Grey's Anatomy (2005–…): Season 2, Episode 24 - Damage Case - full transcript

Derek lets his emotions run away from him, and Burke and Izzie make a new suggestion to Denny. Meanwhile, the interns treat a family involved in an auto accident, Callie makes Meredith and Izzie uncomfortable, and Addison strikes back at Alex.

Grey's anatomy"...

i slept with george.It was a horrible mistake.

I have no interest in obstetrics or gynecology, dr. Shepherd.

Your ass is mine until i say otherwise.

So we spent the night at callie's last night.

So i figured we'd just spend the night here.

Oh, hi.

You're falling for a vet.

I'm also dating. You.If you still want to.

I got home. He was listless and hadn't eaten all day

oh, no. Let's have a look.
Hey.



Hey. Is he sick again?

Yeah.

We all go through life like bulls in a china shop...

a chip here, a crack there,

doing damage...to ourselves,to other people.

So, uh, i don't cook.

Nobody asked you to cook.

I know.I'm just saying that,you know, i don't cook.

So you don't have to cook.I don't expect you to cook for me.

Okay. You... sit there.

Sit down.

I wa you to drink this and try really hard

to act like you aren't scary and damaged.

I'm not scary and damaged.
Yeah, you are.



No!I'm not scary or damaged.

Mm-hmm. All right.

Then why don't you tell me about your family?

Okay...

me not wanting to talk about my family

does not make me scary or damaged.

Okay.

Tell me about the last guy you slept with.

The problemis trying to figure out

how to controlthe damage we've done,

or that's been done to us.

What did you say to him?

Nothing. I fled the scene.

(muffled voice) you didn't tell him about george or derek?

Nope.

Hmm. You like him.

I could like him.

Is the sex any good?

I don't know.

Four dates and two sleepovers at his place, and no sex?

Not even a kiss good night.

Oh, i am proud.

I'm like a proud mama.

Shut up.

Mornin'.

Sometimes the damagecatches us by surprise.

Oh, my god.

Did that just happen?

I'm having a seizure.I'm clearly mid-seizure.

I'm seizing.
Oh, my god.

She didn't even wash her hands.

oh, my god.

Sotimes we thinkwe can fix the damage.

All i'm saying, george,is if she needs to pee, she could at least wear a bra.

Or maybe wait till she's alone.

And for the love of everything sanitary,could she just washer hands?She's a surgeon.

You said yourself you guys were blocking the sink.

Anyway, i think you're exaggerating.
She peed. Naked peeing.Ask meredith.

Oh, that's right, i forgot.You're not talking to her.

If you were, she would tell you that callie crosses the line.

So across the line.

It's so freakin' crossed.

Oh! We're still pretending that you're not seeing a patient, right?

People, what's with all the evil misery, huh?

Live and let live.

You're cheerfu

oh!

You are.
Come on.

How's that possible?

I scrubbed in on a 4-hour paraesophageal hernia last night,

then i got laid,

and now three ambulances are coming in full of bloody,broken car crash victims,
all who need to becut open.

So i'm cheerful.I'm cheerful...

and sometimes the damageis something we can't even see.

Sorry, sir.

Hey.How's my dog?

Much better.Finn's running tests.
Good.

Our dog.

What?

Our dog. You said "my dog."

He's our dog.

Yeah, whatever.

Are you mad at me or something?

Now is not the time.

25-year-old restrained driver,noah reynolds.

Noah, you still alive?

I'm still alive, baby.

My wife's side took all the impact.

Her parents were in the other car.

Some jerk slammed into them and then they slammed into us.

On three.One, two, three.

22-year-old pregnant,restrained passenger.T-boned on her side.

Prolonged extrication in the field.

B.p. 90 over 50.Pulse in the 80s.

trauma room one.

Trauma?No, i'm fine, really.

You don't have to go to all that trouble.

Mercy, no, i am fine, really.The air bags went off.

If you could just check on my baby and the rest of my family and my husband.

Noah, you saw mama breathing, right?

And daddy...where the hell's daddy?

Mama and daddy are still alive, right?

They're in the ambulance right behind us.

They're still alive, right?

Please don't move, ma'am.

Mama and daddy... i need to know.

