Say something if you're conscious || Alex Karev
You were a surgeon. It was a fucking miracle.
You also had POTS. Postural Orthostatic Tachycardia Syndrome. Some days were harder then others but you were trying your damnedest to succeed.
You had moved into Meredith's early on, one of the first roommates.
Probably the longest standing tenet. You kept to yourself most the time.
You made it months before you passed out for the first time in front of anyone in the group.
Scared the shit out of Izzie then swore her to secrecy.
No matter who owned the house, you stayed there. Kept quiet, observed and tried to take care of yourself privately.
However when Alex sold the house back to Meredith you knew you needed to find somewhere else to live. So you got an apartment, your symptoms went into a flare one week and you ended up calling out for several days in a row, the chief well aware of your situation.
You somewhat managed, gave up on cooking, caught something and got worse.
It felt like the flu at first and you were worried you were sick, but when it didn't go away you realized you just got worse and it was your new normal.
You assumed it was the stress that made your symptoms worse.
When you finally got back to work you realized you missed a whole new batch of drama, as always.
Alex was the first to notice you, "Where were you? You look like shit."
You gave a chuckle, "Feel like shit, it's not contagious though."
He stared quiet for a few minutes.
Your day went back to normal, eventually catching wind of what happened.
The days was quick. Over in a heartbeat.
By the time you made it out to your car you were breathless. Everything hurt.
Getting in your door was quick too.
You were in then your stuff was on the floor and you were on the couch.
You laid there peacefully for a few minutes before you heard the knock.
You threw your legs over the side standing taking a step and then having your knees buckle.
You threw your hand back to catch yourself on the couch vision going completely spotty, rainbows radiating from the edges as you dropped to the ground wacking your leg against the coffee table, a glass falling.
When your vision cleared again you had a pounding headache, your pants were wet, and your leg was throbbing.
You sat there for a few minutes, the door now a banging.
"Y/n! Y/n are you okay? Fuck. Please... Please fucking answer, I need to know you're okay?"
You called out, words slurred a bit, "M okay"
You dropped a hand over your head laying there for a another few minutes, your heart pounding.
The thud slowing down a little bit.
You felt your brain come back into focus, the edges becoming a bit sharper again.
You slowly propped yourself against the back of the couch a bit straighter, slowly moving up again.
The spots danced around your eyes again you stood still for a few seconds.
Then you made your way to the door.
Opening it to see Alex standing there with a suitcase.
He didn't even hesitate, pushing his way in, dropping the suitcase in the door and grabbing your shoulders looking you over.
You nodded, "Yeah. Why're you here?"
He stared for a second, "I'm crashing here for a while?"
"I'll clean and do whatever the fuck you need. I just... I can't stay with Jo, I couldn't kick her out."
You gave him a once over, too tired to care.
"Fine. There's a guest room down the hall."
You just stare at each other for a second.
You practically avoid him the first few days, not wanting him to ask the question worried he's on to you. Eventually that settles though and you realize he isn't going to question it.
The company is nice. Knowing someone else is in the house.
Everything comes to a head though when you get home and drop onto the couch.
The second you do you realize you forgot to take your meds at lunch.
Jumping up hoping to take then quick enough that you wont' have to delay your next dose.
Except instead you drop like a sack of potatos over the corner of the coffee table.
Your vision is out as soon as you're on your feet, and stays that way for a some time, you can't tell how long, could have been a second, could have been 2 minutes.
When things start to come back into focus your head is pounding.
You can hear Alex freaking out on the phone, "Hold on she's coming to."
When your eyes open the light's bright and Alex is leaned over you, you're in recovery position on the floor, legs propped against the couch.
Your hand goes to your eyes blocking the light.
"Hey hey, easy. An ambulance is about to be dispatche-"
"I don't need an ambulance."
He stares down at you for a second.
You wait and hear him talk with the operator again.
You slide your hand over your face when he hangs up.
Eyes opening to peak at him, "What the hell was that."
He leans back onto his knees as you slowly move to sit up.
This feels like a sitting up conversat-
Nope this is a laying down conversation.
You feel how your heart picks up when you try to move.
Laying there quiet on the floor for a second, his voice is demanding, "You just- you collapsed. You weren't breathing right.-"
His eyebrows furrow, "No shit you fainted." You hear the subtle raise in his voice, "People don't just faint like that. Surgeons don't just faint like that, What the hell happened."
