Chapter 5
Jack had been expecting far more headaches from the media revealing to Seattle Grace that their chief spinal surgeon had been one of the Oceanic survivors. He had been greatly relieved to find out that this was not the case.
Oh, there had certainly been some problems with some of the residents - a couple of them had asked repeatedly what it was like to have to perform trauma surgery on an island. Finally, he had told them straight out that it had been hell. While keeping Boone's name out of it, he had told them how horrible it had been to try and save a patient who he had known was going to die, and whose last several hours on earth had probably been as much agony for the doctor as it had been for the patient. That had shut most of them up.
The attendings had been far more understanding. Bailey and Torres had been more than willing to act as body men - or in this case, body women- to make sure that the last year and a half had been difficult for him, and that, if anything, this made him far more qualified to operate her than anyone else on the staff. Weber, who had admitted that the fact that Jack had been the survivor of a plane crash and subsequent rescue had not factored one iota in his being hired, had been more than clear that Seattle Grace was proud to have him on staff. The only thing he had asked was that Jack considered spending some time with the staff psychiatrist. Jack, who'd had more than his share of nightmares since coming back to civilization, agreed, even though he had been reluctant to share too many details about what happened on the island with a shrink.
After a month had passed, and the media attention had gone back to other, more flashy news stories, Jack had begun to think that he might have undergone the worst of it.
And then, Claire had called him. And had told him that something truly horrible had happened, and that only he could help. And while it didn't involve seeing his dead father, having to push a button every 108 minutes, or John Locke, it only served to remind him that this world was filled with often far more mundane horrors.
"Derek!"
Jack had gotten to know the surgeon who (almost) had the same last name as his well enough over the past five months, but he knew very well that he and the head of neurosurgery weren't friends. To ask him to do what he was going to was going to be a pretty big ask, deserving of an explanation that would require Jack to open doors he really didn't want to open here. But he'd seen the charts. He knew that Claire needed his help. And, despite the fact that he'd only seen her a couple of times since they had gotten back to civilization, he still felt that he owed her.
"Have you got any patients scheduled for the next hour?" he asked.
"I don't have any surgeries for the rest of the day. I was planning to catch some z's." Jack knew the neurosurgeon well enough to know that this meant sneaking in one of the closets for a quickie with Meredith. For two people who had been broken up for more than five months, they sure spent a lot of time screwing.
"I need your help on a consult," Jack told him.
"Need I remind you that we have different specialties?"
"It's neuro, and it's not a patient. It's personal."
Derek considered this for a few seconds. "Someone from your plane?"
"It's more complicated than that." Jack took a deep breath. "Can we go into my office?"
Even though the world knew who the Oceanics were, the story that they had been telling for the past year left little room for maneuverability. Jack knew he was going to have to do some hedging. He just hoped Derek was sensible enough to focus on the case study he was going to hear, and not on how weird the surroundings were.
"When the plane crashed, one of the patients that I had to deal with was young girl around twenty-three. I would later find out that she was eight months pregnant. Her name was Claire Littleton. She'd been flying to LA to give her baby up for adoption. The more time we spent on the island, the more I worried about what was going to happen when she gave birth." Jack took a deep breath. "Ironically, the night that she finally went into a labor, I was busy trying to keep another man from dying from a fall off a cliff. It didn't work, but by some miracle, Claire's child was delivered healthily."
"That was the boy named Aaron, right?"
Jack nodded. "Claire was fairly open about her life. She told us that she never knew her father and that her mother was dead. In point of fact, she wasn't, but it was even worse than we thought. About two years before she got on the plane, Claire and her mother were in an automobile accident. Claire escaped with minor injuries, but her mother ended up in a coma, and the doctors all told her that she would never wake up." He took a deep breath. "Which is why it came as such a shock to her, when she returned to Sydney after we were rescued, and found out that her mother had awakened from her coma about a month before."
