"A Rush of Blood to the Head"
by Bleu
Chapter One
She knew she was in trouble.
As soon as she slowed down from her frantic dash to avoid being tagged "it" by the despicable Tucker Doyle who never left her alone at recess, she took a deep breath, only to shudder as a tremendous squeeze in her chest cut off her inhale. She tried again moments later to take another breath, but the invisible vice around her heart held her insides in a strangling grasp. Her mouth fell open a bit as her eyes widened in surprise.
"Sadie?" Tucker asked, his smile from a victorious tag fading as his victim stared glassily at him. "Sadie?" he demanded with more urgency when her wide blue eyes clouded over.
"I-I-I…" her vision was fading to black around the edges, making Tucker's concerned face blur into a distorted Halloween mask. His uncharacteristic worry validated what she already knew.
She was in trouble.
"Sadie? Do you want me to get the nurse?"
"No…" and right before she lost consciousness and hit her head on the hard asphalt of the school's playground, she managed, "I want my Mommy."
"What do we have?"
"Eight-year-old female; fell on playground at school and lost consciousness. They couldn't revive her, and the blood concerned the principal, so they sent her here."
"What are her vitals?"
"Heart is racing, pupils are dilated, B.P. is low. She's bleeding pretty heavily, but I think the wound is mostly superficial…"
"Wait a minute…"
"What is it?"
"This…this is Addison Shepherd's daughter! Her name is Sadie!"
"Carol, page Addison Shepherd. And then after you get a hold of her, try to call Derek Shepherd, too. If you can find him, that is."
"Ten blade." Addison Shepherd commanded neutrally, extending a bloodied, gloved hand. Jamie Powell, her best intern, handed it over obediently.
"Do you think he's going to make it?" he asked, peering over her right arm at the painfully tiny infant she was operating on. His voice was saturated with worry, and Addison acknowledged in the back of her mind his attachment to this case. It was important to be involved, but Jamie had a tendency to get over-involved, and too attached. Unfortunately, she knew a remedy for that, thanks to Dr. Richard Webber.
"Well the infected tissue I removed is extensive, and these stitches are still just a little too big for him, but he should be okay as long as that woman is kept away from him. When I'm done, which will be shortly, we'll move him to a secured NICU." She smiled under her mask at him reassuringly. He nodded, relieved.
"Dr. Montgomery-Shepherd?" a voice asked from her peripheral.
"Yes, Ms. Watts?" she responded, identifying one of the head nurses without looking away from the baby.
"There's…you're needed in the emergency room and you weren't answering your page." The normally composed, professional woman informed her.
Addison creased her brow. "I have a three-month-old baby with a bacterial infection on the table. What did you expect me to do?"
"It's…it's an emergency." Carol Watts returned.
"That would be why it was in the emergency room, wouldn't it?" Addison looked up now, as she waited for Jamie to hand her the stitches, with annoyance in her eyes as they glared at the woman over the white surgical mask. She normally would have been less abrasive, but her evening had been…difficult.
"Well, yes, but…"
"Is it something my intern, Dr. Powell, could handle?" she interrupted once she went back to stitching up the wounds.
"Well, under normal circumstances yes."
"Then why do you need me?"
"It's your daughter."
She paused mid-loop.
"What?"
"She…she's in the emergency room with head trauma."
Sadie? No... She took three breaths before turning her attention, composed she hoped, to Jamie.
"Dr. Powell?"
"I'll take it from here, Dr. Shepherd."
She watched him finish the first few stitches, then she bolted from the room, ripping off her scrubs in the meanwhile.
"Ms. Watts, get me a telephone."
Holly Carlisle was having a bad day. She'd been vomited on twice, and a case of bowel blockage had just resolved itself—on her scrubs and in her blonde hair. She was trying to collect herself—post shower—behind the nursing station with a candy bar and a magazine when the most attractive man she ever had the pleasure of laying her eyes upon breezed up to her station.
