Grey's Anatomy S2E26 Script

Deterioration of the Fight or Flight Response (2006)

[Meredith] Human beings need a lot of things to feel alive.

[continuous beep]

[George] Family.

[Cristina] Love.

[Izzie] Sex.

[Derek] But we only need one thing...

[Preston] To actually be alive.

[ticking]

[Cristina] We need a beating heart.

[Addison] When our heart is threatened...

[Alex] We respond in one of two ways.

[George] We either run... [Preston] Or...

[Izzie] We attack.

[Richard] There's a scientific term for this.

[Alex] Fight... [Addison] Or flight.

[Miranda] It's instinct.

[muted sound]

[Meredith] We can't control it.

[continuous beep]

[Izzie] Or can we?

[continuous beep] [George] Izzie.

His heart's barely beating.

We need to call a code.

I can't feel a pulse. Izzie, we need to call a code!

No! I have a plan. He's crashing! I need to call the...

No! If we call a code, they will rush him to surgery and replace his LVAD and he will stabilize. He needs to get worse to get this heart.

Izzie, this is crazy. He has to get this heart.

He will die waiting for another chance.

We have to call a code! No!

You press that code button, I will hurt you.

Not a lot, 'cause we're friends, but enough so that things will break and you lie on the floor out of my way.

Izzie... You have a decision to make.

You can stay here and help me with this or you can go.

What's it gonna be, George?

[siren]

[Cristina] Chief! How bad is it? It looks bad.

I'm here. I can help. If there's anything surgical, I can help.

Why don't you go run Trauma 2, Dr. Yang?

I get to run Trauma 2 all by myself?

Yes, but find me if you need help. And get consults.

I'm on it!

[siren wailing]

How bad is it? GSW to the right shoulder.

He's lost a lot of blood. Get him to Trauma One and keep the blinds closed. Yang's on the floor.

Self-inflicted GSW to the head. Pulse is thready.

This is the shooter? Emptied his clip, then shot himself.

And blew off half his head. OK.

Push one of epi and get him on the monitor.

You're running this? Damn right, I am.

Hey. Wait. I'm fine.

You need to lay down. You lost a lot of blood.

I'm fine. Let go. I'm fine! I have a patient that I have to go check on.

No, you are the patient. Lay down!

[chuckles]

Dr. Bailey, when did you get here?

Page Shepherd.

[rapid beeping]

Take over compressions.

You're shot? Cristina?

[Richard] Back to your station. He's shot?

Yang, we got it. It's OK. That guy shot you.

Move. He's a lost cause.

He's circling the drain. You don't get to kill yourself.

You do not get off that easily. Push high-dose epi.

Dr. Yang... What?

I want to be able to tell his family I did everything I could to save his pathetic, miserable life. Give him three of epi. Now!

We should be hearing from Dr. Burke any minute.

That's what you said half an hour ago.

Well, whether or not we hear from him, we hit that hour mark, I'm going in to get my heart.

OK, no exit wound. Entry upper right shoulder.

Could be lodged in the spine. OK, let's roll him over.

[Richard] Easy. [Derek] Watch the arm.

Easy. OK, Dr. Burke?

The bullet is in dangerous property here OK?

We need to check your hand function.

I want you try and squeeze my fingers, OK?

They moved my guy upstairs. How is he? Wait outside.

I'm not going to wait outside. Burke?

Can we have a moment?

Only a moment.

I don't want to waste any time. OK?

Cristina.

Honey, you don't have to say anything.

I know you're sorry.

I know you didn't mean to kick me off the transplant and I'm not mad.

I mean, I was, but I'm not anymore, so don't worry about it.

Don't even think about it. OK?

I mean, all that matters is that you get better and you get through this.

And I'm here for you.

Whatever you need. Anything.

I need... you... to... to go...

to check on Denny Duquette.

[Preston sighs]

OK. [grunts]

OK, that was my best "supportive girlfriend" and you kind of ruined it with medicine. OK?

Addison! Thank you for meeting us.

[Addison] You want to tell me what's so important I'm keeping it secret from my Chief of Surgery?

I was chaperoning a prom for my niece.

We had a little bit of a situation.

