Season 1, Episode 1: A Hard Day's Night
Overall Episode Number: 1
Created by: Shonda Rhimes

/ / /

"The game. They say either a person has what it takes to play, or they don't. My mother was one of the greats. Me, on the other hand... I'm kinda screwed."

- Meredith Grey

/ / /

Meredith Grey, a surgical intern, enters a room filled with other interns as the chief of surgery, Richard Webber, talks.

"Each of you comes here hopeful. Wanting in on the game. A month ago you were in med school being taught by doctors. Today, you are the doctors. The seven years you spend here as a surgical resident will be the best and worst of your life. You will be pushed to the breaking point. Look around you. Say hello to your competition. Eight of you will switch to an easier specialty. Five of you will crack under the pressure. Two of you will be asked to leave. This is your starting line. This is your arena. How well you play? That's up to you."

/ / /

"Like I said. I'm screwed."

- Meredith Grey

/ / /

"Mackenzie? Wake up sweetheart."

Mackenzie Shepherd-Sloan groaned as she rubbed at her eyes. "Five more minutes?" She asked as she pulled her blanket over her head.

Two seconds later, the blanket came off and Mackenzie groaned as the bright light in her room shone in her eyes. "Why must you do this to me?" She asked her father, who was none other than world-class neurosurgeon Derek Shepherd.

Derek gave his daughter a sympathetic smile. "I know you're not a morning person baby girl, but if you don't get up on time, we'll both be late to the hospital."

Mackenzie sat up and stretched. "Papa, you never came home last night. And you weren't on call, either. Where were you?"

Derek froze ever so slightly. "I stayed at a motel last night. Had too much to drink. I should've called you, and I'm sorry I worried you, baby girl." He smoothly lied and kissed the top of his daughter's head.

"It's okay, Papa. You're a grown man. But now I'm going to change, and I need some privacy please." Mackenzie said and closed the curtain to her room in Derek's trailer.

Derek chuckled from the other side of the curtain. "Mack, you do know that privacy has never existed in your family?"

"Doesn't mean we can't start making privacy exist now, Papa!"

/ / /

Derek and Mackenzie walked in Seattle Grace Hospital together, and got on the elevator with Dr. Miranda Bailey and Dr. Preston Burke.

"Dr. Bailey, Dr. Burke." Derek greeted politely.

"Dr. Shepherd." Bailey and Burke acknowledged simultaneously.

Mackenzie stood at the back of the elevator next to Derek, holding his hand.

"Good morning, Dr. Burke and Dr. Bailey."

Bailey and Burke both looked towards the 11-year-old girl with sweet smiles. Miranda Bailey and Preston Burke didn't smile often... unless they had their favorite patients in the hospital.

The fact that Mackenzie could get both of them to crack a smile at her was a feat all on its own.

"Good morning, Mackenzie." Burke greeted.

"There's Mack Attack. I don't like a lot of people... but I like you." Bailey told the girl.

Mackenzie's eyes brightened when Bailey said that she liked Mackenzie. "Good luck with your new interns today, Dr. Bailey."

Bailey chuckled. "Thank you, Mack. I'm gonna need a hell of a lot of luck for these interns."

Derek smiled as he brought Mackenzie to his side when they stopped on the 5th floor. The three doctors exited the elevator, but Mackenzie remained.

Derek furrowed his brows in confusion. "Honey, where are you going?"

Mackenzie gave her father a sly smile. "Peds floor. They have the best cartoons and the best patients."

/ / /

After spending time with the patients on the peds floor, Mackenzie decided to go to the cafeteria on the 5th floor for lunch.

The 5th floor cafeteria had the best vending machines in the entire surgical wing of SGH.

Mackenzie had enough money to buy a bag of chips and a water from the vending machine, and bought a sandwich from the sandwich guy.

When Mackenzie looked for an open table to sit at, she found a table that seated a blonde intern. She decided to sit across from said intern at the table.

Dr. Isobel 'Izzie' Stevens.

