"Meredith?" Owen asked sitting down next to her and Mark.
Richard and Bailey were stood in front of them, all of their faces were somber. This panicked Meredith and Mark who both stood up instantly.
"Is he okay?" Meredith blurted out.
"He is in his room, he has already been through recovery and he is doing fine, we need to talk to you first before you can see him." Owen said standing up.
"Okay, how did his surgery go?"
"Fantastic, luckily his appendix hadn't burst but he still does have a nasty case of pancreatitis." Bailey said.
"What's wrong?"
"Meredith, Mark will you sit down?"
"Ummm...okay." Mark said.
They both looked at each other and sat down on the blue hospital chairs.
"What's happened?"
"We...we got his test results back, Meredith, Mark he has APL." Bailey said.
Meredith burst into tears and Mark looked straight into the abyss in his head.
"Dr Swender is going to take over his case, we have caught it really early, have you noticed anything different with him?" Owen asked.
"Erm...he has been tired...you sent him home, he looked like hell and in the OR he almost fainted. I...I think he's lost weight, he seems skinnier." Meredith said through his sobs.
"I know it is hard but do you want to tell him or do you want us to?"
"Let me." Meredith sighed.
"Do you want to go now?"
"Okay, do you know when he will start his treatment?"
"I think it might be in the next few days, with APL you need to start fast to help."
"Okay, Mark?"
Mark was completely out of it, he couldn't imagine having to tell his 'adopted' mom that his only biological son had cancer. Flaming cancer! How could he watch his brother be on the brink of death and be strong for him. He felt a hand touch his shoulder and he snapped out of his dark thoughts.
"Mark?"
"We need to go talk to him now and talk to Dr Swender with him."
They all walked out of the small hospital waiting room towards his room. They all got into the elevator and stayed in silence until they reached his hospital room. Dr Swender was waiting outside for them but didn't say anything yet.
Meredith took a deep breath and walked into her sick husband's room. He was laying with his eyes tightly shut and his arm over his stomach. When Derek heard the door open he opened his eyes, looked over at Meredith and smiled until she saw her red puffy eyes.
"Mer? Why have you been crying?"
Meredith looked at Mark and he nodded at her. She walked over to the bed and sat down next to him squeezing his hand tightly.
"Derek you have APL." Meredith said.
Instantly, she leant forward and hugged him tightly avoid his stomach because she knew it would hurt him. After a minute or two she leant back and looked at Derek's terrified face.
"I'm so sorry Der." She said not letting go of his shaking hand.
Dr Swender walked into the room and stood next to Hunt and Mark.
"Hi Dr Shepherd." She said smiling.
"Hi." He sighed looking and feeling exhausted.
"Derek, I don't have to explain to you about APL but we need to start you on treatment as soon as possible. Your in here for 2 more days then if you have 3 days at home resting you can start the first round of chemo in 5 days. Your going to be in the hospital for 6 weeks, the entire time of your first round then if you require a second round that can be administered from outpatient."
"6 weeks?" Meredith asked shocked.
"Yes, we don't know how his body will react to the chemo so if you are at the hospital we are prepared for whatever happens."
"Erm...what are his chances?"
"I try not to let my patients and family talk about topics such as that but because you are doctors then you will most likely know. 7 and a half out of every 10 get full remission, you have around a 75% chance of survival, compared to some cancers your odds are amazing."
"That's amazing Derek." Meredith said looking at him.
He was lost in his dark thoughts, Meredith knew this was going to be extremely hard on him, mentally and physically. She also knew how dark Derek could become and she was worried about that happening again.
"We have to run 2 more tests on him to find out more about his cancer so I will come back in half an hour."
"Okay thank you Dr Swender."
Dr Swender smiled and walked out of the room shortly followed by Hunt, Bailey and Webber.
"Mom." Derek whispered.
"Do you want me to tell her Derek?" Mark asked solemnly.
"No."
"Do you want to do it now?"
"Yes please."
Meredith went around the bed and found his phone in his backpack. She passed it to him and he started to dial her number.
"Derek?"
"Hi mom."
"How are you?"
"That's why I'm ringing."
"What's wrong?"
"Mom, can you sit down for me?"
"Okay."
Silence.
"Okay I've sat down now."
"Mom, this morning I thought I had the stomach flu and couldn't stop throwing up but it was getting really bad so I came to the hospital."
"Oh my god."
"I had appendicitis and pancreatitis but then I got even more tests done that are compulsory. Mom, I have APL."
