Hey, lovelies! This was meant to be finished and posted last night, but yesterday I broke out in hives for some still-unknown reason and spent the evening in a Benadryl coma instead of writing. Apologies. I also spent a good part of today mainlining caffeine to offset another Benadryl coma so I could work, but I managed to finish this. I certainly hope it was worth the wait for all you angst fiends.
The following morning Addison is awake early. Mark is behind her, one arm draped across her hip. She'd love to go back to sleep, his warm weight comforting against her, but she needs to put her mind at ease so she carefully disentangles herself and slips into the bathroom unnoticed.
She'd never gotten around to taking the tests the night before, so she locks the door and retrieves them from their hiding spot. With a plea for mercy sent out to whichever supreme being might be listening she opens the boxes, does her business, and waits impatiently for the results.
…..
It's her day to go to the hospital with Emme. She stuffs the tests in one of the grocery bags and disposes of them in the hotel lobby on their way out. He'll never have to know anything about this, she thinks as she walks away, Emme skipping alongside her swinging her tote bag.
At the hospital she's surprised to find Doctor Rasgotra waiting for them instead of their usual nurse; it generally isn't a good sign when a doctor shows up to do what a nurse is perfectly capable of doing. "Doctor Rasgotra, everything okay?" she asks, trying for Emme's sake not to sound nervous.
The doctor gets Emme hooked up to the machine. "Doctor Montgomery, unfortunately we've not been able to collect as many stem cells as we'd hoped. Today's harvest should just get us to the bare minimum, but that is far from the ideal number. If you're available this afternoon I'd like to meet with all parties involved to come up with a new game plan."
Addison frowns and leans in to speak quietly with the doctor. "Is there something wrong with Emme? Why isn't she producing enough stem cells?"
"I assure you it's nothing to worry about. She had an extensive workup before we began, as I'm sure you recall, and she's as healthy as can be. Some patients just don't respond as well to the filgrastim, but there are other options."
"So, what are those other options?"
"We'll go over that this afternoon. See you at three?"
Addison sighs. "Yes, of course."
An hour later Addison has called Mark to inform him of the meeting, and Emme is playing with Addison's tablet. Addison is attempting to read a magazine and not worry about the upcoming meeting when two people enter the room and stop in front of her. She looks up from the tabloid to find Meredith and Cristina, steaming cups of coffee in hand. Her eyes shift from one to the other. "To what do I owe this honor, ladies?"
"Oh, we were just passing by on our way back from getting our caffeine fix," Meredith says casually, but Addison doesn't trust the smirks on either of their faces.
"The coffee cart is on the other side of the hospital. Why are you really here?" Addison asks suspiciously.
"Cristina says you still haven't taken a test."
Well, I wasn't expecting that. Addison glances at Emme; the girl is oblivious to her surroundings, headphones on and engrossed in her game. "That was yesterday."
"So, you did take the test?"
"I did."
Meredith is clearly getting impatient. "And?"
"Why do you care?"
Meredith shrugs. "Riley's had a rough couple of days and I need someone else's problems to distract me for a while," she admits.
Addison rolls her eyes. "I see. Back to using me for my problems. Nice. Just so you know, I'm not going out to but you booze this time," she teases.
"So, is there a problem?" Cristina prods.
She tries deflecting the question yet again. "You know this really isn't a healthy coping mechanism, right? A therapist would probably be more helpful."
"Oh, and not taking the test so you don't have to admit you're pregnant is healthy?" Cristina challenges. "Come on. Help this poor, dark and twisty soul out. You knocked up or what?"
"You know what? Maybe I don't like you," Addison shoots back good-naturedly, recalling Cristina's words from almost a week ago. "But yes. I can't deny it any more," she finally admits.
"Is Mark excited?" Meredith inquires.
"Oh, God, I didn't tell him! He always gets so excited. Gets this big, goofy grin on his face, starts making predictions about the gender, what they'll look like...I can't tell him I'm," she pauses to make sure Emme is still distracted, then lowers her voice, "pregnant, and then tell him I'm not keeping it. I'll just...he's supposed to go to a conference the week before Cece's surgery. I'll make an appointment, and...take care of it...and he'll never have to know."
"Okay, what were you saying about healthy coping mechanisms?" Cristina asks bluntly. "Look, I am all for the right to choose, and you definitely shouldn't keep it just because he wants it, but you should tell him. Just in case something goes wrong, or whatever."
