This is part one of a two part crossover with Private Practice. The episode concludes on Private Practice in S5 Ep15 You Break My Heart.
Lexie: We've operated on worse.
Derek: Lexie, she showed us a picture of a little boy.
Lexie: I know. It-- It's clear that she is passionate...
Derek: My sister's too emotionally wrapped up in this patient to clearly see that she can't help this woman.
Lexie: You know, it tells me that she's passionate enough try harder.
Derek: Yeah, well, all her passion in the world is not gonna make her plan doable in 90 seconds. You wanna see that yourself, fine, set it up.
Lexie (mutters): Only you're gonna be the one who sees a thing. (Derek glares at her) I mean, thank you.
Callie: What's your plan, Grey?
Meredith: My plan is they get this thing off then we assess.
Callie: Right, but what if they don't? You need an alternate plan.
Meredith: Well, I don't need an alternate plan, because they're gonna get it off. (the monitor starts beeping)
Mike: What'd you do?
Tommy: I didn't do anything!
Meredith: The more you guys loosen that the more he's gonna bleed.
Mike: Should we stop?
Meredith: No, just keep going. Just go faster.
Callie: Y-You sure you have time for that?
Meredith: If you have something to suggest, why don't you?
Callie: Now you're just wasting everyone's time.
Meredith: Well, we have to get him up to the O.R. or else he's gonna bleed out.
Callie: Yeah, well his hand's still stuck in that grinder.
Meredith: Let's get a pneumatic turiquit on his arm above the grinder. That'll buy us a few minutes.
Meredith: I can give you guys 15 minutes, but then I have to amputate.
Lexie: Hey, you paged?
Amelia: Look, I can remove the tumor and the diseased cartoid together. All I have to do is run ballon catheters in through the femoral, place them in precise position, inflate them to stop the blood flow, do two arteriotomies, then feed a hepernized shunt into place, and reestablish blood flow.
Lexie: That's all?
Amelia: Oh, and I have to do it in 90 seconds. Any more than that and she strokes out.
Lexie: Is that even possible?
Amelia: Not sure. I would love to test it out.
Lexie: We should set up a simulator.
Amelia: Uh, don't we need to get Derek's approval?
Lexie: Yeah, but that shouldn't be a big problem--
Amelia: He loves to say no to me. That is his favorite thing to do.
Lexie: Maybe you should refrain from calling him a jackass.
Amelia: I can't help it, 'cause he is one.
Lexie: Maybe I should ask him.
Amelia: Would you? He's in surgery, O.R. two.
Lexie (turns to leave but stops): You just called me down here so that I would go to Derek for you, made me feel like it was my idea.
Amelia: Aren't I good?
Lexie (unenthused): Amazing.
Meredith: Dr. Torres, Dr. Webber suggested that I--
Callie: Unh unh. Here's how this is gonna work-- I talk, and you listen. You are here because you and your little pals are all freaked out about the oral boards, and Dr. Webber suggested that Callie Torres might have a special secret study method, right?
Callie: Yeah, Dr. Webber's correct. Callie Torres does have a study method, an excellent study method, but she's not about to just give it away. Callie Torres' study method has to be earned. Frankly, she doesn't think Meredith Grey has what it takes.
Meredith: I think she does? I think Meredith Grey has what it takes?
Callie: For her sake, Meredith Grey better hope that she's right. 'Cause today, today's gonna be a grind.
Paramedic: A grind? Really?
Callie: It's a meat grinder. Oh, whatever. Like you weren't thinkin' it, too.
Mike: But, you're just gonna cut off his arm? I mean, I--
Callie: No, this is a teaching hospital, Mike, okay? I'm doing a thing. (turns to Mer) Grey, here's how it's gonna work if you want my help on the boards. You're gonna run this. You're gonna decide our course of action. You're gonna be the person that stands between Dominic and a hook for a hand. You in or are you out?
Meredith: I already said that amputation is our best option.
Callie: Oh. Best?
Meredith: Yeah, best.
Callie: Okay, so book an O.R. and fire up the bone saw. Let's move him out people. Grey wants to amputate.
Meredith: Dr. Torres, wait. I have a finger here.
Callie: I knew that already, Dr. Grey.
Meredith: No, a viable finger. (presses the finger) Look at the cap refill.
