Grey's Anatomy S5E3 - English Transcript

previously on "grey's anatomy" the surgical training protocol is officially changing,people. you thought that you'd defend youriboyfend to me,and I'd just take it? He's not my boyfriend. - Hi. - Hi. You and derek will not work. Why do you care what I think? If I'm gonna do this with him,I need you to cheer me on. as surgeons,we are trained to fix what's broken. I'm in a hurry. I can't stay. The chief's having a big meeting. Uh,but I wanted to tell you that I'm finished with therapy. The breaking point is our starting lineat work. Meredith,you are not finished. You have worked incredibly hard. Look how far you've come. But you're just scratching the surface. Well,derek's moved in,and we've taken it to the next level. It's not about derek. I'm happy. You're not done. I am happy. - Isn't that the point? - No. But in our lives,the breang point is a sign of weakness I need you to stayfor the session. I-I--no. The meeting,the chief,I thank you,dr. Wyatt. Thanks for everything. And we'll do everything we can to avoid it. - Whoa. - Oh,sorry. What are you doing in here? I'm thinking about making this my office when you move T. When I move out? When am I moving out? Ohsoon? Did you know meredith was planning on making us move out? I'm kinda busy here,iz. You can join us if you want. No! When were you planning on telling us we had to move out? When were you planning on telling them they had to move out? What?Why do they have to move out? Meredith,hey,look,I made this especially for you. It's a zoo,a frat house,with alex and his parade of women his parade of skanks. Whatever. Am i apartment hunting or what? I don't know. I have to think about it. Well,just,you kn,eat the muffin,mer. Taste the muffin. Remember the muffin. I like my roommates. I like them,too. That was your life. This is our life. And I'm excited about building our life together. Come on. It's gonna be great. so derek wants alex and izzie to move out. Well,since when does he say "jump" and you jump? Well,I'm happy. I'd be pissed off but,you know,whatever you want. hey,you hear anything about what the new rules are? last I heard,you were at hand holding,foot rubs and lots of late-night gab sessions. Excuse me? listen up,everyone. Oh!No,you were talking about the,uh,chief's new rules. I thought you were referring to you and torres. I've been wrong before. We're busy people,so I'm gonna try and be brief. I am implementing a new teaching protocol here at seattle grace. Now some of these rules are new,and some are old and are going to be newly enforced. jack o'brien,47,scheduled for an abdominal aortic aneurysm repair. His,uh,last C. TShowed calcification, so I ordered a C. T. Angio to determine whether it had worsened or remained stable. Nice catch,yang. You can take him down after rounds. Dr. Karev will take over. Dr. Yang,you're done here. Thank you. First-,second- and third-year residents will no longer be allowed to de facto specialize. The practice interferes with theevelopment of a fully rounded surgical education. -No more. -barry patmore,63 has been experiencing chronic headaches for the past seven years, has been treated with narcotics,antiseizure medications,antidepressants and antipsychotic medications with no success. how severe is the pain today,mr. Patmore,scale of one to ten? Eight. It's always an eight. Which is why mr. Patmore's last consult suggested a bilateral cingulotomy -- I'm sorry,a frontal lobotomy for a headache? too loud. Please. And could you do something about the buzzing? Do we need all these machines? mr. Patmore has been experiencing intense pain all day,every day for seven years. But the cingulotomy could cause seizures or cognitive defects or behavioral changes. Which is why we are going to explore every other possible option before resorting to such a radical surgery. More tests. Yes. Dr. Yang,you'll be assisting dr. Shepherd today. personal relationships personal loyalties and personal favorites will no longer be a factor in our training program. Attendings,you will spread your wealth of knowledge equally among all of the residents. In addition,we will refocus our attention on patient communication and bedside manner. For some of us,this means learning the lost art of humanity and compassion. For others,this means learning how to treat patient without becoming emotionally involved with them. Shelley boden,30,stage iv colon cancer with liver mets. Shelley has been through extensive chemo