Lightning Strikes Twice - Part 34A
Title: Lightning Strikes Twice
Fandom: Grey's Anatomy
Pairing: Duh. (Mer/Der)
Rating: M
Timeline: Post Time After Time.
Okay, so I lied. I don't have a clear idea of Part 35 yet at all (aside from what is supposed to happen in it). I haven't mapped out any dialog or anything. But I loved this part. Loved it. And I want to share, so I'll take my chances. I have a business trip this week, I'll be out of town, so I don't know when I'll have time to finish Part 35, or even start it really. But this? This was... This was a veritable playground of character analysis for me. This is why I wanted to do this. Not because it's dramatic or flashy or because I get my kicks out of making characters suffer, but it lets me pick things apart, figure out what makes them work, and go for the jugular when I explain my ideas to everyone else. My original goal with this story was to reboot McDreamy and open up his back story and motivations with a can opener. That's what I'm doing. The reboot, I consider successfully completed. But this is where I truly hit pay dirt on the can opener front, I think. I hope you like it, but if you don't, my eyes are always looking for suggestions :) Or course, any and all feedback is relished.
You might recognize some of the dialog at the start of this. Credit goes to Grey's writers, at least for Mark's side of things. This was the first time I've actually borrowed so much of the show at once, so I figured I'd mention it.
~~~~~
Seattle Grace was busy. Derek sat in the waiting area wedged as far in the corner as he could manage, his head propped up on his palm, his elbow resting on the little side table. His legs splayed, he sat in a wilted, slumped, defeated slouch. He hadn't been looking forward to coming in for his appointment, hadn't been looking forward to dealing with the stares and the questions. He hadn't been looking forward to contributing to the newest broadcast on the gossip network. McDreamy is McSick, McWitless, and McDoped.
McYuck.
He hadn't slept well the night before. Every time he'd fallen into a doze, the throbbing pain had yanked him back out of slumber and into the reality. The reality of time. Time passing in a funeral procession of moments, slow, somber, unrushed. And he'd lain there. Staring at the ceiling until his eyes had drooped shut and the whole cycle had started again, over, and over, and over in the nastiest use of instant replay ever.
When Meredith had woken up for her shift, it'd seemed like eons since she'd gone to sleep. He'd tried to be functional. He'd tried to get up and get ready, take a shower, shave, brush his teeth. He'd tried. Slow. Hurting. He'd felt like some sort of lumbering glacier of suffering. Coordinated acts of grooming had all strung into a long session of self-torture, but he'd managed. Sort of. He'd nicked himself with his razor. Twice. He'd gotten his dental floss caught at least four times. By the time he'd stumbled downstairs to the foyer, dressed haphazardly in an old t-shirt and jeans that Meredith had blessedly pulled out for him, saving him some effort on the coherency front, he'd felt like any sort of thought, particularly any thought that was expected to connect up with the one that had occurred before it, was impossible. Meredith had asked him questions, pelting, rapid, worried. He'd answered as best as he possibly could, but every word he'd had to formulate had been yet another form of torture. Meredith had gotten the idea, and had driven him in silence to the hospital.
That had been about four and a half hours before. Dr. Weller had been at the hospital overnight, and had been able to see Derek within about thirty minutes of his arrival. Dr. Weller had taken one look at Derek and given him some better pain medication to help in the interim while he made a more complete diagnosis. Tylenol with codeine. It'd kicked in after a few minutes, and the pain, the whole mountain of it, had receded in a sluggish, oozing wave, leaving just a little murmuring ache and a metric ton of exhaustion in its wake. The rest of the physical examination had passed sluggishly while Derek had struggled to stay awake and answer Dr. Weller's questions about his symptoms. And, as if that hadn't been grueling enough on his torn and frazzled nerves, Derek had had to get scans done after that. Even that early, the line for the MRI machine had already been backed up. It'd been a long, tiring wait. He'd actually fallen asleep during his MRI despite the hum and the clicks and the closed space and the clinical impersonality of it all. The technician had had to wake him up when it'd been over. Derek had shuffled back down to the waiting area, and there he sat, waiting for Dr. Weller's analysis of the films. And who knew how long that could take? Dr. Weller had been called away to deal with an emergency with one of his post-op patients.
His eyes slipped shut. His head started tilting. He snapped awake, blinking, unhappy, unhappy to be there. He just wanted to go home, curl up in the dark under sheets that smelled like Meredith, and sleep. Really sleep. Finally. Tylenol with codeine had sedative effects. He was tired anyway. It was a horrible combination. He wanted Dr. Weller to finish looking at everything and send him on his way. He'd take a taxi back home or something. Meredith had offered to drive him back during her lunch break, but he didn't think he could wait that long.
At least nobody had noticed him sitting there, looking pale and pasty and tired and unwell. Nobody had come to talk with him or offer pleasantries. Derek Shepherd the high-powered neurosurgeon wasn't really a holey-jeaned, t-shirted, pile of sickly, exhausted unwellness kind of guy. Out of the corners of peoples' eyes, he probably blended in as just another ill and weary patient, especially as slouched as he was, especially since he held his head routinely cradled in his hands while he stared at the weave of the carpet at his feet, stared until it blurred into a murky, peach-colored blot of color and nothing else. He went unnoticed. Unseen. And that suited him just fine. He felt...
Unwell.
The pain was a bare memory, etched into the blur of the morning leading up to the first pill Dr. Weller had given him, but he felt like he was just waking up from a bad bout of flu, sickness still wafting out of all his pores. Seattle Grace was busy. Noises shrieked and clicked and laughed and beeped and rang and shuffled and groaned all around him in a hailstorm of sound. They didn't worsen the remnant ache he felt, but the desire for quiet and dark held him in its thrall, and the cacophony was enough to send his index finger rubbing along his brow in irritation. The waiting room was bright. And that did hurt, but it was a dull, distant hum that he could deal with. He could. Easily. He let it throb without comment. He thought about wandering off to an on-call room or maybe even to his office, but if he let himself amble into the areas of the hospital highly trafficked by doctors, he was pretty sure he'd have to field questions or friendly get wells. And walking... Walking upstairs and finding an empty room... Effort.
Meredith had been checking in every forty-five minutes or so when she could spare a few seconds. She'd been ecstatic to find him relatively pain free, had kissed him, hugged him, babbled lightly about how busy the day was going to be, and he'd let himself fall, relaxed, into the comforting cadence of her excited voice. The operating rooms were booked solid, she'd said, which had made sense of the early activity in the MRI rooms. Something about a bad pileup on the freeway involving a semi. Meredith had said she was going to scrub in for a liver transplant later that day, but that she hadn't been assigned to anything that morning.
He'd suspected that she had been lying. That she'd stayed out of morning surgeries to be more available for him. But he hadn't said anything. He hadn't been able to. Selfishly, he'd liked that she'd kept showing up to keep him company. Her voice was a balm. Her scent. Her warmth. Everything. In the moments she was there, he didn't feel sick, didn't feel like he couldn't. And that was better than any pain reliever or sedative.
She saved him from the moments like this one, where all he could think about was sleeping. He would have to talk to Chief Webber later about taking the rest of the week off. He wasn't sure how he felt about that, but hovering in the lazy fuzz of tiredness did have one advantage. Worrying was just too much effort, so, he wasn't really thinking much about taking leave at all. He was thinking about beds. And being in them. And not being awake. Dreaming.
His sighed, and his head started to tilt again.
Cross trainers that weren't his own stepped into his limited field of view of peach, ugly carpet. A presence hovered on the edge of his personal bubble for a procession of tense, weary moments. A sigh stuttered into the silence above him. The chair next to him rocked as Mark sat down next to him and he thumped his bag down in a heap.
"What are you doing here?" Mark said. "I thought you were on sick leave."
Derek managed a flat, "Sitting here," through clenched teeth. He brought up his gaze, blinking at the harsh light. Mark was still in his street clothes, stonewashed blue jeans and a black button up shirt that peeked out from underneath his leather coat. He'd dropped his heavy, bulging briefcase into the chair on his other side. The side flap of the bag had his beeper and all of his phones clipped to it. Derek prayed that one of them, any of them, would ring. That would be nice.
"You look like shit, man," Mark said. He slouched forward and brushed his palms over his face in a tired gesture.
"Thanks, Mark. Thanks for the astute observation," Derek snapped. "I'm just waiting."
