He sat in his small closet, an eight by ten foot office, working on the mountain of paperwork he'd been long neglecting. His old oak desk sat perpendicular to the wall that was adjacent to the door. A stained desktop computer several upgrade cycles behind the flow of the world at large sat at the corner of his desk, silent, its main purpose to serve as an extra shelf for things he hadn't yet integrated into the greater disarray. Sometimes, he did use it as a word processor. Sometimes. Two empty, beat up chairs faced him from the other side of the desk, put there as an afterthought for consults, and the rest of the small room was a cascading, tumbling wall of papers, books, leaflets, notepads, memos... Medical journals sat stacked in the corners of the room in no particular order with crumpled, faded sticky notes pointing out articles in the vast mess that he thought were interesting or relevant to his work. His shelves had long been filled to the brim with old research and other things, some of which he'd long forgotten the purpose for. The musty smell of old air circulated with the quiet thumping of the ducts. And the carpet, probably once a vibrant shade of tangerine, lay bleached of color and threadbare on the floor. For all the perks his job offered, his office wasn't one of them, but he felt at home there all the same.

This little cluster of space was his haven of disorganization. The one place in his life that he let be a mess for the sake of being a mess, and a torrential one at that, which was why, in general, he commandeered empty conference rooms for private discussions with future patients. If they saw this… hole, he doubted anyone would ever consider him a capable surgeon, not enough to operate on parts of them like brains and spines and nerve clusters. But he needed this. Needed this space where nothing was ever in control, and he could be lost in it without feeling some strange need for careful composure. It was his chaos place.

The paper he was working on blurred in front of him, and he set his pen down, watched it roll lazily to a stop as it hit the spine of his notepad. He'd been jotting notes for several hours now. Pages and pages of words, hasty diagrams, and other scribbles sprawled across the yellow-lined paper in a latticework, a spider web of theories, observations, practices. This was something he'd let languish for a while in favor of the more active aspects of his job, surgery after surgery. It felt good to get it out of his system, where it had begun to twist around in circles and get confused with other things, other papers he had yet to write.

He leaned back and sighed, working his hands over his shoulders, vaguely surprised at the shooting protests lodged by every sinew as they stretched. The surgery he'd performed in the morning at Dr. Weller's behest had been long and grueling, and he'd been in a world of aches and pains when the ten-hour session had concluded, but usually, by now, those aches would have gone away. Then again, the adrenaline he usually experienced, the wonder as he stood over an open body cavity, knowing that he was one of the few people in the country who was equipped with the knowledge and the skill to do this, to save this life, had been absent, leaving him for the duration of the procedure with an unsettled feeling, like for some reason he didn't fit in his own skin. Didn't belong there.

He'd needed an uncharacteristic break midway through to inhale an espresso and then another break at about the three-quarters point to fight the expanding blur of dulled senses and detachment. He'd never had that happen before. Surgery had always been exhilarating for him. Not quite like good sex, but similar. Today, there'd been no spark. And people had noticed. On top of that, Meredith's phone call had startled him, stabbed him with a bit of sharp, serrated guilt as the sound of her special ring tone had pealed through the operating room. He knew she didn't like waking up alone without an explanation. Dr. Weller, the neurosurgery resident he'd been teaching the procedure to, had asked not once, but twice, if he was all right. He'd laughed it off, blinked it away, but…

He looked up at the soft tap on the open door. "I thought I might find you here," Mark said as he shuffled into the room and took one of the rickety consult seats. He was dressed in his street clothes, a frayed pair of jeans and an old, faded red t-shirt that'd been his favorite for years and years.

"Mark," Derek said, neutral, trying desperately not to inflect the pain that seeing Mark always brought to him. To not let Mark know just how badly scarred Derek had become. To not let Mark know that Derek considered him the living, breathing representative of the fucked up tangle he'd allowed his life to become. It was always a battle, to not let Mark know. A battle that he often failed.

"Want to grab a beer?" Mark asked. "My shift just ended, and you've been here even longer than me."

