Previously on Grey's Anatomy:
- You and Burke, are you OK? - We're existing in silence.
That hand is worth two million dollars. I want it fixed.
Mark and I, it wasn't a one-night stand. I was in love with him.
At least I thought I was.
Your sister's been admitted for a C-section.
- Molly's not my sister. - You have the same father.
Why didn't you stay and fight for us?
- I did. I tried. - Why didn't you try harder?
You're officially off my service.
For what it's worth, I think you'll miss me.
Harold O'Malley, 63, esophageal cancer and aortic regurg.
You think I want to die and leave my boy in charge?
You are not going to die.
Morning.
- Were you watching me sleep? - Maybe.
What are you, some kind of weirdo who watches women sleep?
Maybe.
- Izzie. - What?
I just dropped eight point seven million dollars on the floor.
And?
I shouldn't be able to drop eight point seven million dollars on the floor.
You need to deposit that check!
George, your father's surgery is tomorrow.
Any chance you're misplacing your anxiety on me and my check?
No! There is no chance.
That check ruins my morning. Every morning. It belongs in the bank.
Would you just please, as a favor to me,
would you just put it in the bank? Please?
Mm... No.
But if you're nice to me for the next seven minutes
I will give you a ride to work.
You don't deserve eight point seven million dollars!
So true. So true.
- How's Burke doing? - I don't know.
He just had surgery yesterday and you don't know how he's doing?
- They're not speaking. - Thought they made up.
They did, sort of.
- But she's still not speaking to him? - He's not speaking to me.
- They're not speaking to each other. - OK.
Did you ask Derek about Burke's hand?
I don't want to get in the middle. Derek and I are happy.
Could we just keep it that way?
You could swallow your pride and ask him yourself.
- Her gut's not big enough for that. - Oh, Alex, that hurt me.
There's Georgie.
Everyone, quiet down!
- Morning, everybody. - Good morning.
- Who's presenting? - Can Georgie do it? He's real good.
- Yeah, Georgie, yeah! - Come on.
Um...
Harold O'Malley, 63, status: Post-aortic valve replacement.
Morning chest X-ray showed no atelectasis after aggressive CPT
for the last two days.
Scheduled for a transhiatal esophagectomy tomorrow morning at 9::00.
That's it.
For the next few minutes, I think it would be best if the extended family
- could wait out in the waiting area. - Aw!
Just a few minutes, then you can come back.
- All right. - Hey, Georgie.
- How are you feeling, Mr. O'Malley? - He's feeling great.
Better than ever. Which is why we had everybody come out today
because we figured after today, he maybe won't be feeling so great for a while.
After the surgery, then when do we start chemo and stuff?
That protocol depends on what we find when we open you up, Harold.
- What do you mean what you find? - Uh, Grey?
There's only so much they can tell from labs and scans,
so they need to get a good look inside to see if the cancer has spread.
And, if it's spread, that changes how much chemo he needs?
- That changes a lot of things. - Like what?
I'll let the oncologist explain that to you later today, Harold.
Dr. Grey'll be taking you through a final battery of preoperative tests
before we go, so, um...
So it would be best if the party went home.
Dr. Shepherd. Dr. Burke's hand, has he had any tremors?
- That's confidential. - I'm one of his doctors.
You're also his girlfriend. Ask him yourself.
Good morning. Who's presenting? Good morning.
Preston Burke, post-op day one from I and D
of a compressive hematoma to the brachial plexus.
He's afebrile and vital signs were stable overnight.
Incisions are clean, no infection. Morphine was given at 2:00 this morning.
- Ask about the hand. - You ask.
No, it's just one question. Be a friend.
Dr. Yang. Something you want to share with the rest of us?
No, ma'am. Sorry.
You look good, Preston. Take it easy on the nurses.
I'll do my best.
O'Malley, your father's surgery is today?
Tomorrow.
- You OK, honey? - Yeah.
- Can you just help me? - Mm-hm.
- Scoliosis? - Looks like a birth defect.
Looks like hell.
What are you all staring at?
