Nurse: What do you need?
Izzie: Mr Jones has junkie veins and he really needs antibiotics so I should start a central line.
Nurse: So start one. [Pause.] You don’t know how.
Izzie: I’ve never done one.
Nurse: Well, you know what that means. [looks to Bailey]
Izzie: Can’t we just…page someone else?
Nurse: She’s the on-call resident.
Izzie: Okay. Okay, I’ll just – I’ll wake her. [walks over, taps Bailey’s shoulder] Dr Bailey, I don’t mean to bother you, but –
Bailey: Then don’t.
Izzie: It’s Mr. Jones.
Bailey: Is he dying?
Bailey: Then stop talking to me.
[Izzie turns away, turns back. Bailey gives up on sleep and sits up.]
Bailey: What is it?
[Cut to Bailey finishing up with the central line.]
Bailey: Next time you wake me, he better be so close to dead there’s a tag on his toe.
[Cut to the city going from night to day. Several shots of Cristina/George/Izzie looking overworked.]
Karev [male intern]: 4B’s got post-op pneumonia. Let’s start antibiotics.
Nurse: Are you sure that’s the right diagnosis?
Karev: Well I don’t know, I’m only an intern. Here’s an idea, why don’t you go spend four years in med school and let me know if it’s the right diagnosis. She’s short of breath, she’s got fever, she’s post-op. Start the antibiotics. [walks over to Meredith] God I hate nurses. I’m Alex. I’m with Jeremy, you’re with the Nazi, right?
Meredith: She may not have pneumonia, you know. She could be splinting, or have a PE.
Karev: Like I said, I hate nurses.
Meredith: What did you just say? Did you just call me a nurse?
Karev: Well, if the white cap fits…
Meredith’s pager beeps and she walks away.
Meredith: Damnit, Katie…[not running this time]
Karev: She seeing anybody?
George: I don’t know.
Karev: [whistles] She’s hot.
George: I’m friends with her. I mean, kinda friends, I mean, not, you know, actually friends, not exactly, but we’re tight. We hang out. I mean, really only just today –
George: - but –
Karev: Dude. Stop talking.
[Cut to Meredith, walking up the stairs to Katie. She’s not in a hurry. She sees nurses rushing into the room and starts to run.]
Nurse 1 [echoey voice]: What took you so long?
Nurse 2 [echoey voice]: She’s having multiple grand mal seizures, now how do you want to proceed? Dr. Grey? Are you listening to me? She’s got Diazepam, 2mg Diazepam, I just gave her a second ago, Dr. Grey, you need to tell us what you want to do. Dr Grey!
[Meredith is panicking. She picks up the chart and voices stop sounding echoey.]
Meredith: Okay, she’s full on Prazepam?
Nurse 1: She’s had 4mg.
Meredith: Did you page Dr. Bailey and Dr Shepherd?
Nurse 2: The Prazepam’s not working.
Meredith: Phenobarbital, load her with Phenobarbital.
Nurse 2: Pheno’s in.
Nurse 3: No change.
Meredith: You paged Dr. Shepherd?
Nurse 3: I just told you.
Meredith: Well page him again! Stat.
Nurse 2: What do you want to do? [back to echoey voice] Dr. Grey, you need to tell us what you want to do!
Nurse 2: Heart’s stopped!
Nurse 1: Code blue, code blue! Code blue, code blue!
They pull out the defibrillators. Meredith takes them, her brain’s working again.
Meredith: Charge pulse of two hundred.
Nurse: Charged. Clear. [Meredith defibs]
Nurse 2: Still defib. Nothing.
Nurse 1: Charging. 19 seconds.
Meredith: Charge to 300.
Nurse 1: 300. Anything? 27 seconds.
Meredith: Charge to 360. [still nothing] Come on, Katie.
Nurse 3: 49 seconds.
Nurse 2: At 60 seconds you’re supposed to admit her -
Meredith: Charge again! [nurse doesn’t] Charge again. [nurse does, we see Katie’s BP register] Anything?
Nurse 1: I see sinus rhythm.
Nurse 2: Blood pressure’s coming up.
Nurse 1: All right now. Pressure’s returning. Grid’s coming back…
[Shepherd runs in.]
Derek: What the hell happened?
Meredith: She had a seizure, and –
Derek: A seizure?
Meredith: her heart stopped.
Derek: You were supposed to be monitoring her.
Meredith: I checked on her and she –
Derek: I got it. Just – just – go. [Meredith turns away] Someone give me her chart, please?
[Cut to Meredith walking towards Bailey.]
Bailey: You get a 911, you page me immediately, not in the five minutes it takes you to get to the emergency, immediately, you are on my team and if somebody dies it’s my ass, [Meredith’s walking away] you hear me, Grey?
[Meredith walks outside into the rain, Cristina follows. Meredith throws up on the grass; Cristina has stopped at the door.]
