A/N: Here is chapter 11 (not bankruptcy, thank goodness) Thank you all so much for reviewing that last chapter. This next plot twist is pretty big (as many of you guessed) and it's going to color the next phase of the story. Sorry to take so long to update, but the end of the academic quarter is always super tight for me. Luckily it is winding down, and I'll have a lot more time for updates over my holiday break! I am not a medical professional, and all the information about surgery and medicine in this chapter comes from the internet. Please let me know what you think, and thank you all for reading.
Meredith strode out of the elevator, quickly making her way to the pit in response to an emergency page. Car crash consult. Dr. Bailey appeared at her side, coming from another direction, and falling into step with Meredith's pace.
"You get called in on this too?" the small woman asked matter of factly. "What was it? Three car pile up?"
"Yep," Meredith replied. "I'd guess the ice we had this morning my be the culprit."
She steeled herself, and took a deep breath as they passed through the automatic doors and into the chaotic ER. It always amazed her how different this part of the hospital felt. Since completing her residency and neuro fellowship, Meredith had had less and less need to spend as significant amounts of time down here as she had before. Now, she only went down for emergency consults, and spent most of her time in the OR or upstairs in the Neurology Department. Where it was quiet and orderly. Where most of her procedures were preplanned, and not gruesome. Meredith had no idea how Kepner and Hunt could handle the pace and the crazy day in and out.
"Dr. Grey? Dr. Bailey?" Ian Olant, one of the fifth year residents beckoned them to the nurses station and handing them each a chart.
Meredith didn't know him all that well, because he mostly stuck to trauma and ortho rotations, but the few times she had worked with him Olant had proved to be skilled and thorough. He was April's project. They all kind of had 'pet' residents of their own now, which was weird because it seemed as though only a second had passed since they were in the same position themselves. Alex may complain and scream at Dr. Lacey all the time, but he also hardly ever let her go on someone else's service. Meredith preferred to work with her own neuro resident, Dr. Rooney, if given the choice. And Cristina, who'd only been back in Seattle for a matter of months, almost always requested to work with 'Six', otherwise known as Gina Chi. It's just how things went.
"What have we got?" Bailey asked urgently, flipping open the chart and following Olant to a curtained off bed.
"Car accident, some abdominal injuries, and possible head injury," the young surgeon said eagerly. "Patient came in with her grandson. She is female in her mid-sixt-"
"M-mid-sixties?!" an indignant voice came from the bed. "Mid-sixties! There's no w-way I look that old..."
The flustered and confused comment would have been funny, except for the flicker of recognition that Meredith saw cross Dr. Bailey's face. Bailey's jaw hung slightly open, and Meredith's eyes darted back and forth between her old mentor and the woman on the bed. She also felt an odd sense of familiarity from the woman before them, but she couldn't quite put her finger on why.
"I...I know you..." the patient said in confusion, eyeing Dr. Bailey and reaching a shaking hand up to the gash on the side of her head.
"Uh," Bailey fumbled for a moment, before pulling her professional face on and locking in. "That you do, Mrs. Stevens, and I am going to take care of you today, can you tell me what happened?"
Now it was Meredith's turn to stare in shock. Mrs. Stevens. Oh God. Robbie Stevens. She recognized the face now. Izzie's mom. She'd seen a few pictures here and there back in the old days when Izzie lived in her house and George was alive and everything was different. She'd even spoken with her on the phone a few times. Meredith hadn't heard from Izzie in a long time, and seeing her mother in a Seattle hospital was more than a little surprising.
Robbie Stevens, squinted in thought, panic rising in her features as she seemed to remember what happened, "It's a car accident. We...driving in the city. Seattle has so many cars...we-we got hit. And Kyle...oh my God Kyle!"
Her eyes widened and she sat up straight in her bed, clamoring to get up. Dr. Olant and the nurses held her down.
Meredith shook herself a little, reaching for the penlight in her pocket. She began carefully checking Robbie's eyes. Kyle? Must be the grandson. Grandson. The concept gave her and uneasy sort of feeling. Because Izzie was an only child, and so this had to be her boy. And Meredith knew enough about the side effects of Izzie's chemo treatments to know that having a biological child of her own after the fact was unlikely. Alex had been married to her at the time, and they'd frozen embryos before the damaging treatment. After the divorce, Meredith had no idea what had become of them. Alex never talked about it. And now, it just made Meredith wonder.
Calmly, Dr. Bailey grabbed Robbie's hand, and began doing a quick examination of the woman's midsection, "Don't worry about him right now. I'm sure he is in good hands."
"H-he was...with that gimpy surgeon," the woman said, dazedly, eyes darting around as Meredith shined the light on them.
Bailey gave Meredith a pointed look, and reassured Robbie, "Dr. Kepner is very good. I'm sure she is doing everything she can..."
Oh dear. The uneasy feeling in the pit of Meredith's stomach grew even more. April would be the one surgeon at the hospital who would end up with this particular patient. And with the concerns she was beginning to have about this whole thing, April treating Kyle, the grandson of Robbie Stevens, added yet another layer of complication over what Meredith was certain was already going to turn out to be an incredibly complicated situation.
