34┃solo surgery

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S5 EP10

THE GROUP OF SECOND-year residents gathered outside the conference room, where the Chief of Surgery and every attending surgeon were in. Chats were exchanged among the residents, and bets were taken.

The anxious mood in the air seemed to heighten when they saw the chief standing up from his seat at the end of the long table. The residents' eyes followed the chief's step before he finally opened the door; the attendings inside were staring at them with mixed expressions.

"I am happy to announce that the first solo surgery will take place tonight," Webber prefaced, "A below-the-knee amputation, bone cancer..."

"No appy?" Meredith asked the group of residents, who shrugged.

"Saw action, sweet," Alex smirked.

"Choosing who gets first solo surgery isn't just about who has the best surgical skills or who's logged the most hours in the OR. It's about the highest form of trust," Webber continued, "The trust to put a patient's life into one of our resident's hands.

"And for the first time that I can recall, every single attending picked the same person: Dr Yang," he announced, and Cristina stood behind him with a disappointed look on her face. "However, Dr Yang is out of the running. She is going to pick the winner instead."

The residents looked at each other with their eyes widened. "The chief's torturing Cristina," Norah whispered to the group.

"Dr Yang will post her decision on the OR board at 4:00 pm," Webber informed, "Also, since your interns are still banned from the OR... except for three of them... Well, the winner will pick a fellow resident to scrub in with them. Good luck."

The residents scattered off, going in different directions. Norah headed straight to the ER to flag down the Ortho resident, then planned to stay in the library to do some reading about the amputation.

She had assisted Callie in a few limb amputations, but none of which she took the lead in the OR, so 'talk to Callie' and 'hit the books' were the two only things that came to her mind.

❦ ❦ ❦

TALK TO CALLIE. HIT THE books.

Norah did manage to speak to Callie, but she was now stuck in the ER. She sat between two sisters, who were bickering back and forth without a break, filling the ER with yells and curses towards each other.

Norah had just bandaged up one of the girls, Emma's leg as Callie spoke, "I gonna have to check your X-rays. I think your leg's broken. You'll be off it for a while."

"No-no!" Emma shouted in frustration while Callie stared back at her blankly. "I can't miss my Future Leaders of America conference!" the girl snarled, throwing a glare at her sister, "Holly-!"

"Emma, I'm gonna be grounded till graduation," Holly scoffed.

"I was going to D.C.! I've been waiting for this for a year!" Emma yelled back, "Mom and Dad spent two grand-they've now wasted two grand!"

She tossed the first item she picked up towards her sister; Meredith chuckled at the annoyed look on Callie's face while Norah stared at them, amused. The brunette caught the ice pack that Holly was throwing back, and the senior resident finally snapped at the two girls.

"I'm separating you two," Callie drew the curtain that parted them from each other, and Norah turned to Emma to check on her stats.

"Listen, I've been here. Lots," Sadie comforted the girl on the bed while Norah flashed a light over the patient's eyes. "Your dad won't be pissed. He'll be happy you're safe."

"He'll kill me," Holly whined, "He'll take away everything!"

"How long have her eyes been like that?" Norah questioned the intern, who had no idea what she was talking about. "Page Dr Shepherd," she instructed as Alex hurried over, "And tell him she might have a basilar skull fracture. Alex, get her up to CT now!"

"I didn't see... I'm sorry," Sadie spoke, but Alex shut her off.

"You can do scut," he ordered, "I'll call you when she needs another pep talk."

On the other side of the curtains, Emma perked her head up when she saw her sister getting wheeled away. "Where's she going?" she queried.

"Just to run a few tests," Meredith replied.

"Good, get her out of here. Take her away!" Emma yelled at Holly, "I hope you die!"

Norah pulled the curtains away and scowled at the girl on the bed. "What the hell is wrong with you?" she scoffed, "That's your sister over there."

"I don't care! I hate her!" Emma rolled her eyes, and Norah stared at the girl, shaking her head disapprovingly.

If that was Timothy getting wheeled away, she could not guarantee that she would not jump out of bed just to follow him, to keep him close by her side. Clearly, the resident and the patient shared a very different relationship with their siblings.

❦ ❦ ❦

HOLLY HAD CODED WHEN she was getting her CT, and she got immediately rushed to the OR. Derek had managed to stabilise her while both the Neuro and Cardio departments worked on her simultaneously. Norah stood next to the neurosurgeon as she observed the surgery.

