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Chapter 21 - Struggle

Meredith got woken up hours later by alarms going off. She was very confused and disoriented. She couldn't quite piece together what happened after she woke up after her surgery. All she remembered was Derek being there when she woke up and feeling incredibly sick. She remembered fragments of conversations. All after that was pretty much a blur of single pictures of doctors and nurses.

She hadn't yet opened her eyes but her mind was conscious. She started assessing her situation. She still had a headache and she could tell where they had cut into her. She was in pain. The nausea was still very present but luckily she didn't feel like she had to throw up immediately. She felt hot, sweaty and very itchy. A nasal cannula was providing her with extra oxygen and there was a sharp pain right where she knew they typically placed central lines in patients. Meredith could feel the pulse ox monitor on her finger and the restricting blood pressure cuff around her arm. Her room was filled with the monotonous summing of the monitors and IV pumps and now also the annoying alarm of one of the monitors. Her body hurt all over and she was dizzy. The back of her bed was slightly angeled but she almost lay flat. Multiple pillows stabilized her head. From assessing her situation alone Meredith could tell that her body was not happy with something, something was making her sick. She ran her hands over the blanket and could feel the familiar fabric of a cooling blanket. As she shifted her body she felt the now warm icepacks that had been placed around her body to cool her down. Someone entered her room to attend to the signaling pump and as soon as everything was sorted they left again.

Meredith opened her eyes slowly and carefully. She took in her surroundings, the sterile rectangular room with the sliding glass door. Through the sliding glass door, which was left ajar, Meredith could see the brightly lit hallway. Her room herself was only lit by the electric light up screens of the monitors, but the aggressive fluorescent light of the hallway was lighting her room just as much. She could make out a nurses' station from her bed, which meant she could be seen as well. She was alone. Meredith swallowed hard, which made her already dry throat hurt more. She was alone. Derek was not here, he had left her by herself. Finally, he had seen enough and left. Part of her mind began to panic, her heart began to pound in her chest. The other rational medical part began to reason with her. Obviously, she was in the ICU, she had no idea how she ended up here, but she did. She had lost her concept of time, what time was it? How long has she been here?

They didn't let people – even trained professionals – stay in the ICU overnight. They had bend so many rules for them that she forgot that they weren't actually at home. They had probably sent him home. Meredith closed her eyes again, she was exhausted. Now the monitor started to alert to low blood pressure. She found some sleep just to wake up again soon after. It was a rough interrupted unrestful couple of hours in the ICU. At some point, someone had given her some medication that made her drowsy and she was able to rest again.

Last night Derek had sat with Meredith in the ICU for some time, she had been hocked up to all kinds of monitors and pumps. Bailey had sent over her medical records which he had handed over to her team. It hadn't felt right to hand over her medical records, that told the medical story of her intern year to doctors who had no understanding about the circumstances. He had felt like he was violating her privacy by doing so, but as her medical proxy, he had felt the importance of handing over every potential important detail to make her better. He hadn't stayed to explain.

An ICU nurse had polity but forcefully told him that he should go home, get freshened up and get some rest. He had been worried about what would happen if Meredith woke up and he wouldn't be there, but they had assured him they would handle the situation if it came to it.

Derek had driven to his sister's alone, covered in throw up and so exhausted that he couldn't remember when he had slept last. Amelia had been great dealing with him in his state, he had updated her while he was still at the hospital, so she hadn't been surprised when he showed up at her doorstep. After a much-needed shower and a snack, he had dropped dead tired on her guest bed.

At four thirty in the morning, Derek woke up to Amelia getting ready for work. Once awake there was no thought of going back to sleep. Despite the early hour and his minimal sleep, he decided to tag along with his sister.

Back at the hospital, Derek realized how early it actually was. The hallways were empty and barely lit. Amelia went to the surgical floor to get ready for a very early surgery. Derek went back up to the ICU and slipped into Meredith's room unnoticed. He occupied the hospital chair that was standard to almost every hospital room across the country. He had brought his documents for his paper, he had promised Richard that he would be writing while he was gone and fulfill some of his publishing duties that came with the job. It wasn't something groundbreaking but more a summary of experiences he had gained over the last year teaching neurosurgery residents. He was surprised by how alert he was given the early hour and his jetlag.

Around five thirty one of Meredith's pumps was notifying to the end of a dosage. Without a second thought, Derek stopped the beeping pump in order not to wake Meredith. This was the first time a nurse had come in her room since he had come in. It was the same nurse that had sent him home last night. She was surprised that he was already back when her message had been so clear. Luckily she knew that he was a physician and who his sister was, so he didn't have to explain himself for turning off the pump. Both talked, while she checked on Meredith's lines. She told him, that she had a rough night, with more throwing up and more hypotension. Meredith had finally been able to fall asleep two hours ago after some more sedative medication. Derek felt bad for not being there, but there had been no way he would be allowed to stay. He watched her drained body, which was finally able to catch up on some much-needed sleep.

