August was always a busy time in at Seattle Grace Mercy West, schools were on break and people were on holiday. Derek hadn't felt the 100% for a few weeks but he pushed it away just saying he was exhausted from the busy few fortnight. Meredith had confronted him about it when she realised he hadn't been eating that much but he just denied it. The day after the confrontation Derek was in the OR with Lexie and Meredith and started to get really dizzy and warm all of of a sudden. He grabbed onto the table in a desperate effort not to collapse onto the OR floor. Meredith realised and placed her hand on his back.

"Derek." She whispered.

"I'm okay." He lied.

"No your not." She protested.

"I'm exhausted Mer and dizzy." He admitted.

"You have finished, let Lexie finish."

"Okay."

Derek suddenly walked out of the OR without instructing Lexie on how to finish so Meredith did it for him.

Meredith couldn't find her husband anywhere after that, she had looked in every on-call room until she bumped into Dr Hunt.

"Have you seen Derek?"

"I sent him home." He said nonchalantly.

"What?"

"He looked exhausted and he could barely stand up he was so dizzy, it's 8pm now so I told him to go home and just rest, he looked like hell. You go too!" Owen said.

"Okay thank you."

The entire journey home Meredith was worrying about why he had gone home and what was wrong with him. It must've been bad for Derek Shepherd to go home. When she pulled up his car was outside but she couldn't see any lights on in the house she began to panic even more. She slowly unlocked the door and saw his shoes, bag and coat screwed up, much unlike Derek. She snook up the stairs to their bedroom. Meredith walked into the bedroom to see him fast asleep on the bed laying in the foetal position wearing his pyjamas and fluffy robe. Meredith could tell he wasn't feeling his best so just left him to sleep.

She had something to eat, had a shower and went to bed before 10pm for a change, a good change. Derek was slightly snoring. She played with his curls for a few minutes before falling blissfully to sleep.

Meredith's alarm was blazing loudly as she opened her tired eyes. She couldn't remember the last time she had slept so peacefully with no disruptions. She was in her 4th year of residency now and she was absolutely exhausted. She rolled over to hug Derek but he was absent from his side of the bed. Meredith sat up slowly rubbing her eyes and looked around her room. She saw the door slightly open and decided to find him. She stood up putting a dressing gown and a pair of slippers on and walked out of the room. All the lights in the house were off except for the bathroom light peacefully twinkling in her eyes. The door was slightly ajar so she walked in.

"Derek?" She whispered.

Derek was sat against the bathtub with his knees at his chest and his head hanging lowly towards the floor. He had a glass of orange juice and a few pieces of tissue next to his shaking body. He slowly lifted up his head to reveal his sickly complexion. Derek was always pale but his skin was ashy, almost grey and he had huge bags under his droopy tired looking eyes.

"Oh Mer..." He sighed.

Derek had woken up at 4am with a nauseous gurgling feeling in the bottom of his gut so headed to the bathroom where he proceeded to spend the next 2 hours throwing up.

"What's happened?" Meredith said sitting down next to him and wrapping her arm around him.

"Sick, very, very sick." He sighed.

"Oh Der, why didn't you wake me?"

"You looked so peaceful and you need the sleep."

"How long have you been here?"

"What time is it?"

"6:15." She said looking down at her watch.

"2 hours and 15 minutes."

"Derek!"

Before he could reply he darted forward and threw up again. Meredith leant forward and rubbed large circles into his sticky, sweaty back.

"It's okay, your okay." She reassured.

When he finished Meredith passed him the glass of water.

"Spit it into the bowl."

He did as she said and then took a few small sips of the water. Derek then laid back against the wall panting heavily trying to get his breath back.

"Your okay." She soothed.

Derek collapsed down onto Meredith's lap and fell asleep. She was starting to worry a little bit when she felt the fierce heat radiating off his sweaty forehead. Lexie and Mark burst into the door kissing the faces off of each other.

"Shower?" Mark said stroking Lexie's hair.

"Uh-hum." Meredith interrupted.

"Oh my god!" Lexie shouted.

"What the hell?" Mark said.

"He's spent the last 2 hours throwing up his guts and he's just collapsed onto me a few minutes ago. I think he has the stomach flu or something."

"Oh my god, does he need anything?"

"Can you get a thermometer and some meds?"

Lexie ran out of the room and Mark stayed where he was staring at his deathly looking 'brother.'

"Mer..." He whispered.

