2009

GREY'S ANATOMY

2x19: What Have I Done To Deserve This?

Original Airdate: 2/26/2006

Written by: Stacy McKee

Directed by: Wendey Stanzler

(Meredith's townhouse)

(George is sitting on the floor of his bedroom against the door)

George Voice Over: Ok so sometimes even the best of us make rash decisions.

(George is standing in front of Meredith from last episode in her bedroom. It flashes back to George looking uneasy as he glances back at his door)

GVO: Bad decisions. Decisions we pretty much know we're gonna regret the moment, the minute, especially the morning after.

(Meredith is removing George's shirt. Meredith's bedroom where Meredith is lying in bed fully dressed also looking uneasy)

GVO: I mean maybe not regret, regret because at least you know we put ourselves out there. But still ... something inside us decides to do a crazy thing.

(Meredith's alarm goes off and she hits it off)

GVO: A thing we know that'll probably turn around and bite us in the ass.

(Derek's trailer)

(Doc barks and runs up to the bed where Addison and Derek are lying. Derek seems fast asleep and Addison is wide-awake holding the pillow to herself)

GVO: Yet, we do it anyway.

(Doc barks loudly again and Derek wakes up groggy)

Derek: Oh god. I'm coming, Doc. Just hang on. Just hold it until I get there please.

Addison: I'll walk him.

(Addison gets up)

Derek: No it's my turn.

Addison: No it's ok. I'll walk Doc. You just s...sleep. Good. (She puts on a dressing robe) Fresh outdoors. Spring morning. You just sleep.

Derek: Ok.

Addison: Unless you wanna talk.

Derek (eyes closed and hugging his pillow): Oh god here it comes.

Addison: Well I'm not saying that we have to talk. I'm just saying if you want to talk we could you know. I could start you know and, and you could talk about anything...at all you wanna talk about.

Derek(groggy): Ah it's just too early for me to interpret girl flip-out into normal conversation.

Addison: It's just that you usually ... you start yelling you know when you get mad. And Mark showed up yesterday and you haven't yelled yet. I'm trying to give you a chance. So just go. Yell.

Derek: I don't wanna yell.

Addison: You don't wanna yell? You?

Derek: I just want to sleep. (Doc barks) Doc, he wants to pee. Preferably not inside this trailer.

Addison: Ok.

(Derek sighs. Addison puts on a dorky looking cap and stops at the doorway)

Addison: You could yell if you want to. I can take it! I'm ready!

Derek: Addison.

(He pulls a pillow over his head)

Addison: Alright. I'm going. (Doc barks) I'm going. Come on.

(Meredith's house)

(Meredith is grabs her keys and listens at the doorway to see if George is out there)

GVO: What I'm saying is ... we reap what we sow.

(George is opening his bedroom door very carefully)

GVO: What comes around goes around.

(He creeps out and we see that Meredith is also walking down the hallway also creeping quietly. She stops uncomfortable when see sees George and he stops too when sees her. All of sudden Izzie's bedroom door opens with a naked Alex pulling on his underwear and heading to the bathroom. Izzie steps out in her PJs)

Izzie (to Meredith): Morning. (She turns and sees George) Morning. (The other two are just silent) What? So I slept with him again. So I'm a big whore. Big horny whore who can't get enough. Can we get over the shocked silence already?

(She looks confused as she realizes George looks a little uncomfortable)

GVO: It's karma and any way you slice it ...

(Meredith hurries back to her bedroom and Izzie turns to George)

Izzie: What's going on?

(George shrugs)

GVO: ... karma sucks.

(SGH)

(Locker room)

(Meredith is getting ready in front of the mirror tying up her hair. George walks up to brush his teeth but goes back when he realizes Meredith is there. Cristina is standing with Izzie and Alex who are sitting on a bench at the lockers a few feet away watching the whole situation unravel)

Alex: 50 bucks says O'Malley caught her doing Mark Sloan.

(Izzie hits him. Meredith heads to her locker)

Izzie: There's something going on. I mean look at them.

Alex: Alright he walked in on her doing McDreamy.

(Cristina looks bemused and Izzie gives him a look)

Alex: Did I just call that dude McDreamy?

Cristina: Oh you know you did.

Alex: Awesome. (to Izzie) You are ruining my life.

Izzie: Ha.

(He moves up to her really close and moves to kiss her but Izzie gets up)

Cristina: Get a room.

(Izzie walks up to them and Cristina follows her)

Izzie: Guys.

George: Excuse me.

Izzie: Oh sorry. (she ducks out of George's way) What's ah...what's a going on?

(George and Meredith both give Izzie weird looks)

Meredith: Nothing.

Cristina: Oh you know we're going to find out anyway.

Izzie: You tell us and maybe we can help.

George: There's nothing to tell.

Cristina: Oh that means there's something to tell.

George: Come on.

Meredith: There's nothing to tell.

(Patient room where a middle-aged man named Keith Paulus lies in bed. His fianc�e Amy is sitting on chair next to the bed as Nurse Olivia takes Keith's temperature)

Amy: Well how bought Gardenias? Like masses and mountains of Gardenias?

Keith: Are we worried about bees?

Amy: Okay that's why I love him.

(Olivia smiles)

Amy: No Gardenias.

(Izzie, Alex, George, Meredith and Cristina are in the room. Burke walks in)

Burke: Who would like to present?

Cristina: Ah Keith Paulus admitted last night with chest pains. (Keith nods smiling at Dr. Burke) Status post acute MI. Ah no family or personal history of heart disease. No cardiac risk factors.

Amy: He's healthy as a horse.

Keith: A horse who's in bed after just having a heart attack.

(Meredith moves around uncomfortable as does George. Izzie notices)

Amy: See now any minute I think you're going to tell us this was a false alarm and it just seemed that he had a heart attack.

(Burke checks Keith with his stethoscope)

Keith: She talks when she gets nervous.

(Keith winks at Amy)

Burke: Hmm I understand. Mr. Paulus unfortunately the scans show what looks like a mass around your heart. A very, very large mass.

