A Hard Day's Night

"The game. They say a person either has what it takes to play, or they don't. My mother was one of the greats. Me on the other hand... I'm kinda screwed. Like I said I'm screwed. I can't think of any one reason why I want to be a surgeon. But I can think of a thousand reasons why I should quit. They make it hard on purpose. There are lives in our hands. There comes a moment when it's more than just a game. And you either take that step forward or turn around and walk away. I could quit, but here's the thing... I love the playing field."

- Meredith Grey

A Hard Day's Night is the first episode of the first season and the 1st overall episode of Grey's Anatomy.

Short Summary
Meredith Grey, Izzie Stevens, George O'Malley, Cristina Yang, and Alex Karev become interns at Seattle Grace Hospital. Meredith discovers that her one night stand was actually with one of her bosses and she and her new friends discover that being a surgeon isn't as easy or fun as they thought it would be.

Full Summary
A woman wakes up from her couch, wraps a towel around her and begins to pick up her clothes. She throws a cushion on a man, who wakes up sleepily and passes her bra to her. The woman is embarrassed, and tells him to get dressed. They make small talk while he gets dressed. Apparently, she is going to be late on her first day of her new job. He compliments her on her house, but she says it isn't hers. It was her mother's and she is selling it. He tells her he is sorry and she quickly explains her mother is not dead. She then says they don't have to do the thing where they pretend to care. She goes to see him off but forgets his name. He quickly re-introduces himself as Derek and she re-introduces herself as Meredith. She then runs upstairs to shower.



A short while later, Meredith leaves her car and catches up with the other group of new interns at Seattle Grace Hospital. The Chief concludes his tour by saying that the next seven years will be the best and worst of their lives.

In the locker room, Meredith bonds with another intern, Cristina Yang. They discover that they have the same resident, Bailey or "The Nazi". Overhearing the conversation, another introduces himself as George O'Malley. He talks nervously and tells Meredith that they met last night. He describes what she was wearing but quickly stops when he realizes they think he is gay. The three interns (along with another intern, an ex-model, Isobel Stevens) are called out to go to Bailey. Walking up to Bailey, they are shocked to see she is a woman (and not a nazi either). Isobel suggests that the nickname may be professional jealousy. Cristina scoffs but nevertheless, Isobel introduces herself to Bailey, telling her that she is Isobel Stevens but that everyone calls her Izzie. Bailey ignores the introduction, shows them their equipment, gives them a short tour and tells them her rules. She then receives a page and she and the interns run onto the roof. On the roof, a chopper lands and gives details on the patient (Katie Bryce) who is having seizures. In the hospital, the interns and nurses inject Katie who finally stops moving. Another doctor, Preston Burke, walks in and describes her as a wet fish on dry land. He then orders them to do all the basic tests. George is work ups, Cristina is to do labs, Meredith is assigned to Katie Bryce and to get her a CT. Izzie is ordered to perform rectal exams by a smiling Bailey.



Izzie performs the rectal examinations, Cristina gets the test results (still managing to hint to Bailey she would like a surgery), George tries to perform a simple procedure on a patient. Getting tiresome, Burke pushes him out of the way and does it himself. George then jokingly says that Burke himself probably messed up a lot at first too. Through gritted teeth, Burke smiles and tells George hes going to have fun with him, George gulps. Meanwhile Meredith is lost in the hospital with Katie continuously talking about the beauty pageant she's missing and how she was great at it other than when she fell over doing rhythmic gymnastics and occasionally stopping to tell Meredith that she is lost.



A group of interns are sitting in the canteen (after 7 hours of their first shift) when Izzie says that she is screwed because a resident already hates her but George sympathizes by saying he already has attendings hating him. Cristina then interrupts to ask if anyone else knew that Meredith's mother is the famous surgeon Ellis Grey, who performed wonderful surgeries, wrote books and even won the Harper Avery Award twice. The conversation is quickly cut short by Meredith who tells everyone that Katie is unbearable. Preston Burke then arrives at the table to say he gets to choose one intern to assist him in a surgery. He picks George to scrub in on an appendectomy and then walks away.

Miranda Bailey complains to Burke about his decision saying that O'Malley barely made it into the program. He insists that if he terrorizes one that the rest will fall in place but Bailey continues to attempt to persuade him. Katie Bryce's parents walk into her room. After making sure Katie feels okay they question Meredith about if she may need surgery. Meredith quickly explains that she isn't the doctor. She goes to Bailey to find Burke but he is off the case so she directs Meredith to the new attending on the case, Dr. Shepherd. Meredith looks over at him just as he looks up, Meredith quickly walks away as Dr. Shepherd is her one-night stand, Derek.

