My mother called it the greatest
and most terrifying moment in her life.
He said Karev.
Standing at the head of the surgical table,
knowing that the patient's life depends on you and you alone.
- He said Karev! - Yes!
- Are you sure? - Yeah.
You're "sure" sure?
Huh.
It's what we all dream about.
Because the first person that gets to fly solo in the OR?
Kind of a badass.
- Stevens! He said Stevens! - Which is it, moron?
- Stevens or Karev? - This is stupid.
Trust imbeciles to tell you who's getting solo surgery?
Is this hard for you, being banned from the solo surgery?
- It must be really hard for you. - A mean streak. I like it.
He may change his mind. He's been known to change.
Don't do that. Go ahead and will yourselves to be voted in.
- Use the Secret. - Grey!
The Chief said Grey.
- What? This is bogus. - You just figuring that out?
Steve is not a lip reader. None of the interns are lip readers.
You have to wait for the attendings to vote, just like we did when I won.
- You won your solo surgery? - I'm gonna pretend you didn't
feel the need to ask me that, Yang. Of course I won. I was good.
I didn't cut LVAD wires or put my hand in bomb-y body cavities
or have my interns operating on themselves. I was special.
I was young, gifted and black, and everybody knew it.
The attendings knew it, the Chief knew it.
I didn't have to act like I could read lips.
Just go about my work calmly,
waiting for my name to get called.
It's done!
- Whatever, Helen Keller. - No, I'm serious.
The Chief sent me. They made their choice.
Who is it?
It's you.
I am happy to announce that the first solo surgery will take place tonight.
A below-the-knee amputation, bone cancer...
- Poor bastard. - No appy?
- Saw action, sweet. - Choosing who gets first solo surgery
isn't just about who has the best surgical skills
or who's logged the most hours in the OR.
It's about the highest form of trust.
The trust to put a patient's life into one of our resident's hands.
And for the first time that I can recall,
every single attending picked the same person:
Dr. Yang.
However, Dr. Yang is out of the running. She is going to pick the winner instead.
Dr. Yang will post her decision on the OR board at 4:00pm.
Also, since your interns are still banned from the OR,
the winner will pick a fellow resident to scrub in with them. Good luck.
This is torture for me.
I'm not even done.
- Sir? - Dr. Dixon is back.
You'll be spending the day with her. You will impress her.
You will make sure this hospital impresses her.
By end of the day, I want that woman to be my next head of Cardio.
If she's not, I'll know who to blame. Good luck.
We held a retractor for 12 hours together.
You said I had small hands. Good for surgery. Remember?
No. Go away.
I operated on a heart in an elevator.
Over a year ago. O'Malley's 007.
Think how poor your decision would look if you gave it to him.
Your turn.
I don't know why you are even bothering.
- We know who she's gonna pick. - She's not gonna pick me
because I'm her best friend. She'll pick me because I'm the best.
Stop! Are you guys kidding me?
Fine. I'll think about it.
Just... go and do surgical things.
Are you coming? We gotta go do clinic. Flu season fun.
Yeah.
I... will catch up with you.
- Me, too. - Shut up.
Not you.
My head. Shut up!
When I win, you can scrub in for me.
Alex, she's not... not gonna pick you.
I'll scrub in for you, too, if you win, which you won't. 'Cause I will.
- Enough! - I... I gotta go.
Cristina still hasn't talked to me. Which is normal. Except it's worse.
Two weeks suspension and she hasn't said one mean thing.
Karev called me a moron. Which is good.
- Residents don't look at me. - Least they could do is hate us.
I'm gonna get some sex.
- Sex always makes me feel better. - Don't look at me.
- Me, neither. - That makes three of us.
Hi.
I get it.
I organized a crazy cabal of secret cutter interns.
The thing is, I've been advised to seek out sex
as a way out of my sad predicament, but I'd rather just learn today, so...
what do you say? You, me...
Why are you talking about sex? Inappropriate. I'm your teacher.
