Grey's Anatomy (2005–…): Season 7, Episode 21 - I Will Survive - full transcript

We've all heard the saying.

It's one of those things we learn
in seventh grade science class.

Adapt or die.

- I don't understand.
- It's two words:

- "No sex. "
- I'm sure there should be more words.

If you're gonna choose a chief resident,
you have to be impartial.

- Come on, this, now?
- Sex with me,

however hot and excellent,
could cloud your judgment.

- This is blackmail, is what it is.
- No, it is not.

Final interviews are today, and
coincidentally, I am on your service.

- Coincidentally.
- Since Teddy's shutting me out



of cardio, where I can show my stuff,
I'm gonna show it to you.

So today you'll see me,
not as your naked and desirable wife,

but as a focused, organized,
efficient and deserving candidate.

- Who's getting in the shower.
- I'll come with you.

No, no, no. No clouding.

Owen, this hurts me
more than it hurts you.

- No, it doesn't.
- I know.

Adapting isn't easy, though.

You have to fight your competition,
fend off their attacks.

And sometimes, you have to kill.

Good morning.

You're meeting with Owen
this morning, right?

Yeah.

You're not gonna say anything
about me or the trial, right?



You know, I thought you were gonna
say something like, "Good luck. "

But I guess it's
every freaking man for himself, huh?

You do what you need to do to survive.

Tell him that you were instrumental
in getting the chief's trial approved

for phase one human testing.
From mice to humans.

- I'm not doing that.
- Yeah, OK.

I know, you don't like
bragging about yourself.

But you don't even have to brag.
Your diabetes trial does it for you.

It's gonna win every award. Seriously.

- Just make sure that he knows that...
- I got it.

- That you've been instrumental...
- Got it!

He don't got it.

I got it.

I got the job at Baylor,
over 50 applicants.

- I... I got it.
- That's awesome.

Well, I don't know.
I mean, it's in Texas.

There are a lot of factors
to consider, right?

Yeah, but that's what you wanted.
It's a great program.

Well, I mean, I was thinking of
sticking around here for another year.

Crap. I gotta go. I gotta
prep for my meeting with Hunt.

Besides, if I'm here when you win chief
resident, you'll still have a friend.

Look, we all get it's not personal.
I mean, it's a competition.

Sometimes you gotta be a shark.
Congratulations on Baylor.

Hm? You see?

- Sorry I'm late. I was cramming.
- What, for Hunt?

- You've got it in the bag.
- No, I'm more worried about

the interview with the social worker.

Don't laugh at me, Derek. Nothing
in my life has prepared me for this.

My mother was about as nurturing
as a steak knife.

I don't know anything about making
lunches or Halloween costumes.

Good moms make Halloween costumes.

- You can sew.
- I sew skin.

Yeah. Z's gonna be fine.

It's just instinct, right?

You go with her.
There you go. There you go.

Baby...

OK...

She looks good! Her weight's up
and her previous incisions have healed,

the labs are within normal limits
and she's super-duper cute! Arert you?

So it's an uncomplicated hernia,
so you don't have to use

- any artificial closures, right?
- Yeah, no. No, it should be simple.

I'll do a short incision
in her suprapubic crease

to do a traditional exposure,

and then I'll...

...finish with... Chupo!

I'm sorry.
That's what Callie calls a pacifier.

Zola hasn't eaten because of the
surgery. She's probably really hungry.

You might wanna try
and soothe her with a pacifier.

Come here, baby.
Come here, little lady.

Oh, yes, there you go.

- Chupo.
- Wow.

All right. I'll call you when
we're ready to come take her up.

See? We'll figure it out.

Are you excited? It's been a month,
Abena, you ready to go home?

I snagged some extra hydroxyurea.

Wait, wait, wait.
You forgot something.

You need to take that at home, OK,
along with your antibiotics.

It's gonna help with the sickle cell
symptoms and the attacks will be

- less severe when they happen.
- Thank you.

I'll make sure she takes it.

Now, you have sickle cell, Lebo, so you
need to make sure you take some, too.

