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HomeNewsGrey's anatomy season 05 episode 18:" Stand By Me

Grey’s anatomy season 05 episode 18:” Stand By Me

While Meredith’s voice talks about surgeons and their less-than-nice disposition, Izzie and Cristina are going over treatment courses for Izzie in Meredith’s kitchen. Cristina thinks they could cut this thing out. They hide everything as Alex comes in. He leaves for work after kissing Izzie. Izzie is sure she doesn’t want to tell him yet. Cristina gives Izzie information to read before going to see her oncologist, Dr. Swender. Meredith comes in and asks Cristina what she’s doing here, as she told her she’s fine. Cristina disagrees with that. Meredith will be fine when she knows Derek is fine. She still hasn’t heard from him. Cristina thinks Izzie should call in sick, but Izzie doesn’t want to. Meredith asks if they’re coming as there’s a big surgery today. Cristina gathers her material as Izzie follows Meredith.

Bailey wants to talk to Richard, but he keeps asking other doctors if they’ve heard from Derek. No one has. Meredith refuses to go back out there. Callie comes over and sees her surgery got moved. She wants to talk to the Chief about this, but Bailey tells her that he’s a wreck. The OR board’s a mess. Bailey has too much on her plate to go talk to Derek, but she wants Callie to do it. Callie says she doesn’t do woods and she barely knows him. Bailey wants Callie to remind him that they’ve all been through this, but it gets better. Callie says she’s a bully. Bailey says it works well.

George tells his interns that the upcoming surgery is unique. The patient is a male who got hit by a drunk driver 12 years ago. He’s suffered severe blows to the face.

Alex tells his interns they dubbed the patient Blowhole, as he has no nose or lips. He’s had nine reconstructive surgeries, but none of them was successful in restoring shape or function.

Meredith says the surgery’s only been 4 times world-wide. Patients must undergo extensive psychological testing before the surgery to determine whether or not they can handle the process.

Cristina tells her interns that psychological testing aside, there’s also a major chance of rejection or infection.

Izzie tells her interns that the patient will have to be on anti-rejection drugs for the rest of his life, which will put him at risk for several other diseases. One of Izzie’s interns mentions the nickname. Izzie tells him not to talk anymore, ever.

They all enter the patient’s room. While Meredith’s voice over says that arrogant surgeons are exactly who you want by your side when you’re really screwed, the interns finally get to see Blowhole. Mark introduces everyone to David, who’ll be receiving a face transplant.

Owen will recover the facial donor graft. They’ll be replacing 70% of David’s face. Mark shows them a computer model of the hoped result. Allotransplantation works better than traditional approaches because it has a better esthetic and due to the reinnervation, a better functional result. They know they’re in the clear when the graft turns pink. David asks if anyone’s seen the donor. Mark says he is a match. David asks what he looks like. Mark thinks he’ll be satisfied. David will take anything so he’s not a freak anymore.

Owen tells Alex he’s on his team, but they have to move fast as the donor’s life support is fading. Mark says Izzie and Lexie are with him. Mark only needs one resident as it’s gonna be crowded already. Cristina doesn’t think Izzie has time to scrub in, but Izzie says she can handle it. The interns whisper about Lexie getting to be on the surgery by sleeping with Sloan. Bailey comes over and tells Meredith and George she needs them on pre- and post-ops. Half of the attendings are going to be involved with the big surgery, so the residents need to have their services covered. Cristina is with Bailey today and she’ll get to fly solo. She’s going to fix a hernia. Meredith congratulates Cristina, but not a big enough person to mean it.

Cristina greets Kendall Sulley, who’s hernia she’ll repair. Kendall’s friends are on a European tour without her, and they wrote down questions. Kendall told them to go as they’d been saving up. As she’s looking in her purse for the questions, Cristina gets a call. She says it has to be today because it’s stage IV. Cristina tells Kendall she’ll get to the questions when she comes back for an exam.

Callie sits down with Derek, who’s drinking beer. She knows how hard this can be. She had this young guy a few years ago, and he was fine after a simple knee replacement. She put him on blood thinners for a PE and it wasn’t until he was looking her in the eyes and throwing up dark blood, telling her that he was dying, that she realized she was wrong. It wasn’t a PE but an internal bleed. It wouldn’t have been fatal if it weren’t for the blood thinners. Callie will never forget the look on his wife’s face when she returned with a sandwich. Derek asks how she lives with it. He knows they call it malpractice, but he wants to know how she can look herself in the mirror. She overthinks it, and then asks for a beer.

