"Surgeons are all messed up." "We're butchers, messed-up knife-happy butchers." "Sir, would you like a card set up for you in her room?" "We cut people up." "We move on." "Patients die on our watch." "We move on." "No." "I'm a doctor here." "We cause trauma." "We suffer trauma." "Wait." "And here it comes." "We don't have time to worry about how all the blood, and death, and crap really makes us feel." "This is how you went wine, by watching two hours straight advanced coronary artery." "Christina?" "Everything okay?" "Christina!" "Hunt!" "It's 3 in the morning, Christina." "This better be good..." "Callie." "What?" "He what?" "It's me." "Christina." "What's going on?" "Owen's out there upset." "Callie was screaming." "I'm fine." " I'm Fine, I'm fine, I'm fine." " Oh, my God." "Your neck!" " I will kill him." " No." "It was a nightmare." "He had a nightmare." "Christina, please." "She all right?" "I just need to know if she is all right." "No." "No." "No." "No." "Christina, no." "I am so sorry." "I don't know what happened." "I'm ..." "I don't know what happened." "I'm sorry." " Look at me." " I'm sorry." "Look at me." "I'm fine." "See?" "It's okay." "You were asleep." "It's okay." "Okay?" "It's okay." "It's okay." " I'm sorry." " It's okay." "I know." "It's okay." "You were asleep." "It's okay..." "It's okay." "It's okay." "Season 4 Episode 19 Elevator Love Letter" "Here's coffee." "No." "I don't like this." "Today is your first day back to the hospital." "Today is about Izzie." "You have to operate on her brain." "You have a gift." "And you can do this." "I'll get a shower before I go there." "You're wearing a turtleneck under your scrubs." "It's ugly." "Not as ugly as the fact you hugged him." " You hugged him." " I get it." "Hear you." "Let's move on." "Turtlenecks aren't okay." "You're not okay, and your boyfriend's not okay." " Is your boyfriend okay?" " What?" "To be cutting into brains today." " Is he okay to be back?" " Yes." "Of course." "Derek is fine." "I was there for his carnage in the OR." "Remember?" "This isn't just any patient today." "This is Izzie." "George." "Hey." "I'm surprised you're not..." "I mean isn't there a big presentation happening with Izzie?" "I didn't even know she was sick." "Bailey told me after Christina told her." "Izzie trusted Christina." "I was the very last to know." "Well, I'm sure Izzie wasn't trying..." "I don't even want to talk about it anymore." "What I wanna do is work." "You have any room on your service?" " Yeah." "I have 3 hip replacements and a tibia repare." " Thank you." "Uh..." "You three." "Okay." "I understand why you're here." "I know you wanna help." "But I will be the resident on her case today." "I will be preping her for surgery." "And if you going into that hospital room today, you'll do so as her friends." "Izzie needs her people around her." "She needs you tell her everything will be fine." "She needs you hold her hands." "She needs you." "Not more doctors." "Understood?" "Great." "Let's get started." "As you know, you have stage IV metastatic melanoma." "We have a lot of surgeries and a lot of procedures lined up for you over the next few weeks." "We've seen evidence of METS on your liver." "So one of those surgeries Dr. Bailey and I will resect them." "We also lined up Dr. Parker from OB to harvest as many healthy eggs as she can before you undergo any radiation." "Right." "Babies." "You just leave me a word before if you wanna" "But our priority today is to address the temporal lobe mets on your brain." "I'm surprised we need to catch it soon." "This kind of thing can cause headaches and seizures." "And intense hallucinations." "But hopefully delusion has cleared much since I can remove it all." "Are you people done?" "Over the next four weeks, you're slated for three major surgeries." "Seven out-patient procedures." "That's just for the METS we've already found and all likelihood we will find more, which means we may have to cut into you more." "You may get used to the idea now." "I'll be adiministering all your radiation chemotherapy and immunotherapy." "The treatment will be agressive." "It would be harsh." "You should prepare yourself." "I will be overseeing all your procedures, including today's with Dr. Shepherd." "Which means every surgeon in this room now answers to me." "Welcome to the counseling, folks." "See you in the OR." "Seriously, don't just stand there