A/N: Hello my darlings! A new chapter and so sooooon! Sorry we're still in angstville, I promise it'll work out! Don't give up hope! We must always travel in hope, right? I actually wrote this before the last chapter and then had to back up and try to fit it all together. I know it probably feels like there are just so many plots happening right now but is that not the nature of ensemble? Of actual canon Downton?! There's a plan, I promise! Thank you for sticking with me and your reviews and tumblr love. I always get so excited to sit down and see where the story goes! 3

"Mum?"

Cora's hand froze above the door handle and she turned. "Oh, hello darling."

Mary took a few steps closer to her, "Are you here to have lunch with Dad?"

"No," Cora said, "I was just — I had a physical."

"Oh. Are you headed to Dad's office now? I was just about to head there myself, I could walk with you."

Cora held her gaze a moment, hoping that her daughter would not notice that her eyes had grown bloodshot as the day had worn on, and there was a deep crease in her brow that was threatening to become a permanent fixture.

"Actually, darling, I have to head back home. I have to take Isis to the groomer this afternoon."

"Oh, well, another time then." Mary said, "Perhaps I'll come for dinner this weekend."

"I hope you will. Sybil will be home from school and I'm sure she'll want to visit with you."

Mary raised an eyebrow, "I suppose she's going to be wandering these halls over her holiday?"

"I wouldn't be so sure. She'd really rather not."

"You can hardly force her. I imagine if you do she'll only cause trouble. And believe me, Downton doesn't need anymore trouble from the Crawley girls."

Cora sighed, putting a hand on Mary's shoulder. "Have you had a chance to speak with Dr. Carson?"

Mary shook her head, "I think I need a bit more time to gather my thoughts."

"Your father said that Isobel's son is on the case now."

Mary hummed non-commitally, busying herself with a hangnail.

"I was just upstairs in Dr. Clarkson's office and she seemed excited that he had decided to take a job here after all. I didn't mention anything about the case but I assume she knows by now."

"She may not," Mary said. "Matthew doesn't strike me as the type to speak just so he can be heard."

"Perhaps when this blows over you two will have a nice working relationship. It would be nice for you to have a few colleagues that you could stand to be around, Mary."

"You'd better go on," Mary said, shaking her head, "You don't want to be late for the groomer. You know it always takes them twice as long to get Isis to settle down." she leaned over and kissed Cora on the cheek and took off through the main doors. Cora watched her eldest daughter striding away, a confidence in how she carried herself so much richer than what Cora had ever possessed. Stepping out into the sunlight and making her way toward the parking lot, the rush of fresh air made her feel infinitely better. The nausea had subsided for the time being and while her heart still beat fiercely in her chest, the warmth of the sun against her skin calmed her. As did the peculiar heaviness in the nest between her hips which all at once became sweet and familiar.

As the nurses bustled around her, Elsie hovered over Liddy's isolette.

When she'd returned to the room after the spinal tap, Dr. Bates met her in the doorway — his face colorless.

"She went into respiratory arrest," he said. "I got the tap, though. I'll send it off for analysis but it was clear." When she'd pushed past him into the room, Gemma looked up at her, tears streaming down her face.

"Do something!" she screamed.

"Mrs. Rout—" Anna said, putting her arm on Gemma's. She helped her sit down and Anna crossed the room to Elsie. "They've got an isolette set up for her."

"I was only gone for a moment, how could she have decompensated so quickly?" Elsie said, more to herself than Anna.

Now, several hours later, Elsie stood before the isolette in the nursery, watching Liddy's ragged breathing as she slept and asked herself the same question. She thumbed through the pile of literature next to her and even went so far as to pull over one of the mobile computer units so that she could dig even deeper into Liddy's symptomatology.

As far as she was concerned, Liddy did not have polio. But she very well might have something clinically similar. Elsie conjured up a few vague memories of news reports playing in the nurses' station over the summer. American children who had mysterious episodes of paralysis. It had been believed to be linked to a virus in the polio family, and although the literature wasn't solid, it was worth putting in her differential. It took merely a cursory Google search to find the event she recalled.

