The Fight For Four

Chapter Nine

Meredith couldn't remember ever having a longer night than she'd had that first night with Derek in the ICU. She'd cried when she finally looked at the clock and found it was morning. He'd made it. He'd pulled through, against the odds, and he was still there with her. Really, given his injuries and the delayed response time after he was stabbed, statistics said he had only about a ten percent chance of surviving. Ten percent was crap. Meredith replayed the number over and over in her head, figuring it was one of the worst odds they could be up against. And yet, for now, his heart was still beating.

The night hadn't been without its struggles, though. Her sleep had been restless, and somewhere around three that morning he'd coded again. Teddy had been paged out of a dead sleep to come do an echocardiogram at his bedside, and Meredith had held her breath, waiting for her to tell them whether or not his chest was again filling with blood. It hadn't been, at least not then, but his heart was struggling even after they'd shocked him yet again. She'd clung to the normal sinus rhythm on the screen, not that it meant much. Teddy had once again adjusted his ventilator settings and increased his medications, though she'd pointed out they were then maxed out. They had Derek on as much support as possible. It would be up to him, from there, to survive. Either his body would fight back and make it, or it wouldn't.

Owen had woken her around five, concerned about the fever Derek had developed. No one was really surprised that he'd developed a post-op infection, but they weren't happy about it either. He'd changed his antibiotics out with stronger ones, but warned Meredith that he wasn't sure it would make any difference.

Teddy took over around six, and Meredith sort of just went through the day in a daze. Mark and Lexie dropped by with Weston, and she'd visited with him for a few minutes before they dropped him off in daycare. Somehow Mark managed to convince her, with the help of Cristina, to at least step away long enough to get a bite to eat. She'd returned back to his side within an hour, panicked at how long she'd been away. Derek hadn't changed, though. He was still there, still relying on something other than his body to keep him alive. He hadn't attempted to breath over the ventilator at all yet, and Meredith could feel hope slipping away from her. It terrified her to think that maybe his brain had damage from hypoxia, though Teddy insisted it was far too early to worry about it. They needed his heart and lungs to heal first. After those things happened, then they could look elsewhere.

Still, it almost killed Meredith, sitting there in that ICU hour after hour without so much as a finger twitching on his end. By that first evening he seemed to be more stable, enough so that Teddy went home for the night. It had been hours since the last scare he'd given them, and Owen assured her it was a good sign that he was starting to recover. Meredith knew though, with him refusing again to leave overnight, that they weren't out of the woods. She couldn't remember the last time one of them had babysat a patient for that long. It was rare, and really most of they time they did it, the outcome wasn't good anyway.

- GA - GA - GA -

It was a full forty-eight hours after the stabbing before they all agreed that it was likely he was going to live. Meredith had even agreed to go home that morning, and she'd slept well into the afternoon under the watchful eye of Carolyn Shepherd who had flown in the day before. She'd insisted on taking care of things until life was back to normal. Meredith had argued at first, especially about her keeping Weston, but she seemed good with him and he'd warmed up to her quickly, so she'd finally agreed to let him stay at home rather than go to daycare. She'd spent a few hours at the hospital late that afternoon and into the early evening, but had gone home again after that at the insistence of Cristina assuring her that there was no way he was going to wake up.

On the morning of that third day, Meredith showed up at the ICU with a tiny amount of hope. Teddy had called to tell her that he'd done really well overnight, and that she thought it was time to discontinue his sedation. Despite the nerves it released inside of her, she knew it was a huge step in the right direction. Eliminating medications was essential to his recovery, and the sooner they could get him awake, the sooner they could get him on the path to being himself again.

"Morning, Dr. Grey." Kelly James, the nurse that had been there much of their time in the ICU, greeted her with a smile as she walked in. "Dr. Altman just came by and gave the thumbs up to discontinue his sedation."

