Grey's Anatomy s05e01 Episode Script
Dream a Little Dream of Me (1)
[Meredith.]
We all remember bedtime stories of our childhoods.
The shoe fits Cinderella, the frog turns into a prince, Sleeping Beauty is awakened with a kiss.
Once upon a time.
And then they lived happily ever after.
Fairy tales.
The stuff of dreams.
The problem is, fairy tales don't come true.
It's the other stories, the ones that begin with dark and stormy nights, and end in the unspeakable It's the nightmares that always seem to become reality.
[# Black Tables: Other Lives.]
- [flatline tone.]
- What happened!? A bus in front of him hit a telephone pole.
- He tried to swerve to miss it - How bad is it? You are gonna have to be strong.
[gasps.]
Derek! [flatline tone continues.]
No No! [muted dialogue.]
No! No! Derek! [sobbing.]
No! No! Derek! [continues sobbing.]
[gasps.]
[Meredith.]
The person that invented the phrase ''Happily ever after, '' should have his ass kicked so hard.
Back up, you're sucking all my oxygen.
- l'm trying to see.
- lt's not up yet.
- lt supposed to be posted at four.
- lt's 4:1 5.
Hit the refresh button.
You have to reload the page.
l am hitting the button every ten seconds.
- ls it up yet? - No.
- Hi.
- Hi.
- ls it up yet? - No.
Wait.
Think we move up a slot.
Pass Hopkins, move to number one.
- Not passing Hopkins.
We'll stay two.
- Mayo could surge ahead.
We'd be three.
- Three? Pessimist.
- Realist.
Rankings of teaching hospitals change based on any number of things.
Three's top five.
l can live with three.
- Hit the refresh button.
- Stay back! l'm doing this.
- ls it up yet? - No! - Here, hit the refresh - l am hitting the refresh! OK, all of you, back up.
Stop hovering.
Stop speculating.
The rankings will go up when they go up.
We have no control when they are posted.
When it is up, l will say it is! Until then, back up.
- Leave me alone so l can - lt's up! Number one, Hopkins.
Number two, Mayo Told you.
- Number three, Cleveland Clinic.
- What? - Number four, Mass Gen.
- What? We moved down to five?! No.
We are not five.
- Twelve, O'Malley.
- lt's so upsetting This is not a number 1 2 teaching hospital.
lt's a great l do not run the number 1 2 surgical program.
Out with it! We've been downgraded from Level One trauma center to Level Two.
What does that mean? You don't need to explain, it's just details Twelve.
l couldn't ask him about when he's gonna schedule my test, with all the you-know-what hitting the fan.
For all l know he's gonna spring it to me, what, like, in an hour.
You'll be ready.
Causes of hypotension? Uh, hypovolemia, Ml, cardiac dysrhythmia Uh - Hypoxia ls that good? - Very good.
Yeah? What? The snow it's so pretty.
lt's like a fairy tale.
Lexie, it's it's the fall.
lt's not so much a fairy tale as global warming.
That's the Apocalypse.
lt's like dropping to number 1 2.
And me failing my intern test for the second time.
l adore you, by the way Just Oh! Hey, sorry l'm late.
l was just helping No talking unless it's medical.
So l keep having the dream.
The Derek is dead dream.
Know who does residencies at number 1 2 hospitals? Losers.
And l am not a loser.
Go get the charts.
So the dream is about me being afraid of the house of candles, taking the big step.
And l'm afraid of having a happy ending.
l have a PhD in biochem.
l am a double doctor.
Double doctors should not do residencies at second rate hospitals.
Wyatt says l should just lean into the wind.
lnto the fear.
So l'm gonna ask Derek to move in with me.
l could transfer.
Cleveland Clinic has a huge cardio program.
- Still top 20.
Pretty good.
- Pretty good is not enough.
l want to be great.
Greatness.
Which is why l'm going to ask Derek to move in with me.
Just that's it's a big step.
Don't wanna mess up, l've messed it up before The break ups and the on and off again, and the sleeping with George.
You slept with George? No talking unless it's medical.
So, l'm just gonna do it.
l'm gonna ask him to move in.
You think it's the right thing? - [pager beeping.]
- Ugh.
Bailey's paging.
Uh, so, medically, Meredith and George had sexual intercourse? Uh, when? And how many times? - lt's humiliating.
Twelve.
- Yeah.
You're the best neurosurgeon in the country.
ln the world.
You wanna say anything about me? You're the best plastics guy at Seattle Grace.
- Nice.
Really nice.
- Don't force me to praise you.
- Hey, Rose.
- Hello, Dr.
Sloan.
Mm.
She took it well in the beginning, hoping we could be civilized.
- She working my OR.
- Civilized is out.
lt's gone.
lt's a trail of fairy dust.
Now she's got delayed rage.
- Delayed rage? - She was being big before.
Putting on a brave face.
She's had time to think.
She hates your guts.
You have to break up with her.
- l did.
- You did personally.
Now you have to do it professionally.
Good luck with that.
Delayed rage.
l'd like a list.
From you of ways that l can improve.
Not right now.
Richard, you told me that l'm a bad teacher.
Now we're number 1 2, and l don't like to be number 1 2, - so l'd like a list.
- Not right now.
But if there are ways that l can improve, ways that l can help the program regain its ranking.
lt's snowing.
You know what happens when it's nighttime, snowing and the temperature's hovering right around 32 degrees? - No.
- The snow begins to melt.
And then it freezes again creating black ice.
The deadliest kind of ice, because it is invisible to drivers.
That'd usually mean that our ER would fill up.
But Mercy West is a number one level trauma center and we're not.
Their ER gets the traumas while we get their castoffs.
Which pisses me off.
So when l say not right now, what l mean is not right now.
Oh, um - [indistinct chatter.]
- [siren wails.]
[Bailey.]
Stop shivering.
You're embarrassing me.
l didn't realize we were gonna be outside.
- l'm OK.
You don't have to do that.
- Bundle up.
You're turning blue.
- Dr.
Bailey, it is kinda cold - Someone will come.
- No one is coming.
- Maybe old people with hips we can fix.
Stop talking.
We are Seattle Grace Hospital.
Rankings or no rankings, we are going to stand outside.
At the ready.
On alert.
Give the best care available to every patient that arrives at our door.
We may no longer be ranked the best, but l'm the best.
You are my residents.
Which means you're the best.
lt's a matter of pride, people.
- [siren wails in distance.]
- What are we doing? - We're waiting.
- For? - A miracle.
- Someone will come.
- Mercy West is getting traumas first - Someone'll come.
So we're here in the hopes that someone is severely injured? Wishing and praying that someone is so hurt, so near death, that the ambulance has to bring 'em here - 'cause we're closer than Mercy.
- Yep.
Wow.
You and God are cool with that? Damn it.
l forgot about God.
All right, let's just go on back inside [tires screeching, horn honks.]
Go, go, go! Watch out! - Are you OK? - l drove a limousine on ice! All by myself! Ten blocks! You OK? My dress.
There's blood all over my dress.
- What happened? - l got us to the hospital in one piece.
Try not to move.
Sit until we can get you a wheelchair.
We need a wheelchair! We're not the patients What's his name? - Benny Billy.
- Billy? Our limo driver.
He flew through the windshield.
Help him, please.
Uh, Yang, come around, help me.
Get a board, bring out a gurney and a c-collar.
- [man grunting.]
- Wha Wha? Press it.
Press.
- What do we have? - Billy Matthews, 45.
Arterial bleed, haven't isolated cause l got this.
Get him to Trauma One - Holding pressure over the bleed - l've got this.
