Grey's Anatomy (2005–…): Season 3, Episode 16 - Drowning on Dry Land - full transcript

...viously on Grey's Anatomy.

We just received word of
a mass-casualty incident nearby.

You cannot tell Shepherd
until I've told Meredith.

Cristina and I, are engaged.

Immediate! Immediate!
I need help down here!

My buddy's trapped.
He's trapped under a car.

Dr. O'Malley and I made a deal.

He's gonna find my son.
Before I go into surgery.

I just have to bandage him up.

We're gonna find someone
to take him to the hospital

- and then we're gonna find your mom.
- I gotta get outta here.



Like I said,

disappearances happen.

Pains...

Go phantom.

Blood...

stops running.

And people,

people fade away.

There is more I have to say.

So much more.

But...

I've disappeared.

Did you check on Kramerin on 2309?

Because his x-rays are done,
and I don't know what to do.



Higgins in 2312 needs

- diet orders before he can eat.
- Done and done.

I need you to monitor Collins in 2323.

Page me if his systolic drops below 90.

I gave him a loading dose of dig
to lower his heart rate. right now.

Have either of you seen, Dr. Grey?

I checked on her earlier,

- but she's a little sedate today so--
- Not Dr. Ellis Grey.

Dr. Meredith Grey.

- No.
- Not since this morning.

Fine, if there's anything
emergent, page me in the pit.

George...

Did you find him ?

Is Chris okay ?
Is he awake ? Is he...

Answer Mrs. Heit, O'Malley.

Chris is fine.

He's glad you're okay and
he'll be waiting for you after surgery.

He's being very brave.

That's my Chris. That's my boy.

Thank you, Dr. O'Malley,
so much.

Dr. O'Malley.

Hold up a second.

So what happens when
the happy mother in there

wakes up after surgery and her
son isn't there to greet her ?

What then?

How you gonna explain that, O'Malley?

If she wakes up after surgery because

my lie helped to save her life,
I'm okay with that, Dr. Bailey.

- Find that child.
- Yes, Ma'am.

Her echo showed cardiac tamponade.

So our first priority is stabilize

the traumatic pericardial effusion.

Well, keeping mom alive
means keeping baby alive.

I'll monitor the surgery
while he operates.

I'll notify the O.R.

Chief, we got a mob scene
in the clinic

of people looking for
missing family members

and nothing but
a 2-hour-old list of patients.

No one has any more
information than you do.

The police are asking us questions.

Search and rescue can't track it.

We'll have to do it ourselves.

Is there some kind of system that--

You're the system, Karev.

Figure it out.

How's she doing?

Well, we won't know until
we get her up to the O.R.

Is she still a Jane Doe?

Yeah.

Oh, to be in that condition and have
no one who knows you even know...

What?

I mean, she's all alone.

It makes you think.

You know, if I went missing, would...

anyone notice I was gone?

Do something.

He's still seizing.
There's nothing more I can do.

You're supposed to put
something in his mouth

so he doesn't bite his tongue?

Nobody's putting anything
in his mouth.

We just have to let him ride it out.

Wh-What are you gonna do?
You just can't let him die.

Th-They're gonna come soon--
In a little while, and they...

get him out.

You said we don't got much time.

What if they don't get him out
from there before he--

I don't know.

I don't know, okay?
I don't know.

I don't know. Please, you can't
quit on us now. You just--

You just gotta try something else.

I'm out of practice.

I've been watching.
For weeks, I've just been...

watching. I...

I'm sorry.

I'm sorry.

You stopped the bleeding.
That was good.

Come on. Please, Doc.

I know this guy.
I believe in him. I...

believe he can make it.

You gotta believe in it, too.

You gotta believe
you can do this. Please.

Don't stop now.

Who's got a cell phone?

You guys good?

You okay?

- Yeah, what do you got?
- Nearly severed leg,

but he had his artery tied off, so...

- that's something.
- Yeah.

Who tied off the artery?

Was it Dr. Grey?
This is her jacket.

We found him like this.

She must have moved on.

Yeah, okay.

- Doc.
- Yeah.

What is it?

Yeah, just stabilize the fracture

and get him to the hospital
as soon as possible.

Hey.

You okay?

Hey, did--

Did the doctor bring you here?

Meredith?

Is Meredith okay?

Hi, my name's George.

Is your name Chris?

No.

Is he yours?

Thank you. Thank you very much.