- Yes, ma'am.
- Promise me.

Yes, Dr. Alex.

And don't forget, you both have
to have your blood counts monitored

- at the clinic, even if you feel fine.
- I will. Just as you told me.

I promise. Thank you. Thank you for
helping my sister. Thank you so much.

- Are you in pain, Lebo?
- No, no. I'm fine.

- We have to go.
- Dr. Bailey.

Maybe we
should check you out.

She'll miss the plane.
It's no trouble, I'm fine.

OK, wait. Hold...

Gurney!

OK, OK.

- How about her?
- She's smiling.

- Who smiles when they go for a run?
- Happy people.

Happiness is overrated. What about you?

Shouldrt what's his name be off
to save the world pretty soon?

What's his name is
taking a break from world-saving.

He was offered
a permanent position at Landstuhl.

- On your left.
- Watch out.

It's a U.S. Military hospital
in Germany.

- And he leaves in a week.
- That's great.

He asked me to go with him.

- Wow.
- You OK?

Yeah.

I mean, I really... I like him.

I feel like things
could be good with us.

That's just crazy, right? Besides,
I have too many obligations here.

I'm in the middle of my contract,
I have residents to teach,

- I have you.
- You just listed me as an obligation.

- No. That's not what I meant...
- No, I get it. Like I'm dead weight.

- I'm an anchor dragging you down.
- No, stop. No!

If I move, it might cause you
insurance headaches.

I'm just saying that we would sort of...

- We would just have to sort it out.
- OK.

OK.

What about her?

Yeah, if a unibrow was my thing,
I'd be all over that.

You're hopeless.

What do you got?

Seventeen-year-old pregnant female
with syncopal episode outside the ER.

She's got blood
in her left lower quadrant.

Could be a splenic rupture,
but it's hard to tell.

- Abena?
- Abena's fine.

Don't worry about her right now.
You need to worry about yourself.

- You need to have surgery.
- Lebo, why didn't you tell us

- you were pregnant?
- You would have said I cannot fly.

I had to be here for my sister.
Is something wrong with my baby?

I see a strong heartbeat, but there's
not much fluid surrounding the baby,

- and he's very small for 32 weeks.
- She's eight months along?

Yeah, I'm gonna need
to monitor this baby.

We need to take her
to CT first to see where

- the abdominal bleeding's coming from.
- OK, I'll meet you in surgery.

She's barely breathing.
I'll get an ambu.

I've got blood hanging and her BP's
still dropping. No time for a CT.

Call up and get an OR ready.

It's based on a protocol
used in aviation.

A simple checklist has led
to a huge drop in plane crashes.

- Because it cuts down on human error.
- Exactly.

And I thought, instead of... thanks...
telling you about it in an interview,

I'd walk you through it.

So the checklist is the first page
on every patient clipboard.

So you can see, at a glance,
that Mr. Aranda has been checked in

for coughing up blood, has been seen
by a physician, has had a chest X-ray,

and those results have come back.
So now we just need to get a consent

- for bronchoscopy to rule out cancer.
- Cancer?

- He might have cancer?
- Like Grandpa had?

- He died.
- What are you talking about?

I'm sorry. I said "rule out" cancer.

There's a spot on your X-ray that
we just need to take a closer look at,

so that we can be sure that your dad's
just fine. Just to be sure. OK?

OK, so that's "update the patient. "

Dr. Hunt, bed seven is admitted for
observation, bed five is discharged,

I put in a drain in bed nine and
I'm reporting for further instruction.

- You are organized.
- And focused and efficient.

Well, Mr. Aranda here needs
to go up to bronchoscopy.

- Well, I'll take him.
- Actually, no, proper protocol

is to page Dr. Altman,
she will schedule the bronchoscopy.

See? It's right here
on the checklist. Protocol.

OK, so the next step
is the OR checklist.

Mr. Aranda,
let's get you up to bronchoscopy.

There's a lot of bleeding here.
More suction?

- Where's the source?
- Well, so far, the spleen looks good.

