Into You Like a Train (2005)
[Miranda] Previously on Grey's Anatomy...
What is going on with you?
The hospital grants you four months to retake the medical board exam.
Karev, take the scalpel. Alex, come on.
Your choice. It's simple. Her or me.
Addison is my family.
And in one day, I'm supposed to sign a piece of paper and end my family?
Your date? My husband.
You're married? Ten years today.
Burke wants a relationship.
OK. We're a couple.
So pick me. Choose me. Love me.
I'll be at Joe's tonight. If you do decide to sign the papers, meet me there.
Tell me what to do.
I actually said "Pick me." Right? I did? "Pick me"?
I think it's romantic. It's not romantic, Joe. it's horrifying.
Horror movie horrifying.
Carrie at the prom with the pig's blood horrifying.
OK, fine, it's horrifying.
But Carrie took out an entire senior class as revenge.
Gotta say, I like that in a girl.
I said "Pick me."
When you tell someone "I'll meet you later at a bar tonight", how long exactly does that mean you are supposed to wait?
Do you think he's really not coming? It is getting a little hard to watch.
It was hard to watch an hour ago. Now it's just pathetic.
You, who pretend to be my friends, are calling me pathetic behind my back in front of my face.
Why don't you just dump the pig's blood on me now and get it over with?
He's really not coming.
[man] Joe, turn up the TV.
[woman on TV] A massive train wreck occurred just outside of Seattle minutes ago.
911. We just worked a 30-hour shift.
I don't have any clean underwear.
The Vancouver-bound train was carrying over 300 passengers.
Looks ugly. - Paramedics are on scene helping victims.
You're leaving? No, you can't leave.
Sorry, gotta go tend to someone else's train wreck.
You gotta at least stay for a cup of coffee.
You're in no shape to cut people open.
Plus, I don't want to hear the ending.
Maybe it's for the best. Maybe I don't want to know.
That's the stupidest thing I've ever heard.
[Meredith] In general... Bye, Joe. people can be categorized in one of two ways.
[man] He was in the front of the train.
[Meredith] Those who love surprises, and those who don't.
Dude, you're late.
[woman on TV] Once again, a massive train wreck occurred just outside of Seattle minutes ago.
[Meredith] I've never met a surgeon that enjoys a surprise, because, as surgeons, we like to be in the know.
We have to be in the know.
Because when we aren't, people die and lawsuits happen.
Am I rambling? I think I'm rambling.
I think I saw a pneumothorax. I hope I get a pneumothorax.
Hey. Thought you weren't talking to me.
Thought you needed a friend, so I'm rising above.
Why would you think that? Because you freaked out.
I did not freak out.
Missed your chance to perform an open-heart surgery.
O'Malley plugged the hole with his finger.
I thought you could use someone to talk to.
Well, I don't. To someone who cares about you.
What are you looking at? [Cristina] Is that a dress?
Nothing. What? hey, you, go get me my damn shoes.
Let's move, people.
Hello. I seem to be a little bit drunk.
I was off duty.
So was I. Anybody else half in the bottle?
No. [Miranda] All right then.
Grey, just stay out of the way. I'll deal with you later.
The rest of you, stick with me and wait for your assignments.
I know you get all a-quiver at the sight of blood and organs but it's gonna be a long night and you're already tired.
I don't want any mistakes. Come on.
I'm done. Done.
I'm so not tired anymore. Me neither. I'm not tired either.
I've got a third-trimester burn victim here.
Dr. Bailey, I'm gonna need some help.
Izzie, go. Yes. Have a nice nap.
Have you had any contractions? No.
Hey. Joe told me to tell you that McSteamy came looking for you.
You mean McDreamy?
Joe said McDreamy came looking for me?
No, I'm pretty sure it was McSteamy. Yeah.
[woman] Dr. Shepherd, could you take a look at this?
Does that mean he picked her?
If it does, I just lost 50 bucks.
Got the leg!
I want that leg. He lost a lot of blood at the scene.
Pressure dressings applied, two large-bore IVs started.
Anything for pain?
Base ordered morphine. Five migs given so far.??
Dr. Bailey, who you got?
Cristina, go. Yes!
Rule out other injuries and book an OR.
