Now or Never

"Doctors spend a lot of time focused on the future, planning it, working toward it. But at some point you start to realize your life is happening now. Not after med school, not after residency, right now. This is it. It’s here. Blink and you’ll miss it. Did you say it? "I love you. I don't ever want to live without you. You changed my life." Did you say it? Make a plan. Set a goal. Work toward it, but every now and then, look around. Drink it in 'cause this is it. It might all be gone tomorrow."

- Meredith Grey

 is the twenty-fourth and final episode of the fifth season and the 102nd overall episode of Grey's Anatomy.

Short Summary
George delivers stunning news to Bailey, sending shockwaves throughout the hospital, and Izzie’s friends anxiously await her recovery from surgery. Meanwhile Bailey is surprisingly displeased after being accepted into the pediatric fellowship program, and the victim of a near-fatal traffic accident brings the talents of Seattle Grace’s doctors together.

Full Summary


Bailey walks into Izzie's room with all the residents sleeping around her bed, inadvertently waking them up. She asks if there's been any change overnight, with Cristina answering that there hasn't. Bailey is paged by the Chief, reminding George that he has a surgery to be in 10 minutes and they both leave, Bailey telling the residents that somebody should make a coffee run. Meredith suggests to Cristina that they should probably leave as well. Alex worries that Izzie won't wake up and begins to take it out on Meredith, demanding to know if Derek has told her anything, or if he was lying, but he's told that all they can do is wait. As Cristina leaves she is surprised to see Owen and George, shaking hands and then hugging, but looks on.

Bailey walks into the Chief's office, who she gives an update to about Izzie and explaining "not to take her face personally" as she also is having a bad day. Arizona runs in and delightedly tells Bailey that she has been accepted into the program, but Bailey looks saddened. Richard tells her that he wasn't before but now, he is on board and is delighted for her, trying to be a bigger man and asking if she can at least meet him half way, but still looking upset, she leaves.

Alex waits by Izzie's bed and is delighted, begging for her to wake up, when she finally wakes up and mutters "I have a headache.", leaving Alex ecstatic and calls for Shepherd.

Cristina approaches Owen on the bridge asking about O'Malley earlier, but he tells her that he slept peacefully for the first night since he came back, because Cristina helped him. Cristina, confused, asks how that's related to George, to which he replies he has great news and he'll let George tell them in his own time. He tells her he is fine now and he wants to get back together with her, he can be a better man, and be a better man with her. He asks her not to say anything yet, just think about it.

George finds Bailey and tells her he has some news and although he knows she won't be happy at first, but he is sure about this decision and he's sure eventually she will be very proud of him, and continues rambling, even going as so far as doing an impression of Bailey. Bailey, not impressed, informs him this isn't quick. He blurts out that he is joining the army to become a trauma surgeon and that he reports for duty tomorrow. Bailey, silent, quickly explodes "You did what!?", exactly how George thought it would be.



At the nurses' station Meredith and Cristina are talking, Cristina still confused about Owen and George. Cristina probes Meredith about her therapy, if she actually is better, or just fake better, but all Meredith says is that she's getting married today, no mess, no fuss, just quick and dirty. A surprised Cristina asks if she wants her to come, but Meredith says it's fine. Cristina gives her a grocery list on a post-it note (something old), a clean post-it (something new), her favorite pen (something borrowed) and tells her all of them are blue so she okay. Cristina notes that for the first time, Meredith is really happy. They debate over whether to hug but decide not to.

Outside the E.R., Callie, Owen, and Meredith meet the paramedics as they unload two patients: one who is completely unrecognizable after being hit and dragged by a bus after saving the other, Amanda. The John Doe, being clamped down, posed difficulty and the paramedics were unable to intubate and so are furiously squeezing the ventilation bag as they wheel him into the E.R, as Amanda looks on asking if he is going to be OK.

In the trauma room, Amanda runs in, explaining she didn't see the bus and he pushed her out of the way, she doesn't even know who he is. Lexie tries to get her out, but after hearing this, she tells her to stand in the corner and don't move as the doctors perform CPR. He stabilizes, and the trauma procedure is initiated. The bandages around his face are removed, revealing a horribly disfigured person underneath, and so they call for Shepherd and Sloan, until Amanda vomits, and so Callie tells Lexie to get her out now.

