01x01 - A Hard Day's Night (Pilot)


1x01: A Hard Day's Night

Original Airdate: 3/27/2005

Written by: Shonda Rhimes

Directed by: Peter Horton

Meredith VO: The game. They say either a person has what it takes to play, or they don't. My mother was one of the greats. Me, on the other hand...I'm kinda screwed.

(Meredith wakes up on the couch and pulls a blanket off a naked man on the floor, wrapping it around herself. She hits him with a pillow and he grunts, waking up. He lifts up her bra.)

Man: This...is...?

Meredith: (grabbing it, smiling) Humiliating on so many levels. You have to go.

Man: (sitting up) Why don't you just come back down here and we'll pick up where we left off?

Meredith: No, seriously. You have to go, I'm late. Which isn't what you want to be on your first day of work, so

Man: So, ah, you actually live here.

Meredith: No.

Man: Oh.

Meredith: Yes. Kind of.

Man: (dressing) Oh. It's nice. Little dusty. Odd. But it's nice. So how do you kind of live here?

Meredith: I moved two weeks ago from Boston, it was my mother's house, I'm selling it.

Man: Oh, I'm sorry.

Meredith: For what?

Man: You said was.

Meredith: Oh! My mother's not dead, she's - you know what, we don't have to do the thing.

Man: Oh. We can do anything you want.

Meredith: No, the thing, exchange the details, pretend we care...look, I'm gonna go upstairs and take a shower, okay, and when I get back down here, you won't be here, so, um, goodbye...um...

Man: Derek.

Meredith: (they shake hands) Derek. Right. Meredith.

Derek: Meredith.

Meredith: Yeah. (he comes closer, she backs away) Mm-hmm.

Derek: Nice meeting you.

Meredith: Bye Derek (smiling and fleeing for the stairs).

(Cut to Meredith leaving the house. Derek is presumably gone. Panning shots over the city as Meredith drives to work. Meredith enters a room filled with other interns as a doctor talks.)

Doctor: Each of you comes here hopeful. Wanting in on the game. A month ago you were in med school being taught by doctors. Today, you are the doctors. The seven years you spend here as a surgical resident will be the best and worst of your life. You will be pushed to the breaking point. Look around you. Say hello to your competition. Eight of you will switch to an easier specialty. Five of you will crack under the pressure. Two of you will be asked to leave. This is your starting line. This is your arena. How well you play? That's up to you.

Meredith VO: Like I said. I'm screwed.

(Fadeout to logo, then cut to intern locker room.)

Doctor: Okay. Martin, Robinson, Bond, Parkins.

Meredith: Only six women out of twenty.

Female Korean intern (Cristina Yang): Yeah. I hear one of them's a model. Seriously, like that's going to help with the respect thing?

Meredith: You're Cristina, right?

Cristina: Which resident you assigned to? I got Bailey.

Meredith: The Nazi? Yeah, me too.

Male intern (George O'Malley): You got the Nazi? So did I. At least we'll be tortured together, right? I'm George O'Malley, uh, we met at the mixer, you had a black dress with a slit up the side, strappy sandals...(Cristina and Meredith exchange looks)

George: Now you think I'm gay.

Cristina: (walking away) Uh-huh.

George: No, I'm not gay, it's, ah, it's just that, you know, you were, I mean, you were very, unforgettable.

Doctor: O'Malley, Yang, Grey, Stevens.

George: (muttering) And I'm totally forgettable.

Cristina: (to Doctor) Bailey?

Doctor: End of the hall.

Cristina: That's the Nazi?

(Medium shot of Dr. Bailey. She's short, black and a bit overweight. She doesn't look very threatening.)

George: I thought the Nazi would be a guy.

Meredith: I thought the Nazi would be...the Nazi.

Pretty female intern (Izzie Stevens): Maybe it's professional jealousy. Maybe she's brilliant, and they call her Nazi because they're jealous. Maybe she's nice.

Cristina: Let me guess. You're the model.

(Izzie gives Cristina a look and turns to Dr. Bailey, smiling and extending a hand)

Izzie: Hi, I'm Isabel Stevens, but everyone calls me Izzie.

(Bailey looks her up and down, doesn't respond or shake her hand)

Bailey: I have five rules. Memorise them. Rule number one, don't bother sucking up, I already hate you, that's not gonna change. (indicates stuff on the bench) Trauma protocol, phone lists, pagers. Nurses will page you, you answer every page at a run. A run, that's rule number two. Your first shift starts now and lasts forty-eight hours. You're interns, (�Hour 1' comes up on the screen), grunts, nobodies, bottom of the surgical food chain, you run labs, write orders, work every second night till you drop and don't complain! (Cut to Bailey opening the door to a room with a couple of bunk beds). On call rooms. Attendings hog them, sleep when you can, where you can, which brings me to rule number three, if I'm sleeping, don't wake me, unless your patient is actually dying. Rule number four, the dying patient better not be dead when I get there, not only would you have killed someone, you would have also woke me for no good reason, we clear?

