01x06 - If Tomorrow Never Comes


1x06: If Tomorrow Never Comes

Original Airdate: 5/1/2005

Written by: Krista Vernoff

Directed by: Scott Brazil

(Scene: Sunrise)

MVO: A couple hundred years ago, Benjamin Franklin shared with the world the secret of his success. "Never leave that till tomorrow," he said, "which you can do today."

(Scene: Meredith lying in bed, staring at the ceiling. It is storming outside and her alarm starts buzzing.)

MVO: This is the man who discovered electricity. You'd think more of us would listen to what he had to say.

(Scene: George walking through the hall towards Meredith's room with two cups of coffee. Izzie comes out into the hall. George spills the coffee on himself.)

MVO: I don't know why we put things off, but if I had to guess, I'd say it has a lot to do with fear. Fear of failure, fear of pain, fear of rejection.

Izzie: Wouldn't it be easier to just ask her out?

(George walks away and Meredith hits snooze again.)

George: She's gonna be late.

Izzie: Maybe not.

George: We should wait for her.

Izzie: Definitely not. I'm not her mother, and you are not her boyfriend. Not yet, anyway.

George: Stop, ok? I told you I'm not interested.

Izzie: Life is short, George. Do you really want to die before you ever ask her out?

George: I do not want to ask her out.

Izzie: Do you really want to die a liar?

George: I'm not...I'm not dying.

(Seattle scenes)

MVO: Sometimes, the fear is just of making a decision.

(Scene: SGH parking lot, Meredith is rushing)

MVO: Because, what if you're wrong? What if you're making a mistake you can't undo?

(Derek arrives and parks next to Meredith)

Meredith: Crap.

Derek: Crap?

Meredith: Hi. I'm late.

Derek: You're avoiding me.

Meredith: Yes, but also late.

Derek: Ok, are we going to talk about this?

Meredith: No.

Derek: About us and Bailey and what she saw?

Meredith: I don't need to talk about it. I experienced it, naked.

Derek: This is getting complicated.

Meredith: Complicated for me. I'm the intern sleeping with the attending. Bailey isn't speaking to me anymore.

Derek: Not that that's a bad thing. If I was a better guy, I'd walk away.

Meredith: Yes, you would.

Derek: Do you want me to be a better guy?

Meredith: Yes.

(They enter hospital. He pushes elevator button.)

Meredith: No. Crap. I'm late.

(Meredith walks away.)

Derek: Take your time. Think about it.

(Scene: Cristina putting pants on. Her and Burke obviously just finished having s*x in a lab room.)

Cristina: That was definitely worth being late.

Burke: (Sighs) Thanks. Is this a...? Should we talk about this?

Cristina: Yeah, definitely.

(Cristina leaves then enters the locker rooms. Meredith is inside.)

Meredith: You're late.

Cristina: So are you.

Meredith: I know, and I can't afford to piss off Bailey any more. Do you think she told anyone?

Cristina: About you and McDreamy?

Meredith: Yeah.

Cristina: No, he's her boss too.

Meredith: If they find out, what can they...? Can they kick me out, or...?

Cristina: No... Not officially. You'll just get edged out, blacklisted, banned from his surgeries, passed over for chief resident. (Sighs) It'll be humiliating, but you'll live.

Meredith: I have to end it. I definitely have to end it. I have to end it, right?

Cristina: Meredith, shut up.

Meredith: What?

(Meredith and Cristina are rushing upstairs and through hallway.)

Meredith: Did you seriously just tell me to shut up?

Cristina: Oh, please. You got a hot doctor who like to make you open up, and say "ahh." It's the American dream, stop whining about it.

Meredith: No. No good can come from sleeping with your boss.

Bailey: Cristina, you're late.

Cristina: So is Meredith.

MVO: Whatever it is we're afraid of, one thing holds true. That, by the time the pain of not doing a thing gets worse than the fear of doing it, it can feel like we're carrying around a giant tumor.

Bailey: When we walk in this door, you will maintain decorum. You will not laugh, vomit, or drop you jaw. Are we understood?

(All open door and enter room 2111)

Izzie: Why would we laugh?

Alex: Oh, just you wait.

Bailey: Good morning, Miss Connors.

Miss Connors: Good Morning.

(Woman is lying in bed with an extremely large tumor.)

George: What is it?

Cristina: Tumor.

MVO: And you thought I was speaking metaphorically.

(Seattle Scenes)

(Annie Connor's room)

Alex: Good morning, Annie. How are you? This is Dr. Bailey and these are my fellow interns.

