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It's a look patients get in their eyes. There is a scent, the smell of death. Some kind of sixth sense. When the great beyond is headed for you, you feel it coming. What's the one thing you've always dreamed of doing before you die? Okay, hello? Clearly not my dream. See, I told you. Not my dream.

It's the End of the World is the sixteenth episode of the second season and the 25th overall episode of Grey's Anatomy.

Short Summary[]

Meredith has an overwhelming feeling she's going to die today - until Cristina forcibly kicks her out of bed. Bailey returns to deliver her baby as her husband ends up on Derek's operating table. Meredith's feelings prove true, as a bomb in a body cavity enters the ER.

Full Summary[]

While Meredith's voice over talks about how you have a sixth sense that tells you when you're going to die, there are flashes of a crying Meredith and Derek standing in a completely empty OR.

Meredith, Izzie, and Cristina are naked in the shower together, soaping each other up. George opens the door and Izzie tells him he's the most masculine man she's ever seen. Cristina tells him he's smarter than her and she compliments his hair. Meredith tells him she's always been and will always be in love with him. He gets in the shower with them and drops his towel onto the ground.

George rolls out of bed and wakes up from his dream. Izzie comes in, carrying a box of cereal, and tells him he's got to use a plunger if he clogs up the toilet again. She says something's wrong with Meredith.

George and Izzie are in Meredith's room. Meredith refuses to go to work today. She doesn't care about surgeries.

Cristina is in the room now. She's heard that Meredith has a feeling. Meredith says she feels like she might die. Cristina says everybody dies eventually, but now they're late. Cristina decides to be supportive and sits down to listen. Meredith says the man she loves has a wife and he chose that wife over her. Addison has her McDreamy and her McDog, and Meredith has nothing. Meredith can't even remember the last time they kissed, because you never know the last time is the last time. Also, her conditioner stopped working and she thinks she has brittle bones. She needs something to happen. She needs some hope in order to convince herself to go on. In the absence of hope, she's gonna stay in bed and feel like she might die. Cristina jumps onto the bed, says everyone has problems, and starts kicking Meredith out of bed. As they leave the room, Cristina tells George and Izzie they're good to go.

Burke joins Richard in front of the OR board. It's a quiet board, which is a bad sign. Derek joins them and also comments on the board. Richard repeats a quiet board bodes bad news and walks off. Derek thinks it's time he and Burke start calling each other by their first names given how closely they've worked together. Burke thinks not.

Cristina is aching for some OR time. She, George, Izzie, and Alex enter the ER while commenting they miss Bailey because all the other residents suck. Meredith takes a moment before following them. Derek asks if she's all right. She says she has a feeling. He knows that, but promises they pass if you wait long enough. She then walks into the ER. Addison comes over and asks Derek what he's doing. He says he's waiting for it to pass. She wonders what.

The five interns are waiting in the ambulance bay. Izzie tells Alex that while she may have forgiven him for sleeping with someone else, her legs are closed for him now. Cristina wonders which surgeon they're gonna have to suck up to today. "That would be me," Bailey says as she comes out of the ER. She's only been gone for 2 weeks and her interns ran off 2 residents. People are phoning her at home to complain about them while she's supposed to be on bed rest. George steps forward and hugs her. She tells him to get off. Bailey tells George to page Addison, and she asks to get a wheelchair. The others can wait for the ambulance. George wonders what to tell Addison. There's a sound of splashing water. "Tell her my contractions are 10 minutes apart and my water just broke all over your shoes," she tells George. Izzie and George take Bailey inside.

Alex, Cristina, and Meredith go to the arriving ambulance. A screaming woman climbs out. Alex and Cristina are surprised to see that one of the paramedics has her hand inside the patient's body cavity.

Cristina tells Burke about James Carlson, the patient with the large sucking chest wound. Burke brings up she was gone when he woke up. She says she had a thing to do. He says once again, she's a little bit crazy.