(Meredith raises a hand.)

Bailey: Yes.

Meredith: You said five rules. That was only four. (Bailey's pager beeps).

Bailey: Rule number five. When I move, you move. (runs down the corridor, followed by the interns, yells at a few doctors blocking the hallway) Get out of my way!

(Cut to shot of a helicopter over the city, cut to the interns and Bailey moving a stretcher over to it, on the roof of the hospital.)

Bailey: What've we got?

Paramedic: (as Katie's put on the stretcher and taken in to the hospital) Katie Bryce, fifteen-year-old female, new onset seizures, intermittent for the past week, ID lost en route, started grand mal seizing as we descended.

Bailey: All right, get her on her side, Izzie, ten milligrams Diazepam,

no, no, the white lead is on the right, righty whitey, smoke over fire, a large bore I.V. don't let the blood haemolyse, let's go!

(Izzie injects her and she stops seizing. A new doctor, Preston Burke, enters, black, tall, young.)

Burke: So I heard we got a wet fish on dry land?

Bailey: Absolutely Dr. Burke.

Burke: Dr. Bailey, I'm gonna shotgun her.

Bailey: That means every test in the book, CT, CBC, chem. seven, tux screen, Cristina, you're on labs, George, patient workups, Meredith, get Katie for a CT, she's your responsibility now.

Izzie: Wait, what about me?

Bailey: You - honey, you get to do rectal exams.

(Cut to Izzie pulling on gloves and covering her fingers with gel.

Cut to Cristina peering into an operating room, where Bailey is.)

Bailey: What are you doing here?

Cristina: Um, Katie Bryce's labs came out clear, there's nothing in the results that explain her seizures, I just thought you'd wanna know.

Bailey: Okay. (goes to pull her mask back up and close the door)

Cristina: Ah, I - I heard every year the attending on call picks the best intern and, and lets them perform a procedure, during the first shift? (Bailey stares at her) I'm, I'm just saying it's what I heard...

Bailey: Go away. Now.

(Cut to George using a stethoscope.)

George: Yeah, sounds good.

Woman: He'll be fine? You'll be fine.

Patient: (smiling, lying back) If you don't count that my bacon days are over, sure.

George: You'll have surgery tomorrow with Dr. Burke, I hear he's good, and after that, you can have all of the bacon-flavoured soy product you can eat.

Patient: Mmm, kill me now.

George: I wish I could, but I'm a healer. (gets weird looks)

(Cut to Meredith with Katie (on a bed) in an elevator.)

Katie: You're lost.

Meredith: I'm not lost. How are you feeling?

Katie: How do you think I'm feeling? I'm missing my pageant.

Meredith: You're missing your pageant. (wheeling her out of the elevator and around a corner)

Katie: The Spokane Teen Miss? I was in the top ten after the first two rounds. This is my year. I could've won. (sitting up, being wheeled back around the same way) Hello? You're so lost. What are you, like, new?

(Cut to Izzie...doing her job.)

Izzie: Okay, so I'm gonna, just gonna, insert my fingers...into your rectum.

(Cut to George giving his patient an injection. And again. It's hurting the patient.

Cut back to Izzie's face. Cut back to George)

George: Nope.

(Cut back to Izzie, who's really disgusted now but not saying anything.

Cut back to George's patient. Dr Burke is pulling on a glove.)

Burke: (to George) Out. Out.

George: Bet you missed a lot when you first started out. (Burke looks derisive.)

(Cut to Katie and Meredith.)

Katie: I twisted my ankle. I do rhythmic gymnastics, which is like, really cool. Nobody else does it. And I tripped over my ribbon, and I didn't get stuck with someone this clueless. And that was like, a nurse.

(Cut to Burke)

Burke: (to George) You and I are going to have so much fun together.

(Cut to Izzie closing a curtain, cut to the cafeteria. HOUR 7.)

George sits down. Izzie is staring at the food with some horror.

George: This shift is a marathon, not a sprint, eat.

Izzie: I can't.

George: You should eat something.

Izzie: You try eating after performing seventeen rectal exams. The Nazi hates me.

George: The Nazi's a resident. I have attendings hating me.

Cristina: You know Meredith is inbred?

George: Like it's uncommon around here to be a doctor's -

Cristina: No, I mean royally inbred. Her mother is Ellis Grey.

