chapter nine ━ emergency contact
( season three, episode ten )

❝Me? Tense? Not at all.❞

𝐀𝐁𝐁𝐘 𝐀𝐍𝐃 𝐃𝐄𝐑𝐄𝐊 𝐒𝐀𝐓 𝐈𝐍 𝐑𝐈𝐂𝐇𝐀𝐑𝐃'𝐒 office with Bailey, Cristina, and Burke, a stinging silence filling the room. Abby glanced at Derek just as Bailey stood up in frustration and walked to the door before pausing and turning to look at the chief of surgery.

"What's gonna happen to them?" she asked, gesturing to the cardio surgeon and intern.

"What?"

"Dr. Burke and Dr. Yang—" she clarified. "What are you gonna do to them, their punishment?"

"Dr. Bailey—"

Bailey shook her head. "There's a need for justice here."

"'Justice'?" Derek repeated, furrowing his brows. He looked at Abby who simply shrugged.

"Justice has no definition within the four walls of a hospital, Dr. Bailey," Richard told her. "This isn't a court of law."

"I just wanna know what's gonna be done."

Abby tilted her head. "It's a valid question."

Richard sighed and leaned back in his chair. "Legally and technically, they've done nothing wrong. Nobody died, and there was no malpractice. I haven't made a decision."

Bailey's face hardened. "Excuse me. He—"

"He what?" Richard questioned.

Burke looked at Bailey and she clenched her jaw, looking him directly in the eye. "Nothing."

"Dr. Yang," Richard said, looking at the intern. "You'll go back on the floor with Dr. Bailey."

"Sir—"

"Dr. Bailey, am I not understanding this?" Richard asked, becoming visibly annoyed with the resident. "Does this situation directly harm you in some way?"

Bailey crossed her arms. "No, sir. I am fine."

"Then get back to work." Bailey sent one last glare at Burke before leaving the office with Cristina following her. Abby let out an exasperated breath as the door closed. "Burke, you, Shepherd, and Thompson need to come together on this tremor as soon as possible."

"He doesn't want my help," Derek told him.

"Derek—"

"I don't want his help," Burke confirmed.

"That hand is worth $2 million," Richard said, calmly but forcefully. "I want it fixed, and I want it fixed yesterday. If you don't want Derek's help, then Abby will do it. Either way, figure it out. Am I understood?" The two neurosurgeons both nodded and he looked at the cardio surgeon. "Burke?"

He let out a breath. "Yes, chief."

"Good." He leaned back in his chair. "Shepherd, Burke, you can go. Abby, could I have a word?"

As the door closed, she looked at Richard. "Is something wrong?"

"I just received a phone call from Seattle Presbyterian's chief of surgery," he began and she furrowed her brow. "It would seem that your brother is there under observation." She scoffed lightly, shaking her head. "Now, he's okay. However, there seemed to be a high level of cocaine in his system."

Abby nodded. "So he OD'd?"

"Yes."

"And nobody got hurt?" she asked. "It was just Adam?"

"Yes, but—"

"Well." She stood up and nodded. "Thank you for telling me. I'll be sure to visit when I can."

"Abby, there's—"

"I'm sorry, I can't do this again," she said, cutting off Richard. "I just—I can't. I write a check every month to a facility to take care of my sister. And it's all because Adam was high."

Richard pressed his lips together. "He's been asking for you."

"Of course he has..." she muttered, shaking her head. "Why wouldn't he? I'll visit him when I have a chance, but he isn't my highest priority anymore."

"You've been put down as his emergency contact," he told her and she sighed. "If something happens again, you'll be the first to know."

Abby nodded. "Great. Thanks, chief. I'm sorry you got the call."

"No problem at all, Abby."

She quickly left the office and found Derek and Burke on the bridge, talking about his tremor. "—I don't want another surgery," the latter was saying.

"It could be a small clot," Derek said, trying to convince him otherwise. "I just go in—"

"Shepherd." Derek sighed and hung his head. "I don't want another surgery. The first one caused enough damage."

"I can do this," he insisted. "Abby and I... we can do this."

Burke scoffed in disbelief. "That's what you said last time. Now I have a tremor."

"Which could have easily been resolved if you had told us," Abby said, walking over to the two men. "I get it. You're pissed. But the bottom line is that you never told us. We're neurosurgeons — your surgeons... it's our job to work on nerves and we had to find out about it because O'Malley brought in Erica Hahn? Yes, it didn't go to plan. But we don't get the full blame. Some of it's on you for not telling us."

