My mother called it the greatest and most terrifying moment in her life, standing at the head of the surgical table knowing that the patient’s life depends on you and you alone. It's what we all dream about because the first person that gets to fly solo in the OR, kind of a badass. We enter the world alone and we leave it alone. And everything that happens in between, we owe it to our self to find a little company. We need help. We need support. Otherwise we’re in it by ourself. Strangers, cut off from each other and we forget just how connect we all are. So instead we choose love. We choose life and for a moment we feel just a little bit less alone.

All By Myself is the tenth episode and mid-season finale of the fifth season and the 88th overall episode of Grey's Anatomy.

Short Summary[edit | edit source]

After a long period of waiting, the solo-surgery winner is finally chosen, Cristina. But as punishment for recent events, she is not allowed to perform it and must choose one of her fellow residents to replace her instead. To make matters worse, the Chief is demanding she continue to woo Dr. Dixon. Mark and Bailey attempt to reconstruct a larynx while Lexie and Mark flirt under Bailey's radar and the ER has two teenage sisters involved in a car crash with devastating consequences for one of them

Full Summary[edit | edit source]

Lexie walks by a conference room where Richard is in a meeting with the attendings. She reads his lips, rushes to the other interns and says the Chief said Karev. Ryan then rushes to the resident's lounge and informs the residents that he said Karev. Alex cheers, but the others asks if he's really sure. He's not.

Lexie is spying on Richard again. This time, Graciella goes to tell the residents that he said Stevens. Cristina tells the others not to trust the interns. Izzie bounces back it must be hard for her to be excluded. Denny, sitting next to Izzie, says he likes the mean streak. Meredith thinks Richard may change his mind. Steve runs in and says he said Grey this time. Bailey says they just have to wait for the vote, like she did when she won. She was young, gifted, and black, and everybody knew it. She just went about her work. Lexie comes in and says they made their choice. The Chief sent her. George asks her who it is. She points toward someone.

Richard tells Meredith, Alex, Izzie, and George that the first solo surgery will take place tonight. It will be a below-the-knee amputation due to bone cancer. Richard says choosing the winner isn't about the best surgical skills. It's about the highest form of trust, to put a life in their hands. For the first time, every single attending picked the same person: Dr. Yang. However, she's out of the running, so she has to pick the winner instead. Since the interns are still banned, the new winner will choose another resident to scrub in. As the residents walk off, Cristina says this is torture. Richard has more for her: she also has to impress Dr. Dixon again, because he wants her to be the new Head of Cardio. If she's not by the end of the day, he knows who to blame.

The residents are trying to suck up to Cristina. Izzie doesn't bother, because they all know she's going to pick Meredith. Meredith says she's just the best. Cristina will think about it, but asks them to leave. George asks Izzie if she's ready for the clinic, but she says she will catch up with him. Denny says he will, too. Izzie tells him to shut up, leaving Alex and George to wonder who she was talking to. Alex kisses Izzie and tells her she can scrub in with him if he wins. He kisses her again, which angers Denny. Izzie leaves with him.

Lexie says Cristina hasn't talked to her in weeks, not even a mean thing. The other interns haven't had much interaction with their resident either, especially Sadie. Ryan says he's gonna get some sex as it makes him feel better, but all his female colleagues pass.

Lexie approaches Mark and says she was told to look for sex as a way out of her predicament, but she'd rather learn today, so she wants to know if he's interested. He replies it's inappropriate for her to talk to him about sex. Lexie was talking about teaching medicine. Bailey comes over. She heard Mark is doing a hypopharynx reconstruction to make a woman speak again, and she'd like to scrub in. He says she can join him and Dr. Grey in the OR. Bailey points out Lexie is banned from the OR, but Mark says she's on cappuccino duty. Lexie leaves to get him his cappuccino.

