48 Hours

July 1, 2007

"Jo, what are you doing up?" Alex asked through a yawn as he made his way into the kitchen appreciatively sniffing the air. The delicious smells of bacon, toast, and coffee filled his senses. It was 5:00 in the morning, and he had just been woken up by the harsh chirping of his alarm clock signaling the start of his first day on the job as a surgical intern at Seattle Grace Hospital.

"I made you breakfast," she said simply with a soft smile lighting her eyes. She poured his coffee and carried the mug over to him placing a quick peck on his lips, "Good morning." She moved back over to the stove and heaped a pile of eggs, bacon, and toast onto a plate for him. "How excited are you?" she asked eyes dancing. She set the plate down and took the seat beside him.

"Almost as excited as you are," he chuckled before forking a big bite into his mouth. "You didn't have to get up and do all this you know."

"I know," she replied, "but I couldn't let you go to work without a good breakfast could I? And I couldn't let you leave without telling you goodbye." She was beyond excited for him; he was at the starting line of his new career, his new life. He had been working so hard for so long to reach this goal. But she wasn't looking forward to not seeing him for the next two days; his first shift was 48 hours, so she got up before the break of dawn to spend the first few minutes of his day with him.

He gave her one of his trademark smirks and leaned over to kiss her lips, "Thank you." He wouldn't admit it, but he was glad to have the company on that morning. He couldn't wait to start his new job, but he was nervous too. In the back of his mind he couldn't help but wonder if he was ready for this, if he was good enough or smart enough. Those were thoughts that had plagued him for years. A psychiatrist would probably have a field day laying blame to his broken relationship with his dad and his troubled past in and out of foster homes. But he kept his doubts to himself covering them up with bravado and a cocky attitude.

After finishing his breakfast, Alex quickly got dressed and ready for work. He snuck into Briar's bedroom and sat on the edge of his bed. "Hey, buddy," he whispered quietly, rubbing his hand gently up and down the sleeping boy's back. When he didn't get a response, the dad shook his son's shoulder lightly trying not to startle him. Finally, Briar rolled over to face his dad rubbing his eyes. "Hey, bud, I'm going to work now," Alex told him, and the little boy nodded in acknowledgment. "Remember, I'm not gonna see you until the day after tomorrow, okay?" he reminded his son. Briar sat up and lunged himself into Alex's arms squeezing him tightly. "I love you kiddo. Take care of Mom, okay."

"Okay, I will, Daddy. Love you too," Briar mumbled. Alex gave him one last hug and then tucked him back into bed.

Jo walked with Alex to the door and stood up on her toes to kiss him goodbye. She wrapped her arms around his neck and held him close breathing in his scent as they ended the kiss. She stopped him just as he was stepping out the door, "Do you have everything?" she asked checking his bag.

"Yes, Jo, I have everything. I gotta go," he pecked her lips one last time, "I love you, see you in a couple days."

"I love you too. Now go kick ass," she swatted his butt as he left the house. She sighed and went back to the kitchen to clean up. She had gotten used to spending all her days with him over the last month or so since graduation. They would have to get used to not seeing each other everyday again. During Alex's undergrad days he would be gone on overnight wrestling trips and then more recently when Jo was in college as well as working there were days when they would only see each other very briefly. She knew they could do it, but it was a lot nicer when they didn't have to. She finished up in the kitchen and shut the lights off, then went to lay down on the couch to get a couple more hours of sleep until Briar woke up.

Alex arrived at the hospital and found his way to the locker room designated for surgical interns. He put his stuff in his locker and changed into the light blue scrubs provided for them. He looked around the room sizing up the other doctors. Moments later, Dr. Richard Webber, the chief of surgery, entered the room and gave a brief welcoming speech. Finally, the interns were assigned to the resident they would be working under. The young surgeons in training all waited anxiously for their name to be called.

Alex was grouped with four other interns. Three women and one other guy. They had been assigned to "the Nazi", whatever that meant, Alex thought as he filed out of the locker room behind his new gang. The tall, curvy blonde was talking excitedly and introducing herself. The other three seemed to be halfway interested, Alex however, only grunted in response. They all quickly clamped their mouths shut as they approached Dr. Bailey, the Nazi, seeing the scowl on her face. They scurried after her as she walked at a fast pace down the hallway enumerating her rules as they moved.

At the end of her lecture, Dr. Bailey instructed each of the new interns where they would be working. Alex was assigned to post-ops with Meredith Grey; George O'Malley, the only other male in their group, would be leading the code team; and Cristina Yang and Izzie Stevens, the chatty blonde, got to work in the ER. The doctors all dispersed and went to their designated areas. Meredith tried striking up a conversation with Alex as they made their way to the surgical floor, but he remained aloof and dismissive giving short clipped answers to her questions.

After a long morning of running labs and checking incisions and vital signs, Alex found his way down to the ER. Anxious for some kind of real action on his first day working as a doctor. He ran into Dr. Bailey who glared at him and demanded he go back to take care of his patients. "There's nothing down here for you," she snapped. He turned to make like he was going but just ducked around a corner, finding out first hand where the resident's nickname had come from. Being careful to avoid his superior he trolled around for an interesting case.