"No, I don't want to get a beer," Derek snapped. He surreptitiously glanced at his watch for the first time in hours and tried not to betray his surprise at the truth in Mark's words. It was well past 8 PM. He'd been there sixteen hours. Sixteen hours, and it was all an achy, dull blur. The ability to sleep seeming to have abandoned him, after Meredith had finally dozed off, he'd gotten up that morning, showered, and come in to work. Voluntarily. In the pitch black of pre-dawn. He'd needed to… get away. To breathe. To think. To… Something. He hadn't left yet.

"Oh, come on," Mark protested.

Derek glared. "When did I ever give you the impression that grabbing a beer with you was anywhere on my list of priorities?"

Mark switched tactics, the subtle planes of his face shifting from friendly to serious to worried. "How is Meredith?" he asked.

"She's fine," Derek said. He picked up his pen. Made a point of shuffling his papers. "Look, I'm kind of busy here."

Mark ignored his hints. "If she's so fine, then why are you still at work doing voluntary overtime? The ER is as quiet as it ever gets. The OR board is practically blank. And you're still here."

"What business is it of yours?" Derek asked, putting the pen back down. He crossed his arms in front of his chest.

Mark sighed. "Derek, I'm trying here."

"Don't try. Go away."

"No."

"Mark…"

"Look, Derek. I've tried the subtle route already, and it hasn't worked. Come grab a beer with me. You can glower at me and hate me while you drink it, hell, you can even put it on my tab, but I know you well enough to know that you need to talk to someone."

"No."

"Something's got you messed up, man, and it isn't me. Almost dropping a scalpel? Come on… You need a drink. I'm buying. End of story."

Mark stood up, walked around the desk, and yanked Derek's chair back. Then his hands were on Derek's shoulders, pulling him, forcing him away from the desk. Derek's lab coat cut into him in the underarms at the seams as Mark dragged him, mercilessly plowing forward. Derek stumbled, felt his legs tripping around like appendages of a broken marionette as they tried to get purchase for his feet.

"Get off!" Derek said, his voice a low hiss of sudden, overwhelming rage, but he was so surprised at the invasion of his personal space that he was out in the hallway before he dug his feet down in protest. His sneakers shrieked across the floor tiles for a yard or so before Mark came to a halt with a grunt and turned to face him. Mark didn't let go of the handful of lab coat he had clenched in his palm.

Derek reached up and clawed at Mark's fingers, forcing his former friend to release him or risk injury. "Stop trying to fix this, Mark," he growled as he backed away and shook himself off, straightening his skewed lab coat as an afterthought. "You can't fix this. You can't ever fix this."

Mark, unperturbed, said, "I'm not trying to fix anything but you, Derek. You need help, man. And I'm one of the few people who knows you well enough to see that you're drowning."

The words could not have been a harder sucker punch. Derek blinked and froze, froze standing there in the hallway, his face a red blush of rage, rage at Mark, rage at life, rage at everything. He sucked in a breath, sucked in a gasping breath, but it did little to restore his equilibrium. His arm tensed up, bicep straining, wanting to explode, and then he pulled back and released, ramming his closed fist toward Mark's waiting face.

But Mark dodged, easily he dodged, ducking under Derek's swing without word or smirk. He wrapped around Derek's upper torso, and suddenly Derek found himself in a chokehold, gasping. "And I know how you fight, Derek," Mark said. "You bottle shit up and let it whittle away at you, until someone or something pokes you too hard and you blow up. I'm just glad it's at me and not Meredith."

"You don't get to talk about Meredith."

"I wasn't planning on it," Mark said. "But you need to."

And that brought him pause. Pause. A moment of hesitation. A wobble. A hint of toppling before the cliff. "Meredith is fine. She's fine," he said, even as the Technicolor memories bled back into existence.

"Right," Mark replied, though his tone belied the word.

Derek was beyond hearing.

Meredith in the water. Meredith under his hands, dead. Meredith, her lips touching his in the lifeless, hollow kiss of mouth-to-mouth. And suddenly he couldn't think. Couldn't breathe as the fear seized him. He stood, stood in the hallway, panting, frozen, like a deer caught in the haunting glow of an oncoming car at midnight.

"She is. She is. She—" Derek broke off with a pant, his eyes burning, his sight blurred he was so close to losing it entirely.

