10 days later
Teddy's phone went off in the middle of the night. It was a BC number she didn't recognize, "hello?"
"Is this Dr. Teddy Altman," asked the male voice on the other end.
"Yes," replied Teddy, "may I ask who's calling?"
"This is Dr. John Smith from Surrey Memorial Hospital, your daughter Annabeth McKellar has been asking for you," the voice said.
"What happened to Annie," asked Teddy.
"She has sustained blunt force trauma to her chest and abdomen, there are also several laseractions on her face and neck," the doctor spoke, "she is refusing to let us call the parents listed as contacts in her file. Given that Annabeth is 19 I have to honour her wishes and call you."
"Do you know how she sustained the injuries," Teddy asked.
"Your daughter isn't talking, she's just asking for you," the doctor replied, "she only told me to call you that you're a doctor."
"I'm a cardio thoracic surgeon," Teddy replied, "but I do a lot of trauma as well. What can you tell me about Annie's injuries?"
"I'm waiting for her CT, she's on her way there now," the doctor said, "we've drawn labs and are waiting for them back."
"On the initial exam what came up," Teddy asked.
"Decreased breath sounds on the left with a pneumothorax, I placed the chest tube," tension and swelling in the abdomen," the doctor said.
"Are you an emergency room physician," Teddy asked, "I want a trauma surgeon on her case."
"I am a trauma surgeon," the doctor said.
"What is your plan after the CT," asked Teddy.
"Take her up to the OR and repair any damage," he said.
"What do you think it is," Teddy asked.
"Where the major bruising is concentrated I'm concerned about her liver, kidneys and spleen. Once we have the CT we will preform a laparotomy and repair any damage," the doctor said.
"Open or laparoscopic," Teddy pressed.
"It depends on the CT but likely open," the doctor said.
"Then I want plastics to close and to do the facial lacerations," teddy commanded.
"Mam we don't do that here," the doctor said.
"You do as your patient wishes," Teddy said , "I am my daughters advocate."
"We will try to call plastics in," the doctor replied.
"I also want you to contact your police department, treat all of her injuries as suspicious," Teddy said.
"Do you have reason to believe she was beaten beyond the injuries," asked the doctor.
"Yes," replied Teddy, " I think it was her adopted sister Jessica McKellar. Jessica has bipolar disorder as well as borderline personality disorder."
"We need your daughter to confirm," the doctor said.
"Annie is not to talk to the police until I am there and she has had all of her injuries treated," Teddy commanded , "no one is to see her until I arrive."
"Where are you coming from Dr Altman," he asked.
"I'm in Seattle Washington, I should be there in three hours," Teddy said, "I will be out my door in 10 minutes."
"I will let your daughter know," the doctor said.
As she had been talking Teddy had thrown items into her overnight bag. Clean pajamas, a few pairs of shorts and shirts, some sweats and a hoodie, socks, underwear and bras.
"How is her mental status," Teddy asked.
"Anxious but alert and oriented to time and place, pupils are equal and reactive," the doctor said, "we did a head CT as a precautionary measure."
"Thank you doctor," Teddy replied, "I'm on my way."
Teddy hung up on the hospital and called Owen.
"Teddy what's going on," Owen asked.
"It's Annie," she sobbed , "she's at Surrey Memorial Hospital."
"Why is Annie at the hospital," Owen asked.
"She was beaten, I think Jessica did it. She was in CT when the doctor called me, their preparing for a laparotomy and to fix a pneumothorax," Teddy cried.
"I'm coming to get you," Owen said, "I'll be out the door in 5 and at your house in 15."
"You stay," Teddy cried , "I know Christina is just back but tell her she's running my service."
"Teddy you can't drive," Owen said , "of course I'm coming."
"Owen I'm fine," Teddy protested.
"No you're not Altman," Owen said, "call Richard and tell him. I'll see you in 15."
Owen drove like a mad man to Teddy's where she was waiting on the porch with her overnight bag and purse in either hand. She threw them into the back seat and sobbed as Owen headed towards the interstate and turned north. Owen hadn't seen Teddy this upset before.
"Teddy breath," Owen soothed, "we're getting there as fast as they can. The surgeon will do exactly what we would. They'll call you with updates."
"I just don't want Jessica to get close to her," Teddy said.
Owen asked, "where are Leslie and Dan?"
"Annie asked that they not be called," Teddy replied, "she's very afraid of Jessica she's been threatening Annie for months."
Owen asked, "did you tell the hospital to get the RCMP?"
"I asked for the police," Teddy said, "and told them about Jessica."
"Have you called her parents," Owen asked.
