"i can't see my hands." the patient spoke up.

"oh, my god. he's conscious." george marveled.

"breathe deeply, george. you won't pass out." alex mocked.

"leave him alone, alex." madelyn barked.

"use four milligrams of morphine. titrate up to ten. you know what? i don't want him to move." derek ordered.

"it's okay." madelyn soothed,

"we need you to be very still, mr..."

"cruz. jorge cruz. he tripped and fell down a flight of stairs holding a nail gun." the nurse finished.

"somehow he managed to miss a blood vessel. that's a minor miracle. optic nerves been affected." derek told the interns,

"can you feel this?" derek asked. jorge didn't respond.

"numbness on his right side. what's our immediate concern?"

"infection." madelyn answered.

"right. i'm gonna be pulling these nails out in the next half-hour. i need a c.t." derek announced.

"c.t.'s are down." the nurse spoke up.

"what?" derek said in disbelief.

"they exchanged them out last night. computers crashed, have them back up by 1:00." the nurse finished.

"typical. what are the options?"

"an m.r.i." george suggested.

"brilliant. the mans got nails in his head. let's put him in a giant magnet. you want films from three axis points and a c-arm in surgery." alex corrected.

"excellent. you guys dig up research and find out if this has happened before." derek instructed.

madelyn and alex gave him a nod, and left the room to go to the archives.

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"23. people have been accidentally shot in the head with nails 23 times." george scoffed.

"one was attempted suicide, doesn't count." alex added.

"i'd day for the sake of this case, it counts." madelyn shot, alex gave her a dirty look.

"a nail to the head is a nail to the head, suicide or not." she defended.

"oh, so he pointed a nail gun at his head on purpose? that makes me feel better." said george.

"so, uh, grey and stevens really walk around in their underwear?" alex asked.

"alex!" madelyn scolded.

"sorry." he mumble, shooting her a toothy smile.

"not all the time. i mean, some of the time, you know. but not all the time." george stammered.

"sexy underwear?" alex pushed.

madelyn looked at him, wide eyed with her mouth hanging open.

"do you want to die? that's my sister!" she screamed. alex shot her a smirk, quickly pecking her cheek.

"you're the only one i got eyes for, babe." he flirted.

"i'm still mad at you." she pouted.

"so they just let you look at them." alex preceded with his conversation with george.

"well, yeah.."

"so, like sisters."

"i don't think of them as sisters."

"but they're not coming onto you."

"not exactly."

"they don't except you to do anything."

"no...but..."

"like sisters. just like sisters."

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"you bug him too much." madelyn laughed, biting into her salad.

"easy target." alex shrugged.

"i've never seen you eat a salad before." alex. commented.

"i'm trying to eat healthier. i'm a doctor, better take my own advice."

"shepherd's calling." george chimed in.

alex picked up the phone.

"hello, dr.karev." he answered. there was a pause then alex spoke up again,

"23. one was suicide." alex nodded then handed the phone to george.

"biggest problems were bleeding and infection. but the odds improved the shorter surgery times." he handed the phone to madelyn.

"bottom line was get them out quickly and watch for bleeding." madelyn summed up.

"i got it. in other words, i'm on my own." shepherds voice rang from the other line. madelyn hung the phone up and sat back in her chair, letting out a sigh.

"whatta day."

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"hey madelyn."

"derek. ready for your surgery?"

"almost. i was wondering, i could use your extra eyes. meredith will be in the o.r. already, but it's always nice to have another person, you in?" derek asked.

"yes! of course i will! see ya soon." madelyn hung up the phone, rushing to the o.r. she quickly scrubbed in and stood beside meredith and derek prepared.

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"as you can see, the patient has shot several nails directly into the scull without doing significant damage other than the optic nerve, and we may be able to save that. the idea is to remove the nails at exactly the angle they entered. any wiggle, and we risk doing more damage than when they went in." richard narrated to the people sitting in the gallery,

but madelyn wasn't paying attention, she was mesmerized by the whine of the drill derek was using. she was fascinated, just staring at the inside of someone's brain.

all throughout med school, the brain had always been her favorite organ. she loved the way that it would fire neutrons and could receive signals. she loved how everything had a purpose, a job, one single thing that it was in charge of.

the way she saw it, it was a perfectly organized chaos.

derek carefully started to remove to nail from the mans brain, his hand staying perfectly still and calm the entire time.

"gel foam." derek said in a flat voice, indicating he was very concentrated.

a few hours passed and madelyn watched as derek removed the nails one by one from the mans head, not making a single mistake.

"bleeding?" derek asked.

"it's clean." the radiologist answered.

"all right. way to go , team. good job, everybody. thank you. i don't think we made it worse. the big question is the optic nerve. we'll know in the morning." derek ranted.

"should i order the m.r.i.?" meredith asked.

"he needs to stabilize. we'll do it tomorrow."

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"ohh. your mom's a bigger woman." nurse fallon said from her bed. madelyn and meredith stood in the doorway.

"you were her scrub nurse." meredith spoke up.

"liz fallon. come in."

"madelyn grey, this is meredith. she wanted us to send her regards." madelyn introduced.

"that doesn't sound like her." liz added.

"excuse me?" meredith asked.

"well, the ellis grey i know didn't have regards for anyone except ellis grey. but you know that, already. don't you? where is she now?"

"traveling." meredith answered.

"traveling. huh. is she practicing?"

"not so much.wanted to see the world." madelyn answered, trying to sound as convincing as she could.

"doesn't sound like her, either. she was all work, just like me. she never left the hospital. but you know that too, don't you?"

there was a long pause, and a flash of guilt washed over madelyn. she hated lying to liz, a sick woman and her mother's best friend.

"is she well?" liz asked.

"she's fine." meredith quickly spit out, nodding her head to make it more believable.

"good."

"she just wanted to send her regards."

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"cmon madelyn, just for fun!" izzie pushed, holing two pregnancy tests she had stolen from the clinic.

"it's always good to be sure! just do it!" izzie whined.

"fine. but only to prove i'm not pregnant."

"you could be. you've been looking rather glow-y lately. plus you and alex have been doing it like rabbits the past couple weeks." izzie wiggled her eyebrows deviously.

"whatever." madelyn mumbled in embarrassment, snatching the stick from her hand.

she walked into the stall, quickly peeing on the test.

madelyn sat in the stall as she watched the one line appear on her test. she let out a relieved sign.

she looked back down at the test, and her heart skipped beats and her stomach dropped as a second line started to appear on her test.

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