If you're expecting me to be the brave and heartwarming differently-abled girl,
that isn't going to happen. So go ahead and do your thing.
Yeah.
Stevens?
Heather Douglas, 17, past medical history ofVATER syndrome.
- Which is? - VATER syndrome is a genetic condition
that affects the vertebra, anus, trachea, esophagus and renal system.
Wow. Give this girl a medal. She memorized the whole acronym.
Which, I assure you, is a hell of lot easier than living with it.
- Stevens? - Right. Um...
Heather is in today for a lithotripsy to remove kidney stones
and thoracoplasty to alleviate pressure on her lungs.
I know I'm just supposed to be here to remove a few ribs,
but have you tried anything more radical to treat the spinal curvature?
Let's see. If by more radical, you mean
having a steel rod inserted into my spine, then yeah. We've tried.
The rod just bent.
Removing kidney stones may seem minor. It will improve your quality of life.
Really? So this surgery is going to get me laid?
- Heather, stop it! - Mom, I'm sorry,
but she's talking about improving my quality of life.
I don't think doctors should make promises they can't keep.
Laura Grey-Thompson, born four days ago
with jejunal atresia, corrected surgically.
Post-op course...
Oh, I'm sorry. Am I interrupting?
Her mom and grandma have the flu and they asked me to get an update.
She's doing very well, Mr. Grey. We'll be out of here in just a minute.
- Dr. Grey, you were saying? - Um...
Excuse me. I'll just come back a little later.
Grey?
Um...
Laura Grey-Thompson had some dilation of the bowels on X-ray this morning.
We need to do a barium enema to make sure there's no intestinal stricture.
Dr. Grey, stick with Mr. O'Malley this week.
Yang, pit. Karev, Sloan.
Stevens, prep Heather Douglas for surgery.
- O'Malley? - Yes?
- You taking this week off? - Yes.
Take today too. Spend time with your family.
Thank you. Dr. Bailey, as things progress with my dad...
You know sometimes we... with families, we coddle them, sugarcoat things.
It would help ifyou were straight with me as things progress.
- OK. - Thank you.
Dr. Bailey? Dr. Bailey? I know I'm supposed to prep her only,
but any chance I can scrub in on Heather Douglas?
A VATER patient isn't something you see often.
- No. - But I'm ready. I am ready.
Your psychiatrist hasn't given you an all clear.
He's...
I have done everything he has asked me to do. Everything.
Except deposit my inheritance check.
Wait. You have not deposited a nearly nine million dollar check?
He is being unreasonable. That check has nothing to do with any...
You're losing thousands of dollars a day in interest.
That's unreasonable. You clearly are not reasonable yet.
Which I think is the point your psychiatrist is trying to make.
Hey. I need a CBC and a CHEM-7 on Harold O'Malley.
I need these labs ASAP.
- Everybody needs everything ASAP. - Oh, yes.
Throughout this hospital, people are dying while you give me crap about ASAP.
- Hey, are you OK? - Why wouldn't I be?
Your father? Freezing up on rounds. God, that was mortifying.
Thank you. Thanks.
Oh, OK. It wasn't mortifying?
I just wish the baby would get well and go home and Thatcher would go with her.
Is that wrong?
Wrong would be if you wished the baby wouldn't get well.
- OK, good. Thanks. - You know, if you want to thank me,
you could ask Derek if Burke has had any tremors.
- Talk to him. - No. Because then he wins.
Wins what?
Forget it.
Do you have a father?
I have a stepfather.
He's nice. I see him for Yom Kippur.
What did I tell you about how I like my charts?
I like to round on pre-op before post-op.
Do you like wasting my time? Is it fun for you?
- No, sir. - Then get it right.
Do you like abusing your interns? Is it fun for you?
Yes. It is.
In case you've forgotten, you don't get the high horse this week, Addison.
Not this week.
He's an ass.
Not this week.
You know Shepherd pretty well?
Lots of hair, too many women, likes elevators and walks on the beach.
What's the best way to get him to do something?
What kind of something?