Meredith's brain was slowly registering her surroundings again. The continues beeping and summing of the monitors, typing next to her, the aggressive smell of antiseptic, the bright lights that she could feel through her closed eyelids, the busyness of the hallway. And then came the pain in every inch of her body. She could handle pain, the last year had shown that, but this really sucked. She could feel wet traces running down her face, was she crying? No, her eyes were just leaking water. The typing stopped, she heard shifting. And then she felt the one thing that made her almost forget everything else. Her hand was in a death grip, with his thumb running over her knuckles. He was here.

"Der," Meredith whispered, her throat dry as sandpaper. She opened her eyes to see her fiancé sitting on the only available chair next to her. He wore fresh clothes but still looked pretty tired.

"Hey there." He smiled.

"Hey, you're back. Have you slept?" Meredith rasped.

"Yeah, I am back. I slept, they kicked me out last night."

"Good. You still look tired, you should have slept more. What time is it?" she whispered barely audible. Speaking hurt, her throat dry from the intubation and all the sickness.

"It's 5:45." Derek checked his watch. "I got up with Amelia, it's fine."

"So it's almost three in Seattle." Meredith coughed, which made her wince in pain. Derek ran his hand over her cheek. "I'm still NPO?"

"Yes." Derek looked at her sadly.

"Because of the throwing up?"

"Yes. You had a really rough night." Derek confirmed. "How are you feeling?"

"Horrible." She let out with a breath, tears wetting her face again. Seeing her like this broke Derek's heart, he leaned forward and kissed her temple to comfort her. Her forehead was still very warm to touch, she was still running a fever. The couple stayed like this for a minute.

"What's happening?" Meredith asked, tears still running down her face.

Derek tried his best to fill her in her gaps with all he knew. But by this point, he didn't know much. He didn't know what tests they had run overnight nor did he know if they had figured out a cause yet. Meredith took in all the information. She was a fragment of herself. She was about to say something but clearly struggling to stay awake, when Derek stopped her.

"You don't have to figure out anything. Don't fight it, if you need to sleep just sleep." Derek told her. As his words left his mouth she had already stopped fighting against her exhaustion.

Half an hour later Meredith's night nurse came back for one last assessment before handover at seven. She checked all of Meredith's lines and pumps before she proceeded to check on Meredith herself. By that time Meredith was awake again, she had opened her eyes but had stayed quiet.

"Good morning, Sweetheart." Her nurse Ashley greeted her. She was small and blonde and had a very bubbly personality.

"Morning." Meredith rasped silently which lead to instant coughing. "Ow."

"Deep breaths. You are still NPO, but why don't I get you an ice cube so you can at least moisture the inside of your mouth and lips. Maybe that will help a little. I'll be back." She rose the back of the bed, so it was easier to breathe and left the room to get the needed supplies. She had left the chart opened on the counter.

"Der…" Meredith whispered barely audible, which made almost cough again. She was in a lot of pain.

"I am here. Try not to speak until you tried the cube." He told her. "It'll get better."

Meredith looked at him sadly. "Okay," she mouthed.

Derek saw the opened chart on the counter and his curiosity got the better of him. He knew he shouldn't look but he just needed to take a peak. He wanted to be in the know, what was going on.

He had had a hard time accepting his role as a family member and not as a surgeon when it concerned Meredith's surgery. Neither of them had planned to be in this situation after her surgery. Derek was sure that she was just as curious as he was. He got out of his chair walking over to the counter that also housed the sink and some typical ICU supplies. In record speed, Derek went over her chart to get as much information as he could in the limited time he had until Ashley would be back. He flipped through the pages looking for useful information to get a clear picture of the situation. Meredith picked up what he was doing.

"I want to see, too." Meredith rasped quietly.

"I know you do. I am going to tell you." He said as he sat back down, just as her nurse came back with a paper cup in her hand. Ashley moisturized Meredith's lips with one of the cubes and gave her the tiniest ice chip to suck on to get some moisture in her mouth.

"Thanks," Meredith whispered, she had to admit that even though her throat was still bone dry it had helped her mouth immensely.

"You're welcome," Ashley said and continued with her assessment. There was a routine in the way she took the temperature, her vitals, changed out empty IV bags, administered fluids and meds. "Okay, all done for now. Do you need anything else?"

"Can I get more pain meds?" Meredith whispered, very much in pain, she hadn't expected to be in so much pain after her surgery.

"You are due to have your next dose in an hour. I am sorry." Ashley said honestly. "If you need anything just call." She disposed of her gloves, took the chart and left the pair alone.