Derek examines Izzie with Cristina and Alex, and after asking her some questions to make sure her memory is back, he tells her the surgery was successful; he got all the tumor out. A few seconds later she asks if the surgery was successful, at first Derek brushes it off, but as it goes on, they all become more concerned. Outside, Alex is reminded of the woman who couldn't remember her husband and asks if Derek screwed up, but Derek is paged away.

‎

Derek and Mark walk into the trauma room, and Mark assesses the left arm, saying they need to move fast if they want to save it. John Doe crashes again, and Derek notices his pupils are blown, telling them to hold CPR and has Meredith perform a burr hole as Callie, Mark and Owen look on. John Doe stabilizes and regains consciousness, and Meredith welcomes him back.

Mark leaves the John Doe and finds Lexie doing sutures and coldly tells her to redo them. Lexie explains he was talking about moving in, getting married, and she wasn't ready and that she doesn't have the power in the relationship, as Amanda listens. He ignores Lexie and treats the patient who tells him that he is the woman in this relationship, but does tell him he should just buy a house without her.

Bailey walks into the trauma room, confronting Owen about what he got George to do, about joining the army to be a truama surgeon in Iraq, shocking both Meredith and Callie, until John Doe crashes, again. Bailey tells Hunt to undo this, but Owen brushes Bailey away as he tries to resuscitate John Doe, and tells her he didn't expect George to enlist. John Doe stabilizes again, but Callie works out why he keeps crashing: an open book pelvic fracture - if they take him to an OR now, he'll die on the table, so they prepare him for angio to keep him alive.

Arizona approaches Bailey and asks why she isn't happier about coming to peds but at the same time Callie tells her that she has a plan to stop George. Bailey informs Arizona that George joined the army and agrees to Callie's plan, leaving and ignoring Arizona. Arizona asks why they would want to stop him, it's "awesome", angering Callie, as this isn't the George she knows, and since Izzie is not available, it her turn to step up.

In the canteen, Meredith is wolfing down a sandwich waiting to be paged about John Doe, when she asks Alex how Izzie is, until Callie and Bailey appear. Bailey tells the residents that they are scheduling an intervention at 6pm, after George's surgery with the Chief, though intervention may not be appropriate in this case as interventions does not involve "whooping people on the behinds, with belts". Meredith is to "coax him back as a loving friend", Cristina will use "logic and reason to point out the idiocy of his ways", Izzie will "make sad cancer eyes" and if all fails, Alex will use his "raised in the outback with trash cans roots and beat the crap out of him". ‎

‎

Meredith and Owen are in angio with John Doe and he tries to write something using his finger, but Meredith gives him a pen and paper but fails, Meredith tells him he'll get stronger soon and goes outside to talk to Amanda who refuses to leave him because he saved her life, but she was so horrible to him in their 30 seconds of interaction. All he did was smile at her, but she looked through him as he wasn't hot enough.

Arizona catches up with Bailey and demands to know why she isn't more excited, but Bailey tells her it's a big decision. Arizona, clearly annoyed, tells her this isn't - Bailey was her choice, this is the best it gets. Bailey take no time in explaining that her husband said if she went to peds for the extra two years of training, instead of being a general surgery attending and making it home for dinner, he would divorce her. Bailey reminds her again this is a big decision, and walks away, leaving Arizona speechless.

Over John Doe's X-rays, Mark tells Derek he is getting a house and Derek tells Mark he is getting married, they both hug but are interrupted by Owen, who sets out the plan for the surgery.

Arizona approaches Callie but Callie acts overly sarcastic in her presence, furious that she would think George joining the army is awesome, as George is sweet and kind and couldn't hurt a fly. Over surgery, they all talk about if they could jump in front of a bus for a total stranger. Derek points how that's what Major Hunt has been doing for the last few years, but he plays his role down as more of a clean up brigade. They all move onto whether or not George will live or die in Iraq: Callie doesn't think so; Derek believes George will surpised them all; Mark reckons he's coming back in a body bag and Meredith tells them all to shut up.



