Dream a Little Dream of Me, Part 1/Transcript

(Meredith is still waiting on Derek's land)

MVO: We all remember stories of his childhood. The shoe fits Cinderella. The frog turns into a prince. Sleeping Beauty is awakened with a kiss. Once upon a time, and then they lived happily ever after. Fairy tales, the stuff of dreams. The problem is, fairy tales don't come true. It's the other stories, the ones that begin with a dark and stormy nights and end in the unspeakable. It's the nightmares that always seem to become reality.

(The candles extinguish as time passes)

(Cristina and Richard are standing outside a patient's room and are looking through the window. Meredith comes bursting through the ER doors)

Meredith: What happened?

(Cristina and Richard rush over to her)

Cristina: A bus in front of him hit a telephone pole. He tried to swerve to miss it, but...

Meredith: How bad is it?

Richard: Meredith...

Cristina: Meredith, you're gonna have to be strong.

(Meredith goes to the window and sees a bloodied Derek having CPR performed on him by Bailey. Mark is steadying his head.)

Meredith: Derek! No! No!

(Bailey stops CPR as they realize Derek's dead.)

Meredith: (Screaming) No! No! Derek! No! No! Derek! Derek!

(Meredith awakens with a start on a makeshift bed in the back of a hallway. She was sleeping the whole time. She gets up and runs down the hall.)

MVO: The person who invented the phrase "happily ever after" should have his ass kicked so hard.

(Bailey's at a computer. Derek is looking over her shoulder. Erica, Cristina, and Mark are also there.)

Bailey: Back up. You're sucking all my oxygen.

Derek: I'm trying to see.

Bailey: It's not up yet. There's nothing to see.

Erica: It's supposed to be posted at four.

Mark: Four fifteen.

Cristina: (Reaching to touch the keyboard) Hit the refresh button. You have to reload the page.

Bailey: (Swatting her hand away) I'm hitting the refresh button every ten seconds. Just wait.

(Meredith comes over)

Meredith: Is it up yet?

Bailey: No.

Derek: (To Meredith) Hi.

Meredith: Hi.

(Alex comes over)

Alex: Is it up yet?

Bailey: No! Wait.

Mark: I'm thinking we move up a slot. We pass Hopkins, move up to number one.

Derek: We're not passing Hopkins. We're gonna stay number two.

Erica: Mayo could surge ahead. We could be three.

Derek: Three? Pessimist?

Erica: Realist. The rankings of teaching hospitals change based on any number of things.

Derek: Ah, three is top five. I can live with three.

Alex: (Reaching to touch the keyboard) Hit the refresh button.

Bailey: (Swatting his hand away) Get... Stay back. I'm doing this.

(Izzie comes)

Izzie: Hey, is it up yet?

Bailey: No.

Izzie: (Reaching to touch the keyboard) Well, here. Just hit the refresh...

Bailey: (Swatting his hand away) I am hitting the refresh... (Looking at everyone) Okay, all of you, back up. Stop hovering, stop speculating. The rankings will go up when they go up. We have no control over when they're posted. When it is up, I will say "it is up". Until then, back up, shut up, and leave me alone, so I can push the...

Meredith: It's up.

(Everyone looks at the screen)

Bailey: Ah, number one, Hopkins. Number two, Mayo.

Erica: Told you.

Bailey: Three, Cleveland Clinic?

Derek: What?

Bailey: Four, Mass Gen.

Mark: What?

Cristina: Wait, wait. We're moving down to five?

Bailey: No. We are not five.

(Richard is walking down a hall with George)

Richard: Twelve! Twelve, O'Malley!

George: It's so upsetting.

Richard: This is not a number twelve teaching hospital.

George: No, it's a great teaching hospital.

Richard: I do not run the number twelve surgical program in the country.

George: Sir...

Richard: Out with it, O'Malley!

George: We've been downgraded from a level one trauma center to a level two? What does that even mean? You don't need to explain. It's just details.

(Richard stops and George leaves)

Richard: (To himself) Twelve!

(George is talking to Lexie in the locker room)

George: You know, I couldn't ask him about when he was gonna schedule my intern test with all the you-know-what hitting the fan. I mean, for all I know, he's gonna spring it to me, what, like, in an hour? Two hours?

Lexie: And you'll be ready. (Testing George) Causes of hypotension?

George: Uh, hypovolemia, MI, cardiac dysrhythmia, uh, hypoxia. Yeah. Is that good?

Lexie: Very good. (She leans towards George's back and seems to be sniffing his back)

George: Yeah? (Turns around and notices Lexie's abnormally close) What?

Lexie: (Facing the window) The snow, it... It's just so funny. It's like a fairy tale.

George: Lexie... It's... It's the fall. That's not so much a fairy tale as, uh, it is global warming. That's the apocalypse. That's like... Well, it's like dropping to number twelve, and me failing my intern test for the second time. (He walks out)

Lexie: (To herself) I adore you, by the way. Just...

(Cristina and Meredith are walking down the hall. Lexie appears.)

Lexie: Oh, hey, uh, sorry I'm late. I was just helping...

Cristina: No talking unless it's medical.

Meredith: So, I keep having that dream. The Derek-is-dead dream.

Cristina: You know, who does their residencies at number twelve hospitals? Losers, and I am not a loser. (To the interns behind her) Go get the charts.

(The interns go get the charts)

Meredith: So, I mean, the dream is about me being afraid of the house of candles and, you know, taking the big step and... I'm afraid of having a happy ending.

Cristina: You know, I have a PhD in biochem. I'm a double doctor. Double doctors should not do their residencies at second-rate hospitals.

