Surprises can come in all shapes and sizes.  They can be surprises from a birthday party and someone gave you a gift that you had no idea of.  Or people can surprise you.  They can surprise you by the way they are able to come back from a loss, how strong they are or unforgiving they can be.  Who knows... you might even be able to surprise yourself.

-

"Doctor Burke, can I talk to you?" Alison asked the heart surgeon to which he nodded his head.

"Of course.  Step into this office.  What did you want to talk about?"

"Your hand."

"What about it?" He laughed lightly trying to play it off.

"I know that you are still having trouble with it and that Doctor Yang is helping you.  How were you even cleared for surgery?"

"I tried telling the chief," he let out a sigh as a ran a hand through his short hair.  "But he was just so excited about me returning that I felt like I owed it to him somehow.  Cristina is helping me when my hand starts to shake.  When I start to feel it coming that's when I let her take control.  I'm honestly surprised that Shepherd cleared me for surgery, if I'm being honest.  I didn't think I was ready."

"You didn't think you were ready or that you are scared to come back to work?"

"I'm not scared," he let out a tired sigh.  "Not anymore.  My worry though is that I won't ever have good range of motion in my hand again.  That I won't be able to perform heart surgery ever again.  Who else knows?"

"No one but me," she gave him a small reassuring smile.  "But Preston, the only way you will ever get better is by practicing and using your hand.  Have you thought about therapy?  Seeing a hand specialist might help.  Or even talking to Derek again.  Maybe he cleared you too early."

"I don't know.  I don't think therapy can help me with this one.  You see, when I put my hand out like this and it's in that position for too long, it starts to tighten up and shake.  Like this," he showed her almost as if it were perfect time.

"You know my hands shake from time to time too.  When I was younger they used to be really bad.  Not from a gun shot wound, but from letting the nerves get to me.  So what I like to do if it's a surgery I'm really stressed out about beforehand, I just take my hand or hands outward and just shake them like this," she told the cardiologist as she demonstrated.  "I also will then bring them up to my chest, one over the other and take deep breaths in and out.  That and I would also take Propanol."

"I thought you never got nervous?"

"Well, I don't so much anymore.  But when it's a really big case, I definitely do.  There's no shame in that, Preston."

"Thank you, Doctor Alison," he smiled at the Ped's surgeon to which she smiled and laughed and they walked out of the office room.

*

"Transfer from Mercy West," George told the two Ped's doctors as they walked outside to help their new patient.  Noelle Lavatte, thirty-two weeks along.  Pregnant with twins.  One appears to be developing more slowly than the other," he told them as he handed the charts over to Addison and she took reading through them then handing to Alison to read.

"Hi there," a deep male voice greeted the two and they looked up.

"Hi," the duo greeted the couple.

"Greg Stanton.  This is my fiancé and the future Mrs. Stanton.  Noelle," he told the doctors with a big grin on his face.

"Greg, I promise you that you are the only person who cares or not."

"He's okay," Alison told the couple as they were walking through the doors with a smile, comforting the patient.  "Congratulations."

"They told us that we had to come here because her condition could be serious," Greg told the doctors.  "Is it serious?"

"I gotta say you don't seem in terrible condition for Mercy to send you over here in an ambulance.  You aren't in labor, you aren't bleeding, your vitals are fine," Addison told the Noelle.

"They told me I needed a specialist because of my thing," Noelle told them.

"Your thing?" Addison asked confused.

"Two uterus's," Alison told her and O'Malley walked up to Addison as she was thoroughly confused and they stopped walking.

"Ms. Lavatte was born with two uteri," he told Addison to which she looked at the chart better.

"Uterus'," Addison told her making Alison let out a small giggle at O'Malley's mispronunciation.

"That's very rare," George whispers to the patient as Alison had an amused look on her face.

*

"Izzie, you're back!" Alison greeted the blonde intern with a smile.  "Welcome back."

"Thanks," she greeted the Ped's surgeon and was about the say something else but Alison looked at her pager seeing that Mark was paging 911 to her and she hurried to where he was which was the on-call room.

"I gotta go," Alison told her in a hurry.

Izzie thought that was different.

"Really?" She asked hands on her hip.  "You called me for sex?  Mark that's not what the pager is for," she whined slightly making him chuckle.

He was beginning to get handsy and Alison could feel her worries dissipate as she let the feeling of lust and want overcome her.  

"Fine," but make it quick.

"I only need thirty minutes," he told the Ped's surgeon.

"A bit cocky are we?" She raised a brow and he let out a laugh at her play on words.

