"Dr. Karev, a phone call for you". A nurse he has never seen called out to him handing out the receiver. Probably a temp, he thought to himself. He walked over to the nurses' station and picked up the phone.
"Hello, is this Alexander Karev?" a strange voice asked.
"Yes it's Alex Karev. Who are you? How did you get this number?", Alex was getting annoyed. Probably one of the nurses had given his number to a patient for follow up.
"This is… urghm… I'm… eh… I'm Tom. I'm Nickie's husband…".
That got Alex's attention. "I know who you are", he replied coldly. "What's wrong?", he added in a bit more concerned tone. He hasn't heard from his sister since their mother's funeral. That was 6 years ago and the conversation didn't end well.
"There has been an accident", Tom's voice cracked. "Nickie… has been… she was…. She….". He took several deep breaths.
Alex started to panic as his brother in law struggled to get the words out. "Tom, is she okay? Was she hurt? I can be there in…
"She died", Tom cut his sentence. "I'm… eh… I'm sorry. The funeral is tomorrow. She wanted to be buried near your mother. To make things some how right, I guess. The funeral will be in Iowa. I just thought you should know. I… eh… I have to go now, I have to get the kids back from school. I'll see you tomorrow at the funeral". And he hung up.
"Dr. Karev, is everything alright?", nurse Olivia asked sounding worried. "Alex? Are you okay?".
He didn't even bother to answer. He just took off, shoving her not so gently as he passed her by. He walked around the corner and entered the on call room. He leaned against the wall, trying to take deep, even long breaths. He could feel himself hyperventilating and the small room was starting to spin. "Get a grip", he told himself, angry now at his own reaction, at his sign of weakness. He took a few more deep breaths and pushed himself off the wall, convinced that he is not going to pass out. He ran a shaky hand through his hair and over his face and stepped out.
He was supposed to be covering the pit so he headed downstairs. He spotted George and Lexie by the elevator and took a turnn, choosing to take the stairs instead, wishing to avoid any chance of running into someone. He crossed the ER, ignoring his intern who was approaching him, clearly in the need of a consult and went out side.
He let the cold air feel his lungs and cool his skin. She was gone. Just like that. He tried to let the truth sink in, but he couldn't bring himself to admit it. He had never felt more alone.
He sat down on a near by bench resting his head on his hands. He listend to the sirens as they grew louder and louder. The ambulance stopped in front of him and a young female paramedic rolled the gurney out. He knows he should approach her. The pit is his responsibility today but he feels so numb he is not sure he will be able to even stand. And he is definitely cold now. Not "it's chilly, lets get inside" kind of cold, but a "chilled to the bones" kind of cold. But still he is unable to move.
He tries to remember what were the last words he had ever spoken to her. It was right after their mother's funeral and the words were spoken in a heated argument. Nicky was clearly drunk and he was at least a little buzzed, making it ever harder to remember. He remembered her yelling at him: "She was you responsibility. You were supposed to take care of her. How could you let it get this bad? Why didn't you stop her? Where the hell were you?". The sentences are all mixed up in his head making her harsh words sink: "It's you fault she died. She shot herself because of you. You weren't good enough; you couldn't take care of her. You weren't a good enough reason for her to want to stay. You killed her".
He remembered that he wanted to shout back at her. To tell her that she was the one who left, while he stayed behind. He wanted to tell her how bad it got after she had split. He wanted to tell her what it felt like to hear the gun shot and running towards the sound, knowing at the pit of his stomach that something is wrong, very wrong. He wanted to tell her that he was the one who broke down the bathroom door and found his mother lying on the floor in a pool of her own blood. That he knew she was already dead, but that he tried to resuscitate her anyway, like he had been taught. He wanted to tell her that he was the one who scrubbed the bathroom walls for four hours to get all the blood out, so that when she gets there she wouldn't be so shocked. He just wanted to scream that he did the best he could and that he is sorry his best wasn't good enough.
But he never answered her back, just remained silent. He remembered that by the time she was done yelling at him she was sobbing and shaking so badly that she fell to her knees. He remembered feeling that he should be doing some thing. Get her off the ground. Help her inside. Stroke her hair, making her know he is there for her. Something. But instead, he just left her there sobbing uncontrollably.
That was the last time ever saw her. God he misses her. He starts to hyperventilate again and all of a sudden he gets feeling he can't stay there, that he might suffocate if he doesn't leave right now.
He gets up slowly and takes several tentative steps in the general direction of getting a way from the hospital. The problem was that once he started he could not stop. He started walking faster and faster until he was sprinting, lungs contracting, chest tightening, breaths short and ragged. And it felt good, the pain so vivid in comparison to the numbness he had felt before.
He runs and he runs, and it feels good that he doesn't have think about where he is headed or about the fact that he should be at the hospital, that Baily will skin him alive for taking off like that. He doesn't have to think about the fact that he is only wearing thin scrubs or that his shoes are not made for running and are hurting his feet. He doesn't have to think about his dead sister, or his dead mother, or his absent father, or his dead daughter.
And all of a sudden he has to stop. His stomach churning at the memories of everyone he lost and he feels he is going to be sick. He walks to the side of the road, doubling over, hands resting on his knees, as he retches violently, emptying everything he had for breakfast.
