"Surgeons are all messed up." "We're butchers." "Messed up, knife-happy butchers." "Sir?" "Would you like a cot 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 makes us feel." "This is how you unwind?" "By watching two hours straight of advanced carotid endarterectomy?" "Cristina?" "Everything OK?" "Cristina?" "Owen!" "What?" "What?" "It's three in the morning, Cristina." "This better be..." "Callie?" "What?" "He what?" "It's me." "Cristina!" "What's going on?" "Owen's out there upset," " Callie was screaming..." " No changes in visual acuity." "No petechiae." "I'm fine." "Oh, my God!" "Your neck!" "I will kill him!" "No, no." "He had a nightmare." "Cristina, please." "Is she all right?" "Meredith, I need to know if she's all right." "No, no, no." "Cristina, no." "I am so sorry." "I don't know what happened." "I'm sorry." "I don't know what happened." " Look at me." " I'm sorry." "Look at me." "I'm fine." "See?" "It's OK." "You were asleep." "It's OK." "OK?" "It's OK." "It's OK." " I'm sorry." " It's OK." "It's OK." "You were asleep." "It's OK." "OK?" "It's OK." "It's OK." "It's OK." "There's coffee." "No." "Not like this." "Today's your first day back at the hospital." "Today's about lzzie." "You have to operate on her brain." "You have a gift." "And you can do this." "I'm gonna shower before I go in." "You're wearing a turtleneck under your scrubs." "It's ugly." "Not as ugly as the fact that you hugged him." " You hugged him..." " I get it." "I hear you." "Move on." "Turtlenecks aren't OK." "You're not OK." "Your boyfriend is not OK." " Is your boyfriend OK?" " What?" "To be cutting into brains today." "Is he OK 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." "This is lzzie." "George, hey." "I'm surprised you're not..." "Isn't there a presentation happening with lzzie?" "I didn't know." "Bailey told me after Cristina told her." "Izzie trusted Cristina." "I was the very last to know." " Izzie wasn't trying..." " I don't want to talk about it." "I want to work." "Room on your service?" " Yeah." "Three hip replacements..." " Thank you." "You three." "I understand why you're here." "You want to help." "But I will be the resident on her case." "I will be prepping her for surgery." "If you're going into that hospital room, you will do so as her friends." "Izzie needs her people around her to tell her everything will be fine." "She needs you to hold her hand." "She needs you, not more doctors." "Understood?" "Great." "Let's get started." "As you know, you have stage four metastatic melanoma." "We have surgeries and procedures lined up for you over the next few weeks." "We've seen 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." " Leaving the option open for you," " if you want it." " But our priority is mets in your brain." "I'm surprised we didn't catch it." "It causes headaches, hallucinations." "Hopefully the lesion has clear margins and I can remove it." "Are you people done?" "Over the next four weeks, you're slated for three major surgeries, seven outpatient procedures, just for mets we've found." "In all likelihood, we will find more." "We may have to cut into you more." "You might as well get used to the idea." "I'll be administering your radiation, chemotherapy and immunotherapy." "The treatment will be aggressive, it will be harsh." "Prepare yourself." "I'll be overseeing procedures, including today's, which means every surgeon in this room now answers to me." "Welcome to the cancer wing, folks." "See you in the OR." "Thanks." "Seriously, don't just stand there staring at me." "It's making me nervous." " Get out of here." "Go save lives." " We have rounds." "OK." "See you later." "Karev, I just reviewed lzzie's most recent MRI." "Doesn't look like the tumour has grown since her last scans." "Do you have concerns you'd like to discuss with me before we brief lzzie?" "Just try keeping her frontal lobe inside her skull this time." "Good morning, lzzie." " You coming?" " No." "I'm on this old lady, so..." " This'll only take a minute." " I gotta go, really." "Hi, Dr Sloan." "These are Aunt Joyce's nephews, my brothers Tobin and Luke." "They just flew in this morning." "Dr Sloan did the surgery." "Your aunt is very sick." "There's not much more we can do for her." " Probably time to say goodbyes." " Do you mean say our goodbyes now or sometime in the next 24 hours?" "What kind of time frame are we talking?" " Twenty-four hours seems unlikely." " You sure?" "I have a flight