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An Honest Mistake

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There’s this thing that happens when people find out you’re a doctor. They stop seeing you as a person and begin to see you something bigger than you are. They have to see us that way, as gods, otherwise we’re just like everyone else, unsure, flawed, normal. So we act strong, we remain stoic. We hide the fact that we’re all too human. Patients see us as gods or they see us as monsters. But the fact is, we’re just people. We screw up, we lose our way. Even the best of us, have our off days. Still we move forward. We don’t rest on our laurels or celebrate the lives we’ve saved in the past. Because there’s always some other patient that needs our help. So we force ourselves to keep trying, to keep learning. In the hope that, maybe, someday we’ll come just a little bit closer to the gods our patients need us to be.

An Honest Mistake is the sixteenth episode of the fifth season and the 94th overall episode of Grey's Anatomy.

Short SummaryEdit

Derek's confidence is shaken like never before as he faces off with Addison over what treatment is best for their dying pregnant patient, Jen. Cristina calls the abilities of a renown surgeon into question after she botches a standard procedure. Bailey, who has decided to pursue a fellowship in Pediatrics, is appalled by the Chief's less-than-stellar recommendation letter. Izzie gets some bad news and Callie asks Arizona out on a date.

Full SummaryEdit

Derek's looking at scans in Jen's room. Rob is sleeping next to her. She wakes up and Derek tells her good morning. She asks if he's proposed, but he says not yet. She'll be the first to know. Jen smiles. Rob wakes up and asks how she's doing. Derek says she's okay. Rob kisses her on her forehead. Meredith comes to check if she can get Derek anything, but he's good.

Alex joins Meredith outside the room. He says Addison thinks Derek's still beating himself up. Meredith says Derek's fine. Alex thinks it bugs Meredith that Addison is still hanging around Derek. She denies it. Derek comes out of Jen's room, where monitors are beeping. He asks Alex to ask Addison to stay. Meredith then admits it bugs a little.

Derek informs Jen they can't put the surgery off any longer. He hopes the procedure will stop the seizures. Jen's worried about the baby, but Addison says she'll be there to monitor them. Derek asks Addison for staying, but she's happy to after he saved Archer. Rob follows them outside and informs them he wants them to save his wife, should it come down to a choice. They can't make another Jen.

In the ER, Callie informs Cristina and Owen that her patient fell down a flight of stairs, which seems to have been caused by the cholecystectomy he had 5 days ago. Callie shows them the scar, which reveals the procedure was done non-laparoscopically. He had the surgery in this hospital, performed by Dr. Campbell. Cristina says that explains it. They distance themselves and Callie informs him that Campbell was Seattle Grace's first female surgeon, as pioneer as it gets. She mostly sits in her office spreading prestige around, but she still does routine surgery now and then. Cristina corrects her: she botches routine surgery. Owen wants her to page Campbell, but Cristina rather not have a dinosaur who refuses to retire. "The dinosaur is here," a voice behind her says. Campbell says there's no need to page her.

Callie asks Mark if he's had a chance to check out Arizona, but he hasn't. He's carrying a cup of coffee, but it's for Lexie. As he walks off to give it to her, Callie and Addison watch. Lexie doesn't want his coffee. She's done with him hiding in the attic, because it makes her feel like she's dating Anne Frank. Mark says he wants to tell Derek soon, and then she can be his date to Derek's wedding.

Arizona asks Bailey how she's feeling about her applications. Bailey rather keep her emotions to herself, but she does have several letters of recommendation, but not one from the Chief. Arizona says the Chief's is the only one that matters. Arizona is really excited to have her. Bailey reminds the Chief, who walks by, that his letter is due by the end of the day. He says she'll get it. George comes over and says he needs more time. It's not easy distilling a doctor of her stature to 500 words or less. Bailey chose him because he's the only one she can trust not to screw up.

The surgeons are taking Jen to the OR. Jen tries to tell Rob to only let the baby go to public school so he doesn't become a snob. Rob knows how she feels about that. He's sure Jen will be there for him. It's time to say goodbye. Jen tries to tell him she loves him. He knows. He loves her, too. He'll see her after the surgery. Addison is worried because her bp is a little higher, but Derek tells her not to worry. They're both great doctors and they can be good together. They walk off.

