Meredith: Bailey had no business calling you out like that.
Derek: She's nervous. Everybody's nervous. Everybody should be nervous.
Meredith: It's not our fault. Is it?
Derek: It feels like it is.
Meredith: Hey, congratulations.
Derek: For what?
Meredith: You acoustic neuroma. You got your hand back. You're you again. We can be happy about that. I flew on a plane today.
Derek: You did?
Meredith: I did.
Callie: Ugh. This... (scoffs) This is so stupid. We're a level-1 trauma center. This woman's an idiot.
Arizona: Well, and a little bitchy.
Callie: Ugh. (groans) This was supposed to be a good day. Shepherd did a 23-hour surgery. We're supposed to be popping champagne.
Arizona: Let's try and go to sleep.
Callie: Ugh! I don't think I can. I'm so pissed.
Arizona: Do you want to go to the beach with me?
Callie (laughs): What?
Richard: Alana. Uh, you've been here three days. I've been here for years. Maybe you judged us a little harshly. Maybe we can work together--
Alana: Being a harsh judge is a necessary part of my job, sir. I can see you're disappointed in me, but it was your job to judge me when you were my teacher. You're not anymore.
Richard: No, that's not the case. I'm--
Alana: You said something to us during my intern year that I have never forgotten. You said 'Medicine is constantly changing. You need to be part of that change or get out.' I'll be making some changes. You should be proud of me. By the way, you logged fewer O.R. hours than any other general surgeon on staff last month. Good night.
Alana: Alright, alright. Thank you everyone for coming. It has been a privilege to watch you work, and I am so impressed with what I've seen. Dr. Karev's pediatric African exchange program--
Cristina: You cannot cut that program. I'm sorry, but these children, these... little orphans-- We are the only hope they have. (Bailey rolls her eyes and Mer smirks) Many of them have rare disorders that most Western doctors rarely have the opportunity to treat. And if you stop the program, I will never get that chance again. ... They. They will never get that chance, the precious children.
Alana: I have no intention of cutting it.
Cristina (to herself): Super.
Alana: Alright. It's a no-brainer from a P.R. standpoint. That kind of positive visibility is gold. However, there will have to be some cuts. And I'm going to suggest one that is going to seem surprising at first, but that addresses fiduciary concerns with nominal impact on the core facility and the human and physical resources.
Jackson: Oh, I'm sorry. What?
Bailey: Uh, yeah. I'm out.
Alana: I am proposing that we close your E.R.
Owen: We're a level one trauma center.
Richard: We're a hospital.
Alana: In the last three days, your E.R. went from being in shambles to peak efficiency.
April: Well, then why would you propose cutting it?
Alana: This allowed me to see that in either case, it's not bringing in the money.
Owen: It's bringing in the patients.
Alana: Over half of who are non-emergent, under-insured, and belong in a primary care physician's office. You have surgical interns in there doing chest exams. It's hemorrhaging resources. Look, I know these cuts are going to be painful. But understand that I am trying to keep your hospital doors open.
Derek: This is ridiculous. You can't close the E.R. You went to med school. You have to ask yourself--
Bailey: Do you have a better idea? Because the way I see it, this woman is trying to keep the hospital from closing, in-in which case there'd be no patients, we'd have no jobs, and some of us don't have a few million to fall back on. So unless you have a better idea, why don't you just sit there and listen to what she has to say?
Alana (clears throat): Alright. So the other proposals... (music starts playing as the scene fades)
Alex (about Nyah): Her heart is pumping like a champ.
Makena: Thank you. Both of you.
Cristina: What else do you have over there?
Makena: I'm sorry?
Cristina: Uh... sick... orphan... children? Kids with heart problems? (Alex nudges her) Ah.
Alex: She means, she's glad the program is up and running again. Both of us are.
Shane: Oh, no. Did I step on your foot?
Meredith (crying): No. I'm not mad this time.
Shane: Oh. So you cry when you're happy, too?
