Month Five
911.
The shrill bleep of her pager, woke April suddenly from her dream. Rubbing her eyes, she proceeded to blink furiously. In the shadow of the evening sky, the on call confused her for a moment. She had been dreaming about her bed at home, with Jackson besides her offering her a little more than 'spooning'. To wake up here, and alone, was a disappointment to say the very least.
Grappling with the cocoon of sheets, she managed to stumble from the bed and collect her pager from the desk across the room. "Crap." She cursed, stuffing it in her scrub bottoms pocket, scanning the room for her top half. It had become lost in the heat of the passionate embrace she had found herself in the midst of little over an hour previous. All she knew was that Jackson had removed it with haste and thrown it in some sort of direction.
The pager bleeped furiously once more, commanding her attention. "Crap, crap, crap." She continued, bending at the waist to retrieve the flash of blue from beneath the bed. Stuffing the item over her head, she hastily silenced the bleeping and exited the on call room.
"Major trauma." Alex puffed, scurrying up behind her as they headed in the direction of the ER. "Lots of gore!"
April rolled her eyes but proceeded with a small smile. It was wonderful to see such passion in the minds of her friends, even if like Karev, they were not always with the concern of the patient at the heart. Entering the ER, chaos surrounding her, she knew this was where they all felt the safest and the strongest, besides the operating room of course. "What have we got?" She asked, advancing on a trolley crashing through the ambulance bay doors.
The paramedic produced a clip board, suspended from the trolley and began to explain what had happened. "Jane Doe, approximately late twenties in a car that was hit by a truck, truck won. Suspected tib and fib fractures, obvious head laceration and some nasty burns on her arms and face. Definitely KOed at the scene."
April nodded along, whilst her eyes scanned the patient in question; The head laceration was indeed extremely prominent, despite the large surgical pad strapped over to cover it. It was hard to believe she was still breathing, considering the other multitude of detected and still undetected ailments she had as a result of the crash. Swallowing hard, April snapped on her left glove. "Ok… trauma room 3 please!" She called as she eagerly followed the paramedics, swinging left as they approached the room in question. Once the patient was settled on the table in the centre of the room, she took a moment to lower herself and speak to the woman.
"I'm Dr Kepner. Can you hear me?" She asked, ignoring the other bodies that had poured into the room following their arrival. She would let them set up the equipment and achieve the right tools for diagnosis, including the necessary bloods and scans. Talking to her patient, and reassuring a woman who was quite clearly petrified, was her first and foremost job.
"Um… Hmm… Ma…" The patient struggled, quite obviously trying to communicate but physically unable to. Her arms began flailing wildly, to which April responded by grabbing the one closest and squeezing it tightly. "Don't try to speak. Concentrate on letting us help you. Relax." She soothed, although still feeling the eager fight of the patient through their connected hands.
"Kepner." Alex said gruffly, catching the attention of the female doctor. She nodded and stepped back from the table, letting the patient's hand return to her side.
"Ok, let's do a full body exam please." She instructed, removing her jacket and stepping to the observation monitor to her left. "Her BP is low, and she's tachycardic. She must be bleeding, somewhere."
Alex stepped forward, alongside two members of the nursing staff. "This is pretty nasty." He remarked, looking back over his shoulder at April as he lifted back the blankets that had been covering her. April nodded before he turned back to the patient. "Crap!"
"What?" She asked, stepping forward with panic at the sound of Alex's exclamation.
"Oh yeah," Piped up the paramedic from the corner of the room, casting her eyes to the Doctors from the form he had been completing. "She's heavily pregnant too. I'd say close to full term."
"Page the OBGYN on call." Alex said loudly in the vague direction of the nursing staff. "And Torres, Avery, Grey and Sheppard whilst you're at it."
*/\*
"What have we got?" Jackson asked, hurrying into the trauma room closely followed by Callie and Derek.
Instantly, Jackson's eyes fell upon the exposed abdomen of the patient, before flicking over to his wife. She stood by the observation monitor, intently studying the waves of the ECG; even with emotion lacking on her face, her could only imagine what was going on underneath her surface. "April?" He spoke, causing her to turn to him.
"Jane Doe, approx. late twenties. Head to head collision with a truck. Sustained some nasty injuries, fractured tib and fib, head lac and partial thickness burns to arms and left side of face. Also, approx. 35 weeks pregnant." She replied, barely registering the concern that her husband had been trying to convey with a look. Despite the fact most of those in the room knew what had happened to April barely a month previously, he didn't feel right to verbally express his concern for the sanity of his wife.
