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

Doctors spend a lot of time focused on the future, planning it, working toward it. But at some point you start to realize your life is happening now. Not after med school, not after residency, right now. This is it. It’s here. Blink and you’ll miss it. Did you say it? "I love you. I don't ever want to live without you. You changed my life." Did you say it? Make a plan. Set a goal. Work toward it, but every now and then, look around. Drink it in 'cause this is it. It might all be gone tomorrow.

Now or Never is the twenty-fourth and final episode of the fifth season and the 102nd overall episode of Grey's Anatomy.

Short Summary[]

George delivers stunning news to Bailey, sending shockwaves throughout the hospital, and Izzie’s friends anxiously await her recovery from surgery. Meanwhile Bailey is surprisingly displeased after being accepted into the pediatric fellowship program, and the victim of a near-fatal traffic accident brings the talents of Seattle Grace’s doctors together.

Full Summary[]

Cristina gives Meredith something old, new, borrowed and blue.

Bailey walks into Izzie's room with all the residents sleeping around her bed, inadvertently waking them up. She asks if there's been any change overnight, with Cristina answering that there hasn't. Bailey is paged by the Chief. She reminds George that he has a surgery to be in 10 minutes and they both leave. Bailey tells the residents that somebody should make a coffee run. Meredith suggests to Cristina that they should probably leave as well. Alex worries that Izzie won't wake up and begins to take it out on Meredith, demanding to know if Derek has told her anything, or if he was lying, but he's told that all they can do is wait. As Cristina leaves, she is surprised to see Owen and George shaking hands and then hugging, but looks on.

Bailey walks into the Chief's office. She gives him an update about Izzie and explains "not to take her face personally" as she also is having a bad day. Arizona runs in and delightedly tells Bailey that she has been accepted into the program, but Bailey looks saddened. Richard tells her that he wasn't before, but now, he is on board and he's delighted for her. He's trying to be a bigger man and asks if she can at least meet him half way. She leaves, still looking upset.

Alex waits by Izzie's bed and he's delighted when she finally wakes up and mutters "I have a headache.", leaving Alex ecstatic. He calls for Derek.

Cristina approaches Owen on the catwalk, asking about O'Malley earlier, but he tells her that he slept peacefully for the first night since he came back, because Cristina helped him. Cristina, confused, asks how that's related to George, to which he replies he has great news and he'll let George tell them in his own time. He tells her he is fine now and he wants to get back together with her. He can be a better man with her. He asks her not to say anything yet and just think about it.

George finds Bailey and tells her he has some news and although he knows she won't be happy at first, he is sure about this decision and he's also sure that eventually she will be very proud of him. He continues to ramble, even going as far as doing an impression of Bailey. Bailey, not impressed, informs him this isn't quick. He blurts out that he is joining the army to become a trauma surgeon and that he reports for duty tomorrow. "You did what?!" she yells, exactly as George expected her to.

John Doe.

At the nurses' station Meredith and Cristina are talking. Cristina is still confused about Owen and George. Cristina probes Meredith about her therapy, if she actually is better, or just fake better, but all Meredith says is that she's getting married today. No mess, no fuss, just quick and dirty. A surprised Cristina asks if she wants her to come, but Meredith says she just wanted to let her know. Cristina gives her a grocery list on a post-it note (something old), a clean post-it (something new), her favorite pen (something borrowed) and tells her all of them are blue so she's okay. Cristina notes that for the first time, Meredith is really happy. They debate over whether to hug but decide not to.

Outside the E.R., Callie, Owen, and Meredith meet the paramedics as they unload two patients: one who is completely unrecognizable after being hit and dragged by a bus after saving the other, Amanda. The John Doe, being clamped down, posed difficulty and the paramedics were unable to intubate and so are furiously squeezing the ventilation bag as they wheel him into the E.R., as Amanda looks on asking if he is going to be OK.

In the trauma room, while Callie is performing CPR, Amanda runs in, explaining she didn't see the bus and he pushed her out of the way, she doesn't even know who he is. Lexie tries to get her out, but after hearing this, she tells her to stand in the corner and don't move. He stabilizes, and the trauma procedure is initiated. The bandages around his face are removed, revealing a horribly disfigured person underneath, and so they call for Shepherd and Sloan. Amanda vomits and Callie tells Lexie to get her out now.

Derek examines Izzie with Cristina and Alex, and after asking her some questions to make sure her memory is back, he tells her the surgery was successful. He got all the tumor out. She's delighted as she thought she was going to be a turnip. A few seconds later, she asks if the surgery was successful. At first, Derek brushes it off as normal, but as it goes on, they all become more concerned when Izzie all delighted again. She notices they look weird, but they pretend it's nothing. She again asks how the surgery went. She's once again delighted at the answer.