Izzie looked at Mackenzie with confusion written on her face. "Are you lost?" She asked.

Mackenzie looked at Izzie. "Nope. I'm not lost; I just don't usually eat with interns. But you guys are new, so... don't knock it till you try it, right?"

Izzie gave Mackenzie a smile. "I'm Izzie."

Mackenzie smiled back. "Mackenzie. And if you're wondering, I'm 11 years old."

Izzie nodded and she went back to staring at her food. Another intern joins the two blondes at the table.

Dr. George O'Malley.

George took the seat next to Izzie, and his eyes focused on Mackenzie with the same confusion that Izzie had on her face. Izzie was staring at her food with some horror.

"This shift is a marathon, not a sprint, eat." George told his fellow intern.

Izzie shook her head. "I can't."

George shrugged. "You should eat something."

Izzie looked at George. "You try eating after performing seventeen rectal exams. The Nazi hates me."

"The Nazi's a resident. I have attendings hating me." George whined.

Mackenzie looked at the both of them. "They don't hate you. They're hard on you because they used to be you. And don't call Dr. Bailey 'the Nazi.' I'm pretty sure that's offensive."

George looked at Mackenzie, genuinely impressed. Then his confusion returned. "I'm sorry, who are you?"

"Mackenzie. I joined Izzie for lunch." Mackenzie said and stuck her hand out to George.

George shook the 11-year-old's hand with a smile. "I'm George O'Malley."

Before the conversation could continue, another intern joins Mackenzie, Izzie and George for lunch.

Dr. Cristina Yang.

Cristina doesn't even pay attention to the 11-year-old that's sitting next to her. She's too busy looking at George and Izzie. "You know Meredith is inbred?"

George shrugged. "Like it's uncommon around here to be a doctor's — "

Cristina cut George off. "No, I mean royally inbred. Her mother is Ellis Grey."

Mackenzie looked up in surprise. "Wait. The daughter of Ellis Grey works here?"

Izzie looked just as surprised as Mackenzie. "Shut up, the Ellis Grey?"

Cristina nodded. "Uh-huh."

George looked like a clueless puppy. "Who's Ellis Grey?"

Izzie and Cristina laughed while Mackenzie gave George a raised eyebrow.

"The Grey method? Where'd you go to med school, Mexico?" Cristina joked.

Izzie nodded. "She was one of the first big chick surgeons, she practically invented the abdominal — "

Cristina interrupted Izzie. "She's a living legend, she won the Harper Avery. Twice."

George looked at his food. "So I didn't know one thing."

Mackenzie gave George a smile. "Don't get down, George. Keep your head up and be positive today."

Cristina finally acknowledged Mackenzie's presence. "You're too young to work in a hospital. Are you a patient?"

"Nope. My papa works at the hospital. I've spent a lot of my free time in this hospital for the last six weeks. I'm Mackenzie, by the way." Mackenzie introduced.

"I'm Cristina, but this does not make us friends. I'm too old to be your friend." Cristina said.

Mackenzie looked at Cristina pointedly. "You're twice my age. I can have friends that are older than me."

Izzie cleared her throat to ease the obvious tension between Cristina and Mackenzie. "Talk about parental pressure."

Cristina nodded. "I would kill to have Ellis Grey as a mother. I would kill to be Ellis Grey. All I need is one good case."

Meredith came over and sat down with her tray. She hadn't noticed Mackenzie just yet.

"Katie Bryce is a pain in the ass. If I hadn't taken the Hippocratic oath, I'd Kevorkian her with my bare hands."

The other four look at Meredith weirdly.

Meredith gives them a weird look in return. "What?"

Burke arrived at the table full of interns and Mackenzie. "Good afternoon interns. It's posted, but I thought I'd share the good news personally. As you know, the honor of performing the first surgery is reserved for the intern that shows the most promise. As I'm running the O.R. today, I get to make that choice."

Burke clapped George on the back. "George O'Malley. You'll scrub in for an appendectomy this afternoon. Congratulations."

