Chapter 9

Notes: Okay since it's been LITERALLY 10 years, I figured you deserved another… and fast

"Room 346, A. Dianetti" Callie's pager read as she looked down at the offending noise coming from her hip. Lexie and Ryan must have finished taking care of Alexandra's scans and taken her up to a more comfortable room, Callie thought to herself as she tapped the top of her pager to silence it. Two hours had passed since she ordered the two interns to tend to her ten year old patient. She'd found her way to an on-call room an hour ago and was attempting to get a few moments of rest during her shift. It was just after 11 PM and even though her review of the scans could certainly wait until morning, Callie's curiosity had gotten the best of her. She needed to see those scans, now.

Ryan and Lexie were sitting with Alexandra when Callie reached the girl's room. Alexandra's parents were nowhere in sight, but Lexie had pulled a chair up beside Alexandra's bed and was reading passages from the Harry Potter book in her hands. Callie smiled at the sight, her chosen interns for the night taking good care of their patient – a child.

"Did Alexandra's parents leave for the night?" Callie questioned Ryan with a whisper. Ryan was watching Lexie with the child from the far left side of the room, updating Alexandra's chart for Callie. The results Callie couldn't wait to see sat on the table beside him in their protective envelopes.

"Gabrielle went home. Alexandra has an older brother it turns out. His name is James, and Mom needed to relieve their babysitter. This family has its hands full. Mack went to get Alexandra some popsicles. She asked Lexie to watch Alexandra for a few while she was gone," Ryan told Callie, pausing on his updates to the little girls chart.

"They look comfortable," Callie stated, taking the chart from Ryan's hands. "Want to come check out the scans with me?" Ryan nodded eagerly, excited to see what was really going on in poor Alexandra's body. The two slipped out of the room, careful not to disturb the Harry Potter reading going on across the room.

Callie led Ryan two doors down to the X-Ray room. She made quick work of pulling the scans out and lining them up on the negatoscopes on the wall. She studied them in horror.

"What do you see?" Callie asked Ryan after a few moments of review. This was a perfect teaching moment. It was rare that anyone showed any real interest in orthopedic surgery so Callie loved catching an interesting case. While this one was particularly devastating, she was happy that it had sparked the interest of one of her interns.

"Well, the metal implants definitely snapped," Ryan stated, pointing to the broken rods protruding outward on the scans. "They were supposed to support her spine, but it's clear they did not do their job."

"What else do you see?" Callie asked.

"The rods are clearly not helping," Ryan answered with a huff. "How could this have gotten so bad?"

Callie smiled. Ryan was smart, but sometimes failed to let that show. Callie wasn't one to let that type of behavior slide. "I'm asking you Ryan. Tell me what else you see. Think out loud," Callie told him, patting him on the back.

"Scoliosis affects about 2-3% of the population and is common in children. The kyphosis is rare in kids, but she's got an extreme case of it. The severe outward curve of her spine is likely causing severe compression of her lungs. And, it explains the hunchback shape of her upper back." Ryan explained to Callie as he continued to review the scans in front of him.

"And what degree would you surmise her spine is bent at?"

"Approximately 115 degrees," Ryan guesses. Callie was impressed, she would've guessed about the same.

"This kid's body is literally collapsing in on itself," Ryan added, releasing a large breath.

"Good work Ryan, I'm impressed with your initial assessments," Callie told him, patting his back again and switching the light off on the negatoscope.

"So, what are you thinking we'll do?" Ryan asked. This was way outside his scope of knowledge.

"Let's take a look at the MRI results," Callie stated, moving to access the files on the computer to Ryan's left. "Now tell me what you see," Callie added, moving to give Ryan access.

"Is that – Is that a…" Ryan stuttered, zooming in on the upper portion of the MRI photo he had open on the desktop.

"A tumor? Yes. And it looks like it has some friends." Callie stated bleakly. She had suspected that an abnormal growth somewhere in Alex's bones was leading to the kyphosis. She pointed to the tiny tumors surrounding the larger tumor, "See these? They're skip metastases." Callie explained as she zoomed in on the images.

"Is it cancer?" Ryan asked.

