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How much can you actually
accomplish in an hour?
Run an errand maybe?
Sit in traffic?
Get an oil change?
When you think about it,
an hour isn't very long.
That's it.
In medicine, though,
an hour is often everything.
We call it the golden hour.
That magical window of time
that can determine
whether a patient lives
or dies.
Thank you, doctor.
Are you gonna help me at all
or are you just gonna sit
there and eat potato chips?
I performed four back-to-back
fem-pop bypasses today.
This is the first chair
I've seen since 7:00 A.
M.
,
and this is the first food
I've had since yesterday.
I choose potato chips.
you might want to get that.
Seattle Grace Mercy west emergency.
You brought this on yourself, you know?
- You volunteered to help run the E.
R.
?
- Got it.
We've got a suspected appy on a 10 year old.
Let's page Robbins.
You know,
I saw a need and I filled it,
like any good chief resident candidate.
Sadomasocochisc chief
resident candidate maybe.
What is up with you?
You're all perky and cheerful.
Ah, you know, it's the, uh, fertility drugs.
We have stepped it up.
I'm pumped full of hormones.
You know what's perky?
Quoi?
My ***.
They're huge.
Am I supposed to like big ***?
Oh, god, no.
They'll make you fall over.
So, um
Callie mentioned a thing.
Or it might not be a thing.
- At least I hope it doesn't become a thing.
- Hey, I got a patient
with a headache better after sumatriptan.
He's ready to be discharged.
- Just need you to sign off.
- Is he neurologically intact?
- Mm-hmm.
- You did a C.
T.
?
I did.
It was negative.
The most interesting thing
about this guy is that he came into the E.
R.
for a glorified migraine with
- a girlfriend from hell.
- Ooh, which one is she?
Just point with your eyes.
No, I mean, I know.
It's just not a priority
Right now, obviously
Mm-hmm.
Mm-hmm.
- Here.
- Thank you.
- So, um, Callie had a thing.
- Yeah.
- What kind of a thing?
- Grey, you paged?
- Yeah, we have
a suspected appy on a 10 year old
- two minutes out.
- Okay.
An unexpected thing.
Grey, call up.
Tell 'em to get an O.
R.
ready.
I already did.
O.
R.
five
is prepped and ready for you.
Callie asked me to be her baby's godmother.
Oh.
Well, you said no to that, right?
You gotta say no to that.
Um
E.
K.
G.
results.
Thank you.
The guys at work overreacted
and insisted I come to the E.
R.
Sweetie, I had a big lunch.
It hardly qualifies as chest pain.
No, what I need are some antacids.
I'll be there.
I promise.
Just tell Max to put on his jersey.
Okay? I'll be outta here soon.
Hi, I'm Dr.
Grey.
I'll be your doctor today.
Oliver Richter.
Sorry about the phone.
I'm supposed to be picking up my son
- for the huskies game right now.
- I'm sure he'll understand.
You don't know my son.
There are very few things
more important to him
- than basketball.
- Big fan, huh?
- I'm just gonna take a quick listen.
- All right.
The biggest 9-year-old fan you've ever seen.
Okay.
So it says here
that you've been
experiencing some chest pain.
- When did that start?
- Uh, an hour ago, maybe two?
But I'm already feeling much better.
And you wouldn't just be saying
that to get discharged faster?
Look, I got my son tickets
to this game for his birthday.
He's been marking off the days
on his calendar for weeks.
I can't be the reason he misses it.
Okay.
Well, your E.
K.
G.
looks normal,
and your heart sounds good,
but if there's one thing
we don't take lightly around here,
it's chest pain, so
Could we go back and just
pretend I said heartburn?
- Would that get me out any faster?
- No, probably not.
but Tyler is going to do
a portable chest X-ray.
And we're gonna do a chest pain workup,
and we will try to make
it as quick as possible.
- Okay?
- Thanks, Dr.
Grey, so much.
Thanks.
So this is gonna be a thing.
Why am I telling Callie no again?
Um, while you're here,
I need a second opinion on this E.
K.
G.
Do you see anything?
No.
Looks, uh, normal.
What are you doing here?
- Thought you had the night off.
- Yeah, I do.
I'm not here.
What's medical records' extension?
Looks like you're here to me, which is good,
because we're swamped.
