I didn't go through hell with this kid to just back off
A/N Ever since I saw 8x09/8x10 when Alex and Meredith were in the ambulance crash I've wanted to add more in for Alex because you have repeated scenes where they hint something is wrong and Arizona has noticed but nothing ever really happens so I'm changing it to how I want it. I own nothing of Grey's Anatomy as per usual.
Alex's head collided with the door of the ambulance, he felt the lancing pain shoot through his skull and felt his body start to crumple against the door, but he was knocked out before the ambulance had even come to a stop. When he wakes up he doesn't know how much time is passed, Meredith is already sat up with the baby and doesn't seem to have noticed him at all. Slowly sitting up he takes stock of his injuries, his left shoulder feels like it's going to have one heck of a bruise but he's pretty sure it's not broken or dislocated, and his back's not exactly happy with the way that he's landed on the stairs but that will just add to his collection of bruises nothing to major.
His main concern is his head he reaches round with his right arm to feel the back of his scalp and feels the sting of a small cut on the back of his head but it's not bleeding much so he grabs some gauze and after pressing it on there for only a minute or so it's already stopped. His head is still throbbing though in time with his heartbeat though and when he gets to his feet he's feeling a bit light-headed and queasy. No time for that now though.
He manages to push through what he's feeling to help Meredith with the baby and when they get out of the ambulance to see the family he really shoves his own discomfort down deep in favour of doing all he can to help them. The other ambulance pulling up in front of Meredith and he feels so relieved he almost sinks to his knees, but he knows it's not over yet, he's still running on adrenaline and rushes around issuing orders to get the baby the care it needs and checks that the family are all into an ambulance before he finally gets into the ambulance with the baby.
In the back of the ambulance he finally allows himself to relax for a second, now that he has done all he can and they are on their way back to the hospital. He lets his head rest against the wall of the ambulance where he is sitting, but quickly jolts forward as the cut stings and the pain in his head returns so suddenly that he gasps involuntarily and has to sit forward breathing deeply to get control of himself before he throws up. When he sits up again the paramedic next to him who was attending to the baby is now watching him carefully and even has a cardboard kidney dish in his hand which he offers to Alex.
He holds his hand up to decline the bowl "I'm good just hit me all at once".
"You sure you're looking very pale and I can see that you're in pain" the paramedic says his eyes concerned but Alex just smiles at him tiredly and seeing that they've just pulled into the Ambulance bay he throws open the back door and starts pulling the incubator out of the ambulance.
Arizona strides out into the ambulance bay having just finished the operation on the boy who was attacked by a dog and smiles when she sees Alex stepping down from the back of the ambulance looking uninjured. She'd been so worried that he was going to come back in an ambulance as the patient rather than a passenger. She holds back from giving him a hug as she knows he's not the sort for that, instead she walks up as he's speaking rapid fire telling her what she needs to know about the baby and they both begin to fast walk up towards the NICU.
As he walks Alex feels the throbbing in his head only getting worse and he wonders if he should tell someone about it, but again brushes it aside. Once the baby is settled into a bay in NICU he begins doing what needs to be done "She went about two hours with no antibiotics, and an unknown amount of fluids because we didn't have a pump" he hears Arizona telling him to be careful but ignores her continuing with all his focus on saving the baby.
He vaguely hears her saying something about him having done well but 5 words in particular manage to cut through the pain his head "I've got it from here".
"What no" he says breathlessly, but she is already pulling his hands away from the baby telling him he's got to sit this one out and get checked over. "I'm not sitting anything out" he says trying to make her understand but she just says goodbye and he realises she's not going to let him stay.
He stalks off and goes down the hallway finding a toilet, he goes in to splash some water on his face hoping that might help the throbbing in his skull, but it does nothing other than make him feel sick again. This time he doesn't try and hold it back and instead slams back the door of the cubicle and throws up most of the contents of his stomach into the toilet bowl. He's left kneeling in front of the toilet feeling shaky and worn out, and just sits there for a minute before reaching up to flush the toilet. He has to put his hands on the toilet to push himself upright and even then he leans on the divider between the cubicles for a few more seconds before he goes over to wash his face and hands.
It's at this moment Owen walks in, he pauses briefly in the doorway on seeing Alex, "Hey I heard you and Meredith's ambulance got crashed into, you ok?", he says taking in how pale Alex looks and the way his hands are shaking.
