twenty-five

Presents with a pulsatile, expanding abdominal mass." Jackson read out the card, "Go."

"Ruptured triple-A. I would take the patient straight to the O.R. and access the peritoneal cavity through a vertical midline incision." Allison responded.

"Nice." Jackson complimented as he stared at her for a few minutes as she concentratedon patients charts, while Alex and Meredith joined them.

"You guys studying for the oral boards in the middle of the day?" Meredith asked, as she walked up to them.

"Benefit of having a study buddy." April shrugged, as she updated the board, "You should get one."

"I have one, it's just that my stupid study buddy's too busy trying to save her stupid marriage to actually help me study." Meredith said, looking at the O.R. board.

"Well, you know what's better than a study buddy?" Alex asked them, "A study lackey. Check it." Alex whistled grabbing the attention of an intern.

"Trauma incident or a surgical situation?" Morgan asked.

"Surprise me."

"A 12-year-old boy fell off his bike, hitting his abdomen against the handlebars complains of progressive abdominal pain and is short of breath..." Her voice begins to trail off since Alex and her are walking away.

Hearing Jackson's phone go off Allison glanced his way, "What is it?"

"Sloan. 9-1-1." He said, before leaving the girls alone.

"Hey, if you want we could..." April motioned towards her, Allison and Jackson. Allison shook her head, knowing Meredith is going to refuse her offer.

"I don't need help." Meredith shook her head, "I'm an excellent surgeon. You know it, and I know it. Everybody knows it. I don't have to prove myself to anyone."

"Yeah, except to the American Board of Surgery." April told her.

Meredith sighed, "Yeah, there's them." Before walking away.

***

"I was paged." Allison said, as she made her way inside the radiology room, seeing Lexie standing in front of the monitors with someone else. "Amelia?"

"Allison, hey." Amelia smiled turning around greeting the girl with a hug, causing her to yelp in surprise. Allison hugged her back before Amelia let go and pointed at the scans. "Look at this tumor."

Allison walked up to take a look at the scans in front of them. It showed a large tumor, an inoperable one and a damaged carotid. "Amelia, this is an inoperable tumor."

"I can remove the tumor and the diseased carotid together. All I have to do is run balloon catheters in through the femoral, place them in precise position, inflate them to stop the blood flow, do two arteriotomies then feed a heparinized shunt into place and reestablish blood flow." Amelia explained.

"That's all?" Lexie asked, giving a small scoff.

"Oh, and I have to do it in ninety seconds." Amelia added, "Any more than that, and she strokes out."

Allison crossed her arms across her chest, "Is that even possible?"

"Not sure. I would love to test it out" Amelia said looking at Allison and Lexie.

"Why was I paged?" Allison asked confused since she wasn't on neuro's service today.

"You're the best in neuro, I want the best with me on this." Amelia nodded.

"We should set up a simulator." Lexie suggested causing the two girls to turn around.

"Don't we need to get Derek's approval?" Amelia asked.

"That shouldn't be a problem." Allison shook her head.

"He loves to say no to me." Amelia nodded, "That's his favorite thing to do."

"Maybe you should refrain from calling him a jackass." Lexie pointed out.

"I can't help it, 'cause he is one."

"I could ask him." Allison suggested, knowing she can convince Derek one way or the other.

Amelia hopeful eyes stared at Allison, "Could you?" Allison nodded, "He's in surgery, O.R. two."

Allison nodded as she made her way through the door but stopped as she turned around to face Amelia, her eyes narrowed, "You just called me down here so that I could talk to Derek for you like it was my idea."

"Aren't I good?" Amelia asked as she chuckled.

Allison nodded, "Amazing."

***

"We've operated on worse." Allison pointed out as she stood next to him watching him operate on a patient.

"Allie, she showed us a picture of a little boy." Derek said, knowing Amelia is close to the case. Allison was about to respond but Derek beat her to it, "My sister is too emotionally wrapped up in this patient to clearly see that she can't help this woman."

