Disclaimer: NCIS and its characters do not belong to me and this story is not intended as an infringement of copyright. It has been written solely for entertainment and no profit has been made from its creation.
A/N This is the third story in my In Loco Parentis series. Please be aware that this is a Tony kidfic and, consequently, it is very AU. Some familiar characters appear in unfamiliar roles – such is the power of an AU fic. If this is not your "cup of tea" go no further and let's part as friends. It makes no sense to ignore this warning and criticize me later.
The initial chapter will contain a recap and, as my little Tony character has some serious medical issues, there is quite a bit of set up to do. I hope you enjoy the story. SMcG
Nova initia – New Beginnings
Chapter One
Regretting his decision to brave the weather without an umbrella, Doctor Donald Mallard shook the rain from his hat and Mackintosh and wiped his glasses dry with a fine linen handkerchief. The journey across the hospital's large open foyer felt all too familiar as he hurried into the elevator and pressed the button to the paediatric ward.
Although fate had not seen fit to bestow parenthood upon him, Ducky had always found the paediatric ward to be a special mix of immeasurable heartache and soul-restoring inspiration. When it came to eight year-old Anthony DiNozzo, those feelings were never far from the surface.
A shudder ran down the ME's spine as he recalled the near-fatal injury the boy had suffered when two gunmen forced their way into his family home and brutally murdered his father. Only four months earlier, the child had tragically lost his mother to a devastating illness leaving his estranged uncle, Nicholas DiNozzo, as his only living relative.
Despite the fact that the child had suffered serious, physical and psychological impairment, Ducky's long-time friend, Leroy Jethro Gibbs, formed a deep affection for the boy and petitioned for custody. Upon DiNozzo's return to Washington a preliminary hearing was held and guardianship of the boy was awarded to his uncle.
DiNozzo immediately made plans to take the child back to Switzerland and have him admitted to a rehabilitation facility where he could leave his nephew's care to paid professionals while he laid claim to Tony's considerable inheritance. Only a mammoth effort by the MCRT prevented that from happening when they uncovered that Nicholas DiNozzo had orchestrated the murder of his brother. With DiNozzo awaiting trial, temporary custody had been awarded to Gibbs who declared his intention to leave NCIS and become the boy's full-time carer.
Showing resilience and courage that belied his young age, Tony's condition had improved considerably but the serious gunshot wound and massive blood loss left him confined to a wheelchair and diagnosed with acquired epilepsy. The boy's progress during the last two months had been an ongoing series of 'one agonising step forward and two frustrating steps back' and as the length of Tony's hospital stay dragged on with no end in sight, tensions were running at an all-time high.
Stepping from the elevator, Ducky made his way toward Tony's room, taking a peek into the brightly coloured bag he carried. He gave a nod of satisfaction at the hard-covered copy of The Adventures of Tom Sawyer. He'd purchased the gift for his young friend and was delighted that the boy appeared to share his passion for the classics. Stopping at the door to Tony's room, his eyes darted to the bed where the child appeared to be sleeping peacefully – the same could not be said for his temporary guardian who was currently pacing the room like a caged tiger.
"Jethro?" Ducky said quietly, in deference to the sleeping child.
Dispensing with the usual greeting, Gibbs snatched up Tony's medical chart.
"Eighteen minor and three majors seizures in the last 24 hours," he said. "The last grand mal was thirteen minutes."
"Oh dear," Ducky replied with genuine disappointment. "To be fair, many of those seizures occurred when the lad was sleeping and lasted less than a minute. However, I do agree that this new anti-seizure medication appears to be as ineffective as the others."
"Ya think, Duck?" Gibbs snapped, running agitated fingers through his hair. "You sure these guys know what they're doing."
"Now, Jethro, I know you're frustrated but you know as well as I that treating epilepsy is not an exact science. There is so much we still don't know about the function of the human brain. Doctors McNally and Enright are leaders in this field; Anthony is in the best possible hands."
Gibbs nodded begrudgingly and dropped heavily into a chair by Tony's bed as Ducky took a seat beside him.
