06x07 - Give Peace a Chance

[bunniefuu]

Ask most surgeons why they became surgeons, and they usually tell you the same thing.

It was from the high, the rush, the thrill, that comes from cutting someone open, and saving their lives.

For me, it was different.

You take care yourself today.

Maybe because I grew up in a house with four sisters ...

No, definitely because I grew up

In a house with four sisters ...

But it was the quiet that drew me to surgery. How you doing?

Fine. Why, did Meredith say something to you?

She mentioned you were a little down about the merger, Lack of a cardio god. Your wife is dead.

As soon as her liver grows back, she's dead. Be glad she did. That's why I put you on my service.

Mm. You need a god? Neuro god right here.

Godly? Your entire day consists of putting shunts in people. Today? Temporal lobectomy.

Oh.

Richard: ... Our schedule for several months now.

Hospitals across the country

Have reported substantial savings ... How bad is it today? The chief's implementing a computer model

For scheduling our surgeries from now on.

Something about efficiency and progress. 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. Dr. Sloan.

I know what you're all thinking.

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.

This computer knows me better than I know me.

Chief, this thing has rearranged my schedule for the entire week.

I mean, haven't we had enough change here already? Change is good, everyone.

Embrace it.

You two need to stop bickering. It's unattractive.

The operating room is a quiet place, peaceful.

It has to be in order for us to stay alert, Anticipate complications. Your ass is in my way.

I was in the o. R. All night

Sewing a hang glider's intestines back together.

I'm kinda sore.

[ whispers ] I kinda don't care.

[ normal voice ] move.

Cristina: hey, Alex.

I just got a call from swender's office

That Izzie has an I. L. -2

treatment this week

That she hasn't called back to confirm. And?

And, um ... She's your wife, who could die.

She'll show up.

She's a crappy wife, but she's not an idiot.

Okay, uh, well, it's ... it's Thursday at 10:00, So you know.

Don't worry.

Being ditched by cancer wife won't change my mind.

You're still a douche.

When you stand in the o. R. , Your patient open on the table ...

All the world's noise, all the worry that it brings ...

Disappears.

Dr. Shepherd.

Isaac, if you don't stop calling me Dr. Shepherd, I'm seriously gonna have to cut you off. Right. Forgot. Derek.

Thanks. I have your scans, Derek.

I didn't order any scans. I think they're for a consult, But I can come back if you're busy. No, it's okay.

A calm settles over you, time passing without thought ...

For that moment, you feel completely at peace.

[ sighs ] oh. It's a tumor on the spinal cord, Possibly a hemangioblastoma. You've seen one before?

Not this big.

You see how the tumor has worked its way up the spine?

It's taken over the blood supply.

Hmm. It's a perfect tumor.

You know if the patient still has leg function?

Yes. Incredible.

He shouldn't be walking. He should be paralyzed, dead.

You'd have to operate quickly, then, to take the tumor out?

, I'd love to operate on this.

But, no. No, you have to cut the cord, Paralyze the patient, to k*ll the tumor.

Who's thdoctor on this one?

You.

I'm sorry?

These are my scans.

The tumor is mine.

I'd like you to take it out.

I'd like you to try.

One doctor said it was bad circulation, Another one, pinched nerve.

But when the pain started to interfere with work, I decided to run an m. R. I. On myself.

[ pager beeps ]

Isaac, had I known this was your scan, I wouldn't have ... I have been to every doctor, Derek.

Every time, it's the same thing.

They look at the tumor and ey're defeated.

But not you. You were inspired.

That's why I know I was right to come and work here.

I needed to meet you. You got a job here to meet me?

I have researched every neurosurgeon in this country.

I know their statistics, I know who wins the most prizes, But I also know who takes the most risks.

That's you.

Isaac, I know you believe I can take this tumor out, And I wish I could.

But this surgery will k*ll you.

Take the scans. Look them over.

But stop your mind

Before the part where it gets to "no."

Think "yes."