George looked at Burke in disbelief. "Me?"

Burke smiled. "Enjoy."

Burke left the cafeteria and no one spoke. Everyone was in some state of shock.

"Did he say me?"

/ / /

While Meredith talked to Mr. and Mrs. Bryce, Mackenzie sat at Katie's bedside.

Katie looked at Mackenzie with confusion. "You're not supposed to be in here. You're not family... are you?"

Mackenzie looked at the teenager. "I'm not your family. But I am the daughter of your new doctor. He's a brain surgeon."

Katie rolled her eyes. "Well your dad is lame. And so are you."

"He's not lame. He's the best of the best."
Mackenzie said and left Katie's room.

"Stupid bratty teenager." Mackenzie mumbled under her breath.

/ / /

Meredith walked up to Bailey after a botched conversation with Katie Bryce's mother and father.

Bailey looked annoyed. "What?"

"Katie's parents have questions. Do you talk to them, or do I ask Burke?" Meredith asked.

Bailey shook her head. "No, Burke's off the case, Katie belongs to the new attending now, Dr. Shepherd, he's over there."

Meredith took a few steps in that direction. When Meredith saw Derek, her eyes widened and she started to turn to go.

Derek glanced her way and does a double take. She turns and leaves. He's still staring.

Talk about karma biting you in the ass.

/ / /

Meredith walks down the hall and Derek grabs her arm.

Meredith is shocked at what Derek just did. "Hey — "

Derek pulls her into a stairwell where there's no one around.

Meredith sighed. "Dr. Shepherd — "

Derek interrupted. "Dr. Shepherd? This morning it was Derek. Now it's Dr. Shepherd."

Meredith shook her head at Derek's words. "Dr. Shepherd, we should pretend it never happened."

"What never happened, you sleeping with me last night? Or you throwing me out this morning? Because both are fond memories I'd like to hold onto." Derek smirked.

"No. There will be no memories. I'm not the girl in the bar anymore, and you're not the guy. This can't exist. You get that, right?" Meredith emphasized.

Derek nodded. "You took advantage of me and now you want to forget about it."

Meredith started to argue. "I did not take — "

"I was drunk, vulnerable and good-looking and you took advantage." Derek summarized.

Meredith smiled. "Okay, I was the one who was drunk, and you are not that good-looking."

Derek chuckled. "Well, maybe not today. Last night, last night I was very good-looking. I had my red shirt on, my good-looking shirt, you took advantage."

"I did not take — "

"You want to take advantage again? Say Friday night?" Derek flirted.

"No. You're an attending. And I'm your intern. Stop looking at me like that." Meredith said pointedly.

Derek chuckled. "Like what?"

"Like you've seen me naked."

Derek smirked and Meredith shook her head.

"Dr. Shepherd. This is inappropriate. Has that ever occurred to you?"

Meredith left and Derek sighed.

He was pretty out of practice with his flirting.

/ / /

Mackenzie sat with Meredith, Izzie, George and Cristina on spare beds in an empty corridor.

"007. They're calling me 007, aren't they?" George fretted.

George had screwed up during the appendectomy, and now everyone was calling him 007.

Izzie, Mackenzie and Meredith looked at George. "No one's calling you 007."

George looked at them in return. "I was on the elevator and Murphy whispered 007."

Cristina groaned. "Oh, how many times do we have go through this, George, five, ten? Give me a number or else I'm going to hit you."

George looked down. "Murphy whispered 007 and everyone laughed."

"He wasn't talking about you." Izzie lied.

George looked unsure. "You sure?"

"Would we lie to you?" Meredith questioned.

"Yes." George and Mackenzie answered.

"007 is a state of mind." Cristina stated.

"So says the girl who finished top of her class at Stanford." George bit back.

Meredith's pager started beeping.

"Oh man. It's 911 for Katie Bryce. I gotta go."

George waits for Meredith to leave. "Maybe I should've gone into geriatrics. No one minds when you kill an old person."

