Dr. Webber enforces an 80-hour-per-week maximum rule for the interns. Derek wants to enroll Ellis in an experimental treatment for Alzheimer's , but Meredith doesn't want his help and Derek needs Dr. Webber to intervene. Alex treats a writer who ate his entire novel. Izzie seems to be getting over Alex when she shares an undeniable chemistry with Denny Duquette, a patient awaiting a heart transplant. Bailey goes to retrieve Denny's heart, taking Cristina along for the ride. Meanwhile George and Addison treat Bex, a young teen who is intersex .
(Meredith's house) (Izzie is in the bathroom standing against the door, holding a coffee mug in one hand. You can hear Doc barking and growling really loudly and you can also hear George's muffled yelling) George (screams): God, holy, ow. I said down, back...IZZIE! IZZIE! Incoming! (Izzie looks startled and moves to open the bathroom door and George runs in and they both slam the door shut) MVO: Fresh starts. Thanks to the calendar, they happen every year. (Izzie hands George her coffee mug which he accepts gratefully) MVO: Just set your watch to January. Izzie: You know I'm thinking about coloring my hair. Maybe red. George: Yeah. Red's good. I'm thinking about cutting mine. Izzie: Yeah? You look good shorter. George (looks a little surprised): You think? (You can now hear Meredith giving the dog compliments and the barking has stopped. George and Izzie open the door tentatively and peek out) Meredith: What a good dog? Who's mommy's good boy? (They see Meredith patting and shaking the dog's paw) Meredith: Silly. Yes, I know. You're a good boy. You're such a good boy. (They look absolutely amazed by this) Meredith: What are you guys doing in there? We're going to be late. George: We need to talk about the dog. Izzie: That's not a dog. It's a hyena, escaped from the zoo dressed in dog clothing. George: Whatever! I don't chew up his clothes. I don't urinate on his bed. I don't try to mount him from behind! Meredith: People, he's our dog. We love our dog. He loves us. (She continues patting and leaves. Doc turns and growls at Izzie & George and then lets out a bark) Izzie (apprehensive): He tries to mount you from behind? George: Tries to. (Doc barks loudly and George whispers) Tries to. (Derek's trailer) (Derek decked out in full fisherman's gear is heading into the trailer carrying a trout) MVO: Our reward for surviving the holiday season is a new year. Bringing on the great tradition of New Year's resolutions. (Derek walks in and up to Addison is blow drying her hair actually standing outside the bathroom) Derek: I got a trout. Addison: Oh! Derek: Rainbow trout. Addison: Why, why did you bring a trout into the house? (Derek walks to the tiny kitchen, with the trout and starts washing it) Derek: The trailer. Addison: Why did you bring a rainbow trout into the trailer? Derek: Breakfast. Addison (dead-panned): Breakfast. Derek: Yeah, you hungry? Addison: For trout? Derek (smiling): Yeah. Addison (fed up): I hate this Derek! (She tries to storm up to him but the blow dryer cord pulls her back) I... argh! I hate this! I hate, hate! I hate this trailer! (She huffs and slams the door of the bathroom behind her) Derek: So no trout for you then? MVO: Put your past behind you and start over. (Nursing Home) (Richard is visiting Ellis Grey at the nursing home. He's helping them to cups of coffee at the coffee/food table. Ellis is standing next to him) Ellis: I'm standing there with Pritchard and Lewis and they keep on asking me who was I with in the on-call room last night. Richard (uncomfortable): Uh. Ellis (grinning): They heard us. (chuckles) Were we that loud? Richard: Huh, you're loud. Ellis: Stop. (Richard starts moving towards some seats and a table) I am loud aren't I? Richard: Pritch. Was always sticking his nose in someone else's business. You know I actually saw him again ... at his wife's funeral. (They sit down) Ellis: What? Pritchard isn't married. Richard: Ah oh right, right. I'm thinking of someone else. Just confused. Ellis (nods): You need sleep. Residency is wearing you down. (They sip their coffee) Richard: Ellis? Ellis (smiles): Yes? Richard: Nothing. I just hate being an intern. Ellis: Mmm. Me too. MVO: It's hard to resist the chance at a new beginning. A chance to put the problems of last year to bed. (OR Scrub Room) (Cristina is getting scrubbed up for a surgery. Burke walks into the room and hands Cristina a scrubs mask which she accepts smiling) Burke: So, in the name of the new year ... Cristina: Oh, I don't do resolutions. Burke: In the name of the New Year, I thought you could give me an answer to my question. Cristina: Your question? Burke: About you ... moving in. Cristina (sighs): I don't have an answer. Burke: Cristina. Cristina: I'm not being Cristina. I just ... I don't have an answer. Burke: Then answer me this. What were you planning to do? Cristina: About what? Burke: The baby. (Cristina looks up at this but a scrub nurse enters the room) Nurse: Dr. Burke, we're ready for you. (Cristina leaves and Burke is left looking upset) (Richard is standing up on some stairs talking to a crowd of interns and doctors that are standing at the base of the stairs. Meredith walks up to the crowd and stands next to Alex who is also standing there) Richard: Listen up people. New Year, new rules or should I say New Year and we will be enforcing the rules mandated by the residency review committee. There were too many mistakes made last year. (Alex looks down at this) Fatigue played too big a role. Exceeding 80 hours per week will not be tolerated. George (whispers to Izzie): Does that mean we actually get to have a life? Izzie: I think so. Richard: Sullivan, you were on-call for 28 hours, leave when you hit 30. Grey you were here to 2am last