(Cristina and Meredith start walking down the hall. The interns follow.)

Meredith: Wyatt says I should just lean into the wind, into the fear, so I'm just gonna ask Derek to move in with me.

Cristina: I could transfer. Cleveland Clinic has a huge cardio program.

Meredith: You know, we're still in the top twenty. That's pretty good.

Cristina: Pretty good is not enough. I wanna be great. Greatness, Meredith. Greatness.

Meredith: Which is why I'm going to ask Derek to move in with me. It's just that it's, you know, it's a big step, and I don't wanna mess it up again. I've messed it up before... The breakups, and the on-and-off again, and the sleeping with George. It's just...

Lexie: (Overhearing) You slept with George?

(They stop walking. Meredith and Cristina turn and look at her.)

Lexie: No talking unless it's medical.

(Meredith and Cristina turn and continue down the hall)

Meredith: So, I'm just gonna do it. I'm just gonna ask him to move in with me. You think it's the right thing, right?

(Everyone's pager beeps)

Cristina: Uh, oh, Bailey's paging.

(Meredith and her interns continue down the hall. Cristina goes down another hall and her interns follow. Lexie catches up with Cristina.)

Lexie: Um, uh, so, medically, um, Meredith and George had sexual intercourse? Uh, when? How many times?

(Derek and Mark are walking past the waiting lounge)

Mark: It's humiliating.

Derek: Yeah.

Mark: Twelve? You're the best neurosurgeon in the country.

Derek: Thank you.

Mark: In the world! (Derek doesn't reciprocate) Don't you wanna say anything nice about me?

Derek: Uh, you're the best plastics guy at Seattle Grace.

Mark: Nice. Really nice.

Derek: Don't force me to praise you.

(Rose comes up between them at the nurses station)

Derek: Hey, Rose.

Rose: (To Mark, ignoring Derek) Hello, Dr Sloan.

Mark: Mm.

(Rose walks away)

Derek: She took it so well at the beginning. I was hoping we'd be civilized. You know, she's working my OR.

Mark: Civilized is out. It's gone. It's a trail of fairy dust. Now she's got delayed rage.

Derek: Delayed rage?

Mark: She was being big before, putting on a brave face. Now she's had time to think. Now she hates your guts. You have to break up with her.

Derek: Well, that's the point. I did already.

Mark: Well, you did it personally. Now you have to do it professionally. Good luck with that. (He leaves)

Derek: (To himself) Delayed rage?

(Erica walks up to Richard who's on the bridge looking out of the window)

Erica: I'd like a list, from you, of ways that I can improve.

Richard: Not right now.

Erica: Richard, you told me that I'm a bad teacher. Now we're number twelve, and I don't like to be number twelve. So, I'd like a list...

Richard: Not right now. (He starts walking away)

Erica: But if there are ways that I can improve, ways that I can help the program regain its ranking...

Richard: It's snowing. You know what happens when it's nighttime and it's snowing, and the temperature is hovering right around thirty-two degrees?

Erica: No.

Richard: The snow begins to melt, and then it freezes again, creating black ice, the deadliest kind of ice, because it is invisible to drivers. That would usually mean that our ER would fill up, but Mercy West is a number-one level trauma center and we're not, which means their ER gets the traumas while we get their cast-offs, which pisses me off. So, when I say "not right now", what I mean is "not right now".

(Richard walks away, and Erica walks in the opposite direction. Callie comes through the door towards her. When they see each other they stop dead in their tracks. Erica pretends she her pager has beeped and goes in the other direction. Callie holds up her newspaper to shield her face, and goes back where she came.)

(Ambulance bay. Meredith, Bailey, Izzie, and Alex are waiting for an ambulance. They're cold and rubbing their hands together.)

Bailey: Stop shivering. You're embarrassing me.

Izzie: I didn't realize we were gonna be outside.

(Alex gets a blanket and puts it around Izzie)

Izzie: Oh, I'm okay. You don't have to do that.

Alex: Bundle up. You're turning blue.

Meredith: Dr Bailey, it is kind of cold out here.

Bailey: Someone will come.

Alex: No one's coming.

Izzie: Maybe some old people with broken hips we can fix!

Bailey: Okay, stop talking. We are Seattle Grace hospital, and rankings or no rankings, we are going to stand outside at the ready, on alert, and give the best care available to every single patient that arrives at our door. We may no longer be ranked the best, but I'm the best, and you're my residents, which means you're the best. It's a matter of pride, people.

(There's a siren in the distance. Cristina comes out)

Cristina: What are we doing?

Bailey: We're waiting.

Cristina: For?

Meredith: A miracle.

Bailey: Someone will come.

Cristina: Dr Bailey, you know that Mercy West is getting all the traumas first.

Bailey: Someone will come.

Meredith: So, we're standing out here in the hopes that someone is severely injured? Wishing and praying that someone is so hurt and so near death that the ambulance has to bring them here, because we're closer than Mercy West?

Bailey: Yep.

Izzie: Wow. You and God are cool with that?

Bailey: Damn it. I forgot about God. All right. Let's just go on back inside and wait...

(A limousine with a dented hood comes screaming around the corner. It seems to be skidding out of control.)

Bailey: Whoa! Whoa! Whoa! Whoa! Hey, watch out!

(The car screeches to a halt. Meredith runs up with Bailey behind. A woman, Sarabeth, in an evening dress gets out of the driver-side door.)

Meredith: Are you okay?

Sarabeth: I drove a limousine on ice, all by myself. Ten blocks.

(Izzie goes to the passenger door and a woman, Betty, steps out)

Izzie: Are you okay?