Meredith tells Cristina it’s the not knowing that’s worrying her, but Cristina is not listening to her. Meredith understands, as she has G.I. Joe and a solo surgery. Cristina says she hasn’t had G.I. Joe as they only kissed. Like friends with benefits, but without the benefits. No sex, so it’s not a charmed life. Intern Pierce delivers lab results and they see he has been punched in the eye, but they decide not to ask.

Richard’s overseeing things as Alex and Owen retrieve the facial graft. Alex thinks it must be creepy for the donor’s family that there will be a man walking in the city with their loved one’s face, but Richard says David won’t look the same as the underlying facial structure is different. Owen says style and eyes also play a big part. The other transplant surgeons are getting antsy. Owen says they always are. He makes the final dissection. Alex lifts the graft.

Meredith asks Pierce to re-dress the wound of a post-op patient. George asks Megan to go take out a drain, but she’s crying. Intern Steve comes in with a bloody hand. Meredith asks the patient if she’s passed gas yet, because they can’t release her until she does. The patient is trying to listen but she’s distracted by the wounded and depressed interns.

George and Meredith are watching the interns from a distance, wondering what to do with them. They decide to remain professional and not get in the way of personal business, as they’d be wasting time and thereby would be unable to go watch the other surgeries. Bailey overhears them talking.

Mark once again tells David it’s important to take his anti-rejection meds after the surgery. Lexie asks when his family’s coming. David doesn’t have family but his friends are coming after the surgery. He’s excited to meet them and show them his new face. He met them on an orchid lovers forum. Izzie asks David to practice with a device that helps strengthen his muscles that are used for breathing. The interns can’t help but allude to his nickname. Izzie throws them out.

Out in the hallway, Izzie is yelling at her interns for not being professional. Mark comes over and sends the interns away. He agrees they were inappropriate, but so is Izzie. This case is Mark’s baby and she and her emotional life can’t piss all over it. Mark bars her from the OR. He’ll allow her to be there for David before and after the surgery. He tells her to get under control whatever’s wrong with her. George has overheard the conversation.

Cristina goes to check on Kendall, who’s found her questions. One of her friends is a retired surgeon and he told her to ask these. Cristina takes the note. She can’t believe a doctor would want her to ask if she’ll finally be able to pick up her grandkids. Kendall says she added a few of her own. She wants to know if it’ll hurt. Cristina says it’s just normal post-op pain. Cristina gets another call. She puts Kendall’s notes in her pocket, and tells the person calling that she’ll take the appointment. She’ll get in touch with Izzie right away.

George and Meredith are talking about the patients they already covered. George says something’s wrong with Izzie, but he doesn’t know what. Meredith says they don’t need resident drama on top of intern drama. If it’s a problem, she’ll tell them. Until then, he should ignore it. Steve runs past them and Bailey, this time with a bloody nose, too. Meredith repeats: ignore it. Bailey comes over to ask what’s going with the interns. Meredith says they don’t know as it’s personal. Bailey reminds them she also got in the middle of their personal drama. George says they were not this bad. Bailey lists what they did and tells them to manage it. Steve, meanwhile, is chasing a crying Megan and yells that he loves her, bumping into a patient in his chase.

Meredith tells Megan and Steve they need to stop whatever’s going on. They should stay away from each other. George and Meredith don’t allow them to explain things. The interns then go their separate ways.

Bailey paged Owen because she needs him to drive out to the woods and talk Derek into coming back. He also might run into Callie. She sent Torres after Derek and she’s fallen off the grid. She’s normally not a panicky person, and she’s creating all these scenarios in her head. Owen has to bring them back before the Chief notices. Owen knows he can do this, but he doesn’t want to. Bailey stares him down and she says people don’t so no to her when she says please. She’s saying please.

Lexie tells David his friends are early. Two women and a man come in, all carrying orchids. David turns his face away. Shayna introduces herself. She hopes he’s not mad they came early, but they wanted him to know they’re with him all the way. David asks them to go as they’re strangers, but Shayna says they’re hardly strangers as they chat every night. David tells them to get out. Izzie escorts them out of the room.