"She's sure?" Suddenly Meredith wasn't. She wanted him awake with her, looking at her, present with her, more than anything. But being awake meant being in pain and being aware of everything around him. She wanted to protect him from that as long as she could, especially while he was still on the ventilator. She knew patients did it all the time, but she couldn't really imagine how scary and uncomfortable it must be to have a machine assisting your breathing while you were awake.

The nurse nodded, adjusting Derek's pillows. She checked on his compression stockings, the ones helping to prevent blood clots from his lack of mobility and recent surgery. She recorded the numbers on the bag connected to the catheter that was emptying his bladder. She made sure his ventilator settings were correct, that his central line still looked good, and that the tube going down his nose and into his stomach to give him nutrition was in place. "She'll be back in just a couple of minutes. She was going to make a phone call to Dr. Hunt first."

Meredith watched her, systematically recording in her mind everything Derek would wake up to. Tubes shoved in almost every body part he had. There were still two chest tubes in place as well. Tears filled her eyes, and she looked down to avoid the nurse's gaze.

"Good morning." Teddy walked in as if on que, smiling when she saw Meredith there. "You look refreshed. I take it Derek's mom is being a great mother hen?"

"Something like that." Meredith quickly wiped the tears from her eyes before looking over. "Are you sure about this? He's still on the vent, and not really doing a lot of breathing work on his own. It could be days before he comes off of it."

Teddy could hear the apprehension in her voice, and she thought back to when Meredith was the one in that bed and Derek had refused to let them pull her sedation until she was breathing on her own. He'd been a pain in the butt to deal with, but she'd understood where he was coming from. "The longer we keep him sedated, the longer he's immobile." She reminded her gently. "And for a patient with recent heart surgery..." She let Meredith finish that thought.

"I know," Meredith sighed, knowing it would be the wrong thing to do to argue.

"I really think he's going to do much better than you think." Teddy insisted. "He's getting a lot stronger already, and I honestly wouldn't be surprised if a lot changed today. I've seen patients go from full respiratory support to ready to wean in just twenty-four hours. If we get him awake and he's struggling with all of this, we'll take care of him. I don't want you to worry that we're going to just sit back and watch him suffer."

"He's peaceful right now." Meredith's voice broke, and she could no longer keep herself from crying. "Teddy...none of his body is his own. There's crap shoved in him...everywhere. He's going to wake up to this...and I don't even know if he remembers what happened."

"Meredith," Teddy knelt down next to the chair where she was sitting. "I know this is different when it's your family. I know this is hard. I can't imagine how scary this must be for you. But Derek is in good hands. We are going to keep him as comfortable as we can. I give you my word on that. This is a big step for him. We need to let him take this step so we can work on getting him home with you."

Meredith could only nod through her tears, her hand reaching out to grab her husband's hand. "Just do it." She wanted it over with. She needed the mounting anxiety to stop. She knew herself well enough to know that until it was all over, her panic would just build. "I'm here, Derek." She knew she was speaking more for her own comfort than for his.

Teddy smiled a bit and stood, glancing over to Kelly. "We have Versed, in case he needs something, right?"

Kelly nodded, pointing to the syringe on the bedside table. "Right here, just in case." She looked over to Meredith. "Do you want to step out?"

"I'm staying."

Teddy knew she would. She stepped over to the IV pump, messing with a few buttons to discontinue some of the medications dripping down into the tubing.

They waited. Seconds ticked by. Minutes turned into what seemed like hours. The room was eerily quiet aside from the sound of the machines. Everyone held their breath, watching, waiting.

"Derek," Meredith noticed the wiggle of his foot first, then a small shift of his hand. She let out a slow and unsteady breath, reaching over and gently running her fingers up and down his lower arm. "Derek," She whispered again. "It's okay to open your eyes. I'm right here. You're safe." Tears stung the edges of her eyes, but she ignored them.

