Thank you for the lovely reviews you've left, the feedback really keeps me going! I especially want to thank casfics; your review made me cry a little bit (in a good way, don't worry!)
Disclaimer - in the first part of this chapter, I'm quite blunt about mental health. It is purely based on my own experiences; I know that everyone experiences MH differently and you may disagree with the way I've described it.
In this chapter, I reference an old episode, S25E34, 'Momentum,' because it's relevant, but the chapter will still make sense if you haven't seen it - although I recommend it if you're like me and enjoy a bit of Dylan angst!
And finally, the flashback part of this chapter is set at Christmas… I make no apologies for misplaced festivity (or lack of festivity, as you will read shortly!)
Holby, Autumn 2017
On reflection, Obsessive Compulsive Disorder was not creeping back into Dylan's life. It was thundering towards him like a runaway train; as though he was the stereotypical weak character in an old western film, tied to the tracks waiting powerlessly to be decimated by his uncontrollable psychological condition. It was a matter of when, not if.
His mental health, or lack thereof, was a shapeshifter. It always had been. It was a small consolation that in recent years, his experience of mental illness had not been inextricably linked to situations with Sam in them. At least he could reflect on these newer memories without the nostalgia, resentment and (although he didn't approve in the least) bittersweet happiness that accompanied thinking about Sam.
Back at King's, before he was really conscious of the enemy inside his head, he had tapped things as an outlet for the stress he had felt. He had tried to fool himself as much as he had everyone else, telling himself that stress was all it was. Unfortunately, other people had been far easier to convince. If only had been as simple as 'just' tapping things. He could recall the thoughts as clearly as if they were happening at the present moment. It wasn't a voice, not as such, but with its urgent clarity it might as well have been one. An irresistible order, generally without rhyme or reason. Tap the defib three times, or the next time it won't work and your patient will die. There wasn't a pattern to the numbers, either. It could be anything from one to twenty or so. One day stood out in his mind: the day that Sam's cohort of F1's was due to leave and her paperwork was the last outstanding and incomplete. He had been compelled the click the top of his pen top twenty-eight times. Keeping count had been an utter nightmare, especially with the distraction of Sam herself, leaning lazily (or, more accurately, leaning with great relief) against the back of his office door, carefully but swiftly working her hair free of its tight French plait.
Looking around his boat's compact living room, it was a relief that his past obsessive need for symmetry had also passed. It was simply out of the question now, considering Dervla's important but messy presence. Although, 'messy' did her something of a disservice. She had never emptied a bin or rolled in freshly-mown grass to traipse it through the boat. As dogs went, Dylan thought himself quite lucky.
It was also true that he was over his obsessional fear of the number four, that "awful business" as it had once been crassly described to him.
No, these days, his mental state was characterised by deep, constant unease. That he'd suffered the blow of a panic attack in the ED was a grating and lasting source of embarrassment. At least, when that had happened, he had had an ally in David. Someone who understood what it was like to be let down by your brain. It was (another) worry, now that he had pushed David away too, that next time he panicked like that he would have no-one.
But there was a lingering question - did David understand at all? Sure, he had a bank of mental health experience, but he didn't know Dylan's whole truth. David had assured Dylan that Cal's death had been nobody's fault but Scott Ellison's, least of all Dylan's fault. But what David was missing was the knowledge that Dylan had a precedent with death by stabbing. His past in this area was now concealed, shrouded in silence because the last person to have been there on that day and to care about him in any capacity, was now three thousand, six hundred and forty-two miles away. Seven years ago, Zoe had done her best to convince Dylan that he was not omnipotently complicit in the 'accidental' murder of Polly Emmerson. He had barely taken the care to learn her name at the time, but after the promising young paramedic (whose warm heart would ultimately cause her untimely end) had lost her life at the hand of a mental distressed patient whom Dylan had tried to ignore at every opportunity…
Dylan squeezed his hands into fists, feeling his fingernails dig into his palms. His thoughts were accelerating.
The name Polly Emmerson was etched onto his memory as a life he should have been able to save, alongside a host of others.
He had been offered counselling after Cal died. He had refused it, and no-one had pursued his insistence that he had compartmentalised and moved on. It was far more necessary that everyone rally around Ethan; a grief-stricken brother was more important than a (secretly) mentally ill consultant. If Zoe had still been part of the ED team, she might well have argued otherwise.
Having been ensnared by addiction to varying degrees for many years, it didn't baffle Dylan that he was still drawn to and intoxicated by the electricity of the ED atmosphere, despite it throwing him one traumatic event after another. When he wasn't been battered by its impact, he was good at it, picking apart mysteries and fixing people.
At that moment, Dylan was seated in his living room. A vinyl record played classical music in the background, an untouched cup of coffee sat on the table in front of him and a thick paperback book was propped in his lap. But he hadn't read a word in some time and hadn't been concentrating on the book for far longer. How could he concentrate when he had broken his most important rule?