Meredith closed her eyes already exhausted and worn out again.

Derek sighed, he had read her chart and knew how much they had struggled overnight to keep her blood pressure in a stable range. They had tried every method, given all the medications that were safe in that situation. They had her on pressers and as a last resort, they had limited the pain meds to the point where she was virtually on no effective pain medication, considering that she just had surgery. She must be in a lot of pain if she was asking for more meds, he knew how stubborn she was.

"What's on your mind?" She asked quietly.

"Oh just thinking." Derek took her free hand and squeezed it, putting all his emotion in their touch.

"Are you going to tell me what is in my chart or do I need to steal it myself?" Meredith joked with a very hoarse voice.

Derek told her honestly what he had read and filled in the missing pieces to the puzzle. He explained how they suspected that her fever and the seizures might have come from a reaction to the anesthesia. That they had sent in more blood work to determine whether she had malignant hypothermia but the results would take days to come in. That her doctors had drawn blood the last night, to see any other potential causes for her fever, since it wasn't breaking as they had hoped. He told her how they wanted to do a lumbar puncture to test for bacteria in her spinal fluid and how he had to stop them. Meredith cringed at that. Derek also told her about her dangerously low blood pressure and how her team struggled to keep it stable overnight. By the end of his recollections, Meredith was quietly digesting the information. Derek feared he might have overwhelmed her when she stayed quiet for some time, just to see her eyelids falling shut over and over again. Minutes later she snapped her eyes open.

"You okay?" Derek asked surprised by her sudden awakening.

Meredith gave him the smallest nod.

"Do you want to talk about it?"

Meredith shrugged and instantly winced in pain. "It hurts. It hurts like crap," she cried big tears.

"I know, I am sorry. Just let it out." Derek sat down on the bed next to her, he wrapped his arm around her the best he could.

"I don't feel well, heck I feel horrible. I am still so nauseous, lingering nausea, the one when you feel like crap but can't throw up. I am probably on a nice cocktail of anti-nausea medication to be like this. I am sweaty ... and clammy ... and itchy ... and dizzy and everything hurts. ... I can't keep my eyes open. It is exhausting." Meredith continued to cry. "I hate this. Hate it. Hate as in rectal exams ... and draining infected ... abscesses hate. I didn't sign up for this. This ... wasn't supposed to ... happen. I am a doctor. This is pathetic. And it's only ... day one." Desperately trying to catch some air in between her sobs. More and more tears were running down her face. Derek just held on to her and whispered sweet nothings in her ear while she cried. It broke his heart to see her like this. Meredith was clearly struggling emotionally with her situation. And there wasn't much he was able to do for her. He let his fingers run over her exposed arm to comfort her. It was not too long until she had cried herself back to sleep. He stayed right there next to her. The recovery so far was going far from ideal. He patiently waited for her to wake up again keeping busy with a medical journal he had brought. Only minutes into her slumber, Meredith jolted awake again, she looked panicked.

"Mer?" Derek asked carefully.

"Did you call Cristina?" Meredith asked concernedly.

"I talked to her when you were in surgery and texted her when came out of surgery."

"Good. So she doesn't know … about all of this." Meredith rasped motioning her hand over her body.

"No. Not yet."

"Good. That's good." Meredith whispered pensively.

"Mer, we have to tell her at some point. I don't know how long we can delay this phone call. If it wouldn't be for the surgeries I would be certain Cristina would show up here when she doesn't get an update. Besides Bailey knows." Derek confessed.

Out of reflex, Meredith lifted her head off the pillow turning to glare at Derek and regretted her decision instantaneously. Wincing in pain she let herself fall back into the pillows again causing more pain. Meredith groaned frustrated.

"I know it sucks. They will be able to give you something very soon."

"Yes, it really does suck." Meredith agreed, "And why the heck does Bailey know?"

"Well, they needed your medical record. So I had to call Bailey and you know her, you don't just call with a request like that, without her grilling you for information. She told me to tell you, that you need to get your act together, she needs you back." Derek explained.

"They wanted my medical record? All of it? Everything that happened last year?" Meredith whispered, clearly devastated.

"Yes, I am sorry," Derek confirmed.

"So now they know everything? The bomb and the ferry boat incident?"

Derek just nodded to that. "I am sorry. I know you wanted to keep as much under wraps as possible."

"I guess there isn't anything that we can do about it." Meredith sighed. Dr. Welch obviously knew the cliff notes, but now everybody knew. "The universe hates me."

"The universe doesn't hate you."

"Yes, it does. This is not where I'm supposed to be right now. I am supposed to be in an OR assisting on a tumor resection or an ex-lap. Hold a retractor for ten hours. I am supposed to be the doctor with the patient in the ICU, not the patient." Meredith complained.

"Mer,…" Derek sighed, just to be interrupted by Meredith.