"Hello, I'm Derek Shepherd, I'm looking for Addison Shepherd…" he said hurriedly, the words so quickly forthcoming from his lips they seemed to collide and fall upon each other.
She took a minute to examine his just-so tousled black hair, probing blue eyes, straight perfectly-shaven jaw-line, and realized she envied Addison Shepherd more than just her fantastic wardrobe, eternally long legs, and gorgeous hair.
This man seemed in quite a hurry to be in her company.
"She's right down the hall in Peeds. Room 305." Holly resigned herself, watching his face shift in anxiety.
"Thank you." And he was gone.
It's not true what they say. Red heads definitely have more fun.
As Derek nearly sprinted down the corridor, he nearly crashed right into Addison as she exited the bathroom. She had been crying.
"Derek!" she exclaimed, wrapping her shaking arms around him instinctively.
"Addie! What's going on? Where is she?" he asked, returning the embrace and taking a moment to breathe in her smell. Even after hours of surgery, she still held that same sugary whisper as when she would come out of the shower, steam rising from her skin…but he couldn't think about Addison and her scent right now. Or at all.
"She fell on the playground. She told me she tripped and fell. They couldn't bring her around at first. She has a nasty gash, and they did an MRI but couldn't find a hematoma." Addison explained, her voice shaking but her resolve to stay calm winning out.
"If she fell hard enough to lose consciousness, she has to have one somewhere." He told her, a question in his voice, as they moved toward Sadie's room.
"I know, Derek, but I saw the scans myself. There isn't one." Addison emphasized, her voice edgy.
"All right, all right. Addie, that's a good sign, what's wrong?" he asked, wondering what she wasn't tell him.
"I was scared Derek! They came into a surgery and told me she was in the emergency room with head trauma!"
"That wasn't a very good idea. I'm sorry, Addie." He said quietly, looking at her with soft, unspoken consolation in his eyes. She looked back at him for a brief moment, and then glanced away from his beautifully comforting eyes.
"I'm okay, I'm just…glad you're here."
"Me too." He agreed under his breath. He wouldn't push the matter. He wouldn't mention what had been said the night and morning prior.
Addison pushed open the door to the room just then, and his eyes met his daughter's. "Hey, baby."
"Hi, Daddy." Sadie smiled her crooked little half smile that made Derek melt. He gently wrapped an arm around her and kissed the uninjured part of her forehead. She looked up at him with Addison's wide, intelligent blue eyes from under a curtain of impossibly silky, slightly wavy black hair he knew could have come right out of his head. She nuzzled slightly under his arm, and a warmth rose in him, coupled with a chilly worry.
"What's going on here, Evil Kenevil?" he asked lightly, though tightening his embrace.
"Aw, Daddy, I only fell. I didn't jump the Grand Canyon." Sadie joked, smiling, even though her head was pounding. Her father and mother were in the same room in the middle of the day with her. Despite the circumstance, she still found herself smiling.
"Not yet, anyway." Addison quipped, sitting next to her daughter and brushing her hair delicately from her face. Sadie grinned slyly at her mother in response, another damnable trait courtesy of Derek. Usually it earned a scowl or even a playful slap on the arm when it came from Derek, but Sadie only got a pursed-lipped smile.
"Hi, Dr. Shepherd, I'm Dr. James Ianello." The young man who had been examining a chart at the desk nearby finally said, extending a well-manicured hand in obvious reverence. "Big fan, if you don't mind me saying and it doesn't sound too much like a groupie."
"Hello, Dr. Ianello. Thank you." He returned sincerely. "But uh, what's the story with my daughter?"
"Well, Sadie told me she was playing tag, ran, tripped, and fell. She fell forward, and hit her forehead, directly on the left temporal lobe. She lost consciousness for a half hour, according to her principal and the attending in the emergency room. Fortunately, somehow when she came to, her memory was intact, her speech and vision were clear. We also found no hematoma anywhere in her brain. Just a mild concussion." Ianello explained, but it seemed when he stopped, he had done so mid-speech.
