Grey's Anatomy s04e16 Episode Script

My mother used to say that for a surgeon, a day without death is a rare gift.
Time of death, 11:53.
Every day we face death.
Every day we lose life.
Time of death, 1 8:36.
Time of death, 1 5:52.
And every day, we're hoping for a stay of execution.
What do you remember about it? We were at home.
- You were there? - Yes, I was there.
It's OK to talk about it.
Dr.
Wyatt, my mother took a scalpel and sliced her wrists in front of me.
I sat on the kitchen floor in a pool of her blood, waiting until she passed out so I could call 911.
It's not OK to talk about it.
Why did you wait until she passed out? She asked me not to before she slit her wrists, so I knew I would get in trouble if I tried to save her life.
But you did save her life.
She didn't want it saved.
You must be very angry at her.
No.
- Not at her.
- Who are you angry at? We're attached to death.
Chained, like prisoners.
Captives.
- Do you want to dance it out? - No.
- Do you want to drink tequila? - No.
Do you want to call me names, mock me endlessly? - No.
- I'm trying to cheer you up.
Yeah? Well, stop it.
It's annoying.
And it's not working.
I'm deep in the wilderness here.
Do you want the sparkle pager? - That's not funny.
- You're sad.
Actually sad.
I know it's the right thing to do to give you the pager.
You're so sad, you're not asking me.
Shiny, shiny pager with lots of shiny, shiny surgeries.
If I were the kind of person who kissed people, I would kiss you.
I tried to change.
Turn over a new leaf.
- But the leaf isn't turning.
- You weren't ready to change.
And that's OK.
Adele wanted me to change, to retire.
Well, I'm still the chief, and this weekend, I'm moving back home.
- Does Adele know that? - She'll be fine.
She was wrong.
- I was right.
And now we're - Doing it like bunnies.
I can't change.
I can't change.
I can't change.
Be who you are.
I am who I am.
- A man.
- A man.
I have a way about me.
I'm a man who is who he is.
I have a right to be that man.
I'm not gonna say anything.
No judgment.
The man you are slept with my wife.
And you, you've been on my land for six months.
But I got no judgment.
- I'm gonna miss living on the land.
- It is beautiful.
- Wanna buy it? - You can't sell this land.
You have blueprints.
This is your living room window.
- The house that Derek built.
- That's over.
- I'm getting a place in town.
- But you love this land.
This land and ferry boats are who you are.
A man can change.
I'm selling the land.
Ferry boats crash.
- Morning.
- Hey.
All right.
Come on.
Can you take my cases this morning? Check in on my post-ops? - Not coming to work? - I'm gonna hang with Rebecca.
So if you could cover for me Hey, take a bite.
Yeah, I'll cover for you.
- Alex, she's not looking very good.
- She's fine.
Come on.
Take a bite.
Dr.
Bailey, I got an answer for you from the chief about your schedule.
You're not spending enough hours in the OR, between clinic and chief resident work.
I checked with the attendings and nailed the chief down to a hard count.
You need to spend at least 1 5 to 20 more hours per week in surgery in order to sit for your boards.
Should I tell the chief that's possible? Just trying to use my power as the chief's intern for good, so - Dr.
Bailey? - Hush.
I'm trying to see something.
When I'm trying to see something, I can't do it if you ask me questions.
- What are you trying to see? - Dr.
Bailey, listen.
I am really worried about Ava.
I mean Rebecca.
I mean Alex.
Well, Alex and Rebecca.
Who used to be called Ava Anyway, listen, she's crazy, and I don't mean funny crazy.
OK? Bad crazy, OK? Alex is home with her, and he's all, "Take a bite.
" It's weird and sad and I want to help, I don't know what to do.
I need you to tell me what to do.
- What do I do? - She's trying to see something.
She doesn't need you asking questions.
What are you trying to see? The bigger picture.
It's just you and me and Erica.
And we're grabbing you, ripping off your clothes.
And then you're naked.
You're so hot.
And naked.
- And then Erica starts kissing you.
- Hold on a minute.
Erica's kissing you like you need to be kissed.
And then I pin your hands.
- Hold on.
- Above your head.
And then I watch as she uses one finger Hold on a minute! Oh.
Oh.
