one hundred fifty five

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standing in the radiology gwen was looking at some ct's together with derek, who she asked for a consult.

"you asked for a consult. this is my-"

"that's not the point." gwen cuts him off. "i have to control the infection."

"surgery first." derek insists. "she has an abscess-"

"if i don't operate, she will die." gwen says.

"let's have one conversation." owen interjects the siblings making them shut their mouth.

"meredith, what do you need?" derek asks her as she entered the room.

"gwen paged me." meredith explains.

"yeah, i need a general consult on her chest." gwen looks at her.

"what about webber?" derek asks his sister.

"i paged meredith." gwen states.

"shepherd, make your case." owen looks at gwen making derek sighs annoyed.

"i respect my brother's opinion, but i need to go in first to debride the infection before it shuts down her heart, her lungs, all of her organs. and she is my patient." gwen clarifies looking at derek. "i paged you for a consult, derek."

"i'm sorry, but if the ventricle ruptures, it could be catastrophic." derek says. "i can't sit back and let that happen."

"if you go in first, she will die on your table." gwen reminds him.

"if you do, she could come out a brain-dead patient." derek retorts. "owen, will you look at the scans? the abscess is up against the ventricle. it could cause significant brain oedema and severe meningitis."

"so, basically, you're both racing the clock on this girl." owen discovers.

"if the time hasn't run out already." derek says.

"we'll know if her heart stops." gwen jokes folding her arms.

"grey, what do you think?" owen turns to her who looked at the three with wide eyes.

"i agree with gwen." meredith tells them much to derek's dismiss. "i think we get to the neck and the mediastinum first."

"look at the head ct." derek tries to convince his wife.

"i did. i still think gwen is right." meredith tells him.

"no, no, no, let me show you-"

"i know how to read a brain scan, derek." meredith rolls her eyes. "i leanerd from the best, remember?"

"all right, enough." owen speaks up. "i know what we're gonna do. let's go and talk to the patient."

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they all stood in holly's, the patients, room talking to her about the upcoming surgery.

"i'd had a root canal." holly tells them.

"last week, and it's hurt for like a week." claire, her mom, adds.

"but i figured, it's a root canal." holly continues. "it's supposedto hurt, right?"

"yeah, well, you should have told me." claire scolds her daughter. "anyway, she passed out at work yesterday, and she's run a fever ever since."

"holly, you got an infection from the dental procedure called descending necrotising mediastinitis. it's spread quickly into your neck and down into your mediastinum, which is the space between your lungs that houses your heart." gwen explains.

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