"Can you order pizza, I'm starving?" Jo said, running her fingers through her hair as they got dressed.

"Don't you have any healthy food around here?" Alex asked, going over to open the fridge and finding it full of takeout containers and ketchup. "Guess that answers that."

"You have no right to judge me," Jo said, pointing her finger at him when he glanced back at her. "This baby has had me on a diet of crackers and juice since I got back to Seattle and I just started enjoying real food again."

"Okay," Alex said, holding up his hands as he turned back to look at her. "Did you really not know you were pregnant until five weeks ago?"

"Denial is a hell of a drug," Jo said, with a shake of her head, as she looked down and held her bump.

When she looked up, Alex was staring down at the pizza takeout menu. She could tell that he was trying to hide his sadness. She remembered how he felt when he found out he missed the first five years of the twins' lives. She knew he would be disappointed when he found out he had missed a few weeks of her pregnancy.

"Alex?" Jo said, looking over at him as she held her bump.

"Yeah," Alex said, as he paused, typing the Pizza number in his phone and looked up with her.

"It's not your fault that you missed it," Jo said, as she walked over to him.

"It is," Alex said, putting down the phone and coming over to put a hand on her bump. "You and I were separated long before we did this whole scheme. We saw each other three days a week and not even three full days at that. I didn't even notice you were pregnant when you came to visit, but I noticed when Eli and Alexis were coming down with a cold the day before they started showing symptoms. If I had paid more attention to you, I wouldn't have missed the first trimester. I missed so much time with you and our baby, time I'm never going to get back."

"Then let's focus on you being here now," Jo said as she put her hand over his on her bump. "Why don't I call Carina and see if we can set up an ultrasound for today so see you can see them."

"I'd really like that," Alex said, a huge smile blooming across his face as he looked up at her, but then his smile fell. "But I'm not going to be able to be here forever. I have to go back to see the twins."

"What are we going to do?" Jo said, looking into his eyes a little hesitant as if she was still afraid to ask.

"Well, first of all, I've got to tell Meredith and Bailey that I'm back and endure the shitshow that's about to come from all that," Alex said, rubbing the back of his neck. He already feared Meredith's anger about being lied to and the disappointed look Bailey would give him.

"No, I mean about Alexis and Eli," Jo said, pulling back and looking at him all too seriously.

Alex looked at her and then down at his hand over her bump. She knew in an instant that he didn't think any of this through when he came home to her because, of course, he didn't. Alex was never good at thinking anything through, and sometimes she loved that about him, but there were times like this when they needed a plan.

"Well, Izzie said that we could see them whenever we wanted. They have a soccer game on Saturday and I said I'd be there for that. I figured I could fly out and do weekend visits as much as I can. Then maybe as it gets closer to your due date, Izzie would be okay with letting the twins fly out to see you and meet their new sibling. I don't know how it's all going to work out, but we're going to figure it out. Even if that means I'll be a part-time father to all of my kids, running across the country all the time. It's going to be hard, but I want to make it work."

"Maybe we should move to Kansas," Jo said, sure of her words as his eyes grew wide and his head shot up at her.

"What?"

"I know I can't fly, and I want to stay here until the baby's born, but after that, we can move. Then we'll all be together, that's what's best for everybody, especially for the twins. So that's what we should do," Jo said with a nod as she laid it out to him and watched him take her words.

"Jo, are you sure? Izzie and I have been talking about her moving back," Alex said, taking her hands, making sure that she was sure.

"Yes. I love Seattle, I love our friends, and our family here, and I know you do too, but we have kids now, three of them. We need to do what's best for all of them, and if that's moving to Kansas, that's what we should do," Jo said, more sure of it than before.

"Are you really sure," Alex asked again, looking into her eyes. "We have to think about what's best for our kid and that means what's best for you as well. Our family is here, Jo. Your support system, Link and Meredith, are you sure you're okay with leaving?"

"Yes," Jo said without hesitation.

"Okay, well, why don't we see how things go. I don't want to put too much stress on either one of you," Alex said, looking at her so seriously as he put his hands back on her bump.

"Now that's the Alex I know and love," Jo said, looking up at him as he stared up at her with such adoring eyes and she ran her fingers through his hair. This was her Alex.

He smiled under her gaze as he leaned in to kiss her bump and to kiss her lips before he pulled back. "Alright, well, in the meantime, let's order some pizza. You said that you and the baby were starving, so what do you want? You're usually pepperoni or something else?"

"Pepperoni with extra cheese please," Jo said with a smile as he went back to the kitchen table and she pulled on a pair of her new maternity jeans.

She pulled the black stretch fabric up over her bump as she walked over to his suitcase that was left in the entryway and opened it. Jo took out the unfolded clothes that he had thrown in there in his haste to get to her. The shelves were still empty where his clothes used to be and she smiled, as she knew the shelves would be filled again. She took a moment to bring one of his shirts up to her nose and breath in his scent. She had clung to this pillow, desperate for any part of him she could get, and now that he was home, she had the real thing.

