116. Meredith Goes Back

Disclaimer: Grey's doesn't belong to me.

Meredith rubbed her eyes as she walked down the hall toward the resident lounge after changing into her scrubs in the bathroom. Being back to work felt so oddly familiar and still so foreign. The hospital used to be her life. Surgery after surgery; hours and days spent without leaving the building. Now though, she was pretty certain she'd give all that up to be at home with Lilly and Derek. She knew coming back to work was the right decision, but she couldn't shake the feeling of guilt that weighed on her shoulders.

She turned the handle and entered the lounge, greeted by her friends who were getting ready. "Welcome back!" George said.

Meredith smiled at them as she set her bag down on the bench. "Thank you."

"So, how's it feel?" Alex asked.

"Well, I kind of feel like the world's crappiest mom right now, so not too good," Meredith answered honestly, trying to bite back tears that were in her eyes since she left the house this morning. "I just need today to go by fast. After today, I'm hoping it'll get easier." She wiped at her eyes, and started to maneuver her belongings back in her cubby that she'd taken home with her during her maternity leave.

Izzie frowned. "Mer, Derek is an amazing father. Hell, he could probably run a daycare by himself. Lilly is gonna be just fine," she said.

"Yeah, I know. It's just hard. As much as I want to be here, I want to be home with her," Meredith said, smiling when she saw one of Lilly's ultrasound pictures still taped to the back wall of her cubby. Even a 3D, in-utero photo of Lilly was enough to brighten her mood.

"Aren't they coming up here at lunch?" Cristina asked as she shrugged on her white jacket.

"Yeah. That's all that's getting me through the next four hours," Meredith said, pulling her hair back into a ponytail. "Until then, I just want to work."

"Morning, people," Bailey said as she walked into the resident lounge. "Welcome back, Grey."

"Thank you, Dr. Bailey," Meredith replied.

"I know you're probably all scheduled to be scrubbed in somewhere, but we've got a trauma rolling into the pit, so I need you all down in the ER to assess the incoming," she said.

"Any word on what happened?" Cristina asked as they all followed her out of the room and down the hall.

"Tailgate party gone bad," Bailey said.

"It's 8:15 in the morning," Alex laughed.

Bailey waved her arms in a shrug. "Must be very loyal fans, then," she said sarcastically.

"See? A nice, possibly drunken, Monday morning trauma. That'll lift your spirits, right?" Cristina asked, patting Meredith's arm.

"Yeah," Meredith said, her voice barren of any enthusiasm.

Cristina pulled her aside as they all waited for the elevator to arrive, and looked at her friend, concerned. "Hey, are you okay? Really, Mer, Lilly's fine. I mean, I'm not one to praise McDreamy for his unwavering perfection, but he is a good dad."

"Obviously, I know that," Meredith snapped. She sighed, shaking her head slightly. "Sorry, I'm not mad. I'm just... this isn't an easy day, okay?"

"Okay," Cristina accepted, backing off. "I'm here if you need to talk."

"I know," Meredith said softly.

The six of them stepped into the elevator, and the doors closed behind them. The whole way down to the ER, Meredith silently hoped that whatever was in store for her downstairs was enough to keep her mind occupied, and not focused on her six week old baby at home. When the doors opened again, she nodded in satisfaction. Normally, she hated the chaotic ER, but today, she welcomed the hustle and bustle with open arms.

"Alright, O'Malley and Karev, wait outside for more incoming; Izzie, take Trauma 1; Meredith, Trauma 2; Yang, 3. Looks like we've got lots of burn victims," Bailey said, coughing at the charred smell mixed with the scent of alcohol. "With a side of booze."

Meredith scrunched her nose, trying to get accustomed to the smell that she'd probably be contending with for the next few hours. She walked into the trauma room, ready to walk right back out the door when she saw a baby on the table, covered in soot, and crying. Meredith took a breath to regain composure, then immediately began assessing the infant.

"What happened?" Meredith asked a young man, who she presumed to be the baby's father.

"We were at a tailgating party for the baseball game this afternoon. The dude who parked next to us was making burgers when the grill just blows up. I guess there was too much gasoline or something," the man said.

