Chapter Seven: How We Operate


A little joy
A little sorrow
And a little pride so we won't have to borrow
Wherever you lead, I'll follow
Turn me inside out and upside down
And try to see things my way
Turn a new page, tear the old one out
And I'll try to see things your way

Gomez

…

"You paged 911, Dr. Karev?" Lexie said as she appeared on the maternity floor, a little out of breath from running to get there as soon as possible.

With a knowing grin, he informed her, "That was just to get you to hurry. I've noticed that it takes you at least five minutes longer when the page isn't 911."

Lexie just shook her head and remarked bluntly, "You and my sister get a twisted thrill out of torturing me, don't you?"

"Something like that. Anyway, you're scrubbing in on a C-section and then a tumor removal with Dr. Montgomery," he explained quickly.

"Whoa… I get two surgeries? Seriously?"

Alex looked up and nodded. "Can you handle that, Dr. Grey?" When she eagerly assured him that she could, he then replied, "Well, in that case, let's go scrub in. Hope you had enough coffee; it's gonna be a long day."

Meanwhile, after buying Lillian's pink teddy bear in the gift shop, Meredith and Izzie had retreated back to the waiting room, where an uncomfortable silence rested over them. No one really wanted to speak because, really, there was nothing to say. So instead, they watched the children playing happily, for the most part unaware that anything was wrong.

Finally, however, Izzie broke the silence as she decided, "I should call George and let him know what's going on. He'd want to know. He'd want to be here."

Meredith nodded in agreement and managed to smile as Hayden crawled up onto her lap to cuddle. "Hey, you," she whispered, resting her cheek against his soft blonde hair and suddenly her attention went to the sleeping baby girl in her husband's arms. Would Cristina get the chance to know her little girl? Would Aida and Lillian be able to grow up together and become best friends like their mothers? And what in the world would she say to Cristina if the answer to those questions was "no"?

"Mommy, you look sad. Are you sad?" Hayden wondered, holding his mother's face in his little hands.

"Yeah, I'm a little bit sad. I'm worried," she said softly.

Hayden nodded thoughtfully and answered, "Oliver is worried, too. He said Lillian is sick. Is she?" When Meredith explained that she was, he stated simply, "She'll be okay."

"I hope you're right," she whispered into his ear before kissing his cheek.

"All right. I just talked to George, and he's on his way. And I met up with Preston in the hallway, and they're bringing Cristina in to the OR in a few minutes. He looks so worried—I mean, anyone would be—but I told him that he should get something to eat and some coffee. But he said he wants to be there with her," Izzie reported.

"That's good. I'm a little worried about the boys, though. Should we… I don't know, should we talk to them about what's going on? This must be so scary for them, especially Oliver," Meredith wondered as she and Izzie turned their attention to the two Burke boys.

Aaron and the twins were playing quietly, although the usually boisterous and rambunctious little boy was uncharacteristically calm. Oliver, who tended to be quiet most of the time, was sitting next to Elena flipping through the pages of some brightly colored children's magazine.

"I don't know, Mer. I feel like we should tell them something, but is it really our place? Preston was in such a daze, though; I don't know if he's even thinking straight right now," she recalled, the memory still fresh in her mind of him standing in front of the OR board, just looking so helpless and lost. "I think we should. I'll do it," she volunteered, calling the boys over and gently explaining the general ideas of the mystery that had everyone so worried.

"Meredith, I'm a little bit hungry, and Oliver said he was, too," Elena told her stepmother a moment later. "I was thinking that I should go get everyone sandwiches or something."

But Derek was the one who volunteered. "That's a great idea, Elle. In fact, I'll go with you because there's a patient I need to check on—post-op for a spinal tumor removal."

"Okay!" she agreed enthusiastically. It was very rare that she actually got to meet any of her parents' patients, and she was eager to see the outcome of her father's work. In fact, the only time she had ever really spent with a patient was about a year ago when her mother decided to personally supervise one of her post-op newborns. Words couldn't describe Elena's excitement as she was allowed into the NICU and put on the oversized sterile surgical gown, just like she was a real doctor, just like she dreamt about becoming someday.

…

"You're quiet," Derek commented as he and Elena walked hand-in-hand toward the elevator.

"Lillian isn't even born yet, and she might die. Her mommy and daddy love her, and it's not fair that mommies and daddies who love their babies have to lose them. Why does life work that way, Daddy?"

