A/N - This is my new story. It started out as something I wrote whenever I had no inspiration for my real fics, but has transformed past recognition since the beginning. It will be ten chapters, of which this first one takes place about three years before the rest of the story.

While I absolutely love the fact that Meredith and Derek adopt in the series, the fact that they have not just one, but two biological children in this fic was a too big cornerstone for me to change after having written almost all my chapters. As you read on, bear in mind that any similarities with certain elements in the show actually are coincidences, since I began writing this way back.

If you like it, please leave me a comment. I have been working a lot with this, and I will be happy for feedback!

Derek stood in the corner of the waiting area in the maternity ward, impatiently eyeing the posters on the notice board. Here were lists of what to do and not do to during pregnancy, where pictures of things like smoking, drinking and something he suspected should resemble a raw fish were crossed over in red. One poster stated that THE MOMMIES OF TODAY FORM THE CHILDREN OF TOMORROW. He saw sign up sheets for therapy sessions, Lamaze classes and even babysitter services, but couldn't muster enough interest to actually look into them.

He had just come downstairs, having hurried from the surgery he had performed on an older man with a bad GSW to the head and just stopped briefly to get two Styrofoam cups of coffee, one of them decaf. He wasn't sure of Meredith's schedule today, but if he knew her, she wouldn't slow down and hydrate much. Both of them would be off before seven tonight, though, and he was looking forward to spending a Friday night together with his family, since those tended to be characterized by 'where's Mommy' or 'when is Daddy getting home'.

Josie would benefit from a quiet night with them both, he hoped. He was concerned about their daughter. At three, she was still not confident enough to talk to other children without an adult there to coax and support her. Although she'd been enrolled at the hospital's daycare almost her entire life, she still hadn't got used to playing with others. The teachers repeatedly reported that Josie hid from the other kids, that she only watched their games and that she constantly needed one of the teachers to even consider participating in anything. Derek had seen the same pattern every time they had their friends over for dinner, or when Josie tagged along with one of them during hospital hours. Even Lexie or April that she'd known her whole life took a while for her to warm up to each time she met them, during which she grew quiet and clung either to him or Meredith. They had discussed this problem several times, without really coming up with an answer. He knew Meredith worried that their working hours prevented them from giving Josie the security she needed. To be honest, he was too. They were both glad for the temporary respite Meredith's maternity leave would give them, but they knew that keeping her home would never be a permanent solution. Their daughter needed to be around other children to develop socially.

Their daughter wasn't the only one who would benefit from family time. Lately, he'd had the feeling that Meredith didn't hesitate taking another shift when she could have avoided it, if he was off and could take the baby. The occasional nights they did have together tended more and more to be about calling daycare teachers, grocery shopping or scheduling the coming week. He didn't like this lack of own time with Meredith. Even though the reasons were completely different, he recognized the signs from his and Addison's marriage. He felt nowhere near the distance he'd experienced with her, but he knew they were heading down a dangerous path in letting each other slip, not taking care of what they once both had been sure of that they had.

He was slightly aware of that his left foot was tapping against the floor when he saw Meredith enter the room. Not catching his eye, she sank down in one of those steel-legged chairs with a soft cushion that looked comfortable but that really wasn't. In this stage of Meredith's pregnancy with Josie, she had been much more scared and unsure of herself than this time around, but she had also been less tired. Derek guessed the same went for him. He knew as well as she did that coming home from a hectic day at work wasn't the relaxing oasis it had been before they had Josie. Without a word, he placed the coffee cups at the small table and sat down next to her. Meredith cast him a surprised glance, then closed her eyes briefly and leaned back as best as she could on the hard-backed chair.

"I was called in to consult on a kid with a vascular malformation today," she mumbled. "I've never seen anything like it. It had taken over half of his cheek."

"You did?" he replied, partly because it sounded like an interesting case, partly out of habit. Then he sighed. He didn't want their rare moments together consist of conversations about work. "We need to talk, Meredith," he said instead.

"Is it about Josie?" Meredith asked tiredly. "I spoke to the daycare yesterday..."

"About us," Derek interrupted. "We need to talk about us."

He could feel Meredith tense next to him. "This is not the time, Derek."

He was about to protest. He hated it when she did like this; avoided important talks, pretended everything was fine. Then he thought better of it. In the midst of the turmoil their relationship had been in the beginning, he'd learned by trial and error just which discussions not to take at wrong times. He'd just been stupid to suggest something like it here; the waiting area in a ward where they were patients wasn't the right place for the discussion he wanted.

