The money he'd saved by riding his bike to work since he'd relocated to L.A. had allowed Alex to buy a used laptop from one of the attendings at the hospital, and it had changed his life.  Instead of hours spent fighting over the available computers that the residents and interns shared in the hospital, Alex now routinely copied the images and articles he needed for his surgery prep onto a flash drive and then lounged at home on his couch, studying at his leisure.

It was another example of the freedom that his new life offered, and Alex usually embraced it wholeheartedly.  But somehow he couldn't bring himself to shut down and pack up and head home tonight, despite his orders from Ross to get some rest in preparation for the days ahead.  Technically he was off--had been for four hours.  He'd left the intern that annoyed him least on call to monitor Ryan and really, he should've been sprawled out on his couch at home.

The thing was, he knew she wasn't going home, and it seemed wrong somehow for Addison Montgomery to be here in the hospital all night while he went home to his own bed and slept.  Sure, he knew that while he was a resident, he wasn't [i]her[/i] resident, so feeling guilty about going home while she tried to grab a nap in an on call room or in a chair seemed pretty lame.  But he still felt that way, and so instead of getting ready to leave, he grabbed his I.D., clipped it to his t-shirt hem and started back toward the NICU.

Everyone on staff, of course, knew this case was going to be different, and you could feel that in the pulse of the unit.  Even if she wasn't one of their surgeons, doctors, interns and nurses alike had all read her articles or heard about her surgeries, and that put an edge on everything that wasn't usually there.  The chief often said their expected level of proficiency in every procedure was 110%.  Now it felt like they were all looking for a few extra percentage points because no one wanted Childrens to be the place that lost Addison Montgomery's little boy.

It didn't mean they could save him, and they were all keenly aware of the elements that were entirely out of their control.  But like most surgical staffs, they were ignoring that for now, pushing those thoughts away.  Until something forced you to give up your illusion of control, you never surrendered it.  It was a lesson Bailey had drilled into him, and one Alex tried now to instill in his own students.

He was pleased to find, as he flipped open Ryan's chart at the nurses' desk, that Iger, the intern he'd left on call, had just been by to do his hourly check.  Ryan's blood pressure was holding steady, but his oxygen levels were lower than Alex liked.  But considering what kind of shape his heart was in, the infant was in good pre-surgery shape. 

After dropping the chart back into place, Alex turned toward the NICU.  To his surprise, Addison wasn't inside the unit at her post beside Ryan's isolette.  Instead, she was out in the hall with two men, the taller one trying to insist she take a bag of what appeared to be take-out.  She was rolling her eyes at the men when she caught sight of him standing by the desk, and when she waved him over, Alex headed that way.

"Don't think you're gonna get the young, hot guy to save you.  We told Naomi we weren't leaving till you ate dinner, and you haven't eaten yet so..."

Addison put her hand on the arm of the man who'd just spoken, effectively interrupting him as her other hand gestured toward Alex.

"Dr. Pete Wilder, Dr. Alex Karev."

Alex extended his hand and Pete reciprocated.

"Oh, the young, hot guy is that guy.  Nice to meet you, Alex."

"You, too.  You're the quack, right?"

Pete shot Addison a look as the other man snickered.

"I said alternative medicine guru.  He rephrased it as quack," she defended.  Before Pete could respond, the other man chimed in.

"But you told him I was the phenomenal, super-talented pediatrician who is also James-Bond handsome, right?

Addison chuckled slightly and turned her attention back to Alex.

"And Mr. Humble here is Cooper Freedman."

Alex knew from their earlier conversation that Cooper was the doctor who had initially drawn Addison into Ryan's case.  And he'd known about Pete's specialty because she'd tried to distract herself from the desire to cry by telling him all about her practice--her partners, her patients and the chief of staff at St. Ambrose who she liked even though most of the other Oceansiders couldn't stand her.

"Nice to meet you, Cooper."

The two men exchanged a handshake, and then Alex pointed to the bag Pete was still holding.  Pete motioned toward the redhead.

"Her favorite Chinese... which she has to eat, or Naomi will kill us, and Naomi doesn't play."

"Yeah, I got that impression when I met her this morning," Alex offered.  "I made the mistake of asking who she was and why she was in my NICU, and she told me in no uncertain terms that she was the woman who was going to kick my ass from here to Santa Monica if I didn't take the very best care of Ryan I could and then some."

Addison chuckled at the story, and Alex flashed on the stunned but amused look that she'd had upon returning to the NICU from a bathroom break to catch the end of Naomi's overprotective tirade.  Later, she'd introduced them and Naomi had apologized, and they started over with proper introductions, but hearing Addison laugh over it now and seeing the clear relief both Pete and Cooper felt at her stress lightening for even a moment made it worth exposing his slight embarrassment.

