Previously on "Grey's Anatomy"...
What is going on with you?
The hospital grants you four months to retake the medical board exam.
Karev, take the scalpel.
Alex! Come on!
Your choice?
It's simple. Her or me.
Addison is my family.
Then one day, I'm supposed to sign a piece of paper and end my family?
- Is that your date? - That's my husband.
- You're married? - Ten years today.
Burke wants to have a relationship.
Okay, we're a couple.
So pick me. Choose me. Love me.
I'll be at Joe's tonight.
So if you do decide to sign the papers, meet me there.
Tell me what to do.
I actually said "pick me."
Right? I did?
"Pick me"?
I think it's romantic.
It's not romantic, Joe.
It's horrifying.
Horror movie horrifying.
Carrie at the prom with the pig's blood horrifying.
Okay, fine, it's horrifying.
But Carrie took out an entire senior class as revenge.
I gotta say, I like that in a girl.
I said "pick me."
When you tell someone I'll meet you later at a bar tonight,
how long exactly does that mean you're supposed to wait?
Do you think he's really not coming?
It is getting a little hard to watch.
It was hard to watch an hour ago. Now it's just pathetic.
Who's pathetic?
What?
You who pretend to be my friends are calling me pathetic behind my back in front of my face.
Why don't you just dump the pig's blood on me now and get it over with?
He's really not coming.
Joe, turn up the TV.
A massive train wreck occurred
- just outside of Seattle moments ago. - 911?
We just worked a 30-hour shift.
I don't have any clean underwear.
The Vancouver-bound train was carrying over 300 passengers.
Looks ugly.
Paramedics are on the scene helping victims.
You're leaving?
No, no, no, you can't leave.
Sorry, gotta go tend to someone else's train wreck.
You gotta at least stay for a cup of coffee.
You're in no shape to cut people open.
Plus, I don't want to miss the ending.
Meredith?
Maybe it's for the best.
Maybe I don't want to know.
That's the stupidest thing I've ever heard.
In general,
people can be categorized in one of two ways--
those who love surprises
and those who don't.
I... don't.
Dude, you're late.
I've never met a surgeon who enjoys a surprise.
Because, as surgeons, we like to be in the know.
We have to be in the know.
Because often, when we aren't, people die and lawsuits happen.
Am I rambling?
I think I'm rambling.
I think I saw a pneumothorax.
I hope I get a pneumothorax.
I thought you weren't talking to me.
I thought you could use a friend, so I'm rising above.
And why would you think that?
- Because you freaked out in the elevator? - I didn't freak out.
- And missed your chance to perform an open heart surgery? - O'Malley plugged a hole with his finger.
- I thought you could use someone to talk to. - Well, I don't.
- Someone who actually cares about you. - Thanks for asking, but I don't.
What are you looking at?
Nothing.
Hey, you, go get me my damn shoes.
Let's move, people.
Hello.
I seem to be a little bit drunk.
I was off duty.
So was I.
Anybody else half in the bottle?
- Uh, no. - No.
All right, then.
Grey, just stay out of the way. I'll deal with you later.
The rest of you stick with me and wait for your assignments.
I know you get all a-quiver at the sight of blood and organs,
but it's gonna be a long night and you're already tired.
I don't want any mistakes.
Come on now!
- I'm so not tired anymore. - Me neither. I'm not tired either.
We've got a third-trimester burn victim here.
Dr. Bailey, I'm going to need some help.
- Uh, Izzie, go. - Yes!
Have a nice nap!
- Have you had any contractions? - No.
Oh, hey, Joe told me to tell you that McSteamy came looking for you.
You mean McDreamy.
Joe said McDreamy came looking for me?
No, I'm pretty sure it was McSteamy.
Yeah.
Dr. Shepherd, could you take a look at this?
Does that mean he picked her?
If it does, I just lost 50 bucks.
Got the leg!
I want that leg!
He lost a lot of blood at the scene.
Pressure dressings applied, two large bore ivs started.
Anything for pain?
Base ordered morphine.
5 migs given so far.
Dr. Bailey, who you got?
Cristina, go.
- Rule out other injuries and book an O.R. - Yes, sir.
Dr. Webber.
We have a train wreck, Derek.
We need all hands on deck.
Now clear me for surgery or you're fired.
