|“||People are really romantic about the beginnings of things. Fresh start, clean slate, a world of possibility. But no matter what new adventure you're embarking on, you're still you. You bring you into every new beginning in your life. So how different can it possibly be? It's all anybody wants, right? Clean slate, a new beginning. Like that's gonna be any easier. Ask the guy pushing the boulder up the hill. Nothing is easy about starting over. Nothing at all.||”|
Arizona seeks Mark's advice as she tries to reconcile with Callie, who has big news of her own. Teddy must make a key decision for Henry during his surgery and on the same day the residents receive a crop of med students to show around, the Chief announces he is looking for a new Chief Resident.
Meredith and Derek are waiting for the result of a pregnancy test. It's negative. He says next time. She says it won't work as a baby doesn't want to set up shop in a hostile uterus. He says they'll just keep trying.
Callie is in Mark's bathroom, wiping her tears but also laughing. Mark calls her from the other room as they need to leave.
As they leave his apartment, they find Arizona moving her stuff into her old apartment. She explains she bought out their subletters so she's moving back in. Callie says they were her subletters. Arizona says she now is her subletter. Callie coldly says her lack of interest in seeing her is not a strategy. She turned her life upside down for Arizona, who walked away because she was cranky for a week. Arizona is untrustworthy and self-centered, so she's sure Arizona will hurt her again if she lets her back into her life. Callie tells her to get her crap out of the apartment and walks off. Arizona tells Mark it's good that Callie's mad because that means she cares.
Cristina and Meredith are at the hospital. Cristina advises her not to get defeated by a piece of plastic covered in urine. Cristina herself has done a lot of surgeries lately. She's unstoppable. Jackson, Alex, and April join them as they all got paged. In the lobby, they find out why. Richard and Lexie are waiting there with a group of first-year med students. Richard says the residents will show them around today so they can learn what it's like to be a surgeon. Lexie assigns Fred Wilson to Cristina, Kira Donnelly to Meredith, Hudson Powell to April, and Alex is happy to have the beautiful Laurel Pinson assigned to him. Jackson gets stuck with Edward Taylor. Richard takes Cristina aside and tells her she'll be on his service today so he can monitor her progress. He loudly announces that he'll pick his Chief Resident in a couple of months and she's still a prime candidate. The residents wonder how long he's been evaluating them. Since their first day here, Richard replies.
Meredith leaves the bathroom and tells Kira that they're with Dr. Shepherd today. He's her husband but also a very good surgeon. Kira's happy that Meredith isn't one of those workaholic surgeons who are cold and dead inside.
Fred is reading Henry's chart to Cristina, who tells him med students are to be seen, not heard. Richard and Bailey join them. They enter Henry's room. Bailey introduces herself, but Henry says that nurse Eli has told him a lot about her. Richard notices some tension between Eli and Bailey, but she brushes it off. Henry asks who Fred is. Cristina replies nobody, but Richard gives him an actual explanation. Richard tells Fred that Henry had no insurance. Fred says he's sorry, but Henry says he's on his wife's insurance now. Richard is happy to hear that his girlfriend wised up, but Henry says it's not that. Teddy comes in and she's surprised to see the other surgeons in there. Henry says he's got the forms right here, all he needs are a few signatures. Teddy picks them up and says she'll get them back to him in a couple of hours. She leaves and Henry tells them that woman was his wife. Richard is shocked.
Owen, Jackson, and Edward join a cranky Callie in the ambulance bay. The paramedic tells them about the patient: Brady Sullivan, 32 years old and complaining about back and neck pain, possible crush injuries after being trampled by a horse. A man climbs out of the rig and says it was actually a team of horses. He asks them not to let Brady die on their wedding day.
In the trauma room, Kyle explains he and Brady were going downtown this morning to sign their domestic partnership papers. Kyle had a horse-drawn carriage pick them up from city hall and there were bagpipers because Brady really likes being Scottish. The horses were spooked by the bagpipers and they ran over Brady. He apologizes to Brady, who's mad at him as he only agreed to tuxes. Callie asks for Shepherd. She also instructs Jackson to take Kyle out of the room.
Richard is scolding Teddy for marrying Henry. He says it's fraud, but Lexie says according to the National Medical Anti-Fraud Association, it's not. It's just frowned upon. Still, Richard says it's highly unethical. Lexie says the medical community is actually split on this. Is it better to let the patient die? Richard says you marry someone you love. Teddy non-convincingly says she loves Henry so much. She appreciates his concern, but it's done. Henry has insurance and now Richard can save his life. Richard walks off and Lexie confidentially tells Teddy she thinks it's awesome.