"I know the surgery was more than necessary. I am well aware of the fact. But it was supposed to be quick and easy, textbook. In and out. Out of the hospital in two days, on a plane back to Seattle after a week, back at work after two weeks and back in the OR after four." Meredith said, slowly losing the little of a voice she had, while Derek rolled his eyes letting out a sarcastic laugh.

"I know and you will be back in no time operating circles around everyone again. Give the others some time to catch up. You and your optimistic recovery plan." Meredith opened her mouth for a witty respond but ended in the most painful coughing fit yet. She was losing her energy fast. "Okay, no more talking." Derek kissed her temple.

Derek had moved back to his chair, he had given up on writing for the moment. It was seven in the morning by now. The day shift had just come in. With a clear view of the unit's nurses' station, Derek was watching the hand over with great interest. It had been years since he had been at a hospital full time and taking on his role as head of the department at Seattle Grace he had even less the opportunity to observe how the others worked. He either was in the OR, teaching, neck deep in department paperwork or in meetings. With the little time he actually had for his actual job, he was immensely grateful for the nursing staff and the residents at Seattle Grace. He watched as they came together, going over what had happened over the last night.

At some point, he must have fallen asleep himself. One moment he was watching the nightshift dayshift handover outside Meredith's room, the next a new nurse had entered the room. New faces were running by their room. The clock above the door told him that it was seven thirty in the morning.

"Good morning. I am Susan. I am Meredith's nurse for the day." She introduced herself as she wrote her name on the whiteboard that held all the important patient information, "You are here early. I am a little surprised, normally I am all alone during first assessment."

"Derek. My sister got up early for work so I got up as well."

"Oh okay." She busied herself by getting the room ready to her liking. After an initial vitals check and checking all the pumps and lines, Meredith had woken up as well. Susan changed Meredith's blanket to a regular more comfortable one. Their forwent the sponge bath and just changed her hospital gown since she was clearly not up for more.

They had been told that her team would be in to round on her within the next hours. Then they would be discussing the further plan of treatment. By the end, Susan finally administered the next dose of pain meds that knocked Meredith right out. She had tried to force herself to stay awake a little longer but she couldn't muster the strength to do so.

Derek dived back into his paper. After some time he got a taste of the struggle they had faced overnight. About twenty minutes after Meredith had gotten her dosage, her blood pressure was dropping below her set threshold. The alarm started blaring waking up Meredith, whose heart started racing. Susan came in, turned off the alarm opened up her fluids in hopes it would be the solution to the problem and administered more medication.

Over the next hour, Meredith's blood pressure scratched the threshold multiple times but luckily didn't drop beneath it. After being woken up by the alert, Meredith tried her best to stay awake but her eyes kept falling shut for short periods of times, even if she tried to force them to stay open. They were having light conversation stopping whenever Meredith took one of her minute naps. In those times Derek watched the hallway, there had been a change of energy, it was daytime now. Half an hour ago, he saw the first white coats running around. It was almost time for rounds.

Rounding had been one major change from his private practice to a teaching hospital that took some time to get used to. It took way longer to round on his patients now that he had the obligation to teach a new generation of surgeons. Finding the balance between efficient rounding, teaching, and patient interaction had been a struggle at first. It took a lot of trial and error of reading the patients, their family members, and the circumstances to determine how much he could teach in front of them. Sometimes he did the teaching in the room others he did it out in the hallway or in a conference room.

Now he was on the other side for the first time in his career as a surgeon and a teacher. He watched as the armada of doctors went from ICU room to ICU room, taking their time with every single patient and debriefing before moving to the next. It was a long, tedious but necessary process. They were rounding on the patient that occupied the room next to Meredith's.

"I hope they come in soon. At least then we know it's over." Meredith whispered, her voice still very weak. Derek followed Meredith's gaze out on the hallway, where ten med students stood cramped up against the immobile part of the door, to listen in on what the leading physicians were saying.

"I know. It's weird being on the other side, isn't it?" Derek thought out loud.

Meredith yawned and faintly nodded her head in agreement, wincing in discomfort.

"They should be here soon, they've been to almost every other patient on this floor so far," Derek said. The wall only partly muffled the conversation on the other side of it, they could make out parts of what was being said. The doctors were wrapping up with the patient and were ready to move on to the next.

5/11/19

This story is now old enough to drink legally drink in every country. I hope you enjoyed this chapter. I really appreciate all your reviews. I was blown away by last weeks feedback. Thank you, you make this far more fun than I ever anticipated. I can't say thank you enough. Let me know what you think, maybe we can beat last week or break the 100 review mark? If you have any ideas that you have to read in this story, you can write me a PM. Also if you have ideas for chapter names, I really struggled with this one - clearly. Have a great weekend. Bye