|“||As surgeons we are trained to fix what’s broken. The breaking point is our starting line... at work. But in our lives the breaking point is a sign of weakness and we’ll do everything we can to avoid it. Bones break. Organs burst. Flesh tears. We can sew the flesh, repair the damage, ease the pain. But when life breaks down, when we break down, there’s no science. No hard and fast rules. We just have to feel our way through. And to a surgeon there’s nothing worse, and there’s nothing better.||”|
George attempts to re-take his exam, Lexie discovers she has feelings for George and the hospital suffers severe flooding.
A happy Meredith tells Katharine that she's finished with therapy. Katharine says she's not. She's worked hard, but she's only scratching the surface. Meredith says Derek has moved in, but her therapist said it's not about Derek. Meredith says she is happy and thinks it's all about that, but Katharine disagrees. She wants Meredith to stay for another session, but Meredith gets up, thanks Katharine, shakes her hand, and leaves to go to the Chief's meeting.
Izzie enters her room and finds Derek in there. He's in there to measure the room, because he's thinking about making this room his office once she's moved out. Izzie asks when she's moving out and he says he hopes soon.
Izzie bursts into Alex's room and asks if he knows Meredith is making them move out. He says his busy, but his one-night stand says she can join if she wants. She's horrified, says no and closes the door as she leaves.
Alex, Izzie, and Derek catch up with Meredith at the hospital, all wondering when she was gonna tell Izzie and Alex that they have to move out. Meredith wonders why they have to move out. Derek doesn't want to live in frat house, but Meredith says she has to think about it. Izzie gives Meredith a homemade muffin and tells her to remember the muffin. Izzie and Alex leave and Meredith tells Derek she likes her roomies. He says they were her life, but this is their life together now.
Cristina is texting as she waits for the meeting to begin. Meredith sits down and tells her about what Derek wants. Cristina asks since when Meredith does what Derek wants, because she would be pissed off. The Chief gets on the stage.
In the audience, Erica asks Mark if he's heard anything about the new rules. He lists rules for romantic couples as he thought she was referring to her and Torres, but he's been wrong before.
The Chief begins his speech. He's implementing a new teaching protocol. There are new rules and old rules that are going to be newly reinforced.
Cristina is presenting a case to Hahn. Erica compliments her and rewards her by allowing Cristina to take the patient down after rounds, but Richard interferes and tells her that Alex will take over the case.
Richard tells the audience that first, second, and third-year residents will no longer be allowed to de facto specialize. That kind of practice interferes with a well-rounded surgical education.
Meredith presents a neuro case to Derek. None of the approaches they've tried has worked. Derek asks the patient about his pain level. The patient says 8, it's always an 8. Derek suggests a frontal lobotomy, which Cristina deems extreme for a headache. The patient is sensitive to noise and asks if they can do something about the machines buzzing. Derek tells the interns, residents, and the Chief that the patient has had intense pain for 7 years, but they're going to rule out every other option before the radical surgery. Richard tells Cristina she'll be assisting Derek today.
Richard tells the audience that personal relationships and favors will no longer be part of their training program. Attendings should spread their knowledge equally amongst all residents and they should focus on patient communication and bedside manner. For some of them, that means learning the lost art of humanity and compassion. For others, this means treating patients without becoming too emotionally involved.
Izzie presents a case of Shelly, a woman with cancer. They think a liver resection will cure her. The patient herself is really convinced it will. Jenn, Shelly's sister, wonders what happens if they find more cancer. The patient tells her they won't, and Izzie's already answered her questions three times. They love Izzie. Richard introduces Meredith and says she'll be taking over.
Richard says this a surgical program. Psychiatry is on the fifth floor, let's not confuse this. He adds that interns reflect on their residents. If they fail, their residents fail. He tells the attendings this goes for residents as well. He tells everyone to teach and learn with enthusiasm. They're surgeons, they cut out malignancies. Let's start in the program.
Richard and a proctor enter the conference room where George's been waiting to retake his exam. George says he's ready. Richard says he's got three hours to complete the test, starting when he breaks the seal. He wishes George good luck and leaves. George tells himself he can do this now that he's not cheating or married. As he wants to open the test, water drips onto it from a leak in the ceiling.
