Notes: This is a fanfiction based on characters from the TV shows, Grey’s Anatomy, and Private Practice. This rewrites parts of the second season finale of Grey’s Anatomy. But this fanfiction tells an alternate story of what happens after Derek and Meredith have sex in the exam room at Seattle Grace hospital. Instead, it asks the question: What if Derek and Addison didn’t end things after Derek cheated on her with Meredith? What if they decided to give their relationship one more shot? This story and chapter were originally posted on Archive of Our Own on December 15th, 2021. This is chapter four so it is necessary to read the fourth chapter before moving on. This has been edited to include headings and images.
Start Again: Chapter 5
For the rest of the day, as well as the next day, Sam and Naomi relentlessly campaigned. And everyone hated it. Derek and Addison included. Dell at least tried to get Naomi to let him log more hours so he could be a midwife. Meanwhile, Addison continued working with Jeffrey and Kathleen, her patient from the day before, and got Pete to help. After a lot of assurance from Violet and even Derek. Derek and Addison weren’t believers in the alternative medicine route, but even he had to admit that it was time for Addison to let Pete try. After all, they were supposed to be practicing cooperative medicine. So, they might as well embrace it.
As for Derek, he got to deal with his first patient, which he got from a referral from Dr. Charlotte King, St. Ambrose’s chief of staff. Everyone at the practice didn’t seem to like her much, but Derek didn’t get the same vibe from her. Instead, she found her impressive for being one of the youngest chiefs of staff in the country. And while he saw why the other doctors might not like her, Derek had worked in hospitals long enough to know that as annoying as it was, administrative crap was just part of the job. And he found it wrong to just place all the blame on her when all she was really doing was her job.
Sam and Naomi’s arguing and constant campaigning came to a head in the middle of the day when they were openly arguing in the kitchen. They weren’t just arguing about the practice, though it was definitely a big part of it. Naomi threatened to leave to go work for St. Ambrose, which she didn’t really want to do but she also hated what things had come to over the past week. Sam tried to defend himself for pushing everyone but Naomi didn’t really give him much of a chance to speak. Then, Naomi brought up their marriage so to say it was getting out of hand was an understatement. And everyone was fed up with it. So Addison thought it was only time to step in, once again.
“Addison!” Sam exclaimed as he tried to get her to butt out.
“We’re trying to have a private conversation here!” Naomi added.
“I don’t care,” Addison shouted louder so they’d both stop arguing.
“Great,” Naomi muttered to herself.
“Look, maybe this is my fault,” Addison admitted.
“Addie, it’s not your fault,” Derek added.
“No, I pushed us to try to recapture the past. To what this place used to be,” Addison started.
“You don’t even know what this place used to be!” Violet interrupted.
“No, but it didn’t take long for the rest of you to tell us,” Derek said as he came to his wife’s defense. And he was right. Over the last few days, as everyone became stuck in Sam and Naomi’s fight, both Derek and Addison had heard stories about what Oceanside Wellness used to be: a cooperative medical practice. One that put the patient’s care above everything else.
They Propose a Solution
It sounded more like a fairytale, but they all insisted that this practice really used to be something. But Derek and Addison also weren’t naive. They knew that as great as the medicine was at this place, the financials, or more specifically, how the financials were managed, were atrocious. They loved Naomi, but it became clear that she’d drive the practice into the ground if they hadn’t stepped in.
When Naomi and Addison spoke on the phone, Naomi even admitted to her that she let a patient pay her off so that she’d implant her with a baby with a genetic match to her dying son. The ethics alone there were disastrous, but she did anyway because they needed the money. And the fact that Naomi refused to let anyone help only made matters worse.
“Look, the past is clearly cluttered with anger and mistakes, and we need to bury that,” Addison started again, thankful that her husband stepped in to defend her.
“It doesn’t matter who did what when, it matters what we do now. What we want this place to be moving forward,” Addison said as everyone listened intently, realizing that she was right.