staring at me." "Well, I admit it." "I can be nervours." "Get out of here." "Go save lives." " Yeah." "We're on rounds." " Okay." "See you later." "Karev, I just reviewed Izzie's most recent MRI." "Doesn't look the tumor's grown since her last cancer." "That's good news." "Do you have any questions or concerns you'd like to discuss with me before we brief Izzie." "Just try keeping her frontal lobe inside her skull this time." "Good morning, Izzie." "You come?" "No." "I'm on this old lady." "So..." " Are you sure?" "This'll only take a minute." " I gotta go." "Really." "Hi, Dr. Sloan." "These are Aunt Joice's nephews." "These're my brothers Toben and Luke, they flew in early this morning." "Dr. Sloan is doing the surgery." "I'm sorry." "Your aunt is very sick." "There's not much more we can do for her." "Probably time to say goodbyes." "You mean, like say our goodbyes now or some time in next 24 hours?" "I mean, what kind of time frame are we talking about?" "24 hours seems unlikely." "You sure?" "Because I have a flight to catch in the morning." "And if I wait past noon, I can't change it." "I actually need to be on the plane tonight." "Board meeting tomorrow." "So do you think she'll die before tomorrow?" "You really think Shepherd's a God for Steven's surgery today?" "Did you have somebody else in mind?" "Shepherd wouldn't be my choice given his recent history." "But hey, it's not my brain that man's handling." " No." " Damn!" "She's HLA type D3." "Have to hit her with the DTIC and high dose IO-2 instead." "IO-2." "That's pretty toxic." "It's about as bad as I guess." "You're gonna tell Izzie this right now?" "I am her oncologist." "Study show that giving patients bad news right before surgery can drastically increase their chances of complications on the table." "Today or tomorrow, the news is the same." "And right now, I have time." "You coming?" "I believe Izzie is down in radiology now." "Fine." "We can wait an hour." "Chief." "You paged me?" "Oh, Karev." "Yes, I did." "As you know, we're gonna be harvesting eggs from Stevens." "Who I believe is someone you're having relations with." " Chief." " Frozen eggs have a better survival rate when they're..." "fertilized." "Fertilized." "I know this is a lot to digest." "So take some time." "Think about it." "If you decide this is somebody might want to consider" "Just give me the cup." " Karev." "You need to speak to Stevens." " Just give me the cup." "She's doing okay?" "Yeah." "Well, she said she is." "Do you believe her?" "No." "Not really." "Oh." "Heads up." "What do you hear?" "Motorcycle lost control." "No helmet." "Massive head trauma." "Lots of vital signs unmoved." " Good to have you back, Shepherd." " Thanks." "Come on." "Hunt." "You hear me?" "Owen." "Swender has no vision." "He grabbed his hands on your throat this morning." "You pretending like nothing happened?" "Just focus on Izzie." "Hunt literally tried to kill you." "He's barely back from Iraq." "It's obvious he has issues." "That doesn't mean you have to stand by." "So like if he had a heart attack or stroke or lost a leg." "Would--would you walk away?" "So how is it anymore acceptable that I walk away from this?" "He's wounded." "He's war wounds." "Meredith." "It's not cut and drive." "And it is not as bad as you think it is." "Clear." "This might be it." "From your lips to God's ears." "Charge to 360." "Clear!" "Oh, for the love of God." "Hey, you know how many people are in this hospital right now waiting, hoping that their loved one might actually live?" " You're a bunch of vultures." " But we're not." "Aunt Joyce was given one month to live three years ago." "And we were crushed." "And we held her hand at her bedside for weeks, and we said our tearful good-byes." "And then..." "She stabilized." "She's been in and out of the hospital once a month." "Each time, we jump on a plane, sit by her bed, say our good-byes all over again." "And each time, she winds up getting better." "We want to be here when she goes." "We--we really do, but..." "It's a lot of flying around the country." "She's ready." "We're all ready." "It's time." "And I've got a board meeting tomorrow." "Big one." "You know, they're doing tests that show altered brain anatomy in patients with PTSD." "They're actually getting close to understanding the physical side of the psychological trauma." "It's amazing what you can see with an MRI." "What did