As his hand fell on the clock, silencing the chirping of the alarm, Derek rolled onto his back and stared at the ceiling. As was so often the case, he hoped that today was "that day" -- the one when he could finally let go of his anger and resentment and the past and start loving his wife again in the present.

Addison was already out of bed, probably, he guessed, grumbling somewhere about her hatred of the trailer. They were still dividing time between here and her hotel suite because he refused to move and she refused to buy a house without him. It was just another spot on the map of life where they found themselves unable to intersect. More and more, he wondered if they could ever find common ground again. The fact that they were married legally, that they'd shared a life--that wouldn't always be enough to hold them together.

After taking a beat to prepare himself for another round of "Derek, how the hell do you expect me to live here?" breakfast conversation, the doctor climbed from bed, ruffled his hair and headed out to the kitchen.

"I take it we're stopping to buy coffee today since I don't..."

Derek froze as his eyes fell on Addison, as he realized why she hadn't started a pot of coffee and why he hadn't heard her moving about. His heart began to pound in his chest even as his feet moved forward, and as he moved, Derek felt something inside himself rip in two somewhere between his head and heart.

His head moved him to Addie's side, his fingers moving deftly to check for her pulse, to see if she was still with him, to check on how much blood there was beneath her on the floor and to locate its source. His brain commanded him to reach to his left to grab the telephone and call for an ambulance and then to call ahead to Seattle Grace and make sure that Bailey would be in the E.R. waiting for them.

Derek Shepherd did all the things he had to do because his mind was here in the present and it knew what needed to be done. But his heart was somewhere else... in another kitchen, in a brownstone far, far away from the Seattle trailer. And instead of a man whose daily thoughts were about whether he felt love or hate for his wife, the man in that kitchen in that brownstone was a husband in terror, a doctor bereft of his skill for the sheer panic enveloping him as he cradled his wife's head and waited for the sirens to come closer.

The sirens sounded different here in the woods of Washington with no buildings to cause them to echo, but they arrived upon the same picture--Derek frantically trying to awaken a blood-soaked and unconscious Addison. And as she was pulled from his grasp in the present, Derek realized the mistake that the last year of his life had been built upon. It was this moment in the kitchen in the Brownstone... this moment exactly... when the bond between he and Addie had started to break, not the night that he had found her with Mark. And he was as much at fault as she was.

*****

"I'm here, Addie. I'm right here. Please just wake up."

How many times had he said that to her on the ambulance ride from the brownstone to the hospital? It seemed impossible that it was less than a thousand because it was all he could think. 'Please wake up.' He had been sure if she would just open her eyes, it would all be okay.

He caught the words slipping past his lips now in the transport bound for Seattle Grace and tears filled his eyes. He had forgotten how afraid he had been to lose her; he'd lost track of the implausibility of Derek without Addison. But he remembered now what it had felt like... and his throat tightened as he squeezed her hand and leaned down, whispering beside her.

"Please, Addie. Just wake up."

*****

Bailey was halfway out of the E.R. doors as the ambulance pulled up. Something akin to relief tugged at Derek's mind. Bailey would help... Bailey would fix this. He didn't let himself think about the last time and how another doctor, another trusted friend, had been unable to fix it.

The paramedics began to fill the resident in on their patient's condition. Derek kept thinking he needed to say something, but he couldn't imagine what. What had he said last time that had helped? Nothing... nothing had helped. Nothing had been all right. So maybe if he said nothing this time...

"Dr. Shepherd."

Derek felt Bailey's hand fall on his chest as she gently halted his progress into the treatment room. He took a step forward as if to argue, but found himself done in not by "the Nazi's" commanding presence, but by the concern of his friend.

"Let us take care of her, Derek."

The softness of her words stopped him cold and he took a step back, surrendering.

"She... she had a placental abruption in the eighth month three years ago. Her blood pressure went through the roof and... I wasn't there."

"Okay, I'll let you know what's going on as soon as I know," was Miranda's only reply.

He felt himself nod and then Bailey disappeared into the chaos of the treatment room, the door swinging shut after her. Unsure what else to do, the man also known as the head of neurosurgery stood outside the door and peered inside, an utter sense of uselessness settling on his shoulders as he watched the activity inside. Izzie drew over an ultrasound machine. George sought out the meds Bailey demanded. And through it all, Addison would not wake up... again.

"Are you all right?"

The words were accompanied by the touch of Richard's hand on Derek's shoulder. He gave a half-assed "fine," for a response, his gaze remaining on the movements in the treatment room.

"Bailey called me. I'll step in and let you know as soon as we've got something."

"I told her," Derek said. "I told her about... before."

Richard nodded. "Okay."

"It's not like before."

Derek wasn't sure why he'd felt the need to say those words out loud, but he had... he'd felt them struggling to get out of his body.

"No," Richard answered, his hand pressing down a bit harder on Derek's shoulder. "It's not like before."

