It's intense, what happens in the OR...
when lives are on the line
and you're poking at brains like they're Silly Putty.
You form a bond with the surgeons right next to you.
An unbreakable, indescribable bond.
It's intimate, being tied together like that.
You up?
- No. - Yes.
Whether you like it or not,
whether you like them or not, you become family.
- The Wicked Witch is dead. - Metaphorically dead, or dead dead?
- Who are we talking about? - Hahn.
Her name is off the surgical board.
Her surgeries have been canceled.
I don't know how or why, but I do know Hahn is gone.
It's too bad. She was really talented.
- You're not talking to me. - Mm-mmm.
- Hi. Is Grey home? - Hi.
Yes.
Death! Come on, where are you, Death?
- Death! - Die!
- Oh, my God, it's been... - Forever.
- You look like... - You look like...
Death!
The guy in the pajamas your boyfriend? 'Cause if so, then hot.
- Right? - Hey.
- Uh... Who are you? - I'm Sadie. Who are you?
I'm Cristina.
Wow.
Apparently they went backpacking around Europe or something.
Before med school.
That woman all but kicked me out of the bed.
That's terrible.
And Death? Meredith's name is not Death, it's Mer.
I really feel for you.
She's never even mentioned this woman.
How good of a friend can she be?
Good enough to kick us both out of bed.
Welcome to my world.
This woman is the reason I went to med school in the first place.
I figured if a slacker like Death could handle slicing people open, I could too.
- Meredith's not a slacker. - I could tell you some stories.
But you won't.
Sadie, you postponed your residency to work in a morgue?
Yeah. All the fun cutting, none of the rules.
But I got bored, started craving blood that was flowing.
And now you're here. I can't believe you're here.
Yay.
Iz, you coming?
- Yeah. I just need a minute. - I get it.
Hahn's case brought up the Denny thing, but Hahn's not even here anymore.
It's stuff from the past.
Stuff from the past, Iz.
- You don't understand. - I might, if you talk to me.
Fine.
See you inside.
- I'm walking. - Good morning.
- Walking straight ahead, all by myself. - You look good.
Tired, but good.
Did I mention I find the short hair kind of sassy?
Now I'm turning this corner. Again, all alone.
Ow!
Um... These are scratches from my kitten.
He's a crazy scratchy scratcher.
- You're a cat person? - I meant hairbrush.
I have a crazy scratchy hairbrush.
Solo surgeries are at stake here, Three.
I can't have you acting weird.
- Or wounded. - I'm on top of my game, really.
I'm sending you to Plastics, far, far away. Just go.
What do you know about a heart guy named Dixon?
Dixon? No, not a guy. I've heard of Virginia Dixon.
Got an incredible record, really low mortality...
- Wait, is she coming here? - Yeah, today.
Piggyback heart transplant. I'm on the case.
What? Why am I not on the case?
So she's your pre-Cristina Cristina?
You're gonna tell me why she calls you Death?
The adventures of Death and Die are better left untold.
Pedia's julienning her little arms.
No word on what made H hitch a ride with the flying monkeys.
- Translate that for me. - Lexie may be a secret cutter.
- Still no word on why Hahn quit. - That true about Lexie?
- I don't know. - What are you gonna do?
- Nothing. - You can't do nothing.
- She's your sister. - And?
- And your family. - I'm not understanding.
Lexie's your family.
Forget it.
- Hello, Dr. Hunt. - Dr. Yang.
Thank you.
- What do we got? - Crush injuries.
- Couple minutes out. - What do you know about Hahn?
- She's gone. - Yeah, but why?
I don't know.
- You two are friends. - I don't want to talk about it.
I want blood and guts and mangled bones.
I want a guy so smashed up it takes all day to fix.
I want to rock a surgery. I don't want to talk about Hahn.
Unidentified man with prolonged extrication time.
Had to fish him out of a garbage truck. Multiple crush injuries,
open fractures, GCS three, couldn't unhook him.
- Unhook him? - His femur's broken in half
and is puncturing his torso. He's impaled.
- Impaled on himself? - Human pretzel.
That'll do.
- Wow. - Check his popliteal pulse.
- I'm getting nothing. - 'Cause his knee's over here.
