After returning to her office and changing into her scrubs, Arizona reheated her coffee and sat down at her desk to eat her breakfast while going over her patients' charts before rounds. Tapping on the name of one of her patients who was supposed to be discharged yesterday, Arizona blindly reached for the paper bag, pulled out a muffin and smiled as she realized Callie hadn't gotten her just any muffin, but her favorite strawberry cheesecake muffin. Taking a large bite, she groaned in delight as the sweet berries and tart filling seemed to explode on her tongue. She loved these muffins and never managed to make it to the coffee cart at just the right time to purchase one since they only ordered a certain amount from the bakery down the street and they were always gone before she remembered she'd skipped breakfast. Taking another bite of the sweet treat, she couldn't help but smile at Callie's thoughtfulness.
Taking a sip of her coffee, also her favorite, she felt the warmth in her chest as her stomach did a little flip and her hand froze in mid-air, her mouth already open to take another bite when she realized that feeling had nothing to do with hunger. It suddenly occurred to her that while it felt perfectly natural for Callie to bring her breakfast knowing she'd skipped it, these things were no longer the norm for them; Callie buying her favorite coffee and muffin when she knew she had a long day ahead of her, or her favorite ice cream and topping when she knew she'd had a rough day. These weren't things Callie did just to do, she'd put thought and effort into it, in the same way she herself had made sure to prepare her ex-wife's favorite comfort meal and make extras for her to take home. These were the little things, the little things that they'd lost along the way, the little things that added up to be big things, and for the second time that week, she wondered when they stopped doing those things for one another and why they had started doing them again.
Shaking that thought from her mind, as she had done every other thought she'd had about Callie since the night before, Arizona focused on her tablet, read over her charts, ate her muffin, and without even realizing it, quietly hummed a familiar tune. When her alarm went off indicating it was time to start her rounds, Arizona finished her coffee, dropped the bag and the cup in the trash and started out the door only to find Meredith standing in her doorway smirking at her. The other blonde arched her brow and asked, "Were you singing Beauty and the Beast?" Arizona could feel her cheeks burning with embarrassment and again mentally scolded herself for letting her thoughts linger to the evening spent with her family, specifically that moment when the words of the song she'd sang a hundred times over, took on new meaning, shook her head and tried to laugh it off as she replied, "Yeah, I guess I was. I just watched it with Sofia." She wasn't sure why she omitted Callie, maybe she wasn't ready to share that just yet, or maybe she didn't want her friend to get the wrong idea and start pelting her with questions. Quite possibly though, she just wanted to keep that little piece of information all to herself until she actually had answers to those inevitable questions.
Meredith watched as the blush crept up the fetal surgeon's face and wondered why she was embarrassed by singing a children's song, one that was very popular in her own household. Deciding that it must be just that, she was caught singing a children's song, she waved her hand in the air and tried to put the other woman at ease, revealing, "That's nothing, the other day I was singing 'Let It Go' while doing a bowel resection." Arizona couldn't help herself and burst into laughter, all embarrassment or thoughts of chastising herself gone in that simple admission. Shaking her head, she declared, "We really need to get out more." Meredith nodded and agreed, "We really do."
As the two continued down the hall, Arizona asked, "What brings you up here? Do you need a consult?" Meredith nodded, handed her a chart and explained, "Twenty-eight year old female, three months gestation, presenting with severe abdominal pain in the lower right side, fever, vomiting…" Arizona glanced at the chart and asked, "Appendicitis?" The general surgeon nodded and replied, "That's what it looks like, the baby doesn't appear to be affected. The patient went to her OB first and he sent her to us." Arizona pursed her lips and asked, "Is it perforated?" Meredith shook her head and answered, "No, not yet, but it looks pretty irritated." Arizona handed back the chart and suggested, "If you plan to do the basic laparoscopic procedure, she should be fine. I'd do it sooner rather than later though." Grey nodded and replied, "She's in pre-op now…just in case. Anything I should look out for?" Arizona shook her head and responded, "Nothing other than the usual. There's a slightly higher chance of abscesses forming at the site, just keep an eye on that. If it ruptures, give me a call." Meredith took back the chart and Arizona didn't miss the fact that her gaze dropped to the ground, or to her leg to be exact, before quickly coming back up to meet her eyes.
Tensing up slightly, as she always did when she knew someone was about to ask her about her leg, she forced herself to relax when she recalled that Meredith had taken care of her the other day and this was her friend being concerned, not a doctor trying to offer unsolicited advice. Smiling softly, she offered, "It feels much better today. I kept my prosthetic off all day yesterday and that seemed to do the trick. Thank…um…thank you for your help the other day." Meredith knew better than to ask and thought she was being discrete in checking Arizona's gait, apparently she wasn't as stealthy as she thought she was, blushed slightly, and chuckled when she replied, "I wasn't going to ask, but yes, I was wondering how you were feeling. I'm glad I could help." Relaxing once again, Arizona realized that it wasn't as hard as she thought it would be, as it used to be, to talk about her leg, and offered, "You really did. I let it get too bad." Knowing the other woman didn't like attention being drawn to her leg and not wanting to make her uncomfortable, Meredith shrugged and retorted, "Imagine that; a surgeon ignoring their own needs to focus on a patient." Not at all expecting that response, at the same time grateful for it, Arizona let out a bark of laughter, shook her head, and genuinely offered, "Thanks Grey."