Meredith tell you about last night?" "What did she say?" "Post-Traumatic Stress is a real injury, Owen." "It can be healed." "There are resources-- vet centers, therapy." "You shouldn't try and handle this on your own." "I came back in one piece." "I have both arms, both legs." "Lots of guys came back with real injuries." "If the worst I have is a couple nightmares or" " Or freezing for a moment" " Is that what happened last night?" "You had a freezing moment?" "If you want, I can help." "Oh, yeah?" "I'm not the one who needs help around here." "I'm not the one who cut out half a woman's brain then ran off to hide." "I'm not the one who half this hospital is talking about behind their back." "So maybe you should spend a little less time worrying about me, and, you know, just take a look in the mirror, all right?" "Karev." "Just checking in, see how your c" "See how you're doing." "I'd be doing better if you weren't on the other side of the door listening." "Uh, right, right." "Sorry." "I said go away." "You left the door unlocked." "That's bold." "The chief send you in here?" "Nope." "I offered to come in, in case you needed to talk." "You think talking will help?" "You think a dixie cup full of my swimmers will make everything okay?" "It's crap." "This is crap." "You just can't go messing with people's heads like that." "Even if she freezes the embryos, you think--you think we'll get a chance to use them?" "You think she'll still be here?" "You think she'll survive all this?" "Do you think..." "I think..." "She t-told me" "She told me she was seeing a ghost, okay?" "And I'm so used to all the crazy chicks in my life that I didn't even..." "I'm a doctor." "A doctor!" "And I didn't even think..." "And now she's..." "This is..." "This is wrong." "This isn't how it's supposed to happen." "I know." " It's crap." " I know." "I hate this." "I know." "This isn't..." "This isn't how we..." "how we were supp" "This isn't how I wanted to do this." "This isn't how Izzie and I were supposed to make a baby." "I haven't seen you all day." "What if I hadn't woken up?" "I can't even remember what happened." "It's gone." "I have no memory, no--no way to..." "I would never hurt you, ever." "But I did." "My hands just..." "I mean, how could-- How could my own two hands be capable..." " I can't do this, Cristina." " But you did wake up." "We need to stop seeing each other." " We have to stop seeing each other." " Why?" " Cristina, I almost" " Almost what?" "I told you, I know my limits." "Let me decide what I can handle." "Oh, good." "Stand right there." "Let me see." "I never know how long to make these." "I like the color." "Who's it for, Karev?" "Haven't seen much of him today." "He's working." "They're all working." "I told them to go work." "They're doctors." "Their patients shouldn't suffer just because I have things growing on my organs." "I have a colectomy this afternoon." "If you were the resident assisting me, and I were to say to you, "divide the cecum"." "What would you use?" "Dr. Bailey, I'm not assisting you, and you're not gonna ask me to divide the cecum." "But I'm not gonna let you get rusty." "A year from now, you need to be able to do this stuff." "You need to be able to teach your residents how to do it." "You really think I'm gonna be here a year from now?" "Yes, I do." "So..." "I have exposed the right lower quadrant, and you are dividing the cecum with..." "Forceps." "I lift free from the arachnoid." "Tacking sutures." "Patties." "Suction." "Lets train a little more." "Here's your cup, all filled up." "I'm eating here, Karev." "It's fine." "I washed my hands." "Did you talk to Izzie about this yet?" "Considering you two are basically conceiving a child together today, don't you think you should talk with her about this?" "Look, you said she needed my..." "Contribution." "Here's my contribution." "Whatever." "Hey, how's Izzie?" "I don't know." " How's Izzie?" " Why?" "Have you been to see her?" "No, I've been working with Swender all day." "What?" " Have you been to see Izzie?" " No, haven't you?" "You finished that thing in one day?" "Had some free time." "I've had a lot of free time." "Nobody came up to visit?" "It's okay." "If I were them, I wouldn't want to step foot in this room either." "You don't have to keep checking up on me, you know?" "I do have to." "I have to start you on this before your surgery." "Right." "Surgery." "Well, and