"Mark Zuckerberg launched this site from my building, and all I can get from my web of Harvardians is a birth date! We basically knew that."
"We know she was on time. Healthy. A girl," Wilson added from the scanner she was feeding.
"Great, Google, give me a healthy, mixed-race girl born November 22nd, 1983." Lexie typed as she spoke, not expecting to get anything back. "Huh. That was Thanksgiving. Could be something there. God, I bet she never heard the end of that." Being born the day after Valentine's Day was bad enough. If her adoptive parents had been anything like Mom, they probably made a huge deal about being grateful for her.
She hoped they did.
"Mixed-race?"
Lexie winced. This was why she didn't like knowing things! "Uh-huh."
"That could help a lot, actually. I grew up in foster-care. There aren't as many kids wanting to search for their parents as there are with private adoptions, but some are like…like me, relinquished as a baby. There are message boards—"
"Dr. Grey doesn't take boards vey seriously."
Lexie jerked her chair to the side, blocking the computer screen, although if Robbins could figure anything out from what was pulled up, it was better than she'd done. "Can we help you with something, Dr. Robbins?"
"I'm here to tell you peds can't spare anyone for your little seminar with Syria. You can tell me what you were thinking with that stunt you pulled last month."
"I brought in a vender—"
"Don't give me that. I bought what you were selling through all of this. I thought you'd finally started to mature. To think of someone other than yourself—"
"Excuse y—?"
"But first you pull that. You used Calliope for drugs—and with everything that came out about her after she disappeared, I have to wonder about the timing."
"I've apologized to Dr. Torres," Lexie said. Wilson's proximity made her feel uniquely calm, like she had whenever someone had yelled in front of Molly. "But I don't think that's your problem. I would've, until I saw you react to Meredith—what Meredith said in that meeting. It made you just a little bit less special."
And, a little bit less superior. She wasn't a hundred percent sure of how much older Arizona was than Meredith, or if she was older than Callie, but she'd noticed the tone of superiority she took with her, especially back before Callie had taken ownership of her sexuality. Meredith had been sure for over twenty years. How long had it taken an officer's daughter to reach self-acceptance in the eighties? Not Lexie's field of expertise, but she'd been hearing a lot about gut feelings over the past few days. Was that behind Callie's original idea of how to organize the hospital? Not wanting to be constantly overruled, like she could've been by her wife and Mark? It wasn't a nice thought, but Lexie had seen the power of hierarchies around here.
"I don't like that the rest of us didn't get to run from the pain," Robbins retorted. "We had to face it head-on and get on with lives that don't fit, because no one…. Your sister and Derek, and you, you had each other out there. That's great. It's great that they've gotten stronger from this, but for them to turn around and talk like they lost—"
"They lost Mark!"
"Sofia lost her father, and all anyone tells the new hires about is your love story. How you were meant to be. Who gave them that phrase, Lexie? Do they know you weren't actually the successors to the Grey Shepherd power couple? That you left him because you couldn't get over wanting to be the youngest—"
"That didn't matter to me."
"Innocent, immature Little Grey didn't want the responsibility. You didn't love him enough for that, and now you mope around here like a martyr. The board doesn't need a 'community liaison.' We can pay someone to do this. It's busywork your sister and Shepherd created to keep you from getting in trouble with your gimp gang.
"I can say it, Wilson, put your hackles down. I'm one of them."
"And you hate it," Lexie snapped back. "You stand out less now than you did skating down the halls—"
"You think I want attention? Whenever something feels the least bit normal, there's Calliope acting like a new prosthetic is going to fix anything—"
"What needs fixing? You've got your family, and your job. You're able to afford multiple prosthetics for aesthetics! You can't roller skate? Have you tried? Have you considered that there might be a prosthetic for that? I'd be looking into it. Could make your patients who are amputees very happy. But that's not what you want.
"You think I ran from the pain? You locked it up in your heart, and you won't let go of it. You can't face the fact that Callie was right. That you wouldn't rather have died. You could've trusted your wife, the orthopedic surgeon to make the right choice. That you made her feel selfish for keeping you alive!
"I didn't have to make that sort of decision for Dad, but what I could do was stressful. Having to do it and know you're breaking a promise? I can't imagine how awful that must've been for her. You say I'm all mopey? Look in a mirror. I know my body changed, and that changed me. Callie knows you feel different, but she can't know why if you don't tell her—"
"I do! I did! Whatever I say it's always: oh, but you're just as hot in flats—"
"Maybe because she's afraid that if you keep listing negatives, you'll start blaming her again."
Arizona took a step back. "Did she say that?"
"No. I'm a second generation Grey. I know a thing or two about guilt. And my other sister is a military wife. You think you didn't earn the amputation, don't you? That's for guys who step on IEDs. Doesn't it matter that you were saving lives too, and you still can?"
"How many of those guys survive getting crushed by a plane?" Wilson muttered.
"Probably enough," Lexie advised her, before continuing,"That's why you don't want to meet with the Syrians. You're ashamed of how you lost your leg. That it wasn't in a war zone. God, you're just like Meredith."
"Excuse you?"
"She can't stand hearing that she's brave, because she wasn't hurt badly. But she was, because we were. She's connected to everyone here, and she cares so much that she gets bitchy every time there's something new to care about. Except…Except she's excited about the baby. They have this whole family coming together. I'm just the mad sister in the attic, and I'm not even up there anymore.