Yes? Cristina: Shepherd, I've been paging you.

Shunt patient, o. R. Two.

Screw the t. Let's operate on that.

You know what this is about, right? Mnh-mnh.

You're no longer daddy's favorite, So you've gone in search of some crazy ass tumor

To get his love back. Actually, it's about my patient.

I haven't made up my mind yet. I'm just looking. Isaac has a cord tumor?

Oh, it's awesome. Look. Awesome in a bad way.

It's eaten five levels of his spine.

Wait, you're not seriously considering

Trying to take it out? Of course he is.

He's Shepherd.

It's a bad caseof t?

Isaac's got a bone spur or a herniated disk, not a ... 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.

[ giggles ] I'm sorry. Do you even know who isaac is?

No idea.

Hey, what's everyone ... Oh, a spinalumor.

I read about a case at mayo where the surgery took 17 hours.

The head surgeon had four rotating assistants, One of whom just administered fluids.

Okay, you know what? Don't try and lexopedia your way on this.

This is my tumor. What happened to the patient at mayo?

He d*ed. That's why it only took 17 hours.

Hey, I just heard. Isaac has an inoperable tumor? It's isaac's tumor?

Okay, yeah, yeah. Boo-hoo, okay?

Who says it's inoperable? Cristina.

[ beeps ]

Callie: oh, come on. It's all the way up to t-2.

Mark: see, this is why is got into plastics.

Arizona: oh, that's gotta be ... [ doctors all talking at once ]

why aren't you all at your surgeries?

Go, get to your o. R. S.

Don't screw with my schedule on day one.

I-I ha ... I haven't made a decision.

No rush. I'm a patient man.

Everyone said you'd found the great white of tumors, But just had to see it for myself. And now that you have?

You want my flow attending answer

Or my fellow surgeon answer?

Fellow surgeon.

This tumor idangerous ... Complicated ... And smart ... Beautiful.

This tumor is the reason

I got into medicine in the first place.

To successfully take out this tumor would be

An achievement you could hang your hat on

For the rest of your career.

[ laughs ] you could retire on this tumor.

I wouldn't go near it. It's a beast.

It's a malpractice suit waiting to happen, Even if we could get his insurance to cover it.

Did I mention he was an employee?

Our pro bono budget can't cover high-risk surgeries

For every employee in this hospital.

We're not a charity. What happened to you?

Excuse me? There was a time you would've convinced me to do this surgery, But now your first instinct is no.

Happened to you?

You came to me as the chief of surgery and I said no.

As for my medical opinion, it is still no.

There is such a thing as an inoperable tumor, Derek. What if it's not? What if I get in there, I open it up, I look around ... there is no way. Anything other than cutting the cord

Would k*ll this man.

I don't know how many times you want me to say it.

You are not operating on an inoperable tumor.

It's a tough job, Derek. You sure you still want it?

Meredith: so what did you do?

I scheduled the surgery.

I'm taking out the tumor.

Microsurgery is about precision.

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.

Who wants to go first?

Take your time.

Derek: wow. Do over?

No do overs. Way to go, two.

Really concentrate. Take your time.

Next. Here you go. Take your time.

We've got nothing but time.

No. Next. Somebody, please.

Well off the Mark.

[ man speaks indistinctly ]

Man: get out. How did you get into this program?

Derek: Mr. Confident.

Next. Next. Next. Next. Next.

Disappointed. I'm so disappointed.

Ooh. Here we go.

Nicely done.

If somebody improves on that, I'll be out of a job.

Well, I guess you might need to retire, then.

[ chuckles ] okay.

[ residents ] oh! Okay.

Dr. Avery, You'll be scrubbing in.

[ lowered voice ]

word on the o. R. Floor

Is that you've gone rogue.

I'm doing a surgery I fully believe in.

To piss off the chief. Since when did Richard become your b. F. F. ?

He's not my b. F. F. He's the chief. For now.

Have you gone rogue? I'm doing a surgery I believe in.

