Kay, guys, against my better judgment, the next section is up. I think it works, finally, but I'm writing and posting at the same time. Therefore, there will be some editing/correction to previous chapters made as I figure out the minute logistics of the plot.
A couple notes: The line was supposed to be "fed him grapes." Spellchecker didn't catch it; neither did I. Way to go, eagle eyes! I've corrected it.
Everything that's medical came from Wikipedia and WebMD. I'm a high school senior, not a premed student or a doctor or anything.
Disclaimer in Part 1.
Also: Addison is still Dr. Montgomery-Shepherd because, if she is referred to that on the show, she was married to Derek and changed her name before taking her boards. Even though she divorced him, all of her work and publishings, plus her certification, would be in that name, so she wouldn't change it. For that same reason, Cristina is still Dr. Yang, Meredith is still Dr. Grey, and it's why Ellis kept her husband's name after their divorce(which is mildly significant in this chapter).
Anyways, read and review! I love constructive criticism. I have a very tough skin.
"Alright, tell me what we have here." Cass said authoritatively to her herd of interns. Meredith observed carefully from behind and to the right of Cass.
"Kaitlin Baxter, age 38, admitted last night because of headache complaints and vomiting. No personality changes reported, though moments of memory loss. Typically neurology would handle this; I believe those interns have already been through this morning. We were called in preemptively because of her history. About five years ago Ms. Baxter had an anaplastic astrocytoma located in her primary motor cortex, which Dr. Shepherd removed. She then underwent chemotherapy and was pronounced cured. Her recovery was phenomenal and her function returned to normal. " David O'Brien, a hardworking, serious intern, intoned.
"Okay, David, why is that so unusual?" Cass quizzed.
"Most patients with that sort of tumor live only 14 to 18 months. The five-year survival rate hovers around 5 percent. Also, the location made the operation quite delicate, and a complete recovery is something most patients can only dream about."
"Okay, we're going to work on editorializing in front of the patient later." Cass said, noticing Ms. Baxter's discomfort.
"Nah, it's okay. I was just freaked that I actually understood all that techno-babble this time around." She smiled slightly pitifully.
Just then, another woman, about in her thirties, walked in with one-year-old in her arms. She bore a resemblance to Kaitlin Baxter, leading Meredith to believe she was a sister.
"This is my sister, Amy Masters, and my daughter Hallie." Kaitlin said. She reached for her daughter.
"What's the diagnosis?" Amy said anxiously.
"We were just getting there." Cass smiled. "I'm Dr. Cassandra Whitmore-Fielding, the resident on your sister's case. This is Dr. Meredith Grey, our neurosurgeon, and my interns."
Meredith smiled at the sister before turning back to the interns. "What's the standard course of treatment?"
"An MRI to determine location and if the headaches mean the cancer has returned, and then either a biopsy or surgery depending on what sort of tumor there is—if there is one." Another intern, Jessica During, said.
"Possible side effects?"
"Too early to tell." Jessica smiled. "Ask again once we have results from the MRI."
"Great. Dr. During, get a MRI by noon. Page me with the results, and then I'll ask you the question again." She turned to Kaitlin. "I assure you, Ms. Baxter, we're not going to be too hasty. We're going to move as efficiently as possible to figure out what's causing these headaches."
"Great," Kaitlin said nervously, holding her daughter.
"She's very cute." Meredith told her, smiling at the cherubic baby as she leaned in to check Kaitlin's pupils. "How old is she? About one?"
"Fourteen months." Kaitlin responded. "After my first surgery—well, I had been married, but we weren't…working out. We'd gotten pregnant in college, got married, lost that baby, and sort of coexisted for about ten years. After the miracle recovery from the tumor, I decided I wasn't living anymore. He understood. We got a divorce, and two years ago I decided I still wanted to be a mom." She played with Hallie's curls and smiled at the baby. "Sperm donors—godsend." She looked up suddenly at her doctor, and narrowed her eyes into a crinkly smile. "Are you—expecting?"
