A/N: I had planned to take a little break after finishing Try and Catch the Wind. But as Bizzy Montgomery says, "People plan and god laughs." So, I'm back with a new story. There's not much to say in terms of setup, just that I hope you like it, and would love to hear your thoughts. As always, thanks so much for reading and reviewing!

The Drum Beats Out of Time

Secrets stolen from deep inside;
The drum beats out of time.

-Cyndi Lauper, "Time After Time"

"So I was thinking, maybe tonight we could have dinner together," Addison begins as she and Derek walk into the hospital together. "I could find somewhere new … make a reservation." She looks at her husband hopefully. "We could get dressed up."

"Tonight?"

"Yeah."

"But it's a weeknight."

"So?" Addison shrugs. "That never stopped us in the past."

"Things are different now, Addison," Derek mutters, not meeting her eyes.

"I know," Addison concedes reluctantly. "I was just thinking it would be nice to have dinner together. We could talk and—"

"Talk?" Derek challenges, pinching the bridge of his nose. He feels a headache coming on.

"Yes, talk." Addison sighs. "About us. About our marriage. About—"

"It's too early in the morning for us to be having this conversation, Addison."

"You know, there was a time you could talk to me about anything," Addison says, gently running a hand up and down his bicep. "Anything at any time."

"But thigs are different now," Derek repeats, firmly pulling his arm away. "A lot has changed."

Addison sighs. "It's just dinner, Derek. I'm not asking you to forgive me completely. I was just asking you to have a meal with me."

"This isn't the time or place to get into this, Addison." He makes a vague gesture their surroundings for emphasis. "This is our place of work."

"I'm well aware of that," Addison says tightly.

"Are you?"

"I just said I was."

"Fine." Derek shakes his head in annoyance. "People around here already know way too much about our personal lives."

"And whose fault is that?" Addison challenges, jamming a hand on her hip.

"Yours, actually." Derek glares at her icily. "Before you showed up, nobody knew anything about me. I was a blank canvas, a clean slate … just a guy in a bar."

"But you're none of those things, Derek," Addison retorts. "You have a past … which let me remind you wasn't all bad."

"It wasn't all good," Derek disagrees.

Addison rolls her eyes at Derek's selective memory. "Well, I'm sorry I showed up and ruined idyllic little Seattle for you. But, seriously, Derek, what did you expect? I'm your wife."

She can't help noticing the way he cringes at her use of the word, "wife." And she can't say it doesn't hurt.

"This conversation is over," Derek says, running a hand through his hair in frustration. "I told you, it's too early for this. We'll talk about it later."

Addison shakes her head sadly. She knows they won't.

"Do you want to meet for lunch then?" she ventures. "Since dinner is apparently off the table?" She knows it makes her sound desperate and pathetic. But they're supposed to be working on their marriage. And she has every intention to do so.

"I'll probably work through lunch."

Addison nods, doing her best to appear unaffected. It's hard to work on a marriage when only one person is willing to put in the work.

"Then, uh, I guess I'll see you later." She meets his eyes, search for something … anything to reassure her that she's not trying in vain. That maybe he's trying too. "Have a good day, Derek."

"You too," he says, pressing a kiss to her temple.

It's not a sweet kiss. And it's certainly not a loving kiss. It's a dutiful kiss. The kind a husband is supposed to give his wife. The kind McDreamy is supposed to give.

"Bye, Derek."

"Bye, Addison."

She watches his retreating form for a moment, and swears she detects a lightness in his step … a weight being lifted from his shoulders as he walks farther and farther away. The effects freeing himself from Satan, she thinks ruefully.

"Good morning, Dr. Bailey," Derek greets as he joins the resident by the nurses' station.

"Good morning, Dr. Shepherd. You and your wife seemed … cordial this morning."

Derek shoots the resident a disapproving look. "I'm sorry, Dr. Bailey; I didn't realize my marriage concerned you."

"It doesn't," Bailey shrugs nonchalantly. "But you're making it painfully clear that you have no desire to make things work with your wife … and that has my interns running around the hospital like wild toddlers in a bouncy castle. They're unfocused and impossible to control. And it's making my job a lot harder than it needs to be. So, that makes it my business."

"Excuse me, Dr. Bailey, but where do you get off saying I have no desire to make things work with Addison. Marriage is hard. And we're trying."

"No, she's trying. You're going through the motions … and making googly eyes with Meredith Grey."

"I—"

"Nobody at this hospital is blind, Shepherd. You're not fooling anyone."

"You don't know the first thing about my marriage," Derek insists through gritted teeth.

"And I'd prefer to keep it that way. So, please don't make your marriage my business."

"Can we just stop talking about my marriage already?" Derek sighs in frustration. "This is supposed to be my time to get away from my marriage, away from Addison, away from—"

"And yet you're the one whose still talking about your wife and your marriage," Bailey points out smugly.

"Well, now I'm done," Derek insists firmly. "You won't hear me mention Addison's name the entire morning we work together. I promise you that. I—"

"Dr. Shepherd … Dr. Bailey," Richard cuts in, the urgency in his voice evident.

"Chief," Derek greets, taking in Richard's ruffled demeanor. "Is everything alright?"

"We have a patient who was just transferred here from St. Ambrose Hospital in Los Angeles." He hands Derek a file. "Here are her latest scans."