Sleeping in the Dumpster and they started crushing the trash?
- That's a bad day. - I'm here. What did I miss?
Your first day. Stand back and shut up.
Breath sounds are clear and equal. Both sides. Unbelievable.
No punctured lung. We need a portable X-ray and an ultrasound.
- Someone page us? - I did.
- You did? That's a first. - So's this.
I've seen guys cut in half, amputations, eviscerations,
but I've never seen anything like this.
I wondered if you could help.
You hire when you're number one, not number 12.
But I need you to be my ambassador today.
Show Dr. Dixon what Seattle Grace is all about.
I've thrown a lot of money, big title and a lot of research dollars at her,
- but... - But what?
She's a little different. She's a little off.
So we're wooing today, Bailey.
I can woo with the best of 'em.
- So, what, Dixon's a nutjob? - Excuse me?
I've already had my quota of crazy for the year.
I've had my off days. Wanna judge me?
You never even met the woman.
Now you heard the chief, our job is to impress Dr. Dixon today,
- so be impressive. - I've got the chart for Dr. Dixon.
I'm ready to work. I'm excited.
- Don't be. She's off. - Karev.
- Are you OK? - Yeah.
Heads up. Here she comes.
Dr. Dixon. Hi.
Welcome to Seattle Grace. We're very happy to have you here.
- I'm Dr. Bailey. - I brought my own lab coat.
I'm here to perform a heart transplant today. I do hearts.
A procedure invented by Christiaan Barnard in 1967. I do hearts.
Uh... I'm Dr. Webber. We spoke on the phone.
Karev, get Dr. Dixon the latest labs.
Stevens, let's prep the patient, please.
OK, then, she's a little off.
His femur's in pieces. Except the part stuck in his torso.
No way I'm saving that leg.
Impaled piece is lodged under his clavicle.
C-spine looks clear. Without a CT, hard to be sure.
- Why can't we get a CT scan? - Way he's impaled, no clear reading.
A stupid question.
A limited window. With vitals like these in a few hours...
Won't be able to withstand surgery.
Good thing he's unconscious.
Can't do anything till we dislodge the femur from his clavicle.
Let's un-impale him.
Yang, Grey, new kid, hold his shoulders. Brace hard.
- I'll hold his C-spine. - I got his torso.
I need to guide posterior hip dislocation.
Second that leg is out be ready to assert pressure, stop bleeding.
Better than working on corpses, huh?
On the count of three. One... two...
Three!
Femur's really wedged in...
OK, almost there. Steady.
Just a little bit further. Sloan, I need you to rotate his knee to my right...
- Push ten of morphine now! - Stop! Stop!
Corpses don't do that.
- I need you to calm down, sir. - What are you doing to me?
Can you tell us your name?
Get out of my face and your hands off! You're hurting me!
Do as he says. Hands off, everybody.
Hands off!
Thank you.
- What's your name? - Timothy Miller.
Mr. Miller, we need to get you into surgery.
I'm gonna be able to walk, right?
We're trying to keep you alive.
Our cardiac wing is extensive
and well-equipped with all...
The first successful heart transplant was performed on September 7, 1896,
by Dr. Ludwig Rehn, Frankfurt, Germany.
OK.
Excuse me, I don't mean to interrupt.
Please... I mean, just...
Please update Dr. Dixon on the patient.
Dr. Stevens is prepping your transplant patient for surgery.
They scheduled a transplant six years ago,
but the heart was too small.
They added a donor heart to help his own heart function.
- They did a piggyback... - Heterotopic transplant.
Piggyback is the colloquial name for the procedure.
Don't do that.
How about we take you to meet the patient?
They told me my heart belonged to a girl hit by a car while she was hitchhiking.
And now when I'm driving, I see hitchhikers all the time.
Always up ahead, just up ahead.
When I get up ahead they're gone.
You're not buying this, are you?
I should never have gotten the heart.
- I don't understand... - Navajos, we don't touch the dead,
don't touch their bodies or belongings,
the spirit clings there.
So to have part of a dead body sewed into my chest is...
My friends, who follow the old ways,
they begged me not to do it.
- I should've listened. - Sorry, I don't understand.
