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Let the Truth Sting

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Doctors give patients a number of things. We give them medicine, we give them advice, and most of the time, we give them our undivided attention. But, by far, the hardest thing you can give a patient is the truth. The truth is hard. The truth is awkward, and very often, the truth hurts. I mean, people say they want the truth, but do they really? The truth is painful. Deep down nobody wants to hear it, especially when it hits close to home. Sometimes we tell the truth because the truth is all we have to give. Sometimes we tell the truth because we need to say it out loud to really hear it for ourselves. And sometimes we tell the truth because we just can't help ourselves. And sometimes, we tell them, because we owe them at least that much.

Let the Truth Sting is the third episode of the fourth season and the 64th overall episode of Grey's Anatomy.

Short SummaryEdit

Callie hides in her office, frustrating Bailey who's itching to teach someone. Elsewhere, age becomes the theme as Izzie tries to convince 'Really Old Guy' he shouldn't die, Webber and Sloan set out to prove they're not too old to learn a new technique, and Karev is saddled with an intern who's past his prime.

Full SummaryEdit

Izzie is pacing in front of the elevators.

Alex and Lexie are riding an elevator. Their eyes meet and they smile. The other interns get on and they're talking about how George is the best intern ever. Alex scoffs, but Lexie gestures at him to keep his mouth shut. The doors open and Alex tells Izzie that the others don't know that George is a repeater. She doesn't care.

Derek ends up on an elevator with Meredith and Cristina, who notices the awkwardness between him and Meredith. As they get off, Cristina tells Izzie that Meredith is doing McDreamy and lying about it. Izzie herself is disappointed that George is not on the elevator. Cristina thinks Meredith is lying because she thinks Cristina can't handle it because of the stuff with Burke. "Poor Cristina," Izzie says, and Cristina agrees before walking off.

George gets off the next elevator. Izzie asks him what happened, but he quickly shakes his head as Callie follows him off the elevator. Izzie looks on as the two walk off together.

Meredith and Derek finish having sex in a supply closet. This is secret break-up sex. Derek asks if the secrecy thing is about Cristina. Meredith doesn't know what to do. She and Cristina don't talk about the Burke thing. By being with Derek, she's cheating on Cristina by not being a good friend. 

Alex gives their interns their assignments. Richard comes over with Dr. Norman Shales. He's transferring in from UCLA. He is an intern. Alex is surprised, because Norman is old. Norman and Richard agree that age is just a number. Alex thinks it's an important number.

Meredith meets with Cristina at a nurses station. Cristina acts all sad, claiming the Burke thing is hitting her now. She doesn't want to talk about it yet. She just wishes she had a bloody surgery, because that would make her feel better. She walks off with her interns.

Mark, Richard, Meredith, and her interns enter Connie's room. Her friends Joanne and Elaine are with her. They all think the doctors are very pretty. Connie asks Richard about Adele. He replies they're dating again, and she agreed to a date tonight. He asks how she's doing. Connie had a small tumor removed from her tongue, and now she's here to have the rest removed. Mark has bad news. The cancer has spread more than they'd hoped. It's in more than 60% of her tongue, meaning the best option is to replace the tongue with a microvascular free-flap. They'll use flesh from her leg. She'll be able to breathe and swallow, but it's uncertain if she'll be understood when she talks.

Alex and Norman enter the clinic. He wants to leave Norman with Bailey while he trolls for surgeries. He suggests a favor for a favor. She wants to collect her favor now. She tells him to take care of curtain five.

Alex and Norman introduce themselves to Hunter and his mother Mary, who is convinced her son's on drugs. He's lethargic, irritable, and his schoolwork's gone down the drain. Hunter insists he's not on drugs. Alex says a drug test will be included in the ordered test. Norman knows about a mother's instict from his own family.

Izzie drags George into Really Old Guy's room and asks what happened with Callie. He tried to tell her, but she wouldn't let him. He wanted to kill her but than he remember sh helped him through a lot of stuff, but then again, who marries someone who just buried their father? Then he just went to bed. Izzie's interns appear in the doorway for rounds. They'll start with Really Old Guy. He's been semi-comatose for a year after a fall. Izzie says treatment is simple: daily labs and dialysis three times a week. Suddenly, Really Old Guy tells her not to bother with more dialysis. He's planning to die today. Izzie is shocked that he's woken up. He says it's nice to meet her, but his name is Charlie Yost.