"Meredith getting off shift soon?" Mark said.
Derek sighed and didn't comment. Mark didn't need to know. Mark didn't need to know about the PCS. Mark didn't need to know that Derek was on pain medication and ready to collapse. Mark didn't need to be next to him in this chair, but Derek was too tired to get up and walk away, and so he sat, quiet, grinding his molars. The ache that had been just an annoyance sharpened its claws. He didn't need this right now. He didn't need this ever.
And yet... "Meredith told me you wanted to talk," Derek said, and for the briefest of moments, behind all the muck and mire of the creeping tiredness, a sliver of hope pierced the space behind his heart. Maybe this would be the time. Maybe this would be the time Mark would finally get it. Or maybe this would be the time Mark would finally go away for good. Every time he talked to Mark, this happened. This stupid, twisting dream that the tangle with Mark would finally fix itself. Finally resolve. Like a disease. Gone. Healed. Exorcised.
Every time he talked with Mark, this happened. And every time he talked with Mark, Derek came out of the conversation feeling just a little bit like he'd relapsed into the night he'd found his former best friend in his bed. Fucking his wife.
Mark was an addictive poison.
One day, maybe Derek would learn.
"She's gone, Derek," Mark replied without precursor.
Derek blinked. Meredith? "Who's gone?" he said.
Mark didn't answer. "What's in LA?"
"What?"
"For Addison. Any idea what she might be doing there? The Chief told me yesterday that's where she went. She just... up and left. Sunday, she was here. Monday, she was gone."
"No," Derek said. Disappointment tripped on his anger, and they fell into a jumbled heap of bitter, dark churning. He drew his fingers up to the bridge of his nose and started massaging himself. This wouldn't be. This wouldn't be the time. And he really wanted to sleep. He couldn't even bring himself to be surprised that Addison had skipped town. Couldn't bring himself to wonder. He just didn't care about her anymore. They were on terms that weren't hateful. But he expected that was as far as he could ever recover from that. First the one night stand. Then discovering it had been a whole lot more. A whole. Lot. More. It had disgusted Derek when the whole thing had been an impulsive mistake. It had horrified him when he'd discovered it had been a calculated, continuous error over several months.
"We were gonna try," Mark said, oblivious. Fucking oblivious like he always was. "We were gonna make a go of it. As a couple. She bet me I couldn't go sixty days without having sex."
Derek sighed. He didn't want to hear this. "Leave me alone, Mark."
"She didn't want to be with me," Mark said. "I thought she did. I thought she might. But she didn't. And I caught her. You know..."
"Leave me alone, Mark," Derek hissed. At least Addison being Addison, desperate for validation from a man, had maybe ripped a hole in Mark as wide as the hole Mark had ripped in Derek when Derek had caught them. Vengeful. He was being vengeful.
But he just didn't care anymore. Because Mark was pestering, and Derek was tired.
"I told her I did it," Mark continued, ignoring him like always. Ignoring. Mark was bigger. Mark had always been bigger.
But I don't want to TP that house. It's wrong. What if we get caught?
A fist had slammed into his side, roughhousing, playful, but hard. Hard enough to make him wheeze. Mark had always been bigger.
You're such a pansy, Derek. Live a little.
And Derek had found himself doing it anyway, serving as lookout while Mark leapt around, throwing roll after roll of fluffy pink toilet paper into the tree in front of some poor victim's house, one of the very few trees. Derek had tried to ignore the pit of sickness twisting inside his stomach. Against the rules, against the rules, against the rules. Tried to ignore, at the same time, the little zing of thrill. Breaking the rules, breaking the rules, breaking the rules.
See, you big baby. It's fun.
"I told her I lost the bet," Mark continued. "I told her I slept with someone. I figured if she didn't want to be with me, she shouldn't have to feel guilty about it."
"I don't want to hear about your fucked up problems with my ex-wife," Derek snarled. "Who you fucked, Mark. You f-- Leave me alone."
"I love her, Derek," Mark whispered.
Derek squeezed his eyes shut. He didn't want to hear this. He didn't want to ever hear this. He just wanted it to go away. He leaned down onto his knees with his elbows and covered his mouth. Just thinking about it made him want to vomit. Mark. Addison. Mark spilling himself into the woman who had been Derek's for eleven years. Mark had taken everything away from him.
"My point," Mark continued. "Look, it was never about you. It was never... It was never meant to... You can't help who you love, Derek."
And, once again, Mark was passing blame. Bile rose, but Derek swallowed against the burn and breathed. He breathed. He breathed. When he rose back up into a full sitting position, he peered at Mark through dark, angry eyes. Why didn't Mark ever. Fucking. Get it?
"I don't care," Derek said. "She was my wife, Mark. I've known you since I was five. It should have been about me."
He sighed and ran tired, clenching fingers through his hair, resisting the urge to just lean forward and... sleep. He blinked tiredly, and every time he opened his eyes again it was harder. Harder. He should have hidden in his office, where Mark would have been very unlikely to accidentally run across him, because, while Mark was a relentless, nosy prick who never seemed to give up on the idea of reconciling despite the heinous betrayal, he seemed to understand that the office was off limits except for professional reasons, that Derek needed a place where Mark was guaranteed not to be. He should have hidden there, locked the door, told Dr. Weller to page him whenever he was ready to finish up. Derek would have been easier for Meredith to find, too. And maybe she would have come around more than every forty-five minutes if she'd known exactly where he had been the whole morning while he waited. Maybe.
"I just wanted," Mark continued, his voice falling away in a bout of uncharacteristic speechlessness. Mark always knew what he wanted to say. Split second. Bam. He said what he thought. Like an idea, if it was hurled with enough abruptness, was a fist he could use to hit things with. "Look, what I wanted to talk about..." Bam. "Did you have to take away my family, too?" There it was.
Except, usually, Mark's barbs made more sense than that.
Derek sighed. "What are you talking about, now?"
He was too tired. Too tired to follow Mark's leaps of bullshit. Derek pondered getting up and leaving. He pondered it. Effort. Walk and suffer getting away, or sit and suffer staying there. A conundrum.
"The reunion," Mark clarified. "How was it?"
"Fine."
"Are you happy? Have you gotten your revenge in?"
"What are you fucking talking about?" Derek snapped.
"Oh, come off it, Derek," Mark replied. "You emotionally blackmailed them. You traipsed off with Meredith to your happy little barbecue after skipping both Thanksgiving and Christmas. I was there. I was there at Thanksgiving. And Christmas. I was there, and you weren't. And yet the reunion comes around and I don't even get a fucking phone call? Funny how that works out. Don't you think?"
Derek blinked. He hadn't really considered why Mark hadn't been at the reunion. He hadn't really thought about it beyond the relief of knowing he wasn't coming. His mother had simply said not to worry about it. Relieved. He'd been relieved. But he'd certainly had nothing to do with it. Nothing.
"You think I..."
"Yeah, Derek. I do."
"I had nothing to do with the guest list," Derek said. "Mom called me and threatened to come out here instead if I didn't go. She wanted to meet Meredith, who, thanks to Nancy, Mom originally thought would be a slutty, gold-digging bar whore."
Mark had the decency to look rebuffed. He frowned, ran his hands down his face in a slow trail as he sighed. "Oh."
"Please, Mark," Derek said. "Please, go away."
He didn't even care that he was begging. He just wanted to be left alone.
"No," Mark said. "I want to know. I want to know how you can fall so desperately in love with Meredith that you cheat on Addison with her, and yet you can't bring yourself to understand what happened with Addison and me."
"Leave me alone," Derek said, his tone harsh and grating. The words fell from his lips like gunfire, but Mark, stupid, stubborn Mark, wouldn't comply, and Derek suspected, at this point, if he moved, Mark would follow him around like a yapping dog. Now, now, now. I want the answers now.
"I'm not moving, man. I'm tired of letting your passive aggressive bullshit ruin my life. I want to know."
Derek sighed and slouched back in his chair. The little murmur of ache from before escalated just a little into a whine. Like a mosquito. Whining. Still nominal, but harder to ignore in the long term. Eventually, the urge to swat would suck him down into frustration. He hoped Dr. Weller would come back soon. He needed either another dose of the Tylenol, or he needed a prescription to fill. Something. He never wanted to go back to where he'd been that morning.