Outside, Alex is reminded of the woman who couldn't remember her husband. He asks if Derek screwed up, but Derek is paged away. Derek asks him to stay calm, as freaking Izzie out won't help.

A Post-it.

Derek and Mark walk into the trauma room, and Mark assesses the left arm, saying they need to move fast if they want to save it. John Doe crashes again, and Derek notices his pupils are blown, telling them to hold CPR and has Meredith perform a burr hole as Callie, Mark and Owen look on. John Doe stabilizes and regains consciousness, and Meredith welcomes him back.

Mark leaves the John Doe and finds Lexie doing sutures on Amanda. He coldly tells her to redo them. Lexie and Mark distance themselves. She explains he was talking about moving in, getting married, and she wasn't ready and that she doesn't have the power in the relationship, as Amanda listens. He ignores Lexie and treats the patient who tells him that he is the woman in this relationship. However, you don't need a man to build your future, so he should just buy a house without her.

Bailey walks into the trauma room, confronting Owen about what he got George to do, about joining the army to be a trauma surgeon in Iraq, shocking both Meredith and Callie. John Doe crashes again. Bailey tells Hunt to undo this, but Owen brushes Bailey away as he tries to resuscitate John Doe, and tells her he didn't expect George to enlist. John Doe stabilizes again, but Callie works out why he keeps crashing: an open book pelvic fracture - if they take him to an OR now, he'll die on the table, so they prepare him for angio to keep him alive. Bailey tells Owen she knows he's messed up from the war, but he better fix this. Callie leaves for her other patients. Mark comes in and wonders how Owen pissed off all the women.

Arizona approaches Bailey and asks why she isn't happier about coming to peds. Callie comes over and tells her that she has a plan to stop George. Bailey informs Arizona that George joined the army and agrees to Callie's plan, leaving and ignoring Arizona. Arizona asks why they would want to stop him, as it's "awesome", angering Callie. This isn't the George she knows, and since Izzie is not available, it is her turn to step up.

In the canteen, Meredith is wolfing down a sandwich waiting to be paged about John Doe, when she asks Alex how Izzie is, until Callie and Bailey appear. Bailey tells the residents that they are scheduling an intervention at 6 PM, after George's surgery with the Chief, though intervention may not be appropriate in this case as interventions does not involve "whooping people on the behinds, with belts". Meredith is to "coax him back as a loving friend", Cristina will use "logic and reason to point out the idiocy of his ways", Izzie will "make sad cancer eyes" and if all fails, Alex will use his "raised in the outback with trash cans roots and beat the crap out of him". ‎They will be there.

Callie holds Arizona's hand.

Meredith and Owen are in angio with John Doe. She tells John he's a hero. He tries to write something using his finger, but Meredith gives him a pen and paper, but he can't hold the pen. Meredith tells him he'll get stronger soon and goes outside, and finds Amanda. She refuses to leave him because he saved her life, but she was so horrible to him in their 30 seconds of interaction. All he did was smile at her, but she looked through him as he wasn't hot enough. The next thing she knew, he swept her off her feet to save her. The man in the bed is her prince.

Arizona catches up with Bailey and demands to know why she isn't more excited, but Bailey tells her it's a big decision. Arizona, clearly annoyed, tells her this isn't. Bailey was her choice, this is the best it gets. Bailey takes no time in explaining that her husband said if she went to peds for the extra two years of training, instead of being a general surgery attending and making it home for dinner, he would divorce her. Bailey reminds her again this is a big decision, and walks away, leaving Arizona speechless.

Over John Doe's X-rays, Mark tells Derek he can save John Doe's arm if he can get to it in time. Also, he is getting a house. Derek tells Mark he is getting married. He wishes he could save Izzie, but Mark says he has the right to be happy. They both hug, but are interrupted by Meredith and Owen, who have come up with the plan for the surgery. Owen is confident it'll work, as he's seen people come back from worse.

Arizona approaches Callie but Callie acts overly sarcastic in her presence, furious that she would think George joining the army is awesome, as George is sweet and kind and couldn't hurt a fly. Arizona still thinks it's awesome. Callie says it's not and gets into the scrub room.

Over surgery, they all talk about if they could jump in front of a bus for a total stranger. Derek points how that's what Major Hunt has been doing for the last few years, but Owen plays his role down as more of a clean up brigade. They all move onto whether or not George will live or die in Iraq: Callie doesn't think so; Derek believes George will surprise them all; Mark reckons he's coming back in a body bag and Meredith tells them all to shut up.

