Meghan paged Annie to the pit, being the middle of the night she jumped out of bed and ran down the stairs arriving breathless.
"Annie I need you for this," Meghan said, "we have a 17 year old female whoes not saying much yet but we know the injuries were caused by her sister."
"You want me to talk with her," Annie said, "where's psych?"
"Parents refused psych," Meghan replied.
"That's not a choice," Annie replied, "I can be an understanding ear but she needs psych. I will treat physical injuries but I'm not qualified mentally. Meghan I don't know if I'll ever be over what happened to me."
"Come help me Annie," Meghan begged, "Owen says he can't do it. There's a collapsed lung, Nate and Maggie are out of town and Teddy is in the OR."
"I know she wouldn't let me scrub in," Annie whined.
"How long had you been working," Meghan asked.
"22," Annie replied, "I told her I was going to use the washroom and join her and she sent me to bed."
"I need you now let's go," Meghan commanded.
Annie knocked on the trauma room door before going in. Josh was there with his interns getting the paitent ready to move to the OR.
"May I come in," Annie asked.
"Whoes there," cried the girl.
"My name is dr Altman but you can call me dr Grace if that makes you more comfortabl ," Annie replied.
"It's okay Sarah," Josh promised, "she's my wife and an amazing surgeon."
"Dr Hunt asked me if I could take a look at the injuries to your chest," Annie said, "may I ?"
"Yes. But don't tell my mom and dad," Sarah said.
Josh sensed that it was best to let Annie handle this.
"Why don't you want us to call," Annie asked.
"I made Carmen mad again," Sarah said, "it's my fault I triggered her."
"Sarah I want you to took at me," Annie soothed, "look at my face."
Annie waited for the girl to look at her.
"This is not your fault," Annie promised, "dr Riggs or you can call him Josh and I are going to do everything we can to make sure your not just safe but you feel safe. What your sister did those are her actions and hers alone you do not control them with anything you did or didn't do. You are going to be okay and you are very very strong. You can do this. Is there some one else you would like us to call? A neighbor, coach, relative, grandparents?"
"Can they call my auntie Michelle," Sarah asked.
"I would be happy to," Josh replied, "do you know her number?"
"It's in my phone," Sarah replied.
Annie grabbed it from the belongings bag, "can you unlock it please?"
Sarah unlocked the phone and found the number for Josh to write down.
"Dr Riggs is going to go call your aunt and ask her to come," Annie explained, "I need some pictures of your ribs and heart. I'm going to ask another doctor to come in and do an X-ray because I can't do it myself right now. Is there anything about your medical history I need to know? Any reason I should worry about giving you an X-ray?"
"Why can't you do it," Sarah asked.
Annie replied, "I'm pregnant I can't. I'm going to ask one of the dr hunts to come do it."
"Will my baby be okay," Sarah asked.
Annie was shocked this wasn't in the chart, "how many weeks?"
Sarah shrugged, "I don't know."
Annie asked, "when was your last period?"
Sarah thought, "Halloween."
Annie replied, "before I can do X-rays I need some blood work and an ultrasound to take a look at your little one. May I call another doctor to look at your baby?"
"Is she safe," Sarah asked.
Annie smiled, "Dr Deluca is the very best. I trust her with my baby."
"Will you stay with me," Sarah asked, "I'm scared."
Annie replied, "I have to step out and tell the rest of the doctors a couple things. Dr Hunt wants you in surgery as soon as we can. Once we know everything is safe her and I will get you ready."
"She wanted to do a lap something does it leave a scar," Sarah asked.
"Laparotomy it will scar. I was a couple years older than you when I had one done. The scar usually isn't too bad," Annie replied.
"Can I see the scar," Sarah asked.
This caught Annie off guard she wasn't usually asked to see her scars, "it's starting to stretch and distort a bit. It's usually a thin line."
"Please can I see it dr Altman," Sarah asked, "I have to know how bad it's going to look."
"Mine was ten years ago," Annie said before pulling up her scrub top just enough to show her scar.
Owen stepped in to the room at that moment, "dr Altman what's going on?"
"I asked to see her scar," Sarah said, "to know how bad mine will be."
Owen kept his face neutral but this letting someone and a patient at that see her scar was a huge step for Annie.
"Sarah can we do the surgery I got permission from your parents," Owen said.
"Dr Hunt we need to wait for a consult from Dr Deluca she's on her way down now. We're estimating ten weeks," Annie said, "I need OB and a urine sample to confirm."
"We have blood in the lab. I'll add it to the panel," Owen said.
"Dr Altman Will my baby be okay," Sarah asked, "Carmen kicked me in the stomach."
