- - -
the harder the hit, the more it'll sting. that's usually the case. so we prescribe meds, ice, compression, elevation. things you do to stop the immediate pain.
- - -
"andrew perkins hasn't signed off on her," richard shakes his head, walking from the conference room to the nurses station, as lia and owen follow him. "you disagree with him?"
"no," owen protests. "keeping residents out of the o.r until they're ready is the right approach for them, but not for cristina."
"she won't feel like herself until she's back in surgery again," lia adds. "you know yang."
"i do," richard nods. "and you want to start her on an ex-vivo heart reconstruction? i thought you were smarter than that, alivia."
"this is a once in a lifetime-" lia begins to protest.
"it is a hell of a lot of pressure is what it is," richard cuts her off.
"well, she helped me operate on- i mean, she helped me save derek shepherd with a gun to her head," lia reminds him. "i don't think that pressure is the issue for her."
"we owe her this, richard, and she needs it," owen insists. "put her back in the game."
■ ■ ■
"linda cotler, age fifty one, has been here three times in the last eight years for removal of malignant myxomas from her heart," jackson reads the chart to lia and they stand with cristina in the patient's room.
"but we won't be doing that again," linda adds.
"no, by removing atria, and hopefully all of the cancerous cells, you won't have to keep coming back here," lia reassures her, and she nods.
"hello, dr. yang," linda looks past lia to cristina. "nice to see a familiar face."
"finally, someone we know," mr. cotler sighs in relief.
"mrs. cotler was a patient of dr. burke's," lia explains, turning to cristina. "you assisted on her last myxoma removal."
"of course. of course," cristina nods, stepping forward. "hi."
"nice to see you again," linda tells her.
"well, uh, sit tight, and we'll be back in with some forms for you to sign, and then we'll take you up," lia smiles.
"thanks, dr. webber," linda nods.
■ ■ ■
"i'm sorry," mr. cotler raises his voice slightly, looking over the forms for his wife's surgery. "why is this better than what dr. burke did?"
"dr. burke's approach was conservative and correct for the first few surgeries," lia calmly explains. "this is radical and risky, but-"
"well, it sounds like it's gonna kill her," mr. cotler cuts her off.
"linda's heart wall has grown weaker with every surgery, so there are greater odds of cardiac rupture," lia informs him, maintaining her calm tone. "this may be her last chance."
"paul..." linda turns to her husband. "honey, every two years, we come here, they cut me open, and i watch it take ten years off your life. i can't do it anymore. and neither can you."
"what about you?" paul looks to dr. yang. "do you think this is the best idea?"
"oh, i'm not, um-" cristina shakes her head.
"because what you and dr. burke did, it's kept her with me so far," paul adds. "if this was your husband, would you let dr. webber tear apart his heart?"
"yes," cristina nods after a moment of silence. "an aggressive approach is your only option. this is what you want."
"okay. alright," paul exhales deeply, before hugging his wife.
"okay," lia smiles. "we'll see you in there."
■ ■ ■
"i'll resect both atria, and build new ones out of bovine pericardium," lia explains to cristina, mark, and jackson, demonstrating on the virtual o.r table. "and during reconstruction, dr. sloan will stay with linda, using a human donor aorta to prepare the vessels for reimplantation."
"and all of this in just four hours?" jackson raises a brow.
"we have to be fast," lia warns them. "we all set?"
"let's go," jackson grins with enthusiasm.
"alright," lia nods. "prep her and page me when she's ready."
they all turn to leave, but cristina remains stood looking at the virtual o.r table. lia realises and stops at the door to look back at her.
"cristina," lia says and the resident looks up. "are you excited?"
"yes, absolutely," cristina tells her.
"good. good," lia nods, and then leaves. she begins walking down the hallway, unaware that mark had stopped outside to wait for her.
"you sure your up for this?" mark asks, beginning to walk with her and she jumps at his presence.
"mark... i'm fine," lia warns. "i'm back, and i told you that i don't need you to keep checking on me. i just need you to prepare the vessels."
■ ■ ■
"alright," mark says at the beginning of linda's surgery. "the heart is ready."