OK, I'm sorry, 'cause that was good for me.
That was really, really good for me.
Good boy.
But I have a big trauma coming in downstairs, so we have to do this the fast way.
Every page goes in every set of documents.
Miss one, you're on scut.
These are the most promising trial patients.
I don't want mistakes.
- Hard-ass.
- Where were you? - I had to stay with Cristina.
- That's so nice.
- Rebecca's at the house.
I needed you.
- She's crazy.
We've had this discussion, and decided it's not appropriate - to call Izzie crazy.
She's spirited.
- Spirited.
Yeah.
Not me! I'm not crazy.
Rebecca's crazy.
Alex is pretending she's not.
It's - Hello.
- I was just helping Meredith collate.
- I'm on my way to check your patients.
- That's fine.
Take your time.
- You seem cheerful.
- I'm gettin' my groove back.
I'm gettin' jiggy with it.
I'm gettin' down with the get down.
- Meredith gave me the sparkle pager.
- What? She needed it for her mojo.
- Ever think I needed it? - You'd waste it.
I need it to get out from under Hahn.
I won't have to beg her for OR time if I have the pager.
She's not gonna teach, I'll teach myself.
She's just gonna use it for evil.
I I would use it to do good.
And besides, the pager is sacred.
Sacred sparkle.
You can't just give it away.
She can't do that.
- I think it's nontransferable.
- You don't make rules.
- But I am the chief's intern.
- You're the chief's bitch.
And you have no power.
Because the power is in the pager.
That's the chief with something important and powerful.
No need for pagers covered with glue and glitter when you work for the chief.
- Rebecca.
- Me and my world-class neurosurgeon are gonna use a cutting-edge technique to save a life.
So I don't have time for crazy.
Work it out.
Ooh, a trauma.
- What do we got? - Not, "What do we got?" - What do I got, I don't know.
- Sparkle pager rules.
- Whatever it is, it's mine now.
- What do we have? - I don't know.
Sparkle pager.
- No.
You can't sparkle pager it.
It's not her pager.
Yang, it's yours.
Stevens, cover the pit.
You volunteer to oversee Karev's post-ops? - Yes - Don't have time for pettiness.
Go.
- Hey, Callie.
- Hi.
Hello, Erica.
- What's the matter? - Nothing.
Nothing.
- You look all hot and bothered.
- No.
It's just, there's a trauma, and it's really big.
That's all.
It's big.
- It's a big trauma.
- You're acting weird.
- She uses one finger - Really big trauma.
Torres, it's like you never seen a really big trauma before.
Oh, my.
Really big trauma.
So how you want to handle this? I Uh Help me.
Really big trauma.
Please.
Help me.
- Look, we were just joking around.
- Yeah, it was a dare.
You dared him to lay in a vat of cement at a construction site.
Hey, we never thought he'd do it.
It's Andy.
He never does anything.
- He doesn't have the guts.
- In the middle of the night, you snuck into a construction site - and dared your friend - He's not our friend.
The four of us, we're friends.
But he's not really our friend.
OK, you dared him to lie down in concrete.
Nobody made him do it.
You're making it sound like we did something wrong.
- How long? - What? How long did your not friend lay in that vat of cement unable to move before you four geniuses, you band of brothers, future Mother Teresas, how long did he lay in that cement yelling that he couldn't move before you called the police? Yeah.
That's what I thought.
The cytoplasmic viral particles in the malignant cells but not in the normal tissue.
No idea what you're saying, but it sounds brilliant.
Boring but brilliant.
- You wanted to spend time together.
- I meant the movies or ball games.
But a clinical trial is just as good.
- Hi.
- Hey.
Fr1 904 and trichostatin increases the expression of the virus in the tumor.
Introduce them during the M phase of the cell cycle? - Exactly.
- Champagne with our name written on it.
She understands how brilliant you are.
OK, so Jeremy West is patient number 1 2, and patient 13 is Beth Monroe.
Jeremy is suffering from grand mal seizures, Beth is paralyzed on the right side.
Who do you want to meet first? Jeremy's surgery's today, Beth's isn't until tomorrow.
- They're young.
- Yeah, which makes them resilient.
- OK.
- OK.
Bye.
