Grey's Anatomy s05e15 Episode Script

Before and After

[# Keri Noble: Emily.]
Every patient's story starts the same way.
It starts with them being fine.
It starts in the ''before.
'' They cling to this moment, this memory of being fine, this before, as though talking about it may somehow bring it back.
- Long time.
- Naomi.
We got an lCU bed all ready for him.
But what they don't realize is that the fact that they're talking about it to us, their doctors He was fine.
We went to lunch means there's no going back.
By the time they see us, they're already in the ''after.
'' What the hell are you doing? The interns are broken.
They've been punished for taking out their appendixes and it's making them hate medicine.
They're lost, and they've forgotten this thing they hate is actually a thing they love, so l'm gonna remind them.
ls this about Denny? ls this some kind of dead boyfriend art therapy? This is not about Denny.
lt's about the interns.
- Who cares? They're losers - They're not! They're not.
They're just They need to have a little fun.
And so do l.
Where are the damn scissors? They're right in front of you.
- Right.
- lz Will you hand me that large bow, please? Great.
Just put it down.
See? lt's gonna be great.
- Does he know how he got the parasite? - From eating unwashed fruit in Mexico.
- He's bradycardic.
- And hypotensive? A reaction to the fentanyl drip.
Stop the drip, push Narcan Wait! Derek, he was in status.
lf you take him off and he seizes, there could be brain damage.
- Better hope that doesn't happen.
- Hope? That's what your plan is hinging on? Hoping the worst doesn't happen? l'm hoping he's stopped seizing.
lf we don't reverse the drip, his heart is going to arrest.
So unless you have a better idea.
Push the Narcan.
And while every patient's story starts the same way, how the story ends depends on us, on how well we diagnose and treat.
- We know the story hinges on us - [long beep.]
He's in v-fib.
Get the crash cart.
- and we all want to be the hero.
- [gasps.]
Morning, Chief.
l heard there was a guy here with worms in his brain.
Does anyone know the medical term for worms in the brain? Dr.
Stevens requested you today for a special project.
OK, take an envelope, pass the rest back.
Do not open them, you'll need them for the first game we're gonna play.
That's what we're doing today? Playing games? Cheer up.
We are gonna have so much fun! Don't open! Don't you know how to play a simple game? - l did when l was eight.
- Let's just go.
[all groan.]
Bailey's with Addison, so l'm gonna hand out your assignments.
Addison's in the hospital? Her brother was admitted with parasites in his brain.
Addison's brother has neurocysticercosis? - [Richard.]
See? - Huh? That's what l'm taking about! l cleared my schedule.
- You didn't have to do that.
l'm fine.
- Your brother has parasites.
l cleared my schedule.
You cut your hair.
- Yeah.
- l like it.
Miranda Bailey.
l'm sorry.
Miranda, Naomi.
Naomi, Miranda.
Naomi's our fertility specialist at Oceanside and one of my oldest friends.
- Nice to meet you, Miranda.
- How is he? - l don't know.
- He's groggy.
His eyes are open but l don't think he's awake.
He hasn't tried to kill me.
- Her brother hates me.
- [groans.]
- People pick sides in a divorce, Derek.
- He picked sides in the marriage.
He first seized during sex with his girlfriend.
Wonder why she's not here? Oh, she is.
Naomi? l'm going in there.
- You and Archer? - No.
Well, yeah.
l don't know.
l don't know what we are.
How's Sam? Sam's good.
And how's Meredith, is that her name? She's good.
- Good.
- Yeah.
Look at us.
We're making polite conversation about your girlfriend.
You two are divorced, me and Sam are divorced.
l'm with Archer, sort of What the hell happened? l mean, you wrote Addison a song, Derek.
Let's forget about the song.
- Enough about the song.
- What? You wrote her her own love song and sang it to her at the wedding.
Mark wrote it or Sam.
l don't remember.
l do.
l was drunk at the time, but l remember thinking you were going to last forever.
- We were all gonna last forever.
- Yeah.
You should call Sam.
He misses you.
- [Callie.]
How'd you sleep? - [groans.]
Not too well.
- Shoulder pain? - No.
