Lightning Strikes Twice - Part 4

[ariaadagio]

Title: Lightning Strikes Twice
Fandom: Grey's Anatomy
Pairing: Duh.  (Mer/Der)
Rating: M
Timeline: Post Time After Time.

~~~~~

The car skidded to a stop, and Meredith sat there for a moment, stunned, blinking.  A myriad of spider web patterns lanced out across the windshield.  Her airbag was out, slowly deflating in her lap with a hiss.  She swallowed and blinked.  What.

What?

One moment the road had been clear.  The next, something had darted out in front of them, the barest ghost in the headlights.  Meredith hadn't even had time to gasp in surprise before it had slammed into them.  There'd been a horrific shrieking, roaring, breaking noise, followed by a pop.  White had flown up into her face as she'd pitched forward.  The car had spun.  The windshield had snapped and crunched, and a series of thuds had clunked down the back of the roof overhead.

What?  She blinked again.

The hood of the car, barely visible beyond the windshield, was shorter than it should have been.  Shorter, and bent up like an accordion in the middle.  The car ticked quietly in the new silence, like an engine settling on a hot day.  The headlights had both gone out, shrouding the road in front of them in darkness, only the moon overhead providing any sort of light.

"Derek?" she whispered, her voice coming out in a gasp.  She started to shake as she fumbled with her seatbelt.  She turned to look at him when there was no answer.

His chin rested on his chest, and he hung there, slightly forward in his seatbelt like a broken rag doll.  Blood poured over his crown and down onto his face.  Painful stillness held him in a limp, bleeding pile.  She frowned when she noticed his airbag wasn't out.

"Derek?" she said.  She reached over to his neck, felt along his jugular, and relief swelled when she got a relatively steady pulse thumping back against her fingertips.  "Derek, wake up!"  He didn't stir, didn't moan, didn't do anything.  She swallowed back fear.

Shaking, she fumbled for her purse.  Where.  Where was her purse?  It.  It had been on the seat behind her.  She turned around and searched for it in the darkness.  Her side brushed Derek's shoulder as she looked, and she bit back a sob when he didn't react, just stayed there, dangling against his seatbelt, out cold, bloody.  Phone.  She had to get the phone.  Had to call for help.  Finally, her hands met with her purse strap.  She yanked it back into the front seat and pulled out the phone.  The signal she got was only two bars.  She prayed as she dialed 911.

By ring number three, her heart was racing, and her breaths came in a speed just short of sobbing.  Her eyes stung as she stared at Derek.  She reached out and touched his shoulder, trying to reassure herself.  But touching him, only to have him stay there, silent and unresponsive, scared her more.  He looked dead.  She would be convinced he were dead if it weren't for the pulse.  She checked again just to make sure, and she was so wrapped up in it, that she barely heard the operator come on the line with a canned message about stating the nature of the emergency.

When the operator started saying, "Hello?  Are you hurt?" it finally snapped her back to reality.

"Hel... Hello.  I've been in... an accident," Meredith said, strangely lacking words, even as she searched for them desperately.  "A car...  car accident."

"Can you tell me where you are, ma'am?"  The voice was rich and calm and male, and sounded like someone had sprinkled it with honey.  It would have been soothing at any other moment but this one.

"I don't..."  She breathed, trying to stay the panic.  She had no idea where they were.  None.  Derek had known where they were going.  He hadn't printed out maps or even told her directions.  She'd just... happily watched the scenery go by.  "Derek was the one who knew where we were going... I...  I don't know."

"Is there another person in the car with you, ma'am?"

"Yes.  My boyfriend," she said with a warbling sob.  Together, Grey.  Keep yourself together, she scolded.  But everything felt shaky and bad.  "He's unconscious."

"Are you on a highway?  Was there anyone else involved in the collision?"

"No... it's... it's not a highway," she said, looking around.  There was a double yellow line in the middle and only one lane on each side.  Beyond that, she couldn't see a thing.  "It's dark.  I don't know...  I think we hit an animal.  I don't know...  I don't..."

"Okay, calm down, ma'am.  I need you to stay calm.  We're trying to triangulate your signal.  Is your boyfriend breathing?"

