A little bit of information, PLEASE READ BEFORE YOU BEGIN:

This story begins in Season 6. It is after Izzie leaves, but before the shooting. However, I do include the shooting much later on in the story.

I am aware that Alex's little sister is actually supposed to be 16 or 17, but I made her younger for the story.

The first chapter briefly mentions that Alex's mother and his brother, Aaron, struggled with drug addiction. I know that they are both schizophrenic, the drug addiction is something that they developed to cope with their illness. That did not happen on the show, but I decided to include it.

Jackson Avery already lives in Meredith's house in my story. I really like his character and I wanted to include him from the beginning. So for the sake of wanting to include his character, he lives with them before the shooting.

While I try to remain true to the story line of the show, I do change things from time to time. So if you notice any other differences, feel free to ask me about it, but things will not always occur exactly as they did on the show.

Disclaimer: Sadly, I do not own Grey's Anatomy.

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"Are you in or out Karev?" Bailey repeated impatiently. "Karev!" She shouted, anxiously trying to obtain the young surgeon's attention. Alex was quickly jolted out of his thoughts.

"In or out for what?" He asked, slightly embarrassed at his own absent-mindedness.

Bailey sighed, growing increasingly annoyed with the young resident's lack of focus. "Are you scrubbing in?" She repeated slowly, annunciating each syllable as if talking to a child. "Although, I'm a little afraid to ask at this point…"

Alex bit his lip, trying to resolve the internal struggle plaguing his mind. He really should head back to the house. Mrs. Clark would be there within the next few hours to drop off Amber. He couldn't help but assume that being present to receive custody of his sister should take precedent over his work. But still….passing up any surgery, no matter how common a surgery, was a deadly sin at Seattle Grace Mercy West – especially with Miranda Bailey.

"I'm in." He decreed, snapping back to reality. And I'm a horrible brother. He thought glumly.

"Great, let's move it." Bailey replied, turning towards the pediatric wing. "We've got an 11-year-old male, admitted with severe abdominal pains. He will be undergoing an appendectomy today…. unless there is something else you would rather be doing." She added at the end, wanting to make sure he knew that she had noticed his spacey behavior.

Alex resisted the urge to roll his eyes. Of course I can do an appendectomy, it's only the easiest surgery known to man. He knew he was being stupid, risking not being home when the social worker arrived…but he couldn't deny that he was interested in declaring a specialty in pediatric surgery. If he wanted Bailey to put in a good word with Dr. Robbins, he assumed he shouldn't pass this up."No Dr. Bailey, I am thrilled to have the opportunity to scrub in." He assured as he followed behind her.

Bailey wasn't one to make conversation when there was business afoot. Alex couldn't help but notice that despite her short legs, she sure could book it down a hallway in record time. He struggled to keep up with her quick pace. People tended to part and make way for her, even her superiors. Alex was shown no such gesture and therefore had to shove his way past several nurses to avoid losing her in the process.

When they finally arrived in the surgical preparation room, a large smile formed on Bailey's face. She was one of those surgeons who truly loved her patients. It was her residents and interns that she tended to be cold and strict towards. "Hey there Joshy." She greeted cheerfully.

The little boy offered a nervous wave with one hand and clutched onto his mother tightly with the other. She smoothed his hair out comfortingly. Alex couldn't help the butterflies that formed in his stomach at the sight of such parental action. Was he meant to do things like that starting today? Would he have to comfort Amber when she was scared? Would she even let him? Would he have to help her with her homework? Cook for her? He had no idea how to be a guardian…he just couldn't stand by and let her go into foster care.

"Alright Mrs. Matthews, we're getting ready to take him down. We're going to have to ask that you head to the waiting room. Someone will be out with an update as soon as we're finished. It won't take long." Bailey informed the patient's mother.

Mrs. Matthews nodded and Alex turned away so he wouldn't have to see the final exchange between mother and son. It was too large of a reminder that he was already flaking out on Amber…and he hadn't even gotten her yet.

After his mother was gone, Alex picked up the boy's chart and scanned over it quickly. He wanted to make sure he had all of the basics covered because Bailey would be asking him questions during the surgery. She, and of course Dr. Robbins, had been really drilling into him lately about his bedside manner.

