Chapter 1

"Chronic Obstructive Pulmonary Disease is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, non-reversible refractory assthma and some forms of bronchiectasis. The disease is characterized by increasing breathlessness. With COPD, your lungs do not work as well as they once did and you find it more and more difficult to breathe. As the diseases progress, the symptoms tend to get worse and more and more damage occurs. This damage is permanent." Bailey told the gang.

Meredith looked at Alex who was reciting the patient's file during rounds "Fine. Chuck Eaton, 54, has stage 3B non-small-cell lung cancer with possible invasion of the pleura and a history of COPD. He's had extensive chemo-radiotherapy with minimal regression of the tumor. He's been admitted for radical en-bloc resection."
"I was a smoker. The, uh" he coughed "oncologist He explained that I have a 25 percent chance of surviving the surgery."
Meredith looked at Bailey and was hesitant to do anything- this case wasn't interesting and she had a history of COPD. Derek's words about coming clean had gotten to her and she still fought an inner battle whether she should tell Cristina and Izzie about her husband or call a lawyer – or call him. "Well, unfortunately, that's about right. If you should elect not to proceed, we can make you more comfortable." Bailey offered.
"With all due respect, uh there's no way that you can make a man dying a slow death comfortable. I'll roll the dice." The patient said.
"Do the pre op, Grey" Bailey handed Meredith the chart.

Her patient was about as awful as dealing with her past. He had recorded about 20 tapes telling every person he had ever met how much he hated them. It was no way Meredith wanted to die. She leaned against the nurses station to enter a few details in the patient file when somebody walked up to her "Invasive non-small-cell with a history of COPD? That guy's pretty much a goner."
The voice was familiar and she knew the words. "That guy's pretty much a goner" was the first sentence her husband had heard from her and she wanted to turn around, but couldn't move. The symptoms of COPD were shortness of breath, frequent coughing, increased breathlessness, feeling tiered, wheezing and tightness in the chest. Was this happening in her head? It wasn't possible, was it? A man walked up to Meredith from behind. He had not expected to see her face ever again, but there she was – as captivating as the day he had first seen her when he had been a resident. It seemed like a reflection of a different time – a time where his friends had been happily married and he had transformed into a different man for a while. But this was the present and he was looking at the woman that had left him years ago.
"Sensitivity. I like that in a" she turned around and looked at him. She meant to say stranger, but he wasn't a stranger- or her mind was playing tricks on her. He was anything but a stranger. She had touched every inch of his skin, she had recognized the voice, but by now it was only a distant memory. He was a face she knew all too well. Her husband -the one she had told Derek would never show up at the hospital – was standing right in front of her – in the hospital she had never believed he would show up at "Mark, what are you doing here?"
"Visiting. Confounded by all the rain and it's only my first day in town." He smirked. He certainly hadn't lost any of his charme.
"You get used to it." Meredith looked at him and was instantly reminded why she had fallen in love with him in the first place "Not that I want you to get used to it." She wondered what he was doing here and he was surprised that she was working at this hospital.
"Makes me want to stay in bed all day." He looked at her with a grin.
"We just met and you're talking about bed. Not very subtle." Meredith snuffed.
"Subtle's never been my strong suit." Mark smiled at her "You know that. So do you go out with co-workers?"
She swallowed and wondered if he knew about whatever had happened between Derek and her. "I make it a rule not to."
"Then I am so glad that I don't work here." He smiled. She wanted to punch him as all the emotions she had felt two years ago came to surface. "Dinner?"
"Are you hitting on me? In a hospital?" she giggled and shook her head and rolled her eyes.
"Would that be wrong, Meredith?" He wondered when he was suddenly punched with a fist. Meredith looked to the side. This felt like an out-of-body experience, but she looked at her hand and it hadn't been hers. Someone had punched Mark and that someone was Derek.
"Ow. Ow." Mark said as he sat on the ground.
"What the hell was that?" Meredith looked at her ex-boyfriend. Derek had punched her husband.
"That was Mark." Derek told her. She knew it was Mark, but this couldn't have been about what she had told him a week ago. She had never mentioned his name. Suddenly the shoe dropped "Your Mark?" she looked at him in disbelief. The universe hated her.
"You know him?" Derek looked at her in surpise. She was just as surprised that Derek didn't know.
"I happen to be his wife." She stated and looked at Derek who was dragged away by Addison. "So much to him not showing up at the hospital" she mumbled.
"Well, that's funny." Mark said and got up before he was punched by Meredith only to end up on the floor again. Those tiny ineffective fists knew what they were doing.
"What was that for?" Mark looked at her.
"You slept with Addison" Meredith reminded him.
"You saw us. Yeah, I almost" he paused. Meredith couldn't believe what she heard. She had seen him and Addison. She had been the first one that walked in on him -months before Derek did.
"I walked in on you and Addison?" she starred at him and was almost glad that Addison had taken Derek away. By now she was glad that she had punched him with her ineffectual fists. It felt like the universe was screwing with her head "Derek saw you, you ruined their marriage" she stuttered.
"You don't get to be mad about Addison - that second time." Mark paused. He had been miserable after she had left. He had made a mistake, but she had never given him the benefit of a doubt and just walked away.
"How did you know where to find me anyway?" Meredith looked at him.
"I wasn't looking for you Deth." Mark told her and looked down "I was looking for her. I wanted to talk to her, get her to come home"
"Well, she's living my McLife" Meredith told him "You are a little too late and we have to get an x-ray"

