Chapter 5

Trauma is messy. Chaotic.

Looking at a body that's been reduced to a bloody pulp, it might seem difficult to know where to start. Luckily, some very clever person developed a protocol: the ABCs. Airway, breathing, circulation. The ABCs keep your patient alive so you can figure out how to tackle the rest of the mess.

If only all of life's problems could be solved with an intubation tube. The ABCs of trauma are a handy tool for keeping a patient alive, but they're only a starting point.

Once the patient's airway, breathing, and circulation are all clear and accounted for, the real work begins.

The messy work.

There's no telling how long it's gonna take to clean up that chaos once you've begun, because sometimes, you don't know what you're in for. You don't know exactly what you're about to face. You don't know what secrets the body in front of you holds and whether, by the time it's all over, if there's anything left worth saving. Meredith Grey; Don't Let's Start

Meredith was now sitting fallen together on the floor and stared at the wall, even though Amelia and Maggie who had joined them 'cause she wanted to be there for Mer, were pretty sure that she didn´t see the wall at all.

She just stared through it. "This can't be happening." She whispered quietly. She didn't want to believe it. But she was glad that they treated him here and in some lame-ass hospital at the end of the freaking world. The surgeons at Grey Sloan Memorial, they knew how to treat patients, when to do a head scan to rule out intracranial hemorrhage. Why was all of this happening? They were supposed to get their happily ever after.

They were finally happy, Derek was resigning and Meredith pregnant.

He wanted another baby. He said it himself that he wanted another baby with her. What if he won't be alive to see this baby grow up? Meredith shook her head in denial. This can't be their end, they just figured it all out. "We just got back together, we were happy with how things were. He was going to hand in his letter of resignation and then come back. He promised he would and now there is the chance that he might be gone …"

Meredith stared at the wall as she tells them this. Amelia was nervous too, she doesn't want to lose her brother. He was her rock when their father died. He saved her when she overdosed and right now she could do nothing but wait how things will turn out. "He has to survive." Meredith murmured, running her hands through her hair. Amelia nodded, staring at the clock.

"And he will." Maggie told them, keeping up a positive attitude. "But we still haven't heard from them and the surgery's going long." Meredith was on the verge of freaking out. "That the surgery's going long is a good sign, Mer." Maggie said.

"It means they can actually work. It would have been worse when it isn't going long. So they take the time to be thorough and not miss something." Meredith nodded quickly, then closing her eyes and inhaled and exhaled deeply in order to calm her nerves down. She was just so worried about Derek. What are the odds of him being still alive? Odds were normally against them.

After all the disaster they've lived through – shootings, plane crashes, earthquakes, ferryboat accidents, bombs in body cavities, storms including power outage, car crashes, ambulance crashes … it goes on.

What are the odds of Derek surviving this?

She hoped he would, she can't imagine living without him.

"So Bailey and Owen got him. He's in good hands, being taken care of." Maggie said, trying to give her hope.

"Yeah." Meredith said, then she turned over to Amelia who had been quiet the whole time they have been waiting. This was killing her. "Amelia, you have seen his head scans, right?" She wanted to be assured by her sister in law. Amelia didn't react at first. "Amelia." Meredith repeated a bit louder and nudged her husband's sister gently in the arm. "Uh, yeah, what did you say?"

Then Maggie Pierce, she wanted to go over to Meredith and Amelia, heard her pager beeping.

She looked at it and made a dash for the operating room. "I knew there would be complications." Meredith couldn't, didn't want to believe this was really happening. "You don't know." "In my life, the bad things always happen." Meredith replied.

"Yeah, you can say that." Amelia nodded in reply. Suddenly, Meredith wasn't feeling very well.

"Amelia … I …" Meredith stammered as the room goes blurry, immediately Amelia's attention was on her sister in law.

Meredith felt like she was falling. She heard Amelia screaming her name, but it seemed so far away and she just couldn't take it anymore. Then, blackness surrounded her... Amelia saw her sister in law´s struggle to breathe. "Meredith?" She asked worriedly. Meredith didn´t seem to hear her. "What, Mer, are you okay? Meredith ..." She couldn´t even finish her sentence before Meredith was falling.

Instantly she screamed her name. But before Meredith could even attempt to answer, she was losing consciousness. Amelia watched the whole scene shocked, this couldn't be happening. First Derek and now Meredith?

