A/N: Yay for reviews! You guys are awesome. I appreciate the feedback as well as your continued trust in me to write these characters in such a difficult situation.

Special thanks to John for so much assistance with the medical aspects of this and following chapters as well as being a great sounding board for plot ideas.

"We will perform the surgery tomorrow morning," the surgeon explained as they sat in his office at the Royal National Orthopedics Hospital the next day. The man had introducing himself as Mister Hall before sitting down behind his desk. Wasting no time, he said briskly, "Now, Mrs. Bates, your husband and I have discussed this already but I want to make sure you're both fully aware of what will take place."

Anna listened as the surgeon went on to explain the procedure to her and John, although she could tell that most of the information was directed at her. Her husband showed little surprise at any of the details, but every bit of it frightened her immensely. Surgery - any kind of surgery - was a dangerous and frightening undertaking, and so much was riding on this particular surgery.

"We will give him medication for the pain and use ether for the anesthetic. Despite the risks and the side effects, I believe it to be the best agent available," the man stated, looking at her as though she should understand. Anna glanced from him to John in confusion.

"Ether can be explosive," her husband told her quietly.

A cold chill went down Anna's back. While she knew the surgery would be dangerous, that it might not go well and that John might not be able to walk despite the doctors' best efforts, she had not truly understood the other risks until that moment. Fighting back her growing unease, she nodded uncertainly for him to go on.

"We will monitor him throughout the surgery," the surgeon chimed in, continuing with his explanation. "But afterwards, when he regains consciousness from the anesthesia, he will be extremely sick for several hours."

Anna paled.

"Are you sure you want to be here for this?" Bates asked her gently. "You don't have to if it bothers you."

"No," Anna said decisively, "I want to hear. I need to know everything about what they're going to do."

The surgeon picked up a film from his desk and moved to a table on the side wall, gesturing for Anna to follow him. While she stood up, Bates remained seated, obviously already having seen what Mr. Hall was about to show her. The man laid the film on a piece of glass set into the center of the table and flipped a switch which turned on a light inside the table. The light shone through the film, and Anna recognized the see-through material for what it was but had trouble understanding what it depicted.

"A few weeks ago, Mister Bates had several x-rays taken at a visit to a local clinic, which were forwarded to me with his referral. This one shows the embedded shrapnel." He pointed to several obvious spots on the film, and Anna suddenly recognized it as a picture of the interior of her husband's damaged knee. Speaking to directly to her, Mr. Hall went on, "We can also see the degeneration around where the metal has been rubbing against the bone and cartilage. Because the initial wound healed poorly, Mister Bates has had to compensate in walking with a limp which has progressively misaligned the joint and led to further damage. Based on the pain as your husband has described and what I see in this x-ray, he is suffering not only from the embedded shrapnel and resulting damage, but also arthritis and general wear and tear in the years since he was injured. And while the knee has been deteriorating, the shrapnel has been burrowing further into the joint all these years. It may have finally struck a nerve or just caused too much damage, which may be why your husband has been in such pain these past months."

Flipping off the light in the table, the surgeon walked back to his desk, leaning against it as he addressed both John and Anna, who had retaken her seat by her husband.

"But we won't know for sure the extent of the damage until we can see inside. Our main goal will be to find the shrapnel and remove it. In addition to being a major cause of the pain and causing further damage to the knee, if the metal comes into contact with synovial fluid, it could dissolve and cause lead poisoning. We will also need to address any other issues we encounter."

"What sort of issues?" Anna asked, her mind still whirling from the possibility of lead poisoning. She had little experience with medical matters, but she knew that this was all something she had to learn and understand, for John's sake.

Mister Hall informed her patiently, "Mister Bates likely has some permanent damage to his tendons and ligaments and as I mentioned, he suffers from arthritis. There may be more damage from the initial trauma which is not visible on the x-ray. We will also need remove the cartilage which is too damaged to heal."

The surgeon paused for a moment. "Mister Bates already knows this, but Mrs. Bates, you should know as well - if the knee is too damaged to recover, we may have no choice but to amputate the leg."

Anna's mouth fell open in shock. Immediately, she looked to her husband for his reaction, but he simply stared ahead at the doctor, his stone-like expression completely unreadable. The surgeon allowed his statement and the very dire possibility to settle in for both of them before pressing on. The moment of silence left Anna light headed as she tried to picture how John Bates could ever stand to live his life missing a limb. No wonder he'd been so adamant in suggesting that he would not return home with her if the surgery did not go as planned.

"Even if we succeed in removing the shrapnel and repairing what we can, there will still be a great deal of damage to that knee which simply cannot be repaired, not with modern medical science."

"But what about the pain?" Anna asked carefully, her voice remarkably steady even to her own ears.

"Minimizing your husband's pain is another chief goal of the surgery," the man answered. "Of course, considering the delay in dealing with the shrapnel for the past few months, there may also be nerve damage."

Anna closed her eyes for a moment, inwardly cursing herself for not insisting on John coming to a doctor sooner. He'd been so stubbornly resistant and she'd been a fool to listen to him.

The surgeon went on, "The pain may continue to some extent even after surgery and would need to be managed with morphine on an ongoing basis."

