It was a hectic Saturday in the pit. Owen was coordinating traumas when a massive car accident came in.
Annie grabbed a gurney with a 10 year old girl on it. The girl was having trouble breathing but was conscious and was trying to talk.
"What's your name sweetie," Annie asked.
"Julie," the girl replied.
"Julie I'm dr Altman," Annie said soothingly, "we're going to take you inside and get a look."
"I want my dad," Julie cried.
"I know this is scary," Annie said, " until your dad gets here do you want to hold my hand?"
Julie nodded and took Annie's hand.
Annie began to issue orders to her interns for tests.
"Julie I need to listen to your heart and lungs," Annie said, "can I do that?"
Julie nodded. Annie closed her eyes and listened.
"Page mama Altman," Annie called.
"Julie we're going to call the other dr Altman before I do a couple more tests," Annie soothed, "while we wait we're going to take you to get some X-rays done."
Annie supervised the x rays and ordered a CT.
"Annie what do you have," Teddy asked.
"Car accident victim age 10 year old girl her name is Julie multiple crush injuries to the chest and abdomen. Currently conscious and alert," Annie said, "decreased breath sounds on the right will do a chest tube after the X-ray."
"Do it and call me if it's surgical," Teddy said, "we'll take her up if it is."
Annie got the X-ray back and placed the chest tube before taking her to CT. Seeing the results she saw it was surgical a broken rib was damaging the pericardium.
Annie paged Teddy and got her interns to prep Julie for surgery. Annie met Teddy in the scrub room.
"I can do this," Annie said.
"Tell me what you're going to do," Teddy commanded.
"Open, crack the chest, repair the pericardium and page ortho to put a screw and plate in the rib," Annie said, "once she's stable close and up to the peds ICU. I'll stay to monitor overnight."
"Interns monitor," Teddy said, "you're almost at 36 hours and haven't slept."
"I napped," Annie said, "about 90 minutes."
"This surgery then you're done," Teddy said.
"Yes mama," Annie replied.
The interns were surprised by the easy interaction between the demanding chief of cardio and their soft spoken resident. They liked their resident. She was a third year and kind to them. The interns appreciated that she took the time to teach them and help them instead of barking orders like many of the senior residents. They also realized they would get a lot of cardio time as Annie's speciality was peds cardio.
Annie saw their faces, "I assumed you knew we were related from our names."
"I thought she was your aunt," one of the interns said.
"No my mother," Annie smiled.
"I was in Med school when I had Grace," Teddy explained, "but we need to get going."
"So you grew up in the OR," an intern asked.
"I didn't start scrubbing in with her until I was 19," Annie explained.
"I wasn't asking," the intern replied, " but explains why you two look almost identical."
"We get that a lot," Annie replied, "Brechin your scrubbing in the rest of you back to the pit and see where the Hunts need you. Find Riggs Jr and he'll make sure you have something to do he's down there."
Teddy laughed, "your fiancé babysits your interns."
"And I babysit his interns," Annie laughs.
"You and Riggs jr," asked an intern.
"Since med school," Annie replied.
"How do you do that," the intern asked.
"We were best friends first then in our last year of school it became more," Annie said, "we came here together and got engaged in April."
"There's going to be a few in our class who are disappointed," one of the interns said.
"He's mine," Annie laughed, only half joking.
Teddy smiled, "Owen and I keep an eye on each other's residents."
"You only have three of us," Annie said as they scrubbed.
"I do and two leave me in July," Teddy said, "you'll do 4th and 5th as my senior resident and my go to."
Annie smiled, "I'm your go to now as a third year."
"When I get you away from Karev and Nathan," Teddy said.
Annie and Teddy scrubbed in and began the surgery. The interns watched amazed as the two of them worked seamlessly together and conversation was kept to a minimum as they worked quickly to repair the damage to the girls heart and lungs.
"Start with damage control," Teddy directed.
Working on the heart Annie said, "call down for a replacement valve, it's a bicuspid one it has to go."