I have things to teach. Double board-certified things.
That's... That's what I was talking about. For you to teach me.
Medicine. The sex... That was a joke.
Dr. Sloan, I heard you're performing a hypopharynx reconstruction today.
- I'm gonna make a woman speak. - Let's hope.
- I read up on the surgery... - You read up on my surgery?
Since it's your first time performing what is a cutting-edge surgery,
I was hoping you might need an extra set of hands.
Fine. You can join Dr. Grey and me.
Dr. Grey who is banned from the OR?
She's on cappuccino duty.
- Which I'm still waiting for. - Right away. Thank you.
Dr. Virginia Dixon. It says she arrived over half an hour ago!
- Where is she? - Nervous?
What are you doing here? This is cardio wing. Only cardio gods allowed.
I know. I'm looking around, getting to know other parts of the hospital.
What else is there? The OR, the ER and the place with the food.
Somebody's got a lot to learn.
Kathleen Patterson. Laryngectomy five years ago resulted in loss
of her ability to speak. Undergone surgical attempts
to restore her voice in the past. None have been successful.
This time, though, this time we have a good feeling about this.
Right, honey?
As discussed, I'll get blood supply from your arm, cartilage from...
from your...
Kathleen?
Honey?
Honey.
You can talk to me.
I'll get skin and blood from her arm, cartilage from her nose
to construct a speaking tube which will become her new voicebox.
You should be aware there's a chance the procedure might not work.
- He's clear on that. - I'm just reminding him
not to get his hopes up.
Any other questions I can answer?
Kathleen? Honey?
Tell me everything to know about Karev.
- Why? - I'm his intern.
He seems cool enough at your house.
Whatever he's got going with the girl who masturbates all the time...
I don't like to judge.
Still, officially, I'm his intern, so what's his deal?
Sadie, I can't be your friend in here. I'm a resident, you're an intern.
You have to figure out how not to piss off Alex Karev yourself.
- OK. I get it. - Good.
And ugly! It wasn't my fault!
I had to tell those guys where to meet us!
I said I'd do it that way you could drive! I'm telling!
- I'll kill you! - You need to calm down.
- Tell her! - Shut up!
- What happened? - Sisters, 16 and 15, crashed dad's car.
All we know since they won't stop screaming. We need your names.
- Don't tell her. Don't say a word. - Her name is Holly Anderson.
She was driving. And texting. While driving!
Is there an officer? I want to press charges.
- You suck-up! Suck-up assface! - We need your number
- so we can call your parents. - Here. I speed-dialed my dad.
- You are such a bitch! - No, you are!
- Make it stop. - Shut up!
You are dead when Mom and Dad show up. The doctors will save you again.
- I hate you! - I hate you more!
- I hate you both. - All the time!
- So easy, OK? - Come on!
I know you still see me as 007, but that was day one.
I've grown a lot since then, and learned a lot.
Anyone can have brains, or anyone can have talent,
but the key is to grow.
So, sure, I had a rough start and I had to re-do some of my intern year,
but I came out the other side,
smarter, better.
The important point is I never gave up.
Because I'm a fighter.
Thank you.
I have to check your X-rays, I think your leg is broken.
- You'll be off it for a while. - No. No!
I can't miss my Future Leaders of America conference! Holly!
Emma, I'm gonna be grounded till graduation.
I was going to D.C.! I've been waiting for this for a year!
Mom and Dad spent two grand, they've now wasted two grand!
- You stupid baby! - I'm separating you two.
Listen, I've been here. Lots.
Your dad won't be pissed. He'll be happy you're safe.
He'll kill me. He'll take away everything.
How long have her eyes been like that?
- Her eyes? - Page Shepherd.
She might have a basilar skull fracture. Get her up to CT now!
- I didn't see... - Do scut.
I'll call you when she needs another pep talk.
- Where's she going? - Just to run a few tests.
Good, get her out of here. Take her away!
I hope you die!
- Oh, crap. - Somebody's in big trouble.