Pleased that she'd said the right thing and also understanding that the subject was closed, Meredith nodded and teased, "So does this mean I still get my free babysitter? After all, you did say I need to get out more." Arizona laughed again and joked, "Ahh the truth comes out. Here I thought you were genuinely concerned." Laughing, the general surgeon responded, "Oh but I am. I'm concerned about what my son will do to me if I tell him he can't come over. I've woken up every day this week to 'Is it today? Do I go to A'zona's house to play today?'" Feeling the little tug at her heartstrings, Arizona smiled and cooed, "Aww, that's so sweet. I wouldn't dare disappoint him. Did you want to drop them off or do you want me to pick them up?" Meredith thought for a minute and asked, "Were you planning on taking them anywhere? If not, then it would probably be easier for me to drop them off. That way we don't have to fight with transferring the car seat and booster chair to your car."
Arizona shivered at the thought of fighting with the bases and trying to fit two booster seats and a car seat in her car, and replied, "No, I think we are going to just stick around the house. I'm feeling better, but I'm not sure I'm up to chasing three kids around in public." "Good choice, it's not all it's cracked up to be," Meredith replied then added, "I don't get off until 5:00 pm. How does 6:00 – 6:30 sound." Arizona smiled, getting excited about the prospect of spending the evening with her daughter and her friends and answered, "It sounds perfect." The two women continued to talk until Arizona reached her patient's room and Meredith took her leave to prepare for her emergency appendectomy.
XXXX
Arizona stood in the middle of the viewing room staring at her patient's latest scans in disbelief. She knew the tumor was growing rapidly, but she hadn't expected this. Glancing toward the adjacent wall at the previous set of scans, taken only a week ago, she sighed, ran her hand through her hair, and muttered, "Damn it!" "What's wrong?" Callie asked as she entered the room and closed the door behind her. Startled, Arizona spun on her heels, a move she instantly regretted, flinched, and muttered, "Ow! Shit," as she wrapped both hands around the top of her left thigh and gritted her teeth in pain.
Worried that Arizona's leg hadn't had time to heal, Callie only hesitated briefly before she rushed to her side, pulled up a chair, helped her sit down, crouched in front of her, and asked, "Arizona, is your leg still bothering you?" While she'd almost expected to get snapped at, Callie was surprised to see her ex-wife smirking almost bashfully. Slightly embarrassed, Arizona continued to rub her leg, chuckled, and admitted, "Sometimes I forget I can't do that anymore." Seeing the concern on Callie's face, she rubbed her upper thigh and assured her, "I'm okay it doesn't hurt anymore…from before, but when I turned like that, my socket pinched my skin. It'll be fine…well, I'll have another bruise, but it'll be fine." Relieved that Arizona was neither hurt, nor angry, Callie pulled her lips past her teeth in a sympathetic grimace, glanced at her ex-wife's leg and offered, "I'm sorry, I didn't mean to startle you." Arizona shook her head and reassured, "You're fine, it wasn't your fault. I think I'm more frustrated at this." She waved her hand in the air toward the scans but when Callie turned to look, she grabbed her shoulders and commanded, "Wait!"
Seeing Callie there reminded Arizona why she'd asked her to meet her prior to the surgery in the first place. Though she'd be performing the procedure, she wanted to prepare Callie for what she was going to see. She knew her ex-wife had no idea what to expect and quite honestly, might freak out or panic if she didn't know what was happening and she wouldn't have time to explain or calm her in the midst of the delicate procedure. Knowing how Callie felt about babies, she wondered if maybe this wasn't the best surgery to have her watch for the first time as it was extremely disturbing, even to her. Having taken one look at the scans that she'd ordered just yesterday, however, she realized she no longer had a choice. She needed an ortho consult and she needed the best.
Callie furrowed her brow in confusion but kept her gaze on Arizona. Taking a deep breath, Arizona explained, "Before you look at the scans, I think I need to prepare you." Slightly offended, thinking Arizona didn't trust her skills, Callie pursed her lips and argued, "I've seen an SCT before Arizona." Unbothered by the defensive response, almost expecting it, the blonde nodded and agreed, "You have, I know you have, and you've removed them, successfully, because you're the best." Realizing that she'd immediately thought the worst, Callie felt the guilt rising in her chest at Arizona's words, found herself relaxing and nodded for the blonde to continue. Arizona bit her lip nervously and resumed, "The thing is…um, you've never seen one on a fetus, and this one…this one is very big."
Seeing that Arizona appeared to be somewhat anxious, Callie realized just how different this might be from anything she'd seen before. Nodding in understanding, keeping her eyes on Arizona, she asked, "How big?" Arizona closed her eyes and revealed, "Honestly, it's increased by half the size it was just a week ago and I know I asked you to observe, but now…now I need you in there." Unsure she was understanding what her ex-wife was getting at, she asked, "You need me in there?" Arizona nodded and explained, "Based upon how quickly it's grown externally, I'm almost certain it has also started to grow internally as well. While I know what to look for, it doesn't mean I know what to do once I see it…if I see it. So, I need your eyes, I need your expertise, and I need you to walk me through the internal removal." Taken aback by the admission, by the fact that her role had changed from observer to participant, Callie fell back on her heels and waited for her heart to stop beating out of her chest. This wasn't something she'd ever done before and oddly she'd found herself worried that she would let Arizona down.
