A/N: Less Shepherd/Grey interaction here, but it'll heat up in the next chapter! Using the episodes as skeletons and then building my own story off of them is really helpful, at least for the first season, which is why you're still seeing lots of borrowed dialogue. Hopefully the conversations I've invented read as natural as the script. Anyway, happy beginning of March and let me know what you think in a review!
Chapter VII: Waste
A bitter cold but windless day, a light snow sifting out of the morning fog like confectioner's sugar and melting on contact with the damp ground. The air hits her cheeks hard when Meredith opens her car door in front of the hospital. Izzie and George shuffle out behind her, grumbling over the cold, but Meredith remembers Massachusetts winters and knows this day is an anomaly for Seattle. Cristina climbs off her motorcycle and walks into the hospital with Meredith.
"You look terrible," Meredith observes.
Cristina gives her a look. "I'm tired, I'm cold, I'm caffeine-deprived, and I have the flu."
Meredith shrugs. "Well, we are in a hospital."
"Yeah, I'd rather be in bed at home."
Once they've changed into their scrubs and Cristina manages to drink the remaining half of Meredith's strong, black coffee, Dr. Bailey appears, unfazed by the cold weather and bunch of miserable-looking interns.
"O'Malley, Yang, Karev, go on to the clinic." When the interns don't react, except Cristina catching a whiff of Alex's post-run sweat and looking nauseas, Bailey snaps her fingers. "Hey! Patients are waiting!" The three interns shuffle off to their posts. "Izzie, you're hangin' with me today." Izzie smiles, pleased with her placement. "Grey, there's a consult in the pit. A girl with a fever and abdominal pain, then go check all post-op patients, Izzie and I are doing pre-ops. Go."
Meredith nods and heads to the elevator, instead opting for the stairs to hopefully wake her up. A patient with a fever and abdominal pain could be a possible appendectomy, and she'd love to perform one solo. Perhaps if she stays on Bailey's good side -if such a thing exists- she'll be able to do it.
Her patient is a young girl, looking very forlorn and small on the large gurney, framed by her parents. Meredith takes her chart from Tyler and skims over it. "Hello," she greets the family. "I'm Dr. Grey. Do you mind if I do a quick exam?"
The girl shrugs, and Meredith picks up her stethoscope, placing it on the left side of the girl's chest. Heartbeat is slightly raised but nothing to worry about, normal breath sounds.
"I think she got some bug on her trip to Mexico with her friends," the girl's mother says. She stands in sharp contrast to her daughter, tall and thin as a needle, with a sharp nose and confident voice. "I told her not to go to a third-world country but does she ever listen?"
The girl sits chewing at her nails, clearly nervous.
"She's been weak ever since, and she's lost weight," her father says, concerned.
The girl looks up. "Barely."
Meredith takes a step back, taking in the girl's appearance.
"And this morning Claire passed out in the shower," her father adds.
"When was the trip?" Meredith asks.
Claire shrugs. "A couple weeks ago. I'm really fine, I just have a fever."
"Okay, well can you just lie back for me so I can finish the exam?"
She freezes. "No. Please. I don't need an exam. Just give me some antibiotics and send me home."
Meredith looks at the girl, trying to read her calm, quiet gaze. It's one she recognizes as a look she often wore when she felt like too much of a burden on her mother.
"Well, maybe it is just a fever," she says reassuringly, "but they called down for a surgeon, so I have to finish the exam to make sure you can go home." Meredith notices Claire's parents hovering, and makes a decision she knows most teenage girls would appreciate. "You know, this might be easier if Claire and I had some privacy."
"Okay, Claire, I'm just going to apply some pressure on your abdomen," Meredith says gently. "You tell me if I hurt you."
Claire nods, more relaxed than she had been with her parents, but still trembling slightly.
Meredith presses low on Claire's abdomen, then moves up, her touch light but firm. Suddenly, Claire gasps.
"Don't push so hard," she says.
Meredith sighs. "Can you lift your shirt so I can examine your stomach?"
Claire hesitates for a long time, and Meredith gives it to her, even knowing that patients are waiting for her upstairs. Then, slowly, Claire raises her shirt. Four small surgical scars are visible on the left side of her abdomen, clearly recent.
"Where did you get these?" Meredith asks gently. "These scars are still pink. Did you have a procedure done in Mexico?"
Claire looks up at her. "Don't tell my parents," she implores.
Meredith takes the stairs again, but when she opens the door to the stairwell she sees Dr. Shepherd coming into the hospital, apparently having skipped pre-rounds. He catches a glimpse of her and turns, walking toward her. Meredith tilts her head in a secret smile, then chokes down a laugh when his calm approach turns into him pushing her back through the door to the stairwell. His mouth tastes like sweetened dark roast when he kisses her, his fingertips sinking into the nest of hair beneath her ponytail, and she's wide awake. It's wonderfully familiar and surprising at the same time.