"Be objective, Dr Yang. Consider accomplishments, achievements, look for the stand-outs," Derek told the resident, who was still conflicted in choosing a replacement for the solo surgery. "Right now, let's see what kind of stand-out Lawrence here proves herself to be when I ask her to sew the graft."

"Yeah?" Norah's face brightened up instantly. "Yes-! Thank you, Dr Shepherd," she grinned under her mask as the attending stepped aside, and she took over.

"Dr Yang, watch Lawrence to see if her skills are up to par for the solo," Derek suggested.

"A system! Devise a system," Dr Dixon, the new cardiothoracic surgeon, spoke, "Rank everyone accordingly. That's all." Norah looked at Derek, who shared the same confused look on his face.

She frowned at the open brain in front of her eyes. "Dr Shepherd, her brain's changing colour," she pointed out, just as the monitor started beeping rapidly.

"She's haemorrhaging," he stated as they quickly swapped places again, "Push 100 of mannitol."

"D-Did I do something?" Norah asked concernedly, yet she felt only the tiniest bit of comfort when Derek shook his head.

The atmosphere quickly grew thick with nervousness, and the uncertainty only thickened as time went by. Norah stood behind, lifting her chin in an attempt to see the swift movements of the attending while her hands unconsciously copied his actions.

The surgical team spent another ten minutes doing the best they could to save Holly. But when the rapid beeping on the monitor still had not stopped, Norah felt her heart sink to her stomach. She frowned when Derek finally put down the tools in his hands.

"She had a carotid dissection," the neurosurgeon informed, "Nothing we could have done." Norah shook her head and sighed.

"She had a massive CVA. The blood to her brain was cut off and cannot be restored," Dr Dixon explained, "So even though Dr Shepherd was able to fix the hole in her brain that allowed the brain tissue to leak through her nose-"

"-the subsequent carotid dissection has caused loss of her cerebral function," Norah finished the attending's words, "Yeah, I get it. She's... brain dead." Derek turned to her with narrowed eyes-she was never one to interrupt an attending in an OR.

Norah lifted her gaze from the dull-coloured brain to him, exhaling heavily. "The last thing her sister said to her was 'I hope you die'," she muttered sickly, "I just... I can't imagine if that's my brother on the table, you know? And she's only sixteen..."

"That's good news," Dr Dixon spoke in a rather delighted tone, causing everyone in the OR to turn their attention to her. "She'll be an excellent candidate for organ donation. Excellent candidate. Excellent organs-young."

Norah felt disturbed.

❦ ❦ ❦

TIMOTHY ROAMED THE halls until he reached the library with two coffees in his hand. Through the window, he saw his sister spinning in circles on a chair while she flipped through what appeared to be three medical books and journals at a time.

Concernedly, he pushed open the door and walked inside, placing both cups of coffee on the desk. "Hey," he greeted, yet she did not seem to hear him. He finally got her attention when he forcefully stopped her spinning chair. "Hey."

Norah lifted her head from the crowded words to him, a sigh escaping her mouth. "Hey back."

"Is the solo surgery decided yet?"

"Four o'clock. I still have..." she glanced at her watch, "two hours to go through it again."

Timothy sighed at the stressed look on her face, looking around the library before turning back to her. "You know, you're smart-like super smart," he stated, "The genius kid in our fucking home."

"Tim, our home consists of you and me," she deadpanned, "And we're both surgeons."

"Oh, come on, Nor, have some fucking confidence in yourself," he smiled before grabbing away all the reading materials from her hand. When she let out a sound of protest, he shushed her off and placed the materials aside, turning back to her. "Okay, explain the steps to me like I'm the one performing it later."

Norah stared at him for a long time before giving in. "Alright, fine. I mark out the incision with a marker, make sure the lines are drawn clearly. Make an incision at the midshaft of the tibia. Elevate the periosteum carefully, then cut the tibia with a saw. Finally, ligate the neurovascular bundles and release the tourniquet," she recited. "Happy?"

Timothy nodded with a cheeky grin on his face. "See? You're all set and have nothing to worry about," he stated and lifted one of the paper cups to her, "Coffee?"

"You drink vanilla," she deadpanned, "Ew."