Wha What's going on? Vincent will worry if l'm late.
You've been in a car accident.
You're at the hospital.
We're going to take good care of you.
ls she OK? Might be a concussion.
l'm gonna order a CT to make sure it's nothing.
All this blood.
Should've waited for the ambulance.
[woman.]
We did.
They never came.
Billy was hanging through the windshield.
You extracted your limo driver from the windshield? By yourselves? - Pretty heroic.
- lsn't Michael answering? No.
Try Phil again.
Shouldn't have even been going to the stupid ball in a storm like that.
- What ball? - Fire and lce Ball.
Would you believe? ln a storm? Just goes to voicemail.
Maybe their phones are off.
- Can't reach Vincent? - Husbands were in another car? We won't ride with them.
We're three happily married women except when our husbands drag out cigars, and they drag out the cigars in the limo.
Your arm is not broken, just bruised.
O'Malley is gonna suture your cuts and you're all set.
You're lucky you didn't sustain more injuries.
- What doctor are you? You're young.
- l'm an intern.
lnterns don't touch the face.
The plastic surgeon touches the face.
What's happening? [woman.]
Where am l? We were in an accident.
You're OK.
We're all going to be fine.
- Hi.
- Hi.
l've been really busy.
l know, l've been, like, crazy.
Researching things.
A lot of research.
- ln the library.
- Oh, yeah? Me too.
lncredibly busy.
Lot of research.
Like you.
Only l use the lnternet.
- l've got to check in with Bailey.
- Me too.
- Bailey, anything else? - Nothing.
Nothing else.
That's the problem.
l'm charting.
The chief took my one trauma, l gave up my clinic and now l'm charting.
Chief wanted you to take a look at these.
Billy Matthews, limo driver, multiple crush injuries from the MVC.
Hemopericardium.
Hemopericardium can lead to cardiac tamponade which can be detected by Beck's triad: increased JVP, hypotension, and muffled heart sounds.
This is a teaching hospital.
l'm trying to improve my teaching.
Don't try it on me.
- [Mark.]
Wanna know how l teach? - No.
l'm like a guru.
They come to me for help and l gently guide them along the path to truth and wisdom.
Hey, George.
l heard a thing.
A surprising thing.
A very unexpected non-medical thing.
- About you and - Hold on Dr.
Sloan, hi.
Sarabeth Briar's got a facial lac, - but she will only let you touch her.
- You paged me for a cut? What kind of moron are you, are you a special moron from the lsle of Complete and Utter Morons? - l don't - Shut up.
Truth and wisdom.
He's an ass.
This is what we get for being 1 2.
A bunch of women in ball gowns and a half-dead limo driver.
Those women are amazing, tried to save his life.
- That's who l wanna be.
- An aging princess? They've been with the same men for years and they're happy.
They did it.
l could do it.
- Mer - [Derek.]
Hey.
Who paged me? Bailey and lzzie paged you.
You should see Bailey.
- She's got the limo driver.
- OK.
- Wanna move in with me? - Wanna live together? - Well, l mean, l could l just - Yes.
- Yes? - You sure you're ready? l'm leaning into the fear to get a happy ending.
l don't even know what that means.
[Richard.]
Damn it! - [flatline.]
- Time of death, 20:47.
Limo driver, traumatic arrest.
Never regained a pulse.
Tell them not to book the OR.
- l have a dream, Yang.
- Excuse me? That one day, a trauma will come through those doors.
l have a dream.
- l share that dream.
- Number 1 2.
Number 1 2.
Right now dispatch is squawking about three men.
Three.
Serious injuries every one.
They're taking them to Mercy West.
- Three men? - That's what l said.
Three men who could be married to those ladies in ball gowns? - [Mark.]
Little stick.
- Squeeze my hand, squeeze my hand.
- Just like when you had Pete, remember? - Ugh! Pete hurt less.
You're gonna love me later when there's virtually no scar.
Ladies, um, l've been on the phone with ambulance dispatch.
Three gentlemen in a limo collided with another vehicle on Broad Street.
- Possible it was your husbands.
- Oh, no.
- Taking them to Mercy West.
- Across town.
Unless you prefer that they be brought here.
- We can do that? - Oh! You can insist.
lf l were you, l would insist.
Oh.
Then, l guess l guess we insist.
- Yes, we insist.
- You insist.
[sirens approaching.]
Am l to understand that you stole these traumas from Mercy West? - No idea what you are talking about.
- Good job.
lt's personal.
Yang, come with me.
We got a situation.
Fifty-eight-year-old male, MVC.
Tacking 1 60.
VP, 80 palp.
Decrease bilateral and breath sounds.
- What did you do? - l didn't.
He did.
Gl Joe trached him in the field before l got there.
With a pen?! You trached with an ink pen? So? Move this guy inside.
Now! Let's go.
Move, move, move, move.
Pen Trach? Hot.
OK, what do we got? Vincent Kenner, 58, unrestrained passenger of a limo that took a nosedive.
Muffled heart sounds and a large scalp lac.
- Vincent! - Betty [lzzie.]
l'm sorry, Dr.
Hahn, but she That's my husband.
What happened? ls he all right? l promise to give you an update as soon as we know, but right now l have to get you to a CT.
- Vincent! - l'll bring you back.
- Free fluid in the abdomen.
- Depressed skull fracture.
Decreased breath sounds, bilaterally.
Guy's getting an express ticket to the OR.
- Let the chief know.
- Can l scrub in? Fine.
[woman.]
He has a pen in his throat! Michael! Oh, God, Michael! Are you ls that a pen in his throat? Does he have a ballpoint pen in his throat? - Let the doctors work.
- They have to be careful.
Michael's been under stress, and the last thing he needs Can you handle this woman? We're gonna take you to your husband, around the corner.
Sweetheart, l'm here.
Michael, l'm here.
- This is not her husband? - Nope.
- Oh, my God, Michael! - lt's her husband.
- What happened to him? - Come with me.
- What happened to him? - Please, please.
You trached a man in the field using a ballpoint pen? lt was all l had on me.
What? lt's not like l didn't clean it off with fresh snow.
lt's awesome.
Really? You're going with a size 6 shiley tube on that? Get this guy away from me.
l'm gonna need a CT of his belly, chief.
Karev, get us some line.
His trachea's crushed.
Going to need an OR and hands.
Who's available? - Grey.
- The good Grey? - The intern Grey.
- And l'll throw in O'Malley.
Oh.
Nice.
Perfect.
Phil? Oh, my God.
Oh, my God.
What happened? [moans.]
The limo hit a patch of ice.
Next thing l know, we're all upside down and we're rolling and - Anna, l can't feel my legs.
- Oh, my God.
Oh, Phil, l'm so sorry.
OK, get her out.
l gotta get a consult from Shepherd.
Oh.
Sir, Dr.
Hahn's working on multiple crush injuries.
- Wants you to take a look.
- On my way.
You're bleeding.
My car was right behind theirs at the intersection.
l cut it on impact.
[Richard.]
And you triaged these men? Major Owen Hunt.
US Army Second Forward Surgical.
l'm a trauma surgeon.
- Just got home on leave.
- Yang, take care of Major Hunt's leg.
- Sir l'm scrubbing in with you - After you take care of Major Hunt.
- Where are you going? - To check on my other patients.
No.
You are the patient.
[Betty.]
Hello? Vincent? Are you there? Where am l? You've been in a car accident, Betty.
You're having a CT.
lt's gonna be OK.
Everything is OK.
Don't move.
Some nutjob trached a guy with a pen.
- Pretty cool.
