|“||I’ve seen a lot of surgery residents come and go in my time and they’re all addicted to surgery. It comes before food, before sleep. It becomes the most important thing, the only thing. What they don’t know is that living on that high can eat them alive. Some make it through they come out on the other side. They survive with their sanity intact. They become better doctors and stronger people. I didn’t. I broke. I didn’t kill anybody and I give thanks for that every day. But I hurt people. Scared the hell out of myself. I am 45 days sober today. I am Richard and I am a grateful and recovering alcoholic.||”|
In his new role as Chief, Derek restores the hospital lecture series, and Richard, Bailey and Callie present to the group pivotal surgical cases from their pasts - Bailey reflects on her first days as a shy resident, Callie looks back on a polio case, and Richard recalls a case in which he and Ellis worked on a patient diagnosed with GRID, a virus later called AIDS.
While Richard's speech talks about all the residents he saw come and go and their addiction to surgery, Bailey checks herself in a mirror in a lounge. Ben observes her from the doorway and tells her she looks nice. She tells him to go away, although she does seem to like the compliment.
In their bathroom, Arizona and Callie are sitting next to the toilet. Callie is panicking, thinking she might hurl again. Arizona asks her not to, as she just got the last of the puke out of her hair. Callie hates public speaking and Derek Shepherd. Arizona says that all she has to do is talk about being a great surgeon. "To a giant room full of people, from a giant stage. With a microphone." Callie says.
Richard finishes up his speech at the AA meeting. He's thankful that he didn't kill anybody, but he did hurt people. It scared the hell out of him. He's 45 days sober. His audience applauds.
In his old office, Richard tells Derek that he thought that his job would be waiting for him when he came back from rehab. Derek apologizes, but there's pending board approval. Maybe they'll reassess in a few months, but until then, Derek remains Chief. Derek has, however, been authorized to offer Richard a position as general surgery attending. Richard refuses to come work under Derek and leaves.
Derek follows Richard and tells him he has an open spot for lecture day. Derek understands why Richard would want to go, but if he really is leaving this place, he doesn't want Richard to leave it the way he did. He asks Richard to give one last lecture. Richard agrees to think the matter over.
The staff has gathered in the lecture room. Derek is excited about lecture day. As he gives his opening speech, Meredith and Cristina practice stitches. Derek presents Dr. Bailey. Bailey walks onto the stage as the staff applauds. Bailey greets everyone and sees what Meredith and Cristina are doing. She hits Cristina's face with a chocolate, saying that if she has to stand there, Cristina has to listen. Bailey is gonna play a game. When she asks a question and one answers it right, she'll throw them a chocolate. if not she'll bean them in the face. As Cristina can agree, her aim is exceptional. Bailey starts her story, which started in 2003, 3 days into her intern year.
Back in 2003, resident Nicole Baylow presents the case of Alicia Tatum to Richard. As she hesitates before answering one of his questions, a whisper from the back of the room answers it before she can. Much to Nicole's annoyance, one of her interns, a nerdy-looking and timid Bailey, outs herself as the one who answered the question. Richard promises the patient they'll find out what's causing her pain and asks Nicole to prep her for surgery. As everyone leaves the room, Nicole picks Bailey to draw the patient's blood and insults her. Bailey has some questions, but Nicole refuses to answer them because she's an intern, the bottom of the surgical food chain.
In the present, a shaking Callie is looking for her presentation on her computer. Cristina tells Meredith that it's Callie's pee dance. Callie accidentally opens a photo of her and Arizona that makes the audience laugh. She then finds the right pictures of extremely disfigured legs, which shock the audience. Callie then turns towards the audience and begins reading from her cards in an inaudible voice. "Can't hear you!" someone shouts from the room. She continues, louder this time, but she can't hide her nerves.
In a flashback to Callie's residency, Callie arrives in the ER. Alex says he's the one who paged her and asks her to put him on the case, as she seems like a cool person and he needs some cool cases ever since the heart in the elevator incident. Callie gets enthusiastic when she thinks he's the heart-in-the-elevator guy, and he goes with it. She says he's not like she pictured him when she heard the story, as he's hot, not dorky. Alex brags and says that maybe the experience transformed him. He asks if that turns her on. She pulls aside the curtain around their patient's bed and says that a case like this is what turns her on. It's Sunder Atluri, the patient with the extremely disfigured legs.
