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From Silence Into Silence

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She is in the passenger seat, spinning her rings nervously, a habit she knows drives her husband crazy. But she can't help it. They're late. Well, they're not late yet, but they will be in fourteen minutes and traffic downtown is at an absolute crawl like usual.

She's trying to breathe through it.

"You're going to flip out, just...save it," Derek reminds her, pinching the bridge of his nose.

She knows he hates driving in this sort of bumper to bumper grind. He always has, but he's better at it than she is, and she knows that too.

Inhale, exhale.

Someone manages to find three inches in front of them to cut into and Derek slams his hands onto the horn, the car beginning to be dusted with wetness. It's never a matter of if it will rain here. It's when, and how much. The umbrella drew too much attention to her foreigner status so she ditched it after the first week, but she misses it. The water that is constantly splashing up the back of her calves and drizzling down her neck is not something she is accustomed to yet.

After they get caught at the same light for a fourth time, she suggests parking here and walking the rest of the way. It'd probably be faster, but he seems hellbent on making it where they need to be and she pulls her phone out to let the receptionist know they're behind. Though honestly, if anyone made it to anything on time in this town it'd be a miracle.

"You're huffing and puffing over there like you're having the baby now."

"It's just..."

Derek resigns, she sees it in his eyes, the sudden slouch of his shoulders.

"She hasn't met you yet, Dr. Adams. I believe she thinks I made you up, like a crazy person."

"Why- nevermind," he decides immediately. "I'm here now aren't I?"

"Can we-"

"Can we what Addison?"

"Do you want to know the sex of the baby?"

"You don't know already?"

He's eyeing her skeptically. Like she'd keep that from him, but then, nothing about this has been conventional or pleasant really. "We couldn't tell last time, he or she was being a little shy and it was still early and I didn't know if you wanted to know so we stopped trying pretty quick. Do you want to know?"

He takes literal minutes to answer, concentrating on the road in front of him, the green car that just started to move. "Whatever you want to do is fine."

"I don't want fine, Derek," she almost explodes. "Can we at least act like we've been married for more than ten days and figure out an answer to this simple question together?"

"I don't care Addison, whatever you want."

"Great," she sighs, unbuckles and hops out onto the street. She hates surprises, she knows he knows this. It was hard enough to wait three weeks to an appointment he could actually to make it to. When she looks back with a glare he's rolling down the window in protest to her antics. "I'll see you there, if you make it." She waves him off and begins walking.

Maybe she is going crazy.

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"So where have you been?" Addison asks excitedly, hunting through the wine collection in the dining room for what she knows her brother will love. Nothing less than the best, especially after the paltry offerings at the bar they came from.

"Zihuatanejo," Archer says happily. "Swam with some dolphins, did a few press junkets at the resorts. Great place, you should go."

"Found it!" She announces.

"Where's Derek?" Archer asks earnestly. He looks to the one glass on the table and back to his sister. "On call?"

"Always, it feels like. And Derek is still tied up at work, he'll be home later. Tell me more about your book tour."

Derek didn't actually take her call. Sent it to voicemail, and now that he has a trailer to hide out in, she doesn't expect that he will be making an appearance this evening. They make small talk for ten minutes and she gives him the grand tour before she senses Archer is growing impatient.

"Cut the crap," Archer demands as they find their way back downstairs. "What are you doing in this hell hole?"

"The hospital-"

"You could've gone anywhere Addison, with your resume. Anywhere. Instead you fell off the face of the earth."

"I didn't realize this was an inspection."

"Well, she's not going to come out here herself," Archer relays, but it should seem obvious that Bizzy isn't planning on dropping one precious heel onto this sodden ground. "And it's always an inspection. The house is nice, she'd like the flowers out back," he gives it a cursory glance from his planted position in the sitting room.

"Addie! Home!" Derek yells, keys falling onto the hook, back door slamming. He obviously didn't listen to her message, and part of her is not-so secretly pleased by the scene that he is about to encounter.

"Oh good, I can ask him," Archer smiles already out of his seat and on his way to ruining someone's evening. "Derek."

"Archer," Derek speaks softly.

"Come join us, Addie was just about to tell me how you convinced her to move away from her life, friends, and family for seemingly nothing but rain in return. Maybe you can enlighten me further."

"I need a drink," Derek warns, Addison quick to her feet.

"Why is he here," Derek hisses into her ear, creeping up behind her seconds later, warm palm flattening against the center of her back as she pours him a scotch.

"No idea."

"How long is he planning on staying?"

"I'm staying until I can figure out why Seattle is so appealing!" Archer yells down the hall, grins, and flops himself back into his seat, more at home than Addison has felt in her months of living here.