Cristina wants to know where Dixon is as she arrived half an hour ago. Owen comes over and asks her if she's nervous. She wonders what he's doing in the cardio wing. He was getting to know other parts of the hospital, but all she cares about is the OR, ER, and cafeteria. Owen says she's got a lot to learn.

Lexie is presenting the case of Kathleen Patterson, the woman who can't speak. Her husband is feeling good about the surgery and asks if Kathleen is, too. She shows him a post-it that reads "yes". Mark wants to talk about the procedure, but Kathleen is too focused on her laptop. Mark then explains the procedure to her husband. Bailey reminds him not to get his hopes up as it might not work. Kathleen has no other questions.

Sadie wants to know more about Alex. Too bad he's got a thing with the girl who masturbates all the time. Meredith says she can't be her friend at the hospital. Sadie has to figure out how to not piss off Alex on her own.

In the ER, two sisters are bickering. Callie explains they crashed their dad's car. The younger sister says Holly was texting and driving. She wants to press charges. Callie wants to call their parents. Emma speed-dials her father. Alex yells to make them stop screaming, but it doesn't work. Callie hates it.

George approaches Cristina as she's brushing her teeth. He says he's grown a lot since day one, when he was 007. Anyone can have talent, but the key is growth. He came out the other side, smarter and better. He's a fighter. Cristina thanks him.

Callie thinks Emma's leg is broken. Emma says she can't miss her future leaders of America conference. She's been waiting to go to D.C. for a year and now their parents have wasted 2 grand. They throw supplies at each other, so Callie closes the curtain. Sadie tells Holly her father won't be that mad, but Holly says he'll take away everything. Alex checks her eyes and asks to page Shepherd, as she might have a basilar skull fracture. Sadie didn't see that, so Alex tells her to do scut. Emma is happy to see they're taking her sister away and yells after her that she hopes she dies.

There's a line outside the clinic. Izzie forgot to open and staff it. She apologizes to the people waiting and says she'll be right back with the keys. Denny asks if this happens a lot, because it's giving his clinic a bad name. George then sees Izzie talk back to him as she walks away.

Cristina finally finds Dixon, who's looking at the OR board. She apologizes to Dixon for the wait. Dixon says there's an empty spot on the board for an amputation. She'd like to do a surgery, but she hasn't done an amputation since her residency. Cristina stutters as she tries to explain the empty spot. Dixon asks if her stuttering is pathological, because she stuttered as a child, but it can be treated with rigorous speech therapy. She then explains she has to pick one of her peers for the surgery. Dixon makes a weird noise.

Lexie has forms for Kathleen to sign. She asks her husband, standing outside the room, if she has time. He says his wife is a blogger, who's now famous in Internet circles. Lexie thinks they have a great way of communicating now, but he disagrees. The post-its caused for the words to lose their meaning.

Sadie sees Callie looking at scans. She loves broken bones. Callie says they can treat this tibia fracture with close reduction and casting. Sadie leans in to look at other scans. Callie grabs her scans and leaves to go see her patient, but bumps against a chair on her way out. Sadie smiles at her awkwardness.

Derek and Alex are looking at Holly's scans. She needs a cardio consult. Meredith comes in and says her future leader needs scans. Meredith doesn't mind that Derek voted for Cristina. Derek says Cristina still knows Meredith deserves it, even though they're fighting. Meredith says that's over. Holly crashes in the scanner. She's bleeding from her nose, and there's brain matter in the blood. They need to go to the OR right away. Emma shouts Holly's name from the hallway.

Meredith finds Cristina and says she knows Cristina knows she deserves it most, but she doesn't want it be a big awkward thing, so Cristina has to do what she has to do. Cristina says okay.

Callie is putting a cast on Emma's leg. She asks about Holly. She hopes Holly won't die, because her wish for Holly to die can't be last thing Holly heard from her. Meredith will get an update from the OR.

