Grey's Anatomy s07e15 Episode Script
Golden Hour
[Meredith.]
How much can you actually accomplish in an hour? Run an errand, maybe? Sit in traffic.
Get an oil change.
When you think about it, an hour isn't very long.
- [Clock ticking.]
- Sixty minutes.
Thirty-six hundred seconds.
That's it.
In medicine, though, an hour is often everything.
We call it "the Golden Hour".
That magical window of time that can determine whether a patient lives or dies.
[Chattering.]
[Telephone ringing.]
Thank you, doctor.
Are you gonna help me at all, or just sit there and eat potato chips? I performed four back-to-back fem-pop bypasses today.
This is the first chair I've seen since 7 am.
And this is the first food I've had since yesterday.
- I choose potato chips.
- [Phone continues ringing.]
You might wanna get that.
- Seattle Grace Mercy West Emergency.
- You brought this on yourself.
- You volunteered to help run the ER.
- Got it.
We've got a suspected appy on a ten-year-old.
Let's page Robbins.
You know, I saw a need and I filled it, like any good chief resident candidate.
Sadomasochistic chief resident candidate, maybe.
What is up with you? - You're all perky and cheerful.
- You know, it's the fertility drugs.
We have stepped it up.
I'm pumped full of hormones.
- You know what's perky? - [Cristina speaks foreign language.]
My boobs.
They're huge.
Am I supposed to like big boobs? Oh, God, no.
They'll make you fall over.
So Callie mentioned a thing.
Or it may not be a thing.
At least, I hope it doesn't become a thing.
Hey, I got a patient with a headache, better after sumatriptan.
He's ready to be discharged.
Just need you to sign off Is he neurologically intact? You did a CT? I did, it was negative.
Most interesting thing about this guy is that he came into the ER for a glorified migraine, - with a girlfriend from hell.
- Which one is she? Just point with your eyes.
[Indistinct dialogue.]
[Cristina.]
Mmm-hm.
- Here.
- Thank you.
- So Callie had a thing - Yeah.
- What kind of thing? - Grey, you paged? Yeah, we have a suspected appy on a ten-year-old, two minutes out.
- An unexpected thing.
- [Owen.]
Grey, call up.
- Tell them to get an OR ready.
- I already did.
OR five is prepped and ready for you.
Callie asked me to be her baby's godmother.
Oh.
Well, you said no to that, right? You gotta say no to that.
Um - EKG results.
- Thank you.
The guys at work overreacted and insisted I come to the ER.
Sweetie, I had a big lunch.
It hardly qualifies as chest pain.
No, what I need are some antacids.
I'll be there, I promise.
Just tell Max to put on his jersey.
I'll be out of here soon.
Hi, I'm Dr.
Grey.
I'll be your doctor today.
Oliver Richter.
Sorry about the phone.
I'm supposed to be picking up my son for the Huskies game right now.
- I'm sure he'll understand.
- [Scoffs.]
You don't know my son.
Very few things more important to him than basketball.
Big fan, huh? I'm just gonna take a quick listen.
Biggest nine-year-old fan you ever seen.
[Chuckles.]
OK.
So it says here that you've been experiencing some chest pain.
- When did that start? - [Exhales.]
An hour ago, maybe two.
- But I'm already feeling much better.
- You wouldn't just be saying that - to get discharged faster? - I got my son tickets to this game for his birthday.
He's been marking off the days on his calendar for weeks.
- I can't be the reason he misses it.
- OK, well, your EKG looks normal, and your heart sounds good.
But if there's one thing we don't take lightly around here, it's chest pain, so Could we go back and just pretend I said heartburn? - Would that get me out any faster? - No, probably not.
But Tyler is going to do a portable chest X-ray, and we're gonna do a chest pain work-up.
And we will try to make it as quick as possible, OK? Thanks, Dr.
Grey, so much.
Thanks.
[Woman on PA, indistinct.]
So, this is gonna be a thing.
Why am I telling Callie no again? While you're here, I need a second opinion on this EKG.
- Do you see anything? - No.
Looks normal.
What are you doing here? I thought you had the night off.
Yeah, I do.
I'm not here.
What's Medical Records' extension? Looks like you're here to me, which is good, because we're swamped.
Take your pick: Impacted bowel, suspicious rash - or a really smelly guy.
- Forget it.
I only came in because Medical Records called and said I had to sign all my unsigned charts - or they would suspend my privileges.
- You're getting suspended? - Dibs on his solo splenectomy tomorrow.
- I better be able to finish this crap before the game tonight.
I told a patient yesterday he didn't have cancer, and he was so happy, he gave me two floor seats.
- You took a gift from a patient? - Did you tell him you cured his cancer? [Pager beeps, vibrates.]
Oh.
Colectomy time.
I'm out.
- [Boy whimpering.]
- Excuse me.
Hi, I'm sorry.
We were told that somebody would be by to set our son's leg.
Nathan Englundar? It was a while ago, several hours, actually No, I know, you've been here a while.
I'm sorry.
The problem is we just don't have enough ORs available for non-emergent cases.
- An OR? Why would you need an OR? - Your pediatrician hasn't been by to speak to you yet? Your son has a broken femur, which is a severe break.
It requires a full cast on the broken leg connected to a cast on the other leg to keep everything still - so the bones will heal properly.
- Two full leg casts on a four-year-old? And because your son is so young, we can't set the bones properly - without putting him under.
- Under, meaning anesthesia? And that requires an OR.
I'm sorry.
I know you've been waiting a long time.
As soon as an OR opens up, I'll let you know.
- Thank you.
Thank you.
- OK.
The losers in Medical Records aren't answering.
Are you sure you can't stay and help out with some of this stuff? Floor seats! I understand what you are suggesting.
I know it is done by many medical professionals in this hospital.
But I am not a medical professional - who would ever consider - Maybe you should consider it.
[Giggles.]
Eli Lloyd! Do not test me.
Maybe you should consider the potential benefits.
All the intensely exciting, toe-curling potential benefits.
Dr.
Bailey.
[Woman indistinct on PA.]
OK.
This is gonna be for a prescription-strength migraine medicine.
Just don't take it with alcohol.
We're missing our anniversary dinner because you have a headache.
A headache.
Do you know how hard it is to get reservations at this place? I'm sorry, Gia.
I am.
But it really hurts.
Hi, I'm Dr.
Grey.
I'll be Mrs.
Webber? - Hi, dear.
How are you? - I'm fine.
How are you? - Does the chief know you're here? - Please don't bother him.
I had a little fall, is all.
Got home from work, slipped off the step ladder [winces.]
Ooh.
landed on my wrist.
It's basically nothing.
- Well, it's not nothing.
- I brought lots of magazines and a good novel, I am perfectly fine waiting until you make time for me.
I know you have far more pressing patients.
Well, you're the chief's wife.
So that makes you my most pressing patient.
- [Man.]
they opened the doors for us.
- Are you sure about that? We'll be in and out.
But I can't believe you wouldn't let me drive.
You're drunker than I am.
I can't believe you tried to stiff the cabbie.
Wow, it is bright in here.
Hey, could somebody do something about this? - [Quiet chatter.]
- [Machine beeping.]
You're a little early.
I thought our date was at 6:30.
I'm here now because a guy just walked into the pit with a knife - sticking out of his head.
- Sweet.
- I mean, poor guy.
- Is he stable? - He's neurologically intact, but - All right.
Well, I need to check on him sooner than later.
So, Avery, take him down to CT.
- Stay with him until I get there.
- Will do.
OK.
So you'll be down to see knife guy when you're done? - I will.
- And then we'll have our date? - Wouldn't miss it.
- 6:30.
Don't forget.
How'd this guy get a knife in his head? Apparently, there was a brawl at a tailgate party.
So you know how stupid guys get Dr.
Bailey! I'm taking a nap! [Stammers.]
I'm sorry.
What I mean to say is, I'm going to use this room to take a nap.
Because that's what people do in these rooms.
When they are tired.
'Cause I have a child and a full-time job and work long hours, so I am just tired.
Just very, very tired.
[yawning.]
- [Meredith.]
OK.
- OK.
I was just gonna ask you, had you seen Dr.
Altman? No! I have not seen Dr.
Altman.
Nor any other doctors or nurses.
Because I will be in this room.