Arizona thinks Callie is frustrated because everything comes easy for Arizona. She seems to think Arizona has no flaws so now she's gonna pound the crap out of this one, but Arizona says she has a lot of flaws. Mark advises her to tell them to Callie. They're followed by Alex and April. Laurel recognizes Alex from Seattle Medical. She's really interested in regenerative medicine. He promises to show her the lab after rounds. April quietly reminds him he's her teacher, but he says that's only for the day.
They enter Sarah Cassidy's room. She suffers from a rare genetic disorder called Treacher Collins syndrome, which causes her to have no cheekbones, leaving her orbital floor unprotected, and thus she's at high risk for eye injury. Sarah says that means the only extracurriculars she gets to do are things that don't involve things flying at her face. She really wants to do sports. While Mark takes a look, Arizona explains they're gonna build cheekbones from pieces of her skull. She asks if she can participate in the volleyball tryouts in two months.
Teddy gives Henry the signed forms. He hates that he has nothing to give her in return. He offers her his fruit cup. She takes a bite, but it's disgusting. He jokingly agrees he wouldn't eat it if he were dying. She wishes him good luck with his surgery.
Outside Sarah's room, Mark suggests they use cadaver bone for Sarah's surgery, but Arizona deems it too experimental. She wants to be conservative. She'll see him in surgery.
Jackson and Meredith explain to their med students that one of Brady's neck joints was knocked out of its place and his back is broken. Kira asks if the one surgeon checking the scans is her husband. Meredith affirms and Kira compliments her. Callie says she can snap the neck back into its place before surgery, so Brady can be intubated.
Richard, Fred, Cristina, and Bailey are looking at the tumor on Henry's scans. Fred has trouble reading the scan and Cristina doesn't help. Richard explains an MRI is always in reverse. He stresses that empathy is a good quality for a Chief Resident, after which Cristina helps out Fred to read the scan. He now sees the tumor is eating into the kidney. Richard hoped that removing the adrenal gland would suffice, but it looks like he's gonna have to take the kidney out too.
Callie's about to snap Brady's neck back into place. She advises Kyle to leave, but he refuses to be kicked out again. Callie then tells him to hold Brady's hand. He does so. Callie does her thing and Brady squeezes Kyle's hand in pain causing Kyle to cry out in pain as well.
Henry asks Cristina about the results of the scan as she takes him back to his room. Since he has tumors removed as a hobby, he knows she can't tell him but he'd like a hint. She says Richard will come by soon. He turns to Fred, who gets all nervous and assures Henry it's all gonna be okay because his uncle also had his kidney removed and he's fine. Henry is surprised they have to remove his kidney.
Richard is explaining to Henry why they have to remove the kidney. Bailey assures him it's their best option. Henry wants to hear what Teddy thinks, because he trusts her and he'd like her on board, even though it's not her area of expertise.
Mark had Arizona paged to a room so he, Alex, and April could show her slides that compares pros and cons of using skull bone versus cadaver bone. From the slide, cadaver bone looks like the best option. Arizona has seen enough. She knows what the research says, but those are some complications. Mark takes a marker and draws on Hudson's head to show Arizona the area that wouldn't even be touched if they did the surgery his way, which would mean no risk of hitting the brain. Arizona repeats it's experimental, so as the lead doctor, she makes it clear they're doing it as planned. Mark tells Arizona she can add "bad listener" to her list of flaws for Callie. He then apologizes to Hudson for using permanent marker.
Richard finds Teddy and calls for Mrs. Burton. It takes her a while to realize that that's her. Richard talks to her about Henry's surgery and that Henry prefers her recommendation over his. Teddy takes a look at the scan and says she agrees with Richard's recommendation. Richard again says this relationship is totally inappropriate. Teddy says there are inappropriate relationships everywhere in this hospital. Eli butts in and adds Bailey and her nurse to Teddy's list of examples. Bailey clarifies they are not dating.
Over lunch, Meredith tells Cristina that she's tired of peeing on sticks. Still no positive test. April, Lexie, and Jackson join them and they observe Alex teaching his hot med student over at another table. April calls him inappropriate, but Meredith finds the girl's thong more inappropriate. They all judge her and Lexie points out they all sound old.
Arizona approaches Callie and says she's ready to listen now. Callie repeats she wants Arizona's crap out of her apartment.
