Grey's Anatomy (2005–…): Season 5, Episode 14 - Beat Your Heart Out - full transcript

Come on.

Come on, come on...

Damn it.

Any first year med student
knows that an increased heart rate

is a sign of trouble.

- All day of this.
- Stuck with Stevens.

Why are we in a clinic? I thought
we're supposed to be surgeons.

Not today we're not.
Today's gonna be about flu shots.

- And enemas.
- What a colossal waste of time.

Morning.

A racing heart could
indicate anything...



... from a panic disorder...

- Oh, God! Sorry!
- No, I'm sorry.

I... No, I didn't even look, I'm sorry.

Where? No, no.
I'll leave. I'll leave.

No. Sleep.
You've been here all night.

How did you know
I've been here all night?

... to something much...

I just knew.

... much more serious.

You should wear your hair up more.

Shows off the back of your neck.

I like the back of your neck.

A heart that flutters...

... or one that skips a beat...



Hey. I thought you were sleeping.

- Hunt was in the on-call room.
- You had dirty sex with Hunt?

No. It's not dirty
and it's not sex. It's...

- I don't know what it is.
- ... could be sign of secret affliction.

- Hey, how's it going?
- Oh, my God. Thank you for asking.

It's great. I mean,
he's fun and funny.

Even with no sex allowed,
we just laugh.

- We talk...
- Yeah. I don't want to hear this.

Come on! But you have to!
You're the only one who knows.

I'm terrible at keeping secrets.
It makes me sick.

Alone people don't like to hear
about together people.

Even if alone people
are alone by choice. It's mean.

It's like bringing a six pack to
an AA meeting. Keep it to yourself.

I am.

I need a favour. My mother's ninth
journal. I need you to pre-read it.

- Why?
- She had an affair with the chief.

Your mother had an affair
with her chief resident?

- Rock on, Ellis.
- No, no, no. Not her chief.

Our chief.

- Yeah, you'll go blind reading that.
- Or it could indicate romance...

... which is the biggest trouble of all.

- What is that?
- What you think it is.

Dangerous. People who carry guns
are likely to fire.

I'm ready to fire it. She's the problem.
She spooks easy.

I have to fire at the right time, in
the right way, or she'll panic and bolt.

- She's not ready. Think she's ready?
- I don't know. More importantly,

if you don't know,
don't do anything.

- Dr Sloan.
- Dr Hunt.

Let's make this quick.

- So we're good to go?
- Yep. Use it wisely.

Hey. I'm with you today.

- What's going on with you and Mark?
- What? Nothing.

Why? What did you think is... was?

You've been on his service
for over a week.

Yeah, I'm really interested in Plastics.
As a specialty. Fascinated.

I like faces.

Vehicular blunt trauma, right shoulder
stabilised in the field.

- Somebody help us! Please!
- Jen, slow down. We're here.

Can you help my husband?
I ran him over with the car!

Sweetie, sweetie.
You have to calm down.

- I'm gonna be fine.
- OK. I'm calm. I'm calm.

- All right.
- I'm calm.

Oh, my God.
That's my stupid pregnant brain!

I left the car in drive.
Baby, I'm so sorry.

- It's a normal neuro exam.
- He's got an inferior

shoulder dislocation and fractures.
You'll need surgery.

- Sloan will d?bride burns in surgery.
- Surgery? Oh, baby!

- Her BP is 170 over 100.
- Give her five of hydralazine.

- Calm down. How's the baby?
- Kicking. Pressing right on my bladder.

Look on the bright side. She's not
running you over with a truck.

Hey, you wanted the SUV, right?

- Pregnancy-induced hypertension?
- Get her BP down before

- it affects the baby.
- Nice couple. They'll have cute kids.

Not as cute as ours, but cute.

- What?
- Nothing.

It's been three days.
Three days of vacation.

The only days I've taken,
other than my maternity leave.

- I know I'm behind, but...
- Bailey, I get it.

Jackson Prescott was not an easy case.

Frankly, sir, I would rather not
work on another dying kid again.

But no need to worry.
I will catch up...

I'm not worrying.

I'm promoting you.

I need another attending
in General Surgery.

