So...fun ending last time, wasn't it? Sorry about that.

'Wishin' and hopein'' was based on the real-life case of Gloria Ramirez, but, unfortunately, there wasn't an awful lot of information on her so I used what happened to Gloria's doctors, plus what happened in Grey's anatomy, plus a PubMed paper I found to write this chapter.

As always, enjoy! :)

"Derek Shepherd, thirty-five, found unconscious on the floor of an on-call room. He was exposed to DMSO, or dimethyl sulphate, this morning. He collapsed at the time like everyone else, but showed no other signs of complications." Bailey listed off as his team assembled around his bedside.

"Hypertensive and bradycardic, sats are in the eighties." Burke added as he placed EKG wires across Derek's chest. "Dyspnoea: his breathing is shallow and weak, even with the O2. I'm thinking about intubation if he deteriorates any further."

Bailey sighed as she re-checked his eyes. She was hoping something had changed since she last checked but, if anything, it was worse. "He's got jaundice in his sclera; there's something going on with his liver. But his pupils are equal and reactive so that's- that's something."

"Previous hepatic history?" He pressed, knowing that Derek had a long, dense medical history.

"I think he had a grade one or two liver lac that we didn't have to treat surgically. We removed his spleen, as well as his left kidney after a grade five lac. The right was only grade three, but I know he's had some problems since." Richard explained. "Most of his organs had something wrong with them."

"What caused the damage?" Burke asked, surprised by that information. He knew Derek had remaining health issues other than the obvious, but he wasn't expecting all of that.

For the first time since he was found, no one talked and no one moved.

Half of the staff had been pondering that question since the day they turned up at the hospital, and the other half knew they were supposed to keep his secret under wraps. Derek was aware that people talking about him an awful lot, especially what happened to him. Or rather, the lack of information about what happened to him. He knew there were theories - some completely wrong, some quite close to what had actually happened - but he was great at maintaining a straight face while people were suggesting their ideas.

After a few seconds, Bailey finally decided to speak. She was just about a resident when Derek's accident occurred, so she didn't know as much as the attendings with her, but she did know quite a lot. "Blunt force trauma."

"Blunt force trauma?" He echoed.

"No penetrating trauma, no crush injuries. Just...just an awful lot of blunt force trauma."

"So does that-" Burke tried before pausing when the trauma room's door burst open.

"Tell me everything."

"Mark-"

"Everything." He begged as he pushed his way past fellow surgeons and nurses to reach Derek's side.

Both of his eyes were hidden by his eyelids, while an O2 mask covered the rest of his face. His skin was almost grey, but he could see a yellowish tinge coming through some parts of his face, as well as a light pink coming from just his cheeks. His arms had already been attacked by needle after needle, and his clothes had been ripped away. He was aware that when - if - Derek woke up, he would be annoyed that he didn't cover his scars, but he didn't have time to worry about that now. Saving his life was what was important here.

"Found unconscious in an on-call room. He's bradycardic at forty-six, hypertensive at one-forty-two over ninety-seven, dyspnoea, fever at one-zero-two-point-two, vomiting, jaundice. We're still waiting on bloods but I'm going to guess high creatinine and bilirubin."

"So what are we going to do? What does he need? How do we fix him?" Mark asked desperately.

"I don't think we're going to know anything until we get bloods back. They'll tell us more about the state of his liver and kidney."

"So it's the DMSO, right?" He concluded. "That's why this is happening?"

"We don't know yet." Bailey replied level headedly. Just because it seemed like there was a simple explanation, that didn't mean there always was one. He could have handled the situation perfectly, but his body had picked up a serious bug just the day before.

"What other cause could there be?" Mark asked.

"The symptoms fit DMSO."

Mark looked over to the quieter, more broken voice that had just spoken to find one of the last people he expected to see. "Okay, no interns- Interns kill, and no one is killing Derek." He snapped at the sight of her.

"Hypertension, bradycardia, dyspnoea, vomiting, pulmonary oedema, fever-" Meredith paused as she sniffled her tears. If anyone asked, she was just traumatised by finding an attending in much an adverse condition. She had no idea what she would be like if it was a random doctor, but there wouldn't be the added layer of grief and fear and pain and despair.There were so many questions that Meredith wanted to ask, but she couldn't show too much concern. As much as she wanted to fall to the floor screaming of fear and ask so many questions that her muscles of mastication snapped, she couldn't. Or she could. Maybe. But she couldn't reveal that she was in a relationship that she wasn't actually in."They are all symptoms of DMSO poisoning."