A consult that the patient hasn't requested,
but that the Ortho resident thinks is worth pursuing.
Shepherd thinks he's busier and more important than everyone else.
- Standard neurosurgeon breed. - Exactly.
- OK, so...? - So he'll say no.
- Until you stare him down. - Stare him down?
Stare him down.
- You're way too hot to be a doctor. - OK.
Aren't people who look like you supposed to be dumb?
Just saying. You're not going to be in my surgery, are you?
Because I'm a little too young to die.
- I will not be in on your surgery. - See. I knew it.
- You're not even a doctor. - I am a doctor.
It's just that when my fianc� dropped dead not too long ago,
I went a little nuts, and no surgeries for me for a while.
Well, so much for my theory that life doesn't suck for pretty people.
- I'm sorry I was such a bitch to you. - Well, you're in pain.
Sometimes I'm a bitch for no good reason at all.
I'm so sorry to bother you. I know you're very busy,
but there's a girl here with scoliosis from VATER syndrome.
She's here because her ribs are pressing against her lungs.
She's had two spinal fusions and a spinal instrumentation that didn't work.
She's bent over 90 degrees, which clearly sucks.
Clearly sucks? Is that your professional assessment?
My professional assessment is that we can help her.
My day's impossible.
I'll come by for a consult in the morning.
I'm a good starer.
Doctors, could I get a word?
- How you feeling, Harold? - Feeling great. Feeling fine.
It's just that the oncologist...
He said that if the cancer is in other organs,
that maybe you wouldn't proceed with the surgery.
That's right. If the cancer's spread to your other organs,
it would compromise your ability to recover from the surgery.
So, if you close me up and then send me home, I get what?
- A couple weeks to live? - You'd have weeks or months, yes.
No. No, you got to take the tumor out.
Because I can survive this. I know I can.
O'Malleys, we're fighters.
Mr. O'Malley, it's just not a good idea.
My wife... We've been married 40 years.
I make her crazy.
Forty years.
She needs me. My family needs me.
I can't tell them there's nothing that can be done when I know I can fight it.
So... I'm asking for your word.
I want you to take the tumor out.
Mr. O'Malley, my job is to do the best I can for you medically.
Closing me up and sending me home to die isn't best for me.
Not medically or any other way.
Please.
Take the tumor out.
All right.
All right?
Thanks.
This falls under confidentiality?
If you're asking if you can tell his son, the answer's no.
- You're watching me sleep again? - You're cute when you sleep.
Don't you sleep? Why are you always up before the alarm?
I'm a light sleeper. It's no big deal.
- So something woke you up? - It's no big deal.
- It's just that... you snore a little. - What?
- I do not! - Yes, you do. I love it.
I find it charming that such a big noise can come from such a little person.
- Do you know what's not charming? - What?
Your morning breath.
I'm sorry? What?
I'm just saying, seeing how you're always up before me,
you might consider brushing your teeth.
OK, this is me brushing my teeth.
Thank you.
- Surgery's today? - Yeah.
- I'm OK. - Yeah. I have a really good feeling.
- Yeah? - Yeah.
- I didn't even bake anything for you. - Thank you.
Dr. Silva, two point five.
- Bone dry cappuccino. - At least something's dry.
- Does it ever stop raining? - Not really.
Great. Good to know.
What the hell is this, Karev, vanilla?
Are you trying to poison me or just trying to make my day worse?
- Mark! - Coffee cart must've screwed up.
If you can't handle coffee, you can't handle plastics.
Maybe you ought to head back to the gynie squad
where life was all squishy and pink.
Squishy and pink though it may be,
I have an amazing surgery today, Karev, if you want in.
Yeah.
Good morning, Dr. Burke.
Yes, it is. Beautiful morning.
- I love watching the rain. - Feeling good?
- Not too much pain? - Feeling great.
And your hand, your right hand?
Feeling good today?
I'm sorry, Olivia. I just... You're going to have to tell Dr. Yang
that I'm not ready to give her that information.
Right. OK, then. Sorry.