Betty: My dress. There's blood all over my dress. What happened?

Sarabeth: What happened was I got us to the hospital in one piece.

Izzie: Ma'am, please, try not to move, okay? Just sit right here until we can get you a wheelchair. We need a wheelchair over here.

Sarabeth: We're not the patient. Where's what's-his-name? Benny? Billy?

Betty: Billy?

Sarabeth: The limo driver. He flew through the windshield.

(Meredith opens the back door. A woman, Anna, is sitting there with a bloodied man lying with his head on her lap.)

Anna: Help him, please.

Bailey: Uh, Yang, come around. Help me. Get a board, uh, bring out a gurney and a C-collar.

(Cristina comes to help the man and Anna removes a handkerchief she was holding on his neck. Blood squirts into the air.)

Cristina: Uh! Okay, get...

Bailey: What... Press it. Press. (Cristina does so)

(Michael is wheeled into the ER)

Richard: What do we have?

Bailey: Billy Matthews, forty-five, arterial bleed, haven't isolated the cause.

Richard: I got this. Okay, let's get him in Trauma One.

Bailey: Okay, but I'm holding pressure over the bleed.

Richard: I got this.

Bailey: I just need... Chief...

(Richard takes over applying pressure as he's wheeled into the trauma room)

(Room with Anna, Betty and Sarabeth on beds being attended to by Meredith, Izzie, George and Callie)

Anna: What's going on?

Betty: Vincent will worry if I'm late.

Izzie: You've been in a car accident. You're at the hospital, but we're gonna take really good care of you.

Betty: Oh.

Sarabeth: Is she okay?

Izzie: Might be a concussion. I'm gonna go order a CT and make sure it's nothing more than that.

Anna: All this blood. We should've waited for the ambulance.

Sarabeth: We did wait. We waited. They never came. And Billy was just hanging there through the windshield.

(Sarabeth has a cell phone to her ear)

Callie: Wait, you guys extracted your limo driver from the windshield by yourselves? Wow, that's pretty heroic.

Anna: Isn't Michael answering?

Sarabeth: No. Try Phil again.

(Anna tries calling on her cell phone)

Sarabeth: We shouldn't have even been going to the stupid ball in a storm like that.

George: What ball?

Sarabeth: The Fire and Ice Ball, would you believe, in an ice storm?

Anna: Just goes to voice mail. Maybe... Maybe their phones are off?

Betty: You can't reach Vincent?

Meredith: Your husbands were in another car?

Sarabeth: We won't ride with them. We're three of the most happily-married women ever, except when our husbands drag out their cigars, and they drag out their cigars in the limo.

Callie: Well, your arm is not broken, just bruised. So O'Malley here's gonna suture up your cuts, and then you're all set. You ladies are lucky you didn't sustain more serious injuries.

Sarabeth: (To George) What kind of doctor are you? You're young.

George: I'm an intern.

Sarabeth: Interns don't touch the face. The plastic surgeon touches the face.

Betty: What's happening? (She looks at Anna) Where am I?

Anna: We were in an accident. You're okay. We're all gonna be fine.

(Erica and Callie bump into each other in a hallway)

Erica: Hi.

Callie: Hi.

Erica: I've been really busy.

Callie: No, I know. I've been... I've been, like, crazy, researching things, a lot of research, in the library.

Erica: Oh, yeah, me, too. Incredibly busy. A lot of research, uh, like you, only I use the Internet.

Callie: Well, I gotta check in with Bailey...

Erica: Me, too.

(They arrive at a nurses station at which Bailey's sitting.)

Callie: Bailey, anything else?

Bailey: Nothing. Nothing else. That's the problem. I'm charting. The chief took my one trauma. I gave up my clinic, and now I'm charting.

(Callie walks away. Bailey hands Erica an X-ray film.)

Bailey: The chief wanted you to take a look at these. Billy Matthews. He's the limo driver. Multiple crush injuries from the MVC.

Erica: Hemopericardium. Hemopericardium can lead to cardiac tamponade, which can be detected by Beck's triad. Increased JVP, hypotension and muffled heart sounds. This is a teaching hospital. I'm trying to improve my teaching.

(Mark walks over)

Bailey: Well, don't try it on me.

Mark: Wanna know how I teach?

Erica: No.

Mark: I'm like a guru. They come to me for help, and I gently guide them along the path to truth and wisdom.

(Lexie runs up to George who's walking down the hallway)

Lexie: Hey, George.

George: Hi.

Lexie: I heard a thing.

George: Yeah?

Lexie: A surprising thing. A very unexpected, non-medical thing about you and...

George: Oh, hold on.

(He leaves Lexie in the hallway and goes to Mark at the nurses station. Erica and Bailey are still there.)

George: Uh, Dr Sloan. Hi. Sarabeth Breyers has got a facial lac, but she will only let you touch her.

George: You paged me for a cut? What kind of moron are you, O'Malley? Are you a special moron from the Isle of Complete and Utter Morons?

George: I don't think so.

George: Shut up. (He winks to Erica) Truth and wisdom. (He walks out)

Lexie: He's an ass.

(Meredith comes up to Cristina at a nurses station)

Cristina: You know what? This is what we get for being number twelve. A bunch of women in ball gowns and a half-dead limo driver.

Meredith: Those women are amazing. They tried to save his life. That's who I wanna be, you know?

Cristina: An aging princess?

Meredith: They've been with the same men for years, and they're happy. They did it. I can do it.

Cristina: Mer...

(Derek walking up cuts her off)

Derek: Hey. Who paged me? (Meredith and him walk off together)

(Derek and Merredith walking down the hall)

Meredith: Bailey and Izzie paged you, but you should see Bailey first, because she's got the limo driver.