Bailey: Dr. Karev, we refer to patients as "mister"...

Annie: I told him to call me "Annie." "Miss Connors" makes me feel old and fat, which I am, but why feel that way?

(Burke enters)

Burke: Good morning.

Alex: Annie, this is Dr. Burke (Whispers) Awesome surgeon.

Bailey: Dr. Karev.

Alex: Annie Connors is a 43-year-old woman who presented last night with progressive shortness of breath for the past three months. Found to have a very large tumor of unknown origin pressed against her diaphragm. Stable vital signs. Scheduled for CT this morning, sir.

Burke: Thank you, Dr. Karev. (To Annie) Are you at all claustrophobic?

Annie: I've been housebound for the last year. How claustrophobic could I be?

Burke: All right then. Dr. Stevens is going to take you up for a CT. It'll give us a better look at the tumor, and we'll know how to proceed.

Annie: Could someone tell my mom? She'll worry if she gets back and I'm not here.

Burke: Yeah, of course. Of course.

Annie: And would it be possible for Alex to take me instead? I mean, he...He's just so fun to look at.

Alex: (Laughing) Annie.

Burke: Sure. Sure, Ms. Connors. Excuse me.

(Leave Ms. Connor's room)

Izzie: How much do you think it weighs?

George: 60 pounds.

Izzie: More. She's carrying a whole extra person.

Cristina: This one's going in the books. I've got to get in.

Izzie: I almost did. Have you ever seen Alex like that? He actually seemed sincere.

Meredith: "Seemed" being the operative word.

Alex: He was on call last night when she came in. I am never leaving this place again.

Bailey: Let's move, people. Ms. Connor's surgery, should we choose to proceed, will take most, if not all, of the surgeons off the floor, which means you people will have to work extra hard not to kill anyone, �cause we won't be there to fix your mistakes.

Cristina: I really want in on this.

Burke: I thought we weren't talking.

Cristina: I'm not talking. I'm just saying.

Burke: Find her mother, get a family history, and I'll tell Bailey.

(Another room)

Izzie: Mr. Harper had a coronary bypass yesterday. His blood pressure, currently 100/65. It was running low overnight down to 70/30, but responded to medication. Postoperative labs show a crit of 30 and normal coagulation. Chest-tube output has halted over the last two hours.

Bailey: What's you plan?

Izzie: Chest x-ray and check the tube for possible occlusion.

Bailey: Good. (To wife) He's doing fine.

Mrs. Harper: Thank you.

(Scene: Walking down stairs in SGH)

George: I know you think I like Meredith but I don't like Meredith.

Izzie: What?

George: No. I like Meredith. Obviously, I like Meredith. I just...I don't have a thing for her.

Izzie: Ok.

George: It's just this morning...I know you were probably just teasing, But I don't want you to say anything like that to her. Because you know, we live together, and that'd be awkward.

Izzie: George, stop talking.

George: Ok, then.

(Scene: Hospital room where a man is trying to walk but is having difficulty.)

Bailey: Morning.

Derek: Mr. Levangie, this is Dr. Bailey and her fine staff of surgical interns.

(Derek, Meredith and Bailey all exchange glances.)

Mr. Levangie: Welcome to hell, kids.

Bailey: Who's presenting?

George: Edward Levangie is a 63-year-old man admitted for pain management for Dyskinesia. He's been stable since last night, and responding to the bolus injections.

Bailey: Izzie, possible treatments?

Izzie: For Parkinson's disease? Um, deep brain stimulation has shown...

Derek: Not for Parkinson's, for spinal pain.

Izzie: Oh, um...

Meredith: Intraspinal catheter. That way, he can have constant pain medication.

Derek: Excellent. This is Dr. Grey. She's gonna prep you for the procedure and assist.

Derek: (Pager beeps) Excuse me.

Bailey: You make yourselves busy, I'll catch up with you.

(Bailey follows Derek out. They are in elevator alone.)

Derek: Miranda.

Bailey: Excuse me?

Derek: Well, that's your name, right? It's on your jacket. (She looks smug) All right, fine. I'll just call you Bailey then.

Bailey: You think you're charming in that talented, neurotic, overly moussed hair sort of way, good for you. But if you think I'm going to stand back and watch while you favor her...

Derek: I don't favor her. She's good.

Bailey: I'm sure she is.

(Elevator opens and Bailey gets out)

Derek: You know, can I point out that, technically, I'm your boss?

Bailey: You don't scare me. Look, I'm not going to advertise your extracurricular activities with my intern. However, the next time I see you favoring Meredith Grey in any way, I'll make sure she doesn't see the inside of on OR for a month. Just for the sake of balance.