Asleep.
By myself.
Actually, I see her now.
Dr.
Altman! [Yawning.]
I'm I'm Dr.
Altman, do you have time for a quick consult? I was supposed to be off by six, but OK.
Sure.
- Just walk with me.
- OK, so Damn it, he's early.
Um Just, Grey, gimme a second.
- [Telephone ringing.]
- [Chattering.]
- Hi.
William.
- Hey.
- It's, it's nice to see you.
- Wow.
You look amazing.
- Oh.
- And so official.
I mean, I knew you were a doctor, but you are a doctor.
- Sorry, I didn't have time to change.
- I'm just - No, the scrubs are strangely sexy.
Thanks.
You know, I have a few things to wrap up.
Do you mind hanging out for a few minutes? Like ten, tops.
Yeah, no problem.
Take your time.
I'll just grab a seat here.
Hey, stranger.
Henry! [stammers.]
I didn't I didn't know that you were here today.
Yeah.
They wanted to run a blood glucose test on me.
So they gave me this nasty, orange Kool-Aid to drink.
In about an hour, I gotta go give 'em some blood.
Or pee.
And we really don't need to talk about my bodily fluids.
- Sorry to be rude.
Hi.
- Hey.
Oh, sorry.
Yeah William, Henry.
Henry, William.
- Are you a patient of Teddy's? - Something like that.
[Nervous chuckle.]
Anyway, I gotta go, but I'll be back.
Soon.
Promise.
- All right, Grey, what do you got? - OK, 42-year-old male, complaining of midsternal chest pain.
No cardiac risk factors, no angina, pain doesn't radiate.
The EKG looks clean.
These are his films.
They're mostly clear, but I don't know.
Does the mediastinum look a little wide to you? Because I know sometimes that can happen with a portable X-ray.
- You got cardiac enzymes? - Yes.
- Hey, Kepner! - Yeah? How good are you at forging signatures? Even if I were good at forging signatures, I wouldn't do it.
It's unethical and probably illegal, so I'm sorry, you're just gonna have to finish signing your charts on your own.
I'll check on Mr.
Richter right now.
Call Radiology.
Get him in for a PA and lateral films, and tell them to rush it, 'cause I would really like to get out of here and go on my date.
I mean, did you see that guy? No forging signatures, Karev! - Radiology, please.
- Forgery? Why am I not surprised? Whatever.
I just wanna get out of here so I can get to this game tonight.
Wait, you have tickets? Tonight? It's the PAC-10 title game.
- Yeah, I know.
- Win this and the Huskies get - an automatic bid to March Madness.
- Why do you think I'm powering through all these stupid charts.
Hey, what are you doing? Of my ten patients in labor right now, none of them are past three centimeters, which means I have some time to kill, and you can't miss this game.
- Hand me a pen.
- I thought you thought I was a loser.
You're a little less loser-y now I know you like college hoops.
Hey.
Where's the knife guy? Is it true he's walking and talking? - What about your colectomy? - Ah, postponed.
The wife snuck him a cheeseburger and fries before surgery.
So this thing with Callie.
I mean, you know it's a bad idea, right? You don't want to be Callie's baby's godmother.
- I don't? - No! Think of how many people have to die before you even get to step up.
Mark, Callie and Arizona.
- That's a lot of people.
- It is.
Yes.
- A lot of dead people.
- Right! Whereas, if you were my baby's godmother-in-waiting, it's only me and Derek.
One wrong turn down a dark, twisty road, - boom, you're in.
- [Elevator dings.]
OK, let's be clear.
If I am ever a godparent to anyone's kid, it will be in name only.
I will not be taking care of children.
That's what boarding schools are for.
Which way to Butcher Block? - Trauma two.
- [Man 1.]
Feels like a roller, dude.
- [Man 2.]
I've never seen - I understand you might be thirsty, but I'm sorry, you cannot drink beer in here.
- You're wasting it! - Cool.
Oliver, did you see Dr.
Altman? She's sending me off for another X-ray.
I know you guys have to cover all your bases I know, I'm sorry.
But I put a rush on the X-ray, - so hopefully it'll be quick.
OK? - [Richard.]
Grey! Excuse me.
I was finishing a surgery just now, when a scrub nurse asked me how my wife was feeling.
Because she'd heard Adele was in the ER, and I hadn't.
Would you like to explain to me why I found out my wife was a patient in this hospital from my scrub nurse and not from you? Richard, hush.
Let Meredith do her job.
She hasn't even had a chance to examine me yet.
- Is that true? - [Adele.]
Don't mind him, dear.
He's just worried about me.
He gets gruff when he's worried.
I hurt my wrist.
I was trying to get out the holiday decorations and I, ooh, I slipped off the step ladder.
Stupid.
I should have waited for Richard to get home.
He's so much taller than me.
[Meredith.]
I requested an X-ray and an ortho consult.
I will call and make sure that they're coming down, but I - [people shouting.]
- [Lexie.]
Don't touch that! - I think I better go see what that is.
- You better.
Is everything all right? - [Man 1.]
Yes.
- [Lexie.]
No.
I was just showing these guys how, when I scrunch up my eyebrows, - the knife moves, see? - Oh, my God! - Don't do that! - Stop! - Stop moving the knife! - OK, OK! You guys shoulda seen the brawl.
Stew-ball kicked that other guy's ass! And now Stew-ball has a knife in his head.
OK, let's focus.
Stewart, how much is 14 plus four? - Eighteen.
- Twenty-seven minus 13? - Fifteen? - No.
One seventy-two minus 60? I have no idea, but it's not because of the knife.
- It's just 'cause I'm so drunk.
- No, actually, - it's just 'cause he's dumb.
- Thanks, David.
Really?! Unbelievable.
His mental status is completely intact, if you don't account for his math skills.
[Lexie.]
It's like the knife did no damage at all.
So why don't you just pull the thing out? We've got a games to gets to! I'll drink to that! - No! No beer! - [Stewart.]
Buzz kill.
- Uh-oh! Hey! - [Lexie.]
No! How many do you have? OK.
Oliver's in X-ray, Stewart is stable and waiting for Derek, who should be here soon.
Adele is waiting on Ortho.
And can I get the discharges from the last hour, please? Oh, and the boy in bed seven with the broken leg, Nathan Englundar.
Let's check on the status of the OR for him, please.
Is this Lexie's patient with the headache? - [Tyler.]
Yeah.
- Mitch Turner? - How long ago was he discharged? - Not long, a few minutes ago.
Did he leave? Did he already leave? Mr.
Turner! Mr.
Turner, I need you to try to smile for me, please? - Who the hell are you? - I need you to try to smile for me.
Can you lift your arms above your head like this? - Dr.
Grey, is everything all right? - No, it's not.
We got a code CVA.
Let's get a stretcher out here stat! Can you repeat after me? "The dog chased after the cat.
" [Stammering.]
The The dog chase chased after What's going on? What's happening to him? - [Meredith.]
I need you to help me.
- What's happening to him?! - We need to get him on the ground.
- The dog ch OK.
Get your purse under his head quickly, please, and help me secure his arm.
Hold it like this.
- OK, but why are we doing this? - Because he's having a stroke.
[Sirens approaching.]
[Meredith.]
Unsteady gait, slurred speech, asymmetric smile.
Symptoms started no more than 20 minutes ago.
So we should be well within the golden hour.
[Gia.]
I know, a stroke.
Right in front of me.
What if he'd been driving me in the car when it happened? - Hang on, here's the doctor.
- Hi.
So the stroke team is taking him up to CT.
We're gonna see if he's eligible for the clot-busting medicine.
We caught the stroke early, which is very good.
So, on a scale of one to ten, ten being I might have to cancel our Aspen trip in a week, how is he? You should cancel the trip.
[Sighs.]
You will not believe this.
Looks like the blade landed in the maxillary sinus.
Chances are the knife itself is tamponading any major bleeding.
Probably best just to go ahead and open up the cranium.
Or we could just take him to the OR and pull this thing out.
[Mark.]
Really, Avery? Just pull it out? Let me guess.
You wanna get out of here early to go to the game just like everyone else.
Or, since it looks like the blade didn't hit any major arteries or veins, he knows that a controlled extraction would be both safer and less invasive than a complete craniotomy.