I'm submitting to the board
that it be you.

And that it starts this July.

The minute you've
completed your residency.

I know there was some talk
a while back

about you getting tired
of appies and gall bladders...

A full roster of appies and
gall bladders sounds just perfect.

All right. But not today, though.
Dixon's requested you on her service.

This is subject to board approval,
Bailey, though I'm not worried.

You have less to say now?

Get out of here.

Dr Dixon is not big on eye contact,

so don't be surprised
if she doesn't look at you.

Also, try to avoid physical contact,
loud or disruptive noises.

- She's OK? She's a good doctor?
- She's amazing.

You couldn't ask for a better surgeon.
I'm telling you so you'll be prepared.

Dr Dixon, Dr Bailey,
this is Dan and Lisa Pollock.

I need to see the patient.
Where's the patient?

- Hi.
- This is Stacy Pollock, age nine.

She's suffering from
pulmonary hypertension due to a VSD.

Her EKG also shows a left
ventricular hypertrophy, also...

- Hi. Can I help you folks?
- Not him.

- What's the trouble?
- Not him either.

Thank you. We'll wait.

What about him? Hello.
Could you help us, please?

- We need to talk to a grownup.
- This is the chief of surgery.

Just hold on. That doesn't mean
I'm not a doctor. How can we help?

- My husband...
- Our children went to college.

One's at Stanford,
the other at U-Dub.

We tried something... a new thing.

- Something slipped and we lost...
- Rachel.

We were reading this thing
in a magazine...

Here.

"Twenty Techniques
to Re-lgnite Your Nights."

We did Number Nine.

- Let's get you in a gown...
- No. He did Number Nine.

- We did Number Nine.
- I'm not the one with it stuck in my...

It's him. He's the patient.

Have a seat.
We'll... take care of you.

I'll stand.

- Taking him now? For surgery?
- It's a good thing.

We'll get his dislocation fixed so we
prevent problems with circulation.

Her last BP was still up:
162 over 102.

The OB was worried
about placental blood flow.

Stay with her.
Try to keep her calm.

- OK.
- Cheeseburgers and...

- Painkillers are working.
- Anything else I can get you?

I'm OK. Are you really taking him now?

Yeah.

Cheeseburgers... Cheeseburgers.

She's more relaxed when she eats.

- Cheeseburgers calm her down.
- Thanks for the tip.

Stacy has a VSD,
which has gotten worse over time

and created pulmonary hypertension.

- Does she need surgery?
- Are you OK?

That child looks like she's gonna die,
I am walking out.

I'll perform a transcatheter closure
to repair the defect in the septum.

That baby doesn't understand
a word she's saying.

She says we're gonna fix the part
of your heart that pumps the blood

- to your lungs.
- It should be a simple patch repair.

- Probably something easy to fix.
- But a full midline sternotomy incision

- may be required.
- Now she's making stuff up.

- I like your socks.
- Thanks. They're for soccer.

I'm the best on my team.
Mom says that's bragging.

Dad says it's not,
it's just the truth.

You can't fight who you are.
If you're the best, you're the best.

When you fix my heart, how soon
will I be able to play soccer again?

- I missed half the season already.
- Well...

...we'll have to see.

Cristina.
Did you tell her about the ring?

- I don't want to talk about your ring.
- Don't.

You're not doing a big, McDreamy thing?
She'd hate that.

- She built a house of candles.
- She built you a house of candles.

- You like that sort of thing.
- OK, thanks.

How is it? The journal? Is it gross?
Are they naked?

No, not yet. It's kind of...

...hot, actually.
But, like, chastely hot.

It's all stolen glances
and loaded exchanges.

The thing reads like
a Victorian romance novel.

- Chaste is good.
- I'll let you know when they do it.

She said a thing about babies.
Like babies was a totally ordinary idea.

- Not afraid. She's ready.
- When are you gonna do it?

- What?
- Shepherd's proposing.

- No kidding! Outstanding!
- Thank you.

- How are you gonna do it?
- I don't know. I just decided.

- Morning.
- Shepherd's proposing.

- Congratulations. Big step.
- Thanks. Telling everybody?

You need advice.
Hunt, you ever proposed?

