♤Season 9, Episode 12♤
Angela leans over the nurses desk in the front as every one gathers for a meeting when she hears a laugh from behind her, "You okay? You look like you are about to give birth."
"Don't tease me. This baby takes after his father and everything needs to happen at his pace," She complains to Callie and Derek as they stand next to her, "I swear if I could reach in and break my own water, I would."
"Why don't you just get induced?" Callie questions.
"Because I'm only a couple days past due. If this goes on any longer, then I will be. Until then, I am content to be in never ending discomfort and annoyance."
Derek snorts, "Seems like it."
Angela glares at the neurosurgeon, "Careful or I will stab you with that pen."
Meredith chuckles from her chair behind the desk, "You have my permission if that makes it easier."
The three women share a laugh as Derek just shakes his head and looks up as Owen starts the meeting on the stairs, "Okay, folks, let's just start. As many of you know, Seattle Grace Mercy West has suffered a financial setback. The administration is working hard to keep the impact of that setback as small as possible. To that end, we're gonna have to initiate some cost-cutting measures. The Board has hired a Physician Advisor to help."
"What's a Physician Advisor?" Meredith asks.
"Well, she consults on maximizing efficiency, streamlining processes, assessing where we can trim our budgets."
Bailey pipes in, "Who to fire and when to fire them?"
Owen clears his throat, moving past her comment, "She's here to advise and to help. I was hoping to introduce her in person, but she seems to be late."
Angela looks up from her position, "On her first day?"
Cristina finishes her thought, "Not very efficient."
The others laugh as Owen continues, "You can expect to see her in the halls, in your labs, in the OR."
"So we're gonna have an accountant following us around in the OR?" Derek asks.
"She's not an accountant. She is a trained surgeon."
"Who went over to the dark side as an accountant?" Angela guesses, feeling a kick from baby boy.
Owen just sighs, shaking his head, "Thank you for your cooperation."
Angela goes back to leaning over the desk and cradling her bump, groaning before feeling a hand messaging her back, "You really should think about going on maternity leave."
"Alex, if I've told you once, I've told you a hundred times, as long as I'm walking I will be working. Now, we have a patient, let's go."
"Yang can take it. You should rest and relax so that he'll-"
"If you try and tell me what is good for my baby, my body and me again, you'll have to have a stapler removed," Angela threatens before standing up and starting to waddle to the peds floor.
Alex looks to Cristina and Callie who are still standing around, "Anybody want to trade."
They both shake their heads, "Your sister, your problem."
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Angela looks over scans as Arizona and Alex talk with the patient's mother, "Everyone at Namboze was so worried when we heard the program might move to UCLA, myself included. You make the kids feel so at home here."
Alex reassures her, "Well, we were never gonna let that happen."
Arizona agrees, "No, I was away, but now I'm back. And as long as Dr. Karev and I are here, then the program stays here."
"Okay, so," Angela turns, ready, "Nyah's pericarditis is quite severe. The pericardial sac that is around her heart is inflamed," She makes motions with her hands to help give a visual example as she talks as she finds it helps a lot of kids, "And it's starting to adhere to the heart itself. So, my plan is to perform what's called a pericardial stripping. I'll remove the sac and Nyah's heart will start beating on it's own again."
"What shall I tell her?" Her mother asks.
Alex shrugs, "Oh, tell her we're gonna fix her heart and she'll breathe much better."
She does that as Alex and Angela exit the room, "I'm proud of you for this program. You're doing so great with them. I can't wait until you're an uncle to this little boy. Only 70 more years to go."
"Oh, come on, you won't be pregnant that long. Stop being so dramatic," Alex rolls his eyes, causing Angela to shove him, apparently harder than she intended because he basically flew into the wall causing Angela to laugh.
"You are so lucky you're pregnant."
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In surgery, Angela does a couple snips, "Okay, the pericardium is free. You should see an increase in cardiac function."
Alex comments from beside his sister with Arizona across from her, "It's weird. Heart's floppy. Still not the way a kid's heart should look."
"No, it's not. Could be endocarditis," Angela thinks out loud, "I'll do a biopsy. Biopsy needle, please," She looks down, "Unless...oh, my God. It can't be. This could be endomyocardial fibrosis. I've only read about it. It's rare, subtropical. Could this be that?"