[Mark.]
Is that true, Avery? That why you suggest we pull it out of his head? Yeah.
And I want to get out of here early to get to the game.
Me, too.
I'm good with that.
Let's just do what he said.
Lexie, I need to speak with you.
Thank you for getting me out of that room.
I swear, it takes everything just to be civil to Mark lately.
Such an ass.
- What's up? - Take a look at this.
Look closely.
What do you see? This is the patient's admitting signature when he came in.
And this is his signature when he was discharged.
- Oh, no.
- Mitch Turner, the patient you just discharged, is up in Radiology - being treated for a stroke.
- Oh, God.
I know you know the signs of a stroke.
How did you miss this? Are you distracted by the Mark thing? Is that it? No! I checked the CT.
He was having a classic migraine, he's had them before.
There's no way that he was having a stroke when I treated him.
Lexie, I know you know.
This kind of headache can be a precursor to a stroke.
When you said you needed an Ortho consult, you could have mentioned it was the chief's wife, Grey.
I would have been down here a hell of a lot sooner.
I am so sorry to keep you waiting, Mrs.
Webber.
You hurt your wrist in a fall? It was so silly.
I'd just gotten home and I was trying to get some [gasps.]
Oh! reach something on the top shelf.
- I just landed wrong.
- Her wrist absorbed all the impact.
It looks painful.
We'll get you some more pain meds to help with that.
Your X-ray shows a hairline fracture.
So it could have been a lot worse.
We'll splint you up and get you out of here in no time, OK? [Pager beeping.]
You have me paged if you need anything, OK? OK.
Thank you for covering for me before with the chief.
- You didn't have to do that.
- Excuse me? When you said I hadn't been by to examine you yet.
So you said that you fell - when you got home from work.
- Yes, yes, that's right.
Do you remember hitting your head when you fell? - Not that I recall.
- [Tyler.]
Dr.
Grey? I have the new X-rays for Oliver Richter.
- OK.
Let's get Mrs.
Webber a head CT.
- OK.
Oh, damn it.
Excuse me.
[Chattering.]
[Telephone ringing.]
- Hey.
- Hey.
- Sorry to make you wait.
- No.
No problem.
Really, Henry here's been keeping me company.
Although, he's probably sick of me by now.
I've been grilling him about the major leagues.
You didn't mention he used to play pro ball.
- I I didn't know that he did.
- [Henry.]
It's not a big deal, really.
Although there is a baseball card out there with my face on it somewhere.
I don't mean to hold you guys up.
You probably have a reservation waiting.
Excuse me, Dr.
Altman.
Mr.
Richter, mediastinum looks borderline on the PA films.
Take a look.
OK, um That reservation may have to wait just a little bit longer.
I'm sorry.
- If you want to reschedule - No! Nonsense.
I'm happy to wait.
You are saving lives.
The least I can do is take you out to dinner when you're done.
Thank you.
Did you ever pitch against Jeff Bagwell? Once.
And it wasn't pretty.
You were right.
Get a CT to be safe.
I'll stick around to look the results.
At least somebody's having a good night.
[Laughing.]
- [Alex.]
Tell me.
- No, I can't possibly.
- [Oliver.]
Good news? - [Sighs.]
Or not such good news.
[Meredith.]
Oliver, your second X-ray is still concerning.
Dr.
Altman and I agree that you should have a CT to rule out anything serious.
- And how long will that take? - [Cell phone rings.]
Ah, that's my son calling.
He's worried we'll miss tip-off.
What should I tell him? Do I need to tell him we're gonna miss this game? I wish I had an answer for you, but I think it's a safe bet you'll be late.
Max, hey buddy.
How's my little man doing? Oh, Daddy'll be fine.
Don't you worry.
Don't worry.
You just worry about all that popcorn we're gonna be eating.
Make sure he's on broad spectrum antibiotics.
You booked an OR? Wow.
It didn't hit any brain matter at all? [Lexie.]
Doesn't look like it from this.
[Owen.]
How long till Shepherd gets down here to take a look? He should be out of surgery any minute.
Good.
The longer that thing stays in there, the higher the risk of infection or abscess formation.
Ow! So now can we get out of here? [Owen.]
How is he, Grey? Pupils are equal and reactive, he's alert and awake.
Can I get some more gauze for this wound, please? - Reflexes seem normal.
- [Scoffs.]
Gimme that.
[Stewart.]
I'm fine.
It's just a little headache is all.
- I've had hangovers worse than this.
- What's the status on the blade? - Well, about that - Yeah, there is no blade anymore.
What happened? Sir, just lay back.
Let me examine you, OK? [Crying.]
- Can you get a doctor, please? - [Derek.]
I wanna look at the CTs.
- It's gonna be OK, Nathan.
- [Mother.]
He's really hurting.
OK.
I'm gonna write an order for more pain meds.
It's OK, monkey.
I know you wanna go home.
It'll just be a little while longer, OK? It will be just a little longer, right? - Tyler, where is the OR for Nathan? - I haven't heard back yet.
OK, well, let's call them again, and let's call the Ortho team and make sure they're ready to go.
OK? We will get to Nathan as soon as possible, I promise.
- How's he doing? - The blade went through his skull, didn't hit any major nerves or arteries.
He's gonna be fine.
- Flesh wound? - Yeah.
- That's the luckiest guy alive.
- You're also pretty lucky, too.
It's past 6:30, and we haven't had our date yet.
I'm swamped.
I can't leave.
I have one patient in CT, another one waiting for an OR.
- Your patient's CT isn't ready yet.
- No.
And the OR you're waiting for isn't either.
So OK, I mean, maybe I do, right at this precise moment, - have one minute, but it's a minute.
- That's perfect.
That's all I need.
Just a minute.
I need a minute.
Hey.
- Wha? [screams.]
- Oh, sorry! - What?! - No one.
It was nothing.
That room is occupied.
Never ask me what I might have seen or might not have seen in there.
OK, well, if we can't go in there, where are we gonna go? I have an idea.
[Upbeat pop music.]
- Where are we going? - Nowhere.
We're gonna do it here.
- We? No, we're not! - Come on.
No! No way! Are you kidding me? - Drop your pants.
- [Elevator rings.]
Come on, I'll be quick.
I'll be in and out.
Oh, my God! Eyes up here! Seriously, are you kidding me? I'm serious about this.
Where is your sense of adventure? My sense of adventure is down on the first floor.
- It's not in this elevator.
- Come on.
If not for me, then do it for your future baby.
Come on.
- Turn around.
- I cannot believe I am doing this.
This future, imaginary baby of ours better be worth it.
OK, here we go.
- Oh, there it is.
- Ouch.
- Ooh.
There.
I told you I'd be quick.
- [Gasps.]
I can't wait to meet our future, fictitious baby.
- [Elevator rings.]
- Me either.
[Elevator dings.]
[Pop music continues.]
We got through those charts fast.
Floor seats, here I come.
So I just helped you get through three dozen charts in a fraction of the time it would have taken you to do on your own, basically ensuring you get to your floor seats on time.
How long do I have to wait till you ask me to go to the game with you? Oh [stammers.]
I mean, I was supposed to take Avery, but screw him.
Sure.
You wanna go? No, I'm on call tonight, actually.
I just wanted to see if I could get you to ask me out.
[Elevator dings.]
Excuse me.
- Just admit it.
You like her.
- Shut up.
I don't think you do understand, actually.
This has been going on since yesterday.
We took our son to an after-hours clinic, where he was misdiagnosed and then he was sent home without so much as a painkiller.
He was up all night crying.
This morning, our pediatrician sent us here and now we've been waiting around all day with our four-year-old son.
Believe me, I understand a kid with a broken leg doesn't take precedence over a guy with a knife in his head, but my son is scared.
And he is in pain.
So could somebody please just get to his leg already? - Please.
- [Nurse.]
Yes, sir.
You still haven't helped that kid yet? He's four with a femur fracture.
- You know how much that hurts? - I know, it's just one of those days.
- Tyler, isn't that OR ready yet? - They're prepping it now.
Grey! My wife was cleared by Dr.
Torres.
You ordered a head CT for a broken wrist? - I can explain.
I have some - Dr.
Grey, they're calling from CT.
- Your patient is coding in the scanner.
- What?! They say he's coding! [Machine beeping rapidly.]