(Bailey walks away and elevator closes with Derek inside.)

(Alex is getting Annie ready for her CT.)

CT Tech: We're all set, doc.

Alex: Ok. (To Annie) There's going to be a microphone in there for you in case you get scared or you want to get out, but, um you know, try not to do that, because then we're going to have to start all over again.

Annie: I'm fine. I'll be fine.

Alex: I know you're going to be fine, because I'm going to be right over there behind that glass, waiting for you. All right?

Annie: Ok.

Alex: You ready? Are you really ready? Let's do this. (Pushes button) See ya.

(Alex goes into the operator room, his pager makes a noise, he slaps it.)

Alex: Oh, hey, man, you got an extra battery?

CT Tech: Unbelievable.

Alex: Oh, I know, right.

CT Tech: I've never seen anything like this. God.

Alex: Well, what I don't understand...is how a person lets it get like that. (Annie can hear Alex speaking) I mean, man, that is a whole lot of nasty.

CT Tech: Maybe she's afraid of doctors. Poor thing.

Alex: Poor thing? Please. If you're afraid of doctors, you take a pill. She's just sick, like, warped, you know? Seriously, I don't know how she lives with herself.

(Scene: Cristina talking to Mrs. Connors in the hospital lobby.)

Mrs. Connors: Well, at first, we thought she was just putting on weight. When we realized what was happening, I tried to get her to go to the doctor, but she was scared. And, the bigger it got, the less she wanted to go. And she never really felt all that sick until last night. She couldn't breathe.

Cristina: Because the tumor was crushing her lungs.

Mrs. Connors: Yes, well, I called 911. It just seemed like the right thing to do.

Cristina: You know, the right thing to do would have been to call a year ago. Thank you.

(Mr. Levangie's room)

Meredith: Ok, Mr. Levangie. We're going to get you more comfortable, ok? I'm going to go downstairs and I'll be back up shortly.

Mr. Levangie: Ok

Meredith: Ok.

(Meredith leaves; daughter follows her into the hall)

Ms. Levangie: Excuse me. I'm sorry, doctor...

Meredith: Grey.

Ms. Levangie: My dad seems to like you. He's always liked skinny blondes. Is that rude? I'm sorry. I'm so tired.

Meredith: Is there something...?

Ms. Levangie: I was wondering if you would talk to him.

Meredith: About?

Ms. Levangie: Brain surgery. The doctor mentioned it, and I've read about it online. If it worked, it could help with most of his symptoms, not just his pain.

Meredith: Is he a candidate? I don't...

Ms. Levangie: He is, but he's afraid of it. Surgery on his back, he can understand, but his brain...And there are risks. But his quality of life...

Meredith: There isn't any.

Ms. Levangie: And, it keeps getting worse. I'm getting married next month. I already lost my mom. And I want him to walk...I want him with me. Maybe that's selfish, but...you don't know what it's like having a parent...Watching him...

Meredith: I do. I do know what it's like. I'll see what I can do.

Ms. Levangie: Thanks

Meredith: You're welcome.

Ms. Levangie: Thank you.

(Meredith walks away. Bailey, Derek and Burke are examining x-rays from Annie Connors.)

Burke: The right hemidiaphragm is so high that it's completely displacing her lung tissue.

Derek: It's infiltrated her spinal canal in three places. We should start there. It's going to take 3 or 4 hours to get around those nerves.

Burke: I'd prefer to start in front, and then flip her. You never know what kind of vessels are involved, how intertwined they are. I'm going to need a good head start.

Derek: I should really go with the spine fresh, if I miss a step, she's paralyzed.

Burke: If I don't relieve the pressure on her lungs, she'll be dead. So, she won't mind if she can't walk.

Bailey: Do you think she really wants to live? Come on. She's been housebound. She's been living under this thing, just watching it grow for how long? She doesn't seem stupid. Doesn't even seem all that scared. Why would anyone wait this long unless they wanted to die?

Derek: People do things every day that they know could kill them. Doesn't mean they want to die.

Bailey: What are her chances of surviving the surgery?

Burke: Slightly better than if we do nothing.

Bailey: So is it worth it? (Burke looks at her, Derek sighs) Hey, come on. You were already thinking it, I'm just saying.

Burke: She's 43. It's worth a try.

(Burke leaves)

Derek: Ha! Morning.

(Derek and Bailey leave, Meredith is waiting in the hall.)