Clinical trial, fun.
- So, what do you want to do first? - I don't know.
OK.
Well, what do you want us to do first? - I don't know.
- All right, look, we blasted him out of the job site, but we figured, don't blast too close.
This is a lot of concrete.
Planning on treating him, we need to start.
- So, what do you want to do? - I don't know! I'm sorry.
Uh I know I'm not doing my best to instill a sense of confidence in my abilities.
It's just that you are trapped in what I'm guessing is several tons of cement, and I've never seen a boy How old are you? - Nineteen.
- Then you're a man.
I've never seen a man trapped in several tons of cement before.
But now that I have, I'm gonna figure this out.
I'm gonna work with other surgeons, we'll figure out a plan and we're going to save you.
OK, I never, ever promise life, but I'm promising this to you.
Do you understand? - I do.
- OK.
I don't know much yet, but the one thing I do know is that the cement you're encased in is slowly leeching the water from your body, and you're gonna need all the water you can get, so no crying.
You're a strong young man.
I know you can do this.
Good.
Good.
OK, you're gonna live.
I'll make sure that you live.
Here you go.
- Hello.
- Hello.
- Dr.
Grey, is this him? - Him? - She has a pet name for you.
- The Seattle Grace Brain Butcher.
- Beth.
I'm sorry.
- Oh, no, that's fine.
That's me.
- How do you do? - Nice to meet you.
Pleasure.
Um, that hand's just for show.
So come on.
How does this work? You're going to inject a live virus into her tumor? Mm-hmm.
- And that's safe? - The virus is in testing stages.
I've made adjustments that destroy the tumor.
- Hey, tumor destroyers.
I like that.
- Has this ever worked before? - No.
- So I'm your lab rat.
- Beth.
- I'm just saying if this works, my name will go down in the annals of some book.
That's cool.
- Not if I beat you to it.
- Beth.
This is our other patient.
- Jeremy.
- You didn't call.
- Know each other? - I thought you backed out.
As if I'd break our pact? Come here.
They know each other.
- What is he doing here? - His surgery is this afternoon.
She didn't find this clinical trial on her own.
Bizarre experimental surgery, it had to be Jeremy.
They met when they were both being treated at Mayo last year.
They went through chemo, radiation, a support group.
- You don't want them to be together? - Look, we like Jeremy.
He's a good kid.
I feel for him that he's going through this alone, but we worry about Beth.
She thinks that she's in love with him.
We just don't want her getting so attached to someone that might - Die.
- If something happens, if he doesn't survive, Beth won't want to live.
She's my only child.
She has to She has to want to fight to stay alive.
- You paged? - Oh, O'Malley.
There's a binder on occupational medicine articles in my office.
Should be a toxicology section.
See if you can find anything on cement.
- Yes, sir.
- Let Shepherd or Grey know - I need to see them.
- Will do.
Oh, my God.
Oh, my God.
My God.
Why? Wh? What is everybody doing standing around here? - This is what your guys told us to do.
- And exactly where are my guys? Work from the outside in! No more time.
This is what we have to do.
- I am right.
- Why is the patient in there and all of you are in here? Torres is worried about limbs.
Bailey about abdominal crush.
Dr.
Sloan feels the burns should take the first look, Hahn feels the heart and lung issues are gonna kill him - before we get to any of this.
- In other words - No one can agree on where to start.
- I know where to start.
Cement's contracting.
I don't get in, he could lose legs and right arm.
I'd like to see him without a liver.
We'd prefer him to suffer a painful death as the alkaline continues to burn through his skin? You can't chip away.
Once his circulation opens up, the built-up toxins will stop his heart, not to mention rhabdomyolosis.
- Treat with dialysis.
- Let us work.
- I found an article, doesn't say a lot.
- Put in a Swan-Ganz.
usually at the bottom of a river.
- You are so wrong.
- I'm so wrong? - You are.
Wrong.
- You two working together on this? - Everybody stand down! We are fighting the clock.
It took one hour for the kids to call 911.
Three hours for search and rescue to get this guy cut out of the cement.
Less than four to six hours to get him out of cement and into the OR before he is dead.
We are fighting one hell of a clock.
Every minute counts.
We work as a team, or that man dies.