In her room, Izzie wakes up to see Alex sticking post its all over her room. She asks him why and he points to the post it saying her memory "sucks". He starts quizzing her on what time she woke up and what her potassium level, hoping to help her memory, but Cristina senses Alex is pushing Izzie too hard and talks to him, but Alex makes it all clear, whatever happens to Izzie, it's on him. He promised her she'd be out of the hospital with a life.

Outside John Doe's room, Meredith explains they need to watch him overnight and allows her to sit with him. As Meredith checks on Izzie, she tells Cristina she's going to City Hall to do the "thing". Cristina asks Meredith if it is really the best day to get married but Meredith says that if anything, the day proves that you should say "I love you" while you can. She tells Cristina she loves her and they embrace in a hug, smiling. ‎ Callie sits in the doctor's lounge on her own. Arizona walks in and tells she may not understand George, but to her George is a patriot and it is people like him that keep them safe, like her brother who died in the war, who died because there were not enough doctors. She goes to leave but Callie quietly apologizes by holding her hand.

Owen goes down to the vents and finds Cristina, she tells him he traumatized her and she can't breathe without him. She tells him she loves him and he says all she has to do is say yes to him.

Izzie, still forgetting everything, tells Alex to back off as she needs a break. Failing this, she tells him to get everything off his chest because she won't remember anyway. So Alex begans to shout that he may not be the one with a carrot for a brain, but he is the one married to the carrot. He promised her she would not live like this, and now doesn't know what to do: smother her with a pillow? Shoot her up with a morphine overdose? Leave Her? He's not excited by any of the choices. He apologizes and waits for her to forget.

In the scrub room Bailey asks Richard if she can go back to general surgery and explains the situation with her husband. But then she tells him she is still leaving Tucker because a marriage should not resort to ultimatums. She breaks down and cries as this is the first time she acknowledges this, and they just stand there in each other's presence.

Lexie walks into an office and finds Mark looking at houses to buy and sees that he is trying to make her feel guilty and move on without her. Mark makes it clear: he's moving on, to a better woman than Lexie.

Derek finds Meredith in the locker room and they realize they have no time to get married, as John Doe needs to go back into surgery, Derek wants to check on Izzie and Meredith has the George intervention. Derek asks Meredith for some paper to write vows - a contract, and she hands him a post it, where they write down their vows: to love each other even when they hate each other; no running, ever, no matter what happens; that they'll take care of each other even when they're old, smelly and senile, and if Meredith gets Alzheimer's, Derek will remind her who he is, everyday; this is forever. They sign, kiss and declare themselves married.

In her room, Cristina has to do an EKG on Izzie and Izzie tells Cristina about her fight with Alex and Cristina discovers that Izzie's memory is back as there is no note. Cristina leaves, finds Owen, kisses him and tells him yes.

‎

Callie walks in on Bailey and the Chief and asks where George is but Richard says he gave George the day off to see his mother and he left this morning, disappointing and terrifying Callie and Bailey. Meredith walks in to John Doe's room and Amanda leaves as they take him to surgery. The John Doe tries to write again and traces the numbers "007", Meredith takes some time to work it out, but it then dawns on her who John Doe is.

Cristina pages Alex and tells him he's a dipwad for trying to off his wife, saying she told her. Alex runs to her, he apologizes and he hugs her but suddenly she goes limp and starts to code, Alex shouting for Yang.

Meredith runs through the halls screaming "It's George!" and Callie, Owen and Derek rush him to surgery.

Cristina has Shepherd, Bailey, and the Chief paged immediately.

Owen rushes George into surgery telling him he's going to be OK. Derek and Meredith scrub in and get George ready for surgery telling him he's not going anywhere, until his blood pressure drops and they move quickly to begin.

The Chief and Bailey run into Izzie's room, to find the hyperkalemia is causing the heart arrhythmias and her blood pressure is dropped rapidly. Alex sets up for an intubation, but Cristina reminds him of the DNR, Alex ignores her, but Cristina tells him she knew this could happen. This is not what she wants. Izzie flatlines and Alex calls for a crash cart and starts CPR. Alex continues to give her compression and the Chief finally says "Screw the DNR!". He, Bailey and Cristina take over while Alex stands back crying, while in the OR, George's pressure drops and they begin losing him.