"It tells me she's passionate enough to try harder." Allison nodded.

"Yeah, well, all the passion in the world is not gonna make her plane doable in 90 seconds, you need to see that for yourself, fine set it up." Derek said

"Only you're gonna be the one who sees a thing." Allison spoke up, causing Derek to look at her, "I mean, Thank you, Shep."

***

"Boom!" Amelia jumped up from her seat, her hands raised above her head as she finished a run through on the simulator, Lexie and Allison sitting down.

"Ninety-seven seconds." Lexie told her, looking at the stopwatch.

"Bite me!" Amelia grabbed the timer out of Lexie's hand and threw it at the wall, causing it to shatter. Seeing the residents gazes on her Amelia apologized, "Sorry—I just, I've been at ninety-seven seconds for eight freaking times now."

"Maybe not a ninth." Allison said looking at the bright side, "If Lexie could find another stopwatch."

Amelia shook her head, "I mean, Derek's probably right. I'm just—I'm gonna let her down. He should know, I've let him down enough times."

"Let's take a break." Lexie suggested, "Let's go, uh, you want to get something to eat?"

"I want something." Amelia exhaled, "It's not food."

"There's a guy who got his hand stuck in a meat grinder." Allison shrugged remembering the case she saw Meredith on.

"I wouldn't mind seeing that." Amelia nodded. As the three of them left the skills lab.

***

Alex was talking about Morgan, his intern, needing surgery as Amelia, Lexie and Allison walked inside the gallery to watch Callie and Meredith surgery on the patient who's hand was stuck in the meat grinder. Allison sitting in between Jackson and Amelia.

"Morgan needs surgery?" Lexie eyes widen as she heard the last bits of Alex's sentence.

"How do you know about Morgan?" Alex frowned, since he didn't know she was pregnant, let alone he didn't even remember her name.

"Everybody knows about the pregnant intern, Karev." Jackson said, without looking at the patient's files he was reading. When his phone went off, "There's my ride. Here we go"

Without so much saying anything, Jackson got up leaving the gallery to get to his surgery with Mark.

"If Morgan needs surgery, then why are you here?" Allison asked, turning her head to look at Alex.

"My attending gave me a job—call the boyfriend." Alex explained, "I left like six messages."

Lexie nodded, "Chris is a fourth year at the Cleveland Clinic." Lexie informed Alex, "I mean, you know how busy it gets."

"How do you know his name?" Alex asked, looking at Lexie as if she were weird to know this.

Lexie ignored his question as she looked back at the surgery, "They're not just amputating and fitting him for a prosthetic?"

"No." Alex answered, "She thinks she's gonna be able yo salvage the finger bits and reattach, because she's cracked."

"That's gonna be so much harder." Amelia spoke up for the first time.

"You know what else would be harder?" Allison asked Amelia, "Going through the carotid."

Alex chuckled, "For fingers?"

Amelia turned to face Allison knowing what she was talking about, "It would be harder, but there'd be better control than going through the femoral."

The three of them quickly got up and left the gallery.

***

Allison walked up to Derek as Boki was leaving, "You should at least listen to her."

Derek shook his head, "Look, I swear, you gotta stop encouraging her."

"Derek, you taught me this, to never give up."

"Because you can handle it, when we lose a patient, I know if you're okay or you're not because I'm there with you and I know you." Derek paused, "With her, I cannot do that, because I don't think she can handle it. Not now."

"You are the one who is too emotionally involved." Allison paused as they came to a stop, "If this tumor had come to you from any other doctor, you would still be looking at it. You're so worried about your sister's outcome, you won't even think about her patients." Allison looked at her best friend, "And don't tell me I'm wrong because I know you."

Allison left Derek before he can say anything so she could finish her charts as he went to go help Amelia.

triple update :) since i have written a lot these past few days, so enjoy seeing as i have finals week starting tmr...so wish me luck