Of course, Meredith had a patient to care for. No time to dwell on any of that now. She continued her thorough exam, working to determine the extent of the older woman's head injury. Luckily, even though Robbie was clearly concussed and confused, her pupil responses matched which didn't indicate that she was suffering from a brain bleed. Still, it was a good idea to be sure.
Meredith gestured to a nearby intern, "I don't think she has a brain bleed. Get her prepped for a CT scan."
Bailey chimed in, "And a chest and abdominal scan as well."
The intern quickly darted off leaving them alone with the patient and Dr. Olant. Bailey looked on sympathetically, holding the woman's hand, "We'll get your scans finished soon, and then we'll work on fixing you up. I can try to get some updates on your grandson as well..."
Meredith nodded, and let her eyes drift to the other side of the ER, where a commotion was underway, surrounding another curtained off bed. Alarms and beepers were going off, and she could see April clamored up on the bed, giving a tiny boy's chest electric shocks with ER paddles. Damn. The child looked bad. Calculating quickly Meredith knew what she had to do.
Reaching her hand out and pulling the curtain further around Mrs. Stevens bed, to obscure her view, Meredith gestured for Dr. Olant to come on the other side with her.
"Yes Ma'am?" he asked politely.
"I assume Dr. Kepner had you page for a peds consult on the grandson, yes?"
"I didn't need her to tell...um, yes. A pediatric consult should be on it's way," Olant nodded, glancing over to Kyle Stevens still chaotic bed area looking puzzled.
"Who did you page?"
"Uh, just a general call to pediatrics Dr. Grey," the young resident shrugged. "Who ever isn't in surgery and can come help..."
Meredith nodded briskly and glanced back at the curtained off patient behind them, "Okay. Have you contacted next of kin? The child's mother?"
"That is very next on my list, Dr. Grey."
She nodded, "Good. Do that. I'm going to go see what I can find out about peds. I need you to page me as soon as Mrs. Stevens CT comes back. Can you do that?"
Dr. Olant nodded slowly, and tilting his head to one side, "Are you the neuro consult for both cases Ma'am? I thought there would be two separate-"
Meredith shook her head. The resident was too smart and too nosy for his own good. Derek would be coming down to check over Kyle Stevens the minute Kepner had the boy stable enough for a neuro exam. If she could get him there. Or, if his other injuries were too life threatening, that would mean surgery first, and brain check ups later. It really all depended.
The real reason she wanted to find out who was doing the pediatric consult on this case was not to coordinate care plans between neuro and peds. Meredith's real and growing concern was that Alex would be the surgeon to come down from peds.
She was beginning to have serious suspicions about the identity of Robbie Stevens grandson. Alex could well be his father, and even if he wasn't, the fact that the child was likely Izzie's was also reason enough for Alex to stay off the case. No matter how you looked at it, he was much to close. No way Meredith would let him operate.
Meredith put on a stern glare and demanded, "Just do what I ask."
"Yes, Ma'am," Olant mumbled quickly, seeming stung by the sharpness of her tone.
Unable to spare a moment or a care for the crest fallen resident, Meredith quickly headed away from the bed toward the elevators. She needed to head off Alex as soon as possible. She hovered around the elevators for only a few minutes before the doors opened and Alex burst out, with his resident Dr. Lacey only a few steps behind.
"Alex-" Meredith said, holding a hand up to his chest.
"Not now, Mer. We've got a consult on a car crash kid..."
"Well, I really think you should let Dr. Lacey have a chance to go solo on a consult," Meredith replied quickly, blocking Alex's path and his view to the ER.
Lacey's eyes lit up and the young resident squared her shoulders, "M-Me?"
Meredith knew that Kyle's case was serious, and she didn't want to deprive him of top notch care, but Dr. Lacey was a very good resident, and there were a number of other peds attendings who could be called upon to assist if this was out of her depth.
"Yes, you," Meredith said with as much confidence as she could muster given her growing apprehension. "I think it's a good opportunity to show your talents."
Dr. Lacey grinned and looked to Alex with excitement, "Can I?"
Alex ignored his resident and glared at Meredith in confusion, "Where the hell do you get off telling me what my residents are capable of-"
"Dr. Lacey will page Dr. Robbins if the situation becomes more than she can handle," Meredith said firmly, giving the young resident a pointed look.
Eagerly Dr. Lacey turned to Alex, "I promise I will. I can do it Dr. Karev. I know I can."
Alex scowled and crossed his arms across his chest with his jaw set, glaring at Meredith.
Grabbing his arm and looking him seriously in the eye, she spoke evenly, "Trust me, Alex."
Those words, to Meredith's relief, seemed to be enough for her moody friend, because after a moment he gave a nod of approval to Dr. Lacey. As she bounded off to the ER, Alex turned his attention back to Meredith, allowing her to guide him into a secluded hallway, just beyond the family waiting area. His expression was still irritated.
"This better be freakin' good, Meredith," Alex snarled. "I don't need you or anyone else telling me how to handle my own god damn residents-"
"Alex, I..." Meredith interrupted, not entirely certain where to begin. She knew Izzie Stevens and Alex's first marriage were topics he hated to discuss. "Alex, there is a woman in the ER who...it's Robbie Stevens. Izzie's mother."
