Disclaimer: Not mine.
AN: My medical facts are just what I found on the internet. Enjoy.
Seattle Grace, Tuesday morning
"Meredith, you got a minute?" Alex pokes his head into a patient's room, and asks her. She nods to him, and follows him into an on call room. When they enter the room Alex locks the door behind them.
"What's going on Alex?" Alex sits down on the bed; Meredith quickly sits down as well.
"I need your help with something, something important."
"Sure, what is it?"
"I think there's something really wrong with me..." Alex is reluctant to continue, Meredith takes his hand in hers, and urges him on. "At first I thought I just had the flu, but it hasn't gone away, and yesterday my gums were bleeding. I'm probably being stupid, but would you mind just checking me out?"
"Of course I'll help you. Meredith gets up of the bed. "Take off your scrub top, and lie down." Alex does so, after making a couple of stupid jokes about Meredith and on call rooms.
Meredith does a thorough physical exam, and then reports to Alex. "Okay, lymph nodes and spleen are swollen, you have a low fever, and you're probably anemic. I'll draw some blood, do a full work up. Okay?"
"Yeah fine." Meredith leaves the room, and returns a minute later carrying blood test supplies. She places the tray onto the bed, and then takes the rubber tourniquet, and ties it around Alex's arm, just above his elbow. Then she picks up the needle, and pushes it into Alex's arm, causing him to wince slightly and complain, she ignores him, and quickly collects several vials of blood before withdrawing the needle, and placing a Band-Aid over the puncture site.
"You're going to keep this quiet, right?" Alex says as he pulls his scrub top back on.
"Of course, I'll let you know when the results come in." Meredith says before gathering up the various pieces of medical paraphernalia, and walking out of the room. Alex is so tired, he just sits there until his pager goes off.
Seattle Grace pathology lab, Wednesday morning
Meredith reads through the test results for the hundredth time, no matter how much she wishes that she just read it wrong she knows that they are consistent with leukemia. How the hell do I tell Alex? Is he going to die? He wants me to keep this quiet?
Just then Alex spots her, and walks over. "Are those mine?"
"Yes." Her expression tells him everything. "I'm sorry."
Alex collapses into the chair beside her, and buries his head in his hands. "So what is it? Leukemia or lymphoma?"
"Acute lymphoblastic leukemia." Meredith wraps her arm around him, and to her surprise he didn't resist her attempt to comfort him. "It's going to be alright Alex; you're going to get through this." Meredith comforts him. He calms down after about ten minutes.
"What am I going to do?" He asks her softly, looking directly into her eyes.
"You need to see an oncologist, and we should tell Bailey."
"We're not telling anyone here, please Mere." He stops, and thinks for a moment. "A mate of mine's an oncologist over at Mercy West, his name's Sam Payton. I'll give him a call, make an appointment."
"Okay, um, do you want me to come to the appointment with you?" After a few weak attempts at resisting he caves.
"Please."
Outside surgery, Wednesday afternoon
Alex has been assisting Sloan in surgery for almost five hours, normally this wouldn't bother him at all, but he was so worn out today. He went into the locker room, and lay down on one of the benches for awhile before going over to his locker, and taking out his phone. He called Dr Payton; they had met at a conference last year, and had kept in touch.
"Hello, Dr Payton speaking." The man answered professionally.
"Hey Sam, its Alex Karev..." He pauses for a moment "...I need to make an appointment to see you."
"What's going on Alex?"
"I haven't been well lately, so I got one of my friends to do a blood test, and..." He can't bring himself to say it.
"And what did it show? I'm guessing cancer; otherwise you wouldn't be calling me, what type?"
"Leukemia." Alex almost whispers.
"Oh, I can squeeze you in first thing tomorrow, does that work?"
"Yes, thanks."
"Seven thirty, and remember to bring along the test results."
"Thanks man."
"See you then." Alex hangs up the phone; he has another twelve hour left in his shift. All he wants to do is go find a bed, and hide there until he can go home, but his pager has already gone off four times while he was on the phone, it was going to be one of those days. Though the rest of the day Meredith checked up on him about fifty times, and cover for him quite a bit too. He had told her when his appointment was, and she had promised to be there, they could go together before work.
