Title: All the Difference

Author: slimwhistler

Pairing: Alex/Addison

Disclaimer: They belong to Shonda and friends, not me.

In the same universe as All the Difference and Tempering. There's actually supposed to be another piece between Tempering and this one, but I haven't completely figured that one out yet. Plus, I've had a chronic health condition flare up, so I felt like indulging myself with snippets starring little Montgomery-Karevs. No beta on this; for some reason I wanted it to be a total surprise, so if you have complaints, come to me. A few of the sections are dialogue-only, and I know the title and names are kind of corny, but that's just the way things worked out. ;o)

Feedback would be like all the yummy things I can't eat right now, and make me very happy.

Thanks for reading!


Breaking the News:

"Twins?" Alex stares, looking dumbstruck. "Seriously?"

"Twins," Addison confirms. "As in, you know, two babies?"

"Yeah. Yeah, two. Wow. Two. Huh."

He looks as though he might just slide from his barstool and land in a stunned heap on the floor. Half-amused, half anxious, Addison bites her lower lip and tries not to giggle at the image; she has a feeling she might become a little hysterical if he doesn't say something of substance quite soon. "Alex? Say something, will you please?" she asks a bit desperately.

"Um, wow. Well, I'm really glad I'm in a bar right now. Hey Joe, can I get a whiskey over here? A large one?"

Okay, so not exactly what she was hoping for, but at least he's not babbling any longer. It's something, anyway.

Joe comes over with the drink, glancing between the two of them. "Problem?" he asks, raising his eyebrows.

"Not exactly," Addison replies wryly as Alex gulps at his drink. "Twins. Daddy here hasn't gotten over the shock yet."

Joe immediately brightens. "No kidding? Hey, that's great. Congratulations. Man, wait 'til "I tell Walter there'll be more twins in the family. He'll be thrilled." He turns to Alex. "Hey, don't worry, man. Twins are great. I mean, there's twice the mess and twice the noise and everything, and you almost never get any sleep, or sex, but…it's amazing." He grins at them before ambling away, whistling under his breath. He's clearly tickled.

Addison smiles softly and turns back to Alex. He's staring into his empty glass as though he finds it infinitely fascinating. "Hey. You okay over there?" she asks quietly.

He looks up and gives her a crooked little smile. "Yeah. Sorry I shorted out on you there for a sec. I just…I never thought about two, you know?"

"I know." She pauses. "Do you mind?" She tries to ask casually, but she's pretty sure she comes across as nervous anyway.

His eyes snap up to meet hers. "What? No. I mean, it's pretty awesome, right? Just a little, you know, nervous is all."

Addison chuckles. "That's pretty normal."

He regards her seriously. "But I mean, for me…am I gonna be able to do it right with two? You know I never had much of an example growing up, and with two at once…I might totally screw them up."

"Well, it'll probably happen anyway, whether we have two or one."

He grimaces. "Yeah, I know, but…"

Leaning forward, Addison puts one hand on his leg; the other finds his hand. "Listen, Alex. You will be just fine. You're great with your sister, with her kids; they all adore you. Nate's like your little shadow, for goodness' sake. Don't you think you must be doing something right?"

"We won't get to give these two back at the end of the day, though."

"So we'll go a little crazy, like all the other parents do. Nobody's immune, no matter how prepared they think they are. And if we screw up, we won't be the first, or the last, to do so. I think we can do it, anyway. You'd better think so, too, because there is no way I'm raising two babies on my own. Not without becoming very, very cranky and unleashing my ire on hapless residents, that is." She tilts her head, considering him. "So," she ventures, "you in?"

He lets out a deep breath, almost as though he's steeling himself. "I'm in." He grins at her, looking both terrified and eager. "Let's have ourselves some babies."


Zero Hour:

'Oh my God, I'm having a baby…babies' Alex thinks wildly as he careens through the halls.

He'd bolted as soon as he got the page, and nearly tripped over his own feet in his haste. The others had laughed at his clumsiness, his panic, and Meredith had called out "Good luck, Daddy," before collapsing in a fit of giggles with Izzie. Yang had merely looked bored and muttered something about demon-spawn, while O'Malley had gotten all flustered and looked like he was on the verge of trying to say something supportive. Of the three, Alex isn't sure which reaction he preferred.

