04x01 - A Change is Gonna Come

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GREY'S ANATOMY

4x01: A Change is Gonna Come

Original Airdate: 9/27/2007

Written by: Shonda Rhimes

Directed by: Rob Corn

Provided by TVTDB.com

(Seattle scenes)

(Richard sits at his desk)

MVO: In the practice of medicine, change is inevitable. New surgical techniques are created, procedures are updated, levels of expertise increase.

(George enters the locker room with the new interns)

MVO: Innovation is everything. Nothing remains the same for long. We either adapt to change...or we get left behind.

(Cristina's interns walk up to her)

Cristina: I have five rules. Memorize them. Rule number one, don't bother sucking up, I already hate you. That's not gonna change.

(Izzie is with her interns at a nurse's station)

Izzie: Trauma protocols, phone lists, pagers. The nurses will page you. You answer every page at a run...a run. That's rule number two. You're supposed to follow me.

(Alex is walking through the hall with his interns)

Alex: Your first shift starts now and lasts 36 hours. You're grunts, nobodies, the bottom of the surgical food chain. You run labs, you write orders, you work every second night until you drop, and you don't complain.

(Meredith is showing her interns the on-call rooms)

Meredith: On call rooms. Sleep when you can, where you can. You know, but not with anybody. Not attendings...especially not attendings. Sleeping with attendings...not a good idea. Where was I?

George: Um, rule number three. If you're sleeping, do not wake you unless a patient's actually dying.

(Cristina is showing her interns the on-call rooms)

Cristina: The dying patient better not be dead when I get there, because not only will you have k*lled someone, you will have woken me for no good reason. Are we clear? (Lexie raises her hand) Yes?

Lexie: That was four rules. You said five.

Cristina: Rule number five...when I move, you move. (They all stand there) Go!

(Alex, Izzie, Cristina and Meredith are in the deserted hallway hangout)

Cristina: I hate them.

Meredith: You don't hate them. You hate you.

Izzie: That was hideous. I feel like a fraud.

Alex: I rocked it. I think I'm the new n*zi.

Cristina: Oh, you are not the new n*zi.

(George enters)

George: Meredith, I need to talk to you.

Izzie: George. Hi.

George: Hey.

Izzie: How was your vacation?

George: Um, fine. Um, Meredith, can we...

Izzie: Cause mine was... I didn't do much. I hung out alone...for 17 days. Which is the last time that I saw you, the day of Cristina's wedding, which was...well...then Mer and Cristina went on Cristina's honeymoon without me.

Alex: Girl-on-girl honeymoon.

Izzie: And then Alex took a road trip to see Ava without me.

Alex: I did not go to see Ava. And her name's Rebecca. And I didn't go see her. I just drove in that direction.

Cristina: Oh, why is everyone so tingly and hurt? I mean, I'm the one who was left at the altar. I'm fine, by the way. I honeymooned in Hawaii and I snorkeled.

Izzie: What'd you do, George?

George: Um, Meredith...I...I really need to talk to you.

(Interns enter the hallway)

Cristina: Uh, hey, you want to know...hey, um, this is for residents only. No interns.

Meredith: Yeah.

Izzie: Yeah, get outta here.

Alex: Babies.

Izzie: Yeah, go away.

Alex: 007's in training.

Cristina: Seriously.

George: I guess I should be going, too.

Meredith: No, george.We didn't mean you.

George: No, I'm an intern.

Meredith: Wait. What did you want to tell me?

Cristina: Uh, is this how it's gonna be all year? Because Bambi has got to learn how to cope.

Izzie: At least he came back.

Meredith: Yeah, cut him some slack.

Alex: Dude, he failed his exam and got left back in kindergarten.

Cristina: Mm-hmm.

Izzie: He won't even look at me.

Meredith: Have you seen Burke?

Cristina: No. Have you seen Derek?

Meredith: No.

Izzie: Wait, you haven't seen either of them since the wedding?

Cristina: Nope.

Izzie: And you're all fine?

Meredith: Yep

Izzie: Wow...You're either incredibly healthy or completely messed up.

(Bailey walks up the desk where Derek is standing)

Derek: Your interns are back from holiday today.

Bailey: Uh, not my interns. They're residents. I'm free.

Derek: Right. Well...here,nurse. The point is, uh, Dr. Yang. The Burke thing...she doesn't know. I'm supposed to tell her. Burke asked me to tell her. Any thoughts?

Bailey: Honesty always works best.

Derek: Yeah, that's true. You want to get together for a drink after work tonight?

Bailey: Why?