"Extremely," he told her as he led her back to the small bed and she let out a groan as he had easy access to pepper kisses down her neck.

*

"So two uterus', that's pretty cool," George tells their patient making her smile slightly at the comment.  "And you're engaged.  That's also cool."

"Greg talked me into it," she told him then looked at her fiancé.  

"Yeah, from the first moment I saw Noelle, I was ham."

"Did you just say ham?" George asked shocked that someone else got it too.

"Your either ham or eggs."

"Here we go," Noelle rolled her eyes.

"You got to ask yourself in every situation are you the chicken or are you the pig?"

"Sorry, pig or chicken?" George was still in shock.

"You gotta play the ham and eggs," Greg nodded his head.  "Now the chicken is involved in the beginning but the pig is in it.  So the question is: are you involved?  Or are you committed?"

"Ham or eggs," George said relieved that someone finally understood him and Greg pointed at him as if they were now best friends.

"Ham or eggs," he smiled.

*

Alison and Addison were walking through the hallways when all of a sudden Addison sees a familiar figure and notices that it's one of Derek's sisters.  

"Nancy," Addison greeted the Shepherd sister with a smile as she hugged her.  "Let me guess, mom sent you out here?"

"Derek's trying to ban you from Seattle."

"Did he also tell he's living in a trailer?"

"Whose this?" Nancy asked noticing the blonde who was with Addison.

"This is Doctor Alison Anderson, my fellow resident Ped's doctor.  Alison this is one of Derek's sister, Nancy."

The blonde's eyes widened as she was surprised that the Shepherd sister came to visit.

"It's nice to meet you," she told her as she put her hand out for a handshake.

"Forget the handshake," Nancy told the blonde doctor. "Give me a hug," she said with a laugh.

Alison looked to Mark and Addison and they both smiled at the blonde before she gave in and gave the Shepherd sister a hug.

"I've heard so much about you," she smiled as she released her.  "Are you free for coffee?  I would love to chat and get to know you."

"Yeah, I have about fifteen minutes to spare right now.  Is that alright?"

"It's so good to see you two and meet you as well," Nancy told the two doctors and referring to Alison.  

"You too Nanc," Mark told her with a smile.  

"I want to see the two uterus'," Nancy told Addison.

"Yeah, just stay with Alison and she will let you in."

*

"I didn't even know you were coming to visit Derek," Alison told the Shepherd sister as she drank her Starbucks iced caramel macchiato coffee as they sat outside, enjoying the fresh air.

"Derek didn't even know I was coming," she laughed making Alison also laugh.  "I surprised him and his slutty intern."

"Meredith?" She asked with wide eyes.

"You know her?"

"Yeah.  She's really not bad, I promise."

"Well she broke up a marriage..."

"I know it might seem that way but the marriage was already over before she came in the picture.  Trust me."

"I know you need to go see your patients but I just wanted to tell you how thankful I am that Derek has someone like you in his life.  I know I don't know you well enough yet but I can already tell how great of a person you are," she got up to hug the woman.  "Oh and whatever is going on between you and Sloan just make sure that you're careful going into it but you both would make a beautiful couple and babies," she told her with a wink.

Nancy's ending statement made the blonde woman freeze and her cheeks were now tinted with a blush color.  The brunette chuckled as she looked over her shoulder to see the blonde still standing there looking puzzled, unsure of how she knew in the first place.

Did Mark tell her?

*

"He said he was leaving," Noelle told George as she now stood at the side of the bed and was heavy breathing as George was trying to calm her down, knowing that stress wasn't good for the babies.

Just then Alison and Addison walked into her room as George spoke.

"She's hyperventilating," George told the two.  "The baby's had some brain cardiac."

"Okay, Noelle, I need you to lie in bed.  Can you do that?" The red hair asked their patient as she helped me in the bed."

Alison was looking at the results then looked to the attending Ped's doctor.

"Addison you might want to take a look at this," she handed her the results from the lab and was shocked.

"Did he leave?  Like really leave?" Noelle asked George.

"Deep breaths," George instructed her.

"Have you had any cramping?  Any pressure at all?" Alison asked her as she helped stabilize her.

"I can't do this without him," Noelle panted as she was hyperventilating and not being able to calm down.  "I'm always hard on him telling him what to do.  But he's really great.  You know?  He loves kids whereas they scare me.  We have to get past this."

She let out a yell as she felt pain and started to cry as the three doctors helped her into bed.

"Stay on your left side," Addison told her, calm.  

George put a non-rebreather mask on Noelle in hopes that it might calm her down.  

