Stand By Me

"Surgeons aren’t known for being warm and cuddly. They’re arrogant, impatient, mean as often as not. You’d think they wouldn’t have friends 'cuz who could stand them? But surgeons, are like a bad cold. Nasty, but persistent. Surgeons: nasty, aggressive, unstoppable, just the kind of people you want on your side when you’re really screwed. Practicing medicine doesn’t lend itself well to the making of friends. Maybe because life and mortality are in our faces all the time. Maybe because in staring down death everyday, we’re forced to know that life, every minute is borrowed time. And each person, we let ourselves care about is just one more loss somewhere down the line. For this reason, I know some doctors who just don’t bother making friends at all. But the rest of us, we make it our job to move that line. To push each loss as far away as we can."

- Meredith Grey

 is the eighteenth episode of the fifth season and the 96th overall episode of Grey's Anatomy.

Short Summary
The OR board is a mess and the Chief is falling apart without Derek. Bailey tries to help, but inadvertently ends up loosing two doctors to Shepherd. George and Meredith face their first "Intern Drama" while Sloan performs an extremely rare facial transplant and Lexie is being judged by her peers. Following Izzie's confession, Cristina cannot focus and to add to the chaos, she is awarded her first solo surgery. thumb|300px|right

Full Summary
Cristina started the day trying to talk to Izzie about different treatments for her cancer. Alex walked in and Izzie hid the whole cancer thing from him. Then Meredith walked in and Izzie quieted Cristina again. Meredith left and Cristina suggested Izzie call in sick. She didn't.

The chief was concerned with Derek's absence, asking Sloan and Meredith if they'd heard from him. It was distracting him from even keeping the board straight. Bailey told Callie she tried to call Derek 100 times, then she urged Callie to go talk to Derek. She reluctantly agreed.

All the residents were preparing their interns to take part in an extremely complicated surgery. Everyone gathered in the room and stared at the patient, who was missing a nose and lips as a result of being hit by a drunk driver 12 years earlier. Sloan introduced him as David Young, "today he'll be receiving a face transplant."

The doctors were preparing to replace 70 percent of Mr. Young's face. Lexie was correctly answering all the questions. Mr. Young asked if anyone had seen the donor, but then realized that if he ended up looking like anything but a "point and stare freak" he'd be satisfied.

Sloan put Izzie and Lexie on the case -- surprising everyone with the choice. Bailey would be the second resident on the case. Cristina told Izzie she didn't have time to work the case. Some of the interns were upset that Lexie got to be on the case because of her connection to Sloan, and Izzie told them to shut up.

Bailey told the other doctors to work pre- and post-ops, then gave Cristina her first solo surgery -- and old woman's hernia operation. The patient had a ton of questions for Cristina, and was quite chatty, in general. Cristina took a phone call that was about Izzie's appointment with an oncologist, then she stepped outside to talk -- ignoring her own patient.

Callie went to talk to Derek at his trailer in the woods, where he was drinking beer in the morning. She told him about a routine surgery that went wrong and her patient bled internally. She got teary-eyed remembering the look on the man's wife's face when she got the news after going to get him a sandwich. Derek asked how a doctor is supposed to wake up in the morning after that kind of experience. Callie asked him to pass her a beer.

The doctors peeled off the donor's face while talking about how even the donor's family wouldn't recognize the same face on another person because of the underlying facial structure and all the other things that make individuals unique.

Meredith and George were treating a patient while all their interns came in with weird stuff going on: one guy had a cut near his eye, a girl was crying, and another guy was holding a hurt, bloody hand. "They're supposed to be doctors?" the patient asked.

"We're going to reserve judgment on that, for now," George said. It was clear there was a love triangle situation going on and Meredith thought they should ignore it, which would be the professional thing to do.

Izzie was showing Mr. Young how to use a device that will help him breathe when the interns made a joke about his nickname, "Blowhole." Izzie snapped and yelled at them in front of the patient. Sloan got upset with Izzie and took her off the case, telling her to get whatever was going on with her under control.

Cristina was with her hernia patient again and was again too distracted by Izzie's situation to answer her questions.

George told Meredith there was something wrong with Izzie, and Meredith said they should ignore it. Bailey noticed the intern love triangle drama and told them to manage it. The interns were running around the hospital, with one of the guys telling the girl, who was crying, that he loved her.

Bailey told Hunt to go talk Derek into coming back to work. He warned him he might run into Callie, who she said had "fallen off the grid." Hunt said he didn't want to do it, but Bailey gave him a look that made him ask, "People don't really say no to you, do they?"

Mr. Young's friends from his online chat group for orchid lovers showed up before he went into surgery and he panicked, telling them to get out because they were strangers.