- Any headaches today? - No.
- Dizziness? Nausea? Blurred vision? - No, no and no.
- Now get out of my way. - Fine, but I'm coming with you.
- Or I'm fired. - Up to you.
- Was that a nod? - Yes.
- Do we know what it meant? - No.
Am I invisible?
Okay, so my point actually, and I do have one,
has nothing to do with surprises or death or lawsuits or even surgeons.
My point is this--
whoever said "what you don't know can't hurt you," was a complete and total moron.
Because for most people I know, not knowing is the worst feeling in the world.
Okay, fine.
Maybe it's the second worst.
His B.P.'s holding steady at 90 over palp.
She's had two hypotensive episodes to the low 70s.
You couldn't get a saw in there?
Not without moving 'em.
Which would've been a very bad idea.
Did you bolus her with fluids?
Is this the craziest thing you've ever seen?
Um, yeah.
Yeah.
Me too.
Okay, then, you guys got it from here.
Hey, uh, you were at the scene?
Won't be too bad for you.
Lot of carnage.
Not a lot of survivors.
They're never gonna fit into C.T.
We're gonna be flying blind.
Get x-rays and labs and page me the minute you're done.
Excuse me.
Hi, I'm Dr. Burke.
You shouldn't turn your head.
You want to try to move as little as possible.
Oh, okay.
So are you gonna pull this pole out of us anytime soon?
It's a touch uncomfortable.
I'm sorry. We can't do that until we get a better look at what's going on internally.
But I assure you, we will work as quickly as possible.
Well, in that case, does anybody have a breath mint?
For me.
Not for you.
Get them going.
Uh, O'Malley, get them to x-ray.
Thanks.
Move them extremely carefully.
This never would've happened before the elevator.
You go, George.
Alex, cover the E.R.
You can do sutures while you get over your newfound fear of scalpels.
That was mean, even for you.
You are drunk.
Go get yourself a banana bag I.V., put it in your arm and then find me.
Do not speak to any more patients.
Do not practice any medicine.
Well, should I just go home?
Well, unless you drank the whole liquor bottle, you'll be sober in a few hours.
And the I.V. fluids will head off your hangover.
Then you can assist with the many mangled victims you see spread out before you.
Besides, if I'm not going home, nobody's going home.
Ten years of marriage.
I didn't even get to finish my damn lobster.
Well, um, is there anyone you'd like me to call?
No, they called my wife from the ambulance.
And my fianc�. They're flying down from Vancouver together.
Normally Amanda would be a tad upset to find me pressed up against another woman.
But in this case, I think I'll get a pass.
You two weren't traveling together?
No, we just met.
Bit of an awkward introduction.
You have very nice pores.
Oh, it hurts to laugh.
- Hey. - Hey.
- You can go ahead. - Oh thanks!
- Do you like, uh, I could-- - Yeah, go ahead.
Dr. Stevens, did you need something?
No.
Oh, I'm sorry. Am I doing this too--
Was that a...
- did I have... - A contraction.
It was definitely a contraction.
We need to book an O.R.
Look, you are in no shape to push, and the baby is still in some distress.
We're going to have to proceed with a c-section.
Okay.
Okay, but can we call a lawyer first?
I don't have a will.
And there's no father.
And in case something happens to me...
There's no cause for panic, Brooke, we have some time, okay?
Okay.
Hello.
Oh, no, no, we're fine, honey.
Yeah, some redneck tried to outrun the train.
Honey, the train slammed into his ass
- and then it rolled. - Does that hurt?
Oh, no, no, no, no, that dude is toast.
Honey, him and about 200 other people.
And Mary got her face all cut up.
Does it hurt anywhere else?
Here.
A whole bunch of luggage, when they hit the brakes, it just came flying at us.
All right, we'll take you for an x-ray, see if anything's broken, if there's any internal injuries.
Okay.
Yeah, wait, wait, you know, hold on.
I'm gonna have to call you back.
Hey, hey, hey, excuse me, excuse me.
Um, where you going?
I'm taking your friend for an x-ray.
No offense, little boy, but you look like my oldest son.
And he's nothing but trouble.
Yvonne, shut up.
I said "no offense."
I'm just saying.
Are you sure you're a doctor?
Yeah? Oh, yeah, yeah, we fine.