Snap back. Snap forward. Snap back. He saw Meredith again, floating, hair strewn out from her face in wispy, ethereal streaks, like an angel, floating. He felt the touch of her dead fingers as he swam for her, reached for her. Felt the vomit at the back of his throat when he remembered the hours and hours of waiting, waiting to know whether she would wake up. Felt the inner coil of dread, like snakes writhing in his stomach, when he thought about the second, that one precious second that it had taken Meredith to decide not to fight, that one precious second that told him he couldn't always be there for her, that he couldn't always know that she would be living, breathing, smiling the next time he saw her. Everyone had seconds like that, seconds that defined his or her life, shaped it, or ended it. And she had chosen end, and it scared him witless, even though he thought he understood it, because as much as he did get it, he couldn't ever fix it. She had chosen end, for just one second, and there had been nothing he could do about it. Not. One. Thing. It terrified him, drenched him in the sort of fear that was a churning, sick, awful thing that burgeoned, kept burgeoning, out of control. He couldn't stop it.

"So, do you want to get that drink now?"

Derek watched Mark, watched his former best friend, former brother, felt the roiling, ugly emotions as they bled out of him as if from a wound and left nothing but numb denial behind. He inhaled. Inhaled again. He wanted… He didn't know.

Mark turned, and Derek found himself following. His feet, of their own volition, followed Mark down the hall, into the elevator, out into the drizzle and the night, all while he stood behind his eyes, watching. Watching, but not stopping.

He remembered back when they had been in college. Pre-med school. Mark had been in a motorcycle accident. He'd flipped completely off his bike, tumbled and skidded on the pavement, all while Derek had watched, thinking his heart was stopping. Mark had miraculously stood up, brushed bits of glass and pieces of road debris off his leather jacket, his leather pants, and said, "Wow," as Derek had run up to him. Then he'd stumbled. Fallen. "Probably should have followed the speed limit," Mark had said, had mumbled, "But damn, that was fun," as he'd drifted off into shock and Derek had called the ambulance.

It had always been like that. Derek, always picking up after Mark, the irresponsible lout. Derek, always buying the drinks. Derek, always cursing when he came back to find the sock tied to the dorm room door handle, letting him know that Mark was having his way with another gullible woman.

For the first time ever, Mark led Derek. And Derek watched, numbed, not speaking, trying to figure out what the hell was going on. The world had gone topsy-turvy on him. It was spinning, and he couldn't stop it. He was sitting at a table at Joe's, a foaming pint of Guinness sitting in front of him, untouched, waiting, before he caught up with the world again and time snapped back into focus.

"So what's going on, Derek?" Mark asked.

Derek stared at his drink. Stared. He took a sip. It tasted awful, bitter. His tongue curled. He wondered why he liked Guinness. And then he took another sip. The alcohol plowed through him like a sack of bricks hanging from a pendulum. It was probably bad that he hadn't eaten more than a cracker or three in practically two days. More than two days. Probably bad, yes. Bad. He upturned the tall glass and took a few more chugs, until the world was spinning again, and it had nothing to do with confusion, and everything to do with the warm, fuzzy feeling of bliss that the beginnings of inebriation brought him. That was why he liked Guinness.

But the bliss lasted only for a second before it dragged him, tumbling down, down, down, into the pile of messy feelings, hiding, lurking at the back of his mind, waiting for him to slip up and let them out. Let them out and… The words began to tumble, tumble, tumble, his own free will, blitzed and gone, doing nothing to stop them. He pictured his inhibitions, sitting there somewhere in his head, piled on a lawn chair, sipping a daiquiri, laughing as he made a fool of himself, babbled endlessly to the man who was supposed to be his enemy. The man he hated.

"I can't look at her. Can't look at her without thinking about her dead," he said, and was ashamed at how the words just dribbled out of him. "I can't lose somebody else, Mark. I can't. I don't have anything but her left to lose at this point. You took everything I had, Mark. You took Addison, you took my best friend, you took my life in New York, and you took my marriage, all in one night you took them. And so I moved here, found her, tried to get some semblance of a life back, a life I would enjoy living. But I never came back from that, Mark. I don't have anything except Meredith, and now I can't look at her without feeling sick inside, but I know that if I blink, she might be gone."

