Chapter 33: The Truth is Coming Out

Derek scribbled the patient info into the chart. It was his last patient for the day, but he had to be neat with his handwriting. He had heard an earful from Meredith about completing the patient files conscientiously. She could be a slob personally but not when it came to her job. Sometimes, he could almost understand what she had meant by being a cold-hearted bitch'.

He shut the chart close with a relived sigh. It was a busy day. Hopefully Meredith was done as well. He smiled contentedly as his eyes infallibly found Meredith's birthday present, the picture of a cowboy giving his horse beer, hanging proudly on the wall. They fell into some kind of a pleasurable routine. Go home- He was coming home with her every day. His grin faltered as his vision slid to the wall calendar. The date of his final return home. New York- September 7th; was approaching. He hoped that he'd be able to change Meredith's mind as to permanence of their relationship, just like he had managed to change her mind in so many issues already. But even if he did, how would that work out? Meredith's arguments were well thought out and not devoid of reason.

Putting off the issue for later, he grabbed the chart and got to his feet. Once out of his office, he walked up to Izzie briefly noticing a dark-haired woman that was sitting in the lobby.

"Meredith's with a patient?" he asked her, handing her the chart.

"Yes, she should be finishing any minute," the blond nurse replied with a wide meaningful grin as she looked at him.

"What?" he chuckled self-consciously.

"Nothing," she shrugged, beaming. "Just you guys are so cute. The looks and the smiles, and you always ask about each other- Meredith has never looked happier- You're staying, right?" she finally braced herself to ask bluntly. He suspected it was her intention all along.

"Izzie-" he sighed. He appreciated her concern but didn't want to get into that conversation with her. He remembered the woman waiting in the chair against the wall. "Is that our last patient for today?" he pointed behind with his head.

"She is-"

"I'll take her. Do you have a chart for her? She's not from around here, is she?" he asked turning to glance at her again. She seemed to be very busy with her palmtop, her rich brown hair fell along the side of her olive-complexion face. The face that now looked oddly familiar, Derek realized. Not Rachel familiar, however, it was as though he was remembering this face from behind a mist, from a previous life.

"I'm sorry, Derek, she's here specifically for Meredith," he heard Izzie's explanatory, and a bit gossipy voice.

"For Meredith?"

"Yeah, that's the second time she's in Rachel," went on Izzie. "She came here two years ago with no other than Meredith's sister-"

Derek was barely listening now as a disbelieving realization took over his brain. He slowly made his way to the solitary woman, thinking that maybe it was a trick of light or the angle from which he was looking at her because it sure as hell couldn't be who he thought it was.

"Dr. Crawford?" he asked with a voice that couldn't possibly betray greater shock. "Dr. Helen Crawford?"

The woman lifted her eyes from her phone and there was no mistake. Derek's mouth went slightly agape, one of the most prominent surgeons in New York, the head of neurosurgery at Mount Sinai was staring at him with almost equally bewildered eyes.

"Derek Shepherd?" she breathed out, standing up, her regard roving over his face and his lab coat. "You're here now, too?"

"Huh?" a surprised sigh escaped him, and a frown of incomprehension creased his forehead. "Too? I'm- long story short, I'm working here- temporarily I guess-"

"Working here?" frowned Helen, trying to wrap her mind around the whole weird situation. "Last time I heard you were still my counterpart at Pres-"

"I am, I still am," he confirmed, albeit somewhat reluctantly. "I- I inherited half of the practice from my uncle William-"

"William Shepherd," Helen finished pensively. "What a small world- I'm sorry for your loss, William was a truly great person, almost like a father to Meredith."

"Yeah, about that, how do you know Meredith? Forgive my obscene curiosity, but what brings you here?"

Her eyes went even wider than when she first spotted him, as she cocked her head scrutinizing him silently.

Before any of them could add anything significant to the conversation, the door to Meredith's office opened and she walked out following her patient.

"Of course, Mrs. -" she trailed off mid-sentence, stopping in her tracks at the sight of Derek and Helen obviously engaged in a conversation.

"I'll walk you off, Mrs. Lamont," Izzie stepped in knowingly, taking the elderly lady by the elbow as she eyed the three doctors curiously.

"Mer," the first true smile for days or even weeks lit up the surprise guest's face and she quickly walked up to her friend to hug her closely.

Meredith reciprocated the embrace with equal emotion only to give her a wary frown when they pulled away. She could feel the force of Derek's shocked stare on her, but she'd have to deal with one thing at a time. For a moment, it was the cause for her friend's sudden arrival.

"Helen, I didn't expect you for the next four months at least-" she looked at her questioningly, in the corner of her eye she caught a glance of a big brown envelope sitting against the wall near Helen's purse.

Helen's eyes seemed to silently confirm her suspicions, she knew her friend wouldn't leave New York just for a chat-

"Now, don't make that face," Helen rolled her eyes, grinning. "You look like I killed your cat."

"Can we- Let's talk in my office, okay?" Meredith sighed apologetically and turned to Derek whose astonishment was yet to wear off. "Derek, I- I'll explain just- Can you give us- Can you wait for me?"

