Chapter 7
In life only one thing is certain, apart from death and taxes: No matter how hard you try, no matter how good your intentions, you are going to make mistakes. You are going to hurt people. You are going to get hurt. And if you ever want to recover, there's really only one thing you can say. Forgive and forget. That's what they say. It's good advice, but it's not very practical. When someone hurts us, we want to hurt them back. When someone wrongs us, we want to be right. Without forgiveness old scores are never settled. Old wounds never heal, and the most we can hope for is that one day we'll be lucky enough to forget. Meredith Grey, Heart of Matter
Derek was standing there, shock covering his face. Complete and utter shock. He was at loss for words. Meredith didn't know what she should answer. She is like frozen. She could not move and could not speak. She couldn't do anything except breathe. Because she had to. Derek was impatiently waiting for a very much needed answer. Meredith felt ashamed for not telling him. It was the biggest mistake she ever did in her whole life. Derek was looking at her, waiting impatiently for her to answer his questions. "Meredith, why didn´t you tell me?" He asked with a breaking voice. She was avoiding his gaze. Meredith swallowed hard. Then she looked him right into the eye. Derek made eye contact with her. Her blue eyes were looking right into his. For a moment, he enjoyed this moment before he remembered what was going on here.
"I always meant to tell you, Derek. I … I just needed time. You weren´t supposed to find out like that. Please, I was always going to tell you. And maybe I am a bad guy for thinking that you´ll leave me if you knew about…" She stopped in the middle of her sentence. Derek studied Meredith. She was pale, paler than ever before. She looked tired out, exhausted. Why didn't he notice before? She was sick and he didn't noticed. Guilt overcame him and he needed to sit down because his legs weren't able to hold him steady. He wobbled a bit. Then he sat down on the bed, Meredith was still lying there. Her hands were covering her face, she seemed sad and angry. She was angry of herself. She should have trusted Derek. She should have trusted him. Oh, these damn trust issues.
Meredith didn´t finish her sentence. Silence. They could hear each other breathing. Nobody was talking. "If I knew about what, Meredith?" Derek asked loudly, there was slight anger and disappointment in his voice. But also worry. He was worried about her. He cares about her after all. "For all I know is that you have a scar on your chest." He eyed the scar on her chest, then he realized what this means. And the revelation hit him like a ton of bricks. It was horrible- he had never felt like that. It was like he was falling and there was nothing. Free Falling. And then, hard ground when he landed. That was descibing it, but it wasn't all. There were much more emotions. Worry. Fear. Anger. Guilt. Meredith was his only thought. Why was this happening? He realized, his neurosurgeon brain eventually realized what that meant. The scar.
For Meredith.
She´d been on the operating table more than once.
Most likely because of a congenital heart defect.
After realizing this fact, he swallowed hard and his face expression changed to shocked, because he was shocked, it came all out of sudden. "You've had open heart surgery." He stated with a shaking voice, trying to process everything but it was too much all at once. He still could not believe a single thing. All things were crashing down on him out of sudden and there was nothing he could do. "Yes, I've had open heart surgery three times when I was a child." Meredith confessed. Derek just stared at her, couldn´t believe what he was hearing and couldn´t help but feel sorry for what she´d been through when she was a child. He could truly believe it was not easy to live with something like that. There was no way that it could have been easy for her or on her. Surgery is ...
Meredith waited a few second before continuing: "I was born with a heart defect. A congenital heart defect. Actually, there were three different kinds of cardiac abnormalities." She paused, trying to gain control over her emotions but everything was just weird and stressful and exhausting for her. She knew she needed rest. Derek just listened to her telling her story, because he wanted her to have the chance to explain things. She needs to have that chance. It wouldn't be fair otherwise.
She deserved to get a chance to try and make things right between them.
She deserved that chance ...
And Derek wanted nothing more than to hear her out.
"At first the doctors thought everything was normal and I was born healthy. That´s what they thought, but the truth is that I wasn´t healthy. The only indication were my somewhat low oxygen levels, but they blamed is on the fact that I was born a few weeks premature. I was a preemie, so they didn´t order any further tests, until I developed severe cyanosis ... My condition deteriorated fast, I have gone into cardiogenic shock, I suffered from metabolic acidosis with BE -5. My patent ductus arteriosus closed and my heart started to fail." Meredith's voice shook as she told him that. Derek shuddered, his heart began to beat faster. Meredith stared at the wall, trying to sort the thoughts that were overwhelming her.