Izzie’s having lunch and Cristina tells her the appointment is in 15 minutes. She loves that she got Izzie the appointment as it usually takes weeks to get in. Izzie hasn’t read the research. She just wants to eat. Cristina says she doesn’t have the time. The others join them and they start speaking in code. Izzie was supposed to get an enema, but she’s decided it can wait. Cristina says they need to talk about it as she’s been complaining about being backed up, so she got Izzie an appointment. She tries to get Izzie to go. Alex thinks Cristina is panicking for her solo surgery. He’ll scrub in and take over when she freaks out. George asks Izzie what enema is code for. Izzie says it’s her business and leaves. Meredith says this is a strange day.

Owen tells Callie and Derek about an accident. The patients were a family. The mom, dad, and the kids were all fine, laughing and talking in the ER. Turns out both parents had massive internal injuries. He lost both of them. If he had moved faster, he might have been able to save them. The 9-year-old tried to comfort the 5-year-old and 3-year-old, and Owen can’t ever forget that image. He doesn’t know how he came back the next day, but he thinks part of him never did. Derek’s surprised Owen didn’t talk about Iraq. Owen says he doesn’t talk about Iraq, but the point is that he showed up. Derek concludes he’s dead inside, because if you’d let yourself actually feel it, there’s no going back. He gives Owen a beer.

Cristina finds Izzie in the residents lounge. She can’t believe Izzie didn’t go to her appointment. She pulled in every favor she has around here. Izzie wonders why Cristina cares so much. She says everyone was calling David Blowhole, and she wonders what people are going to call her when she’s the patient. Izzie doesn’t want to be a piece of meat while they all fight over who gets to slice her up and then laugh while doing it. Cristina says this is an emotional thing she’s having, which is why she should tell Meredith or George. Cristina refuses to let Izzie die in her arms. Izzie doesn’t know if she even wants treatment. She knows too much. She knows how violent surgery is. Surgery fails all the time. Derek is proof of that. Even if they do everything right, she only has 5% survival rate. She wonders why she should put herself through hell if it’s not going to work anyway. Cristina wonders why Izzie told her, then. Izzie tells her to forget about it.

Mark tells David he needs to call his friends back. David tells him to do his job. Mark says he can’t do his job anymore as David has no support system now. The ethics board won’t let David do it alone. He needs his friends. David says the orchid in his room is dark and droopy to anyone who doesn’t know it, how it’s adapted and strong enough to survive. A photo of that orchid is all his friends ever saw of him. People look away from him. Kids cry and adults cringe. He didn’t want his friends to do the same. Lexie says his friends didn’t look away. David is the one who looked away. Lexie says they flew all the way here. It’s not too late to call them back.

Bailey finds Richard and asks him how his mood is. He’s eager and anxious, and excited about Sloan’s surgery. He’s also concerned about Derek. Bailey tells him she lost Callie and Owen. She was trying to solve the Shepherd situation, but it appears she’s made it three times worse. Her next step will be to call the police, as she’s half convinced they’re all dead.

In the gallery, the interns are talking about a hard decision. George wonders why the surgery is starting late. Meredith informs him about the problem with the recipient. Steve comes in and Pierce calls him a home wrecker. They start fighting, but Meredith and George break it up.

George asks Ryan to start talking. He tells them to talk to Steve. George wants him to start talking as he and Meredith have surgeries they want to watch. Ryan says it’s not his place. Meredith wants to hear everything now, or she’ll make sure he gets every disgusting procedure. Ryan says Megan was with Pierce, but when they broke up for a while, she slept with Steve, and then got back together with Pierce. Steve wrote an e-mail about it and accidentally sent it to a bunch of people instead of just Megan. Now Steve loves Megan and Pierce does too, and Megan is freaking out. Meredith sighs as the story keeps on going.

David wonders why his friends would come back as he was cruel to them. Izzie says he was scared as they surprised him. He was in shock. Izzie says he was trying to protect them. She thinks they’ll understand. His friends then come back in. David says he didn’t want them to see this ugliness. Shayna says the coloring reminds her of a species of orchids. The others agree. David says he might turn out uglier if he rejects the face. Shayna says he’s a survivor and that is written all over his face. She kisses him on the cheek.