Hold CPR! V-fib! Page Altman! Give me the paddles now! Charge to 200! Clear! - [Machine beeping rapidly.]
- Charge to 300! Clear! - [Man.]
Got a pulse! - [Meredith.]
Yes! - Scans are up! - Grey, talk to me.
He was coding when I got here.
I defibrillated him three times, I gave him three rounds of epi, two of atropine, I loaded him up with amiodarone.
But he's tachycardic now, he's barely hanging on.
- He needs surgery.
Book an OR.
- [Meredith.]
OK.
- I'll get a room prepped and ready.
- No time.
His aorta is dissecting as we speak.
- He needs surgery right now.
- They're saying all the ORs are booked.
Well, tell them to bump someone because we're coming up either way.
I have an OR.
Tell them to bump mine and prep it for an emergency cardio.
All right, here we go.
Got it? Go.
All right, let's clear it.
Let's hold that elevator! - Come on, come on, come on! - Once these doors open, we're gonna have to get him in the OR and open him as soon as possible.
- I know.
- Even then, if that aorta tears, we may already be too late.
- We're not gonna have time to scrub.
- I know, I know.
Thanks.
[Elevator dings.]
[Teddy.]
Just pour the betadine straight onto the chest.
It doesn't need to be pretty.
We need to get in there.
All right, plug me in.
Scalpel.
Cautery.
Cauterizing now.
Get in there quickly, Grey.
Time is myocardium.
All right, saw.
Get that retractor ready.
This guy thought he had a bad case of heartburn.
He went from that to this in less than 45 minutes.
That's how these work.
How's his pressure? Seventies, and dropping.
Retractor! Every beat of his heart rips this tear a little bit wider.
All right.
How many of these ruptured dissections have you caught in time to operate? - Forty, maybe 50.
- How many have you been able to save? Three.
All right, I'm in.
[Machine beeping rapidly.]
- [Meredith.]
Oh, no, no, no, no! - [Teddy.]
Damn it! He's bleeding out! His aorta's wide open.
Clamp! Come on, come on, come on! All right, Grey, let's try sucker bypass.
OK.
Cannulas! It's not working.
There's too much blood.
Once we get him on bypass, it'll be easier to control.
Heart's fibrillating! [Teddy.]
All right, cardiac massage! - Paddles! - I've almost got him cannulated.
Charge to ten.
[Meredith.]
Clear! Damn it.
He's bleeding out of his nose and ears! I've been loading him up with blood, FFP and Factor Vll, - but I can't keep up with the losses.
- Foley's full of blood, too.
DIC.
His cannula sites are oozing.
Let's push three of epi.
Set me up for another shock.
Clear! - [Teddy.]
Damn it! - Well, what can we do? - Just tell me what to do.
- Nothing.
His aorta is in shreds.
- Well, what about? - There is nothing left to do.
Call it.
- Call it, Grey.
- No [Teddy.]
Grey, we got here too late.
These are almost impossible to catch.
There's nothing that we can do.
I'm sorry.
We need to call it.
[Machines beeping.]
[Breathing heavily.]
Time of death, 18:52.
[Baby cries.]
Hey.
I heard you lost a patient.
[Exhales.]
You know, it's not that I don't want to share you.
I mean, I don't want to share you, but that's not the reason I don't want you to be Callie's baby's godmother.
Oh OK.
It just seems like if you agree to be Callie's baby's godmother, you're saying that I'll never have a baby of my own.
Meredith, you know I am in no way saying anything I know.
It just feels that way.
- OK.
- [Sighs.]
Well, I have to go have a really uncomfortable conversation with Callie.
How about you? What are you up to? I have to go contact Oliver's family.
Oh, hey, wait.
You've got blood or something.
[Whispers.]
All right.
- Thank you.
- You're welcome.
Hey, chief.
- About earlier - It's all taken care of.
I checked Adele's head CT myself.
It was clean.
Her wrist is in a splint, and I'm taking her home now.
I still have some concerns.
And if her CT was clean, - then I have even more concerns - Thank you, Meredith, but I assure you, Adele is fine.
Chief, she's been getting things very confused.
Meredith, she is fine.
And I'm taking her home right now.
Why was she getting Christmas decorations down in February? - Good night, Meredith.
- [Meredith.]
She said she'd just gotten home from work.
Didn't she retire? - Meredith - Chief, something isn't right.
OK, that's enough.
I know what you are implying, and while I appreciate your concern, that's enough! Adele had a scare today.
She had a fall.
Any number of things could account for her mixing up a couple of details, not the least of which is her being interrogated by you! If something bigger were wrong with my wife, I would know it.
You've got Alzheimer's on the brain.
You buy a car, you start seeing it everywhere you look.
You've been working on this Alzheimer's trial 24l7, I get it.
But Adele is not your mother, Meredith.
She's my wife.
Now, good night.
[Door opens, closes.]
[Chattering.]
Hi.
I am so sorry, I got pulled into an emergency surgery.
- Where is Nathan? - Actually, a doctor came by to get him a little bit ago.
He's getting his casts put on right now.
Great.
That's great news.
Dr.
Grey, we have a surgical abdomen in bed three - Let's just get Oliver Richter's chart.
- OK.
[Oliver's cell phone rings.]
Hello? Hi, Max.
This No, it's your daddy's doctor.
Is your mom around? [Meredith.]
An hour.
One hour can change everything.
Forever.
We'll have to keep you overnight for observation, - but your prognosis is very good.
- Great! So maybe we don't have to cancel our Aspen trip after all.
- I just had a stroke.
- I know.
And you're worried about our travel plans? It's a non-refundable trip.
Cancel the trip.
You know what? In fact, cancel all our trips.
How have I put up with you for two years? I am done with this.
We're done.
Get out of here.
Now, before you give me another stroke.
Wait, wait.
Can I see your keys? [Whispers.]
OK Here.
OK.
Now you can go.
[Mid-tempo pop music.]
[Meredith.]
An hour can save your life.
So before he gets off the phone, and since I now have to go pee in a cup, I just have to say this.
I basically spent the past hour on a first date with William myself, and I don't know how much you know about the guy, but this is what I know.
He wears driving gloves.
Yeah, and he doesn't live with his mother, but until recently, he lived above her house.
And he used the word "shan't", and he wasn't being funny.
And he's yet to tell me a story about himself in which he is not the hero.
So, as your husband, I think we can do better.
Good news.
Not only was I able to push the reservation, but I also got us a table by the window.
Black truffle gnocchi awaits.
- Ready? - Ready.
[Music continues.]
[Meredith.]
An hour can change your mind.
OK.
So when's your next break? [Stammers.]
OK, uh-uh, no This will never happen again at work.
- Understood? - Sure.
OK.
Until your next break.
[Meredith.]
Sometimes an hour is just a gift we give ourselves.
All right, Stewart, you're choosing to leave against medical advice, so you're free to go, but this is my number.
If you experience any of the neurological symptoms on this sheet, you call me.
Somebody should stay with you tonight, and have plenty of fluids.
Not beer! - Not beer.
- Will do, doc.
[Engine starts.]
- [Stewart.]
Thanks, doc.
- All right.
[Meredith.]
For some, an hour can mean almost nothing.
I can't believe he walked in with a knife in his head, and is walking out an hour later to go to a ball game.
Speaking of which, any chance you wanna go to the game, too? Apparently, Karev didn't want his floor seats.
So you interested? Actually, yes.
Yes, I am.
[Music continues.]
[Meredith.]
For others, an hour makes all the difference in the world.
Now, Nathan, when you wake up, you're gonna have two big casts on your legs.
But that's a good thing, because it means it's gonna make your leg better, OK? But right now, I have a very important question for you.
And that is, what is your favorite color? Blue.
Blue it is, then.
Let's prep the blue casting material, please.
All right, I'm gonna take this mask, Nathan.
I'm gonna lower it.
And you have to count [Meredith.]
But in the end it's still just an hour.
[Music continues.]
One of many.
Many more to come.
Sixty minutes.
Thirty-six hundred seconds.
That's it.
Then it starts all over again.
Hi.
I'm Dr.
Grey.
I'll be your doctor today.
It says here you've been experiencing some abdominal pain.
- When did that start? - [Clock ticking.]