She nodded in understanding before glancing at John. He seemed to be dealing well with the harsh truths the doctor was laying out for them. But of course, he'd heard all this before. He had known what to expect with the surgery, the ways circumstances could go wrong. And even if everything went smoothly, other difficulties would lie ahead.

"What happens after the surgery?" Anna asked, wanting to know the full extent of the process.

"Mister Bates will need to recover for some weeks while we ensure the wound is healing properly. There is a great risk of him developing pneumonia or an infection while he is recuperating and he won't be able to move very much until he heals, so he will have constant care. If the surgery is successful enough for him to use the knee, he'll be allowed out of bed for short periods in the beginning until he regains his strength. From there we'll be able to assess the success of the procedure."

"And then he can go home?" she asked. The question did not betray a naivety of the situation, but rather a desperation for hope. Despite all the dire warnings and frightening images running through her mind, Anna needed the words spoken out loud. She needed the thought of a happy future to fortify her for the coming days.

Mister Hall smiled at her - his first real display of emotion since they'd arrived. "Yes, Mrs. Bates, then he can go home."

Anna looked from the surgeon to her husband. Reaching out to take his hand, he asked her, "Are you ready?"

With a smile, she responded, "I should ask you that."

"Now, once you are admitted, you will need to stay off your leg for a full day, Mister Bates, before we can perform the surgery tomorrow morning. And you won't be allowed any food or drink tonight..."

As Mr. Hall stood from his desk and proceeded to lead her husband to a room where he could change into a hospital gown, Anna followed them slowly. She watched as her husband moved on his crutches, slowly making his way down the long corridor. She was reminded of how badly he'd limped during his first months at Downton, leaning heavily on his cane for support. But even then, he'd stood tall and proud, an imposing presence which could not be overlooked.

While he was still as tall and large as before, she could see the slump in his shoulders caused by the crutches and the horrendous difficulties he'd faced over the past months. And he'd lost weight. While Anna was glad to see him free of the whiskey, she knew he was still recovering from the addiction, not only physically but on a deeper level. It was all so much to deal with in so short a time.

She knew she would always love him, no matter what came of the surgery. Even if he lost his leg, she would love him with no less than her full heart. But Anna knew her husband and how he saw himself. If he could not walk, he would not count himself a man, no matter how often she told him otherwise. And she worried what that loss of identity would do to him.

Bates felt rather foolish as he just lay in bed, waiting for the surgery which might cure him or end his life. Wishing they could just get on with it, he forced himself to rise above his growing anxiety. He did not mind the lack of food and drink for the evening, even if he was growing thirsty, but they would not let Anna stay with him. Unfortunately, the hospital maintained strict times for visitors - a couple hours in the morning and a couple in the evening, and with those over, she had to leave.

He would see her the next day several hours after the surgery but not before, so their parting had been bittersweet. Neither of them had said much, but he could still feel the press of her lips against his just before she told him, "I'll be here waiting for you. I love you John Bates, no matter what happens tomorrow."

"I love you," he'd responded.

Even though they had only been reunited for the past day, he found that he missed her presence as he lay alone in the hospital bed. He reached out to the small nightstand beside his bed and grabbed hold of a book he'd brought with him. Ignoring the words on the pages, he flipped through it until he found the letter he'd slipped into it earlier, the one he always kept with him. The envelope was old and worn and creased, having traveled many miles with him since he'd first received it that day in prison years earlier: the first letter to him Anna signed with her married name.

My Dearest Husband,

You have no idea how wonderful it is to be able to write that word, even under these circumstances. My husband. We waited so long for this and now it seems our troubles are far from over. But I am glad we did not delay. No matter what comes, I can rest easier knowing that I am your wife. Though we had but one night together, the memory of what we shared will always be with me, a comfort and a joy until we are reunited.

I know in my heart that the truth will prevail and you will come home to me. We will have the happy life we talked about so long ago - a family, children, and even someday a hotel where we can work together. I have faith in our future, and I have faith in you. Never forget that.

Your loving wife,

Anna Bates

He used to read that particular letter over and over again when he was in prison. While he'd received many letters from her since that time, this one he treasured in particular. He kept it separate from the prison letters and those she'd sent to him via his solicitor while apart from her at the Dalrymple House. All her notes were special to him, but this one he carried on his person to refer back to during his most trying moments.

Anna's love was the only constant he'd been able to count on in his life. Vera had never been stable in her affections, instead proving fickle and disloyal very early in their marriage. His mother's faith in him wavered as he took to the bottle following his injury in Africa. The same injury effectively ended his career in the military. Being dishonorably discharged from the army and serving two years in prison for Vera's theft had crumbled it into dust. Even Lord Grantham, the man whose life Bates had protected and on one devastating occasion even saved, had almost dismissed him from service for his disability.

Only Anna showed unwavering faith. Only Anna continued to build him up and support him when the rest of the world tried to tear him back down. Even when he hurt her, when he left her or was taken from her against both their wills, even then she refused to abandon her belief in him. Even when he lost his way and could not believe in himself, her faith carried them both.

After re-reading her letter again, Bates felt himself begin to relax. Soon the surgery would begin and this would all be over, one way or another. And Anna would be waiting for him.

TBC