"She's lucky to even by alive." Callie stated flatly, moving toward the table and surveying the obvious fracture in the left leg. Whilst the protruding bones were of great interest to the orthopaedic surgeon, she couldn't help the overwhelming sense of sympathy she felt towards the young woman.
"We think there's a bleed somewhere." Alex cut in, now talking directly to Meredith who had suddenly appeared in the room behind the other Doctors. "It could be spleen, liver, gall bladder. I palpated her abdomen and it's pretty rigid, but the baby makes it difficult to get a clear idea."
"Have you paged an OBGYN? I'll get an intern to strap on foetal monitoring. We need scans stat." Meredith replied, before she left the room in the direction of the nursing station.
"I'll try them again." Responded a Nurse from the other side of the room.
As Callie continued to assess the bone injury, and Derek stood beside the patient assessing the head trauma, Jackson edged around to the other side of the table. Under the pretence he was assessing an upper arm burn, he stood closer to April and allowed their hips to touch. "Are you sure you can be here?" He asked her quietly, not allowing his eyes to leave the patient. He knew April well enough to know, she would not want special consideration or any form of obvious favour.
"I'm ok." She replied with a firm tone. Yes, she was surprised, that was not of any news but she did not need to be treated like a charity case. "I'm a Doctor, I treat patients, even pregnant ones and don't lose my mind."
Jackson bit his lip with some force with her words. He knew she would react in such a way, even though all he was trying to do was show her concern. She had told him that her counsellor, Doctor Ormishaw, had made it clear support was absolutely necessary from those you love when dealing with trauma and grief. Whilst he had always been quite sceptical of psychoanalyse, for once he thought he better listen. Even if at current his wife seemed to be resisting his attempts.
"I was just checking in." He replied, running a gloved finger along the length of skin on the patient's arm. "I didn't mean to make you feel… whatever."
It was hard to even begin to understand exactly how he was feeling at his wife's blatant lack of willingness to accept any form of his help. Stubbornness was one of those many things he hated, and yet loved about his wife.
"The full body scanner is free. I think she's stable enough to move." Meredith called out, re-entering the trauma room, mobile phone in hand.
"Call us when you have the scans." Derek told Alex, stepping back from the bedside, proceeded by Callie. "Nothing more we can do until then."
Jackson glanced sideways at April, before returning to an upright position, snapping off both gloves and his gown. "We'll talk later." He told April as he passed, following Callie and Derek back into the bustling ER.
*/\*
The sun was settling across the Seattle skyline as April emerged from the OR. It was possibly some ungodly hour of the morning, around the end of her shift she hoped. The last few hours had been extremely gruelling, leaving every muscle in her back, legs, arms and shoulders sore and stiff. Returning home to her bed, sleeping beside her husband for the next few hours before she returned for another night shift, was all she could think about as she slipped along the corridors in search of Jackson.
In her tired state, making sense of the events of the night, were proving difficult. Although she did know she was possibly going to be in some sort of trouble. Ignoring protocol completely, she had gone against the advice of her fellow surgeon and had done it anyway. Despite everything she had gone through personally, and how tired she had been from controlling the stream of blood in the patient's abdomen for the last hour, it had been the right choice. She knew this and planned to explain this as so. Yet first, she needed to tell Jackson and then they needed to go home, safe in the knowledge she had finally found the clarity she had been searching for.
"He's in the CT scanner." Owen piped up, noting a drained, pale looking April. She was stood in the lobby, not far from the lifts with a confused look in her features. He had heard about the events of the evening and knew without doubt, she was almost possibly too tired to function on the correct level. With a smile, she nodded to her mentor and friend and pushed her legs, allowing them to carry her in the direction of the scanner. Sure enough, her husband sat staring intently at the screen before him, studying something with such concentration.
Quietly slipping in, she sat beside him and allowed him a moment before she spoke. "What time is it?"
Turning in his chair, Jackson smiled as he caught sight of April beside him. Quickly he noted her matted hair, sunken eyes and dried lips. "Hi beautiful... Heavy night?"
She nodded, tipping her head a little and smiling softly at her husband. "I… I just delivered a baby."
The words were so casual. Jackson had to offer her a confused expression before she nodded and he realised he had indeed heard her right. "The Jane Doe baby? What? Why?"