*****

Two hours and seven minutes after she had taken Addison into surgery, Miranda Bailey sat down next to Derek and leaned her head back against the wall.

"There was torsion, so we had to remove the left ovary," she said. "Those damn cysts can be so tricky. Addison probably had one twinge before it ruptured and knocked her off her feet."

"Yeah," he said, unable to think of anything else to say.

"You can go on in to see her, you know?"

Derek turned and looked at the woman beside him. She was looking at him with an expression that seemed a mix of concern for him and a strong desire to shake him out of whatever strange fog was keeping him sitting here instead of rushing to his wife's side.

"How are you?" he asked, his hand flickering to point to her expanding belly. Bailey gave him a wry grin and shook her head.

"'Bout as well as I can be with one of you growing in here. I'll tell you what, my husband owes me a girl next time. This boy kicks me in my ribs again, I might be temped to kick him back."

He smiled at the pure "Baileyness" of Miranda's response. But he could see that despite her humorous take, she was overjoyed at her pregnancy and excited about the new life coming. He remembered that look on another woman's face and he felt a knot form in his stomach at the memory.

"Eight months... they couldn't save the baby?"

She'd asked the question as gently as she could, Derek knew that. And he could hear the sadness that asking it had caused his friend.

"We'd been fighting for two weeks about when she'd go on maternity leave. She wasn't doing surgeries anymore, but she was still trying to get these twins out of the NICU, and she kept saying, 'as soon as they go home.' I came back from my workout and she was getting dressed to go down and check on the twins and I just... I got so mad at her that she didn't seem to want to just sit around the house and think about our baby. So I grabbed my stuff and went to work. Took a shower, got dressed, did rounds. And then I went down to the NICU to tell her that her back wouldn't be hurting and her feet would be half as swollen if she'd just stayed at home."

"I can't imagine she would've liked that much," Bailey offered. Derek shook his head.

"No, all the other times I'd done it, she did not like it very much. But this time, I walked in and Addison wasn't there. And so I called her, and as I'm dialing, I'm thinking, 'say something sweet about her staying home, you know. Don't be smug or a jerk. Just be nice about it.' But she didn't answer. So I called her cell. And she didn't answer. So then I went home."

Three years of denying that something horrible has happened to you buries it pretty deep, but the moment you put a crack in the protective layers, they can tear wide open, baring the pain you were trying to run away from. And that's what happened to Derek as he let himself remember walking in the doorway to the kitchen. The breath had left his body as he'd seen her laying there in a huge pool of blood, her body contorted because she'd been trying to reach for the phone with one hand while she held the other protectively around their unborn child when the pain or the blood loss or both had rendered her unconscious.

Panic had flooded him as he raced over and dialed 9-1-1, screaming into the phone like a terrified husband, not a world-class surgeon. And then the pleading had begun... the begging her to be okay, to wake up, to tease him or yell at him or do anything she wanted to him just so long as she woke up and was all right.

But she hadn't woken up... not then... not for hours to come.

"I left her there all alone," he said aloud now in the present, unable to look over at his friend for fear of what he would see there. "I was angry and I left her there all alone when she needed me."

Bailey stood and stretched a little in an effort to loosen her stiff back and to refresh her tired legs. Then she tapped Derek on the shoulder and waited until he had looked up at her before she spoke.

"She still needs you. You need each other. You two wouldn't be going through this if you didn't. Just find a way."

*****

He'd always loved watching Addie sleep. Even when they had first started dating and she had fallen asleep on his couch while they studied for their Endocrine and Reproductive Systems' final... even then, he'd loved the way she looked when she was so relaxed and at peace. For years, even though he had known that internships and residency and building their careers would postpone parenthood, Derek had imagined he'd feel that same sense of love when their son or daughter fell asleep in his arms.

That long-held dream had not prepared Derek for sitting in the small room beside the NICU where the nurses drew the curtains and then placed the tiny, unmoving form of their daughter into his arms. She'd had red hair and perfect soft skin and Addison's nose and, from the look of her lips, she'd have had his smile. But she had been too long without oxygen following the abruption and Addison's collapse... and so not even the emergency C-section had been able to save Baby Girl Shepherd. And so there she had lain in his arms as his tears ran down his cheeks, and Derek had wondered what it was he would say to his wife when she finally answered his prayers and woke up.

Now as he sat by her beside in Seattle, he realized how very little they had said to each other at all. Addison had recovered and they had both cried. They had buried their unnamed little girl at the foot of Addie's late father's grave. They had cleaned out the baby items that had been collecting in the nursery for eight months and donated them to charity. They went back to work. And Addison had pulled away from him and he had stepped further away from her on his own while they both pretended that everything was all right, and finally he had come home and found his wife in bed with his best friend and he had run as fast and as far as he could run.

"Hey."

Her voice cracked as she spoke and she sounded weak, but Addison was awake. Derek sighed with relief and leaned in closer to the bed, her hand held within his.

"Hey."