Camille Travis, 17, lost consciousness during sexual intercourse?

Keep it down.

It's OK, Aunt Adele. I'm fine.

When your Uncle Richard finds out you were cashing in your V-card, none of us will be fine. [girl] Camille?

Mrs. Webber! My God! Is she OK?

No one ever died from having sex, right?

You're not going to tell my parents, right? I used a condom and everything.

[sighs]

[door slides open]

George's page said it was an emergency.

You paged Meredith? We need help!

What the hell is going on? What the hell is going on?

Exactly what I said. [George] She cut his LVAD wires!

What do you mean cut his LVAD wires! Are you trying to kill him?

I'm trying to save him. All I have to do is confirm that his condition is worse, then Burke can call UNOS and he'll move up on the list and will get his heart.

She's gone insane, right? It's not just me.

About Burke... It will be fine!

Izzie! When Burke gets here, everything will be fine. he will know what to do. About Burke...

What? He's been shot!

[Izzie] Burke's not coming? Cristina, are you OK?

I'm fine. Burke's not coming?

Why didn't I take the internship in San Diego?

None of this would be happening in San Diego?

Burke's not coming! No, Izzie. Burke is not coming.

I know you have problems with your possible murder charges and stupid idea about stealing a heart, but Burke's kind of busy right now!

[Izzie] Denny's going to die.

Denny's going to die and I killed him.

You shouldn't have done it! [Meredith] George.

We have to tell someone.

No, Denny won't get the heart and Izzie'll get kicked out of the program.

I'm leaving. Cristina!

Burke could die, too.

Complications arise all the time because of gunshot wounds!

You think about that. Oh, my God.

You know what? None of this would have happened, If you were thinking with...

I did what I thought was best!

[all argue]

Shut up!

No one is leaving. And no one is dying.

[breathlessly] Thank you.

It was kind of getting on my nerves, all this dying talk.

Denny.

It's OK.

I think, maybe we should all listen to Meredith.

It looks like she might have a plan. You have a plan?

Just give me a minute.

You girls should go back to the prom. Will you call Camille's parents?

Not until I have to. You know her mom.

She gets a little hysterical.

[Richard clears throat]

Brian, disappear. What?

Go! Disappear! Richard.

[breezily] Richard. Adele.

What? Are you here to see Preston?

No. What happened to Preston? Preston was shot.

[gasps] Preston was shot? Yeah.

Camille. What happened to Camille?

Why didn't you call me? Richard, she's 17, sweetheart.

She'll be 18 in a few months. Most girls lose it way before...

[groans]

Do you think I want to hear that?

Do you think I want to picture my baby niece... "losing it"?

Richard, take deep breaths.

Well, the bleeding has stopped, but her pelvic exam does concern me.

I'd like to do an ultrasound.

Three years ago, Camille was diagnosed with ovarian cancer.

They only removed one ovary to try and preserve fertility, but her checkups have been clean since then.

OK. Well, let's not worry until we have to.

[Adele sighs]

You! You wait right there! I want to talk to you!

[mouthing words] I said wait. Stop! I said stop!

Richard, take deep breaths! Richard!

That's a stupid plan! Well, if Burke isn't coming, then we have to confirm Denny's condition ourselves.

We get the blood work. We do the echo.

And no one even has to know what, Izzie did.

None of us have done an echo on our own.

Cristina has. Burke taught her.

I'm not involved.

What if this were Burke?

What if you were me? This is bad.

This is bad and serious and against a lot of rules.

It's not fun for me, I don't wanna play. [Izzie] What if you were me?

I wouldn't fall for a patient. You fell for an attending.

What's the point? We can't help who we fall for.

[scoffs] Yeah.

Yeah.

His hands are cold.

My hands are always cold. Your hand is cold, Preston.

I have cold hands.

[Preston coughs]

Bullet could be lodged in the brachial plexus. That's dangerous.

It's very dangerous.

[softly] My hands are always cold.

[Richard] We'll have to do an angiogram.

I'm always cold.

[rapid beeping]

Trachea's deviated to the right!

Absent breath sounds on the right side! Let's go!

[Derek] 14-gage angio.

Let's hurry.

