Grey's Anatomy s07e08 Episode Script
Something's Gotta Give
[Pop music playing.]
[Meredith.]
The human body is a highly pressurized system.
[Car horns honking.]
[Meredith.]
The blood pressure measures the force of blood pulsating through the arteries.
Great! What the hell am I gonna do now?! [Meredith.]
It's important to keep this pressure regulated.
Damn it! Damn it! When a heart wasn't available, I opted to continue with Roy Henley's lung transplant [Meredith.]
Low or inadequate pressure can cause weakness or failure.
- It's all in your head.
- My name isn't on the OR board.
I checked the schedule, nobody wants to work with me - because I'm not on anybody's service.
- It's an oversight.
- Just ask around.
- Do you know how many things - I've screwed up in the last month? - Stop it.
I'm serious.
Just ask around, and get on someone's service and get back to work.
You smell like you're sweating booze.
Where have you been? - I want the weekend you had.
- What happens in Vegas, you know? Hey, who's Stark? I'm supposed to be on Stark's service today.
Oh, me, too! He's the new Peds attending, since Robbins left.
Crap.
I can't handle a bunch of sick kids today.
I can't do it.
- So was it a bachelor party? - Sh.
They're talking about Cristina.
Oh.
It became clear to Dr.
Yang that they were gonna need to switch modalities.
- The patient was put on - [Meredith.]
It's when the pressure gets too high that problems really occur.
And why did Dr.
Yang opt to use the intra-aortic balloon pump over an RVAD? I, um I can't answer for Dr.
Yang.
- And why isn't she here? - She, um She quit.
She left the program.
I'm sorry, what? She what? Dr.
Yang cleared the balloon pump with Dr.
McQueen, - who agreed that it was the best - [cell phone rings.]
Go back.
Go back.
- Yang quit the program? - Where have you been? It's the first I've heard of it.
Hunt, what the hell happened? - She told the chief she quit.
- Richard.
- If we could finish the presentation - [Derek.]
I have a question.
Can you tell us about your decision to put Dr.
Yang in charge of this patient? - Sorry? - But she didn't "quit" quit, right? Grey? You're joined at the hip, what'd she say? She hasn't spoken to me about it.
[Meredith.]
If the pressure continues to increase, a closer examination is called for.
Stop looking at me.
Look up there.
Does Torres know anything about this? - I'm calling Torres.
- [Teddy.]
Can we please just I guess I'm asking you, why did you choose to put Dr.
Yang - under so much pressure that day? - [Teddy.]
I didn't.
I intended the opposite.
I gave her a simple pre-op checklist on a stable patient.
Stable patient? - The patient almost died twice.
- I couldn't have seen that coming.
I'm sorry, is this a, uh, a patient presentation, or a post-mortem on Dr.
Yang? Well, you saved the patient.
[Meredith.]
Because it's the best indicator that something is going terribly wrong.
[Blowing nose.]
[Sighs.]
[Exhales deeply.]
- [Sighs.]
- [Phone rings.]
Hey, Mark.
No, no, I was, um, I was actually on my way out.
What's up? She what? I don't know what Shepherd's problem is.
What the hell was that? How is she doing? Is she? We're I don't know.
She's We're good.
We're fine.
It's like nothing's changed.
Yet she refuses to talk about work.
I bring up work, and she goes blank.
Altman, Hunt, emergent patient, ten minutes out.
- Can you meet me in the VIP wing? - VIP wing? Who is it? You'll find out when we get there.
Listen, Hunt, I'm required to send a letter to the American Board of Surgery declaring that Dr.
Yang has officially left the residency program.
I have to let them know.
I'm asking you, is there any reason I need to hold off on sending that letter? - Yes! - Yes! Please, don't mail it.
Just give us a little more time.
OK.
Let's go.
- Grey, who are you with today? - Shepherd.
Damn it! I've already blown it with Shepherd, I can't ask him.
Uh Bailey, I haven't blown it with her yet.
- Thinks no one wants to work with him.
- Are they saying that, - or are you saying that? - Who are you with again? - Karev.
Uh, I mean Stark.
- No, you meant Karev.
- And you don't want to go there.
- You don't know where I'm going.
- He's right, don't want to go there.
- I'm not going anywhere! He's not the guy for you.
OK? Trust me.
And don't be paranoid.
Trust me on that, too.
Oh, but it's OK for you to go there? I'm a guy, I live there.
- I gotta find Bailey.
- [April sighs.]
Hello? Cristina? Oh, hey.
Hello? Hello! - Hello! - Ah! - Uh, what are you doing here? - I'm not back until next week.
So it's true? You guys broke up? She's in Africa? OK.
Sloan told me that you quit.
- [Turns music back up.]
- Hey! What are you doing? - This! Go away! - OK, this is disturbing.
- Hey, stop! - [Turns off music.]
Look, I was unpacking, but then I didn't enjoy it.
- What are you doing? - What do you mean? You don't have a job to go to.
You don't have a girlfriend telling you you have to go to Africa.
You're completely free, do whatever you want.
The world is your oyster.
Make lemonade! I'm trying.
I was gonna get my hair cut today.
Like, make a radical change.
But then I thought, hm maybe you shouldn't do radical things right after a blond woman has ripped your heart out of your chest and stomped on it.
What are you? [gasps.]
Oh, my God! What are you doing?! - [Cackling.]
- Are you insane?! Let's make lemonade.
- [Laughing.]
- Oh, my God.
[Beeping.]
Uh Ninety-seven-point-six.
Stick out your tongue.
- Ow! Cut it out.
- We'll have fun today.
Stark's got a four-month-old biliary atresia patient who just found a donor.
[Sighs.]
A liver transplant on an infant? Enough with the damn ping-pong balls! - Jerk-face! - Whoa! Inside voices here, please.
So you must be Dr.
Karev.
You missed my rounds today.
Ugh! Sorry I I had car trouble.
Well, there's a classic.
So, what, you're here just to yell at my patients? I'm sorry.
Look, Dr.
Stark, I am feeling very sick today.
So I think since you have Kepner - [beeping.]
- Well, let's see here.
[Stark.]
No fever.
You don't seem to be vomiting.
- You retaining control of your bowels? - Ew.
- Yes.
- Well, since hangovers are not contagious, I'd say you're working.
And you can start by prepping my atresia kid.
She's only a few months old, so try not to be a jerk-face.
Give me that! Dr.
Webber? Ronald Dace, State Department.
We spoke on the phone.
- These your surgeons? - Uh, yes, this is Doctor Right now, we need to limit access to this area to only essential personnel.
- Why is that necessary? - [Dace.]
No one can know this man is being hospitalized.
No one can know he's in the country.
[Men speaking foreign language.]
[Owen.]
Everyone, stop! Give me the paddles.
I need a reading.
- Stay back.
- He's in v-fib, charge to 200! And from a global perspective, it would be great if he didn't die.
- [Paddles charging.]
- Clear.
- [Rapid beeping.]
- Clear! They faxed more of his records.
- These are all in Arabic.
- Clear! - There was a car accident? - The emir's car was hit by a truck - as he was leaving the meeting.
- What's he doing in Seattle? He's not.
Let it suffice to say, if he dies, we've got a serious international incident.
Not to mention, his people are supposed to see their first elections, right? - I'm not at liberty to - [Teddy.]
Unless he dies, in which case the door is open for Al-Qaeda to move in and then your secret meeting was for nothing.
You don't just skip to the crossword, do you? - I worked in that neck of the woods.
- I know, Dr.
Altman.
Three years in Baghdad.
Two years in Landstuhl.
- Wow, you guys are fast.
- [Dace.]
We are.
Our best outcome here is we get him stable enough to be put on a plane home.
Our best outcome is we save him.
[Man.]
He takes two medications, one for high blood pressure, one for his cholesterol.
Uh, he was hospitalized late last year for exhaustion.
- Did he receive any treatment then? - No, just rest.