The blue striped carrier bag by the door contained a large bottle of whiskey. He hadn't kept alcohol on the boat in years, not since Zoe had moved out and he could no longer trust himself to self-regulate anymore. It had been so much easier when he wasn't alone - Zoe would usually drink wine and although it was always about, he hadn't always been compelled to drink it. While she was there, keeping him right, he had considered himself a successfully recovered alcoholic.
Now, staring with a judicious glare at the bag, he was certain that this was no longer the care.
In the ED the next morning, Dylan (accompanied by that old, familiar pounding headache) was certain that everyone was talking about him. It wasn't really a surprise - he should have expected to be one-half of the new rumours. Perhaps it was the hangover making him react so strongly to it. His intense introversion made this a very private reaction, but it was a reaction nonetheless.
He met an ambulance patient at the door and followed them into resus, listening intently to Sam's handover. It was difficult to separate her in this new capacity from everything that he already knew about her, and equally, everything that he did not know. Her handover was absolutely flawless, not a single stumble on her words or even a moment's pause for breath as she faultlessly reeled off the patient's injuries and statistics. She met his eyes for less than three seconds on arrival, an expression of wonder evident in her glance, before continuing as if it had been any other doctor taking the patient.
It was of no question in Dylan's mind that her time both in military trauma medicine and on the other side of the handover in British hospitals had contributed greatly to her professional perfection.
When she had finished, she looked up at Dylan again for his approval. She blinked once, and he found himself irresistibly drawn to her long eyelashes, as though they were back at King's all those years ago and he was noticing for the first time just how pretty she really was.
But in truth, he was stunned by her ability, momentarily silenced by her handover.
Sam was still staring at him, impatience growing. She wanted to tell him to put his tongue back in (metaphorically of course) because they weren't anything anymore. But out loud, she cleared her throat.
"Alright?"
Dylan blustered. "Yes, of-of course. Um, thank you," he added before Sam dismissed herself and Iain from resus.
When was the last time he had ever thanked a paramedic for their handover?
Damn her, for being so professionally attractive!
Catterick Garrison, 18th December 2009
Christmas had never been Dylan's favourite time of year, there having been too many unpleasant festive experiences in his childhood. His mother had loved it, painstakingly decorating the house and going to every effort to play happy families. She tried so hard, year in year out. Every year, it would be spoilt: a drunken rage sending the tree flying, a conspicuous absence, a blossoming bruise or a split lip.
But Sam loved Christmas too. She was almost childish in her enthusiasm for the season. Every letter since mid-November (plus the singular phone call she had managed at the end of that month) had been fizzing with anticipation of coming home for Christmas. She'd been slowly bringing him around to liking it too; he'd found himself looking forward to the twenty-fifth almost as much as he looked forward to the day she was flying home.
General Practice in the country didn't compare to emergencies and trauma in London, that much was certain. But this was a necessity, something that he had to do to remain a constant in her life. It was a necessity, but that didn't stop it occasionally becoming mind-numbingly boring, listening to small-talk and gripes, prescribing paracetamol and advising bed rest to people who never listened anyway. Emergency medicine was all pushing and pulling but it was ever-changing, and rare were the occasions when patients would come back and demand continuity of care. All that aside, there was something strangely pleasant about being known, and being cared about even in a minor way by those who recognised him at once as Major Nicholls' husband. There was immense pride in telling people exactly why he had come to work in a GP surgery on an army patch.
This patient was proving a little more interesting than the rest, and a little more like what he had been used to in London. Of course, there were limitations on the tests Dylan could run from here, and the timescale on these was vastly longer than he would have liked, but a mystery was not something he would turn his nose up at, under any circumstances.
So it was a source of great irritation when Margaret, one of the clinic's secretaries, knocked at the door of Dylan's consultation room and opened it without even waiting for confirmation that she could enter. She was in her mid-sixties, with flyaway hair slowly turning grey and her spectacles balanced on the top of her head. She was firm, and took none of Dylan's more unkind acerbity. But she was also kind; an army widow of many years who had never left the area, preferring to give back to the community which had at one point kept her in one piece.
"Dr Keogh, there's a phone call for you in the office," she said, ignoring the scowl which had been sent her way.
"Can't it wait? I'm a little busy," Dylan said, looking back to his patient.
"Dylan." That had got his attention. "Would I interrupt you with a patient if it wasn't important? You wound me. It's an international call."
Dylan stood up from his desk immediately and walked from the room without another word. He didn't think twice about his patient, who had shrugged off the whole thing. International call was an accepted euphemism around here, for a call from deployed personnel. Everyone knew that they were few and far between, and never without good reason. You didn't say no to those calls.
In the surgery's office, there was one thing between Dylan and the phone, and that was a young woman filing her nails at the door.
"Move," Dylan said, standing in front of her, all pleasantries and manners going out the window.
"I don't think so," the woman replied, eyeing the few people in the waiting room who were eagerly listening in. "I've been trying to get an appointment since the middle of last week, and there's been 'no-one' to see me."
