Warning: please be aware that this chapter contains material that some readers may find disturbing.

Chapter 10, All Hell Broke and Finally Took Its Toll

"There you are!"

When he heard the soft, familiar voice and felt her crouch down next to him, Mark hesitated, not sure if he wanted to react. He didn't know if he wanted her there. He thought, really, all he wanted was to be left alone. But someone was going to come eventually, and very probably someone less comforting and less safe than Callie Torres.

"Callie." His voice cracked as he said her name and he swallowed and cleared his throat, before looking cautiously into her warm, brown eyes

"Hey, Mark." She put a tentative hand on his arm and smiled. "So I have an interesting new patient, sitting in exam room 4 and yelling about you to anyone who'll listen." The concern that was vying in her expression with mild amusement got the upper hand, and she rubbed his arm gently. "Are you okay?"

He nodded and hung his head. "I guess." Then, for no good reason, he added, "I'm sorry."

Callie raised her eyebrows and made a little, ironic kissing sound with her lips. "I don't think it's me you should be apologizing to. The guy's pissed. You know he wants to file a complaint?"

Mark nodded again.

"I sent him for x-rays." She laughed slightly. "I told him they were backed up down there, and Grey's going to hold onto the films until I get back—"

"Grey?" he interrupted, slightly panicked. "You mean Meredith?"

"No. Lexie. The intern, remember? The one you called stupid." Callie studied him, before sighing and going on. "I'm guessing it's a simple fracture, but there could be some cartilage damage. I won't know for sure until I get the films back." She gave a quick, nervous grin. "Anyways, I doubt he'll be asking for a nose job any time soon. At least not from you!"

"Shit! I have a rhinoplasty scheduled this afternoon. I forgot." Mark half got up, then slumped back down, because the effort of dealing with his life right now was beyond him. He looked at his watch. It was 2:00 pm. He sighed. "Karev'll prep her," he said, mostly to himself. "Won't matter if I scrub in a little late."

"You're going to scrub in?" Callie asked. Apart from the obvious fact that punching out nurses wasn't exactly normal behavior, everything about him worried her. She glanced up at the sky and then down at her dampened scrubs. "You think maybe you should get out of this rain first?"

"Huh?" he asked, then looked down at himself and registered for the first time that the rain had gotten heavier and that he was half soaked. "It's raining," he said and shook his head, bemused. "I guess I hadn't noticed."

"Well, it's Seattle. Raining all the time," Callie joked, eyeing Mark uneasily as she stood up and smoothed down her scrubs. She reached out a hand to him. "Come inside and dry off."

As wet and miserable as it was outside, Mark wasn't sure that he wanted to go back into the hospital. But he would have to some time and over the past few minutes he'd gotten used to Callie's presence and he didn't want her go in and leave him behind. Her friendship made him feel connected to something. He felt as though, if she went away, he would just fade away into his own depression. And as much as part of him wanted that, another part wanted to cling onto the hope her presence gave him. Hope of what, he didn't know; hope of something he wasn't quite ready to let go of, but couldn't hold onto by himself.

"The Chief must be looking for me by now," he said, looking up.

Callie gave a little shrug. "If the gossip got to him already, which is possible I guess, knowing this place. But I'm the surgeon in charge of nurse-boy's case, and I haven't informed him yet." She waggled her fingers in his direction. "Come on, Mark. Come inside with me and get dry. I have to get back to the guy. Plus I'm scrubbing in with Shepherd this afternoon."

Mark held out his right hand to meet hers, putting his left on the ground to push himself up. But, instead of taking his hand, Callie stopped dead. "Oh my God! That must hurt like hell? Let me see!" She rushed around to his right side, knelt down and placed his hand on her palm.

"Shit, I didn't . . ." He shrugged helplessly. His hand was bruised and swollen and, under Callie's scrutiny and careful examination, he felt the stinging ache for the first time. "I didn't notice." He couldn't explain why. Maybe it was adrenaline; maybe just that he could care less what happened to him, he had no idea.

"Swelling and lac over the dorsum of the MP joint," Callie muttered to herself, then stared at him almost accusingly. "You realize that could mean a fracture, right? On your right hand, for God's sake." She shook her head. "What the hell were you thinking? I can't even flex your fingers until I've gotten an x-ray, 'cause I don't know what damage I might be doing to the — what was it again? — best plastic surgeon on the East coast."

"Seattle, you mean," he muttered. But Callie ignored him and suddenly the significance of what he'd done dawned on him. "You think it could be broken?" he asked, with a vulnerability that made her stop what she was doing and stare at him.

