The Chief makes a career-changing decision that shocks Seattle Grace Hospital; Cristina and Owen try to find normalcy in their relationship; April continues to struggle in her new role; and the 5th year residents are given their first solo surgeries, only to find out that even the most routine procedures aren't always easy.moreless
Dr. Teddy Altman
Dr. Arizona Robbins
Dr. April Kepner
Dr. Jackson Avery
Dr. Meredith Grey
Dr. Cristina Yang
Chyler Leigh (Lexie) does not appear in this episode.
Derek is blacklisted from ever doing a clinical trial again.
Richard: Okay, let's get started.
Mark: Yep, got a lot of standing around to do today.
Richard: He's right, people. Starting today fifth year residents rotate in as lead surgeons.
Callie: And we've alerted the morgue.
Richard: Attendings, you will observe and stay silent. Offer help only when you absolutely have to.
Bailey: Yeah, before you help them swim, let 'em sink a little.
Richard: Next order of business: Effective at 9am this morning I have resigned as Chief of Surgery at Seattle Grace Mercy West hospital. I will stay on the surgical staff and I will turn this meeting over to the new Chief of Surgery, Dr. Owen Hunt.
Owen (stands up): Thanks, Dr. Webber. I know this comes as a surprise to you too and I appreciate over the next couple of days your help and your patience. So, I have your call schedules, but I can have them--
Arizona: Wait, what happened?
Mark: Why did it happen?
Derek (quietly, to Richard): Is this the board? Are they forcing you to step down?
Teddy: Hunt. You're the new Chief of Surgery. Nice!
Bailey (annoyed): Dr. Hunt, may I have my call schedule, please?
Owen: I'm sorry?
Bailey: My call schedule. Which I usually get at the staff meeting but I didn't because you said that you would distribute them but you haven't so I have to come find you and you're not very easy to find, not unlike my call schedule. So, may I have my call schedule, please?
Owen: Of course. I... Just as soon as...
Bailey: Thank you. (walks off)
Callie: That was very less chief-y there.
Owen: Okay, what did I do?
Callie: Oh, nothing, nothing. She was Webber's right hand man, she'd hate anyone in your position. I know it's not about making friends, but you really want Bailey as your enemy? (walks off)
Callie: No, leave it up, leave it up. I'll just do the meniscus repair myself.
April: Great. And now I lose a procedure. This is worse than being an intern.
Callie: Yeah, being chief resident sucks. I did it once.
April: Well, how'd you do it? How'd you get them to listen to you?
Callie: Uh, I didn't. I sucked. (laughs) Look, it's not about making friends but it is about getting them on your side. You wanna be the person that they come to not the one they run from. Y'know, kinda like your little contest, you know, getting them to compete for good outcomes.
April: I know, it's awful, right?
Callie: No, it was a good idea. They thrive on competition. You gave them what they needed. And either way, the patient wins. That was a good idea.
Callie: That wasn't your idea, was it?
Meredith: We should have never been together in that OR today.
Derek: What do you mean?
Meredith: We're not a team anymore, anywhere. And when we get Zola back, before we get that phone call we need to figure out if we can be one. If we can even be together. So, now is the time to say how you feel.
Derek: I can't. I'm gonna say things that are uh...
Meredith: Oh, Derek, just say it. Whatever it is, we can deal with it. I can accept the consequences.
Derek: Meredith, you have never accepted a consquence in your life. Since the moment you switched over those files you haven't suffered one bit.
Meredith: That is not--
Derek: While those around you have lost their jobs and lost their reputations.
Meredith: And I lost Zola.
Derek: So did I! Because when you do things, you just dive in and never give damn about how deep the water is and who you land on.
Meredith: I know that I messed up. But all of this happened before Zola was even in the picture. Don't you think I've changed?
Derek: I don't think you can change. You stole a baby, Meredith.
Meredith (sighs): I told you why I did that. What do you need for me to say I'm sorry?
Derek: I need you to be sorry.
Meredith: Of course I'm sorry.
Derek: You did it again today in the OR.
Meredith: What? I had a successful surgery today.
Derek: You refused to listen to me.
Meredith: I didn't listen to you because I didn't need to listen to you. I knew what I was doing and I was right. You just couldn't trust me.
Derek: Why should I ever trust you? Why should I trust you? You ended my trial, you set back my career, you nearly ended your own, you destroyed Richard's. I have no reason to trust you.
Meredith: Then why are you with me?
Derek: Because of that. (points at the post-it) Because I meant that. I promised that I wouldn't run. I promised that I would love you...
Meredith: ... even when you hate me.