You cringe internally, "I stood up too fast."
You watch his face just drop, dumbfounded, "That's not- What the hell are you talking about."
You run another hand down your face, "It's nothing Alex, I've managed it for years. I just forgot my meds at lunch."
"Meds, Hold on, i'm not following, what do you mean for years. What the hell is going on?"
You give a short chuckle, "I have a condition. It's not dangerous, just inconvenient."
"Not dangerous my ass, you were unconscious. What condition."
It's quiet for a second, "Why the hell didn't you tell anyone?"
"I told the chief. I can manage it, it's why i'm always sitting down during surgery's. No one else really needed to know, i've got it under wraps."
"Under wraps, So what. You've been passing out alone? At home? At the Hospital? And you didn't stop to think, 'Oh I should tell my friends about this in case you know I fucking die?'"
You'd laugh at his high pitched impression of you if this conversation was a little less serious.
"I'm not dying Alex. Seriously. It's not like that."
"That's not what it fucking looked like, You were completely out. I didn’t know if you’d hit your head, if you were choking, if you were- Fuck. You can't hide this from people who care about you."
You prop up slowly onto your palms moving into criss cross applesauce.
“I’m not leaving you alone like this,” he finally says. “I don’t care what your plan was, or what you think you can handle. I’m staying. And I’m helping. I'm not going to look for a new place, i'll pay rent, I don't care, you're not getting rid of me.”
"No, Save it. I don't care if you want a babysitter, you almost cracked your skull open-"
"I just forgot my meds at lunch, i'll be more care-"
"No, I'm not watching you die in your living room because you think you're invincible."
"Alex seriously, it's just POTS."
"What the hell- What is POTS."
You roll your eyes, "Postural Orthostatic Tachycardia Syndrome."
"It’s a form of dysautonomia. My autonomic nervous system just… doesn’t regulate when I’m upright. Blood pressure drops, heart rate spikes. I get dizzy, lightheaded, faint if I’m not careful. I'm on beta blockers to try to manage the symptoms and spikes, when I forget them I tend to do way worse."
"How long have you had this?"
You shrug scooting to put your back against the couch, "Since High School. It got worse in Med School, that's when I got put on beta blockers."
“You’ve been passing out since before med school,” he repeats slowly. “And you didn’t tell anybody?”
“I managed it,” you say quietly. “I always have.”
He laughs—one sharp, disbelieving bark. “No. No, you’ve been covering it. That’s not the same thing.”
“You could’ve hit your head. You could’ve cracked your neck. You could’ve-” His voice falters. He looks away. “You can’t keep this shit a secret. Not from the people you live with. Not from me.”
You glare for a second, "Seriously, I don't want to be a problem."
"You're not a problem, You aren't fragile either, that's not what this is, you're stubborn, but hiding this, that isn't going to cut it anymore. You need help sometimes, so do I. We're human, it happens."
"I don't have to do that, you didn't sign up for it."
"You're right, i'm imposing it on you. Get over it."
“Look… I get why you hid it. People judge. People treat you different. I know.” He gestures vaguely toward his chest, like the ghost of his past trauma is sitting on his shoulder. “But this” He points at you, hunched over your knees back to the couch. “This isn’t something you can deal with alone.”
“I’ve been doing it alone for years.”
“And look how well that worked out,” he snaps. Then softer, “You scared the shit out of me.”
You shrug, "M sorry, I can't control it. It's not like I wanted to have POTS. I just forgot my meds at lunch, a patient was coding and I got busy."
It's quiet for a few minutes, "Do you need anything? Water? Snack? A blanket?"
You shake your head, "Just my meds, they're in my purse, I just need one."
He doesn’t move at first.
Not because he’s ignoring you—because he’s staring at you like the words “I just need one” physically hurt him.
Then he exhales sharply through his nose, pushes up from the floor, and mutters:
“Yeah. Okay. Fine. Meds.”
He practically sprints to your purse, yanking it open like it personally offended him. You watch him rummage through it, muttering under his breath:
“Ridiculous… forgot her meds… not dangerous my ass… freaking beta blockers in a damn bottomless pit…”
You watch him pull out the bottle and flip it around reading the label.
You know what it says, you know how it looks.
“Next time?” he says, voice low. “You tell me. Before you faceplant into the furniture and I have to call 911 like some panicked idiot.”