and radiation, and according to the C. T. ,A liver resection at this point could be curative. Will be curative. Will. Do you have any other questions for us? What happens if you find more cancer than you expect? No,jenn. "A," that's not gonna happen,and "b," izzie's already answered all of your questions three times. Well,izzie's not the main surgeon. Izzie's awesome. We love izzie. This is dr. Grey. She's gonna prep you for surgery and answer any more questions you have. izzie's not staying? This is a surgical program. Psychiatry is on the fifth floor. Let's not confuse the two. In addition,residents,your interns reflect on you. If they fail,you fail. If they succeed,you succeed. Attendings,that goes for residents as well. Teach with enthusiasm. Learn with enthusiasm. We are surgeons. We cut out malignancies. Let's start at home,people. o'malley. This is dr. Bennett epstein. He'll be your proctor for the exam today. You about ready,o'malley? Oh,yes,sir. You have exactly three hours from the moment you open the test. Once you break the seal,you may not leave the room until you have completed the entire exam. Good luck,o'malley. Thank you,sir. I can do this. I am not married and cheating on my wife with my best friend. everything's just as it should be. damn chair. Hang on. Looks like the wheel's broken. That's how things work around me. My toaster broke last month,then my cat ran away and my back porch collapsed. Also,my tv only shows the color green. I'll get another chair. Don't bother. I'll walk. Probably safer. No,mr. O'brien,you need to stay in the chair. Uh,it's hospital policy. - Mr. O'brien! - I've also had three car wrecks in the last year. mr. O'brien. Somebody get me a gurney over here. Sir,im very sorry. I hit my head. I'm very,very sorry. Okay,get him a C. T. And I want hourly updates on his condition. Yes,sir. You're gonna be okay. mike,my ceiling's raining here. It looks like a pipe burst. We gotta turn off the water and isolate it. No,no,this is the surgical floor. Water's required to scrub in,to clean equipment,to keep people alive. I need you to fix this with the water on. I can try. All right,keep me posted. um,chief there is some kind of leak in the conference room. You don't say. I was wondering if there was some--anywhere else that I could take the exam. I will find a different room on my own. Thank you,sir. We have a problem. Mark sloan has found us out. mark's known from the beginning. I told him. He's mark sloan. Well,you don't have a person that you talk to about things? You are the person that i talk to about things. And I like to keep my private life private-- from everyone-- but most definitely from marksloan. How long will the operation be? At least a couple of hours. You think it could be longer? Well,if there are complications or if the mets are more extensive -- they won't be. Jenn-- - but what if - jenn,please stop. Just call mom and dad,tell them two hours. Since I got cancer,my sister's only capable of talking about cancer,which is so much worse than the cancer. So I know I don't know you,but spill. Spill what? Anything,I'm begging you,before she comes back and asks you to describe my liver cell by cell. Please. Okay. Um do you want to hear about my stupid boss or my stupid boyfriend? Oh,boyfriend. Definitely t boyfriend. Okay,mr. Patmore. I'm gonna give you a variety of different stimuli so we can take a look at the wave patterns generated. I need you to remove your hand from your eyes now. okay,are we still at an eight? It's still at eight. Okay. Starting visual stimuli. if you were me,you'd want 'em out the roommates. I'm not being unreasonable,right? His pulse is coming down. But u have to admit,you'd want them out. if you were me,you would want them out. if we have to operate,I'll let you drill burr holes by yourself. fine,I'd want them out. Whatever. Knew it. Okay,mr. Patmore. Okay,we're gonna change your position now,okay? um,dr. Yang,I think I have an idea. Well,don't think,know and run to the lab for his test results. But izzie bakes and alex fixes things. Okay,when I am no longer cancer girl and I can go out and meet a hot doctor who rocks my world and wants to move in with me, I might forgo the baked goods and repair work. ooh,heads-up,12:00. Just so you know,cristina thinks you should move them out you should talk to her. Dudeyou failed to mention the hair. Yeah,yeah,the hair. It's one of the many things that makes me happy. Dr. Sloan,um,I'm working with shepherd