The First Cut [Isn't Always] The Deepest

Disclaimer: All characters (except Elizabeth, who doesn't actually appear in person) are the property of the BBC. They are not - I repeat, NOT - mine.

A/N: I wrote this story a few months after the end of season 2 of Holby City (before it was once a week, every week without a break). We know Nick agreed to the divorce when he left Holby and Karen. We then tune into season 3 and Julie is now Acting Ward Sister, with no sign of Karen. Nobody ever said what happened to her, so this is one of my theories. It's VERY long. I only registered with FF.Net a couple of months ago, but I wrote this fic 3 years ago and it's just sat on my computer ever since. Also, Kath and Charlie are the only characters in Casualty and Holby City who are still left, so please, remember when I wrote this when you review!!!!!

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(June 2000)

She gripped the steering wheel of her car tightly, unsure of what he'd have to say to her. She hadn't done anything more about divorce proceedings since she'd got that letter from him the day he left, saying that he'd agreed to it. She hadn't known what to do, back in April. Now, though, she'd decided to drive up to Leicester from Holby to see him. She had an address. Whether or not he would be there was a completely different matter.

"Drive past the football ground," she muttered, glancing at the directions she'd got out of an A-Z of Leicester. She stopped at the traffic lights (well, a pedestrian crossing really) and looked all round. "Where the hell is Filbert Street?" she moaned.

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An hour and many wrong turnings later, she was parking outside his smallish semi-detached house in one of the smarter and nicer parts of the city. Oh well. It was now or never.

"Come on, Karen Newburn. You've got this far, so don't chicken out now," Karen ordered herself as she slowly got out of the car, locked it and went up the path. Palms sweating, she rang the doorbell. She heard someone hurrying down the stairs before opening the door.

"Karen," Nick Jordan stated, shocked.

"Bet you weren't expecting to find me here," Karen replied in her strong Geordie accent. She raised one eyebrow.

"Y-you'd better come in," Nick stammered, standing to one side.

"I got your letter," Karen commented, stepping inside.

"And?" Nick looked at her warily. He shut the door firmly.

"I don't .I mean, I can't .I won't go through with it," Karen told him, shaking. "I know we're officially - I mean, legally - separated, but there's the off-chance we might - after the last few months - there's a possibility we could." Her voice trailed off as she fought back the all-too- familiar feeling of pending rejection.

"Just say what you've come to say, Karen," Nick snapped irritably. "I haven't got time for any dithering on your part."

Karen stared at him in disbelief. "I don't believe you!" she hissed in anger. "This isn't easy. In fact, it's bloody hard!"

"Just spit it out, then go," Nick ordered impatiently.

Karen placed a hand on the catch of the door and opened it. "Forget it, Nick. If you're going to be like this, just forget that I ever came, alright?" She hurried outside and back to her car, tears streaming down her cheeks. Why had she bothered coming? He probably had some girl upstairs, she thought bitterly. Never mind that she was technically still his wife. It was obvious he didn't want her any more.

Fumbling with her keys because the tears blurred her vision, she eventually managed to unlock the car and immediately rested her forehead on her arms on the steering-wheel, crying because he heart had been shattered - by a man who was supposed to fix them. She'd heard him slam the door behind her. Typical Nick, she thought angrily. Not even bothering to come and see if I'm OK or not.

After a few minutes, she had recovered sufficiently to drive, and she put the key in the ignition. Putting her seatbelt on, she drove off to the outskirts of Leicester until she found a quiet area of trees, a lake and some fields. Dogs were being walked and people were around, but Karen didn't notice them. She glanced down at her clothes - black jeans, a forest- green poloneck and a dark red/maroon cardigan. Not that she was particularly hot, as the weather this year didn't seem to want to become a fully-fledged summer. Anyway, the long sleeves hid the numerous scars on her arms from when she was a teenager. She'd got herself into a downward spiral of depression and self-harm. Nick had helped he beat it, but every now and then just recently, she'd started again. After he'd left back in April, he'd put a note on the kitchen table. That had triggered the depression again, and that night she'd dug her nails into her arm. They'd hardly left a mark, though, and several days later she'd used a knife to cut open the skin. Nobody asked how it had happened. There were other scratches too, although she kept to scratching over her old scars. And she used concealer to hide the marks. She was deeply ashamed of herself for doing this, and she'd slipped back into the viscious circle. She'd get deeply depressed and would then scratch or cut herself (it depended on how bad she was feeling). By doing this, she would temporarily feel better. After a while, though, the realisation of what she'd done would sink in and she'd then hate herself even more for doing it. She'd feel even worse and would then self-harm again. It was a circle she couldn't truly break free from, despite her best efforts. Only Nick had known about it - she'd refused to see anyone for professional help. 'I'm a nurse; I help people,' she'd stated. 'I don't need "help" from anyone.'

