Still of Amelia (played by Caterina Scorsone) in a hospital bed from Private Practice 5x22

My Son the Unicorn: A Grey’s Anatomy/Private Practice Fanfic Part 1

Notes: This is a fanfiction based on characters from the TV shows, Grey’s Anatomy, and Private Practice. This rewrites parts of the latter half of Private Practice season five when Amelia’s pregnant and Addison has baby Henry. This fanfiction tells a different story where Derek comes to LA for Addison’s help with a patient and discovers Amelia’s pregnancy. This is part one of what will be a two-part story. It will all eventually go up on Archive of Our Own as a oneshot after it’s posted here but is edited to include headings and images to improve readability. Thank you to @tivashepherd on Twitter for requesting this prompt and for naming this fanfiction as well.

My Son the Unicorn: Part 1

Still of Derek (played by Patrick Dempsey) in Grey's Anatomy

“Are you sure we have to go all the way to LA for this?” Liam asked.

“I think we do,” Derek looked at both Liam and Courtney. He’d only seen a few cases of omphalocele. Most notably, he remembers the quints from a few years back. But he had Addie then. This time around, things would be a bit more complicated with Courtney’s seizures, but he knew if anyone could help see them through this pregnancy, it was Addison. 

But when he called Addison to come out, she said she wanted to help but had patients in LA to tend to. So he offered to travel there (after asking his patient, of course). He didn’t think she’d say yes, especially after he said he’d have to come too to help get Court’s seizures under control, but she agreed. 

“If it means our baby’s gonna be okay, we’ll do it,” Courtney said as she repositioned herself in the hospital bed. After seeing her, both Derek and Liam helped support her back as she move around.

“I’m fine guys, really,” Courtney gave them both an appreciative smile.

“So, I think we can leave tomorrow morning at the earliest,” Derek said as he checked out her charts. 

After he left the room, he started calling Sam. If he was going to LA for a few weeks, it might be fun to stay with him instead of getting a hotel room. Little did he know, he’d be in for quite the surprise.

Sam Tells Derek Why He and Addison Aren’t Together Anymore

Still of Sam (played by Taye Diggs) and Addison (played by Kate Walsh) clinking  their glass of wine from Private Practice 6x03

“Hey,” Sam chuckled on the other line.

“Hey Sam,” Derek chuckled back. 

“What’s up, man? Seattle too cold for you now?” Sam joked, knowing full well that Derek would be coming to LA soon.

“I’d stay here if I could but Addie’s the best person for the job,” Derek joked. Sam just laughed back with him.

“Listen, I was wondering if I could stay with you for a while,” Derek started. “Just until Courtney delivers the baby,” 

“Uhhhh,” Sam hesitated.

“If this is about you and Addison, I promise not to intrude,” Sam told him about him and Addison getting together and he was understandably a little weirded out by it. But it’d been a while since then and the last thing he wanted was to make things awkward.

“Actually, we’re not together anymore,” Sam admitted.

“What? What happened?” Derek was surprised. When he confronted him about it before, Sam swore it was real between them. And as strange as Derek thought it was, he knew how unexpected love could be. He never thought he’d leave Addison let alone fall for an intern of all people. But he did.

“Honestly?” Sam sighed. “She wanted a baby and I don’t,”

Derek Takes Addison’s Side

Still of Derek (played by Patrick Dempsey) hugging Sam (played by Taye Diggs) from Grey's Anatomy 5x15

“Well you can’t be that surprised,” Derek said half-joking. “She’s a baby doctor,”

“Yeah but I already did that,” Sam tried to defend himself. “I already have the family, I mean, I’m a grandfather for God’s sake. I just wanted…her,”

“So, you can see why she wants it,” Derek said back. Sam groaned slightly at the sound of that. Addison said the same thing when they broke up the first time. And the worst part was he knew they were right. Of course Addison wanted to be a mother. It’s why she first came out to LA. But Addison dropped this on him and all of a sudden, it was now or never. He understood why after she explained it, he just wished their timing was better.

“So, if you and Addison aren’t together anymore, why can’t I stay with you?” Derek was confused. Wouldn’t it be better this way? They could skip past the awkwardness and revert back to being old college friends.

“Well…,” Sam started. “Amelia’s kinda living with me right now,”

“Amy? I thought she lived with Addie,” Derek was confused. Why was Amy living with Sam of all people? He knew Addison’s new baby probably didn’t sleep through the night yet so there’d understandably be an adjustment period. But that couldn’t be the reason why they weren’t living together anymore. Not when it came to those two.

Addison and Amelia’s Friendship

Still of Amelia (played by Caterina Scorsone) and Addison (played by Kate Walsh) from Private Practice 4x17

Ever since Amy met Addison, it was like their bond was instant. She took her to get her ears pierced and told her about birth control when she asked. Their mother wasn’t all too fond of it when she found out and it became a whole thing. But he had to admit Amy was right when she said that no one else was talking to her about sex.

