TW: Some mentions of medical procedures but nothing too graphic.

It's been 2 weeks since the guardianship papers got approved. It was fairly simple given Jackson's classification level paired with his consent. But it's there, in black and white. Mark is Jackson's guardian. Temporarily. They'll have to reapply in 6 months.

A lot can change in 6 months. Mark tries not to get ahead of himself. Whether it's a positive or negative outcome.

The ER is quiet this late Wednesday morning. Mark just signed off on last night's patient to head home. He plans on using the time to catch up on paperwork when he hears the sirens coming from outside. He rushes over with Owen to assist the nurses. Even before he reaches there, he can hear Matt barking out the information.

"Male, early 30s. Regressor according to ID. Passed out at Safeway and hit his head. But when he woke up, he was complaining of abdominal pains and couldn't move. Been in and out of consciousness since."

Owen reaches the chaos first. He takes one look then turns back to Mark, holding out his hand. Mark furrows his brows.

"Move, Hunt."

"You need to back up."

"Seriously, man, we need all hands on…"

He trails off when a familiar moan breaks through the commotion. Mark shoves Owen out of the way. His heart rate picks up when he gets a good view of the stretcher zooming past.

"Jackson!"

Mark ignores Owen as he chases after the stretcher. The man is strapped to the stretcher, eyes shut as he withers in pain.

"What's wrong with him?!"

"That's what we're trying to figure out, Dr. Sloan," Matt says.

They unstrap Jackson and begin to transfer him to the bed. Jackson cries out, holding his right side.

"Be careful!" Mark snaps.

Matt and the nurses have the audacity to ignore him. Have they always been so careless when transporting patients?! This is a person, not a sack of potatoes that you throw on the back of a truck.

Anxiety brews within him as he watches their second attempt. Jackson is still moaning. Mark takes a step forward, ready to do the examination when a firm grip holds him back. Looking down, he's face to face with Meredith. Her eyes are narrow and lips pursed together.

"Mark, move."

"I wish everyone would stop telling me that! He's my kid."

"That's exactly my point. Now that you are Jackson's legal guardian, you cannot treat him."

Mark shakes his head. "Bull! I'm a doctor. I'm the best one to take care of him."

"Right now, you're not. Now, you can stand here having this power struggle with me and I can get security to escort you to the waiting room." Mark's jaw drops. Meredith holds up a hand as her eyes soften. "Or, if you can stay out of my way, you can stand over there and let me look him over."

Mark draws a deep breath. He wants to fight her on this. Call her bluff. No way she'd actually call security. That would draw far too much attention.

Then, this is Meredith Grey. She's jumped into large bodies of water to save people. That kind of stubbornness doesn't just go away.

"The more we stand here, the more time Jackson has to wait to be treated," Meredith continues.

Jackson glances over her shoulder. A nurse is trying to get him to lay flat, but he recoils from her touch. He's whimpering. Soft tears stream down his cheeks.

Mark remembers when Addison flew down to fix what was wrong with Sloan's baby. He interrupted the surgery and ended up prolonging the inevitable. Luckily, everything was okay. If something had happened, he'd never forgive himself.

He can't make that mistake twice.

Mark steps out of the way. Meredith gives him a small smile and steps forward.

"Hey, Jackson," she says, using the voice she usually does for younger patients. "It's Meredith. I'm going to check out your tummy, okay?"

Mark lingers by the curtain. Jackson isn't responding. He's too far away to truly tell if he's regressed. It seems Meredith is erring on the side of caution. Jackson only communicates in moans.

Meredith leans forward and presses down on the left side of Jackson's stomach. "Does that hurt?" He shakes his head. "Okay, good." She moves over to the middle. "How about there?"

"No," Jackson just barely makes out.

"Alright, one more place."

The moment Meredith touches Jackson's right side, he screams out in pain. Mark practically leaps forward.

"Can't you be gentler?"

"Mark." Meredith gives him a stern glance. "Do you need to wait out there?"

