02x15 - Break on Through


2x15: Break on Through

Original Airdate: 1/29/2006

Written by: Zoanne Clack

Directed by: David Paymer


(The floor of SGH where there is a thick red line)

MVO: In surgery there is a red line on the floor that marks the point where the hospital goes from being accessible to being off limits to all but a special few. Crossing the line unauthorized is not tolerated.

(SGH Entrance)

(There is a large group of nurses protesting having formed a picket line in front of the hospital. They are chanting 'Fair hours, fair wages!' They're also holding various signs protesting. George and Izzie stand at the end of the picket line looking at it all)

George: Can't. Can't, can't cross the picket line. I can't.

Izzie: I don't like it either, George, but what choice to we have? Ok you took an oath to heal. You're a healer.

George: Dad's a truck driver. Mom's a teacher. The evening news shows me crossing the picket line ... they'll outlive me just to pee on my grave.

(Izzie gives George a weird look)

MVO: In general, lines are there for a reason.

(Cristina walks up to them)

Cristina: Has there been any blood yet? Heard they brought in scab nurses.

MVO: For safety. For security. For clarity.

Izzie: I think the nurses know that we are on their side.

Nurses: Don't cross the line!

Izzie: Don't they?

Cristina: Well we're doctors. We have sick patients inside. We have surgeries.

Izzie: Ok. ... Then you go first.

Cristina: Screw it.

(She heads through the line and has food thrown at her which she attempts to fend off)

Cristina: Yeah doing my job! Doing my job! Ha-ha!

(She makes it into the hospital)

Izzie (to George): They threw food at her!

(George nods)

Izzie: That is just wrong! Fine I'm going in!

(She goes in and also has food thrown at her. She uses her bag to fend the fruit off. In the mass of nurses she walks past Olivia who screams at her)

Olivia: Change your own bed pan Stevens!

Izzie: Yeah, enjoy your syphilis Olivia.

(She makes it to the front doors and squeals as one last one is thrown at her)

Izzie (yells out): George, are you coming?

George: No, I'm good here.

(He just stands at the end of the picket line watching)

MVO: If you choose to cross the line, you pretty much do so at your own risk.

(Meredith is entering the Nursing Home where Ellis is. She walks up to the nurse on duty)

Meredith: Good morning.

Nurse: Morning, Meredith.

Meredith: How is she today?

Nurse: She's great. She really lights up when Dr. Webber visits.

(The nurse turns to look into the living room and Meredith follows her gaze. There she sees Richard and Ellis having a good old laugh in the living room. Meredith appears shocked and confused at the closeness the two appear to have. Especially with all the not so subtle touches on each other's arm)

Ellis (laughs): And I did not back down. Not in my OR. Not in front of those jock ortho idiots.

Richard (chuckles): Yeah that was the last time Windsor called you little lady. Not even behind your back.

Ellis: One day I'm gonna be the Chief of Surgery. First woman Chief! You watch!

Richard: I don't doubt it Ellis.

(Ellis laughs kinda evilly)

MVO: So why is it ...

Richard (takes one of Ellis' hands in his): Don't doubt it for a minute.

MVO: ... the bigger the line, the greater the temptation to cross it?

(Meredith seems weirded out and leaves the way she came)

(Outside of SGH picket line where the nurses are still chanting and George is still standing in his stand still position)


(Patricia is walking down the hall with one of the temp nurses up to a nurses' station. The place looks a little bit like a disaster area)

Patricia: And I can't say this enough charts are organized by room number. I know your temp nurses but there's no excuse for sloppiness.

(The nurse nods and walks into an adjoining room. Patricia walks up to the nurses station where are Derek and Burke standing going over their own charts, complaining about the whole situation and how they can't do their job properly)

Patricia (interrupts their babble): You know why I stopped being a nurse? Doctors. Doctors who don't know how to pitch in.

(She walks off)

Burke: Right.

(Richard walks by and the two pounce on him)

Derek: This place is going to hell.

Burke: We need to find a way to compromise.

(Burke walks off)

Derek: We need the real nurses back.

Richard: We need an additional 40 nurses to relieve the overtime that they're striking about. That's 2 million dollars a year we don't have.

Derek: Have you checked under the couch? I always find spare change under the cushions. (Richard gives him a sour look) Ok, I'm silencing myself.

(Richard and Derek part ways)

(Cristina, Alex and Izzie are waiting for their new resident. Cristina sees a doctor walk by)

Cristina: Yes, yes that's him. He's been published twice and he's flawless.

Izzie: Oh, I don't want that guy. That guy's a freak. He doesn't let you speak in the OR.

Cristina: Yeah, but he's flawless.

(Another doctor walks by)

Alex: I think it's him. What's his name again?

Cristina: Oh yeah, mouth breather guy. But he'll let you do a procedure on your own if he likes you.

(Meredith walks up to them)

Meredith: What are we doing?

Alex: Trying to figure out who they're going to pick for Bailey's replacement.

(A loud booming voice sounds from the stairs)

Sydney: Yang, Stevens, Grey, O'Malley, Karev!

(A young, cheerful female doctor named Sydney Heron bounds down the stairs and makes her way up to them)

Sydney: Here you are! I was looking for you guys in the locker room but you weren't there and then I thought well maybe my interns are looking for me too and then I come out her and here you are. (She chuckles) Yeah. (Cristina looks horrified) You guys look like a great group. (Meredith looks like she wants to laugh) Which is awesome. Because my horoscope said it's going to be a very challenging day and I was a little worried but no you guys ... yeah, you look like a good group. Which is great! Because we're going to have so much fun! Hi!

(She holds out her arms and hugs Cristina)

Sydney: Hi, First of all hi! Hi.

(Cristina remains stiff and uncomfortable)

Cristina: Ow, ow, ow.

(Sydney backs up)

Sydney: Ooh, am I hurting you?

Cristina: Ah, no you're, you're touching me.