"Surgery is hot, it's the Marines, it's macho, it's hostile, it's hardcore. Geriatrics is for freaks who live with their mothers and never have sex." Cristina told him before she and Izzie walked off.

George looked at the 11-year-old next to him. "I've got to get my own place."

"Stop whining, George. I live in a 2-bedroom trailer in the middle of the freakin' woods. Your housing situation is better than mine."

/ / /

Later that night, Bailey was sleeping on a bed in a hospital corridor. Izzie looked a little unsure.

One of the male nurses at the nurse's station saw the intern's uncertainty. "What do you need?"

"Mr. Jones has junkie veins and he really needs antibiotics so I should start a central line." Izzie explained as Mackenzie popped her head up from the book she was reading. She hung around a lot of nurses.

"So start one." The nurse said.

There was a pause before the nurse came to a realization. "You don't know how."

Izzie nodded. "I've never done one."

"Well, you know what that means." The nurse said and looked towards the sleeping Bailey.

Izzie panicked. "Can't we just...page someone else?"

Mackenzie spoke up. "She's the on-call resident. I'll get her."

Izzie paled as Mackenzie went over to Bailey, crouched down and politely tapped her shoulder.

Bailey stirred and opened one eye to see Mackenzie staring back at her. "What's wrong, Mack?"

Mackenzie looked back at Izzie and then to Bailey. "Dr. Bailey... Izzie needs help starting a central line for Mr. Jones. She's never done one before. I wouldn't wake you up just for kicks, but she needs help."

Bailey sighed and sat up, causing Mackenzie to stand up and move out of the resident's way.

Izzie let out a silent breath of relief. Mackenzie was one of the only people that Bailey was polite to.

/ / /

After finishing with Mr. Jones's central line, Bailey looked at Izzie with a stank face.

"Count yourself lucky, Stevens. If it was anyone other than Mack waking me up, I'd be grumpy."

/ / /

After a long day in the hospital, Derek and Mackenzie head out to Derek's truck. Time to go to the trailer for some quality sleep.

"How was your day today, pumpkin?" Derek asked as he drove down the road.

"It was interesting. Hung out with some interns. I made two new friends and found out that one of the interns is royally inbred." Mackenzie answered.

Derek chuckled. Mackenzie was a social butterfly, and he was glad that she'd made some friends. She had been particularly lonely in New York.

"Tell me about your new friends."

Mackenzie smiled. "Well there's Izzie Stevens. She's really smart, but she's afraid of Dr. Bailey for whatever reason. Poor girl performed 17 rectal exams today, and she was shown how to start a central line. Izzie shows great potential as a future surgeon."

Derek nodded at her words. "And your other new friend?"

"George O'Malley. He's really sweet — definitely has a big heart. He got chosen by Dr. Burke to assist on an appendectomy this afternoon, but apparently, he made a mistake. Interns are calling him 007, which is rude. I think George will do extraordinary things in the future." Mackenzie explained.

"And the intern who's royally inbred? How'd you find that out?" Derek inquired.

Mackenzie smirked. "I was told by Cristina Yang at lunch today. Get this: the daughter of Ellis Grey is an intern at Seattle Grace. Her name is Meredith. Meredith Grey. I met Meredith; she seems cool."

Derek stopped at a red stoplight and gave his daughter a smile. "Well I'm glad you're making friends and discovering things on your own, Mack. Just try to stop growing up so fast, okay?"

Mackenzie smiled. "I make no promises. But I'll try for you, Papa."

Derek nodded and drove the rest of the way home internally panicking.

Mackenzie met Meredith.

Derek slept with Meredith Grey.

Derek works with Meredith Grey.

How long would it take Meredith to realize that Mackenzie was his daughter?

And how long would it take Mackenzie to figure out that Meredith and Derek slept together?

Derek was in deep shit now.

/ / /

Mackenzie woke up to hearing Derek's frustrated groans the following morning. She scrambled out of bed and poked her head out of the trailer door. Derek was sitting on the deck with x-ray results in his lap.