"From what you're telling me, that sounds great. But your tone is suggesting otherwise."
"Well, when Sadie came in, her heart rate was at 180 beats per minute." Addison added, taking Sadie's hand.
"Okay…suggesting?" Derek asked Ianello.
"We ran some tests, and her oxygen level in her blood is low, and the on-call nurse noticed a bluish tint around her nails and fingers when she first arrived."
"He asked me if she had been diagnosed as a baby with any heart-related illness." Addison told Derek, still holding Sadie's hand as the little girl sat staring at the floor, suddenly sullen.
"But she wasn't. So what…what do you think is wrong?" Derek asked, more agitated.
"I'm not entirely sure, but if I could ask Sadie some questions?"
"Of course."
Ianello nodded, and took a seat on the stool in front of the bed. He wheeled over, eye-level with Sadie, and casually took her pulse using the hand not being held by Addison.
"Sadie, do you ever feel tired when you're playing? Sooner than your friends?" he asked, equally as casual as his touch.
Her eyes were softened when she murmured, "Sometimes…yeah."
"How about pains, like in your chest…right here?" Ianello asked, indicating her heart area.
Even more hesitantly, Sadie replied, "…Yes."
"Do you ever get blurry sight? Ever have trouble seeing right after you're done playing?"
"Yes." She responded quickly, looking miserably between the increasingly concerned expressions of her bewildered parents.
"Honey, what's the matter?" Addison asked when a few tears fell from Sadie's eyes. Sadie only shook her head, and Ianello leaned back, folding his arms.
"Sadie…did you really trip today? Or did something make you fall?"
It was Derek's turn to crease his brow. He looked at Sadie's guilty expression, then ran over the facts in his head. Then he looked to Addison, who obviously made the same calculation. But Sadie spoke before either of them did.
"Something…something made me fall."
"Why didn't you tell the nurse?" Derek demanded, his expression slack with worry.
"I didn't want to…I don't know…" Sadie whimpered, taking her hands and scrubbing roughly at her tearing eyes.
"Has it ever happened before, honey?" Addison asked quietly, taking her daughter's hands down and dabbing them lightly with tissues.
"…Yes."
"Sadie! Why didn't you ever tell us, baby?" Derek crouched down next to the bed, his voice tight with distress.
"I don't know…I thought it would go away. I didn't want you to worry." Sadie replied sadly. "You both have other patients who would die without you. I didn't think I would die…"
"Oh, honey…" Addison collected her daughter in a hug, stroking her hair.
"What does this mean, Dr. Ianello?" Derek asked as he rubbed his temples.
"I certainly would hate to speculate before conclusive testing."
Both Derek and Addison knew what that meant. Their daughter was in trouble.
"Derek?"
Addison's voice slid through the darkness tentatively. It didn't startle him—he was wide-awake. He had been for hours, and anticipated being so for the next few, as well.
"I'm awake. What is it?" he replied softly, not wanting to awaken the finally sleeping Sadie in the bed across the room.
"…I'm afraid." She replied into the blackness of the room. He moved his head to look at her striking silhouette against the light from the city outside that refused to be blotted out. Her hair was knotted loosely at her neck, and she was tugging at it nervously. He couldn't see her eyes, but he was sure they were still puffy and red, and looking right at him.
"So am I, so am I." he agreed, feeling her worry.
"When they told me she was in the ER…I didn't think I could ever be that frightened. But then…when Ianello…they want to do heart surgery, for Christ's sake. On Sadie." She shifted, and he watched her pull the blanket around her tighter. "I keep thinking how hard I've worked all these years to be good at what I do. I'm not immodest to say I'm one of the best neonatal specialists around. I worked hard for that, and now…"
"It doesn't make a difference, because you can't help her." He finished for her, his distress obvious. "I know, Addie, because I've been thinking the same thing all night."