Alex is transporting his patient in a wheelchair, but the wheel seems to be broken. The patient says he attracts bad luck. Alex leaves to get another chair, but Mr. O'Brien gets up and says he can walk. A few moments later, he slips in a puddle of water and falls to the floor. Alex rushes to his side and yells for a gurney.
Richard and Alex help the patient get on a gurney. Richard orders a CT and demands hourly updates. He then tells a janitor it's raining here. The janitor says a pipe burst so they gotta turn the water off, but Richard says that cannot happen on a surgical floor where water is required. He asks that they fix it with the water on. Richard spots more leaks in the ceiling and as water drips on his head, George and proctor come over and tell him about the leak in the conference room. He asks if there's a different room he can take the exam in, but derives from Richard's face he can find one on his own.
Erica tells Callie that Mark's found them out. Callie says he's known since the beginning because he's the person she talks to. Erica wants to keep her private life private, most definitely from Mark Sloan.
Izzie notices a flyer for an apartment on the bulletin board and takes the paper off.
Jenn asks how long the surgery will take. Meredith says a couple of hours, but it may be longer if complications arise. Shelly says there won't and orders Jenn to call her parents and tell them it'll be 2 hours. Jenn leaves with her phone and Shelly says her sister can only talk about the cancer, so she asks Meredith to spill anything. Meredith asks if she wants to hear about her stupid boss or boyfriend. Shelly chooses the boyfriend.
Lexie, Derek, and Cristina are doing more tests on Barry. His pain's still at an 8. While she's observing the brain waves, Derek says Cristina would want the roommates out as well if she were him. He says she can drill burr holes by herself if she admits that. She does so. Derek changes Barry's position while Lexie approaches Cristina. She thinks she has an idea. Cristina tells her to know instead of think and sends Lexie out to get Barry's test results.
While Shelly's being transported to the OR, Meredith is talking about her roommate problem. Derek comes over and tells Meredith she should talk to Cristina. He walks off and Shelly compliments his hair.
Lexie tells Mark she's working with Shepherd on a pain patient and she read this article when she was helping George study and she has this photographic memory and she thinks the patient needs an ENT. She thinks she should speak up, since the Chief said interns are to be heard. She knows Mark is an ENT.
Mr. O'Brien is having scans taken. Izzie enters the CT booth and shows Alex the apartment ad. She can't afford it by herself and if he can get over himself, they can live there together. He says no thanks. He'd rather live in his car. As Izzie leaves, Richard comes in and asks if they're looking at a lawsuit. Alex says he doesn't look like the lawsuit type. Suddenly, the water streaming through a crack in the ceiling causes sparks in the CT machine before the lights go out. "Hello?" Mr. O'Brien asks.
Richard and Alex help the patient get up while Richard says he can't apologize enough. He wants this patient to be treated like a king. Jack lists more bad things that have happened to him and says God hates him.
Bailey and Meredith are operating on the tumors of their patient. Bailey talks about the beauty of general surgery. It's just you and your scalpel. They then see something bad inside the patient.
Richard finds a stressed George. He's missing George now that the hospital is in chaos. The proctor returns and tells George he's found a room. Richard tells George to go ahead, but George can't let it go and says he can help, since he's still Richard's intern for at least one more day.
Mark asks Derek to run a test on his patient. He's taking the teaching thing seriously and decided to actually listen to his intern. Lexie says she read something about swelling and compression of the ethmoid nerve, which they can test by running a lift up the patient's nose. Derek says okay. Mark introduces himself and runs the test. The patient starts screaming in pain and says that is what's causing the pain. Mark tells Derek a simple middle turbinectomy will fix it. Derek tells Lexie she did good.
Shelly wakes up after her surgery. She asks how it went. Bailey has to tell her the mets were more extensive than detected pre-op. They need to start a new round of chemo. Jenn gets a call from her oncologist and leaves to answer. Bailey apologizes for not having better news. Shelly asks Meredith what she decided to do about her roommates. Meredith says she's sorry for Shelly, who asks how good the boyfriend is.