Dr. Webber? We have a train wreck, Derek.
We need all hands on deck. Clear me for surgery or you're fired.
Any headaches today? No.
Dizziness? Nausea? Blurred vision? No, no and no. Out of my way.
Fine. But I'm coming with you. Or I'm fired. Up to you.
[woman on PA] If you're a resident, page the operator.
Was that a nod? Yes.
Do we know what it meant? No.
Am I invisible?
[Meredith] OK, so my point actually, and I do have one, has nothing to do with surprises or death or lawsuits or even surgeons.
My point is this, whoever said, "What you don 't know can't hurt you" was a complete and total moron.
Because for most people I know, not knowing is the worst feeling in the world.
OK, fine, maybe it's the second worst.
His BP's steady at ninety over palp.
She's had two hypotensive episodes to the low seventies.
Couldn't get a saw in there? Not without moving them.
Which would've been a very bad idea. [Preston] Did you bolus her with fluids?
[paramedic] We're pushing it open...
Is this the craziest thing you've seen?
Yeah. Me too.
OK, then. You guys got it from here.
Hey, you were at the scene?
Won't be too bad for you. Lot of carnage. Not a lot of survivors.
They're never gonna fit into CT. We're gonna be flying blind.
Get X-rays and labs, then page me the minute you're done.
Hi, I'm Dr. Burke.
You shouldn't turn your head.
You want to try to move as little as possible.
So are you gonna pull this pole out of us anytime soon?
I'm sorry, we can't do that until we get a better look at what's going on internally.
I assure you we will work as quickly as possible.
Well, in that case, does anybody have a breath mint?
For me, not for you.
Keep them going. O'Malley? Get them to X-ray.
Thanks. Move them extremely carefully.
This never would've happened before the elevator.
You go, George.
Alex, cover the ER.
You can do sutures while you get over your newfound fear of scalpels.
That was mean, even for you.
You are drunk.
Go get yourself a banana bag IV, put it in your arm and then find me.
Do not speak to any more patients, do not practice any medicine.
Well, should I just go home?
Unless you drank the whole liquor bottle, you'll be sober in a few hours.
And the IV fluids will head off your hangover.
Then you can assist with the many mangled victims you see spread out before you.
Besides, if I'm not going home, nobody's going home.
Ten years of marriage. I didn't even get to finish my damn lobster.
Well, is there anyone you'd like me to call?
No, they called my wife from the ambulance.
And my fiance. They're flying down from Vancouver together.
Normally, Amanda would be a tad upset to find me pressed up against another woman.
But in this case, I think I'll get a pass.
You two weren't traveling together? No. We just met.
[man] Bit of an awkward introduction. You have very nice pores.
Hurts to laugh.
Whoa. You can go ahead and just... Oh, thanks.
Do you think I could... Yeah, go ahead.
Dr. Stevens, did you need something?
Ow! I'm sorry. Am I doing this too...
Ow! Was that a... Did I have... A contraction.
It was definitely a contraction. We need to book an OR.
Look, you are in no shape to push, and the baby is still in some distress, so we're gonna have to proceed with a C-section.
But can we call a lawyer first?
I don't have a will. And there's no father.
And in case something happens to me...
There's no cause for panic, Brooke. We have some time, OK?
[cell phone rings] [woman] Hello.
Oh, no, no, no, we're fine, honey.
Some redneck tried to outrun the train.
The train slammed into his ass and then it rolled...
That hurt? Uh-uh.
Oh, no, no, that dude is toast.
Him and about 200 other people.
And Mary got her face all cut up. Does it hurt anywhere else?
A whole bunch of luggage, when they hit the brakes, it just came flying at us.
We'll take you for an X-ray, see if anything's broken, or if there's internal injuries.
Yeah. Wait. Hold on. I'm gonna have to call you back.
Hey. Excuse me. Where you going? I'm taking your friend for an X-ray.
No offense, little boy, but you look like my oldest son, and he's nothing but trouble.
Yvonne, shut up.
I said "no offense." I'm just saying, are you sure you're a doctor?
[cell phone rings]
Yeah? Yeah, we're fine.
Yeah, this redneck tried to outrun the train...