At lunch, Cristina was telling Izzie to go to the oncologist appointment she'd set up for her in 15 minutes. Izzie just wanted to eat, then when the rest of the group showed up Izzie claimed Cristina was talking about an appointment for an enema. George asked what "enema" was code for and Izzie got up and left.

At the trailer, Hunt told Derek about a case in which he was treating a family that had been in a car accident. The family seemed fine, but the parents had internal injuries and Hunt lost them both, leaving their 9-year-old son with his two younger siblings.

"I don't know how I came back the next day," Hunt said. "And part of my never did."

Derek said he thought Hunt was going to talk about Iraq, and Hunt said "I don't talk about Iraq." He said the point was that he came back to work. Derek said he was dead inside, because if he actually felt the pain there was no way he was going back. Hunt said nothing and Derek handed him a beer.

Izzie told Cristina she didn't want to be the patient that the interns and other doctors would make fun of the way they making fun of Mr. Young. Izzie told Cristina she didn't even know if she wanted treatment.

"Why did you tell me, then?" Cristina asked. Izzie told her to forget she ever told her, and walked out.

Sloan told Mr. Young he needed his friends, and said he wouldn't be able to go through with the surgery if he didn't have his support system. Mr. Young likened himself to the orchid that represented him in the chat room. It was ugly and droopy, which he said only people who know orchids would understand. He said he didn't want his friends to look away from him. Lexie jumped in and said they didn't look away, he turned away from them. She told him that he gave up on them and said he should give his friends a chance. Izzie saw all this.

Bailey told the chief she was worried she lost Callie and Hunt. She was ready to call the police.

The doctors gathered in the gallery for the face surgery and the intern love triangle sparked again. Meredith and George pulled one of the interns out and forced him to tell them what was going on.

Mr. Young worried that he was awful to his friends, and Izzie told him he was scared and was trying to protect them. "The they're your friends, they'll understand."

They walked into his room and he apologized and told them he didn't want them to see his face. They said his face looked just like one of the orchids. He said that if the surgery didn't work, he'd end up "uglier" than he was already. One of his friends said, "Don't call my friend ugly." She said he was a survivor, and it was written all over his face. Then she kissed him on the cheek. Izzie saw all this and got slightly emotional.

The chief pulled up to Derek's trailer, finding Callie and Hunt there with Derek, and said, "What the hell is this?!" He started telling Derek all the things Callie and Hunt had already told him. Then the chief said, "Everybody dies." Derek told the chief he should feel bad that he sent Meredith out to the woods expecting a ring. The chief said he was trying to help.

Derek told the chief he hit the ring into the woods. Then said, "You destroyed me," and walked into his trailer.

In the face transplant surgery, Sloan had Lexie help him place the new face on Mr. Young. The interns in the gallery giggled and mocked Sloan and Lexie's little romantic face transplant moment.

The chief confronted Derek and told him he wasn't taking Derek's shenanigans anymore. He said that Derek wasn't being himself and had turned on his best friend Sloan and Meredith, and told Derek he'd need a friend when he came out of the hole he'd dug for himself. Derek said he didn't know if he could go back. The chief asked Derek if he'd called Meredith and Derek asked what he could say to her. The chief told Derek he had an affair for years and somehow Adele took him back.

Meredith resolved the intern drama, telling them to pull it together and telling the girl she was pregnant. "That was very Bailey," George told her as they walked out.

Cristina's patient was just about to go under the knife and asked her to tell her she would be OK. She said she knew it was just a silly, simple surgery, but she was afraid to die. "This is not a silly surgery to me, and I will get you through this," Cristina said.

Cristina paused for a moment as she looked at her patients stomach area and looked at the tray of surgical tools. She took a breath, then told Alex and Bailey that Izzie has Stage 4 melanoma and is resisting treatment. "She needs help," Cristina said. Then she asked for the scalpel and cut into her patient.

Mr. Young was out of a successful surgery and his friends wanted to see his new face. Sloan said it was still early and the face needed time to heal, but they snuck a peek and they all smiled.

Outside that night, Cristina told Izzie that she told Alex and Bailey and said she wanted Izzie to fight because "sometimes we win."

"Thank you," Izzie said.

The interns were mumbling to themselves about Lexie before Sloan walked in. No one said anything, then Lexie planted a big kiss on Sloan as the interns all looked on. She said they could survive in a hostile environment.

Meredith went to Derek that night at his trailer. He said he loved her and she said she knew.

"Would you still love me if I wasn't a surgeon?" Derek asked her.

"No," she said. She explained that Izzie has cancer that has spread to her brain, "and you're one of about 20 people in the world who can save her. And I don't know if I could respect somebody who could walk away from a gift like that." She handed him Izzie's scans and said, "It's pretty bad."

In the locker room, Izzie looked up to see the chief, Bailey and Alex looking at her. No one said anything. In silence, Bailey told George something and pointed, and George ran.