Working too hard.
He works very hard.
He has a wife, four children.
Five, if you count me.
He's more than my boss, he's been, um He's given me everything.
So, please We'll do everything we can.
[Rapid beeping.]
- He's in v-fib! Alright, charge to 300! - Clear! - We'll bring your baby up soon.
- Lisa.
Her name is Lisa.
The donor was an adult, so the liver will actually be split - between your baby - Lisa.
Sorry, we read that if the doctor knows your baby's name, it helps you to kind of bond with her.
We read that's important.
Will Dr.
Stark be splitting the liver in situ? We that know ex vivo takes less time, but we also read that in situ gives better results? We're not trying to tell you how to do your job.
No, of course not.
Please don't apologize.
We'll find out for you.
One second.
- Blow up as many of those as you can.
- Dr.
Stark.
- You got it.
You got it.
- Dr.
Stark? Can you come talk to the Collises, please? They've got a lot of questions.
Yeah, I gotta check on that kid's harvest team.
- Did you ever hang glide? - What? I No.
It's apparently a very good way to become a liver donor.
Sir, are you splitting the liver in the body, or ex vivo? Parents want to know.
OK.
Those folks have been spending a little too much time consulting Dr.
Internet.
Listen, just hold their hands.
Let them feel smart.
Tell them I'm busy getting their baby a liver.
Her name's Lisa.
I said I don't need any help.
I've got an easy day.
Two laparoscopic surgeries.
I can't use you.
- Maybe I could - I'm sorry, ma'am, I can't admit you.
You don't need to admit me.
I'll just walk in there myself.
I do it all the time.
Uh, Chief Webber paged me in there.
- I'm sorry, ma'am.
- Well, who's in there? Is it the president? Or the vice president? - Is it Bono? - Bono? - Ma'am, I'm sorry - Bailey.
Can you take my patients today? I got a situation in here.
- Oh, of course, sir.
- Louise Cortez is a readmit after surgery for chronic pancreatitis.
CT showed a pancreatic fistula.
- And she spiked a fever this morning.
- Right.
Sir - You put in a drain? - Yes.
Just keep a close eye.
Sir! Is it Bono? Come on, Avery, I can use you.
OK, but I don't understand, I'm on your service.
I don't need you.
The craniotomy's been cancelled.
I don't have anything for the rest of the day.
- So, what am I supposed to do now? - Go study.
- Study what? - I don't care, Lexie.
Go somewhere else.
Oh, my God.
- How do we have time for this? - We have to make time for this.
- Should I call her? - Call who? - Cristina! - Why? Because she quit and I feel like I should do something.
That's not your fault.
You didn't do anything wrong, no matter what she says.
OK? - You just need to make time for this.
- But - [knocking.]
- Oh, my God.
Lexie.
- What?! - I'm looking for Dr.
Meredith Grey.
What did you do? [Scissors snipping.]
How's it going? - Can I see? - Fantastic, shut up.
OK You know what you need? To get this place done? You need to throw a housewarming party.
- Put a little pressure on yourself.
- We should throw a housewarming party! Oh, my God! - Oh, my God.
No! - Tonight! I'll text everyone! - No! - Yes! I have several credit cards - and nothing to do.
- OK, this is not what I wanted.
I look [stammers.]
I look injured.
Do you even cut hair? - I need furniture! - Look at my hair! Yeah.
I sort of can't believe you let me do that.
- Cristina! - It's OK, we'll go to the mall! You might want a hat.
- [Beeping.]
- Clear! We need to get him to a cath lab.
If he'd stop coding long enough.
I'm inserting a pacemaker.
- You paged? - Yeah, Grey, grab me a pacemaker kit.
- [Cell phone rings.]
- Hey, Hunt, you're throwing a housewarming party tonight? - Tonight? I am? - Well, your wife is.
- That's a good sign, right? - It's a weird sign.
But maybe it's an opportunity.
I mean, maybe I could talk to her.
Better yet, maybe you could, Grey.
We all could.
I mean, it's gonna be hard for her to walk out of a room at her own party.
- How bad is it? - I'll tell you when I know.
Maybe a little less party planning Hey, I don't tell you how to polish your sunglasses.
- Look, between you and me, he's a good man, and it'd be a shame if something like this screwed up - what he was trying to do.
- Wow.
Every time I talk to you, I feel a little more relaxed.
The last thing Cristina wants is to talk to me.
I have to just give her some space.
We don't have time to give her space.
She gonna be locked out of this program.
And I do not believe that, that is what she wants.
I mean, do you think that's what she wants? I'm asking you, Grey.
I still don't understand what I'm doing back here.
Dr.
Webber said something about a fist? A fistula.
It's a complication from your surgery that's leaking pancreatic fluid.
The drain takes the fluid out of your body so it won't go where it's not supposed to.
OK The pancreatic fluid is made to digest your food.
If it leaks in your body, it starts to digest your other organs.
- That wouldn't be good.
- Exactly.
But not to worry, yours is looking just fine.
I just want to keep a close eye on you, OK? Seems like I just was home, and here I am again.
- You know, I say that every morning.
- Dr.
Bailey, the OR's ready.
OK.
Um, Ms.
Cortez, your temperature's still a little high, so you just rest and we'll get you home in no time.
OK.
- OK, you're not scrubbing in.
- I'm not? No.
Watch Mrs.
Cortez.
If the fluid in her drain changes color, you page me.
If her fever goes up one digit, you page me.
- 'Cause the fever could mean - An abscess, early sepsis, pneumonia, any number of nasty things.
Remember your first rule of residency: "Eat when you can, sleep when you can" [both.]
"Don't screw with the pancreas.
" So much for my easy day.
[Stark.]
Nice anastomoses.
No leaks.
- How are we doing? Are we good? - [Alex.]
It's not It's not quite fitting, is it? There's not enough room in the peritoneal cavity - for the graft.
- [April.]
The liver's too big? Or the baby's too small.
[laughs.]
- [Beeping.]
- BP's 64 over 40.
[Stark.]
It's compressing the hepatic vessels.
Sponge.
No, no, no.
Larger, larger, larger.
There we go.
Let's get this sponge up under there, take the pressure off the vessels.
And Yeah, that's doing the trick there.
All right.
I think we're done.
- But the liver's not gonna fit.
- We're not gonna close her up today.
Just wrap her.
This happens with adult split livers.
You just gotta sit tight and hope that the swelling goes down enough - so you can close her up.
- Well, how long will that take? As long as it takes, Karev.
Thank you all, great work.
[Sighs.]
This graft is big.
The swelling is going to take a lot to go down.
How long can it stay like that with that sponge in her? - I don't know.
- [April.]
Isn't it gonna start to deteriorate? She could get infected.
And what if the swelling doesn't go down enough? The liver will die and she'll be back on the donor's list.
- Geez, how is this a solution? - [Sighs.]
It's not.
[Light rock plays.]
Um, how can you not talk to Meredith about this? She's your best friend.
- Ooh, I love that lamp.
- You can't just cut yourself off from a person, pretend your whole relationship never happened.
I mean, you can, but it makes you a heartless, soulless monster - who I thought I knew, but didn't.
- With wheels on her shoes.
Oh, God, how was I OK with that? I used to be a lot cooler than that.
- I was a lot cooler when I was single.
- You were hardly ever single.
[Laughs.]
I know.
I know.
[Sighs.]
I'm actually excited to spend time on my own.
OK, I thought we were going to a hair salon.
- Next.
We're doing me now.
- Can I help you find something? Yes.
I will take that.
- That sofa? - That room.
All of it.
I'll take it.
You do same day delivery, right? - Great.
- So it went very well.
Baby looks good, liver looks good.
- And we can all exhale a little bit.
- When can we see her? Soon.
We'd like to keep an eye on her.
There's a little bit of swelling, and I wanna see that go down, - but, uh, we'll let you know.
- Thank you.
Thank you so much, Dr.