Pain in the ass wife.
l kept him up because l was afraid my aneurysm was gonna explode and l was gonna die.
- Hi, l'm Dr.
- Where's Dr.
Grey? She's supposed to be in my surgery.
She and Dr.
Shepherd got called in on an emergency.
So he's not going to get to your aneurysm until later.
- Wha Later when? - Could be a few hours.
- Could be tomorrow.
- [man.]
Tomorrow? She's waited until tomorrow.
Today is tomorrow.
- l'm sorry, who are you? - l'm her husband.
- l look like this because - l ran him over with our car.
Before l knew l had this huge time bomb in my head.
When l was just a big old pregnant person waiting for her baby.
So, just please, if he could get to me sooner rather than later [Callie.]
Um [clears throat.]
- What's the emergency? - Addison's brother.
Addison's here? We were having dinner and he just passed out.
l am telling you, it is probably just my hernia.
He has an inguinal hernia.
lt doesn't seem to be the source of obstruction.
lt's gonna take these doctors a long time to figure this out.
l'm fine.
- You gotta go to work.
- He hates it when we try to help him.
He's a lot like my second graders that way.
OK, Daddy.
You win.
l have my cell, so call me if you need me.
l have colorectal cancer.
l've had five polyps removed in the last three years and radiation.
My daughter doesn't know and l'd like to keep it that way.
Um Dr.
Yang's going to set you up for a CT with contrast.
Where have you been treated? We'll need your records.
Columbia Hospital in Verona.
l l work here now.
l saw you were in and l [man.]
You waited till she left to come in and say hello.
Just like you to face up to things like a man.
You should tell her about the cancer.
She deserves to know.
You lost the right to tell me anything about her when you broke off your engagement in a two line email.
[Naomi singing.]
- [chuckles.]
What was the next line? - Can we talk about something else? [Archer singing.]
- Greatest love song of all time.
- Hey! You get to the part where Derek rhymes ''gross anatomy class'' with ''Addison's fine ass,'' because l wrote that line.
[Addison clears throat.]
- Oh, my bad.
- No, no, it's fine.
l, uh l think it sounds like a fine song.
Archie, heard you were gonna let Derek remove those suckers from your brain.
- Maybe.
- He is.
l hate surgery.
Especially brain surgery.
Being a neurologist you probably see a lot of patients post-op - who are scrambled eggs up there - [Addison.]
You're not helping.
We're sitting here trying to convince him that surgery is ls not an option.
According to these scans, the single cyst you had on your last CT has now multiplied by eight, all clogging the third ventricle.
There's no way l could surgically navigate through a mess like that without rupturing one.
So, what does that mean? You're in a room full of doctors, who are all being very quiet right now.
l'm gonna die.
That's what it means.
lnside each one of your envelopes is the name of a surgery.
Your task is to drape your patients accordingly.
On your marks, get set Go! Come on, lighten up, this is supposed to be fun.
Don't take it so seriously.
You suck at this! My grandmother could drape better than you! - l'm sorry.
l'll try to do better - No, you're doing great.
l'm trash talking.
l'm having fun.
lt's just fun.
What are you? Woo! Woo! Woo! Woo! - [George.]
Looking good! Good job! - Done! - [Lexie.]
Laparoscopic cholecystectomy - Yeah, that's good.
- [George.]
Your next challenge.
- [Sadie.]
l'm done, too.
A whipple is for pancreatic cancer.
Were you planning on going in through the mouth? [George.]
Start over.
There's just no way, Addie.
Conroy at Cedars and Larry at Mayo, they agree l've put you in a tiny box.
After the divorce l made you petty and inconsequential and nothing special, so that you could fit into this tiny, little box that would help me get out of bed in the morning.
But now now l have to take you out of the box because l need to believe that you can do this, that you can save my brother.
l need you to be a god.
Just today.
Be a god.
Montgomery, Archer.
l'm a friend.
l'm Dr.
Miranda Bailey.
l'm a friend of Addison's.
- Which one are you? - l'm sorry? Archer is Addison's brother.
Archer's girlfriend is Addison's best friend who married Derek's best friend who Derek hasn't spoken to - since the divorce.
- That would be me.
The ex-husband, Dr.