This silenced her for a moment. Never in either of their lives had either of them felt so helpless.
Addison watched her husband suffer this new emotion, his beautiful face clamped with anguish.
"What are we going to do?" she murmured finally.
"Ebstein's Anomaly is treatable, we have to remember. And we're going to get the best heart surgeon out there to treat Sadie."
"Where?"
"Hello?" a sharp greeting, indicative that the individual delivering it had better things to do than answer a personal phone call.
"Hi, Richard, it's Derek." Derek responded, his head jerking up from it's lolling position, a result of waiting nearly a half-hour to speak to this man.
"Derek Shepherd? Well, I haven't heard voice in a long time! How have you been?" Richard Webber relaxed visibly. Any other call, he would still be wrapped tightly in tension, but Derek Shepherd had one of his favorite interns. Next to, of course, Addison.
"I've been pretty good, how have you been? How's Adele?"
"I've been good. You know how it is. And Adele's great…she's always great." He paused, not wanting to delve into the various aspects of his complex marriage right now. Instead, he changed the subject. "How's Addie?"
"She's…great too." Derek replied, pausing for the same reason Richard had. He and Addison hadn't spoken about the other night since Sadie had been diagnosed, so it had been easy to forget.
"What about your little girl, Sadie? She must be what—eight now?"
Derek's eyes drifted to the hospital room. Through the window, he saw Sadie curled in bed on her side, her hair a dark tangled cloud around her head as a result of restless sleep, and Addison, sitting next to the bed but with her head resting on her arms, which were wedged right next to Sadie.
"Yeah, she's…she's only eight." He told Richard softly, with a pang in his heart. "Really tall, really smart, sometimes too smart—a spitting image of Addie."
"She always was, even when I saw her last, and she was just a little thing then." Richard thought fondly of the little Shepherd but noted Derek's apprehension, and asked, "So as much as I enjoy the reminiscing, to what do I owe this pleasure, Derek?"
"Actually…it's about Sadie."
"Really? What's the matter?"
"She was diagnosed yesterday with Ebstein's Anomaly. It's severe—they're talking tricuspid repair surgery." He had started out calmly, clearly, but by the end of the sentence, his voice had choked up and was barely his own.
"Oh no." Richard closed his eyes slowly, and shook his head. "Derek, I'm so sorry."
"Thanks, Richard." Derek cleared his throat. "The reason I'm calling is I know Preston Burke is in Seattle working for you, and I know he's the best cardio-thoracic surgeon out there right now. I also know getting to him for a consult and surgery is damned near impossible. I was hoping there was something you could do to help."
"Of course, Derek, I'd be more than happy to."
"Thank you, Richard, thank you so much. You don't…I'll find a way to repay this favor."
"That's unnecessary, Derek. This is your and Addison's little girl!"
"Still…thank you, so much." He couldn't take his eyes off of the sleeping form of his daughter.
"All right, I'll let you know as soon as possible. How…how are you handling all of this?"
"Right now," Derek replied, thinking of his only daughter, but also of his equally fragile relationship with his wife. "I'm dealing with the medical aspects, aspects I'm familiar with, so I'm all right."
"What about the non-medical aspects?" Richard asked in the voice of a friend.
"Just let me know as soon as you can, please, when Dr. Burke can see her."
A/N: So this chapter was a little boring, and long…I know. But it's going somewhere, hopefully somewhere good, so stick with me! Support, ideas, criticism, and general observations are appreciated hugely. Thanks!
And in case this wasn't clear- I'm writing a scenario in which Derek and Addison had a child earlier in their marriage, pre-Mark/Seattle, and they still live in New York. The interns we know and love, who I promise will be soon involved, are in Seattle and all is normal there, sans the Drs. McDreamy. Okay...so that's it. More to come!