to catch in the morning, and if I wait past noon, I can't change it." "I need to be on a plane tonight." "Board meeting tomorrow." "So do you think she'll die before tomorrow?" "Think Shepherd's the guy for Stevens' surgery?" " Someone else in mind?" " Shepherd wouldn't be my choice, given his recent history, but it's not my brain he'll be manhandling." " No." " Damn." "She's HLA type B3." "Have to hit her with the DTIC and high dose IL-2 instead." " IL-2?" "That's pretty toxic." " About as bad as it gets." " You're gonna tell lzzie this now?" " I am her oncologist." "Studies show giving patients bad news before surgery can drastically increase their chances of complications." "Today or tomorrow, news is the same." "Right now, I have time." "You coming?" "I believe lzzie is down in radiology now." "Fine." "We can wait an hour." " Chief, you paged me?" " Karev." "Yes, I did." "As you know, we're gonna be harvesting eggs." "From Stevens." "Who is someone you're having relations with." " Chief." " Frozen eggs have a better survival rate when they're... fertilised." " Fertilised." " I know this is a lot to digest." "So take some time, think about it." "If you decide this is something you might consider..." " Give me the cup." " Karev." "Speak to Stevens." "Just give me the cup!" " She doing OK?" " Yeah." "Well, she says she is." " Do you believe her?" " No." "Not really." "Heads up." " What?" " Motorcycle lost control." "No helmet, massive head trauma, lost vital signs en route." " Good to have you back, Shepherd." " Thanks." "Get back inside." "He's DOA." "Hunt?" "Did you hear me?" "Owen." " Swender has no vision." " Wrapped his hands around your throat," " you're pretending nothing happened." " Focused on lzzie." "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..." "If he had a heart attack or a stroke or if he'd lost a leg, you'd walk away?" "How is it acceptable I walk away from this?" "He's wounded." "He has war wounds, Meredith." "It's not cut and dried." "And it's 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." "Know how many people are in here waiting, hoping their loved one might live?" "You're a bunch of vultures." " But we're not." " Aunt Joyce was given a month to live." "Three years ago." "And we were crushed." "We held her hand at her bedside for weeks, we said our tearful goodbyes." "And then she stabilised." "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 goodbyes all over again." "And each time, she winds up getting better." "We want to be here when she goes." "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." "They're doing tests that show altered brain anatomy in patients with PTSD." "Close to understanding the physical side of psychological trauma." " Amazing what you can see with an MRI." " What did Meredith tell you?" "Post-traumatic stress is a real injury, Owen." "It can be healed." "There are resources, vet centres, therapy." "You shouldn't try and handle this on your own." "I came back in one piece, both arms, both legs." "Lots of guys came back with real injuries." "The worst I have is nightmares or freezing for a moment..." "Is that what happened last night?" "You had a freezing moment?" "If you want, I can help." "I'm not the one who needs help." "I'm not the one who cut out half a brain and ran off to hide." "I'm not the one half the hospital is talking about." "You should spend less time worrying about me and look in the mirror." "Karev?" "Just checking in." "To see how you're com..." " See how you're doing." " I'd be doing better if you weren't on the other side of the door listening." "Right." "Sorry." "I said go away." "You left the door unlocked." "Bold." " The chief send you in here?" " No." "I offered to come in" " in case you need to talk." " You think talking will help?" "A Dixie cup full of my swimmers will make everything OK?" "It's crap." "This is crap!" "You can't go messing with people's heads like that." "Even if she freezes the embryos, you think we'll get a chance to use them?" "You think she'll still be here?" "You think she'll survive all this?" "You think..." "I think..." "She told me she was seeing a ghost, OK?" "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 to..." "And now she's..." "This is..." "This is wrong." "This isn't how it was supposed to happen." " I know." " It's crap!" " I know." " I hate this." "I know." "This isn't..." "This isn't how we were..." "This isn't how I wanted to do this." "This isn't