Grey's Anatomy (2005–…): Season 5, Episode 16 - An Honest Mistake - full transcript

There's this thing that happens
when people find out you're a doctor.

Good morning.

Did you...

...patter?
- Propose? No. Not yet.

You'll be the first to know.

They stop seeing you as a person
and begin to see you as something

- bigger than you are.
- How's she doing?

She's... OK.

She's OK.

They have to see us that way, as gods.

Otherwise we're just
like everyone else.



Unsure, flawed, normal.

- How's she doing?
- No change. This the MCA Doppler?

Yeah. Can I get you anything?
Coffee?

I'm fine, thanks.

So we act strong, we remain stoic.

We hide the fact
that we're all too human.

He still beating himself up? Addison
thinks he's still beating himself up.

- Alex...
- The head of Neuro hasn't left

- his patient's bedside for three days.
- He's fine.

- I thought Addison left.
- She put her brother on a plane.

Admit it, her hanging
around your guy, it bugs.

It doesn't bug. You bug.

Karev, page Addison.
Tell her I need her to stay.

OK, it bugs a little.



The lack of blood flow is causing
the mini-strokes and aphasia.

We can't put the surgery off any longer.
I'll do a repair called an EC-IC bypass.

And that will fix the strokes?
She'll be better after this?

- I'm hoping it will work, yes.
- But...

They wouldn't operate unless it were
safe for the baby. Dr Montgomery?

Your blood pressure's high, but I'll
be there to monitor you and the baby.

Get some rest. We'll see you soon.

- Thank you for staying.
- Least I could do for saving Archie.

I know what we said before
about the baby,

but if something should happen, if it
comes down to a choice, save my wife.

We can make another baby.
We can't make another her.

Fifty-two-year-old male,
fell down stairs.

Five days post-op from a cholecystectomy
which looks to have caused the fall.

Why would having your gallbladder
removed cause a fall?

A non-laparoscopic cholie?

Sir, what hospital
did you have your operation at?

- Here. My surgeon was Dr Campbell.
- That explains it.

Excuse us for a moment.

All right, what?

Campbell was Seattle Grace's
first female surgeon.

Mostly she just sits in her office
and spreads prestige around.

She still does the routine surgery
now and then.

Botches routine surgery.
I'll page the chief.

- No, page Campbell. It's her patient.
- And let her maim the guy again?

Page someone who knows how to operate,

instead of some dinosaur
who refuses to retire her scalpel

and go join her friends in Boca.

The dinosaur is here.

No need to page me.

- So did you scope her out yet?
- Who?

- Arizona.
- Oh, right.

I haven't had a chance to swing by
Peds and ask the nurse to point out

the attending who kissed my friend
in a bar bathroom.

- At least you're still good for coffee.
- Not for you.

- Coffee. Why, thank you, Mark.
- That's not for you either.

- Good morning, Dr Grey.
- You can keep your secret coffee.

Until you tell Derek, our relationship
continues to consist

of hiding in the attic
and me smuggling snacks past Mer.

- Know what that makes you?
- Your boyfriend?

Anne Frank. I'm dating Anne Frank,
and I'm tired of it.

I want to go downstairs.
I wanna tell the Germans to kiss my ass.

I'm gonna tell him. Soon. When I do,
you'll be my date to the wedding.

- Derek proposed?
- Not yet. But when he does.

This is the first step
in the start of a new life.

How are we feeling?
Positive? Confident?

I am good. Great.

- You take care of your own feelings.
- Peds Surgery is super competitive.

Why I'm armed
with letters of recommendation

to put the competition to shame.
Shepherd says I'm talented.

Sloan finds it an honour
to work with me...

- What does the chief think?
- I'm still working on that.

Chief's recommendation matters.
Everyone on the committee...

I know! You calm down.
I've got it under control.

Good. Because speaking on behalf of me,

we couldn't be more excited
to have you. Yay.

Chief? Just a friendly nudge.

Your recommendation is due
by the end of the day.

- I'll remind Patricia.
- You have written it?

You'll get your recommendation.

- I need more time.
- No.

Don't get me wrong.
I am honoured that you asked me

over all the other residents,

but it's not easy distilling a doctor
of your stature to 500 words or less.

I chose you because you're the only one
to do this without screwing up. Don't.