Yeah, some redneck tried to outrun the train, right?
What are you doing?
Trying to insert my banana bag, which sounds vaguely dirty, but it isn't.
I can do it.
So how's it going with Addison?
Bad mood?
Good mood?
Yay, my husband picked me mood?
Uh, I think it's more of a I hate the smell of charred flesh mood.
Before you judge me, I know there was a train accident.
People are very badly hurt.
And that I'm a vapid narcissist when you mix me with alcohol.
In case you were wondering, I know that.
Well, for what it's worth, I take issue with her salmon-colored scrubs.
I mean, what self-respecting surgeon wears salmon-colored scrubs?
This is what I'm saying.
Thank you.
Yang, how's that wound looking?
Pretty clean.
Some dirt and gravel mostly.
This guy was lucky.
It's a guillotine injury.
If we do this right he'll have full use of his leg.
Dr. Shepherd?
It'll wait.
I'm fine, Derek.
Just adjusting to the light.
All I'm saying is there's no shame in taking a little more time off.
It doesn't make you old or tired or rusty.
Yeah, okay, that came out wrong.
You're the only attending neurosurgeon.
You're obviously needed elsewhere, and I'm fine here.
Page me if you need me.
When you're finished cleaning that wound, you can help me here, Dr. Yang.
Is the wound clean, Yang?
Yes, sir.
- I-- but... - But what?
If your plan is to be a watchdog for Dr. Shepherd,
or if you think your job here is to babysit me, then you can think again.
I've been a surgeon longer than you've been breathing.
And if I were not ready to be in this O.R., I would say so.
- Is that understood? - Yes, sir.
Now do we have a problem, Yang?
Uh, yes.
No, sir, I-I'm thrilled to learn.
And I'm grateful to be here. It's just...
that...
Sorry.
- His legs-- - What about them?
They're both left.
Find the man's leg, Yang.
- Find it now. - Yes, sir.
- Is it going straight through her spine? - It is.
T8's completely crushed.
What happened?
Uh, tequila.
I'm keeping an eye on her.
Look at this.
These people are still alive?
They're still making small talk.
The pole's tamponading the wound as far as we can see.
It's hitting the aorta.
Look at him. It's right in line with his inferior vena cava.
Is there any way to operate without separating them?
No.
- If we remove the pole then... - They'll both bleed out.
What if we don't move the pole?
What if we move one of the patients off the pole to get the saw in there?
Then we can hold the pole steady in the other one.
Move it very slowly and repair the damage as we go.
Who?
Which would you move?
With her aortic injuries, her chances of survival are extremely slim no matter what we do.
But if we move her, we have a real shot at saving him.
Well, I could argue since her injuries are more extensive, we should move him.
Give her the best shot we can.
So basically, whoever you move doesn't stand a chance?
So how do you choose?
How do you decide who gets to live?
We have to make this call soon if we want a shot at saving either one of them.
I'd like to examine them before I weigh in.
I'll wait for your page.
Dr. Grey--
Dr. Grey needs to get herself a blood alcohol test before practicing any medicine tonight.
What? No, I'm totally fine.
Look.
Totally fine.
Right, okay.
I'm fine.
Regretting that last shooter about now, aren't you?
What are you doing in here?
Uh, the leg you brought in with the amputee--
I didn't bring in an amputee.
Okay, well, um, one of you did, and it's, um--
Because all paramedics look alike to you, right, doctor?
Okay, really, I cannot straddle another giant ego right now.
I'm already doing the splits, so I need the right leg,
right now or the chief of surgery is going to take away my pretty blue scrubs.
When the train derailed, it hit an overpass.
The roof of the dining car was sheered off and it sliced through a passenger car.
There were multiple decapitations.
Your guy can live without his leg.
This is so not about the leg or the guy.
But thank you.
For all that you do, really.
Thanks.
Mm-hmm, yeah.
Oh, yeah, honey, we fine.
Yeah, but some redneck tried to outrun the train.
Then they go and give us this little boy doctor--
All right, the scar shouldn't be too bad.
Can you tell me, my friend, she's pregnant, too.
She was put in a different ambulance.
She was burned.
Do you know where she is?
If she's not down here, she should be up in maternity.
Okay, I need to see her.
We're not finished yet.
- We still have to do a full exam. - My baby's fine.