What will he do? Will he run? She hoped he wouldn't. But she wouldn't blame him if he did. "I ... sorry ... I ..." Meredith didn't know what to say. "Mer." He said, gently running his thumb over her cheek and she looked at him with big eyes. Unsure what to do. She feared one false movement would destroy everything.
"Yes." She responded, unsure of herself.
"Meredith, look at me." Slowly, she looked up. Right into his eyes. "It's okay. Just go on." He calmed her.
Meredith's heart raced. She was having all sorts of self- destructive thoughts. Her mother had told her everything she needed to know about her heart condition as soon as she was old enough to fully understand what it means. That is how she knows. After she found this chart with all these echocardiography pictures and chest x-rays and other things related to that, she found out more than she already knew ... She never knew about the fact that she had bacterial tracheitis as a kid. She was too young to remember ... "Surgery was the only option to save my life." She told him with a quiet voice.
Derek shuddered slightly when he heard those words.
Meredith stopped and took a deep breath, before she revealed the whole truth about her shocking medical condition. Instead of saying something Derek simply took Meredith´ hand and squeezed it slightly to comfort her. Meredith gave him a weak but thankful smile. Meredith told him with a small voice: "The cause was an interrupted aortic arch, short IAA, but I think you know that considering you´re a surgeon." "Neurosurgeon. I am a neurosurgeon. Burke is the cardiothoracic surgeon at Seattle Grace. You should know that." Derek immediately commented. Meredith shot him a glare before continuing with her story.
"This is so not funny, Derek. Let's get back to the point. IAA requires immediate surgery. I am sure you know that even though you´re a neurosurgeon." Meredith paused.
"That's right, I am a neuro god." He grinned.
She slapped him playfully on the arm. "Hey, now is not the time."
"But I am." Derek said, not sounding a bit ruefully. "And you are the best intern I've ever seen my entire career."
Meredith chuckled, but suddenly got serious. Derek noticed it too. "What's up?" He asked. "Isn't it a bit weird that we are talking about that right now?" She wanted to know. "Maybe. I don't know." Derek answered honestly.
"They also discovered that I've had a congenital defect called Double Outlet Right Ventricle. Because of the interrupted aortic arch they rushed me into surgery as soon as possible. In surgery they also discovered that my Taussig- Bing- Anomaly was combined with an Atrioventricular Septal Defect. The interrupted aortic arch was corrected with a Yasui- procedure in the first surgery, then after three or five months, they did the second procedure ... " Meredith replied, trailing off ...
Suddenly, Derek thought about something, he cursed himself that he hadn't thought about that earlier. Then he asked the important question which would determine if there were residual defects and what kind of procedure it had been. He hoped it had been a corrective procedure. The chances were lower for complications than with palliative procedures. Also, she was at risk on getting bacterial endocarditis whenever she went to the dentist's for dental caries prophylaxis which meant she had to take a broad-spectrum antibiotic to prevent bacteria to get to her heart ...
"Second corrective procedure? Right? It was corrective?" Derek wanted to know. He was scared about what she would answer. What if it hadn't been corrective? They were looking at a lifetime of possible cardiac complications.
Meredith just looked at him and immediately he knew that it hadn't been a corrective procedure.
"The surgeons at Seattle Pres decided to perform an atrial switch surgery-" Meredith explained quietly, her voice quivered when she searched for the right words. "God, that means your right ventricle pumps the blood into your system. Am I right?" He interrupted out sudden, panic was evident in his voice. He sounded shocked, which was totally understandably considering the situation. Meredith gazed at him and nodded slightly.
"You are right, it wasn't a corrective procedure neither anatomically nor physiologically." She then confirms his suspision. "My right ventricle pumps the blood into my system and the left ventricle circulates the blood back to lungs. Then, when I was five years old, I had a cyanotic seizure. They discovered that my right outflow tract had been too small. It was a RVOTO, right ventricular outflow tract obstruction. Over the years of my childhood I was in and out in hospitals. Can you imagine that, living with a heart defect?" Meredith said, finished with telling her story.