Against the chief's orders. He'll freak when he finds out. There is a computer schedule

Saying that I'm doing craniotomies all day.

He is not gonna find out. No. Shh. Don't say anymore.

'cause me, the chief, secrets? [ whispers ] bad idea.

Hey, I think it is badass. Come on.

Let's go.

Should I be offended?

Because I've bn trying to come up with a good reason

Why you paged every resident to the skills lab but me.

Me. Your sister. Your sister, Derek. I think you're on my service.

Little Grey, I didn't page you because I have

Another job for you. You gave me the idea, actually.

I need somebody in the o. R. Who's gonna remind me

To take breaks, to bend my legs, to drink water.

I will be your patient, essentially.

You want me to be your doctor? If Dr. Sloan's okay with you

Giving up his services, of course.

You love me, and this is a once-in-a-lifetime tumor.

You're nervous, right, about being in there that long?

Me, too. What do you have to be nervous about?

Shepherd didn't even let you compete.

No. That's ... that's because he needs me

To maintain his while we're in there.

I'm his doctor, basically. Wow. So you fell for that?

'cause, I mean, it sounds ... It sounds more like you're his bitch.

What? No. I'm ... that ... it's ... I'm ... I'm not ... You're gonna need to take a break eventually and ... and ... and you're gonna need to stretch.

You're gonna need to pee.

And when you do ... I'll be there to take over.

Yeah, I don't ... I don't take breaks.

[ laughs ] you seriously think

You're gonna last all day in there? I've done it before, yeah.

But that's because I know how to stop taking fluids

Before a long surgery.

Have fun playing nurse.

I mean, it sounds ... Neat.

I don't know, I think Izzie had it right.

You know, get fired, run away, die ... Mer, I gotta call you back.

Is that what I think it is?

What? No. No!

No. No.

No! Gimmie!

A diaper?

It's for the surgery. Please don't tell anybody about this.

That's genius. You never have to leave the o. R.

You can hydrate all you want. You're mocking me.

Fine. Whatever. It's not like I was gonna use it anyway.

Of course you are. This is the definition of hard-core.

You're like an astronaut. This is surgery nasa-style.

You know what? You put it on right now.

I'll guard the door.

Anybody opens their mouth and they're fired.

You, too.

Oh, Dr. Shepherd, I was just describing

Our new schedule to some of our board members.

This must be ... Mrs. Taylor.

And she's undergoing a craniotomy.

It's Mr. It's ... We're, uh, still working out a few kinks, clearly.

We should go. Keep the trains running on time.

Nice meeting you all.

[ man and woman ] mm-hmm.

Isaac, if I get in there and it looks too dangerous to remove, The responsible thing is to close you back up.

No, don't close me up.

If you get in and if it's too complicated, Cut the cord.

Paralyze me if you must.

I survived a w*r. Did you know that? No.

I survived a w*r where they put bodies into mass graves

Where there's once a playground.

I survived the death of my family ... My parents, myrothers and sisters.

Then I survived the death of my we and child

When they starved to death in the refugee camp.

I survived the loss of my country, Of hearing my mother tongue spoken, Of knowing what it feels like to have a place to call home.

I survived.

And I will survive the loss of my legs.

If I have to, I'll survive it.

Okay?

But, Derek.

Yes?

There is always a way.

When things look like there's no way, There is a way.

To do the impossible, to survive the unsurvivable ... There's always a way.

And you? You and I

have this in common.

We're inspired.

In the face of the impossible, we're inspired.

So if I can offer one piece of advice

To the world's foremost neurosurgeon ... Today if you become frightened ... Instead become inspired.

Hmm?

Okay.

I'm ready now.

Put me to sleep.

Derek: the dura's opened.

Let's get our first look at the tumor.

Jackson: wow.

That's, um ... Wow.

The vessels are more intricate than the m. R. I. Showed.

There's no way I can get the tumor out

Without rupturing one and k*lling the cord.