In the present. the crowd mumbles excitedly when Richard walks onto the stage. He starts talking about his residency at this hospital, and how much you can learn from your peers rather than only your superiors.
Flashback to 1982. An attending chats with his residents as they walk up to their patient's room. As they arrive their, a blonde female resident is about to start reviving the patient. A male resident wants to take over, saying it's no job for a nurse. The woman snaps back that he knows damn well that she's not a nurse and shocks the patient, successfully reviving him.
Richard tells the audience that the woman is Ellis Grey, his colleague on the case. A case that changed his life. Richard tells everyone to look around, as the biggest influences in their life are sitting right next to them at the moment. Cristina and Meredith agree this is gonna get interesting.
Richard says Ellis Grey was a ground-breaker, the best most hospitals have ever seen, but back in 1982, she was known as the opposite, if known at all.
1982. Dr. Gracie, the attending on the case, tells his residents that their patient came in for a simple hernia repair, and he's getting sicker instead of better. They better figure out why. The white male residents gather to consult, leaving Ellis and Richard to work together.
Callie has dropped her cards and starts yammering as she's trying to pick them up. The audience is getting bored waiting. Arizona calls out to just tell them what happened. She nervously says that the patient only wanted his club foot fixed, but she had a different idea.
"You told him he could walk?!" an angry Richard asks resident Callie. She was in the Peace Corps, she's seen polio and the procedures. Richard remembers from her application that she grew up privileged, which made her arrogant, and arrogance is dangerous in an unseasoned surgeon. Callie says she didn't make the promise lightly. She can do this. Richard asks if she told the patient she'd try to get him to walk, or if she promised him he'd walk. Callie's guilty face tells him it's the latter. Richard says she'll live or die on this case: she's putting her career at Seattle Grace at risk.
Ellis and Richard are going over the case. Ellis is upset with their attending. Talking about the case, they enter an on-call room, and soon after start making out, both feeling they're going down the wrong road. While making out, Richard thinks he figures out what's wrong with their patient, so he leaves.
Bailey asks the audience for the most important step in the treatment process. After a few wrong answers, Lexie gets a chocolate for saying it's checking the patient history.
Richard and Nicole are operating, while intern Bailey is trying to peek over her fellow interns' shoulders to be able to see what's going on. Richard and Nicole find gallstones, which Nicole says are caused by fatty foods. Bailey brings to their attention that Alicia is a vegan. She proves she knows the patient history. Richard tells Nicole that her intern is doing a hell of a job, but instead of complimenting Bailey, Nicole gives her a cold look.
After the surgery, Nicole tells Bailey that she'll end her if Bailey ever embarrasses her in front of the Chief again. She gives Bailey a ton of scut work to do as a punishment.
Back in the present, Richard says that scut is the punishment for interns, which has Bailey in the audience smile. He and Ellis did mountains of scut work. Testing tissue samples was boring, but it's how they found out that their patient had a fungus.
1982. Ellis and Richard asks their patient if he's traveled to an exotic country, but he replies he didn't leave the U.S. He also doesn't live near a bird aviary, and he's not around pigeons a lot. Eileen, Phillip's girlfriend, asks what kind of questions these are.
Richard tells the audience that he and Ellis asked Eileen to step out, as they had to ask Phillip some pretty uncomfortable and personal questions. They suspected he might have GRID. Richard asks if anyone knows what GRID is, and Lexie answers "AIDS."
"Gay-related immune deficiency?!" Phillip yells angrily. He's offended and berates them. He'll get the antibiotics he needs somewhere else, from real doctors that don't insult him. He's also gonna talk to their superiors about this.
Richard tells the audience that in early 1982, they didn't know anything about AIDS. Because it was isolated to the gay community, the government wasn't funding research. It became known in 1983, but there wasn't a test until 1985. It was so new in 1982 that not even Dr. Gracie knew what it was.
Dr. Gracie calls out Ellis and Richard for what they did to Phillip, who's "not even a gay". He's now threatening to sue them for slander, causing him to put the two doctors on probation.
Callie is nervously drinking from a bottle, making everyone laugh.