Sydney (has an Oh look on her face but loses it quickly): I'm Sydney Heron. 4th Year and my philosophy just so you know is um is heal with love. (Alex and Izzie raise their eyebrows) Ok, so wonderful. So, Alex, Izzie, Meredith, Cristina and our little group is just missing-

Cristina (interrupts): O'Malley. Yeah he's cowering behind the strike line like a little girl.

Sydney: Standing up for what he believes in, that's my kind of little girl. Right? So ... The E.R needs somebody down there for a consult, does anybody ... who wants to ...

Meredith: We get to pick?

Cristina: Oh me, I'll, I'm on it.

Alex: I'll help.

(They both dash off quickly)

Meredith: I have patients I need to check on.

(She dashes away fast as well leaving Izzie by herself)

Sydney: So it looks like it's just you and me, Izzie McGee.

Izzie (force chuckles): Right, right, it's ah, It's ah Stevens. It's Izzie Stevens.

Sydney: Oh, no I knew. I was just rhyming.

Izzie: Oh, rhyming right, yeah. That's, that's neat.

(Addison comes up to Izzie)

Addison: Hey Dr. Stevens.

Izzie (answers eagerly): Yeah.

Addison: Could use you on a consult?

Izzie: Ok. I'm on it. Absolutely.

(She drops what she's doing and grabs Addison's file. They leave)

Sydney: Yeah.

(The pit where Alex and Cristina are walking with an ER resident)

Alex: You need a consult for a rash?

Resident: It's spreading pretty fast. I wanted to make sure nothing surgical going on.

(Cristina moves back the curtain concealing a bed)

Cristina: Mrs. Solomon, oh!

(A young couple, Claire and Wade Solomon are making out pretty heavy on the bed. Alex looks amused. They stop when they realize the doctors are there)

Claire: Oh god. Sorry. Sorry.

Wade: We're on our honeymoon.

Claire: Yeah.

Alex (nods approvingly): Sweet.

Cristina (shoots Alex a disapproving look): Ah, can you um ... dismount? Please.

Claire: Yeah.

Cristina: Ok, great.

(Wade starts moving off the bed)

(Meredith is walking down the hall when she hears a person crying out)

Grace: Len!

(Meredith walks up to the door where she's an elderly woman named Grace Bickham lying on a hospital bed looking like she's in pain)

Grace: Lenny is that you?

(Meredith looks around for any doctors but she can't see anyone)

Grace: Lenny!

(She has trouble breathing and Meredith rushes in)

Meredith: Are you ok ma'am? (She looks down at her name on the bed) Grace Bickham. Mrs. Bickham do you know who your doctor is?

Grace: Len, Lenny ...

Meredith: I don't see your chart here.

Grace: Are you there?

Meredith: I'm gonna need you to calm down for me, ok?

Grace: Lenny?

Meredith: Is that your husband?

Grace: Oh, where is he? He was here.

Meredith: I'm sure he'll be back any moment. You're having some trouble breathing. I'm going to need to run some tests. (Grace just moans) Nurse! I need a nurse in here!

(Picket Line)

(George is still standing outside, shaking his head and refusing to go in. The nurses are still chanting 'Fair hours, fair wages'. Nurse Olivia walks up to him holding her own sign looking resigned)

Olivia: You can go, George. We won't throw donuts.

George: Oh I can take the donuts.

Olivia: Then what are you still doing here?

George: Teachers strike of '03 mom walked the line for 48 days. I can't ... just, I can't cross.

Olivia: So go home.

George: I can't go home! You just don't go home. Yeah and get kicked out of the program. Lose my place as a resident. I'm a doctor, no way. Don't... Don't...I'm a union guy.

(Olivia smiles broadly)

Olivia: So that means ...

George: Give me that sign.

(George takes the sign from her and walks down the picket line. The sign reads 'Proud to be a Nurse'. The nurses applaud him)

Olivia: Alright, Dr. O'Malley!

(Grace's room)

(Grace is having more trouble breathing than before)

Meredith: Help! I need a nurse in here please!

(A temp nurse named Angela comes in)

Meredith: Her pressure's falling. She's stopped breathing.

Angela: Whoa. Is she dying?

Meredith: Are you a nurse?

Angela: Um, I'm like a nursing student.

Meredith: I need to intubate. Get me a 7 and a half tube. They're out in the hall.

(Angela rushes out as Meredith prepares to intubate Grace. Angela comes back in quickly with a tray of stuff)

Meredith: Not that one. The one that says seven five.

(She hands Meredith the tube and she intubates. Angela holds a breathing bag and pumps it. Meredith checks Grace's heartbeat)

Meredith: I'm in.

Angela (smiles): Awesome.

(Meredith gives Angela a look and she immediately stops smiling)

(Exam room where Addison and Izzie are performing an ultra sound on a young black girl named Cheyenne Wood who is pregnant. Cheyenne's mother sits next to her)

Cheyenne: Is that too much?

Addison: It's a lot of extra amniotic fluid Cheyenne but your baby looks strong.

Ms. Wood: Does that mean we can go? I mean appreciate you seeing us, I really do but this is a long drive for us and I can't afford to miss another shift.

Addison (to Cheyenne): Unfortunately Ms. Wood the mass on the baby's neck is what's causing the build up in fluid. It's also obstructing her airway and the spine.

Cheyenne: Mom.

Ms. Wood: It's alright. Just listen.

Addison: We're going to do a procedure called an exit surgery. Basically we do a C-section and only half deliver the baby.

Cheyenne: Half deliver?

Addison: That's right. We pull the head and the arms out but we don't cut the umbilical cord.

Cheyenne: Why?

Izzie: The tumor won't let air get to the baby's lungs. So we need the umbilical cord to keep her alive during the operation. It's kinda cool if you think about it. You'll be like your baby's life support machine.

Addison: And then after the surgery if all goes well, we cut the umbilical cord and you'll be the mother of a healthy baby girl. How does that sound?