Izzie: Shut up, the Ellis Grey?

Cristina: Uh-huh.

George: Who's Ellis Grey?

Izzie and Cristina laugh.

Cristina: The Grey method? Where'd you go to med school, Mexico?

Izzie: She was one of the first big chick surgeons, she practically invented the abdominal-

Cristina: She's a living legend, she won the Harper Avery. Twice.

George: So I didn't know one thing.

Izzie: Talk about parental pressure.

Cristina: I would kill to have Ellis Grey as a mother. I would kill to be Ellis Grey.

All I need is one good case. (Meredith comes over and sits down with her tray).

Meredith: Katie Bryce is a pain in the ass. If I hadn't taken the Hippocratic oath, I'd Kevorkian her with my bare hands (everybody stares at her).

Meredith: What?

Burke: Good afternoon interns. It's posted, but I thought I'd share the good news personally. As you know, the honour of performing the first surgery is reserved for the intern that shows the most promise. As I'm running the OR today, I get to make that choice. (he claps George on the back) George O'Malley. You'll scrub in for an adipectomy this afternoon. Congratulations.

George: Me?

Burke: Enjoy.

Burke leaves, no one speaks.

George: Did he say me?

Cut to another part of the hospital.

Bailey: I've seen his file. George O'Malley barely made the cut to get into this program, he's not your guy.

Burke: No, he's my guy all right.

Bailey: sh1t, every year you pick your guy, and every year your guy suffers more than any other intern on surgery.

Burke: Terrorise one, and the rest fall in line.

Bailey: I get it, I respect it, but George? O'Malley's a puppy, he can't even take the pressure. (walking away. Camera moves to a man and a woman, not doctors)

Woman: Katie Bryce, 3604?

Nurse: It's right there.

Woman: Thank you.

(Cut to inside Katie's room.)

Woman: Katie, honey, mom and dad are here.

Meredith: They gave her a sedative for the CT scan, so she's a little groggy.

Mother: Will she be all right?

Father: Our doctor at home said she might need an operation, is that true?

Mother: What kind of operation?

Meredith: She's, um, well, you know what, I'm not, I'm not the doctor, uh, I'm a doctor, but I'm not Katie's doctor, so I'll go get him for you.

Meredith goes to Bailey.

Bailey: What?

Meredith: Katie's parents have questions. Do you talk to them, or do I ask Burke?

Bailey: No, Burke's off the case, Katie belongs to the new attending now, Dr. Shepherd, he's over there. (we can't see Dr. Shepherd)

Meredith takes a few steps in that direction. She stops dead. We can see him now, he's talking to another doctor. It's Derek, from this morning. Meredith's eyes widen and she starts to turn to go. He glances her way, does a double take. She turns and leaves. He's still staring.

(Commercial break)

(Meredith is walking down the hall and Derek grabs her arm.)

Meredith: Hey - (he pulls her into a stairwell, no one's around.) Dr. Shepherd, -

Derek: Dr. Shepherd? This morning it was Derek. Now it's Dr. Shepherd.

Meredith: Dr. Shepherd, we should pretend it never happened.

Derek: What never happened, you sleeping with last night? Or you throwing me out this morning? Because both are fond memories I'd like to hold onto.

Meredith: No. There will be no memories. I'm not the girl in the bar anymore, and you're not the guy. This can't exist. You get that, right?

Derek: You took advantage of me and now you want to forget about it.

Meredith: I did not take -

Derek: I was drunk, vulnerable and good-looking and you took advantage.

Meredith: (smiling) Okay, I was the one who was drunk, and you are not that good-looking.

Derek: Well, maybe not today. Last night, last night I was very good-looking. I had my red shirt on, my good-looking shirt, you took advantage.

Meredith: I did not take -

Derek: You want to take advantage again? Say Friday night?

Meredith: No. You're an attending. And I'm your intern. Stop looking at me like that.

Derek: Like what?

Meredith: Like you've seen me naked. (Derek smirks) Dr. Shepherd. This is inappropriate. Has that ever occurred to you?

(Meredith leaves, Shepherd sighs.

Cut to George, about to go into surgery.)

George: (muttering) Open identify ligate irrigate close. Open identify ligate irrigate close. Open identify ligate irrigate close.

Intern 1: He's going to faint. He's a fainter.

Intern 2: Naaah, code brown. Right in his pants.

Intern 1: He's all about the flops, he's going to sweat himself unsterile.

Intern 3: Ten bucks says he messes up the McBird.

Cristina: Twenty says he cries.

Intern 2: I'll put twenty on a total meltdown.

Meredith: Fifty says he pulls the whole thing off.