Meredith's house, Thursday morning
As Alex wakes up the early the next morning he can feel blood flowing from his nose. Oh crap, this is bad. He grabs a tissue, and blocks the blood flow, several minutes later it finally eases up, and he goes into his bathroom to clean off the blood. As he looks in the mirror the sight before him is shocking, between the caked blood, deathly pale skin, and obvious weight loss. He turns away, and takes a shower before heading downstairs; the hot water has only slightly eased the excruciating pain in his joints.
Meredith and Izzie are already sitting in the kitchen eating waffles, Izzie offers Alex a plate, which he quickly declines, he doesn't feel like eating.
"But you have to eat breakfast, come on Alex sit down and eat." Izzie says, pushing the plate at Alex.
"Meredith, you almost ready? We'd better get going." Alex says to Meredith, ignoring Izzie's attempts to make him eat.
"Five minutes." Meredith tells Alex, she then gets up from the table, puts her plate in the sink, and goes to find her coat. Leaving Izzie and Alex in the kitchen together.
"Where are you and Meredith going? Your shifts don't start until nine am."
"None of your damn business Iz. Let it go." Alex almost yells at her, the last thing he needs right now is for her to be bugging him.
"Sorry. See you at work." Izzie says as she fights back tears, why does he have to be such a jerk?
Alex walks out to the car to wait for Meredith. As he leans against the car waiting his knees, ankles, and hips feel like they are on fire, he knows that joint pain is part of the disease, and he wonders how he is going to stand up through a surgery when he can barely walk out to the car.
After a couple more painful minutes of standing there Meredith walks over, and unlocks the car. "Sorry, the phone rang." They both climb into the car, Meredith notices how much pain Alex is in, and decides to be one driving.
Consultant rooms, Mercy West, 7:30am
Dr Payton is waiting in the outer office for them when they arrive. "Morning Alex." He greets Alex, and quickly shakes his hand. "And you are?" He says, referring not unkindly to Meredith.
"Hi, Dr Meredith Grey, I work with Alex." She replies. They then all walk into Dr Payton's office, exchanging polite conversation as they go.
When they enter the room Dr Payton pulls the door shut behind them. He sits down behind the large desk at the back of the room, and motions for Alex and Meredith to sit on the other side of the desk, in the substantially less comfortable plastic chairs, causing Alex considerable discomfort. Meredith fishes through her tote bag to find the test results, and then hands them to Dr Payton.
"These are from a few days ago." He spends a few minutes reading thorough them before looking back up at Alex.
"Why did you take so long to seek treatment?"
"I've been busy, and it just felt like the flu."
"Okay. Well these results quite conclusively show ALL. What symptoms are you having?"
"Fatigue, joint pain, nose bleeds, bleeding gums, and breathlessness."
"Yeah, that's pretty consistent. I'll just do a quick physical exam, come over to the bed." Alex lies down obediently, and Dr Payton proceeds to listen to his chest, feel his lymph nodes and abdomen, manipulate several of the already painful joints, and a number of other tests before allowing Alex to sit up, and put his shirt back on. They then walk back over to the desk and sit down.
"I'm going to arrange for you to be admitted immediately, and schedule a bone marrow aspirate and biopsy and a spinal tap to confirm the diagnosis."
"But I've got a double shift today, I can't..."
"You've already delayed this too long, the sooner we can get the tests done the sooner you can start treatment, and the quickest way to get tests done is as an inpatient." Dr Payton turns to his computer, and starts typing. "I'll show you to admissions, alright?"
"Thanks." Meredith says before Alex has a chance to argue again.
"Do you want I can call your chief, inform him of the situation."
"No way, no one over there can find out."
"Alex." How long does he think he can keep this up?
"Mere, please."
"Fine, I'll sort something out."
Alex's room, 10am
Alex is lying on the bed, dressed in scrub pants and a hospital gown. Dr Payton had wasted no time in putting him on oxygen, monitors, and IV fluids and morphine, which Alex was extremely grateful for by the time they reached the room. Meredith is sitting on the side of the bed, flipping through a magazine she found.
"You'd better get to work before we're both out of a job." Alex says, only half joking. "Seriously, you don't need to stay in here." He'd been going to doctors alone since he was eight; his parents were always to drunk or stoned to take him.
Meredith moves closer to him. "I'm not going to leave you here. This is not something that you should go through alone. I called in for both of us."
"Um, thanks." It's kind of good having her there, talking to people, and helping him.