Just keep exploring.

Just a little more retraction.

There. Please.

- What's he doing there?
- Nobody move! Gown me. I'm going in.

How did her baby get
tangled up in her intestines?

Right over here.

The baby survived a full term
outside of the uterus?

Yeah, it's extremely rare.
Her tubes are scarred,

so the fertilized egg found a place to
implant where it could continue to grow.

Dr. Bailey, grab his foot while I

- free him from these adhesions.
- Why didn't it show up

- on the ultrasound?
- Believe it or not

it's missed about 50 percent
of the time. Keep suctioning.

OK, he's coming out.
Clamps to Dr. Robbins, please.

Dr. Karev, cut the cord
and take him to get checked out.

OK, the blood in her abdomen
is from her placenta ripping apart.

We need to remove as much as possible.
Be prepared for

torrential hemorrhage. Check the...

- Pressure's dropping.
- Damn it! Clamps!

Zero Vicryl! We've got to stop this
bleeding or we're gonna lose her.

Cross-match six more units of RBCs,
and get them up here stat!

- Alex, I don't hear that baby!
- Come on, buddy, give it up.

And I've been doing some research
on diabetes,

and I heard you're starting
a clinical trial.

- I'd like to see if I could get on it.
- The trial has very specific criteria.

The subjects have to remain impartial.

The fact that you're married
to one of my attendings...

Look, I know you've never been wild
about the fact that Teddy married me,

but the truth is, I really like her.

And not just for her insurance.
But she still sees me as a patient.

As an insurance sponge.
I need to get my own insurance.

So in order to do that, I need a job.
And in order to get a job,

it would be helpful if I wasrt going
into diabetic shock every five minutes.

- Hey. What's this?
- Just a med change.

Hunt, my knee replacement got canceled
and I need to break some bones.

- Arert you supposed to mend them?
- Well, it's my first day back.

And I left my baby for the first time
since we got home.

I need to remember why I love
being a surgeon so much,

or I'm afraid I will walk out of here
and never come back.

It doesn't have to be big.
Just a sprained ankle,

a hairline fracture. Anything.

- OK.
- Oh, my God,

anytime I hear a baby cry,
it makes me think of Sofia.

They all sound like her.
Wait, that really sounds like her.

- What! What are you doing here?
- It's Bring Your Daughter to Work Day.

- No, it's not.
- I bathed her, changed her, I fed her,

I napped her, we read a book, played
with that little hanging jingling thing.

And it was still only 11:30.
I needed some adult contact.

Mm-hm.

Please take this baby away from me.

- Sure.
- I'm serious, take her, Mark.

Oh, my God! Oh, my God!
This baby's crack.

- She's a crack baby.
- You shouldn't call her that.

Torres, you're in luck.
Motorcycle crash, 20 minutes out.

Yes. OK. Oh, I love you,
but Mommy's gotta go to work.

- Take her, Mark.
- Give me the baby.

- Physically lift her from my arms.
- OK.

- Oh, hi... No!
- No, it's not that big of a deal.

- OK, I'll be right... OK.
- Back.

Lebo's bowel looks clean.
We got all the adhesions.

- How's the baby?
- Good.

APGAR scores nine and ten.
How's she doing?

We got the bleeding under
control and removed the placenta.

We're about to close.

- She's gonna be just fine.
- For now.

She's gonna go back there, she won't get
the follow-up care that she needs.

Once she and her sister run out
of the sickle cell meds we gave them,

- then what are they gonna do?
- The best they can.

What about the kid?
He's probably a sickler, too.

- Who's gonna give him his vaccination?
- How about you, Karev?

- What?
- You.

Go there. Go back with them.

The job at Namboze Clinic
has never been filled.

They're looking
for someone who's single,

unattached, with minimum
three years residency.

There's a med school loan
forgiveness grant attached to it.

They've been coordinating with you,
they know you. You're kind of perfect.

Well, it's pretty far
to go for a follow-up exam.

You'd be great. I could take care of it
with one call. You just think about it.

Sir.

