Now that The Captain and Bizzy went back home, Derek and Addison went back to work. Addison focused on her work at the practice as Derek continued expanding St. Ambrose. Both internally and externally. It took some convincing but Derek got the board to put in the money to build out the hospital's surgical wings. This way, they'd have the physical space to teach surgical residents. But the construction was just the first step. Derek knew that there was a lot of work left to be done.

The new proposed changes included a brand new burn center, which Mark appreciated, some additional ORs for more surgeries, and some lab areas for future interns and residents to practice. It was a lot of change and a lot of money, but Derek's vision was starting to get clearer. And his confidence and conviction so far convinced everyone at St. Ambrose that he would succeed in making St. Ambrose into an even better hospital. It'd just take some time for it to fully come to fruition.

"This knockin's drivin' me crazy," Charlotte said as she got some files out from the drawer of her desk.

"Yeah, they're gonna be here for another two weeks," Derek sighed.

"This better be worth it, Shepherd," Charlotte said before leaving to get back to Oceanside Wellness.

That's what he was scared of. There was a lot on the line. His career, his reputation, and this entire hospital. He'd never done anything like this before, but it was something he was passionate about. All he wanted was to prove himself. And this was his ticket to the big leagues. He thought he could ask Richard for his advice but he was apparently too busy with this big merger with Mercy West coming up.

"Yeah, I'll talk to you tomorrow," Addison said on the phone as Derek hung up his jacket.

"Who was that?" Derek asked before leaning down to give his wife a quick kiss as she sat laid out on the couch.

"Callie," Addison said.

"Did Richard tell you about this merger?" Addison asked.

"Yeah, he did. Why?" Derek asked.

It was true. When Derek called Richard for his advice, Richard made his feelings very clear. He wanted Derek and Addison back in Seattle. Things weren't perfect in LA but it was getting there. For a while, they sunk back into their previous patterns of pretending to be happy together. Or at least focusing on what made them happy when they were together and ignoring their problems. But they'd gotten past that now. And now, things felt pretty close to perfect for them. So, when Richard asked him if they could come back, Derek refused.

He wasn't happy about it, but he understood. Sort of. Things with him and Adele weren't great either as they were separated and had been for a while now. Eventually, it would lead to a divorce, which Richard didn't want. But he also seemed unwilling to fight for her. When Derek told Addison this part of their conversation, Addie called Richard to convince him to call Adele and work things out. Even if Adele didn't take him back, Addison convinced him that he needed to at least try. Richard took her advice and Adele, according to him, was still thinking about it. But it was a start.

With all of Seattle Grace's staffing and money problems, Richard thought Mercy West was the answer. It seemed to be the only way to keep Seattle Grace afloat. But it also meant a lot of changes were coming.

"They're laying off like half of the doctors," Addison said.

"Half? Are you sure?" Derek asked stunned. He knew layoffs were coming but he didn't think there'd be that many.

"Yeah, they just went through the first round of layoffs, and Callie's girlfriend said that they fired three-quarters of one of the residency classes," Addison explained.

"Richard told me about the merger and the layoffs, but three-quarters?" Derek asked still stunned by the sheer amount of layoffs.

"Yeah. And you know, Callie's looking for another job. I mean, she quit Seattle Grace because of Richard just for Mercy West to get bought out by Seattle Grace,"

"Wow," Derek sighed. He knew things were bad financially back in Seattle. But he didn't realize it was that bad.

"So, what's she gonna do?" Derek asked.

"Funny you should ask that," Addison said.

"What? Funny how?" Derek caught onto Addison's suspicious comment.

"Well 'cause I told her she should come out here," Addison added after a minute.

Derek's ears perked up as he saw her smiling widely back at him. He couldn't help but smile wider back.

"What'd she say?" Derek couldn't help but ask.

"She said she was looking at taking a job in Portland but since I was asking…," Addison teased, letting Derek wait a little longer for the answer. Derek tilted his head closer waiting for her to finish her sentence.

"She'd strongly consider it," Addison smiled.

"Have I told you how much I love you?" Derek teased as he walked closer to her.

"Yeah?" Addison asked coyly.