Callie looked at him, waiting for him to recognize his statement.

"Likely, but we'll need to confirm with a biopsy," Ryan quickly corrected himself, earning a smile from Callie.

"Figure out when we can get the biopsy done, and I'd like you to handle it," Callie told him as she moved away from the computer and toward the door. "Good work Ryan."

"I'll start on the necessary paperwork and get Alexandra prepped for the biopsy," Ryan told her, following Callie out the door.

"We need to talk to her parents first," Callie reminded him.

"Should I go handle the paperwork while you go see if Mack is back yet?" Ryan asked her, clearly eager to get out of having to notify Alexandra's mother of their recent findings.

"No, we'll be talking to the Dianetti's together," Callie told him, starting back toward Alexandra's room just down the hall. "You are her doctor, Dr. Spalding," Callie reminded him. "You can do this."

Callie pushed open the door to Alexandra's room to find Lexie still reading Harry Potter to the little girl. Alexandra had an ice pop in her hand and was sucking on it contently, listening to Lexie read from the book in her hand. Mack is back, Callie thought to herself, just as the door to the attached bathroom opened.

"Dr. Torres," Mack greets the doctor, throwing the towel she'd just dried her hands with into the trash can beside the door. "I didn't expect to see you again tonight, it's getting so late. Don't you get to go home?" Mack walked back over to her daughter and Lexie, helping her daughter scoot into her as she laid herself down onto the bed beside Alex.

"I've still got a about 14 hours left to go on this shift, Mrs. Dianetti," Callie replied softly. "Besides, how could I resist helping this sweet little angel of yours?"

Mack smiled down at her daughter. Lexie finished the last sentence of the chapter she was on and marked off the page. She placed the book on the side table beside Alex's bed and rose from the chair beside her.

"It's been a pleasure reading to you Alex, you are a very smart little girl. Dr. Torres told me you were a superhero, and I didn't believe her until now," Lexie said smiling down at the little girl.

"Thank you, Dr. Lexie," Alex said barely above a whisper. The little girl was clearly spent. Her eyes started to flutter closed almost instantly as she cuddled into her mother a little tighter.

"Mrs. Dianetti," Ryan began after receiving an encouraging look from Callie, "We need to speak with you about the results of Alexandra's scans."

Mack quickly placed her hand in the air, sensing the tone in the room shift. "Please," Mack pleaded, "Don't give me more bad news."

"Mrs. Dianetti, I wish I could say that I understand your fears right now, but I don't. I'm not a father," Ryan started to say, "That's your baby right there, and you want to protect her. I know you don't know me, and you don't know Dr. Torres, or Dr. Grey, or Dr. Robbins who I'm sure will be joining our team soon, but I can tell you that I do. These people are my team, and they're going to take the best care possible of your team. I understand not wanting to hear more bad news, but we're not even at that stage yet. We don't know where we are yet."

Callie smiled from beside Ryan, giving him yet another pat on the shoulder to signal a job well done.

"What Dr. Spalding here is trying to say, is that we understand all of this is scary. But we're going to give Alexandra the best treatment. She's a superhero after all," Callie cut in. "We saw some things that are concerning on the various scans we took. Most of what we already suspected was confirmed, Alexandra has severe scoliosis and kyphosis. Her spine has twisted to severely that her body is, for lack of a better term, caving in on itself."

Mack nodded, listening intently as Callie explained what she'd found in simple terms, "So, what did you find?"

"We'd like to take a biopsy of Alexandra's bone," Callie stated plainly.

"A biopsy? Cancer?" Mack spit out frantically, as she tightened her grip on her daughter slightly, careful not to hurt her.

"Let's not jump to conclusions," Callie started to explain, "But we do not want to rule anything out either. Mrs. Dianetti, you already know this, but your daughter is very sick. We, at the very least, need to get her strength up for surgery."

