A/N: So those reviews…lol. Thank you all who want to take a gamble on this story, I appreciate you and your encouragement so much! It has really kept me going in fanfic land all these years. You all are amazingly wonderful. Y'all that were harsh: I appreciate your takes too, but wonder how harsh y'all could get if dissatisfied with a service you actually paid for lol. I do want to address some of the questions that repeated in the reviews:

-Jo and Cormac not being a match: I get that, I do, but he is new so who knows who he could match with (I love him and Meredith, but their friend vibe is giving me life so right now I'm hoping that's all they will be for now) There are very specific reasons I used him as Jo's husband for this story...

-Can't picture Jo as stepmom to Cormac's kids: This genuinely baffled me guys. Jo typically can establish rapport with anyone and I can see her being the cool laid back stepmom. Plus, if her and Alex get back together she'll be a step mom, is that any different? Just my thoughts…

-Don't want to read if Alex and Jo aren't going to get back together in the end: Totally understandable. I'm probably 85% sure they will reunite in the end, but my feelings of anger and hurt are still raw and I've put them in a mess of a situation. I will update the summary of this story at the end so people will know if they do reunite romantically, for those of you that want to skip this story unless that happens.

I do promise this story will be a roller coaster of emotions. At least I hope it's that way for you all. It's hurting me to write I know that.

Thanks again guys, your encouragements and insights keep me going :)

Disclaimer: Still don't own anything, but I'm thankful to get to borrow others' creations.

"So you already have the orientation packet and hospital ID. There are no surgeries scheduled for you today unless an emergency comes in. Figured you'd want to get your feet wet a little bit first."

Alex nodded as they continued to walk down the hallway, "Thank you, Dr. Bailey."

"Don't thank me; just try not to embarrass me." Alex rolled his eyes as they turned a corner headed to the main elevators, "Now Karev, I need to walk you through some cases that are somewhat sensitive and try to prepare you for how things have changed around here since you've been gone."

Alex gave a tight-lipped smile as he pushed the up button at the elevator, "I went through the new electronic system training, Bailey. I think I can handle it."

Dr. Bailey looked up at him unamused, "Is that so?"

"Mer always talked my ear off about changes around here. I've been a doctor for a couple of decades now, Bailey. I don't need the handholding."

Bailey looked on unimpressed, barely containing a knowing smirk, "You're sure?"

She received a tight lipped smile in response as he entered the elevator and punched a button with a little more effort than needed, "I'm sure."

Bailey peeked in the elevator and pushed her own button, "Peds is now on the fifth floor." He rolled his eyes as she stepped back out, calling over her shoulder, "Good luck with your day, Karev."

Alex used the time alone in the elevator to make sure his lab coat was on straight and rolled his shoulders to alleviate some tension. He was trying his best not to show it, but he was anxious. He wasn't looking forward to the looks he was bound to get from familiar faces who knew about him and his time at Grey-Sloan before. And how he left Seattle. He definitely was not looking forward to running into Jo after the way he left things and the years with no contact, but on the other hand, seeing her again consumed his thoughts. He had run through a hundred scenarios of how their reunion would go. Would she cry? Dump her drink in his lap? Laugh in his face for coming back with his tail between his legs? Part of him hoped with time they could go back to being friends at least. He had definitely missed her over the years and the longing for her seemed to get worse as time went on.

As soon as the elevator opened, he was met with a wide eyed blonde in light blue scrubs holding a tablet close to her chest, "Good morning, you must be Dr. Karev. I'm Allison Taylor, I'm your intern for the day."

Alex groaned internally, "Great, who do we see first?"

Dr. Taylor gestured to her left, "Matilda Hayes, age four. Stage 4 high-risk neuroblastoma. Admitted for dehydration and low blood counts. Had feeding tube placed last week. Oncology is wanting to plan for tumor resection later this week since she finished chemotherapy last week."

Alex nodded and took the tablet as they entered the room, "Good morning, Matilda. I'm Dr. Alex Karev."

He smiled brightly at the young girl as a voice on the other side of the bed made his guts drop. A voice that had haunted his dreams for years, "She goes by Mattie." Alex's head shot up to meet beautiful hazel eyes that didn't look any different from the day he left. Alex took in the circles under her eyes and small laugh lines that had developed in their time apart. Her hair was cut short, reminding him of the night she first showed him the loft. He tried not to get consumed by the flood of memories he was experiencing or how insanely good she looked. "She may not answer to Matilda."