"Papa? What's got you all grumpy?"'

Derek looked up and saw Mackenzie. He beckoned her over, and she stepped out of the trailer. Mackenzie walked over to her father and took a look at what he was so frustrated about.

"I have this girl. Her name is Katie Bryce. She's 15, and she's having seizures. Her C.T. and M.R.I. both came up clean. I have no idea what's wrong. I don't know how to treat her. I'm frustrated, honey. I'm really frustrated."

Mackenzie looked between the x-rays and Derek. "Well, here's a thought: have the interns solve the medical mystery. If one of them can figure out what's causing Katie's seizures... you could reward that intern by letting them scrub in and assist on Katie's surgery. It'll be an intern bloodbath, but at least it'll put you at ease."

Derek looked impressed by Mackenzie's suggestion. He set the results back in the folder and kissed his daughter's face.

"You, my dear, are a genius. You're brilliant. Absolutely brilliant."

/ / /

"Well good morning. I'm going to do something pretty rare for a surgeon, I'm going to ask interns for help. I've got this kid, Katie Bryce. Right now, she's a mystery. She doesn't respond to her meds. Labs are clean, scans are pure, but she's having seizures. Grand mal seizures with no visible cause. She's a ticking clock. She's going to die, if I don't make a diagnosis. Which is where you come in. I can't do it alone. I need your extra minds, extra eyes, I need you to play detective, I need you to find out why Katie is having seizures. I know you're tired, you're busy, you've got more work than you could possibly handle. I understand. So, I'm going to give you an incentive. Whoever finds the answer rides with me. Katie needs surgery. You get to do what no interns get to do. Scrub in to assist on an advanced procedure. Dr. Bailey's going to hand you Katie's chart. The clock is ticking fast, people. If we're going to save Katie's life, we have to do it soon." Derek spoke.

All the interns scrambled to get a copy of Katie's chart. Derek held back a look of sheer amusement.

Mackenzie was right: this was going to be a bloodbath between the interns.

/ / /

Cristina and Meredith were busy looking for answers in the library.

"Well, she doesn't have anoxia, chronic renal failure or acidosis. It's not a tumor because her CT's clean. Are you seriously not going to tell me why you won't work with Shepherd?" Cristina asked.

Meredith shook her head. "No. What about infection?"

"No. There's no white count, she has no ceteal lesions, no fevers, nothing in her spinal tap, just tell me." Cristina begged.

Meredith caved. "You can't comment, make a face, or react in any way. We had sex."

Cristina opens her mouth, closes it, and changed the subject. "What about an aneurysm?"

"No blood on the CT, and no headaches." Meredith answered.

Cristina nodded. "Okay. There's no drug use, uh, no pregnancy, no trauma...was he good? I mean, he looks like he would be, was it any good?"

"What are the answers? What if no one comes up with anything?" Meredith pondered.

Cristina looked at Meredith. "You mean if she dies?"

"Yeah." Meredith nodded.

"This is gonna sound really bad, but I really wanted that surgery." Cristina said.

Meredith sighed. "She's just never going to get the chance to turn into a person. The sum total of her existence will be almost winning Miss Teen whatever. You know what her pageant talent is?"

"They have talent?" Cristina asked with seriousness in her voice.

"Rhythmic gymnastics." Meredith answered.

They laugh.

Cristina laughed more. "Oh, come on."

"What is rhythmic gymnastics? I don't know - I can't even say it, I don't know what it is." Meredith said.

"Isn't it like something with a ball, and a ...what? Meredith, what?" Cristina said when Meredith went quiet.

Meredith looked at Cristina. "Get up! Come on!"

/ / /

"...the only thing she could possibly need is a - Oh, oh, Dr. Shepherd! Just one moment, um, uh, Katie competes in beauty pageants — "

Derek cut Cristina off. "I know that, but we have to save her life anyway."

