Chapter 2

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Derek: "Take your time

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Derek: "Take your time. Think about it. Hey." he says when Meredith leaves and Sky comes over to him
Sky: "Hey."
Derek: "So you decide to take the job?"
Sky: "Still not 100% convinced, but Richard is going to the beyond to impress me so I figured he went through all the trouble of setting everything up and I wouldn't want him to have wasted his time."
Derek: "So pretty much, you want to see how far he's going to go to impress you."
Sky: "Yep." she says as he laughs at her as the elevator opens

Sky: "Good morning." she says coming into the room where Bailey and the interns are at
Alex: "Annie, this is Dr. Rivers. Awesome surgeon." he says fake whispering the last bit as Sky smiles at Annie
Bailey: "Dr. Karev."
Alex: "Annie Connors is a 43-year-old woman who presented last night with progressive shortness of breath the past three months. Found to have a very large tumor of unknown origin pressed against her diaphragm. Stable vital signs. Scheduled for CT this morning, maam."
Sky: "Thank you, Dr. Karev. Are you at all claustrophobic?"
Annie: "l've been housebound for the last year. How claustrophobic could l be?"
Sky: "All right uh..." she says looking at the interns whose names she's still learning "Dr. Stevens...?" She questions the woman wanting to make sure she got the name right, making her nod "Is going to take you up for a CT. lt'll give us a better look at the tumor, and we'll know how to proceed."
Annie: "Could someone tell my mom? She'll worry if she gets back, and l'm not here."
Sky: "Of course."
Annie: "And would it be possible for Alex to take me instead? l mean, he...He's just so fun to look at."
Alex: "Annie."
Sky: "No problem. I'll also be sending Dr. Burke and Dr. Shepherd in to meet you that way you'll know all the doctors on your case. Excuse me." she says smiling at Annie before walking away

Izzie: "How much do you think it weighs?" she asks when they walk out the room 
George: "60 pounds."
Izzie: "More. She's carrying a whole extra person."
Cristina: "This one's going in the books. l've got to get in."
Izzie: "l almost did. Have you ever seen Alex like that? He actually seemed sincere."
Meredith: ''Seemed'' being the operative word."
Cristina: "He was on call when she came in. l am never leaving this place again."
Bailey: "Let's move, people. Ms. Connor's surgery, should we choose to proceed, will take most, if not all, of the surgeons off the floor, which means you people will have to work extra hard not to kill anyone, 'cause we won't be there to fix your mistakes."
Cristina: "l really want in on this." she says falling behind to talk to Burke
Burke: "l thought we weren't talking."
Cristina: "l'm not talking. l'm just saying."
Burke: "It's Dr. Rivers case. The interns choice is up to her" he says as she sighs at him and he licks his lips while looking away before turning back to her "Find her mother, get a family history, and I'll suggest to Rivers that you scrub in." he says as they part ways

Sky is standing at the nurses desk looking through a file when Richard comes over to her

Richard: "What more do you want woman?" he asks surprising her
Sky: "What do you mean?"
Richard: "I named you Chief of Trauma. I've upped your budget. Almost to the point where it's more than mine. Hell I gave you a tumor. When are you going to sign the contract."
Sky: "I'm still not sure." she says shrugging her shoulders at him as he glares at her
Richard: "What more do you want? To operate on me."
Sky: "I mean it would be fun" she says shrugging her shoulders and he goes to respond but she stops him "I'm kidding. Look I really have to focus on this tumor so I'll talk to you later. Ok." she says grabbing the chart and walking away

Burke: "The right hemidiaphragm is so high that it's completely displacing her lung tissue." he says as they look over Annie's scans
Derek: "lt's infiltrated her spinal canal in three places. We should start there. lt's going to take 3 or 4 hours to get around those nerves."
Burke: "l'd prefer to start in front, and then flip her. You never know what vessels are involved.  l'm going to need a good head start."
Derek: "lf l miss a step, she's paralyzed."
Burke: "lf l don't relieve the pressure on her lungs, she'll be dead. So she won't mind if she can't walk."
Sky: "Do you think she really wants to live? Come on. She's been housebound. She's been living under this thing, just watching it grow for how long? She doesn't seem stupid. Doesn't even seem all that scared. Why would anyone wait this long, unless they wanted to die?"
Derek: "People do things every day that they know could kill them. Doesn't mean they want to die."
Bailey: "What are her chances of surviving the surgery?"
Burke: "Slightly better than if we do nothing."
Bailey: "So is it worth it?" she asks making Burke give her a look of disbelief "Hey, come on. You were already thinking it, l'm just saying."
Sky: "She's 43. lt's worth a try." she says walking out