"How did he seem when he regained consciousness?"
"Confused, exhausted…frightened," Gibbs replied. "S'been asleep for over an hour."
"We've witnessed from prior incidences, that the more severe Anthony's seizures, the deeper and more prolonged the postictal phase."
"He's had enough of hospitals, Duck," he said, reaching for Tony's lax hand. "We both have."
"The lad's been through a dreadful ordeal; more than any child should have to bear. It's a testament to his young character that he's not shouted his frustration from the rooftops."
"Kid doesn't complain about anything," Gibbs said, gently brushing the bangs from Tony's forehead. "Gets quiet; draws into himself then comes out ready to fight again."
"He's a remarkable boy."
"I need to take him home, Duck."
"Perhaps I can help you with that," a voice from the doorway commented.
"Jennifer, how nice to see you," Ducky greeted cordially.
Mindful of the sleeping boy, the men moved to the doorway as the hospital's chief social worker, Jenny Shepard, produced an envelope from the file she was carrying.
"This just arrived," she said handing the envelope to Gibbs. "I thought I'd deliver it personally."
The agent eyed the envelope warily. Removing the letter, he read its contents and his usually perfect posture slumped with relief.
"Congratulations, Jethro," Jenny said, unable to suppress her smile any longer. "You have successfully completed your foster carer's course and the home-safety visit surpassed all Child Services' requirements. As soon as Tony is well enough, you can take him home."
"This is splendid news!" Ducky enthused. "Heartiest congratulations, my friend!"
Gibbs ran minutely trembling fingers across his heavily bristled jaw; he reread the letter and looked hopefully at Tony's caseworker.
"It's done?"
"Judge Harland has approved custody and placed Tony in your full-time care. You've got yourself a foster son," Jenny told him with genuine delight. Her smile transformed into a frustrated scowl as her pager sounded and she read the digital message. "I have to run. I'm afraid there's more paperwork for you to sign...call me and we'll make a time…and give Tony a hug for me."
Gibbs was still trying it take it all in as Jenny walked quickly down the corridor and out of sight.
"Gibbs?" a little voice called from the bed.
"Hey," Gibbs said moving quickly to Tony's side and brushing the dishevelled blonde hair back from the boy's face. "Howya feeling?"
Blinking sleepily, Tony sighed wearily.
"I had another seizure," he said glumly.
"Yep," Gibbs replied, trying to keep the concern out of his voice.
"A big one?"
"Big enough," Gibbs responded.
Tony studied the former gunny's face, sensing more than seeing the change in the man's mood. His brow furrowed in confusion.
"Is something wrong?" he asked tentatively. "Am I in trouble?"
"Nope," he replied flashing a rare unbridled smile. "Nothing's wrong and you're not in trouble."
Tony's frown deepened and his shoulders tensed as Gibbs and Ducky continued to beam at him. The lead agent held up the letter and explained.
"See this?" he said waiting for the blonde head to nod. "It says, as soon as you're feeling better, you can come live with me."
The little jaw dropped open.
"Really?" he whispered, his green eyes filling with unshed tears.
"You bet," Gibbs replied around the lump in his throat. "That's if you still want to."
Little arms flung around the agent's neck and squeezed with all the strength the small boy could muster.
"I believe that's a yes," Ducky chuckled.
Watching the touching scene play out before him, the ME's spirits soared. As chief medical examiner, death and despair dominated his working life on a daily basis yet, despite it all, Ducky marvelled at the wonders of a world that saw fit to unite a childless father and a fatherless child.
Pulling back from the embrace, Tony turned his face upward to meet Gibbs' gaze.
"When, Gibbs? When can I come home? Today?" he asked as the tear spilled from his eyes and streamed down his face.
The words tugged at the former Marine's heart and as he gently wiped the boy's tears away with the pads of his thumbs the boy stilled in his arms and the all-too-familiar vacant stare appeared in the glistening green eyes. Gibbs exchanged a glance with Ducky and both acknowledged another absence seizure. The ME had barely enough time to record the details in Tony's seizure diary when the boy recovered and repeated the question.
