Chapter 13

How much can you actually accomplish in an hour? Run an errand maybe? Sit in traffic? Get an oil change? When you think about it, an hour isn't very long. 60 minutes. 3,600 seconds. That's it. In medicine, though, an hour is often everything. We call it the golden hour. That magical window of time that can determine whether a patient lives or dies. An hour. One hour can change everything forever. An hour can save your life. An hour can change your mind. Sometimes an hour is just a gift we give ourselves. For some, an hour can mean almost nothing. For others, an hour makes all the difference in the world. But in the end it's still just an hour. One of many. Many more to come. 60 minutes. 3,600 seconds. That's it. And it starts all over again. And who knows what the next hour might hold? Meredith Grey; Golden Hour

"Wait." George stopped the blonde doctor, before she could do anything overhasty. Izzie stopped when George O'Malley tightened the grip on her arm, trying to keep her from doing what she was planning to do. "Be quiet, Izzie. I wanna hear what they say. You have to be quiet." George whispered in her ear. Izzie nodded. The nurse glanced at them before turning back to her colleague and asked her to continue. "She said something about Grey laying in CICU." Izzie's eyes widen instantly when she heard what the nurse was saying. George was standing there speechless. Maybe, he thought, he misunderstood what they were talking about, but a short glance to Izzie confirmed him that he wasn't wrong. He did hear it right. Izzie heard the same thing he did. And that was more than shocking. Izzie was standing there, the ballpoint pen still clutched in her fingers, while she was listening. It was shocking. They both couldn't believe their ears. There had to be a mistake, something they were missing ... maybe. Maybe not. Maybe it was the simple truth. Izzie's thoughts were overwhelming her. There were questions forming in her brain that slowly registered what she just heard.

Meredith was admitted to the Cardiac Intensive Care Unit? They have to be kidding. She would knew if something was wrong with her, wouldn't they be paged? They were friends. Why wouldn't they be paged if it concerns one of them? Izzie shook her head in confusion. Was Meredith really being treating in the cardiac intensive care unit of Seattle Grace Hospital? "Do you think this is really happening?" George suddenly whispered.

"Do you think that what they say is the truth?" He asked. Izzie first didn't respond to his question.

But then she remembered Grey and Yang's weird behavior back in the exam room, where she opened the door without knocking.

Maybe that was the key to all of this ...

"She told me that Grey collapsed while she was in the Chief's office. Maybe she did something wrong and the chief had to call her in for a meeting. I think she couldn't handle him being angry with her and just ..." The nurse put a stack of charts on the table while her friend looked at her with wide eyes. "What? She collapsed? In the Chief's office? Oh, my ..." The nurse replied shocked at what she just heard.

Izzie couldn't believe her ears.

What the hell are they talking about? They don't know a shit about Meredith, but she had to admit that she did not know all about Meredith, although she, her and George were roommates. But that doesn't say anything. They did not know a little, important detail. Meredith was hiding it from them for some unknown reason. That she was born with a life-threatening heart condition that could have killed her without surgical intervention. They didn't know that. That she had open heart surgery in order to survive and get as far as she has gotten today.

"She collapsed?" George was alarmed. "Oh no this doesn't sound very good."

Izzie did not answer. "I knew something was going on..." She mumbled, but decided not to continue.

The laughter of one of the nurses brought her back to reality. "Okay, it was fun talking to you I have go, see you later at Joe's for a drink?" "Yeah, I'll be there. When does your shift end?" She wanted to know. "Seven thirty and you?" She got as a reply, not really giving a shit about the intern they just gossiped about. "The same. So, drinks at Joe's after work?" After her colleague and apparently, also friend confirmed one of them left. The other one continued to type something.

Izzie looked at George, who was writing something down in a patient chart.

"Come on do it." She tried to persuade him, but just ignored her. "Why do I have to do everything myself." She exclaimed and George began to laugh.

"You sound like Cristina."

"I don´t." Izzie glared at him warningly, before she leaned over the counter towards a nurse who was sitting there and she was staring with interest on the screen of a computer.

"Hey, you." Izzie called out, causing the nurse to look up.

