"Number one rule of surgery is limit exposure." "Good." "Keep your hands clean, your incisions small and your wounds covered." "I've removed the tumor and placed the catheters." "Now, I'm going to flood the abdomen with heated chemo." "It allows a greater concentration of drugs to be delivered directly to the affected area, and the heat helps target the cancer cells while leaving the normal cells virtually unaffected." "OK, start perfusion." "OK." "We'll place him in Trendelenburg, then reverse Trendelenburg as we agitate the abdomen to make sure that the chemo really washes everywhere." " OK, she saw me." "Now I can go." " She's just getting started." "I have a headache." "I need coffee." "I have a cure for a headache that doesn't involve coffee." " I'm leaving." "There's a seat there." " Thanks." "OK." "Ooh, yeah." "I've never seen a hot chemo lavage before." " It's fascinating." " I thought you were leaving." "The chief asked me to finish out my contract, which has a few more weeks." "Number two rule of surgery is when rule number one stops working, try something else." "What I said I didn't mean." "You mean offering to trade Owen like a horse or a baseball card or a stale peanut butter sandwich from your lunchbox." "It was..." " It was thoughtless." " Fine." "Fine." "Cristina, let's just forget about it." "Because sometimes, you can't limit exposure." "Sometimes, the injury is so bad you have to cut and cut big." " No!" " Yes!" " No!" "If you report him..." " He's an alcoholic!" "If you report him, it'll be the end of his career!" "You don't give people any room!" "Flaws are unacceptable to McDreamy." " Don't McDreamy me." " McDreamy is being a McAss!" "He's an alcoholic!" "How long has he been drinking?" "Since the holidays?" "You want to take notes so you can show it to the board so they can offer you his job?" "You want his job." "You know it, and I know it." "I'm the head of neurosurgery." "I have a responsibility to this hospital." " Admit you want to be chief." " I'm done having this argument." "I'm going to the board, I'm reporting Richard." "Post-it!" " You can't call Post-it." " I am calling Post-it." "Because I told my secret about my friend to my husband, not the head of neurosurgery." "My husband." "Which I have to be able to do." "So the laws of Post-it clearly prevail." " This is wrong." " Post-it." " The chief..." " Post-it!" "Fine." "I won't tell." "Fine." "Damn it, you just make me want to..." "Lzzie's coming home." "I have to tell Alex." "I won't go to the board." "I won't say a word." "Just think about what I said." "OK." " Alex, lzzie's coming..." " Izzie's coming?" "...home." " Crap!" "Lzzie leaves and Mark gets a kid, and you two decide the best way to deal is to get drunk and mash your genitals together?" "No freaking way you get to judge us or give relationship advice." "Besides, you were a total dirty mistress, like, two weeks ago." " Are we calling me a dirty mistress?" " That was two years ago." "And his wife didn't have cancer!" "Because I've only been with, like, six guys in my whole life." "Alex and I, we've done it before." "I was recycling." "It was like good for the environment." "Izzie's gone, I was horny, she was there." "Crap!" "I am a dirty mistress." "Oh, God, you're gonna tell Derek and Derek will tell Mark that I'm a whore!" "No, I am not going to tell Derek, and neither are you." "And you're not gonna say anything." "We are keeping our mouths shut." "Izzie is coming home." "No one needs to know." "Hi." "Know what?" "There were no sterile supplies in the OR last night." " I heard." " Surgery came to a complete stop" " for a full hour." " Central Supply and Maintenance are understaffed and the autoclaves have been breaking down." "Anything else?" "Richard..." " I want to help." " I don't need your help, Derek." "The sterilizers are up and running, so..." "Not the hospital." "You." "You stopped operating." "You're not teaching anybody but Meredith." "I'm wondering if..." "If you need some help." "No shame in asking." "You know that." "You can help." "By doing your own job." "And letting me do mine." " Anything else?" " No." "I'm done." "So I went to the trailer." " I don't live in the trailer anymore." " Yeah." "So Meredith called me and told me you might be moving on." " Iz..." " OK, just..." "Just wait." "I realize now that I was wrong to blame you for getting fired." " I'm sorry." "It wasn't your fault." " I don't wanna have some big talk." "I gotta go to work." "I have a PET scan later, so maybe I'll see you at the