She found a bench by the lake and sat down, gazing unseeingly over the water. Her mind was on other things, and she was furious with herself. Nick had agreed to the divorce. She should have realised that that meant he didn't want her in his life any more. How stupid could she be? He must think she was a total idiot for not getting the underlying message. He wanted a pretty young woman with long, golden hair and blue eyes, tall and curvy and slim, with a flawless body. Karen wasn't any of the above, in her eyes, at least. She had grey eyes and her natural hair colour was mousy brown. Her hair itself was very short - it was easy to take care of that way. All she had to do on the mornings was quickly run a brush through it. She was short, stockily-built and not exactly what one could refer to as 'curvy'. And her body definitely wasn't flawless. Her feet were permanently red in some parts and had various blister scars over the toes. This was all due to the many hours she had done ballet every week, and her feet were what her snobbish sister called 'common dancer's feet'. She had stretch- marks from when she had gained weight during the time she was being bullied at school, from comfort-eating. Then she had developed anorexia, going from one extreme to the other. Fortunately it had been caught early and she had completely recovered. And all the while there were the scars from the deliberate self-harming. Those were the worst. The stretch marks faded. The self-harm scars didn't.

After a while, she decided to find a café, have some coffee and then head back home. Staying here would be pointless.

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It was nine o' clock when she got back home. The small terraced house she lived in seemed altogether too quiet for Karen. It reminded her of how lonely she was.

Her first thought was to find a teaspoon, put the kettle on and make some coffee. As she reached into the drawer, her fingers brushed against the vegetable knife, which she got out as well as the teaspoon. The handle was slightly loose, so she left it out to remind herself to get a new one soon.

The kettle was playing up. After several attempts to get it to work, Karen gave up, her temper frayed enough already today, and screamed at it. Her temper was worryingly destructive, and before she knew what she was doing, she had snatched up the nearby vegetable knife, pushed up her left sleeve and pressed it into the skin on her arm as hard as she could. Blood immediately came out of the wound and dripped onto the worksurface. She took the knife out of that wound and chose another spot, pressing hard first to break the skin and then to make as much blood as possible come out. She did this half a dozen times before letting the knife fall onto the worksurface. She would have picked it up to restart cutting if the doorbell hadn't rung. It was then that she realised she was crying, and she reached up to her face to wipe the tears away, unaware of the blood she had inadvertently streaked her face with. "Coming!" she called, faking cheerfulness and ignoring the blood running down her left arm. She hurried to the door and opened it to find Keller's ward sister, Kath Shaughnessy, probably her only friend, standing there.

"Karen! Whatever's happened?" Kath cried in horror. She saw the tears and the streaks of blood on her friend's face, the manic look in her eyes, and her bleeding arm.

"Nothing major," Karen answered quickly - too quickly, for Kath's liking.

"Can I come in?" Kath asked gently. Something was definitely very wrong, even if Karen wouldn't admit to it.

"Can I make you a coffee?" Karen asked brightly, then giggled hysterically. "Oops, no, forget that. The kettle isn't working." She giggled again, and Kath was scared. She followed Karen through to the kitchen/dining room area, pausing only to shut the front door.

Once in the kitchen, Kath decided to get to the bottom of this. "Karen, what happened?" she asked, gently but firmly. "And no lying."

"I'm fine, I'm great!" Karen replied, still giggling in that hysterical, manic way. Kath was scared now. Karen had always been a calm, rational person, if a little difficult and brusque most of the time. Now, however, she was wild, irrational and almost psychotic.

"In fact, I've never been better!" Karen exclaimed.

Kath suddenly grabbed Karen, forcing her down onto the nearest chair. "That arm is obviously a mess. Now let me look at it," she ordered, kneeling down to get a better look at the injury. When she saw the extent of the damage, she gasped. "We're going to A&E," she told Karen firmly, hauling her to her feet. "Now." Grabbing a teatowel, Kath wrapped it tightly round Karen's arm and they left the house.

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They arrived at Holby City Hospital half an hour later. Karen had fallen deadly quiet, silently sobbing in the passenger seat. Kath had to help her out of the car, she was shaking so badly. Although Kath was an experienced nurse, self-harm was not something she had had to deal with closely. She gently led Karen through the doors to Reception and was relieved to see Charlie Fairhead, head nurse in the A&E department, and Lisa Duffin, aka 'Duffy', standing at the desk. "Charlie, Duffy!" Kath called out. "We need help now!"

"What's happened?" Duffy asked, hurrying over.

"About half a dozen fairly deep lacerations to the lower left arm," Kath informed her. She looked meaningfully into Duffy's eyes. "Self-inflicted."

Duffy's eyes widened. "We'll get her into Resus; it's quieter than a cubicle," she said in low tones. "Max!"

Max Gallagher, A&E's senior consultant, hurried up, and he took over from Kath, picking Karen's trembling body up and carrying her into the Resuscitation room. He knew they would have to tread carefully with Karen. She was currently very unstable, and she could do anything in that state.

Duffy spoke to Karen gently and constantly in low tones, to keep her colleague as calm as possible. Karen was crying softly now, curled up into a tight ball, refusing to allow anyone to see her damaged arm. After half an hour, Duffy had managed to persuade Karen to let the staff inspect her injuries.