Derek: Even when I hate you. I'm trying, Meredith. I am trying but you make it so damn hard.
Meredith: I understand and I don't want you to keep the promise, not if you don't want to. And not if you can't trust me with our daughter.
Derek: I do. I trust you with Zola.
Meredith: Well, you just said--
Derek: That's not what I said! ... I know you took her to protect her. I know you altered the trial for Adele and Richard. You stood in front of a bullet for me. I know why you do all of it. It's what I love about you.
Meredith: And what you hate about me.
Meredith: So, you can't trust me at work?
Derek: No, I can't.
Meredith: Well, that's easy then. So, we just don't work together.
Derek: So what are you saying?
Meredith: I'm off your service. That's my consequence. If we wanna stay together, with or without Zola, we just won't work together.
Richard: If you wanna be mad at someone, be mad at me.
Bailey: I'm not mad at you.
Richard: Yes, you are.
Bailey: Everyone knows who to be mad at.
Richard: The only thing that Meredith did to me was to give my wife a little more time. And I'm damn sure gonna spend it with her. I'm happy, Bailey. And I'd like you to be happy for me, too.
Bailey: I'll try. ... You're gonna have to give me a while.
Richard: I'll wait.
Owen: Uh, Dr. Bailey, hold up please. Uh, I learned in the Army that a leader is only as good as the people around him. Now, you are one of the best people on this team and I just wanna make sure that I have you on my side.
Bailey: Have I done something wrong?
Owen: Uh, no.
Bailey: Is there something in my job performance that prompts you to ask me this?
Owen: Not-- No.
Bailey: Or do you just need me to like you?
Owen (laughs): It-It's not that.
Bailey: Are you sure?
Owen (shocked, shakes his head): Carry on, Dr. Bailey.
Jackson: Okay, so who lost the bet?
Meredith: Not me. My bomb was diffused perfectly.
Cristina: My appy was flawless.
Jackson: Except it was finished by a nurse.
Cristina: Who told you that?
Jackson: Karev's guy didn't even wake up, septic shock.
Cristina: You blew a bowel resection? That's like mispelling your own name.
April: Hey, guys.
Jackson: Well, it's Karev. Sorry, dude but enjoy that skills lab.
April: Can I just point out that Jackson never even touched his patient. Sloan did the whole procedure.
Jackson (quietly): What does between you and me mean?
April: So, it would seem to me that he loses by forfeit.
Jackson: I don't think that that's--
April: You want a rematch? We could go again tomorrow.
Cristina: And the next day.
Meredith: And the next day.
Cristina: I don't wanna go home.
Meredith: I don't, either.
Cristina: Do we really have to talk about it?
Meredith: Yes, you do. Maybe I'll come over later.
Cristina: Oh, that would be great.
Meredith: No, actually that would be bad because that would mean that my marriage is over.
Mark: No shame, no shame at all. You're still the goober.
Cristina: I can't remember the next step.
Teddy: Well, you might remember this the next time your screaming at an intern for skipping the fundamentals.
Cristina: Will you just do it, please?
Teddy: Take your time. It'll come back.
Cristina: No, it won't, honestly. I can stand here all day. It's not gonna-- Oh my God, you don't know either.
Teddy: Don't try to make this about me.
Cristina: Okay, then tell me what to do.
Teddy: You should now what to do.
Cristina: So should you.
Teddy: Well, it's been a little longer since I've done one.
Cristina: Well, I need your help.
Teddy: We need to be helping her right now.
Nurse: You probably want to ligate at the proximal edge, apply a straight clamp and lay down a per-string suture at the base.
Teddy: Of course. Thank you. I got it.
Cristina: I got it.
Arizona: You know, you have a kid and your worry a lot about screwing them up. Like something you do or say, or something you don't say will change 'em forever.
Jackson: Yes ma'am.
Arizona: I was just thinking, you're totally determining the course of this kid's life. You will determine whether or not this kid gets made fun of for his looks or if he cries when he looks at his school picture every year. And today you will decide who goes to prom with, and who he will marry, I mean if he gets married at all. If he dies all alone, unattractive and unloved. Did you want me to call Sloan?
Teddy: What are you doing now?
Cristina: Are we still doing this thing where I have to tell you every little move?
Teddy: It never gets old. What are you doing now?
Cristina: Blind seperation of the oblique muscles.
April: You know Sam's wife took care of him after his last two surgeries, she died of a stroke last year. His son Jason dropped out of college one semester before graduating and he was--
Alex: What the hell, Kepner. Why are you telling me this?
