Hi! I'm back, and I'm starting another story, which is stupid, because WIPs.

This popped into my head when I rewatched Addison's Season 4 return to Grey's for the ectopia cordis case, where she thinks SGH is the same old bordello it's always been, but things are different. I realised I've never read a fic that was in Derek's voice - or maybe I have and I've forgotten like the goldfish I am - but I thought it might be nice to delve into whatever might have been happening behind those dreamy eyes and under that perfect hair.

Since I've been dumb enough to have tried an Addek Season 5 reconciliation (a fic called Twice), I decided to just work my way backwards and see how our two favorite fools could have gotten back together in season four.

Maybe I'll do an awkward season three fic next, if I'm bored enough.Anyway, enough rambling.

Set in and after Grey's S04E13, twisting the plotline and definitely the timeline because that never made sense to anyone except Shonda Rhimes, whose property all these characters are and whose copyrights I do not intend to infringe.

"Addie."

It leaves my mouth as two syllables, in one surprised breath. Didn't expect to see her here.

Still here, anyway. Outside Joe's. Still in that fussy geometric patterned blouse she was wearing this morning. I've rarely seen her wear so much color; maybe it's an LA thing. Like the non-surfing.

"You're…still here." I say, and she smiles …apologetically?… and takes a step back so she isn't standing so close anymore.

"The Jones baby didn't do so well," she shrugs,and there's something in her eyes that's more than exhaustion; there's a tinkle of bells behind her just then and Mark and Dr. Torres stumble out of the bar, Mark's hands resting casually low on the resident's hips, both of them laughing breathlessly and not a little tipsily.

Ah.

"Catch you later?" Torres mouths at Addison at she passes: she raises a hand in farewell, smiling wryly. Mark slaps me on the back as he passes.

"That's the same." Addison says, watching them go.

"What?"

"That's the sa- never mind."

Dr. Hahn comes up behind her, disgruntled. "Erica and I were just headed to dinner."

"I'd like that," I say automatically.

"I wasn't inviting you," Addison arches an eyebrow. I've always wanted to learn how to do that, but I can't get mine to move separately from each other. She tried to teach me once, in the mirror in the bathroom of her student apartment she shared with Naomi, until Mark told me it was 'kinda gay', because Mark was the kind of jerk who used the word gay as an insult for anything and everything in the eighties, and didn't know it was wrong.

"Don't be rude." Erica says. "You should come, Derek. I really need adult company today."

I run into him outside Joe's, of course I do. First this crappy day, and dinner with my ex-husband to top it off.

Yes, I say ex-husband now. Funny what nearly a year of not wearing the rings and living a messy, messy sad single life can do for your accuracy.

It's so ... Derek of him to invite himself. He doesn't even know he's invited himself; he's too oblivious.

Or maybe he's desperate, which would be a novel concept for him. You see, Derek Shepherd hasn't ever been the outsider. People just look at him and they love him, and forty (okay, plus) years of this means he expects to be included.

Erica is chattering away, complaining about the interns to him, and he's nodding, a few words of agreement here and there. He's doing the thing, the mental two-timing, where he says random words and almost sounds like he's following the conversation, but really he's thinking of something way more important than you in his head. He never used to do it with me, at least not until we were attendings and then he really did have Very Important Things to be thinking about.

Or maybe that's just when I started noticing that he was doing it with me.

Anyway we're in my rental car, and Derek is driving, because he's always toed that thin line beween chivalry and chauvinism in a way that has most humans with dual X chromosomes falling at his feet. He only ever scoots over it occasionally, usually with me, and almost always by deciding his career or opportunities or whatever matter more than mine.

Do I sound bitter?

I might have insinuated to Stevens that if I were to, say, hypothetically come back to this damp hair-ruining hellhole, I might get back with my husband.

Ex - husband. Damn.

Not that I want to, but I could. Hypothetically.

Speaking of hypotheses..… "How did your trial patient do? It was today, right?"

He sends a murky look my way that I interpret as dead, not talking about it, but before I can open my mouth again and annoy him some more, my phone rings.

If I ignore Erica grumbling about Yang in his backseat and close my eyes - I won't close my eyes, I'm a good driver, I'm not Addison, for god's sake, checking her hair in the rearview mirror while steering with one hand and okay that only happened one time (that I saw) but I'm the better driver - I can almost imagine it's any day of the last decade or so of my life.