Graciella asks Izzie if they maybe get to scrub in today, but Izzie doesn't think they're ready to hold a life in their hands. Lorraine approaches Izzie. She was told she may have cancer by Izzie, and a lot of tests later, it turns out she's only anemic. Someone mislabelled the blood. Lorraine's lawyer told her not to come here, but her conscious told her to come say it, so the patient with the cancer gets the right diagnosis.

After some staring, Izzie opens the drawer and gets her own test results from a few days back that said she was anemic.

Derek and Meredith are working on Jen's brain. Jen's hypotensive, which has its effect on the baby. Addison says the baby needs to come out. The baby can't handle 3 surgeries in 4 days. Addison decides to take the baby out. Derek tells her to leave it in. He's done, which gets the pressure back up.

Callie tells John he won't need surgery to repair his fracture. John knew his wound wasn't healing as fast as normal, but he never expected this would happen. Campbell tells him to call her next time. She asks Cristina what she should have done differently to avoid this complication. Cristina says it should have been laparoscopically. Campbell asks Owen to explain why she chose to do it this way. Owen says some doctors believe the new technology is riskier as they can't see or move around during surgery. John feels Campbell did right. Campbell asks Cristina to take John to CT, as she might learn something in the process, while she will talk to Owen about the new course of treatment.

Izzie finds Bailey and says Sadie mislabelled blood, so the clinic might get sued. Bailey says it's a good thing Sadie no longer works here, then. Izzie is mad because all the interns are capable of the same mistake. This is personal, so she gets to be emotional. She's worked so hard to teach them. Bailey says she felt the same way about them, and the Chief always told her to get out when she went to complain.

Jen wakes up and sees Derek. She says he doesn't get a lot of rest. Everyone's relieved to see she's okay. Addison comes in and informs Jen that the baby is stable, but her new labs show that she's preeclamptic. They had hoped to keep it from progressing to this stage, but the stress of the surgery took a lot from her body. Rob asks if they need to be worried.

Outside the room, Derek tells Addison she should have waited, but Addison thinks it's a serious thing. Derek asks Addison stop fighting him on this. They just had a victory, and he wants to focus on that. Addison says it's their job to give patients all the information. Alex tells Meredith her guy won the round. Addison sends Alex off to the lab and asks Meredith for one good reason not to go to the Chief. Derek caused a series of complications by making a mistake in the first surgery and he feels responsible. Meredith says during their clinical trial, they lost a lot of patients. She thinks it changed him in a good way, as he cares more now. Addison just has to trust him. Addison says okay.

Callie approaches Arizona and greets her. She admits she's been avoiding Arizona after the kiss. This is a new adventure and she's so ready to take it for the second time. She asks if Arizona wants to go on a date with her. Arizona says no, as Erica was her first woman. Arizona says Callie is still experimenting, which is exciting for her, but Arizona tries not to hang out around newborns in her personal life. She is super flattered, though.

Richard gives Bailey his letter. As Bailey reads it, Callie comes over and talks about how there's nothing newborn about her. She wants Bailey to agree, but Bailey is too preoccupied with the Chief's form letter. Callie reads it. He described Bailey as fine. Bailey says she's better than fine. Callie says at least he didn't call her a baby.

John's in the scanner. Owen joins Cristina in the booth. He says Cristina's tough on people. No one's perfect in medicine. Cristina says years of experience mean nothing if you don't keep up. Owen says she can't judge Campbell on one patient. The scans come up, which shows a severe mistake.

Izzie finds a private room and starts checking her skin in front of a mirror. She finds a mole on her back.

Cristina is in Richard's office. She's charging Campbell with negligence. Richard asks if Owen agrees. He says it's Cristina's call. Owen says Campbell outranks him, so it's better if he talks to Campbell directly. Richard decides he wants to speak to John before the surgery. "Way to take a stand," Cristina says as she walks past Owen.

Mark finds Derek and asks about his patient. Derek says she's stable. Today's the first time since a long time that he remembers what it feels like to be good at his job. Mark compliments his skills and his looks, especially his facial beard. Mark says he wants to discuss something. Derek tells him he can have sex with Addison, but Mark says that's not it. He then says it's nothing. Derek leaves.

