Her first time with Dr. Stark was even better then she'd imagined. It was candles and roses and dinner and he was her knight in shining armor and her first time fantasy came to life.

They'd all been wrong about him – the gossipy nurses and the snickering residents – and she reported that smugly days later as she sauntered off to scrub in on a bowel repair with him –imagining their next time, when she might be scrubbing in with him more literally, like Lexi and Jackson did, when they did it in the shower.

She giggled at the thought, and their second time was better than the first – and their third time was the first time she opened her eyes, and the fourth time made her understand why Jackson always had his tongue down Lexi's throat.

It was just like the stories her mother told her and her sisters when they were young, about princes and white horses and magic glass slippers. It was just like the romance novels she read in high school, while her friends went out on dates and to dances and ice skating at the mall. It was just like the fantasies she'd had in med school, about Dr. Lawton, who was tall and blond and had bright blue eyes that lit up when he spoke – though never actually to her.

It was just like that fluttery feeling she got whenever he lectured their Gross Anatomy class– the feeling Reed teased her about – because Matthew Lawton was forty three and an instructor at Ohio State Medical School and a rock star surgeon and widely published in his field and he had every woman in the hospital after him, even the vivacious super model turned head nurse in Renal Transplant.

Reed would have been after him, too, April imagined, if she'd thought she had a shot at an Attending, and she'd have been jealous to hear about her and Robert Stark, and Reed had told her she'd be a virgin forever if she didn't grow up and get her head out of those fairy tales. She wished Reed was here now, so she could tell her that some fairy tales do come true… and watch her turn green with envy.

They could gossip all they wanted, too, for all she cared, the snickering nurses and the snippy nutritionists and the giggling technicians, because she wasn't April the thirty year old wall flower anymore, and she wasn't April the plain, over eager intern who tried too hard anymore, and she wasn't the fumbling mess who no one would ever take seriously – certainly no Attending – and she wasn't the April who was invisible to men anymore, and it was fine – it was – if they chattered jealously about how she did it with Robert, as if Lexi or Meredith or Cristina or even Dr. Bailey was any different.

Their fifth time was the first time she could make a sound without cringing, or wondering if she'd done something wrong, or was being too loud, or too grabby, and for the sixth time she bought something red and lacy to wear. It wasn't her, exactly. But she'd seen it in one of those slick magazines she'd always been too embarrassed to read before, and the article said that men liked shiny satin.

Her ears pricked up, too, and she listened to the casual conversations about it, now – even the ones that didn't involve her doing it on the hospital roof- as if she and Robert would ever do it in a public place, in broad daylight – and she almost smirked, because she's part of it now, the gossipy buzz, and she's not the only one at the hospital whose not doing it, and she's doing it with an Attending, and he's wonderful, and it was all worth waiting for, and it's almost like she's one of them now, like Lexi and Meredith and Cristina and Bailey and…everyone, even her sisters, who happily send advice and encouragement from across the country.

Their seventh time was the first time they used an on-call room, much to the SGH grapevine's delight – and the eighth time was the first time his wallet fell from his lab coat. That was the first time she saw his ring, spinning madly on the polished tile floor, and the picture of his wife, faded and crinkled, spilling out between his credit cards and his membership to a local golf course.

That was the third time her hands shook as she scrambled for her clothes, and the sixth time tears sprung to her eyes, and the fifth time her cheeks burned, and the first time she'd ever turned her back on an Attending demanding that she stop and listen, and wait for him to explain, as she hastily pulled her scrubs on and frantically fled the room.

She said it was a cool scar, and she didn't freak when she saw it, and she just giggled and moved on when Alex pushed her hands away from it and she wasn't blonde and it didn't matter if she was crazy because she'd be gone by morning.

It had been weeks, anyway, and she was too buzzed to ask much about the shooting, and he'd already perfected the story just in case – the story about how he would've kicked the guy's ass, if the freaking coward hadn't offed himself first, the story about how the bullet tingled when he showered, the story that never mentioned anything about the lifeless body in the supply room and the vacant stare and the black hole between her eyes - the eyes that followed him into his dreams, boring into him at 3:00 a.m.