"Sometimes I wish I'd moved out a year ago, because getting there now is going to be a lot harder. Part of you wishes you'd stayed in Africa, and it kills you. As much as you love Sofia and Callie, you're pissed because you think you don't have the option anymore. You think I wasn't devastated enough by losing Mark, then? When you came back for Callie, and had that happy family? It took me longer than you to make the choice, but I made it. I wanted to be part of Sofia's family."
"But you're not. You're not his widow, or his grieving girlfriend. You're not a doctor. You're nothing, Grey. If you'd really been coping as well as everyone thought, you'd have come to terms with that.
"Excuse me. I have a kid with a thyroid tumor going under."
"I'm nothing to Sofia." Lexie said. Robbins kept walking away for a few steps, and then turned. "I remember. Mark told you that you weren't anything to her. He was being irrational, and it had a lot to do with medical proxy stuff. It was still awful. Then, he turned around and assumed that anyone he was dating would be involved with her. It's internalized patriarchal homophobic bullshit he didn't mean, but that doesn't mean it didn't hurt.
"I don't have a right to be anything to her. But I do love her. And I'm her cousin's aunt, so she's gonna know me. She's going to know I loved her dad, and I'd never have come between them. I'm not some symbol of why he's not here."
Arizona's face shifted, a tiny bit. "I'll try to arrange my schedule for the Syrians."
"I appreciate it."
"He left you, too."
"I'm sure leaving her was harder."
"I don't know about that." She pivoted again and let the door slam behind her.
"Wow," Wilson said, making Lexie startle. "She really can't give any ground, can she? Guess that's why she was so good at training Alex."
Lexie shrugged, and pressed her knuckles against her temple. "She saw herself in him. He was a dorky fat kid in and out of care, and he came out swinging. She was a small, blonde, lesbian who would've been miserable if she'd enlisted. She probably didn't fit in until college. Here, she'd figured out how she wanted to stand out, and it had a lot to do with being perky, optimistic, and independent. Weirdly, it's similar."
"Huh. That was the first thing I'd heard that doesn't make Dr. Sloan seem sanctified."
Lexie actually laughed at that, but it came out as a sour bleat. "Mark was incredible. Trouble rolled off of him like oil off a duck. But he could be a classic doofus." The swoosh of a reply coming in cut off whatever Wilson would say to that. "I'm out for the day," she said, clearing out the text that said sure, 5mins. "Debrief me in the morning?"
"Sure…." Wilson turned to face her. "I think we should consider bringing in Brooks."
"Not Edwards?"
"Pretty sure Brooks's social skills suck because she spent high school in her room with a keyboard in her lap."
"Meaning she's a hacker?"
"White hat, since we had to have background—I could be wrong, but it'd be worth adding her to our Ocean's 8 team."
"If it becomes eight, we'll be the ECCH Eight, and my sister will be in jail for beheading us." Lexie groaned. "Have fun with Myers. If you can."
"Should you really be pushing me toward your ex?"
"I don't trust guys who do OB in this day and age. Ask him about it. If he says anything about vaginas, run."
Wilson muttered something, staring at the computer again. On her way to the lobby, Lexie bumped Wit-Sec up on her list of possible Wilson backstories.
Faye already had the passenger-side ramp extended when Lexie got to the lobby. Lexie noticed a couple of kids standing next to the valet stand watching her, their lips forming the double o's of cool.
"Thanks for this," she said, as they worked together to secure her chair. "Sorry I've been…."
"Thorny? We all have our times. Your text said you're ready to take Betty here on a spin. Everything okay with D.R. J.P?"
"Hey, D.R. Alexandra Grey with the M.D. I'm Jean-Philippe D. R, Will they give me a D.M.?"
Lexie sighed. "He get you in on it too? No…. Never mind. I'm barely a doctor these days. He's fine. I just want to see…how it feels."
"He is fine, even my Kinsey six eyes see that."
"God, what is it with everyone? First my sister's ex offered to get me a vibrator and now—"
Faye let out a whoop of laughter and it wasn't until she started apologizing for it that Lexie replied why. The heat in her face told her it must be at least as red as Derek's had been when Sadie started pitching the studies to them over lunch, but then she cracked up.
"Whoa. You have had a busy couple months."
"It's not—It's pretty weird. She's a medical equipment heiress, and they're supplying a bunch of studies aiming to get them designated as adaptive medical devices so that insurance—Oh, don't turn. Not Roseridge. I know a place. It's where my mom took me to learn to drive the first time. I want to go somewhere less…covered in Thorns.
"I want to tell you about Mark. The first thing you should know is that he was probably whispering in her ear telling her to keep talking, and right now he's somewhere laughing his ass off," she said, dragging her sleeve over her eyes.
She could still feel the adrenaline from being behind the wheel hours later. It transferred into a jitteriness. Words she didn't think she'd want to say were dancing on the edge of her tongue, and she didn't know why. She'd heard about Meredith's day without being on-site. She didn't become part of it until she and Zola got home that evening.
She'd met the delivery guy, and got it plated before they came through the door.
"Mama doing the hafta go," Zola informed her, straddling her scooter.
"One kid to cause it, one to announce it." Meredith swept Zola up under her armpits. "You're coming to scrub up, twiddle bug."
Lexie propelled the scooter into a parking spot, and remembered the day Zola received it. She was glad she'd never managed to get Cristina to understand what she'd been worried about. Meredith was obviously dealing with stuff, if she was going to Wyatt, but it wasn't as extreme as Lexie had feared.
Meredith was an attending with a kid and a fetus on board; it'd been insane to think she'd be a…what had she said? Secret cutter? Her disdain then should've been enough to keep Lexie from going there. She'd just wanted a reason to focus on someone else's problems. Like sister, like sister.