"Impressive, Grey, how do you know that?" Richard asked, surprised by the list. Although most of those symptoms could be associated with many other diseases, it still helped.

"Research." She just about managed to get out. She'd pulled up as many articles as she could the second she heard about what was going on and, most importantly, that Derek was one of the effected doctors. She wanted to be able to notice any minor signs that he was struggling before he deteriorated, and now she felt horrible for not checking on him sooner.

"Okay, so what else are we looking for?"

"Um- well, I'm guessing if he was conscious he'd probably complain of- um chest tightness, nausea, abdominal pain, dizziness, weakness, chills, headache. There's quite a few dermological problems that can develop with DSMO. Um- Brady- and tachycardia were both reported, same with hypo- and hypertension so- I guess current status could change. We should expect um- cardiac problems- v-tach, v-fib. Severe neurological symptoms like seizures and um- encephalopathy have been reported but- I don't know, I don't think they were that common."

"Dr Grey, I appreciate this but-" He stopped when his politeness ran out. He couldn't just kick her out without thanking her, but, at the same time, he didn't have time. Derek didn't have time. "I think you should go."

"I- I'm just-" She faltered. She just what? What did she think she was going to say?

"Just- attendings and residents only, I'm sorry but-" He paused as he finally looked up at her. Before that, his eyes were glued to Derek.

Her wet eyes, her trembling lip, how tightly her hand was squeezing his, how much pain she was in when she looked at him- those weren't the kinds of behaviours that were bought about by witnessing a traumatic event occurring with an acquaintance. She looked so broken, as if a close friend or family member was in the hospital, not an attending. But that was because, to her, Derek wasn't just chief of neurosurgery or a plain old attending. He was her best friend, and the man she was in love with.

Meredith Grey was the woman he'd been talking about this whole time. She was the one he was in love with and, from the looks of it, he was the one she was in love with too.

Before he could speak, the door opened again, and a nurse rushed in with a piece of paper before practically shoving it into the chief's hands. "Labs, Dr Webber."

He scanned the results without a single word, but his heavy swallow told the room enough about what he was reading.

"What?" Mark pushed. "What is it?"

"Right, bilirubin is up- looks like toxic hepatitis, but...his creatinine is through the roof." Richard sighed. "I think he's in acute renal failure."

Bailey nodded as she looked through the test, agreeing with his conclusion. "Okay, I need someone to set up dialysis as soon as possible, and get a room in the intensive care unit."

"I'll give him a kidney." Mark interrupted. There was no way he was going to let Derek lie unconscious in the ICU for hours, preying for the dialysis to both work on fixing his failing kidney, as well as fix all the other problems the build up of toxins had created.

"Mark-" Bailey sighed.

"You know I'm a match. We tested at the time because we didn't know if he needed one, and I'm a match. Let me give him a kidney."

"There's a possibility he won't go into ESRD, Mark, he might be fine on dialysis and fluids."

"He might be. I'm not taking that risk."

"That's weeks off of work, a painful recovery, risk of post-operative complications-" Bailey tried. Of course Mark knew all of that, but doctors stopped being doctors the second the patient was a friend or family member, so she knew she had to remind him of what he was really getting himself into.

"And you know what a complication of acute renal failure is? Death."

Richard stared at Mark for a long second before sighing. "Someone book two ORs and find me a consent form for a kidney donation."

"Tequila, Joe."

"What happened?" Cristina asked.

She picked up the drink before she even sat down on the bar stool beside her four friends. She drank it in what Cristina swore was less than a second, and didn't even wince.

"Did he say no?"

Meredith didn't even acknowledge that Cristina was talking to her. She didn't look round, she didn't reply, she didn't do anything. "Another one."

Joe glanced at Cristina with concern before obeying Meredith's request and pouring her another drink.

"Meredith, talk to me."

She downed the second drink quicker than the first.

"What's going on?" Izzie asked, confused.

"She was supposed to be asking out the guy she likes." Cristina explained quickly as she turned to Izzie, George and Alex before looking back to Meredith. She clutched her arm in the hope she'd finally be noticed. "Meredith, what happened? Did he say no?"