Derek catches up with her and pulls her into a stairwell. Meredith quickly decides to pretend it never happened, Derek instead says that she just took advantage of him. She starts to disagree but he quickly asks her if she wants to take advantage of him the next Friday. Meredith smiles and says it is inappropriate and walks away.

George is in the operating room and up in the gallery the other interns start making bets against him but Meredith quickly defends him. George starts the procedure and it runs perfectly until the very end where he accidentally pulls the purse strings too hard and breaks them. She starts to bleed but can't think what to do. After a few seconds, Burke pushes him away and finishes up the procedure. In the gallery the interns nickname George, 007 (license to kill).



After the procedure, George worries about being nicknamed 007. He is being consoled when Meredith is paged and leaves as she got a 911 for Katie Bryce. George says he should have gone into geriatrics but Cristina says geriatrics is for losers who never have sex and live with their mothers. George then quietly mutters to Izzie that he really needs to get a new place. Meredith runs through the hospital to see that Katie is fine and that she faked a seizure and wants Meredith to call someone. Annoyed, Meredith leaves.

Nurse Tyler asks a staring Izzie what she needs and she replies by saying that Mr. Jones has junky veins and he needs antibiotics. She should start a central line, but doesn't know how. Tyler smiles and tell her since the sleeping Miranda Bailey is the on call resident then Izzie has to wake her up. Timidly, Izzie walks over, Bailey asks if the patient is dying and when Izzie says no, she goes back to sleep. After a few seconds, she gets up grumpily and starts the central line. She then tells Izzie that the next time she is woken up the patient better be so close to death that he has a tag on his toe.



Another intern, Alex Karev, is staring at a patients chart he tell the nurse they have pneumonia and to start the antibiotics. The nurse asks if hes sure and he sarcastically asks if she went through 4 years of medical school. He walks over to Meredith and says he has Jeremy as his as his resident but Meredith just says that the patient may not have pneumonia, it may be splinting. Alex then calls her a nurse, Merdith gets insulted but has to answer her page, another 911 from Katie. Alex wonders to another intern if shes single and George says they're friends. Alex quickly cuts across and tells George just to stop talking.

Meredith runs into Katie's room where she is shocked to see Katie having severe multiple seizures. The drugs administrated didn't do anything so she tell a nurse to page Bailey and Shepherd. When the drugs still have no effect, she charges the paddles. On the fourth try, Katie's heartbeat and blood flow are normal. Shepherd then arrives and tells Meredith to leave. Bailey then walks by and lectures Meredith but Meredith ignores her and continues to walk briskly out the hospital doors. Worriedly, Cristina follows and is shocked to see Meredith throw up against a tree. Meredith walks back into the hospital and tells Cristina not to tell anyone.

Back in the hospital (hour 24), Shepherd explains to Katie's parents that it may not be a seizure disorder. Her parents tell Shepherd they want somebody else on the case because he isn't working hard enough.



In another area of the hospital, Burke explains to a patient the procedure. He will put him on bypass, fix his heart and then hes done. Gloria (Tony's wife) asks if she has to worry but Burke assures her that he is very good at what he does although it is surgery and does involve risks. He walks off but Gloria is still worried so George then consoles her and promises her that it will be okay and Tony will sail through the surgery.

While waiting impatiently for Dr. Shepherd, Cristina sutures a banana. She then calls George 007 when he laughs, but she quickly apologizes saying she gets mean when she's tired. Shepherd then walks in and explains that Katie is having seizures with no visible cause; she is a ticking clock. The intern who finds out the cause will get to scrub in on the advanced surgery. All the interns take copies of the chart.

Alex Karev walks up and asks the nurse if she paged him, she says yes and that the patient in 4B still isn't responding to antibiotics and they should have worked by now, he ignores it, saying she is old and asks the nurse not to page him again. Meredith walks away and Cristina runs up to her asking if she wants to work together so they can each get a 50% chance of getting in on the surgery. Mereedith accepts her proposal but says she doesn't want the surgery because she doesn't want to spend anymore time with Derek than possible.