Samuel Bennett.
Sorry, l didn't think the ex-husband would show up at the ex-wife's boyfriend's bedside.
Don't worry about it.
Even l don't know why l'm here.
- But yeah.
- Third floor.
Room 3420.
Thank you.
- Dr.
- Uh Sam.
Shepherd is still studying the scans looking for a way to operate but it looks like a difficult case.
Hey, Addison's brother probably isn't gonna make it.
- His cysts are inoperable.
- Worms in the brain.
- Not how you want to go.
- l didn't know Addison had a brother.
You'd think Derek would have said something at some point.
Or sang something while he played his guitar.
- Speak English.
- Derek used to play guitar.
Owen's ex-fiancée is in the hospital.
His ex-fiancée he never told me about.
- What's wrong with her? - She calls her dad ''daddy.
'' No, what's wrong with her? Why is she in the hospital? She isn't.
Daddy is.
You should ask Owen if he plays the guitar.
''Find Dr.
Sloan, ask his symptoms, diagnose him correctly to receive your next challenge!'' What are your symptoms? Right now, l'm battling a rapid heart rate, also feeling a little flushed.
l don't even want to mention what's going on below the belt.
l don't do dirty, secret flirting with you, anymore.
l told you, if you want to go public with me, with us, l will do dirty public flirting.
l mean, l will flirt publicly, not dirtily maybe a little dirtily.
Please tell me your symptoms so l can concentrate.
Tachycardia, angioedema, hypotension, severe chest and abdominal pain, - difficulty breathing, throat closing.
- Anaphylactic shock! - Whoa! Whoa.
Foul! - What? - You heard her answer.
- The whole hospital heard.
You should've kept a distance.
New symptoms.
Resume play.
Woo! You must have questions, so ask.
When was his last polypectomy, since you're familiar with the patient? - Not what l meant.
- l know what you meant.
- Dr.
Yang, symptoms? - Not a good time Heavy feeling in the abdomen, accompanied by nausea and an acute pulling sensation in the scrotum.
Testicular cancer! Woo! - Cristina - l have to get Mr.
Whitman to the CT.
l wasn't doing anyone any good at school so [woman.]
Owen? l don't understand.
What? l work here.
What do you mean? What do you mean? - [Owen.]
- When did you get back? l just saw your mom.
She didn't l thought you were in lraq.
l've been praying for you every night.
Every night, l'm on my knees, praying that you're gonna make it back, that you'll make it another 24 hours, that you you'll make it home.
Owen, you're back! [# Liam Finn: Gather To The Chapel.]
- What is she doing? - lt looks like she's praying.
Mm, no Addie doesn't pray.
- [Callie.]
What's she doing? - [Naomi.]
Uh, she's praying.
Addison doesn't pray.
She must be hiding.
l can hear you.
l'm not hiding, l am trying to pray, but l don't know how because l'm a WASP.
We only go to church on Christmas.
You guys go.
l got this.
l have no clout with God.
God doesn't even know who l am.
Which sucks, because l could l could use some help.
[Callie clears throat.]
[exhales deeply.]
Dear God, l need your guidance.
- l kissed a peds surgeon.
- You kissed a peds surgeon? l never thought l'd end up with a woman.
Not until lately.
That's not the problem, the problem is the peds thing.
She's perky and has butterflies on her scrub cap.
But she's also hot.
Really hot.
So help me get over the butterflies.
You're an amazing doctor, you save babies.
God knows who you are.
Do you really believe in all this? ln God? Sometimes.
Most of the time.
When it counts.
Your wife's in the chapel, praying.
She's not my wife and she doesn't pray.
- How are you? - Hey.
You know, midlife crisis.
l got an earring, but l let the hole close up the very next day.
- That would have been a good look.
- l met, uh Meredith.
She's not a midlife crisis.
She's the real thing.
That's great.
l'm happy for you, man.
- Happy for you.
- Yeah.
- l should have called - No.
stayed in touch.
lt's my fault.
People move, they change, we all did.
- Yeah.
- So But, yeah.
She's praying.
She's expecting a miracle.
l can't deliver one.
l've seen patients with one cyst in the ventricle, maybe two.
