Family is Hard

*TRIGGER WARNING: death (I'll put these * when it is coming up)**

Derek walks into the elevator where Ivy is looking through a chart.

"Alex's brother showed up at our front door this morning. He hasn't been home in seven years. Hasn't seen his siblings in seven years," Derek comments.

Ivy doesn't look up from her chart, "Is this your way of saying that I need to talk to our sisters more?"

Derek laughs, shaking his head, "No, because that would make me a hypocrite. But we should talk more, I mean we talk about work but I wanna know about your life."

Ivy shuts the chart she was looking at, "The last time we tried that, you interrogated my guy friends. Who are now holding it over my head. So no. But, I will be talking Meredith later so you can ask her."

She exits the elevator, waving at him. She makes her way to rounds with Webber, and April, the first patient being Allison Clark.

"So then a couple days ago, we're at the grocery store, Gary and I, and the next thing I know, I'm flat on my back in the frozen foods section," Mrs. Clark tells us.

Mr. Clark looks at us, "She fainted."

She kind of laughs, "And I've never fainted. I never seen anybody faint. I don't believe in fainting."

"Did you hit your head?" Webber asks.

She puts her hand on her husband's arm, "I would've if this one hadnt caught me."

"You've got a good one. Mrs. Clark is anemic and guaiac positive, so there's defintly some internal bleeding, which looks like-" Ivy is cut off by April.

"-Friable tumor near the ambulance of vater," she finishes.

Ivy kind of smirks at April, "Yes. Thank you, Dr. Kepner."

"Dr. Swender told us the biopsy showed the cancer was back. But she said you might be able to take it out," Mr. Clark says to Webber.

"Theres a chance I won't be able to go in as deeply as I need to, but I promise to do everything I can," Webber assures.

Mr. Clark is close to tears, "Anything you can do."

"We appreciate it, Dr. Webber, thank you, thank you," Mrs. Clark says.

She kisses her husband's hand.

○○○○

Ivy is in on the surgery on Mrs. Clark, "Dr. Webber, did you consider doing a whipple on Mrs. Clark?"

"I did, but since the cancer came back, I think I can do a local resection and get the entire visible tumor. Dr. Kepner, are we boring you?" Webber says.

"No, sir. I just- I wasn't expecting Cheif Shepherd to be up in the gallery during a general surgery. But I guess the chiefs job, right- evaluating, observing," April says.

Ivy looks up and sees her brother on the phone and Lexie sitting up there, glaring at April.

"Dr. Kepner, you're in my O.R., and the only one observing and evaluating you right now is me," he sternly says.

April looks back down, "Yes, sir. I'm sorry, sir."

She looks back up, Ivy taking notice.

After the surgery, April goes to inform Mr. Clark that his wife will be alright.

○○○○

Dr. Webber is double checking everything Ivy did since Mrs. Clark isn't waking up, "Tell me everything you did."

"I was trying to wean her off the ventilator, but then I realized that she wasn't breathing on her own. So I put her back on her previous vent settings. Dr. Webber, whats happening to her?" Ivy asks.

"She may have stroked out. Get a C.T and get the scans to your brother, and also run an E.E.G. We need to find out right away if there's any brain activity. If there's not then we need-" Webber is cut off by Mr. Clark and April coming back.

Mr. Clark smiles at his wife, "She-she looks great. Oh, thank God. Dr. Kepner told me you got the tumor. Thank you so much, Dr. Webber. Can I wake her? Sweetheart? Oh. You still sleeping? The doctors said you did great in there. Honey? You awake? Alison?"

Ivy turns, with tears in her eyes to get the scan and give them to her brother.

○○○○

"The patients had a massive hemorrhage. Look, you see here? The left temporal lobe. The hemorrhage, its- it looks like it-" Derek is interrupted by Meredith and April coming in.

Meredith looks at the scans, "Wow. That bleed is huge."

He scans her up and down, "What?"

"You look even prettier in your scrubs."

Ivy gags in disgust, "Could you not do that in front of me. I would like my breakfast to stay down."

"Uh, what are you going to do about your giant stroke?" Meredith changes the subject.

"Nothing."

"Nothing?" April asks.

Derek looks at her, "Yeah. Mrs. Clark has a left temporal lob hemorrhage that's extended into the ventricular system. There's nothing we can do. Want to get a cup of coffee?" He asks Meredith.

"Only if you keep telling me how pretty I am," Meredith jokes, leaving with Derek.

Ivy lays her head on April's shoulder, "You need to get this thing under control."

"I'm trying but its hard."

Ivy thinks, "I have so old high school pics from his ugly phase, want to see them?"

April shakes her head, leaving.

"Oh, boy."

○○○○

"She could wake up, right? I mean, people wake up from comas all the time," Mr. Clark tries to reason.

April, Ivy and Webber stand on the opposite side of the bed, "I'm sorry. Your wife's coma is irreversible. Dr. Shepherd, would you explain it, please?"

She nods, "Mrs. Clarks scans showed a massive hemorrhage in her brain and the E.E.G. showed minimal brain activity."

"But that means there's hope, right? Because... at least there's activity. And- and her heart is still beating," Mr. Clark is almost in tears.

April explains, "Only because the mechanical ventilator is breathing for her. When we turn the machine off, the heart won't get the oxygen it needs, and it will stop."