In the hospital library, they try to figure out what is wrong, all the while Cristina asks why she won't spend time with Derek. Meredith eventually admits that they had sex. They move back to the discussion about Katie when Meredith realizes something. She tells Cristina to get up and they go off to find Derek Shepherd. They confront Derek telling him, although they have no proof, she may have an aneurism. As she fell but the fall was so minor her doctor didn't mention it. Derek goes to check it out and is shocked to discover that they were right, Katie was one in a million and is bleeding into her brain. He says Katie could have gone through her entire life without it being a problem and he conragulates the girls. He then picks Meredith to join him in the O.R. As soon as he leaves, Cristina glares at Meredith and storms away.

Meanwhile, Burke is operating on Tony Savitch and after a while, he leaves and goes out to George. George is shocked that Burke was so fast but Burke says the heart had too much damage and Tony died. George is shocked and upset. He tell Burke he had promised Gloria that Tony would be okay. Burke is outraged saying that the only person who can keep a promise like that is God, he also tell George that he can be the one to tell Gloria.



Izzie and Cristina are sitting down in private and Izzie tries to convince Cristina that maybe it wasn't Meredith's fault but Cristina stops her. Meredith appears and tries to apologize but Cristina says that Meredith can't come to her for absolution and at least she didn't get into med school bcause opf her mother or good surgeries because she slept with her boss. Meredith then storms off.

George is in the waiting area and tries to tell Gloria that Tony died. He tries to apologize but she just asks him to leave and collapses into a chair.

Derek is shaving Katie's head but Meredith says she doesn't want to scrub in but Derek insists that she does, that his decision wasn't because they had sex but because Meredith was Katie's doctor and on her first day at work she helped save her life.

Meredith and George are sitting on a window ledge outside wishing they had chosen different careers. George then says that his parents tell everyone that he is a surgeon as if its a big accomplishment. Meredith then says that when she told her mother that she wanted to go to medical school, she tried to talk her out of it because she didn't think Meredith had what it took so George shouldn't feel so bad.

The chief asks Alex a few questions and when Alex doesn't reply, he asks the room does anybody know the common causes of post-op fever. When nobody answers, Meredith does. The Chief asks her what she thinks is wrong with the patient and Meredith correctly assumes, walking saying patient 4B is a prime candidate for a pulmonary embolism. The chief asks her how she would diagnose and she does so correctly, again. The Chief then tells Alex to do what Meredith said and then he is off the case. Walking away, the chief tells Meredith that he would know her anywhere and that she looks exactly like her mother.



Meredith walks to the O.R where Katie is being prepped. She observes admiringly and when Derek tells her to take a look, she does so and stares amazed. She then realizes it is more that a game and they make it hard on purpose. They have lives in their hands.

Outside the O.R. when the surgery is finished, Cristina compliments her and after a few minutes, the girls make up. Almost as soon as Cristina walks away, Derek appears and Meredith tells him the surgery was amazing and such a high, much more than she expected. The two share a moment and Derek leaves saying that he will see her around.

Meredith later leaves the hospital with Cristina, Izzie, and George and even later, she goes up the steps of a house through the rain. She tells a woman that she won't be selling her house anymore that she will get some roommates and that her fellow interns are really great. The woman asks Meredith is she her doctor but Meredith says no, but she is a doctor. The woman asks Meredith her name and Meredith reminds her. The woman then proceeds to tell Meredith that she thinks she was a doctor and Meredith smiles and tells her she was. The woman is Ellis Grey and she has Alzheimer's.

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
 * Isaiah Washington as Dr. Preston Burke
 * Patrick Dempsey as Dr. Derek Shepherd

Guest Stars

 * Skyler Shaye as Katie Bryce
 * Randall Arney as Mr. Bryce
 * Kate Burton as Ellis Grey

Co-Starring

 * Robbie Troy as Mrs. Bryce
 * Moe Irvin as Tyler Christian
 * Lynn Marie Stewart as Nurse
 * Laura Carson as Gloria Savitch
 * Sean Palmer as Intern #3
 * Sendhil Ramamurthy as Intern #2
 * Richard Gilbert-Hill as Small Town Doc
 * Grinnell Morris as Intern #4
 * David Vegh as Tony Savitch
 * Kathleen M. Darcy as Anesthesiologist
 * Brad Pennington as Radiologist

Featuring

 * Noelle McCutchen as Nurse #2
 * Josh Bywater as Intern #1
 * Gregory Erff as Mr. Jones
 * Billy Wood as Senior Resident

Uncredited

 * Martin Ighani as Rectal Exam Patient
 * Joel Schmidt as Gloria's Brother

Katie Bryce

 * Diagnosis:
 * Aneurysm
 * Subarachnoid hemorrhage


 * Doctors:
 * Meredith Grey (surgical intern)
 * Derek Shepherd (neurosurgeon)
 * Cristina Yang (surgical intern)