"What do you need?" She answered, not exactly looking up from what she was doing. "What did you talk about just now? Why were you talking about Dr. Grey? And don´t say you don't know what I want, 'cause you know. I know it and you know it." Izzie confronted the nurse. "So tell me what you know." She glared at the nurse. "I... I..." She stuttered, obviously taken off guard. "It's just me, an intern. Everybody at Seattle Grace knows how chatty you are. No offence, but..." Izzie showed a small, fake smile.

The nurse sighed and began to speak, but was interrupted by Dr. Sloan, who started flirting with her. Soon she was distracted by his cocky appearance. Then he turned his attention towards George and Izzie, who looked both a bit overwhelmed, when he asked them where Yang was. George answered the question of the attending from plastic surgery: "We don't know, we haven't seen her around. Maybe she is in the OR gallery watching some interesting surgeries, though somehow we doubt that."

"Do you by any chance where Bailey is? We were wondering where she is and we couldn't find her." Izzie interrupted George's rambling with a question. Mark Sloan did not seem very interested in her question.

"Have you tried paging her?" Mark tried to be helpful.

"A few times. But she did not answer any of her pages ... So we were wondering ..." "You already told me you were wondering where she is. Sorry, I do not know. Have you seen Yang? She has to finish her patient notes." Sloan said. He didn't know about Meredith yet. Otherwise he would have done them himself. "Like I said, no idea." Izzie simply replied.

"Very helpful. Impressive. Keep that up." He answered them, sounding a bit sarcastic and disappeared over the floor.

Izzie rolled her eyes at the plastic surgeon, who seemed very full of himself, but what they did not now was that mostly Mark´s behavior was just façade and not the real Mark behind it. He kinda was like Meredith, they had some parallels like the sleeping around and crappy childhood thing. Then Dr. Bailey stood behind them and caught them doing things they should not be doing during working shifts.

"What are you doing? Don't you have somewhere to be right now?" She asked sharply, not even bothering to look at the lab reports George had in his hand.

"Dr. Bailey, I have your lab reports." George O´Malley told his superior, who acted somewhat weird.

"Give me that." She snapped at Izzie who was holding an apple in her hand. "Don't eat that now. You have breaks to do that. Now you've got to see patients. And I give you some advice: Don't mess with me today. I am in absolutely no mood to deal with that." She gave them the famous Bailey look. Izzie and George were confused. "Now, hustle. You have things to, things I want off my plate. I have more pressing matters to deal with." She glared at the both of tehm intimidatingly.

Something really was different, and it had to do with Meredith for sure.

It was always Meredith when comes to that.

Always.

Izzie pinched her eyebrows and eyed Bailey. But there was only one way to find out. Asking her.

"Has it to do with Meredith? Sorry, we've just heard some rumours about her being admitted to Cardiac ICU."

George waited for Dr. Bailey's reaction after Izzie confronted her with what they had heard. "And don't even start saying it is none of our business. It is. She is our friend and we care about her."

Dr. Bailey looked at them almost empathically and finally she answered: "I know you people care. But I don't think it's my place to tell you. Also, the rules of patient confidentiality apply here. So, not a chance. So, O'Malley, I need you to cover my post-ops and do the discharges." He nodded and followed her orders. Izzie on the other side wasn´t about to let this be. She was determined to find out why everyone was acting weird.

"Dr. Bailey, just tell me."Izzie pressed.

Wanting attention from her resident who was already stressed due to some for her unknown problem / cause.

"Who is your attending. On whose service are you on?" She asked.

"I am supposed to be shadowing Yang and Sloan, but neither of them are here or anywhere to be find. Except Sloan, but he kept asking for Yang." The blonde doctor said.

"Go help O'Malley with today's discharges and post-ops. I have more important things to do. Meaning, I am not gonna babysit the two of you nor do I have time to do that. I have to take some blood work down to the labs." Bailey said and before they knew Bailey was already running down the hallway in a hurry. "Ok, what was that?" Izzie asked. "Why is she acting like this?" She asked. George was baffled as well. Izzie was now very confused, but she knew something was wrong with Meredith.

