Did I screw up the timeline? Probably. Is this medically accurate? I tried. Did I write this all in one day? Yes.
This takes place after the episode She's Gone (season 8 episode 2) because I hated how they handed Alex's hear arrhythmia.
And now, on with the story!
•••
"Another whiskey, Joe." Alex rubbed his eyes, knowing the blurriness was probably from the alcohol and not the lack of sleep.
"I'm only supposed to let you have two drinks-"
"What are you, my mother?" Alex snapped, looking up at Joe's face, "I said another whiskey."
Joe nodded and walked behind the bar, leaving Alex to look down at the bar counter; the diagnosis of a heart arrhythmia was the last thing he needed to focus on right now after the Nambozie clinic gave his now ex girlfriend his job, getting Meredith fired, getting her baby taken away and having to put Aaron in a psychiatric hospital.
So if he wanted to drink more than the allowed two drinks for men under sixty five with heart arrhythmias, he was going to despite the fact that many of his colleagues were in the bar right now, probably glaring down his neck. But if it was for disobeying Altman's orders or for getting Meredith fired, he didn't know.
He made sure to hand Joe an extra two dollars when his whiskey arrived as a way of apologizing, watching as he pocketed the change before bringing the glass to his lips.
"I thought you weren't supposed to be drinking after you went into v-fib while performing surgery," Meredith's unusually sweet voice that didn't fully fit her personality hit his ears, "can you get me a vodka soda please, Joe?"
Alex waited for the bartender to disappear before turning to Meredith, "I'm sorry I got you fired, and for getting Zola taken away. I'm really sorry."
"You did your best to fix things, Alex. And the chief got me my job back, so if you want to move back in, you can." Meredith nodded, handing Joe the money as he slid her drink over to her.
"You'll let me?" Alex asked softly, wincing as his chest pounded. He had been living in the hospital for weeks given that she had forced him out, and nothing would be better than if he could sleep in his bed.
"Of course," Meredith smiled before sipping at her drink, "Christina and Owen figured everything out, so she's moving back in with him. Derek's still mad at me for tampering with the trial to save Adele, and god forbid that Lexie and Jackson stop having sex so loudly that they know it's bothering April and I."
Alex swallowed down another sip of whiskey, his throat feeling too thick and his vision going really foggy. 'Maybe this whiskey was a bad idea.' He thought to himself as his stomach dropped to his feet.
"Alex? You okay?" Meredith's voice sounded like he was underwater as she put her hand on his shoulder.
Alex's vision went black before he felt himself hit the ground.
•••
Meredith thought that the hardest thing she'd do today was begging Derek to pretend they were together so they'd be granted custody of Zola again.
But Alex passing out at the bar, his head hitting the stool as he fell to the ground, was way worse.
"Joe, call an ambulance!" She shouted as she pressed her hand to his neck, swallowing back her panic when she didn't feel a pulse, "I need some help! He's in v-fib!"
"Start compressions," Teddy Altman demanded as she seemingly came out of nowhere, "How much did he drink tonight?"
"I don't know," Meredith insisted, keeping count in her head as she pounded on her friend's chest and trying to get him back, "come on, Alex. Don't die on me."
"Ambulance is here!" A voice shouted, but Meredith couldn't focus on who it was. She had lost Derek and Zola already. 'I am not losing Alex too.'
"Meredith, keep doing compressions until they say clear." Teddy's voice was the only one she could focus on, her hands still pressing down in a repetitive motion, almost by memory. 'Focus on keeping Alex alive.'
She did her best to remain emotionless as she continued to pound on his chest, but as soon as an unknown voice shouted "clear!", the tears came running down her cheeks in large droplets, staining her face.
Luckily, the monitor that they had hooked him up to indicated that he was back in sinus rhythm, allowing Meredith a sigh of relief as he was put in the back of the ambulance with Teddy following behind.
"Meredith, meet us at the hospital. I need to know exactly what happened here tonight."
Meredith nodded and as soon as the doors shut, she marched her way to Joe as she saw red, "are you trying to kill Alex?"