[woman] Ow! Ow. Ow.
What are you doing? Trying to insert my banana bag.
Which sounds vaguely dirty, but it isn't.
I can do it.
So, how's it going with Addison?
Bad mood? Good mood?
"Yay, my husband picked me" mood?
I think it's more of an "I hate the smell of charred flesh" mood.
Before you judge me, I know there was a train accident.
People are very badly hurt.
And that I'm a vapid narcissist when you mix me with alcohol.
In case you were wondering, I know that.
Well, for what it's worth, I take issue with her salmon-colored scrubs.
I mean, what self-respecting surgeon wears salmon-colored scrubs?
This is what I'm saying. Yeah.
[Richard] Thank you.
[Richard] Yang, how's that wound looking?
[Cristina] Pretty clean. Some dirt and gravel mostly.
This guy was lucky. It's a guillotine injury.
We do this right, he'll have full use of his leg.
[Richard] More irrigation right there. [pager beeps]
[Derek] It'll wait.
I'm fine, Derek. Just adjusting to the light.
All I'm saying is that, there's no shame in taking a little more time off.
It doesn't make you old or tired or rusty, it...
OK, that came out wrong.
You're the only attending neurosurgeon, you're obviously needed elsewhere.
And I'm fine here.
[nurse] Dr. Shepherd?
[Derek] OK. Page me if you need me.
When you're finished cleaning that wound, you can help me here, Dr. Yang.
Is the wound clean, Yang?
Yes, sir, I... But... But what?
If your plan is to be a watchdog for Dr. Shepherd or if you think your job here is to baby-sit me, then you can think again.
I've been a surgeon longer than you've been breathing.
If I were not ready to be in this OR, I would say so. Is that understood?
Yes, sir. Now do we have a problem, Yang?
Yes. No, sir.
I'm thrilled to learn. And I'm grateful to be here.
It's just that...
Sorry. His legs...
[Richard] What about them?
[Cristina] They're both left.
Find the man's leg, Yang. Find it now. Yes, sir.
Is it going straight through her spine?
It is. T8's completely crushed.
I'm keeping an eye on her.
[Derek] Look at this. These people are still alive?
They're still making small talk.
Pole's tamponading the wounds as far as we can see.
It's hitting the aorta.
And look at him. It's right in line with his inferior vena cava.
Is there any way to operate without separating them?
No. But if we move the pole then...
They'll both bleed out.
What if we don't move the pole?
What if we move one of the patients off the pole to get the saw in there?
Then we can hold the pole steady in the other one.
Move it very slowly, and repair the damage as we go.
Who? Which would you move?
With her aortic injuries, her chances of survival are extremely slim no matter what we do.
But if we move her, we have a real shot at saving him.
Well, I could argue since her injuries are more extensive, we should move him.
Give her the best shot we can.
So basically whoever you move doesn't stand a chance?
So how do you choose?
How do you decide who gets to live?
We have to make this call soon if we want a shot at saving either one of them.
I'd like to examine them before I weigh in.
I'll wait for your page.
Thank you. Dr. Grey?
Dr. Grey needs to get herself a blood alcohol test before practicing medicine tonight.
What? No, I'm totally fine, look.
Regretting that last shooter about now, aren't you?
What are you doing in here?
The leg you brought with the amputee...
I didn't bring in an amputee. OK, well, one of you did and it's...
'Cause all paramedics look alike to you, right, doctor?
OK. Really. I cannot straddle another giant ego right now.
I'm already doing the splits, I need a right leg, right now, or the Chief of Surgery is gonna take away my pretty blue scrubs.
When the train derailed, it hit an overpass.
The roof of the dining car was sheared off and it sliced through a passenger car.
There were multiple decapitations. Your guy can live without his leg.
This is so not about the leg. Or the guy.
But thank you. For all that you do.
Yeah, honey, we're fine.
Some redneck tried to outrun the train, then they give us this little boy doctor.
All right, scar shouldn't be too bad.
Can you tell me, my friend, she's pregnant too.
She went put in a different ambulance.
She was burned.
Do you know where she is?
If she's not down here, she should be in Maternity.
I need to see her.
We're not finished here. My baby's fine. I feel her kicking.