When I wasn't killing people's husbands for sport in a clinical trial dreamed up by my ex-girlfriend, when my current girlfriend wasn't a nurse who is possibly the most straight-edged person in the whole hospital, and everyone didn't expect me to show up in a cape and save every damn day.

The visual is nice, but I'm not a twenty-five year old intern anymore. Reality has well and truly bitten me in the ass.

Addison's still talking, gesturing expansively like she does even on the phone - I used to think it was cute, the waving and pointing and all, but now I think she just does it to take up more space, make herself more than she is.

"Turn around," she mouths at me, then goes back to barking instructions at whoever is on the other end.

"You don't even work here, why are you getting called in?" Erica groans from the back. "Shepherd, let me out here, will you? I'll take a cab home."

Addison apologises to Erica - they make plans to have dinner tomorrow (how long is she staying?) - and then starts digging into her bag, pulling out a visitor's ID and looping it around her neck.

She pulls her hair out of the band, and it hits me.

"Your hair." I say. Stupidly.

"Yes?" I can see the glint of her eyes in the dark car, the stilling of her hands.

"It's … brown." I don't think I like it. It's too startling against her skin, which doesn't looks she's been beach-walking and scuba-diving, by the way, it's the same rosy fair it's always been, and she's always been a redhead.

Mark asked me once, crassly, if the curtains matched the drapes, and I don't remember if I answered. Guess he went and found that out on his own.

"I wanted a change." she answers primly, smoothing invisible wrinkles from her skirt like she does when she doesn't want to look at someone and needs to look busy. She adjusts the ID so it's facing forward, and I see they've used her old picture.

You can provide your own picture, but no one has the time or the inclination, so they usually just march you into a chair while you're up in HR filling out all the endless personnel forms and snap a picture. Her hair is red in the picture, the same auburn-red-gold I remember, curled like she wore it when she needed to look intimidating.

We called it her fuck-you outfit - by we I mean Savvy and I, because I had the misfortune to be on that shopping trip before some seminar she was supposed to give, and I remember her wearing it while she stamped all over my life in pointy shoes in the hospital lobby nearly two years ago.

All black, hair in those round weird curls that feel stiffer than her natural texture, neutral expression. She looks sad. How can I tell she looks sad from that little postage stamp of a picture?

I don't know.

I've missed this.

A rainy ambulance bay with yelling paramedics and clamoring interns, a screaming patient and a desperate husband? Yes, I've missed it.

No, not my desperate husband.

Ex.

The patient's desperate husband, who - go ahead and tell me I'm judgemental - I peg as a problem almost immediately.

Maybe it's the tribal symbols tattooed on his very pale forearms, or the black dot on his forehead, or the weird crystal necklace in his blond chest hair.

You see, there's a not-insignificant woo contingent in the medical profession, the smooth, glib practitioners who sell you herbs and snake oils and like to stick little needles in you, and the kind that like to let their patients give birth at home in a plastic kiddie pool, and for whom prenatal care consists, apparently, of feeding their patients spirulina smoothies and chanting mantras to align the baby's freaking chakras.

If that sounds weirdly specific, that's because it is.

It's what my patient has been doing for the last thirty eight weeks, and even now, strapped to a gurney, she's worked her feet free of the straps and is bending her knees, pressing the soles of her feet together to 'enlarge the birth canal'.

I exchange a look with Derek, who's trailed me into the ER and who looks like he's trying to decide whether he wants to laugh or be annoyed. He catches my eye and then I'm the one trying not to snort -that would be unattractive, not to mention unprofessional- and I focus on my patient.

She's twenty-one years old. Twenty- freaking- one. When I was twenty- one, I was sleeping with my Psych TA and sweating it out in libraries, ensuring I got into med school and could then spend the next two decades studying.

She's twenty-one, and her name is Kaydee (yes, a double-e, and no, I don't know what, if anything, it means) and she's ten centimetres dilated and has been pushing for four hours, the baby's at plus-one and breech with a sinking heart rate, her blood pressure is 140/95 and climbing and she's terrified.

So while they strap on one of our own fetal monitors and set her up in stirrups for examination and bring in all the paraphernalia you need to save a baby who insists on barging into the world early, I sit down next to her. I hold her hand, and I tell her that I am going to try to help her.

Try.

Because the truth is, at this point, nothing can help her. Or her baby.