"Derek you okay?"

He quickly sat up and threw up again. Meredith rubbed his back and moved his usually perfect hair out of his face. He couldn't stop coughing and spluttering even when he laid back weakly on Meredith's lap.

"Take a sip of this." Meredith said offering him the glass of half empty glass of juice.

He shook his head and closed his eyes to try ease his pounding headache.

"You...you go back to bed Mer, you have rounds in a few hours."

Meredith could feel his warm breath on her abdomen and his lips were pasty and he had the chills. A few small drips of sweat trickled down his face from his hairline or the top of his brow. His hair fell straight down and the sweat made it stick to his forehead.

"I'm not going to work Derek, we are both having 2 or 3 days off, it's probably just a 24 hour bug so you should start to feel better."

"Okay." He said wincing in pain as his stomach twisted its self into coils.

"What hurts Der?" She asked placing her hand on his warm stomach.

"Head, stomach, everything." He said quietly.

"Okay, Mark can you tell Hunt and say we won't be in today or for the next few days?"

"Erm...yes." Mark said.

"Why don't we get you back in bed?"

"Yes please."

Derek stood up and stood a very unsteady step forward but felt a strong sinking feeling in his legs. He sunk back down to the floor in a heap.

"Derek!"

"Here's fine." He said sleepily.

Derek fell straight back to sleep on the cold floor with Meredith stroking his hair trying to comfort her weak, hurting husband.

The pain had been excruciating. He had spent most of his day curled in the fetal position around the toilet, groans escaping from his lips as she tried to make it easier for him. His head had been killing him, so she had turned off the lights, demanded that all the phones be unplugged. She had done everything possible to make it easy, and instead he had suffered most of the day on the bathroom floor.

It had seemed okay at first. She thought that he just had the stomach flu or a sickness bug that would just require him to sleep all day and he'd be fine in a few hours. Derek being Derek refused any sort of pain meds for his head ache or constant throwing up. Instead by the time he wanted pain pills he hadn't been able to keep them down.

She couldn't actually count the number of times she had put the anti-vomiting pills on his tongue, couldn't count how many times she tried to get him to swallow the pain pills, only to watch them end up in the toilet as he vomited. It was above and beyond bad. It hadn't been a little stomach bug. She didn't actually think it being this bad.

He was trying to speak to Mer but most of the time he had been in too much pain to even manage that. The pain was killing him and she had never seen the love of her life in so much pain. Meredith had no idea how she was supposed to help her husband when he was in this much pain.

He didn't expected her to do this. He didn't expected her to be strong and do this. That wasn't how he thought she was but she was there trying to comfort his aching body. He didn't want to admit it but he needed her.

He had spent most day clinging to her desperately, his arms wrapped tightly around her waist as he buried his head in her lap. He needed her and no one else. Even when she had moved to grab a washcloth for his head or his pain pills, he had grabbed onto her and whimpered, begging her not to leave him. Derek's high fever and pain made him go into a sort of dissociative state so he didn't know he was doing any of it.

She understood. If she was feeling like he was, she knew Derek would be there taking care of her. He was her rock so now she had to be his. She just wasn't sure how she was supposed to be his person when she certainly needed one herself. Derek hadn't ever clung to her like that , he hadn't held onto her like he needed her to be there. She didn't know how to handle that.

Mark had stayed at their house that day so that he could get anything needed for Meredith or Derek. Hunt went round at one point because he was so worried about his colleague after Mark explained what was wrong. Derek was asleep most of the time he was there, the pain had been that excruciating he could barely stay conscious.

It was 3pm before Meredith even considered moving him. He hadn't thrown up in an hour and he didn't exactly look comfortable on the hard floor.

"Meredith." Mark said looking worried.

"Yes?"

"Hunt has just called, he wants us to go to the hospital now."

"What why?" Meredith said quickly standing up.

"He knows what's wrong with him."

"What?"

"He says that he has appendicitis and pancreatitis. Then he said we could either take him or call an ambulance what do you think?"

"It makes sense, we can take him, he'd hate an ambulance."

"Okay, I'll tell him that we will take him over to the trauma bay and get him in like that."

"Okay, I'll get him changed."

Mark left the room shutting the door behind him and Meredith tried to wake him up.

"Der...Der...Derek."

His eyes fluttered open, they were glazed over from the fever and a groan escaped his mouth as he'd forgotten about the pain. Meredith sat him up against the wall,

"We're taking you to the hospital, you stay here, I'm going to pack you your stuff."