Derek: Well, I don't know. I just thought it might be a good idea to get together and have

Bailey: Oh, you don't have anybody to talk to.

Derek: No, I have people to talk to.

Bailey: Addison is gone, Burke isn't around, and you and Grey aren't smelling each other in the elevators anymore.

Derek: I have people to talk to.

Bailey: Who?

Derek: I have...chief. I...I have the chief to talk to. Hey, chief. Want to get together for a drink after work?

Richard: I don't drink. Dr. Bailey, we need to talk.

Bailey: We have traumas coming in.

Richard: You're avoiding me. We need to talk.

Bailey: About you choosing Dr. Torres to be your chief resident over me? Respectfully, no, sir. We're not going to talk about that.

(Mark walks up)

Mark: Someone mention a drink later? Cause I'm in.

Derek: Nobody mentioned a drink.

Richard: You mentioned a drink.

Derek: I did not mention a drink.

(Richard enters the ER)

Richard: All right, people. We've got three MVC'S rolling in back-to-back from a multi car pileup. We need every trauma room open and everyone suited up.

Callie: Is there anything I...I should do, sir?

Richard: Save lives.

Callie: No. I mean as, uh, chief resident. Anything in particular?

Richard: Make sure your residents run their traumas. This is their first day on their own. Where...are the residents you've assigned to this ER?

Callie: Oh. Oh, I, uh, I, uh, I paged them. I...I paged them. Bailey?

Bailey: What?

Callie: Uh, I, uh, paged, uh, Grey, Yang, Stevens and Karev, but they're not here yet.

Bailey: When I page 'em, they come running.

Richard: Get it together, Torres.

Callie: Yes, sir.

(Richard walks away)

Bailey: Okay, you did not have to say that in front of the chief.

Bailey: You asked...boss.

(The interns are in the hall outside the ER)

Meredith: There's Derek.

Cristina: Is Burke with him?

Meredith: I don't see him.

(They enter the ER)

Callie: Where have you been? We have multiple MVC'S due any second.

Alex: We're here, aren't we? We're here.

Callie: Just...just get ready, okay? And monitor your interns.

(Cristina points to her interns)

Cristina: Okay, one, two, go get stat packs. Uh, three, four, go meet the ambulances.

Meredith: "One and two"?

Cristina: No, I can't remember their names.

(George raises his hand)

George: I don't respond to being called a number.

Meredith: George, go wait for the ambulance. The rest of you come with me.

(Alex talks to his interns)

Alex: All right, you guys stand against the wall and out of the way unless I call for you.

(Izzie talks to her interns)

Izzie: Okay, this is what's called a trauma situation. So there's gonna be lots of activity and a lot of patients, so if you guys have any questions at all, just ask, okay?

(Izzie walks away but overhears her interns)

Male Intern: I heard she, like, freaked out and k*lled a guy and had to go on probation.

Female Intern: Great. We're stuck with a dud.

(Lexie and George are in the ambulance bay)

Lexie: So, hey, you're an intern...again.

George: Yeah.

Lexie: I won't tell anybody. The other interns, I won't...

George: That's...that's okay.

Lexie: Do you know which one is Meredith Grey?

George: Yeah, I haven't, uh, told her you're here yet. I was going to...

Lexie: So you know who I am?

George: Yeah, I know who you are.

Lexie: What's she like? I...I mean, is she nice? 'Cause...cause my dad, he won't...he won't tell me. Is she...she...

(The other residents enter the bay including Bailey)

Bailey: Uh, Grey, don't let them just stand here.

Meredith: Let's move, people.

(The ambulance arrives)

Ambulance Driver: Unrestrained driver, DOA at the scene. Just need someone to pronounce him.

Cristina: Oh,crap. Dead guy. Why'd you get me all excited with the sirens? Okay, who wants to see a dead guy?

(Other ambulance)

Ambulance Driver 2: Nancy Walters, 34 years old, weeks pregnant. Complete upper arm amputation. Pressure dressings applied. Two large bore IVs started.

Nancy: Did he say "arm"? My arm is gone?

Bailey: Miss Walters, you're gonna be okay. Grey, check the wound.

Nancy: I really need my arm.

(Another ambulance)

Ambulance Driver 2: 45-year-old male, sustained a knee injury.

Joey: That guy, the guy that's dead, he hit a deer, and then the lady hit him, and then I hit the lady.

Callie: Knee is blowing up like a balloon.

Joey: Hey, I'm hungry. Can I get something to eat?

Cristina: Okay, everybody get a good look? Time of death...8:22.

