Annie and Josh made their way to the surgical floor at the Portland Hospital. He clung to her hand as they made their way up. She had Ellie in the carrier not wanting to navigate a stroller through a strange hospital.
"Dr Riggs and Dr Altman to see Ian Riggs," Josh said to the nurse at the nurses station.
"Room 315," the nurse replied, "Dr Edwards will be in to see you soon. I'll let her know your here."
"You can't take a child into the ICU," a resident said.
"She's a nursing infant," Annie replied, "she can go anywhere I go."
"But," the resident began.
"She is in the carrier," Annie replied, "I'd like to speak to your attending."
"What," the resident asked.
"You're a resident," Annie said.
"How did you know," the resident asked.
"You're nervous, your lab coat says md no specialty," Annie said, "we're both fellows at Grey Sloan. I know we can take our eight month old into the ICU in the carrier. I've done it when she was beyond clingy and I needed to write orders."
"She has to stay in the carrier," the resident said.
"We wouldn't take her out unless we absolutely had to," Annie said.
"Fine," the resident replied.
"Now will you show us where 315 is and page Dr Edwards. Tell her mini Altman and Riggs jr are here," Annie directed.
"You names," the resident asked.
"Dr Grace Altman and Dr Josh Riggs," Annie replied, "we're here to see my father-in-law Ian Riggs."
"This way doctor Riggs and dr Altman," the resident said.
"What do you know," Josh asked.
"We'll wait for dr Edwards," the resident replied.
Josh drew a ragged breath as they got to the door of the room. He recognized the machines keeping his dad alive.
"Breathe," Annie said running her hand down his arm.
"Those stats don't look good," Josh said.
"Wait for Edwards," Annie said, "we've seen worse. Just breathe love. We're okay."
"Mini Altman what are you doing here," Stephanie Edwards asked.
"My father in law," Annie replied, "what's the prognosis?"
"Have a seat," Edwards said.
Josh took a seat in the single chair and Annie stood beside him with her hand on his shoulder.
"Currently Mr Riggs is stable," Edwards began, "his intracranial pressure is very high and when running an EEG minimal brain activity was detected. His chances of waking up are minimal. We are unsure of his ability to breath on his own he is currently on the ventilator and in a medically induced coma."
"What choices do we have," Josh asked.
"We can wait a few days and see what happenes," Edwards said, "we can look into longer term care options."
"Can you run the tests again," Annie asked.
"Of course dr Altman," Edwards replied.
"Get all the information and wait for my uncle," Josh said.
"I'll send a couple residents to do it," Edwards said, "you two stay here as long as you want. I'll let them know your both surgeons. You're both still residents right?"
"Fellows," Annie replied, "I'm peds cardio Josh is trauma."
"Your child," Edwards asked.
"Ellie she's 8 months," Annie replied, "we already fought one of your residents to bring her up here."
"I'm going to go order the tests. I'd like to do a repeat head CT," Edwards said.
"An MRI," Josh suggested.
"If the CT doesn't show what I want it to," Edwards said, "I'm going to go."
"Thank you," Annie replied.
Josh moved from the chair and sat on the edge of the bed.
"Dad I'm here," Josh said, "it's okay. I'm here and so are Annie and Ellie. Nathan and Meg are coming. Well get you through this."
Ian began seizing.
Annie smacked the code button on the wall seeing the monitors going downhill fast. The code team sprang into action.
In the hallway Josh leaned against the wall with his back to Annie. She stood beside him gently rubbing his back silently reassuring him as he had so many times for her.
"He's not going to make it," Josh whispered.
"What do you want to do," Annie asked.
"I want him to be comfortable ," Josh whispered, "Annie that's not my dad."
"I know," Annie whispered, "let's find a corner and breathe. Deep breaths in and out."
"He's not going to wake up," Josh said, "that's the there's no hope speech we've both given it."
"Don't give up," Annie said, "it's bleak but not impossible."
"Someone has to tell my mom. She should know," Josh whispered.
"I will," Annie replied, "we should tell her. You go sit with your dad and I'll phone."
