A/N: I'm sorry I took so long with this update. Thank you very much for all the reviews for the last chapter; that really meant a lot to me.

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

Chapter 11 – Grey Would Be the Color If I Had a Heart

Mark felt in his jacket pocket absently and pulled out the now slightly crumpled pack of cigarettes, followed by his lighter, and started to tip out a cigarette.

"You're smoking now?"

He had almost forgotten that Derek was there. Whether they had been sitting here for hours or just minutes, Mark had no real idea. His mind was somewhere else, with the phantoms that refused to leave him alone.

Squinting a little at Derek, the unlit cigarette in his hand, it took him a few seconds to respond. His voice and his thoughts had lost their automatic connection and his throat was dry and, in the end, all that came out was a croaked, "Yeah, I —" followed by a small shrug. His hands shaking a little, he lit the cigarette and took a long drag.

Derek watched with distaste as the smoke drifted in his direction, and scanned the windowless room for air vents. But, really, his aversion was just a welcome, temporary distraction from feeling useless and at a loss what to do next. Paging Psych seemed less and less like a last resort and increasingly like the only option. During the past half-hour, he had tried to get Mark to talk, saying his name, asking simple questions, softly, with decent intervals in between, but Mark gave no real sign that he'd even heard him, until just now. Derek supposed that was a start.

Mark blew smoke through his nose and then cleared his throat noisily. "Pass me the trash can, would you?" he asked hoarsely, pointing to the base of the desk.

Derek reached over and picked up the metal container and handed it to Mark, who dumped out the three or four scrunched up pieces of paper it held, and flicked ash into it before setting it on the floor next to him. He sighed deeply and puffed on the cigarette again.

"I told her," Mark said, his voice deep and quiet. "I told her I'd hurt her." He closed his eyes. The image of his mother burned into his mind and he rubbed his eyelids with the back of his hand, trying to push it all away. But nothing helped. Nothing made any of it go away. He opened his eyes again and looked in Derek's direction; if for no other reason, just to have some kind of witness that he was speaking out loud, and something to look at that wasn't inside his own head. "It's like being under a fucking curse."

Derek coughed awkwardly. "I heard you broke up with Meredith."

"She's better off."

"Do you want to talk about it?"

Mark shook his head, stubbed out the half-finished cigarette aggressively, then immediately shook out a fresh one and lit it. Derek considered making a comment but thought better of it. Smoking, other than being another worrying symptom, wasn't exactly the most serious of Mark's problems right now.

A loud knock startled both of them and, without waiting to be invited, Alex Karev opened the door abruptly and came in.

"Dr. Karev." Derek stood up and walked a couple of paces towards Alex, instinctively shielding Mark, who hunched even further into himself.

Alex took in the scene in the room and shifted uncomfortably. "I need to talk to Dr. Sloan." His eyes flickered towards Mark, then back to Derek. "The Chief sent me."

"Why don't you tell me?" Derek said, aware and slightly disturbed that his voice had taken on the self-consciously calm quality that people use around the mentally ill. He moved a little closer to Alex and raised an eyebrow expectantly. "I'll—"

"What?" Mark interrupted, his voice surprisingly strong, and looked up at the two men.

Alex peered over Derek's head, into Mark's eyes, searching his face.

"What, Karev?" Mark repeated irritably, almost but not quite sounding like the person everyone, including himself, expected him to be.

"You blew off the rhinoplasty," Alex finally said, his eyes alternating between staring at the floor and taking glances at Mark. "The Chief wants to see you.

"Something came up," Mark deadpanned; at least he tried to. But his voice had given up on him again and the attempt at humor got lost in his obvious sadness and confusion.

Alex nodded awkwardly and Derek allowed a frustrated sigh to escape, before smiling in a conclusive way to indicate that the conversation was over and trying to usher Alex to the door.

"The Chief suspended your surgical privileges until you go see him." Alex's words were rough and quick as he tried to conceal his worry for Mark.

Mark slowly raised his eyes, and Alex had to look away again when he saw the pain there.

"He fired me?"

"He—"

"He suspended your surgical privileges," Derek broke in patiently. He wanted to spare Alex the discomfort of this discussion. "He didn't fire you. You just need to talk to him. When you're ready. Richard's a reasonable man."

Mark nodded. Other than that, he gave no response, except to visibly withdraw yet further into disconnected dejection.