Take your pick
Impacted bowel, suspicious rash,
or really smelly guy.
Forget it.
I only came in
'cause medical records called
and said I had to sign
all my unsigned charts
- Or they would suspend my privileges.
- You're getting suspended?
Dibs on his solo splenectomy tomorrow.
I better be able to finish
this crap before the game tonight.
Told a patient yesterday
he didn't have cancer,
and he was so happy,
he gave me two floor seats.
You took a gift from a patient?
Did you tell him you cured his cancer?
Uh, colectomy time.
I'm out.
Excuse me.
Hi, I-I'm sorry.
Uh, we were told that somebody would be by
to set our son's leg Nathan Englundar.
It was a while ago.
Several hours, actually.
- And I was
- No, I know.
You've been
here a while.
I'm sorry.
The problem is, we just don't
have enough O.
R.
s available
- for non-emergent cases.
- An O.
R.
? Why would you need an O.
R.
?
Your pediatrician hasn't been
by to speak to you yet?
Your son has a broken femur,
which is a severe break.
It requires a full cast on
the broken leg, connected to
a cast on the other leg
to keep everything still
so the bones will heal properly.
And because your son is so young,
we can't set the bones properly without
- putting him under.
- Under meaning anesthesia?
And that requires an O.
R.
I'm sorry.
I know you've
been waiting a long time.
As soon as an O.
R.
opens up,
- I'll let you know.
- Thank you.
Thank you.
- Okay.
The losers in medical
records aren't answering.
Are you sure you can't stay
- and help out with some of this stuff?
- Floor seats.
I understand what you are suggesting.
I know it is done
by many medical professionals
in this hospital.
But I am not a medical professional
who would ever consider
Maybe you should consider it.
Eli Lloyd do not test me.
Maybe you should consider
the potential benefits.
All the intensely exciting,
toe-curling potential
Benefits.
Dr.
Bailey.
Okay, uh, this is gonna be
for a prescription-strength
migraine medicine.
Just don't take it with alcohol.
- Okay.
- We're missing our anniversary dinner
because you have a headache.
A headache.
Do you know how hard it is
to get reservations at this place?
I'm sorry, Gia.
I am.
But t it really hurts.
Hmm.
Hi, I'm Dr.
Grey.
I'll be
- Oh, Mrs.
Webber.
- Hi, dear.
How are you?
I'm fine.
How are you?
- Does the chief know you're here?
- Oh, please don't bother him.
I had a little fall is all.
Got home from work,
slipped off the stepladder
ohh landed on my wrist.
Oh, it's basically nothing.
Ohh.
Well, it's not nothing.
Well, I-I brought lots of
magazines and a good novel.
I am perfectly fine waiting
until you make time for me.
I know you have far more pressing patients.
Well, you're the chief's wife,
- so that makes you
my most pressing patient.
- Oh.
Look, stew-man.
They opened
- the doors right for us.
- Are you sure about that?
This is gonna be fast.
We'll be in and out, man.
But I can't believe you
wouldn't let me drive, dude.
Dude, you're drunker than I am.
I can't believe you tried
to stiff the cabbie.
Wow, it is bright in here.
Hey, could somebody do something about this?
You're a little early.
I thought our date was at 6:30.
Well, I'm here now because
a guy just walked into the pit
- with a knife sticking out of his head.
- Sweet.
I mean, poor guy.
- Is he stable?
- He's neurologically intact, but
All right.
Well, I need to check on him
sooner than later, so, Avery,
take him down to C.
T.
- stay with him until I get there.
- All right.
Will do.
Okay, so you'll be down
- to see knife guy when you're done?
- I will.
- And then we'll have our date?
- Wouldn't miss it.
How did this guy get a knife in his head?
Oh, apparently there was
a brawl at a tailgate party.
So you know how stupid guys get Dr.
Bailey.
uh, I'm taking a nap.
Uh, I'm sorry.
What I-I mean to say is,
I'm going to use this room to take a nap,
because that's what people do in these rooms
when they're tired,
'cause I-I have a child and a full-time job,
and work long hours,
so I'm just tired,
Just very very tired.
Okay.
Okay.
I-I was just gonna ask you,
had you seen Dr.
Altman?
D no, I have not seen Dr.