While the surgeon in her was dying to see the tumor, something in Arizona's eyes told her not to look just yet. She kept quiet and Arizona declared, "Fetal surgery, it's hard…not just because it's in utero, but because it's babies, it's a fetus and they are so helpless and you know if you mess up, it could mean they never even make it to the outside world." She'd never quite thought of her ex-wife's specialty in that way, never realized the pressure she was under day in and day out. She'd never allowed herself to think about it and knew now wasn't the time to do so. Without even thinking, Callie shook her head and muttered, "Not helping your case Arizona." Though she was reluctant to do so, Arizona reached out, took Callie's hand, ignored the burning in her own, softened her voice and stated, "You have such a big heart Callie, you feel for your patients and that's part of what makes you such an amazing surgeon. Before you look at these scans, before you agree to help me, I need you to try to separate that part of you, the part that loves babies and feels so much for her patients." Callie knew what Arizona was saying, she also knew it was something the peds turned fetal surgeon had never been able to do, shook her head and argued, "I'm not sure I can do that. You don't…you're the same way. You can't do it…right? You don't disconnect." Arizona knew her ex-wife was right and there was no way she could just turn off her emotions. Sighing, she shook her head and agreed, "No, no I don't disconnect." Callie took a deep breath to steel herself, nodded, and suggested, "Walk me through it, tell me what's happening."
Swallowing thickly, Arizona exhaled slowly and explained, "The patient's name is Diane and she's 20 weeks pregnant with her baby girl, Kelsey. She and her husband, Scott, live in Texas. They went to her OB for her 14 week ultrasound where the doctor discovered a small mass on the fetus' spine. She was sent to a neo-natal specialist near her home but it took two weeks for her to get an appointment. By the time they got in to see him, the tumor had nearly tripled in size, it was a quarter the size of the baby. They ran several tests, determined it was indeed a sacrococcygeal teratoma, and after wasting another week gathering a team of specialists, they basically told her they didn't have the expertise to remove it and recommended her to me. It took another week for them to make the trip since they had to drive because it's so late in her pregnancy. By then, a month had gone by and the tumor had doubled in size. That was just a week and a half ago. I immediately admitted her and have been trying to reduce the size of the tumor non-invasively but it's now affecting the baby's heart rate and could cause fetal hydrops or mother mirror syndrome. I have no choice but to proceed with the removal…which brings us to today. The scans I ordered yesterday are showing that the tumor is now three quarters the size of Kelsey's body on the outside and based on the size of the tumor and how she is positioned in the womb, I can't tell how it is affecting her inside her body. That's why…that's the reason I need you in there with me. I don't trust anyone else to do it."
Hearing all of this, understanding that she really had no idea what she was about to see, Callie realized now that Arizona wasn't doubting her, but was trying to protect her. She rarely worked with babies or younger children, not unless Arizona requested a consult. Pediatric orthopedics was a specialty within itself and other than the normal breaks, inserting pins, or other routine procedures, she worked strictly with adults, partially because it broke her heart to see children and babies in such pain. Realizing Arizona knew this about her, hearing the proof that just maybe she still trusted her skills, Callie felt a calm wash over her and that familiar warmth rise within her chest. Looking down, realizing her hand was still enveloped in the smaller pale hands, she smiled inwardly, appreciating that though she felt the tingle, it didn't quite surprise her like it had earlier. Turning her hand and squeezing Arizona's, she smiled softly, and agreed, "I'll do whatever I can. I don't know how much help I can be, but you've got this Arizona, we'll figure it out." The blonde let out a sigh of relief, smiled in return, and chirped, "Good. Okay. Let's look at the most recent scans first."
Callie stood up and stepped back, and though her hand was itching to reach out and assist her, she allowed Arizona her own space to stand, then turned her attention toward the scans filling the monitors on the nearest wall and gasped at what she saw. Each monitor held the image of the tiny baby girl at various angles, her body completely obstructed from view by the enormous tumor. She'd never seen anything like it, on a fetus or any other patient, and she walked closer to get a better look. Leaving all emotion behind, her surgeon's brain kicked fully into gear, and what she saw before her was a puzzle to solve, a maze of bone, muscle, and tissue to unravel, a challenge to conquer. Arizona stood to the side and watched as Callie pulled her bottom lip between her teeth and lifted her hand to one of the monitors and began tracing the contours of the tumor where it met the spine and muttered to herself the entire time. She could barely make out the words, but she knew the ortho surgeon was reciting the name of each bone and muscle as she traced the area where it should be located were it not for the tumor. She recognized that this was Callie…Dr. Torres…at her finest. She was in the zone now and that's exactly where she needed her to be.
Callie turned, walked across the room to the older scans, studied them closely, and thought aloud, "It looks like the tumor started here at the base of the coccyx and is growing upward. That's going to be the tricky part…if you can clear away the rest so we can get a better look, I can walk you through it." Finally turning to face Arizona, Callie asked, "What is your plan?" Realizing they were on the same page as they usually were when it came to developing a surgical plan, Arizona stepped up beside her ex-wife, motioned toward the screen, traced the lower half of the tumor, and explained, "Exactly what you just said actually. I figured it would be best to excise the external tumor, take another scan to see what is going on inside, then we decide our next steps."
