2009

GREY'S ANATOMY

3x21: Desire

Original Airdate: 4/26/2007

Written by: Mark Wilding

Directed by: Tom Verica

(Seattle Scenes)

(The interns are at Cristina and Burke's apartment studying for intern exams)

Alex: What percentage of Americans look at an acute apnea?

MVO: As interns we know what we want...to become surgeons. And will do anything to get there...

Alex: What are the signs of a central line infection?

Meredith: Puss, redness and fever.

MVO: Suffer through killer exams, endure 100-hour weeks, stand for hours on end operating rooms. You name it we'll do it.

Alex: What's Kahn's syndrome?

Meredith: Wait, wait, I know this.

Izzie: Tick tock dude.

Meredith: Um...

George: Cracking under the pressure?

Meredith: No! Um...hypocortolis...cortolism...

Cristina: Primary hypro dostrolonism. Yes, out of the seat. My turn.

Izzie: No it's my turn.

Cristina: No it's not.

(Burke walks up with cake)

Cristina: Oh honey I...

Burke: Try this one. White sponge with vanilla butter cream.

Cristina: Ok yeah. I'm trying to study for the most important test of my intern career. I don't have time for wedding cake.

Burke: Just try it.

Izzie: Go, go!

George: What is the strongest layer of the small bowel?

Cristina: Fine, yummy, go!

Izzie: Damn it. Damn it. Damn it. Damn it.

George: It is not snot.

Izzie: Submucousa

George: Yes.

Cristina: Wait, wait. How do you know that? Are you studying with the wife's cards?

Meredith: What cards?

Cristina: Callie was ranked number one in her year after this test. She has legendary flash cards.

Izzie: So don't need the flash cards. We are independently brilliant.

George: Dream team.

Cristina: Yeah, yeah. I wanna hurl. Out of the seat.

Alex: No, no my turn.

Cristina: Oh come on.

(Burke walks up with more cake)

Burke: This is the lemon, might be a little tart.

Izzie: What is atenicaratosis?

Alex: Uh...atenicaratosis is uh...pre-malignant lesion.

Cristina: In old people.

Alex: In anyone.

Burke: Is it too tart?

Cristina: Baby, I don't care. I mean, is Alex right or am I?

Burke: You don't care? Well I'll get another bride.

Cristina: I love it. I love all cakes. Now break the tie.

Burke: Karev's right.

MVO: The tough part though is reconciling this huge thing we want, to be surgeons, with everything else we want.

(Derek is entering the hospital, Meredith is right behind him)

Meredith: Hey.

Derek: Hey.

Meredith: I haven't seen you in a few days. I left messages.

Derek: Yeah, I know. I was just trying to be...

Meredith: I know I told you to stop hovering and you did and I appreciate but now stop the stopping.

Derek: No, you're right. It's ridiculous to worry about you all the time.

Meredith: It's sweet that you worry.

Derek: Mmm hmm.

Meredith: It is. I should communicate more.

Derek: Right?

Meredith: You don't think I can do it? I can do it.

Derek: Really?

Meredith: In a few seconds, I'll be getting on that elevator. And then I'll be going on rounds. See that? I'm getting on the elevator. Communicating.

(Mark and Addison enter an elevator)

Mark: 28 more days and then it's you and me in a locked room for a record breaking, earth shattering, mind blowing...

Addison: Ok! I get it. Thank you.

Mark: That was less then enthusiastic.

Addison: I'm gonna be more enthusiastic when we uh...cross the finish line.

Mark: Ok. Just making sure you haven't lost interest in the project.

Addison: No, not at all.

Mark: Good.

(Mark leaves the elevator and Addison looks sad and disappointed)

(Cristina and the other interns enter a conference room where Burke is setting up wedding cake samples)

Cristina: Um, what are you doing?

Burke: The bakery wants me to make a decision by tomorrow so if you can tell me your favorite by then that would be great.

(Burke leaves)

Cristina: Cakes and little place cards? Ok, he's turning into a girl.

Izzie: I think it's sweet. He obviously cares about this stuff.

Alex: This white one tastes pretty good.

Meredith: I should bring a piece to Derek, right? That's what good girlfriends do. Take their boyfriends cake and communicate.

Alex: No, the best ones just keep all that stuff to themselves.

Cristina: Did you bring Callie's cards?

George: Uh...no.

Cristina: No cake for you.

(Bailey enters)

Meredith: Dr. Bailey, I saw hemiglossectomy on the board. Can I scrub in?

Bailey: No, your not doing surgeries today.

Meredith: What?

Bailey: Your intern exams are in two weeks. You need to spend every available minute studying for them. Believe me, when you won't have to repeat your year as interns, you'll be thanking me for this opportunity. So, Grey and Yang, you're doing scut. O'Malley and Stevens, you'll be joining me in the clinic. Karev, you're with Ava.