Derek tilted his head. "She's got a point." Burke walked away with a huff and Derek looked at the brunette. "You okay? You seem... I don't know... tense."

"Me? Tense?" she repeated, shaking her head. "Not at all."

Richard walked out of his office and found the two neurosurgeons. "Ah, Thompson, Shepherd. We got a case."

Abby let out a breath. "Thank God."

___________________________

"𝐉𝐀𝐊𝐄 𝐀𝐍𝐃 𝐏𝐄𝐓𝐄𝐑 𝐖𝐄𝐈𝐓𝐙𝐌𝐀𝐍, 𝟑𝟓-year-old pygopagus conjoined twins attached at the lumbosacral junction," Bailey presented while Abby read the chart over Derek's shoulder and Mark walked around to get a better look.

"But not for long, right, Dr. Webber?" Jake asked.

Richard nodded. "The Weitzmans came about six months ago for a separation procedure," Richard said, looking at the three interns. "They opted out because of the risk."

"Pete chickened out," Jake clarified.

Pete shrugged. "Well, forgive me for wanting to live longer, even if it meant living with you."

"Yeah?" Jake asked. "Well, you wasted six months of our lives..."

"Oh, come on."

Jake nodded. "Thank you very much."

"Stop it."

Abby looked at Mark and leaned closer to his ear. "They remind me of Ana and Aiden," she whispered.

He glanced between them and nodded in agreement. "I can see it," he replied quietly. "Except for the whole 'conjoined at the back' part."

She chuckled softly and turned back when she heard Alex's voice. "You guys came back at the right time," he said. "We just scored New York's top plastic surgeon."

"'New York's top'?" Abby repeated, raising her eyebrows and Mark smirked at her.

"Mark Sloan, plastics," Richard said to the twins, gesturing to the man on Abby's right. "And you remember Dr. Shepherd. Dr. Thompson'll join him."

Abby smiled at them while the former friends shook their hands. "We, uh, we used to work as a team, actually," Mark told them, gesturing between himself and Derek.

"We worked together," Derek corrected. "We were never actually a team."

Abby glanced at Mark who looked defeated that Mark was still icing him out.

"Mr. Weitzman?" George asked.

"Call me Jake," he said at the same time as his brother. "Call me Pete."

Abby smiled to herself. "So much like Ana and Aiden..."

George nodded. "Jake, Pete, um, why — do you mind me asking why now when you thought the procedure was too risky six months ago?"

"Well—"

Jake was cut off when the door opened and a woman walked in. "Guys." She stopped, looking around the room. "Whoa. That's a lot of doctors. I'm—I'm just gonna come back later."

"No, no, no." Jake stopped her and she looked at her. "Elena, come in, come in. You wanted to know why. This is why — the love of my life — Elena."

Abby tilted her head having seen Pete's demeanor change when Elena came in. She glanced at Derek who was also looking at him.

"Jake, don't—" Elena shook her head and let out a breath. "I—I told him not to do this, not for me anyway, 'cause that's just crazy. 'Cause Pete said that they could end up paralyzed. They could end up dead."

"Why do you tell her things like that?" Jake asked his brother with a sigh.

"I wasn't telling her," Pete replied. "I was telling you. She just happens to be the only one who listens to me."

"She happens to be right," Derek told the twins.

Jake let out a breath. "Do you know what it's like to be stuck to the same person—"

"Here we go."

"Every—that's right. Here we go."

"Here we—"

"Do you know what'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?" Jake asked. "Well, nobody should have to live like that."

Abby tilted her head. "What do you think, Pete?"

"I think..." He sighed. "Why would I want to be attached to someone who doesn't want to be attached to me?"

Abby followed Derek out of the room when her phone rang. She glanced down at the contact and pressed decline with an eye roll.

"Everything okay?" he asked, glancing at her as they made their way to the scan room.

She shrugged. "Just... my brother."

Derek opened the door and they walked through, looking at the twins' scans with Richard behind them. "Conjoined twins," he was saying. "Conjoined adult twins."

Abby chuckled softly, glancing at Derek. "He sounds more excited than you do."

"I mean, it's rare enough to separate conjoined infants. But conjoined adults?" Abby and Derek both nodded, the former deeply amused. "Can you imagine the press, what a surgery like this could do for this hospital?"

Abby looked up at him, her eyebrows raised.

"I know." Derek nodded. "Which is why I don't think we should do it." Richard looked at him. "Their spines are fused together from the L4 down. Their blood flow is intricately connected. They could end up paralyzed. Or even dead."