Derek then took Addison in his arms and pulled her in for a passionate kiss before picking her up to take her upstairs. After they had their fun, they called for takeout and decided to have dinner in bed. Addison told him about her cases that day as Derek talked out his problems of trying to build out St. Ambrose and its reputation. It wasn't an easy task, and they both knew that going into this. But Derek was determined to make it work. He saw real potential in St. Ambrose and the doctors he worked with were exceptional. Talking through his ideas and getting Addie's input helped him figure out what he wanted to do.

The next day, Derek came out of the scrub room after a craniotomy to find Addison waiting outside with two coffee cups in her hands.

"Hey," Derek said giving her a quick kiss before taking one of the coffees out of her hand.

"What are you doing here?" Derek asked.

"Emergency c-section," Addison replied as they both started walking arm-in-arm toward the nurse's station.

"Plus, I have some good news for you," Addison said suspiciously.

"What kind of good news?" Derek asked curiously as he went to fill in his patient's charts.

"Callie called," Addison said as she looked over his shoulder just as he finished filling out the chart.

"What'd she say?" Derek asked anxiously as he turned around to fully faced her.

"She's in," Addison smiled putting her arms around her neck.

Derek matched her smile and leaned in for a long, passionate kiss. They were like two teenagers making out in the hospital. It could've been anything. Something about the adoption, her family, the hospital. Anything. Derek was hoping it was something about the adoption, especially since they hadn't gotten any news for months. They almost got a baby last time but the birth mother chose someone else. And it was heartbreaking. But it didn't deter them from still wanting a baby. The news about Callie, however, was still good news. Plus, he knew it'd make Addison happy to have another friendly face around.

"You coulda at least gone into an on-call room or somethin', you know?" Charlotte said catching the two kissing.

"It's nice to see you too, Charlotte," Addison said giggling.

"Plus, you'd be kissing me too if you knew what she just told me," Derek joked.

"I might be kinky but I don't need to know what you two do behind closed doors," Charlotte joked laughing along.

"No, I mean, Addie got us an ortho attending," Derek laughed.

"What do you mean?" Charlotte asked, now intrigued by what the neurosurgeon had to say.

"Our friend, Callie Torres, is coming to work here at St. Ambrose," Addison filled her in.

"And she's a great orthopedic surgeon," Derek added.

"And in high demand," Addison added.

"What do you mean by in high demand?" Charlotte asked suspiciously.

"She's the one everyone called when they needed an ortho resident at Seattle Grace," Derek explained.

"Alright," Charlotte said impressed.

"So, now we have a new neuro, plastics, and ortho," Charlotte gathered.

"Yup," Derek said, proud of the progress they were making.

They still had a long way to go in terms of great surgical attendings, but they were in a good place. They already had a few great attendings that Derek knew would take St. Ambrose to the next level. Other than just Derek, Mark, Charlotte, and now Callie, they had plenty of great ER/trauma doctors on staff as well as some other great attendings like general surgeon Dr. Allison Hernandez, trauma surgeon Dr. Joseph Amari, perinatologist and neonatologist Dr. Vanessa Hoyt, and many more. Callie would make the perfect addition.

After that, Charlotte's pager started going off. With that, Derek and Addison followed her to the ER to check out what was going on. Addison didn't officially work at St. Ambrose but she was always intrigued by the ER. And today of all days, it was a good thing she followed them because Charlotte needed an OB anyway.

"It hurts," The young female patient exclaimed, holding onto her pregnant belly.

"That's because you're in labor sweetheart," Charlotte said gathering the information from the residents.

Apparently, this teenager was heading toward the hospital already. And she had a contraction that caused her to collapse right as she was getting closer to the doors. Again, Addison didn't directly work for St. Ambrose but Oceanside Wellness still worked with the hospital on a regular basis. So, she didn't mind lending a hand whenever she could.

"Montgomery, we could use your help," Charlotte said gesturing for her to come over.

"Hi there, I'm Dr. Montgomery," Addison said after she reached the patient on a gurney.

"I need an ultrasound, please," Addison said referring to the residents around her.

"What's your name, 'hon?" Charlotte asked as Addison set up the ultrasound.

"Um…Riley," the girl said, her hands clutching onto the sides of the gurney.

"Riley, do you have someone we can call?" Charlotte asked.

"No," Riley said. This teenage girl was alone. No baby daddy, no parents. And clearly scared. Both Charlotte and Addison couldn't help but sympathize with her.

