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Ivy jumps off the rig, "We need 4 units of o-neg. Bring that bench over here. They went to cut off the door, and all I could think of was Derek. If those doctors had done everything possible to save, he might be here. I wasn't going to let someone lose Keith when there was more we could do. I wasn't going to watch him bleed out. I kept thinking we need more time but I realized, no, we need less distance from the O.R. So-"

Amelia chuckles at her sister, "You brought-"

Maggie finishes, "-the whole damn car."

"How is he?" Meredith asks, getting ready to climb up.

"He's hanging on, barely," following her.

"Uh, this isn't the way we usually do that," Webber starts to say.

Ivy climbs onto the rig before looking down at him, "Welcome to trauma. You don't save people by staying inside the lines," April laughs, nodding from her spot in the crowd, "I had to do it this way."

Jackson smiles at her, "No, no, no. We see why you did it."

As she turns to the car, Jackson admires her. This was his wife. The kickass surgeon who didn't give a crap about anything but doing everything she could for her patients.

"I just wanted to give him-" She starts to tell Meredith.

"A second chance. We got a second chance," Meredith understands, "Hey, Keith. It's Meredith."

"Thanks for having me over. How's Joan? What's the word on my baby?" Keith asks.

"We'll find out for you. We got you," she reassures him.

○○○○

Ivy stands on the ground as Meredith preps Keith to be able to be removed from the car. The firefighters tell her they're ready, "Grey, we're ready go cut off the roof."

Meredith covers him before moving out of the way. They cut, "Roof coming off! Okay, guys, you're clear."

She immediately calls out, "We need a trauma panel and type and cross for eight."

Owen nods, "Got it. Drawing labs."

Everyone crowds around Keith as Maggie says, "No blood in the pericardium."

"Penetratihg thoraco-abdominal injury. Ultrasound, please," Owen assess.

"Keith, talk to me. How do you feel?" Meredith asks.

"Uh, popular," Keith wheezes out.

Meredith nods, "Funny. That's funny."

The fireman get their attention, "Okay, guys, when you clear, we're gonna cut away the piece of the door here that's impaling him, then you can get him inside, okay?"

"All right," Ivy nods.

"Dr. Grey," Wilson comes up to the group, "I have an update on the fiance."

Ivy hears Webber yelling as the sawing stop. She watches as the couple looks around before Catherine hands Webber his ring back. Ivy looks down, as they continue to saw.

Keith starts screaming before Meredith yells,  Okay. stop! Hey, stop! Stop! Stop!"

"What is it, Mer?" Ivy asks.

"We can't do this. Not like this. It's gonna tear him apart," she tells her.

○○○○

They have to reevaluate. Quickly, they have a plan. Wilson asks, "We're gonna open him up out here?"

Meredith nods, "Its the only way. We start an ex-lap."

"Clamp everything we can. It'll buy us time until we get him upstairs," Ivy adds.

"Only five or six minutes till he bleeds out," Maggie reminds.

"Thats plenty of time."

Warren tells them, "Guys, guys, all O.R.s are full."

Ivy can't believe it, "All of them?"

He nods, "Tunnel collapse victims."

Jackson stops them, "No, no, we have a plastics O.R. available."

"Thats all the way at the other end of the building," Meredith reminds them.

"Thats impossible."

"Nothings impossible," Jackson and Ivy say at the same time.

They share a look before Jackson continues, "We just- all right, we clear a path to the east elevator. Move everything out of the way, stop all foot traffic, lock down the elevator."

Maggie asks, "Can we make it that far?"

Jackson states, "No, but he will. He doesn't have a choice, right?"

"So, we run. All out, no stopping. It's plenty of time," Ivy nods.

"Its plenty of time," Meredith repeats.

Ivy nods, "Okay, let's prep him for an ex-lap out here."

They break, "Okay."

○○○○

She starts assigning tasks, "Warren, you'll incubate. Hunt, you and I will do the ex-lap. Get control of whatever bleeding. Grey, you and Pierce need to be scrubbed and ready in the O.Rm when we get there, we got it?"

They all nod, "Okay."

Ivy starts prepping all the supplies she needs, "Shepherd-Avery, I'm gonna need a minute."

"Okay," she sees the look on her face, its important.

○○○○

She sees Meredith and Alex coming so she turns to everyone, "Okay, everybody. Stop what you're doing. Quiet, please. Make a hole. Make a hole."

Ivy watches as Keith sees his son for the first time. She feels Jacksons hands on her shoulders as she leans against him.

He places a kiss on her forehead before mumbling in her ear, "I love you."

"I love you, too," as Meredith takes the baby away, Ivy nods, "All right, let's bag him. Push 200 of ketamine."

"Don't go," Keith reaches for Meredith.