today on a pain patient, and I read this article while i was helping george study pathetic. Yes. I know,I'm pathetic but I did read this article and I do have a photographic memory, and the chief's on his new thing where he wants the interns to be heard and not just seen-- use fewer words,grey. I think he needs an E. N. T. You're an E. N. T. ,Right? How you doing in there,mr. O'brien? Could be worse. Could have brain leaking from my ea . That's the spirit. It'll only take a couple more minutes. Hang on. Guess what I found-- an apartment,a beautiful apartment with hardwood floors and an honest-to-god fireplace that you can build honest-to-god fires in, and I can't afford it by myself. So I thought if you could get over yourself,we could live together. No,thanks. Did I mention the hardwood floors and the nest-to-god fireplace? I'd rather live in my honest-to-god R. Right. How's he doing,karev? You think we're looking at a lawsuit? Well,we don't ha e picture yet,but,uh,no. This guy doesn't seem like the lawsuit type. Well,let's hope you're right. hello? hello? I cannot apologize enough. You treat him like a king. You hear that,mr. O'brien? Dr. Karev is gonna take great care of you. You're our number one priority today. You okay? God ha s me. -Mr. O'brien,I am-- -my wife left me. My accountant stole from me. the store I worked at burned down. I was diagnosed with an aneurysm for which I require surgery in a hospital that seems to be crumbling around me. God hates me. You can see the remaining tumor is easily identified here. Her liver looks so healthy. That's the beauty of general surgery. You see badness surrounded by goodness-- cut out the badness,all is right with the world. It's just you and your scalpel,one-on-one,mano a mano. Y-- okay,this is me teaching with enthusiasm. Oh,no. -O'malley. -What? if you're finished with your test, um,look,the hospital's flooding,the C. T. Is on the fritz, my post-op and pre-op patients are backed up for days. I gotta get a handle on this thing before the patients find out and our ranking drops way past 12. I found a nice,quiet room in psych for you to take your exam. Oh,I-I-I see. Um,yeah,you--you-- you go ahead. Chief. I am your intern at least for one more day. I can help. dr. Shepherd,a word. Excuse me one second. Uh,do you,uh,mind if I run a quick test on your patient? He's in a lot of pain,mark. I don't think he needs a tummy tuck. Oh,that's funny. No,uh,dr. Grey came to me with an interesting idea, and,uh,unlike you,I'm taking the chief's new teaching protocol seriously,so I listened. Uh,I-I read a thing about swelling and compression of the ethmoid nerve. I believe if we were to stick a cottle elevator up his nose-- no,I'm--I'm sorry. Up his nose? If dr. Grey is on the right track,the,uh,patient will let us know. Okay. Mr. Patmore,I'm dr. Sloan. I'm the head of plastic surgery and an ear,nose and throat specialist. I'd like to run a quick test if I can have your permission. I've seen 16 E. N. T. S not one could help me. Now breathe normally. I'm gonna angle this into here. you let me know when you feel any pain or anything. That's it! That's the pain! That's what's causing the pain. oh,my god. Oh,my god. okay. Anterior ethmoid neurovascular complex. A simple middle turbinectomy will fix it. Unless you still want to chop out the front of his brain. nicely done. hi. How'd it go? hi,shelley,um we found that the mets were much more extensive than the C. T. Detected, and the main tumor actually extended in and around the major blood vessel behind the liver. We're just gonna start a new round of chemo. That's all. I already have a call in to your oncologist. That's him. I'll--I'll be right back. we can manage your pain. I'm sorry we don't have better news. So did you decide what to do about your roommates? I'm so sorry,shelley. Come on. So how good is the hot boyfriend in bed? look we don't even know what we are yet. So how does mark sloan know? Why are you talking to him instead of me? Ladies. Am I interrupting? You're timing is perfect. Really? Are you about to feel her up? stop. You have to stop. I can'T. Seriously,she hates it. That's why I can'T. Don't--you want a spanking? -I-- - okay? So you told derek you think I shouldick them out? No. No,I s-- I told him I would want them out--me,not you-- and I only said it 'cause hewouldn't stop talking. So you don't think I should kick them out? 