Cristina nodded. "Okay, she has no headaches, no neck pain, her CT's clean, there's no medical proof of an aneurysm — "

"Right." Derek encouraged.

Cristina continued. "But what if she has an aneurysm anyway?"

Derek looked skeptical. "There are no indicators."

"Ah, but she twisted her ankle, a few weeks ago when she was practicing for the pageant — " Cristina tried before Derek cut her off again.

"Look, I appreciate you're trying to help, but — " Derek was cut off by another doctor in the elevator.

"This is not helping!"

Meredith sighed. "She fell. When she twisted her ankle, she fell."

Cristina nodded. "It was no big deal, not even a bump on the head, you know she got right back up, iced her ankle and everything was fine, it was a fall so minor her doctor didn't even think to mention it when I was taking her history, but she did fall."

Derek shook his head. "Well, you know the chances that a minor fall could burst an aneurysm, one in a million! Literally."

The elevator door is finally allowed to close. Meredith and Cristina sigh and turn away. The elevator dings and Derek steps out. They turn back.

"Let's go."

Cristina looks confused. "Where?"

"To find out if Katie's one in a million."

/ / /

Cristina, Meredith and Derek are looking at a scan.

Derek sighed. "I'll be damned."

The scan showed dark spots in a part of Katie's brain.

"It's minor, but it's there. It's a subarachnoid hemorrhage. She's bleeding into her brain."

/ / /

Meredith, Derek and Cristina are walking.

"She could've gone her entire life without it ever being a problem. One tap in the right spot — "

"And explode." Cristina finished for Derek.

Derek nodded. "Exactly. Now I have to fix it. You two did great work. Love to stay and kiss your asses, but I gotta tell Katie's parents she's having surgery. Katie Bryce's chart, please."

The receptionist hands Derek Katie's chart. "Here you go."

"Oh, and Dr Shepherd, you said that you'd pick someone to scrub in if we helped." Cristina reminded n

Derek nodded. "Oh, yes, right. Um, I'm sorry I can't take you both, it's going to be a full house. Meredith, I'll see you in O.R."

Meredith looked shocked.

Cristina looked betrayed.

/ / /

Izzie, Mackenzie and Cristina were sitting on the spare beds in the empty corridor again.

Cristina was upset because Derek didn't pick her for Katie's surgery. Instead, he picked Meredith. But Mackenzie didn't know why Cristina was upset with Meredith.

Meredith walked towards the girls. "I'll tell him I changed my mind, you can — "

Cristina cut Meredith off. "No, no, don't do me any favors. It's fine."

"Cristina — " Meredith tried again before said girl interrupted her a second time.

"You know what, you did a cutthroat thing, deal with it. Don't come to me for absolution, you want to be a shark, be a shark."

Meredith tried to deny it. "I'm not — "

"Oh yes you are. Only it makes you feel all bad in your warm gooey places. No, screw you. I don't get picked for surgeries because I slept with my boss, and I didn't get into med school because I have a famous mother. You know, some of us have to earn what we get."

Meredith leaves.

Mackenzie's eyes widened. "Meredith slept with Dr. Shepherd?" She asked.

Cristina scoffed. "Oh, what's it to you? Aren't you the daughter of a nurse here or something?"

Mackenzie stood up. "No, actually. My father — well, one of them — is Dr. Shepherd."

Izzie and Cristina gaped at her.

"But how?" Izzie managed.

"The rare male carrier gene. He has it." Mackenzie answered before walking away to find George.

Cristina looked at Izzie, still in shock.

"McDreamy is a McDad. Holy crap! Meredith has no idea she slept with Mackenzie's dad."

/ / /

Derek was shaving Katie's head while Meredith looks on.

Derek smiled. "I promised I'd make her look cool. Apparently being a bald beauty queen is the worst thing that happened in the history of the world."

"Did you choose me for the surgery because I slept with you?" Meredith asked.

Derek gave Meredith a straight face. "Yes......I'm kidding."

Meredith shook her head. "I'm not going to scrub in for surgery. You should ask Cristina. She really wants it."