Meredith left him in the bathroom and went into the bedroom to get some clothes and books for him. She knew this was bad, Derek would never admit he was ill or he was in pain, he'd power through it. He couldn't even stay conscious. Meredith quickly found a back pack and stuffed 2 pairs of pyjamas and 3 t-shirts. She found a pair of slippers, a few books and his phone and with the clothes put them in the bag. She grabbed the bottle of orange juice from next to his side of the bed and took it with her to Derek.

When she got back into the bathroom, he was leaning over the toilet throwing up again with Mark rubbing his back. When he finished he wiped his face with a tissue and Mark flushed the toilet.

"Why don't we get him up now and get him in the car?"

"Okay, I have his stuff."

Mark and Meredith grabbed him from under his armpits and heaved him upright. His legs were immensely weak and he could barely support his own weight underneath him. He managed to walk to the stairs at the end of the landing before he collapsed back down. They gave him a few minutes before standing him back up and continuing to walk to the car.

After 10 minutes they managed to sit him down in the passenger side of the car. As soon as he sat down he fell asleep. Meredith sat in the back and Mark drove his prized black Porsche. Derek was burning up more and more by the minute and it was worrying Meredith. She felt guilty because she thought it was just a stomach bug but now it turned out to be a lot more serious.

About 15 minutes in to the 30 minute journey they were driving down a windy quiet road.

"Stop the car." Derek whispered.

"What Shepherd?"

He took a deep breath and tried again,

"Stop the car!" He said quietly.

Mark quickly pulled over next to some trees, there was no one else around luckily for Derek's sake. He stumbled out of the car and took a few steps forward until the nausea took over. He bent over double and threw up once again. Mark slightly winced at the sight of his 'brother' and Meredith ran out to help him. She rubbed soothing circles into his back until he finished. He looked awful and he was in so much pain. Meredith helped him back to his seat in the car and passed him the bottle of juice from his back. He managed a few sips which was okay. The rest of the way was silent except for the low pitched quiet hum of the radio playing.

When they finally arrived after having to stop twice more, Bailey, Webber, Hunt, Karev and Lexie were all waiting for them with a gurney. Mark pulled up and Meredith got out quickly. She opened up his door and Owen went forward with the gurney to help him.

"I can walk myself." He sighed.

"Derek!"

"I...I can." He stuttered.

Derek stood up out of his car and grabbed hold of the car door forgetting how weak he was. Meredith grabbed his hand and waist and they walked straight towards trauma 2. She helped him lay down on the gurney and then she got ushered out of the way by Mark. They all rushed in and started to connect wires to him.

"Pulse ox is low, start him on 3L of oxygen."

Whilst Lexie started to put him on oxygen and start a cannula on his arm and hand, Bailey and Richard started to do an exam on his agonising stomach. As soon as they touched the lower righ side of his stomach he called out in pain.

"Definitely appendicitis, we need to get him to OR 1 now."

"Okay, let's get him ready to move."

"Sick." Derek gagged trying to sit up.

Webbed quickly passed him a salmon basin and helped him sit up. Derek violently vomited the little amount of food in his body and Lexie rubbed his back for him.

"Can someone draw some blood and do a blood panel please?" Owen shouted.

Karev did as instructed as soon as he finished vomiting. Derek passed straight out, fast asleep, his body was working overtime due to the illness and something else he didn't know.

Owen and Webber talked to Meredith and Mark while Bailey scrubbed and Alex prepped him. As soon as he was intubated by the anaesthesiologist, Bailey and Alex walked in to start the procedure.

"Where is Lexie with the blood results?" Bailey asked angrily.

As if by fate, Lexie appeared through the doors with a mask covering her face and her eyes said and somber.

"Lexie?"

"Dr Bailey, Erm... the blood panel suggests he has acute promyelocytic leukemia." Lexie said shocked.

The entire OR fell completely silent, most staring at him looking so weak and defenceless.

"What?" Bailey said still in shock.

"APL."

"Show me the damn papers Grey."

Lexie went over and showed her the papers. In big bold letter APL was written at the bottom of the sheet.

"Okay, page Dr Swender, Dr Hunt and Dr Webber. We need to do his surgery."

Bailey took a deep breath and looked over at Derek. She knew what was about to come, he was peaceful now but as soon as he woke up his life would have changed so much. She looked over at Karev, nodded and started the surgery...