"Ah, yes, that sounds like our Nai" Cooper said, and Pete nodded in agreement before he touched Addison on the shoulder to get her attention.

"Speaking of Naomi, she'll be here in the morning, and then you'll have one of us rotating through every half day till the little man is in the clear."

"Pete," Addison began, a tone of exasperation in her voice, "you're already a doctor down while I'm out on leave. You guys can't keep running over here to--"

Alex almost missed it when Pete pushed the bag of food toward him, but he managed to grab the load before it fell to the floor as the older doctor's hands moved to Addison's arms, taking a firm hold.

"We're your family.  Stop trying to protect us and let us take care of you.  Or, you know, you can fight with us nonstop.  Whichever you prefer."

He recognized the urge in her to argue, to insist that she didn't need to be taken care of, but Alex noted with some relief of his own that she gave in without a fight and simply nodded her acquiescence to the plans her "family" had made to keep her from going through this alone.  It was a stark contrast from the way he remembered things in Seattle, where despite her friendships with Bailey and Callie, Alex had always felt like Addison was standing alone on a ledge with everyone else unaware of just how much she was hurting.

The two men turned their attention to him then, making Alex promise that he'd sit down and eat with her so Naomi wouldn't beat them all, and after a few more moments of teasing between the partners, it was finally just the two of them sitting together in a couple of chairs as they popped open containers of cashew chicken and lo mein.

"Your partners seem pretty cool."

Addison nodded as she finished chewing a mouthful of noodles.

"They're kinda great yeah.  Sometimes I think we all know each other a little too well, but then I remember what it was like being a Shepherd and being surrounded by family... so I know a little more about Cooper's sex life than I might like... small price to pay to have people you can count on."

"Hey, at least you don't all live together.  Trust me, avoid that."

Alex rolled his eyes as his finished speaking and Addison gave him a sly look.

"Oh, life at Casa de Grey wasn't all fun and games?"

"Not once your ex-moved in.  Damn, I thought O'Malley was annoying, but can I tell you, seriously, I'm not sure how that guy ever ended up with a woman like you?  Did he drug you or something?"

That made her laugh mid-bite, and Alex scrambled to hand her a bottle of water when she started choking.

"World-class surgeon, but I can't eat and laugh at the same time.  Nice."

She took a few more sips of water, then ate a few more bites of food.  When she set the to-go container on the small table between them, he fought down the impulse to insist she eat more.

"You could go grab some sleep in the on call room," he offered.  "I can hang out with Ryan for a few hours."

"That's a nice way of telling me I look like death warmed over."

Alex snorted at the very idea.  She did look tired and sad, but she hardly looked bad.  Still, he knew arguing that point with her was off the track he was really concerned about.

"It's a real way of saying I know you've gotta be worn out.  And who better to leave in charge than, you know, you're all-time favorite student?"

She couldn't fight off the smile his teasing drew out, and he couldn't help but to return the grin.  And then her face dropped and her eyes began to moisten.

"When I decided I was gonna do this, Nai and Violet came to the hospital and Violet stayed with Ryan so we could go shopping.  Naomi took me to this baby store by our office that we must have walked past a hundred times.  By the time we left, I had a whole room... crib, changing table, this great upholstered glider, bedding.  I even got inspired and bought paint.  I got it all home, and before I could cut a single box open, Violet called and said Ryan's blood pressure had skyrocketed."

She paused and took a drink of water, then rested her head against the wall.  Alex set the remnants of his dinner down beside hers and just waited for her to go on.

"It took us two days to get him stabilized, and I was sitting there beside him, trying to will him to stay alive.  I ended up getting this piece of paper and drawing out the plan for his room, and I talked him through the whole thing... where the chair was going, how the pictures would go on the walls.  I told him how much I wanted him to see that room."

"You must have sold it, because he sure seems determined to get home."

He expected that to get the smile back, but instead, it drew out the tears she'd been fighting so hard, and they began to run down her cheeks.

"I can't bring myself to go home long enough to put it together.  It's all still sitting there in boxes in the middle of... it's his room, and I promised him that it was waiting, and I can't even leave him long enough to make it happen."

She sobbed with the last admission, and Alex reached over and took hold of her hand.

"Hey, look at me."

She didn't want to, but Alex gave her fingers a gentle squeeze, and finally Addison shifted her eyes toward him.

"He's your kid.  And you're scared to death, and you should be because you know how all this works.  But you're doing the best you can for him.  You brought him to us, and you planned him a great room.  And once we fix his heart, then... then you'll be able to go home and put it all together."