"When, Gibbs? When can I come home? Today?" he asked, completely unaware of what had happened.
"Soon as the doc says you're better," he said, watching as Tony's head dropped dejectedly. He slipped a finger under the boy's chin and raised it until their eyes met again. "You're doing great, Sport. Abs will be planning your 'gotcha party' before you know it."
Tony slumped back against the pillows, turning his face away to hide his disappointment. Gibbs shifted in his chair, remaining quiet and watching as the boy lost his battle with exhaustion. He waited until Tony was on the cusp of sleep before he leaned forward and gently rubbed his knuckles on the boy's cheek.
"Gonna take you home with me, Sport," he whispered. "No matter how long it takes."
Despite Gibbs' being awarded custody, the inability to control Tony's seizures with medication had frustrated and terrified them both. Every night, the former Gunny resumed his vigil by the boy's bed; his heart skipping a beat with every murmur, sigh or restless movement Tony made in his sleep. Even the presence of the EEG and seizure monitor alarm brought little comfort.
During the past two months, Gibbs had frequently been amazed by the courage shown by this small boy. After each new setback, Tony had mentally dusted himself off and determinedly continued the fight to regain his health…but this time was different. The boy was quiet and listless; terrified that the slightest movement would trigger another seizure. For the first time, Tony began to doubt that he would ever leave the hospital.
Gibbs and his team did their level best to reassure and encourage him and while Tony responded politely when spoken to, his lack of conviction concerned them all. Losing hope that he would ever go home, the little boy had started to withdraw from them. Tony had fought too hard and been through too much for the former Marine to let that happen – so he had called in the big guns.
On the third day after the grand mal seizure, Gibbs watched as a very subdued boy sat in his wheelchair and poked at his breakfast without interest or appetite. Too much pain, too much grief and too many days confined to a hospital ward had resulted in an unnatural pallor that highlighted the tiny freckles on the bridge of his nose and the fringe of long dark lashes framing his green eyes. The agent heard the familiar voice approaching from down the corridor and checked his watch – right on time.
"I gotta go meet your doctor," Gibbs said quietly, waiting until the boy looked in his direction. "I got someone to sit with you…I bet he'd enjoy reading your new book."
Tony nodded his head and shrugged one shoulder dispassionately.
"Well now, I was kinda hoping for a warmer welcome than that," Jackson Gibbs stated from the doorway.
Green eyes grew as large as saucers and the dimples that had been conspicuously absent for the last few days, made a welcome appearance as the small face lit up with surprise. Jack returned a matching grin as he placed a parcel on the end of Tony's bed. Propping on his cane, he made his way over to the boy and enveloped him in a Grandpa-sized hug. Overwhelmed, Tony swiped at his tears and nuzzled his face against the older man's shirt.
"Hey, what's all this?" Jack asked, placing his large hand gently on the crown of the boy's head. "Thought you'd be happy to see your old Grandpa Jack."
"I am ha-happy. I just haven't seen you in w-weeks," Tony hiccupped; wiping his face with the bottom of his t-shirt and smiling tremulously as if to prove his point.
"Grandpa Jack has to run his store, Sport," Gibbs reminded him.
"But when I heard there was a chance they were busting you outta this joint, I just-"
Tony's head swivelled toward the former Gunny.
"I'm going home?" he asked in surprise.
"Hang on, Sport," Gibbs replied calmly. "That's what I was trying to tell you. I gotta go meet with your doc. Decision's his but we're gonna ask him to let you come home."
"He'll just say no again," Tony said despondently. "He always says no."
"We'll never know if we don't ask, right?" Gibbs told him. "Tony, if you're not ready, if you wanna wait-"
"I'm ready, Gibbs," Tony replied. "I'm really, really ready!"
Gibbs cupped the boy's cheek.
"Listen to me, Tony…if the doc says no-"
"Why? Why won't he let me? I want to go home with you, Gibbs!"
"I want that, too…more than anything…but I'm not gonna risk your health. If the doc says no, we keep trying till you're better and he says yes. You got that?"
