S6 EP7

"HOSPITALS ACROSS THE country have reported substantial savings..."

Norah sighed at the nurses' station while she listened to the chief talking about how to help regulate the hospital's budget... again. It has been a daily routine for all hospital staff to gather while Webber gave what seemed to be a roll-call every morning.

"How bad is it today?" Derek asked as he stood next to Norah and Bailey, his arms folded above his chest.

"The chief's implementing a computer model for scheduling our surgeries from now on," Bailey replied.

"Efficiency and progress, he says," Norah added with a forceful smile before sipping on her coffee.

"...And to make sure this was the right decision, I have enlisted one of our own to do a trial run for the last month," Webber declared before turning to the plastic surgeon next to him, "Dr Sloan?"

Mark leaned against the empty OR board with a clipboard in his arms. "I know what you're all thinking," he prefaced, "'It's a machine. It doesn't know me. It doesn't know what I like.' But after using this new system for the past month, I gotta say, people-I'm a convert."

Norah clamped her mouth shut, trying her very best to fight the urge to snort at her boyfriend's speech. Mark caught her eyes in the crowd and quirked a brow at her; she returned him with an encouraging yet grim smile.

"This computer knows me better than I know me," he nodded firmly with one of his charming smiles to reassure the staff.

Derek walked up from the crowd of surgeons towards Webber, ignoring the plastic surgeon who stood at the side. "Chief, this thing's rearranged my schedule for the entire week," he complained before turning to the crowd, "I mean, haven't we had enough change here already?"

"Change is good, everyone," Webber claimed before focusing back to the neurosurgeon, "Embrace it."

As the crowd slowly scattered off, Mark walked up to Norah, who was still sipping on her coffee. She passed it to him, and he took big gulps, nearly finishing it when he returned the cup. She glared at him with an 'are-you-serious' look across her face.

"How did I do?"

She raised a brow at the hopeful look on his face, a break of laughter finally escaping her mouth. He stared at her blankly while his confidence drained by the second.

"Mark, I love you, but... I mean, 'I'm a convert'? 'This computer knows me better than I know me'?" she mocked with a grin while his face faltered, "Not convincing at all, Dr Sloan."

Derek was snorting next to them as he patted his best friend on the back. "Poor you," he faked a sympathetic look before turning to the resident, "That was very, very blunt."

"Nah. That was very, very honest," Norah corrected with a smirk.

"You had reduced his ego into ashes, Norah," Derek chuckled, "Great job."

"Don't mention it."

Mark snapped his head between the two of them. "I hate this Neuro duo," he huffed before finishing the coffee from Norah's hand. The latter made a sound of protest, in which he shut her up with a kiss before turning and walking away.

"I, on the other hand, love this Neuro duo."

"Mm-hmm. Me, too."

❦ ❦ ❦

NORAH WALKED INTO THE CT room along with Callie, both wide-eyed and shocked. "Isaac has a cord tumor?" Callie questioned.

"Oh, it's awesome. Look," Cristina stated as she held the scans in front of her. Callie and Norah walked to her; the latter held the scan up to the light while observing the image.

"Awesome in a bad way," Callie noted.

"It's eaten five levels of his spine..." Norah furrowed her brows, "Awesome in a brilliant way."

"What-" Callie shook her head at the resident, who was still admiring the scans. "Wait, you're not seriously considering trying to take it out?" she asked Derek.

"Of course he is!" Cristina proclaimed as he clapped the neurosurgeon on the shoulder, "He's Shepherd."

Arizona walked into the room next with her eyebrows furrowed in concern. "It's a bad case of telephone, right? Isaac's got a bone spur or a herniated disk, not a..." the Pediatrics attending trailed off when Norah passed the scans over to her. "He diagnosed an osteosarcoma case for me a month ago. I thought it was a shadow, but it turned out to be the tiniest little lesion on an X-ray."

"That says more about you than it does him," Mark pointed out.

"I'm sorry-do you even know who Isaac is?" Arizona smiled at him weakly.

"He doesn't," Norah replied instead before walking over to her boyfriend. She snatched over his coffee and took big mouthfuls of it, returning it to him with only less than one-eighth of it left. "Payback feels good," she smirked.

"Hm, I have other ways to taste my coffee," Mark mumbled back before lowering his head to catch her lips, tasting the caffeine from her tongue.

"Oi-no PDA in the CT room, thank you very much," Cristina cleared her throat loudly at the pair while Derek pried them away from each other.

Lexie peeked her head in when she saw the many surgeons clustered in the room. "Hey, what's everyone-oh, a spinal tumor?"

