The silence from the night before was reflected in the ride to work the next morning. Meredith chewed on her lip nervously, and Derek's fingers turned white as he gripped the steering wheel.
"Am I still scrubbing in?" Meredith asked quietly as they pulled up to the hospital.
"I couldn't do it without you," Derek replied, leaning over to kiss her before getting out of the car.
Meredith hopped out of the car and slung her bag over her shoulder. Derek came up next to her and gripped her hand tightly as they walked through the doors and into the crowded elevator.
"I'll prep him," Meredith informed Derek as they parted on the surgical floor.
"See you in the OR."
It surprised her when Derek grabbed her upper arms and pulled her in for a long kiss before they headed off to separate locker rooms.
"Good morning, Mark," Meredith said as brightly as she could when she entered his room a few minutes after six. "Ready for the big surgery?"
He stretched his arms above his head. "I'm always ready, babe."
Giggling, Meredith approached to prep him.
"You are so sexy," Mark observed as she leaned over him.
"Mark!" Meredith reprimanded. "I'm your doctor."
"Doesn't change the facts." He gave her a wink.
She rolled her eyes. "What am I going to do with you?"
Mark suddenly grew serious. "Hopefully help save my life. But, Meredith, if he can't don't let him blame himself. I know he'll do everything he can."
"Don't worry, Mark." Meredith took his hands in hers. "I'll take care of him. But Mark, you have to believe you'll be fine."
"Oh, I do. Mark Sloan is invincible."
GAGAGAGAGAGAGAGAGAGAGAGAGAGAGAGAGAGAGA
"What do you see, Dr. Shepard?" Derek asked grimly once Mark's brain was exposed.
Meredith's face fell at what she saw. "The arteries around the tumor are sucking his blood. You'll have to be carefully not to nick one or he'll bleed out."
"Still think this was his best shot?" Derek whispered.
"Yes," she replied as confidently as she could, knowing the surgery had gotten much more complicated than either one of them could have anticipated, and that Derek would need all the confidence he could get.
Derek shook his head, and went to work on getting around the arteries. "Suction, Dr. Shepard. I need this area completely clear."
They stood shoulder to shoulder as Derek carefully manipulated his way around the arteries. It was hours before the tumor was exposed.
"Long surgery," Derek observed, in a voice that would have sounded causal to someone who didn't know him as well as Meredith. She detected the slight tremor in his voice that revealed how truly scared he was.
"Scalpel," he requested, and Meredith was proud of how steady his voice was.
"Watch the artery in the left field," Meredith said in a low voice as he began to cut the tumor.
"I see what you mean," he noted when he got to that area. The scalpel came within millimeters of the fragile artery, but he managed to cut the tumor without doing damage. "We're almost in the clear," he announced after that cut.
Derek moved the scalpel towards the front edge of the tumor. He had been blocking out whose brain this was with the practiced distance of an experience surgeon, but now that he was almost done, he began to realize whose brain this was.
This was Mark. His man-whore best friend. His brother. The one who had joked about sleeping with Meredith only hours ago, though Derek knew Mark would never do that again. The man who had stood beside him through his father's death, pulled all-nighters with him throughout med school, and catalyzed the end of his first marriage. Who had indirectly brought Derek to the best thing that had ever happen to him – Meredith.
He heard her melodic voice softly speaking his name. Of course she would notice that his concentration was drifting. She knew him well enough to notice everything, and it made him love her all the more.
His attention focused once again on the open brain before him, but now the distance was gone. He wasn't looking at a medical problem; he was looking at the very essence of his brother. Derek closed his eyes, and tried to bring back that distance he had so carefully been constructing over the past week, as he had shut out Mark, even shut out Meredith.
He almost had it, and he opened his eyes, and moved his scalpel to cut once again.
But almost is never enough, and Derek's hand trembled slightly, hardly noticeable, but enough to cut the edge of an artery, and flood the field with blood.
Feeling outside his body, Derek withdrew his hand form the brain, and dropped the bloody scalpel on the tray. He could hear the machines beeping frantically, he could see Meredith frantically suctioning, and could feel the eyes of everyone else on him, wondering what had gone wrong and why he wasn't doing anything.
His awareness came back to him when he heard the all too familiar sound of a flat line. His brother didn't have a heartbeat.
Derek knocked over a tray of instruments as he pushed his way to Mark's chest, and grabbed the paddles from a crash cart.
"Get him blood!" he ordered, before running the shocking of Mark's heart.
The blood couldn't make a difference at that point, and everyone in the OR knew this, but they followed the Chief's orders, and worked on Mark to the point where Derek himself was giving chest compressions. He couldn't concentrate on anything but bringing Mark back, until he felt a gentle pressure on his arm.
"Derek, it's been half an hour, you have to call it," Meredith whispered, her voice catching.
It was as if they were the only people in the OR as Derek looked at her face desperately, wondering why the woman who always made everything better was telling him that. She had tears running down her face, into her mask, and he saw in her eyes that she knew they were powerless to do anything. Powerless surgeons, the worst oxymoron Derek had ever heard.
"Time of death, 3:32," Derek muttered, before shoving his way into the scrub room.
"Derek!" Meredith called, pushing past the full OR and tearing off her gloves and gown so she could get into the scrub room. "Derek," she said more softly when she saw him, leaning over the sink, looking as though he would fall over with the slightest nudge.
She approached him, and washed her hands as quickly as possible, before drying them, and touching his shoulder gently. "Derek," she repeated. "This is not your fault."
She wrapped her arms around him, and pressed herself as close to his body as she could get. His arms wrapped around her automatically, and he squeezed her body almost too tightly, before suddenly pushing her away, making her fight for her balance.
"This is my fault, Meredith," he growled. "Did you see my hand? Did you?" He gripped her shoulders tightly, making her flinch, shaking her slightly when she didn't answer. "Did you, Meredith?"
"Yes," she whispered, honestly a little scared. In his right mind, he would never hurt her, but she knew at that moment he wasn't in his right mind.
"I did this," he moaned.
"No, Derek." Meredith started to cry again. She couldn't stand to see him do this to himself. "You didn't."
"I did." He shoved her away from himself almost violently, and she had to catch herself against the opposite wall.
"Derek," she whimpered, wishing she weren't so powerless to help him.
Burke suddenly opened the door to the scrub room. "I heard, are you okay, Shep?"
"Did you hear that it was my fucking hand that did this?" Derek shouted, and it looked for a moment that he was going to hit Burke. Instead Derek shoved past him into the hallway. "I'm going to Joe's."
Meredith rubbed her hands over her face in an effort to wipe away the tears that wouldn't stop falling.
"Meredith." Burke gave her a friendly hug. "He'll be okay."
"Burke, I don't know if he will." She looked up at him with teary eyes. "His hand. He was almost done, but then he realized, and his hand shook. He won't forgive himself for that. He won't."
"Meredith, he will be fine," Burke promised. "I'm off now, and I'll go with him to Joe's and make sure he's alright. What time are you off?"
"Six," she sighed.
"Okay, meet us there then unless I call."
She nodded through her tears.
"I'll take care of him, Meredith. It will be fine."
"It won't." Meredith spoke so softly he couldn't hear her words.
"What was that?"
"Nothing, it's nothing," she lied.
"Alright. Take care."
Burke left, and Meredith stayed, leaning heavily against the wall. "It won't be," she whispered again to herself. She had a feeling, and when she got those, she was rarely wrong.