I Will Follow You Into the Dark

After learning at a deposition that more of his patients have died than survived, Derek leaves both the hospital and the house, even as Meredith refuses to give up on him. Meanwhile Bailey and the Chief continue to bicker over her peds fellowship until his wife, Adele, is called in, thoroughly annoyed at the both of them. The interns make a disturbing breakthrough on "Patient X," unaware that the charts they're looking at are actually Izzie's, prompting Izzie to confide in the most unlikely of people.

Music

 * "Front Row" - Metric
 * "Duet" - Rachael Yamagata
 * "Treeology" - Shady Bard
 * "A Storm Is Going to Come" - Piers Faccini

Trivia\Notes

 * This episode's title originated from the song, "I Will Follow You into the Dark," which was originally sung by Death Cab for Cutie.
 * Goof: While operating on the first of the siblings, the Chief's eyes change from looking at the patient to looking at Bailey between camera angles.

Quotes

 * Meredith (opening voiceover): Every surgeon I know, has a shadow. A dark cloud of fear and doubt, that follows even the best of us into the OR. We pretend the shadow isn't there. Hoping that if we save more lives, master harder techniques, run faster and farther, it'll get tired and give up the chase. But, like they say, you can't outrun your shadow.


 * Chief: Oh, Shepherd! Thank God you’re back. Can you swing two brain biopsies today?


 * Derek: I'm not operating.


 * Chief: Look, I know you've got a big lawsuit breathing down your neck, and I know you lost a patient. But, I need you back to work doing the job I hired you to do.


 * Derek: I'm not operating! (starts walking off)


 * Chief: I'm not asking, I'm telling, as chief surgeon of this hospital, if you don't get back in that OR today, Shepherd... (Derek keeps on walking)


 * Owen [to Alex]: You did a hell of a job today. The Chief is gonna hear about it.


 * Arizona: Pretty impressive for a resident. You fix that attitude of yours, you could be the future of this hospital. The one to watch. You go, Karev!


 * Arizona [to Callie]: So, I've had quite a day. I got my ass handed to me by Alex Karev, a second year resident. Which is humbling, for a surgeon, especially a know-it-all, type-A…


 * Callie: We don't have to do this. We don't have to be friends, it's a big hospital with lots of floors, lots of places to hide. And I'm perfectly okay with doing that for the next few years.


 * Arizona: You're not hearing me, Calliope. Sometimes, I panic, in the moment, and I call it wrong. I misjudge a situation. So, if you're up for it, I'd like to take you to dinner.


 * Callie: Maybe. (gets off the elevator)


 * Arizona: Maybe?


 * Callie: Yeah. My schedule's kinda insane right now, so I'll get back to you. (walks off, the elevator start to close, she walks back over and before they close she puts her arm between them so they don't) How's, uh, tomorrow? (Arizona laughs, Callie smiles)


 * Meredith: How'd it go with the lawyers?


 * Derek: They told me my death rate. (looks at small pile of files) These are the people I saved. (looks at big pile of files) These are the people I killed.


 * Meredith: Okay. Well most of those people were terminal when they came to you. You were their last chance, and you take on impossible cases. Look at the clinical trial.


 * Derek: It's just so many people. More than Dahmer, Mason, and Bundy combined.


 * Meredith: You're not looking at the big picture.


 * Derek (points to the big stack of files): This is the big picture.


 * Chief: Where the hell is Shepherd?!


 * Mark: Uh, you can't rely on Shepherd, sir, is there anything that I can do?


 * Chief: Well, my neuro surgeon's been missing for days, I still have no head of cardio, I've got general surgeons quitting on me left and right, surgeries piling up on me like dead fish, and no surgeons to do 'em.


 * Mark: Well, now would probably be a bad time to that my hand is still out of commission and I can't operate. ... You know what? Leave me on the board Chief, and I won't let you down.


 * Dr. Nelson: I could do that craminotomy, Chief.


 * Chief: Uh, put Dr. Nelson on the cramiotomy. Apperciate it John. (walks off)


 * Dr. Nelson: It.. It's Jim.


 * Mark: You must be new. Welcome to Seattle Grace.


 * Dr. Nelson: I've been here for ten years. I was the interm Chief of Neuro until Shepherd and his red cape swooped in from New York.


 * Mark: Mark Sloan, Plastics.


 * Dr. Nelson: We've met... three times.


 * Lexie (walks up to Mark): Hi! (touches his hand)


 * Mark: Hand!