"And we're back!" Meredith announced, depositing Zola into her seat. "Send a picture of the delivery bags to J.P. and get him to show Darren."
"Uh. Why?"
"He's a fear-monger."
Lexie rolled her eyes. She was fine. Bonkers, but fine.
That didn't mean that being shut out of surgeries by Webber didn't make for a shitty day. Lexie wasn't about making it harder on her, even if she was determined to do that herself.
"I don't need to shower tonight."
"Did Derek threaten you again? We've got at least ten weeks of this to go—"
"So I can skip one shower."
"Lexie—"
"I want to talk to you."
That was enough to get Meredith to give in to shortening her routine. Derek had told her to try for it, but it wasn't a him thing, either.
"I am sorry if what I said to Webber affected that whole situation," she said, when they were both sitting on Lexie's bed.
"It didn't."
She wasn't going to say anything more than that, and Lexie didn't push. She'd taken action the last time they talked about him, and she wasn't sure if it'd been a good choice.
"Okay. So. When things were bad, with the pills,…a I did something."
"You did a lot of things, Lex."
"I know, but this was…it was more like…I let someone do me?"
Meredith's reaction wasn't the dramatic one that she would've gotten from Molly, and it definitely wasn't the thinly veiled disappointment Mom would've displayed. Her eyes went momentarily wide, but her tone stayed conversational. "Okay. You say 'let'—"
"It was my idea. My…plan.
"There are always guys at Roseridge who are freaked out about their schlongs. The Lloyds. It took going to group a couple of times, but it wasn't hard to find someone willing." It was a uniquely Roseridge thing, to combine the in-patient and outpatient group meetings several times a week. It helped the newbies to know what the challenges would be, but also to see people in their situation back in their lives. And it gave the discharged patients a yardstick, a way to be sure they had made progress.
"Willing to pay to screw you. With drugs."
"Um. Yes. Pretty much exactly."
"And this was when?"
"Started after lunch with Dani."
This time, Meredith's reaction was more pronounced; her eyebrows leapt up. "Were you inspired by the tattoo?"
"No! I…. Oh my god. No. Just. No."
"You're protesting a lot."
"Because it's not what happened," Lexie insisted. She really didn't think it was the case, but she couldn't stop laughing.
"Just putting it out there.I'm not Why Why Wyatt; I'll let you delude yourself."
"Whatever."
"Normal people might assume that since you're laughing, this isn't some huge trauma. I know better."
"It…doesn't feel like it," Lexie admitted. "When I was in the hospital, I got used to people moving me around; doing stuff with my body. I have way more autonomy now," she added, in response to Meredith's features tightening. "But I learned to sort of…disconnect. Honestly…I feel like I used him."
Meredith jerked herself off the pillows propped against Lexie's headboard, and stared down at her. "Seriously?"
"Come on, Mer. It's the same ethics as sleeping with a patient, isn't it? This guy, he was a hiker. Terrified his life would never be the same, and there I was—"
"Your heart really is in your vagina."
"I'm not in love with him!"
"No, but you're…I don't know. Look, Lex, you were vulnerable, too. The guy consented, yeah?"
"He…uh, he thanked me. He…he was nice. I mean, he didn't spread it around. I'm not getting propositioned there, or anything."
"That's good. And…I hate that have to ask this, but none of this happened while you were there representing the hospital, right?"
"No, It was before that."
"I guess it would have to be. You sold yourself short, if you were back in the cabinet by the weekend."
"Actually, I'm sure he gave me more than I'd have gotten at the going rate. But I kinda screwed myself over. I kept asking myself what Mark would think, and I took more…. I told myself I knew. Manwhore, right? But that wasn't…actual prostitution."
"Depends on how you look at it. There's not the same power dynamic. With a one-night stand, you're both using each other for what you need, right? It's just that both of you need…orgasms, or companionship, or escape—something the sex provides. We freak out when someone, usually a woman, is getting something else, that's all. I can tell you for sure that Derek probably would've looked at me with less disgust if he hadn't thought I was getting the same thing I had with him from strangers."
"What are you talking about? Derek looks at you like you're the most fascinating thing he's ever seen."
"I forget how much you missed sometimes. I'm sure you've heard some of it. The scorned Dr. Grey leaving Joe's with a different guy every night…. You definitely heard about George. Then, there was the vet. We actually dated—and I never slept with him. But this one night, I helped him birth a pony. I never got to be a horse girl, and it was like getting a life time of that in a few hours. Incredible.
"Doc got sick that night. Our dog. Derek brought him in; I was in Finn's clothes, my hair was wet. I don't blame him for the conclusion he jumped to.
"It was the way he looked at me….
"I'm a woman who openly likes sex, with different kinds of people, and I was allergic to commitment. People have called me all kinds of things. I never let myself care. But having Derek look at me like…like he didn't know me, but he knew I was nasty. That I felt."
"He picked you up at Joe's."
"That's different. He'd never done that, and since we were us…. It's different to him. There were a lot of factors; Mark's manwhoriness was part of it. It wasn't all me. That's why I told him….
"A couple days later, he made some crack about how I got around, and I'd be screwing Alex next—Alex, who'd been giving people syphilis—He was jealous, like it was any different from me having to think of him with his wife….
"That's all old shit; we've dealt with it. But I told him that he didn't get to call me a whore. He didn't get to judge how I'd fixed what he broke."
"That is badass."