(The man breathes)

Cristina: Not time of death. This guy is not dead.

Ambulance Driver: He was dead.

Cristina: Well, he's not dead now. Let's bag him. Okay,we've got a...we've got a guy who's risen from the dead over here.

Meredith: Get outta the way!

Lexie: Are...are you Meredith Grey?

Meredith: Yeah.

Lexie: I...I'm Lexie.

Meredith: Great. Move.

Lexie: Lexie Grey. I'm...I'm your sister.

(Nancy's trauma room)

Meredith: That girl out there, the dopey, wide-eyed one? Apparently we're related.

George: Oh, you...you met Lexie?

Meredith: Oh, you knew. Knew about it and didn't tell me, huh?

George: I've...kind of had a lot going on.

(Izzie and her interns enter)

Izzie: This is trauma room one. As you can see, it's...there's a trauma. Hey, guys, do you need some help? Please tell me you need some help.

Meredith: It's a little crowded in here already, Iz.

(Mark enters)

Mark: What do you got for me?

Meredith: Uh, Nancy Walters. Complete amputation.

George: The baby looks fine, but she's having some contractions.

Mark: Hi, Nancy. I'm Dr. Sloan. You mind if I take a look?

Izzie: It's a clean cut.

Mark: You want to rub up against me, you gotta buy me a drink first. Hang antibiotics and put on a sterile, moist dressing. There's a chance at a good recovery here. Do we have an arm?

Meredith: They're looking for it

Nancy: My baby has no father. He's already down two arms. So he really needs me to have an arm.

Mark: Get me that arm.

(Callie's trauma room)

Callie: Okay, somebody set up for a traumatic effusion drainage.

Joey: Ah...

Callie: And order him 4 of morphine.

Alex: She means one of you morons. Get her an 18 gauge needle and a 20 cc syringe and the damn morphine.

Joey: Hey, uh, morphine's cool, but I'd k*ll for something to eat.

Callie: A healthy appetite after a trauma like this? That's a very good sign, Joey.

Alex: You think he'll need surgery?

Callie: That depends on the x-rays. Knee looks good. No surgery.

(While Alex and Callie are looking at the x-rays, Joey starts eating cotton balls)

(Cristina's trauma room)

Izze: Okay. This is Cristina...Dr. Yang. She's working.

Cristina: Yep, saving lives and taking names.

Izzie: So...I have these interns and nothing to do. And, uh, I think I'm a really bad teacher. And I think they hate me. And now I'm a fraud. So any chance you wanna let me in on this? Please.

Cristina: Izzie, this guy was dead, and now he's undead. So that kinda makes him like a zombie my personal zombie. So no, you can't get in on this. Now go be A...fraud somewhere else.

Izzie: I don't like you.

Cristina: Mm-hmm.

Izzie: Let's go, people.

(Lexie enters)

Lexie: Excuse me.

Cristina: You know, where have you been? I've been waiting for these.

Lexie: I got...I was...I met my sister, uh, for the first time ever...

Cristina: Oh, hey.

Lexie: Which, uh, got me, you know, weird. So then I got, um, lost on my way to x-ray 'cause I was all in my head, you know, about...about meeting Meredith.

Cristina: Meredith is your...is your sister?

Lexie: Meredith Grey. Lexie Grey. We're half sisters. So you know her?

Cristina: Oh, we need to page Dr. Shepherd.

Lexie: Dr.Shepherd. He...he's the, um...neurosurgeon?

Cristina: Okay, somebody page Derek shepherd right freakin' now.

(Derek walks up to where Meredith is on the phone)

Meredith: Grey. Thank you. Seattle grace. Thank you.

Derek: Hi. How are you?

Meredith: I have a patient with a severed arm and no one seems to be able to find it. Have you seen it?

Derek: Your severed arm? No, I haven't seen a severed arm.

(Lexie walks up)

Lexie: Meredith, how...hey, um, I'm...I'm so sorry about before. I just was so nervous about meeting you. Don't block the ER doors. I know that now. That was a good lesson.

Derek: You're the girl from the bar.

Lexie: Sorry?

Derek: The girl from the bar?

Lexie: Oh, my god. Yeah. Oh, my god. Yeah.

Derek: Yeah.

Lexie: Oh, my god. You...you work here.

Derek: Yeah, I do.

Meredith: Girl from the bar?

Derek: Mm-hmm.

Meredith: I'm the girl from the bar.

(Meredith storms away)

Lexie: Uh...she hates me. My sister hates me.

Derek: Meredith is your sister?