"You're Katie's doctor. And on your first day, with very little training, you helped save her life. You earned the right to follow her case to the finish. You...you shouldn't let the fact that we had sex get in the way of you taking your shot."

/ / /

George and Meredith were sitting outside.

"I wish I wanted to be a chef. Or a ski instructor. Or a kindergarten teacher." Meredith told George.

George sighed. "You know, I would've been a really good postal worker. I'm dependable. You know, my parents tell everyone they meet that their son's a surgeon. As if it's a big accomplishment. A superhero or something. If they could see me now..."

Meredith smiled somewhat bitterly. "When I told my mother I wanted to go to medical school, she tried to talk me out of it. Said I didn't have what it takes to be a surgeon. That I'd never make it. So, the way I see it, superhero sounds pretty damn good."

George looked at Meredith. "We're going to survive this, right?"

/ / /

Mackenzie watched from the nurse's station as Richard Webber talked to a cocky intern, Alex Karev.

"She's still short of breath. Did you get an ABG or a chest film?" Richard asked.

Alex nodded. "Oh, yes sir, I did."

"And what did you see?" Richard pressed.

"Oh, well, I had a lot of patients last — "

Richard stopped Alex mid-excuse. "Name the common causes of post-op fever."

Alex nodded. "Uh...yes, sir."

Alex pulled a notebook out of his pocket.

Richard shook his head. "From your head. Not from a book. Don't look it up, learn it, it should be in your head. Name the common causes of post-op fever."

Alex looked lost. "Uh...the common causes of post-op..."

Richard looked around the corridor. "Can anybody name the common causes of post-op fever?" He asked loudly.

Everybody stops and one girl pulled out her notebook.

Meredith spoke up. "Wind, water, wound, walking, wonder drugs. The five Ws. Most of the time it's wind, splinting or pneumonia. Pneumonia's easy to assume, especially if you're too busy to do the tests."

Richard gave Alex a pointed look. Then he looked to Meredith. "What do you think's wrong with 4B?"

"The fourth W, walking. I think she's a prime candidate for a pulmonary ambulus." Meredith answered.

Richard raised an eyebrow. "How would you diagnose?"

Meredith looked at the Chief. "Spiral CT, VQ scan, provide O2, dose with Heparin, and consult for an IVC filter."

Richard looked at Alex. "Do exactly as she says, then tell your resident that I want you off this case." He told Alex. He then looked to Meredith. "I'd know you anywhere, you're the spitting image of your mother. Welcome to the gang."

Mackenzie watched as Alex walked away grumpily.

"Go, Meredith."

/ / /

In the O.R. for Katie's surgery, Meredith stood a little to the side.

Derek, dressed in his ferry boat scrub cap, smiled. "All right everybody, it's a beautiful night to save lives, let's have some fun."

/ / /

"I can't think of any one reason why I want to be a surgeon. But I can think of a thousand reasons why I should quit. They make it hard on purpose. There are lives in our hands. There comes a moment when it's more than just a game. And you either take that step forward, or turn around and walk away. I could quit. But here's the thing: I love the playing field."

- Meredith Grey

/ / /

Meredith was sitting outside the OR, dazed. Cristina walks through the door and turns back.

Cristina looked at Meredith. "It was a good surgery."

Meredith nodded. "Yeah."

Cristina sat and sighed. "We don't have to do that thing where I say something, and then you say something, and then somebody cries, and there's like a moment..."

"Yuck." Meredith said.

"Good. You should get some sleep. You look like crap." Cristina said.

Meredith smirked. "I look better than you."

Cristina laughed. "It's not possible." She then left.

Derek comes through the same door, stops at a desk to do some paperwork. Meredith stares at him, still looking dazed.

"That was amazing."

Derek nodded. "Mmmm."

Meredith continued. "You practice on cadavers, you observe, and you think you know what you're going to feel like standing over that table, but...that was such a high."

Derek looks at her properly now and nods.