Crossing his arms and looking down his nose, Alex shrugged in response, "Whatever...it's not like I ever had a beef with her or something. And she's obviously not the patient I was paged for, and I am perfectly capable staying professional."
Meredith winced and looked at her feet, "Alex..."
There was just no nice or easy way to explain her gut feelings of unease. Alex looked even more royally pissed off, as the silence lengthened, so Meredith finally continued, "You can't operate on that consult. You can't operate...because the patient is Robbie Stevens's grandson."
Alex blinked.
He stood still for a minute, still scowling, as though he was really trying to process the ramifications of Meredith's statement. He opened his mouth, sucked in a shaky breath, and closed his mouth again. He raised a hand to his chin and made to speak again, only to shut his jaw once more.
Finally her friend sputtered, "You mean...her biological grandson?"
Meredith nodded, "As far as I know."
"Like her...blood, DNA grandkid?"
"Yes," Meredith nodded. "It seems that way."
"So..." Alex trailed off, eyes wide.
"So...he's probably Izzie's son," she reasoned. "Since...I mean, she didn't exactly have brothers and sisters."
Alex still seemed too stunned to process, and shook his head in agreement, "Yeah, it was just her. Wow...Izzie has a kid...holy crap."
"I...I don't mean to pry, Alex," Meredith began tentatively. "But...in the divorce...I...what exactly happened with the, um...with the embryos?"
Jerking out of his stunned haze, Alex turned to gape at Meredith as though this possibility, which was the one she herself had the most concern about, hadn't yet crossed his mind.
"She-they're still frozen...I thought...she-she wouldn't!"
Meredith just shrugged. She didn't know. Izzie had done a lot of things in the wake of her cancer and George's death that surprised Meredith. And she hadn't really kept in touch, their contact tapering off over the years, so she really had absolutely no idea at all what her old friend would and would not do.
"Could she have?"
"I-" Alex shook his head in a daze. "She sent me the divorce papers in the freakin' mail. She...I just wanted to get it over with. Give her what she wanted and whatever..."
"What did the papers say about the embryos?" Meredith pressed.
Lifting his hands to his head, Alex shook his head in disbelief, "Custody went to Iz...usually they go to the...the mother, anyway. Guys don't usually contest in court. I just...I...I can't believe she freakin' used one with out even telling me! How the hell could she just-"
Alex was angrily making his way out of the waiting area, no doubt wanting to go to the ER to talk to Izzie's mother, but Meredith held up her hands, "Look, we don't actually know if this boy is on of the embryos or not..."
"But its her kid, so it is a big freakin' possibility!" Alex said, before swearing violently, and throwing a nearby cart down the hallway. It's contents crashed out onto the tide floor, earning them some startled looks from the nurses at the end of the hall. "Shit!"
"He could be adopted?" Meredith suggested plaintively, stepping back from his outburst and not really quite believing that possibility. "Or...maybe she used a different donor?"
Alex started to pace, "Iz's cancer treatment was really aggressive, Mer."
"Yeah," Meredith replied glumly, understanding the full implications of Alex's statement.
She knew just how damaging that level of radiation therapy could be. The chances of getting pregnant with your own eggs and a donor after the fact were very slim.
Whatever eggs hadn't been harvested and used before the treatment were basically infertile now. And as far as Meredith knew, the only healthy ova that had been removed before Izzie got her chemo were those that had ended up as frozen embryos. With Alex. If the other woman wanted to have a biological child, those embryos would be her best option.
"How...how bad is he? The kid?" Alex asked suddenly, using two fingers to pinch the bridge of his nose. "The page was...for a car crash right? How old is he? Is he really hurt?"
"I didn't actually see him," Meredith answered. "Or his chart. Mrs. Stevens has some pretty intense injuries...and...it looked like April was working pretty hard to keep the boy alive actually."
"Damn it!" A pained expression flickered across her friends face. "Crap."
Meredith leaned against the hallway wall and let Alex pace, uncertain of how to really comfort him.
"Does April...I mean, does she know who he might be?"
"No," Meredith shook her head.
Kepner hadn't really been around for the downfall of Alex and Izzie's marriage. She'd been fired so quickly after the merger, and after she came back, the divorce was already a done deal. Meredith wasn't sure if the the women had even met more than once or twice. Sure, April had to know a little bit more about it, because of Alex, but she also had a feeling his first marriage wasn't something Alex talked about much.
Meredith was certain, with a sinking sort of feeling that April had no reason at all to suspect anything about the patients connection to her fiance. "I don't think she knows...I mean, Stevens is a common enough last name."
Alex laughed humorlessly and slumped his shoulders forward, "Shit."
After a few moments, Dr. Olant came striding up the hallway, breathlessly stating, "Oh, Dr. Grey! Here you are!"
The young resident stopped short, shrinking under the rage and pain filled glare he received from Alex and dismayed by the mess off the over turned cart. He looked at Meredith with a confused look on his face, and she quickly waved things off. She had no intention of explaining anything to a random 5th year.
"What have you got for me, Olant?" she demanded curtly.