Lexie: My half sister, yeah. Hey, uh, you're Dr. Shepherd.

Derek: That's right.

Lexie: I'm...I'm supposed to be finding you for a consult.

(Callie and George are in the x-ray room)

Callie: Hey. There you are. I missed you this morning.

George: Yeah, I didn't want to be late for my second first day as an intern.

Callie: Maybe you can look at it like this...you have one up on everyone. You're gonna be, like, the rock star intern.

George: Yeah, I'm sure that's how everyone's gonna see me when they find out. Or maybe they'll see you as the daddy intern.

George: What? What...what did you just say?

Callie: Oh...I'm not...I'm not pregnant. I just...I mean, I might be pregnant. Yeah, my boobs are a little sore, which...Hey, I'm trying to cheer you up here, George. This is...I mean, if I am knocked up, that's a good thing, right?

George: Callie, I'm just a little distracted. I'm having a bad day.

Callie: Okay, you're having a bad month.

George: Okay, I'm having a bad month.

Callie: Love you.

(Michael and Chris enter the ER)

Michael: Help! We need doctors. Help!

Chris: Inside voice. Uh, we found an arm in the road.

Meredith: Here, I bagged that...that's my arm.

Michael: Dad, dad, tell them she's hurt! Dad, come on. Tell the doctor! Tell 'em she's hurt.

Male Intern: Uh, any way we can go with the severed arm?

Michael: She's in the truck, and she's hurt.

Izzie: Is that your blood? Are you hurt?

Michael: She's in our truck, and she's not moving. She's bleeding really bad.

Izzie: There's another crash victim. We're gonna need gloves, IVs, gauze, ab pads, trauma gowns. Still want to baby-sit the arm?

Michael: Come on

Chris: Michael!

(They get to the truck to find a deer inside)

Female Intern: No way.

Michael: Is she dead?

Izzie: Michael, this is a hospital, and I'm a people doctor. I...

Michael: Can you save her?

Chris: Michael, come on.

Izzie: I'm sorry, but she's...

Female Intern: Roadkill.

Michael: She opened her eyes. Look. She's still alive!

Izzie: Oh, god. Don't look at me like that. Or like that.

Chris: Michael, let's go back to the truck Come on..

Michael: Please.

Izzie: Oh, okay, all right. All right. Uh, I'm gonna need a jumbo catheter, a 16 gauge needle, the biggest ambu bag you can find and something that shaves fur. What's the matter with you people? When I say move, you move. Move!

(Derek and Cristina are in the trauma room viewing room)

Derek: Back of his skull is completely disconnected from his first cervical vertebrae.

Cristina: He's been internally decapitated. Holy crap.

Derek: Yeah, 90% of these die in the field.

Lexie: And the other 10%?

Derek: I've never seen one live.

Lexie: There's always a first time, though, right? I mean, he came back from the dead.

Derek: Henry, I'm Dr. Shepherd. The back of your skull is disconnected from your spine. I'm gonna try and reconnect it in surgery. Do you understand me? Blink once for yes, twice for no.

(He blinks twice)

Derek: Okay, good. I know it's scary, but I promise you, I'm gonna do everything I can. Do you have family? All right. We're gonna contact them, okay? All right, let's get him in a halo.

Cristina: Uh-huh.

Derek: Contact his family. Find out if he's an organ donor.

(Alex is in Joey's room with his interns)

Alex: You, finish up with the splint, then get him up on crutches.

(Callie enters)

Callie: Hey. How's Joey?

Alex: It's a hungry hippo missing a kneecap. Can't you assign me something good?

Callie: I don't switch out patients, Karev.

Alex: But it's not even surgical. It's a waste of my skills.

Callie: You're staying here with Joey.

Alex: Come on.

Callie: No!

Alex: Fine. I'm going to Bailey

Callie: You are a resident. You go where I say.

(Meredith is in Kathy's room)

Kathy: My arm is gone.

Meredith: We have the arm, and Dr. Sloan is checking right now to see if we can reattach it. Is there someone we can call?

Kathy: There's no...no, I just...I just moved here. I'm all...I'm all by myself. There's no one. I have no one.

Meredith: Well, Dr. Sloan should be here any minute.

Kathy: I wanted a kid and...I was sick of waiting for the right guy, so...in my family...in my family, you don't go out and get pregnant. So now I'm alone and...I'm having a baby, and I don't have a father for the baby, and I don't have an arm.

Meredith: It's okay. Here's Dr. Sloan.

