On the way home, Mark's brain was reeling with a thousand questions about their baby's condition, and Addison was doing her best to answer them. Though he was somewhat familiar with the birth defect, it was far from his area of expertise.

Mark couldn't stop thinking about how their life was never going to be the same. Instead of arguing about names or what color scheme to do the baby room in, they would have to discuss surgeries and treatments. Instead of teaching the child to walk, they knew they might have to face putting the child in a wheelchair.

But Addison hadn't stopped rambling the medical side of the equation.

"We'll have to consult with one of my colleagues to see what our best course of action is depending on how severe the condition is. Sometimes the fetus is operated on in-utero, and sometimes the fetus…"

"Addison, stop calling our child a fetus!" Mark interrupted as he pushed open the door to his apartment. She had referred to the baby as a "fetus" since they left the hospital, and he found himself unable to take it anymore. "Stop talking about him like he is one of your nameless, faceless patients!"

"He or she is nameless and faceless!"

"No, he is not. He will have a name. He will have a face. It will be our face. He's going to look like us." Mark took a deep breath. "He's going to be ours, and you have to stop talking about him in only a medical sense."

"I have to call him a fetus, because the second I start talking about him like he is ours and not some baby I will only know surgically is the second I'm going to completely lose it!" Addison shot back. She sank down into Mark's couch and dropped her face into her hands.

"Hey." Mark's voice softened, and he took a seat beside her.

"We're being punished." Addison said through her tears. "We're being punished for having an affair."

Mark rubbed slow circles on her back. "Look, I don't spend much time talking to God, but he doesn't seem like the type of guy who would inflict pain on innocent babies to get back at their parents."

"Then why?" Addison looked up, and Mark wiped the tears from her cheeks with his fingertips. "Why is this happening to us?"

"Why does this happen to anyone?" Mark responded pointedly. "We're not exempt just because we're doctors. Instead of wondering why us, we need to focus on our baby's quality of life and making the best decisions for him."

Addison shook her head. "I don't get how you are so calm about this."

"I'm not calm." Mark answered. "I am absolutely terrified. I was already scared of being a terrible father, and now, we're having two babies, and one is going to have special needs. I have no idea how we are going to handle this; I just know that we can, and we will. It's going to be incredibly difficult, but it's a manageable defect."

"You're right." Addison leaned her head on his shoulder and allowed him to stroke her hair. She took a few deep breaths to steady her breathing. "After all, we're surgeons… We know how to work under pressure."

Mark dropped a kiss on the top of her head. "Exactly."

Addison snuggled into his chest, grateful that Mark had his moments of logic and clarity. Mark ran his hand gently over her small baby "pooch" (and he only called it that in his head and never aloud to her). He wondered if they were having boys or girls, or one of each. He wondered if they would look like him, her, or both of them. Most of all, he wondered if could be a good father to them when he'd never had a real one of his own.

Mark has always said that as a plastic surgeon, he fixed what was on the outside to cure what was wrong on the inside. In truth, he didn't see how a set of D-cups could really cure anyone's insides. But, working with children was different.

Amy was a bubbly eight-year-old with one last surgery for her cleft lip and pallet to go. Mark's view on surgery had changed after he realized that he was going to be a father to a special needs child. In Amy's parents, he saw what was to come for him and Addison. The fear of surgery after surgery. The painful task of trusting your child to someone else's hands. He found himself with a better bedside manner than he'd had since medical school, before he had become jaded.

"One more surgery, and you'll have that superstar smile you've been telling me you've always wanted. Are you ready?" Mark asked as he and an orderly rolled Amy down the hall to the operating room.

Amy nodded slowly. "I'm a little scared, though… I know I've had surgery before, but, I get scared every time."

Mark patted the little girl's hand gently. "I know. But we talked about what's going to happen, remember? You know what to expect. It's going to hurt, but then you'll feel better, and then you'll be happy with your smile. You know I'll be with you every step of the way until you feel better."

"Right." Amy smiled. "Dr. Sloan, you're good with kids. You got any?"

Mark smiled slightly at the first time he has been able to answer that question without vigorous shaking of his head. "Yeah. I have twins on the way."

"Awesome!" Amy grinned. "You'll be a great dad. I know. I can tell."

It was at that moment that Mark and Amy passed Addison at the nurse's station in the hall. Unbeknownst to them, she had been watching their entire exchange with interest. Addison gently reached out to touch Mark's arm and whispered.

"I think so, too."

Back in her office, Addison stared at her divorce papers, neatly stacked against blue paper. After seeing Mark's calm, comforting demeanor in the hall with Amy, she'd known it was time to pull them out. He had told her that he was "all in," but she had to admit that she had yet to become "all in" herself. Signing the papers was the only way to get to that level.

There was just one blank line, waiting for her signature. She looked at the sonogram of the twins, propped up against her computer monitor. Without looking away from the grainy black and white picture, Addison snatched a pen off of her desk and signed "Addison Montgomery-Shepherd" on the line, knowing it was the last time that would ever been her name. As she sat back in her chair and stared at the signature, she realized she couldn't send the papers herself. Though she wanted to, she couldn't end the marriage herself that way.

She stood up from her desk and walked out to the reception area of her office. She held the papers out to her secretary, Jenna, along with a Post-It note with a phone number hastily scribbled on it in Addison's illegible doctor handwriting that only Jenna and pharmacists could decipher.

"Um… Could you…" Addison fumbled.

Jenna nodded silently. Besides being her secretary, Jenna had been a pretty good friend to Addison. She was one of the few people who knew the details of Mark and Addison's relationship, about the twins, and about the divorce. She took the papers from Addison's shaky grasp and crossed the room to the fax machine. Addison hung back and listened to the horrible noises that the machine makes as it dials Seattle. She watched as Jenna fed the machine each page that would end the last eleven years of her life.

As the fax machine beeped to signal that the transmission to Derek's lawyer was complete, Addison realized that she finally felt free to love Mark and their children.