This got Derek's attention; he clearly was beginning to get where this story was going. "What the doctors say?"
"They were considerably shocked. At least one doctor had suggested taking her mother off life support, so they were stunned when she finally awoke. There were months of physical therapy, and it was beginning to look like Claire and her mother were getting a happy ending."
"And then?"
"About three weeks ago, Mrs. Littleton began complaining of headaches. She went to the hospital for an MRI." Jack opened the envelope he had been carrying, and put it on the screen. "See for yourself."
Derek took a look. Jack may not have been a neurosurgeon, but he could see for himself that there was a big problem with the scan. There was a small white dot right at the center of the occipital lobe.
"That's one mother of an aneurysm," Derek told him. "Nearly two centimeters. How old are these scans?"
"This is the most recent. Three days ago." Jack told them. "I don't know what the health care system in Australia is like, but they told her that there were only a handful of neurosurgeons in the world qualified to operate, and none of them were on that side of the planet. She's been looking everywhere ever since."
"And she learned about me through you."
This was the weird part. "Actually, she had no idea we were working together. She saw your name online, and thought you and I were related."
Derek raised an eyebrow. "Seriously?"
"We were on a deserted island for three months. The exact spelling of my last name was not a priority." Jack shook his head. "Claire's always been something of a spiritualist - power of dreams, astrology, that sort of thing. She thought that seeing your name in this hospital had to mean something."
"I hope that you didn't make her any promises when she called you."
"I told her that she was mistaking coincidence for fate," Jack admitted. "But I also told her that I couldn't see the harm in showing you her mother's scans. So, now that I've done that, is there anything that can be done for her?"
Derek didn't answer right away. He looked at the scan for several moments. "How old is Miss. Littleton?" he asked first.
"Forty seven," Jack said after glancing at the chart.
"You have the rest of her medical history?"
Jack looked over the files he'd been sent, then handed them over. "Is there an option?"
"I need to look some things up. I'll have an answer for you in a couple of hours." Derek looked at him. "I realize that time is critical. I need a consult, but if there's a solution to this problem, it won't be an easy one."
Jack gave a small laugh. "We're used to not having easy answers."
Derek was as good as his word. Less than two hours late, he was back in Jack's office. Jack was only mildly surprised to see that Meredith Grey was there; all of the snickers about their relationship aside, Meredith was one of the better residents they had.
"I've had a talk with Hahn and Weber. There is a surgery that could potentially save Carole Littleton's life, but it's very risky. Given her previous condition, I'm not wild about performing it, but otherwise I wouldn't think she'll live much longer."
Jack considered telling him he should be telling this to Claire, not to him, but he guessed that Derek respected him enough to tell him that he could be lucid about this. "Go ahead."
"There's a fairly new form of treatment called cryosurgery. Basically, I would lower the patient's body temperature to ninety degrees Fahrenheit, effectively stopping her heart. Once the blood flow to the brain had been stopped, the aneurysm would be far easier to clip. That said, I'd have less than fifteen minutes to do it, or we would risk permanent brain damage. And considering her previous condition, she might very well go into a permanent vegetative state."
Jack considered this for a moment. "I know you're not in the numbers game, but what are the odds of Claire's mother recovering if she survives the surgery?"
"The surgery's been around for nearly a decade," Meredith told him. "They've had a lot of success with it over the last few years. That said, even with someone who was in perfect health, the odds of survival are less than forty percent."
Neither Meredith nor Derek had to tell him how much worse the odds were for a woman who had spent the better part of three years in a coma.
"And not to put a price on this woman's life, but it would be very expensive," Derek told him. "I've looked over her insurance, and my guess, neither Australia's nor ours would be willing to foot the bill for this type of surgery."
"Believe me that part of it isn't a problem," Jack said quickly.