Meredith: If you tell anyone, ever…[re-enters hospital].
[More cityscape and sunrise: Hour 24.]
Katie’s father: [to Derek] You said it was a seizure disorder. Now you’re saying it isn’t?
Derek: I’m saying that I don’t know.
Mother: Well, what do you think it could be?
Derek: I don’t know.
Father: [frustrated] When will you know?
Derek: I don’t have an answer for you. For now, Katie is stable –
Father: Wait one damn minute. We came here because this hospital is supposed to be the best in
Derek: Mr. Bryce, -
Father: No, I want someone else. A doctor who knows what they’re doing. You get me someone else. Someone better than you.
Derek: Mr Bryce, I assure you that I am working hard on Katie’s case.
Father: No, you’re not. If you were, you’d be able to give me some answers.
[Cut to Burke, talking to the guy who can’t eat any more bacon.]
Burke: I put you on a bypass machine, which pumps blood for your heart, fix your ticker, take you off the machine, I’m done. Simple procedure.
Woman: So, I shouldn’t worry?
Burke: I’m very good at what I do. It’s still a surgery. There are some risks. I’ll see you in the OR this afternoon, Mr. Savage.
Mr Savage: You’re not going to leave me in there alone with that guy, are you?
George: Oh, I’ll be outside the OR the whole time. Dr Burke is very good. Don’t worry. I’ll see you after.
Mrs. Savage: He’ll be fine, right?
George: It’s one he’s going to sail through. You have nothing to worry about. I promise. Gotta go.
[Cut to Cristina and Meredith.]
Meredith: What are you doing?
Cristina: I’m suturing a banana, with the vain hope that it wakes up my brain.
Cristina: What’re you smiling at, 007?
[George stops laughing.]
Cristina: I’m sorry, I get mean when I’m tired.
George: You know what? I don’t care. I comforted a family, and I get to hang out in the OR today. All is well.
Cristina: Does anybody know why we’re here? [lots of interns, packed into one room. Derek enters.]
Derek: Well good morning. I’m going to do something pretty rare for a surgeon, I’m going to ask interns for help. I’ve got this kid, Katie Bryce. Right now, she’s a mystery. She doesn’t respond to her meds. Labs are clean, scans are pure, but she’s having seizures. Grand mal seizures with no visible cause. She’s a ticking clock. She’s going to die, if I don’t make a diagnosis. Which is where you come in. I can’t do it alone. I need your extra minds, extra eyes, I need you to play detective, I need you to find out why Katie is having seizures. I know you’re tired, you’re busy, you’ve got more work than you could possibly handle. I understand. So, I’m going to give you an incentive. Whoever finds the answer rides with me. Katie needs surgery. You get to do what no interns get to do. Scrub in to assist on an advanced procedure. Dr Bailey’s going to hand you Katie’s chart. The clock is ticking fast, people. If we’re going to save Katie’s life, we have to do it soon.
[All interns grab copies of her chart. Cut to Meredith and Alex.]
Alex: Look, give the antibiotics time to work.
Nurse: The antibiotics should’ve worked by now.
Alex: She’s old, she’s freaking ancient. She’s lucky she’s still breathing. Now, I got a shot to scrub in downstairs and a patient who wasn’t alive during the civil war. Don’t page me again. [walks off, Cristina comes over]
Cristina: Hey, I want in on Shepherd’s surgery. You’ve been the intern on Katie since the start. You want to work together? We find the answer, we have a fifty-fifty chance of scrubbing in.
Meredith: I’ll work with you, but I don’t want in on the surgery. You can have it.
Cristina: Are you kidding me? It’s the biggest opportunity any intern will ever get.
Meredith: I don’t want to spend any more time with Shepherd than I have to.
Cristina: What do you have against Shepherd?
Meredith: If we find the answer, the surgery’s yours. Do you want to work together or not?
Cristina: [grinning and shaking her head] Deal.
[Cut to library.]
Cristina: Well, she doesn’t have anoxia, chronic renal failure or acidosis. It’s not a tumour because her CT’s clean. Are you seriously not going to tell me why you won’t work with Shepherd?
Meredith: No. What about infection?
Cristina: No. There’s no white count, she has no ceteal lesions, no fevers, nothing in her spinal tap, just tell me.
Meredith: You can’t comment, make a face, or react in any way. We had sex.
[Cristina opens her mouth, closes it, and]
Cristina: What about an aneurysm?
Meredith: No blood on the CT, and no headaches.
Cristina: Okay. There’s no drug use, uh, no pregnancy, no trauma…was he good? I mean, he looks like he would be, was it any good?
Meredith: What are the answers? What if no one comes up with anything?
Cristina: You mean if she dies?
Cristina: This is gonna sound really bad, but I really wanted that surgery.