Derek briefly closed his eyes and sighed again, curtailing the sound when he heard the blatant exasperation it expressed. "Karev," he said under his breath. "Please tell the Chief that you left the matter in my hands and that Dr. Sloan . . . or, if he isn't able to, I . . . never mind. One of us will talk to him later."

"'Okay," Alex said hesitantly. He eyed Derek and then blurted out, "What the hell is wrong with him?" He hated that it mattered to him so much.

Derek shook his head. "I don't know," he said. "He's had a hard year."

"You think he could be having trouble adjusting to being in remission? You know, that now he's well it's all hit him?" Alex asked echoing Derek's own suggestion the last time he'd talked to Mark. But then he looked down and inhaled. "It seems like it's more than that, though." He indicated Mark, who had shut himself off from the conversation, knees drawn up to his chest, one arm wrapped around them, with his head resting on that arm; the other hand held a lit cigarette.

Derek steered Alex towards the door again. "Have Dr. Torres push my DCS implantation to tomorrow. I might be here a while." He paused. "And would you do me a favor, Karev? After you've seen the Chief and Torres?"

Alex nodded cautiously.

"Could you find me some coffee? Two coffees? And," he looked around quickly at Mark, "perhaps a blanket?"

"You think he's going to be okay?"

Derek shrugged. "I hope so," he said. But he had no certainty about this and it was evident in his voice.

Alex swallowed. "Bone dry double cap, right?" It was a gesture. Getting the right kind of coffee seemed like some kind of support. The only support he could offer.

Derek smiled. "I'm sure he'll appreciate that." Actually, he wasn't sure; he doubted that Mark would care. But Karev's suggestion made him feel a little better. He stole another glance at the broken man sitting on the floor on the other side of the office and felt a moment's nostalgia for the bombastic ass who demanded the perfect coffee, hit on anything female and reveled in his surgical abilities. Derek almost had difficulty believing they were the same person.

"Mark." Someone was shaking him and he unstuck his bleary eyes and looked up to see Derek's face.

"Derek?" Mark didn't understand what was happening or where he was at first, but as consciousness returned, he realized he was lying on a hard floor, curled in a ball. Yet another memory from childhood; another recreation. It was getting so the past bled into the present so much that he hardly knew who or where he was.

"You fell asleep." Derek was reticent, choosing his words carefully. "It seemed as though you were having a nightmare and I thought I should wake you." He didn't know how to bring up the fact that Mark had been whimpering and sobbing in his sleep, and that his reason for waking him was that he couldn't bear it.

Mark pushed himself into a sitting position and leaned back against the wall with a groan. A blanket slid down his body, dislodged by the movement and he fingered the soft fabric and looked at Derek questioningly.

"Karev brought it. I asked him to." Again, Derek's words were cautious. "I was worried you might be cold."

Mark swallowed to lubricate his throat, which was now dry to the point of soreness, and said, "Thank you."

"Better than that," Derek stood up and walked towards the desk, a falsely bright smile on his face, "he brought coffee." He picked up a cup and brought it over to Mark. "It's probably barely warm by now, though."

"Doesn't matter." Mark took the cup gratefully, pulled off the lid and drank down half the liquid. He hadn't realized before now how thirsty he was and how much he craved caffeine.

"Bone dry cap. Karev's idea," Derek said, a little over-enthusiastically.

Mark peered into the cup, then back at Derek. "Oh, yeah," he said without interest and then gave short laugh. He used to care about this; before Meredith; before his life shattered into this mess of memories and pain and self-hatred. But at some level he appreciated the thought, even though he felt bad that he'd dragged Alex into all this. "Poor bastard. I'll bet he wishes he'd stayed in neonatal." He put down the coffee cup, rifled under the blanket and pulled out another cigarette and lit it.

"He obviously likes working with you," Derek said. "It's also obvious that he cares about you. So does Torres." He paused and then added quietly, "So do I."

Mark nodded. He couldn't take it all in. He had no right to expect anybody to care about him. This morning, with Meredith, he'd proved that.

"Do you feel like talking now?" Derek ventured.

Mark shook his head. "No." He took a long drag on the cigarette. "Why are you here, anyway?" He wanted Derek there, but how could he sit here and accept his friendship after what he'd done to her? Nobody should be his friend. Nobody would be if they knew any of it. "It's not like we're really friends anymore."

Derek sighed and rubbed his eyes wearily. "I'm here because apparently you're punching people out and missing surgeries and now you're sitting on the floor of your office chain smoking. I'm here because Torres thinks you're suicidal. I'm here because," he hesitated, "because you broke up with Meredith, which isn't something I think you'd do easily. I don't think anybody would break up with Meredith easily. And the fact that I am here after she left me for you ought to tell you that you and I are friends."