hospital?" " Is everything OK?" " Yeah." "I found some residencies with open spots and applied." "They all just want to make sure I'm stable." "One of them is close." "It's in Tacoma, so we'd be OK." "I could commute from here, and..." "I know you don't want to have some big talk, but..." "I have to get to the hospital." "That place really sucks these days." "You should be happy you don't work there anymore." "Hmm." " Sorry." " Don't be." "I am happy." "I'm gonna work in Tacoma, and it's gonna be awesome." "You're gonna be jealous." " You're operating?" " I am." "A Whipple?" "That's big." "I say go big... or go home." "Uh..." "Excuse me, sir?" "You're taking Dr. Bailey's Whipple?" " Is that a problem?" " No, not at all." "No, I'm the resident on the case." "I'm thrilled to be assisting you." " I will be assisting you, right?" " You can open." "That way Dr. Grey will be fresh when she dissects the neck of the pancreas from the portal vein." " That's the hardest part." " It's a fifth-year procedure." "It's what we've been practicing." "And I'm telling you, you're ready." "But if you don't think you're ready..." "No, I'm ready." "I'm ready." " What's going on?" " Hunt's got an MVC in here." " Use a hand?" " What?" " Can I help?" " You know what you can do first?" "Make that stop!" "Dude, stop singing!" "I'm trying to get you to understand the seriousness of the problem." "I've lost my upper register completely." "Dr. Karev, this is Mr. Mafrici, your consult." "I just need some antibiotics." "I open in Tosca in a week." " And he gave me bronchitis." " I did not give this to you." "Take a deep breath." "He teaches piano to children." "I can hear them hacking away during their lessons, and then he comes in the house and touches things." "Stop talking." "He's got decreased breath sounds on the left side." " He needs an X-ray." " Can you take him?" "Page an intern." "I don't have time." "Hunt took him up." "Said thanks for your help." "You got time now?" " You're hot." " You're hot, too." "No, you're "hot" hot." "Oh, OK." "Thanks." "No, you have a fever." "You have a fever." " What is that?" " What?" " Oh, my God!" " What?" "Pox!" "Pox!" "You have chicken pox!" "Teddy." "Turns out she loves Owen and thought she came here to be all, you know, Teddy and Owen, but there's me, and now she's pained and threatening to leave, so I told her she could have him." " What?" " She's an amazing teacher." "And I'm happy again." "And I'm in the OR, and I'm feeling like myself." "And, of course, I didn't mean it." "I mean, I love Owen." "I love him." "But that means I don't get to have her." "So..." "Maybe I meant it?" "OK, here's the thing." "You can't talk like this." " It's like, I get you." " Yeah." "But other people don't." "So you can't talk like this." "I mean, it's crazy." "It's like if you tell someone their baby is ugly." "They know it, you know it." "Everybody knows it." "But you don't talk about it." "OK, but you're saying surgery, right?" "Gun to your head, you'd choose surgery over Derek." "I'm saying don't talk about this." "And don't talk about it to Owen." "Little Grey?" "That's the world-class specialist you wanted me to see?" "OK, Little Grey has had the chicken pox vaccine." "I snooped in your personnel file." "I, on the other hand, have not." " Nor have I ever had them as a child." " You're a pediatrician." " How have you never had?" " I am a pediatric surgeon." "I don't do little diseases on little people." "I do big surgeries on little people." "You know what?" "This is ridiculous." "I'm going home." "Hey, hey, hey!" "You're not going anywhere." "You're highly contagious right now." "You leave this room and you'll touch doorknobs, elevator buttons." "Then you'll be the outbreak monkey." " I'm going to kill you." " I love you." "Stop scratching." "You're just gonna make it worse." "And then you're gonna scar." "I gotta get my hands in a body again, Mer." "I think I'm gonna get an offer from Oregon, but I can't take it." "It's too far." "I can't do that to Alex." "I gotta get this Tacoma thing." "You know what would help?" "A call from Derek Shepherd, head of neurosurgery." " Hey." " Hi." "Talk to him." " Talk to me about what?" " She's up for a job in Tacoma." " She wants you to call." " Tacoma isn't ranked in the top 20." "Yeah, but it's close." "She can repair things with Alex." "Fine." "Have her get me the number." "I read the board." "The chief is doing a Whipple, and you're scrubbing in." "Well, you can stop worrying." "He's fine." "He hasn't operated in months, and