"Has there been any bleeding," Annie asked.
"No," Sarah said.
Carina came in, "Grace can you step out."
Annie stepped into the hallway and pulled the other doctors together, "how did no one know she's pregnant?"
"What," Meghan said.
"She's with Carina now but about ten weeks," Annie replied, "who took the history?"
"One of my interns," Josh said.
"Who did the exam," Annie asked.
"I did," Meghan said, "I was looking for abdominal injuries I didn't even think to feel for it. I was looking for tenderness I thought it was blood in the belly of injury."
"We still have to fix those injuries under general," Owen said.
"I want Carina in there for her then," Annie said.
"It depends on the injury," Meghan said, "it's early."
"You have to look after her baby," Annie said, "protect it."
Meghan sighed, "Annie you can't get emotional about this. She's ten weeks it's still small."
"We will do what we can," Annie declared.
"We will," Meghan agreed.
Carina joined them, "ten weeks but baby doesn't look good. I don't know if we can save it."
"We can try," Annie said.
"We will," Carina agreed.
"We need to go now people," Owen said.
They moved Sarah to the OR and started the surgery.
An hour in Annie said, "dr Hunt I need to scrub out for a few minutes."
"You need to stay here Annie and finish that liver," Owen said.
"I will be back in five minutes Eaket can keep the clamp on it for that long," Annie said her eyes challenging Owen.
"Annie you need to finish that," Owen said.
"I need five," Annie roared.
"Do not yell at me in my OR," Owen snapped.
"Please uncle Owen I need five," Annie tried begging.
Meghan in the same side of the table noticed Annie crossing her legs.
"Owen let her go," Meghan snapped.
"Why," Owen replied, "she knows you don't leave in a critical part."
"Owen," Meghan hissed, "this isn't the Time for a teaching moment."
Annie snapped, "George put your hands where mine are and keep pressure. I'm going to the washroom."
"Annie," Owen hissed.
"I'm going now," Annie said, "I need five minutes tops."
"Run," Owen barked.
When Annie was out of the room Meghan turned on him, "you dum dum you absolute dum dum. Your daughter was asking to use the washroom and you were going to make an example of her. Really supportive there."
Owen groaned, "I didn't know that's what she wanted. She didn't say."
"Did you look at her body language, she asked to take five," Meghan asked.
"No," Owen admitted, "I thought it was about her surgery at 19 I wanted her to push though."
"Asking to take five is what she's been using with me, Teddy, Bailey and Grey," Meghan said, "when she needs five we have to let her go."
Carina jumped in, "dr Hunt your step daughter is going to need more frequent breaks to use the washroom, eat and get some water. She is a good surgeon but she needs you to let her go when she asks to. The baby is going to push on and kick at her bladder and when that happens she has to go now."
"I'll keep that in mind," Owen said, he hadn't even thought Annie was at that point yet.
Annie left the washroom and ran into Teddy.
"Wasn't your name on the board with Owen," Teddy asked.
"I needed five," Annie declared, "he said no until Meghan yelled at him."
"Did you tell him what you needed," Teddy asked, she knew she was caught in the middle of a disagreement between her daughter and her husband. This would be tricky to stay neutral to help Annie and Owen work this out.
"I'm not announcing to the whole OR that I have to pee," Annie said, "that's why I've been using take five with you, Meghan, Bailey, Grey, Shepherd you all get it."
"We're all moms sweetheart we know what you're going through," Teddy said, "the male attendings you need to be more direct with."
"I don't want to go back there uncle Owen is mad at me," Annie whined.
"Do you want me to come," Teddy asked, "and you can explain to him what take five means."
"Please," Annie replied.
"Let's go scrub," Teddy said.
"This surgery is hard," Annie said, "she's 17, been beaten by her sister, same injuries I had at 19 and the girl is ten weeks pregnant."
"So you're emotional about it as well," Teddy asked.
"Yes," Annie admitted looking at her shoes.
"Your care for your patents has always been your strength. Deep breaths and use your experience to help this girl," Teddy said, "you are the only one here who understands what she's going through."
"Let's go back," Annie said.
They scrubbed quickly.
"Teddy what are you doing here," Owen asked.
"Just checking in," Teddy said.
"Annie we need to talk about what just happened," Owen said.
"Can we talk after," Annie asked, "when I say I need to take five I need 5 not because I'm being lazy or defiant I genuinely need five."
"We'll talk after," Owen said, "but I heard from Meghan and Carina. I'm sorry I wasn't more understanding."
"Thank you," Annie said, "do you want me to continue?"
"You know your job," Owen said.
