AUTHOR'S NOTE:
Hi everyone! Thank you for all of your great reviews after the previous chapter I uploaded! I love to read them! This chapter takes place exactly where the last one leaves off. Enjoy!
Chapter 3
Callie held Arizona as she sobbed in her arms. She rested her chin on the smaller woman's head and she was able to feel her shaking with each cry she let out.
Could this really be happening?! Sure, they were both so incredibly lucky that it isn't Sofia that has cancer, but Briley was no better. Their hearts shattered for the teenager that was about to be forced into battle against her own body. They shattered for their friends, who are already feeling paralyzed by fear, who are about to hear the worst news of their lives thus far. And more than anything, Callie and Arizona's hearts shattered for their own little girl, who was about to be crushed by the news that her friend would have to fight for her life.
To make matters worse, being doctors, Callie and Arizona were intimately familiar with pediatric oncology and it's survival rates, treatments, and success stories. Briley would have to walk right through hell as she endured the treatment for Ewing Sarcoma. The surgeries, chemotherapy, radiation therapy, and side effects will seem endless for over two years. And even with all of the treatments available, the future outcome is still unclear, especially when the cancer was this far along.
Briley had started off her day as any normal teenager, and she will go to bed as one of the 46 children that are diagnosed with a form of childhood cancer everyday in the United States. A scary statistic for a scary situation.
Alex watched as his friends processed the news. He looked on as Callie tried her best to comfort Arizona, all while barely keeping herself together in the process. He could see that Callie wanted to badly to break down as well, but she was being strong for her wife.
They stayed that way for a couple minutes longer, until Arizona seemed to have no tears left to cry. As Callie and Arizona pulled themselves together, they realized it was now time to deliver the difficult news to the patient and family. Over the course of their careers, both surgeons had done this more times than they could ever imagine. But this time it was different. It was someone they knew, someone they cared for, and someone they loved. They felt almost as if they were transported back to intern year when they delivered a bad outcome to a family for the first time.
The walk back to the peds ward was slow and silent; none of the three doctors knew quite what to say. Though this was a devastating blow, they needed to transform themselves into the hopeful and confident doctors they usually are. They needed to be prepared for how each family member would take the news- denial, sadness, anger…
Alex, Arizona and Callie paused when they reached the hospital room where Briley, her parents, and Sofia were waiting. Alex looked between the two women, checking to make sure they wouldn't crumble at the drop of a hat.
"You sure you wanna do this? I can tell them myself, you don't have to be here if you don't think you can handle it," Alex offered.
Both women were quick to shake their heads.
"No," Arizona sniffled. "We have to do this. The Lockes know us, they trust us… we just have to."
Callie nodded in agreement. When Arizona turned to look up at her, Callie licked the pad of her thumb and rubbed away the smudged mascara from under Arizona's eyes.
They took a collective deep breath together as Alex opened the door. Looking very groggy from the anesthesia, Briley appeared so small in the big hospital bed. Sofia sat on the bed's foot, protectively staying close by her friend. Nicole was sitting on the chair in the room as Chandler paced back and forth by the windows overlooking the Seattle skyline. Every head turned as the door opened and the three doctors walked in.
"Sof, why don't you go wait in your mom's office down the hall while we talk to the Lockes, okay?" Callie asked her daughter.
Sofia was very quick to object.
"No. I'm not a little kid anymore, you can't just shoo me away. Whatever you have to say, you can say to me too. I can handle it," she said.
Arizona, immediately recognizing the good-natured stubbornness that her daughter had inherited from herself, realized that Sofia probably should be in there when they deliver the news. Arizona placed her hand in Callie's, signaling to her that Sofia had her permission to stay.
Alex took the lead.
"In surgery, we biopsied, meaning we took samples from, both of the tumors that were found in Briley's left leg. We rushed the tests from the lab, and we just received the results."
Feeling it was her turn to speak, Arizona swallowed before she picked up where Alex left off.
"The tests showed an oncological event. They came back positive for a bone cancer called Ewing Sarcoma."
Color drained from the faces in the room.
"She… She has cancer?" Chandler asked, his voice cracking as he spoke. Tears welled up in his eyes. Nicole began to cry.
Arizona nodded with a sad look on her face.