Silence. Meredith could herself and Derek breathe. Nobody said a word, they just sat there in silence.
Derek just sat there for a long, long time and doing nothing. She heard him breathe in and out, slowly. In and out. He tried to process everything he had heard and tried to wrap his his mind around all the information he got. Meredith was getting nervous when Derek didn't say anything. Tears were in her eyes. Maybe she had just destroyed her relationship with the love of her life. What did she think about that? Why did not she tell him about everything? Had she really been that dumb? Obviously, yes. She decided to take things into her own hands and was about to ask him what he thinks what he will do. "Derek, can totally understand if you need time to process everything …" Meredith said, while choking tears back. Derek answered: "Meredith, I…" But before he could finish his sentence, both of their pager signaled an emergency.
"Looks like we have to work." Meredith commented.
"And I was hoping to get some sleep." She added, sighing loudly. Derek watched her with a worried expression. Meredith knew what he was thinking.
"I am okay, Derek. You don't have to worry about me." She backed away. Maybe you will leave me anyway, she thought, guilt washing over her. "I worry about you even if you don't like the whole Hovering- thing, because I love you, Mer and it's the right thing to do if you love someone. And you not telling me from the beginning? Well, it came as a giant shock, but it doesn´t change anything. I still love you, even if you made mistakes. I made mistakes too, it's what makes us human. I make them, you make them and then we learn from our mistakes. Mistakes are human. But we can discuss the whole situation after we come home tomorrow. Now we have to get going." He told her. Meredith silently cried when she heard his words.
He was not going to leave her. He was not going to leave her ...
"Hey, Mer." He said, embracing her in a tight hug. "Come here, it's okay. I've got you." He said, he softly ran his hand through her hair and enjoyed their hug. "Someone special like you I will never find again. I love you, Mer and I want you." He assured her, mumbling these words in her brown blonde hair.
Meredith just sat there. She did hear her pager, but she just looked at Derek. He knew and he wasn't going to leave her. "So you are not going to leave me?" Mer asked with a small, shaking voice. Fear sounded in her voice. She was pale and looked extremely fragile. "No." Derek exclaimed, seemingly surprised. Why would she think that, he asked himself. He was would never leave her. "Why'd you think that?" He asked carefully choosing the right words. "I lied. I freaking lied about everything. You should hate me. I am a liar. Nobody knows. Just you and Cristina know." She confessed, avoiding eye contact with Derek.
Derek looked at her for a few seconds. He couldn't believe his ears, was she really saying that he should hate her for what she had done? That she doesn't deserved him? A good man like him? Why on earth would she think that?
"Wait, you said something about me hating you?" He asked shocked that she would even think that.
"I am a liar. I don't deserve you."
He sat next to her, embracing her in a giant hug. Meredith relaxed in his arms and he mumbled in her hair: "I could never hate you, even when I hate you, Mere." He confessed his deep feelings to her that wouldn't just go away because she didn't told him a little detail. "Really? You won't leave me? I mean, you didn't tell me about your wife, Derek. Please don´t, I would have told you some day. Really, please believe me when I say that." Meredith rambled nervously. She sometimes had a hard time stopping when nobody stopped her. Derek listened to her, then he did something to stop her from continuing to ramble. First he tried with words, then he had an idea. "Meredith, stop." Derek quieted her with a small kiss placed on her lips. "Sorry." He said. "It was the only way to interrupt your rambling, Mer. Actually, it is pretty sweet." When Derek told her that, she blushed a little.
Just a little. But it was sweet.
"You are a great and strong person, Meredith, but you are so stubborn. I love that about you. You're sweet, loving and caring and you deserve good things happen to you. So, Mere, when you say you don't deserve me, you are wrong, you deserve love and happiness and I won't go anywhere, except with you - I love you, Meredith. I won't leave you because you withheld that little detail." Derek said. "Look who is now rambling." Meredith chuckled, she was already back to her old self.
For a moment nobody said anything. They just sat on their bed in a hugging position.
