Author's Note: This is another one-shot in response to a prompt from AriaAdagio which said "Derek finds out Meredith was/is in therapy with Dr. Wyatt. You pick when." It's un-beta'd as per the rules of our writing challenge, which explains why I'm able to post this now as opposed to updating my multi-part fic (which is currently being held hostage by my dear, sweet beta, but it will be posted soon, I promise!). To see more about this insane prompt-writing/responding endeavor, you should visit the Live Journal community Elevator Junkies. Enjoy!

A sliver of light peeked out from beneath the bedroom door, flooding a narrow path that ushered her footsteps. She'd been tiptoeing, and she wasn't sure why. It wasn't terribly late – the sun had set only an hour ago – and Derek was the only person home to be disturbed. She was so small, even if she tried to make a lot of noise, she'd never be able to clomp-clomp-clomp through the hallway like one of the guys. As she drew up on the balls of her feet and rested her hand against the brass doorknob to her bedroom, she couldn't rationalize the tiptoeing. The light was on, he wasn't asleep, and he'd known she was coming home now. She'd promised him she'd be there when he left the hospital earlier in the day.

Most of the time, when Meredith came home later than Derek, she was pleasantly surprised by what was behind their bedroom door. Sometimes he'd be settled into bed with a book or medical journal, other times he'd be naked and waiting for her. On only the rarest of occasions would he be asleep already. As she gathered the courage to step behind door number one, however, she guessed that he wouldn't be in any of those positions. All rules for Derek Shepherd had been thrown away the moment he'd had the OR showdown with Addison, and Meredith had been trying to figure him out ever since.

The door squeaked against the hinge like nails on a chalkboard as she pushed it open, but Derek didn't move. The bed was unmade, and he sprawled on top of the pile of blankets and sheets fully clothed in the suit he was wearing at the hospital. The tie seemed a bit looser, and it dangled off to the side like a noose. His shirt was untucked, his finely pressed jacket and pants crumpled around him, and his shoes were untied, but still on his feet. He draped his arm over his forehead as if he was trying to shield himself from the light, but he was awake. Meredith could tell by the way his body tensed as he inhaled. That wouldn't have happened if he'd been asleep. She'd noticed over the last few days that sleep was the only time that wouldn't happen.

Meredith closed the door behind her and continued to tiptoe toward him. Her heels never touched the floor, but it felt more like trudging through muck than drifting into bed. She pulled back the covers to slide beneath, but stopped as she realized that slipping between the sheets would only create another barrier between them. She neatly pulled the covers back into place and crawled on top. She inched toward him carefully as if he was a sleeping giant and only slight movements would enable her to get close. With graceful precision, she moved his tie back into place, rested her head against his shoulder, and spread her fingers over his sternum.

Derek sighed, expelling the air from his lungs with such force that her hair drifted against her cheek. The silk of his tie grazed her knuckles each time he breathed.

She wanted to say something to make everything better and resurrect the playful, confident man she loved. She could hear his heart, just below the surface of his skin and bones, thudding in the familiar way that told her he was still there, but little else felt familiar. His body was stiff and gaunt, unresponsive to her touch. His jaw was lined in far more stubble than her lips had ever encountered, and the musky scent of his aftershave was a distant memory more likely to be smelled on the sheets than on him. His eyes were dark and sunken, and his voice didn't soothe her like it used to. Probably because every time he spoke, bits of him seemed to crumble away. His confidence, his ego, his optimism, chipped off like pieces of ice being sculpted into something unrecognizable.

"Derek," she said. Her voice was shaky, and she didn't have any clue what else to say to him. She mostly wanted to know if he'd respond to the sound of his name. She needed some confirmation that he was still there beneath the shell he'd burrowed into.

He moved his arm out from beneath her and wrapped it around her back, gently hugging her to his side, but he didn't speak.

He didn't speak, but he was still there. He still needed her.

"You have to go back," she said.

