Chapter 7- The Necessity of Atonement

If there was anything about his life in Oakbrook Falls that really concerned Derek's family, it was the fact he hadn't really touched a woman in twenty years. He was a doctor so of course he had touched his patients, but it had always been in the clinical sense. He hadn't dated and he hadn't had sex and really hadn't felt the desire to do either since that night. His sister had told him a hundred times that choosing to become celibate at twenty-five wasn't a healthy response to grief or trauma, but Derek had always figured it was part of his punishment. Two years after that night, his mom had brought a priest to see him, a priest who had talked to him about atonement and forgiveness, and while Derek pretty much thought the whole God thing was bullshit, his exhausted brain had latched onto that. And so, for twenty years, he hadn't even thought about another woman in terms of being beautiful or sexy.

There were patients who flirted with him, but they were harmless. Pamela Covington came to his office at least twice a week to flirt and a couple of the moms who had recently moved to town couldn't seem to help it. But all of it was harmless and he didn't really pay attention to it. Sophie and Emily claimed that he wasn't that bad looking, which probably translated from sister speak into handsome or something, and Mark had begrudgingly admitted he had grown into his looks. But none of that really mattered when it came to his own forced celibacy. He was sure any therapist would have a field day with it, it would probably be some sign that he wasn't doing better, but he had never really cared. It just wasn't part of his life or his routine. At least, it hadn't been until he had shaken Meredith Grey's hand.

The world had shifted on its axis. It was probably a little crazy to think that, but so far, it was the only way Derek could think of to describe what had happened when he had met his newest patient. When Patty had grabbed him out of the end of an appointment with nine year old Alex, who had stuffed a marble up his nose after a fight with his mom, all she had told him was that they had a thirty-eight year old pregnant woman who was alone and had fallen in the shower. His advice had been to support her as much as possible, in case the news was bad. He hadn't known what to expect, but he had had to quickly prepare himself to tell someone the worst news imaginable. Instead, his entire world had done a weird flip when he walked in and saw her for the first time.

She was small, with wavy blonde hair and golden green eyes that had been filled with tears when he had first smiled at her. His first urge was to comfort her, but then he had touched her hand and he had felt everything shift, he really had. He probably would have dismissed it as static electricity, except it had kept happening. Every single time he had touched her wrist to try to get her to calm down, the shock had rocked every inch of him. She had been so scared, even after he had heard the comforting sound of the baby girl's heartbeat, and all he had wanted was to make her feel better, to see her smile.

He wanted it to be that he was a big brother and hated the idea of her being upset. She was pregnant and alone in a new town and had clearly struggled to accept what was happening to her. So he wanted to believe there was some brotherly protective instinct that was taking over him. But then she had started talking about hiking and it had taken everything in him not to ask her to go with him once her ankle was healed. It was insane and he didn't know that voice inside him. No one went hiking with him on Saturdays and he liked the quiet. He liked how quiet and orderly his life was and now it felt upside down. He didn't have a back up plan for this because he had never needed it. Never once had he looked at a woman and thought she was pretty or that her eyes looked golden. He hadn't spent any time in the past staring at his hand and wondering why it was still tingling even hours after he had squeezed her hand. He didn't want this feeling. He couldn't have this feeling. He didn't know how long it would take to atone for what he had done, but he figured it was several lifetimes. He didn't want to do this and it didn't make sense.

She was his patient, his pregnant patient. That alone meant he couldn't be feeling this way, outside of everything else. There were rules about doctors and patients and even beyond that...she was pregnant. She had a tiny rounded stomach and he was pretty sure her soft curves were from her changing body. Not that he had noticed the soft curves, but the paper gowns really didn't leave much to the imagination. In a few months, she would have a newborn and that was probably what she was most concerned about. It was what he needed to be concerned about, too. He was her doctor and the world turning on its axis was not part of his routine.