"Am I going to have a scar?" The young patient piped up worriedly, staring up at Alex with wide brown eyes. Alex stopped prepping for a moment and came down to the child's level.

"Yeah dude, you will." He replied honestly. The boy lowered his head, allowing his sandy blonde hair to fall over his eyes. Alex glanced at the chart quickly, searching for the boy's name. "But…. I'll tell you something Josh." Alex began quietly, glancing around as if he were about to reveal a huge secret. "Chicks dig scars." The boy's eyes seemed to brighten slightly, and Alex sighed with relief as he began to wheel the bed out the door.

"Are you ready man?" He inquired.

"I guess." Josh replied as he offered a small shrug.

See, I'm not so bad with kids. He decided, scoffing at the comment Dr. Robins had made earlier, referring to him as "far too angry at the world to be around her tiny patients." The real test, he supposed, would come later that day. Then again, he didn't know if he should consider Amber as a child anymore. After all, she was….sixteen? Fifteen? Seventeen? Damn it…I should probably figure that out.

Having come to the conclusion that he literally knew nothing about his little sister, not even her age, he solemnly accepted he was most likely the worst brother who ever lived, not to mention an unfit guardian. However, that didn't stop social services from deciding he was best suited to care for a teenage girl. Not just any girl, but a traumatized teenage girl who recently watched as her mother overdosed while being sexually assaulted by said mother's flavor of the week. It made him sick to his stomach to think about what she had been through, his baby sister, the little brunette girl with braids who used to look to him as if he made the sun shine.

Alex entered the O.R., his thoughts still preoccupied. He quickly scrubbed his hands thoroughly, pulled on his mask, and pushed open the door using his shoulder.

"What do you say we take care of that appendix?" Bailey suggested, sounding slightly muffled through her mask. Alex walked around to the side of the operating table as the anesthesiologist entered the room. Josh looked up at him, his eyes full with panic. Alex gave his shoulder a reassuring squeeze.

"Josh," he spoke softly, "this man is to give you something to make you go to sleep and when you wake up you are going to have a super cool scar and an excuse for your parents to give you ice cream whenever you want." Josh seemed to relax slightly at Alex's words. They waited patiently to get the green light.

"Alright, let's get started." Bailey initiated the start of the surgery, passing a scalpel to Alex.

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The surgery was quick, as appendectomies usually are. Without complications, they are almost always around 45 minutes long. This one had been slightly longer because Bailey had Alex basically do everything on his own, only offering small snippets of advice periodically. As soon as the surgery was over, worry set in. Was it considered a termination of his custodial rights if he wasn't present when the social workers brought over the final paperwork? Most likely. Then again, perhaps she wouldn't mind waiting another 20 minutes for him to get back to the house. Jackson and Lexie were there. Alex was confident in their ability to keep her from putting his sister on the next plane back to Iowa.

Alex didn't have to wonder for long. As soon as he walked through the double doors that led to the main floor of the hospital, he was face to face with a small, black haired woman in a pencil skirt and matching jacket. She looked exactly how he would have pictured a social worker. Her demeanor was serious, but her appearance gentle. Her posture was board-straight, giving new meaning to looking like she had a pole up her ass.

"Dr. Alex Karev?" She asked, glancing down at the clip board clutched in her tiny hands.

"Yes." Alex verified, suddenly noticing the teenager lingering behind her. Seeing how grown up his little sister was almost brought him to tears, smacking him with the reality of how much of her life he had missed. She was small, somewhere around 5"3. She was also very thin, but clearly athletic, sporting a purple "Varsity Soccer" t-shirt. Her wavy, brunette hair hung down to her shoulders, framing the face of a beautiful young woman.

"I'm Gertrude Clark. I arrived at your house about an hour ago, but one of your roommates told me that you got held up in surgery. I assumed that delivering the final paperwork here would be easier for you than rescheduling." She said to him, her tone stiff and professional.

Alex made a mental note to thank Jackson Avery for covering for him. "Yes that's fine. Would you like to go sit down where we can go over it?" He asked. The woman nodded and followed him as he led her to the resident's longue. Amber dragged her feet slowly behind them. As they walked through the door she passed him, and uttered very quietly, so quietly he wondered if he had imagined it, "I see surgery still comes before family."