His soft massage along her spine slowed to a stop.

Meredith wrapped her fingers around his tie, clutching it. "You have to go back," she repeated.

"I can't," he said with a sense of resignation that Meredith hadn't expected. She'd expected him to break a little more, his breathing to hitch—something to show that he was conflicted about the decision, not that he'd already decided. "I'm done."

Meredith pulled away from him and sat up. Her head was spinning with confusion. This wasn't Derek. This couldn't be Derek. Derek wasn't a quitter.

Except he was. He'd deferred to Finn, given up the race for chief, quit breathing for her… Time and again, he'd stumbled when things got tough. He'd needed to fight, and he'd bowed out and forfeited the match. Anger surged through her veins, and she wanted to yell and scream until he changed his mind. He needed to see that she wasn't going to step aside and let him pull away this time.

"So, just like that, you're quitting," she said. The words felt gritty on her tongue, abrasive, like sandpaper.

Derek folded his arms under his head and blinked. "I can't do it anymore."

"And that's it? You're giving up?"

Derek rolled over to face away from her, drawing his arms and legs into his body like a turtle withdrawing to its shell. "I'm tired."

She wanted to push him and shove him and make him see that he couldn't do this. She wanted to grab a pillow and smack him with it over and over again until he realized what he was doing. But she stayed motionless and did her best to remain calm.

"What a fucking waste," she choked out. She knew the words would sting; she needed him to feel something.

He trembled slightly, but not enough to crack. "I'm just so, so tired," he said.

"You don't get to be tired. You don't get to quit. You're too good to quit," she said. Her eyes were burning from unshed tears, and a tide of unspoken arguments was flooding to the surface. He'd always accused her of running away, but she wasn't the quitter. That was his role.

"Please, Mere…"

"It wasn't your fault, Derek. You did everything—"

"I didn't!" He sprung up from bed as if it had been doused with gasoline and she had lit a fuse. "Stop saying that! I'm not a god. I'm not some miracle worker. I can't keep doing this." The words were venom on the tip of his tongue, and he spat them bitterly.

"You can't keep running away, either!" Meredith said. Her heart hurt from the burst of adrenaline raging through her veins, and she could feel her carotid artery pulsing in her neck. "I can't stand by and watch you give up again."

"So, don't. No one's forcing you to stay. Run off to Cristina's or something, and I'll be out in the morning."

He didn't mean it. She knew he didn't mean it, and he was just lashing out. He did that when he was hurt. It was like calling her a whore or saying they killed people together. She needed to let it wash over her without penetrating her skin.

"You're right," Meredith answered. "No one's forcing me to stay by your side. But I'm not going anywhere. I'm not going to be the one to walk away. I'm not giving up on you, and I won't let you leave, either."

He glared at her. He was trying to push her away, and she wouldn't budge.

"If you need me to breathe for you, I will," she added. "I can breathe for both of us. I'm not giving up."

The words hit him like a gun shot. He stumbled back into the wall and crumpled, sliding down into a heap on the floor. He was breaking. "Please, Mere," he sobbed. "Just let me…"

Fury fizzled away and evaporated. She was done provoking him, done being angry. He needed her, and she had to find a way to make him better. She stood up from the bed and moved to his side, pushing away his hands and twining her arms around him as he shook. The tension was gone, and he clung to her like a sapling clings to soil in a hurricane.

"I can't let you give up," she said, holding him tighter so he couldn't slip away. "Let me help you through this. I can help you."

"I'm tired of all the death," he murmured. "So many patients, so many names."

"I know," she said, "but you'll never forgive yourself if you walk away." She pressed her lips against his cheek and tasted the salt of his tears. "You can't walk away from the people that need you."

He shook his head. She wasn't getting through to him. He was still defeated.