They enter the trauma room where Meredith updates them on the man's status. Burke wants the man intubated and he orders them to place an occlusive dressing over the wound. Hannah, the paramedic with her hand inside the patient, says her hand was the only thing that'd stop the bleeding. Hannah's partner advised her not to do it. Burke asks him to leave the room. Hannah thanks him, but Burke tells her she's won herself a trip to the OR. He tells Meredith to prep the patient for transport, and Cristina can occupy herself with the screaming woman so she can find out how this happened. Cristina regrets rousing OR-bound Meredith, as Burke's given her "a thing" to do and missed out on the good case.

Mindy just keeps on screaming. Olivia informs the interns that there's an MVC accident 5 minutes out. Izzie and Cristina head to the ambulance bay, and Cristina tells Alex to shut Mindy up. Alex tries to ask Mindy some questions, but she really won't stop screaming. He suddenly screams loudly, which makes her stop screaming but leads to her starting to sob uncontrollably.

Richard finds George lurking outside of the room where Addison is examining Bailey's cervix. Richard orders him to stop looking. George is pretty amazed by the miracle of life. Richard says it feels good to have Bailey back. Derek asks what's going on and peeks through the window. He comments he'll never get that visual out of his head and Addison comes out of the room. Derek leaves and Addison says Bailey's refusing all pain meds. Bailey comes out of her room. Richard asks if there's something he can do for her. Bailey replies that unless he can give her a new vagina, no. She doesn't need the attention, it's just childbirth. She only needs her husband. George asks for his number so he can call him. Bailey says she doesn't want to see either of them again until after the baby's born.

In the trauma room, Izzie and Cristina are working on the MVC victim. He keeps asking about his wife. Derek comes in. Izzie informs him the patient is Tucker Jones. He has a depressed skull fracture and an epidural hematoma. Izzie takes the meds as Tucker's phone rings. While Tucker has a seizure, Izzie answers the phone and she's surprised to hear George. By talking to him, she realizes that the patient is Bailey's husband. Derek and Cristina take Tucker to the OR.

Hannah's in the OR. She says her hand's getting numb, and this is not good for her gag reflex. Meredith says she can go once Burke scrubs in. Hannah says it's her second week as a paramedic. Meredith says she's rather new at this herself.

Derek and Burke greet each other. Addison's heard about Tucker's accident and wonders what to tell Bailey. Derek tells her to wait until they have something concrete to tell her. When she says bye to Preston, Derek is surprised to find out they are on a first name basis. Burke says he likes Addison, and replying to Derek's question- not Derek. They both head to their ORs.

Tucker is about to be put under. Tucker knows who Derek is. He says Bailey really likes him. Derek says he likes her, too. Tucker says they are having a baby. Derek promises to take care of him and get him back to Bailey safe and sound.

Mindy's gotten into a gown. Nurse Tyler was surprised that all the blood on her clothes wasn't hers. Her acute anxiety reaction from earlier aside, she's fine. Alex gave her some meds to calm her down. Mindy says she's absolutely in shock. She's going to kill her husband for scaring her like this. Just as Alex asks her how James got injured, someone enters the ER looking for Mindy. She tells him about James's condition. She calls him and James idiots. They put on costumes and play with their self-made toys. Paul says they reenact World War II, which is not playing. Mindy and Paul say that he and James build a bazooka replica. They went into the backyard and tried to shoot the thing. Paul says James is the loader. Mindy says it didn't work, so James went to stand in front of his big gun. That's when the stupid toy started working. Alex verifies if James actually shot himself with a bazooka. He asks if there was an explosion. Paul says no. Alex runs off. Mindy has no clue what's happening.

Alex runs to the OR, ignoring Richard's warning to slow down.

Derek starts opening up Tucker's skull.

Bailey tries to call her husband again.

Burke gets ready to do a thoracotomy so Hannah can pull her hand out. Meredith is going to clamp the bleeding when they have more exposure. Hannah is ready. Burke asks for the scalpel.

George notices that Tucker's phone is ringing in the trauma room. Bailey is leaving him a message, saying he better be lying in the street somewhere dead. She's having his baby.