"Mmm. It was like a week before I fully wittingly became his dirty mistress, so…. Maybe not as done with him as I claimed. But the point stands." Meredith put an arm around Lexie's shoulders. "We all came back broken, Lex. I'm not gonna judge how you tried to put yourself back together. Not gonna let you kill yourself with Oxy, but…I get the appeal.
"Surgery is my anti-drug. I don't know what I'd be without it. Especially if I'd lost Derek, too. But I do know his opinion wouldn't matter. Even if there's some clouds and harps afterlife, how I kept going in this one wouldn't be his business." She tilted her head and added, "Whether I'd be able to convince myself of that or not is a different question."
"He'd want you happy. Whatever it took to get there."
"Yeah. That's…. It's why you're not sister-in-law to a vet. Derek bowed out. Said…basically that. It seemed like it should've been a relief. Having the choice made for me. But what I felt was terror. I'd made my choice months before. I was just scared of what life with him would mean. When you got here, that had kinda…taken over. But it was nothing like the thought of not having him in my life.
"I'm not sure what I was really doing with Finn. I mean, talk about conventional commitment….Wyatt and I have come to a few conclusions. I did like him. He was a really good guy; not my usual type. He was…he was like Riley in Buffy."
"Riley…Finn?"
"Shut up, klepto brunette sister who came out of nowhere."
"If I'm Dawn, I'm the key."
"The key to what, is the question."
"Hey!"
Meredith grinned at her, and even when her face settled back into calm consideration of the past, a smile played on her lips. "I doubt Finn would've ever come to cheat on me with…women of the night, vampires or not, but he did represent the normal life I'd never had. He understood my job, but his wasn't as competitive or demanding. I'm sure I'd have scared him away eventually. But holding onto him once Derek was an option….
"This is ancient history, and it has nothing to do with your story."
"No way! You can't stop there!"
"There's not much to it. Some of it was probably about putting Derek through something core to what he did to me. I humiliated myself for him, even if it showed how new to the whole relationship thing I was. And wanting him to see I wasn't going to just…jump into the deep end with him. It took a while before I was actually able to do that without pretending that none of it mattered.
"Maybe I do have a relevant point. There's no way to just eject your past. Coming here, almost moving back to Boston, I had to accept that. When Sadie joined your year…. Derek had the broad strokes of who I was before med school. She had details. Led to me telling him things I hadn't planned on. But, I don't think you ever really get over stuff. You get past it, yeah, but it's part of you, so the person who's supposed to know you best…it helps if they know."
Lexie lifted her head. "You think you don't get over things?"
"Maybe I think that shouldn't be the focus. Think of it this way: If you make a major mistake as an intern, that becomes part of how you practice for the rest of your career. If you can't learn from having it happen once, that's an issue. It's true for good things, too. On rough days, like that night where I lost three patients, there are certain cases I can think of that were such huge wins, and it makes it easier to scrub in the next day. But those kids are still gonna motivate me to be better. And not to let Richard's hissy fits keep me from doing my best work, regardless of his presence in the O.R.
"Your whole life was changed. That's always going to be true. You're gonna be different. You're also still you. Weaving that all together—it's gonna get knotted up sometimes. You probably wouldn't have done that a year ago, but you wouldn't have been in a situation where you felt like you had to, so you can't judge yourself through that lens.
"If it's not something you want to happen again—"
"It's not!"
"Then it's an intern mistake. Make it pay of you."
"I'm not ashamed. I was making use of what I had. I just…."
"If you wanted someone to judge you, you came to the wrong incubator."
"Mer!"
"What? It's not all I am. But at the moment, it's one of my roles. Right, Fetus? Is it too much to hope you're getting your wiggles out early?" She smirked at Lexie. "He's a great excuse for talking to myself. I thought it'd be weirder, talking to him, but it's so obvious that he's a whole being of his own. You wanna feel him?"
"Yeah? I heard you smacked a nurse for touching you the other day."
"Without asking! We wouldn't do that to a patient unless it was an emergency! And I only swiped her hand away. Forcefully. You're not a busybody floor nurse. Give me your hand."
Lexie did, and Meredith pressed it against the side of her belly. Almost immediately, she felt the bump of a baby body part against her palm.
She'd felt babies in utero during her OB rotation, and once she happened to have visited home on the weekend of one of her high school friend's baby showers. It was always sort of strange, and very awe-inspiring, but the times she'd felt this one were different.
"That's your nephew," Meredith murmured. "Fetus, that's your Aunt Lexie. She's pretty badass, too."
(interlude fifteen)
Yale Daily News
Oct 2nd, 2008
The Pros and Cons of Prodigies
Be honest, Yalies, how many of you were called "a prodigy" as a child (even if only by your parents)? Maybe you are an actual genius, by one definition or another. Maybe you once appeared on the local news reciting the vice presidents in alphabetical order.
I feel safe in saying, you're not a prodigy.
According to the Encyclopedia Britannica, a prodigy is "a child who, by about age ten, performs at the level of a highly trained adult in a particular sphere of activity or knowledge." Contemporary psychologists argue that applying an age limit is not necessary; what makes a prodigy unique is the speed with which they acquire knowledge. A commonly-cited example is that of Wolfgang Amadeus Mozart, who began composing at the age of four. A more modern example, albeit fictional, is that of Doogie Howser, the medical prodigy portrayed by Neil Patrick Harris in the television series Doogie Howser M.D, that aired from 1989-1993. Dr. Maggie Pierce, Yale School of Medicine, Class of 2003, is frequently compared to the pint-sized physician. She says she doesn't mind.