At least they gave him something to think about. He pauses outside the delivery room and leans against the wall, scrubbing his hands over his face. 'Thirty weeks is okay,' he tells himself, 'they'll be okay.' He can't afford to fall apart in there. Addison needs him. One of them has to stay sane.

For Alex has discovered that Addison and excessive hormones don't always mix very well. One minute she'll be dreamily considering names and paint colors, and the next she's bawling and wailing that she looks like a pudgy, doddering penguin. It doesn't matter how much ice cream he keeps in the freezer. One night, completely bewildered, he'd finally called his mother. She'd told him to simply hand Addison tissues and wait for it to pass.

He loves his mother.

Enough. Alex takes a deep breath and pastes a smirk on his face. He strolls in, finding Addison huffing and puffing away, surrounded by Torres and Bailey. Rubbing his hands together in mock anticipation he says cheerily, "All right, let's get this party started!" All three women shoot him withering stares, and he smiles. Mission accomplished.

"Alex, come over here," Addison says. Her face is flushed, and the sweat is already plastering damp strands of hair to her forehead. When he reaches the bed, she grabs the front of his scrub top with such a lightning quick motion he's surprised. "Listen to me," she growls through gritted teeth, "you are never having sex again, Aleksei Karev. Do you hear me? Never, ever-aaahhh…"

Her tirade is cut off by a groan. Alex is so startled that he begins to babble. "Yeah, sure, babe, whatever you want. Sex is bad. Sex is very, very bad. Just, you know, breathe. Breathing is good. Just-" Addison's hand comes up and grips his so tightly that after a minute he's sure all circulation to the area has ceased. "Uh, Addison? Hand. Need hand. Surgeon. Really need hand, here, I- thank you."

The contraction passes, and Alex brushes the damp hair from her face. "How you doing?"

Addison lets out a weak chuckle. "I'm okay, I guess." Suddenly, her eyes fill with tears. "Alex, they're too early. What if-"

"Everything's gonna be fine," he soothes. "You'll be fine, the babies will be fine. Nobody here's gonna let anything happen. Hey, if you don't believe me, remember that you've got Dr. Bailey here, and Callie. Nothing and nobody tangles with them and lives to tell about it, trust me."

"You got that right," Bailey says firmly.

"Totally," agrees Callie."

"Well, all right then," Addison says gamely. "Let's have ourselves some babies!"

Alex grins, and holds her hand.


A C-section is pretty much inevitable, and that's how the babies arrive. Alex fidgets as he sits by Addison's head; this is what he does, and he wants more than anything to go help, wants to make sure with his own eyes and hands that his kids are going to make it. Addison just rolls her eyes at him and tells him to relax.

Both babies do make it, and without their father's intervention. They're tiny, but perfect and squalling under their own steam from the get-go. They'll have to spend some serious time in the NICU, but for the first time Alex truly believes it when he tells himself that he, Addison, Jackson Bailey and Louisa Calliope will really be just fine.


Six Months:

Alex has a system. As usual, he wakes up around 4:30 am and gets dressed. He kisses Addison's shoulder and whispers "going for a run," and as usual, Addison groans, mumbles "insane," and burrows back into the pillows. As usual, when he returns he heats up some bottles and turns the coffee maker on, then races upstairs to take a shower. Dressed, bottles in hand, he makes his way to the nursery. As usual, Loula's still fast asleep, but Jackson is up and babbling.

This is when usual ends, and fun starts.

"Hey, hey, little man. Up already, huh?" Jackson gives him a big, drooly smile, and Alex can't help but smile in return. Alex tickles Jackson's belly, and the baby laughs. He never would have believed it, but making your kid laugh really is some of the best medicine in the world.

"Let's get you all cleaned up so you can go see Mommy, huh? You know, you get to spend all day with Mommy today, isn't that cool? Daddy had to get up early just so he could see you guys before he has to go to work. Daddy's not as important as Mommy, you know; he can't call the shots like she does. "Course, Daddy had to go running, too. Maybe you'll come with me someday, huh? We can let your mommy and lazy Miss Loula sleep in, and we'll go to the park. Maybe if we feel nice we'll bring them back some muffins. How's that sound, Jack-Jack?"

"BAAAAA!" Jackson says agreeably. "BABABABABAA!"

Alex grins. "Good deal. That's right, wake up your silly sister, too. Okay, buddy, we'll go see Mommy, and she can give you your breakfast."