She took a look at the scans with her eyes narrowed, recalling a similar case she came across. "I read about a case at Mayo where the surgery took seventeen hours," she shared, "The head surgeon had four rotating assistants, one of whom just administered fluids."

"Okay, you know what? Don't try and Lexipedia your way on this," Cristina snarled at the younger resident, "This is my tumor."

"Uh, no, that's not your spine," Norah stated with a tone of sarcasm before turning to the intern. "Lexie, what happened to the patient at Mayo?"

"He died," Lexie informed grimly, "That's why it only took seventeen hours."

Owen passed by the room and reversed his steps when he saw the gathering. "Hey, I just heard Isaac has an inoperable tumor?"

"It's Isaac's tumor?" Lexie exclaimed, her eyes wide.

"Okay, yeah, yeah, boo-hoo, okay?" Cristina snapped at them, "Who says it's inoperable?"

"Cristina," Derek called as he pointed at the new scans that had just come up on the computer screen.

Everyone in the room leaned their heads towards the screen, and everyone was talking and commenting at once. Norah felt a rush of adrenaline getting up her head as she observed the scans in silence.

"Oh, come on. It's all the way up to T2."
"You need three or four assistants..."
"See, this is why I got into plastics."
"Oh, that's gotta be..."

"Seemingly inoperable tumor, Derek," Norah whispered. Derek turned his head to the knowing smirk on her face before letting out a long sigh.

❦ ❦ ❦

"MICROSURGERY IS ABOUT precision," the neurosurgeon told the group of residents; Norah perked up a bit at the word.

"The microscope changes your perspective radically. The hand-eye coordination required can be learned, but right now, I need naturals. Each one of you will get a chance to guide this pen through the hole in the cup. The person who makes a mark closest to the president's nose and doesn't hit the side of the cup gets to scrub in."

Derek walked over and demonstrated while everyone watched curiously. He lifted the dollar bill and showed the red mark he had made-exactly on the nose. "Who wants to go first?"

Everyone's arm shot in the air like hungry lions, aiming this rare surgery like it was their prey.

Many residents took their turn and had failed in their attempt. They either hit the side of the cup or was not even near the cup at all.

Cristina was yawning and stretching her arms at their attempts; Norah watched in amusement as many of them grumbled in frustration, some cursing at the machine and others had already left the skills lab.

"Here we go," Derek handed a dollar bill to Jackson, who stood in front of the microscope and had his concentration on the view through the lenses. He carefully guided the pen, and with a 'clank' sound, he hit the tray underneath; Derek finally grinned.

"Nicely done," he nodded, impressed, at Jackson's attempt, which was very close to the nose. "If somebody improves on that, I'll be out of a job."

"Well, I guess you might need to retire, then," Cristina spoke as she got up from her seat. Derek chuckled at her confidence.

"Don't be a bitch, Cristina!" Norah cooed from behind, and the residents in the room snorted.

"Hey, you-shhh!" Cristina was focused, without a doubt. Yet when the tip of her pen hit the top of the cup, Norah couldn't help but cough away her laugh.

"Dr Lawrence, let's see Dr Sloan's word about your precision."

Norah got up and gently moved the frozen Cristina away from the machine; the latter was still staring in disbelief.

Derek handed her the dollar bill, which she placed on the tray without hesitating. She adjusted the microscope to her eye level and covered the cup over the money. Picking up the red pen and holding it between her thumb and index finger, she carefully lowered the pen without a rush...

Hearing the 'clank' from the tray again, a smirk formed on her face.

"Time to look for a new job, Dr Shepherd."

She picked up the dollar bill and showed it to the neurosurgeon, who nodded proudly-it was less than one millimetre away from the centre of the president's nose.

"Precise," Derek commented.

"Dr Sloan's exact words," she grinned, and he shook his head with a smile. "I'm keeping this for snacks," she waved the dollar bill in her hand, "Or for a lucky charm."

"Alright, Dr Lawrence and Dr Avery, you'll both be scrubbing in," Derek announced.

Norah stepped down and patted the jaw-hanging Cristina on the back. "Karma's a bitch," she smiled and received a glare from her friend.

"You jinxed me!"

"Whatever helps you sleep at night, sweetie."

❦ ❦ ❦

1 HOUR 13 MINUTES

"THE DURA'S OPENED," Derek informed, "Let's get our first look at the tumor."

"Wow. That's, um... Wow." Jackson stared at the tumor impressively. Norah, too, had her eyes widened next to him as she stared through the microscope. Being the closest to hitting the president's nose, Norah had the first shift in assisting Derek on the spinal tumor.

"The vessels are more intricate than the MRI showed," Derek muttered under his breath, "There's no way I can get the tumor out without rupturing one and killing the cord."

