Here's some AO3 style pairings & tags/warnings before we get started. There are heavy topics but as I'm still in the process of writing, I'm still unsure how detailed I'll get.

Pairings: Carlisle/Esme

Tags: Alternate universe, implied/referenced domestic violence, implied/referenced rape, mental health issues, suicide, character death (but not canon character death), blood, pregnancy mention, parent-child relationships, slow build, and eventually a Cullens-adopt-a-human story

Happy reading!

January 2011

Esme's POV

Do Josh and Amanda want any coffee?

Before I could second-guess myself, I sent the text to Carlisle and tried not to feel like I was desperate for company. Now that Emmett, Rosalie, and Jasper were back in Seattle for their spring semester, the house felt too empty. The emptiness meant I was preoccupied with thoughts I'd rather forget.

My phone buzzed with Carlisle's reply. Do they ever not want coffee? ;)

I half-smiled; Carlisle's favorite nurses never turned down an opportunity for free coffee. I asked him for their orders, though I could guess what they would be. But sometimes humans could be spontaneous and try something different, so it felt rude not to ask. Carlisle's reply came quickly (the usual orders) and then I was out the door.

It was misting heavily as I drove into town. Even after a couple of months living here in Olympic Peninsula, the vibrant green of the encroaching forest was still a shocking change from open rolling cornfields of Iowa.

Locals in Forks said Mocha Motion was better than Starbucks, but having no way to compare, I didn't know if it was true or not. I made sure to order a simple hot black coffee for Carlisle. It was a handy way to help him fit in and warm up his hands.

At our last home, Carlisle became known around the hospital for always having a steaming coffee mug around to the point where his coworkers asked if he ever slept. Carlisle had jokingly told them no.

Immortality would be boring if you didn't troll the humans. Just a little.

It didn't take long to get to the hospital from the coffee shop. I didn't particularly like the hospital. The combined smell of sickness, blood, and chemicals set my teeth on edge. I supposed it was the same for humans, but not to the same degree. I still found it hard to understand how Carlisle could manage to ignore the smell enough to work.

Even so, being at the hospital was better than being alone with my thoughts.

I made her way past the nurses' station, where I was well known, to the break room. Amanda was showing Josh and Carlisle a video on her phone and they all looked up when I entered.

"Oh my God, yes, the good coffee's here," Josh crowed and jumped out of his chair.

I lifted the drink carrier out of reach. "If you're not going to say hi to me, I'm going to take yours back," I mock threatened.

Josh flashed a smile that made him look rather like Emmett. "Hi, Esme."

"Yours barely even counts as coffee," Amanda said, flicking Josh on the back of his head. "It's mostly sugar." She took a grateful sip of her iced latte. "Ah, that hit the spot. Thanks."

I smiled and shrugged. "Thought you could use the pick-me-up."

"At least I'm not drinking it iced," Josh grumbled.

"Iced coffee is still real coffee. Right, Esme?"

Oh no, I was not going to get in the middle of this one. "I have no opinion."

"Esme's more of a tea person," Carlisle said, coming up beside me and taking his small mug of black coffee. He put a hand in the small of my back and I leaned into his touch.

It was true, in a way. I liked having a mug of tea around whenever I worked on my art. There was something about the smell and the warmth radiating from it that was comforting, even if I couldn't drink it.

Amanda shrugged. "Fair enough." She eyed Carlisle speculatively. "And what do you think?"

"I think…" Carlisle hedged and glanced at Esme from the corner of his eye. "Making coffee is very personal."

Josh groaned. "Ugh, that's a non-answer."

"Sorry, it's the best I've got," Carlisle said, not sounding sorry at all.

"You two are no fun," Josh complained.

"We get enough of petty arguments at home," I said. It happened less often now that Edward lived separately with Bella. He and Rosalie always butted heads and their arguments could last for days. Though sometimes Emmett and Jasper could really get into it whenever they competed with each other.

"Younger siblings will do that," Amanda said sagely. She had three younger siblings of her own. "Are Rosalie and Jasper back at school?"

"Yes, classes started up this week," Carlisle answered. Rosalie and Jasper were pretending to be his younger half-siblings, while Emmett was a family friend that had been dating Rose since high school.

"What are they studying again?" Amanda asked.

"Rosalie is studying astronomy and Jasper sociology."

"Rose's boyfriend Emmett is still undeclared," I added. It was the usual for him. He like the atmosphere of college but didn't feel the need for degrees. In his mind, he knew what he knew and he didn't need a piece of paper to prove it. He only completed one degree in zoology ten years ago and that was only because Carlisle bet him on it.

"Ah, so you couldn't convince them to follow in your footsteps. So much for big brother being an influence," Josh teased.

Carlisle shrugged. "It's not for everyone." Never mind the fact that Rosalie did actually have a medical degree of her own. "Besides, it's not always that glamorous. Certainly not when you're getting puked on."

That earned murmured of agreement from Josh and Amanda and for a moment I was on the outside. "Just how often does that happen?" I asked.

