Chapter 34

"Eight surgeons have said this is inoperable, even the tumor board at Cleveland clinic." I say as Derek and I look at the scans of a huge tumor. For the past month Derek and I have been operating on risky tumors, that most doctors wouldn't go near. That probably wasn't the best idea for me considering I need to avoid bad outcomes, but what can I say? I'm a tumor junkie and fortunately I'm still at zero bad outcomes.

"Well I can see why. Catch." Derek says before throwing me a quarter.

"What's this for?" I frown.

"Heads we do it, tails we don't." He smiles.

"You're insane, we cannot just let a coin decide if we operate on this tumor."

"It's a gut check, I get a feeling when it's in the air, what I want it to land on. Flip it." He smirks, before I flip the coin into the air and catch it, it lands on heads meaning we're doing the surgery. We look over the scans for a little while longer before going to talk to the patients mother since he's a minor.

"His neuroblastoma is more complicated than most we've seen. It's very rare that someone has age..." I say.

"They're mostly in younger kids, I know." His mom says.

"It's in a very large region of his spine." Derek says.

"There is the very likely risk of paralysis." I say.

"From his upper body down, there's also the risk of death, a death that he is gonna meet in three months anyways if you don't do surgery. I understand the risk. The surgeon in Boston compared it to dismantling a bomb with your eyes closed and the one in Chicago said it was patching a dam with gum, so what I want to know is if you two are gonna say anything different or do I have to take my kid somewhere else?" She asks.

"There's only a 5 percent chance of success, maybe a little less, but if you're willing we'll try." Derek says causing her to hug both of us.

"Okay, should we go tell Wes?" I ask.

"Wait there's something else. He doesn't know about this tumor. He's 11 and knowing that he's very likely gonna die is not something that's gonna do him any good." She says.

"Why does he think he's here?" I ask.

"A backache, a very bad backache." She says. We go into the room and examine our patient before I take him to get some X-Rays. After finishing his X-Rays I help him back into his wheelchair.

"Did the tumor grow more?" He asks me.

"What did you say?" I frown.

"I know what I have. I overheard some doctors talking about it at the last hospital. I didn't tell my mom that I know, she'd just freak out."

"She's your mom, she needs to know." I say.

"She cries in the bathroom, she cries at night, she cries in the morning when she thinks I'm not awake yet, she cries all the time and the only thing that makes her happy is to think that I don't know. You can't tell her. If I'm happy, she's happy." He says.

"Okay, I won't tell her." I sigh.

"You're not lying?" He asks.

"I'm not lying." I say making him smile.

"Do you think I'm gonna die?" He asks me.

"Dr. Shepherd and I have worked together on some tough cases, you and your mom couldn't ask for a better duo to help you." I assure him, before taking him back to his room, then I go to residents lounge where Alex, April, and Jackson are eating and grab my lunch before sitting by Jackson.

"I need food for Zola's party. I thought I was gonna have time to go to the store, but Richard's 10,000th surgery is gonna take forever. You think Teddy's gonna care if I take one of her widow casseroles." Meredith asks. Her and Derek ended up getting Zola back a month ago, the day after we had our incident in the ambulance. They've both pretty much been on cloud nine lately.

"No, go for it. You know what take this one too, it's turkey tetrazzini." Cristina says walking into the lounge.

"Hey, I meant to ask you why are there like a thousand throw pillows in the house?" Jackson asks me.

"Because when I was off yesterday I felt like something was missing and I realized it was throw pillows. I mean what house doesn't have them?" I shrug chewing on my food.

"She's right every house needs throw pillows." April agrees.

"You know I hate those things, there an inconvenience. When I wake up in the morning I don't want to spend the first five minutes of my day rearranging those stupid pillows." He says.

"Well I like them, so they're staying." I shrug.

"Are you two seriously arguing over throw pillows? You sound like an old married couple." Alex says making me laugh before my pager goes off.

"I gotta go." I say taking one last bite of my lunch before going to Wes's room so I can take him to surgery.

"Are you ready?" His mom asks me.

"Yeah, but I can give you a few more minutes." I smile.

"No, we're ready. Wes time to put the computer away. You are gonna be okay and the doctors are going to take really good care of you." She says blinking back tears and hugging him.

"Mom, don't cry." He says.

"You know me. I cry when you leave for a sleepover."

"Well don't. Dr. Garcia and Dr. Shepherd are the best duo I could have to help me." He smiles.

"You're right as usual." She laughs giving him one last goodbye and a hug before I take him to the OR and get scrubbed in.

