Grey's Anatomy s04e10 Episode Script

Previously on Grey's Anatomy: - This is Mary.
She lost consciousness.
- How's Shane? My partner? I didn't want her to see.
She might take offense.
- Can you get my wife? - Baby? You're gonna drill into my skull? The navigational system is dead? Damn it, Stan! Stan.
Stan.
Can I watch the surgery? Can you sneak me in? You're busted.
I'm gonna tell him.
I don't want him seeing other people.
- What? - Nothing.
I'm gonna be late.
We need to talk.
- My wife gets panicky.
- I will keep her updated.
You seeing anyone? At the end of the day, the experience of practicing medicine bears little resemblance to the dream.
Hey.
Are you Are you Are you really OK? Yeah.
Yeah.
Alex.
Come on.
That was intense.
Intense and crazy and just awful.
How can you be OK after a day like that? We go into medicine because we want to save lives.
You did a good job today.
That was not easy.
What you did was not easy.
It was brave.
We go into medicine because we want to do good.
We go into medicine for the rush, for the high, for the ride.
But what we remember, at the end of most days, are the losses.
What we lie awake at night replaying is the pain we caused.
The ills we couldn't cure.
I don't want you to date other people.
It may not be enough for you, but I'm trying here.
I don't want you to date anybody but me.
The lives we ruined or failed to save.
Can I get some help? The end of the day, the reality is nothing like we hope.
The reality is, at the end of the day, more often than not, turned inside out and upside down.
Over here! Meredith, get in there! We don't have time to lose! OK! I got the shirt open.
I'm almost there! Stop! Stop! Stop! Hold still! OK.
OK, that's it.
I got it.
It stopped.
I got it.
Holy crap.
My artery blew.
- Your artery blew.
- I didn't think that would happen.
Thought it was something they say might happen because they have to, but didn't think it'd happen.
Me neither.
- Their local tech's in Spokane.
- That's five hours away.
- Tell them I was in somebody's brain? - Yes.
The tech is still in Spokane.
You can't just pull the probes out and go to a full craniotomy? - No.
Why not? - The probe is in the tumors.
Pulling out without navigation system could damage brain tissue.
You can't leave the probe in without swelling.
- That's good.
What's your name? - Two.
Steve! Steve Mostow.
- Dr.
Steve Mostow.
Intern.
- Hi, Steve.
Run to the nurses.
Make an announcement.
We need computer technicians in OR Three.
- Go fast and scrub in.
- Yes, sir.
- Dr.
Shepherd? - Yes.
I did three semesters in computer science before nursing.
I don't know what's wrong, but if it's something reasonably basic, I I'd feel better if your voice wasn't shaking.
Shakes when I'm nervous.
I'm imperfect.
It doesn't mean I can't fix it.
Rose has semesters of computer science at what school? - Santa Cruz.
- That's a party school.
Insult my education or want me to help you save your patient? Who can beat three semesters of computer science at Santa Cruz? Anybody? - OK.
Give it a shot.
- I appreciate the vote of confidence.
Can you see anything yet? Uh, I see the diaphragm moving.
Move it up a little more.
- Meredith? - I'm working on it! You're not doing a very good job.
I am doing a damn fine job.
Don't you worry.
- Can you Can you close his eyes? - What? Stan.
Can you close his eyes? I'm sorry.
I'm so sorry.
Meredith, stop.
Stop right there.
I want to freeze that frame.
Yeah, his pericardium's full of blood.
That's not good.
That's not good at all.
Oxygen, IV start kits.
Arnie, monitor.
You, pericardiocentesis kit.
His anatomy's all screwed up because he's hanging upside down.
Get someone from cardio! Go! I've got Tucker waiting for me and I'm late.
Do me a favor and take the patient through to post-op.
- What? - OK, I wanted to say - when you took me off Hahn's service - Something's wrong.
- His blood pressure's bottomed out.
- I'll hang it.
Here you go.
- Dr.
Bailey! - O'Malley OK.
I need you to talk to Tucker.
I need you to ask him to wait.
He's not going to be inclined to, so ask him nicely.
Can you please go and ask him nicely to wait? - Yes, ma'am.