'Cause I think I'm going to. I mean,I think it's the adult thing to do,don't you? What does yourhrink say? I quit my shrink. I'm happy. We're happy. Hey,can I sit here? George,hey! George,uh,how--how did it go? I just-- there was a water problem. I mean,I'm just trying to help the chief even though all the mecal facts are falling out of my ear onto the floor. Eat this. It's brain food. My dude with the aneurysm? Fell in the water,smacked his head and got stuck in the C. T. Machine. My patient's dying. I hate it when I like them and they're dying. our guy's been living in pain-- pain at a constant eight for the last seven years-- because of an inflamed nerve in his nose. That's crazy. I wish I had an inflamed nerve in my nose. There is no way that that guy has been living at an eight. He a wimp. His eight,my three. I can take pain. You can't talk to my boyfriend for ten minutes. Well,there's pain and then there's torture. And I can take pain. Seriously,test me. nothing. That's impressive. Shut up. You barely touched her. -No,no. -No! Knock it off! Stop it! Um,how did you diagnose that nerve,because I've never even heard of that condition before? I remembered an article from the "british journal of E. N. T. ," And it was issue number 47,page 19 from 1964. Photographic memory. Dude,lex-opedia. Oh,I hate you. Don't hate me. I can help you. Oh,uh,chief. What's going on with the flood? It's not a flood,bailey. It's a pipe that it's minor,okay. Not to worry. Aren't you headed to surgery? Yes,sir. Uh,chief,a few months ago,little tuck flushed one of his action figures down the toilet, and I thought it was no big deal,minor. Buthen I came home to a kitchen filled with several inches of poop water. Poop water? In my kitchen,sir. Thank you,dr. Bailey,but I have this under control. Yes,sir. Poop water. Hey so apparently there's some kind of leak, and the chief wants me to move all the pre-op patients to the clinic. So who's free to help me? not a high pain threshold,huh? You know what?Throw him out. Not me,just him. She likes me more. I bake for everyone and I clean. The only thing you bring to the house is filth. What would you prefer,meredith,chocolate cake or an S. T. D. ? water! Oh,god. It's everywhere. -What's happening?What happened? -come on. -Let's keep moving. Move! -somebody get the chief. Post-ops to rooms 2415. Pre-ops to rooms 2233,4 and 5. The overflow goes into the clinic. Chief. I-I got everything under control up here, but I need you to oversee stevens with the pre-ops in the clinic. Okay,sir,maybe we need to shut down, just send the patients to mercy west,seattle pres. They can repair the pipe,and we'll be up and running in no time. I am sending all our patients to dry ground. I closed all but two O. R. S. Maintenance has isolated the broken pipe. So thank you,dr. Bailey, but when I say that I've got it under control, that's what I mean. But,sir,they may have isolated it, but a lot of water got out before they did. I'm just saying that maybe-- dr. Bailey,clinic,now! Yes,sir. On my way. Hey,hey,slow down. Okay,what next? Wait. Are you sure you have time for this? I really want you to get to take your test. Thank you. grey. Uh,despite your,uh,unfortunate taste in men, it turns out you're not entirely useless. Mr. Patmore's condition is extremely rare, anyou nailed it. You can scrub in. Now? You're doing the surgery now,with the--with the flood? The flood's contained,and our man's been in pain for seven years. See you in surgery. I can'T. I'm sorry,um,but I'm busy-- I'm really busy helping the chief with the-- chief's,um,iern. I-I--thank you,but maybe next time? No,lassie. There won't be a next time. Pathetic. Mr. Patmore,I'm just gonna draw somdbloo and, uh,place a topical decongestant before I take you to surgery. Absolutely. Of course. How's your pain level now? Eight. It's always at eight. Oh. Well,it looked like you had some relief. I've spent seven years I've seen 39 doctors And I've tried every kind of painkiller,and nothinhelps. I've had doctors tell me it's my imagination that I'm crazy call me a drug addict. My wife died last year. After spending years carting me around to doctor after doctor, test after test,she died. She was my best friend. she was my favorite person. And she died and I couldn't feel it. I couldn't feel that pain because I was so completely occupied witthis one. and now I finally know what's wrong, and dr. Sloan's gonna fix it. So you're right. you're right that I'm feeling some relief. okay,let's get your blood drawn. I'm not gonna do it. I'm not gonna have