You think you're haunted by your transplanted heart, but
you're here for a new transplant.
No! That's what I'm trying to tell you. I don't want it!
I don't want the new one. I want you to take the old one out.
OK, that's just plain stupid. Take the heart, man. Take it if they offer it.
Did he just say he doesn't want the donor heart?
- Yes, ma'am. — Clay Bedonie, are you aware
without a new heart you'll live a short life attached to a machine
before dying a sudden and agonizing death?
See, that's what I'm talking about.
Five parallel pulley stitches per cut, then switch.
- Are you sure I'm numb? - Toughen up.
When one of our residents gets picked for the solo surgery,
one of us gets to scrub in.
We have a goal here. Focus on the goal.
Solo surgeries, totally worth it.
Hello. I need someone to run these labs
and pull these X-rays, please.
Will do.
This looks like a cool place to hang out. What are you doing?
This is for interns, it's our hangout. Go find your own.
Sorry.
Solo surgeries. Totally worth it.
I won't live if I can't walk.
- We'll do our best to save the leg. — I'm homeless.
Walking is how I survive, it's how I get from one day to the next.
Marion Street's safe from 2:00 to 6:00am,
and then I go over to Hadley Bridge
and I hang there till 6:30 until the traffic hits.
And then I go over to Belltown,
and I hang out over at the waterfront.
And then the waterfront, if it's trouble,
then I go back to 4th Street. I'm homeless. I can't not walk!
I... What am I gonna do? What am I gonna do?
Your injuries are critical. If we don't get you to surgery...
Will your surgery make me walk?
Huh?
Then I don't want it!
OK. All right.
You heard the man. The surgery's off.
I appreciate you trying to advise me to do what you think is best.
- These are facts, not opinions. - What I'm saying is...
He's trying to say he'd rather live a shorter life unhaunted
than a longer one that is.
I'm not saying I agree, I'm just...
I'm just gonna stand over here.
That was a good idea.
The heart that you take out of me, what happens to it?
It goes from the OR to pathology to medical waste.
I need that heart back, for a ritual.
We have laws. There are rules. Rules are rules.
Maybe there's a compromise to be made here.
We could, I don't know,
give him back the old heart to do the ritual,
then give him a chance to live by putting the new heart in.
- No. - No.
- Doesn't work that way. - I'd still be haunted.
Just by a new ghost.
There are rules. We have laws and rules are rules and laws are laws.
No.
So that's it? No surgery, you're just gonna walk away.
I'm respecting the patient's wishes.
Patient's unstable with an open wound.
Which we are packing.
- This guy's circling the drain. - You cannot walk away.
Don't tell me how to run things in my ER.
- Your ER? - We save lives here.
We don't just patch up patients and leave them to die.
If you can't handle that, go back to the desert
and leave us here to do our jobs.
Dr. Torres, please tell me...
you could figure out some way to build this man some legs.
The right femur's toast. So's the hip and half the pelvis,
but if I put some pins here, and maybe a plate here...
I mean, there are some viable bone fragments.
Not starting from nothing. What do you think?
- I think it's wild. - She wasn't talking to you.
It's her first day. Could you not...
She needs to learn her place.
I think it's a lot of hardware.
What the guy needs is a whole new leg.
Maybe I can do that. Yeah, it's kind of a puzzle.
I just need to figure out what equipment I need and how to pull it off.
- Like Lincoln Logs. - A little more high-tech than that.
It's exactly like Lincoln Logs.
I need you guys to grab every piece of titanium we've got.
OK.
I need the hospital rules to specify the fact
that we must respect all religious and spiritual beliefs of our patients.
- The rules? - I'm asking you to declare a rule
of our department.
That we respect the beliefs of our patients?
- Yes. - Isn't that common courtesy?
- Yes. - Then why am I declaring it?
Um... Dr. Dixon doesn't do common courtesy,
but she understands rules. So if it's a rule, we're golden.
If not, we have a pissed off patient,
an apoplectic surgeon,
and none of those things makes for a successful procedure
on a faulty heart.
Not to mention the failure to woo.
You want me to announce it as a rule?
I'm here as a witness. You can raise your right hand,
put your left one on the Physicians' Desk Reference.
