Previously on Grey's Anatomy: Derek is married, and his estranged wife Addison showed up at the hospital, which Richard justifies as a business decision. George got the syph and tackled Alex, Burke broke up with Cristina, Cristina is pregnant but hasn't told Burke yet, George secretly loves Meredith, Addie cheated on Derek, Derek tells Meredith she saved him from (emotionally) drowning. (Wow, isn't that ironic given the turn of events in Season 3?) Meredith tells him that's not enough and finds solace in the arms of her old friend tequila. And overall, both Meredith's hair and this show were really, really good.
Meredith VOs about her aunt, who, when pouring anything, would instruct the liquid's recipient to "Say when." Meredith lies down on some hard floor and says, "It's not us, it's them. Them and their stupid boy...penises." Okay, I'm as guilty as anyone of referring to men my age as "boys," but in her baby voice it's actually a tad bit creepy. As I think they were actually going for "funny," I'll try and ignore my discomfort for everyone else's sake. "They didn't tell me they had a wife. They gave absolutely no warning that they were going to break up with you." This conversation is filled with too many penises and pronouns; it's getting confusing. It turns out she is talking to Cristina, who is lying in the bathtub, who slides back the door to see Mere and to clarify that it's not that there was no warning, but it's how he did it. He acted like he was the boss of her and it was all business. Mere points out the frustratingly obvious point that he actually is her boss. But even that isn't Cristina's real problem; her real problem is that she cares about what happened. Meredith hauls herself up and over to inspect the water in the toilet bowl veeery closely. Her VO says that even though her aunt instructed them to say "when," they never did. The voice-over bought her time to catch her breath, and we mercifully don't have to hear her vomit. Cristina announces that the problem is estrogen, but Meredith clarifies that it's tequila. Cristina cries, "He turned me into this fat, stupid, pregnant girl. Who cares! Estrogen!" Wow, typed out, that looks like some very strange form of Tourette's that she's got, there. Onscreen, she sold it without sounding quite so random. Izzie and George come in and join them, Izzie pouring water for Meredith. VO: "We don't say when because there's something about the possibility of more." Meredith says she feels empty, and Izzie answers that two hours of vomiting will do that. VO: "More tequila, more love, more anything. More is better." Oh, Meredith, you, I, our livers and our respective toilets (or wastebaskets placed to the bed by a great friend) all know that the first part of your statement isn't really true. She says again that she feels empty and Cristina barks, "You're lucky. I feel pissed off," and with that slams the door shut to close herself in the bathtub again. Thunder rolls to dramatically end the scene and take us to the hospital.
Meredith gets out of her car and yells at someone to stop -- it's at Derek, who she says has been stalking her, but he just wants to know if she heard anything he said. "Your wife screwed your best friend," she announces. He explains that that's why she didn't exist to him any more. Yeah, it's as lame an excuse as could possibly be, since he was still legally married to her. Or, as she puts it, "You had marital amnesia." He claims that he bared his soul, but has clearly underestimated the shock and anger one might feel at discovering one's boyfriend bared all of his soul except for the part that was legally bound to another person. She tells him it's not enough; he had two months, and she still learned the news from Addison herself showing up, "all leggy and fabulous and telling me herself. You pulled the plug. I'm a sink with an open drain. Anything you say runs right out. There is no enough." George and Izzie have heard everything, and George says, "She probably could have picked a better metaphor." He picked the joke right out of my typing.
Derek's groveling is interrupted by Burke, who lets him know an organ donor is coming in that afternoon. Because of that he's bumping Derek's surgery, and the two of them get pissy and snipe at each other while Derek also stares longingly at Meredith and the whole gang of interns stare at the two grown men acting like schoolboys. Burke finally orders that this is the way it's going to be, since he's chief, and Derek quickly points out that that's an interim title. Cristina tries not to laugh. As the interns all pile into the elevator, Burke shoots his own Meaningful Look at Cristina as the doors close.