Annie was standing outside the ICU telling Gloria what was going on when Meghan and Nathan arrived. They waited for Annie to finish.
"Nathan their in 315 fourth on the right," Annie said, "it's two at a time."
"Thanks Annie," Nathan said, "you don't want to sit with him?"
"Ellie will need to be fed soon," Annie replied, "I'll come after."
"I'll stay here with the kids," Meghan said.
"Meg," Nathan said.
"I'll change Catrina then come," Meghan promised.
Nathan walked away.
"How bad is it," Meghan asked.
"We have a decision to make," Annie replied, "long term care in a vegetative state or palliative care."
"Withdraw care," Meghan asked.
"We've seen two seizures. His stats are bad," Annie said, "Meghan this isn't good. Maybe a 5% chance of him waking up. And who knows what the deficits will be."
"How's Josh," Meghan said.
"A mess," Annie said, "as soon as I feed Ellie I'll go back in there. He's barely functioning."
"Gloria," Meghan asked.
"I talked to her and she sounded drunk," Annie replied.
"Faroke," Meghan directed, "your going to take your sister and Ellie down to the garden so we can talk to the doctors."
"When," Faroke said.
"As soon as Ellie is fed and Catrina is changed," Meghan commanded, "you need to make this easy for us. No complaints, no whining you need to help us."
"Nana," Faroke asked.
"I'll call my mom," Meghan agreed.
"We need mama and dad," Annie said.
"Call her," Meghan said.
"Even if we have nana to help with the babies," Annie said.
"I'll tell my mom," Meghan said.
Annie felt Ellie pulling at her top.
"Feed this one then I'll go back in," Annie said, "can you deal with nana and mama?"
"Do you need Teddy," Meghan asked.
"I want her on stand by," Annie said.
"Okay," Meghan said.
"I forgot something so Catrina will have to be fully in formula while we're here," Annie said.
"If you want to stop it's okay," Meghan said, "it's been a lot of work for you and gave her a good start."
"I'm going to reevaluate when Ellie is a year," Annie replied.
"Okay," Meghan said, "if you want to stop for Catrina we won't be hurt. Don't put pressure on yourself."
"We were rushing out the door I just forgot," Annie said, "I'm sorry."
"Let's call it," Meghan said, "thank you for doing that for Catrina as long as you did. Just focus on Ellie."
"Are you sure," Annie asked.
"We are," Meghan replied, "focus on Ellie. This week you just worry about Josh and Ellie. I have Nathan and our kids."
Annie walked away to feed Ellie and Meghan got her two kids set up in the waiting area outside of the icu.
"Faroke can you watch Ellie as well," Annie asked.
"I need something to put her in," Faroke said.
"Hold one, put the other in the stroller," Annie said.
"Annie," Faroke said, "I can't do two babies."
"Faroke you have to," Annie said, "Meg and I will check on you. We need you to be helpful. You have to be the big kid here."
"Annie," Faroke asked, "is uncle Ian going to die?"
"I hope not," Annie replied, "your job is to help with the babies and stay positive. Your dad needs you to be positive and calm. The best thing you can do is to help without being asked. Faroke I know bei the oldest is hard but you need to step up."
"Annie," Faroke said, "I don't know how."
"Keep both babies happy," Annie said, "me or your mom if you need help. This is really hard on Josh and your dad."
"Can you keep Ellie," Faroke asked.
"Until nana comes then you have to help nana with the babies," Annie directed.
"What can I do," Faroke asked.
"Watch your sister and pray," Annie said, "I'm going to go back in. I'm leaving our diaper bag with you my wallet is in it."
"I'll watch it," Faroke replied.
"Thanks bud," Annie said, "I'm going back in."
Annie walked back into Ian's room and immediately looked at the monitors the numbers had gotten worse. Catching Meghans eye she shook her head. They all knew what was coming.
"I think we need to look at comfort care," Josh mumbled, "those numbers are getting worse."
Annie put her arm around him and held him close.
"I agree," Nathan choked out, "but we need Gloria."
