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Alex Karev had always been good at keeping secrets. Outside of his home, no one had known about the bruises his mother
lived with or the fury his father could let loose on the family. And until he'd spoken about it with Scott Seibert, no one
had known that it was Alex's actions that had driven his violent father out of the Karev house once and for all.
There
were other things about him that Alex had figured no one would ever know. He didn't let anyone see how much he hated the low
expectations set for him at every level of his education because he was good-looking and athletic, and so clearly, as far
as most people were concerned, couldn't be very smart. He doubted most women stopped long enough to think about how he went
through them like water not because he wasn't capable of monogamy and commitment but because no one ever seemed to demand
it of him.
And the one thing Alex could barely admit to himself, and then only on very rare occasions when he was
feeling particularly vulnerable, was how much he craved having someone in his life who just cared about him, his well-being,
with no ulterior motive other than just wanting him to succeed. Not that he didn't think his mother loved him or that Izzie
couldn't have loved him if he hadn't gone and screwed it all up, but his mother had needed him to save her and Izzie had needed
him to let her try to save him, and Alex still bristled when he thought about the expectations of both.
All the hiding
and the secrets and the arrogance and the attitude he had conjured to cover them up had left Alex mostly alone. Sure, he had
friends, but the one time he'd tried to let someone inside his carefully crafted exterior, it had been a disaster. So now
he supposed he and Izzie were friends again, but whatever had been between them felt lost, and he and Meredith were friends
mostly because they could bond over their mutually screwed-up selves. And he told himself he was fine with his limited world
because his life wasn't going to allow for a lot of connection anyway. He was going into plastics. He was going to be the
West Coast version of Mark Sloan. And he'd be fine with it.
Of course, when someone had finally come along who could
read all of his secrets silently, easily, without so much as a Cliff's Notes summary of his history, Alex hadn't recognized
it or seen it as much of a benefit. Instead, he'd bitched and moaned and plotted and purposefully pissed her off so badly
she'd finally given up on him. At least, it looked like she'd given up.
Yes, when Addison Shepherd née Montgomery
had extended her hand to him, Alex had slapped it away. He'd done more than that. When she'd challenged him, it had pissed
him off beyond reason--more than when her then-husband had done it, more than when Burke had done it--and so he'd retaliated,
landing her smack in the middle of a malpractice threat. He'd also honestly expected nothing to come of it. He saw Addison
as the type of woman who was too proud to want to acknowledge an intern had gotten the best of her, and Alex assumed he'd
never have to work with her again, that he'd gotten the last word.
Instead, that pride sent her in the other direction,
requiring her to take the final word back from Alex so that she could put him in his place.
Becoming the personal
slave of the best neonatal surgeon in the country was a living nightmare for Karev, and he'd done everything he could to make
her pay for choosing what he'd seen initially as revenge over simply cutting her loses. Every time the redhead paged him,
Alex strove to make it as uncomfortable as possible, and he seized every opportunity that he could find to anger her.
So
it was odd... incredibly odd... that when he'd finally succeeded in pushing her to the point where she'd let him go, ordering
him off her service, that Alex felt regret almost the instant she'd said her good-bye. He'd dismissed that initially as a
shallow reaction to not getting so many glimpses of her amazing legs anymore, determining that was all he was going to miss.
But as the days passed and he was plunged into life with Mark Sloan as his primary attending, Alex began to see that there
was far more to the months Addison had commandeered from his internship than just her wanting to torture him.
She
had been trying to save him... from himself.
When she'd told him Mark Sloan had nothing to teach him because he was
just like him, Alex had taken it as a compliment. Then he'd spent a week following Sloan around, and realized that being like
the famous plastic surgeon wasn't necessarily such a good thing. Because Mark Sloan was exactly the guy Alex was, only 14
years further down the line. Nearing 40, he was still the good-looking guy no one expected much out of as a person; he was
the kind of guy who'd fallen in love with his best friend's wife and then screwed up his chance to have her even after he'd
ruined his friendship to get her; he was alone.
And now Alex knew what Addison had meant when she'd said she wasn't
looking out for herself during their last argument outside of labor and delivery.