(Cheyenne looks relieved)

Ms. Wood: That sounds expensive.

Addison: Well your doctor at the clinic is a former student of mine, so it's covered. (To Izzie) I'm gonna go head up and take this to the lab.

(She leaves the room)

Izzie: The hospital gets a write off the surgery. And it makes Dr. Shepherd look good, so ...

Ms. Wood: So it's not charity?

Izzie: It's not charity. What time's your shift?

Ms. Wood: 6 to 6.

Izzie: Graveyard. (Mrs. Wood nods) In Chehalis?

Ms. Wood: Yeah.

Izzie: It's 3 hours away. Better get going. (Mrs. Wood looks at her) I'll look out for her.

(Cheyenne nods at her mother)

(Meredith is walking down the hallway where she sees Richard standing in front of the OR board. She walks up to him)

Meredith: Chief.

Richard: Hello, Meredith.

Meredith: Saw my mother this morning.

Richard: Did you? How is she?

Meredith: She's fine.

Richard (uneasy): I'm glad to hear it. Give her my best.

(He walks off)

(The pit where Claire is now sitting up right on the bed with Wade sitting next to her on a chair. Claire and Wade are very touchy feely. Alex is there. Cristina is there also drawing a black line across her leg)

Claire: Why are you...

Cristina (interrupts): Oh I'm drawing a line to mark the borders of the infection. We'll watch it for a couple of hours. If it doesn't cross the line you'll get IV antibiotics.

Wade: And if it does cross the line?

Alex: Well it would mean the infection is aggressive. We'd have to do a muscle biopsy.

Claire (stops giving lovey-dovey looks and looks concerned): You have to take out a piece of my muscle?

Cristina (nods): Mmm Hmm.

Claire: Well we're supposed to run a 10k tomorrow.

Cristina: Oh, on this leg I doubt it.

Alex: Can you tell us when you first noticed the rash?

Wade: When we were climbing Rainer yesterday.

(Sydney the cheerful Resident comes up to them)

Sydney: Wow! You took the Emmons Glacier route?

Claire: Please you can do that in an SUV. We did 'Liberty Ridge'.

Sydney: Wow! That's hardcore. (She shakes Wade's hand) Hi. I'm Sydney Heron. These guys teacher.

Claire (shakes her hand): Hi. I'm Claire. This is Wade. It's our honeymoon.

Sydney: Wow, that's amazing. God, look at that rock.

Cristina (annoyed): Ah did you sustain any trauma on the hike? Did you fall down? Or bang your leg against something?

Claire: No.

Wade: Oh, she cut her foot on some oyster shells at the beach a couple of days ago. (He turns to Sydney) We were windsurfing in 'Puget Sound'.

Sydney: Oh wow sounds like you guys are going to need a honeymoon to recover from your honeymoon.

(Wade and Sydney chuckle and Alex forces himself to chuckle. Cristina mean while checks Claire's leg)

Claire: Ow.

(Cristina continues checking)

Claire: My leg's going to be ok though, right?

Alex: Oh, yeah, yeah, it's probably just a simple skin infection.

Cristina: Ah, no it's not. Look.

(They all look closely at the black line. The infection has passed the line really fast)

(Meredith is wandering down the hallway. Derek comes up to her)

Derek: Hey.

Meredith: Hey.

Derek: Your dog's fine.

Meredith: He's your dog now.

Derek: Hmm.

Meredith: I miss him.

(Derek nods and is about to speak but Addison comes up and interrupts)

Addison: He misses you too.

Derek: Ah.

Addison: You should come visit. (Meredith looks uncomfortable. Addison chuckles) The dog, I mean.

Meredith: I'm walking away now.

(Meredith walks off. Addison turns and faces Derek)

Addison : So um I'm looking for a neurosurgeon to consult on a fetal spinal tumor. You know anybody good?

(Derek chuckles)

(Picket Line outside where the nurse's are marching and still chanting. George is marching with them, still holding his 'Proud to Be A Nurse' sign. Nurse Debbie, Olivia and Tyler are all walking behind George whispering to each other)

Olivia: Don't ask George.

Debbie: Why not he's a doctor? Go ahead.

Olivia: Don't worry about it.

Debbie: Just go ahead.

(George notices this)

George (to himself): I see whisper and point. I'm showing support, they whisper and point.

(Olivia walks up to him)

Olivia: George.

George: What?

Olivia: We need a favor.

Debbie: Ava Jekins in PEDS, Room Forty-One, Fourteen. It's almost time to change her dressing and it's scary for her but if you sing the alphabet or the 'wheels on the bus' song she can handle it.

(George looks mighty confused)

Tyler: Mrs. O'Brien, Twenty-four, twelve. She'll have a major panic attack if they don't check on her at least once an hour.

Olivia: And there's this guy in Twenty-nine, Twenty-four-

George (interrupts): Hey, Hey, hang on! Hang on!

(They stop walking near the side of the line)

George: What you want me to cross the picket line?

Olivia, Tyler & Debbie: Yeah.

George (amazed): Why?

Olivia: Because they're our patients too, George. (looks nervous) And we can't.

(OR where Sydney is operating on Claire Solomon's leg. Alex and Cristina are helping and watching)

Sydney: Anyone care to probe the wound?

Cristina & Alex (at the same time): I do.

Alex: I'd really like to try your method of healing with love.

Sydney: I like the way you think Alex. (She hands him the scalpel while Cristina looks on annoyed) You do the honors. ( Sydney notices Cristina's look) Cristina, looks like someone needs to learn how to share. (To Alex) Oh, there just go ahead and slide it in.

(A phone rings)

Alex: Whoa. No resistance.

Cristina (hisses to him): Let me see.

(Cristina grabs the scalpel off him)

Nurse (holds a phone up to Sydney): Dr. Heron.

(Sydney listens to whoever is on the line)

Sydney (into the phone): Yes?