(Amy gets up and moves to stand next to Keith nervous)

Keith: Mass ... okay. Is that code for tumor?

Amy: Okay that's absurd. He doesn't have a tumor. He's incredibly healthy.

Burke: We won't know until there's further exploration which is why I'd like to do an angiogram today.

Keith: Okay, good.

(Amy looks a little shocked)

(Meredith is walking down the hallway. Izzie and Alex follow laughing and grinning at each other. Cristina follows those two with George lagging behind. George purposely drops his pen in front of Cristina to stop her walking. He picks it up)

George: Did Meredith say any...anything to anyone about anything?

Cristina: No. Are you gonna dish?

George: No. (Cristina looks at him) No.

(She starts to walk again)

Cristina: Leave me alone I'm working.

George (walks up to her): Well good because I don't want to talk about it. Ever.

Cristina (looks like she doesn't care): Fine. Then don't.

George: I'm just saying.

Cristina: Uh.

(The doors at the opposite end of the hallway open and Addison walks through as if she's got a major wedgie. They all stop and stare at her as she walks by)

Cristina (to the others): Are you? That's weird.

(Patient's room with Derek. There's a cute young black boy named Shawn Begleiter lying in the bed holding a bucket. His parents Rick and Michael are standing with him at his bedside. In relation to Rick just imagine Jack from 'Will and Grace')

Rick: Do you need to throw up again?

Shawn: No.

Rick: Cause there's no shame in needing to throw up.

Shawn: Dad I don't need to throw up.

Alex: Shawn Begleiter. 11 years old. In for intractable vomiting after a minor head injury.

Rick: Oh I wouldn't exactly say minor.

Michael: He was hit in the head with a baseball.

Rick: Yeah playing first and this little dolt hairy dopple hammer hits the line-diver out of nowhere and Shawn wasn't looking and (he makes a gesture and sighs. Derek is checking Shawn. He mutters to Michael) You know this is my fault. I knew I shouldn't have let him play little league. It's clearly a dangerous sport!

Michael: Rick, let's let the doctors talk.

Rick: They wanna know what happened. Michael, I'm telling them what happened.

Michael: Shawn's gonna be ok. (to Derek) Right?

Derek: Yeah we have to keep a close eye on him. (Rick nods) Okay recommendations?

Meredith: Traumatic brain injury could indicate anything from a concussion to intracranial hemorrhaging. (Rick brings his hand to his chest upset) I'd start with a H & P, do a thorough neuro-exam and get a CT.

Derek: Good.

Rick: Are you sure you don't need to throw up?

Shawn (sighs): Dad.

(Rick nods)

(Addison is standing at the doorway of Tucker's patient room where he is dressed and packing up his things ready to go home. Addison still looks like she has a major wedgie or something)

Addison: Tucker.

(Tucker turns around)

Tucker: Dr. Shepherd.

Addison: How um ... how are you feeling?

(She walks into the room)

Tucker (smiles): I'm feeling great. I get to go home.

(Addison forces a smile back)

Addison: That's fantastic. Is Miranda gonna meet you there?

(Bailey opens up the bathroom door and walks out of the bathroom holding her little baby Will)

Bailey: No. I'm driving him there.

Addison (looks relived): Oh thank god.

Bailey: You okay?

Addison: I need a consult.

(Tucker gives Bailey a look)

Bailey (defensive to Tucker): I'm not working.

Addison (clears her throat): Hmm. Miranda, I need a consult.

(Exam room where Addison is sitting on a table in stirrups and Bailey is looking under Addison's skirt)

Bailey: Oh no.

Addison: Please don't say that.

Bailey: Addison, I'm so, so, sorry. You have poison oak, ( Addison moans and lies back on the exam seat/bed) where nobody wants to have poison oak.

GVO: Like I was saying ...

Addison: Oh god.

GVO: ... payback's a bitch.

(Tucker's room where Derek is checking on Tucker who is holding William)

Derek: It's official my friend. You get to go home.

Tucker (smiles): I can't thank you enough. I thank you. My wife thanks you. (Will gurgles) Oh and my son thanks you.

Derek: Hey where is your wife? You can't drive for another six weeks.

(Richard walks in)

Richard: Dr. Shepherd is a stickler when it comes to his patients' recovery. I should know.

(They shake hands)

Tucker: Hey Richard.

Richard: Wanted to stop in before Bailey took you home.

Tucker: Uh well she's here somewhere. (he gestures to Derek) Ah your wife came in earlier. Said she needed a consult.

(Derek looks confused)

Richard: Consult? Bailey is on maternity leave.

Tucker: Seemed like some kind of personal consult. It's okay. I don't mind waiting.

(Addison is in the exam room. Bailey pulls back the curtain and sits down in front of Addison who looks very irritated at the itchiness of her legs)

Bailey: Okay I'm back.

Addison: You didn't make up a chart did you? Please tell me you did not make up a chart.

Bailey: I did not make up a chart which means (Bailey puts on some gloves) we are officially stealing this calamine lotion and these gloves. You take it up with the Chief.

Addison (horrified): The Chief? No, no, no, no. I can not take this up with the Chief.

Bailey: I'm just kidding.

Addison: Okay did I make jokes with you when you were in the stirrups?

Bailey: No you did not and I'm apologizing.

Addison (tries to rub her legs together): Uh!

(Bailey lifts up Addison's skirt)

Bailey: Oh my!

Addison: What?

Bailey: These blisters are growing awful fast. Yeah I gotta give you a shot of steroids.

Addison (sits up aghast): Steroids?

Bailey: I've never seen a case of poison oak this bad. ( Addison sighs and lies back down and Bailey continues looking) Ew, girl what did you do?

Addison: Oh for the love of God Miranda, the calamine!

Bailey: Oh right sorry.

(She moves to get the calamine lotion)

(Alex is pushing Shawn in a wheelchair down the hall. Meredith is walking with them holding Shawn's chart)

Alex: What happened with you and O'Malley?

Meredith: Nothing.

Alex: Well whatever it is I've done worse.

Meredith: How do you know I did something? How do you know George didn't do something?

Alex: Because Bambi looks pissed and you look guilty.