"I called but she didn't sound like she was in the right frame of mind," Annie added.
"They called us," Josh said.
"Ian and Gloria divorced," Meghan said, "Josh and Nathan are next of kin."
"I want one more brain activity scan before we decide anything," Nathan replied.
"We can't leave dad as a vegetable," Josh said, "he would hate that."
"He would," Nathan agreed.
"We need to tell mom but I think we withdraw life support if there's no brain activity," Josh declared.
Annie hugged Josh not knowing what to say but holding him tight.
"He's not him," Nathan agreed.
"Annie," Josh asked, "what do you think?"
"It's your dad," Annie said, "what is going to be best for him? What would he want?"
"This isn't dad all the machines doing everything," Josh said, "I'm trying to think like a doctor but all I see is my dad."
"I know," Annie said, "let's give it 24 hours and see what happens. We can stay here. We won't leave him."
"I agree," Meghan said, "my mom is on her way down and can take the kids."
"I'll keep Ellie here," Annie said, "we don't have any bottles for her. I can't send her with nana."
"Even if mom kept them in the vicinity and brought Ellie to you when needed," Meghan asked.
"I want her close," Annie said.
"Keep Ellie here," Josh said, "you've had her in the carrier for a while now. I want her."
Annie lifted Ellie out of the baby carrier passing her to Josh and stretching her back.
"Are you okay if I go get the stroller from the truck," Annie asked.
"Go," Josh agreed.
When Annie returned with the stroller Josh had Ellie in his arms sitting on the side of the bed. Annie stood beside him with her hand on his shoulder, trying to hold back her tears and be strong for Josh.
"Dad I don't know if you can hear me but I'm here. Annie came and so did Ellie. Were here with Uncle Nathan and Auntie Meg, and their kids. We're right here dad. I love you," Josh whispered.
"Hey Ian," Annie whispered, "we're not going anywhere. You have a great team looking after you. We're not going anywhere. Ellie says she loves her papa. We love you."
"Dad please give us a sign you're in there somewhere," Josh pleaded.
Ian's hand twitched.
"Keep talking," Annie said, "look at the monitors when you talk."
Josh kept talking to his dad telling funny stories from when he was a kid and little updates about Ellie. That the baby now sat up on her own and was trying to pull herself up on the crib bars to stand. He was stabilizing and his stats were improving.
Back at the conference Dan joined a group of men about his age. He was surprised by the pastor leading the group, he recognized the man from Ellie's christening and the few family events he had been included in. This was Evelyn's friend.
"Dan, do you want to walk with me," David offered.
"Sure," Dan replied, "you're a friend of Evelyn's right?"
"I am," David replied, "we're getting married in April."
"Congratulations," Dan replied, "so you know her kids and grandkids."
"I know Annie if that's what your asking," David replied, "I think I have some ideas to help you reconnect with her."
"I don't know," Dan said, "I don't think she wants to."
"She does," David reassured, "let's walk."
"Sure," Dan replied, putting on his coat.
They walked in silence for awhile before David spoke, "Dan I've never been a dad but I've been a pastor for 50 years. I've seen a lot. Annie wants you in her life. I've seen the tears over it a few weeks ago. Her and Chris. Evelyn's cabin is only a 20 minute walk I want to show you something."
"The cabin," Dan asked.
"The cabin," David echoed, "let's go. Evelyn asked me to check on something for her."
"I'd like to see it," Dan agreed, "my kids really like going."
"I know Annie better I'm still getting to know Chris," David replied, "they seem really close. They support each other."
"They have since high school," Dan said, "they really respect each other."
"They really respect each other and haven't always spent a lot of time together," David agreed, "last spring when your youngest was in the hospital he was the only family member that knew Annie. That understood her. Your parents really try and are around a lot. But Chris and Annie get each other. A couple days after Jessica's surgery they were at evelyns for dinner. I sat with them for hours praying. They were so anxious, Annie was physically uncomfortable but all they could think about was Jessica. Annie was desperate to make you love her again."
"When did you find out about Ellie," Dan asked.