So he shrugged and sank back, and they stayed in silence. Even though it wasn't uncomfortable – and Derek felt hope linger in his chest that it wasn't – they both looked up expectantly when a nurse appeared in the doorway, calling for Dr. Grey.

They both rose, and then stood a little awkwardly, each one waiting for the other to go first. Derek gave the nurse a quick smile, a little hesitant where to go now he wasn't in charge. The nurse motioned for Meredith to follow her into an exam room and Derek sat down on one of the chairs by the wall, nodding politely at the man in the mid-thirties that was setting up the monitor for examination. Derek vaguely recognized him, but it must be from the cafeteria or maybe from Joe's, because he was sure he had never worked with him.

"Let's see, Dr. Grey," the radiologist said and smiled reassuringly at Meredith as she reappeared from behind the little curtain in the corner of the room, clad only in a hospital gown and with her hair swept back in a loose ponytail. "If you could lie down for me at the table, we'll soon have your little guy up on the screen."

Meredith returned his smile a little nervously and climbed up at the exam table as graciously as she could. She hadn't turned very pregnant yet; Derek knew she still was able to hide it underneath her scrubs and a white coat, but she was bigger than when she had been pregnant with Josie and definitely heavier than desired for that kind of gymnastics.

"You okay?" he asked, reaching forward and taking her hand in his. She nodded a little and shifted positions slightly.

"Not the most comfortable bed," she muttered and scooted a little higher up. The radiologist still fiddled with the monitor and Derek bent down to stroke his hands over her swollen belly.

"Hey there, little one," he murmured. "As soon as we've seen you, we're going to go home and let Mommy rest in a much softer bed, what do you say about that?"

Meredith smiled a little at that and then closed her eyes as the radiologist pushed her gown up over her abdomen and squirted some gel onto her skin. Derek saw that she shivered a little at the cold touch and squeezed her hand a little harder. She opened her eyes.

"Talk to me," she said. "I'm gonna lie here and pretend that I'm not lying on a damn hard table and that it's okay to relax before my next consult, but I need you to talk me through it."

Derek laughed a little. It was a sign as good as any that he found himself having missed her way of rambling when she got a little nervous.

"Do you remember the ultrasound we did with Josie?" he said to distract her. "I know you were nervous, but I think I was even more."

"No, you weren't." Meredith shot him a incredulous look. "I was a mess and you just held my hand and told me everything would be fine."

He knew she was right. Few times had he been so anxious – only at Josie's actual birth and when Meredith had had her two death scares back in her intern years – but Meredith had been terrified and somehow that had made him hold his pieces together enough to calm her down. He almost cringed a little when he remembered how he had constantly kept track of every little move the radiologist had done and every little flicker on the tiny screen. This time he had promised himself not to be such a pain in the ass again. It was actually enjoyable being in a hospital room as a patient when it had less to do with life-sustaining breathing tubes and more with the prospect of a new little person that was soon to be theirs.

This would be their second miracle baby. Josie had come to them after three miscarriages and too many tries to be counted. After the twelfth week mark, the pregnancy had been smooth even if both of them had lived in constant fear of something happening every step of it. They'd never dared to hope they would get to have that a second time. They'd never even explicitly tried for another baby, although the hope of one never had stopped lingering.

The radiologist kept up a steady stream of good-natured small-talk, retelling tales from his career and making them tell him about Josie while he moved the transducer over Meredith's abdomen and made the gel smear out evenly. The minutes ticked by and Derek had almost lost himself in thoughts, listening only with one ear to the conversation when he heard a soft, thumping sound filling the room.

"That's it," Meredith breathed. "That's the heartbeat."

The radiologist nodded, but didn't say anything and kept listening closely. Derek silently counted together with him and grinned proudly when the radiologist finally made some notes in Meredith's chart and looked up at them.

"150," he said. "It's strong, as you can hear." But the frown that had creased his brow ever since the steady beat had begun hadn't disappeared and his jovial features had been replaced with something Derek couldn't put his finger at. He glanced at Meredith. She didn't seem to have noticed anything and was tenderly stroking her belly with a slight inwardly smile on her lips.

"It's okay?" he said quietly, addressing the radiologist. "There isn't anything wrong?"