So, uh, what do we do?

If I start t-2, I could avoid hitting the feeding vessels, So maybe I should go lower?

There's less vascularity around t-7, So that does seem better, no? Jackson: it does seem better.

And you'd only get function loss below the chest. But I risk

Rupturing the anterior spinal artery there.

Probably. The tumor tapers off there.

Higher is better maybe?

Either way, I risk sending him into hemodynamic collapse.

[ lowered voice ] he's not talking to us, is he? Not at all.

T-2 shows less potential for bleeding.

At t-3, the vessels have ... Increased.

I'm sorry about the contest.

Who told you about that? No one. I just ... Well, I overheard people talking in the pit.

[ groans ]

It sounded hard.

Well, it wasn't hard. It was a moment of ... You know what? We ... we don't have to discuss it.

Watching lexie in a diaper is punishment enough.

Wh-what? [ laughing ]

lexie is wearing what?

[ laughs ] well, that ... that is a reason

You should be glad that you're not down there.

No, that is the reason I want to be down there. What?

Lexie gets to pee in a diaper, and I don't.

You ... you wanted to pee in the diaper? Oh, god. No, no.

I want to have to pee in a diaper,

To be in a surgery so difficult and so long

That my only option

Is to put on a diaper and pee in it.

[ scoffs ] are they just gonna Let him stare at the thing all day?

He hasn't made a single cut.

If I clip the draining veins without getting the feeders, They'll burst. Dr. Shepherd, I really think it's time for you to take a break.

It's been er 8 hours. I could go under the tumor here, But I might cut the radicular artery.

Let's look for, maybe if I go ... Dr. Shepherd ... Du, if you need a break, just take a break. Please. I don't need one. I'm hard-core.

Are ... are you wearing a diaper? Shut up.

At least bend your legs. You can't bring yourself to use it, can you?

Shut up! Shut the hell up.

Grey, I don't need a break. If you do, take one.

Either of you open your mouths again, you're out of the o. R.

Bathroom break.

Um, Dr. Shepherd.

What? !

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 o. R. Three shortly.

So if you're planning on doing something, anything, You might want to do it soon.

Thank you, Dr. Bailey.

Alex: Stevens.

Izzie Stevens.

I-I know she's not at home.

You have to try her cell.

Fine. Just ... no.

Tomorrow at 10:00. Don't cancel it.

She'll be there.

[ hangs up receiver ]

What?

You missed the contest this morning.

Oh, the one you tanked? Whatever.

Shepherd has assigned us

To round on his canceled craniotomies.

And as much as I'd rather watch his ser-secret surgery

From the gallery, I can handle it myself if you want to, you know, Deal with your Izzie stuff. I respected you more when you called her cancer wife.

At least it was honest. I'm trying to be human here, Alex.

You think if I'm not there, you might get to do

Some big, bad neuro, and tell Shepherd you did isolo, Which, by the way, makes you the douche. You know what? I tried.

Go ahead. Throw away your marriage.

I will be rounding. I'll be rounding.

Mark: this is why you don't go rogue.

Look at him. He's cracked.

I coulda told you this was gonna happen.

Don't be smug. This is one of our people's lives at stake. Oh, this is so depressing.

Ten hours staring into his spine, And he can't figure out what to do. What did you just say?

What? No, I didn't ... did I? I didn't ... Robbins?

Dr. Shepherd.

Dr. Shepherd.

Am I to understand that you canceled your surgeries today

To operate on a spinal cord tumor?

Dr. Shepherd.

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.

So I am demanding that you close this man up.

Close him up and relinquish the o. R.

Right now, Derek.

Okay.

That's it. Let's close him up.

There was no way of taking it out

Without risking your life.

And to cut the cord at this point, I just ... I won't do it. You're still walking, isaac.

Let's reassess this in a few months.

I understand. You worked hard today.

You're tired.

I'm sorry.

You'll try again tomorrow.

Tomorrow?

No, I can't try again.