"Yes.  Yes...  He hit his head..."

"Are you injured?"

"N... no?  I don't think so..."  She sniffled, clawing at her face with her hands.  This couldn't be happening.  It couldn't.  She would wake up in a few minutes, Derek would be hogging the bed, and she'd have to smack him with a pillow to get him to roll over.  That was how this was going to work.

"Okay, ma'am, I've dispatched rescue workers to your location.  The triangulation wasn't as accurate as it could be, so it might take them a while to find you.  You don't see any road signs or anything?"

She blinked against the tears.  "No.  No, it's dark..." she stuttered.  "And...  And I...  I don't know."  Even if it had been light out, she doubted she would have been able to read any road signs.  But it was moot.  Moot because there were no signs, and there was nothing she could do.  Wake up, she told herself.  Wake up!

"Okay.  Is your boyfriend still unconscious?"

She stared at Derek and felt for his pulse again.  Still the same.  And he was still out.  "Yes."

"Does he show any other sign of injury?"

"He's bl-"  She hitched on a breath.  "Bleeding."

"Where is he bleeding?"

"His head.  God, I-"

"Okay, ma'am, don't try to move him-"

"I know what to do," she snapped, wanting to laugh at the absurdity of it all.  She was going to be a brain surgeon.  A fucking brain surgeon.  Derek actually was a brain surgeon.  They fixed brains.  And Derek was sitting there with a potential traumatic brain injury, and she couldn't do a goddamned thing about it.  He couldn't do a goddamned thing about it.

Concussion, she breathed, trying to stay her mind back on its original course.  It wasn't a severe traumatic brain injury, it was just a concussion.  Except Derek wasn't waking up.  And people with concussions usually would have woken up by now.  Usually.

"Ma'am?"

"I'm a surgeon," she said, gritting her teeth.  Her eyes streaked over with salty tears again.  She couldn't stop them.

"Okay, ma'am.  The ambulance is on the way, so just sit tight.  Do you need to stay on the line with me?"

"No..." she said with a choke.  "No, I have to take care of Derek."

"Okay, ma'am.  Call back if you have any problems.  The ambulance will be there as soon as they find you."

"How long?" she asked.

"You're in a rural area, ma'am.  And we don't know exactly where you are."

Great.  That meant it could be forever.  She tried to breathe.  She did.  "Okay.  Okay."

"Ma'am?"

"I'm fine.  Thank... Thank you."

She turned to Derek as she hung up the phone.  "Derek, can you hear me?  Derek!"  He still didn't move, and she bit back a sob.  Concussion.  It had to be a concussion.  How long had it been?  She shakily glanced at her watch.  He must have been out for at least five minutes already.  This was bad.

She refused to think it was anything worse than a concussion.  Not right now.

Shaking, she got out of the car and shuffle stepped around to the driver's side.  A deer lay mangled in the middle of the road behind them, not moving, not twitching, barely visible in the darkness.  At least it had died quickly.  The air chilled her as she started to pant with nerves.  She opened the driver side door and knelt next to Derek.  The cabin light turned on, giving her a dim view of the situation.

"Derek, come on.  Can you hear me?"  She squeezed his shoulder, dug her nails into it, trying to give him some painful stimulus.  Nothing happened.  He didn't even twitch.  She dug in harder, almost willing to draw blood if it would just wake him up, but still nothing.

Sniffling, she leaned across him and grabbed a napkin from the center storage compartment.  She was going to put it on his head to try to mop up some of the bleeding, and almost did, but then she thought better of it.  The blood loss wasn't horrible yet, and if he had a skull fracture or something worse, pressure on the wound might do more harm than good.  She wanted to scream at herself, scream for not thinking straight.  She swallowed.  Blood dripped down off the tip of his nose in a steady, slow drip, drip, drip.  It was maddening, just watching it.  Maddening and terrifying.

Concussion, she thought.  Concussion, concussion, concussion.  The kind athletes got after a good knock.  They took a week or two or three off and were back at it.  That's what it was.  Concussion.