He took another deep swig of Guinness, sucked it down, until the pint was gone, and the room started to fuzz up and haze. Halos rimmed the lights. The noises in the bar grew louder. Everyone's laughter pounded on his eardrums in a deep, pulsing throb. And a flush began to spread across his skin. He raised his hand, sort of, and signaled for another pint.

"Newsflash, Derek," Mark growled. "Everything in life that's worth having is something you can lose. Deal with it fast. Because worrying about losing Meredith is totally not worth actually losing her."

"Dn't you think I know that?" Derek said, his voice sounding strangely slurred and lispy to his ears, either because he genuinely couldn't talk, or because his ears weren't on straight. Joe appeared with a fresh, foaming pint of Guinness, and Derek started on it in moments.

"'M a doctor," he continued, clarity degenerating as he took a long draught. "I know what this is. S'traumatic stress."

Mark frowned at him.

"Want to play a round of darts, Derek? Could be therapeutic, beating the crap out of the dartboard with tiny pins."

Derek shook his head, let the world tumble back and forth, back and forth. "You g'ahead," he said. "You always hve t'get your game in."

Mark smirked. "So you do remember some things. We used to be friends, Derek."

"Used to be," Derek said.

Mark wandered off, and Derek took the time to drink some more, and more, until the room blurred so badly it felt like somebody had smeared Vaseline over his eyes, until he didn't dare stand up, because he knew he'd fall over, and he also knew he wouldn't care. For once, the alcohol tearing up his system was welcome. If he drank some more, then he wouldn't care at all about anything. And the temptation of oblivion was a sweet, sweet siren.

He finished off his second drink and raised his hand, signaling Joe for another. The bartender nodded, and a new pint of foaming, bitter Guinness sat in front of him in less than two minutes. He tipped the glass back and inhaled, inhaled, inhaled. The world melted.

"Well that sucked. I think the board was rigged," Mark said, back from his game of darts, sudden, as if he had popped in from thin air.

Derek blinked at him.

"Ordered another round without me? I'm hurt," Mark said with a mock frown. He tilted back his own beer, some imported crap from Austria that Derek had always hated. After taking a long swallow, Mark set his glass down, still his first one, and stared at Derek for a moment. Joviality bled from away from his stare, leaving only a serious, contemplating gaze behind. "So, when did this start?" Mark asked.

"Drinkin'?" Derek asked, momentarily confused. Things had started to move slowly, so slowly, glacially. Colors seemed bright, too bright, painful, sharp, and whenever he moved his head, everything in front of his face hazed in and out.

"No, Derek," Mark said with a smirk. "The stress."

"Dunno." Derek shrugged, his whole body a wave of uncoordinated motion. He felt loose, muted, like every coherent thought was getting rammed through a trash compactor, arriving mangled for him to pick and choose from. He took another swig. "I thought I ws fine. An' then I brought her home."

"And?"

"Had lots of noisy, shouty, great sex. An' by the morning I was in fuckin' pieces. Pieces!" He shot his hand up for emphasis, sort of waved it there mid-air. It dangled listlessly, and then flopped back to the table with a smack. He stared at it, wondering what had made it jump like that. The room spun, and he stopped caring so much about the what and why. Round, and round, on a merry-go-round.

Mark raised an eyebrow. "Derek, you've never been this much of a lightweight. You're not even done with that third pint and you're plastered. Are you okay?"

Derek bobbed his head, marveling that such a little motion could seem so momentous, and slugged the rest of his drink down. He set the glass on the table next to the other two, where it twirled about on its axis and came to rest. He stared, fascinated. "You shdnt drink when you havn't eat'n," Derek slurred. "S'bad to do that. Goes strght t'the head."

"Oh man," Mark said. "When did you last eat?"

"Coupla days," Derek answered, manic, happy, and careening down, down, down. The world fuzzed in and out. And he thought he saw Mark standing in front of him, in a way that totally broke the concept of personal space and fed it to the dogs. The table rushed him, and the last thing he remembered thinking before everything blinked out was that peanuts stank, the tablecloth was awfully sticky, and he didn't care one lick about it.