It was Annie's first week as an attending. She had done it, she was an attending pediatric cardiothoracic surgeon. She sat in her office thinking about the first time she had sat in here as a pre med student. Back then it had been Teddy's they had sat here to go over her anatomy homework between surgeries. She thought of the day she interviewed for Harvard medical school and her parents excitement when she had been accepted essentially on the spot. She had been 19 the first time she sat in this office waiting for Teddy, today she sat here now as a 32 almost 33 year old woman. Annie smiled at the pictures on her wall today her first day as an attending one stood out. It was her with Owen and Teddy the first time she wore her sea otter scrub cap, that photo was a bit of foreshadowing, Annie had only been 19 that day. Six days before the incident that would change everything. The last thirteen years had brought a lot of changes, Harvard, Josh, Seattle, marriage, Ellie and in March a new baby would join them. Her and Josh had found out that morning. Leaning back in her chair she let her hand rest against her stomach where she knew the little one was growing.
"Altman," Josh said, sticking his head in her door.
"Hey love," Annie smiled.
"You're a million miles away again," Josh said, sitting on her desk. He looked around at the family photos on the walls with her diplomas.
"Just thinking about the first time I scrubbed in. This was mama's office back then," Annie smiled, "and our peanut."
"You're feeling okay," Josh asked.
"Right now," Annie said, "I'll be fine. We've done this before. Ellie is three we did this love."
"And you found the first few weeks hard," Josh reminded.
"We're not going to think like that," Annie replied, "no hovering."
"When are we telling the family," Josh asked.
"Ellie soon," Annie replied, "do we need to make it special and a huge announcement this time?"
"Teddy should know soon," Josh reminded.
"If we can get a moment with her today I'll tell her. It's new intern day," Annie replied.
"Seven years," Josh smiled.
"Eight," Annie corrected, "12 together."
"We're attendings," Josh said.
"When we met could you have pictured this," Annie asked.
"Being a surgeon, yes," Josh answered.
"Us, Ellie, the new baby," Annie asked.
Teddy walking past heard Annie's new baby comment. Annie was pregnant with their second. This time she wasn't completely surprised Annie had mentioned they were trying for a second child, and had complained bitterly that it wasn't happening. They had been trying for almost a year.
"This part no," Josh beamed, "us and our kids a family of four."
"How will Ellie take it," Annie asked.
"She'll be fine," Josh assured.
"We have to make sure she still feels special," Annie replied.
Josh's pager went off, "the pit."
"Go," Annie said, "I have some charts to review before I get to join the other attendings on the catwalk to scare interns."
"See you there," Josh replied.
He walked out of her office and Annie pulled up the electronic charts.
"Dr Altman," Kira Eaket said as she knocked on the open door.
Annie smiled at her resident, Kira was now a fourth year and had chosen peds cardio.
"Have a seat Kira," Annie said, "you can call me Grace. I called lots of my attendings by their first name once I specialized."
"It feels wrong," Kira said, taking a seat.
"Your interns," Annie asked, "what do you know?"
"One Canadian from UBC," Kira said, "Kaitlyn McKellar."
"You got Katie," Annie said.
"Katie," Kira asked.
"My cousin that came down to scrub in," Annie reminded.
"Has she thought of a speciality," Kira asked.
"Cardio or neuro," Annie replied, "don't assign her to me, mama or Jenna right away. I want her to spread her wings. It was tough being with my parents as an intern. Once it's out that she's my cousin Katie will be compared to me for everything."
"Be nice," Kira asked.
"No special treatment," Annie commanded, "it was always questioned if I got things because I'm the chief's daughter. But we're not talking about interns today. It's your fourth year you're officially my resident now. We need our plan."
"You don't just tell me," Kira said.
"When do I ever just command," Annie said, "it's your career Kira you have a voice."
"Peds cardio," Kira confirmed, "I want to learn to do an Altman on my own. Not first assist you."
"You will before your done residency," Annie confirmed, "this next six months I need to see you taking point in the HLH repairs, your solo on valves, your ready, I want fully solo on pacemakers. What else do you want to do?"
"CBAG," Kira said.
"Not many on kids I may float you to Yang, Pierce or Riggs for that. You need more cardio trauma time with Riggs and the Chief," Annie said.
In the hall Richard led the interns towards Annie's office.
"This is a new unit for us," Richard said, "staffed by both cardio and Peds. This is our pediatric cardiothoracic surgery unit. 10 beds plus outpatient areas. Our attending who has built this program through her fellowship is Dr Grace Altman. She started here as one of you an intern."
"Dr Webber I heard my name," Annie smiled stepping into the hallway.
"Dr Altman," Richard said, "I was just giving the residents a tour."
"Do you want me to do my unit," Annie offered.
"Please," Richard smiled.
"Welcome to peds cardio," Annie began, "you'll all rotate through my service after some training on working with kids. Peds cardio combines two demanding and high stakes specialties. We share a few facilities with Peds neuro next door and dr Silverstone. At the center of our unit is our play space. Room for children and families to play and be together. Toys are available as well as scooters, bikes and tricycles. We want kids moving. Our goal is to make this as calm and positive as possible."
"How do we get on your service," a young woman asked.
"When your resident assigns you to me," Annie replied.
"Why is most of the medical equipment hidden or disguised," a man asked.
"Patient comfort," Annie said, "I'd like to do more to make it less hospital like. Especially after seeing my three year olds response to outpatient surgery to get tubes in her ears."
"You have children," a girl asked.
"My daughter is three," Annie replied, "I'll let Dr Webber finish your tour. I have some charts to review before I meet the chief."
"One last question you and the chief have the same last name. Are you related," a boy asked.