"He..." She swallowed. "He said no."

Cristina didn't speak for a second, thinking. She wasn't very good at being warm and comforting, but she was pretty sure that was what Meredith needed. "Did he say why?"

"It's complicated."

"Was it to do with, you know, the thing?" She pressed, knowing that if she said what she wanted to, the others would instantly know the identity of who they were discussing.

"I don't know. I don't-" She sighed, and felt her eyes brim with tears again. He was probably in surgery by now. She was still in love with him and all she wanted to do was run to his side. But she couldn't. Not when he didn't want her. "I just-"

"What in the world did he say to you to make you cry-" Izzie paused when their pagers exploded with beeps. "Crap, 9-1-1."

Four out of the five interns stood up and collected their belongings to return to the hospital. Luckily, they hadn't drunk any alcohol yet, despite being there for quite a while.

"Cristina." Meredith grabbed her arm.

She sighed as she looked down to where Meredith's fingers were so desperately grasping at her forearm before turning around to the others. "You guys go. I'll be there in a minute."

The trio agreed, and hurried out of the bar, knowing that whoever was the quickest would get the best trauma.

"What really happened then?" Cristina asked after Meredith still refused to speak.

"The reason you're getting paged is probably because all the attending are in surgery and they need pit cover."

"Okay." She agreed hesitantly. "So...did something happen?"

"Derek is in ARF."

"What- why aren't you at the hospital? Don't you want to- I don't know, wait for him or something?" She asked. She didn't know a lot about romance and crushes and love, her previous relationships weren't built on the same kind of love that Meredith described, but she was pretty sure that even she would sit and wait in the hospital for someone she was in love with. Maybe she wouldn't cry in the waiting room or anything along those lines, but she'd at least want to be there for updates.

"No." She shook her head as she looked at her empty glass. "I just- I'm just going to drink."

Cristina swallowed. "Look, I don't do romance or- or whatever but- are you sure? That doesn't sound like what you're supposed to do when you're in love."

She sighed as she looked away. "Get me another shot of tequila, Joe."

"Okay, explain why you think he said no one more time."

"Don't panic, okay- it's okay. You collapsed. You need surgery, but you're going to be absolutely fine." She reassured him as she squeezed his hand and smiled. Mark had asked for her specifically to be the one who prepped him for surgery alone, and she knew he had done it on purpose. So-called McSteamy definitely knew that she was in love with him now, but she doubted that he was going to spread that information through the hospital. "Mark is giving you a kidney because you're in renal failure after that toxic patient. He volunteered before I could but turns out we're not the same blood type anyway but- Derek, the reason I wanted to find you today- the reason why I wanted you to meet me in that room was because I...I wanted- needed- I...I needed to tell you that I... love you, Derek. And that I've been in love with you for freaking forever. And that I don't care about whatever crap you're going to come up with about you being undatable because I fell in love with you like this and-" She snorted. "The only time I didn't love you was when I didn't know and I was shouting at you for being a lazy ass, so just- no excuses. No saying no. Unless you just hate me but- God, Derek I hope to god you don't hate me because I am not doing all this stupid love stuff with someone else all over again. And that means no dying as well, because then it'd be the same. Okay? You hear me? No dying. I, Meredith Grey, am telling you I'm in love with you. And that's insane because I- I don't like stuff like this. I don't like cheese and I don't like romance and I don't like boyfriends but I want a cheesy romance with you. I want anything I can freaking get with you. Anything. But to have that, you've got to live. So no dying, because I love you, okay?"

She stared, hopeful, at him with sparkling, teary eyes. She wasn't sure if she was crying of worry about him for surgery, or because she was emotional from just spilling so many feelings, or if it was a combination of both.

He loved her. She was so sure that he loved her.

Until his hand pulled away from hers.

"I told him I loved him. And he pulled his hand away. He tried to let go and he pulled away."

"Let go of your hand?" Cristina repeated, confused.

"I said I love you, and he pulled away. That means no. That means I don't love you too, does it? Otherwise, he would have squeezed my hand back or just- he would have done something. Something other than that."

"Have you considered the possibility that he was just half unconscious and weak and dying at the time?"

She swallowed. "I- yes, I've thought about it but just-"

"Just what?" Cristina pushed, hoping to rationalize Meredith's thoughts.