Resident Callie is operating on Sunder. The anesthesiologist says it's getting harder to ventilate the patient, so he asks Callie to wrap up. However, Callie just started. Alex says they've been operating for 8 hours, but that's only because she's working meticulously. The patient is getting really unstable, but Callie keeps on going. Alex asks her if she wants Sunder to walk or keep breathing, which makes Callie come to her senses.
Bailey tells the audience that you learn most from failures. She says Alicia came back a month after being discharged with symptoms consistent with appendicitis. However, it turned out differently. She diagnoses Alicia with appendicitis, and Doctor Webber decided that the appendectomy was going to be her first solo surgery.
Webber is standing next to intern Bailey as she operates, complimenting her. They're happy to have her at Seattle Grace. He looks up at the gallery and sees the angry look on Nicole's face. He says surgery is a shark tank, so he urges her to be shark too, not a minnow. She asks if he's referring to her height. He's not. God made her short, but he wonders who made her quiet. He stops her and informs her the appendix looks completely healthy. As Nicole gloats, he says it's normal to have a negative appy every once in a while. She can take it out anyway.
A nervous Callie is having difficulties getting her story straight. As the audience gets more and more bored, she starts looking through her cards again. Arizona asks Alex to help out, as he was there. He reminds Callie that they saw the dude doing the thing with his foot.
Callie tells Sunder that the surgery was more difficult than she anticipated. She was able to do the tendon release, but since his heart and lungs couldn't withstand any more time under anesthesia, she couldn't do any more than that. Sunder understands and asks when they'll do the next surgery. Callie is even doubting there will be a next surgery. He urges her to look at his foot. He can wiggle his toes, which he hasn't been able to do since he was 7. She did that for him. He's always been stared at. He wants to walk and stand straight up, and he believes she can do that for him. He begs her to try.
Richard tells the audience that surgeons don't like to give up on patients, but when a patient refuses treatment, you're done. So he and Ellis were done with Phillip, or that's what they thought.
As Ellis and Richard flirt a little, a young Meredith comes running over, holding her Anatomy Jane doll. Ellis tells Thatcher that that was supposed to be for her birthday. He knows, but he got desperate when she kept on crying because she missed her mother. As Richard and Thatcher greet each other, Ellis says she has a few seconds to look at Meredith's doll. However, she and Richard get paged to the ER. Meredith clings to her mother's leg so Ellis asks Thatcher to take her and pushes Meredith off her leg. While Meredith begs her not to go, Ellis takes off with Richard.
In the ER, Dr. Gracie, covering his mouth with a surgical mask, tells Richard and Ellis that their GRID patient from a few months back has returned with Kaposi's sarcoma. Everyone is afraid to be around the guy, except Richard and Ellis. Phillip takes off his mask and apologizes. He admits they were right about everything. He begs them to help him.
Bailey is distributing chocolates as the audiences gives more suggestions about what they would do to find out what's wrong with Alicia. It's a difficult case that proves that sometimes, you have advocate for your patients and push to get things done.
Intern Bailey approaches Nicole Baylow, asking why Alicia Tatum is being discharged with nothing but a note for a psych consult. Nicole says Alicia only came here for pain meds, as she's depressed. Months of severe untreated pain will do that, Bailey says. She's not ready to give up on Alicia, but Nicole is not willing to spend thousands of dollars on tests for something that can be cured with Prozac. Richard comes over and asks what they're doing with Alicia Tatum, and he agrees with Bailey. Nicole then takes on Bailey's ideas and suggests they could test Alicia for lupus, lead poisoning, and hemochromatosis. Richard compliments her.
Ellis, Richard, and Gracie are looking at Phillip's scans. There's an intussusception, which they've never seen in an adult. Gracie doesn't want to operate. He deems Phillip a lost cause, as he has AIDS. They don't know anything about AIDS. They don't know how it spreads, so operating could endanger the life of his staff. Richard brings up the oath, which has Gracie snap that the two of them wouldn't even be allowed in this program 10 years ago (with the obvious implication that Richard is black and Ellis a woman).
Alex and Callie are going over the story together. At some point, Alex gave her a rousing pep talk.
