Medicine: that became my life's work, and looking after a few special students, like you. ...She did what she thought was best for me. The truth is I had to thank her. I was the only female surgeon in my class. Male residents just tortured me, but it rolled of my back. After your mother calls you a whore, nothing else hurts. ...We're women, honey. The strength finds us.
Vivian Carlsmith to Addison Forbes Montgomery

Vivian Carlsmith was a world-renowned obstetrician-gynecologist and a pioneer in maternal-fetal medicine. She was also Dr. Addison Montgomery's mentor.


Before Dr. Carlsmith began her career as a doctor, she had a baby in 1954 when she was 15. Although she wanted to keep her baby, her mother did not allow it, and her baby was given up to a Catholic family.

After a long career and having devoted her life to medicine, she eventually retired and moved to California some time after she was diagnosed with gastric cancer. She eventually was hired by UCLA as part of their guest lecturer series.

In 2013, when she began to experience abdominal discomfort, she was admitted to St. Ambrose Hospital's emergency medicine department by Dr. James Peterson. When Dr. Carlsmith was discovered by Addison in the ER, she reconnected with her former student.

During Dr. Carlsmith stay, she also bonded with Dr. James Peterson. She reminded him of his grandmother, who had also passed from cancer. They played gin as they discussed her test results and Dr. Peterson updated her diagnosis as end-stage cancer since it had metastasized to her liver. Although the news of dying soon didn't dismay Dr. Carlsmith, she refused hospice care and placed her trust in greater forces, to the surprise of Dr. Peterson.

Dr. Carlsmith also met Addison's son and revealed her past regarding her own baby. She counseled Addison through troubles with a former patient and requested for Addison to write a letter and deliver it to her daughter.

She later succumbed to her illness at the age of 74 and died at St. Ambrose Hospital not knowing that her daughter had lived a wonderful and full life.



She gave birth to a baby at age 15. She wanted to keep the baby, but her mother sent her away to give birth and give her baby to a catholic family. After the baby was born, she was supposed to have time to hold her before she was taken away, but Vivian's mother wouldn't allow it and took her home right after she gave birth.


Addison Forbes MontgomeryEdit

She served as a mentor for Addison when Addison was becoming a doctor. When Vivian was diagnosed with gastric cancer, Addison visited her frequently and brought her son to visit as well. Vivian asked Addison to write a letter for her and dictated a letter to the daughter she'd been forced to give up. Addison then delivered the letter.

James PetersonEdit

When Vivian was hospitalized at the end of her life, James regularly visited her. He told Addison she reminded him of his grandmother, who had also died of cancer.


Dr. Carlsmith was an obstetrician-gynecologist and a perinatologist. She made advances in maternal-fetal medicine during a time when there was no treatment for high-risk pregnancies, inventing a technique to place a temporary plug in the fetal trachea.

During her OB/GYN residency, she was the only female surgeon of her class. Despite being tortured by the other male residents, Dr. Carlsmith forged ahead, accrediting her strength to her mother.

Later in her career, Dr. Carlsmith served as a mentor for Dr. Addison Montgomery and worked with Dr. Richard Webber and Dr. Derek Shepherd.

Additionally, she published a paper regarding patients presenting with labor in Frank Breech, and how to treat using the external cephalic version technique. The paper has been said to contain descriptions that were so clear that it can be performed flawlessly.

Notes and TriviaEdit

  • Dr. Carlsmith most likely worked at the same hospital in New York, mentoring Addison with Richard.
  • 40 years prior to her death, Dr. Carlsmith was a "beauty"; a description that Dr. Peterson shares even now.
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