Make sure he planes the patio...

- Plates the...
- We'll get him piano lessons. Yes.

Only puddle shell...

Only public...

Public school so he doesn't
become a snob, I know.

But I don't have to.
You're gonna be there

to make sure I don't
turn him into a jerk.

We're here.

I love just...

I know. You love me.

And I love you. I'll see you in a few.

Her blood pressure's higher
than it was yesterday.

- We can't wait.
- I know...

You want me to be aware.
You're a good doctor. So am I.

Let's just be good together.

- Your and my guy work well together.
- My guy works well with everyone.

- Dr Stevens?
- Yes.

Think we'll get
to scrub in on a surgery?

You think you're capable
of holding someone's life in your hands

when you could barely finish
the intern bowl? Really? Come on.

Dr Stevens, remember me?

I was here a couple of days ago
when you told me I might have cancer.

You sent me to an oncologist,
who sent me to an immunologist,

who then sent me to some other ologist
I never heard of

before I set foot in this deathtrap.
80 thousand dollars in tests later,

the only thing wrong with me
is that I'm anaemic!

- Anaemic?
- My lawyer seems to think

that someone here
mislabelled the blood.

Switched it with someone else's.
I was told not to come here,

but my conscience wanted to make sure
you went through those files

of everybody who was here
at the clinic that day.

Of course we will. I'm so sorry.

Don't apologise to me.
I'm just anaemic.

You apologise to that dying person.

- Is that the middle cerebral artery?
- Yes, after I connect the STA,

- we will close.
- Baby's having spontaneous decels.

Mom's hypotensive. I don't know
how much they can handle.

MCA's bleeding.
It shouldn't contribute.

Pressure's dropping.
The baby's gonna need to come out.

- Almost done. Wait.
- Not me that can't wait.

- The decels are getting more frequent.
- A foetus can't handle

three surgeries.
We have to get the baby out.

- He's too young to come out.
- Last decel lasted a full 30 seconds.

Let's go. I'm taking him out.

- Ten-blade
- Leave the baby in.

Done. I'm done.

I'm done.

You've got a minor fracture
so you won't need surgery.

You should on your feet
within a few weeks.

I don't know what I was thinking.
The wound wasn't healing as fast...

Next time, you call me, John.

Dr Yang, explain to my patient

what you feel
I should have done differently

in order to avoid this complication.
Don't be shy, Dr Yang.

OK. Well, patients status post
minimally invasive procedures

have been shown to have decreased
post-surgical discomfort...

In human please, Dr Yang.

This surgery should have
been done laparoscopically.

Dr Hunt, perhaps
you can explain to Dr Yang

why I chose to do the surgery this way.

Although some doctors prefer
to use the new technology,

there are others who believe
it's more risky

since we can't see or move around
as much during the surgery.

It's half a dozen either way.

Bravo, Dr Hunt.

- Do you understand, John?
- Yes.

I have no doubt you did
the right thing by me.

Wonderful. Now, Dr Yang,

please take our patient to CT.

Maybe you'll learn something
in the process.

While I confer with Dr Hunt
about our course of treatment.

- I'm on a deadline.
- Sadie Harris mislabelled

a patient's blood sample.
The clinic's getting sued.

- Good thing Sadie no longer works here.
- No, it's not.

Because it isn't just her.
The interns, all of them,

they're capable of the same mistake.
They are dangerous and they are bad.

Don't tell me I'm overly emotional
and it isn't personal!

Because it is personal!
I've worked so hard to teach them,

- and... and it is personal.
- Stevens.

I thought the same thing
about you every day

for the first year you worked here.
Know what the chief told me?

Get out.

You don't get much rest,
do you, Dr Shepherd?

- Did you hear yourself just then?
- Oh, my God!

Oh, my God! I can talk!

I know! Listen to you!

And the baby?
How's the baby?

The baby's stable. However,

your new labs show
that you're pre-eclamptic.

We hoped to keep it from progressing
to this stage, but stress of surgery

- was a lot on your body.
- So do we need to be worried?

Come on! Dr Shepherd, please tell me
we're done being worried.

First moment of hope
they've had in a week.

Pre-eclampsia is serious.
You're too close to this patient.

Stop fighting me on this.
We had a victory. Focus on that.

