Original subtitles

[Richard] Previously on Grey's Anatomy...

[Izzie] I had sex last night with the wrong person.

This is our secret, OK?

Go 60 days with no sex, no other women.

[Mark] If I'm not having sex, neither are you.

Chief resident?

The one fifth year resident that rules all residents.

I went to the board this morning and told them I was retiring.

[Derek] I came out to be Chief and Meredith complicates that.

I have to pick one?

[Alex] If you don't pick one, this is gonna be your face the rest of your life.

My name is not Ava! You made it up! It's not me!

["Secrets of Amanda Pines" playing]

What percentage of Americans will get an acute atopy?

[Meredith] As interns, we know what we want - to become surgeons.

And we'll do anything to get there.

[Alex] What are the signs of a central line infection?

[Meredith] Pus, redness and fever.

[Meredith] Suffer through killer exams, endure 100-hour weeks,

stand for hours on end in operating rooms.

You name it, we'll do it.

What's Conn's syndrome?

- Wait, wait. I know this. - [Izzie] No. Tick-tock, dude.

- Cracking under the pressure. - No! Um...

Hypercortis... cortisolism!

Uh-uh! Primary hyperaldosteronism!

- Yes, out of the seat! My turn! - [Izzie] No, it's my turn!

No, it's not!

Try this one. White sponge with vanilla butter cream.

I'm trying to study for the most important test of my intern career.

- I don't have time for wedding cake. - Just try it.

[Izzie] Oh, go!

Uh... What is the strongest layer of the small bowel?

Fine. Yummy.

Damn it, damn it, damn it.

It is not snot.

- Submucosa! - [George] Yes.

Wait, wait, wait. How do you know that? Are you studying with the wife's cards?

What cards?

Callie was ranked number one in her year after this test.

She has legendary flashcards.

[Izzie] We don't need the flash cards. We're independently brilliant.

Dream team.

[Cristina] Yeah, I wanna hurl. Out of the seat.

[Alex] No, no, no. My turn! I'm kicking all your asses.

This is the lemon. Might be a little tart.

[Izzie] What is actinic keratosis?

[Alex] Actinic keratosis is a premalignant lesion.

- In old people! - In anyone.

Is it too tart?

I don't care. I mean, is Alex right or am I?

Learn to care or I'll get another bride.

I love it. I love all cakes. Now break the tie.

- Karev's right. - Yes!

[Meredith] The tough part, though, is reconciling this huge thing we want,

to be surgeons, with everything else we want.

- Hey. - Hey.

I haven't seen you in a few days. I left messages.

I know. I was just...

I know I told you to stop hovering and you did and I appreciate that.

But now stop with the stopping.

No, you're right. It's ridiculous for me to worry about you all the time.

- It's sweet that you worry. - Mm-hmm.

- It is. I should communicate more. - Right.

- You don't think I can do it? I can. - Really?

In a few seconds, I'll be getting on that elevator

- and then I'll be going on rounds. - [elevator dings]

See that? I'm getting on the elevator.

Communicating.

Twenty-eight more days

and then it's you and me in a locked room for a record-breaking,

- earth-shattering, mind-blowing... - OK, I got it. Thank you.

That was less than enthusiastic.

I'm going to be more enthusiastic when we...

cross the finish line.

OK.

Just making sure you haven't lost interest in the project.

Not at all.

Good.

[Cristina] Um... What are you doing?

The bakery wants me to make a decision by tomorrow.

So if you can tell me your favorite by then,

that would be great.

[Cristina] Cakes and little place cards? OK, he's turning into a girl.

[Izzie] I think it's sweet. He obviously cares about this stuff.

[Alex] This white one tastes pretty good.

[Meredith] I should bring a piece to Derek, right?

That's what good girlfriends do. Bring their boyfriends cake and communicate.

No, the best ones just keep all that stuff to themselves.

- Did you bring Callie's cards? - Uh, no.

No cake for you.

[Meredith] Dr. Bailey, I saw a hemiglossectomy on the board.

- Can I scrub in? - No, you're not doing surgeries today.

What?

