Meredith is back on the schedule at Seattle Grace, but with all the new competition around, she can't get on a surgery so she makes out with Shepherd in the morgue or something.
Also back roaming the halls of Seattle Grace is one Isobel Stevens. Yes, Izzie's back from her hide out in Chehalis and she has her favorite high school teacher in tow. He's the one who voted her most likely to be a doctor when she grew up and with his dementia, he still thinks she is. Izzie is certain that he's been misdiagnosed and she has brought him to Seattle Grace for the top-of-the-line treatment awarded to all fired surgeons and their mentors. But when a diagnosis is made and her beloved teacher can't afford the surgery that will save his mental state, Izzie points out to the Chief that she donated $8 million dollars to the hospital and he better do the surgery pro bono. Obviously he agrees and Meredith sneaks Izzie into the gallery to watch the procedure. Meredith then tells Alex that Izzie is there and he risks getting shot down to go talk to her. And, boy, does he get shot down. Izzie blames him for getting her fired (she also blames Dr. Percy and probably the Chief) and she can't forgive him for taking her job away from her. Alex is fed up too and announces that he can't forgive her for making an assumption and walking out on him and never giving him a chance. That's a whole bunch of yeeouch!
Owen brought Cristina a present. He forgot to wrap it, but Kim Raver looks better au natural. She's the new Cardio God (live sacrifices at high noon), but Cristina is unimpressed with her resume. However when Ms. Cardio God diagnoses a rare cardio problem with merely the use of her ears, Cristina is impressed. And when she lets Cristina repair the defect, Cristina is sort of in love. What? Like you didn't think Cristina was gay for cardio. But she better watch out because her present might bite back when she makes a play for her old army buddy Owen and he shoots her down.
Bailey's day starts with Adele, the chief's wife, anxiously looking for him since he didn't come home last night. Bailey finds him asleep in the on-call room after working all night on the budget. She props him up, caffeinates him, and trundles him off to emergency surgery and for her trouble Adele demands to know if Bailey is having an affair with her husband. Bailey gags a little at the thought, but Adele knows the signs and if the Chief isn't having an affair with Bailey, he's having it with someone.
Lexie works with the chief on a surgery and when complications arise, it looks like the chief may have made a serious error. Bailey repairs his error and makes sure that no one knows about the issue. But the chief is done. He is stepping back from surgeries and he wants Bailey to take over for him. He's distracted and he made a serious error. But his distraction isn't from an affair -- he's drinking again.
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Meredith is back at work and back giving the voice-over. This week her monologue involves a doctor's constant progress and how if you stand still you will be left behind. But sometimes the past comes to bite you in the ass. That is fucking poignant. It should really be embroidered on a pillow or something. Or maybe a Successory mug. Meredith is waiting impatiently in a little used hallway. She paces, kicks the walls, and just generally loiters until one Isobel Stevens walks in wearing a full-length sweater and pushing an older man in a wheelchair. Meredith may be excited to see Izzie, but decides to show it by jumping on her about where the hell she has been. Izzie tersely reports that she was in Chehalis with her mom. And, yeah, if I had just spent a few weeks in Chehalis I wouldn't want to talk about it either. The man in the wheelchair pipes up that this doesn't look like Chehalis. Izzie puts some jam on his nose and shoves him back into the teapot. She explains to Meredith that this is Dr. Singer, her high school science teacher who really pushed her and is the reason she became a surgeon. [And he's played by Joel Grey, which made my musical loving heart happy - Angel] She does not seem to mind that he was the type of high school science teacher who insisted on being called doctor. Meredith is confused, and so is Dr. Singer. Izzie explains that she kidnapped him from his nursing home because she thinks his vague diagnosis of dementia doesn't fit. There is something wrong with him and she is going to fix it. Or she is going to hover over whoever still works at the hospital and make sure THEY fix it. Meredith can't believe that Izzie was hiding out (not that staying at your mom's house counts as "hiding out") in Chehalis and she didn't send them a postcard of the World's Largest Egg or anything and the only reason she came back was so Derek could look at some guy's noggin. She punches Izzie a few times to drive her point home. Don't punch Cancer Girl, Meredith, even if she really deserves it. Izzie tries to ditch the doctor with Meredith, but he won't be ditched, so she stays in the hospital with him. In his confused state he thinks Izzie is fifteen and pregnant and that she needs to confront her baby daddy and show up those nasty cheerleaders. Sticking it to cheerleaders is pretty much always good advice.