- Ask him. Ask him. - Uh-huh, uh-huh.
You know Cristina's stalking your room?
I do.
- Your father? - Yeah.
The surgery my dad's having has a 50 percent morbidity rate.
O'Malley, that statistic,
it means 50 percent of the people who undergo the surgery survive.
If you're going to hang your hat on statistics,
then you have to look at them from both sides.
Heather, I've looked at your case history,
and I know you've been through painful and unsuccessful surgeries.
But I think I can significantly help with the spinal curvature.
By "help" you mean what, exactly?
I think I can get you standing up straight.
Are you messing with me? It's not nice to mock crippled kids.
You see this curved part here?
I'd remove it.
You want to remove a portion of my daughter's spine?
Mm-hm. And I would replace it with a titanium mesh cage
that would fill the space between the vertebra.
I've seen case studies. There've been successes.
And the ones that aren't successful?
They result in paralysis or death.
But Dr. Shepherd is the best there is.
- She's 17. - Mom.
I know you still think death is the worst thing that can happen to a person.
Death is not the worst thing.
I'm in.
They're going to cut out a piece of her spine. Heather Douglas.
Drs. Shepherd and Torres, they're going to straighten her spine.
- And? - And it's a once-in-a-lifetime surgery.
Please.
She's my patient. I've gotten to know her.
I would really like to scrub in.
- Did you deposit the check? - It's my money.
I should get to do what I want with it.
You get a five percent return on a six-month CD?
In the time we've been standing here, you could have made $400.
- Dr. Bailey! - It's not reasonable, Stevens.
- Dad, it's your discard. - I'm sorry about running over Bucky.
- What? - Your dog. That yappy dog, Bucky.
When you were a kid I ran over him and I told you he ran away.
- I'm sorry about that. - You ran over my dog on purpose?
Of course not. He was chasing after the truck
and he got caught up under the tire.
You were so sensitive, you were such a soft kid. I couldn't bear to tell you.
- I wasn't soft. - I mean it good, Georgie.
Not... you were kind and you loved animals.
You were always looking to help people,
and I couldn't face you and tell you that I killed your dog.
So I told you a lie.
- I'm saying I'm sorry. - OK.
You're a good kid, Georgie.
Always been such a good kid.
- I want to tell you... - Dad.
Stop acting like you're dying. You're not dying, OK?
I want to tell you that I think you're crazy
- if you let that Callie get away. - Dad, please!
No, she gets you.
She gets you in a way that your family never has.
And I'm sorry about that.
That you grew up feeling so different all the time.
That's another thing I'm sorry about.
Dad, stop it. Stop apologizing. Stop saying good-bye.
You can't... That's no way to go into surgery.
I'm going to die someday, Georgie.
We're all going to die, and lying here, in this bed,
gives me time to think about all the things I haven't said.
OK.
Well, just discard.
- Nothing you want to say to me? - Dad!
All right. I'm discarding.
Dog murderer.
- Tell me what I want to hear. - If I die, you'll kill me.
He's a quick study.
Meredith. Hello.
- Hello. - And... how are you?
Good. Busy with work. We have a patient.
- Hello. - Hello.
- Hi. - Hi.
Uh... All right then.
- Oh. I'm sorry. - Nice seeing you.
OK.
- Is that your ex-boyfriend? - No, that's my ex-father.
You see, Grey?
Good exposure to the esophageal hiatus.
Yes, sir.
Now we will inspect and palpate the abdominal cavity.
Those are the mets, right?
Throughout the stomach, the celiac lymph nodes, the liver.
- It's everywhere. - So we're closing him back up?
No. We will proceed.
- But I thought... - The patient asked us to proceed.
- What does that mean, exactly? - This man asked for a chance to fight.
What it means is, he's going to have to fight like hell.
But he can recover. There's a chance?
There's a chance...
Dr. Grey, the request from the patient...
- Was private. - Yes.
OK.
- Preston. - Addison.
- How you feeling? - Better.
I'm looking forward to going home.
