Grey's Anatomy Universe Wiki
Grey's Anatomy Universe Wiki

When you're little, night time is scary because there are monsters hiding right under the bed. When you get older, the monsters are different. Self doubt, loneliness, regret. And though you may be older and wiser, you still find yourself scared of the dark. Sleep. Its the easiest thing to do. You just close your eyes. But for so many of us, sleep seems out of grasp. We want it, but we don't know how to get it. But once we face our demons, face our fears and turn to each other for help, night time isn't so scary because we realize we aren't all alone in the dark.

In the Midnight Hour is the ninth episode of the fifth season and the 87th overall episode of Grey's Anatomy.

Short Summary[]

Cristina and Meredith come to Lexie's aid after a routine surgery goes wrong, Izzie is distressed over the appearance of Denny, Derek and Mark take a case which reminds them of their childhood as all the doctors admit they need somebody.

Full Summary[]

Meredith's voice over talks about the monsters adults face at night.

Self doubt, she says, as she and Cristina are operating by themselves, looking panicked.

Loneliness, she says, as Callie lies on the floor in the ER with a bleeding nose.

Regret, she says, as a regretful Lexie sits in a hallway.

Izzie tells herself she's crazy, but Denny disagrees. He's a dead man who loves her, but she touched him. She thinks she's reliving moments. This is residual grief. In that case, they have to do something they never had the chance to do in real life. He takes off his shirt and they kiss as they fall down onto the bed.

Cristina arrives at the ER as Owen's waiting in the ambulance bay. She's here for a possible appy, the ambulance is on its way in. He wants to say something, but can't bring himself to do it, so he asks how she beat the ambulance. She says she lives across the street. She goes inside.

Meredith's reading on the bathroom floor as Sadie comes in to pee. The sofa sucks, so she's barely slept. Meredith says she's reading her mother's journals from when she was a resident. They hated her mother, but Meredith now thinks she would have liked her if she hadn't been her mother. She's funny and intense, like Cristina. Sadie only gets the former from Cristina. Meredith tells Sadie to give Cristina some time, as she is loyal and Sadie is gonna need some allies around here. Sadie thought about Lexie as an ally, but Meredith tells her she was raised right with rules and smiley posters, so no. Meredith gets paged on her sparkle pager about the appy. Loyalty, she says. Sadie says she'll come with Meredith.

Out in the hallway, they hear Izzie moaning in her room. Meredith is confused when Alex gets out of his room. He bribed a nurse to page him for an appy. Meredith wonders who's in there with Izzie then. "Derek?!" she yells. Derek stumbles out of their room and comes over. He asks who's making a porno in Izzie's room. Alex says she's flying solo and knocks and tells Izzie they have to go for the appy. Sadie yells she's ready from downstairs, and Meredith explains to Derek she's living here for a couple of days. He says no more strays. Izzie opens her door all sweaty, and says she's going to skip the appy as she "has the flu".

Bailey arrives in the ER, only to find Meredith, Cristina, George, and Alex waiting. She figures out they heard the Chief chose an appendectomy as the solo surgery the last two years, and now they're here to learn from the master. She says it's kinda cute. She can use two of them. Owen brings in his patient, a man who fell from a second story window. He needs a resident and Bailey assigns George, as he is on call. A nurse comes over to ask Bailey for another resident for a patient with abdominal pain. Bailey assigns Alex. He says he's here to help in any way he can.

In the basement, the interns are testing on Steve where he can feel. Sadie comes in to inform them the residents are in, and asks what they're doing. Lexie says they gave Steve an epidural. Steve has peed himself and they realize they forgot the catheter. Sadie is impressed with Lexie and says Meredith is wrong about her. She says Meredith called her a priss. Lexie then says they can take out Steve's appendix as he doesn't need it. They can find an empty OR and do it there, and Steve can stay under the epidural. They can switch shifts so he can recover, but Steve refuses. Sadie says they can take out hers, then.

Callie tells Mark their patient fell through a window as he was sleepwalking. He must have no idea how he got in the hospital. Callie says that's like her life: married, betrayed, gay, abandoned, and no idea how she got here. This must be as bad as it gets. They enter the trauma room, where Derek ordes a head CT. The patient wakes up and starts fighting the doctors as he thinks someone is going to kill his daughter. He doesn't hear his daughter saying she's right there, behind him. As the doctors try to restrain him, he hits Callie on the nose and she falls down.

The interns are looking for a place to do the appendectomy. They think outpatient surgery is the place to be. Meredith comes over and asks if they're looking for something. Lexie pretends they're giving a tour and continue. Sadie tells Meredith she's sticking to her allies. Meredith reminds her about the posters.

