Author's Notes: Thank you all for your follows, favorites and kind reviews! I honestly didn't think so many people would be interested in a story like this. You guys are awesome and encourage me to keep going with my writing and I couldn't be more grateful!

Merry Christmas to all of you celebrating!

I totally made up this hospital and its staff (other than Izzie) because I'm lazy and didn't want to do any research, ha!

Izzie stood frozen staring at the image on her patient's cell phone. "ICE-Alex Karev" in bold white letters screamed at her from the display as if she needed additional confirmation that her patient was married to her ex-husband. Both the brunette and Alex had their arms around each other with hers snaking inside his leather jacket. He was resting his slightly unshaven chin at her temple. Both were smiling, maybe even laughing at something off camera as if someone captured the moment without them knowing and shared the picture later. Izzie tried to think of a time that she had ever seen Alex so unguardedly happy and sadly realized she could not.

"Can you find it? It wasn't damaged was it?" Jo asked worriedly as the song repeated itself.

"No, I found it," Izzie answered the call mildly disappointed that the image was now gone. "Hello, this is Dr. Stevens at St. Elizabeth's." She listened to the officer's report and her heart sank as Alex's condition was described. "I will let her know. Thank you." Izzie turned back to her patient, "They were able to get him out and he was hanging on at the scene."

Izzie could feel Jo studying her as if trying to read her, "What aren't you telling me?"

"He lost a lot of blood and has not regained consciousness."

She again felt the younger woman was scrutinizing her, "That's all?"

Izzie took a deep breath, "That's all the officer said." She felt Jo was searching for something more. Izzie hoped the woman couldn't read her thoughts or sense her anxiety about seeing Alex again. She thought of him often and had, on numerous occasions, been close to calling him over the years. She had even at one point considered making a trip to Seattle to visit her old friends and attempt to rekindle their romance. Leaving Alex was without a doubt the biggest regret of her life.

Izzie was shaken from her reverie by a nurse entering the room hurriedly, "Hello Mrs. Karev, I need to get some medical information about your husband."

"Her name is Ms. Wilson," Izzie interjected. At Jo's confused look she added, "I mean that's the name you came in with right?"

"Actually legally my last name is Karev. I just never got around to changing it on my driver's license when I got married, which is probably what the paramedic went off of." Jo turned to the nurse, "I did change it for our insurance so that shouldn't be an issue."

The nurse smiled softly before peppering Jo with questions, "Any allergies?"

"None that we know of."

"Medications?"

"No"

"Health conditions or major surgeries?"

"He has a heart arrhythmia, but it doesn't usually cause any problems."

"What do you mean usually?" Izzie interjected. She had never known Alex to have any cardiac issues. Jo had to be wrong.

"The only time he ever had an issue with it was when one of his closest friends injected him with epinephrine by accident." Jo gave a sad smile and a small laugh, "You should hear him tell that story. It's hilarious when he tells it."

The nurse gave a sympathetic smile, "Any other issues we should know about?"

"No. Well, wait yes. He was shot in the right side of his chest about five...maybe six years ago." Jo trailed off uncertainly. "I can't remember for sure."

"He was shot?" Izzie asked unbelievingly before she could catch herself. Maybe this guy was Alex's long lost twin who had taken his name or something equally bizarre. She would know if Alex had been shot.

Jo gave a confused look before nodding her head, "It was a workplace violence situation. He just happened to be in the wrong place at the wrong time, walked in on the guy and got shot in the chest."

The nurse nodded her head in understanding, "What procedures were performed?"

Izzie couldn't focus on Jo's answers, her mind was on Alex, her Alex getting shot. She had of course heard about the tragedy on the news and anxiously read the list of victims when it was released looking for names of friends she had left behind. She remembered being upset about a nurse that she was fond of and had some guilt about Charles Percy, but had such relief that none of her close friends' names were listed. She had assumed that if any of them were injured she would have gotten a phone call from someone.

Izzie's musings were disrupted by a parade of doctors entering the room including a neurologist, general surgeon, and orthopedic. The head of neurology, Dr. Clifford, went to Jo's left side and took her hand as he introduced the other doctors, "Mrs. Karev, we are the team that will be working on your husband. His injuries are extensive and will require multiple surgeries. Of most concern is a large bleed at the temporal lobe of his brain that we need to repair ASAP. We're also worried about some internal bleeding and our general surgeon will repair that as I work on the bleed in his brain. Do you have any questions for us?"

"Why is the orthopedic here?" Jo asked simply. Izzie raised her eyebrows and decided she was similar to many doctors' wives Izzie had met over the years that believed themselves to be junior physicians just because they were married to an M.D.