Mike: I-Is that bad or good?
Callie: Dr. Grey, is that bad or good?
Meredith: It's good.
Callie: Alright, so what do you want to do?
Meredith: I think that we should take this thing off and see what's left.
Callie: Alright. Time's a factor here, Grey.
Tommy: Why is time a factor?
Meredith: Because the longer his hand stays in there, the more we compromise his circulation.
Callie: Tick tock, Dr. Grey.
Meredith: So, let's call up to mantience and get a sawzall.
Callie: Mm. You really want to wait that long?
Meredith: Uh, fire and rescue has tools.
Tommy: Hey, these tools, what are they gonna do? Rip apart the grinder?
Meredith: To save his hand.
Tommy: Yeah, we dropped a couple grand on that thing. You can't trash it.
Meredith: To save his hand?
Tommy: Mike, how long is it gonna take you to get that thing apart?
Mike: I- I take that thing apart every night and clean it. We can get him out. And quick.
Meredith: Dr. Torres?
Callie: Can you do it in under 45 minutes?
Mike: Give or take?
Meredith: Dr. Grey what? Do I think it's okay to let a couple of civilians take apart the machine that's grinding their brother's hand?
Meredith: Let's do it.
Mike: Okay, I'm gonna need a set of allen wrenches and a Phillips head screwdriver.
Tommy: Make that two.
Jackson: You paged me 911 so I could get yelled at?
Mark: No, I paged you 911 so you could help me convince Bailey we're doing the right thing here. You failed.
Jackson: Okay, so what do we do now?
Mark: Well, let's hope Carrie's a little bit more persuasive than you are.
Alex: Okay, uh, Megan. Let's go schedule that gastroscopy.
Morgan: Uh, it-- it's Morgan.
Alex: What is?
Morgan: My name. It's Morgan.
Alex: Whatever. Same difference.
Richard: Meredith Grey.
Callie: No. Not Grey. Yang, maybe.
Richard: Yang's a cowboy.
Richard (makes face): Kepner?
Callie: Not Kepner. Definetly not Grey. She spent all that time in neuro, and suddenly, she's chasing general. She's unfocused.
Richard: You're underestimating her. I think she'd surprise you.
Callie (chuckles): She'd have to.
Richard: She will.
Callie: She'd have to come to me.
April: Hey, if you want, we could--
Meredith: I don't need help. I'm an excellent surgeon. You know it, and I know it. Everybody knows it. I don't have to prove myself to anyone.
April: Yeah, except to the American Board of Surgery.
Meredith: Yeah, there's them.
Meredith: You guys studying for the oral boards in the middle of the day?
April: It's just another benefit of having a study buddy. You should get one.
Meredith: I have one. It's just that my stupid study buddy's too busy trying to save her stupid marriage to actually help me study.
Alex: Well, you know what's better than a study buddy? A study lackey. Check it. (to intern) Hey, you. (whistles) Brown-haired girl, you're up.
Morgan (walks up): Uh, trauma incident or a surgicial situation?
April: You made your interns come up with study questions?
Alex (to Morgan): Surprise me.
Arizona: How's she doing?
Alex: Morgan? Oh. I haven't checked. (Arizona gives him a look) I ran a pregnant chick all over the hospital today. Made her quiz me on my stupid boards 'til she damn near died, and I haven't even checked to see how she's doing. Apparentaly, I'm the only person in this hospital who didn't know she was pregnant... because I'm too busy worrying about my own stupid damn self to even make an effort to learn my interns freakin' names. It doesn't matter if I pass those boards or not, I don't deserve that fellowship.
Arizona: You know why I like you so much?
Alex: I honestly have no idea.
Arizona: You remind me of me. Peds surgeons? We're-- We're vicious. We're the most hardcore surgeons in the hospital. I mean, when I was a resident, I was... I was a full-on horror show. But that's what it takes to learn how to save tiny humans like this one.
Arizona: Yeah. Do me a favor? Learn your interns freakin' names.
Callie: You're impressive.
Meredith: I am.
Callie: Look, there's always been a lot of hype surrounding you, okay? 'Meredith Grey, ooh child of Ellis. Ooh, isn't she so special?'
Meredith: You don't have to help me if you don't want to.