- I won't be long.
Do you see this, Stevens? Sternum's cleaned out.
- Which means we're almost out of here.
- Don't want to watch me work? It's offensive, Dr.
Sloan.
Flat out.
I asked if you wanted to watch me work.
Offensive? You play dumb? Does that work for you because of the way you look? - What are you talking about? - If you were homely, you would have lost your job a long time ago.
The chief needs you in the ambulance bay.
- Paramedic with cardiac tamponade.
- Alrighty then.
Let's go, Stevens.
OK, um Nick, can you reach your call button? - I think so.
- No, no! Don't move that much! OK.
Uh just Can you reach your phone? Without moving very much.
I think so.
I got it.
OK.
Good.
Good, good, good.
OK, dial eight, OK? OK.
- Is that eight? - OK.
OK.
Put it to my ear, OK? - Hello, Nurses Station.
- Hi.
Hi, this is Dr.
Grey.
Mr.
Hanscomb's carotid just blew and Can you page Dr.
Sloan for me please? And also Dr.
Yang? I'm gonna go ahead and call this a code blue.
Yes.
Code blue.
Can you announce that please? Thank you.
- You can put it down.
- Code blue.
That means I'm dead, right? That's what they call when people go, like, flatline.
I figure we can use all the help we can get.
I don't care who it is.
I don't care who it is, Jolene.
I am leaving when I am finished.
If the patient is on fire, I'm not scrubbing in.
It's Dr.
Yang's.
Lexie Grey is paging you 911.
Dr.
Yang? Your intern called a code blue on a patient who is not code blue.
What? Why would she call a code if Go find out.
You needed me here.
That's why you pulled me off of cardio.
No, I'm fine.
Go kick some intern butt.
- How you doing, Dr.
Grey? - Lexie.
I'm OK.
Are you OK? I'm a little freaked out, if I'm being honest.
Mostly because you look like Carrie at the prom.
- You're wearing half my blood.
- Which is why we're hanging more.
- I'm having trouble getting a vein.
- Why? - Hypovolemic.
His veins are flaccid.
- That's not a nice thing to say.
That's not a nice thing to say at all.
Ow! Ow! - Son of a bitch! - It's OK! It's OK! - It's OK! - Stop the bleeding! - My hand slipped.
I got it.
- That can't happen anymore.
- That can't happen anymore.
- Apply steady, firm pressure.
I called for Sloan.
Should we take him to an OR? No, there's no OR.
I was just down there.
Tyler? You should run and get some more blood.
Just in case, OK? - Apply pressure.
I'll get Sloan.
- Leaving? I'll be right back.
You're doing this.
You seeing this, Karev? How I'm tightening the cable by hand? Yeah.
- That's my face.
- What? In the gallery.
I built that face.
That's Jane Doe.
The one with the amnesia.
She a surgeon? - Uh, I don't - You are so busted.
Nick Hanscomb's carotid blew.
Karev, irrigate thoroughly, finish up, pack the wound.
- Leaving? - Other guy can't survive.
- There's no OR available.
- This one will be.
Get this room turned around ASAP.
I'm bringing down my carotid bleed.
Tucker! Hey.
She's busy, right? She can't make lunch? She can make a slightly later lunch.
She's in surgery.
- Always is.
- Taking a little longer.
Always does.
She's having a really bad day.
She's saving the life of a white supremacist, which is not a good day.
So she asked me to ask you if you wouldn't mind waiting a little while longer.
Please? She did said please.
Which, as you may know, is not a word she uses that frequently.
She really is sorry.
It shouldn't be much longer.
Fine.
But tell Miranda I said don't keep me waiting long.
Please.
OK.
Lucy.
If it's all right, I'll update Mr.
Nolston's family and meet you in the ambulance bay.
He's your patient.
Keep the family informed? Think like a surgeon.
You're thinking like a social worker.
If you want to be a social worker, save yourself effort because the training is two years, not 1 2.
Want to be a surgeon, you can update the family when the crisis has passed.
You're right.
Absolutely.
I'm sorry.
I - Steve.
- Yes, sir? - Did you bring anybody with you? - No.
The nurses made an announcement.