"okay. here we go," lia nods. "start the clock. dr. yang... take the heart please."
cristina removes mrs. cotler's heart, and turns around to take it to put it on ice. when lia looks up, she notices mark is staring at her.
"what?" she frowns at him.
"nothing," mark says quietly, looking back down at at mrs. cotler's open chest.
lia rolls her eyes, before heading over to where cristina is placing the heart in a metal bowl of ice, and when she does so, mark looks back up at her.
"alright. here we go," lia says, wiping her gloved hands. "excising the right atrium. welcome back, dr. yang."
"thank you," cristina replies, whilst assisting lia.
■ ■ ■
"time, please," lia requests in the middle of the surgery.
"two hours and forty two minutes," mark tells her.
"we're behind," lia sighs. "dr. sloan, where are you at?"
"putting in the aortic graft," mark informs her.
"this tissue is more than i need," lia states, handing it to cristina. "dr. yang trim this pericardium, please. three centimetres."
"avery, give me some irrigation in here please," mark asks jackson.
"sure," jackson nods, and turns around. as he does so he knocks an instrument tray, creating a loud clatter of instruments. "sorry. sorry. sorry. sorry."
lia jumps slightly at the noise coming from behind her, but remains calm. "alright. are we alright?"
"it's alright. it's alright. it was just a tray," mark assures her. "the aortic cannula is dislodged. avery, some suction in here, please."
"mark, talk to me," lia calls over.
"i need a purse string in the aorta," he informs lia. "avery, give me some more visualisation in here, please. get in there."
"yang, come help me. yang?" lia calls, and when she doesn't get a response she looks around the o.r where she sees cristian's legs sticking out from under a table. "cristina, talk to me."
"oh, damn it," mark groans. "grab the aortic cannula. hold it there."
"cristina, you are okay," lia attempts to reassure her, as she continues working on the heart. "can you get up? jackson, i need that tissue now."
"is it usable?" mark asks.
"no," jackson shakes his head.
"time, please," lia requests again, becoming slightly panicked that they're running out of time. "time!"
"uh, two hours, forty five," jackson tells her.
"alright, jackson, call down to the pharmacy and get another piece of tissue please," lia instructs him.
"no, don't call," mark shakes his head. "yang. yang, you go. go now and get one. run. go."
"look, i'll just go," jackson removes his hands from the patient, due to cristina's lack of response and the fact she's still on the ground. "i got it."
jackson runs out of the o.r, and lia and mark continue to work until meredith runs in holding a scrub mask to her mouth. she runs past lia and crouches down next to cristina.
"cristina," meredith says, moving so that she's lying on the o.r floor in front of her.
"i can't be in here," cristina breathes. "i can't."
"okay, so let's go," meredith says softly. "let's get out of here."
"i can't- i c- i cant feel anything," cristina cries.
"i know," meredith nods. "i know. come with me."
"no, no," cristina's voice begins to break. "i... i cant move. i can't move my legs. i can't- i can't feel anything."
"um..." meredith begins with uncertainty, removing cristina's glove and taking her hand. "f- f- feel my hand. take my hand. do you feel that?"
"uh- uh-huh," cristina breathes erratically. "uh-huh."
"okay," meredith nods. "you're okay. we're gonna go when you're ready. okay? so you tell me when you're ready, okay?"
- - -
but you can only dull the pain for so long, and when the drugs start to wear off, it really hurts. there's a reason these fixes are called temporary. they were never meant to last forever.
- - -
meredith is leading cristina through the hospital, away from the o.r floor, with her arm around her when mr. cotler sees them, and stands up from his seat in the waiting area.
"is it over?" he asks from behind them, and both surgeons spin around. "how is she?"
"oh, i'm- i'm sorry," cristina's voice breaks, as she turns and walks away. mr. cotler's eyes begin to fill with tears.
"no, no, no, no," meredith reassures him. "no- i- i- she's fine. uh, the doctors are still working, and someone will be out when they're finished."
meredith then turns to run after cristina, leaving mr. cotler very confused about the well-being of his wife.
- - -
so what happens when you're faced with a fix that's more permanent? do you fight it? do you try to resist? or do you step back and decide that maybe acceptance is the best fix of all?
- - -