Mysterious Virus Paralyzing Children

Elsie sighed wearily; she detested melodrama and journalists had a way of fear mongering anything medical, particularly where children were concerned. As she probed further, sidestepping the reporting and going straight for the clinical research, Liddy's symptoms suddenly aligned; a constellation in which Elsie would find the answer that could save her.

"EV68 is one of the more than one hundred types of enteroviruses, a group of ssRNA viruses containing the polioviruses, coxsackieviruses, and echoviruses."

"Most of the illness caused by EV-D68 in the US has been respiratory disease, mainly in children."

"There have also been some cases of polio-like illness in children in several states associated with EV-D68. In Colorado the virus was isolated from four of 10 children with partial paralysis and limb weakness." *

"Elsie?"

She looked up. Beryl had materialized next to her, a muffin in each hand.

"I thought you might need something to fortify you." Beryl said, handing one of her treats to Elsie.

She knew it was meant as a peace offering, but Elsie had her reservations. Her mind wasn't in the right place to be talking about the row they'd had — she already felt that she had miles to run in order to catch whatever was making Liddy so ill, and she'd already wasted valuable time.

"Thank you." she said, taking the muffin and admiring it. Beryl was the best cook she'd ever known and a particularly good baker. Elsie was lucky to poach an egg on the second go.

"I'm sorry we had a row earlier. I was only cross because when you're not on the unit to help me wrangle these nurses I lose my damn mind."

Elsie chuckled, pulling the muffin apart into smaller bite-sized pieces. It was lemon, sunflower seeds and ginger — one of her favorites. "I know."

"I'll apologize for being short with you but I won't apologize for insinuating that there's something between you and Dr. Carson."

"Beryl, there's nothing there. I assure you of it."

"It's there, you just don't see it."

Elsie shook her head, popping a bite of muffin into her mouth. "Beryl, stick to nursing and baking. Don't go starting a dating service."

"I don't need to set you up — you're already practically an old married couple, presiding over this hospital like the great Ma and Pa —"

"Please, Beryl. Just drop it."

Sighing heavily, Beryl picked at her muffin, crumbs scattering into her palm. "I don't bring it up to taunt you, Elsie. Really I don't. I just think it would be nice to see you happy is all."

"I am happy."

"Are you?" Beryl said, looking up at her.

Elsie's eyes fell from hers and she let her gaze land on Liddy, who had woken and was staring up at her drowsily. "If I'm unhappy, Beryl, I don't have time to worry about it. The only unhappiness, the only pain, the only life that I'm concerned with at this moment is Liddy Rout's."

Beryl nodded, "You're a damn good doctor Elsie Hughes."

Elsie smiled at her as she turned to go, but Beryl paused and turned back after a few steps. She groped around in her scrub's pocket and lifted out an envelope.

"Oh, nearly forgot — this came down with the afternoon's batch of inter-office mail. Looks important. Maybe that audit?"

Brushing crumbs from her hands, Elsie nodded eagerly, taking the letter from her. "Oh, bless you Beryl. Hopefully one thing to scratch off my to-do list."

"Do me a favor and add "tell Daisy to quit calling Beryl 'Nurse Patmore' to it — makes me feel like I'm in One Flew Over The bloody Cuckoo's Nest!"

Elsie laughed, sliding her finger into the envelope and ripping it open, "Are you not?"

"Ach!" Beryl groaned, bustling off down the hall.

Sliding her glasses down to perch upon her nose, Elsie lifted the letter from the envelope and was perplexed to see it was on not the letter heading of Robert Crawley, but Dr. Richard Clarkson.

Elsie,

I received the results of your routine mammogram. I have attached the radiology report.

Please make an appointment with me ASAP.

Fumbling to flip to the next page, Elsie's eyes widened as she scanned the report. From the tone of Dr. Clarkson's letter, and the niggling memory of feeling a heaviness in her breast that she couldn't quite account for, she already knew what it would read.

Highly stratified lesion (4b)* of left breast — suspicious for malignancy.

Follow up: biopsy and possible excision of the lesion.

"Edith, I don't want you to think I'm coming down hard on you to prove a point or sidestep any accusations of nepotism here — but you need to think very, very long and hard about your treatment decisions regarding Margie Drewe."