Callie: No, no, no, no. That's not-- That's not what I'm saying. I'm saying... you're tougher than I thought. I'm saying, you're smart. I'm... (sighs) saying-- Okay, look, we've never been friends, not even when I was with George. Mainly because you thought I was a freak and you're blonde and very... (sighs) And now you have a baby and I have a baby and we're both married, and... I don't know. I'm saying, we're both alike. I'm saying I'll help you.
Meredith: You're not a freak. And we can be friends.
Callie: Every morning, five days a week, you are in my office at 4:00 A.M. And we work, Grey. And if you don't show up, or if you're late, I will kick you ass. We work, Grey. We work. And you're gonna pass this test. And you're gonna pass it hard.
Amelia: You haven't even looked.
Derek: Amy, I am telling you it is unrescetable. Let it go.
Amelia: I came all the way from L.A to show you this. You could spend more than 30 seconds.
Derek: I am looking right at it. It's a gliosarcoma that has invaded the carotid artery. You try and remove it and she will stroke out.
Amelia: Stop being a jackass.
Lexie (exhales and smirks): Wow. (Amelia and Derek look at her) I'm-- She called-- She called you a jackass.
Derek: Dr. Grey, excuse us.
Amelia: Dr. Grey, stay here. I need backup.
Derek: Fine. You just got out of rehab. I want you to get on your feet. But you can't help her.
Amelia (puts up a picture of Mason): Look at his face. His name is Mason. This gliosarcoma belongs to his mother Erica. He's a great kid. I don't know him that well, but he seems great. I do know his dad well, his name is Cooper, and he works with me and he is a good guy. He is a good dad, which means he is the one who is gonna have to tell Mason that his mom is dead, that he doesn't have a mom anymore because we didn't do anything.
Derek: You tell Cooper you're sorry. You tried. Let it go. I have a surgery.
Meredith (opening voiceover): When you've tried everything but that headache don't go away, you can't stop coughing, the swelling don't go down. That's when you turn into a professional. As surgeon we spend years developing skills of perception that allow us to see exactly what the problem is. Trouble is sometimes all that time spent developing those skills of perception can leave a person with an extremly narrow point of view... And how are you supposed to argue with someone who has science on their side?
Meredith (closing voiceover): We may not like it but it really is important to stop every once in a while, get out of your own head and see the bigger picture. Actually find out that you were looking things all wrong can be sort of liberating. And suddenly you see new potential, new posibilities we've never seen it before and that's all fine when a hopeless situation suddenly looks good. Unfortunately sometimes it goes the other way.
Owen: We fight.
Cristina: No, we don't. You yell and then you go silent.
Owen: I yell because you... (clears throat) We don't communicate. There's no intimacy.
Cristina: There's intimacy.
Owen: Okay, alright, there's intimacy. But we're not on the same page.
Cristina (laughs): Oh, be-- Because I don't do what you want me to do.
Owen: Because you had an abortion.
Cristina: Uh, we've done couples therapy before. He has P.T.S.D
Owen: From the war, and she's had it, too.
Cristina: From the shooting. But not at the same time. We-- We didn't have it at the same time. And mine wasn't as bad as his is.
Owen: You laid on the floor of an O.R.
Cristina: You choked me.
Owen: You quit being a doctor.
Cristina: So... For a little while. But now we're fine. (Owen scoffs) Really?
Owen: Oh, sure. Okay. We're fine.
Cristina: I meant the P.T.S.D.
Owen: Okay, yeah. We're fine.
Cristina: We're fine.
Owen: Mmhmm. Except for the part where you aborted the child that I wanted.
Cristina: Except for the part where you held my hand while I exercisied my right to choose and the four months later, you screamed I killed your baby in front of all our friends.
Cristina: There is no deeper reason.
Owen: There has to be.
Cristina: There is no deeper reason. I wasn't abused. I- I don't have a dark secret. I wasn't mugged by a baby. I just don't want kids.
Owen: Nobody doesn't want kids.
Cristina: People can not want kids. It's a thing.
Owen: That is not a thing.
Cristina: Well, it's my thing.
Owen (sighs): You're gonna change your mind. You're gonna change your mind in three years or five. You're gonna change your mind about having a baby, and then it's gonna be too late. And you're gonna regret it.
