Josh carried their suitcases to the car. Looking in the back of Annie's car Josh realized they had more stuff for Ellie than for themselves.
"Babe do we need all of this baby equipment," Josh asked.
"We do," Annie said.
"Annie it's just Portland," Josh said, "why are we driving? The hospital would fly us."
"Ellie is a month old," Annie said, "she's not big enough to fly. I'd rather do the 4 hour drive with her."
"She's fine to fly," Josh said.
"I don't want to be that mom with the screaming baby on a plane," Annie replied, "I'm not even ready for this exam. It'll be amazing if I pass."
Josh replied, "you're ready. You worked with your mama and Meghan. How many hours did you and Jenna work?"
"Not enough," Annie fretted, "I've spent more time being mommy than dr Altman. I'm supposed to be studying while she sleeps but she falls asleep on me and she's so cute and snuggly that I just want to cuddle her. And I end up spending more time staring at Ellie than studying."
"Relax babe," Josh said, "you're probably more prepared than I am. You were ready before you had her."
"That was a month ago," Annie retorted.
"You've got this," Josh said, "you're an amazing surgeon. Stop, we are not doing this for the whole drive to Portland. Annie your spiraling. Don't do this now."
"Nine years of work," Annie said, "on one three hour oral exam. I hope she cooperates with Meghan while we're in the exam room."
Josh replied, "she'll be fine with Meghan."
"I'd rather her be with mama," Annie said, "but she's an examiner."
"Meghan is good with her," Josh said, "you trust Meghan. She likes Meghan as much as she likes Teddy."
"What if she's hungry," Annie asked.
"You get breaks," Josh replied, "and were leaving bottles with Meghan. Teddy will have told the examining board about Ellie. They will allow you a longer break to feed her if needed."
Annie replied, "let me feed Ellie bug then we can go."
"I thought you had," Josh said.
"She didn't really eat and that was a couple hours ago," Annie said, "I want her full and sleepy for the drive."
"I'm going to shower then," Josh said.
Annie walked inside with Ellie and sat in her favourite chair. Once the baby was settled Annie grabbed her flash cards from the end table and flipped through basic cardio procedures focusing on the minute details that would make or break her test. Mama had told her that this test wasn't about being flashy or ground breaking. This was about proficiency, solid basics and clear communication. She needed to follow protocols and be consistent.
Annie asked, "ready for your first road trip Ellie bug?"
"It's you I'm wondering about," Josh said, "10 minutes in the car and she's asleep."
Annie laughed, "if you don't have a good playlist I'm sleeping."
"Do you have snacks," Josh asked.
"In the cooler," Annie replied.
"That's in the trunk," Josh said.
"I told you to put it on the backseat with the diaper bag," Annie replied.
"It was too big," Josh said, "it would shift and squish Ellie. We wouldn't have this problem in the truck."
"Car looks better than a truck for a professional situation," Annie said.
"I'm taking the 10 minutes and loading the truck," Josh said, "who will see what we pull up in. We'll be the only people driving ourselves."
Annie rolled her eyes, "okay. We'll take the gas guzzler."
"There's more room for Ellie and her stuff in the cab than your backseat," Josh said, "we should have just taken it in the first place."
"Then you drive the whole time," Annie said, "I hate driving the truck. With the car we can take turns."
"When was the last time you drove on a road trip," Josh asked.
"Up the island highway," Annie said, "I drove most of the old and new sections because we had my car and I remembered the road. That was the last road trip we went on."
"That was our honeymoon," Josh said, "we don't get away enough."
Annie nodded, "we don't, we've had our honeymoon and disneyland since we've been married but those have been our only trips other than when we got engaged.."
Josh came back from loading the truck as Annie was strapping Ellie into her car seat.
"Ready," Annie asked.
"We are," Josh replied.
They got into the truck and headed towards Portland. As Josh had predicted Ellie was asleep in ten minutes and Annie followed five minutes after they got on the I5. He knew Annie was worn out, Ellie woke up 2 or 3 times at night to feed and Annie insisted that a bottle and formula were not a choice. Josh supported Annie's choice to feed the baby herself but at times wished he could give Ellie a bottle in the middle of the night to let Annie get much needed sleep. Annie pumped, but Ellie preferred her mommy to a bottle even when it was daddy cuddling her and feeding her, Ellie would scream until Annie fed her.
