[Meredith] Surgeons aren't known for being warm and cuddly.
They're arrogant, impatient,
- mean, as often as not. - Go with straight-up chemo
and immunotherapy. Survival rates are low, but there's been a lot of success
with mestastasectomies. We could probably cut this thing out.
You'd think they wouldn't have friends. Who could stand them?
- What are you hiding? - Nothing. It's just work stuff.
- What is that? A cool surgery? - No, it's nothing. It's nothing.
Whatever it is, they'll pick me. I flew solo. You're still on training wheels.
- Sure you still don't wanna tell him? - Yes, I'm sure.
OK. Look, I researched a ton of information. Read all of this
- before you see the oncologist. - When?
I called Dr. Golding. He gave me a referral to Swender.
- I'm gonna try and get you in today. - Shh!
What are you doing here? I told you I was fine.
- You are so not fine. - I'd be fine if I knew Derek was fine.
You still haven't heard from him? No word?
Izzie, don't you think you should call in sick today?
- What? Why? - Because this is a lot of reading,
- and you're sick. - You coming? Big surgery today.
- Yeah. - Yeah. Izzie, just...
But surgeons are like a bad cold:
Nasty, but persistent.
- Uh, Chief, I need to ask you about... - Sloan, have you heard from Derek?
No.
I'm sorry. You were saying? Oh, Meredith.
No, I don't know how he is. I've heard nothing. Nothing today, nothing
yesterday, nothing the day before. And no, I will not go back out there.
Hey, who moved my surgery? Chief? Chief?
Don't. Just don't. He's a wreck. He's disintegrating before our eyes.
- That's why men die earlier than women. - Mm. The board's a mess.
He can't lose Shepherd. I'd go talk some sense into him,
- but I've got too much on my plate. - Tried calling?
About 100 times.
Mm.
No. Oh, you...
You want me to go to the woods? No. I don't do woods.
The woods are dirty and there are many, many bugs.
What am I gonna say? I barely know him.
You don't have to know him. You're surgeons, been through the same war.
Just remind him we've all been there, we all came back.
You're kind of a bully, you know that?
I wouldn't do it if it didn't work so well.
This is one of the biggest surgeries you may get near so pay attention.
The patient is a 38-year-old male hit by a drunk driver 12 years ago.
- He suffered severe facial trauma. - No nose, no lips.
That's why we dubbed him Blowhole. He's had nine reconstructive surgeries,
none of which have brought back full form or function.
This surgery has only been done four times.
All candidates have to undergo extensive psychological testing
to determine whether they can handle the process.
Psychological components aside, this has a chance of rejection or infection.
He'll be on life-long anti-rejection drugs which put him at risk
for lymphoma, diabetes, hypertension, renal failure.
- I hear they call the dude Blowhole. - What did you just say?
Nothing. I just heard he had a nickname.
Don't talk anymore. Ever.
- Holy crap! Blowhole is right. - What'd I tell you?
[Meredith] Surgeons: nasty, aggressive, unstoppable.
Just the kind of people you want on your side when you're really screwed.
Ladies and gentlemen, this is Mr. David Young.
Today he'll be receiving a face transplant.
[Mark] Dr. Hunt and his team'll be recovering the donor graft.
We're replacing 70 percent of Mr. Young's face.
- You can see the deficit here. - Or here.
The donor recovery will include his nose, left eye, lips, left zygoma.
Why will allotransplantation work better than traditional techniques?
Aesthetic outcome allows re-enervation of nerves, giving a better result.
Very good, Dr. Grey.
We'll position the flap over Mr. Young's face.
- How do we know we're clear? - The graft turns pink.
Excellent.
- Dave, any questions for us? - Has anyone seen the donor?
Yes, he's a match with your age, skin tone and blood type.
- What does he look like? - I think you'll be satisfied.
Who am I kidding? It's a face, right?
If I end up anything above a point and stare freak,
I'm gonna call it a success.
Karev, you're with me and the donor. Usually we take them at the same time,
but donor's life support is fading. Move.
- Thank you, sir. - Stevens, Grey.
- Yes. - No, the other Grey.
- Really? Great. - Great.
You did an awesome job in there.
- Call me after the pre-op labs come in. - Dr. Sloan, only one resident?
Wait for Bailey. There's enough of a crowd.