Ye, i'll ask someone about mama.

And daddy.

Driver and front seat passenger,both early 50s,both restrained,both stable.

The passenger has some leg and arm pain.

The driver is complaining of chest pain.

Shoot!Dang it all to heck!

Excuse my french, honey,but i need some...whatever kind of horse pills you got
because this hurts like the dickens!

Uh, that would be mama?

Mama, you okay?

I am in pain.

Get off. get off.

Sir, i need to clear your spine.

My spine is fine and you can sew up my head later.

Where's my girl? Mellie!

Daddy.

Jim.

Noah.

Mel.

mama.

The hillbilly picnic.

Can everybody shut up for a minute, please?

I'm trying to find a fetal heartbeat. Hold on.

Is the baby okay?
Hold on.

The baby's heartbeat is 152 and strong.

It's... it's okay.

They're both good.They're good.

Oh, thank the lord.Thank the lord they're all right.

dr. Bailey,another car crash victim.

That's him!That's the guy who hit us.

I'll kill him!I'm gonna get you!

You son of a bitch.

Big jim,just hold your horses.He's hurt.

He's already hurt.Good!

Daddy!

Don't ask me to be neighborly.He slammed into us.

Trauma three.Page ortho and neuro.

O'malley, give her a hand.

What happened?

Whoa, whoa, whoa.

What do you think you're doin', young man?

I'm just trying to examine you.
I don't think so.

i don't have any panties on.I do not know you well enough to let you see my good girl.

Get me a lady doctor.

I need a chick over here.

What happened?"Marshall stone."

Surgical intern over at mercy west.
What happened?

Page ortho to take a look at his wrist and let c.t. Know we're coming.
Yes, dr. Shepherd.

Marsha, i'm gonna say three words to you, okay?

And then i want you to repeat them back to dr. Grey.

Can u do that?
Okay.

Okay, bat, orange, car.

Do you think you can remember that?

Mm-hmm.

Good. Okay. Here.

He has a closed head injury.Watch for vomiting,

confusion and loss of consciousness,okay?

Okay.

Good.

Derek...

not now.

Let me know when you get the c.t. Report back.

Marshall...

can you remember those words?

What... what happened?

big jim.

I don't call him big jim.

The family,they call him big jim.

Stupid hicks.

Really? Being southern makes you stupid?

Do you know that he owns half of alabama?

Yeah, i bet he even washes his hands after he pees.

That's uncalled for.
Hey, this is a place of business.

Uh, discharge the mother,discharge the father.
Yes, dr. Bailey.

Karev, get the husband to the o.r. For surgery.

Dr. Karev, there you are.You're supposed to be up on o.b.g.y.n. Rounding on my patients.

Oh, yeah, i got paged.9-1-1.

Pregnant mom. Car accident.Very serious.

Pity. I've got three surgeries on the board.

I was gonna ask you to scrub in, but...

i guess you should stay by that pregnant lady's side all day.

You' see to it,dr. Bailey?

Karev, go find your patient.

Stevens, scrub in on noah's patella fracture.

The she-shepherd just walks in here and pulls me off surgery?

You burn the she-shepherd, she burns back. Go.

The c.t. Won't hurt the baby or nothin', right?

No, it won't hurt the baby or nothin'.

Okay, on three.One, two, three.

I was havin' a shower today.A baby shower.

That's why mama and daddy are in town,

'cause i'm having a baby.

How nice is that?

Nice.

Isn't it?

Mm-hmm.

What are you doing here?

I'm captain of the vagina squad.

Oh, this nice man is gonna take care of you now.

And he really likes to talk,so chat away.

Well, it was nice meeting you.
Not cool, yang.

What does she mean, "captain"?

And what kind of squad are you on?

Uh, you shouldn't be reading your own chart.

Well, i want to find out what caused me to swerve my car into oncoming traffic

and not be able to remember it.

Hey, those people, the ones i hit,they're gonna be okay, right?

No serious complications?

They're still checkin'em out.

Dr. Torres.
Yeah.

I was told you're performing the noah reynolds' surgery.

Yes.

Well, i'm your intern.So whenever you're ready...

okay, well, head up and prep the o.r.I need to put on splint.

did you wash your hands?
hat?