Annie took back over from her intern and finished the liver repair. Teddy slipped out of the OR things would be fine.
They completed the surgery and scrubbed out.
"Dr Hunt can I grab water and meet you back in post op," Annie requested.
"Why don't your interns to post op and you check back later," Owen suggested
"Thank you," Annie smiled. She walked to her locker and grabbed a bottle of water and a container of veggies and hummus.
"Uncle Owen I can take over from here," Annie replied, "I can sit and watch her in the ICU. There are chairs, I have water and a snack, she's going to need someone who understands when she wakes up."
"She will," Owen agreed, "if you're sure you're okay with it."
"Snack, water, phone," Annie replied, "I'll finish the chart and try to get some supports for her and her family in place. She can't be discharged without psych."
"Do what you need to do," Owen said, "the aunt is coming from San Diego so will here in the morning."
"Okay," Annie replied, "I'll stay."
"Annie you need rest," Owen reminded.
"I can do this," Annie replied, "this lets me bank some floor hours and ICU hours for later."
"Okay," Owen said.
"If you see Josh can you send him up," Annie asked.
"I will," Owen said.
After Owen left the room Annie pulled the table over and dropped it down to height of the chairs to put her snack and water on with her ipad. She scooted the two chairs closer together and settled into one with her feet on the other one. Josh appeared about an hour later and lifted her feet up so he could sit.
"If you're going to sit there," Annie started.
"You want me to rub your feet," Josh asked.
"Please," Annie replied.
He untied her shoes placing them on the floor and began to work the knots out of her feet and calves.
"That feels nice," Annie murmured.
"Do you want me to keep going," Josh asked.
"Please," Annie replied.
Walking through the ICU Teddy smiled seeing Annie and Josh like that she remembered the night her and Owen sat with a patient and he spent most of the evening slowly and gently working all of the tensions, stiffness and pain out of her feet and calves. Any other residents, even these two at any other time she would have told to be more professional but knowing the day Annie had had she let it go.
"Mommy," Sarah moaned.
"No it's Dr. Altman and Dr. Riggs," Annie replied, she swung her feet out of Josh's lap and slipped them back into her shoes.
"How do you feel," Josh asked, walking towards the bed.
"I'm thirsty," Sarah whined.
"We'll get you some water," Annie said.
"Can I have orange juice," Sarah asked.
"We need to see you keep water down first," Annie said, "then we can try some apple juice."
"Okay," Sarah agreed.
"So Dr. Riggs is going to go get you water and apple juice, and he's going to bring me juice," Annie said.
Josh left the room gently closing the door behind him.
"I'm scared," Sarah cried.
Annie stood beside the bed, "I know. I've been there."
"My parents are going to be so mad at me it's all my fault," Sarah sobbed.
Annie held the young girls hands, "it's not your fault. Your parents are not going to be angry, they're going to worry about you."
"How do you know," Sarah asked.
"Because if you were my child that's how I would feel," Annie smiled.
"What happened when you got your scar," Sarah asked.
"I had the same surgery you did for the same reason," Annie replied.
"What did your parents do," Sarah asked.
Annie chose only to share part of the story, "I have two sets of parents. My mama and step father stayed with me the whole time. You met my step father today Dr. Hunt, the man who did all the yelling, he's just loud, he's really a huge teddy bear. Then dad and mom moved between me and my sister."
"You call your stepmom, mom," Sarah asked.
"It's a long story but I have mom and dad then mama and Uncle Owen. I'm closer to mama you'll see her around she's the other Dr. Altman, she's in charge around here," Annie said, "she's going to talk to your parents when they get here."
"Will I be in trouble," Sarah asked.
"No," Annie promised, "you are not in trouble. You are safe. We will not let anyone into your room you don't want to see. I put it in your chart that the nurses have to check with you before bringing anyone in to see you."
"Will they be mad about my baby," Sarah asked, "did my baby make it?"
"Your baby made it," Annie replied, "did you know about your baby?"
"No," Sarah said, "I thought something was weird with my period but I didn't think it could be that. My period goes missing all the time."
"What do you mean all the time," Annie asked, this caused some flags to go up for her.
"When I'm spending a lot of time in the gym sometimes I don't get it for a few months," Sarah said.
"How much do you work out," Annie asked, "what sports do you do?"
"I'm a gymnast," Sarah replied, "I'm in the gym 50 hours a week."
"What about school," Annie asked.
"I home school," Sarah said.
"Tell me about the boy, how did you meet," Annie asked, she just wanted to keep the girl talking.
"Cam goes to my gym we train at the same time he's my only friend," Sarah said.
"Have you told him," Annie asked.
