Warning - this will be the 3rd child in the ER/hospital chapter I've written for this fic and I am completely aware of it. I would have to assume that children are the hardest part of Katie's job, especially since she is also a mother. There is no Steve in this chapter, although I did have Five-0 as part of it initially. But then I thought that this chapter and the one I am working on next would be better if Katie had this one all to herself. I hope you agree...

Thanks again for everyone who is taking time to read and review this fic. I truly appreciate it, even if I forget to say "thank you" before I publish each chapter!

Chapter Twenty One – This Mother's Work

"Becoming a mother makes you the mother of all children. From now on each wounded, abandoned, frightened child is yours. You live in the suffering mothers of every race and creed and weep with them. You long to comfort all who are desolate."

-Charlotte Gray

The next morning…

"…and the surfer in Exam 1 needs his leg suchered up before we send him back out into the Pacific," Dr. Giordano instructed, handing over the last of three charts she had been working on to the young nurse on duty in the ER. Four hours after leaving Honolulu Medical Center, Katie was back at her post and ready for another day in the trenches. Luckily, the early morning was the quietest time in the ER. . .the drunks and gang members had all gone home and most people weren't even awake yet. But, it was taking all the coffee she could find to keep the surgeon's eyelids from collapsing. She had gone through the first half hour in a sort of daze, checking in on Kyle and the other patients who had stayed overnight and ordering tests on the woman who had just arrived with a broken arm.

"You look like hell."

Katie looked up from her next chart just in time to see Dr. Malia Weston sidle up next to her at the ER nurse's station with a playful smirk on her face.

"And good morning to you, friend," the brunette shot back snidely and then drawled, "And I use the word *friend* in the loosest sense of the word."

"What is that supposed to mean?" Malia quipped, setting a fresh cup of coffee down on the counter next to the tired surgeon.

"You know what that means," Katie told her, raising an eyebrow at her best friend as she settled into one of the arm chairs behind the desk. Picking up her coffee, she asked, "And why the hell is everyone bringing me coffee all of a sudden?"

Malia chuckled and asked, "Did we get up on the wrong side of the bed this morning, sunshine?" Taking a sip of her own coffee, she asked slyly, "Or is all that pent up sexual frustration finally making its way to the surface?"

"Don't you have anyone else to annoy?"

Malia playfully checked her watch and said, "Nope. My schedule is pretty clear for the next few minutes." Grinning at her friend's attempts to ignore her, the pediatrician quipped, "You seriously do look like hell."

Katie just shook her head and tucked the lock of chestnut hair that was falling in her face behind her ear as she replied, "Seriously...thanks."

"You don't look at all like yourself," Chin's fiancé continued, grinning like a Cheshire cat, "No make-up, bags under the eyes, pasty skin...rough night?"

"I didn't sleep well."

"Ah," Malia said triumphantly, "but the big question is...did you sleep alone?"

Katie gave her friend and colleague one of her patented evil eyes across the desk and said, "Despite your best efforts. . .yes, I went to bed alone. Like I have every night for the past six years."

"My best efforts?" Malia asked, pasting an innocent look very similar to Matt's on her face. "What on earth are you talking about, my dear?"

"You are as bad at this as your ten year old partner in crime," the surgeon informed her, not looking up from her paperwork. "And you are both completely busted."

Malia laughed out loud at the statement and then asked, "So, how did your date go?"

Katie was silent for a few more minutes, hoping that Malia would go away. But, of course, she didn't so Katie put down her paperwork and glared across the desk as she said, "If you must know...he is a fantastic kisser."

Malia's eyes widened in surprise, but she kept up the innocent act as she exclaimed, "I knew it! But I didn't know anyone who had kissed him until now."

"Malia..."

"What?"

"You are engaged," her friend reminded her, "you shouldn't be thinking about whether or not Steve McGarrett is a good kisser."

"I'm engaged, not dead," Malia reminded her with another grin before she added, "But more importantly…my girl's got her groove back! Outstanding!"

"I do not have my...groove...anywhere!" Katie hissed. "This is awful."

"What is awful?"

"Didn't you hear me?" Katie hissed wide eyed as she looked around to make sure none of the hospital gossips were within earshot. When she was sure they were in the clear, the doctor repeated, "I kissed Steve McGarrett last night! Many, many times!"

"Yes, I heard you," Malia assured her with a grin. "And now I want details. Many, many details."

"No."

"Excuse me?"

