The Shepherd Legacy

Derek's Struggles

Heavily based on Season 5, Episodes 16 and 17 of Grey's Anatomy. It is a continuation of "A Miracle for Addison."

Derek was preparing for a challenging procedure on his patient, Jen, who was struggling with recurrent mini-strokes and aphasia due to a lack of blood flow. The stakes were high, not just for Jen, but also for the unborn child she carried.

Entering the neuro wing, Mary found Derek emerging from Jen's room. His expression was a blend of determination and concern. The monitors inside beeped steadily, a constant reminder of the fragility of life they were battling against.

"Everything okay?" Mary asked, her brow furrowed.

Derek nodded his mind clearly elsewhere. "Yeah, go page Addison. Tell her I need her to stay. We can't delay Jen's surgery."

Mary understood the gravity of the situation. "Yes, sir." Without hesitation, Mary turned to execute Derek's request.

--

Jen, pale and visibly worried, lay in bed while her husband, Rob, stood by her side, his face etched with concern. Addison, checking Jen's vitals, tried to offer reassurance.

"The lack of blood flow through the vessel is causing the mini-strokes and aphasia," Derek explained to the anxious couple. "We can't put surgery off any longer, so what I'm going to do is a repair that's called an E.C./I.C. Bypass."

Rob, clinging to a sliver of hope, asked, "And... and that will fix the strokes? She'll be better after this?"

Derek nodded. "I'm hoping it will work, yes."

Jen's voice was weak but laced with fear. "But... the..."

Rob interjected, seeking assurance, "I'm sure they wouldn't operate unless it were safe for the baby, right, Dr. Montgomery?"

Addison offered a comforting smile. "Oh, your blood pressure is still high, but that's why I'll be there, to monitor both you and the baby." She paused, letting her words sink in. "Get some rest. We'll see you soon."

As Derek and Addison stepped out of the room, a moment of mutual understanding passed between them. "Thank you for staying," Derek said, his gratitude evident.

"It's the least I could do after you saved Archie," Addison replied, gently embracing Derek.

Before they could discuss further, Rob hurriedly followed them out. The concern in his voice was palpable as he made a heart-wrenching request, "I know we said before, about the baby, but if something should happen, if it comes down to a choice, save my wife. We can make another baby. We can't make another Jen."

--

In the OR, tensions were high as two critical procedures unfolded simultaneously: one to save a mother, the other to protect her unborn child.

Derek, with Mary by his side, was engrossed in the delicate task of repairing the damaged vessel in Jen's brain.

Mary, though young, remained calm, asking Derek clarifying questions, "Is that the middle cerebral artery?" she asked, her focus unyielding.

"Yes, after I connect the STA, we will be able to close," Derek replied, his hands steady as he maneuvered through the intricate network of arteries and tissues.

Only a few feet away, Addison and Alex Karev monitored the fragile condition of Jen's baby, their expressions growing increasingly concerned. The monitors beeped insistently, depicting the baby's distress.

Alex, checking the readings, announced, "The baby's having spontaneous decels. Mom's hypotensive."

Addison, her eyes darting between the monitors and the surgical field, voiced her concern to Derek. "Derek, I don't know how much more they can handle. You need to hurry up."