"Unlike Doogie, I wasn't in the hospital as a kid. TV shows fed my interest in medicine as much as books did. I would've been happy being Doogie, but my parents wanted me to be a kid. We had to make some compromises."
According to Dr. Harley Mirren, whose research centers on various forms of neuroatypicality in children "prodigies generally show prowess in one form of intelligence. That means that other areas of their development, particularly social development, [progress] at the rate of any other child." That's why Dr. Pierce's parents refused to let her leave home until she was sixteen.
"They let me skip junior high," Dr. Pierce explains. "I was being teased for being a nerd, and having a lisp. I think they hoped that by high school, most kids aren't going to be all that interested in the ten-year-old in their classes. Even then, they made me keep doing things with my age group. Classes at the Y, stuff like that."
Dr. Pierce's TV counterpart here is not Doogie but T.J. Henderson, portrayed by Tahj Mowry in the 1997 show Smart Guy. Ten-year-old T.J. is skipped up into his less academic-minded older brother's classes. Although the brothers have moments of competition, older brother Marcus, Jason Weaver, serves as his little brother's protector, when necessary. Mostly, dimple-cheeked T.J. is respected by his classmates, a kind of pet to the older students. Dr. Pierce did not have that social boost. "No one in high school wants to talk biology during lunch. The girls in my neighborhood always wanted to hear about the 'cool high school boys,' but they were just as gross to me as boys my age." Dr. Pierce received her high school diploma at fourteen. Living in Boston, her next step seemed obvious. "My parents aren't professors or anything, but when your twelve-year-old is applying for access to medical libraries, you start to make connections in a city made of colleges and hospitals. But I knew that if I started at Harvard, or even BU, it'd be easy to wake up at thirty and never have gone anywhere. I didn't want to do that."
The Pierces struck a deal; Dr. Pierce would complete the requirements for medical school while living at home. Once she'd done that, they'd start touring medical schools. Going to college at sixteen isn't unheard of, after all, and in many countries medical training begins directly after high school.
You can't blame her parents for being cautious. The Rape and Incest National Network cites Department of Justice statistics state that of all victims under eighteen, two out of three are twelve to seventeen, and 82% of sexual assault victims under eighteen are female. "I think they really hoped it would take me longer to finish the pre-med classes, or I'd decide I wanted a more traditional college experience. But so much of that is about exploring what you want to do. I'd done that. Thanks to the credits I gathered in high school, a lot of my actual college classes were in the humanities. It wasn't just a matter of acing Org Chem."
Even with courses in sociology and world literature on her transcript, not every university would accept her directly into a graduate program. But Yale knows a gem when they see it.
"The administration was very accommodating. I was encouraged to join undergraduate clubs and organizations, but, you know, there's not a lot of extra time once you're enrolled at the School of Medicine.
"It was understood that I was the Doogie. For me, that was frustrating .Everyone was very…mindful of my age. And everyone came with different levels of life experience. Some had already had whole careers, or spent time in the military, or the Peace Corps. We were all dissecting our first cadavers, and interviewing our first [Standardized Patient Actor]. Age had nothing to do with that."
These days, as a cardiothoracic surgeon at Tufts Medical Center, Dr. Pierce is no longer known as "the Doogie." She claims that she is just "obnoxiously young," At twenty-four, she was given one more opportunity to skip ahead, having been hired on at Tufts as an attending without having completed a fellowship; usually a requirement.
"I still learn quickly," she notes, which may be what most sets her apart from those of us who were lauded for being gifted or incorrectly deemed prodigies as children. Our brains might work differently, but the gaps close as time and drive make up for other factors.
Most articles of this kind would outline the pros and cons based on the importance of socialization versus academic pursuits, or the grand question of nature versus nature. It's a valid question to apply to Dr. Pierce's case. Many child prodigies, Mozart included, had parents whose professions matched up to their children's area of proficiency. Dr. Pierce's parents are not medical professionals. She's adopted, and the two things her parents could tell her about her biological mother were that she was white (Dr. Pierce is mixed-race, and her parents African American) and she was a doctor. A sure point for the nature proponents; however, Dr. Pierce believes a predilection toward medicine would've meant nothing if her parents had not been as loving and supportive as they were.
"They don't always get what I do," she says. "But they love who I am."
In spite of her unique qualities, Dr. Pierce has never felt the compulsion to search for her biological relatives. "I used to be kind of a brat about it," she admits. "I insisted that the only reason to do it would be to learn more about your medical history, and that was a solvable problem. The professionals who wanted to study me were never against running all the genetic tests they could."
What Dr. Pierce's results say about the genetics of child prodigies remains to be seen; however, they do give you something to consider when it comes to fairness. Since she was first tested for heritable diseases in 1995, Dr. Pierce has known that she has the biological markers for Early On-Set Familial Alzheimer's Disease. About the possibility of developing the disease, a Pierce says,"It's something to find out you could lose your mind while you're in the process of shaping it."
Of course, there's no guarantee that Dr. Pierce will develop the disease. The Alzheimer's Association says around 200,000 Americans under sixty-five have been diagnosed with Alzheimer's or about one in every fifteen-thousand.
Prodigies are as rare as one in five to ten million.
"Kawasaki Disease!"
"All right, Wilson."
"Kawaski Disease, though!" Wilson repeated, slamming her hand down on the cafeteria table. Lexie cringed at the number of people who turned. "I thought the mom was just being paranoid—or that it was like…that girl from The Sixth Sense, you know? With the tape?"
"Medical child abuse."