Meredith and Alex appear in the doorway, having heard the news about Charlie. He knows who they are and what happened in their lives. He could always hear them as he was semi-comatose. Izzie thinks his kidneys may be working again, which may be why he woke up. Charlie says it just means he's gotta pee before he dies.

Richard brings up functional muscle transfer to Mark. They could microsurgically reinnovate her hypoglossal nerve. Mark thinks a nerve graft is too risky. Richard says Connie loves to talk, so this procedure could give her a chance at that. Mark is on the fence. George wonders why a surgery neither of them has ever done would be better than one that would give her a normal life. Richard and Mark take it that he thinks they are too old to learn new ways. They say they still got it, and decide to go for the functional muscle transfer. Age is just a number.

Bailey finds Callie doing paperwork and tells her that Alex is in the clinic with her, and that he's clearly not interested in teaching. Callie thanks her for letting her know, but she doesn't seem too interested.

Derek sits down with Mark, who asks if he ever feels old, like new techniques are passing him by. Derek jokes he's a genius and a scholar. Derek says Meredith isn't telling Cristina about them. Mark figures out that Derek thinks that Meredith will grow up and want to get back together.

Cristina sees Meredith approaching in the ER and she starts sighing and acting all sad again. Meredith is on the tongue surgery while she's stuck in the pit with her stupid interns. Meredith asks if they're ever gonna talk about the Burke thing. Cristina says she's not like Izzie lying on the bathroom floor. She's gonna lie here, on the counter. Meredith says Cristina can have the tongue surgery to make her feel better. Meredith walks off. Alex witnessed the whole thing and says he knows Cristina was pretending. He wants to try it too, so Meredith will maybe take his new intern. Cristina tells him to find his own pretend emotion.

Charlie is calling for Blondie. Izzie says she's too busy. Charlie wants lobster for his last dinner. Izzie says he's not dying. Charlie says it's just not worth it anymore. All his friends and family are dead or on their way to dead. She'll know it when she's older and less naive. She says she's not naive, but he thinks she is. George is not gonna leave his wife. Guys always say that, but there are no signs he's really gonna do it.

Meredith tells Lexie she's taken over from Cristina in the ER, so she can come to her with her questions. Lexie has a lot of questions, but no medical ones. A new patient is brought in by paramedics after a car accident. Meredith takes Lexie with her into the trauma room and allows Lexie to try and intubate. She gives her pointers, but Lexie panicks a little.

They just called time of death on the patient. Meredith tells Lexie it wasn't bad for her first intubation. Lexie thinks it's a joke as the guy is dead, but Meredith says he was dead on the scene. They brought him in because they're legally obligated to, like Meredith is obligated to teach Lexie. Lexie is mad, but not about the patient. Meredith sends her off to go help Bailey in the clinic.

George is doing research for the tongue surgery. Izzie joins him and talks about Really Old Guy. She wants to make sure George is going to tell Callie. George would like to do his research, and reminds Izzie that she didn't want him to tell Callie just yesterday. She angrily leaves.

Norman tells Mary that Hunter is not on drugs. The tests came back clean. He's fine. Norman says he's raised 4 teenagers himself. Suddenly, Hunter shows signs of dysphasia. Alex orders a full head CT and labs.

Connie's friends are comforting her while George is examining her. Connie wonders what if the surgery doesn't work. She has still so much to say. Her friends decide to let her say anything now. Connie is doubting, but George tells her she should say it if she has something to say. Connie tells Joanne she needs to buy pants that aren't so tight. She tells Elaine her breath is really bad, and she needs a new hairdo.

Tyler is trying to stop Charlie from pulling off his monitor leads. Charlie wants to die now and he doesn't hear that pulling off the leads won't help him. Izzie pulls off some more wires to "help him", until Charlie goes into cardiac arrest. Izzie swears to Tyler she didn't do anything.

Izzie uses the paddles to shock Charlie twice, which brings him back. Charlie opens his eyes and asks her to stop saving his life.

George is on his way to the OR with Connie, who can't believe she said all that. She wonders if her friends will forgive them, and then blames George for urging her to tell those things. He says he's really sorry.

Lexie arrives in the clinic and says Meredith didn't want to work with her anymore. Bailey says the clinic is not a dumping ground for strays. Lexie really doesn't want to go back. Lexie feels that Meredith hates her, her father, and her mother, so she'd really like to work here today. Bailey tells her to go stitch up a kid in curtain three.