Something like a half laugh, half sob rang out of her before she took a deep breath and started to steady herself.

"It sounds so rational and easy when you say it."

Alex shrugged and chuckled.  "Well, you know, I have the easier job here.  I get to do the fixing.  You have to do the waiting."

Addison eyed him a moment and then she shook her head.

"Quoting me now?"

"I only steal from the best."

Sighing, she let her head rest against the wall again, her eyes closing slightly.  Looking down, Alex realized he was still holding her hand, and he tapped her palm lightly with his fingers.

"I'm not asking you to go home or even to the hotel.  Just an on call room for a little rest while you have a highly trained surgical resident on hand to babysit."

When she spoke to him again, she sounded less like a worried mom and more like the mentor who'd busted his chops and taught him so much back in Seattle.

"Shouldn't you be the one getting some sleep?  Surgery's at 8 a.m."

"I'll have plenty of time to sleep.  Come on.  Just... two hours.  I'll send one of the nurses to wake you up if you haven't already come back by then."

Her eyes were still closed, but he could sense her weighing the undeniable need she must be feeling for sleep with the potential guilt of being away from Ryan.  Alex decided it was time to play the ultimate card, because if it didn't work, he was never going to get her to go and rest.

"If anything happens, I'll be right there with him.  I promise."

Another beat passed, and then Addison looked over at him and nodded.

"Two hours."

She stood and started to pick up their trash from dinner, tossing it back into the to-go bag.

"Thank you for the company... and the reassurance."

An old autopilot trigger in him wanted to play off her thanks, dismiss it as nothing more than doing his job.  But he knew it was more than that.  Addison was a big part of the reason he was here at Childrens doing a job he loved, and he felt like he had managed to pay her back at least a little.

"Well, hopefully you can thank me for some sleep, too.  Now go.  Me and Ryan have guy stuff to talk about."

She started to walk off, dinner garbage in hand, but then she turned back and pointed at him.

"Keep it G-rated, Karev.  He's just a baby."

"Go to sleep," he called after her, and finally she turned and made her way down the hall and around the corner.

Alex stepped into the scrub room and cleaned up before heading into the NICU.  He made a quick check of Ryan's vitals and found them unchanged, and when he saw that his charge was now wide awake, big brown eyes looking all around, Alex pulled Ryan out of his isolette and settled down into the chair Addison had practically lived in since the baby's admission.

"All right, Ryan, I figure this is a good time to fill you in on some basics, since you're new and all.  If you're a Childrens baby, you have to pick USC over UCLA.  That's a rule.  And honestly, during football season, you'll want to be an SC fan anyway.  Maybe someday I can take you to the Coliseum to watch them play, huh?"

*****

There were times when Alex did miss Seattle... or rather when he missed who he'd been in Seattle, back when he was a hotshot know-it-all who thought he was smarter than all his attendings, back when it was a near-death-match brawl for every surgery.  He'd been a cutthroat, willing to screw over his friends and fellow interns in a heartbeat if it meant getting the best surgery on the board.

What he missed about those days was the sense of disconnection he had from it all.  He wanted to win.  He wanted to score points with the chief and the attendings he had quickly learned had the power to crush his life.  He wanted to best his friends.  He wanted to be the intern who got to do the coolest things, so much so that everyone hated him.

As much as Alex knew that he, as a resident, would hate the guy he'd been back then, there was one benefit to his narrow-minded attitude of first year--his heart had been safe.  And then he'd gotten all bogged down with maturity and compassion and feelings, and it all started to get more complicated.

He had thought about that long and hard before really settling on neonatal surgery as his specialty.  The devastation he'd felt when Melanie Reynolds had died, her newborn son motherless... he'd played the case over in his head several times wondering if there was anything else they could've done.  He remembered keenly listening to Addison describe the struggle to save the sometimes hopeless infants, about how unfair it all seemed but then you'd save one, and it was all worth it.  And Alex had thought about the exhilaration of helping to save Meredith's niece, of the miracle that he'd been part of as Addison delivered one baby from a split-uterus, faux-twin pregnancy while leaving the other safely inside the mother to finish developing.

Finally, he had just realized that the highs were worth it, and he remembered that most every day, even the ones that ended with lost patients and the cries of heartbroken parents.  And the greater his skills became, the quicker his reflexes both physical and mental got, Alex felt more and more confident that he was practicing the type of medicine he'd been born for.

None of that helped to unravel the knot in his stomach as he stood in the locker room shower with Ryan's surgery looming.

