Mamma said there'll be days like this, there'll be days like this my mamma said

-Mamma Said, The Shirelles

"How are you feeling, today?" Caroline slipped into bed next to Elena. Her face was slick with sweat. Caroline knew pregnancy wasn't a picnic, but Elena's condition was horrible.

"A little worse." Elena admitted, cradling her torso. Truthfully, it felt like Elena was going to explode from the inside, but she didn't dare admit that to Caroline.

Not for the first time, Caroline wished it was Damon in bed with Elena. She knew Elena wished it, too. But he couldn't look at her, not without begging her to stop what she was doing. And every time he did, she left him to lay on the couch.

You'd think he'd be a quick learner, but he'd done the same thing tonight. Elena made a move to leave, but he stopped her. He didn't like her sleeping on the uncomfortable couch when she was already hurting, so he took it for his bed tonight. And he'd asked Caroline to stay with Elena, as he did every night she refused his company.

"I don't know why he doesn't understand, Care." Elena looked at her sister with pain-filled eyes.

She refrained from saying that she understood perfectly, that Elena was the one being stubborn. But then Elena would leave the bed. Maybe even go to a motel for the night. She'd done that once.

So instead of saying anything, Caroline wrapped her arm around her sister.

They began to relax, but then Elena went out a small moan and they both tensed.

"Do you need to go to the hospital?" She'd asked it every day for a month, and every day Elena refused. Today was no different. "Just tell me if you do, ok?" She stroked Elena's hair and started to sing softly.

Elena started to cry. Partly from the pain, but also because Caroline was singing the song their mother always had when they were sick. "I remember that," she gasped as another wrenching pain shot through her.

"I'm no singer like mom, though." Caroline said sadly.

"Your voice is beautiful." Elena's face was now wet with flowing tears. She didn't realize it, but her grip on the arm Caroline had put around her was leaving bruises. Her sister didn't move or tell her to stop.

Eventually, Caroline lulled Elena into sleep and then fell into it herself.

Caroline woke in the early morning and the spot beside her was cold. The sheet that had covered them was hastily pulled away from the bed. Caroline froze when she saw the blood. She didn't let herself panic. She carefully looked around for Elena and saw the bathroom light was on.

She slowly moved toward the door. Elena was nearly catatonic on the floor, just staring off into space. Her pink pajama bottoms were stained red. "C'mere, honey," Caroline called out to her sister and held her hand.

"The pain's gone." She looked at Caroline for the first time and Caroline got shivers. Her sister's eyes looked dead. "Why is the pain gone?" She asked innocently.

Caroline took Elena under the armpit and tried to help her up. "We have to go to the hospital." She told her.

"I don't want to. They want me to hurt the baby." But Elena stood like a zombie and leaned on Caroline all the while.

Caroline swallowed at the small pool of blood where Elena had been sitting. "I know, but they also want to help you, honey."

Caroline walked her to the car and into the emergency room. She told the receptionist that her sister was pregnant with a known ectopic embryo and that she was bleeding. She'd never seen anyone admitted so fast.

Caroline stayed through the examination and all the tests and x-rays. She was there when they told her they'd have to take her into surgery. She waited, unable to think and a complete mess for hours until they told her she would be okay.

She was with her sister when the doctor came in. "Elena," he said, but she didn't seem to be paying attention. "Your miscarriage resulted in internal bleeding," he continued. "I'm very sorry, but there's nothing anyone could have done. Ectopic pregnancies simply don't survive. You're very lucky we were able to control the internal bleeding through surgery." He tried to catch her eye, but she was looking into a corner.

"Lucky," she scoffed. Caroline had never heard anyone sound so defeated or so bitter.

"There's something else." The doctor said cautiously.

She finally looked at him, and what he saw made him very reluctant to continue. "What else could there possibly be?"

"I'm afraid there were more complications with your miscarriage."

"I am getting very tired of that word: complications." Elena said icily. "Why can't you just say that I'm fucked up?"