- Want cool? Check this out.
- Every 30 seconds.
- ls someone there? Where am l? You've been in a car accident, Betty.
You're having a CT.
lt's OK.
Every 30 seconds her memory resets.
Every 30 seconds.
Might not be bad.
Like hitting the refresh button, everything's new.
How you doing? You keep asking me that and l keep telling you l'm fine.
l know, it's just Sometimes l think Denny's right around the corner, and he's been dead a long time.
lt just takes a while to get used to.
Rebecca didn't die.
lt's not like that for me.
l'm good.
But thank you for asking.
Hello? ls someone there? Where am l? You're in a spaceship, you're going to the Moon.
Enjoy the ride.
[laughing.]
Alex.
[pager beeping.]
A spaceship? Excuse me? You're having a CT, Betty.
You're gonna be OK.
You've been in a car accident.
Just don't move.
- Thanks a lot.
- Bailey paged me.
See you later.
He has a depressed skull fracture.
l could elevate the skull fragments, but there's no telling how much damage has been done.
- We're saving this man.
- We're looking at an aortic tear.
Not to mention vast amounts of blood - in his abdomen - l can handle the bleeding.
- [Hahn.]
He is circling the drain.
- l have other traumas.
We're saving this man.
Does everyone understand or do l have to repeat myself? - Yes.
- Understood.
Book OR Two.
l know it's overwhelming, but Phil couldn't be in better hands.
lt's not just Phil.
lt's also Michael.
But you already knew that.
l didn't know for sure lt's pathetic, isn't it? A married woman cheats on her best friend with her husband.
You can't go much lower than that.
These things happen.
l ran into Michael in the mall.
We had lunch, then a week later we had another lunch.
And, here we are, eight months later.
And Sarabeth has no idea.
When you When you spend your life with someone and you have kids together you think it'll always be this amazing and wonderful.
You think that you'll always feel that kind of love.
And l do.
l do love Phil.
l just Just what? Well, little pieces of you get chipped away.
By another person.
And then you shave little pieces of yourself away.
So that you'll fit together.
And one day you look up, and you don't even know who you are.
l better get back to my husband.
- He'll be wondering where l am.
- OK.
- That graft is actually holding.
- l am impressing even myself.
- Shep? - Mm.
Almost there.
Everybody, take a look at the monitor, please.
Now, to elevate the last of the skull fragments, l'll need a large, flat instrument to get under the bone.
Uh, curved number two penfield.
You know what, l want a number four penfield.
lnteresting.
Why do you want to use the number four penfield instead? Sorry? Oh.
How would you explain it? l'm observing your teaching style.
- Hope you don't mind.
- Yeah, OK.
So the penfield? You changed it because? - l changed my mind.
- [laughs.]
ls there a problem, Rose? Not at all, Dr.
Shepherd.
You changed your mind.
Got it.
Huh.
Dr.
Shepherd? l've got a guy with a high level spinal injury.
l've started him on steroids, but he needs to be decompressed.
- You almost done? - Yeah.
l'm done right now.
Close up for me? So we consider him a good teacher, right? l'm just checking.
The spine is crushed from C6 to T1 , impinging on the cord.
We need to relieve the pressure on the spinal cord.
- But with these injuries - People don't walk again.
- Phil.
You don't know that.
- Anna, sweetheart, it's OK.
You have to do something.
Phil's very strong.
He has grandkids.
You have to do something.
- You could freeze him.
- Shouldn't be in here.
lf you want him to have a shot at walking again.
Who the hell are you? Army Surgeon Badass did something crazy with a pen on a guy's throat.
Appreciate it if you didn't give my patient and wife false hope.
Until you exhaust options, it's not false.
lt's hope.
You should keep current on your research.
They did make a football player walk at Buffalo Gen using therapeutic hypothermia.
Buffalo's patient was 20 years old, in prime cardiac fitness.
My patient is in his 60s and is a very risky candidate.
l'd prefer he live to see his grandkids.
Book an OR.
Tell this patient this is not an option, despite Uncle Sam's assessment.
We're closing up your leg now.
Michael can live after they put a pen in his throat? The emergency trach helped him breathe.
Dr.
Sloan needs to get him to the OR Surgery? He needs surgery? When your husband was pinned underneath the car he suffered a laceration to his windpipe, which Dr.
Sloan needs to fix to stabilize his airway.
He also has some bruising around his kidney and a lac on his liver.
Will he need surgery for that? There's a chance the abdominal injuries will heal, but if they get worse, yes, he will need surgery.
Two surgeries? l can't believe this is happening.
- Hold on, this is today? - Tonight.
At midnight.
- Ma'am, there's one other matter.
- More? There's more? According to billing, your insurance expires at midnight.
We're gonna treat you, of course, but to make it easier on you later, is there another card, or insurance policy? My husband, he takes care of these things.
OK.
OK.
[grunts.]
l'm going to numb Wow! - Uh, you're not numbed.
- So? - So Ow! Ow! - [grunting.]
Can't get an angle on these.
Could you? [laughing.]
OK [grunting.]
Thank you.
Don't mention it.
- Can l ask you something? - Uh What? Um, him, actually.
Oh.
Sure.
l've got surgery.
And poke yourself.
Talk to me about the freezing thing.
Betty Kenner, closed head injury from the limo wreck.
Subdural hematoma.
- Why she has memory loss.
- Yep.
Might ease up once we relieve pressure.
Book an OR.
l'll go in on her after l finish Anna's husband.
Busy OR today.
That's kinda your thing, right? Juggling more than one person at a time? - Hey, how's Betty's husband? - l'm scrubbing in on him now.
Shepherd did what he could, but the chief and Hahn are working.
He's an ugly mess.
Sarabeth's husband may need another surgery once Derek's done.
These poor women.
Anna, the one with cuts, is married to the guy on Derek's table.
And she is sleeping with Sarabeth's husband.
- The one Sloan's working on.
- Kidding? - No, don't tell Betty.
- She wouldn't remember if l did.
That happens? Married 40 years, then become a big, fat, lying cheater? lf 40 years doesn't make you committed, what does? What's the point? - What if l move in with Derek - Give you 1 00 bucks if you talk about something else.
lt's not about the years, it's about the man.
Derek's a good man.
- l'm out of here.
- There are a lot of really good men.
George is a really good guy.
l mean Nope, Sloan's not.
Alex.
Yeah.
Alex has turned into a very good man.
- You and Alex? - No! l'm making a point.
But it is nice that we're friends.
He's changed.
He's actually opening up to me.
You think if you moved in and got married, in 40 years, you'd feel dead inside? Enough to cheat on him? Wow.
[Richard.]
Yang, Major Hunt all taken care of? [Cristina.]
l did my best, sir.
[Richard.]
Put pressure on this bleeder for me.
You know what l think? l think the number 1 2 ranking was a mistake.
A clerical error.
l'm gonna start making calls about it as soon as l get out of this surgery.
So, l've been observing teaching styles.
Shepherd likes to teach by thinking out loud, Bailey is blunt and direct and doesn't overteach, and Sloan Well, Sloan just likes to berate and humiliate.
[Richard.]
lf you really wanna learn about teaching, you should talk to your students.
Find out how they learn best.
Yang? - [Hahn.]
That's not necessary, sir - Are you serious or not, Dr.
Hahn? Fine.
Go.
For me, personally, l learn better when l'm asked questions, the Socratic method.
That's the cornerstone of medical teaching.
lt's what we do in rounds.
Not everyone does it.
Some people simply tell you what to do.
Who? Are you talking about me? [Richard.]
lt's OK, Dr.