Avery, that chart over there,
Henry Burton, needs to be screened.

If he meets the criteria,
put him in line for phase one.

Chief, I... I'm sorry.
I need to step away from the trial.

- You what?
- I appreciate the opportunity. I do.

I don't want to inconvenience you
going forward.

I'm not worried about me. You're a big
part of getting this thing where it is.

I don't know why
you want to give it up.

That's very nice of you to say, sir,

but I feel like I need to focus
on surgery right now.

- You're sure about this?
- Respectfully, yes.

I am.

Thank you, sir.

Excellent work, Dr. Karev.

- Grey, just give me two seconds.
- OK.

No. I didn't say anything.

But maybe you should
if you're so worried about it,

- before somebody finds out.
- No one is going to.

- Grey? Ready?
- Yeah.

OK, there it is.

Doesrt look like a tumor.
It looks like...

Wait... What is that?

I'm gonna come at it from a
different angle. There, that's better.

I just need to get a little closer.

Oh, my God! Wait, is that...?

- Is that...?
- Is it?

Yes.

- Should we call Dr. Altman?
- No.

No.

Merry Christmas.
You don't have a tumor,

you have a tree growing in your lung.

- My husband has a what?
- A tree.

You could have inaled a seedling,
and somehow it took root

- and started growing in there.
- We were, um, trimming our trees

a couple of months ago,
and stuff was flying around, but...

Whoa. How can it grow?
There's no light, there's no soil.

It happens. Somehow, it just adapted.

- So my dad doesn't have cancer?
- No. He doesn't.

But he'll need a little surgery,
and then he'll be fine.

Dr. Yang, can I please
see you in the hall?

- My dad doesn't have cancer.
- That's great!

To be clear, I never said he had cancer.

- You were wrong! You're a bad doctor!
- Shh. Hey...

Dr. Yang? One minute, please?

I'll be back.

- You falsified his checklist!
- I streamlined it.

- And I found a tree in his lung.
- You never paged Dr. Altman.

- You just hijacked this patient.
- A tree, April. A conifer.

That's...

- Well, that's...
- Mm-hm.

Well, did you...
Did you tell Dr. Altman?

No. I found it, he's my patient.
And I'm gonna take it out myself.

- You're what?
- It's a biopsy.

- A glorified lung biopsy.
- Otherwise known as a thoracotomy,

which is a procedure that needs to be

- supervised by an attending.
- One little breach in protocol won't...

So you do admit
it was a breach of protocol!

April, if you do this with me, I will
put in a good word for you with Owen.

- Why would you do that?
- 'Cause it's a tree in a mars lung.

I got your CT and bloodwork,
reviewed your files.

- Yes, and...?
- And, it looks like, medically,

you're a candidate.
But, uh, I still have some reservations.

- Dr. Webber.
- Andrew Perkins?

This is a surprise.
Hope you're not here on business.

Actually, I have
a lunch date with Dr. Altman.

Hey.

- Hey.
- Hey.

Andrew, this is my friend,
who I told you about.

- Oh, the VHL guy with diabetes.
- Among other things, yes. Henry Burton.

- Sorry. I didn't mean...
- No, it's fine. I am Teddy's friend.

The VHL guy with diabetes.

But hopefully not for long.
Henry's gonna be on my clinical trial.

That's great. You didn't tell me that.

Well, I don't like to brag, so...

- So should we get to lunch?
- Yeah, sure.

- Congratulations.
- Thanks.

I'm in? What about your reservations?

You're going against Andrew Perkins.

Let's just say...
I have a thing for the underdog.

- He is a handsome man.
- He's also one of the world's foremost

trauma counselors. If there
was an earthquake, a plane crash,

any kind of catastrophe,
he swoops in and helps.

So you're saying he's a professional
knight in shining armor?

I'm saying you need
all the help you can get.

Thanks.

How long of a commitment
would you need?

OK. No, I understand.

Yeah, I just wanted a few days.

Yeah. I will. You, too.

- How's she doing?
- Was that...?