The Emergency of the Week begins to arrive in the ambulance bay. The man that they're unloading was hit head-on and seems to be in a really bad way. The paramedics have been doing CPR for 20 minutes, on top of the 20 minutes it took them to get him out of the car, and they say he's pretty much gone. Bailey announces not until they say so, and orders George to "Take him to an OR and save him." She's so no-nonsense, I'm amazed the victim didn't just sit up and say, "Yes ma'am, things are fine!" She tells Mere to help while George grumbles, "He's dead." His hair is an absolute mess. I'm so glad he finally cut it all off later in the season and looked like he actually groomed himself once in a while. Olivia is with him to help the guy, and they shock him, to no avail. George can't believe it when Meredith says to try again, but Olivia points out (calling him "George") that she thinks it's what Bailey wanted them to do. When she sees the snit he's in, she corrects herself to address him as "Dr. O'Malley." Meredith observes it all and adds, "It's what she wants, Dr. O'Malley," and so they go again, George dragging his heels. It's fascinating to watch this episode again after watching nearly two full seasons since -- George really has matured as a doctor and person, ignoring all of the ridiculous romance drama that we know is coming.
Also different are the establishing camera angles that are used, and there's an unfamiliar shot of the bay as more ambulances arrive. The guy unloaded was in the car that jumped lanes, and he was wearing no seatbelt. To add to the surely-to-occur hijinks, he's on the transplant list to receive a liver. Burke's going to need to operate immediately, and Izzie is the first to call the case as his intern. Karev is assigned to a boy who was in the accident and Cristina to his mom, about which she's clearly disappointed since there appears to be much less blood and guts in this case. A Random Hospital Dude announces that there's one more. I assume he means one more patient, but where? In the ER? In the hospital at large? It looks like at this point they didn't do as good a job of basing the surgical interns largely out of the surgical wing. Regardless, a patient has a bowel obstruction and won't say what it was, which usually is code for drugs.
Bailey finds Mere in with George and Olivia. She compliments the group on the work that they're doing and asks what their step is. George wants to just call it, and I can't help but be a little surprised that this is the guy who already has been nicknamed the "angel of death." Is that a nickname you really want to continue to live up to, George? Bailey won't let him do it. She pulls Mere away to send her to Mr. Bowel Obstruction, and George actually seems to be jealous since that guy is still alive. Olivia merely asks, "What , Doctor?" And roll the actual credits, for what I imagine to be one of the last times they were actually shown.
Derek's examining the Chief, while the Chief tries to swat him away. It's continuing the theme of men-as-schoolboys we've seen so far. Derek insists he needs to do this to discharge him when Adele's voice asks, "What makes you think he wants to be discharged? Derek, don't you know this hospital will crumble unless Richard is here holding up the walls?" Richard is surprised, as she's supposed to be in the Virgin Islands at that moment, but she counters that he's in trouble for having brain surgery without telling her. Seriously, that's got to rank up there on the all-time omissions list. Is it any wonder this marriage later ran into problems? Richard says he didn't want to worry her. That's...sweet? He wonders how she found out and then realizes that Derek called her. Derek yells back that Richard called Derek's wife, and also points out that the only way he's being allowed home is if someone is there to take care of him. Speak of the devil, Addison pokes her head in the door and says, "I thought I saw a fabulous woman walking by." There's a joyful reunion between the unwanted wives, until Adele happily says she always knew that Addie and Derek would get back together. Addison quickly says she's there on a case, and Derek unceremoniously announces that they're over. Addison says they're not divorced, but Derek says they nearly are. When Adele asks if they had counseling, Derek answers, "We had adultery. That was enough." Awkward! Nothing worse than infidelity talk thrown into a happy reconnecting with friends. Adele maintains that Derek should give Addison a chance, but he just kisses her cheek and leaves. Richard looks properly shamed when Adele turns on him.
The boy on whom Alex is working (who is 18 years old, and I am officially old for calling him a boy) asks if his mom is okay. Alex distractedly tells her he thinks so while he takes x-rays. The boy tells him that his parents had been fighting at breakfast. His mom is also telling the story, but her version is very different. Overlapping each other in their respective hospital rooms, he tells a story of his dad getting angry and running three red lights before getting pissed at another driver and losing his cool, landing them in this horrific crash. His mom tells a much more tepid story about husband/dad Bob just being a bad driver who swerved to avoid something in the road. She also mentions that they were having a lovely morning before it all happened, and begins to cry about his bad liver. The son gets in the last word when he finds out his dad is in critical condition in surgery, and coldly declares, "At least the son of a bitch got what he deserved."