When the retching is over and he only dry heaves he finally straightens up, whipping his mouth with the back of his sleeve. He looks a around and realizes he has no idea where he is or how long it has been since he left the hospital. So he turns around and heads back the same way he got there.
By the time he finally gets back, cheeks flushed, hair dripping and his cloths damp with sweat, he is completely and utterly exhausted. He leans against the wall for support, trying his best not to fall over.
"Karev, where the hell have you been? And what, for god's sake where you thinking when you just took off like that leaving the Pit unattended?!" Dr. Baily yelled at him, seeming to appear out of thin air. He doesn't even remember getting back.
For just a split second, he thought he might just tell her. "My sister died". Only 3 words. She will understand. But he can't bring himself to say it out loud. Just the thought of it making him nauseous and he worries he might throw up again.
She looks at him, taking his physical state. He was obviously jogging, or something. In this cold, wearing nothing but his scrubs? He must be freezing. He is freezing, she realizes, when she notices him clearly shivering. But then she remembers the patient that would have crashed, had she not been there to cover for Alex's absence. And all concern leaves her and she is left with the anger she had felt before. Alex still stares at her, not uttering a sound and that makes her even angrier.
"Just get inside, and finish your post-op. We got it covered." And she can't help herself and adds "no thanks to you". And turns on her hills, leaving him in his numb state.
"Sorry". It is barely a whisper and he knows she is long gone and can't hear him, but he feels he has to apologize. To Dr. Baily, to his sister, to his mom, after all he had promised her a life time ago that he would make it right with Nicky and now he will never get that chance. "Sorry", he repeats and gets inside.
He walks into the locker room and heads to the shower, ignoring the stares of on of Meredith's interns. He turns on the shower and gets undressed. He adjusts the water until it is steaming hot and steps inside. He closes his eyes and lets the water run down his face. He allows himself to cry, knowing that no one will tell with the water running. He stays under the water for a long time, until he gets his breathing under control and he trusts himself not to break down in front of any one.
He needs to find some one to cover for him for a few days he realizes. The funeral is tomorrow, Tom said. And he needs to catch a plane or maybe he should just drive back to Iowa. Or maybe it is a bad idea to burry her there near his mom and … and Kate, he stutters at the memory of her. Or maybe this is all just a bad joke, or a nightmare and he will wake up any minute now. He starts laughing at the thought. Nick too is dead, along with everybody else he ever let himself care about. How funny is that? How funny that is that he is still here breathing and walking and she is just…. just isn't. He has no family left. How funny is that?
Hilarious, he thinks to himself.
He really does need to find some one to take over his shifts. So he gets dressed, his movements are on auto pilot but some how much slower, like he is moving underwater. He feels tears pricking his eyes and he wishes them away. "Get a grip". He tells himself for the second time that day and walks out.
He spots Meredith and Christina by the nurses' station and approaches. "Can either one of you cover for me tomorrow?" he asks, trying to make his sound as casual as possible.
"After the Hudini stunt you just pulled at the Pit, for which I have to thank now that I am covering the ER, you still have the nerve to take a little vacation?" Christina doesn't even try to hide her annoyance.
So that's a no, he thinks.
"Alex, is everything okay? You seem… off some how. Did something happen?"
Meredith's tone is more concerning and for the second time he nearly says it out loud. But instead the words coming out of his mouth are a perfect match to the mask he has back on.
"Nothing's wrong. I just have this thing I need to take care of, that's all ".
He feels guilty about it, for not mentioning her, like he forgets her. But then he remembers he never mentioned Nick to anyone and the way she had left and why. And the way it was like, after she had left. He is suddenly overwhelmed by grief and he thinks he might throw up again and he doesn't hear Meredith at first.
"So I can't cover you tomorrow and Izzie is already on. Maybe you should just ask Baily, but I would give her some time to cool off if I were you… It could get ugly…." Her beeper goes off and she leaves, Christina following her giving him the evil eye as she passes him by.
He knows now that he is not going to tell anyone. Not that it matters anyways. No one will make the slightest effort to help him out.
He gets through the rest of his shift the same way he has been like from the moment he got the call: Functioning merely on auto pilot, relying on the force of habit alone.
His shifts ends at 8 P.M. he figures that if he drives all the way back, he could probably make it in time for the funeral and back in one day. No one will even need to know.
He leaves a few minutes before his shift is over. He has no desire of seeing everyone else, or talking to anyone. He walks home this time. His car his back there, having car pooled with Izzie this morning. His feet are still sore from his earlier run, and he realizes it is even colder than before. But he doesn't stop. The cold air and the pain are the only things that remind him he is still alive.
Finally, he reaches Meredith's house, home. He takes some time looking around him, slowly taking in his surroundings. Funny, how he has gotten so used to this place to call it a home. Funny, how he never thought he could call anywhere a home again, especially after their deaths, his mother's and his daughter's. And now his sister's. People just keep dying around him.
He walks up to his room, glad no one else is home yet. Happy for the sidetrack, for having something to do, he starts packing. He remembers to pack a suit for the funeral. He takes the same suit he last wore for Christina's wedding but it's the first suit he finds and he doesn't have much time if he wants to make it to the funeral tomorrow and back. All in one day, as if it had never happened.
He goes down stairs lifting his bag. He leaves a note on the kitchen table: "Be back tomorrow night. Tell Baily I had something to do that cannot wait…" and he walks to his car, slamming the door behind him.