The tumor is inoperable.

I can't fix this.

Go home. Sleep on it.

We'll talk more tomorrow.

I don't understand.

There's nothing to understand.

I stood there for ten hours, staring.

In the o. R. ?

You stood for ten hours and did nothing?

Yeah. Okay. Let's talk about you now.

How was your day? My day?

Mm. Oh, my day was ... you know, I-I slept, And I ate an entire box of cereal.

I left three voice mails for Izzie.

I'm sure she won't return any of them. Mm-hmm.

I started and gave up on "Anna karenina"

For the fifteenth time.

You want to talk about the tumor? I do, please.

Just admit it. I'm a surgery junkie.

It was more vascular than the m. R. I. Showed.

But you were able to do the decompression? Yes.

But you weren't able to find a plane to dissect? No plane. Nothing.

It was just ... There was no path, nothing distinct.

Well, why?

Because it was just ... It ... You know what?

I have an idea.

What are you doing?

Just watch and learn.

Okay.

The tumor is here.

Now you've completely lost your mind.

T-7. It goes all the way up to t-2.

You're drawing on the wall. I open up the posterior column. It's chaos.

I didn't know what vessel was connected to the tumor

Or to the cord.

So what I did was ... Start here, the anterior spinal artery could rupture.

The cord could die.

Here, you risk catching

The radicular artery under the tumor.

The cord dies.

But why not just cut the draining veins at the top, Expose the arteries? The draining veins are very thin.

You slip up, they burst.

He leaves my o. R. A quadriplegic.

I might as well cut the cord. Which you didn't do.

No. Even though isaac said you could, Even though you knew it would save his life. Well, he still has function in his legs.

No, but what I mean is, you didn't cut the cord.

You stood in the. R. For ten hours.

You knew the chief would stop you.

Anybody else would've, and you didn't.

So there must be a reason why.

Richard: this patient understands

What cutting the cord means?

The loss of function in both legs and possibly more?

We have to cut the cord to k*ll the tumor.

There's no other way.

[ sighs ] okay.

That'll only take an hour or two.

You can have o. R. One.

Hunt needs it right after so he'll have enough time. Thank you.

Good luck.

We're not cutting the cord.

We're not? Mnh-mnh. The mistake I made yesterday

Was that I wanted a plan.

There can be no plan.

I just have to pick a point and cut.

But what you said yesterday, if ... if you cut an artery

Or hit the cord ... Isaac wants us to take the risk.

He wants a cure, and it's our job to try.

See you in the o. R.

This is bad.

This is really, really bad.

Are you kidding?

No one at mercy west was this badass.

This isn't badass. This ... this is ... Okay, you saw him yesterday.

He was spinning himself in ... in circles, Mumbling like some crazy psych patient.

And he was mean. Well, he's your psych patient now.

Deal with it, diaper genie.

Hey, I wore a diaper yesterday, yes.

And I will wear one today.

If it helps get Dr. Shepherd through this surgery, I will wear a diaper, 'cause my diaper is awesome.

My diaper is hard-core.

You wish you had the balls to wear my diaper.

I'm gonna wear it, and I'm gonna wear it with pride.

And if I have to pee in it, oh, I'll pee, Because I am a surgeon.

This is america, and I will do what needs to be done.

So you can kiss my hard-core, diaper-wearin' ass.

You woke me from a nap. This better be good.

Napping during the day? Actually, that is good.

You're gonna need the rest.

A redo retroperitoneal sarcoma? Mm-hmm.

That's like a 12-hour surgery.

Yeah, 15 if things get ugly.

Go, gear up.

Ah, Dr. Hunt. Yeah.

Hey, uh, Cristina ... No. N-no.

Sh-Shepherd needs the o. R.

I put on a diaper.

Okay. I've gotten the plane.

Ready to make our first cut.

I heard you needed some support.

You need people to talk to ... experienced surgeons.

And you can't say no because I'm in charge, And this is what I'm prescribing.

