Tuesday morning Owen and Teddy walked into the main conference room for the weekly attendings weekend. They were meeting this week to discuss some changes and challenges with the residency program. Teddy was glad to see intern schedules on the agenda before she could bring it up.
Bailey called the meeting to order. She went through the essentials like supervising residents at all levels in the OR unless a major emergency came up. Then she brought up the intern schedule.
"I have been notified by Human Resources that there is a problem with the intern schedule and I need you people to help me figure out what's happening. I have six interns who are routinely well over 115 hours a week," Bailey said, "my chief resident says she can't find the error in her schedule. Have any of you seen or heard anything?"
Teddy raised her hand, "do you have the list of which interns are routinely over?"
"I do. One is your daughter, it's also Joshua Riggs, Jenna Silverstone, Duncan Jones, Cassidy Liard and Jeremy Lee," Bailey replied, "all very strong interns."
Teddy asked, "do you know why it's routinely that group? Who are their residents?"
Bailey asked, "do you know something I don't Dr. Altman?"
"I can't say without breaking my daughter's confidence," Teddy said, "she came to me as her mother, not her attending."
Nathan said, "I've noticed Josh isn't himself. Something is worrying him. He keeps mentioning that if he doesn't pick up extra hours he'll be removed from the program."
Teddy nodded, "I'm worried about the health and safety of both our interns and residents if it continues. But I can't be part of the process of getting to the bottom of it. I'm involved personally as it includes my daughter and I'm reacting as a mother not as an attending. I see the exhaustion, the lack of time to eat, the stress and I have to be her mother not her attending."
Nathan added, "I'm out. I'm too involved. Josh is my nephew. He comes to me with his concerns as his uncle."
Bailey sighed, "two of my three cardio attendings out of this process?"
Teddy said firmly, "it has to be impartial. I can't be on this. Dr Pierce is the head of cardio and the only one of the three of us without a personal stake in it."
Richard asked, "what would you want us to do?"
Teddy replied, "meet with each intern and resident and check in. Go over their recent schedules with them and get the information."
Owen said, "compare the posted schedules to the time sheets, charts and OR logs. I know I consistently see the same residents and interns on the same shifts. Which means those with the Monday to Friday day shifts are only really getting scheduled procedures and the nights and weekends group is getting traumas and emergencies. It's not training good surgeons. We also need to let interns know that they can use on call rooms to nap. I've found them sleeping on old gurneys in the basement and the benches outside the OR."
Nathan said, "I found one of the interns sleeping on the floor in a supply closet. I agree with Teddy and Owen that all schedules need to be re-evaluated and the hours worked compared to their scheduled hours. This needs to be looked into."
Meredith asked, "why is it suddenly a problem now? This has never happened before."
Amelia spoke up, "I have heard of some senior residents that are uncomfortable working with the children of attendings as their interns. They find it difficult to be good teachers for them when they find out who the parents of their intern is. It's intimidating for them."
Owen asked, "Jo Wilson is uncomfortable with Grace?"
Amelia replied, "I never said it was Wilson but who is she close to?"
Richard said, "I will meet with them all over the next couple of weeks. Until then I will build a fair call schedule for all residents and interns. Do we have any requests for specific ones on your services?"
"Grace Altman," Nathan said, giving Teddy a wink.
"Joshua Riggs," Owen called.
"Jenna Silverstone," Teddy said.
There were a few other requests that Richard wrote down.
Bailey asked, "if any one has heard anything or thinks they hear something please come speak with me or encourage the intern involved to see me or Richard privately."
Teddy shook her head. There was no way Annie was going to go forward. She knew Annie's style, head down, work hard, be as close to perfect as possible and don't rock the boat. Annie had seemed perkier when they passed in the hall earlier. Teddy hoped that being home the last two nights and in her own bed had helped. Teddy also thought having time with Josh May have helped improve Annie's mood.
Richard began to plan his interviews with residents and interns.
"Dr Altman May I have a word," Richard said.
"Of course," Teddy replied.
