Grey's Anatomy s05e06 Episode Script
Life During Wartime
[Cristina.]
Previously on Grey's Anatomy: [Derek.]
The Chief's under the spell of some insane man in camouflage.
[man.]
Major Owen Hunt.
l'm a trauma surgeon.
You're reading your mom's diary? l'm not half the surgeon my mother was.
[Cristina.]
Chief wants us to give George one of our interns? You didn't even think to ask for me? Screw you, Dr.
O'Malley.
We can take it slow.
Maybe just first base.
[# Vampire Weekend: Walcott.]
- Meredith.
- [both giggling.]
- l'm only opening one box.
- Plan was not to open any.
The plan was to take the boxes to the attic.
[gasps.]
Look, it's Anatomy Jane.
[Meredith.]
For a surgeon, every patient is a battlefield.
- l'll never have my own office.
- [Meredith.]
They're our terrain, where we advance, retreat, try to remove all the landmines.
- And she still has her little twosh.
- Her what? Anatomy Jane had detachable organs.
l could never remember the real names, so l made up names.
Like the twosh was next to the chubbel.
And that was connected to the slivvy.
- Oh, and look, it's the jelly pouch.
- Jelly pouch, my favorite.
Still can't get enough of the jelly pouch.
[Meredith.]
Just when you think you won the battle, made the world safe again along comes another landmine.
- Are we screwing other people or not? - What? l want to know if you're gonna go screw O'Malley or some other loser.
Then l don't cancel my plans with the chick from Peds.
[sighing.]
You're an ass.
What? [both gasping, chuckling.]
- That was amazing.
- Yay.
lt was for me, too.
- l mean, that was amazing.
- For me too! [both chuckling.]
My whole life, my whole adult life, l have been with men, and it always felt, you know, fine, good.
But l never l mean, l did, but not Not like this.
This is like needing glasses.
- l blinded you? - No.
When l was a kid, l would get these headaches and l went to the doctor, and they said that l needed glasses.
l didn't understand that.
lt didn't make sense to me because l could see fine, and then l get the glasses and l put them on and l'm in the car on the way home, and, suddenly, l yell because the big green blobs l'd been staring at my whole life, they weren't big green blobs! They were leaves on trees.
l could see the leaves.
And l didn't even know l was missing the leaves, l didn't even know that leaves existed, and then leaves.
You are glasses.
l am so gay.
l am so, so, so gay.
l am extremely gay.
- [Erica chuckling.]
- [stammering.]
Um l have to go.
Gentlemen, l want you to meet the new head of trauma at Seattle Grace, Major Owen Hunt.
You remember Derek Shepherd, Mark Sloan? - He stole my patient.
- Mine too.
- Now you'll get a chance to steal mine.
- Looking forward to it.
[Richard.]
l talked to a friend of mine at the DOH.
Now that we have Owen, we are being reclassified as a level-one trauma unit by the end of the month.
[Derek.]
That explains it.
My mom bought it for me when l was five, which was a super creepy gift for a five-year-old, but l liked it.
Run! - OK, what was that all about? - l just saw Owen.
Major Owen Hunt.
The guy who pulled the icicle from my chest.
- l thought he was in lraq.
- Now he's here, in my hospital.
- OK, so? - So So we kissed.
He kissed me.
lt was stupid, it was nothing.
Stupid nothing.
But you don't think he thinks it was a stupid nothing.
He obviously likes me, he's back.
What's he doing? Don't think he quit the military for you? That'd be severely stalkery, but very romantic.
l'm not getting involved with another attending.
[exhales.]
Coast clear? - You paged me, chief? - Yes, l did.
'Cause generally, when l'm paged to the helipad, there's something landing.
Yeah.
You pulled off a 1 2-person domino surgery last week.
That's the kind of thing we need every week.
lt's the kind of thing that shows me you'll be a great surgeon someday.
- Well, thank you, sir.
- lt's not enough.
l don't want you to be just great.
l want you to be the best.
lf you're gonna succeed me as the best general surgeon in this hospital, you need to start now, today, which means you need to be me.
You want to take point on a surgery, take point.
Problem comes up, solve it.
Don't talk to me, just do it.
- Be me.
- Be you? Be me.
l can do that.
l don't know why you had to bring me all the way up here to That's why.
Lake Washington Med is sending over a 1 0-year-old girl with an abdominal leiomyosarcoma.
lt's inoperable.
You're gonna have to put together a team and come up with a plan to save her.
- Save a girl with an inoperable tumor? - [Richard.]
lt isn't easy being me.
- [lzzie sighs.]
- What's wrong with you? What's wrong with me? We've been sleeping together for a week and already you're bored.
l'm hot and great in bed, so what's wrong with you? l didn't say l was bored.
l asked if l should keep sleeping with Michelle.
l'm asking if you're all in.
What's wrong with that? You're a barbarian.
How can l be all in with an actual barbarian? Fine.
Claudia in Radiology thinks l have a hot ass.
l'll tap that next.
You do that.
Would you mind picking up Lexie, l'm your roommate.
- You'll eventually have to talk to me.
- l reject that supposition.
- l reject your rejection.
- l ignore your rejection of rejection.
- l don't reject you, George.
- [George.]
Thank you.
OK, two things.
You all have a skills lab this morning.
lt is mandatory.
Don't think about trying to get out.
Second, one of you will not have to go to the mandatory lab because you will be assisting me in my efforts to remove an inoperable tumor from a 1 0-year-old girl.
- l'll do it.
- [Bailey.]
You won't.
You have a hundred delinquent charts.
You will do those after the lab.
Slacker.
How can you operate on an inoperable tumor? - Karev is also out.
You doubted me.
- [Alex.]
What did l say? - l don't doubt you.
- Yang is out too.
You weren't supportive of a fellow resident who couldn't get his paperwork under control.
What is that? Grey, is that Anatomy Jane? - Yes.
- With the 24 removable organs and the optional parts to simulate pregnancy? - Yes.
Does that mean l'm out too? - No, that means you're in.
- Yes! - Not fair.
Next time you'll know to bring in an ugly doll.
Dr.
Yang, what exactly happens in a skills lab? - Who are you? - l'm your new intern.
Ryan Spalding.
l'm never gonna remember that.
You're 4.
2.
Three, Three.
- ls everything OK? - Shut up.
Don't move.
l'm Dr.
Hunt.
Over the next few months l'll be teaching you how to work quickly and efficiently to keep someone alive in the circumstances where the safe bet is they're dead by the end of the hour.
Anyone have a problem working with live tissue? - Live tissue? - Anyone? Speak now.
ln fact, leave now.
lf not, l own you for the rest of the day.
Good.
Here we go.
[indistinct murmuring.]
Each resident gets a pig, interns assist.
[Owen.]
Hang on.
- [stabbing noises.]
- [all gasping.]
- [stabbing continues.]
- [gasping continues.]
Go ahead.
Save their lives.
You're a monster.
They're under, they didn't feel any pain.
- You stabbed them! - Yeah, so we can save them.
We can practice on surgical mannequins.
We can learn to do the same stuff.
- Does that mean you're out? - Yeah, l'm out! ln that case, who wants two pigs? Tori Begler, age 1 0.
Tori has an abdominal leiomyosarcoma.
The tumor is wrapped around her celiac artery, her splenic artery and her left gastric artery.
lt is considered unresectable.
Did you understand a word of that, Tori? Not really.
Grey.
This is Anatomy Jane.
- [Tori.]
She's kinda funny-looking.
- She is funny-looking, but helpful.
So the tumor is way down here in your belly.
Hard to get at because it's underneath all these organs.
- Hard but not impossible, right? - We're gonna try everything we can.
Everything you can should include your cardiothoracic gal.
Dr.
Stewart at Seattle Pres said the vasculature is the problem, and you stole the best cardiovascular surgeon he's ever had.
lf she's not on Tori's team we're leaving, going to San Francisco.
Fudge? lt's homemade.
[clears throat.]
- l love this hospital.
- Yeah, no small talk.