We give the family all the information.
That's our job, Derek.

- Looks like my guy won that round.
- Meredith?

Karev, can you go get
Jen's blood test results?

Give me a reason
why I shouldn't go to the chief.

- What? The surgery was a success.
- He made a mistake in her first.

He caused complications.
He feels responsible.

Tell me why I shouldn't go to the chief.

During the trial, he lost patients.
It affected him.

For the better, I think.
He cares more, if that's possible.

You just have to trust him.

OK.

- Hey.
- Calliope.

- I haven't seen you around.
- Well, I've been avoiding you.

I know, it's so weird.

You share a kiss with a woman
you've never seen...

Honestly, this is a new adventure,
one I'm so ready to take,

for the second time, and...
Anyway.

Do you want to go on a date with me?

Wait, Erica and you. She was your first?

Yeah.

OK. So then I guess my answer is no.

- I'm sorry.
- Wait. What?

You kissed me, out of nowhere,
in a bathroom.

OK, this is what I try to avoid.

You're all exploring
and experimenting and...

Yay! This is a really
exciting time for you.

But I work in Peds.
I spend my entire day around newborns.

So I try not to in my personal life.

Thanks for asking, though.
I'm super flattered.

Super.

- As discussed.
- Thank you.

Newborn. I'm not a newborn.

I'm a senior resident.
I'm a great surgeon.

I'm a divorcee, for God's sake.

I'm...

I'm... looking for you to agree
with me here, Bailey.

- Bailey?
- The chief,

he wrote me a form letter
of recommendation.

That's insane.
He's chief, you're Bailey.

"Pleasant in the OR
and enjoyed by the nurses.

She's completed a serviceable
amount of research.

- A fine addition to any programme."
- Fine! He used the word "fine".

A blank page would mean more.
I pulled off a 12-person domino surgery.

I took out and put back six
of a dying girl's organs!

I am Dr Bailey.
I am better than fine!

At least he didn't call you a baby.

Just a minute more, Mr Terzian.

Done tending to Her Highness?

You're tough on people.

It's good to hold such high standards,
but this is medicine.

- No one's perfect.
- She's stubborn and out of touch.

- Forty years experience means nothing?
- Not if you don't use them correctly.

She wants to be old
and keep operating? Fine.

- Just keep up with the medicine.
- Cristina, this is one case.

You can't judge someone
based on one case.

That patient deserves to know his
doctor, no matter whose feelings

it happens to hurt.

Laparoscopic or open, none of us
should have made that mistake.

You realise you're
charging one of our hospital's

most respected surgeons
with negligence.

Yes, sir.

Dr Hunt, do you agree
with Dr Yang's assessment?

- This is Dr Yang's call.
- I'm asking you, Dr Hunt.

Campbell outranks me, sir.

I think it would be best for you
to discuss it with her directly.

Very well. Page Dr Campbell.

I want to speak
to that patient before surgery.

Yes, sir.

Way to take a stand.

There he is, the legend himself.

How are you, legend?

Are you drunk?
Should I be worried about you?

He's got his sense of humour back.
How's your patient?

She's good, stable.
Today's the first day in a long time

I remember what it feels like
to be good at my job.

You? Come on, you're like
the Dalai Lama of surgery.

People from all over the world come to
let you cut into them. Know what else?

You look good doing it.
I like the facial hair, by the way.

- Keep it that length. No more, no less.
- Stop.

Derek, there's something
we need to discuss.

- Go ahead and have sex with Addison.
- Addison?

- Go for it.
- I don't want to.

Really? What did you want to discuss?

Nothing.

OK.

- How's my mother?
- Bitter.

Angry. Genius.

What's so wrong is how much
the chief and your mother fought.

- Sex must have been great.
- Saying that, that's wrong.

What's wrong? Our entire
healthcare system? 'Cause I agree.

Here it is. "March 3, 1979.

Assisted Margaret Campbell
on a splenectomy.

Impressive resume, adequate technique."
See? Hack! Even then.

- You're working with Margaret Campbell?
- Yeah. Ye Oldy Timey thinks

she's sane enough to do surgery.
That's what I like about your mom.

She wasn't Alzheimer-y
and still operating.