And Amy was right at that age of being curious about sex, but not knowing enough to even know what to ask. Plus, it didn’t help that their mom still saw her as a baby. And maybe she always would. But Amy was growing up, and Addison could see that. She could see her. More than he could, and definitely more than their sisters. He remembered the arguments with Addison after his mom found birth control pills in Amy’s backpack. 

Addison had the same response Amy did when he confronted her. She didn’t have anyone else to tell her about any of it. And if Amy was having sex (although Addison said that Amy swore that she wasn’t), she should at least be responsible. As much as he hated it, Derek had to admit Addison was right there. He wasn’t thrilled to learn that his baby sister wasn’t a baby anymore, but he was glad that Addison looked out for her. 

That Addison still looked out for her, even after the divorce. Even after Derek cut her out of his life. After she crashed his car into a tree and almost died. Addison still remained the one person that stuck by her through it all. Took care of her when Derek couldn’t anymore. Though, it was unclear if that was still true considering the fact that they no longer lived together.

Derek Calls Addison

Still of Derek (played by Patrick Dempsey) on the phone from Grey's Anatomy 11x24

“It’s complicated,” Sam didn’t feel right exposing Amelia’s secret. But he knew it was only a matter of time before he’d figure it out. She was already eight months along and well past showing in the baby bump department. But he knew the baby was a sore subject. He knew Derek didn’t know. And he knew Amelia didn’t want him to ever know. But if he was coming to LA, it wouldn’t be long until he figured it out.

“Well, I guess I’ll find a hotel then,” Derek said as he decided not to probe him anymore. He could tell by the sound of his voice that there was more there. But he figured whatever it was, he could confront Amy in LA. She wasn’t answering his phone calls but she couldn’t run if he was there in person.

“Or you could always stay with Addison,” Sam joked as he started laughing. “I mean, she does have a spare guest room now that Amelia’s here,”

“Yeah, I’m sure my wife would love that,” Derek laughed along. Although, if he was being completely honest, staying with Addie didn’t sound like the worst idea. 

He hated staying in hotels. He never understood why Addison insisted on staying at the hotel when she came to Seattle. Granted, the trailer was small, but he still thought it was better than a hotel room. After hanging up, he immediately called Addison just to see if she’d even go with the idea. To his surprise, she said yes. In fact, she seemed completely unfazed by the ask. 

Addison Tells Derek about Henry

Still of baby Henry from Private Practice 5x19

“Really?” Derek asked.

“Really,” Addison sighed. 

“Why?” Derek asked.

“Did you not actually want to stay in my guest room and just thought it’d be fun to ask me for kicks?” Addison joked.

“No, I just…didn’t think you’d say yes. At least not without some convincing,” Derek said.

“Yeah, well, you caught me at a good time. Or a bad time….A good time for you, bad time for me,” Addison started to ramble a little.

“Yeah, I heard about you and Sam,” Derek said.

“It’s not just that,” Addison added.

“Is it the baby? You’re not regretting it, are you?” Derek joked.

“No, definitely not,” Addison chuckled. 

“He’s the best,” Addison said, honestly. She couldn’t help it. She was obsessed with baby Henry.

“Yeah, I remember when I first met Zola,” Derek reminisced. “I don’t know what it was, I just knew she was supposed to be mine,”

“Yeah,” Addison breathed. She knew exactly what he meant.

“And for what it’s worth, I think it’s great that you’re doing it on your own,” 

“Thank you,” Addison said, appreciatively. 

They both fell silent for a minute. After all the drama she and Derek went through with the affair, the divorce, and the other affair, it was nice that they were finally in a good place. They were amazed that they could still maintain their friendship after everything. She just wished things were better with Amelia.

“I guess my sleepless nights with Henry will turn into your sleepless nights too,” Addison joked.

“And right when I was starting to get used to Zola sleeping through the night,” Derek joked back and they both laughed.

Derek Packs for LA

Still of Derek (played by Patrick Dempsey) kissing Meredith (played by Ellen Pompeo) as Zola sits on her lap holding a bag of snacks from Grey's Anatomy

Later that evening, Meredith came home to find Derek in their bedroom, packing his luggage. Meanwhile, Zola sat in her baby jumper watching.

“What do you think you’re doing?” Meredith asked as she walked over to pick Zola up.

“Packing,” Derek said, plainly.

“For what?” Meredith strained slightly as she lifted Zola up into her arms.

“LA,” Derek answered as he got up off the floor.

“Why are you going to LA?” At this point, Derek hadn’t told Meredith about leaving. He told her about his patient and his frustration over her seizures, but he, Courtney, and Liam had only just decided they’d go to LA earlier that day.

“I need Addie’s help,” Derek said, looking straight into Meredith’s eyes. He knew she wouldn’t be happy that he brought up his ex-wife.

“With what?” Meredith was confused but curious as to why he’d need Addison’s help of all people.

“My patient, Courtney,” Derek went back to grabbing more clothes from the closet. “Her baby has an omphalocele,” 

“Her baby’s organs are outside of her body?” Meredith clarified.