- It's a rule. - Thank you.
Dr. Dixon? I'm Cristina Yang. I'm a resident.
Been focused on cardio since I began my internship.
I'm certainly looking forward to...
Were the other ones taken off my case?
- What other ones? - The black one, the male one,
the one with yellow hair.
- Not that I'm aware of. - Then why are you talking to me?
What happened to Hahn? Whatever made Hahn leave it can be fixed.
Unless she was... She wasn't fired, was she?
- Not coming back. - You don't know that.
- She kind of does. - How?
Because she doesn't...
Look, it's just too...
We had a fight.
Oh, please. Meredith and I fight all the time.
We still work together.
It's not like Hahn was your girlfriend or something.
Oh, my God. She was your girlfriend?
We hadn't... figured it all out.
- So are you a lesbian now? - I don't know.
Maybe you were a "oncebian?"
Or a "twicebian." Whatever. It's over.
- Are you OK? - She's fine. Leave her alone.
I hit the titanium mother lode.
- Hi. - Hey.
Oh, come on, really?
Hey, Lexie. How are you?
- Is everything going OK? - Did somebody say something?
- I was doing something? - No, I'm asking as a person
who's sort of related to you if there's anything bothering you.
This is not as a boss or resident or superior who keeps an eye on what I do?
No, I'm a compassionate person. I'm just wondering
if you're channeling your tragic pain into self-mutilation.
- Are you a secret cutter? - No!
Little Grey, Torres is trying to set a world record
for most titanium rods used in one patient. You in?
- Little Grey? - Little Grey, Big Grey.
It's how I tell you two apart.
Yeah, I'm in. I'll just be a minute.
Can't you people let a guy die in peace?
Your vitals are slipping.
I'm not gonna lie to you, that's not good.
- I've been through worse. - Yeah. I imagine you have.
Oh... Don't get like that.
Don't look at me like I'm some tragic hero...
with a secret past.
You have a story.
We all have a story.
I took a turn, with my life, and I couldn't connect.
I lost.
I couldn't connect.
My life, it took a turn and...
I just couldn't turn it back.
Guys, we need to shut down for a few days.
People are starting to get suspicious.
I was accused of being a secret cutter.
So wear long sleeves.
I didn't realize we were inviting more people here.
Are you kidding? A secret intern society?
I'm all over that.
Well, I still think we need to take fewer risks.
Fewer risks? Come on, you got a guard at the door.
You're using more local anesthetic for three sutures
than you would upstairs for a chest tube.
Look, I get that you're doing all this to learn new skills,
but you'll only learn so much by being careful.
Actually, I would disagree. I think the only safe way to...
Ouch.
Who wants to stitch me up?
Oh, right here.
You gonna tell me about Death and Die?
Nope, but I did talk to Lexie for you.
- I need you to do something for me. - What?
Tell Mark to keep his Little Sloan out of Little Grey.
- Is he hitting on you? - No! Not my little Grey, Lexie's.
The last thing she needs is Sloan going man-whore on her.
So you need to tell him to step away from Little Grey.
- I'll see what I can do. - Little Grey, Derek. Little Grey.
Did she, uh...
- Did she say goodbye to you? - Nope.
- You OK? - Do I look OK?
You look great.
Then I'm OK.
So, there's a nine-day ritual to undo a haunting?
It starts with a nine-day ritual.
Are you really gonna waste nine days on this?
- Dr. Stevens... - Yes?
Why are you so interested in my haunting?
Can ghosts do things?
I mean, can they make things happen in your life?
I've had two cases, two patients in a row
that have really reminded me of my dead fiancé.
Heart transplants and LVADs.
Could he be doing that? Could he be bringing them to me?
Izzie, come on.
Is he here right now, your ghost?
I... I hate to ask, but...
Oh...
You don't want me in your surgery.
Not that I think there's something wrong with you,
it's just... I don't need extra ghosts in my operating room.
- Mr. Miller... - What does a guy have to do
to get a little peace and quiet around here?
The fatigue you're feeling is from blood loss, queasiness, dizziness.
You're slowly bleeding to death.
- What, you trying to scare him? - No.