He watches you take the pill, waits until you swallow, then finally leans back on his heels, still breathing hard.
“Jesus,” he mutters, rubbing a hand over his face. “You forget your lunch meds in med school too? Or is this a new ‘I like terrorizing Alex Karev’ thing?”
"Seriously though, is this why you took forever to answer the door the first day I was here?"
You nod a bit, you should have seen that question coming a mile away.
You watch him get all frustrated all over again.
“I thought you were dead. So don’t… don’t do that again. You can't let this keep happening.”
You blink at him.
“Alex-”
“No.” He points at you like he’s scolding a resident. “I’m not doing the whole tragic-surgeon-found-alone thing. I’m not finding you on the floor like that again. You live with me now.”
You snort. “I already live with you.”
“Then you live-with-me live with me,” he counters immediately. “No more shutting yourself in your room. No more skipping meals because you’re charting. No more ‘I’m fine’ when you’re sweating bullets and can’t see straight.”
You raise a brow. “You done?”
“I’m setting alarms on your phone.”
“I’m checking in during your shifts.”
He huffs, crosses his arms. “Good. Because sane Alex apparently isn’t enough to keep you upright.”
You curl further in on yourself looking at your floor more intently.
"hey... i'm not mad at you... i'm just mad you were alone, handling this alone. Come on,” he says. “Couch. You’re not getting up again tonight.”
He rolls his eyes. “Take my damn hand.”
Grabbing it he pulls you up and guides you onto the couch.
Then he sits on the floor again, right beside you, arms draped over his knees.
“You scare me,” he says quietly, not looking at you. “And I don’t get scared.”
You open your mouth, but he cuts you off one more time.
“And don’t say sorry. Just… don’t hide this from me. Ever again.”
The next morning you're up before he is, getting ready faster.
You know what this is, you're in a flare. But you're so goddamn stubborn, you don't want to stay home. Call off sick again. You don't want to have to do that. You know your situation. You know you should, but Alex is here and if you call out hell call out and if he calls out someone will get suspicious.
You practically race to the hospital.
Not wanting to confront Alex.
You practically race through hallways. You're not sweating you know that's a bad sign.
You're hot then cold then hot again and not sweating.
Your feet feel swollen, ankles too.
You know you're in a flare. That this isn't good. You can't stop now though.
You're leaning on counters, on the wall, every chance you get, you're leaning on something to keep upright. To keep moving.
Chanting internally, 'Just keep swimming, just keep swimming.'
You have to make it through the day.
By the time you're in surgery you feel the world do a spin but stay in the same place at the same time.
It sucks. You tell a nurse to get you a chair.
The surgery goes off without a hitch, you're worse for wear after though.
You stand up again to do the closing and your vision goes dark.
You bump your knees agains the chair for a second. Your vision coming back as you stand there.
Then you continue. You close.
The second you're through the door Alex grabs your upper arm tightly.
You nod, face drained of color, body going hot again, feeling naseous.
"Y/n, you need to take a break."
You don't fight him, just back against the wall and slide down onto the floor.
You put your head between your knees as you sit on the ground.
Alex freaks out, "God are... are you okay?"
You nod, "I'm in a flare. Shit sucks."
He grabs your wrist pulling it forward.
You listen to the hustle and bustle of the hospital as he takes your pulse.
"Shit, your hearts doing a goddamn sprint."
You chuckle, "I could have told you that."
You sit for a good 15 minutes, "I'm okay, i've gotta go make rounds."
As you stand Alex is basically attached at the hip.
"Alex, i'm alright, seriously. You can go-"
His pager goes off and you watch him check down then up again, "Fine, but if you feel any worse, stop while you're ahead. Don't pass out in an OR or worse."
You roll your eyes scoffing.
He doesn't leave, "Fine. Now shoo." he nods rushing off as you make your way slowly to do your rounds.
By the time you're around you take a break.
Finding a table to sit at while you eat and take your meds.
You're up on your feet again after, practically running around as you walk into the pit.
Your downfall is when a patient codes.
You do chest compression while Christian runs up.
When she takes over you back to the wall, turning to walk out except the second you take a step you drop. Face first into the corner of the cart you're next to. Forehead rebounding off the edge.
Your body gives out with zero warning, just an instant of static behind your eyes and then nothing. It gets quiet but tunes back in quick.
Your forehead slams into the metal edge of the crash cart with a sickening, hollow crack.