Could this situation be any more cruel than it already was?

"She's lost consciousness. Damn it, what the hell is going on?" Amelia called out as she watched Meredith passing out.

She began taking over commands, when she couldn't save Derek because she was family, then she needed to make sure that Meredith was okay. He'd want her to do that. Amelia was not able to think straight but she forced herself to think, to recall medical things in order to help Meredith, she looked around hectically seeing Jo Wilson talking to someone she doesn't know.

Her brother's wife was laying there on the ground and Derek, her Meredith love of her life, was in surgery or worse, wait, she didn´t know what his condition is. "Let´s move, People. Wilson, come over. I need a little help here." Dr. Amelia Shepherd ordered Jo Wilson who came over after noticing what was going on.

"Come on, Grey. Don´t do this now." Of course Meredith couldn´t hear her in the state she was in.

"We need to run her labs now. I knew we should have just done the consult." Amelia muttered under her breath as she puts Meredith in stable side position to protect her airway. As if Derek being in a serious, life-threatening accident and him currently being operated on was not enough, no there has to something else that goes wrong as well and of course it's Meredith. "Get me a gurney now." Amelia commanded. "Wilson, come with me." She then ordered. "Oh my god, what happened to her?" She exclaimed as she Meredith lying there.

"We need to do some more research and tests on that matter." Amelia shortly replied.

"Okay." She was trying to sort out her thoughts, looking at the unconscious figure lying there.

"And someone get me a monitor stat." She called. After she took her blood she sent it to the lab, telling Jo to put a rush on it. She also put an IV access in so that she can administer fluids since she's pretty sure the cause is dehydration.

"Let´s get her hooked up to an IV and fluids. I am sure she is dehydrated. Damn, I should have thought about that in the first place. God, I am a doctor. A freaking doctor and didn´t thought about that?"

Because of Derek and the situation he was in ...

Maggie already feared the worst when she was running toward the operating rooms, heading for OR 1.

She was pushing open the door to the scrub room, already hearing the hysterical beeping of the cardiac monitors. She quickly scrubbed in, then entering the OR and asked Bailey to fill her in on Derek's current state. "Can I get a quick update, please?" Bailey looked up from her patient, we've fixed the abdominal bleeders but he's unstable. We think there might be something wrong with his heart other than the presumed cardiac contusion." Maggie nodded.

"Should we crack his chest or …" Bailey waited for Maggie to tell them how to proceed.

"Prep for sternotomy, I need the visibility."

The monitor was still beeping loudly. There was a lot of blood after Maggie did the first cut. Apparently, there was a tear or something in the heart, luckily, it was the right ventricle and not the left.

"Whoa, we need to work fast." She said as she sees the damage that has been done.

They waited impatiently for the results to come back. Meredith still hasn't regained consciousness and they were starting to get worried. "Are there any news from Derek?" Amelia suddenly asked.

"How is he doing, nobody has given us an update on him." Jo looked over to Amelia, then she said: "I'll go check." With that she left the room.

Now Amelia was alone with Meredith.

Then the labs came back. "We have the lab results …" Stephanie Edwards said as she entered the room, Amelia glanced up and was walking toward her, grabbing the results. As she read through them, her eyes went wide and she looked over to Meredith. This wasn't what she had expected. "She's pregnant?" She asked as she stumbled over the line with the elevated HCG levels.

"Every kiss before the right kiss doesn't count anyway. I've kissed a lot of women. The first time I kissed my wife, well... I mean, she wasn't my wife then. She was just this girl in a bar. And when we kissed, it... it was like... I gotta tell you, it was like I never kissed any other woman before. It was like the first kiss. The right kiss." Derek told them, they were all listening except Charlie who was only semi-conscious.

"It's so good to be back." Derek said, inhaling deeply before taking a sip of coffee and then he made his way to the door, he was sure that he was coming back to live with Meredith and the kids. "I'll be back before you know it." Derek told Meredith.

"It's time." Meredith just watched the neurosurgeon, a happy smile covering her face.

She couldn't actually believe that Derek was actually resigning. She couldn't believe that he was actually giving up the job in D.C. Finally, he gets it that it's just a job and that a job doesn't matter when he can't be with his family. So giving up the job is pretty minor in comparison to what he has in Seattle.