"The cancer has metastasized, making it stage four. The original tumor, the larger one, is located in her upper tibia, and the disease has spread into the middle part of her femur," Callie explained, holding up the scans and pointing out the diseased spots. "Ewing Sarcoma in general, is very difficult to treat, and stage four makes it even harder. But, both Arizona and I have had success in removing and treating this cancer in the past, and there is no doubt in our minds that Briley's case won't be any different."
"We are going to pore over the files tonight and determine the best course of treatment for Briley. We will come back with our plan tomorrow morning and present it to you. We can get Briley started with round one of chemo then as well," Arizona informed them. "But, for now, we'll let you be. If you have any questions or concerns, please call either of us anytime. Come on, Sofia, let's give Briley some time with her family."
Alex, Callie and Arizona left the room as Sofia hugged her friend. With tears present in both of their eyes, she placed her hands on Briley's shoulders.
"I know this sucks. I know. But don't be scared because my moms are the best in the world at what they do. They save lives every single day. You are in the best hands. Love you," Sofia told her friend. Briley nodded, a tear streaming down her face.
Callie and Arizona watched the encounter unfold from outside the window of the patient room. It was in that moment that they fully realized what a compassionate, empathetic, caring girl Sofia had become.
…
"Do you think a rotationplasty would be best?" Arizona asked her wife, open medical journals sprawled over their entire living room.
Callie shook her head.
"The tumors are too far apart. A rotationplasty wouldn't work," Callie replied, turning down the cutting edge partial-amputation surgery where one's foot is rotated 180 degrees and reattached to a different bone on the leg, so that the ankle joint acts as a knee.
It was nearly 1 AM, and Callie and Arizona had spent the entire night debating how they should treat Briley's cancer. Running on sugary drinks and pizza, the women had managed to flip through every textbook and journal they own to attempt to find a solution to their case.
Callie pulled another orthopedic surgery book off of a shelf and began flipping through it hoping to find some answers. Arizona, who had discarded her prosthetic hours before, was sitting on the couch elevating her residual limb so that it wouldn't swell. With her crutches next to her resting against the couch, she had her laptop on her lap as she drafted e-mails to send to pediatric surgeons over at Boston Children's Hospital, St. Jude Children's Research Hospital, and Children's Hospital Los Angeles- some of the best pediatric cancer treatment facilities in the country. Maybe one of the world-renowned doctors there could be of some help.
"I don't want to even attempt a limb salvage surgery," Callie stated, not looking up from the book on her arms. "Briley's an active girl, and the recovery time for a surgery like that is months. And even then, she'll never get back to full function."
"You know what we should do, Callie," Arizona said, closing her laptop. She waited for Callie to meet her eyes.
Callie looked up and sighed when she saw the look on Arizona's face. She set the book she was reading back on the shelf and went and sat on the couch next to Arizona. She laid her head on Arizona's shoulder and took a deep breath.
"I know."
"You said it yourself. Briley is a very active girl. She'll want to be back on her feet as soon as possible, and no limb salvage surgery could have her doing that."
"I know."
"This is stage four Ewing's, Callie. The cancer is already likely to kill her, so we need to pursue the option with the least chance of the cancer relapsing. Don't let your love for her cloud your judgment as a doctor," Arizona advised. She hesitated before adding, "We should discuss amputation."
The words that came out of Arizona's mouth hit Callie like a ton of bricks, despite the fact that they had both been thinking the same thing. She immediately stood up and found a new oncology journal to indulge herself in.
"Calliope…" Arizona said as she sensed that Callie was avoiding the topic of amputation.
"No! I will not do that to this little girl!" Callie said sternly, tears in her eyes. "There has to be another option!"
"Callie, you have done a million amputations in cases exactly like this! You have been an orthopedic surgeon long enough that I shouldn't have to fight you on the fact that this is the right thing to do! Before the plane crash, I think you would have seen it!" Arizona protested.
All of the tears that Callie had been holding in all day let loose. She dropped down to her knees and broke down. Arizona could see how this situation could hit so close to home for Callie.
Placing her crutches under her arms, Arizona stood up and made her way over to the armchair by where Callie was crying. Sitting down in the chair, Arizona was able to rub Callie's back and stroke her hair until her breathing slowed down. When Callie was finally calm, Arizona broke the silence yet again.