Meredith: She’s just never going to get the chance to turn into a person. The sum total of her existence will be almost winning Miss Teen whatever. You know what her pageant talent is?
Cristina: They have talent?
Meredith: Rhythmic gymnastics. [they laugh]
Cristina: Oh, come on.
Meredith: What is rhythmic gymnastics? I don’t know – I can’t even say it, I don’t know what it is.
Cristina: Isn’t it like something with a ball, and a [Meredith goes still] …what? Meredith, what?
Meredith: Get up! Come on!
[Cut to them running.]
Cristina: - the only thing she could possibly need is a – Oh, oh, Dr. Sheppard! Just one moment, um, uh, Katie competes in beauty pageants –
Derek: I know that, but we have to save her life anyway.
Cristina: Okay, she has no headaches, no neck pain, her CT’s clean, there’s no medical proof of an aneurysm –
Cristina: - but what if she has an aneurysm anyway?
Derek: There are no indicators.
Cristina: Ah, but she twisted her ankle, a few weeks ago when she was practising for the pageant –
Derek: Look, I appreciate you’re trying to help, but –
Other doctor in elevator: This is not helping!
Meredith: She fell. When she twisted her ankle, she fell.
Cristina: It was no big deal, not even a bump on the head, you know she got right back up, iced her ankle and everything was fine, it was a fall so minor her doctor didn’t even think to mention it when I was taking her history, but she did fall.
Derek: Well, you know the chances that a minor fall could burst an aneurysm, one in a million! Literally.
The elevator door is finally allowed to close. Meredith and Cristina sigh and turn away. The elevator dings and Derek steps out. They turn back.
Derek: Let’s go.
Derek: To find out if Katie’s one in a million.
Cut to Cristina, Meredith and Derek looking at a scan.
Derek: I’ll be damned.
Tech operating scan: [indicating dark spots] There it is.
Derek: It’s minor, but it’s there. It’s a cerebachnoid haemorrhage. She’s bleeding into her brain.
Cut to Meredith, Derek and Cristina walking.
Derek: She could’ve gone her entire life without it ever being a problem. One tap in the right spot –
Cristina: And explode.
Derek: Exactly. Now I have to fix it. You two did great work. Love to stay and kiss your asses, but I gotta tell Katie’s parents she’s having surgery. Katie Bryce’s chart, please.
Receptionist: Here you go.
Cristina: Oh, and Dr Sheppard, you said that you’d pick someone to scrub in if we helped.
Derek: Oh, yes, right. Um, I’m sorry I can’t take you both, it’s going to be a full house. Meredith, I’ll see you in OR.
[They stand there for a moment or two. Cristina looks at Meredith, who’s flustered.]
Derek: Good. Thank you. [leaves]
[Cristina looks back at Meredith and walks off, clearly pissed.]
[Cut to George watching bacon-man’s surgery. It finishes, Burke leaves.]
George: Wow, that was quick.
Burke: His heart had too much damage to give him a bypass. I had to let him go. It happens, rarely. But it does happen. The worst part of the game.
George: But I told his
Burke: You what?
George: They have four little girls –
Burke: Who the hell are you to promise anything on – this is my case. Did you hear me promise? The only one that can keep a promise like that is God, and I haven’t seen him holding a scalpel lately. You never promise a patient’s family a good outcome!
George: I – I thought –
Burke: You’re important enough to make promises to Mrs. Savage, you get to be the one to tell her that she’s a widow.
[Cut to Izzie and Cristina, sitting on the spare beds in the empty corridor again.]
Izzie: Maybe Meredith couldn’t –
Meredith comes in.
Meredith: I’ll tell him I changed my mind, you can –
Cristina: No, no, don’t do me any favours. It’s fine.
Meredith: Cristina, -
Cristina: You know what, you did a cutthroat thing, deal with it. Don’t come to me for absolution, you want to be a shark, be a shark.
Meredith: I’m not –
Cristina: Oh yes you are. Only it makes you feel all bad in your warm gooey places. No, screw you. I don’t get picked for surgeries because I slept with my boss, and I didn’t get into med school because I have a famous mother. You know, some of us have to earn what we get.
Meredith leaves. Cut to George going to see Mrs. Savage.
George: Gloria…there were complications in the surgery. Tony’s heart had a, a lot of damage. They – we tried to take him off bypass, but…there wasn’t anything we could’ve done.
Gloria: Uh…what are you talking about?
George: He…Tony died. He’s dead. Gloria, I’m so sorry.
Gloria: [whispered] Thank you. Please…go away.
[He does. We hear her crying. Cut to Derek shaving Katie’s head while Meredith looks on.]
Derek: I promised I’d make her look cool. Apparently being a bald beauty queen is the worst thing that happened in the history of the world.
Meredith: Did you choose me for the surgery because I slept with you?
Derek: [straight-faced] Yes. [pregnant pause] I’m kidding.