Happily "married".

In her room, Izzie wakes up to see Alex sticking post its all over her room. She asks him why and he points to the post it saying her memory sucks. He starts quizzing her on what time she woke up and what her potassium level is, hoping to help her memory. While Izzie keeps getting upset over the news that George is joining the army, Cristina senses Alex is pushing Izzie too hard.

Outside the room, she tells Alex that Izzie needs rest after her surgery and IL-2 treatment. Alex thinks he has to help her to maintain the memory she still has, but Cristina is determined to protect her patient. Alex fears the life he has ahead of him. Cristina thinks she'll get better, but Alex says Izzie's future is on him.

Outside John Doe's room, Meredith explains to Amanda that they need to watch him overnight. Meredith allows her to sit with him.

As Meredith checks on Izzie, who's still not doing any better, she tells Cristina she's going to City Hall to do the "thing". Cristina asks Meredith if it is really the best day to get married but Meredith says that if anything, the day proves that you should say "I love you" while they can hear you. She then tells Cristina she loves her. Cristina says she has changed for real. Cristina hugs her, and they smile.

Callie sits in the doctor's lounge on her own. Arizona walks in and tells she may not understand George, but to her George is awesome. It is people like him that keep them safe, and she thinks that is brave. She is a person who watched them unload her brother's body in a coffin, and all they got was a flag. Her brother died over there because there weren't enough doctors over there, so that's why she thinks George is awesome. Callie takes her hand and apologizes.

Owen goes down to the vents and finds Cristina there. She tells him she loves him. He reciprocates, but she's not done. She, Cristina Yang, said "I love you". He traumatized her, but not by choking her. He made her love him and she can't breathe without him. Owen says they can do this. All she has to do is say yes. He leaves.

Alex keeps quizzing Izzie, but she's more focused on her jell-o and how tired she is. She says she needs a break. Alex tells her to suck it up. She tells him to get everything off his chest because she won't remember anyway. So Alex begins to shout that he may not be the one with a carrot for a brain, but he is the one married to the carrot, and that was because they thought she would be dead within a week. He promised her she would not live like this, and now he doesn't know what to do: smother her with a pillow? Shoot her up with a morphine overdose? Leave her? He's not excited by any of the choices. He's screwed as well. He then apologizes and waits for her to forget.

In the scrub room, Bailey asks Richard if she can go back to general surgery and explains the situation with her husband. She is still leaving Tucker because a marriage should not resort to ultimatums. She's going to be a single mom, so it's not the time for new specialties. She breaks down and cries as this is the first time she acknowledges this. Richard says Tucker is just scared, but Bailey says everyone is. One of her residents is set to go to war, and another one almost died of cancer. What Tucker is facing is not scary, he's just weak. He just stays with her.

Lexie walks into an office and finds Mark looking at houses to buy. She sees that he is trying to make her feel guilty about him moving on without her. Mark makes it clear: he's moving on. He says he's a better woman than Lexie.

Derek finds Meredith in the locker room and they realize they have no time to get married, as John Doe needs to go back into surgery, Derek wants to check on Izzie, and Meredith has the George intervention. She says there's just no time today. Derek asks Meredith for some paper to write vows, a contract, and she hands him a post-it, which is all she has. They write down their vows: to love each other even when they hate each other; no running, ever, no matter what happens; that they'll take care of each other even when they're old, smelly and senile, and if Meredith gets Alzheimer's, Derek will remind her who she is, everyday; this is forever. They sign, kiss, and declare themselves married. He sticks the post-it in her locker and says they got plenty of time now.

Cristina tells Owen she wants to be with him.

In her room, Cristina has to do an EKG on Izzie. Izzie tells Cristina about her fight with Alex and Cristina discovers that Izzie's memory is back as there is no note in the room and mentions what Alex said during the fight. They smile.

Cristina finds Owen, kisses him and tells him yes. She has to go now to find Alex.

Callie walks in on Bailey and the Chief and tells Bailey it's past 6 already. Bailey tells Richard about the intervention plan, but Richard says he gave George the day off this morning to go spend time with his mother, as he's leaving soon. Callie and Bailey are disappointed.

Meredith and Derek walk into John Doe's room, and tells Owen they did get married. Owen and Derek leave to go prep for the surgery. Meredith also asks Amanda to leave. Amanda tells her to hold the man's hand, as it makes him feel better. Once Amanda's gone, Meredith takes his hand and assures him he's got a good team up there. The man tries to write again. He writes 007 and grasps her hand. She gasps as she realizes who the man is.