"Wait." Derek interrupted the silence. "You said nobody except me and Cristina know about you suffering from a CHD?" Meredith nodded, looking to the ground. She already knew Derek would be for telling Bailey and Bailey about the circumstances. Derek's brows were furrowed as he looked at Meredith who was still in his arms. "Just me and Cristina? You told her? What about the chief and Dr. Bailey? Do they know about your heart condition?" He wanted to know. But before Meredith had the chance to answer the pager beeped again, loud enough for them to hear.
"The accident. God, I totally forgot about the ER page." Derek muttered almost inaudibly but Meredith had heard him. She grimaced and had the same opinion as him. As much as she loves her job, sometimes it's really determining your whole life. And some people really need to learn how to freaking drive in the winter. It was still ice cold, it was snowing. But hopefully the snow would be melting soon. He and Meredith put some clothes on, before rushing to the hospital. With Derek driving the car, Meredith watched the streets go by and the sun disappear behind the sea. Then they reached the hospital. "We are here." Meredith said and opened the door of her car as soon as Derek had stopped it in the place where it belongs. "We are." Derek said, grasping Meredith's hand and they both entered Seattle Grace Hospital.
Then they saw the sign: Emergency Department, Seattle Grace Hospital and knew that they reached their destination. It was going to be a long long day. Exhausting. Meredith and Derek chared a look and then they stared at they chaos that was the pit. There were so many injured patients, all beds were occupied. There were already gurneys standing in the hallways and blocking them. "Wow." Meredith said, looking at the scene. "That is gonna be long and exhausting." "You might be right." Derek answered with a nod. "Now come with me, we have lots of work." He advised her. When they came to the pit, Meredith just said after one look: "Now that is gonna be one long night, Dr. Shepherd." Meredith said, dark rings were under her eyes.
"You're right, but why did you call me Dr. Shepherd?" He asked interested in why she had done that. "Because we are professionals at work. We agreed our relationship wouldn't interfere with our work." Meredith replied simply. "Aha." Derek responded. The ER was full of injured patients. All available beds were occupied. Someone was shouting for a crash cart in curtain six. Then Dr. Webber was coming towards them. He was all hectic, in working- mode. He approached to them. "We have a head trauma coming in. Ambulance is two minutes out." He called over to Derek and Meredith. "What happened?" Derek asked, wanted to know what the situation was.
"Bus collided with car. Means lots and lots of patients and we've got more incoming." Dr. Webber explained. "No no no, don't. The path has to stay free." He said to a nurse who wanted to park a patient there. "Where do need me?" Meredith asked, unimpressed from the chaos around her. "You're with me, Grey. Come." Derek interjected, before Dr. Webber could answer. Meredith obeyed without any further questions and followed the neurosurgeon. Meredith and Derek waited outside for the ambulance. They could hear the sirens wailing and thereafter the ambulance arrived with sirens.
The blonde-haired paramedic jumped out and opened the back of the ambulance. "34 year old male, crashed his car into a pole. Sustained possible closed head injury. Increased intracranial pressure, GCS is 6. He was hypotensive en route. He was conscious for a few minutes on the scene but passed out again in the ambulance." The paramedic stated the facts. „Clear a trauma bay right now." Derek ordered. Meredith and he worked on stabilizing the patient.
"Make sure CT is on standby. If there is a bleed or something and I need to go in, I want the OR prepped and ready the minute I know what we´re dealing with." He ordered loudly. "Of course, doctor." The nurse quickly replied and contacted the OR. But all ORs were being used. They were swamped with so many patients and a grear amount of them needs surgery. They were swamped, backed up. Meredith and Derek were in the trauma room, trying to stabilize the patient, but they couldn't get his blood pressure up.
„We need to consult general. His abdomen is rigid. Page Dr. Bailey. And then get him to CT." Derek constructed, while testing the patients pupil reaction. They were reacting a little sluggish. Before the doctors could do anything the patient started crashing. "Damn, he is crashing." The heartbeat became more and more irregular and monitor signaled with a rapid and erratically tone that the patient had gone into ventricular fibrillation.
"Damn it." Derek muttered, before shouting: "I need a crash cart now."