Addison stirs as the door opens, smiling sleepily when she sees a happy little face. "Well hello there," she croons.

"Hey, Mommy, look who it is, Mr. Jack, ready to face the day. He's a little hungry, though."

"I can imagine."

Alex deposits the baby on the bed and hands Addison the bottle. "You good? I'll go get Loula up, then."

Addison bites back a smile as he jogs through the door. Who would have guessed that Alex Karev would turn out to be SuperDaddy? Addison had had an inkling, of course, but most of the hospital staff still isn't over the shock.

"Come here, little guy," she says, lifting Jackson into her lap. "You hungry? We can take care of that, yes we can."

In no time at all he's going to town, sucking away like there's no tomorrow. Addison strokes his cheek. "My laid-back boy, hmmm? You're so good. Your sister got all the fussy, didn't she? I guess you're kind of like your daddy that way; he's a pretty straightforward guy, too. It's really not a bad way to be, except that it confuses us high maintenance types sometimes." She removes the bottle, and Jackson grins up at her, his mouth dribbling formula, and all of a sudden Addison feels such a surge of love for him that she pulls him close. In the doorway, Loula (and Addison still thinks that name sounds like some country western singer's, but it's stuck anyway) is laughing madly as Alex lifts her high above his head and makes airplane noises.

"No," she whispers in Jack's ear, "it's really not a bad way to be at all."


Eleven months:

"Alex, we have to talk about Jack."

"What about him?"

"Come on, Alex, you know what I'm talking about. Loula's standing and Jack's barely trying to crawl."

"The prematurity-"

"Even if you take his prematurity into account, he's still behind. Loula's just as premature as he is."

"Every baby's different."

"Not this different, Alex. You know that. We have to take him to a specialist."


"Well, based on what I can see, as well as what you've told me, I'd have to say that there's definitely a significant level of motor impairment; its cause is most likely neurological."

"Neurological. So we're talking about what, cerebral palsy or something?"

"Most likely, yes."

"Most likely? That's all you can say?"

"Alex."

"No, okay? If this guy's gonna sit here and tell me my kid has a serious condition and the best he can say is 'most likely,' I have a problem with that."

"Dr. Karev, it's very difficult to make a conclusive diagnosis of cerebral palsy at this stage. I'll want an MRI and CT scan, but even those may not show any definite problems. We may not know for sure for another year, even two. We'll just have to see how he progresses, and what delays or deficiencies may develop over time."

"So that's it?"

"Look, I realize this is difficult. But other than his motor problems, Jackson is a happy, healthy child. He's on track socially and perceptually, certainly verbally, and he's already extremely determined. These are all very good signs."

"Is there anything we can do?"

"Just keep a close eye on him for any weakening, Dr. Montgomery, and keep note of what skills he does and does not develop. I'd also start him off on physical therapy sooner rather than later. As I'm sure you know, the brain is extremely plastic, particularly at this age. The sooner Jackson learns how his muscles can and should work, the better off he'll be."


Alex stares straight ahead, stony faced. His hands grip the steering wheel so tightly his knuckles are white. Addison looks blindly out of the window, her eyes filled with tears. Neither of them speaks.

From the backseat comes Jack's obliviously cheerful babbling. He says, "Geen, geen!" whenever he sees a tree or a particularly bright lawn. An avid fan of Kermit the Frog, 'green' had been Jack's first word after "mama," "dada," and "no." In fact, he liked the word so much that Alex had taken to calling him Ribbit. Thinking of this, Addison isn't sure whether to smile or cry.

When they get to the house, Addison cradles Jack close as she goes to the door. Inside, Callie looks up from where she's playing with Lou on the living room floor. "How'd it go?" she asks softly. "Is everything okay?"

Addison shakes her head. A tear slips down her cheek. "No."


Addison falls asleep curled around Jack, lulled by his soft humming and cooing. When she wakes, he's fast asleep, so she puts him carefully in his crib and goes to look for Alex.

She finds him in his "office." They still call it that, even though it's really a workout room. He's got his rowing machine and his weight bench, a sound system and a little refrigerator. Due to her insistence, the posters on the wall are framed. He's got a ratty couch and armchair too, as well as an old big screen TV that Callie bequeathed when she bought a flat screen. It's where he goes when he needs to unwind and be by himself, or so he says; Addison knows there's a playpen in here somewhere, though.