In the OR, Meredith asks Kira if she wants to take another look at the stitches, but Kira is busy texting her boyfriend. Callie comes in with another gurney. The doctors roll Brady onto the gurney, but something's wrong with him. Owen suspects delayed internal bleeding and decides to do a laparotomy. Jackson has told his med student to step back, but Edward saw the heart monitor while they were turning Brady over and he suspects it's hyperkalemia. They administer drugs and calcium, which fixes the problem. Edward says they were just taught that the previous Friday. Owen tells him good save.
Arizona approaches Mark and asks him to tell her about his idea for Sarah. He's happy she's finally learned to listen, but she wants him to drop the personal issues and just talk about the surgery.
Mark is explaining to Sarah and her parents how the procedure will work with the cadaver bone. This way, there's a much smaller chance that the bones will degrade over time, which is key for playing sports. Sarah's parents are worried about the whole experimental part. Arizona clarifies the other option means that Sarah won't be able to play sports. Sarah wants the cadaver option. She's a tomboy, but she never could be a tomboy. If her parents don't let her take this chance to let her be who she is, she'll be prone to depression, addiction, and eating disorders. Sarah's mother says she's too smart for her own good. Sarah says that is because all she does is read. She wants to be a dumb jock.
Cristina, Bailey, and Richard are operating on Henry. Richard compliments Cristina's work. Cristina offers Fred to come take a look up close. He does so, but faints after a few seconds. As he's carried out of the OR, Richard says he likes to see the first-year med students once a year, because they remind him of where he started. He thinks humility is also a good quality for a Chief Resident. Also, he likes watching the med students fall. Cristina asks Richard to take a look at something.
Callie finds Kyle and tells him that Brady is fine, but his recovery will be slow and painful. Kyle says this was supposed to be the best day of their lives. He thinks Callie thinks he's silly with the horses and bagpipes. Brady does, too. They don't get married in Washington. They get domestic partnerships and have to stand in line at city hall. He wanted a big day like everybody else. He fought for it, but they still said no. He and Brady got tired of waiting, so he decided to make signing the papers special. Brady's the best thing that's ever happened to him and he wanted it to feel like that. Callie says things don't go the way you want them to, ever. She says they can go see Brady.
Teddy was paged to Henry's OR. Richard says they found a cyst on Henry's pancreas. Removing it will make Henry diabetic. They didn't discuss that possibility with Henry, so they decided to ask his wife. She's also his emergency contact person, so Richard asks her if he has the support system to deal with the disease. Teddy says she doesn't know if there's someone to call. She gives Richard permission to act as he sees fit.
Eli asks Bailey if she found his note. She did. She says he's dirty. He asks if she wants to be dirty with her in an on-call room, but she says she's going home. He kisses her and tells her he gets off in an hour, in case she changes her mind.
Cristina sits down with Fred on a bench outside the hospital. He tells her he has a PhD. He's number 1 in his class so he's not an idiot. He's just never seen this stuff up close before. Cristina tells him to always back up his resident, and if a patient asks for information that he's not allowed to give, he should stall or say he doesn't know. And if he ever panics in an OR, he should stop thinking and take a deep breath. That usually helps. Fred says he feels like an ass now. He tells her to disregard his evaluation. He says they all had to turn in evaluations on their residents and he used the word "heartless" in his. She turns around and goes back inside.
Bailey joins Teddy outside Henry's room. Teddy asks Bailey to lay the speech on her, about Richard being right and all. Bailey says she's not dating a nurse, but they are having fun. She looks at him and he's pretty, but there's no future there. He left a dirty note for her in a chart. What if the Chief had found it? He's inappropriate, but she's gonna go with it. "Why not?" is her attitude these days. She walks off. Teddy has no idea what just happened.
In the OR, Alex lets his student hold the cadaver bone. April loudly asks if that's okay, seeing Laurel has so little experience. Mark agrees with April. Students are only allowed to observe. Arizona asks Mark if stubborn, passive-aggressive, and resenting obligations cover her bad flaws. Mark says he chooses Callie over her in the divorce. Arizona knows that since they've been friends for a long time, but she sees Mark as her brother. She actually considers him family. Mark adds "patronizing" to her list.
Teddy's sitting by Henry's side as he wakes up. She gives him some water and tells him they had to remove a part of his pancreas after she gave her consent. That means he might be diabetic for the rest of his life. It'll be a big adjustment. Henry says he's used to adjustments with all the tumors. She says she's sorry. He knows she's also angry because he listed her as his emergency contact person. She admits this was supposed to be just the paperwork. Life and death decisions weren't part of their deal. Henry says his parents are dead and his sister lives in Prague. She's broke and his health thing is exhausting, so they don't have the best relationship. He had a best friend, but he married a woman who always made it very clear that Henry's disease was exhausting. He always had to change jobs because he kept maxing out on his insurance policies. It's not easy to make friends that way. It's not his intention to make Teddy feel sorry for him, but he wants to explain that she's the closest he has to a friend. That's why he put her down, not because of the fake marriage. She takes his hand. He says it sucks that he might be diabetic.