(The walk into the CT room)

Alex: Here we are. Come on buddy let me help you up here. (He lifts Shawn on the table of the CT machine) There you go.

Meredith: Fine. I did something. A terrible, terrible something.

Shawn: One time I put a raw egg in my sock drawer for a month and then I smashed it in my teacher's grade book.

Meredith: Ew.

Shawn: My Dads were really mad.

(Alex looks amused)

Meredith: Well what I did was worse than that.

Shawn: Cool.

Alex: Cool.

(OR where Burke is doing an angiogram on Keith. Cristina and George are assisting. George shoots a glance at Cristina)

Cristina: Stop pouting.

George: I'm not pouting.

Cristina: Oh please I don't have to even look at you. I can feel you pouting. Whatever Meredith did it wasn't on purpose so get over it already. (Burke clears his throat loudly) I'm not being inappropriate. He's acting like she skinned his puppy.

Burke (whispers back to her): Cristina, it's not nice.

Cristina: Well I'm not a nice person.

George: If you knew what she did you would understand.

Cristina: No I don't understand. I don't wanna know. What I want is to analyze this angiogram, put this sucker into surgery and excise his cardio-thoracic mass.

George (looking at the screen): Doesn't look like a mass to me.

Burke: That's because it's not.

(Keith's patient room where he is now back in sitting upright on the bed. Amy is sitting next to him. Burke is standing there with his chart. Cristina and George are there as well)

Burke: What we thought was a mass is actually a coronary artery aneurysm with a fistula into one of your heart chambers.

Keith: Is it ah easy to fix?

Amy: Before you answer that question I just want to let you know that we are getting married. We're, we're in love and we're getting married and we're not so young so we've been waiting a long time for this. I have my dress and everyone's coming and it's supposed to be the happiest day of our lives and that the only reason I'm telling you this is because you have this look on your face. This dark ominous look and...

Keith (interrupts): Oh honey.

Amy (continues on force smiling) ... we're silver lining kind of people so I just thought I might help if you knew that.

Burke: Dr. Yang, would you close the door? (Cristina shuts the door and Burke clears his throat and Amy instantly looks scared) We can ah- we can operate on the aneurysm. Try to repair it. But this type of lesion is extremely delicate. Chances of it rupturing in surgery are high.

Keith: What keeps it from rupturing if I'm just walking down the street?

Burke: Nothing. The risks are high either way.

Amy: This isn't happening. This can't be happening.

Keith: It's okay Amy.

Amy: No it's not.

Burke: I know it's a lot to process but if we're going to operate, we need to do to it as soon as possible.

Amy (shocked and teary-eyed): We're getting married.

Keith (strokes her hair and whispers): Honey.

Amy: We're getting...we're getting married.

Keith (soothingly): Hey, hey, hey, hey, hey.

(Burke, Cristina and George are outside Keith's room)

George: They seem like a really nice couple. They don't seem like they deserve this.

Burke: Um they never do.

George: Really? I guess I just think I believe in karma. You know I mean good people deserve good things. At least that's how I thought the universe worked.

Cristina: How can you think that and practice medicine?

(George gives looks up at her shocked and Burke gives her a disapproving look)

George (angry): Why...I'm not saying that everybody who gets sick or everybody who dies is bad. I'm just saying that ah I think that there's a balance. Or there should be balance! I should...there should be some sort of balance. That's (he shrugs and mutters to himself)

Burke: Good god O'Malley, what the hell did Grey do to you?

(George looks up at Burke and then gives Cristina a look and Cristina just looks amazed)

(Shawn's room where he's back in his bed. Derek is standing in front of Shawn's bed and Shawn's parents are both standing at the bedside)

Michael: What exactly do you mean when you say blood in the ventricle?

(Derek nods but doesn't get to answer)

Rick: Oh my god his brain is bleeding?

Derek: Well there's no need to panic. It's a small amount of blood and these injuries often resolve themselves.

Rick: Yeah but what if it doesn't? Will he lose IQ points? Because he's very smart (Derek shakes his head no and Michael shakes his head apologetically) and that's very important to him and he likes to be smart. (to Michael) Do you think we should sue that little brute that hit the ball? (Michael raises his eyebrows) Or the coach? We should sue the coach.

Michael: Shawn loves the coach.

Rick: Yeah Shawn's brain is bleeding!

Michael: Rick.

Shawn: Dad, I'm fine. Geeze.

Derek: Yeah. He's awake, alert, minimal pain. These are all good signs. I just want to monitor him over the next forty-eight hours.

Rick (nods): Okay. Good. Hear that Shawn? Good signs. (Shawn nods) That means honey you shouldn't be scared.

Shawn (nods): I'm not.

Rick: I am.

Michael & Shawn (at the same time): We know.

(Izzie is wearing a yellow gown coming out of the Pit to outside into the waiting area for the ambulances. Alex is sitting on a bench holding a cupcake)

Izzie: Oh they paged you too? Must be something big.

(Alex stands up)

Alex: Nobody paged me.

Izzie (refers to the back of her gown): Can you tie this?

Alex: Nobody paged you either.

Izzie: Yes they did. I just got a page. (Alex pushes her against the wall and Izzie starts smiling) Did you page me? Alex. (He holds up the cupcake to her) Oh. Oooh.

(She starts licking the cream of the cake and Alex starts kissing her cheek)

Alex: You free tonight?

Izzie: I might be. Hmm ... Hey are you still working with Meredith?

(Alex shakes his head and kisses her. An ambulance can be heard coming in)

Alex: I'm trying to kiss you.

Izzie: Yeah but she won't say anything about what happened between her and George (Alex shakes his head) because I'm starting to get really worried.

(Alex just kisses her)

(You can hear Ray the paramedic wheeling in a patient)

Ray: 35 year old male. Shortness of breath. Had a syncopal episode.

(Izzie looks to the side and sees Denny Duquette the heart transplant patient from episode 2x13 being wheeled in)

Ray (trails off as he wheels Denny): Pulse is rapid and irregular.

Izzie (pulls away as she realizes): Oh my god. It's Denny.