I'm not the guy to ask.
When are you gonna do it?

- More importantly, how?
- What do you use, a twist-drill?

Not if you don't want
a partial-parietal haematoma.

- Hi.
- Good luck.

Don't tell anybody else, OK?
I thought I could trust you.

Of course you can trust me.

We got the short end of the stick.

- Quit laughing! We're gonna get reamed.
- Dudes...

The patient can see you giggling
over here like schoolgirls.

- Enough wise cracks.
- Cracks!

- What's funny?
- Sorry, sir.

These idiots were screwing around,
and I kind of got... sucked into it.

Enough. If you children
need a lesson in professionalism,

then come and see how it's done.

Mr Kramer, your biplane abdominal
radiographs show a foreign body.

We'll perform a sigmoidoscopy
and proceed with manual extraction.

- You'll get it out?
- We'll get it out.

- Hold it.
- That's the third time!

- What's the problem?
- She can't find a vein.

And she's pokin' me
like I'm her needlepoint.

What is wrong with you people? Didn't
you practice this on each other? Look...

All right. When you have a good vein,
it should feel bouncy,

like this one, OK? You go in
at an angle, not at 90 degrees.

Yeah. Yeah, like that.

Good.

Next time she'll do it on you.

You know, why don't you
run them both.

Listen up, you guys.
Before you run any more procedures,

come see me first.

So, clean bill of health from Hunt?

- Gonna get back on the horse?
- I wouldn't use the word "horse".

That's not gonna work out. Things
changed. I'm gonna break up with her.

You're what?
What is wrong with you?

I had to make sure the patient's wife
is stable. She's hypertensive.

I think this surgery's
more stressful on her than him.

Damn it. There's a huge tear. Clavicle
jutting into the artery. Hold this.

I'll hold pressure.
Page Hunt. Get him in!

No, they can't. Patient's unstable.
Subclavian's bleeding out.

- It doesn't look good.
- Thanks.

What'd they say?
Did they say it's going well?

It's taking... a little longer
than expected.

But don't worry,
because it's going great.

- It is? Are you sure?
- Yes.

You know, it's good
when they take their time.

Right now, there is no reason
to believe that he's not gonna be...

...just fine.
- OK.

Thank you.

Hey, your pressure's way down.

Jen?

Jen!

- What's happening?
- She's tamponading.

Her BP crashed
and she has muffled heart sounds.

Damn it. Gloves.
Yang, Betadine and give her local.

Stacy, sweetie,
you're gonna be all right, OK?

Don't worry. 18-gauge.

- What are you doing?
- Lisa, turn around or leave.

You're not gonna wanna watch this.
Keep the ultrasound over the effusion.

Stacy, honey, you're gonna feel a little
pinch and then a lot of pressure.

And then you're gonna
be all better, OK? Here we go.

Good. Oh, good job, Stacy.

There. See? It's all better. Good job.

Good job, honey.

All better.

Her pulmonary pressures are high.
She's got cor pulmonale.

I'm moving up her surgery. Yang's
getting an OR now. See you in there.

Let me know how it goes.
Great save, Dr Bailey.

I think you better stay.

I'm not scrubbing in on this one.

Bailey.

- You can handle this surgery.
- I can.

What I can't handle
is feeling another child slipping away,

- right in front of me.
- Mostly, they don't slip away.

Even the really sick ones.
Jackson was a special case.

- Even he survived.
- By the skin of his teeth.

But he survived.
Children are resilient.

In all likelihood, you'll open this
girl's chest and fix something simple.

Then you'll hand her back
the rest of her life.

I'm telling you, Bailey,
you want to be there for that.

Come on, come on, come on, stabilise.

BP's going up. Going up.

- Thank you.
- He should be good to go.

- Dr Grey? Jen Harmon...
- Tell Jen he's stable.

She's not. She had a seizure.

- A seizure?
- We got him, Grey. Go help her.

- You're an idiot.
- Excuse me?

You're an idiot.
What is your problem?

He is proposing to her. That makes
Little Her his little sister.

And I can't sleep with any more
of his sisters. And she's young.

- And I'm her boss.
- And I'm celibate.