I can feel her kicking. I've gotta see Brooke.
Uh, wait, you can't just leave like that. Just wait.
Come here, come here.
Sorry.
You operated on a heart earlier, George.
You'd think you could draw a little blood.
I rocked that heart.
Yeah, you did.
I think I'm strung out on the scalpel.
Nothing wrong with that.
- So any news about... - No.
I can't read him.
You know, I think it's pretty amazing you even gave him the choice.
And I think, for what it's worth, I think he's crazy if he doesn't pick you.
Please tell me you've seen a right leg.
A cleanly severed right leg?
No.
How weird is this job?
Weird.
Brooke?
Jana?
Thank god.
Dr. Karev?
- I couldn't stop her. She wanted to see her. - She was on the train?
- Yes. - Have you done an ultrasound?
Cleared her c-spine?
Is there any reason you can think of that this patient should be wandering around the hospital unattended?
She's not unattended.
I came up with her.
You can leave now, Dr. Karev.
Irresponsible, even for an intern.
What, you disagree?
She wanted to see her friend.
I mean, what was he supposed to do? Tackle her?
Dr. Stevens, why don't you get our new patient into a bed?
Shall we?
Can you feel that, Miss Krasnoff?
You're a cute doctor.
Cute doctors get to call me by my first name.
Bonnie.
Okay, Bonnie.
Can you feel that, Bonnie?
Can I feel what?
Oh. Oh, well, I guess that's a no.
- Excuse me, Dr. Shepherd? - Yes?
- I got the labs. - Oh, great. Thank you.
Hold that, please.
Could you try to wiggle your toes, Mr. Maynard?
Are they moving?
Yes, they are.
Good.
- That's good, right? - Yes, it is. Yes, it is.
What about me?
Are mine moving?
Yes, they are.
Yay me!
Dr. Shepherd, is it?
Yes, it is.
Dr. Shepherd, Bonnie and I...
are we gonna live through this?
Now that's just morose, Tom.
I'm sorry, dear.
Doctor?
We're going to do everything we can, Mr. Maynard.
About time, Yang.
I was starting to think my work here would be wasted.
I'm so sorry.
It wasn't easy to find.
I took the liberty of checking the wound, and it's a very clean-cut, well-preserved.
Uh, Dr. Webber?
Sir?
Notice anything else about that leg?
Anything other than that very clean cut?
Did you happen to notice, for example, that it was shaved recently?
And manicured?
Take a look at my patient, Dr. Yang.
Does he look like a man who woke up and shaved one of his legs this morning?
No.
I'll go find the, um, right--
the right right--
- the right right-- - Thank you.
- Where are we? - You were right.
Her vitals are erratic.
Pulse is weak.
Spine's severed.
I was hoping it didn't hit the--
but from that angle, it can't have missed the aorta.
What about him?
Think he can live?
He's got better odds.
All right, let O.R. one know we're coming.
And, O'Malley?
Close off the gallery.
We don't need an audience for this.
She's cracking jokes.
How do you tell someone she's gonna be dead in a few minutes when she's sitting up cracking jokes?
Excuse me.
Is there any chance we can get out of here sometime this year?
Well, the lab's backed up, and so is radiology.
I can't discharge your friend until I'm certain she doesn't have any internal injuries.
Hello?
Yeah, we're still here.
'Cause our doctor's friggin' useless.
I realize you're dealing with a lot of carnage.
I'm asking if you could maybe sift through some of that carnage and find--
Hello?
Damn it.
Cristina, you paged me?
If I don't find this leg, the chief is going to cut me from this program.
And I cannot go back home, Burke.
It is too sunny in Los Angeles.
It's sunny every day.
And you paged me because?
I need you to help me find the leg!
I checked the board. You're not in a surgery, right?
You're my boyfriend! I mean...
I know I don't have much experience with this kind of thing but...
Aren't boyfriends supposed to help in situations like this?
Cristina, when we're on duty, I can't be your boyfriend.
Okay, so, uh, when we're on duty, I can have sex with someone else?
Dr. Yang, I'm walking away now.
Fine. Fine.
But when the chief cuts me, you might rethink this.
Addison yelled at you in front of a patient?
She didn't exactly yell.
- Fine, she's Satan's whore. - Thank you.
