In the morning Annie texted Teddy.

Annie, "mama can we do coffee in your office after my review?"

Teddy, "i'll probably have Allison but come by."

Annie, "text me when you take her back to daycare."

Teddy, "you okay?"

Annie, "I just want to talk to you."

Teddy, "she doesn't understand yet."

Annie, "I need half an hour just you and I."

Teddy, "what's going on?"

Annie, "I'll talk to you later."

Teddy, "okay. Text me when you're on your way up and I'll take her back to daycare."

Annie, "thanks."

Teddy asked Owen, "do you have any idea why Annie wants to talk to me alone not even Allison around?"

Owen relied, "just listen to her. There's a lot on her mind. Just listen."

Teddy," I always listen to her."

Owen, "just give her the time. I think she misses your adventures and her time with you. You and her had a lot of fun before Allison and I and you haven't done that since you came back to Seattle."

Teddy asked, "did she say something to you?"

Owen, "not in as many words but she's been quiet and pulling away from us. I know she's 25 but there's a lot of ways shes still very young and insecure. I'm starting to wonder if she ever had a strong secure attachment to Leslie or Dan. The more I read about attachment theory and making sure Allison is secure the more I wonder about Annie having had secure attachments to the family that raised her. We need to spend time with her."

"She is insecure in how she fits in with the family," Teddy said, "but I don't know how to help that. I've talked with her and tried to show her. Meg has two. Maybe I need to find a day off and Annie and I go for an adventure and you spend the day with Allison. Ali can have solids now so she doesn't need as much milk left for her and I can plan ahead and leave extra bottles. Your attachment theory idea may be worth a look. Or is it how her PTSD plays out? We both know that it can do weird things and make you distrust the people you love."

"Just listen," Owen said, "that's all she wants is to feel listened to. It could easily be PTSD she's had significant trauma."

"I will," Teddy said, "I do want to wish her luck before her exam."

"Go wish all of them luck," Owen said, "I'm coming too."

Annie and Josh put their bags away in the locker room and walked to the skills lab to do their exam. Teddy and Owen were waiting in the hallway outside.

"Good morning mama, Uncle Owen, Ali bean," Annie called.

"We're just here to say good luck and we'll be out of your hair," Teddy said.

Owen stuck out one pinkie, "good luck Annie go be awesome."

Annie connected pinkies with him, "thank you."

Teddy held her free arm out for a hug, "good luck sweetheart."

"Thanks mama," Annie said, returning the hug.

"Allison can you give Annie a kiss for good luck," Teddy asked the baby.

Annie kissed her baby sister's cheek, "thanks Ali bean. Have fun at daycare."

Annie went into the room and sat at her assigned seat. She took out her pencils and added her name and ID number to the scantron page. She was relieved that the whole test was multiple choice and she just had to colour in the bubbles for the answer she wanted.

The proctor called for the interns to start the test. Annie took a deep breath, she had four hours and she would use the whole time to make sure she was through. Her career was riding on this exam. After the first two hours only half of the interns remained in the room. Annie still had half of her test to go. She worked methodically through the questions.

"Five minutes remaining," the proctor called.

Annie had three more questions to go, she read them and quickly bubbled in her answers. This had been harder than she expected.

"Time," the proctor said as Annie filled in her last bubble, she looked around the room and she was the only one left.

Annie handed in her test book and scantron page. She checked her watch, she had 30 minutes before her meeting. Annie grabbed her lunch from the locker room and found her friends in the deserted stairwell to eat.

"That was hell," Annie said.

"You're the last done," Julia said, "we've seen everyone else."

"I know i'm the last done," Annie said, "some of those questions were tricky."

"They were," Jenna agreed, "I just guessed on a couple."

Annie chatted with her friends for a few more minutes then walked to Bailey's office.

Annie knocked on Bailey's door.

"Dr. Altman come in," Bailey greeted.

"Thank you Dr. Bailey," Annie replied.

"As you know we're here to discuss your progress this year and your future in the program," Richard said.

"We have some feedback for you both positive and constructive," Bailey said.

Jackson asked, "to start can you tell us about some things you think have gone well this year."

Annie thought for a moment before replying, "I have been able to build relationships with patients and put them at ease, I've worked in the clinic and assisted Dr. Kepner with her street outreach program on my days off, I have provided research assistance to Dr. Shepard and Dr. Pierce."

"You don't mention your involvement with Meghan Hunt's surgery and recovery, why," Asked Meredith.

"I greatly enjoyed my time working with Dr. Hunt and getting to see the amazing advances in medicine that were made on her case. However I can not be certain I was chosen for the role I played in the initial transfer to the hospital because I was the best fit intern," Annie said, "I was chosen because of family connections."

"I encouraged Hunt to take you because I thought you would be the best intern for the job in an emotionally charged situation. I needed an intern he had a connection to," Bailey said, "tell us about your role with Meghan Hunt in her first weeks with us and supporting her recovery once she was discharged."