"Annie's birthday dinner," David replied, "she told your parents because your mom was concerned she didn't have wine. I think she said nine weeks then."
"Leslie and I didn't know until your thanksgiving," Dan said.
"At that point when was the last time you had physically seen Annie," David asked.
"Christmas of 2011," Dan said, "she was 21 and had just gone to Boston."
"Through her medical school years, the first part of her residency you didn't see her," David clarified.
"I couldn't," Dan said.
"You had a choice," David said, "think about this your a 21 year old kid moving across a continent and to a different country and your parents that have raised you and loved you your whole life don't come visit. Don't answer your calls or texts. How would you feel?"
"Alone," Dan said.
"So where did Annie turn," David asked, "who would have been there?"
"Teddy," Dan said.
"And," David prompted.
"Owen," Dan admitted, "but why?"
"They see her as their own," David said, "they talk about three kids."
"She is Teddy's biologically," Dan said, "we raised her. We always knew Teddy cared. Teddy always wrote back to us. Never saying much about herself but she always replied. Owen I don't understand."
"Owen, Meghan, Teddy and Nathan have a long history," David said, "Teddy is the newcomer to the group and she met them in 2002."
"Owen and Meghan are siblings," Dan said.
"Yes and Meghan and Nathan met in medical school," David said, "they all served together a few tours. Teddy and Owen ran the team together. They were originally in the same group and then became each others best friend. They were best friends for years before they became a couple. They became a couple when they had Allison. They did things a bit out of order but it works for them and makes them happy. One thing I've learned in my career is that you have to let people make their own choices and do what makes them happy."
"How did Owen never question Annie," Dan asked, "he just accepted her."
"What I understand is at first it was his love of teddy and that teddy was his very best friend," David said, "then he got to know Annie. Annie has a way of making people love her instantly."
"She alway has," Dan said, "she's just sweet and lovable."
"Why did you stop reaching out," David asked.
"Leslie and Jessica didn't want me to," Dan said, "they wanted control of Annie."
"Dan that's an excuse," David said gently, "I'm talking about you and your actions."
Dan thought for a long time before whispering, "I didn't know how. I wanted to David I really did but I wasn't sure how she would take it if it was just me reaching out. Annie and Chris that's why I left Leslie."
"Why didn't you," David asked.
"I didn't know how," Dan replied, "Leslie and her parents were angry about Annie's choices. Medical school out of province was fine. We talked to her while she was in Boston but Annie spent her breaks with Teddy or Teddy would go to her. I would never want to come between that bond of Annie and Teddy. But Leslie got jealous, she wanted control and to run Annie's life. To limit her. Medicine was fine, surgery was not. The real break happened when Annie chose surgery."
"Dan from spending time with six now seven surgeons I've seen that it is something God calls you to do. It is a gift and a calling," David said, "they have an incredible gift. It's a calling like being a pastor or a teacher."
"I know that," Dan replied, "Leslie's family is very traditional MB. her parents were not thrilled about me. They didn't fully understand our choice to adopt. They love Annie but they didn't understand why we made that choice. Leslie's parents were angry when Annie chose medicine. They don't see the gift that she has to help and to heal."
"Annie works with babies a lot of the time," David said, "I volunteer as a hospital chaplin and I've sat with some of the families she works with. She has patients under three pounds, babies on the edge of viability."
David turned down the path leading to the cabin.
"I can see why Annie likes coming up here," Dan said.
"She does," David agrees, "they were up here two weeks before her due date with Ellie. Josh just wanted her to get away and relax. It's close enough, they feel safe and each couple has a room or will soon. Come on in."
David unlocked the door and flicked on the light. Dan looked around and the white wood paneled walls covered in family photos, some he realized were of Meghan and Owen as children and in high school but there was also one that caught his eye of a very pregnant Annie on a swing.
"When was that taken," Dan asked.
"Easter," David replied, "I dabble in photography, it's one I snapped when she was playing on the swings with Allison. She was relaxed and laughing with her little siblings. I did Ellie's newborn photos as well, in the backyard at their house."