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Karen felt trapped. Trapped inside herself. She was horrified at what she had done to herself again. She couldn't escape, no matter how hard she tried. They'd patch her up, send her home and forget about her problems, like everyone else did. Why had she gone to see Nick? That was a stupid thing to do, she scolded herself angrily.

"Karen? Karen?" Duffy's gentle but firm voice finally penetrated Karen's mind. "Are you listening to me?"

Karen nodded and slowly opened her eyes. She found herself looking into Duffy's concerned face.

"We're going to have to put some stitches in your arm, alright? Those cuts are quite deep," the A&E Sister explained gently. Karen nodded briefly and Duffy continued. "And Helen James is coming down to speak to you soon."

That got through to Karen. "I don't need a shrink!" she yelled angrily, pulling away from Duffy "I'm not going crazy!" She jumped off the trolley and whirled to face Duffy, her eyes blazing.

Duffy held he hands up. "Nobody said you were," she said calmly, startled by Karen's reaction.

"Then why the hell's Helen coming down?" Karen demanded.

"Karen! You deliberately injured yourself several times quite badly. You're a nurse, so you know as well as I do that self-harm warrants a psychiatric assessment," Duffy explained calmly. She wouldn't lose it - if she did, she might push Karen too far and then she might do something really stupid. This was a hospital, so there were plenty of drugs around for an overdose, plenty of scalpels to slash wrists, and the building itself was tall. Plenty of floors to fall past if someone jumped off the roof. And they'd die on impact. No question of it.

"I don't care! I am not seeing a shrink!" Karen yelled, almost hysterically. She turned and ran for the doors. She bumped into Charlie, who was coming to see what all the commotion was about. He grabbed her and held her tightly as she lost all reserve and broke down in tears. Her whole body was shaking, and Charlie gently rocked her as she cried. Mouthing the words, he asked Duffy to delay Helen James's arrival. Duffy nodded and left the room. She found Kath in Reception, explaining something to Amy, the receptionist. "Kath?"

Kath turned. "How is she?"

"She completely flipped when I said Helen was coming." Duffy turned to Amy. "Amy, can you pull Karen's file now, please? We need to know how long this has been going on. There are several old scars."

Kath nodded. "I know. Her whole arm is an absolute mess, although I suspect she uses concealer to hide them." She paused. "She hasn't been left alone in there, has she?" she asked worriedly.

Duffy shook her head. "Charlie's in there, which is good, seeing as he's a psychiatric nurse. If anyone knows how to handle her, he does."

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Charlie waited till Karen had calmed down before saying anything. He gently led her to the bed and sat down with her, one arm around her shoulders. "Helen won't be coming yet," he said.

"Good," Karen replied forcefully. "Because I'm not going crazy, Charlie, I'm not." She looked at him earnestly. "I just got upset. Everyone gets upset from time to time. Even Meyer must do sometimes."

Charlie couldn't help but smile at that. Anton Meyer, Holby's top cardiothoracic surgeon, rarely showed any emotion except the occasional irritation. Everyone was in awe of him. He was the best.

"So why did you get upset?" Charlie probed carefully. They were on a very delicate subject here. The slightest error could prove fatal.

Karen stared at her hands. "I went to see Nick," she answered eventually. She laughed briefly in a bitter tone. "I actually thought he'd want us to get back together. He agreed to the divorce when he left Holby and I still thought he'd want to rescue our marriage. How stupid can you get?" That harsh, bitter laugh again. "I can't believe I actually drove all the way to Leicester for that."

"So it was being rejected?" Charlie guessed.

Karen stiffened. "Don't try to psychoanalyse me," she said tightly. "I'm not a nutcase." Yet, she added silently.

"I'm not. I'm just listening. As a friend."

Karen relaxed. "Sorry. That was unfair," she apologised. She gazed at the resuscitation chart on the wall opposite her. "You're right," she finally admitted. "I did feel rejected. I tried to explain it all to him but he just got so impatient. I didn't finish what I was saying. I couldn't, not after the way he'd reacted. So I left."

"So then what did you do?" Charlie pressed.

"Drove around a bit, then came home. The kettle wouldn't work again. I really need to get a new one." She laughed in that way again, sending shivers down Charlie's spine. "Can you believe I got upset over that stupid kettle not working? Maybe I really do need to be locked up in the loony bin."

"It sounds like a combination of recent events," Charlie observed. "Nick left, and that must have hurt a lot."

"It did," Karen whispered.

"Then there was the worry over Mike, Nick agreed to the divorce. Then you went to see him yesterday. I think the kettle not working just pushed you too far. You let all that frustration explode at once. And you saw the knife on the side and cut yourself," Charlie concluded. Karen nodded and Charlie thought for a moment. He'd never personally known a self-harmer before. "How did you feel when you were actually cutting yourself?"

Karen tensed. "I don't remember."

"Okay, then." Charlie was fully aware that she was lying to him, but he didn't say so. "What about afterwards, when Kath came?"