"I don't even know how it happened. One minute we were operating and the next… I was cutting her womb open. Alex was shouting at me, telling me to wait for the OBGYN but… but she wasn't there and I needed to do it." April stuttered, trying to explain the enormity of the events that had unfolded in the OR. Still she was struggling to grasp any of it. What had quite made her snap, pick up the scalpel and starting cutting, was still a mystery. For most of the night, she had been spending as a little time as possible involved with the care of the baby. Then she was there, preforming an unplanned but necessary C-section.
"Why didn't you wait for the OBGYN? God, Hunt is going to kill you." Jackson shot back, struggling with the news himself. When he had left the operating room, they had been suctioning blood and hanging clotting factor, not preforming a C-section. Even though he knew the baby was in some sort of distress, he wasn't quite sure how this had led to April bringing the new life into the world. Disregarding, of course, the fact she had pretty much stamped all over almost every protocol in the hospital.
A little hurt, April felt her lower lip slip into a pout. "I thought you'd be pleased. I'm cured." She almost joked. Clearly sarcasm was technique she employed when tired.
Jackson sighed, rubbing his left eye, still visibly unsure. "April, I… I'm happy. God, I'm overjoyed… you managed to deliver a baby, with virtually no OBGYN experience, and mom and baby are well but still… April, Hunt could have your ass for this."
"Trust you to be more concerned about the hospital than your wife." She spluttered in return. More often than not, her husband's involvement in the running of their work environment was the source of great contention in their marriage. Is affiliation with the board and close working relationship with his mother and with Owen Hunt, provided a deep routed level of support for it, when sometimes April just wanted him to hate it with her.
"April, don't act like you're mad with me over this. You know I'm talking sense." He battled back, unwilling to let her continue to believe that this could possibly end well.
Taking to her feet, April stood before him with one hand on her hip. Did he really not get where any of this was going? Even if the sudden need to take charge was not with reason, the conscious choice she made not to let her emotion end the life of a patient was evident.
"I wasn't going to let her die Jackson, and the baby too. I knew if we got the baby out, we had a better chance at saving her… and now she's ok, she's in recovery and will probably make it to see her daughter graduate college!"
Looking upward at his wife, Jackson noticed the sudden colour change in her cheeks. She was truly intent on turning this into a battle it seemed. "April, I don't want to argue with you. I'm proud of you, and support you no matter what you know that."
April simply rolled her eyebrows in silent protest. If that were true, she asked herself, it didn't seem logical why he would be missing the bigger picture despite the fact it was staring him in the face. The events of the night had proved something to her, and she had wanted them to prove to her husband also. She knew her depression was being managed well, and the counselling sessions were also helping, so making such a huge choice to throw herself in at the deep end without thought was surely the final piece of the puzzle? Screw protocol. She was no longer broken and scared to ever think of pregnancy or children.
"Jackson, tonight proved something to me, even if I had to break protocol to make that happen." She told him, her voice a little quieter now. He was right, they didn't need to argue, considering just how tired and irritable the night shift had made them.
"What?" He asked, clearly confused.
"I'm getting better, Jackson. A month ago, I was emotional and useless. I couldn't even look a baby without it crying." She began, choosing now to return to her seat opposite her husband. "But tonight, something happened… the part of me that was still broken saw something… something much worse than what I went through. A woman almost lost her baby, and her own life, and still… still, she fought hard and now she's there, with miles to go before she'll be able to cope with her baby alone but she pulled through. Even in the darkest hour of her life, she grappled with the balance between life and death and she won… That's why I did what I did, Jackson. I needed to do it to win my own fight."
Jackson sat for a moment, somewhat stunned by the revelation April had just shared with him. How could it have not been that clear from the start, he pondered watching her? Although it was a great deal to take in, as it processed slowly, it almost all seemed to make sense to him. Was that something marriage, and loving a person indefinitely enabled you to do? He wasn't sure. Yet he was glad.
Breaking slowly into a soft, tender smile, he eased out a hand toward April, which she took with some trepidation. Raising it to his lips, he pressed a light kiss to her fingers and squeezed them tightly. "You amaze me." He almost whispered.
April was now smiling too, watching her husband as he expressed his love for her. "Like you said, together we'd make it… and we will, because I'll get better. We'll be us again."
"April Avery, there isn't a time in our lives I can foresee, when we won't ever not be us."