Derek smiled back at his wife. They were really happy now. He was happy and the kids were happy and Meredith was happy. And it was actually okay to have his sister as his boss. It really was. Meredith followed her husband to the door, he was leaving for D.C., he has a plane to catch. Maybe it'll be delayed or something because he was running late.

"I don't know, I just feel like I just got you back and now you're leaving again and …" She kinda starts to ramble. Derek turned around, he can't leave before saying actually goodbye. What if something happens to him? He wants to have a very good moment with her before he actually needs to leave. "And I just have to stay here." She completed her sentence, looking at him with her blue eyes.

"You do, you have to stay here." Derek told her, smirking at her for a second. "Stay here. Stay here. Wait for me." He said dreamily. Meredith was lost in his eyes.

She didn't want him to leave but she knows he has to in order to really come back. "Don't move. Wait for me." He repeated, his eyes were saying 'I wish I could stay now, being here spending the day with you and the kids'. But he knew this wasn't possible. Then he just kissed her, he leaned forward and their lips touched. For a moment, their world stopped and they just enjoyed this moment. After what feels like a second (she really wanted it to be an eternity) Derek broke the kiss.

"I'll be back before you know it."

Funny, isn't it? The way memory works? The things you can't quite remember, and the things you can never forget.

The carousel never stops turning. Then she watched Derek leave. He went over to his car, started it and drove off. He was going to the ferry slot, he wanted to take a ride with the ferry. He loved ferryboats and that was the quickest way over the water.

In the meantime, Meredith was getting the kids ready. She had to work today. In this moment, her phone started ringing. But it appeared that she hasn't been able to hear it.

"Okay, Zozo." Meredith said, she was being happy.

"You have to move a little faster 'cause we are late." She told her daughter, she already had Bailey on her arm, she was only waiting for Zola. "And who can never be late?" She asked. "Surgeons." Zola answered in a sweet voice. "That's right. What happens if surgeons are late?" Meredith asked her. "People die." This was so foreshadowing Derek's car accident.

"Right on, sister." Meredith answered and walked to the door. She didn't hear the ringing of her phone. She'd later curse herself for not hearing the phone. It was Derek calling.

But she didn't know because she didn't hear the phone.

Then she left their house with the children to work. "Hey." Derek was standing there, looking out of the Sound and had a cell phone pressed against his ear. He was calling Meredith but she didn't pick up the phone. "It's me. I'm on …" He continued. It was a bit windy. "I'm on the ferry. I just wanted to say that I love you." He completed. But when he got off of the ferryboat, he was in the middle of a damned traffic jam.

He is so missing his flight, he was sure of that. But then he remembered the shortcut and had an idea.

While changing the lanes, he turned on the radio. Soon the traffic was behind him and he was on his way to the airport … without being stuck in the traffic, which was a huge relief.

"And also dehydrated." Amelia added. "We might want to page someone from OB to get her and the baby checked out, I don't want to take chances. "Hm, I'll page them right away." At the same time she made the pager call. Now they waited for some doctor from gynie squad to let her get checked out.

After a while, Meredith slowly regained consciousness. "What happened?" She asked. She noticed that she has an IV access on her hand. Cristina flinched at her words. "Grey. You are awake." Dr. Bailey saved her from explaining. "Can you remember what happened?" Meredith thought. Then her face expression changed. "Derek." Sheer terror plastered on her face.

"The accident... God... no..." Meredith exclaimed breathing heavily. Amelia saw the scene concerned, knowing that this wasn't good for the baby. "Meredith." She said loudly, trying to calm her down, since it wasn't good for the baby. "Where's Derek?" Meredith asked as she sat up abruptly. "Stop, don't do this, Meredith." "What I have to see Derek, he's …" Meredith got out.

"No, you've nothing to do but to take care of yourself. You're pregnant, I've seen it on the labs and I paged someone down from OB to get you checked out." "What? No, I don't need an ultrasound, I'm fine." Meredith tried to tell her but of course Amelia didn't believe her, why should she when Meredith passed out after Maggie got paged to Derek's surgery.

"You really want to go there? Because everyone in this room knows this is a lie. My brother and your husband is currently being operated on by skilled surgeons but still I am worried about him. He's my only brother … and I don't want to lose him." "You won't." Meredith suddenly said, apparently taking a leap of faith. She needed to believe in Derek and the surgeons who worked on him.

"But you also need to take care of yourself and the little one." Amelia reminded her.