"Yeah," Meredith smiled. "I'm about four and a half months along. My husband actually is your former doctor, Dr. Shepherd."
"Lucky woman." Kaitlin smiled. Her face darkened then—"Do you think the cancer's really back?"
"I'm not going to answer that question until Dr. During books an MRI and we examine the results." Meredith said firmly.
"Good answer." Kaitlin sighed again. "I'm sorry, I'm taking up so much of your time."
"No, it's fine. I understand how scary this must be." Meredith said. She turned to Amy, "But I do still have some more patients to see, so I've got to be going. Dr. During will be here soon to take you for a CT, and I'll be back after that. If you have any problems, don't hesitate to have a nurse page me."
"Great. Thank you, Dr. Grey." Kaitlin smiled, looking slightly relieved. She returned to playing with her daughter as Meredith went on her rounds.
Meredith circled through the rest of her patients, completing her post-ops from Friday afternoon. She hadn't had many surgeries lately—she had a feeling Derek and Burke were conspiring again. She circled back to Kaitlin's room, but found that she was already at the MRI. Pleased, Meredith headed towards the nurses' station, where Cristina was filling out clipboards. "Hey," she said, standing beside her.
"Hey," Cristina flipped a clipboard shut. "What's up?"
"Not much. Possible surgery this afternoon. I'm pretty excited; I haven't had one since Friday. I need a surgery."
"Welcome to pregnancy." Cristina continued to tear through her reports. "They try to mommy-track you. No surgeries. Even if you're sleeping with the guy that schedules surgeries. Especially if it's his kid."
"Slow down there, you might make a mistake." Cass walked up to them.
"I want to get this done so I can move up our surgery; Izzie said that there's a cool surgery at three that I want to see." Cristina explained.
Hearing her beeper, Meredith quickly looked down. "Crap." She said, by way of an excuse. "Urgent in 3203 And Burke's surgery isn't all that cool; it's an endocarditis-correcting surgery. See ya." She jogged down the hallway.
Cass flipped open her own report. "Ours sounds cooler." She said. The two of them were removing part of a man's small intestine and reattaching it at one. She looked around. "Did I tell you what Sanchez told me?"
"Which one's Sanchez?" Cristina said blankly, continuing to fill out reports.
"Lyndsea. One of my interns. Still a year older than I am. Anyways. She said that George has been offered a position at a hospital in Kansas City; some saint of something. He's considering taking it."
"George? Baby Boy George?" Cristina looked around. "He got recruited? Are you sure?"
"According to Lyndsea, yes. He got recruited. And you know how it works around here. Interns. They gossip."
"He got recruited? Why haven't I gotten recruited yet? I'm a hot commodity."
"Yang, I'd appreciate it if that talk didn't happen at the hospital." Bailey said, mildly irritated, coming up behind them. She knew that it was a losing battle—Cristina was married to another hospital employee (oh, hell, her boss), it was bound to happen—but she still tried to curb it during office hours.
"No, Dr. Bailey, we weren't talking about Cristina's sex with the boss." Cass had a way with words. "Word on the street is that George is being recruited by a hospital in Kansas City, as head of pediatric cardiothoracic surgery. And he's considering taking it. And Einstein here's comment was outrage that she hasn't been head-hunted yet."
"Cristina, you're married. To. The. Head. Of. Surgery. Now why would anyone recruit you?"
"Still—offers are nice. Shows that you're appreciated." She looked hard at Bailey. "Have you heard anything?"
"No I have not. And this is O'Malley's business. George's and Kayla's, and that's all. You should be happy for him. This is a big opportunity, if the intern gossip it right."
"Of course it's right." Cass defended her source. "Interns are either the source of gossip or the chain. And George isn't an intern. So my source is secure."