Derek: Okay.

Meredith: Do you wanna move in with me?

Derek: You wanna live together?

Meredith: Well, I mean, I could... I just, uh... If you don't want to, I...

Derek: Yes. Absolutely. You sure you're ready?

Meredith: I am leaning into the fear to get a happy ending.

Derek: I don't even know what that means.

(They reach Billy's trauma room but stop in the doorway.)

Richard: Damn it! Time of death: twenty forty-seven. (Seeing Derek and Meredith) Limo driver. Traumatic arrest. Never regained a pulse. Tell them not to book the OR.

(Cristina and Bailey at a nurses station)

Bailey: I have a dream, Yang.

Cristina: Excuse me?

Bailey: That one day, a trauma will come through those doors... I have a dream.

Cristina: I share that dream.

Bailey: Number twelve!

Cristina: Number twelve.

Bailey: Right now dispatch is squawking about three men. Three serious injuries. Every one, they're taking them to Mercy West.

Cristina: Three men?

Bailey: That's what I said.

Cristina: You mean, like, three men who could be married to those ladies in the ball gowns?

(Bailey looks at Cristina)

(Mark's dealing with Sarabeth's laceration)

Mark: Little stick. (Sarabeth winces)

(Anna is sitting by her bedside)

Anna: Squeeze my hand. Squeeze my hand. Just like when you had Petey, remember?

Sarabeth: Pete hurt less.

Mark: Yeah, but you're gonna love me later when there's virtually no scar.

(Bailey and Cristina enter)

Bailey: Ladies, um, I've been on the phone with ambulance dispatch. Three gentlemen in a limousine collided with another vehicle on Broad Street. It's possible it was your husbands.

Anna: Oh, no.

Cristina: They're taking them to Mercy West...

Bailey: Which is across town.

Cristina: Unless, uh, you prefer that they be brought here.

Sarabeth: We can do that?

Bailey: Oh, you can insist.

Cristina: And, uh, if I were you, I would insist.

Anna: Oh, well, then, I guess... I guess we insist.

Sarabeth: Yes, we insist.

Bailey: You insist. (She looks happy)

(Ambulance bay. Richard rushes over to Bailey and Cristina who are waiting for the ambulance which is just now arriving.)

Richard: Am I to understand that you stole these traumas from Mercy West?

Bailey: I have no idea what you're talking about.

Richard: Good job, 'cause now it's personal. Yang, come with me.

(Richard goes to the back of the ambulance and opens it)

Paramedic: We have a situation. Fifty-eight-year-old male, MVC, tachy one-sixty, BP eighty palp, Decreased bilateral and breath sounds.

(He pulls the patient, Michael, out on a stretcher, followed by a man, Owen, in military uniform)

Richard: What did you do?

Paramedic: I didn't do it. He did. GI Joe trached him at the field before I got there.

(The soldier puts his mouth over a pen which is inserted into the patient's throat)

Richard: With a pen? You trached this guy with an ink pen?

Owen: So?

Richard: Move this guy inside now. Come on. Let's go. Move, move, move, move.

Cristina: Pen trach? Hot.

(Derek walks into Vincent's room where Cristina is scanning him)

Derek: Okay. What do we got?

Cristina: Vincent Kenner, fifty-eight, unrestrained backseat passenger of a limo that took a nosedive. Muffled heart sounds and large scalp lac.

Betty: (Coming in) That's Vincent!

Vincent: Betty.

Izzie: I'm sorry, Dr Hahn, but she wanted to see her husband.

Betty: Vincent. That's my husband. What happened? Is he all right?

Izzie: I promise to give you an update as soon as we know something.

Betty: No.

Izzie: But right now, I have to get you to the CT.

Betty: Oh, God. Vincent?

Izzie: I'll bring you back. I'll bring you back.

(Izzie leads Betty away)

Cristina: Free fluid in the abdomen.

Derek: Compressed skull fracture.

Erica: He's also got decreased breath sounds bilaterally. This guy's getting an express ticket to the OR. Let the chief know.

Cristina: Can I scrub in?

Erica: Fine.

Anna: (Screaming just outside Michael's room) He has a pen in his throat!

(Michael's room. Anna enters)

Anna: Oh, Michael! Oh, God, Michael! Oh, God, is that a...? Is that a pen in his throat? Does he have a ballpoint pen in his throat?

George: Ma'am, you need to wait outside. Let the doctors work.

Anna: But they have to be very careful with him. Michael's been under an incredible amount of stress lately, and it's the last thing he needs now...

Richard: Grey, can you handle this woman, please?

Meredith: Mrs Loomis, we're gonna take you to your husband. He's around the corner.

Anna: Sweetheart, I'm here. Michael, I'm here, sweetheart.

(Meredith ushers Anna outside)

Richard: This is not her husband?

George: Nope.

(Another door opens and Sarabeth enters)

Sarabeth: Oh, my God! It's Michael!

George: It's her husband.

Sarabeth: What happened to him?

George: Please come with me, ma'am.

Sarabeth: What happened to him?

George: Please, this way.

(George ushers Sarabeth out)

Sarabeth: Michael!

Mark: (To Owen) You trached a man in the field using a ballpoint pen?

Owen: That's all I had on me. (Mark shakes his head) What? It's not like I didn't clean it off with fresh snow.

Alex: That's awesome.

Owen: (Looking at what Mark's doing) Really? You're going with a size-six Shiley tube on this?

Mark: Somebody get this guy away from me.