"No, no," he shook his head, "This-was requested by your boyfriend. And I'm sure he wouldn't mind you drinking half of it before I bring it to him."

Norah narrowed her eyes at him while she took away the coffee. "He's getting you on coffee runs?" she questioned, then purposely drinking a few more mouthfuls of the cappuccino. "I'm gonna have a word with him."

Timothy chuckled before frowning at the weight of the cup when she returned it to him. "Nor, I know I said half of it... but you didn't have to drink exactly half of it."

"Tell Mark I was thirsty."

❦ ❦ ❦

THE RESIDENTS GATHERED, once again, in front of the OR board. The bouncing legs and nail picking had only gotten worse as they waited for the empty column on the board to get filled in.

The interns were there, too, mostly to confirm who would be winning in their bets. A few attendings were around the corner. Mark stood next to Norah with his arms folded in front of his chest.

"Nervous?" he asked.

"A bit," she shrugged, her head resting on the side of his shoulder. "Oh, hey-"

"Oh, no. That's not a nice 'hey'..." he muttered, turning his head to her carefully.

"Yeah-good thing you recognise it," she rolled her eyes, "Don't you dare get Tim on your coffee runs again. I won't guarantee that I'll not finish your coffee next time."

"You always finish my coffee either way," he shrugged, and she sent him a glare. "Okay, fine. He-Lawrence doesn't get me coffees. Got it."

The group straightened their backs as they watched Cristina walk steadily towards the OR board; all eyes were fixed on her. The resident picked up the marker and lifted her hand to the whiteboard. In neat writing, a name was written:

Lawrence, H.

Mumbles filled the hallway at once. Most of the residents groaned in frustration, and half of the interns pumped their fists in the air triumphantly. "Congratulations," Meredith spoke, and Norah thanked her.

Mark was about to kiss her on the head when she pushed herself off the wall and walked to the OR board, leaving him to sigh with a shaking head.

Norah picked up the marker; the residents around her were curious about who she was choosing to assist her. She spent no time taking off the cap and pressed the marker below her name. Her handwriting, messier than the one above, wrote:

O'Malley, G.

George's eyes widened in surprise. Norah clicked the cap back on the marker and retreated from the board. She gave him a fist bump, reminding him to close his jaw that was hanging.

"You've grown a lot. You've learned a lot. You're the most hardworking one among us," she stated, "You never gave up, and I really respect that, George."

"Wow-thank you, Norah!" he exclaimed, giving her a big hug; his eyes creased with the biggest smile on his face.

Alex raised a brow at her. "What did you bribe Yang with?" he asked, though in a joking tone.

"Ooh, Karev's jealous," Norah cooed with a laugh. "But I haven't seen her after this morning."

"You knew the procedure like the back of your hand," Cristina pointed out as she walked past them; Norah raised a brow at her, confused. "I was in a corner at the library."

The brunette shifted her gaze to Timothy, who stuck a tongue out at her while collecting the interns' betting money. That sneaky little git.

"Besides, I'm sure the patient would want the cleanest and finest appearance," Cristina added, "You're the best in plastics in our class."

"Wow, my Cardio-junkie's giving out compliments? Can I kiss you?" Norah grinned at her, and Cristina faked a disgusted look on her face before returning with a wink and walking away.

"Congratulations, Dr Lawrence!" Kirian chimed as he walked towards his resident, Jace and Nina following next to him. Norah smirked at the two, who clearly had something in mind they dared not speak up.

"I'll talk to the chief, try to convince him to let you two scrub in," she stated, and their eyes lit up. "Only to observe." Kirian was trying not to jump up and down happily; Jace had a surprised look on his face. Norah turned to the other intern, "You're still on probation, Lee. I can't do anything about it."

"It's okay, I understand," Nina nodded with a sad smile. "But I'm sure I can get a better view from the gallery, while these two flirt their asses off inside the OR."

Kirian and Jace each threw a playful scowl at her; Norah shooed them off before she walked back to the wall. Mark was still standing there, waiting for her; his gaze fixed upon her had never left.

"I got it-the first bloody solo surgery!" she exclaimed, a surge of excitement rising in her chest.

"Not to brag, but I knew it'd be you," he smirked. His head lowered to her, almost catching a kiss before she pushed him back against the wall roughly. "Oh, come on, I wanna kiss you so bad right now, Laurie," he moped, "I haven't seen you the whole day, and you were gone by the time I woke up."