his first surgery back is a seven-hour procedure with a 20 percent complication rate." "First, you were worried that he wasn't operating." " Now, you're pissed that he is?" " I don't trust him anymore." " Meredith?" " Post-it." "He's fine." "He's fine." "I thought it was infection." "Right?" "Like pneumonia?" " That's one of the possibilities." " What are the others?" "Fluid could also indicate..." "Yang." "Karev made the diagnosis." "Let him talk." "Heart failure and cancer could also cause this much fluid to occur." "Cancer?" "Would you have to remove my lung?" "Aaron, he just said cancer is only a possibility." " I sing." "It's my entire life." " Besides me." "What you meant to say was that singing was your entire life, besides me." "You heard the chief is operating today?" "Uh-huh." "Took my Whipple and is having Meredith Grey do the pancreatic dissection." "A procedure that I performed for the first time just last year." "The chief's judgment is not clear and rational." " Miranda, there's nothing I can do." " You're the only one who can." "I performed intraperitoneal hyperthermic chemo this morning." "And I kept looking up into the gallery to see if the chief was there." "That was a big deal for me." "Anyway, he wasn't there." "And I don't know why I thought he would show because the truth is he's gone." "And he's been gone a long time." "Arizona thought some work might take your mind off your itching." "Scratching will take my mind off itching." "Take off my gauze paws." "She said that you'd say that and that I should say no." "So how about we start with the tibial plateau fracture, room 2240?" "Hey, hey." "I'm an attending, you're a resident." "As your superior, I'm ordering you to take them off!" "She said you'd say that too." "Technically, I'm on her service today, so she's my boss, not you." "We have the Lisfranc fracture, room 2211." "Please, let me scratch!" "Just for five minutes." " It'll scar." " I don't care!" "I don't care." "Scars are hot." "Scars are bad-ass." "Scars are poetic." " I am begging you, Little Grey." " No." " Please don't call me Little Grey." " I'm in pain!" "Down to the core of my being pain, I'm going crazy pain, scary, "will this ever go away" pain." "Do you get that?" "Do you know what I mean when I say that?" "Because this pain is need to scratch an itch that I can't scratch!" "The pain of a thousand itches!" "And it's making me crazy!" "Not funny crazy, bad crazy!" "OK?" "Dark crazy." "Make a suit out of someone else's skin crazy." "OK?" " Pain, Little Grey." "Pain!" " I had sex with Alex!" "I had sex with Alex." "Which I regret." "Completely." "Because I'm in love with Mark." "I think." "But I'm scared that I can't handle the daughter and the baby and the Mark's" " gonna be a grandpa thing." " Why are you telling me this?" "I'm in pain, too, is what I'm saying." "I get your pain, don't you see that?" "I do feel your pain because I'm in pain too." "I have pox between my butt cheeks." "Your "pain" does not begin to compare to mine." "Get out!" "Just out!" "Out, out, out, out, out!" " What are you talking about?" " She's on this thing." "If you had to choose between the thing you love, surgery, and the person you love, which would you choose?" "You would choose lzzie, right?" "Because you're gonna get back together." " Shut up." " Why do you have to choose?" "Doesn't matter." "You just do." "Which is it, surgery or love?" " I want both." " That's what I said." " You can't have both." " Why the hell not?" " Why the hell is he here?" " I said he could be in here" " because he's in the Whipple, too." " Whatever." "Once again, you cannot have both." "You have to choose." "Choose what?" "My..." "My PET scan got pushed back an hour." "So I thought I'd join you for lunch." "OK?" "That." "You have to give up that." "Learning the procedure, tuning out the world until you get it, like, you know, doing the procedure is the only thing that matters." "If you don't get to do it, you'll die." "That's what you have to give up." " For what?" " Love." " Why?" " That's what I said." "That's not the point!" "You know you couldn't do it." " You know you'd choose a procedure." " Fine, if I had to choose, gun to my head, I would choose surgery." "OK, well, thank you!" "Is that so hard to say?" "I don't know why is it so bad to say that out loud." "Because it's crazy." " How?" " It's crazy." "Surgery, it's just a job." "It's just a job." "It's the thing you come home from, not the thing you come home to." "And if you lose your job, you get another