It was getting into late morning, and activity had built over the slow crawl of hours. The doors to the hospital seemed to always be greeting or saying farewell to a crowd. Noise. Everywhere. An old lady hobbled in on a walker, moving at a pace that would very likely compete with a snail. Barely. The walker creaked and clinked as she moved. Rickety. A young teen hopped out the door by an older woman's side. Her mother? Perhaps. It didn't matter. Bounce, bounce, bounce on the floor. Her feet slammed against the welcome mat with hollow thumps. Noise. Everywhere.
He leaned forward, clutched the bridge of his nose, and breathed into his palm.
Soon. This would be over soon. Dr. Weller just needed a spare minute to finish up his diagnosis.
"I want to know, Derek," Mark prodded, and Derek had to force himself to focus. Know? Know what?
He sluggishly rewound the conversation and found his answer. Why had screwing Meredith at the prom been all right? Except, it hadn't been. It hadn't been all right. He'd cheated. He'd broken them.
The rules.
He'd been that person.
He knew why he'd done it. But that would never make it okay, despite Meredith's reassurances to the contrary. It would never be okay.
And that was where he and Mark differed. That was where they would always differ. Until Mark finally realized, until he got a fucking clue, until he finally got it.
"I didn't love Addison anymore," Derek said.
"So?" Mark said, his voice stuffed full of incredulous surprise. "That gave you the right to cheat?"
Derek shrugged. "No."
"No?" Mark said. He spluttered, actually floundered on some empty syllables that may have been words if he hadn't been so obviously confused, as if he'd expected to have to force Derek to expound on justification, not denial. "But..."
He was confused because he didn't get it. Derek didn't think he ever would.
"Leave me alone," Derek said. "Leave me the fuck alone, Mark."
"What do you mean, no?" Mark asked, ignoring him.
"I mean no," Derek snapped. He rubbed his eyes with his index fingers. "I mean, no, I should never have slept with Meredith at that stupid dance. I treated Addison like shit, I hate that I didn't care at the time, and I made what should have been something beautiful into something cheap and tawdry. Is that what you wanted to hear? Go away, Mark."
"No," Mark said, his voice snappy and irritated. "I don't understand. I thought..."
"There is nothing. Similar. About what you and I did."
"Why?"
"Because I fucking learned something, Mark." Derek sighed. "I learned that I am the luckiest person in the world, because I behaved like a fucking bastard, and Meredith took me back, anyway. And, because, at the time, I didn't love Addison anymore, but, when you fucked my wife, I'm fairly certain we were still brothers, unless I missed the fucking memo."
Mark shook his head minutely, flummoxed, stunned. "I don't..."
"My point. Go away. Go away, now."
"Please, Derek..." Mark said, his voice harsh, confused, hurting. He really didn't get it.
A tall, brown-haired man cleared his throat about three feet from them. Derek hadn't even seen him walk up, but when he turned to find Dr. Weller standing there, he didn't care. Didn't care that he'd been so out of it, so oblivious, so stressed he hadn't even noticed. He didn't care that he hadn't felt his colleague's approach. Relief flooded Derek. Home. He would finally be able to go home. And he would get a replacement dose for the painkiller that was starting to wear off. Relief. Overwhelming, unadulterated relief that had him sighing, blinking, almost elated, until he stopped feeling relieved long enough to read the expression on Dr. Weller's face.
"Dr. Shepherd," Dr. Weller said. Between his spindly fingers, he clasped a large, flat manila envelope. A black strip poked out the open end of the envelope, and the little red string that would tie the envelope closed dangled against Dr. Weller's white lab coat. Films. They were films. And Dr. Weller looked... Apologetic and worried. It was the type of face that said I'm sorry, but you have cancer. I'm sorry, but you have six months to live. I'm sorry, but we need to take the leg. I'm sorry, but... It was a purely doctor sort of face, and the expression contained nothing of his colleague, a man who, if things kept progressing at their current pace, might become a friend. Eventually. Dr. Weller's brown eyes were wide and unblinking, as if he were afraid to look away. Some people, when they had bad news, couldn't do anything but look away. Others couldn't stop staring. Dr. Weller seemed to be a constituent of the latter group. Everything about his posture said tense. Tense and concerned.
"Dr. Weller," Derek replied, unwilling to let the stab of worry knock him down. He clenched the arms of his chair, and his heartbeat thumped in his chest, thumped like it was going to suck everything down into the floor with it. Sinking. He felt.
Sinking.
"We should move into a conference room," Dr. Weller said. His gaze briefly moved to Mark before flicking back to Derek with a fluttery prey versus predator skittishness. "I finally had a chance to look at your MRI results, and I'd like to discuss them with you."
Derek recognized Dr. Weller's tactic immediately. Mark was an unknown quantity. This was where Derek was supposed to say anything you need to tell me, he can hear. If Mark was family or a loved one or both. Which he wasn't. Not anymore. Not ever again. This was also the opportunity for Derek to say this man has no business knowing about my medical problems. He chose the latter option.
"Okay," Derek said. Dr. Weller nodded and turned. Derek shoved himself into a standing position. He blinked as the room fuzzed up and went dark for blood-rushing, sinking second. Tiredness. Just tiredness. And probably the codeine. Tangoing in his head, dulling him down. The room came back in seconds.
Mark stared at him. His lips parted. He'd obviously caught that little stumbling episode.
"Wait," Mark said, as if he were finally, finally clued in to why Derek would be sitting in the hospital, looking like crap, waiting in the waiting room of all the places he had access to, like his office, the attendings' lounge, the on-call rooms, the break rooms. "Wait, you're a patient?"
Derek paused and turned. "Go. Away."
"What's wrong with you?" Mark said, his tone devolving into uncharacteristic, biting worry. The pace of Mark's speech picked up, and he animatedly followed Derek as he slogged after Dr. Weller toward the nearest conference room. "Meredith said you were fine. You're fine. Right, man?"
Derek didn't answer him. Go away, he thought silently. Go away, and leave me alone. Finally, finally, leave me alone. Except Mark kept badgering until Derek wound up having to shut the door to the conference room in his face to get away from him.
Dr. Weller sat down at the head of the conference table. Derek couldn't help but look back over his shoulder. Mark paced back and forth outside, visible through the conference room's side panel glass windows. Dr. Weller looked up and followed the line of Derek's gaze to Mark. He cleared his throat, stood, and went over to lower the blinds on the windows before coming to sit back down again. Silence hummed in the room, thick, tangible.
Dr. Weller sat, his hands clasped, licking his lips, as if he were trying to figure out how best to let his boss know he was dying of some sort of terrible plague, but all it did was make Derek start to shiver with worry. "So?" Derek prodded, conscious of his stiffening muscles. He tried to relax, tried to let them loosen up, but they just kept winding back up like a spring release getting ready to go.
"Dr. Shepherd," Dr. Weller said, "You've developed what looks like a wide area subacute subdural hematoma."
"Let me see," Derek replied.
Dr. Weller sighed, his fingers sliding along the edges of the envelope. "Dr. Shepherd..."
"Let me see," Derek said, snatching the films from Dr. Weller as soon as they cleared the edge of the envelope. He raised the first one to the light, squinting, blinking. His name was sprawled at the bottom of the films in loopy handwriting. Derek Shepherd. His head. His brain. For a slow, terrifying moment, he felt like he had felt when he'd first woken up the week before. Muddled. Slow. Fragmented. Unable to think in the higher terms required to be a neurosurgeon. He was staring at something that may as well have been an illustrative guide to the Cyrillic alphabet in Swahili. But as he blinked, as he adjusted to the light, as he forced himself to breathe and really look at what he was seeing, it all started to make a certain amount of sense. "This is..."
"Clotting," Dr. Weller said. "You have a large amount of clotting. Which means-"
"Craniotomy," Derek said, quick, a habit, though he wasn't sure why anymore. He tried to think about it as he lowered the films back down onto the table. They slid an inch on a thin pocket of air before settling in the middle. He ached. But without the throbbing block of pain in his skull, thinking wasn't nearly as difficult. Even so, he still felt... scattered. Like... to make a coherent analysis of his situation, he had to draw in thoughts and ideas and conclusions from all directions and distances, north, south, east, west, up, down, near, far, and it was exhausting. Exhausted. He already was. He closed his eyes for a moment and let everything hum and assemble at its lumbering, frustrating, glacial pace. Craniotomy. Not... burr holes. Burr holes were only useful if the blood stuck inside his head still had the ability to flow and spurt to escape from the pressure. Clotting meant... What did? Clotting meant everything was stuck. And craniotomy meant...