Stark.
Thank you.
Yeah.
My pleasure entirely.
You aren't gonna tell them any more than that? What would you want me to tell them, Karev? That there's a chance of infection, that if the liver doesn't conform, they could be back on the donor's list? I mean, they're smart people, they want to know what could go wrong.
Make them more worried than they are? I think you're not worried enough! - Tell me a better solution.
- I, uh Can you give me a better solution? - No.
- Well, then keep your mouth shut, and go do something you can do.
You can start with my post-ops.
You tried.
Ow! OK, since when is it OK to shoot people in this hospital? - Now Bailey's given up on me, too.
- You're on her service! - Why are you still freaking out? - No, Bailey's in surgery.
She trusts me to watch a post-op drip fluid in a bag every ten minutes.
- Ow! - Inappropriate! You should relax.
You get an easy day, you take it.
Shepherd didn't need me, so I took a nap in the research library.
Give me Give it to me.
- Jerk-face.
- He's having a rough day.
- New Robbins is no Robbins.
- Check this out.
- Armed escort to get a yogurt.
- OK, who is it? Is it Bono? It's totally Bono.
It's all over the hospital.
- It's not Bono.
- Are you going to Cristina's tonight? I don't know.
OK! - Not OK.
- It's addicting.
Put it away before my guy wrestles you to the ground.
- Give me that.
- No.
- Give me the ball.
- No.
Get - What's his problem? - He's having a rough day.
[Man clears throat.]
Jeez, I'm coming.
The Emir's cath confirmed that he has a tear in one of his coronary arteries.
We've stabilized him with a balloon pump, but I am gonna have to perform open heart surgery to repair the tear.
- [Men speaking foreign language.]
- Doctor, doctor, please.
- Was the tear in his? - Quiet, please.
Was the tear in his artery an injury - sustained in the car accident? - [Owen.]
There is no way - Doctor, don't answer that.
- There's no way of knowing - if that was the cause.
- [Man speaking foreign language.]
Can we have assurances that your finest surgeons - will be operating on His Highness? - [Richard.]
Yes.
These are the chiefs of my cardio-thoracic and trauma departments.
[Man speaking foreign language.]
Sorry.
He was asking your State Department.
He didn't mean the finest surgeons in this hospital.
Which is why you might be more comfortable travelling - to your own country, where he can - [all chattering.]
All right, quiet! Quiet, please! Quiet, please.
Thank you.
I understand that there are a lot of concerns and agendas here, but we all have the same goal, and that is to see this man live.
Now, we are out of time, which means we are out of options.
I am your only shot, and you have to take me.
I can only say that if you knew me better, you'd feel pretty good about your chances.
[Sighs.]
Dr.
Hunt and I are going to operate.
And we will update you as soon as we can.
[All chattering.]
Good luck.
You have to tell them to stop.
- Tell them they can't operate.
- Why? What's the problem? [Whispering.]
Come with me.
He didn't want anyone to know.
He made me swear.
- Just tell him what you told us.
- Four months ago, the Emir was diagnosed with an unruptured cerebral aneurysm - in his left temporal lobe.
- [Derek.]
He's in CT now? His first neuro came up clean, but now he's got a blown pupil.
- So we think it's burst.
- Scans should be up by now.
I swore to him, I wouldn't say anything until after the election.
I'm still not sure I should have told you.
I might be costing him everything.
- You're trying to save his life.
- He's trying to save seven million.
To make it so seven million people can walk the street without the fear of being murdered by the extremists.
He doesn't, um He risks his life every time he steps out his door.
You're trying to protect him too, and I'm sure he'll understand that.
- He was headed to surgery? - Yeah, we're going on - dissected coronary artery.
- [Derek.]
Yeah, that aneurysm's blown.
- Damn it.
That's a huge bleed.
- Well, not surprising.
He was shocked seven times and given a blood thinner, which is unfortunate.
He presented like an MI.
I treated him appropriately.
- I couldn't have seen this coming.
- You've been saying that a lot today.
You know what, Shepherd? I don't need crap from you.
Apparently, I hold the whole fate of the Middle East in my hands.
Apparently, now I do, too.
Book an OR.
We'll gonna have to work simultaneously.
Can't wait.
Cristina's having a party? Cristina Yang? Yeah, I know, but I'm gonna go.
We're all gonna go and talk to her.
You should come, too.
You quit once.
You walked away and came back.
So maybe you have something to say that could help.
- No.
- No? Do you remember when you came out to talk to me about coming back? Do you remember when I hit your engagement ring with a baseball bat? - Oh, that was a great day.
- She's already lashing out.
Don't go and try and confront her.
No intervention of Cristina Yang.
Do you hear me? It's a bad idea.
What are you sterilizing? You're kidding me.
- What was so important? - Uh Sir, I was out of line earlier.
But I think I found a solution for Lisa Collis's liver.
- What is that, a ping-pong ball? - It's the perfect shape to keep the liver from compressing her blood vessels.
It's made of celluloid, not plastic, so it won't break down, like a sponge will.
It's gas-sterilized, so there's little risk of infection.
You could leave it in there forever.
Her liver will just grow around it.
I think it's - You think it won't work? - No I was thinking I left you to do my post-ops, and here I find you playing with balls.
I don't know, Karev.
Am I gonna have to talk to your chief about you? Yeah.
Right.
I want it sort of like bad-ass, you know? A little dangerous, unpredictable.
- Did you bring a picture? - Mm It's more of a feeling.
What do they do all day, the mall people? Look at them.
They move so slowly.
They all mosey.
- Look! - Yeah, I can't turn my head.
Do they just eat things and buy things and complain about their breakups? - Yes.
- Fantastic.
Look at that lady.
She's just gonna eat that pretzel.
That's all she's gonna do.
So, what are you gonna do? You're just gonna become a mall person? - Shop and eat? - This yogurt's pretty good.
I'm serious.
I'm getting a pretzel.
[Sighs.]
- Avery, how's our patient? - No change.
That's what I like to hear.
I'm going into my colon.
So you still don't want me to scrub in? - No, I need you to watch - Ms.
Cortez.
Right.
Like I said, no change.
Avery, I need you where I need you.
I don't have time.
No, ma'am, that's fine.
I get it.
[Owen.]
I'm saying with this letter, there's a timeframe now.
You're content to stand back and watch Cristina - lose her spot in this program? - I'm saying an intervention is not a good plan.
Suction.
It's not an intervention, Shepherd.
We just thought, - since we were all together - [Owen.]
Torsades! Damn it.
He's in v-fib.
Shepherd, I need you to stop.
- We have to shock him.
- [Derek.]
No, wait, - I'm right in the middle of - [Owen.]
Internal paddles.
- [Teddy.]
Charge to ten.
- [Derek.]
Hold on, hold on! [Beeping.]
Shepherd! - [Derek.]
OK.
Clear! - [Paddles charging.]
[Owen.]
Sinus tach.
Hey.
Did Stark ever respond to my page? He's got three discharges, one of them's been here since yesterday.
Dr.
Stark's in surgery.
He went back in on Lisa Collis.
What? [Richard.]
It's a great idea.
So simple.
[Stark.]
Let's see if it works.
It is the right shape.
It's celluloid so it won't break down.
[Richard.]
And the liver will conform to it.
- It's a great idea.
- Whose idea was it, Dr.
Stark? Originally? Was it yours or Dr.
Karev's? Let's just see if it works.
And I'm back, Ms.
Cortez.
Did you miss me? Could you please let the dog out? He won't stop barking.
She's delirious.
Pulse is thready! I think she's in shock! Get her vitals.
Oh, no, no! Damn it! Get me a monitor in here! Call Dr.
Bailey now! - [Nurse.]
Right away, doctor.
- Come on.
I'm almost done here.
Get her into an OR, open her up and wait for me.
- I'll be there.
- Open? Did you say open her up? No word from Dr.
Bailey? OK.