Meredith sits down with Cristina, who's reading another one of Ellis's journals. She tells Meredith she and the Chief fought so much that the sex must have been great. Meredith says that's wrong. Izzie sits down with them. Cristina finds an entry that mentions Campbell and her adequate techniques. Cristina likes that Ellis stopped operating when she got sick and didn't try to continue. Alex mentions Derek is also trying to cover his ass after knicking the aneurysm. Meredith and Alex get paged.

Jen is moaning in pain as Derek informs them the patch must have blown. He asks them to page Addison as they need to get down to the OR right away. They move Jen and Meredith tells Rob she'll come update him.

Derek swears in the OR as the swelling's not going down. He decides he has to take out the temporal lobe. Addison explains it won't kill her, but it will affect her speech and memory. Derek says the brain can rewire. He's done it before to stop seizures. Alex says the baby's got decels again. Addison asks Derek what he's doing. He keeps on operating.

Alex wonders what to tell Rob as they're on their way to see him. Meredith says they'll tell him the truth: that Derek is doing everything he can to save Jen's life and the baby's. They arrive in the waiting room. Alex tells that despite the baby's heart fluctuations, Addison is doing everything she can to avoid early delivery. Meredith says Derek is trying to control the bleeding, but they won't know more until the surgery's finished. Rob asks if Jen will die. Alex says Derek is doing everything he can to make sure she lives. They return to the OR. Meredith thanks Alex.

Richard tells John that his scans show a change from Dr. Campbell's original assessment. There was a complication. He has a lacerated bile duct and artery. He needs surgery to repair it. John's relieved that that's it, as he thought he was going to die when they said the Chief of Surgery was coming to see him. Richard clarifies John can choose another surgeon. John decides to stick with Dr. Campbell. 

Cristina follows Richard outside and says she thinks the patient is not entirely clear on what happened. Richard says she heard the patient. Cristina wants to object, but Richard tells her to back down. 

George tries to get Izzie to read his letter for Bailey, but Izzie's mad at Bailey for not listening to her. They enter the dermatology department. Izzie tells him to write how she used to be. He should probably go. George comes up with dependably selfless and thanks Izzie. He leaves and Dr. Daisy Pepman calls Izzie's name.

Richard enters Campbell's OR. She says it's been a long time since she's had him in her OR, the last time being when he dropped a clamp in a body cavity. She remembers that as he was her student. She wonders how the upcoming classes learn anything with the way they teach these days. Attendings seems to use encouragement to teach instead of instilling residents with fear and shame that causes one to remember in the first place. Owen agrees the rigid part of his training made him the doctor he is today. Campbell thinks Cristina never really faced fear in the OR. Cristina says she'd appreciate any opportunity to learn. She asks Cristina how she'd do a pulmonary embolectomy. Cristina would use a steerable catether and a fluoroscope. Campbell asks what if the power would go out, or if she were to operate in a hospital without a fluoroscope. She thinks just because there's a machine for it, it shoudn't always be used, like a calculator. Cristina says it should if it helps to avoid mistakes like this one. Everyone is shocked. Campbell throws her out.

Jen's bleeding into her frontal lobe. The baby's decels are getting longer. Addison says she has to deliver. Derek says no, as Jen's lost so much blood that the cut would kill her. He can save her. Addison asks how. He has to cut out the frontal lobe. Addison tells him to stop. He's done enough. Addison knows he wants to save Jen, but he's done enough. Not this way. Derek says he can save both. Addison objects that she'll lose everything that makes her human. Meredith asks Derek if he can do this. He says he has no choice. Addison says he's creating a monster. He doesn't get to play god. Jen is gone, but the baby has a chance to live. He has to let it go. Addison decides to get the baby out. They both tell each other to put the scalpel down. Addison sends out Alex. 

Derek keeps on working. Addison turns to Meredith, who tells Derek that it's too late to save Jen. She asks Derek to look at her.

While scrubbing out, Campbell tells Richard and Owen she made a careless mistake and she's sorry, but she's only human. For that, she does not apologize. She leaves. Alex comes in to take Richard to OR 1. Owen tells Margaret he was fired from the army, an honorable discharge. They knew it was his time, even though he didn't. He's grateful for that.