Dr. Weller said, "Yes." Somewhere beyond the roar.
"But..." Derek said. His voice stopped. It just... stopped. And the thoughts he'd had dissolved, only to be replaced by a bitter, winding, silent fear.
Craniotomy meant he'd be naked and under anesthesia for hours with his skull cracked open for all his snarky, gossipy interns to see. All his staff. He'd be naked, and helpless, and when he woke up, he'd be drugged and unable to move more than a few inches on his own for a while. A day, at least. It meant he'd feel fatigued and weak and nearly helpless for another week or more after that. And he'd feel sick and down for another six to eight weeks after that while he would be routinely rebuffed for any physical activities with aching tiredness. All the time. And that was the optimistic outlook. The pessimistic outlook was that he could develop epilepsy and be forced to resign. People prone to having seizures weren't really the best surgeons, what with the possibility of a complete neurological misfire of electrical charges able to send them careening to the floor, twitching, incontinent, and helpless at any time. He had problems thinking now, but at least there was the hope that it'd spontaneously resolve overnight. A craniotomy could potentially interfere with his thought processes for weeks. More than weeks. Months. Even permanently if something got botched. There was the possibility of post-operatic pneumonia and or complications that would require yet another craniotomy, either of which would keep him in the hospital even longer. He'd...
No.
"Dr. Shepherd," Dr. Weller said, and then his voice lowered into something more considerate. Something more friendly. "Derek. We need to admit you. Immediately. You need to be put on diuretics to keep swelling down and anti-convulsants so you don't start to seize. And I need to operate. Before permanent damage occurs."
"But it could... heal," Derek said. Sometimes these things healed. "On its own. It's been ten days. It's been... It's a slow bleed. It could just..."
Heal.
He remembered. He remembered the squeal of the ambulance as it had approached. He remembered getting picked up and dropped by half a dozen hands onto a gurney like a sack of meat. He remembered watching the fluorescent lights pass by overhead as he stared up at the ceiling, and they rolled the gurney into the trauma ward. He remembered trying to breathe, remembered the way every inhalation had been a sharp knife, slipping under his ribs. Except every breath he'd taken hadn't been nearly enough, and he'd just had to take more, and more, and more, until he'd been gasping and struggling and trying so hard. He'd been nauseated. And confused. But he'd been awake, and they'd just...
No.
He hadn't been Derek. He'd been that guy with the pneumothorax and a concussion.
No.
"You know that's very unlikely."
"No."
"No?"
"I don't want to..."
Be that guy with the bleeding brain. No.
"Derek," Dr. Weller said as he stood and pulled his chair around the corner of the table and scooted closer. "I know this has to be a little surreal for you. But if we get to this quickly, you have an excellent chance at a full recovery. All of your current symptoms can be attributed to hematoma. I'm willing to bet you never had PCS, or, if you do, it's not nearly as bad as what you're currently experiencing."
Reasonable. Dr. Weller sounded so incredibly reasonable. Don't worry. Everything's fine. Congratulations, no PCS. It's just a huge clot of blood wreaking havoc. Nothing big. Gone with the flick of a scalpel and a drill.
A drill.
To his head.
"My last MRI didn't show any bleeding at all. I checked it myself," Derek said. He'd checked it himself because he hadn't trusted Dr. Zalkind. After his MRI had been finished and Dr. Zalkind had been flashing the gift of Xanax at him, he'd checked it, forced himself to check it despite the sucking pull of panic. Dr. Zalkind had put it up against a backlight for him in one of the hallways, and he'd stared at it. Curled up on the stretcher, shaking, blinking, he'd stared at it, until another roll of nausea had pulled his gaze away, and he'd finally given in. Given into Dr. Zalkind's suggestion of sedation. There hadn't been any bleeding on that scan. There hadn't been. He looked down at the new scans, resting on the table, cool, and dark, and barely visible under the spread of his fingers. "It's a slow bleed," he added uselessly.
Dr. Weller nodded. "Yes," he said. "It may have taken a long time to start showing up on scans." He smelled like antiseptic. And right that moment, Derek wanted to retch.
"It's PCS," Derek said, pushing the films away. It was PCS, and that scan was a mistake. Something had... messed up the imaging software. His name had gotten switched with some poor fool who'd been driving drunk after a binge at a bar, not driving sober to take his girlfriend to meet his mother, only to be felled by a cruel fluke. He didn't need a craniotomy. He'd heal. He'd take the PCS back. He shouldn't have complained about the headaches and the nausea and all the rest. He was fine. He could deal with them. He could visit a psychiatrist and get a prescription for something that would help lessen the anxiety. Effexor, maybe. Or... Or... What did Kathy use for depressed, suicidal maniacs? What... And... The pain. He could live with that. "I agreed. PCS. I don't misdiagnose people."
He could live with PCS. He could. He hadn't meant to let it drag him down.
"Derek, based on the faxes of your medical records Sharon Hospital sent me, I would have agreed," Dr. Weller said. "Your reasoning was flawless for the data that you had, and, certainly, the doctors at Sharon did their best. But there've been new developments since then. As you said, this is a slow bleed. The last time you had an MRI was only four days after the accident. But this new MRI shows a massive amount of clotting. Deficits in your ability to concentrate have become debilitating. Your headaches have escalated."
"But Meredith," Derek said. "Last night, I told her it was PCS. It's all still consistent with..."
What was he going to say to Meredith? She'd just told him one of her deepest fears was of him dying before she did. He hadn't even wanted to admit he had a headache at first. She didn't need to be scared. She didn't deserve to be scared. He couldn't make himself younger, but he liked to think he could at least not scare her any more than the seven and a half extra years loitering in his bones already did on their own. She... She was going to marry him. But this? This was...
This was ridiculous, and unreal, and...
Not him on those scans. Because he was fine, and he could heal. He'd make himself fix it. He was healthy.
"Your cognitive abilities have been affected," Dr. Weller said, blunt and sharp all at once. "This is why doctors don't doctor themselves. And Dr. Grey, as skilled as she may be, is an intern who probably hasn't had enough experience yet to know better. She's also your girlfriend. Loved ones tend to make very subjective judgments."
"But I said it was PCS and that I was okay. I am okay. I'm fine."
Dr. Weller sighed. "Derek, give me a list of potential symptoms resultant from a subacute subdural hematoma."
"Headaches," Derek replied, instant, knowing, definitive. He knew the potential symptoms of a subdural hematoma. It was textbook. He performed at least one or two craniotomies or some sort of emergency decompressive surgery a week, particularly during the holidays when people got drunk and stupid. He'd seen enough bleeding brains to know what havoc they wreaked on a human body. Headaches. They caused... headaches.
"Yes," Dr. Weller said. "What else?"
"Nausea," Derek continued, but that one was harder. Harder to say. And the next few symptoms came to him even more slowly, like tired horses, moping across the finish line in last place at the end of a race. "Vomiting. Ataxia. Seizures."
"Yes, and?" Dr. Weller prodded.
"And..." Derek paused. "Dis... Disorientation."
"And?"
Derek blinked. There was more. There had to be more. He knew there was more. Tons more. What was? Deviated. Deviated something... Slurred. What? Slurred what. "I..."
"Derek, you can't think straight," Dr. Weller said, his voice low and friendly and soothing and calm, like he was talking to some sort of wild, frenzied animal, like he was trying not to get his hand snapped off in said wild, frenzied animal's jaws.
"I can think fine," Derek said. "It's just..." Slow. It would come to him. Deviated gaze. That was it. Slurred speech, deviated gaze. He didn't have either of those. He just had headaches. And nausea. And anxiety. And light sensitivity. And... memory problems.
"You're struggling with something you should be able to rattle off in five seconds by rote," Dr. Weller said. "You need to get this done, or you'll most likely suffer permanent brain damage and or death. I don't know what else to say to convince you."
Derek leaned onto his elbows and tore his fingers through his hair as he sighed. He wasn't... He could be fine. He could be. Sometimes, bleeds resolved on their own. "I need to... Talk to Meredith first."
"Okay," Dr. Weller replied, frowning. "You have my pager number, of course."
"Yeah," Derek nodded. Go away. Go away. Go away.
Dr. Weller sighed and left, but not without adding in his honeyed, rich, deep baritone, "Dr. Shepherd, you need to make this decision as soon as possible."