Mark clicks his tongue and takes a deep breath. "No."

Jackson speaks again, looking around frantically. "M…Mark? Want Mark."

Mark rushes to his side. He caresses his cheek as he takes in his head. No bumps or swelling. He quickly scans the rest of his body. Jackson's a little pale. His dark green eyes are bloodshot. A pout is on those already full lips. Mark takes his hand.

"Mark's right here, Ducky," he coos without thinking of the people around them. "I'm right here." Jackson tries to lean into his hand but cries out in pain. Mark looks back at his friend. "You need to order an ultrasound. It's probably appendicitis."

"I was just about to do that," Meredith says, keeping her voice in that same "you're a child and need things dumbed down". She turns back to Jackson. "I'll be right back. You stay here with your crazy caregiver, okay?"

Meredith leaves them alone, but that's when a nurse steps in. She begins taking Jackson's vitals. He squirms and whines as he's poked and prodded, given instructions to open and say "ah". Mark has to bite his tongue from snapping again. Meredith will forgive him and treat Jackson right no matter what. He can't promise the same for the nursing staff, who already have some issues with him.

"102.6," she declares.

"He can't have any medicine in case he needs surgery."

"I know, Dr. Sloan. I know. Dr. Grey should be back soon."

The nurse disappears, leaving them totally alone. Mark caresses Jackson sweaty, clammy forehead. His little one looks up at him with wide eyes.

"It hurts," he whimpers.

"I know, baby, I know." Mark frowns as he takes in Jackson's attire. Just an ordinary black v-neck long sleeved t-shirt paired with jeans. "Were you little when you left the house?"

"Nuh uh."

"But your tummy hurt?"

"Only a little." Jackson groans. "Went to get some medicine. But…" He clutches his side and bends down a bit. "It got worse."

"My poor, poor baby. You should've called me. I would've had it delivered."

"P…please don't be mad," Jackson begs. "Please."

Mark frowns. "I'm not mad, Jack Attack. Not at all. I'm just worried. You're sick and you were all by yourself."

More tears fall down Jackson's face. "Big boy."

"Jack, of all times you'd want to be a big boy, now is not one of them. Don't fight it. I'm right here. I won't let anything bad happen, okay?" Mark kisses his forehead. "You can, and should, regress right now. It'll help with the pain."

Jackson slowly nods. Mark rubs his hand up and down his arm. He hates having to wait. The answer is obvious. Maybe it should've been earlier. Jackson was sleeping when he left the house around 6 AM. All cuddled up under a cocoon of blankets. He hadn't eaten much the night before, but there are times this boy is like a bird.

Mark hears footsteps around the corner and the curtain is pulled back. He prepares to give Meredith some space, when Derek walks in. Mark rolls his eyes.

"It's just you."

"Quite the greeting," Derek quips back. "I heard we have a VIP patient." He walks over to the foot of the bed and smiles. "Hey, Jackson. Can't get enough of this place even on your day off?"

Jackson squeezes Mark's hand tightly. "Hurts."

Derek nods, pouting sympathetically. "I'm sure, bud. But Meredith is going to look you over and fix you right up. While she does that, Mark is going to wait with me, okay?"

Derek is looking right at Jackson while he talks, but Mark knows who he's really trying to get through to. If they honestly think he's not going to watch the surgery, they are insane.

"Wanna go home," Jackson says, snapping Mark out of his irritation.

"Home? Bud, you just heard Derek. Meredith has to look you over."

"Don't wanna be in the hospital," he whines. "I don't get sick."

"You don't, huh?" Mark ignores Derek's chortle in the background. "You have a fever and a stomachache."

"'m fine. Take me home."

"Absolutely not. You need to be checked over, Ducky. I told you, I'll stay right here."

Jackson starts crying again. Mark bites his lip. He hates seeing him so pitiful and scared. All he wants to do is climb in that bed next to him. But that'd only put him more at risk of hurting his belly.