Dr. Clifford smiled warmly at the patient, "Your husband has a significant fracture to his right leg. We will try to repair it tonight depending on how his body handles the first portions of the surgery." Izzie wanted to scream, he was already doubting Alex would have a positive outcome and would be too weak to handle all the procedures.

"Can I see the films?" Jo asked firmly.

Izzie resisted the urge to roll her eyes, "What do you want the films for?"

"I'm in my fourth year of surgical residency and I'm specializing in ortho," she directed at Izzie before glancing at the other doctors, "It will help me to see the leg."

Izzie tried to hide her disbelief. She had assumed her patient was a barmaid or at best a nurse that Alex had knocked up and felt obligated to marry. Her being a surgical resident for whatever reason made Izzie feel as if their relationship was a little more real. The longer she spent with the woman, the more it was sinking in that Alex was in fact married and to a half decent woman at that. Izzie tried to ignore the pain in her chest and focus back on the conversation with her patient. Jo was asking thoughtful questions about Alex's injuries and the planned procedures.

"There's a good chance he won't be able to operate again with these injuries," she said matter-of-factly while glancing at the team for confirmation.

The orthopedic nodded grimly, "We will do everything we can, ma'am. While they work on his other injuries, I will be working to reset your arm and fix this wrist."

He then showed her the films of her extremity, and Jo nodded in understanding, "Well I guess we can just not operate together," and somehow managed a rueful smile. Izzie instinctively placed her hand on the woman's shoulder and squeezed lightly.

"Let's just see about that," Dr. Clifford responded confidently. "Let's move people." the nurses began disconnecting all the medical equipment and began to push Jo out of the room.

Izzie followed behind to scrub in so she could monitor the baby. Alex's baby. Each time she thought about this it was as if someone kicked her in the stomach. Her head snapped up as she heard Jo call out "Alex! Oh God, can I see him for a minute?" Izzie's heart raced as she realized that Alex was also being transported out of the ER.

Dr. Clifford nodded solemnly, "We need to make it quick. Every second counts."

Izzie walked beside the gurney as Jo was pushed to Alex's side. Izzie felt nauseous as she caught sight of Alex. Even laying on the blue sheets he looked extremely pale. His skull looked to be slightly indented on the left side and there was blood crusted in his hair. He had been intubated and was receiving a transfusion.

Jo sat up slightly to caress the side of his face that was less impacted, "Oh Alex, you just had to be protective didn't you? Baby boy and I are fine, we are just fine. No contractions and the heart rate is good. I need you to be good Alex, I need you to fight in there. Fight hard for us." She then pulled his hand to her lips and kissed it softly before placing it on her belly, "We both love you so much." She then looked back up at Dr. Clifford solemnly.

Dr. Clifford nodded, "Okay people let's move." within seconds Alex had been rolled down the hall and around the corner out of sight.

"Dr. Stevens, I think I need to call someone now," Jo said with determination as she defiantly swiped at her tears with her uninjured hand.

Izzie felt strong compassion for the younger woman as she tried to keep her own emotions at bay, "Who would you like me to call?"

"Meredith Grey. Her number is in my phone."

Izzie tried to hide her dread as she vigorously nodded her head, "Okay."

Izzie watched as the nurses and residents pulled Jo's bed down the hallway. She hesitantly turned back to the trauma room to retrieve Jo's phone. She scrolled through the contacts, a weird feeling overcoming her at seeing the names of so many people she used to know flying up the screen. She paused for a half second when she arrived on Meredith's name, her nerves threatening to overwhelm her. Izzie took in a deep breath and hit the name. She was met with another picture, this one obviously from Alex's wedding to Jo. He was in a basic suit and she was in a simple sundress with small flowers in her hair. Meredith had on a sleeveless lavender dress and had a small child on her hip that appeared to be screaming. Alex had his arms around both of the women and all three were smiling brightly.

With each ring Izzie became increasingly anxious about how this would go. She knew she had hurt Meredith when she left and she understood that there would still be some anger and hurt directed towards her. She still wanted to reconnect with her old friends, but definitely not in this way.

Her heart jumped as Meredith's familiar voice came across the line, "Wilson! How's the second honeymoon going?"

Those words were like a knife twisting in Izzie's heart, "Uh Meredith...Hey it's Izzie...I'm calling for Jo. There...there's been an accident."

There was a pause on the line before Meredith responded, "Okay, I don't know how much the hyena twins paid you to do this, but tell them it's not funny and give them the phone back."

"Mer...," Izzie started, unsure what to say to convince her she wasn't a cruel prank. "I'm not calling as Izzie, I'm calling as Dr. Stevens from St. Elizabeth's Regional Hospital in Atlanta. And please believe me when I say I wish I wasn't making this phone call. I just... It's bad Mer...it's really bad," she squeaked out, her voice cracking with emotion.

She could hear Meredith rustling with something, "Tell them I'm on the way."