"Good morning," he says, his morning voice is a bit husky.
"It sure seems like one so far," Meredith says, trying to break free of his arms. He squeezes her close for a moment, not letting her out, and she laughs and pushes at his arms. "Dr. Shepherd, I have to answer a page!"
He pouts. "On Sunday it was Derek."
She rolls her eyes. "Derek, let me go. I need to find Dr. Bailey."
He lets her go and she turns, ready to leave but lingering. "That wasn't so hard, was it?" he asks.
Meredith shakes her head, steals one last look, then opens the door and lets herself out, clearing her throat as she sets off to find Bailey.
She finds her resident walking up another staircase, trailed by a sick Cristina. "You paged?"
"Where are we?" Bailey asks.
Meredith catches up with her, skipping steps. "My pit patient is febrile, and she has peritoneal signs. I think she had some sort of illegal surgery done in Mexico."
"Botched abortion?" Cristina offers, her voice coming out as a croak. Bailey looks at her intern and sighs.
"Cristina, go find yourself an I.V and an on-call room. Find me when you're hydrated and no longer a walking disease."
Cristina looks relieved and slows behind them, trudging down the rest of the stairs slowly.
"It's not a botched abortion," Meredith continues. "She has four laparoscopic scars on her abdomen and won't say what they're from. The parents are clueless."
"And she's a minor?" Bailey asks.
Meredith nods. "Seventeen. Freshman in college."
"Did you order up for a C.T?"
She nods again. "Yes."
"Okay. Work on those post-ops while you're waiting. But first take Cristina that I.V."
Meredith gently knocks on the on-call room Cristina paged her to, opening it to reveal a black room that smells slightly of vomit.
"Cristina? Are you awake?" A noncommittal 'hmm' comes from the bottom bunk and Meredith flips on the light switch. The voice grumbles again and when she sits up Meredith sees that it's Cristina.
"Bailey told me to bring you this," she says.
Cristina groans again. "A banana bag? I'm probably missing killer surgeries. I think Burke has an aortic valve replacement at noon."
Meredith sits down on the floor beside the bed and takes Cristina's arm, quickly tying a tourniquet. Cristina bristles and sits up straighter. "What are you doing?"
"Banana bagging you."
She shakes her head. "No, no, I don't trust those hands."
Meredith smiles. "Come on, these are magic Ellis Grey offspring hands! I can find a vein."
Two failed attempts later and Meredith succeeds in hooking Cristina up to electrolytes and fluids designed to replenish her immune system and take away her flu symptoms. She's now leaning against the wall with a stack of post-op notes, filling them out thoroughly in the relative calm of the on-call room.
"I slept with Burke," Cristina reveals quietly, her eyes still closed. Meredith had thought she was sleeping. She puts down her pen.
"What?"
Cristina opens one eye to look at her friend. "Oh, don't look at me like that. And don't think I'm taking advantage of him because I'm not." She closes her eyes and misses Meredith's skeptical look. Cristina opens her eyes again. "Okay, it would be nice if he could get me in to some interesting surgeries, but other than that it's…strictly…professional."
Meredith scoffs, amused. "Professional? How many times have you slept together?"
Cristina shrugs, then grimaces when the motion causes her to feel dizzy. "Enough for him to think it means something."
"Does it?"
"I don't know. No. Not to me, anyway." She closes her eyes again. Meredith thinks carefully, then decides to come clean.
"I made out with Shepherd."
Cristina turns her head to look at her. "You two haven't had sex yet?"
Meredith looks shocked. "No! Wait, you thought we were sleeping together?"
Meredith hands her some charts and Cristina, marginally better, looks them over while they talk. "Yeah, well, I assumed."
"Well, we're not. And I don't plan on it," Meredith says, unsure, putting down her last chart. "I want us to stay strictly…professional."
"Strictly professional or strictly professional?" Cristina asks. "Because that wouldn't work for you two."
"What do you mean?"
Cristina scoffs. "You know, you can be really clueless." She looks at Meredith, staring back at her with her clear eyes, confused. "Oh, come on, Meredith. George is clearly in love with you, Alex would probably sleep with you if you said yes, and Shepherd…"
Meredith, overwhelmed with this information, motions for Cristina to continue. Cristina sighs. "McDreamy has it bad, Meredith. You should see the way he looks at you when you're in surgery together."
Meredith frowns. "He should be looking at his patient."