Bailey: Uh, I'm gonna need a CT of, uh, his belly, Chief. Karev, get us in line.

Mark: Looks like his trachea's crushed. I'm gonna need an OR and an extra set of hands. Who's available?

Bailey: Grey.

Mark: The good Grey?

Bailey: The intern Grey.

Richard: And I'll throw in O'Malley.

Mark: (Sarcastically) Oh, nice. Perfect.

(Phillip's room. Anna enters. Callie's attending to Phillip.)

Anna: Phil? Oh, my God. Oh, my God. What happened?

Phillip: The limo hit a patch of ice. Next thing I know, we're all upside down, rolling around, and now... Anna, I can't feel my legs.

Anna: Oh, Phil. I'm so sorry.

Callie: Okay, get her out of here. I gotta get a consult from Shepherd.

(Richard comes out of Michael's room, followed by Owen. Cristina catches up with him in the hall.)

Cristina: Oh, sir, Dr Hahn is working on multiple crush injuries. She wants you to take a look.

Richard: Mm-hmm. I'm on my way. (Looking at Owen's leg) You're bleeding!

Owen: Uh, my car was right behind theirs at the intersection. I cut it on impact.

Richard: And you triaged these men?

Owen: Major Owen Hunt, US Army, second forward surgical. I'm a trauma surgeon. I just got home on leave.

Richard: Dr Yang, take care of Major Hunt's leg.

(Richard starts walking away. Cristina catches up with him.)

Cristina: Uh, sir, I'm scrubbing in with you.

Richard: After you take care of Major Hunt.

(Owen starts walking away)

Cristina: Hey, where are you going?

Owen: To check on my other patients.

Cristina: No, no. You are the patient!

(CT room. Betty is in the machine.)

Betty: Hello? Vincent? Are you there? Where am I?

Izzie: (On intercom) You've been in a car accident, Betty. You're having a CT. It's gonna be okay. Everything is okay. Don't move.

(Alex walks in)

Alex: Some nut job down there trached a guy with a pen. Pretty freaking cool.

Izzie: You want cool? Check this out. Every thirty seconds.

Betty: Is someone there? Where am I?

Izzie: (Intercom) You've been in a car accident, Betty. You're having a CT. It's okay. (To Alex) Every thirty seconds, her memory resets. Every thirty seconds.

Alex: Might not be so bad. Like hitting the refresh button. Everything is new again.

Izzie: How you doing?

Alex: You keep asking me that, and I keep telling you. I'm fine.

Izzie: I know, it's just... Sometimes I still think Denny's gonna be right around the corner, and he's been dead a long time now. It just takes a while to get used to.

Alex: Rebecca didn't die. It's not like that for me. I'm good. But thank you for asking.

Betty: Hello? Is someone there? Where am I?

Alex: (Intercom) You're in a spaceship. You're going to the moon. Enjoy the ride.

Izzie: (Laughing) Alex!

(Alex's pager beeps)

Betty: A spaceship? Excuse me?

Izzie: (Intercom) You're having a CT, Betty. You're gonna be okay. You've been in a car accident. Just don't move. (To Alex) Thanks a lot.

Alex: Bailey paged me. I'll see you later.

(Vincent's room. Derek's examining an X-ray)

Derek: He has a depressed skull fracture. I could elevate the skull fragments, but there's just no telling how much damage has been done.

Richard: We're saving this man.

Erica: All right. I think we're looking at an aortic tear, not to mention vast amounts of blood in his abdomen.

Richard: We are saving this man. I can handle the abdominal bleeding.

Erica: He is circling the drain.

Derek: Yeah, I have other traumas to get to.

Richard: We are saving this man! Now does everyone understand, or do I have to repeat myself?

Erica: Yes, sir.

Derek: Understood.

Richard: Book OR Two.

(Meredith is with Anna in the waiting lounge)

Anna: It's pathetic, isn't it? A married woman cheats on her best friend with her husband? You can't go much lower than that.

Meredith: These things happen.

Anna: I ran into Michael in the mall, and we had lunch. And a week later, we had another lunch. And here we are. Eight months later, and Sarabeth has no idea. When you... When you spend your life with someone, and you have kids together, you think it'll always be this amazing and this wonderful. You think... You think that you'll always feel that kind of love, and I do, I... I do love Phil. I just..

Meredith: Just what?

Anna: Well, little pieces of you get chipped away, by another person, and then you shave little pieces of yourself away so that you'll fit together, and then one day, you look up, and you don't even know who you are. I better get back to my husband. He'll be wondering where I am.

Meredith: Okay.

(Vincent's surgery)

Richard: That graft is actually holding.

Erica: I am impressing even myself.

Richard: Shep?

Derek: Mm-hmm. Almost there. All right, everybody take a look at the monitor, please. Now, to elevate the last of the skull fragments, I'll need a large, flat instrument to get under the bone. Ah, a curved, number-two penfield, please. You know what? Actually, I want my number-four penfield.

Erica: Oh, that's interesting. Why did you wanna use the number-four penfield instead?

Derek: I'm sorry?

Erica: Oh, well, how would you explain it? I'm observing your teaching style. Hope you don't mind? So, the penfield. You changed it because?

Derek: I changed my mind. (Rose laughs to herself) Is there a problem, Rose?

Rose: Not at all, Dr Shepherd. You changed your mind. Got it.

(Callie walks in)

Callie: Dr Shepherd, uh, I've got a guy with a high-level spinal injury. I've, uh, started him on steroids, but I believe he needs to be decompressed. Are you almost done here?

Derek: Yeah. I'm done right now. Close up for me? (He leaves)

Erica: (To Richard) So, we consider him a good teacher, right? (Richard stares at her) I'm just checking.

