In the Midnight Hour

Summary
Izzie questions herself, claiming herself to be crazy, delayed grief, after seeing Denny, until she has sex with him.

Cristina arrives at the hospital for a possible appy, while Owen waits for a trauma. Uncomfortably, Owen asks Cristina why she is at the hospital, and if she is there for him - or at least his trauma case.

Sadie cannot sleep on Meredith's sofa, and wanders into the bathroom, with Meredith sitting on the floor with her mother's journal, and seeing a new side to her mother. Sadie questions whether Lexie would be a good ally for her, but Meredith interjects, Lexie was raised properly with a family, unlike the both of them, but she's interrupted by Cristina paging the sparkle pager - the appy is arriving, and Sadie decides to go with her, to "get some time in the skills lab".

As they pass Izzie's room, they hear moaning from her room. On seeing Alex, Meredith, concerned who is with Izzie, shouts for Derek, who tiredly stumbles outside of their bedroom, Alex believes she's "flying solo". Alex gets Izzie, but Izzie is feeling "ill", Sadie wants to leave and Meredith kisses Derek goodbye, as Derek asks Meredith not to bring any more stray people home.

Bailey arrives through the ER only to be greeted by her residents wanting the appy, while Dr. Hunt takes a man who's fallen through a window, multiple lacerations and head trauma and a nurse asks Dr. Bailey for a resident to have a look at a abdominal pain patient. George claims he's on-call, Cristina and Meredith know the patient's history and Alex claims he's lucky to have Bailey as his surgeon. Naturally, George takes the trauma, Cristina and Meredith prep the appendectomy and Alex is stuck with the abdominal pain. The residents fighting over cases greatly amuses Bailey.

The interns have performed an epidural on Steve, when Sadie walks in, who is disappointed that she was not informed of the epidural, until Steve wets himself. Sadie jokes they could have done a c-section if he was pregnant, until Lexie seriously considers doing an appendectomy - he would just need to stay on the epidural, they can be in and out of an OR in an hour, and Ryan will swap shifts to let him recover. The plan is set - but Steve protests and Sadie volunteers instead.

Back in the ER, Callie and Sloan get on a trauma gown, while Hunt and Shepherd are working on the man who fell through the second story window, until he gets up screaming for his daughter. What makes the screaming odd is when Derek comments he is still asleep. While the attendings attempt to restrain him, he inadvertently elbows Callie in the face, and she falls to the ground.

Mark treats Callie's nose, which is now broken.

Izzie lies in bed with Denny, simply basking in his presence. She later wakes up and finds he's not there and shouts at him. He died, he cannot be here, he should not be here, until she is paged to the hospital.

Alex sees to his abdominal pain patient, and her husband ridicules her for believing it's stomach cancer, "because the internet told her". Lauren admits she ordered antibiotics online to clean up what she believed what a staph infection. She now has C-diff, and her husband is getting more annoyed by the minute. Once Alex reveals a fecal transplant is necessary, Seth demands she admit it was only a pimple and not a staph infection. Alex tries to convince her to just admit it, but she refuses.

Lauren tries to compromise, but Seth is having none of it. Alex reasons with him, telling him at least she's being honest, and Lauren unloads, effectively admitting she's a hypochondriac, and she doesn't see how he doesn't see it. Seth agrees and Alex treats her.

Hunt, Shepherd and George treat Arthur and learn more about his night terrors, medication etc. While he apologises to his daughter for the incident. Mark sees Ivy, and learns she has not slept properly in a long time looking after her father and his night terrors.

Ivy confesses that her father did take his meds and breaks down in front of the doctors, being so tired she fell asleep and was unable to prevent her dad from walking through a window. Derek run some tests, believing it to be more complex than he believes.

Derek and Hunt operate on Arthur, and Derek successfully treats the epilepsy. Mark comforts Ivy, and finds her drinking strong coffee. Mark admits his own childhood, turning on all the lights and TVs trying to get to sleep, to get some human contact. Ivy eventually falls asleep on his shoulder.

Lexie prepares for the surgery, and stumbles upon Mark. She quickly leaves and Derek sees Mark and Lexie leaving the supply closet - Derek gently reminds him what he said.

In surgery, Cristina and Meredith quiz Bailey over the appendectomy procedure, Bailey having to think about the answers as she's too used to doing this procedures she doesn't have to think any more.

Meanwhile the interns prepare to operate on Sadie, now she's numb. They are about to start, but Lexie is hesitant, until Sadie makes the first incision on herself. Continuing the surgery, the interns are excited until they notice the appendix is a little inflamed - this is not a routine procedure. An intern gets worried and leaves.

Post-surgery, Meredith notes her interns are not responding to her pages, until Cristina sees the intern that left binge eating candy. Cristina confiscates the candy and shares it between herself, Meredith and Alex. On discussion, Cristina learns Sadie is here, and that her interns are idiots and goes off to find them.

Meredith is paged, and a worried Lexie turns up behind her, asking her for a moment. Cristina finds Steve, and learns he has an epidural. Both run into out-patient surgery to find Ryan holding a suction over Sadie's unconscious body, he thinks she's dying. Cristina and Meredith take over and order Sadie and Ryan to page the Chief and get Bailey immediately.

Bailey rushes in and talks Cristina and Meredith through the procedure and Sadie makes it through.

The Chief talks to Meredith and Cristina and commends them on their response, surgically and ethically, until Lexie bursts in and accidentally reveals that Cristina knew the interns were doing something. After the Chief chastises Yang, her and Meredith argue that Meredith did not support Cristina.

Bailey prepares to leave, only to be met by her residents yet again, asking for a speech for the interns. Bailey moans at them, telling them she raised them right, her own babies, and they know what to do.

And so, the residents have all their interns present Sadie's case and apologise to her. They are now on probation until further notice, until Pierce comments about Izzie cutting Denny's LVAD. Alex aggresses him as Izzie stands in the hallway, listening the whole time.

Bailey visits Callie, and Bailey remembers what it was like when she was an intern and junior resident, and comments she's getting tired of general surgery, she needs something to make her bounce up and down. Callie reassures her, and both recognise they are tired and they both need somebody.

Meredith visits Sadie, and shouts at her, as her boss and her friend.

Derek and Mark reminisce over their childhood, when Derek took Mark home, so Mark could have some semblance of a family.

Owen sits outside Cristina's apartment block, unsure why he's there and Cristina just sits next to him. He tells her she's beautiful.

Derek takes Lexie home, and Meredith comments he's taken in his stray.

Izzie tries to admit to Alex she's a mess, but Alex says he in this relationship, and as Izzie goes into her room, she looks on at Denny.

Music

 * "Band/Singer" - Song

This episode's title originated from the song In the Midnight Hour, originally sung by Wilson Pickett.

Quotes

 * Derek: Who's making a porno in Izzie's room?

Hospital Staff

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

Guest Starring

 * Kevin McKidd ... Dr. Owen Hunt
 * Melissa George ... Dr. Sadie Harris
 * Brandon Scott ... Dr. Ryan Spalding

Patients and relatives

 * Joshua Malina ... Seth Hammer
 * Leslie Grossman ... Lauren Hammer
 * John Allen Nelson ... Arthur Saltonoff
 * Madeline Carroll ... Ivy Soltanoff

Special Guest Starring

 * Jeffrey Dean Morgan ... Denny Duquette, Jr.