Cristina pages Alex and tells him he's a dipwad for trying to off his wife, saying Izzie told her. Alex happily walks into Izzie's room. He apologizes, but she knows he loves her too much to shoot her up with morphine. He hugs her, happy to have her back, but suddenly, she goes limp and starts to code. Alex shouts for Yang.

Meredith runs through the halls screaming "It's George!". She arrives at the OR board and tells Callie, Owen, and Derek. They rush off.

Cristina has Shepherd, Bailey, and the Chief paged immediately.

Owen rushes George into surgery telling him they've got this. Derek and Meredith scrub in and get George ready for surgery, telling him he's not going anywhere. His blood pressure drops and the anesthesiologist puts him under.

The Chief and Bailey run into Izzie's room, to find the hyperkalemia is causing the heart arrhythmias and her rapid blood pressure drop. Alex sets up for an intubation, but Cristina reminds him of the DNR. Alex ignores her, but Cristina tells him she knew this could happen. This is not what she wants. Izzie goes into v-fib and Alex calls for a crash cart and starts CPR. Alex continues to give her compression and asks for the crash cart again. Cristina and Bailey hesitate, but Richard decides to screw the DNR. He, Bailey and Cristina take over while Alex stands back crying.

Izzie in the elevator.

Meanwhile, in the OR, Derek has started operating.

Richard shocks Izzie.


In some sort of vision, Izzie gets on the elevator, wearing her prom dress. When the doors open again, George is standing on the other side. They look at each other.

The doctors are still trying to resuscitate Izzie.

In the OR, Owen says they're losing George.

Izzie and George continue to look at each other, while Richard shocks Izzie again. Alex stands in the back, crying, as Richard shocks Izzie one more time. Meanwhile, Meredith's voice over says that you have to stop and look around at your life sometimes, because it might all be gone tomorrow.


Main Cast[]

Guest Stars[]


Medical Notes[]

Izzie Stevens[]

  • Diagnosis:
    • Stage IV metastatic melanoma
    • Hyperkalemia
  • Treatment:

Izzie had not woken up after her surgery. She eventually woke up, but her memory reset every 30 seconds. By the end of the day, she was able to retain things, but the hyperkalemia caused her to code. Despite the DNR she had signed, they started resuscitating her.

Webber's Patient[]

  • Diagnosis:
  • Treatment:
    • Surgery

Richard operated on a patient. George was supposed to scrub in, but when Richard found out that George had joined the Army, he sent him home.

John Doe[]

  • Diagnosis:
    • Avulsion injury to left forearm
    • Fractured skull
    • Open-book pelvic fracture
    • Epidural bleed
    • Crush injuries
    • Re-bleed
  • Treatment:
    • Burr holes
    • Antibiotics
    • Bacitracin
    • Angiography
    • Surgery
    • Internal fixator

An unidentified male was brought into the ER after being dragged by a bus. He had an avulsion injury to his left forearm and his skull was bashed in. Derek drilled burr holes to relieve the pressure on his brain. After that, he was conscious. He also had an open-book pelvic fracture which caused him to keep coding. He was taken to angiography to stop the pelvic arterial bleeding. From there, they planned to take him to surgery. In surgery, the plan was for Derek to evacuate the epidural bleed while Owen and Meredith worked on his internal injuries. Then Callie would place an internal fixator on his pelvis. Then Mark could work on his arm. After his surgery, he was taken to ICU. In the ICU, he had a re-bleed, so they had to take him back into surgery. Before they were able to take him back into surgery, he wrote "007" on Meredith's palm, telling her that John Doe was George. They rushed him into surgery, where he started to code.


  • Diagnosis:
    • Arm injury
    • Arm laceration
  • Treatment:
    • Stitches

Amanda was injured when she was pushed out of the path of a bus. She had a laceration on her arm, which Lexie stitched up, but Mark said she'd have too much tension and told her to redo the stitches. He ended up doing them himself.


Song Performer Scene
"All Love" Ingrid Michaelson
  • The residents are sleeping in Izzie's room until Bailey comes in to check.
  • Alex is worried because Izzie hasn't woken up yet.
  • Cristina sees Owen hug George.
"The Battle" 'Missy' Higgins
  • Callie is mad at Arizona for saying it's awesome that George is joining the army.
  • In the OR, the surgeons discuss the patient who jumped in front of the bus, and George joining the army.
"Flashdance…What a Feeling" Hollywood, Mon Amour featuring Yael
  • Derek and Meredith write vows on a Post-it.
  • They both sign it, share a kiss, and declare they're married.
"Off I Go" Greg Laswell
  • Izzie crashes and the doctors rush to revive her after deciding to screw the DNR.
  • Meredith informs her colleagues that John Doe is George, after which they rush him into surgery. They start to lose him.
  • Izzie meets George in limbo.