(Mark enters)

Mark: Nancy...I'm happy to report that your arm is in good shape. Dr. Grey here is gonna clean it up a little, and...and I'm gonna put that arm back where it belongs, okay?

Kathy: Okay.

Mark: Okay.

(Izzie is in the truck working on the deer)

Izzie: We got a 150-pound female with...lacerations on the chest and haunches, short, fast breaths. Any recommendations?

Chris: Uh, doctor, Michael's a big boy. He doesn't need you to perform make-believe medicine, right, Michael?

Michael: It's not make-believe. She can help.

Chris: Michael, enough. I apologize. We're just wasting your time.

Female Intern: No kidding.

Chris: Michael.

Michael: Please don't let her die.

Chris: Michael, it is a deer. We're gonna take her home and skin her and freeze the meat, okay?

Michael: What? Why?!

Chris: Because that's what you do. You don't try and save 'em. You eat 'em.

Michael: No, dad. The doctor can save her.

Chris: No, she can't.

Izzie: You don't know that.

Chris: My son needs to learn to grow up and face things.

Izzie: You're right. I am not helping him. I'm helping Bambi. So get me the ambu bag and the saline. I'm starting an IV.

Michael: Thank you.

(Meredith is cleaning up Kathy's arm when Cristina enters)

Cristina: Still no sign of Burke. Oh, you've got a severed arm.

Meredith: My arm. Mine. Get away from it.

Cristina: Maybe he's not on today.

Meredith: Maybe you should just see him and get it over with.

Cristina: No, no, no, no. If I never see him again, I won't care.

Meredith: Well, I've seen Derek, and Derek has seen me.

Cristina: And?

Meredith: Awkward. Plus he seems to know Lexie.

Cristina: And?

Meredith: More awkward. Your intern is my half sister. How weird is that?

(Izzie enters)

Izzie: Well, I'm trying to save Bambi's life. My interns think I'm a loser. Severed arm.

(Alex enters)

Alex: Callie's a bitch.

Izzie: Word.

Alex: She won't let me off my patient, and there's nothing wrong with him except he's a nut job. Severed arm.

Izzie: Does anybody know anything about deer?

Alex: They taste good.

Izzie: Evil.

(George opens the door but remains in the hall)

Cristina: Oh, George, severed arm. Plus Mer's half sister is my intern, Izzie is playing Dr. Dolittle, oh, and Alex hates your wife.

George: Dr. Sloan's ready for the arm.

Meredith: I'll say it. George is being an ass.

Izzie: I think it's my fault. I said some things, and now he's not talking to me.

Alex: I don't know what he's got to complain about. Those new chick interns are hot.

Cristina: He's married, Alex.

Izzie: Yeah, he's married.

Alex: You know who's seriously hot? That Lexie girl.

Meredith: Get out...before I hurt you.

Alex: I'm going over Callie's head to bailey.

Cristina: Uh, Callie is over bailey's head.

Meredith: Spiritually, Bailey's over everyone's head.

(Richard and Bailey are in the ambulance bay)

Richard: Dr. Bailey. How are things going?

Bailey: I wouldn't know. Ask Dr. Torres.

Richard: Miranda...

Bailey: I don't want to talk.

Richard: Miranda, it is not like you not to want to talk.

Bailey: Fine. How's your wife?

Richard: Well, she's...she's...good. I haven't moved back in yet. She hasn't let me move back in yet. She's not taking my calls. Wait. That's not what I want to talk to you about. I want to talk about chief resident. Now we're gonna have this conversation.

Bailey: Are you ordering me to stand here and talk to you about this, chief?

Richard: No, I'm not ordering you. But I just thought we could...

Bailey: Okay, then. Good-bye, sir.

(Cristina and Derek are at a nurse's station)

Cristina: I talked to the family they're on their way.

Derek: Good. I put an entire OR on hold. We don't have much time.

Cristina: Uh, can I get a progress note?

Derek: Uh, do you maybe want to have a drink later?

Cristina: What?

Derek: A drink. Give me one reason why we can't hang out.

Cristina: I don't like you.

Derek: You don't like me because of Meredith?

Cristina: I don't like you because you're you.

Derek: Hmm. How is Meredith, by the way? Is she okay?

Cristina: She's fine.

Derek: She's always fine. That's her problem.

Cristina: We're fine people. We do fine. We're fine. How's Dr. Burke? I haven't seen him around. Is...is he off today?

Derek: Here. Dr. Burke handed in his letter of resignation two weeks ago. He wanted me to tell you.

Cristina: He's gone?

Derek: I'm sorry.

