Had I known How to Save a Life

Worst Case Scenario

Chapter 17
*Meredith POV*

When faced with a crisis, you're either an optimist or a pessimist. You either think things are going to be okay, or you think the sky is falling. There are two kinds of people in this world when faced with a crisis. One thinks of the best case scenario. While the other thinks of the worst case scenario. As surgeons, we must be both kinds of people.

My pager begins to beep. Shark attack victim. I'm paged to the helipad. Why are they bringing a shark attack victim here?

I begin to high tail it to the elevator where I run into Arizona and Alex, Bailey and Richard, Owen and April, Jackson, Callie, and Derek.

"All right people, April and I are going to bring them down. I want 2 trauma rooms ready right now. We have two teenage shark attack victims coming. They're being flown here because the hospital they were is not as equipped as we are. We can do this okay?" Owen says.

"It's 7 AM, who's in the ocean before 7 AM?" I ask.

"Obviously the shark attack victims." Alex says sarcastically.

April and Owen bring them down. "What the hell did that shark do to these two?" Alex asks horrified.

"Alright this is Adam, 17 years old, obvious bite marks to upper leg. Abdominal tenderness..." His list of injuries goes on.

"Is that a tooth?" Bailey asks.

"In his head? Yeah." Derek answers.

"This is Amanda, 16 years old, right forearm is shredded, abdomen is rigid..." Owen continues.

"Grey, Robbins, Webber, Kepner, you're all on Amanda."

"Jackson you get to choose who's big wounds won't leave a huge scar first."

"Shepherd, Karev, Torres, and I are on Adam. Let's move people." Owen says.

I wonder what these two were doing in the water so early. Plus they should be in school. We get into the trauma room and just shocked by the injuries.

"Hello..where..where am I" she chokes out.

"She's awake. Oh my God." I say.

"Hi, I'm Dr. Kepner, you were attacked by a shark. But you're at Grey Sloan Memorial Hospital now. And we're going to do everything we can. Okay?" Kepner tries to ease her.

"Ad-Adam. He's my b-boyfriend. We skipped class...my parents think I'm in class right n-now" Amanda says. "The shark, it came out of no where. We were playing around on surfboards and a-a shark came out of no where." She continues.

"Hi Amanda, I'm Dr. Grey, you have crush injuries and punctures to your abdomen so, Dr. Webber and I are going to fix that." I tell her.

The CT shows the bleeding coming from her pancreas. Hopefully I won't have to remove it or else she'll be a diabetic.

We rush her into surgery and begin. We get in there and there's so much bleeding. "I need all then o neg you can give. She's lost more than half her volume." Arizona says.

She's hypotensive, her heart beat is weak. "Damn it. The pancreas isn't the only source of bleeding." Richard days.

The phone rings and a nurse answers it. "Doctors, the patients parents are here and they'd like an update."

"Grey and I can go. You two, keep her alive." Arizona says.

Amanda's parents are scared out of their mind. "Hi, I'm Dr. Robbins, the pediatric surgeon and this is Dr. Grey one of the general surgeons. Your daughter is in surgery-" Arizona is saying before the father interrupts.

"What the hell happened? Her boyfriend Adam picked her up to go to school." He says.

"Your daughter was attached by a shark. She and her boyfriend skipped school to go surfing. She has severe abdominal injuries and her right arm is shredded. We're going to do everything we can." I tell them.

"Wha-what's the best and worst case scenario?" Her mother asks.

Arizona and I look at each other. Well, "worst case scenario, we can't find the source of bleeding and she bleeds out or her arm is amputated." I tell them.

"Anything that's not the worst case scenario, is the best case scenario. Now if you excuse us, we need to get back to surgery." Arizona tells them.

"Grey, kidneys are the other source of bleeding. I think we might have to remove one." Richard tells us.

"See how Torres is doing on the boyfriend. We need her to look at this arm." He continues.

We remove one kidney that's far beyond repair. Callie gets in here. It's odd, that's pretty quick.

"What's the story on the boyfriend?" I ask.

"Oh my, God. I managed to save the leg. Let's just say, the kids probably going to walk with a limp the rest of his life. Bailey removed the spleen. Derek removed the tooth, nothing happened bad there. Jackson is making sure there's no ugly scars. Oh and he coded on the table. Pierce came in relived some fluid around the heart." She says.

Best case scenarios are really just something better than the worst. Right now, the best case scenario for my patient is that she doesn't die.

Callie manages to keep the arm on the body. Richard and I close.

Suddenly her pressure drops lower. "V-Fib!" Kepner yells.

"Get me those paddles. This kid is not going to be the worst case scenario." She continues.

"Charge 250. Clear!" No change.
"Charge 300. Clear!" The heart starts beating again and we all take a breath of relief.

That surgery was long. Thank God, Ellis wasn't attacking me with kicks.

Derek and I go to an on call room. "The was exhausting." I begin to say.

"Oh yeah it was." He agrees.

We lay there sleeping after a long day.

I go to the attendings lounge and find some food to eat. When I return I snuggle back with Derek. I'm almost sound asleep when our pagers beep again.

"No! I just want 5 more minutes." I complain.

"Ah here we go again." He says. We laugh and go attend to the incoming trauma.

When we prepare for worst case scenario, it's not that we're preparing for death. We are preparing to prevent it. The thing about best and worst case scenarios is, no matter which you're preparing for, the goal is the same. Our goal at the end of the day is to simply fight like hell to avoid the worst humanly possible situation.