Let the Truth Sting

"Doctors give patients a number of things. We give them medicine, we give them advice, and most of the time, we give them our undivided attention. But, by far, the hardest thing you can give a patient is the truth. The truth is hard. The truth is awkward, and very often, the truth hurts. I mean, people say they want the truth, but do they really? The truth is painful. Deep down nobody wants to hear it, especially when it hits close to home. Sometimes we tell the truth because the truth is all we have to give. Sometimes we tell the truth because we need to say it out loud to really hear it for ourselves. And sometimes we tell the truth because we just can't help ourselves. And sometimes, we tell them, because we owe them at least that much."

- Meredith Grey

Let the Truth Sting is the third episode of the fourth season and the 64th overall episode of Grey's Anatomy.

Short Summary
Callie hides in her office, frustrating Bailey who's itching to teach someone. Elsewhere, age becomes the theme as Izzie tries to convince 'Really Old Guy' he shouldn't die, Webber and Sloan set out to prove they're not too old to learn a new technique, and Karev is saddled with an intern who's past his prime.

Full Summary
The truth. It stings sometimes. We all know this to be true, and all of our favorite doctors are about to find this out in one way or another. Cue the elevator. Lexie is giving Alex eyes as a group of interns enter and gush about how an intern totally saved a guy yesterday and how he never makes a mistake during rounds. He’s the best intern ever! It's George! Lexie convinces Alex not to blow his cover.

On a different elevator, Meredith and Derek chat awkwardly. Cristina picks up on the fact that Meredith is doing McDreamy and dodging her because of the Burke situation. She decides to use this to her advantage and finagle - what else - surgeries out of Mer's sympathy.

There’s a new doctor in Seattle, and while he's got to be old enough to be our interns' grandfather, Norman is Alex's intern. This leads to some funny exchanges. They meet a patient whose mom thinks her son is on drugs because he’s lethargic, cranky and his grades have been slipping. Norman, having worked in a pharmacy for 30 years, assumes she's right.

However, the teenager’s toxicology results come back negative. Norman is shocked. That's when the kid - who insists he's clean - gets annoyed and tells is mom that she has apple hair and he threw the pancake into the river. Alex asks what he was trying to say just then and he says he wanted to go home. Alex orders a CT scan.

The chief treats a woman who has tongue cancer. She’s very talkative. Mark has to remove 60 percent of her tongue and replace it with grafts, which may make it hard for her to talk again. The Chief wants to try a procedure that would allow her to have full use of her tongue. The only problem? It has never been done before.

The lady is freaking out about the prospect of not being able to talk. She says she has so much to say. George tells her to just say it if she's got something on her mind. The woman does, and she ends up hurting her friends' feelings with some personal criticisms. Sometimes the truth stings.

The tongue surgery hits a snag and The Chief and Sloan admit they got in over their heads. They page Derek because he’s good with nerves. Derek comes in and takes over, and eventually saves the day. Unfortunately, that’s when teenager Alex is treating decides to collapse.

His pupil is blown and spinal fluid is backing up and putting pressure on his brain. Derek, while assisting Mark and the Chief, tells Alex what he must do in the next 10 minutes or the kid will die - get a tongue depressor and stick it under the kid’s eyelid, the take a gigantic needle and drain the spinal fluid from behind the eye. On his own, saves the day!

Since Meredith gave Cristina a cool surgery to make her "feel better," she is stuck with Lexie as her intern. A trauma comes in where there has been a car accident and a patient has been down for 24 minutes. Meredith lets Lexie do her first intubation and the guy cannot be revived. Lexie freaks and calls Meredith a bad doctor, essentially. Sick of her hysterics, Mer banishes Lex to the clinic.

Bailey then takes over and tells Lexie that the clinic isn’t a place for stray interns, and to go give a kid stitches. Later, Meredith gives Lexie her mother’s death note to share with her. She wants to go over it so Lex can have closure, and understand that it wasn't Meredith's fault, that it was a 1:100 chance what happened to Lexie's mom. They share a nice moment as Mer tells Lexie that she was very fond of her mother.