Five hours later they reached the hotel looking stressed and rumpled. Teddy met them in the lobby.
"Mama," Annie greeted.
"Hi sweetheart," Teddy replied. She leaned over the stroller and gushed, "hi Ellie bug how's grandma's girl?"
Ellie wiggled.
"How was your flight," Josh asked.
"It was good," Teddy said, "most of our group has checked in and we're doing dinner in an hour and a half."
"We'll meet you," Annie said, "quick dinner to see everyone, then we should go to bed early, Ellie takes a while to settle for the night."
Josh checked into the hotel confusing the clerk why he needed two keys most of the doctors were traveling alone. Then they took turns checking in for their exams the next day.
"We only need Meghan for one session," Annie pointed out, "my third overlaps with your first."
"Do you think they did that on purpose," asked Josh.
"No not when I was the only one eligible for extended breaks," Annie said, "it's not like many people bring their newborn to their boards."
After getting to their room Annie quickly showered and dried her hair before sitting on the bed to feed the baby. Both Annie and Josh were dressed casually. Annie in a purple fit and flare dress with buttons down the front. Josh was in jeans and a blue button down. They had dressed Ellie in her I heart my mommy onesie and a pair of black baby leggings with pink hearts on them.
"We should take the stroller shouldn't we," Annie asked.
"I would," Josh replied, "we can put her down when she falls asleep that way."
Annie replied, "I'm going to carry her down though."
"Of course you are," Josh said, "you never put her down unless you give her to someone else to hold."
"I can't help it," Annie said, "she whines when I put her in her bed or swing if she's not asleep first."
"Because you give in and pick her up," Josh said, "she has to learn that you can put her down and will come back, that she's safe in her bed to fall asleep."
"She needs to know I'm here no matter what," Annie said.
Josh sat with them, "what is this really about?"
Annie sighed, "it's silly."
Josh put his arm around her, "not if it's bugging you this much. We have time before we go."
Annie shook her head, "you'll think I'm being stupid."
Josh asked, "is this about Leslie?"
Annie nodded, "I know it's dumb. But I want Ellie to know I'll always be there no matter what and that I won't replace her or give up on her."
Josh realized suddenly how much Annie had been hurting, "I'm so sorry I didn't see it sooner Annie. You're not letting Ellie go so she knows you're always there."
Annie nodded, "I know it's silly. But I don't want her to ever feel how our parents made us feel. I had so many questions and feelings I couldn't talk about growing up. Who really wanted me, who actually loved me, why didn't mama keep me?"
Josh simply held Annie and let her talk.
Annie continued, "I still don't understand how Leslie could just give up on me. Why hasn't she asked about Ellie? I was always second best to Jessica growing up, never good enough to fit in no matter what I did. Why wasn't I good enough for them? They choose me? I was a choice for them and they turned their backs on me."
Josh kissed the top of Annie's head, "I know it bothers you. It hurts that they don't understand us. Annie, your mom doesn't understand how to connect with you. Dan is really trying. He wanted to come visit this weekend but we're here. He calls or texts us every day now."
Annie continued, "I know we've built our own family with mama, Owen, Nathan, Meghan, the kids, nana and David. But I want my other family two all of it, not just Dan and Chris. Dan comes next week after school is out and he's finished the office work for the summer. Time with us is his reward for finishing his time table for next school year. "
Josh said, "that's progress with Dan."
Annie said, "I don't know how I'm going to be a good mom to Ellie and go back to work. Our hours are so long."
Josh said, "I thought we agreed to use the daycare at the hospital. You're going to just be doing cardio the first few months. Most of it is scheduled with office time and you have research days in your week."
Annie said, "I'm actually going to talk to mama about a slight change in my fellowship. They haven't finalized any spots yet. I think I want to do plain cardio. I don't think I can be the mom Ellie needs and have the craziness of both of us on call. I need to do just scheduled cardio for a while, no peds call and no trauma. Ellie bug needs me."
Josh replied, "I thought you might do that. You're a good cardio surgeon but peds is your calling. It's your choice. They'll put you only in peds cardio and add trauma when you're ready. You're too good at it for them not not. If you want to do just peds cardio while she's nursing I support that."
Annie nodded, "I do. And I'd be one of only a handful of peds cardio surgeons in the country."