"When dr Hunt arrived at the base she was critically injured and required surgical intervention to restore both function and quality of life. The primary concern when dr Hunt and I picked up Meghan was her mental state. Having been gone for nearly 10 years it was uncertain who she would remember and how she would respond to them," Annie said.

"What happened at the base," Jackson asked, "for clarity can you use first names for both of them and your usual name for your mother."

"When Owen and I arrived at the base we went through security with him presenting his military credentials and introducing me as both his surgical intern and Major Altman's daughter. I was aware of that plan of connecting me to mama at the gate and with the medical team because it would give some name recognition as the doctor overseeing Meghans transfers had worked with Mama and Owen in Iraq and mama in Germany," Annie explained, "as directed I waited near the rig until Owen called me by last name. I was introduced to Meghan who saw the resemblance right away before Owen told her who I was. I assisted with her transfer to the rig and made sure she remained stable during the transfer to Grey Sloan where dr Grey took over her care. Over the coming weeks I assisted with bedside procedures and tests as well as ambulation. I was honored to scrub in to assist dr Grey with the abdominal wall transplant."

"You were good in that surgery," Meredith said, "what was your role after discharge."

Annie replied, "my role following discharge was mainly as social support and encouraging physical therapy. Once she was cleared for activity we ran together a few times. I also helped her to remember some of the traditional highland dances which help to retrain core control and balance as well as cardiovascular fitness."

"Where do you see yourself as needing to improve," Richard asked.

Annie paused to gather her thoughts before speaking, "I am working on being more assertive particularly with family members. Lines often become blurred between the attending and the resident or parent and child. I am also hoping to spend more time in a variety of specialties as most of my year has been in cardio and trauma. I think for me the biggest area I need to work on is trusting myself that I know what I am doing and am making decisions in the best interest of my patients."

Bailey asked, "you've had a lot of changes in your personal life that are hospital gossip. How do you feel that has affected your work this year?"

Annie replied, "at times the gossip has felt isolating. It has made it difficult to know who to trust and who just wants to get close to me to learn the latest Teddy and Owen gossip. Hopefully that dies down after the wedding. I've also been learning to navigate a new relationship with my mother. Working together and seeing each other daily is new for us."

"I couldn't imagine scrubbing in with my mother," Meredith said.

"I think you've been very accurate in your self assessment Grace," Richard said, "that being said we do have some feedback for you. This is not meant to be punitive. Our goal is to move you forward. Your spot in the program is secure as long as you passed your exam this morning."

"Passed or top five," Annie asked.

"Passed which is 75%," Richard replied.

Jackson said, "let's start with areas for growth. We need to see you finishing rotations with your assigned attending. That means saying no to your mother and stepfather. I've done it as a resident and it's hard but you need to do it. We can talk about strategies later. You have to be more assertive on rounds and speak up, first to answer, don't hide what you know."

Meredith added, "you have to communicate better with patient families. You're stiff and cold with them. You don't make patient families trust you. You give them the hard facts but not the emotional side. You spend a lot of time trying to make people like you, sometimes to the detriment of your own career. You let others walk all over you."

Bailey said, "when I was an intern I was introverted and didn't speak up until I had a very wise attending tell me that I had to stop being the minnow and it wasn't because of my height. Grace sometimes you need to be a shark. You are very passive and you let others go ahead of you. You're a good team player but you have to be assertive. In a couple weeks you'll have interns and you have to lead them. Right now I don't see you as a leader. You're a great teammate but not a captain. You need to learn to lead."

Annie asked, "I need to use my voice and stand up for myself?"

Bailey nodded, "that and share your ideas."

Richard added, "Grace this is not meant to hurt you. We need to see you lead and use your voice. You have surgical skills and medical knowledge but you don't show it until someone pushes you to."

"You're hiding from your name," Jackson said.

Annie asked, "what do you mean?"

Jackson said, "you wait to be asked to do surgeries or procedures and hide in your mother's shadow after is to let her down. I did it. Grace you have to embrace it. Avery, Grey, Altman these family legacies come with strings and expectations. You have to let that go and be the best surgeon you can. Try different specialities, speak up on rounds, not just memorized charts but ideas and thinking."

"You've shown you can thing," Bailey said, "how did you come up with hashimoto's disease at the intern bowl?"

Annie thought for a moment, "I was diagnosed with adolescent onset hashimotos at 15. I gave you my treatment protocol. It's been managed and stable for the last 4 years."

"We've give your a few things to focus on and we will give you a copy of your written feedback for you to look at later," Richard said, "before you go I would like to discuss what is going well and plan for the next year or so."

"You have shown flexibility," Bailey said, "you move services at the drop of a hat and do it with a positive attitude. You've been able to switch specialties within the same shift. I've also seen you remain focused on your patient even when something of great personal importance was happening."

"You have surgical skills," Richard added, "you work quickly and neatly. You try to minimize pain and recovery time for your patients. You think on your feet and look at all the information. You have the medical skills."

"So I need to continue to work with my patients and spend more time with their families to put them at ease I'll work on speaking up and be more of a leader with my peers," Annie asked.

"As well as standing up to your mother and stepfather," Bailey said, "you have to get out of her shadow and find your own place."