night, see you at noon. Meredith (to Alex): I get to go? Free time? Alex: Run before he changes his mind. (Meredith leaves) Richard: Oh and people our nurses are gonna have to work extra hours to compensate so treat them well. Cranky nurses don't do us any good. (The crowd disperses and Izzie and George walk past Alex) Izzie (to Alex): Well maybe you can cheer them up. (George chuckles and Alex gives her a look. Izzie stops walking and turns around) Izzie: You know what? My New Year's resolution was to let it go, and I am.I have...let it go. I apologize. (They all start walking down the hallway together) George (amazed): You do? (Alex smirks at George) Izzie: I do. How'd your test go? Alex: I feel pretty good about it but I won't know for a few days. Izzie: Well we're all pulling for you. George: We are? Izzie: We are. (Burke is performing surgery in the O.R with another doctor. Cristina is standing a few feet away watching) Burke: He can see the mesothelioma better now that I've partially dissected it. Cristina: Um, I can't uh, I can't really see it from here. Can I, can I go in closer. Burke: You're fine there. (Richard enters the O.R) Richard: Preston, good news. We have a heart for Denny Duquette. Burke: Great news. Has he been called? Richard: Got here 10 minutes ago. Burke (nods): Good. I was worried we couldn't find a match in time. Richard: We have a plane ready to take you to Twin Falls, Idaho for the organ recovery. 90 mins each way. How much more do you have here? Burke: Uh, heart comes out first. I'll be cutting it too close. Richard: They have a local heart team there so ... Burke: No, Bailey. Send Bailey. She'll be our eyes. (Richard nods and then stares at Cristina) Richard: Dr. Yang, you need to leave this O.R. Cristina: Excuse me? Richard: You've exceeded your 80 hour limit for the week. You have to leave the hospital. Cristina: Okay um, um as soon as the mesothelioma is dissected out. Richard: Dr. Yang. Now. (Cristina nods and Richard walks to the door but Cristina still stands there) Burke: You heard him. (Cristina looks down and walks out of the OR, the door being held open by Richard for her) (Bailey, Alex, Izzie & George are doing rounds. They enter Denny Duquette's room. A reasonably good looking heart transplant patient's. He is lying in a hospital bed as a nurse fixes his IV) Bailey: Denny Duquette. Denny: Hey Dr. Bailey. Bailey: I hope seeing you here means that they finally found you a heart. Denny: No offense doctor but I'm not a big fan of hospitals. It takes something pretty special to get me in here. Bailey (to Izzie): What do we know about Mr. Duquette? Denny (smiling at Izzie): Capricorn, single, loves to travel and cook. Bailey: Denny be quiet. Let her show off. Izzie (looks down smiling): Denny Duquette, 36. Admitted today for a heart transplant necessitated by a viral-cardiomyopathy. Bailey: Hmm and what does that mean? Izzie: That his heart is unable to fill and pump blood normally. Bailey: Good. Denny this is Dr. Stevens. She'll be tending to your private surgery. Denny (grins): So I guess I'll be seeing you around, Dr. Stevens. (Alex looks on less than amused as Izzie smiles back. They leave the room and stand at the nurse's station as Bailey finishes checking on Denny) Alex: Gotta hand it to the guy, trying to get some action when he's practically a corpse. Izzie: Alex, he's just trying to be nice. (Bailey and George walk out of the room and start walking down the hallway. Izzie and Alex catch up to them) Bailey: No one enforced an 80 hour work week when I was an intern. 110, 120 hours suited me just fine. I learned more because I worked more. George: Well at least this way you get a rest before you have the baby. I mean being that pregnant, keeping up this pace. Bailey: Are you saying I look tired O'Malley? George: No, not tired, no. You look fresh, spry. You glow. What (he looks at his watch) stop now? Bailey: O'Malley, go do an intake on Addison Shepherd's patient. George (still looking down): Addison. (He walks off. Bailey turns to Izzie and Alex) Izzie: You do glow. Alex: Like the moon. Bailey: And you can spend the day in the pit Karev. (Bailey and Izzie walk off) (A young girl named Bex is sitting on the hospital bed drawing on a drawing pad. Her parents are next to her talking to each other. George walks in and is followed by Addison a few seconds later) Addison: Dr. O'Malley. George: Hi. (He hands Addison the chart) Mr. and Mrs. Singleton, Rebecca, this is Dr. Montgomery-Shepherd. (Addison shakes hands with the parents) Mrs. Singleton: You don't think it's cancer, do you? Bex is too young for cancer right? Addison: Mrs. Singleton, I'm just getting up to speed. I'm sorry. Dr. O'Malley? George: Rebecca has been admitted for... Bex (interrupts): Could you stop calling me that? Mr. Singleton: She prefers Bex. Not Rebecca. George: Bex has been admitted for an ultrasound-guided biopsy on an enlargement of the pelvic lymph node. Addison: Okay Bex, you mind if I check it out? Mr. Singleton: Okay, I'll just ah ... (He nods and leaves the room) Addison: It's a minor procedure Bex, but we'll give a local anesthetic to manage the pain. (Addison starts feeling around Bex's stomach and chest) George: What are you drawing? Bex: Just a dumb comic. George: You're really talented. Mrs. Singleton: It's big, I know. It just appeared one day. Addison: I'll perform a biopsy this morning and Dr. O'Malley will have to take some blood so we can run some tests and then we can start to get you some answers. Ok? Mrs. Singleton there's no need to panic. I'll keep you posted every step of the way. Mrs. Singleton (nods): Thank you. (Addison leaves) George: Sorry about this but I'm going to need that arm to get some blood. I'll be quick. (Bex stops drawing and George takes