Ten blade.
[Teddy.]
The artery is at the base of the heart.
Bypass would be so much better.
[Derek.]
I cannot manage this bleed on bypass.
OK, good.
I can clip the aneurysm.
I need you to stop what you're doing.
I am trying to do a coronary graft on a hemorrhaging heart.
- What do you suggest I do? - Do it faster.
All right, I need you to stop making this my fault.
Pack that.
I tried everything I could for Yang.
I encouraged her into the OR, I kept her out of the OR.
I don't know what else I could have done differently.
Hold pressure.
More! OK, good.
Go.
Yang was my student.
Don't you think that I wanted to help her? I have no doubt that's what you wanted to do.
- But you're saying that I failed.
- I'm saying that we all failed.
- So now it's time to back off.
- No, Shepherd, you need to back off.
She's my wife.
I'm not gonna give up on her yet.
All right! It's clear we all have the same goal.
We want her back.
[Derek.]
Done.
I got it.
I'm sorry.
I have a personal stake in this, too.
I would not be standing here if it wasn't for her.
Right.
But you're asking us to do nothing, and we can't do that.
- I can't do that.
- OK.
Let's start closing.
[Flat line tone.]
Damn it! Time of death, 7:41.
- [Exhales.]
Son of a bitch! - This is not my fault! She got a fistula, they got delayed hemorrhage! Post-op pancreatectomies always get fistulas! I didn't screw this up! - Avery - No, you listen! They always get fistulas, then they get severe complications, and they die! I did what you said! You told me to open her up, and then you weren't here.
- I tried to fix it.
- Avery.
- This is not my damn fault! - Dr.
Avery! Step out of my OR.
We are awesome.
I can't believe we did all this.
Uh, I did all this.
You opened one bottle of wine.
- Could you find where the napkins are? - Hello? - Damn it.
Uh, not ready! - Hi.
Hey, if you're here for the party, you're like way too early.
I'm not here for the party.
- Are you here to tell me to come back? - No.
But a bunch of other people are coming to do that.
Oh, God.
Are you OK? [sighs.]
I'm sorry.
I tried to find you.
He is awful! He tried to take all the credit.
- Is the kid OK? Is it gonna work? - Yeah! Of course it's gonna work.
It's brilliant.
I'm gonna talk to the chief.
Because it is so unfair.
You did every single thing right today.
You covered that attending's ass and you got You got crapped on every step of the way.
The chief should know that.
No, no.
You're so What you did today was so great.
You know, you don't deserve this.
I just I wanted you to know that somebody knows that.
That I know that.
You know, I'm, uh I've never, um - This is my first time.
- I know.
You want to stop? No.
No, I don't wanna stop.
I just - Can we just go, uh slower? - What? Can Can we please just go a little slower? It's just I need You need what? What do you need? What do you need from me? You wanna screw? Let's screw.
You don't? Then get out! I'm not gonna hold your virgin hand and walk you through it, damn it! You're not a child! I can't take care of you! I can't take care of everybody in this friggin' place! - Hi.
- Hey.
Uh, I usually do a post-op exam right now.
Yeah, well, he's on a C-130 halfway across the country by this time.
So I don't get to check on his recovery? He's being well taken care of.
- You did a good job.
- Oh I can tell you that.
What are you doing hanging around? Well, I wanted to say thank you.
And that it, uh It was nice meeting you.
I'd say the same, but you were never here.
[Indistinct chatter.]
[Mark.]
Welcome.
Wine's on the table, beer's in the fridge.
- I have a fridge? - And since you actually live here, I'll hand over the hosting duties to you.
- Where's Cristina? - Haven't seen her.
Which is sort of rude.
Torres might know, hang on.
- Callie, Yang say where she was? - Oh, um Can I move in with you? - That might be the rebound talking.
- [Laughs.]
Not like that, not that.
Just till I can get rid of the sub-letter in my place.
I'm starting from scratch.
And I don't want to do it alone.
Can't we be alone together? Isn't it easier to be single in pairs? This a riddle? No, I'm drunk.
- Come on.
Can I? - Sure.
Yay! - Your hair is hot.
- Right? [Laughs.]
Oh, hi.
Um [stammers.]
I Sorry, I didn't I know I should bring a gift.
Like a housewarming gift to things like this, [sobbing.]
but I didn't really have time to bring anything.
- So I'm really sorry.
- It is really It's no problem.
What happened? April? Hey, hey.
Come on.
Has anybody seen Cristina? If you're asking my opinion, I think you should.
I think you absolutely have to.
You should keep and refinish the original floors.
Why do I have to? I mean, you guys did what, like, bamboo or something? We're building our house from scratch, we can put down whatever we want.
- You have original oak floors.
- Yeah, but, what if I don't like it? - I mean what if I hate oak? - Doesn't matter.
You have to do it.
The building's historic.
I know.
God! OK.
OK.
OK! [Meredith.]
Every pressurized system needs a relief valve.
There has to be a way to reduce the stress, the tension I got there as fast as I could.
It was a grade-C fistula with a ruptured splenic artery.
You did everything you could.
Avery, too.
- Why don't you go home.
- Yes, sir.
- Bailey look - Why do we see so many post-op fistulas after pancreas surgeries? Your operation is flawless.
It doesn't matter, we still see fistulas in What, 20 percent of patients? I think there's a way to bring that number down.
I just got to find it.
- Miranda - I needed a win, sir.
I've got a string of big losses.
I could use a win, that's all.
Yang.
Yang was the one I didn't have to worry about.
I know.
I know.
[Meredith.]
before it becomes too much to bear.
Look into the pancreatectomy patients.
Figure it out.
- And then let me know how I can help.
- Uh, can I use Avery? He actually gave me the idea.
He was great today.
Well, that's good to know.
You know, Alex Karev saved a baby's life with a ping-pong ball? - Ping-pong ball? - Yes, he did.
Alex Karev.
[Meredith.]
There has to be a way to find relief.
Because if the pressure doesn't find a way out it will make one.
Listen.
Let me talk to her.
- [Crowd gasping.]
- All right.
[grunts.]
Come here, come on, here.
Come on! [Meredith.]
It will explode.
OK, OK.
Let's go.
Outside.
[Meredith.]
It's the pressure we put on ourselves that's the hardest to bear.
You think it was hard for Yang? To quit, to just walk away? Oh, don't be stupid.
You're not quitting.
Besides, you might have just gotten yourself fired.
- Or arrested.
Probably both.
- Yeah, well, April is the only friend I have left here.
So Don't be stupid.
[Meredith.]
The pressure to be better than we are.
[Meredith.]
What the hell were you thinking? She's a virgin.
- Why would you do that? - I know.
God.
Ow! Ow! If you needed it that bad, Alex, you should have gone back to Vegas.
- There's a whole industry there.
- I didn't go to Vegas.
- I went to lowa.
- You went to lowa? I went home.
- My brother, remember Aaron? - Yeah.
Doctor said He got diagnosed schizophrenic.
Just like my mom.
You know how they figured it out? He tried to kill our little sister.
She's 16.
She's a kid.
And her brother tried to kill her.
And my mom didn't do anything 'cause she's off her meds and Anyway, I was in lowa.
That's where I went.
To my brother's commitment hearing.
I had to commit him.
Whatever.
[Meredith.]
The pressure to be better than we think we can be.
- Well, it's good that you were there.
- I wasn't there.
I wasn't.
I showed up, I held my sister's hand in the hospital for like ten minutes, I shoved some pills down my mom's throat, I signed my brother into a nuthouse.
Then I got the hell out of there as fast as I could.
I wasn't there.
I'm the ass who can't stand to be there.
[Meredith.]
It never, ever lets up.
[Cristina.]
I should go down there.
I have to go down there.
Yeah, I should go.
You good? Anything else you want to talk about? - What are you doing for bathroom tile? - Oh.
Bathroom tile.
Um I don't know yet.