- What the hell? - Izzie, I don't think you have time
- to scrub in. - Don't worry. I can handle it.
- Awesome job. - She probably quizzed him in bed.
- She gets to work on Blowhole... - Shut your mouths!
Finish the chart. I'll be back.
O'Malley, Grey? I need you on pre-ops and post-ops.
There's the biggest surgery in the world happening.
Yes. Half our attendings are involved, which is why we need strong residents
on pre-ops and post-ops. Yang, you're with me.
- Moving to the big leagues. - What?
- She gets a solo? - Today?
Nice old lady with a hernia, you're gonna fix it.
Congratulations. I know I should seem more enthusiastic,
- but I'm not that big a person. - Don't worry about it.
Is it wrong to have hatred in your heart?
Good morning, Miss Sulley. I'm Dr. Cristina Yang.
- I'll perform your hernia repair. - Lovely to meet you.
- Have any questions before we start? - Yes. Hand me my purse.
My friends gave me a bunch of questions, and I can't remember any of them.
They're such worrywarts. They're all off on a European tour without me.
They threatened not to go when this became a problem. I told 'em no.
No. We have been saving up for this for two years.
I was able to get my deposit back with a doctor's note.
[phone ringing]
Cristina Yang. Yes?
No. No, it has to be today.
It's stage four. She has to see Dr. Swender, not a partner.
Um, I'm sorry, ma'am.
I will get to your questions when I come to examine you. OK?
Referral is Golding? Golding.
[Callie] A little early in the day for that, don't you think?
- You sound like my mother. - I met your mother. I liked her.
- Who sent you, Richard? - Uh, Bailey.
Of course.
I'm sorry about your patient. I know how hard it can be.
I had a patient a couple of years ago...
Young guy, 50 maybe.
Simple knee replacement. He was post-op, he was fine.
I told his wife she could get him lunch. A simple knee replacement. Nothing.
He'd been getting short of breath. I put him on blood thinners
for a post-surgical PE.
And... it wasn't until he was vomiting up dark blood, looking me in the eye,
telling me that he was dying that I figured it out.
That I was wrong. It wasn't a PE. He was bleeding internally.
It wouldn't have been fatal, but the blood thinners...
God, I will never forget the look on his wife's face
when she came back with that sandwich in her hand,
asking me why her husband wasn't in his room anymore.
How do you live with it?
Killing him.
Taking him from his wife. How do you live with it?
- We call it malpractice... - I know. I'm asking when you get up,
how do you look at yourself in the mirror?
Look, I'm not... I'm...
I'm asking.
Can I get one of those?
Yeah.
[exhales]
It's the not knowing that does it. Not knowing if he's OK,
not knowing if he's coming back. Maybe I've just been dumped.
It's not knowing if I'm single that makes me wanna throw up all day.
- You are not listening to me, are you? - Uh, sorry.
No, no, that's OK. I get it. You've got solo surgery and Gl Joe.
It's a charmed life. You don't have time for me.
I have not had Gl Joe. We've kissed a couple times.
It's like friends with benefits... without the benefits.
- Still no sex. - Mm-mmm. Not a charmed life.
Lab results from the splenectomy.
- Do we ask? - No.
'Cause he might tell us.
Can you imagine? This guy's got a family, right?
Wife, kids? One day they'll see his face on somebody else's body.
- It's kind of creepy, right? - Mr. Young won't look exactly
like the donor. The underlying facial structure of two people can be
- very different. - A person's identity is more than
skin and bone. His expression, style, eyes.
The donor's family wouldn't recognize this face on anyone else.
- Transplant surgeons are antsy. - They're always antsy.
They can't relax until they got live tissue in their coolers.
I am making the final dissection. Karev, hold right of the temple
and gently lift. Don't tear the flesh.
Awesome.
Tenderness around the incision is normal. No signs of infection.
Could you redress that wound?
- Megan, will you please go to 20... - [sniffling]
Um, go to room 2214
and just take out the drain.
When you're ready.
It's seems personal, we wouldn't ask if we didn't need to know,
but have you passed gas yet?
Sorry.
We can't release you until that happens. The gas.
I'm sorry. I'm trying to listen, but are they supposed to look like that?
- Like what? - The bleeding and the shiner.
And that one looks like she's suicidal.
- They're supposed to be doctors? - We're gonna reserve judgment on that.