(Everybody looks at her, silent.)

Meredith: That's one of us, down there. The first one of us. Where's your loyalty?

(A pause.)

Cristina: Seventy-five says he can't even ID the appendix.

Izzie: I'll take that action. (others agree)

Burke: Okay, O'Malley, let's see what you can do.

Meredith: Here it comes.

George: Scalpel.

Nurse: Scalpel.

(George takes it, the interns cheer from the gallery. Burke motions for them to shut up.)

Cristina: That Burke, he's trouble. (interns laugh)

(George gets ready to cut.)

Burke: More pressure. Human flesh is a tough shell, dig in.

George: Pick-ups.

Nurse: Pick-ups.

George: Clamp.

Nurse: Clamp.

George: Met some bone. I'm there.

Intern 1: Damn, he got the peritoneum and he opened him up.

Meredith: I told you, he's going to pull it off.

George: Scalpel.

Nurse: Scalpel.

George: Appendix is out (tossing it into a tray, to cheers)

Burke: Not bad.

George: Thank you.

Burke: Now all you have to do is invert the stump into the secum and simultaneously pull up on the purse-strings but be careful not to (rip) break them. (groans) He ripped the secum. Got a bleeder. You're filling with stool, what do you do now?

George: Uh...uh...

Burke: Think. You start the suction, and you start digging for those purse-strings before she bleeds to death. Belky, give him a clamp.

Nurse: BP's dropping.

Cristina: He's choking.

Meredith: Come on, George.

Burke: Today. Pull your balls out of your back pocket, let's go. What are you waiting for, suction? (beeping starts)

Nurse: Getting too low folks... Dr Burke...

Burke: Get out of the way. Pansy-ass idiot. Get him out of here. Suction. Clamp.

Intern (Alex Karev): 007.

Other intern: 007, yep, that's a total 007.

Izzie: What's 007 mean?

Meredith: Licensed to kill.

(Cut to Seattle at night. Hour 19.

Cut to interns sitting on spare beds along an empty corridor.)

George: 007. They're calling me 007, aren't they?

Izzie and Meredith: No one's calling you 007.

George: I was on the elevator and Murphy whispered 007.

Cristina: Oh, how many times do we have go through this, George, five, ten? Give me a number or else I'm going to hit you.

George: Murphy whispered 007 and everyone laughed.

Izzie: He wasn't talking about you.

George: You sure?

Meredith: Would we lie to you?

George: Yes.

Cristina: 007 is a state of mind.

George: So says the girl who finished top of her class at Stanford.

Pagers beep.

Meredith: Oh man. It's 911 for Katie Bryce. I gotta go. (takes off at a run)

George: Maybe I should've gone into geriatrics. No one minds when you kill an old person.

Cristina: Surgery is hot, it's the Marines, it's the macho, it's hostile, it's hardcore. Geriatrics is for freaks who live with their mothers and never have s*x.

George: I've got to get my own place.

(Cut to Meredith running to Katie. She goes in, Katie's reading a magazine.)

Katie: Took you long enough.

Meredith: You're okay? The nurse paged me 911.

Katie: I had to go all Exorcist to get her to even pick up the phone.

Meredith: Wait. There's nothing wrong with you?

Katie: I'm bored.

Meredith: You little...I'm not a cruise director.

Katie: You don't have to wig out. The pageant's supposed to be on cable, but this crappy hospital doesn't get the channel. If that cow Kylie Wood is gonna walk off with my crown, I have to see it. Can you call someone?

Meredith: Okay. This is an actual hospital. There are sick people here. Go to sleep, and stop wasting my time.

Katie: But I can't sleep. My head's all full.

Meredith: That's called thinking. Go with it.

(Cut to Bailey, collapsed on a stretcher in a hallway. Izzie is standing nearby, looking uncertain.)

Nurse: What do you need?

Izzie: Mr Jones has junkie veins and he really needs antibiotics so I should start a central line.

Nurse: So start one. (Pause.) You don't know how.

Izzie: I've never done one.

Nurse: Well, you know what that means. (looks to Bailey)

Izzie: Can't we just...page someone else?

Nurse: She's the on-call resident.

Izzie: Okay. Okay, I'll just - I'll wake her. (walks over, taps Bailey's shoulder) Dr Bailey, I don't mean to bother you, but -

Bailey: Then don't.

Izzie: It's Mr. Jones.

Bailey: Is he dying?

Izzie: No.

Bailey: Then stop talking to me.

(Izzie turns away, turns back. Bailey gives up on sleep and sits up.)

Bailey: What is it?

(Cut to Bailey finishing up with the central line.)

Bailey: Next time you wake me, he better be so close to dead there's a tag on his toe.