- So did you yell back? - No.
- Dude, you lost your mojo. - Excuse you?
I was trying to talk boy.
O'Malley plugs a hole with his finger and everyone walks around like he's some kind of hero.
- I have one off day-- - You chickened out.
I hesitated briefly.
Why didn't you kiss Izzie?
And now I'm leaving.
It's not in the morgue.
I've looked in the ambulances, in the E.R.
How is one bloody, hairy leg going to destroy my career?
Dr. Karev?
I hope you find your mojo, Alex.
- I find you disturbing without it. - Me too.
This is hard because your body is in a certain amount of shock.
It's preventing you from feeling pain, from feeling the extent of your injuries.
Dr. Shepherd?
We have a metal pole cutting a path through our insides.
I don't know about Tom here but,
I didn't expect to walk out of here anytime soon so...
whatever it is you have to say, just please say it.
Okay, Bonnie.
In order to operate on Mr. Maynard, we have to separate you two.
In order to do that, we have to move you backwards off the pole.
Can't you just pull the pole out of both of us?
Well, if we did that, you would both start bleeding very quickly.
Too quickly.
Right now the pole is plugging the wounds.
Once removed, the organs will shift.
And there is a great deal of damage.
So if you move me...
I'll die?
- We're gonna do everything we can to... - No. No.
If anybody has to go, it should be me.
You just move--
Mr. Maynard, Mr. Maynard,
your injuries are less extensive.
If we pull the pole from you as we operate around it, we have a better chance at repairing the damage.
It's not right.
It's not fair.
Tom...
it's not fair either way.
Is, um...
is my Danny--
is he here yet?
There are delays at the airport.
Um, the storm...
We could wait, but the longer we do,
- the higher the risk of infection for-- - No. No.
This is better.
Danny wouldn't understand.
I've had a couple of hours to, you know, process all of this.
But if he had to see me, talk to me like this, I...
well, I just think it would be too hard.
Right there--in between the vertebral spaces.
Don't be shy about pressure.
That's good.
You are doing so good.
Somebody called for a notary?
I asked for a lawyer.
I couldn't get one at this time of night, but the hospital has pretty standard forms.
It just says that in the case of death or permanent vegetative state,
that your child will remain in the custody of, and then we'll put her name in.
Wait, what?
What are we? Who's dying here?
There's some danger.
With any surgery there's danger.
But with the trauma of Brooke's Burns, there's an additional risk of shock.
She just wants to be certain.
That's ridiculous.
You're being ridiculous.
- You're gonna be fine, do you hear me? - I hear you.
But we still have to sign the forms.
Unless you want our son to end up with my mom.
How long have you two been together?
Since third grade.
We're not lovers.
We're best friends.
We just wanted our kids to have two parents.
So we got a sperm donor.
The same donor? So your babies are brother and sister?
Oh, how cool is that?
That's--
- wow. - Wet.
What?
- I'm wet. - Oh, god.
I think my water just broke.
Good news.
You've got a broken rib.
We're gonna give you some painkillers and, uh...
after that, you should be good to go.
Thank you.
Yvonne, answer your phone.
Yvonne? Yvonne?
Yvonne?!
Code blue, I need some help over here!
Yvonne?!
Push one of epi. Hold C.P.R.
Her abdomen's distended. It's rock solid.
She's lost too much blood. She's been bleeding for hours.
But there's no blood. She's not bleeding.
She was bleeding internally.
She didn't say anything.
She wasn't...
she wasn't even a patient.
I didn't know.
Dr. Karev, she's gone.
No! No! No!
- Yvonne! - I'm sorry.
Time of death--2:51.
No! No! No!
Try again.
Jana, this is our O.B. resident Dr. Hoffman.
She's gonna be taking care of you from here.
You're doing great, Jana.
Just keep breathing.
I'm gonna check your cervix now.
Brooke, we've booked an O.R., but they're not gonna hold it for long so we need to go now.
Right now?
But we're supposed to be together. We took classes.
I'm sorry, but we can't wait.
That's okay, Brookie.
You go have your c-section and enjoy those drugs.
This is already not fun for my vagina.
Dr. Stevens.
No.
If I have to go, she has to stay.
Someone has to stay with Jana, please?
Brooke, Dr. Stevens is a surgeon,
- but I'm gonna find you some-- - It's okay.