 * Lexie: Hand! Oh god! I'm sorry! I forgot. I'm so sorry. (sighs) I feel terrible, about everything. About the fight, and your hand, and Derek. You know he's not doing so well, I really think that you should talk to him.


 * Mark: I should talk to him?


 * Lexie: Mhmm.


 * Callie: It's still swollen. I'd give it another day of rest.


 * Mark: I haven't operated in 3 days.


 * Callie: Don't hit people with your scalpel hand. Have you talked to him yet?


 * Mark: He threw the first punch.


 * Callie: You did catch him at a bad time.


 * Mark: So he lost a patient, boo hoo. We're surgeons. We're men. We lose patients. It doesn't give him the right to go around behaving like a drunk frat boy. Now I'm supposed to go crawling back begging for his forgiveness? (Callie sees Arizona walking by, and shushs Mark, and hides behind him) Wh-What are you doing?


 * Callie: I went all... say anything on the peds surgeon, in front of the peds surgeons date, so now I am hiding from the peds surgeon.


 * Mark: Mature.


 * Callie: Uh, you got in a fist fight. No judging.


 * Lexie [to Mark]: Yes, the odds are against us. I'm a one woman wrecking ball, all I do is break you. Your hand, your penis, your relationships, your life. I'd say our survival rate is about 3%. And that's...that's, that's bad. But, it's not nothing. And I don't think we should give up on this. At least not yet because... (Mark puts a finger to her lips to stop her) Okay.


 * Mark: You think you broke me Little Grey? ... You're the one that put me back together. (Lexie smiles)


 * Alex: You want me to sit here and babysit the band nerd? That's an intern job.


 * Owen: I don't see any interns around.


 * Beth: I seized during the performance? But I took my meds.


 * Alex: Relax. It's not like you crapped your pants or anything.


 * Beth: But it is like I crapped my pants. I had a seizure in front of the entire marching band. It is exactly like I crapped my pants. They're going to kill me.


 * Alex: Who?


 * Beth: Seizure patrol.


 * Meredith [to Derek]: You cleaned all of your clothes out of the closet at the house.


 * Derek: Go home, Mer. Just go home.


 * Meredith: Well, how long are you planning on hiding out here? Because that's what you're doing. You're hiding. You made a mistake, she's dead and you can't hide from that.


 * Derek: I'm not hiding. I'm done. I'm done operating. (starts hitting the empty beer cans with the baseball bat)


 * Meredith: Oh, okay. So you're just quitting?


 * Derek: You should understand better than anybody else. You wrote the book on quitting. Running, hiding, you've written a lot of books Meredith. (hits another beer can)


 * Meredith: That may be true. But I'm here now.


 * Derek: Oh, hmm, you're here now? (scoffs) You've wanted me out since the day I moved in.


 * Meredith: That is not true.


 * Derek: Because you're incapable of anything that resembles commitment. You lied to me, you said you were healthy. That you were healed. There's no fixing you, you're a lemon. (hits another beer can)


 * Meredith: Derek Shepherd, you are drunk! And you're angry, and I've been there so I get it. But that does not give you the right...


 * Derek: Just go home, Meredith.


 * Meredith: You don't get to just stand here and tell me to leave.


 * Derek: This is what you want, I'm giving you an out. Go.


 * Meredith: I'm not going anywhere.


 * Derek: I said leave! Meredith, leave!


 * Meredith: ... I know there's a ring.


 * Derek: What?


 * Meredith: The Chief told me. I know there's a ring.


 * Derek: You want the ring? Here's your ring. (takes out the box, takes the ring out of it and hits it with baseball bat, then throws the bat on the ground and walks into the trailer)


 * Meredith: Is that the best you've got? 'Cause I'm not bailing, we're in this together!


 * Derek: Go home, Meredith!


 * Lexie: I learned a lot today. Diagnosing a patient from beginning to end. So, thank you for teaching us.


 * Izzie: What would you say? To patient X. How would you... How would you break the news?


 * Lexie: Um, I would say that I was very sorry, and that there were support groups. Th... I ... I don't know. What do you say to somebody whose, whose gonna...


 * Izzie: You say, they have a choice. They can runaway and hide from it, or they can face it. You say they need to be around the people who love them, because it's gonna be the toughest fight of their life, and no one should have to do it alone. And then you give them the odds. And even though a 5% survival rate is bad, it's really bad. You say.... you say....


 * Lexie: Screw the odds! People die of the hiccups. My mother died of the hiccups. Survival rate for that is what... 100 percent? The odds are that she should be alive right now. The odds are... The odds mean crap! So people should face it and they should fight. ... Maybe not those words.