- Freak show. - What the heck do we do with them?
- Can we shove them in a locker? - We should talk to them.
No. We're professionals. That's clearly personal.
Besides, we'll waste time, never see the solo surgery
- or the face transplant. - Oh, that's a good point.
- I guess we should ignore it then. - Yeah, just ignore it.
- It's the professional thing to do. - Professionally...
It's important that you take all the medications...
Risk of rejection and infection. I know. You drilled it into my head
- a thousand times. - Is your family here yet?
I ask because someone needs to take care of you afterwards.
I don't have family, but my friends are coming after the surgery.
I'm excited to meet them and show them my new face.
We met in an online chat room for orchid lovers.
We've never actually "met" met, so...
Dave, after the surgery, this device helps prevent lung problems
by exercising the muscles you use to breathe.
- I'd like you to practice on it now. - Sit up straight.
Take three easy breaths and then blow into that.
- Hole. [snickers] - That's it!
Both of you, in the hall, now! You really think that was OK?
- That was doctorly?! - Find something else to do.
- What the hell's going on with you? - They made inappropriate jokes
at the expense of the patient. Right in front of him.
I have been trying to teach them, and they were cruel and inappropriate.
OK, they were inappropriate. You know what else is inappropriate?
This. You.
This case is my baby. I've spent three years planning for it,
and you are not about to piss all over it.
- You're off the case. - No. He needs me in there with him.
- You can't leave him alone with them. - You wanna be there for his feelings,
you can be there before and after the surgery,
but you're not coming in my OR. Whatever's going on with you,
get it under control.
[door shuts]
- I found them. - What?
- Your questions about the surgery? - One of my friends, Phil Ferguson,
he's a retired surgeon. He told me to ask you these.
I can't seem to find my glasses. My friends should be here.
I put my glasses down somewhere, they find them...
Will you finally be able to pick up your grandkids? A question from a doctor?
No. No, my other friends helped me with questions. I added a few on my own.
Like, "Will it hurt?"
Will it... hurt?
- You'll be anesthetized. - Yes, I know that.
- I mean after. Will it hurt? - You should expect normal post-op pain.
[phone ringing]
Yes? Yes. No, that is fantastic. I'll take it.
Thank you so much. I'll get in touch with her right away.
2:30. Anytime is fine.
So I've covered 22, 13, 19 and 33.
Yeah, OK. I've got 2011 and 2007.
Mer, there is something wrong with Izzie.
- What do you mean? - I don't know.
- I know that there is something wrong. - We're drowning in intern drama.
We don't need resident drama too.
If it's a problem, she'll tell us. Until then, just ignore it.
I repeat, ignore it.
- What in God's name is going on? - A personal issue.
We are just trying to give them their privacy.
Gee, you think for a second I wanted to get involved with your intern drama?
- We were not this bad. - Getting married in Vegas.
Shacking up with attendings. Cutting LVAD wires. You don't have to like it,
- but you have to manage it. - We've got it under control.
[sobbing]
Wait! I love you, Megan!
[gasps]
Sir, are you OK? Oh, God, I'm so sorry.
Whatever it is the two of you have going on, it stops now.
- I didn't mean to... - Don't talk while she's talking.
You are scaring the patients. You're making this hospital look ridiculous.
- You're making us look incompetent. - Not a good idea.
Just stay away from each other. So much as a tear or a glance at each other,
- and it's over. No! - I don't understand.
- Don't talk while I'm talking. - That's what I was trying to tell...
Now just get out! Go!
Not together.
That felt good.
- You paged me, Dr. Bailey? - Oh! Yes.
Um, finished your part of the face transplant?
I cleared my schedule to watch Sloan and Yang do surgery.
Whatever it is you need, I hope it's not too time-consuming.
That all depends on how fast you can drive and talk.
- I'm sorry? - I need you to drive out to the woods
and talk Derek Shepherd into coming back here.
And I believe you also might run into Callie Torres. With a flat tire.
Or a broken heel. Or an axe-wielding serial killer.
- You're serious? - I sent Torres after Shepherd,
and she's fallen off the grid. Her phone goes to voicemail.
I'm normally not a panicky person, but I'm a fan of daytime television.
My crazy scenarios... Never mind.
