Denny needs a heart or else. Izzie and George go crazy trying to get him one. Derek has the life of a friend in his hands as he operates on Burke who has been shot. Burke cannot operate on Denny after Denny's heart stopped and now Denny is in a dire condition. Cristina gets put in charge of the ER and she is worried about Burke.
Part 2 of a three-hour season finale. This episode is the first hour of a two-hour episode which is two hours long and will air on a Monday in a different time slot than it would on Sunday. Aired on Monday, May 15, 2006 from 9 PM EST to 10 PM EST.
Dr. Meredith Grey
Dr. Cristina Yang
Dr. Isobel "Izzie" Stevens
Dr. Alex Karev
Dr. George O'Malley
Dr. Miranda Bailey
Dr. Erica Hahn
Richard: Derek, is the arm paralyzed?
Derek: We have to do a wake up test.
Derek: There's only one person who can help me figure out if I've damaged the relay or not and that's Burke.
Richard: He's been through a lot of trauma today.
Derek: I'm trying to prevent the trauma he's going to feel if I have to tell him he's paralyzed.
Burke (about to have surgery): Shepherd.
Derek: You don't have to thank me. I'm sure you'll return the favor one day.
Burke: I was going to say please try not to kill me. (they all chuckle)
Derek: I'll do my best.
Derek: You could take up fishing.
Burke: I don't fish.
Derek: Fishing is a lot more fun than surgery.
Burke: I have 80 percent hand function now.
Derek: Mmm. 80 percent is not enough. Not for you.
Burke: Fishing, huh?
Derek (smiles): You don't fish.
Richard: There's never a good place to hide in this hospital.
Derek: I'm trying to get perspective. It feels enormous, like it's all- I- I- I can't get perspective.
Richard: My niece's cancer has come back. She's 17 years old and she's gonna die. (pauses) ... Plus ... 25 years ago I had a secret affair with ... Ellis Grey. (Derek looks up at him at this) And today I find out that my wife knew the entire time. (Derek sighs and sits back into the couch) There was no secret. And she stayed with me.
Derek: I respect him, you know? Dr. Burke, I- I respect him. He's decent. He's honorable. An arrogant ass who just hogs the O.R and thinks he's God but … he's decent and he's honorable. I respect him. He's one of the foremost cardiothoracic surgeons in the country and I've gotta just ... It's his hand. I can not get perspective. I can't do this. I can't be responsible for him.
Richard: Preston is an honorable and decent man but Derek, so are you. (Derek just shakes his head) You are honorable and decent and you're too honorable and decent to run. (Derek just remains silent and Richard looks at the coffee cup in his hands) You don't know how much I wish this was bourbon.
Alex (on the phone): He's been shot! Dude!
Meredith: We're going to have to run the test ourselves.
Alex: UNOS gave us an hour. In a couple of minutes our time is up. I'm telling you this chick is hardcore. She's not going to wait.
Meredith: Okay, okay, you just have to stall her.
Alex: I'm not getting involved with this! Look I don't care if that- that drawling bed whiner ever gets a heart.
Meredith: Alex. Do this. For Izzie.
Alex (looks comtemplative): I'm not guaranteeing anything!
Richard: Camille? What- what happened to Camille?
Richard: Why didn't you call me?
Adele: She's 17, sweetheart. She'll be 18 in a few months. Most girls lose it at--
Richard: Ah ah! You think I wanna hear that? You think I wanna picture my baby niece (whispers) losing it?
Adele: Richard. Richard, take deep breaths.
Addison (walks up): Well, the bleeding has stopped but her pelvic exam does concern me. I'd like to do an ultrasound.
Richard: Three years ago Camille was diagnosed with ovarian cancer. The only removed one ovary to try and preserve fertility. But her check-ups have been clean since then.
Addison: Okay, well, let's not worry if we don't have to. (walks away)
Richard (seeing Brian): You! You wait right there! I want to talk to you! (Adele makes a gesture for him to run) I said wait! (Brian starts to move away) Stop! (Brian runs down the hallway past the corner. Richard chases after him. Adele chases after Richard) I said stop!
Adele: Richard, take deep breaths! Richard!
Cristina: You don't have to say anything. I know you're sorry. And I know you didn't mean to kick me off the transplant and I'm not mad. (pause) I mean I was but I'm not anymore. So don't worry about it. Don't even think about it, okay? I mean, all that matters is that you get better and we'll get through this. I'm here for you, whatever you need. Anything.
Burke: Okay. I need… you to--to check on Denny Duquette.
Cristina: Okay. That was my best supportive girlfriend and you kinda ruined it with medicine.
(Catching all of them in Denny's room)
Bailey: You fools better have a good explanation for this. Step away from the patient. (they all step away but Izzie) Step away from the patient!
