Is anyone actually even reading? Anyway if you want me to keep updating please review, I need some ego boosting.
ADDISON'S POV
"What's this? "
"That's the hot tub babe. "
" And that ?"
" That's the foundation. For the house ?"
" It looks like a hole in the ground . So does everything. Everything is a hole, Derek !"
Mark can't help but snigger at her , stumbling around in the dark , her shoes absolutely pointless in the slick mud.
" And you are a different kind of hole , Mark Sloan. Don't you laugh at me."
" Maybe you should go back in the car , Ads. That way we won't have to haul you out of holes you may fall into." he says to her.
" I'm not going back in the car, I wanna see the house too. Derek where are you? "
"Here." . He's standing at the place where the trailer used to be, surveying the dug up land in a very satisfied kind of way.
"It s finally happening, Addie, we'll have a house in ten more months and then you can knock yourself out decorating."
" Excellent. Can we go now, before it starts raining ? You can talk about power tools and decks at home. "
It's been three months since Stevens and Karev 's surprise wedding, but it may as well be three years because so much has changed, Cristina and Burke broke up after they gave away their wedding and Burke went god knows where; she misses him more than she thought she would.
Callie and Arizona have finally moved in together and have actually gone on vacation together.
Richard is still balking over the Chief thing.
Mark is on his third girlfriend in as many months and showing no signs of slowing down, in fact she thinks she's already identified a fourth , that pretty PA in peds who brings doughnuts sometimes, so she likes her already.
Her neonatal wing has really taken off , she's got patients flying in from all over the world and Derek keeps pretending to be jealous that she's in almost every journal these days, but she knows that he hangs out in her OR gallery every chance he gets.
Not that he gets many, because he's busy too - but they're not doing this like New York, ,not again.
They're sticking to the rules; no nights, no crazy emergency surgery unless there is no one to cover for them, and they communicate now, tell each other where they are and stuff like that.
The baby making is going well, not so much in the way of success but she's trying not to let it get to her, at least the process is fun.
Lots of fun.
Her thoughts are interrupted by Derek and Mark crashing back towards her through the mud and tools scattered around what is supposed to be looking like a house.
" Come on , guys, surgery at 7. " They only ever have time to come here in the mornings, although if Derek had his way he'd be here all day, yelling at the contractor and annoying the workers.
They're taking her Mercedes today, she tries not to bitch about the mud everywhere and actually manages it.
She just has the one surgery today and it goes smoothly, a balloon inflated in a fetus' airway and suddenly it has the potential to be a healthy baby.
She has a couple of consults and then she's free, maybe around three.
She's just going to check if Derek gets off at the same time, because Callie isn't here and Mark is doing what he calls the z - plasty of the century so she has no one to hang out with.
She hasn't put one Prada encased foot out of the Neonatal wing before she gets paged to the NICU, so she turns back, wondering what the hell happened.
The little miracle patients were all stable when she rounded on them ten minutes ago, all twelve of them.
But it's not a baby in distress , it's Stevens.
She finds her hunched in a rocking chair, clutching her head and breathing hard.
" Izzie what happened? "
" She just sat down, says her head hurts like crazy and she's kinda dizzy. Heart rate's elevated, BPs up. " rattles off a nurse.
" Get a gurney and page Karev and Dr. Shepherd. "
"On it."
"Izzie. Your tumor has started hemorrhaging into your brain, it's causing your intracerebral pressure to rise. We don't have a monitor in you at the moment so I can't tell how bad it is already, but the bleeding is significant and we need to stop it right now or you will have permanent brain damage. Or worse. " Derek is saying.
" My baby? " Izzie asks, turning to Addison. So does Derek.
" You're at twenty two weeks, Izzie. I can deliver -"
" She's too small. "
" Izzie how old was my youngest preemie? "
" She's too small, she's not ready I can't let her die to save me..."
" Izzie . How old? You know this, you read the file in and out. "
" Twenty one weeks and five days."
" Exactly. Trust me Izzie, I will do everything I can to - "
" Addie her pupils are blowing up I can't wait, she could herniate, bleed out , I need to get in there now."
" Izzie."
" Don't let my baby die , Dr .Montgomery. "
DEREK'S POV
They scrub in silence, minds focused on the uphill task in front of them.
" Wait until I have the baby out . Then you go. "
" I know the drill Addie, we've done this before. "
" Not like this we haven't, not on someone we know . She's like my little sister Derek, if I let her baby die... "
" Hey. Addie. Look at me. You have this. You are the best, if anyone can save that baby, it's you.
Have you seen your stats in the last three months? Eighty seven surgeries and only four bad outcomes .You're are on a roll, honey, you're at the top of your game , you're kicking ass and taking names. That doesn't stop because she's someone you know and love. It just means you fight harder."
"Thanks for the ego inflation . I needed it. "
" Tell me if you need any deflation. " he jokes, trying to lighten her up.
" Do I ever ?" she says, a hint of the usual confidence creeping back.
" No more than I do." he laughs, drying his hands.
Surgeons are confident by nature, they have to be. To cut into someone's body, pick up a scalpel and save a life , you have to be sure of yourself , of your skills .
They hold people's lives in their hands, in the OR they are literally gods, people live and die under their hands.
They choose when they have to keep fighting; they choose when enough has been done and it's time to let go.
That said and done, he and Addison are at the higher end of the arrogance spectrum, but still rightfully so .
But while he is consistently a self admitted raging egomaniac, Addie has little moments of self doubt, usually they hit right after she loses a patient she was expecting to do well .
Like what happened with the Brandon baby.
They're in the OR now, Addison is by the table already, greeting her nurses and doing the little hand flutter thing she always does before surgery.
