All Along The Watchtower - Part 19A
Title: All Along The Watchtower
Fandom: Grey's Anatomy
Pairing: Mer/Der
Rating: M
Summary: S6 continuation. Immediately post Sanctuary / Death and All His Friends.
Thank you, as always, to the people who take the time to leave feedback. I really appreciate it! Betas, as usual, you guys are my favorite people, and you're awesome. Road trip coming up next. Hope to see all of you there. I promise fluff, both figuratively, and possibly contained in marshmallows :)
All Along The Watchtower - Part 19A
The shower rained around him, washing the vomit and bile away. Derek looked at the white and red tiled blur beyond his eyelashes, but didn't see. Nausea swirled. His mouth hung open, and his lips dripped the fluid remains of his stomach as he stood there. Helpless. Mark's bare, shaking arm wrapped under Derek's shoulders and held him up under the spray, but that was Derek's only barrier between upright and collapsed.
“See,” said Mark, his voice low-pitched and playful despite everything, “I imagine this is why people think we're gay.” The washcloth rasped against Derek's skin. Soap and suds spilled over him.
Derek shifted with a low groan. He hurt. Everything. His head throbbed. His joints creaked. His bones and muscles thrummed with discomfort. The battered fault line in his chest slipped with every breath, and he felt a bit like he'd swallowed acid.
Warm water gushed against his skin, and Mark stood against Derek's back to hold him upright, a massive well of body heat, but Derek was cold. Empty. He shivered. A deep-seated, crushing need squeezed him with every heartbeat. He needed to be full, and he would never be full again. His foot shifted and slipped on the porcelain floor of the tub. He didn't have the wherewithal to fight for balance, and so the slide continued until Mark squeezed, and his grip tightened around Derek's chest. Pain crushed him, and his armpits throbbed as he was dragged to his feet.
Again.
“Almost done,” Mark said.
Derek blinked. Water dripped into his eyes. His neck wouldn't support his head, and his gaze lurched to the side. He saw the slope of Mark's pale arm, a mist of water, and then nothing. “Hurts,” he croaked.
“I know,” Mark said. “Almost done.”
Derek shook his head. He needed. He needed. He wasn't almost done. He would never be done. He would never be full again. This hell would never end. He would be stuck here for... forever. His eyes pricked with tears. “It hurts,” he repeated, caught in a sob as the shower spun around him. He couldn't stand anymore. He couldn't--
Mark held him up. “I know,” said Mark. The washcloth rasped.
Derek's stomach churned. He tried to move. He tried. He twisted, feeble. The tub seesawed. Naked skin slipped on naked skin. Mark grunted with pain. Derek ended up bent over Mark's forearm at the waist, and the washcloth merely shifted to Derek's back, rasping. Derek panted. Each breath brought a line of fire to the slipping fault line in his chest, and his throat hurt. It hurt. His stomach clenched, and he vomited onto the floor of the tub by Mark's bare foot. Burning bile dripped from Derek's teeth as he sputtered and choked. He had nothing left. He was empty, and he hadn't slept. Empty, empty, empty. And tired. And glacier cold despite the steam and swelter and Mark.
“Stand up straight,” Mark said, his voice strained as he kept Derek from crashing to the floor of the tub. Barely. Derek shook. The washcloth made a wet splat as Mark slapped it onto the rack and grabbed Derek with both arms. The world shifted like a pinwheel. Colors. Pain. “Stand up,” Mark commanded again, and whether Derek could or would obey, it didn't matter. Pain followed, and Mark dragged Derek up. Bigger. Mark had always been bigger. And stronger.
“Mark,” Derek wheezed more than said.
“I know this sucks, man,” Mark said. “But you have to help me out a bit.”
Derek needed, and it hurt. “Can't.”
Mark's grip shifted, and he sighed, but he said nothing.
Derek shook. “I'll taper,” he said, his voice the barest wisp of sound between tortured panting. “Please.” He was empty. And broken. And he would never be full again. And he needed. Pounding shame wrapped around him like a frigid cloak as he begged. “Please.” He swallowed. “You could get me... refill.” He tripped over the words. Unforgiving ache loitered in his throat.
Mark washed the soap away, and the new vomit, and everything, without comment or complaint. He twisted the shower knobs and the thunderous rain ceased. Silence constricted around Derek. Empty. All empty. And cold. Freezing.
“Please,” said Derek, breathless as he dripped.
Mark shook his head, all vestiges of good humor sapped from his expression. “Even if I did get you a refill, and I let you take a pill,” Mark said as he dragged Derek out of the tub, “At this point, you'd just puke it up anyway. I'm not interested in more cuddle sessions in the shower, and I'm really not interested in cleaning up the rest of the fucking rug.”
Mark pounced on Derek with the towel as though he expected a fight. Derek didn't struggle as Mark wrapped him up. Derek had nothing. And he needed. The room lurched as Mark hauled Derek onto the toilet seat. The towel tightened and wicked the dripping water away. Derek shivered. He stared over his knees at the floor mat. He hurt, and he needed, and there was nothing else.
