It was Annie's first day back at work and Ellie's first day of daycare. Last week Annie had brought Ellie to visit the daycare and see Josh while Annie met the new cardio fellows she would be working with. The pediatric cardio program was exciting working between Maggie, Christina and Alex. Over the last few years she had gotten to know Maggie and felt better about working with Alex considering their first meeting 10 years before where he ranted about Altman having a kid and his refusal then to teach Annie.
Annie walked into the daycare, "okay Ellie bug. Mommy has to go to work and help other kids. You're going to stay here with Miss Crystal and Miss Sarah. Your going to have so much fun baby bug. Mommy will be back to feed you in a few hours."
Teddy walked in with Allison, "good morning."
"Good morning mama," Annie greeted, "Ellie look Who's here. You have Allison to play with and she's going to be really nice and make sure you smile."
Annie crouched to look Allison in the eye, "Ali bean. I need a huge favor. Can you be the best auntie ever and make sure that Ellie smiles at least once today. It's her first day and she doesn't know anyone yet. Can you be her friend today?"
Allison hugged Annie, "I promise. Pinkie swear. I love Ellie."
Annie smiled, "I know you do. Have a good day bean."
Allison skipped off to her friends after waving to Teddy.
Teddy shook her head, "she doesn't even want me here anymore."
Annie asked, "how did you just leave her here when she was this little."
"It was hard but I didn't like maternity leave as much as you have. We're going to go get Ellie settled," Teddy directed, "give her a kiss then go get your scrubs. You're in navy blue now. Go work when they page you to feed her, come back and give her cuddles and another kiss. You can feed her in my office if you want the privacy."
"Two of the other cardio fellows know why I've been off for the last few months," Annie replied, "they want to meet Ellie. I'll probably feed her in our office and see how it goes then they can meet her when she's happy."
Teddy nodded, "we like happy healthy babies here. Go get her settled, take a couple pictures then get to work. Where's josh?"
Annie replied, "he's in OR 8. He's finishing a 36 and off at 3. He's going to take her home because I'm not off until 7. He wanted to be here but you know what being married to a trauma surgeon is like they don't have a schedule. Today I'm meeting 3 families with HLH babies to plan and checking in with Jonah to see how he's doing with his LVAD and then bugging unos about his transplant."
Teddy smiled, "then give Ellie a kiss and get started."
Annie hugged Ellie one more time before putting her in a baby swing, "have fun Ellie bug. Mommy will be back soon for a snack. I love you baby girl."
Teddy guided Annie to the infant room before directing, " finish settling Ellie, scrubs, take your caps to laundry, then patients. "
"I went through my box of caps from school last night," Annie said, "I brought my sea animal ones. The orca one I've only worn twice ever. That's from my last Christmas in B.C. "
"I remember picking that one out with Henry," Teddy said, "why didn't you wear it?"
"Because it used to make me sad then it got buried at the bottom of the box because I never used it," Annie said, "maybe it's time I wear it. But I'm starting with my otters."
"The otters," Teddy asked, "the same one?"
"It is. It's my first cap the one uncle Owen got me," Annie said.
Annie finished settling Ellie in and gave her a kiss before putting her in a swing, Ellie loved the baby swing. Annie crouched in front of the swing rocking it gently smiling at her baby.
"Annie it's time to go," Teddy called gently, "she's going to have a good day."
Annie gave Ellie a final kiss and whispered, " mommy doesn't like this anymore than you do. I'll see you soon Ellie bug. Daddy is going to come say hi as soon as he's out of surgery. Maybe later mommy or daddy can bring you up to the gallery to watch. I love you sweet girl. "
Teddy put her hand on Annie's arm and guided her out of daycare.
"Annie you need to breathe," Teddy said, "I know this is hard . But I'll check in soon. You're going to go put your bag in your office, get changed into scrubs and meet Pierce."
"What if she's not happy," Annie asked.
"She will be with teachers who are wonderful," Teddy promised, "you're in the same building. Most of your day is on the same floor. Come back when it's time to feed her and you'll see how happy she is. She's a happy baby sweetheart because you're a good mom. But you're not going to be happy if you don't work. You've said you miss it."