“Yup,” Derek confirmed. “And I need Addie’s help to safely deliver him.

“How long will you be gone?” Meredith asked as Zola started playing with Meredith’s hair.

“Couple weeks,” Derek continued walking back and forth between the closet and his luggage that was laid out on their bed. “A month tops,”

“A month?!” Meredith exclaimed. An entire month with his ex-wife. Perfect.

Meredith Isn’t Happy About Derek’s Plans

Still of Derek (played by Patrick Dempsey) and Meredith (played by Ellen Pompeo) in bed from Grey's Anatomy

“I don’t want this baby coming before he’s ready,” Derek explained. “But I still need to monitor Courtney’s seizures and get Addison’s help in case he comes early,”

“But a month?! If she still has another month to go, can’t you wait to go out to LA?” Meredith asked.

“Look, I know it’s not ideal,” Derek put his hands on Meredith’s shoulders as Zola stayed glued to her hip. “But this isn’t for me. It’s for Courtney, Liam, and their baby,”

Meredith rolled her eyes as Zola started cramming her fingers in her mouth. Derek smiled at the baby but pulled her fingers out of her mouth. He didn’t want her to form a habit of sucking on her thumbs. 

“I’ll call every day,” Derek promised. “Plus, it’ll give me a chance to see Amy and make sure she’s okay,”

“Didn’t Addison tell you she went through rehab already?” Meredith asked.

“Yeah, but she hasn’t said much since. Actually, neither of them have said anything since,” Derek thought back. Why hadn’t either of them updated him?

“Well, I guess it’s a good thing you’re going out to see her then,” Meredith said in a somewhat mocking tone.

“Everything’s going to be fine,” Derek reassured her as he kissed Meredith’s temple and proceeded to kiss Zola on the cheek.

The next morning, Derek flew out to LA and met with Courtney, Liam, and Addison at the practice. When he got there, he found Liam and Courtney at the entrance, who also just arrived.

“You guys ready?” Derek asked.

“Ready as we’ll ever be,” Courtney tried her best to sound enthusiastic. But they could both tell that she was terrified.

Derek, Courtney, and Liam Arrive at Seaside Wellness

Exterior shot of Seaside Wellness Group from Private Practice

Derek led them both inside where they took the elevators upstairs to Seaside Wellness Group’s lobby. It almost had the opposite effect of a hospital with its warmer gray and brown hues and clear glass office walls. He didn’t know what he was expecting, but it certainly wasn’t this. 

“Hi, we’re here to see Dr. Montgomery,” Derek said as he walked towards the receptionist.

“Of course,” She said back, politely. Then, all three of them watched as the receptionist walked out from behind the desk to Addison’s office door. Soon after, Derek saw his ex-wife walk out the door. Her hair was much shorter the last time he saw her. He was actually surprised how short it was before. This time around, her hair flowed right past her shoulders and was red and vibrant as ever. This time around, she more closely resembled the woman he married years ago. But he was surprised to see a male doctor he’d never seen before walk alongside her.

“You must be Courtney and Liam,” Addison held out her hand to shake the husband’s hand.

“I’m Dr. Montgomery,” Addison continued. “And this is Dr. Reilly. He’ll be helping us out as well,”

“And this,” Addison gestured to Derek as she spoke to Jake. “Is Dr. Derek Shepherd,”

“Nice to meet all of you,” Jake said as he shook everyone’s hands.

Soon after, they all headed inside Addison’s office and started talking about a plan on what to do for Courtney, Liam, and their baby. 

Derek Confronts Addison About Jake

Still of Addison (played by Kate Walsh) and Derek (played by Patrick Demspey) in Grey's Anatomy 4x13

After Liam and Courtney left, Derek stayed back and caught a glimpse of Addison and Jake in her office. Did she just blush? How long had it been since he’d seen that? Addison never said anything about seeing someone else. When he talked to Sam on the phone, he didn’t mention anything about it. But maybe he wouldn’t have said anything anyway. 

When Addison and Jake went their separate ways, she walked towards Derek who had a look on his face. A suspicious one. Addison Montgomery was already moving on. And she looked happy. She was a new mom and had something going on with a new guy. Everything seemed to be working out for her. Now if only he could figure out what happened between her and Amy.

“What?” Addison said as if she were being accused of something.

“Is something going on between you and…,” Derek’s voice trailed off. She knew what he meant.

“Honestly? I don’t know,” Addison replied.

“What do you mean you don’t know?” Derek chuckled. 

“It’s a long story,” Addison struggled to find her words for a minute.

“Well it’s a good thing I have time then,” Derek joked.

Derek Discovers Amelia’s Secret

Still of Addison (played by Kate Walsh) talking to Amelia (played by Caterina Scorsone) from Private Practice 5x19

After that, Addison walked him over to the kitchen where they found Amelia standing behind the island eating a yogurt.

“Derek,” Amelia caught sight of him before he saw her.

