Grey's Anatomy

Season 5 Episode 19

Elevator Love Letter

Aired Thursday 8:00 PM Mar 26, 2009 on ABC
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Episode Summary

All eyes are on Derek as he is set to perform his first surgery after his breakdown; attention is also set on Izzie, whose medical condition requires her to undergo a difficult surgery; and Owen has another PTSD episode that injures Cristina and traumatizes both of them, throwing the future of their relationship into question.moreless

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Ellen Pompeo

Ellen Pompeo

Dr. Meredith Grey

Sandra Oh

Sandra Oh

Dr. Cristina Yang

Katherine Heigl

Katherine Heigl

Dr. Isobel "Izzie" Stevens

Justin Chambers

Justin Chambers

Dr. Alex Karev

T.R. Knight

T.R. Knight

Dr. George O'Malley

Chandra Wilson

Chandra Wilson

Dr. Miranda Bailey

Kimberly Elise

Kimberly Elise

Dr. Swender

Guest Star

Molly Hagan

Molly Hagan


Guest Star

Todd Waring

Todd Waring


Guest Star

Jessica Capshaw

Jessica Capshaw

Dr. Arizona Robbins

Recurring Role

Brandon Scott

Brandon Scott

Dr. Ryan Spalding

Recurring Role

Mark Saul

Mark Saul

Intern Steve

Recurring Role

Featured Episode Clip

Trivia, Notes, Quotes and Allusions


  • TRIVIA (2)

    • When Meredith is leaning on the OR Board while Izzie's in surgery you can see Izzie's birthday as 06/23/81. So, that would make Izzie almost 28 years old.

    • While the Chief is eating, Alex hands him a bag of his sperm. After Alex leaves, a disgusted Chief moves the bag away from him with his fork. Why on Earth would he do that with the same fork he was using to eat?

  • QUOTES (33)

    • Alex: (speaks to aunt Joyce) Hey. I'm doctor Karev. You're a fighter you know that? You worked hard today (speaks to Lexie) She needs some rest. Umm see the family, make sure they don't come back in here, give her a break from all the love.
      Aunt Joyce: No, they're impatient. It's been a long time, but they always come. They're my people, people keep you going, people are better than no people.

    • Izzie (waking up): Hey.
      Alex: I snooched into a cup for you today.
      Izzie: Um... thank you?

    • Meredith: I'm engaged.
      Cristina: I broke up with Owen.

    • Owen (about to get a CT): I want to apologize for earlier. What I said was, it was out of line.
      Derek: It's already forgotten.
      Owen: Thank you for doing this.

    • Richard: Surgery went well today.
      Derek: Mmmm.
      Richard: Shouldn't you and Meredith be out celebrating or something?
      Derek: She turned me down twice. She says she understands, she forgives me for what happened in the woods, but...
      Richard: So you showed her your dark side. Meredith never struck me as a woman afraid of the dark.
      Derek: I don't know.
      Richard: Do you know it was Meredith's idea to ask Izzie if she wanted to harvest her eggs? So Izzie could have a chance at the future she wanted. The future, Derek. She was confident that you'd succeed today. Meredith believes in you.

    • Cristina: Did her vitals remain stable the entire time?
      Meredith: Were there any spikes in her intracranial pressure?
      Alex: Was there any residual tumor?
      Bailey: Shepherd was able to resect all of the tumor. She'll be in packing view for about an hour. She's fine. ... Your friend is just fine, no thanks to any of you. Tomorrow, do better!

    • Richard: What are you all doing out here?
      Alex: Waiting for Izzie, Sir. We're waiting.
      Richard: You're scared. I'm scared, too.

    • Meredith: I'm worried about you.
      Cristina: Meredith.
      Meredith: Choking.
      Cristina: Stop.
      Meredith: It's unacceptable.
      Cristina: Back off.
      Meredith: Hands around the neck.
      Cristina: Ring thrown in your face.