They all have these little quirks before surgery ; he says his little line and starts the music, Burke used to do that shoulder roll and crack his neck, Bailey takes a deep breath after she gets up on her stool and before she cuts , Richard makes a bad joke, Callie likes to give her drills a whirl , Mark hits on a different nurse every time ,for luck he says.
" Ten blade. ". He watches as she slices surely, swiftly into the abdomen, scissors please, cut and dissect ,retract a little more , watch that fluid , and he leans in to watch her place steady hands around the unbelievably tiny baby curled safely in its mothers womb, lift it out tenderly - hello, sweetie - , clamp and cut the cord .
"Derek , go go go. "
It's his turn now and he's focused , but out of the corner of his eye he can see that things are falling apart.
" Apgar is two " .
" Start bagging. "Addison orders , leaning over the baby.
He starts drilling, the sound of various alarms going off is increasing , the soundtrack of a patient crashing.
" I'm going to intubate - no , a smaller one, I can't believe how tiny the trachea is - give me the suction there's too much fluid in here.
Derek how's it going over there? "
" I've evacuated the clots and stopped the bleed , the tumor is still capsulated, doesn't seem to have ruptured much so it's going to be too easy to take it all out."
" Cocky arrogant neurosurgeons are something I like."
" Good. I like kickass baby surgeons too."
" Maybe we should go out sometime Mr. God complex . " she's giddy with relief , he can tell by the bantering.
" I can't. I'm sorry, but I'm married to this horribly bossy - "
" Push .5 of epi through the umbilical vein, and get me a chest tube. Smaller. "
What happened?
He looks up from the partially excised tumor in time to see Addie stab a hair thin needle between the baby's finger wide ribs, can see her chest inflate almost instantly but then fall again.
" Damn it she's not breathing on her own at all - get that bag over the tube and don't stop till I tell you to - god I wish I had Stevens for this.
But clearly , that is impossible, so you get over here. Turn the baby on her side and bag her for thirty seconds after I push the surfactant through the tube. We'll do the same thing on the other side, or her lungs will keep collapsing. "
He carefully teases the ugly greyish tomorrow from its lair in Izzie's brain, staunches bleeds and watches as Addison starts cardiac massage, suctions , oxygenates the baby , measures getting progressively wilder as the machines sound impending death.
Now would not be a good time to tell her that Karev is pressed to the window upstairs and that this tumor is the ugliest SOB I have met in a long time.
His work is steady , predictable - keep the brain , cut the tumor - but Addison is fighting a ever changing enemy, everytime she gets one problem fixed another arises.
" Hang a unit of blood, slow infusion please or you'll tear the veins. There's still no circulation.
Get me the ultrasound ..." she trails off.
Not good.
" Derek who's on call for cardio? "
"That new woman Richard dragged out of Afghanistan, Teddy Altman or something, today's her first day or something , I've only met her when she came in for her interview. Why?"
" Someone page this Teddy woman. I have a coarctation in an aorta smaller than my pinky finger and I'd like a cardio thoracic surgeon in here now." She barks, reaching for a tiny balloon tipped catheter .
" Addie what are you doing? "
"You know what I'm doing Derek, and don't try to talk me out of it because I just managed to convince myself to do it.
If I don't Izzie's baby is going to die because there is no blood getting through that aorta, and she's not dying in my watch so please just...stop. I can do this. "
" I know you can . Deep breaths, Addie. "
She's always had this problem, she gets panicky even when she knows exactly what has to be done and how , never believes she's good enough, but when she's through with it she's incredibly calm, focused like a laser and unstoppable.
She's threading the catheter through the miniscule femoral artery now, staring intently at the screen where she can see it's progress. He knows how delicate fetal tissues are; one slip and she'll kill this baby who has been forced into a world that is too harsh for her , too soon.
The new blonde cardio chief, physically as opposite to Burke as possible, slams into the OR.
" What the hell are you doing?"
" Where the hell were you ?" Addison snaps.
" I'm almost there anyway ... got it. I just have to inflate the balloon now and restore blood flow, but thanks for coming anyway."
The baby's heartbeat goes back to normal and the blaring alarms go quiet, she pinks up a little , and the whole OR lets out a collective sigh, nervous relieved laughter and cheers breaking out among the tumultuous applause from the staff in the floor and in the gallery .
Karev looks down, blinking against tears now openly falling from his eyes.
Richard is there too, smiling at Addison like a proud parent and craning his neck to see the baby.
"You're neonatal , not cardio. I don't care if you're the Chief's little star , you can't just up and start doing cardio procedures whenever you feel like it, you could have killed the patient with your stupid little game, that's what this is, isn't it , you want to be Chief so you do cowboy surgery and you don't care about what actually happens to the patient - "
Oh no she did not just say that.
The OR goes deathly silent, nurses and techs cringing in anticipation of what they have experienced once and don't ever want to see again.
Up in the gallery, Richard rums his hands through his hair and looks away.
" Dr. Altman, when was the last time you performed surgery on baby born at 22 weeks? " Addie asks in that cold silky voice he dreads because it means she's about to explode.
" I - "
" Go on. Never , right? I'm sure you're an amazing surgeon; for Richard to have hired you , you must be.
But this is my patient and I no longer need you here, I'm pretty sure I can handle this because I've been operating on unborn babies while you've been meatballing in Afghanistan.
I only wanted you here in case a complication arose - which , I assure you , rarely happens to me - but you were apparently too busy , so get the hell out of my OR."
" Excuse me?"
" Get out. "
She turns on her heel and leaves.
The OR is silent for a minute. Richard is trembling with laughter in the gallery, shaking his head.
" Way to say hello, Addie. " he says, snorting.