"All the patrons are in charge of their own health, all I can do is advise against it and take keys." Joe insisted, his eyes full of both remorse and fear.
Meredith allowed herself to take a moment and breathe. She knew he was right, that by law he wasn't allowed to deny service unless someone was way too drunk, so she calmed her voice before speaking again, "I have to meet Dr. Altman at the hospital and tell her what happened, so please tell me one thing. How many drinks did he have?"
•••
Alex groaned as he returned to consciousness, his eyes fluttering open slowly; for a moment, he couldn't place where he was until the familiar fluorescent lights shone back at him along with the white tile ceiling.
"Shit," He mumbled, feeling the cannula tickle his nose as he shifted before a gloved hand touched his upper arm and he looked up to see Cristina staring down at him; he couldn't hold in his laughter at the irony, "of course you're my resident."
"Are you trying to drink yourself to death, idiot?" She sneered back, still holding onto his upper arm, "You went into v-fib in the bar and gave yourself a mild concussion on the way down. You're supposed to stay down."
"What're the odds that you're the one working on me since you tried to kill me in the OR?" He mumbled as he pulled away from her grasp, seeing her glare follow him.
"Shut up. The epinephrine was a complete accident and you know it. I'm not the one drinking double the amount I'm allowed to."
"It was four whiskeys. That's normal."
"Not with your health issues, it's not," Cristina explained as she tied a band around his left arm, "have you at least been taking your medication? And be honest, cause if you're not then I'll see it in your blood."
"Why do you care so much, Yang?" Alex groaned as the needle entered his vein, "this is intern work, why are you doing this?"
"I don't trust any of those interns to find your veins, and also, I've done this before. Helping people who claim one thing and do the opposite."
Alex winced as she removed the tubing from his vein, but not because of the sting. Rather, the mention of his ex wife's cancer and how Cristina had known about it long before the others.
"At least she continued to take her-"
"Yes, I've been taking my meds not a moment before or after I'm supposed to. You're gonna see it in the workup," Alex insisted as Cristina stood with the tube in her hand, "I promise."
"Okay," she smiled and gently patted his blanket covered thigh before turning to take the blood to the lab, her voice calling behind her, "be ready for the ass whooping Bailey's gonna give you!"
And with that, Alex was alone in the dark room with only the grainy TV to keep him company that he would be lucky to get turned on. 'Alone. Exactly why I was drinking in the first place.'
•••
"Joe said he had four whiskeys, including the one he was drinking when I got there. I don't think Alex is suicidal, Dr. Altman." Meredith explained as she continued to write what happened for the hospital records; Teddy had been breathing down her neck since Alex had been stabilized and she could barely talk and write at the same time.
"Well, he went from having a mild tachycardia arrhythmia that was manageable by medication to needing an implantable cardioverter-defibrillator put in very quickly. I have reason to believe it was stress and alcohol induced, despite the medication he was taking to prevent this."
"Alex was not trying to drink himself to death," Meredith insisted, putting down the pen to look directly at Teddy, "I kicked him out because he got me fired. Lucy took his job at the Nambozie clinic. Chief resident was given to April instead of him. He's upset about what happened with Zola. I had an alcoholic father, I know the difference between trying to get through your day and being suicidal."
Teddy sighed as she pushed her hair out of her face before looking back at Meredith's eyes, "figure out what happened so I don't need to put him on suicide watch. Understand?"
Meredith stood, handing the written statement to the nurse behind the desk before nodding to Teddy. "Yes, Doctor."
Before she could respond, however, Meredith was already making her way towards Alex's room with one goal in mind. 'Figure out exactly what's going on in his brain.'
However, by the time she had made her way to his room, she hadn't expected to see a very exhausted Dr. Bailey making her way out.
"How is he?" Meredith asked, her voice not coming out above a whisper.
"Grey, I am very tired. I was taking care of my sick three year old when I was called in by Yang to yell at Karev," Bailey stopped to yawn before continuing, "he's upset and stressed. I'll talk to Altman and explain, but then I am going home. He needs someone to stay with him and make sure he doesn't eat or drink anything before his procedure that he doesn't know about yet."