In a flashback, Alex gives her the pep talk, asking her what would've happened if he had quit in the elevator. He had every reason to panic, but he didn't and saved the guy's life. He tells her to pretend she's in the elevator with Sunder and asks if she's going to quit.
The audience is totally getting on board with Bailey's story, all guessing possible diseases Alicia could be suffering from, but all tests they ran were negative. Then they did what Bailey always tells them to do when they're stuck: hit the books.
Bailey is getting drunk at Joe's bar while saying she wasn't raised to be a shark. She's a minnow on the inside.
Richard tells the audience that he and Ellis weren't noble, they were just more arrogant and they had more to prove.
Richard and Ellis inform Phillip about what's going on with him. It's a complicated problem, but they can fix it in surgery, which they'll perform. Phillip says he can see the scared people outside his room, one of which is Gracie, staring and pointing at him and mumbling about him. He doesn't blame them for being scared, as he's scared too. He used to be scared that people would find out he's gay, but now he can't even hide it anymore. He breaks down. His story touches the doctors. Ellis says that letting them operate is his chance to change his life. Phillip asks what the point is, as no one recovers from this. Richard says he can buy himself some time, as they don't know when a cure will be found.
Callie is sitting down on the stage and is finally relaxed. She says that she and Alex researched and practiced and finally, they were ready.
Alex and Callie are operating, but suddenly Sunder has a pericardial tamponade. Callie stays calm and starts performing heart massage while telling Alex that they need to perform a subxiphoid pericardiotomy to drain the blood that's squeezing the heart, which is like the miniature version of what he did in the elevator. Alex panicks and says he can't do it, as it wasn't him who did the thing in the elevator.
Callie says he can do the procedure anyway, trusting that he can do it. She tells him to pull it together and take the scalpel. So he does.
Richard says he and Ellis were aware of the risks of what they were doing, as back then, they didn't know how AIDS was spread.
While scrubbing in, Ellis and Richard says it's sad that Phillip's been living a lie. Richard says they're living a lie too. He wants to stop their affair. Ellis says that their relationship is what's right. Their marriages are the lie. They should leave their spouses, but Richard doesn't want to do that. He says she doesn't have to operate with him, as she has Meredith to think about. Ellis concludes that despite his different skin color, he's just like the rest of them. She gave birth to a child, that only makes her a mother, it doesn't make her inept, less of a woman, or less of a surgeon, no matter how much everyone wants it to. She enters the O.R.
Bailey says that none of her research helped. Baylow sent Alicia home, which had Bailey thinking that she wasn't cut out for surgery. However, a couple of months later, Alicia wound up in the hospital again.
Alicia is happy to see a familiar face as Bailey enters her room. The pain has gotten worse. They want to open her back up to take another look at what might be wrong. Bailey takes a look at her chart as Alicia states she thinks she can't take it anymore. Bailey then sees Alicia's urine and stops the guys who are about to take Alicia up to surgery.
Bailey tells the audience that it was stupid to cancel her resident's surgery, but in this case, it was necessary.
Nicole calls out Bailey for cancelling her surgery and asks a nurse to rebook Alicia for surgery. Bailey says that Nicole was going to open Alicia back up to explore an obstruction while she doesn't have any adhesions. Just because Alicia's had previous surgeries doesn't mean they shouldn't look for another possible cause. She found one: Alicia has a pseudo-obstruction that can be resolved with an NG tube. If Nicole had looked a little further and if she had actually talked to her patient, she would've seen that along with abdominal pain, she also had weakness, palpitations, numbness, skin changes and dark urine. That still doesn't ring any bells with Nicole. "Your patient, who's been sliced nine ways to Sunday, has porphyria," Bailey says as Richard appears behind her. She keeps on blaming Nicole for everything they unnecessarily did to Alicia. Bailey admits she's also at fault for not looking at the whole picture until just now, but the difference is that she learned something from it. She learned not to cut and to listen to her patient. She keeps on insulting Nicole and showing off until Richard stops her. He wants to speak to her in his office, now.
Callie says they did a series of short surgeries on Sunder. It was grueling for him, but worth it in the end. Callie shows the audience the before and after scans, which show a huge difference. They spontaneously applaud for her. Callie says it was amazing. She and Alex celebrated big time after the last surgery.
A flashback shows her and Alex making out in the basement of the hospital, where she lived at the time.