Meredith was about to get on the ergometer. They already did a pulse oxymetry to see how high the the amount of oxygen in bloodstream is. After the time on the ergometer they will do another pulse oxymetry and a repeated blood pressure measurement. Now they were about to start the stress echo to see how high the gradient is under high pressure. Dr. Burke already did the short-time electrocardiogram, after the stress ECG they have to do an long-term echocardiogram over 24 hours. As a child she had always hated that. In fact, she was fairly sure she hated it now as well. "Come on, Mer. You need these tests to determine the severity of your condition." Derek said, trying to be helpful.

"Yeah, I know why I need those tests, doesn't mean I have to like it."

Meredith turned away.

Now everything was starting again. She had been so sure that she was through with it, finally but apparently there were more hurdles to jump through before she could live ... just live. Like anybody else ...

"Now we have to do the stress echo." Burke told his patient, even though he knew that she knew the proceeding.

There were several ECG leads and electrodes connected onto her chest. Each ECG lead was marked with another colour to differentiate the ECG leads and to make sure they are connected to the right point, otherwise there could be incorrect polarity reversal of the ECG derivations if for example green is switched with the yellow lead. That could lead to a wrong diagnosis, just as muscle potentials (usually mentally or disease-related trembling), AC superimposition and motion artefacts causes non-evaluable ECG recordings that can't be interpreted by a physician.

"Grey, are you ready? I'll increase the resistance every minute, so it will be a lot harder for you to hold the rate between 25 - 30. 30 is the limit, if you are over 30, slow down, but don't stop. Otherwise we have to repeat this." Meredith nodded, She knew how this worked. She sat on the ergometer, waiting for Dr. Burke's sign to start with pedaling. "Ok, Grey, I'll start recording the electrical activitity of your heart."

He was sitting behind a computer, where he could see the recorded heart rhythm of his patient.

Also her systolic pressure gradient and blood pressure could be monitored closely.

"Go." Meredith began pedaling. At first it was very easy to hold the tempo limit between 25 - 30. But then Dr. Burke said: "I'll increase the resistance a bit. Please try and stay in the range between 25 - 30. If you notice any discomfort, dizziness or anything else, like trouble breathing let me know. Then we'll stop before you pass out. But that would be worst-case scenario." Derek watched her worried, not letting Meredith out of his eyes.

Meredith slowly nodded. She used all her strength for pedaling. It was getting much more difficult to get enough air into her lungs. Her breathing got heavier with each second that passed. Derek's gaze turned to the poster that was hanging on the wall, displaying the different kinds of arrhythmias.

Ventricular tachycardia.

Ventricular fibrilliation - practically cardiac arrest.

Supraventricular tachycardia ...

Sick Sinus Syndrome. Premature Ventricular Contractions.

Complete heart block.

Atrial fibrillatio.

... and lots of other arrhythmias. Some life-threatening, others not ... Then he got distracted by Dr. Burke who was sitting in front of the computer recording Meredith's heartbeat. "Is everything okay?" He asked. Burke never gave him a decent answer.

"Dr. Burke." Derek pressed firmly. "What's going on?"

Dr. Burke stared at the monitor, then at his patient. Derek was looking at Meredith worriedly. She was pale, her lips slightly blue. Tha could only mean that she wasn't getting enough oxygen. Also the aortic valve gradient increased rapidly. It went from 50 mmHg up to almost 90 mmHg, which was too high, a lot to high and considered as a serious aortic stenosis in the need of surgical intervention. Meredith could not concentrate on staying within the asked range. She was pedaling but not in the range between 25 - 30. She was much slower. "Dr. Burke. Shouldn't we stop the reading?" Derek asked as he watched Meredith breathing loudly, gasping for air.

Struggling.

Breathing wasn't supposed to be that difficult.

He nodded. This was it. He wouldn't watch this any longer. Dr. Burke noticed the struggle his patient had and stopped the recording. Meredith could hear Dr. Burke's voice as if he was miles away, when he told her to stop immediately. Meredith tried to control her breathing. Dr. Burke reached for an oxygen mask and strapped it over Meredith's mouth and nose.