"Derek?" she prodded again, pushing on his shoulders gently, careful not to destabilize his neck any worse than it already was.  God, what if he'd snapped his neck or his back or something?  It was impossible to tell, especially in the piss poor light.  "Wake up.  Please, please wake up.  You're scaring me.  Please, Derek.  Please."

The seconds ticked by.  Drip, drip, drip.  Where was the damned ambulance?

She grabbed his hand and squeezed it.  "Please, Derek.  Derek, wake up," she said, her voice warbling and crying, until she finally screeched, "Wake up, damn it!"  Her words echoed off into the night and bounced.  A wind blew through, chilling her to the bone, rustling as it fingered its way through the surrounding trees and grass and wilderness type things.

She blinked, shivering, cowering by the car door.  It was a concussion, she told herself.  A bad concussion.  He would wake up any moment now.  Any moment, he would wake up.  It wasn't diffuse axonal injury.  It wasn't.  Because that was something he wasn't likely to wake up from.  And she refused to believe that he wasn't going to wake up.  It wasn't a broken spine or a broken skull.  She started to recite all the things it couldn't be, growing more panicked by the moment as she thought of worse and worse things that could have knocked him out like this.  She hated it.  Hated knowing all the possible causes.

Seconds stretched to minutes.  Minutes stretched into longer.

When he moaned at twenty-two minutes and forty-seven seconds, she almost screamed, part in shock, part in happiness, part in general upset.  She leaned next to him, squeezing his hand again, squeezing it hard, but he didn't squeeze back.

"Derek?" she asked, pawing at him frantically.  "Derek, can you hear me?"

He swallowed.  His hand twitched in her grasp.  He snuffled, made a weird sound in his throat that could have been a word, and then he was vomiting all over his lap.  She scooted back while he emptied himself.  "Derek?" she said as he stopped retching and leaned his head back against the seat, finally raising himself up off the support of the seatbelt.  "Derek, can you hear me?"

His eyelids fluttered.  He moaned again, swallowed.  His mouth moved like he was chewing something.  Finally, he was awake, staring blankly ahead of him, not appearing to notice her at all.  She dabbed his face with the napkin she'd been planning to use as a bandage.  He was a mess.  His nose dripped the blood that streamed down off his forehead. Vomit covered the front of him, and the smell of it almost made her nauseated enough to contribute to the mess.  Yet all he did was stare and twitch.

"Derek?  Derek?" she asked, trying not to cry as he swallowed again and didn't make a sound other than a strange, pitching warble in his throat.  His hand still twitched inexplicably in her grasp.  He made another noise, like some sort of wounded animal.  It tore her heart to shreds.  She fought the panic that threatened to yank her down into an abyss of gelid fear.

"Derek, can you speak to me?  Do you know where you are?" she asked, trying to make her voice firm and loud and piercing, enough to break a stupor apart.  His hand jerked in her grasp, and he turned his face toward the sound of her voice, but he just... he wasn't looking at her.  In her direction, yes, but not at her.  His stare was vacant, confused, blank.  His head ticked a little with small, bitty tremors that almost made him look like he had Parkinson's disease or something.

He blinked at her, looking horrific as the blood continued to ooze down his pale face.  "Wh..." he stuttered, breathing in short, tortured gasps through his mouth.  "Wh..." he stuttered again.

"Come on, Derek.  Use a word.  You can do it," she said, pleading, begging.  She squeezed his twitching hand, trying to encourage him, trying not to cry as he sat there trembling, hurt, broken.  God, just thirty minutes ago they'd been talking and laughing.  And now...

"I'm afraid to move you," she continued.  "Can you hear me?  Can you speak at all?  Please, Derek.  Say anything.  Anything, please."

His lips rolled together and then parted.  "Mmmer..."  It could have been a groan.  Could have been a word.  She chose to grab onto hope and pretend it was a word.

"Meredith?  Yes, it's me, Meredith," she said.  "We hit a deer, Derek.  Do you know where you are?  Can you speak?"

Whatever headway she'd been gaining lost traction.  His eyes slid shut.  She squeezed his arm, hard.  "Derek!"