I've got to see Brooke. You can't just leave.
[Alex] Just wait. Come here, come here.
So you operated on a heart earlier, George.
You'd think you could draw blood.
I rocked that heart. Yeah, you did.
I think I'm strung out on the scalpel.
Nothing wrong with that.
So any news? About...
No. I can't read him.
I think it's pretty amazing you even gave him the choice.
And I think, for what it's worth, I think he's crazy if he doesn't pick you.
Please tell me you've seen a right leg, a cleanly severed right leg.
How weird is this job?
Thank God. [Addison] Dr. Karev?
I couldn't stop her. She was on the train?
Yes, but... Have you done an ultrasound?
Cleared her C-spine?
Is there a reason you can think of that this patient should be wandering around the hospital unattended?
She's not unattended. I came up with her. She's...
You can leave now, Dr. Karev.
Irresponsible even for an intern.
What? You disagree?
She wanted to see her friend. I mean, what was he supposed to do, tackle her?
Dr. Stevens, why don't you get our new patient into a bed? Shall we?
Can you feel that, Miss Krasnoff?
You're a cute doctor. Cute doctors get to call me by my first name.
OK, Bonnie. Can you feel that, Bonnie?
Can I feel what?
Oh. Well, I guess that's a no.
[George] Excuse me, Dr. Shepherd? Yes.
I got the labs. Great, thank you.
Here you go. Hold that, please.
Could you try to wiggle your toes, Mr. Maynard?
Are they moving? Yes, they are.
Good. That's good, right? Yes, it is. Yes, it is.
What about me? Are mine moving?
Yes, they are.
[man] Dr. Shepherd, is it? Yes, it is.
Dr. Shepherd, Bonnie and I...
Are we going to live through this? Now that's just morose, Tom.
I'm sorry, dear.
We're going to do everything we can, Mr. Maynard.
About time, Yang. I was starting to think my work here would be wasted So sorry. It wasn't easy to find.
I took the liberty of checking the wound and it's very clean cut, well preserved.
Notice anything else about that leg?
Anything other than that very clean cut?
Did you happen to notice, for example, that it was shaved recently?
Take a look at my patient, Dr. Yang.
Does he look like a man who woke up and shaved one of his legs this morning?
I'll go find the right... the right right leg.
The right... Thank you.
Where are we? You were right. Vitals are erratic.
Pulse is weak. The spine's severed. I was hoping that it didn't hit.
But from that angle, it just can't have missed the aorta.
What about him? Think he can live?
He's got better odds. Let OR 1 know we're coming.
And, O'Malley, close off the gallery.
We don't need an audience for this.
She's cracking jokes.
How do you tell someone she's gonna be dead in a few minutes when she's sitting out cracking jokes?
Is there any chance that we can get out of here some time this year?
Well, the lab's backed up and so is Radiology.
I can't discharge your friend until I'm certain she has no internal injuries.
[cell phone rings]
Yeah, we're still here, 'cause the doctor's friggin' useless.
I realize you're dealing with a lot of carnage.
I'm asking if you could maybe sift through some of that carnage and find a... Hello... Dammit.
Cristina. You paged me?
If I don't find this leg, the Chief is gonna cut me from this program.
And I cannot go back home, Burke.
It is too sunny in Los Angeles.
It's sunny every day.
And you paged me because?
I need you to help me find the leg.
I checked the board. You're not in surgery, right?
You're my boyfriend. I mean...
I know I don't have much experience with this kind of thing, but aren't boyfriends supposed to help in situations like this?
Cristina, when we're on duty, I can't be your boyfriend.
OK, so when we're on duty, I can have sex with someone else?
Dr. Yang, I'm walking away now.
Fine. Fine. But when the Chief cuts me, you might rethink this.
Addison yelled at you in front of a patient?
She didn't exactly yell.
Fine, she's Satan's whore. Thank you. So did you yell back?
No. Dude, you lost your mojo.
Excuse you? I was trying to talk boy.
O'Malley plugs a hole with his finger and everyone walks around like he's some kinda hero.
I have one off day... You chickened out.
I hesitated briefly.
Why didn't you kiss Izzie?
And now I'm leaving. It's not in the morgue.