You washed your hands, right?

Of course i washed my hands.

No, no, of course you did.

Uh, marshall, this is gonna hurt a little bit, okay?

My e.t.o.h. And tox screens were pristine, so i wasn't drinking...

Or under the influence.Ow.

Okay, we get the c.t. Result back yet?

Not yet.

My g.c.s. Was 13.Why haven't i had a c.t.?

Dr. Grey.

C.t. Was backed up.And he's lucid now, so...

so get it done, now.

Hey.

Daisy duke's case was boring me to tears.

So, um, you got any good hearts that i can cut open?

Or, you know, bad hearts that we can make good?

Burke...

use words.

You fell asleep.

When?

This morning in the on call room.

I fell asleep after we,you know.

Not after. not after.

Oh.

Oh, l-i'm... sorry.

L-i was really tir...seriously, seriously,my bad.

I'm really sorry.

Don't let this threaten your manhood or any...
oh, this is not...

i am very confident in my manhood.

Thank you very much.
Well, good, you should be because, i mean...

i fell asleep because i had already finished.

Twice.

I hadn't finished.

I was tired.

It's not like i did this on purpose.

Oh, did you stay in the hospital last night on purpose?

Because you weren't even on call.

It was a paraesophageal hernia.I had never seen one.

You know what? I'm a surgeon first, just like you.

No, no, not just like me.I am a person first.

Someone paged me.

Denny!

He collapsed.

What happened?

Too far, too fast.

What were you doing?

Stairs.

Real bright, huh?

Okay, your lvad battery is almost dead.

Um, get him to his room.I'll get dr. Burke.

Okay, let's get him up.

Nice and easy on one, two, three.

Denny, you knew the lvad wasn't a cure.

I want to go home.

I want to go home yesterday.

I know this is hard to hear,but that's just not an option at this point.

Since when do you get to decide what's an option in my life and what isn't?

My heart may be on your battery packs,

but it's still my heart.

It's my decision.It's my damn life.

That's right.

It is your life.

And it is your life that is at stake.

And it is your life that will end

if you continue to push like you did today.

You said the lvad would make me better.

I told you the lvad would buy you more time, nd it will

if you respect its limitations and your own.

I wanna go home.

What do we do?

Put him on a tight leash.

And tell the nurses to keep an eye on him,

make sure he doesn't take any more endurance hikes in the stairwell.

Yeah. But...

preston, what do we do?

The damage to his body we can try to control,

but the damage to his spirit...

for a man like denny

to lie on this bed for years on end?

That's not something we could really understand.

And his feelings about it

aren't something we should try to control.

Give him room, izzie.

Just give him room to grieve.

you finally got melanie to shut up.

Finally. Thanks for that,by the way.
How's she doing?

Images coming up now.

oh, is that a teardrop fracture?

Yeah, no head bleed though.That's good.

Look at her lungs.
Is that her liver?

whoa.
How is she alive?

Karev, page shepherd, burke,montgomery-shepherd, the chief

and every surgeon with an available hand and get an o.r. Opened. Go!

Melanie. Me...

Get me a stretcher and let's pull her outta there now.

(miranda) melanie.

Hey.

Have you seen izzie?

She was supposed to prep an o.r. For noah's surgery,and she completely bailed.

What?

Mr. And mrs. Johnson.

Dr. O'malley.

Oh! That little girl right there says she's gonna fix noah's leg all by herself.

Dice que ella sola arreglar* la pierna de noah.And she just gave him a big ol' shot for his pain.

I really like her.

Mr. And mrs. Johnson.Big jim.

Is it... mel?

Yes, ma'am, it is.

What? What?

When your daughter came into the e.r.

Her body was over-pumping her bloodstream with adrenaline,

which kept her conscious and alert and, uh, pain-free.

During the c.t. Scan,she was lying still for an extended period of time,

and so her body relaxed

and the adrenaline stopped flowing, which...

allowed her to succumb to the full extent of her injuries, which...

they're catastrophic.

Excuse me?

Good. Bovie.

More suction here.

Clamps.

Internal saw.

Karev, sit down.I can't see.

The only thing i want you to do is sit at that fetal monitor

and watch that baby's heartbeat.