"I don't know why anybody does drugs."

Derek nodded slightly, looking tired. "Yeah."

Meredith smiled. "Yeah."

Derek was smiling back a bit. "I should go do this."

"You should." Meredith agreed.

Derek started going. "I'll see you around."

"See you around. See ya." Meredith said.

/ / /

"So. I made it through my first shift. We all did. The other interns are all good people, you'd like them. I think. I don't know. Maybe. I like them. Oh, and I changed my mind. I'm not going to sell the house. I'm going to keep it. I'll have to get a couple of roommates, but it's home, you know?"

- Meredith Grey

/ / /

Derek finished the paperwork for Katie Bryce, and then decided to go find his own daughter.

After Katie's case, he really needed to spend some time with his daughter after operating on someone else's daughter.

Derek searched every floor of the hospital. He was unsuccessful until he walked in the empty corridor where the interns hung out. Mackenzie was sitting right in between Meredith and George.

"Mackenzie? Why is Dr. Shepherd looking at you?" George asked.

Mackenzie looked over and saw Derek. "It's a long story. George, Meredith, Izzie, Cristina... this is Derek Shepherd. He's one of my dads. Papa... this is George O'Malley and Izzie Stevens. And you've already met Meredith and Cristina."

Meredith stared. George's eyes widened. Izzie and Cristina looked knowingly at Derek.

Derek waved awkwardly. "Hello. Mack, sweetheart, I've been looking everywhere for you. I was thinking we could have a lunch date? I can clock out early and we can get out of here. Sound good?"

Mackenzie nodded. "Sounds great, Papa. Bye, lame people. See you all tomorrow." She bade farewell to the interns.

"Bye, Mackenzie!" George responded.

Once Derek and Mackenzie disappeared from eyeshot and earshot, Meredith finally spoke.

"I can't believe McDreamy is a McDad."

Oh, how the tables have turned for Meredith Grey.

/ / /

Mackenzie sat across from Derek at a café close to the hospital.

"How did Katie's surgery go?" Mackenzie asked after sipping on her water.

Derek smiled. "It went good. Really good. You know... the whole time I was operating, I thought of you. I thought of my baby while I operated on someone else's baby."

Mackenzie smiled shyly. Then her face went deadly serious as Derek sipped on his water.

"You didn't tell me you slept with Meredith Grey the other night."

Derek did a spit take to his side. He regained his composure and looked at his daughter. "I can explain — "

Mackenzie didn't give him time to. "You don't need to. I get that she hurt you, Papa. And you wanted to have some adult fun. I'm not mad or anything. But you could've told me the truth."

Derek nodded. "Duly noted. But please don't ever make me do that again. Now my nose is stinging from the water I spit out of it."

Mackenzie held out her pinky finger. "Deal."

Derek linked his pinky with hers. "Deal."

/ / /

After their mother/daughter lunch date and eating leftover takeout for dinner, Derek decided to put an exhausted Mackenzie to bed. She'd fallen asleep an hour after dinner.

Derek carefully scooped his 11-year-old daughter into his arms and carried her inside, gently placing her on her bed. Derek then walked to the other end of the trailer and changed into a sleep shirt and pj pants. He came back to his daughter's room and smiled at her sleeping form; she looked so peaceful.

It was one of those nights where Derek just needed to hold his baby, so he sat on the left end of her bed and got under the covers. He gently maneuvered Mackenzie into his embrace, who automatically curled into his side.

Derek smiled and kissed the top of her blonde head. "I love you, baby girl. Papa loves you so much."

Derek closed his eyes as he fell asleep cuddling his daughter close.

He'd do anything for Mackenzie. She was his life.

Even if it meant moving to Seattle with her to get away from all the drama that was left behind in New York.

To Derek, family was everything.

/ / /

5695 words

Next Update: The First Cut is the Deepest

*How'd I do with the pilot episode? Did you guys like it? Please leave some comments!*

Published:  12/12/2020
Edited:  5/12/2022