“We need to focus on patients, and we need to make money. We need Naomi and we need Sam. The best of both of you. And this vote? It’s a bad idea, an idea that we might never recover from. We shouldn’t do it,” Addison offered a solution. One that made a lot of sense. However, Sam and Naomi still looked at her, unconvinced. Regardless, Addison continued her speech.
Sam and Naomi Ignore Her
“Let’s sit down and figure out what we want this place to be, together,” Addison proposed.
“If you force us to choose between you, that will create scars that won’t heal. We need to move forward, not back,” Addison said after hearing Naomi and Sam groan slightly.
“Addison’s right,” Derek added. The situation they were in, that they were all in, was a crappy one. Here they were, being forced to vote on who should lead the practice. And to make matters worse, neither of them had shown that they were capable of running the place. At least not effectively. Naomi was too insistent on enforcing the practice’s values while Sam focused too much on the money, making it hard for everyone to focus on the medicine.
Having both of them work together would make for a great solution, but it’d only work if they both agreed to put aside their stubbornness and pride. But it didn’t look like that was going to happen, unfortunately. After Addison’s speech, everyone looked around at each other and knew she was right. Well, everyone except Sam and Naomi, who were both still unwilling to let go of their pride.
“We vote at the end of the day,” Sam said adamantly as he got up from his chair and left the kitchen. Then, Naomi walked out the door and after exchanging some more looks, everyone else followed suit.
Time to Vote
After everyone finished up their patients for the day, it was finally time for the vote. Derek had just come back from St. Ambrose after a surgery and Addison performed a hymenoplasty. The patient’s parents arranged a marriage for her back home in Kabul, but her new husband would only have her if she was still a virgin. She told Addison and her parents that she’d been raped, but it ended up being a lie. The truth was she had a boyfriend.
But even after Addison convinced her to tell her mother about her boyfriend, she still wanted the surgery. So she did it. But only after a lot of discussion and deliberation with everyone else at the practice. Naomi included. As angry as Naomi still was at Addison, she still made sure to put in her two cents about the procedure.
When Derek and Addison stepped into the conference room, Derek sat down next to Dell, who gave him a piece of paper and a pen. When he looked back up at Addison, she stayed where she stood, leaning against the doorway.
“So we’re really gonna do this?” Addison asked. Everyone else refused to answer and instead looked back down at their pieces of paper to write down their vote.
“I’m not voting. I won’t be a part of this,” Addison threw her hands up as if she were surrendering. Whatever was going to happen to this place was now out of her hands.
“Well, let’s just…let’s count the votes we have,” Dell said after everyone put their folded-up pieces of paper and put it into a bowl placed in the middle of the table. After both Sam and Naomi earned themselves a vote each, things started to change.
They All Vote for Addison
“Addison,” Dell called out as he read the next card.
“Okay, whoever did that, it is not funny,” Addison added. However, she did think that it must’ve been Derek’s card. But then, Dell read off the rest of the cards and was surprised to hear the rest of the votes went to Addison as well. And it made her think that maybe everyone was just playing some sick joke. But everyone seemed to have a pretty good poker face, so she couldn’t be sure. However, Derek made no effort to conceal the happiness and pride he felt for her.
“No. No, no, no, no, no, no, no,” Addison got up from leaning against the wall as Sam and Naomi got up from their chairs to leave. This was a joke, right?
“No, no!” Addison continued, but there was no use. They had just appointed her as the new leader of Oceanside Wellness. And there was nothing she could do about it. But everyone else (sans Sam and Naomi) stayed sitting at the conference table for another minute.
“Nice speech,” Pete said after he clapped and got up from his chair.
“It won my vote,” Cooper added as he got up and put his hand out for a handshake. Addison returned the favor but it wasn’t much of a handshake because she still stood there, stunned at what had just happened.
“Congratulations, boss,” Dell said as he walked out of the room.
Addison Confronts Violet
“Even you voted for me?” Addison asked Violet, as she continued in her chair. After their conversation earlier in the day about her patient who lied about being raped, she didn’t think Violet liked her all that much. But either way, Addison discovered that rape was a touchy subject for Violet. And it became clear that it was because Violet had been raped at some point.