    • Alex: She needs some rest. See the family, make sure that they don't come back in here. Give her a break from all the love.
      Joyce: No. They're impatient. It's been a long time. But they always come. They're my people. People keep you going. People are better than no people.

    • Meredith: Hey, How's Izzie?
      George: I don't know.
      Meredith: How's Izzie?
      Cristina: Why?
      Meredith: Have you been to see her?
      Cristina: No, I've been working with Swender all day.
      Alex: What?
      Meredith: Have you been to see Izzie?
      Alex: No, haven't you? (they all gaze towards the empty seat at the lunch table)

    • Alex: Here's your cup. All filled up.
      Richard: I'm eating here Karev.
      Alex: It's fine, I washed my hands.
      Richard: Did you talk to Izzie about this yet? Considering you two are basically conceiving a child together today, don't you think you should talk with her about this?
      Alex: Look, you said she needed my contribution. Here's my contribution. Whatever.

    • Cristina: Swender has no vision.
      Meredith: He wrapped his hands around your throat this morning and you're pretending like nothing happened.
      Cristina: Just focus on Izzie.
      Meredith: Hunt literally tried to kill you. He's barely back from Iraq, it's obvious he has issues. That doesn't mean that you have to stand by and...
      Cristina: So like if he had a heart attack, or a stroke or lost a leg would you walk away? So how is it any more acceptable that I walk away from this? He's wounded. He has war wounds Meredith. It's not cut and dry. And it is not as bad as you think it is.

    • Callie (about Cristina): Is she doing okay?
      Meredith: Ah yeah, well she says she is.
      Callie: Do you believe her?
      Meredith: No. Not really.

    • Alex: Chief, you paged me?
      Richard: Oh, Karev. Yeah, yes I did. Um, as you know we're gonna be harvesting eggs, from Stevens. Who I believe is someone you're having relations with.
      Alex: Chief I--
      Richard: Frozen eggs have a better survival rate when they're fertilized.
      Alex: Fertilized.
      Richard: I know this is a lot to digest, so um, take some time. Think about it. If you decide this is something you might wanna consider...
      Alex: Give me the cup.
      Richard: Karev, you need to speak to Stevens before...
      Alex: Just give me the cup.

    • Derek: Karev, I just reviewed Izzie's most recent MRI and it doesn't look like the tumors grown since her last scan, so that's good news. Do you have an questions or concerns that you'd like to discuss with me before we brief Izzie?
      Alex: Just try keeping her frontal lobe inside her skull this time.

    • Bailey: Ah, you three. Okay. Yeah, I understand why you're here. I know you wanna help, but I will be the resident on her case today. I will be prepping her for surgery, and if you are going into that hospital room today you will do so as her friends. Izzie needs her people around her. She needs you to tell her everything will be fine, she needs you to hold her hand. She needs you, not more doctors. Understood? (they walk into Izzie's room)
      Izzie: Great. Let's get started.
      Bailey: Okay, as you know you have stage 4 metastatic melanoma. You have a lot of surgeries, and a lot of procedures lined up for you over the next few weeks.
      Richard: We've seen evidence of METS on your liver, so one of those surgeries Dr. Bailey and I will resect them. We also lined up Dr. Parker from OB to harvest as many healthy eggs as she can before you undergo any radiation.
      Izzie: Right. Babies.
      Bailey: Just leaving the option open for you if you want it.
      Derek: But our priority today is to address the temporal lobe METS on your brain. I'm surprised we didn't catch it sooner. This kind of thing can cause headaches, seizures and intense hallucinations. But, hopefully the legion has a clear margin so I can remove it all.

    • Callie: George, hey. I'm surprised you're not-- I mean... isn't there a big presentation happening with Izzie?
      George: I didn't even know she was sick. Bailey told me after Cristina told her. Izzie trusted Cristina. I was the very last to know.
      Callie: Well, I'm sure Izzie wasn't trying...
      George: I don't really wanna talk about it any more. What I wanna do is work. Do you have any room on your service?
      Callie: Ah, yeah. I have 3 hip replacements, and a tib fib repair.
      George (takes the charts): Thank you.