It was actually making him feel a little breathless and his chest feel a bit tight as he signed off on a couple of charts. It was ten minutes to seven, when he usually closed the office and headed home. He had to do that today, had to leave at seven, warm up dinner, and maybe get some reading done. He had wanted to follow up on some things from the symposium anyway so tonight sounded like a good night to do that. Just because the world had done some strange turning thing didn't mean he needed to change anything about his life. He was Dr. Derek Shepherd, the town doctor and he had responsibilities and routines. Those things meant everything to him and how well he was doing here in Oakbrook Falls. A petite blonde pregnant woman wasn't going to change any of that.

"Derek?" Patty knocked on his door before sticking her head in.

"Hey, Patty," he smiled at his nurse.

"All paperwork is wrapped up and all labs were sent to Syracuse," Patty stated. "I forwarded you the results we got back, too."

"Great, thanks," he nodded as he turned to his laptop. "Anything else from today?"

"I put in a supply order. Feel free to sign it after the fact," Patty laughed. "Other than that, I think it was a pretty successful day."

"So do I," he agreed. "Remind me tomorrow to call Tony to walk him through his burn treatment. I'll probably stop by, too."

"He'll love that," Patty shook her head.

"Hmmm..." Derek breathed, staring at the pile of charts on the edge of his desk. "I...the pregnant patient...Grey? Has she called with any concerns?"

"No," Patty frowned slightly. "Everything looked good when that poor girl left though. She limped herself home to rest, I think."

"That's good," Derek nodded. He had seen her limping out of the office after her blood work, munching on a couple of cookies as her wounded hand rested on her stomach. He had just pretended to not see her because the second he had, his world had felt both bigger and smaller all at once. "I might call to check on her."

"You're still worried about the fall?" Patty asked. "Or more worried that the poor thing was obviously trying to hide her pregnancy and hadn't come to terms with it?"

"Don't be judgmental, Patty," he frowned at his nurse.

"I'm never judgmental and you know it, Derek Shepherd," she denied. "I found it sad."

"So did I," he admitted as he flexed his tingling hand. "I talked to her after and I think...anyway, I'm going to call her and check on her before I close up."

"It never hurts," Patty smiled at him. "Do you mind if I head out?"

"Of course not," he sighed, shaking his head. "Go home and I'll see you in the morning."

"See you in the morning, Derek," Patty returned before she walked out of his office. Derek took a deep breath and stared at his phone. He did do follow ups occasionally, though usually not the day of unless something life changing had happened. And for Meredith...well, she had found out she was having a healthy baby girl and that had seemed pretty life changing. She might just need someone to talk to now that things had settled and he did want to make sure there weren't any consequences from the fall. He sighed and opened her chart before reaching for his phone.

"Hello?" Her soft voice answered and Derek did his best to ignore the way his chest seemed to almost immediately relax.

"Meredith, hi," he said, "it's Derek Shepherd. I just wanted to call to check in before I went home for the evening."

"Oh, Dr. Shepherd," she giggled. "Is this another perk of a small town doctor?"

"Derek," he corrected. "And yes, it is."

"Derek," she echoed.

"Yeah," he ran his hand through his hair. "How are you doing?"

"I'm okay," she answered. "Ankle is elevated and there's ice on my wrist."

"Excellent first steps," he smiled. "And Baby Girl Grey?"

"She's good, too," Meredith laughed. "She's fluttering around. And wants mac and cheese."

"No contractions or bleeding?"

"None," she confirmed.

"Good," he murmured as he stared at her file, of the ultrasound photo that was paper clipped to her paper work. "And how are you feeling? I know today was a lot."

"Are you the town shrink, too?"

"I listen a lot," he shrugged. "You don't have to talk if it makes you uncomfortable."

"No," she denied as she took a deep breath. "I mean, it's been a lot lately and I guess...I really don't know how to explain this."

"You weren't ready for her to be real yet?"

"I guess not," she sighed. "And I've been through the morning sickness and the heartburn and the peeing and the weird pain in my side-"

"Round ligament pain," Derek offered. "It's the ligaments stretching to accommodate your uterus as it grows."

"Oh," she breathed. "Right. Round ligament pain."

"You'll keep feeling them as she gets bigger," he smiled into the phone.

