In Which Addison Teaches a Lesson
It's the middle of pretty stressful day at Seattle Grace Hospital but hey, at least it isn't raining, not that I've had the chance to go outside and enjoy the day anyway. I've been inside having back-to-back surgeries with the quints. Speaking of, I'm on my way up to see them right now.
When I arrive at the quints' room, I find all of Dr. Bailey's interns each manding one of the quints. It's quite an adorable sight but when I see Meredith, I have to stop at the Nurses' station to gather myself. I'm looking in the camera on my phone to make sure I look okay but I can't help but to overhear the interns' conversation.
"I have the best quint. Lucy," George says to the rest of interns, "she just smiled at me."
"She's nine hours old, George." Izzie retorts.
"I'm saying there are five babies here, and clearly, mine is the advanced one," he counters back.
"Charlotte's smart," Meredith injects, "She's got wrinkles on her foreheadㅡ very serious."
"Okay, 'A', this is not a competition, and 'B', my quint kicks your quints' asses," Izzie points out, "Emily is strong. She won't let go of my finger."
"Hey, Julie has her organs on the outside of her body," Cristina adds, "and she's still alive, thank you."
The incompetent intern walks into to the room just to chime in, "Kate's the best one." He checks her monitor then looks over at my intern, "Izzie."
"Leave," she says simply. I wonder what happened between them.
"Can we please just talk?" he asks.
"You're too busy screwing nurses to talk. Just get out."
Whoa, I wasn't expecting her to say that. Were they a thing? How could I not have noticed? He looks at Kate's monitor again then he asks before he leaves out, "Can someone make sure that Kate's vitals remain stable?"
"I will," Meredith offers.
As soon as he's out the room Izzie speaks up again, "He is unbelievable. I'm so glad I never slept with him. Which is his loss. Because I'm really good in bed. Mind blowing. Mind-blowingly good in bed."
"Are you trying to seduce us?" Cristina jokes.
"And he sleeps with Olivia, instead of me," Izzie laughs, "Olivia?!"
"Hey, I slept with Olivia." George says defensively.
"Well, then you both have bad taste," Izzie retorts.
I think I've heard maybe a little too much. I came here to talk to Meredith but if I go in now it may look weird. I just have to wait for the right moment. I see Miranda coming down the hall to check on her interns so maybe I'll walk in with her but for now, I can't help but overhear their conversation.
"You know, you can't say that you weren't warned," George says to Izzie, "Alex has always been Alex."
"You dodged a bullet, Iz," Meredith adds, "You're better off without him."
"Why are you even surprised?" Cristina says, "You sleep with a snake, you get bit."
"Thanks, guys... for the support," Izzie says sarcastically. Poor girl, she's a lot like me when I was her age. I wish I could do something to help but it's not my place. We're not even friends although I'd like to be someday. She's just my intern.
Miranda walks into the room seconds later, "Who's on-call tonight?"
"I am," Izzie says. It seems as though she's been on-call every night since the quints arrived.
"All right, the rest of you go home, sleep." Dr. Bailey looks around the room, "All five quints are still alive. It's a good day."
Miranda walks out the room and the rest of the interns file out behind. I spot Meredith and I walk up beside her pulling her away from the rest of the group.
"Hey, what are your plans for tonight?"
"I don't believe I have anything planned, Dr. Montgomery," she smirks. Our first date went really well and the second date we went out we saw a movie. It was a scary movie… I shouldn't have let Meredith pick. I feel like I looked like a punk the entire time but it didn't seem to run her away.
"I was thinking maybe we could do another dinner and a movie date. This time at my house? I realized that I've been to your place but you've never been to mine."
She giggles and shakes her head, "Does being drunk there even count?"
"Of course, as long as you remember it," I wink but after a pause I bit my lip, "Maybe it can just be a movie night because honestly, I can't cook but we could order take-out."
"Make it pizza and I'll consider it."
"Fine, pizza it is."
"I'll see you at," she looks at her watch, "seven."
"I'll text you my address," I say as she walks away. Now I have to rush home and prepare.
By the time it's seven o'clock, I have three movie choices for Meredith, I couldn't just pick one, the light dim, dip, two bags of chips, wine and the pizza literally got here 5 minutes ago.
I hear the doorbell ring and I have to restrain myself from running to the door. I let Meredith inside and welcome her to my home.
"Your house is beautiful, Addison," she says coming into the house, "I didn't know you lived on the beach. I'd have to come here more often."
That made me blush… I'd love to have her here more often but now I'm at a lost for words. "Oh, um, thank you. Uh, pizza just got here. I hope you like chicken on your pizza. If not, I also got cheese."
"You could put just about anything on a pizza and I'll eat it," Meredith said taking off her coat and grabbing a slice. I smile hard because she looks beautiful just reaching for a pizza.
If I'm going to ask her to be my girlfriend, I'm going to have to tell her about Derek. I was about to start that conversation when she grabbed the wine and pizza and went over to the couch, "So what are we watching?"
