Chapter 16: Depression

A firm rap sounded from the open office door. Oliver was deep into reading a new study on prevention of opportunistic infections in AIDs patients and didn't bother to look up. Lance cleared his throat and Oliver finally glanced over.

"Hey," Lance said stepping inside the office and shutting the door behind him. "I'm glad I caught you."

Oliver raised an eyebrow, urging his deputy mayor to continue.

Lance cleared his throat again and said, "I had that meeting at the community center on the new environmental protections bill. It went pretty good. The response was better here than it was when we had the meeting with the business stakeholders."

Oliver nodded. Frankly, he wasn't sure he remembered what the new environmental bill contained. Recently he had trouble focusing on many parts of his role as mayor. He liked to think he was hiding it pretty well – he was used to wearing a mask in public - but the only parts of his position that he really mentally engaged with anymore were public safety and health concerns. Beyond that, he was more than happy to give new information a cursory glance and leave the discussion process to his capable cabinet. It had been just two months since he had learned about Thea's HIV diagnosis and only a few weeks since she met criteria for AIDs. Everything that didn't have to do with life or death issues felt banal and tedious.

Lance seemed to understand that he wasn't going to get any further reaction and nodded a bit to himself. He glanced at the closed door behind him, then stepped closer so he could lower his voice and still be heard.

"Hey, how's Thea doin'?" Lance asked, brow furrowing as he dug his hands into his pockets.

Oliver felt his shoulders slump as he felt the weariness of Thea's situation come over him. Oliver sighed and said, "I honestly couldn't tell you. Thea's doing a pretty bang-up job of avoiding everyone." Lance's eyes sparkled with fatherly concern. "Sin's keeping Laurel up-to-date on the sly and it sounds like Thea is still going to work and has gone out patrolling a few times. Beyond that -" Oliver shrugged his shoulders helplessly, "she's dodging calls and making up excuses for why she can't see us."

Lance nodded sadly, "Laurel's tellin' me the same things. She hasn't talked with me at all since she fell sick in my office. I'm hopin' she's not holding a grudge for me calling Laurel."

Oliver shook his head quickly, "I'm sure that's not it. You saved her life, Lance. If you hadn't gotten her help that night…." Oliver let the thought hang in the air.

Lance shifted his weight from one foot to the other and said, "Yeah. I couldn't have done anything else, you know? She feels like my own kid sometimes." Oliver nodded, then scrubbed at his face. "Look – I'm sure she just needs a little time. She's dealing with a lot." Yes, Oliver could only hope. His sister had always had an independent streak, but he didn't agree that with her health in such a precarious position she should be allowed to be out of contact.

"Ya know," Lance said hesitantly. "Since she hasn't been by to work on our case, she hasn't heard the news." Lance paused and waited for Oliver to glance back at him. "Seth Aubrey – one of our perps – is dead."

"Huh," Oliver said in a mildly interested voice.

Lance studied Oliver for a moment. Then he rolled his eyes and said, "Yeah, someone disemboweled the guy. He bled out slowly. Didn't make it out of surgery. Turns out there's not a whole lot for paramedics to put pressure on when all your insides are bleedin'."

"Sounds like a rough way to go," Oliver said evenly.

"Pretty horrific stuff," Lance said. "Sounds like the police don't have any leads, but – I don't think they'll be looking too hard. Sounds like it's just as well that this guy is gone. He was pimping out little kids."

"I'll certainly sleep easier," Oliver responded.

"It just got me to thinkin'," Lance said, eyes purposefully studying Oliver. "Made me wonder what Thea would do when she found out. It'd probably hit pretty close to home. She might even have some questions. Like how this guy even got on his killer's radar."

"Thea's smart," Oliver said evenly. "When she finds out, I'm sure she can look into whatever answers she wants."

"I just hope that it doesn't mess anything else up for her, ya know? She's got a lot going on right now, and this isn't the thing she should be worrying about."

Oliver didn't appreciate the point Lance was making. "Frankly, it seems like the fact that she has a lot going on right now is exactly why it works out that she has one less thing hanging over her head."

Lance tilted his head and said, "I hear you. I just hope that Thea sees it the same way." Lance retreated from Oliver's office.

Groaning in annoyance that Lance had brought all of his concerns for Thea back front and center, Oliver grabbed his phone and called Laurel.

"Hey," Laurel's voice responded in a low tone, a good indicator that Oliver had caught her somewhere public with work.

"Hey," Oliver responded. "I was just checking in – have you talked to Thea? Or Sin?"

Laurel sighed. "I haven't managed to catch Thea. I went by yesterday to try to take her to lunch and Thea dodged me, saying she was meeting a client for lunch. If she was faking, she was committed to the bit. She really did leave when I did."