"Is this your son?" Meredith asked, checking the baby's airway. She breathed a sigh of relief when she noticed it was free of soot, then put her stethoscope in her ears.

"Yeah. Ryan. Ryan Krauss."

"How old is he?" she asked.

"He turned one in, uh, January," the man said.

"Can I ask, what was your eighteen month old son doing at a tailgate party at eight in the morning?" she asked him as she listened to the baby's heart and breathing.

"My girlfriend had to work, so I just took him with me," he said. "She's gonna kill me."

As a way to keep her frustration with the man in check, Meredith focused on comforting the crying baby, whose father seemed more interested in texting someone on his phone. "It's okay, Ryan. You're gonna be okay," she soothed, gently examining the infant's body for signs that he may have been burned. "Was your son anywhere near the grill fire?"

"A few feet away. He was in a stroller."

Meredith spotted some minor heat rashes on the baby's calves and looked over to the nurse who was taking down notes. "Can you page Dr. Sloan to take a look at his legs, please?"

"I just saw him. I'll try to get him in here," the nurse said, setting her chart down and leaving the trauma room.

"Dr. Sloan is a burn specialist. These don't look serious, but I want him to check before I start treating your son," Meredith said. "Now, where were you when this happened?"

"I was putting ice in the cooler. I was a few feet away," he said.

Meredith felt the blood pulsing in her ears when she smelled the scent of alcohol on his breath, and stared him in the eye. "Sir, have you been drinking?"

The man shrugged. "Just one of two. I'm not drunk or anything."

"So, you were drinking while well aware that your child is under your care?" Meredith assumed.

"What's the big deal? I told you, I'm not drunk," he upheld.

"Okay, sir, I need you to leave the room," Meredith said, pointing to the door.

"What's going on in here?" Mark asked as he walked inside the trauma room, noticing the angered look on Meredith's face.

"Eighteen month old with heat rash on his legs after a grill blew up at a tailgating party. I wanted you to take a look. I'm also going to call up to respiratory to make sure his lungs sound clear. I didn't find any soot, but I'm not taking any chances. And I'd rather not put him under for intubation until I know," Meredith said. "Also, the boy's father has been drinking."

"Woah, what's your problem? Want me to take a damn breathalyzer? I'm not drunk," the guy said, raising his voice in annoyance.

Like Meredith had done, Mark pointed to the door. "Sir, you need to leave. I don't give a damn if it was a sip of beer or you chugged a keg. Dr. Grey and I need to assess your son. Now, leave the room or I'll have security do it for you," Mark said firmly, but keeping his demeanor calm.

"Fine, whatever. The reception in here sucks, anyway," he finally gave in, pulling the door open and walking toward the ambulance bay outside.

"Son of a bitch shouldn't even have kids," Mark said as he surveyed the baby's legs carefully so he wouldn't irritate the red, bumpy skin. "What's his name?"

"Ryan," Meredith said, dialing the nurses' station on the phone so respiratory could be called down.

"Alright, Ryan. It's okay, buddy," Mark said. He waited for Meredith to hang up the phone before he talked to her. "Some cold compresses on his legs should make the irritation go down. If it were more serious, I'd call up to pharm. for some ointment, but I don't want to trap in any heat."

Meredith nodded. "Okay."

"What the hell was a one and a half year old doing at a tailgating party at eight in the morning?" Mark asked.

"Same thing I said. And I wanted to punch him in the face when I smelled beer on him," Meredith said, shaking her head in disgust as she rummaged through the cabinet for gauze.

"First day back after maternity leave, and you get to deal with parental idiocy right out of the gate," Mark said. "Fun, huh?"

"Oh, yeah," Meredith said as she filled a clean basin with cold water. She hopped up onto the exam table and propped the infant on her lap. "Hey, Ryan. I'm gonna put these on your legs, okay?" she said, dipping the gauze into the water and draping the pieces over his legs.

Mark pulled a pen from his pocket and began scrawling down diagnosis and treatment notes on the chart, noticing the weariness of Meredith's eyes. "You look sad," he said.

Meredith wiped some of the black grill charcoal from Ryan's hand. "I was crying by the time I backed out of the driveway this morning," she admitted.

"It's only your first day. You knew that wasn't gonna be easy," Mark said.