(Cut to the city going from night to day. Several shots of Cristina/George/Izzie looking overworked.)

Karev (male intern): 4B's got post-op pneumonia. Let's start antibiotics.

Nurse: Are you sure that's the right diagnosis?

Karev: Well I don't know, I'm only an intern. Here's an idea, why don't you go spend four years in med school and let me know if it's the right diagnosis. She's short of breath, she's got fever, she's post-op. Start the antibiotics. (walks over to Meredith) God I hate nurses. I'm Alex. I'm with Jeremy, you're with the Nazi, right?

Meredith: She may not have pneumonia, you know. She could be splinting, or have a PE.

Karev: Like I said, I hate nurses.

Meredith: What did you just say? Did you just call me a nurse?

Karev: Well, if the white cap fits...

Meredith's pager beeps and she walks away.

Meredith: Damnit, Katie...(not running this time)

Karev: She seeing anybody?

George: I don't know.

Karev: (whistles) She's hot.

George: I'm friends with her. I mean, kinda friends, I mean, not, you know, actually friends, not exactly, but we're tight. We hang out. I mean, really only just today -

Karev: Dude.

George: - but -

Karev: Dude. Stop talking.

(Cut to Meredith, walking up the stairs to Katie. She's not in a hurry. She sees nurses rushing into the room and starts to run.)

Nurse 1 (echoey voice): What took you so long?

Nurse 2 (echoey voice): She's having multiple grand mal seizures, now how do you want to proceed? Dr. Grey? Are you listening to me? She's got Diazepam, 2mg Diazepam, I just gave her a second ago, Dr. Grey, you need to tell us what you want to do. Dr Grey!

(Meredith is panicking. She picks up the chart and voices stop sounding echoey.)

Meredith: Okay, she's full on Prazepam?

Nurse 1: She's had 4mg.

Meredith: Did you page Dr. Bailey and Dr Shepherd?

Nurse 2: The Prazepam's not working.

Meredith: Phenobarbital, load her with Phenobarbital.

Nurse 2: Pheno's in.

Nurse 3: No change.

Meredith: You paged Dr. Shepherd?

Nurse 3: I just told you.

Meredith: Well page him again! Stat.

Nurse 2: What do you want to do? (back to echoey voice) Dr. Grey, you need to tell us what you want to do!


Nurse 2: Heart's stopped!

Nurse 1: Code blue, code blue! Code blue, code blue!

They pull out the defibrillators. Meredith takes them, her brain's working again.

Meredith: Charge pulse of two hundred.

Nurse: Charged. Clear. (Meredith defibs)

Nurse 2: Still defib. Nothing.

Nurse 1: Charging. 19 seconds.

Meredith: Charge to 300.

Nurse 1: 300. Anything? 27 seconds.

Meredith: Charge to 360. (still nothing) Come on, Katie.

Nurse 3: 49 seconds.

Nurse 2: At 60 seconds you're supposed to admit her -

Meredith: Charge again! (nurse doesn't) Charge again. (nurse does, we see Katie's BP register) Anything?

Nurse 1: I see sinus rhythm.

Nurse 2: Blood pressure's coming up.

Nurse 1: All right now. Pressure's returning. Grid's coming back...

(Shepherd runs in.)

Derek: What the hell happened?

Meredith: She had a seizure, and -

Derek: A seizure?

Meredith: her heart stopped.

Derek: You were supposed to be monitoring her.

Meredith: I checked on her and she -

Derek: I got it. Just - just - go. (Meredith turns away) Someone give me her chart, please?

(Cut to Meredith walking towards Bailey.)

Bailey: You get a 911, you page me immediately, not in the five minutes it takes you to get to the emergency, immediately, you are on my team and if somebody dies it's my ass, (Meredith's walking away) you hear me, Grey?

Cristina: Meredith?

(Meredith walks outside into the rain, Cristina follows. Meredith throws up on the grass; Cristina has stopped at the door.)

Meredith: If you tell anyone, ever...(re-enters hospital).

(More cityscape and sunrise: Hour 24.)

Katie's father: (to Derek) You said it was a seizure disorder. Now you're saying it isn't?

Derek: I'm saying that I don't know.

Mother: Well, what do you think it could be?

Derek: I don't know.

Father: (frustrated) When will you know?

Derek: I don't have an answer for you. For now, Katie is stable -

Father: Wait one damn minute. We came here because this hospital is supposed to be the best in Washington. That's my kid in there. My kid. And you have the audacity to stand here and tell me I don't know?

Derek: Mr. Bryce, -

Father: No, I want someone else. A doctor who knows what they're doing. You get me someone else. Someone better than you.