The short pause before the radiologist looked him in the eye made his world shatter. Clinging to the hope that he very well could be mistaken, he held the dizziness at bay and forced himself to sound calm in front of Meredith.

"It's okay?" he repeated and was surprised that his voice carried like he'd ordered it.

The radiologist cleared his throat. "There appears to be some kind of anomaly," he said sympathetically. "I'm gonna go find the ob-gyn and she'll take a look. Try not to worry too much."

"An anomaly," Derek repeated. "What kind of anomaly?" In the corner of his eye, he could see that Meredith had frozen in her slow, circulating motions. "Look again," he demanded. "Look again and tell us."

"I'm sorry, Dr. Shepherd," the radiologist excused himself. "This is not my area of expertise. I'll get an ob-gyn for you immediately and she'll be able to give you some answers."

Standing up, he turned off the monitor, which had been angeled so that neither Meredith nor Derek could see it from where they were sitting. The sudden silence when even the thumping wasn't there to distract them anymore seemed to fill the room entirely. The nurse that had been going in and out of the exam room for the time it had taken to set everything up came back but kept herself busy in the far corner.

"Derek," Meredith whispered. "What's wrong?"

He looked at her. Her hands were still hovering over her stomach, but she didn't wear the smile she had just a couple of minutes ago. Instead of touching her baby bump in wonder, she seemed to suddenly protect it with all of her body. A few strands from her ponytail hung loose in front of her eyes, but it didn't seem to bother her. Her eyes were focused on him.

"He wouldn't tell me," he said tight-lipped. "I don't care who he'll bring, I'm looking for myself." He picked up the transducer and reached forward to turn the monitor back on, but Meredith shook her head no before the nurse could step in and do the same.

"Don't," she said. "Wait." She bit her lip before she took a deep breath. "The heartbeat is strong," she mumbled. "It's strong. It's gonna be fine."

And Derek slowly put back the transducer and sank back down on his chair, giving in to her wish to pretend for these last minutes that everything was okay.

"Hold my hand," Meredith said in a small voice. "Like you did before."

And that's how they stayed, tightly gripping each other's hands, both of them at a loss for anything to say at all. At last, when Derek had began wondering if it was possible to lose his mind in the very same hospital where he had spent almost every day for more than seven years, a sturdy woman opened the door and stepped inside.

"Hi, I'm Dr. Lincoln," she said and smiled gently. Her hair was curly as ever Cristina Yang's but instead of raven black it was reddish blonde and her eyes were warm and blue. "Dr. Grey, the radiologist tells me your ultrasound showed some unusual activity and wanted me to take a look."

"An anomaly," Derek broke in, unable to hide the mix of bitterness and fear he knew his voice held. "He said there was an anomaly."

"Okay," Dr. Lincoln said reassuringly. "Why don't we take a look so I can see for myself?" She turned the monitor back on, but didn't immediately place the transducer on Meredith. "I know that you two are both doctors in this hospital," she said. "That doesn't mean you're able to think like doctors in a situation like this. In here, you're parents to a baby that possibly has a health problem and even though I know you would be able to take in and understand all the medical information, had it been a different situation, I'm going to speak to you as parents."

Meredith nodded and Derek hesitantly did the same. He was afraid of what this woman would be able to tell them but at the same time strangely comforted by her gentle, yet capable manner. He closed his eyes briefly, unable to focus on anything else than the low murmuring buzz from the machine, no matter how much he wanted to do just about anything than waiting desperately for the heartbeat to pick up again. At this point in their ultrasound for Josie, they had been thanking the doctor and happily clutching on to the little black and white picture of her little body curled up in a way that made her look more than a peanut than anything. That night, Meredith had called her friends and his mom and proudly announced they were having a healthy baby girl. And then he had made her dinner and they had toasted in cider over his garlic chicken – garlic had been Meredith's craving for almost the whole second trimester.

"Have you been thinking of a name for the baby?" Dr. Lincoln asked as she repeated what the radiologist had done before her, prodding the device over Meredith's abdomen to find the fetus's rhythm. This time, Meredith didn't flinch when the cold gel touched her stomach. Derek opened his mouth to point out that they actually just wanted to know what was going on with their baby. They were doctors, not inexperienced first-time parents that needed to be distracted. But to his surprise, Meredith picked up.