her arm and rolls up her sleeve. He notices several slash and cut marks on Bex's wrist. He looks up at Mrs. Singleton who just looks down) (Mauer Paskowitz and his fianc� Audrey's room) Alex: Mr. Paskowitz, we've located the source of your abdominal pain. (He points to the x-ray film he's holding) There. It's called a bezoar. Mauer: Bezoar, huh? Alex: Yeah it's a clump of foreign matter that couldn't be expelled with a pro-kinetic agent. Mauer: I love it. In a hospital a laxative is a pro-kinetic agent. Audrey: So what you just go up his butt and grab it? Mauer: Baby, please. Alex: Actually we won't be able to reach it that way. We will have to get it from here. (He points directly at Mr. Paskowitz stomach) So Mauer, tell me what you've been eating? Mauer: Garbage. Absolute garbage. Alex: Could you be more specific? Audrey: Tell him what you ate, Mauer. (Mauer just stays silent) He's a writer. Suffering for his art. Alex (nods): Ok. Audrey: He ate his novel. Alex (does a double take): Huh, I'm sorry what? Mauer: I ate my novel, ok? The whole damn thing. Every last piece of that unmitigated crap. (Audrey just smiles and shakes her head. Alex is left looking amazed) (George is walking up to Addison, who is standing at a nurse's station) George (hands Addison a chart): The labs for Bex Singleton. Addison: Anything? George: Yeah her hormone levels, estrogen, progesterone are sky high. Addison: Huh, you did a history right? Any mention of birth control pills? George: No, but her parents were right there. Addison (hands him back the chart): Talk to her again. George: But she hasn't hit puberty yet, isn't that weird she'd be having s*x? Addison: These days Dr. O'Malley it's not that unusual. Talk to the patient. (Addison leaves) (Richard is walking up to Derek who is dressed in regular clothes, using his phone in the middle of a hospital hallway) Richard: Derek. Derek: Oh, morning Richard. Richard: You busy? Derek: No, my surgery just got cancelled. Why? Richard: I need a favor. Derek: Sure. (Bex's room, where she is now by herself, drawing some really amazing comics. George enters the room) George: Hey Bex. Is your mom and dad ... Bex: Food. George: Great. ... Because I wanted to talk to you. Your lab work showed ... have you been taking birth control pills? Bex (stops drawing & looks up scared): If you tell my mom and dad- George (interrupts): No, I won't. I just ah need to know why. Do you have a boyfriend? Bex: Like anybody would want to have s*x with me. George: Well then why? Bex: I'm as flat as a board. I took like 5 of those pills a day and nothing's different. (George just stares at her confused) Boobs, dude. George (realization dawns): You were trying to make your breasts grow. Bex: I wanted to be normal for once in my life. (George nods to himself) Is this what caused the tumor? George: No. No the pill wouldn't have any effect on your lymph nodes but it would ... the amount you were taking is really dangerous and it caused a pretty major hormonal imbalance. Have you been feeling any different than usual? Bex: I feel like how I always feel. (She brings up one arm and rests on it. It reveals the scars on her wrist) (Derek is standing in an elevator, reading a paper with two other nurses. The doors open and reveal Meredith standing outside dressed to go home. She walks in and the two nurses leave) Meredith: Hi. Derek (puts the paper away): Hi. You leaving? Meredith: 80 hour limit. You? Derek: Surgery was postponed. (It looks like he's checking her out. He can't stop smiling or looking at her. Meredith looks over at him) Meredith: I have a dog. Derek (smiles): You have a dog. Meredith: My point is I have a dog. Derek (full on grinning now): You have a dog. Oh you know what? I love dogs. Meredith: I've moved on so don't give me that look. (He moves from his position against the wall and stands up close to her) Derek: What look? Meredith: That look. Our look. I'm over you. Derek: I'm over you too. Meredith: You are? Derek (shakes his head smiling): No. Meredith (matter of factly): Oh, well I am. Over you. Derek: I'm over you too. Meredith: You just said ... (He raises his eyebrows at her) Shut up. (The doors open and they are both smiling at each other until they see who is standing in front of the doors. Addison. Who is by the way not looking very happy) Derek (to Addison): Hi. Meredith (to Derek): Bye. (Meredith walks out of the elevator. Derek resumes his original position of leaning against the wall and Addison walks in. She has a very ill look on her face but doesn't say anything) Derek (sighs): There is a land called 'passive-agressiva' and you are their queen. Addison: I am fine. Derek: Except when you shriek about trout. Addison: I was not shrieking about trout. Derek: Right, you weren't. You were shrieking about Meredith. Addison: No, I was shrieking about the trailer. I hate the trailer. Derek: Oh okay, so the past three weeks have been about the trailer? Addison: Yes. Derek: Not about the fact that I said I love Meredith. Addison: Loved. Derek: What? Addison: You said you loved her. Past tense. Derek (looks down): Right yes past tense. Addison: Well then I have been shrieking about the trailer. Derek (nods disbelieving): Mmm. (The doors ding open and Addison leaves. Derek just shakes his head) (Alex is entering Mauer's patient room with another intern, who is wheeling in a gurney) Alex: Ok Mauer it's time to return your book to the library. Your surgery is in an hour. Mauer: What's up with this flop sweat? (Mauer is sweating like crazy) Alex: Probably just nerves. Mauer: But I'm sweating like, like, like Nixon. President Richard Milhous Nixon. (Audrey just shakes her head) That guy could sweat. And I Mauer Paskowitz, I wrote an epic-like crap novel that I sure as shine can sweat