Cristina: And I will know and understand that I made a choice. I choose medicine. I choose me. I choose that over the remote possibility that I might one day regret not having a child. And by the way, it's alright to not want kids. Some people don't ever want kids.
Owen: Well, I wanna know why. Why?
Cristina: I have always been clear--
Owen: You have no always been clear. She loves to say that.
Cristina: Always been clear-- I do not want kids. He knew that.
Owen: I did not know that.
Cristina: You knew that.
Owen: I did not know that in the beginning.
Cristina: What, I have an icicle in me, and I'm supposed to tell a stranger, 'Hey, I don't want to have kids'?
Owen: I'm not talking about the icicle. I'm talking about after. (Cristina scoffs) After.
Cristina: No, I told you when it was relevant to the relationship.
Owen: Most people would consider dropping a bomb like that before the wedding. That is when it would've been relevant.
Cristina: Well, uh, you proposed and we were married like 12 hours later. So sue me if, in the moment I was thinking of other things.
Cristina: You have to try.
Owen: I am. I'm-- I'm trying.
Cristina: We're supposed to focus on each other and breathe, and you're not. I mean, your mind is totally elsewhere.
Owen: Oh, so, now you know my every thought and intention?
Cristina (sighs): We used to be able to look at each other. And I'd feel... like we were gonna be okay. There is we're together, Owen. There is a reason we're married. Please. Look at me.
Owen: Alright. I'm looking at you. Right now... I'm looking right at you. (Cristina sighs and looks away)
Cristina: He has to stop holding a grudge. He has to see me for who I am. He has to take his little list of all my crimes and rip it up, otherwise--
Owen: Otherwie what?
Cristina: You know, I-I don't know.
Owen: How about you stop thinking that you're the sun, and that I revolve around you, and that being a cardio god, maybe that isn't everything, and maybe what I need is worthy of some consideration?
Cristina: And we're back to the abortion?
Owen: Yeah. Yeah, we are.
Cristina: Oh, come-- Meredith and I do not do everything together.
Owen: The twisted sisters.
Cristina: Yeah, well, we're best friends. What do you expect?
Owen: She has a baby.
Cristina: Oh, my god. That doesn't mean that I have to.
Owen: I don't see why not. You do everything else together. It's like you're a team.
Cristina: Because she's my person.
Owen: I should be your person.
Cristina: Be my person! Be my person, Owen! Be my freakin' person!
Owen: Be my person.
Bailey: Dr. Sloan, I need a word with you about Avery.
Mark: Dr. Bailey, I have a patient.
Bailey: Avery-- He was... was right. She's gonna be able to use her arms. So... why did I say no?
Mark: You were being careful.
Bailey: Yeah, but she was my prize patient. I've done ground-breaking work on her behalf.
Mark: You were a resident, like Avery. You get more experience, you get more conservative.
Bailey: C-Conservative? O-Oh is that what success buys you? What, you get happy and then you get scared? Don't want anything in life to change?
Mark: You're a grown-up, you're reisk-averse, 'cause you know risk has actual consequences. That's why we keep residents around. They keep us fresh.
Bailey: Are you trying to tell me that I'm not young anymore?
Mark: I'm trying to tell you, you've arrived. ... Oh. You pull that crap in my O.R, again I'll report you to the board.
Lexie: What are you doing?
Amelia: We needed two surgeons. One on the internal carotid, the other on the external, controlling the balloons. We almost got it to 90 seconds.
Lexie: You think it's gonna work?
Derek: Let's not get ahead of ourselves. It's one step. One step in a very complicated tumor.
Amelia: He doesn't think it's gonna work.
Derek: Well, we're gonna go down trying. (to Lexie) That's all. Thank you. You can go.
Lexie (turns to leave, and stops when she sees Mason's picture): I wanna go down trying.
Derek: Okay. Pick up the stopwatch.
Jackson: Sorry, Dr. Sloan, just a little distracted here.
Mark: Dr. Avery, let me give you one small piece of advice. If there is anything, I mean anything, distracting you from helping your patient, you need to leave it outside. (they look at Bailey)
Jackson: Oh, respectfully, I...
Mark: This is your patient now. Yours.
Bailey: Uh, someone had better tell me what's going on and had better tell me right now.
Jackson: Dr. Bailey... You need to leave this O.R.
Bailey: Excuse me?