Cristina: Oh! No healthy muscle gives away that easily.

Sydney: Oh my god. Oh this poor girl.

(She pulls away from the phone and the scrubs nurse hangs up)

Sydney: Ok everyone, we're locking down the O.R. All non-essential personnel must leave now.

Cristina: Was that pathology? Is she...

Sydney (interrupts): It's necrotizing fasciitis.

Alex (amazed): The flesh eating bacteria?

Sydney: In the flesh.

(Meredith is entering Grace's room. Patricia is in there looking concerned)

Meredith: Oh good somebody's in here. How's she doing?

Patricia: You intubated her?

Meredith: Yeah.

Patricia (disapproving): You intubated her.

Meredith (defensive): I had to. She was struggling to breathe. Her sats were in the 80s. She was in her room all alone. (She notices Patricia's look) What?

Patricia: One of the temp nurses found the paperwork from her chart on the second floor. And...

(Grace's friends are standing at the doorway of the room and are outraged)

Agnes: You put a tube in Grace!

Ruth: She put a tube in Grace?

Eleanor: She put a tube in Grace?

Patricia: Mrs. Bickham was diagnosed with end-stage COPD. She's on hospice.

Meredith: End of life care?

Patricia (holds out the chart with DNR on it): DNR. Do not resuscitate.

(Ruth comes in and bangs her bag against Meredith's back. Meredith jumps and turns around startled)

Ruth: You little schnook. You were supposed to let her die.

(Meredith is surrounded by Grace's friends in Grace's room. Patricia has left the room)

Eleanor: No machines, she said.

Agnes: She did. I remember because her daughter Alice was there with her girlfriend... Ah She's a lesbian. (Meredith nods but looks uncomfortable) The daughter. Nice girls. But...

Ruth (interrupts): Stop with the rambling Agnes. Make your point.

Meredith: I'm sorry.

(She walks out of their little surrounding circle and turns to face them)

Meredith: Who are you, exactly? Mrs. Bickham's sisters?

Agnes (chuckles): Oh no. No. (The other two shake their head) Her sister Rose died in '83.

Ruth: May she rest in piece.

Agnes: Influenza. Or croup.

Eleanor: Only babies die of Croup! Rose died with a cold in her chest.

Agnes: Pneumonia!

Eleanor: Right, pneumonia. And there was her other sister, Harriet.

Ruth: May she rest in peace.

Agnes: They cremated her.

Ruth: Gracie wanted to die. She made us all promise.

Meredith: This really is something that I need to speak with her husband about.

Eleanor: Lenny never talked much when he was alive. Good luck getting a word now.

Meredith: Lenny's dead?

Ruth: May he rest in peace.

Meredith: But Grace said she just saw him.

Agnes: Because she was trying to cross-over.

Ruth: She almost died twice in the last month. Said she saw him each time. You ask me that's a little meshugena.

Eleanor: It's not meshugena! He was waiting for her in the light.

Agnes: Mmm Hmm.

(Ruth rolls her eyes)

Agnes (to Meredith): Which thanks to you, she can't reach now!

(Eleanor nods)

(George is still dressed in his normal everyday clothes walking quickly down the hospital hallway with a notepad. He sees the Chief opposite and darts to the side to avoid him)

Richard: O'Malley, I need you to round all those 21...

George (interrupts): I'm not here.

Richard: Excuse me?

George: I'm here but I'm not here.

Richard (angry): You won't be anywhere in about thirty seconds if you don't...

George (interrupts): Sir, all do respect, no offense intended. Ah but I won't cross the picket line.

Richard: And yet somehow you're standing in front of me.

George: Uh, yep well because some of the nurses want me to check on their patients and so I am but then I'm going right back out there to join them.

Richard: You're a doctor!

George: Yes sir ... but I'm also a union man. ... All do respect, no offense intended.

Richard: Fine!

(He starts to walk off)

George (runs after him): Sir, while I have you here I'm supposed to tell you that ah Mrs. O'Brien in twenty-four twelve is allergic to chocolate but she pulls the allergy sticker off her chart every chance she gets.

Richard: Wonderful.

George: And ah that ah you're supposed to watch Mr. Roberts in Twenty-One Nineteen take and swallow his diuretics. Apparently he likes to hoard them under his mattress.

(Richard stops walking and turns around angrily)

Richard: Is that it?

(George nods fast. Richard turns around)

George: 40 to 50 hours of mandatory overtime is extremely...

Richard: O'Malley!

(George turns and runs off)

George: Yes sir, I'm very sorry. No offense intended!

(Waiting room where Cristina, Sydney and Alex are delivering the news to Wade about Claire's leg)

Wade: What? Wait, flesh eating ... I mean this is some kind of joke right? She put you up to this.

Cristina: Ah no it's not a joke. We have to amputate the leg.

Sydney (disapprovingly): Cristina.

(Cristina gives her a 'what' look)

Wade: We're on our honeymoon.

Sydney: I'm sorry Wade. I know this is scary but amputation is not the only option.

Cristina: It's the only sane opt... (She stops herself and turns to Wade) Excuse me if we don't get this infection under control immediately she is going to die.

Wade: But there is another option?

Alex: Well we can try to save the leg by cutting out the infection. It won't be pretty but we might be able to keep it functional.

(Cristina looks like she can't believe this is even being discussed)

Sydney: Gold star for Dr. Karev.

Wade: Ah I need to see her.

Cristina: There's no time.

Alex: By the time we take her out of anesthesia and put her back under ... you need to make a decision now.

Wade: Uh I mean she runs marathons. This is our adventure honeymoon. It's, it's who she is.

Sydney: Ok, then we'll do everything we can to save the leg.

(Cristina looks upset and Sydney walks off. Alex follows and Cristina catches up to him)

Cristina: You seriously think this is a good idea?

Alex: I seriously think this is a way cooler surgery.

