"I officially want to stab myself in the eye with my scalpel," Erin declared.
Alex chuckled from where he was sewing the hole in Lydia's diaphragm shut while Erin and Arizona tried to put some stitches into the stomach to keep it from moving up again.
"It's the worst diaphragm in the world," Alex said. He groaned as the stitch he'd just done pulled right through the muscle. "I am doing my most delicate stitching and it's not working. The muscle is falling apart. She needs a transplant," Alex said.
"Nobody has ever transplanted a diaphragm before and I don't think this is the right person for us to test it on," Arizona said.
"Do we have any other options?" Alex said.
"We could try 3D printing an enforcing wall, maybe? Like Cristina printed the thing for the heart?" Arizona said.
"We're going to need a shit ton of them made in so many different sizes so we can see which one fits best, and then there's the risk of contaminating all of them while we move them down here," Erin said.
"Where could we find a diaphragm for a transplant?" Alex said.
"Well, we'd need to find someone the same age who has the same blood type and then we'd need to wait for them to get into the position we need them to be in to take it, which might not happen because what parents of an eight year old are going to let us take their child's organ to attempt a transplant nobody has ever done before?" Erin said.
"Can we make a fake diaphragm? Or grow one? We grew a trachea," Alex said.
"It's literally falling to pieces in your hands. We're going to have to replace it with something," Arizona said.
"Erin, swap with me. You're better at the tiny stitches," Alex snapped.
Erin sighed and swapped places with Alex, starting to attempt to suture the hole up herself. The diaphragm wall was falling to pieces in her hands and she knew this wasn't good at all.
"What if we take some muscle from somewhere else and use it to block off the hole?" Erin said.
"Might reject it," Alex said.
"Same risk as a transplant or building her a new one," Erin said.
"It might work. Where would you take it from?" Arizona asked.
"I don't know. Any muscle that's stronger than this one?" Erin said.
"We can consider it. Can you close her for today?" Arizona asked.
"I can, but it won't last. She's going to have to stay in bed so she doesn't tear the stitching or move her muscles and induce another hernia. So, we're going to have to be quick. They said she wouldn't make it to thirty, but she won't make it to nine at this rate," Erin said.
"We'll think of something," Arizona said.
"We're going to have to," Erin said, a grim look on her face. "Or this kid is gonna die," she said.
Erin stared at the scans lining the walls of the CT lab she'd claimed to work on Lydia's condition. She had stacks of books open on the research of the treatment of this hernia condition, but there were only three hundred deaths reported a year for this and most were in children, as nobody knew how to treat them.
She knew it was late, too. Arizona had filled Meredith, Amelia and Maggie in on what was going on, so the three of them had taken the Grey-Robbins kids home while Arizona was currently in the library gathering more books on hernia conditions and Alex was phoning surgeons across the country who'd dealt with patients like this.
"Knock knock."
Erin didn't look away from the scans.
"You know, saying knock knock is stupid. Just fucking knock," Erin said.
"I know you're stressed right now, so I'm not going to shout at you for that," Bailey sighed, sitting on a chair beside Erin. "I found Arizona carrying a total of seventeen books, with a horde of interns having even more. She's sent them to find any research on hernia conditions they can in kids, and the treatment. I asked why, so she told me about Lydia," Bailey said.
"She's going to die," Erin said, voice monotone. "I have no fucking idea how I'm going to save this kid's life, Bailey. Like, seriously, her diaphragm is disintegrating as we speak. She will die if I don't come up with something and I can't fucking come up with anything," Erin said.
"You've only had this case for one day, and she was rushed into surgery pretty quickly. You haven't had time to think," Bailey said.
Erin looked at Bailey with a frown.
"Bailey, in my intern year, I pioneered an entire surgery to do heart grafts in utero, with three different ways to do it. I did that while being in an abusive relationship. And then I decided I'm gonna try and cure cancer, and I managed to save a little girl's life when her parents thought she was going to die like her big brother did. I'm still saving lives because of the people using my research, and I did that while I was pregnant with Rueben. And now, now Katelyn and Brianna are here because of the reputation I've built and I have no fucking idea how to save their kid," Erin said.