Erica finds Callie and asks why Callie is talking to Mark instead of her, since they don't even know what they are yet. Mark comes in and detects he's interrupting. Erica sarcastically says his timing is perfect, which leads to Mark asking if that means they were about to feel each other up. Erica leaves angrily as Callie tells Mark to stop. He can't. Callie attacks him with grapes.
Meredith sits down with Cristina in the cafeteria and brings up the roommate problem. Meredith thinks it's the adult thing to kick them out. Cristina asks what her shrink said, but Meredith informs her she quit since they're happy. Lexie sits down with them and she calls George over. He's helping the Chief and now all his medical knowledge is disappearing. They all talk about their patients. Cristina thinks her patient is a wimp and she says her pain treshold is high. Alex tests this and confirms. Cristina asks Lexie how she diagnosed the patient. Lexie admits she remembered the article because of her photographic memory.
Bailey asks Richard what's going on with the flood. He tells her not to worry as it's minor. Bailey says that's what she thought when Tuck flushed an action figurine down the toilet, but she ended up with several inches of poop water in her kitchen. He repeats he's got it.
Izzie gets on an elevator with Cristina, Meredith, and Alex. The Chief has instructed her to move all pre-op patients to the clinic because of the flood and asks who can help her. Alex slaps Izzie to test her pain threshold, which appears to be low. Izzie tells Meredith to just kick Alex out. Alex only brings filth to the house. The doors open and water gushes in. The residents get out and wonder where all the water came from.
Richard is instructing people to move patients. The hallway is flooded and more water is streaming down from the ceiling. Bailey catches up with Richard and suggests they shut down and send patients to the other hospitals so they can fix the pipes. Richard says he's sending all the patients to dry ground and the broken pipe has been isolated. He's got it. Bailey still insists that lots of water has come out before they isolated it. Richard gets mad and yells at her to get down to the clinic. She's pissed and walks off.
Lexie asks George what's next. He wants to know sure if she's got time for this. She really wants him to take the test. Mark comes over and says that despite her terrible taste in men, she's not useless as she caught their patient's condition. She gets to scrub in now. Lexie says she can't scrub in as she's busy helping George. Mark says there won't be a next time and calls her pathetic.
Cristina enters Mr. Patmore's room to draw blood before the surgery. His pain level is still 8. Cristina says it looks like he's got some relief. Patmore tells her all he's been through: doctors thinking he faked or was a drug addict, test after test without any results, and his wife died last year. She was his best friend, but he couldn't feel that pain because he was so completely occupied with this one. Now he knows what's wrong and it'll be fixed, so, indeed, he'll get some relief.
Jack says he doesn't want to move as things will go wrong and he'll be in pain. Alex says he needs the surgery if he wants to live. Jack is not so sure he wants to live. Alex tells him about Rebecca and now his roommate is wanting to throw him out and he doesn't have a chance of getting a loan, so chances are he's gonna be homeless next week. Alex looks at Izzie at the other side of the room and tells Jack that there must be something worth living for, or at the least the possiblity of something. Jack says there's this girl at the grocery store he's interested in. Alex says the chances are his luck is going to turn around, and then he can finally say hello to that girl.
Izzie and Cristina got snacks from the vending machine and decide to share. Izzie tells Cristina she's not a terrible person. Izzie shows her the apartment she found and says it's perfect for Cristina, knowing it must be terrible for her to live at Burke's old place. She tells Cristina to think about it.
Bailey sits down in the gallery, where it's quiet.
Alex and Erica are operating. Alex tells her about the patient's superstition. Suddenly, water starts dripping from the ceiling. Bailey looks up and tries to tell them to move the patient, but they don't understand her. Then, part of the ceiling falls down, followed by a gush of water. Alex and Erica duck over the patient in an attempt to protect him from the water.
Hahn orders irrigation and tells Bailey to go find the Chief to inform him. Hahn wants a new OR, but a nurse tells her that all the ORs have been shut down except for this one and Sloan's. Erica sends out Alex to find out if Sloan can still close.