In the Pit Owen met an anxious father.
"Mitch Klassen," Owen asked, approaching the man.
"Owen Hunt," Mitch asked, "I remember you."
"Mitch," Owen said, seeing the man's face clearly, "I haven't seen you since undergrad. How are you?"
"I'm good what are you doing here Owen," Mitch asked.
"I'm the chief of trauma surgery," Owen explained, "what brought you in?"
"Daughter was in an accident," Mitch said, "she was rushed to surgery."
"What's her name? How old is she ," Owen asked.
"She's 10 her name is Julie," Mitch said.
Owen pulled up the chart on an iPad , "my wife is the attending and the resident is my step daughter. Julie is in good hands with Teddy and Grace. Teddy is an incredible cardio trauma surgeon and Grace is a pediatric cardio resident. It's an amazing mother daughter team."
"You're married with a step daughter," Mitch looked shocked, "last time I saw you you were dating Beth."
"I am. Teddy and I have been together a while now and her daughter is my step daughter," Owen said.
"Will she be okay," asked Mitch.
Owen replied, "I'll find out what's going on. Why don't you come with me and we'll go up to the surgical waiting area. Teddy or Grace will come find you as soon as they can. They both use Dr. Altman."
"Can you get me any answers," Mitch asked.
"I will," Owen said, "I know how hard this is. Grace had a major trauma surgery a few years ago. Teddy and I sat all night waiting to hear. I will get you all the information I can about Julie."
"Thank you Owen," Mitch said.
Owen went to Teddy's OR.
Teddy saw Owen step into the room.
"How bad is it Teddy," Owen asked.
"It's major," Teddy said, "we're looking 6-8 hours minimum. The impact broke two ribs and ruptured the pericardium there's a tear in the right ventricle and we discovered a bicuspid valve that I'm going to replace while she's open."
"Julie's dad and I went to high school and undergrad together," Owen said, "I'm going to go let him know."
"We've got this," Teddy said, "we'll have this little one back in her dad's arms as soon as we can."
Owen left and updated Mitch on his daughter.
Finally hours later Annie and Teddy approached Owen. They were both tired but had good news for the anxious father.
"Mitch," Owen said, "they're done with Julie."
"Mr Klassen," Teddy greeted, "I'm dr Teddy Altman the chief of cardiothoracic surgery and this is my resident dr Grace Altman she's specializing in pediatric cardiothoracic surgery. We've just finished our surgery on your daughter Julie. Why don't we have a seat and we can talk."
"Is Julie okay," Mitch asked.
"She will be," Teddy said, "her recovery will be a few weeks but she will be back on her feet and playing soon. Grace, can you explain the procedure."
"Julie came in with a broken rib that ruptured the pericardium, the sack around her heart and tore the right ventricle. When we were repairing the ventricle we discovered that she had a bicuspid valve between her right atrium and ventricle. We replaced the valve that wasn't working properly and not allowing proper blood flow in her heart. I placed a porcine valve."
"A what valve," Mitch asked.
"Porcine, it comes from a pig," Annie said, "it's a very common replacement especially in children."
"Will it be okay," Mitch asked.
"The valve replacement is a very common surgery," Teddy said, "we will monitor her for the next few years. The valve should be good for 20 to 25 years. She will need an annual check up with a cardiothroratic surgeon. I'm going to take her case myself. We were able to use bovine, cow, pericardium to patch Julie's heart and were able to repair her pericardium. She has had a plate and screw placed in the shattered rib which will also be monitored as she grows. I understand how hard this is for you to hear and that you just want to see your daughter."
"When can I see her," Mitch asked.
"I can take you to her in about half an hour," Annie said, "she's in post op now and will be moved to the pediatric ICU once she is awake from the anesthetic. I will be staying here tonight to monitor Julie."
"Can I see her once she's in the ICU," Mitch begged.
"I'll go check on Julie and make sure she's stable before I come and get you," Annie replied.
