Webb sees Hunt and tells him he thought he was supposed to be in surgery. Hunt says he switched with Callie, but she arrives behind him. Webb tries to go into the OR, by Arizona stops him and says Derek can't be distracted. After Webb leaves, Arizona starts to cry on Callie's shoulder.

Bailey enters the OR and tells Derek he should focus on the surgery. Derek says there is one vessel he is not sure if it supplies the tumor or the spine. He decides to come back to it later. After 21 hours, Avery hand starts to cramp. Derek realizes Avery hasn't taken in any fluids and asks Lexie to take over. Later, Derek asks the doctors which vessel he should cut, but hey tell him he should make the decision himself. Derek finally picks a vessel and cuts. Cristina, who is on the phone with Meredith, tells her that Derek made the cut.

After the surgery, Derek waits next to Isaac's bedside. Isaac is worried since he can move his toes. Derek explains he will be fine since they removed the tumor. Isaac starts to cry after he realizes he will be okay.

Reed meets with Alex and informs him that Derek is finished with the surgery. Alex says that Izzie didn't show up for her treatment then starts to cry. Hunt finds Cristina practicing the skills test and gives her some pointers. She tries again and is successful.

Derek meets with Webb while he assigning doctors to surgeries. Derek tells him they shouldn't fight anymore. Webb tells Derek he is fired and orders him to get out of the hospital. Derek tells him to go home, sleep on it and talk to him tomorrow.

Derek brings Meredith a bottle of champagne. Meredith asks Derek to tell her his side of the story, but he falls asleep.