I need you to go get Torres and Shepherd and bring them back here
- before the chief notices you're gone. - Shepherd's been gone all week...
Hunt! You survived a war, you can do this.
I know I can do this. I'm saying I don't want to.
People don't really say "no" to you, do they?
[Bailey] Not when I say please.
I'm saying please!
OR is set, transport's on its way.
- You ready? - I've been ready for 12 years.
You said you had friends coming to take care of you?
- Yeah, after my surgery. - They're coming now.
Surprise!
Hi. It's me, Sheena.
You can probably tell from my Vanda roeblingiana.
I hope you're not mad that we came early.
We thought we should be here through it all. Make sure you knew...
Get out. Get them out. They're strangers. I don't want them in here.
We're hardly strangers, Dave.
We chat every night, all night, for years.
- We flew in... - Get out! We've never met.
You don't know me, anything about me. Get out!
Get them out! Get out. Get out!
Get out!
Hey. Did you get my page? I got the appointment.
It's in, like, 15 minutes. How amazing am I?
Usually takes weeks to get in. You look at the research?
- Seriously, can I just eat? - No.
- I'm sorry. You don't have time. - Time for what?
There's a... an enema.
- Uh, Izzie's enema. - Yes.
I was supposed to get an enema today, but I decided it can wait.
- Talk about something else? - We need to talk about it.
You've been complaining about being really backed up.
- I got you an appointment. - If you need an enema,
- you shouldn't have fries. - You booked her for an enema?
You can't just say that you're all backed up and just sit there.
If you make the decision to get an enema,
- you should get an enema. - Maybe you're the one that's backed up.
Solo surgery panic? Tell you what.
I'll scrub in. If you can't handle it, I'll take over.
I don't... OK. You know...
I'm just saying... enemas can be a serious business.
OK. Izzie, enema is code for what?
- My enema, my business. - Uh, fifteen minutes!
This is a really strange day.
I was a second-year resident. MVC rolls in.
Parents in the front seat. Three kids in the back. Kids were OK. Mom and dad
a little banged up. Nothing terrible, talking and laughing in the ER.
Turns out both parents had massive internal injuries.
I operated on them both that night. Hours.
Lost them both.
If I'd moved faster, rushed them to CT, known how bad off they were sooner,
but... I didn't. The oldest kid was nine.
When I came out to tell them about their dad,
he was consoling the three- and five-year-old about their mother.
I'll never get that image out of my head. This nine-year-old boy
trying to hold these two little ones, his arms just not big enough.
I don't know how I came back the next day.
[exhales] I think part of me never did.
I'm surprised you didn't talk about Iraq.
I don't talk about Iraq.
What my point was, I kept...
You know, I... I went back.
I showed up. I...
I showed up for work, you know?
You go dead inside...
You go dead inside because if you felt it,
if you let yourself feel that, no way you're going back.
No way.
[beer can tops popping]
- You blew it off? - Cristina, please.
I called every favor I had in this hospital and then some.
Swender's the best surgical oncologist. Why didn't you go?
- Why do you care so much? - Why don't you?
I'm working really hard on this. The least you could do...
They were calling the guy Blowhole. Not just the interns, Alex.
What are they gonna call me when I'm the patient?
- Swiss Cheese for Brains? - No, that's awkward and long.
- Blowhole's pithy. - I'm not gonna be a piece of meat
while you all fight over who gets to slice me up
- and then laugh while you do it. - OK, this right here,
this, um, is an emotional thing you're having,
which is why you should tell Meredith, or George...
I'm not telling anybody, so just drop it!
No! You're not dumping this on me. You're not dying in my arms.
- So either you tell them or I will. - I don't even know if I want treatment.
I know too much. I know how violent surgery can be.
They're gonna cut into my brain, slice open my abdomen
and pull my organs out. And for what?
Surgery fails all the time. Derek Shepherd is in the freaking woods
because we fail all the time!
Even if they do everything, I have a five percent chance of survival.
Five percent.
Why would I put myself through hell, run poison through my veins,
irradiate my brain if it's not gonna work anyway?
Why did you tell me then?
If you don't want my help and you're not gonna do anything about it,
why did you tell me?
Keep your mouth shut. Forget I told you anything.
Izzie!
You need to call them back, Dave.
You're my surgeon, right? You're not my shrink.
- So why don't you just do your job? - I can't do my job anymore.