Dr. Burke? You gotta stay with me now.

There you go. That's it!

There you go! You're all right. Right here.

Your lung collapsed. You're OK.

You're OK now.

He's been shot? Dude.

We'll have to run these tests ourselves.

UNOS gave us an hour. In a couple of minutes, our time is up.

I'm telling you, this chick is hardcore. She's not gonna wait.

OK, well, you just have to stall her. - I'm not getting involved with this, I don't care if that drawling bedridden whiner ever gets a heart.

Alex. Do this. For Izzie.

I'm not guaranteeing anything.

So... was it totally romantic?

Yeah, before... the pain and the paramedics and everything?

[everyone laughing]

OK, so...

[whispers] You know that feeling when you look into someone's eyes and you're totally comfortable and you aren't self-conscious and everything just...

[laughs] is, like, perfect?

Camille, have you had any symptoms... any abdominal pain?

Nausea?

Anything? [girl] No, she's been fine.

You haven't been fine, have you?

No, not for, like, a month or so.

You've been feeling sick for a month?

I wanted to go to prom. I, I... I didn't want to be the girl with cancer, again.

You're not.

She's not, right?

Hey.

[Adele chuckling]

I was just trying to remember the night I lost my virginity.

And I can't. [chuckles]

I remember who it was with and I remember I was 18, but... I can't remember any of the details.

I can remember all of the details.

Kind of wish I couldn't. That bad?

No, just not good.

[inhales]

Good came later.

And then really good came.

[chuckles]

[sighs]

That little girl in there's just getting started.

She hasn't even seen what good is yet.

Please. Addison.

Tell me she's going to have a chance, to see what the good stuff is.

I'm so sorry, Adele.

How's his heart looking?

His left ventricle's shot and he's barely pushing blood out.

I'm sorry.

I know that you're worried about Burke.

You know, whatever. It's fine.

Cristina, can't you just try to understand?

I love him.

You don't even know him. I do know him.

You've never even seen him outside this hospital. You don't know him.

I know him.

Maybe I don't live with him or work with him like you do with Burke, but I do know him.

And there's... there's possibility here.

And given the choice of running or staying...

You should run.

A sane person, a person who values her career and everything she's worked for, a person who values her own heart, for God's sake... that person would run.

[Denny, softly] A sane person... would marry me.

What? What did you say?

What did he say?

He said marry me?

He said marry me, right?

He did.

Denny. Wake up. Denny.

[rapid beeping]

What's happening?

I'm pumping harder. I don't know.

He's flatline! [Cristina] He's not flatline.

There's movement in his heart. OK, um, uh, let's shock him.

Charge the defibrillator. Ventilate, George!

I am. Charging to 200!

[Cristina] You got it? Yeah.

[defibrillator charging]

Clear!

[defibrillator discharging]

Is Dr. Burke alive? Yes.

Shame. He'd probably have made a good donor.

OK, people, let's get our organs and get out of here.

That heart is not yours. Seattle Grace is still waiting for test results.

Well, I'm not. Ten blade.

You can't do that.

I just did.

[chatter] [telephones ring]

Girls.

I called Jillian and I called Tessa.

And they called Simon and Bianca and Deborah.

Girls... It's her prom, Dr. Webber.

She can't miss her whole prom! So... we, like, brought it to her.

Kids!

Kids! Listen up.

Look, I know you wanted to see Camille.

Why don't you come back tomorrow?

During the day. In smaller groups.

[muttering]

Look, I'm sorry, girls.

I can't have a bunch of teenagers running in the hallways.

People are sick. People are d...

Dying?

Yeah, we know.

[elevator bell]

[Derek] How're you doing?

I'm developing numbness in my... fourth and fifth fingers.

And there's a pseudoaneurysm in the subclavian artery.

[inhales] You know the drill.

Wait a few days, maybe the aneurysm won't grow.

Yeah, if... if it stays this size, there's too much damage.

We'll just go in there and we'll fix it.

Relieve the compression on the nerves.

But the operation could cause damage to the nerves.

Yes.

And I could... Lose function of the entire arm.

[inhales]

Yes. [sighs]

You can do this?

You're good enough to do this?

I think so.

But you're not sure.