“If either one of them had won, this place still would’ve been divided,” Violet said as she too headed for the door.
“What am I supposed to do now?” Addison sighed and sat down across from Derek, who’d been sitting there the whole time.
“I guess it means we’ll have to figure out what the new future is,” Derek said, smiling back at her, despite the fact that Addison felt completely out of her element.
“We?” Addison raised an eyebrow.
“You didn’t think you’d have to do this alone, did you?” Derek teased as he scooted close enough to his wife to hold her hands.
“We’re gonna be okay,” Derek reassured her. “We’ll figure out how much it’s gonna take to keep this place running and put in new rules so that this place will last a long time,”
After Derek kissed her forehead, they both got up to leave. Addison told Derek that she just needed to change (because she was still wearing her scrubs) so Derek told her he’d meet her at the elevator. After the day she had, Addison had one more place she wanted to stop before going home.
Addison Makes One Last Stop
“Violet,” Addison knocked on Violet’s office door frame.
“About what happened earlier…” Addison started. She wasn’t completely sure what she had to say to her now, but she knew she wanted to say something that would assure her that she could talk to her. Despite the fact that they were practically strangers.
“I don’t…I don’t want to talk about it,” Violet said quickly.
“Are you sure?” Addison asked, hesitantly.
“Yeah. We’re not…we’re not going there, Addison,” Violet quickly dismissed Addison again. She appreciated Addison’s concern but she wasn’t ready to talk about it openly. At least not with Addison.
“Well, if you ever do want to talk,” Addison added. “My door’s always open,”
After that, Addison walked back over to Derek, who was waiting by the front desk next to Pete, looking at something behind Addison. So once she got there, she turned around to look at what they’d been staring at. And there they were, Sam and Naomi, in his office, kissing. And they all couldn’t help but smile. It felt like they’d all just been through a war this past week. But it somehow brought Sam and Naomi together. And even though Naomi and Addison’s friendship was at a standstill, Addison had always been rooting for Sam and Naomi all along. After all, if Derek and Addison could find each other again after everything, Sam and Naomi should be able to too.
“Do you think they’re gonna make it?” Addison asked Derek as he watched the basketball game on TV.
“Sam and Naomi?” Derek looked up at her.
“Yeah,” Addison said softly as she sat on the arm of the couch.
“I’d like to think so,” Derek said, giving her his signature “McDreamy” smile.
Addison Doubts Herself
“Do you think I’ll really be able to lead the practice?” Addison asked after a beat.
“Yeah, I do,” Derek got up from his seat and put his hand on her cheek. “You’re gonna be a great boss,”
“You really think so?” Addison asked softly. “Because you know, you’ve always been better with all the administrative stuff. I mean, you’ve always wanted to be chief of surgery. I mean, that’s why you moved to Seattle, and…” she began to ramble and before she could add anything else, Derek kissed her.
“You’re gonna be a great boss,” Derek said again, reassuring his wife. “And I will be right here by your side,” he added.
This time, Addison leaned in and kissed him, and he only pulled her closer. Before they knew it, Addison climbed on top of him on the couch. After a while, Derek flipped her over and climbed over here. Before they knew it, they were naked and out of breath on the floor.
“When was the last time we did that?” Derek asked, breathlessly.
“What exactly?” Addison teased as she raised an eyebrow and rested her chin on Derek’s chest.
“Had this much fun?” Derek finally added after waiting for a beat. When she smiled back at him, Derek stroked her cheek with his hand as her red hair fell on his hand. Addison smiled back at him and kissed his hand before turning back over and resting her head on his bare chest.
Derek, Addison, and Dell Look for Money
After a week, Addison (with Derek’s help) came up with a plan to help the practice. Oceanside would now open for longer hours and work Saturdays, which they previously didn’t do. But even after that, they still needed to find another $487,000. And since Derek still only had a small number of patients, he agreed to help her find that money. After all, he was the one who actually figured out how much they needed to keep the practice afloat.