"I understand." Meredith nodded, waiting until Dr. Bailey walked away before sending a text to Lexie so she knew where she was. Then, she pocketed her phone and opened the room door slowly to see Alex laying in bed and holding his phone in his hand.
"Please don't give me another anti alcohol lecture," he pleaded as soon as he saw her, "Bailey looked like she was three seconds away from punching me."
"Do you blame her? One in twenty people die from alcohol related causes," Meredith fired off the statistic before sitting beside him and taking his hand, "but I'm not going to lecture you. I grew up with an alcoholic father, I know nothing I say changes things."
"I'm not an alcoholic, Mer. I'm just trying to cope with...with everything."
"I know," Meredith nodded, squeezing his hand reassuringly, "which is what I told Teddy, who genuinely thinks you were trying to drink yourself to death."
"No, that's a stupid way to die."
"One in twenty."
"Okay. Common, but stupid."
"Go to sleep, Alex," Meredith insisted as she let his hand go, "I'm staying here, but you've gotta go to sleep."
"I don't need a babysitter." Alex mumbled as his eyes started to flutter shut, giving Meredith the chance to dim the lights, whispering just loud enough so she could hear.
"Sleep, Alex. You need it."
•••
"Alex, you gotta get up," a voice coaxed him awake and when he turned, Cristina offered him a brief smile, "Meredith woke up for work, and I gotta examine you before the interns get here."
"And to think I was gonna get some sleep," Alex mumbled before turning over to face Cristina, "just be honest with me. Do I need surgery?"
He saw the flicker of regret on her face before her professional smile popped up, "why don't we wait for Dr. Altman? Sit up."
"So yes," Alex groaned before sitting up, allowing Cristina access to his lungs with the stethoscope, "how bad is it?"
"We are waiting for Dr. Altman."
He knew that Cristina had been working on her professional tone since they were interns and she had definitely improved, but after getting her normal brash personality last night, her fake cheery tone definitely worried him more than he'd like to admit.
He let her finish her examination and take more blood in silence, knowing he wasn't going to get more answers before the interns got there, but when she turned her back to him, he couldn't stop himself from asking, "Yang? Who's got my cases?"
"We divided them up, and Arizona is taking care of everything involving the Nambozie clinic. Just rest."
She left after that, leaving him to smack the remote against his bedside table and hope that it worked.
However, she was back shortly after, "hey, Alex? I need to call someone for you. Do you have an emergency contact, or a family member?"
Alex smacked the remote against the table one more time, finally getting the TV to cut on. His mom and Aaron were no help and Amber was only seventeen, which ruled a family member out. As for emergency contact, that was either Lexie, who had been made his emergency contact after the shooting by Mark, or Izzie…
"Yeah, Lexie. She's my emergency contact."
"Okay, I'll let her know."
And with that, she was gone yet again, leaving him to do the only thing he could until he got answers. Watch the grainy TV and hope that he wasn't going into extensive open heart surgery.
He zoned out for a bit as the tv continued, hardly paying attention as a nurse came in to adjust his bed so he was sitting up until Teddy came in with Cristina and Jackson.
"Dr. Yang, present the case."
"Alexander Karev, thirty-one. Was diagnosed with a mild tachycardia arrhythmia last month and was discharged with medication to slow his heartbeat down. He was rushed into the ER last night after going into cardiac arrest at a bar along with sustaining a mild concussion."
Alex made sure to glare at the interns who were trying to hide their laughs at his situation, which they quickly stopped giggling at him and turned to his chart instead.
"-his blood alcohol level was at 0.1 when he was brought in, but it's completely down to zero now. He had taken his medication on time."
"Good job, Dr. Yang," Teddy insisted, writing something down before turning to Jackson, "Dr. Avery, what would be the best course of action for Mr. Karev if he wants to continue his work as a fifth year resident?"
"Inserting an implantable cardioverter-defibrillator."
"No, absolutely not," Alex shook his head, "I don't need a defibrillator in my chest when I just drank too much."