The six-year-old's question stopped him in his tracks. He knelt down in the middle of the hallway and looked into her big, green eyes. "Elle… I wish I knew the answer to that, but I don't. In fact, I wonder the same thing all the time. But I don't have the answer for you."

Elena nodded with a sigh. "It's okay, Daddy. Maybe there isn't an answer. Maybe all the bad things happen for a reason… like to remind us about the good things we have."

Somehow, the child always managed to put things into perspective for him. If you looked hard enough, you could find the good in any situation. Elena herself had been the blessing to come from an otherwise tragic situation; if Derek could have had his way, both Leni and Elena would be there with him, but things seldom go the way one expects. Elena was one of his three miracles, and no matter how bad things seemed, she was a reminder of what was really important in life.

"Mr. Meyner, how are you feeling this afternoon?" Derek asked when he and Elena finally arrived at his patient's room.

A man in his sixties replied jovially, "I'm feeling just fine, Dr. Shepherd. Just fine." He then noticed Elena standing just outside the doorway and wondered, "And who is that pretty little thing standing over there? Why, if I had my brushes and paints, I'd be able to paint an angel."

Derek motioned for Elena to enter the room and introduced them to one another. "Mr. Meyner, this is my daughter, Elle. And Princess, this is Mr. Alan Meyner; he's—"

"A painter," she finished. "I saw your collection at the Met when my class went there last spring. Your work is beautiful, Mr. Meyner."

"Beautiful and good taste in art," he replied. "Little one, you are intriguing. Come and sit by me, and let's chat for a moment, shall we?" he requested, and Elena walked toward him, silently amused at his eccentricity. "Are you an artist, Elle?"

The little girl shrugged. "I don't know; I've never tried painting. I'm in ballet and I play the piano, though," she volunteered.

"Hold up your hands," he instructed. After a quick glance in her father's direction—and an unknowing shrug in reply—Elena did as he asked. "Ah, yes. My dear, you have the hands of an artist—delicate, yet strong. Humor an old man and promise me that you'll at least have a go at painting."

"Okay, I will," she assured him cheerfully, eager to see if he was right.

…

"Dr. Grey, why am I making a transverse incision as opposed to longitudinal?" Alex questioned as Lexie stood by his side, watching eagerly. Addison was waiting in another OR across the hall, anxious to begin surgery on baby Lillian as soon as possible. Preston was also in the OR, gently holding Cristina's head in his hands and feeling uncharacteristically helpless.

"A transverse incision decreases the chances of the need for repeat C-sections in subsequent births, as well as less blood loss and decreased recovery time," she answered without hesitation.

He nodded and commended her, "Good job, Grey. Looks like next time your sister is on your case, I can tell her you've been doing your homework after all. You doing all right over there, Cris?"

"Oh, yeah… just great," she answered, and he was glad to hear her familiar sarcasm despite the fear she must have been feeling for her daughter.

"That's great. Okay, Lexie, I need you to put your hand right there," he instructed, suddenly getting a flashback of his first completely solo delivery. It had been Elle. He remembered how nervous he had been, how he worried that every move he made would somehow cause harm to Leni or Elena. And he remembered how, after holding that tiny, fragile baby in his arms for just a moment, he knew what his true calling was.

A moment later, Alex was holding another tiny baby girl in his arms. She had ten fingers and ten toes and big, dark eyes. She was crying loudly, and if he hadn't known how terribly ill she was, he would've thought that everything was perfectly fine. Knowing that this was potentially the first and last time that they might see their daughter—a thought that caused a sinking feeling in his stomach—he held her up for them to see. "So, what's the final verdict on her name?"

With a sad smile and a look of pure love and adoration in his eyes as he looked at his newborn baby girl, Burke answered, "Lillian Imani."

"Lillian Imani," Alex repeated before handing her off to Lexie's waiting arms. "Get her to Addison, stat."

Lexie quickly cleaned the baby, checked her vitals, and wrapped the baby in a sterile cloth. She then hurried across the hall to Addison's OR, where a second surgical team was waiting. "Dr. Montgomery, the C-section went through without any complications, and the baby's vitals are stable. Dr. Karev is closing up as we speak."

Addison nodded. "All right, then. Let's get moving, people. We have to work fast if we're going to save this little girl's life," she said, very business-like. However, she then did something that completely surprised Lexie; as the anesthesiologist was putting the little girl to sleep, Addison gently held Lillian's hand in her own. "You're gonna be just fine, Sweetheart," she whispered, determined to stay hopeful.