surgery. It's just gonna hurt. She's gonna slice me in half and probably kill me. If she doesn't kill me,it'll just hurt like hell. Probably get infected and hurt worse. I'm not gonna do it. Look,I get that you're scared, but if you want to live,you need the surgery. If I want to live? Have you been paying any attention? My girlfriend had a hysterical pregnancy,went nuts, cut her wrists while I was in the next room and had to be committed. And now my roommate's planning to make me move out. I have no money for a deposit anywhere else, so chances are,next week,I'm homeless. You making stuff up to make me feel better? Look,you must have something to live for. Or even just the possibility of something. There's a girl at the grocery store. I keep meaning to say hello. Instead I just keep asking her about the produce. All right. So you get the surgery. 'Cause chances are your-- your luck's gonna turn around. It's science. It's--it's-- it's the law of averages. It's gonna turn around. And when it does you say hello. I say hello. chips? Chocolate? Thanks. What? You're not a terrible person. Okay. I know we don't always see eye to eye,but I found this really great apartment. It's right across the street from the hospital. It has really great light. I know you can afford it,and it's burke-free. It must be kind of awful living in his old place. Think about it. you can open that retractor up a little more if you want to get a betterooK. Just make sure you keep the small bowel inside. We want to avoid a post-op ileus. Well,we better. The dude thinks there's a dark cloud following him around. Well,that sounds overly dramatic. what's that? What's-- what the hell? Hey,mo-move-- move the patient. What? Move the patient! Oh,my god! Is everyone okay?How's our patient? He's stable. Vitals holding steady. All right. Irrigation,please. How can I help? Uh,find the chief and tell him what happened. God,we need a new O. R. They shut down all the other O. R. S except for this one and dr. Sloan'S. Okay,uh,karev,go to sloan. He just got started. Maybe he can close. All right. I need everybody's help. We're gonna get ready to move mr. O'brien. What do I tell sloan? Just tell him the damn sky is falling. nasal speculum and lidocaine. larger speculum. Another lidocaine. We're just watching? I'm a pain specialist,and I would've missed this thing. So,yes,we're just gonna watch. don't ever use me again to try and influence her. You and i are not team meredith. We need the O. R. We need the O. R. ! On a patient? Yes,sir. Collapsed? Your staff wasn't hurt,but the patient's abdomen was open. He's stable as far as I know. dr. Bailey,spread the word. We are closing the surgical floor and shipping our patients out to mercy west and seattle presbyterian. Yes,sir. And,dr. Bailey try not to gloat on the way out. No gloating,sir. Anybody see any more damage,any bleeding? no,no bleeding. I just cleared the lower left quadrant. Give me the pulse irrigator. dr. Hahn,take a look at this right here. The pancreas--is that,uh,damage from the debris? No,no. That's a tumor. Oh,son of a ***. -you're the shrink,right? -Yeah. Well,you can't let her quit. Let me guess. Cristina? She talks ab-- whatever. Um,you can't let her quit because I'm no longer allowed an opinion because I'm being supportive. So you're my last hope. I mean,it's your job to have an opinion,right? You're paid to have an opinion? That's right. Okay,so,um she lives her life at an eight. Her pain on any given day,she lives at an eight. And he doesn't get that. I mean,he moves in and expects her to-- to move her roommates out? Which goes to show you how completely he doesn't get her,because she needs them. So you need to tell her not to move them out. I mean,it's not gonna work out in the long run anyway, and she thinks that she's happy,but she's not. And it's your job to tell her. It must be incredibly painful for you-- the idea of losing meredith to derek. You're a terrible shrink. -just talk to the oncologist. -No. There's a clinical trial using chemo plus avastin. And there's-- you're not a doctor. Please stop talking like you're a doctor. Did you have me paged? Yes,because I'm dying,and you can't let me die without knowing what you decided. You look very serious. Oh,my god. Are you gonna break up with him? No fair. I'm dying,and you're casting all that hotness in the wind. No fair. No fair. No fair. It's no fair. It's no fair. No fair,no fair,no fair. Dr. Hahn's gonna come in and talk to you in a couple