The fear was a good thing, he knew that.  Overconfidence was a surgeon's Achilles' heel because it left you unprepared for the unexpected.  Alex remembered how grateful he'd been that even though at the time he'd wanted to throw something at her, he had actually paid attention when Addison admonished him about how little time they would have to save the Reynolds' baby if Melanie crashed.  It had been him who had said they were out of time, him who had remembered because it was his job--his only job--to keep that baby boy alive.

It was little things that sometimes made all the difference, and even though in his mind he'd already seen Mitchell Ross' hands moving through the whole surgery, Alex was trying to anticipate where to be more vigilant, almost trying to irrationally predict the things that could go wrong.

With the surgery mentally rehearsed at least a half dozen times, Alex tried to shift his focus to what was in their favor.  Ross was an incredible surgeon, and he'd already drilled their surgical team on every aspect of the procedures.  To put an extra set of capable hands in the O.R., Alex had even chosen an intern he disliked but knew was incredible in an emergency.  Actually, Susan reminded him a lot of Cristina in that respect.  And then there was Ryan himself. 

His heart was physically sick, but the kid was a fighter.  Alex could see it in how alert and alive the baby was despite his condition.  As they'd sat in the NICU together, Ryan had listened to the details of USC football as if it were the most interesting thing he'd ever heard, smiling when Alex described incredible plays, laughing once when his doctor had tickled him while doing play-by-play on a sack.  Sometimes babies as sick as he was started to lose their personality in the exhaustion of trying to stay alive, but Ryan's had definitely been on full display.

Addison had returned to the NICU two hours and some change after he'd sent her off to sleep, and he was glad to hear that she had actually been able to drift off for at least a little while.  Then it had been her turn to lecture him and send him off to sleep, and Alex had gone without a fight because he didn't want her worried about his fitness in the O.R.  But once he'd made his way into the on call room to try to rest, Alex had struggled to shut his mind down.

The idea of parenthood was so terrifying to him... mostly because of his history, he knew, but also because more and more of his life was spent dealing with all the things that could go wrong.  He'd wondered to himself once, back when Addison was still trying to fix things with her asshat ex-husband, if she'd delayed having kids herself because she was just too close to all the wrong turns the process could take.  But seeing her now, he knew he'd been wrong to project his own feelings onto his mentor.  There was no doubt that if she'd given birth to a baby as sick as Ryan, she'd have dove in wholeheartedly to fight to save the child.  But every time he thought about her choosing to love and fight for this sick little boy when she could have turned and walked away... it amazed him and confused him at the same time.

He wasn't sure he had it in him to make a choice like that.  Sure, if it was his kid, he'd have had to man up, but to willingly take it on?  To know that you were giving your heart away to someone who could die at any moment?  It seemed foolishly brave to him even if he admired the hell out of her for doing it.

Alex glanced at the locker room clock and turned off the shower.  He made a conscious decision to leave his jumbled emotions there in the draining water and made quick work of drying his hair and dressing in his scrubs.  Then he headed to Dr. Ross' office, sure that his boss was making a final review of all the latest material on the aortic resection and ventral-septal closure just in case some new piece of vital information had slipped past him.  It was the same thing Alex had done when he first woke up this morning.

"Play it back to me, Karev."

Ross always asked Alex to repeat the major steps in the surgery before they operated.  He remembered being worried that meant his attending didn't have confidence in his memory before the chief had told him it was a Ross' superstition.  He liked hearing the information repeated back to him by someone he trusted so he could evaluate it and make sure he himself hadn't skipped anything.

"We'll fix the ventral-septal defect first," Alex began.  "That will provide some immediate relief to the distended left ventricle and hopefully ease the strain on Ryan's heart when we take him off bypass and the resected aorta has to be tested."

"Right, right," Ross said absently.  "We need to keep a close eye on that ventricle in post-op."

Alex nodded.  "I put it in his chart notes already.  After we've patched the hole, we move to the aorta, resect the narrowed portion, then perform the reanastomsis."

"Then we take him off pump and we have a working heart."

Ross' statement was matter-of-fact, and Alex smiled in response.

"And then we have a working heart."

Mitchell tapped the top of his desk and then moved to shut down his laptop.

"I'll see you in the O.R."

Alex stood and headed out of the office.  He was at the NICU door five minutes later, stunned to see that instead of finishing the prep for Ryan's surgery, Susan and two of his other interns were standing outside staring at Addison.

"Man, you realize your career is over if you guys kill her kid, right?"

"I heard they used to call her Satan in Seattle.  She must be kind of a bitch."

Alex didn't do them the favor of providing notice of his arrival by clearing his throat or purposely increasing the weight in his step.  Instead he grabbed Susan with one hand and Jack Iger--who had been the least annoying of his interns--with the other and pulled them out of view of the NICU window.  The third intern wasn't one of his, but she followed along anyway, knowing not doing so was probably going to get her into worse trouble.

