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Hunt gathered all of the fifth year residents to warn them once again about how hard fifth year was going to be. They couldn't exceed more than 10 bad outcomes in the O.R. If they really wanted a chance at fellowships next year.
They all had to leave their bad outcomes to a minimum which meant for most of them that they would start taking on easier cases instead.

Izzie was on a neuro rotation. She was originally going to be on Peds but Lexie was driving Derek crazy and he needed someone else.

While Meredith was delivering a baby she found out that the mother had an inoperable butterfly tumor. She had Lexie and Izzie convince derek to look at it.

After over a day of convincing Derek decided to talk some scans and discovered the tumor was operable. The patient was all for it but her husband had doubts. She had six months left but those six months would be important for their daughter, Emma, to spend with her mother.

They waited for the couple to make a decision. While waiting Lexie and Izzie joined Alex and Meredith and Cristina in April's office.

'Iz, did Derek get scans of Mary's butterfly tumor' Mer asked her.

'Yeah, and he thinks he can get it if he reaches under the pericollosal vessels and reached the tumor on both sides.'

'So he's operating?'

'No Clay, Mary's husband, is afraid of the risks' Lexie informed them.

'Did you tell them how good he is?'

'Yeah... kind of.'

'Do I have to do everything myself?' Meredith complained as she got up and left the room to go talk to Clay.

Meredith finally convinced Clay to have the surgery.

Mary held her daughter until she had to go into surgery.

The tumor was smart. Butterfly tumors are smart, growing on both sides of the brain so surgeons would be too scared to cross over. Most surgeons would be to scared to cross over, but Derek wasn't.

While in surgery Mary started herniating. A vessel leaked and the tumor started to swell. Shepherd was left with no choice but to drain the ventricle blindly.

Although it was difficult Shepherd got the whole tumor.

Afterwards to celebrate Izzie and Alex went to Joe's with Jackson and Lexie.

April made it very aware to them that they weren't playing any more games. If they didn't listen to her or made fun of her they were getting punished with scut.

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