I think I'm going to [Meredith.]
It just builds and builds and builds.
[Meredith.]
The human body is a highly pressurized system.
[Car horns honking.]
[Meredith.]
The blood pressure measures the force of blood pulsating through the arteries.
Great! What the hell am I gonna do now?! [Meredith.]
It's important to keep this pressure regulated.
Damn it! Damn it! When a heart wasn't available, I opted to continue with Roy Henley's lung transplant [Meredith.]
Low or inadequate pressure can cause weakness or failure.
- It's all in your head.
- My name isn't on the OR board.
I checked the schedule, nobody wants to work with me - because I'm not on anybody's service.
- It's an oversight.
- Just ask around.
- Do you know how many things - I've screwed up in the last month? - Stop it.
I'm serious.
Just ask around, and get on someone's service and get back to work.
You smell like you're sweating booze.
Where have you been? - I want the weekend you had.
- What happens in Vegas, you know? Hey, who's Stark? I'm supposed to be on Stark's service today.
Oh, me, too! He's the new Peds attending, since Robbins left.
Crap.
I can't handle a bunch of sick kids today.
I can't do it.
- So was it a bachelor party? - Sh.
They're talking about Cristina.
Oh.
It became clear to Dr.
Yang that they were gonna need to switch modalities.
- The patient was put on - [Meredith.]
It's when the pressure gets too high that problems really occur.
And why did Dr.
Yang opt to use the intra-aortic balloon pump over an RVAD? I, um I can't answer for Dr.
Yang.
- And why isn't she here? - She, um She quit.
She left the program.
I'm sorry, what? She what? Dr.
Yang cleared the balloon pump with Dr.
McQueen, - who agreed that it was the best - [cell phone rings.]
Go back.
Go back.
- Yang quit the program? - Where have you been? It's the first I've heard of it.
Hunt, what the hell happened? - She told the chief she quit.
- Richard.
- If we could finish the presentation - [Derek.]
I have a question.
Can you tell us about your decision to put Dr.
Yang in charge of this patient? - Sorry? - But she didn't "quit" quit, right? Grey? You're joined at the hip, what'd she say? She hasn't spoken to me about it.
[Meredith.]
If the pressure continues to increase, a closer examination is called for.
Stop looking at me.
Look up there.
Does Torres know anything about this? - I'm calling Torres.
- [Teddy.]
Can we please just I guess I'm asking you, why did you choose to put Dr.
Yang - under so much pressure that day? - [Teddy.]
I didn't.
I intended the opposite.
I gave her a simple pre-op checklist on a stable patient.
Stable patient? - The patient almost died twice.
- I couldn't have seen that coming.
I'm sorry, is this a, uh, a patient presentation, or a post-mortem on Dr.
Yang? Well, you saved the patient.
[Meredith.]
Because it's the best indicator that something is going terribly wrong.
[Blowing nose.]
[Sighs.]
[Exhales deeply.]
- [Sighs.]
- [Phone rings.]
Hey, Mark.
No, no, I was, um, I was actually on my way out.
What's up? She what? I don't know what Shepherd's problem is.
What the hell was that? How is she doing? Is she? We're I don't know.
She's We're good.
We're fine.
It's like nothing's changed.
Yet she refuses to talk about work.
I bring up work, and she goes blank.
Altman, Hunt, emergent patient, ten minutes out.
- Can you meet me in the VIP wing? - VIP wing? Who is it? You'll find out when we get there.
Listen, Hunt, I'm required to send a letter to the American Board of Surgery declaring that Dr.
Yang has officially left the residency program.
I have to let them know.
I'm asking you, is there any reason I need to hold off on sending that letter? - Yes! - Yes! Please, don't mail it.
Just give us a little more time.
OK.
Let's go.
- Grey, who are you with today? - Shepherd.
Damn it! I've already blown it with Shepherd, I can't ask him.
Uh Bailey, I haven't blown it with her yet.
- Thinks no one wants to work with him.
- Are they saying that, - or are you saying that? - Who are you with again? - Karev.
Uh, I mean Stark.
- No, you meant Karev.
- And you don't want to go there.
- You don't know where I'm going.
- He's right, don't want to go there.
- I'm not going anywhere! He's not the guy for you.
OK? Trust me.
And don't be paranoid.
Trust me on that, too.
Oh, but it's OK for you to go there? I'm a guy, I live there.
- I gotta find Bailey.
- [April sighs.]
Hello? Cristina? Oh, hey.
Hello? Hello! - Hello! - Ah! - Uh, what are you doing here? - I'm not back until next week.
So it's true? You guys broke up? She's in Africa? OK.
Sloan told me that you quit.
- [Turns music back up.]
- Hey! What are you doing? - This! Go away! - OK, this is disturbing.
- Hey, stop! - [Turns off music.]
Look, I was unpacking, but then I didn't enjoy it.
- What are you doing? - What do you mean? You don't have a job to go to.
You don't have a girlfriend telling you you have to go to Africa.
You're completely free, do whatever you want.
The world is your oyster.
Make lemonade! I'm trying.
I was gonna get my hair cut today.
Like, make a radical change.
But then I thought, hm maybe you shouldn't do radical things right after a blond woman has ripped your heart out of your chest and stomped on it.
What are you? [gasps.]
Oh, my God! What are you doing?! - [Cackling.]
- Are you insane?! Let's make lemonade.
- [Laughing.]
- Oh, my God.
[Beeping.]
Uh Ninety-seven-point-six.
Stick out your tongue.
- Ow! Cut it out.
- We'll have fun today.
Stark's got a four-month-old biliary atresia patient who just found a donor.
[Sighs.]
A liver transplant on an infant? Enough with the damn ping-pong balls! - Jerk-face! - Whoa! Inside voices here, please.
So you must be Dr.
Karev.
You missed my rounds today.
Ugh! Sorry I I had car trouble.
Well, there's a classic.
So, what, you're here just to yell at my patients? I'm sorry.
Look, Dr.
Stark, I am feeling very sick today.
So I think since you have Kepner - [beeping.]
- Well, let's see here.
[Stark.]
No fever.
You don't seem to be vomiting.
- You retaining control of your bowels? - Ew.
- Yes.
- Well, since hangovers are not contagious, I'd say you're working.
And you can start by prepping my atresia kid.
She's only a few months old, so try not to be a jerk-face.
Give me that! Dr.
Webber? Ronald Dace, State Department.
We spoke on the phone.
- These your surgeons? - Uh, yes, this is Doctor Right now, we need to limit access to this area to only essential personnel.
- Why is that necessary? - [Dace.]
No one can know this man is being hospitalized.
No one can know he's in the country.
[Men speaking foreign language.]
[Owen.]
Everyone, stop! Give me the paddles.
I need a reading.
- Stay back.
- He's in v-fib, charge to 200! And from a global perspective, it would be great if he didn't die.
- [Paddles charging.]
- Clear.
- [Rapid beeping.]
- Clear! They faxed more of his records.
- These are all in Arabic.
- Clear! - There was a car accident? - The emir's car was hit by a truck - as he was leaving the meeting.
- What's he doing in Seattle? He's not.
Let it suffice to say, if he dies, we've got a serious international incident.
Not to mention, his people are supposed to see their first elections, right? - I'm not at liberty to - [Teddy.]
Unless he dies, in which case the door is open for Al-Qaeda to move in and then your secret meeting was for nothing.
You don't just skip to the crossword, do you? - I worked in that neck of the woods.
- I know, Dr.
Altman.
Three years in Baghdad.
Two years in Landstuhl.
- Wow, you guys are fast.
- [Dace.]
We are.
Our best outcome here is we get him stable enough to be put on a plane home.
Our best outcome is we save him.
[Man.]
He takes two medications, one for high blood pressure, one for his cholesterol.
Uh, he was hospitalized late last year for exhaustion.
- Did he receive any treatment then? - No, just rest.
Working too hard.
He works very hard.