Meredith immediately responded. She handed the paddles. „Charge to 200. Clear." He warned the others. He shocked the patient once, but he didn't respond, neither to the first round of ACLS drugs or to the shock. "Charge again." He wasn't about to give up and let this man die. He pressed the paddles to the patients chest. "Clear." The next shock sent the patient´s body flying upwards and back on the gurney. After three rounds they were able to revive him. "We really need to get a CT done." Dr. Bailey waited for them in CT. The short- legged woman was waiting impatiently on the results.
"What do we have?" She asked. "MVC, he suffered traumatic brain injury and possible abdominal injuries, that´s why we paged you. We are still waiting for the images to come up." Derek answered. After a while the images were up. "Damn, he has suffered major trauma to his abdomen. Grade IV liver laceration." Bailey stated after looking at the images. "Well, that's not all. What can you see, Dr. Grey?" Derek directed to Meredith, who studied the monitor carefully, before answering: "Acute Subdural Hematoma. He needs an emergency craniotomy. Causes are major trauma and it has a mortality rate of 50%." "You are right, the hematoma expanded along the inside of the skull, and it's creating a concave shape that follows the curve of the brain, stopping only at the dural reflections like the tentorium cerebelli and falx cerebri. We need to get him to the OR."
"Well, then let's get him to an OR, before he bleeds out."
The surgeons rushed the patient to the OR, but there weren't any available ORs. "How come there is no OR available. I have an emergency craniotomy or my patient will die." Derek was furious. The nurse stuttered helplessly: "I cannot do anything about it." She looked overwhelmed by everything but Derek did not take a no for an answer. "Well, bump any non-emergent patients. Clear the OR rotation now and maybe someone just started operating. Maybe they can close up. I don't care, just get me a damn OR." Derek was adamant.
The nurse nodded and reached for the phone.
"That seemed to work. What is surgical plan?" Dr. Bailey commented. "I will go in first to relieve the intracranial pressure and when I am finished you can start fixing the liver lac? How does that sound?" He wanted to know, looking at the heart monitor which was beeping in a normal rhythm. "Good. Will you page me when you´re done operating?" "I will." Derek replied. The nurse interrupted with: "OR 2 is ready." They rushed the patient into surgery. Meredith assisted Derek in surgery. Brain surgery was interesting. The brain was a mysterious organ. That is why the brain is so interesting. It was quiet in the OR.
Any loud or disturbing noises weren't welcome, because it was important to concentrate. "Can you see that?" Derek asked and Meredith nodded. "That is the bleeder, right?" She asked interested in the surgery she was whitnessing. "Yes, you are definitely right." Derek responded and smiled under the mask at Dr. Grey who replied with smile in his direction. "I am starting to remove it. Suction, now." Derek voiced.
Then there was noise from one of the pagers.
"Whose is it?" Asked Derek slightly annoyed. "It's your pager, Dr. Grey." The nurse replied and read the message: "It's a page from Dr. Burke. It says you should come to patient room 12534." Meredith breathed in, then out. "That's Lily, the one who is here for a heart procedure." Meredith mumbled to herself, but Derek heard her. "Who is Lily?" He asked. "I will talk to you later, Derek." Meredith stepped away from the operating table. This page could mean something had happened to Lily. Meredith scrubbed out and ran to Lily's room.
Dr. Burke was already there. "What happened?" Meredith asked, a little bit gasping for air. "She's been having arrhythmias. We are going to do an EP study, which is short for electrophysiological study." He was half talking to Lily's mother and half to Meredith. Meredith always hated this when she was the patient. Every three years they did a heart catheter on her, while she was laying there wide awake, although they´d always given her a sedative. That reminds her that she needs to schedule one in the near future, but that would mean that she has to tell the Chief and Dr. Bailey.
Everybody would know if she decides to do it here in Seattle Grace Hospital. "Are we doing it now?" Lily asked sleepily, having a hard time to keep her eyes open. "And more important: Does it hurt? Will I have to be awake, Dr. Grey?" Meredith wasn't surprised that she directed her question to her. She was born with a heart defect too, so chances are, she already had one and knew how it worked. Dr. Burke face expression showed surprise. Well, he didn't know why. And it should stay that way. Meredith felt everyone's eyes on her and she was nervous.