I've looked in the ambulances, in the ER...
How is one bloody, hairy leg going to destroy my career?
[man] Dr. Karev?
I hope you find your mojo, Alex.
I find you disturbing without it.
[Alex] Me too.
[Derek] This is hard, because your body is in a certain amount of shock.
It's preventing you from feeling pain, feeling the extent of your injuries.
[Bonnie] Dr. Shepherd.
We have a metal pole cutting a path through our insides.
I don't know about Tom here, but I didn't expect to walk out of here anytime soon, so... whatever it is you have to say, just please, say it.
[Derek] OK, Bonnie.
In order to operate on Mr. Maynard, we have to separate you two.
In order to do that, we have to move you backwards off the pole.
Can't you just pull the pole out of both of us?
If we did that, you would both start bleeding very quickly. Too quickly.
Right now the pole is plugging the wounds.
Once removed, the organs will shift.
And there is a great deal of damage.
So, if you move me, I'll die?
We're gonna do everything we can to...
[Tom] No. No.
If anybody has to go, it should be me.
You just move me... No, Mr. Maynard.
Your injuries are less extensive.
If we pull the pole from you as we operate around it, we have a better chance of repairing the damage.
It's not right.
It's not fair.
It's not fair either way.
Is um... Is my Danny... Is he here yet?
There are delays at the airport. The storm...
We could wait.
But the longer we do, the higher the risk of infection for...
This is better.
Danny, he wouldn't understand.
I've had a couple of hours to, you know, process all of this, but if... if he had to see me, talk to me like this...
Well, I just think it would be too hard.
[Addison] Right there. In between the vertebral spaces.
Don't be shy about pressure.
That's good. You are doing so good.
Somebody called for a notary? I asked for a lawyer.
I couldn't get one at this time of night.
But the hospital has pretty standard forms.
It says that in the case of death or permanent vegetative state, that your child remains in the custody of, and then we'll put her name in.
Wait. What? What are we...
Who's dying here?
There's some danger.
With any surgery, there's danger.
But with the trauma of Brooke's burns, there's an additional risk of shock.
She just wants to be certain. That's ridiculous.
You're going to be fine, do you hear me?
I hear you. But we still have to sign the forms, unless you want our son to end up with my mom.
How long have you two been together?
Since third grade.
We're not lovers, we're best friends.
We wanted our kids to have two parents.
So we got a sperm donor...
The same donor?
So your babies are brother and sister?
How cool is that?
I'm wet. I think my water just broke.
Good news. You've got a broken rib, we're gonna give you some painkillers.
After that you should be good to go. Thank you.
[cell phone rings]
Yvonne, answer your phone.
Code blue! I need some help here! [Mary] Yvonne!
Push one of epi. Hold CPR.
Her abdomen is distended, it's rock solid. She's lost too much blood.
She's been bleeding for hours. [Mary] There's no blood.
She's not bleeding. She was bleeding internally.
She didn't say anything.
[Alex] She wasn't even a patient.
I didn't know.
[nurse] Dr. Karev, she's gone.
[Mary] No! No!
No! No! Yvonne!
Time of death, 2:51.
[Mary] No, no, no, no.
Don't. Try again. Try again.
Jana, this is our OB resident, Dr. Hoffman.
She's gonna be taking care of you from here.
You're doing great, Jana, just keep breathing.
I'm gonna check your cervix now.
Brooke, we've booked an OR but they won't hold it for long so we need to go now.
But we're supposed to be together. We took classes.
I'm sorry, but we can't wait. That's OK, Brookie.
You go have your C-section.
And enjoy those drugs.
This is already not fun for my vagina. Dr. Stevens?
No. If I have to go, she has to stay.
Someone has to stay with Jana. Please.
Brooke, Dr. Stevens is a surgeon, but I'm gonna...
It's OK. I'll stay.
Brookie. Stay alive, OK?
[man] Hey, Doc. What?!
Easy, killer. Jill said you guys were freaking out looking for this leg.
Thank you. No problem.
[Alex] Right on.
Chief Webber, I'm extremely sorry, I...
[Richard] Pull that tendon down with those pick-ups.
You found the leg? I found the leg.