Your intern exams are in two weeks. You need to spend every available minute

studying for them.

Believe me, when you won't have to repeat your year as interns,

you'll thank me for this opportunity. So Grey and Yang,

you're... doing scut.

O'Malley and Stevens, you'll be joining me...

in the clinic. Karev, you're with Ava.

I don't always have to be on her case. Someone else can have her.

Or not.

So... last night we studied together,

today we're treating patients together.

And we're fine. We're not tortured. It's not weird.

We made a mistake and we've moved on.

If anything, I think it brings us closer together as friends.

- We're very impressive. - I think we are.

Larry Jennings just checked into the hospital.

- What's the matter with him? - I have no idea.

His assistant said it was a matter of the utmost discretion.

Oh, that's never good.

Whatever it is, it was important enough for him to cut short his vacation

and fly home.

I want you on point on this one. No clinic today.

I can do both.

Miranda, we're talking the chairman of the board of Seattle Grace Hospital.

The clinic will survive without you for a day. Learn to delegate.

Who am I supposed to delegate to?

Chief Webber? You paged me?

Sydney Heron reporting for duty.

[Ava] Hey.

I was wondering if I was gonna see you today. Where you been?

- Just getting my assignments. - Yeah? Anything good?

Anything as good as a crazily hormonal, pregnant amnesiac

with a tendency to yell at the wrong people?

Your blood pressure's higher than it should be.

So, what? We're not friends anymore? Fine.

Then I won't tell you about Dr. Montgomery's sex bet.

With the overly hot Dr. Sloan? Yeah.

If he can go 60 days without sex, they're getting back together. Apparently,

they used to be a thing back when she was married to McDreamy.

Question is how do you know all that?

I'm on bed rest five feet from the nurses' station

and I have excellent hearing. I know everything. It's like watching a soap.

Do you know how many doctors in this hospital nurse Olivia has slept with?

Oh, wait. Who am I talking to? You're one of them.

Anyway. I'd strongly advise you to move on Dr. Montgomery before you lose your shot.

- I would if we were friends. - So, if she wants to be with Sloan...

Dude, if she wanted to be with Sloan, she'd be with Sloan.

The other board members have a say in who gets to be Chief, but Larry?

He's the one who really decides. He knows it and they know it.

- If the attendings find out he's here? - The man won't get a moment's peace.

- [all] Chief! Chief! - You have to leave now.

I want you all out of here. Look, go, go, go. Out!

- [Mark] You know where to find me. - Celeste, Larry's assistant. He's in here.

Go away!

- But we can help. - We can help.

- What is that supposed to mean? - He doesn't have any woman parts.

- It's not like we don't know where he is. - [Mark] Right. We'd just come back anyway.

Richard. Finally.

What are the Four Musketeers doing here? What happened to "I'll be discreet"?

Larry, they're here for the same reason I am. To see if they can help.

[Larry] Right.

Bunch of ghouls. All right, one of you wants to be the new Chief?

There.

Fix this...

and you got my vote.

And no, those are not grapefruits.

Well, it looks as though you won't be needing my services after all.

[Bailey] And suprapubic tenderness.

That's because I haven't taken a leak in three days. Three days.

- Could be a hernia. - A hernia wouldn't do that.

Was there trauma?

Testicular torsion, twisting?

Twisting? You'd have to tie them in

a triple knot to get that kind of fluid buildup.

Am I wrong?

I was taking a two week raft ride down the Amazon.

Maybe it's a tropical disease. Schistosomiasis? Filariasis?

Now they're just guessing, Richard.

Dr. Bailey. Call Dr. Fischer

in Urology to do a suprapubic cath and order an ultrasound on KUB.

Larry, have you called Nancy?

I don't want to worry my wife unless I have to.

She wasn't on the trip with you?

White chocolate with vanilla butter cream...

- Dr. Montgomery? - I can't decide.

Triple berry has fruit, so I can pretend it's healthy, but...

Ava's BP's 171 over 118.

- She's pre-eclamptic? - I ordered blood tests,

did a biophysical profile on the baby, who's fine, but Ava's got edema.