"Yeah, I'm fine, I've got to go." Alex says going to push past Owen but an arm has come up in front of him and he crashes into it swaying a lot more than he should do really. Owen must have noticed the swaying because he's looking at Alex with a concerned look and he's frowning. Alex knows he has to get out of here so he pushes again and Owen lets him past watching him walk up the corridor with the frown now very firmly in place but he doesn't have time to chase after Alex because he's got a lot on his plate today anyway so he lets it go and continues on.
Alex heads back towards the NICU and is happy to see that Arizona is nowhere to be found, going back up to the baby he checks on it and realises that it needs a bedside gastrostomy. Telling the nurse to hand him the kit he starts getting prepared for the procedure, not noticing Arizona until she's right next to him. He starts slightly at her sudden appearance but quickly argues back with her when she tries to tell him he's not on the case. "Look I've been with this baby since yesterday, she almost died, I almost died, I didn't go through hell with this kid to just back off!" he shouts at her and he sees her re-consider and finally she concedes that he can stay but that he should slow down. "Yeah I know just ughh suction please" he says shaking his head slightly in an attempt to clear his head enough to continue. He doesn't notice the concerned look on her face at his stuttered response but he just continues on, finishing the procedure in pretty good time.
As soon as he's done Arizona forces him out again telling him to at least go get some food, so he heads for the cafeteria and snags an apple not really feeling up for anything more. He goes to a quieter area of the hospital and sits on a gurney to eat his apple, but ends up only really nibbling on it before throwing it away. About half an hour passes as he sits on the gurney just staring off into the distance and his headache is slowly getting worse and worse which he didn't really think was possible. While he's set their he thinks back to the accident but finds that he can't really remember anything except some occasional flashes, but what suddenly comes up bold in his head is that he forgot to do the tension pain anastomosis, how could he have been so stupid, he jumps off the gurney stumbling slightly and charges off to an elevator before going up to the floor that the NICU is on. Emerging from the lift the bright lights sting his eyes and he's feeling dizzy again and he has to dash into a toilet to be sick again before he can continue, but none of that matters as he charges in grabbing a gown and gloves pulling them on.
"We have to go back in… on the baby I forgot to place the tension pain anastomosis, you hear me I forgot to place it" he says urgently, Arizona doesn't seem to understand and he goes to repeat himself but she is right in front of him.
"Whoa look at me, you did the anastomosis I watched you do it, you used the double layer technique…. you remember?" she says looking questioningly into his eyes and he realises that he can't remember much so why she's surprised he forgot that is a mystery.
"Umm" is all that comes out of his mouth as he falters and comes to a stop, not knowing quite what to do now.
She must have seen this confusion because she's suddenly stepping towards him hands up in a pacifying gesture and reaches up taking hold of his shoulders and gently guiding him to the chair at the end of the incubator "OK, you need to sit down, you need to sit down" she repeats to him. He nearly trips but manages to get onto the chair and sits down looking round confused, his head is hurting and he's having trouble staying calm.
Arizona sits him down realising that something is wrong, he doesn't seem very focussed and has obviously forgotten things, she has to take hold of his head to get him to focus on her and reaches up pulling his eyelid back and looking into his right eye, the pupil looks relatively normal, but then when she looks in his other eye she sees that the left pupil is considerably larger than the other one. 'Damn it' runs through her head and she takes hold of his wrist checking his pulse, feeling it racing at about 130 she tries to soothe him "Alex I need you to take a deep breath for me ok try and calm down, you're ok the baby is safe but you need to calm down". He just looks up at her confused still breathing heavily and looking just as panicked and confused.
"Alex do you remember if you hit your head in the accident at all?" she asks hoping he can give her some more information that might be helpful.
Alex heard that question and suddenly he remembers lying on the steps "I got thrown against the wall and landed on the steps, my head hit the door and my shoulder hit the shelves, it's not broken I don't think, my head was bleeding, it hurts now, I think Owen nearly saw me throwing up I threw up twice but I still feel sick" he grimaces trailing off as he recalls the accident, but suddenly Arizona is tapping his face to get his attention.
"OK Alex I'm going to have a look at you, is that ok? Alright just stay still and I'll do my thing" she says trying to comfort him after having taken in everything he mumbled to her. She leans round and looks at the back of his head seeing the small amount of blood mixed in with his hair, she gently probes the area but he cries out making her stop. Coming back round to the front of him she looks him in the eyes to get his attention "Alex which shoulder hurts?".