"So, uh, what do we do?" Jackson asked, squinting at the sight in the surgical field.

"I think if we start at T2, I could avoid hitting the feeding vessels, so maybe I should go lower?"

Jackson glanced at the neurosurgeon, a puzzled expression on his face. Norah smirked knowingly under her mask as she cleared the lower spines for Derek to observe and continue mumbling to himself.

"Okay, there's less vascularity around T7, so that does seem better, no?"

"It does seem better," Jackson responded, "And he'd only get function loss below the chest."

"But I risk rupturing the anterior spinal artery there."

"Probably," Lexie spoke up this time, "The tumor tapers off there."

"Higher is better, maybe? Either way, I risk sending him into hemodynamic collapse."

Jackson furrowed his brows confusingly before turning his head to Norah. "He's not talking to us, is he?" he queried in a lowered voice. The brunette shook her head with a tight smile while the other two residents shared a look.

"T2 shows less potential for bleeding, at T3, the vessels... increased."

❦

8 HOURS

"IF I CLIP THE DRAINING veins without getting the feeders, they'll burst..."

Lexie peered at the surgical clock that showed that eight hours had passed with no movement from the neurosurgeon. "Dr Shepherd, I really think it's time for you to take a break," she spoke up, "It's been over eight hours."

"I could go under the tumor here, but I might cut the radicular artery."

"Dr Shepherd," Lexie called again.

"Dude, if you need a break, just take a break," Jackson interjected sharply.

"Please. I don't need one," Lexie scoffed back. "I'm hardcore."

Jackson narrowed his eyes at her. "Are... are you wearing a diaper?" he asked, and Lexie told him to shut up; Norah gave both of them a warning glare, in which they brushed her off.

"At least bend your legs," Lexie told the attending.

"Hey, shush it!" Norah whisper-yelled at the two.

"You can't bring yourself to use it, can you?" Jackson taunted.

"Shut up! Shut the hell up!" Derek finally snapped, and Norah sighed. "Grey, I don't need a break. If you do, take one," he ordered, "Either of you open your mouths again, you're out of the OR."

Lexie quickly turned around and headed for the door. "Bathroom break!" she squealed at Bailey, who was entering the OR.

Bailey frowned, "Um, Dr Shepherd."

"What?!" Derek snapped and took his eyes off the microscope, doing a double-take after he realised it was Bailey who had addressed him.

Bailey had an unamused scowl on her face. "Okay, I'm sure this is a completely authorized surgery, but I thought you might like to know that the chief is scheduled to do a surgery across the hall in OR 3 shortly," she informed, "So if you're planning on doing something, anything, you might want to do it soon."

"Thank you, Dr Bailey."

Soon, apparently, did not come.

❦

10 HOURS 21 MINUTES

THE CHIEF BARGED INTO the OR, covering a mask over his face. He had an unpleasant look through his eyes, which everyone in the OR noticed. "Dr Shepherd, am I to understand that you cancelled your surgeries today to operate on a spinal cord tumor?" he demanded, but Derek had no interest in hearing. "Dr Shepherd!"

Lexie sent an alarming look to both the third-year residents, who were both still concentrated on the patient's spine. Webber stormed over next to Derek when the attending did not answer him.

"The rate of infection for this patient is increasing every second you keep him open. Not to mention the thousands of dollars you are wasting, standing here doing nothing," he informed, "So I am demanding that you close this man up. Close him up and relinquish the OR."

Norah lifted an uncomfortable gaze towards the chief, then turned to Derek. She furrowed her brows at the concentrated look on the neurosurgeon's face, the glimmer behind his eyes-there was a hint of something she could faintly see from them.

"Right now, Derek."

Derek took another long look through the lenses while the residents stared at each other.

"Okay," the attending declared, "That's it. Let's close him up."

❦ ❦ ❦

MARK SAT ON THE KITCHEN stool, watching Norah pace around the kitchen as she blurted out their surgery's progress-which did not quite exist a 'progress'.

"So, Derek stood in the OR for ten hours, and he did not do anything?" he questioned while taking a slice of pizza from the box. "Nothing at all?"

"Except mumbling to himself? Nope," Norah shook her head, "But I'm almost certain that he's gonna try again tomorrow."

He raised a brow at her. "What makes you so sure?"

"He had a hint of... something in his eyes, I saw it," she shrugged and finally sat down next to him. "Besides, when have you heard him backing away from a challenge?"

"When we were in college," he replied with a snort at the memory, "He backed away from a dare to speak to Addison across our campus."

Norah did a double-take at his words. "Wait, wait, wait... You're telling me that Derek Shepherd..."