Yang.
Dr.
Hahn is eager to learn.
You can be honest.
[rapid beeping.]
[Hahn.]
He's crashing.
Get me an aortic clamp.
[Richard.]
l can't get a handle on this bleeding.
We may have to start doing damage control soon.
[Richard grunts.]
l see a tear in the renal artery.
You familiar with single layer continuous closure? - Of course.
- BP's still dropping.
Max out on levophed, keep pushing the blood.
Get in there and stitch, Yang.
There's a problem with the insurance.
As we explained, he can't talk right now.
l know but, Michael, l called them.
And the credit card company.
And they said that The cards have been cancelled.
l l don't understand.
l just need to know what to do.
l don't know what to do.
l'm sorry.
l'm really sorry, but we need to get him to Dr.
Sloan now.
[metal clanking.]
ls there something l can do? Someone l can call? l l don't l don't handle the money, but lf you can just tell me who to call.
l'll talk to billing, see what l can do.
Thank you.
lt's stuck.
Can't seem to get it down the left bronchis.
- You almost got it, George.
- What are you, his little cheerleader? Step aside, wonder boy, before you make things worse.
O'Malley, go find out if the OR's ready.
lf you can manage that.
You're a little mean to George.
Unnecessarily mean.
He's studying to retake his intern test, so he's stressed out.
So l was just thinking maybe you could be nicer.
You're an intern.
Why are you talking to me? You're You're my half sister's boyfriend's best friend.
So l You thought that makes us friends? Thought you'd defend your boyfriend to me and l'd take it? - He's not my boyfriend.
- But you want him to be.
- Do not.
- Do too.
- Do not.
- Do too.
Does he know? - Shut up.
- l'm your attending.
Can't tell me to shut up.
Want me to be nicer to O'Malley? - Please? - Confess your love, - l'll think about it.
- Shut up.
[PA.]
Dr.
Leone, call the blood bank.
- Know anything about health insurance? - No.
Why? Trying to help out a patient.
The softer side of Alex.
lzzie was right.
- What's that supposed to mean? - Nothing.
What did lzzie say to you? She said you were a good man.
She said you'd changed.
lt was nothing.
Did she say that l cried? Because that is a lie.
- She didn't say that.
- Should keep her mouth shut.
Alex, l made a stupid joke.
She didn't mean anything.
[Richard.]
Yang, how you doing? lt's, um l can't get it, it's not holding.
- lt's tearing.
- [Richard.]
Damn it.
Move.
l thought you said you've done the stitch.
- l have! A hundred times.
- On hearts.
On hearts.
Your forceps were macerating the tissue.
You were handling the bowel incorrectly.
Which you would know if you weren't allowed to clock so many hours in cardiothoracics at the expense of your general surgery knowledge.
Crap.
His vocal cords are damaged beyond repair.
- ls there anything we can do? - Probably won't talk again.
- l think that question was for me.
- Sorry.
You get to take your intern test again, think that makes you big man on campus? Doesn't change the fact you failed the first time.
- Dr.
Sloan.
- l'm sorry, Grey.
Was there something you wanted to say to anyone? No.
There wasn't.
- Coward.
- Shut up.
- Lexie! - [rapid beeping.]
Pressure's dropping.
- lt looks like defib.
- [flatline.]
- Twenty joules.
- Clear! [# Jade McNelis: Wins.]
Hang another unit of packed cells.
As many as it takes.
Somebody go get some FFP! Suction, please.
Suction! l got it.
This is too much blood, too much blood We're losing him.
What's going on? Am l in a hospital? There was an accident, but you're going to be fine.
We're all going to be fine.
[sighs.]
Yeah Um l was able to repair your husband's vertebrae, and relieve the pressure from his spine, but, uh - He's still paralyzed? - Yes, l'm sorry.
Oh, God Oh, Phil.
And Michael? What about Michael? l repaired his trachea, but unfortunately, his vocal cords were completely severed in the accident.
He can't talk? He'll never be able to talk? We have to be strong.
We have to be strong for Phil and for Michael.
l'll be ready for Betty in OR One when you're done here.
- [Richard.]
Um - ls it Vincent? What's happened? - Please.
- [Richard.]
Came through surgery.
He's stable, but still critical.
- Oh, my God.
- This is Dr.
Yang.
She is going to be responsible for seeing to it that your husband makes it through the night.
l'm l will keep you posted.
Keep me posted about what? Where am l? Where's Vincent? She has a subdural hematoma.
Her memory resets every 30 seconds.
Perfect.
Rose Please look at me.
lf you're gonna behave like this, you can't be in my OR.
[sighs.]
OK, there's no good way to say this l've been acting this way because l'm l'm carrying your child, Derek.
Ha! Gotcha.
[laughs.]
[Derek laughs weakly.]
- This is your idea of a joke? - Oh, please, you deserve it.
Who do you think you are? ''lf you're gonna keep behaving this way, you can't be in my OR.
'' You should transfer to a different specialty.
You should transfer to a different specialty.
- l'm a neurosurgeon.
- You should've thought of that while repeatedly assuring me that you were over your ex.
See you in the OR.
l'm not going anywhere.
Chief, about Phillip Loomis? Shepherd's spinal patient? l was thinking, what about therapeutic hypothermia? You want to freeze a spinal injury? They did it in Buffalo, and Mass Gen had success with it too.
- And Major Hunt, he swears by it.
- What does Shepherd think? He thinks it's too risky in Mr.
Loomis' case.
- He's not as fit, he's older - Loomis isn't much older than me.
l can do the procedure, chief, l just need your OK.
- What were you doing back there? - l was trying to help you.
Telling an attending to shut up in his OR? That's not helping.
What makes you think you can? You're sleeping with him? - What? No! - Yes, you are! Why would you say that? Jealous? Of the fact that you can tell Sloan to shut up? Yeah.
You know, he's right.
l'm the hospital joke, it's my fault.
l'm the one who failed my intern exam, and got married in Vegas and cheated on my wife.
You don't understand.
The only reason he was Doesn't matter, l can take care of myself.
He's got fishing gear and boots and hair products.
l don't have room for that stuff.
He talks.
And not a little.
He chats.
- He's chatty freaking Cathy.
- Not right now.
You know what's gonna happen after he moves in, don't you? We build a house on his land, our land, because we'll be married.
And then l'll be Dr.
Mrs.
Shepherd.
And you know what comes after that? Babies.
There'll be his babies.
So they'll have perfect hair, and they'll be chatty.
l'll have five chatty children, a chatty husband and live in a house in the wilderness.
Then start sleeping with your husband.
Gotta tell him l changed my mind, don't you think? - Meredith! - lt's What? [# Emiliana Torrini: Jungle Drum.]
- Why are you making that face? - Shut up! Just shut up about Derek.
Shut up about moving in with Derek.
Shut up about your relationship! Because l've heard it all before.
You guys get together, l have to listen to it.
You break up, l have to listen to it.
l almost killed a man in surgery today.
OK, you wanna know what l think? OK, you really wanna know? You and Derek will not work.
Moving in together is a mistake of massive proportions.
You are dreaming of dead Derek, which should tell you it will not work.
- Cristina - No.
This ''happily ever after?'' Does not exist.
So please, please, please, as you weigh your options here, just consider the possibility of shutting the hell up.
Because l can't listen to it anymore.
- l - No! - OK.
- No! - l - That's it, that's it.
l'm done.
Ah! Oh! Ow! Ow! l'm not gonna say you deserved that, but you deserved that.
[laughing.]
Thanks.
Help me Help me up.
[crackling.]
[gasping.]