After holding a morning meeting with everyone to lay out their new plan, Addison also roped Dell into helping them find the extra money. Though everyone was distracted by some patient named Jenna, so they weren’t as appreciative as she hoped they’d be. Plus, Naomi was still clearly mad at her and refused to talk to her unless it was work-related. Despite Addison’s best efforts. But Derek reassured her that she was doing the right thing.
Soon after, Dell informed her that the practice was due $142,000 in overdue accounts. It wasn’t the full amount, but definitely a good start. So Addison pushed him to become the enforcer to get that money. With an hour to kill, Derek decided to help Dell call previous patients to tell them to pay up. Especially since Dell didn’t seem to be doing well.
Derek even came up with a sure-fire way for Dell to get the money from their past patients. But the real key was getting Dell to not let them talk about how bad the economy was or any personal details that gave them an excuse not to pay. It was cruel, especially after Dell had already heard countless excuses of being left by their spouses or death of a loved one, but they needed the money.
Dell Gives Up
After checking in with Jenna, everyone else’s shared patient apparently, Addison was concerned. She was a 17-year-old girl who was dying from cancer but they were all helping her get pregnant. They’d apparently known this girl since she was five, so they were all attached. But Addison still couldn’t believe they’d taken things this far. So she couldn’t help but say something to Jenna’s husband, Nick when she literally bumped into him when leaving an exam room. To say that everyone was even more unhappy with Addison now was an understatement because Nick panicked and ran off. Though, Addison couldn’t blame the kid. This was a lot for anyone to take in, let alone a 17-year-old kid.
With everyone still pissed off with Addison, she went over to Dell and Derek, who were still calling patients. Derek was doing well, but Dell was still struggling. But having Derek around definitely helped as he pushed him to keep going with their plan, despite the patient’s sad excuses.
“How’s it going over here?” Addison asked.
“I’m done. You know the economy’s really bad, right? People are hurting,” Dell was exasperated. He hated this. He was good at his administrative duties, but he wanted to practice more medicine. And he didn’t feel right trying to force people to pay when he felt they had legitimate reasons as to why they haven’t yet.
“Dell,” Addison sighed as she did some paperwork.
“I came here to be a midwife. I thought I was going to do less administration,” Dell explained. “Wasn’t that part of the deal?”
“And when we dig ourselves out of the hole, you will. Right now, everyone’s taking on extra duty,” Addison said.
“They’re doing more medicine!” Dell exclaimed. “I’m a…bill collector,”
Dell Reveals a Secret
“Well, we’ve gotta get that money somehow,” Derek sighed. He didn’t necessarily mind the extra work. At least not right now. He wasn’t getting to practice much medicine either because he was still fairly new to this practice. But he also recognized that this was temporary. They couldn’t just do nothing. Not if they wanted this practice to survive. But after Derek said this, both Derek and Addison caught Dell giving them a suspicious look but then turning away. And it was then when they realized he knew something. Something that would help with the practice’s financial problems.
“What?” Derek asked, suspicious of what he knew. “You know something,”
“No, I…I don’t” Dell got up to walk away and stuttered because he knew they were right.
“Dell,” Addison said as she blocked his exit from the front desk.
“I don’t know anything,” Dell insisted as he admitted defeat by standing in place now as both Derek and Addison blocked both of his exits from his desk.
“William Dell Parker,” Addison warned as Dell sighed.
“What do you know?” Derek asked.
Before they knew it, Dell told them both about the fourth floor, which was empty. But Sam and Naomi were still holding onto it with the hopes of turning Oceanside into more than it was now. So Derek and Addison each grabbed Sam and Naomi, respectively, and dragged them to the fourth floor for an explanation. They were all killing themselves over finding the extra money, the money that they all knew the practice needed to stay afloat. And there was just a whole floor of prime unused office space that was hemorrhaging their profits.
Derek and Addison Confront Sam and Naomi
“We’ve been killing ourselves trying to save this practice and you have 10,000 square feet of prime office space on the fourth floor?!” Derek exclaimed.
“It is not as simple as it sounds,” Naomi said calmly against Derek and Addison’s angry demeanor.
“Then help us understand, Nai!” Addison exclaimed. “The practice is at stake here!”