"I didn't think it'd be this hard," Meredith said, letting the baby grab hold of her finger.

"That's the same thing Derek said on his first day back."

She smiled slightly. "Yeah?"

"Yeah."

"How did he make it through?" Meredith asked.

"He pulled out his phone every thirty seconds to look at pictures of Lilly," Mark said, signing his name to the chart and flipping it closed. "You just gotta get through today. On Derek's second day back, he was a little better, and better than that on the third day. I guarantee that by Friday, you won't cry when you pull out of the driveway."

"You think?"

"Absolutely," he nodded. "Tell you what, if I'm wrong, Friday's cup of coffee is on me."

"And a muffin?" she leveraged.

Mark laughed. "Deal."

"Okay," Meredith agreed, reaching out her hand and shaking his.

"In the meantime, I'll call up to social services. I want them to talk to Father of the Year outside," Mark said. He smiled at the baby on Meredith's lap and patted his foot. "Good luck, Ryan."

As Mark left the room, the respiratory specialist, Dr. Weston, entered, a dry, humorless man in his fifties that Meredith didn't like to associate with unless she had to. He flipped through the papers in the chart before speaking, and looked at Meredith. "No soot in his throat?"

"No. But I didn't want to take any chances. His breathing sounds normal, but I wanted a second opinion before I discharged him," Meredith said.

Dr. Weston coaxed the baby's mouth open with his finger, and examined his throat with a tongue depressor and a light. "Throat looks normal," he said before taking a listen to Ryan's lungs and heart. "Airways sound clear."

"Should I do a portable chest X-ray, just to be safe?" Meredith asked, feeling Ryan ball up the fabric of her scrub pants and lean into her.

"That's not necessary," Dr. Weston replied. "He can be discharged."

Meredith held her tongue, and simply nodded. "Okay," she said.

Dr. Weston left without another word, and Meredith rolled her eyes. "Goodbye to you, too..." she said sarcastically. She gently laid Ryan down on the table and hopped off, much to his chagrin. He started to fuss, and Meredith smiled at him. "Hey, hey. You're okay," she said. "I don't care what he says. I'm doing the X-ray anyway, Ryan."

She pulled the machine out from the corner of the room, and positioned it over the baby, then draped his body with lead blankets everywhere but over his chest and face. "I'm just taking your picture. It won't hurt," she said, mostly for the sake of conversation with him, knowing that he didn't understand what she meant.

After turning it on, Meredith brushed her finger over his cheek. "This will only take a second, so make sure you hold still, okay?" she said. She pressed the hand-held button attached to the X-ray machine, then snapped the photo. "Good job, buddy. All done."

Meredith took off the lead blankets, and removed the film tray before wheeling the X-ray machine back to its spot. Rather than risk leaving Ryan alone in the room for even a second, she flagged down Tyler, passing by in the hall. When he entered the room, Meredith smiled at him. "Hi. Can you take this up to radiology to have it printed, please?" she asked, handing him the film tray. "I can't leave him here."

"Yeah," Tyler said, taking it from her. "I'll ask someone to come in sit with him, so you can move on to other cases if you want."

"Okay, thank you," Meredith nodded as she re-dipped the gauze strips into the cold water.

Tyler left and a nurse named Shannon came in seconds later. "Tyler said you needed me to look after him?" she said.

"That would be great; thank you. His dad is probably being questioned by social services, and honestly, I don't want him in here, anyway," Meredith said, letting go of Ryan's hand.

When Ryan realized that Meredith was leaving, his lip quivered, and he let out a wail, his little face scrunching up in wrinkles in much the same way Lilly's did when she was upset. Meredith's stomach turned at the sad sound, and she let go of the door handle, letting it close. "I'll stay with him," she told Shannon.

"Are you sure?" Shannon asked.

"Yeah," Meredith replied, walking over to Ryan and rubbing his hand comfortingly. She smiled at Shannon. "Thank you, though. I appreciate it."

"Sure," Shannon said, before leaving the room.

Meredith took a clean wash cloth from the cabinet under the sink, then ran it under some warm water. "Since you don't want me to leave, how about we clean you up a little, okay?" she said. She rung out the cloth and sat back up on the table so she could hold him. "This isn't a very good day for you, huh?"