"Wow," Derek mutters as he quickly assesses the scans. Even a brief glance at the patient's scans is enough for him to know it's serious. "The chances of survival here are …"

"Not great," Richard fills in. "I know. She does too. She's a retired doctor. She was very big in her field." He meets Derek's eyes. "And she specifically requested you, Derek."

"Me?"

"You're the best there is."

"Yeah, but …"

"You also know her."

"I do?" Derek asks in surprise.

Richard nods and hands Bailey another file. "Come with me, you two. I'll bring you to her room."

"Yes, Chief," Bailey answers dutifully as she follows behind Richard.

But Derek still has his doubts. "Richard, who's the patient?" He turns to Bailey when the chief meets his question with silence. "Dr. Bailey, do you know who it is?" He gestures to the chart in her hands. "Does it say there in those files? Come on," he persists when Bailey remains quiet. "I'll be better equipped to do my job if I know who the patient is. You should never blindside a doctor. That's med. school 101."

"Okay, we're here," the chief announces. He turns to face Derek and Bailey. "Now, I know you two know this, but this is a VIP patient. Which means I need you to act with even more discretion and professionalism than usual."

"Of course, Chief," Bailey nods.

"Good," Richard smiles. "Now, eventually, I'd like to assign an intern or two to this case. But since this is a special patient and the prognosis doesn't look good, I wanted to limit the initial consult to just the two of you. Does that make sense?"

"It does," Bailey nods.

"Good," Richard approves. "Okay, follow me."

They do as they're told and follow Richard into the room.

And as they do, Derek can't help thinking about premonitions. Sure, in the OR, he has certain rituals he refuses to deviate from; but outside of work, he doesn't consider himself a very superstitious person.

Still, there have been times in his life where he's known something big is about to happen. He felt it day he got his acceptance letter to med. school. He felt it the morning he first met Addison … the day they were paired together in gross anatomy class. And he felt it the night he came home from work and found Addison and Mark in bed together.

And he feels it now too—that weird premonition that something big is about to happen.

"Good morning," he hears Richard greet their patient cheerfully. "How are you feeling today?"

He hears the patient respond and feels his mouth go dry. He'd recognize that voice anywhere.

"This is Dr. Bailey," Richard continues. And Derek watches Bailey step forward.

It's like a horror film unfolding in front of his eyes. And all he wants to do is press the pause button … but there's no pause button in sight.

"And I think you already know Dr. Shepherd," Richard says, ripping Derek from his thoughts.

"Hi, Derek," the patient greets him with a warm smile. He remembers that smile too.

"H-hi," Derek stammers. It's all he can get out. His lips are dry. His throat is dry. Everything feels numb.

This can't be happening. This can't be true.

"Dr. Bailey," Richard prompts. "Why don't you read the chart to Dr. Shepherd?"

"Sure," Bailey nods. She clears her throat. "Dr. –"

"Stop," Derek cuts in.

"What?" Bailey asks, shooting Derek a look of confusion.

"I know."

"What?" Bailey asks again. "What do you know?"

"I know who she is … and what her prognosis is."

"Dr. Shepherd," Richard scolds. "Let Dr. Bailey read the chart."

"Yeah, come on, Derek," the patient corroborates. "It's good practice for her. And this is a teaching hospital, right?"

"Right," Derek says weakly, unable to look away from his patient … unable to believe it. He forces himself to look at the resident next to him. "Sorry, Dr. Bailey. Please continue."

Bailey nods dutifully before consulting the chart. "Dr. Viv—"

"Vivian Carlsmith," Derek cuts in, his voice choked.

"Dr. Vivian Carlsmith," Bailey echoes. "Sixty-nine years old. Grade four glioblastoma. This was discovered two days ago at St. Ambrose hospital. Initial tests have been run and scans have been taken, but no course of treatment has been determined yet." She turns to Derek. "Dr. Shepherd, what course of treatment do you suggest?"

"Course of treatment?" Vivian asks, raising an eyebrow skeptically.

"Dr. Carlsmith, significant progress is being made in this area," Richard reassures. "And Dr. Shepherd isn't going to give up without a fight." He turns to Derek. "Isn't that right, Dr. Shepherd?"

"I … yeah," Derek gulps. His heart is beating so loudly, he swears everyone in the room (and surrounding rooms) must be able to hear it.

"Dr. Shepherd," Bailey cuts in, ripping Derek from his thoughts. "What course of treatment do you recommend?"

"I," Derek stammers. His face is growing warm. He can feel beads of perspiration forming at the base of his neck. This can't be true. It can't be real.

Vivian Carlsmith … Addison's mentor. Except she's more than that to Addison. All mentors and mentees are close; but Vivian and Addison's relationship was something different. Vivian was more of a mother to Addison than Addison's own mother. She was more like family to Addison than Addison's actual family. And she was one hell of a doctor and a teacher.

He feels his throat quivering. Vivian can't be here. She can't be this sick. And she can't be relying on him to perform some type of miracle.

"Dr. Shepherd?" Bailey prompts, once again cutting into Derek's thoughts. "What do you suggest we do?"

"I, uh …" he stutters. "Dr. Bailey," he breathes, meeting her eyes and giving her a pleading look. "Get Addison."