- Do you have a new list?
- Not yet.

Nothing? How can there be
no new information?

Isn't there someone you can call?
Someone who knows something?

Uh, nobody knows anything
right now, so...

- Please!
- Quiet!

All right, that list is all have
for you, and it sucks, but that's it.

I can't believe you don't have
some kind of a system. I mean--

Give me a minute to think.
I'll come up with a damn system.

I just want you to know

that I understand you're
under a lot of pressure.

If you-- If you just need
to sit for a minute...

or if you need a hand...

or a hug...

This is chief Webber.

Oh, chief, I got a guy here,

and-- And we--
We can't extricate him.

- Hold on. Hold on. Who's this?
- And I've tried everything.

It's Izzie Stevens.

I'm at the dock. I've got a patient
with a depressed skull fracture

and probably an intracranial bleed.

Is he showing signs
of increased pressure?

Yes. His left pupil is blown.
He's gone limp.

He's seizing, and now
his right pupil is dilating.

He could be herniating. What's
your E.T.A. to the hospital?

That's what I'm saying.
We can't get him out.

He's stuck under a car,
and we can't get him out.

Okay, first you've got to stay calm.

I can't stay calm.

Calm was over minutes ago.
Calm is gone. Calm...

is an impossibility.

I've got his best friends here,
and I can't let him die.

So please just tell me
what I need to do.

You need to do some burr holes.

Burr holes?

I can't do burr holes out here.

Do you want to save
his life, Stevens?

- Yes.
- All right.

I need a mine to check
something out in the book,

and then I'll talk you through it.

You're looking it up in a book?

I'm not a neurosurgeon, Stevens,

and I want to make sure
we get this right.

Somebody find me a copy
of boardman's neurosurgery!

Everything okay?

You know anything
about making burr holes?

Done it a couple of times.

Good.

Don't go anywhere.

Stevens, listen to me.

I'm gonna need a drill.

- There's one in my truck.
- What do you need a drill for?

I've gotta drill holes
in your friend's head.

Watch, your back!
Come on, come on, go.

Uh, hello.
I'm suturing here.

- Sorry. I'm--
- What, you-- Oh, you just got back?

Yeah, Um, I'm looking--

Have you, uh, seen any
lost children down here?

Is Meredith back, too? 'Cause
I need her, it's really important.

This is important. This kid's missing.
His mom's in surgery.

- What kind of surgery?
- This kid's lost.

You didn't see it today, Cristina.
You weren't out there.

I know.

Have you seen any lost kids
down here or not?

- Not.
- Okay.

- Do you know where, uh, Meredith is?
- I'm leaving.

Yeah, I know.

All right, if you can identify
the patient,

please write their name on the picture.

I've got markers.

These patients are in surgery,

and these patients
are in the I.C.U.

This is Fatima!

Is she okay?

Uh, yeah. She's in--
She's in the O.R., stable.

Okay, all these people have been
transferred from other hospitals.

Oh, and I have the details.

No.

If it's okay, I got--

I got a case I need to check on.

My husband's not on that board.

Kelly winter-- She's not either.

What does that mean?

It's, uh, it's, uh, they could...

be in shock or...

- walked away from the site or--
- Just say it.

A lot of people died. They're dead.

W-We don't know that.

So how can we know?

My wife,

she wasn't in these photos either.

But she's pregnant.

Is-- Is it possible
you just didn't see her?

She's pregnant?

What?

It's okay. Just think.

Where is she?
Which way she go?

It's okay, take your time.

Take all the time you need.
You're doing great.

What is it?

Good

Okay.

Use your words

Where exactly is Meredith?

The leak in the heart is coming
from the right atrium.

Are you gonna put her on bypass?
'Cause that could compromise the baby.

No, I can fix her heart
while it's still beating.

Push 40 milligrams of esmol.

I found her husband.

I found him.

She's not a Jane Doe.
Her name's Casey.

Casey Clark.

What?

How do you know?

What?

How do you know, it's Casey Clark?

Well, she's pregnant and--

There were hundreds of people
on that ferry, Alex, hundreds,

and chances are that more
than one was pregnant.

Now do not give that man hope

unless you are certain.
Do not give him hope

until you've checked every
last body in the morgue.

- Dr. Burke, can I, uh...
- yes, make it fast.

I gotta tell you,
this group of interns...

- Emotional.
- Headstrong.

Hotheaded, stubborn.