 * Izzie: No. Exactly those words. Thank you Dr. Grey.


 * Alex: Dude. None of you are normal. You're freaking band nerds!


 * (Derek is sitting on the couch eating cereal, in a mess of empty containers, and papers. Everyone is looking at him from the hallway)


 * Alex: Dude, he's fried.


 * Meredith: He is not fried. He lost a patient and got hit with a lawsuit all in the all in one week. He just needs time.


 * Alex: He's been sitting there for three days. The sofa cushions are gonna start bonding to his ass, and he's eating all of my cereal.


 * Izzie: He's taking stock. Something huge and life-altering happened to him, and he's taking stock, figuring out his next move. We shouldn't judge him, we shoudn't rush him.


 * Alex: Whatever. Sylvia Plath's picking out all of the marshmallows. They're the best part!


 * Meredith [about Derek]: And he just walked out. Without saying a word, he just walked out!


 * Cristina: Hunt won't even look at me, since he went all "Apocalypse Now" on me this morning.


 * Meredith: He had to get all scalpel happy up in that patients brain, and now he can't face it!


 * Cristina: He thinks I'm what? This wilting flower? Well guess what, I'm the strong one.


 * Meredith: Oh my god! I'm the strong one.


 * Cristina: You see, if I had that stomach cancer gene, I would get that gastrorectomy no problem. I face things, I don't walk away.


 * Meredith: Derek walks away. Maybe walking away is the answer?


 * Cristina: See it's not emotional, it's science. You have a problem, don't ignore it.


 * Meredith: Well, sometimes if you have to pee and you ignore it, it does go away.


 * Izzie (laughs): You guys are hilarious! I mean do you even know what she just said? Or what she just said? (Meredith and Cristina look at each other) I can totally see you guys in 50 years, at a nursing home, just talking at each other with your hearing aids off. (laughs) Hi-larious! Ah, I love lunch.


 * Adele: Out of all the petty, ridiculous, infantile-- Are you running a hospital here or a playground?


 * Chief: Adele, I won't be spoken to in that--


 * Adele: Hospital or playground, Richard?!


 * Chief (sighs); Hospital.


 * Adele: Well, then start actin' like the Chief of a hospital and (motions to Bailey) apologize to that woman right now.


 * Chief (mutters, and doesn't turn around to face Bailey): Sorry.


 * Adele: You call that an apology? Now you better not leave this room until the two of you have worked this out. Because if I have to drag myself down here through rush hour traffic again, to police this damn jungle gym…


 * Chief: Adele, you've made your point. (Adele goes to leave and sees Bailey with a huge smirk on her face)


 * Adele: And you wipe that smile off your face, you're no better. Tattling on a man to his wife.


 * Chief: You told Adele on me?


 * Bailey: You stopped speaking to me, sir. That didn't exactly leave me many options. I'd like to know if you'd have reacted like this if I left general surgery for neuro or cardio?


 * Chief: I don't follow.


 * Bailey: Or is it because you regard peds as a soft specality? Is that what's bothering you?


 * Chief: Oh, that's ridiculous.


 * Bailey: Well, maybe, but it seems to me that every time I do something that you perceive as soft, like havin' a baby, takin' some time off to see my baby, specializing in babies, I'm dead to you. You wanna know what I think, sir?


 * Chief: Not particularly.


 * Bailey: I think that you're scared that you've gone soft. You blame this whole hospital;s decline on it. And you wanna know what I think about that?


 * Chief: You're gonna tell me anyway.


 * Bailey: It's not doin' one bit of good. I mean, surgeons are still droppin' like dominoes around here. So, maybe it's time that you got in touch with your femnine side. Maybe you need a little soft.


 * Chief: ... You still shouldn't have ratted me out.


 * Bailey: Sorry.


 * Chief: Me, too.


 * Meredith (closing voiceover): Every surgeon has a shadow. And the only way to get rid of a shadow,is to turn off the lights. To stop running from the darkness, and face what you fear, head on.

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
 * Kevin McKidd ... Dr. Owen Hunt
 * Patrick Dempsey ... Dr. Derek Shepherd

Guest Starring

 * Jessica Capshaw ... Dr. Arizona Robbins
 * Brandon Scott ... Dr. Ryan Spalding (Credited as Intern Ryan)

Patients and relatives

 * Michael Rady ... Mike Shelley
 * Wendy Hoopes ... Tricia
 * Erin Cahill ... Meg
 * Susane E. Lee ... Beth

Hospital family/Friends

 * Loretta Devine ... Adele Webber