Dr. Yang refuses to acknowledge that she kissed Dr. Avery at Arizona's crappy birthday party. Which is probably a good plan. She also refuses to answer any of his lechy questions and proceeds to ignore him as much as possible despite working with him. She finds Dr. Hunt who paged her because he has a present for her: he got her a Cardio God. He points Cristina in the direction of Kim Raver who is up to her elbows in some guy's chest. Cristina is truly touched, but not as much as the guy on the table. After the trauma (no word on whether he lived or died) Hunt makes the introductions. Cristina has never heard of Teddy Altman, the supposed Cardio God, and everyone stares at their feet awkwardly as Cristina's Ivy League snobbery embarrasses them all. Hunt explains that they served together in Iraq and she is giving Seattle Grace a trial run. Cristina remains unimpressed.
Bailey is just out of surgery when the Chief's wife, Adele, stops her in the waiting room. It's never good when Adele shows up at the hospital. Never ever. In her sing-song voice she tells Bailey that the Chief never came home last night and he didn't call. She wants to know if he is like dead or something. Bailey doesn't know, but she saw him last night in his office. He was working on the budget. Lexie interrupts the Great Chief Hunt because she is looking for... the Chief. One of his patients needs emergency surgery. Bailey sighs, tells Lexie to prep the patient, and tells Adele to chillax. Adele does not chillax and does not appreciate being told to chillax even if it is kind of funny in a '90s way. Adele does not abide '90s retroism. Too soon!
Derek Shepherd examines Dr. Singer and I can't help but wonder if medical doctors get pissy about having to call PhDs "doctors" when we all know the only real docs are the ones with scalpels. Dr. Singer was an evolutionary biologist on his way to the Galapagos Islands (um... Darwin already covered that territory, doc) when his dad got sick and he had to go back to Chehalis. Chehalis's town motto is actually, "You Try to Get Out and We Pull You Back In!" but it always has a smiley face over the "I" so it looks friendly. Shepherd finishes his examination and concludes that they need to run some tests. Outside the room Shepherd asks Izzie more questions about Singer's condition. Izzie explains that she saw him over Christmas and he was fine and still teaching at the high school. Six months ago the school let him go. He's currently on every medication the nursing home could throw at him because the only diagnosis they made was old age. Cristina chooses that moment to assail Izzie for missing her cancer treatment and Dr. Percy, who is on Shepherd's service, shows up too and gets assigned to give Dr. Singer a full dementia work up. Izzie explains that she got her IL2 treatment at a different hospital and Cristina can just suck it. Just then Alex walks in. He sees Izzie and looks completely rattled. He just walks away. Can't really blame him either. And he probably has a preemie to suckle.
Cristina, Avery, Hunt and the Cardio God stand in the ambulance bay waiting for a trauma, when it takes too long, Cristina creates her own drama. She presses Teddy for the details of where she studied, where she did her residency, and whether or not she is published. Each answer disappoints Cristina more and embarrasses Avery and Hunt further. It's hard to tell whether Teddy cares, because she is too busy dancing in the rain. I guess living in Iraq is an excuse for wanton paganism. And, frankly, she'll fit right in with Seattle folk. Head on over to Pioneer Square, sweetie, someone will definitely throw a quarter in your velvet jester hat and eventually you can buy a soy chai at Zeitgeist. Cristina is totally harsh to Hunt about his present and demands that he take it back and bring her a real Cardio God. Whatever, Veruca Salt. I know Cristina is supposed to be this unfeeling automaton who has no filter, but why would she be so rude to her boyfriend?
Dr. Singer's test results are back and Izzie rips them out of annoying Dr. Percy's hands. The results are all normal, but she demands a spinal tap, too. Dr. Percy is unimpressed by this request, because he thinks that Izzie just wants to make a miracle diagnosis and win her job back. Izzie swears that she doesn't want her stinky crappy job back, but just wants to see her beloved mentor well again. No one believes her. Dr. Singer wakes up confused and disoriented and gets out of bed. When Izzie tries to convince him to stay he ends up falling flat on his face on the cold hard floor. Good thing Izzie was already fired, because otherwise that would do it.
Bailey has finally found the Chief. He is snoozing in the on-call room (how handy that no one was having sex in there for once). She nudges him awake and jumps back. He wakes with a start. Bailey gives him the bad news that he has an emergency surgery and his wife is there to see him because he is in trouble. She hands him his latte.
Izzie pesters Dr. Percy about getting Dr. Singer a spinal tap. He doesn't think it is called for, but Izzie has no qualms about giving an old man an incredibly painful procedure just to prove she is right. When Percy still resists, Izzie blackmails him by threatening to tell the girl (Reed, I think) that he loves her like no other. He caves. Obviously.