In said surgery, Bob has massive injuries. Nameless, never-to-appear-again Other Surgeon tells Burke that with his liver in the condition it's in, there's no point in trying to save his life. Izzie tells them that he's on the transplant list and both his wife and son are in the hospital.
It comes as no surprise, then, when Cristina finds a huge old bruise on Mom, who claims it is from the accident. Cristina tells her that this is a couple of weeks old.
George is still attending to a guy who we now know is the victim of Bob's road rage/loving gentle touch and poor driving. He reports to Bailey that the patient's heart is not beating, clearly over this whole "trying to save a life" thing. She tells George to open up the chest and aspirate, and then if the heart still refuses to beat, to close him up and call it. At his less than subtle, drooping, sullen body language, she asks if maybe he thinks they are defiling the man's body. George: "Well, we're certainly doing more than..." "Than what?" she cuts him off and then continues, "If they're dead or dying when they come through those doors you hump and hump hard." Um. Wow, this suddenly sounds like a very different show from the wholesome family entertainment we've come to expect. Word choice, people! Everyone is 12 years old at heart, or at least I am. She asks him why they do this and, taking her intended and non-dirty meaning, he guesses it's for the experience. Clearly it's not just that, so she tells him to think on it and it will come to him. It's delivered much more patiently than she is in later episodes, but I guess that's because he's still new and she hasn't had time to get completely tired of various intern antics like not really giving a crap about patients when they feel a patient isn't worth their time.
Mere is transporting Mr. Hubble, ingester of mystery objects, and gently trying to find out what it was that he ate. Instead of answering, he tells her she has beautiful features. "Delicate. Almost porcelain." Hmm, might it be that he has a thing for dolls? She asks again and he says that it might offend her, so she asks if it's drugs. He promises that it's not drugs, and she tells him that's good.
"It's drugs!" The lab tech delivers a disgusted Mere Mr. Hubble's x-rays, saying he swallowed at least ten balloons. This is why I'd be a horrible drug mule. I just couldn't bring myself to transport anything that required my swallowing balloons to get them from points A to B. Let's thank my squeamish nature for keeping me on the straight and narrow, I guess.
Bailey and the interns gather for some group x-ray viewing. First up is Alex with Scott's (Bob McRagey's son) films, that show he was lucky and has no fractures or bleeding. Bailey says to keep him overnight for observation. Then Cristina puts up Mom's film. She gets a name! Leah Siebert is 43 and her films cause Bailey to exclaim, "Dayum!" She shows multiple healed fractures, meaning she's "either a bull rider or she's abused." A second film shows the bruising on her kidney that Cristina discovered earlier. Alex says that Scott told him that the accident was a road-rage thing, and Cristina says that's not the story she heard. Clearly, even without confirmation she guessed that it was bullshit. Mom is advised bed rest and possibly psychological help. Meredith then walks in and takes her turn, announcing that Mr. Hubble ingested drugs. They look at the films and explain the revolting surgery that he'll get to have, which includes taking out his entire intestine, locating the balloons, and cutting them out individually. Bailey tells them they'll all be in on the surgery while Alex stares at the film and asks if they're sure the objects are balloons. Because "This one here's got a face." I was so grossed out on first viewing that my mind went to a hundred horrible horror-movie/medical oddity explanations, and I was actually relieved when Bailey realized, "They're Judys! He swallowed the heads of ten Judy dolls." There's a close-up of one of the creepy, x-rayed Judy faces, which look suspiciously like Barbie faces, which they would only be if the Barbie folks had agreed to have their iconic dolls used in the B plot of the week on network television.
At the nurses' station, Cristina kicks back and reminisces about her mom buying her Judy dolls. Meredith wanted and never got one; Cristina dissected them. She proceeds to go on a totally expected rant about how the dolls are sexist and create unrealistic image expectations. Bailey comes in and asks, "You swallow a bitter pill this morning, Yang?" Clearly, these are early days if she thinks this day and attitude are different than any other for Dr. Yang. "They're dolls." Bailey then sends Meredith to look for family, call for psych, and bump someone to get Mr. Hubble into an OR immediately.