"We've just been calling it Bug," she told the doctor and tried to smile. Her voice was wavering slightly and her right hand, the one Derek wasn't holding, was gripping the edge of the bed so that he could see her knuckles white. "It might sound silly, but we didn't know if it was a boy or a girl and we haven't really been talking about names yet..." Her voice faded, as if she had known she was just pretending this was any other perfectly normal examination and that the talk about names and was totally irrelevant in face of what the doctor actually was here to talk to them about.

"A lot of parents do that," Dr. Lincoln smiled, and focused her attention on the monitor as the steady thumping once again grew louder. Derek reached forward to see for himself what the radiologist had found a reason to worry about, but again, Meredith held him back.

"Let her look, Derek," she mumbled and even though it was against all his instincts not to do anything at all, he took a deep breath and did as she asked him. The time Dr. Lincoln spent examining the monitor stretched out and seemed more like hours than minutes. He was a man of action, and right now, tears pricked his eyes just because of the sheer helplessness he experienced of not even being able to know what was going on.

"Do you want to know the sex of your baby?" Dr. Lincoln asked after what seemed like several hours had passed, but that in reality only must have been a few minutes.

"Please just tell us what's wrong..." Derek began, keeping his voice calm even though all he wanted to do really was screaming with impatience.

"Yes," Meredith whispered beside him. "I'd like to know... it's a girl, isn't it?"

Dr. Lincoln smiled down at her, involving Derek and nodded. "It's a girl. Dr. Grey, Dr. Shepherd, congratulations. Now," she went on before Derek could interject again, "I see that your daughter's skull has enlarged ventricles. As I am sure that you know, that indicates the possible presence of hydrocephalus." She quieted, as to let her words sink in before she said anything else.

Derek's throat suddenly felt dry but he forgot to swallow as the possibilities of their daughter's condition swept over him like a wave.

"Are you sure?" he demanded. As it usually did when he was upset and reacted without thinking first, it came out sharper than he had intended. "What's the LVH/HW ratio? Can you determine the site of fluid obstruction?"

"Derek, don't," Meredith said. Her voice was on the verge of tears, but strong all the same. "Let her finish."

"Sorry," Derek muttered sheepishly, once again forcing himself to calm down.

Dr. Lincoln nodded gently at him. "Don't worry, Dr. Shepherd. At this moment all I can determine is that the ventricles are larger than they should be, given the gestational age. We'll make sure to take this further. I'll arrange for a pediatric neurosurgeon to come talk to you and take all the tests necessary to confirm the suspicion."

Derek took a deep breath, feeling the bile rise in his throat. Two hours ago, the prospect of seeing their new baby had been the subject of the happy conversation he'd had with Josie at his lunch break. He looked at Meredith. She looked unusually pale. She was biting her lip in that manner that was so typically her and had began plucking with the sheet to still her hands.

"Mer," Derek said, trying to not let his worry seep through his voice. "We... I..." He wanted to tell her they would be fine. They were both surgeons. They could make this child healthy. There just must be a way. But he choked on his words, unable to formulate anything that would make her actually believe it.

"May I suggest that you both take the rest of the day off," Dr. Lincoln said gently. "I'll schedule an appointment with one of our pediatric neurosurgeons and a perinatologist as fast as possible. They will perform further tests and help you decide the course of action." She rose and was on her way of turning off the monitor when she seemed to remember something. "That's right," she said. "Would you like me to print the ultrasound picture for you?"

Derek stared at her. Rationally, he knew it was a routine question; probably one parents were looking most forward to during their visits and certainly one they had been asked during their textbook pregnancy with Josie. He still had her picture. It had decorated his office until she had been born and he had some of her as a real person and he knew exactly where he had tucked it away. He didn't know what felt worse now; the fact that the question had only just been remembered by the doctor, or that it had been forgotten at all by himself.

"Of course," he said gruffly before Meredith could indicate otherwise, but she merely nodded and even managed a little smile.

"Okay," Dr. Lincoln said with sympathy. "I'll go print it for you, be back in a couple of minutes. If you feel the need to stay longer, we have a quiet room down the corridor. I can arrange for someone to come talk to you if you prefer."

Without looking at her, Derek waved dismissively in her general direction. "We'll be fine," he mumbled.

As soon as the door had closed behind the doctor, Meredith looked at Derek, fear etched in the lines around her mouth. "What do we do?" she pleaded.