"If you had just gotten too drunk, that would be the case. But you've been making your arrhythmia worse for weeks between drinking more than permitted and the amount of stress you've been under. Your other option would be cardiac ablation, but you'd be awake during that and you'd have to be on medication for the rest of your life. It could lead you to needing a cardioverter-defibrillator in the future anyway."
Alex paused and took a moment; on one hand, the defibrillator would be better in the long term, but on the other hand, cardiac ablation was less invasive. But being awake while it was happening…
"Oh my god, Alex!" Lexie's voice interrupted his thoughts as she ran in and hugged him, "April and I were on the way home and Meredith told me she was staying at the hospital overnight which wasn't weird, but then I got a call from Cristina and she said you went into cardiac arrest at Joe's-"
"Lex, I'm fine," he insisted, hearing the sigh of relief as she let him go, "Yang just needed to call my emergency contact."
Lexie seemingly ignored the part where he said he was fine though, turning to Teddy instead, "how bad is it?"
"I need him to decide between cardiac ablation or an implantable cardioverter-defibrillator, and soon, because the surgery times are different and we're scheduled to start at one."
"Alex, go with the defibrillator," Lexie begged, gaining his attention, "I've helped with the recoveries of both and the defibrillator has a longer recovery time, but it's a lot less painful."
Alex couldn't even stop the words from escaping his lips because all he could focus on was Jackson's glare meeting his eyes, "defibrillator it is, but I need to talk to you privately, Dr. Altman."
The two of them waited until everyone had left, including Lexie, before Alex looked up at her, "I don't want residents in my surgery."
"This is a two resident surgery, Alex."
"They all hate me."
Teddy sighed and looked down at the ground, hands in her pockets before turning back to him, "you can choose what residents you want in your surgery. But not Lexie, she's the one who's advocating for your decisions while you're sedated."
"Meredith. I want Meredith in there." Alex said with no hesitation, he wasn't worried that she would try and kill him after saving his life last night.
"Okay, that leaves Kepner, Avery or Yang. If I were you, I'd go with one of the last two. They're good at hearts."
Alex knew he couldn't pick April, not after the incident where he nearly hurt her because of his anger over trying to have sex with her and given that Avery currently looked like he would kill him because of Lexie's doting, that left him with one option.
"And Cristina."
"Good," Teddy smiled as she put the chart away, "I'll send Grey to prep you in a few hours, but Alex?"
"Yes?"
"Please, for the love of whatever is in the sky even though I'm hoping it's God, follow your post-op instructions. Even if Lexie has to force you to do it."
All Alex could do was nod.
•••
"Hey, how are you feeling?" Meredith asked as she walked in the room before bringing her eyes up from the chart.
"Tired, and my mouth is dry." Alex muttered as he flicked off the TV.
"Here," Meredith insisted as she walked over with a paper cup, "rinse out your mouth, do not swallow," when he grinned, she rolled her eyes with zero hesitation, "and do not make inappropriate jokes while I'm doing your pre-op."
"That's too easy. You deserve the best of my nasty jokes after the hell that I put you through." Alex explained before rinsing out his mouth.
"Like I said last night, I got my job back. I'm gonna try and work things through with Derek, we're going to get Zola back," she stopped to inject what he assumed were antibiotics into his IV, "things are looking up."
"I'm sure the whole "v-fib in the bar" totally helped with that," Alex snickered, although she could tell that he definitely wasn't feeling at his best.
"Cristina, Dr. Altman and I are gonna fix it, and you'll be back to being our favorite evil spawn by the time my sister is done doting on you."
"God, I hope so," Alex muttered as she reached over and pulled a cap over his head, "those feel really weird."
"Yeah, I know. It's weird that we make the patients wear them," Meredith agreed as she paged the others, "We're gonna see you inside. Can I do anything before I have to go scrub in?"
Alex swallowed back his fear; he had only had surgery one time before when he had been shot since he really didn't call Bailey removing the bullet from his chest surgery, and despite the fact that he seemed fearless, he was definitely worried about being the one going under the scalpel instead of holding it.