Derek hangs out when the sonographer, Brenda, shows up to perform the ultrasound. Mark tells Jackson to squeeze his hand as much as needed once she begins rolling the wand across his abdomen. Every so often, his little one still lets out a scream. Mark gives soft kisses to his temple and cheek. Derek steps forward to watch the ultrasound beside Brenda. Any time Mark tries to get a peek, they block him out.

"I'm going to get these images to Dr. Grey," she announces as she gently wipes any remaining goo off Jackson's stomach.

"Is he okay?" Mark asks. "It's his appendix, right?"

"I need to get Dr. Grey."

Brenda rolls the cart out. Mark looks over at his best friend, who's now rubbing Jackson's other arm.

"Does he have appendicitis?"

"We should wait for Meredith…"

"Derek." Mark grits his teeth. "Don't treat me like some uniformed parent. I'm a doctor. I may not be able to treat him, but I would hope the benefit of you being in here means you'll tell me what's going on."

Jackson speaks before Derek can. "Stop," he mumbles. "Be nice."

Derek lets out a soft ha. "It's sad when a regressor has more manners than you."

"Be nice too," Jackson reprimands, shutting his eyes.

Mark develops a brief smirk of his own. Derek shakes his head. "I think your caregiver is corrupting you." He glances back at his best friend and consults his face. A soft sigh escapes his lips. "It's appendicitis."

For once, Mark can't be glad he got a diagnosis correct. While appendicitis is certainly one of the better things, he knows the amount of excruciating pain his little boy has to be in. There have been leaps and bounds over the years when it comes to recovery time. But that's still going to take a minimum of 2 weeks.

Meredith returns a few moments later. "What is it, a party in here?" She walks beside Derek and looks over at Jackson. "Well, bud, you do have appendicitis."

"Know," Jackson slurs as he struggles to keep his eyes open. "Der told me."

Meredith shoots a quick glare to her husband, who shrugs. Mark hears her mutter something about enabling before going back to the patient. "Regardless, we're going to get you into surgery right away. I'm going to be the one doing it."

Mark allows some relief to take over. "Thank you."

She nods. "Jackson, we need to get you prepped. So say goodbye to your Mark, okay?"

Jackson wakes up a little more. "Mark, don't go."

Mark bites his lip. "I have to, Ducky." He bends down and strokes his cheek. "You need to get ready with the nurses and Meredith, alright? I won't be far when you get your surgery. When you're done, I'll get you your favorite Jell-O."

"B'ue."

"That's right." Mark kisses his forehead. "I love you."

"Love you," Jackson whispers.

Mark blinks a couple of times. He's told him for a few weeks now that he loves him. Jackson never returns the sentiment. Mark didn't expect him to. And maybe it's just because he's in pain. Or maybe it's because he's scared. But Mark will take it.

"I'll see you real soon," Mark promises. "And when you wake up, you'll feel a little better." He glances at Meredith. "Who's closing? I don't want him to have a scar."

Meredith doesn't respond and instead looks at her husband. "Please get him out of here."

Before his friend can drag him out, Mark gives Jackson a few more kisses and whispers he loves him one more time (and getting one in return). Derek gently leads him out of the area.

"Deep breaths," he tells him. Mark complies. "I know it's scary. When Alex had that bad flu, I was going out of my mind."

"At least he didn't need surgery."

"There is that. But Jackson is going to pull through. It's a simple procedure. Meredith's done it a million times. Look, obviously you're done for the day. Why don't you go change?"

Mark nods. "Let me know which OR he's going into. I'll head up to the gallery."

"Oh, no you won't."

"Excuse me?"

"The last time you had a kid in my OR, you interrupted the entire thing."

"I won't do that again," Mark argues. "I learned my lesson, alright? Besides, this is too important. There were other options for Sloan. There are none right now for Jackson!"

"We wouldn't let another parent up there."