- What's that have to do with anything?
- Celibacy's lonely. Don't spend time

wondering what you are or who you like

or whether it's right for you or wrong
for you. Let yourself be happy.

Before you find yourself alone...
and celibate.

Does she really need a chest x-ray?
She's got the flu.

Say that after you've
ruled out pneumonia.

Be quick and efficient,
keep a smile on your face

and make stupid happy small talk
to keep them distracted

- and not panicky.
- OK. Should I do the small talk now?

No.

Just tell me to lie still
and take a deep breath.

OK. Big breath in,
and then don't move.

So... how are you gonna do it?

You gonna... go big?
Grand, romantic gesture?

I... I don't know yet. I'm not sure
Meredith's a grand gesture girl.

You want to do the grand gesture.

It's the opening pitch.
It determines the entire game.

You've gotta go all out.
Your plans should include flowers,

candles, exotic foods,
live musicians and a rowboat.

- Skywriting is not out of the question.
- Dr Shepherd.

- Yes.
- You gotta...

- Hi.
- What's up?

- I need a neuro consult.
- OK.

- That's big. You better go.
- Thanks, chief. OK.

OK.

- How we doing, Mr Kramer?
- Oh, fantastic.

They didn't cover this
in the What To Expect books.

- They didn't say "Expect seizures".
- We're doing an exam.

- Look down for me.
- OK.

- What's that?
- Dr Grey.

Could you set up an MRI
for Mrs Harmon, please?

- Did you see?
- Now.

OK.

- Oh, you saw something.
- No, no.

No, I'm sorry.
Can you keep a secret?

You bet I can.

This is intended for Dr Grey.

- Supposed to be a surprise.
- My God, I almost blew it!

When are you gonna do it?
Please do it today.

- Do it here.
- No. I don't know.

I was told it's supposed
to be a grand gesture.

Rob proposed to me
in a supermarket aisle.

He said that was the place
he saw me for the first time.

So I said yes between
the cat food and the tampons.

- That's romantic.
- It was, actually.

We still have to do the MRI, OK?
Just to be safe.

- OK. Dr Shepherd?
- Yes.

- Should I be scared?
- No. Should I?

No.

Eisenmenger's complex.

- Can it be repaired? Too far gone?
- Children are resilient.

Nine times out of ten you'll
find something simple to fix.

- What is it?
- I can repair the VSD,

but this heart is finished. This is one
of the most diseased hearts I've seen.

ECMO might hold her over,
but without a heart-lung transplant,

she's going to die.

Dr Bailey?

- Dr Bailey?
- It's OK. I can take care of this.

Her heart is too far gone.

There's far too much
scar tissue to repair.

We've started her on IV medications,
which she'll need on a continuous basis.

- For how long? How long does she?
- Until she can receive a transplant.

- Months?
- Years, possibly.

- Years? She'll lay in a bed for years?
- I'm afraid so, yes.

Where's Dr Bailey gone?

You want to take narrow slices
with the scans,

- so you get a more comprehensive look.
- OK.

What do you see?

I see a crazy person,

taking expensive tests for no reason.

And I see the chief finding out
and expelling the crazy person.

Then I see joblessness,
homelessness and depression.

It does not look good, lzzie.
It does not look good.

Somebody kick Dr O'Malley
out of the booth.

- Have you seen Bailey?
- No, but I have to talk to you.

Derek is going crazy. I said something
about having cute babies,

and he's been acting weird
and avoiding me

and dropping conversations. He wants
babies. He's always wanted babies.

- He wants babies.
- Maybe not my babies.

- No, that's not...
- My babies will have Alzheimer's.

And suicidal tendencies.
And split ends.

- Might have something.
- I don't think you do.

- Who are you?
- I'm Jen.

How are we doing? All set?

If you're gonna do it, do it soon.
She's really freaking out.

Thank you.

They tried Nine? Who does Nine?

Personally, I'm a fan of Five...

...Seven, Eight...

Pretty much 12 through 20.

- I would try 15.
- Don't try 15.

I would try 16. Yeah.
I've never done that before.

- You'd try 16?
- I would.

I totally would.

Don't do 16 too fast!

You can get hurt. Badly.