I wanted to tell you how my surgery went this afternoon." "Colon guy." "Yeah." "Now the colectomy went great." "But I was in there, and I see a mass." "You're kidding." "Was it a big mass?" "It was big enough, about the size of a fist." "This is going to burn a little at first, but, uh, just for a few seconds." "So we had to mobilize the SMA." "Before we could resect the thing and reconnect the bowel." "I wished Izzie Stevens would die." "I wished her dead every day of every week for I don't even know how long." "I woke up every morning wishing Izzie Stevens would die." "And now..." "What kind of person wishes someone would die?" "What kind of doctor wishes-- knowing how things happen." "What kind..." "What kind of doctor wishes..." "Are you in here, right now, praying for Izzie to die?" "No." "I'm praying for her to live." "Clear." "You know what?" "Why don't you all wait outside?" " Will you let us know if she" " Yeah, yeah, I'll let you know." "Bastards." " Push 1 of epi." " Charge to 360." "Clear." "Come on, Joyce, you old bag." "Don't give 'em the satisfaction." "Charge again." "Clear." "I'm dr." "Karev." "You're a fighter, you know that?" "You worked hard today." "She needs some rest." "Um, see the family, make sure they don't come back in here." "Give her a break from all the love." "No." "They're impatient." "It's been a long time." "But they always come." "They're my people." "People keep you going." "People are better than no people." "Uh, it's not a good time." "He's still scrubbing in." "I know." "It's just, uh, he should wear this." "It's his ferry boat scrub cap." "He loves ferry boats." "Meredith." "What are you doing?" "You're gonna have to rescrub." "I'm not ready." "Yes, you are." "I need to know that at least I have you." "No matter what happens in there, I need to know." " I need you to say yes." "I need to know." " I can't say yes," "Not if agreeing to be with you forever will make it okay if Izzie dies." "I can't say yes." "I love you, and you can do this." "You can do this." "I know you can." "Iz..." "I'll see you soon, dr." "Stevens." "I hope so." "Know so." "Dr. Bailey, if something goes wrong" "It won't." "The scarf..." "I made it for you." "Beautiful night to save lives." "Let's get started." "Okay, so I get why I haven't been camped out at Izzie's bedside holding her hand today, but" "I'm not talking about this." "Why not?" "Maybe it's the fact that I asked Izzie a hundred times what was wrong, and she just ignored me." "And then there's the fact that when she actually needed help," "She turn" "She trusted Cristina, of all people." "And then there's the fact that she's your best friend and she might die on you." "There's also that." "Come on." "We are going to go wait for Izzie." "Come on." "George, you were my husband and you slept with her." "You are the reason that I wished her dead." "You owe me this." "Look, you can lie to yourself all you want, but I know you." "I loved you once." "And I know that you care if she lives or dies." "Surgery started." " Hey, have they started the surgery?" " Yeah." "Dr. Grey, we were wondering, did dr." "Stevens' surgery start yet or" "Keep it moving." "No loitering in the OR hallway." "That's the rule." "If they want to stay, let 'em stay." "People are better than no people." "Okay, clamp." "All right, I'm ready to, uh-- no." "Yes, okay." "I'm ready to buzz the superficial temporal artery." " Tenting sutures." " There's no rush." "Take your time." " Everyone here is on your side." " Are you sure that's gonna hold," " what, with all that friable scar tissue?" " Dr. Swender." "Uh, actually I saw dr." "Shepherd do three different craniotomies last month, each with easily double the amount of friable tissue." "They held just fine." "Next tenting suture, please." "Clear." "Push another epi." "Charge again." "Come on, mrs." "Wallington." "Clear." "Uh, I-I'm so sorry." "She's not responding." "We've done everything we can." "So..." "She's gone." "Thank you." "You did a wonderful job." "Are you kidding me?" "Oh, God." "This is never gonna end." "No, no, she--she's gone." "She's really gone." "It's really gone." "It's--it's, um, it's her pacemaker." "It's still firing." "So it makes it seem like there's a heartbeat, but she's gone." "Just..." "With a heartbeat." "Are you sure she's dead, young lady?" "I--I'm an intern." "I'm not authorized to call time of death in a situation like