(Derek's with Callie in Phillip's room, checking a spinal scan)

Callie: The spine's crushed from C-six to T-one, impinging on the cord.

Derek: Yeah, we need to go in and try and relieve the pressure on the spinal cord. But with this kind of injury...

Phillip: People don't want again.

Anna: Phil, you don't know that.

Phillip: Anna, sweetheart, it's okay.

Anna: You have to be able to do something. Phil's very strong, and he has grandkids. You have to do something.

Owen: (Standing in the doorway) You could freeze him.

Cristina: You shouldn't be in here. (To Derek) I'm so...

Owen: If you want him to have a shot at walking again.

(Later, Derek, Callie, Cristina, and Owen are at a nurses station)

Derek: Who the hell are you?

Cristina: Army surgeon bad-ass, did something crazy with a pen on a guy's throat.

Derek: Well, I would appreciate it if you didn't give my patient and his wife false hope.

Owen: Until you've exhausted all the options, it's not false. It's just hope. Maybe you should keep current on your research.

Callie: They did, uh, make a football player walk at Buffalo Gen, using therapeutic hypothermia.

Derek: Buffalo Gen's patient was twenty years old, in prime cardiac fitness. My patient is in his sixties and is a very risky candidate. I would prefer he live to see his grandchildren. Dr Torres, book an OR, please. Tell this patient that this procedure is not an option, despite Uncle Sam's assessment. (He walks away)

Cristina: (To Owen) We're closing up your leg now.

(X-ray room)

Sarabeth: Michael can live after they put a pen in his throat?

Bailey: Oh, yes, ma'am. The emergency trach helped him breathe. Dr Sloan needs to get him to the OR to... Surgery? He needs surgery? When your husband was pinned underneath the car, he suffered a laceration to his windpipe, which Dr Sloan needs to fix to stabilize his airway. He also has some bruising around his kidney and a lac on his liver.

Sarabeth: What, he needs surgery for that?

Alex: There's a chance the abdominal injuries will heal on their own. But if they get worse, yes, will need surgery.

Sarabeth: Two surgeries? I can't believe this is happening.

Bailey: Hold on. This...this is today?

Alex: Tonight, midnight.

Bailey: Um, ma'am, there's also one other matter.

Sarabeth: More? There's more?

Bailey: Um, just according to billing, your insurance expires at midnight. So we're gonna treat you, of course, but just to make it easier on you later, is there another card or another insurance policy?

Sarabeth: My husband, he takes care of these things.

Bailey: Uh, okay.

(Cristina is treating Owen's leg)

Cristina: Okay.

(Cristina turns her back to him to get something. Owen takes the opportunity to grab a staple gun and use it on his leg.)

Cristina: I'm gonna numb... (Looking at his leg) Wow! Uh, you're not numbed.

Owen: So?

(He puts in another staple)

Cristina: (Sympathetically) Ow! Uh, ow!

Owen: Can't get an angle on these. Could you? (He offers her the staple gun.)

Cristina: (Laughing) Okay.

(She puts in a staple and looks up at him. He motions that he's good. She puts in another.)

Owen: Thank you.

Cristina: Don't mention it.

(Callie comes in)

Callie: Can I ask you something?

Cristina: Uh, oh, what?

Callie: Um, him, actually.

Cristina: Oh, um, yeah, sure. I've got surgery. And, uh, poke yourself. (She holds a needle out to Owen. He takes it and she leaves.)

Callie: Talk to me about the freezing thing.

(Derek in surgery on Phillip. Izzie is showing Derek Betty's head scan on a monitor)

Izzie: Betty Kenner, closed head injury from the limo wreck.

Derek: (Checking the monitor) Subdural hematoma.

Izzie: Which is why she has memory loss.

Derek: Yeah. Might ease up once we relieve the pressure.

Izzie: Book an OR.

Derek: I'll go in on her once I finish up on Anna's husband. (To Rose) Busy OR today.

Rose: But that's kinda your thing, right? Juggling more than one person at a time?

(OR schedule board. Izzie comes over to Meredith and Cristina)

Izzie: How's Betty's husband doing?

(They start walking down the hallway)

Cristina: Oh, I'm scrubbing in on him now. Shepherd did what he could, but the chief and Hahn are still working on him. He is an ugly, ugly mess.

Izzie: Sarabeth's husband may need another surgery after Derek's done with him. These poor women.

Meredith: Well, Anna, the one with the cuts, is married to the guy on Derek's table, and she is sleeping with Sarabeth's husband. The one Sloan's working on.

Izzie: You're kidding!

Meredith: No. Don't tell Betty.

Izzie: She wouldn't remember even if I did.

Meredith: You mean, that's what happens? You're married forty years and then you become a big, fat, lying cheater? I mean, if forty years doesn't make you committed, what does? What's the point? What if I move in with Derek...?

Cristina: Okay, you know what? I'll give you a hundred bucks if you talk about something else.

Izzie: It's not about the years, it's about the man, and Derek is a good man.

Cristina: Oh, well, I'm outta here. (She leaves)

Izzie: There are a lot of really good men, you know? George is a really good guy. I mean, he... (Meredith glares at her) Nope. Sloan is not. Alex, yeah. Alex has turned into a very good man.

Cristina: You and Alex...?

Izzie: No! I'm making a point. But it is nice, you know, that we're friends, and he's changed. He's actually opening up to me.

Meredith: So do you think if you moved in and got married, in forty years, you'd feel dead inside enough to cheat on him?

Izzie: Well...

(Vincent's surgery)

Richard: Yang, Major Hunt all taken care of?