Come on.
- More lessons? - No lessons, just sex.
Nothing fancy, just plain missionary, boylgirl, penislvagina sex.
l mean it.
No dirty talk, no Erica talk.
No talk.
Just grunting and grinding.
- Now who's talking dirty? - Shut up! - What's this about? - [sighs.]
l'm testing a theory.
[grunting.]
Good.
That looks good.
Are you petting the pig? Stop petting the pig.
Spending a lot of time on that anastomosis.
What's your name again? Yang.
Cristina Yang.
Right.
Come take a look at this guy's pig.
- O'Malley? - This is gonna be good.
- Make way for Dr.
Yang.
- See what he did? He stopped the bleeding, then moved on to his liver laceration.
But sloppy work can lead to complications.
Two days from now when this pig starts vomiting blood O'Malley'll wish he'd been thorough.
He can come back later, make things pretty when his pig is stable.
Meanwhile your pig is getting acidotic and hypothermic.
lf this was a scrawny kid he'd be dead by now.
- Quick and dirty, Cristine.
- ''A.
'' Cristina.
[Bailey.]
Let's guide the catheter into the celiac axis.
Turning on the fluoro.
What? Excuse me a sec.
Hello, you can't be in here.
[Tori.]
That's my Uncle Pat and Aunt Jean.
They like to make sure l don't get lonely.
She's not lonely.
Dr.
Grey and l are very entertaining.
[weak cough.]
OK, fine.
They have to stay in there.
There's radiation in here.
All right, let's inject dye.
[Tori.]
ls everything OK? Uh lt's fine.
Owen Hunt is a murdering, sadistic bastard.
- Let me guess, your first wet lab? - He's stabbing pigs, defenseless pigs, or as he likes to call them, ''live tissue,'' God forbid you should call them animals.
He is the new head of trauma, Stevens.
May not be ideal, but if that's how he does things, roll with it.
We don't need live subjects.
What happened to ''first do no harm''? That's about all living things.
Actually, l think it's just about humans.
l'm saying this to you as my roommate and not my attending.
Uh-huh.
You disgust me.
- Damn it! [sighing.]
- What, it wasn't good for you? - lmpossible.
- lt's not that it wasn't good.
[sighs.]
lt's that it was.
- A ''thank you'' would've been nice.
- You paged me? Got a 1 0-year-old girl with a tumor wrapped around her aorta.
- l'm putting together a team.
- This is her angio? Thing is wrapped around five major arteries.
- lt's bad, but l've got ideas.
- Try them on someone who might live.
l admit it doesn't look great, - but her family mentioned you by name.
- That's nice, but l really don't care.
Well, l do.
Don't get emotional, Bailey.
No one likes a girl who gets emotional.
Still, l'd like you on my team.
l'm sorry about this, little guy.
lt must've been awful.
One day you're at some beautiful farm out in the country, breathing in the fresh air, lounging in the mud with your friends.
Next thing you know you're sedated - and stabbed in some skills lab.
- Get it together.
- [pager beeping.]
- Heads up.
Take your interns down to ER.
l'll meet you.
Multiple MVC.
Six incoming.
You, lab's over.
Do your charts.
- What about my pig? - She's got it.
- What? - You're staying here.
With a half dozen crash victims into the pit? You have four struggling victims here.
Keep them alive.
Karev gets to work on people and l have 300 pounds of bacon? Live bacon.
They better be that way when l get back.
Thirty-five-year-old backseat passenger, forehead versus window, the window won.
Second-degree burns on the left side.
Vitals stable en route.
Trauma one.
What do you got? Charles Hiott, 46.
Positive ecchymosis over abdomen.
Last BP 96 over 68.
Know how to do a trauma ultrasound? - Yes.
- ln that case he's yours.
- Can l help you? - Dr.
Karev paged us.
Got it covered.
A head injury and burns.
Don't think you have it covered.
- Karev, are you a doctor? - Yes, sir.
Capable of assessing a patient's injuries? - Yep.
- Like l said, got it covered.
- Let us dive in.
- Appreciate it, but l want my residents to learn to deal with trauma.
They won't learn as much or as fast if they watch attendings do it unless that attending is me.
[Erica.]
Three other hospitals have already sent them away.
And if we were smart, we would do the same thing.
What is the matter with you? We can try and cut around the stomach.
No.
The only way to do that is to take it out.
- They've done ex-vivo autotransplants.
- With livers and kidneys.
Why don't we take out the stomach and kidneys? [Erica.]
That'd be great, if you wanted to kill her.
We're talking about two completely different blood supplies here.
So no, not a good idea, Grey.
Who are those people? Uh, that's Tori's dad, Randy, and his brother, Pat, and Pat's wife, Jean, and Tori's brother David - Why are they staring at us? - l don't think they're staring.
- l think they're just waiting - [pager beeping.]
seeing if we have any news.
Try and come up with something before l get back.
- Close the blinds, Grey.
- [door closing.]
[sighs.]
- You paged me? - Rambo's completely out of control.
- Excuse me? - Hunt.
He kicked me out of my own ER.
- Did he kill somebody? - Not yet.
Call me when he does.
l don't have time for it.
l have a dying 1 0-year-old and doctors who can't stop bickering long enough to solve a problem, except for your girlfriend who's more interested in playing with a doll.
She dragged that thing all around the hospital when she was five, and let me tell you, it was cuter in a child.
- Any luck? - [Erica.]
What do you think? l know you want to be number one, but we can't take in every charity case that comes along.
lt is a huge waste of resources.
lt's your call, Dr.
Bailey.
Grey, put that away.
This isn't playtime.
l'm not playing, l'm thinking.
What if we took out each of the organs where the tumor interferes with the blood supply? By the time you clamp off the aorta you risk damaging the other organs.
- Even if you take them out one by one? - You don't have the time.
What about if we made the time? Dr.
Bailey, let's throw some stuff up on the board.
CT showed a subdural hematoma.
Should l book an OR? First thing's first.
The scalp is bleeding.
What do you do? - Normally l page Shepherd.
- Shepherd's not here.
- What do you do to stop the bleeding? - Suture laceration, tie off bleeders.
That'll take two hours.
What would you use in this room to take care of this? - Staples? - lt's his forehead.
Want this guy to look like Frankenstein the rest of his life? - Skin glue.
- Excellent.
Clean it, close it, stick a pressure dressing over it.
- How are you feeling, Mr.
Hiott? - Not too good.
How'll we make Mr.
Hiott feel better? Ultrasound showed free fluid.
We'll get him to a CT to confirm.
- Pretty much OR bound.
- Excellent.
ls that tetanus? Know who we have to thank for the invention of the tetanus shot? Horses.
First experiments were done on horses.
Want to take out her abdominal organs? - lntestines, stomach, everything? - [man.]
All at once? That's right.
We'll put the organs on ice while we dissect out the tumor, then reconnect the vessels using synthetic grafts and put the organs back in.
Why didn't Graham or Fleisher over at Lake Washington suggest this? They're a couple of smarties.
Probably because it's never been done before.
lt is extremely risky.
There are any number of things that could go wrong.
l don't know, Randy.
Maybe we should try more chemo.
With all due respect, Mrs.
Begler, l don't think there's time for that.
ls it going to save her life? lt's your best shot.
Your only shot.
- Then do it.
- [Richard.]
OK.
Dr.
Bailey, l'm not a vet, and while l can appreciate the value of practicing technique on live tissue, there's a multiple MVC in the pit and my education will be far better served practicing on humans.
- Who's babysitting the pigs now? - My interns.
Major Hunt order the interns to baby-sit the pigs or you? - Not the point.
- Make it the point.
l don't have time.
l'm taking six organs out of a person.
See, that's not fair.
l'm not Dr.
Doolittle.
The zebras and the elephants are thanking their lucky stars for that.
l have a question.
Why aren't we taking out the kidney since the left renal artery is involved? We can remove the tumor without doing that, so why bother? - l have another question.
- Yes? Why can't you look at me? - What? - You can't look at me.