"Uh...Mrs. Stevens' CT came back clean and she is ready for surgery. But Bailey says you should observe just in case. You can join us in OR 1," he replied, observing Alex closely out of the corner of his eye. "And I have made contact with the daughter. She is en route from Tacoma..."
Meredith watched Alex's jaw tighten. Izzie was coming back to Seattle Grace.
April bit her lip behind the veil of her surgical mask, staring at the ceiling and going ever every single possibility in her mind. The persistent beep of all his monitors droned away in her ears, and April shifted against the stiffness in her bad knee. Her gloved hands rested inside the small body of a little boy. Her hands currently were the only things keeping said little boy from bleeding out.
At this moment in time, they were the only thing keeping Kyle Stevens alive.
Think. Think. Think.
This was the reason April didn't specialize in pediatrics, even though she liked the rotation as a resident. The stakes were just too high and the patients were too small.
On the other side of the table, Dr. Lacey's wide eyes expression of panic didn't provide April with any great ideas for what to do next. She still didn't know why Alex had sent the other resident on the consult instead of coming himself. Lacey was good, but still pretty green.
"Do you think we should page Dr. Robbins?" the young resident nervously inquired.
Beside her Dr. Webber, who'd come in as the general surgery consult, lifted his gaze to April, "What do you think Kepner? You're the lead on this surgery."
"Uh," April stammered. Webber might not be Chief anymore, but he still carried a lot of authority in the eyes of the staff, and it was unnerving for April to have him actually deferring to her judgement in a procedure. Even if she was the lead on the case.
She swallowed, listening to the incessant monitors again, and shaking her head. Calling Robbins probably wasn't going to make much difference. Arizona wouldn't be able to tell them anything they didn't already know.
Think. Think. Think.
After restarting his heart they'd gotten the boy in the operating room, and repaired his fractured arm and pelvis. That part of things had done relatively well. Things had only gotten tricky when it came to bleeding. April had already fixed the child's nicked liver, but the impact and the sharp edges of broken bones had created a massive bleed.
There was a bad rupture in the blood vessels, and without a repair, Kyle was in grave danger of bleeding out. Add to that, they had no visualization to do a repair at all, so any small mistake during the procedure could result in the patient bleeding out anyway. It was a like horrible Catch 22. With a blindfold.
"Uh," April repeated as Webber and Lacey looked at her expectantly. "I don't think we need to page Dr. Robbins. There isn't really any new insight to offer, and we already have too many hands on this."
That was another part of the problem. Kyle's body was too small. Because he was only two, and two year old bodies are not meant to be broken and cracked open under the bright lights of an OR. Only so many doctors could work at one time.
Lacey's eyes darted around, "So...what are we going to...I mean, what do we do? What else is there to try?"
April swallowed hard again, and watched Dr. Webber closely. He'd been practicing medicine a hell of a lot longer than she had. His expression remained somber, and he spoke sadly, "We might have let this one go, and call it Dr. Kepner. His body has been through at lot of stress already. He's lost a tremendous amount of blood. Our options are very limited and the odds of success are even lower."
Gasping, April's lower lip quivered, and her body became tense. She knew the odds. She knew the options. And everything Richard had just said was absolutely true. She glanced back down at the tiny body in front of her, still taking great care not to move her hands even one centimeter inside Kyle's chest cavity. She knew it was almost a lost cause.
And yet...and yet, there it was. Almost.
April could feel a persistent pulse with her fingers. Kyle Stevens heart was still going strong. And it was remarkably steady considering everything that had happened. Since his coding and resuscitation in the ER, that heart had never faltered. The only problem was that the blood it was pumping through the child's body was hemorrhaging out of a rupture. It just didn't seem fair.
His heart wasn't ready to die, so April wasn't ready to let him go.
Think. Think. Think.
It was clear that a decision had to be made. April knew that she couldn't just keep standing there staunching the blood flow. She took a deep breath. What was visualization worth anyway? A lot of times surgeries were conducted with little to no visualizations at all. Hunt had had April study a lot of field trauma, and in emergencies and military situations overseas surgeons made the call to act without visualization all the time. All the time.
Granted not on children typically, but whatever. Success was possible.
And what did they have to lose by trying? Kyle would die if they did nothing, and if April tried to do the repair blind then there was a small chance he would survive.
At the very least, the blood vessel repair didn't have to be perfect. It didn't have to be the final patch. Really, all April needed to do was to get the bleeding to stop, or at least slow down, without causing any more blood loss. Once that was stable, any number of other procedures could happen.
Yes, she could formulate a plan now. April could see how it would work. She'd going in blind, to stop the massive bleeding. If, and it was a big if, but if she could do that and the bleeding did slow, then April could continue doing a more permanent repair. It would take time, and it was incredibly dangerous. Kyle had already had half his blood volume replaced.
She knew she supposed to stay detached, but her mind drifted to the woman she'd met coming off the ambulance, Kyle's grandmother, and she couldn't help to think about her own mother and Adam. She had no doubt that Robbie Stevens felt as much love for this little boy as Karen Kepner did for her own son. And she could only imagine how this boy's mother and father felt right now, facing the prospect of losing a child. Agony.
If it was Adam, April knew what she would want.