"The injury you have could suggest a fracture. It's not likely, but it's possible and we need to be sure." She let go of his hand slowly and stood up again. Smiling, wanting to seem practical and reassuring, she said, "So you need to get your ass up off the ground and come inside with me. Now." She held out a hand again, this time directing it towards his left side.

Mark took it and got up carefully, trying not to put all his weight on her. He groaned as his stiff muscles and joints protested at the movement and, just as he got upright, stumbled a little.

"You okay?" Callie asked softly. Every next thing Mark did increased her concern for him. More was going on here than a hand injury, but that had to be her first priority. It was also her comfort zone.

He rubbed his face and gave her a vague, questioning look. "Yeah," he said, "I'm good." Then he focused a little more and added, "Thank you. I . . ." He shook his head, self-expression eluding him. "Just thank you, I guess."

Callie threaded her right arm through his left and, keeping close to him, guided him towards the hospital entrance. "Let's get you inside," she said.

Alex slammed his tray down on the cafeteria table, where Cristina was picking at her salad and pretending to read a journal, and slumped down in the chair opposite her. She ignored him.

"Fucking Sloan!" he erupted and then picked up a sandwich and stuffed half of it in his mouth, before adding, indistinctly, through a mouthful of food, "Fucking attendings, fucking screwing with your mind!"

Cristina glanced at him briefly and rolled her eyes.

"You think you're getting somewhere." Alex threw the remains of the sandwich down on the tray. "Then they bail on you and go to L.A. or have a fucking mid-life crisis."

"Sloan's having a mid-life crisis?" Cristina asked, suddenly interested. Even if Meredith refused to tell her what was going on, maybe Alex's ranting would reveal something. "Does that mean he cheated?"

Alex snorted. "Who the hell knows what he did. All I know is that he's lost it."

"Lost it how?"

He opened his bottle of water and took a drink, replacing the cap as he said quietly, "I liked neonatal, you know? Not just because of —" He shook his head. "Never mind." It wasn't just because of Addison; he'd genuinely liked the work and he'd been good at it. "I only said I wanted in on his surgery the first time because I felt sorry for him. Because of the cancer." He sighed. This was only partly true. He'd wanted the surgery, more or less; but it felt better, right now, to believe that he might not have.

Cristina put down her journal impatiently. "Alex."

"What?"

"The only reason I'm sitting through this is for Meredith's sake. So, if you insist on talking, more about Sloan and less about you."

"He didn't say anything about Meredith," Alex muttered morosely. "They broke up, right?"

Cristina nodded.

"Figures." He shook his head as his mind returned to his own problems. "But then he kept requesting me and I got to like it. I didn't even want to go into plastics. Not once I'd tried neonatal. But I got to like it. I like the procedures; the precision. I like what it does for people. And I get to be a part of that. I could be that guy one day." He sighed, stood up and picked up his tray. "Whatever. Maybe I should go to New York."

Without bothering to find out what he meant by this, Cristina asked, "Are you scrubbing in with him this afternoon?" She thought perhaps she could convince Alex to find something out.

"Supposed to be." After this morning's screw-up, Alex wasn't sure where he stood with Mark, but so far no changes had been made to the roster. "Last time I saw him I told him he should see a shrink and he walked out."

Cristina let out a laugh. "A shrink? Seriously? Although, didn't he see one before?" It was ages ago, when Mark first came to Seattle and they'd stood watching an unfamiliar, hot man suture his own face, but Cristina vaguely remembered Meredith mentioning something about a shrink.

"Well, if he did, it didn't work." He started to go and then half-turned back. "Thanks for listening, Yang."

She raised an eyebrow. "I wasn't listening," she said. "I was present while you complained." She put her head on one side and looked at him. "Since when do you care about Mark Sloan?"

Alex shook his head. "I don't care about him," he said defensively. Because he did care, more than he wanted to. "He's screwing with my life, that's all." He shrugged, trying to cover up the feeling he knew had shown in his voice. He felt like the rug was being pulled out from under him. Mark was his mentor. Mark and Meredith having a good thing going on made him feel kind of hopeful. And like Meredith, Mark made him feel that screwed up people had a chance. But now all that certainty was fading. "I have to prep the patient," he muttered, walking away before Cristina had a chance to ask him to get details.

Mark sat on the exam room table with his head bowed, barely responding to Callie's attempts at soothing banter as she cleaned the wound on his hand. They had stopped for x-rays on the way in, Callie hastily compiling a chart beforehand, and now they were waiting for the results.