She didn't answer. When she'd actually been cutting, she'd felt relieved, as though the tension and frustration was leaving her with the blood. She'd felt almost calm immediately afterwards, but then she'd realised what she'd done to herself and she was shocked and horrified. "I told myself I'd never do it again," she choked out, in tears now. "But I still did it."

"But you can't stop, just like that," Charlie replied softly.

"I know!" Karen cried in irritation. "I just thought - before - that I could promise myself it wouldn't happen again, and it wouldn't!" She was crying openly again and Charlie pulled her into a comforting hug. He didn't say anything.

"You can get help to deal with this, you know," he told her after a while.

"I'm a nurse; I help people. I don't need 'help' from anyone," Karen snapped.

"Karen, even medical staff are allowed to get help," Charlie responded. "I know Max goes to regular counselling to help him deal with Frank's death." Frank was Max's son, an ex-heroin addict, who'd become a drugs counsellor. Sadly, two dealers had attacked him and set him alight after drenching him in petrol. The Holby staff had been unable to save him. "Tina got help after she was raped. Josh goes to Gamblers Anonymous. I've had counselling in the past for all sorts of things." He looked at her. "Karen, you're not invincible. You can ask for help if you can't cope. We won't make it out to be anything to be ashamed of. You can't cope. There's nothing wrong in that."

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"She's going to need a lot of help," Kath remarked. She and Duffy had retired to Charlie's office to look through Karen's medical file. "Depression since she was twelve that's never truly gone away, comfort- eating, anorexia, and all that time she's been self-harming." She closed her eyes, unable to imagine Karen's emotional pain.

"It seems to have stopped after she married Nick," Duffy pointed out. "Her psychiatrist's reports says so, and she stopped going."

"Even after they split up?" Kath sounded surprised.

Duffy nodded. "It's as though she deliberately refused to go, like she couldn't admit to her problems. She probably started cutting again once they split up."

"What about suicide attempts?" Kath asked suddenly.

"No actual attempts, but frequently appeared suicidal," Duffy answered. "She spent several periods in hospital for psychiatric assessment and so on. That was when her psychiatrist noticed the suicidal 'inclinations'."

"She needs to be admitted, Duffy."

Duffy shook her head sadly. "She'll refuse, and she's not a danger to others, so we've got no grounds to put her in restraints."

"But she's a danger to herself. The state she's in, she needs to be on suicide watch," Kath persisted, even though she knew Duffy was right.

"Let her stay with you for the next few days, so you can keep an eye on her," Duffy suggested.

"She'll know what we're up to. It won't work."

"Then what can we do?" Duffy cried in frustration.

"I think all we can do is hope and pray that she sees sense and gets help," Kath replied sadly, knowing deep down that Karen would never admit she needed help.

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Charlie finished up the stitches on Karen's arm and prepared to apply a gauze pad over the top. "All done. I won't bother to give you the run-down on the necessity of keeping the wounds dry," he remarked. He got a weak grin in response. That was good. At least she could smile.

"So I can go home now?" Karen asked when Charlie had finished.

"Well - " Charlie began.

"Good," Karen replied brusquely. "I'll go, then. See you tomorrow. Oh, and thanks for patching me up." She walked quickly out of Resus, snatching up her cardigan as she went.

Kath saw her. "Ready?"

"Yes. Can we go?"

Kath merely nodded. Karen's tone was sharp and emotionless, and she suspected Karen wanted to leave before the on-call psychiatrist turned up. She'd also detected a note of desperation in Karen's voice, and it was also there in her eyes. It was then that she realised Karen was not going to be seeking help anytime soon.

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"Morning, Karen. I wasn't expecting to see you in today," Kath remarked the next day, sounding surprised.

"Why not?" Karen responded shortly. "They're a few small cuts, that's all. They're hardly going to kill me."

Are you sure about that? Kath thought darkly. And she didn't buy the 'few small cuts' line, either. If she was honest with herself, she didn't think Karen was in a fit mental or emotional state to be working. Voicing her thoughts wouldn't be any good, though, so she kept quiet. "What are you going to tell people when they ask what happened?" she asked.

"I'll think of something," Karen returned shortly. "Now, if you'll excuse me, I have a ward to run."

Kath watched her walk off and shook her head. If Karen didn't get help soon, she'd be dead before Christmas.

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Kath went to the main cafeteria for lunch, instead of the smaller, nearer one the Darwin and Keller staff usually used. She was hoping to avoid Jasmine Hopkins and Tash Bandara by doing this. The two had just had yet another argument, and Kath had been the one who had had to break it up.

"Mind me joining you, Kath?" Duffy asked.

Kath looked up. "No, not at all."

"So how come you've trekked all the way over here for your lunch?" Duffy queried curiously, opening her sandwiches.

"Tash and Jasmine are at each other's throats again," Kath explained wearily.

"How's Karen?"

"A mess," Kath answered shortly. "She shouldn't be working, she needs help, and she won't do anything about it."

"I've got a friend who deals with this, over at St. Thomas's," Duffy said. "I could try to get Karen to see her."