Were you just talking
to the Namboze Clinic?

Yeah, yeah. I just wanted
to get some more specifics.

- So you're gonna go?
- I don't know.

I mean, I'd get to do incredible
surgeries right there in the trenches.

Plus, I'd be the boss.
After bringing all these kids over here,

I can't imagine going back
to just being a resident.

Being chief resident could be cool.
I mean, that would be a reason to stay,

but, I mean, who knows? If I don't
get it, where does that leave me?

I'm left here with nothing.
What do you think? Stay or go?

At this point, I really don't think
it matters what I think.

Hey. What are you doing?

Getting ready to remove a tree from
a guy's lung. No time for mommy prep.

OK, what if the social worker
wants to ask me about the time I spent

- sleeping around Europe?
- That's easy.

You were absorbing other cultures.

OK, and what about the fact that
my mother had early on-set Alzheimer's,

and may have passed the gene on to me?

Makes you more appreciative
of the gift of life.

OK, I put my hand on a bomb in a body.
She could think that was...

- Suicidal? No, it was brave.
- I told a shooter to shoot me.

Change the subject.

- Chicks suck.
- What's your problem?

- Like you'd care.
- I don't.

But I've got four floors to kill,
and I'm on a hot streak.

Arizona offered me this job
at her old clinic in Africa.

When I told Lucy I was thinking about
it, she got all pissed and stormed off.

Well, did you ask her to come with you?
Tell her you'd miss her?

- Look deeply into her eyes?
- No.

Well, obviously, she's got feelings
for you. You're dead inside.

You have no feelings.

By the way, you should take that job
in Africa. It'd be totally amazing.

You just want me out of
the running for chief resident.

Just trying to help!

- Can I ask you a question?
- Bring it.

OK. What is it about guys with babies
that makes women go crazy?

I mean, it's like when you're at the
park and you see a guy with a puppy.

Normally, you wouldn't
even notice the guy.

But then he's laughing
and the puppy's crawling all over him,

and then he's tickling the puppy's
little puppy belly, and you're thinking,

"I wouldn't mind spending the rest
of my life with that guy. " What is that?

Everybody's looking at the baby,
and no one's looking at Mark.

Except you.

- Oh, Kepner!
- Cristina.

- Did you book the OR?
- I did.

Yes! Kepner, you know what? I think
I figured out something about you.

I have not had sex
for, like, three days.

And I think it's giving me superpowers.
Everything is bright and clear,

I am solving problems.
No wonder you're so organized,

- you have virgin superpowers.
- I don't think...

Seriously, thank you. I've been
shut out of cardio for months.

And today is like the first day
I've felt like myself.

Thank you, I really needed this.

- Oh, my God.
- What?

You're just, like,
treating me like a friend.

Yeah. So?

I'll go in and excise the tree
with minimal invasion to your lungs.

- Dr. Yang.
- Join us, please.

Sorry. I needed this, too.

I don't understand,
why isn't Dr. Yang doing the surgery?

She's certainly capable,
but Dr. Altman is our chief of cardio.

I have experience
with complex cases like yours.

OK, see, I saw three doctors for this
cough before I came here today.

They all said the same thing:
Lt'll go away, be patient.

Then I wake up this morning
and I'm coughing up blood.

And then this one over here
tells me it's cancer.

Come on, that is not what I said!

Then, finally,
I meet Dr. Yang here,

and she says it's not a cough and
it's not cancer, but a tree in my lung!

And, just like that, I'm not gonna die.

I'm gonna be fine.

So if she can do the surgery,
I'd like to stick with her.

All right. Here is a scenario for you:
You're chief resident.

One of your colleagues comes to you
and says that he's dropping out

of a clinical trial. What do you say?

- Dr. Hunt...
- What do you tell him?

I'd urge him
to think it through carefully.

- But I would respect his decision.
- My opinion is that you have a history

of quitting when things get tough,
of walking away when you are challenged.

Now, maybe it's because you're
not used to working hard for things,

or maybe because you have a
fear of success, but I'm telling you,

you're making a big mistake here.