one." "'Cause there's always another one." "But if you lose your love if you think you're losing your love then suddenly nothing else matters." "This is what you guys talk about during lunch?" "I'm with them." "Love comes and goes." "Surgery doesn't." "Results are back." "You choose love." "Yes!" "I just did a perfect dissection without lacerating the portal vein." "You gonna do that little fist pump in surgery too?" "The tests showed a malignancy on your left lung." "It's called pleural mesothelioma, and it's a cancer that surrounds" " the lining of your lung." " So what?" " You cut out his lung?" " Best case scenario, we won't have to remove any lung tissue except the tumor." " Aaron, did you hear that?" "That's good." " Jeffrey, I'm not deaf." "What's the worst case scenario?" "We get in there and the damage is too extensive and we have to remove more." " My whole lung?" " That's the worst case scenario." "But yes, it is a possibility." "But it's also possible they won't have to remove any." " OK?" "So let's stay positive." " Will you please shut up?" "I can't take your cheerful little voice shoving positive thinking down my throat when my life is basically over." "People do recover from things like this and then they go on to..." " What?" "Go on to what?" " Live." "I won't have a lung." "I'm a singer." "So you see my problem?" " You can direct, you can teach." " Like you?" "I'd rather die than spend two hours every day listening to mediocre music majors doing their scales." "I know that this is a lot to take in, and if you need time to talk" " or get a second opinion..." " I want my lung." "Dr. Altman." "I'm big, too big." "I don't fit in airplane seats, and as Jeff is always telling me, my feelings don't always fit the situation." "If my food is overcooked in a restaurant," "I get enraged." "I want to kill the waiter." "But I don't." "I politely ask him to take my meal back and bring it to me the way I asked for it." "I spend my days making myself smaller, more acceptable." "And that's OK because at night, when I go onstage, I get to experience the world the way I feel it." "With indescribable rage and unbearable sadness and huge passion." "At night, onstage," "I get to kill the waiter and dance on his grave." "And if I can't do that, if all I have left is a life of making myself smaller then I don't want to live." "I don't." "And believe me, honey, you don't want me to live." "Are you stealing sterile supplies?" "I need sterile instruments." "I'm not gonna get caught with my pants down because this hospital can't get..." "I get it." "I wanna do something." "Something that I think is..." "I have a responsibility, but I just..." " What's stopping you?" " Meredith." "Ah!" " The other half of the twisted sisters." " What you call Meredith and Cristina?" " The twisted sisters?" " Yeah." "Well, that fits." "So this... this thing..." "I could come out of it looking pretty bad." "Like I did it for the wrong reasons." "Like I did it for myself." "In my experience, nobody goes into a battle because they want to win a Purple Heart." "You do the right thing, and sometimes that gets you a medal." "Sometimes, it gets you killed." "How do you know it's the right thing?" "When it's the best thing for the most people." "The thing that keeps the most people alive." "How you doing?" "A little claustrophobic." "Focus on your breathing, that always helps." "Alex, I have to know." "When Mer called, she said you were moving on." "Have you?" "Moved on?" "I slept with someone." "Damn it, Alex." "We'll get through it." " Are you still there?" " I'm right here." "Can you hold my hand or something so I know you haven't left?" "I can't reach your hand." " Oh, yeah." " I can hold your foot." "A foot is good." "Look, Derek, I'm busy." "I have a surgery in less than an hour." "You want me to drink that?" "No." "But I believe you will." "I'm gonna go, and you're gonna drink it." "You're gonna try not to." "But, in the end, you'll drink it." "I also believe that this won't be the first drink you drank today." "This tumor is huge." "I've never seen pleura this thick." " Like a watermelon rind." " Damn it." "I'm gonna have to get rid of the lung, the diaphragm and pericardium with this tumor." "Yeah." "That's what I need to do." "That's what's advisable for optimal survival." "But that's not what we're gonna do." "We're going to remove the visible tumor and we are going to treat the lung with intrapleural hyperthermic chemotherapy." "Karev, find out what Bailey used in the procedure this