"Good luck to you, then," Kath replied.

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Karen got home that evening feeling completely and utterly depressed. She knew Kath had been watching her all day, and that had made things even worse. It felt like Kath didn't trust her.

She checked her answerphone. No messages. She hung her coat on the end of the banisters on the stairs and headed into the kitchen to sort out the pile of post. It was all bills and flyers. That was all it ever was. No letters from old friends. But then, she didn't have any, so how could they write to her? Nobody liked her; it was obvious they all hated her. She was cold and sharp towards them, rude and irritable. How could she expect friendship from them? She hated what she had become, but it was too late to change their minds now. Kath and Duffy were the only ones who ever phoned, and even then it wasn't often.

She felt as alone as anyone could possibly be, and the wave of loneliness that swept over her was so strong that it brought tears to her eyes. She angrily brushed them away and filled the kettle. Turning it on, she got a pleasant surprise to find that it had decided to work this time.

She hadn't anticipated its weight. Some of the scalding-hot water splashed onto her hand. The pain was instant and intense, but Karen ignored it. Once she'd put the kettle down, she stared at the area the water had touched the skin, in fascinated horror.

"You stupid idiot!" she yelled out loud. She banged her hand against the side of the worksurface repeatedly, harder and harder. Several times, she hit the sharp corner, so she aimed for that. The harder she hit, the more frustration and anger she was aware of, bubbling up inside her. She knew she was way out of control, but she couldn't stop herself.

Eventually the rage passed, and she collapsed onto a chair, crying hysterically. She couldn't cope with anything any more. She stood up and headed up to her bedroom, flinging herself onto her bed. After a long time, she fell asleep from exhaustion. But it was a fitful, restless sleep filled with tossing and turning, and nightmares.

She was being chased. It was dark and cold. She couldn't see the figure, but it was huge and black; she could sense that much. It was gaining on her, but try as she might, she couldn't get away. Then she fell, and the figure, with a flowing cloak, enveloped her, his billowing cloak falling lightly around her. It was gradually suffocating her, and she didn't put up any resistance. The figure put his face close to hers, and Karen got a shock. It was Nick.

She woke up suddenly, shaking and sweating uncontrollably. Her breath was coming in short, loud, harsh gasps, and she clutched the bedclothes tightly to her chest. She started crying, terrified. Visions from the nightmare haunted her, as vivid as they had been during the dream. Her heart wouldn't stop racing and she knew her blood pressure was sky high. She felt sick with fear and panic, unable to comprehend the final twist in the dream. Nick's face stayed in her mind. She glanced at the clock. 2:17. She had only gone to bed just before midnight.

She didn't get any more sleep that night.

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Coffee hadn't helped much. She'd tried it, to keep sleep away. The memory of the nightmare was too awful. But she had to go to work. Kath would come round to demand what was going on otherwise.

"Morning, Karen," Jasmine remarked as Karen walked onto the ward. Karen nodded curtly at her before heading into the staffroom. Jasmine stared at her in surprise. Karen was never easy to get along with, but today she clearly wasn't in the mood for niceties. "Oh well," Jasmine muttered. "Can't say I didn't try."

Karen put her things in her locker and then slammed the door shut with a loud bang, which did nothing to improve the headache she already had. To be quite honest, she didn't care. She didn't care about anything any more.

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A few minutes later, she was sitting in her office, staring moodily at a pile of paperwork, when Julie Fitzjohn hesitantly poked her head in. "Karen, can I have a quick word, please?" she asked nervously.

"Make it quick," Karen snapped.

Julie flinched at her tone. "Rosie's childminder can't take her today because she's ill, so.er, I've had to bring Rosie in here."

Karen sat silently for a moment. Julie's daughter was a painful reminder of the one thing that wasn't possible for her and Nick. "I don't suppose there's anything I can do. Just.just make sure she stays out of trouble, okay?"

Julie nodded and quickly left the office. Karen wasn't bothered any more about what went on in her staff's lives. She didn't care.

She spent the rest of her shift on autopilot, while really, she was in a dream. She hated her life, and everything in it. Fortunately she wasn't aware of Rosie's presence on the ward. She left at the end of her shift even more depressed than she had been before. Her headache was far worse and she could barely think straight. It took her six tries to get her key in the lock, her hands were shaking so badly. When she finally got in, she stumbled into the kitchen, sat down at the table and nearly burst into tears. However, she stopped herself. If she cried, she would be giving in to weakness. And she wasn't weak.

A book fell off the side, onto the floor beside Karen, landing on her foot. She kicked it away angrily. "Stupid thing!" she screamed at it, and picked it up, flinging it across the room with a force fuelled by frustration. Next, she pushed a chair over. It landed with a bang on the floor. She kicked it, not caring whether it hurt, she pulled open a drawer and flung a load of cutlery onto the floor, before collapsing in hysterical tears.

Eventually she forced herself to bed, but she didn't sleep.