“Amy,” Derek smiled. But then, he saw it. The baby bump. And his smile turned into a confused look on his face. Amy? Pregnant?

“What are you doing here?” Amelia asked, accusatorily.

“He came with a patient for me,” Addison explained, slowly and calmly. “I tried to tell you but you wouldn’t answer my calls. Or stay in a room with me long enough,”

“Why didn’t you tell me?” Derek looked over at Addison. He thought she was supposed to be taking care of her.

“I didn’t think she wanted you to know,” Addison defended herself.

“And that was enough for you not to tell me?” Derek continued accusing Addison even though he knew full well that it wasn’t her fault.

“It’s not my secret to tell, and you know it,” Addison said back, slightly aggravated by Derek’s tone.

“She’s my sister,” Derek’s voice rose as he was still angry at her. Even though they all knew he was displacing his anger.

“You ever think that that’s why she didn’t tell you?” Amelia said, mockingly.

“Well, then you should’ve told me,” Derek turned to face Amelia.

“You know what, I don’t have to deal with this,” Amelia trashed her now empty yogurt cup and went for the door.

“So now you’re just gonna walk away?” Derek exclaimed as Amelia walked out. As she did, Sheldon came into the kitchen.

Sheldon Comes Into the Kitchen

Still of Sheldon (played by Brian Benben) talking to Cooper (played by Paul Adelstein) from Private Practice

“Amelia’s brother,” Addison filled Sheldon in after he looked back at her with a confused look.

“Ah,” Sheldon gave an auditory signal that he understood.

“Why didn’t either of you tell me?” Derek turned to Addison.

“It’s complicated,” Addison looked back, solemnly. It was one thing that Amelia was pregnant. It was another that her baby probably wouldn’t survive for long.

“Everything’s always complicated with Amy,” Derek dismissed Addison’s concerns. Even after seeing the sad look on her face.

“Look, I know we haven’t officially met yet but Amelia needs to deal with this in her own way,” Sheldon stepped in, seeing Addison struggle to find the words to say next.

“Who even are you?” Derek asked, assuming he was just another doctor at the practice. “She’s my little sister,”

“And she’s my best friend,” Sheldon snapped back. Derek looked back at him, slightly confused. Really? This guy out of all people is Amy’s supposed best friend? When Derek looked back at Addison, she gave him a look to confirm that Sheldon was indeed her best friend.

“And trust me, you and Addison aren’t the only ones she’s mad at right now,” Sheldon sighed, frustrated. If he could turn back the clock and not take that trip to see his ex-wife, he would. He should’ve been here. She needed him and he just left. He knew it wasn’t that simple, that Amelia may very well still be mad at him even if he stayed. But for now, blaming himself for Amelia isolating everyone else was his way of coping with the situation.

“So, she’s mad at you, she’s mad at Addie, and she’s mad at me,” Derek started putting it together. “Who isn’t she mad at?”

Derek Learns More About Amelia’s Situation

Still of Derek (played by Patrick Dempsey) and Amelia (played by Caterina Scorsone) from Grey's Anatomy

“Jake,” Sheldon and Addison said in unison.

“Why?” Derek asked. Jake seemed like a nice enough guy, and it meant something that there was something going on between him and Addison. But why him out of all people?

“He’s her OB,” Addison revealed.

“Why?” Derek asked again. “Shouldn’t it be you?”

“Yeah, she’s not too happy with her right now,” Sheldon walked around to grab some snacks in the cupboard.

“Is anyone gonna tell me what’s really going on?” Derek sighed, frustrated by short and concealing answers.

The room went silent. Neither of them knew how to say it. It felt cruel. Saying it out loud felt wrong. Amelia had gone through so much already. Her last slip almost broke her, and since then, it’s just been heartbreak after heartbreak. First Ryan, now Ryan’s baby.

“Well?” Derek said after letting them sulk for another minute.

“It’s the baby,” Sheldon finally said.

“What about the baby?” Derek looked to Addison.

“He’s anencephalic,” Addison finally said. It was a clinical term but saying the baby had no brain or an underdeveloped brain felt crueler.

“What?” Derek looked over at Addison, and he finally understood the sad looks on their faces. It felt like a cruel joke. It felt unreal. Hadn’t Amy gone through enough by now?

Cooper and Charlotte Come In

Still of Cooper (played by Paul Adelstein) and Charlotte (played by KaDee Strickland), who has a hand on his neck from Private Practice 5x11

The room grew silent again. That is until the other doctors started piling into the kitchen. Cooper and Violet were talking about Erica and Mason. More specifically, they were talking about Mason’s refusal to accept that Erica was dying.

“Dr. Shepherd,” Cooper recognized the doctor from Seattle straight away.

“Dr. Freedman, nice to see you again,” Derek mustered as much courage as he could to at least be polite.

“Violet, this is Dr. Shepherd, he was one of Erica’s doctors,” Cooper introduced the two.

“Shepherd, so you’re…,” Violet started.