Well, I'm sure Dr. Yang is looking forward
to having you back there, as well.
- Maybe. I wouldn't know. - Why wouldn't you know?
Is that over?
No, it's not over. It's just silent.
Oh, yes. I heard something about this.
One of the nurses was talking. I just thought it was gossip.
It's not.
So you're not talking to her. Why not?
- Did you ever play, "Say Uncle?" - "Say Uncle?"
Someone bends your arm behind your back harder and harder
- until you say, "Uncle. "' - And then what happens?
Then they have all the power.
I see. So you are not saying, "Uncle. "'
- Yes. - And neither is she.
- It seems that way. - That's pathetic.
- You may be right. - I am right.
If you say something wrong, then you apologize.
- Well, I didn't do anything wrong. - Did she?
She doesn't seem to think so.
It's pathetic.
- Hey. - Hey.
- You're all alone. Where's your family? - Eating. They like to eat.
- You're pacing. - Yeah.
It's just... He's been in surgery for awhile.
- They're being thorough. - Or there are complications.
Somebody would've told you if there were complications.
- It's OK to be scared. - I'm not scared.
I'm just saying if you are, you can talk to me.
- I'm not scared. - You sure about that?
- OK, now I'm scared of you. - Damn it.
- I was staring you down. - Staring me down?
- It worked on Shepherd. - Seriously?
Wait, wait. Let me try it again.
- No, it's not. - No?
I'm still scared.
Hold on. I'll be right back.
Prepare yourself because this was a much more extensive surgery
than the heart valve.
There's a tube in his throat helping him breathe.
Half his stomach was cut out and part of his esophagus,
so there's going to be a big scar. OK? Just be prepared.
Welcome back, sweetheart.
Dad looks like something out of the butcher shop.
It's a cool scar.
You need to breathe.
- He's my dad. - I know.
He's my dad.
I know.
Oh, you have got to be kidding me!
Where is George?
- He slept the night at the hospital. - And you slept in his bed.
- All night? - No.
Just after you fell asleep.
So you're telling me that my snoring is so bad.
How did you deal with it on those nights before I found out about your wife?
He usually sleeps on the couch, sets an alarm,
- gets back in bed before you wake up. - I didn't want to hurt your feelings.
I'm going to do more than hurt your feelings.
Stop it!
Now I'm going to hurt your feelings.
Can I help you?
I... I, um...
I... I inherited eight million dollars.
- I'm sorry? - Almost nine, actually.
Sorry. I'm sorry.
Thank you.
- I'm sorry. Did you say...? - Just take it.
Just take it, please.
Is that...?
It's covered in food.
Is this some kind of joke?
It is kind of a joke.
A really cruel joke.
- You want to deposit this? - If I wanted to deposit it,
- do you think I would look like this? - I don't understand.
I'm supposed to do something good.
I'm supposed to do something good and I...
Can you just deposit the damn thing already!
- I'm surprised they proceeded. - Me too.
I guess they think he's strong enough to fight it.
Is he conscious?
Still intubated so they have him sedated.
The main concern for the next few days will be multi-system organ failure.
That is, the surgery was too intense for his weakened organs to support.
Watch the kidneys. If the kidneys fail,
everything else is starting to go.
So we're watching the kidneys. Thank you.
Do you mind me asking, how's your hand?
I don't mind if you ask.
I will mind if you tell Cristina.
You two have a strange relationship.
Yes, we do.
And when you go home, you're going to have your very own room.
Yes, you do.
And your mom, she got one of those stencils. Mm-hm.
And she made little butterflies and flowers.
- You need something? - No. I'm fine.
Oh, it gets quiet in here.
- You paged me? - I started my shift ten minutes ago.
Her stomach looked a little distended.
Her stomach's distended? I... I didn't notice that.
It's hard to see.
Page Dr. Montgomery stat.
Is everything OK? Is this bad?
Let's just wait for Dr. Montgomery.
Dr. Cohen to Peds ICU. Dr. Cohen to Peds ICU.
What's the matter?
- My father's here. - Your father?