But I'm not sure.

So... what do I do?

It's not like you to ask those kinds of questions.

It's not like you not to have the answers.

How dare you send those kids away?

Adele. Please. You're emotional. OK?

I just told my sister her baby's cancer is back.

[inhales] You're damn right, I'm emotional!

If you don't want to bend your precious rules for Camille, fine.

Don't do it for her. Do it for me.

Do it for your wife who never asks you for anything.

Who says nothing about your long hours.

Who looks the other way while you have an affair with another woman.

Who sobered you up when that woman left you.

Who stayed with you when everyone said I would be better off alone.

I'm not asking you, I'm telling you.

You're going to make this up to Camille.

You're going to prioritize the needs of your family above those of your other patients.

Or... you're going to find a new place to sleep.

[Addison] Derek. Not now, Addison.

Derek. Not now.

[sighs]

There's never a good place to hide in this hospital.

[exhales]

I'm trying to get perspective.

Everything feels enormous. Like it's all just...

I... I can't get perspective.

My niece's cancer has come back.

She's 17 years old and she's going to die.

Plus...

25 years ago, I had a secret affair with...

Ellis Grey.

And today, I find out that my wife knew the entire time.

There was no... secret.

And she stayed with me.

I respect him, you know?

Dr. Burke. I...

I respect him. He is decent. He's honorable.

An arrogant ass who just hogs the OR and thinks he's God, but...

he's decent and he's honorable.

I respect him.

He's one of the foremost cardiothoracic surgeons in the country and I have to...

It's his hand.

I cannot get perspective.

I can't do this. I can't be responsible for him.

Preston's an honorable and decent man, but, Derek, so are you.

You are honorable and decent.

And you're too honorable and decent to run.

You don't know how much I wish this was bourbon.

Anything I can get for you, Dr. Burke?

No. I'm fine.

There... there must be something.

It would be nice... to have some ice chips.

And a touch of morphine if I'm allowed.

[rumble of thunder]

And...

Cristina.

Coming right up.

Where is Cristina?

Where are... where are all of the suck-ups?

Excuse me?

My interns.

My ass-kissing, surgery-hungry, competitive suck-ups.

Where are they?

Why aren't they here fetching you ice chips and morphine?

Why aren't they here sucking up?

You know something.

I'm a patient. Preston Xavier Burke... what have you done with my suck-ups?

What do we do? What do we do? [monitor beeping franticly]

I'm starting dopamine and dobutamine drips. We can use those together, right?

Milrinone? I don't know.

None of us do. Start the dobutamine and dopamine.

What about... what about... Gluceratide? That might help.

[Denny] I feel like my chest is running away.

His heart rate's 217. [Izzie] He's in SVT!

No. Izzie, stop pumping. Stop.

[George] No change. We need that medicine!

What medicine? [Meredith] I'll know when I see it.

I think, the one that stops the heart. Hear hold the mask.

No. The whole point is to keep my heart beating.

No, it only stops it for six seconds.

It's adenosine! His heart is speeding up! Guys!

You guys, we have to do something! He cannot take this for much longer.

[George] What about shocking him? Found it!

[George] Cristina, come over here. Lift up his arm.

The nurses lift the arm when they push adenosine. It gets to the heart faster.

Denny. You're going to feel, um... Izzie!

No, it's OK. It just feels like...

I'm gonna die. You're not, I promise. It's the meds.

[Cristina] Yeah, we're heading back to flatline.

Are you sure we used the right drugs? The book said it was the right one.

I used the one I know! He's not going to die, right?

Right? Right? [monitor beeping franticly]

[continuous beep]

[beeping stops]

[Denny wheezes]

You fools better have a good explanation for this.

Step away from the patient.

Step away from the patient!

I can't. I have to pump his heart.

Olivia, take over for Dr. Stevens.

Izzie, you're done here.

I need you to leave the room.

Izzie... No! Do not touch me!

Olivia, stay with Dr. Stevens.

Help her if she'll let you.

You three. Outside. Now!

[whispers] Where was rational thought?

Where was cognitive thinking?

First do no harm? The morals, the ethics?

Where was sanity when you three decided to help that girl?