Meredith felt panic rise up in her, but she tried to stay calm and answer her patient´s questions.
"We will do the electrophysiological study now. We will start prepping you after I explained everything. You'll be awake during the procedure, but we inject a sedative, so you won´t feel any stress and discomfort, so you´ll be more relaxed. During an EP study we use really small, thin wire electrodes that are inserted through a vein in the groin. The wire electrodes are threaded into the heart, using a special type of X-ray. Electrical signals are sent through the catheter to stimulate the heart tissue to try to initiate the abnormal heart rhythm disturbances for evaluation. It is an invasive procedure that Dr. Burke will be performing in a cath lab. Hopefully we´ll be able to find out what causes your syncopes."
Lily slowly nodded. She knew exactly she didn´t have a choice, so she didn´t even tried to protest. Maybe they will find out what is causing the syncopes. After all the questions were answered, a nurse came to prepare Lily for the procedure.
After Burke left the room, Meredith said: "I'll see in cath lab, Lily." "You'll be there too, right?" Lily asked, she wanted to know for sure that her favourite doctor was going to be there too, she was slowly sitting up. "Of course, I'll be there the whole procedure." Meredith replied with a confident voice. "That´s great, because I trust you. You´ve been through all of this and against all Odds you became doctor. I mean this gives somebody in a Situation like this a whole new perspective." Lily explained. Meredith smiled. She hadn't thought about that in this way.
After Derek finished his surgery he went to find Mark. He wanted to go to Joe's Bar. He knew they weren't exactly close anymore (they were, but neither of them wanted to admit that they needed each other. They were too proud), but he really needed someone to talk to. He couldn't talk to Burke, even if he hadn't been in the cath lab performing an electrophysiological study. Meredith was the intern assisting on that case. He found Mark near the OR board, where he looked at the OR board, stunned. "Which idiot canceled all my procedures?" He wanted to know. "Haven't you heard?" Derek asked. "We've had incoming trauma patients because of some accident. They canceled all elective surgeries to clear the ORs for emergencies. Anyway, that is not why I am here." He ended the sentence"Oh, is Meredith giving you a hard time?" Mark laughed.
"Stop that. Mark. Don't talk about her in that way."Derek hissed. Mark frowned when he watched Derek's harsh reaction. "No need for you to get so defensive." Mark replied. "Why can´t you be serious for one damn Minute. Hell, you slept with my ex-wife - okay, I am not going there, sorry. Have you time to go to Joe's Bar. There are none of these gossipy nurses." "What is your problem with the nurses. They are really good in ..." Mark began, but Derek cut him off. "Oh, Mark. I don´t wanna know. Just don't complete thís sentence. There are certain things I don't want know. I am in a steady relationship and I will be. Now, what about a beer at Joe's." Mark looked at his friend with a frown.
"Okay, okay. Man, is everything okay. I mean you look like you are bit in over head." Mark continued. Both of them headed to Joe´s bar for a drink. "So why'd you want a place without the gossipy nurses?" That was Mark's first question as soon as he took his first sip. "Because they love gossiping. And some things are better off if they remain a secret." Derek answered secret- like, avoiding Mark's gaze.
"Now you lost me." Mark took a sip of his drink.
"You won't believe me, Mark, when I tell you this." Derek shook his head. "C'mon. Just tell me. I am your best friend." Mark reacted, looked at him expectantedly. "Well, I am sure you won't because it is freaking unbelievable. I mean I have mever known a person who was ..." He didn't finish the sentence. "Shep. I don´t understand what you are talking about. What person was what? Clarify yourself." Mark said worriedly as he looked at the surgeon.
"Meredith has a heart defect."
Mark choked, while spitting his drink on the desk and started coughing and gasping for air. Derek watched his friend trying to breathe. Derek felt helpless as if telling Mark made everything very very real. Meredith is ... was ... is ... sick. He didn't know what to do. It was a big thing. When he could breathe again, he said: "This is a joke, right? You are joking or am I on drugs and this some kind weird experience." He shook his head, obviously he did not believe him. "Or is this some kind of weird payback for the wifey- thing?" He asked. Derek looked at him angrily, his stomach churned when he heard Mark asking that.