He has eight.
There is no way l can get a scope in there without rupturing one.
There's too many.
Maybe you're just too close to it.
What if there were just one? Explain to me how you would remove just that one.
What's the prize for winning? - They need a prize.
- They're getting a prize.
A really big prize.
- l need a prize.
- What's going on? Uh, my patients needed a distraction and lzzie needed real patients.
- How's it going? - lt's going great.
We're having fun.
Grey! Am l going to surgery now? Could be any time now.
What? - l can't find it.
- Wh? ls something wrong? ls the baby's heart not beating? You're on the kid's ass.
The heart's over here.
[heart beating on machine.]
[door opens.]
lt's not what you think.
l can guarantee l'm not as much of an ass as you think l am.
Does your mother know you're back? Page me when this is done.
Archer, l need to create room in the ventricle so l can maneuver the scope.
lf l deflate each cyst, the scope can remove them.
The cysts will rupture.
l'm going to grab each one with forceps, pull it up, suction the fluid.
- Suction would have to be precise.
- [Derek.]
lt will be.
- You can't do it.
- l think l can.
- Control the way the cyst ruptures? - [Archer.]
No, he can't.
- You want me to go down fighting but - Coward.
- Excuse me? - You're a coward by trade.
You're a neurologist.
You feed off us, refer your patients to us, let us assume the responsibility, and if something happens, well l can assume the responsibility.
The question is, can you? - A peds surgery fellowship? - Yep.
Just when l'm almost done with general surgery residency.
Crazy, huh? No.
Just surprising.
You don't seem like a peds person to me.
- Why not? - Because you don't smile.
- Peds people smile.
- l smile.
Well, l'm not going to smile now.
But l do smile.
l smile frequently.
- Hey.
He under yet? - Yeah.
A peds surgery fellowship? - Huh.
- [Sam snickers.]
l have a child.
l am familiar with children.
l am going to be an excellent pediatric surgeon! You're gonna want to keep that temper in check around the kids.
- Weird seeing Archie on that table.
- [Sam.]
Looks like l'm low.
Chris, refill this for Dr.
Bennett here.
- Thanks.
- lt's good practice.
Asthma's big with the kids.
Say it, Derek.
Come on, say it, say it, say it, say it [Derek sighs.]
OK, everybody.
lt's a beautiful day to save lives.
- You're gonna have to tell her - This is Beth we're talking about.
She worries herself sick when one of her students gets the sniffles.
She can't handle bad news.
She's a sunshine girl.
And you used to know that about her.
Well, she'll find out eventually.
- [Owen.]
Yang! - What's going on? Ruth, call the Chief and reserve an OR.
- Owen? - lt's a lt's a complication.
He needs surgery.
A complication from what? He's going to be OK.
l'll keep you updated.
Let's go.
Entering the third ventricle.
Securing cyst number one.
Deflating cyst one.
Applying suction.
Any sign of the scolex? [Meredith.]
There it is.
One at a time.
One at a time.
l need to be distracted.
Someone talk about something other than what's going on with my brother.
Uh, Mark is good at talking about himself.
l've been using endoscopy for head and neck cancer resections.
lf l can just focus the criteria for patients, l might have a breakthrough on my hands.
- What happened to you? - He met someone.
Torres said l had to eat.
l'm sorry.
lt's OK.
How is it? lt's amazing.
l'm sorry.
lt's bland.
lt's really bland.
l need my surgery now! What kind of hospital is this? - How long am l supposed to wait - Stop it! Look if you don't settle down your blood pressure's gonna rise and you're gonna start contracting.
Sorry, because l don't know you, but you really need to shut up, OK? All right, look.
Look, there's your son's face.
That's what you need to hold on to for the next couple of hours, OK? ls that a tumor? He's gonna need more aggressive treatment.
- He'll have to tell his daughter now.
- He won't.
Her mother died when she was little.
He feels that's enough sadness for anyone.
He sheltered her, she always had a nice car, clothes, anything.
She'll find out eventually.
She used to call me in tears when there was a spider in her apartment.
Became a joke between Michael and l.
Neither of us could be out of town at the same time in case Beth found a bug.