"I don't want to talk about it," Katie grumbled, looking back down at her paperwork.

"Are you nuts?" Malia asked, standing up and pulling Katie's file out from under her nose, "Of course we are going to talk about it! This is huge. Plus you owe me for not telling me about Steve coming to Matt's football game and the date that occurred afterwards. As your best friend, I am not supposed to hear about such events second hand."

"Hey!" the brunette exclaimed, as she watched Malia take her file, put it on her chair, and promptly sit on it. "And we did not have a date after the football game...we had burgers. And shave ice. Now give that file back to me. I need it."

"No, you need to tell me all of the events that led up to you kissing Steve. . . many, many times." Malia corrected her. Crossing her legs and setting a determined look upon her face, she said, "Now, spill it."

Katie drew in a deep breath and then blew it out again as she muttered, "As if you didn't know."

"No, I don't know," the pediatrician informed her friend. When Katie glared at her, she explained, "I know how he got there, I admit. But what happened between the moment he rang your doorbell and the moment you devoured his luscious lips with your own is what I am not clear on."

"How could you do that to me?" Katie moaned, ignoring Malia's plea for details. "I was all set up to have dinner with my two best friends and ended up having dinner with the man I am trying very hard not to fall for instead."

"And then kissing him," Malia reminded her, wondering if Katie realized that she had just admitted to having feelings for Steve, "Let's not forget the part about kissing him."

"How could I?" Katie muttered and swore that her lips began to tingle as she thought about those skillful lips of his. Shaking those thoughts out of her head, she looked at her best friend again and asked, "So, why did you do that?"

"Do what?"

"Malia..."

"Because it was fun."

"It was not fun!" Katie corrected her. "It was..."

"Any evening that ended with kissing a major hottie like Steve McGarrett had to be just a little fun," Malia reasoned with a playful grin.

"Would you forget about the kissing?" Katie snapped in frustration, ready to bang her head on the desk. "You set me up."

"Yes I did," Malia admitted proudly, "Me and Matty. And Chin, too...but he only came in at the end."

"And you don't see anything wrong with that?"

"Nope."

"Care to explain?" Katie asked, ready to throttle her beautiful pal.

"What's to explain?" Malia asked innocently, taking another sip of her coffee. "You just said that you have been going to bed alone for the last six years. That's just sad. MOre than sad...it's unnatural. So, when Matt said that he had a plan to set you up with the gorgeous, sexy Steve McGarrett. . .I jumped in with both feet. I mean, most of my plans to set the two of you up have failed but Matty seems to be awfully good at it."

"Matt is ten!" Katie reminded her forcefully. "Why do I have to keep reminding people of that?"

Malia chuckled at her and said, "Well he's old enough and smart enough to know that it's time for you to start getting back out there." She cocked her head to the side and said, "We're all a little worried about you, you know."

"Well, I am fine," Katie reassured her. It was amazing how she could be fed up with her best friend in one moment and completely in awe of her again in the next. "And I'm happy. Contrary to popular belief, I don't have to have a boyfriend. I do pretty well on my own."

"Yes, you do," Malia agreed gently. "But you don't have to be on your own all the time."

"I'm not," the surgeon protested, "I have Matt. And my family. And you. And your family."

"Yeah, but I'm getting married soon," Malia reminded her with a grin. "And that means that I'm not going to have as much time to meddle in your life, so I wanted to make sure that I got it all in now." Katie laughed and shook her head as her friend continued, "I have known you a long time, Katy-did, so I know what you look like when you are happy. And it usually coincides with when you are in love. Face it girl, you look good in love."

"And you thought Steve McGarrett was the right man for the job?"

"Yes, I did. And so did Matty," Malia reminded her and then pointed out, "Steve is the first guy in a long time to get past your defenses and actually touch those forbidden lips with his." Katie eyed her friend again and Malia let out a deep breath as she offered up a new explanation, "I just figured that it was kind of perfect, you know? My best friend and Chin's best friend, the whole Navy SEAL thing…who are we to challenge who love chooses to unite? It follows no rules...no logic. I mean, look at my parents. Or yours. Who would have thought that they would find happiness with each other? And me and Chin, for that matter. We were circulating in two different universes before fate brought us back together."

"He's dangerous, Malia."

"Why?" she challenged.

But before Katie could finish, the yellow phone next to Malia's head went off and the mass casualty incident alarm was immediately triggered. As the warning signal of "Code Yellow: Mass Casualty Alert, Code Yellow: Mass Casualty Alert, All Available Emergency Personnel to the ER," sounded, the surgeon watched in alarm as her friend received instructions before hanging up the phone.