They think they know everything.

You can only give them so much rope
before they hang themselves with it.

It's like they lose all rationality,

don't want to listen to reason.

Jeez, preston. Don't hold back.

She's getting hypotensive.

I'm seeing some late decels
on the fetal heart monitor.

The baby is not getting
enough blood.

Almost... just got... one...

more stitch.

Got it.

Turn on the echo.

Baby's heart re is stabilized.

Then we've seen the worst of it.

What's the deal?

Do you know how massive
this hospital is?

How many people--
Not just sick people...

Not to mention, if I'm a little kid,

how many places can I hide?
He's little.

A little kid can hide anywhere.

What, you're looking for a kid?

Yeah.

His mom's in surgery, and I, um...

If I don't find him, Bailey will...

Well, to start, she'll change her

son's middle name to... Elvis or...

Tupperware or...

I'm not kidding. Anything
will be better than George.

I know a place a kid might be.

Really?

You coulda warned me.

Well, you didn't check down here, right?

No.

So stop whining and tell me
if you find a pregnant chick.

You know, you're not the only one
with a detail that sucks.

You know,

I'm supposed to deal
with these freaked-out families.

I'm not good with people. They should
just let me stick to patients.

Patients are people, especially kids.

- You know what I mean.
- He's facedown.

How does that...

Come here and help me
turn his body right.

- Dude...
- Don't tell me it doesn't matter.

- God, I swear to...
- Dramatic much?

This doesn't bother you?

Any of this?

All this death, it doesn't
mean anything to you?

I'm working. Why would it?

Yeah, well, there's working and then...

Caucasian female, about 30 years old.

She's...

She's pretty.

She looks about
seven months pregnant.

Now remember, Stevens,

that drill isn't just gonnstop
like a neurosurgical drill,

so as soon as you feel
a release in pressure,

stop the drill or
you'll pierce his brain.

Even if I don't see blood?

Trust your instincts, Stevens.
Trust the feel of it.

I'm ready.

No, wait. I need to clean
the drill off one more time.

You've cleaned it
a dozen times, Stevens.

It's as clean as it's gonna get.

You ready?

Yes.

Okay.

Place three fingers above the ear

and two or three fingers
in front of that,

on the side
where the first pupil blew.

Got it.

All right. Now use a scalpel

to make a vertical scalp incision

down to the skull.

Jeez.

I see a lot of blood, a lot.

Superficial bleeders.
Nothing to worry about.

- Are you at the skull?
- Yes.

Drill a hole in the middle
of the incision.

Oh, god.

Okay, that can't happen.

Do you understand me?

Sounds can't happen.
Freaking out,

can't happen. Because if you
freak out, I'm gonna freak out.

And I'm the one holding a power
tool to your friend's brain.

So if you're gonna vomit,
If you're gonna make sounds, step away.

If you're gonna stay here,
you have to pull it together.

Okay?

We're good, Doc.

Okay.

I'm ready.

The temporal bone's only gonna be
a couple of millimeters thick.

Okay, I'm in.

But the dura looks fine.

You're gonna have to go in again.

Frontal lobe, right?

That's right.

Just behind the hairline,

a few centimeters off the midline.

This bone will be thicker,

about five times as thick
as the temporal bone.

Okay.

Got it.

Second hole done.

What do you see?

I think I see...

blood. I s-see some blood.

Okay, now this is important.

Drill around the hole
to expand the opening.

You have to try
and relieve the pressure.

Okay.

Okay.

Uh, the hole is about
2 centimeters around now.

I see blood.
I definitely see blood.

Try to evacuate as much
of the clot as you can.

With what?
I don't have suction.

Use your finger,

gauze, anything.

I see clotted blood.

- No arterial?
- No.

Good.

Now how does the dura look?

Is it bulging or does it look lax?

It looks like it's...

pulsating regularly
with the heartbeat.

That's another good, right?

That's great, Stevens.

If it's pulsating, that means

blood and oxygen
are entering the brain.

Okay, now pack it with gauze

so you can minimize
the bleeding.

O-Okay.

Now get that rescue rig in here.

Nicely done, Stevens.

Is that it?
Is he-- Is he gonna be okay?

We've relieved the pressure
on his brain,

but he's still got
a lot of other injuries.

Hey.

His eyes are open.

Hey, kid.

Kid.

You okay?

You need to come with me.

Kid?

Our E.T.A. Is five minutes.