"I do miss it but she's so tiny," Annie said, "I'm really torn. I want to operate and cut I've missed it. I haven't operated in four months but it makes me a bad mom not being with my baby. Leslie said something about me not taking a full year with Ellie."
"If you had the opportunity you would," Teddy replied, "but even you've said you're bored. You need to be happy to be a good mom. You like to work."
"I do," Annie said, "I just don't want Ellie to think we don't care and our jobs come first."
"You set boundaries," Teddy replied, "why do you think I insisted on a deputy Cheif. You can set boundaries on your time. When I used to go feed Allison that was her time or family time if you sat with us to chat. When you're with Ellie you're with Ellie. Don't let people come to you for consults or answer emails. That is baby time."
"I can do that," Annie agreed, "can I maybe take her to the gallery to watch Josh later?"
"Take her up and show her off. Jenna and Cassidy are working today," Teddy replied, "so is Jeremy."
"We're all here," Annie smiled.
"You are so go work and you can take Ellie for lunch with your friends," Teddy said.
"Going to the attendings locker room and getting navy scrubs. They won't be able to tell us apart now," Annie laughed.
"I'm always going to be taller and I'm looking older," Teddy said.
"Mama. You're not old," Annie rolled her eyes, "I'm not going to hear that again."
"I'm 51," Teddy replied, "it's okay. I can still out run you."
"I'll be faster again soon," Annie teased as they got to the locker room.
In her scrubs Annie headed back to the peds floor to begin checking in with and introducing herself to patients. She walked into Jonah's room.
"Jonah," Annie greeted seeing the little boy was alone, "are your mom and dad around?"
"Hi Dr Grace. Dads at work and mom's getting coffee," explained the boy.
"I've been off for a while," Annie said, "can you fill me in on what's happening?"
Jonah asked, " where did you go?"
Annie smiled, "I was at home with my little girl. She needed her mommy."
Jonah's mom walked in, "Dr Grace I didn't recognize you."
"It's the navy scrubs," Annie laughed, "it's good to see you again."
"You had your baby," Mrs Johnson said.
"I did. She's 14 weeks. It's my first day back. Jonah is my first patient. I couldn't wait to see how he's doing," Annie replied.
"A baby girl," Mrs. Johnson said, "name? How big?"
"Ellie, she was 6 pounds 2 ounces at birth she's 11 pound now," Annie replied, "she's the sweetest little girl. She's down the hall in daycare. How is our Jonah doing?"
"He's good," Mrs. Johnson replied, "doing well on the LVAD. Dr. Altman is happy with how he's doing."
"I've been following his case with my mother," Annie replied, "I've been tempted to come say hi a few times when I've brought Ellie by to see her daddy and grandparents."
"Your partner works here as well," Mrs. Johnson asked.
"He does. He's a trauma surgeon," Annie replied, "he works with my aunt and step father in the trauma department."
"Lot's of family here then," Mrs. Johnson smiled.
"One of the reasons I chose Grey Sloan as a resident and my husband and I chose to do our fellowships here," Annie replied.
"How long have you been here," Mrs Jonson asked.
"I started here five years ago as a surgical intern right out of medical school," Annie replied.
"And you've always worked with your mom," asked Mrs Johnson.
"Most of it. The first six weeks of my intern year she was with the army running hospitals then her and my step father decided it was time to get married and they had my little sister so mama came back to Seattle and took a job here," Annie said.
"My husband was in the military, where was your mom stationed," Mrs Johnson asked. She had a hard time seeing their sweet surgeon who took time to play games with Jonah as an army brat.
"Mama was stationed in Landstuhl Germany while I was in medical school then was in Iraq while I was in middle and secondary school," Annie said, "I was with family in British Columbia. Where was your husband stationed?"
"It was before we met but he did time in Iraq as well," Mrs. Johnson replied.
Annie checked her watch, "Jonah I'm going to send an intern to find you and do some tests I want updated then I'll see you later. I was just coming to say hello before I had to meet the rest of my department."