"It's wrapped around more of the vessels than the scans showed." Derek says after we open him up.

"I think we should still start with the T-4 since there's no clear prevertebral plane." I say.

"Okay." Derek says.

"Derek, we have to get this tumor. If we don't we just opened this little boy up for no reason." I sigh before focusing back on the surgery, we continue to try to find a way to remove the tumor, but we are having trouble.

"How about once the vertebrectomies are complete we take the tumor down off the dura and do a myelotomy." I suggest.

"We'd hit the adamkiewicz. He'd be paralyzed and dead in three months." Derek says.

"Okay, we can resect it free from the aorta." I say.

"Spinal shock, dead." Derek says.

"Harvest a radicular branch that doesn't have tumor involvement."

"Dead again."

"Derek Christopher Shepherd, stop saying that." I say raising my voice in frustration.

"Dr. Garcia." Derek says in a stern tone.

"No, we said we would try. You're not even trying." I say.

"Because the surgery will kill him. We have to close him up." Derek says.

"No." I shake my head.

"Dr. Garcia you're thinking with your emotions, not as a surgeon. I think it's time for you.." Derek says.

"No, you're quitting and it's not right. We owe him that 5 percent chance of survival."

"There's no longer a 5 percent chance."

"Derek, we're not stopping. He knows about his tumor, he's known all along and I told him he had the best duo he could ask for to help him. Please Derek, we have to do something." I say.

"Leave the OR right now." Derek says making me sigh, before walking out. I hate days like this, knowing a patient is going to die sucks, but when it's a kid it's even more heartbreaking. I meet Derek in Wes's room, so we can tell his mom the news then we go into Wes's room as he wakes up.

"The surgery wasn't as hard as they first thought, which is good, 'cause that means we can make it to Hawaii now, you're done. No more surgeries or doctors, that's it. It's just us and we're gonna go on another trip after that too, maybe even Normandy like we said, doesn't that sound fun." His mom says to him with tears running down her face.

"You didn't do it." He says looking at Derek and I.

"Do what?" Derek asks.

"You said after the surgery I'd be stuck in here for a few weeks."

"That's right. I did, but sometimes when we get in there things change, that's why you get to go home." Derek says.

"Honey, it's all gonna be fine. You're gonna be okay. Mommy's gonna make sure of it and you don't have to worry I promise." She sniffles.

"You're gonna be okay too, you don't have to worry about me. I'm gonna be with dad in heaven." He says causing her to cry harder. I excuse myself out of the room and go to the locker room to get out of my scrubs. My shift was over and I was more than glad, because today was just depressing. I wait for Jackson to finish up his surgery and he changes also, before we head over to Meredith and Derek's for Zola's birthday party, I really wasn't in the mood, but there was no way I was missing Zola's party. Jackson and I give Meredith, Zola's present before going to the couch to sit down.

"You still down about your patient today?" Jackson asks me.

"Yeah." I nod.

"If it makes you feel any better, we can keep the throw pillows." Jackson says wrapping his arm around me.

"Avery, we were keeping them anyways." I say making him laugh.

"Of course we were. I'm about to go get some food you want something?" He asks me.

"Just a bottle of water." I say.

"Okay, I'll be right back." He says kissing me before walking away. A couple of seconds later Derek walks over to me carrying Zola.

"Take the baby, she'll make you feel better." He says handing me a smiling Zola.

"Her smile is contagious." I smile as I hold her.

"I know today was hard, but they're not called loss causes because they're fun." Derek sighs.

"I don't need them to be fun, they just can't be like today." I sigh.

"Okay, how about this heads you keep doing lost causes, tails you can do the boring stuff that doesn't challenge your potential." He says pulling out a quarter.

"Derek, you know that I don't do boring. I'm in I want to keep doing lost causes." I say.

"Good, now I need to take Zola and find Meredith, but before I go.." He says before pulling out a camera and taking a picture of him Zola and I. "Memories." He smirks making me chuckle before picking up Zola and going to find Meredith. Jackson comes back over and sits beside me eating his food, after he finishes we go socialize with everyone before Meredith and Derek bring out a cake for Richard. Today was his 10,000th surgery, but he didn't get to celebrate it, because Adele was having a rough day because of her Alzheimer's. As Richard starts telling us about his first surgery he's interrupted from Owen and Cristina's yelling at each other in the kitchen so Meredith goes to see what's going on.

"You killed our baby, you don't ever forget that." Owen yells making the whole house go silent.