"Diagnostics," Derek said, watching through the front window to ensure Faye's van had cleared the driveway before turning out the porch light. "We should've thought of that after the Adele thing."

Meredith shrugged from her seat on one of the kiddie chairs at Zola's table. "Alex is gonna start calling her House."

He tilted his head, moving to sit next to her only when Zola tugged on his hand. "She and Wilson have been hanging out a lot. J. Wilson."

Before Meredith's mouth's could open, Zola said, "Gotta reach you head, Mommy," and her stomach dropped into the limited space it had below her ribs.

"Our office manager had a real thing for Hugh Laurie," Derek explained, adjusting the bear earband so that it actually kept hair out of her face. Then, he stroked her cheek lightly, holding her eyes without a hint of condescension or dismissal, and she smiled. She could be sad her baby girl was growing up, but "Mommy" wasn't worth being scared over—her mommy had been the center of her small world, and she'd loved her as she'd loved "Mom," and even "Mother"—which she'd stopped using when she realized it encouraged Ellis's aloofness—but while she might panic every time she took on the next of Ellis's titles, she would not become the woman.

Mommy sometimes played doctor with her, letting her snap plastic bandaids on her wrist while she read journals. Otherwise, time together was being read to, or being still and quiet like a mouse watching all the big people in the house.

Her big people hadn't really taken part in her pretend games. Maybe that was why her imagination had such a tendency to run away with her.

"It would've been nice for him to have a cousin his age, too," Derek murmured, while Zola was digging through her costume box, studying and then rejecting possible animal personas for her father. Meredith grasped his hand under the table.

"Such a scientist," she teased. "You just want to create ideal conditions, in the hopes of getting similar results."

Zola crowned him with a tiara to accompany her own, and then added the lion ears for good measure.

"Is Daddy the lion king?"

"Simba be king," Zola corrected. "Him 'Fasa die."

"Yeah, that's sad, huh?"

"Um, Simba, so 'cited be king!" She sang a few disjointed lines from Can't Wait to be King, and moved on to brewing tea, a task that, in her life, belonged wholly to the world of pretend.

"She's so perfect."

She turned to Derek, a little concerned by his wistfulness. He'd come into bed gray-faced two nights ago. This time the story of a baby whose slate was not blank but broken, had been true, not a product of the imagination she'd been honing for thirty-four years. Worse, he belonged to his sister, not a patient who happened to leave a mark on their lives.

There were a lot of things she could've said that would've absolved him from the guilt. All the reasons he'd had for not going to look for Amelia, for not visiting her in rehab. for not calling enough to sense more going on, had been valid. She hadn't spoken.

Eventually he'd asked, "She's right, isn't she? A year ago, I would've thought that she…if she didn't deserve it that it was for the best. That she couldn't take care of a baby. That…. Anencephaly isn't…. It's sometimes lack of folic acid, or anti-seizure meds, but not opiates, and it occurs before most people know they're…. I…. Would I have blamed her?"

"You'd been waiting for that shoe to drop for a long time when she went AWOL," she hedged. "But Derek, losing Mark didn't transform you into a different person. You'd been changing. Once the initial explosion burned out, you'd have been happy, maybe cautiously, and then devastated along with her. You'd seen her get clean before, and you saw what having Sofia meant for Mark. I think you'd have gotten there, because you did.

"You don't have to beat yourself up over someone you could've been."

"Or so you've heard," he said, his voice thick, and not with mockery.

"You would've had a nephew from your favorite sister. You can be sad that you don't." It felt like a lame offering in relation to a lost baby, but it'd been enough for him to let her see the grief.

There was still some of it in his eyes as he showed Zola how to hold her teacup with her pinky raised. Meredith smiled, picturing him doing the same thing as a ten-year-old, while Mark snuck off to microwave frogs.

"What if he's a monster?"

"If wh—…." Meredith blinked and studied his face. The wistfulness was there, along with fascination as he watched Zola. He wasn't talking about rudimentary brainstems—his thoughts were far closer to home. "He's not gonna be a monster."

"What if he hates her? What if he steals her toys?"

What stories should I be asking Carolyn for? "Well. He is gonna steal her toys, because that's what kids do."