Teddy replied, " I will when I know more and have talked to the surgeon."
"Call them," Owen said, "you'd want them to call you if they were there with her."
Teddy pulled out her phone and called Leslie's cellphone it must have been off because it went straight to voicemail. She left a short message stating that Annie was in the hospital and that she was on her way up, that Annie had requested that only Teddy be at the hospital. She called Dan and left the same message. Teddy decided against calling the house she didn't know where Jessica was and didn't want to make things any worse for Annie.
"Do you know where they are," asked Owen.
"Annie didn't say anything to me, but if she was at the house they should have been home," Teddy replied.
Teddy's phone rang and she answered "Doctor Smith what's your surgical plan?"
The doctor replied , "open laparotomy, repair the damaged lung hopefully I don't have to fully open her chest. I have a cardio thoracic surgeon for that part. While she's under general plastics will deal with the facial lacerations. The concern is her liver and spleen on the CT her kidneys were okay as well as her stomach and bowel. Before we put your daughter under general is she on any medications?"
Teddy replied , "birth control and levoxothyrine 75 micrograms. She's allergic to strawberries and cashews the nut allergy is anaphylactic. She has adolescent onset hashimoto's disease please check her TSH T3 T4 and TPO. Her last levels a month ago were optimal."
"I can see all of her labs for the last 4 years in our system but we will monitor those levels," the doctor said.
"If anything changes in surgery you have my permission to do whatever you see fit to save her life," Teddy stated clearly.
"Annabeth was of sound enough mind to make that decision and has agreed to any and all life saving measures. We're going to take her up to surgery. When you arrive go straight to the emergency department. The main desk will be closed at this time of night the triage nurse and admitting clerk will direct you to Annabeth," the doctor said.
"Please call her Annie," asked Teddy, "she hates Annabeth."
"I will," replied the doctor, "thank you for your time mam."
"Thank you doctor," Teddy said and hung up.
Owen took her hand in a gesture of support , "how long has Annie had hashimotos?"
"She got sick at 15 and it took almost a year to get a diagnosis so she was 16 when she was diagnosed," Teddy said , "she doesn't complain though. Just when she's really tired or cold. She fell asleep in the car after the dance competition the day you and your mom came."
"Is it controlled," asked Owen.
"I went to her last doctor's appointment with her. She wanted my opinion on that and a couple other things, she was scared to take Leslie," Teddy replied , "her thyroid levels have all been optimal for 15 months on her current dosage. I worry the trauma will mess that up though."
"She's a strong girl," Owen said , "we'll get her though this."
They drove in tense silence for most of the drive Teddy lost in thought of all the what if's and the fear of losing Annie so soon after finding her. She also wished Owen was hers not just her best friend but her husband. The way he jumped to come with her tonight pulling himself from much needed sleep he cared about not just Teddy but Annie. He saw her daughter as family.
Owen looked at his best friend slumped and anxious in the passenger seat. For a moment he wondered what would have happened tonight if he had chosen Teddy in Iraq when he had the chance. He knew she was dating Andrew Perkins and technically married to a patient. He already considered Annie family. Going to the strange hospital with Teddy would be so much easier if he was Annie's stepfather. They had no pull, no connections and no clout in British Columbia.
There was no line at the border and the guard hearing their reason to travel so late and the military ID tucked into both passports waved them through.
At the hospital Owen threw the truck in park and lead teddy into the emergency room. He noticed that teddy seemed deflated some how, the joy that had filled her since October was gone. He had seldom seen Teddy this withdrawn.
Teddy walked to the admitting clerks desk and identified herself using her full name and military title as well as her position as SGMW before asking for Annabeth Grace McKellar, she was able to clear the security questions quickly, date of birth, place of birth and date of adoption.
A man approached Owen and asked , "are you with Teddy?"
"I am," Owen said guardly.
"I'm Jim McKellar Dan's brother," the man introduced himself, "I've been waiting for hours to hear how Annie is but they won't tell me anything. They said that Annie had asked for a Doctor Theodora Altman to be her only contact."
"That would be Teddy," Owen said.
"I met her at Easter but didn't know her full name," Jim said.
"I'm Owen Hunt a friend of Teddy's we served together in Iraq and work at the same hospital in Seattle she wanted my second opinion as our head of trauma," Owen said.
"My daughter Catherine says Annie has gotten really close to Teddy in the last year," Jim said.
"They have," Owen agreed. He was trying not to give any information to this man.
"Can you take me to see her," Jim asked.
"At this point I know what you know," Owen said , "Teddy will make the decisions until Annie is alert and oriented."
"Do you think she'll be okay," Jim asked.