Tony slumped back in his wheelchair and released a sigh that travelled all the way from his slippered feet.
"Yes, Sir," he said.
"Hey" Gibbs said, chucking him gently under the chin. "What'd I tell you about that?"
The boy's lips formed a tiny smile.
"Don't call you sir, you work for a living," Tony replied by rote.
"Damn straight," Gibbs grinned, tussling the little blonde head.
"I almost forgot," Jackson said brightly. "I have something for you."
Gibbs cast his eyes around the room that was already filled with books, puzzles, DVD's, a Gameboy and other toys. Jackson, Ducky, Abby and Kate rarely visited without bringing the boy a gift. If Gibbs didn't get the kid home soon, they we're going to need a moving van.
Jack looked at the parcel and paused thoughtfully.
"Sure is nice to have a kid to buy for again," he said, turning to meet his son's understanding gaze.
"I never had a Grandpa before," the boy spoke in a whisper, shyly looking up through long eyelashes. "But you don't have to buy me things. I'm just glad you're here."
Gibbs and Jack exchanged another glance, both failing to hide the emotion washing over them. Clearing his throat, Jack regained his composure and reached for the parcel.
"Well, let me tell you, young fella, that rule number one of being a Grandpa is always spoil the grandkid," he said, handing the parcel to Tony.
The boy directed a questioning look at Gibbs who conveyed his permission with a nod.
"Thank you, Grandpa Jack," Tony said politely before removing the wrapping from a model airplane kit. "Wow!"
"Thought we could make that together for your new bedroom," Jack said, as Tony ran reverent fingers over the picture on the box. "That's a P-51 Mustang. I flew one just like that in the war."
Tony looked up at the older man.
"You flew one of these, Grandpa Jack?"
"Yep, course she was a lot bigger than the one you got there," Jack chuckled, "had a picture of Betty Gable painted on her nose. Ahhh…great gams."
"Can we make it now?"
"Not today, Sport," Gibbs said. "Need a lot of room to put that together. You and Grandpa Jack can start that project when you get home."
Tony nodded sadly and then stilled except for the small jerking motion the fingers of his right hand.
Jackson frowned.
"Is that-"
Gibbs nodded as he reached for the seizure diary and recorded the incident. It was less than a minute until the boy looked up; unaware of what had happened.
"Sure is warm outside today," Jack said, hoping for a diversion. "What say we take that new book of yours out to the garden while Leroy goes to talk to your doc?"
Once again the boy turned hopeful eyes to Gibbs.
"Finish your Cheerios and juice first," the Gunny instructed.
"Okay!" Tony agreed, eyeing his breakfast with renewed interest.
Gibbs checked his watch and climbed to his feet.
"I gotta go," he said, dropping a kiss on the crown of Tony's head. "Dad?"
"He'll be fine, Leroy, I'll tell the nurses where we'll be and I'll take his seizure diary and the portable alert button in case we need it."
The former Marine nodded. As much as he wanted to keep the boy in his sights 24/7 he knew it just wasn't possible and reassured himself with the thought that if anyone loved this boy as much as he did, it was Jack.
"Don't let him get into any trouble," Gibbs said.
"We're going to read a book in the garden, son. Just what kind of trouble you expect him to find?" Jackson asked.
"Wasn't talkin 'bout the kid," Gibbs said with a wink for Tony.
He started down the corridor to his meeting with Jack's blustering and Tony's giggles still ringing in his ears.
By the time Gibbs arrived at the meeting room, Doctor McNally, Ducky and the hospital's chief social worker, Jenny Shepard were already seated. Nodding a greeting to the others, the former Marine took a seat and got straight to the heart of the matter.
"We're two months down the track and my kid's still having seizures," he stated with a pointed look at McNally.
"Jethro, please…" Ducky censored.
"That's quite okay, Doctor Mallard," McNally said before turning to address the lead agent. "Epilepsy is a very complex condition Agent Gibbs, one that can be very difficult to control. Tony's situation is made more difficult by the fact that the anti-seizure drugs we administered, interacted badly with the medication he's taking for his spinal injury. I know this is very difficult but you shouldn't lose sight of the fact that we have made significant progress."