You haven't been able to look at me all day.
l think you're imagining things.
Oh, l don't think l am.
But, hey, if you say so.
l do.
l say so.
lnstead of worrying about whether or not l'm looking at you, concentrate on saving a 1 0-year-old girl that we're about to eviscerate.
[Bailey.]
Dr.
Grey, why do we dissect down in quadrants? [Meredith.]
So we can look at the vessels to make sure we have reconstruction.
- [Bailey.]
Very good.
- [Richard.]
Suction in here, please.
Tori's dad is on the phone.
OR desk wants to know - if they can put him through.
- [Richard.]
No.
- [woman.]
He's insistent.
- [Richard.]
l'm busy.
[Bailey.]
l think Hold this up a little bit higher, Dr.
Grey.
l want to make sure to avoid that! [machines beeping.]
- [Richard.]
Let's get some clamps.
- [Bailey.]
Another clamp, please.
- [Richard.]
Right there.
- Let's hang another bag of blood.
Better hope the aorta's not that friable.
Otherwise all the blood in the world won't save this girl.
- Ryan, what's Reggie's pulse? - Sixty-nine.
Really? 'Cause Wilbur's at 1 02.
l'm pretty sure that's bad.
- Babe's like an ox.
Hers is 52.
- Hey, no cute names! They're not pets, they're subjects.
lt's not our job to get affectionate.
lt's our job to keep them alive, so the attending who thinks we're incapable can choke on his words.
So l don't want to hear Wilbur or Babe.
You want to call them something, call them sausage or prosciutto.
- [machines beeping.]
- Wilbur's crashing.
- What? What did you do? - l don't l don't [Cristina.]
l gotta re-open that thoracotomy.
Pull that chest tray back.
- Dr.
Bailey? - Removing the organs on three.
Ready? One two - three.
- [indistinct murmuring.]
[Richard.]
Let me have it.
[Bailey.]
Wow.
[Richard.]
l'll need medium and large vessel loops to dissect out the tumor.
[nurse.]
Mr.
Begler again.
He wants to talk to you about his daughter.
- l'm pretty busy.
- l already told him that.
- Tell him again.
- l've told him 1 8 times.
[Bailey.]
Chief, you need to go talk to them.
Hey, you did put me in charge.
[sighing.]
l'll be back.
[Derek.]
What the hell? Look at this crap.
ls that glue? You used skin glue? Dr.
Hunt wanted to get him out of there pretty quick.
Because Dr.
Hunt didn't have you revise the wound, he could lose half his face.
You can't rotate a flap, you call someone who can.
He says the ER's like being in the field.
Use what's available.
What qualifies us as a war zone, Karev? Our undermanned gift shop? The lukewarm drinks from the coffee cart? Guy's a meatballer.
What do you expect? - Meatballer? - Trauma guys slap it together.
- Dr.
Webber, how's Tori? - Stable.
We're removing the tumor.
l should be in there to help, - but l'm out here instead.
- l just needed an update.
Not important you get an update right now.
The best doctors we have are focused on your daughter.
Calls and interruptions don't help us focus.
l'm sorry.
l know we have been underfoot sometimes, but we have been to a lot of hospitals, and hospitals are not easy places to get information.
A lot of times it's impossible to get a doctor to talk to you or to get the doctors to talk to each other.
And l don't know if it's neglect or their egos getting in the way, l don't care.
We're just trying to take care of our little girl.
She's 1 0, she's scared and she's sick.
We're doing whatever we can.
Don't ever stop taking care of her like that.
[# Greg Laswell: Days Go On.]
Stevens, have you ever used a GlA stapler? No, but l'm ready, l can handle it.
Answer me three questions and l'll let you.
- OK.
- Question one: The polio vaccine, which animal do we have to thank for that? - This really necessary? - Only if you want to use that stapler.
- [sighs.]
Flipper babies.
- What? Flipper babies.
Ten thousand babies were born with birth defects in the 1 950s because their pregnant mothers took Thalidomide.
First developed on guinea pigs.
Guinea pigs didn't have side effects.
And your point? My point is that humans and animals have different physiologies, - different reactions.
- They can have different reactions.
- Doesn't mean they will.
- Tell that to those babies and moms.
So the polio vaccine, developed using mice and monkeys.
You can keep your stapler.
lt's not worth it.
Give me the status on Reggie and Paddy.
Reggie's fine.
Paddy's pulse ox is low but stable.
- Babe? - Holding steady.
Thought we weren't supposed to give them names.
l could give them numbers but then l'd tell you Three needs antibiotics and find you shoving a needle in Grey's ass.
[sighs.]
His vitals are getting worse, damn it.
- Uh, did you check his lung? - l took out an entire lobe.
- His descending aorta? - l've tried everything.
- [machines beeping.]
- Pulseless.
That's it.
We need to give him more exposure.
- You're opening him up more? - l need everyone's help, stem to stern.
What if he can't take it? You could kill him.
Don't get emotional.
Get ready to start massaging his heart.
Scalpel.
[Richard.]
Bailey, can you dissect any more? [Bailey.]
There's nothing to dissect.
There's barely any artery left.
What about if we extend the Gore-Tex graft? What's left is too friable.
We can't reconnect the organs to the vessels? - Not at this moment.
No.
- [Meredith.]
But if we can't reconnect, they won't reperfuse and they'll die.
- Yes, they will.
- [Meredith.]
Too late for a transplant? Well, we'd have to find six good organs in about eight hours.
- lt's too late for a transplant.
- And a gold star for Grey.
[sighs.]
[Bailey.]
We could put in more Gore-Tex.
Oh, put even more synthetic material in? - What about a saphenous vein graft? - She's getting acidotic.
- That has to be pre-planned.
- What's your idea? Excuse me? You're good at shooting down every idea we come up with.
What's yours? lt was my idea not to do this in the first place, Dr.
Bailey.
Yeah, and you made that very clear every chance you got.
Shut up! l don't care who had what idea when.
Get over yourselves.
Shut up and talk to each other.
What about using human umbilical vein? - Ready to go, already heparinized.
- OK.
l like it.
- Erica, what do you think? - lt could work.
lt's Dr.
Bailey's call, if she wants to do it.
- l do.
- OK, in that case, let's do it.
Nice work on the valve.
First developed in pigs, but more recently in cows.
[mooing.]
Are you done beating me up for the day because l'd like to go home.
- l was trying to teach you.
- You want to teach us? Take us to the Simulab with the plastic guys who have heart rates and blood pressure and croak when you nick an artery.
Until you apply scalpel to skin you're just going through motions.
That attitude? That's from before.
We have technology.
We don't have to torture creatures.
You don't get to accuse me of torture.
Those animals felt no pain.
You don't know that.
You don't know that.
You don't know what they felt, you don't know how scared they were.
Animals are sensitive and intelligent creatures.
And that is not me being emotional, that is simply the truth.
Want me to learn from your methods? Want me to learn anything from you? Then don't stab pigs in front of me and tell me the sky isn't blue.
You are torturing God's creatures in an age where we have the technology that no longer requires us to.
lf you want to do that, go ahead, but don't tell me l'm less of a doctor for walking away.
- [machines beeping.]
- Come on, Wilbur, don't do this.
His heart's not filling.
You know Massage it with both hands, like a heart sandwich.
[Cristina.]
Good.
Good.
There! Right there.
Stupid.
Look at that.
The knife went through his diaphragm into his spleen.
OK.
Hand me those clamps.
[Richard.]
We've got blood pooling the lower left quadrant.
- Anybody see where it's coming from? - Here.
This graft.
Satinsky clamps.
- [Bailey.]
And four-0 Prolene.
- Scissors.
[Richard.]
Waiting, Dr.
Bailey.
[machines beeping.]
[Cristina.]
OK, this thing's coming out.
We're still waiting, Dr.
Bailey.
OK.
Suction.
Clear it out.
OK, release clamps.
[machines beeping.]
[Cristina.]
Hold on, hold on, hold on.
- Right in here.
- [Lexie.]
Still nothing.