Izzie: I can't. I'm pumping his heart.
Bailey: Olivia, take over for Dr. Stevens. Izzie, you're done here. I need you to leave the room.
Izzie: No, do not touch me!
Bailey: Olivia, stay with Dr. Stevens. Help her if she'll let you. You three, outside, now! (they leave and Bailey starts whispering with anger in her voice) Where was rational thought? Where was cognitive thinking? We're supposed to do no harm. The morals, the ethical, where was sanity when you three decided to help that girl?
Bailey: No, no, no. No speaking. Nobody speaks. I do not want to have to testify against you in a court of law. She cut his LVAD wire. (George groans) I said no speaking!
George: I didn't say any--
Bailey: Then no moving. Cristina, Burke is asking for you. Go! (Cristina leaves) I assume you ran labs? I'm asking a question. (they don't say anything) Answer me!
Meredith (quietly): You said no speaking.
Bailey: I know what I said!
Meredith (quietly): Yes.
Bailey (voice starts cracking): O'Malley get me the lab results. Do not pass go, do not talk to another living soul. Get labs and get back here. Grey... come with me.
Derek: You know the drill. We wait a few days. Maybe the aneurysm won't grow.
Burke: Yeah, if... if it stays this size there's too much damage.
Derek: We'll just go in there and we'll fix it. Relieve the compression on the nerves.
Burke: But the operation could cause damage to the nerves.
Burke: And I could... lose function of the entire arm.
Burke (sighs): You can do this? You're good enough to do this?
Derek: I think so.
Burke: But you're not sure.
Derek: But I'm not sure.
Burke: So... what do I do?
Derek: It's not like you to ask those kinda questions.
Burke: It's not like you not to have the answers.
Bailey: Anything I can get for you Dr. Burke?
Burke: No, I'm fine.
Bailey: There, there must be something.
Burke: It would be nice to have some ice chips. And, uh, a touch of morphine if I'm allowed. And, uh, (pause) Cristina.
Bailey: Coming right up. (she starts to walk out of the room) Where is Cristina? Where are, where are all the little suck ups?
Burke: Excuse me?
Bailey: My interns. My ass-kissing, surgery-hungry, competitive suck-ups. Where are they? Why aren't they here fetching you ice chips and morphine? Why aren't they here sucking up? (Burke looks away from her) You know something.
Burke: I'm a patient.
Bailey: Preston Xavier Burke, what have you done with my suck-ups?!
Meredith: Human beings need a lot of things to feel alive.
Derek: But we only need one thing...
Burke: To actually be alive.
Cristina: We need a beating heart.
Addison: When our heart is threatened...
Alex: We respond in one of two ways.
George: We either run...
Izzie: We attack.
Richard: There's a scientific term for this:
Addison: Or flight.
Bailey: It's instinct.
Meredith: We can't control it.
Izzie: Or can we?
George: Bailey's treating us like children, we're not children! We shouldn't have to sit out here like we're in time-out or something.
Meredith: It is a time-out. What we did is way in need of a time-out.
Cristina: You realize we could get kicked out of the program for this?
Izzie: Not we, I did this. I did this. You're probably right, maybe I should run. But I'd rather be running towards someone than running away.
Richard (walking up): Yang, Shep's asking for you.
Cristina: Uh, for Burke's surgery?
Richard: Yes, hurry up.
Cristina: Uh, I-- I can't. I'm in a time-out.
Richard: Time-out's over, Yang we need you. (they walk off)
Izzie: He said marry me right? He did? That really happened?
George: Really happened.
Meredith: It really did.
Izzie (gets a look on her face): Screw this, I'm checking on Denny. (gets up and leaves)
Bailey: Sir, I need to ask you a hypothetical question.
Richard: Can you do this another time?
Bailey: If someone on the staff deliberately unhooked a transplant candidate from his LVAD in an attempt to worsen his condition and get him moved up the donor list, (sounds scared) hypothetically, sir.
Richard: I think you need to tell me exactly what's going on here, Doctor.
Bailey: Believe me sir you want this to stay a hypothetical 'cause I'm thinking if something like that did happen you'd be duty bound to report it and this hospital would be in danger of losing it's credition as a transplant site.
Richard: So, hypothetically...
Bailey: So, hypothetically if the patient got worse would it be unethical for him to receive the heart even though now medically his condition puts him atop the donor list. Hypothetically.
Richard: How bad is he?
Bailey: In the few hours it would take for a new LVAD to be delivered he'd be dead.
Richard: Our responsibility is to the patient then if medically he is at the top of the list then he should get the heart hypothetically.
Bailey (starts to walk away): Thank you, sir.