They didn't matter, anyway, the empty eyes, because he was used to them, because it followed him everywhere. It was Ava's blood trickling through his fingers, and Izzie's wild accusations and his mother's bad patches and Gary Clark's rage, and it stalked him, the madness, and it was right there in front of him again, anyway, in the giggling red head's blank expression, and it wasn't like it mattered, if he was home in his bed or up against a wall at Joe's bar with her tongue down his throat, since it wasn't like the madness was going anywhere, any more then he was.

They were all crazy, anyway, the blondes, the red heads, the brunettes – definitely the brunettes, even the one's pretending to be blondes – and he just rolls his eyes at Mere's prodding the next morning, because she'd be doing the same freaking thing, if Yang hadn't pulled McDreamy back from circling the drain, even if Yang was now dribbling down one herself, bit by bit, as her eyes darted around the kitchen, and her chair rocked to a manic rhythm, and pale fingers clutched her coffee cup.

Mere'd be trolling the bars too, then – instead of planning some Barbie Dream house, as if she didn't already live in a palace, or a brothel – and it would be just like it was their first year, like it always had been in the bars, desperate competition for cheap booze or cheaper attention or drunken flattery or a quick lay, like mangy dogs fighting for table scraps.

It was nobody's business, anyway – the steel in his chest or the chicks at Joe's – because the chicks thought the bullet was cool, and they were too far gone to ask many questions, and he'd be the first one cleared for surgery no matter what Mere or Yang or Bailey said – and he'd move the hell on like he always did.

She spent the next few hours roaming the mall, since the worse thing they could do was fire her, and they'd already done that once before, anyway.

She spent the next few days avoiding everybody, and ignoring the chatter in the hallways, about Philip Stark's sudden departure – his name hadn't even been Robert, really - about his livid wife, about the pretty young nurse on the eighth floor who was threatening to sue Stark and the hospital, for sexual harassment, the rumors went, for terminal humiliation, April imagined.

She ventured reluctantly into the lunch room, where Cristina snarked and Alex smirked and Meredith shrugged while Lexi and Jackson pawed each other, oblivious to it all. She wished that Reed was still here, or Charlie, even if they'd laugh at her, too. But no one mentioned them anymore.

She wished she could talk to Meredith, but she was busy packing for her big move to the dream house that her knight in shining armor was building her. She wished that Cristina wasn't so scary, now that she'd become Chief Resident, and that Alex wasn't still competing with Cristina as if he was chasing another dusty trophy for his windowsill, and that Lexi would come up for air once in a while.

She wished the local grapevine would simmer down, or that she at least had someone to sit with in the cafeteria, so that she could eat in peace, without all the hushed whispers and curious stares. But Meredith had her clinical trial, and Cristina was buried in paper work, and Alex was researching Peds surgeries in journals and Lexi and Jackson were always running off to the tunnels and she ended up eating lunch in her car for the next four days straight, just so she wouldn't get nauseous afterwards.

She'd always been the girl who ate alone in high school, anyway, until she became the girl who cleaned the science lab. Well, that wasn't really a title. But she'd eat fast, and then she'd rinse test tubes until her fingers wrinkled, and it was boring but it made her invisible. High school had gotten much better, she remembered, after she'd become invisible. It was quieter, too – away from the deafening din of the lunch room, of the athletes and the cheer leaders and the band kids and the chemistry geeks – who never had extra seats at their tables, either.

It would give her time to concentrate on her career, now, she imagined, though Meredith still had Neuro occupied, and Cristina would defend Cardio to the death – literally– and Alex was the go to guy in Peads and Jackson had Plastics covered and Bailey still kept calling her August.

It would all die down, eventually, her sisters said, the incessant chatter about her. But not until after Beth's twenty seventh lecture on safe sex, since she'd done it unprotected, and Dani's fifteenth breezy assurance that it happens to everybody, and Cari's cheery insistence that it was no big deal, anyway, since guys come and go, and Jenny's acerbic crowing that at least she got it over with. It would all die down, she imagined, after everyone had weighed in on it.

