Chapter 3

"Ebstein's Anomaly?" Meredith queried as she paged through the rather thick chart Preston Burke had handed her. "Shouldn't neonatal be taking care of this?"

"It's not a neonatal patient, Grey. The patient is almost nine years old." Burke replied, with his back to her as he examined some films on the wide, backlit projector. Meredith eased herself into a chair nearby, quizzically studying the file.

"And it went undiagnosed all these years?" She asked again. Burke pulled a film down quickly and exchanged it for another, never looking at Meredith.

"It seems so, yes."

"But…how?"

"Well, there are a couple of possibilities. It's possible the anomaly was so mild it never caused any kind of murmur or tinting, and was only aggravated now because the patient was growing and approaching puberty. A fluke, nobody's fault." He replied, squinting purposefully at the film.

"That's only one."

"What, Grey?"
"You said there were a couple possibilities, but that was only one."

With that, he dropped his head and turned to her.

"The other possibilities I don't want to speculate about."

But the tone of his voice told Meredith all she needed to know. That, and being the daughter of a surgeon herself. It said in the file, not officially but in a note hand-written by the chief, that the parents of this patient were both surgeons. Foremost in their fields, in fact. Meredith didn't doubt they loved their daughter, just as her mother had loved her, but even so, it was a tough, tough business. Sometimes things non-surgical just slip under the radar. She remembered many occasions in which she got away with murder, basically, because her mother just…didn't seem to see what was going on outside of the operating room.

But Burke was right. Doctors don't speculate on that kind of stuff, especially concerning other doctors.

She abruptly cut off that line of thinking when the Chief opened the exam room door in a whoosh.

"Dr. Burke, Dr. Grey," he greeted abruptly, "The Shepherds have arrived and just got admitted."

He said nothing else, and closed the door so fast Meredith blinked and wondered if he had even actually opened it or just spoken through the window.

"Here we go." Burke said with a nod. Meredith collected the file into some semblance of order, and followed, reserving her judgment…for the most part.


"How's that, baby?" Derek asked as he arranged the chosen few of Sadie's dolls on the windowsill of the hospital room, trying in vain to distract from the grey, drizzling, overcast, ominous-looking sky just beyond the seven small heads. She cocked her head to a side, and put a thoughtful finger to her lips.

"Put Katherine to the left of Audrey." She directly him finally with a vague hand motion. Derek frowned, and looked to the dolls.

"Katherine…?"

"The redhead, Daddy."

"Ah!" he selected the only redhead in the bunch, and then hesitated again.

"Audrey's the skinny one."

"I knew that." He defended, placing the redhead between a skinny, dark-haired, doe-eyed doll and a doll with blonde hair.

Just at that moment, Addison emerged from the bathroom.

"You're putting Katharine next to Audrey? Isn't that a little confusing?" she observed, sitting next to Sadie and examining the arrangement with a devilish glint in her eye as Derek subtly implored her for help.

"You know you're right, Mommy." Sadie agreed. "Put Ingrid between them, please, Daddy."

Derek sent Addison a glare, and turned back to the dolls.
"Okay…Ingrid…"

"She's the blonde next to Katherine!" Sadie giggled after he stood in confusion for a few moments.

"Oh! Of course!" Derek slid the blonde doll out and wedged her between the redhead and skinny brunette. With a hopeful raise of his eyebrows, Derek turned to his daughter.

"Better?"

"Perfect."

"Is Daddy going to change them into their pajamas tonight, too?" Addison asked with a smirk at Derek. Sadie shook her head seriously.

"No, Mommy, he's a boy! They have girl parts! He can't see them!"

Addison laughed, and Derek nodded emphatically.

"That's right, and don't you forget that in the next few years either!" he told her with a slight rise of panic at the thought his little girl and showing her "girl parts" to boys.

Sadie furrowed her brow in confusion, but before she could pose a question, the door to her hospital room opened and Burke stepped in, Meredith right behind him.

"Hello, Drs. Shepherd?" Burke greeted.

"Yes. I'm Derek Shepherd, and this is my wife—,"

"Addison." She supplied for herself as they both rose to shake hands with Burke.

"It's a pleasure to meet you—both of you. I've admired your work from afar."

"Likewise." Derek said with a smile and a nod. It was virtually an unwritten law that upon meeting other doctors, doctors are obligated at least two minutes of ego-inflation.

"Yes, your reputation definitely precedes you," Addison added, "That's why we're here."

"I'm flattered. I'm going to make this trip worth it and then some, too." With that, he turned to Meredith. "And this is Dr. Grey, who will be assisting me."

With a self-conscious flush, Meredith took the hand of Derek Shepherd and shook it professionally, though the man was pretty much the summary of every sexual fantasy she'd had since she was sixteen, standing before her eyes.