Back in the OR, we learn that Bob is on the transplant list but no liver is available for him. However, he won't recover from surgery without a new one. The one that Burke mentioned earlier, which is arriving that afternoon, has already been promised to someone else, so their only hope is a family member. I expected the one coming in to be a huge deal in this storyline, which is logical to assume if the storyline centers on transplant patients and donors and only one particular organ, but it's never mentioned again. I have to wonder if it wouldn't have been easier to give the patient coming in a different Important Transplant Organ of the Day. But this is a small nitpick, considering that even with the sort of predictable storyline and my slight confusion, this episode is smart, compelling, funny, and makes you care about the participants more than pretty much any hour of Season 3 did. With that, let's get back to the "predictable" part. Surgeon Who Isn't A Regular Cast Member wants to let this guy go. "No use in tying up an OR if we're just postponing the inevitable." But Burke is flexing his Chief muscles and asks much work there is to do. When he's told six hours, he declares that's how long they have to find a new liver. SWIARCM shrugs and says, "You're the chief." Burke gives a quick nod, but the pride and the unspoken "YEAH, I am!" are radiating out of his every pore.
George and Olivia are still at work on their near-dead patient. In the quiet, while George rhythmically squeezes some sort of contraption he's got in the guy's chest, Olivia apologizes about Alex. She explains that it was before she and George hooked up, not during; while this is supposed to make George feel better, it just agitates him even more. She then explains that she didn't know she had the syph, even though, as a nurse, she should have. He freaks out at the itch-and-sore talk and decides to leave, just saying, "Things happen." She agrees and adds, "Things you wish you could change." She's sweet, and I feel for her right now in this horribly awkward moment. Plus, it can't make it any easier to have a guy with his chest cut open in front of you while you're trying to have this particular conversation. George gets a page from the chief and goes to leave. Olivia reminds him he needs to call time of death, so he pauses to do so and then bolts, after one frightening moment when he finally realizes she's also begging him to call time of death on them if need be.
Alex is transferring Scott, who is banging rhythmically and disturbingly on the bars of his bed, to a hospital room. He takes the few moments alone in the elevator to delightedly tell him about Mr. Hubble and the Judy dolls to try and distract him. Unfortunately they aren't enough to distract Scott from the thoughts of his rageaholic father potentially killing another motorist in addition to beating his mom, and he looks about to cry. Alex realizes he needs real conversation, and quietly starts to explain how you can hide from the screaming when you're little, but once you're older you feel like you should do something to protect her. He's clearly got his own battered mother perspective, and Scott finally stops his banging to listen. Alex says that when you can't stop it, you don't know if you should be angrier at your dad or yourself. "Usually it's yourself." Scott asks if his mom told them, but Alex says they saw it in her x-rays, and asks if he's beating Scott as well. (He's not.) Scott asks Alex how he copes. "Me? I think about the guy who eats doll heads. He's got problems." The shared calm of man-to-man understanding is sucked out of the elevator as soon as the doors open, since Izzie is waiting for them. Scott knows it's about his father.
Leah is talking to the doctors, telling them, "Bob liked his beers." The woman is unfortunately really bad at putting a soft spin on the various horrible aspects of her drunk, wife-beating, road-raging husband. His liver went bad a couple of years earlier, but so far a match had not come up on account of his rare blood type, blah blah blah storyline convenience-cakes. Scott was tested and is a match, but hadn't decided yet if he was going to donate. Cristina rushes in to tell him that family members shouldn't feel obliged to donate, but Leah gets defensive and says that he's been in counseling to help him make the decision, which is standard procedure. But it turns out there's a bit more than him not just deciding -- a date had already been set for surgery, but then came and went with Scott still unsure. She says she doesn't want to pressure him, so Cristina unceremoniously tells her, "Well then, you shouldn't." Leah cries about not wanting to lose her awful husband, and Burke dismisses the team.