Sky: "l won't lie to you. The surgery is going to be long and difficult, but we have an extremely capable surgical team, and l can-" she says informing Annie about the surgery 
Annie: "Am l going to die?"
Sky: "There's always that risk, but if we don't do the surgery..."
Annie: "I'll definitely die."
Sky: "Yes."
Annie: "Soon?"
Sky: "Yes."
Annie: "Mom, the room's clean." she says looking at her mother who is tucking the blankets in
Woman: "Ok, honey, ok."
Annie: "Mom!"
Woman: "She'll have the surgery."
Annie: "Mom!"
Woman: "No. No, Annie. She will have the surgery."
Annie: "l guess l'll have the surgery." she says after looking at her mother
Sky: "l think that is a very wise decision."
Annie: "On one condition. l don't want him there." she says making Sky raise her eyebrow and turn to look at Alex
Alex: "l'm sorry, Annie. Did l upset you in some way?"
Annie: "lf he's in the surgery, l'm not having it. That's how l live with myself."
Sky: "Ok, Miss Connors. Dr. Karev." she says walking out the room with Alex behind her "What the hell did you do?" she asks as they walk down the hall 
Alex: "Nothing. l-l don't know. Man. The mike must have been on. I was talking to the tech guy-"
Sky: "If anything goes wrong, anything, you are 60 percent more likely to be sued if you've offended the patient."
Alex: "l never would have said that. The mike shouldn't have been on. l didn't realize she could hear me."
Sky: "Dr. Karev do you know what type of patients I operate on?" she asks turning to face him
Alex: "Patients who have zero to no chance of surviving that most doctors would probably say no to."
Sky: "Correct. But it's also on people who are in the situation they're in because of a mistake or decision that they made. Now I might think that they are the most idiotic person on the planet but I think it to myself. I may say it to a colleague or a close friend but I say it in a private space. At no point in time am I ever supposed to voice my thoughts out loud in an area where the patient or a close one of the patient can hear me."
Alex: "I'm sorry."
Sky: "You bet you are. Because you heard the patient's request. You're off this case. You can watch from the gallery but at no point in time are you to enter the OR are we clear."
Cristina: "Dr. Rivers, Dr. Burke said that if I got the tumor history that I would be able to scrub in" she says as Sky motions for her to continue "lt's been growing for a year and a half. lt's the first time she's even had it looked at. lt's like she's fatally lazy." she says making Sky look at her incredulously and roll her eyes while sighing before walking away
Alex: "Why doesn't she get banned?" he asks calling after her as she stops George from walking
Sky: "Go prep Annie Connors for surgery. You're scrubbing in with Dr. Yang. And I better not hear one smart remark come out of your mouth are we clear." she says letting his shirt go and walk away
George: "Really? l mean, thank you. Ok."

Cristina: "lf they pull this off, l'm totally calling Oprah."
Bailey: "You two been working out?" she asks as her, Sky, and Derek walk in the scrub room 
George: "Sometimes l jog, and l try to take the stairs whenever possible."
Cristina: "Why?"
Sky: "See that large pile of tumor? You're going to be retracting it for the next 14 hours, so hope you have strong backs."
Meredith:" Dr. Shepherd."
Derek: "Yes?"
Meredith: "Mr. Levangie has agreed to DBS. lf we do it today. lf he leaves, he won't come back."
Sky:" Don't worry. lt'll take hours before we get around to the spine. l'll page you." she says finishing washing her hands going to walk into the OR with Burke
Derek: "All right, then. Let's do it."