Altman
Nor any other doctors or nurses,
because I will be in
this room asleep, by myself.
Actually, I see her now.
Dr.
Altman.
I'm-I'm-I
Dr.
Altman, do you have time
for a quick consult?
I was supposed to be off by 6:00, but
Oh, okay, sure.
Okay.
Just walk with me.
- Okay, so
- Oh, damn it.
He's early.
Um
All right, just, uh,
Grey, give me a second.
Hi, uh, William.
Hey.
It's, uh, it's nice to see you.
Wow.
You look amazing.
- Oh.
- So official.
I mean, I-I knew you were a doctor,
but you are a doctor.
Thanks.
Sorry, I didn't
I didn't have time to change.
- I'm just
- No, no, no.
The scrubs are strangely sexy.
Thanks.
Um, you know,
I have a few things to wrap up.
Do you mind hanging out for a few minutes?
- Like, uh, ten tops?
- Yeah, no problem.
Take your time.
I'll just, uh, grab a seat here.
Hey, stranger.
Henry.
I didn't, uh, I didn't
I didn't know that you were,
- uh, you were here today.
- Yeah,
they wanted to run
a blood glucose test on me,
so they gave me this nasty
orange kool-aid to drink.
In about an hour, I gotta go
give 'em some blood or pee.
And we don't really need
to talk about my bodily fluids.
- Sorry to be rude.
Hi.
- Hey.
Oh, sorry.
Um, yeah.
Um, William, uh, Henry.
Henry, William.
Are you, uh, are you a patient of Teddy's?
Something like that.
Anyway, I, um, I-I gotta go.
Uh, but I'll be back soon.
Promise.
- All right, Grey, what do you got?
- Okay, 42-year-old male,
um, complaining of midsternal chest pain.
No cardiac risk factors, no angina.
Pain doesn't radiate.
The E.
K.
G.
looks clean.
These are his films,
and they're mostly clear.
But I don't know.
Does the mediastinum look
a little wide to you?
Because I know, sometimes that can happen
- with the portable X-ray.
- You got cardiac enzymes?
- Yes.
- Hey, Kepner.
Yeah.
How good are you
at forging signatures?
Even if I were good at forging
signatures, I wouldn't do it.
It's unethical and probably
illegal.
So I'm sorry.
You're just gonna have to finish
signing your charts on your own.
I'll check on Mr.
Richter
right now.
Call radiology.
Get him in for P.
A.
and lateral films,
and tell 'em to rush it,
cause I'd really like to get outta
here and go on my date.
I mean, did you see that guy?
- No forging signatures, Karev.
- Radiology, please.
Forgery, huh? Why am I not surprised?
Whatever.
I just want to get outta here
so I can get to this game tonight.
Wait.
You have tickets?
Tonight? It's the pac-10 title game.
- Yeah, I know.
- Win this, and the huskies get
an automatic bid to March madness.
Yeah.
Why do you think I'm powering
through all these stupid charts?
Hey, what are you d what are you doing?
Of my ten patients in labor right now,
none of 'em are past 3 centimeters,
which means, I have some time to kill,
and you can't miss this game.
Hand me a pen.
I thought you thought I was a loser.
Well, you're a little less losery,
now I know you like college hoops.
Hey, where's the knife guy?
Is it true he's walking and talking?
- What about your colectomy?
- Oh, postponed.
The wife snuck him
a cheeseburger and fries
before surgery.
So this thing with Callie
I mean, you know it's a bad idea, right?
You don't want to be
Callie's baby's godmother.
- I don't?
- No.
I mean, think of how many people have to die
before you even get to step up
Mark, Callie, and Arizona.
That's a lot of people.
It is, yes.
A lot of dead people.
Right.
Whereas if you're my baby's
godmother-in-waiting,
it's only me and Derek.
One wrong turn down a dark, twisty road,
boom, you're in.
Okay, let's be clear.
If I am ever a godparent to anyone's kid,
it will be in name only.
I will not be taking care of children.
That's what boarding schools are for.
- Which way to butcher block?
- Trauma 2.
Okay.
I understand you might
be thirsty, but I'm sorry.
You cannot drink beer in here.
You're wasting it!
Oh.
Oliver, did you see Dr.
Altman?
Yeah, she's sending me
off for another X-ray.
