"Shep! Come on in!" Richard Webber calls.
Derek enters the office of the Chief of Surgery at Seattle Grace, having been summoned only minutes ago.
Part of him is slightly worried as to why he's been called up, and he takes it as a good sign that he doesn't remember killing anyone lately. Though, as a new transfer as Head or Neuro to this hospital, he has no clue what this meeting could be about.
"Please, have a seat." Richard beckons to a chair across the desk from him, and Derek obeys.
"What can I do for you, Richard?" He asks, settling into the chair and hoping he's appearing more confident than he feels.
"I have an old friend," The older man starts, removing his glasses and setting them on a stack of papers on his desk. "Her daughter has served seven years overseas as a trauma surgeon for the military. First the Navy I believe, then Marines."
Derek nods, impressed. "She?"
"Colonel Dr. Meredith Grey. You heard the name?"
Derek's eyes widen. "The Meredith Grey? Are you kidding? Everyone's heard her name. Ellis Grey's daughter, right?"
"That's her. Just two days ago the Iraqi bombed Kirkuk, where she and her entire medical team were stationed. Colonel Grey was critically injured."
"Oh, is she alive?"
"Yes, she's alive. But the field hospital she's been flown to in Germany can only do so much. They got her stable, but she needs better treatment and doctors they just don't have access to over there."
"Of course." Derek nods, suddenly intrigued by where this is going.
"We're flying her here. To receive treatment from the doctors here, because we have the best."
"Are you calling all the department heads into your office to tell them this?"
"No. Colonel Grey has a major spinal trauma. She was impaled through and through her abdomen with a large piece of shrapnel." Richard studies Derek for a moment before continuing. "I want you to make sure she walks again."
"With all due respect Richard, you know I can't promise anything. Especially with injures like these I-"
"I know, I know. This is important, Derek. She's saved thousands of soldiers' lives and risked her own for the greater good. I knew her as a child. Do everything you possibly can to get her on her own two feet."
Derek sighs. "I will, I always do. But you can't get your hopes up, I haven't even seen the scans."
"Oh! Thanks for reminding me, the German hospital sent over what they had, which isn't much. They're short on everything." Richard shuffles through some papers on his desk before pulling out an envelope and handing it to Derek. "She got back into the US earlier today and they're airlifting her here in two hours."
Derek nods, taking the hint of dismissal and leaving the office. He heads towards the viewing room to put the scans up, joined by Dr. Callie Torres, Head of Ortho and one of his friends, not a minute later.
"I just heard some gossip that Richard fired you." She says, walking into the room and shutting the door behind her. "Is it true?"
Derek chuckles, not turning to face Callie. Instead, all his attention is focused on the spinal MRI and CT scans.
"No. Just a VIP patient."
Callie comes up next to him. "Shit." She breathes, looking at the scans. "This the patient?"
"Colonel Dr. Meredith Grey."
"Shut up, the Meredith Grey?"
"That's the one."
"Oh my god, the poor woman." Callie shakes her head for a second, then grows excited. "What happened? Can I get in on the surgery?"
"I'll need your hands for sure." Derek chuckles. Surgeons get excited about what anyone else would view as horrible.
"Yes!" She exclaims. "When does she get here? You should page trauma or general too, who knows what else we'll find when we get in here."
"Two hours. Can you get Bailey? There's more than just spinal scans here."
Without another word, Callie disappears, and almost an hour later three surgeons sit in the viewing room arguing about the course of treatment when the door opens, and Dr. April Kepner bursts in.
"Did I hear you all are operating on Colonel Grey?" She asks, coming over to look at the scans. April is not as surprised by the other doctors by the looks of the injuries, being a trauma attending herself.
"Yeah, she'll be here soon."
"I served under her. My tour last year in Afghanistan. She's incredible."
"I thought she was in Iraq?" Derek cuts in.
"She's been everywhere." April shrugs. "I can't believe they would bomb medical tents." The redhead shakes her head. "Makes me think about how lucky I was to get out of there alright."
The room falls quiet, each person wondering what it had been like for this heroic woman.
"You don't happen to need another pair of hands, do you?" April asks suddenly.
"Is it a conflict of interests for you to operate on the Colonel?" Bailey casts April a side look.