morning and gather everything I need." "Yang, help me remove this tumor." "This morning, Bailey said hot chemo lavage was only indicated" " in abdominal surgery." " Sugarman at the Brigham has been researching its applications as it applies to pleural mesothelioma." "And he's a singer." "And he needs his lung." "You look like hell." "Chicken pox." "Stay back, I'm contagious." "I had them when I was six." "What?" "Aah..." "Ow..." "How was LA?" "Addison nicked one of the uterine arteries, but she was able to fix it." "Sloan's OK and the baby's gonna be OK, too." "Good." "I slept with Addison." " I gotta tell Lexie, right?" " No." "It's Lexie." "She's so good." " How do you lie to a girl like that?" " Lie." " Really?" " Really." " Really?" " Yeah." "I hurt." " I got you covered, kid." " What are you doing?" "I'm gonna help you." "Oh, my..." "Oh, my." " That's amazing!" " No scar." "No, keep going." "Thank you." "Thank you, thank you, thank you." "You saved the lung?" "The whole lung?" " Yes." " OK." "Well, now what?" "Now, the work really begins." "This is gonna be a long recovery." "But he should be fine." "Does it make me awful to say that I'm just slightly disappointed?" "I guess I was sitting out here thinking, now he's gonna be like the rest of us, who teach and direct and do all the things he finds so demeaning." "You know what's demeaning?" "Loving a man, taking care of him, doing his shopping, making his meals, making sure his humidifiers are clean, 'cause God forbid his humidifiers aren't clean." "What's demeaning is loving a man who thinks so little of you." "He's got an army of nurses, so if you wanna walk out of here, you can." "We'll take care of him." "You can go." "I love him." " You should hear him sing." " Nobody sings that well." "He does." "See that stitch there?" "You just made the dude diabetic for life." "OK." "Shut up." "I'm trying to concentrate until the chief gets here." "Dr. Webber apologizes." "He got caught up in some sort of administrative something." " So let's dig in." "Patient ready?" " Yeah." "We are all prepped and ready." " Just waiting on you." " Dr. Grey, care to open?" "Actually, I was gonna open, Dr. Bailey." "OK." "Sure." "Dr. Webber was going to let me do the pancreatic neck dissection." " So I've prepped..." " I don't believe you're ready for that." "I'll be doing it." "You're welcome to observe." " Go ahead." " Ten blade." "Sorry you didn't get a chance to do the procedure." " Something came up, it happens." " Not surprised about Richard, though." "You're not a dumb person, but right now you're acting like one." "I am not going to turn him in." "Tacoma passed on lzzie." "I did my best." "Just too much history." "Too many red flags." "If I went to the board, they'd make me chief." "First thing I'd do is hire Stevens back." "It's your choice." "It's up to you." "That should be me." "Don't be jealous." "They're just friends." "Best friends." "I had the chicken pox." "I told her I hadn't because..." "I find her miraculous." "Breathtakingly stunning." "Just..." "I can't stop looking at her." "And I was afraid with the ooze and the fevers and the scratching..." "I wanted to stay in the sexy part of things, so I lied to my girlfriend." "And now he makes scratching look sexy." " Mmm." "He makes everything look sexy." "So you get it." "You didn't have to do that, but you did." " You get it." " What are you talking about?" "I'd choose surgery over a guy." "I'm not gonna apologize for it." "Especially to you." "Didn't have to save his lung." "The right thing would have been to remove it." "But the patient was clear that he didn't want to live without his gift." "And you get that." "I choose my gift." "I want to be great." "And I want to learn from you." "I choose my gift." "Hey, how'd your surgery go?" " Great." " See?" "And you were all worried." "You're a rock star." "Speaking of which, do you know" " if Derek has talked to Tacoma yet?" " No, I don't." "OK." "Good. 