"I don't know about your friend's finances-"
"After we returned from the Pacific, Oceanic paid out a major cash settlement to everybody who came back. I walked away with just under nine million dollars. Because Claire was pregnant when she got on the plane, they were willing to pay her fourteen. Even if that was an issue, there are a lot of people on Oceanic who'd be willing to make sure that she didn't go broke handling this." Jack told them. "So let's get down to the real issue. How serious is the aneurysm?"
Derek exchanged glances with Meredith. "A lot of aneurysms, we describe them as bubbles. This, it's closer to being a balloon. It could burst any time now. And if she does nothing, it's maybe a couple of months before it blows."
Jack took a deep breath. "There's like no luck with some of us." He look at them. "Do you think she could even survive getting here?"
"It would be difficult, no question. And even if we were to do the surgery, it would take her a couple of days just to get here fast enough. Money may not be an issue, but it would take a lot just for her to get from here to Seattle."
Jack looked at Meredith who had been mostly silent throughout this exchange. "If this were any other patient, one that wasn't as close to me, would you advise them to do the surgery?:
Meredith considered this for a moment. "Probably not. But ultimately, this has to be her mother's choice. Not ours, not her daughter's."
Jack had made a lot of progress in the last few months, when it came to self-growth. He had come to realize more and more that he couldn't fix everything, and even if Claire and her mother got onboard with this, it wouldn't be his responsibility. But she was still his friend, and he felt he had to at least try to help her.
"I'm going to have a conference call with her in a couple of hours. I'm still not sure of the time difference, but I have a feeling that it won't matter that much." Jack turned to Derek. "I need you to be as brutally honest as you can be, and I need you to explain just what the chances are."
"She wanted to hear from you," Derek said.
"I don't trust myself to remain impartial," It was more honest than he had been about a medical situation then he'd ever been.
It was now pretty clear that just about everybody's bedside manner at Seattle Grace (with the possible exception of Christina Yang's) was better than Jack's. When Derek and Meredith explained Carole Littleton's condition, the kind of surgery that they would need to do in order to successfully clip her aneurysm, and her best chances even if the surgery was successful, they both managed to remain calm and very matter-of-fact. Considering how worked up Claire had been when she had called him the previous day, Jack was inclined to consider this something of a miracle.
Unfortunately, then came the moment that Jack knew was coming. Claire asked him whether he thought she should have the operation.
For the first time in awhile, Jack thought he knew how to handle this. "Are you asking me as your friend or as your doctor?" he asked.
"I've heard enough medical opinions in the last couple of weeks; I'd be looking for my friend's help."
That didn't make what he was about to say any easier. "Claire, I want you and your family to be happy. I realize that we've all gone through so much - you more than most of us - that to have to deal with this may be a blow that you don't think you can recover from" He looked at Claire's mother. "You just got your daughter back. I can't even pretend to know what that must feel like. You want to have more time with her. And this surgery probably seems like your only option. It really depends on whether you want to risk the time you have left on something that may be more of a gamble."
Mrs. Littleton looked at Claire for a moment, was silent for a few more moments than turned to the view-screen. "How much time would you need to get ready?" she asked, after several long moments, looking at Derek.
"In order to do the prep work, and get the appropriate materials," Derek told her. "Two days."
"I'll make the arrangements with my doctors to get to Seattle," Mrs. Littleton told him.
""Mum, are you sure? They said the flight might end up killing you." Claire told them.
"I've spent far too much time in beds like this one. We just made up. I'm not going to risk losing you and Aaron after all this time. I need to live. Really live. And this operation is the best chance I have at that." Carole looked at Derek again. "Thank you for your help, Doctor Shepherd."
Claire looked at Jack. "Would you mind getting in touch with the rest of our friends?"
"Of course," Jack told her assuredly.
When the connection was turned off a few seconds later, Jack turned to Derek. "I realize that you didn't make any promises, and I'm grateful for that much. But if your committed to performing this surgery, I need to know what the chances really are."
"I will do everything in my power to save your friend's mother," Derek told him. "But honestly, I think that even in a best case scenario, she'll probably die on the table."