"Yup."

"That's..."

"I know, right?"

They shared a laugh while they continued eating their pizzas. "You know what I miss about my apartment?" Norah asked through a mouthful, and Mark cocked a brow at her. "Tim's cooking."

"Mmm-definitely-me too," he nodded in agreement.

"If he saw us eating take-outs for... the fourth time this week? He'd freak out-and it's only Thursday!"

❦ ❦ ❦

NORAH, JACKSON, LEXIE, Derek and Webber sat around in a conference room while the chief and neurosurgeon went into a discussion. "This patient understands what cutting the cord means?" the chief questioned, "The loss of function in both legs and possibly more?"

"We have to cut the cord to kill the tumor," Derek noted, "There's no other way."

Webber sighed. "Okay. That'll only take an hour or two," he stated, "You can have OR 1. Hunt needs it right after so you'll have enough time."

As Webber stood up from his seat, Derek watched over his shoulder until the chief had left the room before turning to the three residents. He leaned forward on his chair, looking at them with a slight excitement behind his eyes.

"We're not cutting the cord, are we?" Norah made a wild guess, and Derek smiled back at her; her face gleamed up instantly.

"Wait-we're not?" Jackson perked up curiously but excitedly.

Derek shook his head. "The mistake I made yesterday was that I wanted a plan. There can be no plan," he explained, "I just have to pick a point and cut."

"But what you said yesterday," Lexie interjected with a worried look, "If you cut an artery or hit the cord..."

"Isaac wants us to take the risk," Derek informed. "He wants a cure. And it's our job to try."

Lexie looked horrified while both Norah and Jackson had broad grins on their faces.

"Seemingly inoperable tumor, right?" Derek added, and Norah snorted. "See you all in the OR."

❦ ❦ ❦

- 2ND ATTEMPT -

7 HOURS 48 MINUTES

MARK HAD BEEN BROUGHT in by Lexie as a 'prescription' for Derek. The plastic surgeon sat and watched the MEP monitor with a crossword puzzle in his hand. Norah had thrown him questioning looks, which he shrugged in response before going back to fill in the words.

"I've cleared a path at T5," Derek muttered, "And if I continue along this plane, I..."

The monitor started beeping erratically, causing everyone in the room to grow nervous; Norah quickly suctioned the blood pooling in the surgical field.

"MEP tracing's losing amplitude," Mark notified, "What just happened?"

"A vessel burst," Derek informed with a slight panic to his tone, "It might have been connected to the cord."

Lexie widened her eyes. "But if there's not enough blood reaching the cord-"

"I could've just paralysed our patient," Derek snapped at her, "Yes, suction, please. Suction."

Norah and Jackson quickly suctioned the blood at the spine, but it was just flowing too rapidly. "There's too much blood," Jackson noted.

"We're losing him."

"I should've just cut the cord," Derek stressed, "This is too risky."

Just then, the erratic beeping sound soothed back to normal. "Wait. It's back. Amplitude's up," Mark announced, and everyone exhaled in relief.

"So, the cord didn't stroke out?" Lexie gasped as they finally controlled the bleeding, "You didn't paralyse him?"

"The vessel was connected to the tumor," Norah responded, feeling the adrenaline shooting up her head when Derek nodded at her response. "Brilliant."

"We're okay."

❦

- 2ND ATTEMPT -

13 HOURS 9 MINUTES

CALLIE ENTERED THE OR a while ago after Webber nearly shut off the surgery again. Norah peered at the clock that displayed that they had been standing for more than thirteen hours, and oddly enough, she was feeling hungry above all things.

"I can't tell which one of these vessels feeds the cord and which one feeds the tumor," Derek muttered and exhaled heavily, "I have to do a blind cut."

"Like a tripwire?" Callie questioned.

"If I cut the wrong one, the entire cord strokes out," Derek confirmed, taking a deep breath in while he glanced over to the residents. "Okay, we'll come back to this later," he decided.

"Later?" Callie narrowed her eyes at the neurosurgeon, "So, you could finish the entire surgery only to cut the wrong one? This will all have been for nothing?"

"Exactly," Derek deadpanned, "Thanks for pointing that out."

Well, this is gonna be fun, Norah thought to herself, feeling her tummy grumbling. Oh, god.

❦

- 2ND ATTEMPT -

21 HOURS

NORAH HAD SWALLOWED down a few granola bars in the scrub room... which felt like hours ago.

Derek had only stepped away from his microscope when Lexie barked him down to it and only took a few sips of water before returning to his work-Norah was near to worship him as a literal god.

"How many inches left?" Arizona queried.