"Let's not speculate here." Bailey said. "I have a surgery at 10:30, a bowel resuscitation. Cass, do you have any interns available?"
"Yeah. David O'Brien. Everyone else got grabbed up."
"Good, good, O'Brien's just fine. Page him for me, will you?"
"Has George talked to you lately?" Cristina set her tray down next to Izzie's.
"Of course George and I have talked." Izzie said defensively. "We talk a lot. George is like my best friend."
"So has he mentioned getting recruited to a hospital in Kansas City?"
"What? George? No. George wouldn't leave."
"Well, he's apparently getting recruited, according to Cass's interns." Cristina bit into an apple. "Honestly. They're recruiting him. They're probably wooing him, with perks and offices and intern control."
"Are you madder that George is possibly—"
"Probably." Cristina interjected.
"Fine, probably—getting recruited, or that nobody's come up to you with a perky perk-filled offer?"
"George is getting wooed?" Meredith came up behind them. Cristina unconsciously straightened up in her chair.
Izzie straightened, too. "According to an intern of Cass's, yeah."
"And, I mean, it's Kansas City, so I wouldn't want to live there—it's like one step up from Des Moines—but still. They're wooing him. They want him."
"Have you ever even been to Des Moines or Kansas City?" Izzie asked.
"No, but I wouldn't want to live there." Cristina shot back.
"Be happy for George, Cristina. And it's not like you don't have a husband here—if they wanted to woo you for an advanced position, they couldn't, because they can't go over-budget. They woo him first cause his salary would be higher and then they find a position for you." Meredith pointed out. "It's the same way for me."
"It's just nice to know you're appreciated." Cristina muttered.
"Yes, you poor, underappreciated wife of the chief surgeon, with interns quaking in your wake and medical journal articles flying out of your ass," Izzie snorted into her pita wrap.
"You're just jealous." Cristina said.
"No, that'd be you." Cristina lobbed a crouton at a snickering Izzie.
"Anyways," Meredith segued, biting into her sandwich. "Izzie, do you still have that catalog with baby stuff from that store you knew in LA? I should start baby-supply shopping. We know it's a girl now, so I think that we should start on the nursery soon."
"Cool, yeah, I'll bring it tomorrow." Izzie said quickly. "We can go shopping together. I still need house stuff. Anyone want to go tonight? I'm free after about six or so."
"I can't—OB appointment at 5."
"I have surgery until about eight tonight, but I need to buy Cooper something to wear to throw up all over for his christening. How about after work tomorrow?"
"No, I can't—I'm on call" Izzie said. "Wednesday?"
"Avery has dance; it's my night to pick her up." Cristina shook her head. "Thursday?"
Meredith rolled her eyes. "Dinner with my father." Though she had refused to speak to him for several years, Meredith had begun to rebuild ties with him after her mother's death. She had dinner with his family once a month, and often ran into her half-sister, Lexi, at work—Lexi was a neuro-oncologist, irony of ironies. "Friday?"
"Alex has this thing at his practice." Izzie shook her head. "Some dinner with his partners."
"Crap. This weekend, then, I guess." Meredith said.
"No. Burke wants to go to a winery Saturday." Cristina said. "I think it's cause we haven't had sex since Coop was born and he wants to get me in the mood. I mean, 12 weeks really isn't that long. And, for god's sake, I have three kids. I need recuperation time." She rolled her eyes. "And, actually, Mere, you and Derek agreed to watch my kids because you think you need more practice."
"Yeah, I totally remember that." Meredith swallowed.
Jessica During appeared behind them. "Dr. Grey," she said anxiously. "I have Kaitlin Baxter's MRI results."
Meredith slid backwards in her chair. "Great. Let me see." Sanchez quietly handed them over, and Meredith studied them for a second. "Crap." She said quietly. Then she cleared her throat and said, "What do you see?"
"Necrotic tissue surrounded by anaplastic cells." She said quietly. "Characteristic of Grade IV glioblastoma multiformes. Highly untreatable and usually fatal."