His decision to swallow his pride
and go talk to his former attending wasn't just about seeing his future and hating it. Alex grudgingly admitted that he didn't
get the same buzz from doing body reconstruction or burn debridement as he got from being a part of beating the odds and saving
a baby that most surgeons couldn't have saved. But Addison Montgomery was that good, and they saved more than they lost, and
even though he had never wanted to, Alex loved it.
He'd half expected her to give him hell when he found her in her
office and he voiced his request to return to her service. But as his months under her tutelage had taught Alex, expectation
was something this woman lived to cheat. It was, in fact, that quality that made her so good at what she did.
"I'll
speak with Dr. Bailey in the morning," was all she said. No gloating, no 'I told you so,' no making him beg--all he'd had
to do was say it was what he wanted, and Addison had granted his request.
"You're going to be great at this, Karev."
He had nodded and smiled at her rather than saying anything, for once content to let the last word go.
What
Alex had never expected, however, was to become the holder of her secret. Not that he minded, because really, he owed her.
She never made him feel that he did, but every time he saw one of his fellow interns being berated by Sloan or sent out for
coffee while he was getting ready to scrub in on a surgery, he realized just how significantly Addison Montgomery had changed
his life. So when he saw her rushing toward the bathroom after rounds, and then later saw her taking slow, deep breaths in
an effort not to get sick while she tried to eat her lunch, rather than saying anything to anyone else in the gossipy fashion
he and his fellow interns were famous for, Alex had cornered his boss in the scrub room before their afternoon surgery when
no one else was around.
"If there's anything I can do to help, just let me know, okay?"
She looked at him
with eyes that were both terrified and desperate, and Alex felt the need to ruin his scrub-in by reaching out to touch her
arm.
"I'm not going to say anything to anyone, I promise. But you've taught me a lot about observing my patients.
It was sort of hard for me to miss considering we spend 80 hours a week together."
She bit her lip and nodded. "Yeah,
I guess I was just hoping I was doing a better job of covering."
"You're doing fine," Alex assured her. "No one else
knows anything."
Their surgical team arrived then, so both doctors went back to preparing for their surgery and only
later, when they were at Joe's and Alex had a beer and Addison was nursing a ginger ale did the subject come up again.
"So
I'm guessing Sloan?"
Addison nodded. "Which would be fine, I guess, if I hadn't found out last week that he's been
sleeping with Callie Torres."
Alex sighed and looked at her directly. "I wasn't sure if you two were really, you know,
together or not. I mean, it was obvious you guys were still into each other, but you seemed like you were trying to avoid
it."
"I was," she confirmed. "Mark and I are just... complicated, and sort of disastrous. And I know I have to tell
him at some point, I just need some time first to figure out how I'm going to deal with him, because once he finds out, he'll
be all over me, and if we're going to be together, I need it to be because he wants me enough to grow the hell up, not because
I'm pregnant."
He understood that, and so Alex became the keeper of a secret for the sake of his mentor even though
she looked at him pointedly and gave him a soft smile and an easy way out.
"Karev, you've got your own life to worry
about. Really... I don't want to drag you into this, so... thanks for your discretion today and for listening, but you don't
have to concern yourself with this."
Alex took another sip of his beer and watched her face. She was simultaneously
sad and happy, and she was clearly scared and uncertain. He could also see from the genuine concern in her eyes that she wasn't
dismissing the idea that he could help, she was just saying he wasn't obligated to. And that made him determined to help all
that he could.
"Well, I'm gonna be with you anyway, right? I mean, you're my boss. So, you know, covering when you
gotta run off and puke or, you know, listening while you talk things out isn't really that big a deal. I'm around."
And
he was, and not just for the moments when she was battling morning sickness or when a run to grab her some protein from the
cafeteria meant the difference between Addison being in top form for surgery or about to drop in her office. Alex was also
there when Shepherd turned his cruel streak on his ex-wife. The neurosurgeon sometimes treated her worse after divorce than
when she'd first some to Seattle, and when Karev would see those moments and sense her hurt, he would step between them, inventing
a page they needed to respond to or tests they needed to examine so that she could escape before she broke in full public
view.