"I just..." Meredith paused for a second. "I was climbing Watkins's Trail the first day I was here and she fluttered. And I thought...well, she seemed like she was going to get real. And then today happened."

"Now she feels real?" He asked softly.

"Now I think I might actually love her," she whispered, her voice sounding a little choked. "I...sorry. I don't want you thinking I'm always crying because I'm really not someone who does."

"Scientifically, it's your hormones if that makes you feel any better," he offered.

"It does actually," she giggled and he shifted in his office chair at the shiver ran up and down his body. "I've actually been looking at baby stuff while I chill out on my couch. I haven't done that yet."

"Well, no painting or ladders," he reminded her.

"I promise," she agreed.

"Good," he breathed as he stared at his computer. He had called to check on her and he had. Now would actually be the time to tell her to have a good night and hang up.

"Can I ask a question?" Meredith asked.

"A medical question?"

"I...no," she admitted. "I was just...I'm a journalist."

"You said that," he nodded as he sat back in his office chair.

"Right, well I'm a journalist and I'm not currently really being a journalist but I'm naturally...my dad says I'm inquisitive," she said quickly. "The point is...are you from Oakbrook Falls?"

"Oh," he whispered and then cleared his throat. "No, I'm originally from Long Island."

"I thought I heard an accent," she laughed victoriously.

"I think it's mostly faded at this point," he shrugged. "My parents still live on Long Island and i just visited them a couple weeks ago. Maybe my trip refreshed it."

"I looked you up on the Oakbrook Falls website," she admitted. "It didn't say where you were from but it said you got your neuroscience degree at Bowdoin in Maine and your medical degree at Columbia. I wasn't stalking you. I just…Patty said you do everything and I was curious."

"Oh," he breathed. He hadn't even known there was an Oakbrook Falls website or that he was on it. In the long run, it probably didn't even matter. No one in town knew what had happened twenty years ago and he really didn't think anyone had cared until now. "I um…yeah…I came to Oakbrook Falls on a fishing trip and…the old doctor was a guy named Dave Shetland. He was an amazing doctor and he kind of got me with the idea of helping a whole town instead of selling my soul to a huge hospital." It was the story he had told for eighteen years now and he wasn't going to change it now. It was easier and he could actually say it.

"Is that what Oakbrook Falls does?" Meredith asked.

"What do you mean?"

"You come here and suddenly you can't leave," she pointed out. "I didn't…it never occurred to me to move upstate. I didn't want to go home yet but…and then I came here and hiked and had this crazy idea to move here."

"Maybe," he sighed, glancing at the picture of his family on his desk. "It's still simple here. It's simple and quiet and I think a lot of people still crave that."

"That makes sense," she murmured. "I needed simple for once."

"See? My theory was right," he nodded.

"I wasn't arguing it," she giggled.

"Good," he nodded firmly, a weird warm feeling moving over him at the sound of her giggle. He didn't know what he was doing right now. This wasn't checking in with a patient. This was a phone conversation and he was enjoying it a lot. It was completely out of his routine and he really didn't know what to do about it.

"Is it weird to do everything?" Meredith asked. "I mean, is it weird to go from examining a pregnant woman to helping a kid to diagnosing someone's cancer?"

"Are you interviewing me for a piece, journalist Grey?" Derek raised an eyebrow.

"I don't know, maybe," she admitted as she laughed. "I'm trying to figure out what how to be an unemployed journalist. Maybe an article on the popular small town doctor would sell."

"I don't think anyone will be interested in my day," he shook his head. "And it's not weird. It's challenging, but in the best of ways. I love what I do."

"Apparently since you call patients at seven o'clock at night and let them talk to you because they're sad and lonely and injured on the couch," she pointed out.

"I called to check up on you," Derek pointed out. "You fell today, you're twenty-one weeks pregnant, and you were pretty shocked by the ultrasound. My job is to make sure you're okay."

"I really am doing okay," she promised. "Pink for girls is super cliched, right? I should go for something more original."