As everyone still applauds, Arizona looks at Alex and Callie and seems to realize what happened.
Bailey, visibly thinking she's in big trouble, is in Richard's office, watching Nicole and her fellow residents make fun of her. Richard says it's his job to make sure that his residents are treated with respect. He doesn't allow her to comment. It's his job, so they're gonna sit here with that terrified look on her face for a respectable amount of time so that Dr. Baylow and her friends can assume that she's having her behind handed to her on a platter. He tells her she's gonna make one hell of a surgeon. She starts smiling, but he quickly tells her to lose the smile.
Richard tells the audience that Phillip survived the surgery, but he came back to the hospital with PCP pneumonia 8 months later, and a week after that he died. He won't speak for Ellis, but he lost the sense that he was superhero. He really started thinking about how dangerous it all is. This work is dangerous, and they all change each other, contrary to what they think. He wants them all to remember the physician's oath, because it's too easy to lose your way if you don't. He then retakes the oath, which has a great impact on the audience.
A flashback shows Sunder walking with crutches and Richard complimenting Callie for her work.
While Bailey is chatting with Alicia, Nicole administers the drug.
Ellis and Richard each take one of Phillip's hand and hold each other's other hand as Phillip passes away.
Richard finishes the oath and receives a standing ovation from everyone in the room.
On their way out, Meredith and Derek meet up with Richard. Derek tells him that the job offer still stands, asking Richard to think about it. Meredith and Derek leave.
At what would later become Joe's bar, Ellis and Richard have a toast for Phillip. Ellis tells him you can't toast with a soda pop. She asks the bartender to give him a vodka. Richard says she knows he can't stand the taste of that stuff. She tells him to learn to stand it then. He's a grown up, so he has to act like it. As the bartender gives him the vodka, Richard tells Ellis he can't leave Adele. "We'll see," Ellis says as she drinks. Richard takes a sip of his vodka, visibly disgusted by it.
- Ellen Pompeo as Dr. Meredith Grey
- Sandra Oh as Dr. Cristina Yang
- Katherine Heigl as Dr. Izzie Stevens (credit only)
- Justin Chambers as Dr. Alex Karev
- Chandra Wilson as Dr. Miranda Bailey
- James Pickens, Jr. as Dr. Richard Webber
- Sara Ramírez as Dr. Callie Torres
- Eric Dane as Dr. Mark Sloan (credit only)
- Chyler Leigh as Dr. Lexie Grey
- Kevin McKidd as Dr. Owen Hunt (credit only)
- Jessica Capshaw as Dr. Arizona Robbins
- Patrick Dempsey as Dr. Derek Shepherd
- Sarah Paulson as Young Ellis Grey
- Gregg Henry as Dr. L. Gracie
- Jason George as Dr. Ben Warren
- Missi Pyle as Dr. Nicole Baylow
- Jesse Williams as Dr. Jackson Avery
- Ravi Kapoor as Sunder Atluri
- J. August Richards as Young Richard Webber
- Rachel Nicks as Alicia Tatum
- Ian Jensen as Phillip Nichols
- Steven W. Bailey as Joe
- James Ginty as Dr. Russell
- Rachel Sondag as Eileen
- John Ainsworth as Young Thatcher
- Claire Geare as Young Meredith
- Marty Lodge as Anesthesiologist
- Acid reflux
- Gallbladder stones
- Gallstone removal
- NG tube
Alicia had had an oophorectomy three months prior. She had fever and non-focal abdominal pain. She had gallbladder stones and wall thickening, so they planned surgery to remove the stones. The gallbladder stones were puzzling because the patient was vegan as she found it helped with her reflux. She was discharged, but came back with signs of appendicitis. Bailey operated, but the appendix was not actually inflamed. They ran more tests looking for a cause of all her pain, but they found nothing. Nicole wanted to discharge her with a psych consult, but Webber pushed her to look for other causes. None were found, so she was sent home again. However, she came back a few months later and they suspected an obstruction from her other surgeries. Bailey noticed that her urine was intermittently dark. She had a pseudo-obstruction that could be resolved with an NG tube. She had porphyria and needed hemin.