Meredith: Dr. Shepherd. Mr. Levangie, the Parkinson's patient, is he a good candidate for DBS?

Derek: Yes, but he's not interested.

Meredith: Ok, but I think it's worth talking to him again, pushing him.

Derek: We're talking about a brain surgery that is performed while the patient is wide awake, a risk of paralysis, a risk of death. And, the patient doesn't want it. It is not my job to push him into anything and it's definitely not yours.

Meredith: Ok.

Derek: Since you clearly uncomfortable with my decision in this case, it's probably best you don't scrub in.

Meredith: But...

Derek: It's a minor procedure. You won't be missed.

(Meredith walks away)

Derek: (To Bailey) You know, they call you the Nazi.

Bailey: So I've heard.

(Derek and Bailey walk away in opposite directions.)

(Annie Connors room, Burke and Alex are there. Mrs. Connors is making the bed. )

Burke: I won't lie to you. The surgery is going to be long and difficult, but we have an extremely capable surgical team, and I can...

Annie: Am I going to die?

Burke: There's always that risk but if we don't do the surgery...

Annie: I'll definitely die.

Burke: Yes.

Annie: Soon?

Burke: Yes.

Annie: Mom, the room's clean.

Mrs. Connors: Ok, honey, ok.

Annie: Mom!

Mrs. Connors: She'll have the surgery.

Annie: Mom!

Mrs. Connors: No. No, Annie. She will have the surgery.

Annie: I guess I'll have the surgery.

Burke: I think that is a very wise decision.

Annie: On one condition. I don't want him there. (Points at Alex)

Alex: I'm sorry, Annie. Did I upset you in some way?

Annie: If he's in the surgery, I'm not having it. (Pause while Burke and Alex look at her and each other) That's how I live with myself.

Burke: Ok, Miss Connors. (Turns to leave) Dr. Karev.

(Annie and her mom hold hands)

(Burke and Karev walk through hallway)

Burke: What the hell did you do?

Alex: Nothing. I-I don't know. Man. The mike must have been on. I was talking to the tech guy...

Burke: If anything goes wrong, anything, you are 60 percent more likely to be sued if you've offended the patient. 60%.

Alex: I never would have said that stuff. The mike shouldn't have been on. I didn't realize she could hear me.

Burke: Well, now you won't realize you chance to scrub in. You're banned from the OR. Mine or anyone else's. All week.

(Cristina walks up)

Cristina: I got the history on the tumor. It's been growing for a year and a half. A year and a half and it's the first time she's even had it looked at. It's like she's fatally lazy.

(Burke walks away, shaking his head)

Alex: Why doesn't she get banned?

(Burke grabs George who is walking by)

Burke: Go prep Annie Connors for surgery. You're scrubbing in with Cristina.

George: Really? I mean, thank you. Ok.

(George is in Annie Connor's room, prepping her for surgery)

George: We just need to recheck your labs and get an EKG, so I just need to take a little blood. Dr. Burke is great, and Dr. Bailey. I know you're probably scared.

Annie: That's ok, kitten. You can just do your job. You don't have to talk to the fat, nasty tumor lady. I mean, I let it get this bad. How much sympathy do I deserve?

George: Why did you let it get this bad?

Annie: You're the first person since I got here to ask me that.

George: Well, I guess it's just like the elephant in the room.

Annie: Elephant?

George: I mean...

Annie: It's more like a giant sow, don't you think? (They smile at each other) Every time I went to the hospital, someone died. All four of my grandparents, then my dad. My best friend's mom, my baby sister. They all went in, never came out. So I put it off.

George: You know, you're not the only one to put things off. I mean I never do anything till the last possible minute.

Annie: Like what?

George: Well...I've had this thing for my roommate since, like, day one, and I just...I can't tell her. She probably wouldn't go out with me, anyway, but...How do I know that for sure, if I don't ever ask?

Annie: Seriously? You're equating your pathetic love life with my record-breaking tumor? Seriously?

(Scene: Outdoor lunch tables)

Meredith: It's just that he blatantly favors me in front of her and then blatantly dismisses me.

Cristina: How do you know he was favoring you? Look, you've got a brain. You got into this program. Just because Shepherd wants to munch your cookies doesn't mean you didn't deserve what you worked for.

Meredith: But he's making me look bad. I have to end it.

Cristina: Right.

Meredith: It's over.

Cristina: Uh, huh.

Alex: Is it true you get to scrub in on that tumor?

Cristina: Don't sit here.

Izzie: You get to scrub in? How psyched are you?

Cristina: On a scale of one to ecstatic, ecstatic.

