Chapter 7
Izzie knocked on the door, but she did not get a response, so she opened the door and walked in. She smiled as she saw Meredith sleeping in the hospital bed with Chrissy, both snoring in unison. She hadn't seen Meredith sleeping for weeks; recently, Meredith's eyes opened as soon as Izzie entered the room. Now she went over to Meredith and touched her shoulder.
Meredith stirred, and she opened her eyes.
"Good morning, Mer."
"I hope it's a good morning. We'll have to see what the doctor says."
"I thought you might want to have time to take a shower and change. I brought you some fresh clothes."
Meredith smiled. "I suppose you want me to make a good impression on Derek."
"I just thought you'd like to wear something clean. I think we all appreciate clean clothes."
"Are you telling me I've been stinking?"
Izzie smiled. "No. But I did bring your lavender conditioner so you could smell nice."
"I must have told you that Derek liked my lavender conditioner years ago. You have a great memory." Meredith smiled as she remembered all the times that Derek would sniff her hair.
"Thanks. I did want to let you know that when Derek left last night, he told me to tell you that you didn't need to be afraid of him. He's not going to yell at you, at least not until Chrissy's all better."
"That's good to know. I just hope she gets better." Meredith said with a smile.
"She will. You need to have faith. You also know that at some point you're going to need to talk to Derek without backup."
"Yes, but first I have to shower and change and go to the meeting with Dr. Barkley," said Meredith as she got up, first kissing Chrissy, who was still sleeping.
"You'll have Christina and Bailey there while I'm here with Chrissy."
"I really appreciate your help."
Derek opened the door to the conference room, and he saw Meredith was already there, with Bailey on one side of her and Cristina on the other. They stopped talking as soon as he walked in. Meredith was wearing a purple sweater. Her hair looked like it was still wet, with most of it in a ponytail. She wasn't wearing any make-up, and she looked exhausted and very thin. He wanted to walk over and hug her, but he resisted; he wasn't sure whether she would welcome his hug. Bailey and Cristina looked him in the eye, but Meredith looked away. There was a big bowl of muffins on the table. He smiled his McDreamy smile, and greeted them. "Good morning. I see that Izzie has been busy this morning."
"Yes, strawberry muffins, Chrissy's favorite," said Yang.
"Her mother's daughter."
"Yes," said Cristina.
Derek sat down next to Bailey, and before he could say anything, Dr. Blakely walked in. Derek was first struck by how young he was; he looked like he couldn't be more than 30. "Good morning, Meredith, Dr. Yang, Dr. Bailey, and …" he looked at Derek.
"Derek Shepard, Chrissy's dad," volunteered Derek.
"Pleased to meet you," said Dr. Blakely. He sat down, sitting directly across from Meredith. "I have some good news. Dr. Shepard is a perfect match for Chrissy."
Meredith nervously twisted her hands. She was concerned that Blakely started with the match, not the chemo results.
"What I'd like to do is have Dr. Shepard donate the marrow today. I would like to prepare it and then freeze it so we are sure we have the marrow ready to go. We have found that frozen marrow is better for avoiding rejection."
Derek smiled and said "I'm happy to donate today. However, I've been reading that there is preference for donors under 40, and I just turned 42. Would a sibling match be better?"
"Yes, if there was a sibling. But I was told that there are no siblings. And a half-sibling would be unlikely to be a good match. And 42 is fine."
"But we could create a sibling match, with preimplantation genetic screening for an HLA match." Meredith stared at Derek with a puzzled look. Bailey and Cristina had matching looks.
"A creative idea, but Chrissy doesn't have the time. My goal is to do the bone marrow transplant in about two months. We need to get her in remission asap and then do the transplant," said Dr. Blakely. "Now we need to talk about Chrissy's chemo. She has been doing somewhat better on the new medication, but I think that a few changes in the mix will be helpful in trying to get her into remission. My plan is to do three rounds of the new mixture, starting this afternoon, over the next three weeks. We will meet again then. If she is in remission then, we will put her on a low dose of chemo for a month while we prepare for the bone marrow transplant. She has lost a great deal of weight, and she may lose more with the new chemo. I'd like to have her gain at least five pounds from her weight today before we do the bone marrow transplant."
"Will she have to be in the hospital the whole time?" asked Meredith.
"Well, given that her mom and her mom's roommates are all doctors, I think we could let her go home after she goes in remission and before the bone marrow transplant. Once she has been in remission for a month, she would be readmitted, her bone marrow would be removed, and we would inject the new bone marrow. At that point, she would have no ability to fight infection and she would be hospitalized in a form of isolation for about six weeks, or until her new bone marrow met specific requirements. Visitors will be limited, but her parents can be with her. Even after she's discharged, she would need a central line for up to six months, and, she would need to be kept safe from infection. I recommend no pre-school, no day care, and no school for at least a year, maybe two, depending on how her bone marrow responds. Meredith, you will be able to return to work after she is discharged home, but you'll need in-home help. A nurse would be best while she has the central line. If things go well, she should be able to start kindergarten when she's 5."
"But she loves to play with other children," said Meredith.
"After she returns home with the new marrow, you will be able to let her visit with one or two children, provided that they do not have any infections. You'll need to take their temperature before you expose them to Chrissy. You will also need to use infection control measures; lots of handwashing and using purell and using a mask in public But you're used to scrubbing in and out, so you should be able to adjust to this."
"I'll help, Mer," said Derek. "And my mom can help, too. She's a retired Navy nurse, so she can take care of Chrissy. She'd be happy to come and help. I'll call her later today and then we can talk."
Meredith didn't acknowledge Derek. Instead, she turned to the doctor and said, "I feel like she's losing her childhood," said Meredith, with tears falling down her cheeks. "She loves going to daycare."
"Meredith, we're trying to save her life. Infections are a serious concern with a bone marrow transplant. Our program has been very successful, and I attribute that in large part to our vigilant efforts to prevent infection. Chrissy is young; the treatment is much tougher on adolescents. If all goes well, she will have plenty of time to go to school and play with other children. And she will barely remember this in ten years. You have to take it day by day."
"I know, but it's going to be tough."
"I recommend that you join a support group for parents whose children have cancer. I know you're a doctor, but it's much different to experience this as a parent than as a doctor. We have a group at the hospital that meets once a week, Tuesdays at 7 p.m."
"I'll think about it. I might run into some of my patients. That would be weird."
"There's a group at Seattle Pres, if you think that would work better."
"I'll think about it. If it's here, I will miss less time with Chrissy."
"That's true. Does anyone have any other questions?"
Everyone shook their heads. "Okay. Dr. Shepard , . ."
"You can call me Derek."
"Okay. You can always email me or call me if you have any other questions. Derek, you can come with me."
"I can come with you, Derek," said Bailey.
"Okay," said Derek with a smile. He wished Meredith had volunteered, but he was glad that Bailey would be with him.
After Bailey and Derek left the room with Dr. Blakely, Meredith turned to Christina and said, "Did I hear right? Did Derek suggest that we have another baby?"
"Yes, but his plan did involve IVF and not hot sex."
"Still, why would he want another baby with me?"
"Cause he met the first one, Chrissy, and she is so wonderful."
"You are so objective, being the doting godmother."
"Hey, Chrissy is objectively wonderful."
"Thanks. I'm going to go hang out with her. Want to come?"
"No, I actually a surgery to prepare for."
"Thanks for coming."
"No problem."
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