Don't move.
l'm gonna go get some help.
[gasping.]
We all remember bedtime stories of our childhoods.
The shoe fits Cinderella, the frog turns into a prince, Sleeping Beauty is awakened with a kiss.
Once upon a time.
And then they lived happily ever after.
Fairy tales.
The stuff of dreams.
The problem is, fairy tales don't come true.
It's the other stories, the ones that begin with dark and stormy nights, and end in the unspeakable It's the nightmares that always seem to become reality.
[# Black Tables: Other Lives.]
- [flatline tone.]
- What happened!? A bus in front of him hit a telephone pole.
- He tried to swerve to miss it - How bad is it? You are gonna have to be strong.
[gasps.]
Derek! [flatline tone continues.]
No No! [muted dialogue.]
No! No! Derek! [sobbing.]
No! No! Derek! [continues sobbing.]
[gasps.]
[Meredith.]
The person that invented the phrase ''Happily ever after, '' should have his ass kicked so hard.
Back up, you're sucking all my oxygen.
- l'm trying to see.
- lt's not up yet.
- lt supposed to be posted at four.
- lt's 4:1 5.
Hit the refresh button.
You have to reload the page.
l am hitting the button every ten seconds.
- ls it up yet? - No.
- Hi.
- Hi.
- ls it up yet? - No.
Wait.
Think we move up a slot.
Pass Hopkins, move to number one.
- Not passing Hopkins.
We'll stay two.
- Mayo could surge ahead.
We'd be three.
- Three? Pessimist.
- Realist.
Rankings of teaching hospitals change based on any number of things.
Three's top five.
l can live with three.
- Hit the refresh button.
- Stay back! l'm doing this.
- ls it up yet? - No! - Here, hit the refresh - l am hitting the refresh! OK, all of you, back up.
Stop hovering.
Stop speculating.
The rankings will go up when they go up.
We have no control when they are posted.
When it is up, l will say it is! Until then, back up.
- Leave me alone so l can - lt's up! Number one, Hopkins.
Number two, Mayo Told you.
- Number three, Cleveland Clinic.
- What? - Number four, Mass Gen.
- What? We moved down to five?! No.
We are not five.
- Twelve, O'Malley.
- lt's so upsetting This is not a number 1 2 teaching hospital.
lt's a great l do not run the number 1 2 surgical program.
Out with it! We've been downgraded from Level One trauma center to Level Two.
What does that mean? You don't need to explain, it's just details Twelve.
l couldn't ask him about when he's gonna schedule my test, with all the you-know-what hitting the fan.
For all l know he's gonna spring it to me, what, like, in an hour.
You'll be ready.
Causes of hypotension? Uh, hypovolemia, Ml, cardiac dysrhythmia Uh - Hypoxia ls that good? - Very good.
Yeah? What? The snow it's so pretty.
lt's like a fairy tale.
Lexie, it's it's the fall.
lt's not so much a fairy tale as global warming.
That's the Apocalypse.
lt's like dropping to number 1 2.
And me failing my intern test for the second time.
l adore you, by the way Just Oh! Hey, sorry l'm late.
l was just helping No talking unless it's medical.
So l keep having the dream.
The Derek is dead dream.
Know who does residencies at number 1 2 hospitals? Losers.
And l am not a loser.
Go get the charts.
So the dream is about me being afraid of the house of candles, taking the big step.
And l'm afraid of having a happy ending.
l have a PhD in biochem.
l am a double doctor.
Double doctors should not do residencies at second rate hospitals.
Wyatt says l should just lean into the wind.
lnto the fear.
So l'm gonna ask Derek to move in with me.
l could transfer.
Cleveland Clinic has a huge cardio program.
- Still top 20.
Pretty good.
- Pretty good is not enough.
l want to be great.
Greatness.
Which is why l'm going to ask Derek to move in with me.
Just that's it's a big step.
Don't wanna mess up, l've messed it up before The break ups and the on and off again, and the sleeping with George.
You slept with George? No talking unless it's medical.
So, l'm just gonna do it.
l'm gonna ask him to move in.
You think it's the right thing? - [pager beeping.]
- Ugh.
Bailey's paging.
Uh, so, medically, Meredith and George had sexual intercourse? Uh, when? And how many times? - lt's humiliating.
Twelve.
- Yeah.
You're the best neurosurgeon in the country.
ln the world.
You wanna say anything about me? You're the best plastics guy at Seattle Grace.
- Nice.
Really nice.
- Don't force me to praise you.
- Hey, Rose.
- Hello, Dr.
Sloan.
Mm.
She took it well in the beginning, hoping we could be civilized.
- She working my OR.
- Civilized is out.
lt's gone.
lt's a trail of fairy dust.
Now she's got delayed rage.
- Delayed rage? - She was being big before.
Putting on a brave face.
She's had time to think.
She hates your guts.
You have to break up with her.
- l did.
- You did personally.
Now you have to do it professionally.
Good luck with that.
Delayed rage.
l'd like a list.
From you of ways that l can improve.
Not right now.
Richard, you told me that l'm a bad teacher.
Now we're number 1 2, and l don't like to be number 1 2, - so l'd like a list.
- Not right now.
But if there are ways that l can improve, ways that l can help the program regain its ranking.
lt's snowing.
You know what happens when it's nighttime, snowing and the temperature's hovering right around 32 degrees? - No.
- The snow begins to melt.
And then it freezes again creating black ice.
The deadliest kind of ice, because it is invisible to drivers.
That'd usually mean that our ER would fill up.
But Mercy West is a number one level trauma center and we're not.
Their ER gets the traumas while we get their castoffs.
Which pisses me off.
So when l say not right now, what l mean is not right now.
Oh, um - [indistinct chatter.]
- [siren wails.]
[Bailey.]
Stop shivering.
You're embarrassing me.
l didn't realize we were gonna be outside.
- l'm OK.
You don't have to do that.
- Bundle up.
You're turning blue.
- Dr.
Bailey, it is kinda cold - Someone will come.
- No one is coming.
- Maybe old people with hips we can fix.
Stop talking.
We are Seattle Grace Hospital.
Rankings or no rankings, we are going to stand outside.
At the ready.
On alert.
Give the best care available to every patient that arrives at our door.
We may no longer be ranked the best, but l'm the best.
You are my residents.
Which means you're the best.
lt's a matter of pride, people.
- [siren wails in distance.]
- What are we doing? - We're waiting.
- For? - A miracle.
- Someone will come.
- Mercy West is getting traumas first - Someone'll come.
So we're here in the hopes that someone is severely injured? Wishing and praying that someone is so hurt, so near death, that the ambulance has to bring 'em here - 'cause we're closer than Mercy.
- Yep.
Wow.
You and God are cool with that? Damn it.
l forgot about God.
All right, let's just go on back inside [tires screeching, horn honks.]
Go, go, go! Watch out! - Are you OK? - l drove a limousine on ice! All by myself! Ten blocks! You OK? My dress.
There's blood all over my dress.
- What happened? - l got us to the hospital in one piece.
Try not to move.
Sit until we can get you a wheelchair.
We need a wheelchair! We're not the patients What's his name? - Benny Billy.
- Billy? Our limo driver.
He flew through the windshield.
Help him, please.
Uh, Yang, come around, help me.
Get a board, bring out a gurney and a c-collar.
- [man grunting.]
- Wha Wha? Press it.
Press.
- What do we have? - Billy Matthews, 45.
Arterial bleed, haven't isolated cause l got this.
Get him to Trauma One - Holding pressure over the bleed - l've got this.
Wha What's going on? Vincent will worry if l'm late.