In the OR, Derek tells Cristina to be objective and look for stand-outs. Now, he'll allow Alex to sew his graft so Cristina can see his skills. Dixon tells Cristina to devise a system and rank everyone accordingly. The monitor starts beeping and Holly's brain changes color. Derek says she's hemorrhaging and takes over. Alex wonders what he did.

Callie tells Mark Sadie came to talk to her. She looked at her a certain way and she thinks there was more to it. She's confused. There was no touching and no lip licking. Callie realizes she made it up because she's desperate for attention. Mark says the hot interns are the one that cause troubles by distracting you from your genius, which they should be focusing on instead of hot, available interns.

Mark shows Bailey and Lexie a simulation from the procedure. Lexie leans in to ask questions, but he tells her to back up as she's in his space. Bailey tells her to go prep Kathleen for surgery.

Izzie asks George to cover for him as she has a pressing matter. George is swamped already, but Izzie just walks off. Denny tells George it's hot, hot sex and follows her. A nurse tells George that Izzie hasn't been in the clinic all week.

In the OR, Derek says there's nothing they can do. Dixon says she had a massive CVA and the blood flow to the brain can't be restored, so even though Derek was able to fix the hole in her brain, the carotid dissection caused her loss of cerebral function. Alex gets that Holly is brain dead. Dixon says Holly is only 16, which is good. She'll be an excellent candidate for organ donation.

Alex finds Cristina in the bathroom and says she was robbed. He can't kiss her ass. He tells her how to do a below-the-knee amputation.

Owen asks Cristina if she knows who she's going to pick. Cristina is ranking them according to a system. Owen tells her to go with her gut as she knows her colleagues. Owen says his gut is what told him to choose her.

At a nurses station, Sadie tells Callie her necklace is beautiful. Callie feels awkward and leaves.

Alex was paged to the clinic by George. George asks him where Izzie is. Alex doesn't know. George wants Alex to ask Izzie why she couldn't care less about her own clinic since they're together now. George is convinced something's wrong and she won't talk to him. Alex asks him to never talk to him about Izzie again.

Izzie is in bed with Denny in an on-call room. She gets paged by George and ignores it. Denny wonders why they're fighting over the amputation. Izzie explains that's how they learn, but she has no chance now that Cristina gets to pick. There will always be surgeries, but there won't always be fiancés who come back from the dead. They kiss.

Mark is doing the reconstruction and Bailey gives him pointers, much to his annoyance. He sees Sadie and Lexie in the gallery.

Sadie tells Lexie she's not sorry for what they did. This program is not good, as they should be in ORs, not doing scut or just watching from the gallery. They can call her crazy, but the program is broken. The only time the attendings and residents talk to them is when they want to get in bed with them. Lexie says Mark took the time to teach her, but Sadie says Mark likes her. She's seen the way Mark stares at her ass. Lexie denies this, but seems to like the idea.

Bailey is still giving Mark pointers. He asks if she rather do the surgery herself. She says she was just trying to learn something new and exciting. What he's doing is thrilling. Mark thanks her and asks her to take the flap veins and join them to the internal jugular.

Meredith takes Emma to Holly's room. Holly looks like she's sleeping. Emma asks if Holly can hear her. She thinks Holly can come out of her coma. Dixon says she won't. Her scans showed there's no brain activity, so she has no thoughts and emotions. She introduces herself and says she'll be harvesting Holly's organs if her parents agree. Mr. Anderson says they need more time. Dixon says her organs could save many lives. Emma wants Holly to wake up, but Dixon says Holly can't wake up. Her body is alive, but Holly is dead. Emma yells at her to get out. Meredith thinks that's best, too. Dixon realizes she's offended them, but they are running out of time. Emma continues to urge Holly to wake up.

Izzie finds Cristina and sits down with her. She asks if Cristina's ever had mind-blowing sex that makes you want to die, because the sex she's having is the best thing she's ever had. She knows Cristina will give the surgery to Meredith, but at least she is having mind-blowing sex.