"I am," Edith said meekly, "I think there is insight to be gained here by exploring the delusion. I don't yet know what Marigold represents to her but — but, I think she represents something and whatever that is, it's the key to her breakdown. I'm sure of it."

"I just think you need to exercise a great deal of caution. You don't have the clinical detachment yet. You can't protect yourself from this —"

"I don't need protecting," Edith said, "What do I need protecting from?"

Rosamund sighed, pinching the bridge of her nose. "Edith. You are a sensitive soul. It's one of the things that, no doubt, inclined you to pursue psychiatry. I just worry that combining that with your inexperience, you may not be able to . . ."

"If you think I can't help her than take me off the case." Edith said, rising from her seat.

"I don't want to take you off her case. I just want you to be careful. She's your first delusional case and. . .and it's a compelling case. It involves children. It involves. . .a very nice husband. A husband who himself is very vulnerable right now. You must be mindful, you know as they say, of folie a deux."

"Madness shared by two," Edith laughed ruefully. "This isn't about me is it? This is about you. You sit there and tell me that I lack clinical judgment — that I can't separate myself from the case enough to protect myself — when you're sitting there making this about you. You see me as making the mistakes you made, but I won't. Because I learned from watching you." she threw up her hands, exhaling sharply, "And besides — I'm not married. No prospect of it on the horizon. I don't have anything to lose. There won't be a Marmaduke Painswick to take down with me when and if I go down."

Rosamund's lips came together in a tight line, "You're treading precariously close to the edge here, Edith."

"I'm not going to develop any kind of sordid relationship with my patient's husband." she said, heading for the door, "In the Crawley family lore, you laid claim to that trope long ago. I suppose I'll have to find a dishonor all my own."

Rosamund jumped as the door to her office slammed shut, her hand absentmindedly twisting her wedding band, the skin of her finger red where it spun in an endless loop — till death do us part.

"Oh, you're still up."

Cora looked up from the book she'd been reading in bed, or rather, staring at the same passage for the better part of an hour waiting for Robert to get home. As a young wife she'd waited up for him every night; but once the girls came along she was simply too exhausted at the end of the day to hold vigil for him. Once the girls had grown and gone, and she'd struggled to give meaning to her days, more and more she found herself unable to sleep — even long after Robert had finally come home and laid down next to her in their bed.

She smiled, closing the book a little too eagerly. "Hello darling."

Already beginning to loosen his tie before he'd so much as crossed the room to her, he leaned down and kissed her. "I hope you've had a better day than I did. I could use some pleasant news."

Cora blinked, "What's happened?"

Robert sighed, sitting down on the edge of the bed. "I can't make sense of the breach of Dr. Hughes' records. I've had IT scrub through it three times. I'm convinced now that someone has been nosing around under her name but — the thing is, whoever it is, they're very good. It's started to concern me far beyond Dr. Hughes'; unless they have some personal vendetta against her, I've got every reason to think they'll strike again — and I have no way of knowing when or where."

"How awful." Cora said, resting her hand on his thigh. He gave her a small shrug, then turned and placed a hand against her cheek.

"What about you, darling? How was your day?"

Her heart pounded in her chest. "Um — well, let's see. I saw Mary today."

"Oh?"

"Yes. She seems to be in better spirits. She may come for dinner this weekend."

"That's great — but where did you see her?"

Cora laughed uneasily, "At the hospital."

"Why were you at the hospital?"

Cora paled, lowering her gaze. "I was in. . .in Dr. Clarkson's office."

"Oh, well you should have come by my office after. We could have had lunch." he said, "Were you there for your physical?"

"No — no, not a physical."

Robert scooted closer to her, resting his hand against her shoulder. "Is everything alright? Are you alright?"

Cora gave him a small smile, "I've noticed some things lately. About myself. About my body and — well, I was thinking I might be going through the change."

"Oh God, Cora. How are we old enough for that?" Robert laughed, "I still look at you and see that twenty-two year old undergrad clutching too many books to her chest as we stood talking in the quad."

"I may be old, but apparently I'm not yet old enough for menopause."

"Oh – well, I suppose that's good? But you're okay, right? Nothing's the matter?"