Alex: Oh, I don't always have to be on the case. Someone else can have her. Or not.

(Izzie and George are alone in the conference room)

George: So, last night we studied together. Today we're treating patients together.

Izzie: And we're fine. We're not tortured. It's not weird. We made a mistake, we've moved on.

George: If anything, I think it brings us closer together as friends.

Izzie: We're very impressive.

George: I think we are.

(Bailey and Richard are walking through the hall)

Richard: Larry Jennings just checked into the hospital.

Bailey: What's the matter with him?

Richard: I have no idea. His assistant said it was a matter of the utmost discretion.

Bailey: Oh, that's never good.

Richard: Well whatever it is, it was important enough for him to cut short his vacation and fly home. I want you on point on this one. No clinic today.

Bailey: I can do both.

Richard: Miranda, we're talking the Chairman of the Board of Seattle Grace Hospital. The clinic will survive without you for a day. Learn to delegate.

Bailey: Who am I supposed to delegate to?

(Sydney walks up)

Sydney: Chief Webber, you paged me? Sydney Heron, reporting for duty.

(Richard gives Bailey a look)

(Alex enters Ava's room)

Ava: Hey. I was wondering if I was gonna see you today. Where you been?

Alex: Just getting my assignments.

Ava: Yeah, anything good? Anything as good as a crazily, hormonal, pregnant amnesiac with a tendency to yell at their own people?

Alex: Your blood pressure's higher that it should be.

Ava: So, what? We're not friends anymore? Fine. Then I won't tell you about Dr. Montgomery's sex bet...with the overly hot Dr. Sloan. Yeah! If he can go 60 days without sex, they're getting back together. Apparently, they used to be a thing back when she was married to Dr. McDreamy.

Alex: Question is how do you know all that?

Ava: I'm a bed rest five feet from the nurse's station and I have excellent hearing. I know everything. It's...it's like watching a soap. Do you know how many doctors in this hospital Nurse Olivia has slept with? Oh wait...how am I talking to? You're one of them. Anyways, I strongly advise you to move on Dr. Montgomery before you lose your shot. Or I would if we were friends.

Alex: Well, if she wants to be with Sloan...

Ava: Dude! If she wanted to be with Sloan, she'd be with Sloan.

(Bailey and Richard are walking through the hall)

Richard: The other board members have a say in who gets to be chief but Larry...he's the one who really decides. Ok? He knows it and they know it.

Bailey: So, if the attendings find out he's here...

Richard: The man won't get a moment's peace.

(Bailey and Richard walk around the corner and Addison, Mark, Burke and Sloan are standing in the hall outside Larry's room)

All: Chief!

Richard: You have to leave. I want you all out of here, ok? Look, go, go, go. Out!

Mark: All right but you know where to find me.

(Larry's secretary Celeste walks up)

Celeste: Celeste, Larry's assistant. He's in here.

Richard: Ok. Go away.

Addison: But we can help!

Burke: We can help?

Addison: What is that supposed to mean?

Burke: He doesn't have any woman parts.

Derek: Look, it's not like we don't know where he is.

Addison: Right.

Mark: We'd just come back anyway.

Derek: Right.

(They all enter Larry's room)

Larry: Richard, finally. Oh for God's sake what are the four musketeers doing here? What happened to I'll be discreet.

Richard: Larry, they're here for the same reason I am...to see if they can help.

Larry: Right...bunch of ghouls. All right, one of you wants to be the new chief...(he pulls down his pants) fix this and you've got my vote. (They all look stunned and bewildered) And no those are not grapefruits.

Addison: Well...it looks as though you won't be needing my services after all.

(Larry is in the bed being examined)

Bailey: And supra-pubic tenderness.

Larry: That's because I haven't taken a leak in three days. Three days...

Burke: Could be a hernia.

Derek: A hernia wouldn't do that.

Burke: Was there trauma? Testicular torsion? Twisting?

Mark: Twisting? You'd have to tie him in a triple knot to get that kind of fluid build up. Am I wrong?

Larry: I was taking a two-week raft ride down the Amazon.

Burke: Oh, maybe it's a tropical disease. Ocystalsomiasis? Philaryasis?

Larry: Oh, now they're just guessing, Richard.

Richard: Dr. Bailey, call Dr. Fisher in neurology to do a supra pubic cath and order an ultrasound and KEB. Larry have you called Nancy?

Larry: I don't wanna worry my wife unless I have to.

Mark: She wasn't on the trip with you?

(Addison is in the conference room where the cakes are set up)

Addison: White chocolate with vanilla butter cream. (Alex enters)

Alex: Dr. Montgomery?

Addison: Can't decide...triple berry at least has fruit so I could pretend it's healthy.

Alex: Ava's BP is 171 over 118.

Addison: She's pre-eclamptic.