He has a wife, four children.
Five, if you count me.
He's more than my boss, he's been, um He's given me everything.
So, please We'll do everything we can.
[Rapid beeping.]
- He's in v-fib! Alright, charge to 300! - Clear! - We'll bring your baby up soon.
- Lisa.
Her name is Lisa.
The donor was an adult, so the liver will actually be split - between your baby - Lisa.
Sorry, we read that if the doctor knows your baby's name, it helps you to kind of bond with her.
We read that's important.
Will Dr.
Stark be splitting the liver in situ? We that know ex vivo takes less time, but we also read that in situ gives better results? We're not trying to tell you how to do your job.
No, of course not.
Please don't apologize.
We'll find out for you.
One second.
- Blow up as many of those as you can.
- Dr.
Stark.
- You got it.
You got it.
- Dr.
Stark? Can you come talk to the Collises, please? They've got a lot of questions.
Yeah, I gotta check on that kid's harvest team.
- Did you ever hang glide? - What? I No.
It's apparently a very good way to become a liver donor.
Sir, are you splitting the liver in the body, or ex vivo? Parents want to know.
OK.
Those folks have been spending a little too much time consulting Dr.
Internet.
Listen, just hold their hands.
Let them feel smart.
Tell them I'm busy getting their baby a liver.
Her name's Lisa.
I said I don't need any help.
I've got an easy day.
Two laparoscopic surgeries.
I can't use you.
- Maybe I could - I'm sorry, ma'am, I can't admit you.
You don't need to admit me.
I'll just walk in there myself.
I do it all the time.
Uh, Chief Webber paged me in there.
- I'm sorry, ma'am.
- Well, who's in there? Is it the president? Or the vice president? - Is it Bono? - Bono? - Ma'am, I'm sorry - Bailey.
Can you take my patients today? I got a situation in here.
- Oh, of course, sir.
- Louise Cortez is a readmit after surgery for chronic pancreatitis.
CT showed a pancreatic fistula.
- And she spiked a fever this morning.
- Right.
Sir - You put in a drain? - Yes.
Just keep a close eye.
Sir! Is it Bono? Come on, Avery, I can use you.
OK, but I don't understand, I'm on your service.
I don't need you.
The craniotomy's been cancelled.
I don't have anything for the rest of the day.
- So, what am I supposed to do now? - Go study.
- Study what? - I don't care, Lexie.
Go somewhere else.
Oh, my God.
- How do we have time for this? - We have to make time for this.
- Should I call her? - Call who? - Cristina! - Why? Because she quit and I feel like I should do something.
That's not your fault.
You didn't do anything wrong, no matter what she says.
OK? - You just need to make time for this.
- But - [knocking.]
- Oh, my God.
Lexie.
- What?! - I'm looking for Dr.
Meredith Grey.
What did you do? [Scissors snipping.]
How's it going? - Can I see? - Fantastic, shut up.
OK You know what you need? To get this place done? You need to throw a housewarming party.
- Put a little pressure on yourself.
- We should throw a housewarming party! Oh, my God! - Oh, my God.
No! - Tonight! I'll text everyone! - No! - Yes! I have several credit cards - and nothing to do.
- OK, this is not what I wanted.
I look [stammers.]
I look injured.
Do you even cut hair? - I need furniture! - Look at my hair! Yeah.
I sort of can't believe you let me do that.
- Cristina! - It's OK, we'll go to the mall! You might want a hat.
- [Beeping.]
- Clear! We need to get him to a cath lab.
If he'd stop coding long enough.
I'm inserting a pacemaker.
- You paged? - Yeah, Grey, grab me a pacemaker kit.
- [Cell phone rings.]
- Hey, Hunt, you're throwing a housewarming party tonight? - Tonight? I am? - Well, your wife is.
- That's a good sign, right? - It's a weird sign.
But maybe it's an opportunity.
I mean, maybe I could talk to her.
Better yet, maybe you could, Grey.
We all could.
I mean, it's gonna be hard for her to walk out of a room at her own party.
- How bad is it? - I'll tell you when I know.
Maybe a little less party planning Hey, I don't tell you how to polish your sunglasses.
- Look, between you and me, he's a good man, and it'd be a shame if something like this screwed up - what he was trying to do.
- Wow.
Every time I talk to you, I feel a little more relaxed.
The last thing Cristina wants is to talk to me.
I have to just give her some space.
We don't have time to give her space.
She gonna be locked out of this program.
And I do not believe that, that is what she wants.
I mean, do you think that's what she wants? I'm asking you, Grey.
I still don't understand what I'm doing back here.
Dr.
Webber said something about a fist? A fistula.
It's a complication from your surgery that's leaking pancreatic fluid.
The drain takes the fluid out of your body so it won't go where it's not supposed to.
OK The pancreatic fluid is made to digest your food.
If it leaks in your body, it starts to digest your other organs.
- That wouldn't be good.
- Exactly.
But not to worry, yours is looking just fine.
I just want to keep a close eye on you, OK? Seems like I just was home, and here I am again.
- You know, I say that every morning.
- Dr.
Bailey, the OR's ready.
OK.
Um, Ms.
Cortez, your temperature's still a little high, so you just rest and we'll get you home in no time.
OK.
- OK, you're not scrubbing in.
- I'm not? No.
Watch Mrs.
Cortez.
If the fluid in her drain changes color, you page me.
If her fever goes up one digit, you page me.
- 'Cause the fever could mean - An abscess, early sepsis, pneumonia, any number of nasty things.
Remember your first rule of residency: "Eat when you can, sleep when you can" [both.]
"Don't screw with the pancreas.
" So much for my easy day.
[Stark.]
Nice anastomoses.
No leaks.
- How are we doing? Are we good? - [Alex.]
It's not It's not quite fitting, is it? There's not enough room in the peritoneal cavity - for the graft.
- [April.]
The liver's too big? Or the baby's too small.
[laughs.]
- [Beeping.]
- BP's 64 over 40.
[Stark.]
It's compressing the hepatic vessels.
Sponge.
No, no, no.
Larger, larger, larger.
There we go.
Let's get this sponge up under there, take the pressure off the vessels.
And Yeah, that's doing the trick there.
All right.
I think we're done.
- But the liver's not gonna fit.
- We're not gonna close her up today.
Just wrap her.
This happens with adult split livers.
You just gotta sit tight and hope that the swelling goes down enough - so you can close her up.
- Well, how long will that take? As long as it takes, Karev.
Thank you all, great work.
[Sighs.]
This graft is big.
The swelling is going to take a lot to go down.
How long can it stay like that with that sponge in her? - I don't know.
- [April.]
Isn't it gonna start to deteriorate? She could get infected.
And what if the swelling doesn't go down enough? The liver will die and she'll be back on the donor's list.
- Geez, how is this a solution? - [Sighs.]
It's not.
[Light rock plays.]
Um, how can you not talk to Meredith about this? She's your best friend.
- Ooh, I love that lamp.
- You can't just cut yourself off from a person, pretend your whole relationship never happened.
I mean, you can, but it makes you a heartless, soulless monster - who I thought I knew, but didn't.
- With wheels on her shoes.
Oh, God, how was I OK with that? I used to be a lot cooler than that.
- I was a lot cooler when I was single.
- You were hardly ever single.
[Laughs.]
I know.
I know.
[Sighs.]
I'm actually excited to spend time on my own.
OK, I thought we were going to a hair salon.
- Next.
We're doing me now.
- Can I help you find something? Yes.
I will take that.
- That sofa? - That room.
All of it.
I'll take it.
You do same day delivery, right? - Great.
- So it went very well.
Baby looks good, liver looks good.
- And we can all exhale a little bit.
- When can we see her? Soon.
We'd like to keep an eye on her.
There's a little bit of swelling, and I wanna see that go down, - but, uh, we'll let you know.
- Thank you.
Thank you so much, Dr.
Stark.
Thank you.
Yeah.