of minutes. How'd it go? Okay? Actually,not so okay. Uh,the flood weakened the ceiling in the O. R. The ceiling collapsed in several fragments,landed inside your incision. Because of the ceiling thing,we had to explore your abdomen more thoroughly than we normally would have,and as a result,we found a malignant tumor on your pancreas. Cancer? You found cancer? well,wait,wait. Listen,listen to me,'cause here's the thing-- we took it out,we sent it to pathology. It was only stage I. Only stage I. We never find pancreatic tumors so early. They're almost always a death sentence by the time they're diagnosed. but not for you. we took the tumor,the whole thing. We took it out. You won't even need chemo. That ceiling collapse,it it saved your life. Your luck has turned,man. It's turned. I'm gonna say heO to that girl. I'm gonna say hello. chief. Chief? Ch-chief,I've downloaded all our patients labs and radiology onto dvds, and I've attached them to each of their charts. Is there anything else I can do to help? How'd it go? I-I know. I'm pathetic. And george doesn't know I exist. And I missed my surgery and blah,blah,blah. Could you please just tell me how it went with mr. Patmore? We didn't get to do the surgery. Mr. Patmore has been shipped off to another hospital, and he will be out of pain by this time tomorrow. Photographic memory,huh? Yeah. Periodic table. Go. Hydrogen,helium,lithium,beryllium, boron,carbon,nitrogen,oxygen, fluorine,neon,sodium,magnesium,aluminum, silicon,phosphorus,sulfur I can keep going. we could burn actual wood? See?That's my favorite part. You can't--you can't find that anymore. Look at this. It's gorgeous. What do you think? Thank you!This is a fantastic apartment. -We totally love it. -Love it. Love it. I love it. It was really great of you,izzie. Really,thank you. you're kidding,right? You're kidding,right? Cristina,are you kidding me? I am getting kicked out of my house. You think I pulled this off the board for you? I was asking you to live there with me. -oh,uh,I'm sorry. -Oh,yeah. I'm so--wow. Hilarious. But no,I'm sorry. I-- listen,I--I'm-- I'm walking to the bar. You know what?You are just-- I give me the flyer um I already put a deposit down. I'm sorry. I mean,you should've been more clear. fine. You know what? It's fine. Keep it. That's totally fine. You know,enjoy. That's fine! Thank you. I get that you're a private . Rson but I am not. I process my stuff out loud. And I gave up too much of myself in my marriage. I can'T give up pieces of myself again. And,uh,mark is my friend. I think I just hate him because he's seen you naked. what was the point? All those hours and all that money-- what's the point?The world is a horrible place. Young people die of diseases. It makes absolutely no sense to try to be happy in a world that's such a horrible place. Yes. What? Yes,horrible things do happen. Happiness in the face of all of that-- that's not the goal. Feeling the horrible and knowing that you're not gonna die from those feelings, that's the point. And you're not done. You've made progress because you're feeling and you're telling me about it. Six months ago,it would've been just you and a bottle of tequila. My door is always open. bones break organs burst flesh tears Are you okay? You know,I'm happy for you. I am. I'm really happy for you and derek and that you guys are moving forward. i am I don't know how it happened that I don't have anyone,but I don't have anyone. That's not true,iz. It's not true. Hello. We can sew the flesh,repair the damage ease the pain. I found your mom's vintage martini set. They're my family. You can't just assume I'm gonna kick my family out. And you don't get to announce it to them and ambush me. And you definitely don't get to try to get cristina on your side. They're my family. They're who I have-- you and them. Okay. Okay? I'd like to talk about it again when you're ready. But for now,okay. So you still love me? But when life breaks down meredith when we break down yes. There's no science,no hard and fast rules. We just have to feel our way through, and to a surgeon,there's nothing worse and there's nothing better. You sure about this,sir?You've had a long day. It's one thing to stand on a stage and give a speech. But if I want our teaching program to be the best,and I do, then it starts here,and it starts with me. I can't do anying about the flood, but I can give you your shot,o'malley. You earned it. -You ready? -Yes,sir. okay. Three hours. go.