"APL?"
"Acute promyelocytic leukaemia."
"Cancer?"
"Yes Mom."
"Oh my god." She sobbed.
"I'm going to be okay."
"I'm coming to Seattle with your sisters, even Amy."
"You don't have to do that."
"You have cancer! I am your mother so I am going to come and help out wherever I can. No buts about it."
"Fine Mom."
"When is your first chemo?"
"In 5 days, I am still in the hospital at the moment from the surgery and pancreatitis but I'm going home in 2 days."
"I'm booking a flight for us all in 3 days."
"I have to go Mom, see you soon."
"See you soon dear, rest up."
He hung up the phone and slammed it down on the table. Meredith hugged him again and Mark sat down on the couch.
"I...I need to tell Amy...Kathleen, Nancy and Liz."
"Let your mom do that, you need to rest Der."
"No I have to."
"Why don't you wait until after your tests so you can sleep now?"
"Okay."
"You look exhausted."
"I am."
"You go to sleep and I'm going to call Lizzie and Amy and tell them."
"Thank you."
Derek fell straight asleep and Meredith picked up his phone off the bedside table.
"Good luck telling Lizzie." Mark laughed.
"I'm going to ring her first."
She dialled her number and waited for it to connect.
"Derek?"
"Hi Lizzie, it's Meredith."
"Oh hi, is everything alright?"
"Have you talked to your mom?"
"No but she wants everyone at hers tonight, something about a compulsory trip."
"Okay, can you sit down?"
"Sure?"
"Thanks."
"Okay I'm sat down what's happened?"
"Derek has APL."
"What?" She said shocked.
"He was diagnosed earlier today he wanted to call you but he is exhausted."
"Is that why mom is getting us to go in a trip?"
"Your coming here."
"That makes sense now, do you want me to tell Kathleen and Nancy?"
"Yes please, I'm going to tell Amelia and Addison."
"Be careful telling Amy, she idolises Derek."
"I will."
"I'm going to go tell them now, I'll see you soon Meredith."
"Bye."
"Bye."
Meredith hung up and looked at Mark.
"She took it surprisingly well." Meredith laughed.
"Really?"
"Yes, she even offered to tell Nancy and Kathleen for me, I just have to tell Amelia and Addison."
"Let me, I have a good relationship with the both of them."
"Thank you Mark."
"I'm going to go do that now."
"Okay."
Mark stood up and left the room. Meredith went over to Derek and laid down next to his sleeping, sick self.
"I love you Derek." She whispered hugging him tightly.
Derek was absolutely exhausted, he looked it too. Meredith was laid there tightly hugging his small frame. She could've sworn she had lost quite a bit of weight in the last few weeks but she didn't say anything to him, she wished that she had. She felt so guilty. Guilty for not saying anything when she had see things wrong with, guilty for not seeing the signs, just guilty. All she could think about was how different their lives would be and how they were planning to have a baby but now she needed to help him, he needed her.
Dr Swender quietly knocked on the door and walked in.
"How is he doing?" She asked walking over to the foot of the bed.
"He's tired, really tired."
"Okay, he needs to sleep to get the rest."
"I know, he has slept pretty much since you left except for when he rung his mother."
"What did she say?"
"Her and his 4 sisters are coming from New York and one from LA in 2 or 3 days. I think she is going to help out."
"Okay that's good. Does he have a father?"
"No, he died when he was 9."
"Oh, we need to get him up for some tests now."
"What is he having done?"
"A lumbar puncture and a bone marrow aspiration and biopsy."
"Will I be able to stay with him?"
"Yes of course."
"Der, Derek?" She whispered shaking him ever so slightly.
He slowly opened his sore eyes and blinked a few times to clear his foggy eyes. The pain was immense but he didn't tell Meredith.
"Hey, we have to go do some tests now."
"Can I get changed?"
"What into Der?"
"Scrubs."
"Scrubs?" Meredith laughed.
"I'll go get some." Dr Swender laughed.
Derek sat up and winced slightly when he tried to stand up. He couldn't be this weak, he had cancer, freaking cancer. He had to put on a brave face, especially if all his sisters and his mom were coming. Dr Swender came back in the room and placed the scrubs on the bedside table before silently exiting the room.
"I can get changed Meredith."
"You are only 5 hours post-op."
"I know that but I can put a pair of scrubs on."