Richard furrowed his brow. "Your patients want this operation, Derek. Why are you backing out? This isn't like you. We're moving forward unless there's incontrovertible evidence that this surgery can't be done. Now, are you in? Or is Abby gonna be the only one to do it."

Derek sighed as Richard left the room and Abby let out a breath. "This has nothing to do with Weitzmans, does it?" she asked, looking at him. "This has to do with Burke."

"Because of him, his hand shakes," Abby corrected. "Because he never told us. Because he decided that instead of telling the surgeons who operated on him — and his chief of surgery — he continued doing surgeries with his intern-slash-girlfriend. This is not on you and it's not on me. It's on him."

"Doesn't change the fact that—"

Abby's phone rang and she strangled the air with a groan. She looked down at the caller ID: Seattle Presbyterian. She rolled her eyes as she brought it up to her ear. "Hello?" She rubbed her temple while shaking her head. "Yeah, yeah, alright. Thank you." She hung up the phone. "I gotta go. I'll be back in time for the surgery."

"Is everything okay?"

She sighed and opened the door. "Just gotta go deal with my son of a bitch brother."

___________________________

"𝐆𝐋𝐀𝐃 𝐓𝐎 𝐒𝐄𝐄 𝐘𝐎𝐔'𝐑𝐄 𝐅𝐈𝐍𝐀𝐋𝐋𝐘 awake."

Adam groaned as his eyes adjusted to the bright light, finding his older sister sitting in the chair beside his bed.

"Abby?" he asked, furrowing his brow. "What happened?"

"You OD'd."

Adam leaned back against the pillow and sighed. "Abby, I promise... I was doing good. I was going to meetings and I was trying to get better. I just—I made a mistake. I made one stupid, fucking mistake. I met a woman at the bar and—and one thing led to another and—"

"Okay." Abby let out a breath and leaned forward, holding her head in her hands. "Okay... How many meetings?" she asked.

"What?"

"How many meetings have you been to?" she asked, rolling her neck.

Adam licked his lips. "Two."

"'Two...'" she repeated with a sigh. "I think you need more than just a meeting. I think you need rehab. I'm sorry, but you can't be able to wander. If you're actually serious about wanting to get clean, you have to give it your all."

"I—I get that now." Abby rubbed her face and stood up. "And I'll do whatever I can. I just... I can't afford rehab."

"Yeah, 'cause you blew through all your money," she said, looking at him. "How much have you spent on cocaine?"

Adam paused. "A lot."

Abby sighed and fluttered her lips. "I want you to get better. But I also want you to grow up and be an adult. You have to stop asking me for money, you need to get a job, and you need to stop doing drugs. Because if you don't... you're gonna end up exactly like Mom. And she died."

"I know."

"Do you?" she questioned, tilting her head. "Because you haven't proved that to me." She hung her head and cleared her throat. "Okay... here's what we're gonna do... and you get no say in these conditions." Adam nodded. "I'll pay for the rehab. I will write a check, I will give it to them and you will attend. Once you're out and you have a job, you're gonna pay me back every cent that I have ever loaned you. Every cent. And when you have a job, you will stop asking me for money and you will stop using drugs. If you break any of these conditions, that's it. If you break any of these... you will not contact me again. I will find every way to keep you from seeing Anabel. And we will not speak. This is your final chance, Adam. And this time, I mean it."

Adam swallowed the lump in his throat. "Got it," he said quietly.

Abby nodded. "Okay."

___________________________

"𝐓𝐖𝐄𝐍𝐓𝐘-𝐓𝐖𝐎 — 𝐒𝐔𝐑𝐆𝐄𝐎𝐍𝐒 𝐈𝐓 𝐓𝐀𝐊𝐄𝐒 twenty-two surgeons to do this," Izzie said while Abby and Derek worked on a simulation of the spine.

"So where are we?" Richard asked, putting on his glasses.

"We've gotten to the caudal equina," Derek replied while Abby kept her focus on the simulation.

"I'll be working on the musculature of the perineal floor," Bailey told the chief from beside Abby.

Mark nodded. "And I'll be harvesting the rural nerve for transfer," he said.

"Once I resect this artery, we're gonna have less than two minutes before all sensation to these nerves is gone," Derek said, looking up from the simulation.

"I'm pretty sure we'll have enough nerve to transfer and cover the deficits," Mark told him. Abby glanced between him and Derek, her mind still swirling around her brother. "We can definitely do this."

Derek didn't look up. "Oh, damn it," he groaned and he held up a second nerve. "It's gonna 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."

Abby jumped when she heard the instruments be thrown into the tray harshly. She let out a sigh as Derek stormed out of the room and she glanced back at Richard and Mark who both looked at her. She snapped off her gloves and followed Derek out into the OR corridor.