"Erin-"
"I'm serious, alright? Like, not once have I ever not known what to do when it came to a surgery or anything medicine related. Even when my personal life was literally living hell, I found a way to do it. And I don't know what the hell to do, and this kid cannot die because of me because she is Jesse's ex wife's kid and I feel like I have some fucking obligation to Lydia's moms not to let her die because, fuck, if it was my kid in this position and they were me, I would've gone to them for help, too," Erin whispered.
"Erin, stop," Bailey said, grabbing Erin's hands.
She pulled Erin's chair so Erin was facing her, putting her hands on Erin's knees.
"Erin Elizabeth Grey-Robbins, you are the smartest person I know. The day I met you, you fell over and cut your head open enough to need stitches and helped solve a case that Derek Shepherd couldn't solve. I had my doubts about you interns, but I never had a doubt that you would go on to do amazing things," Bailey said.
Erin's eyes dropped to her knees, tears streaming down her cheeks.
"You're right. You always know what to do and the fact that you don't know is throwing you right off. But you never know what to do when you're faced with something new. You just usually figure it out pretty quick. So, how do you usually figure it out?" Bailey said.
"I, uh, I don't know. It's just usually there in my head, but I've never seen this before," Erin mumbled.
"You had never seen a successful method for that surgery in utero before you made one. You hadn't seen a treatment for that little girl's cancer before you made it. You've never seen a treatment for this condition, but if anyone's gonna get it, it's going to be you. What do you need me to do?" Bailey asked.
Erin sighed and rubbed her face, wiping her tears away.
"Her diaphragm is literally disintegrating because of the hernia's pushing through it and making her get constant surgeries. If we can put a reinforcing wall in, or transplant one, or just find something to go there, we can take out the part of the stomach prone to causing these hernias and she'll be able to live a semi-regular life with just a few check-ups a year to make sure they aren't coming back," Erin said.
"Okay, so, let's look at similar treatments for other hernia conditions on other organs. Something might help and, if it doesn't, it still helps us cross a few ideas off the list to narrow it down," Bailey said.
"We still won't be quick enough," Erin said.
"How much time does she have?" Bailey asked.
Erin looked up at her, green eyes filled with tears again.
"Based on her surgery today? She hasn't even got to her ninth birthday in three months. I need to figure something out so I don't have to go and tell two mothers their kid is gonna die," Erin said.
"Then we're going to figure something out. What books have you read?" Bailey said, looking at the stacks of books open everywhere.
"All of them. I've wrote all the possible ideas down on the notebook on the table, but there are also about eighty cons for every one and two pros, maximum," Erin said.
"Okay," Bailey sighed, grabbing the notebook. "I'll read this, you go and find your wife and best friend. Last I heard, Karev was shouting down the phone at a doctor who tried to talk him out of solving this," she said.
"Of course he was," Erin mumbled, getting to her feet to go and find Alex and Arizona.
"Do you know what I realised last night?" Erin said, shifting Natalie and Jasmine on her hips as she paced the lab the next morning.
"What?" Meredith looked up from the notes Erin and Bailey had spent all night making.
"This is the first time I've ever looked at a case and thought there was no way to solve it. This has never happened before. Is this gonna be the thing that ruins my streak of genius? Is this gonna break me?" Erin said.
Meredith's hands stopped turning the page and she sighed, putting the notebook down. She stood up and walked over to Erin, taking the twins and sitting them on the floor where Erin had set up some toys for them to play with during their break from the daycare.
She looked back at Erin, who had never looked more lost in her life, even after everything she'd been through. Erin had never looked more defeated and Meredith's heart broke for her baby sister.
"Er-bear, you can't save everyone," Meredith said softly. "You are not god or whatever power that chooses who lives and dies. You can't always win, but that's okay. Every surgeon knows their limits and what they can and can't fix. You've always had a higher limit than any surgeon I've ever met, even mom, and I know this is killing you, but it's okay if you can't do this. It's okay," Meredith said.
Erin stared at her for a few seconds before something changed in her face. It was like a lightbulb went off above her head.
"Mind the twins," Erin said, running out of the lab.