"Alright, Riley, this is gonna be a little cold but we're just gonna check on the baby," Addison said gently. After checking the baby, they saw that Riley was in labor. However, it'd still be hours before delivery.

"Riley, we're gonna get you into a room and you're gonna have this baby, okay?" Addison said as everyone started wheeling her towards a private room.

"But I'm not…I can't do this. I'm not ready," Riley said.

"Yes, you can," Addison reassured her.

"We've got you," Addison added as they got into the hospital room.

After that, Addison called Dell to come down to help with the delivery. She'd gotten used to having him around and he was turning out to be a great midwife. And he loved getting to assist in more deliveries, and not just because of the hours. He learned a lot from Addison and while he had a thing for Naomi for a long time, even he had to admit that Addison's cases were usually much more interesting. And he learned a lot more that way.

"Riley, this is Dell, he's just gonna take a look, alright?" Addison asked gently once Dell got to the room wearing a pair of blue scrubs.

OBs usually wore pink ones but Dell asked if he could wear the same ones as the rest of the medical residents. Considering how helpful he was in getting the practice back into the green, Addison convinced Charlotte to let him wear them.

Riley still had some time before she could push, so Addison and Dell spent the day checking on her in intervals. She kept trying to insist she was fine and she even tried to leave St. Ambrose a few times. But she never got far. She was worried about how she'd pay for everything but Charlotte reassured her that it was taken care of. She got in touch with a social worker and they had a conversation that was enough to calm her.

In between checking on her, Addison helped Dell study for his midwifery classes. Plus, he hadn't told anyone yet, but Dell was applying to med school. And Addison happily wrote him a recommendation letter, one that she hadn't given him yet. Mostly because his application wasn't finished just yet. Plus, she wanted to surprise him because he had no idea she was writing him one. Dell had his sights on UCLA so that he could still live close by and he wouldn't have to uproot his life with his daughter, Betsey.

Speaking of Betsey, the rest of the practice finally met her a few months back when his regular sitter came down with the flu. To Addison's (and later Derek's) surprise, no one even knew he had a daughter. The rest of the doctors at the practice had worked with Dell for years and yet no one had any idea. He told everyone how his high school girlfriend, Heather, got pregnant when he was 17. Then, they tried to make it work, with a baby girl and school, but Heather's addiction got the better of her. She OD'd when Betsey was only two.

After that, Dell applied to any and every job he could to support his daughter. Then, he found Oceanside Wellness. He wanted to get into the medical field anyway and the fact that he found Naomi attractive was a definite plus. And the job paid him well enough to only need one job as opposed to two. With a flexible schedule on top of that, Dell could work, get some midwifery hours in, and still see his daughter when he came home at the end of the night.

Later that afternoon, Addison and Dell's patient, Riley, finally reached ten centimeters, meaning it was finally time for her to start pushing. About halfway through, Riley kept pushing as she was told but something was wrong.

"Addison," Dell said gesturing to her to look at Riley's progress.

"What? What's wrong?" Riley asked panicking.

"Everything's alright, your baby's shoulder is just a little stuck so I'm gonna need to free his shoulder," Addison said calmly.

"He's stuck?!" The woman exclaimed.

"How are you gonna get him out? Do you have to like, yank him or something?" The girl asked clearly distraught.

"No, no, we're not going to yank him out," Addison said trying to keep her tone as calm and professional as possible.

In all honesty, the question humored her. And disturbed her just slightly. But I guess silly questions like that were expected when trying to get a 16-year-old girl through labor.

"How are you gonna get him if he's stuck?" Riley asked panting from exhaustion.

"I'm gonna push down hard on your belly while you push and it'll free his shoulder," Addison explained moving over to her side.

"Yeah, it's called the wood screw maneuver," Dell added. Addison couldn't help but smile hearing Dell say the correct term. He really had been studying hard and putting the work in.

"But he'll be okay?" Riley asked.

"Yes," Addison confirmed.

She decided it wouldn't be the best idea to tell her right now that it could crack or even break the baby's clavicle. But this wasn't Addison's first case of doing the wood screw maneuver. It was, however, Dell's first time. He'd seen it done in instructional videos and through textbook readings. But seeing and assisting in the real thing was different.