Back in the cardio trauma drama, Yang is shocked when her Cardio God confesses that she hasn't put in a pacemaker in ten years. She doesn't even care that Teddy was going to let her do the procedure, she's too unnerved by her attending's lack of practical experience. So Avery does it and Yang goes to talk to the Chief. Teddy still doesn't seem to care.
Meredith finds Alex who is either working or hiding. Maybe both. She reports that Izzie has been staying with her mom in Chehalis and has been keeping up with her cancer treatment. Alex doesn't say anything, so Meredith leaves. Meanwhile, Bailey has the Chief vertical, caffeinated, and heading into surgery when Yang finds him. Bailey acts as human firewall to prevent the Chief from engaging with Cristina. Bailey reminds her that she asked for a new cardio attending and the Chief found one after another and Cristina ran them all off. Cristina protests, but no one can really argue with Bailey when she's on a roll. Bailey asks Cristina to consider that perhaps she might be the problem. Cristina is flabbergasted and looks to the Chief, but he seconds everything that Yang said. Bailey sends the Chief off to surgery with an overly touchy arm shove that the camera zooms in on and shows in slow motion so we know we should pay extra close attention. Mark and Callie come ask Bailey about some patient, but Adele doesn't pay them no mind. She just wants to know if Bailey is having an affair with her husband. While Bailey is vehemently protesting, Callie and Mark look like they just won the gossip lottery, which they did. Obviously they don't have the decency to leave Bailey and Adele to fight in peace. Bailey is completely horrified by the accusation, but Adele saw that arm touch and she knows that they finish each other's sentences and spend hours together everyday. After listening to this compelling argument, Mark seems to agree that Bailey is definitely having an affair with the Chief. Callie, however, knows a "work husband" when she sees one. She clumsily explains to Adele that Bailey and the Chief are merely meant for each other at work. But this does not mean they are having an affair. This does not really help the situation. Adele finally concedes that maybe Bailey is not sleeping with the Chief, but after years of watching the Chief during his affair with Ellis Grey, she knows the signs. The Chief is having an affair with somebody. Mark and Callie, chuckleheads that they are, giggle like tweens at a New Moon opening. Adele deigns to glare at them and they scamper.
Dr. Yang is hard at work on a patient when Teddy comes in and asks her to talk her through the angioplasty. Yang bitchily asks if that is because she doesn't know how? Teddy is being way too nice to Cristina and simply smiles because that was supposed to be a teaching moment. Cristina talks her through the procedure, but she is always two steps ahead of her supposed teacher. Cristina remains unimpressed and unsympathetic. Also, pretty much a bitch.
Bailey corners the Chief and awkwardly tries to talk to him about the supposed affair. Unfortunately her approach is so awkward the Chief thinks she is hitting on him. Oh poor Bailey, just go home or bury yourself in a trauma surgery or something, but seriously, DON'T TALK TO ANYONE. Except maybe Cristina. Might be worth yelling at her again. That was awesome and she deserved it.
Dr. Percy has been harangued into doing the spinal tap that neither he nor the patient wanted. And I know that the patient apparently has no wife and no children, but he's got to have somebody other than an ex-student in his life. Where are his canasta partners? His Facebook friends? His colleagues? Anyone who could save this man from Izzie's good intentions? Izzie holds his hands while the lumbar puncture is happening and then Dr. Percy opens his big yap to ask her whether or not she and Alex are going to get back together. None of us can believe that he has the cojones to ask that question, but he claims it is what everyone at Seattle Grace is talking about. Izzie glares him out of the room. Dr. Singer gives fifteen-year old Izzie some advice that is highly pertinent to contemporary Izzie. He tells her not to marry him if she wants to get out of Chehalis and if this boy really loves her he will understand if she does what is best for her. Can't wait for Izzie to regurgitate that at Alex.
Meredith is secretly operating on either a corpse or on that fake body that the Chief bought at some point to train surgeons. You know, the one that talked back to George, may he rest in peace (and probably pieces.) Shepherd finds her and they cuddle and talk about her first day back. Things have changed a lot since she left on her liver leave. Now there are tons of residents competing for surgeries and she hasn't gotten back into the fight fight fight mentality. So she's operating on a plastic person (and not in that Nip/Tuck sort of way). She remarks that there was a moment a few months ago when Izzie had just come out of surgery, Hit-By-A-Bus Guy wasn't George (actually that's his American Indian name), and they had just done their Post It marriage, when everyone was happy. She is trying to get back to that point and she is pretty sure that suturing a fake large intestine is the pathway to happiness. Derek, however, has different ideas of five minutes in heaven and starts kissing her all over. Don't these people have any work boundaries? Sheesh.
