeons what prognoses were and how the victims had been treated, and one screaming mother demanded to know where Tommy was.

Izzie stood still for a moment, not really sure what to do. She was accustomed to the bustle of the hospital. Usually she would be there, bustling with the best of them. She was not, however, accustomed to trying to pull one bustler out of the rest of them.

"Meredith, thank God!" she exclaimed, catching sight of her roommate. "I'm looking for Burke and George, do you know where they are?"

Meredith shook her head, as a small girl was wheeled over to her on a gurney.

"Room eight," the nurse ordered. She nodded, grabbed her side of the stretcher, and began wheeling the girl.

"I'm sorry, Izzie!" she yelled back over her shoulder. "Maybe George would know!"

"Yeah, that helps," Izzie said softly. "Since I have no idea where he is."

Suddenly she felt a biting pain in her back. Spinning, she was Alex impatiently prodding her back with the corner of a gurney. Addison was standing just to his right, not looking amused. Izzie looked at their patients for a moment in confusion. Two pregnant women lay on the stretchers, clasping each others hand desperately.

"Excuse us," Alex said, but his tone didn't sound apologetic at all. "Some of us are trying to save lives, instead of fixating on dying boyfriends."

"He's not my boyfriend," Izzie said softly, but stepped aside so the two could push through. As they sped down the hall, she noticed Addison leaning in to tell something (or, more likely with the relationship between the two, to yell something) at the younger man.

"Dr. Stevens, are you looking for an assignment?"

Izzie nearly cried at the sound of the familiar voice, and turning around, she impetuously hugged Dr. Preston Burke. Blushing, she stepped back immediately.

"Sorry, but I've been looking for you for so long because Denny's fading, and Bailey's been paging you and George but you weren't coming so she sent me out to find you but I couldn't—"

"That's what this is about?" Burke asked, glancing at his pager again. He looked around the ER, which was emptying. "All right. I think I have a moment. Grab O'Malley and let's get going."

"But I don't" She didn't have a chance to finish her sentence as the surgeon headed away. She was saved by another desperate and hopeless search, however, as her best friend came practically barrelling down the hall, ripping off blood-stained latex gloves as he went.

"Hey Izzie," he said. "No time to talk, Preston's called me in on an open heart operation."

"I know that!" She said, perhaps louder than necessary. George only glanced at her without slowing his stride, but several of the nurses stopped dead in their tracks to stare. Izzie sighed. "It's Denny," she explained.

"Denny as in Denny that you're not seeing because he's a patient but you kind of are, Denny?" George asked, with maybe just the hint of a smile on his lips.

"Yes, that Denny," she said. "And now you and me and Burke and Baily are going to save his sorry life."

But, just as she was reaching Denny's room, and just as they were wheeling him to an OR, she received a nasty surprise. Bailey turned to her, and quickly told her to get her "pretty little ass up to the gallery if you want to watch this."

"But—but I want in," Izzie insisted. "He was my patient. I want in."

"We all want things we can't have, Stevens," Bailey said. "Like how I want you gone. Now."

She wanted to throw a fit, a punch, or a chair. But instead, she stepped aside and allowed the three of them to wheel her patient down the hallway. And then she turned and ran to the gallery.

She stayed, glued to the viewing window, as they cut open his chest. She refused to leave as they went in with scalpels and clamps. But when her pager went off for the fifth time, she had to leave. Because, as much as she wanted to be Denny's friend (maybe even more, her heart reminded her) she was still a surgeon first.

It was Addison, she noticed, and remembered that the woman had been working with the pair of pregnant girls. Izzie practically flew down the stairs on her way down. The faster she got the call over with, the faster she could be back in the OR gallery.

"Stevens, good," Addison said. Her wrists were buried in the woman's body. Izzie sighed. Only Addison would page someone when her hands were full of uterus. She pulled the baby out, and handed it over.

"This baby needs immediate care. When it's stabilized, I need you to go check on Karev. His woman seemed all right, but I haven't seen him back."