We didn't... No speaking. Nobody speaks, I do not want to have to testify against any of you in a court of law.

Not one word.

She cut his LVAD wire.

I said no speaking.

I didn't say anything! Then no moving!

Cristina, Burke is asking for you. Go!

I'm assuming you ran labs?

I'm asking a question.

Answer me! You said no speak...

I know what I said! [Meredith] Yes.

O'Malley, get me the lab results. Do not pass go.

Do not talk to another living soul.

Get the labs! Get back here!

Grey...

come with me.

How are you?

You look good.

Are those your films?

Burke...

Shepherd, uh... doesn't know if he can fix my hand.

Maybe I'll wait it out. [inhales]

See if this numbness subsides.

Yeah.

Or I could let Shepherd operate.

Yeah.

I could lose all hand function.

What if I can never operate again?

Yeah.

Cristina? Yeah?

Stop saying yeah. OK.

I need...

I need...

You said you were here.

For me. Yeah.

Sorry.

Cristina.

I need you to tell me...

[slow breathing]

[voice breaking] What you think I should do?

I...

[rumble of thunder]

I told Dr. Bailey that I would be back.

OK? I told her that I wouldn't be long.

Cristina... I'm going to think about it.

I mean...

I'm going to think about it. OK?

[thunderclap]

[breathes heavily]

[pumping]

How're you feeling, Denny?

Really, really good.

Like an athlete or a superhero.

Or some other kind of really healthy person.

You're funny. You're a funny guy. Izzie. No speaking.

I cut my own LVAD wires, you know?

I went rogue. All by myself.

Shush. You're weak enough as it is.

Please don't waste energy on lying.

[door slides shut]

Dr. Bailey? I did indeed say no speaking.

I don't care!

He's going to get the heart, right?

You're gonna sign the charts and talk to the transplant coordinator?

Here are the labs.

See? See, his BUN and creatinine are increasing.

He clearly has pulmonary edema.

He moves up to 1A status on the transplant list.

UNOS will give him the heart. You need to call...

Isobel Stevens, I take my medical advice from doctors.

You are a visitor.

What? You are a visitor in this hospital.

You will not be a doctor in this hospital again until I decide you are.

Olivia, take over the heart pump.

[pumping]

He gets the heart, though, right?

Sir? I need to ask you a hypothetical question.

Can we do this another time?

Uh, if someone on the staff deliberately unhooked a transplant candidate from his LVAD in an attempt to worsen his condition and get him moved up the donor list?

Hypothetically, sir.

I think you need to tell me exactly what's going on here doctor.

Believe me, sir, you want this to stay a hypothetical.

Because I'm thinking if that did happen, you'd be duty-bound to report it and the hospital would be in danger of losing its accreditation as a transplant site.

So hypothetically?

Hypothetically, if the patient got worse, would it be unethical for him to receive the heart even though, medically, his worsened condition now puts him at the top of the donor list?

Hypothetically?

How bad is he?

In the few hours it would take a new LVAD to be delivered, he'll be dead.

Our responsibility is to the patient.

If, medically, he's at the top of the list, then he should get the heart.

Hypothetically. Thank you, sir.

But practically?

Whoever removed the patient from the LVAD, I expect to be given names and there will be severe, severe consequences.

Yes, sir.

Wait. Hold on. Dr. Hahn? Dr. Hahn!

Dr. Hahn!

Can't stop now, Karev. I only have a few hours to get this heart into my guy.

Dr. Hahn.

UNOS gave the heart to Seattle Grace.

The transplant coordinator stopped your guy from being prepped.

Come on!

He has kids. They're four and five.

Do you know how long he's been waiting for this?

He's a good person.

He deserves a heart.

I'm sorry.

[scornfully] I'll bet you are.

No. I am. Believe me.

Listen, we have a chopper waiting on the roof.

And?

You could take up fishing.

I don't fish.

Fishing's a lot more fun than surgery.

I have 80 percent hand function now.

80 percent's not enough.

Not for you.

Fishing?

You don't fish.


Shepherd?

You don't have to thank me.

I'm sure you'll return the favor one day.

I was going to say, please try not to kill me.

[all chuckle]

I'll do my best.