Alex: I ordered a blood test and a bio-physical test on the baby who's fine but Ava's got edema.

Addison: Get her on ammonium hydrolozine.

Alex: What about an epidural...to get her blood pressure down? I mean, am I going overboard or...?

Addison: Believe me, I wish I had someone who cared that much about my blood pressure.

Alex: Yeah well...from what I hear, in 28 days you will.

(Izzie and George are working in the clinic)

James: I have a cold like forever. I've been here three times and they keep telling me it's gonna go away but my nose just won't stop running. I'm like the most disgusting fountain in the world.

Izzie: Sometimes these things just drag on. You might have to wait it out.

James: No, I can't wait anymore. See there's a girl...and we've been out a few times and now it's gotten to the point where we're supposed to...you know, seal the deal. But the nose thing is so gross I can't get anywhere near her.

Izzie: I'm sure if she's really into you, she'll hang in there.

James: No, no, no...you don't understand. Have you ever met someone where the attraction was so intense you thought it may just kill you? You know like your in the same room and your skin is on fire. You wanna touch them so bad...

Izzie: Ok, we get it. We're on the case.

George: Yes, I will do an ENT and you will listen to his...(He stares at Izzie)

Izzie: Chest?

George: Yes.

Izzie: I'm on it.

(Cristina and Meredith are in the hallway studying)

Meredith: Which fluid resuscitation technique is used in acute burns?

Cristina: Packlin formula. Come on Meredith, step it up.

Meredith: What is vertals stria?

(Cristina is looking on at George and Callie talking)

Cristina: Oh, I hate George. He married into the cards. You think he knew? You think that's why he married her?

Meredith: Yeah, that's why he married her.

Cristina: I need those cards.

Meredith: We don't need the cards. What is vertals stria?

(Cristina walks up to Callie)

Cristina: Dr. Torres, Dr. Burke and I are trying to choose a wedding cake and there are some samples in the conference room. If you have a moment, I'd really love your opinion because you have such great taste.

Callie: You're not getting my cards, Yang.

(George walks up to Bailey)

George: Dr. Bailey? You need an intern?

Bailey: Yeah, how's it going...in the clinic, O'Malley? How's Sydney doing?

George: Oh that's...why you wanted to see me? To find out...how things were going?

(Celeste walks up)

Celeste: Dr. Bailey? Can I talk to you for a second?

Bailey: Of course, Ms. Newman. What can I do for you?

Celeste: This is embarrassing. Mortifying actually. I think I need to be tested. Larry and I...whatever Larry has, I probably have it as well.

Bailey: O'Malley, page Dr. Montgomery.

George: Ok.

(Izzie and Sydney are in the clinic)

Sydney: How's it going buddy bud?

Izzie: I'm getting a strep culture on bed nine and discharging Mr. Benton.

Sydney: The gentleman with the sinus issues?

Izzie: It's a runny nose. And I have a test to study for and Bailey doesn't like us to...

Sydney: Ah! Bailey's not here today. Ok, I am. And it's all well and good to open a clinic as some kind of power play for chief resident but chief resident isn't really about big think it's about patient care, ok? So, lets see what we can do to improve Mr. Benton's experience.

Izzie: It's just a cold.

Sydney: Nasal lavage. Because we care.

Izzie: Nasal lavage?

Sydney: Yeah, get yourself a bulb syringe, squeeze an isotomic solution into one of Mr. Benton's nostrils. It'll squirt right out the other side, incredibly restorative. Rinse and repeat...rinse and repeat.

(Celeste's exam room)

Celeste: It's not what you think. I mean it is...it's...it's just not an affair. Though I guess, technically it is. We're in love. The kind of love you think you're never gonna find and then you do and the fact that he's married seems a small price to pay for being happy, you know? At least most of the time but then five years go by and he still hasn't left his wife...you must think I'm a terrible person.

Addison and George: No, no, no.

Addison: No judgment whatsoever.

Celeste: I mean, I know, I should leave him, it's just...do you have any idea how rare it is to find someone you can work and play with. And we love each other. How wrong can it be?

(Larry's room)

Larry: Richard, this thing still hurts like hell and my boys here are not getting any smaller. I wanna know what you're doing about it?

Richard: Well, the urologist just drained your bladder. Next up is an ultrasound and an x-ray. Interns will be taking you...

Larry: No, no, no. I mean, what are you doing for me?

Richard: Getting some of the best surgeons in the world to help you.

Larry: I came here for you. You! You're the best surgeon in this place. At least you used to be.

Richard: What's the matter, Larry? Am I not taking enough care of you?

Larry: How does a man, just lose his desire at 53, 54 or however old you are? How does that happen?

Richard: I haven't, ok? There are other things in life.

Larry: Like what? Adele leaving you? Even more reason to keep the job. You're a surgeon man. I had to go skinny dipping in the Amazon to get that kind of thrill.