How is she doing?

Good.
No intestinal damage.

Missed all her vital organs.

She's almost done here.
You find her son?

I've looked everywhere.
I've been in contact with the scene,

with Mercy West,
with Seattle Presbyterian.

I've checked in, uh...

He's lost...

or...

- or, uh...
- He's in the water.

So when she wakes up,
I get to inform her

that she's not going to die,

she's just gonna want to die.

I'm sorry. I will-- Okay,
I'm gonna keep looking.

Yeah, you do that.

His right pupil's not dilated anymore,

and he's normotensive, but his
pulse is still up in the 130s.

Okay, what's his neurological status?

G.C.S. is 8.

I'm sorry. I ran out of sterile drapes.

I had to use some guy's t-shirt.
It wasn't sweaty or anything.

- He was a clean guy, but--
- Okay, call the O.R.

Tell 'em we're coming up.

I also dropped
the scalpel in the field,

and by that time, I had
used all the alcohol swabs

on the drill bit, so...

I think we should load him up
on antibiotics,

lots and lots of antibiotics.

Stevens you put a drill
through a man's skull

and didn't hit his brain.
You saved his life.

Get cleaned up and get to the O.R.

You got work to do.

The O.R?

Yes, the O.R.

You're officially off probation.

Cristina! Oh, my god. You are
not gonna believe what I just did.

I'm gonna tell you,
but you're not gonna believe it.

- You're gonna think I made this up.
- You're back? Is Meredith back?

I drilled a hole
into this guy's skull...

- What?
- Several holes, actually,

With a drill I borrowed
from a guy named Vince,

patched the hole
with freakin' tissue,

then brought him back here, and now
I get to scrub in on his craniotomy.

- So you haven't seen Meredith?
- It was like a ride,

this crazy roller coaster ride with--

With adrenalin
shooting out of my ears.

You'd think that my hands
would be shaking,

but they weren't.
There was no shaking.

- Did I mention the drill?
- Okay, Izzie.

I get it. You are a hero.

I am jealous.

But I need to know
where the hell Meredith is.

Okay.

I-I don't know,

where the hell Meredith is.

But she should be back here.
I didn't see her at the scene--

The scene where,

I was a rock star, by the way.

Did I mention I'm off probation?

Rock star.

These photos are fatalities.

I know it's difficult,

but please try to I.D. who you can.

We've agreed to let you
do the honors...

A few more burr holes
to start the craniotomy.

Really?

You saved his life.

You might as well help finish
what you started.

After I strip off the periosteum,

you can see
what a high-speed pneumatic

neurosurgical drill feels like.

Drill, please.

I, uh, we, uh,
have two pregnant women.

One of 'em is-- She--
She's in bad shape. She's...

pretty beat up.
She might be hard to recognize.

What? I-I don't know.

What color is her hair?

Brown. R-Reddish.

My wife-- My wife is blonde.

Brownish, but blonde.

Yeah. Sometimes the blood makes
it look darker like that, you know, red.

I know you can't tell from the photo,
But her eyes are--

They're pretty distinctive.

Casey's eyes
are very distinctive.

Yeah, brown,

but not that really dark,
dark brown.

More-- More golden and--
And-- And really warm.

That's not her.

Casey's eyes are blue,

Very, very blue.

I'm sorry.

I thought you-- You said
you had two pregnant women.

Yeah, we, um...

The other one is, um...

She's...

Oh, god. Oh, no.

Oh, god.

Oh, Casey.

Oh...

Oh...

- What do we got?
- Jane Doe, hypothermic drowning--

She is not a Jane Doe.
It's Meredith Grey.

It's Meredith.

Derek.

Derek.

- Derek, how long has she been down?
- I don't know.

She's-- She's alive.

- One, two, three...
- Derek.

She's alive.

Okay, look, I need you
to help me get her inside.

Clear a trauma bay, stat!

Move it!

How was your surgery, Dr. Burke?

Well, the patient is out of
the woods now, Dr. Yang.

Thanks for asking.

You're numbed.

Whatever. It looked harsh.

Fran, finish this, please.

- What is your problem?
- Know, everyone's back.

Everyone's back except her.

And I listen to her

every day about her McLove life

and McDreamy and McCrap, and--

And on the one day--
The one day I have a thing--

She disappears.

Meredith? This is about Meredith?

- She doesn't know yet.
- Meredith?

She's my person.