"I'm scared, okay? You knew I was scared of commitment and scared of- I was scared of everything. And now I'm even more scared so just-" She paused. "I know I'm probably paranoid and stupid but- I am scared Cristina."

"He might not even remember you saying that. He might not even have meant to do that. But you're just going to what- avoid him for the rest of your life?"

Meredith sighed. "I'm going to find some tequila."

"Mark- I've just finished making lunch, can you call me ba-"

"There's a plane to Seattle in thirty minutes." Mark said as he switched his phone to his other hand when a nurse requested to jab him with a needle. He was in a gown, sat on a gurney to get ready for surgery, but he knew there was one phone call he needed to make before either of them went into the OR. "If not, there's one in an hour but if you can manage-"

"Mark, what are you talking about?" Carolyn interrupted, confused.

"Derek is in kidney failure. There was this patient- he was exposed to this toxin in the OR and we thought he was fine but now he just-" He paused to attempt to collect his thoughts. "I'm giving him a kidney. He should be fine but just- I'm guessing you want to be here so-" He gave up on talking when the phone went dead. "Carolyn?"

She'd left the house after just collecting her passport and purse, which was only about two minutes after she ended Mark's call so she could rush off to collect her very minimal possessions. She hadn't brought any clothes, or her toothbrush, or her phone charger, or anything else. So, she was asleep half on her son's bed in jeans and a jumper with unbrushed teeth.

Until she wasn't.

She felt a hand jabbing her over and over on her arm. For a while, she didn't move. The longer she was asleep, the less pain she had to feel over her son, and she wanted to keep that calm for as long as possible. And then she realized which side the tapping came from, and her head shot up.

Derek was the one tapping her over and over.

"Oh, sweetie-" Carolyn breathed. "You're awake."

Nothing. He just stared at her, silent.

"How are you feeling? Can I get you anything? Do you need some water? How's the pain? You have a morphine pump if you need to use it on your left hand." She informed him quickly. "You had a kidney transplant because apparently there was this patient with toxic blood and the toxins were too much for your body to cope with. You have some other problems too, but the surgeons said you'd be fine."

He didn't even process that. Not a single word. He had one singular priority, and it wasn't himself. "Mu- muh-" He faltered as he groped desperately for the word repeating in his mind, experiencing something that he had hundreds of thousands of times.

"Okay, okay- just pause, reset, breathe, you know what to do."

His eyes closed as he gulped before just about managing, "Meredith?"

"I haven't seen Meredith, I'm so sorry sweetie." She apologized with a sympathetic smile. The more pain he was in, the more coddling words came out of her mouth. She knew he hated it, but she couldn't help it.

"I love her, Mom-" He paused. "Meredith- I- I love Meredith."

Her sympathetic expression grew to a grin. "I know. But-"

"But?" He rasped.

"I um- I was told that she doesn't want to see you, Derek. I don't know why but- she doesn't want to come here." She admitted regretfully before moving on, hoping he'd forget about Meredith, "Do you want me to tell you about what happened after you collapsed? Surgical details? I can read you your chart if you want."

"No." He muttered, shaking his head.

"Are you sure?" She asked, surprised. Derek had had what felt like a hundred secondary surgeries for various problems after his accident, and the first thing he wanted to know after every single one was how it went. Was there any unusual bleeding? Were there any complications? Was the prognosis still the same? "Normally it's the first thing you want to know about after surgery."

He only wanted one thing. He wanted Meredith. But he wasn't going to get her.

"Are you feeling okay?" She asked, worried. She squeezed his hand. "Are you in pain? Should I call for help?"

"I'm okay Ma." He sighed. He wasn't okay; he didn't have Meredith.

"No, you're not."

He stared at her for a second before swallowing. After a particularly heavy blink, he felt water wash his eyes. "Does- does that mean she doesn't love me back?"

He was so new to love, despite being thirty-five. He hadn't thought about anyone in that way for a good year and a half, and his ability to cope with a crush seemed to have fallen out of his brain. That or he was so in love that he'd just lost his mind.

"She came to your house with a five-hundred day anniversary cake, does that sound like something someone who didn't like you would do?"

"So why isn't she here now?"

Carolyn sighed. "I don't think I can answer that one, I'm sorry."