Richard: I'm not gonna let you browbeat me into keeping this job.

Larry: Like I'd even want to at this point. When I appointed you chief of surgery, you were hungry. You were the man. Now you're a politician, giving me excuses, handing things off. I hate to think that's the kind of doctor you've become. But if it is, maybe it is best that you're stepping down.

(Bailey enters the room where Cristina and Meredith are studying)

Bailey: I know, I said you could use the day to study but we've got an all hands on deck situation.

Cristina: A bad car accident?

Meredith: Multiple gunshot wounds?

Bailey: A penis, Chairman of the board's penis.

Meredith: What's wrong with it?

Bailey: His testicles have swollen which is the understatement of the year.

Cristina: Fantastic how much? No, don't tell me. Let it be a surprise.

Bailey: Look, you and Grey can take him for his ultrasound and his x-rays.

Cristina: The VI Penis.

Bailey: Just go.

(Burke and Derek are in a computer room)

Burke: Elephantisis?

Derek: Mmm-hmm.

Burke: No way Jennings has that. Did you check combrusolosis?

Derek: Could be the beginning of funia's gangrene.

(Mark enters)

Mark: I don't know. I'd go with gonorrhea before I went there. Then again, I'll be there at the finish line to make him pretty, which is what he'll remember. Oh, Derek...

Derek: Mmm-hmm.

Mark: Grey wanted me to tell you that she's still working on Jennings' x-ray and that she'll be in the x-ray viewing room.

Derek: Good to know. She's communicating. Just when I need time to think, she suddenly starts communicating.

Burke: Time to think about what?

Derek: All of it. The relationship, the chief thing, how to juggle them both without getting distracted.

Burke: With Cristina I have to be explicit. There would be no wedding if I wasn't.

Derek: Well, that's not easy though.

Burke: Oh no. I never said it was easy.

Derek: Right.

(Ava is watching the nurse's desk from her room and sees Callie and Addison talking)

Callie: Hey.

Addison: Hey. How's it going?

Callie: I caught George in a lie the other day. He said he spent the day in the clinic when he spent it doing God knows what with Izzie Stevens. It's probably nothing, right?

Addison: Right.

Callie: Right. So how's your man whore? Miraculously reformed?

Addison: For now. He's never going to turn into what I want.

Callie: Which is.

Addison: The whole thing. I want someone stable who barbeques and teaches little kids how to play catch. And is not Mark Sloan. Which doesn't explain why I've spent the entire day looking at Alex Karev like a puppy and a chew toy.

Callie: Why don't you just go there already?

Addison: Because! He doesn't barbeque either. Plus, he's like twelve years old and can fit all of his belongings in a milk crate.

Callie: I don't know. Guys like Karev...at least you know, he'll never lie to you. Guys like him, they mess around in their twenties but then they, you know, pack it in and teach their kids to play catch.

Addison: Maybe. I need to stop thinking about both of them.

Callie: And I have to stop thinking about Izzie Stevens.

Addison: Hey, Callie, here's the thing. When you're obsessing about something like that, there's generally a reason.

(Izzie is in the clinic performing the nasal lavage on Mr. Benton when Bailey comes in)

Bailey: What the hell are you doing?

Izzie: Nasal lavage.

Bailey: Why?

Izzie: Because she's trying to kill me.

(Sydney walks up)

Bailey: Sydney.

Sydney: Dr. Bailey, we've really turned this place around today.

Bailey: Nasal lavage?

Sydney: Four visits in one month?

Bailey: Oh, you questioning my patient care?

Sydney: Miranda, I get it. Ok? You're protecting your turf. Very mama bear, very chief resident. But this is not about hospital politics, this is about the patient.

Bailey: The patient can go home. Get that stuff out of his nose.

Sydney: No, I'm not comfortable discharging him till we've addressing is problem.

Bailey: The 16 patients in the waiting room aren't comfortable either.

Bailey: (To James) Sir...I don't think there's anything else we can do. You know, colds drag on.

James: Yeah, yeah, I hear ya.

(He gets off the bed)

Bailey: Oh hell.

Izzie: What?

(There is blood/fluid on the pillow)

Bailey: That come out of his nose?

James: See? This is why I'm never gonna have sex again.

Bailey: Wait right here. (To Izzie) Order a head CT.

Izzie: Why? It's not a cold?

Bailey: No, Dr. Stevens. It's definitely not a cold.

(Derek enters the x-ray room where Burke, Mark, Cristina and Meredith are)

Meredith: Hey, just so you know I'll be over here while you're over there, ok?

Derek: Cute.

Meredith: Easy to locate, right?

Derek: Mmm-hmm.

Meredith: Girlfriend comes with a GPS.

Derek: Looks like some kind of foreign object.

Mark: Ouch.

Burke: That almost looks like...

Mark: A skeleton. It's skeleton like, definitely skeletony...