how lzzie 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." "I have no memory, no way to..." "I would never hurt you, ever." "But I did." "My hands just..." "How could my own two hands be capable?" " I can't do this, Cristina." " But you did wake up." "Stop blaming yourself." "It's out of your control." " Stop seeing each other." "I almost..." " Almost what?" "I told you, I know my limits." "Let me decide what I can handle." "Good." "Stand right there." "Let me see." " I never know how long to make these." " Like the colour." "Who's it for, Karev?" " Haven't seen much of him today." " He's working." "They're all working." "I told them to." "Their patients shouldn't suffer because I have things growing on my organs." "I have got 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?" "I'm not assisting you." "You're not gonna ask me to divide the cecum." "Not gonna let you get rusty." "In a year, you need to do this stuff." "You need to teach residents." " Think I'm gonna be here in a year?" " Yes, I do." "So I've exposed the right lower quadrant, and you are dividing the cecum with..." "Forceps." "Lift free from the arachnoid." "Tacking sutures." "Patties." "Suction." "Starting over." "Here's your cup, all filled up." " I am eating here, Karev." " It's fine, I washed my hands." "Did you talk to lzzie?" "Considering you two are basically conceiving a child together, think you should talk with her?" "Look, you said she needed my... contribution." "Here's my contribution." "Whatever." " Hi." "How's lzzie?" " I don't know." " How's lzzie?" " Why?" " Have you been to see her?" " I've been working all day." " What?" " Have you been to see lzzie?" "No." "Haven't you?" " You finished that thing in one day?" " Had some free time." " Had a lot of free time." " Nobody came up to visit?" "It's OK." "If I were them, I wouldn't want to step foot in this room either." " You don't have to keep checking on me." " I do have to." "I have to start you on this before your surgery." "Right." "Surgery." "And I wanted to tell you how my surgery went this afternoon." " Colon guy?" " The colectomy went great, but I was in there, and I see a mass." " You're kidding." "Was it a big mass?" " Big enough." "The size of a fist." "This is going to burn at first, but just for a few seconds." "So we had to mobilise the SMA before we could resect the thing and reconnect the bowel." "I wished lzzie Stevens would die." "I wished her dead." "Every day, for I don't know how long." "I woke up every morning wishing lzzie Stevens would die." "And now..." "What kind of person wishes someone would die?" "What doctor?" "Knowing how things happen, what?" "What kind of doctor wishes?" "Are you in here, right now, praying for lzzie to die?" "No." "I'm praying for her to live." " Clear!" " You know what?" " Wait outside!" " Will you let us know?" "Yeah." "I'll let you know." " Bastards." " Push one of epi." "Charge to 360." "Clear!" "Come on, Joyce, you old bag, don't give 'em the satisfaction." " Charge again." "Clear!" " Charged." "Hey." "I'm Dr Karev." "You're a fighter, you know that?" "You worked hard today." "She needs some rest." "Make sure the family doesn't come in." "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." " He's still scrubbing in." " I know, I just..." "He should wear this." "It's his ferryboat scrub cap." "He loves ferryboats." " Meredith." " What are you doing?" "You're gonna have to re-scrub." " 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 you to say yes." " I need to know..." " I can't say yes." "Not if agreeing to be with you will make it OK if lzzie dies." "I can't say yes." "I love you, and you can do this." "You can do this." "I know you can." "Iz!" "See you soon, Dr Stevens." " 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." "I get why I haven't been camped out at lzzie's bedside holding her hand..." " Not talking about this." " Why not?" "Maybe the fact I asked lzzie a hundred times what was wrong, and she just ignored me." "Then there's the fact that when she needed help, she trusted Cristina, of all people!" "And there's the fact that she's your best friend and she might die on you." "There's also that." "Come on." "We're going to go wait for lzzie." "George, you were my husband and you slept with her." "You are the reason I wished her dead." "You owe me this." "You can lie to yourself all you want, but I know you." "I loved you once." "And I know you care if she lives or