this." "So I--I'm gonna get my superior." "Excuse me." "I'll" " I'll be right back." "Excuse me." " I'm worried about you." " Oh, Meredith" " Choking..." " Stop." " It's unacceptable." " Will you back off?" "Hands around the neck." "Ring thrown in your face." "This will shut the pacemaker down." "Time of death-- 2240." "There you go." "She's officially dead." "You can catch your plane and get to your board meeting." "You can--you can leave." "Actually..." "Could we stay a little while longer?" "What are you all doing out here?" "Waiting for Izzie, sir." "We're waiting." "You're scared." "I'm scared, too." "Damn it." "Some of the sylvian vessels have wrapped around the tumor capsule." "Penfield 4, please." "Really?" "Instead of the arachnoid knife?" "Yes, instead of the arachnoid knife, because the penfield 4 will let me slide the arteries around the met." "I need to dissect it free so that I can debulk the tumors, avoiding unnecessary trauma to my patient." "So yes, penfield 4, please." "Were her vitals stable the entire time?" "Were there any spikes in her intracranial pressure?" "Is there any residual tumor?" "Shepherd was able to resect all of the tumor." "She'll be in the pacu for about an hour." "She's fine." "Your friend is just fine, no thanks to any of you." "Tomorrow, do better." "The surgery went well today." "Shouldn't you and Meredith be out celebrating or something?" "She turned me down, twice." "She says she understands, she forgives me for what happened in the woods, but..." "So you showed her your dark side?" "Meredith never struck me as a woman who was afraid of the dark." "I don't know." "Do you know it was Meredith's idea to ask Izzie if she wanted to harvest her eggs?" "So Izzie could have a chance at the future she wanted." "The future, Derek." "She was confident you'd succeed today." "Meredith believes in you." "I'm here, Iz." "I'm right here." "Izzie's surgery went well." "Good." "That's good." "I wish things were..." "That they could be..." "That we could be..." "Me, too." "Can I hold you?" "Wait." "Uh, Wait." "No." "Y-you can't take that one." " Why not?" " I said don't take it." "I will take the elevator I want to take." "Well, go on." "Hey." "Come on in." "This is the CT for Katie Bryce-- 16-year-old female, subarachnoid aneurysm." "From a fall during rhythmic gymnastics." "I remember." "It was the first surgery we ever scrubbed in together on." "Our first save." "Right here is a cerebral cyst." "Tough save, but we did it." "I kissed you in the stairwell after the surgery." "And this right here is where dr." "Bailey kicked you out of the surgery because she caught us in your driveway in my car." "And right here" "This is a 7-hour craniotomy, and you held the clamp the entire time, never flinched." "That's when I knew you were gonna be an incredible surgeon." "And Beth Monroe, who made our clinical trial a success by surviving." "You talked me into putting her under." "That's when I knew I needed you." "And this is today." "Post-op head CT of Izzie Stevens." "You see that?" "Tumor free..." "Because of you." "You got me into the OR." "If there's a crisis, you don't freeze." "You move forward." "You get the rest of us to move forward, because you've seen worse, you've survived worse." "And you know we'll survive, too." "You say you're all..." "dark and twisty, but that's not a flaw." "It's a strength." "It makes you who you are." "I'm not gonna get down on one knee." "I'm not gonna ask a question." "I love you, Meredith Grey." "And I want to spend the rest of my life with you." "And I want to spend the rest of my life with you." "I don't think..." "I can't handle it after all." "What?" "What do you mean?" "I'm sorry." "I'm so, so sorry." "But I'm lying here in your arms..." "And I'm afraid to fall asleep." "Doesn't matter how tough we are..." "I..." "I wanted to apologize for earlier." "What I said was..." "It was out of line." "It's already forgotten." "Thank you for doing this." "Trauma always leaves a scar." "I'm engaged." "I broke up with Owen." "It follows us home..." "It changes our lives..." "I snooched into a cup for you today." "Um..." "Thank you?" "Trauma messes everybody up." "But maybe that's the point." "All the pain and the fear and the crap..." "Maybe going through all of that is what keeps us moving forward." "It's what pushes us." "Maybe we have to get a little messed up, before we can step up."