Then there was Sloan, who no longer had Torres as his backup since she'd dumped him and gone back to O'Malley.
Alex wasn't above pointing that very fact out to the head of plastics whenever his relentless pursuit of Addison sent her
fleeing to a locked on call room or her office for a few moments of peace and quiet.
The sense of responsibility that
Alex felt towards her, the friendship, was surprising to the intern, but not half as stunning as the moment when he realized
it was entirely mutual.
They had been paged to the E.R. to treat a woman in her seventh month of pregnancy who had
been severely beaten. The police officers who had come in with the patient--Stacey Walker--had informed the doctors the cuts
and bruises had been delivered by the woman's husband. The attack had provoked contractions and the baby's heart rate was
erratic.
The nature of the case had put Alex on edge immediately, but he worked hard to keep his personal issues in
check as they tended to Stacey Walker, and five hours after she'd been admitted, the young woman's contractions finally stopped.
When he and Addison had gone to assure Mrs. Walker that she and the baby were now out of medical danger, though, Alex was
pushed past the limits of his self-control.
[i]"Can you please ask someone to find out when my husband is going to
come? I really need to see him."
Alex felt his attending's eyes on him, warning him to tread carefully. He did not
turn to face her, instead keeping his gaze on the patient.
"The officers who brought you in said that your husband
would probably be in lockup until tomorrow morning."
"No!" The woman's voice was panicked. "I need him here. Please,
can you just tell the police that he didn't hurt me so they can let him go?"
"Mrs. Walker," he heard Addison say,
"we can't lie to the police, and even if we could, they're not going to just let your husband go."
"But he didn't
mean to do anything. We were arguing and I fell into him, and he just tried to keep him from falling. That's all that happened."
Alex slammed the chart down on the bedside table, drawing both women's attention toward him.
"Is that what
you're gonna say when he hits your kid someday, that he didn't mean anything? Seriously, lady, get a grip and stop deluding
yourself. He hits you."[/i]
He had not been surprised when he was ordered out of the room. As the day went on, his
mood darkened, and Alex snapped at nearly everyone who came near him, Meredith and Izzie included. It was when he turned his
venom on the chief that Addison interceded, once again saving him from himself.
She'd had to call him twice before
he turned to respond to her order that they had to go check on a patient in the perinatal unit. Webber had told him to get
the hell out of his face, and Alex did just that, moving toward the redhead who stood hand on her hip, staring him down from
ten feet away. He followed after her as she rounded a nearby corner, and then as she opened the door to an on call room and
stood to the side so he could enter before she closed the door.
[i]"I'm not going to apologize to that woman. She's
an idiot."
Addison stepped toward him with such determination that it made him take a step back.
"I'm not
asking you to apologize to anyone. I get that you're pissed and frustrated and I get why you are. But all you're doing now
is hurting yourself, and that's not going to help anyone, Karev."
He took a breath and prepared to defend himself,
but she didn't give him the chance.
"We can't save people from themselves," she continued. "You put a torn placenta
or a T.T.T.S. case in our hands, and we can have some say, but we can't save people from their own weakness or their inability
to care about themselves enough to have some basic human survival instinct."
"What about her baby?" he asked, his
voice lower and softer than it had been earlier. "That kid's got no one but her to depend on, and she's already screwing up
his life."
"And it sucks, and believe me, I wish there was something we could do besides detail everything in her
medical report on the off chance a cop will get her to pursue the case." Addison sighed and shook her head. "But that's all
we can do, Alex. We treat her, we call Social Services, we hope that she comes to her senses."
She stopped and brought
her right hand up. His eyes dropped momentarily when he felt her palm fall on his arm.
"And if all else fails, we
hope that her son is like you, and that he has the strength to make a life for himself in spite of the hand he's been dealt."[/i]
That night, they'd eaten burgers at the diner four blocks from the hospital, and for the second time in his life,
Alex told the story of how he'd driven his father away. Addison had listened intently and then said that she was glad he had
told her. The lack of judgment in her reaction, either positive or negative, made him glad he had told her, too.
