Cautiously, Amelia climbed the set of stairs that would lead her to the master bedroom. The noise got louder the further up she went. Taking a deep breath she swung open the bedroom door.

"Oh my god!" Amelia screamed.

Amelia pulled the door quickly back in front of her face and turned away from the door. Inside the room, she heard distant muffles and scrambling. Within a minute her niece stepped out of the room in a robe, hair disheveled, slamming the door shut behind her.

"What the hell are you doing?!" Payten said ferociously.

Amelia stood with her face in her hands, "I'm so sorry, I should have knocked,"

"Hell yeah you should've knocked," Payten said grabbing her aunt by the arm and guiding her away from the bedroom.

"Is that the guy from the tattoo parlor?" Amelia grimaced.

"Yep,"

"I could tell by.. you know... all the... tattoos, everywhere..." Amelia said, emphasizing the 'everywhere' part quietly.

"Geez, what are you doing here?" Payten said, finally reaching the bottom of the stairs and letting go of the tight grip she had on Amelia's forearm.

"I was just popping in to say hi," Amelia lied.

"That was really embarrassing and you never pop in just to say hi,"

"I do so," Amelia said sheepishly.

"What's going on?" Payten asked, seeing through Amelia's facade.

After a minute of silence and a long cowboy stare from Payten, Amelia finally breaks, "Your parents just wanted me to check on you."

"Why?" Payten asked genuinely confused.

"They just said you were a little short with them today and thought you weren't acting like yourself,"

"You burst into my room at 11 o'clock at night because they thought I was being rude to them?" Payten asked

"Well... that and.." Amelia started.

"They think I'm using?" Payten said her face turning from confused to angry.

"I told them not to worry about that but, I know that lately things have been a little rough and I just wanted to ease their minds and..." Amelia said before Payten cut her off.

"I am fine. I'm not using. If they are so worried about me they can ask themselves how I am doing instead of sending you over every time they think something might be wrong. Can I not just have one bad day without everyone thinking I am on drugs?"

"I get it. Again, I am sorry," Amelia said holding her hand up in an attempt to surrender.

"Can you please go now? And can we please never speak about this again," Payten said, rubbing her temples with her eyes closed.

"Please I want nothing more than to never think about this again..." Amelia winced while walking her way to the door.

"I'll see you tomorrow," Payten said before ushering her aunt out the door.

A small creek from the old wooden floorboards sounds out from behind Payten, she turns around and is faced with a 6 '4, muscular, tattooed man. His brown hair is a fluffed-up mess, his hazel eyes are sparkling beneath the fluorescent hallway light above his head and he has a mischievous grin on his face. He is wearing nothing but the sheet he had rolled out of bed with to cover himself with. He goes to speak but ends up chuckling.

"I'm so sorry," She says before letting out a long sigh, she can feel her face starting to turn red. He must have heard their whole conversation.

"That was a first," He said still clearly finding the whole ordeal funny.

"My family aren't the best with boundaries," She confessed.

"It's fine really," He smiled sweetly, "Wanna head back upstairs?"

"I'll be up in a second,"

The man walked up the staircase dropping the bedsheet as he went up. Payten felt her heart skip a beat. She turned toward the door, making sure it was locked this time. As she went to follow after her newfound friend, there was a hard and heavy knock at the door.

Payten let out a frustrated sigh, "Who is it?"

"It's me, can you let me in please?" A voice sounded from behind the door, each word heavily slurred.

Payten rolled her eyes, unlocking the door hatch before stepping outside and closing the door behind her.

"Josh, what are you doing here?"

"I came here to see Kayden," He said clearly intoxicated.

"He's asleep Josh, it's almost midnight,"

"Why aren't you letting me see him, P?" He said whilst reaching to grab her shoulder for some stability.

"We haven't heard from you in over a month. And you're using," She said before sharply removing her shoulder from his grasp.

"Using? I've only had a couple of beers," He said trying to straighten himself up.

"You smell like a brewery and you clearly haven't been going to the AA meetings you agreed to so that you can have visitation,"

"Look I didn't come here to fight, I just want to see my son," Josh said before reaching for the door handle and swinging it open.

Before Payten could react, Josh had pushed past her and was now in the middle of the entryway calling out for Kayden. Payten tried to pull him back outside but his yelling only grew louder.

"Please leave Josh, Go!" She pleaded.

"Kayyyden! I'm not leaving before I see my son," He insisted.