“Amy’s brother,” Derek confirmed.

“Amy?” Cooper and Violet asked in unison.

“She used to go by Amy but Derek’s the only one who still calls her that,” Addison filled them in. The two doctors nodded understandably.

“So have you…seen Amelia yet?” Violet asked, hesitantly.

“He just did,” Sheldon inserted himself back into the conversation.

“How is Erica anyway?” Derek steered the conversation away from Amy. They all knew about Amelia and the baby before him and he didn’t feel all that great about it.

“Not good,” Cooper sighed. “It spread to her liver. She’s only got a few days left at most,”

“I’m sorry,” Derek said, solemnly. 

“Yeah, and our son isn’t taking it well. Or at all,” Cooper explained.

“Erica won’t let him see her,” Violet explained further. “They told him she was dying but he’s still waiting for her to get better and come home,”

Derek Meets Henry

Still of Addison (played by Kate Walsh) holding baby Henry from Private Practice 5x19

“So what am I supposed to do?” Cooper directed his question towards Violet.

“Be there for him,” Violet said, simply. “And hope that Erica will let him see her again before she dies,”

Later that evening, Derek followed Addison’s car back to her place. He knew she lived by the beach but he didn’t realize how close. When he got to the door, Addison helped by picking up a bag even after Derek tried to insist that he could carry the load alone. When they came inside, he was astounded by how nice her place was. Seeing her place just reminded him of how great her eye for interior design was. It was minimalistic and modern and having the literal ocean as her backyard helped. After setting one of his bags near the stairs, Addison noticed Derek admiring her place.

“Like what you see?” Addison joked.

“You know when Mark said you lived on the beach, I didn’t know he meant that literally,” Derek said back. Addison chuckled back.

“Good evening, Dr. Montgomery,” Keisha, Addison’s nanny, descended down the stairs holding baby Henry.

“Keisha, this is Dr. Shepherd, he’ll be staying with me for a while,” Addison introduced the two after she carefully took Henry out of her arms.

“It’s nice to meet you,” Derek shook her hand after Henry was safely in Addison’s arms.

“Thank you, again,” Addison said as she started bouncing Henry in her arms just slightly.

“Of course, I’ll see you tomorrow Dr. Montgomery,” Keisha said politely as she headed out.

“And who are you?” Derek asked playfully towards Henry, who just had a blank look on his face.

“Henry, this is Derek,” Addison said, sweetly.

Derek and Addison Talk About Their Kids

Still of Derek (played by Patrick Dempsey) holding baby Zola up from Grey's Anatomy

“Hi Henry,” Derek gently picked up Henry’s small hand and gave it a slight shake with two fingers. Henry looked slightly amused by the gesture.

“You’re a cute one, aren’t you?” Derek cooed over the baby.

“I know!” Addison exclaimed, excited that she didn’t have to pretend like she wasn’t happy. Around the office, she tried harder to hide it for Amelia’s sake but coming home after work was her new favorite time of the day. It was when she got to come back to her sweet baby boy and be as happy and excited as she felt inside.

“I forgot how small they are when they’re this young,” Derek reminisced thinking about Zola. She was already one and he couldn’t believe how fast time passed with a baby.

“Before you know it, he’ll be walking and talking like Zola,” Derek said as he continued cooing over Henry.

“Ugh, don’t remind me,” Addison groaned and chuckled back playfully.

During dinner, they both stuck to talking about surface topics. It almost felt like they were in med school again. Except they weren’t together anymore. But it reminded them that they were more than their romantic relationship. They were practically best friends. They never thought they’d ever get divorced, they were Derek and Addison. But when they did, everything changed. But if this proved anything, it was the fact that they still had their friendship to fall back on. It’d been long enough by now since their divorce, since both of their affairs. Somehow, their friendship was able to survive. And both of them couldn’t be happier about that.

Derek Confronts Addison

Still of Derek (played by Patrick Dempsey) talking to Addison (played by Kate Walsh) from Grey's Anatomy 2x11

After they finished eating, there was a slight lull in their conversation. They talked about their patient, their treatment plan for her, and their kids. But now, a silence hung and they both knew they couldn’t avoid talking about Amelia any longer.

“So, why are you and Amy not talking?” Derek finally asked as he started clearing their plates.

“I did her first ultrasound,” Addison said as she grabbed a baby wipe from the counter.

“So?” Derek was confused. It’s not like it was Addison’s fault.

“I didn’t tell her about the baby right away,” Addison continued. “And then I got Henry and she…couldn’t be happy for me,”

“It’s not your fault you know,” Derek said as he turned on the sink to start washing the dishes.

“Oh, you don’t have to do that,” Addison said as she saw him start to wash the dishes.

“You’re already letting me stay here, this is the least I can do,” Derek argued. 

It was oddly domestic, the way the two of them fit so well together. It was refreshing. They weren’t avoiding an argument in awkward silence the way they used to in the last few years of their marriage. They were just Derek and Addison. The way they were before everything blew up. Except now they were divorced and living separate lives. It was strange, but it was almost like they needed the space and the distance for them to get back to who they used to be: friends.