It doesn't escape Addison that for once there's no trace of sarcasm or bitterness in Cristina's words and finds it oddly touching...or maybe it's just the pregnancy hormones. Still, she's not sure she can take the other woman's advice. "I don't know. But there's time. I have time to figure it out," she decides just as Meredith's phone rings. She's grateful for the distraction from the current discussion.
Meredith steps out into the hall to take the call and returns shortly. "That was Derek. He said Doctor Byrne just stopped by and wants us to meet this afternoon. You know anything about this?"
"Yeah. Doctor Rasgotra was waiting for us when we got here this morning. Apparently they're not getting enough stem cells, so we need to consider other options." Meredith looks somewhat terrified, so Addison feels the need to reassure her. "She says it's nothing to worry about. Maybe she'll want to do the bone marrow aspiration," she muses.
"You didn't want to do the bone marrow aspiration. How come?"
"She had her tonsils out when she was just barely two years old, and she had a bad reaction to the anesthesia. I know it's silly, because they could just use a different anesthetic and she'd probably be fine, but I get so nervous thinking about putting her under again. I mean, if we have to, we have to, but I'd like to avoid it if possible."
"It's not silly at all. I totally get it. I probably wouldn't want to do it either."
"But we will, if we have to," Addison assures Meredith. "So, how is Riley?"
"Not so good. The high-intensity chemo and radiation is kicking her ass. And she spiked a temp of a hundred and three yesterday. They have her on broad-spectrum antibiotics for now until the cultures come back and we know what she has. Hopefully they can nip it in the bud before it gets too bad. I should probably get back up there now. Derek's with her, but I hate leaving with her like that."
"Well, I hope she's feeling better soon. I'll see you later."
…..
Meredith returns to find Derek in the rocking chair with Riley sitting listlessly on one knee, a vomit-filled basin on the other, and a waste paper basket filled with bloodstained tissues on the floor next to him. She gets a washcloth and wipes her daughter's pale, sweaty face before pulling up a chair. "She's still burning up," she notes sadly and he nods slowly as he stares straight ahead, eyes bloodshot with exhaustion and underlined with dark circles.
"She hasn't improved at all since yesterday." He pauses when she starts to gag and thrusts the basin in front of her just in time for her to vomit. She retches at least a half dozen times before she's done and leans back against him, too exhausted to even cry.
Meredith wipes her face again. "My poor little pumpkin. You want me to take her for a while?" she offers, as he had stayed up all night with her. "You can go home and take a shower if you want."
"Wouldn't mind stretching my legs and getting something to eat," he admits as they change positions. "But I'm not going home yet." He empties the basin and rinses it out before handing it to Meredith, and kisses the top of Riley's head. "I'll be back soon, pumpkin."
…..
A few hours later they're all gathered around the conference table once more - the little ones thankfully napping in the stroller, Emmeline on Mark's lap, playing with her little plastic otters - when the doctor enters.
"Okay, the reason I've asked you all here today is that unfortunately, we have not been able to collect as many stem cells as I would like. As of today we just hit the bare minimum needed to attempt the transplant, but as I stated in our first meeting we really prefer to have much more to assure success. At this point, we have two options...we can do a bone marrow aspiration, or we can try another course of the filgrastim with the addition of plerixafor followed by another attempt at PBSC harvest."
"Okay, so what is this...plerixafor?" Addison asks.
"It's another drug used for mobilizing stem cells. It is highly effective and, used with the filgrastim, should yield a satisfactory number of cells within a couple days."
"And what are the side-" Addison starts, only to have her ex-husband speak over the top of her.
"If the plerixafor is so effective, why didn't you use it the first time?" Derek asks, annoyed that they could have potentially avoided this delay in Riley's treatment.
"For starters, the price is too high in comparison to the filgrastim to justify it's use as a first-line treatment."
Derek is clearly more than annoyed now. "Do you think we care about the cost? This is my daughter's life we're talking about here!"
"Well, that isn't the only issue. It hasn't been cleared yet as a standard treatment in pediatric patients. This would be an off-label use," Doctor Rasgotra explains.
"Okay, wait a minute. You want to use an experimental treatment on my kid?" Mark butts in loudly.
"It's not experimental. It has been proven to be safe and effective and is approved for use in adults. There just haven't been enough controlled studies done in children to determine the safety of the drug, but it has been used in a limited number of children as a second-line treatment in cases where filgrastim alone failed to mobilize the number of stem cells necessary for an autologous transplant."
