Bailey: "Jake and Peter Weitzman, 35-year old pygopagus conjoined twins attached at the lumbosacral junction."
Jake: "But not for long. Right, Dr. Webber?"
Richard: "The Weitzmans came about 6 months ago for a separation procedure. They opted out because of the risks."
Jake: "Pete chickened out."
Pete: "Forgive me for wanting to live longer even if it meant living with you."
Jake: "Well, you wasted 6 months of our lives. Thank you."
Pete: "Stop it."
Alex: "You guys came at the right time. We scored New York's top plastic surgeon."
Richard: "Mark Sloan. You remember Dr. Shepherd, your neurosurgeon and Dr. Rivers." he says as the three doctors shake the brothers hands
Mark: "We used to work as a team."
Derek: "We worked together. We were never actually a team."
George: "Mr. Weitzman?"
Both: "Call me Jake. Call me Pete."
George: "Jake, Pete. Why...do you mind me asking why now, when you thought the procedure was risky six months ago?"
Jake: "Well."
Woman: "Guys?" she says coming into the room and seeing everybody turn to face her "Whoa. That's a lot of doctors. I'll just come back later."
Jake: "No, no. Elena, come in, come in. You wanted to know "why now"? This is why. The love of my life. Elena."
Elena: "Jake, don't. I told him not to do this. Not for me anyway because that's just crazy. Because Pete said that they could end up paralyzed. He could end up dead."
Jake: "Why do you tell her things like that for?"
Pete: "I wasn't telling her, I was telling you. She just happens to be the only one who listens."
Derek: "She happens to be right."
Jake: "Do you know what it's like to have to be stuck to the same person? Every-"
Pete : "Here we go."
Jake: "That's right. What it's like to have to be with the same person every minute of every day? To not have anything that's just yours? Not be able to do anything on your own? Nobody should have to live like that."
Sky: "What do you think, Pete?"
Pete: "Why would I want to be attached to someone who doesn't want to be with me?"
➿
Sky: "Conjoined twins, Derek." she says as they sit in a room and look through the twins scans
Derek: "I know."
Sky: "Conjoined adult twins. I mean, it's rare enough to separate conjoined infants, but conjoined adults? Why are you not more excited about this? Do you know how crazy this procedure is?"
Derek: "Yeah I do. Which is why I don't think we should do it. Their spines are fused from the L4 down. Their blood flow is intricately connected. They could end up paralyzed or even dead."
Sky: "The patients want this operation, Derek. Why are you backing out? This isn't like you. Unless there's incontrovertible evidence that it can't be done, we're moving forward."
➿
Izzie: "Twenty-two surgeons. It takes 22 surgeons to do this." she says as they practice on a dummy patient
Richard: "So where are we?"
Derek: "I've gotten to the cauda equina."
Sky: "I'll be working on the musculature of the perineal floor."
Mark: "I'll be harvesting the sural nerve for transfer."
Derek: "And once I resect this artery, we'll have less than two minutes before all sensation to these nerves are gone."
Sky: "I'm pretty sure we'll have enough nerve to transfer and cover the deficits. We can definitely do this." she says trying encourage him when one of the wires break
Derek: "Oh, damn it. It's going to be a lot more fragile in the body. It's one thing if this is a life or death situation and this is all we can do to save them, but these guys are fine. This isn't worth the risk." he says throwing the instruments down and storming out the room
➿
Derek: "All these cables of nerves. Oh, God. I can't do the surgery, Sky." he says as he practices some more on the dummy body
Sky: "Yes you can. Is this about Burke?" she asks making him sigh out
Derek: "I told Burke I could fix his hand and-"
Sky: "You did."
Derek: "Yeah."
Sky: "He is not paralyzed or disabled in any way. He has a tremor. And if he'd been honest about that, instead of worrying about his stupid ego. It could've been fixed a long time ago. You're a great surgeon Derek. Don't let the fact that Burke wants to act like a 5 year old and throw a temper tantrum make you think any different. You can do this." she says as he smiles at her in appreciatveness
➿
Mark: "Dr. Bailey, I'd like my intern to observe from a better vantage point." he says after they begin the twins surgery
Bailey: "Dr. Stevens?"
Mark: "Yes. She's my intern today and I'd like her nearby during surgery, not up in the gallery, if that's ok with you."
Bailey: "No problem."
Richard: "Dr. Bailey, Stevens is without privileges."
Bailey: "Oh, because she messed up? Dr. Yang messed up and she's over in OR 2 right now. Can you hit that for me?" she asks one of the nurses as she speaks into the mic in the gallery "Stevens? I take it you remember how to scrub in? Come on."
Derek: "This vessel is even more fragile than in the bio-model."
Mark: "Let's do a microvascular bypass graft. I could harvest the saphenous vein while I'm down there."
Derek: "I don't know if that's a good idea."
Richard: "We need to make a decision now."
Richard: "Derek, it's your call. Do you or don't you want to proceed?" he asks as Derek looks around the room before looking at Sky who nods her head at him
Derek: "Ok, give me a ten blade."
Sky: "Let's get some suction in here, please. Thank you."
Derek: "Saphenous vein graft in place?"
Mark: "Yeah. I'm ready."
Derek: "Dr. Rivers?"
Sky: "I'm good."
Derek: "Chief?"
Richard: "Ready when you are."
Derek: "All right. The moment of truth. Removing the clamps."
Richard: "Dr. Bailey, check the nerve stimulator."
Bailey: "SSEPs are falling."
Derek: "Pump up the blood pressure. We need as much blood as possible."
Bailey: "I'm going up to two milliamps. Up to three."
Sky: "Wait a minute. I see something. A flicker on the hamstring of twin A."
Mark: "Anything on twin B?"
Richard: "Pump it up some more."
Bailey: "Ok, up to four."
Derek: "A twitch! I got a twitch in twin B's gastroc."
Richard: "It's small, but it's there."
Bailey: "We have a signal."
Derek: "Congratulations, ladies and gentlemen, we have four functioning legs!" he says as everybody claps and him and Sky bump their elbows together
Richard: "Good job, everybody."
Derek: "Aah." he breathes out in relief
Richard: "Ladies and gentlemen, on three. One two three." he says as they slowly pull them apart and begin working on each one separetly
Derek: "It'd be nice if every love triangle could be fixed with a scalpel."
Mark: "If they could, you'd have stabbed me with a ten blade a long time ago." he says as they both laugh