He nodded silently though a thousand questions begged to be asked.


"Now, what is Derek Shepherd really doing in Rachel? Is this some kind of a mecca for neurosurgeons now?" Helen asked with a grin as she took one of the chairs in front of Meredith's desk.

"Helen, the scans-" Meredith began, opening the envelope.

"They can wait a couple of minutes," the brunette waved her hand dismissively. "What is one of the world's best neurosurgeons doing here?"

"That's a long story," Meredith let out a sort of tired chuckle.

"Yes, he did say something along these lines. He's really William's family?"

"Oh, yeah," Meredith laughed softly. "He's been here for over a month now.

"Seriously?"

"Yes," Meredith shrugged innocently. "He came to sell his share of the practice and William's house."

"And?"

"And what?"

"He's still here," remarked Helen soberly.

"Well, he thought he'd do with a vacation, I guess. He's on two months' leave at Pres."

"That's intriguing," Helen peered at her shrewdly. "I thought wild horses wouldn't drag him away from the hospital, or New York for that matter."

"Have you slept with him?" Meredith fired up suddenly, throwing caution to the wind.

"No," Helen gave out a hearty laugh only to narrow her eyes at her. "Have you?"

Meredith lowered her eyes, biting on her lip. Who was she trying to fool? Of course, one of her best friends would pick up the truth sooner or later. It didn't matter, she wanted to avoid it at all costs. The last time they saw each other in person she still claimed to swear off men.

"That sounds more like the Derek Shepherd I know," Helen said stoically. "Not like you though. What happened?"

"I- I don't know-" Meredith threw her head back in frustration. "Trust me, I hated his guts when he came here first, strutting out with his stupid perfect hair and I'm the big important neurosurgeon thing."

"Yes, he's had that going around him," laughed Helen. "I'm sure you put him to place, Dr. Grey."

"I- didn't?" Meredith answered in a small voice. "At least not this way-"

"Wait a second, he doesn't know you're-"

"No."

"How on earth didn't he put two and two together?"

Meredith simply shrugged.

"That's why he looked so clueless- So what's next for you and him? Is it something serious? I would never suspect Derek Shepherd of a long-term commitment; he was always kind of a ladies' man. But you- you're a totally different story-"

"It's something until he's not here," Meredith cut her off. "Then it's back to the way it was."

"So, you're not thinking of going back?"

"Absolutely not!"

"And he-"

"He's not staying either. He was to pack up and leave before I had to bare my soul to him completely. Now you're here, complicating things-" she sighed and reached for the envelope once more. She took out the images and studied them carefully, her heart sinking a little with every minute. "That's-"

"Not good, I know," Helen nodded lightly. "The schedule must change."

"It wasn't supposed to regrow this quickly!" Meredith examined image after image, but all confirmed the same undeniable truth.

"It's got more aggressive, I need to be operated on soon-" she hesitated, "and for the last time."

"What?" Meredith spat sharply, abandoning the scans on the desk.

"This is it, Meredith," she looked into her eyes unwaveringly, steadfast in her decision. Meredith was going to fight with her, fight for her surely. She was too full of life to understand, even after what Mitch did to her that amazing vital drive had not burned out. "I'm done after this."

"Helen-" Meredith shook her head warningly.

"I can't go on like this, now the tumor is so aggressive I'd barely had time outside the hospital- probably only to grow my hair back."

"Helen, no," Meredith stated firmly. "You were the one to tell me that; don't throw in the towel. Remember?"

"I'm looking at the situation as it is. I am going to do this now then I am going to spend whatever time I have left lying on a beach enjoying the sun. The decision is made."

"I won't let you do this," Meredith said lowly, her eyes shooting sparks.

"How do you intend to stop me exactly?" Helen laughed softly. "Refusing to operate on me?"

"This is far from funny, Helen!"

"Believe me, I know," she sighed getting to her feet. "I'll let you to it so you can accept my decision. I thought I'd see Cristina, have a delicious dinner till I'm still allowed. I can stay for the night at the inn too if you're too unhappy with me?"

"Don't be more silly than you're already are-" Meredith hissed, her fists clenching helplessly.

"I'll see you later then and- you know how to pick them," Helen winked at her from the doorway and disappeared.


Derek paced the kitchen nervously, waiting for Meredith and Helen Crawford to conclude their conversation. He had not expected this turn of events. Seriously, Helen Crawford appearing in Rachel suddenly? What was going on? But in the back of his mind, he felt he knew, deep down. His brain built the only humanly possible logical theory- It didn't sink in yet though. Because it was- so crazy and utterly unbelievable.

He stopped making circles once he heard a door opening. With a sense of nervous anticipation, he made his way downstairs to Meredith's office to which the door now stood slightly ajar.

He didn't knock but didn't hide away with his presence as he went in. Dr. Crawford was already gone while Meredith was standing with her back to him, peering out of the window, her body language unmistakably stiff and distraught.

"Meredith? What's wrong?" he asked softly.