“Please,” Derek said, beyond rational thought, beyond anything. The room contracted and constricted. The lights dimmed. He couldn't breathe. He was empty, and cold, and he'd never be full again. “Please, I can't. I need it.”
The towel tightened around his body, and Mark squeezed Derek's shoulders like a vise, unyielding. “You can,” Mark snapped. “Stop saying you can't.”
"No," Derek rasped. He struggled feebly with the wet towel. He couldn't breathe. "No, I can't." He fought the press of Mark's hands on his shoulders and tried to stand. Where would he go? He didn't know. He didn't know anything. The room spun. The towel caught his arms as he flailed for balance, and he stumbled. He fell in a gangly heap on the toilet seat, hobbled, but he couldn't stop struggling. Mark stared, open-mouthed, but the sight was a small needle in a haystack of sensory overload. Derek hurt. He hurt, and he needed. He needed, and he couldn't breathe, and the room was getting smaller and smaller. Shrinking. Crushing. “Please.” His vision blurred as a sheet of tears spilled over his eyes. He fought with the towel. Weak. “I need it.”
“You're weak,” Gary Clark growled. “Pathetic!”
Fire smashed Derek's face as Mark slapped him. The room whipped to the left with the blow. “Get a fucking grip, man. You don't need anything.”
Derek blinked, bell rung for a long moment.
Mark gripped Derek's shoulders, and he leaned in, inches from Derek, eye-to-eye. “You can do this,” Mark said, enunciating. Certain.
Derek swallowed as the room came back to him on an even keel. He was empty, and cold, and he would never be full. He hurt. Everywhere. But the slowly expanding balloon stuck in his chest had popped and dissipated. The pressure died. His feelings didn't grow. He just was. He wasn't becoming more.
“Do you hit all your patients?” Derek said, his voice cracking with strain. His throat bloomed with caustic fire, and he decided he wouldn't speak anymore. He grabbed the towel from Mark and started helping despite his exhaustion. Everything hurt. He was empty. He wanted to lie down and let the world go away.
Mark shook his head. “Just the idiot neurosurgeons,” he said, his voice soft. His eyes crinkled with a hint of returning humor.
Derek nodded. He closed his eyes and rested while Mark grabbed a towel and dried himself. Derek would say thank you when his throat didn't hurt so much.
Gary Clark laughed raucously in Derek's ears, and all he wanted to do was shut it out.
“Have you even listened to a fu-- single word I've said?” Derek snapped, barely holding the top on the funnel of fire in his head. His head hurt, and he wanted to yell until he couldn't anymore, because Gary Clark was laughing, and he wouldn't stop, and Dr. Wyatt thought a pill was the answer.
Dr. Wyatt met Derek's angry gaze with calm rationality. “I've listened to every word, Dr. Shepherd.”
The fish tank burbled. Colorful fish floated lazily back in forth in the small tank. The room smelled like some kind of flower or potpourri. The colors in the room were muted. Taupe and soft oranges and cheerful things. Dr. Wyatt sat in her chair with her fucking pen and her notepad, and he wanted to yank the pillows from the sofa and throw them at her. Or the fish. Or both.
“Then why the hell do you want to put me on Paxil?” he said.
“Because I believe, for your situation, it's the right choice,” Dr. Wyatt said.
Meredith trusted this woman. He'd come here for help. He'd asked for help. He'd spent the last two hours telling her everything. Everything. From the nightmares, to the panic attacks, to the time he'd wandered into the gun shop, to the fact that he couldn't walk through a grocery store without wanting to wet his pants, to the drugs, to everything except for his loitering murderer’s ghost. All the things that had taken him weeks to admit to Meredith, because he needed help, and he wanted to get better, and he was sick and tired of being sick and tired, and Dr. Wyatt's response was that she wanted to put him on a fucking pill for his trouble. All that, and her solution was a drug. One that would take Meredith away from him along with everything else, and he needed Meredith. He needed her.
“I just went through hell to get clean, and you want to put me on another drug,” he said.
“You'll never be free,” Gary Clark said between guffaws. He'd been laughing and commenting for hours. He'd walked in circles around Derek's bed, and Derek had tried to ignore him. Tried to burrow away. He had. Then Meredith had pulled him out of freefall, but Mr. Clark had still been there. “No one can help you,” his ghost continued. “She can't help you. The look on your face when you begged her was worth it, though.” His voice crept into falsetto. “Help me, Dr. Wyatt. Please.”
“Paxil is an SSRI,” Dr. Wyatt explained, her voice rich, cool, calm. Everything Derek didn't feel. “It's non-addictive.”
