His boys were sick and yet he was a highly recommended top doctor who couldn't do a damn thing. Meredith and him took shifts near each boy and it was now a constant struggle day by day and he realized that he and Meredith were falling apart. They never seemed to see each other and when they did, a fight broke out in a matter of minutes due to either exhaustion or frustration. He was angry at Meredith, but even angrier at himself for not being able to fix anything. At the moment, he was sitting next to Noah in the NICU. His youngest son was finally out of his incubator and instead in an open-aired bed where he was breathing on his own with no support at all. Dr. Jameson said that he could go home in about 10 days, but Derek didn't know if he was ready for the baby to come home to a fractured family when what he needed wasn't there.

Mer was sitting in the armchair next to Ethan's bed seeing her little boy sleep with such an angelic face even though it was the shade of the tile on the floors. He was so peaceful and he seemed to be getting slightly better and Dr. Casler said the chemo could start any day now once his fever went down. Her and Derek had taken the news harsh and they both snapped at anything these days. She felt like she was not being the best mom she could be. Even though she and Derek were taking shifts between the boys, she spent more time with Ethan than she did with Noah and that's what she regretted. She hated the fact that she had to choose, but for now she was choosing Ethan and she thought that was the best choice.

Derek had left Noah and was headed towards Ethan's new room in the Cancer Ward of the hospital, ready to switch shifts with Meredith. As he walked into Room 462, he stepped into the room and Meredith looked up, but no words were exchanged. She stood up and then bent down to kiss her little boy's face and Derek saw the tears running down her face. He heard her say "It's going to be ok Buddy. Be strong." With that, Meredith started towards the door, but Derek caught her hand and turned her around to face him. He said "Mer, It's going to be ok." Mer fired back though yelling "Derek, how the hell is everything going to be ok? We have a three year old son with cancer! A three year old who hasn't gone to pre-school or hit his first home run or even gone to his first baseball game. Then we have a newborn who has been struggling since his first day of life and we've been told he may have further problems. How is life going to be ok?" With that, Derek Shepherd watched his wife storm out of the room leaving a devastated husband and a newly waken three year behind.

She was crying as she ran down the hallway and the first supply closet she saw, she went into making sure that she locked the door behind her. She sobbed inside about how her life had been turned upside down in a matter of one month and why this was happening to her. She sobbed until no more tears ran and finally, she picked herself up and walked out of the closet with a tear stained face. On the way up to the NICU, she saw the stares of the people who watched her and she hid her face trying to avoid them. When she got up to the NICU, she couldn't pick up Noah. All she could do was stare at him and see how healthy he was getting compared to his sick brother downstairs, and Mer had hope that Ethan could be the same way. She was startled when Lexie snuck up behind her and tapped her on the shoulder. "Lex, you scared me. What are you doing here?" "Well, your Post-It Note husband sent me up here to see you. Mer, he saw you crying as you left Ethan's room today." Lexie looked over towards Noah and saw he was fast asleep so she asked Meredith "Can we go grab a coffee for a minute?" Mer also saw that Noah was asleep and she nodded her head yes. They walked to the cafeteria in silence and got their coffee before stepping outside on the April night. The air was cool, but flowers were sprouting outside in the garden and the evidence if spring in the air was obvious. They sat on a bench and Meredith was the first one to speak. Actually she more like exploded with everything she had been carrying around for the last month. She yelled "Lex, why the hell is this happening to me? I mean I'm the girl who was abandoned by her freakin father when I was only 6 years old. My mom ignored me and I pushed my way through life. I found great friends and an even better husband to fill that hole and when we decided to have kids, it was suppose to fill that hole anymore. Ethan came and everything was perfect, but then that night ruined everything! My baby cam out sick and almost didn't make it. My husband and I have drifted farther apart and now I discovered the one strong thing in my life, my son Ethan has cancer. I don't know how to live anymore and I don't know if I can."