"Because it was as far as I could get from you," Derek mumbles, downs his drink and holds the glass out for another.

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Derek's in the kitchen, reading, haphazardly eating cereal, drops of almond milk dotting the counter where he's sitting. He has a surgery in a few hours, one that he willingly would've passed off, but aside on waiting for something to come in, he doesn't have a lot else going on. In New York, he was sought after. He had a network of referrals that kept him busy. In Seattle, he hasn't made any connections. He's talented still, but there's no one else saying that save himself. It's frustrating, a dagger to what his wife considers his fragile ego.

"Where's Addison?" Archer asks, sauntering into the room, pressed and polished. Derek could swear he didn't sleep here last night, but he left them early into their evening of reminiscing, saying that he needed sleep when what he needed was to not spend the night listening to them lament their privileged and largely unsupervised upbringing.

"She got called in." He doesn't know this to be true. But she's not home. So she must be at work. She didn't wake him when she left. Something she used to do in their early years. A quick kiss to his prickly cheek, a mumble into his ear of where she was going and when she'd be back or at least that he'd see her later.

They're silent while Archer finds himself a cup of coffee. They don't like one another and without Addison they don't have to pretend to get along or have anything in common, even though there's quite a bit of overlap. Much to Derek's chagrin. Archer always said he didn't belong with Addison, that he should be so lucky, and Derek's own family agreed. But they have things in common despite very different childhoods.

"What are you doing here?" Derek asks, setting down his research.

"Ah, the eternal question. What are we doing here?"

"You know what I meant."

"You kidnapped my sister," Archer reminds him.

Derek shakes his head in response. It's not like they saw her frequently, hell Addison and the Captain haven't spoken in literal years, and she's always so wound up around her parents. It's actually nice that no one is going to expect them for weekends in the Hamptons this year, and that they won't cross paths on any of the fundraising circuits. It took her a week to calm down when Bizzy said she looked well. Which was later explained to be a bad thing, even though to this day it sounds like polite small talk to Derek.

"I miss-"

And suddenly Archer is in a heap on the floor, coffee beginning to seep into the hardwood as he convulses, cup scattered into pieces. It takes Derek a second too long to catch on but then he's restraining his head, groping desperately at the counter for his cell phone, liquid scorching his knees.

He's seen his share of seizures in his job, even caused some just so he could map them. But it doesn't happen in his own home, on a random Tuesday, half a grapefruit next to the sink intended for the person on the ground.

"I need an ambulance," he all but screams into his phone, forgetting that he knows how to do this for the briefest of seconds before muscle memory and reflexes finally dare to step in and fill the cavernous void of immediate fear.

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Their house is technically closer to Seattle Presbyterian so that's where the ambulance drops them off, Derek pounding on Archer's still unconscious body and yelling directions as the doors are flung open in the bay. He doesn't have time to take in the smaller space, the different colors or the flurry of doctors that are trying to pull him off his brother-in-law. Finally, when he's sedated, brain still seizing violently, Derek makes proper introductions. Gets permissions to work in the hospital, carefully forgets to mention they are technically related.

Addison isn't listed as Archer's next of kin or emergency contact, which Derek finds surprising and suspicious considering the midnight call they had five years ago when Archer's car service had a run in with a lamp post. He's tasked with calling the Montgomerys, but they are out of the country and it takes a while for them to call him back. His father-in-law wants detail, mother-in-law wants action, but neither one of them can be bothered to book a flight back from Italy and say to call again when he knows more. Knows something is actually what Bizzy says.

Derek finds the CT disturbing and puzzling. Several lesions in the third ventricle, and this can't have been a shock to Archer. He would have been experiencing symptoms for months. Which would explain his presence here in Seattle. And the medication that popped up on the blood work results.

He's dying.

And by the time Derek gets the other scans from New York it looks like it's going to happen sooner rather than later. He decides to call in sick to work, texts Addison and tells her he is in quarantine at the trailer so he doesn't spread any germs and heads to the cafeteria for some coffee and to wrack his brain for a plan.

He can't go to Addison without something figured out. She'll eat him alive.

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Derek looks like he's four seconds from a meltdown when he enters the waiting room, but he measures his breath as he takes the seat next to her, and peers down at the magazine she isn't actually reading. Celebrity babies don't really interest her, not enough anyway to pull her attention away from her husband's clenched jaw and dry hands that are rubbing at his slacks.

Waiting rooms are particularly difficult. It increases her anxiety, watching all these women, in various stages of their pregnancy looking so thrilled, some with other children present. They're doting and warm, doling out toys from magical bags, speaking calm, hushed words that seem to quiet even the craziest children she's seen. They're so intrinsically linked, these mothers and their children, in lockstep.