Payten jumped in front of Josh trying to block him from climbing the stairs, he shoved her out of the way which made her fall to the ground and hit her head, hard. As Josh reached the top of the stairs, he was met with the 6'4 muscle man who had luckily seemed to put on some trousers.

"Who the fuck are you?" Josh spat out.

With one swift movement, he had managed to send Josh tumbling back down the stairs. Payten jumped up to try and soften the blow but it was too late, Josh smacked his head on the wooden floor and was knocked out, cold.

"What the fuck Ty!" Payten gasped.

"I'm sorry, I didn't mean to hit him that hard, I.." Tyler said as he rushed down the stairs.

A pool of blood started to form from Josh's head, Payten sent Tyler to call the ambulance and grab a towel to place beneath it. All of the noise must've woken Kayden because soon he was standing at the top of the stairs, eyes as wide as saucers.

"Mommy, what happened to Daddy?" He cried.

"He had a fall sweety, but he'll be okay, go back to bed and mommy will be there in a second."

Kayden continued to cry and before long he was standing there howling, Josh was still unconscious and Payten could hear Tyler panicking about going to jail and how sorry he was that he caused this situation. Still holding onto the back of Josh's head, Payten tried to take deep breaths and calm her thoughts. This was all too much.

"Tyler... Tyler!" She yelled, losing patience, snapping him out of his thoughts, "I need you to come and hold his head,"

"What? No, I can't..." He said still in shock.

"Come here, and I'll show you how. I need to calm Kayden down and I need you to keep pressure on this wound,"

Tyler made his way over to Payten who slowly placed his hands on the back of his head, "Hold the towel there, and don't move it until I'm back,"

Payten stood up from her place behind Josh and quickly ascended the stairs, wrapping Kayden in her arms and carrying him back to his bedroom. He was a mess and rightly so, it was beginning to look like a bit of a horror scene down there. She held him for a while and in the distance could hear the sound of the ambulance. Shit, she thought. She would have to ride with Josh. He had nobody else. She would have to call her parents.

"Mom?" She said after hearing her mother's sleepish "Hello?"

"What's wrong?" Addison answered hearing the panic in her daughter's voice.

"I need you to come over,"

"I'm on the way."

Addison's panic began to rise as she pulled into her daughter's street. The ambulance filled the dark street with fluorescent lights, a cop car pulled in behind her. Addison feels her stomach drop. She parks the car a few houses down from Payten's and runs the last few feet to the door. She is stopped by a medic and told to wait outside.

"Please get out of my way, this is my daughter's house and I am a doctor at Seattle Grace Hospital," She says sternly.

"Mom?" Payten says from behind the man blocking her entry into the house.

"Move," Addison says one last time before the man finally steps out of her way.

Payten rushes into Addison's arms, crying and trying to explain everything that has happened. Addison not making sense of any of it. She pulls back and runs her hands all over Payten's head, arms, and face, trying to look for signs of any serious injuries.

"You're okay? You look okay, where is Kayden? Who's blood is all over you?"

"Mom, we are fine. It's Josh mom, he... he came over and he was drunk and he wanted to see Kayden.." Payten started before she began to hyperventilate, "I... he was..."

"Calm down P, take some breaths.." Addison said.

"I need to ride with him to the hospital, can you watch Kayden?" Payten said after regaining her breath.

"Of course."

Addison had paged Amelia on the way to the hospital, knowing that she was the neurosurgeon on shift for the night.

"20-year-old male, MVC, GCS 12. He has a depressed skull fracture. Right pupil is sluggish. Had episodes of bradycardia en route"

"He's probably got an intracranial bleed. Let's send him straight into CT."

Amelia could see Payten pacing outside of the exam room, once some of the nurses and a neuro intern rushed Josh down to CT, she stepped outside to comfort her niece.

"Hey, how are you holding up?" She asked softly.

"I'm fine.. How is Josh?"

"Well.. he's ugh.. He's gone to CT and then we should know more," Amelia said knowing that the injury to his head looked quite extensive.

"I don't know what to do," Payten said looking at her aunt, defeated.

"First, I think you should go get cleaned up," Amelia said, noticing her niece's blood-stained hands, "Then, I think you should try and I mean really try, to get a rest in one of the on-call rooms. It's going to be a long night and an even longer day tomorrow."

Payten grimaced at the idea of getting some rest.

"Go, please. I'll find you as soon as we know what our next steps are." Amelia said before pulling Payten into a quick hug and racing off toward the CT room.

"Josh's injury from the fall caused his brain to swell. We may need to remove a piece of his skull to alleviate the pressure build-up and protect his brain from any permanent damage,"

"Oh my god," Payten uttered.