Richard arrives at the trailer and says he has a hospital to run. He tells Derek they have all been where he is, but they show up the next day and save the next life. Callie and Owen say they’ve already covered that. Richard says nothing can stop death. That’s not on them. Derek says he botched a simple surgery. He should feel badly about it. He then says Richard should feel badly about sending Meredith out here, expecting a ring. Richard says he was trying to help as Meredith didn’t want to come. Derek says he was trying to help himself. He hit the ring in the woods. Richard destroyed him. Derek enters the trailer.

Mark and Lexie are getting ready to connect the facial graft to the vessels and nerves. He and Lexie put the graft onto David’s face. Up in the gallery, a couple of interns are mocking the two of them.

Richard enters the trailer. He refuses to get out. Richard says he’s destroyed several lives, but Derek’s is not one of them. Richard just sent the love of Derek’s life to come see him, but if Derek ruined it with her, that is on him. Richard is not accepting Derek’s behavior. He’s been where Derek is. Derek’s been drunk for a few days, but Richard was drunk for years. He knows Derek will need at least one friend when he gets out of the hole he’s digging. He hopes Derek comes out of it soon. He’ll be there when he does. Derek doesn’t think he can get back. He doesn’t know what to say to Meredith. Richard says he had an affair for years, and when Adele found out, she took him back. You can make your way back from anything.

George tells Pierce and Steve they’re not going to make it through residency if they turn on each other now. Megan comes out of a stall. Meredith tells the interns to never behave like this in the hospital ever again. They are doctors. She tells Pierce to get an ice pack to put in his eye. Steve has to go to the ER to get his hand X-rayed and stitched, and Megan should go to OB, because as the pregnancy test she just did revealed, she is pregnant. Meredith and George leave the bathroom.

In the OR, Kendall needs one thing from Cristina before she goes under. She hasn’t asked for much and she understands Cristina is busy, but she is scared. She may be a batty old lady to Cristina and this may be a silly little procedure, but she needs Cristina to tell her it’s going to be okay. Cristina tells her this isn’t a silly procedure to her. She’ll get her through this. Kendall is ready. She’s put under. Cristina looks at the scalpel. She then looks up at Alex and Bailey and says Izzie has stage IV metastatic melanoma that has spread to her brain, liver, and skin. She only has months to live and she’s resisting treatment. She needs help. She then asks for the scalpel and starts cutting.

Mark and Lexie enter David’s room. As David can’t talk, Shayna says she thinks David would really like to see his face. Mark says it’s early so it’s swollen and bruised, but he can get a sneak peek. He removes the bandage and Izzie holds gives him a mirror. David watches and he gets emotional, with his friends smiling next to him.

Cristina meets with Izzie in the ambulance bay. Cristina says they don’t always fail. Blowhole has a new face and it doesn’t matter what people call him to get through the day. Izzie knows that. Cristina says she told Alex and Bailey, who are telling Meredith and George. Cristina couldn’t do her job. She thinks Izzie came to her for help, and that’s what she did. She says that sometimes, they win. She wants Izzie to fight, for whatever that’s worth. Izzie thanks her. Cristina takes her hand.

Mark walks past the interns at the nurses station and Lexie kisses him. She says that the others think he is taking advantage of her and that she is using him, but they don’t know them. They think that they’re ugly, but Lexie knows they’re beautiful and that they can adapt to a hostile environment.


Meredith arrives at the trailer. Derek thanks her for coming. He called her. He tells her he loves her. She knows. He asks if she’d still love him if he weren’t a surgeon. She says no, because Izzie has skin cancer that spread to her brain and Derek is one of the 20 people in the world who can save her. Meredith doesn’t know if she can respect someone who can walk away from a gift like that. So, she begs him not to. She gives him Izzie’s scans and goes back to her car.

While Meredith’s voice over says that practicing medicine doesn’t lend itself well to the making of friends, because life and mortality are in their faces all the time, Richard, Bailey, and Alex gather in the doorway of the residents lounge, where Izzie is about to change. She looks at them.

Meredith’s voice over says that maybe, in staring down death every day, they’re forced to know that life, every minute, is borrowed time. Bailey tells George about Izzie. George immediately runs off.

The voice over says that each person they let themselves care about, is just one more loss somewhere down the line. After some hesitation, Derek picks up Izzie’s scans and takes a look.

Meredith, Cristina, and Alex are helping Izzie set up in a patient room. George comes in and helps Izzie to tie her gown. Meanwhile, the voice over says that doctors who do bother to make friends despite of that, make it their job to push each loss as far away as they can. Izzie gets under the covers and starts talking to her friends.

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