Alone now at his trailer, Derek pulled out Izzie's scans and looked at them. Back at the hospital, Izzie was in a hospital gown and her friends were all around her as they laid her into a hospital bed.

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

 * Larry Sullivan as David Young
 * Emily Kuroda as Kendall Sully
 * Brandon Scott as Dr. Ryan Spalding

Co-Starring

 * Candace Brown as Milo
 * Michael Merton as Dexter
 * Greta Sesheta as Shayna
 * Darcy Martin as Sharon
 * Mark Saul as Intern Steve
 * Candice Afia as Intern Laura
 * Amrapali Ambegaokar as Intern Dani
 * Tymberlee Chanel as Intern Claire
 * Molly Kidder as Intern Megan
 * Winston Story as Intern Leo
 * Joseph Williamson as Intern Pierce
 * Martin Yu as Anesthesiologist

Notes and Trivia

 * This episode's title originated from the song ', originally sung by Ben E. King'''.
 * This episode scored 14.67 million viewers.

Quotes

 * Meredith: (to Cristina about Derek) It's the not knowing that does it. Not knowing if he's okay. Not knowing if he's coming back. Maybe I've just been dumped. I mean, It's not knowing if I'm single that makes me wanna throw up all day long. You are not listening to me are you?
 * Cristina: Ah, sorry.
 * Meredith: No, no. That's okay, I get it, you've got solo surgery and G.I. Joe. It's a charmed life. You don't have time for me.
 * Cristina: I have not had G.I. Joe. We've kissed a couple of times. It's like friends with benefits. Without the benefits.
 * Meredith: Still no sex?
 * Cristina: Mmm-mmm. Not a charmed life.
 * Pierce: (walks up with a black eye) Lab results for the splenectomy. (walks off)
 * Meredith: Do we ask?
 * Cristina: No. 'Cause he might tell us.


 * Callie: (to Derek as he was drinking beer) It's a little early in the day for that don't you think?
 * Derek: You sound like my mother.
 * Callie: I met your mother, I liked her.
 * Derek: Who sent you? Richard?
 * Callie: Uh, Bailey.
 * Derek: Of course.
 * Callie: Look, I'm sorry about your patient. I know how hard it can be. I-I had a patient a couple of years ago. Young guy, fifty maybe. Simple knee replacement. He was post-op, he was fine. I even told his wife she could go and get him lunch. It was a simple knee replacement, it as nothing. But he'd been getting short of breath so I put him on blood thinners for a post-surgical P.E. and ... it wasn't until he was vomiting up dark red blood, looking me in the eye, telling me he was dying, that I figured it out. That I was wrong. That it wasn't a P.E., he was bleeding internally. And it wouldn't have been fatal, but ... the blood thinners. ... I will never forget the look on his wife's face when she came back with that sandwich in her hand, asking me why her husband wasn't in his room any more.
 * Derek: How do you live with it? Killing him? Taking him from his wife? How do you live with it?
 * Callie: We call it malpractice when we make a mistake.
 * Derek: Yeah, I know what we call it. I'm asking you, when you get up in the morning, how do you look at yourself in the mirror? I'm no... I'm... I'm asking.
 * Callie: Can I have one of those?
 * Derek: Yeah. (opens a beer and hands it to her)


 * Owen: I was a second year resident, MBC rolls in. Parents were in the front seat. Three kids in the back. Kids were okay, Mom and Dad were a little banged up but nothing terrible. They were talking, laughing in the ER. Turns out both parents had massive internal injuries. I operated on them both that night, hours. I lost them both. Now if I'd moved faster, if I'd rushed them to CT. If I'd known how bad off they were sooner... but I didn't. The eldest kid was 9. When I came out to tell them about their dad, he was trying to console the 3 year old and the 5 year old about their mother. I'll never get that image out of my head. This, this 9 year old boy trying to hold these two little ones. His arms just not big enough. I don't know how I came back the next day. (sighs) I think part of me never did.
 * Derek: I'm surprised you didn't talk about Iraq.
 * Owen: I don't talk about Iraq. What I... what my point was, I kept, you know I... I went back. I showed up. I showed up for work, you know.
 * Derek: You get dead inside. You get dead inside because if you actually felt it? If you let yourself feel that? No way you're going back. No way. (Derek hands him a beer)


 * Derek: Thanks for coming.
 * Meredith: Thanks for calling.
 * Derek: I love you.
 * Meredith: I know.
 * Derek: Would you still love me if i wasn't a surgeon?
 * Meredith: No. (sits beside him) No, because Izzie has cancer that has spread to her brain. You're one of about twenty people in the world who can save her. I don't know if I can respect somebody who can walk away from a gift like that. (long stare at each other) So, please don't. Here are her scans. It's pretty bad. (She places them beside him and walks off.)