“This is the practice. This was our first space, mine and Sam’s,” Naomi said as she proceeded to tell them about her and Sam’s original idea for Oceanside Wellness.
They saw this floor as their opportunity to expand the practice. To create a “medical sanctuary”, as Naomi put it. They wanted it to be more than what it was now. They wanted surgical suites, MRI suites, a dedicated lab, and to add on other specialties. It was a nice dream, even Derek had to admit that (at least to himself). But with where the practice was now, financially speaking, there was no way it was feasible. Not now, anyway.
“This was the practice we always dreamed of,” Naomi said as she finished her speech.
“The practice that still can be,” Sam chimed in. He agreed with her, which is why, even when he was hounding everyone to make more money, he held onto this floor.
“Look, now, the only way to lease this place is with a five- or ten-year commitment,” Sam started as Naomi nodded along with him. “And that would mean giving up on our future,”
“If we lease it, we could pay off our debt, our cash flow would be way up,” Derek said as he started counting with his fingers all the ways leasing this floor would help this practice.
“It’ll allow us to stay afloat,” Addison butted in.
Sam and Naomi Refuse
“No,” Sam refused to give in. “This is an issue on which we see eye to eye,”
“We’re not leasing it out, Addison,” Naomi stated. It was still Sam and Naomi’s practice, even though they were both voted out as the boss.
“You are holding on to something that we cannot afford,” Addison argued.
“And once again, you are trying to control everything,” Naomi said, still bitter about it all. Including the Jenna situation.
“What? It’s not bad enough that you ruined the last wish of a dying girl?” Naomi added insult to injury as Addison started pacing.
“You know what, Nai? Keep it up. ‘Cause eventually, I’m gonna stop caring whether or not you forgive me,” Addison was tired of arguing. This wasn’t just about their friendship anymore. Or just about her career. She was the boss now, and that meant taking care of everyone else at the practice. Even if the right thing to do pissed off her best friend.
“And Sam, you knew about this place and you kept it from me,” Addison wasn’t just angry at Naomi anymore.
“Nice. Great,” She added, sarcastically as she walked away.
Derek Defends Addison
“It’s not her fault,” Derek added after Addison left.
“Oh, please, you’re just saying that because she’s your wife,” Naomi argued.
“No, I’m not,” Derek argued back. “She’s right, and you know it. And not just about this floor,”
“What’s that supposed to mean?” Sam asked.
“You realize you were about to inseminate a 17-year-old girl today?” Derek heard about the Jenna situation too, from the other doctors as well as Addison. And after Addison talked to Nick, he knew everyone was mad at her. But he knew that Addison was just being a good doctor. She didn’t have to convince Nick of anything, despite what everyone said. All she did was be a good doctor. Jenna may be dying but it wasn’t just about her. It was about her family and what they were going to do with the baby after she died. And her 17-year-old husband was nowhere near ready to be a father.
“It’s what she wants,” Sam argued. He, too, became attached to the kid. She knew exactly what she wanted to do with her life and here he was, debating whether or not he should get back together with his ex-wife. He divorced her because he felt like he wanted more out of life, but he hadn’t done anything since.
“Yeah, and everyone’s going along with it because they don’t want her to die. But she is going to die. And a baby isn’t going to change that,” Derek pointed out as he walked away.
Derek and Addison’s Past
Later that night, Derek and Addison lay in bed together, silently. They both knew what had to be done. Leasing the fourth floor would make both Sam and Naomi angrier than they already were, but what was the alternative? Letting the practice go under? They had moved their entire lives here for their fresh start. They banked their entire lives, as well as their professional careers, on this practice. If they knew all of this beforehand, they probably would’ve thought twice before moving down here. But here they were. They couldn’t go back. And if they were honest with themselves, they didn’t want to go back.
New York was great, at first. Med school, residency, marriage. It’s where they met, where they fell in love, and where they started their lives together. But, after a while, things changed. They got caught up in their professional lives. Perhaps they even took each other for granted. They used to talk. They used to argue whenever something was wrong. But after a while, they stopped. They stopped caring enough to fight anymore. For their relationship. For their marriage. And then, when Addison leaned on Mark, things got worse. It got so bad that Derek left, and Addison became the cheating wife that was shacking up with her husband’s best friend.