- I've heard.
- You know who likes a good 12?

- You on-call tonight?
- Looks like it. You?

If she misses one dose of medicine,
it would be bad?

- It would be fatal.
- The drug needs to be administered

- at 3-minute intervals.
- She'll live in a hospital...

No. There's another way.
There's a way she won't have to.

- With a diagnosis of pulmonary hyper...
- The girl needs a backpack.

A backpack that has a portable pump
that will deliver her meds

and allow her to play
and go to school and have a childhood.

- Until she gets her new heart.
- This is something we should discuss

- privately...
- She can leave?

She can. She has to wear
the backpack at all times.

Put you in a programme,
teach you to administer medications.

Do you have a prettier one?

- Oh, my God, Dr Bailey. Thank you!
- Dr Dixon, thank you so much!

- So much!
- Dr Dixon!

- Thank you!
- No! No, no!

No!

Dr Dixon, what can I do?
How can I help?

You can observe protocol.
I was getting to that option...

It was too much. There was too
much yelling, too much touching.

Too much.

OK. I'll leave you alone.

No, no! I don't need alone.
I need pressure.

- I...
- I need my nervous system suppressed.

I need tight constant, deep,

tight pressure across
large areas of my body.

I need you to hold me!

- OK...
- Tight... tightly.

Tighter.

You're a very tiny person.

I need a bigger person.
I need more...

Should I?

- What can I do?
- Get over here and hug on Dr Dixon.

- I was thinking a shot of Thorazine.
- Get over here.

- Just...
- Yeah. Good.

An aneurysm? A brain aneurysm?

All your symptoms, forgetfulness,
dizziness, chronic headaches,

- can be associated with pregnancy.
- The reason we discovered yours

- is because of the seizure.
- So, what? You can fix it?

- You can take it out?
- First thing in the morning

after Rob's recovered from
complications with surgery.

Complications? What?

You said... You said it was fine.
You said he was OK.

- You lied to me?
- I'm sorry. I didn't want to worry you

- until I knew. He's fine.
- You'll be fine, too.

- But it could burst, right?
- Jen, you have to stay calm.

You just told me there's
a time bomb in my head!

I promise you that
I'm not gonna stay calm!

Cows are squeezed in a chute
before they're slaughtered.

The chute applies intense pressure.
Resulting in decreased pulse rate,

metabolic rate and muscle tone.

- It calms them down.
- It calms them down.

The same principles apply to me.

A hugging machine is used to relax
the sympathetic nervous system.

Slows the heart.

This is good. This... It's working.

- So we can stop now?
- No.

Almost there, Mr Kramer.

- Hold on... There.
- Oh, my God!

Thank you! Never again
will I try to spice things up.

- I'm not spicing anything up.
- You tried to step it up.

Anything above Five deserves props.

Sounds to me like you're doing good.
You're together,

and you're both bending over backwards
to find new ways to...

...make each other happy.

Take a step back, you realise
that you're doing just fine.

"Bending over backwards."

You can let me go now.

- You can let me go now.
- Sorry.

Dr Stevens, I have
the blood test results.

- What is it?
- You're anaemic.

Anaemic?

Oh, my God!

Do you realise what you did?
Your face said I was going to die,

- not, "Go get a hamburger."
- Well...

That's part of patient care,
controlling your face.

- I just...
- Anaemic.

This is fine. This is no big deal.
It's like nothing!

How's Mrs What's-her-name?

That's not good, is it?

Yeah. No.

Her LDH is off the charts.

What is it? Is it cancer?

Consult Oncology. Start a work-up.

It's OK. We'll tell her together.

Thank you.

Hi.

- I don't want to keep secrets.
- Sorry?

I've been keeping secrets all day.

About surgeries and rings and you.

And that secret, the you secret,
it's giving me high blood pressure.

I don't want that secret.

We're having... a relationship.

And if we are,
if we're in a relationship,

then I need to be in it

in front of my sister.

And Derek Shepherd.
If we can't do that,

then I can't do this.

- What's going on? What happened?
- Sorry. I can't.

- You're shaking.
- Leave me alone.

I saw someone. Someone I knew.
I can't do this. I can't.