Cristina: Well, don't be. I'm...

Derek: Fine?

Cristina: Yeah.

(Alex notices Izzie on the computer)

Alex: Circulatory system of a deer?

Izzie: Shut up.

Alex: Oh, Dr. Bailey. Uh, couldn't you use an extra set of hands in the OR today? I saw an appy on the board. I'm...I'm great at appys.

Bailey: Talk to Torres. She's in charge of what cases you get now.

(Callie enters)

Callie: It's hard to set a shattered kneecap when your patient's in the pit, don't you think?

Alex: Whatever.

(Alex storms out)

Callie: I don't know how you did it.

Bailey: Did what?

Callie: Get 'em to listen to you, to give you some respect.

(Callie leaves)

Izzie: Hey, Dr. Bailey, you wouldn't happen to know anything about, uh, the anatomy of a deer?

Bailey: Not my intern, not my business, not anymore.

(Cristina is in the hall with Henry's family)

Cristina: Your husband's injuries are s-severe. Uh, they're traumatic in the extreme.

Wife: I'm sorry. What does that mean?

Cristina: The only thing holding his head on to his body is skin and muscle. If he moves even a fraction of an inch, it could k*ll him.

Wife: So are you saying that the...

Cristina: I'm...I'm saying that when you see him, this could be the last time...this could be the last time you see him alive.

(They enter the room)

Wife: Are you in pain, sweetie? Good. Two blinks...you aren't in pain.

Daughter: Why isn't daddy answering?

Wife: Just...right now we just need to wish daddy good luck in his surgery and tell him how much we love him. Okay? Cause we do. I love you so much, Henry. (He blinks three times) What's...what's three blinks?

Cristina: Uh, we've only been working with one and two.

Wife: Is it "I love you"? Are you telling us you love us? Three blinks is I love you. We're gonna be fine, Henry. You're gonna make it, and we're all gonna be just fine.

Derek: It's time to go.

Wife: Okay, guys. Let's let these doctors fix daddy up.

(His daughter walks over and blinks three times)

(Izzie runs into George in the stairwell)

Izzie: George. George. Why are you avoiding me?

George: I'm on my way to surgery.

Izzie: No, I don't mean right now. I mean, not one word in 17 days? I tell you that I love you, and not one word? Where have you been?

George: I've been right here. You know where? Exactly where I was a year ago. I'm sorry. I...I'm freaking out. I'm an intern again.

Izzie: Yeah, we're all freaking out. We're all freaking out. I'm in charge of a group of interns who think I'm crazy. And I might actually be crazy, because day one of me being in charge, and I'm obsessed with rescuing Bambi. We're all freaking out.

George: Since when did you start calling me Bambi?

Izzie: What? I'm not calling you Bambi.

George: No, I mean, I know I...I...I under...I expect it from Cristina or Alex, but...

Izzie: I'm Bambi. I'm Bambi, George, okay? If anyone in this situation is a sad little cartoon character, it's me. I'm all alone in the forest...all alone in the forest, George...and my mother's been sh*t by a hunter, and where are you? Where the hell are you?

George: I'm on my way to surgery.

(Mark enters the scrub room where Derek is)

Mark: I really am up for a drink, you know? If you, uh, need to talk.

Derek: What would I need to talk about?

Mark: Meredith. You were lucky, man. That girl jerked you around.

Derek: You have no idea what you're talking about.

Mark: Hey, I'm just...seemed like you could use a friend about now.

Derek: Meredith's mother never wanted her, and her father was never man enough to hang around. She has a right to be damaged, and us, together, it's a big step for her. Her best friend gets left on the altar, and all she sees now is things like this, they don't work. She panics. She wants this. She doesn't know how to have it. And you know what? That's not her fault. So don't ever talk to me about Meredith Grey again, because you do not know what you're talking about. And I don't need a friend.

Mark and Meredith are in Nancy's OR[/i])

Doctor: Okay, Nancy, I want you to count back from a hundred, okay?

Nancy: No. No. I'm not ready.

Meredith: It's just like going to sleep.

Nancy: I can't do any of this alone. I don't want to be alone anymore.

Meredith: I know.

Nancy: No, I'm scared.

Meredith: I know.

Nancy: I am scared, Meredith.

Nancy: I know.

Meredith: I think it's very brave, what you're doing. It's much better to be alone and feel like a success than to be in a relationship and feel like a failure all the time, right?

Nancy: That's what I think.

Meredith: So let's just take care of your arm, and then we'll deal with the rest later, okay?