The Mark of it All
After Derek left, everyone knew. Their families, their friends, their co-workers. Mt. Sinai wasn’t the same without him. Everyone could see that there were problems in their marriage before, but this was an all-time low for Addison. After she left countless voicemails and emails apologizing profusely and begging him to come back, she had to face reality. He wasn’t coming back. So she tried to make it work with Mark. And for a while, it was okay. Everything seemed like it was going to be okay. Her marriage blew up and she wasn’t proud of what she did, but she and Mark kind of fit together. At least for a while.
But then, Mark showed his true colors. Or, more accurately, he reminded Addison that he was a bastard. He wasn’t the commitment type, as much as he cared for Addison. And it crushed her. Discovering he got her pregnant only made things worse. But it did make her realize that she wasn’t happy with Mark. Not really. She was trying to be, she was trying to convince herself that she didn’t just throw away her marriage for a fling. But when she looked at the pregnancy stick, all she felt was terrified. All she felt was dread. She wanted to be a mother, she did. But she wanted to be a mother with Derek by her side. And as much as she loved Mark, it wasn’t the same.
When Derek Left New York
So, when Richard called, it almost felt like serendipity. She knew Derek was still angry. I mean, he wasn’t answering her relentless phone calls or emails. And he wasn’t talking to his family either. And that was hard for her. I mean, to be the one to talk to Nancy and tell her what she’d done. And to know that Nancy would then tell the rest of the family. She loved the Shepherd’s, and felt proud to be a part of them. But she knew that everyone on his side of the family either hated or was ashamed of her now. But going out to Seattle felt like a chance to make it right. At least at first.
Derek already had a girlfriend when she got there. And as much as Addison wanted to pretend like it didn’t bother her, it did. But after he didn’t sign the divorce papers, it gave her hope again. In fact, her entire time in Seattle felt like a rollercoaster. She went from feeling hopeful to feeling hopeless, and they went back and forth on what felt like an hourly basis. But finding the panties in Derek’s pocket felt like a nail in the coffin.
Derek Assures Addie
But then, Derek came home, or the trailer, which never really felt like home to Addison, and she saw it on his face. He wasn’t relieved or happy like she thought he’d be. He was disgusted and ashamed. And it surprised her, and maybe it surprised him too. But seeing him like this gave her hope again. Real hope this time. And it only got better when he agreed to try again somewhere else. Somewhere they could truly start over. And that’s what LA was. What it had been up to this point. And things were going great. They were going better than great. So they weren’t about to give it up just because Sam and Naomi were stubbornly holding onto a floor they couldn’t afford. Even if it meant they’d be pissed.
“Tell me I’m doing the right thing,” Addison finally said as she rested her head on his chest.
“You’re doing the right thing, Addie,” Derek stroked her hair and gave her a sweet peck on the lips. But then, Addison kissed him back, deeper this time as she climbed onto him. Soon after, Derek climbed over her and they both started undressing. They were finally back. Back to being Derek and Addison again. Everything that had happened over the past few months felt stupid now. Trivial. All they could think now was, how did they let things get so bad? And how did they ever let each other go? When did they start forgetting that they loved each other?
I’m just going to stop apologizing for writing longer chapters now because I’d like to start getting into the practice of writing longer chapters anyway. But again, this chapter took a lot of influence from season two of Private Practice. But I promise there will be more original plot stuff coming soon! I have ideas, I just wanted to get through this first because I really did love that storyline from the show. But hopefully, I added enough Addek stuff to make up for that.
I’m also gonna keep this fic pretty PG 13. I have no problem with reading more sexual stuff, but it’s just not my thing when it comes to writing, to be completely honest. So, sorry if you thought you were coming to read some Addek sex scenes lol. I also just wanted to thank everyone that’s enjoyed this story so far and have left nice comments on my previous chapters. It really means a lot to me as a new fanfic writer and I appreciate you all! The next chapter is coming soon!