"Alright," she said, crossing her arms and leaning against the wall. "This isn't about the Weitzman twins. Spill it."

"What if we can't do it?" he asked, shaking his head. "What if we're responsible for their deaths? Just like with Burke—"

"Forget about Burke for one second!" she exclaimed in frustration. "This isn't about Burke, this is about you doubting your abilities!"

He frowned. "What? I'm—I'm not—"

"You are!" she said with a huff. "Do you know why I agreed to come to Seattle? It wasn't for Richard or his desire to want me on his staff. It wasn't even because it would be easier to take care of Anabel. No, I did it because that meant I would work with you. The man who doesn't doubt. The man who has earned himself one hell of a reputation for doing the hard cases. Was I wrong to believe that? Was I wrong, Derek?"

"You just don't understand," he said, shaking his head. "You've never put a foot out of place. Never done anything wrong. You're—"

"What?" she asked, crossing her arms. "Perfect? I'm far from perfect, Derek. I've made plenty of mistakes. I'm not perfect. You're one of the best neurosurgeons that I've ever had the pleasure of working with. So... I hope I see you in surgery because you can do this, Derek. Have some faith in yourself. And for the record... that tremor is not all your fault. Please, please, remember that."

___________________________

"𝐃𝐑. 𝐁𝐀𝐈𝐋𝐄𝐘," 𝐌𝐀𝐑𝐊 𝐒𝐀𝐈𝐃 𝐋𝐀𝐓𝐄𝐑 in surgery. "I'd like my intern to observe from a better vantage point."

Bailey looked up. "Dr. Stevens?"

Mark nodded. "Yes. She's my intern today." Abby looked up and saw Izzie watching from the gallery. "And I'd like her nearby during surgery, not up in the gallery if that's okay with you."

Bailey clenched her jaw. "No problem."

"Dr. Bailey, Stevens is without privileges," Richard reminded her.

"Oh, 'cause she messed up?" she asked, feigning curiosity. "Dr. Yang messed up and she's in OR 2 right now." Richard looked up as Bailey stepped off her stool. "Stevens, I take it you remember how to scrub in." She nodded. "Come on."

"This vessel's even more fragile than in the biomodel," Derek muttered to himself and Mark looked at their work.

He glanced up at the two neurosurgeons. "Let's do a microvascular bypass graft," he said. "I could harvest the saphenous vein while I'm down here."

"I don't know." Derek sighed. "I don't know if that's a good idea."

"There's no need to bicker," Abby said, glancing between them as Mark opened his mouth. "Just put aside your differences and make a decision. Preferably now. Derek... it's your call."

Abby looked at him as he stared at the procedure in front of them. He looked around at the other surgeons before his sight landed on Abby.

"Just breathe," she whispered. "Breathe and find the right solution. You know it is."

He nodded. "Alright, give me a 10-blade."

Abby smiled. "And let's get some suction in here, please. Thank you."

As the surgery continued, Mark and Derek put aside their problems — mostly because they were both scared of what Abby would do if they did.

"Is the saphenous vein graft in place?" Derek asked.

Mark nodded. "Yeah. Yeah, I'm ready."

"Dr. Bailey?"

"I'm good."

Abby looked up. "Chief?"

"Ready when the two of you are."

Abby glanced at Derek and he nodded, letting out a breath. "Alright, the moment of truth. Removing the clamps."

"Dr. Bailey," Abby said, looking at the resident. "Check the nerve simulator, please."

She nodded and stepped off her stool, walking over to the machine. "S.S.E.P.s are falling."

"Alright, pump up the blood pressure," Derek said to Bailey. "We need as much blood through the area as possible."

"I'm going up to two milliamps," she told them. "Up to three."

"Wait a minute," Richard said. "Uh, I see something. A flicker on the hamstring of Twin A."

"Anything on Twin B?" Mark asked.

"Pump it up some more."

Bailey nodded. "Okay, up to four."

"A twitch," Abby said. "I got a twitch on Twin B's gastroc. It's small but it's there."

"We have a signal," Bailey told them and Abby nudged Derek's shoulder with a smile.

"Congratulations, ladies and gentlemen," he said, looking around at the group of doctors. "We have four functioning legs."

"Pretty badass if I say so myself," Abby whispered in his ear making him chuckle. She looked up as they prepared to separate the twins. "On my count. One... two... three." She nodded to herself when they were successfully separated and smiled softly when she saw Derek and Mark laughing together. "Well done, everybody..."