Callie knew how to perform the procedure, like Arizona said, she'd done it a number of times, she just didn't know how this would work. Remembering the multitude of Jello molds that inhabited their kitchen and how Arizona used to practice inserting the probe for the laparoscopic camera, not seeing how any of this was possible, Callie furrowed her brow, and asked, "How…um, how are you going to get to the tumor? Do you use the wand and just…what cut it with the laser and leave it in the womb? Do you break it up and…" She cut herself off, not wanting to make herself sound any more ignorant to the procedure than she already felt.
Realizing that Callie didn't have the first clue about fetal surgery, that her ex-wife truly didn't know what she was capable of doing, Arizona picked up her tablet, pulled up the model of a female form she used to explain procedures to her patients, showed it to Callie, and motioned with her finger as she calmly explained, "I'm going to make a small incision in the patient's lower abdomen, at about the same place where I would if I were to do a c-section, then I expose the womb, find the placenta, then carefully make another cut and remove only the part of the fetus that I need to have visible, to expose as little of her tiny body as possible." Callie stared at the animated recreation Arizona was showing her and was certain her jaw had dropped to the floor and her eyes bulged out of her head like one of those cartoon characters she used to watch on Saturday mornings. Running her shaky hand through her hair, she asked, "You…you can…" She waved her other hand in the air and finished, "You just…are you taking the baby out today?"
Not sure why she felt the need to smile at Callie's reaction, Arizona bit her lip, then clarified, "No, I leave as much of the fetus as possible in the womb and I have a special stapler to ensure there is little to no loss of amniotic fluid, but we keep an infusion flowing the entire time, after we remove the tumor, I'll tuck her back in, sew up the womb, and let her cook until she's ready to come out on her own." Callie looked around the room as if Arizona had just told her some great secret, leaned in, and quietly hissed, "You can do that?" Arizona couldn't contain her smile this time, Callie's response was just so…awestruck, childlike, and…adorable. Shaking off that thought, she chuckled, and answered, "That's what I do nearly every single day Callie. That's what fetal surgery is." Callie shook her head and asked, "But what about all the Jello and the probe and, and…" Arizona cut her off and finished, "That's for exploratory or closed procedures. I also perform open procedures in which I have to have physical contact with the fetus, like now."
Callie was indeed awestruck. In theory, she knew this; she understood what a fetal surgeon did, she knew there were surgeons, albeit very few, who specialized in and mastered maternal and fetal surgery. She'd heard of unprecedented open-heart procedures on a fetus. Until now however, she'd never really thought about the fact that in reality, Arizona was one of those surgeons. Arizona was the person people came to when their unborn baby was in need of care, she was often times their last resort. She'd come to the realization over the past couple of months, that for so long she'd only allowed herself to see the woman she divorced and not the woman nor the surgeon she'd become. Feeling that familiar guilt and anger bubble up from within, Callie quickly tamped it down, knowing that yet again, this was neither the time nor the place to analyze those feelings. Glancing at the scans, then back at Arizona who looked so confident, so determined that not only could she successfully perform this procedure, but that she herself could assist, and felt her own confidence grow. Straightening her shoulders, she turned to Arizona and proclaimed, "Let's do this Dr. Robbins." Arizona smiled despite the internal anxiety she always felt before a procedure running through her veins, nodded once, and led the way out of the viewing room.
XXXX
After meeting the patient and going over the procedure with her and her husband, Callie and Arizona made their way to the scrub room, where they now stood over the sink scrubbing in. Callie glanced over and smiled at the familiar scene of Arizona staring into the operating room at her patient, her lips barely moving, and knew she was silently going through every step of her procedure from the moment she picked up the scalpel to the moment she laid down the sutures. While most surgeons, herself included, sang a song to ensure they'd scrubbed long enough, Arizona never bought into that practice and chose to spend that time reviewing her surgical plan. It never failed to amaze her how, like the flip of a switch, as soon as Arizona stepped into the scrub room and donned that damn pink scrub cap, the chipper, happy, sometimes flighty blonde disappeared and serious, focused, no nonsense Dr. Robbins took her place. If she were being honest with herself, which she knew she had to be soon, both sides of the woman were equally captivating and of all the changes she'd seen in her ex-wife, she was comforted to know this stayed the same.
Oblivious to the fact that she was being observed, Arizona finished her usual routine, reached for a towel, and dried off her hands. Looking over at Callie who was also finishing up, she felt that little surge of excitement over the fact that she would be operating with the ortho surgeon again, smiled her dimpled smile and without thinking, asked the familiar question, "Are you ready to kick some surgical ass Dr. Torres?" Feeling her earlier excitement return, seeing the mischievous twinkle in her ex-wife's eyes, hearing the same question she'd been asked numerous times before, since the first time they scrubbed in together, Callie returned the smile, backed toward the door, and replied, "Let's go be awesome Dr. Robbins."
