It was supposed to be like any other day at Seattle Grace Hospital, too many, too much blood, and too little time to save lives. Yet somehow the air felt different. Most attendings had been paged to treat the severe mass trauma from a multiple car collision downtown. It had all been rushed to SGH as it was closest in proximity.
One of the attendings amongst the many working was Derek Shepherd, focused on his patient yet calmly navigating his way through the complication in front of him. He was in the OR with his recently joined Head of Trauma Owen Hunt, the complexity of the case requiring them to work side by side. The problem though, with their case was far too gone. His impact from the collision had been with an extreme level of force. They had barely gotten the patient to stabilise in order to prepare him for the complex but necessary brain surgery he required.
But the patient had a second bleed, and a soon as he was able to enter the patient's brain, it had insurmountably swelled up in size. Turning to Owen who shook his head with disappointment, "we need to identify him and hopefully contact his family. His organs are only viable for so long, so it will be helpful to find out if he is an organ donor." Derek acknowledging his patient was now brain dead signed, and noted nothing more could be done. Owen instructed his residents and interns to clear away the OR and shift the John Doe to the ICU in hope that they could identify him.
As Derek also stepped away, he sighed with a small amount of grief, the trauma patient didn't look too old, and he probably seemed to have a life ahead of him. Now nothing remained. The worst part Derek thought was his patient today didn't even have a name. He was just a John Doe. Taking one last look at the body, he walked into the scrub room to remove his mask and gown.
It hadn't been that long since he was washing his hands at the sink that a rushed and horrified Meredith Grey came forward interrupting him. Unsure of the urgency, Derek looked back at his girlfriend with surprise, "are you okay? Meredith?"
She looked past him to see what was happening in the OR he just walked out of, "what happened in there?"
Derek just nodded with the sullen expression; he hated losing his patients. "His ICP just went through the roof. We did everything…everything. We are having him moved to the ICU, so that if we can get to his family in time then we know what to do with his organs. It won't be long before he is acidotic and hyperthermia. If he is a donor then there are a lot of lives he could save," Derek said sombrely.
Meredith's eyes widened, she now looked even more horrified at the state of events that had occurred. She wasn't exactly sure how to disclose the information she had just acquired. It was bound to rattle Derek given the consequences of what had happened in his OR.
Giving Derek another hesitant look she tried speaking in her most sincere manner, praying that it would not break him.
"I was just outside, speaking to the patient who delivered her baby at the crash site."
Derek nodded, and he encouraged her to go on.
Meredith looked to her side and continued.
"She told me that a doctor was present at the crash site. He was apparently also stuck between the collision with the others. But he decided to help whoever he could. He apparently delivered their little boy on the couple's backseat."
Derek wasn't sure how this was relevant but decided to keep listening. Knowing Meredith, she would have a point as to why they are discussing this in a scrub room outside this particular OR.
Meredith, not maintaining much eye contact continued, "The couple said right after the doctor delivered their little boy, he began helping other people injured at the crash site. But, then a second collision happened soon after, and that's when the doctor himself became severely injured."
Meredith paused, taking a breath, and looked back up. She wasn't sure how to say the next bit, but she knew her words were about to break Derek's calm demeanour.
"Derek, that was the doctor on your table."
Derek, who was now considerably much more aware and even a little disturbed with the presented information lowered his head almost in respect. He then looked back into his OR to get a final glimpse at the incredible man who lost his life while saving others. He lost his life while bringing life into this world.
Meredith on the other hand, still wasn't finished.
"That's just not it, Derek, the couple said the doctor's name was Dr Sloan."
And then immediately Derek's eyes shot up in horror.
"What!" He choked. The shock magnifying by the second.
A million things were running through his head now. It couldn't possibly be true. He had just seen Mark this morning at the coffee cart.
"That can't be true. I saw him this morning."
Meredith shook her head, an earnest look in her eyes regrettably denied him his theory.
"How can you be so sure Meredith?" Derek said again, knowing he was probably in denial. His hands finally taking off his scrub cap in frustration.
Derek looked straight back into Meredith's eyes until she finally spoke again.
"That's what we were hoping you could help with. We want you to be able to identify him if you can."
