Author: darknessinastateofmind
Summary: "He always knew, one day, that he would get what he deserved. He knew, and he knows." In which Alex Karev is diagnosed with cancer. In which we see everyone and everything fall apart before it all falls together.
Warnings: Cancer
Pairings: Eventual Alex/Izzie
Disclaimer: I do not own Grey's Anatomy nor any of the characters mentioned. All rights belong to the owner.
Author's Note: I'm back again with more Alex angst, but this will have quite a large amount of hurt/comfort and medical jargon too! And it's a multichapter. Let's see if I'll be able to keep it up. Title comes partially from "Neverending Fountain", by S. Carey. Please review and favorite! (But reviews, especially, will make me update faster...) I hope you enjoy.
No one will comfort me
Will know me or what's going on inside
A vacant hole will remain that way for life
To remind me where the both of you once lied
-Friends Make Garbage (Good Friends Take It Out), by Low Roar
CHAPTER: l.
Alex Karev is a dick. He is Evil Spawn, douchebag extraordinaire, dirty Uncle Sal. So, honestly, why the hell is he so surprised when he gets cancer? Karma's a bitch, and all the shitty things he's done in his life went around to bite him in the ass.
He always knew, one day, that he would get what he deserved. He knew, and he knows.
Except.
Except, he is surprised. He's horrified. He's terrified and scared and so utterly shocked that, when the tests come back, he can't do anything much more than just sit there, stare at his oncologist, and try not to panic.
"Mr. Karev," Dr. Young says, his voice calm and placid. Alex realizes with a jolt that it's the same exact tone he adopts when delivering bad news to a patient.
"Doctor," Alex chokes out. "It's Dr. Karev."
"Right, my apologizes. Dr. Karev, first of all, the results from your blood count were… discouraging. Your white blood cell count is very high - too high. After the biopsy, physical examination, and the spinal tap…" He takes off his glasses and clears his throat. "I'm sorry, Dr. Karev. You have precursor b-cell acute lymphocytic leukemia."
And there it is: The end of it all.
He drives home in a blank haze. In complete honesty, Alex isn't entirely sure what just happened. He just focuses on pressing the gas pedal with his foot and hitting the brake when he should, he just focuses on the road in front of him. Any time is brain starts to stray, begins wrapping itself around the enormity of the situation, any time he starts to panic, he tells himself to stop.
Stop.
He'll deal with this when he gets home, when he reaches Meredith's house and he can sit down alone and fully break down and not get into a car accident.
He'll deal with his life later.
Later comes, and he still doesn't know what to do. Meredith and Izzie will be back from the hospital in a few hours. He had left early to get the results, and he had expected to go back, but now he can't even imagine going into that place and act normal.
Alex tries to get some sleep, and he's successful for some time, but he still can't get the suffocating lump of ever-present fear out of his chest.
He stumbles into the bathroom and collapses on the floor, leaning against the sink. He holds the test results in one hand while the other rests on the cool tiles.
Alex sits there for a good half an hour, barely moving. Just thinking and trying hard not to panic because he's losing his fucking mind and he's terrified and tired and he has the worst headache and he doesn't know what the hell he's supposed to do and, oh God, he'll have to tell Izzie and Meredith and Bailey and the Chief and fuck he's screwed, he's starting chemo in a few days so he needs to tell someone so they can drive him, fuck fuck fuck fuck fu-
"Alex?"
He jolts his head up in surprise when the door opens and Izzie's blonde head pops in. He instinctively curls the papers behind his back, even though he knows he's going to have to tell her eventually. "Hey, Izzie," Alex says, and he's surprised at how normal his voice sounds.
She stares at him with an unimpressed expression and crosses her arms. "Alex. Where the hell did you go? Dr. Bailey's gonna hit the roof tomorrow. And Cristina already said she'll kill you 'cause you made her miss scrubbing in on an open heart. Did you hear me? Cristina missed an open heart. Alex, are you even listening? Because Cristina will kick your ass tomorrow, I'm not even joking. And Meredith is pissed, too. She was in the Pit practically all day doing sutures 'cause of you. And George..."
Alex closes his eyes and leans back, resting his head on the side of the sink. He only half-listens to her incessant chatter, because all he can think are three words: I have cancer.
He knows he should tell her. He should cut her off with a firm Izzie, then proceed to say I have cancer in the most dramatic and heart-wrenching way possible, like what happens in those cheesy soap operas Izzie and Meredith are always watching.
But it's not a cheesy soap opera. It's Alex's crappy life, and right now, his butt is aching. And so are his bones and his heart too, a little.
"Hey, are you okay? What did your doctor say about your fevers?" Izzie's worried face swims in his vision, and he blinks to clear the yellow spots from his field of view.
And this is where you tell her. Just say it: I have cancer. Just say it.