"I'll wait with you," Owen offered.
"Owen you don't have to sit with me," Mitch said.
"Do you have family we can call," Owen asked, "you shouldn't wait alone. It was hard enough for Teddy and I to sit and wait while Grace was in surgery a few years ago. Do you want a coffee or water?"
"Our family is all out of town now," Mitch said, "water would be great."
Owen returned with water and asked, "would you like me to sit with you until Teddy and Grace come get you?"
"If you have time," Mitch said.
Owen replied, "I called in another trauma surgeon to cover me. My sister Meghan will run the emergency room until I go back down."
"I heard you joined the army," Mitch said.
"I served almost 7 years in Iraq," Owen replied, "both Meghan and I did."
"When did you come back," Mitch asked.
"I've been here for 7 years now," Owen said, "chief of trauma and chief of surgery for a couple years. What are you doing now?"
"I work for the university of Washington in admissions," Mitch said.
"What about Julie's mom," Owen asked.
"She left when Julie was an infant," Mitch said, "It's just me and Julie."
"Tell me about Julie," Owen said.
"She's a great kid. She does well at school and takes ballet and piano lessons. She loves dogs and riding her bike," Mitch said, "What about you how long have you been married?"
"Teddy and I have been married a year," Owen said.
"How did you meet," Mitch asked.
Owen replied, "we met in 2002 in Iraq we both served together she was in charge of the cardio team and I lead the trauma surgeons."
"What about your step daughter," Mitch asked, "they looked a lot alike and seemed close from what I saw."
"Grace and Teddy are very close," Owen said, "Grace spent most of her childhood with family in British Columbia just outside of Vancouver. Grace is more Canadian than American."
"She was with her father," Mitch asked.
Owen made a split second decision to protect Teddy and Annie's privacy," she was with family. Teddy always knew how she was doing and talked to her often. I met Grace when Teddy came home from a tour and moved to Seattle. Grace was 19 then."
Mitch asked, "do you and your wife have other children?"
"We have a two and a half year old son and a our daughter is 20 months," Owen smiled, "so three kids total. You met the oldest."
"How does the age gap work. You step daughter has to be in her mid twenties," Mitch said.
"Grace is awesome with her little siblings," Owen smiled, "she's a good big sister and babysits a lot. We usually use Grace's childhood nickname at home so when I talk about Annie it's the same person. The family she grew up with used her middle name. I've known Annie since she was 19 and she's 26 now."
"Your wife must have been very young with the oldest," Mitch pointed out.
"Teddy was 21 when Annie was born," Owen said, "we adopted our son Leo. But there's 25 years between our girls. Allison is 20 months, and Annie turns 27 next week."
"Very different life stages," Mitch smiled.
"Annie is a third year resident who just chose her specialty and gets married next summer. Allison is learning to talk and is potty training," Owen said, "we were only planning on training our son now but Allison wants to do everything Leo does. Are you seeing anyone?"
"Not right now," Mitch said, "it's hard to date when you have a daughter."
"Teddy found that challenging as well," Owen said.
"I don't want to introduce Julie to anyone and have her get attached and it not work out," Mitch said.
"Teddy did that with Annie," Owen agreed, "we were good friends for years before we dated but Annie was 19 before I met her."
"How did Teddy know it was time to let Annie meet you," Mitch asked.
"Teddy and I went to a conference at UBC," Owen said, "I was working on some research and ran into Teddy and Annie in the library. It wasn't planned. Teddy was going over some pre med anatomy with Annie and I walked into the library."
"How does it work having step kids," Mitch asked, "does she live with you?"
"Annie lives with her fiancé but we see her almost daily at work and if we don't see her we talk to her. My mom helps with the little two and we have an excellent daycare," Owen said, "Teddy's job allows her to have a more consistent schedule then I have. She does weekdays mainly and every third weekend. My schedule is more difficult than hers because we need a trauma surgeon on 24/7 and there's five of us and six fellows."