“I don't care,” Derek said. “It's still a drug, and I can't...” He closed his eyes, and he ran his fingers through his hair, and Gary Clark laughed. “Stop it!” he roared, and then he collapsed on the couch as his eyes pricked with tears. As fast as the molten fury had sloshed into him, it receded, leaving only desperation. The empty, cold feeling in his gut constricted. He needed this to stop. “I can't... Please.”
“Yes,” said Gary Clark. “Beg more. That will solve it.”
“Dr. Shepherd.” Dr. Wyatt shifted. She put her pen and her notepad down and she leaned forward. “Derek. You're right. It is a drug.”
“But--”
“Drug addiction is often co-morbid with mental illness,” Dr. Wyatt said. “SSRIs are often a first line of defense in treating addiction. Paxil, specifically, is used to treat panic disorders, anxiety, depression, and post traumatic stress, all of which you experience badly enough that they're affecting your ability to lead a normal life. Given those factors, I believe that Paxil is the appropriate choice for you.”
“It's another drug,” Derek said. He wrapped his arms around his stomach. He needed. He needed so badly. He couldn't take needing more. And he couldn't... He didn't want... “I can't. Please, I can't.”
“Can you give me a reason why?” Dr. Wyatt prodded.
“It's a drug. I don't want a pill telling me how to feel.” Taking Meredith away.
“Anti-depressants don't tell you how to feel, Derek,” Dr. Wyatt said, misinterpreting him, not that he blamed her this time. “Not if they're working correctly. They're not like benzodiazepines. All they do is tell you that you don't have to feel like you feel, now.”
“It's a drug,” Derek spat.
Dr. Wyatt nodded. “It is,” she said. “And I know that's invasive.”
“It's a mind-altering drug,” Derek said. “That's pretty damned invasive. And Paxil is infamous for the side-effects.”
“You're right,” she said. Placated. “It is. But it's also lauded for how powerful it is, and how fast it acts. You could be feeling better in a matter of weeks. Not months, if we try something else.”
“If I get the side-effects, I won't feel better,” he said.
“Can you tell me which side-effects concern you?”
“Which do you think?”
“I want you to tell me,” she said reasonably.
He swallowed, and he closed his eyes. Meredith had found him in a shaky heap hours ago. She'd held him close as he'd called Dr. Wyatt, who had not only offered to come in for him on her day off, but had offered to see him immediately. Meredith hadn't complained as she'd driven him to the hospital at 5:00 PM, four hours too early for her shift. She'd waited with him outside Dr. Wyatt's office. She'd hugged him when Dr. Wyatt had arrived, made sure he was okay, smiled her soft, hopeful, effortless smile that he loved, told him everything would be okay in a way that made him want to believe despite everything, made him want to believe Dr. Wyatt could and would help. He could still feel the brush of Meredith's lips on his skin, the heat of her body as she rested against his chest. And she was pregnant. They were going to be parents.
“I don't enjoy anything anymore but Meredith,” he said, blunt, hopeless, because he didn't. He didn't enjoy anything but her. She was his sanctuary. One he'd perpetuated in the Other Place. The one he couldn't go to anymore. “I hate my job. I can't stand being around people. I'm frightened all the time. I'm tired all the time. My body hurts. All the time. I need to be able to have sex. I need to want it. I need it because it's all I have that I look forward to anymore. It's the only thing that feels good except...”
He looked at his feet because he couldn't look at Dr. Wyatt or the fish or anything. He'd spent five days in hell. He'd been held up in the shower by Mark. He'd ruined his and Meredith's bed with his vomit. And he still wanted. Needed. And he couldn't have. Wouldn't have. Never again. His wife was pregnant, and he couldn't do this anymore. His throat closed as hopelessness burbled through his body. This would never stop. And if he took the Paxil, the only thing he found solace in would be gone, and all that would be left was this horrible, eternal wanting.
“The Percocet felt good?” Dr. Wyatt said, as though she'd sensed innately which way Derek's thoughts had drifted.
Silence stretched. He listened to the fish tank. “Yes,” he admitted.
“It helped you forget those things that you don't enjoy.”
“Yes.”
“Like your job, and being around people, and being scared and tired and hurting.”
“Yes,” he said softly.
Dr. Wyatt leaned forward. “What if you could flip a switch?”
He looked up. “What do you mean?” he said.
“What if you could like your job again, and not be scared or tired or hurting?”
He blinked. He wanted that so much. A lump formed in his throat. “But... I couldn't have sex,” he said.
“Derek, that might not even happen to you,” Dr. Wyatt said.
“No,” he said. “No, there are a million things that can go wrong with...” He swallowed. SSRIs caused all sorts of problems. They could tank his libido. Prevent orgasms. Remove pleasure from orgasms. Cause erectile dysfunction or slow his ability to climax to a frustrating level that would sap all the fun out of whatever intimacy he might be able to achieve. The penis was sort of a marvel of biological engineering, and it was one of the easiest things in the male body to fuck up. One broken or weak bit brought the whole system down. “I don't want to mess with it. I need sex. I need Meredith.”