"Dr. Torres," Mack looked up from her now sleeping daughter, raising her voice just above a whisper, "You don't need to convince me of anything. You have my full permission to do whatever needs to be done to save my daughter. My wife, on the other hand, will take some convincing. Gabrielle doesn't have as strong of a stomach for this as I apparently do. Don't get me wrong, I can barely hang on sometimes, watching Alex suffering. But, one of us has to do it. Gabrielle can't watch this anymore, our baby suffering. She doesn't want her stuck in the hospital for the rest of her life, can't bare to watch one more surgery fail."

"Let's start with the biopsy for now," Callie stated. "But we'll need both of your permission to do this."

"She'll consent to a biopsy, surgery is where you'll need to do the convincing," Mack replied, looking back down toward her daughter. "How soon can you do this? I need to know if we're looking at cancer again. I –"

"I know," Callie responded, offering an understanding smile. "Dr. Spalding and Dr. Grey will be taking care of the biopsy. I'll be there to supervise them, but they're both highly capable of performing this procedure. It's rather simple, and we'll be able to get it done fast."

Callie looked over to Ryan and Lexie, indicating it was time to go and for them to start on her order.

Arizona was shocked at her father's response. She broke free of her brothers hold, jumping upwards to wrap her arms around her father as tightly as she could. He still loved her. He still accepted her. She was still his daughter. Their hug lasted several moments as Arizona allowed herself to cry into her Father's dark blue blazer. He rubbed her back, kissed the side of her head and held on tight as his daughter trembled silently in his arms. Arizona finally pulled away when her father patted her back gently and gently moved away, "I'm proud of you Arizona, and I love you," he told her.

"Mom?" Arizona asked, turning to her mother who had still yet to say anything.

Barbara Robbins rose from her seat. She moved toward her children and husband, leaning up to kiss her husband's cheek, then over to her son to kiss him on the top of the head. She looked down at Arizona. Her daughter had tears in her eyes, threatening to fall onto her flushed cheeks. Barbara leaned down and placed a kiss on top of her daughter's head. Arizona looked hopefully at her.

"All my life I've strived to be the best mother and wife I could be," Barbara spoke, gently, "I've prided myself on having an incredible family. My amazing husband, beautiful children, and incredible grandchildren. I've never waivered on that." Barbara placed a hand on Arizona's cheek and directed her eyes to look at her.

"You have been a good mom, Mom, we all make mistakes," Timothy stated reassuringly.

"I cannot say I understand now, I cannot say I ever will. I cannot –" Barbara resumed. "I need time Arizona. Just time. I am incredibly proud of you, and the bravery you've shown today. Please know that I love you, but I need time. And I will respect your wishes and do that on my own." Barbara said, moving to kiss her daughters head once more and turned to grab her things.

"Mom, you don't need to hide away. This is all new, and surreal, and we can figure this all out together," Arizona told her, almost pleading with her. She never expected those words to come from her mothers mouth. And now that she was hearing them, she knew she had to find a way to make this work, to keep her family in-tact. "I can't lose you Mom. I know things weren't always great, but we can… I know we can all figure this out together, as a family."

Barbara offered a smile, "Yes Phoenix, like everything else, we can do this together. But for tonight… I just need some time." Barbara patted her daughter's shoulder lightly, grabbed her purse and started to walk away.

"Daniel, I'm going to head down and take a shower. I'll see you back in the room. Kids, I love you both, and I'll see you in the morning." With that, Barbara smiled weakly, kissed her husband's cheek and headed back toward the elevators to go down to her room.

Dr. Christian Weston was a good man, a strong man. He'd been through a lot in the 36 years he'd been alive. More than most his age.

His mother, Alana Weston, had died when he was a young boy from metastatic breast cancer. She'd been diagnosed with cancer just a few months into her pregnancy with Christian's younger sister, Grace. Christian had been only five years old at the time, and his mother had opted to shield him from the truth of her disease. The pregnancy had caused a surge in Alana's estrogen secretions, leading tumors to grow rapidly in her left breast. She'd gone to the doctor for some tests, discovering that she was not only three months pregnant, but that she had developed stage IV breast cancer right off the bat. Alana's doctors had recommended she terminate the pregnancy and immediately begin an aggressive treatment plan including chemotherapy and radiation. Alana refused, opting to carry out the birth of her daughter before tackling the cancer growing swiftly inside her.