Burke: Are those barbs?

Mark: No...can't be.

Derek: Oh could be.

Meredith: It looks like a teeny tiny catfish.

(Richard enters)

Richard: Close. You see there. Those are spines. This is a candiru fish.

Cristina: A penis fish? This guy has the penis fish. In his...in his...wow!

(Alex enters Ava's room)

Ava: What the hell did you do to me?

Alex: You know, most pregnant laboring women love their epidurals.

Ava: I'm not in labor.

Alex: I'm trying to keep it that way.

Ava: By paralyzing me from the waist down? I can't even sit up in the bed. I'm missing the show. The Seattle Grace show.

Alex: I can help with that.

Ava: So I guess you're talking to me again.

Alex: Well, I can't stay mad at you. I tried but I couldn't do it.

Ava: You make your move on the redhead?

Alex: I thought you already knew everything that went on in this hospital?

Ava: As a matter of fact, I have an update. I saw her talking to the ortho resident.

Alex: Yeah? And?

(Ava starts seizing)

Alex: You're seizing...She's seizing. Somebody page Dr. Montgomery. Somebody page Dr. Montgomery, now.

(Richard is in Larry's room)

Richard: It's the candiru. It's a freshwater fish that lives in the Amazon. It's a parasite.

Larry: I'm not an idiot; I didn't drink from the Amazon.

Richard: Did you urinate in it?

Larry: No, I...what?

Cristina: The candiru is attracted to blood and urine. It's been known to swim up the stream of urine and lodge itself in a man's urethra.

Larry: You mean a fish swam up...

Richard: It's rare but there are documented cases.

Cristina: One man actually saw it go in and tried to grab it. It was too slippery.

Richard: Yang!

Cristina: It's in the literature.

Larry: So this thing is in my...

Richard: It's now in your bladder. Well, right next to it. It's stuck in your prosthetic urethra, which is causing the obstruction. We need to get it quickly before it causes sepsis.

Larry: Sepsis? You mean I could die?

(Alex is taking Ava through the hall to the OR)

Alex: BP shot up to 202 over 134. There's fetal distress, the epidural didn't help.

Addison: It'll help during delivery.

Ava: What's going on? Alex?

Alex: Your blood pressure spiked, you had a seizure.

Addison: The only way we can reduce your blood pressure and the swelling in your brain is if you deliver the baby right now.

Ava: She's only 30 weeks. I'm not in labor.

Addison: We're gonna do a C-section, Ava. Don't worry, the survival rate for preemies at 30 weeks is extremely high.

Ava: Alex, tell her no. I'm not ready.

Alex: You're ready.

Ava: But I can't do this by myself.

Alex: Well then it's a good thing you're not by yourself. (He takes her hand)

(Derek enters the CT room where Izzie and Bailey are looking at the CT results)

Derek: I was doing a consult on the chairman of the board, this better be good. What do we have?

Bailey: Well, we have a patient in the clinic with chronic runny nose, halo sign on the pillow. The fluids are still in the lab but as far as I can tell...

Derek: He's leaking spinal fluid through his nose.

Bailey: Thought you might like this one.

Derek: Ok, look at that. It's a brain herniation. His brain is literally sinking into his skull base.

Bailey: And all along I thought it was a cold.

Derek: Book an OR.

Izzie: Dr. Bailey?

Bailey: Oh no, no. You're still studying. You can watch from the gallery. I'll scrub in with you.

Derek: I thought you were doing Jennings?

Bailey: No, I'll...I'll do both. I sent this guy home three times. I can't not scrub in.

(Ava's OR)

Addison: Your daughter's beautiful Ava.

Ava: She is?

Alex: She is.

Addison: Get her under the warmer right away.

Alex: I'll work on her...

Addison: Hand her off to peds, I need an extra set of hands. Need to hang some blood.

Ava: Why? Why do you need blood?

Alex: Want me to get the uterine arteries? Clamp.

Ava: Alex, what's going on? Alex?

Addison: The bleeding vessels are deep...

Ava: Tell me what's going on.

Addison:...you want to...

Alex: Ligate around the hemostats, I got it.

Ava: Oh my god! Am I gonna die? Oh my god, I'm gonna die.

Alex: Can I?

Ava: I'm gonna die and she's gonna be all alone.

Alex: Ava...Ava...look at me, ok? Look at me! You're not gonna die. You're doing great. You're gonna be fine, you're baby's gonna be fine. I just need you to breathe for me, all right? Nice slow, deep breaths. That's it. Just breathe. Keep breathing.

(George walks up to Celeste in the hall)

George: Celeste, good news. No chance of an STD. Now, Larry's condition...he's having surgery but you're fine. You did hear the part about you being fine, right?

Celeste: That's what I keep telling myself...that I'm fine with things the way they are but I probably won't be really fine until I don't care if he's fine anymore.