"I…yeah, probably," he agreed as he checked his watch and then quickly sat up. It was ten past seven and he needed to be home. He closed the office at seven, walked home, and usually had dinner in the microwave by now. Any difference in the routine was usually bad and he had just shifted it so he could talk to his patient.

"I think so, too," Meredith was saying.

"I…you said you were craving macaroni and cheese," he said quickly as he stood and started gathering his things. "Are you making it?"

"I should actually check to make sure the water isn't boiling yet," Meredith said. "Are you going to yell at me if I walk to the kitchen?"

"You're not on bed rest, Meredith," he laughed slightly. "You just need to rest your ankle as much as possible."

"Okay, well, I'm going to limp to the kitchen then," she giggled.

"Good," he breathed. "I um…I'm actually going to close up the office."

"Oh god…I'm sorry,' Meredith said quickly. "You called to check on me and I turned it into a thing."

"You didn't, Meredith," he murmured. "You can call me whenever. Loneliness is included for a lot of my patients."

"Today was just a lot but you have your own life," she sighed.

"I don't…or…I do," Derek corrected himself as he ran his fingers through his hair. "But the offer still stands…call me if you need anything. And I'll let you know what your lab work says."

"Thanks, Derek," she murmured. "Have a good night."

"You, too, Meredith," Derek sighed before hanging up his phone and turning off his light. He had no idea what had just happened or why it had happened or how he had let it happen. He was calling to check on her and had ended up having a conversation with her that had felt…it had felt different. He wasn't even sure if he still had the word for what the conversation had felt like. But nothing had warned him that he was crossing any lines or ruining his routine. For the last eighteen years, he had started to depend on that voice that made his heart race and his breath come in short gasps. That voice knew when he was doing something that could ruin things and he didn't understand where it had gone tonight.

Talking to Meredith had been fun, even if he was a little worried that she was digging. She was a journalist and she was curious and he got that but he liked that no one in town knew about that night. He liked that no one cared to look up what had happened in 1999, when he had been young and so sure of what the new millennium would look like for him. Dr. Shetland had never looked it up, and Derek didn't think anyone else had either. He was just the small town doctor who had stumbled into Oakbrook Falls in April of 2001 and never left.

But he couldn't worry about something so stupid, especially when she hadn't said anything about how he had ended up here. The point was, he liked talking to her. She was funny and curious and she had a giggle that wasn't annoying but actually…well, he wasn't sure what word would describe her giggle. Honestly, there were a lot of words he thought he might be missing now, or maybe words he just couldn't use again. None of this was making much sense to him right now and it was making his head spin. The warm, comfortable feeling he had had when he was speaking to her was starting to go away and that voice was starting to scream at him as he walked down the street towards his house.

There was so much going on here that wasn't good. She was his patient, she was pregnant with someone else's kid, but more than any of that, he could not do this. He could not try to remember words he had used to describe someone else, he could not laugh on the phone with Meredith, and he could not feel comfortable or warm or safe with someone else. He had worked really hard to get better. He had found Oakbrook Falls, he had gotten a job he loved, and he had taken the therapist's advice to find a routine that made him feel safe. There were times, like when he was back home, that things didn't look as good as they did here. But he was doing better. He just…he had certain rules and he couldn't break them.

Meredith was…he didn't have words for it. But the word beautiful kept popping up, maybe even the word enchanting. But twenty years ago, he had made a promise to himself that this was just…it wasn't going to be a part of his life again. It actually couldn't be a part of his life. He had a lot to make up for and he didn't think laughing with his pregnant patient was good enough. That Derek Shepherd had existed twenty years ago, and as he walked into his house and his brain started telling him what each step needed to be for getting his night going, he fought the urge to open his desk drawer. He had already realized he couldn't do this, he didn't need any other kind of reminder. Even if his hand was tingling and he didn't think he could get Meredith's giggle out of his head, he didn't need a picture to remind him of what his atonement needed to look like.

Give me the burden, give me the blame

I'll shoulder the load, and I'll swallow the shame

Give me the burden, give me the blame

How many, how many Hail Marys is it gonna take?