Look, I know you guys have
to cover all your bases, but
No, I know.
I'm sorry.
But I put a rush on the X-ray,
- so hopefully it'll be quick, okay?
- Yeah.
- Grey!
- Excuse me.
I was finishing a surgery just now
when a scrub nurse asked me
how my wife was feeling,
because she'd heard Adele
was in the E.
R.
, and I hadn't.
Now would you like to explain
to me why I found out
my wife was a patient in this hospital
- from my scrub nurse and not from you?
- Richard, hush.
Let Meredith do her job.
- She hasn't even had a chance
to examine me yet.
- Is that true?
Don't mind him, dear.
He's just worried about me.
He gets gruff when he's worried.
I hurt my wrist.
I was trying to get out
the holiday decorations
and I ohh
I slipped off the stepladder.
Oh, it was stupid.
I should've
waited for Richard to get home.
He's so much taller than me.
I requested an X-ray and an ortho consult.
I will call and make sure
that they're coming down.
Don't touch that!
- Ooh.
- I think I better go see what that is.
You better.
Is everything all right?
- Yes.
- No!
I was just showing these guys how,
when I scrunch up my eyebrows,
the knife move see?
- Oh, my god! my god! Stop! Whoa.
- Don't do that!
- Stop moving the knife!
- Okay, okay.
You guys shoulda seen the brawl.
- Stew-ball kicked that other guy's ***!
- Yeah!
Okay, and now Stew-ball
has a knife in his head.
Oh.
Okay, let's focus.
Stewart, how much is 14 plus 4?
- 18.
- 27 minus 13.
- No.
172 minus 60.
- Oh.
I have no idea,
but it's not because of the knife.
It's just 'cause I'm so drunk.
No, actually, it's just 'cause he's dumb.
Thanks, David.
Really?
Unbelievable.
His mental status
is completely intact,
if you don't count for his math skills.
It's like the knife did no damage at all.
So why don't you just pull the thing out?
'cause we got a games to gets to!
I'll drinks to that! Whoo!
No! No beer!
- Buzzkill.
- Uh-oh!
- No!
- Hey!
How many do you have?
Okay.
Oliver's in X-ray,
Stewart is stable and waiting for Derek,
who should be here soon,
Adele is waiting on ortho,
and, uh, can I get the discharges
- from the last hour, please?
- Sure.
Oh, and, uh, the boy in bed
seven with the broken leg,
Nathan Englundar let's check on the status
of the O.
R.
for him, please.
Is this Lexie's patient with the headache?
- Yeah.
- Mitch Turner?
- Mm-hmm.
- How long ago was he discharged?
Not long.
A few minutes ago.
Did he leave? Did he already leave?
Mr.
Turner!
Mr.
Turner, I need you to try
to smile for me, please.
Who the hell are you?
I need you to try to smile for me, please.
Okay, can you lift your arms
above your head like this?
- Dr.
Grey, is everything all right?
- No, it's not.
We got a code C.
V.
A.
Let's get stretcher out here, stat.
Can you repeat after me?
The dog chased after the cat.
The-t dog ch-chased af
- What's going on? What's happening to him?
- The-the dog
- Okay, I need you to help me.
- What's happening to him?!
- We need to get him on the ground.
- The dog ch
Okay, get your purse under his head.
- Quickly, please.
- The dog ch
Okay.
And help me secure his arm.
Hold it like this.
O-o-okay, but wh-why are we doing this?
Because he's having a stroke.
Unsteady gait, slurred speech,
asymmetric smile.
His symptoms started
no more than 20 minutes ago,
- so we should be well
within the golden hour.
- Okay.
I know a stroke, right in front of me.
I mean, what if he had been driving me
in the car when it happened?
Oh, wait.
Hang on.
Here's the doctor.
Hi.
So the stroke team
has taken him up to C.
T.
We're gonna see if he's eligible
for the clot-busting medicine.
We caught the stroke early,
which is very good.
So-so on a scale of 1 to 10,
our Aspen trip in a week,
how is he?
You should cancel the trip.
You will not believe this.
Looks like the blade landed
in the maxillary sinus.
Chances are, the knife itself
is tamponading any major bleeding.
Probably best just to go ahead
and open up the cranium.
Or we could just take him to the O.
R.