Fandom: Grey's Anatomy
Pairing: Duh. (Mer/Der)
Rating: M
Timeline: Post Time After Time.
Okay, so I lied. I don't have a clear idea of Part 35 yet at all (aside from what is supposed to happen in it). I haven't mapped out any dialog or anything. But I loved this part. Loved it. And I want to share, so I'll take my chances. I have a business trip this week, I'll be out of town, so I don't know when I'll have time to finish Part 35, or even start it really. But this? This was... This was a veritable playground of character analysis for me. This is why I wanted to do this. Not because it's dramatic or flashy or because I get my kicks out of making characters suffer, but it lets me pick things apart, figure out what makes them work, and go for the jugular when I explain my ideas to everyone else. My original goal with this story was to reboot McDreamy and open up his back story and motivations with a can opener. That's what I'm doing. The reboot, I consider successfully completed. But this is where I truly hit pay dirt on the can opener front, I think. I hope you like it, but if you don't, my eyes are always looking for suggestions :) Or course, any and all feedback is relished.
You might recognize some of the dialog at the start of this. Credit goes to Grey's writers, at least for Mark's side of things. This was the first time I've actually borrowed so much of the show at once, so I figured I'd mention it.
~~~~~
Seattle Grace was busy. Derek sat in the waiting area wedged as far in the corner as he could manage, his head propped up on his palm, his elbow resting on the little side table. His legs splayed, he sat in a wilted, slumped, defeated slouch. He hadn't been looking forward to coming in for his appointment, hadn't been looking forward to dealing with the stares and the questions. He hadn't been looking forward to contributing to the newest broadcast on the gossip network. McDreamy is McSick, McWitless, and McDoped.
McYuck.
He hadn't slept well the night before. Every time he'd fallen into a doze, the throbbing pain had yanked him back out of slumber and into the reality. The reality of time. Time passing in a funeral procession of moments, slow, somber, unrushed. And he'd lain there. Staring at the ceiling until his eyes had drooped shut and the whole cycle had started again, over, and over, and over in the nastiest use of instant replay ever.
When Meredith had woken up for her shift, it'd seemed like eons since she'd gone to sleep. He'd tried to be functional. He'd tried to get up and get ready, take a shower, shave, brush his teeth. He'd tried. Slow. Hurting. He'd felt like some sort of lumbering glacier of suffering. Coordinated acts of grooming had all strung into a long session of self-torture, but he'd managed. Sort of. He'd nicked himself with his razor. Twice. He'd gotten his dental floss caught at least four times. By the time he'd stumbled downstairs to the foyer, dressed haphazardly in an old t-shirt and jeans that Meredith had blessedly pulled out for him, saving him some effort on the coherency front, he'd felt like any sort of thought, particularly any thought that was expected to connect up with the one that had occurred before it, was impossible. Meredith had asked him questions, pelting, rapid, worried. He'd answered as best as he possibly could, but every word he'd had to formulate had been yet another form of torture. Meredith had gotten the idea, and had driven him in silence to the hospital.
That had been about four and a half hours before. Dr. Weller had been at the hospital overnight, and had been able to see Derek within about thirty minutes of his arrival. Dr. Weller had taken one look at Derek and given him some better pain medication to help in the interim while he made a more complete diagnosis. Tylenol with codeine. It'd kicked in after a few minutes, and the pain, the whole mountain of it, had receded in a sluggish, oozing wave, leaving just a little murmuring ache and a metric ton of exhaustion in its wake. The rest of the physical examination had passed sluggishly while Derek had struggled to stay awake and answer Dr. Weller's questions about his symptoms. And, as if that hadn't been grueling enough on his torn and frazzled nerves, Derek had had to get scans done after that. Even that early, the line for the MRI machine had already been backed up. It'd been a long, tiring wait. He'd actually fallen asleep during his MRI despite the hum and the clicks and the closed space and the clinical impersonality of it all. The technician had had to wake him up when it'd been over. Derek had shuffled back down to the waiting area, and there he sat, waiting for Dr. Weller's analysis of the films. And who knew how long that could take? Dr. Weller had been called away to deal with an emergency with one of his post-op patients.
His eyes slipped shut. His head started tilting. He snapped awake, blinking, unhappy, unhappy to be there. He just wanted to go home, curl up in the dark under sheets that smelled like Meredith, and sleep. Really sleep. Finally. Tylenol with codeine had sedative effects. He was tired anyway. It was a horrible combination. He wanted Dr. Weller to finish looking at everything and send him on his way. He'd take a taxi back home or something. Meredith had offered to drive him back during her lunch break, but he didn't think he could wait that long.
At least nobody had noticed him sitting there, looking pale and pasty and tired and unwell. Nobody had come to talk with him or offer pleasantries. Derek Shepherd the high-powered neurosurgeon wasn't really a holey-jeaned, t-shirted, pile of sickly, exhausted unwellness kind of guy. Out of the corners of peoples' eyes, he probably blended in as just another ill and weary patient, especially as slouched as he was, especially since he held his head routinely cradled in his hands while he stared at the weave of the carpet at his feet, stared until it blurred into a murky, peach-colored blot of color and nothing else. He went unnoticed. Unseen. And that suited him just fine. He felt...
Unwell.
The pain was a bare memory, etched into the blur of the morning leading up to the first pill Dr. Weller had given him, but he felt like he was just waking up from a bad bout of flu, sickness still wafting out of all his pores. Seattle Grace was busy. Noises shrieked and clicked and laughed and beeped and rang and shuffled and groaned all around him in a hailstorm of sound. They didn't worsen the remnant ache he felt, but the desire for quiet and dark held him in its thrall, and the cacophony was enough to send his index finger rubbing along his brow in irritation. The waiting room was bright. And that did hurt, but it was a dull, distant hum that he could deal with. He could. Easily. He let it throb without comment. He thought about wandering off to an on-call room or maybe even to his office, but if he let himself amble into the areas of the hospital highly trafficked by doctors, he was pretty sure he'd have to field questions or friendly get wells. And walking... Walking upstairs and finding an empty room... Effort.
Meredith had been checking in every forty-five minutes or so when she could spare a few seconds. She'd been ecstatic to find him relatively pain free, had kissed him, hugged him, babbled lightly about how busy the day was going to be, and he'd let himself fall, relaxed, into the comforting cadence of her excited voice. The operating rooms were booked solid, she'd said, which had made sense of the early activity in the MRI rooms. Something about a bad pileup on the freeway involving a semi. Meredith had said she was going to scrub in for a liver transplant later that day, but that she hadn't been assigned to anything that morning.
He'd suspected that she had been lying. That she'd stayed out of morning surgeries to be more available for him. But he hadn't said anything. He hadn't been able to. Selfishly, he'd liked that she'd kept showing up to keep him company. Her voice was a balm. Her scent. Her warmth. Everything. In the moments she was there, he didn't feel sick, didn't feel like he couldn't. And that was better than any pain reliever or sedative.
She saved him from the moments like this one, where all he could think about was sleeping. He would have to talk to Chief Webber later about taking the rest of the week off. He wasn't sure how he felt about that, but hovering in the lazy fuzz of tiredness did have one advantage. Worrying was just too much effort, so, he wasn't really thinking much about taking leave at all. He was thinking about beds. And being in them. And not being awake. Dreaming.
His sighed, and his head started to tilt again.
Cross trainers that weren't his own stepped into his limited field of view of peach, ugly carpet. A presence hovered on the edge of his personal bubble for a procession of tense, weary moments. A sigh stuttered into the silence above him. The chair next to him rocked as Mark sat down next to him and he thumped his bag down in a heap.
"What are you doing here?" Mark said. "I thought you were on sick leave."
Derek managed a flat, "Sitting here," through clenched teeth. He brought up his gaze, blinking at the harsh light. Mark was still in his street clothes, stonewashed blue jeans and a black button up shirt that peeked out from underneath his leather coat. He'd dropped his heavy, bulging briefcase into the chair on his other side. The side flap of the bag had his beeper and all of his phones clipped to it. Derek prayed that one of them, any of them, would ring. That would be nice.
"You look like shit, man," Mark said. He slouched forward and brushed his palms over his face in a tired gesture.
"Thanks, Mark. Thanks for the astute observation," Derek snapped. "I'm just waiting."
"Meredith getting off shift soon?" Mark said.