"And Sin?"

"Sin said she hasn't missed work, but she's vanished every now and again for purported meetings with vendors or clients. Sin's worried. She thinks Thea has lost some weight and she didn't have anything to lose to begin with. Beyond that, she feels like Thea is acting normally enough and they've even hit the streets to patrol a few times this week. Sin said that Thea doesn't want to hang out after like they usually would."

Oliver sighed, rubbing his hand against his eyelids. "Okay. At least that's something."

"Is she still avoiding you?" Laurel asked sympathetically.

"Yeah. She's acting like she's not," he said drily. "She won't pick up my calls, but then texts me like nothing's wrong. She ignores any questions she doesn't like, but then sends me cat memes. I don't know. I just feel like she's playing games."

Laurel hummed in understanding. She added, "Lyla said she didn't accept an invitation for dinner at her place with Sarah. And you know, Thea would do anything for Sarah."

"Yeah," Oliver said, crestfallen. Oliver looked up to see Felicity in his doorway holding a large paper bag with both hands. Oliver said, "Hey Laurel, Felicity's here for lunch. Let me know if you hear anything new, okay?"

"Of course. Say hey to Felicity for me."

Felicity pulled out several small containers, pushing papers to one side to make a clear patch on the desk, and setting them down. Oliver leaned over and pressed a kiss to Felicity's lips. "Hey," he said.

Felicity shot him a quick smile before turning serious. "Laurel still hasn't talked to Thea?" Felicity asked.

Oliver took the wrapped sandwich Felicity held out and said, "No. But we don't need to talk about that right now. How was your presentation this morning?"

Felicity acquiesced and said, "It went well. Really, Curtis took the lead. It was his project. But the review committee seemed impressed, so I think that the additional funding for phase two will be approved."

Sitting in the early afternoon sunlight with Felicity was doing more for Oliver than an entire morning of trying to focus on work and failing had. Oliver even managed a sincere chuckle when Felicity told him about one of her team members accidentally getting their business icon stuck as a cartoon character instead of their actual profile picture right before an online meeting with an important shareholder. He could easily visualize the confusion in the shareholder's voice as she asked if the team member was in the meeting and, in response, the little blue hedgehog icon lit up saying they were present.

The conversation found a natural lull and Oliver said, "Okay, you've waited long enough." Felicity looked confused. Oliver shot her a look and added, "You wanted to tell me about this vacation idea with the STAR Labs team?"

"Hmm, yeah," Felicity agreed through a mouthful of salad. Felicity swallowed and took a sip from her water bottle. "Yes. Look, we've all been through a lot lately, and when everything went down with – you know -" Felicity leaned forward and mouthed "the aliens," before leaning back. "We said we would find time to get together when it wasn't the end of the world. I think a day away from everything is exactly what we need."

Oliver sighed and raised his brow, saying, "You're not wrong. It would be nice to be with people who ... get … things. And relaxing sounds nice." Oliver looked away towards the wall, adding, "If we can even reach Thea to invite her."

"I think we just get a date on the calendar. We worry about getting Thea to come along once things are in motion."

"Okay," Oliver said agreeably. "You've got me. I'm in."

Oliver's cell phone began to ring and a glance at the screen read, "Healthcare". Oliver raised his eyes to see Felicity watching, concerned, before he hit answer.

"Hello?"

"Mr. Queen, this is Dr. Henson."

Oliver hit the speaker button and set the phone onto the desk looking at Felicity. Oliver said, "Dr. Henson. What can I do for you?"

"Thea missed her infusion this week. I was able to talk to her on the phone after she no-showed, but she didn't reschedule then and we haven't been able to reach her since."

Oliver felt his stomach begin to sink as he took in Dr. Henson's words. So, Thea was avoiding more than just her family and friends. "I thought you said Thea has always been good about following through with her treatment," Oliver said, immediately trying to deny what Dr. Henson was telling him.

Dr. Henson acknowledged, "Thea had a recent, major change to her health." Oliver felt Felicity place her hand in his, tightening her grip in solidarity. "It isn't uncommon for patients to experience grief or depression in response, which can often lead to noncompliance with prescribed treatment. Thea may not be trying to harm herself – she's likely just trying to accommodate to her new normal."

Feeling a little dazed by this newest of problems, Oliver tried to understand how the problem could be fixed. "You called me for a reason. What do you need me to do?"

"Thea needs to be seen for her next infusion. I really do believe that the ibalizumab is the only thing bringing Thea's viral counts down and keeping her t-cells stable. If Thea fails to return for her next infusion, not only will it quickly begin to impact her immune system, but her insurance may decline to cover the treatment in the future."