Ryan looked up at her, his blue eyes red-rimmed with tears, and he reached for her face. He pointed to his shirt and said something about Spongebob that Meredith couldn't quite understand, then cocked his head, as though he expected her to respond. "You don't say?" she joked, gently wiping his cheeks off.

"You know, I have a baby at home. You're older than she is, though. Her name is Lilly. Right now, she's home with her dad. He's probably teaching her how to cook an omelet or do a craniotomy or something," Meredith laughed. "He's a really good dad."

Her face became somber, and she hugged Ryan closer to her, his face leaning into her chest as he relaxed in her lap. "I'm sorry that your dad picked a booze-fueled tailgating party over taking care of you today. You didn't deserve that," Meredith said, peeking under the gauze to make sure the redness of his legs was gradually decreasing. "But it'll all work out. I'm gonna make sure you're safe, I promise."

Ryan yawned into her shirt and closed his eyes, his little body becoming more slack in her arms as he began to fall asleep. Meredith carefully continued to wipe him off, making sure every inch of him was clean before she tossed the rag into a nearby trashcan. Outside the window, there were people running around, and gurneys being wheeled in every direction, but with the door to the room closed, Meredith felt separated from all of it. It was just a dull hum of voices and movement, overshadowed by Ryan's breathing as he slept.

She watched as everyone outside the window worked, doctors doctoring in the ER, while she sat, secluded, holding a baby. Technically, she was on duty, treating a patient like everyone else, but it still felt different. Maybe she just wasn't totally back in sync with the rhythm of the hospital after being gone for so long. After being away for weeks, jumping right back into the chaos she had previously been so accustomed to wasn't so easy. Before, the hospital was home. And now, it felt like the place that kept her captive, away from what mattered most to her.

She glanced over at the clock on the wall. 8:57. Three hours until lunch. Three hours until Lilly.

One hour passed until Teddy and Arizona unexpectedly walked into the trauma room with Ryan's X-ray results, and Meredith knew something was wrong. She shifted the sleeping baby on her lap and swallowed thickly, waiting for whatever it was they had to say. "Are those his results?" she asked.

"Yeah. No smoke inhalation, but I did detect something else," Teddy said, putting the films up on the light box and turning it on. "See here?" she said as she pointed to Ryan's heart. "He has PDA."

"Persistent Ductus Arteriosus," Meredith said.

"It's usually detected at birth, but depending on what kind of medical care he had, it was obviously missed," Arizona explained. "The ductus of his heart didn't close properly after birth, and because the gap is still there, more blood goes to his lungs than usual. He's still young, so it probably wouldn't have been detected until he was a little older and more active. He'd be out of breath much faster than normal, and would probably get tired out easily."

"Shouldn't I have heard a murmur? I checked his heart, and so did Dr. Weston. Neither of us thought anything was abnormal," Meredith said, confused.

Teddy put her stethoscope in her ears. "It can be hard to detect unless you're really listening for it, and if he had no symptoms, you'd have to reason to suspect it," she said, listening to Ryan's heart. She concentrated intently for a few moments before nodding. "Yeah, it's there. Faint, but it's there."

Meredith frowned, feeling responsible for letting something so huge slip through the cracks. "I had no idea."

"The important thing is that we saw the abnormality on his X-ray, so now we can fix it," Arizona said.

"Well, I'm glad I decided to do it, then," Meredith said. "Dr. Weston said it wasn't necessary and that I could discharge him, but I wasn't going to risk it without being thorough."

"Good call, Grey," Teddy smiled, flipping the chart open. "Are his parents here so they can sign consent forms for surgery?"

"Sloan paged social services to talk to his dad. I haven't heard anything since," Meredith said.

Arizona raised her eyebrows in concern. "Dark haired guy in his early twenties? Baseball jersey?"

"Yes. Why?" Meredith asked, unsure of whether she really wanted the answer.

"He started a shouting match with the social services rep., and the police were called," Arizona said. "Apparently, it got kind of ugly."

Meredith sighed. "Perfect."

"You were the doctor originally assigned to him?" Teddy asked.

"Yeah," Meredith said. "His dad never gave me any information, though, other than the baby's name and age."