Derek sighed and didn't comment. Mark didn't need to know. Mark didn't need to know about the PCS. Mark didn't need to know that Derek was on pain medication and ready to collapse. Mark didn't need to be next to him in this chair, but Derek was too tired to get up and walk away, and so he sat, quiet, grinding his molars. The ache that had been just an annoyance sharpened its claws. He didn't need this right now. He didn't need this ever.
And yet... "Meredith told me you wanted to talk," Derek said, and for the briefest of moments, behind all the muck and mire of the creeping tiredness, a sliver of hope pierced the space behind his heart. Maybe this would be the time. Maybe this would be the time Mark would finally get it. Or maybe this would be the time Mark would finally go away for good. Every time he talked to Mark, this happened. This stupid, twisting dream that the tangle with Mark would finally fix itself. Finally resolve. Like a disease. Gone. Healed. Exorcised.
Every time he talked with Mark, this happened. And every time he talked with Mark, Derek came out of the conversation feeling just a little bit like he'd relapsed into the night he'd found his former best friend in his bed. Fucking his wife.
Mark was an addictive poison.
One day, maybe Derek would learn.
"She's gone, Derek," Mark replied without precursor.
Derek blinked. Meredith? "Who's gone?" he said.
Mark didn't answer. "What's in LA?"
"What?"
"For Addison. Any idea what she might be doing there? The Chief told me yesterday that's where she went. She just... up and left. Sunday, she was here. Monday, she was gone."
"No," Derek said. Disappointment tripped on his anger, and they fell into a jumbled heap of bitter, dark churning. He drew his fingers up to the bridge of his nose and started massaging himself. This wouldn't be. This wouldn't be the time. And he really wanted to sleep. He couldn't even bring himself to be surprised that Addison had skipped town. Couldn't bring himself to wonder. He just didn't care about her anymore. They were on terms that weren't hateful. But he expected that was as far as he could ever recover from that. First the one night stand. Then discovering it had been a whole lot more. A whole. Lot. More. It had disgusted Derek when the whole thing had been an impulsive mistake. It had horrified him when he'd discovered it had been a calculated, continuous error over several months.
"We were gonna try," Mark said, oblivious. Fucking oblivious like he always was. "We were gonna make a go of it. As a couple. She bet me I couldn't go sixty days without having sex."
Derek sighed. He didn't want to hear this. "Leave me alone, Mark."
"She didn't want to be with me," Mark said. "I thought she did. I thought she might. But she didn't. And I caught her. You know..."
"Leave me alone, Mark," Derek hissed. At least Addison being Addison, desperate for validation from a man, had maybe ripped a hole in Mark as wide as the hole Mark had ripped in Derek when Derek had caught them. Vengeful. He was being vengeful.
But he just didn't care anymore. Because Mark was pestering, and Derek was tired.
"I told her I did it," Mark continued, ignoring him like always. Ignoring. Mark was bigger. Mark had always been bigger.
But I don't want to TP that house. It's wrong. What if we get caught?
A fist had slammed into his side, roughhousing, playful, but hard. Hard enough to make him wheeze. Mark had always been bigger.
You're such a pansy, Derek. Live a little.
And Derek had found himself doing it anyway, serving as lookout while Mark leapt around, throwing roll after roll of fluffy pink toilet paper into the tree in front of some poor victim's house, one of the very few trees. Derek had tried to ignore the pit of sickness twisting inside his stomach. Against the rules, against the rules, against the rules. Tried to ignore, at the same time, the little zing of thrill. Breaking the rules, breaking the rules, breaking the rules.
See, you big baby. It's fun.
"I told her I lost the bet," Mark continued. "I told her I slept with someone. I figured if she didn't want to be with me, she shouldn't have to feel guilty about it."
"I don't want to hear about your fucked up problems with my ex-wife," Derek snarled. "Who you fucked, Mark. You f-- Leave me alone."
"I love her, Derek," Mark whispered.
Derek squeezed his eyes shut. He didn't want to hear this. He didn't want to ever hear this. He just wanted it to go away. He leaned down onto his knees with his elbows and covered his mouth. Just thinking about it made him want to vomit. Mark. Addison. Mark spilling himself into the woman who had been Derek's for eleven years. Mark had taken everything away from him.
"My point," Mark continued. "Look, it was never about you. It was never... It was never meant to... You can't help who you love, Derek."
And, once again, Mark was passing blame. Bile rose, but Derek swallowed against the burn and breathed. He breathed. He breathed. When he rose back up into a full sitting position, he peered at Mark through dark, angry eyes. Why didn't Mark ever. Fucking. Get it?
"I don't care," Derek said. "She was my wife, Mark. I've known you since I was five. It should have been about me."
He sighed and ran tired, clenching fingers through his hair, resisting the urge to just lean forward and... sleep. He blinked tiredly, and every time he opened his eyes again it was harder. Harder. He should have hidden in his office, where Mark would have been very unlikely to accidentally run across him, because, while Mark was a relentless, nosy prick who never seemed to give up on the idea of reconciling despite the heinous betrayal, he seemed to understand that the office was off limits except for professional reasons, that Derek needed a place where Mark was guaranteed not to be. He should have hidden there, locked the door, told Dr. Weller to page him whenever he was ready to finish up. Derek would have been easier for Meredith to find, too. And maybe she would have come around more than every forty-five minutes if she'd known exactly where he had been the whole morning while he waited. Maybe.
"I just wanted," Mark continued, his voice falling away in a bout of uncharacteristic speechlessness. Mark always knew what he wanted to say. Split second. Bam. He said what he thought. Like an idea, if it was hurled with enough abruptness, was a fist he could use to hit things with. "Look, what I wanted to talk about..." Bam. "Did you have to take away my family, too?" There it was.
Except, usually, Mark's barbs made more sense than that.
Derek sighed. "What are you talking about, now?"
He was too tired. Too tired to follow Mark's leaps of bullshit. Derek pondered getting up and leaving. He pondered it. Effort. Walk and suffer getting away, or sit and suffer staying there. A conundrum.
"The reunion," Mark clarified. "How was it?"
"Fine."
"Are you happy? Have you gotten your revenge in?"
"What are you fucking talking about?" Derek snapped.
"Oh, come off it, Derek," Mark replied. "You emotionally blackmailed them. You traipsed off with Meredith to your happy little barbecue after skipping both Thanksgiving and Christmas. I was there. I was there at Thanksgiving. And Christmas. I was there, and you weren't. And yet the reunion comes around and I don't even get a fucking phone call? Funny how that works out. Don't you think?"
Derek blinked. He hadn't really considered why Mark hadn't been at the reunion. He hadn't really thought about it beyond the relief of knowing he wasn't coming. His mother had simply said not to worry about it. Relieved. He'd been relieved. But he'd certainly had nothing to do with it. Nothing.
"You think I..."
"Yeah, Derek. I do."
"I had nothing to do with the guest list," Derek said. "Mom called me and threatened to come out here instead if I didn't go. She wanted to meet Meredith, who, thanks to Nancy, Mom originally thought would be a slutty, gold-digging bar whore."
Mark had the decency to look rebuffed. He frowned, ran his hands down his face in a slow trail as he sighed. "Oh."
"Please, Mark," Derek said. "Please, go away."
He didn't even care that he was begging. He just wanted to be left alone.
"No," Mark said. "I want to know. I want to know how you can fall so desperately in love with Meredith that you cheat on Addison with her, and yet you can't bring yourself to understand what happened with Addison and me."
"Leave me alone," Derek said, his tone harsh and grating. The words fell from his lips like gunfire, but Mark, stupid, stubborn Mark, wouldn't comply, and Derek suspected, at this point, if he moved, Mark would follow him around like a yapping dog. Now, now, now. I want the answers now.
"I'm not moving, man. I'm tired of letting your passive aggressive bullshit ruin my life. I want to know."
Derek sighed and slouched back in his chair. The little murmur of ache from before escalated just a little into a whine. Like a mosquito. Whining. Still nominal, but harder to ignore in the long term. Eventually, the urge to swat would suck him down into frustration. He hoped Dr. Weller would come back soon. He needed either another dose of the Tylenol, or he needed a prescription to fill. Something. He never wanted to go back to where he'd been that morning.