"Alright, I'm gonna need you to really bear down and push for us, okay?" Addison coached her patient as she gestured for Dell to move over to catch the baby.

"Okay," Their patient said as she proceeded to push as hard as she could.

Addison pushed down hard on their patient's belly as the girl continued pushing. She screamed out in agony as both women pushed. After a few more, they heard the baby cry as Dell got him out.

"Is he okay?" The girl asked out of breath.

"He's great," Dell said smiling as he cut the umbilical cord and started cleaning up the baby. As he did, the baby's cries started to subside.

"You did great, Riley," Addison said as she helped Dell check on the baby.

"Is he okay?" Dell asked quietly. He didn't want to worry Riley.

"He's fine," Addison said after checking the baby. His clavicle might be a bit cracked but he'd be fine. Babies heal fast.

With Addison spending her day at St. Ambrose for a change, Derek and Addison decided to go out for dinner tonight. It'd been a while since they had a proper date night out. There was this new sushi restaurant out on the marina that Addison mentioned seeing in the newspaper once so that's where they went. As they were leaving the restaurant, Addison got a call from Callie.

"Hey, what's up," Addison answered the phone as Derek grabbed her coat hanging on her seat.

"Hey, you remember that girl, Arizona, that I told you about?" Callie asked.

"You mean, your girlfriend?" Addison asked teasingly.

"Yes, my girlfriend," Callie laughed back.

"She wants me to stay at Seattle Grace with her, but I don't think I can. Not after what happened with Richard. And it's like a bomb's about to drop here," Callie added referring to the upcoming Mercy West merger.

"Well, you know, Derek's been looking for more surgeons to add to his list of attendings," Addison teased.

"...Any chance he's looking for a peds surgeon?" Callie asked almost jokingly. It'd be great for both of them to work in LA with Derek and Addison. But it was a lot to ask.

"I'm sure he'd love to bring on a great peds surgeon," Addison said, making sure Derek heard her.

"Yes, a hundred percent yes," Derek took the phone out of her hand. Addison just laughed in response happy to see how excited he was.

"Are you serious?" Callie asked, well aware it was Derek at the other end now. She didn't think either of them would take her seriously.

"Yes," Derek said.

"If you're saying she's good, I trust your judgment," Derek continued.

"And we really need you and a great peds surgeon," Derek added.

"She's great. One of the best. She did her residency at John Hopkins and was doing her surgical fellowship here…," Callie started listing her qualifications.

"I get it," Derek stopped her chuckling.

"She sounds great. And we would love to have her here," Derek said.

"Really?" Callie asked excitedly.

"Yes, just get your asses down here," Derek joked. After that, Addison took her phone back.

"Oh my God, you're the best!" Callie exclaimed

"I know," Addison joked. Callie laughed along after realizing her friend took her phone back from her husband. But Derek was still close enough to hear the conversation in full.

"I don't know how to thank you guys," Callie said.

"Just say yes to a double date and you can consider us even," Addison added as Derek hugged her tightly in excitement while she kept the phone up to her ear.

"You've got yourself a deal!" Callie said as she started happy dancing in her apartment.

"Alright, I'll talk to you later," Addison laughed before they said their goodbyes.

"You really are the best," Derek said, pulling his wife closer to him.

Addison closed the gap between him and kissed him sweetly. After that, they left the restaurant and went home. Addison barely even got into the front door before Derek swept her up and carried her up to their bedroom. Everything was finally falling into place.

Prospects of St. Ambrose being a more reputable hospital were really shaping up and it was really a team effort. And Derek and Addison were on the same page when it came to their desires to grow their family. They were still getting restless about the waiting game of the adoption process, but both believed they'd get their baby. They'd just have to wait a little bit longer to get everything they wanted.

A/N: So, this chapter was more about Derek's progress at St. Ambrose and stuff about Dell as well. I always hated the fact that the writers wrote him off the show and said it was because they couldn't think of stories to write for him. So, I used some of what was in Private Practice but changed stuff about Heather and gave him a bit of a richer back story. If it wasn't already clear, I'm not writing him off in this fic so he's gonna stick around. And I promise that Derek and Addison will get their baby in the next chapter and I'm very excited about how it happens. Hopefully, you like it too and I can't wait for you all to read it.