I hear you.

I just disagree. Anything else?

- No.
- Thank you.

- You're actually considering this?
- Look, just answer the question.

- Can she perform the surgery?
- Yes. She can.

- She is capable.
- In my defense,

I was simply streamlining the process,
and took the initiative...

Cut the crap!
You went behind my back to spite me.

- Well, you gave me no choice.
- OK, enough!

You obviously have axes to grind,

and I'm not gonna stand here
while you sort it out.

In the meantime,
this patient needs surgery,

he's more comfortable
with Yang doing it.

She should be suspended
for insubordination,

but you're gonna reward her instead?

I'll decide disciplinary
actions, Dr. Altman,

and I will take them out on Dr. Yang,
not on the patient. You will observe.

Yes, sir.

- Kepner, you'll assist.
- Sir, under the circumstances...

The decisiors been made.

I'll make sure Dr. Hunt considers this
in his evaluation for chief resident.

Let's get him prepped.

If it's a sliding hernia,
she could ligate her ovary.

Look, she's freeing the hernia sac
to make sure that doesn't happen.

Is she preparing
to do a Goldstein test?

Is she thinking about
exploring the other side?

Arizona is just being thorough.
Don't worry, everything's gonna be fine.

I wish you would stop saying that.
You don't know that.

- Saying what?
- Everything's gonna be fine.

She's got a hernia,
hydrocephalus, spina bifida.

Anything could happen. Her bowel could
rupture, her BP could drop out...

Robbins is not gonna let that happen.

What if they find
better parents for her?

- Oh, come on.
- What if they realize

that we rushed into this
without really knowing what we're doing?

Or that maybe a resident
who works 80 hours a week

isn't the best candidate for a mom?

So just please stop saying
everything's gonna be OK.

Because you don't know that.

OK.

Everything... is gonna go...

...the way it goes.
- Thank you.

Mm-hm.

Please don't. This is the
only place she'll fall asleep.

Turns out she's as bored
with radiology as we are.

- I'll get out of your way.
- No, no, no, you stay.

Besides, I... haven't really
seen her up close yet.

She's so much bigger
than the last time I saw her.

Eats like a champ.

- You wanna hold her?
- Oh, no, no, it's OK.

Come on, look at that face.
You know you want to.

No, it's OK. Yeah, I'll just wake her
and she'll cry and you'll hate me.

Besides, she doesn't look
like she really wants to move.

I should go.

I...

I am really happy for you.

- You seem happy.
- I am.

I have everything I always wanted.

Almost.

I have it. I have it.

Can I get some more
suction down here, please?

- Look at that.
- I can't believe it lived in there.

It managed to thrive
in a hostile environment.

- I'm gonna keep it.
- What? No.

No, no, it has to go to Path
and then get destroyed.

It's not cancer. It's a Christmas tree.

It a pathology specimen. Protocol...

Protocol doesn't account
for trees in people!

Protocol accounts for whatever comes up!
That's why we have protocol!

So there are rules and steps
that we can depend on.

Look, I know the rules seem fussy
and annoying, and people hate them,

and the people who enforce them
are fussy and annoying, too.

- But they're there for a reason...
- Fine!

- Take it to Path.
- Thank you. I think you'll...

It's not gonna be you, April.

I don't care how many boxes you check,
you're not gonna be chief resident.

Three-O Vicryl.

I... gave Lebo platelets.

And the baby's stable.
A little smushed, but stable.

It's hard to believe he spent the last
eight months sleeping on a colon.

Nice work.

So you gonna do it? Africa?

Honestly, I'm not sure.

It's a big decision to make in a day.

Are you in love with Lucy Fields?

Lucy and I... It's new.

Why?

Because I don't want the person
that I recommend to pull a me

and go running back
to the girl they left behind.

So just... make sure
you know what you're doing.

Or else you'll have me to answer to.

Admit it.

You saw how good this baby looked on me
so you had to go get one of your own.

Everything's a competition.

- How'd her surgery go?
- Robbins said she's fine.