It was getting into late morning, and activity had built over the slow crawl of hours. The doors to the hospital seemed to always be greeting or saying farewell to a crowd. Noise. Everywhere. An old lady hobbled in on a walker, moving at a pace that would very likely compete with a snail. Barely. The walker creaked and clinked as she moved. Rickety. A young teen hopped out the door by an older woman's side. Her mother? Perhaps. It didn't matter. Bounce, bounce, bounce on the floor. Her feet slammed against the welcome mat with hollow thumps. Noise. Everywhere.
He leaned forward, clutched the bridge of his nose, and breathed into his palm.
Soon. This would be over soon. Dr. Weller just needed a spare minute to finish up his diagnosis.
"I want to know, Derek," Mark prodded, and Derek had to force himself to focus. Know? Know what?
He sluggishly rewound the conversation and found his answer. Why had screwing Meredith at the prom been all right? Except, it hadn't been. It hadn't been all right. He'd cheated. He'd broken them.
The rules.
He'd been that person.
He knew why he'd done it. But that would never make it okay, despite Meredith's reassurances to the contrary. It would never be okay.
And that was where he and Mark differed. That was where they would always differ. Until Mark finally realized, until he got a fucking clue, until he finally got it.
"I didn't love Addison anymore," Derek said.
"So?" Mark said, his voice stuffed full of incredulous surprise. "That gave you the right to cheat?"
Derek shrugged. "No."
"No?" Mark said. He spluttered, actually floundered on some empty syllables that may have been words if he hadn't been so obviously confused, as if he'd expected to have to force Derek to expound on justification, not denial. "But..."
He was confused because he didn't get it. Derek didn't think he ever would.
"Leave me alone," Derek said. "Leave me the fuck alone, Mark."
"What do you mean, no?" Mark asked, ignoring him.
"I mean no," Derek snapped. He rubbed his eyes with his index fingers. "I mean, no, I should never have slept with Meredith at that stupid dance. I treated Addison like shit, I hate that I didn't care at the time, and I made what should have been something beautiful into something cheap and tawdry. Is that what you wanted to hear? Go away, Mark."
"No," Mark said, his voice snappy and irritated. "I don't understand. I thought..."
"There is nothing. Similar. About what you and I did."
"Why?"
"Because I fucking learned something, Mark." Derek sighed. "I learned that I am the luckiest person in the world, because I behaved like a fucking bastard, and Meredith took me back, anyway. And, because, at the time, I didn't love Addison anymore, but, when you fucked my wife, I'm fairly certain we were still brothers, unless I missed the fucking memo."
Mark shook his head minutely, flummoxed, stunned. "I don't..."
"My point. Go away. Go away, now."
"Please, Derek..." Mark said, his voice harsh, confused, hurting. He really didn't get it.
A tall, brown-haired man cleared his throat about three feet from them. Derek hadn't even seen him walk up, but when he turned to find Dr. Weller standing there, he didn't care. Didn't care that he'd been so out of it, so oblivious, so stressed he hadn't even noticed. He didn't care that he hadn't felt his colleague's approach. Relief flooded Derek. Home. He would finally be able to go home. And he would get a replacement dose for the painkiller that was starting to wear off. Relief. Overwhelming, unadulterated relief that had him sighing, blinking, almost elated, until he stopped feeling relieved long enough to read the expression on Dr. Weller's face.
"Dr. Shepherd," Dr. Weller said. Between his spindly fingers, he clasped a large, flat manila envelope. A black strip poked out the open end of the envelope, and the little red string that would tie the envelope closed dangled against Dr. Weller's white lab coat. Films. They were films. And Dr. Weller looked... Apologetic and worried. It was the type of face that said I'm sorry, but you have cancer. I'm sorry, but you have six months to live. I'm sorry, but we need to take the leg. I'm sorry, but... It was a purely doctor sort of face, and the expression contained nothing of his colleague, a man who, if things kept progressing at their current pace, might become a friend. Eventually. Dr. Weller's brown eyes were wide and unblinking, as if he were afraid to look away. Some people, when they had bad news, couldn't do anything but look away. Others couldn't stop staring. Dr. Weller seemed to be a constituent of the latter group. Everything about his posture said tense. Tense and concerned.
"Dr. Weller," Derek replied, unwilling to let the stab of worry knock him down. He clenched the arms of his chair, and his heartbeat thumped in his chest, thumped like it was going to suck everything down into the floor with it. Sinking. He felt.
Sinking.
"We should move into a conference room," Dr. Weller said. His gaze briefly moved to Mark before flicking back to Derek with a fluttery prey versus predator skittishness. "I finally had a chance to look at your MRI results, and I'd like to discuss them with you."
Derek recognized Dr. Weller's tactic immediately. Mark was an unknown quantity. This was where Derek was supposed to say anything you need to tell me, he can hear. If Mark was family or a loved one or both. Which he wasn't. Not anymore. Not ever again. This was also the opportunity for Derek to say this man has no business knowing about my medical problems. He chose the latter option.
"Okay," Derek said. Dr. Weller nodded and turned. Derek shoved himself into a standing position. He blinked as the room fuzzed up and went dark for blood-rushing, sinking second. Tiredness. Just tiredness. And probably the codeine. Tangoing in his head, dulling him down. The room came back in seconds.
Mark stared at him. His lips parted. He'd obviously caught that little stumbling episode.
"Wait," Mark said, as if he were finally, finally clued in to why Derek would be sitting in the hospital, looking like crap, waiting in the waiting room of all the places he had access to, like his office, the attendings' lounge, the on-call rooms, the break rooms. "Wait, you're a patient?"
Derek paused and turned. "Go. Away."
"What's wrong with you?" Mark said, his tone devolving into uncharacteristic, biting worry. The pace of Mark's speech picked up, and he animatedly followed Derek as he slogged after Dr. Weller toward the nearest conference room. "Meredith said you were fine. You're fine. Right, man?"
Derek didn't answer him. Go away, he thought silently. Go away, and leave me alone. Finally, finally, leave me alone. Except Mark kept badgering until Derek wound up having to shut the door to the conference room in his face to get away from him.
Dr. Weller sat down at the head of the conference table. Derek couldn't help but look back over his shoulder. Mark paced back and forth outside, visible through the conference room's side panel glass windows. Dr. Weller looked up and followed the line of Derek's gaze to Mark. He cleared his throat, stood, and went over to lower the blinds on the windows before coming to sit back down again. Silence hummed in the room, thick, tangible.
Dr. Weller sat, his hands clasped, licking his lips, as if he were trying to figure out how best to let his boss know he was dying of some sort of terrible plague, but all it did was make Derek start to shiver with worry. "So?" Derek prodded, conscious of his stiffening muscles. He tried to relax, tried to let them loosen up, but they just kept winding back up like a spring release getting ready to go.
"Dr. Shepherd," Dr. Weller said, "You've developed what looks like a wide area subacute subdural hematoma."
"Let me see," Derek replied.
Dr. Weller sighed, his fingers sliding along the edges of the envelope. "Dr. Shepherd..."
"Let me see," Derek said, snatching the films from Dr. Weller as soon as they cleared the edge of the envelope. He raised the first one to the light, squinting, blinking. His name was sprawled at the bottom of the films in loopy handwriting. Derek Shepherd. His head. His brain. For a slow, terrifying moment, he felt like he had felt when he'd first woken up the week before. Muddled. Slow. Fragmented. Unable to think in the higher terms required to be a neurosurgeon. He was staring at something that may as well have been an illustrative guide to the Cyrillic alphabet in Swahili. But as he blinked, as he adjusted to the light, as he forced himself to breathe and really look at what he was seeing, it all started to make a certain amount of sense. "This is..."
"Clotting," Dr. Weller said. "You have a large amount of clotting. Which means-"
"Craniotomy," Derek said, quick, a habit, though he wasn't sure why anymore. He tried to think about it as he lowered the films back down onto the table. They slid an inch on a thin pocket of air before settling in the middle. He ached. But without the throbbing block of pain in his skull, thinking wasn't nearly as difficult. Even so, he still felt... scattered. Like... to make a coherent analysis of his situation, he had to draw in thoughts and ideas and conclusions from all directions and distances, north, south, east, west, up, down, near, far, and it was exhausting. Exhausted. He already was. He closed his eyes for a moment and let everything hum and assemble at its lumbering, frustrating, glacial pace. Craniotomy. Not... burr holes. Burr holes were only useful if the blood stuck inside his head still had the ability to flow and spurt to escape from the pressure. Clotting meant... What did? Clotting meant everything was stuck. And craniotomy meant...