[Meredith.]
And who knows what the next hour might hold?
How much can you actually accomplish in an hour? Run an errand, maybe? Sit in traffic.
Get an oil change.
When you think about it, an hour isn't very long.
- [Clock ticking.]
- Sixty minutes.
Thirty-six hundred seconds.
That's it.
In medicine, though, an hour is often everything.
We call it "the Golden Hour".
That magical window of time that can determine whether a patient lives or dies.
[Chattering.]
[Telephone ringing.]
Thank you, doctor.
Are you gonna help me at all, or just sit there and eat potato chips? I performed four back-to-back fem-pop bypasses today.
This is the first chair I've seen since 7 am.
And this is the first food I've had since yesterday.
- I choose potato chips.
- [Phone continues ringing.]
You might wanna get that.
- Seattle Grace Mercy West Emergency.
- You brought this on yourself.
- You volunteered to help run the ER.
- Got it.
We've got a suspected appy on a ten-year-old.
Let's page Robbins.
You know, I saw a need and I filled it, like any good chief resident candidate.
Sadomasochistic chief resident candidate, maybe.
What is up with you? - You're all perky and cheerful.
- You know, it's the fertility drugs.
We have stepped it up.
I'm pumped full of hormones.
- You know what's perky? - [Cristina speaks foreign language.]
My boobs.
They're huge.
Am I supposed to like big boobs? Oh, God, no.
They'll make you fall over.
So Callie mentioned a thing.
Or it may not be a thing.
At least, I hope it doesn't become a thing.
Hey, I got a patient with a headache, better after sumatriptan.
He's ready to be discharged.
Just need you to sign off Is he neurologically intact? You did a CT? I did, it was negative.
Most interesting thing about this guy is that he came into the ER for a glorified migraine, - with a girlfriend from hell.
- Which one is she? Just point with your eyes.
[Indistinct dialogue.]
[Cristina.]
Mmm-hm.
- Here.
- Thank you.
- So Callie had a thing - Yeah.
- What kind of thing? - Grey, you paged? Yeah, we have a suspected appy on a ten-year-old, two minutes out.
- An unexpected thing.
- [Owen.]
Grey, call up.
- Tell them to get an OR ready.
- I already did.
OR five is prepped and ready for you.
Callie asked me to be her baby's godmother.
Oh.
Well, you said no to that, right? You gotta say no to that.
Um - EKG results.
- Thank you.
The guys at work overreacted and insisted I come to the ER.
Sweetie, I had a big lunch.
It hardly qualifies as chest pain.
No, what I need are some antacids.
I'll be there, I promise.
Just tell Max to put on his jersey.
I'll be out of here soon.
Hi, I'm Dr.
Grey.
I'll be your doctor today.
Oliver Richter.
Sorry about the phone.
I'm supposed to be picking up my son for the Huskies game right now.
- I'm sure he'll understand.
- [Scoffs.]
You don't know my son.
Very few things more important to him than basketball.
Big fan, huh? I'm just gonna take a quick listen.
Biggest nine-year-old fan you ever seen.
[Chuckles.]
OK.
So it says here that you've been experiencing some chest pain.
- When did that start? - [Exhales.]
An hour ago, maybe two.
- But I'm already feeling much better.
- You wouldn't just be saying that - to get discharged faster? - I got my son tickets to this game for his birthday.
He's been marking off the days on his calendar for weeks.
- I can't be the reason he misses it.
- OK, well, your EKG looks normal, and your heart sounds good.
But if there's one thing we don't take lightly around here, it's chest pain, so Could we go back and just pretend I said heartburn? - Would that get me out any faster? - No, probably not.
But Tyler is going to do a portable chest X-ray, and we're gonna do a chest pain work-up.
And we will try to make it as quick as possible, OK? Thanks, Dr.
Grey, so much.
Thanks.
[Woman on PA, indistinct.]
So, this is gonna be a thing.
Why am I telling Callie no again? While you're here, I need a second opinion on this EKG.
- Do you see anything? - No.
Looks normal.
What are you doing here? I thought you had the night off.
Yeah, I do.
I'm not here.
What's Medical Records' extension? Looks like you're here to me, which is good, because we're swamped.
Take your pick: Impacted bowel, suspicious rash - or a really smelly guy.
- Forget it.
I only came in because Medical Records called and said I had to sign all my unsigned charts - or they would suspend my privileges.
- You're getting suspended? - Dibs on his solo splenectomy tomorrow.
- I better be able to finish this crap before the game tonight.
I told a patient yesterday he didn't have cancer, and he was so happy, he gave me two floor seats.
- You took a gift from a patient? - Did you tell him you cured his cancer? [Pager beeps, vibrates.]
Oh.
Colectomy time.
I'm out.
- [Boy whimpering.]
- Excuse me.
Hi, I'm sorry.
We were told that somebody would be by to set our son's leg.
Nathan Englundar? It was a while ago, several hours, actually No, I know, you've been here a while.
I'm sorry.
The problem is we just don't have enough ORs available for non-emergent cases.
- An OR? Why would you need an OR? - Your pediatrician hasn't been by to speak to you yet? Your son has a broken femur, which is a severe break.
It requires a full cast on the broken leg connected to a cast on the other leg to keep everything still - so the bones will heal properly.
- Two full leg casts on a four-year-old? And because your son is so young, we can't set the bones properly - without putting him under.
- Under, meaning anesthesia? And that requires an OR.
I'm sorry.
I know you've been waiting a long time.
As soon as an OR opens up, I'll let you know.
- Thank you.
Thank you.
- OK.
The losers in Medical Records aren't answering.
Are you sure you can't stay and help out with some of this stuff? Floor seats! I understand what you are suggesting.
I know it is done by many medical professionals in this hospital.
But I am not a medical professional - who would ever consider - Maybe you should consider it.
[Giggles.]
Eli Lloyd! Do not test me.
Maybe you should consider the potential benefits.
All the intensely exciting, toe-curling potential benefits.
Dr.
Bailey.
[Woman indistinct on PA.]
OK.
This is gonna be for a prescription-strength migraine medicine.
Just don't take it with alcohol.
We're missing our anniversary dinner because you have a headache.
A headache.
Do you know how hard it is to get reservations at this place? I'm sorry, Gia.
I am.
But it really hurts.
Hi, I'm Dr.
Grey.
I'll be Mrs.
Webber? - Hi, dear.
How are you? - I'm fine.
How are you? - Does the chief know you're here? - Please don't bother him.
I had a little fall, is all.
Got home from work, slipped off the step ladder [winces.]
Ooh.
landed on my wrist.
It's basically nothing.
- Well, it's not nothing.
- I brought lots of magazines and a good novel, I am perfectly fine waiting until you make time for me.
I know you have far more pressing patients.
Well, you're the chief's wife.
So that makes you my most pressing patient.
- [Man.]
they opened the doors for us.
- Are you sure about that? We'll be in and out.
But I can't believe you wouldn't let me drive.
You're drunker than I am.
I can't believe you tried to stiff the cabbie.
Wow, it is bright in here.
Hey, could somebody do something about this? - [Quiet chatter.]
- [Machine beeping.]
You're a little early.
I thought our date was at 6:30.
I'm here now because a guy just walked into the pit with a knife - sticking out of his head.
- Sweet.
- I mean, poor guy.
- Is he stable? - He's neurologically intact, but - All right.
Well, I need to check on him sooner than later.
So, Avery, take him down to CT.
- Stay with him until I get there.
- Will do.
OK.
So you'll be down to see knife guy when you're done? - I will.
- And then we'll have our date? - Wouldn't miss it.
- 6:30.
Don't forget.
How'd this guy get a knife in his head? Apparently, there was a brawl at a tailgate party.
So you know how stupid guys get Dr.
Bailey! I'm taking a nap! [Stammers.]
I'm sorry.
What I mean to say is, I'm going to use this room to take a nap.
Because that's what people do in these rooms.
When they are tired.
'Cause I have a child and a full-time job and work long hours, so I am just tired.
Just very, very tired.
[yawning.]
- [Meredith.]
OK.
- OK.
I was just gonna ask you, had you seen Dr.
Altman? No! I have not seen Dr.
Altman.
Nor any other doctors or nurses.
Because I will be in this room.
Asleep.
By myself.