We don't let breech babies be born vaginally if we can help it. It's an excellent way to strangulate an infant; the feet and legs are out in the world, the head is still in the birth canal, the placenta says 'hey, I'm done here' and stops giving the baby nice oxygenated blood, and since the baby's nose and mouth are still inside his mother, he will asphyxiate. There's a chance that you can deliver fully before this happens, but then again you might be the one unlucky mom whose baby's shoulders are stuck and then you end up with a child with cerebral palsy, visiting therapists and orthotists and special schools and surgeons like Derek and Callie for the rest of your life.

The second option is that a skilled OB - like me - does a version, which is a fancy name for 'puts her hands on your belly and shoves your baby the right side up'. It hurts like a bitch and I'm sure many a patient has wanted to kick me in the face while I'm doing it. But those patients are the ones who have a safe, supervised labor in a maternity ward, not at home in a grimy inflatable pool after their membranes have broken, where said skilled OB is not present.

Then the third option is that we let the baby cook for the full forty weeks, let the parents pick a date (who are kidding? I pick the date, after I check my schedule) and do a straightforward C and deliver a fat, healthy, happy baby.

Kaydee doesn't get the third option, because her baby didn't wait the full forty weeks. She signaled her mother's body to start labor early, and it did, and then she's stuck and I cannot turn her because according to the ultrasound that made her local ER pack up and send here to Seattle Grace, her baby has no brain.

Now, normally this wouldn't be an issue, because as awful as it is to give birth to an anencephalic child, the labor is nearly normal. Most anencephalic babies don't have fully formed skulls; the rudimentary brain stem is fully exposed to the world, and may don't survive birth. If they do, they live a few hours or a few days at most.

Kaydee's daughter's nervous system development went horribly, horribly wrong in two ways - not only is she anencephalic, but the soft little bones of her head are almost fully formed- not as they would be in a healthy baby, with a small fontanel, but still, she has them - and they're protection for the little bit of nervous tissue she does have, but what they've also done is trap spinal fluid and stop it from draining. She has hydrocephalus.

A condition that we normally explain to patients as 'fluid collecting in the brain'. But her baby has no brain.

How do I tell her this?

It's a good thing I followed Addison in here. The on-call OB took one look at the ultrasound they sent ahead of the patient and paged the MFM, who realised they had a brilliant neonatal surgeon lurking around the hospital anyway and asked Richard to call Addison.

"Just because a brain - actually no brain - is involved doesn't mean we need you, Shepherd." Miranda Bailey says, waving me away as she runs with the gurney through the doors, Addison beside them, murmuring to her patient; they're headed straight for the OR.

"You might."

"The baby's anencephalic." she reminds him.

"To declare brainstem death," I shrug, and she glares at me like I've insulted her personally.

"Stay out of the OR until she asks for you." Bailey tells me sternly. "I mean it."

I wonder if she ever realises I'm her boss and that this is the worst kind of insubordination - treating your attending like he's a mentally challenged ... boor - and wonder if she's ever this way with the other attendings.

She was always civil to Burke, and she gets along as well as one can with Mark. She and Richard have their little mentor-mentee thing, and she even manages to reason with Erica. And she likes Addison.

Why me?

I follow the unfolding tragedy up to OR 2, where I stand back to let Addison and Bailey scrub in first. An exhausted Karev is there too, assisting with the prep, and Stevens is there with the NICU team beside a radiant warmer and the insane amount of equipment that's required to keep a tiny baby alive.

Bailey sails through the doors first, arms aloft, and for a moment I'm alone with Addison in the scrub room. She's standing there motionless, cap in her hands, staring into the theatre, where the patient's husband is being led away by a nurse.

By Rose.

"Addie?"

And it happens again, the nickname breaking the silence in the small room. It's just that is what I've called her, what I've always called her when she's like this: vulnerable. A little shaken.

She turns partway, knotting her mask. I know her ritual, the same way she knows mine. Rings off, pin to top, mask, scrub, deep breath, walk into OR. I stood beside her the first time we scrubbed, surprised at how long five minutes can feel.

She skips the first step now, but the rest is the same. She hits the water, reverie broken, and I follow her.

The first time I learned how to scrub in, Derek was beside me. I think Sam was on the other side, but I definitely know Derek was on my right. An infection control nurse stood behind us, hands on hips, watching sternly to make sure we scrubbed for the full five minutes, and I remember that when she finally said we were done, Derek broke scrub by touching my shoulder.