Alex enters the exam room to meet Lauren Hammer, who has stomach pain. Seth, her husband, tells Alex she thinks she has stomach cancer because the Internet told her. Lauren says she's not a hypochondriac. Alex takes a look and concludes it's not her appendix, which he's bummed about. He's going to need a stool sample.

Mark is taking care of Callie's nose. Three weeks from now, nobody will be able to tell something happened. Callie says it hurts more because of the crappy year she's had. He says they'll use conscious sedation so it'll be a new day when she wakes up. She says she at least still has him. 

Arthur can't believe he hit a doctor. Owen says his daughter Ivy told them he jumped out of the window because he was having nightmares. Arthur says the nightmares started when his wife died a couple of years ago. He went to the sleep clinic and they told him it was stress induced. He hasn't had an episode in a while, so he must have forgotten to take his pill tonight. He thinks his daughter must have been scared, but she's okay. She's just worried about him.

Mark runs into Lexie in a supply closet, as there are no interns around to get him an IV kit. Lexie says the interns are busy. Derek comes in and Mark clarifies he just ran into Lexie in the supply closet. Lexie leaves and Mark says he didn't do anything to Lexie.

Meredith, Cristina, and Bailey are operating. Meredith and Cristina are asking questions. She says they're thinking so hard it makes her tired to look at them.

Sadie is numbed and the other interns are ready to do the appendectomy. Sadie finds it comforting that Lexie grew up with parents and rules and smiley face posters. Lexie marks the incision, using medical textbooks as a reference. She says it's a great day to save lives, as Shepherd always does it. She asks for the scalpel, but says this is a bad idea before she makes the cut. She says they can use their frustration for better, legal things, like demanding better education. Sadie grabs the scalpel, makes an incision, and tells Lexie to just take out her appendix.

The interns are doing the appendectomy. They use a mirror to show Sadie her appendix. Lexie says it looks a little inflamed. If it's inflamed, it's not routine procedure. Graciella says they should call a resident. Sadie says she can't handle anyone panicking, so they should leave if they can't handle it. Graciella leaves. Lexie continues the surgery.

Mark finds Ivy watching TV in her father's room. Ivy asks about Callie, and Mark tells her she'll be okay. Ivy is sorry. If she'd been able to get her dad back to bed, this wouldn't have happened. She usually can talk him into going back to bed. Mark thought it hadn't happened in a while. He asks when was the last time she slept. She says she's not that tired. Mark tells her to get some rest.

Lauren confesses to Alex she ordered antibiotics online to kill a staph infection. Seth can't believe she did that, as the dermatologist said it was just a pimple. Lauren says it went away after the drugs. Alex says she now has C. diff, which won't go away. She killed all the healthy bacteria in her body, so they have to introduce new bacteria. They have to perform a fecal transplant, and the donor has to be someone she shares daily germs with. Seth only consents until Lauren admits it was a pimple. Lauren won't do that.

Meredith says none of her interns are answering their pages. Cristina asks Graciella, who walks by, where the other morons are. Graciella pretends she doesn't know. Cristina takes her chocolate and tells her to go away. Alex asks Meredith and Cristina where the interns are, as he needs someone to page him when Seth is ready. Meredith wonders if they're in the skills lab. Alex says it did his interns well, as they can now put in IVs. Cristina realizes what they're up to and walks off. Meredith asks Alex what's wrong with Izzie, but he doesn't know. He's sick of people not talking to each other. As Meredith gets a page, Lexie comes over and asks her if she has a second.

Cristina enters the room in the basement and finds Steve charting in a bed. She asks where her other interns are. He doesn't know. She asks him to come with her, do the post-op for the appy, and tell her all about the problems he and his friends are in to. Steve says no. He can't walk due to the catheter and the epidural.

Izzie is in bed with Denny. She can hear his heart beating, which is odd as they took it out for the autopsy. She says this isn't real, but he says it is. She decides to keep her eyes closed because it's like that one moment in the morning where dreams feel like they're possible and true. Anything can be real until you open your eyes.

Ryan is suctioning Sadie's blood by himself. Lexie arrives with Meredith and Cristina runs in shortly after. He tells them he thinks Sadie is dying.

Cristina and Meredith are getting gowned and gloved. Sadie's blood pressure is low. Lexie asks if she should call a code, but Cristina says there is no code team in the middle of the night in outpatient surgery. Meredith asks Lexie to page the Chief and Bailey for an emergency.