- Do you understand? - Yes, sir.
Of course.
Where do you want me, chief? Find Grey and be her intern for the day.
I have too many bodies in the room.
Patient's name? Andrew Langston.
OK, let's go save his life.
Hey.
You intimidate me a little.
I mean, you're not an intimidating person, but the legend of Meredith and Derek.
It's intimidating.
- No legend.
- He's selling his land because of you.
- There's a legend.
- Derek's selling his land? He doesn't say it's because of you.
He was making plans to build a house when you were together, and now I'm I'm not trying to I just really like him.
And you intimidate me.
There's no legend.
OK.
OK.
OK.
Izzie had a question about some post-ops.
- What'd I miss? - What? The movie.
What'd I miss? - Hey.
Hey.
- I'm sorry.
Don't be sorry.
I think I wet my pants.
Oh.
Oh, that's, uh that's OK.
That's that's OK.
I'll do better.
I promise.
Don't worry about it.
You're doing fine.
Come on.
I forgot to tell you.
Guess who called me.
Carrie from our support group.
She didn't sound so good.
Have you talked to her lately? - No, she - Oh, God.
Her husband said they tried radiation one last time.
He said it was bad.
The last day, she didn't even recognize him.
And the pain.
She was screaming and begging them to He said it was bad.
Yeah.
Hey.
At least we don't have to worry about that.
You know? This surgery will work.
OK? And if it doesn't, at least we'll die quick.
Yeah, we'll die super-fast and without pain.
Yes.
Dr.
Grey, I thought we talked about changing Beth's room.
It isn't sunny enough in here.
The room is fine, and it's right down the hall from Jeremy.
I'd like to move her as soon as possible.
Mrs.
Monroe, I checked.
There aren't any beds available.
Not in a private room.
Mom, why don't you go find Dad? I can wait for him here.
Mom, why don't you go find Dad so I can kiss Jeremy without you watching? - It's time Jeremy went back - I don't understand wh Nurse! I need a nurse.
He's seizing! All right.
Let's run a second set of labs before surgery.
How's Beth? Was she was she scared? Or She's fine.
Chief wants you or Shepherd.
He says it's important.
- I'll go.
- He put me on you.
- What can I do? How can I help? - You can run labs for me.
- Labs, that's it? - Yeah.
Thanks.
Hi.
- What's that? - Pouring vinegar on your flesh to minimize burns inside your skin caused by the cement.
I'm burning from the inside out? I'm dying.
I'm dying, aren't I? Andrew, that word's not allowed anymore.
I'm banning that word from your vocabulary.
Can you move your fingers? That's very good.
I'm not usually this dumb.
Most people think I'm pretty smart.
I make the dean's list.
I tutor.
I'm not I'm not usually the guy who's dumb enough to jump into a tub of cement for a girl.
Wait, not the girl you came in with? - You did this for her? - Lola.
The guys dared me.
She was watching.
And I She was watching.
And now not only is she totally unimpressed, but after I'm gone, she'll remember me as the idiot who was dumb enough to jump into a tub of cement.
People will write stories about my idiocy and forward them to friends.
I'm gonna die as a bad e-mail forward.
Hey.
We all mess up.
I'm the guy who died in a block of cement trying to impress a girl.
I'm like Han Solo.
In Star Wars? He was encased in carbonite? You wanted to see me? I got a call from the IRB.
The national board that oversees and reviews clinical trials.
Your clinical trial.
You've had 11 deaths.
They're giving you one last patient.
You get it today under the wire and hope for the best.
At midnight, if you lose him, they're gonna shut you down, period.
One last patient.
You're angry at him.
The chief.
- But why? Why am I angry at him? - Because you have opened up your past.
It's like you're reliving it all now.
You're angry with him.
You're angry with your mother.
You're angry with yourself.
Chief went back to his wife.
My mother didn't want to live.
He did what he had to do.
She did what she had to do.
- Your mother didn't wanna kill herself.
- She did.
- How can you be sure? - How can you be? You weren't there.
The answer is right in front of you.
Think about it.
- The IRB is saying I failed? - You haven't.
I failed.
I'll sign the discharge order for Beth.
You can't.
This is her last shot.
You have until midnight.
- Jeremy's today.