He
took a lot of teasing for how he'd become McHot's slave and the She-Shepherd's bitch--the Shepherd-esque nickname one Addison
couldn't shake even post divorce. But Alex just shot back something he knew his friends expected to hear and let the ribbing
go. The only person who could make remarks that actually got to him was Sloan, who was clearly jealous as hell at the closeness
between the woman he loved and an intern. More than once, the plastic surgeon had gotten in Karev's face, implying that there
was more going on than just friendship or a professional relationship. So far, Alex had been able to let it go, albeit while
tightly clenching his jaw. But he foresaw the day when he'd go on the offensive with Sloan, telling the man exactly what a
fool he was for not doing whatever he had to in order to win back Addison's trust.
"You're going to have to repeat
yourself," O'Malley said as he leaned toward Meredith. Something in his tone made Alex look back toward his friends at the
table in the cafeteria after his gaze had wandered over to his boss where she sat alone reading a book a few tables away.
"You know how Alex gets when he's having one of his McHot moments."
Yang, Izzie and Meredith all laughed, and Alex
smirked at O'Malley and threw a French fry at him.
"Dude, you're just jealous 'cause you could never get within ten
feet of something that hot."
The group began to try to one up one another then, and Alex's eyes shot back toward Addison.
She had seemed off all day, and though she'd assured him it was just some general pregnancy discomfort, he couldn't shake
the feeling that something wasn't right.
"I still can't believe you really volunteered for the gynie squad," Yang
said between sips of her soda. "You? I mean, seriously, you're really sticking with that?"
"Like Dr. Montgomery says,"
Alex replied, his attention still split between the two tables, "when you can operate on two patients or more at the same
time, you can talk to me about my specialty."
"Ooh, he's quoting her now," Izzie said, but with far less malice than
any of the others.
"It's love, I tell ya," O'Malley chirped. "Love."
Alex was contemplating another comeback
when he saw Addison flinch in her chair. He waited, watching, and then saw her double over. He was out of his seat and by
her side before anyone else even realized something was happening.
"What is it?"
She shook her head, unable
to answer him, and Alex knew whatever it was, it was bad.
"Okay, I'm gonna get you out of here."
As he slipped
one arm beneath her knees so he could lift her, Alex looked back to the interns' lunch table. They were all staring at him,
trying to figure out what was going on.
"Izzie," he called out, "I need your help."
By the time he had Addison
settled in his arms, Izzie was on his heels. He didn't stop to worry about any of the looks he knew must shooting their way.
"I need you to page Dr. Pollock and Dr. Bailey and tell them to meet us at the perinatal unit right away, and Izzie
don't tell anyone what's going on. They'll find out on their own soon enough."
The blonde nodded, a little shell-shocked,
and rushed off to do as he'd asked as the elevator doors opened. Addison gasped and her body tightened in his arms.
"It's
okay. It's gonna be okay," he whispered, even if he wasn't sure at all it would be.
"Alex, it hurts so much. I can't...
I can hardly breathe."
His eyes shot up toward the lighted numbers above the door.
"We're almost there. It's
gonna be okay. You just have to keep thinking it's gonna be okay."
She nodded and struggled to pull in another breath
as the elevator stopped and the doors opened. Alex rushed toward the nurses' desk, demanding an open room number without stopping.
One of the women directed him to an exam room, and he moved to it as quickly as he could.
"I'm gonna get the ultrasound
so we can see what's going on," he told her as he laid her down on the examination table. Another sharp intake of breath told
him she was fighting the pain again. Alex pulled the ultrasound unit closer and turned it on as his mind began to click through
the possible complications that had left his mentor in such agony.
The soft, warbled sound of the machine filled the
room and Alex could tell Addison was fighting to stay still, the pain making her want to curl up into herself. Her hands gripped
the table, turning white from the effort.
"There he is," he whispered as the grainy black and white image came up
on screen. Addison was in her fourteenth week, and the baby appeared to be the right size. But he was very still.
"Can
you find the heartbeat?" she asked through her clenched teeth. Before Alex could answer, Dr. Pollock raced into the door.