Meredith: Apparently! Eyes on the liver, learn something.
(Arizona is having phantom pain during surgery)
Owen: Robbins. Try to picture the waves.
Arizona: I'm trying.
Cristina: Okay, really, what is-- What is happening?
Owen: Just calm the waves.
Arizona: These are tsunami-force waves, Owen.
(Arizona is having phantom pain during surgery)
Alex: I can switch--
Arizona: Just shut up, I'm at the beach.
Alana: I was worried I missed the whole thing. Where are we at?
Derek: Where we're at is, I'm trying to focus.
Alana: I mean, how long has the patient been open?
Derek: Counting the minutes I'm wasting answering your questions?
Alana: I'd have fewer questions but your intern told me that the surgery had been moved to 3:00. Clearly, it wasn't. So forgive me if I'm trying to play catch up.
Jo: Intern mistake. I apologize--
Derek: Dr. Wilson was under orders not to allow any visitors--
Alana: I'm not a visitor, Dr. Shepherd.
Derek: Anyone who is not surgically necessary is not welcome in my O.R. (Alana leaves)
(Arizona is having phantom pain during surgery)
Arizona: I have to switch, Alex.
Cristina: No one is switching. You're holding the mitral valve, so don't move.
Alex: What's wrong? Are you sick?
Arizona: Take that scalpel...
Cristina: What? What are you doing?
Arizona: And stab me in the foot.
Alex & Cristina: What?
Arizona: My prosthetic, stab me. What is wrong with you?
Owen (from the gallery): Dr. Karev, I am the chief of surgery. This is an order. Stab Dr. Robbins in the foot right now.
Cristina: What? Alex. Arizona? Alex! (Alex stabs Arizona's foot)
Arizona (looks down at the scalpel in her foot): That's better. That's better.
Alana: And how much does the Africa program cost?
Owen: Less than you'd think. Admin costs comes out the endowment, and all the surgical time is donated.
Alana: But endowments don't tend to grow with the popularity of these programs, where, very soon, you have every sick kid in Africa banging down your door.
Meredith: Okay, Ross, there's the knot.
Shane: It's a nice one. Uh, okay. Yes, thank you. Scissors.
Meredith: Careful now. We're just gonna cut the suture as close to knot as possible without--
Shane: Oh, no.
Meredith: Are you serious?!
Shane: Oh, no, no, no, no.
Meredith: You cut the hepatic artery in the hilum. You cut the hilum before I had a chance to say, 'don't cut the hilum!'
Doctor (to his intern): See what he did? Don't ever do that.
(Mer is on the phone with U.N.O.S)
Bailey: Is it viable?
Shane: I think it's a match. She'd be crying if it wasn't. She cries when she's angry, which is whenever she sees me. Look. She's looking at me and not crying. It's gotta be a match.
Meredith (on the phone): Thank you so much. Thank you. (hangs up her phone) We have a match. You're gonna fly to Portland, Oregon.
Shane: I will fly to Portland, Oregon, to retrieve a liver for a woman who I've already destroyed one liver? Is that the wisest use of our resources?
Meredith: I can't. I can't get on a plane. You know that.
Bailey: I know you haven't been on a plane. Maybe it's time you try again.
Meredith: Their procurement team is going to do all of the work.
Bailey: You know good and well we prefer to do the recovery ourselves.
Meredith: All he has to do is carry a cooler.
Meredith: If he's been to a picnic, he can handle this. Shane, have you ever been to a picnic?
Shane: I've been to a picnic.
Meredith: Oh, look at that. He's been to a picnic.
Bailey: These women deserve more experience than a fool who's eaten a potato salad in a park.
Shane: She's right. Maybe I'm not the best person--
Bailey: You're an intern. Of course you're gonna make mistakes. Bad things happen, but you have to move past it. Leave it behind you, the sooner the better, or it'll eat away at you and stop you from moving forward. So just get over yourself. Move past it, and get your butt on that plane.