[Meredith.]
No pulsation.
[Bailey.]
Come on, come on.
[Bailey.]
Reperfusion complete! [gasping.]
The heart's beating on its own.
[all exhaling, laughing.]
[man.]
All right! All right.
[chuckles.]
Everyone, hell of a job.
[all sighing.]
l've known women to be upset because they couldn't make it to the big finish.
Never had anything to do with me.
Usually something to do with their anatomy.
Point is, l've never known a woman to be upset because she could take a curtain call.
You're a conundrum, Torres.
Erica cried this morning.
ln bed.
After sex.
That was a compliment, for you.
- The crying was a compliment.
- lt wasn't a compliment for me.
She was having a revelation.
She was having The sex is awesome with Erica.
We've reached awesome, which is - Awesome.
- Yes, but it's also awesome with you.
So, what's the problem? [sighs.]
Guess l thought there should be a difference between you and Erica.
lf l'm There should be a difference.
The difference between me and Erica is that l know you had sex with her 1 2 hours ago.
She doesn't know you had sex with me, and that makes you a cheater.
Do you want to be a cheater? 'Cause l'm fine with it.
The question is, are you? - [door opens.]
- [gasping.]
Gonna yell at the major general.
Wanna come? - Hell yeah.
Be right there.
- Hey, Torres.
[Callie.]
Hey.
- Hunt, can l talk to you? - Sure.
- Karev? - No, no, he can stay.
Want Karev to hear how you screwed up the flap of my head trauma, fine.
My job's to keep him alive.
lt's what l did.
What you did was almost maim a guy for the rest of his life.
You're lucky l saved the blood supply.
- What would you have done? - A man with a deep scalp wound, and two of the best surgeons in the country standing ten feet away.
l would've asked those two surgeons to step in.
That's what l would've done.
l mean, medically.
What would you have done medically so l can do better? l recognize there's different ways of doing things, even the basics.
Here, someone appears dead, you go to them first.
ln lraq someone appears dead you don't.
This is day one for me.
You think there's a better way then tell me, and l'll listen.
- Again, both of you, great job.
- [Erica.]
Thank you.
- [scoffing.]
- ls there a problem, Dr.
Bailey? Just find it hard to believe you're accepting congratulations, considering you didn't want to do this operation.
When you finally did do it, you fought me every step of the way.
And yet you still had a world-class heart surgeon by your side.
You may be a fine surgeon, God knows l know that, but not today.
Today you were a pain in the ass.
A naysaying, bullying, consistently negative pain in the ass.
At no point did you encourage me or do anything to make me think this surgery could be anything but a failure.
And it wasn't just me.
You made it as hard as humanly possible for all of us.
So, yeah, we did do a nice job today.
We did a great job today.
But that wasn't thanks to you, that was thanks to me and the chief.
And Meredith Grey.
And Anatomy Jane.
Babe is indestructible.
She lost a part of her liver and small bowel but she's doing fine.
[Cristina.]
We had to cross-clamp Wilbur's aorta and massage his heart.
l couldn't locate the source of his bleeding until l found a hole in his diaphragm, realized he had a splenic laceration.
He's a fighter, he's pulling through.
Reggie had some oozing after his colon resection, but we packed it and he's been stable ever since.
Paddy almost bled out because his carotid was sliced right through.
We put in a graft.
He's been stable ever since.
- He's good as new.
- That's good.
That's great work, all of you.
So put them out and make sure you write up all your work.
- What do you mean ''put them out?'' - Terminate them.
Kill 'em.
l'm not killing those pigs.
l spent the day trying to keep them alive.
- Want them dead, do it yourself.
- You resected half of a liver today.
You repaired a diaphragm, did a splenectomy, grafted a severed artery and repaired a lacerated bladder, performed a lobectomy.
And l understand you even removed a tumor.
On Paddy, his thyroid.
You have any idea how much you just learned? They'd be in pain.
Those are massive injuries, months of recovery.
To keep them alive after all that, it's not humane.
Seriously, you don't remember my name? l remember your name, but that was before.
[sighing.]
This last tour, l was on a forward surgical team.
We treated combat casualties in the field.
You're mostly looking to do damage control: Sedate 'em, ventilate 'em, airlift 'em to Baghdad, get out of there.
Only this one time we didn't get out fast enough 'cause we ended up in the middle of an RPG ambush.
There were 20 people in my unit, including me, and 1 9 died.
And then l got discharged.
So l'm not there anymore, in the before.
l knew your name in the before.
Now l'm living in the after.
- Erica.
- You want to apologize to someone, apologize to Bailey.
Thanks to you, l made her life a living hell.
l slept with Mark Sloan.
lf that's your idea of an apology, you seriously Shut up! You were crying and seeing leaves.
And l wasn't.
OK? l may never see leaves.
Or maybe l will see leaves, but l'll also see flowers.
l might be a whole forest girl, l don't know, but l do know that l want to be with you and to do that l have to at least tell you the truth, and the truth is l slept with Mark Sloan today.
OK.
Twice, actually.
OK.
[exhales.]
[door opens.]
- You paged? - Yeah.
How's Tori? She's good, stable.
You weren't imagining things.
You used to run around here with that doll all the time.
Took her everywhere.
The cafeteria, the old art gallery.
Tori's got a whole army.
You didn't have anyone.
Seeing Anatomy Jane reminded me of how much l was to blame for that.
You're a living reminder of every failure in my life.
That's not your fault.
And if l thought ''l'm sorry'' would hold any meaning for you at all, l'd say it.
l'd say it a thousand times a day.
[Meredith.]
Some wars are never over.
[# El Perro Del Mar: From The Valley To The Stars.]
Some end in an uneasy truce.
l can't do it.
l know l'm supposed to, but They'll suffer.
Don't let them suffer.
[sighing.]
- So no more on-call room, huh? - Afraid not.
That's too bad.
Guess l'll, uh, see you around.
[Callie.]
Hey.
Wanna get a drink? Really? Just 'cause we're not sleeping together doesn't mean we can't hang out, be friends.
You're good for more than sex, Mark.
l would love to get a drink.
- She's not gonna cry every time, right? - No.
That passes.
[indistinct chatter.]
[Meredith.]
Some wars result in complete and total victory.
Sit.
Mac and cheese, from the box, not the freezer.
[Meredith.]
Some wars end with a peace offering.
l named the pigs today.
l'm sorry, but l don't know what that means.
l take things personally.
l get too emotional.
There's no place for it at work, not with the pigs and not with you.
l'm sorry.
This is so much better than the freezer kind.
- [knocking at door.]
- [door opens.]
Thought you were sleeping with Michelle tonight, or was it Jackie? - lz.
- l've had a hard day, Alex.
And a sad night.
Please just leave me alone.
- lzzie.
- What? l'm not good at this, all right? l'm not good at relationships or talking about stupid feelings and you are, so maybe you could teach me or something, you know? Tell me what l did wrong.
You don't want us to see other people.
You don't want us to see other people and that's how you tried to tell me by asking if it was cool if you screwed Michelle.
- Laughing's not helping.
- l'm sorry.
l'm sorry.
- So you want lessons, huh? - l want lessons.
OK.
You start with, ''lsobel Stevens, - you are staggeringly good in bed.
- [chuckling.]
You're amazingly smart, wonderfully funny, - and you care about animals.
'' - That's where l start? Yeah.
And then you say, - ''You want to go steady with me?'' - That's what l'd say if it was 1 952.
[# Raining Jane: Prelude.]
- [sighing.]
Alex.
- Yeah? You want to go steady with me? lf that's what you want.
l mean, yeah, whatever.
- [chuckling.]
- [Meredith.]
And some wars end in hope.
Oh, look! l wore this every day to elementary school.
- Nice.
Your mom make that for you? - [laughing.]
Yeah, right.
She probably got it at the lost and found at the hospital.
- Mer, you should do this one.
- ls it more ugly hats? - Another diary? - More than one.
[Meredith.]
But all these wars are nothing Oh, my God.
compared to the most frightening war of all.
