Chapter 27

The alarm clock blared bright and early that morning, and Derek jerked awake. He felt as though he had just fallen asleep; he could barely open his eyes, and his head was pounding. He instinctively tightened his grip around Meredith, whose back was pressed up against his chest. He wanted to fall back to sleep, but he knew he shouldn't, he could not be late today.

Meredith twisted around next to him, and he could feel her eyes on him. He slowly opened his eyes, taking in the sight of her head propped up on her elbow, staring down at him quizzically.

"Morning," he slurred, his voice still scratchy and filled with sleep.

Meredith smiled at him. "Good morning," she bent down and kissed him lightly before moving away from him, much to Derek's dismay.

"Come on Derek," she said, grabbing his hand as she went to move out of bed. "You need to get up."

"Why?" he whined, knowing that he sounded like a five year old. He made a move to pull her back towards the bed, but she was too quick for him.

"Because you definitely cannot be late today. It's your first day, you need to make a good impression." she said firmly, throwing a pair of shorts on over her, or rather Derek's, oversized tee shirts.

"Come on, you go shower and get dressed, and I'll make you breakfast," she said, walking over to the bed and kissing him again.

"Mer, you don't have to get up and make me breakfast."

"I know I don't, I want to," Meredith smiled, heading towards the door again. "Seriously Derek, go take a shower."

"Are you trying to tell me that I smell bad?" Derek teased.

Meredith turned around, a small smirk on her face. "Maybe," she said, winking at him and fleeing into the kitchen before he could try to catch her.

Derek sighed deeply before swinging his legs over the side of his bed and lumbering to the bathroom. Turning on the water all the way, Derek stepped into the steaming shower, hoping to relax and ease the tension and nervousness he could feel building in his stomach. Today was his first day as an attending neurosurgeon at Mt. Sinai Hospital, and Derek was terrified.

Three months ago, when the Chief of Surgery at Mt. Sinai Medical Center had approached Derek asking him to join the staff because one of his neurosurgeons was retiring, Derek was ecstatic. Mt. Sinai was a prestigious hospital with a better reputation than NYU Medical Center, and Meredith had been so proud of him, convincing him that he was perfect for it, that he almost immediately accepted the offer. Plus, the heavily increased salary was an added bonus.

But, now that the day had actually arrived, Derek wanted to crawl back in to bed. Not only was he an Attending now, officially a surgeon who did not have to be supervised during every procedure, but he was also starting a new job. He barely knew anyone at Mt. Sinai, and he had never met anyone in the Neurosurgery Department. All he had going for him was whatever the Chief of Surgery, Doctor Chalke, had said about him. At least at NYU, the other surgeons had known him for six years, and had watched him grow and had seen his talent from the beginning. He didn't have anything to prove anymore at his old hospital, but starting today he had everything to prove.

When the water finally ran cold, Derek got out of the shower and went to go change. He slowly slid on a pair of dress pants, buttoned his new white collar shirt, and decided to throw on a tie for good measure. I should dress nicely, he thought. I want to make a good impression. Opening the closet again, he looked at his tie collection, trying to determine which one would look best.

The blue one, he heard Meredith's voice say in his head, a memory from long ago. When in doubt, always go with the blue. It brings out your eyes.

Derek smiled at the memory. It was about a year and a half ago, and he had applied to half a dozen hospitals for his fellowship, convinced that no one would accept him. He had stood in their bedroom for half an hour, almost late for his interview at New York Presbyterian Hospital because he could not decide whether to wear a red tie or a blue tie with his blue button down shirt. She answered his unasked question for him; he hadn't even realized that she had been watching, but there she was, leaning against the doorway. She had smiled confidently at him, handed him a cup of coffee, told him he would kick ass in his interview, and wandered back into the living room to study.

Derek shook the memory from his head, trying to calm himself down and focus. However, he could hear present day Meredith fussing around in the kitchen, and he smiled at the thought that she had woken up on her day off to make him breakfast and see him off. Even if he knew exactly what breakfast would entail, scrambled eggs and toast because she hadn't been able to master anything more complex, he loved that she cared that much about him to do this small thing for him.