- Move Jeremy's surgery up.
Beth's this afternoon.
Fit them in before midnight.
- If I get the dosage right.
- Close.
You haven't failed.
But are we going too far here? These are people's lives.
- Is my ego too big here? - Your ego is just the right size.
We can do this.
Two patients.
Bends the rules without breaking 'em.
- You'll clear it with the chief? - Yeah.
- Jeremy's going into surgery soon? - In a couple of hours.
- How is he? - Oh, he's stable.
Yeah, he's actually better than stable.
He called me the angel of death.
He's good then.
- Can I see him? - Honey, no.
I'll just be gone a few minutes.
Can you get me a wheelchair? If you're having surgery today, you need to rest.
You don't We just want to spend some time with you.
That's all.
Please.
- We're the last two.
- What? From our support group.
Jeremy and I are the last two still alive.
Hey.
Have you seen Cristina? I've done everything I'm supposed to.
She sees me doing nothing, - not in the mood to get yelled at.
- With cement boy.
- Cement boy? - Don't bother.
Don't need interns.
They don't want interns there.
Interns are in the way! I'm not complaining.
Two minutes of complaining between me and you.
No one has to know.
I have all this power! Supposedly.
I supposedly am imbued with power of being the chief's intern.
But there's a cement boy, and I'm stuck in here, running labs, researching effects of cement on the body in the vain hopes somebody asks me a question.
I'm not in with the cement boy because, even though I have all this power, I can't use it because it's not real power.
- It's fake power? - Fake power.
I can go into the chief's office whenever I want.
You know what he has in there? Files.
Confidential on every resident in this hospital.
And I'm just allowed in, and he's not worried because he knows and I know that I don't have any real power.
I don't have the power to look at them! - Make you feel better if you could? - Know what would make me feel better? If I feel like there was a reason for this, that there was a point.
Oh, God.
My poor, poor parents.
How would they face anyone at the funeral? OK, Andrew, you're gonna make a lot of mistakes in your life, but mistakes are They're pieces.
Like this is a foolish piece, but, you know, it's just a piece.
Be proud of the whole picture.
The whole picture defines you, not just this one piece.
I'm a loser.
I'm a loser.
I'm a loser.
I'm a loser.
- Come on.
Andrew.
- I'm a loser.
Andrew.
Hey, listen to me.
Han Solo is not a loser.
Han Solo got encased in carbonite, and and that was a big mess.
Not what he's remembered for.
He's remembered as the guy who made the Kessel run in less than 1 2 parsecs, and who braved temperatures of the ice planet Hoth in order to save someone he cared about from the big, ugly wampa.
He is remembered as the guy who swooped down, blasted Darth Vader out of the sky so that Luke could use the Force and destroy the damn Death Star, OK? Leia saved him from the carbonite.
And they fell in love and they saved the universe and had twin Jedi babies that went on to save the universe again.
Now, that's the whole picture.
The carbonite, it was just a piece, OK? So I like science-fiction.
Got a problem? - No.
- It's great.
Do what you doing.
I got Jeremy's labs back.
Good to go for surgery.
- Chief sign off on that? - Yeah.
Where are you going? Get a wheelchair.
What are you doing? M-My mom went to go call my grandma, and my dad went to the cafeteria.
There wasn't a wheelchair in my room.
I just want to see Jeremy.
Please.
I don't want the seizure to be the last time I see him.
Please.
- I just need to see him.
- OK, let's go.
Am I going to get to be alone with Jeremy? I mean, "alone" alone? - Alone? - We've never done it, either of us.
We've been waiting until we both were tumor free, but surgery Anything could happen.
We can do it, right? It won't kill us or anything? No, no.
- No, it won't kill you.
- I mean, you've done it, right? - With each other? - I've He's done - He's done it, and I've done it, yeah.
- What's it like? Is it magical? - Yes.
- It can be.
With the right person.
I'm gonna go get you some clothes.
You got shampoo in there? I don't understand.
I don't understand.
I was pregnant.
I was pregnant.
I know I was.
- It's OK.
- I don't It's OK.
You just got confused.
That's all.
You just got confused, OK? OK.
I have never in my life gotten a patient laid, much less two patients.
- It's really sweet.