"Well…sure, but that's not—"
"Munchausen's syndrome, by proxy. We've seen it. Why do you think there are security cameras in the peds rooms?"
"Uh, custody kidnappings."
Lexie nodded to acknowledge that, and a piece of hair fell out of her ponytail. She'd been tugging at the end—she needed to get it cut of her her own reach. "Crap, can you…?"
"Sure thing." The intern leapt up from her seat.
"If he'd had a fever for five days, an enlarged lymph node, a rash, and red skin on his palms and the soles of his feet, what could it have been?'
"What do you…? Oh. There's incomplete Kawasaki, isn't there?"
"You're asking?" It hadn't been that long ago that Lexie had hated that question with a passion. She was working in the face of centuries of women being questioned any time they spoke up; shouldn't a few verbal ticks be overlooked? But patients needed to hear certainty from their doctors, and doctors needed to hear it from themselves.
"Telling. There is incomplete Kawasaki disease."
"Good. In return, I'll tell you this: the Fall 2012 Canadian Journal of Infectious Disease and Medical Microbiology describes a case where a child responding to antibiotics for community-acquired streptococcal pyogenes pneumonia started displaying persistent fever, lethargy, and lessened appetite. Echocardiogram revealed coronary artery dilation."
"He was strep positive, too? with incomplete Kawasaki? But how…? If he didn't have the eyes, or—"
"That wasn't what tipped Mer off with your patient, was it? It was the fever, the timing…. You have to see the whole picture. Kids get low-grade fevers. They're germ amusement parks who sneeze in your face and laugh about it. But that doesn't mean it's not a warning sign. A persistent fever is a big deal.
"How is he now?"
"The…kid? He was admitted to the peds floor to be seen by cardio, rheumatology, and ID. We started him on IVIG in the E.R.."
"And after that?"
"I don't…."
"Bzzt. In Japan, one in one-hundred fifty kids will get Kawasaki, but in the U.S.,we get between two to four thousand cases a year. You had a chance to follow-up with one, and reassure the mom that our hospital is competent.
"How likely was he to be resistant to IVIG?"
"I don't…would you move on to steroids?"
"Fifteen to twenty percent. Some add TNF alpha blockers. Cyclophosphamide and plasma exchange. Research is happening.
"Untreated, between a fifth and a quarter of patients will develop coronary artery aneurysms. Even treated, one percent develop giant aneurysms. Death is most common within two to twelve weeks from onset. Many myocardial infractions in young adults trace to undiagnosed—"
"Okay! I screwed up the differential—"
"That's not the point. When was Kawasaki first identified?"
"I… don't know."
"This was the day of the tanker crash?"
"Uh-huh." Jo finished looping the elastic over Lexie's hair.
"Have you not walked by a computer since?"
"Why, did you find something I—?"
"You're seeing cases you've never seen on a regular basis, or you should be. You have to be reinforcing and adding to what your attendings have time to tell you on your own. You saw that kid for a couple of minutes, and thought you knew best because you have Jo—No, you have Jeffrey Flint's signature on your diploma," she corrected. Wilson did a double take. "What? He started the September after I left."
"No, I know, I…. What's your point?"
"That the mom has a degree in her kid. Antibiotics take time to work, sure, and my sister is impressive, but that's because even though she didn't have time to stand there and compare his symptoms to every possibility on the mom's list, she kept the code running in the back of her head. You know why she could do that?"
"Because she's—"
"Because not only did she trust the mom, she's used to asking a half-dozen interns to provide their opinions on a patient. You don't think that sounds like a worried relative spending too long on WebMD?"
"You're saying…I should've used the mom as my intern?" Wilson sounded almost indignant, and then shook her head. "I shouldn't have dismissed her. Moms know if something's wrong with their kid."
"They do their best," Lexie said, thinking of the night of Molly's appendectomy, or her first bout with walking pneumonia. She'd probably been one of a very few high school sophomores ever to lie about not being sick. "When they can."
"You don't have to—"
"I had a good one. Doesn't mean I don't know they can be awful. Might not be a bad thing to have a few suspicious people out there."
Meredith hadn't turned out that way, generally. Interacting with the parents of other adults? Not her thing. General feeling about parents? Hers sucked, but she'd blamed herself for that for long enough that she wasn't as hard on the species as a whole.
"I think Jason's are normal. I dunno. People who work here are too busy to expect you to meet them, right?"
"Uh…. Ever?" Lexie asked. Jo shrugged, unable to keep hope from her expression. "Depends. My dad lives here, and, uh…he met Alex and…Mark. That he didn't meet Jackson was because he didn't want me to know about the twenty-seven year-old air—.Twenty-eight year-old woman he's dating."
"Wait, but you're…."
"Exactly. It really grossed me out at the time, but…they can have each other."
"Oof."
Lexie shrugged. "I only met Alex's brother, Aaron, because he showed up here a few years ago."
"Oh!"
"Not…it was before his diagnosis. He's a nice guy. Alex did a good job with him."
"He, uh, always sounds proud of them. Both of them.
"I wasn't brave enough to be the one the little kids looked to. And I went in as a baby. You do that, and don't get adopted? People think there's something wrong with you." She shrugged. "It's weird. The only person here I talk to about that is Alex. But he's being so…weird."
Because he's in love with you, sweetie. "The thing about Alex…about all of us…is that none of us were cool in junior high. Maybe we found something to hide behind in high school, or thrived enough in college that it doesn't show all the time, but there are situations where those don't hold up. Alex is being thirteen-year-old dork who doesn't want to share his fr—"
Suddenly, the two-person conversation was interrupted from either side.