She sighed audibly casting her head down. The time came to lay down all the cards. She wondered what his reaction would be, she was oddly curious- and scared. She didn't want pity, everything but pity. After a minute of silence, she turned to him and handed him the a large brown envelope. "I want you to have a look at this."

"CT scans-" he murmured pensively taking the images up to the light. "A pariphalseum meningioma- along the superior saginal sinus."

"Yes. The patient has undergone three surgeries already-"

"It's in dangerous territory, they leave a bit of the tumor, go back every couple of years and tune it up."

"Exactly," she nodded. "What do you think- what do you think about attempting to take it all out?"

"You're thinking about a saginal sinus bypass? What's the patient's age?"

"She's thirty-five."

"She's young, but I still don't recommend it. It holds too much risk."

"What if- what if she doesn't want any more surgeries?" Meredith breathed out rubbing her temples. "What if this one is the last one? What if she doesn't want any more hospitals, doctors, recoveries? No more tests. Just enjoying her life to the full until- until it's over."

"That does change the perspective, I guess. It's a difficult decision-"

"That I know. Medically speaking, I want your honest opinion," she interrupted him.

"I guess it's doable," he sighed, inspecting the images once again. "Daredevil, incredibly high risk but theoretically doable."

"Big balls surgery-" she sighed taking the scans from him, but he held them away.

"These are hers, aren't they? Helen Crawford's?" he scanned the side info, cocking his head with a frown. "My sister Amelia has taken them, she's Crawford's resident."

Meredith took a deep shake breath. There was no way out of this, only the truth. The painful truth.

"She came for your opinion? Why?"

"Derek-" Meredith's voice trembled as she lifted her eyes to look at him. She had kept it from him long enough. He deserved to know the truth. And she needed to let it off her chest. She reached that point when she needed to speak, or she would suffocate. "Derek, have you honestly failed to make the connection all this time?"

"What connection?" he shook his head slowly.

"I'm Meredith Grey, Derek. Dr. Meredith Grey. Not to brag, but you must have heard about me if you're really Derek Shepherd the hot-shot neurosurgeon on whom I read up in the Journal of Neuroscience."

"I-" A light bulb was lit above his head. "Yes- Meredith Grey- the neurosurgeon, Mount Sinai's star, the youngest Harper-Avery winner, the pioneer-"

"Derek, I kind of know," she quipped halfheartedly.

"You're- you're that Meredith Grey?" he sat down heavily on the edge of her desk, his eyes fixed on her as though he'd just seen her for the very first time. He'd been subconsciously suspecting it for the last half hour but the actual confirmation hit him like a freight train. "The genius who disappeared from the medical world-"

"Three years ago," she nodded.

"Oh my god-" he gasped. "Oh, my freaking god-"

"I-eh- I thought it might have at least crossed your mind," she rubbed her hands nervously. "Obviously it didn't-"

"I've been sleeping with a legend-"

"That's your first reaction to the news, of course," she rolled her eyes.

"I'm sorry," he stuttered out. "I guess I'm just shocked-"

"As I expected you would be."

"It's unbelievable, I mean, what are the odds?"

"I'm sorry I kept it from you, I truly am-" she sighed tiredly. "I didn't want you to look at me differently- to change the way you saw me- and now you know who I am-"

At her words, Derek seemed to brush himself off from his stupor. He closed the small distance between them and took her face in his hands. "I always knew who you are, a brilliant, beautiful woman, inside and out. The woman I fell in love with. Nothing can change the way I see you."

"I'm not so sure," she shook her head moving away from him. "I also didn't want-"

"Yes?"

"It's humiliating. I'm a proud person, very. And it's the single most humiliating thing in my life- Poison oak on my privates is not even close in this competition."

"It's because of what Mitch did?" he asked quietly.

"How do you know?" she whirled her head towards him.

"You said his name- when you were feverish after the snake bite."

"And you never asked?" she whispered.

"I- didn't want to pester you, it obviously wasn't a pleasant subject."

"It isn't. It destroyed me. And it starts and ends with my presuming talent and genius," she snorted bitterly.

"You don't have to tell me about it," he assured her quickly.

"I think I do. Don't tell me you're not even remotely curious why I threw my stellar career out of the window."

"It's neither here nor there, I-"

"You know why we had never met while in New York? We definitely should have, seeing as we're both in neuro."

"Mer-"

"I didn't hold the scalpel all that often my last few years in New York. I was hired by a pharmaceutical company, it's a very lucrative business, you know?"

"You were developing medications?"

"Yes, I had my own research team, I was working on an epilepsy drug. It's now one of the most popular ones available on the market."

"Really?"

"Oh, yes," she sighed bitterly. "You don't know how often I wished I had never been involved in this- Anyway, have you ever taken part in a drug trial?"

"No."

"Good for you. Don't let the appearances ever fool you. Pharmaceutics is an industry, corporate business, and as any business it's aimed at making money, unimaginable money. It's a cold and ruthless business, no fair play rules necessary. I wasn't entirely aware this."

He noticed her body going rigid again, her eyes becoming cold as the memories flashed in her mind.

"Then, I met Mitch."