Mark shakes his head furiously. "But this isn't an autologous transplant. In those cases, the patients themselves benefited from the use of this drug. Emme isn't sick. She's not going to benefit from it, and I don't think we can justify the potential risks of an experimental treatment here. I think the bone marrow harvest would be a better option."
"No, no, no. There is faster engraftment and a higher two-year survival rate with the PBSC transplant compared to a bone marrow transplant," Derek informs the group, clearly having done some research on the matter. "I really think the plerixafor is the best option."
"Well we don't necessarily agree. And quite frankly, I'm not interested in putting my kid through five more days of injections, an experimental treatment, and who knows how many more days hooked up to that machine! I say do the bone marrow aspiration and get it over with."
"Well, it isn't up to you, is it?" Derek challenges. "And Addison wanted to avoid putting Emme under anesthesia."
"Don't you use me as an excuse to get your way," Addison snaps. "Mark is right, I don't know if I want to put her through all this again."
Derek smacks his palms on the table and stands up, face red and eyes wild. "Oh, come on! Five shots is nothing compared to what Riley is going through right now. Nothing! I want to proceed with the peripheral stem cell harvest."
"And I don't," Mark counters.
"You really think your opinion matters here, Mark?"
Meredith tugs on her husband's sleeve, trying to get him to sit down. "Derek…" she warns. He brushes her off.
Mark sets Emme aside and jumps to his feet. "It matters a hell of a lot more than yours. My daughter isn't a goddamn guinea pig! We do the bone marrow aspiration or nothing."
"Really? What makes you think you get the final say in this? Or any say at all?."
"Derek, that's enough!"
Derek points at Mark. "You do not get a say in this. You are not her father! I am, God damn it, and I say we try the plerixafor!"
"Derek, what the hell is wrong with you?" Meredith yells, near tears, as Addison gasps.
Everybody else is stunned and silent by now - except Angelina and Cecilia, who are awake and crying, frightened by the shouting - none more so than Emmeline as her eyes dart from Mark to Derek.
"Okay, you know what? You're gonna regret that, because we're done here. Done. We're going home." Mark grabs Emme and heads for the door. "Come on, Addison."
"But Mark-"
"But nothing! We're leaving."
Addison shoots Derek a deadly glare. "I hope you're happy," she spits before grabbing the stroller and hurrying to catch up with Mark.
"Addie, wait!" Derek yells. He tries to follow her, but Meredith grabs him. "I'm calling my lawyer!"
"Stop it! Don't you think you've caused enough trouble already? I can't believe you!" She smacks him a few times before taking off for oncology. He follows her but she turns to glare at him. "No. I'm going to see Riley. You can go...I don't really care where you go, as long as it isn't in the same room as me because if I have to look at you any longer, I'm going to kill you."
He stops dead in his tracks, and she hurries up to oncology where she finds Cristina pacing the floor as Riley wails, her voice starting to get hoarse. "Oh, thank God you're back," Cristina mutters as she thrusts Riley at Meredith. "She would not stop crying. You know I love my godchild but I can only take so much of the crying. Oh, Mer, no. Don't do that. Please don't cry. Who do I need to kill?"
Meredith takes a few deep breaths and tries to pull herself together. "They're leaving. We don't have enough stem cells, and they're going back to New York."
"What? Why? Call Addison. She seems reasonable. And she's a neonatal surgeon. She's a sucker for babies. Call her. Or give me her number and I'll call her."
"It's not Addison that's the problem. It's Mark. Derek wants to continue the PBSC harvest, but Mark would only agree to a bone marrow aspiration, so Derek basically started a pissing match and yelled that he's Emme's father, not Mark. In front of Emme. And then they left."
"Oh. Shit, you're screwed. Can't say I blame them...I will blame them anyways, because I'm on your side, obviously, but I'd be seriously pissed if I was them. So where is McDouchey now?"
"I don't know. I told him I didn't want to see him."
…..
They're barely out of the hospital parking lot before Addison's phone starts ringing. Derek. She hits ignore. Dr. Rasgotra. Ignore. Some number she doesn't recognize - this time she just turns the phone off and shoves it in her purse. When they get to their hotel room the little ones are still crying; Emme is still speechless, looking disturbingly shell-shocked. Finally she looks at her parents. "He's lying, right? Derek's not my daddy. Right?"
Addison is sitting on the couch with a screaming baby. "Emme, sweetie, let me just feed the baby, and then we'll talk."