"Well, not the matter, exactly." Cora sighed, "Have you noticed anything different about me lately? Physically or — emotionally, maybe?"

Robert shrugged, "No — well, maybe you've been a little weepier than usual. Remember last weekend when we watched that movie? George Clooney in space?" he chuckled, "You were really blubbering."

"It was sad, Robert!" she said, smacking his arm. "Have you noticed anything physically different?"

"I feel like this is a trap, darling. Like when you ask me if a dress makes you look fat and of course it never does, but if I tell you that you'll think I'm lying—"

"Oh, Robert!" she huffed, throwing the covers back and standing up beside the bed. She lifted her night shirt, exposing her bare middle. "Look."

"What— what am I looking at?" Robert stuttered.

"This tummy I've got — it's not middle aged spread. It's not toast," she laughed, her eyes starting to water. "Robert. I'm pregnant."

Robert held her gaze a moment, then he let his gaze fall to her middle. "Pregnant? How did this happen?"

Letting her shirt fall back over her middle, Cora threw her hands up exasperatedly, "Oh, I don't know — might have had something to do with the sex we've been having?"

"No — no, I mean— how did — Cora, you haven't been pregnant for eighteen years!"

"You're a doctor, Robert – you tell me!"

There was a moment of uncomfortable silence as she sat down next to him on the bed. Then, she turned toward him, "Are you mad?"

"Mad? Cora, no. I'm not mad. I'm just — I'm shocked that's all." he pressed his hands against his face, a boyish grin spreading across his face. "You're really pregnant?"

She nodded, "12 weeks* — can you believe that? I'm already practically done with the first trimester."

"Oh my God. . ." Robert said, taking his hands from his face and placing them against hers. "A baby — at our age!"

Cora laughed, tears falling onto her cheeks. Robert wiped them away with his thumb, then kissed her softly. When he pulled away, she pressed her forehead to his. "And who knows — maybe we'll get a boy this time!"

"I thought I might find you here."

Elsie looked up to where he stood, leaning against the doorway to the nursery. Even though he was whispering, the low rumble of his voice carried across the room and made Liddy stir in her arms.

"It's very late, Dr. Carson." she whispered, rocking the baby gently. "I would have thought you'd gone home hours ago."

He shrugged, stepping into the room and taking a seat near her in one of the many rocking chairs scattered about the room. "Well, I will be shortly. I just wanted to see if you were alright."

She flicked her gaze up at him, "That's kind of you."

"So, this is your new admit?" he looked down at the baby in her arms, who had fallen back into a fitful sleep.

Elsie sighed, "I think it's Enterovirus D68. I've been reviewing the literature all evening and there was a cluster of cases in America — many of which led to acute flaccid myelitis. Of course it's too soon to know if it will be permanent. For many of the American children it was, so, until I can confirm the presence of the virus I'm going to assume as much. She's stable for now. I made her mother up a cot and she's sleeping, finally. Poor dear. But she's very brave. And this little girl is very strong."

"I'm quite impressed with your diagnosis. Not that I wouldn't have expected you to be up on your literature but – even still. I must say you never cease to amaze me, Dr. Hughes."

She gave him a small smile. Liddy cooed in her arms, punching her tiny fists against the air. Elsie reached her finger down, pressing it into the infant's hand. Fingers clasped tightly round it, the baby gave a deep sigh and fell back into her slumber. Elsie giggled, seeming to forget that Dr. Carson was even in the room.

"Oh my! What a mighty sigh for such a wee bairn," she hushed, lifting the baby up against her shoulder, rubbing her back soothingly. She looked over her swaddled shoulder at Dr. Carson, who was looking at her peculiarly.

"You're kind to say so but I'm only doing my job." she pressed her cheek against the baby's head, letting her eyes close for a moment. When she opened them, he was still looking at her, his bottom lip trembling nervously, as though he had words to say but required her permission. "You've something on your mind, Dr. Carson?"

He broke her gaze, looking down at his hands. He turned them over in his lap a few times, then pressed them together, scratching the top of his knuckles absent mindedly. "I suppose it's always a little strange to see you with the children."