"Hey, ladies, hey, guess who has two thumbs and neeews—"
"Three, I need to squeeze your brain. Mousey, want to learn something?"
"I—uh—" Brooks looked from Cristina to Lexie, and then down at the rolled up papers in her hands.
"Get her tray." Cristina grabbed Lexie's joystick, propelling her jerkily back from the table.
"Whoa, hey, Dr. Yang, major breach of wheelchair etiquette!" Brooks objected.
"I got it, Mousey," Lexie said, slapping Cristina's hand. She didn't flinch, but she did let go of the joystick. "Ask me like I should care."
"I have a patient who's stealing your title, Sleeping Beauty, and I need you to check my work. You were a math tutor, right?"
"I…am not sure I ever told you that explicitly," Lexie said, trying to catch what Wilson and Brooks were whispering behind them, and catching only every few words. "Adopted.…Yale…. Has to be…."
Her heart started to beat hard enough that she was surprised the others couldn't hear it on the elevator. If she'd had enough core muscle strength, she would've tried (and failed) to subtly turn to them.
Cristina led them to an imaging room that had a handwritten sign reading SCREEN BROKEN taped onto the door.
"Uh, I haven't heard anything about—"
Before Lexie could finish wondering how any of their newly installed lightboxes or computers had already broken down, Cristina shoved her master key into the lock and opened the door. If she had been an archeologist discovering the site in a few thousand years, Lexie's first thought would've been shrine.
"Hairball, present."
Wilson's head jerked up, and held the print-out Brooks had given her behind her back. "You—You're calling me…? I haven't been anywhere near this case!" she stammered. Lexie sighed. Sometimes she missed being able to think of her as Bug-Eyes without shame.
"I can do it," Brooks offered from her perch on the desk next to Lexie's lunch, which she'd put down in front of a No Food/Drink sign. Wilson glared at her, and Lexie held up a hand. She could almost get her fingers fully spread at this point. Only interns could make her nostalgic for a claw.
"She knows you can, Brooks, that's why she asked Wilson. Wilson, get your head in the game. You've been here for the past week, haven't you? You've heard the basics."
"R-Right." She looked around, and finally spotted the chart. "Patient is Paul Dawson, forty-five. He was the driver in a collision with an overturned oil tanker. Major intrusion in his area of the vehicle. Uh, came in with a widened mediastinum. Dr. Yang took him to surgery to repair an aortic transection. Injury extended to the aortic arch, bypassed in two circuits to maintain cerebral profusion. Suffered post-op myocardial infraction, and was treated with cooling pads to induce therapeutic hypothermia—"
"Why?" Lexie interrupted. Brooks and Wilson looked to Yang. "For the—I know why I'm asking you."
"Oh, no, we're not doing that," Cristina said.
"Not teaching? You asked if they wanted to learn something."
"Sure, from watching us work the problem." Lexie raised an eyebrow. Us? Stranger, Cristina uncrossed her arms with a sigh. "Okay, we'll go over this once. Mousey, go."
"Uh, we're not sure why it works? In this case, lack of blood flow causes a myocardial infarction, a.k.a. a heart attack. Our guy arrests. We don't want the ticker to stop pumping, especially if it's not sending blood to the thinker—" These words coincided with Brooks pointing just like Zola identifying body parts. "Cooling him down to below freezing, somewhere between ninety-three and eighty-nine degrees, should protect against brain damage. Theory is that the cold lessens inflammation, and-slash-or slows down chemical reactions in the body. Wanting to keep the balance prioritizes getting blood up there, and the heart being sluggish keeps blood in place, too. I assume that helps."
"Dangers?" Lexie prompted.
"Abnormal heart rhythm, infection, sepsis, possibility of clots, raised blood sugar levels, and issues with electrolytes and metabolism," she rattled off, without blinking, and then absently took one of Lexie's cooling fries.
"According to a study in Critical Care last February, the infection risk is exclusively for pneumonia. The patients were being treated for TBI, and maintenance was for up to seventy-two hours. Back to you, Wilson."
By this point, an intern who hung out with an attending should definitely have been better at switching modes. Lexie widened her eyes at Wilson's narrowed ones, and it seemed to get through to her. "Full hypothermia achieved on the night of admittance, and maintained through day two. Rewarming began after twenty-four hours. Temperature was back to 98.6 by morning on day three. He was given a dose of fifty percent Dextrose, in case he wasn't responding due to hypoglycemia. Hypothermia can use up glycog—"
"Yeah, okay, didn't work," Cristina interrupted. "If you need motivation to do your jobs, his wife died; there's a ten-year-old kid, and the longer Grandma has to take care of him, the less likely she is to make it 'til he's eighteen."
"He…just hasn't regained consciousness?" Wilson asked. Lexie turned away before she could catch the glance in her direction. She moved toward the monitor, Cristina rolling the chair away for her while saying, "Different situation. This guy has functioning kidneys, and wasn't stranded in the woods for days."
"You don't think it's related to his injuries?"
"He was conscious before the myocardial infarction," Lexie cut in. "Meaning, the lack of consciousness is likely due to a lack of oxygenation then, or related to the hypothermia. Unless, of course, you can come up with something else. Start with what you know."
"He didn't wake up after the arrest?" Brooks asked.
"If he had, he wouldn't have been a candidate for therapeutic hypothermia."
"Was he sedated then? Could it be a reaction to medication?" Wilson asked.