So now i'm a baby-sitter?

Retractor.

Addison,

we're ready for you.

We are going to do absolutely everything we can.

Uterus is protected.Baby's heartbeat?

146.

Okay, the baby's safe.

You can proceed with the mother.

Lungs are damaged pretty badly.

Pressure just bottomed out.

Let's transfuse.

4-quadrant packing.

Come on, people.Get me some lap pads.

cross-clamp the aorta.
clamp.Got it.

There's too much bleeding.She'll never last. Shepherd?

Damage control.
addison?

If you want the baby to live, damage control.

Burke?

Damage control.
Everyone knows the rules...

we're going to move as rapidly as possibl

don't worry about finishing repairs.

For now, we're on crisis management, people.Just get it done.

Once she reaches the triangle,we stop, no exceptions.

What is he talking about,"triangle"? What triangle?

Blood stops clotting,her muscles produce acid and her organs get cold.

We're talking about the triangle of death.

A ruptured abdominal aortic aneurysm.

What?

I scrubbed in on a...an abdominal aortic aneurysm.

It's a 12-hour surgery.

I'd already worked 30 hours, but l...

i didn't want to miss it.

I fell asleep for...a second behind the wheel.

Closed my eyes for a second at the red light...

a second.

Was only 12 hours.

I've done it before.

We've all done it before.

Dr. Grey.

Meredith.

Meredith.

Does this mean, uh...

are we actually saying that, uh...

today, this morning,

because i stayed in the o.r.To save a life...

i may have killed a pregnant woman?

dr. Grey.

You ordered a c.t. On marshall stone?

We're gonna need a moment here.

I'm backed up here with five patients.

We need... a moment.

marshall?

Marshall?

Izzie, please.

Come on, denny, just...izzie.

Smell. Smell.

Chocolate. And not the crappy,processed waxy kind,

but the really good swiss chocolate that you get at the gift shop that costs way too much money,

but is totally worth it.Try it.

And exhibit "b"...tabloids.

Good, old-fashioned, trashy celebrity gossip rags

that are guaranteed to take your mind off your troubles.
Damn it, izzie,stop it.

Just stop it.

You think i'm feelin' sorry for myself, right?

Poor sad-sack denny just needs a little perspective.

You do need a little perspective.

You have no idea

what is to lose what i have lost.

I know loss, denny.

No, you don't!

I'm a man.

I'm a strong, virile,horse of a man,

stuck in the body of some weak, sick bastatard

that i don't know, like recognize.

Now if you knew what that feels like,

you would've never convinced me to let a battery run my heart.

If you knew what it feels like, izzie...

you woulda let me go.

systolic's 82, folks.It's not getting any better.

how's the spleen,chief?

unsalvageable,i'm afraid.

Karev?

Frequent decels and loss of variability.

the baby's fading.

Okay, we've reached the triangle, people.

Hands out.

Damn it, stop.Everybody, stop.

Cristina.

Slow, erratic,but it's a heartbeat.

The baby's holding steady.

Bring out the plastic.

Plastic?We're not gonna close?

No, we're gonna keep her open,

cover her with plastic and get her to the i.c.u.

and then what?

And then we're gonna see if she survives.

How in the hell do you let a patient get that far off your watch?

I turned my back for a second.

He was in the damn gallery!

He's a surgical intern at mercy wt, and he...
i don't care if he is the surgeon general.

In this hospital,he is a patient

with a head injury who needs a c.t.

In this hospital,he is a scared guy

who does not need to see the massive internal injuries of the woman he rammed with his car!

This is your fault.You had him and you lost him.

You gotta take responsibility for your actions for once in your life.

Derek!

we've given her medications to help her blood clot and to help counteract the acid buildup.

We're slowly raising her body temperature with warming blankets,

warmed i.v. Fluids and blood products.

How long is she gonna have to be like that?

You know with...open like that?

We want her to regain as much strength as possible before we operate again,

but at the same time,we want to repair the damage as soon as possible,

so it's a balancing act.

Uh, i'm sorry.

I don't quite know what you mean.

Melanie will die

if we don't get her back to surgery soon enough,

and melanie will die if we take her back to surgery too soon.