Cristina: Uh, I did my best, sir.

Richard: Okay, come put some pressure on this bleeder for me. You know what I think? I think the number twelve ranking was a mistake. I think it was a clerical error, and I'm gonna start making calls about it as soon as I get out of this surgery.

Erica: So, I've been observing teaching styles. Shepherd likes to teach by thinking out loud. Bailey is blunt and direct and doesn't overteach, and Sloan... Well, Sloan just likes to berate and humiliate.

Richard: I think if you really wanna learn about teaching, you should talk to your students, find out how they learn best. Yang?

Cristina: Oh, that's not necessary, sir.

Richard: Are you serious about this or not, Dr Hahn?

Erica: Fine. (Looking at Cristina) Go.

Cristina: Uh, for me, personally, I learn better when I'm asked questions. The Socratic method.

Erica: Well, that's the cornerstone of medical teaching. It's what we do in rounds.

Cristina: Well, not everyone does it.

Erica: Some people simply tell you what to do.

Cristina: Who? Are you talking about me?

Erica: Uh...

(Suddenly the monitor beeps)

Erica: He's crashing. Get me an aortic clamp.

Richard: Uh, I can't get a handle on this bleeding in his liver. We may just have to start doing damage control soon. Uh, I see a tear in the renal artery. Yang, are you familiar with the single-layer continuous closure?

Cristina: Yes, sir. Of course.

Erica: All right. BP's still dropping.

Richard: Okay, max out on levophed and keep pushing the blood. Get in there and stitch, Yang.

(Michael's room)

Sarabeth: (To Michael) There's a problem with the insurance.

George: As we explained, he can't talk right now.

Sarabeth: I know, but, Michael, I called them and the credit card company, and they said that the cards have been canceled. (Anna appears at a doorway and listens.) I... I don't understand. I just need to know what to do. I don't know what to do.

Lexie: I'm sorry. I'm really sorry, but we need to get him to Dr Sloan now.

(Michael is wheeled out. Alex appears at the door)

Sarabeth: Is there something I can do? Someone I can call? I... I don't.... I don't handle the money, but I... If you can just tell me who to call...

Alex: I'll talk to billing and see what I can do.

Sarabeth: Thank you.

(Michael is in Mark's room. George and Lexie are there.)

George: It's stuck. I can't seem to get down the left bronchus.

Lexie: You almost got it, George.

Mark: What are you, his little cheerleader? Step aside, Wonder Boy, before you make things worse. O'Malley, go find out if the OR's ready, if you can manage that. (George leaves the room)

Lexie: You're a little mean to George. Unnecessarily mean. And he's studying to retake his intern test, so he's a little stressed out, so I was just thinking maybe you can be nicer.

Mark: You're an intern. Why are you talking to me?

Lexie: Well, you're my half-sister's boyfriend's best friend, so I...

Mark: You thought that makes us friends? You thought that you'd defend your boyfriend to me, and I'd just take it?

Lexie: He's not my boyfriend.

Mark: But you want him to be.

Lexie: Do not!

Mark: Do too.

Lexie: Do not!

Mark: Do too! Does he know?

Lexie: Shut up.

Mark: I'm your attending. You can't tell me to shut up. You want me to be nicer to O'Malley?

Lexie: Please?

Mark: Confess your love to him, and I'll think about it.

Lexie: Shut up.

(Alex finds Meredith in the hallway)

Alex: You know anything about health insurance?

Meredith: No. Why?

Alex: Well, I'm trying to help out a patient.

Meredith: Oh, the softer side of Alex. Izzie was right.

Alex: What's that supposed to mean?

Meredith: Nothing.

Alex: What did Izzie say to you?

Meredith: She said you were a good man. She said you changed. It was nothing.

Alex: Did she say that I cried? 'Cause that is a lie.

Meredith: No, she didn't say anything.

(He starts walking off)

Alex: She should just keep her mouth shut.

Meredith: Alex, I made a stupid joke! She didn't mean anything.

(Vincent's surgery)

Richard: Yang, how you doing?

Cristina: It's, um... I can't get it. It's not holding. It's tearing. I...

Richard: Damn it, Yang. Move. I thought you said you'd done this stitch.

Cristina: I have, a hundred times.

Erica: On hearts?

Cristina: On hearts.

Erica: Your forceps were macerating the tissue. You were handling the bowel incorrectly, which you would know, if you weren't allowed to clock so many hours in cardiothoracics at the expense of your general surgery knowledge.

(Michael's surgery)

Mark: Crap. His vocal cords are damaged beyond repair.

Lexie: Is there anything we can do?

George: He probably won't talk again.

Mark: I think that question was for me.

George: Sorry.

Mark: You think just 'cause you get to take your intern test again, that makes you big man on campus? Doesn't change the fact you failed it the first time.

Lexie: Dr Sloan...

Mark: I'm sorry, Grey. Was there something you wanted to say to anyone here?

Lexie: No, there wasn't.

Mark: Coward.

Lexie: Shut up.

George: Lexie!

(Monitor starts beeping)

Mark: Pressure's dropping.

(Vincent's surgery)

Richard: It looks like v-fib.

Erica: Twenty Joules.

Richard: Clear.

(Phillip's surgery)

Derek: Hang another unit of packed cells, as many as it takes.

Rose: I've got it right here. (She hangs it)

Derek: Somebody get me some FFP.

Rose: Right away.

Derek: Suction, please. Suction! There's too much blood.

(Michael's surgery)

Mark: We're losing him.

(Betty's bed. Sarabeth is at her bedside.)

Betty: What's going on? Am I in a hospital?