"Mousey, take notes," Lexie directed, opening up Mr. Dawson's chart. She double-checked the sedatives Cristina named. "June 2012 issue of Intensive Care Medicine had a randomized controlled trial measuring propfanal and remafitanil against midazalom and fentanyl specifically in TH cases. First combo is associated with earlier waking."
"Which is why I used it," Cristina said.
Lexie made a face at the monitor. She'd never admit that Lexie knew something she hadn't.
"Okay, okay, Occam's Razor," Brooks said. "Unconsciousness after TBI is caused by a surge of amino acids. Glutamate is exhibitory, GABA inhibitory, GABA wins over and boom, KO. If it just hasn't depleted—"
"Ambien!" Wilson exclaimed. "It's…zolpidem is a GABA agon—"
"From the same logic, it could be the monoamine axis," Brooks interrupted. "Dopamine, noradrenalin, serotonin—"
"Bromocriptine," Wilson said. "But that's more likely in real PVS, right? Until he opens his eyes, we don't know if he'll be—"
"We're assuming he's getting enough oxygen for the GABA to deplete," Lexie cut in. The interns both looked disgruntled, like they thought only they were allowed to be competitive. "Oversensitivity suggests not. He didn't suffer a TBI? Could there be a clot somewhere else?"
"Shepherd cleared him, but that was before the wife died—Stand down, Mousey, I'm just saying things don't always show up on the first—"
"I've got the CT." Lexie started scrolling, and the voices discussing dosages and infections faded into the background. BCBVB, blood, cisterns, brain, ventricles, bone….blood, cisterns, brain….Oh. She zoomed in and adjusted the window levels, which determined how many shades of gray the computer would differentiate. It could recognize thousands more than the most trained human eye, and the scale that measured CT density had to be condensed. It put thirty Housnfield Units, the middle of the CT density scale, in the center of the gray scale. At this setting, a fresh subdural hematoma (75 to 100HU) would be black. Air and fat (-1000 to -90) would all be white. The spot she was looking at was gray. Not much, but that didn't make it nothing. "Um…. Dr. Yang, do you have a CT angio?"
Almost immediately she felt the weight of Cristina leaning on the back of her wheelchair hard enough that if it'd been the manual she might've popped a wheelie. "I got today's scans done in four millimeter slices…something Owen said—what do you see?"
"It could just be noise," Lexie hedged, although their CTs gave such accurate scans they hadn't needed replacement. "But I think there's a clot in the basilar artery."
The room went silent as Cristina scrolled and clicked, going back and forth to the radiologist's report muttering about firing powers.
"How could we miss this?"
"Uh, because it's a thrombus," Brooks said. Cristina groaned with annoyance and then surprise as Lexie elbowed her. "Those are harder to see…not like a bleed or a an infarct."
"Right," Lexie said, without looking away from the tiny shadow.
"Order an angio C.T.," Cristina instructed. "And page neuro."
"They're on the way," Brooks said. A second later, they heard a muffled voice that Lexie had become familiar with in only a couple of days. "—broken machinery?"
"That's Cristina's room."
"Okay, I did not sign on for giving fellows—"
"No—She's—" The door swung open revealing Amelia Shepherd, along with Derek and Meredith.
"Hey, it's a party," Derek's sister said.
"Probably should be," Brooks said. "Dr. Grey diagnosed the Dozing Daddy." A long silence fell, and the intern looked toward each one of them before saying, "No? Too harsh?"
"Depends," Amelia said, biting into one of Lexie's fries, without asking whose they were, making a face, and depositing it on the untouched napkin. "Can we wake him up?"
Lexie couldn't keep her mind on Cristina's run-through of the situation; her heart was still racing with the rush that'd come when she'd noticed the smudge. She'd done that using one hand on a mouse. Her mind was spinning with thoughts until Amelia cleared her throat, and she realized she was blocking the monitor. Suddenly the room felt incredibly impossible to navigate with attendings pressed against the walls, and Wilson trying to find something to climb on to avoid just backing out of the damn room. Meredith took charge, directing Brooks, Wilson, and, somehow, suddenly, Ross, and pointing Lexie to a space beside the door. It didn't totally separate her from the group, but she didn't feel like part of it. Not usually.
Except, Meredith didn't leave her to go over to the monitors. As Cristina demanded, "Could you take it out, like now? Run a pipeline stent and restore the blood flow to the basilar?" Meredith leaned down to whisper, "Most people don't find multiple clots while on medical leave."
"It could wake him up," Derek said. "It could kill him."
"They don't have entire archives of medical journals in their heads." Lexie pressed her lips together as the other siblings in the room started arguing.
"You haven't hit eight days yet, and I've read that that might not be long enough—"
"If we don't deal with this, it won't matter!"
Meredith put her hands on Lexie's shoulders. "They'll do this until the angio comes back, and longer. Let me get you a fresh lunch?"
"How d'you know that's mine?"
"Guac on the burger."
"Right. Um. Mer? Do you know anyone in diagnostics?"
"Our guys hate me a little. I steal their thunder. But we'll get something figured out." She paused. In spite of the bickering around them, their silence was meaningful. Then Meredith reached around to hug her. "Lexie Grey, you're extraordinary."
Lexie brought her hands up to grasp her sister's arm.
Eventually, they left the Shepherds and Cristina to entertain the interns, but not before Brooks thought to tell Lexie she'd emailed her a link to "the article."
Her need to find answers might be what determined her future, but it didn't make it easier to sit across from Meredith, knowing that she might have the key to a lock that her sister had kept buried, or possibly forgotten about.