She doesn't know if she can do that. If she'll be able to anticipate emotions enough to quell imposing tantrums and comfort fussy toddlers. She can do sick babies. Monitor them, will them to continue living through sheer determination and a heady combination of drugs and interventions. She can operate on them when they haven't even made it out into the cold, harsh world. But her own child, seemingly perfectly healthy so far, she's not so sure. Sometimes, she thinks it might be best if the baby somehow wound up in the NICU because at least then she'd be useful at some point in its life.

Derek's always wanted kids. Derek's going to be a great father, she can't argue that. As long as he remembers to come home every once in a while. She's seen him with his nieces and nephews, giving out horsey rides, tickling them while they scream with delight, meticulously building endless Lego sets and train tracks, grinning when his hard work pays off. He'll put band-aids on stuffed animals and make funny voices when he reads bedtime stories, he'll wake up at two in the morning for nightmares and watch ridiculous animated movies. And it will be effortless, as so many things are for him.

He can't comprehend how hard some people have to work at life. He's never out of his element.

He used to tell her she'd be a good mother, that she was good with all of the children she's met, but ninety-seven percent of those kids have been very ill. They agreed on two, preferably a boy and girl. But she knew he wanted more after growing up in a packed house, so in her head she conceded to three and never told him. He has to know she's terrified, he has to know that even if she's working off the best example of her favorite nanny from when she was a child, she's internally five steps away from finding a landmine and exploding.

"Addison."

She turns when he says her name, pulling her out of her reverie. She looks up and sees an exasperated nurse, who has likely been trying to get her attention for some time now. "Sorry," she mumbles to no one in particular and follows them back to the hallway.

Giving the room one last passing glance, melancholy sets in. Maybe one of them, just one, thinks she fits into this role. Maybe they think she's one of them. They're all busy though. On their phones, occupying prying hands, catching up on the latest gossip laid out on shiny pages.

Next time, maybe.

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"Dr. Shepherd," a young man squeaks in front of him. "You-your patient."

"Yes," Derek sighs, irritated. This puzzle cannot be solved. He's called everyone he knows on the East coast, sent the scans over. Everyone is saying it is impossible. He could and will likely kill Archer if he operates, or worse, leave him a shell of what he was beforehand. And if he doesn't operate, there's no telling. He may never come out of this, let alone leave the hospital.

"You said to run everything-"

"Yes," Derek cuts him off.

"Neurocysticercosis sir."

"Parasites?"

"Yes, the MRI confirmed- sir!"

Derek's already snatched the labs back out the resident's hands, and is rushing off in the direction of Archer's room a mere fifty feet away.

"You really go all out, don't you," Derek's mumbling at the body in front of him. Wires run everywhere, a machine is breathing for him, his brain is still continuously seizing causing an unknown amount of damage. "Let's push propofol," he says, pointing at a nurse.

"What about the pressure, his heart-"

"It will stop the seizing, it will give us time," he interrupts the resident again. He really needs a new human on this case. He ponders the possibilities of having Archer transferred to Seattle Grace. Certainly, Derek would be more comfortable there. He knows his team, can find places without a map. Ellis would love the publicity.

But there's only going to be publicity if he can save him. And despite the fact that the lesions have changed from tumors to parasitic cysts, it doesn't change where they are located and how many of them there are. In fact, it might make things more complicated. He realizes he's talking out loud at the same time the machine in front of him indicates Archer's brain is finally resting.

Derek exhales without relief and reaches for the phone in his pocket. It's time to come clean. He asks her over on a consultative basis. He doesn't explain why he's here and not at home resting, ill. He doesn't tell her if he's seen Archer when she asks because she's been trying to reach him.

"Not now Addison, I don't have time for that right now," he laments when she asks another question that he can't focus on. "Look, can you just push your three o'clock and come over here or not?"

She agrees easily. To almost anything he asks of her these days, which is very little. He's trying to leave her as unscathed as possible while he figures out things. He came to Seattle to think, but it's provided precious little clarity on his marital strife and caused enormously painful professional issues.

This might save him, this case, from a medical standpoint. But it might deteriorate his marriage past the point of reconciliation.

Best case, he saves Archer's pathetic excuse for a life and his wife is overjoyed. Worst case, he loses even more credibility and Addison, who can generally separate work and home, will deny him any validation of a good attempt and leave him altogether.

Not exactly the odds he likes to face.

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"Derek," Addison breathes, meeting him at the entrance of the strange hospital. "This better be important."