(He walks off)

(Cheyenne's patient room where Addison, Derek and Izzie are talking to her)

Derek: Cheyenne, the prognosis is very good. So what we want to try to do is go in and get as much of the tumor out as possible during your surgery.

Cheyenne: So my baby will be fine?

Derek: Yes.

Addison: You may be able to take your baby home by the end of the week.

Cheyenne: That soon?

Addison: Absolutely. She'll be all yours.

Cheyenne: Oh. Ok.

Derek: Ok. Now, if you and your mother have any questions Dr. Stevens will page me. All right?

Addison: See you later.

(Derek nods to Izzie and both he and Addison leave the room. Izzie picks up a book of Cheyenne 's bed table)

Izzie: Oh, Shakespeare.

Cheyenne: I was reading it to my baby. It's really homework for English. Was. The baby wasn't due for another few more weeks. And now I guess ...

Izzie: No more school.

Cheyenne: It's weird. It's like when you're in school ... you hate it.

Izzie: Until you can't go anymore.

(Cheyenne just stays silent)

Izzie: Have you made any plans?

Cheyenne: Plans?

Izzie: Bought a crib? Called about child care? Looked into assistance?

Cheyenne: Not yet.

Izzie: You gonna live with your mom?

Cheyenne: I'm supposed to be saving money to get my own trailer home. I don't know I guess I thought that I'd have more time. Nine months go by fast.

Izzie (kinda teary eyed): Yeah, yeah it does. (She fakes a smile) I'll see you later.

Cheyenne: Bye.

(Izzie takes her chart and leaves)

(OR where Sydney, Alex and Cristina are operating on Claire's leg)

Cristina: So, Sydney, have you seen a lot of necrotizing fasciitis?

Sydney: No have you?

Cristina: If the infection moves to her bloodstream she'll die.

Alex: If she wakes up without her leg she might wish she had.

Sydney: Yeah, Dr. Karev is right. She's young, she's healthy, she's a newlywed.

Cristina: And your treatment plan is based on? Cuteness? If she were an 80 year old man, you'd amputate in a heartbeat.

Sydney: She's not 80. Where's your compassion?

Cristina (disbelievingly): My, my compassion? Trying to save a patient from death is pretty compassionate.

Sydney: I must say I'm disappointed in you. Why can't you be more like Alex?

Cristina: Excuse me?

Sydney: Yeah this guy, he's compassionate. He's warm. He's fighting with me to save Claire's leg.

Alex: And we're going to win that fight.

Sydney: Yes.

(Alex laughs silently at Cristina but Sydney doesn't notice)

Cristina: Ah excuse me, restroom.

(She leaves the table)

(Cristina is walking the hospital hallway looking for Burke. She finds him in front of the nurses' station outside the O.R board. She walks up to him)

Cristina: Burke.

Burke: Hey, I thought you were in surgery.

Cristina: I was. Necrotizing fasciitis.

Burke: No kidding? So why are you out here?

Cristina: Because the new resident, ah she's the new Bailey. Except that she's the exact opposite of Bailey in the most absurd, horrifying, profoundly disturbing ways.

Burke (warningly): Cristina.

Cristina: I think the new resident is killing our patient.

(Burke looks up at this)

(Burke and Cristina are entering the OR with Sydney and Alex still operating on Claire's leg. There is only one other scrubs nurse in there)

Burke: Dr. Heron is it?

Sydney: It is and you are?

Burke: Preston Burke.

Sydney: Dr. Burke. Wow, no kidding. (She chuckles) I'm a huge fan.

Burke: Thank you. I um I heard you had a case of necrotizing fasciitis and we don't see a lot of those around here.

(Alex shoots Cristina an annoyed look)

Sydney: Hmm. Yeah well being a cardiothoracic surgeon I wouldn't think you saw any.

Burke: Right ... well I was just curious about what protocol you were following here.

Sydney: You were curious or Cristina was concerned?

Burke: I'll hope you'll forgive the intrusion. It's nothing personal. (She nods) It's just that we haven't worked with you before and Dr. Yang wanted to be sure...

Sydney (stops doing the surgery, turns around and interrupts): Dr. Yang wanted to be sure that perky little bimbo cheerleader wasn't in here trying to kill a patient. Am I right? Now with all do respect Dr. Burke I know you don't know me very well but I'm pretty good at what I do. And my patient is a 25 year old marathoner and I've told her husband I'm going to try and save her leg. So my plan is to stand here for as many hours as it takes to scrape away every last cell of necrotic flesh. Now when I'm done, if it's still spreading, then we'll take the leg. And if we do then our eager young intern here can hold the saw. Now unlike Dr. Karev, kindness and compassion aren't very high on her list of priorities but a little bone-saw action well maybe that will earn me some respect. (She turns back to the surgery) Am I right? Now Dr. Yang, you ready to scrub back in?

(Cristina leaves the OR upset)

(Richard is talking to Grace's three friends sitting in a small waiting room. Meredith is standing watching)

Eleanor: You're the head of this whole hospital?

Richard: Just the surgeons.

Eleanor (pats Richard's leg): Well they should make you the head of everything.

Ruth (mutters to Agnes): She's batting the lashes. You see that, she's batting the lashes.

Agnes: Dr. Webber, the point is Grace wants to be with her Lenny. She misses him terribly.

Meredith: You realize if I pull out the tube, Grace will die.

Agnes: We're old magpie, not daft.

Ruth: Pull the plug already. It's what she wants.

Richard: Ladies, I appreciate your concern for your friend but we need to contact a durable power of attorney to sign the release.

Eleanor: That's Alice. Call Alice.

Agnes: Grace's daughter.

Ruth: She's a lesbian.

Eleanor: Well that's ok, isn't it? I mean she still could have the power of attorney.

Richard: Ah fine. We'll need Alice's signature.

Ruth: Good luck. She lives in Oregon.

Agnes: Oh she could fax it.

Richard: I'm sorry. We'll need her original signature.

