twenty

as she reached the rest of the residents except Meredith, who was fired from the hospital due to messing with Derek's clinic trial, "Do you guys know why?"

"Who cares?" Cristina shrugged, "As long as it gets me away from Altman."

"She's gonna fire us, isn't she." April panicked, since there was a mix up in the O.R. because they didn't update the board.

The group of doctors walked inside the ER as they watched Bailey standing outside one of the trauma rooms waiting for the residents. Seeing there was a trauma, the residents quickly got a yellow trauma gown to put it on.

"She was pinned under her car, her leg was amputated in a pin of dirt, her abdomen is pulp, and her pelvis is probably crushed" Bailey explained as she pointed at all of the residents, "You will work together to asses her injuries and repair them."

"Oh, in the O.R.?" April asked.

"No, at the Jiffy Lube. Yes, in the O.R." Bailey said, "Now Dr. Torres will supervise your work, if you're killing her, she will step in. Otherwise you're on your own. Don't screw this up, like you screw everything else up you've touched lately" Bailey walked inside the room, "Ladies and gentlemen step away from the patient."

The residents quickly rushed inside the room speaking about who is going to do what.

"It's a pelvic fracture." Jackson sighed as he looked at the scan.

"And a comminuted femur fracture." Allison added, "Has anyone fully examined the stump?"

"Pneumopericardium and an enlarged cardiac shadow." Cristina announced, "She needs a chest tube and a C.T."

"Free fluid. She needs the O.R." Alex argued as he did an ultrasound.

"An embolization and angio would help stabilize the pelvic bleeding." April suggested.

"An angio's just gonna slow us down." Allison shot down the idea.

"We could pack her in the O.R." Jackson cut in.

"Call the O.R. Tell them to prep for an emergent laparotomy" Alex yelled out to a nurse.

"Hello? A C.T." Cristina reminded everyone as Allison kept her focused on the patient, while the others argued on where to start.

"Hello! She's crashing!" Allison yelled as the monitor began to beep rapidly.

"Still want to take her to radiology?" Alex asked, "Maybe wait for a little while till the machine's free."

"Is somebody gonna call the O.R.?" Jackson asked as he looked around.

***

"Let's check the liver first. It's the most likely source." Jackson suggested as they wheeled the patient off the elevator, heading towards the O.R.

"Hey, Yang." Derek called out for Cristina, "Where's Meredith?"

"I don't know." Cristina responded before she looked at Jackson, "She's in cardiogenic shock. That's our main concern."

"Yang!" Derek yelled.

"Th-They fired her." Cristina told him, "Maybe she's putting anthrax in Karev's locker."

"B.P.'s tanking. We need to up her fluids." Alex announced, ignoring Cristina's remark.

"No. Her pericardium is filled with air and blood." Cristina shook her head.

"Do you listen to anyone else, ever?" Alex glared at her.

"All the time. Just not you." Cristina said.

"Or me, apparently." Jackson added.

"Look she's not answering her phone or her pager." Derek pointed out as he yelled out to them.

"I haven't seen her." Cristina said once again, "I was in the pit. She's not in the pit. I was in the elevator, she's not in the elevator."

***

"Give me a ten-blade, please." Cristina requested once the residents were all scrubbed in, ready to operate on the patient.

"Don't give her a ten-blade." Alex shook his head, "The woman just had her leg hacked off. She doesn't need her chest cracked open for something we're not even sure she has."

"Yeah, well, I'm sure and if her heart craps out, she's not gonna give a rat's ass about her leg." Cristina snapped.

"Look, we know that she is bleeding from her pelvis and her abdomen, which gives her plenty of reason to be hypotensive—" April tried to step in.

"Let's just do an x-lap and see what we're dealing with." Alex suggested.

"No!" Cristina argued.

"Allie, start the incision." Jackson instructed.

"What? Why her?" April asked, "Just because you're pissed that I'm chief resident doesn't mean that you can pretend I'm not here."

"Nobody cares that you're chief resident." Jackson yelled at her.

"Shut up!" Allison yelled, "We're wasting time."

Cristina nodded, "She right. The only logical conclusion is take care of the heart first."

"The heart will wait." Alex shook his head, not agreeing with Cristina.

"The changes were subtle on the x-ray, but that doesn't mean they don't exist." Cristina argued her point.

"You're outvoted, Yang."

"This is not democracy." Cristina scoffed, "This is surgery."

"Up to the dopamine to fifteen." Allison ordered as she narrowed her eyes at the others, "Are you happy now? She's bottoming out."

"Well, if we'd get in there and pack the pelvis, that alone will help the blood pressure, right?" Jackson pointed out.

"Yeah, I hope so 'cause her systolic's down to sixty-eight." April nodded.

"Because her heart is exploding." Cristina said.

"We need to stabilize the internal bleeding and then we can get a TEE while we're in there—-" April started to explain while Cristina took a scalpel from a nurse, not hesitating to make an incision, "What are you doing?"