"But if we do, it will be temporary. We will implant the bone fragment in his abdomen, and then we will replant it after the swelling goes down," Amelia stated professionally.

"A craniotomy is a fairly straightforward procedure and we have performed them countless times," Derek chimed in.

"You're going to be there?" Payten asked her dad.

"No.. this is Amelia's case and I have complete trust that she will do an amazing job," Derek said only to ease his daughter's mind and not to boost his sister's ego.

Amelia tried to hide her glee in the comment he had made, "We need to prep him for surgery now. I will see you in post-op,"

Derek followed Amelia out of the room and down the corridor toward the operating theater,

"You sure you're up for this?" Derek said not as convinced as he sounded to his daughter.

"Like you said, I've done this surgery countless times before," Amelia tried to reassure him.

"Never under this kind of pressure, Amei,"

"It will be fine Derek, everything will be fine."

"He's still not awake?" Addison said quietly entering Josh's room.

"Nothing. It's been two days since we closed his skull. His intracranial pressure's down. Scans don't show anoxic brain injury. Nothing. If he doesn't wake up in a few days, we're gonna have to consider a trach," Amelia answered intensely.

"Hmmm.. it's good to see she's getting some sleep at least," Addison said moving toward the recliner her daughter was tucked up in.

"Yeah, she's refusing to leave. Worse than any actual patient," Amelia scoffed.

"The police came over this morning. They arrested Tyler for assault, the guy she was with," Addison said disapprovingly.

"Did they want to speak with Payten?" Amelia asked.

"Just to get a better idea of what happened, why he went there.. if there was a fight that escalated and that's why Tyler stepped in," Addison said after nodding.

"Has she explained what happened?" Amelia said.

"I've barely spoken to her since.. No. You?" Addison asked hopefully.

"No.."

"You doing okay?" Addison asked Amelia.

"I just can't understand why he won't wake up. Derek checked the scans, the tests. Nothing was wrong or out of place in the surgery. I keep rerunning it over and over again in my head. He should be awake," She vented, "What if... what if he doesn't?" Amelia asked becoming teary eyed, "What would I say to Payten... to Kayden?"

Addison moved her way across the room to Amelia, wrapping her tightly in her arms, "This is not your fault Amelia," Addison reassured her before letting her go from her arms, "I'm not going to tell you what to do but I am here. And I will be here for the next two hours. Scout is just down the hall in the nursery and Link is on floor 3. I've got it for a while."

Amelia while hesitant at first, thanked Addison and made her way out of the room. Addison took the seat on the other side of Josh's bed and just hoped that everything would work out all right.

"His status hasn't changed. We may need to perform something called a trach and PEG. That'll give him long-term airway control and keep him getting nutrients," Amelia informed Payten.

"Oh.. okay. Is there no brain activity at all or is it just minimal?" She asked, knowing more than most about brain medicine thanks to her father.

"At this stage, we have only seen minimal brain activity," Amelia said professionally.

Addison grabbed her daughter's hand in an attempt to comfort her, "Do the trach," Payten said simply, breaking free of her mother's grasp and grabbing onto Josh's hand.

Addison felt like she was intruding on a moment that Payten was having and decided this was a good time to get some fresh air. She made her way out of the room and decided to go on the hunt for her husband. She knew he had been working hard with Amelia behind the scenes to figure out the best cause of action for Josh's condition. She incidentally found him in the CT room staring up at Josh's scans.

"Hey," She said timidly.

"Hi," He said staring up at her with his dreamy blue eyes.

"You look tired," She said cupping one of his cheeks with her hand, his eyes falling closed to her touch.

He savoured the moment for awhile before answering honestly, "I don't know where we go from here", Addison gave him a quick peck on the lips and sat down beside him, "Amelia is killing herself to try and fix this and.. there is no logical reason why he hasn't woken up yet," He said.

"Der... some patients just don't wake up," Addison said quietly.

"I know Addie.. I just don't want her to feel this kind of pain,"

"Neither do I, I'm sure Amelia will have some grand ideas on how to fix this," She joked knowing full well that Amelia had taken this case far too close to home.

"She does. I just don't want this to wreck her either," Derek admitted.

"It will be okay, I promise," Addison said as she ran her hand through Derek's thick brown hair.

"How can you promise?" He asked.

"Because no matter what happens, we are here and we are together and we can get through this."

Derek reached up kissing Addison sweetly on the lips. Repeating the words, "It will be okay, I promise" to himself in his head.