Jackson: This patient, my patient, had develope a subclavian bleed because we misjudged her adhesions. But I am nw doing an arterioplasty, which is not an wasy thing to do, and you are making it more difficult by distracting me. You are comprimising my ability to care for my patient, Dr. Bailey.
Bailey: Well, if you're telling me you can't focus--
Jackson: I'm telling you that you need to get out. Now.
Bailey: Oh, Dr. Sloan, if you let your resident speak to an attending this way--
Mark: Dr. Bailey... I believe Dr. Avery made it very clear. Leave the O.R, or I'll have you removed.
Mark: It's still oozing Dr. Avery. How do you want to proceed?
Jackson: Um, I- uh, I don't know.
Bailey: Oh, he did not just say 'I don't know.' Man, tell me what you see.
Tommy: His toe?! Are you serious?
Mike: Tommy, calm down.
Tommy: I'm sorry. I didn't mean to yell. It's just... that's weird.
Dominic: But if I say okay, I get my hand back? Otherwise, you fit me for a hook?
Meredith: A prostetic, but if you give the go-ahead--
Tommy: He gets a hand.
Dominic: Well, what are you lookin' at me for? Take my toe already. Take my left nut if it'll help.
Meredith: I think the toe will be fine.
Richard: I was right. Right?
Callie: Too soon to tell.
Richard: Cut the crap, Torres. You two are gonna put a toe on a man's hand. That was her idea.
Callie: Maybe we are. Maybe we aren't. (Mer gives Callie a thumbs up)
Richard: I was right.
Callie: So, this is how you're gonna spend your time now, pulling strings behind the scenes like some kind of puppet master?
Richard: I am really good at it.
Derek: Alright. Tell me what you're trying to do.
Amelia: Uh... I'm going in through the carotid with two catheters, uh, one in the proximal--
Derek: A carotid stick? That'll kill her even faster.
Amelia: Damn it, Derek--
Derek: Amy, I'm sorry, but you can't stop and reestablish blood flow in 90 seconds. I mean, I can't do it in 90 seconds.
Amelia: Oh, well, the great god of neurosurgery has spoken--
Derek: Look, now, I'm trying to help you. But, please, don't put yourself through this, you're too fragile.
Amelia: I am not fragile. I'm a drug addict. I've fallen off the wagon twice, and I've gotten back on. That does not make you fragile, Derek. That makes you very freakin' strong. I am standing in a building full of pills right now, a fact that I am painfully aware of, but I am doing this. That is not fragile.
Derek: Okay, so show me what you're trying to do.
Amelia: So, you think there's a way?
Derek: No, I don't. But I can't stop you so, um... I'll be here with you. Show me what you're trying to do.
Callie: The thumb is responsible for 40 percent of hand function. Without it, we're done.
Meredith: But, there's gotta be something else. I mean, I read something about surgeons using a man's big toe as-- as a replacement for a thumb. Let's do that. Let's-- Let's use his big toe.
Callie: Listen, Dr. Frankenstein, the big toe, it's pretty important, you know, for walking.
Meredith: And he can learn to rebalance.
Callie: Or he can keep his toe where it is.
Meredith: This is a good fix. I know it is.
Callie: No, it's not.
Meredith: Dr. Torres, it has to be.
Callie: The big toe is not the fix. That is why we're gonna use the second toe. It'll provide the same benefits but reduce potential disability.
Callie: Yeah, but we're not doing anything without the patient's consent.
Bailey: You now that this patient has a history of multiple surgeries in that area.
Mark: She sure does.
Bailey: Okay, then I don't understand why you think it's a good idea to continue to dissect right there.
Mark: Respectfully, Dr Bailey, it's not entirely important that you understand everything I do every step of the way.
Bailey: Uh, no, respectfully, Dr. Sloan, I disagree. I think it's extrememly important. Now if you had read the file likw you said you did, you'd know that she'd have massive scar tissue exactly in the area that you're dissecting, so I think going forward with that dissection is a monumentally stupid course--
Jackson: Respectfully, Dr. Bailey, the bulk of that scar tissue is gonna be found near her axilla. So if Dr. Sloan continues dissecting right there, I really don't think there'd be a problem. And I-I read that in-in-in the file-- the Carrie file that you gave me to read, I... I did, I did read it. (Carrie's montior starts beeping) Oh, we got a big bleeder here.