Get her on a mag and hydralazine.

What about an epidural? To get her blood pressure down.

I mean, am I going overboard or...?

Believe me, I wish I had someone who cared that much about my blood pressure.

Yeah, well, from what I hear, in 28 days you will.

[Man] I've had a cold, like, forever.

I've been here three times and...

they keep telling me it's gonna go away, but my nose just won't stop running.

I'm like the most disgusting fountain in the world.

Sometimes these things just drag on. You might have to wait it out.

No, I can't wait anymore. See, there's, uh, there's a girl.

And we've been out a few times.

Now it's gotten to the point where we're supposed to, you know, seal the deal?

But the nose thing is so gross, I can't get anywhere near her.

I'm sure if she's really into you, she'll hang in there.

No, you don't understand.

Have you ever met someone where the attraction was so intense,

you thought it may just kill you?

And, like, you're in the same room and your skin is on fire.

- You want to touch them so bad... - OK! We get it. We're on the case.

Yes. I will do an ENT and you will listen to his...

Chest.

- Yes. - I'm on it.

Which fluid resuscitation technique is used in acute burns?

Parkland formula. Common, Mer. Step it up.

What is Virchow's triad?

Oh, I hate George. He married into the cards.

Think he knew? Think that's why he married her?

- Yeah, that's why he married her. - We need those cards.

We don't need the cards. What is Virchow's triad?

Dr. Torres! Um, Dr. Burke and I are trying to choose a wedding cake,

and there are some samples in the conference room.

If you have a moment, I would really love your opinion

- because you've got such great taste. - You're not getting my cards, Yang.

[George] Dr. Bailey, you need an intern?

Yeah. How's it going in the clinic, O'Malley?

How's Sydney doing?

Oh, that's why you wanted to see me?

To find out how things were going?

Dr. Bailey? Can I talk to you for a second?

Of course, Ms. Newman.

What can I do for you?

This is embarrassing. Um, mortifying, actually.

I think I need to be tested.

Larry and I... Whatever Larry has,

I probably have it as well.

Oh. O'Malley. Page Dr. Montgomery.

- [George] OK. - OK.

How's it going, buddy bud?

I'm getting a strep culture on bed nine and discharging Mr. Benton.

- The gentlemen with the sinus issues? - It's a runny nose.

And I have a test to study for. Bailey doesn't like us...

Bailey's not here today, OK? I am.

And it's all well and good to open a clinic as some kind of power play

for Chief Resident,

but Chief Resident isn't really about big think, it's about patient care.

OK? So let's see what we can do to improve Mr. Benton's experience.

- It's just a cold. - Nasal lavage.

- Because we care. - Nasal lavage?

Get yourself a bulb syringe, squeeze an isotonic solution

into one of Mr. Benton's nostrils, it'll squirt out the other side.

Incredibly restorative. Rinse and repeat. Rinse and repeat.

It's not what you think.

Um, I mean, it is. It's... It's just not an affair.

Though, I guess technically it is. But we're in love.

The kind of love you think you're never gonna find and then you do.

The fact that he's married seems a small price to pay for being happy,

you know? At least most of the time.

But then five years go by, and he still hasn't left his wife,

and you must think I'm a terrible person.

- No. No judgment whatsoever. - [George] No.

I know I should leave him, it's just...

Do you have any idea how rare it is to find someone you can work and play with?

And we love each other.

How wrong can it be?

Richard, this thing still hurts like hell

and my boys here are not getting any smaller.

I want to know what you're doing about it.

The urologist just drained your bladder. Next up is an ultrasound.

Then an X-ray. The interns will be...

No, no, no, no. I mean, what are you doing for me?

Getting some of the best surgeons in the world to help you.

[Larry] I came here for you.

You. You're the best surgeon in this place.

At least you used to be.

What's the problem, Larry? Am I not taking good enough care of you?

How does a man lose his desire at 53, 54,

however old you are? How does that happen?

I haven't, OK? There are other things in life.

Like what? Adele leaving you?

Even more reason to keep the job. You're a surgeon, man.