Thank you, Dr. Grey.

Okay.

Let's start.

Making the first cut.

What, did you ... you paralyze him?

No. One vessel down.

Settle in. We have many more to go.

[ exhales deeply ]

Alex: I still hear some wheezing, So let's start you on another breathing treatment.

Dr. Karev, could I

see you for a minute?

I'm a little busy.

[ lowered voice ]

Dr. Karev, it's important.

You need to go. It's past 10:00.

You're checking your watch every five seconds.

You're distracted. Just go. I'll finish up here.

Shut the hell up.

Alex, come here.

You don't even know me, so why are you

All up in my face about this?

Because there is a girl sitting down there

On the third floor waiting for her guy.

She doesn't want to see me, okay? She bailed.

She didn't even tell me to my face. She left a note.

So stop trying to act like, And let me get back to my job, okay?

Look, if you are sure about that, then fine. Don't go.

But you better be 100% sure

Thathe's not hoping that you show up, Because right now, you are making a choice.

You, not her.

So you better be at peace with that.

I've cleared a path at t-5.

And if I continue along this plane, I ... [ monitor beeping erratically ]

M. E. P. Tracing's losing amplitude. What just happened?

A vessel burst. It might have been connected to the cord.

But if there's not enough blood reaching the cord ... I could've just paralyzed our patient, yes.

Suction, please. Suction.

[ beeping continues ]

Oh, no.

Meredith: what, Cristina?

What is it?

Easy. Careful.

More suction. There's too much blood.

We're losing him. I should've just cut the cord. This is too risky.

Wait. It's back. Amplitude's up.

Lexie: so the cord didn't stroke out?

You didn't paralyze him? The vessel was connected to, the, uh, tumor. We're okay.

Nice work, Derek.

Thanks.

Dr. Shepherd? Take off my mask.

What? Take off my mask.

Take off my mask!

Get in there. Take a breath and get back in there.

You can do this. You really should drink something.

I'm fine. You're not fine. You're dehydrated and you're stressed.

You really should drink something. I said I'm fine.

Drink the water.

I said drink it!

Dr. Hunt.

Uh, chief. Shouldn't you be in o. R. One?

Yes, actually, but I, uh, swapped with Torres.

She has an emergency laparotomy.

Dr. Torres is doing a laparotomy?

What am I doing?

What? I just heard my name.

[ sighs ] chief ... He didn't cut the cord. Bailey will stop him. She's at the door.

Bailey's in the o. R. With Shepherd. Then who's at the door? Oh god.

Ooh, no ... whoa, whoa, whoa. Move.

No. Dr. Robbins ... I said no. Dr. Shepherd is operating

On the inside of man's spinal cord right now.

Even the most minor disturbance could cause him

To make a mistake on that patient, A patient who happens to work here and whose life

I personally would like to see Dr. Shepherd save.

So no, you don't get to go in there and be a bully.

Not today, chief. Not on my watch.

Okay, I totally thought that was gonna end different.

Yeah, more like that.

Dr. Bailey, care to fill us in?

No, I would not.

Becae anything outside of this o. R. Is not your concern.

Your only concern is this patient.

Now keep going.

Derek: damn it.

What is it?

I can't tell which one of these vessels feeds the cord and which one feeds the tumor.

I have to do a blind cut. Like a trip wire?

If I cut the wrong one, the entire cord strokes out.

Okay, we'll come back to this later. Later? So you could finish the entire surgery

Only to cut the wrong one?

This will all have been for nothing? Exactly.

But thanks for pointing that out.

Arizona: how many inches left?

Uh, less than 2.

So if I do my math, we got, uh, Four or five more hours ahead. Crap. Oh, crap. Oh, crap. Oh, crap.

What is it? It's my hand. It's cramping. Damn it

Don't move. Don't ve. Ah.

[ monitor beeping erratically ]

b. P. 's dropping.

Okay, we're touching the cord. If we disturb it any more, We run ... pulse is down to 52.