Sarabeth: There was an accident, but you're going to be fine. (Anna comes over) We're all going to be fine.

(After the surgery, Derek and Mark come to Betty's bedside where Anna is.)

Derek: Um, I was able to repair your husband's vertebrae, and relieve the pressure from his spine, but, uh...

Anna: He... He's still paralyzed?

Derek: Yes, I'm sorry.

Anna: Oh, God. Oh, Phil. And... And... And Michael? What about Michael?

Mark: I repaired his trachea, but unfortunately, his vocal cords were completely severed in the accident.

Sarabeth: He can't talk? He'll never be able to talk again?

Anna: We have to be strong.

Sarabeth: We have to be strong for Phil and for Michael.

Derek: (To Izzie) I'll be ready for Betty in OR One when you're done here.

(Mark and Derek leave. Richard comes over.)

Richard: Um...

Betty: Is it Vincent? What's happened, please?

Richard: Vincent came through the surgery. He's stable, but still critical.

Betty: Oh, my God.

Richard: This is Dr Yang. She is going to be personally responsible for seeing to it that your husband makes it through the night.

Cristina: I'm... I will keep you posted.

Betty: Keep me posted? About what? Where am I? Where's Vincent?

Izzie: She has a subdural hematoma. Her memory resets every thirty seconds.

Cristina: Perfect.

(Derek hands a chart to a nurse, then sees Rose at the OR schedule board. He walks over to her.)

Derek: Rose. Please look at me. If you're gonna behave like this, you can't be in my OR.

Rose: Okay, there's no good way to say this. I've been acting this way, because I'm... I'm carrying your child, Derek.

(Derek is speechless)

Rose: Ha! Gotcha! (She laughs)

Derek: This is your idea of a joke?

Rose: Oh, please. You deserve it. Who do you think you are? (Mocking him) "If you're gonna keep behaving this way, you can't be in my OR".

Derek: You should transfer to a different specialty.

Rose: You should transfer to a different specialty.

Derek: I'm a neurosurgeon.

Rose: You should've thought of that while repeatedly assuring me that you were over your ex. I'll see you in the OR. I'm not going anywhere. (She leaves)

(Richard is standing in a hallway. Callie comes up to him.)

Callie: Chief, about Phillip Loomis, Shepherd's spinal patient? Um, I was thinking... What about therapeutic hypothermia?

Richard: You wanna freeze a spinal injury?

Callie: They did it in Buffalo, and Mass Gen had success with it, too, and Major Hunt, he swears by it.

Richard: What does Shepherd think?

Callie: He thinks it's too risky in Mr Loomis's case, that he's not as fit. He's older.

Richard: Loomis isn't much older than me.

Callie: I can do the procedure, Chief. I just need your okay.

(George and Lexie are walking down the hall)

George: What were you doing back there?

Lexie: I was trying to help you.

George: Telling an attending to shut up in his OR? That's not helping. What makes you think you can get away... You're sleeping with him?

Lexie: What? No!

George: Yes, you are!

Lexie: Why would you even say that? Wait. Are you jealous?

George: Of the fact that you can tell Sloan to shut up? Yeah. But, you know, he's right. I'm the hospital joke. It's my fault. I'm the one who failed my intern exam, and got married in Vegas, and cheated on my wife.

Lexie: No. You don't understand. The only reason that he was picking on you is...

George: No, it doesn't matter. I can take care of myself.

(Meredith and Cristina are walking down the stairs)

Meredith: So... And he's got fishing gear and boots and hair products. I don't have room for any of that stuff. And he talks, and not a little. I mean, he chats. He's chatty. Freaking...

Cristina: Not right now.

(Cristina starts walking away, but Meredith follows and talks)

Meredith: And then, you know what's gonna happen after he moves in, don't you? We build a house on his land, which will be our land, because we'll be married, And then I'll be Dr Mrs Shepherd. And you know what comes after that, don't you? Babies, and they'll be his babies, so they'll have perfect hair, and they'll be chatty. So I'll have five chatty children, a chatty husband, and live in a house in the wilderness. And then I'll start sleeping with your husband. I gotta tell him I changed my mind. Don't you think?

(They're now outside the hospital)

Cristina: Meredith!

Meredith: What? Why are you making that face?

Cristina: Shut up. You know, just shut up about Derek. Shut up about moving in with Derek. Shut up about your relationship, because you wanna know why? I've heard it all before. Yeah, you know, you guys get together, and I have to listen to it, and then you guys break up, and I have to listen to it. I almost killed a man in surgery today. I... Okay, you want... You wanna know what I think? Okay, you... You really wanna know? You and Derek will not work. Moving in together is a mistake of massive proportions. You are dreaming of dead Derek, which should tell you it will not work!

Meredith: Cristina, I...

Cristina: No! No! You know, this whole thing, this happily ever after does not exist. So please, please, please, as you weigh your options here, just, you know, consider the possibility of shutting the hell up, because I can't listen to it anymore.

Meredith: I...

Cristina: No.

Meredith: Okay...

Cristina: No!

Meredith: I...

Cristina: Okay, that's it. I'm done.

(She starts walking back into the hospital but slips on some ice and falls flat on her back)

Cristina: (Touching her head) Oh, ow! Ow! Ow!

Meredith: I'm not gonna say you deserved that, but you deserved that.

Cristina: Oh, thanks. Oh, help me. Help me up.

(They hear a crack. They both look up and see an icicle on the roof break free, fall, and stab Cristina in the abdomen. Cristina starts gasping in pain.)

Meredith: Don't move. I'm gonna go get some help. (She rushes inside)