"I hope so," Owen replied , "I'm going to trust that the staff here does exactly what I would do if Annie was my patient. And until teddy gets her chart we won't know what is happening."
Teddy joined them and greeted , "Jim what are you doing here?"
"Both girls we're at cousin night at my sisters house when Jessica attacked Annie. Catherine Called 911 and they took Annie in an ambulance and Jessica in an RCMP car. Dan and Leslie are in Hawaii for the week they get back at 2:30pm," Jim explained.
"I've left them both a message so I expect they'll come straight here," Teddy said.
" with you here taking care of Annie they may have to deal with the police first about Jessica. Both of my children Shannon and Catherine have spoken to the RCMP," Jim said.
Owen questioned , "the police are already involved."
"All of the cousins who witnessed it have been asked for a statement. They have all spoken with RCMP," Jim said , "from the sounds of it Jessica lost it over a game of apples to apples and tried to beat Annie to a pulp with a pool cue."
"Have you told the doctor," asked Teddy.
"They won't speak to me because I'm not next of kin," Jim said, "and Annie asked only for you."
Teddy made a snap decision. She liked Jim and knew him and his daughters were some of Annie's favorite relatives, "come with us to the surgical waiting area. They're sending a resident to show us the way. Sit with us until we know more. I'm going to ask Owen to be my second brain on this because he's not as attached to Annie as I am."
The resident approached them , "major Altman if you could follow me please."
Teddy replied , "Dr Altman is fine. This is Dr Owen Hunt and Jim McKellar."
"Major Owen Hunt the trauma surgeon who builds OR tables out of exploded tanks in the middle of a battle field," asked the resident.
"It was a hum v ," Owen said.
"It's an honor to meet you sir," said the resident.
"Thank you," Owen said awkwardly.
"You're a legend," the younger doctor said.
Owen laughed , "okay. I was just doing my job."
They reached the surgical waiting area and saw a few other families huddled in pairs or groups of three.
"What's going to happen to Jessica," Jim asked.
"How old is she," asked Owen.
"Jessica is 16," Jim replied.
"Legally she's still a minor," Teddy said , "I'm aware of both diagnoses but also of the recent history with her sister. She should be undergoing a psychiatric evaluation and placed under a psych hold until she's no longer a risk to herself or others and they get her stabilized."
"How do we start that process," asked Jim.
"The police will have a policy but her parents may request her to be transferred to the psychiatric unit here," Owen said.
"They need to take Jessica to children's hospital in Vancouver," Jim said , "this isn't equipped for kids and teens the way children's hospital is . Plus my wife is one of the high school teachers that works with the kids at children's."
"Their parents can request a transfer," Owen said.
"I only have Annie's permission to be her advocate," Teddy said.
"What if the worst happens," asked Jim.
"We make decisions then," Owen replied.
"If she doesn't make it off the table I know Annie is a registered organ donor," Teddy said , "we give permission for a harvest surgery."
"Without her parents," Jim asked.
"Her and I have talked about it," Teddy replied, "she registered a while ago after her pas de deux partner was killed. Annie made the choice. Asking us would be a political move more than legal. It's what Annie wants. She's also seen me do a heart transplant and a heart lung transplant. "
"She saw Richard's liver transplant last week," Owen said.
"She doesn't watch live does she," asked Jim.
"She was in the gallery for the liver and the heart lung," Teddy said, "but I brought her into the OR with me for the heart last week. She loved it."
"What do Leslie and Dan think," Jim asked.
"We've sent Leslie pictures," Teddy said , "she was shocked the first time, but seems happy."
Hours later the doctor came out , "Dr. Altman."
Teddy stood, "I'm Doctor Theodora Altman."
Owen followed her closely.
"Doctor John Smith," replied the Doctor, "Annie is in the post anastezia unit."
"How is she," asked Teddy, "when can I see her."
"If you don't mind scrubbing and putting on an isolation gown you and your husband may come now," Doctor Smith said.
"Thank you," Teddy replied.
"Of course dr Altman," dr smith replied.
Owen asked , "how is Annie? What did you need to repair."
"Her internal injuries were extensive. I was able to repair her spleen but had to resect 40% of her liver to control the bleeding,``Dr Smith replied.
"How much blood was she given," asked Teddy.
"Your daughter needed 10 units of blood and 3 units of packed cells," Dr Smith replied.
"You mentioned a pneumothorax on the phone," Teddy asked.
"We have repaired the damage without a full sternotomy," dr Smith said , "she's still intubated and with some sedation. Her chest tube will be in place for a few days."
"I've taken an emergency leave from my hospital, my resident and fellow are covering my service," Teddy said.