“That's right,” said Mr. Clark. “Your options are being a eunuch, or being a sobbing, cowardly pansy who wets himself. Pick your poison.” Laughter followed. “I can't believe you thought she'd actually help you. There is no help for you. You're a raging failure, and you're stuck that way.”
“If you have problems, we can always make changes and adjustments,” Dr. Wyatt said. “I just want to get you to a stable baseline as fast as possible.”
“I can't,” Derek said. “Please, I need help, but I can't do that. I can't do... I can't.”
“We can try just therapy if that's what you truly want.”
He pressed his face into his hands and sighed as the lump in his throat bulged like a melon. He couldn’t swallow. His eyes burned. There were no options. It was hopeless.
“But you don't think it will work,” he said. His voice cracked.
She shrugged. “It might.”
“It won't,” said Gary Clark with a sneer. “Ever.”
“Determination can do a lot to help move things along,” Dr. Wyatt said.
Derek sighed and looked up at her. “Then why do I sense a 'but'?” he said.
“Because there is a 'but',” said Dr. Wyatt. “I want you to think about things realistically.”
“How am I not being realistic?”
“You have an illness, Derek. Because of what happened to you, your brain is sick. It's sending you messages that aren't normal, and that you don't want, and that are interfering with your ability to function. Not treating this with medication is like, in my mind, not treating a gushing wound with stitches. The wound might still heal without them, but there will be more scarring, it will be more painful, the skin will take a lot longer to knit, and in your case, things have already gotten infected.”
“How much longer will it take to knit?”
“A lot longer,” Dr. Wyatt said.
“Would it take longer than eight months if I didn't take the pills?” Derek said.
She shook her head. “I don't know. I can't give you that answer. Every person is different.”
“But if I took Paxil, I might feel better next week?”
“Or the week after, or maybe in a month, yes,” Dr. Wyatt said.
“Choices, choices. Don't fuck your wife, or listen to me,” said Mr. Clark. “Forever.”
“I really think it will make you feel better,” Dr. Wyatt continued, “And when you feel better, therapy is a lot more likely to work for you, and you'll be a lot less likely to want to utilize harmful coping methods.”
“Like Percocet,” Derek said.
“Exactly,” she said.
“It would help me... not want that?” He brushed streaking tears from his face. He had no idea when they'd started. He'd given up ever controlling himself again. Things happened, and he was left with the pieces. His vision blurred as his eyes filled up again. He blinked. Wet slivers curled over his eyelashes and tore down his cheeks.
“It would,” Dr. Wyatt said. “Subconsciously or purposefully, you've been self-medicating. If we take away the reasons you did that, I think it would help with the addiction as well.”
Derek, it'll be okay, Meredith had said a long time ago. Maybe not tomorrow. Or next week. But it will be. If I can be here, wrapped around you, not running and not wanting to run after all this, we can be okay. Eventually. It just won't be a surgical fix.
He sniffed. “Paxil is my... surgery?”
“It is,” said Dr. Wyatt, following his metaphor. “I truly believe it is. And if I'm wrong, or if you're unhappy with how it affects things it's not supposed to be affecting, we can always change it. There are lots of different choices we can make. Zoloft, for instance. It's not an exact science. But the sooner we start, the faster we'll get to a solution that works specifically for you.”
“O...okay,” Derek said. Abject misery pulled his face into his hands, and he couldn't look up while he cried.
“Pathetic,” said Mr. Clark. “Eunuch it is.”
“Okay?” Dr. Wyatt prodded.
Derek nodded. He couldn't find his voice.
“We can do this, Derek. Okay?”
He swallowed. “I'm tired,” he said. He sounded pathetic.
Dr. Wyatt licked her lips, and she stood up from the chair. “Derek, we will find something that works for you. I promise we will. And you'll feel better. The point of this is to get you feeling better, not worse. Okay? Some doctors might be happy with a partial solution, but I'm not and never will be, and if you don't like the Paxil, we'll change it once you're stable. This isn't a death sentence for your sex-life.”
The cushions sank as she sat on the couch beside him. She didn't touch, and she kept a wide, professional bubble between her and him, but the closeness... helped. Her calm, reassuring presence helped. He swallowed. His throat felt raw. He thought for a minute about Meredith. What she would want him to do. She smiled at him behind his eyelids.
I want you to be happy again, she'd say. Sex isn't the only way to express love or whatever. Why are you so freaking worried? He could hear her saying the words in all her inarticulate glory.
“I need you to be on board with this, or I won't prescribe it,” Dr. Wyatt said. “Are you on board with this, Derek?”
He nodded. “Okay,” he said.
She nodded. “Okay,” she said with a small smile that was probably supposed to be reassuring. “Now, I know you're tired, but want to discuss your panic attacks before you leave. I think that the Paxil is likely to decrease or eliminate those, given time, but in the meantime, there are lots of things you can do that can help when you experience one coming on.”