Mark is performing the surgery with Cristina and Derek watching. Derek is interested to watch, since he's a pain specialist. Cristina tells Derek to not ever use her again to influence Meredith. They're not team Meredith. Alex comes in and says they need the OR.
In the clinic, Richard's just heard the bad news. Richard decides to close the surgical floor and ship off the patients to the other hospitals. He tells Bailey to spread the word and to try not to gloat. She says no gloating.
Erica has moved her patient to the other OR. Mark, Derek, and Alex are inspecting the patient's abdomen. Alex finds a tumor.
Cristina finds Katharine and tells her she can't let Meredith quit. Katharine knows she's Cristina. Cristina says she's being supportive, so she doesn't get to have an opinion anymore. Katharine is her last hope. Cristina says Meredith lives her life at an 8. Derek doesn't get that, proven by the fact that he's asked her to throw her roommates out. Meredith needs them. She thinks she's happy, but it won't work out in the long run, and it's Katharine's job to tell her that. Katharine says it must be painful for Cristina to lose Meredith to Derek. Cristina says she's a terrible shrink.
Jenn asks Shelly to talk to her oncologist, but Shelly doesn't want to. Jenn gets a call and walks out. Shelly paged Meredith because she's dying and she needs to know what Meredith decided. Meredith closes the door. Shelly thinks Meredith's going to break up with Derek. Shelly says it's not fair that she's dying while Meredith gets to dump her hot boyfriend. She breaks down.
Jack wakes up and Alex informs him Hahn's coming in in a couple of minutes. Alex tells him about the ceiling collapsing, which led them to find a malignant tumor on his pancreas. Jack starts laughing when he hears he has cancer. Alex says it was still at stage 1, which is very exceptional. They took out the whole tumor and he won't even need chemo. The ceiling collapse saved his life. His luck's turned. Jack decides it's time to say hello to the girl.
George finds Richard and says he's downloaded all of the patient's labs and radiology on DVDs and attached those to their charts. He asks if there's anything else he can do. Richard looks at him.
Mark sits down with Lexie at Joe's. She asks how it went. She knows she's pathetic, but she only wants to hear about Mr. Patmore. Mark says they didn't get to do the surgery as Barry's shipped off to another hospital, but by this time tomorrow, he's gonna be pain-free. He asks her to recite the periodic table to test her photographic memory.
Cristina has shown the flyer for the apartment to Callie, who's very enthusiastic. Izzie comes over and asks Cristina what she thinks. Cristina says they love it and says it was really great of Izzie. They thank her. Izzie thinks they're kidding. She meant for Cristina to live there with her. Cristina apologizes. Izzie asks for the flyer, but Cristina informs her she already put down a deposit. Cristina says she should have been more clear. Izzie yells it's fine and leaves.
Callie sits down with Erica. She gets that Erica is a private person, but Callie processes her stuff out loud. She gave up too many pieces of herself in her marriage and she can't do that again. Mark is her friend. Erica smiles and she admits she just hates him because he's seen her naked.
Meredith's on an elevator with Katharine. Meredith asks her what the point was of all the hours and money. The world's a horrible place and it makes no sense to try and be happy in such a horrible world. Katharine admits horrible things do happen, but feeling happiness despite those things is not the point. Feeling horrible and knowing you're not gonna die from those feelings, that's the point. Katharine says Meredith is not done, because she's just started to talk about her feelings. Six months ago, it would've been just her and a bottle of tequila. Katharine says her door's always open.
Izzie is sitting on the swing chair on the porch. Meredith arrives and asks if she's okay. Izzie says she's really happy for Meredith and Derek, but she doesn't have anyone. Meredith sits down with her and says that's not true. Alex arrives too and greets them. He enters the house.
Meredith walks in and Derek tells her he's found her mother's vintage Martini set. Meredith says her roommates and Cristina are her family, and he doesn't get to tell them to move out and ambush her. He definitely doesn't try to get Cristina on his side. He says okay. He'd like to talk about it again when she's ready, but for now, okay. She sits down with him on the couch. She asks if he still loves her. He kisses her neck and says yes.