Alana gave birth to Grace just after Christian's sixth birthday. His father, Joseph Weston, left their family a few months later, not being able to stand the turmoil his wife and children would soon endure. Throughout the next few years, Alana fought hard to stay alive for her children. She'd spent a few years in remission when Christian was 8, and Grace was 2. For a few years, things were good. Alana's mother, Gail, had moved in with the family and helped her raise the two young children, and Alana's prognosis was looking up. Over the years, Alana had been in and out of hospitals, visiting with doctors, spending nights alone and sick in her bedroom. All the while, shielding her children from the reality of her illness. Christian and Grace had a happy childhood. They were normal kids, playing sports, going to camp, completing science fair projects, spending time with their friends. It wasn't until sometime after Christian's 11th birthday, that his world fell apart.

Alana had lost consciousness one night. Christian could never quite figure out how to shake the memory of walking in on his mother, non-responsive in her bed one morning before he left on the bus for summer camp. Grace hadn't woken up yet, and Gail was doing laundry in the basement. He called 911, frantically shoving his mother's body in the bed, hoping she would wake up. Two days later, after being rushed by ambulance to the hospital, Alana succumbed to her disease, passing away at 10:47 PM on August 13th.

It wasn't for another few years that Gail finally sat Christian down and explained how Alana's cancer had spread to her brain, ultimately causing her death. Alana had died blind, alone in a hospital bed while Gail tended to the kids at home. Christian never did quite forgive himself for that. He would've preferred to be by her side. Instead, in that moment, Christian decided that if he did nothing else in life, he would become a world-renowned surgeon – he would make sure that, if he had something to say about it, no child would ever have to say goodbye to their parent like that again.

Christian went on to attend Florida State University as a pre-med student. He graduated at the top of his class in just under 3 years with a double major in biology and chemistry. He went on to be accepted to Columbia University for medical school, graduating two years before the woman who would eventually become his wife. He took a residency position at Johns Hopkins, and had been there since graduation, until moving to Seattle to take over as Chief at Seattle Grace Memorial West.

Christian was sitting alone in his office reviewing paperwork after exiting Alexandra's room earlier that night. He had plenty of forms to finish filling out but couldn't quite bring himself to concentrate. In the last 48 hours, his entire world had come crashing down around him. He and Arizona had just recently started discussing the possibility of having children. When Christian had brought it up, Arizona had seemed excited at the idea of adding a child to their family. Now, it all just seemed like a cruel lie.

A knock at his door drew him from his thoughts.

"It's open," Christian called to the person outside his door. Within a few seconds, the door opened. Dr. Miranda Bailey was standing in his doorway, a smile spread across her face. Dr. Bailey was never one to enjoy overnight shifts, in fact, she was typically grumpy this late in the evening. It was just after midnight at this point. The pit was preparing for a rough night, knowing full well that a major concert was about to be coming to a close for the night. They'd had a few overdoses to attend to, a couple broken bones, and one case of severe dehydration throughout the day from the festival, but everyone knew the real injuries tended to happen after.

"What can I do for you Dr. Bailey?" Christian asked as he placed the paperwork he was currently reviewing to the side of his desk, looking up at his most senior resident. Christian looked tired. His dark eyes were worn out, his expression sullen. For a man who typically oozed confidence and grace, there was no sign of it now.

"I was hoping to talk to you about our new patient, Ms. Alexandra Dianetti?" Bailey stated, deciding not to poke her nose in Christian's business. Dr. Bailey and Dr. Weston had grown close over the last six months. At first, Bailey had hated Christian, angry that he took Dr. Webber's position when he was nothing more than an outsider. As the days turned into months, however, Dr. Bailey found herself possessing nothing but the utmost respect for the talented general surgeon. He'd taken her under his wing, just like Dr. Webber had, and had made a special point to choose her for his surgeries, allowing her to get her hands wet on multiple surgeries over the last 6 months.

"Of course, Dr. Bailey. Come in," Christian told her, gesturing for her to take a seat in one of the chairs in front of his desk. Bailey nodded and moved into the office, taking a seat in the chair to Christian's right.