My pleasure entirely.
You aren't gonna tell them any more than that? What would you want me to tell them, Karev? That there's a chance of infection, that if the liver doesn't conform, they could be back on the donor's list? I mean, they're smart people, they want to know what could go wrong.
Make them more worried than they are? I think you're not worried enough! - Tell me a better solution.
- I, uh Can you give me a better solution? - No.
- Well, then keep your mouth shut, and go do something you can do.
You can start with my post-ops.
You tried.
Ow! OK, since when is it OK to shoot people in this hospital? - Now Bailey's given up on me, too.
- You're on her service! - Why are you still freaking out? - No, Bailey's in surgery.
She trusts me to watch a post-op drip fluid in a bag every ten minutes.
- Ow! - Inappropriate! You should relax.
You get an easy day, you take it.
Shepherd didn't need me, so I took a nap in the research library.
Give me Give it to me.
- Jerk-face.
- He's having a rough day.
- New Robbins is no Robbins.
- Check this out.
- Armed escort to get a yogurt.
- OK, who is it? Is it Bono? It's totally Bono.
It's all over the hospital.
- It's not Bono.
- Are you going to Cristina's tonight? I don't know.
OK! - Not OK.
- It's addicting.
Put it away before my guy wrestles you to the ground.
- Give me that.
- No.
- Give me the ball.
- No.
Get - What's his problem? - He's having a rough day.
[Man clears throat.]
Jeez, I'm coming.
The Emir's cath confirmed that he has a tear in one of his coronary arteries.
We've stabilized him with a balloon pump, but I am gonna have to perform open heart surgery to repair the tear.
- [Men speaking foreign language.]
- Doctor, doctor, please.
- Was the tear in his? - Quiet, please.
Was the tear in his artery an injury - sustained in the car accident? - [Owen.]
There is no way - Doctor, don't answer that.
- There's no way of knowing - if that was the cause.
- [Man speaking foreign language.]
Can we have assurances that your finest surgeons - will be operating on His Highness? - [Richard.]
Yes.
These are the chiefs of my cardio-thoracic and trauma departments.
[Man speaking foreign language.]
Sorry.
He was asking your State Department.
He didn't mean the finest surgeons in this hospital.
Which is why you might be more comfortable travelling - to your own country, where he can - [all chattering.]
All right, quiet! Quiet, please! Quiet, please.
Thank you.
I understand that there are a lot of concerns and agendas here, but we all have the same goal, and that is to see this man live.
Now, we are out of time, which means we are out of options.
I am your only shot, and you have to take me.
I can only say that if you knew me better, you'd feel pretty good about your chances.
[Sighs.]
Dr.
Hunt and I are going to operate.
And we will update you as soon as we can.
[All chattering.]
Good luck.
You have to tell them to stop.
- Tell them they can't operate.
- Why? What's the problem? [Whispering.]
Come with me.
He didn't want anyone to know.
He made me swear.
- Just tell him what you told us.
- Four months ago, the Emir was diagnosed with an unruptured cerebral aneurysm - in his left temporal lobe.
- [Derek.]
He's in CT now? His first neuro came up clean, but now he's got a blown pupil.
- So we think it's burst.
- Scans should be up by now.
I swore to him, I wouldn't say anything until after the election.
I'm still not sure I should have told you.
I might be costing him everything.
- You're trying to save his life.
- He's trying to save seven million.
To make it so seven million people can walk the street without the fear of being murdered by the extremists.
He doesn't, um He risks his life every time he steps out his door.
You're trying to protect him too, and I'm sure he'll understand that.
- He was headed to surgery? - Yeah, we're going on - dissected coronary artery.
- [Derek.]
Yeah, that aneurysm's blown.
- Damn it.
That's a huge bleed.
- Well, not surprising.
He was shocked seven times and given a blood thinner, which is unfortunate.
He presented like an MI.
I treated him appropriately.
- I couldn't have seen this coming.
- You've been saying that a lot today.
You know what, Shepherd? I don't need crap from you.
Apparently, I hold the whole fate of the Middle East in my hands.
Apparently, now I do, too.
Book an OR.
We'll gonna have to work simultaneously.
Can't wait.
Cristina's having a party? Cristina Yang? Yeah, I know, but I'm gonna go.
We're all gonna go and talk to her.
You should come, too.
You quit once.
You walked away and came back.
So maybe you have something to say that could help.
- No.
- No? Do you remember when you came out to talk to me about coming back? Do you remember when I hit your engagement ring with a baseball bat? - Oh, that was a great day.
- She's already lashing out.
Don't go and try and confront her.
No intervention of Cristina Yang.
Do you hear me? It's a bad idea.
What are you sterilizing? You're kidding me.
- What was so important? - Uh Sir, I was out of line earlier.
But I think I found a solution for Lisa Collis's liver.
- What is that, a ping-pong ball? - It's the perfect shape to keep the liver from compressing her blood vessels.
It's made of celluloid, not plastic, so it won't break down, like a sponge will.
It's gas-sterilized, so there's little risk of infection.
You could leave it in there forever.
Her liver will just grow around it.
I think it's - You think it won't work? - No I was thinking I left you to do my post-ops, and here I find you playing with balls.
I don't know, Karev.
Am I gonna have to talk to your chief about you? Yeah.
Right.
I want it sort of like bad-ass, you know? A little dangerous, unpredictable.
- Did you bring a picture? - Mm It's more of a feeling.
What do they do all day, the mall people? Look at them.
They move so slowly.
They all mosey.
- Look! - Yeah, I can't turn my head.
Do they just eat things and buy things and complain about their breakups? - Yes.
- Fantastic.
Look at that lady.
She's just gonna eat that pretzel.
That's all she's gonna do.
So, what are you gonna do? You're just gonna become a mall person? - Shop and eat? - This yogurt's pretty good.
I'm serious.
I'm getting a pretzel.
[Sighs.]
- Avery, how's our patient? - No change.
That's what I like to hear.
I'm going into my colon.
So you still don't want me to scrub in? - No, I need you to watch - Ms.
Cortez.
Right.
Like I said, no change.
Avery, I need you where I need you.
I don't have time.
No, ma'am, that's fine.
I get it.
[Owen.]
I'm saying with this letter, there's a timeframe now.
You're content to stand back and watch Cristina - lose her spot in this program? - I'm saying an intervention is not a good plan.
Suction.
It's not an intervention, Shepherd.
We just thought, - since we were all together - [Owen.]
Torsades! Damn it.
He's in v-fib.
Shepherd, I need you to stop.
- We have to shock him.
- [Derek.]
No, wait, - I'm right in the middle of - [Owen.]
Internal paddles.
- [Teddy.]
Charge to ten.
- [Derek.]
Hold on, hold on! [Beeping.]
Shepherd! - [Derek.]
OK.
Clear! - [Paddles charging.]
[Owen.]
Sinus tach.
Hey.
Did Stark ever respond to my page? He's got three discharges, one of them's been here since yesterday.
Dr.
Stark's in surgery.
He went back in on Lisa Collis.
What? [Richard.]
It's a great idea.
So simple.
[Stark.]
Let's see if it works.
It is the right shape.
It's celluloid so it won't break down.
[Richard.]
And the liver will conform to it.
- It's a great idea.
- Whose idea was it, Dr.
Stark? Originally? Was it yours or Dr.
Karev's? Let's just see if it works.
And I'm back, Ms.
Cortez.
Did you miss me? Could you please let the dog out? He won't stop barking.
She's delirious.
Pulse is thready! I think she's in shock! Get her vitals.
Oh, no, no! Damn it! Get me a monitor in here! Call Dr.
Bailey now! - [Nurse.]
Right away, doctor.
- Come on.
I'm almost done here.
Get her into an OR, open her up and wait for me.
- I'll be there.
- Open? Did you say open her up? No word from Dr.
Bailey? OK.
Ten blade.
[Teddy.]