His eyes creaked open again, but his gaze was even glassier than before.  At least, from what she could tell in the dim light, his pupils seemed responsive, not blown or constricted, which meant, so far, he probably didn't have more than the obvious injury on his crown.  God, she'd seen people come into Seattle Grace with concussions all the time, and it was disconcerting, yes, but she'd never realized how fucking scary it was to have someone you knew, someone you loved, vomiting, bleeding, unable to communicate properly, confused...

Twenty minutes.  He'd been out for twenty minutes.  Which meant that this was really, really bad.  Most concussions were rated in severity in terms of one minute, five minutes of unconsciousness.  Ten minutes was already poking its way toward very severe...  She almost wished she'd been ignorant right then about all the horrible things that might have happened that couldn't be seen with the naked eye.  But he was awake, and his pupils looked fine so far, so she had to believe in the fact that it was just a concussion.  Even concussions could kill, though.  And this was a bad one.  The tremors alone indicated a contrecoup injury on his cerebellum.  She tried not to think about it.

"Please stay with me, Derek.  I'm really scared.  God, where is the ambulance?"

"Mere..." he moaned.  Now that.  That was a word.  Her heart leapt.

"Oh, god, Derek," she said with a sob.  "Can you hear me?"

"Dizzy," he said, slurred, almost like his tongue was too thick for his mouth.  He blinked furiously, and his eyes watered over.

"I know.  You hit your head, Derek.  Do you remember?"

"Car?" he croaked.

"Yes, Derek.  We were in a car accident.  We hit a deer."

Another warbling noise tore through his throat.  He swallowed.  She clenched his hand tightly.  He was silent again for a few twitching moments.

"Car?" he asked again.

She swallowed.  This was normal, she told herself.  Disorientation was normal.  Normal for a concussion.  People with concussions sometimes repeated themselves, not realizing it was something they'd just asked.  He was fine.  Fine, fine, fine.  He had to be fine.

"Yes," she said.  "We hit a deer.  The ambulance is coming."

He moaned, and that was the end of it.  She couldn't get him to answer any more questions, no matter how hard she tried, how often she prodded or poked or said his name.  He just stared, blank and lost, at the cracked windshield, though sometimes he would blink, have a moment of clarity, and ask or say something completely random.  She wanted to tear him from the car and wrap him in her arms, but she refrained, somehow, and settled for just stroking his hand, his warm, trembling hand.

Finally, in the distance, she heard it.  Heard the sirens.  An ambulance followed by a police car pulled up in moments, and then there were people everywhere, crowding her, asking her questions.  Flashing lights overwhelmed her as they backed her out of the way and started doing stuff to Derek, stuff she couldn't see, because they were too busy talking to her, talking at and crowding her.  She started to cry, she couldn't help it.

They had him stabilized on a backboard by the time she came moderately back to her senses.  He was staring up at the sky, blood all over his face, blinking, twitching slightly, not talking at all.  He looked so helpless and alone...  She wanted to start crying again, but she wiped her eyes and hopped into the back of the ambulance without even asking.

Soon, the siren was on, and they were heading back to whatever hospital.  She hadn't even thought to ask where the hell they were.  One of the paramedics kept trying to examine her, kept trying to touch her, flash lights at her, but she pushed him away, snapping and snarling.  "I'm fine, damn it," she sobbed.  They finally left her alone.

She held Derek's hand and stroked it.  "Derek?" she'd prod every few moments, trying to give him something to hold onto, assuming there was any sort of coherency there.  But he just lay there silent, staring unfocused at the ceiling of the ambulance.  Every once in a while, he'd make a chewing motion, sort of half-swallow, and moan.  It ripped her apart every time.

When they wheeled him into the trauma center, she followed, racing along like an intern.  She acted like she knew what she was doing.  The frantic speech of the EMTs as they explained Derek's vitals to the trauma team made sense to her.  She nodded at appropriate moments.  Hell, she even contributed.