April: Talking to paitents is your job, Alex. Because they're more than just... an easy A or something that you can win. It's your job.
Alex: No, it's not. Not anymore. My job is to open him up and to fix him. And if I can't do it, no one's gonna do it for me. It's on me. So I can spend time talking to him or I can use that time figuring out what I'm gonna do after I open him up. Which one do you want me to do?
April: You're really nervous. That's why you didn't wanna work on a kid today. Look, you'll be fine. You're ready. I mean, you feel ready, right? (Alex nods)
Richard: I am throughly enjoying this book, Karev.
Alex: That's great.
Richard: Hopefully I'll finish it in there. Because as long as I'm reading it means that you're not screwing up. Will I finish this book today?
Alex: Yes, sir.
Owen: Hey, so you going in for your mitral valve?
Cristina: My mitral valve turned into an appy.
Owen: Oh, right, well, good luck. ... Oh, so does that mean you'll be home tonight? I mean an appy's what, two hours, tops, right?
Cristina: Right. Well, th-that is true. ... Oh, do you want me to pick something up?
Owen: Or I can. Chinese?
Cristina: Oh, fine. Whatever.
Owen: No, y-you chose.
Meredith (overhearing): Do Chinese, Chinese is great.
Owen: Good. Right. Well, good luck And you, too, Grey. (walks off)
Meredith: You have to talk about it because clearly you can't talk about anything. You two are like bad roommates.
Cristina: How? How do I bring it up? I mean, does he even want me to bring it up? And what is there to talk about because it's done, I can't undo it. It's done.
Meredith: Yeah, but it's not.
Cristina: We have surgery.
Meredith: Don't screw it up.
Cristina: You, too.
Cristina: Next step. You.
Intern: Lift up parnium, open transversly and inlarge the incision.
Cristina: Inlarge how?
Intern: W-With scissors?
Cristina: Are you asking me or telling me? (snaps her fingers at an intern)
Intern 2: With scissors.
Cristina: Okay, okay. Good. Then what? You.
Intern 3: Pull out and isolate the appendix, cross clamp it at the base and...
Cristina: And go on.
Intern 3: I can't remember.
Cristina: Unacceptable. God, you should know this.
Intern 3: Cross clamp the appendix at the base--
Cristina: Yeah, you already did that, okay? Hurry up, he's dying now.
Intern 3: Tie off or wait, li-ligate--
Cristina: Okay, you're losing him. Beep. Beep.
Intern 3: Wait, hang on.
Intern 3: Wait.
Cristina: Beeeeep. Call the morgue, moron. He's dead. Okay, who's next? You.
Arizona: It's perfect. It's a perfect malar rotation on a pig. This pig is now more attractive than your average pig.
Jackson: I deserve to do it. I'm ready, I can do it, I deserve it.
Arizona: You're right. You go, Gunther.
Owen: Dr. Bailey, your call schedule. I'm sorry it's taken so...
Owen: Dr. Bailey, I know you've take over Dr. Webber's ilet cell trial, and I wanted to offer you some protected time for your research. Reduce your OR schedule, lighten your teaching load, make sure you get that time that you need. How does that sound?
Bailey: You tellin' me I don't manage my time well?
Owen: No, no. I- Uhhh, I-I just wanted to make sure that your research got the time and--
Bailey: Oh, you're telling me how to use my time?
Owen: Not at all. I wouldn't. I'm sorry. Just forget I mentioned--
Bailey: Oh, now I don't get the time?
Owen: No, y-you do, you do. You can just do what-- (Bailey scoffs and walks off)
Cristina: I need your pig. I need to remember how to do an open appendectomy.
Alex: No. Does a pig even have an appendix?
Cristina: Oh. Let's find out.
Meredith (walks in): Who wants an aneyurism?
Cristina: I'm about to have one. I have to do an appy.
Meredith: On a pig? Does a pig even have one?
Cristina: No, on a person. I haven't thought about one in... three years.
Meredith: Oh. Well, who wants to trade? I'll do anything.
Alex: I don't know. Clipping those things is like diffusing a bomb, one wrong move and it explodes.
Meredith: Well, I'm worried about Derek exploding.
Jackson (walks in): Can I have your pig?
Jackson: Well, how about just the head, huh?
Meredith: Wanna clip an aneyurism?
Jackson: Good luck, Macguyver.
April (walks up): Ah, there you are, Alex--
Alex & Cristina: Does a pig have an appendix?
April: I don't know.
Cristina: I thought that you were teaching my skills lab.
April: I am. I just left them to practice whip stitches.
Alex: Stop, turn off the lights and close the door. Check this out, I injected florcine die, it makes any viable part of the bowel glow.