Meredith blinked a few times before looking down at Natalie and Jasmine, who were staring at her with wide eyes.
"Mama?" Jasmine said.
"She'll be back, I think," Meredith said, scooping her nieces up again. "For now, how about we go and find your mommy?" she asked.
"Mommy!" Natalie beamed, nodding her agreement.
"Yes," Jasmine giggled, tangling her hands in Meredith's hair gently.
"Then let's go," Meredith smiled, kissing their foreheads.
"Richard Webber," Erin skidded to a stop in the OR viewing room, pressing the red button for the intercom.
Richard slowly looked up from the surgery he was doing with Nathan Riggs on a cardio and general patient.
"Erin Grey," he said.
"Where are my mom's diaries?" she asked.
"Meredith gave them back to me after she finished her research before Yang left," Richard said.
"So, your house?" Erin said.
"Key's in my coat pocket in my office. They're in my home office," Richard smiled.
"Thank you!" Erin said, darting back out of the viewing room.
"Do I want to ask what that was about?" Riggs looked at Richard.
"I wouldn't even be able to tell you," Richard shrugged. "I've learnt that it's best not to question Erin Grey when she's in Ellis-mode," he said.
"Ellis-mode?" Riggs raised a curious eyebrow.
"When Ellis used to have an idea, she wouldn't be able to focus on anything but that idea. She would stop at nothing to bring her idea to life. Erin is exactly the same as her mother when she has an idea," Richard said.
"I suppose that's how she's the surgeon she is," Riggs said, looking back at the heart he was operating on. "I read about her surgical method in her intern year when she made it. I've performed it a few times myself. It's more advanced and safe than any other method created within the last thirty years of cardio history. Not to mention the fact she helped find a faster treatment to cure a little girl's cancer. Everybody read that article when she published it," he said.
Richard chuckled as he moved aside to let Riggs finish the surgery, his part finished.
"She's a very special woman, Erin Grey. I'm very proud to know her," Richard said, leaving the OR with a happy grin to scrub out.
"I think I have an idea," Erin burst into the lab a few hours later, arms laden with her mother's diaries.
Arizona and Alex looked up from their research. Jo Wilson was fast asleep on the sofa, the twins sprawled on her chest napping.
"You do?" Alex said.
Erin nodded, dumping the diaries on the table in the middle of the room.
"I remember Meredith saying my mom had been working on a few things in her diaries, but Mer picked the portal veins. So, I thought, you know, maybe my mom would've looked at something to do with hernias or the diaphragm or just maybe some little piece of wisdom would be in here for me to get an idea out of," Erin said.
"And did she? Did you find anything?" Arizona asked.
"No," Erin shook her head. "Fuck all, actually. That woman was obsessed with portal veins, though. What a psychopath," she said.
"Then... Then why are you so happy and how do you have an idea?" Alex asked.
"Because I was reading all of her work and it was burning my head, to be honest. I mean, she's so self obsessed, talking about how good it would be for her if she pulled this off. Her fucking ego is horrific. And then I realised that I also kind of have her ego because, well, I've pioneered an entire surgical method and found a treatment to cancer and helped Bailey with her genome therapy," Erin said.
"Okay... I'm not following you, baby," Arizona said honestly, a confused look on her face.
"I realised," Erin said, "that I can't save everyone. I can't. I'm not god. But that doesn't mean I'm giving up. So, I think we should look at taking a part of the diaphragm in her, taking stem cells and growing her a new diaphragm. When it's half grown, or it's big enough to completely cover the worst part, we transplant it into her chest and let it grow," she said.
"But what if a hernia comes again? It'll break right through it before it's strong enough to stop it. It'll just wear down again over time," Alex said.
"No, it won't. She's getting hernias in her stomach, which are moving upwards into her chest because of the diaphragm. You're right, if a hernia grows again and breaks through the diaphragm, we're back at square one. But, what if she didn't have to worry about getting hernias?" Erin said.
"What are you proposing?" Arizona said. "A stomach transplant?" she said.
"We don't do stomach transplants. We just cut off the cancerous area and they eat through a tube," Alex said.
