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Autumn finished up with one of her patients as Alex caught up to her. "Hey Dr Montgomery I swapped with Kepner so I'm on your service." Alex says as Autumn gives him a small smile.

"It's been a while Dr Karev but for now we are needed in the E.R." Autumn says looking at her pager.

Autumn and Alex headed to the E.R to assist with on one of her patients who had come in with chest pains as Alex pager kept going off.
~
"Can you describe the pain?" Autumn asks looking at the couple as the husband had come in with chest pains.

"I don't know. Uh, it just, uh...It's like a...It-it's crushing me and I can't shake it." Mr Carroll said to her as she gave him a small smile.

"Hand me the E.K.G." Autumn says looking at Alex as his pager was still going off.

"Uh, it looks like anterolateral M.I." Alex says to her as Autumn checks over the scans.

"We almost didn't come in.We're only in town till tomorrow.We're catching a cruise for Alaska." His wife told them while Autumn looked up.

"Mr. Carroll, you're experiencing a heart attack.We need to take you up to the cath lab for an angioplasty. Can you tell me what you were doing
when you felt the chest pain?" Autumn asks him watching the couple closely.

"We just went out to walk around our bed and breakfast.And, uh, it was like a piano fell onto my chest." Mr Carroll says to her.

"So you were walking. You weren't running or anything else that might have triggered the pain?" Autumn asks confused to what could have caused his heart attack.

"Well...we saw a lion." Mrs Carroll said laughing as Autumn looked slightly confused at the couple before telling Alex to prepare him for surgery.
~
"I'm sorry. Explain it again." Mrs Carroll says looking at Alex.

"Uh, during the angioplasty,Mr. Carroll had another heart attack.We placed a balloon pump to stabilize him,but that only buys us a little time." Alex explains to the couple.

"They're gonna have to do surgery, Emma." Mr Carroll explains to his wife.

"But he-he's going to be okay?" Emma asks looking at Autumn who gave her a small smile.

"If we can perform a coronary artery bypass soon, I'm hopeful that we've caught it in time." Autumn explains looking at the couple.

"I am so sorry, Em.You've been waiting for this trip 50 years.This cruise was a... gift from our kids for our anniversary.And now I've messed it all up." Mr Carroll says to his wife.

"You didn't mess anything up." Emma says to him.

"You wanted to see those humpback whales so bad." Mr Carroll says to his wife who shakes her head at him.

"Forget the whales.We came face-to-face with a lion.It's already a heck of a vacation." Emma says smiling at her husband as Autumn smiles at them.

"Yes, it is." Martin says to her.

"Happy anniversary, Martin." Emma says to her husband.

"Say that to me tomorrow." Martin said to his wife before Autumn looked at Alex going to update her notes.
~
"All right. The grafting is complete.Let's wean him off bypass." Autumn said looking at the anaesthesiologist.

"Dr. Karev, it's yours.It's from a Morgan."Did you get my last text? Where are you?"And then it says,
"We need to talk," all caps." The nurse read from Alex's phone.

"Is that the intern with the preemie?" Autumn asks looking at Alex.

"Yep." He nodded without expanding on the conversation.

""You're ignoring me. You're a total"...then there's a lot of strong language." The nurse told him while Autumn looked up at him.

"If you need to step away, just say so." Autumn tells him.

"I'm fine. Are we warmed?" Alex asks the nurse who nods at them.

"Yes, we are doctor." The nurse tells him.

"For what it's worth,I think you're doing the right thing.She needs to figure out how to take care of herself and her baby.She's alone.There is no time like the present to embrace it." Autumn says looking at Alex.

"Turn it off. Please." Alex says to the nurse.

"All right. Removing the aortic cross-clamp now." Autumn says as she removes the clamp.

"I see some bleeding." Alex says looking up at the head of cardio.

"Damn it. The ventricle's ruptured.3-0 prolene. Get in there with the suction, Karev.Oh, come on, Martin. Come on. Damn it." Autumn said as she looked over at his monitors.
~
"All right. Give me a pledget." Autumn said looking at the heart as she continued to work.

"Shouldn't we go back on bypass and patch it?I mean, one slip, and this guy's as good as dead." Alex reminds her while Autumn looked at him slightly.

"Then I better not slip.Okay, nobody breathe.Okay. Cut it. Let's see if it worked." Autumn asks as she finishes the patch.

"I don't see any blood.Crap. You did it." Alex says smiling at Autumn.

"I did, didn't I?All right. Let's finish up." Autumn says smiling at the team before she closed up Mr Carroll.
~
Autumn went to tell Mrs Carroll but she wasn't moving and had no pulse when she found her. "The nurse said your surgery was flawless,that now I have
the heart of a 50 year old.Thank you, Dr. Montgomery." He said smiling at Autumn.

"Martin..." Autumn said looking at her patient with a solemn tone.

"Where's Emma?Did you tell her yet?" He asks looking for his wife.

"When your surgery was finished...I went to look for
your wife in the waiting room.I thought that she had fallen asleep,so I tried to wake her, but...We performed C.P.R. I tried to resuscitate her myself,
but she...she didn't make it.They pronounced her dead a few minutes ago in the E.R.I am so sorry." Autumn explained to him trying not to let her emotions take over especially with her pregnancy.

"Oh... no.N-not-not Emma.No.She died?" He asks her trying to process what was happened.

"Yes." Autumn says to him.

"Emma's dead?" He asks looking at her.

"Yes." Autumn repeats to him.

"She's gone?" He asks again not truly believing what he was hearing and Autumns heart-broke for him.

"Yes, Martin.Emma is dead." Autumn repeated taking a breath as her eyes glazed over.

"Oh, Emma.Emma.Oh, god, Emma.Oh, no. No.No, no. No." Martin began breaking down crying for the women he has loved as he held Autumns hand.
~
Mark smiled seeing Autumn as she hurried towards him wrapping her arms around him. Mark was confused as he held her closely. "Hey are you okay?" Mark asks as Autumn nodded slightly while Mark kisses her head.

"I lost a patients wife she wasn't even my patient. It was his wife and she died waiting for him to come out of surgery. They were married 50 years. I love you Mark Sloan I know I'm hormonal and can be horrible sometimes but I love you." Autumn says as Mark kept her close to him.

"I love you Autumn Montgomery and I will for the rest of my life." Mark reassures her as held her and they held each other. Remembering that any moment could change the rest of their lives.

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