It made him invincible – the bullet - until it made him sick. It was fine, he was freaking fine – until his head starting spinning, and he was hurling – slumped shivering on the bathroom floor – with freaking Keppner hovering over him, wide eyed and frantic as she tugged on his arm.

He was fine, he insisted, pushing their icy hands away – and voices echoed around him – and suffocating heat radiated through the room and his lungs burned and more hands singed his skin and hasty chattering echoed and packages ripped open and the sharp sting of antiseptic forced tears from his eyes and it all circled like a whirlpool, boring into him with a piercing pain.

He wakes hours later, or maybe a day. Pale moonlight filters into his room, and Mere's handing him water and Keppner 's hovering, her hand over her mouth, and Yang's snickering – dead eyed, still, as she shoves a fist full of antibiotics into his hand, crowing that she'd saved his life – because Mere made her.

It made him invincible – the metal shell that sits gleaming on his nightstand. It should be on the windowsill with his trophies, he imagines idly, dizzy and nauseous as his attention floats in and out in a churning haze. Its dusk -or dawn, chilly and steel grey – and Keppner is still hovering an hour later, the shaky voice asking if he needs anything, a drink or a blanket or something to eat. He's thirsty as hell and the room's freaking freezing and he'd be starving if he wasn't so sea sick, and he just smirks and rolls over because he was still hard core and he'd get his own freaking water as soon as could stand again.

He stumbles down the steps later that evening – past rows of moving boxes, carefully labeled in precise black printing and stacked much too neatly to be Mere's. He's been waiting for that, and he'll be back to living in his car or at Joe's when the dream house is done and she sells this place and it was always just temporary, anyway, because guys like him didn't live in palaces.

He's still shaky and bleary eyed as he drops into the chair across from Mere at the table, after his fourth glass of water, and he shivers as he devours a second stale pop tart, and he hears it vaguely as his head swims – that Keppner and Avery are moving in to help cover the rent.

She says it matter of fact, like it makes perfect sense, to move into a dream house on a hill over- looking the Bay, and to run a hostel for strays on the side. The coffee cup trembles in her hands, though, and she barely smirks at his bad joke about keeping a back-up brothel to return to – just in case – and it all bubbles between them comfortably like the familiar hum of the coffee pot percolating, since she's terrified to move forward and he's stuck in cement – and tequila and pain meds just don't mix, brothel or not.

It all spills out over another stale strawberry pop tart - about the baby that wasn't and the empty nursery in the dream house that she'll never be able to fill and the reluctantly packed boxes stacked in the hall and he makes another bad joke about her adopting Yang and silence settles around them again because they know all about endings and they both know better than to trust beginnings.

The first time April yelled at Meredith was the first week after she and Dr. Shepherd had moved into the dream house, leaving her with the two perverts and Alex – okay three perverts – who never rinsed out his morning cereal dishes, and who just smirked when directed not to drink from the milk carton.

The first time she yelled at Cristina her legs shook and her face burned bright red as Cristina snickered and assigned her to the pit, noting smugly that no Attending had requested her on their service - again.

The first time she yelled at Lexi, she just rolled her eyes and shrugged and went back to screwing with Jackson, right there on the coffee table in the middle of the living room, during a Seinfeld rerun.

The first time she yelled at Alex it was 5:36 a.m. on a chilly Wednesday, and he was chewing too loud – after pawing through the new cereal box to retrieve a toy truck – and smearing chocolate milk on the newspaper - and Meredith had asked her to keep things in order - and he just shrugged and left his glass in the sink and grumbled something about her grabbing her bag if she wanted a ride.

The first time she returned to Peads since – since – since her first time with Stark – she was working on patients from a ten car pile-up on an iced over thruway. Three kids died before her first shift was half over, but Alex managed to stabilize another – a seven year old – using something he'd read about in one of those journals he was always scanning in the lunch room.

They work through the next day, and the kid survives the first 48 hours, and Robbins seems hopeful. It's like a magic number, those first 48 hours. It makes them feel like they can say something authoritative – medically – after the first 48 hours. It's like they have everything under control, if they can just keep the patient alive for the first 48 hours.