Derek turned his head back towards the OR door and then kept looking ahead with deepening dread. He couldn't fathom this. His best friend, his brother, had just been declared brain dead on his own table, by him. Fuck! Leaving aside all the problems he had with both Mark and Addison, this wasn't a fate he wanted them to suffer. Oh God he thought, Addison, how the hell was he supposed to break the news to her if it indeed was Mark. Especially when she was seven months pregnant with his child.
Fuck! Fuck! He didn't want this to be true, this was some sort of a sick joke.
Almost, as if to prove them all wrong Derek stormed back into the OR and told the scrub nurses to step back. His eyes intently staring at the body lying still and artificially breathing.
Derek knew there was a way he could easily tell if this was Mark or not, but the clouds over his judgement were seeing similarities between the body's physic and skin already, all of them ringing alarm bells.
He was aware of a series of scars on Mark's right shoulder, from some definitely lousy sutures that even Derek couldn't help snicker at when he they were done. This was a gift from their bike accident together, an affair where Addison refused to speak to either of them for a while. Also, an incident where Mark was seething with wrath by threatening the resident who had done the sutures in the first place. It was safe to say that the resident was barred from Plastics forever. Addison had bluntly put it to him by saying he should use it as a reminder for never doing something this stupid again.
Derek remembered how much he laughed at that incident once they were both back home. Mark's hands were the true definition of precision and artistry. They all joked that if either one of them were ever on the table they would want Mark to close them up. It was a pact. Mark hated a bad stitch, no matter where he saw one, or who he saw it on, and let alone one on himself.
Closing his eyes with a bated breath, Derek started to peel the sheet below his neck. Eyes scanning to the right shoulder immediately where the remnant scars would be as per his memory. And then as soon as his eyes saw the starting of the three-inch scar line, Derek stepped back in horror. Fumbling and hitting the surgical cart, and then desperately grasping it immediately for support. This was his brother. The man who he had known since they were both 5 years old, and now he was brain dead because of him.
No matter how the rational mind would suggest, there was nothing he could have done, yet this would be a debate he would now face for the rest of his life.
But first he had to decide how to tell Addison. How does one say that the father of their unborn child is no longer alive, not in a sense that matters anyway?
Addison Forbes Montgomery was nearing the end of her shift. Sitting down in the attending's lounge she nursed a cup of herbal tea with some patient reports in-front of her, all while casually stroking her baby bump. The last seven months hadn't been easy for her in any way. She had gotten divorced exactly seven months ago, and then she had decided to start a new relationship exactly 7 months ago. To make matters even more complicated, she had also found out she was pregnant exactly seven months ago. But that was just it, she had found out, not actually become pregnant seven months ago.
Addison Montgomery was already 4 weeks pregnant when she found out. Ironic, she found out on her supposed 12th wedding anniversary, which was conveniently 3 days after their divorce. To think of the moment as life playing a sad joke felt deeply horrible, because she had always wanted to be a mother more than anything. She wanted this child no matter what. But she no longer loved nor respected the man who happened to be the father of this child. She knew that it was her being quite dramatic when she repeatedly told herself that she didn't love Derek. She thought probably somewhere really deep down she may even did, but she also realised that it was so deep down that she couldn't bring herself to care anymore.
That very day, on her supposed 12th anniversary Addison Forbes Montgomery made a very important decision. That very day, the very day she found out, she told herself that she would move on from Derek no matter what it took. And because of that decision Addison didn't want to deal with her ex-husband at all during the reming 36 weeks of her pregnancy.
She felt she deserved some peace of mind at the very least post his humiliating stunt at 'prom'. So, to keep him at a safe distance she unfortunately relied on Mark and asked him to play along until she actually delivered. She knew she couldn't keep her child away from Derek, no matter how much she hated him she wouldn't remove Derek as a dad from her child's life. She couldn't be cruel like that, but she wanted some space to process this experience without him hovering over her. More so that she wouldn't have to witness him constantly wishing that it was his 12-year-old girlfriend who was pregnant and not her.
Mark on the other hand was supposed to be the filler for the time being. Having seen what he was capable of in New York, she felt she couldn't rely on him for a wholesome relationship with exclusivity. But what started off as a way to rebound of Derek then turned oddly serious. Mark initially thought he had miraculously gotten Addison pregnant for the second time. He didn't even pretend to disguise his pride. But she wanted and needed to be honest with him from the get-go, she wouldn't lie to him about something like that. And only if he agreed, would she say that she was pregnant with Mark's child to deter Derek or anyone else who was in love with the Mcdreamy of Seattle Grace from looking down on her. She could vividly imagine the gossip about how she would have trapped the poor Mcdreamy all over the hospital. Not that the gossip she received regarding her now was any better.