"Look at…. She's just so happy. You don't have any idea what's gonna happen do you?"

Meredith freed one of Zola's Mardi Gras strands—her "fancy necklace"—from the tip of her tiara. "I think she will handle him just fine," she said. "You're wearing a princess crown." And asking for tea in an accent I will mock for decades.

"…I am."

"So, she's very good at getting people to submit to her will."

He nodded, and she thought of Liz going leg-to-wrist with him last winter.

"No one's taking anyone's place. They're both going to be our babies. We're going to love them for who they are, not their birth order. And we're going to be the grown-ups." She didn't have to name names for the muscle in his jaw to clench, but it relaxed in the time it took Zola to give her a refill, which suggested the point had been made. "Know what it sounds like, Zo?"

"What?"

"It sounds like Daddy's worried we're gonna get a little Derek."

"Little Derek Critta?"

"He was definitely a little critter."

"I…wasn't bad."

"Maybe we should ask your older sisters about that." She sipped her air and added, "They all had multiple kids. Seems like they'd back you up."

She loved making him wear that dumbfounded look about as much as she loved it that Zola could get him to wear a crown. While his gears were still turning, she held her teacup out toward her daughter. "To little Derek!"

"Chee's!" Zola tapped it carefully with her own.

Derek clinked both of their cups at once. "L'Chaim."

"To life," Meredith agreed.

"Yay, team!" Zola declared.

Of all the toasts she'd been part of, that was among the best.

With Amelia there, they hadn't had the chance to debrief the days immediately preceding the sudden turn in Mr. Dawson's fortune. His recovery didn't mean it had been pried out of her brain. She'd positioned herself as Cristina's sounding board for almost a week. She'd pointed out that in the case of strokes and TBIs the period of therapeutic hypothermia could last up to seventy-two hours without damage, and that cardiac arrest could keep patients who hadn't been frozen from regaining consciousness for longer than a week.

"I expected her to bite my head off at that," she told Derek in bed after their tea party host had retired for the night."Would've been a nice return to status quo. She didn't, and I wonder…I get that it was mostly about Owen and the kid, but…. Hypothermia…and me…."

"Yeah." He sighed. "I've done it a couple of times since Callie went over my head with Phil Loomis. Crushed cord, C-6 to T-1." Meredith smiled to herself. So many doctors would've led with the case details, needing them to bring the name to mind. "Lowering the inflammation works, in rare cases."

"I know it wouldn't have helped Lexie," she assured him.

"As cold as it was out there, she didn't need therapeutic hypothermia. And I…I hate the idea of doing that to her. I hate doing it, especially for the families."

"Their loved one will be cold and alive, though," she said, without thinking. "I mean…I was…." Cold and dead. "They know they'll be alive when they're warmed up."

"I think it's probably terrifying regardless.."

"Yeah," she murmured, and twisted around to face him. "I love you."

"Prove it by not doing that," he chided, nudging her back onto her side. "That day was…awful, but we can talk about it. You know that."

"I know what your face did when Lexie mentioned me not breathing."

His sigh warmed the back of her neck. "I love you." A response and an explanation. "You really do stop feeling pain pretty reliably this way."

His arm was threaded through the gap the pillow created between her legs, his fingers working gently to diffuse the soreness she'd gathered through the day. This had nominally started as pre-labor peritoneum massage, which the research supported as possibly lowering the risk of tearing.

If this year had done nothing else, it was prove that Derek could do all kinds of things with her body and not have it turn into sex, but it also could, and it wasn't weird.

Would it be weird if she didn't know when in time they were? Too much like when she was spiraling, or the day he'd called it "in the woods?" That was the sort of incapacitation they were looking at in the long-run. Not the physical kind. On Lexie's side of Roseridge, they counseled couples on choosing and combining PCA and familial caretaking. Across the street, had there been a way to include Adele in the choice that made Richard decide that not visiting was the answer?

Derek wouldn't do that. She could hardly believe she'd ever see his eyes and not know him, but even if she had the same kind of reaction, he'd find a way to stay with her. Richard had thought the home knew best. So had she.

Maybe they should've had Alzheimer's doulas.