I'm trying to ascertain whether he's suicidal or just defeated.
Mr. Miller, you survive on the streets,
so I know you're a fighter.
That doesn't make me a fighter. Makes me lucky.
How long have you been out there, ten years, 20?
You're not in jail, not dead. That's not luck. You're smart.
You gotta be smart to take care of yourself on your own.
I guess.
This, what you're doing right now, Mr. Miller,
refusing surgery, it's not smart.
There's a rehab center not too far from here.
Medicare takes care of it. You could stay there.
Food, bed, long as you need.
Just let us operate.
Let us operate, and we'll figure the rest out.
Wow. That's the fastest I've ever seen anyone dissect through adhesions.
Dr. Dixon, there is a rule regarding
giving medical waste to the patient.
- Dr. Dixon? - Huh... What?
I was just saying there's a rule,
an official, very, very specific rule,
that, in the event a patient asks for their organ
or body part back, for any reason
related to or involving their cultural beliefs,
we must respect that patient's wishes
and return that organ to the patient.
That is the rule I forgot to tell you about.
If I went down to pathology right now,
would they know about the rule?
The chief would know. It's his rule.
He declared it. Rule's a rule.
Dr. Karev, make sure that we follow the chief's rule
and return the heart to the patient after the surgery.
I'm going back to work now. Clamp.
What the hell is that gooey thing they're taking out of him?
Oh, the silent treatment.
OK, if you're gonna be that way I'll just, uh...
I'll just stand here and be quiet.
OK, that, that is disgusting.
I thought you were gonna be quiet.
You know you're acting like you don't want me to be here.
You know what I've wished for every day since you died?
I've wished that I could see you again.
I'd have given anything just to see you one more time.
Looking at you and knowing that I can't touch you,
it's hurting me.
- Izzie, you can touch me. - You're not real.
You can't be real, so that means that I'm sick
or something is wrong with me and I can't hope for that.
I can't hope...
You're not real.
Izzie, I am as real as you
or that gooey, disgusting thing down there.
Touch me.
Izzie... touch me.
- I'll prove it to you. - No!
Why are you here? Why?
I am here for you, Izzie Stevens.
Clamp.
OK, that's it. The donor heart is separated.
We have the cannulas ready for bypass.
Next step is the LVAD.
Wait, what is that?
That's not right. That can't be happening.
Heart's beating. How's his heart beating on its own?
It can't be happening. It shouldn't be happening.
The heart is beating.
Heart is beating, it shouldn't be beating.
It shouldn't be beating.
I've never seen a reconstruction like this.
Never done one like this. Here's hoping it works.
Ready for the rod. How are you guys doing?
Hemorrhaging bleeding through the packing.
- Try the fibrin sealant. - Good call.
- How are you doing? — Good, moving to the next lac.
Finished already? Let me see.
Wow.
- Pulley stitches. Nicely done. - Thank you, Dr. Sloan.
- So my heart? — Started beating by itself.
If it continues to function like this
you won't need an LVAD or any kind of machinery.
It's wonderful news.
- It's very atypical. - Not for me. I'm finally free.
I'm not haunted anymore.
Your heart had six years to rest,
probably enough time for it to repair itself,
which is why it started beating again. Never seen this before.
Read about it but never seen it before.
You have your beliefs, I have mine.
I don't have beliefs, I have science.
Science is a belief,
a belief in only what you can see and touch.
I believe in more.
Just thought I'd stop in to see how everything's going.
I'm still several hours away, but I may pull this off.
Rebuilding a man's skeleton from scratch.
And we just found out that Dr. Grey here can out-pulley stitch Shepherd.
I wouldn't go so far as to say that.
Excellent job, Dr. Grey.
- Excellent job of teaching, Dr. Yang. - Sir?
Taking time to teach your interns and they retain the knowledge.
Haven't made my decision yet on the solo surgery,
but keep teaching like that and you're my one to watch.
Thank you, sir.
- V-fib. - Start CPR.
Push one of epi and charge the paddles to 360.
Clear.
Thank you so much.
So what do you do now with the haunted piece? Bury it or...?
Burn it. Actually, my tribe's medicine man will burn it.