(She starts running down the hall after the paramedics)

Alex: What?

Izzie (calls back): It's Denny!

(She leaves Alex looking gloomy holding the cupcake in his hand)

(Trauma room where Denny is being placed onto a gurney in the middle of the room surrounded by E.R. doctors. The ER resident comes in)

Izzie: What did you get in the field?

Doctor: Hey this is my patient until I sign him over to you.

(Alex jogs in)

Izzie: I know this guy. He's on top of the donor list for a new heart. That makes him surgical. I've already paged Dr. Burke and he's on his way. So you better start signing now. (to the paramedic) What did he get in the field?

Ray: We gave him 40 of furosemide. Rhythm didn't change after 6 of adenosine.

(Ray and the other paramedic leave. Izzie looks upset at this and Burke walks in)

Burke: What do we got?

Izzie: It's Denny.

Alex: Transplant dude.

Burke: Denny?

Alex: Transplant candidate. Acute dysrhythmia and CHF. Vitals all over the place.

Burke (checks Denny): His heart rhythm is a mess.

Alex: He's in heart failure.

Izzie (panicked): Bizoprolo can reduce the chance of mortality. Can we try that? What about ACE inhibitors? Digoxin! Somebody load him with dig!

Burke: Stevens slow down. He's holding on. Barely but he's holding on.

Izzie (still panicked): Isn't there something more that we can do? There has to be something more we can do.

Burke: The best we can do is to get him up to CICU and wait and see if his heart will stabilize.

Alex: Izzie, we should...we should go.

Izzie (pushes off Alex and goes up to Denny): No you go um I'm gonna stay.

(Alex walks out)

(Bailey is rummaging through some medical supplies in a hallway. Richard comes up to her)

Bailey (to herself): No, yes, yes.

Richard: I see you.

(Bailey jumps a little)

Bailey: No you don't.

Richard: Your husband was discharged over an hour ago.

Bailey: I'm not here.

Richard: Go home. You're not working today. You're on maternity leave.

Bailey: Exactly.

(She takes the medical supplies she grabbed and heads off)

(Cristina is checking Keith's heartbeat with a stethoscope in Keith's room. Amy is standing next to him)

Cristina: Have you made your decision?

Keith: Wh- Oh ah about the surgery um (he glances at Amy) no we're still ah- we're still talking about it. Uh we were thinking maybe we should wait until after the wedding. Um.

Amy: So, so how is he?

Cristina: Ah he's pretty much the same.

Keith: Oh that's good, right?

Cristina: Ahh no. Not really. It... (she sighs) see with your condition you're gonna be okay until your not and if you opt against the surgery and if you leave now it's just a matter of time. And you might make it to your wedding but you might not and you won't know. You're just gonna be okay until you die.

Keith: Wh...what? (he chuckles) You're trying to comfort me?

Cristina: No. I'm trying to convince you to let Dr. Burke operate.

Amy: So that he can die today?

Cristina: He might die today anyway but Dr. Burke is the very best and he's your very best chance.

(Denny's room in the ICU. Burke is at the nurses' station outside just hanging up the phone. Izzie comes up to the desk)

Burke: Stevens. Is everything all right?

Izzie: Ah it's just ... it's just not fair you know. It's really not fair. (she sighs) We treat jerks all the time. Patch 'em up, send 'em off whether they deserve it or not. No big deal but ... Denny. He's a good guy Dr. Burke. He's a really good guy with a bad heart and all we can do for him is wait.

Burke: Believe me I know. I've been treating Denny a long time.

Izzie: He doesn't deserve this.

Burke: What he deserves is the best cardiac care. We're giving him that. (Izzie nods) You really like him don't you?

Izzie (shrugs): He just ... he just doesn't deserve this.

(Addison is in her exam room still in the stirrups. Bailey is sitting in front of her with an ice pack. Bailey puts on the ice-pack on Addison)

Addison : Ah!

Bailey: Sorry, how's that? Is that ice-pack helping?

Addison: I don't know. I don't think so. Eh!

Bailey: Mind if I ask how exactly this happened?

Addison: I slept with Mark!

Bailey: Oh! ... And he had poison oak on his...

Addison: No! I slept with Mark a year ago and apparently this is what I get!

Bailey: Yeah. But how did you...

Addison (upset): I live in a trailer. I have Meredith Grey's dog. And I went outside to throw a stick and I had to pee. So I squatted! Because I didn't want to go inside and wake up my husband because the way he's been looking at me since yesterday. I just wanted a few minutes of peace. (she starts crying and points to her legs) And this is what I get.

Bailey: No. No, no. Don't cry.

Addison (crying): This is what I get!

Bailey: Please don't cry! Please don't cry! (Bailey stands up) Stop! You're gonna make me- (Addison continues crying and Bailey removes her hands from her breasts. Her shirt is all wet) lactate.

Addison (crying): I'm sorry.

Bailey: Get, get me some gauze. Get me some gauze.

Addison (crying and hands over some gauze): I'm sorry.

(There's a knock at the door)

Bailey: Stop. Shh.

(There's a knock again. Bailey opens the door slightly and reveals Richard standing there)

Bailey: Can I help you Chief?

Richard: Dr. Bailey. I don't know what you're doing in there but whatever it is- (Bailey opens the door wider and Richard notices the two large round wet stains on Bailey's top) Oh. Oh. Oh no. Um (he clears his throat) Dr. Bailey. Ah, I'm ... sorry. Uh carry on.

(He clears his throat again and walks away. Bailey shakes her bemused and closes the door)

(Derek is entering Shawn's room. Debbie the nurse is standing over Shawn's bedside and Meredith is standing on the other side. Rick and Michael are standing a bit to the side. Shawn appears conscious and Debbie and Meredith are prepping him for surgery. Another nurse is there as is Alex)

Derek: Okay fill me in.

Meredith: I was doing his routine neuro check...

Derek: Uh huh.

Meredith (continues) I noticed he was altered. Most likely a clot. Acute hydrocephalus.

(Derek checks Shawn's eyes)

Derek: Oh damn. We need to relieve the pressure right now.