(Larry's wife, Nancy, walks up)

Nancy: Celeste, I got here as soon as...is he in surgery yet?

Celeste: Um, no. They're taking him soon. This is Dr. O'Malley.

George: Hi.

Celeste: Dr. O'Malley this is Mr. Jennings' wife, Nancy.

Nancy: Hi.

George: It's a pleasure. He's just in there...they're prepping him for surgery.

Nancy: Thank you. I left my car in front in a no parking zone. Could you move it?

(Nancy hands Celeste the keys and enters Larry's room)

George: What are you going to do?

Celeste: Move her car.

(Cristina, Izzie, George and Meredith are in the conference room)

Meredith: Talk about divine retribution.

Izzie: What?

Meredith: He sleeps with his assistant and a carnivorous fish lodges itself in his penis. That's instant karma if I've ever seen it.

Cristina: Yeah, well Derek wasn't struck by lightning and neither were you.

Meredith: Addison showed up. I had months of pain and self-loathing, Crazy ranting mother and a near drowning off the side of a dock. I mean, it's not fish in my hoo-hoo but it's certainly not an easy ride.

Cristina: Yeah, well, I've cheated on my boyfriends and I'm fine. Am I the only one?

George: Which cake is your favorite or have you chosen one yet?

Cristina: Ok, clearly you're not getting the point. I don't have favorite cakes. That's why you're involved.

Meredith: I gotta go. If you see my boyfriend tell him I had some tuna salad and a yogurt and now I'm off to the OR.

Cristina: Hey, this is uh, it's not eating for pleasure. I really need a choice so mark down your favorite.

(Meredith and Cristina leave)

Izzie: Sorry I froze there...a little bit...uh

George: It's ok.

Izzie: I'm not...I'm not getting weird...you know...it was just a weird time...

George: Shut up and eat some cake.

(He shoves cake in her mouth)

Izzie: (Mumbling with her mouth full)

(Callie is standing outside the window watching George and Izzie giggle and have fun together)

George: Good?

Izzie: Disgusting.

George: You got me covered in cake.

(Addison walks up to Alex in the hall)

Addison: Karev.

Alex: Hey, I was just checking up on Ava.

Addison: Do I have another Denny Duquette situation on my hands?

Alex: What? Are you serious?

Addison: I have never seen you so attentive with a patient. You're always there, checking her stats, running tests, doing research.

Alex: It's my job.

Addison: No, it's my job. I'm her doctor you're my intern.

Alex: Which is why I have to know her stats at all times because I'm not about to stand next to you in your OR and be anything less than over prepared. Ok? There's no way I'm going to go to work everyday with a surgeon like you and not be on top of my game. So, if you wanna yell at me...

(Addison starts kissing Alex and pushes him into an on call room and they both start undressing.)

(Cristina walks up to Callie who is standing at the nurse's station)

Cristina: I know you have to give him the cards cause you're married to him; I respect that. But there is an argument to be made for female surgeons sticking together.

Callie: You're relentless.

Cristina: Sisterhood and all that you know.

Callie: Mmm-hmm. Scary...inhuman relentless.

Cristina: You are like a role model...to me...or something.

Callie: Ok, you know what stop. This is just getting sad. I will give the cards to George, I am sure he will share.

Cristina: No he won't...with me anyway. He'll just share them with Izzie. They're like an exclusive little unit...whatever.

(Cristina walks away and Callie calls after her.)

Callie: Yang. My uh...my locker is on the right side, third one from the door. The cards are on the top shelf.

Cristina: Really...you're...?

Callie: They're all yours.

(Addison walks out of the on call room fixing her skirt. A minute later Alex walks out and they bump into each other.)

Addison: Oh god. I'm sorry.

Alex: It's ok.

Addison: I was...

Alex: Yeah...

Addison: So we're good?

Alex: It's good.

Addison: Good. Ok then.

(They walk away and Mark is standing nearby and has watched the whole exchange)

(Izzie enters the elevator not paying attention and Callie follows her in)

Callie: Don't talk. I know it's not fair and I know it's not your fault and I know there's nothing going on between you and George, I know that except there is. You're his best friend. He loves you. He gets you he needs you. And I'm just...I'm his wife. And I know...I get the sex and the commitment and the life with him but I want him to get me and to need me and I can't compete with you. So I am asking you to please stop...just stop. Find another friend or whatever you do. Just give me my husband back.

(Callie storms out and leaves Izzie standing in the elevator to feel guilty)

(Larry's OR)

Richard: What about the fork stone grasper?

Dr. Fisher: It can lead to urethral injury.

Richard: Well, the forceps aren't working. At this point I'm willing to try anything.

Dr. Fisher: All right, stone grasper.

Richard: Ok.

(Meredith and Cristina enter the OR)

Meredith: (To Mark) Did we miss anything good? (He doesn't respond) Hello? You ok?