Right before Burke starts cutting, Alex bursts in and says they really have to talk. Burke walks up to him and Alex asks if there was an exit wound. Burke says no and wonders why. While Alex delivers the news to Burke, Hannah asks Meredith if Alex is single. The OR staff wonders what's going on. Burke turns to Hannah and asks what she feels inside the patient, metal maybe? Hannah says her fingertips are touching something hard. The anesthesiologist, Milton, realizes something's wrong. Burke tells Hannah she can't move. Hannah says she's scared. Burke tells her everything will be fine, and he asks Meredith to go tell the charge nurse to call the bomb squad, because they have a code black.

Outside the OR, Alex says Hannah may die because she was trying to save the patient. Burke comes out of the OR and tells all the personnel in the hallway to go. He'll wait for the bomb squad with Hannah. Meredith decides to stay as well, among some other people. He tells them to wait by the elevator until the bomb squad has done their job. Until then, it'll be just him and Milton.

Addison is trying to ease labor for Bailey. She mentions that an epidural is not a shame as George walks in. Bailey refuses because it increases the chances of a C-section. Addison tells Bailey this is a big baby, so it won't be an easy labor. Bailey says women do this at home all over the world, but George points out women also die when giving birth at home. Bailey says he's supposed to be making himself useful by finding her husband. Addison says Tucker is not here yet, but George will go find him. Addison gets paged and leaves the room with a shocked expression on her face.

In the OR, Derek's pager goes off. Cristina checks it while Derek says he's still trying to find the source of the bleeding. Izzie can go tell Addison that Tucker's condition is worse than he thought. As Izzie leaves, Cristina tells Derek that they want them to evacuate. There's a code black. Derek says it might be a drill. Whatever it is, he can't leave Bailey's husband with a skull flap open. If anybody wants to go, they can go. Everybody decides to stay. He verifies if it was really code black. Cristina confirms.

George tells Addison he doesn't like lying to Bailey. Addison says now is not the time. George gets the page about code black. Izzie gets on the elevator with them and delivers the news about Tucker. George asks what a code black is. Izzie gets the page as well. They turn to Addison, who tells them to go back to the locker room and wait for instructions from their residents. They say they don't have a resident. They ask if it's bad. The elevator doors open and reveal a hallway filled with people, some of them law enforcement. Addison says it is bad.

In the nearly-empty OR, Hannah asks if she's actually touching live, unexploded ammunition. Burke, regretfullly, confirms this. Milton is manually ventilating the patient. They took him off the machine because the flow of oxygen posed a danger. The Ambu bag is breathing for him now. Hannah wonders- what if she takes her hand out really quickly. Burke guesses the ammo would shift and explode. Burke tells Hannah that she is keeping James alive. The bomb squad is coming soon.

Richard informs the surgical staff that certain patients are being transported to Mercy West and traumas are being re-routed to Seattle Pres. The only danger is to the east surgical wing. Anyone who wants to leave can leave. The staff scatters and Richard tells Addison that he's shut all the ORs down with the exception of Burke's team. Izzie says Derek didn't evacuate either. A nurse comes over and informs Richard that the bomb squad just arrived.

The bomb squad arrives on the surgical floor. Meredith confirms to Dylan Young, head of the squad, that this floor has been evacuated except for Burke's OR. However, one of the men soon finds people in OR 2. Cristina comes out and asks what's happening. Meredith tells her about the bomb. Cristina is disappointed that all she got is Bailey's husband's open brain. Meredith quickly learns that Derek is doing the craniotomy. Dylan tells them to stop talking.

George gives Izzie a sandwich and sits down with her to observe the crowd in the lobby. Izzie says Meredith and Cristina are on the floor with the bomb. She and George are jealous because they feel useless. It's embarrassing that they had to call in Cristina to get Meredith out of bed. Cristina and Meredith are doers, and the two of them are watchers. Izzie then sees Alex in the crowd. She says they have to become doers, too. She gets up and runs after Alex.

Izzie finds Alex. He says it's like the Apocalypse. Half of the staff were meant to be saving lives but fled the building to save themselves. Bailey's husband almost died trying to get here to get to see his kid being born, and the annoying sisters might blow up. It's like a morgue here. Izzie finally gets through to him.

They end up making out in a supply closet. She says she's being a doer. She tells him to take off his pants. She hasn't had sex in 8 months and 12 days. As he takes off his pants, she unhooks her bra and turns the light off.

