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She remembers a bang. It was loud and deafening to the point that when she comes to, there’s an incessant ringing in her ears. She wants to just lay there and sleep, but that’s probably just the mild concussion talking. Instead, she painstakingly cracks her eyes open just enough to get a good view of her surroundings.
Metal. Bright. Debris. Blood.
Blood.
It’s not her own. At least, Jo doesn’t think it belongs to her. It is a trail of blood that extends in front of her, leading in front of a woman with a swollen abdomen who is crying out in distress. Jo picks herself up from the ground long enough to realize what just happened.
She remembers getting on the train back to Seattle after a weekend medical conference in San Francisco with Carina Deluca. It had been a spur of the moment decision, something Alex had surprised her with when he presented her with a train ticket, booked hotel room, and a weekend off. She had been thrilled at the prospect of hearing Addison Montgomery speak as she considered a career switch to OB. It had been the perfect getaway, until about ten minutes ago.
Now, Jo stands in the remains of one of the train cars she’d been traveling in and looks around in horror to see multiple individuals in varying states of trauma. She quickly canvasses the area to determine who seemed okay and who looked as though they were in immediate need of assistance. After getting help from a nursing student, dental PA, and off-duty officer that happened to be riding in the same train car, Jo leaves the other passengers and makes her way over to the pregnant woman who was clearly in labor.
“Hey,” Jo crouches down in front of the woman. “My name is Jo Karev. I’m a surgeon at Grey Sloan Memorial in Seattle. I see that you’re having some contractions. Is it okay if I examine you?” Jo waits until the woman nods her consent before gently pressing her hands on the woman’s bump to determine position. “What’s your name?”
“Alyssa,” the young woman breathes out heavily. “My name is Alyssa Belmont.”
“Nice to meet you Alyssa. Can you tell me how far along you are?” Jo looks down at her watch to monitor the length and interval of the contractions.
“I'm only 35 weeks,” Alyssa’s voice betrays her anxiety. “It’s too early.”
“It’s okay, the ambulance is going to be here soon and we will be able to get you and your baby to a hospital safely where some really nice pediatrician will make sure that they’re just fine,” Jo takes the hand sanitizer from her purse and uses it to disinfect her hands and ruffles through her first aid kit to find a single pair of gloves. “Do you know what you’re having?”
“A boy,” Alyssa nods. “My fiancé is stationed overseas but is supposed to come home in two weeks. He was supposed to be here for the delivery. I’m not supposed to be doing this alone.”
“Hey, Alyssa. Listen to me. You are not alone. I’m right here with you and I promise I won’t leave your side until you are holding a healthy baby in your arms,” Jo locks eyes with the young woman in front of her. “I need to know some things if I’m going to better care for you. Did you get hurt when the train derailed? Did you feel a tearing or a sharp pain in your abdomen?”
“No,” Alyssa shakes her head. “Just the contractions. But I had already been feeling some sporadic contractions throughout the day and the past week if I’m being honest. That’s normal though, right? Like Braxton hicks?”
“Yes, it's completely normal to feel a couple contractions here and there once you’re nearing the end of your pregnancy. It’s your body trying to prepare itself for birth,” Jo takes off her jacket and drapes it over Alyssa’s lower abdomen and pelvis to maintain some semblance of modesty. “Okay Alyssa, I’m going to push up your dress and remove your leggings and underwear so that I can get a look at how much you’ve progressed.”
Prior to the surprise delivery she was pulled into a couple weeks ago where all she had to do was catch the baby, it had been a long time since Jo had delivered a baby that wasn’t a c-section. It had been years since she had to check for dilation and effacement and in that moment she found herself really wishing that Carina - who had opted to stay in San Francisco for a few days more with a friend - had been on this train instead of her.
“Okay, Alyssa. It looks like you're about eight centimeters dilated and I'd say somewhere around eighty to ninety percent effaced,” Jo informs.
“What does that mean?” Alyssa brushes her hair out of her face and winces as another contraction comes over her.
“That means that pretty soon it’ll be time to push,” Jo looks around to the surrounding passengers. “Does anyone have a clean towel or blankets in their bag? And water. I need an unopened water bottle.”
A few of the lesser injured passengers step forward after ruffling through their bags to present Jo with the items she requested, “Here are two bottles of water, one clean towel, and three blankets.”
Jo does her best to keep Alyssa comfortable and wait until the paramedics arrive. But within minutes, Alyssa is fully dilated, effaced, and ready to push. Jo looks down at Alyssa and keeps her face as calm as possible so as not to alert the young woman to the anxiety currently building up inside of her.
“Alright, Alyssa, once you feel your next contraction I need you to push. You’re going to push for ten seconds and then take a break. Do you understand?”
Alyssa grunts in response, “Yup.”
After what seems like an eternity, the train car fills with a sharp, loud cry. Jo feels some tears prickle at her eyes as she’s the first person to hold this little one as it enters the world, “Hey there, little man. You’ve got a set of lungs on you. That’s good. I was worried about your little lungs. Let’s get you cleaned up so your mama can hold you.” Jo uses the surrounding materials to clean and warm up the infant before placing him on Alyssa’s chest.
“Oh God,” Alyssa chokes out a quiet sob. “You’re here. Hi baby. I’m so sorry your daddy isn’t here but I know that he’ll be so happy to meet you.”
Jo wipes a straying tear from her eye on her arm, “I hate to intrude on the moment but we do have to cut the cord and deliver the placenta.”
“Yeah, yeah,” Alyssa shakes her head. “Can I just hold him for one more second?”