It took us three years to find the right candidate, and part of you being
the right candidate is having a support system post-op.
You cannot do this alone. The ethics board will not allow me
to let you do it alone. You need your friends.
You see that orchid?
It's ugly. To anyone who doesn't know orchids, it's dark and droopy
and it's ugly, unless you know it.
Unless you understand how it adapted, what it's lived through,
and how strong it had to be to survive.
A photo of that orchid, that's the only picture my friends had seen of me.
That's how I wanted them to picture me until I had my new face.
People look away from me.
Kids cry and adults cringe.
They look away.
I didn't want my friends...
I didn't want them to ever have any reason to look away.
They didn't look away.
Your friends, they didn't cringe. Not one of them.
They didn't look away. You looked away, didn't trust them.
You looked away from them.
Let us call them. They flew all the way here.
Just let us call them back. It's not too late.
If you want this surgery, Dave, you gotta give them a chance.
Uh, Chief?
- Dr. Bailey? - How's your mood?
Eager. Anxious. I'm excited about Sloan's face transplant.
I'm a little concerned about Derek, but all in all...
- Do I look like a therapist? - You asked.
I've lost Hunt and Torres. I sent them to get Shepherd,
and I never heard from them again.
I was trying to solve the Shepherd situation for you, sir.
But it appears I've somehow made it three times worse.
So I'm telling you, and my next move, I believe,
is that I'm gonna call the police.
Because I'm half convinced they're all dead.
On a spit with a one-armed man turning them into shish kebabs, sir.
It's my mind, it just goes there.
- Don't beat yourself up. - It's a hard decision.
Yeah, you've been with Pierce for the whole year.
Just listen to your heart...
- Why are they starting late? - A problem with the recipient.
They've only got a few hours left for that face to be viable.
Sloan must be freaking out, right?
- Home wrecker. - What did you say? What did you say?
- Guys! - You two, get out. You, come with me.
- Come on. - Hey, buddy.
You need to start talking. You need to start talking now.
- I really can't. Talk to Steve. - You gotta start talking, dude,
because any second, they're gonna start that face transplant surgery.
- Her friend... - Best friend.
...is gonna have her very first solo surgery, and so...
- ...we have little patience right now. - It's not my place...
OK! You are gonna tell me everything that's going on.
Or else every time I have a rectal exam or an infected abscess,
it's gonna have your name on it. Every time!
[sighs]
Megan was with Pierce. But they broke up.
While they were broken up, she slept with Steve.
Then she got back together with Pierce. But Steve sent her an e-mail
about how they slept together. Instead of e-mailing her,
he hit "reply all," went to a bunch of people.
One of them was Pierce. Now Steve says he loves her.
Pierce wants to kill him. Megan's really freaking out
because... OK, wait. So a while back,
someone sent this text message. I didn't get it, didn't get to see it.
It just came to certain people's phones.
Why would they come back? I was cruel. I was hateful.
You were scared. They surprised you.
You were in shock. It wasn't what you were expecting. You were...
- You were just... - I was awful.
You were scared. And you were trying to protect them.
If they're your friends, they'll understand.
[Dave] I didn't want you to see it. This.
This ugliness, it... it isn't me.
I... I didn't want you to see it.
This, right here,
looks just like the Coryanthes speciosa.
- You guys see that? - [man] She's right.
The coloring's just the same.
If the surgery doesn't take, if I reject the donor face, I'll be uglier.
I'll... I'll be even uglier than I am right now.
Please don't call my dear friend ugly.
You're a survivor.
And it's written all over your face.
What the hell is this? This is not OK.
I have a hospital to run. And Derek! What's the matter with you?
- We've all been there. - We said that.
- We've all had tough losses. - He knows that.
We show up the next day and we try and save the next life.
- [Callie] Yeah, we covered that too. - OK, what about this?
Nothing we do can stop death.
We can hold it at bay now and then. But everyone dies.
And that's not on us.
I took a pregnant woman in for a simple surgery, and I botched it.
That is on me. I should feel badly about that.
And you? You should feel badly that while I was out here,
you sent Meredith out here expecting a ring. Why would you do that?
Why in God's name would you do that?
I was trying to help.
She didn't wanna come.
She wanted to leave you out here alone...
- I was trying to help. - Trying to help yourself, not me.
Yourself.