Dylan wants Derek to leave the OR, but Derek doesn't want to leave Tucker to die, but says the rest of the OR staff can go. Most do evacuate, leaving Derek with a skeleton staff. Dylan says the Chief has authorised him to tell Derek that he cannot stay here. Derek says the Chief doesn't scare him; Bailey does. He won't be the one to leave her husband to die, which is what would happen if he closed up now. He tells Dylan to get out.

Bailey's 9 centimeters dilated. She needs that last centimeter. Addison says that's good, but Bailey notices something's up. She asks Addison where exactly her husband is. Addison says he's with her husband.

Burke and Dylan are looking at the scans. Dylan says they need more info. Burke says the longer they wait, the more chance James will bleed out and die.

Milton tells Hannah that the bomb squad calls you pink mist when you blow up. You're liquid when you explode, there's nothing left. Pink mist. Sometimes, they don't even find a finger. One minute, you're a person, the next, you're bloody rain. He hands the Ambu bag to Hannah and instructs her to squeeze it in even beats. He slowly backs away from the table. He tells Hannah he's got kids. He reminds her about the even beats and leaves the room.

Mindy asks Richard how long her husband can have the live ammo in him. Richard admits he doesn't know. He promises they'll try to save James, but the bomb squad has to figure out how to retrieve the device first. Paul apologizes to Mindy, who yells at him. They have three kids! Mindy starts crying and realizes that James is going to die. Richard sends Paul to answer some questions about their device. Richard tells Alex to get Mindy some coffee. Mindy tells herself that this can't get any worse.

George enters Bailey's room. She's looking for her suitcase, because she's going home. She's holding her baby in. She won't give birth like this. She bites through the pain of her contraction. She starts crying and says she can't do this without her husband. She groans in pain.

Meredith and Cristina watch through a window to the room where Burke and Dylan are discussing the scans. Meredith wonders how they're ever going to remove the ammo without killing Hannah and James. They walk up to the OR door and see through the window that Hannah is shaking. They wonder where Milton is. They open the door and asks where Milton is. Hannah says he left. Hannah thinks she's gonna take her hand out now.

Dylan wonders when people are gonna learn. Either Hannah's hand is keeping the ammo stable, or it's just in there with the ammo. They can't know. Dylan says his guys talked to James's friend. The device is homemade, meaning it's unreliable and unstable. It could be a dud, but they have no way of knowing. Add to that that Derek is refusing to leave, so it's definitely as bad as it seems. Suddenly, Cristina calls for help.

They move to the OR. Cristina has taken the Ambu bag while Meredith is trying to talk Hannah into not taking her hand out. Hannah wants to be done with this. Burke says it won't be much longer. Panicky, she rationalizes that she's 22 years old and shouldn't be in here. Dylan says they have to clear the room, but Meredith refuses to leave Hannah. Burke feels responsible for his intern so he won't leave either. Cristina also refuses to go. Hannah keeps saying it's got to come out while all the others urge her to relax and keep her hand where it is. She yells she has to and quickly takes her hand out. Everybody but Meredith ducks to the ground and covers their head. Hannah runs out of the OR. Meredith stares after her. Everybody gets back on their feet and find that Meredith has taken Hannah's place. Her hand is now inside the patient. Dylan urges everybody to stay exactly where they are. Meredith keeps asking herself what she did. 


Main Cast[]

Special Guest Star[]

Guest Stars[]


Medical Notes[]

Miranda Bailey[]

  • Diagnosis:
    • Pregnancy
  • Treatment:

Bailey came into the hospital in early labor. She was admitted to give birth and labor was progressing well.

James Carlson[]

  • Diagnosis:
    • Large sucking chest wound
    • Shock
  • Treatment:
    • Intubation
    • Thoracotomy

James, 46, was brought into the hospital with a gaping wound to his chest. The bleeding was tamponade by Hannah Davies, who stuck her hand inside it because it was the only way to stop the bleeding. In the ER, he was shocky and getting cyanotic. He was rushed to an OR to remove the projectile and repair the damage. Before they could remove it, Alex rushed into the OR and told them that the projectile was an explosive. They stopped operating and called in the bomb squad. When Hannah panicked and fled, Meredith slipped her hand in where Hannah's was.