"More times than you want to think about," Amanda said. She checked her watch and sighed. "I've got to get back to the grind. Thanks again for the coffee, Esme."

"Any time," I said.

Just as Amanda was leaving, Dr. Snow appeared in the doorway. He was middle aged and as Emmett would say, looked like he had a stick permanently up his ass. He didn't acknowledge Carlisle and merely gestured at Josh to follow him. Once Dr. Snow's back was turned, Josh rolled his eyes.

"Good luck," Carlisle told him.

"Uh-huh," Josh muttered.

"Is Dr. Snow still mad at you?" I asked when we were alone. It had been a few weeks ago that Carlisle came home from work irritated and it took a quick hunting trip to get the story out of him. Apparently, Dr. Snow had misdiagnosed someone and didn't like Carlisle telling him that he had it wrong. It got to the point where Dr. Gerandy, head of the ER department, had to intervene.

Carlisle nodded. "If he wasn't so quick to dismiss a patient's pain, we wouldn't have this problem. But he's been here for years and I'm new so what do I know?" He rolled his eyes. Doctors letting their egos get in the way of treating patients was something he had no patience for.

I rubbed his arm. "Well, let him be mad. You did what's right for the patient."

He put his hand on mine. "I know."

There was the sound of footsteps and a new voice came from the doorway. "Dr. Cullen?" It was the new nurse that joined the ER staff a couple of months ago. I'd seen her on previous visits but had never talked to her. She kept to herself and I didn't blame her. It was hard to establish yourself in new small-town places. The only reason why Carlisle became friendly with Josh and Amanda was because they started hanging around him since he was the youngest doctor and close to their age. Physical age, at least.

"Yes?"

"Your patient in bed two hasn't responded to the nebulizer treatment."

Carlisle frowned. "Thanks, Sarah. I'll be there in a moment."

I could tell that he was already thinking about the problem when he turned back to me. "Go on. I'll see you later," I told him, kissing his cheek. "I love you."

"I love you too," he said and followed Sarah back out to the ER.

I didn't stay in town after leaving hospital, since there was nothing pressing that I needed to do to keep up the human charade. As I was pulling into the garage, I got a text from Rose.

My physics professor is a fucking asshole.

I frowned. That was quite a reaction. The semester barely started. What happened?

The reply bubble on my phone stayed there for several minutes. I could imagine Rose typing a whole rant and then deleting it for a more succinct reply. He took one look at me and said, 'you sure you're in the right class?'

Wow. Definite asshole. Unfortunately, Rose had to deal with those kinds of comments from men a lot. They took one look at her and assumed her beauty meant that she was unintelligent and unable to handle "manly" subjects.

How is it 2011 and men are still sexist idiots?

I sighed. I don't have an answer for that. I'd seen a lot of change in my lifetime, but unfortunately, a lot of men were still cut from the same cloth as Ch –

I cut that thought off.

Rose texted, I will ace this class out of pure spite. Make him regret ever saying that.

I expected nothing less. Spite always seemed to fuel Rosalie. It was why she even got a degree in astrophysics the first time. She wanted to show Edward up when he attended medical school again. I texted back, I have no doubt you will. Then I headed inside.

It would still be a few hours until Carlisle got home and I was left with the same dilemma that drove me to the hospital in the first place. I decided to make a cup of tea and head up to my art studio. It had been a while since I had a proper painting session.

Once I settled into my chair and got out my mixed media sketchbook, I absentmindedly chose gouache colors. I didn't have anything specific in mind when I started painting. I just let my paintbrush flow and it wasn't long before I was absorbed.

When I finally really looked at what I was painting, a chill went down my spine.

It was me on that cliff.

I tossed aside my paintbrush and sat back in my chair. That had never come up in my art before. "Get ahold of yourself," I whispered and ripped the page out of my sketchbook.

I got a new palette and picked out different gouache colors to start over. I kept the color scheme brighter and decided on a general nature scene, hoping that would let me stay away from accidentally painting any other dark memories.

I managed to get completely absorbed in painting the landscape that I didn't notice Carlisle had come home until he was wrapping his arms around my shoulders from behind.

My reaction was instant – I stiffened and broke out of his hold. I upended my chair as I whirled around, growling and falling into a crouch.

Carlisle stared at me in alarm and raised his hands. "Easy, love. It's just me."

What's wrong with you? I straightened. "I'm sorry." I couldn't meet his eyes as I set the chair back up. "I don't know why I did that." It hadn't happened in a very, very long time. Not since my early years as a vampire.

"You were concentrating hard. I startled you," Carlisle said. He took a slow step forward, as if to not repeat the same mistake.

I stepped into his embrace and breathed in his scent. Shame bloomed inside me – it really should have been obvious it was him. "How was the rest of your day?" I asked, remembering the patient he left to see.

Carlisle didn't answer and I leaned back to see why. His eyes were on the ripped-out sketchbook page and I inwardly cursed. That was something I didn't want him to see. I crumpled it and threw it in the trash can.