(Alex enters Joey's room)

Alex: Well, it looks like I'm back to babysitting. What the hell? Who took my clamps and the bandage scissors?

(Joey starts choking)

Alex: Joey? There's a foreign body. His abdomen's rigid. Somebody page Dr. Bailey right now. Come on, Joey.

(Outside at the truck)

Chris: You like hamburgers, don't you?

Michael: Yeah.

Chris: And spaghetti with meatballs, and lasagna?

Michael: Mm-hmm.

Chris: That's beef. That's cow you're eating, son.

Michael: What do you mean?

Izzie: Could we have the "circle of life" lesson later? I need to get in here.

Male Intern: Sorry.

Izzie: Her eyes are glassy. You, get in here and ventilate. We're losing her.

Chris: This is absolutely childish and ridiculous.

Izzie: No, it's not. It's not childish to hold on to hope. It's actually hard...very, very hard. Your son just wants to believe that some things can work out for the best. Get me the paddles. Come on, come on, come on.

Male Intern: What's she doing?

Female Intern: Insuring we never see the inside of an OR this year?

Izzie: She's in v-fib. I'm gonna shock. Charge to 300 and stand back. Okay, clear. (She shocks the deer which jumps up) Oh, my god. Oh, my god. She's alive? It worked. She's okay. Everything's gonna be okay. Oh, my god.

(Kathy's OR)

Mark: Got a big bleeder. Dr. Grey, press and hold right here.

George: She's having contractions.

Meredith: Well, take a look, George. Probably the stress.

George: No, these are strong, and they're two minutes apart.

Mark: Call OB and get someone in here.

George: Uh, I don't think there's time to call OB. Her water just broke, and she's crowning.

Mark: Call peds. Get a warmer in here.

George: This baby's coming now.

Mark: O'Malley, get her up in stirrups.

George: Can we put her in a reverse trendelenburg, have one of the nurses press her abdomen since she can't push?

Mark: Try it without all the jostling. I'm holding on to a major artery here.

George: Okay, clamp. Scissors. I got it. I got him.

Meredith: Great job, George.

George: Thanks.

Mark: Yeah, yeah, we're all heroes. Now if no one minds, I'd like to get this woman's arm sewn on. Like she said, she's gonna need it.

(Henry's OR)

Derek: I'm starting the fusion now.

Lexie: Did he just move?

Cristina: Oh, he...he definitely moved.

Derek: The anesthesia's light. Yang, stabilize his neck.

Cristina: Okay, three, come and grab his feet. Go under the drape and do not contaminate the sterile field.

Derek: We need to keep him very still until he is under. We can't risk even the slightest movement.

Cristina: You cannot move. Do you hear me? This is not an option. Everything is not gonna be fine if you move. It will be the opposite of fine. You cannot leave the people you love. They need you. Not just the memory that you love them.

(Callie enters Joey's OR)

Callie: Anyone care to explain to me how my patient wound up in this OR and I wasn't even informed? Karev?

Bailey: Dr. Karev didn't page you because he knows how to prioritize. Ten minutes ago, this patient was coding from a perfed abdomen. Under the circumstances, Dr. Karev's quick thinking is the reason that your patient is even still alive.

Callie: I'll expect a fully dictated chart before you leave tonight, Karev.

(Callie leaves)

Bailey: Ah, jackpot.

Alex: Did he swallow those?

Bailey: Poor fool. He must suffer from pica, an uncontrollable urge to eat any and everything. Alex: Check it out...a buffalo nickel.

(Richard enters)

Richard: Dr. Bailey, I saw you were scrubbed in. I thought I'd stop by and see what you've got.

Bailey: What I've got? $2.37, sir, in change.

(Lexie and George are at the nursery window)

Lexie: It's like a cute festival in here.

George: I delivered that one an hour ago.

Lexie: Oh, my god. Why aren't you, like, jumping up and down?

George: I've done this before. This is d�ja vu.

Lexie: Look, George, you didn't pass your intern test. You know, it...it happens. It's...it's nobody's fault. Right?

George: It's nobody's fault. Yeah, it's just that Callie gave Cristina the study cards, and Meredith didn't write anything down, and Cristina was planning a wedding, and Izzie...Izzie just had to. You know, I'm...I'm...I'm responsible. I've always been the responsible one. I'm not saying, "what about me?" I'm not saying, "when do I get what I want? "When do I get to be someone other than the guy who repeats his intern year?" I'm not saying that, but...

Lexie: But what about you?

George: Yeah!