Old Habits Die Hard

Still of Addison (played by Kate Walsh) and Derek (played by Patrick Dempsey) riding the ferry together from Grey's Anatomy 2x09

After Derek washed the dishes, Addison got Henry ready for bed. When she came back downstairs, Derek was already pouring them two glasses of wine. When she saw the bottle he was pouring, she smiled. The Barolo, her favorite.

“You remembered,” Addison said, fondly.

“Hard to forget,” Derek said as he handed her a glass.

“So how’s Meredith and Zola?” Addison asked as she sat on the couch.

“They’re good,” Derek said as he joined her on the couch.

“How’s she feel about you staying here?” Addison joked. If she’d asked that years ago, it may have come off the wrong way. Like she was trying to start a fight. But now, it was like the pressure was off.

“Not thrilled,” Derek chuckled. He took a sip of wine and let it seep through his teeth. God, he forgot how great Addison’s taste in wine was.

“But it’s better than a hotel,” Derek added.

“I still don’t get what you have against hotels anyway,” Addison said.

“I already work at a hospital, I want to be able to come home to someplace homier than a hotel,” Derek explained.

“Yeah, I guess I get that,” Addison said.

Addison Tells Derek About Ryan

Still of Ryan (played by Wes Brown) talking to Amelia (played by Caterina Scorsone) from Private Practice 5x06

“So what are we gonna do about Amy?” Derek asked, seriously.

“I don’t know what we can do,” Addison said, honestly.

“Well, she’s clearly going through with this pregnancy,” Derek said. “Do you have any idea why?”

“I mean,” Addison sighed as she thought about it. “Maybe because it’s Ryan’s baby,”

“Who’s Ryan?” Derek asked. 

“Her dead fiancé,” Addison said bluntly as she took another big swig of her wine. Derek kept his focus on Addison’s face.

“Fiancé?” Derek asked. “How serious was she about him? I mean, she just got out of rehab,”

“He’s the reason why she went,” Addison explained. “She called me after he OD’d, saying she was ready to go to rehab,”

“Well, we can’t just sit around and do nothing,” Derek finally said after letting it all sink in for a minute.

“It’s hard to do anything for her if she won’t let anyone talk to her,” Addison pointed out. 

“Didn’t you say she was talking to Jake?” Derek asked. He still didn’t understand why his little sister picked him of all people.

“Yeah,” Addison said. “But he won’t say anything,”

Derek gave her a look. He didn’t seem to like Jake so far.

“He’s just trying to be protective,” Addison defended him.

“What do you see in him anyway?” Derek joked as he started chuckling.

“He’s just…I don’t know,” Addison said as Derek saw her blush. “He’s just…good,” 

“You really like him,” Derek gathered.

“Yeah,” Addison breathed. “I don’t know, it just feels different,”

“Well, I guess if Amy trusts him, he must be good,” Derek surrendered. The only reason why he didn’t like him at the moment was because Amy trusted him more than him or Addison. And he still barely knew the guy.

Derek Checks on Erica

Still of Derek (played by Patrick Dempsey) and Amelia (played by Caterina Scorsone) talking to Erica (played by A.J. Langer) from Private Practice 5x15

The next week flew by pretty fast. But it felt slower every time Derek tried to confront Amelia. The minute Amelia spotted him, she’d walk out just like she did when he first got to LA. 

After hearing about Erica, Derek went to St. Ambrose to visit her after checking on Courtney and waiting on some more test results for her seizures. Erica was deteriorating pretty rapidly so he doubted that she really knew he was there, but he couldn’t just not go to see her. 

While waiting around for Courtney’s test results, he saw Charlotte, Cooper, and Mason rush down the hall. He knew they wanted Erica to let Mason see her so he was hopeful that their running meant she finally agreed. And while Erica’s unfortunate but eventual death was heartbreaking, he sought solace in the fact that Mason got to say goodbye.

After that, Derek returned to his patient, Courtney, and discovered the best way to proceed was through a craniotomy. And while there were risks (as there were for every surgery) Liam and Courtney agreed to do the surgery. But to be safe, Addison agreed to monitor the baby just in case. The surgery went without a hitch and the baby was fine. Now all they had to do was wait for this baby to come. They wanted to give their baby all the time he needed to continue growing in Courtney’s safe uterus. 

Derek Struggles to Get Through to Amelia

Still of Derek (played by Patrick Dempsey) and Amelia (played by Caterina Scorsone) from Grey's Anatomy 11x07

With some convincing, Charlotte agreed to let Derek work at St. Ambrose for the time being. It made the hospital look good to have such a renowned brain surgeon work for them, even if it was only temporary, and it gave Derek something to do. More than that, it gave Derek the chance to keep an eye on Amelia.