You've been in a car accident.
You're at the hospital.
We're going to take good care of you.
ls she OK? Might be a concussion.
l'm gonna order a CT to make sure it's nothing.
All this blood.
Should've waited for the ambulance.
[woman.]
We did.
They never came.
Billy was hanging through the windshield.
You extracted your limo driver from the windshield? By yourselves? - Pretty heroic.
- lsn't Michael answering? No.
Try Phil again.
Shouldn't have even been going to the stupid ball in a storm like that.
- What ball? - Fire and lce Ball.
Would you believe? ln a storm? Just goes to voicemail.
Maybe their phones are off.
- Can't reach Vincent? - Husbands were in another car? We won't ride with them.
We're three happily married women except when our husbands drag out cigars, and they drag out the cigars in the limo.
Your arm is not broken, just bruised.
O'Malley is gonna suture your cuts and you're all set.
You're lucky you didn't sustain more injuries.
- What doctor are you? You're young.
- l'm an intern.
lnterns don't touch the face.
The plastic surgeon touches the face.
What's happening? [woman.]
Where am l? We were in an accident.
You're OK.
We're all going to be fine.
- Hi.
- Hi.
l've been really busy.
l know, l've been, like, crazy.
Researching things.
A lot of research.
- ln the library.
- Oh, yeah? Me too.
lncredibly busy.
Lot of research.
Like you.
Only l use the lnternet.
- l've got to check in with Bailey.
- Me too.
- Bailey, anything else? - Nothing.
Nothing else.
That's the problem.
l'm charting.
The chief took my one trauma, l gave up my clinic and now l'm charting.
Chief wanted you to take a look at these.
Billy Matthews, limo driver, multiple crush injuries from the MVC.
Hemopericardium.
Hemopericardium can lead to cardiac tamponade which can be detected by Beck's triad: increased JVP, hypotension, and muffled heart sounds.
This is a teaching hospital.
l'm trying to improve my teaching.
Don't try it on me.
- [Mark.]
Wanna know how l teach? - No.
l'm like a guru.
They come to me for help and l gently guide them along the path to truth and wisdom.
Hey, George.
l heard a thing.
A surprising thing.
A very unexpected non-medical thing.
- About you and - Hold on Dr.
Sloan, hi.
Sarabeth Briar's got a facial lac, - but she will only let you touch her.
- You paged me for a cut? What kind of moron are you, are you a special moron from the lsle of Complete and Utter Morons? - l don't - Shut up.
Truth and wisdom.
He's an ass.
This is what we get for being 1 2.
A bunch of women in ball gowns and a half-dead limo driver.
Those women are amazing, tried to save his life.
- That's who l wanna be.
- An aging princess? They've been with the same men for years and they're happy.
They did it.
l could do it.
- Mer - [Derek.]
Hey.
Who paged me? Bailey and lzzie paged you.
You should see Bailey.
- She's got the limo driver.
- OK.
- Wanna move in with me? - Wanna live together? - Well, l mean, l could l just - Yes.
- Yes? - You sure you're ready? l'm leaning into the fear to get a happy ending.
l don't even know what that means.
[Richard.]
Damn it! - [flatline.]
- Time of death, 20:47.
Limo driver, traumatic arrest.
Never regained a pulse.
Tell them not to book the OR.
- l have a dream, Yang.
- Excuse me? That one day, a trauma will come through those doors.
l have a dream.
- l share that dream.
- Number 1 2.
Number 1 2.
Right now dispatch is squawking about three men.
Three.
Serious injuries every one.
They're taking them to Mercy West.
- Three men? - That's what l said.
Three men who could be married to those ladies in ball gowns? - [Mark.]
Little stick.
- Squeeze my hand, squeeze my hand.
- Just like when you had Pete, remember? - Ugh! Pete hurt less.
You're gonna love me later when there's virtually no scar.
Ladies, um, l've been on the phone with ambulance dispatch.
Three gentlemen in a limo collided with another vehicle on Broad Street.
- Possible it was your husbands.
- Oh, no.
- Taking them to Mercy West.
- Across town.
Unless you prefer that they be brought here.
- We can do that? - Oh! You can insist.
lf l were you, l would insist.
Oh.
Then, l guess l guess we insist.
- Yes, we insist.
- You insist.
[sirens approaching.]
Am l to understand that you stole these traumas from Mercy West? - No idea what you are talking about.
- Good job.
lt's personal.
Yang, come with me.
We got a situation.
Fifty-eight-year-old male, MVC.
Tacking 1 60.
VP, 80 palp.
Decrease bilateral and breath sounds.
- What did you do? - l didn't.
He did.
Gl Joe trached him in the field before l got there.
With a pen?! You trached with an ink pen? So? Move this guy inside.
Now! Let's go.
Move, move, move, move.
Pen Trach? Hot.
OK, what do we got? Vincent Kenner, 58, unrestrained passenger of a limo that took a nosedive.
Muffled heart sounds and a large scalp lac.
- Vincent! - Betty [lzzie.]
l'm sorry, Dr.
Hahn, but she That's my husband.
What happened? ls he all right? l promise to give you an update as soon as we know, but right now l have to get you to a CT.
- Vincent! - l'll bring you back.
- Free fluid in the abdomen.
- Depressed skull fracture.
Decreased breath sounds, bilaterally.
Guy's getting an express ticket to the OR.
- Let the chief know.
- Can l scrub in? Fine.
[woman.]
He has a pen in his throat! Michael! Oh, God, Michael! Are you ls that a pen in his throat? Does he have a ballpoint pen in his throat? - Let the doctors work.
- They have to be careful.
Michael's been under stress, and the last thing he needs Can you handle this woman? We're gonna take you to your husband, around the corner.
Sweetheart, l'm here.
Michael, l'm here.
- This is not her husband? - Nope.
- Oh, my God, Michael! - lt's her husband.
- What happened to him? - Come with me.
- What happened to him? - Please, please.
You trached a man in the field using a ballpoint pen? lt was all l had on me.
What? lt's not like l didn't clean it off with fresh snow.
lt's awesome.
Really? You're going with a size 6 shiley tube on that? Get this guy away from me.
l'm gonna need a CT of his belly, chief.
Karev, get us some line.
His trachea's crushed.
Going to need an OR and hands.
Who's available? - Grey.
- The good Grey? - The intern Grey.
- And l'll throw in O'Malley.
Oh.
Nice.
Perfect.
Phil? Oh, my God.
Oh, my God.
What happened? [moans.]
The limo hit a patch of ice.
Next thing l know, we're all upside down and we're rolling and - Anna, l can't feel my legs.
- Oh, my God.
Oh, Phil, l'm so sorry.
OK, get her out.
l gotta get a consult from Shepherd.
Oh.
Sir, Dr.
Hahn's working on multiple crush injuries.
- Wants you to take a look.
- On my way.
You're bleeding.
My car was right behind theirs at the intersection.
l cut it on impact.
[Richard.]
And you triaged these men? Major Owen Hunt.
US Army Second Forward Surgical.
l'm a trauma surgeon.
- Just got home on leave.
- Yang, take care of Major Hunt's leg.
- Sir l'm scrubbing in with you - After you take care of Major Hunt.
- Where are you going? - To check on my other patients.
No.
You are the patient.
[Betty.]
Hello? Vincent? Are you there? Where am l? You've been in a car accident, Betty.
You're having a CT.
lt's gonna be OK.
Everything is OK.
Don't move.
Some nutjob trached a guy with a pen.
- Pretty cool.
- Want cool? Check this out.
- Every 30 seconds.
