62. Exhausted

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In addition to the new year and all of its shiny resolutions came the added stress of a surgical specialty. With the fourth year of residency quickly approaching in July, it was time to start honing in on that area of surgery that residents would pursue as their chosen field. Meredith knew from early on that neuro was where she belonged. Even as a child, paging through her mother's surgical textbooks, the brain always fascinated her. And it still did, even more so now that she had a husband that was always willing to teach her and let her scrub in whenever she wanted to and was able to.

Right now though, there was nothing more she wanted to do than sleep. The soft sunlight pouring in through the window of Derek's office told her it was probably close to six o'clock, just a half hour until rounds. The sofa bed Derek got them as part of her Christmas gift had become one of her new best friends. Knowing that at the end of a tough day, she and Derek could escape up to the fifth floor, lock the office door, and have their own secluded sleepovers away from the hustle and bustle of the surgical floor on call rooms was something she always looked forward to, now more than ever.

Meredith rolled over in the bed and glanced at the clock on Derek's desk. 5:54. She ran a hand through her hair, mussed and wavy from sleeping, then sighed at Derek's absence. Maybe he'd gotten paged earlier this morning and hadn't wanted to wake her. Derek knew how exhausted Meredith had been lately, so letting her get a few extra hours of rest was probably a good idea.

After regretfully getting out of bed and folding it back into the sofa, she slipped on her shoes, grabbed her pager, cell phone and coat, and walked down the hall toward the elevator. Glancing at her watch, Meredith estimated the amount of time it would take her to get showered and dressed, get coffee, and shove down a quick breakfast. She'd gotten it all down to a science lately. Fifteen minutes spent getting showered and changed, five minutes for coffee and food, and the remainder spent getting prepped for rounds. Life was exhausting these past few weeks, but Meredith knew it would all be worth it.

She made her deadline with three minutes to spare, during which time she leaned against her cubby, coffee mug in hand and closed her eyes. Drained didn't even begin to describe how Meredith felt, but little could be done to relieve the constant exhaustion.

Izzie entered the lounge with a bag full of muffins and immediately frowned when she noticed Meredith dozing off while standing up. She set the bag down on the table. "Mer," she said softly. "You okay?"

"Hmm?" Meredith asked, her eyes popping open. "Oh. Yeah. I'm good, just tired."

"I want you to eat one of these. It'll keep your sugar up," Izzie instructed before frowning. "You should take the morning off, get some sleep. Bailey would probably let you," she said, handing Meredith a large blueberry muffin.

Meredith shook her head. "Can't. I'm down in the ER until noon, then I'm on neuro rotation with Derek. I'm fine Iz, really," she said unconvincingly.

Izzie looked to Meredith with a disbelieving eye. They were as close as sisters, and she could see right through Meredith's act. "If you pass out over an open brain, don't think I won't say 'I told you so,'" she warned.

"Iz..." Meredith groaned, but still taking a bite of the muffin.

"Fine, fine. I'll stop. I'm just worried," Izzie said in explanation.

Meredith smiled. "I know. But I'm fine. Promise."

When Izzie's questioning had finally ceased, Meredith and Izzie joined the others for rounds, which had gone surprisingly well. Patients didn't bitch and moan like they usually did, and there was no vomit. That always made for smooth rounds.

Derek texted her, saying he had some free time until she was scheduled to scrub in on an aneurysm removal at one, so Meredith asked him to meet her down in the pit. If anyone could make that task a little more enjoyable, it was Derek. He found her standing at the nurses' station, writing out a prescription for allergy medicine, so he walked over to her, eager to help her out any way he could.

"Hey," he smiled, kissing her temple. "Anything I can do?"

Meredith turned to her husband and returned the smile. "Hey. If you wanted to take curtain three, I could go take the girl in curtain one for x-rays."

Derek nodded in agreement. "Okay," he said. He studied her face for a moment and pursed his lips. "You okay? You look..."

"Don't finish that sentence," Meredith smirked. "I know I look tired. Izzie already gave me a whole speech about it."

He brushed some hair off her forehead and kissed her. "Okay." In the few seconds of intimacy they shared, she was already anxious to find a nice quiet spot to relax with him. It made the prospect of crawling into bed with him tonight even more appealing.