Richard said, "you did the right thing excusing yourself from the investigation."
Teddy nodded, "it was the only thing I could do"
"Grace is on my service this week," Richard said.
"She was to have ortho with Torres," Teddy replied.
"Torres is taking some personal days last minute
. I took the four interns assigned to her this week," Richard said, "which interns do you have?"
Teddy replied, "none. I'm not usually assigned interns. I'd really like them. I love teaching. I'd like to really focus on building the education program for the cardio department."
"I'll consider that. I've seen you teach you get great results from your residents," Richard said, "do you want interns this week?"
"Please send me any one," Teddy said, "I hardly know this group yet. I'm also happy to take residents. I'll take on a fellow again next summer."
"I'll send you Grace Altman and Jenna Silverstone," Richard said, "they're a great team from what I've seen. A peppy version of Grey and Yang. Can you teach both fairly?"
Teddy nodded, "I will push Grace a bit harder then the others. I know where the line is and how much she can handle. I expect a lot from her but she trusts me."
Richard said, "push Silverstone. I have a good feeling about her."
Teddy replied, "I will. I have a couple things that will be good for them to do today with me supervising. Get their gloves dirty. Tomorrow I'm in the OR most of the day."
Richard said, "go page your interns and tell them. Grace is observant, good with patients and families and picks things up quickly. You taught her well."
Teddy smiled, "thank you. I should get them briefed of our day."
Richard replied, "I'll talk to you later and please encourage grace to be open and honest with me when I interview her."
Teddy replied, "she won't lie but she will omit details or names to avoid getting herself in a position that she feels is risky."
Richard asked, "would she speak freely with another attending besides you?"
Teddy replied, "ask Owen to help you with all your interviews. They all seem to like and trust Kepner and Robbins as well."
Richard replied, "thank you Teddy."
"Thanks Richard," Teddy said, stepping out of the office.
Teddy sent a message for Jenna and Annie to meet her at the cardio nurses station.
"Why is your mother paging me," Jenna asked.
"She's paged me as well," Annie replied.
"It's not like we're doing anything Torres isn't here," Jenna said.
"I was waiting for an incoming trauma and seeing if Hunt or Kepner needed me," Annie said.
"Do you really like trauma surgery," Jenna asked.
" I like it and if I can be there for someone who went through what I did and help them I'd like to be," Annie said.
Jenna asked, "what do you mean? Your always so cryptic about life before medical school."
Annie took a deep breath, "when I was 19 there was an incident with my sister. I needed an emergency laparotomy and lost half my liver. I still have the scar. Only Josh, mama, Owen and Webber know."
"Why does Webber know," Jenna asked.
Annie replied, "he was one of the doctors treating me."
"Is that why you always have a tank top under your scrubs," Jenna asked.
"It hides that scar and some of the one on my back. But I also hate the feeling of the scrub top," Annie said.
"How did that happen," Jenna asked.
Annie shrugged, "my sister."
"Sister," Jenna asked, "I thought you were an only child."
"I have two soon to be three siblings," Annie said.
"So the rumors about your mom and Dr Hunt are true," Jenna asked.
Annie nodded, "not like they've kept it a secret."
Jenna asked, "how old is she? Your what 27?"
"I'm 25 next month," Annie said, "she was only 21 with me. My other two siblings are my adoptive parents children."
"Are you going to do anything for your birthday," Jenna asked.
Annie replied," probably not. Birthdays aren't a big deal. Hopefully both Josh and I are off. I'd be good with a family dinner."
Jenna said, "why don't we go get drinks that weekend at least."
Annie nodded, "that would be good. Grab the guys from our group?"
"It's your boy friend and Duncan is hot so that works for me," Jenna said.
"Good morning," Teddy called as Annie and Jenna approached the nurses station.
"Good morning mama," Annie said, "why did you page us?"
"Dr Torres is out for the rest of the week so you're on my service," Teddy said, "we're already behind let's get going."
"What are we doing," Jenna asked.