Richard: But practically who ever removed the patient from the LVAD I expect to be given names and there will be severe, severe consequences.
Bailey: Yes, sir.
Bailey: How you feeling Denny?
Denny: Really really good. Like an athlete or a superhero or some other really really healthy person.
Izzie: You're funny. You're a funny guy.
Meredith: Izzie, no speaking.
Denny: I cut my own LVAD wires you know, all by myself.
Bailey: Shh. You're weak enough as it is please don't waste energy on lying. (Cristina comes in)
Izzie: Dr. Bailey.
Bailey: I did indeed say no speaking.
Izzie: I don't care! He's gonna get the heart, right? You're gonna sign the charts and talk to the transplant coordinator?
George (walking in): Here are the labs.
Izzie: See? His BUN and creatinine are increasing. He clearly has pulmonary adima and he deserves to move up to 1A on the transplant list. UNOS will give him the heart you just need to call.
Bailey: Isobel Stevens I take my medical advice from doctors, you are a visitor.
Bailey: As of now you are a visitor in this hospital. You will not be a doctor again in the hospital until I decide that you are. Olivia, take over the heart pump.
Izzie: He gets the heart though, right?
Adele: I was just tryin' to remember the night that I lost my virginity and I can't. I remember who I was with and I remember that I was 18. I can't remember any of the details.
Addison: I can remember all of the details. Kinda wish I couldn't.
Adele: That bad?
Addison: No. Just not good. Good came later. And then really good came.
George: That's a stupid plan.
Meredith: Well, if Burke isn't coming then we have to confirm Denny's condition ourselves. We get the blood work, we do the EKO and no one even has to know what Izzie did.
Izzie: But none of us have done an EKO on our own before.
Meredith: Cristina has. Burke taught her.
Cristina: I'm not involved.
Izzie: What if this was Burke? What if you were me?
Cristina: This is bad. This is bad and serious and against a lot of rules. It's not fun for me. I don't wanna play.
Izzie: What if you were me?
Cristina: Well I wouldn't have fallen in love with a patient.
Izzie: You fell in love with an attending.
Cristina: Well so did Mer, what's the point?
Meredith: The point is we can't help who we fall in love with.
George (scoffs): Yeah. (Meredith flinches)
Adele: How dare you send those kids away.
Richard: Adele. Please, you're emotional right now.
Adele: I just told my sister that her baby's cancer is back. You damn right I'm emotional. If you don't wanna bend your prescious rules for Camille, fine. Don't do it for her, do it for me. Do it for your wife who never asks you anything about your long hours. Who looks the other way when you have an affair with another woman. (Richard looks shocked) Who sobered you up when that woman left you. Who stayed with you when everyone--- everyone said that I would be better off alone. I'm not asking you. I'm telling you. You're gonna make this up to Camille. You're gonna proritize the needs of your family above the needs of your other patients. Or you're gonna find a new place to sleep.
Erica Hahn: Is Dr. Burke alive?
Erica Hahn: Shame. He probably would have made a good donor.
George: He's crashing. I need to call a code!
Izzie: No! If we call a code they will rush him to surgery and replace his LVAD and then he will stabilize. He needs to get worse if he's gonna get this heart.
George: Izzie, this is crazy!
Izzie: He has to get this heart. He will die waiting for another chance. You know he will.
George: We have to call a code!
Izzie: No! (she shoves him roughly against the wall) You press that code button and I will hurt you. Not a lot, because we're friends. But enough so things will break and you lie on the floor out of my way.
Izzie: You have a decision to make, you can stay here and help me with this or you can leave, what's it gonna be George?
Addison: You wanna tell me what's so important I'm keeping it secret from my Chief of Surgery?
Adele: I was chaperoning a prom for my niece. We had a little bit of a situation.
Addison (reads the chart): Camille Travis. 17. Lost consciousness during sexual intercourse?
Adele: Oh, keep it down.
Camille: It's okay Aunt Adele. I'm fine.
Adele: When your Uncle Richard finds out that you were cashin' in your V-Card none of us will be fine.
Meredith: Thank you, for calling me about Izzie.
George: I didn't do you any favors.
Meredith: But it meant something, that you called. It meant something to me.
George: It didn't mean anything.
Meredith: Right, okay, sorry.
George: Stop saying that you're sorry! (pause) You wanna know something? I knew. I knew you didn't feel that way about me, even during, when we were in bed I knew. I knew and I still let it happen, because, um, well, I figured that one night with you was better than never. So, will you just stop saying that you're sorry? Cause you didn't know any better, but I did. And... I'm sorry. (turns to look at her) I'm sorry Meredith
Izzie: I'm sorry. I know that you're worried about Burke.
Cristina: Whatever, it's fine.