Eleanor (coos): Can't we just skip that part?

Ruth (mutters to Agnes): Bat the lashes again. I think it was working.

Richard: Excuse me, ladies.

(Richard stands up and starts walking away with Meredith)

Meredith: You're like the old lady whisperer. (Richard cringes) They really cheer up when you come around.

Richard: Meredith, you understand that if the daughter shows up tomorrow and confirms she is DNR ...

Meredith: I have to kill my patient, I know.

Richard: How you doing? Something I can do for you?

Meredith: Oh I'm fine, sir. I don't need any help from you. Thank you.

(She walks off)

(Izzie is walking down the hall dressed to go home past Cheyenne's room. She gets teary-eyed as she sees Cheyenne reading her baby Shakespeare)

(Joe's Bar)

(A group of nurses are camped out at the bar. A large portion of them toast George with their beers and wines)

Olivia: To Doctor O'Malley!

Nurses: Yeah!

(They clink glasses. George laughs)

(Cristina, Meredith, Izzie and Alex are having a drink at the bar. Joe is serving them)

Cristina: She called me unkind. Unkind and lacking in compassion. In front of my boyfriend! I am not unkind.

Meredith: I think I have to kill a woman tomorrow. I have to take out the tube that's keeping her alive.

(Meredith turns to look at the person sitting next to her. Cristina throws a peanut at her)

Cristina: Izzie.

Joe: This is the part where you say what's wrong with you.

(Izzie remains quiet)

Cristina: Where are you going?

Izzie: I have to go, I forgot something at work.

Meredith: I have to kill a woman tomorrow.

Cristina: And that is a problem, why? I mean if it's what she wants, it's what she wants! And that is not unkind or lacking in compassion. I'm a very compassionate person! I'm more compassionate than you Alex!

(Izzie leaves the bar)

Alex: Shut your pie-hole Yang.

(George comes up to the bar)

George: Hey Joe, can we have another round please?

(Joe hands Alex a drink)

Alex: Yeah give Nurse O'Malley a drink on me.

George: Heh, what'd you say? (George turns to his nurse pals) Hey uh Karev just called me a nurse. (To Alex) That's the worst you could come up with. Or wait is that an insult? Or a was I supposed to be...

(George is interrupted by a nurse walking by purposely spilling her drink onto Cristina's lap)

Nurse: Whoopsies.

Cristina: Are you kidding me? I will kill you, you know that?

Nurse: Bring it on!

Cristina: Oh, she, oh Bring it on! Okay Mama. Let's bring it on! Oh look at her spry! What you wanna cheer it out soccer mom?

Nurse: Oh soccer mom!

(They both start yelling at each other. Joe interrupts)

Joe: Hey! Hey! Hey! Beating each other up and there's not gonna be anybody left to set your broken bones.

(They continue to yell ignoring Joe)

Joe: Hey!

(Meredith takes Cristina's arm and pulls her away)

Meredith: We were just leaving.

Cristina: Yeah because I gotta go save lives!

Nurse: Bye!

(Alex is smirking at the whole situation while George pushes through the nurse crowd)

George: Excuse me, they're my ride. Excuse me.

(Cheyenne's room)

(Izzie dressed from the bar, enters Cheyenne's room)

Izzie: You're awake.

Cheyenne: Hey, yeah. Baby jumps up and down on my belly all night. It makes me have to pee all the time.

(Izzie nods)

Cheyenne: You work long hours, huh?

Izzie: Yeah, but I'm off work now. I ... I just came back to talk to you. ... I grew-up in Chehalis too.

Cheyenne: Serious?

Izzie: Serious. Um, Forest Park .

Cheyenne (smiles): The trailer (Izzie speaks at the same time) park behind the church.

Izzie (continues): Yeah. On Route 6. Yeah.

Cheyenne: My friend Shelley lives up there.

Izzie: Yeah my mom still lives there.

Cheyenne: No way.

Izzie: Yeah huh. (They both smile) ... ... Can you keep a secret?

(Cheyenne nods. Izzie reaches into her pocket and pulls out a picture of a young girl and hands it Cheyenne)

Izzie: This is my daughter.

(Izzie is now sitting next to Cheyenne)

Izzie: In the picture she's 6 but she's 11 now. She lived in Santa Barbara but they moved. I don't know where. But I know her name is Hannah and she likes pigs.

Cheyenne (chuckles): Pigs?

Izzie (smiles): Yep, she collects them. Like figurines and stuffed animals, you know. I think it's because her mom probably read her 'Charlotte's Web'.

Cheyenne: I thought you were her mom.

Izzie (tear eyed): I'm her mother but I'm not her mom. ... Look um I know that where we come from this kind of thing doesn't get talked about but I wanted you to know that there's more than one way to be a good mother. I wanted, I wanted better for her than I could do at sixteen.

Cheyenne (teary eyed): I love my baby.

Izzie: Of course you do. But you're reading her Shakespeare. (Cheyenne starts crying softly) When you're working 12 hour shifts at the diner like our mom's, you won't be coming home and reading her Shakespeare.

(Izzie smiles down at Cheyenne's stomach)

(Burke and Cristina's apartment)

(Cristina enters the apartment and finds Burke sitting in the dark holding a trumpet)

Cristina: Huh, I could hear you from six blocks away.

Burke: Sorry.

Cristina: Don't be. I like it. (She heads to the fridge) I'm just not sure how the neighbors would feel which by the way is not a thing someone lacking in compassion would be concerned with.

(She grabs a beer and heads to the bedroom)

Burke: How's your patient's leg?

Cristina: Carved all to hell, but still on her body. (She comes back to the doorway) We're watching it overnight. (Cristina notices Burke seems a little upset) What's going on?

Burke: Never in my career have I questioned a fellow surgeon in their OR. I never understood what the problem was, an intern dating an attending, until today.