"I only thought about it yesterday," Sarah said, "my mom is going to kill me. I'm supposed to be going to olympic trials. We've worked for this my whole life."
"I can ask Dr. Deluca to come back and she can explain your options," Annie said, "there you have choices and you're the only one you can make them."
"You mean like abortion," Sarah asked.
Annie sat on the edge of the bed, "adoption, keeping your baby. We can talk to Dr. Deluca or I can ask our social worker to come talk to you. You have choices."
"What would you do," Sarah asked.
"It has to be your decision," Annie said.
"If it was your baby what would you say," Sarah asked.
"I would tell them that I am here and will stand by them no matter what," Annie said.
"But your having a baby," Sarah said, "did you ever think of not keeping it."
"Sarah I can't influence your choices telling you that would influence you," Annie replied.
"What about Dr. Riggs can he tell me," Sarah asked.
"He won't," Annie said.
"He must be a good friend. I saw him massaging your feet," Sarah said.
"He's my husband," Annie smiled, "he's a good friend. He was my best friend for years first."
"You got him to rub your feet," Sarah said.
"You were awake, why didn't you say anything," Annie asked.
"I needed to think," Sarah said.
"I know that feeling," Annie replied, "do you have any questions?"
"You explained the surgery but when can I go back to the gym " Sarah asked.
"Six weeks minimum," Annie said, "then you're going to have to be careful of hard landings and potential falls on your abdomen."
"Why," Sarah asked.
"It takes 12 weeks for your internal injuries to fully heal and your muscles will need to be retrained," Annie said, "plus your baby will be more visible and you can't fall on them."
"Do you know how hard that will be," Sarah asked.
"I do," Annie replied, "I'm a highland dancer."
"But were you olympics good," Sarah challenged.
Annie didn't usually tell patients her history as an athlete but she sensed this might help the girl, "I was world champion twice. I danced in the ceremonies for the Vancouver olympics and for my college dance team. I know what being an athlete means and how hard you work for it. How much you give your life to it and it's always part of you."
"If I have this baby I'm done with gymnastics," Sarah said.
"You'll need time off for sure but I wouldn't say done," Annie replied, "I still dance at home for fun and I'll take classes again when I'm ready."
"Will my parents be mad about the baby," Sarah asked, "can you tell them I'm scared to."
"With your age you should tell them, your reproductive health is your business as your doctor I can be here with you when you tell them but without your permission for us to share it it has to come from you," Annie said.
"I want you to tell them," Sarah said.
"I will when they come," Annie replied, "your mom and dad will just want you to be happy and healthy that's all any parent wants."
"Dr Altman a word," Teddy called from the door.
"Yes chief," Annie replied, "Sarah I will be back."
Annie followed Teddy to the nurses station and into the office behind.
"I heard that conversation Annie," Teddy said.
"Did I over step," Annie asked.
"You put your patient first, you connected with her in a way on one else could," Teddy said, "I just wanted to check on you."
"I could use a washroom break but I'm fine," Annie said.
"Go then come talk to me," Teddy said.
"I'll be quick," Annie replied.
"Take your time," Teddy smiled, "we're in no rush."
Annie walked to the washroom then stopped by the residents lounge to grab a snack from her lunch bag.
"You stopped for a snack," Teddy smiled.
"I'm hungry," Annie replied, "monkey wanted cookies."
"I like the name monkey," Teddy smiled.
"Better then gremlin," Annie teased.
"You were bear some times two," Teddy replied, "gremlin was when you kicked me in the ribs or wouldn't let me sleep. Will you find out what you're having?"
"Friday," Annie smiled, "three more days."
"What do you think," Teddy asked.
"If the old wives tales are right it's a boy," Annie replied, "Josh thinks it's a girl. What do you think?"
"Girl," Teddy replied, "just a hunch."
"The family is split 50/50," Annie replied, "Allison wants a girl and Leo says boy."
"We'll have to wait and see," Teddy smiled, "but you're okay?"
"Hungry and could use a walk to stretch my legs but my patient needs me," Annie replied.
"You and Josh looked pretty cute in there," Teddy smiled.
"I had my feet up and he was going to take the chair. It's the least he could do," Annie replied.
"It is," Teddy agreed, "he's taking care of you?"
"Too much hovering," Annie said, "I'm not a china doll. But he's as attentive as ever, and affectionate."
"The two of you are cute," Teddy replied, "I see the affection here. Are things good at home?"
"Between Josh and I but were still trying to get Duncan out," Annie replied, "it's starting to stress me out."
"You sure you're okay," Teddy asked.
"Why," Annie asked.