[Richard] You missed out on this one, Yang. but I'm sure they could use a hand down in the ER.
Karev and I can handle it from here.
Can I ask you a question? Mm-hmm.
Do you believe in heaven?
I want to.
I just want to say...
I know. I know.
[Derek] This is Dr. Adams, our anesthesiologist.
When you're ready, he's going to put you to sleep.
So it's not gonna hurt?
[Adams] It won't hurt a bit.
Dr. Shepherd? Yes?
You're gonna be the one to talk to my Danny, right?
What would you like me to tell him?
[Miranda] Why do I feel like we're about to kill this girl?
Dr. Bailey, my labs are in.
Sober? Can I scrub in?
Do it fast.
You know, I went to the bar. I heard.
You take some aspirin with the banana bag? Helps with the hangover.
You're staying with her.
Yeah, she's my wife.
[Miranda] Dr. Shepherd, she's crashing. [beeping]
[Derek] What happened?
[Adams] I just put them under. The pole must've shifted.
I barely touched her. This isn't my fault.
It's nobody's fault. We need to remove her now if we're gonna have any chance.
How do we do this? Team One, continue to stabilize his body.
Team Two, move her back and let's get the saw in there.
This has to be fast and smooth, people.
O'Malley, you hold the pole in place.
Whatever you do, don't let it move. OK.
[Preston] On the count of three. One, two...
That's great. That's great. Take another breath.
[Addison] He's wedged up under her ribs, we're gonna have to pull him out.
On three. One, two...
[nurse] Watch her head. [nurse] Clean towel.
[Preston] He's stable. [Derek] Retract.
[Preston] Let's start with her and see what we can do.
[Miranda] We'll need more blood. Scalpel.
[Preston] Hold onto the blood bag. Grey, get in here and help retract.
[Derek] Richardson retractor.
[Preston] Lap. [Miranda] OK, Got it.
[Derek] Quick, please. Give me some sponges. Sponges.
Bovie suction here. I'm in.
[Derek] Lap sponges. Hand me the cautery.
Her aorta's shredded. She's gonna bleed out.
We have no rhythm.
[Adams] Doctors, he's losing pressure.
[Preston] He's bleeding. [Derek] Let's go.
[man] Change out. Everybody change gloves.
[Meredith] What about her? We can't just abandon her!
[Preston] I'm going in. [Meredith] We can't abandon her!
[Preston] I'm going in stem to stern. Scalpel.
[Miranda] Sternal saw.
[Preston] Give me the sternal saw.
[Bailey] Let's go, Dr. Grey. [Derek] Meredith.
[Bailey] Dr. Grey.
[George] Meredith! What about her?
We cannot just abandon her. We have an obligation.
[Miranda] I'll take care of this.
Meredith, come on, there was too much damage.
There was never anything we could do. We have to let her go.
[Miranda] Time of death 3:49.
Good morning. How's Brooke?
And the baby? He came through, too.
So, have you made a decision yet, Dr. Stevens?
Whether or not you're going to hate me.
You're Meredith's friend.
I'm the wicked witch who came in and cheated on Dr...
Wait, what is it that you guys call him?
Right. God, doesn't that embarrass him?
Yeah, I think it does.
By all rights, you should hate me.
Except that I'm gonna be staying in town for a while.
You are? Yes.
And you show a real gift with my specialty.
And I have a lot to teach, if you want to learn.
So, when you decide how important it is for you to hate me, let me know.
[woman on PA]
Did she uh... Did she suffer?
No. Her injuries prevented her from...
No, she wasn't in any pain.
She asked me to... to tell you that...
She wanted you to know that if love were enough...
that if love were enough, that she'd still be here with you.
[Meredith] As surgeons,
there are so many things we have to know.
Fine work, Dr. Karev. Thank you, sir.
[Meredith] We have to know we have what it takes.
We have to know how to take care of our patients.
[Preston] Tom is doing just fine.
[Meredith] And how to take care of each other.
[Meredith] Eventually we even have to figure out... how to take care of ourselves.
As surgeons, we have to be in the know.
But as human beings, sometimes it's better to stay in the dark.
Because in the dark, there may be fear...
but there's also hope.
Better get cleaned up.
Rounds. Five minutes.