Well, Callie was. Mark didn't really care, even though he knew he ought to. He ought to be praying that his hand wasn't fractured, that there was no tendon damage, anything that could screw him up as a surgeon. He ought to be worried about the asshole's complaint. But he couldn't make himself. His mind was swamped by a kind of numbing, muffling absence. He tried to fight through it, to try and pay attention to Callie and think about what was happening to him. But then he was assailed by fear and by images of Meredith that killed him.

Callie stripped off her surgical gloves and threw these and the gauze she had been using into the medical waste bin, then noticed that the exam room blinds were still open. "Shit!" she said softly, and walked over and closed them, relieved to find that it was a rare day at Seattle Grace when everyone was too busy to stare.

"You want to talk about it?" she asked, moving back to the exam table. "While we wait for your films?"

Mark shook his head, not looking at her.

"'Cause it seems like something more is going on here than a busted hand," she ventured. Her eyes widened and she stared at him. "Oh, God, I wasn't thinking. The cancer's not worse, is it?"

He gave a soft, dry laugh. "No." He shook his head again. "I'm in remission."

"Oh, wow! Wow! That's so great!" She broke into a relieved laugh and pushed his arm gently.

"I guess," he said gruffly.

"Well, of course it's good!" Callie exclaimed, trying to elicit a positive response from him. "I'm so pleased for you. I . . . " She ran out of steam, defeated by his total lack of engagement, and then asked, in a quieter voice, "It's good, right?"

Mark sighed. "Yeah, it's good. Of course it is." He inhaled. "I didn't want to do it any more," he said, still not looking at her, his voice very low and very quiet. "I was a wreck. I was a wreck and then I got sick and I didn't want to do it anymore. It seemed like the easy way out." He paused. "She changed everything. Meredith changed everything. Just because she liked me. And I . . ." He looked into Callie's eyes. "I screwed it up. Like always. So," he dropped his gaze to his hands again and shook his head. "I guess it's good. It fucking should be. It was. It is. But . . ." He sighed.

Completely at a loss, Callie smiled and touched his arm again. "She'll come back, Mark. I've seen you together. It'll be fine." But she kicked herself for the lame-ass words. Her friendship with Mark was mostly teasing and flirting, but underneath that, it went deeper and she wished she had a better response to this. But she didn't know what to say. Not least because her doctor's training kept prompting her that, if this was an ordinary patient, not the Head of Plastics and her friend, she would be getting a psych consult right about now. But this was Mark and she couldn't accept that, so she pushed it to the back of her mind. "It'll be okay," she insisted with false brightness. "You'll work it out, and—"

"I just couldn't see it," he broke in, and looked into her eyes again, so desperately that Callie's heart ached for him. "She wanted . . . and I couldn't . . . " He faltered and sighed. "I hurt her, Cal. I hurt her, worse than I've ever hurt anyone. I hurt her because I thought she —" He shrugged hopelessly. Nothing he had done made any sense. "I don't know what the hell I thought. I made a huge fucking mistake and I don't know how to live with that."

"You slept with someone?"

He shook his head miserably. "No. Not this time. But cheating's not the only way to destroy someone; destroy their trust."

Callie swallowed awkwardly. Mark had always used sex when he was feeling bad, or good for that matter, or for no real reason at all; and she was lonely and he had broken up with Meredith; and she'd been thinking about him the last few days, ever since that encounter in the elevator. Maybe it was worth a try. Maybe it would help him. "You know," she said uncertainly. "If you, you know, need someone. I'm single now and I know what I said before, but, we could . . ." she shrugged meaningfully. "If you want to."

At first, Mark just stared at her with narrowed eyes and, realizing how inappropriate she had been, Callie began to gabble an apology. "God, I'm sorry," she said, blushing, and pushed her hands through her hair. "That was just wrong. Out of line. What was I . . . ? I'm so—"

Out of nowhere, he cupped her face firmly between his hands. "Don't talk," he growled, and pulling her towards him, roughly parted her lips with his tongue and kissed her fiercely, forcing her to kiss him back, until she managed to pull away.

"I didn't mean now!" His hands were still holding her face and she pushed him off. "Grey's going to be here with your x-rays any time now. Not to mention that your punching bag's waiting down the hallway. Seriously, Mark! And," she licked her lips with distaste, "you taste of tobacco, which is kind of disgusting." She rolled her eyes.