(Cristina gives him an upset look and leaves the room)


(Picket Line)

(A new day and the nurses are still chanting 'Fair hours, Fair wages')


(George is walking with Meredith who is taking down notes from George from the nurses)

George: And don't believe twenty-five nineteen when she you she tells that she went to the bathroom. She just wants to go home. She just says she went to the bathroom and then she's back here 2 days later.

Meredith: Got it.

(Burke walks by them)

Burke: Hey! I need sutures in 2602!

George: Can't help ya!

(Burke stops walking and turns back to George. Meredith walks to the nurses' station nearby and George realizing what he just said turns around horrified. Izzie watches from a nurses' station)

Burke: What?

George: ... Fair hours! Fair wages! Fair hours! Fair ... (He stops, Izzie looks amused) It's no offense.

Burke: None taken.

(Burke walks off and George walks up to Izzie who hands him a cup of coffee)

Izzie: Hey. How's the strike going?

George: Do you know? Did you realize how rarely doctors say thank you and please to nurses? How few surgeons even know the names of them? ... (He suddenly looks up) I shouldn't be seen talking to you.

(George moves a little to the side)

(Meredith is rifling through some files. A young woman and her partner come up to her. Unbeknownst to Meredith, this is Alice, Grace's daughter)

Alice: Excuse me. I'm looking for Richard Webber.

Meredith: Can I help you?

Alice: My name is Alice Bickham. (Meredith looks up instantly) I'm here about my mother, Grace.

Meredith: Sure, um ... come with me, please.

(She walks off and Alice and her girlfriend follow her)

(Mrs. Wood comes up to Izzie, angry)

Mrs. Wood: You said you would look after her.

Izzie: I'm sorry?

Mrs. Wood: You told me to go to work and said you would look after her.

Izzie: Miss ah Wood can you ah just follow me?

(She walks a few feet away from the nurses station so George can't hear.)

Mrs. Wood: She's a kid you know? She's scared enough without you putting ideas in her head. How do you tell a scared kid to give her baby away?

Izzie: I didn't tell her. I didn't advise her. I didn't pressure her. I just ... talked to her.

(George is watching from far)

Mrs. Wood: You're not a shrink! You're not her mother. She's my kid and you crossed the line.

Izzie: I'm sorry.

Mrs. Wood: No you're not sorry. You're superior. So what you're a big shot doctor and you get to judge us? You get to tell my kid how to live her life?

Izzie: Cheyenne is smart. She's smart and she's thoughtful and she can have more. She can have more than a trailer park and a graveyard shift at a truck stop diner. Don't you want that for her? (Mrs. Wood glares at her) I mean if you can get past the fact that I'm superior and that I'm judging you and that I'm telling you what's best for your family. If you can just get past all of that, isn't it possible that I'm also right?

(Izzie walks off)

(Post-op room where Claire is recovering from her surgery. Alex and Sydney are in there. Wade is sitting at Claire's bedside)

Sydney: Pretty spectacular recovery Claire.

Claire (groggy): Really? Do you think it's going to be ok?

Sydney: I think we got almost all of the necrotic tissue. A few times in a hyperbaric chamber and I'm thinking you'll be out of the woods.

(Wade nods)

Claire: Thank you for saving my leg.

Sydney: My pleasure. (Cristina watches from the doorway) Now Dr. Karev here will explain the hyperbaric chamber. Dr. Karev.

Alex: Thank you Dr. Heron. A hyperbaric chamber...

(Sydney starts making her way out and passes Cristina)

Sydney: I'll take that apology any time.

(Cristina sighs)

(Grace's room where all of Grace's friends are, Alice, her girlfriend, Meredith and Richard are standing around Grace's bed. Alice signs the form and hands it to Richard)

Richard: Thank you.

Meredith: So, I'm going to give her a sedative which will ease her discomfort and then I'll remove the tube. (Alice nods) Ok.

Alice's girlfriend: Are you ready?

Alice (nods): Yes.

(Meredith is about to inject the sedative)

Alice: Wait.

(Meredith stops quickly almost as she was hoping Alice would stop it. Alice leans forward and kisses her mother on her forehead)

Alice (whispers): Goodbye mommy. (Agnes pats her comfortingly) Oh ... do you want to...

Agnes (interrupts): Oh no. No we already said our goodbyes. We just wanted to be here when Grace crossed over.

(Meredith looks down upset. Alice nods)

Alice (to Meredith): Ready.

(Meredith moves to inject the sedative but Richard puts a hand her shoulder to stop her)

Richard: I can take care of this.

Meredith: I...I did it. I should undo it.

(She injects in the sedative and turns off the life support machine)

Alice's girlfriend: How long? I mean before ...

Meredith: It can take a while.

(Meredith starts removing the tubing from Grace)

(Burke is writing in a very roomy medical supplies closet. Cristina enters)

Cristina: She wants me to apologize.

Burke: You crossed the line.

Cristina: I'm not apologizing.

Burke: You made me cross the line.

Cristina: Oh, like I can make you do anything!

(There is a bit of a silence)

Burke: It's not your fault. It's mine. I'm your teacher. I'm supposed to be. But you came to me as your boyfriend and I responded that way.

(Cristina gives him a look but she knows he's right)

Cristina: I'm not used to being wrong.

Burke: I know. But you're an intern. Second guessing a resident is not your job.

(Richard and Meredith are standing outside Grace's room)

Meredith: How long has it been?

Richard (looks at his watch): 2 hours and 17 minutes.

(Meredith nods)

Meredith: I saw you there. At the nursing home with my mother.

Richard: Oh.

Meredith: They said you go to her 3 times a week.

Richard (nods): Whenever I can.

Meredith: Why did you keep it a secret?

Richard (sighs): I don't know. Would you like me to stop going?

(Meredith avoids the question)

Meredith: I'm gonna go check on Grace.

(She stops at the doorway of Grace's room)

Meredith: Do you think she's lonely? My mother?

Richard: Yeah, I do.