Cristina laughs sadly. "Well, whenever he isn't looking at his patient, he's looking at you. So do something about it, before something happens that you might regret."
Meredith sits in a radiology room, slightly shaken, going over Claire Rice's C.T readings.
"Is this girl fat?" Dr. Bailey asks, confused.
"Not at all. She's a normal college kid."
"So, what do you see?"
Meredith looks more closely. "Her stomach's stapled. She's had a gastric bypass?"
Bailey nods. "And a bad one at that."
Later, they find and talk to Claire's parents. Meredith begins and braves the gauntlet.
"Gastric bypass is a procedure normally done on obese patients to help them lose weight," she explains.
Mr. Rice looks perplexed. "Claire? She doesn't need to lose weight."
Mrs. Rice turns to him. "Are you kidding? This means the world to her." She looks at the doctors. "This is so typical of her to take the easy way out. She's done it with everything since she was a little kid."
"Mrs. Rice, nothing about this is going to be easy," Bailey warns. "She's gonna face a lifelong struggle with malnutrition unless she has surgery to reverse the procedure."
"Do the surgery," Mrs. Rice says firmly. "I told her to watch the freshmen fifteen. 'Don't eat junk, exercise', but when she came home Christmas break who had to take her out and buy her a new pair of size six jeans because she couldn't get in the ones I got her last summer?"
Meredith thinks of her own closet. She's always been slender. 'Skinny as a rail', her mother once called her. But she has clothes ranging from size two to size eight depending on what brand, what article of clothing, and how comfortable she wants to feel. Claire Rice has absolutely nothing to worry about.
Bailey interjects before Mrs. Rice can go any further. "Unfortunately, there were complications with the first bypass."
"What do you mean?" Claire's father asks.
"She has what looks like an abscess under her diaphragm and edema," Dr. Bailey says, "which is a swelling of the abdominal wall. I can't say for certain that she'll recover completely."
Mr. Rice is upset. "Just…do whatever you can to make her well." Bailey nods and Meredith follows her away from the family.
"Prep Claire while I book an O.R."
On the way up to Claire's room Meredith bumps into Alex and they share an elevator. Neither says anything, comfortable in silence, then Meredith turns to him. "If I said yes, would you sleep with me?"
Alex looks her up and down. "Nah. I dig blondes, but you're kind of messed up, you know? Famous mother, all the complexes that come from that. Ask George, though. He's totally into you."
She's never been more pleased to be rejected. The doors open and Alex pats her on the back, then goes off to his next patient, completely unaware that a less dark-humored girl might take high offense at his response.
After her surgery and subsequent shower after Claire's abscess decided to explode all over her, Meredith is charged with informing the Rices of their daughter's prognosis. She goes to them with trepidation, knowing the news will be hard to digest.
"We were able to reverse the gastric bypass," she begins, "but we did lose a significant portion of her bowel. And because of the short-gut syndrome Claire will never eat normally again." As she'd predicted, Claire's father takes this harder than her mother.
"How do we help her?" he asks.
"Well, getting proper nutrition will be a lifelong problem for Claire," Meredith explains.
Mrs. Rice sighs. "Great! As if we don't already have our hands full with her."
Meredith decides to speak up. "She gets good grades. She stays out of trouble. She's smart. I just think she feels like nothing she does is ever good enough for you."
Mrs. Rice draws herself up straighter in defense. "If you somehow think that I'm responsible for this -"
"I think Claire is killing herself to please you."
Mrs. Rice scoffs at her. "If you had any idea of what's going on in that girl's mind-"
But Meredith does, all too well. "You're her mother. She worships the ground you walk on. She didn't do this for herself."
"Meredith! What the hell do you think you're doing?" Ellis cried, and Meredith had jumped in surprise. The knife slipped suddenly, cutting a line across the side of her index finger as it fell to the kitchen counter. Ellis took in the scene -the boneless chicken breast, the suture kit beside it with a curved needle neatly threaded, the novice-sloppy attempts on two other wounds Meredith had inflicted on the chicken.
"I was trying to-"
Ellis tugged Meredith to the sink and turned on the water, running Meredith's hand underneath it until the water ran clear. Meredith was thirteen and stubbornly refusing to cry. It wasn't the cut that hurt, that wasn't serious at all. It was the fright of her mother coming home so early that made her drop the knife. Meredith had already made herself dinner and cleaned up, then took the pilfered suture kit from the hospital and decided to learn how to suture.
"Keep some pressure on your hand. You just need a Band-Aid," Ellis mumbled. "Where do we-"
"Next to the fridge. The first shelf," Meredith said, and Ellis left her daughter to go for the Band-Aid, returning quickly to wrap two bandage-textured Band-Aids around Meredith's finger.