Alex: Cranial access kit is ready.

Rick: Cranial access? Access to Shawn's brain?

Derek: Debbie, get them out of here.

Debbie: Gentlemen.

(She starts leading Rick and Michael out but Rick pushes past her)

Michael: Rick.

Rick: We're not going anywhere.

Derek: Look I'm about to drill a hole into your son's skull. You don't want to watch this.

Rick: He's our son. We're not leaving. (Michael tries to get him to leave) We are not leaving his side!

Derek: 15 blade please. I want a catheter ready to drain as soon as I penetrate the dura.

(Michael takes Rick's hand in his and Rick takes on Shawn's hands)

Derek (to the parents): Do not panic.

(Rick nods)

Derek: I want the drill.

(Alex hands him the drill and Derek starts drilling into Shawn's brain)

Derek: Almost in. Okay there. (A little bit of blood squirts out and Rick clenches his eyes shut) Get that. (he hands the drill back) Okay catheter to go in. (he places the catheter in)

Meredith (checks Shawn's eyes): Pupils reactive.

Derek: Pressure's stabilizing.

Rick: Is he okay?

Meredith (to Alex and Meredith): I want neuro checks every hour and increase the supervision. (to Rick and Michael) We...we're in the clear for now.

Rick: We're in the clear?

Derek: You guys did well.

(Shawn is conscious now)

Shawn: Ah I have a headache.

Alex: Welcome back little man. (his pager goes off) 911.

(He leaves as Derek is sewing up the hole he made. Rick looks a little pale. Shawn notices)

Shawn: Dad you look white, are you okay?

(Rick half nods and then shakes his head and then pulls to the side and vomits onto the floor)

Debbie: Oh great.

(Denny's room where his monitors are beeping rapidly. Izzie is already standing in there with a nurse as Alex comes in)

Alex: You got in here quick.

Izzie: We got to get his heart rate under control. (to the nurse) Push 300 of amniodarone now.

(Burke enters)

Burke: Status?

Izzie: Atrial fibrillation. His heart is beating too fast. If we can't get it to slow down...

Alex (injects the drug and shrugs): It'll give out.

Burke: Alright let's try synchronized cardio-version. (to the nurse) Push 5 of morphine.

(The nurse hands Alex the morphine)

Denny (groggy): Izzie?

Izzie: You're awake.

Denny: Hey, I was hoping I might get to see you.

Izzie: You're working us pretty hard around here.

Denny: The things I have to do to get a girl's attention.

(Alex seems annoyed)

Burke: Denny, we're about to send a series of electric currents through your body. Hopefully the shocks will be enough to slow your heart rate back to normal.

(Another nurse brings in the crash cart)

Izzie: I'll be here the whole time.

(Alex seems really annoyed now)

Denny: Is this gonna hurt?

Burke: It won't be fun.

Denny (to Izzie): Iz, maybe you ought to hold my hand then huh?

(Izzie smiles and takes Denny's hand into her own)

Alex: Do you mind if I handle the paddles?

Burke: Be my guest.

(Alex takes the paddles and moves to shock Denny with them)

Izzie: Ready?

Denny: Yeah. Hit me.

Alex: Clear.

(Izzie drops Denny's hand as Alex shocks Denny)

Denny: AUGH! God!

Burke: No change. Try it one hundred.

(Alex looks like he's getting some kind of sick pleasure from this)

Alex: Clear!

(He shocks Denny again)

Denny: AUGH! Oh, oh, oh! Holy smokes. (his heart monitor returns to normal) Oh.

Burke: Denny, you are a lucky man.

(Izzie looks down relieved)

Denny (breathing hard): Oh. Oh, oh Doc. I outta kick your ass for making me yell like a baby in front of the girl I'm trying to impress man. (Izzie can't stop a smile from forming) Oh geeze.

(Izzie is chuckling and Alex looks on jealous)

(Bailey is walking down the hallway trying to clean up her shirt still. Derek notices her a few feet away)

Derek: Dr. Bailey.

(Bailey starts walking faster and Derek runs up quickly to catch her)

Derek: Dr. Bailey! Did you hear me?

(He stops her)

Derek: Ah, ah I'm a little distracted right now.

(Derek notices the 'spots')

Derek: Oh yes. I've been paging you.

Bailey: I'm not on call. I'm on maternity leave.

Derek: I've been paging my wife as well but she hasn't been answering either. You know where she is.

Bailey: Just because I know doesn't mean you should. (Derek looks confused) There's some things you don't get to know. Not from me and really you don't wanna know.

Derek: Yeah but you have to tell me where she is. (Bailey looks up with a look saying 'Oh really?') I saved your husband's life.

Bailey: She saved my baby.

Derek: So baby trumps husband?

Bailey (nods): Mmm.

(She walks away)

Derek (calls out in disbelief): Baby trumps husband?

(Meredith is walking down a hallway writing in a chart. George is walking the same hall from the opposite direction. They stop when they both see each other. George kinda moves to talk to Meredith but Meredith puts her chart away and walks back the way she came quickly. George looks on hurt)

(Waiting room lounge where George enters to make himself coffee. He notices that the room is not empty but has Amy in it sitting at a table with her wedding planner)

George: Hey Amy.

Amy: The website said you should save your receipts.

George: I'm sorry?

Amy: Oh you know just in case something happens. You know, have them. (She opens up the wedding planner) I have all of ours here right here. You know I've got my dress and the band and the ballroom deposit and the honeymoon. And my mom said I shouldn't you know keep them. It was bad luck. It was tempting fate.

George: This isn't your fault.

Amy: You, you have a life. You, you fall in love. You, you make plans. You have fantasies. (She closes the book and stands up) And none of them involve all of them ending in the blink of the eye.

(George looks sad as he understands and Amy leaves)

(Alex is whistling walking down a hallway where he notices Meredith sitting on some empty chairs in corner. He walks up to her)

Alex: What are you doing?

Meredith: Hiding.

(He sits down across from her)

Alex: Alright, so you slept with O'Malley. Get over it already.

Meredith: He told you?

Alex (shocked): Eh ... no.