In the hallway he demands an explanation from Cristina for her behavior. When she explains Bob's wife-beating ways, Burke explains that those aren't reasons to not use heroic measures to save his life. He tells her to think like a surgeon, and doing that means seeing in black and white that someone needs a liver and someone else has one he can use. When she protests, he argues that the moral issue isn't for them to decide. He declares, "It isn't up to you," and grandly walks away. She mutters, "Well, you made that perfectly clear." He turns around with his eyes blazing (which really sort of worked as an eerie indication of the future, given what we know now about the personalities of certain actors) and icily says, "Well, I'm glad we have an understanding." "I'm sure you are," she shoots back. This is the Cristina I love, and who I hope is coming back in Season 4 -- the one who won't take shit from someone.
Burke and Patricia are going over various chiefly matters when Meredith shows up with Hubble's x-rays to request an OR for the emergency surgery. They all look at the film in sick wonder and Patricia exclaims, "I can see their little faces!" Then, in a tiny voice, "'Help! Let me out!'" More screen time for Patricia, please! Burke doesn't crack a smile and just tells Meredith to bump the hernia operation, but not to tell the bumped surgeon what it is they're removing in the new surgery. Clearly he doesn't know yet how absolutely nothing stays a secret at Seattle Grace.
Burke then walks into the Chief's office and finds Adele shuffling through files. She explains that Richard needs to take things home to obsess about if he can't do it at the hospital, and she'll be done in a moment. Pat happily waves hello before leaving. Adele then starts to muse about how it's always something when you're Chief, and the work never stops. Burke just sits down at the desk wordlessly and basically ignores her, going through paperwork while she talks. That is, until she mentions her initial feeling of relief when she heard about the tumor. She thought Richard might be finally forced to retire, which perks Burke up quite nicely, and she calls him on it. She sweetly continues that it's something they both want. She then tells Burke he's perfect for the job. "Unattached, obsessive. This hospital, this job, it's enough for you, isn't it?" He still doesn't actually say anything to her, and she walks out. I would think that the Chief should also be able to handle people, which seems to be a significant glitch in his circuitry, but I guess that's just me.
Thunder again ominously rumbles the transition to the scene, where clearly Izzie and Alex have just told Scott what's going on. Scott muses that counseling has told him not to force the decision, because you'll just know in one moment what's right, and it should be easy. Alex knows that this is a tough position, but Izzie perkily tells him about how the liver regenerates and he'll be hunky-dory in a couple of months. Alex demands to see her outside. I respect that all these doctors at least confront each other in the hall, but they might work on their responses when getting a colleague into the hall. Right now everyone's about as subtle as if they yelled "I NEED TO TALK TO YOU ABOUT HOW HIS DAD'S AN ASSHOLE" or the like and then slammed out of the room.
Outside, Alex yells at her for making a sales pitch and also informs her that, as Bob's doctor, she shouldn't even be there. She's confused, which is understandable, as Alex hasn't yet told her what this makes this a situation more complex than a son giving his dad a liver so that they can play catch in the yard and BBQ once more.
George wheels the Chief out of his room and down the hall. Richard gives him instructions to call three times a day and to persist if Adele won't let them talk to each other, as Adele tells him not to call and promises to do just that. A confused George just tells him, "Yes, sir." He may be Chief, but as with the various number of awesome strong women on this show, he seems to know who not to mess with.
In the comic-relief wing, the psychiatrist leaves Hubble's room without an explanation as to why he would have eaten ten doll heads. He muses over a number of possible reasons, including that Hubble might simply enjoy it. Bailey is confused (as am I) and tells him she doesn't understand. He explains that Hubble might enjoy it when they, er, come out. Bailey: "I didn't need to hear that." Neither did I.
Addison sweeps by at that moment and asks to speak to Meredith. Mere shoots Bailey a pleading look, but she wants nothing to do with it. The ladies start a brisk walk down the hall. Oh, how I missed a good pedeconference! Addison wants to talk about what happened between her and Derek, but Meredith wants to be kept out of it. When Addie realizes that Meredith didn't take Derek back, she gives her a condescending "Good girl." Meredith pleads again to keep their relationship strictly professional, which Addie disregards by explaining that people will do a lot to get attention. Meredith has had enough, and when Addie calls, "There are two sides to every story!" she's already walking away down the hall.