dies." "Surgery started." " Hey, they started surgery?" " Yeah." "Dr Grey?" "We were wondering, did Dr Stevens' surgery start or?" "Keep moving." "No loitering." "That's the rule." "If they wanna stay, let 'em stay." "People are better than no people." "Clamp." "I'm ready to..." "No." "Yes." "OK." "I'm ready to buzz the superficial temporal artery." " Tenting sutures." " There's no rush." "Take your time." " Everyone is on your side." " That'll hold," " with all the friable scar tissue?" " Dr Swender?" "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!" "I'm so sorry." "She's not responding." "We've done everything." "She's gone." "Thank you." "You did a wonderful job." " Are you kidding me?" "!" " Oh, God, this is never gonna end!" "No..." "No, she's gone." "She's really gone." "It's really gone." "It's her pacemaker." "Still firing." "It makes it seem like there's a heartbeat, but she's gone." "Just with a heartbeat." " Are you sure she's dead?" " I'm an intern." "I'm not authorised to call time of death in a situation like this." "I'm gonna get my superior." "Excuse me." "I'll be right back." "Excuse me." " I am worried about you." " Meredith..." " Choking." " Stop." " It's unacceptable." " Back off." " Hands around the neck." " Ring thrown in your face." "This'll shut the pacemaker down." "Time of death, 2240." "There you go." "She's officially dead." "You can catch your plane." "Get to your board meeting." "You can leave." "Actually, could we stay a little while longer?" "What are you all doing out here?" "Waiting for lzzie, sir." "We're waiting." "You're scared." "I'm scared too." "Damn it." "Some of the Sylvian vessels are wrapped around the tumour capsule." " Penfield four, please." " Really?" " Instead of the arachnoid knife?" " Yes, instead of the arachnoid knife." "Because the Penfield four will let me slide the arteries around the met." "I need to dissect it free so I can de-bulk the tumour, avoiding unnecessary trauma to my patient." "So Penfield four, please." " Vitals stable the entire time?" " Any spikes in intracranial pressure?" " Was there residual tumour?" " Shepherd resected all of the tumour." "She'll be in the PACU for an hour." "She's fine." "Your friend is just fine." "No thanks to any of you." "Tomorrow do better." "Your surgery went well today." "Shouldn't you and Meredith be out celebrating or something?" "She turned me down twice." "She said she understands, she forgives me for what happened in the woods." "So you showed her your dark side." "Meredith never struck me as a woman who's afraid of the dark." "I don't know." "Do you know it was Meredith's idea to ask lzzie if she wanted to harvest her eggs?" "So lzzie 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, lz." "I'm right here." " Izzie's surgery went well." " Good." "That's good." "I wish things were they could be that we could be..." " Me too." "Could I hold you?" " Wait!" "No." "You can't take that one." " Why not?" " I said don't take it." " I'll take the elevator I want." "Well?" "Go on." "Hey." "Come on in." "This is a CT for Katie Bryce." "16-year-old female, subarachnoid aneurysm." "A fall during 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 right after this surgery." "This is where Bailey kicked you out of surgery because she caught us in your driveway in my car." "Right here, this was a seven-hour craniotomy." "You held a clamp the entire time and never flinched." "That's when I knew you would be an incredible surgeon." "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 lzzie Stevens." "See that?" "Right there." "Tumour-free." "Because of you." "You got me into the OR." "If there is a crisis, you don't freeze, you move forward." "You get the rest of us to move forward because you've seen worse, and you've survived worse." "And you know we'll survive too." "You say you're all dark and twisty." "That's not a flaw." "It's a strength." "It makes you who you are." "I am not gonna get down on one knee." "I am not gonna ask a question." "I love you, Meredith Grey." "And I want to spend the rest of my life with you." "I want to spend the rest of my life with you." "I don't think..." "I can't handle this after all." "What?" "What do you mean?" " Are you saying?" " I'm sorry." "I am 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 want to apologise for earlier." " What I said 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." "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."