Fandom: Grey's Anatomy
Pairing: Mer/Der
Rating: M
Summary: S6 continuation. Immediately post Sanctuary / Death and All His Friends.
Thank you, as always, to the people who take the time to leave feedback. I really appreciate it! Betas, as usual, you guys are my favorite people, and you're awesome. Road trip coming up next. Hope to see all of you there. I promise fluff, both figuratively, and possibly contained in marshmallows :)
All Along The Watchtower - Part 19A
The shower rained around him, washing the vomit and bile away. Derek looked at the white and red tiled blur beyond his eyelashes, but didn't see. Nausea swirled. His mouth hung open, and his lips dripped the fluid remains of his stomach as he stood there. Helpless. Mark's bare, shaking arm wrapped under Derek's shoulders and held him up under the spray, but that was Derek's only barrier between upright and collapsed.
“See,” said Mark, his voice low-pitched and playful despite everything, “I imagine this is why people think we're gay.” The washcloth rasped against Derek's skin. Soap and suds spilled over him.
Derek shifted with a low groan. He hurt. Everything. His head throbbed. His joints creaked. His bones and muscles thrummed with discomfort. The battered fault line in his chest slipped with every breath, and he felt a bit like he'd swallowed acid.
Warm water gushed against his skin, and Mark stood against Derek's back to hold him upright, a massive well of body heat, but Derek was cold. Empty. He shivered. A deep-seated, crushing need squeezed him with every heartbeat. He needed to be full, and he would never be full again. His foot shifted and slipped on the porcelain floor of the tub. He didn't have the wherewithal to fight for balance, and so the slide continued until Mark squeezed, and his grip tightened around Derek's chest. Pain crushed him, and his armpits throbbed as he was dragged to his feet.
Again.
“Almost done,” Mark said.
Derek blinked. Water dripped into his eyes. His neck wouldn't support his head, and his gaze lurched to the side. He saw the slope of Mark's pale arm, a mist of water, and then nothing. “Hurts,” he croaked.
“I know,” Mark said. “Almost done.”
Derek shook his head. He needed. He needed. He wasn't almost done. He would never be done. He would never be full again. This hell would never end. He would be stuck here for... forever. His eyes pricked with tears. “It hurts,” he repeated, caught in a sob as the shower spun around him. He couldn't stand anymore. He couldn't--
Mark held him up. “I know,” said Mark. The washcloth rasped.
Derek's stomach churned. He tried to move. He tried. He twisted, feeble. The tub seesawed. Naked skin slipped on naked skin. Mark grunted with pain. Derek ended up bent over Mark's forearm at the waist, and the washcloth merely shifted to Derek's back, rasping. Derek panted. Each breath brought a line of fire to the slipping fault line in his chest, and his throat hurt. It hurt. His stomach clenched, and he vomited onto the floor of the tub by Mark's bare foot. Burning bile dripped from Derek's teeth as he sputtered and choked. He had nothing left. He was empty, and he hadn't slept. Empty, empty, empty. And tired. And glacier cold despite the steam and swelter and Mark.
“Stand up straight,” Mark said, his voice strained as he kept Derek from crashing to the floor of the tub. Barely. Derek shook. The washcloth made a wet splat as Mark slapped it onto the rack and grabbed Derek with both arms. The world shifted like a pinwheel. Colors. Pain. “Stand up,” Mark commanded again, and whether Derek could or would obey, it didn't matter. Pain followed, and Mark dragged Derek up. Bigger. Mark had always been bigger. And stronger.
“Mark,” Derek wheezed more than said.
“I know this sucks, man,” Mark said. “But you have to help me out a bit.”
Derek needed, and it hurt. “Can't.”
Mark's grip shifted, and he sighed, but he said nothing.
Derek shook. “I'll taper,” he said, his voice the barest wisp of sound between tortured panting. “Please.” He was empty. And broken. And he would never be full again. And he needed. Pounding shame wrapped around him like a frigid cloak as he begged. “Please.” He swallowed. “You could get me... refill.” He tripped over the words. Unforgiving ache loitered in his throat.
Mark washed the soap away, and the new vomit, and everything, without comment or complaint. He twisted the shower knobs and the thunderous rain ceased. Silence constricted around Derek. Empty. All empty. And cold. Freezing.
“Please,” said Derek, breathless as he dripped.
Mark shook his head, all vestiges of good humor sapped from his expression. “Even if I did get you a refill, and I let you take a pill,” Mark said as he dragged Derek out of the tub, “At this point, you'd just puke it up anyway. I'm not interested in more cuddle sessions in the shower, and I'm really not interested in cleaning up the rest of the fucking rug.”
Mark pounced on Derek with the towel as though he expected a fight. Derek didn't struggle as Mark wrapped him up. Derek had nothing. And he needed. The room lurched as Mark hauled Derek onto the toilet seat. The towel tightened and wicked the dripping water away. Derek shivered. He stared over his knees at the floor mat. He hurt, and he needed, and there was nothing else.