"No, it's not. I operated on Webber all those years ago, remember?" Derek answers the question. Probably five or so years ago, Derek had been in Seattle when Richard was diagnosed with a brain tumor, and Derek had removed it before returning to his practice in New York.
"I think we'll be okay for now, but if we need a pair of trauma hands with your experience we'll definitely page you," Callie tells the younger attending. April nods and exits the room.
Derek turns back to the spinal scans, addressing the other surgeons. "We'll get new scans when she gets here before we go in to see if anything's changed, but we need to have a rough plan ready."
"I think the spine should be addressed first. You and I can remove that shrapnel and fuse the fractured vertebrae." Callie moves to stand next to him.
The scan shows not only that whoever operated in the field failed to remove a piece of shrapnel which is now lodged in T11, T12, and L1. There are blood clots all along the lower thoracic and lumbar nerves. With a 3D MRI, they'll be able to tell how extensive the nerve and blood vessel damage is.
"God, that's got to hurt," Callie murmurs, her eyes not leaving the scan.
"We can't forget that they just had her open on the table a day ago. Who knows how strong she's going to be or how long she'll last in another extensive surgery." Bailey says.
"You're right, let's have cardio on standby." Derek nods.
"We shouldn't do this all in one surgery unless we have to." Bailey continues. "The spine looks more urgent if we want her to have full use of all her limbs."
"So we do spinal repairs today and finish the abdominal repairs after a day or two of rest. We'll keep her in a coma while she regains strength." Derek agrees.
As if on cue, all three of their pagers go off and the doctors all check their hips. Incoming.
"Let's get to the helipad," Derek says, and the surgeons take off.
On the roof, it's raining and Richard is already waiting as a helicopter quickly approaches.
"Are you all ready?" The chief shouts over the loud sounds of the chopper. They all hold their hands above their heads, trying to shield themselves from some of the rain.
"Yes sir." The surgeons chorus as the helicopter lands and two men hop out, unloading a stretcher.
"Female age thirty-eight, open abdominal-" One man starts.
"We got it from here!" Derek tells, effectively cutting him off. Richard steps near Meredith's head, Derek on the other side as they start moving her towards the elevator.
"Wait," Her voice is hoarse and quiet as she pulls the oxygen mask off her face. All four surgeons are shocked she's awake but stop in their tracks. She smiles, closing her eyes as the rain falls. "It's raining. You know how long it's been since I've seen rain? Hell of a circumstance to finally feel it again."
"Colonel, we have to get you inside before-" Callie starts, trying to shield the rest of the injured woman's body from the rain.
"I know, I know. I'm not trying to die so let's move. You'll let me experience the water again soon, right? It is Seattle after all, rains twenty-four-seven." She talks as they get into the elevator, dripping wet.
They all fall silent as Meredith closes her eyes again. Despite being doped to the high heavens, she can't move her body chest-down without feeling like she's going to explode.
The elevator begins to move, and she studies one of the men above her, frowning. "Richard?"
The man smiles, "I'm surprised you remember me, Colonel."
"Honestly, so am I. Big head trauma." She smirks weakly. "You're getting new scans, I presume?"
"Yes ma'am." Derek answers quickly.
"Get a head CT too. The field hospitals don't have that kind of equipment and I'm ninety-nine percent sure I've got an epidural hematoma."
"We will," Derek assures her.
She glances at him, her vision blurring. "Derek Shepherd, right?" She breathes.
"That's me."
"Neurosurgeon with the biggest ego in existence. Try not to screw up my brain when you're in there."
Derek is taken aback by his patient, and the other surgeons in the elevator muffle laughs.
"People talk." Meredith shrugs, forcing herself to hold back her own laugh, because she knows how freakin' bad it would hurt.
"I hope you know I'm good at what I do, then. I won't let you die."
Meredith scoffs. "I'm pretty damn hard to kill, clearly. I'd like to see you try."
Derek smiles, shaking his head.
Her gaze turns thoughtful. "If you do kill me, don't doubt for a second I'll be back to haunt you."
This causes everyone to laugh again as the elevator doors open. They move her gurney through the halls to the MRI machine, transferring her into the machine.