I'll stay.
Okay.
Brookie, you stay alive, okay?
You too.
Damn it!
- Hey, doc? - What?!
Easy, killer.
Jill said you guys were freaking out looking for this leg.
- Thank you. - No problem.
Right on.
Chief Webber, I'm extremely sorry. I...
Pull that tendon down with those pick-ups.
Oh, you found the leg?
I found the leg.
You missed out on this one, Yang.
But I'm sure they could use a hand down in the E.R.
Karev and I can handle it from here.
Can I ask you a question?
Do you believe in heaven?
I do.
Don't you?
I want to.
Bonnie...
I just want to say...
I know.
This is Dr. Adams--
our anesthesiologist.
When you're ready, he's gonna put you to sleep.
So it's not gonna hurt?
It won't hurt a bit.
Good.
That's good.
- Dr. Shepherd? - Yes.
You're gonna be the one to talk to my Danny, right?
Yes.
- Okay. - Okay.
What do you want me to tell him?
Why do I feel like we're about to kill this girl?
Dr. Bailey?
- My labs are in. - Sober?
- Can I scrub in? - Do it fast.
George.
- Hey. - Hi.
- You know, I, uh, I went to the bar. - I heard.
Did you take some aspirin with the banana bag?
Helps with the hangover.
You're staying with her.
Yeah, she's my wife.
Dr. Shepherd, she's crashing.
What happened?
I just put them under.
The pole must've shifted.
I barely touched her.
This isn't my fault.
It's nobody's fault.
We need to remove her now if we're gonna have any chance.
How do we do this?
Team one, continue to stabilize his body.
Team two, move her back.
Let's get the saw in there.
This has to be fast and smooth, people.
O'Malley, you hold the pole in place.
Whatever you do, don't pull on it.
- Don't let it move. - Okay.
On the count of three.
- One... two... - Three!
That's great! That's great.
Take another breath.
- One... two... - He's wedged up under her ribs.
We're gonna have to pull him out. On three.
One... two...
He's stable for now. Let's start with her and see what we can do.
Scalpel.
Uh, Grey?
Uh, get in here and help retract.
Retractor.
I'm in.
Her aorta's shredded.
- She's got a bleed out. - We have no rhythm.
Doctors, he's losing pressure.
He's bleeding.
What about her?
We can't just abandon her!
Come on, come on.
We can't just abandon her!
I'm going in stem to stern. Scalpel.
Sternal saw.
Give me the sternal saw.
- Let's go Dr. Grey. - Meredith.
Dr. Grey?
- Meredith? - What about her?
We cannot just abandon her.
We have an obligation!
Meredith, come on, come on. There was too much damage. There was never anything we could do.
We have to let her go.
Time of death-- 3:49.
How's Brooke?
She's good.
And the baby?
He came through, too.
So have you made a decision yet, Dr. Stevens?
I'm sorry?
Whether or not you're going to hate me.
You're Meredith's friend.
I'm the wicked witch who came in and ruined her life and cheated on doctor...
Wait, what is it that you guys call him?
McDreamy.
Right.
God, doesn't that embarrass him?
Yeah, I think it does.
Yeah, well, by all rights, you should hate me.
I guess.
Except that I'm gonna be staying in town for awhile.
- You are? - Yes.
And you show a real gift with my specialty.
I've got a lot to teach, if you want to learn.
So?
So when you decide how important it is for you to hate me, let me know.
Did she, uh...
Did she suffer?
No. Her injuries prevented her from...
No, she wasn't in any pain.
Good.
That's...
She asked me to--
to tell you that...
She wanted you to know, that if love were enough...
that if love were enough, that she'd still be here with you.
As surgeons...
there are so many things we have to know.
Fine work, Dr. Karev.
Thank you, sir.
We have to know that we have what it takes.
We have to know how to take care of our patients.
Tom is doing just fine.
And how to take care of each other.
- Okay? - Yeah.
Eventually...
we even have to figure out
how to take care of ourselves.
As surgeons, we have to be in the know.
But as human beings,
sometimes it's better to stay in the dark.
Because...
in the dark there may be fear...
but there's also hope.
You better get cleaned up.
Rounds in five minutes.
Transcript : RaceMan Synchro : Raekwon
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