Working in the ER was always an interesting feat, and hardly ever a walk in the park. Just as Meredith was directing a gurney into the trauma bay doors, a car swerved into the drop off zone. Whenever that happened, it was never good. All alone, Meredith hurried over to the car and peered into the windows, trying to assess what the emergency could be. When she saw a pregnant, contracting woman in the backseat, she sighed. It was one of those days.

She opened the car door and gave the woman a reassuring nod. "It's okay. I'm going to help," she said.

"The baby is coming fast! She's not gonna make it into the hospital," her husband replied frantically.

Meredith peered down and noticed how the baby's head was already emerging. The adrenaline suddenly took over and the sleepiness she'd been feeling all but disappeared. "Okay..." she stalled. "I'll be right back. Just keep breathing. And don't push," Meredith instructed.

She ran back into the ER for supplies when she noticed Derek setting a patient chart in the bin. While grabbing gloves, sterile sheets, a blanket, a suctioning bulb, and a pair of scissors, Meredith called his name. Right now, he was the only one in the room not doing anything too important, so he would have to help. Plus, he kept her calm. "Derek!" she shouted over the noise. He glanced at her, giving her his full attention.

"Come with me," Meredith ordered.

Derek quickly met up with her as she made her way for the ER doors. "What are we doing?"

"Neuro, maternity...they're interchangeable skills, right?" she asked, not caring how little it made sense. "'Cause we're about to deliver a baby in a car..."

"Okay," he agreed. Saying no probably wasn't the best move, so he opted not to.

When they reached the car, the birthing woman was doing her best not to push, despite the contractions that wracked her body. Meredith immediately sat on the edge of the car seat and draped the area as best she could, while Derek stood just outside the door, ready to help when she needed it. When she had done all she could do to keep things sterile, Meredith nodded.

"Okay, I want you to push on the next contraction," she said calmly. "The baby's head is almost out."

Though a moment of high stress, Derek couldn't help but admire how well Meredith was handling it all. How she never froze in a crisis and always did what needed to be done. He'd always admired that about her.

On the next contraction, the woman pushed and her baby's head emerged. Meredith nodded and held it in place. "That's good. Just relax for a second, okay?"

Derek handed her the suctioning bulb so she could clear the infant's airway, which she completed with ease. Setting the bulb in her lap, Meredith instructed the woman to push again. The shoulders were passed through and after another push, the baby slipped into Meredith's arms. "It's a girl," she announced, smiling.

After the father reached around and cut the umbilical cord, Derek wrapped the blanket around the newborn to keep her warm on the chilly January day. "Congratulations," Derek grinned. "She's got a healthy set of lungs," he chuckled.

"Thank you," the new mother said gratefully despite her exhaustion, and the husband echoed his praise.

Meredith simply nodded and smiled. "Let's get the three of you inside."

Derek ran back into the ER with the newborn safely cradled in his arms, and within minutes, the parents were inside, admitted, and on their way up to the OB wing with Meredith and Derek in tow. The two of them gave the woman's OB a rundown of what happened, and signed and dated all of the papers stating that they were the ones to deliver the infant. It was all so quick that they barely got a moment to take in their small victory. On their way out the door, Mr. and Mrs. Halley, the parents' names they'd just learned, stopped Meredith and Derek to express their gratitude one last time.

"Thank you both. So much," Mr. Halley said with tears in his eyes. "Our car kept stalling and by the time we got on the road, Lisa was ready to push and we just...thank you."

Derek let Meredith take the credit, for she was the one that really deserved it. He just stood back and smiled while she spoke. "Oh, it's...it's no problem. I'm just glad we were able to help. And congratulations, she's beautiful." Meredith smiled at the newborn wrapped warmly and sleeping in her mother's arms.

"Thank you," Mrs. Halley whispered, unable to take her eyes off their new daughter.

After Derek and Meredith said their goodbyes, Derek pulled her into the stairwell and kissed her. She smiled against his lips. "What's this for?"

"Mer, you just delivered a baby in a car all by yourself. You have no idea how proud I am of you," Derek grinned, combing his fingers through her hair.

Meredith rested her head against his chest and yawned. The adrenaline was wearing off, and the overwhelming urge to crawl up in a corner and take a nap was settling in once again. "Hmm...what time is it?"

"Twelve thirty," he said. "Don't worry, while you were filling out paperwork back there, I pushed the surgery back an hour."

"Okay," Meredith nodded. "So does that mean I can sleep?"

Derek kissed her forehead and smiled. "You should eat something, Mer. Delivering babies is hard work..." he joked.