Bailey: Respectfully, Doctors, I told you so.
Lexie: You should at least listen to her.
Derek: Look, I swear, you gotta stop encouraging her.
Lexie: Well, this is what you taught me to do. You taught me to not give up until we've tried everything.
Derek: Because you can handle it. When we lose a patient, I know if you're okay or if you're not because I'm right there with you. But with her, I cannot do that, because I don't think she can handle it. Not now.
Lexie: You are the one who's too emotionally involved. Okay, if this tumor had come to you from any other doctor, you would still be looking at it. You are so worried about your sister's outcome, you won't even think about her patient's. Am I wrong? (Derek sighs)
Mark: Oh, that's a good looking lymph node. You got it?
Jackson: Yeah. Oop.
Bailey: Did-- Did he say 'oops'?
Mark: Dr. Bailey. What a pleasant surprise.
Bailey: The man said 'oops'.
Jackson: I didnt't. Actually, Dr. Bailey, I just said 'oop'.
Mark: He was picking up a lymph node, almost dropped it, but didn't. Let's make some room so Dr. Bailey can get a better view of our every move. As you were, Avery.
Bailey: You-- You don't want a little more suction, Avery?
Mark: Dr. Bailey, while I'm always glad to hear your perspective, I'll instruct the resident.
Bailey: But your intstructions result in oops. We don't oops in my O.R.
Mark (to Jackson): Let's try a little more suction.
Callie: Grey, I'm surprised. I wouldn't think you'd be thrown by a little thing like a severed finger.
Meredith: Yeah, well, it's just, it smells like pork.
Alex (watching from the gallery): There she goes again. She's gonna yack.
Jackson: Would you quit with that? I gotta finish this thing before I go into surgery. Hey, where is your study lackey?
Alex: Of course the one competent intern in the whole program just so happens to be pregnant and needs surgery for a coronary artery dissection.
Lexie: Morgan needs surgery?
Alex: How do you know about Morgan?
Jackson: Everybody knows about the pregnant intern, Karev. (gets paged) There's my ride. Gotta go.
Lexie: If Morgan needs surgery then why are you here?
Alex: My attending gave me a job-- Call the boyfriend. I left like, six messages.
Lexie: Chris is a fourth year at the Cleveland Clinic. I mean, you know how busy it gets.
Alex: How do you know his name?
Lexie (looking at Mer & Callie operating): They're not just amputating and fitting him for a prostetic?
Alex: Nope. She thinks she's gonna be able to salvage the finger bits and reattach, because she's cracked.
Amelia: Oh, that's gonna be so much harder.
Lexie: You know what else would be harder? Going through the carotid.
Alex (laughs): For fingers?
Amelia: It would be harder, tut there'd be better control than going through the femoral. (Lexie and Amelia leave)
Alex: Oh, here we go again. Come on, Mer. Just a few chunks. Oh, come on. Just puke already.
Amelia: I've been at 97 seconds for eight freakin' tries now.
Lexie: Maybe not the ninth. If I can find another stopwatch.
Amelia: I mean, Derek's probably right. I'm just-- I'm gonna let her down. He should know. I've let him down enough times.
Lexie: Let's take a break. Let's go, uh, you want to get something to eat?
Amelia: I want something. ... It's not food.
Lexie: There's a guy who got his hand stuck in a meat grinder.
Amelia: I... wouldn't mind seeing that.
Bailey: In 2004, I was removing mets from Carrie's Rissler's abdomen and pelvis, and decided to go for one near her liver when she started bleeding out. As I was trying to stop the bleeding, she went into heart failure. I had to send her to the ICU, tell her daughter Erin that she was in a coma and there was a good chance she wouldn't wake up. But she did. And she still had two more surgeries ahead of her and chemo and radiation. Her body is a battlefield--
Mark: I get it. You talked her out of it.
Bailey: No. You're going the lymph node transfer, but not without reading every page of this file twice.
Jackson: But we're supposed to operate in a half hour.
Bailey: Then start reading. (Jackson takes the file) I'm watchng you, Avery.
Original International Air Dates:
Canada: February 16, 2012 on CTV
Norway: July 31, 2012 on TV2
Germany: October 31, 2012 on ProSieben