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(early August)

Over the next month and a half, until early August, Karen had the nightmares on almost a daily basis. Almost daily, because there were some nights when she didn't get any sleep at all. She had become more and more withdrawn and depressed, and was cutting herself at least once a day now. It didn't make her feel any better, although she felt calm temporarily. But after her initial feeling of calmness, she felt immediately sucked down, even more depressed than before. She hated the constant depression, and the feeling of being unable to break free of the viscious circle she had fallen into. Now, even though it was the middle of summer (what summer? The majority of Brits were saying after waking to yet another rainy day), she wore a long-sleeved top under her uniform to hide the cuts and scars; concealer no longer hid them.

On the morning of the 8th, Karen called in sick and went to her GP about the not sleeping. He listened calmly as she explained the problem.

"How long has this been going on?" he asked.

"Month and a half, or thereabouts," Karen answered shortly.

The GP nodded. After listening to her describing her symptoms (although she had omitted some of the details about the dreams), he decided that she needed something to help her sleep.

Karen listened as he explained what he would be prescribing her, and afterwards, on her way to the pharmacy, considered another use for the pills. If she 'accidentally' took too many, she could end everything -

No. She mustn't think like that. Suicide wasn't the answer. It wouldn't solve any of her problems. And Kath wouldn't tolerate it; she was Catholic. No. There had to be a way to deal with this. Another, better way. But what was it?

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Kath decided to go and see Karen at the end of her shift. Her friend had called in sick, and she'd tried ringing, but had got the answerphone. She tried telling herself that there was nothing to worry about, but she knew she wouldn't convince herself until she actually saw Karen. She hadn't appeared suicidal the previous day, but it was hard to tell with her. So she rang the doorbell with a distinct feeling of nervousness, and felt a huge wave of relief wash over her when Karen answered the door.

"Hi, Kath," Karen said wearily, when she saw who it was. "Come in."

"Are you OK?" Kath asked.

"Had a doctor's appointment."

"How come?" Kath queried gently.

Karen sighed. Reaching the living room, she sat down in the sofa. "I haven't been sleeping well recently," she stated shortly.

"And?"

"And nothing," Karen shot back sharply. "Did you come round just to check I hadn't cut my wrists or taken an overdose?"

"No," Kath replied, taken aback by the fierceness of Karen's tone. "I called by for a social visit, if that's alright with you."

"So what did you want to talk about?" Karen demanded. She knew she wasn't being fair to Kath, but right now she didn't care. She was hurting a lot, and she wanted everyone to feel her pain. She felt like lashing out at the nearest person - who, at this point in time, was Kath.

"Maybe I should just go home, then, and check Danny hasn't made the microwave explode," Kath said, attempting to bring a bit of light relief to the tense atmosphere.

"Yeah. Maybe you should," Karen answered coldly, watching Kath stand to leave. "See you tomorrow." She didn't look as Kath left. When the door shut, she stood to close the curtains. Yanking them violently shut, she almost pulled them off the rail. She hated herself for being so rude to Kath.

The sleeping pills seemed tempting. Very tempting. Karen was a nurse, and she knew how strong these ones were. She also knew, only too well, what they could do if too many were taken at once.

No. She mustn't. She'd already had this argument with herself, and suicide was not the answer. But it was getting harder and harder to convince herself of that.

Bed. She could go to bed and, with the help of a pill, forget everything for a few hours. That seemed like a good plan.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Over the next week, Karen worked herself into the ground. She was short- tempered and irritable with the staff, who now hated her. They never bothered to ask her what was wrong, and now even Kath left her alone. She had given up on Karen. If she didn't want to try to help herself, that was her problem, not anyone else's.

Arriving home after the end of her shift, about a week after her visit to the GP, she first seriously considered committing suicide. She'd had a really bad day. Two family feuds, Tash and Jasmine arguing, a blinding headache that fortunately hadn't turned into a migraine, and her car breaking down. She couldn't cope any more. She'd seen one of Nick's old razors on the side, next to the sleeping pills. Perfect, she'd thought. Do both. They'll never be able to save you if that's what you do. The thought filled her with calmness for a moment.

"No!" she cried, forcing herself to look at something else. "Don't even think about doing something so stupid!"

But it was far from easy, and for the rest of the evening, she spent her time weighing up the pros and cons of killing herself.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Throughout August, suicide weighed more and more heavily on her mind. She withdrew completely from any hint of a social life. The depression tightened its grip on her, day by day, hour by hour, but she put up no resistance. She didn't want to make the effort of living any more. It was too hard. She worked on autopilot, doing what she had to do, and by the start of September, was so unlike the old Karen, it was hard to believe. The marks on her arms grew in number, length and depth. But they remained covered. Nobody knew they were there. She couldn't cope with living any more; didn't want to live. Nobody could have predicted the outcome.

The tenth of September came. That morning Karen rang Kath, telling her she wouldn't be coming in to work that day, because an old college friend was passing through Holby, and wanted to catch up with her. Kath made the worst possible mistake - she believed her.

Karen had it all planned. There was a bottle of whisky Nick's father had left behind on his last visit. There were the sleeping pills - quite a lot of them - and the razor. The alcohol would suppress her gag reflex, along with making things easier to bear. The razor was there to make sure.