"Break time is over, Katy-did," she reported, trying to catch her breath. "We've got a situation."

"What's going on?"

"School bus crash, rear left side collision with a food delivery truck…"

"School bus?" Katie asked as she stopped tying her hair up into a ponytail and looked at her friend in alarm, "Which school?"

"It's not Kauluwela," Malia informed her, knowing exactly what her best friend was thinking. As the two doctors joined in with the chaos of readying the ER for a mass casualty incident, she continued, "The bus is from Kailua…they're splitting up the major casualties between here and Queens General. Matty's not involved."

"But other people's children are," Katie whispered, her heart dropping into the pit of her stomach. Taking a deep breath and preparing herself, she asked, "How many are we looking at?"

"So far twenty-six. Nine major, seventeen minor," the chief of trauma surgery, Dr. Jonathan Cramer, suddenly appeared next to Katie with a grim expression on his face.

"How many are coming here?"

"They're sending all the majors our way."

"Do we have an age range?"

"Elementary…so I'm guessing their ages range anywhere from five to eleven."

"Babies," Katie muttered under her breath before reverting to trauma mode and barking out orders to her team as they stood awaiting her instructions, "Alright people, you know what you have to do. We've got nine majors coming and a few minors." The surgeon turned to her best friend and informed her, "Ages ranging from five to eleven, so let's get as many of the pediatrics staff down here as we can." Malia nodded and took off toward the nearest phone as Katie continued, "ETA is five minutes for the first one. Kelly, get Drs. Green and Callahan and prep trauma one. Everyone else, prepare the rest of the trauma units…we don't know how many we're going to need because we weren't told much. Only to be prepared, which can't be a good sign."

Soon enough the sound of sirens could be heard coming closer and the first of the ambulances came around the corner. It screeched to a halt next to the emergency room doors and immediately a paramedic pushed open the back. She pulled out a child on a stretcher and began talking as Katie and Malia ran over to them.

"Eight year old female, blunt force trauma to the head," said the paramedic Katie directed Dr. Green to take the child to trauma one. "Her name is Allison Stigel and her brother, Bobby, is right behind us. He's fine except for a few bumps and bruises, but it looks like he might need some stitches for the laceration on his forehead."

And then…

"Simon Walker, nine years old," recited the next paramedic who exited the ambulance, "mild concussion with a severe laceration above his left eye. Conscious upon arrival but slightly panicked so we gave him morphine for the pain and to calm him down. No signs of further injury."

"Thanks Frankie," Katie replied hurriedly as Simon Walker was instantly wheeled off by her colleague Dr. Reggie Callahan, "Do you have any information on the other victims?"

"Only that little Simon here is the most healthy," the paramedic replied grimly, Katie's heart falling again at the realization that they had a good chance of losing at least one child today, "The truck struck the rear left of the bus. This kid was sitting near the front and look what happened to him. It's gonna be a bad day, Dr. G."

"Okay," Katie nodded as Frankie and another paramedic got back into the rig and headed off. No more than a few moments later, the second ambulance came speeding around the corner. Two more doctors got in position as the doors opened and revealed another stretcher, this time occupied by a smaller person.

"Jamie Walker, six years old, several large lacerations to the face and left arm. Stabilized in the field but hasn't re-gained consciousness," the paramedic said as he got out of the rig. The boy was unconscious as Katie got to him, looking over the boy and seeing more injuries.

"What caused the damage to his leg?" she asked, lifting the blood soaked sheet that was covering him.

"It was crushed when the truck made impact, it swung around and basically bashed in the entire left side of the bus."

But before she could get any more information, the third ambulance was stopping in front of them. Two paramedics got out with distressed looks on their faces as Katie and Nurse Kelly stepped up to the rig.

"What have we got?"

"Natalie and Sarah Palmer, eight year old twins. Natalie was on the left side of the bus so she suffered the worst of it. Unconscious at the scene, with multiple face, neck and arm lacerations. Possible crushed pelvis and left leg. Her abdomen was rigid upon exam. She coded once on route but we were able to revive her, pulse is weak but steady for the moment. Sarah was on the opposite side. She has a severe concussion, broken right wrist from impact and neck and back strain from the force of the collision."

