Derek says there are many reasons people choose to become surgeons. Some like the excitement, some like power of saving lives. He says he grew up in a house full of women and chose surgery for the peace and quiet. So, the stress of holding a living brain in your hands doesn’t come close to the nerve jangling cacophony of a hen house? I get that. I’d rather disarm a bomb than watch The View.
Big Chief I’m-In-Charge has just birthed another brainchild: He proudly announces they’ve switched over to surgery scheduling software, which would be special, were it 1983. The staff is less uneasy about losing the surety of Dry-Erase markers and a white board than they are of anything the Chief concocts. It’s just like the time he implemented his super-confusing Dress Like a Patient Day and someone accidentally gave George an enema while he was napping.
Meanwhile, Alex’s elfin nemesis, Reed, has turned the locker room into a yoga studio. As Dr. Keebler stretches her hammies, Cristina comes in to remind Alex that Izzie has an oncology appointment. Considering he doesn’t even know if his wife is still in the state of Washington, that’s a cancellation fee waiting to happen.
A hospital employee named Isaac shows Derek an MRI of someone with a very complicated spinal tumor. Derek’s eyes gleam with excitement as he tells Isaac that the growth is so melded with the patient’s spinal cord, any attempt to remove it is sure to paralyze him. And that’s the good news. No one in their right mind would attempt such a thing. Isaac tells Derek the scan is his own and doesn’t want a doctor in his right mind. He wants him.
It isn’t long before everyone’s abuzz about Isaac’s tumor. Even Bailey’s impressed and calls it the “Great White” of tumors. She tells McAhab, “To successfully take out this tumor would be an achievement you could hang your hat on for the rest of your career. You could retire on this tumor.”
Not everyone is excited, though. The Chief takes one look and says, “It’s a malpractice waiting to happen.” Finally, something he knows about. Derek chides the Chief he’s not the risk-taker he used to be. Yeah. He had an affair with a Meredith’s mother and OK’d stabbing live pigs, so students could practice trauma surgery. What happened to that guy?
“I don’t know how many times you want me to say it. You’re not operating on an inoperable tumor!” the Chief says ominously. Seriously, these two need to drop their pants and get it over with. I’ll get a ruler.
Going over the Chief’s balding head, Derek schedules Isaac’s spinal surgery under false pretenses. He auditions residents for an assisting position by making them guide a pen through a Styrofoam cup and hit a dollar bill right on George Washington’s nose. Dr. Vanessa Williams is the only one who nails it, much to Cristina’s shock and deep shame. Being bad at something, especially something surgical, is so foreign to her, she can’t quite wrap her head around it.
Word spreads throughout the hospital that Derek’s going rogue. Callie and Arizona come bounding down the stairs to get confirmation from McRoguey himself. Arizona doesn’t want to know the details because she’s bad with secrets, and plus, has that habit of bursting into tears whenever she’s confronted by bellicose authority figures.
Callie takes her by the shoulders and whisks her away. Did you blink and miss it? They touched
Lexie’s mad because she wasn’t asked to participate in the George Washington Invitational. Derek gives her the dubious honor of fetching him water during what promises to be a 20+ hour procedure. Dr. Vanessa Williams mocks the little Gunga Din in scrubs, bragging he doesn’t drink water so he won’t have to leave the OR. Ever.
Lexie finds a solution in adult diapers. When Cristina catches her with it, she sees the value in peeing one’s pants.
Cristina: That’s genius. You can hydrate all you want. You never have to leave the OR.
Lexie: You’re mocking me. Fine, whatever. I wasn’t going to use it anyway.
Cristina: Of course you are. This is the definition of hardcore. You’re like an astronaut. This is surgery, NASA-style. Put it on, right now. I’ll guard the door.
Ready to go rogue and disobey the Chief, Derek tells Isaac if things don’t look good, he’s going to close him back up and forget it. Isaac is super optimistic, even if it means being paralyzed, and tells Derek he’s already survived losing his entire family and home country to war atrocities. This is nothing.
“When things look like there’s no way, there’s a way. To do the impossible. To survive the unsurvivable. There’s always a way,” Isaac says in that way comfortable Americans with gorgeous hair and fancy cars will never, ever understand.