"Today isn't surgical unless we get an emergency. I'm cardio for the pit today," Teddy said, "two angios and two other tests. You'll both do one of each. Grace you will go first. I know you've seen me do both of these procedures before."
"In undergrad," Annie said, "but I helped Dr Riggs a couple weekends ago."
"Nathan," Teddy asked.
Annie nodded.
"Rounds first," Jenna asked.
"Already done," Teddy said, "I like to do my rounds early. I'll give you half an hour to get up to speed."
"Thank you," Jenna replied.
"I'm on it," Annie replied.
"Do you have any questions," Teddy asked.
Both girls shook their heads.
"I'll see you up there then," Teddy said.
Annie and Jenna introduced themselves and picked up the first patient.
Getting to the lab Teddy reintroduced herself and explained that she would be overseeing the two interns.
"Are you related," the man asked Annie and Teddy.
"We are," Annie said.
"How," asked the old man.
"She's my daughter," Teddy replied.
"I worked for my dad then my son worked for me in our law firm," the old man said, "it's nice when family can share a skill."
Teddy nodded, "it's the first day I've had Grace on my service. It's a nice change for us."
"Are you ready Mr. Johnson," Annie asked.
"I am," the old man replied.
Annie looked at Teddy who nodded for her to begin.
Annie prepared the area and began the procedure. Teddy guided and prompted as needed. She was pleased with the skill Annie was showing even though Annie looked very anxious. Teddy leaned forward and whispered , "breath. Just relax. You're doing fine."
Annie nodded and continued with her task.
After taking Mr. Johnson back to his room Annie and Jenna walked to get their next paitent.
"Will your mom be that supportive when I do mine," jenna asked.
Annie smiled, "that's mama. She loves to teach. You can tell her you're nervous while I take the patient in. Ask questions, she tells me asking questions, let's her know what I'm thinking and what I know."
"She won't mind," Jenna asked.
Annie shook her head, "not at all. She wants us to be open and honest with her. She just knows me."
"The two of you sitting like that side by side to look at the screen, it's crazy how much you look alike," Jenna said.
Annie laughed, "there's a picture when I was 19 the first time I scrubbed in with her and Owen. She lent me one of her scrub caps and it's scary how alike we look. She always has it up in her office."
"You're shorter and smaller," Jenna pointed out.
"A lot shorter," Annie said, "my bio dad's side must be short."
"She's told you nothing about your dad," Jenna asked.
"She's told me everything she knows," Annie replied, "there's very little her and I don't talk about."
They picked up their paitent and went back up to the lab. Teddy again explained why she was sitting back and Jenna was doing the procedure.
"I'm a teacher," the woman said, "you have to let them do it."
Teddy agreed, "the only way to build their skills is to do it. Are you sure your okay with an intern?"
"Let the young doctor try," the woman said.
"Silverstone you're up," Teddy said.
"Right away dr Altman," Jenna replied.
Jenna completed her procedure with prompting and encouragement from Teddy. Jenna also got tense at the halfway point as she was starting to get close to the heart. Again Teddy leaned forward and whispered, "you're doing good Jenna. Just breathe, relax your shoulders."
The woman on the table smiled, "you know your students well Dr. Altman."
"I've spent time with both of them," Teddy replied.
"I can tell," the woman said, "have you been teaching them long."
"Grace I've worked with for six years," Teddy said, "Jenna I've known for a couple months."
"Do you have children Dr. Altman," the woman asked.
"I do," Teddy replied, "do you?"
"Three boys," the woman said, " 21,18 and 14. How old are yours?"
"My daughter is 24," Teddy said, "tell me about your kids."
"My oldest is studying engineering, my middle boy wants to join the army and my youngest likes basketball and football," the woman said, "your daughter?"
"She's a surgical intern," Teddy said, "your boys sound wonderful."
"Is that why you take so much care teaching your students," the woman asked.
Teddy smiled, "my Annie influences my teaching for sure."
Annie had to resist rolling her eyes at Teddy.
Teddy continued, "are you close to your boys?"
The woman nodded, "we lost their father a few years ago. My boys are my world."