    • Meredith: You're wearing a turtle neck under your scrubs. It's ugly. Not as ugly as the fact that you hugged him. You hugged him.
      Cristina: I get it. I hear you. Lets move on.
      Meredith: Turtle necks aren't okay. You're not okay, and your boyfriends not okay.
      Alex (walks up): Is your boyfriend okay?
      Meredith & Cristina: What?
      Alex: To be cutting into brains today. Is he okay to be back?
      Meredith: Yes, of course. Derek is fine.
      Alex: I was there for his carnage in the OR remember? This isn't just any patient today, this is Izzie.

    • Meredith: There's coffee. (Derek is silent, sits down at the table and puts the ring on table) No. Not like this. Today is your first day back at the hospital. Today is about Izzie, you have to operate on her brain. You have a gift, and you can do this.
      Derek: I'm gonna shower before I go in.

    • Meredith (answers the phone): It's three in the morning Cristina, this better be good. Callie? What? He what?! (next scene is of her knocking on the bathroom door that Cristina locked herself in) It's me. Cristina! (Cristina lets her in) What's going on? Owen's out there upset. Callie was screaming. She said--
      Cristina (to herself): No changes in visual acuity, no petechiae. I'm fine. (turns to face Meredith) I'm fine.
      Meredith: Oh my God! Your neck. I will kill him. He's...
      Cristina: No, no, no. It was a nightmare. He had a nightmare.
      Owen (knocks on the door): Cristina, please. Is she alright? Meredith, I just need to know that she's alright. (moves to the door)
      Meredith: No, no, no, no, no, no. Cristina, no! (Cristina opens the door)
      Owen: I am so sorry. I don't know what I'm, I'm... I don't know... I'm sorry.
      Cristina: Look at me.
      Owen: I'm sorry.
      Cristina: Look at me. I'm fine. See? It's okay, you were asleep. It's okay. Okay? It's okay. (they hug)
      Owen: I'm sorry. (sobs)
      Cristina: It's okay. It's okay. I know. It's okay. You were asleep. It's okay. Okay? It's okay.

    • (George is hitting casts)
      Callie: Okay, so I get why I haven't been camped out at Izzie's bedside, holding her hand today, but--
      George: We're not talking about this.
      Callie: Why not?
      George (continues to smash the casts): Maybe it's the fact that I asked Izzie a million times what was wrong, and she just ignored me. And then there's the fact that when she actually needed help, she trusted Cristina, of all people!
      Callie: And then there's the fact that she's your best friend, and she might die on you. There's also that. (walks over to him) Come on. We are going to go wait for Izzie. Come on. George! (takes the hammer from his hand) You were my husband and you slept with her. You are the reason that I wished her dead. You owe me this. You can lie to yourself all you want, but I know you. I loved you once, and I know you care if she lives or dies.

    • Derek (just about to operate on Izzie): We'll see you soon, Dr. Stevens.
      Izzie: I hope so.
      Bailey: Know so.
      Izzie: Dr. Bailey, if something goes wrong--
      Bailey: It won't.
      Izzie: The scarf... I made it for you.
      Derek: It's a beautiful night to save lives. Let's get started. (they put Izzie under)

    • Izzie: Oh, good, stand right there. (holds up the scarf she is knitting to Bailey's arm) Let me see. I never know how long to make these.
      Bailey: I like the color. Who's it for, Karev? I haven't seen much of him today.
      Izzie: He's working. They're all working. I told them to go work. They're doctors. Their patients shouldn't suffer just because I have things growing on my organs.
      Bailey: I have a colectomy this afternoon. If you were the resident assisting me, and I were to say to you, divide the secum, what would you use?
      Izzie: Dr. Bailey, I'm not assisting you, and you're not gonna ask me to divide the secum.
      Bailey: Well, I'm not going to let you get rusty. A year from now, you need to be able to do this stuff. You need to be able to teach your residents how to do it.
      Izzie: You really think I'm gonna be here a year from now?
      Bailey: Yes, I do.