There’s no bracing, no sliding to your knees this time just a straight uncontrolled collapse, shoulder bouncing off the floor after your skull hits first.
And the worst part? You don’t black out completely. You’re aware just enough to hear the chaos erupt around you.
“She hit her head- Jesus- someone get Karev!” you hear Christina yell.
You try to push yourself up but your arm isn’t cooperating. Nothings cooperating.
Your vision is wrong split down the center, one side smeared colors, the other pulsing as things start to come back from the show of spots.
Someone rolls you onto your side. Someone else keeps a hand on your neck. There’s a voice you recognize but can’t place.
And then you hear it, “Move!”
That one you know instantly.
Alex drops to the floor so fast the knees of his scrubs skid.
He grabs your face, not rough, but not gentle either, his thumbs brushing your cheekbones as he tilts your head enough to see your eyes.
“Hey. Hey- look at me. Come on- look at me.”
Your eyes start to focus again, looking towards his face.
“Pupils are uneven,” someone announces behind him.
“No shit they’re uneven,” Alex snaps. “She just hit the cart head‑first because she shouldn’t have even been upright.”
“Okay. Good. Don’t move.” He turns his head, barking over his shoulder, “Page Shepherd. And someone get a collar—now.”
Alex whips back to you like you just insulted his entire bloodline.
“You are not fine. You coded a patient and then passed the hell out into a piece of equipment. Do you understand how not fine that is?”
You close your eyes. “Just… dizzy.”
“Don’t close your- hey.” He taps your cheek lightly. “Stay awake.”
“You’re concussed,” he fires back. “And your heart rate is trying to set a hospital record- holy shit.” He presses two fingers harder into your wrist. “Y/n, it’s like you’re running laps while lying on the floor.”
The collar goes around your neck, and you want to protest, but the second someone lifts your head you nearly vomit.
Alex’s hand shoots to your shoulder, steadying you.
“Easy. Easy. Don’t move.”
You feel your face flush, "I'm okay, please I just-"
“You’re done. You’re so done,” he says, voice cracking. “You’re not standing up for the rest of the damn day.”
You feel yourself get placed onto a gurney, then wheeled out towards a room.
When everything settles down a bit, “Why didn’t you stay home?” he demands quietly, so only you hear.
You breathe shallowly. “Didn’t want you to… worry.”
He lets out a sound—disbelief mixed with something like pain.
“You think I worry less watching you destroy your nervous system in real time?”
“Didn’t want you to skip work.”
He stops walking for half a beat. Just enough that the gurney moves ahead without him.
When he catches up, his voice is lower than you’ve ever heard it.
“Y/n… I would skip work for you in a heartbeat.”
You squint, "That's the point, if you and I both are out, someone's bound to question it. If someone questions it Meredith going to figure it out then there goes every sense of normalcy."
By the time you're in a room a nurse is hooking you up to an IV and Alex is just staring at you quiet.
“She’s stable,” a nurse said, checking your vitals.
Alex didn’t relax. He knelt beside you, one hand on the gurney rail, the other gripping yours. “Stable?” he repeated. “She just hit her head into a metal cart. She’s lucky she’s not unconscious right now!”
You winced, leaning back against the gurney.
“She needs a neuro check,” someone said, glancing at Alex. He didn’t move.
“She’s got POTS,” he barked, not to argue but to clarify. “And she just… collapsed. She’s not fine, okay?”
You hear the door and sit up slow, Christian rushes in, "Y/n Oh my god!"
She's assessing you in a heart beat, "What the hell happened."
Alex scoffs, "She's got POTS."
"Fine? You hit your head, THAT is not fine."
Dr. Bailey strides in sharp, Alex speaks up, "She's stable-" a glare silencing him.
"You hit your head, young lady. That’s not ‘stable,’ that’s lucky. No more walking around alone like this, do you hear me?”
“We’re running full neuro and cardiac checks—no movement until we’re certain she’s stable. Alex, stay with her.”
“I’m right here,” Alex mutters, already positioned beside you like a shield.
“She’s lucky,” Bailey mutters to Shepherd, arms crossed as she keeps monitoring your vitals. “This could’ve gone so much worse if she’d gone down differently.”
Shepherd nods once, firm. “Agreed. And if anyone thinks she’s walking out of here on her own today, they’re wrong.”
Alex leans closer, low and protective. “See? You’re not dying alone. Not on my watch.”
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