Chapter 83

"Derek, why is there suddenly an order for carbamazepine in Eric Schneider's chart?" I ask walking over to the front desk where Derek is standing.

"He needed a good anti convulsant." He says.

"And I know that. That is why I had already written him one for valproic acid. You can't just go around writing orders on my patients." I say sternly.

"I'm doing my job." He smirks.

"No, you're doing my job. I am the Chief of Neurosurgery now and if you have a problem with that, call a board meeting but until then, do not go around changing my patients prescriptions." I say before walking away. Derek has decided to stay in Seattle, because he doesn't want to move across the country while his wife and children are in Seattle. I'm glad that he's staying, but we've definitely been bumping heads more than usual because he acts like he's still the head of neurosurgery and undermines what I want for the department. I get that he's used to running the show, but it's my job to run this department now and I need him to follow my rules like all of the other surgeons in this department so I can do my job efficiently.

I go check in on my post ops from earlier, before I'm paged 911 to the E.R. As soon as I get to the patient's E.R. room to start examining him, Derek is already in there working on him also, which he's did on pretty much all of my big cases lately.

"I need to assess his GCS." Derek says.

"Sir, can you tell me your name? What's your name?" I ask.

"Steve." The patient answers.

"Forget your helmet today Steve?" I ask.

"Aah, it hurts." He winces as Derek examines his head injury.

"I'm giving you something for the pain. You might start to feel sleepy now." April tells him.

"It's a depressed skull fracture. It is pretty deep. We're gonna need a C.T. and because of the position probably an angio." Derek says.

"You know, this is my patient. I can make that decision if you'll give me room to look." I say walking over to get a better view of the fracture before Derek stops me.

"Lily, I don't think he's gonna make it and it's gonna get ugly, so let me do it." He whispers so that the patient can't hear him.

"Derek, you're not the only one who can operate on cases like this. I am just as capable as you, now let me tend to my patient please." I say.

"Maybe you can both take him. Like a team or like best friends, who actually like operating together." April smiles.

"I have him Kepner, you'll assist. Now let's go up to C.T." I say before we take the patient up to run test on him. While April runs the scans on the patient, I go grab a granola bar before meeting Jackson at the front desk.

"My best friend keeps trying to steal all of my surgeries." I say as I chew on my granola bar.

"At least, you have surgeries worth someone trying to steal. Between picking someone to fill Yang's seat on the board and monitoring all the projects around this hospital, I'm down to three procedures a day if I'm lucky and not even long procedures. I'm sucking fat, lifting boob's, butts. Butt implants are huge. I just want a good, intense, smart surgery. The ones where your feet hurt because you've been on them for hours or your mind hurts because you've had to improvise and paint surgeries of joy, but I can't have those because I'm head of the board." He sighs.

"Poor thing. If it makes you feel any better I have a little bit of free time until Kepner finishes running scans on my patient." I smirk.

"That does make me feel better." He smiles before taking my hand and leading me to a on-call room, where we have a little fun until I'm paged by April because it's time for me to operate on the patient. Because of how badly his skull is fractured the operation takes longer then normal, but I manage to repair the fracture before taking the patient to recovery.

"How's our motorcycle guy?" Derek asks joining me as I walk to the front desk.

"My motorcycle guy is great. I fixed him like a boss, which I am the boss." I smirk.

"Liliana, you're an excellent surgeon. You have nothing to prove."

"I know that." I say as I set my chart down.

"But if you try to fight me over the leadership of this department, you will lose. My résumé will kick your résumé's ass. I am better then you." He says.

"Derek, you are being such a narcissist right now. You do not own this department." I frown.

"I have been playing this game longer then you at a much higher level. That is all there is to it."

"Bite me." I snap sarcastically, before walking away. I go to take a quick nap, since I've been operating all day, but shortly after I fall asleep, April pages me and tells me that my patient has to go back to surgery, but to my surprise when I go to take him up to surgery, Derek has already taken him to the O.R., so I rush to the O.R. so I can take over and finish my surgery.

"Gown and glove me." I say as I walk into the O.R. and the nurse gives me my trauma gown and gloves. "I can not believe you Derek Shepherd!" I yell.

"Suction." He says to the nurse "Lily, you don't have to scrub in.?I've got it here." Derek says.

"Yes, I do. I want to be sterile when I come over there and stick that bovie in your eye." I say. "Kepner, move." I say taking April's place and standing beside Derek.

"Lily, he never had a good prognosis. I went in endovascularly to fix the aneurysm, but he started rebleeding." He explains.

"I can see that. Fibrin glue." I say as I start assisting with the surgery.

"Now, why is that suction not working? Okay, can somebody change the canister?" Derek says.

"Got it." The scrub nurse says.

"Lily." Derek says as the monitors begin to go off as the patients brain starts bleeding.

"I see it. 100 of mannitol, 125 of solu-medrol." I say.

"He's gonna herniate." Derek says.