Jack considered this for a long moment. "Start doing the prep," he finally told Meredith. "And tell the chief that he's going to need to prepare for a lot of celebrities to be showing up."
"They're all going to come for this?" Meredith asked.
"Everybody who survived the plane crash is basically Aaron's godparents. I'd be surprised if the media didn't know about this before they do."
"You going to be okay for this, Jack? You just got through the latest round of publicity. This is going to bring it all up again."
Jack thought for a moment. "Maybe you should tell Weber that I'll run point for the media. Keep the pressure off you, at least on that front."
"I'd think you'd want to spend time with your friends," Meredith asked. "And with Claire."
"When they get here, I will." Jack told her, then thought for a second. "You have no idea how hard it is, to not be in charge for this kind of thing. I always felt like I had to fix everything. But this, this is something I can't fix. Right now, I think the best thing I can do is do what I can to make your lives easier, at least for a bit."
"All right, I'll talk to Richard."
Jack had no idea how much more stress he was about to feel just by taking a lesser role.
BOISE, IDAHO
Kate Austen had spent so much of the last five years running that she didn't know what it was like to have a normal life. Sawyer had always had her down cold. It was what she did. In retrospect, she now wondered why she had spent so much time on the island trying to get rescued, when the only thing that had ended up doing was having her run away again.
The big difference was, of course, now it was even harder. Half the world knew what she looked like now, and she'd gone from being the target of a single manhunt to being one of the most wanted criminals in the country. And this had led to all sorts of problems, as she had found out the hard way.
When the first anniversary of the Oceanic rescue had come up, everybody in the world knew her face again. But unlike for Sayid, it wasn't merely an inconvenience. She'd had to basically keep moving for two weeks after the first reports came out. You would think that, given the number of terrorists that were making up all the government's watchlist, they wouldn't have wanted to bother with trying to hunt down a twenty-eight year old white woman, whose complete rap sheet was barely a line on Whitey Bulger's resume. But the U.S. Marshal's clearly didn't like the fact that they were having to answer how they could have let such a defenseless appearing woman elude them for three and a half years, then escape custody after returning from being rescued from a plane crash.
Running had been bad enough, but now her options of where to go were even more limited than they had been when she had fled to Australia in the first place. The TSA now had her on the no-fly list, so getting out of the country was now impossible. They knew about her parents, and they also knew about her friends on the West Coast, so that was out. Kevin Callis had been interviewed, so now they knew about her secret identity in Florida, so that entire identity was burned. Indeed, getting false IDs was a lot harder now, considering that everybody knew who she was. She'd been sticking to the less populated states in the Rockies - Wyoming, Montana, and much of the Dakotas as well. She'd been in Idaho for the last few weeks, because it seemed like the publicity was finally starting to die down.
And then, she had been drinking in some cheap bar in Pocatello, trying to figure out what the next step was, when the TV had suddenly been switched to CNN. And she had recognized the face on the screen. It was Claire.
The bartender had been about to switch the channel to a Trailblazers game, when she told him to turn it back. That probably wasn't a smart idea, considering she was trying to keep a low profile, but she could no more have turned her back on this then anyone else.
"... Miss. Littleton's mother will be undergoing a rare type of brain surgery to clip an aneurysm. Miss Littleton, the only one of the Oceanic survivors still living in Sydney, will be accompanying her mother to Seattle Grace-"
As if in a daze, Kate dropped a twenty on the table, and left the bar.
Once again, she heard Sawyer's voice in her head. You always go back. Another sign that the con man who had always seemed to have her number knew her better than she knew herself. That's what she had done. She had gone back to see her mother twice after murdering her father, and it had been a disaster both times. She had gone back to get Jack even after he had begged her not to come, and it had very nearly cost them their chance to get off the island. And now, here it was: an event that was certain to have all her friends gathered in one place, a hospital where there were sure to be marshals and lawmen, just hoping that Kate Austen would reappear at the front door.