"Uh, less than two," Derek replied, "So if I do my math, we got, uh... four or five more hours ahead."

"Crap-Oh, crap. Oh, crap," Jackson grunted, and both residents snapped their heads to him alarmingly.

"What is it?"

"It's my hand. It's cramping. Damn it," Jackson clenched his jaws as his hand shivered.

The monitor started to beep rapidly, and everyone was feeling anxious. "BP's dropping!" Arizona informed.

"Okay, we're touching the cord. If we disturb it anymore, we run..."

"Pulse is down to 52."

"It's getting worse, guys," Jackson spoke up.

Norah stared at his hand that was trembling alarmingly. "Avery, easy, okay? Stay still. Don't move, or I'll rip your guts out," she warned while carefully reaching over to his cramping hand. "Just breathe, aye? Just a spasm."

She slowly applied pressure on his inner palm, and he let out a deep exhale when he felt it becoming less tense. Mark narrowed his eyes at her-more like sending a glare at Jackson-while the pen ink on his crossword blotched through the paper.

"BP's back up, 100 over 68," Arizona informed, and everyone exhaled in relief.

Derek lifted his eyes from the microscope to the resident in front of him. "Have you had anything to drink today, Dr Avery?"

"What?"

"Muscle cramps are a sign of dehydration," he stated, "You went without fluids, so Dr Lawrence couldn't get her hands on the retractor today, isn't that right?"

"I, uh..." he looked at the resident next to him, who shrugged. "Sorry... sorry."

"Don't apologise. Just step aside," Derek snapped at him, "Dr Lawrence, take over."

"Oof, busted," Norah smirked under her mask, and Derek cocked his head aside, his eyes narrowed at her. "Sorry. Sleep-deprived. No filter."

She carefully switched place with Jackson, taking over the assist. She held the retractor still at its position; he adjusted the microscope to her eye level while glancing over Derek's shoulder.

Arizona rounded to the plastic surgeon and whispered, "Mark, stop glaring at Avery. You're scaring the kid."

❦

- 2ND ATTEMPT -

26 HOURS

NORAH STARTED TO wonder how long she had stood in front of the microscope, holding the retractor without a twitch. Her eyes felt strained, and her throat was dry, but she never moved-she dare not move.

Jackson and Lexie were peering in curiously-and carefully-as Derek slowly removed the remaining tumor.

"A or B?" Derek wondered out loud, "You've been holding the retractor very steady now... Dr Lawrence?"

Norah lifted her eyes from the microscope to the attending. "My luck sucks in this fine game of Russian roulette," she stated. She knew that her lack of sleep was getting to her when she started blurting out jokes in not-right timings.

"Wonderful," Derek sighed before turning to another resident, "Dr Grey, A or B?"

"You're done?" Lexie asked, "You got it all out?"

"Except for the blind cut. I just have to pick one, and we're good to go," Derek informed, "A or B?"

"You're kidding," Lexie scoffed lightly.

"You're stalling," Derek snapped back. "Dr Avery?"

Jackson looked up from the spine to the attending. "I don't like to gamble," he stated.

"Dr Sloan?"

"What, so you can blame it on me for the rest of your life?" Mark sneered, "This is all you."

"Right. My call. Great," Derek sighed.

The OR was silent for a few more minutes as Derek pondered between the two vessels before his eyes. The tension grew high when all eyes were on him-in the OR and up in the gallery-Norah just felt the need to ease up the anxiety.

"Well, there's always 'eeny, meeny, miney, moe,'" she suggested.

Everyone in the OR turned their heads towards her with narrowed eyes; Mark looked visibly amused with her idea.

Derek furrowed his brows at the resident before lowering his head back to the spine. "Eeny, meeny, miny, moe. Catch a tiger by its toe. If he hollers..."

"Are you actually playing 'eeny, meeny, miney, moe'?" Lexie questioned in disbelief while Norah chuckled softly next to her.

"Yeah," Derek laughed before his face dropped into a serious look.

"Take a vote?" Mark spoke up.

Derek cocked a brow at that suggestion. "You and Norah were taking votes over pillow colours-blue or red. And you two settled with purple," he deadpanned, "I'm not taking votes."

"Ouch, Shepherd. Ouch," Norah snorted, looking at Mark amusingly before she shifted her gaze back at the stressful look on Derek's face. She watched as his eyes moved between the two remaining vessels that were openly exposed, just waiting for him to make the cut.

And when he did, it was the right one. The hours paid off. Everyone was on cloud nine; congratulations and applause passed along in the OR, where the pressure had finally subsided.

She noticed the glimmer behind his eyes again, but this time, she knew what it was-

A hint of hope.