- And pull this thing out.
- Really, Avery? Just pull it out?
Let me guess.
You want
to get out of here early
to go to the game, just like everyone else.
Or since it looks like
the blade didn't hit
any major arteries or veins,
he knows that a controlled
extraction would be both safer
and less invasive than a
- complete craniotomy.
- Is that true, Avery?
Is that why you suggested
we pull it out of his head?
Yeah.
And I want to get outta
here early to get to the game.
- Me, too.
I'm good with that.
Let's just do what he said.
- Yeah!
Lexie, I need to speak with you.
Thank you for getting me out of that room.
I swear, it takes everything
just to be civil to Mark lately.
- Such an ***.
What's up?
- Take a look at this.
Look closely.
What do you see? Uh
This is the patient's admitting
signature when he came in.
- And this is his signature
when he was discharged.
- Oh, no.
Mitch Turner, the patient
you just discharged,
- is up in radiology being
treated for a stroke.
- Oh, god.
I know you know the signs of a stroke.
How did you miss this?
Are you distracted by the Mark thing?
- Is that it?
- No, I checked the C.
T.
He was having a classic migraine.
He's had them before.
There's no way
that he was having a stroke
- when I treated him.
- Lexie, I know you know,
this kind of headache can
be a precursor to a stroke.
When you said you needed an ortho consult,
you coulda mentioned
it was the chief's wife, Grey.
I would've been down here
a hell of a lot sooner.
- No
- I am so sorry to keep
you waiting, Mrs.
Webber.
- You hurt your wrist in a fall?
- Oh, it was so silly.
I'd just gotten home,
and I was trying to get some ohh!
Reach something on the top shelf myself.
- I-I just landed wrong.
- Her wrist absorbed all the impact.
Yeah, it looks painful.
We'll get you some more pain meds to
help you out with that.
Uh, your X-ray shows a hairline fracture.
- Oh.
- So it could have been a lot worse.
We'll splint you up and get you
out of here in no time, okay?
You have me paged
if you need anything, okay?
Okay.
Mm.
Thank you for covering for me
before with the chief.
- You didn't have to do that.
- Excuse me?
When you said I hadn't been by
to examine you yet.
So you said that
you fell when you got home
from work.
Yes.
Yes, that's right.
Do you remember hitting
your head when you fell?
Not that I recall.
Dr.
Grey, I have the new
X-rays for Oliver Richter.
- Okay.
Let's get Mrs.
Webber a head C.
T.
- Okay.
Oh, damn it.
Excuse me.
Hey.
Hey.
- Sorry to make you wait.
- No, no problem.
Um, really.
Henry here has been keeping me company.
Although he's probably sick of me by now.
I've been grilling him
about the major leagues.
You didn't mention he used to play pro ball.
Oh I didn't know that he did.
It's not a big deal, really.
Although there is
a baseball card out there
with my face on it somewhere.
Look, I don't mean to hold you guys up.
You probably have a-a reservation waiting.
Excuse me, Dr.
Altman.
Mr.
Richter
mediastinum looks borderline
on the P.
A.
films.
Take a look.
Okay, um that reservation
May have to wait just a-a little bit longer.
I'm sorry.
I mean, if you want
to reschedule, I totally
No.
Nonsense.
I'm-I'm happy to wait.
You are saving lives.
Least I can do is take you out
to dinner when you're done.
Thank you.
Did you-you ever pitch against Jeff Bagwell?
Once,
and it wasn't pretty.
You were right.
Get a C.
T.
to be safe,
and I'll stick around
to look at the results.
At least somebody's having a good night.
Good news?
Or not such good news?
Oliver, your second X-ray
is still concerning.
Dr.
Altman and I agree
that you should have a C.
T.
,
just to rule out anything serious.
And how-how long will that take?
Oh, that's my son calling.
He's worried we'll miss tip-off.
What should I tell him?
Do I need to tell him
we're gonna miss this game?
I wish I had an answer for you,
but I think it's a safe bet you'll be late.
Max.
Hey, buddy.
How's my little man doing?
Oh, daddy will be fine.
Don't you worry.
Don't worry.
You just worry about all
that popcorn we're gonna be eating.
Make sure he's on broad
spectrum antibiotics.
You booked an O.
R.
?
Wow.