- ls someone there? Where am l? You've been in a car accident, Betty.
You're having a CT.
lt's OK.
Every 30 seconds her memory resets.
Every 30 seconds.
Might not be bad.
Like hitting the refresh button, everything's new.
How you doing? You keep asking me that and l keep telling you l'm fine.
l know, it's just Sometimes l think Denny's right around the corner, and he's been dead a long time.
lt just takes a while to get used to.
Rebecca didn't die.
lt's not like that for me.
l'm good.
But thank you for asking.
Hello? ls someone there? Where am l? You're in a spaceship, you're going to the Moon.
Enjoy the ride.
[laughing.]
Alex.
[pager beeping.]
A spaceship? Excuse me? You're having a CT, Betty.
You're gonna be OK.
You've been in a car accident.
Just don't move.
- Thanks a lot.
- Bailey paged me.
See you later.
He has a depressed skull fracture.
l could elevate the skull fragments, but there's no telling how much damage has been done.
- We're saving this man.
- We're looking at an aortic tear.
Not to mention vast amounts of blood - in his abdomen - l can handle the bleeding.
- [Hahn.]
He is circling the drain.
- l have other traumas.
We're saving this man.
Does everyone understand or do l have to repeat myself? - Yes.
- Understood.
Book OR Two.
l know it's overwhelming, but Phil couldn't be in better hands.
lt's not just Phil.
lt's also Michael.
But you already knew that.
l didn't know for sure lt's pathetic, isn't it? A married woman cheats on her best friend with her husband.
You can't go much lower than that.
These things happen.
l ran into Michael in the mall.
We had lunch, then a week later we had another lunch.
And, here we are, eight months later.
And Sarabeth has no idea.
When you When you spend your life with someone and you have kids together you think it'll always be this amazing and wonderful.
You think that you'll always feel that kind of love.
And l do.
l do love Phil.
l just Just what? Well, little pieces of you get chipped away.
By another person.
And then you shave little pieces of yourself away.
So that you'll fit together.
And one day you look up, and you don't even know who you are.
l better get back to my husband.
- He'll be wondering where l am.
- OK.
- That graft is actually holding.
- l am impressing even myself.
- Shep? - Mm.
Almost there.
Everybody, take a look at the monitor, please.
Now, to elevate the last of the skull fragments, l'll need a large, flat instrument to get under the bone.
Uh, curved number two penfield.
You know what, l want a number four penfield.
lnteresting.
Why do you want to use the number four penfield instead? Sorry? Oh.
How would you explain it? l'm observing your teaching style.
- Hope you don't mind.
- Yeah, OK.
So the penfield? You changed it because? - l changed my mind.
- [laughs.]
ls there a problem, Rose? Not at all, Dr.
Shepherd.
You changed your mind.
Got it.
Huh.
Dr.
Shepherd? l've got a guy with a high level spinal injury.
l've started him on steroids, but he needs to be decompressed.
- You almost done? - Yeah.
l'm done right now.
Close up for me? So we consider him a good teacher, right? l'm just checking.
The spine is crushed from C6 to T1 , impinging on the cord.
We need to relieve the pressure on the spinal cord.
- But with these injuries - People don't walk again.
- Phil.
You don't know that.
- Anna, sweetheart, it's OK.
You have to do something.
Phil's very strong.
He has grandkids.
You have to do something.
- You could freeze him.
- Shouldn't be in here.
lf you want him to have a shot at walking again.
Who the hell are you? Army Surgeon Badass did something crazy with a pen on a guy's throat.
Appreciate it if you didn't give my patient and wife false hope.
Until you exhaust options, it's not false.
lt's hope.
You should keep current on your research.
They did make a football player walk at Buffalo Gen using therapeutic hypothermia.
Buffalo's patient was 20 years old, in prime cardiac fitness.
My patient is in his 60s and is a very risky candidate.
l'd prefer he live to see his grandkids.
Book an OR.
Tell this patient this is not an option, despite Uncle Sam's assessment.
We're closing up your leg now.
Michael can live after they put a pen in his throat? The emergency trach helped him breathe.
Dr.
Sloan needs to get him to the OR Surgery? He needs surgery? When your husband was pinned underneath the car he suffered a laceration to his windpipe, which Dr.
Sloan needs to fix to stabilize his airway.
He also has some bruising around his kidney and a lac on his liver.
Will he need surgery for that? There's a chance the abdominal injuries will heal, but if they get worse, yes, he will need surgery.
Two surgeries? l can't believe this is happening.
- Hold on, this is today? - Tonight.
At midnight.
- Ma'am, there's one other matter.
- More? There's more? According to billing, your insurance expires at midnight.
We're gonna treat you, of course, but to make it easier on you later, is there another card, or insurance policy? My husband, he takes care of these things.
OK.
OK.
[grunts.]
l'm going to numb Wow! - Uh, you're not numbed.
- So? - So Ow! Ow! - [grunting.]
Can't get an angle on these.
Could you? [laughing.]
OK [grunting.]
Thank you.
Don't mention it.
- Can l ask you something? - Uh What? Um, him, actually.
Oh.
Sure.
l've got surgery.
And poke yourself.
Talk to me about the freezing thing.
Betty Kenner, closed head injury from the limo wreck.
Subdural hematoma.
- Why she has memory loss.
- Yep.
Might ease up once we relieve pressure.
Book an OR.
l'll go in on her after l finish Anna's husband.
Busy OR today.
That's kinda your thing, right? Juggling more than one person at a time? - Hey, how's Betty's husband? - l'm scrubbing in on him now.
Shepherd did what he could, but the chief and Hahn are working.
He's an ugly mess.
Sarabeth's husband may need another surgery once Derek's done.
These poor women.
Anna, the one with cuts, is married to the guy on Derek's table.
And she is sleeping with Sarabeth's husband.
- The one Sloan's working on.
- Kidding? - No, don't tell Betty.
- She wouldn't remember if l did.
That happens? Married 40 years, then become a big, fat, lying cheater? lf 40 years doesn't make you committed, what does? What's the point? - What if l move in with Derek - Give you 1 00 bucks if you talk about something else.
lt's not about the years, it's about the man.
Derek's a good man.
- l'm out of here.
- There are a lot of really good men.
George is a really good guy.
l mean Nope, Sloan's not.
Alex.
Yeah.
Alex has turned into a very good man.
- You and Alex? - No! l'm making a point.
But it is nice that we're friends.
He's changed.
He's actually opening up to me.
You think if you moved in and got married, in 40 years, you'd feel dead inside? Enough to cheat on him? Wow.
[Richard.]
Yang, Major Hunt all taken care of? [Cristina.]
l did my best, sir.
[Richard.]
Put pressure on this bleeder for me.
You know what l think? l think the number 1 2 ranking was a mistake.
A clerical error.
l'm gonna start making calls about it as soon as l get out of this surgery.
So, l've been observing teaching styles.
Shepherd likes to teach by thinking out loud, Bailey is blunt and direct and doesn't overteach, and Sloan Well, Sloan just likes to berate and humiliate.
[Richard.]
lf you really wanna learn about teaching, you should talk to your students.
Find out how they learn best.
Yang? - [Hahn.]
That's not necessary, sir - Are you serious or not, Dr.
Hahn? Fine.
Go.
For me, personally, l learn better when l'm asked questions, the Socratic method.
That's the cornerstone of medical teaching.
lt's what we do in rounds.
Not everyone does it.
Some people simply tell you what to do.
Who? Are you talking about me? [Richard.]
lt's OK, Dr.
Yang.
Dr.
Hahn is eager to learn.