"Pretty sure the ibuprofen has kicked in, too," she said, keeping her voice light to avoid giving away her thought sojourn.

"There's that," he agreed, and kissed the side of her neck, unfairly sending a shiver she couldn't hold off through her body. No, she realized, rewarding her with it. "Because you know that if you let your hips twist, now, you might hurt more when you get up to pee in an hour—" He had not, she noted, said a word about her elbows. She jerked one back. "Omph. Those are sharp as ever."

"Get to your point," she directed. Not being able to diffuse the tension building in her spine did come with effects that would be benefits, but he wouldn't pick up the pace until he had said his piece. In spite of his attentive circling, it was already starting to feel like he'd simply moved the sum of her aches into her clit.

"My point is…if you decide you don't want an epidural…. Addison had patients who used more…natural pain relief techniques during labor. More than the stuff Callie's showing us. It's…not totally unheard of to have an orgasm during the delivery process. Totally different kind of stretch, with its own fluids, but you do better with this—" He turned his hand, his thumb continuing to circle her glans while two fingers slid into her cunt, facing the opposite direction from the peritoneum massage. "—before that."

Whatever the anatomical truth was about the sensitive spot his fingers found—totally clitoral tissue, she was sure—didn't matter. What he was saying was lost to her for the time it took her to adjust to the sudden increase in sensation. Not rolling her hips became impossible, which probably had something to do with how long he'd encouraged her to stay still to that point.

In what she considered to be a moment of genius, she got her top leg hooked back over his. The distance closed enough that it wasn't hard to get her ass pressed flushed against him.

"Mer—"

"Don't tell me you didn't refuse my offer to jerk you off, left-handed, even, because you knew you were gonna do that. You couldn't have thought I wouldn't notice you creaming your pants when I clamped down on your fingers. Or do you think you're taking blue balls for the cause?"

"Not…. We don't do…Jesus, baby, easy…! Not quid pro."

She hadn't actually gotten more from him about his motives. Her guess was that he'd figured she'd be tired enough that his simple ministrations would help her drift off, not make her more aware. She didn't know if it was normal or not, but she'd only wanted him more often as the weeks passed.

Once he'd moved to take his cock out, she reached back and made him swear a few more times. She kept her leg wrapped around his, letting him lift it far enough for him to slide into her. At the same moment, he adjusted his hand to put his palm against her clit. She'd have preferred to be facing him; to see the face that went with the moan her reaction drew from him, but that wouldn't have been as easy as just getting him to help her roll over with her belly in between. She'd have had to mount him, and just now lifting her head felt like an endeavor.

They'd practiced him holding her leg up in this position so it wouldn't be totally foreign if she ended up pushing on her side. One of the hills he'd determined he'd willingly die on was letting her deliver without pressure on her sacrum, even with an epidural. "It's a joint. Of course having it held in place hurts more than letting it move for the baby to have room in your pelvis."

In spite of how many times they'd wound up in this position because it followed so naturally from their usual sleeping arrangement, she flashed to two Christmases ago, when she'd been pissed that he couldn't explain what was going on with Cristina, but also ovulating. She'd taken the potential benefits of orgasm on fertility into her own hand that day, letting him do what he wanted with her boobs. They'd barely exchanged a word. They'd fallen into the same rhythm; the synchronicity that usually took eye contact and focus had taken over. They'd come together in the same breath, and he'd hooked an arm under her knees, lifting her legs up before she remembered she had legs. It could've felt methodical. Like a procedure. But he'd kissed the ball of her ankle, and run his palms over her calves, reminding her they were in it together, whatever else was going on.

It wast truer now. He might have a surgeon's bias for pain relief, especially with walking epidurals on offer, but as a neurosurgeon devotee of Vertosick he respected pain. Rven having the stories of two OB-GYNs in his head, he trusted that her body could do what it was meant to do, in the right circumstances. He also had far more faith in those.

"Wouldn't you…? I'm not saying yes or no, but you're usually more…discreet than I am," she stammered, wondering why her usual post-coital bluntness wasn't kicking in while discussing…not coitus, at all, but something related. "Even if no one's around…people'd talk. Not like crapping on the table."