"He needs the surgery. Usually, this would be spotted on an ultrasound, and fixed a few weeks after birth, but he's already eighteen months old. The longer we wait, the greater risk of infection; not to mention all of the strain it's putting on his heart and lungs. I don't know if he has medical insurance or not. If not, I'm willing to do it pro bono," Teddy said.

"Me, too," Arizona agreed. She looked to Meredith. "Until any other family members show up, he's legally under your care. Are you available to scrub in?"

Meredith glanced at her watch. It was after ten o'clock. By the time the surgery was underway, it would be close to eleven. The surgery would be at least a few hours, plus monitoring him in recovery. Not even a miracle could make all of that happen by the time Derek was supposed to show up with Lilly at lunch. But she knew that if she was ever going to make it through residency, she had to reach her quota of OR hours. Passing over surgery on her first day back didn't exactly help with making that happen.

As much as it pained her to say it, Meredith had no choice. "I'll scrub in," she said.

"Okay," Teddy said as she, too, added to the notes that both Meredith and Mark had previously written. "We're supposed to be getting Hunt's OR when he's finished, which should be soon. Want to prep him, and we'll meet you up in pre-op in fifteen minutes?"

"Yeah. No problem," Meredith said.

Arizona smiled at her. "Good to have you back, Dr. Grey," she said before leaving the room behind Teddy.

"Yeah. It's good to be back," Meredith replied, pretty sure that felt like a lie. She pulled her phone from her pocket after they left, careful not to jostle Ryan with the hope that he would stay asleep until they gave him the anesthesia for his surgery. The little boy had gone through enough for one day, and she didn't see any point in upsetting him.

She pressed number one her phone, and it speed dialed home. The phone rang twice before Derek picked up. "Hey, Mer," he said, reading the caller ID.

"Hey," Meredith said. "How's Lilly doing?"

"She's good. She just had a diaper change and a bottle, and now she's having tummy time on the floor with me," Derek said. "How's your day been so far?"

"Let's just say I wish I was home, having tummy time with you two right now," Meredith said, brushing her hair away from her face.

Derek frowned on the other end. "That bad?"

"Yeah," Meredith answered honestly. She felt a lump in her throat, and she willed herself not to cry. If Derek knew she was upset, it would make him upset, too, and she didn't want that. "So, uh, I have to scrub in for surgery in fifteen minutes. One year old with a heart condition. I'm not gonna be out until mid-afternoon."

"So, no lunch date today?" he guessed.

"No lunch date today," she echoed.

"No big deal. It's just one day," Derek said.

"I know. I just miss you. I really wanted to see Lilly, so I could nurse her," Meredith said, another round of guilt churning her insides.

Derek smiled as Lilly blew bubbles with her mouth. "She took a bottle this morning without a problem. She didn't fuss at all. No gas, no spit up, nothing," he comforted her, knowing Meredith was hesitant about that.

"Good," Meredith said with relief. "Give her a kiss for me, okay?"

"You got it," Derek said, pressing kisses to Lilly's forehead. "Five kisses from Mommy, Lillybug."

Meredith smiled, overhearing the exchange. "Thank you," she said.

"Maybe it's a good thing that you're going into surgery. Time flies in the OR. And you're off at six. Plenty of time for you to come home and spend time with her," Derek said.

"I know," she said softly. "Love you guys."

"We love you, too."

"I'll call when I'm out of the OR."

"Okay. Talk to you later," Derek said.

"Bye," Meredith said, taking the phone away from her ear and ending the call. Rather than let herself get worked up over not getting to see her daughter until tonight, she scooped Ryan into her arms, and carried him upstairs to the pre-op herself. Lilly was safe and sound with Derek at home. Ryan had no one right now. And the least she could do was be the parent he needed, a promise to him she intended to keep.

...

Charlie barked in excitement as Meredith walked up the pathway toward the front door. It had only been eleven hours since she'd last been home, but it felt like an eternity. She pushed open the door and knelt down, petting Charlie as he spun in circles around her.

"Hey, buddy," she said, letting him lick her face. "How was your day, huh?"

Derek came into the foyer holding Lilly, and the minute Meredith saw her baby, she reached out for her. "Hi, Lilly," she said. She held her close to her chest, breathing in the top of her head that smelled like her flowery baby soap. "I missed you so much today, peanut."