Cristina and Izzie are walking to a table in the cafeteria while Cristina fills her in on what's going on with the Siebert family. They get to an empty table and find a centerpiece made of headless Barbie-looking Judy dolls, courtesy of Alex. Then Cristina, Izzie, and Meredith demand that George tell them what's up with Olivia after they see him brush her off when she walks by. He deflects everything they suggest might be an solvable problem until a light goes off over Izzie's head. Man, was her hair this stringy in every early episode? I feel like they keep her a lot more brushed and fluffed recently; she looks more like an average intern in these old shows. Much to George's embarrassment, she says he's interested in someone else, but he's not too embarrassed to profess that his feelings are deep and that it's not just a meaningless crush. This hits a nerve with Meredith (who has no idea she's really the subject of this conversation) and she demands that he then end things with Olivia, since right now he's leading her to believe he's emotionally available. "There is nothing worse in the world than thinking you have a chance when you really don't." Cristina, her own nerve hit as well, agrees that he needs to tell Olivia there's someone else, so she'll know what's actually going on and she'll have a chance to know what she should think about George and the situation. He wants to know why Cristina's yelling, and she tells him, "Because of all the estrogen!" Izzie is scared, and Meredith seethes.
Burke is staring at a very full-looking board when Derek walks by. He looks up from texting on his Blackberry to comment that it's a mess. Burke denies it, but Derek is absolutely delighted to tell him that the OR being overbooked means it's a mess. He mentions there being a couple of more hours to pull the trigger on the Siebert liver, just as the hernia surgeon who had his surgery pushed comes in, angry that he was bumped. Derek gleefully points out that being Chief isn't easy as he takes a phone call and walks away. Burke scowls like a pro.
Meredith is escorting Mr. Hubble to the ER, and playing Twenty Questions to guess why he'd ingest the doll heads. It wasn't to attract attention, nor any other reason she has come up with so far. When she asks again why ten doll heads, he tells her that eleven would have been too many, like it's the most logical thing in the world. I keep feeling a bit uncomfortable about this guy being mentally competent to okay his own surgery, but I'm pushing that aside for the story (or assuming they're allowed to do what they need to since his life could be in danger).
Once in surgery, Bailey pulls out a head and, to the shock of everyone present, lovingly gives the doll's history. At everyone's surprised looks, she challenges them about anyone having a problem, and declares that she both likes and owns Judy dolls. Burke breaks up the love-fest (and the absolutely disgusting intestinal special effects that they insist on showing) to pull the interns for the various Siebert family members. When Bailey is left just with Meredith, she asks if Meredith knows what's strange. Meredith: "We haven't had enough strange?" Bailey just tells her the doll looks like Meredith, and then throws the head in the bowl with the other decapitated, bloody craniums. Ew, does that mean he wanted to eat her head when they were in the elevator? Thank goodness she's at least marginally larger than one of the actual dolls. It's not a lot, but it's enough.
The original organ donor of this episode has arrived at the hospital, and George and Olivia take her into the ICU until the harvest team can come and collect her. (So to speak.) Olivia mentions that their dead patient's family has been found and will be there soon. They don't know the bad news yet, because she thinks it's better to hear bad news firsthand. She continues to turn the knife, saying that's what she would like. "Get some answers. So I could get on with my life." George ignores this pointed comment and continues to examine the body. When he touches the patient's chest, she reacts. He and Olivia try again, and they realize that she is decerebrate, which in turn means her brain is still alive. The transplant team arrives then and brushes it off, saying that death is imminent and that her cortex is dead so the stem will follow soon. George protests, but the team takes her away, insisting she could die on the way to surgery. The guy sounds quite jolly about it, which is just alarming. This episode isn't the best sales pitch for organ donation, what with her still being alive and all.
Scott is in bed when Alex wheels a wheelchair through the door, announcing that the room smells like a hospital.
Burke is back in Bob's OR, and SWIARCM is awfully testy that he's still operating on someone who could likely just die anyway. He and George should start a club! Burke tells him they're still waiting on an answer. Hour and a half left.