"What's going on, Addie?"
Alex answered for her. "Acute abdominal pain. I've got the image up. I was just
about to look for a heartbeat.
Pollock nodded and he and the intern switched positions as the older man grabbed the
Doppler and began to move it over Addison's stomach. Alex quickly walked to the opposite side of the room, and he pried her
fingers free from the table, taking hold of her hand.
"Where is it?" she asked, her voice choked with pain and worry.
"Hey, remember, what you told me?" Alex replied. "You have to be patient. He's probably all curled up in there wondering
what's going on and he has to turn just so before we can..."
Alex stopped speaking as the baby's heartbeat sounded
in the room.
"There he is," he whispered, and he felt her hand grip his tightly.
"He's okay?"
"So
far, so good," Pollock answered. "Now let's find out what's going on."
Dr. Bailey arrived a few moments later, and
with the help of the ultrasound and a quick examination, Dr. Pollock was able to make a diagnosis that was, thankfully, something
they could fix--an ovarian cyst. Because she was safely into her second trimester and because the cyst was larger than Pollock
was comfortable with, the roomful of doctors agreed that removing it via a laparoscopic procedure was the best move.
Alex
was touched and a little proud when Addison asked Pollock to let him scrub in on the surgery.
With a diagnosis made
and a treatment decided upon, Addison was able to relax a bit even if she was still in a great deal of pain. Bailey teased
her about being a drama queen, and the levity seemed to further help keep the worried expectant mother's mind off the coming
surgery. And then the calm that had come into the room was shattered by the sound of raised voices in the hallway.
"Don't
worry," Bailey said, "I'll put a stop to that foolishness."
The resident started to walk toward the door, but Alex
cut her off.
"I've got this, Dr. Bailey."
His hand remained on the door handle, unmoving, as the intimidating
woman studied him. Finally, she took a few steps back and nodded her agreement. Alex opened the door and stepped outside.
"Tell me something, Derek." Sloan's voice was low, but he was clearly furious. "Why the hell are you even here? Addison's
not your wife anymore and this baby sure as hell isn't yours."
"What did you do," Shepherd said, "get her pregnant
on purpose so she'd feel obligated to take you back?"
Alex was ready to slam the neurosurgeon into the nearest wall,
but before he could react, he was grabbed himself and his own back met with a hard surface.
"You son of a bitch,"
Sloan growled, "You knew she was pregnant with my baby, and you didn't say anything?"
The intern didn't much care
what his next action cost him, and he used an old escape move from his wrestling days to get out of the other man's grasp,
then he drove his fist into Sloan's face with every once of force he could muster.
"Both of you, just shut the hell
up."
Alex wanted to scream the words, but instead, he spat them out in a harsh whisper.
"She's in pain and
she's scared, and the last thing she needs is to hear you two trying to see who can be the bigger ass. So for once in your
stupid, selfish lives, think about her first and shut your damn mouths."
Sloan had gotten to his feet, and he stood
beside his former best friend, both men speechless at the intern's outburst. But if they thought they'd heard the worst of
it, they were wrong.
"You," Alex said, as he stepped toward Derek while pointing an accusing finger, "are an idiot
if you think Addison Montgomery is going to be forced into staying with any man, pregnant or not. I can't believe you even
let something that stupid come out of your mouth."
"And you," he continued, pointing toward Mark Sloan, "why the hell
would I tell you anything about her? You run around telling anyone who will listen that you love her, but then you screw half
the damn hospital knowing she's going to find out about it. You don't deserve her or this kid, and what I will tell you is
that I wish for her sake it was anyone's but yours."
He knew he was dangerously close to losing it and becoming another
source of upset for his friend, and so Alex took a breath and let go of one last thing he'd been dying to say to both men
for weeks now.
"When was the last time either one of you thought for a minute about how what you do affects her? You
both act like you have some sort of license to say and do whatever you want because you know she'll always forgive you. Well,
I'm telling you now, you do or say anything to upset her while she's in there worried about her baby, and I don't care what
happens to me, I'll kick your asses out to the parking lot and back again."