When he needs to go through chemo or gets so sick he needs hospice care, she'll find out when it's already over.
She deserves more than that.
What's the number? [Meredith.]
Seven cysts, seven scolices.
OK, one more.
Damn it! [beeping.]
- [Meredith.]
He's getting bradycardic.
- [Derek.]
See if the flow is blocked.
[long beep.]
Start the code clock.
- [Meredith.]
Derek, asystole.
- Where the hell is it? - Get the crash cart.
Compressions! - No! Stop.
Nobody move.
We can't.
l have to find the worm.
- But he's - We have two, three minutes.
- [Derek.]
How long's he been down? - Two minutes, twenty seconds.
Got it.
Damn it.
lt's starting to tear apart.
Maybe if l rotate and reverse it back.
And that's number eight.
Heartrate's coming back up! [Derek.]
Thank you, everybody.
You made some friends of mine very happy.
[# Shontelle: Roll It.]
Just got out of surgery.
What's going on? - Any minute.
- She needs a prize.
Big prize, but not too big, because they did take out their own appendixes and they're being punished and you think they're not even qualified to hold a clamp.
So Do you have prizes like that? They got their symptoms from their final patients.
Get out the finish line, it's gonna be close.
- [lzzie.]
Here they come! - Come on! Come on, bring it in! [cheering.]
- George? - Three-way tie.
- Ok, final diagnosis? - Motion sickness! - No! - Dengue Fever! - No! - Neurocycticercosis! Ladies and gentlemen, a winner! Whoo! Ha! - Nicely done.
- [groaning.]
- Yes! - Worms? Wait, what's the prize? You get to scrub in on Shepherd's craniotomy and hold the doomsday sucker.
- What's a doomsday sucker? - Doomsday sucker? lt's just a really big sucker.
[woman on PA.]
Leone, call the blood bank.
Leone, call the blood bank.
lt was a hard surgery, some of the bowel was dead as we suspected, but we were able to remove the diseased parts successfully.
He's in recovery.
You can see him in about an hour.
- You don't even look like yourself.
- Excuse me? You don't.
You look hard.
And Look, l know it wasn't easy over there, l hear people come back and l know you can't just come back and be normal right away, but He'll be asleep for a couple hours.
You can see him now.
Two lines in an email? l deserve more than that.
[# Sara Bareilles & lngrid Michaelson: Winter Song.]
Beth, your dad has colorectal cancer.
He's been through radiation treatments and polyp removals.
He didn't tell you because he didn't want to burden you.
He'd like to spare you any pain.
Any more pain.
He had all these friends.
They sang and they played guitar.
lt's like he was a totally different person.
- He was.
- [all laugh.]
lt freaks me out a little bit.
l feel like l don't know him.
Well, l don't know Owen.
We don't.
We don't know them.
[group laughing.]
Hey, hold up.
Hold up.
l wanted to let you know, l'm happy to help you, if you'd like.
Reviewing the basics or putting in supervised skills lab hours.
- Excuse me? - l was a repeater earlier this year, l know how easy it is to get behind.
- l don't need a tutor.
- You don't? - No.
- At this point in your training, you should be able to hear symptoms, diagnose the problem and decide whether or not a patient needs surgery.
Can you do that? Can you? Because they think you can.
And they will put you in situations where you have to.
Sadie, you could hurt someone! l call her.
l call my mother.
Once a week.
l haven't told her l'm back, she thinks that l'm calling from [sighs.]
l keep the conversations short.
l can't bear for her to know that the son she sent off to war is gone.
He's gone.
And if l just got in my car and drove six miles to see her she'd be so sad.
And she would look at me the same way that Beth does now.
Like l'm not there.
The only time l don't feel like a ghost is when you look at me.
Because you look at me and you see me.
You see me.
This is me.
This is me.
Please, Cristina, see me.
See me.
Jen, l am so sorry.
l have you scheduled first thing tomorrow.
l'm using your first name now.
l like you a lot and l'm starting to consider us friends, so l'm using your first name and calling you Derek.
And Derek? l'm begging you please, please don't make me wait another night.
- She's good.
- Try being married to her.
You'll never say ''no'' again.
lt would appear that congratulations are in order.