"I just caught it. I didn't push it out," she managed to giggle, still in his embrace.

"Still. Food is good. And we're gonna be in surgery for a few hours. Come on, humor me," Derek said, trying his best to sound convincing. He knew that when Meredith was tired and stressed out, she never had much of an appetite. There were times when sleeping was just so much more appealing than eating.

Meredith rolled her eyes at Derek's great concern for her and nodded. "Fine."

"We can have sex too, if you wanted to. I know that helps you unwind," he pointed out with a smirk, though he knew it was the truth.

"Hmm, you know how we just saw a baby come out of a vagina? Doesn't exactly put mine in the mood," she sighed.

"Guess not," he laughed, running his hands soothingly down her back.

Meredith breathed him in and smiled contentedly; Derek always smelled good, even after hours in the OR. "Thank you for helping me, by the way. I didn't have time to page anyone from OB, and I figured you would help keep me calm."

"Mer, you were incredible out there. If I were a third year resident, I don't know if I would have been able to handle that so well. You did good; I'm proud of you." Derek kissed the top of her head and chuckled. "You're just as good at OB as neuro."

"Maybe I should switch then..." Meredith mused teasingly, playing with the lapel of his coat.

Derek smirked at his wife. "I'd miss working with you too much."

"Yeah, I guess I'd miss working with you too. I get to keep you in line," she giggled.

They began the walk toward the elevator down to the cafeteria so they could eat something before scrubbing in, and he wrapped his arm loosely around Meredith's waist. Keeping things professional was important to them, but they were always game for making the occasional exception, especially on tough days like this one.

He pressed the down arrow next to the elevator, then grinned at her. "You're good at that, too."

--

"Ready to begin, Dr. Shepherd?" Derek asked Meredith as they walked into the OR, scrubbed in and eager to start the tumor resection on their ten year old patient.

"Yeah," Meredith breathed. She took her normal place next to Derek over the young boy's shaved head, prepped for the incision.

Derek grinned beneath his surgical mask, his eyes sparkling at her. "Well, go ahead."

"By myself?" she asked, dumbfounded. Derek had always let her help, but doing a surgery like this all by herself was practically unheard of.

"Yeah," Derek nodded. "I know you can do it."

Meredith's heart pounded away in her chest. Once again, adrenaline and excitement trumped her tiredness. "Wow. Uh...okay," she said decisively. "Scalpel."

Derek watched as Meredith expertly pulled back the correct portion of scalp, and drilled holes into the skull. Her precision and confidence filled him with such pride that he had to keep from kissing her in the middle of the operation. She removed the skull flap and handed it off to Derek, who placed it on the boy's abdomen to preserve circulation and keep the bone viable.

Once inside the patient's brain, Meredith used a probe to locate the tumor in the subdural area, and gently began removing it, maneuvering around blood vessels and vital brain centers. "Suction," she eventually said softly, barely speaking at all as she worked. Chatting during surgery, like Derek did on a daily basis, was a skill that had to be built over time. Right now, Meredith just wanted to focus on the task at hand.

Derek stepped in to suction the pooled blood in the surgical field. A humble job like that was often the work of an intern, but he didn't mind. He was honored to assist her as she saved a life. As he suctioned, he nodded in satisfaction. "Good."

"Thank you," Meredith whispered; Derek could tell she was smiling under her mask. Knowing Meredith was just as proud of herself as he was of her made all the difference. She examined the area for residual bleeding and frowned. "Damn it. Is that an aneurysm?"

Derek sighed. "The tumor must have been obscuring it on the CT. Alright, I'll expose the area a little more to get better visualization, then you can just clip it. You'll be fine."

"Me?" Meredith asked, her voice shaking slightly. Baby delivering, tumor removing, and aneurysm clipping all in one day. Impressive for a third year resident, but frightening as hell at the same time.

"Yeah. You can do it, Mer," Derek said in a soft voice so only she could hear him.

She subconsciously moved closer to him and let out a breath. "Okay."

Derek gently inserted the probe, carefully pulled back on the area right next to the bulging aneurysm to give Meredith more room to clip it, then nodded. "Now just place the clip on the neck of the aneurysm--gently. Be careful not to nick any arteries near it," he instructed.

Meredith worked with just as much surgical delicacy and precision that Derek would have used himself. She was flawless in her technique, just as he knew she would be. "Good," he said softly. "Now close the clip to pinch off the aneurysm."

"Okay."