Derek struggled. Everything hurt. Everything felt heavy. Something was wrong. Something didn't feel right. His chest was on fire. It burned. He could hear Meredith's voice, faintly, somewhere. Why wouldn't she help him? Why wouldn't she make it stop? His chest was on fire and no one would help. He tried desperately to run, but he was heavy, so heavy. His fingers wiggled in response to his determination to get away. He could feel something in his throat, a strange sensation shoving air into his lungs. He didn't like that. It hurt too, and...it wouldn't stop. Why wouldn't it stop? Why were his lungs being forced to inflate when he wasn't ready? Why couldn't he slow his breathing down? Once again he tried to run. This time his foot flexed. Frustration washed over him. He tried to turn his head but someone's hand was there. Gentle. Soft. But they wouldn't let him go. They wouldn't let him get away from the thing shoved into his body, shoved into his mouth. He wanted to scream, but no sound was possible. Where was Meredith? Why wasn't she talking anymore? He tried to open his eyes but quickly shut them again, angrily fighting the bright light.

"It's okay, Derek." Meredith's voice soothed. She leaned over and whispered against his ear, her fingers running gently through his hair. "You're okay."

"Derek," Teddy stepped over to the other side of the bed. "I need you to open your eyes for me. You're in the hospital. There was an accident. You're okay, but I need you to open your eyes." Her voice was firm.

He complied, but his expression begged for relief.

Meredith could see his panic, and her heart hammered against her chest. "I'm right here, Derek. Right here with you. I know this sucks. I know it hurts. I'm so sorry. I'm not going anywhere."

"Doctor Shepherd!" Kelly's voice suddenly barked when he regained more movement, and she grabbed his free hand as it shot toward the tubing of the ventilator. "Doctor Shepherd, I need you to calm down! Do not pull that out." She jerked his hand back down to the bed, frowning. "Dr. Altman."

"I know." Teddy sighed as Derek began to fight their hold, struggling to yank the tube out. "Derek, listen to me. I need you to relax. I know this is difficult. Just relax for me." She glanced at the monitors that were screaming their protest of his climbing heart rate.

Meredith wanted to panic, but she forced herself to stay right there with her husband, tears streaming down her face as she desperately tried to get him calm. "Derek, look at me. Please, look at me Derek. It's going to be okay. It's alright. You're safe. I know this hurts. Please...Derek." She didn't noticed the soft restraints Teddy and Kelly had used to tie his wrists and ankles to the bed until they were already in place. "What are you doing?! Please, stop! You're just making it worse. You're scaring him! You promised he would be okay, that you would take care of him!"

"Meredith, part of taking care of him right now is making sure that he can't hurt himself. I know this is hard. I'm so sorry." Teddy was already injecting half of the versed dose into his IV. She hoped it would be just enough to take the edge off for him but not enough to keep him completely out of it. "Derek, this is going to help you relax. Try to relax for me." When she was satisfied that he was no longer thrashing around and fighting the machines, she glanced over at Kelly. "Why don't we give them a few minutes."

Kelly nodded, looking sympathetically at Meredith. "We'll be right outside if you need us."

Meredith broke down when they left, her head resting on the bed next to his hand as she cried. She wanted to trade places, to take his suffering from him. Guilt began to consume her again, building until she grabbed the trashcan at his bedside, losing what little she'd eaten that morning.

It was a good hour before Derek stirred again. "Derek," Her breath hitched when she saw him open his eyes, and she quickly reached down and took his hand as best she could with the restraints in place. "You're in the hospital," She said gently, just in case he was confused. "There..." She struggled with whether or not to tell him. "You were stabbed." She could see the fear in his eyes, and quickly continued. "But you're doing great. You're so strong. I'm so proud of you." She wiped tears from her cheeks with her free hand. "You had surgery, but it went really well."