"Nice to meet you. I studied one of your cases—the Holmes pituitary gland reconstruction—in medical school." She informed him, capping her initial reaction.

"Wow, that's impressive." He said with a crooked, nearly self-deprecating smile. "I just aged about ten years."

Everyone in the room produced some kind of chuckle or smirk at the comment, when Addison put her hand out.

"Dr. Grey—any relation to the Grey Method I read about in medical school?" she inquired with a respectful expression.

"Second generation." Meredith supplied with a polite smile.

"That…is impressive." Addison smiled genuinely. With that, Burke stepped in.

"And you must be Sadie?" he asked the little girl perched on the bed.

"Yeah." She replied shyly, wrapping her blanket around her hands.

"I'm Dr. Burke, and this is Dr. Grey." Burke greeted gently, with a tenderness Meredith had never really witnessed before. He came to the little girl, observed the machines which had been pushed behind the bed for comfort purposes, but were still very much attached to her.

"Hello." She greeted with a coy smile, curling her knees up to her chin and wrapping her arms around them. She was one of those children who you carried a kind of adult beauty even at an early age, and would undoubtedly be a knockout when she finally reached adulthood.

Go figure. Meredith thought, considering her parentage. The Shepherds were a sleek, New York kind of good-looking couple, dressed chicly despite a long plane ride, as she expected, but most notably, they weren't the cold, preoccupied surgeon-parents she had expected. Or was used to, personally. They seemed genuinely and entirely focused on their daughter, right now at least.

Addison sat down next to her daughter again and tugged correctively on the braid in the girl's hair, while Derek stood with his arms crossed, intent and concerned.

"How does it look, Dr. Grey?" Burke finally asked, turning to Meredith. Meredith's eyes ticked quickly to the Shepherds, who were now focused intently upon her. Something about having them understand every harsh medical word she was about to say made her hesitant to produce the appropriate words at first.

"Well…the Anomaly in the—Sadie's heart, according to the EKG, has caused a tear on the underside of her tricuspid valve. It is two millimeters in length and one in width. It is at this time, leaking blood into her chest cavity, kept under control by coagulant drugs prescribed by Dr. James Ianello of New York."

"Corrective approach?"

"Well, the Anomaly itself will be corrected by closure of the atrial septal defect, but not until the tear is corrected through tricuspid repair surgery, soon." She felt the gaze of both of the Shepherds upon her, but it wasn't the burning anxiety as a result of misunderstanding, like most patients' families. Somehow, their understanding had made it easier.

"Okay. So what will our next step be?"

"Cardiac catheterization to fully define her cardiac anatomy and function." Meredith finished efficiently.

"Perfect. Why don't you take Sadie upstairs, Dr. Grey, and prep her for that?"

"Certainly." Meredith went to the side of the bed, while Burke began fielding questions from the Shepherds.


"So how have you been feeling today, Sadie?" Meredith asked as they stood—well, Sadie sat in a wheelchair, much to her chagrin—waiting for the elevator. The little girl carelessly rolled her tiny shoulders under her colorful Strawberry Shortcake pajama top.

"Okay, I guess. A little hard to breathe sometimes, and I always feel cold." She responded.

"Well that could be the medicine Dr. Ianello had you on and…" Meredith caught herself as the elevator doors parted and she nudged the wheelchair inside.

"And the fact that my heart has a hole in it?" Sadie supplied helpfully.

Meredith bit her lip. "Well…yeah." Great beside manner, Grey.

"You don't have to be afraid of scaring me, Meredith. Both of my parents are surgeons. I hear stuff like that and worse all the time. I'm not scared." Sadie assured her, turning her head to focus her huge blue eyes on Meredith, who had to admit this little girl charmed her. It was easy to say she didn't want children when she was everywhere but with a particularly adorable one.

"That's good. That's really good, because you shouldn't be afraid. Dr. Burke is the best heart surgeon out there, and he's going to take care of this and you'll be home in no time." Meredith assured her, smiling.
The elevator began its ascension, marked by the round floor indicators becoming alit with an emphasizing ping. Two floors passed before Sadie asked distractedly, "How long will I have to recover?"

"I'm not sure, probably a while."

"I guess I'm going to miss my ballet recital next month." She observed flatly.

"Probably." Meredith sympathized. "But after this, you'll probably be a better dancer."

"That's okay. I only really joined again this year because my mom really likes it. She used to go to the ballet in New York all the time, and when I started dancing, she came to that all the time, too. I finally got a part in one of The Nutcracker last Christmas." The little girl beamed with pride, but then added, almost as an aside, "But she had work, and so did Daddy. They work hard."