Oliver's brow creased in confusion. "Why would insurance decline treatment?"

"Ibalizumab is an expensive medication because it is marketed to a small, specific population - there are only so many people with HIV, and even fewer who have experienced treatment failure of tier 1 drugs. If Thea isn't compliant with treatment, the insurance company will point to the time she wasn't taking it to say it is clear that it isn't needed. Then they're off the hook for paying the cost. And if insurance doesn't pay, Thea would be looking at paying thousands of dollars for each treatment."

The seriousness of the situation washed over Oliver. He thought of how Thea had been dodging him and their friends since she had left the Loft last week. Oliver said, "Dr. Henson, I appreciate all of this, but I'm not sure how I can help. Thea has been avoiding all of us since she was cleared to return to her apartment. Before she went radio silent, my wife said that Thea told her that Felicity couldn't understand what she's going through."

Dr. Henson suggested, "Thea may feel better understood if she connects with an AIDs support group. I can send a list of some resources. She might find it beneficial to be around a group of people who she can relate with."

Oliver winced and said, "I'm not sure that's the best idea – my family has always been tabloid fodder and I think the risk of outing her HIV/AIDs while attending a support group would be too high."

"These types of groups are designed to be confidential, but I can still understand why she wouldn't want to take the risk. She may do better connecting online with a support group where she could remain anonymous." That sounded more doable to Oliver. Dr. Henson continued, "I would also recommend that, if she is not already doing so, that Thea get connected with a mental health specialist and consider going on an antidepressant."

"She's been on one in the past," Oliver admitted. "I'm not sure if she is taking one now."

As the call disconnected, Oliver turned to Felicity. Her eyes held the same concern he felt welling up in his chest. Before he could say anything, Felicity said, "Go – I'll clean up. Just … call when you can." Oliver nodded firmly.

Thea had still not answered her phone, despite his back-to-back calls in the elevator on his way up to the fifth floor of the clocktower. Sin had already confirmed that Thea had left a bit ago saying she was going to a meeting, but Sin had snuck out and watched Thea heading towards the resident entrance to their building.

Oliver reached Thea's apartment door and rapped on it with his knuckles, calling out lightly, "Thea?"

He waited a moment. There was no response from inside. Nothing was stirring. Knocking harder, Oliver called louder, "Thea! It's Ollie."

Oliver felt the familiar panic building from the hollow concern that had gripped him since Dr. Henson's call. He knocked again, even while his phone rang Thea's number in his hand.

Decision made when he didn't get an answer from either his knocking or his call, Oliver pulled out the set of keys in his pocket, flipping to Thea's apartment key – a permanent fixture on his key ring since Thea's concussion. He unlocked the handle and deadbolt, then pushed the door. The door held shut. Oliver shoved at the door again, shaking it in its frame, but it failed to open. Thea must have added a bar latch since the last time he had been there.

Oliver considered his next move for only a moment. Calling out, "Thea, I'm coming in!" Oliver stepped back, and raised his foot, kicking firmly above the door's handle. With a shudder, the door snapped open, banging against the kitchen counter behind it.

Oliver stepped into the threshold and with a breath in, took in the state of the room before him.

The door opened directly into a small kitchen with dark wooden cabinets. Along the far wall of the kitchen was an overflowing trashcan, trash piled high on top. Three full trashbags rested haphazardly along the wall. The sink was piled high with dishes, as were the countertops. An upper cabinet door hung open, revealing completely barren shelves.

Oliver peered past the kitchen, which opened up to a small two-seat table and the living space. He could make out Thea's form lying prone on the couch in a tank top and shorts in spite of the chilly November day. Blankets were piled on the ground next to her in a heap, and the coffee table was weighted with its own burden of half-full bowls of soup and cups with varying levels of liquid.

Oliver had a sinking sensation. The apartment wasn't in terrible shape – but it also wasn't at all typical of his sister. Thea was tidy by nature and her living and workspaces had always reflected that. During his campaign, Oliver used to tease her that she clearly didn't have enough work to do because her desk was always clear at the end of every day. Dr. Henson's words about grief and depression rang in Oliver's mind.

Oliver walked over to the sofa and crouched down at Thea's head. Thea had yet to stir, so Oliver was startled to find himself looking at two open gray eyes which were staring off at nothing, avoiding his gaze.

Softly, Oliver said, "Hey." He glanced behind him and found a nearby armchair. He pulled it to himself and then slowly lowered himself onto the seat.