“Please,” Derek said, beyond rational thought, beyond anything. The room contracted and constricted. The lights dimmed. He couldn't breathe. He was empty, and cold, and he'd never be full again. “Please, I can't. I need it.”
The towel tightened around his body, and Mark squeezed Derek's shoulders like a vise, unyielding. “You can,” Mark snapped. “Stop saying you can't.”
"No," Derek rasped. He struggled feebly with the wet towel. He couldn't breathe. "No, I can't." He fought the press of Mark's hands on his shoulders and tried to stand. Where would he go? He didn't know. He didn't know anything. The room spun. The towel caught his arms as he flailed for balance, and he stumbled. He fell in a gangly heap on the toilet seat, hobbled, but he couldn't stop struggling. Mark stared, open-mouthed, but the sight was a small needle in a haystack of sensory overload. Derek hurt. He hurt, and he needed. He needed, and he couldn't breathe, and the room was getting smaller and smaller. Shrinking. Crushing. “Please.” His vision blurred as a sheet of tears spilled over his eyes. He fought with the towel. Weak. “I need it.”
“You're weak,” Gary Clark growled. “Pathetic!”
Fire smashed Derek's face as Mark slapped him. The room whipped to the left with the blow. “Get a fucking grip, man. You don't need anything.”
Derek blinked, bell rung for a long moment.
Mark gripped Derek's shoulders, and he leaned in, inches from Derek, eye-to-eye. “You can do this,” Mark said, enunciating. Certain.
Derek swallowed as the room came back to him on an even keel. He was empty, and cold, and he would never be full. He hurt. Everywhere. But the slowly expanding balloon stuck in his chest had popped and dissipated. The pressure died. His feelings didn't grow. He just was. He wasn't becoming more.
“Do you hit all your patients?” Derek said, his voice cracking with strain. His throat bloomed with caustic fire, and he decided he wouldn't speak anymore. He grabbed the towel from Mark and started helping despite his exhaustion. Everything hurt. He was empty. He wanted to lie down and let the world go away.
Mark shook his head. “Just the idiot neurosurgeons,” he said, his voice soft. His eyes crinkled with a hint of returning humor.
Derek nodded. He closed his eyes and rested while Mark grabbed a towel and dried himself. Derek would say thank you when his throat didn't hurt so much.
Gary Clark laughed raucously in Derek's ears, and all he wanted to do was shut it out.
“Have you even listened to a fu-- single word I've said?” Derek snapped, barely holding the top on the funnel of fire in his head. His head hurt, and he wanted to yell until he couldn't anymore, because Gary Clark was laughing, and he wouldn't stop, and Dr. Wyatt thought a pill was the answer.
Dr. Wyatt met Derek's angry gaze with calm rationality. “I've listened to every word, Dr. Shepherd.”
The fish tank burbled. Colorful fish floated lazily back in forth in the small tank. The room smelled like some kind of flower or potpourri. The colors in the room were muted. Taupe and soft oranges and cheerful things. Dr. Wyatt sat in her chair with her fucking pen and her notepad, and he wanted to yank the pillows from the sofa and throw them at her. Or the fish. Or both.
“Then why the hell do you want to put me on Paxil?” he said.
“Because I believe, for your situation, it's the right choice,” Dr. Wyatt said.
Meredith trusted this woman. He'd come here for help. He'd asked for help. He'd spent the last two hours telling her everything. Everything. From the nightmares, to the panic attacks, to the time he'd wandered into the gun shop, to the fact that he couldn't walk through a grocery store without wanting to wet his pants, to the drugs, to everything except for his loitering murderer’s ghost. All the things that had taken him weeks to admit to Meredith, because he needed help, and he wanted to get better, and he was sick and tired of being sick and tired, and Dr. Wyatt's response was that she wanted to put him on a fucking pill for his trouble. All that, and her solution was a drug. One that would take Meredith away from him along with everything else, and he needed Meredith. He needed her.
“I just went through hell to get clean, and you want to put me on another drug,” he said.
“You'll never be free,” Gary Clark said between guffaws. He'd been laughing and commenting for hours. He'd walked in circles around Derek's bed, and Derek had tried to ignore him. Tried to burrow away. He had. Then Meredith had pulled him out of freefall, but Mr. Clark had still been there. “No one can help you,” his ghost continued. “She can't help you. The look on your face when you begged her was worth it, though.” His voice crept into falsetto. “Help me, Dr. Wyatt. Please.”
“Paxil is an SSRI,” Dr. Wyatt explained, her voice rich, cool, calm. Everything Derek didn't feel. “It's non-addictive.”