The one you have yet to fight.
Previously on Grey's Anatomy: [Derek.]
The Chief's under the spell of some insane man in camouflage.
[man.]
Major Owen Hunt.
l'm a trauma surgeon.
You're reading your mom's diary? l'm not half the surgeon my mother was.
[Cristina.]
Chief wants us to give George one of our interns? You didn't even think to ask for me? Screw you, Dr.
O'Malley.
We can take it slow.
Maybe just first base.
[# Vampire Weekend: Walcott.]
- Meredith.
- [both giggling.]
- l'm only opening one box.
- Plan was not to open any.
The plan was to take the boxes to the attic.
[gasps.]
Look, it's Anatomy Jane.
[Meredith.]
For a surgeon, every patient is a battlefield.
- l'll never have my own office.
- [Meredith.]
They're our terrain, where we advance, retreat, try to remove all the landmines.
- And she still has her little twosh.
- Her what? Anatomy Jane had detachable organs.
l could never remember the real names, so l made up names.
Like the twosh was next to the chubbel.
And that was connected to the slivvy.
- Oh, and look, it's the jelly pouch.
- Jelly pouch, my favorite.
Still can't get enough of the jelly pouch.
[Meredith.]
Just when you think you won the battle, made the world safe again along comes another landmine.
- Are we screwing other people or not? - What? l want to know if you're gonna go screw O'Malley or some other loser.
Then l don't cancel my plans with the chick from Peds.
[sighing.]
You're an ass.
What? [both gasping, chuckling.]
- That was amazing.
- Yay.
lt was for me, too.
- l mean, that was amazing.
- For me too! [both chuckling.]
My whole life, my whole adult life, l have been with men, and it always felt, you know, fine, good.
But l never l mean, l did, but not Not like this.
This is like needing glasses.
- l blinded you? - No.
When l was a kid, l would get these headaches and l went to the doctor, and they said that l needed glasses.
l didn't understand that.
lt didn't make sense to me because l could see fine, and then l get the glasses and l put them on and l'm in the car on the way home, and, suddenly, l yell because the big green blobs l'd been staring at my whole life, they weren't big green blobs! They were leaves on trees.
l could see the leaves.
And l didn't even know l was missing the leaves, l didn't even know that leaves existed, and then leaves.
You are glasses.
l am so gay.
l am so, so, so gay.
l am extremely gay.
- [Erica chuckling.]
- [stammering.]
Um l have to go.
Gentlemen, l want you to meet the new head of trauma at Seattle Grace, Major Owen Hunt.
You remember Derek Shepherd, Mark Sloan? - He stole my patient.
- Mine too.
- Now you'll get a chance to steal mine.
- Looking forward to it.
[Richard.]
l talked to a friend of mine at the DOH.
Now that we have Owen, we are being reclassified as a level-one trauma unit by the end of the month.
[Derek.]
That explains it.
My mom bought it for me when l was five, which was a super creepy gift for a five-year-old, but l liked it.
Run! - OK, what was that all about? - l just saw Owen.
Major Owen Hunt.
The guy who pulled the icicle from my chest.
- l thought he was in lraq.
- Now he's here, in my hospital.
- OK, so? - So So we kissed.
He kissed me.
lt was stupid, it was nothing.
Stupid nothing.
But you don't think he thinks it was a stupid nothing.
He obviously likes me, he's back.
What's he doing? Don't think he quit the military for you? That'd be severely stalkery, but very romantic.
l'm not getting involved with another attending.
[exhales.]
Coast clear? - You paged me, chief? - Yes, l did.
'Cause generally, when l'm paged to the helipad, there's something landing.
Yeah.
You pulled off a 1 2-person domino surgery last week.
That's the kind of thing we need every week.
lt's the kind of thing that shows me you'll be a great surgeon someday.
- Well, thank you, sir.
- lt's not enough.
l don't want you to be just great.
l want you to be the best.
lf you're gonna succeed me as the best general surgeon in this hospital, you need to start now, today, which means you need to be me.
You want to take point on a surgery, take point.
Problem comes up, solve it.
Don't talk to me, just do it.
- Be me.
- Be you? Be me.
l can do that.
l don't know why you had to bring me all the way up here to That's why.
Lake Washington Med is sending over a 1 0-year-old girl with an abdominal leiomyosarcoma.
lt's inoperable.
You're gonna have to put together a team and come up with a plan to save her.
- Save a girl with an inoperable tumor? - [Richard.]
lt isn't easy being me.
- [lzzie sighs.]
- What's wrong with you? What's wrong with me? We've been sleeping together for a week and already you're bored.
l'm hot and great in bed, so what's wrong with you? l didn't say l was bored.
l asked if l should keep sleeping with Michelle.
l'm asking if you're all in.
What's wrong with that? You're a barbarian.
How can l be all in with an actual barbarian? Fine.
Claudia in Radiology thinks l have a hot ass.
l'll tap that next.
You do that.
Would you mind picking up Lexie, l'm your roommate.
- You'll eventually have to talk to me.
- l reject that supposition.
- l reject your rejection.
- l ignore your rejection of rejection.
- l don't reject you, George.
- [George.]
Thank you.
OK, two things.
You all have a skills lab this morning.
lt is mandatory.
Don't think about trying to get out.
Second, one of you will not have to go to the mandatory lab because you will be assisting me in my efforts to remove an inoperable tumor from a 1 0-year-old girl.
- l'll do it.
- [Bailey.]
You won't.
You have a hundred delinquent charts.
You will do those after the lab.
Slacker.
How can you operate on an inoperable tumor? - Karev is also out.
You doubted me.
- [Alex.]
What did l say? - l don't doubt you.
- Yang is out too.
You weren't supportive of a fellow resident who couldn't get his paperwork under control.
What is that? Grey, is that Anatomy Jane? - Yes.
- With the 24 removable organs and the optional parts to simulate pregnancy? - Yes.
Does that mean l'm out too? - No, that means you're in.
- Yes! - Not fair.
Next time you'll know to bring in an ugly doll.
Dr.
Yang, what exactly happens in a skills lab? - Who are you? - l'm your new intern.
Ryan Spalding.
l'm never gonna remember that.
You're 4.
2.
Three, Three.
- ls everything OK? - Shut up.
Don't move.
l'm Dr.
Hunt.
Over the next few months l'll be teaching you how to work quickly and efficiently to keep someone alive in the circumstances where the safe bet is they're dead by the end of the hour.
Anyone have a problem working with live tissue? - Live tissue? - Anyone? Speak now.
ln fact, leave now.
lf not, l own you for the rest of the day.
Good.
Here we go.
[indistinct murmuring.]
Each resident gets a pig, interns assist.
[Owen.]
Hang on.
- [stabbing noises.]
- [all gasping.]
- [stabbing continues.]
- [gasping continues.]
Go ahead.
Save their lives.
You're a monster.
They're under, they didn't feel any pain.
- You stabbed them! - Yeah, so we can save them.
We can practice on surgical mannequins.
We can learn to do the same stuff.
- Does that mean you're out? - Yeah, l'm out! ln that case, who wants two pigs? Tori Begler, age 1 0.
Tori has an abdominal leiomyosarcoma.
The tumor is wrapped around her celiac artery, her splenic artery and her left gastric artery.
lt is considered unresectable.
Did you understand a word of that, Tori? Not really.
Grey.
This is Anatomy Jane.
- [Tori.]
She's kinda funny-looking.
- She is funny-looking, but helpful.
So the tumor is way down here in your belly.
Hard to get at because it's underneath all these organs.
- Hard but not impossible, right? - We're gonna try everything we can.
Everything you can should include your cardiothoracic gal.
Dr.
Stewart at Seattle Pres said the vasculature is the problem, and you stole the best cardiovascular surgeon he's ever had.
lf she's not on Tori's team we're leaving, going to San Francisco.
Fudge? lt's homemade.
[clears throat.]
- l love this hospital.
- Yeah, no small talk.
Come on.
- More lessons? - No lessons, just sex.