- Did you forget to open it or staff it? - Both.
I'm sorry, everybody. I'll be right back with the keys.
Might want to get nurses while you're at it.
This happen a lot? If it does, you're giving my clinic a bad name.
You're mocking me now? Sweet, very sweet.
Dr. Dixon, there you are. I'm Dr. Yang.
We... I've been assigned to work with you today. I was in the cardio lab.
- Sorry it took me so long. - There's a blank spot on this board.
There's a surgery but no surgeon. I would like to do a surgery,
but that's an amputation and I haven't done an amputation since residency.
Well...
that's... really hard to... That...
Is your stuttering pathological and persistent
or is it occasional and stress-related?
- I don't stutter. - I had pathological stuttering
as a child, but it can be treated with rigorous speech therapy.
Yes, ma'am. Thank you.
Why is this slot on the board blank?
I need to select one of my fellow residents for that slot.
It's the first solo surgery of my class.
The Chief asked you to choose from your peers?
Yes, ma'am.
Mr. Patterson, I have some forms for your wife to fill out.
- Is now a good time? - She's a blogger.
About cancer and voicelessness.
She's famous in certain Internet circles.
It seems like you two have a great system going here.
- You've learned to communicate. - You mean the Post-its?
You think that's a pretty great system?
I... it's...
- convenient? - Yes. No. Hello. I love you.
You read the words long enough, they begin to lose their meaning.
Mid-shaft transverse tibia fracture? Hi. Sorry to barge in.
I was just walking by, and I saw broken bones.
I love broken bones.
Less than five degrees of angulation, right?
Yeah, it...
We can treat it with closed reduction and casting.
Flexion/extension views of the cervical spine?
Yes.
I should go see my patient.
Chair.
She's got a hemopericardium. Let Cardio know.
- Hey. I've got a Future Leader outside, she needs a CT. - Hey.
I'm not mad for not voting for me. It would look like playing favorites.
You deserve it. Cristina knows,
- even if you two are fighting. - You and Yang are fighting?
We're not fighting. Fought. Past tense.
How bad is it? Real bad?
She's crashing.
Code blue, fourth floor. Code blue, fourth floor.
Brain matter in her blood. Let OR know we're coming.
What happened to her? Holly? Holly!
Holly! What did you do to my sister?
Holly! Holly! What did you do to her?
Hey. So you know I deserve this.
You know I'm the most qualified.
But I don't want it to be a big awkward thing.
I don't. So, just, you do what you have to do.
OK.
I'll see you later.
Almost done here, Emma.
Holly will be all right, right?
- She's gonna be OK? - She got into surgery quick.
- That's good. - Are my parents here?
- They're coming. Your dad... - Holly's gonna be all right?
She's not in, like... She won't die?
- Emma, you didn't mean it. - I said, "I hope you die."
That can't be the last thing she heard me say. It can't.
Just don't let her die. Please.
All right, I'll go to the OR and get an update for you. OK?
OK.
Be objective, Dr. Yang.
Consider accomplishments, achievements, look for the stand-outs.
Let's see what kind of stand-out Karev proves himself to be
- when I ask him to sew the graft. - Really?
Absolutely. Dr. Yang, watch Karev to see if his skills are up to par
- for the solo. - A system! Devise a system.
Rank everyone accordingly. That's all.
Thank you.
- Out of the way. - What happened?
Her brain's changing color.
She's hemorrhaging. 100 of mannitol.
What did I do? What did I do?
OK, OK. So the new intern, Meredith's friend?
- Psycho with no appendix? - Yeah. We talked.
She came to talk to me. But it was more than that, you know?
A guy looks at you a certain way, eyes wander when he talks to you.
Bam, you know. This girl thing, it's confusing.
- Was there touching? - No.
- Was there playing with the hair? - No.
- Was there licking of the lips? - Oh, my God.
I made it up because I'm lonely and depressed and desperate
for attention from the hot new intern.