"Esme," Carlisle said in a low voice. "Do you need to talk about anything?"

"No." It was too quick and too sharp. I knew I wasn't fooling him.

He hesitated, then said, "I noticed you've seemed…preoccupied lately.

"It's nothing."

Carlisle sighed. "That wasn't nothing, Esme."

"Just leave it alone, Carlisle," I snapped and when a flicker of hurt passed over his face, I added much softer, "Please."

He watched me for a long minute, and it looked like he was fighting with himself on whether to press the matter. "Okay," he finally said and left for his office.

I had gotten what I wanted but it didn't make me feel any better. There had only been concern in his eyes and that made it worse. I didn't want to admit to him that everything that happened with my ex-husband was haunting me. I didn't want to admit to him that his love and devotion didn't make Charles irrelevant.

I sighed and started cleaning up my workspace. But washing paintbrushes and putting everything away only ate up so much time and I still wasn't sure what to say to Carlisle.

When I stepped through the door that connected my studio to his office, I found him looking over the orchids he kept by the windows. Gardening was one of the many things he picked up in his long life. He said it helped with the loneliness before he finally turned Edward. I wrapped an arm around his waist, and he kissed my hair. "I'm sorry," I whispered.

"I'm not mad," he assured me. "I'm just worried."

"I know." I stared at the orchids, still trying to gather my courage and tell him what was going on in my head.

Carlisle pushed a lock of hair behind my ear. "You're a thousand miles away." His fingers trailed down to my chin, gently lifting it so I'd meet his eyes. "Please talk to me, love."

My throat tightened and my eyes stung with unshed venom tears. "Something's wrong with me. I can't stop thinking about Ch –" I choked on his name. I hated to say it out loud. "Him."

"Esme." Carlisle pressed his forehead against mine. "It's okay."

"I just –" My voice broke and I wiped a tear away. "I don't know why this is happening. I don't know why I keep remembering the things he did to me. It happened so long ago and I hate that it's still affecting me." I kept thinking back over the last few weeks, searching for the trigger, but I couldn't find it.

"You know, the brain can get hurt like any other organ – "

"Then shouldn't venom have fixed it?" I interrupted, a frustrated edge to my voice.

Carlisle shrugged helplessly. "I wish it did."

"I know." I knew that he would give anything to stop people from suffering.

"Trauma affects the brain in so many ways and I guess it's beyond what venom can do," Carlisle continued. He brought me close and kissed me. "You don't need to be ashamed of struggling. What you went through…it's not easy to get over."

I buried my face in Carlisle's neck. Logically, I knew that I didn't need to be ashamed, but that didn't stop me from feeling it.

"Maybe…you should talk to someone about it," Carlisle suggested.

That made my head shoot up and I raised an eyebrow skeptically. "That would be…tricky, to say the least." It's not like I hadn't thought about it before. But the fact that the abuse happened almost a hundred years ago made it difficult to imagine being honest enough for therapy to actually work.

"You'd only have to talk about the most essential details. But it's your decision. I only suggested it because I want to help."

"I'll…think about it."

Carlisle hugged me close again. "That's all I ask."

The next day I called Rosalie when I knew she had a break between classes. Of all the members of my family, I knew she would understand the most.

She picked up after one ring. "Don't tell me you miss me already."

I laughed. "All right, then, I don't miss you."

"Liar," Rosalie said and I could hear the smile in her voice. "What's up?"

"I've been feeling pretty…off lately," I said and explained what's been going on. "Carlisle suggested I seek…help and I'm not sure if I should. I wanted to know what you think."

I heard the sound of a door opening and closing on her end. "Well," she said after a moment. "Seeking help would be a lot healthier than what I've done in the past." There were times when Rose's assault haunted her and she holed up in the garage, furiously working on the cars and not speaking to anyone for days.

"True, I guess."

"If you're worried about a cover story, it would be easy enough to say your ex was deployed to Afghanistan."

Oh. I hadn't thought of that. Usually, I never came up with a cover story that included my previous marriage. I guess I was overthinking this.

"Esme, do you need me to come back?" Rose asked when I hadn't said anything for a while. "I don't really need this degree anyway. I could drop out and stay with you, if that's what you need."

For a moment, I was sorely tempted to take the offer. But something in me balked at accepting. "No, Rose. I'll be fine."

The silence on the other end meant Rose didn't quite believe me. "I'll come back this weekend at least and help you scope out a therapist. Or a support group."

I smiled, grateful for her offer and the fact she wouldn't let me do this alone. "Okay. Thank you, Rose."

AN: Thank you for reading, I'd love to know what you think

A few things to know:
- Canon events in the books don't happen at all

- Bella and Charlie aren't related and Bella is already a vampire

- Carlisle is aged up to being physically 30

- Some vampire physiology is different, such as they don't sparkle

- The Quileutes are not wolves in this story

- Alice doesn't exist