Teddy nodded, "I understand that."
Teddy looked back at the screen, "good work Jenna. You can make your way back out. Keep your eyes on the screen, slow controlled movements."
Jenna's hands were shaking.
"Jenna, shake out your hands," Teddy said, "you're holding your instruments too tight. Let me hold them while you shake your hands out."
"Grace , Jenna ," Teddy said, "what is the follow up from this procedure?"
Annie replied, "observe, medication, follow up in 4-6 weeks."
Jenna finished the rest of the follow up procedure.
Annie went to meet Teddy after they dropped the patient back off in her room, "mama, I've been thinking."
"You thinking," Teddy teased, "this must be serious."
"It sounds weird for you to call me Grace here," Annie said.
"I don't like it either," Teddy said, "I wasn't sure what you wanted. I keep wanting to call you Annie."
"Josh uses Annie here, Owen just yells Altman," Annie said.
"The crazed sea lion call of Altman is yours," Teddy laughed, "he never yells at me like that."
Annie teased, "no you get Teddy or Teds."
"You heard that," Teddy asked.
"Living room couch," Annie said, "I was in the kitchen."
"You have to be louder let us know you're there," Teddy said.
Annie said, "being all cute doesn't bug me."
"Evelyn texted me," Teddy said taking her phone out of her pocket, "Meghan was asking about her old costumes. She wants to show Faroke and see if they still fit."
"I have her Aboyne," Annie said, "it's in the closet in the laundry room."
"Evelyn just texted me," Teddy said, "she's going to tell Meghan you have it and why. But if they want could they borrow it back?"
"I'm not using it," Annie said.
At evelyns
Evelyn sat on the couch with Meghan.
"Sweetheart," Evelyn said , "I have your kilt outfit but about a year after you disappeared Owen and I agreed that we could part with your other outfits. I know where your Aboyne is. I just need to text Teddy and we can get it."
"Why does Teddy have it," Meghan asked.
"Not Teddy exactly," Evelyn said, "I sold it to the McKellar family. They bought it for Annie when she was sixteen."
"So Teddy's daughter has had it all these years," Meghan asked.
Evelyn nodded, "she has. They had it hemmed for her and she made that outfit dance again. I saw her dance a couple times. When she would go to the Seattle games I would go with Owen and Teddy to watch."
"Are there any pictures," Meghan asked.
"Teddy would have them," Evelyn said, "Annie was a beautiful dancer. She was canadian champion a few times and has placed at worlds."
"I'd love to see that outfit one more time," Meghan said, "it was my favourite. You made it for me, it had my name embroidered in the vest."
"Let Annie or Teddy know," Evelyn said, "your name is still in it. But I added Annabeth McKellar then Grace Altman, so it has all three names in the vest now."
"It's a family vest now," Meghan said.
"It is," Evelyn agreed.
"How perfect is it that it found Teddy's daughter before anyone knew Annie," Meghan asked.
"Teddy and Owen said that years ago," Evelyn said.
"Annie had come down for a week to observe at the hospital with Teddy, and the Seattle Games was the first weekend she was down. It was hot, it must have been over 100 in the shade and it was the first outdoor competition Teddy went to. Owen invited me to go with him and we were sitting with Teddy while Annie met her teacher for warm up. Owen recognized the outfit in the costume bag. I almost cried, zipping up the back and pinning the plaid on Annie's back. It made me miss you," Evelyn said, "I cried watching her Blue Bonnets, she made that outfit dance for me one more time."
"I'm glad it went to someone who could make it dance," Meghan said.
Teddy texted Evelyn and Meghan , "the pictures are a few years old."
Meghan, "send them anyway."
Teddy went through the years of photos saved in her phone and found the ones she liked of Annie dancing. She didn't have her all time favorite on her phone, but it was framed in a box to put up in the new house.
Teddy, "sent some of my favourites. Annie or I will bring the burgundy one by tonight. Do you want to see the Jig and Hornpipe?"
Meghan, "just the national."
Teddy, "one of us will bring it too you soon."