- Crazy new intern. - Crazy hot.
No. The hot ones are the ones that cause trouble,
ones that distract you from realizing your true potential.
You need to focus on the medicine. Take that pent up sexual energy
you waste thinking about hot, naked interns
and put it back into your genius, your godliness.
Build someone an organ. That's hot.
She smiled. Did I mention she smiled?
No hot interns!
Then we'll insert the newly constructed tube in between her trachea
and esophagus just... like...
that.
So this valve flips open when she has air...
You're in my space! Back up! Just back the hell up!
Dr. Bailey, will you please find Dr. Grey something to do
- other than interfere? - Dr. Grey?
Finish prepping Mrs. Patterson for surgery.
She was in my space.
George, can you cover for me for a while?
- We're swamped. - There's something I need to do.
- It's pressing. - She doesn't want to miss hot sex.
- Izzie! - It's the clinic.
You can handle the clinic.
You're lucky she even showed up. She hasn't been here all week.
- Dr. Shepherd... - It wasn't you.
She had a carotid dissection. Nothing we could have done.
- So we can't... - She had a massive CVA.
Blood to her brain was cut off and cannot be restored.
So even though Dr. Shepherd was able to fix the hole
in her brain that allowed tissue to leak through her nose,
the subsequent carotid dissection has caused loss of her cerebral function.
- You do understand that? - She's brain dead. I get it.
She's only 16.
That's good news. She'll be an excellent candidate for organ donation.
Excellent candidate. Excellent organs. Young.
Dude.
You were robbed. You got screwed by politics.
The Chief, he needed a scapegoat. It's so unfair.
I'm sorry. I can't do this. I can kiss ass when I have to.
But not yours.
Below-knee amputation: incision at mid shaft of the tibia.
Elevate the periosteum and cut the tibia with saw.
Ligate bundles and release tourniquet.
I've done four: one on a cadaver, three on Stan.
- Know who you're gonna pick? - I'm ranking them.
According to a system. Surgical skills, hours in the OR,
published papers, academic accomplishments.
You know them, their capabilities. Go with your gut.
My gut? I'm not putting a patient's life in the hands of a novice surgeon
- based on my gut. - Well, it worked for me.
Your gut?
It's what told me to choose you.
- Hey. - Hey.
- Beautiful. - What?
- Your necklace. - Oh, right. Um...
- I have to go. - See ya.
I hope you didn't page me to help pass out cough drops.
- Ain't gonna happen. - Where's Izzie?
- I thought she was here. - She's avoiding me.
- What do you want me to do? - You are together now?
Talk to her. Find out why she couldn't care about her clinic.
You're pissed 'cause you can't handle the flu.
Something's wrong, Alex. You need to talk to her.
- She won't talk to me. - Don't talk to me about Izzie again.
It's just George.
Your friends, they're out there fighting for a chance
to chop of that guy's leg. What is that, anyway?
It's how we learn. By doing.
I lost my shot at the solo surgery as soon as the Chief
made it Cristina's decision.
Anyway, there'll always be surgeries.
There won't always be fiancés who come back from the dead.
Good point.
Aren't you going to deepithelialize here
to connect it to the trachea?
You're a very eager student, Dr. Bailey.
- Very thorough. - Any way I can be of service.
- I'm not sorry. - What?
For what we did. It was extreme. Maybe even stupid.
But this program, you should be down in that OR,
not up here in the nosebleeds. I shouldn't be spending my day
transcribing Karev's illegible handwriting.
How is that teaching? They call me crazy Sadie and God knows what other names,
but that doesn't change that this program is broken.
The only time they bother with us is if they think they can get us in bed.
That's not true. Dr. Sloan took the time to teach me,
- and that wasn't about sex. - He likes you.
Who? Dr. Sloan?
Don't tell me you haven't noticed his eyes on your ass.
- You are delusional. - Is he cutting into her throat?
Bloody hell.
So I suppose you'll use a strip test
to confirm flow across the anastomosis?