I'm not allowed to even touch the smoke.
So the not-touching thing, does that apply to just the flesh or...?
No, we don't touch their belongings.
We can cleanse jewelry, metals, but fabric, bedding, clothes,
books that were owned by the dead, we burn all of it.
The spirit can cling to any of it.
Oh, no. Your ghost.
You still don't have anything of his, do you?
Time of death, 19:22.
I built his bones.
You tried. We all tried.
No, I didn't try, I did it.
I did my part, I built his bones.
I built his bones from scratch,
and you, all of you, you were supposed to keep him alive.
That is all you people had to do. You just had to...
keep his body breathing.
You just had to keep him safe and breathing and living
until I made his bones. I made... I made his bones.
Until I made his bones. I made his bones.
Why don't you guys go ahead
and I'll help Dr. Torres clean up.
- Go call the morgue. - We've got it. Go.
Everyone, clear out.
Uh... Excellent job today, Dr. Dixon.
Excellent rule following.
I only have one real area of interest.
The human heart. I love it.
I like its regularity.
I know everything there is to know about it.
I like its predictability. It has rules.
Every chamber has a function, every function has a movement.
I like the color. It's comforting.
Are you familiar with Asperger's syndrome, Dr. Bailey?
Um... Of course. Significant impairment during social situations...
I'm not good at cues like sarcasm or condescension,
but I do know when I'm being manipulated and made fun of.
I don't think I like this hospital very much.
I don't think I like this hospital at all.
Lexie Grey sure knows how to wrap herself around a suture.
- Meredith had some concerns. - That's not news.
About Lexie. Apparently Lexie is fragile,
and getting involved with a superior
might make her more fragile.
I was talking about her sutures.
Keep Little Sloan out of Little Grey.
- What? - Little Sloan
does not enter Little Grey. Are we clear?
- Did you just say...? - Hmm-hmm.
OK, that's just creepy... and inaccurate.
Big Sloan.
You heading home?
I love you.
I will always love you. You own a piece of me.
So even though you'll be gone...
you will never be forgotten. Not by me.
I'm sorry we never got our chance.
I'm sorry we never got to get married,
have children or grow old together.
I wanted that so much.
I wanted to be your wife more than anything.
Why are you telling me this?
I'm trying to let you go
so that your soul could be at peace.
I have peace, Izzie. I'm here for you.
Goodbye, Denny.
I love you, but goodbye.
I can explain.
I did not teach you the parallel pulley stitch.
I can barely do it myself.
Whatever you guys are doing, shut it down.
Do not practice on yourself. That is insane.
Shut it down.
Iz?
I see you.
I've seen you all day.
I see you struggling.
And I know you don't want my help, but let me help you.
Whatever it is, I can help you.
So let me.
Will you burn this for me?
I hate how hard it is.
It's just like... You get attached to someone,
they work their way into your life and you wake up one day...
Suddenly all you can think about is their little...
- Another round? - Oh, I'll get it.
- Tell me the stories. - What stories?
The ones you won't let Sadie tell me.
They're ancient history. Humiliating and ridiculous.
Ridiculous is a grown man telling another grown man
- to stay out of a woman's little... - You did it?
I did. Those exact words. I did it because...
it was nice to see you sticking up for your sister.
I did it for you.
So now, you owe me...
a story.
OK, fine.
But you can never tell anyone ever.
Hey.
I'm sorry we lost him, the patient. I'm sorry.
I don't need you to be sorry.
- OK. - I don't need you to be sorry.
I don't need you. I don't need you.
OK. All right. All right.
The ties that bind us are sometimes impossible to explain.
They connect us,
even after it seems like the ties should be broken.
Some bonds defy distance.
And time. And logic.
Oh, God. I said goodbye.
I burned the sweater.
Yeah, thanks for that, by the way. I loved that sweater.
- You made me that sweater. - Oh, my God! Oh, my God!
- Izzie! - Oh, my God, oh, my God.
- Stop freaking out. - You're not real.
Hey, I told you, I'm here for you.
You're not real, you're not real.
- You're not real. - Izzie, look at me.
Touch me.
You see? I told you I was real.
Oh, my God.
Because some ties are simply...
meant to be.