"Hi," Derek said before he kissed her, letting his lips linger on hers longer than usual.

"Hmm, hi," Meredith murmured, kissing him back. As he went to pull away, Meredith pulled him toward her again. "I need a hug."

Derek chuckled, wrapping his arms around her, leaving enough room so that Lilly didn't get squished in between. "That I can do," he said, trailing his hands up and down her back. "On a scale of one to ten, how bad was it?"

"Seven, maybe eight," she shrugged. "Everything worked out. Just... a rough case, that's all."

"I have paninis toasting in the kitchen. Why don't we go eat, and you can tell me all about it?" Derek said, putting his hand on the small of her back.

"Paninis? Since when do we have a panini maker?" Meredith asked.

"Mark got us one for our wedding. I found it today buried in the back of the cabinet. Still unopened in the box," Derek laughed. "Figured I'd give it a try."

"Smells good," Meredith said as they entered the kitchen. She sat down at the table and Lilly turned into her, burying her face into Meredith's chest. "Are you hungry, Lillybug? I'm sorry I wasn't here today," she said, managing to unbutton her shirt with one hand.

After Meredith adjusted her nursing bra, Lilly put her hand on top of Meredith's breast and latched on. "Good job," Meredith encouraged, rubbing her finger over Lilly's cheek.

Derek came over to the table with two plates, a sandwich on each, and a side of pasta salad. "I hope these taste alright. I used turkey and cheese."

"Thank you," Meredith said.

"Water?" he asked.

"Sure," she nodded, biting into the sandwich. "This is amazing."

"Yeah?" Derek smiled, putting her glass of water next to her plate and taking a seat in the chair next to hers.

"Mhm. My day has improved a thousand percent in the last five minutes," Meredith said as she looked down at Lilly, who was sucking peacefully with her eyes closed.

"Spill," Derek said.

Meredith sighed. "This one year old comes into the ER with his dad because he was burned at a tailgating party. Mind you, this is eight in the morning. Then I smell beer on the guy, and social services are called, and then the police had to get involved. It was a mess. Anyway, I did an X-ray to check for smoke inhalation, even though Weston said not to, and it turned out he needed heart surgery. He's okay. The surgery went smoothly, and his grandma is getting custody for a while," she said.

Derek nodded. "That's good."

"I should be used to stuff like this. I guess I just see it all differently now. I can't imagine putting Lilly in danger. I mean, the baby was hurt. Not 'near death' hurt, but still hurt. All because his stupid father wasn't taking care of him. I can't just go to work, and expect things like that not to affect me," Meredith said.

"I know," Derek said softly.

Meredith sniffled and wiped at her eyes. "I love what I do for a living. I love being a surgeon. But I don't know if I can do that every day; leave Lilly here and go to work. All I know is that I have to, so I need you to talk me back into it," she said before taking a sip of water.

"I'll do that every day if you need me to," Derek promised.

"Thank you," she whispered.

"Just don't throw in the towel. I know it's hard. And it might be hard for a while, but it'll get better," Derek said. "Think about all you did today. If he had anyone else for a doctor, the baby might have been sent home with a serious heart condition and a drunk father. But you were there, and you handled it. You got social services involved to protect him, and you saved his life by getting him the surgery he needed. You did that, Meredith."

Meredith smiled, and he kissed her temple. "We're doing the right thing," he said.

"And Lilly was okay today? She didn't seem upset or anything, or notice I wasn't here?" Meredith asked, spearing some pasta salad onto her fork.

"Nope. She was perfect. I don't think she cried all day," Derek chuckled.

"So she hasn't forgotten who I am?"

Derek laughed slightly. "Meredith, no. When she heard you talking to Charlie when you came in the house, she turned her head toward your voice. She knows exactly who you are, and how much you love her. You never have to worry about that."

Meredith rested her head on his shoulder, combing her fingers through Lilly's hair. "Thank you, Derek."

"For what?"

"Always knowing what to say," Meredith said. "And the hugs. And for Lilly."

"I'm pretty sure Lilly was a two person effort."

"Yeah, well, we did good," she giggled.

Derek smiled into her hair. "Yes, we did."