It can damage the endothelium.
- But don't you need to... - Dr. Bailey,
would you rather do Patterson's surgery? I can leave.
Dr. Sloan, I wasn't... questioning your surgical skills.
I was just trying to learn. Something exciting. Something new.
Residents are fighting tooth and nail for a chance to cut off a leg.
What you've done here, you made something where there was nothing.
And... it's thrilling.
I was just trying to learn.
Thank you, Dr. Bailey.
Would you take the flap veins and join them to the internal jugular?
She looks like she's sleeping. Can I touch her?
Yes, of course.
Can she hear me?
She can come out of it, right? The coma?
- People can do that? - No, she can't.
I'm very sorry for your loss. But tests confirm that, although your sister's
bodily functions are fine, her brain is dead.
She has no thoughts, no emotions, no senses.
I'm Dr. Dixon. I will be harvesting your sister's organs
- if your parents agree. - Please, she's our baby.
- We need time. - I'm sorry for your loss.
But her organs are young and vital. They could save many lives.
Wake up, Holly.
Wake up, come on, wake up.
I'm very sorry for your loss, but your sister can't wake up.
Her basic functions are gone. Her brain is dead.
Her body is alive but, unfortunately, unfortunately, she is dead.
Get out! You cannot have her.
- And you cannot take her. - Dr. Dixon, I think,
I think they understand.
I think you should go now.
I have offended you, but we are running out of time.
Get out!
Holly, wake up!
Wake up, Holly!
Holly, wake up!
Holly, wake up, please!
Have you ever had mind-blowing sex? The kind of sex that makes you want to die?
Just fall on the floor and give up and die?
'Cause this sex I'm having, it's that good.
It's the best sex I've ever had. It's the best sex anybody's ever had.
I don't know why anybody who's had this sex would do anything but have sex.
Izzie...
You're gonna give the solo surgery to Mer, which is typical and boring
and slightly corrupt, but at least I'm having really, really,
really good sex.
Just thought you should know.
I know you're nervous. It may feel strange at first,
- but just give it a shot. - You haven't forgotten.
You can do it.
No! No! No more!
No more typing! No more Post-its!
No!
Talk to me. Talk to me, damn it!
Talk to me!
Maybe we should give her a little time.
Maybe you should go, too. Just go for a walk or a drive.
- Just give her some space. - I've given her five years of space.
- It was my fault. - Excuse me?
What happened, the appy, it was my fault. I knew what I was doing.
So if you want to punish someone, punish me, not Dr. Yang.
You know who your father is and he's why you're still here.
So if I were you, I'd stop worrying about whose fault the appy was
and start figuring out what I was gonna do to make up for it.
Yes, sir. Thank you, sir.
There are people dying right now. There are people dying.
- It's inappropriate. - I'm sorry, it's almost 4:00.
- I have to make this decision. - I'm not talking about your system.
I approve of your system. I was talking about the brain dead girl.
Can't hear her sister, can't feel her hands.
There are patients dying and those organs would keep them alive.
Leave feelings out of it. Leave them out of the science.
Leave them out of the decision-making because people are dying as we speak.
- Is she kidding? - Congratulations.
Whatever.
- Interesting choice, Yang. - He made the best case.
Iz, I won.
Hey. What time is it?
Yang, she picked me for the solo surgery!
She did? That's amazing.
I love you.
- What? - I love you.
I friggin' love you.
I just got the solo surgery and the first thing I did is look for you.
And you weren't there. You're never there anymore.
I've been thinking about it and it might be 'cause you love me, too.
And you're scared of that. 'Cause I screwed it up last time.
- And 'cause Denny died and... - Alex.
Just listen. You had that heart patient
and it reminded you of how bad you felt lying on that bathroom floor.
I get that. I get that you're scared.
But you're not gonna have to feel like that again.
'Cause I'm not gonna die, Iz. And I'm not gonna cheat on you.
I'm not gonna go anywhere.
'Cause...
I think you're my best shot at...