Suddenly, Meredith started tearing up with no obvious reason besides Derek's disastrous car accident.

Amelia thought it were the hormones that were kicking in.

With tears in her eyes Meredith looked up at Amelia.

"I'm pregnant, Amelia. He's going to be a father again, we're going to be parents for another little baby. Zola and Bailey get another sibling." Meredith panicked, realizing that her and Derek's unborn baby would never meet his or her daddy if he died. This seemed unimaginable. Life without Derek seemed unimaginable. She'd said she can live without him but that doesn't mean she ever wants to. She doesn't want to live without with him. Amelia stared at her, she knew it, she'd seen the lab results.

Meredith was pregnant, again. She was going to be an aunt again.

And now she was telling her about it, which meant she knew about the baby before. "You're …" Amelia asked, wanted to make sure she heard everything right. "Yeah, I am." Meredith confirmed her question.

"That's explaining you throwing up." Amelia concluded, relieved that at least Meredith being *sick* was sorted out. Now there was just the constant worry about Derek. Meredith nodded. "We talked about it." She said after a while, tentatively.

"About what?" Amelia asked, knowing that this was kind of a sensitive topic. Amelia glanced at her sister in law.

"About having more kids, and now he's potentially dying. That's so unfair, that there are no words to actually describe it." Meredith told her, confiding in Amelia. "It's unfair." Amelia said, then reaching for Meredith's hand and pressed it slightly. Meredith tossed her a thankful glance. Then the door opened it and the resident from OB entered it.

"You paged?" She asked, her glance wandered from Amelia to Meredith, immediately knowing who the patient is.

"She needs you to do an ultrasound. She passed out, we think it's due to stress and dehydration (that's what the IV is supposed to treat) but since the labs showed that she's pregnant, we …"

Meredith cut her off: "We want to know if my and Derek's baby's okay."

The resident nodded and started prepping for the ultrasound. While she does that she asked Meredith where her husband is: "Where is your husband, does he work here too?" "Yeah, he does but you can't page him since he's in OR 1 being operated on which is the reason for me passing out." Meredith explained. "He's been an accident." Amelia added. "And you are?" "The father's brother. I'm related, if that's your question."

"She really is." Meredith wanted to get her mind of Derek and her getting an ultrasound works pretty good.

"Can we start?" She urged. "I want to see Derek's and my baby."

"Yeah, of course we can. It's getting cold now." She warned as she pressed the gel on Meredith's abdomen who turned her head to see the screen. "Maybe we can even hear the heartbeat, or is it too early for that?" Meredith asked, she really wanted to hear the baby's heartbeat, as sort of a comforter with Derek still being in the OR.

"See that is your baby." The resident said, while pointing at the computer screen. It was very small but it was there. "It's about three weeks." On Meredith's face could a small hint of a smile be seen. "He should be here for this. I can't do this alone, Amelia, I can't." "You don't have to do it alone, Mer." She just said, she was sure Derek would survive. After telling them that everything looked good, the resident asked Meredith if she wanted to have a picture of her baby. She only nodded.

"Here you go." She smiled.

"Page me if there are any problems."

Then she exited the door, leaving Meredith and Amelia in the room. Meredith was staring at the ultrasound image, Amelia was watching her: "Hey, it's going to be okay." She said. "You don't know what is and what will be happening. You don't know." Meredith said, not taking her eyes off of the picture.

There was desperation in her voice, the fear of losing Derek was clearly there. What if they were calling time of death right now? Meredith shuddered slightly, she didn't want to think of that possibility. "I know. I know. I've been through this." Meredith looked up. She had said been through this, hadn't she? She has. "Been through this." Meredith repeated, looking over at her sister in law. Amelia realized now what she had said. Nobody knew. "You have been through what ..." She repeated unsure whether it was appropriate to ask or not.

"You ... you don't have to answer, it's okay ... I'm sorry, if it's too personal." Meredith rambled, clutching the baby image in her hand.

Amelia breathed in deeply before she replied: "It's okay." She told her. "I haven't told Derek or any of my family. Just my people in L.A. know about it ..." Amelia trailed off, glancing away. "About what?" Meredith glanced at her, noticing the tears in Amelia's eyes. "I was pregnant from my dead fiancé." She told her. Meredith didn't budge, she just listened to Amelia's story, reaching for her hand.