"Well, you can't. Not here," she replied, looking around at the dispersing group, "At least not until we make our relationship publ-"

Before she could finish her sentence, Mark had cupped both sides of her face and crashed his lips onto hers. To say that she got caught off-guard would be an understatement. She stumbled backwards a little, stunned; her face was heating up, but her hand was tugging the collar of his scrub top.

The people around them had surprised looks on their faces; Meredith and George smiled while Alex smirked surprisingly; there was a faint wolf-whistle coming from the cheeky brother.

Webber stared at the attending-and-resident pair, shocked. As the thought of more hospital drama surfaced his head, he sighed and walked away, shaking his head.

"There-public," Mark whispered as he pulled back, "Well, kind of..."

Norah blinked at him speechlessly, feeling a little dazed.

"Aw, you're blushing," he cooed, and she struck him in the chest. "Ow-okay, that hurt."

"You're a jerk, Mark Sloan," she grumbled. The half-mad yet completely flustered look on her face made his smile grow.

"I'll be watching from the gallery," he grinned, kissing the top of her head. "I'm proud of you, Laurie. See you in a bit!"

❦ ❦ ❦

THE GALLERY WAS SLOWLY filling up with residents, interns and attendings, all interested in the first solo surgery among the second-year residents.

Mark walked into the gallery and sat in the front row, leaving a space between him and Meredith. Timothy came in shortly after and took the seat next to the plastic surgeon, with Lexie on his other side.

"Bold move out there," Meredith commented with a smirk.

"I didn't even think of doing it," Mark admitted, "It just... happened."

"Does Derek know?" she questioned, and he turned his head to her, the smug look on his face slowly draining. "Oh, so he doesn't know that you're dating his favourite student?"

"No, not yet. But I-Oh, hey, Derek! Hey, man-I saved you a spot!" Mark quickly switched the subject when the neurosurgeon entered the gallery. Meredith snorted and shook her head; Timothy had put on the best poker face he had.

"Thanks," Derek replied and sat down between Meredith and Mark, kissing the former on the cheek. There was an odd silence before he turned to his best friend. "I heard an attending kiss a resident today," he shared.

Mark nearly choked on air before he turned to his best friend. "Really?" his tone was a bit higher than usual, smiling back at the other attending; Timothy and Lexie were holding back from bursting into laughter. "Do you, uh... Do you know who?"

Derek shook his head. "No, I was thinking that you would know."

"Oh? Um, w-why would I know?"

"'Cause you're a world-class gossiper," Derek stated matter-of-factly, and Mark shrugged back, feeling the sweat beading on his forehead. Derek leaned forward to look at the interns. "Lawrence, do you know?"

Timothy grinned at the attending while Mark sent him an urgent look through widened eyes. "Oh, nope, nuh-uh. I was busy collecting bet money after Nor was chosen."

"Grey?"

Lexie shook her head, too. "I was busy paying the bet."

"Huh..." Derek leaned back against his seat just as the OR doors opened.

THE CONFIDENT STEPS Norah took while she walked into the OR did not go unnoticed by everyone. She stretched her hands through the surgical gown before putting on her gloves with the help of the scrub nurse. George followed behind her, along with her two interns.

"It's a full gallery," Jace pointed out in awe.

She looked up to the gallery now packed with people watching her. To say that she was not nervous was a big lie, but the feeling of pride and accomplishment was enough to cover up her jitters.

Most of the residents in her class were observing; Bailey and Derek had proud looks on their faces; Mark gave her a big grin through the glass, and she returned it with a smile under her mask.

She walked towards the middle of the OR, walking to the side where lead surgeons stood. Webber was reading a magazine at the corner of the OR, ready to step in whenever needed.

Enjoy your magazine, Dr Webber, she said in her mind, I can do this.

"Fifty says she calls the chief in ten minutes."

"A hundred she chokes before they turn on the saw."

"Hey. That's one of us down there," Meredith snapped at them, "Show some respect."

Jealous much? Norah smirked to herself. "Marker, please," she requested, and Bokhee handed her the pen. She drew the line about the amputation with George holding the patient's leg steady.

"Imagine if Nor marks the wrong leg," she heard Timothy

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