like Nixon. (The two other doctor's and Alex start prepping Mauer for his surgery) Audrey: It's not that even bad of a book. I read practically every draft. Mauer: Forgive me honey but you are not exactly Lionel Trilling. It blows. Alex: Lionel Trilling? Audrey: He seeks the approval of dead literary critics. The dead don't read Mauer. Alex: You think of being something other than a writer? Mauer: No. I am a writer. Mauer Paskowitz! I have no plan B. Audrey: We can't get married for three years until the damn book is done. Three years I listened to him piss and moan! For what? So he can eat the thing. Mauer: Ha! (They move Mauer onto the gurney) Alex: The computer have a delete button? Mauer: I wanted to literally put it behind me and start a new book. Audrey: Okay, we all get the symbolism. It's painfully obvious. Alex: And obviously painful. (The wheel Mauer out of the room) (Bailey is receiving a container for transporting the heart she's supposed to get. Cristina peers around the corner dressed to go home. Cristina creeps up to her as Bailey grabs her stuff and starts heading down the hallway) Cristina: Uh, hi. I heard that you were going to Twin Falls, Idaho. I've never been. Bailey: You reached 80 hours? Cristina: Technically. Bailey: You're off work Cristina. Go enjoy your day. (Cristina takes Bailey's coat from her and helps her put it on) Cristina: I'll enjoy my day if I can help retrieve a heart. Promise. (Bailey just shakes her head in disbelief but lets Cristina tag along) Cristina: It's a nice coat. (Addison is performing an ultrasound on Bex in her patient room. George is in there but her parent's are not) Addison: You see that Dr. O'Malley? George: It looks like a tumor is compressing an ovary. Addison: That's why I biopsed both ovaries. Bex: Is that bad? Addison: It's really just a precaution Bex. ( Addison moves away from the bed) Apply pressure Dr. O'Malley. (Addison puts the biopsied tissue into containers at the end of the bed) Addison: I'll get this up to Path. You mind doing the dressings? George: Sure. Addison: Alright Bex, then we'll get you the results just as soon as possible. (She takes the containers and leaves. George avoids looking at Bex's wrists which Bex notices) Bex: You're a doctor, haven't you seen scars before? George: I'm just trying to figure out why someone with so much talent would want to do that. (He looks at the comic book that lies on the table in front of her) Bex: It's just a comic book. It's about me and my best friend Jen, when we were kids. Satisfied? George: Did she write it with you? Bex: Jen has a boyfriend like everyone else. I get to be a freak all by myself. George: Oh, freak. That's not the easiest thing to be in high school is it? Bex: You sound like my shrink. George: Hey, I wasn't always a doctor. In high school, I was ... secretary and treasurer ... of the dungeons and dragons club. Bex (chuckles): Oh man! George: Yeah. I was also a mathlete and I won the blue ribbon in biology club. Best fetal pig dissection. Yeah, and let me tell you that had the girls knocking down my door. You just have to get through high school. Cause high school sucks for anyone who's the least bit different. But then there's college. And out in the real world, you will find where you fit in. Bex: You think so? George: Yeah, I know so. (Izzie is entering Denny's room. Denny has his eyes closed and looks like he is asleep) Denny (opens his eyes): Hi. (Izzie lets a small gasp) Izzie: Denny. Ha ha, I thought you were asleep. Denny: Nah, I don't sleep in hospitals. Scared I'll never wake up. (Izzie gets out her stethoscope and checks Denny's heartbeat) Denny: Can I ask you something personal? Izzie: If I say no? Denny: I'll hold my breath which will stop my heart, killing me. You're right here, you'll be charged with murder. Lifetime in prison loved by a big old girl named Hilde. Izzie: So my choices are homicide charges or inappropriate personal questions from a patient. Denny: I know, kinda sucks. (Izzie starts entering information in the computer next to Denny) Izzie: You know what? Hold your breath. I'll take my chances with Hilde. I can do girl on girl. Denny: Oh so you're brining up girl on girl? How can I blackmail if you bring up girl on girl? Izzie (smiling): What do you wanna know? Denny: That guy Alex. You with him? Izzie: No. Not anymore and never ever again. Denny: Good. Izzie: Good? Denny: Yeah good. It means I won't have to fight him for you. Izzie: What makes you think I want you to fight him for me? Denny: Hello? You are in love with me. Izzie (laughs): Am I? Denny (grinning): Yeah, it's not your fault. I mean I'm well off but not into money. I'm smart but I'm not a know-it-all. I'm funny. I'm really nice. I love animals. (Izzie fake swoons) And I'm hot. I'm a catch. You know if you can wrap your head around the enlarged failing heart and the dependency to IV meds. Izzie (playful): You're right. I am so in love with you. It's a shame really, since I'm with Hilde and all. (They both chuckle and Izzie leaves) (Meredith's house) (Meredith has piles of laundry on the kitchen breakfast table. She is folding sheets while Doc sits next to the table) Meredith (to Doc): There. Five loads of laundry. I have literally washed the past out of my life. (Doc just pants) (Pathology lab) (Addison is looking through a microscope. George enters) George: You paged me? Addison: Yeah, have a look at this. It's Bex's biopsy. (Addison moves away from the microscope and George steps up to have a look) George: Biopsied ovary? Addison: Not exactly. I've arranged a meeting with Bex's parents, George. Oh and find out who the on-call psychiatrist is and if they're available to join us. George (looks up): Does she have cancer? Addison: No, it's not an ovary. It's a testis. George: A testis? (He looks back into the microscope) Are you sure? Addison: Yes. I'm sure. George (amazed): Bex is a hermaphrodite? Addison: Yes. (Helicopter) (Cristina is sitting in a seat shooting glances at Bailey's stomach, who sits in two seats across the aisle with her eyes closed. Bailey awakens and sees Cristina looking) Bailey: Yang, why are you staring at my fat pregnant belly? Cristina: Sorry, I'm ... (She looks out the window) (Conference Room) (George, Addison and Raj the psych guy are sitting at a table. Mr. Singleton is pacing around the room, while Mrs. Singleton sits across from them) Mr. Singleton: Let me get this straight. You're telling me that our daughter, my daughter, you're telling me my daughter might actually be a boy? Mrs. Singleton: That, how is that possible? (Mr. Singleton sits down next to his wife) I don't understand. I don't understand how- Mr. Singleton (interrupts): Shouldn't this have been detected somehow? Addison: Externally, Bex has female genitalia. She looks like a girl, but internally she has both female and male s*x organs. Mrs. Singleton (upset): So what now? What are we supposed to do? I don't understand. Addison: Ok, the best news is that the lymph node tumor is benign. So physically Bex is going to be just fine but emotionally (she looks at Raj), psychologically I strongly recommend therapy. Mr. Singleton: She's already in therapy. Addison: I'm talking about therapy for all of you. This is not going to be easy for Bex to hear and it's, it's not going to be easy adjustment for you to make. Mrs. Singleton: My god. My poor girl. Mr. Singleton: A big adjustment? What kind of adjustment? Raj: Many inter-sex people begin to identify very strongly with one s*x and it's not necessarily the s*x they've been raised. Mrs. Singleton (adamant): She's, she's a girl. She looks like a girl; she has always been a girl. George: It at least helps explain why she feels so different. (The parents just stare at him) Raj: The point is that biologically and emotionally speaking, she has a choice to make. Mrs. Singleton: A choice? (Mauer is being wheeled down the hallway for his surgery by the same 2 interns as before and Alex with Audrey walking beside them) Mauer: My mouth feels all weird. Audrey (sarcastic): Chewing paper will have that effect lover. Alex: Weird how? Mauer: Pins and needles. No needles and pins. Needles and pins. Yeah, yeah. Sprouting from my fingers and toes like, like, like ... lord god give me a simile. Alex (to Audrey): Is he always this way? Audrey: The man ate a novel, he's not exactly normal. But he got weirder the more he ate. He's like obsessed. (They stop as they meet the Chief. Alex hands Richard the chart) Richard: Mr. Paskowitz, I'm Dr. Webber. I'm going to be performing your surgery today. (They all wheel Mauer into the elevator) Mauer: I poured my heart and soul into that freaking book and now it's stuck up my ass! Put that on my tombstone Audrey! On my tombstone! (Denny's room as he just taps his fingers in a rhythm obviously agitated. Izzie walks in) Denny: Hey Dr. Stevens. Izzie: Hey Denny. You ok? Denny: I've been waiting for this a long time you know? You're going to open up my chest, take out my heart and replace it with another one. Izzie: Well not me and not another heart. A better heart. Denny: What if something goes wrong? (Izzie walks up to Denny's bedside) Izzie: Don't be nervous. Dr. Burke is an incredible surgeon and you're getting a new heart today. Just keep thinking about that. Denny: Yeah ok. (Burke walks in with Denny's chart) Burke: Denny! Denny: Preston Burke. My favorite cardio-thoracic surgeon. Burke: Oh, your only cardio-thoracic surgeon, but thanks. I will be on the phone with Dr. Bailey as the organ recovery progresses. We wanna make sure that the heart stays viable, isn't damaged while the other organs are perfused. We'll have you in the O.R and if it is a go, we'll start the procedure before she even gets back. (Burke hands Izzie the chart) Denny: Hey Izzie. Izzie: Yeah? Denny: I'm getting a new heart. Izzie (smiles and nods): You're getting a new heart. (They smile at each other) Izzie: I'll see ya. Denny: Bye. (She leaves) [SCENE_BREAK] (Addison and George are walking down the hallway to Bex's room. They meet Bex's parent outside the room) Mr. Singleton: Ah excuse me, ah uh Mary and I were talking. Ah and ah we think Bex should stay... Mrs. Singleton (interrupts): She can't handle something like this. You saw the scars. George (amazed): You're not going to tell her? (Mr. and Mrs. Singleton shake their heads) George: But this could help her. You can't not tell her who she is. Addison: Dr. O'Malley. (To the parents) Uh we'll go ahead and proceed with scheduled surgery to remove the tumor and then you can talk to your daughter in your own time. Mrs. Singleton: Actually, we were thinking (she gestures for her husband to continue) Mr. Singleton: We thought since you're already going to be in there ... Uh we know fixed isn't the right word but- Mrs. Singleton (interrupts): We were thinking that with the hormonal confusion, it might be easier on her to remove whatever boy parts she has. (George looks horrified) Mr. Singleton: Keep her more of a girl. Addison: Just to be clear you're asking me to perform sexual reassignment surgery on your daughter? Mr. & Mrs. Singleton: Yes. George (astounded): Without her knowing? Mr. Singleton: Well all she's said all her life is that she wants to be normal. She doesn't feel normal. Mrs. Singleton: Why can't we just put an end to her agony? Addison: First of all removing her male sexual organs may not do that, in fact it could do just the opposite. Mrs. Singleton: But her hormones... George: Can be controlled with an oral medication. Mr. Singleton: We just want the best for