Intentionally making his voice gentle, Oliver said, "Dr. Henson called. He was worried. He said you missed an infusion." He paused, disconcerted that Thea made no sign of hearing him. "He said that you declined to reschedule and now aren't responding to calls." Thea was silent. "Dr. Henson thinks that your ibalizumab is the only thing keeping your counts stable. He said you really need to get back in to the clinic."

The lack of responsiveness was making Oliver desperate. "Thea," Oliver pled, "what's going on?" Thea's eyes didn't so much as flicker with comprehension.

Despair began to well up in Oliver's heart. He knew the expression on Thea's face intimately. It was the look of someone already beaten down – with no fight left. In her face, Oliver saw himself on Lian Yu burying his father. Holding onto Akio's body. Standing over the decimated Glades knowing his best friend lay amongst the rubble. Hiding away from his mother's funeral.

He knew how rock-bottom felt - but how could he bear it to be on the other side, watching Thea concede to her disease and quit the fight?

Oliver's throat became thick with fear. Fighting to catch her eyes, Oliver admitted, "Thea, you're scaring me. I'm scared that you're giving up. And Speedy, I don't know what to do if you give up, because … god, Thea … I need you, here!" Oliver caught it as something flickered in those eyes that he had known his entire life. She was in there. But how could he reach her?

He thought of the years he had spent away from Starling, fighting for survival, the image of home in his mind like a beacon of hope. The vision of his mother and Thea, snug and secure in his childhood home, waiting patiently for him to return. His mother was gone – how could he lose Thea? The last thread connecting him to his family.

"I have always fought to come home to you," Oliver said in a low voice, rumbling with emotion. "Fought to keep you safe." He drew in a deep breath and choked out, "Thea, I would do anything to take this from you – but I can't. I wish I could. I wish -" He watched as Thea's eyes brightened with welling tears as she continued looking vacantly before her.

He thought about this most recent blow. That she had been so faithful taking medications and infusions for months and years, and yet here she was. She got sick, so sick, and now – AIDs. Almost like an expiration date had been placed on her life.

He reached out and touched Thea's hand where it rested next to her on the couch. Her hand twitched in response, but didn't pull back. In a soft, sad voice, Oliver said, "I can't even imagine what you are feeling right now. But maybe we can find you people that do. We could find a group of other people with … with AIDs, people who would get it."

He sighed, feeling the grief in his throat. "All I know is how … deeply sad I have been since I found out. I can't think about anything else. I can't care about anything else. It all just feels so inconsequential. So … it's okay if you're hurt. Or depressed. You won't scare us away, Thea, I promise. We all love you and we will still be here. But I do think you need some help. We can get you back on the schedule with your therapist, and talk to someone about getting you back on medication. Because, god, Thea, I can't just sit by and see you suffer like this, okay?"

Oliver sat up in his seat a little and tried to start over. "Look," he said earnestly, "We've been focusing on this all wrong. Yes, AIDs has a three-year survivorship. Half of people live three years or less after diagnosis. But, Thea – half of people live more than three years. Maybe many more. You have spent your entire life bucking the odds, and now we're going to trust them?"

Mind spinning, the words coming from Oliver felt like he was speaking them into existence – they felt completely true. He declared, "You are going to make it to twenty-five. Hell, you are going to make it to thirty, and beyond. And we are going to raise money for research and see the best doctors and work with the best studies and we will find a cure. Okay? Because it's a disease and there has to be a way. But – but none of that matters, Thea, if you aren't here for it. We can't do it unless you get up, and you fight, godamnit!" Oliver noticed Thea's eyes had finally flicked over to his and he said, passion making his voice ring out, "You have to fight, Thea!"

He stopped to catch his breath and watched as a single tear trickled down her cheek. Thea whispered slowly, brokenly, "I don't think that I can." The tears which had filled Thea's eyes began to fall silently.

Oliver's heart broke, recognizing the ensnaring hopelessness staring back at him in his sister's face. A deep, smothering darkness had pulled her into despair making it impossible for her to get free. Oh, how familiar Oliver was with the overwhelming paralysis of depression.

As her tears continued to fall, all Oliver could see was his baby sister – the one he had comforted through skinned knees and the storms of grade-school friendships. Without stopping to think, Oliver slid next to Thea on the couch and pulled her body against his, wrapping his arms around her. He cradled her against his chest and rocked her as she buried her face into his shoulder, body shaking with tears.

Oliver soothed softly, "It's okay, Thea. I know."

Thea let out a sharp sob. Oliver added, "We'll get you some help, okay? I promise. And I'm here. I'll be here to keep you going until you're strong enough to do it yourself." He pressed a kiss against the top of her head and whispered, "I've got you, Speedy."