The one I don't talk to and barely know, he's here.
Is he here to see you?
- No. He's here with his other family. - Oh, sorry.
- Where do you sleep at the trailer? - What?
When we sleep at the trailer, where do you sleep?
You know the hammock outside?
Sorry.
I'm a girl with abandonment issues.
You have to sleep with me from now on.
OK.
A note from my hack of a shrink. I get to scrub in.
- Not until I say so. - I deposited the damn check.
You cheap son of a bitch bastards are going straight to hell!
Straight to hell!
- Mrs. Douglas? - Insurance bastards.
They say the surgery's too experimental.
- They won't pay. - It's a 200 thousand dollar surgery.
Plus the hospital stay, plus rehab.
Even if I get three jobs.
Son of a bitch bastards.
Looks like there won't be a surgery to scrub in on. Sorry, Stevens.
Talk to me.
Her abdomen was distended and she needed ventilatory support.
Sorry, I didn't notice...
She's got air beneath her diaphragm. We need to get Laura into surgery.
What? Another surgery? Why?
There's a perforation in the bowel. We need to get in there right away.
- Here's a consent form. Sign it. - I don't... I don't know.
- Her mother has the flu. - You're not authorized to sign?
- I am, but I'd like to fill her in. - We don't have time, Mr. Grey.
Your granddaughter doesn't have time.
All right.
Take out more bowel. I need better visualization.
It's so tiny. I'm afraid I might crush it.
It's tougher than you'd think. Give it a little squeeze.
Cool. Thanks.
Look. The NG tube has eroded right through the stomach wall.
We may have to resect an entire portion of the stomach.
She's hypotensive.
Push 30 cc's of albumin.
Got it.
- Scary. - You're telling me.
This is Meredith Grey's niece.
If I lost her, people might think I did it on purpose.
- How's it going? - OK.
They had a scare a minute ago, but she's stabilized.
Your father is pacing up and down the halls.
He's worried.
Maybe you can give him an update.
He's not a big fan of mine.
- He's not a big fan of mine, either. - Oh, I can't imagine that's true.
Your mother was a force to be reckoned with.
If she wanted things a certain way...
Your father was a good man when I knew him.
He may have a side in this that you don't know anything about.
You think he tried to send me a card every year,
and my mother has a whole drawer full of unopened cards?
Because it's not often that my life turns out that way.
I don't know.
But you don't know either until you ask him.
Hey. How's he doing?
Georgie is obsessed with our dad's pee.
This is weird. Even for Georgie.
- Boys, be nice. - His kidney function!
I'm obsessed with his kidney function, not his pee.
I'm not obsessed, I'm excited.
You're not going to drink that are you, Georgie?
One hundred and thirty cc's!
A hundred and thirty cc's of shiny, yellow urine!
One hundred and thirty in how long?
- Four hours. - No way!
That is fantastic! Yes!
Thank you!
Uh-huh, uh-huh, uh-huh.
Thank you.
Mark.
I'm sorry you're hurting.
You're sorry I'm hurting or you're sorry?
- Karev. - Oh. Hey.
I was just checking the baby's capillary refills.
No, that's good. It's good.
We all need a little human contact from time to time.
It sucks. She hasn't had a chance to deserve this, you know?
Is that why you want to go into plastics?
Because people sign up for the pain they get?
Yeah. For the most part they do, yeah.
You're right.
It does suck watching them struggle.
And that part never stops sucking.
But when you get to see a baby heal,
and they get to go home,
and you just imagine this whole life that they're going to live...
There's nothing better than that. And that part never changes.
But if you want to go back to plastics...
No.
The vanilla latte?
- I did that on purpose. - Why?
Because he was rude to you.
- I'm sorry. - Don't. I'm sorry.
- Go. I'm sorry. - I'm sorry.
No, I'm OK. I'm just... I'm gonna...
OK, yeah. Yeah.
Hey. You need some help?
I can walk to the bathroom myself.
I've been doing it my whole life. Nothing's changing any time soon,
so just get out of my way, OK?
Meredith?