"Left" he mumbles glancing towards the offending shoulder. She pulls his scrub top to the side and winces when she sees the shoulder has gone a deep purple, it does at least still look like it's in place. How he's kept going this long is beyond her.
Leaving him sat on the chair for a moment she gets a wheelchair from out in the corridor, on the way back in she pulls a nurse aside not wanting Alex to hear this bit in case it panics him. "Page Dr.s Shepherd, Hunt and Torres to the pit 911" she asks and the nurse looks surprised but walks over to the nurses station to do as she's told.
Walking back in with the wheelchair she puts it right next to the chair he's in now. "Alex can you move into the wheelchair for me I think you need to go for a little ride with me", he looks up at her still perplexed but slowly gets to his feet.
The dizziness that he was experiencing anyway increases tenfold when he stands up and he begins to pitch forwards, if it hadn't been for Arizona stepping forward and wrapping her arms under his and slowly pushes him back getting him into the wheelchair and lifting his feet one by one onto the rests. He is still awake but does seem very vacant and she knows that she has got to get him downstairs soon or he's going to be in trouble. Stepping behind him she pushes the wheelchair towards the lift ignoring the looks she's getting or more Alex is getting and keeps walking. Once inside the lift she leans down to talk to Alex "Hey Alex how are you feeling, you need to stay awake for me ok? Alex are you awake, come on" she puts a hand on his shoulder and he suddenly sits upright with a jolt obviously having gone unconscious for a second but she's got him back.
The lift doors finally open into the pit and she pushes the wheelchair over to trauma room, she half encourages, half pulls him up onto the bed and moves the wheelchair aside. It's as she leans over him to check his pupils again that the door bursts open and Owen, Derek & Callie all walk in, Derek is the first to speak "Why did you page 911 I thought all the victims of the car crash were upstairs already…" he trails off seeing who it is on the bed. "What happened I thought he was fine, Meredith said he did her stitches for her" Derek said.
"He seemed ok at first but he's just charged into the NICU trying to do procedures on the baby that he's already done and didn't seem to recall doing any of it, when I checked him over his pupils were uneven and pulse 130, he said that he hit his head on the door of the ambulance and he's been getting progressively more confused, he also said that he saw you earlier Owen after he'd been sick which he's done at least twice" she gave them the rundown for his head injury.
"I knew something was off I never should have let him walk off" Owen says, as he slides on some gloves.
"You weren't to know let's just focus on now". Derek pulls out a penlight and goes to check Alex's pupils, but Alex tries to push him away clumsily "No come on Alex let us help you, it's ok", luckily this seems to calm Alex enough and Derek leans in checking both pupils, "They're looking a bit sluggish, and he's cut the back of his head open, I'm gonna need a head CT to confirm but it's looking like a concussion." Derek says carefully feeling the back of Alex's head.
"Not that I'm not concerned about Alex but why have I been called in, you don't need an orthopaedic surgeon for a head injury so was there something else" Callie says looking confused.
"Oh damn yes… right" Arizona says, grabbing a pair of scissors and cutting away Alex's shirt, revealing a dark purple bruise wrapped around his shoulder stretching across and slightly down onto his chest as well.
Everyone in the room freezes at the sight of the bruising "Yeah that'll do it, he's been walking round like this since the crash and never said anything" Callie said immediately moving around to Alex's left side and getting a closer look at his shoulder, "Well it' not dislocated and I don't think its broken so he's gotten lucky in the respect but he's going to need a sling on it and it's going to hurt especially because I'm going to have to ban him from the OR for at least a week".
They take him up for the CT's and x-rays and confirm that it's just the concussion and very badly bruised shoulder. He's set up in a side room with a sling on his left arm and now sporting stitches on the back of his head. Arizona looks in on him before going home again, "You know you could have said something, know ones going to look down on you because you got hurt. You don't have to be a one-man superhero all the time it's ok to need help".
He looks down fiddling with the sheets on his lap "I just wanted to make sure the kid made it, then I was going to say something, just took it a bit too far".
Arizona looks at him and sees the side of him that she's always known was there, his drive and passion to save everyone makes him a great doctor, "You're going to do well Karev, now get some rest because you're out of the OR for at least a week" she says with a wink, leaving before he can reply.