Mark being human, was indeed a little disappointed at first. He wasn't hoping that she would also abort Derek's child just like she had done with his, but he did feel the pang stinging at his heart that she had decided to keep it knowing that they had also parted ways similarly. Derek had also cheated on her, so why did she keep Derek's child but got rid of his? But what could Mark Sloan do? He regretted his own actions so much. He was completely in love with Addison Montgomery, and he had flown across the country for her overnight with one simple phone call. Transatlantic booty call he thought to himself. It was a little too desperate, even for his liking, but he didn't regret it at all. Derek's face was priceless alone for him when he walked into Addison's room at the Archerfield.
Mark always knew that in New York he had made a mistake that cost him his chance with Addison, and this time around he had assured her that even her being pregnant with Derek's child would not stop him from loving her or being faithful to her. Addison at first was very hesitant about everything. She needed him more as a friend and as a distraction to use in-front of Derek, and nothing more. Sure, it was cruel, but it was honest. Afterwords, and somehow things started turning for the better. The love, attention, and care were all breaking down walls for Addison, she knew it could also just be the hormones, but she chose to believe in Mark instead. He was relentless in making her realise that it was now or never for them. Taking a leap of faith in that moment Addison thought what more could she even ask for.
Shaking away the all-consuming thoughts she moved her head back for support so that she could rest it fully against the back cushion. Her surgery had felt a little too long, lengthened by her resident being pulled out in the middle of the procedure because of the entering mass trauma. Thankfully there were no pregnant casualties. Just a woman who miraculously delivered in the crash but required her resident to check up on her for any tears or signs of infection. But other than that, her day was going to be over and very soon she would hang up the lab coat and change out of her scrubs to go home to Mark. She had been assured a back rub and warm bath awaited her in a text. She smiled wistfully at that thought.
The smile widened on her face as she continued to stroke her belly. Not in her wildest dreams could she have imagined how well Mark finally started to take obstetrics seriously . Hell, he was reading her OBGYN journals and asking her about unnecessary procedures that didn't concern her situation at all. She then laughed at a recent memory teasing him "wish you had paid this much attention during your OB rotation."
Addison had always known that Mark was very caring towards her, so that part wasn't a surprise, in-fact that was a given. Had she even been pregnant while still being married to Derek, she knew that Mark would probably have cared for her just as much. Derek probably wouldn't have even had the time to care, or make time for her appointments, so tending to the cravings would have been a far unrealistic expectation that even she couldn't entertain.
As her mind kept carried away and the tea came to a finish, she gathered her papers hoping to get up. Just then her attention was broken with the door opening.
Derek Shepherd walked in holding his scrub cap, his eyes sullen and even slightly blood shot. Just as he looked at her, Addison looked back down hoping to make a quiet and painless exit.
Gathering her papers, she held onto the edge of the coffee table to get up and leave.
"Addison please sit back down," Derek said, almost pleadingly.
This was completely missed by Addison as she continued to wrap up her documents.
"Addison, please." Derek said again. He was hoping she could at least see him while he asked, knowing too well she wasn't in the mood to deal with him these days.
Addison kept her gaze drown but continued ordering her report pages numerically, "so what? You can take a few more jabs at me?" She said as she shuffled her pages.
She then finally locked eyes with him with evident frustration.
She really wasn't in the mood to deal with Derek at all. Not today. His behaviour the past few months had been downright cruel and petty. For someone who had also moved on after cheating as well, she couldn't believe the audacity Derek had to still comment on her relationship with Mark.
"I have tolerated your remarks and snide comments about me and my baby. Hell, the hospital has heard what you have to say about us. And yet somehow, it's still me who is getting bullied in this place. You make it clear no matter where I go in this hospital that I am Satan, and this," pointing to her stomach," is the evil spawn of Satan and the Man Whore." Her eyes starting to become wretched with anger that she had suppressed for months.
"I stopped retaliating a while back, and now I don't even say anything back at all, and yet somehow you see this as a way to bully me even more. Derek have you not noticed? I don't even care enough to listen to your hurtful comments, because even that would suggest that I actually give a damn. Which, I surely don't." Addison said raising her voice.