"Teddy created that fellowship for you the peds cardio," Josh said, "90% of your time will be peds cardio and scheduled. She'll give you a schedule that lets you be with Ellie. "
Annie nodded, "I know. I do like having the option and being able to work traumas with you. We're a great team. "
Josh replied, "always have been. In and out of the OR."
Josh kissed Annie then kissed the side of her neck.
Annie playfully pushed him, "no time for that now we'll be late for dinner and I'm not ready it's too soon a couple more weeks. I want to. I miss you, I miss us."
Josh kissed her, "I know. I love you so much."
Annie replied, "as soon as Carina says it's safe and I get the new IUD. I love you more."
Josh, "you've decided on that."
"I have," Annie said, "and the copper has no hormones so it won't affect feeding Ellie."
"If that's what you want," Josh said.
"I don't want another one yet. Let's enjoy Ellie," Annie said.
"Do our fellowships, get attending positions then decide," Josh said.
"As long as they're closer together than Allison and I," Annie said, "that was really weird."
"You make it work with your siblings," Josh pointed out.
"And growing up with two close in age wasn't a picnic either," Annie admitted.
They finished getting ready and headed downstairs to meet the Grey Sloan group. Josh pushed the stroller with Annie walking beside him. For some of their friends it was the first time they were seeing little Ellie. Annie has chosen to stay close to home to bond with the baby and study the last few weeks. Ellie had only been out to see family or her check ups with Alex. Ellie was passed from surgeon to surgeon that night and fussed over by everyone only being returned to Annie and Josh to be fed or changed.
Annie was going to miss this group when they started to leave. Duncan had an offer in Huston, Julia was off to LA, Max was going to Dallas. These had been their best friends and family over the last five years. They only had a couple weeks together. Annie was a bit disappointed she wouldn't be with them for the celebratory final week. But she had promised to come on the last day and bring Ellie so they could all do the last day together. She would be there for Webber's final speech and Teddy's send off. She knew Teddy had something special planned for their class to celebrate finishing their residency.
The morning of the exam Annie waited outside the room for her test playing with the hem of her black skirt. It was a bit snugger on her stomach than she wanted but her jacket would hide it. She took a deep breath trying to focus on her exam. Ellie was up in their room with Josh she had just been fed before Annie came down, Ellie would have some good cuddle time with her daddy before she fell asleep if it worked the way they hoped she would sleep until the end of Annie's second session.
"Dr Grace Altman," a man called.
Annie stood.
"Come in Dr Altman my name is Dr Preston Burke," he introduced.
"It's nice to meet you dr Burke," Annie replied.
"Dr Altman," a middle aged woman greeted, "I'm Dr Jones. I spoke with your Chief of surgery last night and she let me know you may need extended breaks to care for your daughter. May I ask how old is your child?"
Annie smiled, "Ellie was 4 weeks yesterday. She's still a newborn."
"Please let us know if you need time with her or to bring her into the room. We're all parents,``Dr Jones smiled, "that would be a challenging year for you. I hope your husband was supportive."
"He was," Annie smiled, "he's doing his exam today as well. His first session overlaps with our third so we have my mother and our aunt to watch Ellie."
"You mother came," dr Burke asked.
"She's also my chief of surgery and had early exams to do," Annie explained.
"Your Teddy Altman's daughter," the second man spoke, "I saw her last night, she was my fellow at Mayo. I'm Dr Maco."
"It's nice to meet you sir," Annie smiled, "mama has said great things about you."
"Dr Altman let's see if we can do this efficiently so that we can get you back to your baby girl," dr Jones said.
"She should be okay for a couple hours. She's been fed and is happily cuddling with her daddy ," Annie smiled.
"What type of surgeon is he," dr Jones asked.
"Trauma," Annie replied.
Dr Maco spoke, "we have three scenarios for you dr Altman you need to pass two of your three sections today. You can ask questions during each scenario but you can not return to a previous scenario. Due to your unique circumstances we can adapt your schedule to accommodate caring for your daughter."
Annie nodded, "I understand. Is it possible to take only 10 minutes between the first two to allow me 50 minutes between the second and third without making you late for the candidate after me?"
Dr Jones smiled, "we can do that."
"Thank you mam," Annie replied.
"Okay Dr Altman your first scenario," dr Burke began, "you have a premature infant in the NICU with HLH how do you approach their care."