I waited, no one came.
- Rose? - Damn.
Damn it.
Damn it.
- Rose? - I don't have the steadiest hand.
I need to reconnect wires, and when you talk to me, it is less steady.
- It's about the wires? - I think so.
I'm pretty sure.
- I'll do it.
- What? I'll do it.
You don't have steady hands.
- Because I'm nervous.
- Got that.
Let me take care of the wires.
I'm a neurosurgeon.
Steady hands.
You're holding the leads in the brain.
OK.
Steve, how's your hand? Is it steady? - Hell, yes, sir.
- Better be, or you kill my patient.
I need you to hold this very still.
- Yes, sir.
- Very, very still.
Good.
Sterile sleeves, gloves, please.
Tell me what I got to do.
- You talked to Tucker? - Yes.
As long as you're out soon, he'll wait.
Mother of The hepatic vein was injured.
- Can you check for a new murmur? - Checking now.
O'Malley, go talk to Tucker.
Just ask him to wait a little longer.
- I just scrubbed in.
- O'Malley, ask him! Yes, ma'am.
A person can only rise so high.
Now, I'm rising above, but there's a ceiling and I'm about to hit it! Let me guess, air embolus? We're about to start the pericardiocentesis, but with the position of his body, the blood won't be pooled to the heart I'd still use the subxiphoid rather than the parasternal.
Right.
OK.
Meredith, did you hear that? - Yeah.
Is the kit ready yet? - I'm getting it ready for you now.
How you doing, Ray? You've got to be careful with this technique.
If you aim the needle incorrectly, you could nick the very thin-walled right atrium.
- Cause a cardiac rupture.
- Rupture, a tension pneumothorax.
There's about six different ways she could kill him.
- Are they talking about me? - No.
Don't listen to them, Ray.
Dr.
Hahn? Shut up.
Sir, you're gonna be fine.
Stevens, go get me an 1 8-gauge needle before this man's heart explodes.
Got it.
- How you doing, Karev? - Yeah, good.
I'm fine.
My nose itches.
Itches like crazy.
That's the anxiety.
Can't scratch it, so it itches.
- Whoa! What did you do? - I was irrigating.
- I need more suction.
- Coming from the side of his chest.
I think his heart's starting to bleed.
Hang a unit of blood! Page Hahn and Sloan now! Right away.
Tyler, could you get me more gauze, please? Why do you need more gauze? 'Cause I'm bleeding? - I'm still bleeding? - We have blood going in, too, Nick.
Is it going in as fast as it's going out? I'm asking because I'm starting to feel, like, queasy.
And weak.
Maybe like a person who's losing a lot of blood.
OK, I'm transferring now, Nick.
You ready? Yeah.
Lexie? Should I be calling people? Should I be calling my family or somebody? I think I think the bleeding's stopped.
- How you doing, Nick? - Dr.
Sloan.
It's Dr.
Sloan.
- I think the bleeding stopped.
- You OK? - Do I look OK? - Actually, you do.
- You've got bleeding under control.
- Why would it stop? The herald bleed, which means there's a possibility - of it bleeding.
- I'm gonna get it closed up.
- There's no OR.
- There will be in ten minutes.
Get a pressure dressing on this wound.
Get him prepped straight to OR Three.
Make sure it's cleared out.
Good work, Grey.
Thank you.
Hey.
I'm in love with you now.
I've forgotten entirely about my ex.
- Come on! Are you kidding me? - What? I have a patient on the table I got to go.
- Erica! - Page the cardio fellow, then book an OR.
Have it waiting when they get him free.
Why am I not surprised? Dr.
Bailey is very sorry.
She's very, very sorry.
- I'm out of here.
- She just asked me to ask if you could wait longer.
She's almost done with the surgery.
It's just more complicated than she expected, but she is almost done.
Fine, I'll wait.
But you tell her I'm tired of her choosing everything over our marriage.
The last time.
I'm finished.
Tell her the only reason I'm staying here is to tell her that myself.
- What the hell did you do, Karev? - Nothing.
I cut the cable.
You cut the cable? Showing off for your girlfriend? Any idea how screwed you are? It's not his fault.