Actually, I see her now.
Dr.
Altman! [Yawning.]
I'm I'm Dr.
Altman, do you have time for a quick consult? I was supposed to be off by six, but OK.
Sure.
- Just walk with me.
- OK, so Damn it, he's early.
Um Just, Grey, gimme a second.
- [Telephone ringing.]
- [Chattering.]
- Hi.
William.
- Hey.
- It's, it's nice to see you.
- Wow.
You look amazing.
- Oh.
- And so official.
I mean, I knew you were a doctor, but you are a doctor.
- Sorry, I didn't have time to change.
- I'm just - No, the scrubs are strangely sexy.
Thanks.
You know, I have a few things to wrap up.
Do you mind hanging out for a few minutes? Like ten, tops.
Yeah, no problem.
Take your time.
I'll just grab a seat here.
Hey, stranger.
Henry! [stammers.]
I didn't I didn't know that you were here today.
Yeah.
They wanted to run a blood glucose test on me.
So they gave me this nasty, orange Kool-Aid to drink.
In about an hour, I gotta go give 'em some blood.
Or pee.
And we really don't need to talk about my bodily fluids.
- Sorry to be rude.
Hi.
- Hey.
Oh, sorry.
Yeah William, Henry.
Henry, William.
- Are you a patient of Teddy's? - Something like that.
[Nervous chuckle.]
Anyway, I gotta go, but I'll be back.
Soon.
Promise.
- All right, Grey, what do you got? - OK, 42-year-old male, complaining of midsternal chest pain.
No cardiac risk factors, no angina, pain doesn't radiate.
The EKG looks clean.
These are his films.
They're mostly clear, but I don't know.
Does the mediastinum look a little wide to you? Because I know sometimes that can happen with a portable X-ray.
- You got cardiac enzymes? - Yes.
- Hey, Kepner! - Yeah? How good are you at forging signatures? Even if I were good at forging signatures, I wouldn't do it.
It's unethical and probably illegal, so I'm sorry, you're just gonna have to finish signing your charts on your own.
I'll check on Mr.
Richter right now.
Call Radiology.
Get him in for a PA and lateral films, and tell them to rush it, 'cause I would really like to get out of here and go on my date.
I mean, did you see that guy? No forging signatures, Karev! - Radiology, please.
- Forgery? Why am I not surprised? Whatever.
I just wanna get out of here so I can get to this game tonight.
Wait, you have tickets? Tonight? It's the PAC-10 title game.
- Yeah, I know.
- Win this and the Huskies get - an automatic bid to March Madness.
- Why do you think I'm powering through all these stupid charts.
Hey, what are you doing? Of my ten patients in labor right now, none of them are past three centimeters, which means I have some time to kill, and you can't miss this game.
- Hand me a pen.
- I thought you thought I was a loser.
You're a little less loser-y now I know you like college hoops.
Hey.
Where's the knife guy? Is it true he's walking and talking? - What about your colectomy? - Ah, postponed.
The wife snuck him a cheeseburger and fries before surgery.
So this thing with Callie.
I mean, you know it's a bad idea, right? You don't want to be Callie's baby's godmother.
- I don't? - No! Think of how many people have to die before you even get to step up.
Mark, Callie and Arizona.
- That's a lot of people.
- It is.
Yes.
- A lot of dead people.
- Right! Whereas, if you were my baby's godmother-in-waiting, it's only me and Derek.
One wrong turn down a dark, twisty road, - boom, you're in.
- [Elevator dings.]
OK, let's be clear.
If I am ever a godparent to anyone's kid, it will be in name only.
I will not be taking care of children.
That's what boarding schools are for.
Which way to Butcher Block? - Trauma two.
- [Man 1.]
Feels like a roller, dude.
- [Man 2.]
I've never seen - I understand you might be thirsty, but I'm sorry, you cannot drink beer in here.
- You're wasting it! - Cool.
Oliver, did you see Dr.
Altman? She's sending me off for another X-ray.
I know you guys have to cover all your bases I know, I'm sorry.
But I put a rush on the X-ray, - so hopefully it'll be quick.
OK? - [Richard.]
Grey! Excuse me.
I was finishing a surgery just now, when a scrub nurse asked me how my wife was feeling.
Because she'd heard Adele was in the ER, and I hadn't.
Would you like to explain to me why I found out my wife was a patient in this hospital from my scrub nurse and not from you? Richard, hush.
Let Meredith do her job.
She hasn't even had a chance to examine me yet.
- Is that true? - [Adele.]
Don't mind him, dear.
He's just worried about me.
He gets gruff when he's worried.
I hurt my wrist.
I was trying to get out the holiday decorations and I, ooh, I slipped off the step ladder.
Stupid.
I should have waited for Richard to get home.
He's so much taller than me.
[Meredith.]
I requested an X-ray and an ortho consult.
I will call and make sure that they're coming down, but I - [people shouting.]
- [Lexie.]
Don't touch that! - I think I better go see what that is.
- You better.
Is everything all right? - [Man 1.]
Yes.
- [Lexie.]
No.
I was just showing these guys how, when I scrunch up my eyebrows, - the knife moves, see? - Oh, my God! - Don't do that! - Stop! - Stop moving the knife! - OK, OK! You guys shoulda seen the brawl.
Stew-ball kicked that other guy's ass! And now Stew-ball has a knife in his head.
OK, let's focus.
Stewart, how much is 14 plus four? - Eighteen.
- Twenty-seven minus 13? - Fifteen? - No.
One seventy-two minus 60? I have no idea, but it's not because of the knife.
- It's just 'cause I'm so drunk.
- No, actually, - it's just 'cause he's dumb.
- Thanks, David.
Really?! Unbelievable.
His mental status is completely intact, if you don't account for his math skills.
[Lexie.]
It's like the knife did no damage at all.
So why don't you just pull the thing out? We've got a games to gets to! I'll drink to that! - No! No beer! - [Stewart.]
Buzz kill.
- Uh-oh! Hey! - [Lexie.]
No! How many do you have? OK.
Oliver's in X-ray, Stewart is stable and waiting for Derek, who should be here soon.
Adele is waiting on Ortho.
And can I get the discharges from the last hour, please? Oh, and the boy in bed seven with the broken leg, Nathan Englundar.
Let's check on the status of the OR for him, please.
Is this Lexie's patient with the headache? - [Tyler.]
Yeah.
- Mitch Turner? - How long ago was he discharged? - Not long, a few minutes ago.
Did he leave? Did he already leave? Mr.
Turner! Mr.
Turner, I need you to try to smile for me, please? - Who the hell are you? - I need you to try to smile for me.
Can you lift your arms above your head like this? - Dr.
Grey, is everything all right? - No, it's not.
We got a code CVA.
Let's get a stretcher out here stat! Can you repeat after me? "The dog chased after the cat.
" [Stammering.]
The The dog chase chased after What's going on? What's happening to him? - [Meredith.]
I need you to help me.
- What's happening to him?! - We need to get him on the ground.
- The dog ch OK.
Get your purse under his head quickly, please, and help me secure his arm.
Hold it like this.
- OK, but why are we doing this? - Because he's having a stroke.
[Sirens approaching.]
[Meredith.]
Unsteady gait, slurred speech, asymmetric smile.
Symptoms started no more than 20 minutes ago.
So we should be well within the golden hour.
[Gia.]
I know, a stroke.
Right in front of me.
What if he'd been driving me in the car when it happened? - Hang on, here's the doctor.
- Hi.
So the stroke team is taking him up to CT.
We're gonna see if he's eligible for the clot-busting medicine.
We caught the stroke early, which is very good.
So, on a scale of one to ten, ten being I might have to cancel our Aspen trip in a week, how is he? You should cancel the trip.
[Sighs.]
You will not believe this.
Looks like the blade landed in the maxillary sinus.
Chances are the knife itself is tamponading any major bleeding.
Probably best just to go ahead and open up the cranium.
Or we could just take him to the OR and pull this thing out.
[Mark.]
Really, Avery? Just pull it out? Let me guess.
You wanna get out of here early to go to the game just like everyone else.
Or, since it looks like the blade didn't hit any major arteries or veins, he knows that a controlled extraction would be both safer and less invasive than a complete craniotomy.
[Mark.]