Jo heard Alex finish ordering the pizza as the doorbell rang and she got up to get the door. She figured that was Meredith or Link or one of their other friends coming over to check on her as they had done so often recently. Meredith and Link especially, were determined to keep an extra eye on her and often popped by on her days off.

She pulled open the Loft door only to find that it wasn't her friends. For the second time that day, she was faced with an unexpected visitor from Kansas. Izzie was standing on her doorstep with the twins next to her as she held their hands.

"Jo!" Alexis and Eli shouted as they slipped from Izzie's grasp and ran to hug her as Jo fell to her knees and hugged the twins.

"Hi, Jo," Izzie said, greeting her with a smile as Jo glanced up at her.

"We missed you," Alexis said, tucking her head in Jo's shoulder.

"A lot!" Eli insisted as he squeezed her.

"Let Jo breathe you two," Izzie said, rubbing Eli's back and prompting both of them to pull back from the hug, but neither one of them let her go. Instead, Eli wrapped his arms around her neck and Alexis held onto her side.

"What are you three doing here?" Jo said, looking up at Izzie before she looked between the twins.

Alexis put her hands on the bump looking at Jo's stomach as if she could see the baby. "Is my baby sister really in there?"

"Or it could be a baby brother, right Jo?" Eli said, looking up at her with raised eyebrows and putting a hand on her bump as well.

"Alex told me you were pregnant before he left, and when I told the twins, they insisted on coming to see you and the baby. Besides, we've all missed you so much." Izzie said as she smiled down at her.

"I missed you guys too," Jo said, giving the twins a squeeze as she kissed their heads and she smiled up at Izzie.

"Alexis? Eli? Izzie?" Alex called out as Jo turned to see him come around the shelves with the phone up to his ear, just as surprised as he was to see them.

"Daddy!" Both of the twins shouted simultaneously as they waved at him, not leaving her side.

"How come I don't get a hug?" Alex complained as Alexis relented and let go of Jo to hug her dad, but Eli remained by her side.

"I'm so sorry to show up so unexpectedly like this. I called Alex before we got on the plane, but from the look on your faces, I'm guessing you didn't get my messages," Izzie said as Jo turned to look back at Alex.

"No, we didn't. We've been ignoring our phones as we've been talking," Jo said as she looked over at Izzie.

"Umm yeah, talking," Alex said, avoiding their eyes, but Izzie caught on and rolled her eyes.

Jo shook her head as she moved to stand up, but Eli clung to her. "Eli, buddy, I need to get up and I can't pick you up right now."

"Why not? You used to be able to hold Alexis and me?" Eli asked as he stuck out his lower lip in a pout.

"Because sometimes, when I lift things, I get dizzy. I don't want to fall over if I pick you up," Jo said to him with a quick frown as Eli looked down.

"I'll hold you, bud?" Alex offered, holding out his arm to Eli.

"No, I want Jo," Eli said, turning into her and hiding in her chest.

"You really missed her, didn't you," Izzie said as she knelt down and rubbed his back. "Why don't you and Jo go over to the couch and sit together?"

"Okay," Eli said as he pulled back and let Jo stand as they all walked over to the couch.

Jo sat down as Eli crawled up next to her. He sat in her lap and leaned his head against her shoulder. Not one to be left out, Alexis got up next to them as Jo wrapped one arm around her. She had missed them as much as she missed Alex. It surprised her how quickly she grew to love them and how much she missed them when she was gone. She had never experienced the love she had for them and didn't recognize it was until she found out she was pregnant. Then, she realized the love she had for her baby was the same love she had for the twins.

"What are you guys doing here?" Alex asked, looking over Izzie as he settled next to her and put his arm over the back of the couch.

"Well, if you had answered my calls, you would have known that after you left, I thought things through, and I decided that the five, now six of us should be together, " Izzie said as she sat down in the blue armchair and crossed her legs. "So I quit my job."

"What?" Alex and Jo said as their heads whipped around to look at Izzie.

"Oh, don't act so surprised," Izzie said, looking between the two of them. "When I took the job in Kansas, they were the only place that would hire me after I got fired from Grey-Sloan. They've been great, but it's a small hospital. The free clinic never has enough money. I've been begging for daily supplies and I haven't been able to do the community outreach that I want to do. So I called Bailey and asked about how the Denny Duquette Clinic is doing. Apparently, she needed someone to oversee it and so I offered and she agreed so long as Jo's okay with it. I also asked if Alex could get his job back. She said that she wanted to speak to you in person and I guess it's just a co-head position. I guess there was another guy there."

"I'd love to work with you both and Hayes is really great Alex," Jo said as she looked back at Alex, who scowled.

"I don't care if he's gift-wrapped, special delivery from Cristina. I read up on the guy and I don't like him," Alex said as he stood up and walked over to the fridge to grab something.