"Maybe," Alex looks at the heart with his sister as he thinks, "Remember we had that kid with Pentalogy of Cantrell?"
"This program is testing my knowledge like nothing ever has before."
Alex looks at his mentor as he notices her unfocused, "You all right?"
Angela hands the biopsy needle to one of the nurses, "Get that to path. Stat, please."
Arizona perks up, "Oh, you know what? I'll take it. Alex, you take my place."
"The nurse can take it," Alex argues.
"No, I'd rather take it myself," Arizona is already walking away from the table and degowning.
The Karev siblings share a look before shrugging as Alex moves to the other side, Angela smirks at her brother, "I should take maternity leave. Ha! If I did what you wanted me to do, I wouldn't be able to be on this case. From this point on, I will only do what I want."
"You're only starting that now? I thought you've always done that."
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Angela sets her phone up on a stand as she eats some food and facetimes Teddy, "T, you will never guess what I am operating on."
"What?"
"Endomyocardial fibrosis in a young girl. She's part of the African Program Alex started."
"Oh, my God! I've only ever read about that. How many have ever performed that surgery?"
"I don't know!" She exclaims with happiness, "It's so rare to find here in the US that I might become the first surgeon to perform this surgery stateside. Even 300 years pregnant, I'm still amazing."
"Speaking of your pregnancy, how much longer until my godson/nephew makes his appearance?"
"Hopefully not during surgery tomorrow. Apparently, the new Physician Advisor that the Board hired will be watching my surgery tomorrow. Last thing I need is for my water to break with her in the room and Alex saying I told you so."
"Keep me updated. I have a meeting with a couple generals and what not to prep for."
Angela nods, "Sure. You have fun in meetings while I make history!"
"Shut up."
After hanging up, Angela looks down to her bump, "I know this is your timeline, but if you could please wait until after tomorrow's surgery, that'd be great."
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In surgery the next morning, things are going perfectly fine until Arizona walks away slightly and crashes into one of the trays, knocking stuff over, "Robbins, what happened?"
Alex asks, "You need me to step in?"
"No, no," Arizona shakes her head.
Owen's voice comes over the speaker, "Robbins? Try to picture the waves."
Angela looks up at Owen before looking back at Arizona and starts putting the pieces together. Phantom limb.
"I'm trying," Arizona argues with the Chief of Surgery.
"Just calm the waves," Angela starts assisting Owen in guiding Arizona.
"These are tsunami-force waves," Arizona breathes.
Alex tries getting Arizona out, "Look, you should go. I'll take over."
Angela shakes her head, "No. No one is moving. I'm stripping the endocardium from the papillary muscle. If I screw this up, I'll have to replace the mitral valve. So, don't move. Just calm the waves."
Still not understanding fully what's happening, Alex looks to Arizona, "I can switch out-"
"Just shut up. I'm at the beach," Arizona tells Alex.
Continuing to work, Angela stays silent as Arizona tries to calm the waves.
"I have to switch, Alex," Arizona says after a few minutes, pain evident in her voice.
"No one is switching," Angela freezes as Arizona goes to move, "You're holding the mitral valve, so don't move."
"What's wrong? Are you sick?" Alex questions his mentor.
Arizona sighs, "Alex, take that scalpel..." Angela looks up, knowing where this is about to go, "And stab me in the foot."
"What?" He asks.
"My prosthetic. Stab me."
Alex looks between the two, "What is wrong with you?"
Owen's voice comes back on, "Dr. Karev, I am the Chief of Surgery. This is an order. Stab Dr. Robbins in the foot right now."
He looks to Angela for confirmation, which she gives him, "Stab her in the damn foot, Alex!"
Grabbing the scalpel, Alex does just that as Arizona looks down and is able to calm the pain, "That's better. That's better."
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Alex and Angela stand in Nyah's room after surgery, telling her mother the good news, "Her heart is, uh, pumping like a champ."
"Thank you, both of you," She smiles at them.