I think with you, you make me better.
You make me wanna be better. You make me wanna be good.
And I think I can. With you, I think I can.
I'm not going anywhere. You can stop hiding.
And if you want to be scared, that's OK. Just be scared with me.
Be scared while you scrub in with me for my first solo surgery.
- OK? - You love me.
Shut up.
Solo surgery.
I'm really starting to not like that guy.
I never should have said it. I didn't mean it.
I never should have said it.
Tell her that.
Tell her the last thing you'd want her to hear.
You have to believe if it were you in this bed
and Holly was with you, feeling bad, you would forgive her.
Tell her.
I'm sorry.
I'm so sorry.
I love you.
She loved you, too.
No matter what you said.
No matter what happened between the two of you,
she loved you.
She loves you.
So you were right.
- Cristina and I are fighting. - Go, talk to her.
She's your best friend. It's important.
Derek?
They don't tell you when you become a doctor it's gonna be like this.
They don't tell you that you...
lose more patients than you save.
Sixteen.
I'm sick of the death.
I'm sorry.
- I'll see you at home. - OK.
It's OK. Nobody else is here. It's just me.
And I'm just an intern. I'm nobody.
So you can try, and if it doesn't work, it's OK.
Just... just try.
Hi.
Dr. Dixon, how's your day been?
Feel like you may have a home at Seattle Grace?
Dr. Yang, you tortured her, making her choose among her peers.
Some kind of emotional torture. Was that your intention?
Yes.
Have your board make me a better offer.
We're fighting, and I don't want to be.
Let's just put this past us.
What happened with the Chief and interns, it doesn't matter.
That's why you didn't choose me, why you made it personal.
So let's just move on.
You made it personal.
This, here, is you making it personal. You told me to do what I had to do.
So I chose Alex. He's the most prepared. That's why I didn't choose you.
Not because we're fighting.
Because, unlike you, I can separate my personal life from my job.
You made it personal.
None of you said anything. Those were all our interns.
But I won this.
They picked me.
If I don't deserve this solo surgery, then none of us do.
I don't know if I'm more jealous of Alex or worried about Izzie.
I think something's wrong with her, Mer.
Something's wrong with all of us, George.
It's Alex.
Not here.
Here.
- Hi. You paged? - I need you to scrub in with me.
- Where's Izzie? - I'm freaking out.
I'm freaking out! I told her I love her.
I told her I love her before the solo surgery. I can't believe that.
She's not gonna show, I'm freaking out.
Stop freaking out. If you screw this up and kill this guy, I'm gonna be pissed.
Then I'll know I should have won it. You have to kick ass in there, Alex.
You have no choice.
Big night, Karev. You ready?
You ready?
He's ready.
- Where are we going? - Don't worry. You'll like it.
Come on.
Wait. Just wait.
Wait.
It's OK.
It's good. Right, right?
It's the vent. It clears your head. You feel better, right?
Yes, yeah!
It's out of time, out of space. Anything can happen on the vent.
Anything.
Like what?
Just wait.
You made her speak. Mrs. Patterson. She said "hi".
She spoke. You made her speak.
I respect you.
As a man, as a surgeon, as a teacher, I respect you.
So... teach me.
What are you doing?
- Don't do that. Stop. - Teach me.
- Stop. - Teach me.
We can't do this. You're Little Grey. And I promised.
- And I'm your teacher. - So teach me.
Lexie.
Teach me.
Come on, am I really so bad?
No.
I am.
We enter the world alone, and we leave it alone.
And everything that happens in between?
We owe it to ourselves to find a little company.
Fifty says he calls the Chief in ten minutes.
A hundred he chokes before they turn on the saw.
That's one of us down there. Show some respect.
We need help. We need support.
Otherwise, we're in it by ourselves.
Strangers.
Cut off from each other.
And we forget...
just how connected we all are.
So instead, we choose love.
We choose life.
And, for a moment, we feel
just a little bit less alone.
Ten-blade.