''Izzie steps into the elevator in her prom dress. The doors open and she sees George in his army uniform. They smile.'' Back in reality, Richard charges the paddles attempting to revive Izzie while the others try to save George.

Main Cast

 * Ellen Pompeo as Dr. Meredith Grey
 * Sandra Oh as Dr. Cristina Yang
 * Katherine Heigl as Dr. Izzie Stevens
 * Justin Chambers as Dr. Alex Karev
 * T.R. Knight as Dr. George O'Malley
 * Chandra Wilson as Dr. Miranda Bailey
 * James Pickens, Jr. as Dr. Richard Webber
 * Sara Ramírez as Dr. Callie Torres
 * Eric Dane as Dr. Mark Sloan
 * Chyler Leigh as Dr. Lexie Grey
 * Kevin McKidd as Dr. Owen Hunt
 * Patrick Dempsey as Dr. Derek Shepherd

Guest Stars

 * Jessica Capshaw as Dr. Arizona Robbins
 * Shannon Lucio as Amanda

Co-Starring

 * John Cappon as Paramedic #1
 * Brooke Blanchard as Paramedic #2

Izzie Stevens

 * Diagnosis:
 * Stage IV metastatic melanoma
 * Hyperkalemia


 * Doctors:
 * Richard Webber (general surgeon)
 * Derek Shepherd (neurosurgeon)
 * Miranda Bailey (surgical resident)
 * Cristina Yang (surgical resident)


 * Treatment:

Izzie had not woken up after her surgery. She eventually woke up, but her memory reset every 30 seconds. By the end of the day, she was able to retain things, but the hyperkalemia caused her to code. Despite the DNR she had signed, they they started resuscitating her.

Webber's Patient

 * Diagnosis:


 * Doctors:
 * Richard Webber (general surgeon)


 * Treatment:
 * Surgery

Richard operated on a patient. George was supposed to scrub in, but when Richard found out that George had joined the Army, he sent him home.

John Doe

 * Diagnosis:
 * Avulsion injury to left forearm
 * Fractured skull
 * Open-book pelvic fracture
 * Epidural bleed
 * Crush injuries
 * Re-bleed


 * Doctors:
 * Mark Sloan (plastic surgeon)
 * Derek Shepherd (neurosurgeon)
 * Owen Hunt (trauma surgeon)
 * Callie Torres (orthopedic surgery resident)
 * Meredith Grey (surgical resident)
 * Lexie Grey (surgical intern)


 * Treatment:
 * Burr holes
 * Antibiotics
 * Bacitracin
 * Angiography
 * Surgery
 * Internal fixator

An unidentified male was brought into the ER after being dragged by a bus. He had an avulsion injury to his left forearm and his skull was bashed in. Derek drilled burr holes to relieve the pressure on his brain. After that, he was conscious. He also had an open-book pelvic fracture which caused him to keep coding. He was taken to angiography to stop the pelvic arterial bleeding. From there, they planned to take him to surgery. In surgery, the plan was for Derek to evacuate the epidural bleed while Owen and Meredith worked on his internal injuries. Then Callie would place an internal fixator on his pelvis. Then Mark could work on his arm. After his surgery, he was taken to ICU. In the ICU, he had a re-bleed, so they had to take him back into surgery. Before they were able to take him back into surgery, he wrote "007" on Meredith's palm, telling her that John Doe was George. They rushed him into surgery, where he started to code.

Amanda

 * Diagnosis:
 * Arm injury
 * Arm laceration


 * Doctors:
 * Mark Sloan (plastic surgeon)
 * Lexie Grey (surgical intern)


 * Treatment:
 * Stitches

Amanda was injured when she was pushed out of the path of a bus. She had a laceration on her arm, which Lexie stitched up, but Mark said she'd have too much tension and told her to redo the stitches. He ended up doing them himself.