She watched with a sob stuck in her throat as the trauma team cut away his soiled clothes with scissors and threw them in a garbage bag.  They checked for any obvious injuries besides the gash on his crown, and when they didn't find any, they left him behind a curtain, naked under a sheet, and he would have been all alone had it not been for her standing there, frozen between sobs, in shock at how it felt to be on the other side of things for once.  They didn't think to question her presence until a doctor trotted over to examine him moments later and found her behind the curtain where only Derek was supposed to be.

"Ma'am, you can't be here," the doctor said.   He was a tall stick of a man, with two days of beard growth, and oversized wire frame glasses.  Had it been any other moment but this one, she might have thought he seemed nice.  But at the moment, he was the enemy.  She glared when he told her, "You need to go to the waiting room."

"Are you going to get a CT?  An MRI?  He's got at least a severe concussion, and I think he might have picked up a coup-contrecoup injury, too.  He's got tremors.  That indicates bruising on the cerebellum, right?" she said frantically, ignoring the scruffy doctor's protests.  This wasn't Seattle Grace.  This was probably some hick hospital.  She was immediately prejudiced against everything.  Especially the fact that the doctor wore mismatched scrubs.  Mismatched scrubs were stupid.  Who wore navy with green?  It was stupid.  He probably didn't know what the hell he was talking about.

The doctor pondered her for a moment.  "How long was he unconscious?" he asked as he picked up Derek's hand and watched it tremble for a moment.

"Twenty-two minutes.  He's been minimally responsive since the ambulance ride, though before that he was talking to me, just a little."

The doctor turned to Derek.  "Hello?  Can you hear me?"  He turned to Meredith, his eyebrows raised.  "His name?"

"Derek," Meredith said.  "Derek Shepherd."

"Derek Shepherd!  Are you awake?  Do you know where you are?" the doctor said.

Derek blinked and moaned, his stare wandering blankly.  Then he started to thrash and choke a little, as much as the stabilizers would let him.  Meredith drew her hands to her mouth, trying not to cry as the doctor called over some nurses.  "Okay, it's okay," the doctor soothed as the team of them rolled Derek on his side and he vomited again.  Derek convulsed and jerked as he emptied out more of his stomach.  He went still shortly after and made a distressed sound deep in his throat that tore her into trembling shreds.

"Does he have any allergies? What's his medical history?" the doctor asked as they rolled Derek onto his back.

Meredith froze.  "I don't...  We never talked about that before."

"Right," the doctor said, frowning at her.  He leaned over Derek and flashed a penlight in his eyes.  Derek swallowed, following it with jerky movements.  "Okay, you said he was responsive before?"

"Really confused, yes, but he was talking for a few minutes.  He said my name.  He said it.  Mere, he said.  It's short for Meredith.  He was talking, he was.  He calls me Mere a lot."  She was freaking out.  Oh, god.

"Did he vomit in the car?"

"Y-Yes," she stuttered.

The doctor clapped his hands.  "Okay, I'm going to send him up for some tests to make sure there isn't some more serious problem that we can't see.  The tremors concern me, as does his continued vomiting."

Trauma nurses swarmed.  And suddenly Derek was gone.  The doctor was gone.  And she stood in the empty space left behind and cried.

A nurse came up to her.  "Ma'am?  Are you all right?  Do you need to sit down?"

She couldn't answer.  She was stuck, sucking in breaths, unable to do anything but try not to hyperventilate.  She stood there while the room blacked out on her.  Somebody guided her to a chair in the waiting room, shoved a warm cup of coffee into her hands, handed her a blanket to wrap around herself.  She couldn't tell who it was.  She was in a daze.

Persistent vomiting, confusion that wasn't improving...  It might mean...  God.  It might mean he had something creating too much pressure in his head.  Swelling.  Bleeding.  Either way, he was in trouble.  People with increased intracranial pressure died a lot.  They died.  Derek couldn't die.  Derek was... Derek was thirty-nine.  He was healthy, but...  Older people didn't deal with head injuries so well.  He couldn't... He couldn't die.  The irony of it alone was too cruel to conceive of.  If Derek were working on Derek, she'd bet money that he'd live.  Derek could fix practically anyone.  But he wasn't.  He was in the hands of some unknown doctors in this hick hospital where everyone wore mismatched scrubs.  And there was nothing she could do about it.