"I … his name was Ryan. I think we both … influenced each other in bad ways. We … did drugs, lots of them. But then we decided we wanted to get clean and have a family. But it never came to that. Ryan overdosed. They sent me to rehab. Months later, I found out I was carrying his child. I was like, twenty weeks already. My body was just so screwed up from all the drugs that I didn't paid attention to the symptoms. I know my story is different from yours, minus the drugs and minus the carrying a sick child to term because it was too late to abort."

"Sick." Meredith repeated slowly. She had no idea what that could mean.

"My baby was anencephalic." Amelia told her, meaning her baby didn't have a brain. A silent tear escaped from her eye and wet her cheek. She ignored it. Meredith didn't know what to react.

"You know, remember ages ago, you and I had a really big fight? And I told you, I said, 'you're like coming up for fresh air. Like I was drowning, and you saved me.' I still feel that way when I see you, what we have, our family. That's the feeling. It's you." He confessed, looking at her dreamily. Meredith wasn't able to escape his blue McDreamy eyes and she didn't want to.

Finally, her Derek was back. She smiled when she heard that he still feels that way about her.

"It's always been you. And I want more." He confessed. He wants more?! Meredith had no idea what he was talking about. About having another baby? Was it that what he was trying to tell her? She waited for him to continue, stares at him with big eyes …

"Of this, of us, of... I want to have more. Let's have more. I mean it." He really means it. Meredith's heart rate fastened a little bit. He wanted another child with her (crappy genes that aren't so crappy …)

"You're crazy." She said while looking at him with big eyes although she had to admit that she liked this idea.

"That's not a no." Derek noted, chuckling a bit.

Meredith wanted to assure herself that she had heard correctly: "Another baby?" Derek nodded, replying: "Sure." "Uh, seriously?" Meredith looked at him wide-eyed. "I'm completely serious." Derek told her. Meredith just stared at him for a moment.

After what seemed like an eternity, they were able to finish Derek's surgery successfully.

"Just tell me. Is he..." Meredith pressed for more information.

"He survived, Meredith. He´s suffered extensive injures to spleen and liver and one of his kidneys were damaged, but we were able to stop the hemorrhage. He´s suffered tension pneumothorax ´cause he has broken ribs and one of them punctured his lung during surgery, so we had to page Maggie Pierce. Also, he suffered trauma to his heart, there was a tear in his right ventricle but …"

"I was able to patch it." Maggie interjected, smiling. "Yeah, my words and we did some studies to confirm our assumption that he has a cardiac contusion which means there is the chance that he could go into arrhythmias."

Meredith closed for a moment her eyes and stared at Bailey in shock.

Amelia watched her worriedly, not that she passes out again. "He is in recovery and as soon as his anesthesia wears off, he´ll be moved to ICU. He´s currently stable." Meredith breathed a sigh of relief. "When can I go see him?" She asked. "You are free to go, but please, Grey, take care of yourself and make sure you eat and drink. Otherwise you´ll end up in a hospital bed." Bailey advised her.

"You may not be my intern anymore, but I still care about you." "And remember you have to take care of another person now too. This isn't just about you Meredith." Amelia told her, referring to Baby Shepherd Meredith was carrying. She wasn't showing yet. That'll come soon enough. Meredith nodded, she wanted to see Derek. "Barring any complications he should be okay." Bailey told her. It felt like an eternity.

"Oh thank god." Amelia breathed a sigh of relief. Meredith just asked one question: "Can I see him?" A question she had just asked minutes ago but Bailey hadn't answered. Or has she?

Meredith had no freaking idea.

/

When she entered his ICU room, she swallowed hard. Derek was laying in this bed, hooked up onto a million things like catheters, a central line ... She forced herself to look at him. He was pale, she suspected it was because of the extensive blood loss. Then there were all these medical devices he was hooked onto.

The heart monitor was beeping rhythmically and his sats were stable.

She reached for his hand and squeezed it slightly. Amelia leaned in the doorway, seeing the cardiac monitor beeping rhythmically but as a neurosurgeon she knew that this was not the only sign of life. Her question was whether his brain was working. She really hoped it was. But in fact, she had no idea whether his brain was functioning or not. Then Owen suddenly was behind her, with an unreadable face expression.

"Amelia." He said.

"What is going on, Owen, just say it." She urged him, not taking her eyes off of Derek for one second.