Richard and George enter the gallery. George asks if he's sure, because he's had a long day. Richard says it's one thing to give a speech, but if he really wants his teaching program to be the best, it starts with him. He can give George his shot, because he's earned it. George says he's ready. George sits down and Richard reminds him of the rules. George opens the exam and starts working on it while Richard sits down behind him and starts reading.
- Ellen Pompeo as Dr. Meredith Grey
- Sandra Oh as Dr. Cristina Yang
- Katherine Heigl as Dr. Izzie Stevens
- Justin Chambers as Dr. Alex Karev
- T.R. Knight as Dr. George O'Malley
- Chandra Wilson as Dr. Miranda Bailey
- James Pickens, Jr. as Dr. Richard Webber
- Sara Ramírez as Dr. Callie Torres
- Eric Dane as Dr. Mark Sloan
- Chyler Leigh as Dr. Lexie Grey
- Brooke Smith as Dr. Erica Hahn
- Patrick Dempsey as Dr. Derek Shepherd
- Amy Madigan as Dr. Katharine Wyatt
- Daniel J. Travanti as Barry Patmore
- Jim Ortlieb as Jack O'Brien
- Samantha Quan as Shelly Boden
- Suzy Nakamura as Jenn Smith
- Candice Afia as Intern Laura
- Amrapali Ambegaokar as Intern Dani
- Kate Anthony as Nurse Kate
- Tymberlee Chanel as Intern Claire
- Ariel Felix as Anesthesiologist
- Gloria Garayua as Intern Graciella
- Molly Kidder as Intern Megan
- Nelson Mashita as Proctor
- Miguel Nájera as Janitor Mike
- Joy Osmanski as Intern Lucy
- Mark Saul as Intern Steve
- Winston Story as Intern Leo
- Jennifer Sydney as Naked Hot Chick
- Joseph Williamson as Intern Pierce
- Katharine Wyatt (psychiatrist)
- Talk therapy
Meredith decided that she was happy and that she was done with therapy. She left her session early over Wyatt's objections. Cristina later went to Wyatt and urged her not to let Meredith quit. Later, in an elevator, Meredith stopped Wyatt to talk to her. After they talked, Wyatt told Meredith she wasn't done.
- Abdominal aortic aneurysm
- Pancreatic cancer
- Tumor resection
Jack, 47, was in the hospital for an abdominal aortic aneurysm repair. A CT showed calcification, so Cristina ordered a CT angiogram to see if he had worsened or remained stable. When his wheelchair broke, he decided just to walk the rest of the way, but he slipped and hit his head. While he was getting a CT for that, water shorted out the CT machine. After all that, he wondered if he should just not have the surgery because he had bad luck. Alex told him he needed the surgery to live, so he agreed to it. In surgery, the roof started to leak and ultimately caved in. They covered Jack's open chest and then prepared to move him to another OR. Because they were worried about debris from the roof, they opened the incision larger to search his abdominal cavity. While they were looking, they found a tumor in his pancreas. He thought it was another sign of his bad luck, but Alex said it was actually good luck because they caught it earlier than they usually catch pancreatic cancer. They removed the tumor and sent it to pathology. The tumor resection was considered curative.
- Anterior ethmoid neurovascular complex
- Middle turbinectomy
Barry, 63, had had severe headaches for the past seven years. He'd been given anti-seizures, narcotic pain medications, and anti-psychotics to try to treat them, but nothing helped. He said the pain was always at an eight, so Derek said a bilateral cingulotomy was indicated to treat the pain. However, he wanted to exhaust all other options first, so they ran more tests. While they were testing, Lexie had an idea and she went to get an ENT consult from Mark. Mark did an exam which involved looking up into Barry's nose. When he did, Barry identified the place he touched as the source of his pain. He said that a middle turbinectomy would fix it. Mark started to do the procedure, but when the OR was needed for an emergent patient due to the roof caving in in the other open OR, he was sent to another hospital for his surgery.