"If I ever hear anything as stupid as that conversation come out of any of your mouths again, I'll report you to the chief and request you be thrown out of the program, do you understand me?"

To their credit, none of them said a word, clearly too scared to even try to defend themselves.

"Addison Montgomery came here so her son would get the best care possible, not to be gawked at or gossiped about by immature brats who don't know what the hell they're talking about.  And if you think her nickname from Seattle is bad, you should've heard mine.  Now, you," he said, pointing to Jack, "the chief has a few attendings behind on paperwork.  You tell him I sent you to help get them caught up.  And whoever you are," he said, pointing to the random intern in the mix, "be lucky I don't have time to find your resident right now.  It'll give you time to think up something to say when they bust your ass after I find them later.  Now go."

The two minor offenders skittered off, and Susan stood with her eyes lowered looking like she was about to head to the gallows.  Alex thought she should be so lucky.

"I put you on this case because you have good hands and I trusted them near Ryan.  The fact that I think you're a conceited jerk who tries to one-up everyone else in this place?  I let that go because you have talent.  But I swear to God, if we weren't an hour away from cutting that baby's chest open, not only would I tell Dr. Ross about this and yank you off the team, I'd have you up for suspension in front of the chief."

That got her eyes to rise up to meet his, and he saw the first hint of self-defense start to manifest itself.  And he knew that he was basically yelling at himself and his friends... at the very people they'd been once upon a time, but it didn't matter because now he knew better and this wasn't just any patient, and Dr. Susan Chester had made a mistake he wasn't willing to forgive.

"If you open your mouth right now, even though I know it will piss Ross off, I will replace you with another intern in that O.R.  I'll eat his yelling at me, it'll be worth it."

The rise of pride that had almost caused her to speak disappeared, and Alex took a deep breath and fought to maintain some kind of professionalism as he continued her reprimand.

"From now until he leaves this hospital, your whole life is Ryan Montgomery, you got that?  I tell you to check his blood pressure every fifteen minutes, I don't want to hear a peep out of you.  I say do nothing but sit there and watch his monitors and come get me if there's one beep out of sequence, you do it and you do it with a smile.  And if I hear one more word out of you about Dr. Montgomery, I will report you to Ross and he will feed you to the chief on a platter.  You got that, Dr. Chester?"

Susan bit her lip and nodded.

"I'll get Ryan.  You get out of my sight."

The intern did as she was told, and Alex took a moment to breathe in and out and try to get a handle on himself.  When he felt ready, he walked over to the door of the NICU and headed inside.   Addison was sitting in her usual spot next to the isolette, her hand reaching inside so that Ryan, who was sound asleep, could hold on to her finger.  Naomi was standing behind her, rubbing her back gently.  The woman he had clashed with the day before smiled at him now as he moved closer.

"Hey, Alex."

"Hi there.  How's my patient?"

Naomi looked over at the sleeping baby and shrugged.

"Apparently completely unaware of anything but whatever toy he's dreaming about right now."

Addison tried to laugh, but the most she could manage was a quick smile.

"How's my patient's mother?"

She glanced up at him and he could see how she was.  But she pretended she wasn't terrified and ready to fall apart, her free hand pushing her long hair back behind her ear.

"She's, uh... she's glad her little boy has such good doctors."

This time her smile was more genuine, if just as quick, and Alex walked closer and squatted down so they were at eye level with one another.

"You know how this goes, so I'll spare you the diatribe.  I'll have someone come out and update you as often as I can."

"Not you, though.  You stay with him."

"I'll be with him the whole time.  I promise."

Addison nodded and turned her eyes back toward Ryan.  When the orderly entered, she knew it was time, and she began to ease her finger out of the baby's tight hold.  When their physical connection was broken, she stood and leaned down.

"I'm gonna be waiting for you right here, Ryan, okay?  And Alex is gonna take care of you till you're back with me.  I love you."

She stepped away from the isolette when she was finished, and the orderly moved in to help the nurses disconnect the rest of Ryan's monitors, and Naomi stepped up and wrapped her arms around Addison.  Alex waited until the orderly was ready to move, and as he took up his position on the side of the isolette, he looked back at the woman who had been so many things in his life, but who now was a terrified mother hoping that all of this was going to turn out the way she wanted it to.

"I'll get him back to you as soon as I can."

It was the only thing he could think of to say, and even though she was barely breathing, she smiled at him one more time.  Then Alex turned and nodded to the orderly, and they moved toward the door and headed for the O.R. with Ryan.