"I - I…" Say it. "It was nothing," he blurts out. "Nothing at all, just the flu or something, okay? Can you just go, please? Your voice is really annoying me, and I have a headache."
She reels back. "I was just trying to warn you. Sorry for being nice." She shoots him an icy glare and leaves the bathroom with a flourish, slamming the door closed behind her.
And there he goes again, doing what he does best, the only thing he knows: Pushing people away.
Izzie was right. Work is a hell hole the next day, with Cristina sending him death glares every time he turns a corner that have him legitimately fearing for his life, Meredith ignoring him, O'Malley ignoring him (why, he has no idea), Bailey's endless lectures and saddling him with the Pit and prostate exams, and the pain.
God, he hurts. He has no idea why it hurts so much. Well, he does have an idea, but why so suddenly, Alex doesn't know. Maybe it's because he's suddenly conscious of the life-threatening things constantly multiplying and killing him underneath his skin. Maybe he's dying already. Whatever it is, it's painful. Alex's bones hurt from the deepest orifice. They burn with every movement, with every breath he takes and every heartbeat. And he's tired. In retrospect, Alex supposes he's been tired for a few months now, but today, he's exhausted.
All he really wants is to lie down and sleep for one hundred years.
Which he tries to do, during lunchtime. Alex drags his exhausted body to the on-call room and collapses on a mattress, massaging his aching limbs and his pounding head. It seems like only minutes have passed when Meredith jerks him awake with a harsh poke at his exposed neck. "Alex. Bailey's looking for you." A pause, then: "Alex?"
He groans into the pillow, then turns around and blinks the sleep from his eyes. "Wha-"
Alex is cut off by Meredith's expression. She's staring at him with something akin to horror.
"What?" he asks, standing up and smoothing out his rumpled scrubs.
Meredith's hands dart out and land underneath his jaw. Damn. His swollen lymph nodes. "Get off of me," Alex snarls, ducking away from her hands.
"Alex, they're swollen," she says in a pleading tone. "You have to know what that could mean."
"I have a medical degree too, you know. I know what it could mean. I just have a cold or something, I already went to my doctor yesterday. So lay off, Mom."
Meredith shakes her head, but she stands her ground. "Why do you always do this? Push everyone away when we're just trying to help."
"I don't push anyone away, Mom."
"Alex."
"Mom." And he shoves his pager in his pocket, throws open the door, and then steps into the light.
Bailey puts him on call that night, and it's the first time he's happy to be staying the night at the hospital; he can't face Izzie and Meredith.
It's actually pretty boring. Nothing eventful happens, which gives him a lot of time to think. Like, what the hell he's supposed to do if every time he tries telling someone about his cancer, his mouth does the opposite. Or, maybe the whole entire acute lymphocytic leukemia thing in general.
Alex thinks for six hours, but he doesn't come up with an answer.
He finds himself in the oncology ward around one o'clock, during a calm period with his patients, when they're all sleeping and stable.
Alex tries his best to be subtle, but he's immediately spotted by Dr. Swener. Luckily, he's able to make up some lie about a patient he's supposed to be checking on or something, and she lets him go by without much comment.
The chemotherapy room is closed, but he peeks through the window at the door. There's nothing particularly interesting - just a couple recliners and IV poles. The darkness makes it hard to see. Alex swallows thickly around the large lump that has suddenly developed in the back of his throat, and he backs away from the closed door.
He rubs a shaky hand over his face and slides down against the wall until his butt touches the linoleum.
What is he supposed to do?
He has cancer, he is sick, and he might be dying.
Alex is a doctor, and while he doesn't specialize in oncology, he knows what b-cell common acute lymphocytic leukemia is. And he knows the statistics, he knows the survival rate.
And his odds aren't terrible - they could be much worse. But, just yesterday morning, Alex thought that his chance of surviving the next five years was one-hundred percent, and now, it's down to forty?
It's crazy how quickly a life can fall apart.
His pager beeps multiple times, but he makes no move to respond to them. They're all from Bailey, anyway, not his patients. Alex knows he'll get hell for it after, maybe even serious trouble from the Chief, but at this point, who gives a fuck? He certainly doesn't.
He's far too tired and aching to do anything more than sit with his elbows on his knees and the heels of his hands pushed into his eye sockets, waiting. For what, he doesn't know. But he waits anyways, because he doesn't know what else to do.
"I thought I might find you here."
Alex raises his head slowly from where it has been for the past hour, dreading the inevitable. He knows that it's Bailey; her commanding "Nazi" voice is hard to mistake.
When he finally lifts his head enough to make eye-contact, Alex notices something strange. She doesn't look angry at all, even though he just spent the past hour ignoring all of her pages. Her eyes are heavy and thick with emotion, and they seem red and puffy, like she was just crying.