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Gathering with the rest of the attending's and fellows, Angela winces when she feels a small contraction but focuses when Cahill calls for everyone's attention, "All right, welcome. Welcome, everyone. Thank you so much for coming. It has been a privilege to watch you work, and I am so impressed with what I've seen. Dr. Alex Karev's Pediatric African Exchange Program-"
Cristina stands, upset at the idea that the program that brings unique cases to the hospital may be cut before she has a chance to get a good surgery, "You cannot cut that program. I'm sorry, but these children, these...little orphans-we are the only hope they have. Many of them have rare disorders that most Western doctors rarely have the opportunity to treat. And if you stop the program, I will never get that chance," She stops when she realizes what she said, "They. They will never get that chance, the precious children."
Trying not to laugh was a great distraction from the contractions that were coming every ten minutes now.
"I have no intention of cutting it. It's a no-brainer from a PR standpoint. That kind of positive visibility is gold. However, there will have to be some cuts. And I'm going to suggest one that is going to seem surprising at first, but that addresses fiduciary concerns with nominal impact on the core facility and the human and physical resources."
Everyone looks at each other, confused, before Jackson speaks everyone's mind, "I'm sorry, what?"
"Uh, yeah. I'm out," Bailey agrees.
Cahill takes a moment before sighing, "I am proposing that we close your ER."
That makes everyone let out gasps, as Owen steps forward to argue, "We're a Level 1 Trauma Center."
Webber adds, "We're a hospital."
"In the last three days, your ER went from being in shambles to peak efficiency."
"Well, then why would you propose cutting it?" April questions, seeing as that directly impacts her job.
"This allowed me to see that in either case, it's not bringing in the money."
Owen continues to argue, "It's bringing in the patients."
Cahill stands by her idea, "Over half of whom are non-emergent, under-insured, and belong in a primary care physician's office. You have surgical interns in there doing chest exams. It's hemorrhaging resources."
"It's teaching interns how to be doctors," Angela argues, "It's giving them experience and lessons that will make them better surgeons."
"Look, I know these cuts are going to be painful. But understand that I am trying to keep your hospital doors open."
Derek speaks up, "This is ridiculous. You can't close the ER. You went to med school. You have to ask yourself-"
"Do you have a better idea?" Bailey asks, "Because the way I see it, this woman is trying to keep the hospital from closing, in-in which case there'd be no patients, we'd have no jobs, and some of us don't have a few million to fall back on. So unless you have a better idea, why don't you just sit there and listen to what she has to say?"
Angela's head snaps up at Bailey's accusation, "Because getting that money wasn't a freaking walk-in the park," Bailey looks at Angela as the cardio surgeon glares at her, "Mark and Lexie lost their lives. Derek just performed his first surgery back today. Arizona lost a leg. Sofia will live the rest of her life without her father, which sucks. My son," Angela's voice breaks, "Will grow up never meeting his father. I would give anything to have your life with your new marriage and healthy son but instead, I have money from my boyfriend's death," She then stands, looking at Cahill, "And I do have some ideas. Like getting investors into things like Alex's African Kids project so the time and money we currently spend on that can be directed somewhere else. Or using the resources that Hunt and I have with the military to do surgeries for them and get military funding. Or use contacts that Jackson or Derek or Webber or Robbins or any of us have to drum up investors and interest. Don't take the easy way out and just make cuts. Sometimes, looking a little deeper into solutions provides the best results."
They all look shocked at Angela as she breaths heavily from her outburst.
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After the rest of the meeting, Angela leans against the nurses desk as she looks at her watch to time her contractions.
"Hey, you okay?" Jackson asks, resting a hand on her shoulder.
"Um," Angela thinks, licking her lips, "I-I'm in labor."
The way Jackson's eyes widen would be hilarious if it weren't for the pain of her next contraction hits at that exact moment.
"So, um, I should call Alex, right? And your OB?"
"No, stand there like an idiot. Yes! Call them!"
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AN: I am so sorry it's been so long since I've updated anything but I am hoping to post 10 updates this weekend and here's the first one!
Anglea's in labor! I think that we're gonna skip over the actual labor part next chapter and instead go straight to when people are meeting him.
QoC: final chance- who's going to be the godparents and what will be baby boy's name?
Thanks for all of the votes and reads and comments!!!!