If Alex is wondering where Izzie is, she is making her case to the Chief. Here's a summary: Chief: Budget! Budget! Budget! Izzie: Do it! Do it! Do it! Chief: Budget! Budget! Budget! Izzie: I gave you eight million dollars! Chief: Do it. Outside, Bailey watches the exchange suspiciously.
Arizona and Teddy are paged by Cristina and Dr. Avery to examine a kid with asthma. While Arizona examines the X-rays, Teddy takes a good long listen to the kid's heart. She asks a few questions about his medical history and concludes that they need to book an OR. Cristina balks because she thinks the kid has asthma. Teddy, full up of both all the history and of Cristina's attitude, snaps. She tells her that the kid has cardiac asthma, is in the middle of a heart attack right now, and needs surgery. Also, she's her attending and told her to book the goddamn OR. Cristina looks annoyed, but Arizona smiles at Cristina that she likes Teddy. Heh. Arizona's awesome. But can someone please explain to the poor kid's mother what the heck is going on? Thank you.
Bailey goes to stick her foot further in her mouth and asks the Chief whether he is having an affair with Izzie. Bailey, didn't I tell you NOT TO TALK TO ANYBODY? She tells the Chief that she is going to say a name and he will then tell her that he is not having an affair with her. She says: Izzie Stevens and the Chief just about dies laughing. Bailey, being stalwart and brave, continues to lay out her case that the Chief is sleeping with Izzie: he ignored the DNR, he fired her, they were yelling at each other. The Chief chortles through her entire opening argument, but Bailey is dead serious. And so was his mistake this morning. She ran the test and it looks like the Chief clipped the common bile duct on his patient. So he better stop laughing. He does. Bailey is prepared to do the repair. She assures him that no one knows about his error and no one will. But whatever or whoever is distracting him, he needs to get a handle on it.
Arizona, Teddy, and the two residents are operating on the sick little kid. The coronary artery is attached to the pulmonary artery, not the aorta. This discovery makes Dr. Yang reevaluate her new teacher. Then the cute little birdies on Teddy's scrub cap make her reevaluate her reevaluation. Teddy explains how she knew that the kid's heart was screwed up: she heard a hollow systolic murmuring and saw something on his x-ray. If no one thought it was cardio, why were Yang and Avery there and why did they page Teddy? Whatever. Teddy is a cardio god and Cristina needs to bow. Teddy reassures the residents that time they'll know how to diagnosis it and after today, Dr. Yang will know how to fix it. Cristina is flummoxed, but Teddy asks Arizona if she minds if Dr. Yang first assists, and Arizona willingly steps down. Cristina is completely stunned but takes the scalpel and begins.
Without any surgeries on the horizon, Meredith has nothing better to do than play Dr. Phil. She finds Alex and tells him that the guy Izzie brought in is being operated on and she snuck Izzie into the gallery to watch the procedure. She will be there for awhile if Alex wants to talk to her. Alex doesn't get it. He doesn't understand Izzie and he wants Meredith to explain her to him. Meredith shakes her head, because she doesn't understand Izzie either. And she doesn't have to, because she's not married to her. Alex is not so lucky.
Back in the operating room, Cristina is done with her repair. They start the heart to check her work... and the kid is in v-fib. Cristina starts panicking and trying to figure out what she did wrong. Teddy coolly instructs her not to worry about what she did, but instead to focus on what she wants to do now to, you know, STOP THE KID FROM DYING. The clock is ticking and Arizona and Dr. Avery look nervously at both Teddy and Cristina. Cristina finally realizes that Teddy is not going to jump in, so she thinks and then decides to defibrillate. It works. Together they repair her mistake.
Alex takes a deep breath, plugs his nose, and jumps into the operating room. Izzie is ready and waiting like a shark with a chip on its shoulder. When Alex asks if she is back, Izzie attacks. She doesn't think Alex wants her back since he went to the Chief and told him she wasn't ready to be there and basically got her fired. Whatever, Izzie, you got yourself fired by almost killing a patient and costing her a spot on the transplant list. That was YOU, not Alex, not Dr. Percy, not the Chief. YOU! Nut up and own it. Also, shut it. Alex can't believe what he is hearing. He was trying to protect Izzie, but Izzie isn't hearing it. She thinks Alex interfered and got her fired. And she can't forgive him for that. Alex is fed up. He can't believe that Izzie would just make an assumption and never give him a chance to explain or deny. She just left. He can't forgive her for that. He leaves and Izzie sits prissily in her sweater (designed by Project Runway contestant Irina, obviously!) and let's Alex leave. I really want something to drop on her head right now.