Right.

And if Meredith doesn't approve,
then what?

No. This is not about getting
her approval.

- It's about--
- What?

Telling her makes it...

makes it...

if I murdered someone,

she's the person I'd call

to help me drag the corpse
across the living room floor.

Okay. See, now you're likening
someone here to a corpse.

I'm done.

She's my person.

Removing the bone flap.

Ready with suction.

Looking good.

Yes.

Yes, it is.

Dr. Stevens,

it's your pager.

That's okay. It can wait.

I think you want to take this page.

How's she doing?

She's holding steady for now.

Anybody claim her yet?

No.

She's still a Jane Doe.

I'd notice.

What?

If you went missing...

I'd notice.

Okay, I need a little
more suction, please.

Callie.

O'Malley, I'm working.
What do you want?

I read on the board you're doing an
internal fixation of the lumbar spine.

On a John Doe
from the ferry crash, age 7.

That's right.

Can I see his face?

I'm in the middle of surgery.

I know. I...

Is this boy your patient?

I-I know the picture's half
smeared and hard to see, but...

Please tell me it's him.

Tell me he has been right here

under my nose, open on your table
all day and not..

drifting along the bottom of the ocean.

Just... please tell me that.

Hold the photo under the light
so I can get a better look.

Oh, yeah.

Oh, yeah, that's my kid.
I could spot those goofy ears anywhere.

- Really?
- Really.

Callie O'Malley...

I can't kiss you right now
because you're scrubbed in,

but tonight...

When you get home,

- I am going to--
- Okay.

Okay. All right.
You know what, people?

Let's focus here.

- George, I'm working.
- Yeah.

I'm...

I'm working.

So... yeah.

Bye.

Oh, my god!

Oh, you're safe.

You're safe.

Oh, honey,

mommy's sorry she got lost.

Oh, lisa.

They could only put a 20-guage
I.V in, but I think it blew.

I'll start a central line,

but you have
to get out of the way.

We-- We put, uh, 3 milligram
of epi down the E.T. tube--

Derek!

The last dose was three minutes ago.

- We should push--
- Shepherd, get out.

I think we should push
just 1 at-- atropine.

I think I saw some reactivity,

in her pupils, before the atropine,

and I think she might
have actually had some,

- cardiac activity--
- Shepherd, get out.

We need to put an external
pacer on just to make sure.

We need to save her life.

You can't do this.
We need to do this.

Now go.

Go.

Three, four, five.

Okay, she has a new 18-guage
in her left A.C.

Push 1 of epi through it.

The chief is working on her, man.

He threw me out.

What do you need?

I need you to go in there.

Give me a new warm blanket.

Her temp's still only at 80 degrees.

What can I do?

She needs an A.B.G.

Was that V-Fib?

Charge to 300.
Let's go, let's go, let's go.

Okay. Clear.

Back to asystole.

Keep compressions going.

- Oh, my god.
- She's hypothermic.

Have you tried a warm peritoneal lavage

or even a continuous
bladder lavage with warm fluids?

- You could do a thoracotomy.
- Get back the A.B.G.

Okay, now let's go, people.

How is her temp?

Only up to 81 now.

Come on, Meredith.
Don't do this.

- It's Meredith?
- Yeah.

Are you sure? Did you see her?

- Because it could be anybody.
- It's Meredith.

She will come through this.

You don't know that.

She will come through this.

People die.

I know people die.

People die in front of us every day.

But I believe
Meredith will survive this.

I believe...

I believe-- I...

I-I believe in the good.

I believe tha
it's been a hell of a year.

And I believe that in
the face of overwhelming

evidence to the contrary,

we will all be okay.

I believe a lot of things.

I believe that...

I believe that Denny is always with me.

And I believe...

that if I eat a tub of butter
and no one sees me,

the calories don't count.

And...

I believe that surgeons who prefer

staples over stitches are just lazy.

And I believe that you are a man

who made a terrible mistake
marrying Callie.

And I believe that because
I'm your best friend,

I can tell you this,
and we can be okay.

I believe even though
you made this mistake,

you will be okay.

I believe we survive, George.

I believe that believing we survive...

is what makes us...

survive.

She's gonna be okay.

Push another epi.

How many is that?

This is her fourth round, sir.

We've been here 20 minutes.

Still in asystole.

We're losing her.

Hey.

Hey.

Am I...

dead?

Damn right, you are.

Holy...