 * Treatment:
 * Diazepam
 * Lorazepam
 * Phenobarbital
 * Aneurysm clip

Katie Bryce, 15, was airlifted to Seattle Grace Hospital after having a grand mal seizure. Unable to discern the cause and unable to stop the seizures, Derek enlisted the help of the new interns, who were on their first shift, promising that whoever found the answer could scrub in. Cristina and Meredith joined forces to search for the answer. Meredith remembered that Katie did rhythmic gymnastics and had fallen and hit her head. It was a minor fall, but it caused an aneurysm to burst. Derek successfully repaired the bleed, stopping Katie's seizures.

Tony Savitch

 * Diagnosis:


 * Doctors:
 * Preston Burke (cardiothoracic surgeon)
 * George O'Malley (surgical intern)


 * Treatment:
 * Coronary artery bypass surgery

Tony Savitch was in the hospital to have bypass surgery. George promised him and his wife that he would be okay. However, in surgery, there were complications. He wasn't able to be taken off bypass and he died.

Multiple Patients

 * Diagnosis:


 * Doctors:
 * Izzie Stevens (surgical intern)


 * Treatment:

Izzie did rectal exams on several patients.

Unnamed Patient

 * Diagnosis:
 * Appendicitis


 * Doctors:
 * Preston Burke (cardiothoracic surgeon)
 * George O'Malley (surgical intern)


 * Treatment:
 * Appendectomy

George was selected to perform an appendectomy during his first shift. He made a mistake while operating and Burke had to take over and complete the surgery.

Mr. Jones

 * Diagnosis:


 * Doctors:
 * Miranda Bailey (surgical resident)
 * Izzie Stevens (surgical intern)


 * Treatment:
 * Central Line
 * Antibiotics

Izzie Stevens had to get Miranda Bailey's assistance to start a central line to give antibiotics to Mr. Jones, as he had junky veins.

Alex's Patient

 * Diagnosis:
 * Pulmonary Embolus


 * Doctors:
 * Alex Karev (surgical intern)
 * Meredith Grey (surgical intern)
 * Richard Webber (general surgeon)


 * Treatment:
 * Heparin
 * IVC Filter

Alex incorrect diagnosed a patient with a fever with post-op pneumonia. He ordered antibiotics. When the nurse informed him that the patient wasn't getting better, he dismissed her, telling her to give the antibiotics time to work as the patient is older. When Richard questioned him about it, he was unable to come up with another possibility. Meredith spoke up with the diagnosis of pulmonary embolus and how she would treat it.

Ellis Grey

 * Diagnosis:
 * Alzheimer's Disease


 * Doctors:


 * Treatment:
 * Long-term care

Meredith's mother, Ellis Grey, is in a long-term care facility as she has advanced Alzheimer's Disease.

Notes and Trivia

 * This episode's title originated from the song A Hard Day's Night, originally sung by The Beatles.
 * The part of the episode where Meredith urges Derek to leave the house after their one night stand almost didn't happen, as the ABC executives at the time found that nobody would care about a woman who has casual sex like that.
 * In order to convince them to allow the scene, Betsy Beers revealed that she had sex with a man the night before a new job.
 * This episode scored 16.25 million viewers.
 * Out of all 20 surgical interns, only 6 were women.
 * The interns have 48 hour shifts.
 * Interns work every second day.
 * Justin Chambers (Alex Karev) was not originally in the pilot. Scenes in which he appears were digitally altered or re-filmed.
 * Chief Webber's speech to the incoming interns states that their residency will be for seven years despite their residency finishing at the end of their fifth year. He may have included their possible fellowship, which (for most specialties) means another two years of training, or possible research years. His speech was then amended to five years in Time Stops.
 * The scene on the helipad was filmed on the KOMO building, located in Seattle in the direct vicinity of the Space Needle. For pictures behind the scenes, go here.
 * This episode was submitted for Peter Horton to be nominated for 'Outstanding Directing for a Drama Series' at the 57th Primetime Emmy Awards.

Quotes

 * Cristina: Katie competes in beauty pageants.
 * Derek: I know that, but we have to save her life anyway.