Straightening her shoulders, "We have to say we tried everything. We have to be able to tell his family we did absolutely everything we could. Suction, please."
"So..." Dr. Lacey asked, complying with the demand. "What are we going to do? I...we can't see anything! Suction doesn't make a difference, he's bleeding too fast. How will we know how big the rupture is or what shape of repair we need to-"
April stopped herself for snapping at the young resident. The rupture was obviously big. So big that exact measurements no longer mattered. It was simply too big.
"I can feel the contours of the rupture with my left hand," she replied instead, focusing closely on exactly everything she could feel by the blood vessels beneath her fingers. "We can make a reasonable estimate based upon that until we get the bleeding to slow."
As she proceeded with the next step of her plan, Webber watched closely, with narrowed and unreadable eyes. Calculating. Measuring her. April sighed.
He probably didn't agree with her. He probably thought that this was a bad call, and that she was a terrible attending. This decision was going to have consequences. He'd maybe go to Hunt. His word pulled weight. Once, Richard's potential disappointment would have paralyzed April, but in the moment she realized, that she no longer cared as much.
April did desire Webber's respect, but now she wasn't willing to bend over backwards to earn it. Nor was she willing to compromise her patient. This was Kyle Stevens best chance at surviving.
Dr. Lacey handed April the next instrument, and the trauma surgeon paused and shifted her weight more heavily on her good leg. Mistakes were not an option, but April thought she could do it. She thought she could save this little boy, and she knew she had to try.
It was going to be a long afternoon.
Alex almost didn't recognize her when she came through the automatic doors of the Seattle Grace Mercy West lobby. She'd done something to her hair or whatever. Different hair cut. Different color. Darker maybe. And she walked different too. More assured. Purposeful. Deliberate.
Then again, he supposed it made sense that she would be walking urgently. Her family being in the hospital and all.
From his distance in the lobby, Alex watched as Izzie immediately walked up to a nurses station, speaking sharply. He slowly pulled himself up from his seat, crossing his arms and tilting his head to one side. Meredith had gone with Goody-two-shoes-Olant, and Bailey into the OR to work on Robbie. She'd thought it was a bad idea for Alex to wait for Iz, but he was sure as hell going to be there.
So, she'd coaxed Cristina into being his freakin' chaperone, until her next scheduled procedure. When he stood up, she did too, and he glanced over at her irritably.
"I don't need a freaking babysitter," Alex mumbled as he began walking in Izzie's direction.
"I was thinking more like a referee," Yang said causally, though Alex could see a tightness at the corner of her cheeks that revealed something less calm. It made sense, he supposed. Izzie had been a huge part of everyone's lives, not just his. Other people had been hurt by her leaving.
"You really think I am gonna hit her or something? I don't do that," Alex reasoned as they approached the nurses station. "Her mom and her...kid were in a freaking car accident!"
"A kid you have reason to believe she's been hiding from you his whole life..." Cristina mumbled.
Alex glared,"I'm royally pissed but I am not that much of a jerk."
"I don't have time for this," Cristina mumbled. "Everything was so nice and drama free at Stanford."
Grinning half heartedly at his friend's attempt to lighten the moment, Alex teased back, "And yet you keep coming back..."
Cristina didn't get a chance to reply because at that exact moment, Izzie's eyes darted to her left and her posture slumped when she recognized Alex and Cristina. Her eyes met his briefly, and Alex gulped. It was a strange thing, seeing Iz again. Very surreal. It made him think of crap that hadn't crossed his mind in years.
Random little things. Bears. Cupcakes. LVAD wires. DNR orders. Laughter. Notes is his locker. Tears. Crap.
"Look," Izzie said suddenly, looking at her feet and avoiding eye contact. "I just need to find out-"
"Your mother and your son are both currently being treated for their injuries," Cristina said, voice as crisp and professional as if this were an ordinary patient family, and not...Well, not Izzie.
"They're both in surgery," Alex added, shoving his hands in his pockets.
Izzie visibly relaxed a little when she seemed to realize that her old friends really were going to update her on her family though understandably, she still looked distraught. Twitchy even. Like she was about to cry.
As mad as Alex was at the whole situation and all the emotions Iz brought up, he was surprised at how bad he felt. It would be easier if he could just be mad and stay mad. But Izzie was Izzie, and it totally sucked that her mother and her child were hurt, and Alex couldn't help but care.
"Are...are they? How bad are they? What's going on?" Izzie lifted her hand to her forehead and started to cry. "Oh my God."
"Last check with Bailey and Mer, your mother is in fair condition, suffering from some abdominal trauma from the steering wheel along with some head trauma," Cristina relayed. "She was conscious when she came in, and will probably be in post op within the hour. "
Speaking with Izzie was weird, awkward for both Alex and Cristina. There was so much stuff left unsaid. Where did you go? Why did you freaking listen and not come back? Ever heard of picking up the phone? Did you have a kid and not tell his father? Is that kid who we think he is?
"What...what about Kyle?" Izzie pleaded, looking up at Cristina for the first time.
Alex swallowed hard.