He groaned when his pager went off and rolled his eyes when he realized it was from the same nurse he had just given new orders to. He took his time in getting back to the nurses station and the nurse who was calling him. "Mary Turner in 5313 is continuing to go downhill, Doctor. Her blood pressure and temperature are elevated, she is desatting, and complaining of chest tightness and shortness of breath," the nurse detailed her report.

"Yes, I know. I have already been made aware of that. That's why I ordered new antibiotics," Alex responded with agitation, "She has post-op pneumonia."

"I don't think that's all it is," the seasoned nurse interrupted, "There is something else going on here."

"Continue with the antibiotics and incentive spirometer and give them time to work; she will improve. Now, don't page me again; I'm going to find a real case." He stomped off leaving the nurses shaking their heads in his wake.

"There's always at least one," one of the nurses muttered to the others, "Too cocky for their own good."

The next time his pager went off, Alex returned to the floor impatiently only to find the chief waiting for him with an angry scowl. Dr. Webber called him out about Mary Turner in front of everyone and it was none other than Meredith Grey who correctly diagnosed his patient with a pulmonary embolism. He was promptly removed from her case and pulled aside by Webber. "I don't know who you think you are," the chief began laying into Alex, "but this is no place for a cocky attitude, overconfidence, and disrespect. We work as a team here. Everyone! Doctors, nurses, lab techs, orderlies, even janitors, we are all a team. We have lives in our hands. This is serious business and is to be treated as such. So when an experienced nurse, any nurse, tells you something isn't right with your patient, you listen and you dig and you find out what is wrong. Don't ever let me catch you blowing off one of my nurses concerns again. Do you understand, Dr. Karev?" the older man glowered down at him.

"Yes sir," Alex answered ashamed, looking down at his feet.

"Good. And you can be sure if I hear of anything like this happening again you will be out on your ass," Dr. Webber nodded once and walked away.

Later that night, when the bustle of the hospital had quieted down, the other interns in Alex's group found him sulking in the tunnels in the hospital basement. They hopped up on the abandoned gurneys beside him. Izzie was the first to speak, "I heard what happened," she commented handing him a candy bar, "It was an honest mistake, could've happened to anybody," she soothed. Alex ignored her, not saying a word and leaving the candy unopened.

"Yeah, she's right," O'Malley chimed in, "Do you know how many people I've saved on the code team so far? None, nada, zilch, goose egg," he made a circle with his hand and held it up.

"Psssh," Cristina swatted her hand through the air, "I for one have rocked it today. And Meredith here saved your patient's life," she pointed a finger at Karev. He glared at her with a snarl as the others held back their chuckles.

Alex once again found himself in the emergency room early the next morning. He looked on as Cristina and Izzie tried to assess a young boy who looked to Alex to be about 5 or 6 years old. The two women were polar opposites in how they were approaching the boy but neither was getting him to cooperate. Izzie was treating him like a baby complete with childish baby talk and Cristina was treating him like an adult and getting irritated that he wasn't following her commands and answering her questions.

Alex stepped into the curtained bay, "Hey buddy, I'm Dr. Alex, what's your name?" he pushed past Izzie and Cristina sitting down on the edge of the bed beside the little boy.

"I'm Ricky," the child answered.

"Well, Ricky, those are some pretty cool Ninja Turtle pajamas. You like the Ninja Turtles?" he asked interestedly. At the boys nod he continued, "Which one is your favorite?"

Ricky finally turned his eyes to Alex and his face lit up, "Michelangelo."

"Really? Mine too," Alex responded holding his hand up for a high five. The boy eagerly slapped his hand grinning.

"Can you tell me what happened, Ricky? Where does it hurt?"

"I wanted some coco puffs, but Mommy wasn't up," Ricky said looking at his mother. Alex glanced her way as well noting that the mother looked distressed but pleased someone was finally communicating with her son.

"Yeah. So you went to get your coco puffs, good choice by the way, and what happened?" Alex continued doing a physical exam as he talked with the boy relating to him just like he would to his own son.

"I crawled up on the counter, but when I stood up to reach I fell off," Ricky finished.

"Where did you hit? What hurts?" Alex asked again.

"My head and my back. Except my back don't hurt no more and I can breathe again."

Alex cocked his eyebrow focusing on the child's head and face, "You landed on your back and it knocked the wind out of ya, huh?" Ricky nodded. "All right Ricky, I'm gonna shine this light in your eyes for a second, okay? And then I wanna see how strong you are. I bet you're really strong aren't you?"

"Uh huh, I'm real strong," Ricky said making a muscle with his right arm as Alex looked in his eyes.

"Okay, squeeze my hands as tight as you can. Show me how strong you are," Alex placed his hands in the boy's and then moved down to his feet, "Now push on my hands as hard as you can with both feet." Ricky did as the doctor asked. "Wow, Ricky, you are super strong," Alex said shaking his hand like it was hurting. "I want to have some of my doctor friends see how strong you are; they'll never believe me. Can I do that? Can you show them how strong you are?"