I have to go skinny-dipping in the Amazon to get that kind of thrill.

I'm not gonna let you browbeat me into keeping this job.

Like I'd even want to at this point.

When I appointed you Chief of Surgery, you were hungry.

You were the man.

Now, you're a politician. Giving me excuses. Handing things off.

I hate to think that's the kind of doctor that you've become, but if it is,

maybe it is best that you're stepping down.

I know I said you could use the day to study,

but we've got an all hands on deck situation.

- A bad car accident? - Multiple gunshot wounds?

A penis. The chairman of the board's penis.

What's wrong with it?

His testicles have swollen, which is the understatement of the year.

Fantastic. How much? No, you know, don't tell me. Let it be a surprise.

Look, you and Grey can take him for his ultrasound and his X-ray.

- Uh-oh, the VIPenis. - Just go.

- Elephantiasis? - Hmm.

No way Jennings has that. Did you check brucellosis?

Could be the beginning of Fournier's gangrene.

I don't know. I'd go to gonorrhea before I went there.

Then again, I'll be there at the finish line to make him pretty,

which is what he'll remember.

- Oh, Derek? - Mm-hmm.

Grey wanted me to tell you that she's still working on Jennings's X-ray

and that she'll be in the X-ray viewing room.

Good to know. She's communicating.

Just when I need time to think, she suddenly starts communicating.

- Time to think about what? - All of it.

The relationship. The Chief thing.

How to juggle both without getting distracted.

With Cristina I have to be explicit. There would be no wedding if I wasn't.

Oh, it's not easy.

Oh, no. I never said it was easy.

[Derek] Right.

["Better Off" playing]

- Hey. - Hey. How's it going?

I, uh... caught George in a lie the other day.

He said he spent the day in the clinic.

When he spent it doing God knows what with Izzie Stevens.

- It's probably nothing, right? - Right.

- Right. So how's your manwhore? - [chuckles]

- Miraculously reformed? - [sighs] For now.

It's never going to turn him into what I want.

- Which is? - The whole thing.

I want someone stable who barbecues

and teaches little kids how to play catch. That's not Mark Sloan.

Which doesn't explain why I've spent the entire day

looking at Alex Karev like a puppy at a chew toy.

[Callie yawns]

- Why don't you just go there already? - Because he doesn't barbecue either.

Plus, he's, like, 12 years old. He could fit all his belongings in a milk crate.

I don't know. Guys like Karev...

[Callie] Look, at least you know he'll never lie to you.

Guys like him, they mess around in their twenties

but then they, you know, pack it in,

and teach their kids to play catch.

Maybe. Uh! I need to stop thinking about both of them.

And I have to stop thinking about Izzie Stevens.

Hey, Callie?

Here's the thing. When you're obsessing about something like that,

there's generally a reason.

What the hell are you doing?

- Nasal lavage. - Why?

Because she's trying to kill me.

Sydney.

Dr. Bailey, we've really turned this place around today.

- Nasal lavage? - Four visits in one month?

Oh, are you questioning my patient care?

Miranda, I get it. OK. You're protecting your turf.

Very mama bear. Very Chief Resident.

But this is not about hospital politics. OK. This is about the patient.

The patient can go home. Get that out of his nose.

No, I'm not comfortable discharging him until we've addressed his problem.

The 16 patients in the waiting room aren't comfortable either.

Sir, I don't think there's anything else we can do.

- You know, colds drag on. - Yeah. Yeah, I hear you.

- Oh, hell. - What?

That come out of his nose?

See, this is why I'm never gonna have sex again.

Oh, wait right here.

- Um, order a head CT. - Why? It's not a cold?

No, Dr. Stevens, it's definitely not a cold.

Just so you know, I'll be over here while you're over there.

Cute.

Easy to locate, right? Your girlfriend comes with a GPS.

Hmm.

Looks like some kind of foreign object.

- Ouch. - That almost looks like...

A skeleton. It's skeleton-like. Definitely skeleton-y.

Are those... barbs?

No. It can't be.

- Well, it could be. - It looks like a teeny-tiny catfish.

It's close.