- Stage IV colon cancer
- Liver metastases
- Liver resection
- Palliative care
Shelly, 30, had stage IV colon cancer with liver metastases. She'd had aggressive chemo and radiation and they believed a partial liver resection could be curative, as long as they didn't find any more cancer. In surgery, they discovered new mets and so they told Shelly that they could manage her pain. Her sister talked to her oncologist about a clinical trial, but Shelly decided against it.
|"Cares at the Door"||Sia Furler||
|"Ha Ha"||Emilíana Torrini||
Notes and Trivia
- This episode's title originated from the song Here Comes the Flood, originally sung by Peter Gabriel.
- This episode scored 14.54 million viewers.
- Goof: When Mr. O'Brien fell, he obviously didn't actually hit his head.
Behind the Scenes
- Izzie: Eat the muffin, Mer. Taste the muffin. Remember. The muffin.
- Cristina: Um, how did you diagnose that nerve, because I've never even heard of that condition before?
- Lexie: I remembered an article from the "British Journal of E.N.T.". And it was issue number 47, page 19 from 1964. Photographic memory.
- Alex: Dude, lexipedia.
- George: I hate you.
- Lexie: Don't hate me. I can help you.
- Cristina: (to Derek) Don't ever use me again to try to influence her. Me and you are not Team Meredith.
- Izzie: What are you doing in here?
- Derek: I was thinking about making this my office when you move out.
- Izzie: When I move out? When am I moving out?
- Derek: Oh. Soon?
- Erica: We have a problem. Mark Sloan has found us out.
- Callie: Mark's known from the beginning. I told him.
- Erica: He's Mark Sloan.
- Callie: What? You don't have a person that you talk to about things?
- Erica: You are the person that I talk to about things. And I like to keep my private life private, from everyone. And most definitely Mark Sloan.
- Richard: (to the entire staff) Okay, we're busy people here, so I'm gonna try to be brief. I am implementing a new teaching protocol here at Seattle Grace. Some of these rules are new, and some are old and are going to be newly enforced. First-, second-, and third-year residents will no longer be allowed to de facto specialize, the practice inferes with the developement of a fully rounded surgical education. No more. Personal relationships, personal loyalites, and personal favorites will no longer be a factor in our training program. Attendings, you will spread your wealth of knowledge equally among all of the residents. In addition, we will refocus our attention on patient communication and bedside manner. For some us this means using the lost art of humanity and compassion. For others this means learning how to treat patients without becoming emotionally involved with them. This is a surgical program, psychiatry is on the 5th floor, let's not confuse the two. In addition, residents, your interns reflect on you. If they fail, you fail. If they succeed, you succeed. Attendings, that goes for residents as well. Teach with enthusiasm, learn with enthusiasm. We are surgeons, we cut out malignancies. Let's start at home people.
- Dr. Wyatt: Yes. Horrible things do happen. Happiness in the face of all of that? That's not the goal. Feeling the horrible and knowing that you're not gonna die from those feelings, that's the point.
- George: I can do this. I'm not married and cheating on my wife with my best friend. Everything is as it should be.
A complete overview of this episode's crew can be found here.
The Grey Matter blog post on this episode can be found here.
|Grey's Anatomy Season 5|
|#01||"Dream a Little Dream of Me, Part 1"||#09||"In the Midnight Hour"||#17||"I Will Follow You Into the Dark"|
|#02||"Dream a Little Dream of Me, Part 2"||#10||"All By Myself"||#18||"Stand By Me"|
|#03||"Here Comes the Flood"||#11||"Wish You Were Here"||#19||"Elevator Love Letter"|
|#04||"Brave New World"||#12||"Sympathy for the Devil"||#20||"Sweet Surrender"|
|#05||"There's No 'I' in Team"||#13||"Stairway to Heaven"||#21||"No Good at Saying Sorry (One More Chance)"|
|#06||"Life During Wartime"||#14||"Beat Your Heart Out"||#22||"What a Difference a Day Makes"|
|#07||"Rise Up"||#15||"Before and After"||#23||"Here's to Future Days"|
|#08||"These Ties That Bind"||#16||"An Honest Mistake"||#24||"Now or Never"|
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