Cristina is examining Leah, who wants desperately to talk to Scott. Cristina replies testily that they want Scott to make the decision on his own. Leah says she knows Cristina thinks she's sick, but Cristina tactfully (!) says she just thinks Leah is very emotional, and in that state it can be hard to keep a level head. But she then reminds Leah that her husband killed a man, and nearly Leah and Scott at the same time. Leah just asks Cristina if she's ever been in love. Cristina won't answer; Leah persists until Cristina announces, "Love has its limits." Leah just shakes her head. Oh, if only Cristina had written this as a note to herself and taken it out and read it when a certain little tremor incident occurred months later. I guess it just goes to show anyone can get caught up, but it's aggravating no matter which way you dice it.
George finds Derek and stutters out the story about the organ donor's brain stem still being alive. The two of them book it over to the transplant team, where Derek introduces himself. Practically rolling his eyes at the nuisance, the transplant doctor tells Derek that of course they'll wait until she's dead to harvest her organs. There's a lot of back-and-forth and it turns out they're just going on the word of the doctor at the other hospital, rather than on printed test results, and Derek wants to run his own tests. Burke finally hears a commotion and comes over, acting the big man and asking what's up. I won't give Isaiah Washington much these days, but he's doing a good job showing just how much Burke gets off on playing Chief of Surgery. After a moment's hesitation where it looks like he might not give the patient to Derek solely out of spite, he declares that the patient is his, much to the annoyance of the transplant team. George follows him to assist, and Meredith and Cristina stare after their exes. This is where personal experience comes in, because Burke was such a jerk and is acting like such a blowhard in general that I can't understand why Cristina is mooning over him. But then again, people in glass houses, and all that -- I'm not really in a position, like most women if they're being honest, to deride someone for mooning about an inappropriate ex. I suppose if you really want to nitpick, there's also the matter of her carrying his child. Details! Pish.
Izzie finds Alex and Scott outside. Scott asks Alex about what happens if his dad hits his mom again, but Alex insists he can't make his decision out of anger. Scott just seems so scared, defeated, and angry that I want to give him a hug. But I think this was also when Alex really demonstrated that he wasn't just a one-dimensional jerky man-whore and he's just what Scott needs. When Izzie catches up and chastises them for being outside, Alex lays into her, and she retreats against a wall a ways away. Alex kneels and tells Scott about how he became a wrestler, and then used his new strength to beat up his dad the time he hit his mom. His dad then left and never came back. But he also admits now that he wishes he hadn't done it and that they could have worked it out. It's sad because it hints at the same wishful thinking that Scott's mom clings to, that things might turn out okay. I don't have any snark about this scene -- abuse is bad. That's all there is to it. They then begin to walk back, and Izzie apologizes to them but explains that Burke needs a decision now.
Scott has gone back to the nervous rhythmic pounding of the arm of his wheelchair, as his mom and the doctors all stare at him. Leah pleadingly says his name and he looks to Alex for a moment before answering. He says okay, and his mom breathes her first real breath since they came to the hospital. Burke starts to give orders but Scott interrupts that he has conditions. To his shocked mom, he says that she has to tell the cops the truth about the car accident. She opens her mouth as if to protest, but he continues that when they get home from the hospital, they're moving out. She clearly wants to argue, but he announces, "Enough is enough." Hear, hear! Let's hope that others remember his example when it comes to their own toxic relationships. (...She says, shiftily eyeing most all of the doctors and interns.)
Cristina is just disgusted, sure that Leah will go back to him afterward. Burke says they don't know that, and she interrupts him to take the words out of his mouth: "It's not our call." He pauses and finally awkwardly asks if they could talk. When she pins him down as to what he's trying to say, he asks if she's okay. She pauses and asks her own question: "Can I scrub in?" After a moment, he nods. "Then yes, Dr. Burke, I'm okay." He's definitely got her thinking like a surgeon, whether he likes it or not.