She wrote a note and left it on the kitchen worksurface before heading upstairs. The answerphone was turned on, so as not to arouse suspicion. Sitting on the bed, for the first time in a long time, Karen felt at peace with the world, and perfectly calm. She swallowed a handful of the pills, washing them down with the whisky. She checked to ensure there weren't any left, and picked up the razor. Hands shaking, she attempted to press down hard. She missed the spot she was aiming for and only nicked the surface slightly. She steadied her hand and this time got the spot she was aiming for. Gripping the razor tightly, she dug it in deeply, pulling it slowly and deliberately across the vein. Dark red blood immediately appeared, and Karen allowed herself a small smile.

She switched the razor to her left hand and repeated the process, dark red venal blood now covering her hands. The razor fell to the floor and she took another long drink from the whisky bottle.

A while later, she began to feel dizzy and light-headed, presumably from blood loss. She was also beginning to feel sick and very drowsy from the cocktail of pills and alcohol, and it was not much longer before she passed out on the bed.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

"Earth to Mum. Come in, Mum, are you receiving?" Danny Shaughnessy waved a hand in front of his mother's face.

"Hmmm?" Kath blinked at him distractedly.

"Mum, you've been distracted and out of it ever since Karen rang this morning," Danny explained impatiently.

That brought Kath down to earth. "Get Julie to cover for me," she told her son abruptly. "I'm going to check on Karen." She walked into the staffroom, grabbed her fleecy jacket and car keys, and hurried out of the hospital. She drove straight to Karen's, suddenly terrified at what she might find. She'd tried ringing earlier, but the answerphone had been on. In an instant, she saw exactly what had happened. Karen had phoned her so she wouldn't worry if she wasn't at home, so she could make her suicide bid. But she had forgotten one thing: Kath had a key.

Kath parked outside Karen's house and was immediately at the door. She rang the bell, but when she got no answer, decided to use her key.

The house was deadly quiet. Kath's sharp eyes promptly spotted the paper on the worksurface, and her heart plummeted. Picking it up, she read:

Dear whoever finds this (probably Kath),
I don't really know what to say. I can't stand living any
longer. I have nothing to live for any more. My life is
wrecked beyond repair. Don't bother trying to put me back
together. I don't want it. Karen

Kath stared at it in shock. Karen had attempted suicide. Today; earlier this morning. She realised she had to find Karen. First she looked in the living room. No Karen. Kath felt the panic starting to rise, but she forced it down. Now, where else could she be?

Upstairs. Kath raced up the stairs, taking them two at a time. She flung the bedroom door open and gasped. Karen was lying o the bed, unconscious. There was a half-empty whisky bottle on the floor, and an empty bottle of prescribed drugs. And the razor. Kath looked over at Karen and was suddenly acutely aware of the blood that was everywhere.

Kath saw the phone and dialled for an ambulance. Karen still had a faint pulse, but there wasn't much hope for her, if Kath was to be brutally honest. She'd be dead by nightfall.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Kath sat in the Relatives' Room in A&E. Penny Hutchens, one of the paramedics, was with her.

"How could she do this?" Kath cried helplessly. "All she needed to do was admit she couldn't cope and ask for help! I don't understand!"

"Maybe she didn't know how to," Penny suggested.

Kath didn't respond, and the two sat in silence. Amy had contacted Nick, but he apparently wasn't sure if he was coming. There was nothing more that could be said.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

"How long's she been down?" Patrick Spiller asked, glancing at Charlie.

"Forty minutes," Charlie replied wearily. "It's no good."

"Hold compressions," Patrick requested. The ECG machine let out one long, unbroken tone. "Asystole. Time of death, 13:25," he announced resignedly, reaching up to turn off the ECG. "Thankyou, everyone."

"I'll talk to Kath," Duffy volunteered. She left after Patrick's nod of approval, and went into the Relatives' Room.

Kath looked up at her, and Duffy shook her head. "She was too far gone. There was nothing we could do to save her." She sat down. " I didn't think she'd go this far."

"I should've figured it out straight away!" Kath cried. "When she rang.She's been suicidal for weeks!" She buried her head in her hands, and Duffy put a comforting arm around her shoulders. "If she hadn't managed suicide this time, she'd only have tried it again. You know that, Kath."

Kath nodded uncertainly. "But I still feel guilty. What do you expect - I'm Catholic." She managed a weak grin, before Duffy hugged her tightly.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

"Where's Karen?" a tall, dark-haired man asked Amy three hours later.

Karen who?" Amy returned, not looking up from the computer.

"Don't play dumb with me, Amy," Nick Jordan snapped. "I'm not in the mood for it."

Amy looked up in surprise. "Nick?!" she exclaimed in shock.

"Yes, it's me," Nick snapped irritably. "Look, where's Karen and how is she?"

"You'll have to talk to Duffy," Amy told him shortly. Fortunately, Duffy was just approaching. "Duffy!"