Annie smiled, she had done a lot of these with her mama and Christina. She loved the team work of the NICU, "the first thing I would do is establish a connection with the child and the parent. If the child is stable enough to be held by the parents I would encourage kangaroo care to support healthy bonding and allow the child to hear the parents heartbeat which not only teaches them to regulate their own heart rate and breathing but also reduces stress in both parent and child. It's hard to be stressed and anxious when your baby is asleep on your chest."
"Please explain the rest of your plan," dr Jones prompted.
Annie explained the work she had been doing over the past few months with Christina and how they would use the 3D printed parts to support the child's heart.
"Thank you dr Altman," Burke said, "I didn't realize you had studied with Christina Yang."
"She's the head of research at Grey Sloan she was hired in April," Annie explained, "she's an excellent teacher."
Annie had no clue there had once been a relationship between berk and Christina.
"Would you like a break, Dr Altman, or can we continue to your second scenario and allow you an hour with your daughter," Dr Jones asked.
"I'm prepared to continue," Annie replied.
"You have a 14 year old male with a new heart murmur and worsening cardiac output," dr Jones introduced, "what do you do?"
Annie asked the clarification questions she needed then described what she had done recently with Jonah. She explained the possible surgical interventions before recommending the transplant panel be called in and the child placed on the list as the situation looked like it would continue to deteriorate. She spoke about what they had done to care for Jonah and the discoveries they had made on his case.
"Dr Altman go enjoy that baby of yours," dr Maco said.
"Thank you sir," Annie smiled, "I'll be back in an hour."
"We will see you then Dr Altman," dr Jones replied, "if your daughter needs more time by all means take it."
Annie stepped out and closed the door behind her. She saw Teddy in the hall, "we did two without a break, I have an hour to feed Ellie and cuddle."
"How do you feel," Teddy asked.
"Dr Jones and Dr Maco were pretty positive, I'm unsure about Dr Burke when I described our HLH work he said something about Christina," Annie replied.
"He left her at the altar before she met Owen," Teddy replied.
"Ouch," Annie said.
Teddy nodded, "I have to go to the conference room for a bit about my candidate. Go see your baby and husband."
"I will see you after mama," Annie replied, "I'll meet you here with Ellie?"
"Okay, bring her stroller please I'll take her outside," Teddy smiled, "Meghan is having coffee with Ian before he meets Ellie. I don't know if she'll be back."
"She should be sleepy," Annie replied, "it's about snack and nap time."
"Go see your baby and wish Josh luck," Teddy directed.
Teddy remembered the stress of her boards and doing them herself. She couldn't imagine the added stress of being 4 weeks post baby. Still getting to know her newborn and the wild emotional and hormone swings that were happening. But Annie on the surface was calm Teddy hadn't gotten a good look at her eyes. Her eyes were always her tell if she was okay or faking it.
Annie walked into the hotel room to a crying baby.
"What's wrong," Annie asked.
"She's hungry but won't take the bottle," Josh replied.
Annie quickly shrugged out of her jacket, "give her to me fast."
As Josh crossed the room with the screaming baby Annie unbuttoned her blouse and was ready to feed Ellie.
"That's it baby girl mommy's here. I know you're hungry," Annie soothed.
"Babe are you okay? You're back early," Josh said.
"I'm fine. A bit thirsty but I'm fine. We did my first two with no break so I could have an hour now," Annie explained, "how long has she been screaming?"
"Five minutes," Josh replied, "I was about to come find you."
"She's going to eat then we're both going to our sessions and mama is taking Ellie for a walk in her stroller," Annie replied.
"It's almost naptime," Josh replied.
"I know it is," Annie smiled, "but mama thinks she'll nap in the stroller. You know how fidgety mama gets away from Ali and Leo. Mama is better to move and take Ellie for a walk. I'll send a bottle in case but I doubt she'll need it."
"We should figure out why Ellie won't touch the bottle," Josh said.
"I'll ask Robbins or Karev," Annie said, "until I go back to work I'd honestly rather just feed her. She's happy, it's more comfortable for me. I like the time just her and I."
Josh said, "I know you don't mind feeding her now, but we have to figure it out before you go back to work. How did the first two go?"
"Easy basically Jonah and a typical HLH," Annie replied, "nothing shocking except one of my examiners almost married Dr Yang before she met uncle Owen. I must have been in high school."
"How did that come up," Josh asked.