"We're not going to do either of that to her," Erin rolled her eyes. "We're going to take a part of the healthy stomach and we're going to do the same cell therapy to it as we'll do to the diaphragm. Then, when we go in to implant the new diaphragm, we take out the area of the stomach that's causing the hernias and we put the new stomach in there to replace it. She gets it all done at once and we give her the anti-rejection medication, but it'll be made from her own cells, so the chances of rejection are so much lower," Erin said.
The two of them looked at her for a few seconds before nodding.
"It could work. It's complicated, but it could work," Arizona said.
"It could. Only problem is, about eighty percent of the stomach is bad. We take the remaining twenty, or even ten, to grow her a new stomach and she's gonna need a feeding tube. She won't be able to leave the hospital and we don't know how long it'll take to grow," Alex said.
"Then we need to work out the exact way we're going to do this. We need to get the stem cells and look at how quickly these things will grow and get approval from the FDA and her mom's, and then start the entire thing. We need to know exactly how this will work for Lydia and, honestly, we're on a timer," Arizona said.
"Okay," Erin crossed to the whiteboard they'd brought into the room and grabbed the pen. "Arizona, I'm gonna write the method down. You need to research rates of growth with stem cells for stomachs and diaphragms, or any organ, actually. Anything helps. Alex, wake Wilson up and send her to get us coffee and put the girls in daycare, and then she can come back and help you with planning the surgery to take part of the diaphragm and stomach and whatnot," Erin said.
"You got it, boss," the two of them chorused.
Erin carried Natalie down the stairs the next morning, Meredith carrying Ellis while Maggie carried Jasmine. Arizona had taken Archie, Zola, Bailey and Rueben to kindergarten/pre-k already, while the three sisters (four, if they could find Amelia) were handling taking the babies to the hospital with them.
Arizona had forced Erin to come home last night after they'd ran tests and scans on Lydia, so they were meeting later to talk about them.
"I'm sure Amelia's up. Let's just wait," Maggie said.
"No. If my kids can get up and dressed on time, then so can she," Meredith said.
"We can't just leave her," Erin said.
"Yes, we can. She's made me late too many times. She knows better than to be late for carpool," Meredith said.
The three adults and babies stepped into the hallway, Maggie looking into the living room. Her jaw dropped.
"Don't look," she said quickly.
"What?" Meredith and Erin said, looking into the living room.
Owen and Amelia were naked and having sex on the couch. Erin quickly covered Natalie's eyes, giggling as Ellis started crying.
"Oh!" Meredith gasped, staring at Owen's area.
"Uh... Oh, uh..." Owen grabbed a pillow, covering his bits.
Meredith and Maggie left the house, laughing to each other, while Erin smirked at Amelia, who was bright red.
"We'll wait, but hurry up and get your ass in the car. Preferably with clothes on. My babies don't need to see any more of this," Erin said, laughing as she headed out to the car.
"We fell asleep," Amelia tried to explain.
She was sat in the very back of Meredith's seven seater car, Ellis strapped into her carseat beside her. Erin was in the middle row, her daughters on either side, while Maggie was in the passenger seat and Meredith drove.
"Someone was awake," Meredith said.
"Yeah. Major Hunt reporting for duty," Maggie smirked.
"Can we not talk about it?" Amelia mumbled.
"I don't know why you're embarrassed. We should be congratulating you. Now I know what Cristina saw," Meredith said.
"I think we all learned something today," Maggie said.
"A big something," Erin agreed. "I'm so gonna tell Arizona," she added.
"I'm gonna grab a different ride home," Amelia groaned.
"Don't worry. I'm sure after this morning Owen will want you guys to spend the night at his place," Maggie said.
"No, I'm not gonna see him tonight or any night. That... that was the last time. We cannot be in a relationship. I've got too much stuff. Owen's got too much stuff," Amelia said.
"Yeah, we all saw his stuff," Erin said.
"Yeah," Meredith said.
"Yeah," Maggie and Amelia said.
"Wait. Shut up," Amelia poked Erin.
"Nice one," Meredith smirked at her sister, who smirked back.
"Thanks," she said.