Derek joins Norman and Alex in the CT boot. He's surprised to find out Norman's an intern and welcomes him to the program. Hunter's scans come up. He has hydrocephalus and it's pushing against his Broca's area, which explains the dysphasia. Normas was sure it were drugs, but that's what happens when you've been a pharmacist for 30 years. Derek says they need to put in a shunt. Alex tells Norman to go book an OR. As Norman leaves, Alex tells Derek Norman doesn't know when to shut up, but he doesn't feel comfortable yelling at him.

Cristina finds Izzie. She's heard about Really Old Guy. She smilingly walks off as she's on her way to the tongue surgery. Meredith comes over, just in time to see Cristina walking away with a smile on her face, and she realizes Cristina is faking sadness. Izzie is too occupied with her own problems to mind Meredith and Cristina's fake drama.

Charlie says it's polite to let someone die if they want to. Izzie says it's a lawsuit in a hospital. Charlie really does his best to die, but to no avail. She asks if he really thinks George won't leave his wife. Charlie says that if someone really wants something, they do it. Charlie says he may be wrong. Maybe George and Izzie will end up happy, but he won't be around to see it. Izzie repeats she won't let him die.

Bailey finds Callie, who's still doing paperwork, and tells her about the way Meredith and Cristina treat their interns and the family feud between the Greys. Callie is not interested. Bailey asks her if she's coming out of this room to do her job at some point, but Callie wonders why she'd do that when Bailey clearly does it so much better. Callie has no more fight in her, so she's doing paperwork. Bailey leaves.

Mark and Richard are operating and if they continue at this rate, Richard will be able to make it to his date. Suddenly, they're stuck. Since they've never done this before, they're not sure what to do next.

Mark and Richard go over their options. They conclude they need someone who knows nerves. Richard sends out George to get Derek.

George has told Derek about the procedure. While Derek continues his way to the OR, George stops to talk to Izzie. Izzie says she's the other woman here. George says they're not in this together. Izzie doesn't get to be mad. George is the one who has to destroy Callie. This is about him and Callie, who is a wonderful woman. This isn't something you just blurt out. He'll do, but Izzie has to back off and let him do it. Izzie apologizes.

Bailey can't believe Meredith traded her surgery for the pit, but however that happened, it ended with Meredith dumping Lexie with her. Meredith tells her about the intubation. Bailey says Lexie thinks that Meredith hates her and her mother. Bailey points out that Meredith was Lexie's mother's doctor and that Meredith hasn't had a kind word for her sister ever since she got here, so it's only logical that Lexie thinks Meredith hates her. Bailey tells Meredith she has to help Lexie to be a better doctor.

Tyler tells Izzie that Charlie is leaving the hospital. Izzie says he can't leave as he's sick, and she got him lobster.

Hunter has collapsed in the clinic. Alex checks his pupils and says Hunter's brain is starting to herniate. He asks a nurse to page Derek. They get Hunter on a bed and Alex explains that the spinal fluid is putting pressure on Hunter's brain. The nurse tells Alex that Derek is not answering. Bailey doesn't know what to do next and tells Alex to go get Shepherd.

Alex runs to the OR and tells Derek about Hunter. Derek can't leave the OR but he tells Alex to do exactly as he says, or Hunter will be dead in the next 10 minutes.

Alex arrives back in the clinic and finds a needle. Mary demands to know what he's doing and Norman backs her up, but Alex orders Norman to get her out of here. Alex tells Bailey that Derek told him what to do. Alex uses a wooden spatula to create room in the eye socket and uses the needle to drain some fluid.

Izzie walks into Charlie's room. Charlie is sitting in a wheelchair, looking out the window. Izzie says she knows he feels like his life is over and like he has nobody, but his life's not over. And he has her. She needs somebody to talk to. She thinks George won't leave his wife, so she needs him to tell her what to do. Charlie doesn't react, so Izzie checks on him. He has died.

Alex tells Mary that once they get the shunt in, the excess spinal fluid will be drained to his abdomen. Hunter's gonna be okay. 

Alex walks over to Norman and apologizes for yelling at him earlier. Bailey interferes and tells him not to apologize. Norman got in his way and he's been doing that all day, which is not what's best for the patient. Alex almost misdiagnosed Hunter because Norman interfered. She doesn't care how old Norman is, because he's an intern. They are not hard on interns because it's fun, they do it because this is a life and death job. The pecking order saves lives.