Alex: I used to have a Metallica poster just like this.
Meredith: You might win the bet.
Cristina: Yeah, with a color coded colon.
Alex: No kidding.
Meredith: I have a bomb to diffuse. (walks out)
Cristina: This is crazy. I gotta find a book or a skills... Oh! Skills lab! (walks out)
Jackson: I gotta get some instruments. I can use the head, right?
April: Will you talk to Jason Kenton? He has some questions.
Alex: I'm busy.
April: Turning a pig into a lava lamp? My patient--
Alex: Not my job, you talk to him.
Cristina: I was right. Ruth Bennett's scans show appendicitis, the moron's missed it. I'm shipping her to general surgery for an appendectomy.
Teddy: Why don't you do the appy?
Cristina: Where do I start? Because it's general surgery and I'm on cardio. Because it's first year and I'm fifth year. Because--
Teddy: You know, this is great. Ruth has a heart condition and I mean, we have to monitor her anyway and because of her COPD she has to have an open appy. And we don't want some moron doing it. And you get a procedure.
Cristina: It's a very basic procedure.
Teddy: But you love the basics and your about the fundamentals.
April: Dr. Torres I need to push my meniscus repair until tomorrow, I have to teach a skills lab.
Callie: A skills lab over surgery?
April: Yeah, and then I have to assist Karev on a bowel resection.
Owen: You should be delegating that stuff, Kepner.
April: I tried but no one would cover it.
Owen: Don't try, Kepner, just order them. Leadership isn't about making friends.
April: Oh, then I'm doing it right. (walks off)
Callie: That was nice. Very chief-y.
Arizona: Ugh. It's so sad. I mean, how many years was he chief for?
Teddy: I mean, are we supposed to all pretend that we don't know what really happened?
Arizona (sighs): Why did he cover for her? I mean, what's his deal with her? (Richard walks in)
Arizona, Bailey & Teddy: Hey!
Richard: Good morning, laides. (opens the fridge) So what's the system here? Does everyone have a spot or...?
Teddy: Anywhere is fine.
Richard (puts his food in the fridge): Right here. And I will see you later. (turns to leave) And you all have an excellent day.
Arizona: You, too.
Richard: Already am. (leaves)
Teddy: I mean, he's trying so hard.
Arizona: He talked to a sandwich. (Bailey gets up and leaves)
Intern: Ruth Bennet, age 50, mitral valve replacement, complained over night of stomach pains.
Cristina: These stomach pains, what did you do? (they all raise their hand) You.
Intern 2: We tested her cardiac enyzmes and ran an echo. Both normal.
Cristina: Did any of you touch her stomach? (they are all silent) No one touched the patient. Are you guys the slow class? Palpating the patient's abdomen is first before tests or labs, basics, people, fundamentals. I'm all about not skipping steps. (Cristina touches the patient's stomach, she says 'Ow') I'm sorry. Does it hurt more or less when I take my hand away?
Cristina: See? Basics. Take Mrs. Bennett for a triple contrast CT and try not get lost.
Alex: Hey, I need an intern to assist on my bowel resection.
April: Well, everyone's book so good luck finding someone.
Alex: Isn't that your job?
April: No, my job is making the schedule that you screwed up.
Arizona (walks up): Ah, Karev. I just saw that you turned down my three month old's esphogial ateriga surgery for Webber's (acts like she's falling asleep) I'm- I'm sorry, I was trying to say Webber's bowel resection but then I fell asleep.
Alex: I just thought I could use more practice with bowel resections.
Arizona: No, you're trying to pad your boards with good outcomes so you went with the easy A. You keep that up and you're gonna low-ball yourself out of the fellowship. (walks off)
April: Is that what you're doing? Or is this about winning that stupid bet?
Alex: Just find me an intern.
Richard (walks up): Karev, you ready for your surgery?
Alex: Uh, I think so, sir. Kepner's having a little trouble getting it staffed.
Richard: What's the problem? I've been treating Sam Kenton for years, I don't wanna have to postpone.
April: Uh, no, sir. No, sir. I-I will find someone to assist. I'll get it covered, even if I have to do it myself.
Richard: Well, great.
Cristina: How does he not tell me he's Chief of Surgery?
Meredith: Well, is it because you...
Cristina: Didn't have his baby?
Meredith: Well, has he said anything?
Cristina: No. We haven't talked about it.
Meredith: At all?
Cristina: Is that bad, that's bad, right?
Meredith: Well, I mean--
Owen (walks up): Oh, hey.
Cristina: Hey. I-Is it true?