Mark asks Kathleen to speak. He knows it might feel strange. She shakes her head and starts typing, but her husband gets up, frustrated. He asks her to talk to him. Bailey suggests they give Kathleen some time. Lexie tells Kathleen's husband to give her some space, but he replies he's already done that.

Sadie tells Richard the appy was her fault, so he shouldn't punish Yang. Richard says she's only here because of her father. If he were her, he'd start to figure out what he was going to do to make up for the appy. She says yes sir.

Dixon tells Cristina there are people dying, which is inappropriate. Holly's organs would keep these people alive. Feelings should be left out of science and decision making.

Richard and all the residents but Izzie have gathered at the OR board. Cristina takes the marker and fills in her decision. She chose Alex. Meredith congratulates Alex. Richard tells Cristina her choice is interesting. Cristina replies he made the best case. Meredith stares at Alex's name on the board.

Alex finds Izzie sleeping in the on-call room. He tells her he won. She says that's amazing. He tells her he loves her. The first thing he did was look for her. She's never there anymore and he thinks that is because she loves him, too, and is scared of it because he screwed up last time. The heart patient reminded her of Denny and he gets that she's scared, but she doesn't have to feel like that because he won't die or cheat on her. He won't go anywhere. He thinks she is his best shot at getting better. She makes him want to be good and he thinks he can. She can be scared with him, when she scrubs in with him for the solo surgery. Alex leaves. Denny says he's really starting to not like Alex.

Emma regrets what she said to Holly. Meredith tells her to tell Holly what she really wants to tell her. Emma says she's sorry and tells Holly she loves her. Meredith says Holly loved her too, no matter what happened. Emma's mother comforts her.

Meredith joins Derek in front of the OR board. She says he was right. She and Cristina are fighting. Derek tells her to go talk to Cristina, as it's important to talk. He says they never tell you you'll lose more patients than you save when you became a doctor. He's sick of death. He'll see her at home.

Lexie sits down with Kathleen. She says it's okay. Kathleen can try and it's okay if it doesn't work. Kathleen quietly says "hi". She tries again, louder this time. After a few tries, it's normal volume. Her husband appears in the doorway and she greets him. He's over the moon and goes to hug her. Lexie watches them.

Richard finds Dixon and asks her how her day's been. Dixon asks if it was his intention to emotionally torture Cristina by making her choose. He says yes. She asks him to have the board make her a better offer.

Meredith sits down with Cristina in the gallery and asks to put the whole thing behind them. She knows that's why Cristina didn't pick her. Cristina says Meredith made it personal. She did what she had to do. Alex was the most prepared. Unlike Meredith, Cristina can separate her personal life from her job. She tells the other residents in the room they all had interns, but she won this. They picked her. If Cristina doesn't deserve the solo surgery, none of them do. She leaves and George sits down with Meredith. He says there's something wrong with Izzie. She replies there's something wrong with every one of them. Meredith gets paged by Alex.

Owen follows Cristina and tells her not here. He opens the door to the stairwell.

Meredith meets Alex in the scrub room. He needs her to scrub in. He's freaking out. He told Izzie he loved her and now Izzie doesn't show up. Meredith says she'll be pissed if Alex kills this patient. He has no choice but to kick ass. Richard comes in and asks Alex if he's ready. Alex doesn't reply. Izzie comes in and says he's ready.

Owen takes Cristina to a room in the basement. They stand on the vent and wait for the air to blow. She's amazed. He knows the vent can clear your head. She does feel better. He says it makes him feel out of time and space, like anything can happen. "Like what?" she asks. He tells her to wait. Another stream of air makes Cristina laugh. They share a kiss.

Mark answers his door. Lexie says he made Kathleen speak. She enters the room and says she respects him as a man and as a teacher. She asks him to teach her. She takes off her coat and her shoes. He tells her to stop. "Teach me," she says. He closes the door and says he promised not to do anything to her. She takes off her sweater and once again asks him to teach her. She takes off her top. She can't believe he's still not acted and asks if she's really that bad. He says he is. He walks up to her and kisses her.