Mark, Derek, and Richard are scrubbing out. The surgery was a success. Richard's happy to see he still got it. Mark says they need to figure out what he's going to tell Adele. He can't tell her he wants to move back in because it reeks of desperation. Derek can't hear them anymore. They were this close to Connie losing her tongue if it weren't for him. They had no business doing that surgery, so shame on them. As for Adele, Richard should tell her the truth, that he can't imagine his life without her and that he's constantly thinking about her.

Meredith walks with Cristina and says she's figured out what Cristina needs to get over her sadness. She needs Meredith and her time so they can talk to get to the root of Cristina's feelings. They can talk and cry all night long. Cristina figures out that Meredith knows about the faking. Cristina says she also knows that Meredith is sleeping with Derek. Cristina says lying is not protecting her. That's not what they do. She's dealing the best she can. So, she owes Meredith a surgery and Meredith owes her sex details. Alex comes over, because it's time to do something.

They enter Charlie's room, where Izzie is waiting for them. George comes in, too. Cristina wonders what they're even supposed to say as they don't know the guy. Izzie says they ate lunch in here for a year, so a few kind words is the least they can do. George says he didn't snore too loud. Meredith says he never complained and always took his meds. Alex says he hardly ever farted and survived 12 surgeries this year. Cristina says she got to practice stuff on him, which was good. Izzie says Charlie was a mean and stubborn bastard, but he was a bastard who knew what he wanted. He proved that if you're determined enough, what you want will happen eventually. That gives her hope.

Connie wakes up and George tells her it's looking good. George hasn't seen her friends, but they come in only seconds later. She has a very good chance of talking again. They start talking about the flaws of her husbands and boyfriends.

Meredith finds Lexie in the clinic. She has Susan's death note. She knows everything about her death is in there, because she wrote it. She'd like to go over it with Lexie. First of all, everything that happened had a 1% chance of happening. Her mother was the 1%. Meredith says she was very fond of Susan.

Bailey goes back to Callie. She says she's been having trouble with this whole pecking order. She's used to being #1, but she's not anymore. The best she can come up with is to be the best damn #2. She will be Callie's #2. She will help her. They'll work like a team, because Callie seems to be having a hard time. Bailey is having a hard time, too, but together, they can do this.

Lexie, Alex, George, and a bunch of interns are on an elevator. The interns are talking about George's work on the tongue surgery. Alex says George is a repeater. That's why he knows so much stuff. If the interns really want to learn from someone, they should go talk to a resident. George says Alex is right. He gets off the elevator. Norman gives Alex a look. "Interns," Alex tells Lexie and he scoffs.

George enters the hotel room, where Callie's lying on bed. She sits up and tells George to just say it. He says he slept with Izzie.

CastEdit

  • Meredith Grey
  • Cristina Yang
  • Izzie Stevens
  • Alex Karev
  • George O'Malley
  • Miranda Bailey
  • Richard Webber
  • Callie Torres
  • Mark Sloan
  • Lexie Grey
  • Derek Shepherd
  • Norman Shales
  • Connie
  • Mary Chapman
  • Joanne
  • Elaine
  • Really Old Guy
  • Hunter Chapman
  • Nurse Tyler
  • Ray Sutera the Paramedic
  • E.R. Nurse Melanie
  • Intern Laura
  • Intern Dani (far left, with Lexie and Cristina)
  • Intern Claire (second from right)
  • Intern Graziella
  • Intern Mitch
  • Intern Megan (second from left)
  • Intern Lucy (far right)
  • Intern Steve (far left)
  • Intern Leo Byrider (second from left)
  • Clinic Nurse
  • Code Nurse

Main CastEdit

Guest StarsEdit

Co-StarringEdit

Medical NotesEdit

Connie WilliamsEdit

  • Diagnosis:
    • Tongue cancer
  • Treatment:
    • Hemi-glossectomy
    • Functional muscle transfer

Connie was in the hospital with cancer in her tongue. It had spread more than they expected and they believed they'd have to remove most of her tongue and replace it with a free-flap which would give her tongue the bulk it needs for her to breathe properly, chew, and swallow. But he did not believe she'd be able to speak understandably. Seeing her reluctance, Richard proposed an alternative solution to Mark, a functional muscle transfer, which would allow her to speak normally. They attempted the surgery, but were unsure if they'd done it correctly, so they paged Derek, who helped them finish. Connie woke up after surgery and was expected to be able to talk.

