He burst through the neurology wing at New York Pres with a thunderous step he never knew he possessed. Helen asked him to come... actually she demanded.

"Get out! Get out of here!" Helen's voice carried out into the hall followed by a crash and a surprised yelp. "Do you have any idea who I am? Do you know who you are speaking to? I am one of the foremost neuro- oh!"

"Dr. Crawford!" A young voice called out, "She's seizing!"

Panic rose in Derek's chest and he picked up the pace. He skidded into the room to find Helen in the midst of a grand mal seizure. A quick glance at the monitors and her chart told him what he needed to do as he pushed the frightened resident away. "10 migs diazepam, stat!" He shouted.

But the young man just stood there, "Who are you?" he asked.

"Dammit! Just do it, now!" Derek turned Helen on her side as she shook uncontrollably on the bed.

The resident hesitated, and then figured he was damned either way, so he proceeded to administer the medication. After a moment or two, Helen's seizure stopped, and her body relaxed against the bed. Derek released a long shaky breath as he propped up the pillows behind her and brushed her hair out of her face.

He turned to the resident, "Page her doctor. And then give us a moment, in private."

"Uh, sir?"

After all of the events of the day, he was out of patience. "Page her doctor and tell him that Doctor Shepherd is here to consult!" He snapped.

"Doctor Shepherd?" the man gaped in disbelief.

"Yes! Now go." He turned back to Helen and rubbed his forehead, frustrated. The resident left quickly, the squeak of sneakers evidence of his frantic run as he raced to find his attending.

Derek stepped forward and collapsed in the large chair beside her bed. "I didn't think it would be back so soon," he said to the sleeping Helen. "I'm-" He swallowed, "I'm sorry." And he was. He'd failed again.

Four years ago:

He thought he might find her here. It was the first time that he'd searched for someone on the ferryboat. Usually people searched for him here. But... he had a feeling that Helen was here. As he climbed the last steep step to the top deck, he surveyed the crowd of people, looking for that familiar elegant posture, that familiar dark hair.

He found her on the bench, deep in thought, contemplating life no doubt. Legs crossed, she ticked her booted foot in a nervous gesture. After hearing what he heard, he could understand why. "Hi," he said, sitting down beside her.

Her eyebrow raised from under her sunglasses. "Shepherd. Figures you would find me here."

He smirked, "Yeah... figures."

"Congratulations." Helen said, looking up at the sky.

"Congratulations?" He asked, confused. This was supposed to be about her, not him.

"On your new private practice." Helen said, glancing at him finally.

Oh yeah... It had happened so quickly. One moment he was taking his boards and completing his fellowship, and the next- He shook his head, he was digressing. "Helen..." he said.

"Derek."

"I saw your scans-"

"You realize I have to give up surgery now? Because of the tumor?" She interrupted.

"Helen-" he started again.

"I have tremors. That's no good in the OR. I could have a seizure. Or have a migraine so intense that I'll collapse from the pain. Blurred vision-"

"Helen!" He barked.

She physically jerked at his call. She pulled off her sunglasses to gaze at him thoughtfully.

"I saw your scans... " Derek continued. "I don't know what Dr. Thompson said, but I looked at your scans, and I think I can operate. I can resect as much as I can, and then we'll monitor it, keep an eye on it. We'll have to go back in, eventually, but Helen, I can give you another few years. I can give you as many as you need." He said confidently. He'd seen the MRI. The tumor was big, but he was convinced he could get at least 85 percent of it. That would be enough to relieve the pressure that caused such intense symptoms.

"You're suggesting-"

"I can give you time, Helen. For now. And then, we'll give you a tune-up every few years. The tumor is big, but the surgery is simple enough. I don't know why Thompson wants to pass on it."

Helen sighed and stared up at the sky. "But there's no way to..."

He had thought about it, removing the tumor completely. But it was far too risky at this point. In fact the resection alone would be one intense and difficult surgery, but he didn't tell her that. He shook his head. "Helen... I can do this. You know that. You taught me. Let me do this for you."

Helen sighed so long and hard it seemed her entire body deflated. Derek reached over, hesitated, then placed a hand on her knee. She allowed him. He heard an audible sniff before she spoke again."You know, Jake bought me this..." she pulled out a piece of colored fabric. "A month before I was diagnosed. I never got a chance to wear it."

He smiled as he looked at it. "A ferryboat scrub cap?" he asked, bewildered.

"Hm, yes." she said, tucking it back in her pocket.

"I like ferryboats."

"You do, don't you?"

"It's a good place... to contemplate life, I think." He hoped she got his implied message. He wanted her to take the surgery. To live. Even a few years was better than nothing.

Helen stood up abruptly. "All this contemplating has made me famished," she remarked. "Do they still have those scrumptious donuts around here?"

He offered her his elbow as he slowly grinned. "C'mon, my treat."

"Delightful." Helen said as she slipped her arm through his and followed him back inside for an ooey gooey donut.

Now, in the dimly lit private room, Derek watched Helen sleep, and wondered if it was worth it. Was he just prolonging suffering? If he operated now, it would be his third time. The third time... in the space of four years. The tumor was growing at a rapid pace.

Four years ago, he was optimistic, bold, a little arrogant. A little scared even. But at this very moment, he was broken, and he didn't know... he didn't know if he could do it again.