"Okay, but I'm not just any other parent. C'mon, Derek. Would you seriously go wait in the lobby while Alex was being operated on?"

Derek looks away. Mark nods.

"See?"

Derek sighs. "Alright, you can be there." Mark grins. "But you are not to touch that button. I have patients so I can't babysit you. If I hear you pushed that intercom even once…"

"I'll take all Saturday rotations for the next 2 months."

"I'm holding you to that. I'm sure Ben would love the time off to spend with the boys." Derek snaps his fingers and points to the elevator. "Go change."

It is a special kind of hell for Mark to sit there and not touch the intercom. He bounces his leg as he observes Meredith. There truly is no one else he would trust right now. Maybe she's a newly board-certified doctor, but she's also a Grey. It's in her blood.

He can't see Jackson's face clearly from all the way up in the gallery. He squints to make sure his eyes are closed at least. No horror stories of somehow waking up halfway through for him.

Mark feels helpless. At least when Jackson has a nightmare or a panic attack, he can be there. Holding him tightly in his arms and doing all he can to take the pain away. Now, his little one lays on an operating table a whole floor below him while he watches from afar. Even if Jackson is knocked out, it feels so unnatural that he's all the way up here.

The door opens and Mark gets ready to shoo whoever it is out. Meredith agreed that no residents would watch this one. It's no longer a question of keeping Jackson's classification a secret. That went out the window over a month ago. Rather, Mark didn't want to have to worry about stupid pens clicking or soft murmuring.

Instead, Miranda enters the room. Mark takes a step back. Even in his protective papa bear state, he knows better than to go toe-to-toe with her. She bustles over to the window and peers down before looking back at him.

"First time sick since you started taking care of him?"

"Yup."

"Boy's an overachiever. Couldn't have picked a cold or even an ear infection. Went right for the appendectomy."

Mark can't help but smile. "He is an Avery after all."

"Speaking of. There's a reason I came up here."

Miranda turns to face him, her short yet full stature blocking his view. Mark knows better than to complain.

"As you are Jackson's guardian, you're his emergency contact and next of kin."

"I'm aware."

"I'm sure you're also aware that word gets around. And while we legally do not have to contact Dr. Fox, there is a chance she'll find out."

"She's all the way in Boston," Mark reminds her.

"Yes, but she has friends here in this hospital. It's not a secret that Jackson is now a patient here. And knowing Dr. Fox for a number of years, I know she will be livid to find out this information secondhand." Mark opens his mouth but Miranda barrels on. "Also, not that it's any of my business, but I have to assume she isn't aware of this little arrangement?"

Mark shakes his head. He and Jackson briefly discussed it. As Miranda says, word does get around. They know the best way to prevent her from hearing it from someone else is Jackson just coming clean. But he wasn't ready for that yet. The last thing Mark needs is her flying back here and hearing from some clueless nurse that Catherine can't be told anything, because she's no longer Jackson's next of kin. The man is going through enough right now.

"Jackson gave me consent to let her know when he's ill," he says.

"Alright. Do you want the team to do it?"

"No, no. There's still a chance they can let something slip." He glances back at the window then Miranda. "Are you busy?"

"Outside talking to you?"

"Can you please just sit here and watch over them."

"Dr. Grey is a board-certified surgeon. A damn good one at that. And you're asking me to babysit her?"

Mark clasps his hands together. "Please?"

Miranda scoffs and rolls her eyes, but still gestures to the door. Mark grins.

"Bailey, I could kiss you."

"Please do not. I'm married and not one of those nurses that wants to fling their panties at you. Now, go."

Mark makes a beeline out of the gallery. He heads down to the nearest nurse's desk and pulls out his own phone. Jackson programmed it awhile back, just in case of emergency. Mark takes a deep breath and selects her name, before punching in the number onto the landline. Maybe it'll go to voicemail.

He hears her voice after 3 things.

"Dr. Fox's phone, how may I help you?"