Brady wakes up with Kyle and Callie by his side. Kyle apologizes to him. Brady knows he just wanted it to be special like he always does. He forgives Kyle so he can stop apologizing. Also, he doesn't want Kyle to try and make it up to him, because then he'll be killed for sure. Kyle tells Brady he loves him and they kiss. Callie leaves the room and tells Meredith Brady's awake for a post-op assessment. Kira asks Meredith how long that takes. Meredith says she can go home since she's obviously not interested in learning anything. She was using her phone in the OR and asking about her husband. Kira says she saw Meredith's pregnancy test and Meredith kept sneaking off to the bathroom, so asking about Meredith's husband was her way of getting on Meredith's good side. Kira walks off.
In the resident lounge, Jackson is surprised to hear that they got evaluated today. Meredith says no one will actually read the evaluations, but Richard walks in, holding the evaluations. He reads that Dr. Yang lacked patience and basic compassion. Dr. Kepner is unwilling to delegate. Dr. Avery placed his own learning opportunities before those of his students. Dr. Grey seemed to have a lot going on personally today. The only one with a positive evaluation is Alex. Alex laughs and leaves the room gloating.
Mark and Arizona are watching Sarah, whose parents bought her a volleyball. Arizona says she tries not to think about her biggest flaws, so she needs Mark to tell her. Mark says she bails when things get hard.
Back at home, April says she's a great delegator, which is why she's so organized. Laurel enters the kitchen wearing only a T-shirt. She came down to get some water. Jackson points her to the glasses and he sneaks a peek as she stands on her toes to grab one. April slaps him.
Owen comes home and finds Cristina eating cereal on the couch. He asks about her day. Cristina says a med student screwed her, but she did pretty well. She offers him some cereal, too.
While getting ready for bed, Meredith tells Derek she stole pregnancy tests from the clinic since they're $15 at the store. She says she's a barren thief. Derek says getting pregnant takes time. Meredith says some people hit it off on the first try. Derek says those people are overachievers, but Meredith says she is one, too. She forgot to teach her student today because she was too busy peeing on a stick, and now she's getting her ass kicked in the race for Chief Resident. She says she's softcore now. Derek says they just have to practice.
Arizona gets on the elevator with Callie. She admits she walks away when things get hard. Maybe she never learned to commit because they moved every 18 months when she was a child. But she's here now and she's staying to fight so Callie knows she's committed to this. She says Callie isn't perfect either and not being able to forgive is a flaw, too. Callie might as well forgive her now because they're in love with each other. She wants another chance more than anything. Callie tells her she found out today that she's pregnant with Mark's baby. "How about now?" she asks. Arizona is speechless.
- Ellen Pompeo as Dr. Meredith Grey
- Sandra Oh as Dr. Cristina Yang
- Justin Chambers as Dr. Alex Karev
- 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
- Kevin McKidd as Dr. Owen Hunt
- Jessica Capshaw as Dr. Arizona Robbins
- Kim Raver as Dr. Teddy Altman
- Sarah Drew as Dr. April Kepner
- Jesse Williams as Dr. Jackson Avery
- Patrick Dempsey as Dr. Derek Shepherd
- Scott Foley as Henry Burton
- Daniel Sunjata as Nurse Eli
- Wilson Cruz as Kyle
- Amy Rosoff as Kira Donnelly
- Amber Stevens as Laurel Pinson
- Tommy Snider as Edward Taylor
- Adam Busch as Fred Wilson
- Kevin Christy as Brady Sullivan
- Amanda Leighton as Sarah Cassidy
- Mark Charran as Hudson
- Mark Fite as Jared Cassidy
- Tracy Maddox as Sophia Cassidy
- Grace Rowe as Paramedic #1
- Von Hippel-Lindau
- Pancreatic cyst
Henry was being treated with alpha-blockers for his tumor. However, he was back in the hospital to have surgery now that he was insured. His tumor was the biggest of its type that Webber had ever seen and it was infiltrating his kidney, meaning the kidney would have to be removed. In surgery, Richard discovered that they'd have to remove a large portion of Henry's pancreas because there was a necrotic cyst on it, which would leave him diabetic. He called Teddy in to make the decision. Teddy gave her consent for him to do what he felt was best and he removed most of Henry's pancreas. Henry was stable and awake after surgery.