"No, I'm okay." He told her, hoping that he seemed convincing enough for her to leave.
She reached over and squeezed his hand tightly, "I'm not even gonna lie to you. Knowing how this kind of thing is done and then going under is a lot scarier than not entirely grasping how it works. But, you've got a great heart surgeon, a fantastic budding heart surgeon," she stopped to get a breath, not expecting Alex's scared face to jar her so much, "and you've also got me. Who saved your life in a bar last night."
"Thanks, Mer."
"I'll see you there." She insisted, squeezing his hand again before leaving the room; Meredith couldn't stop herself from sprinting to the bathroom and letting the tears come down as the dam started to shatter.
'Derek, Zola, Izzie, George…and now Alex. Not Alex, not him.' Her tears hit the sink as her breaths came out sharp and shallow, echoing on the bathroom walls. 'Richard said there would be two of us left by the end. George is dead, Izzie left...I really don't want it to just be Cristina and I. Even if she is my person.'
"Mer?" Cristina's voice called out to her, and she gained her breath back before wiping her cheeks, "you okay?"
She plastered on her smile before turning to Cristina, trying to keep herself together. "Yep. Let's go save Alex."
She knew that Cristina knew she was faking her demeanor as the two of them made their way towards OR three, but she couldn't tell her till the surgery was a success.
'Just three to six hours. Then you can let the dam burst.'
Meredith went through the scrubbing routine by memory, only able to focus on Alex on the table with Lexie, who was fully scrubbed in, by his side. Meredith couldn't help but smile at the sight and just how gentle and caring she was even though the two of them had been broken up for awhile. 'She's going to be a fantastic attending.'
"Do you think they'll get back together?" Cristina questioned, snapping Meredith out of her trance.
"Lexie and Alex?" Meredith questioned, seeing her best friend's nod, but she shook her head, "they went through the shooting together, that bonds a person. But she's in love with Mark."
And with that, the two of them went inside of the operating room and were helped into the surgical gowns and gloves.
"Alright, Alex, they're here," Lexie smiled down at him, "so they're gonna sedate you, and I'll be with you when you wake up. Okay?"
"Mer," Alex spoke, already sounding like the antibiotics drowsy effect had kicked in, gaining her attention, "I know it's cheesy, but can you say the thing?"
Meredith nodded before turning towards the team of surgeons, nurses and finally, glancing back down at Alex before saying her husbands' phrase. "People? It's a beautiful day to save lives."
They waited a few minutes until finally, his eyes fluttered shut and stayed shut. "He's out," Teddy nodded before turning towards one of the nurses with her hand held out, "ten blade."
•••
Alex groaned as he opened his eyes, seeing Lexie smile down at him, his hand wrapped in hers. "Hey. How're you feeling?"
He took a deep breath in, feeling his chest burn as he did so, "sore. Very sore. I thought you said recovery for this was easy."
"It's easier," Lexie corrected, "and after your pain meds get adjusted, it's less painful. But you're gonna be okay, I'm gonna be with you the whole time."
Alex nodded, leaning against the pillows and taking in the extra oxygen he was getting from the cannula "You don't have to…," he stopped to take a breath, "do that, Lex. Mer's gonna be with me."
"Don't be ridiculous. I helped you through a gunshot wound, I'm gonna help you through this too," she explained as she squeezed his hand, "and don't worry about Jackson, I explained our situation to him and that I'm not cheating on him."
"One kiss? For old times sake?" Alex joked, unable to hold in his laughter as she smacked his arm until his chest tightened and his throat felt like it was closing up.
"Crap," she muttered as she reached over, pulled the cannula off before pulling the mask over his face and putting her hands on his exposed cheeks, "just breathe, I'll do my best not to make you laugh again."
Alex pulled air through his tight lungs and tried to relax, looking right into Lexie's eyes which was starting to remind him about the shooting.
"Why?" He wheezed through the mask as he took another breath, his lungs starting to ease up, "why are...you staying?"
Lexie smiled at him before pressing a kiss to his forehead that they both knew was completely platonic. "Cause I'm your emergency contact."