Do me a favour and shoot me
if I start making mistakes on patients

- and think it's kosher to cut.
- Sounds like Shepherd.

- Alex.
- Please, my guy's right.

Your guy nicked an aneurysm
and is trying to cover his ass.

Your guy needs to shut up.

- What happened?
- Bypass must have blown.

- Page Addison, meet us in the OR!
- I told them everything was OK.

Dr Shepherd? I don't understand.
He said the surgery was a success.

I'll give you an update
as soon as we can, OK?

The swelling's not going down.

Maybe the ventriculostomy is plugged.

No. Damn it!

Derek?

I have to take out the temporal lobe.

- Won't that kill her?
- No.

She could lose some of her speech,
memory and vocal pattern.

The brain can rewire.
I've done it before to stop seizures.

Have you done it before for this?

- I'm doing it now.
- Baby's got decels.

What are we doing here, Derek?

Bayonet forceps.

What are we supposed to say?
"Shepherd's cutting out parts

of your wife's brain.
She'll pull through?"

Tell him the truth.
Dr Shepherd is doing everything he can

- to save your wife and child.
- The guy's life ended. Tell him that.

Alex, just be...

The baby's having heart fluctuations,

but Dr Montgomery is taking every
precaution to avoid an early delivery.

- And my wife?
- Dr Shepherd is trying to get

the bleeding under control, but we won't
know more until the surgery's finished.

But she won't die?

Please tell me she won't die.

Shepherd is doing everything
to make sure your wife lives.

She'll live?

Dr Shepherd is doing
absolutely everything he can.

We should get back.

Right. Of course. Thanks.

- Thank you.
- Your guy sucks.

Mr Terzian, your scans show a change
from Dr Campbell's original assessment.

There was a complication
from the surgery,

a lacerated bile duct and artery. You'll
need another surgery to repair it.

- Is that all?
- Yes, that's all.

Oh, thank God!

I thought when they told me
the chief of surgery was coming,

I was a goner for sure.

We simply wanted to make you aware

that it's within your rights
to request a change of surgeon.

- Dr Campbell's not available?
- She's available.

No, thank you.
I choose Dr Campbell.

- Very well. Dr Campbell.
- Richard.

Sir, with all due respect, I don't think
the patient's clear what happened.

You heard the patient.
He wants his doctor.

- But sir...
- Back down, Yang.

I just need you to tell me
if it's worthy of Dr Bailey.

Bailey's an ass.
She doesn't listen to residents

when they have important
information about interns.

You're missing the point of
the exercise, to say nice things.

You still hang out here?

George, just say she's dependable.
Say she's selfless.

Everything she was until she wasn't.
Just...

You should probably go.

Dependably selfless.

Thank you.

Isobel Stevens?

It's been years since I've had you
in my OR, chief.

I seem to remember an incident
with a clamp being dropped

into an open body cavity.

You're never gonna
let me live that one down.

A good teacher never
lets up on her students. Although,

I've often wondered how the
upcoming classes learn anything

with the way we teach these days.

Attendings seem more concerned
with inspiring their students,

using encouragement
and validation and so forth,

instead of instilling them
with the fear and shame

that causes one to
remember anything in the first place.

Dr Hunt, you come from the military.

Wouldn't you say the rigid aspects
of your training helped you become

- the doctor you are today?
- Yes. Very much so.

Dr Yang, on the other hand,
something tells me fear

is not something you
have often faced in the OR.

I'd appreciate
any opportunity to learn.

Wonderful. Let us begin then.

Tell me how you'd do
a pulmonary embolectomy.

I'd insert a steerable catheter
into the femoral vein

and position a fluoroscope
adjacent to the embolus.

What would you do
if the power should suddenly go out?

Or if you had to operate in a hospital
that couldn't afford a fluoroscope?

It's like a calculator. Because
there's a machine to do it for them,

children shouldn't have
to learn simple arithmetic?

If it would help them avoid
mistakes like this one.

Out of my OR!

I said get out! Out!

This is still my OR!

She's bleeding into the frontal lobe.
If I can stop the bleed,

save the rest of the brain,
she'll have a chance.

Decels are getting longer.

- Derek, I have to deliver the baby.
- No. Just...

If you cut her, she'll bleed.
I can save her.

How?