Notes and Trivia[]


Grey's Anatomy 5x23 5x24

  • This episode's title originated from the song Now or Never, originally sung by Three Days Grace.
  • This episode scored 17.12 million viewers.
  • This is the last episode to feature T.R. Knight as part of the main cast.
  • The actor that played John Doe was in fact T.R. Knight.
  • According to Shonda Rhimes, George O'Malley's low amount of screen time for most of this season leads up to this episode, where the audience would not notice that George had disappeared for the duration of the episode. This is contradictory with the fact that George was written out of the show because T.R. Knight asked to leave due to his low amount of screen time.
  • Although aired with Here's to Future Days, Shonda Rhimes has commented that this episode was not meant to be a two-part finale.
  • According to Michael Aussiello, the final scene was originally shot with Denny meeting Izzie in the elevator, however, Shonda Rhimes changed the scene at the last minute. T.R. Knight had shaved his head, assuming that production had finished, and so it was decided to put George in a military uniform.
  • In the final scene, George is seen in an Army uniform of an Army Medic, which is correct as he still has to gradute Basic Training and Officer Canditate School to actually be an officer.
  • The post-it was actually written by Patrick Dempsey as they were filming the scene. Normally, a prop is ready before it's actually used in filming.
  • Off I Go, the song featured at the end of the episode by Greg Laswell, was written specifically for this episode.
  • When Mark is talking to Lexie about different houses that are hung on the x-ray viewer, there is a sheet of paper above the viewer. It reads: "Test. 1. Name a rap artist. 2. Name an artist in your kids" The sentence is unfinished. This prop is used to decorate the walls of the room in much the same way various posters do. It was probably written in reference to an ad series that challenged parents to "Name five rap artists. Name five of your child's teachers."
  • There is no Grey Matter blog post for this episode.


Episode Stills[]

Behind the Scenes[]


Meredith: It's George, it's George. John Doe is George!

Richard: Screw the DNR!

Owen: Oh, I'm sorry, I didn't... I didn't know you were here.
Cristina: No. Wait, wait. ... I... love... you.
Owen: Well. I... I love you too
Cristina: No... Just... I love... you. I said... I said I love you! Me. Cristina Yang. What-- You traumatized me.
Owen: You know that I am... I'm so sorry about that.
Cristina: Damn it. No, not about the choking. It's like you come here, and you pull out my icicle, and you make me love you, and I can't... I don't want to. I can't breathe... without you.
Owen: You can do this Cristina. We can do this. All you have to do is just meet me half way. All you have to do is say yes. All you have to do is say yes.

Derek: Meredith...
Meredith: No, you know let's go, we gotta go. We gotta run to city hall, we'll come back, you'll check on Izzie, we'll monitor John Doe, I'll go talk George out of joining the army!
Derek: Look, we'll do this another day-
Meredith: There is no other day! Everyday is like this, everyday there is a crisis, there's no time.
Derek: Meredith...
Meredith: I love you and I do want to marry you, today. But there is no time.
Derek: (cups her face with his hands) Do you have a piece of paper?
Meredith: For what?
Derek: I want to be with you forever. And you want to be with me forever. In order to do that, we need to make vows. A commitment. A contract. Give me, a piece of paper.
Meredith: I don't! I-I-I don't...I have post-its. (Hands him posts-its and a pen. Derek goes and sits on the bench.)
Derek: Okay...what do we want to promise each other?
Meredith: That you'll love me, even when you hate me.
Derek: To love each other...even when we hate each other. (writes it down on the post-its) No running. Ever. Nobody walks out. (Meredith joins him on the benches.) No matter what happens.
Meredith: No running.
Derek: What else?
Meredith: That we'll take care of each other even when we're old and smelly and senile. And...if I get Alzheimer's and I forget you...
Derek: I will you remind you who I am, every day. (They smile at each other.) To take care when old, senile, smelly. (Derek finishes writing on the post-it, then gives it and the pen to Meredith.) Sign.
Meredith: This is our wedding? A post-it?
Derek: Mhmm. Well, if you sign it. (Meredith signs it happily and then hands it back to Derek.)
Meredith: Now what?
Derek: Now, I kiss the bride. (He kisses her tenderly. Meredith's smiling as they kiss. Then Derek slowly pulls back.)
Meredith: Married.
Derek: Married. (Derek puts the post-it note with their vows and signatures on the back of her cubby, then turns to her.) You see that? Plenty of time.

See Also[]

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