He'd seen eyes like hers before. In fact, people seemed to give him them all the time; his sisters when they were little and he suddenly had become the only man in the family; his patients whenever he stood bent over their beds with their test results; Meredith endless times when Josie was an infant and she didn't consider herself capable enough to decide her matters. It was sometimes powerful to know that people trusted you to know the answers. Today, he hated it.

He took a wavering breath and squeezed his eyes shut. He would have to put aside the sight of the large skull on the monitor, so much resembling the scans that came from patients but that didn't. He must forget it belonged to his little one and look at it as he would, had she been a patient. Hydrocephalus could come connected with so many malformations. God know he was familiar with that after having operated again and again on children and adults during the years. He knew that in some cases, if the ventricular dilation was mild, it could resolve itself by the third trimester, but even if his ob-gyn rotation in his intern years had been a long time ago, he knew that those cases were rare.

"Derek?"

He looked at his wife. She was a surgeon just like him. Even though the helplessness of the moment threatened to paralyze them both, not doing anything wasn't on the table. She looked back at him, expectantly, and he realized they needed to take action, no matter how much he just wanted to make his daughter better by wishing hard enough or kissing the belly a thousand times.

"There's... " he stammered, suddenly feeling as if he was an intern again and unprepared asked to rattle off the common causes of whatever condition the patient lying on the table in front of them had. "Um. There's... It could be..." He took a deep breath. "A cyst. A tumor. Aqueductal stenosis."

"Myelomeningocele. Chiari malformation. Dandy Walker syndrome," Meredith filled in, as if the routine of recalling medical facts cramped in late nights in student dorms helped her regain some of her composure.

They were still going over the possible causes – both of them knew that the reason behind hydrocephalus was important to discover given the impact it would have on further treatment and prognosis – when Dr. Lincoln stepped back into the room with them. Derek didn't know if it was in spite of them both working with these conditions on a regular basis, or because of it, that the thought that their child may have brain damage was so terrifying.

"Here's for you," the doctor said with warmth in her voice and gave Meredith the proof that their baby really was inside of her, enlarged skull or not, sealed in an envelope with Seattle Grace's logo. "I spoke to the pediatric neurosurgeon just now. He offered to see you later this afternoon, if you don't mind waiting a couple of hours."

Derek met her gaze and thanked her silently. He knew that specialists had herds of patients waiting outside their doors and signing up for their waiting lists. He wasn't sure if the neurosurgeon's effort to squeeze them in was due to something Dr. Lincoln had said or if it simply was a favor to one of his own. But he didn't care.

"Thank you," he said hoarsely. "We'll take it."

He'd taken her to his office once Dr. Lincoln had run out of things to say. She'd walked slowly and carefully and sunk down in his couch as soon as he'd unlocked the door.

"Do you feel any pain?" he asked, concerned over her deliberate motions. She didn't reply at first, just shook her head.

"What if her spinal cord is exposed?" she said at last, voice thick with tears that she yet had to shed. "I just keep imagine that every move I make could make her bump it and cause more damage."

Derek didn't know what to say to comfort her. She knew as well as he did that wasn't how things worked and he wasn't sure if she wanted to hear the words, just to be absolutely sure she wasn't wrong about them, or if she didn't want it written over her face when she already knew it.

"Derek?" she asked in a small voice before he could come up with something to say. "There's nothing I want more than Josie in this moment. But..." she looked down as if she were ashamed. "Right now, I don't think I would be a very good mommy. I don't want her to see me this upset."

Derek nodded. "Do you want me to page Lexie? Get her to take her for the night?"

"I think she has the day off," Meredith mumbled.

"I'll call her then?"

When Meredith's nod came, hesitant and relieved at the same time, he fumbled for his phone, grateful that there was something he could do to control at least some of the spiraling chain of events the one utterance had started. Scrolling down his phone book, he tried her home number first and swallowed past the lump in his throat when she answered.

"Lexie, it's Derek," he said, spilling no time on unnecessary small-talk. "Is there any possibility you could watch Josie for us tonight?"

If Lexie was surprised over his sudden request, she didn't let it show. "Um, sure," she replied. "What time? Do you have to work late?"

Derek took a deep breath, fighting the feeling of unreality that washed over him and dreading that what he said next would make everything real, like it actually was happening and not just in his absolute worst nightmares, the ones Meredith had to wake him up from by shaking him forcefully.

"There's something wrong with the baby," he mustered, not caring that his voice held a stifled sob. "We're getting another ultrasound and I don't know what happens next."

