"Grey. 911"

Just one beep of his pager, and without warning those seven characters brought Alex's entire world skidding to a stop. He was in surgery, working with Robbins when the page came through. Some blonde intern- Cross, he had heard Arizona call him- read the message at his request. "What?" Alex asked, confused. It was barely 9 am; he had carpooled with Meredith just an hour earlier. She had gotten to the hospital before him, but only slightly. He had seen her jump out of the back of her rig and rush inside to run the trauma.

"Meredith?" He asked, brows furrowed, turning to face Cross. "What, like her patient? An emergency consult?"

"I- I don't know, Dr. Karev. It just says Grey 911." As he finished speaking the pager vibrated again, and he read the next message, looking up at Alex questioningly. "Trauma 3." Alex felt the muscles in his jaw twitch as he tried to suppress a wave of rapidly rising panic in his chest and keep his expression neutral. He must not have done a good enough job, though, because Arizona shot him a worried glance.

"Just go." She murmured, her voice low and concerned. "I can finish up here."

She must have felt it too; Alex thought as he nodded voicelessly in thanks and stumbled through the doors to the scrub room, tearing off his gown and mask and gloves as he went; the dread. The unignorable fear that though he tried to be rational, compelled him to rush through his scrub as quickly as was sanitary and move toward trauma three at a jog.

He knew it was bad when he saw Jo outside the room, waiting to intercept him as he reached the door. Her face was ashen and when her tear-filled eyes met his, the knot of dread in his stomach tightened.

"Alex, wait-" She reached out for his arm. Trying, he thought, to slow him down. Maybe wanting to prepare him for what he was about to see. But he couldn't wait. He brushed past her, her fingers grasping ineffectually at the edge of his sleeve as he burst through the door of the trauma room. Nothing could have prepared him for the scene that was unfolding before him. Meredith's broken, bloodied body lying motionless on the bed, limbs at odd angles, while a team of doctors run a trauma protocol. The floor seemed to drop out from under him and he clutched at the doorframe for support as his knees threatened to buckle. Visceral, painful memories that he thought he had blocked out came rushing back, of the last time he had seen her this lifeless. When Shepherd had pulled her out of the Sound, dead and limp and cold. For a moment, all he could see were her blue lips and all he could hear was the screaming of the flatline from her heart monitor. The memories trapped him, clouding his vision and ringing in his ears. He stood there, frozen in the doorframe for what felt like an eternity but must have only been a moment.

"Karev." Webber's voice dragged him suddenly out of his memories. Kepner and Owen had also glanced up at the slam of the door bursting open and hitting the wall and each met his horrified stare with varying looks of concern and pity. Not bothering to respond, Alex quickly glanced at all of Meredith's monitors, getting a quick snapshot of the severity of her condition. It didn't look good; her oxygen levels were steadily dropping, and her blood pressure was far too low. Jaw working as he fought back tears of anger and helplessness, he forced himself to move to stand by Meredith's head. Carefully out of the way of the fevered activity of the room, he ran a trembling hand over her bloody hair and fought to keep his breathing steady. The voices of the others swirled around him.

"Her vein's collapsed. I can't get in." Warren pronounced grimly.

"Run a central line!" Webber ordered.

Desperate for something, anything to channel his helpless anger into, Alex heard himself volunteering.

"I got it." His voice sounded gruff to his own ears, and he was grateful when Webber didn't try to fight him or uphold the policy of not working on family. Everyone in this damn room was her family anyway. He was securing her I.V. when Kepner announced, with audible relief, "She's back!"

His fingers managed to complete the task through sheer muscle memory, and he rushed immediately back to stand behind Meredith's head again, his hands gingerly cupping her face in what he hoped was a steadying caress. Her neck was immobilized by the c spine brace, but her eyes, wide with panic and wild terror darted around the room. He moved his hands to her shoulders and leaned forward into her line of vision. Her gaze found his frantically and the sheer depth of pain and panic that he saw there nearly wrecked him. He tried to smile reassuringly for her, but his face wouldn't obey and the most that he managed was an upward twitch of his lips that didn't quite meet his eyes.

"It's ok, Mer." He breathed. "I know. I know. I'm right here." The others paused what they were doing as well to reassure her that they had her, to inform her of what they were doing, but she didn't respond. Her eyes still darted around the room, empty and confused. Alex vaguely heard Stephanie urge Meredith to wiggle her fingers or toes, and he glanced up in panic when there was no response.

"Come on, Mer." He pleaded. "Please." There was still no movement and Alex gripped Meredith's shoulders a bit more tightly, this time to anchor himself as the entire room began to spin. "…neurodeficits?" he heard someone ask over the pounding of his heartbeat in his temples.

"No, it doesn't make sense." He heard himself answering, his voice sounding desperate and pleading. "She was responding to painful stimuli!" One hand flew up to cover his mouth, holding back the bile that suddenly burned in his throat. It left a smear of Meredith's blood, sticky and warm, when he pulled it away. He glanced down to see where she was injured, and realized with a jolt that the blood was coming from her ears, dripping down across his fingers a moment ago as they had cradled her face.

"You guys," Alex choked out, simultaneously horrified by this new revelation, and relieved at the possibility of no deficits. "I don't think she can hear us." Stunned silence stilled the room for a breath, and then Jackson muttered, "Are you sure?" and grabbed an otoscope to examine her eardrums. A few moments later, he confirmed Alex's suspicion, "Barotrauma. Both eardrums. There's no way she has any hearing right now."

Without warning, the shrill shriek of Meredith's oxygen monitor pierced through the noise of the room as her body began to buck under his hands and he watched her eyes roll back in her head. "She's suffocating!" Alex barkerd, and witnessing her pain, suddenly he was too.

"Her lung is collapsing!" Owen shouted, "We need to get her intubated now!"

Alex stumbled backward into the window as Jackson shoved him roughly out of the way and straddled the gurney to pop Meredith's jaw back open. The scream she released before blacking out from the pain was raw and guttural and excruciating; and it wrecked him. He felt like it had been torn right out of his own gut. He hated being so freaking powerless to help her, to protect her… His stomach heaved and he lunged toward a biohazard disposal bin, retching again and again until he felt empty and shaky and lightheaded. He was aware of the rumble of gurney wheels and a sudden gust of air as Hunt and Webber rushed an unconscious Meredith past him to emergency surgery, but when he moved to follow them, black spots swam in front of his eyes. He felt the world tilting as he pitched forward, bracing himself for the fall, but instead of hard ground he felt kind hands firmly grabbing his shoulders, guiding him into a seated position against the wall and holding his head between his knees. It was Robbins; he could hear her through the rushing in his ears telling him to stay down, coaching him to breathe.

"All right. Deep breaths, Alex, ok? You're doing great. Just breathe. Breathe with me."

She sounded calm, and he tried to focus on her voice, and on matching his breathing with hers. Eventually, the world stopped spinning and he slowly lifted his head to rest against the wall. He could feel Robbins' concerned gaze on him even with his eyes shut, but he was too far gone to care how weak he looked right now, or what she must think of him.

"If she doesn't make it through, I…" His voice caught, sounding low and rough and desperate. He cleared his throat and tried again. "I've already lost her once." He breathed. 'I can't ever lose her again." He opened his eyes to find Arizona's, braced to see judgement or disdain there in response to his rare vulnerability. But his friend's face was as worried as his own and her stare held only knowing sadness. She didn't say anything, but he didn't need words. All he needed was for Meredith to make it off of that operating table.