She narrowed her gaze, "How so, Dr. Carson? I'm a pediatrician; wouldn't it be far stranger if you never saw me with a child?"

He laughed, "Yes, that's true. Even after all these years I marvel at what a natural you are. Considering you never. . ." he shook his head, dismissing the thought, "No. I won't."

"Well, now you've piqued my curiosity." she said, "It's late, go on then. At our age, come tomorrow, we'll likely forget we've spoken anyhow."

I could never forget our conversations, he thought, tilting his head a bit to look at her. In the dim light of the nursery, the least harsh lighting in the hospital as it were, she looked very calm. She held her face in a tired, but calm, repose. The soft lilt of her voice as she spoke to the baby, to him, thick with sleepiness and shadows of her Scottish roots. As he caught her eye, she tugged at her bottom lip, her eyebrows raising the question.

"I suppose I just wonder if you would have liked to have had children of your own, Dr. Hughes."

If she was startled by his inquiry, it didn't show. She lowered Liddy back into her arms, adjusting the swaddling around her and studying the baby's face a moment before she spoke.

"I've never known you to be sentimental, Dr. Carson." she said without looking up, "Though, I've occasionally wondered the same of you."

"Wondered if I'd have wanted to raise a family?"

She shrugged, "Well, marry at least. Maybe longed for something other than Downton."

Only you, he thought, his heart beginning to race.

Elsie sighed, "When I first started my residency I suppose I thought about it. Many of the women I went to medical school with went on to have fine marriages, a few children — though, none of them are Chief of their department to my knowledge. I suppose I made a choice, as they did. I don't think I chose better, or more wisely — just differently."

"Must you have chosen at all?"

She did look up at him then, "A woman always has to choose, Dr. Carson. Deep down I suspect that had I been trying to balance my work here with raising children of my own, I may not have had the energy, or the heart, to care for all my—" she gave him a mischievous grin, "little darlings."

"In any case, no matter what choice you made, I'm sure you would have excelled in that life as much as you have in this one," he offered, his cheeks pinking.

"You're full of praise for me this evening, Dr. Carson. I'm beginning to worry you're working up to some wretched announcement." her face fell, "Please don't tell me you're retiring!"

"Oh, no no!" he said, a bit too loudly. Liddy squirmed in Elsie's arms, blinking awake. "Damn, I've woken her —" he said, rising to leave.

"Stay," she said, "Why don't you hold her for a moment – I've got to get up and grab one of the infant cuffs so that I can take her blood pressure anyhow."

He lowered himself slowly back into the chair, lifting his arms to accept the tiny bundle from her. Liddy, with her large, inquisitive eyes, stared up at him with an incredulous affection; a look that he was used to getting from a certain Scottish physician, but never a baby.

"She's fond of you." Elsie said from across the room, "See? She quieted right down." Walking over to the chair, blood pressure cuff in hand, she knelt down next to him. As she wriggled one of the baby's arms from the swaddling, she flicked her eyes up to watch Dr. Carson's face. He had a look of astonishment and apprehension. A fatherly look if there ever was one.

"What about you, then?" she said, "Ever wanted a little Carson all your own?"

He faltered, "Well — I don't know, I suppose if — if I'd met the right person." he swallowed hard. He could have sworn that Liddy raised a tiny eyebrow at him.

"Preferably a woman who wouldn't have been opposed to you reading bedtime stories from The Merck Manual*?" she teased, her arm inadvertently pressing against his thigh as she took Liddy's blood pressure. Even through his trousers he could feel how warm she was next to him. It was deeply pleasant and he felt a small smile tugging at his lips.

"In an ideal world she'd have been at my side with a coloring book of anatomical illustrations."

Elsie chuckled, releasing Liddy's arm from the cuff and tucking it tenderly back amongst the blankets. She pressed the tip of her finger to the baby's nose as she stood, crossing in front of him and settling back into her own rocking chair. He lifted his arms uncertainly, trying to gauge if she wanted the baby passed back to her, but she waved her hand dismissively.

"She's content for now and I've got to chart her vitals. Unless you've got somewhere to be?"

He smiled, settling back against the chair. Nowhere I'd rather be, he thought.

