Author's note. Sorry for the super delay in updating. Things were extremely busy for me at work the first few weeks of October, but the rest of the time was me trying to figure out how to handle Sam's therapy. This is part one, there will be second part that deals with the start of Sam's physical therapy and continues the two other plot threads introduced. I hope you enjoy.

Sam was sitting up in her hospital bed, Spencer diligently drawing a sort of mini-mural on the cast that covered her left forearm. It was three days since her recent back surgery and she was in something of a good mood. Dr. Reyes had said the procedure went as well as it possibly could and that all they could do was wait and see how much mobility Sam gained in her lower body. In the three days since, Sam had recovered enough mobility that there was little doubt she would be able to walk again; it was now just a matter of when. Sam still did not have fine motor control over her legs, which would be developed with many hours of painstaking rehab, which was supposed to begin the next morning.

Derek was sitting on the other side of Sam's bed studying for the SAT's he was taking in a few short weeks. Sam's state or no, academic life had to go on and he and Freddie were scheduled to take the exam at the same time. He studied silently, not wanting to distract Spencer's work. Carly had quietly slipped out when Spencer arrived and Freddie had gone off looking for her.

When Carly broke her arm earlier that year Spencer decorated her cast with unicorns and various motifs Carly enjoyed. It managed to cheer her up and make the cast seem less of a reminder of her near-death experience in Montana. Now that Sam was finished having her arm operated on, it seemed a good time for Spencer to do the same thing for her.

He was just putting the finishing touches on a small mural of Girly Cow eating various pork products when Dr. Hendricks arrived for their first session. Spencer quickly packed up his art supplies, said his goodbyes to everyone, and made his way out of the room. Derek left his study materials on the table and kissed Sam on the lips before saying goodbye. He managed to tell her that he was proud of her under his breath and his sentiment brought a smile to her face.

While Sam was beginning her session with Dr. Hendricks, Spencer was hurrying through the halls of the hospital. He had spent far more time in the hospital over the past 9 months than he cared to think about and he wanted to leave as quickly as possible. He truly did not mind coming to see Sam, but otherwise did not wish to spend any more time there than was necessary.

Spencer's mind was somewhere else as he sped through the hospital. He rounded a corner without looking or paying attention. Suddenly and without warning he found himself lying flat on his backside amid a pile of art supplies. It took Spencer a moment to get his bearings; he noticed that he had run into a woman. For a second Spencer thought that maybe he needed to start working out if he could be knocked flat like that by a woman, but then he noticed she was an attractive woman, and those thoughts were quickly put aside.

"I'm sorry miss, I should have been paying attention to where I was going." The woman appeared to be in her mid to late 20's and had strawberry blond hair. Spencer couldn't quite discern her figure since she was wearing a pair of overalls (Spencer imagined it was quite nice) but her face was gorgeous.

"No, it's my fault, I'm running late and wasn't looking where I was going. Are you ok?" The young woman got to her knees and began gathering up art supplies. Fortunately none of the paint containers had opened up.

Spencer managed to get to his knees to help gather up his supplies. "Yeah, I'm fine. You?"

"I'm ok. Thanks."

For a moment the two of worked to gather up the markers, brushes, paints and other assorted supplies. Eventually they both reached the same conclusions and actually spoke the exact same words at the exact same time. "Some of these supplies aren't mine."

Spencer spoke first, "Are you an artist?"

The attractive woman replied, "Yes, I'm painting a mural in the pediatrics wing. You?"

"Uh, I'm visiting a friend."

"Oh, and you bring art supplies everywhere?"

"Uh…no, I was painting her cast. I am an artist, sculptor mainly. By the way, my name is Spencer Shay". Spencer held out his hand.

The young woman smiled and took his hand. "I'm Karen Sanders, nice to meet you."

All the sudden Spencer was no longer in such a hurry to leave the hospital. "I feel responsible for making you even later. Could you use some help with your mural?" Spencer gave his best smile.

It seemed to work. Karen returned his smile with one of her own, "No way will I turn down help from someone so handsome."

"You should be careful, you wouldn't want your boyfriend or husband to hear you talking like that."

"I'm single Spencer."

"I am so glad to hear that."

Freddie had been going over something with Derek when Spencer arrived. Carly had quietly said goodbye to him and he followed a few minutes later. He had assumed she was going to the cafeteria, but when we went there she was nowhere to be found. He had no good idea where she could be and started to check places in order of what he thought was most logical.

From the cafeteria he went to the gift shop. No Carly there. Then it was the maternity section, didn't all women like looking at the newborn babies? No Carly there either. He tried a couple other places with no success and even went to the in-hospital chapel even though Carly was not religious in the slightest. She was not there either. Growing frustrated, Freddie wondered if she had gone to the psychiatric ward for some reason. It was hard to see her doing that, but then Carly was prone to erratic and sometimes unfathomable behavior.