    • Richard (knocks on the door): Karev. Just checkin' in, see how you're com-- See how you're doin'.
      Alex: I'd be doing better if you weren't on the other side of the door listening.
      Richard: Right, right. Sorry. (Meredith knocks on the door)
      Alex: I said go away.
      Meredith (walks in): You left the door unlocked. That's bold.
      Alex: Did the Chief send you in here?
      Meredith: Nope. I offered to come in, in case you needed to talk.
      Alex: You think talking will help? You think a Dixie cup full of my swimmers will make everything okay? It's crap. This is crap! You just can't go messing with people's heads like that! Even if she freezes the embryos, do you think... Do you think we'll get a chance to use them? Do you think she'll still be here? Do you think she'll survive all this? Do you think... I think... She told me, she told me she was seeing a ghost, okay? And I'm so used to all the crazy chicks in my life that I didn't even... I'm a doctor. A doctor! And I didn't even think... and now she's... this is wrong. This isn't how it's supposed to happen.
      Meredith: I know.
      Alex: It's crap!
      Meredith: I know.
      Alex: I hate this!
      Meredith: I know.
      Alex: This isn't... this isn't how we were supposed... this isn't how I want to do this. This isn't how Izzie and I were supposed to make a baby.

    • Derek: You know they're doing tests that show faltered brain anatomy in patients with PTSD. They're actually getting close to understanding the physical side of the psychological trauma. It's amazing what you can see with an MRI.
      Owen: What did Meredith tell you about last night? What did she say?
      Derek: Post traumatic stress is a real injury, Owen. It can be healed. There are resources. Med centers. Therapy. You shouldn't try and handle this on your own.
      Owen: I came back in one piece. I have both arms, both legs. Lots of guys came back with real injuries. The worst I have is a couple of nightmares, or freezing for a moment--
      Derek: Is that what happened last night? You had a freezing moment? If you want, I can help.
      Owen: Yeah? I'm not the one who needs help around here. I'm not the one who cut out half a woman's brain, then ran off to hide. I'm not the one who half this hospital is talking about behind their backs, so maybe you should spend a little less time worrying about me and you know, just take a look in the mirror, all right?

    • Meredith: Surgery has started.
      Cristina: Hey, have they started the surgery yet?
      Alex: Yep.
      Steve: Dr. Grey, we were wondering did Dr. Stevens' surgery start yet? Or...
      Meredith: Keep it moving. No loitering in the OR hallway, that's the rule.
      Alex: If they wanna stay, let them stay. People are better than no people.

    • Richard: Ah, it's not a good time, he's still scrubbing in.
      Meredith: I know, it's just, ah, he should wear this. It's his ferry boat scrub cap. He loves ferry boats.
      Derek (follows Meredith out of the scrub room): Meredith.
      Meredith: What are you doing? You're gonna have to re-scrub.
      Derek: I'm not ready.
      Meredith: Yes, you are.
      Derek: I need to know that at least I have you. No matter what happens in there. I need to know. I need you to say yes. I need to know.
      Meredith: I can't say yes. Not if agreeing to be with you forever will make it okay if Izzie dies. I can't say yes. I love you. And you can do this. I know you can.

    • Cristina: I don't think ... I can't handle this after all.
      Owen: What, what do you mean, what are you saying?
      Cristina: I'm sorry, I'm so so sorry. But I'm laying here in your arms, and I'm afraid to fall asleep.

    • Alex (closing voiceover): It doesn't matter how tough we are. Trauma always leaves a scar. It follows us home, it changes our lives. Trauma messes everybody up. But, maybe that's the point. All the pain and the fear and the crap. maybe going through all that is what keeps us moving forward. It's what pushes us. Maybe we have to get a little messed up. Before we can step up.

    • Callie (in the hospital chapel): I wished Izzie Stevens would die. I wished her dead every day of every week for I don't even know how long. I woke up every morning wishing Izzie Stevens would die. And now ... what kind of person wishes someone would die ... knowing how things happen ... what kind of doctor wishes ...
      Arizona: Are you in here, right now, praying for Izzie to die?
      Callie: No, I'm praying for her to live.