"This way," he urges, a hand landing on her lower back. She waves her credentials at the front desk staff but no one is paying any attention. They've all been huddled together talking about some new case that came in this morning. "Do you at least have the chart. Who am I talking to here?"

"Just come with me," he rasps.

He's still quiet, face a mask, in the elevator. Derek's always been better than her about not getting attached to patients, but the children, he's always struggled through. She used to find it endearing, that he let her see how much it affected him, he would seek her out for comfort after particularly difficult cases. Her, not Mark. Not activities like drinking oneself into a hole, or drowning in television. But he hasn't come to her in years. It's worrying.

"Derek, what's wrong?"

The ding of their arrival breaks his ability to respond. He didn't look like he wanted to answer her anyway.

He turns sharply, suddenly, facing her. The door behind him is closed and she still doesn't know what she's consulting on.

"I need to know what we are doing here before we go in there Derek, I like to evaluate before I speak to the patient's parents. You know that."

He doesn't reply, ignores her almost, cracking the door. He's hard to read.

Then he's guiding her forward, and she's annoyed that he's going to rope her into something yet again that will be difficult and make her look incompetent, but then Archer is there. In a place he doesn't belong, looking terribly pale and still.

Death like.

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There's a nervous stutter of a breath that he doesn't miss, even though monitors are beeping rhythmically, and there's a whoosh of silence that envelops the nurses that are inside.

Drawn in and almost choked on before it's exhaled.

And she's looking at him, to him.

She clears her throat, gains the composure she lost, checks that the witnesses are none the wiser.

She's always so damn stubborn.

A normal response would warrant some duress, some panic, but not from his wife. She spins back around, her height even with his in the heels she has on, and asks for his chart. She reads it silently, looks at the scans he left carelessly hanging. He doesn't try to interrupt her thought process, there's no point.

A gulp, stifled, and she almost breaks again. Maybe he underestimated her earlier. "What's the plan? What are we doing?"

Imploring, those damn eyes, the strong set of her jaw. The staff busies themselves with leaving the room, privacy, she would appreciate that.

Derek finds himself checking to make sure his shoes are tied before trying to explain, patiently and understandingly that he does not have a plan because no one, including himself thinks that there is anything that can be done. He can reverse the drip, but if Archer starts seizing again it's as good as over. He could slice into his brain but he'd likely rupture one if not all of the sacks trying to remove them and kill Archer. He could start administering antiparasitics with steroids and hope for the best but that could take days. Days that Archer doesn't have.

Derek wishes, not for the first time in his life, that Archer wasn't here.

"ETV-" he hears her in the midst of a mumbling, half coherent tirade on the things he could be trying. But she's out of her depth here. And they both know it.

"I don't know if I can get a shunt in there without rupturing the cysts."

"Derek, you have to do something."

He thinks for a second that she may allow some comforting, he can see the beginnings of tears pricking at the corners of her eyes, but she makes a dash across the room and grabs Archer's hand instead, leaning in close and whispering something he isn't supposed to hear.

Promises they aren't going to be able to keep.

She has her head buried in Archer's side, trying in vain now, to keep it all together. He should be five feet further into the room. He should be consoling her. He should be figuring out how to save a man's life. But he's glued to the floor.

A statue. And the for the longest moment he thinks she has forgotten he's here at all. She dabs at her face with her sleeve, ashamed, because that's how they trained her.

"Thank you for bringing him here, instead."

An odd sentiment. A compliment. On something he didn't even purposefully do, something that was decided for him.

Public forums have never been either of their things. They don't need a stage for this catastrophe. It's been difficult enough to keep up appearances at Seattle Grace.

"Addie, let's go find a room and talk," he decides, grabbing the chart back off the edge of the bed where she left it when she was done.

"I'm good here," she demands.

"Fine."

"You can do this Derek," she tells him, standing, straightening her skirt. "You can help him. I know you can. We worked so hard for so long, this, this is what it's for."

He's dealt with parasites before, a few times. Not as advanced as Archer's case is presenting, not as complicated.

What he wants to say is no. What he wants to tell her is that every single doctor he has talked to in the last few hours has called him crazy for even wanting to try. She doesn't want to hear it though, she is back to clutching her brother's hand and looking at him expectantly.

He shuffles out of the room wordless through the white noise of his wife begging behind him.

She wants a miracle.

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A/N: So Archer's here, but we are borrowing from that fun crossover storyline, and he may not be around for long. And a little bit of Derek's perspective this time, not that it excuses anyone's behavior. I am not a doctor, but the google machine is very insightful. All titles belong to Hammock, which is a nice listen if ever you have the time. Let me know what you think.