They in the back of the longue where two fold out tables had been pushed together. Amber sat in the farthest chair possible and crossed her arms, staring down at her lap. Alex had caught a glimpse of her bright, green eyes before she looked down. 'Cat eyes,' he used to call them. They were unusually green, enlarging to what appeared as twice their size whenever she wore earth tones. They were irresistibly charming, and she knew it. As a young girl, all she had to do was bat her eyelashes at their brother, Aaron, and he would let her get away with anything.

Mrs. Clark slipped on a pair of reading glasses and detached a thick packet from her clip board. She got directly down to business.

"Social services has come to the final decision, seeing as the mother of the child has been deemed unfit to provide proper care, the minor, Amber Karev, will be placed in the custody of her older brother, Alex Karev." Alex nodded slowly. "Sign here." Mrs. Clark dictated, handing him a pen. Alex scribbled his signature down and waited for her to continue.

"It is my understanding that you are no longer married to Isabel Stevens? Is that correct?" She asked, flipping through her folder of information, stuffed to the seam with every possible fact about his life imaginable. With this, Amber looked up with an expression of pure shock. Amber, Aaron, and his mother knew nothing about the marriage, the cancer, or the divorce.

"I am recently divorced." Alex mumbled in return.

"I see." She made a note at the bottom of her clipboard before continuing. "I also know that you work an impressive number of hours per week, which is a legitimate concern when awarding custody of a child. However, you wrote here that you share a house with four other doctors, all who are aware of and have offered their assistance and support with your situation. I have statements here from Dr. Derek Sheppard, Dr. Meredith Grey, Dr. Alexandria Grey, and Dr. Jackson Avery. Is this still your current living situation?"

Alex nodded in agreement, not wanting to mention that he was currently looking into renting an apartment near the hospital. Meredith and Derek had assured him repeatedly that they did not mind his sister moving in. Lexie had even moved back into the attic room so that Amber could be closer to him, but he hated depending on them so much.

"If you will put your signature and the date at the bottom of the page, I officially grant you temporary custody of the minor, Amber Karev. Remember that this is subject to change depending on your ability to provide sufficient care. You can expect frequent visits from me as well as other members of social services; we will be present in court when your case is revisited six months from now to determine permanent custody."

Gripping the pen sharply to steady his shaking hands, Alex signed his name and date at the bottom of the page. He exhaled deeply as he set the pen down and slid the stack of papers back to Mrs. Clark.

"Congratulations, and I wish you both the best of luck." She gave Amber's shoulder a squeeze and offered a gentle smile before collecting her briefcase and letting herself out of the room. Alex sat at the opposite end of the table, staring at his sister, willing her to say something. She remained silent, her gaze fixed and unmoving with irritation. After what seemed like forever, she finally offered an opinion.

"I wanted to live with Aaron." She announced flatly.

Alex sighed. His brother had encountered an impressive number of medical issues in the past year or so. Although he had never exhibited any official symptoms, his behavior was beginning to suggest schizophrenia. Alex had seen it all before with their mother, and Aaron's doctor had expressed his concerns to him on more than one occasion. Without warning or explanation, Aaron had moved out of their mother's house a year earlier. That alone was a huge red flag. He had always vowed to stay put, to watch over Amber after Alex left. Their mother couldn't be trusted with her, but for some reason, that stopped concerning him. It didn't take long before he began to turn to drugs to banish reality. Runs in the family. Alex thought bitterly as he was reminded of his father's dependence on alcohol as well as his mother's own recent bout with drug addiction.

"Aaron left you, kid." He reminded her. "He walked out on you and left you alone with mom and her creepy boyfriends. Why would you want to live with him?"

"You left me too." She fired back instantly. "For a lot longer than he did…"

"Amber." Alex said, clasping his hands together. He hesitated for a moment. "Aaron's not well….you know that."

"I would still prefer him." She replied coldly. "He would at least try to take care of me. He's sorry that he left."

"You know I'll take care of you."

"Do I?" She inquired. "You sure didn't have a problem leaving us once."