Ah, I guess it can wait until another time.
The next morning I'm in the NICU with the Russell's checking Emily's vitals when Dr. Bailey and her interns come in for rounds, "Oh, good. Here you are. Mom and Dad are anxious for an update. Dr. Yang?"
"We've done the initial surgery on Julie's omphalocele. A primary closure was attempted, but there was pulmonary compromise, so we couldn't contin-"
"Yang, how about we do this in plain English?" Dr. Bailey finally cuts her off. I'm glad she did before I could speak up. Tom helps Dorie sit down into a wheelchair as Dr. Yang tries again.
"Oh, um, we operated on Julie's external sack of organs, and we pushed as much of the bowel as we could, and we think we can push in the rest with a second operation."
"She has to have a second operation?" Dorie asks.
"Yeah," Cristina says simply and Dr. Bailey looks to her, "Oh, well, not for a few days."
"Dr. O'Malley?" I move it along seeing that there are five babies we have to talk about.
"We put in Lucy's brain shunt yesterday, and she's doing very well. We just have to keep monitoring her to make sure that the spinal fluid doesn't back up."
"Stevens?" I move it onto the next intern.
"Dr. Burke used a catheter to open Emily's atrial septum last night. Today we're gonna go in and try to reconstruct the left chamber of her heart. We're very hopeful."
I nod smiling then move on to the next intern, my favorite intern, "Dr. Grey?"
"Charlotte's lungs were a little more underdeveloped than the rest of the quints. So we put a special mask on her to help her breathe, and we're monitoring her closely."
"And that just leaves Kate," I move it along to the incompetent one. I made sure to give him the healthiest because frankly I wouldn't trust him with a cat let alone a baby.
"She seems to be pretty healthy. No major issues have been identified but we're gonna keep her in the isolette until she makes it to four pounds."
I look at Dorie and she seems so out of it. Tom noticed it too because he squeezes her shoulder trying to be hopeful, "You hear that, honey? Kate's doing really well."
"I'll be in my room," Dorie says as she wheels herself away.
"Dr. Montgomery..." the husband looks panicked as he looks to me.
"Tom, she's just had five babies. Her hormones are all over the place. You've just got to give her some time. She'll come around," I say trying to be helpful as we walk out of the NICU. I look at my watch and see that it's just about time for my surgery with Dr. Burke. I head upstairs to the OR.
I'm already basically done scrubbing in by the time Dr. Burke and Dr. Stevens get into the scrub room. He's asking her questions about the surgery. I guess they're in the middle of something since I only hear Dr. Steven's answer.
"First step in the Norwood is the cardiopulmonary bypass."
Dr. Burke then asks, "With H.L.H.S., what else do you get besides hyperplasia of the ventricle?"
"Stenosis or atresia of the mitral and aortic valves," she answers quick.
"Why are we using the RV-PA conduit instead of the modified Blalock Taussig shunt?"
"It limits diastolic runoff."
"Well, you've done your homework."
"I was on-call last night. I study when I'm on-call."
He chuckles and so do I a little but then he speaks up again, "Well, no matter what the books say, I guarantee you, you have never seen a heart this small."
"Betcha I have," I hear her say under her breath as I slip into the OR after Dr. Burke. I'm sure this is about Dr. Karev.
We're about five minutes into the surgery when we stumbled upon some alarming news about Emily's aorta, "We didn't see this on the echo."
"You can never get an exact measurement," Dr. Burke replies.
"What?" Izzie says not knowing what's going on.
"The baby's aorta is narrower than we thought. The diameter is only a millimeter," Dr. Burke answers, "just not getting enough blood flow."
"Damn," I say to myself. There's no way Emily is going to survive this. I have to tell her parents.
"I wanted you to see this before I started closing up." Dr. Burke says to me. I started moving closer towards the table.
"You're closing up?" Dr. Stevens questions, "You didn't do anything."
"Dr. Stevens," I try to shut her up.
"No, we barely started," she says.
"Dr. Burke has done as much as he can do for now, so unless you know how to do a First Stage Norwood then he's gonna close this baby's chest," I say straight to the point. I hope I didn't come off too harsh but she really needs to control her emotional outbursts... especially in my OR. My pager goes off. It's a 911 to the NICU. I rush off just hoping that we're not losing another quint.
"What happened?" I say entering the NICU seeing Dorie sitting over near Julie and Meredith over at Charlotte's incubator.
"She had an apneic episode. She's still not breathing on her own."
She moves over so I can take over clearly a little freaked out over the baby and I check her breath sounds then I start making quick life-saving decisions, "Let's intubate and give her surfactant. Push .1 atropine and 3 milligrams of ketamine."
"Meds are in," the nurse says a few seconds later.
"Tube," I say as I get her ready to intubate. Meredith inserts the tube and I nod, "Okay. Place the CO2 detector."
"She was doing fine with the chest tube," Meredith says to me as we get the baby breathing again.