You see there? Those are spines.

This is a candiru fish.

The penis fish? This guy has the penis fish?

In his... in his...

Wow.

What the hell did you do to me?

Most pregnant laboring women love epidurals.

- I'm not in labor. - I'm trying to keep it that way.

By paralyzing me from the waist down? I can't sit up in the bed.

I'm missing the show. The Seattle Grace show.

I can help with that.

So I guess you're talking to me again?

No. I can't stay mad at you. I tried, but I couldn't do it.

You make your move on the redhead?

I thought you already knew everything that went on in this hospital.

As a matter of fact, I have an update. I saw her talking to the ortho resident.

- Yeah? And? - [beeping]

She's seizing. She's seizing!

[beeping]

Somebody page Dr. Montgomery. Somebody page Dr. Montgomery now!

It's the candiru.

It's a freshwater fish that lives in the Amazon. It's a parasite.

I'm not an idiot, I didn't drink from the Amazon.

- Did you urinate in it? - No, I... What?

[Cristina] The candiru is attracted to blood and urine.

It's been known to swim up the stream of urine

and lodge itself in a man's urethra.

- You mean a fish swam up... - It's rare,

but there are documented cases.

One man actually saw it go in and tried to grab it.

- It was too slippery. - Yang.

- It's in the literature. - [Larry] So this thing is in my...

[Richard] It's now in your bladder.

Well, right next to it. It's stuck in your prostatic urethra,

which is causing the obstruction.

We need to get it quickly before it causes sepsis.

Sepsis?

You mean I could die?

BP shot up to 202 over 134. There's fetal distress. Epidural didn't help.

- It'll help during delivery. - What's going on? Alex?

[Alex] Blood pressure spiked. You had a seizure.

The only way we can reduce your blood pressure

and the swelling in your brain

is if we deliver the baby now.

She's only 30 weeks. I'm not in labor.

We're gonna do a C-section, Ava. Don't worry.

The survival rate for preemies at 30 weeks is extremely high.

- Alex, tell her no. I'm not ready. - You're ready.

But I can't do this by myself.

Then it's a good thing you're not by yourself.

[Derek] I was doing a consult on the chairman of the board.

This better be good. What do we have?

We had a patient in the clinic, chronic runny nose. Halo sign on the pillow.

The fluids are still in the lab, but as far as I can tell...

He's leaking spinal fluid through his nose.

Thought you might like this one.

Look at that. It's a brain herniation.

His brain is literally sinking into his skull base.

- And all along I thought it was a cold. - [Derek] Book an OR.

- Dr. Bailey? - Oh, no, no. You're still studying.

You can watch from the gallery. I'll scrub in with you.

- I thought you were doing Jennings. - I'll do both.

I sent this guy home three times. I can't not scrub in.

[Addison chuckles]

Your daughter's beautiful, Ava.

- [Ava] She is? - [Alex] She is.

[Addison] Get her to the warmer right away.

- [Alex] I'll work on her. - [Addison] Head her off to Peds.

I need an extra set of hands.

- [Addison] We need to hang some blood. - [Ava] Why? Why do you need blood?

[Alex] Want me to get the uterine arteries?

- [baby crying] - [Alex] Clamp.

Alex? What's going on? Alex.

- [Addison] The bleeding vessels are deep. - [Ava] Tell me what's going on.

- [indistinct conversation] - [Ava] Am I going to die?

Oh, my God! I'm gonna die.

Oh, my God, I'm gonna die.

I'm gonna die and my baby's going to be all alone. Oh, my God!

[Alex] Ava.

Ava. Look at me, OK?

Look at me. You're not gonna die. You're doing great.

You're gonna be fine. The baby's gonna be fine.

I just need you to breathe for me, all right?

Nice, slow, deep breaths.

That's it.

Just breathe. Keep breathing. There you go.

Celeste, good news. No chance of an STD.

Now, Larry's condition. He's having surgery, but you're fine.

You did hear the part about you being fine, right?

That's what I keep telling myself.

That I'm fine with things the way they are, but...

I probably won't be really fine until I don't care if he's fine anymore.