Nothing fancy, just plain missionary, boylgirl, penislvagina sex.
l mean it.
No dirty talk, no Erica talk.
No talk.
Just grunting and grinding.
- Now who's talking dirty? - Shut up! - What's this about? - [sighs.]
l'm testing a theory.
[grunting.]
Good.
That looks good.
Are you petting the pig? Stop petting the pig.
Spending a lot of time on that anastomosis.
What's your name again? Yang.
Cristina Yang.
Right.
Come take a look at this guy's pig.
- O'Malley? - This is gonna be good.
- Make way for Dr.
Yang.
- See what he did? He stopped the bleeding, then moved on to his liver laceration.
But sloppy work can lead to complications.
Two days from now when this pig starts vomiting blood O'Malley'll wish he'd been thorough.
He can come back later, make things pretty when his pig is stable.
Meanwhile your pig is getting acidotic and hypothermic.
lf this was a scrawny kid he'd be dead by now.
- Quick and dirty, Cristine.
- ''A.
'' Cristina.
[Bailey.]
Let's guide the catheter into the celiac axis.
Turning on the fluoro.
What? Excuse me a sec.
Hello, you can't be in here.
[Tori.]
That's my Uncle Pat and Aunt Jean.
They like to make sure l don't get lonely.
She's not lonely.
Dr.
Grey and l are very entertaining.
[weak cough.]
OK, fine.
They have to stay in there.
There's radiation in here.
All right, let's inject dye.
[Tori.]
ls everything OK? Uh lt's fine.
Owen Hunt is a murdering, sadistic bastard.
- Let me guess, your first wet lab? - He's stabbing pigs, defenseless pigs, or as he likes to call them, ''live tissue,'' God forbid you should call them animals.
He is the new head of trauma, Stevens.
May not be ideal, but if that's how he does things, roll with it.
We don't need live subjects.
What happened to ''first do no harm''? That's about all living things.
Actually, l think it's just about humans.
l'm saying this to you as my roommate and not my attending.
Uh-huh.
You disgust me.
- Damn it! [sighing.]
- What, it wasn't good for you? - lmpossible.
- lt's not that it wasn't good.
[sighs.]
lt's that it was.
- A ''thank you'' would've been nice.
- You paged me? Got a 1 0-year-old girl with a tumor wrapped around her aorta.
- l'm putting together a team.
- This is her angio? Thing is wrapped around five major arteries.
- lt's bad, but l've got ideas.
- Try them on someone who might live.
l admit it doesn't look great, - but her family mentioned you by name.
- That's nice, but l really don't care.
Well, l do.
Don't get emotional, Bailey.
No one likes a girl who gets emotional.
Still, l'd like you on my team.
l'm sorry about this, little guy.
lt must've been awful.
One day you're at some beautiful farm out in the country, breathing in the fresh air, lounging in the mud with your friends.
Next thing you know you're sedated - and stabbed in some skills lab.
- Get it together.
- [pager beeping.]
- Heads up.
Take your interns down to ER.
l'll meet you.
Multiple MVC.
Six incoming.
You, lab's over.
Do your charts.
- What about my pig? - She's got it.
- What? - You're staying here.
With a half dozen crash victims into the pit? You have four struggling victims here.
Keep them alive.
Karev gets to work on people and l have 300 pounds of bacon? Live bacon.
They better be that way when l get back.
Thirty-five-year-old backseat passenger, forehead versus window, the window won.
Second-degree burns on the left side.
Vitals stable en route.
Trauma one.
What do you got? Charles Hiott, 46.
Positive ecchymosis over abdomen.
Last BP 96 over 68.
Know how to do a trauma ultrasound? - Yes.
- ln that case he's yours.
- Can l help you? - Dr.
Karev paged us.
Got it covered.
A head injury and burns.
Don't think you have it covered.
- Karev, are you a doctor? - Yes, sir.
Capable of assessing a patient's injuries? - Yep.
- Like l said, got it covered.
- Let us dive in.
- Appreciate it, but l want my residents to learn to deal with trauma.
They won't learn as much or as fast if they watch attendings do it unless that attending is me.
[Erica.]
Three other hospitals have already sent them away.
And if we were smart, we would do the same thing.
What is the matter with you? We can try and cut around the stomach.
No.
The only way to do that is to take it out.
- They've done ex-vivo autotransplants.
- With livers and kidneys.
Why don't we take out the stomach and kidneys? [Erica.]
That'd be great, if you wanted to kill her.
We're talking about two completely different blood supplies here.
So no, not a good idea, Grey.
Who are those people? Uh, that's Tori's dad, Randy, and his brother, Pat, and Pat's wife, Jean, and Tori's brother David - Why are they staring at us? - l don't think they're staring.
- l think they're just waiting - [pager beeping.]
seeing if we have any news.
Try and come up with something before l get back.
- Close the blinds, Grey.
- [door closing.]
[sighs.]
- You paged me? - Rambo's completely out of control.
- Excuse me? - Hunt.
He kicked me out of my own ER.
- Did he kill somebody? - Not yet.
Call me when he does.
l don't have time for it.
l have a dying 1 0-year-old and doctors who can't stop bickering long enough to solve a problem, except for your girlfriend who's more interested in playing with a doll.
She dragged that thing all around the hospital when she was five, and let me tell you, it was cuter in a child.
- Any luck? - [Erica.]
What do you think? l know you want to be number one, but we can't take in every charity case that comes along.
lt is a huge waste of resources.
lt's your call, Dr.
Bailey.
Grey, put that away.
This isn't playtime.
l'm not playing, l'm thinking.
What if we took out each of the organs where the tumor interferes with the blood supply? By the time you clamp off the aorta you risk damaging the other organs.
- Even if you take them out one by one? - You don't have the time.
What about if we made the time? Dr.
Bailey, let's throw some stuff up on the board.
CT showed a subdural hematoma.
Should l book an OR? First thing's first.
The scalp is bleeding.
What do you do? - Normally l page Shepherd.
- Shepherd's not here.
- What do you do to stop the bleeding? - Suture laceration, tie off bleeders.
That'll take two hours.
What would you use in this room to take care of this? - Staples? - lt's his forehead.
Want this guy to look like Frankenstein the rest of his life? - Skin glue.
- Excellent.
Clean it, close it, stick a pressure dressing over it.
- How are you feeling, Mr.
Hiott? - Not too good.
How'll we make Mr.
Hiott feel better? Ultrasound showed free fluid.
We'll get him to a CT to confirm.
- Pretty much OR bound.
- Excellent.
ls that tetanus? Know who we have to thank for the invention of the tetanus shot? Horses.
First experiments were done on horses.
Want to take out her abdominal organs? - lntestines, stomach, everything? - [man.]
All at once? That's right.
We'll put the organs on ice while we dissect out the tumor, then reconnect the vessels using synthetic grafts and put the organs back in.
Why didn't Graham or Fleisher over at Lake Washington suggest this? They're a couple of smarties.
Probably because it's never been done before.
lt is extremely risky.
There are any number of things that could go wrong.
l don't know, Randy.
Maybe we should try more chemo.
With all due respect, Mrs.
Begler, l don't think there's time for that.
ls it going to save her life? lt's your best shot.
Your only shot.
- Then do it.
- [Richard.]
OK.
Dr.
Bailey, l'm not a vet, and while l can appreciate the value of practicing technique on live tissue, there's a multiple MVC in the pit and my education will be far better served practicing on humans.
- Who's babysitting the pigs now? - My interns.
Major Hunt order the interns to baby-sit the pigs or you? - Not the point.
- Make it the point.
l don't have time.
l'm taking six organs out of a person.
See, that's not fair.
l'm not Dr.
Doolittle.
The zebras and the elephants are thanking their lucky stars for that.
l have a question.
Why aren't we taking out the kidney since the left renal artery is involved? We can remove the tumor without doing that, so why bother? - l have another question.
- Yes? Why can't you look at me? - What? - You can't look at me.
You haven't been able to look at me all day.
l think you're imagining things.