"Alex, you just don't like him because Yang also sent him as a present to Meredith and the two of them hit it off," Jo said with a smile as she watched him growl.

"Was he sent in a Christmas box with a bow?" Alexis asked, tilting her head as Jo watched her imagine how that would work.

"No baby, it's an expression. He flew here like you did on an airplane," Izzie said to her, biting her lip to hold back a smile.

"Cristina just recommended him for the job at Grey-Sloan and decided to play matchmaker for him and Meredith," Jo said as she looked down at them and winked as they giggled.

"Now I have to meet him," Izzie said as she and Jo exchanged a smile while Alex's scowl deepened.

"He's nice, Alex. Give him a chance," Jo said, tilting her head at him.

"Fine," Alex grumbled before he went back to looking through the shelves in the fridge.

"Good because he's going to be the baby's pediatrician," Jo said, watching him for his reaction.

"What?" Alex yelled, popping up from the fridge so quickly that he hit his head on the freezer.

The twins immediately started giggling and Jo couldn't help but bite her lip and smile. "Relax, I haven't decided on it yet, but he is a good doctor."

"We'll see," Alex said with another scowl. "By the way, where is the beer?"

Jo didn't say anything, she just gestured to her pregnant belly. Alex quickly caught on and grabbed a soda from the fridge instead. Alexis caught sight of the soda and ran over to pick out a soda of her own as Eli piped up as he looked over, asking for one of his own.

"I've never seen Alex give in to anyone like the way he gives in to you," Izzie said as she looked over at Alex with a shake of her head.

"I don't give in to Jo," Alex said, his eyebrows knitting together as the twins giggled.

"Yeah, you do," Jo said with a little smile as she looked over at Izzie and the two of them exchanged a smile.

They both looked back at Alex and he just smiled at her before glancing down at the twins as they excitedly told him about their first airplane ride. Jo watched him nod along and react with enthusiasm. She had seen Alex with Meredith's kids and the kids on the Ped's floor, but watching him with his own kids was so special.

"I didn't realize he would be so good with the kids," Izzie said, leaning forward to talk to her. "The Alex I knew was not necessarily father material. When I had the twins, I did so knowing that I was doing it as a single mom. I knew I should have told him sooner, but I never expected Alex would be a good dad. I've been so surprised by him in the past few months. I've realized that he isn't the man I knew, he's so much better."

"He really is," Jo said with a smile as she put a hand on her bump. She loved the way he kissed her belly and she couldn't wait to see him hold their baby. "I've watched him interact with the kids on the Ped's floor and it was part of the reason why I fell in love with him."

"So I've heard," Izzie said with a smile as Jo blushed and looked down at her baby bump.

"I guess we should order another Pizza?" Alex said, taking a sip of his soda as he looked over at the clock by the TV.

"Oh, I want a pepperoni with extra cheese," Eli said, turning around on the couch to look at him.

"Well, we already have one of those coming because that one is my favorite too," Jo said as she smiled and pulled him back in a hug.

"It's a good choice," Eli said with a smirk that looked exactly like Alex and it just made her smile.

"What about you Alexis, you want plain cheese?" Alex asked as he moved his arm around her from where she was snuggled up next to him to pull out his phone.

"Of course, Daddy," Alexis said with an eye roll that made Jo laugh. She loved watching the twins and seeing how much they were like Alex and so very much their own persons.

"What about you, Iz? Do you want to just take from both?" Alex asked, looking over at her.

"Yeah, but add a salad or something. We could all use some veggies," Izzie said as she gestured with her hand.

Alex grumbled as Jo shot him a look. "She's right. It'll be good for all of us."

"Veggies," Alex still grumbled as he placed the order online from his phone.

"Jo?" Alexis asked, crawling over to sit next to her.

"Yeah?" Jo asked, watching her as she nervously crawled over to her.

"Can I feel the baby?" Alexis asked with a little smile and she could see that as she held back her excitement.

"Yeah, come here," Jo said, moving Eli off her lap to sit next to her and taking Alexis' hand as she placed her hand over her bump. "They're not very big right now, but they're going to get much bigger. Soon you'll be able to feel them move around and maybe they'll kick your hand."

"That'd be cool. I always wanted a little sibling. Eli's great, but he's my twin, so it's not the same, you know," Alexis said as he smiled down at where her hand was on her belly.

"Yeah, I'm sure that your little sibling is really excited to meet you too," Jo said as she smiled down at her.

Alexis looked up and smiled before she snuggled up next to her. Jo instantly put her hand around her shoulders and held her close as Alexis kept her hand on her bump. Jo looked over at Izzie as she laughed at something that Eli did, Alexis giggled at her side and Alex's laughter joined them. As she looked over, she caught his eye and he gave her that signature Karev grin. He reached out his hand as Jo moved her arm from around Alexis to reach out to hold Alex's hand and he gave her hand a squeeze. Jo smiled as she looked around at him, the twins, and Izzie. She was so happy to have all her family together again.