"Just as natural. We could put that you want as much privacy as possible in your preferences." (That phrasing as opposed to "birth plan" had been a Wyatt suggestion. "Plans do go wrong, and that can lead to stress. Think of it as what you'd prefer, and if something changes, the whole thing won't be thrown off-kilter.") "If it helps you with the pain, I'll do whatever you need, no matter who's in the room. And you know you're not going to end up with anyone you don't know in there."

Four of the L nurses she'd gotten to know over the years had gone to Connie asking to be on her case. Dulce, who she'd worked with the most during her most recent OB shifts had volunteered to vet techs, "You're probably gonna get to a point where you will have no filters, Dr. Grey. Whether you go on about Dr. Shepherd's member, or his family members—you deserve to have that stay in the room. I would love to say that everyone on staff here is always respectful—"

"I'm not always respectful," she'd admitted, and let the nurse get on with her list.

"I was on one of Addison's cases," she told Derek, snuggling back against him. He had a single finger on her hood, moving it just enough for her to feel. No different than if his hand had been on her shoulder, or playing with her ear, unless he added pressure or speed. He'd do that until she fell asleep or told him to stop. He'd done it occasionally to keep her thoughts on track for years, and if he offered more lately; especially if their conversation could send her into a spiral, well…it worked.

The one time she'd ventured isn't it weird? when he asked why she'd rolled out of reach he'd replied, if it feels good, why does it matter?

"One of her breech births." Addison had been known as one of the few area OBs who'd try to deliver a favorable breech baby vaginally. "They'd been hoping for a home-birth. Her wife was a doula, and I kinda got the impression that it was an experiment for her? She stopped…stimulation, because the birthing mom started tearing. Addison had to do an episiotomy, and she generally avoided….you know that."

He nodded against the back of her head and tweaked her clit. It was weird, talking about watching a patient's partner finger her with his ex-wife while he was doing that.

Not weird enough for her to want him to stop.

"I told everyone," she continued. "And their reactions.… They were typical. She…Addison said it happens in maybe point three percent of births. I thought it was bizarre at first, but she said.… Most women only let their husbands see or touch their vulva, and then suddenly it's on display for doctors and nurses; they're touching and stretching her cunt—Okay, she didn't say… She said vagjna." Which word Addison used in bed was not something she knew or wanted to know. "Even if her husband or partner just touches her gently, it can prevent birth-related PTSD.

"We stigmatize every possible way women try to avoid pain, and judge them for seeking pleasure in any context. Men would absolutely stroke their dicks in the same situation. Like the porn pain relief guy.

"Anyway, Izzie was the only person who didn't react totally immaturely, and that's weird, because she once asked me if we were having issues because she heard me getting myself off."

There was a note of…something in Derek's chuckle, and she had an inkling that it'd been just long enough for that to cause an increase in the blood flow to his cock. She'd tried to keep him from pulling out right away.

"All before the ghost sex obviously. George said something about…about why would a husband want to…. We're doctors. Seeing my junk all…bruised and stretched isn't gonna change how you feel about it." She was proud of making that a statement.

"Not in a bad way."

"The point wouldn't be you getting it up."

"If you're in pain, I can pretty much promise that's not happening.

"Unless it's the kind of pain I like. "

"I'm working on that."

"Did…? I guess she'd only hear the last…. You wouldn't be doing the stuff that makes me…."

"You've accepted that the whole hospital might hear you bellow, but you're concerned about the small noises they probably already have ghost stories about?" He flicked her with the pad of his index finger, close to the move that would often work her into high pitched hooting moans.

"Dooon't. 'm done. Ghost stories are okay. Rumors. Confirmation is not."

"Meaning you could go again, but you're exhausted. I've got you, Mer. I will have you. If you're uncomfortable with the idea, then that's all there is to it. I just wanted you to know I'm game. I'll do this, or I'll just rub your back and mess with your hair. I won't touch you at all if you don't want me to.

"And if you don't want drugs…I want to talk about it, but everything is up to you. Just…if Connie says something you don't want is necessary, we're going to get her reasoning, but…. I…I can't lose you. You understand?"