Izzie: Cristina can't you just try to understand? I love him.
Cristina: You don't even know him.
Izzie: I do know him.
Cristina: No. You never even seen him outside the four walls of this hospital. You don't know him.
Izzie: I know him. And maybe I haven't lived with him or work with him like you do with Burke. But I do know him. And there's ... there's possibility here. And given the choice of running or staying...
Cristina: You should run. A sane person, a person who values her career and everything she worked for, a person who values her own heart, for God's sake, that person would run.
Denny: The sane person would marry me.
Izzie: What? What did you say? What did he say? (goes to commercial) He said marry me? He said marry me, right?
George: He did.
Izzie: Denny, wake up. Denny.
Meredith (walking in): George's page said it was an emergency.
Izzie (to George): You paged Meredith?
George: We need help.
Meredith: What the hell is going on?
Cristina (walking in): What the hell is going on?
Meredith: That's exactly what I just said.
George: She cut his LVAD wires.
Meredith: What do you mean you cut his LVAD wires?!
Cristina: Are you trying to kill him?
Izzie: I'm trying to save him. All I have to do is confirm his condition is worse and then Burke can call UNOS and they'll move him up on the list and he will get his heart.
Cristina: About Burke...
George (to Meredith): She's gone insane right, it's not just me?
Cristina: About Burke...
Izzie: Everything will be fine!
Izzie: Because when Burke gets here everything will be fine! He will know what to do.
Cristina: About Burke!
Cristina (teary eyed): He's been shot. (goes to commercial)
Izzie: Burke's not coming.
Meredith: Cristina are you okay?
Cristina: I'm fine.
Izzie: Burke's not coming.
George: Why didn't I take the internship in San Diego? None of this would be happening if I was in San Diego.
Izzie: Burke's not coming.
Cristina: No Izzie, Burke is not coming. I know you're having problems here, what with your murder charges and your unbelievably stupid idea about stealing a heart but Burke's kinda busy right now.
Izzie (sitting down): Denny's gonna die. Denny's gonna die and I killed him.
George: You shouldn't have done it!
George: We have to tell someone.
Meredith: No! Then Denny won't get the heart and Izzie will get kicked out of the program.
Cristina: I'm leaving.
Cristina: You know, Burke could die too. Problems arise all the time because of gunshot wounds. (Izzie mumbles something) If you just would have thought with your head none of this would have happened!
Izzie (crying): I did what I thought was best!
George: Did you think about the rules? Did you think about the rules for one second?
Izzie: I did what I thought was best! (George and Cristina start shouting at Izzie)
Meredith: Shut up! Shut up! Shut up! No one is leaving and no one is dying.
Denny: Thank you. It's kinda gettin' on my nerves all this dyin' talk.
Denny: It's okay. I think uh, I think that we should all listen to Meredith. It looks like she might have a plan.
Izzie: You have a plan?
Meredith: Just gimme a minute.
The starting narration of this episode saw every main character appearing in the episode contribute snippets of speech.
Original International Air Dates:
Bulgaria: August 1, 2006 on bTV
Venezuela: August 25, 2006 on Warner Channel
Spain: October 2, 2006 on Cuatro
Australia: October 23, 2006 on Channel Seven
Netherlands: December 5, 2006 on Net 5
UK: January 25, 2007 on Living TV.
Norway: February 06, 2007 on TV2
Croatia: April 30, 2007 on NOVA TV
Finland: May 2, 2007 on Nelonen
Italy: May 11, 2007 on Italia 1
Ireland: July 17, 2007 on RTE2
Music Featured In This Episode:
1. Universe And U by KT Tunstall plays when Derek tries to hide in a room but ends up exchanging worries with Richard.
2. Look At Her Face by The Coral Sea plays when Dr. Hahn and Alex arrive at Seattle Grace by helicopter.
3. Through The Backyards by Au Revoir Simone plays when Dr. Hahn performs Denny's heart transplant.
4. How We Operate by Gomez plays when Derek must perform a wake-up test during surgery to check Burke's hand for nerve damage.
Bailey: Do not pass go.
"Pass go" is making reference to the board game Monopoly. Players start on the square "Go" and receive $200 every time they pass it. The aim of the game is to buy property, build on them and monopolise the entire board. A player wins once everyone else is bankrupt. When you get sent to jail through Chance or Community Chest the card says "Do not pass go."
Episode Title: Deterioration of the Fight or Flight Response
This episode's title could be a reference to the 2002 The Flaming Lips song of the same title.
Also, the Fight or Flight response is a medicial term first described by Walter Cannon in 1915. His theory states that animals react to threats with a general discharge of the sympathetic nervous system, priming the animal for fighting or fleeing.
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