Amelia was less than thrilled, however. It was already bad enough that Derek was here in LA, privy to her pregnancy and the life she’s made for herself. She would’ve preferred it if he and the rest of their family never knew about this baby. Her baby. God, her whole family would know about him now. She figured Derek would tell everyone. She was the troublemaker of the family. The black sheep. Wasn’t it bad enough she was the drug addict of the family? Now she was the knocked-up drug addict with a baby with no brain. Perfect, she thought. As if things weren’t bad enough.

As for Derek, he knew he should tell his family. Their mother, at least. She’d want to know, they all would. But he could only imagine how hard this was on Amy. Slipping on her addiction was one thing, but to lose a fiancé and eventually a baby was too much. Telling the family and letting them bombard her would push her too far off the edge. Addie said she hit bottom with Ryan. That his death broke her, that it still weighed on her every day. Even more so now that she was having his baby. He couldn’t push her farther. He didn’t have the heart to.

Amelia Continues Shutting Everyone Out

Still of Amelia (played by Caterina Scorsone) getting emotional while talking to Addison (played by Kate Walsh) from Private Practice 5x19

Addison tried to talk to Amelia too. But to no avail. She shut her out. Continually. She could barely get a word in. The minute she entered a room, Amelia left the room. Or if she stayed, she’d lash out at Addison. Amelia knew it was probably just a mix of hormones and personal heartbreak, but she couldn’t help it. She knew her baby was going to die, and it wasn’t Addie’s fault. But blaming her felt easier. It somehow helped take off the weight pushing down on her shoulders.

Derek wanted to pry, wanted to know more about Amy’s plan with this baby. They were doctors, they all were. And they all knew as terrible as it was to admit and say out loud, her baby would die. It was just a matter of time. He also wanted to know more about Ryan, this supposed fiancé. How did she just get engaged in the middle of hitting rock bottom? 

Derek knew better than anyone that love didn’t care about timing. He knew that it could hit you when you least expect it. It’s what happened with Meredith. He came to Seattle to escape, to leave his old life behind. Meredith became the reason why he stayed, even after everything blew up with Addison. He still wanted Meredith, and that’s how he knew it was real with her.

Derek Asks About Ryan

Still of Addison (played by Kate Walsh) confronting Amelia (played by Caterina Scorsone) about her father's watch while Ryan (played by Wes Brown) has his arm around her from Private Practice 5x08

But with all the drugs Amy must’ve been taking with this Ryan kid, who knows how real it was between them? Real enough to get engaged apparently, but he could only suspect so much. With all the drugs in her system, in their systems, she couldn’t have been in the right frame of mind. Either way, he knew it still must’ve been real. Or at least felt real. He wanted to know more, he needed to know more. But it seemed like the last thing Amy wanted to do. Least of all with him.

“What do you know about Ryan anyway?” Derek asked Addison as they sat down for dinner.

“Not much,” Addison said, honestly as she placed a plate of food in front of him.

“Well, what do you know,” Derek asked.

“It’s not like Amy will tell me anything,” Derek said after seeing Addison think about it for a moment.

“I know they did drugs together,” Addison added. 

“Well, that much was obvious,” Derek remarked. Addison shot him back with a sarcastic grin.

“She gave him your father’s watch,” Addison quietly mumbled after a minute. Derek’s nose crinkled as he let it sink in. That watch was everything to him. Didn’t his mother have it?

“Wow,” Derek put down his pair of chopsticks and ran his hand through his hair, sighing. 

“Yeah,” Addison breathed. “And she was not happy when I confronted her about it,”

Addison Reminisces Over Amelia’s Intervention

Still of Ryan (played by Wes Brown) holding Amelia (played by Caterina Scorsone) back as she yells at Addison (played by Kate Walsh) from Private Practice 5x08

She thought back on that day everyone staged the intervention for Amelia. It wasn’t easy. Everyone else seemed to be taking it easier than she did. Well, everyone but her and Jake. He couldn’t even stay for the whole thing. She wasn’t sure where he went but she could tell something about the whole ordeal struck a chord with him. It didn’t help that Sam completely dismissed the idea of addiction being a sickness.

“I can imagine,” Derek sat up in his seat and continued eating the Chinese takeout Addison ordered for them. 

It was a small detail, but it was nice to see that old habits die hard. When they were in med school, they’d always order from the same handful of places. And they’d always order the same things. Addison may be in LA now and the food wasn’t nearly as good as the takeout they had in New York. 

Even so, Addison still ordered the same thing, and she remembered his order too: Addison with her Kung Pao chicken with shrimp toast and Derek with his Mongolian beef and egg rolls. Seattle had some good food, but it wasn’t the same. If he was honest, the food he ate with Addison here in LA was closer to what he used to eat in New York. 

“So, what happened?” Derek finally asked as he grabbed a piece of chicken off her plate. They always shared food when they were in med school, so they easily went back to falling into their old patterns.

Derek Learns More About Amelia’s Addiction

Still of Amelia (played by Caterina Scorsone) marching around the office chanting from Private Practice 5x08

“She called me a bitch,” Addison said, plainly. Then, she started chuckling about it. She knew Derek wanted to know more, that he needed to know everything. But she figured that this was a good place to start.

