Amelia's Lecture

"I don't need any distractions and you're...very hard to ignore," Ivy hears Amelia say to someone.

"Hey, I ju-it was just coffee," she hears Owen tell her.

Ivys jaw drops. Amelia has a crush on Owen. Oh, this will be fun.

"No, I-I so appreciate the coffee."

"Uh, I was just getting some coffee for myself, and-" Ivy laughs to herself at how akward they are being.

Amelia's voice stops him, "Its good coffee. It-its great coffee."

Owen sighs, "I-I, uh, I can-I can just get my own if-if you-I mean, you can get your own so easily."

She sighs, "I don't want to get my own coffee. I-I mean, I do. I can. I will. I-I can get my own coffee all day long. I just-Owen. Thank you for bringing me coffee. I really like it."

"Uh, you're welcome."

It gets quiet and Ivy can assume that the patient in the scanner is talking. As Amelia leaves to walk with Arizona and Herman, Ivy grabs Owen, "I-uh- can get-"

He rolls his eyes, "Do you have a point? Because otherwise I have a long day ahead-"

Ivy stops him, "You mean a long day of bringing my favorite sibling coffee? Or trying to talk to her? Yeah, I can see how that would be busy," she laughs.

"Ivy-"

"No, no. I'm sorry. I shouldn't make fun of this, but growing up, Amy would be the one to tease me about boys and now I can finally do the same to her. Plus, your my mentor which means double the fun. Now, I'm going to watch Amy's presentation, are you gonna join?" Ivy teases.

Owen doesn't say anything, just sighs and starts walking towards the auditorium, Ivy following, "I thought so."

○○○○

Ivy watches as Amelia takes a deep breath, "Life will out. The origins and lessons of life and evolution are long and complex, but what they basically boil down to is, life will out. Life will always find a way to continue. Always. Life..will...out. This is a massive grade four astrocytoma. I want you to take a look at it. Really look."

She studies the scans, shaking her head at the size, "Look at its size. Look at the way it invades healthy tissue. Look at its vasculature. It is blood and tissue and flesh. It's growing, adapting to its environment, struggling to survive, to stay alive. It is alive. We don't like to think of it that way, but it's nested in the womb of a human brain, feeding on its host, growing and fighting for life-almost like a fetus. No, scratch that. Let's just for science and giggles say exactly like a fetus. Because like a healthy fetus, it is thriving. You know, there are even some types of tumors that grow teeth, hair...a stray eye."

Ivy feels her face wrinkle in disgust at that image. Give her blood and bones and a messy E.R. any day.

"Have I repulsed you? It's gross, right? I mean, that is a problem. Nobody wants something that nasty in their head. I'd like you for one moment to consider the idea that, to the tumor, we are the problem. We are the invader. We are the danger. To the tumor, we are the cancer. And the tumor? Well, the tumor sees itself as a sweet, cute, fat-cheeked baby just trying to make its way into the world, and we want to stop it, destroy it, tear it from its happy little home like barbarians. To the tumor, we are the soulless, murderous monsters. Why do I do this? Why do I call it baby and talk about killing it? Because this kind of tumor deserves respect. It deserves a little humanity."

Smiling, Ivy watches as Amelia completely grabs everyone's attention, "Its not just a tumor. It's ingenuity. It's strength. It's adaptability. It's poetry. It's one of God's masterpieces. It is alive. And like any living thing, it wants to stay alive. Like any living thing, it is going to fight like hell to survive. And when I saw open that skull and come face to face with it, with that tumor, with that living thing, it will be almost impossible to remove because it would rather destroy the brain that holds it than go gently into that good night. It is alive. And what's it all come down to? Life..will..out."

○○○○*One Week Later*

Ivy video conferences with Derek, "Derek, you should see her. She's is thriving with this tumor. She has captured the attention of every resident and intern. I've seen you give some good presentations but never one as good as hers."

Derek chuckles, "I'm glad. Amy knows what she's doing. She has her plan. She's adaptable. She's got this."

"You know, if she was the neuro surgeon here when I was a resident, I may have gone into neuro," Ivy tells him.

"What about your rule? No sharing specialties with siblings?" Derek asks.

"She could change my mind," Ivy shrugs, "I mean, I'm used to how you talk about tumors but this is something completely different. I'm- I'm hooked on this case and I, medically, have no reason to be."

Derek laughs, "Tell Amy good luck with her presentation today."

○○○○

Amelia stands on the stage again, "So, our fat-cheeked baby tumor, that's nestled in that brain, it's a creature of habit. It has the same routine day in and day out-to grow, to spread out, to take up space. That's it. At this point, our baby tumor is so enmeshed, so invasive, it's touching virtually every single brain structure. It's pushes existing tissue aside, shoved brain matter out of the way to find room for itself. How do you remove it without destroying the brain around it? How do you kill the baby without killing the mother? I stare at these scans, and the tumor stares back at me, daring m to try to extract it. I mean, this tumor is bold and brazen. This tumor thinks its in charge. This tumor thinks it owns the place."