"Oh," Lexie breathed. "Derek, I... I'll be right there. I'll pick up Josie and take her to my place. We'll be fine. She can stay the night if you need her to."

Lexie was fast. Within half an hour, there was a light knock on his office door. Derek had spent that time frantically researching the pediatric neurosurgeons on the staff and then proceeded to widen his area to the rest of the US, not content with any less than the best. Meredith had declined all his attempts to see to her and refused to lie down. After staring into space for so long that Derek had been considering force-feeding her even though she insisted she couldn't eat anything, she'd finally reached for a banana from the fruit bowl he kept on the bottom shelf for those times lunch wasn't an option and started suturing it.

"I need to do something," she'd said quietly as he'd stared at her fast fingers. "It helps me think."

He took Lexie to the daycare, feeling bad for leaving Meredith alone, but knowing that Lexie's worry that Josie wouldn't want to come with her was legitimate. When they stood outside the doors where Josie had spent pretty much her whole childhood, he had to collect himself for a moment before stepping inside. The realization that his second child might not be able to do the same because of any special needs she might have struck him in the same way an unexpected pinch in the arm would and he didn't want Josie to pick up on it.

"Dr. Shepherd," Ellen, a young and enthusiastic teacher that he knew Josie liked, nodded at him. "Are you here to pick up Josie? You can go right in. I think she's in the play room."

Derek felt a pang in his chest as he entered the large, colorful area where the children usually gathered. There were seven or eight kids in there. Some of them were running around, a few were sitting at a little table coloring pictures and three little girls were engaged in a board game. Josie was sitting in the far left corner, whispering things in the ears of her dark pink pig whose color had faded considerably after four years in her care. She looked up hastily when he walked over the floor, noticable cautious before she regcognized him and jumped up and wrapped her arms around him.

"Daddy," she sighed against his neck as he carried her through the room and out in the hall, where Lexie had remained standing. "Are we going home?"

Derek set her down. "Lexie's gonna take you home today," he told her, putting on a happy voice and trying to make it sound like an adventure. "Mommy and Daddy have to stay at the hospital tonight."

Josie stared at him, her lower lip already starting to tremble dangerously. "I want to go with you," she murmured.

"But Daddy isn't going home," Derek said, sitting down at the floor so that he came eye to eye with his daughter. He hated doing this to her. He knew that her unwillingness wouldn't just disappear once she got alone with Lexie. Only a couple of hours ago, he'd been counting on a quiet night together, a chance for her to get some time with them both in an environment she felt safe in.

"We're going to do a lot of fun stuff," Lexie promised and smiled widely. If Derek hadn't known about the sadness in her eyes, he probably wouldn't have been able to tell. "You have to tell me what you like to do best."

Josie stared blankly at her, her hand searching for Derek's, but at last settling for clutching hard at his sleeve. "Daddy," she whimpered, reaching for him to lift her again, her voice breaking on the last syllable. "No, Daddy."

Derek reached forward and gripped her under her armpits, lifting her onto his lap but didn't let her bury her head in the nape of his neck. Leaning her backwards against his chest so that they weren't facing each other, he slowly stroke her over the hair, forcing himself to remember that right now, Josie needed him as much as Meredith did.

"Have you done anything in daycare today that you would like to take home?" he asked, hoping that steering the conversation to focus on the more practical matters would help.

"No," Josie answered, swallowing a sob and trying to turn around to see him, like she wasn't sure of what had been settled.

"I think you should go get your things then," Derek said gently, tossing aside a dark curl that had strayed away from her face. "Lexie is gonna take good care of you. And then tomorrow, you know what will happen then?"

"What?" she said, although her voice still wavered.

"Both me and Mommy will be home all day and you can be with us. Is there anything special you want to do then? See a movie?"

She took a big, hiccupping breath. "I want to be with you now," she whined. "We can see a movie?"

"Yes, but not until tomorrow. I bet Lexie will watch a movie with you tonight, though. And she's a really good baker; maybe you can help her make some cupcakes?"

"No, Daddy," Josie choked out, rubbing her hand over her face.

"Josie, stop it, please..." Derek turned her around in his lap and carefully ran his fingers over her cheeks that were red and almost blotchy from tears. "What's going on? I know you can do this. Can you tell Daddy what's hard?"