"There's not a heart surgeon at all times," Mitch asked.
"There is but Teddy is head of the department so she does the schedule so she has lots of early mornings to have evenings with our kids," Owen said.
Annie came back, "I'm sorry to interrupt Dr Hunt. Mr Klassen if you would like to come with me Julie is in the pediatric intensive care unit. I can take you to her."
"Thank you dr," Mitch paused as he didn't know her name.
"Mitch this is my step daughter Dr Grace Altman her mother and I usually call her Annie," Owen said, "Annie, Mitch and I went to high school and college together."
"It's nice to meet you," Annie smiled, "Julie is still intubated but should be alert and breathing on her own soon. I'll take you to her. The other dr Altman the head of cardiothroatic surgery is with her now."
"The other dr Altman is that your wife Owen," asked Mitch.
"It is," Owen smiled, "we use first names around here for them or our staff uses mini Altman for my step daughter and mama Altman for my wife."
"Really uncle Owen," Annie laughed, "mini is for friends and coworkers only."
"Take us to Julie," Owen directed.
Annie led the way to the peds ICU explaining what to expect as they walked. They ushered Mitch into the room and let him sit with his daughter.
Throughout the evening Annie popped in and out checking on Julie.
"Dr Altman," Julie asked, "what happened?"
"You had surgery on your heart," Annie said, "in the morning when you've had some sleep and rest I'll bring a couple things in to show you what the other dr Altman and I did. "
"Where's daddy," Julie asked.
"He just went to get something to eat," Annie said, "I'll stay until he comes back."
"I'm scared," Julie cried.
"I know Julie," Annie soothed, "it's hard to understand surgery and what happened. You're going to need a couple weeks in the hospital but you're going to be okay soon."
"I want to go home," sobbed Julie.
"We will get you home as soon as we can," Annie promised.
"When is that," Julie asked.
"Soon," Annie said, "as soon as you're healthy enough to go. We won't keep you any longer than we have to."
"Promise," Julie asked.
"I promise we will get you healthy and back home as soon as we safely can," Annie said.
"Will you always be my doctor," Julie asked.
"On days that I'm here I will see you. The other doctor you'll see in light blue is doctor Jones. He's a good friend of mine," Annie explained, "my mama the Dr. Altman in navy blue is the lead surgeon for you and she will see you most days as well."
"Will they all be nice," Julie asked.
"Of course, they'll be nice," Annie replied.
"I'm tired but daddy isn't here," Julie whined.
"I'll stay until you fall asleep," Annie offered, "would you like me to sing to you or read a story?"
"Daddy always sings until I fall asleep when I'm sick," Julie said.
"I'll sit in the chair here and sing," Annie said, "the only lullabies I remember from when I was a little girl are in french is that okay?"
Julie nodded.
Annie began to sing softly in french the same lullabies her grandmere had sang to her as a little girl. The songs they sang while baking cookies and making tortiere.
Teddy was standing at the nurses station watching, she liked to observe her residents when they didn't know she was there to see them acting naturally. When Julie was asleep and Mitch had returned Annie slipped out of the room and went to the nurses station to update the chart.
"I've never seen patient care quite like that sweetheart," Teddy said.
"She's a little girl that needs love," Annie replied, "kids need to know we're on their side but with them you don't tell them, you show them. Holding a hand, sitting with them, playing a game or singing a lullaby when they're frightened. That, the little girl in the bed is why I want to do peds mama. What we did today is what I want to do. I felt alive in the OR today. I had a purpose working with Julie today."
"I see that sweetheart," Teddy smiled, "I just haven't seen you in peds mode enough. You care for them like you do your little siblings."
"I know you don't always understand my love of peds," Annie said, "but I need to know you support me on it."
"I support you. I'm always on your side Annie. You connect with kids in a way I never have," Teddy said, "I deal with the parent but you work right with the child. Kids trust you in ways they've never trusted me."