Callie has been hiding out doing paperwork because she can't handle the job. Bailey has been running the show. But Miranda has a heart to heart with her and tells her that she has been having trouble not being #1, so she's going to get over it and be her #2 - the best #2 ever. Together, Bailey says, they can do this and do it well. Callie smiles.

Meanwhile, Izzie is stunned when Really Old Guy wakes up and announces his name is Charlie Yost ... and that he only woke up so he could die. That's hard, though. He starts tearing cords out of the wall and unhooking the mechanisms that are keeping him alive. He stops breathing, but Izzie is able to revive him... much to his chagrin.

In between trying to end the suffering, he gives Izzie some advice. Charlie says if somebody really wants to do something, then they do it — he’ll die if he wants to, in other words, while George isn’t leaving Callie (he knew about the love triangle while semi-conscious in his coma, of course).

After talking with ROG, Izzie finds George and confronts him. He says it's not about him and her, that it’s about him and Callie. He’s about to break up a marriage to a great woman and she needs to get off his back and let him do it. It’s not exactly something you just blurt out.

Later, Really Old Guy is checking out of Seattle Grace. He's all dressed up and ready to go in his wheelchair. That's when he dies peacefully. Izzie brings everybody in so they can have a mini-memorial for him. After the surgeons each say some nice words, Izzie talks about how Charlie was a bastard, but a bastard who knew what he wanted, didn’t stop until he got it. Hint, hint, George.

After a moment in which Alex inexplicably blows George's repeater status in the elevator, George returns to the hotel and finds Callie on the bed with her bags packed. She tells him to just say it. Her face says she already knows the truth and that it most certainly stings. As the screen fades to black, George looks at her and says,

“I slept with Izzie.”

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
 * Patrick Dempsey as Dr. Derek Shepherd

Guest Starring

 * Edward Herrmann as Dr. Norman Shales
 * Caroline Aaron as Connie
 * Eve Gordon as Mary Chapman
 * Amy Hill as Joanne
 * Debra Christofferson as Elaine
 * Jack Axelrod as Really Old Guy

Co-Starring

 * Martin Spanjers as Hunter Chapman
 * Moe Irvin as Nurse Tyler
 * Ray Ford as Ray the Paramedic
 * Linda Eve Miller as E.R. Nurse
 * Candice Afia as Intern Laura
 * Amrapali Ambegaokar as Intern Dani
 * Tymberlee Chanel as Intern Claire
 * Gloria Garayua as Intern Graziella
 * Richard Keith as Intern Mitch
 * Molly Kidder as Intern Megan
 * Joy Osmanski as Intern Lucy
 * Mark Saul as Intern Steve
 * Joseph Williamson as Intern Pierce
 * Winston Story as Intern Leo
 * Alison Crowley as Clinic Nurse
 * Peter Smith as Code Nurse

Notes and Trivia

 * This episode's title originated from the song , originally sung by David Gray.
 * This episode scored 19.04 million viewers.

Quotes

 * Cristina: I´m stuck in the pit with these know-nothing interns. You'd think eventually I could catch a break.
 * Meredith: Cristina, are we ever gonna talk about this? The Burke thing?
 * Cristina: I´m not Izzie. I´m not gonna lay at the bathroom floor all day. I´m gonna lay here...on the counter.
 * Meredith: I'll trade you the hemiglossectomy.
 * Cristina: What?
 * Meredith: You take the hemiglossectomy and I will take the ER and your interns.
 * Cristina: Are you sure?
 * Meredith: Take the surgery. Makes you feel better and you start to freak me out. [Meredith leaves]
 * Alex: I saw the whole thing, Yang. You can stop pretending.
 * Cristina: Oh I´m not pretending. I´m sad. I´m very sad. [makes a childish voice] Me so sad.
 * Alex: Maybe I should try it.
 * Cristina: Hey forget it. Sad is mine. Go find your own pretend emotion.