Alex: It's unbelievable. You know what I think? I think Burke wants to get into your scrubs.

Cristina: Why are you sitting here?

Alex: He kicked me off that surgery for the same crap you pull every day.

Cristina: You know what. If I stuck this fork into his thigh, would I get in trouble?

Meredith: Not if you make it look like an accident.

George: Hey!

Izzie: Hi.

Alex: Thank God, man. I'm drowning in estrogen here.

George: (To Meredith) You look...is everything ok?

Meredith: Shepherd's a jackass.

Izzie: Really? I think he's kind of great.

Cristina: He reamed her out in front of Bailey.

Izzie: Why?

Meredith: Cause he's a jackass.

George: Oh. (Throws his tray) Well, bad days are...bad. Maybe tonight, uh, if, you know, if you drink alcohol, I mean, we could all of us, I mean, go out and drink alcohol...because of the bad day.

Meredith: (Pager beeps) I got to go.

Alex: Dude.

George: Shut up.

(Cristina and Alex laugh at George, Izzie pats his shoulder)

(Mr. Levangie's room)

Derek: How's your back?

Mr. Levangie: Still good.

Derek: Good. (To daughter) How are you? Good? (To Mr. Levangie) Can you lean forward for me? I just want to check something. Does that feel ok?

Mr. Levangie: Yeah.

Derek: Right here?

(Meredith enters)

Meredith: Did you page?

Derek: Mr. Levangie, have you given any more thought about the other surgical options we discussed this morning?

Mr. Levangie: What? Why would I? I already told you no. I'm letting you cut into my back, but that's not enough for you. All you guys ever want to do is cut.

Ms. Levangie: Dad, just listen to what he has to say.

Mr. Levangie: I already listened.

Derek: Sir, there's a very small window of opportunity here. You know, once the Parkinson's progresses to a point of dementia, there's, you know, you're no longer a candidate for DBS.

Mr. Levangie: and when I'm no longer a candidate, is that when you people will leave me the hell alone! What? Do I have to start drooling, and forget my name to get a little peace and quiet?

Derek: All right. I'll check back with you later. Try to get some rest.

(Derek walks away, Meredith lingers in the hall.)

Ms. Levangie: Dad, you're being unreasonable. The doctors are only trying to help you.

Mr. Levangie: It's my damn life, and it's my damn brain. You want me to let them cut up my brain while I'm lying her awake, for what?

Ms. Levangie: Dad!

Mr. Levangie: I'll be at your wedding. I will sit in the back. Your uncle will walk you down the aisle. I know it's not perfect, but it's life. Life is messy sometimes.

Ms. Levangie: I know that.

(Daughter leaves)

Mr. Levangie: (To Meredith) If she knows, then what the hell are we still talking for, huh? Why in hell can't she drop it?

Meredith: It is your life. But it's her life too. And you have a chance to get better here. And all she's asking you to do is try.

(Meredith leaves)

(Burke, George and Cristina are scrubbing in for Annie Connors' surgery.)

Cristina: If they pull this off, I'm totally calling Oprah.

(Bailey enters)

Bailey: You two been working out?

George: Um, sometime I jog, and I try to take the stairs whenever possible.

(Derek enters)

Cristina: Why?

Bailey: See that large pile of tumor? You're going to be retracting it for the next 14 hours, so I'm just saying I hope you have strong backs.

(Meredith enters)

Meredith: Dr. Shepherd.

Derek: Yes?

Meredith: Mr. Levangie has agreed to DBS. If we do it today. If he leaves, he won't come back.

Burke: Don't worry, Dr. Shepherd. It'll take hours before we get around to the spine. I'll page you.

Derek: All right, then. (Leaving) Let's do it.

(Meredith and Bailey are alone in the scrub room)

Meredith: Dr. Bailey. I didn't know...that he was my boss, when I met him. I didn't know.

Bailey: I don't care.

Meredith: Really? Oh, well, you sort of seemed to not be talking to me, so I ...

Bailey: You see this, what's happening right here? This is the problem with you sleeping with my boss. Not whether or not you know him before, but how it affects my day. And me standing here talking to you about your s*x life affects my day. And the longer this little fling goes on, the more favors you get over the others, who are fighting tooth and nail just to make it through this program without any assistance. When those people start finding out what's going on and they don't want to work with you and talk to you or look at you, and they start bitching and moaning at me, the more it affects my day. So, no, Dr. Grey, I don't care what you know, or when you know it. Are we understood?

Meredith: Yes.

Bailey: Good.