You can be honest.
[rapid beeping.]
[Hahn.]
He's crashing.
Get me an aortic clamp.
[Richard.]
l can't get a handle on this bleeding.
We may have to start doing damage control soon.
[Richard grunts.]
l see a tear in the renal artery.
You familiar with single layer continuous closure? - Of course.
- BP's still dropping.
Max out on levophed, keep pushing the blood.
Get in there and stitch, Yang.
There's a problem with the insurance.
As we explained, he can't talk right now.
l know but, Michael, l called them.
And the credit card company.
And they said that The cards have been cancelled.
l l don't understand.
l just need to know what to do.
l don't know what to do.
l'm sorry.
l'm really sorry, but we need to get him to Dr.
Sloan now.
[metal clanking.]
ls there something l can do? Someone l can call? l l don't l don't handle the money, but lf you can just tell me who to call.
l'll talk to billing, see what l can do.
Thank you.
lt's stuck.
Can't seem to get it down the left bronchis.
- You almost got it, George.
- What are you, his little cheerleader? Step aside, wonder boy, before you make things worse.
O'Malley, go find out if the OR's ready.
lf you can manage that.
You're a little mean to George.
Unnecessarily mean.
He's studying to retake his intern test, so he's stressed out.
So l was just thinking maybe you could be nicer.
You're an intern.
Why are you talking to me? You're You're my half sister's boyfriend's best friend.
So l You thought that makes us friends? Thought you'd defend your boyfriend to me and l'd take it? - He's not my boyfriend.
- But you want him to be.
- Do not.
- Do too.
- Do not.
- Do too.
Does he know? - Shut up.
- l'm your attending.
Can't tell me to shut up.
Want me to be nicer to O'Malley? - Please? - Confess your love, - l'll think about it.
- Shut up.
[PA.]
Dr.
Leone, call the blood bank.
- Know anything about health insurance? - No.
Why? Trying to help out a patient.
The softer side of Alex.
lzzie was right.
- What's that supposed to mean? - Nothing.
What did lzzie say to you? She said you were a good man.
She said you'd changed.
lt was nothing.
Did she say that l cried? Because that is a lie.
- She didn't say that.
- Should keep her mouth shut.
Alex, l made a stupid joke.
She didn't mean anything.
[Richard.]
Yang, how you doing? lt's, um l can't get it, it's not holding.
- lt's tearing.
- [Richard.]
Damn it.
Move.
l thought you said you've done the stitch.
- l have! A hundred times.
- On hearts.
On hearts.
Your forceps were macerating the tissue.
You were handling the bowel incorrectly.
Which you would know if you weren't allowed to clock so many hours in cardiothoracics at the expense of your general surgery knowledge.
Crap.
His vocal cords are damaged beyond repair.
- ls there anything we can do? - Probably won't talk again.
- l think that question was for me.
- Sorry.
You get to take your intern test again, think that makes you big man on campus? Doesn't change the fact you failed the first time.
- Dr.
Sloan.
- l'm sorry, Grey.
Was there something you wanted to say to anyone? No.
There wasn't.
- Coward.
- Shut up.
- Lexie! - [rapid beeping.]
Pressure's dropping.
- lt looks like defib.
- [flatline.]
- Twenty joules.
- Clear! [# Jade McNelis: Wins.]
Hang another unit of packed cells.
As many as it takes.
Somebody go get some FFP! Suction, please.
Suction! l got it.
This is too much blood, too much blood We're losing him.
What's going on? Am l in a hospital? There was an accident, but you're going to be fine.
We're all going to be fine.
[sighs.]
Yeah Um l was able to repair your husband's vertebrae, and relieve the pressure from his spine, but, uh - He's still paralyzed? - Yes, l'm sorry.
Oh, God Oh, Phil.
And Michael? What about Michael? l repaired his trachea, but unfortunately, his vocal cords were completely severed in the accident.
He can't talk? He'll never be able to talk? We have to be strong.
We have to be strong for Phil and for Michael.
l'll be ready for Betty in OR One when you're done here.
- [Richard.]
Um - ls it Vincent? What's happened? - Please.
- [Richard.]
Came through surgery.
He's stable, but still critical.
- Oh, my God.
- This is Dr.
Yang.
She is going to be responsible for seeing to it that your husband makes it through the night.
l'm l will keep you posted.
Keep me posted about what? Where am l? Where's Vincent? She has a subdural hematoma.
Her memory resets every 30 seconds.
Perfect.
Rose Please look at me.
lf you're gonna behave like this, you can't be in my OR.
[sighs.]
OK, there's no good way to say this l've been acting this way because l'm l'm carrying your child, Derek.
Ha! Gotcha.
[laughs.]
[Derek laughs weakly.]
- This is your idea of a joke? - Oh, please, you deserve it.
Who do you think you are? ''lf you're gonna keep behaving this way, you can't be in my OR.
'' You should transfer to a different specialty.
You should transfer to a different specialty.
- l'm a neurosurgeon.
- You should've thought of that while repeatedly assuring me that you were over your ex.
See you in the OR.
l'm not going anywhere.
Chief, about Phillip Loomis? Shepherd's spinal patient? l was thinking, what about therapeutic hypothermia? You want to freeze a spinal injury? They did it in Buffalo, and Mass Gen had success with it too.
- And Major Hunt, he swears by it.
- What does Shepherd think? He thinks it's too risky in Mr.
Loomis' case.
- He's not as fit, he's older - Loomis isn't much older than me.
l can do the procedure, chief, l just need your OK.
- What were you doing back there? - l was trying to help you.
Telling an attending to shut up in his OR? That's not helping.
What makes you think you can? You're sleeping with him? - What? No! - Yes, you are! Why would you say that? Jealous? Of the fact that you can tell Sloan to shut up? Yeah.
You know, he's right.
l'm the hospital joke, it's my fault.
l'm the one who failed my intern exam, and got married in Vegas and cheated on my wife.
You don't understand.
The only reason he was Doesn't matter, l can take care of myself.
He's got fishing gear and boots and hair products.
l don't have room for that stuff.
He talks.
And not a little.
He chats.
- He's chatty freaking Cathy.
- Not right now.
You know what's gonna happen after he moves in, don't you? We build a house on his land, our land, because we'll be married.
And then l'll be Dr.
Mrs.
Shepherd.
And you know what comes after that? Babies.
There'll be his babies.
So they'll have perfect hair, and they'll be chatty.
l'll have five chatty children, a chatty husband and live in a house in the wilderness.
Then start sleeping with your husband.
Gotta tell him l changed my mind, don't you think? - Meredith! - lt's What? [# Emiliana Torrini: Jungle Drum.]
- Why are you making that face? - Shut up! Just shut up about Derek.
Shut up about moving in with Derek.
Shut up about your relationship! Because l've heard it all before.
You guys get together, l have to listen to it.
You break up, l have to listen to it.
l almost killed a man in surgery today.
OK, you wanna know what l think? OK, you really wanna know? You and Derek will not work.
Moving in together is a mistake of massive proportions.
You are dreaming of dead Derek, which should tell you it will not work.
- Cristina - No.
This ''happily ever after?'' Does not exist.
So please, please, please, as you weigh your options here, just consider the possibility of shutting the hell up.
Because l can't listen to it anymore.
- l - No! - OK.
- No! - l - That's it, that's it.
l'm done.
Ah! Oh! Ow! Ow! l'm not gonna say you deserved that, but you deserved that.
[laughing.]
Thanks.
Help me Help me up.
[crackling.]
[gasping.]
Don't move.
l'm gonna go get some help.
[gasping.]