- We're pimps.
Yentas.
- They're so in love.
- Oh, yeah.
It's all new and fresh and exciting.
I've never been a fan of new.
I like to know the person, their bodies, what makes them moan.
Something happen? Beth isn't in her room.
Oh, well, that's because I had my intern take her down - for a pre-op MRI.
- Thank God.
I was afraid she was lying somewhere in pain.
No, she's not in any pain.
We should go to the conference room.
There's lots of paperwork - you haven't filled out.
- Thank you.
You bet.
I'll be here, doing my thing.
It's at 20 centimeters.
Inflate the balloon.
- I am.
- So then inflate it more.
- Yes, Dr, Hahn.
- They loosen another piece, this leg swells even more.
His pressure is 1 8.
Does he have a pulse with that? I always did enjoy a good game of Twister.
- It's finished.
I'm in.
- Yang, do not sew that in.
Hold it.
I will check your work when I'm done.
- Chief, I've gotta do a fasciotomy.
- What? A what? Relieve the pressure in your leg or you could lose the limb.
Don't worry.
You probably won't feel a thing.
Oh, God.
Hey, Dr.
Stevens.
What's going down? What's going down? Cristina sparkle paging me out of cement boy.
Alex not answering the phone.
Alex and his insane girlfriend.
Alex! Alex! I'm checking in.
Call me back.
God! - Things we do for people we love.
- Exactly.
It's How'd it go? - Derek.
- What? How'd it go? It was, um It was amazing.
Thank you.
We have to take Jeremy down to the OR now.
OK.
- OK.
- OK.
- So I I'll see you after? - Definitely.
I don't think, um I'm not sure you'll be conscious, uh, before we take Beth, so So so I'll see you after your surgery.
All right.
See you after.
- Wait, Jer.
Wait.
- Yeah.
- What if you die? - I won't.
- What if I die? - You won't.
OK, but You changed my life, Jeremy West.
You made it better, you made it brighter, full of joy.
- And if I die - Don't you dare die.
OK? We're not finished yet.
I'm not finished loving you.
OK, go ahead.
Go ahead.
Get your head chopped open.
I'm right behind you.
Do not kill him.
- You nervous? - I have my ego to keep me warm.
- Can't you feel it? - What? The majesty of lifesaving.
When did you become an optimist? Selling your land.
Trying to move forward.
So am I.
- Who's there? - George O'Malley.
- I was paged to the supply closet.
- Are you alone? Lexie? Remember how I said I wasn't a thief? - I think maybe I am.
- Alexandra Caroline Grey! I couldn't help it.
I had to know.
And then once I knew, I knew.
Get these back to the chief's office right now.
I tried to stop reading, but I couldn't.
I have photographic memory, which is how I got through Harvard Med.
I read all files.
Information is burned into my brain.
I read yours.
- No, I don't wanna know.
- You failed the intern exam by one point.
One point.
The OR is booked and standing by.
Dr.
Bailey, what is it? Something Something we're missing.
We're forgetting something.
Gangrene, compartment syndrome, compression, fluid balance, electrolytes.
What is it? What is it? Gangrene, compartment syndrome, compression, fluids, electrolytes.
Gangrene, compartment syndrome, compression, fluids, electrolytes.
Gangrene, compartment syndrome, compression, fluids, elec Bladder.
His bladder.
We've been hydrating him for over four hours now.
- We don't get a catheter in him - His bladder's gonna explode.
Can I have mayo? See? You have an appetite.
That's a good sign.
- Hey.
- Hey, Iz.
I'll be right back.
- What's going on? - How's Rebecca? She's fine.
What do you need? - Did she eat? Call her husband? - Iz.
- Don't get mad because I care.
- Not caring.
Butting in.
- I'm butting in because I care.
- Know how you care? By covering me at work, not calling me every hour and asking - Hang on.
Rebecca? - Alex? Rebecca? Alex? Time of death, 11:47.
Rebecca! You don't have to say any thing.
Don't say it.
Alex? Are you still there? Alex? - I'm so sorry.
- Don't Don't say anything.
OK? Don't say anything.
Don't say anything! Don't say anything! Don't you say anything to me! Don't say anything! Don't say anything! Don't say anything! Don't say anything!