Author's Note: I'm not a new writer on here, but this is the first time I've shown my face, so to speak, here in the Grey's Anatomy pages (I'm a disillusioned ER fan undergoing a slow process of conversion)

Author's Note: I'm not a new writer on here, but this is the first time I've shown my face, so to speak, here in the Grey's Anatomy pages (I'm a disillusioned ER fan undergoing a slow process of conversion). I've recently got into Grey's Anatomy, got struck by an inspirational bolt of light, so thought I'd give it a go at posting here. Please let me know what you think of the story, reviews are always appreciated.

Explanatory Note: This is primarily for the benefit of non UK readers. In the UK, a consultant, which is probably about the equivalent of a senior attending, is addressed as Mr/Mrs/Ms etc rather than Doctor. Great Ormond Street is also a real hospital, but as per the disclaimer, I am making use of the name only, and all it's connotations of excellence in paediatric medical care.

Disclaimer: Standard if-Grey's Anatomy-belonged-to-me-I-would-be-an-awful-lot-richer Disclaimer applies. Also, I have nothing to do with Great Ormond Street hospital, except admire it.

You can run…

Mr Alex Karev

Consultant of Neo-Natal Surgery

Great Ormond Street Children's Hospital, London

That's what his business card said. It also said the same thing on the ream of headed paper that was in the third drawer down of his new (mahogany) desk, and on the brass plaque screwed to the heavy wooden door to his new office. Although they still looked strange and unfamiliar to him, they were beginning, slowly, six weeks in, to sound a little more normal.

If you were to ask him, he thought, precisely how he ended up here, about as far away from Seattle as you could get without leaving the hemisphere, he wasn't sure he would be able to tell you.

In truth, he hadn't felt right, settled, for a very long time. He did sort of know when that lost feeling began, but he didn't like to attribute it to that time, that event, so he preferred to think of it as a gradual occurrence. The main, and most noticeable, symptom was work. As an intern, he'd been all for clocking in, clocking out, not staying at the hospital a minute longer than the end of his shift, but slowly, he found himself being drawn in. His apartment (he hadn't lasted at Meredith's madhouse for long) was cold, empty, lonely, and he found he preferred working more than sitting at home on his own.

He didn't realise quite how much of a workaholic he had become until he was appointed Chief Resident. To be considered harder working, a better choice, more dedicated, than Cristina, well. But instead of doing something about the empty feeling inside, he just filled it with more work. Occasionally he would go out, but only if the others made him.

He and Izzie had gotten back together for a time. It was nice while it lasted, but she didn't set his world on fire and he had relieved as much as anything else when she had told him that her heart wasn't in it either. They had settled on friends, and had become close. It was her to whom he had first admitted there was something wrong.

Typical Izzie had plunged in, straight to the point, one lunchtime in the cafeteria after she had realised he had been on shift for almost three days.

'Talk.'

He'd rolled his eyes. 'What now, Iz?'

'You've changed. You're different these days. In fact, you've been different for years really, compared to when we were interns, but I just thought you were actually growing up.'

'Had to happen sometime.' He had tried to deflect her with a wry smile, but he knew her well enough to be sure it wouldn't work. He just hoped she wouldn't pry too deeply.

'I heard the nurses saying you came on shift at four o'clock on Tuesday.'

'Hm, sounds about right,' he mumbled through a mouthful of fries, poking his fork at Izzie's fingers when she tried to steal one. 'Stop it. I'm too hungry to share. If you wanted fries, why did you order salad?'

She succeeded in pinching a couple of fries and withdrew her hand from the fork's range. 'Don't try to change the subject. You started working on Tuesday afternoon. It is now Friday. The Alex Karev I know, even the grown up one, does not work for three straight days.'

'It's been busy, I've had some important surgeries,' he shrugged.

'Bullshit. You've out-Cristina-d Cristina. In fact, you work so much these days that Cristina isn't even the benchmark anymore, it's you. What's wrong Alex, why are you doing this to yourself? You're an attending now, you're Chief of your department. You've got interns to do the work for you, and residents to make sure they're doing it right. You don't have to do everything.'

'I like it.'

Izzie had sighed deeply then, as if she realised she needed to come at the subject from a different angle. 'You need a girlfriend.'

He remembered her little smile of satisfaction as he actually put down his fork and started listening to her. 'No I don't.'

'Really? When was the last time you got laid?'

'Some things I'm not going to tell even you, Iz.'

'Okay, so when did you last take a girl out?'

He knew better than to answer. Izzie was just getting into her stride and interrupting her was never a good idea. These conversations worked better as monologues, with him providing the occasional nod or grunt when he felt she might be looking for a response.

'Have you even been out with someone since me?' Her questioning look told him that in this instance a response from him was required, so he offered her a brief shake of his head.

Then, just to shut her up before she really warmed up, he blurted out a thought that he hadn't completely realised he was having. 'I'm thinking of leaving.'

Her eyes widened in surprise, then her mouth went into overdrive. 'Oh my God, since when? Where are you thinking of moving? Why? When are you going?'

He groaned, regretting his impulsive statement already, but somehow feeling his resolve harden. 'It's only an idea Iz. But you're right, I'm not happy here, so why shouldn't I move somewhere else?'

'Where?'

'I haven't even thought about it yet.'

'California?' That was as close as she dared to go. Once, shortly after they'd had to decide on their specialties and he had nailed his Neo-Natal colours to the mast once and for all, Cristina had been trying to needle him, get a rise out of him for the hell of it, and he'd absolutely blown up at her. Right in the middle of the cafeteria, in front of everyone, lunch tray on the floor and the whole works. After that, not even Izzie had been brave enough to ask what exactly had happened.

'Not California. But I don't know, somewhere new. Different.'

Izzie had looked at him thoughtfully for a while, then smiled. 'I think it's a good idea.'

'You do?' he'd asked, surprised.

'You need a new start. Go and find one.'