Shane: So... now I'm confused. Who's going to Portland?
Meredith: I can't. (walks off)
Bailey: You and I are going to Portland.
Stephanie (while Jackson is kissing her neck): C.T. results on pelvic fracture. Thoracentesis if positive effusion.
Jackson: Um, musculoaponeurotic grafts?
Stephanie: What are you doing? (laughs)
Jackson: What am I-- What are you doing? I thought you were trying to talk dirty. I don't want you to feel like the only giant nerd.
Stephanie: I was talking out loud?
Jackson: Yeah. (Stephanie laughs) Though I was weirdly kind of into it. (pushes her down on to the bed)
Stephanie: Um, I have 60 million things to do today, and I'm sure I'm gonna forget something. (Jackson takes off her shirt) Kepner's running me ragged.
Jackson: And that's not working for me anymore. Um... you know, if you're too busy for this, we can, um...
Stephanie: I am not too busy for this. (they kiss) I am too busy for this.
Stephanie: Thank you for understanding.
Owen: Okay, breathe. Try to calm the waves. Try to slow them down.
Arizona: What-- What's the point here?
Owen: Well, the idea is, if you can teach your mind to calm the waves, you can teach it to... calm the pain.
Arizona: But I... (sighs) I-I can't do it. I can't do it. This is dumb.
Owen: This is not dumb. It is biofeedback.
Arizona: Look, I can't-- I can't stop the stupid make believe waves. So... What else you got?
Owen: Well, I have a minimally invasive spinal surgery that can deaden your nerves.
Arizona: No, no, I have to operate today.
Owen: Then I got make believe waves or I got a make-believe waterfall, or a make believe campfire. Or I could find a screwdriver and stab you in the foot.
Arizona: Just stab me in the head. (puts back on the vision headset)
Shane: I hope you won't mention my colossal incompetence to your husband. He... still thinks I'm the golden boy.
Meredith: No, stop that. You don't get to do that. You don't get to feel sorry for yourself or make little self-deprecating remarks. You destroyed a perfectly good liver today. When I look at you, that is all I see. A perfectly good liver.
Shane (as his phone is ringing): Uh, hold on a sec.
Meredith: I'm not done. Put your phone away.
Shane: I'm-- I'm sorry.
Meredith: Don't be sorry. Be better.
Shane: I think it's U.N.O.S.
Shane: I want you to know, the thing with the labs, it won't ever happen again.
Meredith: Okay. Just let it go, okay?
Shane: Congrats on the baby.
Meredith: Thank you.
Shane: You must be, what, three months in? Baby's the size of a lemon. So... second trimester, huh? The fetus is growing feet... discharging urine into the amniotic fluid. And you must be feeling better, less nausea. But the second trimester's also known to bring with it swollen gums, heartburn, gas--
Meredith: Do you want me to start crying?!
Meredith: Dr. Bailey. Can I please get another intern?
Cristina: What's wrong with Ross?
Meredith: A lot.
Bailey: The kid made a tiny mistake.
Meredith: Because he's an idiot. If I have to work with him one more second, I'm probably gonna kill him.
Bailey: Uh, you think I didn't want to kill you? You cut LVAD wires, and yet there you stand. So... be merciful and suck it up.
Arizona (sitting down with her leg off): That was the efficiency lady, right? Yeah, so I probably look as crazy as a bag of cats. So it was nice working with you.
Owen: Is it phantom limb pain? (Arizona nods) Callie says it only happens at night.
Arizona: Until now. I'm going crazy, I--
Owen: You're not. You're not crazy. Phantom limb is a very real thing.
Arizona: I just left a surgery because there was pain in part of me that no longer exists. So, I-- What are you doing?
Owen: We're helping you visualize a leg that doesn't hurt. (sets a mirror in front of Arizona) Here we go. Now... Just look at that.
Arizona: Are you kidding me?