He didn't seem too shocked at Elena's angry demeanor. Caroline imagined he'd often had to deal with suffering patients. "I'm afraid you're no longer able to conceive. The left fallopian tube was badly damaged and the bleeding resulted in the infection and subsequent blockage of your right fallopian tube." The doctor informed her with compassion and distance all at once.

Elena was shocked silent for a long while. So long Caroline thought she might never speak again. "You're saying I'll never be able to get pregnant again?"

"I'm afraid not. Your miscarriage caused—"

"Miscarriage!" Elena practically screamed the word. "What does that even mean!?" Tears were running down her face. "Does it mean his tiny little body parts just broke down and poured out of me?! Did it come out with the blood?! What the fuck does that even mean?" She was sobbing hysterically.

"Your baby wasn't developed enough to have had recognizable body parts as you and I see them…" The doctor started. Elena was staring into the wall, no longer crying and no longer listening. "I'll bring you something for the pain."

"I don't want anything." She said quietly. "I don't want any poison."

The doctor motioned to talk to Caroline outside and she went. He looked at her very seriously. "I'll try talking to her later. Maybe if you tried explaining it to her…she should know this isn't the end of the line. There's adoption, In Vitro Fertilization. Her ovaries and uterus are fine. Surgery to remove the blockage isn't recommended, but that's also an option. She's fortunate to be so healthy otherwise." The doctor frowned.

Caroline looked back into the room. "I don't think she sees it that way."

"She'll need to stay here to recover for at least a couple of days after the surgery. When was the last time she's eaten?"

"She hasn't been eating much because of the pain. And when she did, she couldn't hold it down." Caroline admitted.

"So she's been vomiting for a while now?"

"Yes."

"Ok, I'm going to try and bring her something to eat and I want you to make sure she eats most of it, ok?" Caroline nodded at his words. "In the meantime, is there someone else, the father, maybe, that you should call?"

"Oh god, Damon." Caroline exclaimed with horror. He'd been gone to work by the time she'd found Elena. She should have called him the second she'd taken Elena to the hospital, but she'd been so worried…

She didn't want to be the one to tell him any of this.

"It's hard to tell someone such bad news, but it's harder to hear it from a stranger." The doctor put a hand on her shoulder as she processed his words.

Damon came rushing down the hall half an hour later. He should have gotten there sooner, but traffic had slowed him. He'd been so close to getting out of his car and running. He saw Caroline waiting outside of Elena's room and came skidding to a stop, panting. "How is she?" He asked breathlessly.

Caroline was close to tears. "I don't know why bad shit keeps happening to her! Her, of all people. She's better than all of us."

"How is she, Caroline?" Damon repeated desperately.

She shook her head. "Horrible. She hasn't said a word or moved and she's refusing to eat. They have her hooked up to a tube and on suicide watch."

"Suicide watch?" Damon asked with disbelief. He was about to push through to her room but Caroline stopped him.

"I think she needs gentleness right now, Damon. She feels like she's just lost everything."
"She has me," Damon insisted and carefully opened the door.

"Let's hope she remembers that." Caroline whispered as the door closed behind him.

She was on her side facing away from him, towards the window. "Elena?" He put a gentle hand on her shoulder, but she didn't respond.

Damon could have sighed. Not because of the child he would never have, but for relief. He couldn't help but feel grateful he still had her. This could have killed her. Elena was the only thing that mattered to him, but right now he knew that she was in pain. And on suicide watch? He was terrified of what this might do to her.

He took off his shoes and climbed into the small hospital bed. There was just enough room for Damon to spoon her and hold her close. He kissed her neck. "Hey, hey baby. Please don't leave me here all alone."

It was all he said to her, but it seemed to strike something within her. She grabbed his arm and held it close as she began to sob. Horrible, pain-filled and unrestrained, but Damon was glad. If she was finally reacting, finally showing emotion, it meant she would be okay. He was here for her and he would help her get through this.

She ended up falling into a fitful sleep after exhausting herself. He buried his face in her hair and placed his hand on her stomach, as if he could protect what was no longer there. For the first time, he felt a pang of pain for what had been lost and only Elena in his arms kept him from falling apart completely.