(Meredith stares at him and Alex still stares at her shocked until he starts to laugh)

Alex: Oh I was just kidding. Uh. I mean it's not like I should be surprised.

Meredith: Why not?

Alex: Because when your life is sucking, you get drunk and sleep with inappropriate men. It's your thing. Whatever. I find it charming.

Meredith: You sleep with inappropriate women when you're sober.

Alex: One inappropriate woman and Izzie forgave me for that. O'Malley, he's not gonna get over this.

Meredith: Izzie hasn't forgiven you.

Alex: Yes she has. We're together.

Meredith: No you're not. Izzie may be sleeping with you but she'll never see you the way she saw you before you slept with Olivia.

Alex: Why are you trying to piss me off?

Meredith: You're trying to suggest that it's forgivable for you to sleep with Olivia but not forgivable for me to sleep with George.

(George is standing at the doorway near them)

George: You told him? I...

Meredith: George.

George: Wow when I'm wrong about someone...

Meredith (interrupts): No I...

George (continues): I am really wrong!

Meredith: No George! (George starts walking off and Meredith and Alex start running after him) It's not! It's not what you think!

Alex: Dude chill!

George (stops angry): You chill! You chill! I'm not...I'm not gonna chill.

(he starts walking off again and they start following him again)

Meredith: George! I...

(Izzie comes into the hallway)

Izzie: What's going on?

Alex: The fetus is freaking out.

Izzie: I can see that. (She tries to grab George's arm) Why are you freaking out?

(George stops again and Cristina comes in from the other side of the hall)

George: You think that someone is your friend you know. (Meredith looks ashamed and George is angry) You think at the very least she'd respect your privacy!

Cristina: What's going on?

(George starts walking off again and Meredith follows)

Alex: Baby boy is freaking out.

Izzie: She can see that!

Cristina (at the same time): I can see that!

Izzie: Why is he freaking out?

(The others follow as well and see George and Meredith a few feet away. George is standing in front of the door leading into a stairwell)

Meredith: George, can we at least talk?

George: I don't wanna talk! Not to you! I wanted to keep my mouth shut! And if you hadn't been running away from me every time you see me you would know that.

(George enters the stairwell and starts hurrying down the stairs. Meredith follows)

Meredith: Okay, you're right but can we just talk now?

(The others follow)

George (yells): You wanna talk now because you told everyone that we had sex!

Meredith (eyes widen): Shh.

Izzie: You had sex?!

Cristina: You had sex with George?!

George: You didn't tell them?

Meredith: No.

George: Damn it!

(He moves to walk down the next flight of stairs but ends up falling down them instead)

(All the girls yelled concerned)

George: Ah!

(Alex just laughs. Izzie whacks his arm)

(George is sitting in a trauma room with what looks like a sore arm. Alex, Izzie, Meredith and Cristina are watching him through the window. Meredith walks away)

George: Go away.

(They walk away to where Meredith is standing a few feet away)

Meredith: He's gonna be okay right?

Alex: He dislocated his shoulder. He's gonna be fine.

(Alex walks off)

Meredith: That's not exactly what I meant.

Izzie: Meredith, if you can't make this right, if you can't fix this with George, just so you know if it comes to choosing sides, I'm on his.

(Izzie walks off and Meredith turns to look at Cristina)

Cristina: He's the weaker kid. I mean I don't even beat up on weaker kids. It's cheap.

Meredith (teary-eyed): I did a terrible thing. I didn't... (she shakes her head) I did a terrible thing.

Cristina: He's been in love with you since Day One. There's no way you didn't know that. (Meredith looks down) We all do terrible things.

Meredith: Thank you.

Cristina: You're welcome.

(She leaves)

(George is sitting the trauma room looking gloomy. An orthopedic surgeon named Calliope "Callie" Torres walks in with George's chart)

Callie: George O'Malley?

George: Uh hi.

Callie: Dr. George O'Malley. You're the heart in the elevator guy!

George: Yeah that's me.

Callie (smiles): That was amazing.

George: Uh thanks. I uh dislocated my shoulder.

(Callie checks his shoulder)

Callie: Yeah.

George: Oh!

Callie: I can see that.

George: It's really not so bad.

(Callie moves to write in his chart)

Callie: Yes it is. Pick your poison.

George: Uh ... no pain killers, thanks.

Callie: Bold choice.

George: No I just ah officially I'm on duty.

Callie (chuckles): And planning to stay?

George: Mmm Hmm.

Callie: Bolder choice.

George: All I need is help ah popping it back in.

Callie: You got into a fight?

George: I fell, fell down some stairs.

(Callie moves to the side where George has dislocated his arm)

Callie: Where? At your girlfriend's?

George: What? No I'm single.

Callie: Single, huh.

(She grabs George's arm suddenly and snaps it back into place)

George: Augh! Ah!

Callie: It hurts less if you don't see it coming.

(She helps George place his arm into a sling. It's obvious she seems to 'like' him)

George: All set?

Callie: All set.

George: Okay. (he gets up) Thanks.

Callie: You're welcome.

George: Bye.

Callie: Bye.

(George leaves)

(Meredith and Derek are entering an empty elevator. Meredith looks upset and Derek looks at her concerned)

Meredith: Don't.

Derek: Don't?

Meredith: Don't be nice to me. ... I did a terrible thing.

Derek: We all do terrible things.

Meredith: No, I...I...I did a thing that I...I can't even believe I did and ... I was sad (she shakes her head) and uh. I'm pretty sure I'm gonna lose all my friends.

Derek: You won't lose me.

(He half-smiles at her)

Meredith: You're not my friend.

Derek: Yes I am. (She shoots him a look) Well then I could be. (he smiles) I'm a very good friend.

Meredith: No we can't be friends.

Derek: We could be friends. You'd be lucky to have me.

Meredith (upset): How? How can we be friends?

Derek: We could ah ... hangout. Mmm hmm. I walk Doc every other morning. Tiger Mountain Trail. We could meet. Have coffee. Watch Doc play and ... discuss the complex nature of our existence.

Meredith: Right.

Derek: We could. Might be fun. I could be your friend Meredith.