A balancing act.

A balancing act.

yang, call me if she starts actively bleeding.

Karev, where are you going?

What? She's in i.c.u. There's nothing i can do.

You can sit there with her and watch that fetal monitor.

You can't be serious?She's circling the drain.

You know how long a baby can survive inside its dead mother?

Four to five minutes.Minutes, not seconds, karev.

Look at melanie.

Look at her.

And now look around.You see all the doctors and the nurses,even her parents?

Their sole job is to take care of melanie.

My job is to care for that baby.

Now i've got a surgery scheduled,so when i step foot on that elevator and leave,

you are gonna be the only person on this entire floor responsible for that baby.

Do not let me down,karev.

her organs are bleeding,damaged, exposed

and covered in plastic wrap.
Poor marshall.

I mean, one minute,you're a surgeon,the next, you've destroyed an entire family?

Last month, i fell asleep in the parking lot on a bench. I literally couldn't even make it to my car.

I fell asleep at a restaurant

at a table while i was on a date.

Yeah, well, i fell asleep during sex.

Izzi

Callie's looking for you.

You blew off her surgery.

You were hanging out with denny?

Oh, please, do not even talk to me about standards.

The girl can't even wash her hands.

Don't worry about bambi.

If burke can forgive me for falling asleep during sex,

then george can forgive you for crying.

But burke hasn't forgiven you.

I fod izzie.She said she had a patient.

I knew you'd take her side.

What?

He needs an i.v.

Are you...

she's mad at you.

L-i didn't know you were awake.

What'd you do?

Uh, has...has anyone talked to you about your wife,about what's happening?

"What's happening"?Uh...

yeah, you know i can't really,uh, wrap my brain around what's happening.

You know,i'm... i'm from here.

Uh... seattle.

And, uh, you know,i go away to college,and i come back married to this big-haired,

drawlin' southern girl.

And everyone i know thinks i'm crazy,

but i love her.

And i just...

i love her.

And, uh...what's happening

is that my...

big-haired, southern girl

could be dying.

And... i can't think about that.

You know, i need to...i need to think about something else,

something that doesn't matter so much, something that doesn't... doesn't have me burying

my 22-year-old wife and baby.

So, uh, so...what the hell did you do?

I believed my friend when she told me that dr. Torres doesn't wash her hands.

Well, i hope that's not true,

seeing as she just, uh,

performed surgery on me and all.

Yeah.
Yeah.

You paged me?

C.t. Results.

Good. Thank you.

All right, let's see what we got here.

Marshall,everything checks out fine.

The short-term memory loss was a result from the concussion.

To be safe, i want to keep you here overnight for observation, all right?

I have to apologize.

What?

To the woman's family.

I have to tell them i'm sorry for what i did.

You should get some rest.

I never should've told you about george.

No, it's fine.I'm glad i know...

about him and the vet.You really get around.

What did you just say to me?
It's unforgivable.

I don't remember ever asking you to forgive me.

So was the knitting a phase?Who's next... alex?

Cause i hear he likes to sleep around.

You two have that in common.

You don't get to call me a whore.

When i met you, i thought i had found the person

that i was going to spend the rest of my life with.

I was done.

So all the boys and all the bars

and all the obvious daddy issues... whcared?Because i was done.

You left me.

You chose addison.

I'm all glued back together now.

I make no apologies for how i chose to repair what you broke.

You don't get to call me a whore.

This thing with us is finished.

It's over.

Finally.

Yeah. It's done.
It is done.

her temperature is 95.4 degrees. And her ph is 7.28.

Definitely clotting better.

But some of the wounds are still oozing.

Still a fine line.

she may not be quite stable enough.

Y'all don't have to whisper.

I'm sitting right here.I can hear you anyway.

And she's my baby.

She's my little girl.

It's a big decision like this,

uh, goin' back in and sewing up her... organs.

It's the kind of decision that a mama oughta be involved in.

I mean, all her life,she's asked me everything...

from... what color dress she oughta wear to her kindergarten dance
to what she oughta name her baby.

'Cause i'm her mama.

And it's my job to have an opinion, and... it's my job to have an answer.

Well, i may not have an answer here, but i'm still her mama.