"You keep rubbing your stomach," Teddy smiled, "are you okay?"
"Lots of kicks," Annie replied, she looked around and saw they were alone, "have you felt them move yet?"
"No," Teddy replied, "can I?"
"Do you want to," Annie asked.
"I do," Teddy beamed.
"Hand," Annie smiled.
Teddy reached out her hand and Annie placed it where the little kicks were drumming against her side.
"Active baby," Teddy commented, "but you were at this stage so was Allison."
"It's happened a lot today," Annie smiled, "more and more every day."
"That's good means their healthy," Teddy smiled, "and you feel good?"
"Have a couple rough weeks at the beginning and everyone thinks they can hover," Annie groaned.
"Just answer the question," Teddy said.
"Getting tired and hungry but I'm good," Annie said, "my patient is emotionally challenging but physically it's easy."
"I want you with me when I meet with her parents," Teddy commanded.
"I will be," Annie said, "she asked me to tell her parents about her pregnancy."
"She's scared too," Teddy asked.
"She is," Annie replied, "mama we need to make sure that the whole family has support. Both of their children and the parents. I think that was the missing piece. No one ever tried to support mom and dad. There were things in place for me and for Jessica but no one ever supported mom and dad."
"I never thought of tha but you may be on to something," Teddy agreed.
"It can't hurt," Annie replied
"It can't," Teddy agreed.
"I may have overstepped earlier," Annie admitted.
"Owen said something about you showing the girl your stomach," Teddy said.
"She was anxious about the scar and how bad it would be," Annie replied, "so I told her about my surgery and she asked to see the scar. It helped calm her. The scar had gotten pretty thin."
"You only ever let Josh see your scar," Teddy said.
"It's distorting," Annie complained, she showed Teddy, "I don't like it."
"You've never liked your scar," Teddy said, "but it's a cute little bump."
"I'm starting to be okay with it," Annie said, "it took a bit to be okay with it."
"I totally understand," Teddy replied.
"Josh likes it so far," Annie replied, "we'll see when I'm the size of a small whale."
"You have nothing to worry about," Teddy promised.
"Somedays I wish one of my friends had done this or was doing this with me," Annie admitted, "it's hard to be the only one who's married or having a baby. It feels like I don't always fit in their world."
"It is," Teddy replied, "I remember my couple months in New York after my first tour, while I was away my friends had gotten married, lots had babies and I had some good war stories but I was alone. It's not easy being on either end. They're so excited for you though."
"They all want to be aunties," Annie said, "but the attempts to pet me are getting on my nerves."
"I think they're all a bit jealous," Teddy said, "they're always single."
"You're missing a lot of information," Annie giggled, "they all tell me their stories. And I was DD for girls night last week. That was really funny."
"Let's go meet this family," Teddy said, checking her watch.
Annie followed Teddy to her office and they pulled an extra chair to Teddy's side of the desk for Annie. Together they explained the care Sarah and Carmen were receiving and what would have to happen before they would be discharged.
"Can we back up to something," the mother asked, "it sounded like you said Sarah is pregnant."
"She is," Annie replied, "she asked me to tell you because she is nervous to tell you. She's 10 weeks, OB has looked at her and the baby and everything looks good."
"We need to book an abortion," the father said.
"That is Sarah's decision and her decision alone," Teddy said, "we will not force your daughter to do that in any way. No doctor will and keep their lisence."
"She's an olympic hopeful," the father yelled, "I am not throwing away 14 years of work because she couldn't keep her legs closed."
"When you are calm talk to Sarah," Annie said, "she is anxious about this. OB has consulted with her on all of her options and the hospital social worker has also been called to talk to Sarah. She has to make this decision on her own."
"What do you know about this," the father roared, "either she ruins her life or she gets rid of it. I won't support her."
"Sir calm down and take a deep breath," Teddy commanded, "there are many resources, adoption is a viable option."
"What do you know of adoption," the mother yelled.
Teddy kept her face neutral, "I gave up my first baby for adoption because while I was unprepared to be a parent but couldn't bring myself to terminate. Then 26 years later I adopted my son. I know adoption. Let Sarah make her own choices. We will only take her opinion and wishes into account on this matter. Legally it has to be her decision alone. Whatever she chooses we have resources to support her and your family."
"Can I see Sarah," the mother asked.
"When you are calm," Annie replied, "she is anxious and in pain we will take you to her when you are calm."
"We'll step out and give you all the time you need," Teddy smiled before standing up. Annie followed her.
"You handled that well," Teddy said.
"But is it enough," Annie asked.
"That was a shock reaction. Give them time to process and it will be fine," Teddy said.