Josie just shook her head. Her body trembled under Derek's hands and he sighed. He knew she soon would reach a state where she would be almost impossible to talk to and quickly made up his mind. He hadn't planned on telling her anything about the baby before they knew anything definitely and frankly, he didn't really want to. He didn't see the point in making her upset or confuse her when they didn't know what it would be like. He'd have liked to discuss with Meredith the best way to prepare her. But years of dealing with Josie told him that it would be the only thing that would help her see why it was important that she went with Lexie.

"Josie," he said seriously. "Could you listen to Daddy for a little bit?" Josie quieted when his voice deepened a little and he felt grateful that she wasn't too upset yet to recognize the voice he used for times when it was important she knew he was serious.

She nodded silently, blinking away the wet in her eye that Derek knew was well on its way.

"You know Mommy has a baby in her tummy?" he began. When she nodded confirmatory, he took a breath and continued. "We were looking at the baby today. A doctor used a special camera to look inside Mommy's belly and you know what? She could see that it was a girl." Derek smiled. "You're gonna have a little sister."

"I can play with her?" Josie asked, a little to Derek's surprise. Her interest in playing with other children had up to now been almost nonexistent.

"Well, she'll be very little when she comes out. But when she gets bigger, you can."

Josie nodded seriously. "I can take care of her when she's little."

"I bet you can," Derek said. "Mommy and Daddy could sure need your help." He paused and hesitated briefly. "When the doctor looked at the baby in her camera, she also saw that they baby is sick."

"Has she got a fever?" Josie asked, pursuing her lips.

"No, it's not like she's got a fever," Derek replied.

"Has she got a tummy ache?"

"No, honey, it's not like that. You know how you just stay home with me or Mommy when you get a fever? Your sister has a sickness that the doctors have to help her with."

"You're a doctor and Mommy is a doctor too," Josie pointed out. "You can help her."

"I don't think so, honey," Derek said sadly. "We're not the baby's doctors so we have to find another doctor that will do it. But Mommy is sad that the baby is sick, and she has to take more pictures so the doctors will know better how to help the baby. And then Mommy needs to rest a little. And that's why you're going to go home with Lexie today."

Josie looked uncertain. "I can make Mommy feel better," she tried hopefully. "I can hug her. She feels better when I hug her."

"I know she does," Derek agreed. "But you know how sometimes, when you have bad feelings inside you, it feels better after you've cried? Or sometimes you want to scream. I think Mommy needs to do that, and she doesn't want you to see it. You will see her tomorrow, and then she will feel a little better."

"I scream when I'm angry," Josie said and looked at him. "Is Mommy angry at the baby?"

"No," Derek said immediately. "Nobody is angry at the baby. It's not her fault she's sick. Mommy is just sad that she has to be." He studied her daughter to gauge her reaction. "Do you think you could be good for me and Mommy and go with Lexie tonight?"

She hesitated, looking at Lexie and then quickly at Derek again. Everything about her told him she really didn't want to, but she had put it past her the desperate fear that she expressed minutes ago and seemed to actually consider it.

"You know what?" Lexie said, catching the moment. "I think you're going to be such a great big sister. She is gonna need someone when she gets older and I think you might just be perfect. She will be so lucky she has you. What do you say we make a list of good baby names for Mommy that you can show her tomorrow? Maybe you get to decide what the baby's name's gonna be."

Josie wriggled a little in Derek's lap, studying Lexie, clearly contemplating this possibility. She bit her lip, a trait she had inherited from Meredith rather than Derek. "Could I, Daddy?" she asked, as if she wasn't sure Lexie had the rights to decide something like that.

"Well, let's see what names you come up with before promising anything," Derek said and winked at her. "But I'm sure Mommy will be very glad you made her a list."

"Don't forget the cookies," Lexie interjected. "Your mommy loves to eat cookies, but she's not very good at making them. I bet she would be happy if you brought cookies you made yourself when you see her tomorrow. I know you're very good at making cookies."

"What do you think, Jo?" Derek asked, trying not to press her but feeling the need to get back to Meredith and check on her.

She swallowed and he knew she was trying to do as he told her, but was afraid of really taking the leap. "I want to go home," she whispered.

"Hey Josie," Lexie said, kneeling in front of the child. "What do you say you and I go to your house instead of mine? Would that make you feel better?" She looked up at Derek, raising her eyebrows in an unspoken question. "If you guys want to be alone tonight, you can have my key," she said quietly. "Maybe she'll feel better in her own environment."