Lexie: I didn't plan on being here. I was all set for an internship at Mass Gen. And then, my mother gets the hiccups, and I'm at a funeral. You know, we all have problems. Moms die ,and dads drink so much that they don't even know what year they're in, and sisters...I...I didn't even know that there was a Meredith Grey until a couple of months ago. And she won't...she doesn't even want to talk to me. I don't want to be here. You know, I...I'd giving anything to not be here. You know, to...to have my life work out the way I planned, to even have time to ask, "what about me?" So you...you change. You...you get over it. I'm here now, so...and you...you delivered a baby today. So, stop feeling sorry for yourself.

George: You...are kind of awesome.

Lexie: I know.

(Joey's OR)

Richard: Karev why don't you make sure Psych's prepared to consult on the patient? Thank you. Now whether you like it or not, you and I are gonna talk.

Richard: Chief...

Richard: I know you're angry and disappointed.

Bailey: No, I'm not angry. I'm not disappointed. I'm speechless. I don't want to talk because I am speechless. It makes me speechless to realize you didn't think that. I would've made an...an excellent chief resident.

Richard: You're right. You would've made an excellent chief resident. But you'll make an even more excellent surgeon. You belong in the OR, Bailey. Focus on honing those skills, not on how well you can juggle schedules or fill out paperwork. Believe me, I know. You'll thank me for this one day.

Bailey: But not today.

(Mark and Derek are at the surgical board)

Mark: I'm the one that could use a friend. I said that you could use a friend. I could use a friend.

Derek: Look, Mark...

Mark: No, I didn't come to Seattle for Addison. I didn't come to Seattle to be chief. I came to Seattle for you, okay? I came to Seattle to get you back. (They both smile) I know, I want to take it back now, but I already said it, so...

Derek: Yeah, maybe we should have a drink.

Mark: We could.

Derek: Yeah. Not today.

(Izzie is in the parking lot with her interns)

Izzie: I know you didn't wake up this morning expecting this was how your first day was gonna go. You thought you'd get to reattach an arm or observe brain surgery. Instead you helped save the life of a deer. You can bitch and complain about it, or you can adjust your expectations. 'Cause like it or not, you're stuck with me. And I'm the kind of doctor who lets a little kid convince her she can do the impossible. Oh, plus, when I woke up this morning, I thought today was gonna go a lot differently, too. I thought I was gonna get the good interns. Instead I get stuck with the duds. So I have to adjust my expectations as well.

(Cristina watches Henry's family go in to talk to him)

(George enters the locker room. Everyone is looking at him and smiling)

George: What?

Female Intern: We heard...we heard you delivered a baby today.

Lexie: On your very first day as an intern.

George: Yeah.

Female Intern: What was it like?

Male Intern: Did you do it all by yourself?

Female Intern: Was it just like...did your head just explode with the amazingness?

Lexie: Your very first day.

George: It was pretty cool. He came out really fast. I had to, uh, you know, determine the position of the cord. You know what a reverse trendelenburg is?

(Alex enters the abandoned hallway where Cristina is)

Alex: I filled this entire bag with coins from my patient's stomach today.

Cristina: No kidding?

(Cristina looks sad and lost)

Alex: I miss Rebecca.

Cristina: I miss Burke.

Alex: Want some money?

MVO: Change. we don't like it, we fear it.

(Bailey leave the hospital and walks past Callie)

Callie: What? You want to humiliate me some more? 'Cause I get it. I suck. I suck at my job. I suck as a wife. I suck all around, so, go ahead. Humiliate me some more, please.

Bailey: Hope tomorrow's better.

MVO: But we can't stop it from coming.

(Meredith exits the elevator)

Lexie: Meredith.

Derek: Meredith.

MVO: We either adapt to change, or we get left behind.

(She walks away with Derek, leaving Lexie standing there. They enter an on-call room)

Meredith: I, um...

Derek: You're not ready for this?

Meredith: No.

Derek: I asked for too much.

Meredith: I think so.

Derek: So this is it?

Meredith: Yeah.

Derek: We're breaking up.

Meredith: We're breaking up.

MVO: It hurts to grow. Anybody who tells you it doesn't is lying.

Derek: We're broken up.

Meredith: It's done.

(They kiss)

Derek: So a breakup kiss.

Meredith: A breakup kiss.

Derek: And some breakup sex.

Meredith: Yeah, breakup sex.

MVO: But here's the truth. sometimes the more things change, the more they stay the same.

(Izzie answers the door and it's George)

MVO: And sometimes...oh, sometimes change is good.

George: I love you, too.

MVO: Sometimes change is...everything.