"I didn't have a choice! Who do you think pays the larger half of Aaron's medical bills? Who do you think sends money that keeps the house from being foreclosed when mom blows her paycheck on drugs? Who do you think sends Aaron money to make sure you get fed and clothed?"

Amber simply shrugged and returned her attention to her lap, nervously examining her painted fingernails. Alex knew better than to continue this argument, he had been having the exact same one with Aaron for years.

"What do you say we get out of here?" He asked, glancing at his watch. 6:12. She was probably hungry, although he doubted she would admit it. She responded with another emotionless shrug.

The drive home was silent and uncomfortable. He attempted to make small talk, but failed miserably each time. Amber was much more interested in loose threads on the bottom of her shirt or the uniform houses flying past the car windows. They pulled into the driveway and Alex surveyed the various parked cars to determine who was home and who remained at the hospital. Jackson was home, it was his day off. He thought the second car belonged to Lexie, but he wasn't positive.

Amber followed him into the house through the back door, leading to the kitchen. Jackson was sitting at the bar, drinking hot tea and reading the sports section of the newspaper.

"Hey Alex, did you get everything taken care of?" He asked, folding his newspaper and setting it in front of him. His eyes shifted towards Amber, curious how she was taking everything in. He had been the one to let her and the social worker in the first time, but they hadn't really spoken much. He had thrown out a few conversation starters while Mrs. Clark attempted to reach Alex, but Amber was a pretty shy kid from what he could gather.

She looked around calmly and shifted her attention to the floor. "Hello again." He offered.

"Hi." She answered politely before making timid eye contact.

"Yeah, everything's all set. " Alex nodded and looked around himself. "Who else is here?" He asked.

"Lexie I think. She might be napping, she's on call tonight." He responded. "Oh by the way, the social worker left the kid's bags in the foyer."

"Thanks Jackson."

"Not a problem."

Alex started to walk into the den before noticing that Amber hadn't moved an inch. "Amber, come on." He directed. She reluctantly stalked behind him into the den and through the doorway leading to the foyer. Two small suitcases sat at the foot of the stairs. "Is this is?" He implored, pulling out the handles and dragging them down the hallway.

"I don't have much." She mumbled, following behind him at a distance.

"This is your room." He said, pushing open the door. "Mine is right next door in case you need anything."

"I won't." She assured him coldly. Alex chose to ignore the comment and rolled the suitcases in front of the bed, which was now covered with a blue, polka dotted duvet.

"Mrs. Clarke said your favorite color was blue so…." He began, but let his voice trail off.

"Thanks." She cut him off half-heartedly. "I guess I'll unpack."

Alex lingered in the doorway, wondering if there was anything else he could possibly say to lighten the situation. "You can go." She dismissed him without looking up as she unzipped her bag.

Alex sighed and retreated back towards the kitchen.

"She's adorable." Jackson commented as he came back into sight. "Looks absolutely nothing like you."

Alex chuckled, receiving a smirk from his co-worker. "I have no idea what to do with her, she hates my guts." He ground out after a minute.

"Give it some time." Jackson advised as he shuffled through a stack of papers in the top drawer of the center island. "Chinese?" He asked, holding up a menu.

By the time the food had arrived, Derek and Meredith had returned from the hospital, both having just finished a forty-eight hour shift. The bags under their eyes were starting to develop their own set of bags, but they were chipper nonetheless. Alex decided it was probably a good thing. Amber might as well get a feel for what life in this house was really like, sleep deprivation and all.

Alex walked down the hall to the spare room that now housed his sister. Amber had adamantly stated she wasn't hungry, but he ordered her a pint of chicken and broccoli anyways. He was entirely new to this whole 'parenting' business, but he assumed making her eat dinner was somewhere in his job description.

"Dinner's here. Come to the table." He told her, arms folded, leaning against her doorway.

"I said I'm not hungry." She shot back, not bothering to glance up from her Cosmo magazine.

"And I said you can come to the table anyways." He retorted quickly, taking care to make his voice sound somewhat stern. Amber waited momentarily, curious if he would give up and leave her alone. When he showed no signs of movement, she eventually closed her magazine without a word and walked into the kitchen.