Yet she was going to be there. All her friends. She had always been alone for so much of her life.
It had hurt a lot when no one had been waiting in Hawaii to see her. Her mother she hadn't expected to be there; Diane Jansen had make it very clear that she didn't give a damn about her daughter any more. But to not see Sam there. The man may not have been her real father, but he had loved her more than that bastard ever had. What had kept from showing his face? His guilt? His sense of right and wrong?
She had wanted to lean on her friends, and yet two months later, she had left all of them without even a proper goodbye. Whose heart had she broken more, she sometimes wondered when she couldn't sleep. Jack or Sawyer? More than once she had wanted to call somebody - Hurley, Sun - hell, they couldn't be tapping phones in Korea waiting for her - but she had held off over and over. And now, they no doubt would all be gathered in Seattle, waiting to see if Claire's mother would survive. Because that's how much Claire meant to all of them.
And Claire had been her friend, too. Hell, she had helped deliver Aaron. Aaron. Wow. He'd be almost eighteen months now. More than a few times, Kate had wondered what Aaron would look like now. And her mind just kept coming up short. Hell, what did she know about babies?
More than that, her mind just kept coming back to Jack and Sawyer. She knew that Jack's specialty was spinal surgery, but she could see him taking over the OR, trying to do everything in his power to fix Claire's mother. And Sawyer - he hadn't known Claire as well as some of the others, but she remembered how Aaron had always stopped crying at the sound of his voice. Would Aaron be crying when he saw his grandmother in a hospital bed? Could he comprehend what was happening to her at all? Did he even remember any of the others?
Going there would be a mistake. She knew that. Even if, by some miracle, the police weren't there, there were sure to be cameras everywhere. Marshall Edward Mars might be moldering in a watery grave as far as the rest of the world was concerned, but there had to be a shitload of fellow officers who wanted to bag the woman responsible for killing him. Kate knew cops. They never let anything go.
For her to try and go there was beyond stupid. Hell, for her to try and just get there would involve six different kinds of crap. And yet Kate knew the moment that she had seen Claire's face on the TV screen that was exactly what she was going to do.
Using any kind of public transportation would be insane. For that matter, she wasn't certain that she could afford it. She had gotten the hell out of Dodge before Oceanic had cashed out those insurance settlements that all her friends had gotten, and she had been scraping by ever since. She had gone hungry more often in the past year than she ever had on the island.
But she had managed to purchase a used car a little more than a month ago. It had taken her six months of saving at four different jobs in three different states, but she now had a small used Chrysler.. The paint was peeling and she was pretty sure that there were more miles on the odometer than it actually was, but it had held together for the last six weeks. So far, it hadn't shown up on any APB's that had been out on her. Hopefully, her luck would hold a little longer.
At least Boise wasn't that far from Seattle, geography wise. She looked at one of the maps of the Western United States. About five hundred miles. If she kept to traveling below the speed limit, and made just a couple of stops along the way, she could be there in less than half a day. Of course, once she got there, she was going to have to confront the problem of how to get into the hospital, but there were always a couple of ways in.
No place was impenetrable, especially not a hospital.
She got into the car, and turned on the radio. "Leaving On Your Mind" came on almost instantly. Of course it did. Patsy Cline was always with her. If she was the kind of person who believed in signs, she would've considered this a good one
She drove slowly as she headed out onto the interstate.
What Kate didn't know was that after she had left the bar, the network had shown pictures of most of the Oceanic survivors. The bartender didn't recognize her face, but one of the other customers was sober enough to realize that the woman on the barstool next to him had been one of the FBI's 10 Most Wanted. He called the hotline with dreams of getting a piece of the $100,000 reward that had been posted. No one knew where she was going, but the FBI decided to post a couple of marshals at Seattle Grace just in case.
Kate was about to drive into a trap.