[woman] Celeste, I got here as soon as... Is he in surgery yet?

No. They're taking him soon.

This is Dr. O'Malley. This is Mr. Jennings' wife, Nancy.

- Hi. - It's a pleasure. He's just in there.

- They're prepping him for surgery. - Thank you.

I left my car in front in a no-parking zone. Could you move it?

What are you going to do?

Move her car.

- [Meredith] Talk about divine retribution. - What?

He sleeps with his assistant and a carnivorous fish lodges in his penis.

That's instant karma if I've ever seen it.

Yeah, well, Derek wasn't struck by lightning

- and neither were you. - Addison showed up.

I had months of pain and self-loathing and a crazy ranting mother

and a near-drowning off the side of a dock.

I mean, it's no fish in my hoo-hoo, but it's certainly not an easy ride.

Well, I've cheated on my boyfriends and I'm fine. Am I the only one?

Which cake is your favorite, or have you chosen one yet?

OK, clearly, you're not getting the point.

I don't have favorite cakes. That's why you're involved.

We got to go.

If you see my boyfriend,

tell him I had some tuna salad and a yogurt, and now I'm off to the OR.

[Cristina] This is not eating for pleasure. I really need a choice.

So mark it on the paper.

- Sorry, I froze there a little bit. - That's OK.

[stammering] I'm not getting weird...

Shut up and eat some cake. [muffled voice]

- Good? - [muffled voice] Disgusting.

[Izzie] You're covered in cake.

["Again & Again" playing]

- Karev! - Hey. I'm just checking up on Ava.

Do I have another Denny Duquette situation on my hands?

What, are you serious?

I have never seen you so attentive with a patient. You're always there.

Checking her stats, running tests, doing research.

- That's my job. - No, it's my job.

I'm her doctor. You're my intern.

Which is why I have to know her stats at all times.

Because I am not about to stand next to you in your OR

and be anything less than over-prepared.

OK? There's no way I'm gonna go to work every day

with a surgeon like you and not be at the top of my game.

So if you want to yell at me...

[over PA] Dr. Binder to Three West. Dr. Binder to Three West.

I know you have to give him your cards because you're married to him. I...

respect that. But there is an argument to be made

for female surgeons sticking together.

- You're relentless. - Sisterhood and all that, you know?

Mm-hmm. Scary, inhuman relentless.

You are like a role model to me or something.

OK. You know what? Stop. OK? This is just getting sad.

I will give the cards to George. I am sure he will share.

No, he won't. With me, anyway. He'll just share them with Izzie.

They're like an exclusive little unit. Whatever.

Yang!

My, uh...

My locker is on the right side,

third one from the door. The cards are on the top shelf.

- Really? You're... - [Callie] They're all yours.

- Oh, God! Uh, sorry. - It's OK.

I was...

- So we're good? - Yeah, it's good.

Good. OK, then.

Don't talk.

I know it's not fair and I know it's not your fault.

I know there's nothing going on between you and George. I know that.

Except there is.

You're his best friend.

He loves you, he gets you, he needs you.

And I'm just... I'm just... I'm his wife.

And I know I get the sex and the commitment and the life with him.

But I want him to get me and to need me.

And I can't compete with you.

So I'm asking you to please stop.

Just stop. Find another friend.

Or whatever you do. Just give me my husband back.

["Nausea" playing]

♪ Well, I'm a sea-sick sailor on a... ♪

What about the forked stone grasper?

It can lead to urethral injury.

[Richard] The forceps aren't working.

At this point, I'm willing to try anything.

All right, stone grasper.

Did we miss anything good?

♪ Oh, it's nausea, oh nausea, And we're gone ♪

Hello? You OK?

I've had better days.

[Richard] Where's Dr. Bailey?

- Page her. - [rapid beeping]

V- tach. Does he have a pulse with that?

Oh, he's going down.

Yes. He needs 150 of amiodarone.

How much longer do you think it'll take?

[Richard] Oh, you worry about getting his arrhythmias down.

We're gonna have to change our game plan here. The scope isn't working.