Meredith holds back pained groans as she moves. Getting impaled with a piece of shrapnel half the size of her own body is not fun.
She sits quietly in the machine, wishing herself anywhere but there. In the viewing room, her three surgeons sit at the desk, waiting for the scans as Richard leans against the doorway. Suddenly, they're interrupted by footsteps and another surgeon bursting through the doors.
"Why the hell did no one think to tell me Meredith was here?" Cristina Yang, Head of Cardio demands.
"First name basis?" Callie looks at the other attending quizzically.
"Karev and I both know her! She did her residency at Hopkins with me and we all did our fellowships together. God, that was like, seven years ago." Cristina stares in through the glass. The other surgeons exchange confused looks.
"You and Alex never thought to mention you practically grew up with Colonel Grey?" Bailey cuts in.
"You never asked." The Asian woman shrugs. "How is she?"
"Scans are up," Bailey announces, and multiple people crowd around the screens.
"She's getting worse, we need to open her up." Derek stands. "It a miracle she's stable and conscious right now."
"What about the CT?" Callie cuts in. Derek hesitates, debating.
"Yang, go make sure CT is clear, kick out whoever's in it. Let's move her as fast as we can. Head, spinal and abdominal scans?" Derek glances at Bailey, who nods and Cristina is off.
Worry builds in the pit of Cristina's stomach. She and Meredith have kept in contact some the past few years, but that doesn't matter. Neither of them would have survived internship and residency without the other, and that's not an easily breakable bond.
The doctors rush into the room, quickly transferring Meredith back to the gurney and up to CT.
Part of Derek told him to skip the CT, as there's not enough time. But he wasn't going to risk it, he's smart enough to not let his own concerns get in the way of what's best for his patient.
Also, Colonel Grey is an award-winning, experienced military surgeon. He's not going to make a stupid error and kill her.
Meredith picks up on the anxiousness and intensity of the doctors around her. When they get her to CT, she sighs, knowing the intercom is on.
"How bad is it?" She rasps, already feeling weaker. When there's no answer, she tries to use her sharper voice. "I'm no stranger to bad news. How bad is it?" Still no answer. No one wants to tell her, meaning she's probably going to die. Great. "If I don't get an answer in ten seconds I'm walking out of here and into that room to see the scans myself."
She has no doubt that she would not make it two feet if she tried to move, but her well-practiced commanding military voice and reputation precede her, and she finally gets an answer.
"You were right, epidural hematoma. I'll do a craniotomy first." Derek speaks, watching the scans. "Dr. Bailey is going to repair your abdominal damage at the same time."
"I'm going to do my best to save your kidney but it doesn't look too good. You'll need a partial colectomy and a pancreatectomy." Bailey continues, deciding her plan as she looks at the scans.
"That's all we'll do for today. We're going to keep you open in a medically induced coma so you can regain some strength before I go back in with Dr. Torres to see what we can do about your spine." Derek finishes.
He had discussed this change in plans with the other surgeons around him. If they wait any longer to do the craniotomy they risk permanent brain damage and possible brain death. They can't do a spinal surgery right afterward, so abdominal repairs will be done at the same time. Meaning, her spine is going to have to wait.
"Have cardio on standby." Meredith orders as they pull her out of the machine. Who knows what kind of damage there is to her aorta and lungs.
"Cardio's right here, Mer." Cristina comes into the room, meeting the weak gaze of her friend. Recognition flashes in Meredith's eyes.
"Cristina." She smiles widely. "Don't let me die."
"Never."
"How's Alex?" She continues trying to talk, knowing these could very well be her last conscious moments.
"Good. He's the Head of Peds. When you wake up we'll both be here. I promise."
The other doctors join them, transferring her to a gurney and starting to prep her for surgery. Meredith's tough, sarcastic exterior begins to crumble as she feels herself getting weaker. But somehow, she manages to find Derek's gaze.
"I have to be able to walk. Whatever you have to do. I have to walk again." She uses the last bits of her energy to make sure her voice is firm, and Derek only nods.
She knows it's unfair to ask him this, as a fellow surgeon she knows how difficult of a spot it puts them in, but at this point, she doesn't care. This is her life, her career, everything she's worked towards her entire life. She needs her legs.