"Will you stay now," Jonah asked.
"I'll be here Monday to Friday and can be called on the weekend if you really really need me," Annie said, "I won't do as many nights for now."
"Why won't you be here at night," Jonah asked.
"For now," Annie said, "my daughter needs me at home. I promise that no matter what when the call comes for your transplant I will come right away. I will do that myself."
"Do you have any news on the transplant," Mrs. Johnson asked.
"I am going to call UNOS after my department meeting and find out more," Annie said, "that's why we're running new tests. I want updated data to see if I can push Jonah up the list. We are doing everything we can."
"Please let me know," Mrs. Johnson said.
"I will be back as soon as I know more," Annie promised.
Annie walked into the main conference room for the cardio department meeting. She took a seat down the table from Teddy remembering their conversation from the night before about it being time to spread her wings further.
"I don't think we've met," said a young man sitting across from Annie.
"We haven't," Annie smiled, "I'm Grace Altman."
"Colton Walters," Colton replied, "are you a new attending?"
"No I'm a fellow, I did my residency here," Annie replied.
"You're the one that was on maternity leave," Colton smeared.
"Yes," Annie replied, "my daughter is 14 weeks."
"The mommy train to mediocrity," Colton mumbelled.
"Are you adding a sub specialty to cardio," Annie asked.
"Isn't cardio enough," Colton said, "does your baby daddy even support this?"
"My husband is a trauma fellow," Annie replied, "he is very supportive of me pursuing peds cardio."
"Your that Altman," Colton said eyes wide.
"What do you mean by that Altman," Annie asked, "it's not a common name."
"Its true that the chief's daughter is one of us," Colton replied.
"Yes," Annie commented, "there are only two Dr. Altmans here."
"Dr Altman," Christina called.
"Yes Dr. Yang," Annie replied.
"Other Altman Thing One," Chrstina replied, "but did you get to look over my HLH patients?"
"I saw the two in the NICU and looked over the screening for the mothers," Annie replied, "I will get to the ones at other hospitals after lunch. It took me a while do do drop off this morning."
"Drop off," Chrsitina asked.
"It's Ellie's first day of day care," Annie replied.
"Thing one point one," Chrisitna replied.
"One point one," Annie asked.
"Your thing one, we had a thing two a few years ago so your kids can be decimal points," Chrsitina said.
"My brother who you insist on calling thing two will be down to visit next weekend," Annie replied, "thing one was funny when I was a 19 year old pre med student but as your fellow it's no longer funny."
"Come on Annie," Chrisitina said.
"It's Grace Altman at work," Annie replied, "I would like to talk to you about an idea I have for my LVAD patient. He's on the transplant list but I have an idea."
"What are you thinking," Chrisitina asked.
"It might not even be doable but is there a way we could combine your 3D printed scaffolds with the way mama and I have been using bovine tissue to build Jonah a new heart," Annie thought out loud.
"Creative thought," Teddy said.
"It might work," Chrsitina suggested, "but his issue is he needs the LVAD to pump his blood for him. How will you do that?"
"I'm still thinking," Annie replied.
"Keep thinking," Maggie interjected.
Nathan entered the room.
"We're all here," Maggie said, "let's get started. We want to welcome Dr. Grace Altman back from maternity leave, she left as a resident and is returning as our peds cardio fellow. Dr. Nathan Riggs will be going on a one month parental leave as soon as he and Dr. Meghan Hunt welcome their child."
"The female Hunt is pregnant," a resident whispered.
"We're adopting," Nathan clarified.
"Back to business," Maggie replied, "we have a full board this week and not enough OR time."
"I am looking at the OR time available," Teddy replied, "we have 9 ORs total and 8 currently functional. I am waiting on funding to complete the refurbishment of OR 9 which hasn't been used in ten years."
"Does an OR need to be kept on standby at all times," Colton asked.
"We're a level one trauma center," Teddy replied, "I have to have an OR on standby for traumas and a trauma surgeon at all times. The standby OR is used for emergencies other than traumas, c-sections, heart attacks requiring emergent bypass. It is used approrpaitley."