'Cause I just got my scans back and they're really good." "So it would be great if he could mention that I'm officially not dying of cancer when he talks to them." "I'm gonna get this job, Mer." "I'm gonna get this job and get Alex back and be myself again." "I can feel it." "OK, I'm gonna go get Derek and show my scans before he calls Tacoma." "OK." "You know, I'll go tell him." "Derek." "And you go tell Alex." "OK." "OK, fine." "You can go to the board." "Just..." "Sorry." "Car crash came in." "I got here as soon as I could." "That's OK." "It gave me time to get drunk." " So, what's the occasion?" " I thought Beth was an idiot." " If we're being honest here." " I didn't know that we are." "Maybe not an idiot, but just not good enough for you." " So how long you been here?" " You know, I'm sure" " that it wasn't easy for her." " Teddy." "But do you know what she said to me once?" "She said that once you guys were married, she was done." "She was done teaching, and she was just gonna start making babies." "And I remember thinking to myself, "Wow, does Owen know you have, like, zero ambition?"" "Then there's Cristina, there's Cristina, who is exactly the opposite." "I mean, it'd actually be funny if it wasn't so... just not funny." "I mean, I get it." "She... she is beautiful and talented and kind of amazing." " She's right." "I get her." " I'm calling you a cab." "I get her, but she was willing to trade you." "For me." "If I stayed, she said I could have you." " How was your surgery?" " It was good." "It was... it was fine." "It was..." "You want to see?" "I'm so..." "I'm so glad!" "I'm so glad." " It's like it never happened." " Yeah." "But it did." "It all happened, lz." "You got cancer and we got married." "And you died and you lived again." "And you..." "You left and you came back." "And we got through it." "I got through it." "And I'm on the other side." "Iz, I love you so much." "And I..." "Until I met you," "I used to think I just wasn't a good guy." "Growing up in my family, that's what they told me." "But now, after all of it, I know that I'm a good man." "And I thank you for that." "Because I know now that I'm good enough not to deserve this." "Not to have to feel like this." "Not to love you so much that I almost hate you." "I deserve someone who will stay." "I'm happy you're OK." "And I'm happy about your job." "And I want you to go." "And be happy." "And not come back." "Meredith?" "I'm sorry about the surgery." " I got caught up with paperwork." " You don't have to apologize." "You don't have to apologize for anything." "In surgery the healing process begins with a cut an incision the tearing of flesh." "Where have you been?" "You just disappeared." "I left you, like, ten messages." "Are you drunk?" " Wait." "What?" "What?" "What?" " You make me sad." "You think that a surgery is gonna make you feel." "You think a successful career is gonna be make you happy." "You think you know things." "You know things and nothing else matters." "No one else matters." "People do matter." "I matter." "We..." "We matter." "So you don't get to toss me aside." "I won't let you." "We have to damage the healthy flesh in order to expose the unhealthy." "It feels cruel." "Hey." "Hey." "Uh..." " How did Sloan's surgery go?" " I slept with Addison." "Thank God. 'Cause I slept with Alex." "I was feeling so..." "Well, you know how I was feeling." "Which is why this is great." "We're even." "We've kind of canceled each other out." " You slept with Karev?" " Yeah." "While I was dealing with my sick daughter?" "While I was hurting?" "Well, you weren't hurting." "You were sleeping with Addison." "You broke up with me." "Left me." "And you just..." "Wow." "I..." "I can't even look at you right now." "And against common sense." "Do you know what it took for me to make this happen?" "Please tell Derek I'm really sorry." "This isn't about Derek." "It's about me." "It's about us." "You don't just walk away from people." "You don't just throw people away." "I can't, Meredith, OK?" "I can't be here!" "Please!" "Please try to understand." "I have to start over." "I need to start over." "OK?" "Please don't go." " This is your home." " No, it's not." "Not anymore." "It's just a place I worked." "I can do that anywhere." "But it works." "You risk exposure..." "What are you doing?" "You'll get the chicken pox." "So I get the chicken pox." "...for the sake of healing." "And when it's over once the incision has been closed you wait." "Did you see him before he left?" "No." "I didn't think it would make it easier." "For him or for you?" "This is the best thing for him." "You know that." "It's the only thing." "Let's not pretend you did this for him." "It's just you and me here, Derek." "You did this for you." "In the choice between surgery and love, you chose surgery." " You chose ambition today." " So did you." "You knew he wasn't ready to go back into the OR, but you wanted to do that surgery so badly, you were willing to overlook it." "We're the same." "You wait, and you hope that your patient will heal that you haven't, in fact just made everything worse."