Thank you, Dr.
l'd also like it acknowledged that l offer these congratulations professionally and respectfully, without any innuendo or inappropriate body language.
Acknowledged, Dr.
Do you know What's a doomsday sucker? - Addison Montgomery.
- Uh, Lexie Grey.
- [Derek.]
Little Grey.
- Little Grey? Hmm.
l have to meet you at Joe's in a bit.
l have a craniotomy.
- You're holding the doomsday sucker.
- Now? - Great.
Yes! Yes, sir.
- OR 2.
See you there.
Doomsday sucker.
- Can you believe Little Grey and - Did you hear? Derek's going to propose to Meredith.
How about that? l'm off to surgery.
What? Hey.
- lz, what's going on with you? - Nothing.
l'm fine.
You saw.
The interns are not a bunch of losers.
They know things.
They're gonna make good doctors.
Really, l'm fine.
l'm fine.
She knows nothing.
She's a danger to the patients.
l told her she could tell the Chief or l could.
l wanted to let you know, because you're her friend.
Although for the life of me, l don't know how you two were ever friends.
- What happened? - l quit.
O'Malley's a little narc.
l'd rather be deemed a quitter than a cheater.
Did you cheat your way into the program? l said l'm not book smart.
You know that.
l learn on my feet.
l thought if l came to where you were, you could Pull you through? We've seen each other through a lot.
We're not 25 sleeping our way through Europe anymore.
We could, though.
Think about it.
- We could get on a plane and go - No! No.
l can't.
l have to work.
l can't just Well, you know They've sucked the life right out of you.
- The Meredith l used to know - ls right here.
l'm here.
l don't want to sleep my way through Europe anymore.
l want to be here.
l want to be here.
- Sucker at the ready? - Sucker's at the ready.
- You're mocking me.
- Only a little.
- Damn it.
Damn it! - What? What happened? BP's 88 over 60.
Hang two units of blood.
All joking aside, Dr.
Grey, bring in the doomsday sucker.
- OK.
- Right in here.
Go right in here.
[suction sound.]
Oh my God.
- [Derek.]
Temporary clips.
- Wow.
Wow! Wow.
Microsutures, please.
BP's 1 1 0 over 72.
OK, get the sucker out of there.
ls that it? Did you get it? There's good flow.
Yes, we did it.
And that will teach me to never mock an eager young intern again.
[Lexie chuckles.]
[# Slow Runner: Happy Ending.]
- l'm an ass.
- You're such an ass.
l shouldn't have blurted.
- A little warning would've been nice.
- But you're OK? You know, it's strange.
l l expected this horrible feeling, this wave of sadness or something, to just take over.
But people get divorced, they meet new people, they re-marry.
l don't know, maybe it was seeing Archer in that OR, it just changed my perspective.
Or something.
But you sort of wished it had been you first.
Shut it! Are you gonna tell Derek about the Wait.
lf we called Meredith the 1 2-year-old, - What do we call Lexie? A preschooler? - [Mark.]
She's a woman.
- Oh, OK.
- And l'm gonna tell him.
- l'm working on it.
- [door bell jingles.]
There he is! [all cheer.]
That's the kind of welcome l deserve! - Joe! Scotch for the neuro god! - You were a god today.
You were a god in that OR.
You slew dragons, you walked on water.
You You were a god, but now? Now you need to get very tiny again.
And go back in the box.
- How was your craniotomy? - lt was fine.
- Yeah? - Yeah, l stopped in on Archer.
Things are good.
- Good.
- [Naomi clears throat.]
[all singing.]
- [Addison.]
Oh, God! - Shut up.
We can't remember the chorus.
We got all the way through the second verse, your name starts the chorus.
[Addison sings.]
lt wasn't ''summery.
'' l'd never use ''summery'' as a noun.
- ''l met her in the summer, she'' - ''Summer, she?'' Really? - Yeah.
- Come on.
[all singing.]
This is why l don't stay in touch.
[Sam singing.]
[Sam and Naomi singing.]
[all singing.]
Aw, gee.
Yeah, you got it.
Oh, hopeless.
- [gasping.]
- [beeping.]
- [man.]
What's happening? - Page Shepherd.
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