The little boy shrugged, "I guess so." He couldn't believe he had hurt the big doctor's hand; he didn't know he was that strong. He settled back on the bed with a proud look.

Alex left the bay to page Bailey only to find her and Dr. Webber watching him with pleased expressions. Standing just to the side were Izzie and Cristina griping that he had stolen their patient. "Someone had to find out what was wrong with the kid," Bailey spit out at the interns. "What's going on, Karev?" she turned to him.

"The kid fell backwards off his kitchen counter this morning landing on his back and hitting his head. Got the wind knocked outta him but breathing fine now, lung sounds are clear and equal. He has left sided weakness and left pupil is responsive but sluggish," he reported.

"And what do you think is the cause of the weakness?" Bailey quizzed as she moved toward Ricky's bed.

"I'm thinking possible brain bleed, Dr. Bailey," Alex responded.

"Most likely. Good job. Page Dr. Shepherd and bring the boy up to CT," she dismissed Alex and turned to Ricky smiling brightly. "Hey there Ricky, Dr. Alex told me you were the strongest boy he had ever met. Now, I just couldn't believe that and had to come see for myself," she gushed repeating Alex's assessment.

Alex joined the others in the cafeteria for lunch after scrubbing in with Dr. Shepherd on a successful surgery to repair Ricky's brain bleed. "Don't even sit here," Cristina pouted, "That should have been my surgery, Karev."

"You couldn't even get the kid to look at you let alone talk to you," Alex sneered back.

"It's true," Izzie agreed, "You were drowning in there."

"Not like you were doing any better, Barbie," Cristina snapped. Izzie glared and stuck her tongue out in response. "Oh, hurt me," Cristina mocked.

"Brain surgery! That's so cool," O'Malley said popping a French fry in his mouth, "and Dr. Shepherd is the best."

"So we've heard, right Mer," Cristina teased nudging Meredith with her elbow. Meredith kicked her new friend under the table and looked down blushing. The other three at the table didn't seem to notice the exchange much to Meredith's relief.

As lunch wore on the conversation at the table was all over the place. Alex sat quietly listening and observing. He didn't open up about himself or his life. For one thing, it wasn't any of their business and for another, he was there to learn to be a surgeon not make friends. He had a wife and a son at home depending on him; he didn't need any distractions.

He spent the rest of his shift following post-ops and managing Ricky's recovery. After 48 exhausting hours the interns met back up in the locker room to change into their street clothes and finally go home. Izzie stopped Alex on his way out the door, "We are all headed out to celebrate surviving our first shift. You should come."

He shook his head and kept walking. Izzie caught up to him again, "You're so quiet and mysterious; it's kinda hot," she flirted placing her hand on his arm. "Come on, come out with us. Just for a little bit," she persuaded.

He shook her hand off and grunted, "No. I'm going home."

Izzie poked her lip out and pouted rejoining the other three interns who had witnessed the whole thing. "Aww, Barbie has a crush," Cristina teased.

Alex quietly let himself into his house expecting Jo and Briar to still be in bed. He was surprised to find them in the kitchen making pancakes. "Hey, what are you guys doing up?" he asked tousling Briar's already unruly hair and wrapping an arm around Jo kissing her cheek.

"We wanted to make you breakfast, Daddy," Briar explained.

"I hope you haven't eaten," Jo added.

"No I haven't. I couldn't wait to get home to you guys."

"Good," Jo smiled. "It's almost ready. You guys sit down." She finished cooking and brought the food to the table before taking her place. They ate breakfast while Alex told his family all about his first shift and the people he would be working with. The general consensus around the table was that brain surgery was cool. Briar couldn't get over the fact that his dad had seen a "real live brain" and Jo was jealous and couldn't wait for her day to come.

After eating and cleaning up the kitchen, Alex and Jo went in to the living room where Briar was passed out on the couch. "He got me up so early because he knew you were coming home today," Jo whispered. Alex smiled down at his son, picked him up, and carried him back to bed. Jo followed behind and then the couple went to their own bedroom. Alex asked Jo about their days. She hopped up on the vanity in the bathroom while he showered. "The first day we pretty much just hung out here, played video games watched tv. We need to get Briar a bike," she changed the subject.

"Yeah? Okay," Alex's muffled response came from the shower.

"Yeah there's a bunch of neighborhood kids. They were all out riding their bikes. Anyway," she continued jumping back to how their days had gone, "Yesterday we explored Seattle a little bit. You know that fish market, Pike's Place? The one where the guys throw the fish around, put on a show, whatever." He nodded stepping out of the shower and wrapping a towel around his waist. Jo's eyes roamed her husband's wet body. She shook her head distracted. He noticed and smirked. "Briar loves it. We went there... twice." She slid down off the vanity once Alex was done in the bathroom. "We had fun, but we missed you," she said wrapping her arms around his waist and resting her head on his chest. "I'm glad you're home."

"Me too," he kissed the top of her head and held her tight.