"Your son's condition is more critical," Cristina said, in that perfect practiced tone of voice you had to have as a surgeon to give bad news. Thank God for Yang and her perfectly tuned skills. Right now, Alex didn't really trust his own voice to explain Kyle Stevens circumstances.
Things for the boy were much more complex. Lacey had been giving them sporadic updates from April's OR, but they hadn't heard anything in hours. As Izzie's demeanor further deteriorated, Cristina continued, "He is still in surgery. When they finish the procedure, we'll know more. To my understanding he had some crush injuries. Broken bones and internal bleeding."
"Oh God," Izzie breathed, unsteadily making her way over to a nearby chair. Alex and Cristina tentatively followed her, gingerly taking two seats across from where she was sitting. Once, reaching out and pulling her into his arms to comfort her would have been automatic. Freakin' instinct. Something Alex wouldn't have had to think about. And there was something still there. A spark. An urge.
But now, he couldn't reach out to her. There was a distance between them. And not just the distance between the rows of waiting room chairs. It was the distance of thousands of days. A distance of getting shot by a lunatic, and pulling through. And of surviving being trapped in a collapsed building after an earthquake. Of picking peds and staying with it. Of taking care of his mom and Aaron. Of passing boards, and completing a fellowship. Of getting to know his sister. There was a distance between them now.
A distance the size and shape of April and Adam.
Alex wasn't the same guy he'd been when Izzie had left him four years ago. He'd thought that losing his wife would break him. And in a way it had. But Alex was surprised to find that he'd survived the breaking. He'd remade himself too. He'd pulled through it all, and he liked the other side.
Cristina's pager went off and she quickly glanced down and read it carefully, before looking up to Alex, "I've got to go..."
Alex nodded and Cristina eyed him closely. Izzie was still crying quietly across from them, and he could tell that his friend was reluctant to leave him here alone with his ex.
Alex rolled his eyes, "I'll wait with her."
"You sure?"
He was getting irritated now, so he snapped, "Yes."
Cristina didn't look convinced but another loud noise emanated from her pager and she stood up again, stiffly making her way over to Izzie, leaning forward and resting a hand on the other woman's shoulder, "I'll make sure that you get updates as often as possible, okay?"
Izzie nodded gratefully and shook her head, "I-I don't know how to thank you, Cristina...I mean, I know I just...and you don't have to...you don't owe me anything and you have no reason to be-"
Cristina swallowed and the corner of her lips twitched. Izzie leaving had been a big thing for their little group of friends. First George died and then she'd left, and everyone had to readjust. She'd missed a lot, in everyone's lives. Alex felt his anger spike in his chest. It wasn't like he or Cristina would have forgotten all that crap just because of the circumstances that brought Izzie to them now.
"You never heard of email?" Cristina finally answered, as she pulled herself up and headed back to the OR levels. The lightness in her tone did not match her expression.
Izzie gulped and whipped her eyes, lifting them to meet Alex's guarded gaze. He felt a small pang of guilt. The last time, the very last time Iz had left, he had told her to go away. To take her job and not come back. Because she hurt him so much when she left and came back.
Fishing a tissue out of her purse, Izzie continued to dab at the tears on her cheeks. Alex crossed one leg and looked at the ground.
At the same time though, maybe things had worked out for the best. Izzie staying away had changed Alex, and in the long run it had given him his life with April. And Adam. And really, he couldn't ask for anything better. He loved them both more than he thought he could love anyone. It had hurt like hell at the time, but Iz leaving had allowed him to get to where he was now.
The silence stretched out between them, and only one question burned in Alex's head. It wasn't like they could just bust out with normal conversation or anything. 'How you been?' just wouldn't cut it. Still, he couldn't help but want to try to fill the silence with something. If only to keep his mind of the sick feeling he got in his stomach when he thought about the little boy in his fiancee's OR, and the pain he would feel if he was the father and Kyle didn't make it.
"So...you live in Tacoma now?" Alex ventured finally, when he could stand the quiet no longer. Lame and incredibly surface level.
Across from him, Izzie sniffed and paused before replying, "Yes...I...I work at Tacoma General. Just finished my Oncology fellowship."
Nodding, Alex pursed his lips, "Cool...cool. I can...uh, see you picking that...after everything that happened..."
"You, um...you stayed here,"she stated flatly.
"Yep. Peds."
Izzie made a noise that wasn't quite a laugh, and nodded herself.
Then the silence was back. Freaking great. Frowning deeply, Alex shifted in his seat and drummed his fingers against the plastic chair. He let his mind drift to Adam. Today had been an important day for his boy. First day out on the town on a little field trip with the other runts. He wondered how it had gone. Adam was usually a pretty easy going baby, but he had his moments of crankiness, especially when confronted with cold or unfamiliar situations and unfamiliar people.
He'd freaked out just a month before, when April's sister Libby had come up for a visit and she'd kept him at home for a day while April and Alex worked. Which had secretly cracked Alex up because he didn't always get along with his fiancee's older sister all the time himself. That aside, it had shown them that Adam responded better to new situations and people if he was introduced to them gradually. Then again, so far Adam had already formed bonds with his day care caretakers, so odds were good that the field trip had been a success.