With that, Alex walked away, worried that
another moment would be one too long and he'd find himself in handcuffs instead of standing at Addison's side through her
surgery. He rounded the nearest corner and found he had an audience of one waiting for him. Chief Webber stood with his arms
crossed and a look of pure annoyance on his face.
"Sir, I, uh..."
"They upset her, you tell me, and I'll help
you kick their butts out the door. You got it?"
Alex fought back a smile as he gave a firm, "yes, Sir," to the chief
before heading off to get himself together for Addison's surgery.
Seven hours later, the intern approached his attending's
hospital room. The surgery had gone well and Addison and the baby were both going to be fine. Still, he wanted to check in
and make sure that she didn't need anything before he went to grab some dinner. He stopped when he saw Mark Sloan sitting
in a chair outside her door, his head in his hands.
"Is someone in with her?"
The plastic surgeon looked up
at him and nodded. "Derek. And don't worry, he's very contrite. He even got permission from Bailey before he went in."
Alex
nodded. "You seen her yet?"
Sloan shook his head. "I figured I better wait till she says she wants to see me. Not
that I'm sure she ever will. Her not wanting me to know about the baby doesn't speak well for my chances here."
The
younger man sighed. "Dude, man up, okay? She needs to know you want her, and more than that, that you want her enough to stop
the skirt chasing. So do you?"
Mark leaned back and let out a long, slow breath. "I do. And just for the record, most
of those rumors aren't true. I screwed up. I know it. I just don't know how to fix it."
He hated to admit it, but
Alex could see how upset and concerned Sloan really was. And he knew that Addison really did care about the other attending
even if she wasn't entirely sure they had any kind of future together beyond being parents of a shared child.
"Look,
for the record, Addison and I are friends. Period. End of story. So if you can make this better, great. But she is my friend,
and I don't have many. And if I ever hear that you're screwing around on her again, I'll tell her, and she'll be done with
you. We clear?"
Sloan stared at him a beat before he gave a slight nod. "We're clear."
Alex stepped into Addison's
room then, finding Shepherd at her bedside as the redhead slept. Derek stood and came toward him as the door drifted closed.
"She just drifted off. I, uh, I didn't want her to be alone."
"That's good," Alex replied. "Because she's
been alone way too much for a long time now."
Shepherd nodded. "Yeah, I... I'm just gonna go grab some coffee, so...
if she needs company later, just page me or something, okay?"
Contrite was the word Sloan had used to describe his
former friend, and Alex couldn't help but think it was accurate. He nodded agreement to Shepherd's request, and then the dark-haired
man left the room, though he stopped for one last glance at the sleeping woman in the bed.
Alex was reading the printout
on the baby's heart rate when he heard her voice, heavy with sleep.
"How's my boy?"
Glancing up, Alex found
her eyes open and fixed on him. She looked tired, but the pain and worry of earlier was gone.
"Good. Nice, steady
heartbeat, just like we like 'em."
Addison smiled, and he moved closer to the bed. Her hand reached for his, and he
let her take hold.
"Thank you for watching out for us."
"Hey, I got to yell at my two least favorite doctors
today, and the chief gave me a free pass on it, so, you know, it's all good."
She gave him a look, and he knew that
she was aware just how much today's events had gotten to him, which was why he'd deflected her very real gratitude with a
joke. But Addison let him off the hook, demanding no more from him than the chance to give his hand one last gentle squeeze.
"So... Sloan's outside. He wants to see you. I was going to tell you to send him packing, but the guy looks like hell,
and so if you want to take pity on him, you should know he's been warned that if he hurts you again, there's gonna be hell
to pay."
A slight chuckle escaped her throat. "From you or from me?"
"Both."
"You can let him come
in," Addison said after a moment of consideration. "And again, whether you like it or not, thank you for watching out for
us."
He thought about all the ways in which this woman he had tried so hard to hate had changed his life... redirecting
his specialty to something he loved in spite of himself, providing him a sounding board for the darkest secrets of his life,
being a strong teacher and a good friend and balancing those two things perfectly...
This time, instead of avoiding
what he was feeling, he squeezed her hand back.
"Just returning the favor."
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