(Meredith leaves and Bailey continues scrubbing in)

(Seattle Scenes)

(Hallway of SGH)

Alex: This sucks.

Izzie: Yeah well, I'm not a real fan of yours, either.

Alex: Not you. This. Everyone is scrubbed in somewhere.

Izzie: Bright side, we have the run of the floor.

Alex: Great! Want to do it in the stairwell? I'm just saying you never know what could happen.

(Patient in bed in hallway barfs on Alex)

Alex: I'm changing.

Izzie: I'll page you if I need you.

Alex: You do that.

Izzie: (To patient) You are so my favorite person today.

(Annie's surgery)

Nurse: We need to hang another bag of O-neg.

Burke: Cauterizing the small bleeders to keep my visual field clean.

George: (To Cristina) God, is your back killing you?

Cristina: George, shut up. We're in here.

(Izzie with Mrs. Harper in room)

Izzie: Mrs. Harper, let me show you these chest films. We were able to relieve the obstruction of his chest tube, so the buildup of fluid you see should resolve itself soon. (Mrs. Harper looks lost) Which translates as he should be home in no time.

Mrs. Harper: He was making waffles.

Izzie: I'm sorry?

Mrs. Harper: He was making waffles. He was missing batter, and...and then, he was on the floor.

Nurse: Izzie, we need a central line run in 204.

Izzie: Page Dr. Karev, will you?

Nurse: He's not answering.

Izzie: (To Mrs. Harper) I'm so sorry. I'll be back.

(Alex is in locker room, takes his shirt off, there is a woman there.)

Alex: Like what you see, right?

(She leaves quickly, his beeper says "change battery")

(Mr. Levangie's surgery)

Nurse: Neuro sponge

Derek: How you doing, Mr. Levangie?

Mr. Levangie: All right.

Nurse: Drill bit's charged.

Mr. Levangie: Where's blondie?

Meredith: I'm right here. Can't you see me?

Mr. Levangie: I'm shaky. I'm not blind. Anything goes wrong here, I'm blaming you.

Meredith: Ok, in that case, I'll stay where you can see me. Now we just have to drill a hole and try to find the spot that controls the motor function.

Mr. Levangie: You can't see my brain from there. Aren't you supposed to be learning something?

Meredith: I'm good, right here.

(She holds his hands)

Nurse: EEG waves look good.

Derek: Ok, Mr. Levangie. Just take a couple deep breaths. Focus on the pretty girl. Ok, this is going to sound really scary, but try and relax. You shouldn't feel a thing.

(Derek is drilling into his head)

(Izzie with patient)

Izzie: Any pain here? Here?

Patient: No.

Izzie: Ok. (Pager beeps)

Tyler: Dr. Stevens, I need you to check the x-ray in 2103. 2118 needs post-op notes, and Jane's wondering if you want her to start feeding 2112. I'm going on break.

Izzie: Ok, yeah, before you do that, could you page Dr. Karev again?

Tyler: I already paged him.

Izzie: Yeah, Again?

(Alex enters gallery of Annie's surgery)

Alex: Excuse me. How is it?

Doctor: Long and slow. I don't envy those two. They've been holding that thing for eight hours. Their arms have to be ready to fall off.

(Alex's pager's light is blinking)


Burke: Look at the size of this artery.

Bailey: My God. It's as thick as a thumb. You ever seen a vessel this size?

Burke: No. This thing's just feeding on all her blood.

Bailey: We need more O-negative.

Nurse: I'll call the blood bank.

(George stretches and drops the tumor)

Burke: Damn it, O'Malley. Do you want me to kill this patient?

George: No, I ...sorry.

Burke: I mean, is the art of retracting just too much for you?

George: No, I was, uh...um...I had an itch.


Doctor: Way to go, George. Nicely done.

(Mr. Levangie's OR. Doctor is having Mr. Levangie mimic her.)

Doctor: Just keep trying, Mr. Levangie. Mimic my motions. You can do it.

Meredith: You're doing great, Mr. Levangie. Just a little longer.

Mr. Levangie: Oh, damn it!

Doctor: Take a breath and try again. One more time, Mr. Levangie.

Meredith: The probe is almost in. You'll know it when we find the right spot.

(Mr. Levangie stops shaking and mimics the doctor.)

Doctor: Well, how about that?

Derek: There it is.

Mr. Levangie: I'll be a son of a bitch.

(Outside the OR, pushing Mr. Levangie to his room)

Derek: Bailey was on the warpath. I was trying to protect you.

Meredith: You trying to protect me is why she's on the warpath. You can't do me favors. You can't ask me to scrub in when I haven't earned it.