Mindy Carlson[]

  • Diagnosis:
    • Acute anxiety reaction
  • Treatment:
    • Diazepam

Mindy came into the hospital with her husband, James Carlson. She was covered in blood and screaming. The blood was her husband's. Alex said she had an acute anxiety reaction and ordered Diazepam, which calmed her down.

Tucker Jones[]

  • Diagnosis:
    • Chest contusion
    • Depressed skull fracture
    • Epidural hematoma
    • Seizure
  • Treatment:
    • Craniotomy

Tucker, 35, was pulled out of his car after a car accident. He was examined in the ER, where they determined he had a depressed skull fracture and epidural hematoma. When he seized, he was rushed to the OR.


Song Performer Scene
"Dead Streets" The Monotypes
  • Izzie, Cristina, and Meredith shower together.
  • George comes in and they fawn over him.
  • George falls out of bed.
"Miniature Disasters" KT Tunstall
  • Meredith talks to Hannah as they prepare for surgery.
  • Derek and Burke scrub in as Addison talks to Derek about Bailey.
  • Derek enters the OR.
"Kaboom!" Ursula 1000
  • Izzie finds Alex and propositions him for sex.
  • They prepare to have sex in a supply closet.
"In the Sun" Michael Stipe & Chris Martin
  • Cristina and Meredith check on Hannah, who says Dr. Milton left.
  • She wants to take her hand out.
  • Dylan and Burke look at the scans and debate what to do.
  • Cristina calls for help. Hannah is desperate to get her hand out.
  • They refuse to evacuate and leave her alone.
  • Hannah pulls her hand out and runs out of the OR.
  • Meredith has replaced Hannah's hand with her own.

Notes and Trivia[]

  • This episode's title originated from the song It's The End Of The World As We Know It, originally sung by REM.
  • This episode scored 37.88 million viewers, making it the most viewed episode to date.
  • Prep dates for this episode and the next were from November 28 to December 6, 2005.
  • Filming for this episode and the next was scheduled from December 7 to December 16, 2005.
  • The season 2 DVD set includes an audio commentary for this episode by writer Shonda Rhimes, director Peter Horton, and editor Edward Ornelas.
  • Jillian Armenante who played Mindy Carlson later played Arlene in Private Practice.
  • This is the first of a two-part episode.
  • It was aired as the lead-out from Super Bowl XL and has been referred to as "the Super Bowl episode".
  • In this episode, Dr. Milton tells Hannah Davies that people who are killed by bombs are called Pink Mist by bomb squad members.


Episode Stills[]


Cristina: You have a feeling?
Meredith: Yes.
Cristina: Okay, what kind of feeling?
Meredith: Like I might die.
Cristina: Today? Tomorrow? In 50 years? We're all going to die eventually. Now we're late! Let's go!
Meredith: Cristina. C'mon!
Cristina: Okay. This is me being supportive.
Meredith: Really?
Cristina: Yeah, okay, fine, I'm totally supportive. Go.
Meredith: OK. The man I love has a wife and then he chooses her over me. And that wife takes my dog—OK, she didn't take the dog, I gave it to her, but I didn't mean to give it to her, I meant to give it to him—but that does not change the fact that she's got my McDreamy. And my McDog. She's got my McLife! And what have I got? You know, I can't remember the last time we kissed. 'Cause you never think the last time is the last time, you think there'll be more. You think you have forever, but you don't. Plus, my conditioner decided to stop working and I think I have brittle bones. I just-I just need something to happen. I need a sign that things are gonna change. I need a reason to go on. I need some hope. And in the absence of hope, I need to stay in bed and feel like I might die today.
Cristina: (throws back blanket) Whatever - everybody has problems. Now get your ass out of bed and get to work. NOW! Move! Move! Move! (opens the door to find Izzie and George) We're good to go.

Bailey: What are you people doin' out here?
Richard: Are you all right? Can I get you anything?
Bailey: A boy the size of a 10 lb. bowling ball is working his way out of my body. Can you give me something for that. Can you give me a new vagina?
Richard: Uh, well...
Bailey: I didn't think so.

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.