Duffy looked round and saw Nick. Taking a deep breath, she walked up to him. "Nick, shall we go into Charlie's office?" she asked gently, leading him to the office. Once they were inside, she shut the door and indicated that Nick should sit down. "Nick, what exactly did Josh tell you?"

"He said that Karen had been brought in here and that she was in a bad way. Was it an accident?" Nick asked. He looked genuinely worried, Duffy thought. "Is she ill?"

"She committed suicide," Duffy said quietly. "Patrick - Patrick called time of death three hours ago." There was no easy way to put it.

Nick stared at her in horror, her words barely registering. "S-s-suicide?" he stammered out, deeply shocked. "Why?"

"She's been depressed for a while, she started cutting herself, and she didn't admit that she needed help," Duffy explained. "There really isn't anything anyone could have done."

"If I hadn't been so impatient with her that day she came to Leicester." Nick said slowly, a huge wave of guilt sweeping over him. He looked up. "It's all my fault!"

"No it's not," Duffy insisted.

Nick couldn't believe this had happened. Once or twice in the past, Karen had threatened to attempt suicide, but she had never gone through with it. He hadn't thought she was capable of it. Clearly, she had been. He couldn't comprehend the situation, or grasp Duffy's words. Karen was dead. Karen had committed suicide. Karen, who he'd fallen in love with years ago, who he had married, and who had become his wife. He remembered also the rows, his own infidelity, and how, both times, he had been the one to leave her, not taking into consideration what she might do. She was the one person he had truly loved, and he had lost her forever. It felt like part of him had died with her; part of his heart. "I can't believe this has happened," he choked out. "I can't believe she's really.dead."

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

"Everyone, will you please just shut UP!" Kath screamed at the assembled Keller and Darwin staff. Silence fell. Kath cleared her throat. "I don't want any heckling, and there is no easy way to put this." She paused. "Karen - Karen died a few hours ago. She committed suicide."

A murmur rippled through the staff.

"Julie, you're Acting Ward Sister now," Kath said quietly. Julie looked up sharply, wide-eyed. Her face showed a clear expression of shock. She was unprepared for this, but she was willing to step in. She hoped she'd be able to match Karen's standard in running Darwin.

The rest of the staff also had mixed reactions. They were shocked by what had just happened, but several also doubted Julie's capabilities in running the ward.

Kath looked up as a great bear of a man joined the group. "Mike?"

Mike Barratt nodded. "I heard from Patrick," he replied quietly. "Nick's here."

"What? Nick Jordan?!" Jasmine exploded angrily. "Who does he think he is, leaving Karen like that, swanning back only when she kills herself because of him?"

"Jas," Kath cautioned softly, placing a hand on the Nurse Practitioner's arm. "Don't put all the blame onto Nick. Karen's been self-harming and battling depression since she was twelve. She'd probably have attempted suicide sooner or later anyway."

"But he's got a cheek!" Jasmine shot back vehemently.

"Nurse Hopkins." Mike warned. Jasmine subsided, albeit grudgingly, still muttering under her breath until Julie elbowed her in the ribs.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

"Thanks, Charlie. I, er - I know you did your best for Karen," Nick said quietly. They were sitting in the Relatives' Room, and Charlie and Duffy had gone through the last few months of Karen's life, recounting the huge number of times she'd refused help. "Truth is," Charlie concluded, "she didn't want to be helped."

"I should have been there for her. I left her. Again," Nick added, burying his face in his hands. Duffy, sitting on the other side of him, put a comforting arm round his shoulders and gave him a gentle hug. Nick allowed her to embrace him. He needed some support right now. How would he be able to carry on now, knowing that Karen was dead, because of his arrogance and thoughtlessness? He couldn't imagine the torture she'd gone through, or how much she must have been hurting on the inside, and this thought considerably increased the already colossal guilt he was feeling.

A thought suddenly struck him. "Does Elizabeth know?"

"Elizabeth?" Duffy gave him a puzzled look. "Who's Elizabeth?"

"Karen's sister," Nick explained. "She's some high-up person in London."

"I contacted her," Charlie answered, then frowned. "She didn't seem too bothered, though."

"Yeah, well, she wouldn't," Nick answered bitterly. "She's a snob of the first degree. And she's probably one of the reasons Karen did this. Elizabeth's always bullied her, even though she's three years younger."

"She's coming up," Charlie said softly. "But not for a week, at least."

Nick sighed, then stood up and walked out onto the fire escape of the Relatives' Room. He would be the one to make all the arrangements. It was the least he could do. Karen was probably in a better place now, one where she wouldn't have to suffer emotional distress ever again. "Please God, if you're up there, look after Karen. She deserves better. Don't let her suffer any more," he pleaded, gripping the fire escape railings tightly, before bowing his head. He stood there for a long time, beginning to come to terms with his wife's death. Then, slowly, he turned and walked back inside, a grief-struck man contemplating the future, unsure as to his fate. Without Karen. He knew the grief would ease with time, but he was also equally painfully aware that the guilt wouldn't. Nick Jordan would never be the same man again.

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The End