Once they were in the operating room, both surgeons were gowned and gloved and a nurse placed Arizona's loupes on the top of her head. Looking around to see her usual surgical team in place and in their positions, Arizona took her spot as the lead surgeon and Callie rounded the table to take her place as the second. While both surgeons noticed the confused expressions in the eyes of those surrounding them, neither commented on it. Arizona studied both the patient's monitor and the fetal monitor, noting that Kelsey's heartrate was slightly higher than she'd like it to be prior to surgery, however that was part of the reason they were there, to prevent her from going into heart failure due to the tumor. Looking up at the expectant faces, Arizona began, "This is Dianne, she is at 20 weeks gestation with her beautiful baby girl Kelsey who is our actual patient. This is an open fetal procedure to remove a sacrococcygeal tumor which has grown to nearly three-quarters of her size in length and has exceeded her body weight. Dr. Torres is assisting today because there is a high probability that the tumor has reached Kelsey's spine. I don't need to remind you how delicate this procedure is, so let's keep the talking to a minimum."
Callie glanced at the faces of the surgical team, people she'd also worked with for years and could see the respect they held for the fetal surgeon in their eyes, etched into the expressions on their faces. She watched as Arizona looked at the patient, nodded once as she always did to indicate she was ready, took a deep breath to prepare herself, then held out her hand. Without needing to be asked, Anne, Arizona's favorite scrub nurse, placed the scalpel in her hand and waited with the suction. Arizona looked up at Callie who was watching her with rapt attention, nodded toward the nurse who was handing her the cauterizing pen and asked, "Dr. Torres?" Callie followed her gaze, saw the instrument, which was being held out for her, and realized what Arizona wanted her to do; she remembered that she wasn't just observing or consulting on a fetal surgery, she would be taking part in it and that thought both scared her and thrilled her.
Arizona carefully made the small incision, waited for the nurse to wipe up the excess blood while Callie cauterized the wound, then nodded for one of the other nurses to bring the ultrasound machine over. Taking the wand, she explained, "I need to locate the placenta and umbilical cord so I can make sure I don't damage them when I make the cut or insert the amniotic drip." Callie nodded in understanding, recalling that she'd done the same thing when Cayden was brought into the world prematurely and watched while Arizona maneuvered the wand until she found what she was looking for and muttered, almost to herself, "Good, it's at the top of the womb so there is no risk of damaging it." Handing the wand back, Arizona expertly inserted the large needle for the amniotic drip into the womb through the mother's stomach, secured it with surgical tape, then relayed her next steps, "I'm going to make a small incision in the womb and after I remove Kelsey's legs, Dr. Torres, I'll need you to put the blood pressure band around Kelsey's ankle so we can continue to monitor her stats." Callie swallowed thickly, still unclear how this was possible and took the tiny band from the nurse.
As Arizona carefully and precisely made the small incision into the womb while Anne followed with the stapler to secure the amniotic fluids, she could almost feel Callie's anxiety, reminding her how she'd felt the first time she'd scrubbed in on an open fetal procedure. Knowing this wasn't an everyday thing for the ortho surgeon and something she would most certainly appreciate, Arizona glanced up to make sure she had Callie's attention, and relayed, "The first time I assisted on an open procedure, I had no idea what to expect, and I couldn't wrap my head around it. I remember Nicole making the cut, then she reached in…" Performing the same actions she was describing, Arizona slowly reached into the womb, carefully placed both hands on the tiny fetus' hips and gently exposed her lower half to the world for the first time, as she continued, "and pulled out this teeny tiny little arm. I knew I was about to take part in something very few people in the world even attempted. She looked me in the eye and asked, 'Do you know what this is Robbins?'" Callie's heartrate sped up and tears sprang to her eyes as she watched Arizona remove the tiny little baby, even smaller than the one she'd been holding just a few hours ago and whispered, "What is it?" Hearing the awe in her ex-wife's voice, seeing the wonder in her eyes, Arizona smiled behind her mask, knowing at that moment she understood, and finished, "This is privilege Dr. Torres, pure unadulterated privilege." She then nodded toward Callie's hand where she had a tight grip on the blood pressure band and waited for her to attach it to the fetus' ankle.
Completely entranced by what she was witnessing, Callie steadied her hand, reached out, gently lifted the tiny little leg, which was no bigger around than her thumb, and knew in that moment, this was indeed a privilege…one she would never in her life forget, one she'd gotten to share with Arizona. Her amazement soon turned to shock as she shifted her gaze and saw the very large tumor which was indeed taking up the majority of the infant's body and protruding between her legs. Once again, she realized that Arizona was correct and while she'd seen many SCT's, she'd never seen one this large on a baby this size and her heart was breaking at the sight. As if she could read her ex-wife's mind, Arizona softly assured, "She can't feel it and if we do our job right, she'll never be able to tell it even happened."
Taking the scalpel once again, Arizona looked at Callie who was waiting with the cauterizing pen at the ready, and right before she made the first cut, Callie asked, "Don't you have to anesthetize her?" Arizona shook her head and replied, "No, she's too small and her little body wouldn't take it directly. We increased mom's dosage enough that it would reach her through the umbilical cord. It will also keep Diane out a little longer after the procedure so Kelsey can recover as well." Callie nodded, once again surprised by the many details she'd never even thought of that are now second nature to her ex-wife. Seeing that Callie was satisfied with that answer, then double-checking Kelsey's stats to make sure she was out, Arizona slowly cut the surface of the skin around the circumference of the tumor, leaving just enough skin to close up afterward.