"Callie thinks I'm going to kill myself?"

"Well, she's worried about you. She thought you were behaving oddly and she asked me to check on you."

"You think she reached that conclusion before or after she hit on me?" Derek gave him a confused look and he shook his head. "Doesn't matter. It's not her fault. She was just trying to be nice."

"What isn't her fault, Mark? It might help if you talked"

Mark ground the cigarette against the side of the trashcan and stood up. "I'm going to find the Chief."

"I don't think that's a good idea," Derek said quietly.

"No? Actually I think saving my job could be about the best idea I've had all fucking week."

"I don't think you're going to convince Richard in your present frame of mind," Derek persisted. "You're . . ." what? volatile? unstable? borderline psychotic? "You're not yourself and you look like crap. Right now, you'll just confirm whatever suspicions he already has. Why don't you talk to me and —"

"Because it's all I have left, Derek. Being a surgeon is the only thing I have left that feels like me." And that was it. Whatever hadn't hit Mark before now hit with full force and, as the last of his willpower drained away, he sank back down to the floor, resuming his position against the wall.

After a moment, Derek spoke again. "What happened, Mark?"

"It caught up with me," Mark said quietly, staring blankly at the wall on the other side of the room. "I finally became what she made me."

Derek stopped himself from interrupting to ask for an explanation. It seemed more important to let Mark continue to talk now that he had begun.

"I never wanted to be like them. It was the last thing I wanted. And I told her." Mark turned his head to look at Derek, his eyes haunted and desperate. "I fucking told her not to have anything to do with me. I warned her off me. I pushed her away. Because I knew." He took a painful breath. "I knew I'd hurt her." He laughed bitterly. "Because you can refuse their money, but you can't refuse the rest of the fucking legacy. Eventually it all comes back." He inhaled. "Meredith was right all along."

"So this is something to do with your family?"

"It's always something to do with my family. How do you think I got to be the way I am?"

After another pause, Derek asked. "Do you think this could be a side effect of your meds? I read that approximately a third of patients undergoing cytokine treatment develop depression. There's a very strong correlation. Perhaps Julia could help? Or . . ." He trailed off, knowing, before Mark even responded, that this explanation was inadequate, wishful thinking and that he was just speaking for the sake it.

"It's not the meds," Mark said irritably. He realized that he had forgotten to take his meds the last couple of days and he wasn't even sure that he cared. Death had, as Julia had once put it, seemed like the easy way out at the beginning of his cancer treatment; and right now, it seemed like a shame for everybody, himself included, that it hadn't worked out that way. He remembered telling Meredith how cancer had been a gift, because it brought her to him. Then he just remembered Meredith.

Mark picked up the coffee cup again and turned it around in his hand. "I bought her a caramel latte."

"Excuse me?"

"She said, if I loved her, I should buy her a caramel latte. So I bought her a caramel latte."

He remembered the simplicity of the whole thing, of how he and Meredith used to be, before his fucked-up reactions to her natural need to share; before he . . . before he did that to her. He wished he could tell her. He wished he could say, 'It wasn't you; you didn't do anything wrong.' But what good would it do? What possible difference could it make now, after what he'd done? And, anyway, he wouldn't be able to explain, because he didn't want her to know. He didn't want her to know what he came from, what had been done to him. The only thing he could do for her now was spare her the need to feel pity for him, and spare himself the pain of seeing it in her eyes.

"What happened, Mark?" Derek asked softly, pushing for an answer.

"I can't," Mark said. "I can't talk about it. I don't know how. And I don't want to, okay? I don't want —" He covered his eyes with his hands, shaken by another wave of guilt and pain and realization. There was no escape. There were no words that would do justice to this. No rationalizations. No thoughts. Not even self-recrimination. Nothing could make any of it any better. "Why the fuck didn't somebody do something?" he choked out. "Why the fuck wasn't someone there to stop it?"

He heard Derek move closer and felt his hand on his shoulder. At first, it made him flinch, but he allowed it to stay there anyway. Something had broken inside him and Derek's proximity, even though he didn't deserve it, was comforting.

"What happened?" Derek repeated yet again.

"I think I remembered before," Mark muttered. "On my seventeenth birthday. I'm not certain. But I think I remembered before."

Not understanding, Derek didn't reply, but tried to offer silent encouragement.