"She's my mother," Annie said, "Altman, Hunt and Riggs are all related and connected. We're one family with three last names."
"Any advice for the interns, Dr Altman," Richard asked.
"Live outside the hospital," Annie said, "I was still a resident when I got married and had my daughter. Life happens outside of this building."
"Your parents made sure of that," Richard commented.
"In my first couple years until I learned to say when I needed time," Annie agreed, "mama and dad can be workaholics themselves."
"Dr Altman calls her step father our chief of trauma dad or uncle Owen depending on her mood," Richard explained.
"Dad gets his attention faster," Annie replied.
"You'll scrub in with the various combinations of them," Richard said, "the team to watch is the chief and Owen Hunt. Grace Altman and Josh Riggs are a great team so are Meghan Hunt and Nathan Riggs. But the chief and her husband, working together, that's a dance. They've been a team a long time."
"21 almost 22 years," Annie said, "I was 11 when they met. They got married when I was 25. I do have to go meet my mother so I will see everyone later."
Annie turned and walked towards Teddy's office.
"Hi sweetheart," Teddy called from her desk, "how's being an attending?"
"Good," Annie said, closing the door behind her, "mama I have news for you."
"Mama this is personal," Teddy said.
"But it affects work immediately," Annie said.
"What is it," Teddy asked.
"Mama I'm pregnant," Annie announced.
"Congratulations," Teddy shouted, leaping up from her desk to hug Annie, "when are you due?"
"March sixth," Annie said, "I'm only 5 weeks mama. I wanted you to know but we're keeping it quiet and immediate family. You dad, Meg and Nathan, nana, Dan and Ian."
"What about your renovations," Teddy asked.
"We started that when we began trying for this baby," Annie said, "the attic has room for both our home office and a playroom. It's full height and we're doing built in storage on the low parts. Then our current office becomes Ellie's room and her room is back to the nursery."
"You have a plan," Teddy smiled.
"We do," Annie agreed, "Dan is going to help with a lot of the woodwork. He likes projects."
"That's good he's around a lot," Teddy said.
"He'll be excited this time," Annie agreed.
"I think he was about Ellie," Teddy said.
"Jennas bachelorette is this weekend," Annie said, "I'm planning the whole thing. I have to tell her."
"You should," Teddy said, "what's Jennas bachelorette?"
"Nana said we could use the cabin so Jenna, Steph, Cassidy, Julia and I just relaxing and kid free," Annie said, "the plan was lots of wine."
"Tell your friends," Teddy suggested.
"Hopefully not going to be sick this time," Annie said, "there's no time and Ellie won't get it."
"You have that book to explain it all," Teddy said.
"Do you still have the originals the drafts I did with photos of me and ellies ultrasounds," Annie said, "there was one to explain how babies are made, how they grow and another one about how they are born. I want my originals with my photos for Ellie."
"I have them," Teddy replied. You can use them with Ellie. Or make Ellie her own with this babies pictures."
"Maybe both," Annie said, "we're going to announce it at Sunday's dinner. I just need Ellie's shirt."
"What are you doing," Teddy asked.
"You'll see," Annie smirked, "I gave a plan."
"Can I tell Owen," Teddy asked.
"No," Annie replied, "it has to come from me and Josh mama."
"Today then," Teddy said.
"I will," Annie replied, "we have interns to scare soon."
"No scaring interns," Teddy scolded.
"But it's fun," Annie laughed, "Webber brought them by to show them peds cardio. They look all young and shiny."
"You were one not long ago," Teddy said.
"Eight years. I was 24," Annie said.
They didn't realize Owen was at the door.
"Lots of changes, Allison, my wedding, Leo, Meg and Nathan, Faroke, their wedding, your wedding, Ellie, Catrina, now you're pregnant again," Teddy smiled.
"What," Owen said, coming into the room.
"Hi dad," Annie greeted, "we're having a second. I'm due March 6."
"Congratulations," Owen beamed giving Annie a hug, "three years between kids?"
"Almost four," Annie said, "we can have up to six months off and I'm going to take all of it. I came back too soon after Ellie. I'm telling you right now I'll be off from March to October. Come back around my birthday."
"Take the time," Teddy agreed, "you needed more time with Ellie."
"Scare the interns time," Annie said.
"Let's go," Teddy said.
Richard made the introductions of the attendings by department.
"In cardiothroatic surgery we have dr Christina Yang, de Margaret Pierce, dr Nathan Riggs, dr Grace Altman, and Cheif of surgery dr Teddy Altman," Richard pointed, "trauma dr Josh Riggs, dr Owen Hunt, dr April Kepner and deputy Cheif of surgery dr Meghan Hunt."
"Did you hear one of us is related to the Altman's." An intern whispered.
"Katelyn McKellar," Katie said, "Grace Altman is my cousin. Our dads are brothers."
"Your an Altman," a woman said.
"Grace uses her mother's name our dads are brothers," Katie said, "I have no Altman DNA."
"But they'll help you," a woman said.
"They helped me get organized and find a place to rent," Katie said, "dr Silverstone peds neuro is engaged to and has a son with another cousin Grace's half brother."
"You know the Altman's and Silverstone," a man asked.
"Hunts, Riggs it's family," Katie said, "they were all at Sunday dinner at Chris and Jennas yesterday."
"Chris and Jenna," a man asked.
"Dr Silverstones first name is Jenna and she's marrying my cousin Chris in August," Katie said.
"Each year we assign attendings as mentors to our interns," Teddy explained, "this year your three mentors are graduates of the first class the dr Hunts, cardio Riggs and myself did this with. I'd like to introduce your four attending mentors until you choose a speciality. Dr Grace Altman, dr Cassidy Liard, dr Jenna Silverstone and dr Josh Riggs."