He isn't lifting weights or rowing, and he isn't stretched out on the couch in front of the TV. He's at his punching bag, pummeling the hell out of it. His shirt is soaked with sweat, and his gloves are lying discarded on the floor.

"Alex," she says, "you'll hurt yourself."

He keeps right on pummeling.

"Alek, be careful. Your hands." She only uses that nickname when she's pretty damn serious; hopefully it'll get him to stop, at least for a minute.

Sure enough, he stops, but not for the reason she thought. He turns toward her, panting. His eyes are hard. "You think I give a shit about my hands right now, Addison? You think that's what I care about?"

"Alex, look, I-"

"What good are they? Huh? Answer me that! I'm a damned neonatal surgeon, and I can't do a thing for him! There are only two things I'm good at: being a jock asshole, and being a surgeon. Neither one is worth shit right now."

"How do you think I feel?" Addison explodes. "I'm not only a world class surgeon, I'm the one who carried him! I'm the one whose body betrayed him!"

"That's…that's different."

"Of course it's different! It's WORSE!!!!" She takes a deep breath. "But I am trying, as best as I damn can, not to think about that right now, because he's more important, and he needs me. And you forgot one thing you're good at, you know. You're a good father. And that's who he needs right now."


Alex works practically nonstop for the next two days. He snaps and growls at everyone, especially after he notices people giving him sympathetic looks. Eventually, they just leave him alone, which is good, because there's no way he wants people shoving platitudes in his face.

He's updating a chart at the nurse's station when he hears someone clear her throat behind him. "Dr. Karev."

"Dr. Bailey."

"Could I have a minute of your time?"

After a year under Bailey's supervision he knows an order when he hears one, so he turns around, crossing his arms over his chest and raising an eyebrow in the process.

"Oh, do not give me that look, Doctor, it doesn't impress me at all. You listen up, because I mean this and I'm only going to say it once. I'm not going to tell you I know how hard this is because I don't, and I'm not going to tell you I can imagine how you must be feeling because I can't; if I were in your shoes I'd probably be out of my mind. I am going to tell you this: knock it off."

"What?"

"Knock it off. Stop feeling sorry for yourself. You don't have the time for it."

"In case you haven't heard, it's Jack I'm worried about here."

"Jack doesn't need your worry, Alex, especially if it prevents you from giving him what he really needs right now."

"And what's that?"

"Help, Alex. He needs your help. You think that boy's going to be able to get through all the things he'll be facing without you behind him? Absolutely not! Hell, you're bullheaded enough to make twenty kids walk!"

"You think?"

"You ever known me to bullshit anybody?"

"Good point."

"Now, get out of here. Dr. Torres already cleared it with the chief. Oh, and Alex?"

"Hmmm?"

"You bring my godson in to see me sometime soon, you got that? He and his Aunt Miranda are going to have themselves a little chat."


Entering the nursery, Alex ghosts a hand over a sleeping Loula's cheek. "Sweet dreams, little girl," he murmurs. Making his way over to Jack's crib, he finds that his son's eyes are wide open. He smiles and wriggles when he sees Alex, reaching for him. "Jesus, kid, don't you ever sleep?" Jack smiles again, and Alex grins. "Okay, okay. Come on."

Plucking his son out of his crib, Alex settles them both in the big armchair Addison had insisted on installing. "Your daddy is one tired man, kiddo." Jackson's only reply is tugging at the front of Alex's shirt. He continues. "I'm sorry I flaked out on you for a while, buddy. You know that, right?" Alex sighs. "Man, here I am screwing up and you haven't even had a birthday yet! It just…it just sucks, you know? You're gonna have to deal with all this extra stuff right off, and I can't fix it, and that bothers me. A lot. It's no excuse for not hanging out with you, but it's the truth. You know what, though? I talked to this real nice lady at the hospital who's gonna be helping you, and she said it might be a good idea for the two of us to go swimming sometimes. That sound like fun?"

"No!" Jack checks quickly for Alex's reaction and then looks down, cackling away to himself.

"Tough luck, kid. We're doing it anyway," Alex mumbles. He's pretty sure Jack forgives him, because soon his little boy burrows into his chest. Alex tucks himself around him, and they both stay asleep until Addison finds them there in the morning.