"Dr. Fox. Hi. It's Dr. Mark Sloan, from Seattle Grace Mercy West. I'm not sure if you remember me…"

"Of course I remember you," Catherine interrupts. "May I ask what this is in regards to?"

"I'm afraid it's about Jackson. He's going to be fine," Mark quickly adds, even though he's still paranoid about that himself. "But his appendix burst."

"Does he have an infection?"

"Not that's been made evident. He's still in surgery with Dr. Grey. I can have her call you later to go over everything."

"Yes, please do. When did this happen? Was he at work?"

"No, grocery shopping. An ambulance brought him in."

There's a short breath. "Thank you for letting me know." To Catherine's credit, she does sound worried. "If anything should happen, I'll fly out right away. But I'm sure he won't want me out there unless it's pressing."

Mark doesn't respond. He doesn't want to speak for Jackson. Who knows, maybe he really does want his mom. Selfishly, that's the last thing Mark wants.

"Dr. Sloan," Catherine interrupts his thoughts. "Why are you calling me?"

"Oh, well, you're obviously a VIP at this hospital," Mark makes up on the spot. "I figured it'd be better for me to call you and let you know."

"Someone I've rarely spoken to when there."

Mark flinches. "Dr. Grey asked me to," he lies. "I work with Jackson, so we're colleagues."

"Colleagues." Catherine hums. "Okay. Look, I must go now. But please keep me updated on my son. I have a couple of surgeries today, but I can fly out as soon as tomorrow morning."

"I'm sure that won't be necessary. But we'll ask Jackson what he wants."

The moment the sentence leaves his mouth, it hits Mark all at once. He's speaking with the woman who sent her son to that awful place. Maybe Duncan and his colleagues were the workers, but they wouldn't have harmed Jackson had Catherina and Harper not sent him there in the first place. She's the reason why he spent so long hiding his classification. He went years without regressing. Thinking that it was wrong to be a baby. Who knows what could've happened had he not picked up on the signs?

Catherine Fox is highly respected in the medical field. Paired with her ex-father-in-law, she is a part of the Harper Avery Foundation. They spew all this crap about providing the best in medicine. All while believing one can erase such an intricate part of a person.

There's no way he can keep up the façade anymore. The longer he stays on this phone, the more he wants to ream her out.

"I have to go," Mark says. "I'll keep you posted."

"Thank you, Dr. Sloan."

"Of course."

Mark hangs up the phone. The nurse on duty tilts her head and looks at him with concern for a moment. Mark forces a smile the best he can before walking off. If Bailey is still up there supervising, there's a few things he needs to get.

Mark reads the chart. He knows he shouldn't, but he familiarizes himself with the case.

Jackson pulled out of the surgery just fine. No complications in the slightest. He's simply free of his useless appendix.

Mark returns the clipboard to the front of the bed and walks back over to the side. He gently strokes Jackson's arm. He seems so much younger when he sleeps. The gown the team dressed him in afterwards doesn't help much. Not knowing what state he'd wake up in, they selected the one used for children and Littles alike. Bright blue with little lions sprinkled throughout.

Jackson whines a little, his hand going up to his eye to rub. Mark softly hushes him.

"Hey, Ducky," he whispers.

Jackson yawns then holds his stomach. "Wh…where…"

"You're at the hospital, remember? You had a tummy ache and had your appendix removed." Jackson's eyes flicker open. Mark smiles. "There's my beautiful boy." He kisses his forehead. "Such a brave baby."

"Tummy hurts."

"It'll go down within a couple of days," Mark promises. "Then you'll get lots of rest at home. I'm going to take care of you, I promise." Jackson nods. He holds his arms up to him. Mark grins. "Give me a second."

He walks over to the backpack that he brought down from his office. After shuffling through it a bit, he pulls out Hank along with a plastic bag. Jackson instantly snuggles his puppy when it's brought back over.

"So, I know you have Hank," Mark says. "And he's a very good friend to you. But maybe he'd like a friend of his own."

