"Is there anyone left in the city who doesn't have appendicitis?" Meredith asks of the world generally and the OR board in particular.

"It's not that bad," George says. He's trying to placate her. Meredith narrows her eyes at him. She doesn't like being placated. She doesn't even like that the word exists. George raises his eyebrows and gives her his anxious-puppy look. "We'll all get into surgery, at least."

"Seven, George. Seven inflamed, useless intestinal caecums that nobody needs, so they foist them off on us."

"Okay, so that's a lot of appendectomies." George shrugs. "They can't all be amazing cases."

"But I miss amazing cases." Meredith crosses her arms and tries to count how many hours are left in this shift, but the numbers won't stay still in the math problem in her head. "Where are the cardiac tamponades? The acute pancreatitis with full sepsis?"

"I could do without the sepsis," George says.

Meredith shakes her head. "You don't get it."

"Placental abruptions," Izzie says wistfully.

"Aortic dissections," Cristina mourns. "A nice amputation."

"You guys know what we're doing, though, right?" Meredith turns away from the board and leans back against it. She stares off into space and tries to decide if the opposite wall is supposed to spin like that. "I mean, we're wishing people harm. That's what we're doing. Somebody has to be hurt, or horribly diseased, or in pain, just for us to be professionally fulfilled."

"Yes," Cristina says. "Oh. Is that a point you're trying to make?"

Meredith rolls her shoulders. It's a half-stretch, half-shrug. "I don't know," she says. "I just noticed."

"God, how long have you been awake?" Izzie asks.

"I don't know that either." She blinks. She remembers her seventh cup of coffee, three hours in the pit, and her last set of rounds. She doesn't remember waking up. "Huh."

"Maybe you should go to the on-call room," George says.

"Nope." Meredith's resigned, and she raises her index finger in the air to prove it. "If I don't bring an appendix to Bailey today, she'll probably ask to see mine."

"Be careful with the purse strings," George says.

Meredith waves him off. This isn't open heart surgery--no one dies and gets resurrected, or any of the glamour and glitz the attendings see every day. This is a work-horse assignment, probably with a resident--

Except it's Derek scrubbing in at the sink next to her.

"Did you piss off the Chief?" she asks before she can stop herself. This is probably where that 'sleep' thing would come in handy.

"Just keeping myself in practice," he says. He smiles at her, his eyes crinkling in that damnably dreamy way. She wants to glare in return, because she's reasonably certain that is the smile that ruined her life, but the problem with it is that it's a smile that's impossible not to return.

She concentrates on the small things: soaping beneath her nails, thirty seconds washing each finger, keeping the water running down to her elbows.

Surgery is a series of small things. In the OR, focusing on the details is an asset, except when you're holding retractors for your married ex-boyfriend and he is busy being stupidly unaware of his own ridiculous gorgeousness. Meredith starts cataloguing Derek-details along with the laparoscopy. This is the man she woke up next to, every day for weeks. That is the curve of the ear that she licked into when they were making out. Those are the long-lashed eyes she stared into when he told her he loved her.

"We can close now, Dr. Grey," he says.

He leaves the OR, trusting her to finish the sutures.

Surgeons train to notice minutiae, to concentrate on details. Meredith measures every moment of his walk to the scrub room. She can tell everything about him from how he moves. He's already thinking of more important surgeries, of diffuse cerebral tumors and meningeal defects.

Meredith blinks at the world until she finds that the surgery is over, and she's safe from killing someone with a badly-timed nap.

"Hey," George says, handing her a cup of coffee when he finds her sitting in the change room. She's mostly asleep with her eyes open. Blanked out. "How'd it go?"

"Hemispherectomies," she says. "How long since we've had one of those?"

"Um, only a couple of weeks," he reminds her.

"Oh, yeah." Meredith tries to shake off her sluggishness, but it's anchored pretty firmly somewhere right behind her eyes. "I miss those days."

George hmms.

Meredith yawns and slumps on his shoulder. He stiffens a bit, but then pats her hair abstractedly with the hand that isn't holding coffee. His shoulder really is comfortable. "Thanks for the coffee."

"No problem."

Meredith closes her eyes. Derek's probably scrubbing in to his next surgery right now. He has amazing hands. His fingers are so long, and his fingernails are always perfectly trimmed. God, she's pathetic. She can't believe she's still in love with the man's fingernails.

But it really is the small things that she misses most.

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January 24, 2006