Derek: Mr Bryce, I assure you that I am working hard on Katie's case.

Father: No, you're not. If you were, you'd be able to give me some answers.

(Cut to Burke, talking to the guy who can't eat any more bacon.)

Burke: I put you on a bypass machine, which pumps blood for your heart, fix your ticker, take you off the machine, I'm done. Simple procedure.

Woman: So, I shouldn't worry?

Burke: I'm very good at what I do. It's still a surgery. There are some risks. I'll see you in the OR this afternoon, Mr. Savage.

Mr Savage: You're not going to leave me in there alone with that guy, are you?

George: Oh, I'll be outside the OR the whole time. Dr Burke is very good. Don't worry. I'll see you after.

Mrs. Savage: He'll be fine, right?

George: It's one he's going to sail through. You have nothing to worry about. I promise. Gotta go.

(Cut to Cristina and Meredith.)

Meredith: What are you doing?

Cristina: I'm suturing a banana, with the vain hope that it wakes up my brain.

(George laughs.)

Cristina: What're you smiling at, 007?

(George stops laughing.)

Cristina: I'm sorry, I get mean when I'm tired.

George: You know what? I don't care. I comforted a family, and I get to hang out in the OR today. All is well.

Cristina: Does anybody know why we're here? (lots of interns, packed into one room. Derek enters.)

Derek: Well good morning. I'm going to do something pretty rare for a surgeon, I'm going to ask interns for help. I've got this kid, Katie Bryce. Right now, she's a mystery. She doesn't respond to her meds. Labs are clean, scans are pure, but she's having seizures. Grand mal seizures with no visible cause. She's a ticking clock. She's going to die, if I don't make a diagnosis. Which is where you come in. I can't do it alone. I need your extra minds, extra eyes, I need you to play detective, I need you to find out why Katie is having seizures. I know you're tired, you're busy, you've got more work than you could possibly handle. I understand. So, I'm going to give you an incentive. Whoever finds the answer rides with me. Katie needs surgery. You get to do what no interns get to do. Scrub in to assist on an advanced procedure. Dr Bailey's going to hand you Katie's chart. The clock is ticking fast, people. If we're going to save Katie's life, we have to do it soon.

(All interns grab copies of her chart. Cut to Meredith and Alex.)

Alex: Look, give the antibiotics time to work.

Nurse: The antibiotics should've worked by now.

Alex: She's old, she's freaking ancient. She's lucky she's still breathing. Now, I got a shot to scrub in downstairs and a patient who wasn't alive during the civil war. Don't page me again. (walks off, Cristina comes over)

Cristina: Hey, I want in on Shepherd's surgery. You've been the intern on Katie since the start. You want to work together? We find the answer, we have a fifty-fifty chance of scrubbing in.

Meredith: I'll work with you, but I don't want in on the surgery. You can have it.

Cristina: Are you kidding me? It's the biggest opportunity any intern will ever get.

Meredith: I don't want to spend any more time with Shepherd than I have to.

Cristina: What do you have against Shepherd?

Meredith: If we find the answer, the surgery's yours. Do you want to work together or not?

Cristina: (grinning and shaking her head) Deal.

(Cut to library.)

Cristina: Well, she doesn't have anoxia, chronic renal failure or acidosis. It's not a tumour because her CT's clean. Are you seriously not going to tell me why you won't work with Shepherd?

Meredith: No. What about infection?

Cristina: No. There's no white count, she has no ceteal lesions, no fevers, nothing in her spinal tap, just tell me.

Meredith: You can't comment, make a face, or react in any way. We had s*x.

(Cristina opens her mouth, closes it, and)

Cristina: What about an aneurysm?

Meredith: No blood on the CT, and no headaches.

Cristina: Okay. There's no drug use, uh, no pregnancy, no trauma...was he good? I mean, he looks like he would be, was it any good?

Meredith: What are the answers? What if no one comes up with anything?

Cristina: You mean if she dies?

Meredith: Yeah.

Cristina: This is gonna sound really bad, but I really wanted that surgery.

Meredith: She's just never going to get the chance to turn into a person. The sum total of her existence will be almost winning Miss Teen whatever. You know what her pageant talent is?

Cristina: They have talent?

Meredith: Rhythmic gymnastics. (they laugh)

Cristina: Oh, come on.

Meredith: What is rhythmic gymnastics? I don't know - I can't even say it, I don't know what it is.

Cristina: Isn't it like something with a ball, and a (Meredith goes still) ...what? Meredith, what?

Meredith: Get up! Come on!

(Cut to them running.)