Katie stopped and looked down at the twins. Both unconscious and fighting for their lives. Natalie's face was covered in blood and the surgeon could barely tell where she was injured. She swallowed harshly as she watched Kelly wheel the twins away before turning her attention to the second paramedic who emerged from the ambulance.

"Oh my god," she whispered as soon as she saw him, wheeling out a small gurney with a tiny body on it.

"Ethan Hennessey, four and a half years old…"

"Four and a half?" she repeated, unable to take the panic out of her voice as she stepped up and looked over the tiny human, thinking that she had never seen so much blood on such a small child. "Isn't that a bit young for school?"

"Just started kindergarten," the paramedic replied, as much sadness in his eyes as in her own. "He was tossed about ten feet from the bus. Tachycardic at one-twenty, BP one-fifty over ninety-eight, resps seventeen, GCS six. He was gone when we got to the scene but we brought him back. He has a pulse, barely, massive head and abdominal injuries which caused him to code once more on the way over but he came back."

"Got it," Katie acknowledged him but was trying to figure out what to look at first since there was so much blood. She wheeled the gurney through the doors and into bay five with two interns and two nurses running in behind her.

"Oh Jesus," one of them said, covering her mouth with her hand as she watched the scene in front of her unfold. Katie was covered in blood, and all of it from the small child on the table in front of her. The other intern was trying his best to hook the child up to the machines but he was so tiny and it was hard for him to maneuver.

"April, I need your hands. There's too much bleeding so I need you to help me locate the source," Katie ordered to one of the residents who were just standing there in shock. "April!" Katie shouted, snapping her out of it.

"Right, sorry, erm, okay..." the young doctor mumbled, moving towards the table and going over every inch of the child's body. He hadn't moved since Dr. Giordano had gotten her hands on him, the beeping of his heart monitor slowing as she frantically tried to stop all of the bleeders. April gently moved round to the back of his head and noticed a large amount of the blood was coming from there.

"Doctor G," she said nervously as Katie joined her.

"Damn it, he's bleeding out too quickly." She looked back up at April and barked, "Find a neurosurgeon and get him in here now!" Focusing her attention back on Ethan, she shouted, "I need more towels! The bleeding isn't stopping!"

"I got some! I got some," the other resident, Sam Collins, yelled running up to her. Katie grabbed them immediately and discarded the blood soaked ones. There was blood everywhere, all over the boy and dripping onto the floor in a steady stream that belied the nurse's reassuring murmurs that the child was 'going to be fine, a scratch is all, nothing to stop you from standing up and going back to school tomorrow.' Chaos had overtaken the emergency room. The white tiled floor had now turned a bright shade of red as the trauma teams worked vigorously on children in all available trauma bays; nothing seemed to be helping. The petite surgeon didn't have time to think. She needed to focus on saving this child's life.

"Ethan baby, can you hear me?" He didn't respond. "Ethan! If you can hear me, you're in the hospital. You've been in an accident, but we are going to fix you right up. Hang in there for me, little man. Hang in there!"

As soon as the words were out of her mouth, Ethan flat-lined.

"No, no, damn it!" Katie shouted, moving around to his side and starting compressions. "Come on, come on little man," she pleaded. Minutes passed as she tried everything she could to bring him back, but it was no use. She heard the doors open as April returned with neurosurgeon Dr. Kiko Len but she didn't look up. Most of the interns and nurses had stopped moving, only Katie was left trying to resuscitate the child.

"Doctor Giordano," April said gently, but the surgeon did not look up.

"Katie," Kiko spoke softly, moving around to the other side of the room. He placed a hand on Katie's shoulder but she didn't stop. Dr. Len spoke again, his voice full of sadness, "Katie, he's gone. You need to call it."

"No, no I can't…" she whispered, focusing on counting in her head. It wasn't supposed to end this way, not this time. Not with this child. "If it were Matty, I wouldn't want anyone to stop…"

"It's not Matty," the neurosurgeon whispered, a tear falling over his cheek as he did so. As a father himself, Kiko knew that Katie was shredding herself to pieces behind the strong façade she was putting forth. Gently, but firmly, he added, "Doctor, there are other children out there who need you. He got the best medical care we could give him. You have to let him go. Sometimes...it's just time."

The room settled into silence as Katie finally stopped administering chest compressions. She looked up at the clock on the far wall and hastily wiped the tear from her face. For even the legendary Katie Giordano could not work miracles that large and sometimes medicine was not enough to stay death forever.

"Time of death, seven twenty-three am."

And with that she walked out of the trauma bay and back into the chaos.