Derek: Ok, ok.

Meredith: And you can't treat me like crap when I haven't earned that either.

Derek: Ok.

Meredith: I can take care of myself. I got myself into this mess, and I...

Derek: And you'll get yourself out?

Meredith: I don't... know that yet.

(Derek pager goes off, they arrive at the elevator)

Meredith: Don't let me keep you.

Derek: you did great work here today.

Meredith: Dr. Shepherd.

Derek: Yeah?

Meredith: Sorry I called you a jackass.

Derek: You didn't.

Meredith: I did. Twice.

Mr. Levangie: Tell you what, blondie. If you don't marry him, I will.

(Izzie walking down stairs and enters hallway. Her pager goes off again.)

(Mr. Harper's room)

Mrs. Harper: No, no, no, Jimmy! No, no, Jimmy, no!

Izzie: What we got?

Nurse: Pressure plummeted to 64/22, and he has runs of V-tach that aren't perfusing. CVP is sky-high.

Izzie: Give him dopamine, tin mikes.

Tyler: He's already maxed out. The resident was here an hour ago but I can't reach him now.

Izzie: Of course you can't.

Mrs. Harper: Do something! What's the matter with you?

Izzie: Get her out of here!

Mrs. Harper: No, no!

Nurse: Mrs. Harper, you have to get out of here.

Izzie: Does he have a myocardial ischemia?

Doctor: No, it's a clot. Big one.

Izzie: Page someone.

Doctor: It's tamponade. He'll be dead before they get here.

Nurse: You have to open him up, right here, right now.

Mrs. Harper: You said he was ok!

Izzie: Get out of here now!

Nurse: You have to cut.

Izzie: I can't. I've never seen it done. I could kill him.

Nurse: Do nothing, you'll kill him faster. What's your glove size?

Izzie: Six. Oh, God. Oh, God.

Nurse: Take a breath, Dr. Stevens. She has to move over there. Walter, move out of the way. (Izzie gets ready to cut Mr. Harper open) Cut the stitches and then the staples. Don't let them fall into the chest cavity.

Izzie: Wait. I've never cracked a chest before. Oh, God. Oh, God.

Nurse: No pulse. Wide complex rhythm.

Izzie: I can't get this clot out. I need more suction. I need more.

Nurse: He's bradying down. You have to get the clot out.

Izzie: I can't get it. Screw it. I'm using my hand.

(Izzie reaches into the chest cavity and pulls out the clot)

Nurse: Oh, God, look at the size of that clot.

Izzie: Anything?

Nurse: No. You have to massage the heart, doctor.

(Izzie starts massaging the heart)

Izzie: Come on. Come on. Come on, please. Come on, Mr. Harper.

Nurse: We have a pulse.

(Annie's surgery, Derek enters)

Derek: how's it going?

Burke: It's more intertwined than the studies made it look.

Bailey: Hang another bag, call the blood bank. We need more O-negative.

Burke: I'm down 10 units of blood and I haven't even flipped her yet.

Derek: Oh, wow. Look at that. Now how am I supposed to get around that artery? All right, then. Forceps.

(Meredith enters gallery)

Meredith: God, it's unbelievable.

Alex: Right.

Meredith: How did she live like that?

Alex: Watch what you say. You never know who's listening. (Laughs) Look at George. He looks like he's about to fall in.

Meredith: Are you really as shallow and callous as you seem?

Alex: Oh, you want to go out for a drink later and hear about my secret pain?

Meredith: Does that line ever work for you?

Alex: Sometimes.

Meredith: Oh. Must be because you look like that.

Alex: Like what? (Laughs) So is that a yes?

Meredith: No. I can't. I'm seeing someone.

Alex: Look, if you don't want to go out with me, just say so. No need to lie.

Meredith: Oh, ok. Well, I don't want to go out with you. But I think I really might be seeing someone.

(Izzie enters the OR)

Izzie: Mr. Harper, the post-op heart patient in 2114. I had to open his sternotomy bedside.

(Everyone turns to look at her with a look of awe.)

Burke: You what?

All: What?

(Gallery Alex gets up to leave.)

Izzie: He had cardiac tamponade. His chest films were clean this morning. It just... It happened fast. He was in PEA. There was no time.

Derek: (To Burke) Go ahead. I got it. We're ok here.

Burke: Ok.

Derek: I need some retraction. Pull back on the retractor.

(Izzie is in scrub room leaving, Alex walks in.)

Alex: (Yelling) You opened a heart bedside and you couldn't even page me? What needed all the glory for yourself, right?