- Misshapen legs
- Lung disease
- Pericardial tamponade
- Tendon release
- Subxiphoid pericardiotomy
Sunder, 28, had legs misshapen by polio. He wanted to have his clubfoot repaired, but Callie believed she could straighten his legs so he could walk. She took him into surgery and did the tendon release, but his lungs couldn't handle the prolonged anesthesia, so she was forced to stop. After his surgery, he moved his foot, something he hadn't been able to do before. Sunder pushed her to do more because he wanted to be able to stand up and walk. So she planned a series of shorter surgeries. In one of his surgeries, he developed pericardial tamponade, so they had to do a pericardiotomy to relieve the pressure. After he recovered from the final surgery, Sunder was able to start to walk.
- Kaposi's sarcoma
- Pneumocystic pneumonia
Phillip was in the hospital to have a hernia repaired. He became unstable and they were puzzled as to why he was getting sicker instead of better. They later found out that he had a fungus called cryptococcus. They also suspected he had GRID (now known as AIDS). He denied having sex with other men and left the hospital. He came back a few months later with Kaposi's sarcoma and admitted that they were right and asked for their help. He had an intussusception, so Ellis and Richard operated to fix it. He survived the surgery, but came back eight months later with PCP pneumonia and died a week later.
|"Maneater"||Hall & Oates||
|"Our Lips Are Sealed"||The Go-Gos||
|"When You Come Home"||Calahan||
|"Metropolis"||Faded Paper Figures||
|"Shape Up"||Total Babe||
|"Everywhere I Go"||Lissie||
Notes and TriviaEdit
- This episode's title originated from the song The Time Warp, originally sung by the cast of The Rocky Horror Picture Show.
- This episode scored 10.27 million viewers.
- According to the 2/23/2010 Official Grey's Anatomy Podcast, the events of Callie's flashbacks take place alongside the events of Let It Be.
- Callie mentioned in her flashback that she was a third-year resident. While this may be a continuity error, as Callie is in the same year as Bailey and Sydney who are in their fourth year, it is, however, technically correct, as an ortho residency is a 4-year program requiring an additional prerequisite year as a surgical intern. This means that in the flashback of Let It Be, while she is in her fourth year overall, she is still in her third year of her orthopedic surgical training.
- Goof: Miranda Bailey previously stated that she was the only female in her intern class, but this episode clearly shows that there are other females in her class.
Behind the ScenesEdit
- Richard: I solemnly pledge to consecrate my life to the service of humanity. I will give to my teachers the respect and gratitude that is their due. I will practice my profession with conscience and dignity. The health of my patients will be my number one consideration. I will respect the secrets that are confided in me, even after my patient has died. I will maintain by all the means in my power, the honor and the noble traditions of the medical profession. My colleagues will be my sisters and brothers. I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, race, political affiliation, nationality, sexual orientation, social standing or any other fact to intervene between my duty and my patient. I will maintain the utmost respect for human life. I will not use my medical knowledge to violate human rights and civil liberties, even under threat. I make these promises solemnly, freely and upon my honor.
- Richard: You're gonna make a hell of a surgeon, Dr. Bailey.
- Ellis: I gave birth to a child, Richard. That makes me a mother, it doesn't make me less of a surgeon.
- Richard: I am 45 days sober today. I am Richard and I am a grateful and recovering alcoholic.
A complete overview of this episode's crew can be found here.
|Grey's Anatomy Season 6|
|#01||"Good Mourning"||#09||"New History"||#17||"Push"|
|#02||"Goodbye"||#10||"Holidaze"||#18||"Suicide is Painless"|
|#03||"I Always Feel Like Somebody's Watchin' Me"||#11||"Blink"||#19||"Sympathy for the Parents"|
|#04||"Tainted Obligation"||#12||"I Like You So Much Better When You're Naked"||#20||"Hook, Line and Sinner"|
|#05||"Invasion"||#13||"State of Love and Trust"||#21||"How Insensitive"|
|#06||"I Saw What I Saw"||#14||"Valentine's Day Massacre"||#22||"Shiny Happy People"|
|#07||"Give Peace a Chance"||#15||"The Time Warp"||#23||"Sanctuary"|
|#08||"Invest in Love"||#16||"Perfect Little Accident"||#24||"Death and All His Friends"|
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