After completing that task, Derek spoke again. "Now take this..." he said, handing her a needle. "Puncture the clipped portion--"

"To make sure no blood is filling the aneurysm," Meredith finished.

Once again, Derek grinned under his mask. "Exactly." She inserted the needle into the bulge of the aneurysm, and nodded in approval when no blood was leaked from inside. "Good."

"That's it, right?" Meredith asked, a little in awe that she had actually completed the entirety of the surgery by herself.

"That's it."

Meredith looked to her husband and sighed in relief. "I did it."

Derek nodded in agreement, his eyes shining right into hers. Their own little moment of intimacy amidst open brains and the other surgical team. He smiled widely. "You did it."

--

As they scrubbed out, Meredith stared straight ahead, into the OR. Derek noticed the look she had on her face; it was the same one she wore after her first ever surgery. Her surgical high face. However proud she was of herself, Derek knew he was at least ten times prouder. "You kicked ass in there."

"I can't believe you let me do that," Meredith breathed, grabbing a paper towel. "That was just..."

"Awesome?" Derek offered.

She giggled. "Awesome is putting it lightly, but yes...awesome." Meredith paused and smiled at him. "Thank you, Derek."

Now that they were out of the OR and alone, Derek was finally able to kiss her. The second he pressed his lips to hers, Meredith closed her eyes and moaned involuntarily. Even after all this time, kissing Derek still made her weak at the knees. "I wouldn't have let anyone else do that," Derek whispered.

"Hmm...is that because I give you sex?" she asked playfully.

Derek raised his eyebrows, smirking at her. "No," he chuckled. "There's some fifth year residents who wouldn't be able to do that. You're...something else, Meredith. It's an honor for me to get to work with you every day. And I mean that," Derek said with nothing but sincerity.

Meredith just smiled softly, lacing her fingers with her husband's. When he said things like that, all of the exhaustion and fear and wondering why she put herself through it all in the first place? Totally worth it.

--

When Meredith walked into their bedroom that night wearing a pair of his pajama pants and a Dartmouth sweatshirt, Derek pulled back the covers on her side of the bed and chuckled. "Those aren't sex clothes, are they?"

"I'm surprised I didn't fall asleep standing up in the shower. Do you really think I'd be game for sex tonight?" she laughed, releasing her damp hair from her ponytail and setting the hair tie on her nightstand. After she crawled into bed next to him, she immediately pressed her body against his.

She rested her head on his chest and he kissed her when she titled her head up to him. "I'm really not in the mood either," he yawned. "Long day..."

Meredith reached her hand up and placed her palm over his cheek. As incredible as the sex was between them, simply curling up under the covers was pretty dam nice, too. "Yeah," she concurred.

She closed her eyes, taking in her husband's presence and warmth. After long days, this was all she wanted to do. Rest in bed with Derek and their dog, who was already sleeping next to Derek's feet. "Were you this exhausted when you were a resident?" she asked.

"Yeah. I was," Derek admitted, running his fingers through her hair. "But it gets better...rotations are tough. It's like having ten specialties at once. But once you're just in neuro, the workload will drop, which is good," he assured her. "You're okay, right? Not feeling sick or anything? You can slow it down, Mer. It's okay," Derek said worriedly, pressing his palm to her forehead.

Meredith shook her head. "No, not sick. Just tired. And to answer your next question...I'm not pregnant," she giggled.

"I wasn't going to ask that," Derek chuckled, pulling the blanket up over her.

"Well Izzie did. But that's just Izzie. She's our baby cheerleader," Meredith sighed amusedly. "I swear she's going to buy us books about conceiving for our anniversary," she joked.

Derek laughed, kissing the top of her head. "Wouldn't surprise me..."

"Trying for a baby in the same month I start my fourth year," Meredith mused out loud. "We're crazy, aren't we?"

"We can do it," Derek said, his voice strong and reassuring. "It's good that we're waiting until July to start trying. Fourth year residents hone in more on their specific specialties. Less pit work, less hours on-call. More time for baby making sex..." he grinned.

"True..." Meredith giggled, her arm draped over his torso as her head still lay on his chest.

Derek hugged her closer to him, noticing how her eyelids fluttered with the need for sleep. "I love you, Meredith," he whispered, then flicked off the lamp on his nightstand.

Meredith lifted her head and kissed him again, easily finding his lips in the new darkness of their bedroom. She smiled. "I love you too."

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