Maddie finishes her pancake a few minutes later. She looks over at her mom and stares for a minute.

"What is it sweetie?" Meredith asks.

"Do you gots to have yucky medicine today? Yucky medicine that makes you sick?" Maddie asks, sounding more mature than her four year old self.

"No baby girl. I'm staying here with you today for your birthday."

"Okay. Not allowed to be sick, mama." Maddie gets off of her chair and climbs on top of her mom's lap. "I needs you mama."

Meredith wipes away a tear. "I've got you sweetie. Today is all about you." Meredith hugs her daughter.

"Otay! Wanna pway wit me and Nanas? It's Nana's birfday also!"

"Sure baby."  Meredith feels really sick but doesn't want to ruin her daughter's day so she forces herself.

"Come on Mommy! We gots pwaying to do!" Maddie pulls Meredith's arm and Meredith gets up and follows Maddie.

"Mads, careful with Mommy okay? She doesn't feel well." Derek warned.

"Daddy! It's my birfday! Mommy feels good! No sick day member?" Maddie says smiling.

Derek nods, not wanting to say that even though she doesn't have treatment she still feels really sick and weak.

Maddie leads Meredith into the living room and they start playing.

They play for a little while and Meredith is doing everything she can to ignore her headache and nausea but it slowly keeps getting worse.

Derek walks into the room and just watches them play for a few minutes. He frowns, looking at Meredith's pale skin. He knows she's feeling really sick.

"Hey Maddie, why don't you give Mommy a break? Why don't we watch a movie?" Derek suggests. "Maybe Mommy can take a little nap?" Derek says, as Meredith looks completely exhausted and could fall asleep any second.

"I'm fine. I don't need to take a nap. I'm fine." Meredith says softly, coughing a little.

"Mer, you look completely exhausted. You look like you could fall asleep any moment." Derek says.

"I'll be fine. It's Maddie's birthday. I'm not missing any second of it. I don't need to sleep. I need to celebrate my baby's fourth birthday." Meredith insists. She shivers and pulls a blanket onto her, her teeth clattering.

"Mommy!!! You gots goosey bumps on you!" Maddie runs her hands over Meredith's arms! "Wight there! And there! And there!! So many goosey bumps mama!"

———-

"Hey Alex, Cristina. Meredith is sitting on the couch with Maddie watching a movie." Derek says, as Meredith's friends walk inside the house.

"How's Mer doing? I know she's had a really rough time with treatment." Alex says, all concerned.

Derek sighs. "It's been really rough. She's not feeling well but refuses to show it today. I tried to get her to sleep earlier but she refused. The IL2 is really kicking her butt. She's so sick from it, even sicker than the previous chemo. And she's thrown up multiple times today. She keeps sneaking away and tries to hide it but she comes back all sweaty each time and that tells me that she's thrown up."

"Why is she hiding it? She wasn't hiding it before? If she has to throw up, then she needs to. It's going to happen. Why is she being so secretive all of a sudden?" Cristina asked.

"It's just been today since it's Maddie's birthday. She keeps saying she doesn't want to ruin Maddie's birthday. And Maddie keeps saying to Mer that it's not a sick day which is making her hide it even more. She doesn't want Maddie seeing her so sick on her birthday." Derek sighs.

"Daddy!!!" Maddie runs in and her eyes widen when she sees her aunt and uncle. "Aunt Cwis! Uncle Awex!"

"Yeah baby?" Derek asks.

"Mommy's sweeping! And she's still got goosey bumps and is shivering! Mommy's weally cold Daddy! She needs another  blankie!"

"Let's go get her one. Oh, looks like Richard and Adele are here. And Mark just pulled up. Can you guys let them in please?" Derek says.

"Of course." Alex says.

Maddie leads Derek to Meredith and he sees that Meredith is shivering a lot while also being very sweaty. Derek frowns, not liking seeing Meredith this way. He covers Meredith up with a thick blanket and she sighs in her sleep.

"Hey Shep. How's she doing?" Mark asks as him and Addie walk into the room, both frowning at Meredith's condition. "She's extremely pale man."

"She's very sick. Treatment is very hard on her. Her cancer spread as you know and she is on a much harder chemo and her body isn't liking it." Derek says.

"This treatment needs to work! She doesn't deserve any of this!" Mark says, angrily.

Addie puts a hand on his shoulder to calm him down. "Mark, it'll work."

"Aunt Addie! Aunt Addie!" Maddie comes running into the room. "I misseded you!"

"I missed you too birthday girl!" Addie picks up Maddie and Maddie wraps her arms around her and snuggles into her.

"Nanas says hi also!"

"Well hello there Nanas." Addie says.

"Is it cake time? My tummy wants cake!" Maddie asks.

"It can be cake time. Let me wake up your mom." Derek leans down close to Meredith. "Mer, sweetie, time to wake up. It's time for cake."

Meredith groans. "Der...." She whimpers, forgetting where she is for a moment. "Don't feel good."

"I know sweetie. Let's do cake and then we can get you into bed."

"Wait? Cake?" Meredith suddenly remembers that it's Maddie's birthday. "I fell asleep! No! I wasn't supposed to do that! It's Maddie's birthday!"

"Shh, it's okay. You needed the sleep. It's okay."

"It's not okay! It's Maddie's birthday!"

Derek softly whispers to her and finally gets her to be okay with it. He helps her up, feeling how dry her hands are.

"Mama! It's cake time!" Maddie yells excitedly.

"It is! Let's go get some birthday cake then." Meredith says softly.

Everyone gathers in the dining room and sing Happy Birthday to Maddie.

"Here's your cake birthday girl!" Derek says.

"Mmmm yummy cake!" Maddie yells.



We hope you enjoyed! Thanks to my co-writer _Ktje_

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