Excuse me, Dr. Fischer. We're going to have to open him up.

- [Bailey] I don't know how I missed it. - [Derek] It presented as a cold, Miranda.

This sort of thing, at some point, you think it's gonna get better.

You don't really figure it's something that could ruin your whole life.

- [pager beeping] - [Bailey] The Chief.

[Derek] The candiru. Go ahead. We're almost done here.

[Bailey] OK.

- [Bailey] Here. - [Derek] Thank you.

Hey. You want to quiz me on the GI stuff?

[Izzie] No, I'm still trying to get through my cardio notes.

- You OK? - I'm fine.

I should've snuck into the candiru surgery with Meredith and Cristina.

You still can.

George, can you maybe stop talking so I can concentrate?

- What's your problem? - [Izzie] My problem is you.

You're my penis fish.

Your what?

[Izzie] You've crawled in and latched on, and now I can't move or talk

or think or even pee without the nagging feeling

that something is eating through my organs.

You don't even have a penis. How am I the fish?

It's a metaphor, George.

What happened to us being fine?

I don't know.

Maybe we're not.

- [Richard] A little more suction there. - [Dr. Fischer] Suction.

Those barbs won't let go.

[Richard] Dr. Bailey, glad you could join us.

Oh, this is useless. We're going to have to cut it out, Dr. Fischer.

- [Dr. Fischer] I'll repair the bladder. - [Richard] OK, let's do it.

How's his heart holding up?

[Preston] Occasional runs of V-tach. He can't take much more.

[Richard] Forceps.

OK, almost there. Come on, you.

I'm almost there.

Got it.

- [Cristina] Holy... - [all groaning]

Oh!

Ooh...

[Richard] Unbelievable.

[Mark] Unbelievable.

- [Cristina] You see that thing? - [Meredith] Yep.

[Meredith] Remind me never to pee in the Amazon.

What?

What do you say we have a real meeting of the Dirty Mistresses Club?

Like what it should have been from the beginning?

- What are you doing? - Once.

Twenty minutes in the on-call room. Nobody ever finds out.

- Mark! - What? You're telling me

everything's great between you and Derek?

[Meredith] What makes you think there is something wrong between me and Derek?

Something's always wrong between you and Derek.

- Enough! What is wrong with you? - [groans]

Nothing. I'm...

Addison and I were gonna try and make a go of it. Things are not gonna work out.

So you make a pass at me? Like that'll help?

She doesn't want me.

Something's got to help.

Revenge sex is not the answer.

If you're letting her go, let her go.

Be an adult.

Thanks. For the baby,

and for me not dying and stuff.

[chuckles] It's always a nice bonus when the patient doesn't die.

[Ava] You and Red make a pretty good team.

Don't tell Sloan.

Oh, she and Sloan aren't happening. She wants you.

- How do you know that? - I know everything, remember?

I heard her talking to the ortho-doc about how she wants someone

who barbecues and plays catch. She wants someone who's committed.

- Yeah, well, that's not me. - I hate to tell you this, but it is.

You may talk tough, but you're a decent guy, Alex.

Whether you want to admit it or not, you're actually one of the good ones.

Mrs. Jennings, your husband's out of surgery.

- Everything went very well. - Oh, oh, thank you.

Thank you. That's... That's wonderful.

Dr. Webber will be down to fill you in soon.

Uh, Dr. O'Malley, do me a favor.

Could you go tell Celeste? She's a basket case.

And I just don't have it in me to take care of my husband's girlfriend right now.

Of course I know.

The wife always knows.

- [Celeste] Dr. O'Malley? - Yes.

Mr. Jennings's personal physician would like a copy of his medical records.

- Here's the number. - OK.

Mr. Jennings, I've canceled your appointments for next week.

There's just a conference call that's proving a bit difficult to reschedule,

but I'm sure Danny can handle it.

What's... Danny got to do with it?

I've asked him to step in temporarily until you find someone else.

Oh, wait a sec, Celeste.

What the hell was that all about?

Well, I think she just left you.

Goodbye, Larry.

- What the hell's going on here? - I think I'm done here.