Ivy takes a sip of coffee, thinking to herself, "

"The thing about a tumor like this is, you can't let it intimidate you. The tumor isn't smarter than you. You just need a plan of attack. You must be methodical. Point of access is key. And then you start. That is the most daunting step- pushing a blade into the first squishy blob of flesh...because the first cut is what sets the tone. It determines every single move from that point on. So, you have to be careful. You have to be sure. Or your in trouble."

○○○○*One Week Later*

Ivy sits in the front row as Amelia starts her next presentation, "Previous attempts to treat Dr. Herman's tumor with radiation proved unsuccessful. I had hoped to use high radioactive doses to reduce the margins, but at this juncture, that course seems to be unrealistic," Ivy doesn't have to be her sister to know that Amelia is extremely agitated.

"But that's not enough to make me quit. This tumor is fierce and intimidating and aggressive, but so am I. First, I need to see the tumor, all of it- every margin, every last ripple and ridge. So, I will employ fluorescein dye to delineate every border of the tumor, to help me anticipate every possible problem before I get to it. I don't want to leave anything up to chance," Amelia explains.

○○○○*One Week Later*

Ivys gotten into the habit the last few weeks of dropping the kids off, getting coffee and then sitting in the lecture hall to hear her sister. She hasn't had this much neuro in a while and she probably never will again.

"Now, arguably, the most important part of the brain is the part that makes us hope...dream...imagine. One singular, almost immeasurable part is what makes you you.. and me me. And everyone...everyone. It's technically called the fornix, but I call it the dream box. The question is what happens when the dream box is being invaded? When the tumor is so large, so demanding, it's sucking the dream box dry? It's taking over, it's stealing away hopes and dreams. Imagine, when that tumor is removed, what-what will actually be left? Or, rather, who is left? Anything? Anyone?"

Ivy thinks back to a little chest that her and Amelia had. They would put pictures or objects into it that represented what they wanted to do. They called it their dream box.

Amelia shares a smile with her sister before continuing, "How do I access that area of the brain when it's so hidden? And once I access that area, even with the perfect tools, the perfect approach...how do I keep from screwing it up?"

○○○○

Jackson tickles the twins as Ivy laughs on the couch. Alexus giggles, "Dada."

They all stop. Jackson pulls Alexus towards him, "What did my little princess just say? Did you just say dada? Say it again."

"Mama," Alexus says.

Ivy notices Jacksons pout, "Oh, babe. At least you got it once."

He moves onto the couch next to her, "I know, but you get mama all the time."

"Mama!" The twins shout, crawling over to their parents.

○○○○

Amelia points at the screen, "This is the part where things get a little fast and furious. It is arguably thr most dangerous, most precarious portion of the operation. It also needs to happen the fastest. Every step, every move before this has laid the groundwork for this very moment, the moment where I place the radioactive seeds. It requires precision and accuracy and speed- things that do not go together well. Imagine picking up little grains of salt while wearing oven mitts. That is what I'm doing inside somebody's brain. But once I do it, once I place the final seed, well, it's smooth sailing. Night, night, tumor baby. It has been lovely, but we are done."

Everyone starts applauding for Amelia as Ivy cheers. Amelia smiles down at her little sister, "I'd like to open things up to a few questions. Yes."

Wilson asks, "Are you nervous?"

"I'd be crazy not to be. Yes, of course I'm nervous, but I'm also very excited. This is history. This surgery will be history. How could I not be excited about that?" Amelia gestures behind her.

Webber stands up, "What you're describing is seven different surgeries all using the hardest techniques you've ever tried. How long do you anticipate the entire surgery actually taking?"

Amelia crosses her arms, "18 hours...give or take some hours."

"Uh, follow-up question- do you need a second resident on the case?" Wilson asks.

"Uh, not unless Edwards is planning to bail on me. You planning to bail, Edwards?"

Ivy sees her shake her head, "No, ma'am."

Callie stands as Amelia calls on her, "Will you have help?"

"Um, sorry?"

"Well, I'm just, uh- well, are you going to be doing this whole surgery yourself, or is Derek-uh, Dr. Shepherd coming? I'm- I'm just- I'm just asking. I mean, given everything, is it a good idea? Should you be doing this yourself?" Ivy watches Amelia's reaction and response carefully.

Amelia just smiles, "Well, I am, so...next question."

Ivy shakes her head. That was not the confidence that Amelia should have. Amelia is about to do the impossible, something that Derek wouldn't even touch. She needs to believe in herself more because she is about to make history.

○○○○

AN: so this part was abunch of ivy being a supportive little sister and I wouldn't blame you if you skipped over most of this part.

I'm hoping to have the next part out tonight.

QoC: how are you feeling about the Shepherd siblings?

Thank you for all the votes and reads and comments!!