As he rounded the corner to the doorway of the kitchen, the smell of toast filled his nostrils, and he smiled as he took in Meredith. The radio was on, set to some sort of alternative station that Meredith couldn't quite get enough of for some reason. She had just dumped the eggs on to two plates, and placed the pan in the sink. She then proceeded to dance around; or at least what Derek assumed was dancing, it was more of her jumping and bouncing lightly to the beat of the music. She seemed so carefree and light, and Derek couldn't help but feel as if a great weight had been lifted off of his shoulders. In that moment, as he watched Meredith dance around the kitchen with abandon, he forgot all about the day looming before him, and just leaned against the doorframe and enjoyed the view.

All too quickly, Meredith's dancing led her to turn in his direction, and when she caught sight of him grinning at her, she stopped dancing, and her cheeks turned slightly pink.

"I was bored waiting for you to finish showering," she shrugged by way of an explanation. "I was getting worried that you might have drowned in there."

"Just trying to relax," Derek said, sitting down as Meredith placed his breakfast on the table.

"You're okay with me taking this new job, right Mer?" Derek asked, looking up across the table at her, worry filling his eyes. "It was just too good to pass up. The pay is better, there are better benefits, it's closer to home and Columbia, and-"

"Derek," Meredith cut him off, rolling her eyes. "Of course I'm okay with it, I was the one who told you that you should take it, remember? Besides, the only reason why I wouldn't like you taking the job is the fact that I won't see you at work anymore, and I would miss that. Which may be a little true, but it would be very selfish of me to deny you this wonderful opportunity because I'll be lonely while taking various people's blood pressure. The Chief of Surgery at another hospital scouted you out; that's how amazing you are. So, of course I'm fine with it; both my mother and myself would kill you if you didn't take it."

Derek looked at her, amusement in his eyes. "Did you even take a breath?"

"Shut up!" she said as she threw a crinkled up napkin at him, but her eyes sparkled and she smiled at him. "However, I think I do have a right to be a little jealous."

"What?" Derek sputtered. "Why?"

"Please, you think I actually believe you took the job at Mt. Sinai because it was a more convenient commute to work," Meredith began, her tone biting but her eyes still shining. "You took a job at the hospital where Mark did his fellowship and is currently an attending. You just had to be with Mark. I see where I fall on the Derek totem pole," Meredith grinned at this, and Derek let out a sigh of relief; he had honestly thought that she was mad at him for some reason.

"Well, naturally," Derek joked back. "I've only known you what, six years? I've known Mark since I was five. Naturally I would rather work with him than you, so of course I would jump at the chance to work in the same hospital as him again. Plus, it gets me far away from you, which some could say is a benefit." He winked at her, but he realized he may have gone too far; rather than laughing with him, Meredith's eyes narrowed.

"Derek Christopher Shepherd! You better be joking. You better not have gotten that job as an excuse to get away from me!" She started throwing balls of napkins at him again, and Derek had to grab her wrists to get her to stop.

"Mer, of course I'm kidding! I would rather work with you than Mark, you are hot and sexy, and he is not. Clearly he's not on the top of my totem pole," Derek made a disgusted face when he said it. "That sounded dirty. Anyway, he's not higher up than you. But you might be tied," he grinned wickedly at her, and Meredith giggled along with him.

"Mhmm," Meredith quirked her eyebrows. "Just remember who gives you all the sex you want when you reevaluate who's at the top of your pole," she whispered, giving him a seductive smile.

"Oh, you're definitely on top," Derek said, raising his eyebrows.

"So dirty," Meredith commented as she stood, glancing at the time. "Derek, you should probably get going soon."

Derek looked at the time, standing up as well. "Yeah, I should," he agreed, walking over to the sink to kiss her. "I have an early day. They want to ease me in, so I should be home by seven. Want me to pick up anything?"

"No, I can handle it," Meredith smiled, looping her arms around his neck. She kissed him deeply, her tongue sliding into his mouth for a few moments before she slowly pulled away. "I would say good luck," she whispered. "But I know that you'll have a great first day. I love you."

"Thanks, I love you too," Derek kissed her on the cheek, grabbed his briefcase and walked out the door.

XXXXXX

Derek had locked himself in his office. He didn't think he liked it here, he didn't think he wanted to be here at all. Chief Chalke had been very nice to him; he had given him a tour of the hospital, introduced him to some colleagues in the neurosurgery department, and showed him his office. Then, the Chief had left to perform a pulmonary bypass graft surgery, leaving Derek alone in his office. So naturally, Derek shut and locked the door so he could hyperventilate in peace.