Izzie: (Yelling) I paged you 50 times. Do you have any idea what I have been through?

(Alex looks at his pager)

Alex: Oh, man. The battery. I forgot to change it.

Izzie: You forgot? You forgot?!

(Izzie throws his pager on the floor, breaking it. She then starts jumping up and down on it.)

Izzie: You are hateful! You are a hateful, hateful, lazy, arrogant, hateful man! Hateful!

(Izzie leaves)

(The OR could overhear Izzie and Alex.)

Derek: Never a dull moment here at Seattle Grace.

(Blood vessel burst, squirting blood all over Derek and Bailey.)

Derek: Oh!

Bailey: Oh, my God.

Derek: Get right in there.

Bailey: She can't afford to lose this much blood. We need more blood.

Derek: Get me some suction here. I can't see what I'm doing. Clamp, clamp, clamp, please. Is there any blood in the rapid infuser?

Nurse: We're waiting on two units.

Derek: What do you mean, waiting?

Bailey: Well, we didn't anticipate this much blood loss.

Nurse: They're on their way.

Bailey: We prepped a double supply. We've used it all.

Derek: What did you cut?

Bailey: Nothing. It just blew. She came in with too much damage. The artery walls are too weak.

(Alex is watching from the scrub room)

Alex: Annie, come on.

Bailey: Ten units of O-negative.

Derek: I cannot see. George, give me your hand. Push right down here. Pull it towards you. Suction! Suction!

Nurse: The pressure's dropping.

Derek: She needs blood. Where the hell is the blood?!

(Alex runs out of scrub room)

Derek: Somebody grab that. Push it back, George. Come on. (Everyone is breathless) Oh, God. Just squeeze it off right there. Here we go.

(Alex running through hallway runs into a woman carrying blood)

Alex: Is that O-Negative for OR 1?

Nurse: Uh-huh, OR 1.

Alex: OR 1, right? I got it! I got it!

(Alex runs through the hall with the blood)

Derek: Some suction, please, in here, now. Come on. We're losing her now. Look at this. Look at his. Come on. (Starts CPR)

(Mrs. Connor's is waiting in the waiting room)

(Derek is still performing CPR)

Derek: Oh, come on! Come on! (More CPR) Come on! (Stops CPR) Time of death is 11:42.

(Alex runs in with the blood)

Alex: I got it.

MVO: The early bird catches the worm.

(Burke is closing Mr. Harper)

MVO: A stitch in time saves nine.

Burke: Messy.

Izzie: I'm sorry.

Burke: Don't be. You saved his life.

(Bailey and George go to tell Mrs. Connors about Annie)

MVO: He who hesitates is lost.

(Mrs. Connors covers her face, crying)

(Mr. Levangie and Meredith are walking through the hall towards his daughter.)

MVO: We can't pretend we haven't been told. We've all heard the proverbs, heard the philosophers, heard our grandparents warning us about wasted time, heard the damn poets urging us to seize the day. Still, sometime we have to see for ourselves.

(Cristina is in on-call room stretching. Burke enters)

Burke: I'm not doing you any more favors. This was it.

Cristina: (Scoffing) I've been holding up 50 pounds of tumor for the past 12 hours. My back's going to need traction, and the patient died anyways. And you think you did me a favor?

Burke: Look, I'm just...What is this...that we're doing here? What is it?

Cristina: You need a definition? You really want to be that guy?

MVO: We have to make our own mistakes.

Burke: Lock the door.

MVO: We have to learn our own lessons.

(Alex and George walking through a hall)

George: Have you seen Meredith?

Alex: Save yourself the misery, man. She's off the market.

George: What? No, that's not... We're just friends.

Alex: Whatever.

George: But she's not. I mean, if she was seeing someone, I live with her, I would know it.

(George is home, carrying two beers to Meredith's room. He knocks only to find the door ajar and her not inside.)

MVO: We have to sweep today's possibility under tomorrow's rug until we can't anymore, until we finally understand for ourselves what Benjamin Franklin meant. That knowing is better than wondering.

(Meredith is standing in the rain when Derek emerges from the hospital.)

MVO: That waking is better than sleeping.

Meredith: I, um, know this place where there's an amazing view of sunrise over the ferryboats.

(She pulls a bottle of wine out of her bag)

Derek: I have a thing for ferryboats.

Meredith: I remember.

(He opens the car door for her; she leans across and opens his door.)

MVO: And that even the biggest failure, even the worst, most intractable mistake beats the hell out of never trying.