Eight hours later, Derek has yet to make an incision. While he moves into the ninth hour of puzzling out how to begin, Cristina watches with envy from the gallery, wishing she were the one who had to wear a diaper. Alex and Keebler are covering Derek’s other patients and arguing over who’s the bigger douche. Ladies, ladies. You’re both douches. You know they’re going to hook up, right?
Back in the OR, Bailey pops in to warn Derek that the Chief is going to be in the vicinity soon, so he might want to get started sometime today. Mark, Callie and Arizona loiter just outside, wondering how things are going. Callie peeks through the window and says, “This is so depressing. Ten hours staring into a spine and he can’t figure out what to do.”
The Chief comes up behind her and says, “What did you just say?” Busted.
The Chief goes into the OR and tells Derek to cease and desist immediately. After 10 hours of nothingness, Derek concedes it’s time to stop. When he tells Isaac there was nothing he could do, Isaac presses on with the ridiculous tenacity and gently tells Derek to go home and sleep on it. Tomorrow, tomorrow. He loves ya, tomorrow. You’re always a day away.
That night, Derek talks it out with Meredith, who’s been recuperating and so desperate to talk about something other than who was on Judge Judy, she doesn’t even mind when Derek takes a Sharpie to their bedroom wall.
Meredith reminds her husband he’s awesomesauce and not like other surgeons. Behind every great man, there’s a woman with half a liver. The next day, Derek lies to the Chief and gets permission to cut Isaac’s spinal cord, which should take an hour, tops. The moment the Chief leaves, Derek turns to Vanessa Williams and Lexie conspiratorially and says they’re going to try again. Screw the Chief.
Vanessa calls Lexie a diaper genie.
Lexie: Hey. I wore a diaper yesterday, yes. And I will wear one today. If it helps get Dr. Shepherd though this surgery, I will wear a diaper. My diaper is awesome. My diaper is hardcore. You wish you had the balls to wear my diaper. I’m going to wear it, and I’m going to wear it with pride. And if I have to pee in it? Oh, I’ll pee. Because I am a surgeon. This is America. And I will do what needs to be done. So you can kiss my hardcore, diaper-wearing ass.
And that, my friends, is how we beat everyone to the moon. And invented the Snuggie.
Owen gives Cristina a reason of her own to pee her pants by assigning a 15-hour surgery to her. She’s psyched, until Derek tells them he’s going to be hogging the OR for the next couple of days. Son of a bitch! What does a girl have to do to wear a diaper around here?
Meanwhile, things are so tense in the OR, Derek pukes on the floor. The secret surgery has become a group effort: Mark is by Derek’s side for moral support. Lexie yells at him for not hydrating, Owen lies to the Chief, and Arizona is guarding the door. The Chief happens by. The jig is up.
Arizona stands her ground and tells the Chief: “You don’t get to go in there and be a bully. Not today. Not on my watch.” Callie’s mouth hangs open in disbelief that her girlfriend finally grew a pair.
“OK, I totally thought that was going to end different,” she says in amazement. Arizona breaks down on Callie’s shoulder and starts to cry. “Yeah, more like that,” Callie says.
A gazillion hours later, it comes down to two arteries. Cutting one will free the tumor, cutting the other will paralyze Isaac. Just as Derek is about to make the biggest guess of his career, a parched and exhausted Dr. Vanessa Williams’ hand starts to shake. Lexie sees her moment and takes it — she steps in and replaces him. And probably fills her diaper with warm, triumphant vindication.
Derek makes the cut using eeny-meeny-miney-moe, which is only marginally better than having a monkey throwing a dart at his bedroom wall. Two hundred thousand dollars for med school and it comes down to this. Afterwards, Isaac wakes up and can move his toes. Hooray!
Downstairs, (if anyone cares) Alex waited all day for Izzie, who didn’t show up for her appointment. In the Skills Lab, Cristina practices her pen and Styrofoam cup technique until her “tiny little geniuses,” otherwise known as her hands, can hit a dollar bill squarely on Washington’s nose. Who wants to play “Operation” with Cristina? Not me.
After it’s all over, Derek finds the Chief and says, “We can’t keep doing this, Richard. I’m tired of fighting you. Let’s try and put this behind us and move on.” The Chief is happy to do so, but by “move on” he means, “You’re fired.”
Derek doesn’t flinch. He smiles and tells the Chief to go home and sleep on it. Does anyone listen to the Chief? Like, ever? Nope.