The boy dies six days later, five days after she learned that his name was Thomas, four days after they met his frantic parents, three days after they learned that he liked dinosaurs, and oatmeal, and trains, two days after they saw a cell phone photo of his dog, Fred, a shaggy mutt of indeterminate color, one day after they'd removed him from the vent, and thought maybe he'd finally turned a corner.

The first time she went to the grocery story that week, a few days later, she bought an apple pie to go with her raisins and yogurt and fresh lettuce and strawberries. She never bought junk food. But she'd seen Meredith do that for him before, and she had promised to keep an eye on things, and he'd just eat the pie with his fingers right out of the box, anyway, so it wasn't like it'd add to the pile of dishes in the sink – the dishes she would not do, period, because he could certainly use his hands if he wanted to.

He'd been toying with it for weeks, the old guitar propped against his windowsill. It was all about manual dexterity, about keeping his hands busy, and working the muscles in his wrists. It's just random chords, and he pictures the surgical procedures over and over as he strums, and sometimes it comes back to him, the little he'd learned about playing.

He'd started back when he was still out on leave from his surgery, back even before the bullet had surfaced completely. It had freaked them out a little – Bailey and Altman and even Mere - which really made no sense – because it had made him invincible.

He still ran his fingers over it, every afternoon before he fiddled with the steel strings. It should have killed him, but it didn't, and it should have freaked him out, too, but it just made him more focused – on excelling in his job, on moving on, on building himself back up, on being a surgical rock star, to hell with Yang, on being hard core, and he was running again, and lifting weights.

It hadn't gotten back to Iowa, anyway, which was probably just as well. It wouldn't get back there, because Aaron was probably out on the road, and his mother didn't follow the news, and his sister was probably awash in teenage crap – and it was just as well that they didn't know.

It wouldn't have surprised them, anyway, because it's what people expected, because he'd been dragged off to juvenile detention, and moved from house to house, because he beat the crap out of his dad with his fists, because he wasn't enough to handle his mother's bad patches, because that was how guys like him died – young and violently – with metal in their chests.

It hadn't killed him, though, even if they always swore he was the problem – the shrinks and the counselors and the social workers and the cops and the rent-a-families with their neatly kept homes and their white picket fences and their barbecues and their dogs – they always had freaking dogs – dogs that always had their own beds, and food, and toys. It was crazy – the whole thing – that the freaking dogs always had food, but he was never sure if Amber or Aaron did, and that the dogs were freaking spoiled, while they were fighting for table scraps.

The third time she joined him for lunch, he just shrugged and went back to reading his journal articles, again. She'd come prepared this time, though, and pulled out a glossy women's style publication which she'd plunked from the recycling bin near the Nurses' station. That was a mistake, too, she realized, after glancing over the third feature on the year's best – read, most expensive – purple lingerie.

The first time she rode in with him during a snow storm she swore he had a death wish. It was a sea of white flakes and thirty mile an hour frigid wind gusts and he glued his eyes to the road and trudged on with grim determination. It occurred to her sixty minutes into what should have been a fifteen minute ride that it was too important for him to get there, as if it might be the only place he had to go. She thought maybe she got that, though, all things considered.

The first time she walks in on him in the kitchen, on an early spring morning, she catches him taping up a box of meds whose names she recognizes. She catches a familiar glare, too, and a familiar grunt to remind her that they're leaving in ten minutes, and she knows better than to ask about the Iowa address on the package, or the family she's only ever heard him whispering about with Meredith.

The first time she celebrates her birthday alone in Seattle – with basketball tickets sent to her by her parents – she invites him along. He's loud and annoying and will probably stuff himself with hot dogs and cotton candy. But she hates going into the city alone and his eating habits are his problem and they sell unsalted popcorn at the arena, too. Not that he likes it, she knows, since it's never his first choice in microwavable "food" when he watches those cheesy old science fiction movies on the nights he can't sleep. But he will eat it as long as the movie is stupid enough… or the game is good.

The first time she calls her little sister in ages, she almost wishes she hadn't. Cari is just finishing her third year of med school, and she's still young and idealistic and chatters about helping people and about how exciting her residency will be.