Bex. Addison: To do surgery and alter her body permanently is ... well I just would never to do that on someone who isn't aware of the procedure and you're going to hard-pressed to find a surgeon who will. (She walks off) George: Bex will learn the truth someday. (Bex walks up to her room door and looks on) How do you want her to find out? ... Excuse me. (He walks away) (Nursing Home) (Meredith is walking through the nursing home when Nurse Linda calls out to her) Nurse Linda: Meredith! Hi. (Meredith walks up to her) Meredith: Hi. I had the morning off so I thought I would come and see how my mother's doing. Nurse Linda: Oh, she's fine. She's in the sitting room. Meredith: Thanks. Nurse Linda: She's in good spirits. Visitors really cheer her up. (Linda wanders off) Meredith (to herself): Visitors? (She looks over and sees Derek walking up and making himself a cup of coffee) (Seattle Scenes) (Nursing Home) (Meredith is now talking angrily to Derek in an empty hallway) Meredith: What are you doing here? Derek: There is a clinical trial to study the progression of early onset Alzheimer's. Meredith: Okay me you can screw with. My mother, no. Not acceptable. Derek: Well there has been some really promising results from similar studies in Europe. Your mother is a prime candidate. Meredith: My mother is very sick and has very few good days. And I don't want her being poked and prodded for some experimental program. Derek (nods): I'm just trying to help. Meredith: Well see this, what you're doing, being Dreamy. It doesn't help. It hurts me. It messes with my head. Derek: I know the feeling. Meredith: I don't doubt that but you have a wife to go home to and I'm guessing she has no idea where you are right now. Derek (chuckles): No, she doesn't. Meredith: It's what I thought. (She walks away) (Twin Falls hospital, OR) (Bailey and Cristina are in the OR with the operating team about to perform surgery on the organ donor. A scrubs nurse hands Bailey the telephone) Nurse: Dr. Bailey. (Bailey accepts the phone) Bailey: Dr. Burke. (Cristina looks up at this) Burke (over the phone): Talk to me Bailey. What are we looking at? (Cristina makes weird gestures to tell Bailey to say she's not here. Bailey is looking through the donor's chart) Bailey: The uh donor's on 25 mics of dopamine. (Burke is on a mobile phone walking down a hallway in SGH) Burke: 25 mics? That's too much. (Back to the O.R) Bailey: They started him on 5mics of dobutamine 30 minutes prior to arrival. (Back to SGH) Burke: Are they trying to kill my heart? What is the central venous pressure now? (Back to the O.R) Bailey (to Cristina): CVP. Go. Cristina: Around 10. Bailey: Around 10. Cristina: MAP close to 80. (Bailey nods) Burke: And his mean arterial pressure? Bailey: Close to 80. (Switch back to SGH) Burke: I can live with a CVP close to 5 and a MAP about 60. That heart needs to be off the dobutamine. (Switch back to the O.R) Bailey (to the O.R team): The heart needs to be off the dobutamine. (Switch back to Burke) Burke: And tell them to get the dopamine back down to 10 mics. (Switch to the OR where Bailey shakes her head) and get them to get another 2 units of blood. (SGH) (Burke hangs up the phone and walks into Denny's pre-op room where Izzie is already standing) Denny: Are we a go Doc? Burke: Still no final word. I want to you have the healthiest heart I can find. Denny: Dr. Stevens, you'll be in there with us right? (Izzie looks at Dr. Burke who nods at her) Izzie: Yeah I'll be in there with you. (Denny smiles) (Richard is about to perform surgery on Mauer with Alex helping him. Meredith sits watching still dressed in regular clothes. George enters with a cup of coffee and sits next to her) George: Hey aren't you supposed to be having free time? Meredith: Oh, I did 5 loads of laundry. Cut my split ends, studied, cleaned out the fridge. Free time sucks. George: When would it have been the right time to hear about your boyfriend's wife? Meredith (gives him a look): Ok are you mad at me or something? George: No! No. Sorry. It's just I have this patient and I get that there's a right and a wrong time to hear big news but wouldn't you rather no sooner than later? I mean just so you could move forward one way or the other. It's a fresh start, right? (OR) Richard: See the little white line of Toldt. Now we can mobilize the lateral border of the left colon. (to Scrubs nurse) Clamp. (he gets a clamp) When Leo Tolstoy here wakes up, you might get him to revisit the idea of a new vocation. Alex: He was pretty against the idea. Richard: Yeah well hopefully it was just delirium. Alex: If it's alright, I'd like to keep an extra eye on him post-op. He's acting pretty strange. Richard: He ate a novel. Clearly he's pretty strange. Alex: Yeah you know I just don't want to overlook anything. Richard: Seriously Karev I'm short-handed all over the hospital. ... Ok here we go. (He reaches in and pulls out the clump of blood paper that is Mauer's novel. He holds it up for everybody to see) Richard (calls out): Anybody here tempted to read this? ... No takers? Could be the great American novel we'll never know. (He puts the clump in a dish to the side) He needs a plan B. Alex: He's not the only one. Richard: You don't think you passed? Alex: Eh, I thought I passed the first time. Richard: Just wait and see. Right now today, you're still here. (Bex's room where George is checking up on her) Bex: Did you tell my parents about the pill? George: No. Bex: Am I gonna die? Is that what no one wants to tell me? George: Of course not. Bex: Then why are my parents acting so ... would you just tell me what's going on? George (writing in her chart): What's going on is uh we're prepping you for surgery to remove the lymph node tumor that's compressing your ... Bex: Ovary. (Addison and Bex's parents walk into the room) Addison: Hey Bex. Bex (sits up): Mom. Dad. This is really freaking me out. Mrs. Singleton: Oh no everything is going to be fine Bex. Mr. Singleton: It's ok sweetie. Bex: I'm having surgery to remove a tumor that's compressing my ovary, right George? (George is silent) Addison: Dr. O'Malley. (She gives a slight shake of her head for him to be quiet) Bex: George? (George looks sick and remains silent) George? George: What am I just supposed to lie to her? Addison: Ok, that's enough. Dr. O'Malley, please leave the room. (George puts down the chart and starts heading out) Bex: No wait! Tell me what's wrong with me. What is wrong with me? (George just looks at the parents who give each other glances) Mr. Singleton: Bex ... (his wife nods) we learned that your tumor ... it's not compressing an ovary. Bex: Then where is it? Mrs. Singleton: It's on a testis. Bex: Like a testicle? (Everyone is silent) I have testicles? Addison: Yes one. Bex this is a tremendous amount of information for you... Bex (interrupts): And I've had it my whole life? ... Oh my god. Does this mean...does this mean I could be a boy? (Addison gives George a disapproving look as do both the parents) Bex (whispers to herself): Yes. (Hallway outside Bex's room. George is standing out there with Bex's parents who are very upset. Addison is there also) Mrs. Singleton: You engineered that conversation! You forced our hand. George: Well you were lying to her. Mr. Singleton: We were protecting her. Mrs. Singleton: She's a 14-year old girl. George: Well maybe, maybe not. (They give him appalled looks) Mrs. Singleton: This isn't your life! This isn't your child! 14 years! 14 years we have raised a daughter, in one afternoon you expect us to what?!? What is Bex is supposed to do? How is she supposed to go home and tell the other kids? What? You had no right! (Addison moves to interrupt but George gets there first) George: No, I know I'm off the case, right? (He walks away while Mr. Singleton tries to calm Mrs. Singleton down) (Post-op ward where Mauer lies in one of the many beds. Alex walks up to him. Mauer is trying to climb out of the bed) Alex: Whoa, Mauer. Mauer lay back. You just had surgery. You're losing your shirt man. Mauer: Much obliged, brock, brock. Much obliged, pal. Alex (checks Mauer's pupils): How do you feel? Mauer: What's whacked for 20 Alex? Weeds, whack, weeds, whack for 200. (Alex looks on concerned) (Derek is still dressed in regular clothing and Richard walking down a hospital hallway) Derek: I saw Ellis. Richard: And? Derek: I think I can get her into the clinical trial. She's the perfect candidate. Richard: Excellent. Thank you, Derek. Derek: You realize this requires Meredith's power of attorney? Richard (nods): Yeah. Derek: Might be better if it's coming from you. With me, there's baggage. You, you're just trying to help out a friend. Richard: Right. Right. Derek: Well, let me know if Meredith wants me to make the call. (Derek walks off, leaving Richard pondering his own true intentions. He then notices Alex at the nurse's station nearby) Richard: Karev? (He walks up to Alex) What are you doing? Alex: Research on the bezoar patient. Richard: I told you I needed you on the floor. Alex: He has fever, sweats, tingling in his lips, fingers, toes, mood swings and a lack of co-ordination. And did I mention the crazy talk? Richard: Your point? Alex: My point is, he ate his novel. Richard: I know. Alex: Mercury's in the paper. He's got mercury poisoning. (Richard looks a little surprised) (Twin Falls hospital, OR) (Bailey is performing the operation on the donor with other doctors while Cristina watches on) Bailey: Cristina, call Burke. I'm feeling some fairly extensive damage from coronary artery disease. Cristina (looks slightly ill at this): Um... Bailey: Yang? (Cristina walks over to the phone. Scene switches to SGH where Burke answers his phone in a hospital hallway) Burke: Talk me to Bailey. Cristina: It's me. Burke: I can't talk I'm waiting for a call from Bailey. Cristina (quiet): I'm with Bailey. Burke (does a double take): You're in Idaho? (Scene switches back to Cristina) Cristina: Yeah. Burke: You're breaking the rules. Cristina: Yes. (Scene switches to back to Burke. Richard walks up to him) Richard: Preston. What's happening with our heart? Burke: Hello, Dr. Webber. Tell me what I need to know about Denny's heart, Dr. Bailey. (Cristina has an oh crap look on her face) (Denny's pre-op room where Izzie is checking Denny's heart beat again. She looks outside and sees Richard pat Burke comfortingly and walk off. Burke sees her and gestures for her to meet him outside) (Meredith is standing at a nurse's station filling in some paper work when Richard walks up and stands next to her) Richard: This program Derek looked into was a favor to me. Meredith (looks up disbelieving): Nice try. Richard: Sometimes Meredith, a favor is just a favor. This treatment won't cure your mother. It won't give her a new lease on life but it may give her more good days. I urge you to consider. (Mauer is lying in his own post-op room with Alex checking on him) Mauer: Lying here trapped in this flesh prison I've reached a grim conclusion. I'm a failure. (He turns to Alex) You know how that feels? Alex: Dude, if you only knew. Mauer: Even my manic attempt to put my failed novel behind me failed. Time for a plan B, I reckon. Time, indeed. Perhaps I shall play the cello. Alex: We make a mistake here and people die. It happens all the time. Mauer: All the time? Alex: There's a lot. Mauer: This is part of the hallucination, right? Alex: My point is we all have set-backs Mauer. But I'm a doctor and you're a writer. We don't have a plan B. (Richard and Audrey walk into the room. Audrey walks