"You spent more time with soldiers," Annie said, "I couldn't get guys like Chris to respect me the way they see you and snap to attention."
"When soldiers come in I don't use Doctor Altman I use my military titles," Teddy explained, "but doctor will get you respect if you go in confidently. But what I saw today you fit in peds. Annie I think you found where you fit as a surgeon. You made that little girl feel safe. Peds is where you belong. That's all I wanted for you in this was to find where you're happy. It was never about what specialty you chose, I wanted you to find what makes you excited to come to work, what you're passionate about. I saw that today. Julie and Leo, that's where I've seen you the most passionate about surgery."
"I want to work with kids and make them feel better, help them and their parents understand what's happening," Annie said, "I'm still working on the parent part."
"With practice," Teddy said, "that's part of you building your confidence and leadership."
"I love the kids and their tiny little hearts," Annie said, "I love the kids and I know how to connect with them but I need you to teach me how to fix their hearts."
"I can help you," Teddy said, "but I'm not an expert on it. You need to talk to Maggie and Nathan. The peds stuff has been shared between all of us. I have the budget for another cardio attending so maybe I'll look for a peds specialist. Let the other three of us focus on adults and have someone dedicated to peds who can teach you."
"I want you to teach me," Annie said.
"I will do what I can," Teddy said, "but you're going into unknown territory. I do routine proceedures and massive traumas. Tiny kid's hearts and babies I can do but it's not my strength."
"Can I do this," Annie asked.
"You can," Teddy said, "if you work for it. Cardio isn't for the weak neither is peds and you have to master both in the next couple years. Your half way through your residency."
"Half way through residency," Annie echoed, "already?"
"Already," Teddy said, "you've been so caught up in wedding planning that you've lost track of time on your residency."
"I chose my specialty," Annie said, "and I meet with you, Bailey and Webber tomorrow to discuss it."
"We have that meeting at 8am," Teddy said, "are you ready?"
"I am," Annie replied, "just need to iron my outfit."
"No scrubs," Teddy looked surprised.
"Not tomorrow," Annie said, "it's a serious meeting career defining. I can't have that in regular scrubs. It feels like glorified pajamas some days."
"When you're a fellow or attending you can wear other clothes," Teddy said.
"You don't often," Annie replied.
"I do in the office and meeting with patients," Teddy said, "now that you're declaring your specialty you'll do more office work with me. I usually have professional clothes hung up in my office and then change to scrubs when I'm on the floor."
"I'll believe it when I see it," Annie said, "Leo's family doodle had you and Owen as navy blue stick figures."
"Tomorrow what are you wearing," Teddy asked.
"Black pencil skirt, royal blue top and my grey jacket," Annie replied.
"Sounds good," Teddy smiled, "shoes?"
"Black heels," Annie replied, "I can't decide if I need tights or not. It is January."
"It's up to you," Teddy said, "tights or pantyhose no bare legs."
"I have black tights so that's what I'm going with," Annie replied, "Ali is two next week what's the plan?"
"Family dinner on her birthday and then some kids from daycare are coming on the weekend," Teddy said.
"I'm off this weekend," Annie said, "I'll come help with the birthday party."
"It's a zoo animal theme," Teddy said.
"I can come help," Annie said, "I don't see enough of my siblings."
"Only if it doesn't take time away from you and Josh," Teddy said, "you're always complaining about lack of time with him."
"He's waiting at home for me with dinner," Annie said, "I just have to text him when I leave so it's hot."
"What's he making," Teddy asked.
"He wouldn't tell me," Annie smiled, "before I go are you sure you're okay with me doing peds cardio?"
"Does it make you happy? Are you excited to do it," Teddy asked.
"It does," Annie said, "as hard as that surgery was technically today there was an adrenaline rush doing that. I felt alive in that OR today."
"Then you've chosen well," Teddy said, "go see Josh."
Annie gave Teddy a quick hug, "good night mama see you tomorrow."
"Good night Annie," Teddy said, "I'll see you in the morning."