She wishes she still felt that way about medicine – and she curses yet another thing she has to envy one of her sisters for – her sisters who were always the pretty ones or the popular ones or the athletic ones or the artistic ones – the sisters who always had people to sit with at lunch, and who still thought their careers might help them save the world.

She wished she could feel that way. But she still wished the merger had never happened, too, and she always wished that Gary Clark had never happened, and sometimes she wished that she'd never met Robert –well, Philip - that she'd never even come to Seattle, that she'd never gone to med school. Sometimes, she wished she could do it all over again – as someone else entirely.

He's running late the next morning, and she swings by his room to remind him to hurry up, and she gasps because he hasn't quite pulled his shirt down over his chest, and it's all there all over again – the pool of blood, the sticky cold feel of Reed's lifeless body, the gun boring between her eyes, the frantic shrieking as he pulls the trigger – and she's shaking and trembling as she tears down the stairs.

He follows her down the steps, scowling and raising his eyebrows and she tries to explain and he tries to smirk but it doesn't reach his lips and he fumbles for his work bag as he mutters something about them being late. His hands are still jittery as he grips the steering wheel much too tightly, and it occurs to her for the first time that he might be running in place, too.

He hurls in the bushes by the front steps, ignoring Keppner's startled gasp from the porch swing where she sat serenely, probably drinking one of her weird vitamin drinks, or a cup of steaming sea weed.

He smirks as he staggers past her on his way into the house. She was freaking neurotic – and a manic neat freak – and she nagged them all about dirty dishes in the sink and squawked about laundry being put away and glared like a hall monitor when they all ignored the stupid chore wheel and she'd labeled the bins in the fridge – for tropical and native fruits, for root and seed vegetables - and she stammered and blushed beet red when anyone dug into the cookie jar for a condom, as is she wasn't a freaking doctor.

He scaled the stairs up to the shower, his legs still trembling. It's what the coaches always said – run until you hurl – it's the only way to out-last any opponent in the ring. They might be better wrestlers, or bigger, or stronger, or faster – but you could always out work them, that's what the coaches always said. He believed them, too. It didn't matter if his muscles burned or his lungs ached or bile stung his throat – because it was his ticket out – out of Iowa – after he ran off his old man.

It was more than that, by then, and he ran all though med school, ran all through residency – in the cold and rain – and they'd roll their eyes at him and question his sanity but he rarely stopped. He'd stopped once, for Ava, and the baby that wasn't; he'd stopped once for Iz, when the cancer spread. Whenever he stopped, the crazy over took him, and he imagined that made the coaches right – since push, keep running, was the only thing that had ever worked for him– and he wondered if maybe he could outrun it, if he just kept going.

It churned in his head, the voices from practice, and he tossed in his bed, and his mind was racing, but not fast enough to out-pace the vacant eyes that still stared back at him, stalking his dreams. It was almost 3 am before he walked back down the steps, because he was too tired to lift weights and too wired to sleep and it was too late for his guitar and he was just in time to catch the opening sequence of Attack of the Killer Tomatoes III on the Science Fiction channel.

She joined him ten minutes later, rolling her eyes and dropping onto the couch and announcing smugly that it was biologically impossible for a fruit with that amount of biomass to grow ten legs and he just grimaced and dug into his popcorn because he was not getting into the debate over whether tomatoes were fruits or vegetables with her- again – and really, did she not get what the term "mutant" meant, anyway?

The first time she visits Dr. Wyatt's office again it's been months since the shootings and everyone's fine and moving on and she still can't sleep and it all pours out: about how Reed was the first friend she'd ever had who died, about how Reed was the first real friend she ever had, about how her first job was supposed to be exciting and fun, about how all her firsts were turning out to be lasts, and turning out all wrong – and how they all jumbled together in her head.

The first pill she takes makes it official – it's not just grief or frustration or anger or rage or the dirty glasses in the sink or the Attendings who never request her for their services or the chore wheel that goes ignored on the refrigerator or Lexi and Jackson making out on the washing machine or the wife she never knew about or Alex's eating the Halloween candy or Cristina's Pit assignments or her occasional impulse to stand up and scream right in the middle of the cafeteria, if she wasn't sure she'd still be invisible even then – it's clinical depression.