Richard looked at something on his iPad, "we have your results from your exam. You scored 85% on the exam so you will be able to continue in the program."

Bailey added, "we will have a review meeting with you again in a year. We are going to be watching for you to complete your rotations in all specialties as well as building leadership skills with your peers."

Annie asked, "can I know which sections I was weak at so I can work on those areas."

Richard replied, "we don't get that information. You came right in the middle of your class."

"You are on track," Jackson said, "you have areas to work on but you have knowledge and skills. You know how to observe, ask questions and operated."

"You need soft skills," Richard said, "a voice, work on leadership and spend more time with patient families."

"I'll work on that," Annie said.

"We know you have had a busy year at home as well as here," Bailey said, "your family business is on display here every day."

"It is," Annie said, "it wasn't our original plan but we're making it work."

"We are taking you off cardio for the next two months," Richard said, "and trauma for the next month."

"What will I be doing," Annie asked.

"You'll start with plastics," Jackson said.

"Then a few weeks of general," Meredith added.

"Then peds," Richard said, "and ortho."

"We will be addressing attendings pulling favorite junior residents in next week's staff meeting," Bailey said.

"Do you have any questions for us," Richard asked.

Annie thought for a moment, "what is one thing I can do to start showing leadership?"

"We need to hear you speaking up on rounds and suggesting courses of treatment," Bailey said, "you were very strong as a sub intern and your first few weeks here. There was a change when your mother came on staff. I need to see the same person that came on in your first few weeks. That doctor spoke up and took risks with her learning. I need you to stop playing it safe."

"I can do that," Annie replied.

"Is this lack of risk taking related to Teddy being here," asked Richard.

Annie replied, "it is a factor."

"We will be recommending that you not be on her service for your cardio rotations," Richard said.

Annie said, "thank you doctor Webber. I will be mindful of speaking up more and putting myself forward to do more."

Bailey replied, "do that and you will be a good doctor Grace. Stand up and use your voice."

Annie said, "I will."

Jackson said, "it's hard to be in your mother's shadow. You'll find your way."

"Thank you dr Avery," Annie said.

"I think we're done here dr Altman," Bailey said, "we will email you the formal feedback form. There's no surprises on it. It's a short summary of our conversation today."

"Thank you for meeting with me," Annie said.

"It's our pleasure," Richard said, "you'll be great if you work for it."

"Thank you," Annie said as she let herself out of the office.

Annie took her phone out of her pocket to let teddy know she was on her way up and saw the messages.

Teddy, "Allison has a fever and is throwing up. I took her home. Come when you're done."

Annie, "I'll meet you another day. I need to talk to you when you're not distracted by Allison."

Teddy, "are you angry with me?"

Annie, "I need time with you. She's sick and needs your full attention. Maybe on the weekend? I'm off Saturday and Sunday."

Teddy, "it's Friday so let's aim for Sunday. Let me check that Owen is off."

Annie, "let me know."

Teddy, "I will. Call me when you get home?"

Annie, "having people over tonight. Need to clean and get organized."

Teddy, "are you okay? How did your meeting go?"

Annie, "I've been banned from cardio for 2 months and trauma for a month. I have to learn to speak up and lead."

Teddy, "who said that?"

Annie, "Bailey and Webber. I can do it. I'm okay with not doing cardio for a while. It might be good for us."

Teddy, "I see why they would do it but I don't like it. I like spending the time with you."

Annie, "well probably see each other more outside of the hospital this way."

Teddy, "call when you get home anyway. Tell me about your meeting and your exam."

Annie, "if I have time. The house is a disaster and we have most of our class coming over for a BBQ. Allison needs you."

Teddy, "I'll try when I get her to sleep. I want to hear about your review and exam."

Annie, "I get to stay. I have a few things to work on. 85 on my exam."

Teddy, "that's good. I'll try to call later."

Annie, "worry about Ali bean I'll see you Sunday. You, me and a bottle of wine please."

Teddy, "we can do that."

Annie, "my place. Josh and Duncan both work Sunday night and I don't start until noon Monday."

Teddy, "I'll be there. I can bring wine."

Annie, "thanks. See you then."

Teddy stood beside the bassinet and put her hand to Allison's forehead. The baby was still warm even after having Tylenol. She hoped she could get the fever to break. She was worried about Annie as well, it wasn't like Annie to push her away like that. Teddy wondered why Annie insisted on time with just Teddy, but she wanted to chat over a bottle of wine so there was one thing she didn't have to worry about. Teddy was worried about both girls. Allison was sick but Arizona thought it was just a cold, if the fever didn't break by morning they would go back in and take a closer look. Allison was still eating but was very clingy with Teddy.. Annie was more concerning, she was distant and angry plus there were Owens comments about Annie needing time with Teddy. Teddy realized that she hadn't seen Annie on her own since they all went to the cabin at New Years. The last time Teddy had spent time with just Annie was when Annie had dragged her for a walk in the snow, Teddy now wished they had walked just a bit longer that day. Time with Annie was definitely needed.