"What do you got?"

"Severely severed leg, but his artery's tied off and in a tourniquet."

"Who tied off the artery?"

Derek Shepherd, head of neurosurgery at Seattle Grace Hospital, examines the leg when he catches a glimpse of the jacket over top.

"Dr. Phoenix?" His fingers touch her I.D. picture, sighing under his breath. "This is her jacket."

"We found him like this. She must have moved on." The paramedics push him onto the back of the ambulance.

Although not convinced, he simply nods. "Yeah. Yeah, okay."

Meanwhile, across the other side of the pavement, Meredith sits at the last step of the staircase, her legs dangling into the water.

Her skin has returned to its natural complexion, but her cheeks flush red with each choked sob from her throat.

"Help. . .help."

----------

"It's okay."

Derek holds a young blonde girl's hand, the one Leven Phoenix had been seen with. He kneels down beside her, trying to follow her line of sight.

"Just think. Where is she? Which way did she go? " His voice grows desperate with every passing minute. "Take your time. Take all the time you need. You're doing great."

She looks from the triage center to the array of firetrucks. While scanning the crowd, she notices a familiar red sign.

She walks towards the American Red Cross tent with him in tow, only to walk past it into a secluded area on the rescue scene.

He catches up to her at the edge of the dock while looking out into the water.

"Use your words. Where exactly is Leven?"

Confirming his worst fears, she points out into the water. Salty tears prick the inner corners of his eyes, threatening to spill at any given moment.

"Derek!"

A familiar voice calls out his name.

"Derek!"

Someone's nitrile-gloved-hand lifts into the air, weakly waving to grab his attention.

"Meredith?"

----------

"Hey, kid!"

One of the U.S. Coast Guard members approaches the young girl, an orange jacket thrown over his shoulders with his name in white print.

"You okay, kid?" The man bends down in front of her. "You need to come with me, okay?"

Her hazel green eyes continue to stare out into the water, as if she was waiting for something to happen.

"Kid?"

Without a verbal response, he lifts her up from underneath her arms and starts to carry her towards the group of tents.

Splash!

The surface of the water breaks with a loud splash, and out comes three people: a grief-stricken Meredith Grey, a soaking wet Derek Shepherd. . .and a close-to-lifeless Leven Phoenix.

"I need an ambulance. Now."

----------

One, two, three, four, five.

His lips press to Leven's, forcing air into her body.

One, two, three, four, five.

"E.T.A.'s five minutes." A paramedic calls from the driver's seat.

One, two, three, four, five.

"Derek. . ."

Meredith sits in the corner, an emergency blanket thrown over her shivering figure. She watches as he continues compressions.

"When she went in. . ." Her voice cracks. "I think her pacemaker malfunctioned when she jumped in to-to. . ." Another cry leaves her chapped lips.

One, two, three, four, five.

----------

"What do we got?"

Miranda Bailey, a surgical resident who takes care of and bosses over six of the surgical interns, stands at the back of the open rig.

"Jane Doe, pacemaker malfunction, drowning —"

"She's not Jane Doe." His compresses fail to cease. "It's Leven Phoenix. Miranda, it's Leven."

"Derek." She climbs aboard the vehicle. "Derek, how long-how long has she been down?" Her voice quivers in a mess of shock.

"I don't know, I don't know. . .but she's alive. She's alive."

"Derek!"

"She's alive. She's alive. She's alive. . ."

The unstable man keeps repeating those same two words under his breath, trying to convince himself that she truly is alive.

"Ten minutes." Meredith wobbles onto her feet. "She's been down ten minutes — five minutes in the water, five minutes during the drive."

Bailey visibly assesses her status, confirming it's minor. "Grey, go to the waiting room, I'll send someone to check on you."

"No, I want to —"

"Grey, go."

Hesitantly, she walks out of the ambulance and stumbles into the waiting room of the E.R..

"Okay. Look, I need you to help me get her inside. Move it." She guides him and the gurney down the ramp. "Clear a trauma bay, stat!"