It's getting worse, guys. It's ... Derek: easy, easy. Don't move.

Easy. Don't move. Just take it easy. Okay, it's okay. Just stay still.

I'm ... I'm going to reach in.

[ Jackson groans ]

Hey, close your eyes and breathe.

Okay? It's just a spasm.

Arizona: b. P. 's back up.

100 over 68.

Have you had anything to drink today, Dr. Avery? What?

Muscle cramps are a sign of dehydration.

You went without fluids

So Dr. Grey couldn't get her hands on the retractor.

Isn't that right?

I, uh ... Sorry.

Sorry. Don't apologize, just step aside.

Dr. Grey, take over.

Easy.

Got it. Easy.

Okay.

Hmm."a" or "b"?

Dr. Grey ... "a" or "b"?

You're done? You got it all out?

Except for the blind cut.

I just have to pick one, and we're good to go.

"a" or "b"?

You're kidding.

You're stalling. Dr. Avery?

I don't like to gamble.

Dr. Sloan?

What, so you can blame it on me for the rest of your life?

This is all you. Right. My call.

Great.

He's deciding which one to cut.

Guessing which one. There's no logical way to make that call.

I-I-I can't ... I can't look. I ... Oh, my god, mer, this is so good.

Eeny, meeny, miny, moe.

Catch a tiger by its toe. If he hollers ... Are you playing eeny, meeny, miny, moe?

[ laughs ] yeah.

No. [ laughs ]

Yeah. It's a bad idea?

Let's see.

Derek: okay.

Okay.

Derek: ask most surgeons why they became surgeons, They usually tell you the same thing ...

The high, the rush, The thrill of the cut.

For me, it was the quiet.

Come on, Shepherd. Oh, my god. Oh, my god.

Oh, my god.

[ whispers ]

please don't be wrong.

Okay.

[ gasps ] he cut. He made the cut.

Cristina, was it the right one?

Cristina?

Tell me. Cristina?

Isaac: no, no.

No.

Oh, no, no, no, no, no, no.

[ voice breaking ] no.

Isaac, what is it?

I can ... I can move my toes.

It didn't work, did it?

You couldn't do it?

No, no. We got the tumor.

It's gone.

But I can move my toes.

Yeah, because we saved the cord.

It was a successful surgery.

You're gonna be fine.

I knew you would try, but ... I'm going to be okay?

Yes.

[ laughs ] I'm actually going to be okay?

Yes.

[ laughing ]

You're a good man, Derek.

You're a very good man.

Peace ...

Isn't a permanent state.

It exists in moments ...

Fleeting ...

Gone before we even knew it was there.

Shepherd finished the surgery.

And I took care of all the pre-ops.

So we're good to go.

She didn't show.

She can't be this stupid.

I mean, it ... it saved her life.

The I. L. -2 saved her life ... And she didn't show up.

[ crying ] she ... She didn't show up.

Who doesn't show up?

We can experience it at any time ...

In the stranger's act of kindness ...

A task that requires complete focus ...

You're standing too close.

No, I'm not.

Yes, you are. I'll show you.

You?

Look at your hands. They're hams.

Mine are tiny little geniuses.

It's not about the hands. It's about the body.

You know, it's your stance ... Tilt of your head ... there ... And ... Your eye line.

Mm-hmm.

If you stand too close, You throw everything else off.

Good.

Go again.

Or simply the comfort of an old routine.

We can't keep doing this, Richard.

I'm tired of fighting you.

Let's try and put this behind us and move on.

I can ... If you can.

You're fired.

Immediately.

Get the hell out of my hospital.

Go home.

Sleep on it.

We'll talk more tomorrow.

Every day, we all experience these moments of peace.

The trick is to know when they're happening

So that we can embrace them, Live in them ...

Okay, so I've heard almost everything

From Cristina, But I want to hear your version.

So start from the beginning and tell me everything.

Derek?

Derek?

And finally let them go.