"Meredith, you aren't giving me enough credit. The tumor was this big." Derek was recounting his most recent surgical victory with a huge smile as they walked in the room. He held out his hands, creating a gap about the size of a softball. Meredith laughed and rolled her eyes.

"That thing has been growing by the hour." She teased.

As if sensing the presence of a newcomer, they both glanced up and noticed the young girl standing shyly behind Alex.

"Hi there, I'm Derek." Derek said, offering one of his perfect smiles. "This is my wife Meredith."

"Welcome to the jungle." She commented, earning a laugh from everyone in the room including Alex. Derek stood up and pulled a chair out for Amber. She offered her best fake smile and sat down as her brother handed her the chicken he had ordered.

"How old are you, sweetheart?" Meredith implored after a brief period of silence.

"Fifteen." Amber replied, twirling her fork around inside of the plastic container without taking a single bite.

How could I not have known that? Alex chastised himself, extremely thankful that Meredith had asked the question so he wouldn't have to.

"You play soccer?" Jackson entreated, pointing to her shirt with one of his chopsticks. Amber nodded, keeping her eyes on the table.

"Since when?" Alex asked. Before he had moved out, she was dedicated to the swim team. He didn't think she even owned a soccer ball, let alone knew how to kick one.

"Six years ago." She replied sharply. The room became silent. Had it really been that long since he had talked to his little sister?

The remainder of dinner consisted of hospital gossip, tales of difficult surgeries, and comparing schedules for the following week. Amber sat in silence the entire time, silently begging for the night to be over. Finally, Derek and Meredith cleaned their dishes and made their way upstairs while Jackson excused himself into the den to watch television, leaving Amber and Alex alone once again. She started to get up slowly, praying Alex wouldn't attempt another conversation.

"I don't recall excusing you." Alex said looking up at her.

"Really?" She lamented, giving him a 'You have got to be kidding me' look.

"Yes, really."

"Can I be excused?" She asked, not even attempting to hide the strong attitude in her voice.

"No, you barely ate."

"I'm not hungry."

"I'm not asking you to stuff yourself, but Mrs. Clark said you hadn't eaten all day. Seriously, take five bites and I'll let you go." He tried to compromise, standing up and gathering trash on the table to throw away. Amber stared at him for a moment, trying to detect exactly how serious he was. After a moment she came to the realization that if she wanted to get away from him, she should suck it up and give him what he wanted. She took five microscopic bites, folded the Chinese food container shut, and slammed it onto the counter.

"Happy now?" She spat.

"Yep." He replied, continuing to clean up the kitchen.

Amber left the room, making sure to roll her eyes while doing so. She walked into her bedroom and slammed the door shut.

"That went well." Jackson commented, glancing up as Alex walked into the den, plopping himself in an armchair next to the couch.

"That girl is going to be the death of me." Alex declared, feeling completely defeated after only a few hours.

"That's a little dramatic. I doubt it will kill you." He countered. "I'd say, worst case scenario, all of your hair falls out."

"Thanks man, that really helps." Alex replied sarcastically

They watched television for a while, talking small breaks in attention to chat aimlessly about anything that didn't involve the hospital or the young girl residing angrily down the hall. Alex excused himself to go to bed a little after 11:00. He had to be at the hospital by 8:00 the next morning and he was both physically and mentally exhausted from the events of the day.

He walked into his room and swiftly changed into a pair of sweat pants before heading to the bathroom to brush his teeth. On his way back to his room he stopped for a minute outside of his sister's door. He hesitated slightly before opening it and peeking in. She was sound asleep with the bedside light on, the covers in a knot to the side of her. He walked in very slowly, afraid that the smallest sound might wake her. She had been a heavy sleeper when she was a little girl, but years of living in a house where you feel unsafe can change that. He gently pulled the covers up to her shoulders and turned the light off. He stopped in the doorway and took one final look at her before closing the door.

What the hell am I doing? He thought frantically as he collapsed into the welcoming sheets of his own bed, bracing himself for what tomorrow might bring.

You likeeeee? There is so much in store if you keep reading. Drama, tears, laughs, fluff, angst, you name it. You rock for reading this. Hope you continue!

XX Maddie