Alex gave a tight-lipped smile as he glanced away quickly, "Okay Mattie. How are you feeling today?"

"Tired."

He frowned slightly and handed the tablet back to the intern, "Can I look you over real quick?"

"She was able to keep liquids down last night. We tried some jello, but that didn't work out so well." Alex looked up as Jo cradled the child in her arms closer, kissing him on the head before standing and lying the boy down in the visitors' chair without the child stirring at all.

"He sleeps all the time."

Alex startled and looked back at his patient, not aware that he had been watching Jo instead of starting his exam, "He does? That's got to be annoying."

Mattie looked at him in confusion as Jo reached over to squeeze her shoulder reassuringly, "Dr. Alex means that's got to get on your nerves."

Mattie's eyes widened in understanding, "It's okay."

Jo bent down to kiss her daughter's cheek, "We just wish you could sleep that well, huh sweetie?"

Mattie nodded as she yawned. Jo looked over at Alex, who was watching the scene before him with interest, "She's been having more pain so her sleep patterns are disrupted."

Alex nodded in understanding, "We can do a PCA pump for her."

"I'll talk to her dad about it."

Alex closed his eyes briefly, not wanting to think about the man who had fathered a child with her and tried to cover by listening to Mattie's heart, but Jo knew him well enough to know that wasn't the reason. "Will he be coming today?"

"Yeah. He was on-call last night and had an early surgery today, he should be in to check on her soon."

"Hayes." Alex mumbled softly. "It didn't even hit me."

Jo smiled at him for the first time, "Would've thought Bailey would have warned you about the department head's daughter being your first patient." When Alex glanced away, Jo smirked, "She tried to and you wouldn't listen." Alex looked up to give a soft glare, causing her to laugh, "Oh wow, some things never change."

"What things?"

Jo looked over to the door still smiling, "Hey! Mac this is Alex Karev."

Dr. Hayes came over and reached across Mattie to shake hands with Alex, "Welcome back to peds, Dr. Karev." Before Alex could respond, Cormac looked down, "How's my girl today?" Jo placed her hand on his back and quickly stepped around him to move out of the way so he could bend down and kiss their daughter's forehead, a move that Alex studied as he had everything the other doctor had done since he walked in the room. Jo looked at Alex, her eyes widening as if to tell him something. Dr. Hayes then looked up, "Are you done with the exam?"

"Oh. Just need to listen to the lungs." He felt Jo roll her eyes as Mattie sat up, "Deep breaths." Of course she had caught him staring. Gotta get it together or this day will never end. "Okay now let me press on your tummy a little bit."

Cormac put his hand down next to the girl, "Squeeze tight, tight, tight. That's it Matt. You're doing great." Alex watched again as Jo placed her hand on his back and ran her hand across his shoulder blade while staring down at their daughter, "You're our brave little princess, aren't you?"

"Okay," Alex stated louder than he had meant to. "We'll draw some new labs and see where her counts are and see what oncology thinks after they round. I had also talked to….uh.…mom about a pump for the pain. Is that something you want to look at?"

Cormac looked over at Jo, "Last night was bad too?"

Jo nodded sadly, "The meds wore off a good thirty minutes to an hour before her next dose could be given. She'd wake up in pain each time."

Cormac nodded, seemingly having a conversation with Jo before looking up at Alex, "We wanted to avoid that if we could, but please make sure she's comfortable."

Alex noticed Jo squeeze his shoulder before dropping her hand into his, "We'll get that ordered now. I'll be back later after the labs are back." He quickly darted out of the room, scanning the area for an oncall room or restroom, anywhere to have a moment to pull himself together.

"Dr. Karev, the next patient is…"

"Just give me a minute, will you?" When he looked back to see the intern's startled face, he wanted to kick himself, "I'll meet you back at the main desk."

He then darted into the on-call room, locking the door and pressing his forehead against it, his open palm slamming against the surface. Why did he think this would ever be a good idea? Of course she had moved on, why wouldn't she? He had seen the wedding set, the intimate touches. He felt their comfort and content with each other. He slammed his palm against the door again, this time in anger for Jo now having to go through the agony of having a sick child after everything else she had survived, cursing himself once again as he had throughout the past five years for being one of countless tragedies she had overcome.