"He may not have time to herniate." I say looking over at the screen to see that the patient has a rapid nose bleed. "He's in florid D.I.C. he's not clotting anymore." I say.

"Knox, check his pupils." Derek directs the nurse.

"Fixed and dilated. There's no gag reflex." The nurse says.

"He's probably already brain dead." Derek says before we stop operating and call it.

"35 year old male, admitted status post-ejection from a motorcycle without a helmet. Head C.T. revealed..." I say into my voice recorder. After all off my surgeries, I always record a overview of every step taken during surgery. "What do you want?" I frown as Derek walks into the O.R. where I was sitting as the scrub nurse finished organizing the O.R.

"I'll do the op note. If you want."

"No, you don't have to steal this part too." I say rolling my eyes.

"Stealing? No, I'm just trying to help you. This guy was a lost cause." Derek says.

"Whether he was or wasn't, he was my responsibility and my patient. I didn't need your help, I still don't need your help and I don't need anymore of your bullying. I am a perfectly capable surgeon." I say as I stand up.

"Bullying? I am trying to be nice." He says.

"No, no you are not. Ever since you decided that you're staying in Seattle you act like I am below you, like you are so much better than me, but you are not. I am just as talented as you and you know it. I get that it's hard for you to except that you're not the big boss anymore. You were the king of all neurosurgeons, right hand to the president and now you can't have that, so you need to be king of the hospital again and kick around everyone else." I frown.

"You of all people should understand that this was the future of neuroscience. I mean this is what we would've dreamed of in med school, if we'd thought it was even possible that it could be done." He says.

"Then you shouldn't have given it up, but the least you can do is stop stomping around here punishing me for the choice you made to stay!" I yell.

"I didn't make a choice. Meredith made a choice and backed me into a corner and because I love my kids and I love my wife and I want to do what's best for her, I do. I want to give her everything, but something like this will not come again. This is it. This is as high as I go. I have never taken a step back in my career ever. I've never felt like this before and I feel like she forced me."

"And I am sorry that you feel that way and I am sorry that you were put in a position where you had to give that opportunity up, but you do not get to take your urge to have power out on me. You're my best friend, Derek. You trained me and made me the surgeon I am today, and I appreciate it, I appreciate you. But I am the Chief of Neuro now and I deserve this position and just because you helped me build my career, doesn't mean that you will control it, undermine my authority, or blatantly disrespect me like you have been doing these last couple of days. You do not get to control when I am great, when I am extraordinary. That is not on your terms. You do not get to push me to the side because you want to be the boss again, that is not how this is going to work. I am the boss of this department now and you will respect me and you will follow my rules like everyone else and if you undermine me and pull some crap like you did today again I will have you suspended from operating and have Amelia take over all of your surgeries." I say sternly before leaving the room. I hate arguing with Derek, but I'm tired of him disrespecting me and fighting me everytime I tell him something. I'm so appreciative of Derek as my best friend and for everything he's helped me achieve, but I'm not going to keep letting him treat me like I'm not worthy of this position. After the argument Derek and I had, I just wanted to go home and go to sleep, but there's a board meeting for us to vote whether it'll be Alex or Bailey who gets to take over Cristina's vacant board seat. All of the board members gathered in the board room and listened to both sides tell us why they deserved to be a part of the board. After listening to both sides, we made the decision to pick Bailey as the new board member, because overall she has more experience. After congratulating Bailey, everyone is released from the meeting and Jackson and I go change out of our scrubs before going home.

"So I hear you and Derek got into a pretty heated argument today." Jackson says as I lay down beside him in bed after taking a shower.

"Who told you that?" I ask.

"The scrub nurse."

"I forgot she was even in the room." I sigh.

"Do you want to talk about it?"

"No." I say. "You know, Derek has some nerve acting like I don't deserve this job. I do deserve this job, I earned it. Yes, he helped me build my career, but it's my work, my focus, my determination that's gotten me here and I will not apologize for being the boss now, and as my best friend he shouldn't ask me too. He should be proud of me and help guide me through this change instead of making my life even harder. I shouldn't have to threaten to kick him off of surgeries to make him stop undermining me." I ramble.

"Are you about to cry?" Jackson asks.

"No...yes." I sigh as tears begin sliding down my face.

"Come here." Jackson says as he wraps me in his arms.

"I'm just so frustrated. I hate arguing with Derek." I say.

"I know you do, but you're doing the right thing. You're the head of neuro now and you can't just let Derek do anything he wants and disregard everything you tell him. I know he's your best friend, but when you're at the hospital you have to treat him like all of the other surgeons that are a part of your department." He says as he wipes away my tears.

"I know. This is my job now, but I just hate being the bad guy." I say.

"I know, but you're just doing what you have to do. You shouldn't feel bad about that. You need to stop beating yourself up, stress isn't good for you or the baby." He says as he rubs my stomach.

"You're right." I agree. Even though I hate the situation I'm in with Derek right now, I'm only doing my job, the job he picked me for, so he's going to respect me rather he likes it or not.