The chief was furious! "Punching people on my surgical floor! My head of neurosurgery, punching out people on my surgical floor!" Richard yelled at Derek "Put the ice pack on your hand."
"My hand is fine." Derek looked away. He didn't know how to react to the fact that Mark had shown up here.
"Put the ice on your $2 million-a-year hand! Now would someone tell me what the hell happened?" Richard wondered. The two surgeons in front of him had never behaved like this.
"That was Mark." Addison admitted.
"Who's Mark?" Richard wondered.
"He and Derek used to work together back in New York." Addison told Richard. Obviously there was more to the story.
"He and Meredith are married." Derek added "Did you know Mark was married?"
"What? Meredith is his wife? Meredith Grey?" Addison looked at him. She knew that Mark had gotten married, she had never expected that the girl he used to love a lot was so close by. "And, uh we were all close friends. Until Derek found us in bed together."
"You put your weight behind it?" Richard wondered.
"Yes, sir." Derek nodded.
"Well, all right, then." Richard walked out to find Meredith.
"What the hell is he doing here?" Addison looked at Derek.
"I have no idea." He sighed and wondered whether Meredith would have told him about contacting her husband.

The atmosphere in the exam room was tense. Meredith was nervous. Mark hadn't been the first inappropiate guy she had slept with -and not the first inappropiate guy that had turned up at the hospital for that matter, but one she had never expected to show up. "Derek and I always did have the same taste in women." Mark smirked. He was sitting on a bench in an exam room while Meredith looked at the x-ray.
"Excuse me?" Meredith looked at him after she had turned around.
"You're Derek's lusty intern, right? I heard about you all the way back in New York. You're famous." Mark smiled and started to mock her. Sex and mockery had been their thing when they had first met "and I'm offended... you cheating on me... I never thought they were talking about you... it wasn't really flattering"
"Well, I heard about you all the way here in Seattle." Meredith told him and started to clean his wound "and don't go there" He was getting a little too flirtatious. All the things that had happened were too overwhelming.
"So I guess we have a lot in common. We're the dirty mistresses." Mark joked.
"I suppose we are." Meredith nodded. She couldn't help it, he still made her smile.
"My $400-an-hour shrink says it's because behind this rugged and confident exterior I'm self-destructive and self-loathing to an almost pathological degree. That's why things didn't work out with my wife" Mark looked at his wife. He had started seeing someone after Meredith had left -someone who wasn't available, someone he shouldn't have pursued.
"Hey, we do have a lot in common, after all" Meredith sighed and sat down next to him. She couldn't believe that she was sitting next to him. "I never thought I'd see you again"

"You know, it's funny. Der... Derek walks in on me naked with his wife, actually in the throes. And he just turns around and walks away. But he sees me so much as talking to you, and I'm on the ground bleeding. Interesting, don't you think?" Mark wondered. Derek had chosen Addison over her regardless.
"What are you doing?" Mark wondered.
"You need stitches." Meredith reminded him. "Der... Dr. Shepherd hit you"
"I know. Hold the mirror." Mark insisted.
"You don't trust me to give you stitches?" Meredith laughed.
"You are an intern" Mark told her "I don't trust interns. You know how much I hate interns!"
"and you taught me your technique about three years ago" Meredith reminded him. They had sawn together the skins of grapes for one of his procedures all night before they had moved on to cadavers the next day.
"on a cadaver. Does this beautiful face look like a cadaver?" he wondered. "and that was before you saw me cheating on you. I'm suturing my own face"
"How come I never met them – Derek and Addison?" Meredith wondered. "I got a whole lot better. They actually pay me to suture"
"She calls you the perfect twelve-year old now... and..." Mark paused. He had planned a beautiful dinner to introduce Meredith to Derek and Addison. On some subconscianous level he must have known that it'd only be a matter of time until he'd screw things up.
"You were ashamed of me..." Meredith told him. Meredith thought of the things she had told Alex. Maybe he had felt like her. "Maybe you felt like... it was just a matter of time... "
"yeah...maybe I did. Maybe... it's for the better. Can I take you out to dinner tonight... I think we need to talk" Mark took her hand. "about us. But if that's what you want, yeah, we can talk about a divorce too. I guess it's overdue."
"I can't... sorry" Meredith sighed "I need to think"