She heaves a sigh and sits down next to him. "I found these in the locker room." She holds out a thin stack of papers to him.
Alex cautiously takes them from her. He knows what they are, deep down, and he's already read them more times than he can count, but when he reads the words "acute lymphocytic leukemia" and "vincristine, dexamethasone, doxorubicin (VAD) to be administered in three phases over the course of two years" and "intrathecal chemo", he balks. And then he swallows. And then he starts to cry.
He tries hard to quell the overwhelming urge, gulps around the thick lump in his throat. It's too late, though, and the tears come faster than he can control.
Alex can't recall the last time he cried. He truly cannot, because he doesn't. Yet, here he is, crying.
At first, the tears well up in his eyes and slowly crawl down his cheeks. Soon, his shoulders are shaking and his chest feels heavy and it's sort of hard to breath the way he's sobbing so hard.
I can't do this.
Sometime in the beginning of his cry-fest, Bailey had wrapped her short arms around him and placed his head on her shoulder. He had tried to pull away, but she had held fast, saying nothing, because everything was already said. Eventually, he lets her hold him.
He doesn't know when it got to this. Tude and arrogant Alex Karev, blubbering into Bailey's shoulder like some pathetic little kid who had just lost everything.
He's terrified beyond reason.
He stops crying after a while.
He's still empty.
Empty, bare, desolate.
"Who's your oncologist?"
"Dr. Young. Mercy West."
Bailey shifts and looks him in the eye. Her's are filled with sympathy and remorse and something else that he can't really place. He hates it.
"We could get Dr. Swender on your case, you know. She's the best around here." As an afterthought, she adds with a half smirk, "Certainly better than anyone at Mercy West."
Alex huffs out a breathless laugh. "Yeah, probably." A few moments of silence, then: "I can't, though. Fuck - sorry. You know why. I can't." I can't be weak, I can't rely on anyone, I have to be strong.
"No, Karev, I don't. You deserve the best care there is, and Dr. Swender can give you that. So, why don't you put away that thick-headed pride of yours and get better." She turns and stares him down. Her eyes are no longer a jumbled mix of sad emotions - they're hard and determined.
And he wants to believe her. And, maybe a few years ago, he would have. Maybe, if this had happened before his dad started regularly beating up everyone in his family, he would have. But it's been years, and it's been that many years since he's believed in the joke that is called hope.
"Dr. Bailey, with all due respect, you're wrong. You saw those papers, you read them. I have over seventy thousand white blood cells. And I'll have to go through utter hell for the next two years, and for what? A forty percent chance of surviving the next five years? That's shit, Dr. Bailey. You know it is. I'm sorry, but it's shit, and it's my life, and that's just the way it is."
"Yes. That is the way it is, that is the way your cancer is, but that doesn't mean you have to be this way. You're sick, not dying. This isn't a death sentence. You will get better, Karev. Get over your pity party."
Alex just shakes his head. He's far too drained to fight.
"Now, get up and go home. Get some rest. You're starting chemo on Wednesday, right? Don't come to work tomorrow. I'll take care of it."
He nods and slowly stands. The pain in his bones, deeply rooted and sharp, is so blinding he's unable to suppress the breath of pain he emits because ow, that hurts like a bitch.
Her eyes flash with alertness and she stands too, opening her mouth to say something.
Alex puts a hand out, a silent don't and she backs off in understanding. He's already shed half of his ego sobbing into her shirt, so he can't afford to lose any more. "And, if you mention the little incident that just happened to anyone…"
"Are you threatening me, Karev?" she asks, but smiles and nods anyway. "Go home. And don't think you're off the hook for ignoring all of my pages, too."
"Okay, okay." A pause, then, "Thank you."
She nods.
Alex grips the papers in one hand, but then, as an afterthought he says, "Please don't tell anyone. Please, I'll tell them myself."
Bailey sighs. "Alex, I can't do that. You're seriously ill, and you're going to be much sicker very soon. I am going to have to tell the Chief, and I will also bring your case to Dr. Swender. As your chief resident - your boss - your wellbeing is partially my responsibility, and from my perspective, Dr. Swender will give you the best care. So, no. I'm sorry."
He squeezes his eyes shut and releases a long breath. It's okay. It's okay, Alex, get your shit together. "Okay. You can tell the Chief. But, damnit, please, don't tell anyone else. Please, don't go to Dr. Swender. Don't go. Don't tell anyone. I'll do it. Please." He hates that he's been reduced to this - a scared, weak kid who cries and begs and breaks.
Dr. Bailey takes a step and tries placing a hand on his trembling shoulder. He jerks back, retreats into his shell. She nods, once. "Go home, Karev."
Alex shudders, slowly, in slow motion, then turns without a nod and slowly makes his way across the hall.
He drips with shame.
TBC