Freddie started walking towards the psych ward. He had to pass by the plastic surgery section of the hospital. As he was walking past the waiting room for the section he spied a familiar mane of dark brunette hair. Carly was sitting with her back to him; she appeared to be reading a pamphlet.

"Carly? What are you doing here?"

Carly was startled by Freddie's sudden presence. She quickly tried to put the pamphlet aside where Freddie couldn't see it. "Nothing, I'm just sitting here."

Freddie sat down next to Carly. "Come on Carls, you know there's nothing you can't tell me. What's the matter?"

Carly shrugged and reluctantly pulled the pamphlet from where she had stashed it and handed it to Freddie. "This."

Freddie looked at what Carly handed him. It was material on scar removal. "Carly, why wouldn't you want to show this to me?"

Carly looked embarrassed, "It's…well…I know you hate this scar. I was thinking of trying to have it removed, but I can't afford the procedure. Insurance won't cover it and I don't want to ask my father for the money."

Freddie was sitting to Carly's left. He rested his right arm on the back of Carly's neck and turned to face her. "Carly, I love you so much, I don't care about that scar."

Carly adjusted her position so she was facing Freddie, "It's ok, I know you'd prefer a girlfriend who didn't wear so many turtlenecks and scarves."

Freddie laughed softly, "Carly, I wouldn't care if you wore a Snuggie or burlap sack 24 hours a day. There is nobody else on this planet I would rather be with than you. Nobody."

"This is a pretty ugly scar Freddie."

"What about my scars?

"It's different for guys; your scars are kind of….sexy." Carly blushed, she remembered gushing to Sam about Griffen having scars a few years previous.

Freddie shook his head, "Some things never change I guess." Carly looked towards the ground, Freddie continued, "Carly, please look at me."

Carly obliged and Freddie drew her close to him and kissed her tenderly on the lips. She was surprised at first but quickly granted Freddie access to her mouth. After a minute they broke the kiss off and Freddie gave Carly a peck on the nose. "Carly, I will always love you no matter what. If you want to have that scar removed I'll do my best to help you. But do it only because you want to do it; don't do it for me."

Carly looked hopeful, "Are you sure?"

Freddie didn't say anything right away. He untied Carly's scarf and pulled the fabric from her neck. Her scar stood out in stark contrast from the rest of her fair skin. He leaned over and kissed his way along its length. "Carls, I am very sure."

Freddie stood up and held his hand out to Carly. "Come, let me buy you lunch and show you off." She smiled and gladly took Freddie's hand. He led her out of the waiting room while making sure to pocket the pamphlet Carly had given him.

"How are you feeling Sam?" Dr. Hendricks pulled a chair over next to Sam's bed, but not too close.

"Better, it looks I'll eventually be able to use my legs." Sam tried not to betray how uncomfortable she was feeling. She did her best to maintain a casual tone of voice.

"That's wonderful Sam. It must be a huge relief for you." Dr. Hendricks pulled out a notebook and started taking notes, "Do you mind if I take notes?"

The thought of Dr. Hendricks taking notes frightened Sam for some reason, but she did not want to hint that she might be scared. "Fine with me."

"Thanks Sam. Now, I know this is uncomfortable but we have to talk about it; your suicide attempt." Dr. Hendricks never took her eyes off of Sam.

"Do we really have to? I…I wasn't really trying to kill myself."

"Interesting Sam. What were you trying to do?"

Sam hesitated before answering and sighed loudly. "I guess I was trying to put myself in Melanie's place. I wanted to know how she felt just before she…."

"Before she killed herself Sam?"

"NO! Before she….died." Sam, to her credit, did not take her own gaze off of Dr. Hendricks.

"I see. You reacted strongly to my assuming Melanie killed herself. Why is that?"

"Because she didn't kill herself. The doctors said her death was accidental. She DID NOT kill herself." Sam let some of her frustration show.

"Do you believe that Sam?"

"Sure, if the doctors said that's what happened why shouldn't I believe them?"

"You're entitled to your own opinions Sam. Do you think it is possible Melanie might have intentionally killed herself?"

Sam didn't say anything for a few moments; she was clearly mulling something over in her mind. "No, Melanie could not have killed herself." Sam did not sound convincing, even to herself. Dr. Hendricks was certainly not fooled.

"Sam, why would it be so difficult for you to accept that Melanie may have committed suicide?"

Sam looked over Dr. Hendricks' head as a lone tear escaped her right eye. "If Melanie killed herself then what kind of sister, what kind of person, does that make me? I had finally been growing closer to her in the past year and a half; hell, I was her IDENTICAL twin. If she was truly suicidal, if I couldn't sense her pain, then what does that say about me? Maybe I deserved to be the one who died."