"You were right though," he said, only half to her. "Get back on the horse. Fuck like rabbits." He raised an eyebrow and laughed sleazily. "I thought you said it was dirty with me? Guess you must like it that way."

"Mark!" He was really scaring her now and all the thoughts about psych consults were bombarding her brain. "Just stop, okay? We can talk later. But right now, we just need to calm down." But he didn't appear to hear her.

"Once a manwhore, always a manwhore, right?" he muttered, ignoring Callie and focusing only on his own thoughts. When did he last say that? Addison. When Addison left him; when he let her leave him. "Addison said she loved me, but all she wanted was sex. A quick, dirty fuck when she was feeling neglected. She loved Derek, though. She loved Derek and she screwed me." He gave one, humorless laugh. "You know what, Cal? You can have all the sex you want, but all it gets you is more sex, until you can't do without it. Until however much you have, it's never enough. Until that's all you're good for."

He became aware for the first time that Callie was staring at him, obviously worried, and some part of him realized what he had just subjected her to.

"Callie," he said in a gentle, conciliatory voice. "Callie, I'm sorry." He looked pleadingly at her for forgiveness and, eventually, she took a step towards him.

"What happened between you and Meredith?" she asked softly, trying to make some kind of sense out of his outburst.

He shook his head slightly. "She just wanted to talk," he said. "About my family, and —" he stopped abruptly. Images suddenly flooded his mind and he knew for the first time what they were. But he couldn't talk any longer, because what he saw stopped his voice. He had no words for this. He watched — because it felt like watching a grotesque slideshow, but a slideshow he was part of as well as observing — as the blonde girl came towards him, smiling, dangling a champagne glass, laughing. She bent down towards him and lurched a little and spilled some champagne, then wiped it into his skin with her hand. He could smell the alcohol and hear her laughing and then she got closer and her hand pressed against him.

"Mark?" He heard Callie's voice from somewhere that seemed distant and to have nothing to do with him. "Grey's here with your x-rays. It looks as though your hand is okay."

But he couldn't respond. The bile rose in his throat as he felt the girl touch him and he recoiled at the childish, unknowing remembered pleasure of it.

"Jesus," he muttered. "Derek was right. She was —" He couldn't bring himself to say it; couldn't bring himself to acknowledge that even she, the bitch that she was, would do this to a child. Do this to her child. Him.

"Grey, would you excuse us?" he heard Callie say, then a murmured acquiescence as the door opened and closed again.

But all he could see was the images, the series of violations his mind presented to him, one after the other; his mother touching him, making him touch her and . . . flecks of black tried to cloud his eyes and his blood pounded in his ears as his body tried to shut down. But he fought against it, because he had to remember. He had to make himself. And finally his head cleared and he found himself looking at Callie.

"I don't want to say this," she said tentatively. "And I'm giving you a heads up because, well, you're you and you deserve that much. But maybe we should see about getting a psych consult."

"Derek was right." He took a long, wracking breath and shook his head, utterly defeated. "I was a kid. I was just a kid and she—" But there was no way he could tell her. He took another breath and then took in his surroundings. "I have to get out of here," he said and stood up.

"Mark, you're in no condition —"

"Sshhh," he interrupted Callie gently and briefly touched her hand. "I'll be fine. I just have to get out of here. I just need some time to think." He smiled at her. "Thank you. You're a good friend." Then he opened the door and left without another word.

"Ah, Dr. Torres," Derek smiled pleasantly as he signed the chart he was holding and handed it back to the nurse. "All ready for this afternoon's DCS implantation?"

"Not exactly," Callie shook her head. "I need to talk to you," she said urgently.

"Not exactly? We've had this procedure scheduled for weeks." He raised an eyebrow. "Care to tell me what 'not exactly' means?"

Callie glanced surreptitiously at the nurse, trying to indicate they needed to go somewhere private. Her prevarication irritated Derek but, despite this, he put a hand on her arm and ushered her towards a corner away from the nurses' station.

"There's something wrong with Mark," she said. "You need to do something. Because I tried. But I have no idea what's going on with him. He needs to see someone and it would probably be better coming from you."

Derek nodded slowly. Certainly Mark's behavior had worried him yesterday, but nothing quite this urgent.

"I talked to him yesterday and I agree with you. He seems," he searched for a term, "distracted . . . tired. But I'm sure it can wait until after our DCS. I'll check in with him —" He broke off and raised an eyebrow questioningly, as she shook her head. "It really can't wait?"