Richard is reading a magazine as Alex and Izzie get gowned and gloved. In the gallery, the other residents are placing bets. Meredith tells them to show some respect, as it's one of them down there. Bailey is smiling as she looks down. Callie crosses eyes with Sadie, who smiles at her.

Mark and Lexie are making out in his bed.

Cristina and Owen are kissing on the vent.

Dixon is taking out Holly's heart.

Alex marks the incision on the patient's leg. He and Izzie smile at each other. Izzie then looks up at the gallery, where Denny is smiling at her. Alex asks for the 10-blade, which Bokhee hands him. He starts cutting.

Cast[edit | edit source]

Main Cast[edit | edit source]

Special Guest Star[edit | edit source]

Guest Stars[edit | edit source]

Co-Starring[edit | edit source]

Medical Notes[edit | edit source]

Mr. Collinsworth[edit | edit source]

  • Diagnosis:
    • Osteosarcoma
  • Treatment:
    • Below-knee amputation

Mr. Collinsworth was in the hospital for a below-knee amputation to treat bone cancer. Alex won the surgery as the first solo surgery and Izzie scrubbed in with him to help.

Kathleen Patterson[edit | edit source]

  • Diagnosis:
    • Voicelessness
  • Treatment:
    • Hypopharynx reconstruction

Kathleen had had a laryngectomy five years prior and had since had several attempts to restore her speech, none of which had been successful. Mark planned a hypopharynx reconstruction, a procedure he'd never done before, to restore her speech. The procedure went well, but they wouldn't know it was successful until she spoke or attempted to speak. She was initially scared to try, but Lexie convinced her and she softly said, "Hi." before starting to speak more confidently.

Holly Anderson[edit | edit source]

  • Diagnosis:
    • Basilar skull fracture
    • Hemopericardium
    • Carotid dissection
    • Cerebrovascular accident
  • Treatment:
    • Craniotomy
    • Surgery
    • Organ harvesting

Holly, 16, came into the ER with her sister after they were in a car accident. Alex saw signs of a basilar skull fracture, so they took her to CT and paged Derek. While getting the CT, she started crashing. She was bleeding out her nose and there was brain matter in her blood. They rushed her into surgery, but she hemorrhaged and her brain started swelling uncontrollably. She was pronounced brain dead. With her parents' consent, her organs were harvested for donation.

Emma Anderson[edit | edit source]

  • Diagnosis:
    • Mid-shaft transverse tibia fracture
  • Treatment:
    • Closed reduction
    • Casting

Emma, 15, came into the ER with her sister after they were in a car accident. Emma had a broken leg, which Callie reduced and casted.

Music[edit | edit source]

Song Performer Scene
"They Said I Said" Sugarush Beat Company
  • The interns try to figure out which resident will be awarded the solo surgery by spying on the meeting.
  • They report back to the residents with different results.
  • Bailey reveals she won the solo surgery.
  • Lexie comes in with the result.
"Winter Birds" Ray LaMontagne
  • Mark invites Bailey to operate with him.
  • Emma goes to visit Holly.
  • Dixon comes in and brings up organ donation without much tact, causing Emma to yell at her and break down.
"Secret" Max Morgan
  • Cristina writes her decision on the board. It's Alex.
  • Cristina tells Richard that Alex made the best case.
  • Alex goes to tell Izzie he won. He tells her she makes him want to be better, so he's not going anywhere. They can be scared together. He invites her to scrub in with him.
  • Denny tells Izzie he does not like Alex.
"Street Lights" Kanye West
  • Izzie is just in time to scrub in with Alex.
  • Owen brings Cristina to the vent room to unwind. They share a kiss.
  • Lexie goes to Mark's hotel room, starts undressing, and asks him to teach her.
  • The gallery's filled as Alex and Izzie get ready to start the surgery. 
  • Callie and Sadie smile at each other.
  • Dixon retrieves Holly's heart.
  • Alex makes the cut.