"That was a stupid thing to do," Ellis scolds, taking off her coat and scarf and hanging them on a kitchen chair. "Now, sit down at the table." Meredith looked at the mess in the kitchen, confused, then went to sit at the table. She watched as her mother threw out the chicken, washed off the cutting board stained with some of Meredith's blood, and ran a damp cloth over the counter. Ellis leaned against the counter for a moment, then brushed blonde hair out of her eyes. She filled the tea kettle with water and set it on the stovetop, then took out two mugs and dropped a teabag into each one. Meredith continued to watch, sitting silently, fascinated.
Ellis sighed. "Come here," she said finally, impatiently, as if her daughter should have received a cue. Meredith stood from her chair, walking forward, unsure. Ellis took a banana from the bowl of fruit Meredith usually grabbed from on her way out the door in the morning. Deftly, Ellis took a small knife from the cutlery drawer and made a gash across the banana. "Not very neat, but I suppose it'll have to do. Now, you want your first suture to bisect the wound. Come here, Meredith!" She was impatient, but not harsh.
Meredith stood beside her mother and watched as Ellis showed her how to bring the skin of the banana together, just touching. Then Ellis put the needle driver in her daughter's right hand and guided it slowly into the banana-wound, how to hold the skin steady with some tweezers that Meredith had grabbed from the bathroom, and how to tie the first knot.
"That's where I always mess up," Meredith murmured, trying to concentrate.
Ellis rolled her eyes. "That's because you've been practicing for what, an hour?"
The kettle began to sing, and Ellis left her daughter to finish the suture, pouring hot water into the two mugs and leaning against the counter, passively watching Meredith stitch, the girl biting her lip as she concentrated.
"Now do two more sutures bisecting the wound on either side of the first one."
Ellis wouldn't let Meredith go up to bed until she had finished closing the entire gash on the banana. It took almost two hours for the thirteen year-old to perfect each suture, as Ellis insisted her patient not be left with an ugly scar.
After she had finished, Ellis handed Meredith a cup of cold tea and looked over her work. Meredith sipped the tea and awaited her mother's verdict, her heart in her throat.
"It needs work. Your sutures aren't going to hold more than forty-eight hours. That's why I say we open him back up and eat the banana."
Meredith choked slightly on her tea and watched as Ellis peeled the banana and broke it in half with her fingers, leaving the bottom half with the sutures for Meredith.
Shepherd knocks on the door to a second floor on-call room, then opens it quietly. He sees Meredith pacing, and she looks up at him quickly, clearly upset. He closes the door behind him.
"You paged me to an on-call room? What's going on?"
Meredith looks at him and crossed her arms stubbornly. "I'm not very good at relationships," she said, and immediately regrets it as an opener. "I'm terrible, really. The worst. The further it goes the more scared I get, and I'm usually the one to run away when things get complicated." He looks as if he's about to say something but she plows on. "I know you want to do this the nice way: take me out to dinner and a movie, or whatever, but that's not how we work. We're surgeons. We don't have lives outside of this place. The more you talk about dates, or dinners, the less likely they're going to happen."
"Meredith, I-"
She holds up her hand. "Is this going to be one of those things where we make out in elevators, sleep together, and continue on like nothing's going on? Because this slow burning make out in elevators, drink champagne in front of your trailer thing feels a lot like you said before…like teenagers sneaking around. So I just want to know up front what you think we're doing."
Shepherd is momentarily thrown, then looks at her seriously. "I'd like to not have to sneak around with you, Meredith. But because of our jobs -both of them-," he emphasized, "we do have to be careful. Your success in this program depends heavily on the recommendations from your attendings, and if we're together that means trouble for you and trouble for me."
Meredith nods, uncrossing her arms.
"You're not gonna like it, but if we do continue doing whatever it is we're doing, we've got to be careful, and we've got to try to keep it outside the hospital."
Meredith scoffs. "So what, you can walk in in the morning and kiss me behind a closed door and then continue on your day like nothing happened? Because that's what we did this morning, Derek."
"Sorry," he mutters.
"It's okay," she mumbles.
A serene pause. He reaches to take her hand and squeezes it. "I finished my surgeries for today. How about I take you to a fine dinner at the infamous trailer? I make no promises of the quality of the meal, but I do know there is good beer to accompany it."
Meredith smiles and nods. "I'd like that, Dr. Shepherd."
"All right," he says. "Are you ready?"
She shakes her head. "No, I need to get my stuff from my locker. I'll meet you out by the car. Oh, I forgot."
Shepherd looks at her questioningly.
"I don't have to be back home by midnight."