"Torres filled me in on the basics, and asked me if I want on the case," Bailey started simply. Her face curled up into a frowning scrunch at the thought of having to work on another child. She'd taken an interest in pediatrics when Dr. Robbins had arrived at Seattle Grace. There was something about the fierceness in which Arizona fought for her tiny humans that drew Bailey in. They'd been working closely together for the last few months while Christian took a back seat on surgeries to deal with the problems the hospital had been facing after Dr. Webber's departure.

"And is that a problem?" Christian asked her, genuinely curious. As far as he knew, his wife was his biggest competition for Bailey. Arizona wanted a resident, but so did Christian. None of the interns had shown a particular interest in hopping under Christian's wing, aside from Bailey. And, other than Alex Karev, Arizona had no prospects besides Bailey. Bailey had been spending a lot of time in the peds wing lately, and Christian had almost given up hope that Bailey would stick to general surgery.

"Yes," Bailey admitted. She'd enjoyed working in peds, she truly had, but it was too much for her. She did not have the stomach for it. "Yes," she repeated, "It is a problem Chief…. I – I can't work with the little ones anymore. I can't hold back my emotions. I see these children and I see my boy. I don't think pediatrics is the right place for me."

"And did you tell Dr. Torres this?" Christian was slightly taken back by Bailey's confession, but was nonetheless pleased. At least the fight for Bailey with Arizona was over.

"No. She was rattling on and on about this spinal surgery she had started drawing up plans for, and I couldn't get a word in," Bailey confessed, dropping her head slightly.

"And if this was your child, if Alexandra was your daughter, would you want you on the case?" Christian asked her, leaning forward in his chair.

"I – " Dr. Bailey started. She hadn't thought of it that way. Would she want her on the case if this situation was happening to Tucker?

"You don't have to answer me now, Dr. Bailey. But, I need you to think about this. Dr. Torres chose you because she believes you are the best. While I'm sure she doesn't have the whole plan worked out yet, this is going to be a very complicated, yet groundbreaking surgery. Do you want to miss that? Do you feel like you can't handle that because the patient is a child?" Christian added, recognizing that Dr. Bailey was acting on instinct at the moment.

"Christian, I don't need to think. I understand the opportunity I'm being granted here. Dr. Torres is going to save this child's life. And maybe if it were just the scoliosis, I could handle it. But, Callie mentioned a possible cancer diagnosis, and I can't put myself in there. I can't watch a family break, a child die," Dr. Bailey told him.

"But again, you haven't answered my question. Dr. Torres believes you are the best person for the job. Do you disagree?" Christian asked her again, knowing he could push this woman a little as his friend.

"I have no doubt in my capabilities as a surgeon. I doubt my ability to maintain appropriate bedside manner with this family, with this baby… Because that's what she is. She's a baby Dr. Weston, and I cannot be responsible for making her life any harder than it already is," Dr. Bailey finished, knowing full well what she was saying.

"Well then, Dr. Bailey. It looks like you've made up your mind. Do you have a suggestion of someone who should replace you?"

"Yes. Dr. Karev should be in there. I think he's found his calling, sir," Bailey added the last part quickly. Dr. Karev had been shining in pediatrics lately, even more so than her. Dr. Robbins had started splitting the surgeries between him and Dr. Bailey for the last few months, ever since Karev saved that "band nerd," as he liked to call her.

"Then that's what you tell Dr. Torres," Christian told her, rising from his chair. "Let her know soon, because Karev will need to prep and learn to work in tandem with Dr. Torres to effectuate her plan on this. I'll be placing a call to Cleveland Clinic in the morning to get Dr. Minnick over for this as well. You've got some time, if you'd like to continue thinking this over, but think quickly." He walked over toward Dr. Bailey and put a hand on her shoulder. "You are stronger than you think Miranda Bailey. Don't walk away from the opportunity of a lifetime because you think you'll let your emotions get the best of you. We're all human, but you have a chance to help not only save this girls life, but change it. You have the chance here to give this child her life back. Think about it."