Meredith: I’m not going to scrub in for surgery. You should ask Cristina. She really wants it.
Derek: You’re Katie’s doctor. And on your first day, with very little training, you helped save her life. You earned the right to follow her case to the finish. You…you shouldn’t let the fact that we had sex get in the way of you taking your shot.
[Cut to George and Meredith sitting outside.]
Meredith: I wish I wanted to be a chef. Or a ski instructor. Or a kindergarten teacher.
George: You know, I would’ve been a really good postal worker. I’m dependable. You know, my parents tell everyone they meet that their son’s a surgeon. As if it’s a big accomplishment. A superhero or something. If they could see me now…
Meredith: When I told my mother I wanted to go to medical school, she tried to talk me out of it. Said I didn’t have what it takes to be a surgeon. That I’d never make it. So, the way I see it, superhero sounds pretty damn good.
George: We’re going to survive this, right?
[Cut to Dr Webber (head of the hospital) talking to Alex.]
Webber: She’s still short of breath. Did you get an ABG or a chest film?
Alex: Oh, yes sir, I did.
Webber: And what did you see?
Alex: Oh, well, I had a lot of patients last –
Webber: Name the common causes of post-op fever.
Alex: Uh…yes, sir. [pulls notebook out of pocket]
Webber: From your head. Not from a book. Don’t look it up, learn it, it should be in your head. Name the common causes of post-op fever.
Alex: Uh…the common causes of post-op…
Webber: [loudly] Can anybody name the common causes of post-op fever?
[Everybody stops, one girl pulls out her notebook.]
Meredith: Wind, water, wound, walking, wonder drugs. The five Ws. Most of the time it’s wind, splinting or pneumonia. Pneumonia’s easy to assume, especially if you’re too busy to do the tests.
Webber: [gives Alex a pointed look, then to Meredith] What do you think’s wrong with 4B?
Meredith: The fourth W, walking. I think she’s a prime candidate for a pulmonary ambulus.
Webber: How would you diagnose?
Webber: [to Alex] Do exactly as she says, then tell your resident that I want you off this case. [to Meredith] I’d know you anywhere, you’re the spitting image of your mother. Welcome to the gang.
[Cut to Katie’s surgery. Meredith is there.]
Derek: All right everybody, it’s a beautiful night to save lives, let’s have some fun.
Meredith voiceover: I can’t think of any one reason why I want to be a surgeon. But I can think of a thousand reasons why I should quit.
[Cut to Bailey sleeping and Izzie walking towards her again.]
Meredith VO: They make it hard on purpose. There are lives in our hands.
[Cut to the surgery.]
Meredith VO: There comes a moment when it’s more than just a game. And you either take that step forward, or turn around and walk away. [Cristina is seen watching from the gallery. Sheppard waves Meredith over to look through the magnifiers at what’s happening.] I could quit. But here’s the thing: I love the playing field.
[Fade to Meredith sitting outside the OR, dazed. Cristina walks through the door and turns back.]
Cristina: It was a good surgery.
[Hour 48. Cristina sits and sighs.]
Cristina: We don’t have to do that thing where I say something, and then you say something, and then somebody cries, and there’s like a moment...
Cristina: Good. You should get some sleep. You look like crap.
Meredith: I look better than you.
Cristina: It’s not possible.[leaves]
[Derek comes through the same door, stops at a desk to do some paperwork. Meredith stares at him, still looking dazed.]
Meredith: That was amazing.
Meredith: You practice on cadavers, you observe, and you think you know what you’re going to feel like standing over that table, but…that was such a high.
Derek looks at her properly now and nods.
Meredith: I don’t know why anybody does drugs.
Derek: [nodding slightly, looking tired] Yeah.
Meredith: [smiling] Yeah.
Derek: [smiling back a bit] I should go do this.
Meredith: You should.
Derek: [going] I’ll see you around.
Meredith: See you around. See ya.
[Cut to outside the hospital, we see Izzie, George, Cristina and Meredith walking to the parking lot.]
Meredith VO: So. I made it through my first shift. We all did. The other interns are all good people, you’d like them. I think. I don’t know. [fade to Meredith running up stairs in the rain, under an umbrella] Maybe. I like them. [She enters a building, reception waves her on] Oh, and I changed my mind. [Close-up on an older woman]. I’m not going to sell the house. I’m going to keep it. I’ll have to get a couple of roommates, but [we see Meredith is talking to her] it’s home, you know?
Older woman: Are you the doctor?
Meredith: No. I’m not your doctor. But I am a doctor.
Older woman: What’s your name?
Meredith: It’s me, mom. Meredith.
Ellis Grey: All right. [fidgets with her watch] I used to be a doctor, I think.
Meredith: [taking her hand] You were a doctor, mom. You were a surgeon.
[Slow zoomout and fade to black on the two.]