Meanwhile Addison and Derek still sat in Richard's office "I can't believe Mark never mentioned he was married to Meredith Grey. He hated her mother. Did you know that Meredith was married?" Addison looked at Derek.
"She told me last week. She didn't tell me she was married to him though" Derek said. He wondered if he should have known. Mark had never mentioned that he was married. He had mentioned a girl once, and had planned to introduce her to him and his family, but the plans had been cancelled. He had been slightly more bearable towards the end of his residency and throughout his fellowship, but Derek had assumed that his friend had gotten more mature.
"It's funny isn't it?" Addison laughed. "You and me, Mark and Meredith?"
"My hand doesn't think it's funny" Derek spat back, but joined in. "Do you happen to know what he's doing here?"
"No clue. I thought you knew" Addison said "You are his friend"
"Were" Derek insisted. He wondered whether Meredith had called him. After all he had told her to get divorced.

Meanwhile George, Izzie and Cristina looked at the exam room. The blinds were half open, so they had a good idea what was going on until Meredith walked out. "Why are you all gushy with McSteamy in there?" Izzie wondered when Meredith walked out of the exam room with Mark.
"McSteamy is my Mchusband." Meredith stated like this was a well established fact.
"You are married" George looked confused
"I am. Unfortunately." Meredith sighed "and it turns out the universe hates me"
"Why did Shepherd punch him?" Cristina wondered "Did you tell him and not us?"
"Oh, that wasn't about me. Mark happens to be the guy who slept with Addison" Meredith rolled her eyes "It's perfect, right? Screw you universe. It's like I said... we can play whose life sucks the most and I always win"
"This is getting good." Cristina smiled. "Can I look at McSexy's x-ray?"
"Can you ask your husband if I can scrub in with him?" Alex looked at Meredith.
"So out of line" Izzie hushed him.
"What? He's Mark Sloan, the go to plastic surgeon on the East Coast" Alex explained.
"So when did this happen?" Cristina wondered.
"Years ago and I don't want to talk about it" Meredith tried to change the subject. "It's complicated"
"Is he good? He looks like..." Izzie whispered
"Izzie" George looked a little irritated.
"Meredith, the Chief wants to see you in his office" Bailey told her and rolled her eyes.

Meredith lurked through the door and looked at Mark and Dr. Webber "Hey, Dr. Bailey said you wanted to see me."
"So you two really know each other" Richard looked at the two surgeons.
"A bit of an understatement, but yeah, we know each other" Meredith nodded.
"Derek said you are married" Richard looked at the daughter of the woman he had loved "When did this happen? Your mother never mentioned it" Mark rolled his eyes – and Meredith had no clue why her mother would have mentioned it to him.
"This is really none of your business, Dr. Webber. I'm under no legal obligation to disclose my maritial status" Meredith got up and left. "I'll go back to work now"
The door closed and Mark und Richard were alone again.
"Why do you want to know why we got married and when?" Mark wondered.
"I promised Meredith's mother to take care of her" Dr. Webber said.
"Two and a half years ago, we met four years ago... It was all fairytales and magic, but I guess you wake up from your day dream at one point in time. I took her for granted and let her down and she walked out" Mark told Richard. "But I didn't know she would be here when I booked the flight. I never expected her to be here after all that happened here –with her parents. But I guess after what she and I went through... she wanted to get away from the East Coast as far as possible"
"What are you doing here, Dr. Sloan?" Richard wondered.
"I wanted to talk to Addison" Mark told him "But, one of your interns mentioned a lionitis case, I'd like to consult on that"
"It's Dr. Shepherd's case"
"I know" Mark nodded "But the patient deserves the best pair he can get."

COPD is treatable. With proper management, most people can achieve good symptom control and quality of life.