Owen: Uh, yeah.
Cristina: Oh my God, wh-when did you...
Owen: Uh, Webber talked to me last night. I was gonna tell you but you were already asleep, and then this morning you were already gone.
Cristina: Oh, yeah. Um, m-my mitral valve.
Owen: Right, right. Right. Sorry, sorry. Good luck.
Cristina: No, no. Oh, what about you? You-- You're the-- Uh, th-this is great. We should celebrate.
Owen: Uh, I guess so. Yeah. Um... dinner?
Cristina: I have my surgery, mitral valve takes like a minimum of seven hours.
Owen: Oh, well, sometime, okay? 'Cause I gotta... (points to charts)
Cristina: Oh, congratulations, congratulations. (they hug awkwardly. Owen walks off)
Meredith: Yeah, that was bad.
Richard: Is that Alzheimer's trial? Have you heard anything from the FDA?
Derek: I'm sending it to Phoenix. Earl Blackman is taking over. I'm blacklisted. I may never do another clinical trial ever again.
Richard: I've been blacklisted, too.
Derek: And now you're gonna let them fire you.
Richard: I fired myself.
Derek: It was one thing taking the blame for Meredith for abusing the trial but why are you doing this to yourself?
Richard: You know, I came to ask if you've heard anything about your little girl.
Derek: No, I have not. This is not right.
Richard: I hope you hear soon.
(Looking at the surgical board)
Cristina: OR three. Yes. I love OR three.
April: Bowel resection? I thought you had a peds case.
Alex: I switched last minute.
April: You can't just switch.
Cristina: Oh, plastics. I thought you were the Gunther. Wasting all your capita on boob jobs, huh?
Jackson: It's a cleft lip. I'm changing a kid's life today. Look at Kepner, she's fixing a bum knee. Way to shoot for the stars, kid.
April: Okay, guys, you also start teaching skills labs today. I made up a schedule for the month, it's up on the board in my office.
Meredith: In your what? (April opens the door to her office)
Cristina: When did we get this?
April: Uh, we didn't It's for the chief resident, actually.
Alex (about the couch): This is good. I can sleep on this.
April: Yeah. I-I got that on Craigslist. It-It's mine.
Meredith: We got a fridge. (Jackson knocks over a plant, Mer laughs)
Cristina (about the board): What's going on with this?
April: Okay, guys. These are this months intern's skills labs. Each of you has been given one skills lab to teach.
Cristina: Oh, I can't teach today, I'm on a mitral valve.
April: Okay, well then switch with one of these guys.
Jackson: I got a baby's face.
Alex: Bowel resection.
April: Guy's come on. I divided these up fairly.
Jackson: You come on. Every surgery we do this year could end up on the oral boards.
Alex: And they love pickin' the crappy outcomes.
Cristina: This could effect which fellowship I get. I mean, it's not just life or death, April. Now it's our careers.
Meredith: Okay, how about this: Whoever has the worst outcome today teaches all the skills labs for the whole month.
Cristina: That's good.
Alex: I'm in.
April: That's terrible. Th-That's disgusting. No, no, no. There will be no waging on patient outcomes. Th-That's an order.
Alex: So, you're out then?
April: Y'know, just out of my office.
Cristina: Hey, what's going on? Anything about Zola?
Meredith: Oh, no. We were supposed to hear yesterday and then yesterday is today, so, is it up yet?
Cristina: Oh, don't know. Are you okay?
Meredith: I have no choice. I'm clipping my first aneurism today.
Cristina: Well, I got a valve replacement. My valve replacement. Altman just has to shut up and watch. I hope I get a good OR.
Alex (walks up): Is it up yet?
Meredith: No, not yet.
Alex: Hey, you heard anything about Zola?
Meredith: I haven't heard anything.
Cristina: And she's clipping her first aneurism. Are you sure you don't wanna start with something simpler?
Alex: Yeah, like juggling chainsaws.
Meredith: Oh, thanks, that's helping.
Meredith (opening voiceover): You work, you study, you prepare. Months and years leading to one day, the day when you step up. On that day you have to be ready for everything, but there's one thing you can never quite prepare for. A day when you step down.
Meredith (closing voiceover): Sometimes it happens in an instance. We step up, we see a path forward. We see a path and we take it. Even when we have no idea where we're going.
Music Featured in this episode:
"Lost and Found" by Katie Herzig
Original International Air Dates:
Canada: September 29, 2011 on CTV
Sweden: October 19, 2011 on Kanal 5
Germany: April 11, 2012 on ProSieben
Norway: April 24, 2012 on TV2
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