Derek has removed Jen's frontal lobe. Addison tells Richard she needs to take the baby out. Derek says the bleeding could stop and the baby could stabilize. Jen will die if they do a C-section now. Addison says Jen is dead already with most of her brain gone. Addison tells Alex to inform peds they have a preemie on the way. Addison makes the cut. Derek asks Meredith to go get more blood. Richard says no.

Daisy is looking at Izzie's mole. She wouldn't worry too much. Izzie asks even with high LDH levels. Daisy says that could have multiple causes. Izzie mentions the hallucinations. Daisy says patients can convince themselves they're sick. As doctors, they both know that it's their job to remain worry-free until they have actual proof. Tomorrow, she'll have her results.

Addison delivers the baby boy. He definitely has a chance, Arizona says. Jen flatlines. Derek leaves the OR.

Jen's doctors are talking to Rob, telling him they're very hopeful the baby will make it. Rob doesn't understand Jen just died. Derek says he's sorry. Rob knows that, but he wants to know how she died. Meredith says they believe Jen's high blood pressure caused the bypass to fail, which caused the bleeding and swelling in the brain. There was too much damage to her brain to save her, and then Addison stepped in to save the baby. Rob lists what they all went through, and Derek always told them he fixed it. Rob says Derek's a murderer. Rob wants his wife.

Bailey is reading George's letter. She shows it to Richard and tells him this is a letter of recommendation. Richard can't believe he should take pointers from O'Malley. Richard just walks off and Bailey follows him.

In his office, Richard says he does not have time to write letter to boost her ego. His head of neuro is called a murderer, his oldest general surgeon won't retire so he has to fire her, interns are mixing up blood samples in the clinic, and Bailey wants him to write a letter so she can leave him? A career in peds is not what they discussed, so Bailey's wasted a lot of his time. She was supposed to be the next him. Bailey says he doesn't get to pin his hopes and dreams on her.

Derek's gathering himself on the catwalk. Mark comes over and says he's seeing Lexie. It's more than sex. They're happy. Derek punches him in the face. Mark says he maybe deserved that, but then changes his mind. Derek has no right to tell him who he can sleep with. Derek then punches Mark again. Mark punches him back, causing Derek to fall. Derek pulls Mark to the ground and repeatedly punches Mark. As they keep on fighting, Owen joins the crowd that's formed.

in the Chief's office, Richard's attention is drawn away from Bailey by the fight. They rush out of the office as Owen pulls Mark off Derek. Addison and Meredith come over. Meredith walks away with Derek as Alex tells Addison that Derek's her guy now.

Campbell is in the gallery. Cristina comes in and says she'd do a pulmonary arteriotomy to visualize the clot and use forceps to extract it. That's how she'd do a pulmonary embolectomy with a fluoroscope. Campbell says that the fact she came here to tell her that, tells her that Cristina is a much better surgeon than she first thought. Campbell has decided today's surgery was her last. Campbell says not too long from now, Cristina will wake up and find that she is Campbell. She wonders what Cristina will have when she can't cut anymore. Campbell was a god in the OR, but now, she's nothing.

Izzie's with the interns as Bailey comes over. Bailey says the interns seem fine. Izzie says they only screw up when you're not looking. Bailey apologizes for earlier. She was busy with herself. Izzie says she was right. She needed to vent as she's sick of this place. Bailey says she saw Derek punch a man because he was sick of it. That's how it works. The patients they lose and their mistakes is how they learn. Bailey tells her that if she can find another way, she'll be a better doctor than all of them. Bailey walks off, and Daisy approaches Izzie.

Callie has put Mark's hand in a splint. It's not broken, but he should ice it. Lexie comes in and says she's sorry. Mark says it was worth it. Lexie smiles and thanks him.

Callie goes to Arizona at the bar. She says she has experience to give. She has life experience. She was married, and she was in the Peace Corps in Botswana. That convinced her to go to med school. Recently, she's discovered cooking, and she can make delicious meals that Arizona would be lucky to get to experience. The fact that Arizona can't open her eyes to see that makes her a little inexperienced. Arizona then introduces Callie to Julie, her date. Callie takes a sip from her drink and leaves awkwardly.