“I don't care,” Derek said. “It's still a drug, and I can't...” He closed his eyes, and he ran his fingers through his hair, and Gary Clark laughed. “Stop it!” he roared, and then he collapsed on the couch as his eyes pricked with tears. As fast as the molten fury had sloshed into him, it receded, leaving only desperation. The empty, cold feeling in his gut constricted. He needed this to stop. “I can't... Please.”
“Yes,” said Gary Clark. “Beg more. That will solve it.”
“Dr. Shepherd.” Dr. Wyatt shifted. She put her pen and her notepad down and she leaned forward. “Derek. You're right. It is a drug.”
“But--”
“Drug addiction is often co-morbid with mental illness,” Dr. Wyatt said. “SSRIs are often a first line of defense in treating addiction. Paxil, specifically, is used to treat panic disorders, anxiety, depression, and post traumatic stress, all of which you experience badly enough that they're affecting your ability to lead a normal life. Given those factors, I believe that Paxil is the appropriate choice for you.”
“It's another drug,” Derek said. He wrapped his arms around his stomach. He needed. He needed so badly. He couldn't take needing more. And he couldn't... He didn't want... “I can't. Please, I can't.”
“Can you give me a reason why?” Dr. Wyatt prodded.
“It's a drug. I don't want a pill telling me how to feel.” Taking Meredith away.
“Anti-depressants don't tell you how to feel, Derek,” Dr. Wyatt said, misinterpreting him, not that he blamed her this time. “Not if they're working correctly. They're not like benzodiazepines. All they do is tell you that you don't have to feel like you feel, now.”
“It's a drug,” Derek spat.
Dr. Wyatt nodded. “It is,” she said. “And I know that's invasive.”
“It's a mind-altering drug,” Derek said. “That's pretty damned invasive. And Paxil is infamous for the side-effects.”
“You're right,” she said. Placated. “It is. But it's also lauded for how powerful it is, and how fast it acts. You could be feeling better in a matter of weeks. Not months, if we try something else.”
“If I get the side-effects, I won't feel better,” he said.
“Can you tell me which side-effects concern you?”
“Which do you think?”
“I want you to tell me,” she said reasonably.
He swallowed, and he closed his eyes. Meredith had found him in a shaky heap hours ago. She'd held him close as he'd called Dr. Wyatt, who had not only offered to come in for him on her day off, but had offered to see him immediately. Meredith hadn't complained as she'd driven him to the hospital at 5:00 PM, four hours too early for her shift. She'd waited with him outside Dr. Wyatt's office. She'd hugged him when Dr. Wyatt had arrived, made sure he was okay, smiled her soft, hopeful, effortless smile that he loved, told him everything would be okay in a way that made him want to believe despite everything, made him want to believe Dr. Wyatt could and would help. He could still feel the brush of Meredith's lips on his skin, the heat of her body as she rested against his chest. And she was pregnant. They were going to be parents.
“I don't enjoy anything anymore but Meredith,” he said, blunt, hopeless, because he didn't. He didn't enjoy anything but her. She was his sanctuary. One he'd perpetuated in the Other Place. The one he couldn't go to anymore. “I hate my job. I can't stand being around people. I'm frightened all the time. I'm tired all the time. My body hurts. All the time. I need to be able to have sex. I need to want it. I need it because it's all I have that I look forward to anymore. It's the only thing that feels good except...”
He looked at his feet because he couldn't look at Dr. Wyatt or the fish or anything. He'd spent five days in hell. He'd been held up in the shower by Mark. He'd ruined his and Meredith's bed with his vomit. And he still wanted. Needed. And he couldn't have. Wouldn't have. Never again. His wife was pregnant, and he couldn't do this anymore. His throat closed as hopelessness burbled through his body. This would never stop. And if he took the Paxil, the only thing he found solace in would be gone, and all that would be left was this horrible, eternal wanting.
“The Percocet felt good?” Dr. Wyatt said, as though she'd sensed innately which way Derek's thoughts had drifted.
Silence stretched. He listened to the fish tank. “Yes,” he admitted.
“It helped you forget those things that you don't enjoy.”
“Yes.”
“Like your job, and being around people, and being scared and tired and hurting.”
“Yes,” he said softly.
Dr. Wyatt leaned forward. “What if you could flip a switch?”
He looked up. “What do you mean?” he said.
“What if you could like your job again, and not be scared or tired or hurting?”
He blinked. He wanted that so much. A lump formed in his throat. “But... I couldn't have sex,” he said.
“Derek, that might not even happen to you,” Dr. Wyatt said.
“No,” he said. “No, there are a million things that can go wrong with...” He swallowed. SSRIs caused all sorts of problems. They could tank his libido. Prevent orgasms. Remove pleasure from orgasms. Cause erectile dysfunction or slow his ability to climax to a frustrating level that would sap all the fun out of whatever intimacy he might be able to achieve. The penis was sort of a marvel of biological engineering, and it was one of the easiest things in the male body to fuck up. One broken or weak bit brought the whole system down. “I don't want to mess with it. I need sex. I need Meredith.”