Notes and Trivia

 * This episode's title originated from the song , originally sung by Three Days Grace.
 * This episode scored 17.12 million viewers.
 * The actor that played John Doe was T.R. Knight.
 * According to Shonda Rhimes, George O'Malley's low amount of screen time for most of this season leads up to this episode, where the audience would not notice that George had disappeared for the duration of the episode. This is contradictive with the fact that George was written out of the show because T.R. Knight asked to leave due to his low amount of screen time.
 * Although aired with Here's to Future Days, Shonda Rhimes has commented that this episode was not meant to be a two part finale.
 * According to Michael Aussiello, the final scene was originally shot with Denny meeting Izzie in the elevator, however, Shonda Rhimes changed the scene at the last minute. T.R. Knight had shaved his head, assuming that production had finished, and so it was decided to put George in a military uniform.
 * In the final scene, George is seen in an Army uniform of an Army Medic. As a doctor, he would be wearing an Officer's uniform and not that of an enlisted man. However, this error could easily be explained because the final scene took place in Izzie's dying dream.
 * When Mark is talking to Lexie about different houses that are hung on the x-ray viewer, there is a sheet of paper above the viewer. It reads: "Test. 1. Name a rap artist. 2. Name an artist in your kids" The sentence is unfinished. This prop is used to decorate the walls of the room in much the same way various posters do. It was probably written in reference to an ad series that challenged parents to "Name five rap artists. Name five of your child's teachers."

Quotes

 * Meredith: It's George, it's George. John Doe is George!


 * Richard: Screw the DNR!


 * Owen: Oh, I'm sorry, I didn't... I didn't know you were here.
 * Cristina: No. Wait, wait. ... I... love... you.
 * Owen: Well. I... I love you too
 * Cristina: No... Just... I love... you. I said... I said I love you! Me. Cristina Yang. What-- You traumatized me.
 * Owen: You know that I am... I'm so sorry about that.
 * Cristina: Damn it. No, not about the choking. It's like you come here, and you pull out my icicle, and you make me love you, and I can't... I don't want to. I can't breathe... without you.
 * Owen: You can do this Cristina. We can do this. All you have to do is just meet me half way. All you have to do is say yes. All you have to do is say yes.


 * Derek: Meredith...
 * Meredith: No, you know let's go, we gotta go. We gotta run to city hall, we'll come back, you'll check on Izzie, we'll monitor John Doe, I'll go talk George out of joining the army!
 * Derek: Look, we'll do this another day-
 * Meredith: There is no other day! Everyday is like this, everyday there is a crisis, there's no time.
 * Derek: Meredith...
 * Meredith: I love you and I do want to marry you, today. But there is no time.
 * Derek: (cups her face with his hands) Do you have a piece of paper?
 * Meredith: For what?
 * Derek: I want to be with you forever. And you want to be with me forever. In order to do that, we need to make vows. A commitment. A contract. Give me, a piece of paper.
 * Meredith: I don't! I-I-I don't...I have post-its. (Hands him posts-its and a pen. Derek goes and sits on the bench.)
 * Derek: Okay...what do we want to promise each other?
 * Meredith: That you'll love me, even when you hate me.
 * Derek: To love each other...even when we hate each other. (writes it down on the post-its) No running. Ever. Nobody walks out. (Meredith joins him on the benches.) No matter what happens.
 * Meredith: No running.
 * Derek: What else?
 * Meredith: That we'll take care of each other even when we're old and smelly and senile. And...if i get Alzheimer's and i forget you...
 * Derek: I will you remind you who i am, every day. (They smile at each other.) To take care when old, senile, smelly. This...is..forever. (Derek finishes writing on the post-it, then gives it and the pen to Meredith.) Sign.
 * Meredith: This is our wedding? A post-it?
 * Derek: Mhmm. Well, if you sign it. (Meredith signs it happily and then hands it back to Derek.)
 * Meredith: Now what?
 * Derek: Now, I kiss the bride. (He kisses her tenderly. Meredith's smiling as they kiss. Then Derek slowly pulls back.)
 * Meredith: Married.
 * Derek: Married. (Derek puts the post-it note with their vows and signatures on the back of her cubby, then turns to her.) You see that? Plenty of time.