"You're missing the big picture," she continued. "You take the toughest cases. You see the patients that are supposed to be terminal and you give them a chance." A catalog of names ran through her head. They were all the ones that sat in the manila folders that he wasn't looking at in the deposition. Even the ones that had died had at least gone down fighting. They hadn't quit because Derek hadn't let them.

"False hope," he mumbled. His voice was so low it came out as a gravelly whisper.

"What happened to you?" she asked. She coiled her legs around his waist and threaded her fingers through the hair near his temples, holding his head at eye-level in front of hers. "Why are you giving up now after all that you've accomplished? You saved Archer when everyone told you it couldn't be done. The trial was a success—"

"This isn't about the trial," he said, pushing her hands away as he shook his head violently.

She'd struck something. A secret hatch or a hidden door into his psyche. This was about the trial, and she needed to prod deeper.

"I made you do it. You never wanted to do the trial, and I forced it on you," she said. Guilt barreled into her like a raging bull. Had she broken him? Was this her fault?

"I could've said no," he dismissed.

"You did," Meredith said. She was picking up jagged shards of glass and putting them back together. "You tried to stop it, and I talked you out of it. Every time you wanted to quit, I made you keep going. We lost twelve patients. Twelve. Twelve patients, twelve files. That's what affected your death rate."

"The deposition wasn't about the trial," he argued. "This isn't about the clinical trial." The adamancy with which he spoke only made him less convincing.

Liar.

"What is this about, then?" Meredith had him cornered. "What is this really about?" She couldn't help if she didn't know what other part of him was wounded. She couldn't complete her diagnosis yet, and she needed to fix this.

He stared at her with glassy, red-rimmed eyes. She could see the storm coming, replacing the infinite blue with dark clouds.

She bit her lip and stared back. They needed to talk. They never did, but she knew he needed this. He couldn't bottle everything up and let it destroy him from the inside out. She hadn't wanted to talk, but she couldn't sit there in silence, either. It was a waste of their time to sit there in silence listening to the rain thump against the window and watching the shadows of passing headlights cascade along the wall. It was a lot like watching the fish in the tank in Dr. Wyatt's office.

"I was in therapy," she blurted.

A crease formed between his eyebrows and his lips parted. The words probably sounded foreign to him—worthy of a non-sequitur award at the very least—and she watched realization settle on his face.

Meredith shook her head. She hadn't meant to bring it up. The thought had barely crossed her mind before moving onto her lips. Now, she needed to fill the silence before it became impassible. "When we broke up, I had a hard time sleeping." She shrugged. No big deal. "I saw a therapist."

He continued to stare at her.

"I didn't think we'd get back together, but there were things. Things I couldn't tell you, and I didn't know why." She felt like a freak for admitting it. As the awkwardness ticked between them like an exceedingly slow second hand, she understood why she'd never mentioned it before. She wished she could vacuum up the words and stuff them back inside rather than delve into the confession. "So, yeah, therapy," she mumbled.

He pulled her toward him, lacing his fingers around her hips and dipping his head against the curve of her neck. His hands moved along her sides, bunching up her sweater, tracing the seam of her bra, and sliding back until his hands joined along her spine. His thumbs dug into her shoulder blades, jabbing into the sinewy tissue until she gasped.

"Derek?" she sputtered. "Talk to me. Tell me to how to help you." He was melting against her, flooding her body with heat as the gaps between them narrowed and closed. But he continued to shiver and shake against her as if the heat transferred to her body at the expense of his own.

"I'm sorry," he said. "I'm sorry, I'm sorry…" His voice echoed through the room like a scratched record looping over and over.

She squirmed against him, writhing to get her palms flat against his chest so she could push him away. "Stop," she urged. He shouldn't be apologizing. She wasn't seeking an apology. This wasn't about that. Someday, maybe, they'd need to revisit the issue and undo all that had been done or left unsaid, but that wasn't for now. He was already suffering enough, and most of Meredith's wounds had healed. Just occasional phantom pains, really. A case of cold feet and commitment phobia that acted up when a storm was coming or Derek's mom was going to be in town. Otherwise, no real symptoms.