"Everything okay?"

Derek smiled as he filled her in on the diagnosis and the treatment that had followed. Her eyes closed for a moment when he mentioned the removal of her ovary, but then she opened her eyes wide and looked at him.

"Well, at least the other one's okay."

"Yep," he said. "Tip-top shape."

They fell silent a moment, but their eyes remained locked. And then he took a breath and spoke again, daring to touch upon the wound he only now realized had never even begun to heal because they had pretended it had disappeared.

"When I saw you laying there, all I could think about was--"

She squeezed his hand and nodded. "I know."

*****

Derek had offered to stay with Addison at the hotel when she was released from the hospital, assuming she would prefer the creature comforts of room service and the spa. She had surprised him by deciding to return to the trailer. Then he had surprised himself by replacing his flannel sheets with the Egyptian cotton linens he knew his wife preferred before he had run out for fresh flowers and a refrigerator full of her favorite foods.

For the first time since she had come to Seattle, Derek felt like he was bringing his wife home with him as he had driven up to the trailer. And this time, Addison hadn't snarked the woods or complained about the dampness from the lake. She'd noticed all the little things he had done to try to make her feel comfortable and thanked him, and Derek had been surprised at how much it had meant to him that she had paid attention.

He had intended to let her heal more before he continued the conversation they had begun in the hospital with those tenuous first words of his. But when he had gone to leave the room so she could rest, Addison had taken his hand and pulled him back so that he was sitting beside her.

"When the pain started I was in the library," she said, and the mention of the brownstone library Addison had loved told him for certain they were discussing the loss of their child.

"I knew the kitchen phone was the closest, and I tried to get there... but I just couldn't do it, Derek. It hurt so much... and I felt so completely... powerless. I couldn't help her. I was her mother, and I couldn't even get to a phone to call for help so she would be okay."

He wanted to say something to reassure her, but it had taken so long for her to share this with him... for him to realize he wanted her to... that Derek remained silent a little longer.

"I kept hoping she would be okay." Addison swiped at tears at the corners of her eyes, but she kept on. "Even when I woke up in the hospital my first thought was, 'she'll be okay.' Then I saw your face and I knew."

"I had been sitting there for hours," Derek shared, "wondering how to tell you. And when you looked at me... I couldn't find the words to say it out loud."

Addie's tears pooled at her lower lids and spilled over uncontrollably and Derek lost his voice and did not go on. It hurt him to see her cry... and it hadn't hurt him to see that in a very long time. But it hurt more when he reached out to try to pull her too him and she pulled away. He felt Manhattan all over again... the inability to comfort her, the reactionary desire to pull back to protect himself. And just when the pattern that had pushed their marriage to the breaking point threatened to win out again, Addison spoke through her tears and let Derek in.

"I'm sorry, Derek. I'm so sorry. I don't know what I did, I really don't. But I know I failed her... I failed you."

This time when he reached for her, she let him, and Derek pulled his wife tightly against his chest and wrapped his arms around her.

"You kept telling me to stop working, to slow down, and I wouldn't. You kept warning me and--"

"I never thought that, Addie, I swear. I never thought it was your fault. God, no. I-I thought it was my fault. When you pulled away, I thought you were angry with me."

"Why would I blame you?" she asked, her voice muffled by their closeness.

"For leaving you in the first place... for not knowing sooner something was wrong..."

And then the confession he had never made, even to himself, was there suddenly, wanting and needing to be spoken.

"The truth was... I knew that I could survive losing our baby... but I was absolutely terrified of what would happen to me if I lost you... and I guess I thought if you knew that... I would lose you anyway."

"You did, but not for that reason, Baby. We lost each other... because we both let go."

Derek closed his eyes as Addison's words rang in his ears. They had both let go. But that fear he'd felt in Manhattan... that desperate need for her to wake up and be okay... it was still there inside of him. Yes, there had been hurt and anger and betrayal and more hurt and more anger since that awful day... but still he had been afraid to imagine a world without Addison in it. Which meant his only choice was to fix the world in which he and Addison both lived... together. And the only way to begin was just to dive in and tell her what he was feeling right there in that moment.

"I don't think I want to be lost anymore, Addie. I'm ready to be home again."

She tightened her arms around him and Derek smiled as she tilted her head up so she could see him.

"I don't want to be lost anymore either."

Their lips drew together... a kiss of comfort and promise and mostly, of forgiveness. Then Addison leaned back in his arms and Derek pushed a piece of her gorgeous red hair back off of her face.

"What name did you like best?"

He'd always wondered that... what name Addison had wanted to pick. They'd talked about so many, but he'd never known her final choice.

"Charlotte. What was yours?"

"Elizabeth," he answered. "But I wanted to call her Ellie."

"Elizabeth Charlotte Shepherd. Ellie Shepherd," she whispered after thinking about it for awhile. "I bet we would've picked that."

"Yeah," Derek agreed. "I bet we would've."

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