- OK.
- Please, go away.

OK. It's all right.

- It's OK.
- No, I don't want this.

- I don't want this!
- I'm applying pressure.

- I can't do this!
- Relax your nervous system.

Decrease your metabolic rate.
You'll feel more panicked at first.

You'll try to resist it, but eventually
you'll feel your pulse rate slow.

Your pulse rate will slow.
It's OK. Your breath will come easier.

Your breath will come easier. OK.

Breathe.

OK.

I'm sorry for my outburst.
I should have spoken to you first.

It was inappropriate, but I've come
to expect it from paediatric surgeons.

- Always breaking protocol.
- I'm not a paediatric surgeon.

I've landed
a few peds surg cases recently,

but I'm getting back to general surgery
the first chance I get.

You touch the child
whenever you speak with her.

You explain conditions to the child,
not just the parents.

You react to the patient
as if it was your own child.

You break protocol,
which is inappropriate.

Except in paediatric surgery, where
protocols are constantly evolving.

You are not a general surgeon.

You're a paediatric surgeon.

Hey! Did you eat?
Let me change, I'll come with you.

No, no, no. I can't.
I have to... work.

OK, listen. You have been acting
like a basket case

since I dropped that stupid
comment about babies.

If you don't want babies
or if you don't want babies with me

and my crappy DNA, just say so.
You don't have to avoid me

- or make up lame excuses about work.
- Meredith, I want your crappy babies.

- You do?
- All of them.

- OK. Do you wanna eat?
- No. I have... I gotta...

I have to work.

Oh, my God.

- Did you use a BeDazzler?
- Circa 1986.

As seen on TV.

Dixon's right, you know.

You do belong in Peds surgery.

My own baby almost died last year.

The doctors in this hospital, my
friends, all worked to save his life.

And I stood outside the room
feeling so useless,

so pointless and helpless.

Like I was losing everything
in the world.

And when he didn't die,

I knew I didn't want to be anywhere
near that feeling again, so...

I think that makes me pretty unsuitable
for paediatric surgery.

I'd say...

...that makes you uniquely qualified.

- Hey. You mind if I sit here?
- No, no. I'm just...

...overthinking.

You think he'll tell him?

If he's not an idiot.

Are you OK?

I don't... I'm fine.

Derek is act...

What are you doing?

I don't know. I'm just...

...staying here.
- OK. Good night.

He's planning to propose.

- What?
- The chief.

Your mother writes he told her
he would leave Adele.

And come back and get on one knee
and propose,

but I don't think he ever did.

That's sad.

- Is it?
- Or romantic.

It seems we have
no control whatsoever...

... over our own hearts.

- Hey.
- Hey.

- Ortho, right?
- Yeah. Hi.

I'm Arizona Robbins. Peds surgery.
I've seen you at the hospital.

- You OK?
- I'm fine. Fine.

People talk. Where we work.
They talk.

A lot. So for the sake of being honest,

I think I should tell you
that I know things about you.

Because people talk.

Oh... you mean...

- Terrific.
- It is, actually. The talk.

People really like you over there.

They respect you
and they're concerned and interested.

They really like you.
Some of them really like you.

You just look upset.

And I thought that you should know
that the talk is good.

And when you're not upset,
when you're over being upset,

there will be people lining up for you.

You want to give me some names?

- Conditions can change without warning.
- I think you'll know.

Romance can make the heart pound.

Just like panic can.

This is stupid.
She's gonna hate this.

What, the flowers?
Girls love this crap.

It's a clich?. I'm a clich?.

Clich?s became clich?s for a reason.

Because they worked.

It's great, isn't it? When you
feel so strongly for someone,

and it's not just about the sex.

It is...

It's true.

You should not talk like that.

Yeah. You're right.

You're all set here.
I'm gonna leave you to it.

Thanks.

Congratulations.

Thanks.

And panic...

Addison?

... can make it stop cold in your chest.

What happened?

It's no wonder doctors spend so much
time trying to keep the heart stable.

To keep it slow.

Steady.

Regular.

To stop the heart
from pounding out of your chest,

from the dread of something terrible.

Or the anticipation...

... of something else entirely.