Dr. Bailey nodded and lifted herself from the chair she was sitting on. "Thank you, Dr. Weston," Bailey stated as she headed for the door. "I'll keep that in mind and let you know my decision by Monday morning."

We caught a wild case. Arizona had just completed her nightly routine, and was preparing to put her iPhone on the charger to the left of her bed when the phone vibrated in her hand. Looking down, a text message from Christian had come through. She smiled at the message. It felt weird to receive a text from Christian after everything they'd been through. Despite the weirdness, it also felt familiar.

Tell me about it. Arizona quickly typed back. She knew things between her and Christian would take time to heal, but she was glad for the small piece of normal.

We need to pull you in on it. She's 10. Severe scoliosis and kyphosis. Infantile neuroblastoma in remission. Torres ran MRI and X-Ray, haven't talked to her yet. Last I spoke to her she suspected cancer accelerated abnormal growth.

Arizona was instantly intrigued, and equally as saddened. 10? It was rare to see kyphosis in teenagers, no less an adolescent of the child's age. It was entirely possible that cancer had come back and spread. It would explain the acceleration of the curves in the child's spine.

I'll check in with Torres about the scans. I'm available for whatever needed. Arizona almost added that she'd head into the office before Callie's shift ended, but she didn't want Christian's mind to start swimming about why Arizona was privy to such information.

Arizona woke up early that morning, knowing that Callie's 30-hour shift was ending around 3 PM. She wanted to make sure she caught her in time to discuss the patient and see where she was needed. Christian hadn't come home last night, but she hadn't really expected to either. She sent a quick text to her brother explaining that she was heading into the hospital for a bit to consult on a new case. She sent a follow up a few moments later telling him she'd call him when she was done, and they could grab lunch before heading out to do his favorite 'touristy crap.'

It took Arizona all of 15 minutes to make the trek to Seattle Grace. It was just after 9:30 AM, and even though it was the first day of a three day stretch off work, she was excited to see what new problem she would try and help solve.

She strode into the pit slowly, black slacks, a white button down, and her lab coat on. "Anyone seen Torres?" she asked as she approached a group of interns crowding around the huge desk in the middle of the floor of the pit.

"I think she's over there," the lanky one, Steve said, pointing over Arizona's shoulder to a group of doctors huddled around a patient's bed.

Arizona thanked the man, turned, and strode over toward the small commotion going on in the corner. Multiple doctors stood around the patient's bed, looking carefully at the person laying there. Dr. Bailey, Dr. Yang, Dr. Torres, Dr. Grey, and Dr. Hunt were all watching curiously from the side.

Arizona slid up beside the group of residents and attendings. "What's going on?" Arizona asked, stretching up onto her tippy-toes to attempt to see around the doctors.

"Skills test, at this point," Dr. Yang said with a laugh.

"What?" Arizona asked. "Is that a dummy?" She looked closely, realizing that the group of doctors surrounding the bed were interns.

"Yep," Callie replied slyly. "We're not really sure how one of those ended up on the floor, but one of the interns started poking around with it… So, Yang grabbed the controls and... here we are. We're like 65% sure they know it's a dummy at this point, but some of them are pretty good actors."

Arizona laughed, "That's actually ridiculous." She watched as the interns scurried around their fake patient for a few moments before gesturing for Callie to walk with her. Dr. Torres nodded her head, dismissing herself from the entertainment and followed Arizona away from the group. They were in public, at work, Arizona knew better than to grab Callie's hand – but she wanted to. She quickly asked about their new patient.

"Christian told me about the ten-year-old girl? That you might need me for something?" Arizona asked once they were back near the desk.

"Alexandra Dianetti. I was actually on my way to check in with her family when I got distracted by those clowns," Callie explained, leaning against the desk. "We can go see her after I fill you in. We got the MRI and X-Ray scans rushed last night, and it confirmed most of my suspicions. What we don't know is how bad it is. I have little Grey and Ryan assigned to her case for now. So far, they've both been great with the girl and her parents."

"What did the MRI show?" Arizona asked.

"We spotted a tumor, it looked like it was starting to spread," Callie explained, "We need a biopsy. Lexie and Ryan took care of that this morning. Ready to go see her?"

"Ready."