"And I think I tried to tell you. When we were little kids. It probably didn't come out right. But I think I tried to tell you."

"Tell me what?"

Mark uncovered his eyes and stared desperately at Derek. "If somebody had done something, maybe it would've been different. It could have been, right? I wouldn't have done that. If somebody had stopped her. I wouldn't have ended up —" He broke off abruptly. "Christ, Derek. What the fuck did I do? How could I do that? To anyone? How could I do that to Meredith?"

Derek pinched the bridge of his nose. "This is only a suggestion, Mark. But perhaps a psychiatrist could help you sort through what you're feeling."

"I'm talking to you aren't I?"

"Yes, but —"

"I had to report a guy once. Back in New York."

Derek sighed.

"I got called in for a facial lac. But the woman was shaking and scared and nobody was talking to her. You know how they were back there. So I tried and it all came out." He paused. "Aggravated Sexual Contact. It's a felony."

"I know that, Mark. I'm a doctor too, remember? But what does it have to do with anything?"

"That's what I've become," Mark said bleakly. "I'm that guy."

Derek froze, his mind leaping to conclusions that he couldn't bring himself to believe were real. "What exactly do you mean?" he demanded. When no response came, he repeated himself, his voice growing colder with each word. "What do you mean, Mark? Are you telling me you hurt Meredith?"

Mark nodded, swamped by self-disgust and unable to speak.

"You're seriously telling me that you assaulted Meredith?" Derek almost yelled. The only reason that he was still in the room was the hope that this was some kind of delusion. The problem was, all his instincts told him it wasn't. "Why? Why would you do that?" It was, honestly, a stupid question, but Derek needed the outlet of words and he genuinely needed to know why.

Mark shook his head. He'd done it because he couldn't tell the difference between his childhood and now, between dreams and reality. But nobody would understand that, especially when he didn't understand it himself.

"You don't get to do that," Derek straightened up and got to his feet, towering over Mark. "You don't get to do that and tell me about it and then just shake your head. Why? What kind of man are you? Because after what we've been through, I wouldn't put many things past you. But that? I wouldn't have thought even you were capable of . . ." Derek trailed off, sickened, and raised his hands in defeat. He walked a few paces towards the door. "I can't look at you. I can't be here. I . . ."

"I'm sorry," Mark said.

"You're sorry? You think that makes it better? I asked you to look after her. You promised you would look after her. You really think 'sorry' cuts it?"

"No," Mark shook his head. "But she's better off without me. And now she knows that."

"Oh, come on, Mark. We've been through all this before. In this very office. Clearly these bouts of remorse and pretend self-knowledge are meaningless."

Mark nodded slowly. He looked at Derek and swallowed. "Meredith was my lifeline," he said very quietly. He wasn't really following the conversation now. His mind was filled with jumbled emotions and images and pain. He'd confessed the worst thing he'd ever done and, even if Derek didn't give a damn anymore, he had the desperate urge to tell him the rest.

"You have a remarkably funny way of showing it," Derek hissed.

"Yeah," Mark said and looked down at the floor. "I think it kind of goes with the territory."

"Excuse me?" Derek barked, incensed by Mark's apparent flippancy. "What territory exactly? Being a sexual deviant?"

"Maybe." Mark took a deep, difficult breath. "I was sexually abused."

The words were muffled, withheld, almost inaudible. But Derek had heard them and they stopped him in his tracks.

"What did you say?"

Mark looked into his eyes. "I was sexually abused. I blocked it out."

Derek stared at him, indecisive until his anger about Meredith won out again. He reached for his pager. "I think violent and delusional probably calls for a psych consult, don't you?" He started to input the numbers and then stopped short, disconcerted by the pain in Mark's eyes. "Who the hell sexually abused you? I've known you since you were six. How come this never came up?"

"I think I told you. It doesn't matter. We were kids. I probably wasn't clear. I just think I told you." Another memory flooded into Mark's mind. "I think I told you after I tried to tell my . . . him."

"Him?" Derek's certainty was flagging.

"Doug."

"Your father?"

Mark nodded. "You were right. About the dreams." He let out a short, hysterical laugh and tears formed in his eyes. "My fucking mother wanted to fuck me, Derek. Hell, she probably did and I just haven't uncovered that memory yet."

"Your mother?"

Mark nodded again.

"Your mother sexually abused you?"

"Yep." Mark sighed.