Izzie nodded, not even bothering to speak. In the operating rooms, speech wasn't necessary. She bundled the baby over to an incuberator, and quickly got it screaming. She checked its vitals, it seemed okay. With hurried instructions to a nurse, she headed to the next operating room.

"Alex, what the hell are you doing?" she asked as she walked in. A small baby was hooked up in an incubator, its vitals all over the place, while a woman lay half-dissected on a table. Nurses stood around blankly, worried. Alex, meanwhile, was busy banging his fist into a wall.

"Izzie," he said, turning to face her. He took a deep breath. "Look, I don't need you here. Go ahead and get back to Denny."

"What's going on?" she asked, glancing between the woman, the baby, and the intern. "Why—"

"Get the baby out of here," he ordered one of the nurses. "He's going to need a blood transfusion—take him to A25. As for the woman, get your gear on, ladies, we've got work to do." Then, turning to Izzie. "I've got a baby who's arm was torn off in the crash, and not enough AB positive blood to stick in him. I've got a mother with two destroyed kidneys and a severely tattered uterus. If I don't get some blood and a kidney stat, they're both going to die. So, enjoy your last minutes with your boyfriend."

Izzie just gaped at him, before turning and literally fleeing the scene. She'd known Alex to be an asshole, cruel, and downright evil when it came to treating patients, but he'd never been so cold to her.

When she reached the viewing room, her day just began going from bad to worse. George was staring at the vitals screens.

"He's flatlining!" he yelled.

"No. . ." Izzie breathed, putting her hands against the glass and staring down at the scene below.

"Burke, give me—"

"It's over," Burke said. Bailey shook her head. "Yes," he said again. "O'Malley, time of death?"

"3:42," George said, as he dutifully wrote it down. Izzie slid to the floor, one hand still on the glass, the other venturing to cover her mouth. She felt like she might either vomit or cry at any moment. Maybe both.

"I need a kidney," Alex said, walking into the room.

"What are you doing in here, Karev?" Bailey exploded. "You are covered in—"

"Yes, I'm covered in blood and uterus," he said. "And I need a kidney, right now, or a young mother is going to die."

"Complete renal failure doesn't occur immediately," Burke said. "There are channels to go through."

"Complete renal failure occurs immediately when a woman lost two kidneys," Alex retorted. "I checked his records, he's an organ donor, so let's let the man donate."

At those words Izzie ran out of the gallery and downstairs, just as Alex was putting a cooler beside Denny's still body.

"You can't just cut him open!" she yelled. George looked at her, startled, and then glanced back at Denny's body, which was still open from the attempted surgery.

"He has AB blood?" Karev said, glancing at him. "Get me some of that, too, before it's useless." A nurse immediately began working with the IV lines.

"Alex, what are you doing?" Izzie asked, staring at him in disbelief. "This is so unethical."

"No, this is cutting through red tape," Karev said, and gently placed the liver into the cooler, which he sealed. He turned to the nurse. "Get that to 25A ASAP," he said, and began walking quickly out of the room. Izzie hurried after him.

"I cannot believe you," she growled. "I'd known that you didn't have a heart, but this is really sick."

Alex didn't respond. He just set his jaw more firmly, and picked up his step a little. Izzie hurried to keep up with him.

"Asshole," she said, and just began to realize that tears were streaming out of her eyes. "Asshole."

He reached his OR, and firmly shut the door in her face. She stared at it blankly. A moment later, the door to the right opened, and an exhausted looking Addison stepped out of it. She stared at Izzie's face.

"He didn't make it, huh?" she asked. Izzie shook her head.

"No," she responded.

"How's Karev doing?" Addison asked, gesturing with flying red hair toward the OR. Izzie sighed.

"Well, he's trying to stick Denny's kidney into the woman, so I guess we'll just have to see."

"What?" Addison exploded. She turned and abruptly ran into the room. Izzie sighed and headed to the cafeteria. Coffee. Coffee couldn't make everything better, but at least it would be a start.