Mark tells Derek he thinks Arthur's night terrors are happening more than he knows as his daughter is exhausted. He says it must be scary not to know what you're gonna wake up to. Derek says that's like living with Meredith, who takes in strays. Mark says it's his fault he's now thinking about Little Grey. Derek planted the seed. Derek tells him to unplant it.

Lauren tells Seth she believes that he believes that it was a pimple. He says no poo for her. Alex says it's better that she's telling him what's real for her than lying to him. He should stop walking away. Lauren still thinks this could be stomach cancer. She always thinks the worst. The world is a scary place. Lauren doesn't see how he doesn't see that.

Ryan finds Bailey and tells her there's an emergency in outpatient surgery. He asks her to come.

Derek wants to do an EEG on Arthur, as there's a chance his nightmares are caused by seizures in his frontal lobe. They have reason to believe his problem is worse than he thinks. Arthur says he just forgot his pills, but Ivy says he did not. They did everything they usually do, which includes him taking his pills. Ivy confesses she tries to stay awake at night as she can usually talk him back to bed, but tonight, she must have fallen asleep. She didn't want to cause him stress as that causes the nightmares. Mark tells her they may be caused by the epilepsy. If the test confirms that, that means it wasn't her fault. Arthur consents to the test.

Izzie wakes up and finds Denny gone. She puts on a robe as she yells his name, but then sees him standing in the doorway. She says he can't just disappear. He told her he's here for her. Izzie says he left her all alone. Denny says she's not alone anymore. She was over him and got a life with a job and a boyfriend and now she's talking to herself and going crazy. He says he's sorry he died. She says he doesn't get to apologize for dying because she was the one who killed him. She sits down on the bed and he sits down next to her. He tells her he loves her. She reciprocates.

Bailey arrives in the OR where Meredith and Cristina are working on Sadie. Lexie confesses it was her idea. Meredith tells her the interns's stitches came off. Sadie is really bleeding. Meredith says she needs a partial cecectomy. Cristina panics as she has no visualisation, but Bailey guides her to feel instead of see the problem. Cristina places the clamp and Meredith ties it off. She lets Meredith pick the suture.

The interns are lined up in hallway. They all fear they're going to jail. George arrives. He just heard and asks Lexie what happened. Lexie should have come to him, as he might have been able to stop her. Lexie says this was the one thing she did in the last few months that wasn't about getting him to notice her. This was all her. Graciella wonders how George missed the fact that Lexie is in love with him.

Lexie sees how Richard is talking to Meredith and Cristina and then walks into a conference room.

Izzie gets paged 911. She has to go. She wonders if Denny goes back to heaven or wherever now to talk with his friends about the last night he gave her. He jokes they usually talk about sports, and then tells her he's not going anywhere.

Alex is ready for the transplant. Lauren apologizes to Seth for all her crazy. Seth says he loves her anyway. It's finally time for her to take his crap. He thinks it's better if he doesn't see this, so he'll be there for his wife in the lobby.

In the OR, Derek, Owen, and Mark have eliminated the seizure area. Derek can't believe Arthur didn't notice. George says it's not his fault, as he thought his daughter would have told him. If you really love someone, you talk to them. Owen says they didn't know what went on between them, as sometimes words fail.

Mark tells Ivy her dad will be in surgery for at least another hour, so she can take a nap. She's drinking coffee as she likes the taste. Mark tells her he was raised by parents who weren't interested in having kids. They weren't around much and he'd turn on all the TVs and every light in the house before he went to bed, and he still couldn't sleep. It's hard to sleep when you don't feel safe in your own house. Ivy understands the feeling. Mark takes the coffee from her and orders to sleep. He'll be there for her. She rests her head on his shoulder and closes her eyes.

Richard says he was finally sleeping when he got a call. Meredith still can't believe what happened. Richard tells her not to beat herself up too bad, as he's seen a lot of maturity throughout the mess. She and Cristina handled the crisis and they called for help right away. A time not so long ago, they would have tried to hide the mess. Sometimes, it's just hubris to protect your colleagues, not solidarity. He's glad to see they know the difference. Lexie barges in and says it's not right to blame them, as she didn't listen when Cristina told her to shut it down. Richard can't believe Cristina knew. 

Out in the hallway, Meredith is mad at Cristina, who clarifies she only knew they were doing sutures. She thought she had shut it down. Meredith points out she didn't as Lexie almost lost her job, and Sadie almost died. Cristina says Sadie did that to herself, and Meredith shouldn't pretend she cares about Lexie. Meredith says she cares about her job and doing the right thing. Cristina reminds Meredith she's not an attending yet, despite sleeping with one, so who is she to lecture her on the right thing? Meredith asks if it's about Derek, but Cristina says it is about Meredith not having her back in that room. She should have said something to defend her. This is not just on Cristina as they all had interns in that room, yet Cristina is the only one taking blame. Now she's out of the running for the solo surgery. They all failed and if Sadie had died, that would have been on them too. Meredith should have said that.