The Chief watches his patient as he sleeps and recovers from the repair surgery. Bailey finds him standing there and reports that there were no complications and the repair should work. Also, no one knows. The Chief doesn't look comforted by this. He answers with a non sequitur: he's not having an affair. Bailey wants to know what it is then, because something has him distracted. Is it the merger? The budget? His unending fight with Shepherd? The Chief doesn't answer, but simply announces that he is stepping back from surgery. Bailey doesn't think that's necessary, but he does. He has too much on his plate as Chief and he can't afford another mistake. He wants Bailey to take over his surgeries. She protests, but he is firm.
Izzie goes to check on Dr. Singer. He is recovering nicely. He describes the difference as it being like someone turning on the lights. Izzie says he did so well in surgery that he can get home to Chehalis and back to teaching in no time. Dr. Singer has no intention of wasting his newfound mental faculties on those ingrate sex-crazed teenage alcoholics. He has no idea what he is going to do , but thanks to her, much like the Scarecrow, he has a brain now and can give it a good think.
Cristina gloats to Meredith about her awesome cardio surgery. Cristina admits that Teddy might be a cardio god after all. Live sacrifices promptly at noon, please!
The Chief hands off his surgical charts to Bailey with the promise that they can go over them tomorrow. Just as the Chief walks away leaving Bailey with a stack of charts, Callie comes up to her for the latest installment of gossip about the Chief. Bailey tells her that the Chief is taking a break from surgery because he is exhausted and needs some time off. Bailey then has one of her rare personal moments and moans that now she doesn't have a work husband or a home husband. Callie offers herself as a replacement, but Bailey points out that she has Sloan already. Callie suggests Shepherd, but Bailey can't abide looking at that hair all day. You and me both, sister, you and me both. My roommate once dated a guy who had more hair products than me and my roommate combined. You can guess how that turned out, right? Yep, they soon realized their entire relationship was based on a mutual love of V05 Hot Oil treatments and when he wanted to switch to Prell, she dumped him because she was exclusively a Breck girl. Sad, really. We all saw it coming.
Outside the hospital Owen is waiting for Cristina, but is happy to see Teddy. She doesn't waste time chit chatting, but asks him about Cristina. He apologizes for not telling her earlier, but he wanted her to judge Cristina and her skills without any bias from him. She asks about his ex-girlfriend and he explains that he broke up with her a while back. Teddy keeps smiling when she says that she thought Owen would have called her when he broke up with the ex. She thought they had something. Owen looks surprised and Teddy looks really embarrassed. She didn't realize it was all in her head; she clearly made up a Bridges of Madison County story in her head, but now she can let it go. She bids him good night. He watches her leave until Cristina comes out and plants a big happy enthusiastic kiss on him and thanks her for her present. Pssst, Cristina! You might want to take that back, since she just made a play for your boyfriend. Cristina thinks Teddy is amazing, even if she does have birds on her scrub cap. Owen explains that Teddy's best friend loved birds and died in the second tower. That's when Teddy gave up her attending position at Columbia and joined the army. Even socially-inept Cristina realizes her foot is in her mouth. They walk silently while Cristina tries to tug it out.
Meredith brings Alex a drink. She thinks Izzie will be back; Alex downs a shot in response. She asks if Alex wants to keep drinking and he nods silently. She heads to the bar, where the Chief is also drinking alone. He orders another club soda from Joe who asks if he is going back to the hospital or home after the one. The Chief explains that he is having one more club soda and then going home. Joe asks for his keys. This is a puzzling exchange until Joe takes the Chief's glass, ducks low behind the bar, and fills it with vodka or gin. He hands it back to the Chief with a look that the Chief ignores. As he takes a drink, all the troubles and hardships and difficult decisions he has made in the past few months come back to haunt him. His fight with Derek, his car accident, his other fight with Derek, his talk with Thatcher Grey, his other fight with Derek, his firing of Izzie, his firing of Derek, and finally his surgical error that almost cost a patient his life. I had sort of forgotten that the Chief was a recovering alcoholic, but I'm pretty sure that is what the flashbacks were implying. His drinking gives an interesting prism to his recent behavior, but I can't quite tell whether it is ret-conning or this was the actual plan all along. I also can't tell whether his drinking caused him to fire Derek and Izzie or whether he was drinking BECAUSE he fired Derek and Izzie and lost George. Anyway, he's back on the hooch. When he sees Meredith at the bar, he gets up and leaves, barely touching his "club soda". Not sure whether he has decided to give up the drink already or whether he is just afraid of getting caught. Or whether he just can't stand the sight of Meredith's face. You are not alone, my friend.