- I have to cut out the frontal lobe.
- What?

Derek, no. Stop. Derek.
You've done enough.

Can she live without
frontal and temporal?

- Yes.
- No, Derek, she can't.

This baby isn't getting any oxygen.

You want to save Jen, you feel
like you have to, but not this way.

I can save them both.
She will live.

Not as the person her husband
and child need her to be.

She'll lose everything about her
that makes her human.

- Meredith.
- Are you sure you can do this?

- I have no choice. Bipolars.
- Baby's heart rate is bottoming out.

Damn it, Derek!
This has gone too far.

Taking the frontal lobe out, even if
she lives, you're creating a monster.

You don't get to play God here!

Jen is gone, but this baby
has a chance to live. Let her go.

Let it go. Please, let...

- I'm taking the baby out.
- Put down the scalpel, Addison!

You put down the scalpel.

- Addison, put the scalpel down.
- You put the scalpel down!

Get off the scalpel, Addison!
Take it off!

- Meredith...
- Do not go anywhere.

Karev, go!

- Derek, don't do this.
- Do not touch my patient, Addison.

Meredith.

Derek, look at me.
You don't have to do this.

Jen's gone. It's too late.
You can't save her. She's gone.

We can save the baby.

Derek, look at me.

Certain surgeries
get the best of all of us.

I made a mistake.

A careless mistake.

And for that, I am sorry.

But I am only human,

as human as any of us.

And for that, I do not apologise.

- Margaret, you don't have...
- No need to discuss it further.

No need at all.

- Chief, we need you in OR 1!
- Karev?

Right now, sir!

I was fired. From the Army.

They call it an honourable discharge,

but they knew it was my time,
even though I didn't.

I'm grateful to them for that.

The baby's still in distress.
I need to take it out.

Wait. Just wait.
The bleeding could stop.

The baby could stabilise.
We do a C-section now, she'll die.

- She is dead, Derek.
- Please, just wait.

Most of her brain is gone. For all
intents and purposes, she's dead.

Karev, page Dr Friedman's team.
Tell her we have a preemie on the way.

Stop cutting.

Why are you cutting?

Meredith, get some more blood.
She needs more blood.

Get more blood.

- She needs more blood.
- No more blood, Derek.

No more blood.

You're smart to get it looked at, but
it doesn't look too suspicious to me.

Even combined with high LDH levels?

That could be caused by anything,
mono, exercise even.

Coupled with neurological episodes?
Hallucinations?

There we go. All done.

You and I both see patients
do this everyday.

Find something suspicious,
convince themselves they're sick.

But as doctors,
you and I both know

that it's our job to remain worry-free

until we have proof that says otherwise.
That's what you should do.

Relax. By this time tomorrow,

you'll be laughing at the fact
you thought anything was wrong.

He looks strong.

- He definitely has a chance.
- Let's get him intubated.

Placenta.

The steroids we gave your wife
allowed your baby's lungs to mature.

That, combined with the three extra days
that Dr Shepherd took

to do the surgery, makes us
very hopeful that he'll survive.

I don't understand.
She just died?

I'm sorry.

Yeah, I know. You said that.

I'm asking how she died.

We believe your wife's high blood
pressure caused the bypass to fail.

That caused the bleeding
and swelling in the brain.

Dr Shepherd did everything he could.
There was too much damage to her brain.

That's when Dr Montgomery
stepped in to deliver the baby.

You said it was a routine procedure,
that she would be fine.

Then there was a complication.

And you said you fixed that.

But then the baby got sick,

and that made Jen sick.

But then you said you fixed that, too.

And now she's dead.

- I'm sorry.
- Stop saying you're sorry!

You killed her!

You're a murderer!
A murderer!

Where's my wife?

I want my wife!

I want my wife!

I want...

I want...

I know it's bad. But I tried.

You're just very complex,
and word-defying.

Chief!

- That is a letter of recommendation!
- O'Malley? Take pointers from O'Malley?

You'd be hard-pressed to find
a better person to take pointers from.

- Chief? Chief!
- Exactly!

I am the chief of surgery. I don't have
time to write letters to pump your ego.

My head of Neuro is called a murderer,

I have to fire my general surgeon
because she won't retire,

interns are mixing up
blood samples in your clinic,

and you want me to spend my time writing
a recommendation so you can leave me?