“And that’s supposed to be funny?” Derek joked, laughing along.

“It wasn’t at the time,” Addison remarked, still chuckling slightly. “But I don’t know, maybe it’s been long enough that it is now,”

“I’m assuming that wasn’t the end of it,” Derek added.

“No,” Addison said, grabbing an egg roll out of the container with her chopsticks. 

“All she wanted to do was get out of there but we wouldn’t let her until we knew she’d be okay. She already disappeared for 12 days, we didn’t know if she’d ever come back if we let her leave again,” Addison let it all spill out. Derek continued listening intently.

“She lashed out at everyone and started chanting about how she wanted drugs,” Addison giggled thinking back on her screaming “I want drugs” while marching around the lobby.

“Chanting?” Derek asked, amused.

“Yeah. She marched around the lobby chanting, what do we want? Drugs! When do we want them? Now!” Addison laughed, trying to keep her composure. It was ridiculous thinking about it now how incredibly high and irritable Amelia was at the time. Pete and Violet obviously saw it because she caught them both giggling in the kitchen, but she couldn’t see it then.

“Oh, I would’ve loved to see that,” Derek laughed along.

Derek and Addison Commiserate Together

Still of Derek (played by Patrick Dempsey) and Addison (played by Kate Walsh) in Grey's Anatomy 2x01

They both knew it was odd to laugh, but there was something strangely refreshing about it. Over the past couple of weeks, they spent a lot of their time tiptoeing around Amelia. It was nice to just laugh again. 

“I’m sure she would’ve loved that,” Addison joked.

“Seriously though,” Derek started. “What are we gonna do?”

“I don’t know if there’s anything we can do,” Addison said, honestly as she grabbed some food off Derek’s plate. 

“There’s gotta be something,” Derek insisted as he took a sip of water.

“She’s made it pretty clear that she doesn’t want anything to do with me,” Addison said, sadly.

“Yeah, well, we’re both in the same boat there,” Derek added.

A comfortable silence sank in as they both continued eating and picking at their food with their chopsticks, wondering what to say next. Or rather, what they could say to make it all better.

“So, Jake,” Derek switched the subject just slightly. And at the sound of his name, Addison started blushing a bit.

“What about him?” Addison asked, sitting up straighter in her chair as she took a sip of water.

“Do you think he’s doing enough to take care of her? I mean, she won’t talk to us but if Jake’s taking care of her…,” Derek’s voice trailed off.

“I think he’s doing the best he can,” Addison said, honestly. “And he’s a good doctor, a great one. I have no doubt in my mind that Amelia’s well taken care of in his hands,”

Courtney Goes Into Labor

Still of Jake (played by Benjamin Bratt) and Addison (played by Kate Walsh) in Private Practice 5x13

“It’s just hard to tell with Amy,” Derek said, frustrated. He wanted to help, but he knew he couldn’t if Amelia kept pushing him away.

“I know. She’s gonna be okay,” Addison said, sympathetically as she placed a hand over Derek’s.

Derek smiled slightly and grabbed some of Addison’s fingers with his thumb and index fingers. If it were anyone else telling him this, he probably wouldn’t believe them. But he knew that the only person that knew Amy better than he did was Addison.

The week after that, Courtney went into labor, and Addison and Jake helped deliver him. Then, they immediately took him into surgery to help get his internal organs inside his body. But when it wouldn’t fit initially, they decided the best plan would be to wait a couple of days to try again. So they did just that, and the baby, who Courtney and Liam named Jack, was just fine. 

“We’ll need to monitor him for another couple of days, just to be safe,” Addison said as they all stood in the NICU looking at baby Jack. “But after that, you guys will be able to take him home,”

“Thank you!” Courtney exclaimed.

“Both of you,” Liam added, referring to Jake, who stood beside Addison.

“Of course,” Addison said back, smiling. Saving a baby and being a badass surgeon always made her day. This was no exception.

Additional Notes

And that’s part one of this fanfic! Part two will be out next week and will be the conclusion of how this story ends. Derek may have finished up with his patient, but he’s not leaving LA just yet. I wanted to add a lot of stuff from Private Practice as well as some Addek and Jaddison stuff (because they’re my favorite ships). But hopefully, there’s also enough Derek and Amelia stuff as well. Also, apologies for any medical discrepancies. I know next to nothing about medicine so I’m hoping that everything about Liam and Courtney’s baby as well as Amelia’s baby is accurate.

Courtney’s baby diagnosis is inspired by one of Dorie Russell’s babies (the quintuplets) from Grey’s Anatomy season two. I kept Courtney’s seizure condition pretty vague but it’s loosely based on Gwen Graber, another Grey’s Anatomy season two. Hopefully, you all enjoyed this story, especially @tivashepherd on Twitter. Thank you again for suggesting this prompt and again, part two will be out next week.

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