It didn't hit any brain matter at all?
Doesn't look like it from this.
How long till Shepherd gets
down here to take a look?
He should be out of surgery any minute.
Good.
Longer that thing stays in there,
- the higher the risk of infection
- One, two
- Or abscess formation.
- Oh!
So now can we get outta here?
How is he, Grey?
Pupils are equal and reactive.
He's alert and awake.
- Can I get some more gauze for this wound, please?
- Yeah.
Reflexes seem normal.
Give me that.
I'm fine.
It's just
a little headache is all.
I've had hangovers worse than this.
All right.
What's the status on the blade?
- Well, about that
- Yeah, there is no blade anymore.
What, uh, what happened?
Sir, just lay back and
let me examine you, okay?
Could we just get a doctor, please?
I want to take a look at the C.
T.
s.
It's okay, bud.
It's okay.
- It's gonna be okay, Nathan.
- Mommy, help me.
- He's really hurting.
- Okay,
I'm gonna write an order for more pain meds.
It's okay, monkey.
I know you want to go home.
It'll just be a little while longer, okay?
It will just be a little longer, right?
Tyler, where is the O.
R.
for Nathan?
I haven't heard back yet.
Okay, well, let's call them again,
and let's call
the ortho team and make sure
they're ready to go, okay?
We will get to Nathan as
soon as possible.
I promise.
How's he doing?
Well, the blade went through his skull,
didn't hit any major nerves or arteries,
so he's gonna be fine.
- Flesh wound?
- Yeah.
I mean, that's the luckiest guy alive.
You're also pretty lucky, too.
It's past 6:30, and
we haven't had our date yet.
I'm swamped.
I can't leave.
I have one patient in C.
T.
,
another one waiting for an O.
R.
Well, your patient's C.
T.
isn't ready yet.
No.
And the O.
R.
you're waiting for isn't either.
So okay.
I mean, maybe I do
right at this precise moment
- have one minute, but it's a minute.
- That's perfect.
That's all I need is a minute.
I need a minute.
Hey.
What Aah!
Oh, sorry
- What?!
- No one.
It was nothing.
That room is occupied.
Uh, just never ask me what I might have seen
- or might not have seen in there.
- Okay, well,
If we can't go in there,
where are we gonna go?
I have an idea.
Where are we going?
Nowhere.
We're gonna do it here.
- Wait.
No we're not.
- Come on.
No! No way! Are you kidding me?
No.
Drop your pants.
- Come on.
I'll be quick.
I'll be in and out.
- Oh, my god.
Eyes up here! Seriously.
Are you kidding me?
No, I'm serious about this.
Where is your sense of adventure?
My sense of adventure
is down on the first floor.
- It's not in this elevator.
- Come on.
If not for me,
then do it for your future baby.
- Come on.
Turn around.
- I cannot believe I am doing this.
This future imaginary baby
of ours better be worth it.
Okay.
Here we go.
Ooh.
Oh, there it is.
Ouch.
Ooh.
There.
I told you I'd be quick.
Mm.
I can't wait to meet
our future fictitious baby.
Me either.
We got through those charts fast.
Floor seats, here I come.
So I just helped you get
through three dozen charts
in a fraction of the time
it would have taken you to do on your own,
basically ensuring you get
to your floor seats on time.
How long do I have to wait
till you ask me to go to the game with you?
Oh.
I I-I mean,
I was supposed to take Avery,
But screw him.
Sure.
You-you want to go?
No.
I'm on call tonight, actually.
I just wanted to see
if I could get you to ask me out.
Excuse me.
- Just admit it.
You like her.
- Shut up.
God, I don't think you
do understand, actually.
This has been going on since yesterday.
We took our son to an after-hours clinic
where he was misdiagnosed,
and then he was sent home
without so much as a painkiller,
and he was up all night crying.
And then this morning,
our pediatrician sent us here.
And now we've been
waiting around all day
with our 4 year old son.
Believe me.
I understand
that a kid with a broken leg
doesn't take precedence over
a guy with a knife in his head,
but my son is scared and he is in pain,
so could somebody please
just get to his leg already?
- Please.
- Yes, sir.
You still haven't helped that kid yet?
He's 4 with a femur fracture.
You know how much that hurts?
No, I know.