One by one, the rest of the six interns — Cristina Yang, Isobel Stevens, Alex Karev, and George O'Malley — receive a page from their respective areas.

Phoenix — 9-1-1.

"They put a 20-gauge I.V. in but I-I think it blew."

His wrinkled fingers, still intertwined to each other, press softly against her chest.

"I'll start a central line." Bailey obliges. "But you have to get out of the way, Derek."

"We put three milligrams of epi down the E.T. tube —"

"Derek."

". . .that was three minutes ago. We should push —"

The door swings open, and chief of surgery Richard Webber stops at the sight of the colorless girl lying across a trauma table.

"Shepherd. . .get out."

He forces the words out from the back of his mouth.

"Meredith said her pacemaker malfunctioned, which caused her to fall into the water." Derek lets the chief take over with C.P.R.. "I think we should. . .I think we should, uh. . ."

"Shepherd, get out."

His fingertips trail across the side of her head, clicking his tongue against his teeth when he feels the scar her bullet wound left behind.

"We need to —"

"We need to save her life." Webber cuts him off. "You can't do this, Shepherd. We need to do this. So, go. Go now."

Derek's slick wet hair presses against his freezing forehead, but the only thing he can think about. . .is her.

"She. . .she warned me not to fall in love with a dying girl."

"Phoenix isn't a dying girl."

"I fell in love anyway."

He reluctantly lets go of her and follows the chief's order of leaving.

Outside of the trauma room, his head falls into his hands, silent but shaking sobs wrack through his body, just as Preston Burke enters.

Ever since Burke began dating — now engaged to — Cristina, his relationship with Derek has grown stronger, feeling the need to befriend his male coworker.

Having argued with Cristina about telling their friends about their engagement, he lets out an exhale when he sees Leven fighting for her life in the solitude room.

"He threw me out."

"What do you need?"

"I need you to go in there."

Without a second thought, Burke enters the room for his friend. After learning of the malfunction in her pacemaker, he prepares himself to perform surgery on her.

"Oh my God."

Addison Montogmery — a neonatal surgeon, medical geneticist, and who happens to be the ex-spouse to Derek Shepherd — stands at the door in shock.

When she first arrived in Seattle in an attempt to save her marriage, she saw the looks he gave to her. . .the looks she never received.

She couldn't deny her seething jealousy for her, but as the weeks passed. . .she grew fond of Leven. She couldn't find herself hating the woman she long ago blamed for her divorce.

Not that she could ever admit. . .but she thought of Leven Phoenix as a confidante. . .and a close friend, much to her personal disbelief.

And here lay the struggling body of her newfound friend.

"Water in her lungs, corrupted external pacemaker."

Outside in the hallway, Mark Sloan approaches a distraught Derek Shepherd. When he glances into the window, he's shocked by the unfolded sight — Leven Phoenix.

From flirting with her unashamedly on his first day in Seattle. . .to working with her in a sexual reassignment case, Sloan adored the vibrant bubble she is.

Her sarcasm never failed to make him laugh behind his mask or under his breath.

But more than that. . .he was the only one other than himself who knew he'd be able to mend his broken relationship with his best friend.

The only one who believed he could.

He sits beside Derek, his knees hugged into his chest. A gentle hand holds Derek's forearm, a comforting move on his part.

If only he could mend his relationship without losing one of the few good things in his life.

Outside of the closed doors stand the five other interns under Bailey's care, arriving at the same time after receiving the page.

"What happened?"

"She saved my life. And-And. . ."

Meredith slips into another fit of uncontrollable sobs, using the door handles as a support.

Cristina tries to peek into the room, to glance into the room for a positive sign.

George has his back against a wall, silent tears flowing freely down his cheeks.

Alex keeps a strong forward front, although inside. . .his walls of pent-up emotion crumble involuntarily.

Izzie, however, looks at her friends determinedly, as if she knew their friend would make it out alive.

----------

"Hello?"

"Welcome to the Bridge Between Life and Death."