"Talking about HLH babies," Annie replied, "they didn't seem thrilled that I recommended kangaroo care for the baby. But their so much calmer and vitals are so stable with skin to skin. It was nice to be dr Altman for a little bit."
"One more session," Josh said.
In the conference room Teddy went to get a cup of coffee.
"Dr Altman," Dr Maco greeted.
"Dr Maco, how is your morning going," Teddy asked.
"I'm interviewing your daughter," Dr Maco replied, "you studied with me for two years and never once mentioned her."
Teddy nodded, "I had her my first semester of medical school. She was with her dad. We always had very open communication."
"She reminds me of you as a fellow is some ways," dr Maco smiled, "but there's something different I can't explain."
"She's 29, married and has her first baby. It's a different perspective. I was a single, workaholic, who's daughter was in British Columbia when I was working with you," Teddy explained.
"Is that why you chose Seattle to be close to your daughter," dr Maco asked.
"When I left Mayo I did a couple years at Columbia then after 9/11 I did several years with the MedCom in Iraq," Teddy explained, "my daughter and I were separated for years we wrote, she was 18 and a finishing her freshman year of college when I took the job in Seattle. That was the best decision I made even though she was at UBC, it was two or three hours to see her and she texted nonstop."
"That would be hard for you Teddy to be away from her so much," Dr Maco said, "do you have other children?"
"I do with a huge age gap from my oldest. My son is 5 and my younger daughter is 4," Teddy smiled.
"So married," dr Maco asked. He had loved teaching Teddy; she had been compassionate with her patients, brilliant, dedicated and hard working. She was a gifted surgeon when he worked with her if a little guarded.
"Three years ago," Teddy replied, "but I've known him since I enlisted. I don't know if you know many of the trauma surgeons on the west coast but dr Owen Hunt."
"I taught two Hunts at Harvard before I went to Mayo," dr Maco said, "brother sister team of redheads. Very different but both good."
"Sounds like Owen and my sister in law Meghan," Teddy smiled, "we're all in Seattle at the same hospital training my oldest and her husband."
"I've heard rumors of a happy family bubble in Seattle," dr Maco said.
"If you're ever in Seattle please come visit," Teddy replied, "just tell them you're looking for the chief of surgery. If you ask for dr Altman you'll get my daughter."
"I shouldn't be telling you but she's excellent," dr Maco said, "clearly cares about her patients."
"She's anxious about passing," Teddy admitted.
"She can relax," dr Maco said, "we sent her to see her baby."
Teddy nodded, "probably time to feed Ellie."
"Ellie," dr Maco said.
"Elizabeth Grace Altman-Riggs," Teddy replied, "my daughters, granddaughter and I all use nicknames. My oldest uses Annie and my youngest Allison we call Ali or bean."
"Do you have any sessions left to examine," dr Maco asked.
"One candidate at 4 pm. For the next few hours I'm grandma and taking Ellie for a walk so my daughter and son in law can relax and take their exams," Teddy smiled.
"Your daughter will be fine," dr Maco smiled, "what's her plan for her fellowship?"
"We have a peds cardio one focusing on innovation working with Christina Yang and Margaret Pierce," Teddy replied, "if today goes well the spots Annie's. Her husband has a trauma fellowship with us as well."
"Keeping you kids close," dr Maco asked.
"They've always talked about staying in Seattle," Teddy replied, "it's been great to see you but I should go and get ready to babysit."
"Enjoy your granddaughter," Dr Maco smiled.
Annie and Josh met Teddy and Meghan in the lobby and passed off the stroller and diaper bag.
"Annie," Teddy said, "go take your exam and call me when you're done. Ellie is fine with us."
"It's the first time she's not with one of us," Annie said.
"She's with grandma and auntie Meghan," Teddy said.
Meghan reached out a pinkie to Annie, "go be awesome."
"I will," Annie smiled, "Ellie bug be good mommy loves you and will see you in about an hour."
Josh whispered to the baby, "i love you Ellie. See you soon."
Standing in the hallway outside the exam rooms Annie gave Josh a quick hug, "good luck in there. Knockem dead Riggs."
"Break a leg Altman," Josh replied holding her tight.
Annie giggled, they had said the same things before their interviews for internships at Grey Sloan.
"Dr Joshua Riggs," a man called.
Josh walked towards the door.
"Dr Altman," Burke called.
Annie walked back into the room for the final session of her exam.