Alex, George, Meredith, and Cristina were wondering what Bailey is gonna say to the interns. She won't say anything. She raised her babies, and they are grown now, so they can raise their own babies. Meredith asks what they can say. Bailey knows they don't need the speech from her, because she knows she raised them right.

The residents and their interns walk into Sadie's room. Lexie and Ryan present the case. Lexie tells Sadie they made mistakes that reflect bad on the hospital, which won't happen again. Meredith says that effective immediately, all interns present are on probation. None of them will see the inside of the OR again until further notice. They lost the Chief's and the residents's respect, which is hard to get back. Pierce tells Alex he still seems to respect Izzie despite the fact that she killed a patient. Alex says that's different as she tried to save a man's life, while they almost killed Sadie for fun. Izzie appears in the doorway.

Bailey visits Callie in the clinic. Callie asks if she heard correctly that the interns went crazy. Bailey confirms that. Bailey can remember what it's like to be an intern, being so excited about medicine and wanting to operate. Now, she can do most of her surgeries without thinking about it. It's like driving. She doesn't remember most surgeries or the lives she saved. The residents are working so hard for a surgery that she's come to hate. Appys bore her. Maybe she doesn't want to do general surgery after all. Maybe she needs a new challenge to make her excited again. Or maybe, she's just tired. Callie is exhausted, too.

Mark puts a sleeping Ivy on a bed in her father's room.

Sadie wakes up as Meredith enters her room. Meredith tells her it was irresponsible, and it makes Meredith question if Sadie has what it takes to be a good doctor. She wonders what's going on with Sadie. Sadie doesn't know.

Mark and Derek see Lexie sitting in the waiting room. Mark tells Derek his mother used to take him home, seeing how tired he was and deciding he needed a family. That was a good thing. So either Derek brings Lexie home, or Mark will.

Owen is sitting outside Cristina's apartment as Cristina comes home. He doesn't know why he came here. He doesn't want to come in as it wouldn't be appropriate. He also doesn't want to go someplace else. She sits down with him on the doorstep. Owen thinks Cristina is beautiful.

Meredith finds Lexie in the kitchen. Derek is in the laundry room. He's going to make up a bed for her. He brought home a stray.

Upstairs, Alex tells Izzie he's going to get some sleep as he has to be back at the hospital in 6 hours. Izzie tells Alex she's a mess. She's sorry. He deserves better. He stops her. If she doesn't want to be with him, it's okay, but she'll have to break up with him. He can handle the mess, so he's not going anywhere. He asks if she's coming to bed with him. Before walking into his room, she turns to Denny, who's standing in the doorway of her room, and tells him she's sorry. He says it's okay. He'll be right there. She closes the door.


Main Cast[]

Special Guest Star[]

Guest Stars[]


Medical Notes[]

Sadie Harris[]

  • Diagnosis:
    • Severe hemorrhaging
  • Treatment:
    • Appendectomy
    • Lactated ringers
    • Partial cecectomy
    • Antibiotics

Sadie, 30, offered to let Lexie remove her appendix as practice. When they opened her up, however, they saw that her appendix was inflamed, meaning it wasn't a routine procedure. When they realized they were in over their heads, Lexie came to get Meredith. Meredith and Cristina ended up removing a portion of her cecum. They expected her to be fully recovered in two weeks.

Arthur Soltanoff[]

  • Diagnosis:
    • Head trauma
    • Multiple fractures
    • Lacerations
    • Left tibia/fibula fracture
    • Epilepsy
  • Treatment:
    • Clonazepam
    • Stitches
    • Surgery

Arthur, 45, fell from a second-story window while sleep-walking. He had multiple fractures, head trauma, and lacerations. He had free fluid in his abdomen and they ordered a head CT. He told the doctors he'd been taking clonazepam for the sleep-walking. When they discovered that his night terrors were worse than he thought, they looked for other causes. They ran an EEG, which confirmed a form of epilepsy in his frontal lobe. They took him into surgery to correct the problem and repair the injuries from his fall.

Jason Kron[]

  • Diagnosis:
    • Appendicitis
  • Treatment:
    • Appendectomy

Jason, 47, came into the ER with tenderness over McBurney's point, indicating appendicitis. Bailey took him into surgery to remove his appendix.