Derek struggled to reach up and touch his wife's face. Tears of frustration and pain filled his eyes when he realized his mobility had been reduced to almost nothing. Meredith's tears were almost enough to make him forget about his own pain, and he desperately wanted to reach out and comfort her. Another forced breath from the machine, however, meant he was reminded again of the agonizing burn in his lungs and chest. He jerked both hands against the restraints, clenching them into fists. He needed the pain to stop, yet he had no way to even communicate that to her. Panic began to set in, and he stared at her, begging her to see his desperate need for the slightest relief from the hell he was in.

Meredith didn't need him to say anything. She knew his pain was overwhelming. She reached over and pushed the button for the nurse. "We'll get you something for the pain, Derek. I'm so sorry."

Kelly appeared in just minutes, smiling at the two of them. "Everything okay?"

"His base dose of morphine needs to be increased." Meredith glanced over at her. "I need you to ask Teddy to let him have something now as well."

"I'll see what she can do." She glanced at Derek. "Welcome back Dr. Shepherd." She smiled. "I'll see if we can find something to fix your pain."

When Teddy had finally come and gone, giving Derek just a little more morphine and promising to change his dose, Meredith's eyes wandered to his clenched fists. "I can take those off," She said gently, running her fingers over his wrist, beneath the restraints. "But you have to be calm."

Derek was grateful that the effects of Morphine were almost immediate when given by IV. He closed his eyes for a minute, willing himself to relax though it was still nearly impossible. Pain or no pain, he was uncomfortable, and he still hadn't figured out how to set aside the anxiety that seemed to be creeping up. He glanced at Meredith, catching her gaze, and managed a tiny nod. Just the small movement caused him to jerk back though, sending even more discomfort through his his trachea.

Meredith's hands were shaky and she couldn't help the tears that fell as she carefully untied the restraints on his feet first, and then his hands. She gently rubbed his wrist, glancing at him to make sure he wasn't going to fight everything again. She didn't exactly have permission to remove them, and she knew Teddy would be furious if it caused something to go wrong. Still, the half-empty syringe of Versed was on the table, and Meredith knew how to use it if she needed to. "I'm so sorry." She whispered. "Is that better?"

Derek struggled to remind her he couldn't answer that. Slowly, carefully, and with much effort, he reached up and touched her cheek. The heaviness in his arm was frustrating, but the way her skin felt beneath his hand was worth the effort.

Meredith leaned into his touch, reaching up and pressing her hand against his. "Hi." She whispered, a huge sigh of relief escaping her lips when she realized he was still in there. Her Derek was still there, looking right at her. "I've missed you, so much."

He was so tired, but not ready to let go of her yet. She was a breath of fresh air, and the only reason he didn't reach up and yank the breathing tube from his mouth. Focusing on her was the only reason he had the strength to remain even halfway calm. He moved his hand from her cheek, slowly making the motion of writing, hoping she would understand. His mind was already tired. Just giving himself a simple command seemed far more difficult than it should have.

She looked at him, confused. "I don't..." She followed his gaze to the counter where his chart and a pen sat. Suddenly, she understood. "Just a second." She reached over, grabbing a blank piece of paper from the back, and the pen. She folded it a couple of times, holding it for him. Carefully, she put the pen in his hand, helping him close his fingers around it. "In a minute, you need to rest." She insisted. She could see the fatigue in his eyes, begging him to sleep. It would be that way for a while, she knew. Five or ten minutes was a lot for someone who'd gone through what he had, and despite how difficult that was for her, she would do whatever it took to support him.

Derek struggled, the pen almost falling to the floor. He was grateful when she helped his hand close around it again. After a moment of staring at the paper, he finally scribbled a few words. "I love you, Mer." There was so much more he wanted to say, but he couldn't manage anymore. The pen fell from his grasp, hitting the tile.

Meredith couldn't help but smile, tucking the note into the pocket of her scrub pants. "Important stuff, that is." She teased, her smile growing when she saw the twinkle in his eyes. "I love you too Derek, so much." Her fingers ran gently through his hair as he fell asleep.

Let me know what you think!

*Revised 6/2017