"I'm sorry I hurt you," he insisted, resisting her efforts to push him away. His grip made it impossible for her to inflate her lungs fully.

"That's not the point," she argued. "I'm not looking for an apology. All that's water over the bridge or whatever."

The crush of his arms around her loosened. "Under," he mumbled.

"What?"

"Water under the bridge," he said. A nervous laugh whuffed past her.

"Right," she said. She stopped struggling and let him continue holding her. "Under. Whatever. My point is, you shouldn't bottle it all up, and you don't need to do this on your own. You can talk to me or see a therapist or something. But you can't quit." Her voice was firm and authoritative, obscuring the fact that she still felt like a hypocrite when she told him he needed to talk. It wasn't something they were good at.

Derek's body slowly became limp again, and his arms fell away from her body to hang beside him. He leaned back against the wall as if he needed it to prop him up. He looked small against the pale paint on their bedroom wall, his eyes appeared more sunken beneath dark caverns and his five o'clock shadow edged closer to midnight or maybe forty-eight hours beyond five o'clock. She inched off his lap and sank back down to the carpet between his parted legs, folding her legs over his like she was doing the crab walk in kindergarten.

"Do you still go?" he asked.

"To therapy?"

He nodded.

"No, I stopped," she said. She rested her elbows on her thighs and rubbed her hands together nervously. She'd done that a lot in therapy, too. "I didn't think I needed it as much after you moved in."

Derek fixated on her hands while a torrent of emotion visibly swirled inside him. She could tell that he was thinking about her, letting the new information mix with the old. His lower lip tightened, and the concentration lines formed across his forehead. Exhaustion aged him like The Picture of Dorian Gray.

"I thought I'd fixed it," he said. He whispered each word carefully, weaving the secret between them. "I made a mistake, but I thought I could fix it. I thought I'd gotten it right."

Her hands found his kneecaps, and she squeezed his legs gently. "You did everything you could do," she reassured.

"It wasn't enough," he said. "I tried, and it wasn't enough. He still lost her."

"There wasn't anything you could do," Meredith continued, even though her heart felt like it was splitting in two. Breaking for him, not over him. "She didn't go down without a fight. You gave her every possible chance to hold on, and she fought as long as she could."

"But he's alone. My best wasn't good enough."

Meredith crawled over and sat beside him, leaning back against the wall. "He's hurt, but he'll go on," Meredith said. She reached out her hand and interlaced her fingers with Derek's. "She wouldn't have loved him so much if he was the kind of guy that gave up without a fight. He'll dust himself off and keep going. He'll learn from the mistakes and try again." She squeezed his hand. She didn't have to tell him she wasn't talking about Jen and Rob anymore.

"I'm just so tired, Mere." He pulled his hand away and sank down further, resting his head in her lap.

Meredith ran her fingers through his hair, swirling her fingertips through the dark curls. "I know you are. I know," she whispered. "You should rest for a while." Sleep. You need sleep. You relax more when you sleep. "Rest, but don't quit."

He closed his eyes and nodded, but she could still see a bead of water forming at the corner of his eye. "You don't have to stay. If you need to leave—"

"I'm not going anywhere," she concluded. "I'm not giving up on you." She swept her hand along his jaw, feeling the stubble scrape against her fleshy palm until she reached the collar of his shirt. His tie hung awkwardly to the side, reaching for the floor. She carefully undid the knot and pulled it off before unfastening the top few buttons of his shirt. "I'm not giving up," she repeated, her own little lullaby to help him fall asleep.

His eyes relaxed, his breathing slowed, and a peaceful expression broke through his pained features. If it wasn't for the reminder marked by the cut on his nose, he almost looked normal. She knew it couldn't last long – they'd both become too uncomfortable in this position on the floor – but it was a few moments of therapy. Time they both needed.