Notes and Trivia[edit | edit source]


Grey 's Anatomy 5x10 Promo

  • This episode's title originated from the song All By Myself, originally sung by Eric Carmen.
  • This episode scored 15.15 million viewers.
  • While Alex prepped for surgery, the residents took bets on whether he would fail or not, Meredith defended him saying it was one of them down there, the dialogue is very similar to when George performs the first surgery of all the interns in A Hard Day's Night.
  • Cristina was unanimously voted for as the recipient of the solo surgery by the attendings.
  • This marks the start of Lexie and Mark's first relationship.

Gallery[edit | edit source]

Episode Stills[edit | edit source]

Quotes[edit | edit source]

Mark: Stop!
Lexie: Teach me.
Mark: We can't do this, you're Little Grey, and I promised, and... I'm your teacher.
Lexie: So... teach me!
Mark: Lexie...
Lexie: Teach me. Teach me. Come on, am I really so bad?
Mark: No. I am.

Alex: Iz, I won!
Izzie: Hey, what time is it?
Alex: Yang, she picked me for the solo surgery!
Izzie: She did? That's amazing.
Alex: I love you.
Izzie: What?
Alex: I love you. I freaking love you. I just got the solo surgery and the first thing I did was look for you, and you weren't there. You're never there anymore. And I've been thinking about it, and I think it might be because you love me too. And you're scared of that. And cause I screwed it up last time, and cause Denny died, and...
Izzie: Alex...
Alex: Just listen, you had that heart patient and it reminded you of Denny and how bad you felt when you were laying there on that bathroom floor. I get that, I get that you're scared but you're not going to have to feel like that again. Cause I'm not gonna die Iz, and I'm not gonna cheat on you, and I'm not gonna go anywhere. Cause I think you're my best shot at.... I think with you, you make me better. You make me wanna be better, you make me wanna be good. And I think I can. With you, I think I can. So I'm not going anywhere, and you can stop hiding. And if you wanna be scared, that's okay. Just be scared with me. Be scared while you scrub in with me for my first solo surgery. Okay?
Izzie: You love me?
Alex: Shut up!
(They kiss.)
Alex: Solo surgery! (leaves)
Denny: I'm really starting to not like that guy.

Mark: You read up on my surgery?
Miranda: Since it's your first time performing what I understand to be a very cutting-edge surgery, I was hoping you could use another set of hands.
Mark: Fine. You can join Dr. Grey and me.
Miranda: Dr. Grey, who's been banned from the O.R.?
Mark: She's on cappuccino duty.

Miranda: Steve is not a lip reader. None of the interns are lip readers. You'll just have to wait for the attendings to vote. Just like I did when I won.
Cristina: You won your solo surgery?
Miranda: I'm gonna pretend you didn't feel the need to ask me that question Yang, of course I won. I was good. Didn't cut LVAD wires, put my hands on bombs in body cavities, or have my interns operating on themselves. I was special! I was young, gifted and black, and everybody knew it. Attendings knew it, Chief knew it. I didn't have to act like I could read lips. I'd just go about my work, calmly, waiting for my name to get called.

Richard: Choosing the first solo surgery isn't just about who has the best surgical skills. Or who's logged the most hours in the OR. It's about the highest form of trust. The trust to put a patient's life into one of our residents' hands. And for the first time I can recall, every single attending picked the same person. Dr. Yang. However, Dr. Yang is out of the running. She is going to pick the winner instead. Dr. Yang will post her decision on the O.R. board at 4 p.m. Also, since your interns are still banned from the O.R., the winner will be allowed to pick a fellow resident to scrub in with them. Good luck.

See Also[edit | edit source]

A complete overview of this episode's crew can be found here.

The Grey Matter blog post on this episode can be found here.

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