up to Mauer's bedside) Mauer (jokingly): Call Security! (Audrey just takes his hand and smiles at him) Richard (to Alex): Have you determined a course of treatment for the mercury poisoning, Dr. Karev? Alex: Yeah the patient has been administered a chelator called British Anti Leukocyte which will absorb the mercury over the next several days. Richard: Good work doctor. (Richard leaves the room) (Helicopter) (Cristina and Bailey are sitting in the same spots as they were before. Cristina is caught staring at Bailey's stomach again) Bailey: Yang. (They look at each other for a bit) Cristina: You know what's wrong with having an 80 hour limit? It protects the weak. It levels the playing field. Which not only sucks. It's, it's dangerous. Bailey: 80 hour work week. That's what's on your mind? (Cristina looks down) I thought about it. Not keeping it. Cristina: You did? Bailey: My husband and I ... we tried for years but still when that stick turned blue ... Well you can't work the way we work, you can't want the kind of careers that we want and not take pause. I took pause. Cristina: You paused? Bailey: I paused. I paused a very long time. Cristina: So why did ... Bailey: I sat up one night. Middle of the night ... and I knew I could do this... I still don't know how I'm gonna do this, but ... I knew I could do it. You just have to know and when you don't know then no one can fault you for it. You do what you can, when you can, while you can. And when you can't, you can't. (Denny's room) (Izzie is standing in the room waiting for Denny to wake up) Denny: You're stalking me. You're a stalker. (Izzie turns around to face him) Izzie: Well, can you blame me? Denny: So it's bad. Izzie: You have time. Denny: Liar. Izzie: Fine, there's no time. Denny: Well that's just spiteful. ... I didn't get the heart. Izzie (shakes her head slightly): You didn't get the heart. (Seattle Scenes) (Bex's room) (Bex is sitting up on her bed by herself looking fairly happy. George enters the room) George: Hey. Bex: Hey George. (He drops himself down on the bed) George: Hey, I just, I just wanted to check in on ya. Bex: Heard my parents weren't too happy with you. George: Nope. Bex: Thanks for telling me. For making them tell me. George (nods): You know um there are people that you can talk to. I can if you'd like... Bex (interrupts): I know. ... ... George, do I have to be a boy now? George: No. No. Bex: But I can if I want to. George: Yeah you can, if you want. Bex: Hey, could you, would you bring me some scissors? (George nods) MVO: Who gets to determine when the old ends and the new begins? (Meredith is waiting against a wall on the hallway for Derek who comes out an elevator and stops in front of her when she calls out his name) Meredith: Derek. Derek: Hi. Meredith: Tell me about the program. MVO: It's not a day on a calendar. Not a birthday, not a new year. (Izzie is standing in front of the hospital entrance with Denny who is sitting on a wheelchair being pushed by a nurse) Izzie: Denny, I'll see ya. Denny: Goodbye Dr. Stevens. (The nurse pushes Denny out the sliding doors. Izzie starts heading back more into the hospital when Alex comes up to her) Alex: Hey. (Gestures to Denny) He's leaving? Izzie: Didn't get the heart. Alex: Sorry. Izzie: Yeah. Alex: He's a good guy. Izzie: Yeah, he is. (Izzie stops and looks outside through the doors and sees Denny standing up. He nods towards her and starts walking off) MVO: It's an event, big or small, something that changes us. Ideally it gives us hope. (Bex's room where Bex is sitting on a chair holding a mirror and looking in it while George cuts her long hair off. Mr. and Mrs. Singleton enter and George stops. Mrs. Singleton walks in and holds out her hand to George. George hands her the pair of scissors and heads out. Mrs. Singleton continues cutting Bex's hair. George watches from the doorway) MVO: A new way of living and looking at the world. (Derek's trailer) (Derek sits on an outdoor chair nursing a beer, his trout cooks on the BBQ. Addison exits from her car) Derek: I'm cooking the trout outside. Addison: Thank you. (She walks up the stairs to the veranda and sits on an empty chair next to Derek) Addison: Oh. (relaxes) ... There is a land called 'passive-aggressiva' ... and I am their queen. Derek: That's all I'm saying. Addison (she takes the beer from him and takes a sip): So what? With Meredith? Am I just supposed to wait it out? Wait until it passes? Derek: That'd be good. Addison (nods): I still hate the trailer. (She hands him back the beer) Derek: As is your right. MVO: Letting go of old habits, old memories. (SGH Parking lot) (Cristina is standing, waiting outside for Burke. Burke walks out and up to her) Cristina: I wasn't gonna have it. The baby. And you don't get to be mad about that, we barely knew each other. I was an intern and there was no way I could even... Burke (interrupts): I'm not mad. Cristina (appraises him): You're not? Burke: No. I just wanted to know. (Cristina half nods) I wanna know things. MVO: What's important is that we never stop believing, we can have a new beginning. (Meredith's house, bathroom) (Izzie and George are sitting on the floor sharing a pizza. Doc is heard barking loudly. You can also now here Meredith yelling at the dog about her laundry. Izzie and George look up at this. Meredith opens up the bathroom door) Meredith: You don't eat laundry. Bad dog! Bad dog! Bad! (She closes the door with arms filled with laundry) MVO: But it's also important to remember that amid all the crap are a few things really worth holding on to. (Meredith throws down her laundry and sits next to George who opens up the pizza box for her. Izzie resumes reading her magazine and Meredith takes a slice of pizza and starts eating it)
Begin the Begin