"When can we hope to see OR 9 running," asked Chrisitina.
"It hasn't been used in ten years and needs new lighting and equipment," Teddy replied, "I have approached the board for funding as well as the Fox Foundation. I expect to hear back in the next few weeks. When the work is completed we will reduce the congestion for OR time."
"How do we get the time we need," Colton asked.
"We need to consider more round the clock scheduling," Teddy replied, "start scheduled procedures earlier in the day and work later into the night. I am also going to talk to plastics about extended scheduling."
"As much as we hate doing this we need to look at our errors in the month of August," Maggie said.
The cardio team settled into discussing the surgeries in the previous month and plans for research. Annie thought about the last time she had sat in one of these at the beginning of May, more about how she had paced the back of the room trying to get comfortably and sooth Ellie's kicks. She had only half listened to the conversation then instead counting the hours until she could go home. Today annie's mind was also elsewhere during the conversation about the mistakes of the previous month, today she was wondering how Ellie was doing in daycare.
The meeting finished and Annie went to check on Ellie.
"Chief Atlman may I have a word," Colton asked.
"Dr Walters, what can I do for you," Teddy asked walking briskly down the hall.
"I had a question about the fellowship positions," Colton said, "your daughter is the peds cardio fellow I applied for that position and you gave it to your daughter who already missed the first two months of it."
"Grace will make up the time on the back end of her fellowship," Teddy replied, "you can not use her maternity leave against her."
"She's already gone to the day care after one meeting. How does that show the dedication to patients you demand," Colton questioned.
"Legally she can go feed her daughter," Teddy replied, "Dr. Altman's personal life is none of your business."
"But she's already not pulling her weight," Colton said.
"I believe your question for me is why were you not selected for the peds cardio position," Teddy replied.
"Yes mam," Colton replied.
"I spoke with your attendings in Iowa," Teddy repluied, "a big part of the peds position is being able to connect with children and parents. To put children at ease and understand how they respond to the hospital experience. Your assisting your attendings with research into heart disease in children was a step but they did not speak positively of your bedside manner with children. You are able to assist on peds cases as they come up."
"What does she do that I don't," Colton asked.
"Dr. Altman has published a series of picture books for children detailing different surgical procedures and common procedures outside of the OR in a way children understand. She has partnered with a local artist to illustrate them. She build our demonstration kids for children. I suggest you go check out the one in the skills lab," Teddy said.
"She did that as a resident," Colton asked.
"She did," Teddy replied, "we have high expectations of our residents. Another thing before I have to go scrub in. I will never hear you mention the mommy train to mediocrity again. I have three children I had my first when I was in med school. Dr. Grey is a single mother of three. Dr. Meghan Hunt has a son and is adopting another, Dr. Shepard has a son, so does Dr. Bailey. We support families here. We are an extended family and support eachother. I do not tolerate that sort of judgemental attitude in my staff."
"I don't have anything scheduled may I scrub in with you," Colton asked, "I haven't seen the off pump CABG before."
"You may observe," Teddy replied, "I have two residents and Dr. Altman scheduled to assist."
"Why is Dr. Altman assisting," Colton asked.
"I like to have cardio surgeons scrub in with me their first day back from an extended leave," Teddy replied, "her and I have done several together. Any music requests?"
"Music," Colton asked.
"We like music," Teddy replied, "if you don't put in requests it's our standard playlist."
"I don't usually listen to music," Colton said.
Annie was called to the pit and ran down the stairs to the emergency room.
"This is one way to come back," Annie smiled dashing into the trauma bay, "what do we have?"
"12 year old male penetrating chest wound following an MVC," Josh declared, "2 min out."
"Trauma gowns and go," Annie said dashing to the ambulance bay.
Waiting for the ambulance Josh whispered, "you look hot in navy blue."
"Josh," Annie said, "focus. I've already been accused of being on the mommy train to mediocrity today."
"You could never be mediocre," Josh said, "your Annie Altman."