"That's because it's the week before Christmas and all of the lucky GP's who aren't here, have had their significant others sent home." His temper was rising, and with this, his defensive silence was falling. "Excuse us for wanting a little time with people whom we don't get to see, and who risk their lives just by doing their jobs. My wife is on the phone, her name is Major Samantha Nicholls and she is deployed in Helmand Province. I hear her voice once a month, at best, so I would thank you to get out of my way."
This was the downside to working in a surgery on the outskirts of a patch. There were patients who simply didn't understand. Looking abashed, the woman stepped aside, allowing Dylan into the office. He slammed the door behind him.
"Sam?" he said, seizing the phone and sitting down heavily. He hoped that with his delay, she hadn't had to abandon the call altogether. "Are you still there?"
"Of course I am," came her reply. Usually, when she called, Dylan could practically hear her smiling. The absence of this addition to her voice alerted him to the fact that all was not well. "Wouldn't dream of dragging Dr Grumpy out of an appointment just to hang up again." She was cracking jokes, how could she possibly not sound happy? She teased him all the time, always with at least half a smile.
"What's the matter?" he pressed, holding the phone to his ear but resting his elbow on the table. He closed his eyes, hoping that it wasn't anything too terrible. But then, why wouldn't she wait? She was flying home in two days - unless that was why she was calling.
"I don't even know how -" Her voice cracked. Was she crying?
"No, no, no," Dylan said at once, swallowing the lump in his throat to step up as the husband she needed him to be. "Please, please, don't cry. Whatever it is, I know that you can handle it."
There was a sound of static that Dylan assumed to be Sam running a hand through her hair, although this didn't stop the moment of fear that the call would be cut off unexpectedly. "Sorry," she said.
"You don't have to apologise."
"Right - just, oh for God's sake, I'll have to just come out with it. I'm not coming home for Christmas."
Dylan dropped the phone. It clattered onto the desk and slipped off it, dangling by its curled cord. He felt sick, that awful stomach lurch that came with slipping off the bottom stair or jolting awake in the middle of the night. In the middle of this chaos, there was Sam's voice, calling down the phone still.
"Dylan? Are you alright? Say something."
He picked up the phone. "I'm fine," he said hollowly, knowing that he didn't sound fine and that Sam wouldn't believe that he was fine either. "I have to be," he affirmed. "It wouldn't be without reason."
"No, you're right," Sam replied, sighing. "We - um - we lost three of the lads out of the unit yesterday. That's why I have to stay."
"I'm really sorry about that," Dylan said, realising that somewhere along the line he must have picked up some social graces because he had just thrown her a platitude he usually detested. "Look, I'm sure you did everything you could, this doesn't change anything about you as a doctor."
"I know!" Sam snapped. "But that doesn't change that it happened, does it?!" She paused. "I'm sorry for shouting at you. I just really wanted to come home, and to have our first proper Christmas."
"What was last year, a dress rehearsal?"
"Oh shut up," Sam said, and at last Dylan could hear just a hint of a smile in her words. "Our first married Christmas, I mean."
"I knew what you mean," Dylan conceded, instinctively turning his wedding band on his finger as he spoke. "I just wanted to say something that might make you a little bit more cheerful."
"You're an idiot," Sam said. But she laughed too, even though it wasn't the time to be cheerful, or laughing.
"I know." Silence. "I've missed you."
"I've missed you too, more than I ever thought I would. I want to wake up on Christmas morning beside you and know that it's cold outside but we don't have to go anywhere. I want to open Christmas presents with you, in our house, not in the Officers' Mess."
At that moment, Dylan's heart sank all over again. The last posting date for forces mail to arrive by Christmas Day was 28th November. He hadn't sent anything because Sam was supposed to come home.
After reluctantly ending the phone call, Dylan let himself out of the office and walked back to his consulting room in silence. His disappointment must have been written all over him because no-one broke his stride.
Behind the safety of his closed door, Dylan pulled the tinsel from the door frame (his feeble attempt to avoid being called a grinch) and threw it into the bin so he didn't have to look at it. It didn't feel much like Christmas anymore. He paced the room, hands at the back of his neck, trying to return his face to his expression of neutrality that everyone here had come to expect. But it was impossible.
He didn't cry until his brain started to convince him that he needed a drink.
There came a cautious knock at the door, and he swung it open straight away, perhaps more forcefully than was necessary.
"Was it bad news?" It was Margaret, of course it was. No-one else would have dared to come anywhere near him with the possibility of him being in a bad mood.
Perhaps his lack of brash response was more telling than anything he said. "No - not bad. I mean, yes, bad, but Sam's fine. She's just had her leave cancelled, that's all."
The older woman reached out a hand to Dylan's shoulder. "I'm sorry, that's not what you needed to hear today, is it?"
Dylan just shook his head. He pinched the bridge of his nose. "You can cancel the on-call cover for the twenty-fifth. I'll do it."
"Are you sure? If I were you, I'd take the day anyway and just have it off, regardless of -"
"No, I will take the on-call. I can do more good doing that; I categorically do not want to sit in an empty house doing nothing when everyone else is having their Christmas."
He bought a large bottle of whiskey on his way home that night, the only way to quiet the OCD that had landed back in his brain with such ease that it felt as though it had never left.