"No problem Alex, why don't you try and rest while I go home and get some things for you."
Alex's room, 11am
Dr Payton enters the room, followed by a nurse pushing a cart. "Alex, Meredith. Are you ready to get started?"
Alex shrugs "I guess so."
"Alright then, we'll do the biopsy first. Meredith if you want to say you'll-"
"I know the drill, where are the gowns kept?" She interrupts him. He points at a cupboard near the door, she puts on a gown, booties, and hair cap.
She goes back over to Alex, who is now lying on his stomach, with a sterile drape across his lower back, the hole in it positioned over his right hip. "How are you going?" She asks him as she takes a seat on the stool next to Alex, and moves her hands hold his.
"Nervous." He admits, looking ashamed.
"That's okay, you have every right to be, you're going to have a painful procedure. Just try to think about something else." She says, reverting to doctor mode.
"Bull. Don't you dare start treating me like some random patient Mere."
"Sorry." They are sitting in silence until Dr Payton starts the procedure. When he is starts to push in the aspirate needle in Alex tenses, and bits his lip to avoid crying out. "Alex, just breathe. Squeeze my hands if it helps...I can take it." He quickly responds by tightly gripping her hands. He continues to do this until Dr Payton finally withdraws the needle, places a small dressing over the site, and helps Alex roll back onto his back, effectively putting pressure on the site.
"I'll be back in a while to do the tap, just relax for awhile." He briskly walks from the room.
"This is crazy." Alex exclaims randomly.
"What?"
"I thought I had the flu, if I was the doctor in this situation I would think the patient was an idiot, but here I am." Meredith smiles at him apologetically.
"Yeah, but at least you are getting treatment now."
Dr Payton comes back into the room about twenty minutes later, carrying a procedure tray, which he places on a stand, and pulls over to the bed. "Meredith, all the nurses are busy, can you assist?"
She looks at Alex, seeking his approval before responding. "Sure, what do you need me to do?"
Dr Payton has Alex roll onto his side, pull his legs towards his chest, and put his chin to his chest. "Just help him keep still." Meredith responds by moving her left hand up behind Alex's head, and her right around his legs. Alex can't help but make a few dumb comments, trying to lighten the mood.
"Little sting now." Dr Payton warns Alex as he injects the local anesthetic. A minute later he picks up the second needle. He looks at Meredith, indicating to her to tighten her grip on him. "You're going to feel some pressure now, just stay still." He inserts the needle into Alex's back, and quickly collects a couple of vials of fluid before pulling the needle out, and putting a dressing over the site. "All done, remember to stay lying down for an hour or so; We should have the results by tomorrow afternoon."
Meredith's house, almost midnight
"Hey Mere, where'd you and Alex disappear to today?"
"Alex had a family emergency; I drove him to the airport, then my car wouldn't start, you know how it goes."
"What happened?" Damn, I should have known Izzie would want details.
"He didn't go into specifics, if you don't mind I'm going to bed, it's been a long day." I can't believe how easy that was.
Seattle Grace, Friday evening
"Thanks for letting me scrub in Dr Sloan, it was an amazing surgery."
"No problem Grey, I was going to have Karev assist, but he seems to have gone AWOL."
Their conversation is interrupted by the sound of Meredith's phone, after checking the caller id she answers. "Hello Sam, the results are in?" Meredith jumps straight to the point, stepping away from everyone so she isn't overheard.
"Yes, as we expected, acute lymphoblastic leukemia. I've already spoken to Alex, and we're going to start him on chemotherapy and radiotherapy tomorrow morning."
"Okay, what regimen are you planning?" If I'm going to be involved in this I might as well know what's what.
"Probably eight cycles of Hyper-CVAD chemo, and four weeks of radiotherapy."
"Alright, thanks for the call. Can you let him know that I'll try to be there tomorrow?"
"No problem. See you around."
At that moment Meredith realises that Bailey is standing right beside her. "What's going on Grey?"
"It's nothing, really."
"Alright, but you look pretty upset about a 'nothing' that involves regimens and a man."
"Fine, there is something, but I promised him I wouldn't tell anyone."
Bailey's pager goes off. "I've got to go, but don't think I won't find out eventually Dr Grey."
TBC.
Please let me know what you think?
BTW I haven't decided how this is going to end, so when you review let me know if you want him to live, or not.