"If I didn't know better I'd say you were almost enjoying this moment, Dr. Carson." Elsie said, tossing her hair back from her face so that she could put on her glasses. She gave him a knowing grin and turned to Liddy's chart. For a moment, the only sound in the nursery was the flow of her elegant script across the paper and Liddy's tiny rasps.

"Truth be told, I could never have had a child of my own in good conscious." he chuckled, "Imagine a baby as small as this one— with a nose like mine!"

She offered him a small laugh at the self deprecation, leaning back and removing her glasses.

"Mine probably would have had a thick brogue before their first birthday and hell-fire red hair."

"You don't have red hair." he said, raising his eyebrows playfully at Liddy, who offered him a weak smile. Elsie chuckled, suddenly realizing how exhausted she was. Rubbing the sleep from her eyes, she thought, I don't, but Becky does.

He blinked a few times, his brow furrowing. "Who's that?"

"Hm?" she said, yawning widely.

"Who's Becky?"

Her breath hitched and he saw, in that moment, her entire demeanor shift. Even the air in the room suddenly felt oppressive, like suffocating in a smoke-filled house. Her eyes widened fearfully, and after a few moments they glistened with unshed tears.

She'd never meant to say it out loud.

"I'm sorry —" he said, "You just — you said "Becky does,"—has red hair, I mean—"

He studied her a moment but he couldn't figure out what her look meant. Was she in the throes of concocting a lie? Struggling to reveal some terrible truth to him? He felt his stomach drop and he wondered if he'd hurt her. Whatever she'd said was clearly never intended to be verbalized. He was only relieved that if it was some awful secret of hers, there was no one else around to hear it. She could count on him to keep it — and certainly Liddy wouldn't be a worry. She was preverbal.

In the heavy moments that followed, Elsie too reverted to a preverbal state. She hemmed and hawed, trying to make her mouth form words.

"You don't have to say," he said finally, standing and leaning over her, gently lowering Liddy into her arms, "I should be getting home."

He turned to leave and heard her voice, aching from across the room, just as he reached for the door knob.

"My sister," she said. "Becky is my sister." He turned slowly, his mouth drying out.

He inhaled deeply, suddenly nervous for her somehow. "I thought you didn't have any family left?"

He was just far enough away that he couldn't be sure that she had begun to cry, but as she spoke again, he became certain that at the very least she was teetering on the edge of a long overdue sob.

She looked down at Liddy, letting her hand rest against her head, wisps of soft hair against her palm. In that moment, feeling the weight of her failures — with Becky, with her patients, with him, she felt a pain so deep in her heart, so prolific in its presence, that she wondered if that's what the radiologist saw in her breath; not a cancer, but a wound. Not of her breast, but her heart. He hovered in the doorway, clearly not sure if he should leave her or step back in. She knew he was waiting for her to speak, but she wasn't sure what to say.

So, as she lifted her face to him, she settled for the truth.

"Probably because that's what I wanted you to think."

* E68, which we still don't know all that much about. I'll be taking a bit of literary license here because, frankly, the research is quite new even if the actual virus itself was discovered decades ago. The link to the paralysis is what's relatively new.

* BI-RAD (Breast Imagining Reporting and Data System) is what radiologists use to assess breast ultrasounds and mammograms. So, it's staged in various categories from like, benign to confirmed malignancy. 4B is a sub rating of 'suspicious abnormalities' seen by a radiologist that is not confirmed malignancy, but probably warrants either a biopsy or excision — or both. 4A, 4B and 4C are various levels of probability of malignancy, 4B being intermediate.

* Particularly since Cora is quite tall (well, because Elizabeth McGovern is, haha) and she wasn't even considering that she could be pregnant, it's entirely probable that she wouldn't be showing as much as other women might by the end of the first trimester. Though, after having three pregnancies she's probably showing enough to notice something, if not a totally obvious bump. It's always different for every woman, and even different for each pregnancy in the same woman, but just know that I didn't choose the week arbitrarily ;)

* The Merck Manual is like, the medical Bible. It's a big ol' textbook of symptoms, conditions, diseases, injuries. . .everything. Mine is on my nightstand!