Addison finds Bailey and gives her a letter of recommendation, figuring it's the least she could do before returning to Los Angeles. Bailey thanks her. Addison tells her to kick ass so she doesn't regret writing that Bailey is the most promising peds surgeon she's ever had the pleasure of working with.

Owen sits down with Cristina at a table. He tells her she was both a teacher to someone who needed to learn as a bully to someone who needed compassion. Cristina denies that she was a bully. She was right. Owen says Cristina's a lot like Campbell: stubborn, opinionated, and smart. Forty years from now, he'll have to pry the scalpel from Cristina's hand, too. Cristina says from her cold, dead hands. Owen says she's missing the point. He wants to be around her forty years from now.

Rob is saying goodbye to Jen. He gives her one last kiss. He leans on Alex and breaks down.

Meredith sits down with Derek on the couch. She pours him a drink, which he immediately downs. He pours himself another one.

Izzie's gathered the interns and tells them they're unmotivated, selfish, careless, and distracted, so she wouldn't trust them with her life. But, that is the way it's supposed to be. They're babies. They're lucky to work here, because they get to save lives. That's their job. Not a lot of people get to do that. Izzie has a new game. She shows them scans and says this is Patient X. They misdiagnosed this 29-year-old woman with anemia when she came to them for the first time. She says not to make that mistake again.

CastEdit

  • Meredith Grey
  • Cristina Yang
  • Izzie Stevens
  • Alex Karev
  • George O'Malley
  • Miranda Bailey
  • Richard Webber
  • Callie Torres
  • Mark Sloan
  • Lexie Grey
  • Owen Hunt
  • Derek Shepherd
  • Addison Montgomery
  • Arizona Robbins
  • Jen Harmon
  • Rob Harmon
  • Daisy Pepman
  • John Terzian
  • Ryan Spalding
  • Dr. Margaret Campbell
  • Lorraine
  • Intern Steve (right)
  • Intern Graciella
  • Intern Megan

Main CastEdit

Special Guest StarsEdit

Guest StarsEdit

Co-StarringEdit

UncreditedEdit

  • Unknown actress as Julie

Medical NotesEdit

Jen HarmonEdit

  • Diagnosis:
    • Pregnancy
    • Aphasia
    • Mini-strokes
    • Hypertension
    • Pre-eclampsia
  • Treatment:
    • Steroids
    • EC/IC bypass
    • Temporal lobectomy
    • C-section delivery

Jen was still in the hospital three days after surgery. She had a lack of blood flow through a vessel, which caused mini-strokes and aphasia. Derek planned an EC/IC bypass. The baby started having decels, so Addison planned to do a c-section, but Derek finished what he was doing and the baby stabilized. After surgery, she was able to speak normally. Her baby was stable, but she had pre-eclampsia. Later, her patch blew and she had to be taken back into surgery. Derek decided he needed to take out her temporal lobe. When that didn't stop the bleeding, he tried to remove her frontal lobe. However, they stopped him and Jen was pronounced dead after her son was delivered.

John TerzianEdit

  • Diagnosis:
    • Ankle fracture
    • Lacerated bile duct
    • Lacerated artery
  • Treatment:
    • Casting
    • Surgery

John, 52, came into the ER after falling down the stairs. He was five days post-op from a cholecystectomy. He'd had an open procedure rather than laparoscopically. His ankle fracture was minor, so Callie told him he wouldn't need surgery and casted it. Campbell sent him to CT, which revealed a lacerated bile duct and artery. Campbell operated to fix the problem.

LorraineEdit

  • Diagnosis:
    • Anemia
  • Treatment:

Lorraine came back into the hospital to tell Izzie that while they had sent her to an oncologist because they believed she had cancer, she was actually just anemic. She believed someone had switched the blood with someone else's. She told Izzie so that she could find the person who got her diagnosis and actually had cancer.

Izzie Stevens/Patient XEdit

  • Diagnosis:
    • Mole
    • Cancer
  • Treatment:
    • Mole removal

After Lorraine came back in and said her test results had been mixed up, Izzie searched her body for signs of cancer. She found an unusual mole on her back, so she went to dermatology to have it removed. Dr. Pepman didn't seemed worried about it, but she later came to Izzie with the results. Izzie used her case to teach the residents, calling herself Patient X.