Can you be a vault?

I think I need a vault because I've eaten, like, a cake and a half

and it's just not cutting it and you don't gossip.

Because nobody tells me anything.

I was with a married man. It was...

I don't mind that nobody tells me anything.

It was George.

I was with George.

It should be firm inside, not spongy.

The frosting? I like meringue.

Light and not too sweet.

I always thought chocolate inside,

but now [laughs] I'm leaning away from that.

You've thought a lot about this cake.

This cake.

For this day.

With this woman.

The red velvet's your winner, by the way.

What are you doing here?

I wanted you to know where I was so I thought I'd come and tell you.

You're mocking me.

I'm apologizing to you.

You're making light of things.

I'm running my fingers through your hair.

[Meredith] I'm standing in your bedroom.

Unbuttoning my shirt.

And now I'm taking off my pants.

And now I'm getting in your bed naked.

Mark.

We need to, uh...

We should go get a drink and maybe talk. Do you have some time?

[sighs] I mean, uh, something's always wrong with you and me...

You don't want to have a drink with me.

I'm not what you're looking for.

What are you talking about?

I slept with someone. Couldn't hold out.

Once a manwhore, always a manwhore, right?

- Miranda, go home. - I'm almost done.

Go home. See your family.

You have to accept there're days where you can't do it all.

You have to delegate.

- I did. - And then you do all the work anyway.

And you're still doing it!

You didn't have better things to do than to ride herd on that VIP case?

There was a fish in a man's penis.

There's always gonna be a fish in a man's penis, Chief.

You can say you're moving on all you want, but are you really?

If you don't slow down, you might end up without a family to go home to.

- Good night, Miranda. - [thunder rumbles]

- Oh, see. You can't do that. - Do what?

Not look happy after sex. It's bad for the ego.

I'm fine.

- Are we fine? - Sure.

Not so convincing.

I shouldn't have accused you of hovering. It wasn't nice.

You were just trying to be there for me.

But... now I'm being available

and communicating and getting naked and doing all of your favorite things.

Good things.

Then why are you still staring at the ceiling?

I don't know. I just...

That day...

you came out of the water...

I spent the scariest hour of my life trying to breathe for you.

I love you and I want you, but I don't know what to...

You didn't swim.

You didn't swim and you know how to.

And I don't know if I can...

I don't know if I want to...

keep trying to breathe for you.

["What Am I Doing" playing]

[sighing deeply]

I should go.

♪ My voice is strong I've never been alone... ♪

I'll go.

[Meredith] Too often, the thing you want most is the one thing you can't have.

[Cristina] What acid-based finding do you classically get with significant vomiting?

Hypokalemic, hypochloremic, metabolic, alkalosis. Unbelievable.

Did you pick a cake?

Uh, I liked the red one.

- The red velvet? - Yeah.

♪ ...The road is tough ♪

♪ I didn't think I'd have to Work this hard ♪

♪ So how am I doing? ♪

[giggles]

♪ How am I doing? ♪

- [George] That's the girl? - [Izzie] Runny nose guy's big love.

I don't know how we do this.

I don't know how we work together and be friends and act like it's all OK.

I...

There's a spot available at Mercy West. I called them.

You're going to transfer to Mercy West?

I have to.

[Meredith] Desire leaves us heartbroken.

It wears us out.

Desire can wreck your life.

- Hey. - Hey.

I was going to go get a drink. You want to head over to Joe's?

Yeah, I'm kind of under with this test.

OK.

You know, um...

I took that test, once upon a time.

We could, um, go back to my hotel, I could quiz you.

Look, uh, this... this isn't...

You're not my girlfriend. OK?

What?

No offense. Today was awesome, it's just I'm really busy.

I have a lot of work. I don't have time for...

No, of course.

Uh...

Study.

That's what you're here for, right?

♪ And you, and you And you, like you ♪

[Meredith] But as tough as wanting something can be...

♪ ...And you So how am I doing? ♪

...the people who suffer the most...

♪ ...How am I doing? ♪

...are those who don't know what they want.

♪ ...How am I doing? ♪