The first session with Wyatt confirms it all – it has a name and a diagnosis and little yellow pills in clear plastic bottles with warning labels in tiny black print – and she's careful to hide her meds from Alex, to prevent them from being inadvertently shipped off to Iowa, or from turning up as the latest talking points on the SGH grapevine.

Word gets out anyway, since once you're a permanent branch on the grape vine you're always under observation and eyes are everywhere, especially around the comings and goings from Dr. Wyatt's office, and debate swirls about whether it was because of the shootings or of Robert, well Philip, or because she'd been fired once for killing a young mother or because Derek Shepherd would never know her name or because she just couldn't handle it… any of it.

The news of her impending insanity burns up the national network spanning her sisters' phones, too, and Jenny offers medical advice, as if she was a doctor herself, and Cari tells her to call mom, as if the Robert – well, Philip, conversation hadn't been awkward enough, and Dani tells her to think positive – as if that isn't easier if you're tall and blonde and busty and live on the upper West side – and Beth just tells her to get out more, Beth who would only ever need under three hours to throw together a party for her two hundred closet friends.

It's all awkward and creepy, anyway – with Lexi's watery, sympathetic eyes, and Jackson's weak smile – as those two move into a downtown condo together and she just lingers at the hospital as their fifth year of residency winds down, since the house is too big and Alex hogs the remote and still ignores the chore wheel and stays awake all night watching ridiculous movies about mutant vegetables.

It was just for a week, he insisted to himself, the pills. The psych guy had prescribed them back when he'd cleared him to return to surgery. It would help him sleep, he insisted, just for a few days. It would get him through the next surgical rotation, through the next few sixteen hour shifts, until his next few days off. It would just be for a week – he promised himself – because it had been 3 a.m. with mutant fruits or vegetables for months and his eyes wouldn't close and he was just tossing and turning and his hands were getting fumbly in surgery and his concentration was waning and that couldn't happen because he was hard core.

It was just a week going on two weeks and the pills didn't mix with beer or tequila and they made him groggy and listless in the morning and he just sat slumped on the couch after work– watching sports news or nature shows or the freaking weather channel and she'd just glance at him sometimes like he was a freak.

It was a week going on three weeks when he started taking them earlier in the evening – because they warmed his body and calmed his nerves and slowed his racing mind to a pleasant haze – and her looks got even funnier – or maybe she was just looking away – and she always averted her eyes when he wobbled into the kitchen to retrieve another beer.

It was a week going on a month when he spied the clock on his nightstand, and 4:00 p.m was still too early to take them even if he was already counting the minutes and he was fiddling with his guitar when he caught the glint of the steel strings in the dresser mirror, flashing across his father's hands.

It was another hour – maybe two – before he flushed the pills down the toilet with a fresh stream of vomit – before he wiped his mouth and changed his shoes and charged out into the chilly fall evening, running at a steady pace as his breath billowed around him. He ran until his legs screamed and his lungs burned, ran until he collapsed back onto the porch with a heavy thud, cursing himself for letting it close in on him again as he'd sat in a stupor on the couch.

It wasn't going to be him – it wasn't – he insisted, gasping and breathless and trembling as the icy air swirled around him, and he just smirked and laughed manically when the front door creaked open, and he pushed her hesitant hands away, staggering to his feet and shaking his head to clear it as another fierce shiver shot through him.

It wouldn't be him, he muttered, ignoring her curious scowl as he entered the hall way; it wouldn't be him, he insisted, as he dragged up the stairs; it wouldn't be him, he insisted, as he showered and changed; it wouldn't be him, he nodded to himself, grabbing the remote and dropping onto the couch, as another late night movie marathon kicked off, much to her dismay.

It wasn't going to be him – and it wasn't going to be pills – and he was back to Joe's the next night, and he couldn't quite tell if she was a brunette or a red head, since his brain was fogged and his eye scarcely slit open, when she pinned him to the wall – and it didn't matter, anyway, since the madness was everywhere.