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In later seasons, Derek often griped about how his subsequent interns and residents – mainly Lexie Grey, Shane Ross and Heather Brooks – did not quite measure up to Meredith.
The social worker comes back and announces they are the official parents of Zola.
He comes to terms with the fact that his career as a surgeon may be over and is grateful that he is alive.
When Callie Torres (Sara Ramirez), head of orthopedic surgery, tells him a more risky surgery could give him back full function of his hand or reduce its function if it goes wrong, he agrees, accepting the possibility of never again holding a scalpel.
They begin to have feelings for one another and it causes some awkwardness at work, particularly after her supervising resident Dr. Meredith's housemates and fellow interns George O'Malley and Izzie Stevens both antagonized her for some time as they felt she was using her relationship with Derek to further her career.
He generally tolerated them despite his dislike of sharing his living space with the interns who worked under him.
Since their divorce they have remained on amicable terms, with Addison even admonishing Meredith for breaking up with Derek in season three.
In the Private Practice episode "Ex-Life" Derek finally tells Addison that his mother never liked her in the first place.
He admits to Meredith that Addison cheating on him with Mark was partly his fault as an absentee husband.
Due to their tight schedule, they instead informally marry and Derek writes down their "promises" on a post-it note.
They legalize their marriage in season seven in order to adopt Zola, a young African orphan treated for spina bifida.