I'm holding this guy's coronary.
- Did somebody page Hahn? - What the hell happened? - Graft blew.
- Damn it! - If you need me to - I need you to stay quiet.
- Get more suction in here.
- Just hold onto that.
O'Malley? - Your husband is waiting.
- Good.
- He's waiting and - Look, I heard you.
Why aren't you scrubbed in? I could use a hand.
He said something about you choosing everything over your marriage.
He said that? - What else did he say? - I think that was about it.
You think or you know? He said this was the last time, and he was finished.
I'm in surgery, O'Malley.
Did you tell him that I'm trying to save a man's life? - Yes.
- That I want to be there with him now, but if I were to leave, this man would die? - Tell him that? - Yeah.
Yes.
You need to go back out there and tell him that I took a vow.
A vow to save lives.
Remember that he also took a vow.
For better or for worse.
You tell him that it's his job, as a husband, to understand that.
You tell him that I'm standing by my vow.
For better or worse.
Tell him I'm holding him to his vow.
You tell him if he's thinking about leaving right now, that he might find himself hurt and wounded and needing an operation.
And he may not get a surgeon who is as married to her vows as I am.
You tell him that! - Can I just go do some charts? - Go! - It's in.
- It's in? The wire's in.
- Steve, are you still? - Yes, sir.
Very still.
Stop looking at me like I killed your patient.
I am not a technician.
- I did my best.
- You didn't.
Yes, I did do my best, damn it! Calm down.
Take a deep breath and think.
What did you miss? What are you forgetting? - You forgot the restart button? - I forgot to press restart.
Yeah, working.
It's working.
It's working.
It's working.
Santa Cruz is not just a party school.
- Dr.
Shepherd? - Yes? Your sleeves.
This was never my plan.
To die this way.
- You're not dying, Nick.
- You're going to the OR.
I know.
That's what I'm saying.
I think we kind of have some say.
Or at least a feeling.
But I never had that feeling, so I can't die, right? I don't feel good.
I feel - Oh! Nick? Nick? - Can you squeeze my hand? - Oh, my God! What happened? - The blood to his brain It looks like he had a stroke.
Let's go.
Let's move him carefully.
Let's go.
You can't cry, Lexie.
This isn't over.
You can't cry.
Hey, you need to find the xiphoid process.
You feel it? - Got it.
- Go two finger breadths to the left - of the xiphoid.
- I'm there.
Here.
- Eighteen-gauge.
- Yeah.
- That is a very big needle.
- I know.
I'm sorry.
Angle the needle toward the left shoulder.
Don't stab.
Don't hit the ventricle, don't drop the lung.
- That wouldn't help matters either.
- I changed my mind.
I want out.
This is gonna help you, Ray.
I'm gonna go on three, OK? - One, two - No, wait.
Tell Stan's wife I'm sorry.
Tell Sara I'm sorry about Stan.
Tell her yourself.
One, two Wait.
Wait.
We're running out of time.
- Just wait.
- OK.
- What's taking so long? - He's not ready.
I'm trying not to be scared.
I don't want to die scared.
- I want to not be scared.
- Ray, listen to me.
It's good to be scared.
It means you still have something to lose.
Yeah? Are you scared? All the time.
OK.
That's good.
OK, I'm ready.
But don't count.
Just do it.
Do it so I don't know it's The infection went to his heart.
His hack of a surgeon didn't check grafts.
Should've caught it.
Should've checked.
I missed.
Damn it, how did I miss it? Stupid, stupid, stupid.
- That's fascinating, Dr.
Hahn.
- What? You're as unkind to yourself as you are to everyone.
Sloan.
Dr.
Sloan, his artery blew and he appears to be having a left-sided CVA.
- Where is he? - You told me bring him here.
- Hahn, you close? - No.
Yang, get him to a sterile procedure room.
Run! - Let's go.
- I can help.
What do you want me to do? - Anesthesiologist, nurse, equipment.
- I'm on it.
Stay with Hahn.
This man has four children.
He has four children.
I feel like I'm going in too far.
Pull back! Pull back! - Pull back! Pull back! - Chief, what am I doing? Too far in.