"Ma'am?  Are you Meredith?  The one that came with the man with the head trauma?" a nurse said.  "We need you to fill out these forms, if you can."

She stared at the clipboard in her hand and shook.  She couldn't even read the words, and they expected her to fill out paperwork for him?  His insurance information?  His medical history?  All she really knew was that at some point in his life, he'd crashed his Harley and gotten in an accident bad enough to spook him away from bikes for the rest of his life.  She could barely write his name straight.  She gave up after she had to look at her wallet to remember their own address.

Derek couldn't die.  He couldn't...

The ER doctor who'd triaged Derek trotted up to her.  "Ma'am?" he said after clearing his throat.

"Dr. Grey.  Meredith.  I'm a doctor," she said, her voice guttural and weeping.

"I'm Dr. Zalkind, and I kind of gathered that from your triage assessment," he replied.  "Well, your...  Friend...  He's up getting a CT and an MRI to see if there's any other damage, and then we'll talk about medevacing him to Mount Sinai in New York, if necessary, since this hospital doesn't have the capability to deal with severe neurosurgical cases.  The vomiting is what worries me.  He might just be really badly bell rung from the concussion, but it could mean he's got cerebral edema or a hematoma.  You know what all that is, right?"

"Yes," she replied dully.

"Has he ever had a concussion before?  That might explain his bad reaction."

"He was in a motorcycle accident when he was younger, but I don't know what happened.  I know he has a scar on his forehead from it, and he won't touch a bike again."

The doctor nodded.  "That might indicate a past history with concussion.  Usually, the second time around is worse than the first."

"Will he be okay?  I just...  He can't die.  He--"

"Dr. Grey, I'm sure you know we're doing everything in our power to make sure that won't happen, but, well, you're a doctor.  You know that this might be serious.  Head trauma is nothing to joke about.  Really, we'll have to wait and see."

"Okay," she said.  She started to cry again when he left her sitting there alone.  Wait and see.  Wait and see usually meant make funeral arrangements.  It's what doctors said when they had no fucking clue how to tell the horrific truth that they either didn't know, or the prognosis sucked so bad it was impossible to put into friendly words.  God.  She hated being a doctor and knowing all this stuff.

When her phone started ringing, she was so distraught, so worried, so unhappy, that she sort of picked it up reflexively without thinking.  "Hello?" she sobbed into the phone, sniffling as she wiped her face with her palms.  Her skin was sticky with tears.

"Um, hello.  Where's Derek?" an unfamiliar, female voice asked.

Meredith blinked and pulled the phone away to glance at it.  Shit.  This was Derek's phone.  She hadn't even looked before she'd answered.  "He's... he can't come to the phone right now," she said, her voice sounding wheezy and warbling.

"Oh," said the woman.  "Well, is this Meredith?"

"Yes..." Meredith answered warily, sniffling.

"This is his sister Kathy.  The family's waiting to start dinner.  We were wondering if you two were held up at the airport or something.  You're two hours late."

"Oh, god," Meredith said.  She started to cry into the phone.

"Meredith?" Kathy said, her voice growing concerned.

"Derek..." Meredith sobbed.  "Derek's..."

"Calm down, Meredith.  What happened?  Are you two okay?"

"Car accident.  Derek's been taken up for tests..."

Kathy gasped.  "What?"

"I'm in the waiting room.  I don't know... God.  I can't.  I can't breathe..."

"What hospital?  Where are you?  What happened?"

"I don't know.  I never..."  She glanced around, looking for a sign, any sign.  "Sharon Hospital," she said.

"That's only twenty minutes from us, we'll be right there."

The line went dead, and Meredith sat staring at the phone for a long, long time.  She blinked.  And then she started to freak out.  She would have to meet Derek's family... like this?  When Derek was... Oh, god.  Derek was going to die, and she wouldn't even be able to say goodbye alone.  And they'd probably hate her.  She sobbed again.  The medical clipboard with all the blank fields she was supposed to have filled out fell to the ground with a clatter, and she rocked back and forth and back and forth, unable to do anything functional but fall apart.