He didn't mean to do it, it was just second nature. We were fresh interns then, just out of med school, and geting to scrub on an appy was making us giddy and nervous. But he broke scrub, because he touched my shoulder, and he did it to check on me.

I was nervous. He could tell, and that little point of contact grounded me. He got yelled at by the nurse, of course, and apparently not breaking scrub was one of the criteria for choosing the intern who ultimately got to do the (heavily supervised) appy, so he was automatically out. I won that surgery, but he never resented me for it. He said he was proud of me.

He does it again, now, his hand on my elbow, stopping me. "Addison-"

"It's fine."

"You can ask someone else to do it, you don't have to take this on," I say. She knows it, and I know it, and I know this won't end well for her. For the patient - Kaydee - for Kaydee's unborn daughter.

The problem here is not will the baby live?

It's that this baby will live. Or it will exist, a painful, miserable existence that's no real life at all, an existence that's going to drag on and on until the primitive stub of nervous tissue in her malformed skull gives up, or until her parents choose to let her go.

An anencephalic baby mimics a healthy newborn in certain ways; since so much of what newborns can do is actually down to primitive brainstem and spinal cord reflexes, an anencephalic child will breathe and suck, sometimes enough to sustain life. A few days, weeks, we can't tell. Even if we could, you try telling a young mother that the baby she just pushed out of her own body is not alive in any real sense of the word alive.

That her child will never be able to go much beyond suckling weakly and breathing adequately and maybe holding her finger, that the adorable little baby she carried for nine months lacks the cortex she needs to learn to support her neck, roll over, sit up.

You do that - walk into a room, look that mother in her bright, hopeful eyes, while she cradles her newborn baby, and her husband sits behind them, taking pictures and pretending he isn't crying, and you tell them this bubble has to burst. That they won't be happy for much longer - that the only choice they have is to wait for their child to either stop breathing on her own, or give up on her. Let the doctors keep her comfortable while she dies.

You do that, and you won't walk out of the room unmarked. It feels wrong to cry, because it isn't your baby to grieve, but the grief clings to you and you carry it through the hospital and take it home with you.

I know, because I've done it. I've watched Addison do it.

Neither of us were okay.

If I do this, I know I'll have to see it through. I won't deliver this baby and leave; I'll stay until the choices are made. She's mine now. I will not be able to return to LA, not while she still…exists in Seattle.

I can't back away if I wanted to. The section will be complicated, the fetal head is impacted and I'm worried about Kaydee. She's weak, exhausted, I'm not sure how much she or her husband - Cameron - have understood of their daughter's prognosis.

The worst thing is that this was preventable. Now is not the time, but Kaydee is going to find out that if she had gotten prenatal care, an ultrasound, this could have been avoided. If we had known, earlier, the extent of her fetus' malformations, she could have had the choice to terminate, avoiding this sick farce of a life for her baby.

I won't tell her now, but she's going to find out. And she's going to hate herself for it.

I believe that life starts at birth, or at least whenever a fetus can support itself outside the mother's system. Once Kaydee's baby is out, she's going to be alive, if only in the loosest definition of the term, and then the whole game changes.

I've terminated pregnancies at late as twenty-four weeks, but I've also saved babies who were born at twenty-four weeks. Sometimes younger. This is a fact that never ceases to torture me, but I've gotten better at swallowing my own indecision for the sake of my patients. Even though I do sometimes wonder if I'm headed straight for Lucifer's lair after I die. At least he'll get a laugh out of the nickname Derek gave me my first week in Seattle.

But those were choices I made based on clinical facts and figures and data, choices made after ethics committees and a fellow physician had deliberated over it and signed papers saying they agreed with me. Those were lives that I ended in their mothers wombs, because bringing them into a world they were incompatible with was too cruel, or because their tiny existences were draining their mothers of life.

Kaydee's daughter is too late for that choice.

She's going to burst into this world, and she's going to feel all the pain - not physically, we don't know that for sure - but she's going to live a painful little life, and she's taking all of us along for the ride.

And we're off.

That episode was so strange: Derek and Meredith are broken up, Mark and Lexie aren't really a thing yet, Bailey is miserable, Callie is confused, Richard is still trying to lure Addison back...so why not?

I crave reviews the way Season 2 Addison craved Derek's attention, so please please let me know how you feel about this story. Don't make me follow you down every corridor.I'll

be updating a few WIPs while quarantined in the next few days, so I hope you're still interested!