"Don't become negative, Dr. During. What do we do next?"
"Talk to her, book an OR, probably for in a few days, bring in a neurologist and an oncologist. Start on corticosteroids if the neurologist and oncologist agree. These scans have already been sent to her neurologist, Dr. Macalester."
"Good." She stood up. "Let's go." She turned back to her friends. "See ya guys."
They first paged Dr. Lennox, the head of neurology, and Kaitlin's neurologist was sent down to meet them. Dr. Macalester brought down Dr. Alexandra Grey, the consulting neuro-oncologist.
"Lexi," Meredith nodded, surprised. She and her half-sister tried to keep their professional distance, finding their situation to be incredibly awkward. "Have you two met with Ms. Baxter?"
"Meredith," Lexi nodded in acknowledgement before continuing. "Dr. Macalester met with her this morning and has been her neurologist for the past two years; I've consulted with her before but I'll review the file later. I thought it would be nice to be involved at the early stages."
"Right." She smiled grimly. "Let's do this." She knocked before walking in. Kaitlin was sitting there, playing with Hallie. Amy was looking out the window and talking on her cell phone.
Jessica, as she was supposed to, did the introductions. "Ms. Baxter, I'm sure you remember Dr. Meredith Grey, our neurosurgeon. We've also brought in Dr. Macalester and I'd like you to meet Dr. Alexandra Grey, our neuro-oncologist."
Kaitlin Baxter smiled. "That must be difficult, two Dr. Greys at this hospital. Are you two related?"
"Half-sisters, actually." Meredith said, smiling uncomfortably and reaching for the MRI scans.
"How unusual, we're technically half-sisters too." Amy shut her cell phone.
"What a coincidence." Meredith tried another smile before getting down to business.
Kaitlin seemed to notice her somber demeanor and immediately handed Hallie off to her sister. "Ames, can you take Hallie to see the new babies or something?"
"Yeah, sure," Amy said quickly, her eyes darting between the doctors before grabbing her niece and exiting.
As soon as the baby was out of the room, Kaitlin said flatly, "The tumor's back, isn't it? You all wouldn't come in if it weren't. And the symptoms are there, and the history's there. It's back, isn't it?" her voice was careful, controlled.
Meredith nodded slowly and motioned to Jessica to reveal the scans. "We've discovered a Grade IV tumor located near the Broca's area."
"Broca's area—where speech is controlled." Kaitlin said dully. Meredith decided not to correct her; it was semantics anyways. "And Grade IV—that means that it's got necrotic area."
"Yes. You know your stuff."
"I also know the survival rate." Kaitlin replied. "So, what's your first last-ditch attempt to save my life?"
"We're scheduling surgery to remove the tumor for Thursday, probably in the morning." Meredith replied. "Dr. Grey will give you a complete work-up, and after surgery, she and Dr. Macalester will figure out a plan for treatment. Chemotherapy and radiation will probably be involved."
"What sort of surgery?"
"We're going to perform a craniotomy and remove the tumor. We'll also be using stereotactic MRIs continuously through the surgery to get as much of the tumor as we can. We'll continue to monitor the tumor and probably perform stereotactic radiosurgery—radiation administered while you're under anesthesia but no craniotomy—in a few weeks." She looked empathetically at her patient. "You know the risks for the surgery—they're very low; it's combating the disease that's tricky. But you know the odds, because you've beaten them before. There's no reason why this can't happen again. The good news is you're surrounded by the best surgeons in the Northwest and we're going to be behind you fully." She cocked her head. "Do you have any questions?"
"No. I think I'm good. Last time—there were so many questions. Now, not so much. I assume I'll be started on the steroids pretty soon?"
"You'll start receiving them intravenously this afternoon to prep for surgery." Lexi stepped forward. "We should go over the treatment, pre- and post-surgery. Would you like your sister present in these?"