“I don’t see why not,” Jo barely has time to get those words out of her mouth when paramedics come rushing through the train car. She breathes out a sigh of relief and flags one of them down. “Hi, I’m a surgeon at Grey Sloan Memorial Hospital in Seattle. This woman just gave birth to a premature infant at thirty five weeks. She and the baby need to go to the hospital immediately.”
The paramedic quickly calls her partner to assist her as they make quick work of getting Alyssa out of the train and into an ambulance. Just as Jo is about to turn around and head back inside to help in any way she can, Alyssa puts her hand on Jo’s arm, “Can you come with us? Please. You said you’d be there and I really don’t want to be alone.”
Looking up at the paramedic to make sure that it’s okay to ride along, Jo squeezes Alyssa’s hand gently, “Of course.”
+++
Jo shouldn’t have been all that surprised when she feels a familiar set of arms tighten around her, bringing her close to his chest. She sighs contently as she allows her husband to hold her tenderly. She whimpers in protest when Alex pulls away to get a good look at her.
“Jo,” he breathes out in relief. “You scared the shit out of me. ” Alex presses a light kiss to her forehead. “When I saw the crash on the news I almost had a heart attack. I tried calling you and the hospitals but no one was saying anything. No one knew what was going on. All we knew was that the train derailed in the middle of nowhere Oregon and some of the cars detached and got flipped on their sides. What the hell happened?”
“I delivered a baby today,” Jo huffs a laugh. “After the crash knocked me out for a few minutes, I got up and there was a woman in premature labor. Her name is Alyssa. I-I delivered her baby. I was the first person in this entire world that got to hold him. The world was literally crashing down around us, but I got to deliver this beautiful baby boy with a surprisingly well developed set of lungs for how early he was born. I’ve been with her ever since it happened. They’re moving her up to a room right now. I’m supposed to meet her up there.”
“Baby, that’s incredible. But have you gotten checked out?” Alex asks quietly. “I need to know that you’re okay.”
“I’m okay, Alex,” Jo assures him. “I have a mild concussion and a couple of bruised ribs. Nothing that some ibuprofen and rest won’t fix.” Alex scowled unconvinced, causing Jo to laugh. “I’m fine. Really. Now do you want to come with me to see them?”
“Okay, fine.”
They make their way up to Alyssa’s room and Jo introduces Alex and Alyssa to each other. They spoke softly for a few moments until Alyssa’s doctor showed up outside the room.
“Sorry to interrupt,” the doctor smiles sheepishly at the group. “But you can go ahead and see your baby Miss Belmont. I can get one of the nurses to take you up to the NICU.”
“That’s okay, we can take her,” Jo and Alex help Alyssa out of the bed and into a wheelchair, carefully bringing her to stop beside her son’s warmer. “There he is.”
Alex looks up at the monitors as he listens to a resident list off the results of the studies they’d been conducting over the past few hours, “His SATs and his APGAR look great, all things considered. He’ll probably spend a week or two here before he’s sent home. He’s a strong and resilient little guy.” Alyssa and the resident both look at him in question. “I’m a peds surgeon.”
The hours go by quickly and before anyone knows it, night has fallen. Alex nudges Jo slightly, “Hey, I think we should get going. You need some rest. I got us a hotel room for the night.”
Jo nods in agreement and goes to move when Alyssa places a hand on her shoulder, “Wait. You can’t leave without knowing what the baby’s name is. I finally decided on a name.”
“What is it?” Jo asks expectantly.
“His name is Joseph Benjamin Harold. Joey for short,” Alyssa reveals. “It’s only fitting that he be named after the person who helped bring him into this world.”
“Are you serious?” Jo’s face breaks out into a wide grin. “I-I feel honored.”
“Thank you, Jo. For everything. I couldn’t have done it without you.”
Those words stick with Jo all the way back to the hotel. As they’re getting into bed that night, Jo cuddles up to Alex and sighs dreamily.
“What was that for?” Alex’s face turns up into a half smile as he glances down at his wife.
“I’m just so happy right now,” Jo shakes her head. “I know I shouldn’t be. Today was a horrible day for a lot of people. There was a tragic accident. But in the midst of all of that, I helped bring a baby into the world and I feel so much joy because of it.”
“There’s nothing wrong with that,” Alex pulls her closer. “A big part of why I love peds is because of the joy you feel every time you’re able to save a kid and give them hope for a future. And I’ve assisted on quite a few deliveries and it’s pretty incredible.”
“I think I wanna switch. I wanna make the switch to OB,” Jo exhales. “I love surgery, don’t get me wrong. And maybe one day I’ll venture into maternal-fetal surgery, but I want to be an OB, Alex. I want to deliver babies and feel that same kind of joy every single day.”
“Okay. So as soon as we get back to the hospital, we’re going to talk to Bailey and see about getting a letter of recommendation to the OB program so that you can switch specialties without repeating an intern year,” Alex rubs circles on Jo’s back.
“Are you sure? I know this is a big decision. I’ll be a resident again. I’ll have longer hours and be making resident money again,” Jo eyes widen at Alex’s simple response to her desire to make the change.
“Jo, I make plenty of money for the both of us. We’re married, we have a joint bank account. You don’t need to worry about the money. We dated throughout your entire surgical residency and everything was just fine. I want to support you however I can, and if what you want is to be a part of the vagina squad then I’m going to support you in that. I’m going to be there for you every step of the way,” Alex’s lips curve into a smirk. “Besides, I think you’ll look really hot in pink scrubs.”
“Shut up,” Jo laughs and shoves him lightly.
“What? It’s the truth. But then again, I think you look hot in everything.”
“You’re so good to me,” Jo’s eyes shine with happiness, “I love you.”
“I love you more.”