"That's the thing with R.D.S. cases," I put on my stethoscope and listen for Charlotte's breath sounds, "Just when you think the baby's getting better, they can slip right back." I listen for a few seconds, "Breath sounds equal." I nod putting up my stethoscope,"Good."
Meredith takes a breath and then looks to the mother seeing that she got up and left, "Mrs. Russell?"
Later that day, I find myself sitting across from the chief in his office. I've been working with Izzie a lot… I've seen first hand how attached she can be with her patients. It's not good for her in the long run and I want her to be the best surgeon she can be… Maybe it's because I see a lot of younger me in her but she is extremely talented as well. All this thinking keeps bringing me back to one memory...
"Remember what you did to me when I was an intern?"
"How could I forget? You didn't speak to me for almost a year." I still slick hate him for it but it did make me a better surgeon in the long run. He continues speaking, "But you learned."
"Yeah, well, I think I gotta do that to Izzie Stevens."
"Well, she's smart, hardworking. Gets a little too involved with her patients. A lot like you."
"I know," I say sadly standing up, "It took me a long time to recover from that, Richard."
"But it made you a better surgeon, Addison." I nod understanding what he's saying... "The question is, is she talented enough to make the lesson worth it?"
"She's the best I've seen in years. I was hoping that we couldㅡ"
"You're not here to make friends, Addison. You're here to make better surgeons, and being a teacher can be a lonely business."
I nod walking out of his office and up to Dorie's room to talk to her about Emily's condition before I head out for the evening. I hate to have to tell her that she's going to lose one of her baby girl's especially after everything she's been through. I glance over to window to see Meredith in the room with the quints. We're supposed to be going to dinner tonight but I don't even think I can after today. I think I just need a drink.
I have all of the plan set up with the nurses before I go talk to Izzie. I find her down in the lobby as I'm about to leave. I'm glad she's still in her scrubs, "Dr. Stevens."
"Dr. Montgomery, is there something you need?"
"Yes, Dr. Burke and I have reassessed. We think there's a chance with the Norwood if Emily can make it through the next ten hours," I say putting on my coat. "Would you look after her for the night?"
"I was on-call last night," she says and I just look at her, "but, I mean, yeah, of course."
"Good. I left a list of meds, and uh," I pause for a second. I hate that I even have to do this to her, "and you're familiar with pediatric life support?"
"Got myself certified as soon as I got in the program."
"Okay then," I say walking away.
"Is there anything else I should know to look out for?"
"No," I say simply turning around to face her, "That should do it."
"Should I notify Mrs. Russell about Emily'sㅡ"
"No. I've done that," I sigh then I turn on my hard demeanor, "Dr. Stevens, this baby is your responsibility. She better be alive when I get back in the morning."
"Okay," she says as I turn around to walk away. I already hate myself for doing it. I want to call it off right now but I have to think like a teacher in this moment. She needs it.
When I arrive home, the first thing I do is pour myself a glass of wine. I don't know if I can handle this. I can't help but feel how I felt when Richard did to me so many years ago. I decide to run myself a bubble bath. I'd normally call Meredith and just talk to her but she's working tonight.
After my bath, I pour myself one more glass before making myself comfortable in bed. I grab my reading glasses and my book off the nightstand. I read my book until I drift off to sleep.
I'm in the room with Mrs. Russell the next morning when I see Izzie standing outside the door. She looks like someone just ran over her dog. Poor girl. I decide it's time to tell her. I come outside and I pull her away from Dorie's window.
"It wasn't your fault," I start.
"You put me in charge. I fell asleep," she shakes her head, "I killed that baby."
"No, you didn't. She was going to die anyway. She had a restrictive atrial septum and virtually no aorta. As soon as Dr. Burke opened up her chest, we knew she didn't have a chance."
"I don't get it," she says hurt and confused. "You ordered me to stay the night..."
"Izzie," I try to talk but she continues on.
"Take care of her. I worked my ass off doing C.P.R. and pumping her full of every drug on the planet, and, I mean, God, do you have any idea how scared I was? It was all for nothing?"
"Hardly. If the situation ever comes up again, I know you'll be able to handle the pressure."
"You lied to me," she looks at me with so much hurt in her eyes.
"You have to learn distance, Stevens. You'll be a better doctor for it."
"A betterㅡ a better doctor?" she shakes her head at me and scuffs as she walks away. That was so hard for me to do. She was the one of the only people I truly liked at this hospital and she probably won't speak to me ever again.
I walk back towards Dorie's room when I see Meredith in the next room over with the quints. I stop at the Nurses' station and I smile watching her in there with the babies. Dr. Bailey walks in and up to Meredith, "I heard you worked a miracle last night."
"Charlotte came around so fast, I thought the equipment was malfunctioning," her smile is so huge that they reach her eyes. "Her stats are completely stable."
"She's gonna make it. Go home, Grey. You earned it," Dr. Bailey says walking out then she turns around, "and Grey, way to go."
Once she leaves, Meredith turns back to the babies in the incubator together, "You heard that guys. She said 'way to go'."