His fellow neurosurgeons seemed nice enough, and polite, but none of them seemed to be interested in making friends or partaking in small talk, which made Derek feel like this would be a lonely job. He had no idea what he was going to do for the next ten hours; he didn't have any surgeries scheduled for the week; the Chief had wanted him to ease into the routine of the hospital. This left nothing to do, not even paperwork. He thought about heading down to the ER to do some consults, that would pass the time.

He was just about to head out when there was a knock at his door. He opened the door quickly, and looked up at the smirking face of Mark Sloan.

"Mark," Derek breathed, thinking that he had never been happier to see Mark in his life. Mark worked here, not in the same department, but in the building. Derek would have a friend here; someone to joke around and hang out with when neither one of them were in surgery. He could do this.

"Hey man. Word in the lobby is that they hired some superhot neurosurgeon with great hair. His office is supposed to be around here," Mark said as he looked down both ends of the hallway and into Derek's office. "Funny, I don't see a hotshot surgeon, I just see an idiot with a crooked nose."

"Ha ha very funny Mark," Derek said sarcastically, rolling his eyes. In reality, Derek was thrilled to be joking with his oldest friend again.

"Seriously man, I'm a plastic surgeon now, I can fix that ugly nose of yours," Mark said, walking into Derek's office, uninvited, to survey it.

"Meredith likes it," Derek said simply. "She says that it's rugged and sexy, so I think I'll keep the crooked nose."

"Seriously dude, you are so whipped," Mark rolled his eyes as he sat on the sofa along the side of the wall. "So, how's the first day treating you so far?"

"Boring," Derek said. "I haven't been scheduled to do any surgeries for the week, so there is literally nothing to do."

"Well that's nice, at least you'll have plenty of free time. Maybe you can give Mer a grand tour, christen your new office," Mark said with a wink.

"You like the world's most juvenile human being I've ever met in my life," Derek laughed.

"What? You two have a lot of sex. You're like addicts. You know, the first step to recovery is admitting you have a problem," Mark continued.

"And how many nurses have you slept with this week?" Derek shot back.

"That's not a problem man, that's an adventure," Mark smiled.

"Yeah, whatever."

"So, since you have nothing to do, you wanna come grab lunch with me and Addison? I've got about an hour before my next surgery, and Addison says she hasn't seen you in about a month."

"Yeah sure," Derek nodded, grabbing his lab coat and pager from his desk. "Addison still works here; I thought she was trying to get a job in private practice or something."

"She wanted to, but changed her mind. Thought it would be better if she spent another year at a hospital before making the shift," Mark answered as they headed down the hallway. "Which you would know if you spent time with your friends."

"I'm sorry, I've been really busy, and Mer's been really busy, so when we're not busy we just like to hang out with each other."

"I get it," Mark nodded, and the conversation ceased until they reached the cafeteria, where Addison was already sitting.

"Hey Derek, long time no see," Addison teased, standing up to give him a hug.

"Hey Addie, it's good to see you," Derek said.

They were able to catch up for about a half an hour, and Derek found himself relaxing a little more as time went on. He did miss seeing Mark and Addison regularly, and Derek was just about to invite them over for dinner later tonight when a shrill beeping cut through the conversation.

"Aren't one of you going to get that?" Derek asked, looking from Mark to Addison.

"Hey, it isn't our pagers," Mark said. "It's yours."

"What?" Derek exclaimed, jumping up and pulling out his pager, which was flashing the message '911'. "It can't be! I'm not supposed to be doing any surgeries today! It's my first day here."

"Relax Derek, they're paging you to the pit, maybe it's just a consult." Addison said, trying not to laugh as Derek clumsily pulled on his lab coat and ran down the hall.

When he reached the ER, Chief Chalke was waiting for him. "Listen, we had a three car pile-up, and there is an eighteen year old boy coming in here with a severe head trauma. You're going to have to do a craniotomy."

"An emergency craniotomy?" Derek choked out the words, in shock. "But, but it's my first day. I thought you wanted me to ease into the hospital."

"I know Derek, but we're in a bind. Perkins is currently working on a tumor resection, Gideon was going to do it until one of his patients started seizing, James was on call last night so he went home, and the other two have the day off. Which means that I have literally no one else but you, so you have to scrub in."

Derek nodded resolutely. "Yes Chief."