OK.

[monitor beeping rhythmically]

[Erica] Look at that thing.

Left ventricle's excessively dilated.

He wouldn't have lasted another hour with this heart.

No, he wouldn't have.

[Derek] OK, retract that little bit right there.

OK, I am now removing the aneurysm from the nerve cluster.

[beeping] NAPs are dropping.

Arterial pressure's down 50 percent.

[Richard] Did you cut the nerve root?

I don't see any discontinuity of the nerves.

All right, let's do a reflex test on his hand.

Chief. OK.

[Richard] Nothing. Damn it. Try it again.

This doesn't make sense. I'd know if I severed a nerve.

Derek, is the arm paralyzed?

I have to do a wake-up test. Derek.

There's only one person who can help me figure out whether or not I've damaged the relay or not, and that's Burke.

He's been through a lot of trauma today.

I'm trying to prevent the trauma he's going to feel if I have to tell him he's paralyzed.

Bailey's treating us like we're children. We're not children.

We shouldn't have to sit out here like we're on a time-out or something.

It is a time-out. What we did is way in need of a time-out.

You realize we could get kicked out of the program for this?

Not we.

I did this.

I did this.

You're probably right.

Maybe I should run.

But I'd rather be running towards somebody than running away.

Yang? Shepherd's asking for you.

For Burke's surgery? Yes. Hurry up.

I can't. I'm... I'm in a time-out.

Time-out's over. Right now. Yang, we need you.

He said marry me, right? He did?

That really happened?

It really happened.

It really did.

Screw this. I'm checking on Denny.

[Derek] OK. How we doing?

[man] He's at the edge of consciousness. Very light. He should be up soon.

OK. Yang? You're up.

What? I'm sorry. What do you need me to do?

When he comes to, he's going to be disoriented and he'll probably fight the intubation.

We can't numb the arm because we need him to move his fingers.

He will be in a lot of pain. So, we need you to keep him focused. OK?

OK. Yeah.

[Derek] OK, let's, let's wake him up.

Burke?

Thank you. For calling me about Izzie.

I didn't do you any favors.

Well, it meant something that you called.

It meant something to me.

It didn't mean anything.

Right. OK. Sorry.

Stop saying that you're sorry!

You want to know something?

I knew.

I knew you didn't feel that way about me.

Even during...

When we were in bed, I knew.

I knew and I still let it happen.

Because...

[sighs] I...

I figured that... one night with you was better than never.

So, you just stop saying that you're sorry... because you didn't know any better.

But I did.

And...

I'm sorry.

I'm sorry, Meredith.

Burke, it's Cristina.

I'm sorry.

Wake up.

Wake up. Burke.

Baby, wake up. Do it for me. Open your eyes.

Hi. Hi.

[groans]

[Derek] Get ready. Get ready. Hold him down.

Calm him down. [Richard] Yang!

Cristina, get in there. Get in his face. Talk to him, Cristina.

[Richard] Yang! Get in there!

[coughs] [Derek] Hold him down!

Yang! Calm him down! Cristina!

[Erica] Scissors.

[Alex] It's beautiful work, Dr. Hahn.

The hard part is still to come.

All right, let's start taking him off bypass.

[beeping]

See if this heart will beat on its own.

[Miranda] Nothing. Come on, Denny.

Beat for me.

[muffled screams] Cristina!

[Preston grunts and strains]

Hold him down, Chief. Hold his arm.

Preston? Preston, look at me! Look at me!

Right here. Listen, listen. Calm down.

Listen, there was a complication. We can fix it.

We need you to move your fingers on your right side.

Can you do that? Come on, you can do this.

Look at me. On your right hand. OK? I know. I know.

It's just you and me. We can do this. OK. Come on. Focus. Focus.

Now you're going to move your fingers on your right hand. Can you do that?

Come on, Preston. You can do it.

Move your fingers.

[Derek] Move your fingers. Come on.

[Preston strains] Come on.

Come on.

[thud]

[continuous beep]

No response. Charge to 20.

[defibrillator charging] Clear.

[thud] [Erica] Come on.

[continuous beep]

[Erica] Come on.

[splutters]

[monitor beeping frantically]

Come on.