I hit the ring in the woods.
In the woods.
You destroyed me.
This is the final dissection. We'll place the facial graft.
I'll connect vessels and nerves. Get the microscope ready.
[woman] Yes, right away.
OK, people. It's time.
- Ever put a new face on someone? - Really?
I'll take the right side. You take the left.
Very gently.
That's it. Take your time. He's not going anywhere.
Thank you.
Watch the left corner of his mouth. You're off center just a bit.
There we go. Careful around the eyes.
Good. Very good, Dr. Grey.
[people laughing]
- Get out. - No.
- Get out! - No!
- Richard, get out! - No!
I've destroyed lives before. Several, in fact.
Yours is not one of them. I sent the woman you love out here to help you.
I sent the woman who loves you out here to bring you back to your life.
If you ruin it with her, that's on you. I don't accept it.
You're scared, drunk, don't know which way is up.
You threw a punch at your best friend, a ring at Meredith, wanna throw me out.
I'm not accepting it!
Because I'm older than you, and I've been where you are.
You been drunk for a few days. I was drunk for years.
And I know you're gonna need at least one friend
when you come out of that hole you're digging.
I hope you come out of it soon.
I'll be here when you do.
I don't think I can get her back.
Did you call her?
What am I gonna say?
I had an affair for years.
When Adele found out, somehow she...
She took me back.
You can make your way back...
...from anything.
This is year one of your residency.
You turn on each other now, you're not gonna make it.
[# Royal Wood: A Mirror Without]
OK. Here's what's gonna happen.
All of you are going to go find the sense the good Lord gave you
and never behave like this within the four walls of this hospital
ever again. You are doctors.
Pierce, get an ice pack and put it on that oozing, disgusting mess of an eye.
And, Steve, go to the pit and get that unsanitary,
bloody hand X-rayed and stitched.
And, Megan, you should go to OB because yes, you are pregnant.
That was very Bailey.
- You ready, Dr. Yang? - Wait! I'm sorry.
I need one thing from you before I go under.
I haven't asked for much. You haven't answered my questions.
I understand you're busy, but I'm scared.
I don't wanna die. I want to go on a tour of Russia with my friends.
I may just be a batty old lady to you, and this may be a silly procedure,
but I need you to tell me that it's gonna be OK.
You're my surgeon, after all.
This isn't a silly procedure to me, Miss Sulley.
- And I will get you through this. - OK.
Thank you.
I'm ready now.
Izzie has stage four metastatic melanoma
that has spread to her brain, liver and skin.
She may only have months to live and she's resisting treatment.
She needs help.
Scalpel.
Don't try to talk. It'll only hurt.
- You did great. - Can he see his new face?
- I think he'd really like to see it. - It's still early.
It's very swollen and bruised. The tissue needs time to settle.
But yeah. I'll give you a sneak peak.
[siren wailing]
Sometimes we fail, but that's not always the case.
I know.
Blowhole has a new face. And what people call him to get through the day has...
I know.
I told Alex. And Bailey.
And they're telling Meredith and George.
- Cristina... - I couldn't do my job.
I think you came to me for help, and that's what I did.
Because sometimes we win, Izzie.
And I want you to fight.
OK? For whatever that's worth, I want you to fight.
Thank you.
[chattering]
Dr. Grey.
They think you're taking advantage of me, that I'm using you.
But they don't know us.
They think that we're ugly, but I know that we're beautiful.
And we can adapt to a hostile environment.
[# Great Northern: Driveway]
- Thanks for coming. - Thanks for calling.
I love you.
I know.
Would you still love me if I wasn't a surgeon?
No.
No, because Izzie...
...has skin cancer that's spread to her brain.
You're one of about 20 people in the world who can save her.
I don't know if I respect somebody who could walk away from a gift like that.
So please don't.
Here are her scans.
It's pretty bad.
[Meredith] Practicing medicine
doesn't lend itself well to the making of friends.
Maybe because life and mortality...
...are in our faces all the time.
Maybe because in staring down death every day...
...we're forced to know that life...
...every minute...
...is borrowed time.
And each person we let ourselves care about...
...is just one more loss, somewhere down the line.
For this reason,
I know some doctors who just don't bother making friends at all.
But the rest of us...
...we make it ourjob to move that line.
To push each loss...
...as far away as we can.