Owen: We are rerouting your brain, reminding it of what happened. There are many treatments for phantom limb. There's heat, there's massage, there's virtual reality therapy. I knew a guy in the army who had to stab his prosthetic with a screwdriver as hard as he could.
Arizona: Well, that's not crazy.
Owen: Well, for him, it was the only thing that worked. Now... Is your pain any better?
Arizona: Y-Ye-- It is a-a-a little.
Owen: You see? You just need to figure out what works for you. Callie knows all this. What does she say?
Arizona: I- I haven't told her.
Owen: She's an orthopedic surgeon.
Arizona: And I have been her patient for so long. And I am just starting to feel like a wife again, and she needs me to. I cannot have this. I am finally getting my life back together, and-- and I will not be screwed over by something that's not even there!
Owen: Alright. We're gonna work together. We're gonna work together, and I'm gonna help you, and we are gonna figure this out. Okay? (Arizona nods)
Alana: Are there pastries and bagels in every one of your lounges?
Owen: No. Well, I don't know. Maybe. Is that the kind of thing you're gonna be looking at?
Alana: I will be looking at everything, doctor.
Cristina: This program is a medical freakshow goldmine. They can't cut it.
Alex: Nobody's cutting it. Robbins, tell her to stop saying that.
Jo: Your hero sent me to trade services with you. (hands Shane a chart) You're welcome.
Shane: Can't. I'm waiting for U.N.O.S. to call with a liver.
Jo: So go wait in the O.R. while you play teacher's pet with Shepherd.
Shane: I'm not moving from this spot. Great cell reception, see? Five bars.
Jo: You know it's not like ordering a pizza, right? It could take days.
Shane: My patient doesn't have days.
Jo: Well, fine. I'll wait. And when U.N.O.S calls I'll run to Medusa. I promise.
Shane: Give me my phone. If I miss the call Grey is gonna kill me.
Jo: If I go back to Shepherd, and I'm not you, he's gonna kill me.
Owen: Shepherd, this is Alana Cahill. She is our physician advisor.
Derek: Derek Shepherd. (they shake hands)
Alana: Neuro. I saw you're doing an acoustic neuroma. Very exciting.
Derek: First thing tomorrow.
Alana: Patient's here today. Are pre-op overnight stays typical in all departments?
Derek: That is a question for chief Hunt. Now if you'll excuse me I have to prep.
Alana: Well, I'll see you in the O.R. tomorrow.
Derek: Typically, you need to be invited.
Alana: If things were running typically I wouldn't be here, now would I?
Meredith: Do not... say anything.
Shane: I am so... so sorry.
Meredith: Wow. Is this you not saying anything? (turns her back to him and starts crying) Go away and do not come back without a liver.
Shane: Um, can I get you a tissue?
Cristina: Nice program. Shame to see it go.
Alex: Thanks. Wait. What?
Cristina: We're getting a visit from the efficiency fairy. You think she's not gonna make this disappear?
Alex: Look, shut up. We just got it back.
Cristina: She's trimming fat. You're flying kids across the world for a pro bono surgery. That's pretty fatty.
Alex: Yeah, they're orphans.
Cristina: Well, now you're just making my point.
April: I apologize for the wait, ma'am. You're experiencing shortness of breath?
Alana: Luckily, no. 45 minutes in an E.R. bed before a doctor pulls of a stethoscope? I'd likely be experiencing shortness of life.
April: I don't understand.
Alana: Alana Cahill. I'm a physician advisor. Could you point me towards chief Hunt? I'm afraid you've made me late for a meeting.
Stephanie (to April): My bad.
Stephanie: Dr. Kepner, um, we're swamped, and I have a shortness-of-breath lady who needs a consult, and you probably have better things to do, but I need help, please. I'm drowning here.
April: What bed?
Stephanie: One, two, three--
April: What are you-- Stop it. Edwards, if you're covering the pit, it is your job to know every bed in the pit. (sighs) Okay. Put on your big girl pants, you're about to learn how to run the pit. Let's go.
Meredith: Hey, can I get a minute? It's urgent.