The doctor showed them into the room and to Annie's bed. Teddy stood beside the bed and brushed Annie's hair back before leaving a kiss on her forehead , "it's okay sweetie I'm here little bear so is uncle Owen. We have you, you're okay."
"Annie you've got this. You're strong," Owen said , "we're here it's time to open your eyes."
Teddy grabbed Annie's hand, "she's squeezing my fingers Owen."
"Good," Owen said, "keep talking to her."
"Sweetie open your eyes you can't talk with the tube in your throat to help you breath, just look at me," Teddy soothed. Her free hand stroked the messy blood soaked blonde hair back from Annie's forehead.
Annie opened her eyes and tried to cough.
"You have a tube in your throat to help you breath," Teddy said , "look at me and stay calm. Annie listen to my voice."
Owen got the doctor , "she's breathing over the tube and fighting it. I'm going to take it out."
The doctor came , "Annie I need you to try to cough for me. I'm going to take the tube out of your throat."
Annie coughed. The Doctor pulled the tube out.
"Mama," Annie cried.
"It's alright little bear," Teddy said , "I have you."
Owen came to the other side of the bed, "your okay Annie we're here. We have you."
Annie tried to sit up , "mama I'm scared."
"I know little bear," Teddy said , "I won't let Jessica hurt you again. Uncle Owen and I are here."
"What's wrong with me," Annie asked , "where am I?"
"You're in the PAC unit at Surrey Memorial hospital," Teddy said , "you've had major surgery. You were in there 6 hours. The doctors had to fix your spleen and remove part of your liver. You had 10 units of blood. You're going to feel bad for awhile. In a little while their going to move you to ICU."
"Don't let mom and dad in," Annie said, "they'll be mad and I'll have to apologize to Jessie again."
"I'll do what I can," Teddy soothed, "no one is mad at you sweetheart. You did nothing wrong. You're okay, I have you. Right now you need to rest."
"I'm thirsty," Annie whined.
"That's a good sign. I'll go get you some water," Owen said. He went to get water from a nurse.
Owen listening realized that Annie was being abused not by her parents but by her sister. Right now she needed the same protection they would give victims of domestic abuse that came into the pit. He knew the police were aware of the situation. He also saw tonight just how deeply Teddy loved Annie. Teddy would fight for her and be strong for Annie. Tonight Teddy was a mom, he knew one day he would fight for his own kids that way. Christina would understand that Teddy was his person and he would be there for Teddy and Annie. Owen texted Christina and let her know what was happening and not to expect him the next night. Teddy had held him together when Dan died, when he lost his platoon and when Megan disappeared. He would be here though this with her and Annie.
Owen wordlessly handed Teddy the cup of water and straw. He placed his hand comfortingly on her back.
"Little sips," Teddy said, holding the straw to Annie's lips.
Annie drank most of the cup of water.
"That's it Annie," Teddy soothed.
Checking her watch Teddy saw it was 5am. A nurse came to Annie's bed, "dr Altman we're going to move your daughter to the intensive care unit. I'm going to ask you to go to the waiting room on floor 5 east. We will come find you and your husband when Annie is settled."
"Thank you," Teddy said. She took her purse off the chair.
"They're going to move you now," Teddy said to Annie , "I'll see you soon." She squeezes Annie's hands again.
"I'll be with your mama," Owen said, "you'll be fine."
Owen led Teddy down the hall and to the elevator. They both noticed that Jim was no longer in the waiting room.
"She called me mama," Teddy said as they walked.
"She did," Owen said , "she has to think of you as her mama. She can't filter with that much pain medication in her system."
"She's always been my baby," Teddy cried , "I just wish it didn't take this to get her to call me mama."
"Right now she needs her mama," Owen soothed. He gave Teddy a hug.
"Why do all of their staff assume you're my husband," Teddy asked.
"Because I came in with you," Owen said, "I'm supporting you and Annie."
"You're my person Owen," Teddy whispered, "I need you here."
"I'll stay as long as I can ," Owen said , "I won't go until she's out of ICU."
"Christina is going to kill me," Teddy said.
"She knows you're my person and Annie is my niece," Owen said , "Christina crawls into bed with Meredith and Shepard. She will be fine with me sitting at the hospital with you."
They sat down in the waiting area outside the ICU. Teddy spoke to a nurse and asked them to clean Annie up a bit and to try to get the blood out of her hair, she was told that it was part of the settling in process.
Teddy sat in her chair with her head in her hands. She didn't know what to do, she knew her next step was a conversation with Annie's parents. She didn't know how to talk to them as a fellow parent, Teddy could have this conversation as a doctor but as a family member she was lost.