Is that true, Avery? That why you suggest we pull it out of his head? Yeah.
And I want to get out of here early to get to the game.
Me, too.
I'm good with that.
Let's just do what he said.
Lexie, I need to speak with you.
Thank you for getting me out of that room.
I swear, it takes everything just to be civil to Mark lately.
Such an ass.
- What's up? - Take a look at this.
Look closely.
What do you see? This is the patient's admitting signature when he came in.
And this is his signature when he was discharged.
- Oh, no.
- Mitch Turner, the patient you just discharged, is up in Radiology - being treated for a stroke.
- Oh, God.
I know you know the signs of a stroke.
How did you miss this? Are you distracted by the Mark thing? Is that it? No! I checked the CT.
He was having a classic migraine, he's had them before.
There's no way that he was having a stroke when I treated him.
Lexie, I know you know.
This kind of headache can be a precursor to a stroke.
When you said you needed an Ortho consult, you could have mentioned it was the chief's wife, Grey.
I would have been down here a hell of a lot sooner.
I am so sorry to keep you waiting, Mrs.
Webber.
You hurt your wrist in a fall? It was so silly.
I'd just gotten home and I was trying to get some [gasps.]
Oh! reach something on the top shelf.
- I just landed wrong.
- Her wrist absorbed all the impact.
It looks painful.
We'll get you some more pain meds to help with that.
Your X-ray shows a hairline fracture.
So it could have been a lot worse.
We'll splint you up and get you out of here in no time, OK? [Pager beeping.]
You have me paged if you need anything, OK? OK.
Thank you for covering for me before with the chief.
- You didn't have to do that.
- Excuse me? When you said I hadn't been by to examine you yet.
So you said that you fell - when you got home from work.
- Yes, yes, that's right.
Do you remember hitting your head when you fell? - Not that I recall.
- [Tyler.]
Dr.
Grey? I have the new X-rays for Oliver Richter.
- OK.
Let's get Mrs.
Webber a head CT.
- OK.
Oh, damn it.
Excuse me.
[Chattering.]
[Telephone ringing.]
- Hey.
- Hey.
- Sorry to make you wait.
- No.
No problem.
Really, Henry here's been keeping me company.
Although, he's probably sick of me by now.
I've been grilling him about the major leagues.
You didn't mention he used to play pro ball.
- I I didn't know that he did.
- [Henry.]
It's not a big deal, really.
Although there is a baseball card out there with my face on it somewhere.
I don't mean to hold you guys up.
You probably have a reservation waiting.
Excuse me, Dr.
Altman.
Mr.
Richter, mediastinum looks borderline on the PA films.
Take a look.
OK, um That reservation may have to wait just a little bit longer.
I'm sorry.
- If you want to reschedule - No! Nonsense.
I'm happy to wait.
You are saving lives.
The least I can do is take you out to dinner when you're done.
Thank you.
Did you ever pitch against Jeff Bagwell? Once.
And it wasn't pretty.
You were right.
Get a CT to be safe.
I'll stick around to look the results.
At least somebody's having a good night.
[Laughing.]
- [Alex.]
Tell me.
- No, I can't possibly.
- [Oliver.]
Good news? - [Sighs.]
Or not such good news.
[Meredith.]
Oliver, your second X-ray is still concerning.
Dr.
Altman and I agree that you should have a CT to rule out anything serious.
- And how long will that take? - [Cell phone rings.]
Ah, that's my son calling.
He's worried we'll miss tip-off.
What should I tell him? Do I need to tell him we're gonna miss this game? I wish I had an answer for you, but I think it's a safe bet you'll be late.
Max, hey buddy.
How's my little man doing? Oh, Daddy'll be fine.
Don't you worry.
Don't worry.
You just worry about all that popcorn we're gonna be eating.
Make sure he's on broad spectrum antibiotics.
You booked an OR? Wow.
It didn't hit any brain matter at all? [Lexie.]
Doesn't look like it from this.
[Owen.]
How long till Shepherd gets down here to take a look? He should be out of surgery any minute.
Good.
The longer that thing stays in there, the higher the risk of infection or abscess formation.
Ow! So now can we get out of here? [Owen.]
How is he, Grey? Pupils are equal and reactive, he's alert and awake.
Can I get some more gauze for this wound, please? - Reflexes seem normal.
- [Scoffs.]
Gimme that.
[Stewart.]
I'm fine.
It's just a little headache is all.
- I've had hangovers worse than this.
- What's the status on the blade? - Well, about that - Yeah, there is no blade anymore.
What happened? Sir, just lay back.
Let me examine you, OK? [Crying.]
- Can you get a doctor, please? - [Derek.]
I wanna look at the CTs.
- It's gonna be OK, Nathan.
- [Mother.]
He's really hurting.
OK.
I'm gonna write an order for more pain meds.
It's OK, monkey.
I know you wanna go home.
It'll just be a little while longer, OK? It will be just a little longer, right? - Tyler, where is the OR for Nathan? - I haven't heard back yet.
OK, well, let's call them again, and let's call the Ortho team and make sure they're ready to go.
OK? We will get to Nathan as soon as possible, I promise.
- How's he doing? - The blade went through his skull, didn't hit any major nerves or arteries.
He's gonna be fine.
- Flesh wound? - Yeah.
- That's the luckiest guy alive.
- You're also pretty lucky, too.
It's past 6:30, and we haven't had our date yet.
I'm swamped.
I can't leave.
I have one patient in CT, another one waiting for an OR.
- Your patient's CT isn't ready yet.
- No.
And the OR you're waiting for isn't either.
So OK, I mean, maybe I do, right at this precise moment, - have one minute, but it's a minute.
- That's perfect.
That's all I need.
Just a minute.
I need a minute.
Hey.
- Wha? [screams.]
- Oh, sorry! - What?! - No one.
It was nothing.
That room is occupied.
Never ask me what I might have seen or might not have seen in there.
OK, well, if we can't go in there, where are we gonna go? I have an idea.
[Upbeat pop music.]
- Where are we going? - Nowhere.
We're gonna do it here.
- We? No, we're not! - Come on.
No! No way! Are you kidding me? - Drop your pants.
- [Elevator rings.]
Come on, I'll be quick.
I'll be in and out.
Oh, my God! Eyes up here! Seriously, are you kidding me? I'm serious about this.
Where is your sense of adventure? My sense of adventure is down on the first floor.
- It's not in this elevator.
- Come on.
If not for me, then do it for your future baby.
Come on.
- Turn around.
- I cannot believe I am doing this.
This future, imaginary baby of ours better be worth it.
OK, here we go.
- Oh, there it is.
- Ouch.
- Ooh.
There.
I told you I'd be quick.
- [Gasps.]
I can't wait to meet our future, fictitious baby.
- [Elevator rings.]
- Me either.
[Elevator dings.]
[Pop music continues.]
We got through those charts fast.
Floor seats, here I come.
So I just helped you get through three dozen charts in a fraction of the time it would have taken you to do on your own, basically ensuring you get to your floor seats on time.
How long do I have to wait till you ask me to go to the game with you? Oh [stammers.]
I mean, I was supposed to take Avery, but screw him.
Sure.
You wanna go? No, I'm on call tonight, actually.
I just wanted to see if I could get you to ask me out.
[Elevator dings.]
Excuse me.
- Just admit it.
You like her.
- Shut up.
I don't think you do understand, actually.
This has been going on since yesterday.
We took our son to an after-hours clinic, where he was misdiagnosed and then he was sent home without so much as a painkiller.
He was up all night crying.
This morning, our pediatrician sent us here and now we've been waiting around all day with our four-year-old son.
Believe me, I understand a kid with a broken leg doesn't take precedence over a guy with a knife in his head, but my son is scared.
And he is in pain.
So could somebody please just get to his leg already? - Please.
- [Nurse.]
Yes, sir.
You still haven't helped that kid yet? He's four with a femur fracture.
- You know how much that hurts? - I know, it's just one of those days.
- Tyler, isn't that OR ready yet? - They're prepping it now.
Grey! My wife was cleared by Dr.
Torres.
You ordered a head CT for a broken wrist? - I can explain.
I have some - Dr.
Grey, they're calling from CT.
- Your patient is coding in the scanner.
- What?! They say he's coding! [Machine beeping rapidly.]