"There's something going on with him," she said. "He punched out some idiot, outside the hospital." Derek's eyes widened. "And I found him out there, in the rain, with what could easily have been a fracture to his hand."

"He fractured his hand?"

"No. But he could have, and he didn't even seem to care much." She took a deep breath. "His responses are off. He's disoriented. In the exam room, he started talking to himself. I shouldn't have let him leave. But what the hell was I supposed to do? How do I call in a psychiatrist for Mark Sloan?" She rubbed her eye with the heel of her hand and sighed. "Except I should have. I made a wrong call. And I couldn't think of anyone to tell except you."

"What about Meredith?" Derek asked.

"They broke up," she said and Derek raised an eyebrow. "I think that may be part of the problem."

Derek nodded. "Where is he now?" he asked.

"That's just it," she said. "He left. He said some stuff about me being a good friend and that he had to think and he left. And I don't think he should be alone right now."

Derek shook his head reassuringly. "He wouldn't do anything stupid," he said. "You don't have to worry."

"Have you been listening?" Callie demanded. "He's not rational. He hardly knows where he is. And I wouldn't be so sure."

He stared at her for a few seconds, his eyes roaming over her face as he thought. "Push the surgery back an hour," he said finally. "I'll try to find him and I'll let you know."

"Dr. Karev." Richard Webber strode into OR2, holding a surgical mask in front of his face. "Where's Dr. Sloan?"

Alex sighed. He'd been waiting here for fifteen minutes now, with a prepped patient, a pissed off anesthesiologist and two nurses. It wasn't a complex procedure; a minor open rhinoplasty, that's all. But it was rapidly becoming a fuck-up and all these people seemed to hold him personally responsible for Mark's absence.

"I have no idea," Alex snapped, adding, "sir" as an afterthought.

Richard sighed. "Yesterday's mess — the one I spent my morning digging you out of — wasn't sufficient for one day?"

"Wasn't my mess," Alex muttered, feeling put on the spot, then said, "Sorry," but Richard ignored him.

"Dr. Gregory," he said to the anesthesiologist. "Bring the patient out of anesthesia. Karev, find Dr. Sloan and tell him to come to my office immediately."

Alex pointed to the patient. "If I found him," he said, "couldn't he scrub in first?" He had to make some effort to stand up for Mark.

Richard eyed him impatiently. "Just tell him to come to my office," he repeated. "Until he's seen me and explained his actions, Dr. Sloan no longer has surgical privileges in my hospital. You can tell him that too when you find him. After that, have Dr. Bailey assign you somewhere else."

After what Callie had said, Derek decided that paging Mark wasn't a good option and tried to call him on his cell phone, hanging up when the ringtone turned into Mark's gruff, impersonal voicemail message. Reluctant to wander through the hospital without a plan, he tried to mentally list places where Mark might be.

When they were younger, especially when they were kids, Mark had a tendency to go off by himself when things were going badly. Derek would sometimes find him in the dusty old boathouse on his parents' property or hiding out in the tree house they had built with Derek's dad. Of course, Mark always claimed that nothing was wrong, but Derek would sit with him anyway and occasionally Mark would talk.

Mark rarely used his office at Seattle Grace, but Derek figured that this might be where he would choose to go in a crisis. And it turned out he was right.

The room was dim. Mark hadn't turned on any lights. He was sitting, knees drawn up to his chest, on the floor in the corner of the room and, when Derek said his name, didn't make any indication that he had heard him.

Derek closed the door quietly, walked in and crouched down. "Mark," he said again, and touched him on the shoulder.

Mark stirred slightly and hunched further into himself. "Go away, Derek. Please," he said in a voice that hardly worked.

"Callie asked me to check on you," Derek said. "And now that I've seen you, I can't just go away." He paused. "Do you want to talk about it?"

"You going to get psych down here?" Mark asked roughly.

"Honestly? I don't know. For now, though, perhaps we should just talk."

"You should go ahead and page them," Mark said. "Because I have nothing to say." He let his head drop into his arms, dragging his hands through his hair. "I have nothing to say," he repeated in a softer voice. "What the hell can I say?"

Derek sat down and leaned against the wall. "Then I'll just stay with you for a while. If that's okay." This couldn't go on indefinitely, but he could give his friend a little time.

Mark gave a nod that was only just perceptible. Then, after a long pause, he said, very quietly, "Thank you."

Title song: Drown Out, by Glen Hansard

Drown out, the voice that breaks the silence
And talks the joy out of everything
You were found out and had to walk
In darkness without the only thing you care about