There's some ST elevation.
Try angling more forward.
I got it! I got it! Ray? That feels good.
I can breathe.
He's almost stable! Get ready to cut him out! All right.
All right.
We're gonna get you out of here.
We're getting you out of here right now.
- You're bleeding.
- It's Ray's blood.
I can see that.
It could use a couple of stitches.
But you stayed calm and focused and efficient in a very stressful situation.
That's impressive.
I was scared.
You did it anyway.
Like I said, impressive.
Do not tell me that there isn't an OR.
This is for the chief.
A paramedic's life is on the line.
- You need to find one now.
- I'll see where we are.
Dr.
Stevens? Thank God.
How is he? I I believe he's still in surgery.
- But I don't know.
- You don't know? Why don't you? You said that you were gonna keep me informed I'm sorry.
I'm on another case, but I was gonna check back - You're on another case? - I'm sorry.
I have four kids here.
I have four terrified children who think that their dad's gonna die.
Did you have instructors who didn't teach you how to be a doctor, or really bad parents who didn't teach you how to be a decent human? - Stevens, OR Two is clearing out now.
- Thank you.
My husband, Jacob Nolston, went into surgery hours ago.
Would you please just find someone who can tell me if he's dead or alive? - She said that? - If you could wait a few more minutes, you guys can talk to each other.
Because things get lost in translation because this is clearly not a way to have what is - a very, very important conversation.
- It's clearly not very important.
Our marriage is falling apart and she sends you.
Tucker.
She's in surgery.
She's literally saving a life and she's gonna be here soon.
She's always saving a person's life.
She'll always be here soon.
You go ask her, when exactly is soon gonna come? Excuse me.
You're You're the one who came to get me.
- Who told me about Stan.
- Yes.
- Is Ray? - He's in surgery.
OK.
I have to go.
I have to get out of here, so Look, can you tell him that I'm sorry? I can't stay here? I just can't come back here right now? Ray wanted me to tell you that he's sorry too.
He's sorry he couldn't save Stan.
He wanted me to tell you that in case he didn't make it.
- You think he's not gonna make it? - I hope he makes it.
But you won't be here, so My husband is dead.
He's dead.
Somewhere in this hospital.
How am I supposed to stay here? I don't know.
I don't know.
But I know that if Ray makes it, he's gonna wake up and he's gonna have no one.
And you're gonna go home and you're gonna have No one.
I think it's better to have someone.
Even if it hurts.
Even if it's the most painful thing you have to do.
Even if it's the most painful thing you've ever had to do.
I think it's better to have someone.
See this skin, O'Malley? It looks a little jagged.
Does it look jagged to you? Because if it is, jagged, I'm going to have to reposition the incision so that it approximates more correctly.
If I do that, this man's swastika tattoo might be unrecognizable.
- Yeah, it's a little jagged.
- I thought so too.
- He left, right? - Yes, he left.
Ten-blade.
More lap pads, Stevens.
Pack them all around the heart.
Suction.
Come on, Ray.
Fight.
You will not die.
You will not die.
You will not die.
You will not die.
You will not die.
Don't do this, Mary.
Come on, don't do this.
I need more light.
Can I get more light? Come on! - He's coding.
- Come on.
Live, please live.
Please.
Please live.
He looks bad.
He looks really bad.
His heart was severely damaged.
And his lungs were compromised.
But he's young and strong and our hope is that he'll be just fine.
Ray? Ray? I'm here.
Well, your liver had more damage than we saw on the CT and then we found a perforation in your bowel.
But we took care of it all, and you should have a full recovery.
Not a full recovery.
Dr.
Bail She did this on purpose, right? I don't understand.
You have a black partner, right? - Yeah.
- Mary? Yeah.
Do you know how she is? Are you two are friends? Look, I'm not the devil, OK? I'm just a guy with a belief system.
Mary's a nice girl.
We save lives together.
That's a good time.
If she wanted to marry my brother, I'd have a problem with that.
But so would a lot of people.
I'm not that much different than most of the people that you know.
Well, Dr.
Bailey did save your life today.
A black woman saved your life at a great personal cost.