The artery is at the base of the heart.
Bypass would be so much better.
[Derek.]
I cannot manage this bleed on bypass.
OK, good.
I can clip the aneurysm.
I need you to stop what you're doing.
I am trying to do a coronary graft on a hemorrhaging heart.
- What do you suggest I do? - Do it faster.
All right, I need you to stop making this my fault.
Pack that.
I tried everything I could for Yang.
I encouraged her into the OR, I kept her out of the OR.
I don't know what else I could have done differently.
Hold pressure.
More! OK, good.
Go.
Yang was my student.
Don't you think that I wanted to help her? I have no doubt that's what you wanted to do.
- But you're saying that I failed.
- I'm saying that we all failed.
- So now it's time to back off.
- No, Shepherd, you need to back off.
She's my wife.
I'm not gonna give up on her yet.
All right! It's clear we all have the same goal.
We want her back.
[Derek.]
Done.
I got it.
I'm sorry.
I have a personal stake in this, too.
I would not be standing here if it wasn't for her.
Right.
But you're asking us to do nothing, and we can't do that.
- I can't do that.
- OK.
Let's start closing.
[Flat line tone.]
Damn it! Time of death, 7:41.
- [Exhales.]
Son of a bitch! - This is not my fault! She got a fistula, they got delayed hemorrhage! Post-op pancreatectomies always get fistulas! I didn't screw this up! - Avery - No, you listen! They always get fistulas, then they get severe complications, and they die! I did what you said! You told me to open her up, and then you weren't here.
- I tried to fix it.
- Avery.
- This is not my damn fault! - Dr.
Avery! Step out of my OR.
We are awesome.
I can't believe we did all this.
Uh, I did all this.
You opened one bottle of wine.
- Could you find where the napkins are? - Hello? - Damn it.
Uh, not ready! - Hi.
Hey, if you're here for the party, you're like way too early.
I'm not here for the party.
- Are you here to tell me to come back? - No.
But a bunch of other people are coming to do that.
Oh, God.
Are you OK? [sighs.]
I'm sorry.
I tried to find you.
He is awful! He tried to take all the credit.
- Is the kid OK? Is it gonna work? - Yeah! Of course it's gonna work.
It's brilliant.
I'm gonna talk to the chief.
Because it is so unfair.
You did every single thing right today.
You covered that attending's ass and you got You got crapped on every step of the way.
The chief should know that.
No, no.
You're so What you did today was so great.
You know, you don't deserve this.
I just I wanted you to know that somebody knows that.
That I know that.
You know, I'm, uh I've never, um - This is my first time.
- I know.
You want to stop? No.
No, I don't wanna stop.
I just - Can we just go, uh slower? - What? Can Can we please just go a little slower? It's just I need You need what? What do you need? What do you need from me? You wanna screw? Let's screw.
You don't? Then get out! I'm not gonna hold your virgin hand and walk you through it, damn it! You're not a child! I can't take care of you! I can't take care of everybody in this friggin' place! - Hi.
- Hey.
Uh, I usually do a post-op exam right now.
Yeah, well, he's on a C-130 halfway across the country by this time.
So I don't get to check on his recovery? He's being well taken care of.
- You did a good job.
- Oh I can tell you that.
What are you doing hanging around? Well, I wanted to say thank you.
And that it, uh It was nice meeting you.
I'd say the same, but you were never here.
[Indistinct chatter.]
[Mark.]
Welcome.
Wine's on the table, beer's in the fridge.
- I have a fridge? - And since you actually live here, I'll hand over the hosting duties to you.
- Where's Cristina? - Haven't seen her.
Which is sort of rude.
Torres might know, hang on.
- Callie, Yang say where she was? - Oh, um Can I move in with you? - That might be the rebound talking.
- [Laughs.]
Not like that, not that.
Just till I can get rid of the sub-letter in my place.
I'm starting from scratch.
And I don't want to do it alone.
Can't we be alone together? Isn't it easier to be single in pairs? This a riddle? No, I'm drunk.
- Come on.
Can I? - Sure.
Yay! - Your hair is hot.
- Right? [Laughs.]
Oh, hi.
Um [stammers.]
I Sorry, I didn't I know I should bring a gift.
Like a housewarming gift to things like this, [sobbing.]
but I didn't really have time to bring anything.
- So I'm really sorry.
- It is really It's no problem.
What happened? April? Hey, hey.
Come on.
Has anybody seen Cristina? If you're asking my opinion, I think you should.
I think you absolutely have to.
You should keep and refinish the original floors.
Why do I have to? I mean, you guys did what, like, bamboo or something? We're building our house from scratch, we can put down whatever we want.
- You have original oak floors.
- Yeah, but, what if I don't like it? - I mean what if I hate oak? - Doesn't matter.
You have to do it.
The building's historic.
I know.
God! OK.
OK.
OK! [Meredith.]
Every pressurized system needs a relief valve.
There has to be a way to reduce the stress, the tension I got there as fast as I could.
It was a grade-C fistula with a ruptured splenic artery.
You did everything you could.
Avery, too.
- Why don't you go home.
- Yes, sir.
- Bailey look - Why do we see so many post-op fistulas after pancreas surgeries? Your operation is flawless.
It doesn't matter, we still see fistulas in What, 20 percent of patients? I think there's a way to bring that number down.
I just got to find it.
- Miranda - I needed a win, sir.
I've got a string of big losses.
I could use a win, that's all.
Yang.
Yang was the one I didn't have to worry about.
I know.
I know.
[Meredith.]
before it becomes too much to bear.
Look into the pancreatectomy patients.
Figure it out.
- And then let me know how I can help.
- Uh, can I use Avery? He actually gave me the idea.
He was great today.
Well, that's good to know.
You know, Alex Karev saved a baby's life with a ping-pong ball? - Ping-pong ball? - Yes, he did.
Alex Karev.
[Meredith.]
There has to be a way to find relief.
Because if the pressure doesn't find a way out it will make one.
Listen.
Let me talk to her.
- [Crowd gasping.]
- All right.
[grunts.]
Come here, come on, here.
Come on! [Meredith.]
It will explode.
OK, OK.
Let's go.
Outside.
[Meredith.]
It's the pressure we put on ourselves that's the hardest to bear.
You think it was hard for Yang? To quit, to just walk away? Oh, don't be stupid.
You're not quitting.
Besides, you might have just gotten yourself fired.
- Or arrested.
Probably both.
- Yeah, well, April is the only friend I have left here.
So Don't be stupid.
[Meredith.]
The pressure to be better than we are.
[Meredith.]
What the hell were you thinking? She's a virgin.
- Why would you do that? - I know.
God.
Ow! Ow! If you needed it that bad, Alex, you should have gone back to Vegas.
- There's a whole industry there.
- I didn't go to Vegas.
- I went to lowa.
- You went to lowa? I went home.
- My brother, remember Aaron? - Yeah.
Doctor said He got diagnosed schizophrenic.
Just like my mom.
You know how they figured it out? He tried to kill our little sister.
She's 16.
She's a kid.
And her brother tried to kill her.
And my mom didn't do anything 'cause she's off her meds and Anyway, I was in lowa.
That's where I went.
To my brother's commitment hearing.
I had to commit him.
Whatever.
[Meredith.]
The pressure to be better than we think we can be.
- Well, it's good that you were there.
- I wasn't there.
I wasn't.
I showed up, I held my sister's hand in the hospital for like ten minutes, I shoved some pills down my mom's throat, I signed my brother into a nuthouse.
Then I got the hell out of there as fast as I could.
I wasn't there.
I'm the ass who can't stand to be there.
[Meredith.]
It never, ever lets up.
[Cristina.]
I should go down there.
I have to go down there.
Yeah, I should go.
You good? Anything else you want to talk about? - What are you doing for bathroom tile? - Oh.
Bathroom tile.
Um I don't know yet.
I think I'm going to [Meredith.]
It just builds and builds and builds.