Mark: I've had better days.

Richard: Where's Dr. Bailey? Page her.

Richard: V-tach. Does he have a pulse with that?

Cristina: Oh, he's going down.

Burke: Yes. He needs one epi amnioterone. How much longer you think it'll take?

Richard: Oh, you worry about getting his arrhythmia's down. We're gonna have to change our game plan here. The scope isn't working. Excuse me, Dr. Fisher, we're gonna have to open him up.

Dr. Fisher: All right.

(James' OR)

Bailey: I don't know how I missed it.

Derek: It presented as a cold, Miranda. This sort of thing, at some point, you think it's gonna get better. You don't really figure it's something that could ruin your whole life.

(Bailey's pager goes off)

Bailey: The chief.

Derek: Candiru, go ahead we're almost done here.

Bailey: Ok.

Derek: Thank you.

(George enters the gallery where Izzie is)

George: Hey. You wanna quiz me on GI stuff?

Izzie: No, I'm still trying to get through my cardio notes.

George: You ok?

Izzie: I'm fine. I should've snuck into the candiru surgery with Meredith and Cristina.

George: You still can.

Izzie: George, can you, maybe, stop talking so I can concentrate.

George: What's your problem?

Izzie: My problem...is you. You're my penis fish.

George: Your what?

Izzie: You've crawled in and latched on and now I can't move or talk or think or even pee without the nagging feeling that something is eating through my organs.

George: You don't even have a penis. How am I the fish?

Izzie: It's a metaphor, George.

George: What happened to us being fine?

Izzie: I don't know. Maybe we're not.

(Larry's surgery)

Richard: A little more suction in there. Those barbs won't let go. (Bailey enters) Dr. Bailey, glad you could join us. Oh, this is useless. We're gonna have to cut it out, Dr. Fisher.

Dr. Fisher: I'll repair the bladder.

Richard: Ok, lets do it. How's his heart holding up?

Burke: Occasional runs of v-tach. He can't take much more.

Richard: Forceps. Ok, almost there. Come on you. Almost there. Got it.

Cristina: Holy...

(Everyone makes noises and whispers amongst themselves when Richard holds up the candiru.)

Burke: Unbelievable.

Cristina: You see that thing?

Meredith: Yep.

(Meredith and Mark are in the scrub room)

Meredith: Remind me never to pee in the Amazon. What?

Mark: What do you say we have a real meeting of the dirty mistresses club? Like what it should have been from the beginning.

Meredith: What are you doing?

Mark: Once, twenty minutes in the on-call room, nobody ever finds out.

Meredith: Mark!

Mark: What? You telling me everything's great between you and Derek?

Meredith: What makes you think there is something wrong between me and Derek?

Mark: Something's always wrong between you and Derek.

Meredith: Enough! What is wrong with you?

Mark: Nothing. I'm...I'm...Addison and I were gonna try and make a go of it. Things are not gonna work out.

Meredith: So you make a pass at me like that'll help?

Mark: She doesn't want me. Something's gotta help.

Meredith: Revenge sex is not the answer. If you're letting her go, let her go. Be an adult.

(Alex enters Jane Doe's room)

Jane Doe: Thanks for the baby...and for me not dying and stuff.

Alex: It's always a nice bonus when the patient doesn't die.

Jane Doe: You and red make a pretty good team.

Alex: Don't tell Sloan.

Jane Doe: Oh, she and Sloan aren't happening. She wants you.

Alex: How do you know that?

Jane Doe: I know everything remember. Heard her talking to the ortho doc about how she wants someone who barbeques and plays catch. She wants someone who's committed.

Alex: Yeah, well, that's not me.

Jane Doe: I hate to tell you this, but it is. You may talk tough but you're a decent guy, Alex. Whether you want to admit it or not, you're actually one of the good ones.

(George walks up to Nancy Jennings in the waiting room)

George: Mrs. Jennings, your husband's out of surgery. Everything went very well.

Nancy: Oh...oh thank you. Thank you. That's...that's wonderful. The doctor will be down to fill you in soon. Dr. O'Malley, do me a favor. Could you go tell Celeste? She's a basket case and I just don't have it in me to take care of my husband's girlfriend right now. (George looks shocked) Of course I know. The wife always knows.

(George is in Larry's room. Nancy is sitting next to his bed reading a book when Celeste enters)

Celeste: Dr. O'Malley?

George: Yes?

Celeste: Mr. Jennings' personal physician would like a copy of his medical records and here's the number.

George: Ok.

Celeste: Mr. Jennings, I've cancelled your appointments for next week. There's just a conference call that's proving a little bit difficult to reschedule but I'm sure Danny can handle it.

Larry: What's...what's Danny go to do with it?

Celeste: I've asked him to step in...temporarily...until you find someone else.