He glanced at his watch. 4:37 pm. The trip to the park was long since finished. If today had gone according to plan, Alex would be finishing up his shift in an hour and a half, at which point he'd take Adam home and do the night time routine while April worked a double shift. Now, however, everything had shifted. Instead, Adam would be spending the evening at home with Hunt. Quality Uncle Owen time, as the older man described it when Alex had made the arrangements. Yeah, sure, whatever. He knew that by 7pm his son would be asleep, and Hunt would be sitting on his couch watching cable. Quality.
Alex, however, wouldn't be leaving the hospital until April finished her surgery on Kyle Stevens. He just had to know what happened to this kid. He felt a pull to know.
Thinking about Adam and this other kid, Kyle, Izzie's kid, made the anger rise up in his chest once again. What if this boy really was his son? One of those embryo's he'd helped create all those years ago in the painful hope that his wife would survive her freakin cancer and live to better days. She'd survived, but at the time, Alex had never thought they'd come out on the other side without each other. Funny how that worked.
And sure, Alex knew that somewhere deep in the black and white letters that filled the pages and pages of his divorce papers, there had been something about the custody of the embryos. Something about them going to Izzie. He knew he'd signed it. Because he'd felt like crap at the time, and she'd just sent the freakin' envelope in the mail and the only people who'd ever really talked face to face during the whole thing was their lawyers anyway. He'd just wanted to get it all over with. Looking back, Alex realized, maybe he should have been less willing to go along with it all. Maybe.
If Kyle was his kid; Alex almost couldn't comprehend the idea. This kid was two years old. Two whole years. Alex felt like crap. Adam wasn't even a year old yet, and already he'd been there for everything. The first ultrasound. The first time he moved. The first time he breathed. He'd paced back and forth rubbing Adam's back through his first cold. He'd been there for his first real smile. For rolling over. Blowing bubbles. Eating solid foods. Cutting teeth. Alex had been there for everything. Everything.
If Kyle was his son, he'd missed two whole years of the boy's life. And if he died, Alex would have missed his whole life.
It wasn't fair. Alex's biggest fear all along, all through April getting pregnant and all of that, was the fear that he would not be a good Dad. Because of everything that had happened to him in his life with his own father. He was freakin' afraid of that, so he worked twice as hard to be the best father he could be to Adam, and if Izzie's son was his son too, that meant that the whole time he was working hard to be a great father for Adam, he was a total dead beat for someone else. And Iz hadn't even him the chance to be there. If Kyle was his kid and had gone to any other hospital, Alex would have had no freakin' idea he even existed.
Alex was more than just pissed, he realized. What he felt was a deeper sort of rage. He was furious at Izzie.
"Just ask. I know you want to," she said abruptly pulling him from this thoughts. She was still tearful, and didn't meet his gaze. "All there is to do now is wait and I can tell you want to ask. So, go ahead, and freaking ask me. "
Alex set his jaw and lifted his eyes before responding slowly, "Is he my son?"
Even though Izzie had pushed this conversation, it was clear that she was very uncomfortable with the situation. She sighed and crossed her arms, giving Alex one firm nod that changed his life forever.
He knew it. He just freaking knew it. Kyle was his kid. Their kid. Holy crap.
Nostrils flaring in rage, Alex leaned forward, demanding in a harsh whisper, "And you were going to tell me this when?"
"Alex you signed away any rights to those specimens the moment you agreed to the divorce settlement. They belong to me and I can use them how I please."
"Specimens? Specimens? Really? What the hell, Iz?" Alex felt his blood pressure rising. He was helpless to control his anger now.
"There is no legal obligation for me to tell you anything..." Izzie answered defensively.
"Maybe you didn't have a legal obligation to tell me Iz, but what about the freaking moral obligation? I never thought you'd...I have a right to know if I have any kids out there!"
"Oh, come on, Alex," Izzie snapped. "You can't think that Kyle is the only kid out there that you don't know about. Look at the life you've lived."
"Shut up. You don't know anything."
She didn't know anything about the life Alex lived now. But, if he was honest, Alex didn't know anything about the life she lived now either. Even though he was so pissed he practically couldn't see straight, Alex could see that the woman across from him was becoming more and more distraught. Her kid, their son was in the OR. Critically wounded. And here he was, however justifiably, chewing her out for her choices. Once he would have taken the opportunity to twist the knife; to say any one extra thing that he knew would hurt her. Now Alex felt overcome with a wave of sympathy.
Kyle's life was on the line. This wasn't the time to have this discussion. Anger and resentment and whatever could come later.
Taking deep breaths to calm down, Alex lowered his voice and spoke evenly, "I don't want to fight right now. It doesn't help us and it doesn't help Kyle."
Surprised, Izzie finally looked up and held his gaze. He supposed she expected him to be nastier. Or maybe, deep down, she understood that he really did have a reason to be angry.
"Oh my God," she started to sob again. "Kyle...who is on his case? Dr. Robbins, or...anyone I know? Did you?"
"Uh...I didn't seen him, no," Alex answered gently, pausing before he spoke again to really think about his next words. "He's...if he has a shot at all he's got a good team looking out for him. I swear. One of my residents, Dr. Lacey is scrubbed in. And Webber is on general consult for the case. And...I don't know if you remember...April Kepner? She's the trauma lead working on him."