Cristina: - the only thing she could possibly need is a - Oh, oh, Dr. Sheppard! Just one moment, um, uh, Katie competes in beauty pageants -

Derek: I know that, but we have to save her life anyway.

Cristina: Okay, she has no headaches, no neck pain, her CT's clean, there's no medical proof of an aneurysm -

Derek: Right.

Cristina: - but what if she has an aneurysm anyway?

Derek: There are no indicators.

Cristina: Ah, but she twisted her ankle, a few weeks ago when she was practising for the pageant -

Derek: Look, I appreciate you're trying to help, but -

Other doctor in elevator: This is not helping!

Meredith: She fell. When she twisted her ankle, she fell.

Cristina: It was no big deal, not even a bump on the head, you know she got right back up, iced her ankle and everything was fine, it was a fall so minor her doctor didn't even think to mention it when I was taking her history, but she did fall.

Derek: Well, you know the chances that a minor fall could burst an aneurysm, one in a million! Literally.

The elevator door is finally allowed to close. Meredith and Cristina sigh and turn away. The elevator dings and Derek steps out. They turn back.

Derek: Let's go.

Cristina: Where?

Derek: To find out if Katie's one in a million.

Cut to Cristina, Meredith and Derek looking at a scan.

Derek: I'll be damned.

Tech operating scan: (indicating dark spots) There it is.

Derek: It's minor, but it's there. It's a cerebachnoid haemorrhage. She's bleeding into her brain.

Cut to Meredith, Derek and Cristina walking.

Derek: She could've gone her entire life without it ever being a problem. One tap in the right spot -

Cristina: And explode.

Derek: Exactly. Now I have to fix it. You two did great work. Love to stay and kiss your asses, but I gotta tell Katie's parents she's having surgery. Katie Bryce's chart, please.

Receptionist: Here you go.

Cristina: Oh, and Dr Sheppard, you said that you'd pick someone to scrub in if we helped.

Derek: Oh, yes, right. Um, I'm sorry I can't take you both, it's going to be a full house. Meredith, I'll see you in OR.

(They stand there for a moment or two. Cristina looks at Meredith, who's flustered.)

Derek: Good. Thank you. (leaves)

(Cristina looks back at Meredith and walks off, clearly pissed.)

Meredith: Cristina...

(Cut to George watching bacon-man's surgery. It finishes, Burke leaves.)

George: Wow, that was quick.

Burke: His heart had too much damage to give him a bypass. I had to let him go. It happens, rarely. But it does happen. The worst part of the game.

George: But I told his wi- I told Gloria that he would be fine. I promised her that -

Burke: You what?

George: They have four little girls -

Burke: Who the hell are you to promise anything on - this is my case. Did you hear me promise? The only one that can keep a promise like that is God, and I haven't seen him holding a scalpel lately. You never promise a patient's family a good outcome!

George: I - I thought -

Burke: You're important enough to make promises to Mrs. Savage, you get to be the one to tell her that she's a widow.

(Cut to Izzie and Cristina, sitting on the spare beds in the empty corridor again.)

Cristina: Izzie.

Izzie: Maybe Meredith couldn't -

Cristina: Izzie!

Meredith comes in.

Meredith: I'll tell him I changed my mind, you can -

Cristina: No, no, don't do me any favours. It's fine.

Meredith: Cristina, -

Cristina: You know what, you did a cutthroat thing, deal with it. Don't come to me for absolution, you want to be a shark, be a shark.

Meredith: I'm not -

Cristina: Oh yes you are. Only it makes you feel all bad in your warm gooey places. No, screw you. I don't get picked for surgeries because I slept with my boss, and I didn't get into med school because I have a famous mother. You know, some of us have to earn what we get.

Meredith leaves. Cut to George going to see Mrs. Savage.

George: Gloria...there were complications in the surgery. Tony's heart had a, a lot of damage. They - we tried to take him off bypass, but...there wasn't anything we could've done.

Gloria: Uh...what are you talking about?

George: He...Tony died. He's dead. Gloria, I'm so sorry.

Gloria: (whispered) Thank you. Please...go away.

(He does. We hear her crying. Cut to Derek shaving Katie's head while Meredith looks on.)

Derek: I promised I'd make her look cool. Apparently being a bald beauty queen is the worst thing that happened in the history of the world.

Meredith: Did you choose me for the surgery because I slept with you?

Derek: (straight-faced) Yes. (pregnant pause) I'm kidding.

Meredith: I'm not going to scrub in for surgery. You should ask Cristina. She really wants it.

Derek: You're Katie's doctor. And on your first day, with very little training, you helped save her life. You earned the right to follow her case to the finish. You...you shouldn't let the fact that we had s*x get in the way of you taking your shot.