Y'all just don't have to whisper.

All right.

what do you think,dr. Bailey?

I think...if we wait much longer,she'll go into multiple organ failure.

Okay.

If it's all right with you,mrs. Johnson,

we think it's time to get back in there and finish what we started.

okay. I'm done.

yang, get in here and start washing out the abdominal cavity.

Bleeding is controlled in the chest.

I had to resect a part of her lung, but...
fetal heart rate's down to 80.

Uh, mom's heart rate's slowin' down.

ruptured retroperitoneal hematoma.

She's bleeding out.
Idioventricular rhythm.

Do we have a b.p.?

Trying to run it.

Nothing's registering.
yang, get your hands in here and hold pressure.

Fetal heart rate down to 60.

Heart's fibrillating.
dr. Webber, can you see the source of the bleed?

Give me the internal paddles.

We're losing the baby.
Charge to 20. clear.

we're chasing our tails here.Get addison shepherd.

Melanie's crashing.
It's right there.

You hear me?She's crashing.

I'm elbow-deep in a pient's uterus, karev.

What do you want me to do,leave this womanand her child to die?

I'm doing my job.

And i'm doing mine.

Do what you can. I'll be there as soon as i can.

Okay, people,let's speed it up.

they'll know where to find us...

when there's news?

They'll know we're in here?

Yes, ma'am.

Okay. Okay.

I mean, is there something i should be doing,someone i should talk with or something?

You're doing everything you can do, big jim.

i know this isn't the best time,

but marshall would very much like the chance to apologize to the family

if they'll let him.

He's one of us, george.

shepherd's still in surgery.I told her to hurry.

how's her heart?

Asystole.

How long has she been down?
Five minutes.

we need to do a c-section.Glove me.

I need to get that baby out.

Tell me what to do.

Yang, you're going to...

hold the intestines.

I'll expose the uterus.
Call pediatrics.

Open the uterus with a midline vertical incision.

Make sure you don't cut the fetus.

okay, go.

Baby doesn't look good.

How are we doing on the mother?

Oh, she's still bleeding pretty profusely.

I can't get it controlled.

Burke?

She's not coming back.

Let's stop.

time of death... 1948.

Chief.

i am sorry.

i am so...

i am so... so sorry.

please...

you're gonna get in trouble.

I don't care.

I'm not gonna cheer up for you.

You don't have to cheer up.I'm not here for me.

I'm here for you.

Okay?

Okay.

We're all damaged, it seems.

Some of us more than others.

You must be tired.

Yeah.

i'm tired, too.

We carry the damage with usfrom childhood.

Then as grown-ups,

we give as good as we get.

good work, karev.

Yeah.

Kid's alive...without a mother.

ultimately,we all do damage...

see you at home?

Yeah.

Okay, see you.

Okay.

And then we set aboute business of fixing

whatever we can.

izzie.

Hmm?

Would it be wrong for me to feel you up right now?

Mm, not so much.

you're such a dirty boy.

i know.

i washed my hands.

L-i went down to the kitchen and i washed my hands.

I didn't wash my hands in the bathroom

because those girls were staring at me like i was a rodent or something,

like i was in high school,like i was having the naked dream,

only it was actually happening.

I didn't even know they were home.

I washed my hands.

you have to stand up for me.

You have to say i washed my hands.

i'm sorry.

you're driving me crazy with the hovering.

This could be a mistake.

This. Us.

You... you're...

you're a really nice guy, and... and, well...

you... you don't want to get involved with me.

If you knew me...

scary.

Finn.

if you knew me,

if you knew my family,

if i told you the guys that i've slept with lately,

the scary and damaged may actually be more than you can handle.

my mother's dead.

She got cancer when i was 10,

and she suffered for a really long time,

and then she died.

My father never recovered.

It was kinda like he died with her,

except his body's above ground

and permanently placed in front of the tv

with a bottle of scotch in his lap.

The last woman i slept with was my wife.

But she died, too.

It was a car crash, so it was quick.

She didn't suffer, which i appreciated.

Don't worry.

I'm thinking my luck is beginning to change because... i've met you.

And you like dogs and you enjoy pony births

and you have the ability to save lives.

i never said i wasn't scary and damaged, too.