Izzie shook her head and shrugged, "I...she came over with Mercy West right? Oh, did she hang out with the pixie bitch? And she got fired...didn't she? Around the same time I did. That's the one, right?"
"Yeah..." he didn't know how to say it. "I-"
He didn't know to explain more. Alex didn't have the words. Once, he'd thought that Izzie was the one true love of his life. He'd told her as much. She made him act better. She made him want to be better. He'd wanted to spend the rest of his life with Izzie once. But that hadn't happened. And now, he knew he loved someone else. He was being better for someone else. Living a life with someone else.
"I...she's...I'm with her. April, I mean," he said finally. Maybe it was like pulling off a band aid. Quicker the better. "It's been two...almost three years."
"We...have a baby," Alex continued, grinning as he thought of his little boy. "Adam. He's upstairs."
Izzie was a little taken aback, "Wow..."
Alex shrugged, "I thought I'd tell you...cuz right now, I think secrets are giving us enough crap. We don't need anymore."
A faint smile fell across her features, "I can't argue with that."
"You don't have to worry," Alex continued awkwardly. "If you thought...April's a good doctor. It wouldn't matter anyway...but she...she doesn't know...or suspect anything about Kyle...that I could be, well that I am..."
"I guess she'll in for a surprise," Izzie quipped, pressing a tissue to the corner of her eyes once more.
Alex looked at his hands. True freakin' story. He really didn't know how April would react. He had no clue how any of this would go forward. If Kyle lived, would Iz let him see his son? Would he want that? It seemed like the right thing. Certainly what Kyle deserved. But what kind of a Dad would he be? He only knew how to be a father who was there in the house, and what if he couldn't cut it any other way? And what would April think, if she knew he wanted to? What would she say? And eventually, what would Adam think? Or Kyle?
Then again, all those possibilities hinged upon one thing. Whether or not Kyle survived. If he didn't...there was a whole other set of possibilities and Alex just couldn't think about. It was actually painful. Which was weird. This morning when he'd woken up, he was the father of one. Moments ago, he'd found out that he was actually father of two. And, it was like...a light switch. In an instant everything was changed. Alex loved Kyle. He did. And he didn't know what he'd do if he never go the chance to know him.
"Are...are you happy?" Izzie whispered.
"Yeah," Alex nodded. " I really am. Ha...I didn't think I' get there, but I am."
"I am too," she breathed, running her hands down her knees. "I mean, I was until today. I've been happy. Working. Being a mom."
A thought suddenly crossed Alex's mind. He'd moved on, why not Izzie? Maybe she hadn't allowed him to be a father for his son because someone else was already there. Not that that made any of it right.
He asked, "So, it's just you...or?"
"Just us. Me and Kyle," she replied. After a moment she looked at him again. "I just...I just wanted to start over. I wanted to be a mother and I wanted a fresh beginning, and those embryos were a way to do it. I needed something good, so I just...I did it. I thought there wasn't any harm in trying. I did the IVF and it worked. I thought...I thought about telling you. But...I don't know. Not such a fresh start when it's attached to someone else, I guess. I didn't want you to get the wrong idea. Having Kyle wasn't about...it wasn't a way to try and get back together. Then, it seemed like I waited too long. And I wanted to see if I could do it. By myself, you know?"
Alex swallowed. Well, it wasn't exactly a proper justification. Nothing was. And he had to wonder. Depending on the timing...if he'd known Iz was having his kid, before he'd realized his feelings about April. Before the earthquake. Where would he be? What would he have done?
Yet another set of possibilities Alex didn't want to think about.
Before Alex had a chance to formulate some sort of response, he caught sight of Dr. Olant striding into the waiting room. The young resident spotted them, and quickly made his way to the corner where Alex and Izzie sat across from one and other.
Izzie sprung to her feet, recognizing that he had news,"What's going on? Can you tell me something happened?"
"Ms. Stevens?" Olant said, glancing to Alex suspiciously.
"Yes!" Alex and Izzie both replied in frustration.
Shrinking back, Olant continued, "O-kay...well, I am Dr. Olant...we spoke on the phone."
"I remember," Izzie prodded impatiently.
"You son is still in the OR. But, I just wanted to let you know, that your mother's surgery went smoothly. She is going to be fine. She's in post op on level 3, and you can go sit with her if you like."
Relief washed across Izzie's race, "Oh, thank God."
Unexpectedly, she flung her arms around Dr. Olant, "Thank you. Thank you."
Olant winced and patted her back twice, "It's...it's nothing Ma'am...Just doing my job."
Alex stood by, watching the scene awkwardly with his hands in his pockets. He was glad to hear that Robbie Stevens had pulled through surgery. That was definitely a good thing. But, he couldn't help but wonder what was going on with...well, with his older son. He wanted to know if Kyle would pull through his surgery. He needed to know.
Unfortunately, right now, there wasn't anything to know. Obviously, Kyle's procedure wasn't finished, and no one had any new updates. The boy either would or wouldn't survive. And there was nothing Alex could do at this point to freakin' help.
Alex was powerless. He hated that feeling.