(Cut to George and Meredith sitting outside.)

Meredith: I wish I wanted to be a chef. Or a ski instructor. Or a kindergarten teacher.

George: You know, I would've been a really good postal worker. I'm dependable. You know, my parents tell everyone they meet that their son's a surgeon. As if it's a big accomplishment. A superhero or something. If they could see me now...

Meredith: When I told my mother I wanted to go to medical school, she tried to talk me out of it. Said I didn't have what it takes to be a surgeon. That I'd never make it. So, the way I see it, superhero sounds pretty damn good.

George: We're going to survive this, right?

(Cut to Dr Webber (head of the hospital) talking to Alex.)

Webber: She's still short of breath. Did you get an ABG or a chest film?

Alex: Oh, yes sir, I did.

Webber: And what did you see?

Alex: Oh, well, I had a lot of patients last -

Webber: Name the common causes of post-op fever.

Alex: Uh...yes, sir. (pulls notebook out of pocket)

Webber: From your head. Not from a book. Don't look it up, learn it, it should be in your head. Name the common causes of post-op fever.

Alex: Uh...the common causes of post-op...

Webber: (loudly) Can anybody name the common causes of post-op fever?

(Everybody stops, one girl pulls out her notebook.)

Meredith: Wind, water, wound, walking, wonder drugs. The five Ws. Most of the time it's wind, splinting or pneumonia. Pneumonia's easy to assume, especially if you're too busy to do the tests.

Webber: (gives Alex a pointed look, then to Meredith) What do you think's wrong with 4B?

Meredith: The fourth W, walking. I think she's a prime candidate for a pulmonary ambulus.

Webber: How would you diagnose?

Meredith: Spiral CT, VQ scan, provide O2, dose with Heparin, and consult for an IVC filter.

Webber: (to Alex) Do exactly as she says, then tell your resident that I want you off this case. (to Meredith) I'd know you anywhere, you're the spitting image of your mother. Welcome to the gang.

(Cut to Katie's surgery. Meredith is there.)

Derek: All right everybody, it's a beautiful night to save lives, let's have some fun.

Meredith voiceover: I can't think of any one reason why I want to be a surgeon. But I can think of a thousand reasons why I should quit.

(Cut to Bailey sleeping and Izzie walking towards her again.)

Meredith VO: They make it hard on purpose. There are lives in our hands.

(Cut to the surgery.)

Meredith VO: There comes a moment when it's more than just a game. And you either take that step forward, or turn around and walk away. (Cristina is seen watching from the gallery. Sheppard waves Meredith over to look through the magnifiers at what's happening.) I could quit. But here's the thing: I love the playing field.

(Fade to Meredith sitting outside the OR, dazed. Cristina walks through the door and turns back.)

Cristina: It was a good surgery.

Meredith: Yeah.

(Hour 48. Cristina sits and sighs.)

Cristina: We don't have to do that thing where I say something, and then you say something, and then somebody cries, and there's like a moment...

Meredith: Yuck.

Cristina: Good. You should get some sleep. You look like crap.

Meredith: I look better than you.

Cristina: It's not possible.(leaves)

(Derek comes through the same door, stops at a desk to do some paperwork. Meredith stares at him, still looking dazed.)

Meredith: That was amazing.

Derek: Mmmm.

Meredith: You practice on cadavers, you observe, and you think you know what you're going to feel like standing over that table, but...that was such a high.

Derek looks at her properly now and nods.

Meredith: I don't know why anybody does drugs.

Derek: (nodding slightly, looking tired) Yeah.

Meredith: (smiling) Yeah.

Derek: (smiling back a bit) I should go do this.

Meredith: You should.

Derek: (going) I'll see you around.

Meredith: See you around. See ya.

(Cut to outside the hospital, we see Izzie, George, Cristina and Meredith walking to the parking lot.)

Meredith VO: So. I made it through my first shift. We all did. The other interns are all good people, you'd like them. I think. I don't know. (fade to Meredith running up stairs in the rain, under an umbrella) Maybe. I like them. (She enters a building, reception waves her on) Oh, and I changed my mind. (Close-up on an older woman). I'm not going to sell the house. I'm going to keep it. I'll have to get a couple of roommates, but (we see Meredith is talking to her) it's home, you know?

Older woman: Are you the doctor?

Meredith: No. I'm not your doctor. But I am a doctor.

Older woman: What's your name?

Meredith: It's me, mom. Meredith.

Ellis Grey: All right. (fidgets with her watch) I used to be a doctor, I think.

Meredith: (taking her hand) You were a doctor, mom. You were a surgeon.

(Slow zoom out and fade to black on the two.)