"Do you do a lot of the photos we see," Dan asked.
"I did the Christmas ones," David said, "I have a really cute one of Ellie in the snow. And one of Ellie and Catrina on the same baby sled."
"I'd like to see them," Dan said.
"Do you drink coffee," David asked.
"A cup would be good," Dan agreed.
"Evelyn always has instant in the cupboard for a quick cup," David replied, "I'll make two."
They sat at the table with their coffee.
"Dan, what do you want to do with your older two," David asked.
"I know Annie and Chris are a packaged deal," Dan said, "they will stay close to each other. They were more twins than siblings in a lot of ways. They want to raise their families together."
"They are close," David agreed, "I know Annie has been helping Jenna and Chris figure things out. They will have their families together as part of our family."
"How does that family just absorb others," Dan asked.
"Evelyn raised her kids alone," David said, "Meghan and Owen have a unique way of deciding that people are just part of the family. It's a web of interesting connections. It's only going to grow with Chris, Jenna and their baby. I haven't earned a special name yet but Evelyn is nana to everyone 31 and under. Dan it's time for you to figure out what your role in what happened was. Not what Leslie or Jessica made you do. What choices did you make? How are you going to change the story?"
"I chose to listen," Dan admitted, "I knew it was wrong but I didn't know how to stand up and say something. I wanted to but I was torn. I missed her. I miss her. I wanted to see her. I know it was wrong and I hurt her. She won't even call me dad anymore. I messed up. Listening to the other guys today I realize that. I ended my marriage because I couldn't watch Leslie hurt our kids anymore. I want to fix things with Annie. I know it's probably too late. I want to see my daughter and really know her."
"Tell Annie," David urged, "tell her that you miss her and love her. That you know you hurt her. What you told me now, what you said in the group today."
"How do I get her to listen," Dan asked.
"Annie responds well to a cup of coffee and a chat," David replied, "she's learned Teddy's tolerance for games."
"So none," Dan said.
"Exactly," David said, "they have an agreement of total honesty between them. The family works with total honestly, no secrets. Annie is going to hold you to that."
"No secrets," Dan asked.
"Not really," David said, "you hear some I don't want to talk about it or I'm not ready to talk about it."
"So I need to talk to her when she's back from Portland," Dan said.
"Portland," David asked," why is she in Portland. No one said anything on Tuesday about it."
"Josh's dad was in an accident," Dan said, "they want us to pray."
"We have a few things to pray about then we should get back," David said.
In Portland Annie and Josh sat by Ian's bed having sent Meghan and Nathan to deal with their younger kids. Ellie was sleeping in her stroller, Annie knew they would pay for having Ellie off schedule but there was nothing they could do. The baby was picking up on their stress.
"Dad," Josh said, "come on you have to wake up. You need to wake up."
"Dr Riggs," Edwards said.
"What do the tests show," Annie asked, she knew Josh was in no shape to handle this she had to be the voice for him.
"It hasn't changed," Edwards said, "why don't you two get some sleep and come back in the morning?"
"We can't leave him alone," Josh said.
"We don't usually do this but do you want an on call room," Edwards offered, "take turns, one of you can lay with your little one and let them sleep."
"Ellie is asleep in her stroller," Annie said, "she's okay for now. We really appreciate the offer."
"Mini Altman think about it," Edwards said.
"We will," Annie said, "Dr. Edwards can I talk to you outside?"
"Of course," Edwards replied.
Annie whispered in Josh's ear, "can you keep your ear on Ellie?"
"I will," Josh mumbelled, he reached out one hand and rocked the stroller back and forth.
"Dr Edwards," Annie asked as they stepped into the hall, "honestly what are we looking at?"
"If I was to give a number less than 10% if he makes it through the night," Edwards said.
"We'll stay," Annie said, "deficits if he makes it?"
"Global," Edwards replied.
"As a doctor what would you do," Annie asked.
"I would do palliative care," Edwards replied, "he's already showing signs of sepsis."
"I understand," Annie replied, "we'll stay here tonight."
"Of course mini Altman," Edwards replied.