Derek and George are looking at their patient's tumor on an MRI. George thinks it looks bad, and Derek asks him if he's ever had a really crappy day. But it's not what you think -- this one is going to be a better day! He tells the transplant team to go home, announcing he'll be the only one doing surgery that day. "Our friend here has a viable brain." Personally, this five-minute story is one of the most disturbing I can remember in recent viewings. I feel like affixing a Post-It to my driver's license, right to my donor sticker, saying, "As long as I'm really brain-dead!" with, like, a little smiley face. I don't want to offend the team of doctors about to cut up my body, and I'm happy as a clam to give up my organs, but only if they're 100% sure I really don't need them anymore. This 90-something-percent business that seems to be unfolding is skeeving me out. To their credit, the transplant team all nod and leave without a peep, so it does seem like they meant it that they didn't want to just reach in and pull the beating heart from a living body. Derek explains to George that she has a viable chance at recovery once they get the tumor out, and then gets up to leave. On his way out, he turns and tells George to look out for Meredith before he walks away. George then gets paged. Hello, guys? Your patient is still hanging out in the MRI machine, and you all just left. Hello? Anyone? Care to get a girl out of the giant claustrophobic tube?
The page was from Olivia, letting him know that the family is there. Saving someone's life seems to have stiffened his spine and he tells Olivia that the problem isn't Alex or the syphilis, but that there is someone else with whom none of that would matter to him. Wow, that's...horribly awkward. But honest, which is good. "I like you, Olivia...I just don't like you enough." Well, so his delivery and word choice need some work, but it's a step in the right direction. And she seems to know that too, saying she gave it a shot, and at least he's honest. He kisses her forehead, and she then asks if he knows what he's going to say to the family. "Why do we hump" -- again, with the humping! Word choice! -- "on every dead or dying patient that comes through those doors?" She guesses, "Experience," not remembering he already lost points for that wrong answer. He answers, "So we can tell their family that we did everything we could." She then watches through the glass as he goes to break the awful news to a very nice-looking family of extras.
Derek is on his Blackberry -- a recurring theme of its own this hour -- when Addison joins him. She asks if he told Meredith what happened with them, and he confirms it. He then asks what she told Meredith, and she repeats, "Sometimes people do desperate things to attract attention." He's aghast and can't believe that her side of the story is that he didn't pay her enough attention. Yeah, you act horrified now, but it's going to be even worse when you change your tune and give this relationship another try. Ouch, sometimes it hurts to know what's coming. When he asks if that's what she thought when she got naked with his best friend, she says that was just scratching an itch, not thinking. She then says that she and Derek got busy and lazy and didn't even fight anymore, and then Mark was there. She claims that she's sorry but at least she's talking to him. But he leaves the elevator and closes the circle of the episode and the day, announcing, "I'm a sink with an open drain, Addie!"
Mr. Hubble is in recovery, and Meredith tells him they got all the heads but that it was neither easy nor pleasant. When she asks how he feels, he replies that he's empty. Meredith: "Yeah, I've been feeling a little bit of that myself lately." He could see that, which I think isn't so much a testament to his intuition as a comment on how dramatic all these people are when they're supposed to be professionals. But I digress. She again asks him why doll heads fill him up, but then decides that she doesn't actually want to know since it might be too much information. "Maybe I'm better left in the dark."
VO: "There's something to be said about a glass half full. About knowing when to say when." Alex speaks to Scott, while Burke stares at the surgery board and gets a pat on the arm from SWIARCM. "I think it's a floating line. A barometer of need. And desire." Burke leaves as a nurse writes new surgeries up on the board, and on his way down the hall passes Leah's room, where she is giving a statement to the police. "It's entirely up to the individual." The Burke tour continues when he passes Bailey, holding a bag with all the bloody doll heads. She shakes her head at the loss of collector's items and then throws them in the medical waste bin. Which, thank God, because for one horrible second I thought she'd sneak them out, clean them up, and love them forever. But that kind of crazy thinking seems reserved mostly for interns or attendings in this particular hospital, and she chooses the legal and sanitary way of disposal. "And depends on what's being poured," Mere's VO continues.
Burke sees Cristina and smiles at her, and she just stares at him. VO: "Sometimes all we want is a taste." Derek's in the OR with George, performing the brain surgery. Burke watches from the gallery, but when he leaves, we see Meredith, staring sadly down at Derek. Well, who wouldn't? I'm a sucker for neon-lit magnifying surgical glasses. Rowr. "And all we want, is more."