She did. She comprehended, and she caught every implication. Immediately after she'd told him about the miscarriage, he'd assuaged her fear that he'd be angry at her for attempting to make that bargain with Clark, not because of her life being endangered, but her putting the potential baby's life on the line. Whether she'd truly believed Clark would shoot her, or wanted to buy time, the stress from that moment could've caused the miscarriage. If she'd been asked if she thought about being pregnant before Cristina had announced it, she'd have had to say no.

If the choice was her or the baby, she wasn't sure what she'd want. She'd take a bullet for Zola. Could she choose to leave her baby girl and a newborn motherless? She and Derek had both been raised by devastated mothers—but Derek would find someone else, and what kind of mother could say save me; let my baby die?

Wasn't that exactly what abortion exemptions based on the mother's health were?

Rationally though….

She'd have to live it to know. But knowing that Derek felt that way…. That she mattered to him like that….

She shoved herself over, which ended up involving him in adjusting the pillow, and the baby, and wasn't at all spontaneous. She tried not to let that matter. She had to face him.

"I used to think Mom wouldn't come to my funeral if there was an ex-lap she could do instead. Then, I realized she'd be in charge of arrangements, so I probably wouldn't get a funeral. So…even if…if that…if what you said changes—"

"Never. Mer. I love this baby, but you're…. I couldn't."

"You can't know…. I'm saying…you saying that, now….believing it…that's enough for me."

He kissed her, and caught the tears on her cheeks with his fingers. "And you wonder why I think you've been through enough pain?"

"I don't, and I'm not…. It's not that I think I have to take on the sin of Eve, or go through some sacred experience. It's safer. And…. Apart from the increased chance of more interventions…I'm afraid that I'd freak out over being numbed."

"Oh, Mer. That didn't evt—"

"I might not. It wouldn't be my whole body. But…I don't want a C. This is me, Derek. I've never had surgical complications, and it's gonna happen eventually! Epidurals increase the chances of that, or forceps and vacuums—I'm not a body-builder at the best times. My crunch number is pathetic. My abs are gonna need all the strength I can give—"

"Which might be more if you're not in pain for as long! You're not high risk. And no one can say if the correlations are high enough to worry—"

"I know! I know, I know, I know! But we have to consider the Grey factor. Ben Warren could do my spinal block perfectly, and somehow we'd have another case of paralysis in the house!"

"Meredith." Derek sighed and smoothed her hair—Would he be disappointed when it started thinning out again?—"This is what I'm afraid of, love. That you'll work yourself up, and that kind of pain—stronger pain you can't control—will make it worse. I'm afraid you'll get so focused on accepting the pain, you won't report, or realize, if it's worse or different than it should be. I'm afraid that the anxiety will make it hurt more. That if there's a decel, you'll blame yourself into a panic attack. I spent twelve years married to an OB-GYN and I took care of Nan's kids while she saw so many cases; the last part is when the life-threatening complications happen."

"Like neonatal encephalopathy after perinatal asphyxia."

"Yeeeeah, that is a…very specific concern. For the baby."

"Therapeutic hypothermia," she murmured.

"Ah. 'Perinatal' give you a whole new world of worries?'"

She shrugged. "Not there yet."

"We have to think ahead. I'm afraid that even if it goes well, you'll be so sure the shoe is going to drop…. The fourth trimester is a real deal, and we'll be focused on him….

"Promise you'll keep talking to me."

"It's going to be a lot for you, too."

His thumb slid against the apple of her cheek as the corner of his lips quirked. "Mer."

"I did the thing. Okay. If this was a kidney stone or something, I'd want all the meds I could get. I'd have let you give me anything when I had that last migraine. But this isn't appendicitis.

"I want the best chance of being able to recover quickly; to be there for Zo, and you, and the baby. The best chance of getting a baby who can come home when I'm discharged. I want to have him at the hospital—Grey factor—but…my body has gotten this far. Expelling the neonate is part of the process. You'd think a hostile uterus would be great at that. I'll give it the benefit of the doubt. Epidurals, IV pain meds, Pitocin—they're tools. If I need them, I'll use them. Same for the non-medicinal tools. I can withstand pain, especially if I know it has an endpoint. And…if you're with me."