Dr. Weller said, "Yes." Somewhere beyond the roar.
"But..." Derek said. His voice stopped. It just... stopped. And the thoughts he'd had dissolved, only to be replaced by a bitter, winding, silent fear.
Craniotomy meant he'd be naked and under anesthesia for hours with his skull cracked open for all his snarky, gossipy interns to see. All his staff. He'd be naked, and helpless, and when he woke up, he'd be drugged and unable to move more than a few inches on his own for a while. A day, at least. It meant he'd feel fatigued and weak and nearly helpless for another week or more after that. And he'd feel sick and down for another six to eight weeks after that while he would be routinely rebuffed for any physical activities with aching tiredness. All the time. And that was the optimistic outlook. The pessimistic outlook was that he could develop epilepsy and be forced to resign. People prone to having seizures weren't really the best surgeons, what with the possibility of a complete neurological misfire of electrical charges able to send them careening to the floor, twitching, incontinent, and helpless at any time. He had problems thinking now, but at least there was the hope that it'd spontaneously resolve overnight. A craniotomy could potentially interfere with his thought processes for weeks. More than weeks. Months. Even permanently if something got botched. There was the possibility of post-operatic pneumonia and or complications that would require yet another craniotomy, either of which would keep him in the hospital even longer. He'd...
No.
"Dr. Shepherd," Dr. Weller said, and then his voice lowered into something more considerate. Something more friendly. "Derek. We need to admit you. Immediately. You need to be put on diuretics to keep swelling down and anti-convulsants so you don't start to seize. And I need to operate. Before permanent damage occurs."
"But it could... heal," Derek said. Sometimes these things healed. "On its own. It's been ten days. It's been... It's a slow bleed. It could just..."
Heal.
He remembered. He remembered the squeal of the ambulance as it had approached. He remembered getting picked up and dropped by half a dozen hands onto a gurney like a sack of meat. He remembered watching the fluorescent lights pass by overhead as he stared up at the ceiling, and they rolled the gurney into the trauma ward. He remembered trying to breathe, remembered the way every inhalation had been a sharp knife, slipping under his ribs. Except every breath he'd taken hadn't been nearly enough, and he'd just had to take more, and more, and more, until he'd been gasping and struggling and trying so hard. He'd been nauseated. And confused. But he'd been awake, and they'd just...
No.
He hadn't been Derek. He'd been that guy with the pneumothorax and a concussion.
No.
"You know that's very unlikely."
"No."
"No?"
"I don't want to..."
Be that guy with the bleeding brain. No.
"Derek," Dr. Weller said as he stood and pulled his chair around the corner of the table and scooted closer. "I know this has to be a little surreal for you. But if we get to this quickly, you have an excellent chance at a full recovery. All of your current symptoms can be attributed to hematoma. I'm willing to bet you never had PCS, or, if you do, it's not nearly as bad as what you're currently experiencing."
Reasonable. Dr. Weller sounded so incredibly reasonable. Don't worry. Everything's fine. Congratulations, no PCS. It's just a huge clot of blood wreaking havoc. Nothing big. Gone with the flick of a scalpel and a drill.
A drill.
To his head.
"My last MRI didn't show any bleeding at all. I checked it myself," Derek said. He'd checked it himself because he hadn't trusted Dr. Zalkind. After his MRI had been finished and Dr. Zalkind had been flashing the gift of Xanax at him, he'd checked it, forced himself to check it despite the sucking pull of panic. Dr. Zalkind had put it up against a backlight for him in one of the hallways, and he'd stared at it. Curled up on the stretcher, shaking, blinking, he'd stared at it, until another roll of nausea had pulled his gaze away, and he'd finally given in. Given into Dr. Zalkind's suggestion of sedation. There hadn't been any bleeding on that scan. There hadn't been. He looked down at the new scans, resting on the table, cool, and dark, and barely visible under the spread of his fingers. "It's a slow bleed," he added uselessly.
Dr. Weller nodded. "Yes," he said. "It may have taken a long time to start showing up on scans." He smelled like antiseptic. And right that moment, Derek wanted to retch.
"It's PCS," Derek said, pushing the films away. It was PCS, and that scan was a mistake. Something had... messed up the imaging software. His name had gotten switched with some poor fool who'd been driving drunk after a binge at a bar, not driving sober to take his girlfriend to meet his mother, only to be felled by a cruel fluke. He didn't need a craniotomy. He'd heal. He'd take the PCS back. He shouldn't have complained about the headaches and the nausea and all the rest. He was fine. He could deal with them. He could visit a psychiatrist and get a prescription for something that would help lessen the anxiety. Effexor, maybe. Or... Or... What did Kathy use for depressed, suicidal maniacs? What... And... The pain. He could live with that. "I agreed. PCS. I don't misdiagnose people."
He could live with PCS. He could. He hadn't meant to let it drag him down.
"Derek, based on the faxes of your medical records Sharon Hospital sent me, I would have agreed," Dr. Weller said. "Your reasoning was flawless for the data that you had, and, certainly, the doctors at Sharon did their best. But there've been new developments since then. As you said, this is a slow bleed. The last time you had an MRI was only four days after the accident. But this new MRI shows a massive amount of clotting. Deficits in your ability to concentrate have become debilitating. Your headaches have escalated."
"But Meredith," Derek said. "Last night, I told her it was PCS. It's all still consistent with..."
What was he going to say to Meredith? She'd just told him one of her deepest fears was of him dying before she did. He hadn't even wanted to admit he had a headache at first. She didn't need to be scared. She didn't deserve to be scared. He couldn't make himself younger, but he liked to think he could at least not scare her any more than the seven and a half extra years loitering in his bones already did on their own. She... She was going to marry him. But this? This was...
This was ridiculous, and unreal, and...
Not him on those scans. Because he was fine, and he could heal. He'd make himself fix it. He was healthy.
"Your cognitive abilities have been affected," Dr. Weller said, blunt and sharp all at once. "This is why doctors don't doctor themselves. And Dr. Grey, as skilled as she may be, is an intern who probably hasn't had enough experience yet to know better. She's also your girlfriend. Loved ones tend to make very subjective judgments."
"But I said it was PCS and that I was okay. I am okay. I'm fine."
Dr. Weller sighed. "Derek, give me a list of potential symptoms resultant from a subacute subdural hematoma."
"Headaches," Derek replied, instant, knowing, definitive. He knew the potential symptoms of a subdural hematoma. It was textbook. He performed at least one or two craniotomies or some sort of emergency decompressive surgery a week, particularly during the holidays when people got drunk and stupid. He'd seen enough bleeding brains to know what havoc they wreaked on a human body. Headaches. They caused... headaches.
"Yes," Dr. Weller said. "What else?"
"Nausea," Derek continued, but that one was harder. Harder to say. And the next few symptoms came to him even more slowly, like tired horses, moping across the finish line in last place at the end of a race. "Vomiting. Ataxia. Seizures."
"Yes, and?" Dr. Weller prodded.
"And..." Derek paused. "Dis... Disorientation."
"And?"
Derek blinked. There was more. There had to be more. He knew there was more. Tons more. What was? Deviated. Deviated something... Slurred. What? Slurred what. "I..."
"Derek, you can't think straight," Dr. Weller said, his voice low and friendly and soothing and calm, like he was talking to some sort of wild, frenzied animal, like he was trying not to get his hand snapped off in said wild, frenzied animal's jaws.
"I can think fine," Derek said. "It's just..." Slow. It would come to him. Deviated gaze. That was it. Slurred speech, deviated gaze. He didn't have either of those. He just had headaches. And nausea. And anxiety. And light sensitivity. And... memory problems.
"You're struggling with something you should be able to rattle off in five seconds by rote," Dr. Weller said. "You need to get this done, or you'll most likely suffer permanent brain damage and or death. I don't know what else to say to convince you."
Derek leaned onto his elbows and tore his fingers through his hair as he sighed. He wasn't... He could be fine. He could be. Sometimes, bleeds resolved on their own. "I need to... Talk to Meredith first."
"Okay," Dr. Weller replied, frowning. "You have my pager number, of course."
"Yeah," Derek nodded. Go away. Go away. Go away.
Dr. Weller sighed and left, but not without adding in his honeyed, rich, deep baritone, "Dr. Shepherd, you need to make this decision as soon as possible."