Larry: Wait... wait a second, Celeste. (Celeste leaves) What the hell was that all about?

Nancy: Well, I think she just left you. Good-bye Larry. (Nancy leaves)

Larry: What the hell's going on here?

George: I think I'm done here. (George leaves)

(Burke enters the conference room where Izzie is eating wedding cake)

Izzie: Can you be a vault? I think I need a vault cause I've eaten like...a cake and a half and it's not just not cutting it. And you don't gossip.

Burke: Because nobody tells me anything.

Izzie: I was with a married man. It was...

Burke: I don't mind that nobody tells me anything.

Izzie: It was George. I was with George.

(Burke eats some cake)

Burke: It should be firm inside, not spongy. The frosting, I like. Meringue, light but not to sweet. I always thought chocolate inside but I'm leaning away from that.

Izzie: You've thought a lot about this cake.

Burke: This cake...for this day...with this woman.

Izzie: The red velvets your winner, by the way.

(Meredith enters Derek's trailer)

Derek: What are you doing here?

Meredith: I wanted you to know where I was so I thought I'd come and tell you.

Derek: Now you're mocking me.

Meredith: I'm apologizing to you.

(She kisses his neck)

Derek: You're making light of things.

Meredith: I'm running my fingers through your hair...I'm standing in your bedroom...unbuttoning my shirt...and now I'm taking off my pants...and now...I'm getting in your bed naked.

(Mark walks by Addison on the stairs)

Addison: Mark, we need to um...we should go get a drink...and maybe talk. Do you have some time? I just...something's always wrong...with you and me.

Mark: You don't wanna have a drink with me. I'm not what you're looking for.

Addison: What are you talking about?

Mark: I slept with someone, couldn't hold out. Once a man-whore, always a man-whore, right?

(Richard walks up to Bailey who is writing on the OR board)

Richard: Miranda, go home.

Bailey: I'm almost done.

Richard: Go home see your family. You have to accept there are days when you can't do it all. You have to delegate.

Bailey: I do.

Richard: And then you do all the work anyway. And you're still doing it.

Bailey: You didn't have better things to do today then to ride herd on that VIP case?

Richard: There was a fish in a man's penis.

Bailey: There's always gonna be a fish in a man's penis, chief. You can say you moving on all you want but are you really?

Richard: If you don't slow down, you might end up without a family to go home to. Good night, Miranda.

(Meredith and Derek are laying in bed)

Meredith: No, see, you can't do that.

Derek: Do what?

Meredith: Not look happy after sex. It's bad for the ego.

Derek: I'm fine.

Meredith: Are we fine?

Derek: Sure.

Meredith: Not so convincing. I shouldn't have accused you of hovering. It wasn't nice. You were just trying to be there for me. But now I'm being available and communicating and being naked and doing all of your favorite things.

Derek: Mmm, good things.

Meredith: Then why are you still staring at the ceiling?

Derek: I don't know. It's just that...that day...you came out of the water...I spent the scariest hour of my life trying to breathe for you. I love you and I want you but I don't know what to...you didn't swim. You didn't swim and you know how to...and I don't know if I can...I don't know if I wanna...keep trying to breathe for you.

Meredith: I should go. I'll go.

MVO: To often, the thing you want most is the one thing you can't have.

(Cristina and Burke's apartment)

Cristina: What acid based finding do you classically get with significant vomit? Hypokalemic, hypochloremic, metabolic, acilosis. Unbelievable.

Burke: Did you pick a cake?

Cristina: I like the red one.

Burke: The red velvet?

Cristina: Yeah.

(He takes her card from her and kisses her.)

(Izzie and George are outside of James' room where a woman is inside)

George: That's the girl?

Izzie: Runny nose guys big love...I don't know how we do this. I don't know how we work together and be friends and act like it's all-ok.

George: I...there's a spot available at Mercy West...I called them.

Izzie: You're gonna transfer to Mercy West?

George: Yeah, I have to.

MVO: Desire leaves us heartbroken; it wears us out. Desire can wreck your life.

(Alex is in the lobby studying when Addison enters)

Addison: Hey.

Alex: Hey.

Addison: I was gonna go get a drink. You wanna head over to Joe's?

Alex: Yeah...I'm uh...I'm kinda under with this test.

Addison: Ok. You know, um, I took that test once upon a time. We could, um, go back to my hotel. I could quiz you.

Alex: Look...this...this isn't...you're not my girlfriend. Ok?

Addison: What?

Alex: I mean, no offence, today was awesome but...I'm really busy, I have a lot of work. I don't have time for...

Addison: No, of course...uh...study. It's what you're here for, right?

(Addison leaves the building)

MVO: But as tough as wanting something can be...(Addison pauses in front of the hospital)...the people who suffer the most...(Addison turns and looks back at the hospital)...are those who don't know what they want. (Addison walks away)