Derek: Yeah. (cuts to them in an on-call room kissing) This was urgent?
Meredith: Yes. It's the stupid pregnancy hormones. It makes me want to have sex all the time, urgently.
Derek: Oh, I like the stupid hormones.
Meredith (after she gets paged): Oh, no.
Meredith: Oh, I have a consult.
Meredith: I have a consult. (starts to cry)
Derek: Are you crying?
Meredith: No. Yes. I cry every time I get mad.
Derek: You're not-- You're mad?
Meredith: Yes, I'm mad, because I can't have sex because I have this stupid consult.
Shane (knocks on the door): Dr. Shepherd?
Shane: Sorry to bother you, sir, but I was hoping to scrub in with you today, and I'm supposed to be on Dr. Grey's service. So I was wondering if maybe you could talk to your wife for me.
Meredith: I'm gonna kill him. (opens the door, to Shane) No, Ross, he cannot talk to his wife for you, because you are with me, and we have a consult with a pregnant lady with abdominal pain. So go do the work-up and I will see you there. (Mer slams the door on him, goes and kisses Derek and leaves)
Derek: I am liking the stupid hormones.
Owen: As many of you know, Seattle Grace Mercy West has suffered a financial setback. The administration is working hard to keep the impact of that setback as small as possible. To that end, we're gonna have to initiate some cost-cutting measures. The board has hired a physician advisor to help.
Meredith: What's a physician advisor?
Owen: Well, she consults on maximizing the efficiency, streamlining processes, assessing where we can trim our budgets.
Bailey: Who to fire and when to fire them?
Owen: She's here to advise and to help. I was hoping to introduce her in person, but she seems to be late.
Cristina: Oh, on her first day? Not very efficient.
Owen: You can expect to see her in your halls, in your labs, in your O.R.
Derek: So we're gonna have an accountant following us around in the O.R.s?
Owen: She's not an accountant. She's a trained surgeon. Frankly, she is here to try to help us.
Callie: Uh, an acoustic neuroma?
Derek: Oh, boy.
Callie: A long, difficult surgery with a stupid-high post-excision mortality/morbidity? That's what you want to start my hand with?
Derek: It's my hand. And thanks for making it sound so fun.
Callie: You can't try something with a little more margin for error?
Derek: I was supposed to operate on Jimmy months ago, but then the plane crashed. It has to be today.
Callie: Well, if you can do this, I guess my hand can do anything.
Derek: Still my hand.
Matthew: Ah, sorry to interrupt.
April: Do you need something?
Matthew: Kinda. I've been watching you for two days. You don't seem to slow down. I thought you might need a break. Maybe grab a cup of coffee? Probably shouldn't have started with the whole "watching you" thing, huh? Now you think I'm some sort of creeper. I'm not. Unless you're inclined to have coffee with creepers, in which case, I totally creep, like, all the time.
Cristina: African babies are a godsend.
Meredith: You don't have to tell me.
Cristina: Oh, not Zola. Not the cute ones. The sick ones. They're exotically diseased, beautiful little train wrecks. I just found a case of E.M.F., and I get to do an endocardial stripping of the left ventricle. Do you know how many other people have done that?
Cristina: Me neither. (cheery) It's unheard of.
Meredith: (opening voiceover) Patients who undergo an amputation often feel sensation where the missing limb was, as if it's still there. The syndrome is called phantom limb. It's as if the body can't accept that a terrible trauma has occurred. The mind is trying to make the body complete again. Patients who experience phantom limb report many different sensations. But by far, the most common is pain.
Meredith: (closing voiceover) The body can be stubborn when it comes to accepting change. The mind holds out hope that the body can be whole again. And the mind will always fight for hope, tooth and nail, until it finds a way of understanding this new reality and accepts that what is gone is gone forever.
Original International Air Dates:
Canada: January 24, 2013 on CTV
Norway: March 5, 2013 on TV2
Germany: March 27, 2013 on ProSieben