"No." Derek shook his head, he clenched his fists, trying to gain control over his wild running emotions.
"It´s the truth, but the whole truth is nobody knows, let alone Bailey and the chief. And she didn´t even tell me. I figured out when I saw the surgical scar on her chest. Only then she told me about her medical condition." Derek supported his head with his Hands as he stared at the dirty table top. Mark didn´t know how to react or what to say in a Situation like this. "But Mark, no gossiping, okay? Don´t tell anybody about what you heard. This stays between us. Otherwise I will get very displeasing and angry. So, please for god´s sake, keep your mouth shut. I mean it, really."
"I promise I won´t tell another living soul in this hospital." Derek glared at his ´used to be-best friend´, until he sighed and corrected: "Fine, won´t tell anybody. Happy now?" "Good. I hope for that you will Keep your mouth shut, because it could cause Problems for not only me, but for Meredith, so I told you this as a friend. So don´t disappoint me, Mark." Derek repeated another few times.
Mark looked him in the eye, then he sighed.
"Shep, I may have slept with Addison, but I am not an idiot." Mark reassured his friend. "Joe, can you get him another Scotch? I´ll pay." Joe nodded. Derek looked up, no longer avoiding Marks gaze and said: "Thanks, Mark, for being here." "Well, that´s what real friends do. Help eachother out if there´s some sort of crisis. And I think this is a kind of crisis, right?" Mark asked. "It definitely seems to be." He answered the question himself shortly afterwards. Derek did not reply, but that was not neccessary.
"Finally you get it, Mark." Derek mumbled in his half filled glass with Scotch in it.
"I need details." Mark suddenly said. "You can´t you drop a bomb like that on me and then expect I have no questions." "Well, I do." Derek answered. He emptied his Scotch with one gulp. "Pleeaase, detaaaaaaaaaaaails. Come on." Mark pressured him. "No, I don´t tell you the details. It is just more ammo for you and if you accidently slip, Meredith will kill me. Literally."
"You´re funny, Derek. She would never do anything like that to you."
"I wouldn´t be so sure."
A/N: Hope you liked that chapter.
Cardiovascular surgical procedures or operations may have one of several goals. Anatomically corrective procedures are required to make heart structures normal. Physiologically corrective procedures are required to separate and/or Redirect the blue and pink blood circulations. These corrective procedures range from the relatively simple, such as closing or patching a hole or tying off a vessel, to the complex, such as switching vessels or rerouting blood streams. Palliative procedures are required to improve, but not correct, an abnormal heart function. Palliative operations are performed to improve the heart function, usually in children too young for corrective surgery or sometimes corrective surgery can't be done like in cases when one ventricle is hypopastic or the structures of the heart aren't like they should be in order to the corrective procedure. The aim is to lessen cyanosis, to control heart failure, or to prepare the circulation for later repair.
A Subdural hematoma, also known as a subdural haemorrhage (SDH), is a type of hematoma, usually associated with traumatic brain injury. Blood gathers between the dura mater, and the brain. Usually resulting from tears in bridging veins which cross the subdural space, subdural hemorrhages may cause an increase in intracranial pressure (ICP), which can cause compression of and damage to delicate brain tissue. Subdural hematomas are often life-threatening when acute. Chronic subdural hematomas, however, have better prognosis if properly managed. Large or symptomatic hematomas require a craniotomy, the surgical opening of the skull. A surgeon then opens the dura, removes the blood clot with suction or irrigation, and identifies and controls sites of bleeding.
Acute bleeds often develop after high speed acceleration or deceleration injuries and are increasingly severe with larger hematomas. They are most severe if associated with cerebral contusions. Though much faster than chronic subdural bleeds, acute subdural bleeding is usually venous and therefore slower than the typically arterial bleeding of an epidural hemorrhage. Acute subdural bleeds have a high mortality rate, higher even than epidural hematomas and diffuse brain injuries, because the force (acceleration/deceleration) required to cause them causes other severe injuries as well. The mortality rate associated with acute subdural hematoma is around 60 to 80%.
I will try to post the next chapter as soon as I can manage. Please leave a review ...