Meredith sighed as the elevator slowly rose. She could have been listening to her eight-year-old-self talking. She looked down at Sadie Shepherd, seated obediently with her hands folded on her lap, careful of the IV when she occasionally shifted position. Her dark hair was pulled back and loosely braided, secured with a pink band, falling around her delicate, rounded face. Her pajamas were brightly colored with the familiar little red-headed cartoon character smiling cheerily all over, and her slippers were thick pink socks with bits of glitter in them. She looked, by all accounts, like the average, well cared for eight-year-old girl, but she wasn't. Not on the inside.

"You know, I know what it's like." Meredith said suddenly.

"What?" Sadie asked, intrigued enough to turn her very adult-like gaze back to Meredith.

"Being the child of a surgeon. It's hard, sometimes." Meredith said with a shrug.

"Yeah. Try having both of your parents being surgeons." Sadie remarked.

"They're probably not home much, are they?"

"Nope. Not together, anyway. And when they are…"

"They fight." Meredith finished, a pang of sour familiarity jabbing in her stomach.

"Sorta. Or just don't talk much to each other. They just go into their offices after dinner and work on stuff for their patients." Sadie told her, her voice sounding noncommittal to the average listener, but not quite overcoming the well-hidden hurt Meredith knew too well.

Meredith nodded. "Yeah. There was that, too. It's not easy, in fact, a lot of the time, it hurt—,"

Sadie cut Meredith off, her chin quivering but her resolve firm.

"For me? No…I'm not dying. Their patients are. That's more important than—,"

"Ballet recitals?" Meredith offered softly.

A beat of silence passed, cut through only by the seventh floor's ping as it changed to the eighth floor.

"It is." Sadie insisted, turning her gaze to her hands, which had wadded up her blanket into a ball on her lap. Meredith knelt beside the wheelchair and took one of her hands.

"You know, Sadie, just because your parents spend a lot of time on their patients doesn't mean they think they're more important than you. They love you, very much, more than any patient."

"I know." The little girl murmured, meeting Meredith's understanding gaze with one of sadness.

"Well, it's good that you know that. Because sometimes, I used to wonder."


"That's two heart surgeries."

"Yes."

"In one day."

"Yes."

"On our…Sadie."

"Yes."

"To correct an Anomaly someone—we—should have detected years ago."

"Yes."

"We didn't notice Ebstein's Anomaly in our own child."

"Yes."

"Damn it Addison, stop saying yes!"

With that change in his voice from flat calm to near panic, she turned from the window of Sadie's hospital room and looked with her anguished eyes at Derek, who sat on the bed.

"Okay."

With that, he stood and strode to the bathroom, slamming the door.

After a few moments, she went to the door and leaned against it, tears running down her cheeks.

"Derek?"

No response.

She edged the door open and saw him leaning over the sink, his head in his hands.

"We are pathetic." He mumbled.

She nodded, averting her gaze to the floor.

"These past weeks," he continued. "Hell, not even weeks. Years. We've been absorbed so much in our own battles we didn't even notice."

Derek straightened, and looked at her from the mirror, his face stained with tears. She barely suppressed a sob by digging her teeth into her lip.

"She could have died." She said brokenly, her face twisting under pressure from a battle to keep from crying. Derek hurriedly covered the two strides it took to cross the room and wrapped his arms around her waist.

"Shh, shh, Addie…" He whispered as she cried. He slowly turned her so she was facing him completely, and then gently guided her head to his shoulder. She bunched his shirt in her hands, gripping onto him for dear life. He leaned down into her hair, tightening his embrace, equally for his own comfort as well as hers.

"Derek, what's wrong with us?" she demanded.

"I don't…know." He felt ashamed, and even worse, more helpless than he ever had before. His daughter was sick and his wife was crying, and there was very little in either case he could do to fix either problem. Addison never cried like this or this often, and as she choked from the pressure of her agony against him, it tore him open inside, burning his eyes with tears. He tightened his embrace again, and kissed her hair by her ear.

"Addison, you need to calm down. Grey is going to be back in a little while with Sadie—do you want her to see you like this?" he whispered gently. She took a few moments to cease crying, and finally sat on the edge of the toilet.

"I'm okay." She assured him as she scrubbed at her eyes with the heels of her palms. He knelt by the toilet and took her hand.

"About the other night…" he said slowly, her eyes widening in reaction to his mention of their previous argument. "Let's forget about it. It's in the past now, can't be changed, and we have more important things to worry about."

Her lips parted slightly, in shock maybe, and Derek took the opportunity to lightly kiss her.

"It's okay, Addie." He reassured her against her mouth when she didn't speak. She blinked, and then shook her head.

"No, Derek, it's not." She whispered coarsely. He sat back on his heels.

"What are you saying?"

"I'm saying," Addison murmured as new tears blossomed on her lashes and plunged down her cheeks, "That we should get divorced."


A/N: Don't hurt me, please! More is coming! And if you're an Addek fan who is plotting my demise, don't. It's not over yet!

As a side note, I love the feedback thus far. Thank you, it makes me smile. :)