"He averages twenty minor and five major seizures a day. You call that progress?"
"When Tony was first admitted, the EEG showed he was having up to sixty minor and fifteen major seizures a day. Many of the minor seizures are occurring during his sleep so, yes, I consider that progress," McNally defended.
Gibbs nodded his head in reluctant apology. He had no axe to grind with the doctor -other than the fact that he had not yet discovered a miracle cure to Tony's acquired epilepsy. McNally and his team had provided exceptional medical care for the boy from the moment Tony was rushed to the hospital barely clinging to life. But with every passing day, the boy's ray of hope was growing dimmer and Gibbs was desperate to do anything to reignite it. As the silence grew thick between them, Jenny Shepard added her calm voice of reason.
"Doctor McNally, we know that there are several surgical options, including VNS, that are available for children with epilepsy. In your opinion, is Tony a candidate for any of them?"
The doctor paused to gather his thoughts before responding.
"Epilepsy surgery is considered only if the area of the brain where the seizures start, can be removed without impacting any critical functions such as language, sensation and movement," he said. "Tony's seizure focus is dangerously close those areas of his brain. While surgery is still an option, at this point, I'd prefer to consider it as a last resort."
Gibbs released a breath he didn't know he was holding. Tony was only eight years old yet, in his short lifetime, his experiences with hospitals were heartbreaking. He had stood by his mother's hospital bed, holding her hand and watching helplessly as she succumbed to a devastating illness. Then, a little more than two months ago, he awoke in a hospital bed and entered a world of pain and suffering. This brave little boy had reawakened the former Marine's paternal instincts that had lay dormant within him since the death of his family and Gibbs despaired at the thought of the boy having more major surgery. He mentally shook himself from his musings as Doctor McNally continued.
"I realise how difficult it is to watch someone you care about endure this process," he said. "As I told you from the start, it may take several months before we determine the best drug and dosage for Tony. However, there is another non-surgical option I think we should explore – the ketogenic diet."
"Since making the lad's acquaintance, I have taken the liberty of researching various epilepsy treatments," the ME said. "If memory serves, results of recent studies of the ketogenic diet have had very pleasing success rates."
McNally nodded in agreement.
"The ketogenic diet is a very strict, medically supervised diet that is high fat, low carbohydrate and moderate protein diet. It ensures the child's body burns fat instead of carbohydrate for energy. This creates a condition called "ketosis" and, for many children, having a high level of ketones in their blood helps to reduce seizure activity."
"Side effects?" Gibbs asked.
"There are some potential side effects with putting a child on this diet but Tony may or may not be affected. Initially, we'd keep him here in the hospital, so that we could monitor him for potential short term side effects such as vomiting, low blood sugar and dehydration; we would also adjust his medication whenever necessary."
"Doctor, what about long term side effects?" Jenny asked.
"High cholesterol, kidney or gall stones, pancreatitis, poor growth, weight loss."
"How long would he need to stay on it?" the agent asked.
"If it's effective, most children notice a significant reduction in seizure activity and can even reduce their medication within a two year period. But at this stage of Tony's recovery, I'd like him to remain here in the hospital for at least another six weeks."
Gibbs' shoulders slumped and he sighed wearily.
"The kid's had enough of hospitals, Doc. He needs to go home."
The doctor shook his head emphatically.
"Tony needs to be carefully monitored. He'll need frequent blood tests to measure his response to the medication. His red and white blood cell counts, blood sugar, blood calcium and electrolyte levels need to be carefully monitored as does his liver and kidney function."
Ducky stroked his chin thoughtfully.
"Your caution is admirable, Doctor," he ventured. "However, would you have any objection to us arranging for a dietician and a specialist epilepsy nurse to make home visits? They could monitor the lad's progress and perform any tests necessary in the comfort of the boy's home."