"Deep breaths," Alison told her.  "That's it," she told her as she rubbed her arm in comfort.

"Okay, Noelle, it looks like we need to prep you for emergency c-section.  It looks as though you are going into premature labor," Addison said.

"Will the babies be okay?" Noelle asked worried as she lifted the mask slightly to talk.

"The babies will be just fine," Alison told her with a small reassuring smile.

*

Alison had to put it behind her as she needed to perform surgery on their patient to save the patient's baby.  After the surgeons were scrubbed in they had already began the surgery.  There were many surgeons not only in the room with them but also in the gallery watching them.  

"Okay, I've completed the incision and I'm going to ask you to move the top uterus to the side so that I can reach the one underneath," Alison told George.

Alison was in her final year of being a resident which meant that Alison wanted her to have as much practice with all different types of surgeries and patients.  Addison was there in case Alison needed help with anything but so far she had golden hands and she couldn't be prouder of her.

"Got it," he told her.

"I don't want to alarm you or make you nervous in any way O'Malley because you seem like a decent person but I've got about 120 seconds to get baby one out of the uterus while you are holding uterus two.  If you so much as hiccup you could tear the uterine wall and kill this woman's child," Alison told him.  "So do what you can, okay?"

"Okay," George nodded his head in understanding.

"Wow, look at that," Nancy said in amazement as Alison moved the uterus. 

"Amazing, isn't it?" Addison told her.

"Now ready for uterus two?"

"Wait, Doctor Anderson," George began getting nervous.  "It's moving.  It's really moving and I can't hold it."

"I need you to hold her still if I'm going to do this c-section," Alison told him.

"I'm trying."

"I mean it, O'Malley," Alison told him as the heart rate monitor started beeping indicating that the mother's heart rate was going up.  

"What should I do?  It's really moving.  I can't hold her."

"I need you to breathe, O'Malley.  Just take deep breaths in.  Try not to freak out.  When you feel like you are ready hold baby girl so that I can get baby boy out.  Can you do that?"

"You are sending her into distress you have to get that baby to stop moving," Nancy told the intern.

"How do I do that?"

"Talk O'Malley," Karev told him sternly growing impatient. 

"Karev, back away from the table," Addison told him annoyed that he got himself involved.

"You need to calm it down."

"Karev, step away," Addison commanded the intern but Alison wasn't having it. She knew how good Alex was and that in many ways he was the baby whisperer.

"Let him do it, Addison," Alison told the attending. "He knows what he is doing," unlike O'Malley, Alison wanted to mutter the last part she didn't.  "It's okay, Doctor Montgomery," Alison told her seeing something different in Alex.

"October 30, 1974.  It's the fight known as Rumble in the Jungle.  World heavyweight champion George Foreman against Muhammed Ali.  His first major fight after three in a half years in the ring."

"It's working," George tells the doctors.

"He wants to win.  He's younger.  He's stronger.  But he's not prepared for what Ali does called the rope a dope..."

She loved having George O'Malley work at the hospital.  She really did.  But sometimes, like now, he was very unsure of himself and his skills and that was never a good thing to have especially while in surgery.  It could freeze you up and make it to where you can't think.  Patients can't and don't need that.  They deserve to have the utmost faith in their doctor knowing that they will do whatever the hell they can to make sure that their loved one survives.

Alison continued working on the c-section as she was incredibly thankful for Alex Karev in this moment.

*

"By the way stop bossing Alex around," Alison told Mark as she drew shapes on his chest as they were now at her apartment.

"Alex?" Mark asked confused for a minute then he understood.  "Karev you mean?" He asked and she nodded her head and he laughed loudly at that.

"Yes!  He's a good guy, he means well.  As an attending you are not supposed to be having him do your dirty work for you."

"Your really thinking of Karev after we just had sex," he let out a groan.

"I am," she told him knowing that it was messing with his ego.  

"What if we did another round?  Would you still think of him then?"

"I don't know," she murmured as she trailed hot kisses up his chest making him groan.  "But I wanted to talk about something else."

"What?" he let out a sigh and placed his head in the crook of her neck to which she let out a small giggle.

"Nancy knows something is going on between us," she told him as he stopped kissing her neck after leaving a hickey.

"What now?  Did she say something to you?"

"Yeah, when I met up with her afterwards she totally knew."

"Well shit."

Sometimes surprises will surprise us in a good way.  Or they can hold us back from moving on.  The choice is yours.

--

Surprise update!!  What did you think of Alison's talk with Burke?  And Nancy coming into town. . . 

Be prepared for loads of cute chapters of Mark and Alison from now on!