Chalke slapped him on the shoulder as he walked away, leaving Derek to crumble. He was about to perform an emergency craniotomy. That meant no time for MRI and scans to figure out what exactly is wrong and no plan on how to fix it. Flying blind, on an eighteen year old kid. If he killed him, he would feel so incredibly guilty, as he always did, but it wasn't just that. Everyone in the hospital would look down on him; he would be the Attending that killed his first patient on his first day of work, even though he had six years of training and a good reputation. He would be a real 007: License to Kill.

He bolted to the nurses' station, knowing what he had to do. "What is the ETA on the kid with the head trauma?" he asked the nurse sitting at her desk.

"Umm," she flipped through some papers before she found the answer. "Eight minutes."

"Perfect," Derek muttered, pulling out his phone as he moved to the side of the ER. It was less crowded and less busy, but he would still be able to see when the ambulance rolled in. Hitting number two on his speed dial, he mentally willed for the phone to connect faster.

"Hello," Meredith answered after the second ring.

"Meredith!" Derek gasped, suddenly finding it hard to breath.

"Derek?" Meredith asked, immediately sensing his fear. "What's wrong?"

"I-I-I'm not supposed to operate today," Derek stuttered. "I was supposed to have a boring day. But there was a crash and now the chief wants me to do an emergency craniotomy on a teenager. I can't do this."

"Yes you can, Derek." Meredith said calmly. "You have a gift, and you can do this."

"I'm not ready," Derek said softly.

"Yes you are," Meredith said resolutely.

"No, no I can't. If he dies, then it's my fault, and everyone will think I'm incompetent. I can't."

"I love you, and you can do this. You can do this, I know you can. No one is going to think any less of you; they've all had losses, so they won't judge you. But this patient will not die, I know you can save him, and if you can't, then you did everything in your power to try, and I'll be proud of you."

"Thank you," Derek said as he inhaled deeply. She had calmed him down a little, now he was only nervous, not panicky. The ER doors opened suddenly, and a stretcher carrying a teenager barged through.

"I think he just got here Mer, I have to go."

"Good luck! I love you."

"Love you too," Derek said as he hung up, heading for the scrub room in OR 3.

His hands were shaking as he scrubbed in, watching the nurses prepare the OR and the anesthesiologist put Kevin Green, the boy, under. He dropped the soap into the large sink, and rather than pick it up, he gripped the edge, breathing deeply to calm down.

"Doctor Shepherd, we're ready for you. Are you alright?" Derek looked up at the nurse that just walked in to get him. She was tall, with wavy brown hair and wide, doe like brown eyes. She looked at him curiously.

"Just nervous," Derek admitted. "Don't want to kill someone on my first day."

"You won't kill anyone," The nurse tried to assure him, but it was not nearly as effective as Meredith's words. "Everyone has heard about what a talented doctor you are, they won't think any different just because this one might not make it."

"Hmm," Derek sighed, shaking the moisture off of his hands as he walked into the OR, a nurse placing the gloves on him when he reached Kevin's head.

"Okay," Derek said as he stretched his neck, looking at the people around him. He suddenly felt the need to address them, but was unsure as what to say. "Uh, it's a beautiful day to save lives. Let's have some fun." And with that, a scrub nurse handed him a drill, and he began to open the boy's skull.

The surgery was long and tiring, Derek's added stress making it that much more difficult to concentrate. However, despite flat lining twice, Kevin made it through surgery and was expected to be okay. Derek breathed a huge sigh of relief as he closed and went to scrub out, and his hands were shaking again, this time out of excitement. He just performed his first surgery as an Attending, and it was a success.

He didn't think he had ever been on such a high before. Sure, when he had been a part of procedures and done his first solo surgeries, Derek had felt the rush afterwards, but this, this was something different. He couldn't wait to go home to Meredith and tell her all about it, he knew that she would be excited for him and want to celebrate right along with him.

"Nice work Doctor Shepherd," a woman said. Derek looked up from the sink, and it was the same nurse who had spoken to him before.

"Thanks," Derek said, running his hands through his hair. "And you can call me Derek if you want."

"Derek," the nurse nodded stretching out her hand. "I'm Rose."

"Nice to meet you Rose," Derek smiled, shaking her hand.

A/N: Please don't kill me! I promise you, this is a Meredith and Derek story, and they will have a very happy ending. What happens in this story is almost nothing like what happens in the show; I wouldn't do that to my favorite couple, but it could be an interesting plot point. Please keep reading and reviewimg, it lets me know that you still care