“That's right,” said Mr. Clark. “Your options are being a eunuch, or being a sobbing, cowardly pansy who wets himself. Pick your poison.” Laughter followed. “I can't believe you thought she'd actually help you. There is no help for you. You're a raging failure, and you're stuck that way.”
“If you have problems, we can always make changes and adjustments,” Dr. Wyatt said. “I just want to get you to a stable baseline as fast as possible.”
“I can't,” Derek said. “Please, I need help, but I can't do that. I can't do... I can't.”
“We can try just therapy if that's what you truly want.”
He pressed his face into his hands and sighed as the lump in his throat bulged like a melon. He couldn’t swallow. His eyes burned. There were no options. It was hopeless.
“But you don't think it will work,” he said. His voice cracked.
She shrugged. “It might.”
“It won't,” said Gary Clark with a sneer. “Ever.”
“Determination can do a lot to help move things along,” Dr. Wyatt said.
Derek sighed and looked up at her. “Then why do I sense a 'but'?” he said.
“Because there is a 'but',” said Dr. Wyatt. “I want you to think about things realistically.”
“How am I not being realistic?”
“You have an illness, Derek. Because of what happened to you, your brain is sick. It's sending you messages that aren't normal, and that you don't want, and that are interfering with your ability to function. Not treating this with medication is like, in my mind, not treating a gushing wound with stitches. The wound might still heal without them, but there will be more scarring, it will be more painful, the skin will take a lot longer to knit, and in your case, things have already gotten infected.”
“How much longer will it take to knit?”
“A lot longer,” Dr. Wyatt said.
“Would it take longer than eight months if I didn't take the pills?” Derek said.
She shook her head. “I don't know. I can't give you that answer. Every person is different.”
“But if I took Paxil, I might feel better next week?”
“Or the week after, or maybe in a month, yes,” Dr. Wyatt said.
“Choices, choices. Don't fuck your wife, or listen to me,” said Mr. Clark. “Forever.”
“I really think it will make you feel better,” Dr. Wyatt continued, “And when you feel better, therapy is a lot more likely to work for you, and you'll be a lot less likely to want to utilize harmful coping methods.”
“Like Percocet,” Derek said.
“Exactly,” she said.
“It would help me... not want that?” He brushed streaking tears from his face. He had no idea when they'd started. He'd given up ever controlling himself again. Things happened, and he was left with the pieces. His vision blurred as his eyes filled up again. He blinked. Wet slivers curled over his eyelashes and tore down his cheeks.
“It would,” Dr. Wyatt said. “Subconsciously or purposefully, you've been self-medicating. If we take away the reasons you did that, I think it would help with the addiction as well.”
Derek, it'll be okay, Meredith had said a long time ago. Maybe not tomorrow. Or next week. But it will be. If I can be here, wrapped around you, not running and not wanting to run after all this, we can be okay. Eventually. It just won't be a surgical fix.
He sniffed. “Paxil is my... surgery?”
“It is,” said Dr. Wyatt, following his metaphor. “I truly believe it is. And if I'm wrong, or if you're unhappy with how it affects things it's not supposed to be affecting, we can always change it. There are lots of different choices we can make. Zoloft, for instance. It's not an exact science. But the sooner we start, the faster we'll get to a solution that works specifically for you.”
“O...okay,” Derek said. Abject misery pulled his face into his hands, and he couldn't look up while he cried.
“Pathetic,” said Mr. Clark. “Eunuch it is.”
“Okay?” Dr. Wyatt prodded.
Derek nodded. He couldn't find his voice.
“We can do this, Derek. Okay?”
He swallowed. “I'm tired,” he said. He sounded pathetic.
Dr. Wyatt licked her lips, and she stood up from the chair. “Derek, we will find something that works for you. I promise we will. And you'll feel better. The point of this is to get you feeling better, not worse. Okay? Some doctors might be happy with a partial solution, but I'm not and never will be, and if you don't like the Paxil, we'll change it once you're stable. This isn't a death sentence for your sex-life.”
The cushions sank as she sat on the couch beside him. She didn't touch, and she kept a wide, professional bubble between her and him, but the closeness... helped. Her calm, reassuring presence helped. He swallowed. His throat felt raw. He thought for a minute about Meredith. What she would want him to do. She smiled at him behind his eyelids.
I want you to be happy again, she'd say. Sex isn't the only way to express love or whatever. Why are you so freaking worried? He could hear her saying the words in all her inarticulate glory.
“I need you to be on board with this, or I won't prescribe it,” Dr. Wyatt said. “Are you on board with this, Derek?”
He nodded. “Okay,” he said.
She nodded. “Okay,” she said with a small smile that was probably supposed to be reassuring. “Now, I know you're tired, but want to discuss your panic attacks before you leave. I think that the Paxil is likely to decrease or eliminate those, given time, but in the meantime, there are lots of things you can do that can help when you experience one coming on.”