Callie followed the same path, quickly and efficiently sealing off any bleeders and when Arizona finished with the surface cuts, without needing to be asked, Callie passed over the cauterizing pen and held the tumor steady for her while she slowly and carefully burned the tissue to separate it from the tiny body it was attached to. After thirty minutes of careful cutting, the tumor was nearly completely severed, save the piece that was entangled in the muscles, tissue, and bone of Kelsey's coccyx. The two surgeons stared at the tiny tailbone that was nearly engulfed by the tumor, and Arizona declared, "I'm not sure I can save it. It's barely formed as it is. I know she can live without it and do just fine, I just…" she trailed off, and Callie finished, "You don't want her to."
Callie knew that Arizona was well aware of the research that suggested the tailbone served no purpose because her ex-wife had heard her rant about it enough. While she agreed that one could function perfectly well without the small group of bones, she believed that every bone was important, otherwise we wouldn't be born with them. In this case, she felt these bones served as a buffer for the spine during impact and could prevent serious spinal injury. Apparently, she'd convinced her ex-wife of that as well. Without waiting to be asked, Callie requested, "Anne, can you get my loupes please?" The nurse nodded, stepped away from the table and quickly returned with Callie's magnifying glasses and secured them on her head.
Arizona bit her lip behind her mask and asked, "What are you thinking?" Callie leaned in closer to the tiny body, bent down to try to see beneath the tumor, then looked to Arizona and asked, "Is there a way we can see underneath?" Arizona knew what Callie was thinking, shook her head, and answered, "No, the wand is too large and the probe doesn't work outside the body." She then shifted to the side, nodded toward her hand which was holding the tiny coccyx and suggested, "You can feel it though." Callie swallowed thickly, she knew bones, she knew them better than anyone else and Arizona was right, she could feel it, she just wasn't sure… "You won't hurt her," Arizona interrupted her thoughts and nodded toward her hand once again.
Hesitantly, Callie reached out, and instead of replacing Arizona's hand with hers, she covered it and guided it from the top of the tailbone and asked, "Do you feel that right there? This is the largest bone in the coccyx, if we move down just a few millimeters, that's the second…" as she continued to move their fingers downward, all she could feel was tissue, nothing bonelike at all and explained, "You don't feel the other two bones because they haven't formed yet, I can't say that they will now, but if you cut the bulk of it here," she gestured with her other hand, then continued, "Kelsey won't be losing any bone." She then stepped back and Arizona sighed in relief, pleased to learn she didn't have to physically alter the baby in any way.
With her free hand, Arizona picked up the cauterizing pen and scalpel and carefully followed Callie's pinkie finger as she pointed out where to cut. The two worked side by side, wordlessly, as they cleared away the remainder of the tumor. When it was hanging on by only a tiny little strand of tissue, Callie held up her hand to stop Arizona from cutting and leaned in closer to the baby, examining where the final connection was made. Arizona's eyes darted from Callie to the fetus and could tell simply by the look in those emotion-filled brown eyes and the furrowed brow that she'd found something she didn't like. Callie looked up at Arizona, shook her head, and confirmed, "You were right, the tumor started to grow inside as well." She then moved to the side to give the fetal surgeon a better look and explained, "It appears that the tumor has wrapped around S3, S4, and S5 and may restrict her spine from growing properly." Arizona closed her eyes at the verbal confirmation of what she'd feared, nodded, and declared, "Okay, let's get the rest of this out of here and see what damage has been done. I don't dare leave even the tiniest bit behind. I can't take the risk of it growing again."
Callie nodded in understanding, agreement, she wasn't sure which, and watched while Arizona carefully and meticulously removed the remainder of the tumor. When it was finally free, Arizona placed the large mass in the metal pan Anne was holding out for her and requested, "Can you weigh this, chart it, then take a few biopsies and send them to the lab please?" Anne nodded, then took the specimen away to complete her task. Needing just a moment, Arizona took a step back from the table, stretched her neck and arms, then took her place once again. Leaning in closer, she shook her head and hissed, "Damn it!" Callie bent down to get a closer look and could instantly see what had Arizona so upset, nearly all of the cartilage between the three vertebrae had either been destroyed by the tumor or Arizona had to cut it out to ensure she removed the entire mass. The blonde shook her head, chewed on her lip, and muttered, "It's all but destroyed, if I don't figure something out…" She cut herself off midsentence and snapped her head to look at Callie then almost pleaded, "Tell me you still keep a supply of artificial cartilage ready in case you need it."
Callie's eyes grew wide at the request and she asked incredulously, "You want to inject my cartilage into the spine of a fetus?" Arizona nodded, waved her hand at the tiny baby and asked, "What would happen if I just closed her up now, like this? Is there a better option?" Callie furrowed her brows in concentration, looked at the tiny spine, and realized Arizona was right, artificial cartilage was the best option. She just wasn't certain it was the best option for a fetus. She knew nothing about fetal medicine and…Arizona interrupted her thoughts with, "If I close her up now, the cartilage which wasn't destroyed by the tumor will deteriorate and that part of her spine will fuse together, causing a painful and debilitating curvature which would need at least two different surgeries to correct after the baby is born and again as she starts growing." Exhaling loudly, Callie nodded, and agreed, "You're right. I just, this has never been…"
Narrowing her eyes at the other surgeon, Arizona studied her closely and tried to figure out why she was being so hesitant. The Callie she used to know would be the first to jump on a groundbreaking procedure and put her innovations to the test. This wasn't a test however; Callie's artificial cartilage had been used for nearly ten years now. Seeing the concern take over dark chocolate eyes, Arizona realized that this had very little to do with her cartilage or even her belief in herself. This was about her, about them, about the fact that, like she'd recognized earlier that morning, she'd chipped away at Callie's confidence until she didn't trust herself at least around her, or at the very least her ex-wife didn't think she trusted her skills anymore. Recognizing this was the perfect opportunity to try to fix that, while also benefiting her patient, Arizona held up her hand to interrupt Callie's ramble, then nodded her head for her to step away from the table.