Leave you? Sir, I am

applying for a fellowship
in paediatric surgery.

Which is not what we had discussed!
Do you know how much time you wasted?

The amount of work
it takes to groom someone?

- You were to become the next me!
- You wanted me to become the next you.

I am not your son or your daughter.

You don't pin all your hopes
and dreams on me, sir!

I'm seeing Lexie.

I'm sleeping with her too,
but it's more than that. We're happy.

I'm happy.

OK, that's... Maybe I deserved that.

You know what? I didn't. You have no
right to tell me who I can sleep with.

You're worried about your legacy.
But I am not your legacy!

And me applying to Peds is not...
You are not listening to me.

What the?

Oh, my goodness!

Come on. Come on!
Come on, stop. Come on!

Come on.

It's done.

That's her guy.

I'd do a pulmonary arteriotomy,

directly visualise the clot and use
atraumatic forceps to extract it.

That's how I'd do a pulmonary
embolectomy without a fluoroscope.

The fact that you felt
the need to come tell me that

tells me you're a much better surgeon
than I first thought.

I've decided today's surgery
was my last.

You look at me like you won't wake up
one day not that far from now,

so much faster than you can imagine,

and find that you are me.

When you can't cut anymore,

what will you have?

I was a god.

In this OR. Holding a scalpel.

I was a god.

And now...

What will you have?

I don't see anyone
burning the place down.

That's how they do it.

Do everything right. As soon as you
look away, they screw it up.

Hey, I'm sorry.
I was busy earlier.

With myself, I was busy,
so I'm sorry.

Don't be.

I called you an ass.
And you were right.

I think I just needed to vent.

- I'm sick of this place.
- Hell, I just watched Derek Shepherd

beat up a man because he's so sick
of it. That's the way it works.

The patients we lose, the mistakes
we make, that's how we learn.

It's the only way it's ever been done.
Figure out a better way, and you

will be a better doctor than us.

Patients see us as gods.

- Izzie?
- Or they see us as monsters.

But the fact is, we're just people.

Hi.

OK, well, it's not broken.

But you should ice it.
Lots and lots of ice. Goodbye.

- I'm so sorry.
- It was worth it.

No. It wasn't.

Maybe a little.

Thank you.

We screw up.

We lose our way.

- I have experience to give.
- Calliope?

Life experience. Like I was married.
Did you know that?

Or that I was in the Peace Corps.
Botswana.

It convinced me to go to med school.
And I've experienced the joy of cooking.

I make an excellent chicken piccata, in
addition to many other delicious meals

you'd be lucky to experience.
That you can't open your eyes

to see that makes you
a little inexperienced.

- Calliope, this is Julie.
- Hi.

My date.

Even the best of us have our off days.

Letter of recommendation.
Callie told me about the chief's.

I figured it was the least I can do
before getting on a plane back to LA.

- Addison Montgomery, thank you!
- Don't thank me. Just kick ass.

Don't make me regret writing you are
the most promising young Peds surgeon

I've ever had the pleasure
of working with.

Still, we move forward.

Today, you were a teacher to someone
who needed to learn,

but you were also a bully to someone
who needed compassion. You were both.

I wasn't a bully.

And... I was right.

Right.

You're a lot like her.
Stubborn, opinionated, smart.

Forty years from now I'll have to pry
that scalpel out of your hand, too.

From my cold dead hands.

You're missing the point.

I wanna be around
40 years from now.

We don't rest on our laurels or
celebrate lives we've saved in the past.

Because there's always some
other patient that needs our help.

So we force ourselves to keep trying,
to keep learning.

You're unmotivated,
careless, selfish, distracted,

and pretty much the people in this
hospital I'd least trust with my life.

But that's the way it's supposed to be.
You're interns. You're babies.

And you're all lucky to work here.
We're all lucky because we save lives.

Every day, we get to save lives.
That's our job, and...

It's not something a lot
of people get to do, so...

- In the hope that...
- Let's begin.

- ... maybe...
- New game.

- ... someday...
- This is Patient X.

She's a 29-year-old female
we misdiagnosed with anemia

the first time she came to us.

Let's not make the same mistake again.

... we'll come just a little bit closer
to the gods our patients need us to be.