    • Cristina: I haven't seen you all day.
      Owen: What if I hadn't woken up? I can't even remember what happened. It's gone. I have no memory, no way to... I would never hurt you, ever. But I did. My hands just... like how could... how could my own two hands be capable... I can't do this. Cristina... I can't... We can't do this... we need to stop seeing each other.
      Cristina: But you did wake up. Stop blaming yourself for something that is out of your control.
      Owen: We have to stop seeing each other.
      Cristina: Why?
      Owen: Cristina, I almost--
      Cristina: Almost what? I told you. I know my limits. Let me decide what I can handle.

    • Alex (opening voiceover): Surgeons are all messed up. We're butchers. Messed up, knife happy, butchers. We cut people up. We move on. Patients die on our watch. We move on. We cause trauma, we suffer trauma. We don't have time to worry about all the blood and death and crap really makes us feel.

    • (An elevator opens, Meredith is about to get in it)
      Richard (rushes over): Wait. Um. Wait. No. You can't take that one.
      Meredith: Why not?
      Richard: I said don't take it.
      Meredith: I will take the elevator I want to take. (she tries to walk by him but he slides into her way, they do that a couple times. The doors to that elevator close. She presses the button, the other elevator comes. She looks at Richard questioningly)
      Richard: Well, go on. (the elevator doors open revealing Derek waiting for Meredith, with CTs plastered every where)
      Derek: Hey! Come on in. (she gets on, the doors close) This is a CT of Katie Bryce. 15 year old female severed aneurysm.
      Meredith: From a fall during rhythmic gymnastics, I remember.
      Derek: It was the first surgery we ever scrubbed in together on, right? Our first save. Right here is a treable cysts, tough save but we did it. I kissed you in the stairwell after the surgery. And this right here is where Dr. Bailey kicked you out of the surgery because she caught us in your driveway in my car. (Meredith laughs) And right here this was a seven-hour craniotomy and you held the clamp the entire time, never flinched. That's why I knew you were going to be an incredible surgeon. Beth made our clinical trial a success by surviving. You talked me into putting her under. That's why I knew I needed you. And this is today. The post op head CT shows of Izzie Stevens. See that, right there, tumor free. Because of you. You got me into the OR. If there's a crisis you don't freeze. You move forward. You get the rest of us to move forward. Because you've seen worse. You've survived worse. And you know, we'll survive too. You say you're dark and twisty. It's not a flaw. It's a strength. It makes you, who you are. I'm not going to get down on one knee. I'm not going to ask a question. I love you, Meredith Grey. And I want to spend the rest of my life, with you.
      Meredith: And I want to spend the rest of my life with you. (they kiss)

  • NOTES (4)

    • International Episode Titles:
      Slovakia: Vyznanie lásky (Declaration of Love)
      Czech Republic: Nouzové zastavení času (Emergency Stop Time)

    • Original International Air Dates:
      Latin America: June 8, 2009 on Sony Entertainment Television (aka Canal Sony)
      Italy: June 8, 2009 on Fox Life
      Australia: June 18, 2009 on Channel 7
      Germany: August 5, 2009 on ProSieben
      The Netherlands: October 12, 2009 on Net5
      Norway: December 22, 2009 on TV2
      Slovakia: February 15, 2010 on STV1
      Czech Republic: June 24, 2010 on Prima

    • Music Featured In This Episode:
      1. Little Pieces by Gomez
      2. The Weight Of Us by Sanders Bohlke
      3. That Home by The Cinematic Orchestra
      4. Rise Up by Ben Lee
      5. With The Notes In My Ears by Peter Broderick
      6. We Do What We Want To by O+S
      7. Like A Ghost by Calahan

    • Every season (except the first one) has an episode where the narrator is somebody other than Meredith (this time is Alex). However, this is the first season with two of those episodes (Denny narrated "Stairway To Heaven").