"Abused you how?" It was an inappropriate question and Derek didn't want to know the answer. But he had to make a choice, now, between fury and compassion. To do that, he had to know if what Mark was saying was true and this question was the best his overwhelmed brain could come up with.

"You're seriously asking me for details?" In Mark's mind, his mother's image flaunted itself again, and he squeezed his eyes shut, a reflex that he already knew made it worse but couldn't help, then quickly opened them again.

"No . . . of course, not. I just . . ." Derek pulled himself together. "You told me before?"

"I don't know, Derek. I think so. Like I said, we were kids. I guess I hoped you'd tell your mom. It's no big deal." He sighed. "She stopped anyway, in the end. After that it was just routine emotional abuse. But you know all about that."

Derek retraced the few steps he had taken away from Mark and crouched down in front of him.

"What?" Mark asked, defiantly, fighting his need to cry. "It doesn't change anything. I'm the abuser now."

"You're telling me the truth?"

"Why the fuck would I lie about it, Derek? What possible reason would I have to lie?"

"It changes something," Derek said.

Neither of them spoke again for what seemed like an eternity of slow-moving minutes, until Mark broke the silence.

"I don't know who I am anymore," he whispered. "I don't know what I think or feel or who I'm supposed to be. I don't understand myself. I don't know if my choices are mine or just . . . fuck, I don't know . . ." The tears now began to run down his face and he didn't bother to wipe them away or check them.

Watching Mark, trying to make sense of everything he had just heard, Derek felt the weight of their friendship; of all the years they had known each other. He had learned a lot about Mark during the past year. Now another layer had been uncovered and one that he didn't know how to work into his stance on life. All the time he and Mark had been friends as children, Mark had carried this horrible scar around with him. When Derek forced him to go fishing with him; when Mark attempted to teach him to play football and how to hit on girls; when they were in med school, as interns, at Derek's wedding. All of it.

Very carefully, he lowered himself to the ground and sat down next to Mark. "I can't forgive you for Meredith."

"You think I can forgive myself?"

"I'm just being honest," Derek said quietly, almost gently, but still determined. "That's how I feel. I can't help it. But the other stuff. The abuse. I want you to know that I believe you. I met your mother too many times and I saw how she was. I don't want to believe you. I don't want to think that this happened to you. But I believe you. And, for that, I'm here for you. I've known you too long to leave you to deal with this by yourself."

Mark snorted and wiped his nose on the back of his hand. "I don't want her to fucking win." Tears trickled from his eyes again. "I thought I'd escaped, Derek. But now it's all turned to shit."

Derek had no words. Instead, slowly, he put an arm around Mark's shoulder and Mark accepted it quietly, without fuss or deflection and rested against his friend.

"Will you let me page Psych?" Derek asked. "I'll stay with you if you want me to. But you need to see someone."

After a pause, Mark nodded his acquiescence and Derek got out his pager and input the code and the message.

"Do you need anything, while we're waiting?"

Mark shook his head.

"You'll get through this." Derek tried to reassure him.

Mark swallowed. "Except I've lost my job —"

"You don't know that, Mark. Like I said, Richard's a reasonable man and I'll talk to him. Everyone's allowed to get sick. Until last year, you never had so much as a head cold."

"Meredith was . . . I loved her."

"I'm not talking to you about Meredith," Derek said tightly. "Anything else, but not Meredith. I told you that."

"I'm sorry."

"I know."

"Yeah, I know. But I need to say this." Mark sighed. "You were right, when you said I bring everything down to my level. I brought you down. I screwed up your whole —"

"Okay, that's enough now," Derek interrupted softly. His conflicted emotions meant he could be there, but not talk. He didn't trust himself not to get angry; and he didn't want to say anything that would make Mark worse. "Let's just wait for the psychiatrist. Okay?"

Mark nodded. The prospect of seeing a psychiatrist scared the shit out of him. He was scared of the diagnosis; scared of the treatment; scared of being categorized as something pathologically broken that couldn't be mended, just had to be managed. And he couldn't even pretend. His ability to construct a convincing façade had eroded and now he was just exposed, as himself, utterly flawed and helpless and without the slightest clue how he was going to go on. But somehow Derek – the honesty they had just shared; his support despite everything – made it seem possible to try. He reached into his pocket and pulled out a cigarette, but this time he left it unlit.

Title song: Something I Can Never Have, Nine Inch Nails

In this place it seems like such a shame.
Though it all looks different now,
I know it's still the same
Everywhere I look you're all I see.
Just a fading fucking reminder of who I used to be.