Mark reaches into the bag and pulls out a duckling plush. It's got a soft corduroy fabric. Mark probably could've bought the same one at Wal-Mart for 5 bucks versus the $20 the hospital gift shop gouged him. But he wasn't about to leave while waiting for Jackson to wake up. And from the way Jackson's sleepy and pained eyes brighten, it was worth it.

"Ducky," Jackson squeals.

Mark nods and tucks it under his arm besides Hank. "And I got you a book for us to read." He rustles through the bag and picks out Madeline. "It's about a little girl who has to have her appendix take out too."

"T'ank you," Jackson mumbles, moving his new duck to his mouth.

"Of course, baby." Mark puts the book on the end table. "Here, don't chew on your new friend. Or Hank for that matter. I brought my backpack. And once Derek gets off, he's going to grab some more stuff for us, alright?"

Jackson reaches out and grabs his hand. "Don't go."

"I'm not going anywhere," Mark promises. "They won't be able to kick me out of here."

He grabs his backpack and pulls out the pacifier. Jackson latches onto it rather quickly. Mark carefully lays beside him on the bed. Jackson whimpers at first, grabbing his newly wounded area. Mark nearly jumps back up, but the man grabs his arm. His eyes are filled with desperation.

"Stay."

"I don't want to hurt you."

Tears well up in Jackson's eyes. It's enough to keep Mark right there. He leans back against the pillows and rubs his back.

"Shhh, I'm here. I'm right here," Mark whispers. "Da…"

He cuts himself off. Jackson looks up at him, cuddling both of the stuffed animals to himself. He's still pale, body hot from his lowering fever. Mark has spent the fast few hours worried out of his mind. No, he's spent the past few months doing so. Wondering if Jackson is okay. If he's regressing enough. Feels safe in their apartment. If he's picking up on all the signs.

Mark knows it takes more than changing diapers and feeding bottles to make a parent. He's sure his own did that when he was small. That didn't make them capable of raising a child, let alone a cactus. He's lucky he met the Shepherds around the time he was 10 or he would've ended up on an even worse path. Carolyn constantly kicked his butt into gear. He spent enough time at their house for him to no longer be considered a guest, but a 6th child.

During a particularly difficult year when he and Derek seemed to get up to nothing but trouble, Carolyn chewed them out. Mark, in all of his frustration, yelled that she wasn't his mother. He expected Carolyn to throw him out of their house and ban him from ever seeing Derek again. Instead, she gave him a hug.

"Family is more than blood, dear. It's those who love you unconditionally."

Jackson is a good person. His biggest fault is perhaps his arrogance, but that's at about the bottom of Mark's misdeeds. Even if Jackson did all he had. If he was worse and somehow went out on a crime spree, Mark is sure he'd still love him.

This is his son. Jackson's his kid. He doesn't need Jackson to call him dad. It isn't fair to expect or ask. But he never asked Carolyn to be his mother either. She just stepped up to the plate and took over for the people in his home that threw money in his face while emotionally neglecting him.

Mark cuddles Jackson like a teddy bear and kisses his cheek. "Daddy's here," he whispers.

Jackson rests his head on his shoulder. He doesn't whisper it back. In fact, he doesn't say anything. Yet, the fact that he doesn't pull away is enough confirmation to tell Mark that he didn't just totally screw up.

"Get some more rest," he encourages softly. "I'll be here when you wake up."

Jackson nods. "'Kay."

He's back asleep within minutes. Likely all the medicine trying to keep his pain and fever down. Maybe there's a chance he'll forget the 5-letter word Mark just said.

He finds himself hoping he doesn't. If it's out there, it's in the air. Even if Jackson never calls him that, at least he knows it's an option.

Maybe it's selfish, but Mark wants it to be an option.

The next few chapters will go into the aftermath of it all. Lots of hurt and comfort. As well as stubborn Jackson because we all know doctors make the absolute worst patients ever. Especially when he finds out he can't work for 2-3 weeks...