Lauren Hammer[]

  • Diagnosis:
    • Clostridium difficile colitis
    • Hypochondria
  • Treatment:
    • Fecal transplant

Alex was sent to tend to a patient with several abdominal pain. Lauren believed she had stomach cancer after searching the internet. Alex noted that she didn't have appendicitis and said they needed a stool sample. She admitted that she'd used antibiotics she bought online to kill a staph infection she believed she had. The antibiotics had killed off the healthy bacteria, causing C. diff. She needed a fecal transplant to introduce a new colony of bacteria. Her husband provided the sample and the transplant was successful.

Callie Torres[]

  • Diagnosis:
    • Broken nose
  • Treatment:

Callie was hit in the face by a patient having a night terror. The hit broke her nose, which Mark fixed under conscious sedation.


Song Performer Scene
"Boys With Girlfriends" Meiko
  • Meredith and Cristina notice their interns have disappeared. Cristina realizes what they're up to.
  • Alex is done with people not talking.
  • Meredith gets paged as Lexie approaches her.
"Quiet Times" Dido
  • Izzie and Denny are naked in bed.
  • Izzie loves that this feels real, like a dream in the morning right after you wake up.
"No Time to Sleep" Tina Dico
  • Izzie wakes up looking for Denny. She yells at him for disappearing on her and admits she feels guilty.
  • They tell each other they love each other.
  • Bailey guides Cristina and Meredith to fix the problem with Sadie.
  • The other interns are worried.
"Ocean and a Rock" Lisa Hannigan
  • Denny tells Izzie he's not going anywhere.
  • Lauren apologizes to Seth for her crazy.
  • George and Owen talk about talking to people you love and how words can fail.
  •  Mark sits down with Ivy and talks about the way he was raised. He gets her to sleep leaning on his shoulder.
"Ordinary Girl" Waz
  • Mark carries Ivy into her father's room.
  • Meredith yells at Sadie about her surgery.
  • Mark tells Derek to bring Lexie home with him.
  • Cristina and Owen talk outside her apartment.
  • Meredith sees Derek brought Lexie home.
  • Izzie tells Alex she's a mess, but he can handle it.
  • Izzie apologizes to Denny and joins Alex as he goes to bed.

Notes and Trivia[]


Grey's Anatomy Promo 5x09

  • This episode's title originated from the song In the Midnight Hour, originally sung by Wilson Pickett.
  • This episode scored 15.74 million viewers.
  • This episode begins at about 3 A.M.
  • This episode features a guest appearance by Joshua Malina, who portrays David Rosen in Shonda Rhimes's other TV show Scandal.


Episode Stills[]


Derek: Who's making a porno in Izzie's room?

Izzie: This isn't real, is it? I'm just gonna keep my eyes close because this is like that moment in the morning when you first wake up and you're still half asleep and everything seems... things are possible, dreams feel true and for that one moment between waking and sleeping anything can be real, and then you open your eyes and the sun hits you and then you realize that... I'm just gonna keep my eyes closed.

Izzie: Alex, wait. I'm a mess. I'm a frickin' mess and I know that and, I... you deserve better.
Alex: Stop it. If you don't want to be with me, if this is too much for you right now, it's okay. But you're gonna have to break up with me, because I'm not going anywhere. I can handle the mess. It's up to you.

Richard: I've seen a lot of maturity from you throughout this whole mess. You handled the crisis. And you call for help right away. There was a time not so long ago when you would have come to a different conclusion. You could have stuck to the code and saved your own. Tried to hide the whole mess. You know sometimes, protecting your colleagues is solidarity. And sometimes it's just hubris. I'm glad to see you know the difference.

Cristina: Okay, Sadie did that to herself. And let's not pretend that you have some sort of relationship with Lexie? Let's not pretend that you care about her.
Meredith: I care about my job! And I care about doing the right thing.
Cristina: Who are you to lecture me about doing the right thing!? Are you kidding me? You're not an attending, Meredith. You may be sleeping with one, but you aren't one yet.

Meredith: Is that what this is about? Derek? It's always going to be about Derek?
Cristina: Okay, fine, it's not about Derek, it's about you and me, and the fact that you didn't have my back in that room!
Meredith: What would you have wanted me to say...
Cristina: I don't know, anything! You should have said anything! You have a relationship with the Chief. You have his ear. But you didn't say anything to defend me! Because this isn't just on me. You just stood there and you watched him take me out of the running for solo surgery. You let me take all the blame. But the fact is that we all had interns in that room. We all failed to supervise them. And if your friend had died in there, that would have been on all of us too. You should have said that.

Sadie: Death is so wrong about you.
Lexie: What did she say?
Sadie: That you're a priss.

See Also[]

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

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