 * Bailey: I have five rules. Memorize them. Rule number one, don't bother sucking up. I already hate you. That's not gonna change. Trauma protocol, phone lists, pagers. Nurses will page you, you answer every page at a run. A run, that's rule number two. Your first shift starts now and lasts forty-eight hours. You're interns, grunts, nobodies, bottom of the surgical food chain, you run labs, write orders, work every second night till you drop and don't complain! On call rooms. Attendings hog them, sleep when you can, where you can, which brings me to rule number three, if I'm sleeping, don't wake me, unless your patient is actually dying. Rule number four, the dying patient better not be dead when I get there. Not only would you have killed someone, you would have also woke me for no good reason, we clear?
 * (Meredith raises a hand.)
 * Bailey: Yes.
 * Meredith: You said five rules. That was only four.
 * (Bailey's pager beeps.)
 * Bailey: Rule number five. When I move, you move.


 * Cristina: That's the Nazi?
 * George: I thought the Nazi would be a guy.
 * Meredith: I thought the Nazi would be... a Nazi.
 * Izzie: Maybe it's professional jealousy. Maybe she's brilliant, and they call her Nazi because they're jealous. Maybe she's nice.
 * Cristina: Let me guess. You're the model.


 * Izzie: Okay, so I'm gonna, just gonna, insert my fingers... into your rectum.


 * Derek: Dr. Shepherd? This morning it was Derek. Now it's Dr. Shepherd.
 * Meredith: Dr. Shepherd, we should pretend it never happened.
 * Derek: What never happened, you sleeping with last night? Or you throwing me out this morning? Because both are fond memories I'd like to hold onto.
 * Meredith:' No. There will be no memories. I'm not the girl in the bar anymore, and you're not the guy. This can't exist. You get that, right?
 * Derek: You took advantage of me and now you want to forget about it.
 * Meredith: I did not take -
 * Derek: I was drunk, vulnerable and good-looking and you took advantage.
 * Meredith: (smiling) Okay, I was the one who was drunk, and you are not that good-looking.
 * Derek: Well, maybe not today. Last night, last night I was very good-looking. I had my red shirt on, my good-looking shirt, you took advantage.
 * Meredith: I did not take -
 * Derek: You want to take advantage again? Say Friday night?


 * Katie Bryce: Took you long enough.
 * Meredith: You're okay? The nurse paged me 911.
 * Katie Bryce: I had to go all Exorcist to get her to even pick up the phone.
 * Meredith:' Wait. There's nothing wrong with you?
 * Katie Bryce: I'm bored.


 * Meredith: That was amazing.
 * Derek: Mmmm.
 * Meredith: You practice on cadavers, you observe, and you think you know what you're going to feel like standing over that table, but...that was such a high... I don't know why anybody does drugs!


 * Ellis Grey: Are you the doctor?
 * Meredith: No. I'm not your doctor. But I am a doctor.
 * Ellis Grey: What's your name?
 * Meredith: It's me, mom. Meredith.
 * Ellis Grey: All right. I used to be a doctor, I think.
 * Meredith: You were a doctor, mom. You were a surgeon.


 * Meredith: Did you choose me on the surgery because we had sex?
 * Derek: Yes. Kidding.


 * Izzie: Dr. Bailey, I don't want to bother you …
 * Bailey: Then don't.


 * Richard: Each of you comes here hopeful. Wanting in on the game. A month ago you were in med school being taught by doctors. Today, you are the doctors. The seven years you spend here as a surgical resident will be the best and worst of your life. You will be pushed to the breaking point. Look around you. Say hello to your competition. Eight of you will switch to an easier specialty. Five of you will crack under the pressure. Two of you will be asked to leave. This is your starting line. This is your arena. How well you play? That's up to you.


 * George: Maybe I should've gone into geriatrics. No one minds when you kill an old person.
 * Cristina: Surgery is hot, it's the Marines, it's the macho, it's hostile, it's hardcore. Geriatrics is for freaks who live with their mothers and never have sex.
 * George: I've got to get my own place.


 * Katie: I can't sleep. My head's all full.
 * Meredith: That's called thinking. Go with it.


 * Meredith: What if no one comes up with anything?
 * Cristina: You mean if she dies?
 * Meredith: Yeah.
 * Cristina: This is gonna sound really bad, but I really wanted that surgery.
 * Meredith: She's just never going to get the chance to turn into a person. The sum total of her existence will be almost winning Miss Teen whatever. You know what her pageant talent is?
 * Cristina: They have talent?


 * Cristina: We don't have to do that thing where I say something, and then you say something, and then somebody cries, and there's like a moment...
 * Meredith: Yuck.
 * Cristina: Good. You should get some sleep. You look like crap.
 * Meredith: I look better than you.
 * Cristina: It's not possible.