Next time you're looking at your tattoo and you're thinking how much better white guys are than everyone, think about that.
Because between you and me? If I had been alone in that OR, you'd probably be dead right now.
And, since we're sharing belief systems, I believe if you were dead, the world would be a better place.
How's he doing? He's OK.
Surgery was pretty hairy.
He blew a graft when we were closing.
- But he's starting to rally.
- Good.
That's good.
- What are you doing here? - I was just checking We did fine without your help.
Do you mind? You're not heading home? Just easier, at this point, to stay here until Tucker's asleep.
You know, I rose above too today.
- Yes, you did.
- You were having a hard day.
You were busy rising above.
But so was I.
Which is why I haven't said anything.
But now the day is over and I'm done.
- Excuse me? - Pulling me off of Hahn's surgery was an abuse of power.
You know, you needed help, OK.
But you used me.
Because of the color of my skin.
I mean, you compromised the quality of my education because of my color.
I resent it.
- You saved her life.
- No, I fixed her brain.
Restored motor skills.
A stressful, extremely difficult procedure, but no.
You saved her life.
OK.
Thanks.
That was OK.
- Your voice is shaking.
- I'm an imperfect person.
Are his parents coming? They're on a plane from California.
You gonna wait? Yeah.
I'm gonna wait.
- Hey.
- I don't want you to date other people.
It may not be enough for you, but I'm trying here.
So I don't want you to date anybody but me.
That's it.
Except I'm scared as hell to want you.
But here I am wanting you anyway.
And fear means I have something to lose, right? And I don't want to lose you.
- Meredith.
- Don't.
Don't say anything.
I'm gonna leave and you can say something tomorrow.
That's progress, right? Hey.
Hey.
Hey.
Are you? Are you really OK? Yeah.
Yeah.
Alex.
Come on.
That was intense.
Intense and crazy and just awful.
How can you be OK after a day like that? Alex.
Alex.
Why won't you talk to me? What do you want to talk about, Rebecca? How a guy almost bled out while I watched? How I got suspended because you were there? - Ava.
It's Ava.
Not Rebecca.
- Right.
You're playing dress up.
You're here playing dress up.
You have a husband, Rebecca.
You have a baby.
And I have a life.
That girl you were talking to when playing med student? I'm screwing her.
She might be a bigger wreck than I am, but she's not married.
She's not gonna get me suspended.
She's not pretending to be somebody she's not.
- Alex - Ask yourself what you're doing here.
Because, I think if you can get honest, if you could just tell the damn truth for one minute, I think you have to admit you're not here to talk.
You did a good job today.
That was not easy.
What you did was not easy.
It was brave.
We killed him.
The hospital Sloan, us We were not prepared.
Yeah.
Yeah, that happens sometimes.
That's Do you have any idea how backwards that is? We help more than we hurt.
I have no one.
This is gonna sound bizarre.
I realize, at this point, that this is gonna sound bizarre, but any chance you people want to get a drink with me? - Why would we want to do that? - She's saying she needs a friend.
- OK.
Fine.
Let's drink.
- You won't hit on me? - I can't promise that.
- If I say please? He still can't promise that.
Fine.
Hey.
I brought supplies.
Some days, the world seems upside down.
She's got no one.
I'm drinking.
Are you drinking, Lexie? Yeah.
A drink would be good.
Hey.
I was Hahn's right hand today.
That's good, right? That's great.
I think a patient feels better if they know their kids aren't terrified.
They're more likely to pull through surgery if their wives are not panicked.
Those things matter.
Well, they do matter.
I'm never gonna be Cristina.
Not gonna happen.
I'm never gonna be Erica Hahn.
I am not kick-ass.
Thank God for that.
I love you.
I love you.
We're not gonna make this work, are we? Marriage is hard.
I mean, even when it's right.
It's hard.
And the next time I do it, I just want it to be forever.
And I don't think it's our chemistry.
I think it's our timing.
But I don't think it's our chemistry.
So we're saying maybe someday? Yeah.
Yeah, we're saying maybe someday.
Come on, Izzie.
Dance party.
You want to dance? I will if you want me to.
And then, somehow, improbably and when you least expect it, the world rights itself again.