(Grace's room where Grace's friends, Alice and her girlfriend, Richard and Meredith all keep a close watch over her)

(OR where Addison and Derek are performing the surgery on Cheyenne's baby. Izzie is there helping them. Izzie cuts the umbilical cord and Addison takes the baby out. She hands the baby to Izzie who takes the baby girl to the side and rests her down a lined table. She smiles at the baby)

(Grace's room where Grace is breathing very shallowly. All of the family and friends are touching and comforting Grace. Grace suddenly stops breathing. Meredith watches)

Ruth: May she rest in peace.

(Agnes struggles not to cry and puts an arm on Ruth's shoulder to comfort her. Eleanor rests her head against Agnes)

Meredith: Time of death (she clears her throat) 12:42.

(Meredith looks upset and heads out of the room)

(Meredith is exiting out of the room almost in tears and looking like she's having difficult breathing. Derek from afar notices Meredith who has her back to him and is about to walk up to her. He looks confused as she rushes into the nearest linen closet)

(Interior of the linen closet where Meredith is sitting down taking large gulping breaths. It seems like she's almost hyperventilating. Derek enters and looks concerned when he sees her. Meredith starts to cry as he crouches down next to her.)

Meredith (crying): I don't. I can't. I can't. I don't want. I don't. I can't. I don't. I don't want my mother to die alone.

(Derek just continues to look on comfortingly and concerned)

Derek (whispers): Slow down. Just slow down. Shh. Slow deep breaths now. Slow deep breaths.

(Meredith just continues to cry and breathe difficultly)

(Derek stands up and reaches above Meredith's head. He pulls down a white paper bag and hands it to Meredith)

Derek (calm quiet voice): Here. Take it easy. Slow down. Slow down.

(Meredith breathes into the bag. She takes on of his hands in hers and holds onto tightly. Her breathing slows down and she stops crying. She rests her head against Derek's shoulder. Derek brings up his other free arm around her and holds her and rests his head against hers. Meredith pulls away the bag and eventually sits up)

Meredith: I'm ok.

Derek (smiles): You're ok.

(She wipes a tear away and Derek brushes the hair away from her face)

Meredith: Thank you.

Derek: You're welcome.

(They stare into each other's eyes for a long time almost as if they might kiss. Meredith breaks the moment by looking away. She gets up and walks out leaving Derek sitting in the closet by himself)

(NICU where Izzie is checking on Cheyenne's baby who is in an incubator. Cheyenne is sitting on a rocking chair next to them)

Cheyenne: Do you ever wish you hadn't done it?

Izzie: No. I really don't.

Cheyenne: If I give her up, if I give her away, do I still get to name her?

Izzie: You can name her for yourself.

Cheyenne: Did you name yours?

Izzie: Uh ... Sarah.

Cheyenne (smiles): That's a pretty name.

Izzie (nods): Yeah.

(Meredith is walking down the hall and up to Richard. Richard looks apprehensive and Meredith smiles)

Meredith: I think you should keep visiting her.

Richard: You sure?

Meredith: Yeah. She lights up when you're around. She's alive.

(Burke and Cristina are walking down the hall. A few feet away is Sydney who's talking to Alex. Cristina stops walking)

Cristina: Oh, she's with Alex. I can't do this in front of Alex.

Burke: Well, you can and you will.

Cristina: Excuse me why aren't you apologizing?

Burke: I'm, I'm an attending. I don't apologize to residents. You on the other hand are an intern.

(He walks up to Sydney and Alex. Cristina follows)

Cristina: Sydney, I just wanted to ... (She glances briefly at Alex who looks very smug and straining to hear what she has to say) ah Just wanted to ah to ... (very quietly) apologize for you know overstepping, I'm sorry.

Sydney: Well that's the compassion I was looking for. Apology accepted. Okay, you wanna hug it out?

(She holds out her arms for a hug)

Cristina: Oh.

(Burke raises his eyebrows and watches Cristina's reaction)

Alex: Go, go hug.

Cristina: No, yeah.

Sydney: Come on.

(Cristina backs away and walks off. Burke walks with her)

(Patricia and Richard are in a small waiting room looking at a TV which shows the protest going on outside)

Richard: We need them, Patricia.

Patricia: Yes, we need them.

(They start walking down the hallway)

Richard: So where do I find the spare change? It's not like whatever's hiding underneath the couch cushions is gonna do it.

Patricia: Well I seemed to remember pushing through paperwork for a multi-million dollar surgery robot.

Richard: There was a two-year waiting list for that. It will bring a huge business.

Patricia: And could you and the robot handle that business without nurses?

(She walks off and Richard looks resigned)

(Picket Line)

(The line is deforming and the nurses are cheering. Richard is out there talking with them)

MVO: We can't help ourselves. We see a line. We want to cross it. Maybe it's the thrill of trading the familiar for the unfamiliar. A sort of personal dare.

(Derek's trailer, bedroom)

(Addison and Derek are in bed, with Addison lying in Derek's arms)

MVO: Only problem is once you've crossed it's almost impossible to go back.

(Meredith's house, George's room)

(George is lying in bed playing on his PSP. His door creaks open and closes. Izzie has come in. She gets in bed next to George and lies next to him. She sighs)

George: Are you okay?

Izzie: Yeah. Yeah I am.

(George returns back to his PSP. His door opens again and this time Meredith enters. She goes to the other side of George's bed and lies down next to him. She closes her eyes)

George: Are you ok?

Meredith: Yeah.

George (to both of them): What happened today?

Meredith: Nothing.

Izzie: Nothing.

George: Ok.

(He turns back to his game boy)

Izzie: We don't know everything about each other, George.

Meredith: Yeah.

George: True.

MVO: But, if you do manage to make it back across that line. You find safety in numbers.

(Meredith turns off lamp on the bedside table and the whole screen goes dark)

George: Anybody want to have s*x?

(Meredith laughs)

Izzie: George.