McNally leaned back in his chair and considered the request. His expression remained inscrutable as he looked at the faces of the people sitting opposite him. There was no question that they all had genuine feelings for the boy but he was an expert in his field - a scientist and a man of medicine - he knew what was best for his patient and he was not about to be swayed by emotion.
The doors to the elevator conveniently opened as Gibbs approached it and he pressed the button for the ground floor level. Leaning heavily against the wall, he thought back to the outcome of the meeting with Doctor McNally.
Due to the complexity of Tony's other medical issues, the neurologist had insisted the boy remain in hospital where his condition could be closely monitored in case of complications. However, when Ducky suggested they find a nurse and a dietician willing to make house calls, McNally conceded and tentatively scheduled Tony's discharge for three days time.
While Ducky and Jenny hurried off to make enquiries about hiring a specialist epilepsy nurse, Gibbs went in search of Jackson and his kid. His kid. The words made his heart flutter and a small smile quirked his lips – fate had presented him with a second chance at fatherhood and he couldn't wait to finally take the boy home.
The beautifully manicured grounds offered a temporary sanctuary from the illness and grief synonymous with hospitals. A large oak tree stood tall in the centre, providing welcome shelter from the midday sun. Gibbs scanned the garden with a trained eye but saw no sign of his father and Tony.
"Agent Gibbs?"
The former Marine turned to see Michelle Davis approach him from a nearby bench where she and two other nurses were having their lunch break. Nurse Davis had been on duty the night Tony was admitted. She was a highly regarded member of Doctor McNally's team and had quickly formed a good rapport with Tony.
"If you're looking for your Dad and Tony, you just missed them."
"Missed them?"
"Tony had a seizure – just a small one and he's fine," she added hastily, noticing the worried expression on the agent's face. "He was a little disoriented so your Dad took him back to his room to rest."
Gibbs immediately turned on his heel when the nurse spoke again.
"Agent Gibbs? I thought you'd like to know…Jack handled the seizure like a pro. He kept Tony calm and talked to him the whole time; he did everything right."
Gibbs felt the tension ease slightly and managed a relieved smile.
"Good to know" he said nodding his thanks.
Double-timing it across the lawn and into the hospital foyer, he took the stairs two at a time, ignoring the protest of his bad knee. As he approached the door to Tony's room he heard the familiar cadence of his father's voice as he read from The Adventures of Tom Sawyer.
"And when the middle of the afternoon came, from being a poor poverty-stricken boy in the morning, Tom was literally rolling in wealth. He had besides the things before mentioned, twelve marbles, part of a jews-harp, a piece of blue bottle-glass to look through, a spool cannon, a key that wouldn't unlock anything, a fragment of chalk, a glass stopper of a decanter, a tin soldier, a couple of tadpoles, six fire-crackers, a kitten with only one eye, a brass door-knob, a dog-collar – but no dog – the handle of a knife, four pieces of orange-peel, and a dilapidated old window sash. He had had a nice, good, idle time all the while – plenty of company – and the fence had three coats of whitewash on it! If he hadn't run out of whitewash he would have bankrupted every boy in the village."
Leaning against the door jam, Gibbs took a few calming breaths and committed the image before him to his memory. Jackson absently threaded the fingers of one hand through the boy's blonde hair as Tony sprawled on the bed, his lips parted in sleep and his face turned toward Jack as if listening to every word.
Looking over the top of his glasses, Jack noticed his son's arrival and raised his finger to his pursed lips. He watched as Gibbs removed his jacket and shoes and silently climbed onto the bed. Easing the sleeping boy into his arms, Gibbs leaned back into the pillows and smiled as Tony muttered incoherently and rested his head on the former Marine's chest.
Dropping a kiss on top of the blonde head, Gibbs closed his eyes and lost himself in the feeling of holding this brave little boy. For a moment, his father's voice grew thick with emotion as his continued to read. In three days, he would take Tony away from the hospital and into his home where they would start a new life…together.
A/N Italics represent an excerpt from Mark Twain's novel The Adventures of Tom Sawyer.
Thanks for reading. SMcG