Once they were out of earshot, Arizona softly asked, "Do you remember the day you got the cartilage to solidify?" Unsure where Arizona was going with this, just thinking about that day, about how excited her girlfriend was for her, Callie's lips twitched behind her mask and she replied, "Yeah, we were eating Chinese food in my lab and I shook the tube and there it was…" Arizona's eyes twinkled as she finished, "And you were so excited, we were so excited, and do you remember what I said to you that day?" Callie did remember, she remembered how strong and confident and…powerful she felt knowing that Arizona believed in her, she also knew how it felt when she lost that faith, nodded, dropped her head and mumbled, "You said I was amazing." Seeing that she was right, that Callie thought she no longer felt that way, Arizona bent her knees and tilted her head so she could catch Callie's eye and confidently proclaimed, "And I meant it then, I meant it when I said it earlier, and I still mean it. Callie, you are an amazing surgeon with a brilliant mind. Your cartilage is being used all over the world on humans and on animals. The fact that this human hasn't been born yet doesn't make a difference, it will work the same way. It's safe, it's proven, and it's what Kelsey needs if she's got even the slightest chance of living a normal, pain-free life." Callie couldn't swallow past the lump in her throat, nor breathe for the fact that her heart was racing so fast. Staring into cerulean blue eyes filled with trust and admiration, Callie knew for certain, the truth hit her like a ton of bricks, Arizona did indeed still believe in her, she still trusted her, and she still had every confidence that she could help her patient.
Feeling all of her self-doubt fall away, Callie straightened her shoulders, nodded her head once, then turned to a nurse and confidently asked, "Can you call the lab and have them rush a vial of my cartilage to us please?" The nurse nodded, replied, "Yes, Dr. Torres," then turned to pick up the phone. Relieved that Callie agreed and based on the spark the appeared in her expressive eyes, she also seemed to understand what she was saying on a much deeper level, Arizona bounced on her toes and whispered, "Yay! Thank you Callie." Callie chuckled at her ex-wife's exuberance and was certain her dimples were popping deeper than ever behind her mask and felt her heart clench when she realized she was missing it. Pushing that thought aside, she moved back toward the patient, and explained, "When I inject cartilage, I usually take the back of the scalpel and scrape the surface of the remaining cartilage or bone, just to rough it up a bit so it has something to cling to." Arizona nodded and held her hand out for the scalpel, then proceeded to do as the ortho surgeon instructed.
She'd no sooner finished when one of the lab assistants knocked on the glass in the scrub room and held up the vial. Nodding to the nurse to retrieve it, Arizona looked to Callie and asked, "Um…how does this…how do I know how much to inject?" Callie pursed her lips and explained, I measure the bones and the space between them and determine the age of the patient and what the cartilage should measure at that time and…" At Arizona's blank stare, she chuckled and arched her brow and asked, "How about I just tell you when to start and when to stop?" Arizona tilted her head, looked at the vial, then at her patient and though she was sure Callie could walk her through it, it made far more sense just to have her do it herself. Making the decision she asked, "Would you mind doing it? I'm sure I could, but since you are here and know exactly how much to add and where, I'd feel more comfortable if you did it."
Taken aback by the request, Callie shook her head and replied, "Of course not." She then turned to the nurse, told her how to prepare the cartilage for injection and waited until she handed her the syringe. Glancing at Arizona, she asked, "Can you hand me the calipers please?" Arizona passed the instrument over then watched while Callie measured each of the three vertebrae and the spaces between, then listened as she muttered her calculations and watched while she injected the thick serum which nearly hardened on contact. Waiting for another minute or two, Callie checked the cartilage to make sure it set, measured it again to make sure her calculations were correct, then lay her instruments on the tray and declared, "Patient is all yours Dr. Robbins."
Arizona looked down into the open spine, studied her ex-wife's work, and murmured, "Good as new." She then looked up at Anne and declared, "Let's get her stitched up and tucked in safe and sound." Callie stood back and watched while Arizona carefully stitched up the tiny baby's backside, essentially reconstructing the entire area as it was completely disfigured by the tumor. She was amazed by the intricate stitch she'd employed to ensure there was little to no scarring and was almost certain her ex-wife would put even the best of plastic surgeons to shame with her skill. Glancing across the room where the large teratoma lay open on a tray, Callie knew she would never believe that was attached to a baby less than an hour ago, if she hadn't seen it with her own eyes. Arizona did that. Arizona saved a baby before she was even born…if she even would have made it to that point. She'd saved a baby, given her a chance at a normal life and ensured that her parents…that they would become parents, they would get to hold their perfectly healthy daughter.