Baby HarmonEdit

  • Diagnosis:
  • Treatment:
    • Intubation
    • NICU Care

Addison delivered Jen's baby at 24 weeks. He was taken to the NICU after birth. They were hopeful because Jen had been given steroids, which allowed his lungs to develop more.

Mark SloanEdit

  • Diagnosis:
    • Bruised hand
  • Treatment:
    • Ice

Mark got in a fight with Derek and injured his hand. It wasn't broken, but Callie told him to keep ice on it.

MusicEdit

Song Performer Scene
"Turn the Page" Matt Hires
  • Jen wakes up and talks to Derek.
  • Alex and Meredith talk about Derek and Addison.
  • Derek asks Alex to page Addison.
"Error Error" Dash and Will
  • Meredith, Cristina, Alex, and Izzie talk about Ellis's journal and Campbell.
  • Meredith and Alex get paged to Jen's room.
"Twice" Little Dragon
  • Richard intervenes on Jen's surgery.
  • Daisy Pepman takes a biopsy from Izzie's mole and tries to calm her.
  • Addison delivers the baby.
  • Jen dies and Derek leaves the OR.
  • The surgeons deliver the bad news to Rob, who blames Derek for what happened.
"Like a Ghost" Calahan
  • Callie accidentally interrupts Arizona's date.
  • Addison gives Bailey a letter of recommendation.
"The Planets Bend Between Us" Snow Patrol
  • Owen and Cristina talk about Campbell and him being around.
  • Rob says goodbye to Jen.
  • Meredith and Derek drink.
  • Izzie has decided to teach the interns through a case study of Patient X.

Notes and TriviaEdit

Grey's Anatomy 5x16 An honest mistake Promo01:01

Grey's Anatomy 5x16 An honest mistake Promo

  • This episode's title originated from the song An Honest Mistake, originally sung by The Bravery.
  • This episode scored 15.39 million viewers.
  • This concludes the Grey's Anatomy-Private Practice Crossover.

GalleryEdit

Episode StillsEdit

QuotesEdit

Callie: Campbell is Seattle Grace's first female surgeon, as pioneer as it gets. Mostly she just sits in her office and spreads prestige around.

Campbell: Look it's like a calculator: just because there's a machine to do it for them, children shouldn't have to learn simple arithmetic?
Cristina: If it would help them to avoid mistakes like this one.

Miranda: He used the word "fine". A blank page would mean more. I pulled off a 12-person domino surgery. I took out and put back six of a dying girl's organs. I am Dr. Bailey. I am better than fine.

Campbell: I've decided today's surgery was my last. You look at me like you won't wake up one day not that far from now, so much faster than you can imagine, and find that you are me. When you can't cut anymore, what will you have? I was a god in this O.R., holding a scalpel. I was a god. And now... What will you have?

Izzie: You're unmotivated, you're careless, selfish, distracted and pretty much the people in this hospital I would least trust with my life. But that's the way it's supposed to be. You're interns. You're babies. And you're all lucky to work here. We're all lucky because we get to save lives. Every day, we get to save lives. That's what we do. That's our job, and it's not something a lot of people get to do.

Callie: I have experience to give.
Arizona: Calliope...
Callie: Life experience, like the fact that I was married. Did you know that? Or that I was in the peace corps? Botswana. That's what convinced me to go to med school. And most recently, I've, uh, experienced the joy of cooking. Yeah. I make an excellent chicken piccata in addition to many other delicious meals that you'd be very lucky to experience yourself. And the fact that you can't open your eyes to see that makes you inexperienced.
Arizona: Calliope, this is Julie. My date.

Owen: Today you were a teacher to someone who needed to learn, but you were also a bully to someone who needed compassion. You were both.
Cristina: Well, I wasn't a bully and I was right.
Owen: Right. You know, you're a lot like her. Stubborn, opinionated, smart. 40 years from now, I'm gonna have to pry that scalpel out of your hand, too.
Cristina: From my cold, dead hands.
Owen: You're missing the point. I want to be around 40 years from now.

See AlsoEdit

A complete overview of this episode's crew can be found here.

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