(The doors ding open)

Meredith: No, we can't be friends.

(She walks out. The doors close on Derek who is looking down and gloomy)

(Denny's patient room in ICU. Izzie is in there with him. He smiles at her and she smiles back)

Izzie: Just adding nitro. Your blood pressure is stable now. Your CHF has improved and the atrial fibrillation resolved.

Denny (smiles): I like the way you say fibrillation.

Izzie (sexy voice): Fibrillation. (she laughs)

Denny (smiling): Tease.

Izzie: How are you feeling?

Denny: You ah ... you believe in karma?

Izzie: Um ... actually I do. Yeah.

Denny (grins): I think you might be mine.

Izzie (chuckles and smiles): Well you must have been very, very good to deserve me.

Denny (grins): Must have.

(Izzie laughs. Alex is looking on jealously through he window of the patient room)

(Derek is walking down the hall and about to knock on the door to Addison's room. Richard comes up to him)

Richard: I wouldn't do that if I were you.

Derek: Dr. Bailey said she...

Richard (interrupts): If she wants some privacy then we will give her, her privacy, understood?

Derek: Well Dr. Bailey paged me.

Richard: She did?

Derek: Yeah.

(Bailey comes up to them also carrying her baby boy)

Bailey: I did and I'm still not here. I'm still on maternity leave and (to Richard) I still need some privacy Chief. (She opens the door to the room and to Derek) Come here.

(Both Derek and Richard try to walk in but only Derek gets in before Bailey closes the door in Richard's face. Derek is in the room trying to peer over the curtain shielding Addison)

Bailey: No moving, no peeking, no pulling the curtain. Just stand there. Let her talk to you, understand?

Derek: Is this really necessary?

Bailey: I said do you understand?

Derek: I'm not mentally challenged.

Bailey: I'm not so sure about that. (speaks loudly so Addison can hear) Let her talk.

(Bailey leaves the room)

Derek: Addison, this is ridiculous.

Addison: Stay where you are! Promise!

Derek: Okay, I promise.

Addison: I'm gonna show you something and when I do you do not get to laugh and you do not get to gloat.

Derek: Why would I gloat?

Addison: I have poison oak.

(Derek pulls back the curtain to reveal Addison sitting upright in the stirrups looking glum)

Derek: What?

(Addison slowly pulls up the sheet covering her legs. Derek looks confused and then steps forward and peers down at Addison lower body. He stands up amused)

Derek: Hmm. You do indeed have poison oak.

(Addison has a very grumpy look on her face and Derek is struggling not to smile)

Addison (yells): So are we even yet? I mean is this bad enough? Have we repaid my debt to society, Derek?

(Derek cracks up laughing and Addison throws a pillow at him also trying not to smile. He continues laughing and throws the pillow back at her. Addison chuckles)

(Bailey is outside listening in through the door)

Derek (amused): Alright, let's take a look.

Addison: Get out!

(Bailey smiles and starts walking down the hallway with her baby)

Bailey: Oh. Ah. Come on Tuck. Let's take your daddy home. Oh. Big boy. Big boy.

(George has his arm in a sling and Cristina walking down the hallway)

George: She really didn't tell you about it?

Cristina: No. God is that a bad thing?

George: Well she tells you everything. So it didn't even matter enough to her to talk about it.

(Cristina stops George walking)

Cristina: Okay George, the pity thing? Not good. If you want crappy things to stop happening to you, then stop accepting crap and demand something more.

(Cristina walks off to the nearby nurses' station and George is about to walk into Keith's room when Amy comes out with her wedding planner and her bag)

George: Hey Amy.

Amy: Oh could you tell ah Dr. Burke that um Keith is going to have the surgery.

(Cristina walks up to them)

Cristina: Oh that's great.

George: Where are you going?

Amy: Um I'm...I'm not strong enough for this.

George: Oh Amy I know it's hard but your fianc�e say is going into surgery. You're gonna want to be here when he wakes up.

Amy (sad): No I won't. Um he's not my fianc�e anymore.

(She moves to walk off)

George: You're leaving him?

Amy: I'm not strong enough for this.

Cristina: So the in sickness and in health part of your vows, you're just planning to leave those out?

Amy: Please try to understand. I don't like that I'm not strong enough. I just know that I'm not.

(Nurse Olivia suddenly opens the door to Keith's room and pops out)

Olivia: George, he's crashing.

George: What?

Cristina: His aneurysm may have blown. Page Dr. Burke!

(They rush into Keith's room where you can hear the monitors beeping rapidly. Amy looks sick and walks away)

(Burke is about to operate on Keith in the O.R with an O.R team. Cristina is assisting)

Burke: Okay everyone. It's actually a coronary artery aneurysm.

(George is sitting in a fairly empty gallery by himself watching. Olivia comes in dressed to go home)

Olivia: He's gonna live?

George: Burke's a miracle worker. Do you know this guy's fianc�e left?

Olivia: Oh. Sounds like he dodged a bullet.

George: I don't think he's gonna see it that way.

Olivia: If she can't love him back the way he loves her ... then she doesn't deserve him.

(George looks down)

George: You heard about me and Meredith?

Olivia: Well everyone heard. George, you were yelling about it in the hallway. (George sighs and brings his hand to his forehead) Must've sucked. I'm sorry.

George: I'm sorry. (Olivia looks confused) Um...If I made you feel anything like I'm feeling right now. ... I'm sorry.

Olivia: That's nice to hear.

(Olivia leaves)

(Meredith's house, George's room)

(George is emptying out his sock drawer with his one agile arm. He dumps it onto the bed. The scene switches him to shutting his suitcase and locking it. He opens the door to Meredith's bedroom and he pauses at the doorway. He flashes back to the previous night)

(George and Meredith are in her bed together. He moves from under the sheets to rest on top of her. He appears breathless. They both appear to be naked. George seems to be happy)

George: How's that?

Meredith: Good. Really good.

George: Yeah?

(He leans to kiss her neck)

Meredith: Yeah.

George: Cause I could ah...I could do it again. I like doing it.

Meredith: No it's...