Her breath hitched at that thought and in that moment another truth hit her so hard, she felt her knees nearly buckle beneath her. Arizona was responsible for making sure these parents didn't suffer the loss of their child. A loss she knew all too well and lived with every single day, a loss she'd blamed her own body for. Arizona didn't become a fetal surgeon to avoid having other children or to further her career, Arizona became a fetal surgeon because when the opportunity presented itself to help ensure other women didn't suffer like she had, she couldn't pass it up. She wondered if her ex-wife had ever tried to tell her that, if she'd ever given her the chance to do so. She wondered if she would have listened, if she would have understood, but she was certain, based on their talk the day before, that she wouldn't have. Feeling the now ever-present guilt rise up again like bile in her throat, knowing that it too would present itself as anger if she dwelled on it, Callie mentally counted to ten and reminded herself this was not the time.
Turning her attention back to Arizona, who was just finishing her last few stitches, Callie watched as she carefully tucked the baby's bottom half back inside the womb, and faintly heard her say, "Goodnight sweet girl. I'll see you in a few months," then proceeded to close up the amniotic sac. She smiled at the sweet statement, then watched in awe as the baby disappeared and Arizona closed the patient's abdomen as if nothing ever happened, as if she didn't just have an unborn baby lying on the table in front of her, as if she didn't just save that baby's life and fight to ensure that she would be able to walk when the time came. Callie knew Arizona was talented, she'd always believed she performed magic and miracles, but this…what she just did, it was truly fascinating and amazing, and it was exactly as she'd said earlier, it was pure unadulterated privilege. A privilege she'd tried to deprive her wife of, a path she didn't want her to take out of her own selfishness. She knew this wasn't the reason Arizona invited her to join her today, to prove she'd made the right decision, but that's exactly what happened nonetheless and now…now she had to tell her as much.
XXXX
Arizona stood at the sink trying to focus on scrubbing her hands but kept stealing glances at Callie who'd barely said a word since she'd injected the cartilage. Worried that she'd somehow upset her or forced her into doing something she didn't want to do, she softly started, "Callie, did I…" She stopped when Callie abruptly turned to face her and nearly gasped at the expression she saw on her face, the look in her eyes. It was so haunting, so filled with regret, remorse, and…and something she wasn't quite ready to see, and asked, "What is it Callie?" Inhaling deeply, Callie shook her head and explained, "I didn't get it Arizona. I didn't understand until today. You just operated on a tiny little baby who isn't even born yet. You made sure she would live, she would walk, you made sure her parents would actually be parents. You…you did this…you did all of this so they wouldn't have to go through what you went through, so other parents wouldn't have to deal with the loss. I was wrong Arizona; I was so wrong. You weren't putting off having a family, you weren't putting your job before your family…you were doing…You did the right thing Arizona, you made the right choice." She then shook her head in shame, felt the tears spring to her eyes, and murmured, "I'm just…I'm sorry I made you make that choice, I'm sorry I made you choose."
Arizona felt all the blood rush to her head and grabbed the edge of the sink to steady herself. Her heart was beating so fast that she could almost hear it, drowning out everything except the echo of Callie's words as they ran through her mind. The words she'd never thought she'd hear, the apology she never expected to receive, hung in the air between them and she could feel her own tears stinging the backs of her eyes. This, Callie's choice to end their marriage was something that hadn't come up since their first conversation and here she was, without prompting, without argument, without days of ruminating on her thoughts, offering a sincere, heartfelt apology. She got it, she understood, she knew now what this meant to her and suddenly, the hundreds of hours she'd thrown into her work while feeling the slightest of pains in her heart wondering what would have come of her marriage had she not chosen this specialty, was worth it. Hearing Callie tell her she made the right choice meant…everything.
Letting out a sob, she turned to face Callie once again and the two women fell into each other's arms, holding as tightly as they could as they each felt yet another wound begin to heal. Callie rubbed Arizona's back and continued to whisper, "I'm sorry, I'm sorry I didn't listen." Arizona shook her head and returned, "I'm sorry I didn't try to explain, I didn't make you listen." Callie snorted at that and muttered, "Yeah, because I would have." Arizona chuckled too, pulled back to look Callie in the eye, caressed her cheek, and softly declared, "Thank you Callie. Thank you for saying that, for seeing that I needed to do this." Callie lifted her own hand to brush Arizona's tears away, and replied, "I do see that. I see how much you've changed, how much stronger you are…more confident, because of this. You need to know, I see it. I see it and I am so, so proud of you Dr. Arizona Robbins." Arizona's breath hitched and she understood in that moment, she needed to hear that Callie believed in her, trusted in her skills just as much as her ex-wife needed to hear it from her.
Squeezing her ex-wife a little tighter before completely letting go, Arizona turned her head, placed a soft kiss on Callie's cheek, and murmured, "Thank you. Thank you for believing in me." Everything inside of her, every piece of her that she'd fought for two years begged her to slide her lips over just a couple of inches and claim what she really wanted, instead, she stepped back and tried to ignore the fact that her lips were tingling just like her finger earlier and her forehead the day before. Callie's entire body felt as if it were going to go up in flames and turn to ash the moment Arizona's lips touched her cheek and she wanted so badly to turn her head and feel those luscious soft lips on hers once again. She was almost relieved when her pager started ringing into the quiet room, glanced down at it, then back at Arizona and muttered, "I ahh…pit…911…gotta…yeah…" Then she turned and ran straight into the door, so flustered was she that she forgot she had to pull instead of push.
A/N: We're getting closer.