Derek stood up and started to change. Meredith stood around him to help if he needed it. He winced in pain every time he moved his legs and stomach, Meredith kept trying to help him but he was adamant he could do it. After 5 painful minutes Derek sat back down on the bed and Dr Swender knocked on the door.
"Come in." Meredith shouted rubbing his back comfortingly.
"We are ready for you, let me go get a wheelchair for you."
"No, I can walk myself."
"Dr Shepherd! Do you understand how much stress your body is under at the moment? Not only that but you are also 5 hours post op and you have a bad case of pancreatitis just allow us to get you a wheelchair."
Derek look down at his hands on his lap and placed a hand over his aching stomach.
"Okay."
The pain was so much worse then than it even was that morning. He hadn't been sure he could have been in more than he had been previously but he was. The tests were hell. Even with his wife clinging to his side, holding his hand through everything, even now, it didn't make the pain more bearable. He had finally found something Meredith couldn't make go away. And now he could only wish he hadn't.
His body burned with every movement he made. The Lumbar procedure, which he had always told patients was uncomfortable, forced him to hunch over, the pain in his back so severe he could barely breathe. The pain in his hips from the bone marrow aspiration and biopsy made walking next to impossible, and even sitting down hurt him.
Meredith just kept clinging to his hand. She had smiled and talked to him gently through it all, talked to him as if this was all routine, as if this was nothing to her and he was still just the strong, energetic man she had fallen in love with. Which was amazing. He hadn't known what to expect from her with this but she was being amazing. Even thought right now he was in complete pain, he loved that.
Derek finally arrived back in his room at 10pm, it was rare for doctors to do procedures so late but he was an exception. He was in agony, it hurt to even breathe. Meredith got him settled in bed and Mark, Hunt and Dr Swender all walked into the room. The pain made it hard for him to see, hear or concentrate so he was struggling a lot.
"Dr Shepherd, you definitely have a sub type of acute mylegoeneous leukemia known as acute promyelocytic leukemia."
"Okay," Meredith breathed, squeezing Derek's hand as he gasped lightly.
"Essentially, you have an excess of immature cells and a deficiency in the mature cells," Dr. Swender explained.
"It's not a common diagnosis, but it is good news for us."
"Good?" Meredith asked.
"APL is the most treatable form of AML," Dr. Swender nodded.
He didn't know what to say so he stayed silent. Trapped in his thoughts so Meredith had to speak for him.
"Okay."
"We have caught it early so it is far more treatable. We start chemo on Tuesday, it's Thursday today. You have exceptional chances Derek."
"Derek, that's good, really good." Meredith said placing her hand on his shoulder.
Derek slightly nodded before returning to his deathly silence.
"I'm going to leave you to come to terms with your diagnosis, I will come see you tomorrow, bye."
"Thank you Dr Swender."
"Call me Rebecca."
"Thank you Rebecca."
Rebecca left the room followed by Hunt but Mark walked over to his brother laying on the bed with tears forming in his piercing blue eyes.
"You can beat this Derek, I know you can, we all know you can."
"Mer...sick." Derek said trying to sit up but the pain prevented him from doing so that fast.
Mark quickly helped him sit up and Meredith placed a basin on his thighs. He leant over and threw up while Meredith held his hand tightly and Mark rubbed his back where the spinal tap hadn't been done. He pulled back once he had finished and wiped his mouth with a piece of tissue and took a sip of freezing cold water.
"Any better?"
He shook his head.
"You go to sleep now Der, we can talk in the morning baby."
"Goodnight." He whispered.
"Goodnight."
Derek tried to make himself comfortable but he couldn't so just gave into the drowsiness and fell asleep. Meredith and Mark went and stood outside next to the window so they could talk and still see him.
"This isn't good."
"I know Mark, has he ever been like this before?"
"What do you mean?"
"Dark?"
"After umm... well... Addison and I did what we did he became very depressed. Like very depressed. All he'd do was sleep and drink beer. I think he might've tried to commit suicide, that's what Nance told me and Addie but it was unsuccessful. Then he moved here trying to forget about everything but I think the emotions are coming back already."
"Suicide?"
"In think so Grey."
"Oh my god, I would've never known, you get off Mark I'm alright with him."
"Are you sure?"
"Yes, see you early tomorrow morning."
"Seven sharp." He laughed.
Mark hugged Meredith and walked away towards the elevator while Mer walked back into his room to her sleeping husband. She quietly grabbed a blanket and a few pillows from the cupboard and laid down on the couch. She got settled and fell peacefully to sleep.