"At least he's done suffering," Meredith suggested, staring sympathetically at Izzie. "Didn't he say. . ."

"Can you just be quiet?" Izzie asked, gently placing her head on the table. Blonde hair fell out of its tight bun, and for once she didn't try to brush it away. "I'm glad that you guys are here for me, really, but can we just be quiet?"

"Okay," Meredith agreed. Even Christina looked compassionate for once, not saying anything, just getting another cup of coffee when Izzie had finished hers.

When Alex came in, nobody said anything. Meredith nodded to him, and George attempted a smile. Alex himself didn't respond at all. He grabbed a cup of coffee, sat down beside Christina, and dropped the coffee so heavily that it splashed over the sides onto his hands. He looked at it for a moment, before wiping off the steaming liquid.

"How's the woman?" Izzie asked. Alex shrugged.

"She should live. Addison's playing with the remains of her uterus right now. Doesn't look like she'll be having any kids for a while."

"The baby?"

Alex had to work to stifle a smile. "The baby's fine. The blood took. They'll both be missing body parts, but they'll be alive."

Izzie sighed. "At least someone's alive."

Christina abruptly stood up. "Page," she explained apologetically, before running off. George followed her in half a second.

Meredith reached over and grabbed Izzie's hand, giving it a tight squeeze. Izzie didn't respond. Instead, she just looked up at Alex with dull eyes.

"Can I see the baby?" she asked. Alex looked at her for a long moment, his expression completely unreadable.

"Yeah, sure," he said. He threw away his untouched coffee as the two of them stood and walked out, leaving Meredith at the table.

They didn't say anything as they walked. Izzie was glad. Her friends had tried to be understanding, but they hadn't been there. Alex had been. . .in a way.

The pediatrics nurse tried to shoo them away, but Alex simply brushed by her. He spoke in hushed tones with a series of interns for a moment. One of them, a young woman, listened the longest, nodded her head, and hurried off. Izzie sighed. He'd probably slept with her.

A moment later the intern returned, a small blue bundle in her arms. Alex reached out and grabbed the baby, holding it a little awkwardly as he walked over to Izzie. She stared at him. If there was one thing she'd never expected out of Alex, it was to see him holding a baby. Ever. She'd been willing to bet that he was the kind of man who would refuse to take a paternity test, lest he be accused of being a father. But there was a certain degree of tenderness in the way he held the baby. She smiled, just a little.

"Here," he said when he reached her, pushing back a bit of the blanket.

"What's his name?" Izzie asked, reaching out and gently touching the baby's one hand. Alex rolled his eyes.

"You're asking me that?"

She smiled a little more, and turned to the nurse. Some things never changed.

"His parents named his Christian," the nurse said. "Because he rose from the dead."

"He wasn't ever dead," Alex said. "Just close to it."

"Hi, Christian," Izzie said, with tears in her eyes. "Hi, Denny."

Alex took the baby back to the nurse, and returned to stand next to her.

"You going to be okay?" he asked. Izzie looked up at him, and nodded.

"Yeah," she said. "I mean. . .I didn't really love him. I didn't have time. It's just. . .it's just that I think I could have loved him. And I think that he could have loved me. That's all."

Alex nodded. "Let me buy you a cup of coffee."

"I've already had four," Izzie laughed a little. Alex grinned.

"Then let me buy you some coffeecake to go along with it."

"I don't like coffee cake," Izzie said, but when Alex took her hand in his, she didn't protest.

"Streusel then. Muffin? Donut? Bagel?" he asked.

Sometimes, no amount of good planning in the world can keep something from happening. People die, babies are born, and doctors are worn out. It's just the way the world works. Surgeons are around to try and control these little, natural inevitabilities, but even a doctor is not a miracle worker. Sometimes the inevitable was good. Sometimes it was bad. And sometimes, it took one person's death to save two people's lives. Sometimes it took the end of one relationship, to open the possibility of another.

That's just the way life is.