Slowly, her breathing normalized.

"I am fine." She told them having trouble catching her breath, knowing herself it was a lie.

Derek looked at her as if she had lost her mind.

"Don´t even think about trying the I'm fine - thing here, Grey. Your test results show something is not right." Dr. Burke told his patient, a serious look covered his face. Almost, a grave-like look was gracing his features. Derek swallowed harshly. None of this was fair. Not to Meredith. "I am sorry, Grey, that I don't have better news, but we need to order further studies unless we can say something definite. But looks to me like you will need surgery, probably soon."

Meredith gaze wandered through the room, avoiding everybody in the room. No. This could not be true.

"What studies?" She asked, her voice shaking slightly.

He cleared his throat before he answered: "Well, an electrophysiological study of course, but we already scheduled that and then maybe stress echo and a heart catheter. Again I am really, truly sorry that I don't have better news for you." He glanced towards the neurosurgeon who looks like he could not believe it. It was an unescapable moment.

Meredith seemed like in daze, like she faded the others in the room out ...

Cristina had left the room. She had been paged to the Emergency Department, although George was covering, but they paged her instead of him. When she entered the pit, she did not see any major traumas or any other patients. Cristina made her way to the ER registration desk and asked a nurse. "I was paged to the pit." She said. "But I don't see any traumas around here." She concluded. Before the nurse could answer, another voice interrupted the beginning answer of the nurse sitting on the registration desk. Cristina breathed in deeply. She'd rather spend time with Meredith, especially now. Now she needs her person and Cristina wasn't about to let her go through this mess alone.

"Well, but we have a trauma. Orthopedic case. Come with me. I am kind of babysitting for Dr. Bailey." A voice behind her back said almost monotone. Cristina turned around and saw Callie Torres, ortho resident in the same year as Dr. Bailey and maybe- girlfriend of George. The orthopaedic surgeon glanced at her and motioned her to follow her.

Ortho?

Really. Orthopaedic surgery? Hopefully there will be a surgery.

But on the other side ... Orthopaedic surgery is boring. Why does it have to be ortho?

"Where?" Cristina asked.

"You'll see, Yang. Believe me, ortho is fun." Callie tried to make an attempt to make Cristina rethink her negative opinion about orthopaedic surgery. "Breaking bones is fun? Says who?" Cristina gave back, not in the mood for perky persons, even if Callie wasn't a very perky person. Izzie was perky and sometimes annoying. Thank god that she wasn't working with her today. "Don't even go there, Yang. Just because you had a bad day you don´t have to spread your evil whatever here." Callie scolded her, not exactly knowing what happened.

If she had known what happened, she wouldn't have said anything.

Cristina almost laughed. She did call her day bad?

Well, that was the understatement of this fucking year. It was an understatement, really. Only Callie didn't know. How could she know? She wasn't there when it all happened. Callie observed Cristina's weird behavior. Then she made a decision to end this conversation at this point and get back to their patient.

"So, let's get back to our patient who is laying there in pain. So, if you don't mind, Yang, I'd really appreciate getting back to work now."

"You paged me and then downplayed my day which was wrong, 'cause my day was bad, very, very fucking bad. Well, not as bad as Meredith's day, but watching your person collapse in front of you isn't something you take lightly. Even if I am Yang and sometimes roboter-like. Now, you said something about treating the patient, let's do that." Callie looked at her, trying to process the words. So that was what was on Cristina's mind. She was worried about her friend. That must be the reason for her being even snarkier than usual.

"Is she okay?"

She couldn't not ask.

Cristina laughed without happiness.

"Of course she's not okay. What do you think? Her right ventricle is pumping the blood through the body. Of course is she not okay." Cristina exploded, all the pressure she felt was now ...

Callie swallowed hardly.

But then decided not to ask any more questions about Meredith and her current situation.