- She's feeding again.
- Good.

Because Sofia can't wait to have
a new friend. Isn't that right, Sofia?

You and Zola are gonna be best friends,
isn't that right?

Oh, you just wait. This crap will be
coming out of your mouth, too.

Well, let's hope so.

We're dealing with the
international adoption treaties.

And the waiver we need, they just
don't... usually give those things out.

You're both surgeons.
You'd make good parents.

They're gonna see that.

We'd be naive to get ahead of ourselves.

You're Derek Shepherd. There's a reason
I've been jealous of you my whole life,

and it's not your hair.
You're gonna be OK.

Even Sofia knows that.
Right, Sofia? Say hi to Uncle Derek.

That's Zola's daddy. Yes, he is. Right?

Ohh.

- I'm gonna go feed her.
- Mm.

So I see here that your mother
was a surgeon. What was that like?

Well, being raised by a surgeon,

you definitely
get to be very independent.

And... not that I would raise Zola
the way that my mother raised me.

She didn't bake.

She wasrt a bake-sale mom,
and I... plan on baking all the time.

How about you tell me about Zola?

Well, Zola had already had
a shunt and spina bifida surgery,

and then we realized
she had this hernia.

And today in her surgery,
it looked like she might go into SVT.

And just as the anesthesiologist
was about to push the adenosine,

it's like she knew to stop,

and her heart just slowed down
all by itself and she went into sinus.

I... I'm sorry.
That's not what you asked me, right?

You want me talk about
how cute and sweet she is.

And she is very cute and sweet.

And... I'm not doing very well, am I?

I don't have
an agenda here, Dr. Grey.

I'm just trying to get
a sense of who you are.

I'm a surgeon.

And I'm a good surgeon.

And I want to be a good mother.
Honestly, I don't know much about it.

But I am ready to learn.
And I'm a fast learner,

and I will do whatever
it takes to be a good mom.

You know what good moms do?

They brag about their babies,
and that's what I heard today.

As it turns out, Zola's day didn't
involve playgroup or baby gym class.

It involved surgery. And you knew
where she was every second.

I appreciate you sharing that with me.

I was showing initiative!

That doesn't mean you get
to pretend that you're an attending!

I wasrt pretending,
I just didn't need an attending.

- Oh, my God!
- Teddy is doing a disservice to me,

and to the education that I deserve.

I had no choice but to take
my learning into my own hands.

So I took the initiative
and treated a patient

and followed through
to a successful outcome.

If that doesn't show the qualities of a
chief resident, I don't know what does.

You're not gonna be the chief resident.

It's not gonna be you. I'm sorry.

Is this from the chief, or from Teddy?

No, it's from me.

You real...
You know how important this is.

Chief resident can make your career.

- You have your pick of fellowships...
- You never had the qualifications.

- Based on what?!
- Chief resident is more

than just a r?sum? boost. It's managing
schedules, overseeing interns,

pushing papers, working
within the system. That isn't you.

- It's never been you.
- I'm protesting this!

- You are screwing with my career.
- And it will kill you!

You're a surgeon.

Anything that keeps you
from being a surgeon will hurt you,

and it will make you crazy.
We saw it today.

You're not built for this job.
You will hate it and you will resent it,

you will fight against it
until you fail. So just be a surgeon.

You know, it's what you are.
Just be excellent at what you are.

- Are you done?
- Yes.

Thank you for your time.

I'm not going to Africa.

- Right. Let me just say this...
- No. It's the right thing.

I can finish my residency and then maybe
we can both go to Africa together...

- Alex, I just... Just listen to me.
- You were right this morning.

You said there were other factors
to consider. And you are a factor.

I'm sorry I didn't say that sooner.

When Robbins said they were
looking for someone single...

I mean, that's how I think of myself.
Because whenever I think of a future

with someone I always get kicked
in the teeth. So I stopped even looking.

- But now, with you...
- Alex, stop! OK, just stop.

You were right, this morning.

Career comes first.
It's how it should be.

And so I... I took the job.