Dr. Hendricks felt like Sam was starting to make a bit of a breakthrough. "Sam, why would you think that? Yes, you were Melanie's sister and twin, but that does not make you omnipotent. Even trained professionals like myself have difficulty telling when a person may try and kill themselves. There is no way you could have known."

"I should have known. Like I told you the other day, I have had bouts of depression before and thoughts of killing myself. I should have known Melanie might have them too."

"And because you could not foresee Melanie dying, you think you deserve to die?"

Sam started to cry a little heavier. "Maybe."

Dr. Hendricks shook her head, "No Sam, you do not deserve to die. You may think you do, but I don't think it's ultimately because of what happened to your sister. I think you've felt that way for a long time."

"Why would I feel like I deserve to die if not because of Melanie?"

"Sam, I hope you don't mind, but I've talked to your boyfriend and a couple of your friends; Carly and Freddie. They all told me that deep down you are a loyal and caring friend, but usually mask those traits with aggressive behavior and bullying."

Sam was shocked. "How dare they…"

"Please don't be mad with them Sam. I sought them out and told them it was important for your well-being if I knew more about you before we started our sessions. I told them nothing about what we might talk about."

Sam was only slightly mollified, "I'm still pissed."

"Sam, can I ask you about the hyper-aggressive behavior?"

"It sounds really bad when you put it like that doctor. All I did was mess around with Gibby and Freddie."

Dr. Hendricks raised an eyebrow. "I think maybe it was a little worse than that. Didn't you break Gibby's thumb and push another boy out of a tree?"

Sam was not proud of some of the things, ok many of the things, she had done in the past. Those acts were among them. "Ok, I give up. I was a mean bully and a rotten person, but I'm not proud of it and I've been trying to stop."

"That's good Sam, but do you know why you bullied people?"

"I don't know, I guess it felt good at the time." Sam rarely thought about why she did the things she did, she was not used to that sort of introspection.

"Is it possible you were a bully as a type of defense mechanism?"

"I don't get how."

"Well Sam, didn't you break Gibby's thumb after he asked you to a dance?"

"Yeah, so, I didn't want to go to the dance with him. He was such a nub then."

"When you were at your worst as a bully, how many people would you say you were truly close with? How many people could you confide in or just be yourself?"

Sam thought about that for a second, but knew the answer immediately. "Just one I suppose, Carly. Maybe her brother a little bit, but not really."

"Ok Sam, why do you think that is? Why didn't you let Freddie or Gibby or anyone else get close to you?"

"Who knows, I just didn't want to be friends with nerds like those two then. It's not because I was afraid of getting hurt."

Dr. Hendricks smiled, she had mentioned nothing about Sam worrying about getting hurt. Sam made that connection with no help from her. Dr. Hendricks did not say anything, instead she waited for Sam to realize what she had said and its importance.

It took Sam a little bit of time, but she finally realized what she had said, "So you think I beat people up and bullied them because I was afraid of getting hurt by them first?"

Dr. Hendricks shook her head again slowly, "No Sam, it's not what I think, it's what YOU think. You're the one who made that connection and you would not have done so if you did not think it was at least a little bit true."

"It doesn't make any sense."

"Yes, in a way it does make sense. You have such a low opinion of yourself you just assumed any person who tried to get close would wind up trying to hurt you. You took to bullying them first as a defense mechanism; if they couldn't get close they couldn't hurt your feelings. The only person you let inside completely was Carly."

"So I beat people up and think I deserve to die because I have low self-esteem?"

Dr. Hendricks could not help but smile. "That is exactly what I am saying."

"Then why have I stopped bullying and acting so aggressively so much lately?"

"There are a few reasons for that. One, you are getting older and channeling your negative feelings about yourself in different ways, most likely in ways that are more internal in nature. Two, you have had romantic relationships in the past year. People in relationships tend to feel better about themselves in general."

Sam pondered Dr. Hendricks' words; they seemed to make sense to her. "So as long as I'm still seeing Derek I'll get better."

"No Sam, it's not quite that easy. Your lack of self-esteem is still a problem, especially when combined with what I feel is clinical depression. You did try and kill yourself and that needs to be dealt with."

Sam looked glumly at the ground. "I'm pretty messed up aren't I?"

"No Sam, I wouldn't put it that way. We're just at the beginning of a long process that will involve more therapy sessions and probably some medication as well, ok? Please don't be so down on yourself; it's only your first session and you have already come to one important realization."

"What's that?"

"You figured out that you will not get better until you learn to do one important thing: learn to love yourself."

Author's note. I hope the beginning there was worth some of the wait. I was sort of blocked in writing the part with Sam's therapy. I was also dreading that section as well. Sometimes things are scary to write and that was one of them. I hope you understand. Thank you to everyone has been reading this story and the updates should be coming a little quicker now.