Hold CPR! V-fib! Page Altman! Give me the paddles now! Charge to 200! Clear! - [Machine beeping rapidly.]
- Charge to 300! Clear! - [Man.]
Got a pulse! - [Meredith.]
Yes! - Scans are up! - Grey, talk to me.
He was coding when I got here.
I defibrillated him three times, I gave him three rounds of epi, two of atropine, I loaded him up with amiodarone.
But he's tachycardic now, he's barely hanging on.
- He needs surgery.
Book an OR.
- [Meredith.]
OK.
- I'll get a room prepped and ready.
- No time.
His aorta is dissecting as we speak.
- He needs surgery right now.
- They're saying all the ORs are booked.
Well, tell them to bump someone because we're coming up either way.
I have an OR.
Tell them to bump mine and prep it for an emergency cardio.
All right, here we go.
Got it? Go.
All right, let's clear it.
Let's hold that elevator! - Come on, come on, come on! - Once these doors open, we're gonna have to get him in the OR and open him as soon as possible.
- I know.
- Even then, if that aorta tears, we may already be too late.
- We're not gonna have time to scrub.
- I know, I know.
Thanks.
[Elevator dings.]
[Teddy.]
Just pour the betadine straight onto the chest.
It doesn't need to be pretty.
We need to get in there.
All right, plug me in.
Scalpel.
Cautery.
Cauterizing now.
Get in there quickly, Grey.
Time is myocardium.
All right, saw.
Get that retractor ready.
This guy thought he had a bad case of heartburn.
He went from that to this in less than 45 minutes.
That's how these work.
How's his pressure? Seventies, and dropping.
Retractor! Every beat of his heart rips this tear a little bit wider.
All right.
How many of these ruptured dissections have you caught in time to operate? - Forty, maybe 50.
- How many have you been able to save? Three.
All right, I'm in.
[Machine beeping rapidly.]
- [Meredith.]
Oh, no, no, no, no! - [Teddy.]
Damn it! He's bleeding out! His aorta's wide open.
Clamp! Come on, come on, come on! All right, Grey, let's try sucker bypass.
OK.
Cannulas! It's not working.
There's too much blood.
Once we get him on bypass, it'll be easier to control.
Heart's fibrillating! [Teddy.]
All right, cardiac massage! - Paddles! - I've almost got him cannulated.
Charge to ten.
[Meredith.]
Clear! Damn it.
He's bleeding out of his nose and ears! I've been loading him up with blood, FFP and Factor Vll, - but I can't keep up with the losses.
- Foley's full of blood, too.
DIC.
His cannula sites are oozing.
Let's push three of epi.
Set me up for another shock.
Clear! - [Teddy.]
Damn it! - Well, what can we do? - Just tell me what to do.
- Nothing.
His aorta is in shreds.
- Well, what about? - There is nothing left to do.
Call it.
- Call it, Grey.
- No [Teddy.]
Grey, we got here too late.
These are almost impossible to catch.
There's nothing that we can do.
I'm sorry.
We need to call it.
[Machines beeping.]
[Breathing heavily.]
Time of death, 18:52.
[Baby cries.]
Hey.
I heard you lost a patient.
[Exhales.]
You know, it's not that I don't want to share you.
I mean, I don't want to share you, but that's not the reason I don't want you to be Callie's baby's godmother.
Oh OK.
It just seems like if you agree to be Callie's baby's godmother, you're saying that I'll never have a baby of my own.
Meredith, you know I am in no way saying anything I know.
It just feels that way.
- OK.
- [Sighs.]
Well, I have to go have a really uncomfortable conversation with Callie.
How about you? What are you up to? I have to go contact Oliver's family.
Oh, hey, wait.
You've got blood or something.
[Whispers.]
All right.
- Thank you.
- You're welcome.
Hey, chief.
- About earlier - It's all taken care of.
I checked Adele's head CT myself.
It was clean.
Her wrist is in a splint, and I'm taking her home now.
I still have some concerns.
And if her CT was clean, - then I have even more concerns - Thank you, Meredith, but I assure you, Adele is fine.
Chief, she's been getting things very confused.
Meredith, she is fine.
And I'm taking her home right now.
Why was she getting Christmas decorations down in February? - Good night, Meredith.
- [Meredith.]
She said she'd just gotten home from work.
Didn't she retire? - Meredith - Chief, something isn't right.
OK, that's enough.
I know what you are implying, and while I appreciate your concern, that's enough! Adele had a scare today.
She had a fall.
Any number of things could account for her mixing up a couple of details, not the least of which is her being interrogated by you! If something bigger were wrong with my wife, I would know it.
You've got Alzheimer's on the brain.
You buy a car, you start seeing it everywhere you look.
You've been working on this Alzheimer's trial 24l7, I get it.
But Adele is not your mother, Meredith.
She's my wife.
Now, good night.
[Door opens, closes.]
[Chattering.]
Hi.
I am so sorry, I got pulled into an emergency surgery.
- Where is Nathan? - Actually, a doctor came by to get him a little bit ago.
He's getting his casts put on right now.
Great.
That's great news.
Dr.
Grey, we have a surgical abdomen in bed three - Let's just get Oliver Richter's chart.
- OK.
[Oliver's cell phone rings.]
Hello? Hi, Max.
This No, it's your daddy's doctor.
Is your mom around? [Meredith.]
An hour.
One hour can change everything.
Forever.
We'll have to keep you overnight for observation, - but your prognosis is very good.
- Great! So maybe we don't have to cancel our Aspen trip after all.
- I just had a stroke.
- I know.
And you're worried about our travel plans? It's a non-refundable trip.
Cancel the trip.
You know what? In fact, cancel all our trips.
How have I put up with you for two years? I am done with this.
We're done.
Get out of here.
Now, before you give me another stroke.
Wait, wait.
Can I see your keys? [Whispers.]
OK Here.
OK.
Now you can go.
[Mid-tempo pop music.]
[Meredith.]
An hour can save your life.
So before he gets off the phone, and since I now have to go pee in a cup, I just have to say this.
I basically spent the past hour on a first date with William myself, and I don't know how much you know about the guy, but this is what I know.
He wears driving gloves.
Yeah, and he doesn't live with his mother, but until recently, he lived above her house.
And he used the word "shan't", and he wasn't being funny.
And he's yet to tell me a story about himself in which he is not the hero.
So, as your husband, I think we can do better.
Good news.
Not only was I able to push the reservation, but I also got us a table by the window.
Black truffle gnocchi awaits.
- Ready? - Ready.
[Music continues.]
[Meredith.]
An hour can change your mind.
OK.
So when's your next break? [Stammers.]
OK, uh-uh, no This will never happen again at work.
- Understood? - Sure.
OK.
Until your next break.
[Meredith.]
Sometimes an hour is just a gift we give ourselves.
All right, Stewart, you're choosing to leave against medical advice, so you're free to go, but this is my number.
If you experience any of the neurological symptoms on this sheet, you call me.
Somebody should stay with you tonight, and have plenty of fluids.
Not beer! - Not beer.
- Will do, doc.
[Engine starts.]
- [Stewart.]
Thanks, doc.
- All right.
[Meredith.]
For some, an hour can mean almost nothing.
I can't believe he walked in with a knife in his head, and is walking out an hour later to go to a ball game.
Speaking of which, any chance you wanna go to the game, too? Apparently, Karev didn't want his floor seats.
So you interested? Actually, yes.
Yes, I am.
[Music continues.]
[Meredith.]
For others, an hour makes all the difference in the world.
Now, Nathan, when you wake up, you're gonna have two big casts on your legs.
But that's a good thing, because it means it's gonna make your leg better, OK? But right now, I have a very important question for you.
And that is, what is your favorite color? Blue.
Blue it is, then.
Let's prep the blue casting material, please.
All right, I'm gonna take this mask, Nathan.
I'm gonna lower it.
And you have to count [Meredith.]
But in the end it's still just an hour.
[Music continues.]
One of many.
Many more to come.
Sixty minutes.
Thirty-six hundred seconds.
That's it.
Then it starts all over again.
Hi.
I'm Dr.
Grey.
I'll be your doctor today.
It says here you've been experiencing some abdominal pain.
- When did that start? - [Clock ticking.]
[Meredith.]
And who knows what the next hour might hold?