"I will be. For every step."

"I'm gonna ask Lexie to be there, too. I don't…I don't want to be in the woods. Not—I'm not talking about dissociating. If that happens in transition or whatever…sorry. I know you don't like it, but…it could happen—I meant I don't want to be suffering and miserable. I…I don't want to be alone. I don't want to be in the dark.

"I'm not gonna think I'm weak if something changes—but if it doesn't…. Everyone tells me I'm strong; objectively I see why, but I don't feel it. Doing this…I think it could give me that back." She said all of that with her eyes on his face, and she was still startled by the smile she saw before he kissed her.

"I think you have a right to weakness. And I'm not sure asking for pain relief is weak. But what you're saying makes sense. If you change your mind, you'll just have to say the word. I'll be right there for that, too. If the numbness is an issue, I can help with replacement skills as much as comfort measures."

"Tangled or telfa?"

"Either." He kissed the tip of her nose. "Do you want me to let you know if the window is closing?"

She could see the same thing he could; her hitting a wall, whispering the word, and being told it was too late. She'd handle it, but going into delivery defeated wasn't a good plan.

"Use your judgement."

"Yeah?"

"I trust you. If…If it's one of those situations where I'm exhausted, and won't have the strength without a break, you can suggest it. I just don't want people acting like I'm…. Like it's inevitable. And…I do…it's cliché, but I do want to experience it. Even if that's turning the meds down, I've had this guy inside of me for months. I want to feel him come into the world."

She didn't think she had to feel the baby come out of her for some woo-woo connection, but she did want to see the thing through. A C wouldn't be the worst result, but it added risk, and would worsen the immediate postpartum period, where the chances of developing other issues were already higher.

She didn't want a new source of PTSD. That meant trying to avoid pain that made her wistful for the woods of Idaho. But if the numbness felt too much like the detachment from her own nervous system? She'd never wished that she'd been in Lexie's cohort before, but she might've gotten the chance to determine what her reaction would've been.

Except, then she'd been much further out from her last incident.

"There's nothing wrong with that," Derek reassured her. "It's not something everyone gets."

"Yeah…you have to wonder if Mom was just curious about the childbirth part."

"I'm happy with the end result."

She rolled her eyes, and realized how heavy her lids had gotten. Derek's thumb paused. "Comfortable here?"

"Mmm. Hafta pee inna hour anyway."

He put his arm around her. "Dream bigger, sweetness. Could be two."

"Then Zola will come in first." The one thing she used to have was if she fell asleep, and her dreams permitted, she didn't wake up in the night. That had been lost this month; although, she also had fewer nightmares. "It's hard to believe he's gonna come out of me. Not, like, the holy-shit-I-don't-stretch-like-that—knowing relaxin works miracles doesn't help as much as I think it should, but I have seen it—Like, one day I'll be like this, and the next…or else, little fetus, no squatters rights…. I'll be a mess of hormones in fishnet panties and still carrying some excess stuff, but I'll just be me, and Fetus will be a baby."

"With your nose."

"Your eyes."

"Your smile."

"Your optimism."

"Your determination."

"We're goin' pretty deep into epigenetics here."

"He's gonna get the nurture. Look at Zo-Zo's take-home report today."

"You mean her calling that kid a booger?"

"Which she wouldn't have done if he hadn't knocked over Sofia's blocks. That's your loyalty. Your fire. Your sense of justice. Your bravery." He took her braced wrist in the hand that wasn't entwined with hers. "I'm proud of you for going to see Callie."

"It would've just gotten worse if I hadn't. One major nerve issue per family is more than enough, and we're already past that. I caught Lexie printing out articles on nerve transfers the other day."

"That reminds me, she told me that she wouldn't mind keeping her room downstairs, but she wants to be able to help with the baby. She's planning on looking for an apartment once he's older, so we don't have to renovate—"

"But she's crazy, 'cause part of helping with the baby is getting up at two a.m. I vote we move her up here, and give you your study."

"I'll call Amar." Derek brought her hands up to brush his lips over her knuckles. "Your hands. Just in case he wants to be a surgeon."

"Your confidence." Meredith said. "In case he doesn't."