Bailey: "Begin more suction." they say as they are in the middle of the surgery
Woman: "We need to hang another bag of O-neg."
Burke: "Cauterizing the small bleeders to keep my visual field clean."
George: "God, is your back killing you?"
Cristina: "George, shut up. We're in here."
Man: "Hold it right there."
Man: "Irrigation."
Sky: "Little more pressure. That's good hold it right there."
Burke: "Look at the size of this artery."
Bailey: "My God. lt's as thick as a thumb. You ever seen a vessel this size?"
Sky: "No. This thing's just feeding on all her blood."
Burke: "We need more O-negative."
Woman: "l'll call the blood bank."
Burke: "Damn it, O'Malley" he says as he twitches making everything move "You want me to kill this patient?"
George: "No, l-Sorry."
Burke: "l mean, is the art of retracting just too much for you?"
George: "No, l was, uh...Um l had an itch."
Burke: "Ok, follow with suction."
Derek: "How's it going?" he asks coming into the room 
Sky: "It's more intertwined than the studies made it look."
Bailey: "l need another bag. Call the blood bank. We need more O-negative."
Burke: "l'm down 10 units of blood, and we haven't even flipped her yet."
Derek: "Oh, wow. Hmm."
Bailey: "Hold it steady."
Derek: "Look at that."
Bailey: "Sponge."
Derek: "How am l supposed to get around that artery?"
Woman: "Let me call down and see ok."
Derek: "All right, then. Forceps." he says sighing out
Woman: "Here you go."

Woman: "Yeah. No, it's up here. It's up here. It's up here."
Derek: "We're still in the middle of surgery."
Izzie: "Mr. Harper, the post-op heart patient in 2114. l had to open his sternotomy bedside." she says coming into the room shocking everyone
Burke: "You what?"
All: "What? What?"
Izzie: "He had cardiac tamponade. His chest films were clean this morning. lt happened fast. He was in PEA. There was no time."
Sky: "Go ahead. We got it. We're ok here."
Derek: "Yeah, l need some retraction. Pull back on the retractor."
Woman: "l got it."
Alex: "You opened a heart bedside, and you couldn't even page me? Needed all the glory for yourself, right?" they yell as everyone glances at them
Izzie: "l paged you 50 times. Do you have any idea what l have been through?"
Alex: "Oh, man. The battery. l forgot to change it."
Izzie: "You forgot? You forgot?! You are hateful! You are a hateful, hateful, lazy, arrogant, hateful man! Hateful!" she says breaking his pager and walking out
Derek: "Never a dull moment here at Seattle Grace."
Sky: "I'll say." she says just as a vessel pops and blood squirts out
Bailey: "Oh! Oh, my God."
Sky: "Get right in there."
Bailey: "She can't afford to lose this much blood."
Sky: "Get me some suction. l can't see what l'm doing."
Derek: "Clamp, clamp, clamp, please. ls there any blood in the rapid infuser?"
Man: "We're waiting on two units."
Derek: "What do you mean, waiting?"
Sky: "We didn't anticipate this blood loss. We prepped double. We've used it all." she says as they rush to get Annie back
Derek: "What did you cut?"
Sky: "Nothing. lt just blew. She came in with too much damage. The artery walls are too weak."
Bailey: "Ten units of O-negative."
Derek: "l cannot see. George give me your hand. Push down here. Pull it towards you."
Sky: "Suction!"
Man: "The pressure's dropping."
Derek: "She needs blood! Where the hell is the blood?! Somebody grab that. Push it back, George. Come on. Oh, God. Just squeeze it off right there. Here we go."
Sky: "Some suction, please, in here, now." she says as the machine flatlines
Derek: "We're losing her now. Look at this. Come on" he says as he starts CPR on her "Oh, come on! Come on! Come on!" he pants out
Sky: "Derek." she sighs after a few minutes making him stop and somebody turns the monitor off
Derek: "Time of death is 11:42." he says taking his headlamp off as everyone breathes heavily
Alex: "l got it!" he says running it seeing Annie lying on the table and everybody starting to clear out

After washing their hands and getting the blood of their faces Sky, Bailey, and George go to deliver the news to Annie's mother

Richard: "Come in" he says when he hears a knock on his office door and Sky comes in back in her normal clothes "I heard your surgery didn't go well. Sorry to hear that."
Sky: "Yeah well it was a high risk procedure. It would have taken a miracle for it to go over well." she says stretching her arms out
Richard: "What can I do for you?"
Sky: "You got those papers?" she asks as he pulls them out of a drawer and hands it to her while she looks through them before signing and handing it back to him
Richard: "Welcome to Seattle Grace Dr. Rivers." he says smiling at her as she nods and smiles back before walking out

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