Oh, l don't think l am.
But, hey, if you say so.
l do.
l say so.
lnstead of worrying about whether or not l'm looking at you, concentrate on saving a 1 0-year-old girl that we're about to eviscerate.
[Bailey.]
Dr.
Grey, why do we dissect down in quadrants? [Meredith.]
So we can look at the vessels to make sure we have reconstruction.
- [Bailey.]
Very good.
- [Richard.]
Suction in here, please.
Tori's dad is on the phone.
OR desk wants to know - if they can put him through.
- [Richard.]
No.
- [woman.]
He's insistent.
- [Richard.]
l'm busy.
[Bailey.]
l think Hold this up a little bit higher, Dr.
Grey.
l want to make sure to avoid that! [machines beeping.]
- [Richard.]
Let's get some clamps.
- [Bailey.]
Another clamp, please.
- [Richard.]
Right there.
- Let's hang another bag of blood.
Better hope the aorta's not that friable.
Otherwise all the blood in the world won't save this girl.
- Ryan, what's Reggie's pulse? - Sixty-nine.
Really? 'Cause Wilbur's at 1 02.
l'm pretty sure that's bad.
- Babe's like an ox.
Hers is 52.
- Hey, no cute names! They're not pets, they're subjects.
lt's not our job to get affectionate.
lt's our job to keep them alive, so the attending who thinks we're incapable can choke on his words.
So l don't want to hear Wilbur or Babe.
You want to call them something, call them sausage or prosciutto.
- [machines beeping.]
- Wilbur's crashing.
- What? What did you do? - l don't l don't [Cristina.]
l gotta re-open that thoracotomy.
Pull that chest tray back.
- Dr.
Bailey? - Removing the organs on three.
Ready? One two - three.
- [indistinct murmuring.]
[Richard.]
Let me have it.
[Bailey.]
Wow.
[Richard.]
l'll need medium and large vessel loops to dissect out the tumor.
[nurse.]
Mr.
Begler again.
He wants to talk to you about his daughter.
- l'm pretty busy.
- l already told him that.
- Tell him again.
- l've told him 1 8 times.
[Bailey.]
Chief, you need to go talk to them.
Hey, you did put me in charge.
[sighing.]
l'll be back.
[Derek.]
What the hell? Look at this crap.
ls that glue? You used skin glue? Dr.
Hunt wanted to get him out of there pretty quick.
Because Dr.
Hunt didn't have you revise the wound, he could lose half his face.
You can't rotate a flap, you call someone who can.
He says the ER's like being in the field.
Use what's available.
What qualifies us as a war zone, Karev? Our undermanned gift shop? The lukewarm drinks from the coffee cart? Guy's a meatballer.
What do you expect? - Meatballer? - Trauma guys slap it together.
- Dr.
Webber, how's Tori? - Stable.
We're removing the tumor.
l should be in there to help, - but l'm out here instead.
- l just needed an update.
Not important you get an update right now.
The best doctors we have are focused on your daughter.
Calls and interruptions don't help us focus.
l'm sorry.
l know we have been underfoot sometimes, but we have been to a lot of hospitals, and hospitals are not easy places to get information.
A lot of times it's impossible to get a doctor to talk to you or to get the doctors to talk to each other.
And l don't know if it's neglect or their egos getting in the way, l don't care.
We're just trying to take care of our little girl.
She's 1 0, she's scared and she's sick.
We're doing whatever we can.
Don't ever stop taking care of her like that.
[# Greg Laswell: Days Go On.]
Stevens, have you ever used a GlA stapler? No, but l'm ready, l can handle it.
Answer me three questions and l'll let you.
- OK.
- Question one: The polio vaccine, which animal do we have to thank for that? - This really necessary? - Only if you want to use that stapler.
- [sighs.]
Flipper babies.
- What? Flipper babies.
Ten thousand babies were born with birth defects in the 1 950s because their pregnant mothers took Thalidomide.
First developed on guinea pigs.
Guinea pigs didn't have side effects.
And your point? My point is that humans and animals have different physiologies, - different reactions.
- They can have different reactions.
- Doesn't mean they will.
- Tell that to those babies and moms.
So the polio vaccine, developed using mice and monkeys.
You can keep your stapler.
lt's not worth it.
Give me the status on Reggie and Paddy.
Reggie's fine.
Paddy's pulse ox is low but stable.
- Babe? - Holding steady.
Thought we weren't supposed to give them names.
l could give them numbers but then l'd tell you Three needs antibiotics and find you shoving a needle in Grey's ass.
[sighs.]
His vitals are getting worse, damn it.
- Uh, did you check his lung? - l took out an entire lobe.
- His descending aorta? - l've tried everything.
- [machines beeping.]
- Pulseless.
That's it.
We need to give him more exposure.
- You're opening him up more? - l need everyone's help, stem to stern.
What if he can't take it? You could kill him.
Don't get emotional.
Get ready to start massaging his heart.
Scalpel.
[Richard.]
Bailey, can you dissect any more? [Bailey.]
There's nothing to dissect.
There's barely any artery left.
What about if we extend the Gore-Tex graft? What's left is too friable.
We can't reconnect the organs to the vessels? - Not at this moment.
No.
- [Meredith.]
But if we can't reconnect, they won't reperfuse and they'll die.
- Yes, they will.
- [Meredith.]
Too late for a transplant? Well, we'd have to find six good organs in about eight hours.
- lt's too late for a transplant.
- And a gold star for Grey.
[sighs.]
[Bailey.]
We could put in more Gore-Tex.
Oh, put even more synthetic material in? - What about a saphenous vein graft? - She's getting acidotic.
- That has to be pre-planned.
- What's your idea? Excuse me? You're good at shooting down every idea we come up with.
What's yours? lt was my idea not to do this in the first place, Dr.
Bailey.
Yeah, and you made that very clear every chance you got.
Shut up! l don't care who had what idea when.
Get over yourselves.
Shut up and talk to each other.
What about using human umbilical vein? - Ready to go, already heparinized.
- OK.
l like it.
- Erica, what do you think? - lt could work.
lt's Dr.
Bailey's call, if she wants to do it.
- l do.
- OK, in that case, let's do it.
Nice work on the valve.
First developed in pigs, but more recently in cows.
[mooing.]
Are you done beating me up for the day because l'd like to go home.
- l was trying to teach you.
- You want to teach us? Take us to the Simulab with the plastic guys who have heart rates and blood pressure and croak when you nick an artery.
Until you apply scalpel to skin you're just going through motions.
That attitude? That's from before.
We have technology.
We don't have to torture creatures.
You don't get to accuse me of torture.
Those animals felt no pain.
You don't know that.
You don't know that.
You don't know what they felt, you don't know how scared they were.
Animals are sensitive and intelligent creatures.
And that is not me being emotional, that is simply the truth.
Want me to learn from your methods? Want me to learn anything from you? Then don't stab pigs in front of me and tell me the sky isn't blue.
You are torturing God's creatures in an age where we have the technology that no longer requires us to.
lf you want to do that, go ahead, but don't tell me l'm less of a doctor for walking away.
- [machines beeping.]
- Come on, Wilbur, don't do this.
His heart's not filling.
You know Massage it with both hands, like a heart sandwich.
[Cristina.]
Good.
Good.
There! Right there.
Stupid.
Look at that.
The knife went through his diaphragm into his spleen.
OK.
Hand me those clamps.
[Richard.]
We've got blood pooling the lower left quadrant.
- Anybody see where it's coming from? - Here.
This graft.
Satinsky clamps.
- [Bailey.]
And four-0 Prolene.
- Scissors.
[Richard.]
Waiting, Dr.
Bailey.
[machines beeping.]
[Cristina.]
OK, this thing's coming out.
We're still waiting, Dr.
Bailey.
OK.
Suction.
Clear it out.
OK, release clamps.
[machines beeping.]
[Cristina.]
Hold on, hold on, hold on.
- Right in here.
- [Lexie.]
Still nothing.
[Meredith.]
No pulsation.