"Grey?" Dr. Burke asked worriedly. "You hear me?" Meredith was just sitting there, shocked. Fading the others out. She inhaled and exhaled deeply. She didn't look up at all. "Shall I page Cristina? Let her deal with this? She's the only one who can ... who speaks Grey-ish." "That's not necessary. I'm perfectly fine. Let's get this over with." Meredith shrugged, awakening out of her stupor. Dr. Burke and Derek watched her attentively. "You sure you okay? You just spaced out for quite a time." Derek asked, worried. This was making him worry. Meredith gave him a smile, the one she only reserved for him. They were about to begin with the recording of the long- term electrocardiogram. "So," the cardio-thoracic surgeon said, looking at the neurosurgeon sitting next to Meredith. "I have to do some important work- related things, but I will be back to check on you. Derek." He adressed. He looked up.

"I expect you to page me if anything seems to be going weird. If something ... anything happens."

"i won't take any risks with the person I am meant to be together. I'd never do that." He answered, smiled slighty at Meredith, who mouthed: "I love you, Derek Shepherd."

Dr. Burke did not know what he felt when he left the room.

This was scary. He might has to operate on a colleague and a friend (he considers her a friend since she and Cristina are practically inseparable), someone that was respected by everyone ...

This was something to be scared off. He was scared of screwing this up.

This was Cristina's person.

Somehow that's ironic. Cristina loves cardiothoracic surgery and her best friend has a congenital heart condition. Doesn't that sound ironic? In some way, it does.

Within a few hours everything changed. He never thought that Grey, the daughter of the famed Ellis Grey, suffered from a life- threathening heart defect. That was, he did not even know what that was... He didn't know how many hours ago he was paged to the Chief's office due to an emergency involving one of their own. He couldn't believe it when he entered the room. He couldn't. But it explains Cristina's behavior over the past view months. Her research about congenital heart defects and so on. It all makes sense now ... He sighed.

Meredith leaned against Derek, her head on his shoulder. Her breathing was even, she seemed relaxed. As relaxed as someone could be in a hospital and about to undergo a surgical procedure. Derek was happy about that. "Meredith." He asked, wanted to know whether she is awake or sleeping. Her reply was a soft Hm, it was all he could get out of her. But that was okay. It seemed like she dozed off. Derek breathed in deeply, his arms embracing Meredith's slender form. He breathed in her lavender scent. A small smile came over his face. A little normalcy in all the chaos. After a while, Meredith moved gently, but her eyes stayed closed. Then suddenly she groaned loudly and then started shifting her head abruptly.

That was causing her to open her eyes and cry out in pain.

Derek was freezed.

No. No, this cannot be true... Crying out means she is in pain...

Suffering...

What is going on with my Meredith? Why is she crying out like she's in pain?

Isn't a potiential surgery not enough? Does also have to be that? He needs to ... needs to ... page Burke, yes that is what I need to do.

"What is it, Mer? Tell me, so I can help you." He said, trying desperately to suppress the shock and worry in his voice. Meredith could barely her him. There was just pain, pain that faded everything else happening out. She couldn't concentrate, couldn't think. He needed to stay focused, he needed to page Dr. Burke. He told him to page him whenever something seems to be going wrong. And now, Meredith was in pain. He could see it in her gorgeous eyes, which were normally full of life.

But now they were dull and a pained expression covered her.

"Make it stop, make it stop. Derek, please." Meredith whimpered, her eyes hurt when they hit the light.

"Where´s your pain? Meredith. Meredith." He started an attempt to get her to focus on him. When all the talking did not help, he took her face in both of his hands. Meredith squeezed her eyes shut, the sudden sensitivity to light irrtated her. "Meredith, I need you to focus on me. Can you do that?" Derek asked tensely.

"Head..." She whispered softly, followed from a quiet moan. "... hurts."

She lets out a suppressed sob, the pain in her head was excruciating. She grimaced and rubbed her temples.

"Okay, Mer, it´ll be better soon. I promise." Derek told her, grabbing his pager. "But you need to calm down, the crying will intensify the pain only." He noticed her pale face and the sudden need to embrace her and take all her pain away...

A/N: I'm sorry for this being so Izzie and George centered. The next chapter will be MerDer again. Hope you liked it. Please review.