Lying on the bed is Meredith. The color is drained from her face. Her eyes are closed and her face is turned towards the window and the linens that surround her already frail body are covered in blood.
"Oh God," he hears himself whisper. His feet are frozen in place momentarily as the blood drains from his face, his pallor now matching that of Meredith.
His vision blurs as he trips over his feet, somehow managing to stumble towards the bed. He reaches up and presses the call button before beginning to fumble with the blood-drenched blankets covering Meredith's body.
"Can I help you?" a female voice asks.
Derek doesn't answer as he turns to the cabinet behind him to retrieve a handful of clean towels.
"Can I help you?" she asks again, this time a hint of aggravation in her voice.
"I need some help in here," he manages to choke out as he lifts Meredith's hospital gown up over her abdomen. His hands are now covered in her blood, a Macbeth of his own making.
He can see the blood oozing from her now-open wound, that crimson liquid affecting him more than it ever has.
"What's going on?" he hears the voice of his mother ask as she runs into the room.
Derek shakes his head as he applies pressure to her wound. "Her stitches," is all that he is able to manage.
His mother tries to take over, but Derek refuses to move. He refuses to look her in the eyes as he reverts his gaze to his blood-covered hands.
"Derek?" his mother questions him.
He shakes his head no as his vision blurs. It isn't until he notices tears mixing with blood that he realizes he is crying. He feels a gloved hand grab his wrist.
"Derek, let me take over here. You go comfort her," the voice of his father instructs him.
He doesn't want to move, but he doesn't fight his father as Dr. Shepherd replaces his son's hand with his own. The voices blend together in the chaos of the room as he focuses his attention on Meredith's face. She doesn't look like she is in pain. She looks as if she is sleeping peacefully, an image that only adds to the horror of the scene.
He runs his blood covered fingers along her jaw line, smearing blood on her face, but he doesn't care. "Mer, please wake up," he whispers as he places a soft, desperate kiss on her brow.
"Call the blood bank for one unit of blood. She is small, we don't want to overload her," his mother orders to a nearby nurse. She soon turns to another nurse. "I want a unit of fluid on her while we wait," she tells another nurse before walking over to her husband. "How bad is it?" she asks him in a hushed voice.
He shakes his head. "It doesn't look too bad, but I don't think the bleeding is going to stop on its own," he answers as he lifts the cloth off of Meredith's abdomen, allowing more blood to seep from her wound.
Mrs. Shepherd turns to the only remaining nurse in the room. "Go get me a suture kit," she instructs him. He simply nods before exiting the room, leaving the newly-formed family all alone.
"Derek, honey," she begins as she places a gentle hand on his back, "her blood pressure and heart rate are a little low, but not dangerously slow. She has lost a lot of blood, but we are going to take care of her. She is going to be fine," she tells him in a motherly voice, but he doesn't seem to hear her.
"Derek?" this time it is his father's voice, stern yet comforting. "Why don't you set her bags down and go clean up? You don't want her to see you like this when she wakes up, which should be soon."
Derek simply nods as he pries himself away from Meredith. He drops her bags in a chair next to her bed before rinsing his hands in the sink. He becomes mesmerized by the sight of the water cleansing the blood from his hands. His eyes follow the path of the stream of blood as it circles the bottom of the sink before disappearing down the bottomless drain. Meredith's blood. Meredith's red, sticky blood on his hands.
The bile once again begins to rise up his esophagus as his stomach never ceases its churning motions. The past twenty-four hours have left him emotionally drained and his body is beginning to retaliate, demanding vengeance for the stress it has endured. He grips the sides of the sinks with his wet hands as he forces his eyes closed. The room has finally stopped spinning, but in its place is the image of the diluted blood winding its way down the sink. He has washed her life down the drain. The blood is the life, and he has simply washed it away.
He feels tempted to climb under the cabinet and disassemble the pipes in order to reclaim that life that has been treated with such little worth. He needs to let her know that she is not nothing. He needs to let her know that she is everything. He needs to let her know that he is there for her, and not for him.
He finally opens his eyes, but the blood that he has washed off remains. The spot will not dissipate, just as the guilt over her situation burns into his soul.
But he must push these feelings down. He must quell the rising storm before it consumes him. Meredith needs him. He needs to be there for her.
He wipes away the remnants of tears of his face with the back of his hand, determination now creasing his brow. He will be strong for her. He has to be strong for her.
However, his resolve is immediately threatened as he hears a tired, strained voice call out to him.
"Derek?"