Derek looked at Josie, who reluctantly jerked her head in a slow nod. "Okay." He was willing to agree to pretty much everything by now. "Lexie will take you home, sweetie."

Josie hesitated briefly and nodded again. "Daddy," she sighed, her voice breaking again, putting her head on his shoulder and her arms around his neck.

"I know," Derek responded, circling his hands on her back in soothing motions, trying to mediate that he knew this was scary for her. "I know," he said again, looking up at Lexie, who nodded, ready to take over. He sat Josie down, smiling at her. "May Daddy have a kiss? Like the ones you give me in the mornings?"

To his relief, Josie didn't struggle this time, but merely leaned forward and touched his cheek with her soft lips, then resignedly let herself free and obediently began stuffing her extra clothes into her backpack and holding it for Lexie to take.

Derek sighed inwardly, standing up and brushing the faint hint of dust from his dress pants. Opening the door to the daycare, he blew Josie one last kiss.

"I see you in the morning," he said, carefully making his voice sound like this was any morning he left her for work or any night he tucked her in and not making this an even more emotional goodbye than it had already dragged out to be.

"Ok," Josie merely said, reaching for the left of the little red shoes Meredith had gotten her on a Gap sale earlier that spring and he slipped out of the door, grateful that Lexie seemed to have things under control.

One hour and seventeen minutes later, he found himself staring out of the window in an abandoned hallway on the fifth floor. It was a clear night, even if he could tell that rain was in the air, as always in Seattle. Winter had been unusually mild this year and the trees' branches weren't weighed down with snow anymore and people no longer wore heavy coats. The street outside the hospital was not empty. People hurried down it to get home from an early shift, to not stretch some deadline, or to get to the grocery store in time to make tonight's dinner.

"Excuse me, Dr. Shepherd," somebody said behind Derek's back and he turned immediately, his nerves on the surface. The day shift nurse, whom he no doubt had worked with endless times but couldn't for his life remember the name of, smiled gently. "You look tired. Why don't you go and sit down in..."

"Thanks, but we'll be in any minute now," Derek interrupted, not having the energy to do anything resembling politeness other than nod to acknowledge her concern. Tired was probably the less offensive euphemism anyone could come up with. It was more like exhausted didn't even begin to cover it now that the adrenaline rush had worn off and he could do nothing but wait.

The pediatric neurosurgeon had hasted past him just a couple of minutes ago and introduced himself as Dr. Thomas. He'd assured Derek that he'd be seeing them as soon as they had set up their equipment and caught up with Meredith's chart. The perinatologist that had accompanied him was right now in the exam room closest to where he was standing, preparing what felt like endless tests when the wife and child were your own – but that in reality Derek could count on his hands and knew by heart. Being the head of neurosurgery had its perks, but the downside was that he knew the drill. He knew the tests, the possible results and their consequences. And right now, he'd rather not.

They had moved from the quiet eeriness of his office half an hour ago in some kind of belief that it would somehow make the doctor page them earlier and figuring that if nothing else, they could just as well wait there as anywhere. After fifteen minutes of sitting down on uncomfortable wooden chairs, watching women of various ages stream in and out with either small, elf-like infants cradled at their chest or with bellies that looked like they would explode any minute, Meredith had left with the excuse that she wanted to drink some water before the examination. He kept watch over the door into which she'd disappeared and tried to will her to come through it before the doctor would open his.

As she did, he noticed how the look in her eyes matched the mix of fear, hope and anticipation that was jumbling around inside him. She had wetted her hair a little and swept it back in a more tight ponytail than before and she had a little more color in her face than that faint shade he hated and that she'd been wearing earlier.

He nodded at the door. "Any minute now."

Her response was a deep breath. She took his hand and threaded her fingers through his but she didn't say anything, just bit her lip the way Josie had done when trying to decide whether going with Lexie would be dangerous or not.

When the door behind them was opened and a distinguished, gray-haired nurse called their names, Derek stood up, not letting Meredith's fingers go. He swallowed and tried to suppress the little ball of pain that was doing gymnastics in his stomach, multiplying itself with an amazing speed.

"We can do this, Derek," Meredith whispered, seeming to focus on his discomfort rather than her own. "Right?"

He closed his eyes briefly, doing his best not to make any assumptions about the what obstacles his daughter would face in the future and to just concentrate on how to deal with whatever verdict would fall upon them in just a matter of minutes.

"Right," he replied hoarsely. "We'll do it."