[Bailey.]
Come on, come on.
[Bailey.]
Reperfusion complete! [gasping.]
The heart's beating on its own.
[all exhaling, laughing.]
[man.]
All right! All right.
[chuckles.]
Everyone, hell of a job.
[all sighing.]
l've known women to be upset because they couldn't make it to the big finish.
Never had anything to do with me.
Usually something to do with their anatomy.
Point is, l've never known a woman to be upset because she could take a curtain call.
You're a conundrum, Torres.
Erica cried this morning.
ln bed.
After sex.
That was a compliment, for you.
- The crying was a compliment.
- lt wasn't a compliment for me.
She was having a revelation.
She was having The sex is awesome with Erica.
We've reached awesome, which is - Awesome.
- Yes, but it's also awesome with you.
So, what's the problem? [sighs.]
Guess l thought there should be a difference between you and Erica.
lf l'm There should be a difference.
The difference between me and Erica is that l know you had sex with her 1 2 hours ago.
She doesn't know you had sex with me, and that makes you a cheater.
Do you want to be a cheater? 'Cause l'm fine with it.
The question is, are you? - [door opens.]
- [gasping.]
Gonna yell at the major general.
Wanna come? - Hell yeah.
Be right there.
- Hey, Torres.
[Callie.]
Hey.
- Hunt, can l talk to you? - Sure.
- Karev? - No, no, he can stay.
Want Karev to hear how you screwed up the flap of my head trauma, fine.
My job's to keep him alive.
lt's what l did.
What you did was almost maim a guy for the rest of his life.
You're lucky l saved the blood supply.
- What would you have done? - A man with a deep scalp wound, and two of the best surgeons in the country standing ten feet away.
l would've asked those two surgeons to step in.
That's what l would've done.
l mean, medically.
What would you have done medically so l can do better? l recognize there's different ways of doing things, even the basics.
Here, someone appears dead, you go to them first.
ln lraq someone appears dead you don't.
This is day one for me.
You think there's a better way then tell me, and l'll listen.
- Again, both of you, great job.
- [Erica.]
Thank you.
- [scoffing.]
- ls there a problem, Dr.
Bailey? Just find it hard to believe you're accepting congratulations, considering you didn't want to do this operation.
When you finally did do it, you fought me every step of the way.
And yet you still had a world-class heart surgeon by your side.
You may be a fine surgeon, God knows l know that, but not today.
Today you were a pain in the ass.
A naysaying, bullying, consistently negative pain in the ass.
At no point did you encourage me or do anything to make me think this surgery could be anything but a failure.
And it wasn't just me.
You made it as hard as humanly possible for all of us.
So, yeah, we did do a nice job today.
We did a great job today.
But that wasn't thanks to you, that was thanks to me and the chief.
And Meredith Grey.
And Anatomy Jane.
Babe is indestructible.
She lost a part of her liver and small bowel but she's doing fine.
[Cristina.]
We had to cross-clamp Wilbur's aorta and massage his heart.
l couldn't locate the source of his bleeding until l found a hole in his diaphragm, realized he had a splenic laceration.
He's a fighter, he's pulling through.
Reggie had some oozing after his colon resection, but we packed it and he's been stable ever since.
Paddy almost bled out because his carotid was sliced right through.
We put in a graft.
He's been stable ever since.
- He's good as new.
- That's good.
That's great work, all of you.
So put them out and make sure you write up all your work.
- What do you mean ''put them out?'' - Terminate them.
Kill 'em.
l'm not killing those pigs.
l spent the day trying to keep them alive.
- Want them dead, do it yourself.
- You resected half of a liver today.
You repaired a diaphragm, did a splenectomy, grafted a severed artery and repaired a lacerated bladder, performed a lobectomy.
And l understand you even removed a tumor.
On Paddy, his thyroid.
You have any idea how much you just learned? They'd be in pain.
Those are massive injuries, months of recovery.
To keep them alive after all that, it's not humane.
Seriously, you don't remember my name? l remember your name, but that was before.
[sighing.]
This last tour, l was on a forward surgical team.
We treated combat casualties in the field.
You're mostly looking to do damage control: Sedate 'em, ventilate 'em, airlift 'em to Baghdad, get out of there.
Only this one time we didn't get out fast enough 'cause we ended up in the middle of an RPG ambush.
There were 20 people in my unit, including me, and 1 9 died.
And then l got discharged.
So l'm not there anymore, in the before.
l knew your name in the before.
Now l'm living in the after.
- Erica.
- You want to apologize to someone, apologize to Bailey.
Thanks to you, l made her life a living hell.
l slept with Mark Sloan.
lf that's your idea of an apology, you seriously Shut up! You were crying and seeing leaves.
And l wasn't.
OK? l may never see leaves.
Or maybe l will see leaves, but l'll also see flowers.
l might be a whole forest girl, l don't know, but l do know that l want to be with you and to do that l have to at least tell you the truth, and the truth is l slept with Mark Sloan today.
OK.
Twice, actually.
OK.
[exhales.]
[door opens.]
- You paged? - Yeah.
How's Tori? She's good, stable.
You weren't imagining things.
You used to run around here with that doll all the time.
Took her everywhere.
The cafeteria, the old art gallery.
Tori's got a whole army.
You didn't have anyone.
Seeing Anatomy Jane reminded me of how much l was to blame for that.
You're a living reminder of every failure in my life.
That's not your fault.
And if l thought ''l'm sorry'' would hold any meaning for you at all, l'd say it.
l'd say it a thousand times a day.
[Meredith.]
Some wars are never over.
[# El Perro Del Mar: From The Valley To The Stars.]
Some end in an uneasy truce.
l can't do it.
l know l'm supposed to, but They'll suffer.
Don't let them suffer.
[sighing.]
- So no more on-call room, huh? - Afraid not.
That's too bad.
Guess l'll, uh, see you around.
[Callie.]
Hey.
Wanna get a drink? Really? Just 'cause we're not sleeping together doesn't mean we can't hang out, be friends.
You're good for more than sex, Mark.
l would love to get a drink.
- She's not gonna cry every time, right? - No.
That passes.
[indistinct chatter.]
[Meredith.]
Some wars result in complete and total victory.
Sit.
Mac and cheese, from the box, not the freezer.
[Meredith.]
Some wars end with a peace offering.
l named the pigs today.
l'm sorry, but l don't know what that means.
l take things personally.
l get too emotional.
There's no place for it at work, not with the pigs and not with you.
l'm sorry.
This is so much better than the freezer kind.
- [knocking at door.]
- [door opens.]
Thought you were sleeping with Michelle tonight, or was it Jackie? - lz.
- l've had a hard day, Alex.
And a sad night.
Please just leave me alone.
- lzzie.
- What? l'm not good at this, all right? l'm not good at relationships or talking about stupid feelings and you are, so maybe you could teach me or something, you know? Tell me what l did wrong.
You don't want us to see other people.
You don't want us to see other people and that's how you tried to tell me by asking if it was cool if you screwed Michelle.
- Laughing's not helping.
- l'm sorry.
l'm sorry.
- So you want lessons, huh? - l want lessons.
OK.
You start with, ''lsobel Stevens, - you are staggeringly good in bed.
- [chuckling.]
You're amazingly smart, wonderfully funny, - and you care about animals.
'' - That's where l start? Yeah.
And then you say, - ''You want to go steady with me?'' - That's what l'd say if it was 1 952.
[# Raining Jane: Prelude.]
- [sighing.]
Alex.
- Yeah? You want to go steady with me? lf that's what you want.
l mean, yeah, whatever.
- [chuckling.]
- [Meredith.]
And some wars end in hope.
Oh, look! l wore this every day to elementary school.
- Nice.
Your mom make that for you? - [laughing.]
Yeah, right.
She probably got it at the lost and found at the hospital.
- Mer, you should do this one.
- ls it more ugly hats? - Another diary? - More than one.
[Meredith.]
But all these wars are nothing Oh, my God.
compared to the most frightening war of all.
The one you have yet to fight.