It's just
been one of those days.
- Tyler, isn't that O.
R.
ready yet?
- They're prepping it now.
Grey, my wife was cleared by Dr.
Torres.
You ordered a head C.
T.
for a broken wrist?
Yeah, I can explain that Sir.
I have some concerns
Dr.
Grey, they're calling from C.
T.
- Your patient's coding in the scanner.
- What?
They say he's coding.
Hold C.
P.
R.
V-fib.
Page Altman.
Give me the paddles now.
Charge to 200.
Clear.
Charge to 300.
Clear.
- Got a pulse.
- Yes!
Scans are up.
- Grey, talk to me.
- Uh, he was coding when I got here.
I defibrillated him three times.
I gave him three rounds of epi,
two of atropine.
I loaded him up with amiodarone,
but he's tachycardic now.
I mean, he's barely hanging on.
He needs surgery.
Book an O.
R.
- Okay.
I'll get a room prepped and ready.
- No time.
His aorta's dissecting as we speak.
He needs surgery right now.
They're saying all the O.
R.
s are booked.
Well, tell 'em to bump someone,
- 'cause we're come up either way.
- I have an O.
R.
Tell 'em to bump mine and
prep it for an emergency cardio.
- All right.
Here we go.
- Got it.
Go.
All right.
Let clear it.
Let's hold that elevator!
Come on.
Come on.
Come on.
Once these doors open,
we're gonna have to get him in the O.
R.
- And open him as soon as possible.
- I know.
Even then, if that aorta tears,
we may already be too late.
And we're not gonna have time to scrub.
I know.
I know.
Thanks.
Just pour the betadine
straight on to the chest.
It doesn't need to be pretty.
We need to get in there.
All right.
Plug me in.
Scalpel.
Here you go.
- Cautery.
- Here.
- Cauterizing now.
- Get in there quickly, Grey.
Time is myocardium.
All right.
Saw.
Get that retractor ready.
This guy thought he had
a bad case of heartburn.
He went from that to this
in less than 45 minutes.
That's how these work.
How's his pressure?
Retractor.
Every beat of his heart rips
this tear a little bit wider.
- All right.
- How many of these ruptured dissections
- Have you caught in time to operate?
- 40.
Maybe 50.
- How many have you been able to save?
- Three.
All right.
I'm in.
- Oh, no.
No, no, no, no, no, no.
Damn it.
- He's bleeding out.
His aorta is wide open.
All right, clamp.
- Come on! Come on! Come on!
- Here.
All right, Grey.
Let's try sucker bypass.
Cannulas.
It's not working.
There's too much blood.
All right.
Well, once we get him on bypass,
it'll be easier to control.
Heart's fibrillating.
All right.
Cardiac massage.
Paddles.
I've almost got him cannulated.
Charge to 10.
Clear.
Damn it.
He's bleeding
out of his nose and ears.
I've been loading him up with blood,
F.
F.
P.
and factor VII,
but I can't keep up with the losses.
Foley's full of blood, too.
He's D.
I.
C.
his cannula sites are oozing.
Let's push 3 of epi.
Set me up for another shock.
Clear.
- Damn it.
- Well, what can we do?
Just tell me what to do?
There's nothing.
His aorta is in shreds.
- Well, what about
- There is nothing left to do.
Call it.
Call it, Grey.
- No, I mean, we
- Grey, we got here too late.
These are almost impossible to catch.
There is nothing that we can do.
I'm sorry.
We need to call it.
Time of death 18:52.
Hey.
I heard you lost a patient.
You know, it's not that
I don't want to share you.
I mean, I don't want to share you,
but that's not the reason
I don't want you to be
Callie's baby's godmother.
Oh.
Okay.
It just seems like, if you agree to be
Callie's baby's godmother,
you're saying that
I'll never have a baby of my own.
Meredith, you know, I
I'm in no way saying anything that-that
I know.
It just feels that way.
Okay.
Okay.
Well, I, uh
Have to go have really
uncomfortable conversation
with Callie now.
How about you? What are you up to?
Oh, I have to contact Oliver's family.
Oh, hey, hey, hey, wait.
You got, uh
blood or something.
Thank you.
You're welcome.
Hey, chief.
- About earlier
- It's all taken care of.
I checked Adele's head C.