Hunter ChapmanEdit

  • Diagnosis:
    • Dysphasia
    • Hydrocephalus
    • Brain herniation
  • Treatment:
    • Shunt placement

Hunter was brought into the clinic by his mother, who believed he was using drugs. He was lethargic and irritable and his grades had gone down. Alex said they'd run tests and his mother insisted on a drug test first. His drug test came back clean, but he presented with transient dysphasia, so they did a head CT and labs. The CT showed that he had hydrocephalus and it was pushing up against Broca's area, which caused the dysphasia. He passed out in the clinic. His brain was herniating, so Derek talked Alex through using a large needle to reduce the pressure. Then he was taken into surgery to place a shunt to drain additional fluid to his abdomen.

Charlie YostEdit

  • Diagnosis:
    • Cardiac arrest
  • Treatment:
    • Dialysis
    • Resuscitation

Charlie, 82, was semi-comatose. He had fallen nearly a year prior and had surgery, after which he never woke up. He had daily labs and dialysis three times a week. However, he woke up and told them not to bother with dialysis as he planned to die that day. Izzie believed that his kidneys were working again and that might be why he woke up. He later went into cardiac arrest and had to be resuscitated. He decided to leave AMA, but before he could, he died in his room.

Lexie's PatientEdit

  • Diagnosis:
    • Splinter
  • Treatment:
    • Extraction

Lexie pulled a splinter out of a patient's toe and had to write up a report about it.

ER PatientEdit

  • Diagnosis:
  • Treatment:
    • Attempted intubation

A 40 year old man was brought in after a car accident. Meredith had Lexie attempt to intubate him to learn. Despite this, he was pronounced dead in the ER.

Clinic PatientEdit

  • Diagnosis:
    • Laceration
  • Treatment:
    • Stitches

Bailey sent Lexie to do stitches on the kid in curtain three.

MusicEdit

Song Performer Scene
"My Moon My Man" Leslie Feist
"The Ocean" The Bravery
"Best Friends" The Perishers

Notes and TriviaEdit

Grey's Anatomy 400:31

Grey's Anatomy 4.03 Promo - Let The Truth Sting

  • This episode's title originated from the song Let the Truth Sting, originally sung by David Gray.
  • This episode scored 19.04 million viewers.

GalleryEdit

Episode StillsEdit

QuotesEdit

Cristina: I´m stuck in the pit with these know-nothing interns. You'd think eventually I could catch a break.
Meredith: Cristina, are we ever gonna talk about this? The Burke thing?
Cristina: I´m not Izzie. I´m not gonna lay at the bathroom floor all day. I´m gonna lay here...on the counter.
Meredith: I'll trade you the hemiglossectomy.
Cristina: What?
Meredith: You take the hemiglossectomy and I will take the ER and your interns.
Cristina: Are you sure?
Meredith: Take the surgery. Makes you feel better and you start to freak me out. [Meredith leaves]
Alex: I saw the whole thing, Yang. You can stop pretending.
Cristina: Oh I´m not pretending. I´m sad. I´m very sad. [makes a childish voice] Me so sad.
Alex: Maybe I should try it.
Cristina: Hey forget it. Sad is mine. Go find your own pretend emotion.

Izzie: Charlie, the truth is you were a bastard. You were, you were mean and stubborn and just a bastard. But you were a bastard who knew what you wanted and you stuck to your guns and you proved that if you want something badly enough, if you're determined enough and appreciative enough eventually it will happen. It will, that gives me hope so thanks for that. Good bye, Charlie.

Mark: Ever feel like you're gettin' old?
Derek: Meredith isn't telling Cristina about us. She tells Cristina everything.
Mark: I thought you broke that off!
Derek: I meant to.
Mark: You think she's gonna wanna get back together. You think she's gonna grow up, and get all whole, and want a relationship.
Derek: I do not.
Mark: You're a bad liar.
Derek: You're old.
Mark: I'm just getting started my friend.

Callie: Just say it.
George: I slept with Izzie.

Izzie: George! It's really old guy! We could bring a marching band in here and he wouldn't know the difference!

See AlsoEdit

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

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