"Cal, I think you're scared to to palliative amputations… and I'm afraid that may be my fault," the words stung as they came out of Arizona's mouth. Her amputation rarely made its way into conversations anymore, and she honestly forgot that her life used to be any different. But now, saying it out loud like this, threatened to bring back many unpleasant memories from her darker days.
When Callie's eyes met Arizona's, she noticed they were swollen and puffy from crying. In that moment, Arizona really realized how her amputation had affected Callie and those around her. The way she had reacted after her own surgery had nearly traumatized Callie, making the ortho surgeon uneasy when performing the same operation on other patients.
"I can handle this, Callie, and you can too. You and I both know that amputation is the right route to follow, especially with this agressive of a cancer. I want you to know that you can do this. And that I love you more than anybody in the world, and I believe in you."
Though she was still hesitant, Callie knew deep down that it was the right thing to do. She nodded, wondering how this would all be received by the Lockes in the morning.
…
The next day, Callie and Arizona were back on their usual daily services. Despite much protest, Sofia had to return to school in the morning. Callie and Arizona had arrived to work early to brief Karev on the treatment plan they had finalized at nearly 3 AM. He supported everything that Callie and Arizona had suggested, so the final phase of the plan before they could hit the ground running was to go tell the family.
Arizona knocked on the door to the patient room before opening it and entering with Alex and Callie close behind.
"Good morning, Bri! Good morning mom and dad!" Arizona greeted them. "How'd you sleep?"
"Awful," Briley said, rubbing her eyes. She really wasn't holding any emotion back today.
"It was a rough, pain-filled night," Nicole told the doctors.
"I can help with that," Alex assured them as he upped the dosage on Briley's morphine drip.
"We just wanted to fill you all on on the course of treatment we developed for Briley last night," Arizona said, handing a packet of paper to Briley's parents.
"The plan we have set in place includes around two years of chemotherapy, ten weeks of radiation, a possible stem cell transplant, and a major limb surgery," Arizona explained. "As for the surgery, we are all ultimately recommending an above knee amputation."
The room was quiet.
"You want to cut off my leg?!" Briley asked with alarm, looking at the doctors like they each had two heads. "Absolutely not!"
"Listen, a prosthetic would give you a better life than any limb sparing surgery could. The recovery time is a lot faster, and you could be back running up and down the soccer field by next season if you're lucky," Alex told her.
Briley still shook her head, looking to her parents for support.
Nicole and Chandler, who had been rather quiet this morning, exchanged a look.
"Would the amputation be the best way to get rid of the cancer? And would it make sure that the cancer didn't come back?" Chandler asked, obviously taking the doctors' professional opinions into consideration.
"While it can't guarantee a hundred percent that her cancer wouldn't return, it really is the best option for the long run," Callie replied.
Nicole sighed, nodding her head. "That sounds good to me."
Briley's eyes practically bulged out of her head.
"Are you kidding me?! No way!" Briley stayed firm on her answer. "I won't be the same person without a leg! Mom, Dad, if you give them permission to take my leg, I will never forgive you! Never!"
This outburst surprised both Callie and Arizona. Briley had always been a very laid-back, go with the flow kind of kid. This type of behavior was the last thing they expected of Briley, even despite the circumstances.
"Briley, we are all just trying to give you the best future," Nicole calmly explained to the short-tempered, sleep deprived teen.
"What kind of future will I have with only one leg?!" Briley cried.
The last comment hit Arizona like a slap on the face. Sure, a similar statement may or may not have come out over her own mouth when she was in that hospital bed, but now she thought very, very differently. She learned firsthand how fulfilling a second chance at life could be, even with the loss of a leg, which in the long run, wasn't actually that big of a setback.
Chandler stood up, handed the packet back to the doctors and said:
"We want to give her the best chance of survival, and if that means an amputation, then she'll have the amputation."
Thanks for reading! I hope you all enjoyed this chapter! I hope it wasn't too slow. Next chapter things will really take off. Please leave your thoughts and reviews for me to read!
I don't think I will get the chance to update again before the Christmas, so I hope you all have happy holidays!
xoxo Arizona Robbins MD