"Tell me now."
"Emme-"
"Tell me!" With a savage growl, Emme kicks at Cecilia's tower of rainbow-colored stacking cups on the floor; Mark cringes as one narrowly misses Angelina's head and another bounces off the window.
Mark reaches for her arm. "Come on, kiddo, just sit down-"
She jerks away. "I'm not sitting down! Just tell me!"
"Em-"
She knocks a bowl of Goldfish and a stack of picture books off the coffee table. "Tell me!"
"Emmeline, you need to calm down right now," Mark says in his no-nonsense tone, calm but firm. She's still wild-eyed and breathing hard, looking around for something else to kick or throw, so he picks her up; she fights him, but he holds her in a bear hug until she tires herself out. Once she's still Addison speaks.
"Okay, honey, you know how your friend Philip lives with his mommy, but he visits his daddy on the weekends because his parents are divorced?" Emme nods, but is clearly confused because they're not talking about Philip, they're talking about her, and Derek, and Mark, and what does Philip have to do with anything? "Well, Derek and I used to be married. But then we...got in a fight, and we got divorced. And when he left, you were just a tiny little baby in my tummy, but we didn't even know it yet and he moved out here to Seattle. So, yes. Derek is your father-"
"No!"
"Emme-"
"No! He's not my daddy!" By now her lip is trembling, tears threatening to spill down her flushed cheeks as she turns to face Mark. "You're my daddy. Not Derek. I don't want Derek!"
"Love bug, I will always be your daddy, but he is your father."
"You're a liar! You're both liars!" Emme manages to escape his grasp and runs to her room, slamming the door hard enough to rattle the windows.
…..
The rest of the day is fraught with tension, and the little ones seem to pick up on it. Cecilia is clingy and whiny, and refuses to eat the dinner they ordered from room service so Mark eventually gives in and lets her have applesauce and Goldfish; Angelina goes into hysterics any time Addison attempts to put her down. Emme hides under the covers crying and screams any time Addison or Mark tries to talk to her, so they reluctantly leave her alone. Eventually Emme cries herself to sleep, and after what seems like an eternity they finally manage to get the other two down for the night. When Addison tucks them in she notices that Emme's otter, which once held a place of prominence in her bed, has been discarded in a corner.
As soon as the kids are in bed Mark takes Addison by the elbow and steers her to their bedroom. "We're not doing it. We're going home."
"But what about the baby?"
"Forget the baby! That jackass doesn't care about our kid, why should we worry about his? They got the minimum number of stem cells needed. That's going to have to be enough."
"It's not her fault."
"It's not Emme's fault either! She's miserable, and heartbroken-"
"And she'll be miserable and heartbroken whether she's here, or in New York. She still has the PICC line in, it's not going to hurt her to continue."
"Unbelievable. Whose side are you on, Addison?"
"I'm not on anyone's side! But I will never be able to live with myself if that baby does."
"That baby is not your responsibility. Emme is!"
"But Mark-"
"But nothing! Okay, look. I know that for whatever reason, you still feel guilty for what we did, but you can't just offer your child up like a sacrificial lamb to atone for your sins. And you shouldn't have to. You screwed up but you know what? He did too. He was a shitty husband, at least the last few years, and you owe him nothing. You just want everyone to get along and like you, and do whatever it takes to achieve that, but where does it get you? Nowhere. Especially in this situation, because as soon as that baby is better, he'll have no use for either of you. Maybe you can handle that, but can Emme? She's not even my kid, according to that jackass at least, but I'm the only one looking out for her best interests. You're not, because apparently you're too busy trying to get back on his good side, and Derek sure the hell isn't. There's only one kid he's trying to protect, and according to him I don't get a say in this so Emme needs you to look out for her. Grow a fucking spine and quit trying to win his forgiveness at the expense of your daughter."
Before she can put together a coherent thought, he's out the door. Her first instinct is to run after him, but she can't leave the girls alone so she stays.
She returns to her room and turns her phone back on for the first time since that afternoon, and it explodes with notifications. Missed calls, voicemails, text messages from Derek, Meredith, Doctor Rasgotra, Riley's oncologist, even Richard. With a sigh she scrolls through her contacts and her finger hovers above one name. She hesitates, knowing that no matter what she does she's going to pay a price, but knows what she has to do. Swallowing hard, she clicks on the name and waits for the person to answer. "Meredith, I am so sorry…"