T.
myself.
It was clean.
Her wrist is in a splint.
And I'm taking her home now.
Well, I still have some concerns.
And if her C.
T.
was clean,
then I have even more concerns.
Thank you, Meredith,
but I assure you, Adele is fine.
Chief, she's been getting
things very confused.
Meredith, she is fine,
and I'm taking her home right now.
Why was she getting Christmas
decorations down in February?
Good night, Meredith.
And she said she had just
gotten home from work.
- Didn't she retire?
- Meredith
- Chief, something isn't right.
- Okay, that's enough.
Now I know what you're implying.
And while I appreciate your concern,
that's enough.
Adele had a scare today.
She had a fall.
Any number of things could account
for her mixing up a couple of details,
not the least of which is her
being interrogated by you.
Now if something bigger
were wrong with my wife,
I would know it.
You've got Alzheimer's on the brain.
I mean, you-you buy a car
and you start seeing it everywhere you look.
Now you've been working on
this Alzheimer's trial 24/7.
I get it.
But Adele is not your mother, Meredith.
She's my wife.
Now good night.
Hi.
I'm so sorry.
I got pulled into an emergency surgery.
Where is Nathan?
Actually, a-a doctor came by
to get him a little bit ago.
He's getting his casts put on right now.
Great.
That's great news.
Dr.
Grey, we have
a surgical abdomen in bed three.
Okay, let's just get Oliver Richter's chart.
Okay.
Hello.
Hi, Max.
This is No, it's your daddy's doctor.
Is your mom around?
An hour
one hour
can change everything
forever.
Well, we'll have to keep you
overnight for observation,
but your prognosis is very good.
Great.
So maybe we don't have to cancel
our Aspen trip after all.
I just had a stroke.
I know.
And you're worried about our travel plans?
Well it's a nonrefundable trip.
Cancel the trip.
You know what?
In fact, cancel all our trips.
How have I put up with you for two years?
I'm done with this.
We're done.
- Get outta here.
- Oh
Now, before you give me another stroke.
W-wait, wait.
Can I see your keys?
Yeah.
Okay.
Now you can go.
An hour can save your life.
So before he gets off the phone
and since I now have to go pee in a cup,
uh, I just have to say this
I basically spent the past hour
on a first date with William myself.
And I don't know how much
you know about the guy,
but this is what I know
um, he wears driving gloves.
Yeah, and he doesn't live with his mother,
but until recently he lived above her house,
and he used the word "Shant,"
and he wasn't being funny,
and he has yet to tell me
a story about himself
in which he is not the hero.
So as, uh, as your husband
I think we can do better.
Good news.
Not only was I
able to push the reservation,
but I also got us a table by the window.
Black truffle gnocchi awaits.
Ready?
Ready.
An hour can change your mind.
So when's your next break?
Okay.
Unh-unh.
No.
This will
never happen again at work.
Understood?
- Sure.
- Okay.
Until your next break.
Sometimes an hour is just
a gift we give ourselves.
All right, Stewart, you're choosing to leave
against medical advice,
so you're free to go,
but this is my number.
Now if you experience any
of the neurological symptoms
on this sheet, you call me, all right?
Somebody should stay with you tonight
and have plenty of fluids
Not beer.
Not beer.
Will do, doc.
- Thanks, doc.
- All right.
For some, an hour can mean almost nothing.
I can't believe he walked
in with a knife in his head
and is walking out an hour
later to go to a ball game.
Speaking of which
any chance you want to go to the game, too?
Apparently Karev didn't want
his floor seats.
So you interested?
Actually, yes.
Yes, I am.
For others
an hour makes all
the difference in the world.
Now, Nathan, when you wake up,
you're gonna have
two big casts on your legs.
But that's a good thing, because it means
it's gonna make your leg better, okay?
But right now, I have a very
important question for you,
And that is, what is your favorite color?
Blue.
Blue it is, then.
Let's prep the blue
casting material, please.
All right, I'm gonna take this mask, Nathan,
and I'm gonna lower it
But in the end
it's still just an hour
one of many
many more to come.
That's it.
And it starts all over again.
Hi, I'm Dr.
Grey.
I'll be your doctor today.
It says here you've been
experiencing some abdominal pain.
When did that start?
And who knows what the next hour might old?