Derek felt shame sinking in, and he was far to disturbed himself to even stop her. He just hung his head low, letting her finish and also knowing the news he would deliver would make this so much worse.
"Well Derek, I am just done. I am so exhausted from simply doing a 3-hour procedure, which I could have done in my sleep but because now I don't get any sleep, and I work in a hospital that is simply hostile towards me, and that's all thanks to you and your broken heart." She stated sarcastically.
"And what's worse is that I can't even leave because I signed a damned multi-million-dollar contract because you wanted me to stay. You! You're the reason I am still walking around here. You had your chance to end this the day I came wanting you to sign those damn divorce papers, and now too bad, you yourself have to suffer me walking around with my evil spawn!"
Addison couldn't believe how furious she was. Her hands were up in her hair as she let out a breath. Wanting to waste no more time she picked up her papers and strutted past Derek only to realise Richard Webber was right behind him. Richard had also walked through the glass door, causing Addison stop in her way out. Richard's eyes also melancholic but upon meeting Derek's they silently questioned if he had broken the news to Addison.
Derek just shook his head saying no.
Addison on the other hand felt outraged and was still reeling from her outburst, she could probably rip Derek apart even more the way she did, but realised that it just wasn't worth it. Her baby didn't need more hostility. Their circumstances were bad enough that his biological dad was calling him evil spawn. A choice of words Addison knew one day Derek would greatly regret.
Derek had in that moment had come to a realisation of how disturbingly demeaning he had been towards Addison. It had been as bad as she had described to him. Somehow the realisation had only occurred in that moment, and maybe that was because Mark was no longer between them. It took Mark dying for him to realise how horrible he had truly been to woman who he once considered family.
Addison then looked again at Richard and started becoming weren't saying much. Derek had not even said a word back to her while Richard was looking at her like he had to break some sort of news. As she kept looking between both of them, she then slowly realised that their look was the one she knew a little too well. It somehow missed her today. It's the same look she had when she goes to her patients' families to deliver bad news. Finding herself the nearest wall, Addison stepped back and leaned against it by gliding her arms and closing her eyes. She readied herself for what was about to be said.
"Whats happened, who is it?" She asked gravely.
Her eyes painfully opening and looking directly towards Richard for answers.
"It's Mark, Addie."
Unsure of how else to continue, Richard looked at Derek for support hoping that he would say something. Derek then looked towards the floor, his eyes welled away, but he knew fully he had to be the one to give her the explanation.
Derek spoke with a broken voice. "He was hit amongst the mass trauma that came in; he was probably on his way back home. I am so sorry Addie. I am so sorry. His ICP just went through the roof, there was serious swelling in the brain. He is brain dead Addie. We did everything we possibly could."
Addison's eyes widened while trying to process what Derek had just said but she also tried to suppress the scream etching in the back of her throat. Failing at both.
Her scream pierced through the room and her eyes squeezed shut. The pain slowly taking over.
"Oh no no no no, not Mark!" she bargained.
Her eyes darted to Derek, who continued to look at the floor. His tears streamed down, but even he knew how ashamed he was to show them to her. He didn't deserve to show his pain.
Addison's knees eventually gave up and she slid down the wall onto the floor. Pushing her arms out she stopped both Derek and Richard from touching her as they rushed to her aid. No one could make this better: No truly felt like the beginning of the end.
"His face was badly disfigured when they brought him in Addie, we treated him as a John Doe. Derek was in the OR with Hunt when he just collapsed. I am so so sorry Addie….." Richard spoke with a heavy heart.
Richard had always looked at Addison like a daughter, this very conversation and knowing what the girl had been through in the past few months broke him tremendously. She didn't deserve any of this, period.
Derek, who then crouched down and finally grew some courage to look back at Addison noticed her face growing paler by the second. Her eyes becoming so hollow like he had never seen them before in the 16 years he knew her. Addison kept trying to suppress her chokes, so much so that she refused to breakdown in-front of him anymore. Derek had treated them miserably; she wouldn't let him have the satisfaction of this. She would protect what was left of them.
Derek tried speaking again, but his voice continued to break "Addie , you have…."
But she cut him off immediately.
"Please don't, just don't." She said almost with an indifference and swayed her head to the side.
Then almost like something had hit her on the inside, dawning on a realisation her teeth bit down a harsh smile and she looked back at Derek with bitterness, "are we even now Derek?" She asked.
Addison just couldn't imagine how much worse her life was about to get.