- Crush injuries
- Tandem lesions
- Fracture translocation at L-4 and L-5
- Unilateral jumped facet at C-5 and C-6
Brady, 32, was brought to the ER after being trampled by horses on his wedding day. Scans revealed a neck bone that was knocked out of place and a broken back. Callie used traction to re-align his neck so that they could properly intubate him for surgery. As the doctors were positioning him on the OR table, Brady became unstable. Owen thought it was due to delayed internal bleeding. However, Edward, Jackson's med student, said it was probably hyperkalemia because he saw signs of it on the heart monitor as they rolled him onto the table. They pushed meds, and he stabilized. They were then able to complete the laparotomy. After surgery, his husband was informed that he'd have a long recovery, but he'd be okay. He woke up after his surgery.
- Treacher Collins Syndrome
- Re-building cheekbones
Sarah, 15, was born without cheekbones. She was in the hospital to have surgery to take a part of her skull to rebuild her cheekbones. Mark proposed an alternate solution that used a cadaver bone graft, which would speed her healing time. Arizona believed it was too experimental. However, she later came around and agreed to use the cadaver bone graft. This plan would allow the bones to grow with Sarah's face, which would give her a better outcome. They operated successfully.
|"Cry Baby"||Cee Lo Green||
|"Under Rays"||Eux Autres||
|"Harder Than Easy"||Jack Savoretti||
Notes and Trivia
- This episode's title originated from the song Start Me Up, originally sung by The Rolling Stones.
- This episode scored 12.15 million viewers.
- Cristina: It's like court-ordered community service.
- Meredith: I'd rather be picking up trash off the side of the highway.
- Arizona: I bail. Okay, when things get hard I... I walk away, maybe it's because I grew up an army brat and we moved every 18 months. Maybe I never learned to commit, but I'm here now, and I'm staying because I'm gonna fight to make sure you know that I'm committed to this thing. I'm not perfect but neither are you, and you... you wanna talk about faults? How about not being able to forgive? At some point your gonna have to forgive me, and it may as well be now because I am in love with you Calliope and you are in love with me and all I'm asking for is one more chance.
- Callie: You want another chance?
- Arizona: Yes. More than anything, I want another chance.
- Callie: Today I found out that I'm pregnant. With Mark's baby. How about now?
- Richard: Mrs. Burton. (Teddy ignores him.) Mrs. HENRY BURTON. (Teddy looks up.) Your husband requested that I talk to you about his upcoming operation. We would like to remove the kidney.
- Teddy: Well, a man can live without a kidney. If that's, um, your recommendation.
- Richard: Funny, because that's exactly what I would recommend, but apparently, my recommendation as Chief of Surgery, with over 30 years of General Surgery experience under my belt isn't enough. He would like your recommendation. The recommendation of a cardiothoracic surgeon, who happens to be his wife.
- Teddy: I see. Yeah, I agree with your recommendation. There you go.
- Richard: This is a totally inappropriate relationship. Totally inappropriate!
- Teddy: You wanna talk to me about inappropriate relationships? Everywhere I look in this hospital there are inappropriate relationships! Grey and Shepherd, Hunt and Yang, the other Grey and Sloan--
- Eli: Dr. Bailey's dating a nurse. Taking full advantage.
- Bailey: Oh! (She slaps Eli.) Ignore him! We are not dating!
- Miranda: Okay, I'm not dating a nurse. We're not dating, but we're having fun. I look at him and he's pretty, but there's no future.
- Cristina: Ok, you think peeing is exhausting. Wait 'til you have a mewling, poo-covered infant hanging off of your boobs 24-7.
- Cristina: I'm unstoppable and you got defeated by a piece of plastic covered in urine. Buck up.
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 7|
|#01||"With You I'm Born Again"||#09||"Slow Night, So Long"||#17||"This is How We Do It"|
|#02||"Shock to the System"||#10||"Adrift and at Peace"||#18||"Song Beneath the Song"|
|#03||"Superfreak"||#11||"Disarm"||#19||"It's a Long Way Back"|
|#04||"Can't Fight Biology"||#12||"Start Me Up"||#20||"White Wedding"|
|#05||"Almost Grown"||#13||"Don't Deceive Me (Please Don't Go)"||#21||"I Will Survive"|
|#06||"These Arms of Mine"||#14||"P.Y.T. (Pretty Young Thing)"||#22||"Unaccompanied Minor"|
|#07||"That's Me Trying"||#15||"Golden Hour"|
|#08||"Something's Gotta Give"||#16||"Not Responsible"|
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