Kaitlin shook her head. "Yeah. Yeah, we probably should."
Meredith stepped backwards. "I'm going to go—this is all about the treatment; I'm going to go book and prepare your surgery."
"Thank you, Dr. Grey," Kaitlin smiled, numbly.
Meredith quickly ducked out of the room and headed to Preston's office, shaking her head. It all seemed so…tragic. This woman had put her life back together, and had totally recovered, and now was even sicker.
She ran into Derek outside of Burke's office, reviewing some files. "What's up?" he snapped the file shut. "You look freaked."
"This patient—I just feel badly for her. I'm coming to schedule her surgery."
"What kind of surgery?" he said casually.
"Don't get defensive and protective. It's a craniotomy to remove a Grade IV tumor."
"That's a five-hour minimum."
"I'll be fine." She stood quickly, wanting to avoid this conversation. "Quit worrying about me." She knocked quietly on the door. "Dr. Burke?"
Bailey was inside but standing to leave, so Meredith let herself in. "Just giving you a head's up, Preston." Miranda said as she sauntered out.
"Anything I should know about, or is this secret?" Meredith said quizzically.
Burke shook his head. "It's fine. Dr. Webber apparently just called her to say he's coming to visit."
"Oh, that will be nice." Meredith said.
"What can I do for you?"
"I need an operating theatre—Thursday, preferably in the morning. I have a craniotomy. We're sitting a few days to give the steroids time to reduce swelling. Which one can you give me?"
Burke raised his eyebrow. "A craniotomy? That'll take some time."
Meredith quickly felt her patience wearing thin. "Burke—I've been at this hospital for ten years, working my way up, becoming respected, leaping when you say jump, working around the fact that I married my boss—you're not going to pull this protective crap right now. That's what it is—crap. You wouldn't do it to your wife—it's damn insulting. I've worked too hard to be mommy-tracked when my career is finally taking off. And if you and Derek are in cohorts, I will absolutely not tolerate it."
Burke looked slightly taken aback, but rightfully in his place. "Right." He looked down at his chart, which had the Board mapped out for the next week. "We'll put in OR 2 at 10 AM. Patient's name?"
"Kaitlin Baxter." Meredith rattled off her stats as Burke copied them down. "I'll see you later. And don't—do that thing, with my husband, were you plot. You're really pretty bad at it, you know."
"We'll try not to meddle." Burke smiled.
Meredith went through her day trying not to think about Kaitlin Baxter. She watched a surgery and tried not to think about it, and filled out patient forms trying to not think about it. She made it all the way to her OB appointment trying not to think about it. Derek was unable to make this one; he had to work until at least six.
"Dr. Grey? We're ready for you." The anxious, young-looking OB nurse said.
"Great." Meredith grabbed her purse. Her OB, Lenore Renard, was capable, smart, and always willing to speak up for Meredith when the boys wouldn't let her work. "Hey, Dr. Renard." She smiled.
"Hi, Meredith." Dr. Renard smiled, quizzed her briefly on her habits, routines, and any new insecurities before saying, "Well, let's do a sonogram and some tests."
First, there were the standard blood pressure and heart-rate tests, before the gel was spread over Meredith's gently swollen stomach. Meredith leaned back and relaxed. She was staring at the sonogram machine, smiling sleepily at the baby when she felt Lenore's wrist stiffen. "What's wrong?"
"See this?" Lenore said. "Look. Right there." She pointed.
Meredith gasped. "There's….there's a mass. Right there. Is that the lung?"
"It appears so." Lenore quickly finished the ultrasound. "I wouldn't be worried yet. Really, Meredith. Most of the time, any sort of mass will eventually dissolve."
"We damn well better be running more tests."
"Of course. I'll schedule one for…within the next two days. I'll call Izzie Stevens in on a consult. Don't worry, Meredith."
"Right." Meredith said slowly, the icy gel slowly cooling and freezing her to the bone.