George: I could do it until you...

Meredith (forces a smile): No it's okay. I'm fine.

George: Yeah?

(he leans into kiss her)

Meredith: Ow.

George: Oh sorry.

Meredith: You're in my hair. Okay.

George: Sorry.

Meredith: It's okay. Yeah. There

George: Right there?

(Time seems to have moved forward and they actual seem to be in the throes)

George: Meredith. Meredith.

(George collapses on her)

Meredith (tears in her voice): Oh George.

(He props himself up)

George: Meredith? (Meredith starts crying really badly) What's wrong?

Meredith: Oh, oh, oh nothing! (she shakes her head crying) Nothing is wrong. Why would you think anything is wrong?

George: You're crying.

Meredith (crying): Oh. It'll stop. Just ignore me.

George (smiles): No. I can't. I can't ignore you.

Meredith (crying): Yeah. It's fine. It's fine. Just...It's okay. Just...You're almost done, right?

George (a little shocked): No.

Meredith (cries out): George.

George: Meredith. Meredith.

(Meredith just continues on crying even more than before)

Meredith: George, please.

George: Sleep...Sleeping with me is really this awful for you?

Meredith (crying): No George! It's not. (George moves off Meredith quickly and grabs a blanket and wraps it around himself) It's not you! (George leaves and slams the door behind him. Meredith continues on crying) George!

(George is standing at the doorway now. He enters the room and grabs his shirt from the previous night off the floor. He stands up and finds Meredith standing at the doorway)

Meredith: There's a suitcase in the hall.

George: I was just getting my shirt.

Meredith: There's a suitcase...

George (interrupts): Yeah ah I don't live here anymore. (He moves to walk past her) Excuse me.

(Meredith steps into the room and sits on her bed. George stops at the doorway)

George: Why? I just wanna know why you ... If you didn't want to...

Meredith: I didn't know I didn't want to. ... You were there and you were saying all these perfect things and I was sad. And so I thought maybe, maybe I've just been overlooking what's been in front of me. And if I just give it a chance because you're George and you're so great ... ... I didn't know I didn't want to until I knew I didn't want to.

George: Yeah. (he nods) Ok.

(She turns to face him)

Meredith: Can we please just go back to everything the way it was?

George (looks at her in disbelief): I don't know how to go back. No. I'm done. We're done.

(He walks off)

GVO: One way or another, our karma, will leave us to face ourselves.

(Locker room)

(Izzie is standing in front of a mirror ready to go home but looking very nice. She is applying lipstick)

GVO: We can look our karma in the eye or we can wait for it to sneak up on us from behind.

(Alex appears behind Izzie smiling also dressed to go home)

Alex: You ready?

Izzie: What?

Alex: Aren't we...I thought we had plans for tonight.

(She turns around to face him)

Izzie: Oh I forgot. I'm sorry. Raincheck?

Alex (a little off put): Sure.

(Izzie turns back to the mirror and Alex walks away)

(Keith's room post-op. Keith is lying in bed. Burke comes in)

Keith: Amy ...

Burke: She's not ah ... here. ... Um but you are. That's what important.

Keith: She left? She really left. ... Who does that? (tears in his voice) What kind of person does that?

(Burke tucks Keith in)

GVO: One way or another, our karma will always find us.

(Izzie walks all dressed up nice but completely casual with a large paper bag to Denny's CICU room. Denny is reading a book)

Izzie (smiles broadly): Hey.

Denny (smiles back): Hey yourself.

(Izzie is placing a small table cloth on the table in front of Denny)

Denny: Wow. (Izzie puts two plastic wine glasses on the table and fills them with apple juice) I gotta say, not exactly how I envisioned our perfect first date.

Izzie: Are you kidding? Do you know how hard I've had to work to get a cute boy in bed before?

(Denny smiles at her)

Denny: You think I'm cute.

Izzie (chuckles): Okay. Shut up and drink your juice.

GVO: And the truth is as surgeons we have more chances than most to set the balance in our favor.

(Outside SGH)

(George is sitting on a ledge of a window of the hospital. Callie dressed to go home walks up to him)

Callie: George?

George: Dr. Torres.

Callie (smiles): Callie. (She notices the suitcase on the ground next to him) You're going on a trip?

George: It's ah...sorta.

(he nods at her)

Callie: Well in that case ... (she grabs out a pen from her bag and writes her number of George's hand) Give me a call when you get back in town.

(George looks at her amazed and she blows gently on his hand to dry the ink. She smiles and walks away. George looks to the side and sees Dr. Burke standing at the entrance ready to go home looking at him)

GVO: No matter how hard we try, we can't escape our karma. It follows us home.

(Burke and Cristina's apartment)

(Burke and Cristina are in bed. Cristina is rubbing lotion on her legs.)

Burke: He's your friend. He needed our help.

Cristina: Are his problems surgical?

Burke: Mmm no.

Cristina: Then technically he doesn't need our help.

(Burke puts his book down and puts his glasses on his bedside table)

Burke: You're a good person.

Cristina: I am not.

(She puts her lotion away and switches her lamp off so they're shrouded in darkness. They lie down and pull the sheets over them. Burke cuddles up close to Cristina)

Burke: Goodnight.

Cristina: Ah ha, goodnight.

(They both close their eyes)

George (calls out from the living room): Goodnight.

(Both of them open their eyes)

(George is lying on the couch with a blanket and everything reading a journal. He switches off the lamp next to him)

GVO: I guess we can't really complain about karma. It's not unfair. It's not unexpected. It just ... evens the score.

(Forest Park, Tiger Mountain Trail)

(It's daybreak and Doc is eagerly running and barking along the trail. Doc stops and then barks more. Derek is slowly walking smiling behind Doc with his leash. Doc is running up to Meredith where she pats him)

GVO: And even when we're about to do something we know will tempt karma to bite us in the ass ...

(Derek walks up to Meredith smiling and they both turn to watch Doc run about)

GVO: ... well it goes without saying ...

Meredith: So.

Derek: So.

Meredith: Just friends.

(He nods)

Derek: Just friends.

GVO: ...we do it anyway.