- So call them. Call Baylor...
- At Namboze.

I took the job at Namboze Clinic.

You what? My job? You took my job?

Like you said, it's not personal.

Sometimes you have to be a shark.

My job in Africa?
The bitch stole it out from under me.

- Who?
- Lucy. I told her I'd stay.

You open yourself up to someone

- for one freaking second...
- Mm-hmm.

Callaghan, I'll take a double whiskey.

I freakir better get chief resident.

Here you go.

Scotch, please.

Here you go.

You know, the rules
are there for a reason.

- Oh, boy.
- I killed a woman

when I first started here.
I got fired for it.

Because I missed a little step.
One simple step.

We follow the protocols,
we don't skip steps.

People live, simple as that.

You know, you're right,
I probably won't be chief resident,

but the checklists work.
You can't tell me they don't.

Dropping out of the chief's trial
was a real bonehead move, Avery.

- Sir...
- Such a bonehead move,

that I started thinking,
maybe the chief's trial is flawed.

So I looked into it myself.

The methodology is flawless. In fact,
it's kind of the stuff that wins awards.

Big awards. Like the Harper Avery.

You dropped out of the chief's trial
because you knew that

if your name was on it,
it would ruin the chief's chances.

I respect that you don't
want to succeed on your name,

but don't you ever let it hold you back.

There you are.

- Hey. Everything OK?
- Completely.

I wanted you to be the first to hear
just how OK everything is.

- I got my old job back.
- You're kidding.

Mm-mm. I told them about Webber's trial,
that I'm getting a new pancreas.

I've never used a pancreas as a
selling point in a job interview before,

but it did the trick.

Which means that I'm gonna have my
own insurance in a couple of months.

- That's really good news.
- I'm glad you think so.

Because I've been thinking about us and
our situation and where we go from here,

- and I wanted to ask you...
- Teddy!

Yeah, I will be right there,
Andrew.

Lunch and dinner.
The mars getting serious.

Dinner's to celebrate
what we decided at lunch.

I'm going to Germany with him.

Oh.

Well, that's...
That's really good news, too.

It is.

- Right?
- Yeah.

Because, like I said,
I'm gonna be fine.

Which brings me back to the question
that I wanted to ask you.

What's that?

May I please have a divorce?

Oh.

Yeah, I guess. Sure.

I mean...

...you don't need me anymore, right?

Right.

- I gotta go.
- Yeah.

Yeah. OK.

Adapt or die.

As many times as we've heard it,
the lesson doesn't get easier.

I fed her, I changed her diaper.
Prettiest poop you ever saw.

- Hi, baby girl.
- Oh! I've missed you.

Yes, Mommy got to be
a surgeon again today.

I got to fix two dislocated shoulders,
and save a leg from amputation.

Problem is... we're human.

We want more than just to survive.

- Were you staring at Sloan again?
- Oh!

The... The baby. Did you see her?

- How did the interview go?
- I'm out.

- What? What happened?
- It's a long story. It's fine.

Seriously, I'm OK with it.

I have you, what else do I need?

We want love.

Hey.

Hi.

Hi, Zola.

I'm Meredith.

I'm hoping to be your mama.

We want success.

You know it's gonna be Mer, right?

It doesn't mean that you're
a bad surgeon or a bad doctor.

Some people just don't fit the bill.

They're better at other things. Like you
and those kids, you're good at that.

But between you and Mer?
She's organized.

People like her, people trust her,
she's a natural.

- People trust her.
- I'm just saying,

go steal your job back. Go to Africa.

That's what you're good at.
Go do what you're good at.

We want to be the best that we can be.

OK, I know you're mad, but you can't
just sit here and drink all night.

So I'm gonna take you home...

I... I was not expecting that.

You told me to be excellent.

So I'm gonna be.

I'm gonna be an excellent surgeon.

And I'm gonna be excellent
in bed tonight.

So we fight like hell
to get those things.

All right, Karev?

Meredith messed
with the Alzheimer's trial.

Anything else feels...

...like death.