"εα૮ɦ of you comes here hopeful; wanting in on the game. A month ago you were in med school being taught by doctors. Today, you are the doctors. The seven years you spend here as a surgical resident will be the best and worst of your life. You will be pushed to the breaking point,"
"Look around you. Say hello to your competition. Eight of you will switch to an easier specialty. Five of you will crack under the pressure. Two of you will be asked to leave. This is your starting line. This is your arena. How well you play? That's up to you."
•.
"Okay, Martin, Robinson, Bond, Parkins."
Evi puts her hair into a loose ponytail at the back of her head while observing the called interns move towards the door.
"Only six women out of twenty." A blonde says from beside her.
"Yeah. I hear one of them's a model. Seriously, like that's going to help with the respect thing?" A Korean woman says from Evi's opposite side.
"Your Cristina right?" Evi starts, "And your Meredith? We met last night at the mixer."
"Which resident you assigned to? I got Bailey." Cristina asks as the three girls move to stand in a circle.
"The Nazi? Yeah, me too." Meredith confirms.
"Why do they call her 'The Nazi?'" Evi asks.
"Maybe she is a Nazi." Cristina tells the girl.
"You got the Nazi? So did I. At least we'll be tortured together, right? I'm George O'Malley, uh, we met at the mixer, you had a black dress with a slit up the side, strappy sandals-" George cuts himself off as he observes the three women's faces.
"Now you think I'm gay." George says defeated.
Meredith, Cristina, and Evi all exchange looks before Cristina walks away.
"It's okay if your gay George, I don't judge." Evi says to him before turning her attention back to her cubby.
"No! I'm not gay it's just that-" George cuts himself with a sigh off as Evi walks away.
"O'Malley, Yang, Grey, Stevens, and Jensen, at the end of the hall." The resident calls.
"That's the Nazi?" Cristina asks in disbelief as they walk down the hall and see a short black woman at the nurses station.
"I thought the Nazi would be a guy." George says.
"I thought the Nazi would be... A Nazi." Meredith says.
"She doesn't look like a Nazi." Evi joins in, as a pretty blonde walks up to the group.
"Maybe it's professional jealousy. Maybe she's brilliant, and they call her Nazi because they're jealous. Maybe she's nice." The blonde says.
"You're the model, aren't you?" Evi asks looking at the woman.
The girl sends Evi a look.
"Hi, I'm Isobel Stevens, but everyone calls me Izzie." Izzie says sticking her hand out for Bailey to take.
"I have five rules. Memorize them," Bailey begins ignoring Izzie's hand. "Rule number one, don't bother sucking up, I already hate you, that's not gonna change,"
Bailey gestures to the items on the counter. "Trauma protocol, phone lists, pagers. Nurses will page you, you answer every page at a run." The interns scramble to grab one of each item.
"A run, that's rule number two. Your first shift starts now and lasts forty-eight hours. You're interns, grunts, nobodies, bottom of the surgical food chain, you run labs, write orders, work every second night till you drop and don't complain!" She continues, the group following her across the catwalk.
"On call rooms," Bailey says swinging a door open to show a bunk bed and a desk. "Attendings hog them, sleep when you can, where you can, which brings me to rule number three, if I'm sleeping, don't wake me, unless your patient is actually dying. Rule number four, the dying patient better not be dead when I get there, not only would you have killed someone, you would have also woke me for no good reason, we clear?" She says looking at each one of them as Meredith raises her hand.
"Yes?"
"You said five rules. That was only four." Meredith says, as Bailey's pager rings.
"Rule number five. When I move, you move." Bailey says looking down at her pager before breaking out in a jog. "Get out of my way!" She yells to another group of interns lounging in the hall.
•
"What've we got?" Bailey asks as the interns wheel a gurney on the helipad awaiting a patient.
"Katie Bryce, fifteen-year-old female, new onset seizures, intermittent for the past week, ID lost in route, started grand mal seizing as we descended." The paramedic lists as they pull Katie out of the chopper.
"All right, get her on her side, Izzie, ten milligrams Diazepam," Bailey orders.
"No no, your doing it wrong, smoke over fire-" Evi starts as Bailey cuts her off.
"no, no, the white lead is on the right, righty whitey, smoke over fire," Bailey instructs Izzie before turning her attention to George. "A large bore I.V. don't let the blood hemolyze, let's go!"
Izzie injects the medication into Katie causing her to stop seizing, giving the interns a chance to breathe. They slowly relax their hands allowing Katie to rest on her back when another doctor enters the room.
"So I heard we got a wet fish on dry land?" The tall darkskin doctor asks Bailey.
"Absolutely Dr. Burke" Bailey confirms.
"Dr. Bailey, I'm gonna shotgun her." He states.
"That means every test in the book, CT, CBC, chem seven, tox screen," she lists.
"Cristina, you're on labs, George, patient workups, Meredith and Evi, get Katie for a CT, she's your responsibility now." Bailey orders the group around before sending them on their way.
•.
"You're lost." Katie states to Meredith and Evi.
"We're not lost." Meredith denies.
"How are you feeling?" Evi and Meredith say at the same time.
"How do you think I'm feeling? I'm missing my pageant." Katie says.
"You're missing your pageant." Meredith states back.
"People still do pageants?" Evi asks.
Katie looks at Evi in disbelief.
"The Spokane Teen Miss? I was in the top ten after the first two rounds. This is my year. I could've won. Hello? You're so lost. What are you, like, new?" Katie says when she notices the two interns taking her in circles.
"I twisted my ankle. I do rhythmic gymnastics, which is like, really cool. Nobody else does it. And I tripped over my ribbon, and I didn't get stuck with someone this clueless. And that was like, a nurse." Katie says as their still lost.
•
Evi sits at the table with the rest of the interns.
Izzie is looking at her food with a tinge of disgust and George looks cheerful.
"This shift is a marathon, not a sprint, eat." George tells Izzie.
"I can't." She responds.
"You should eat something." George says pointing his fork towards Evi.
Evi picks at her food. "I got lost on the way to get Katie a CT. Not a good thing to do on your first day."
"You try eating after performing seventeen rectal exams. The Nazi hates me." Izzie says, and Evi sends her an apologetic look.
"The Nazi's a resident. I have attendings hating me." George retorts.
"You know Meredith is inbred?" Cristina says sitting at the table.
"How so?" Evi asks, finally taking a bite of her salad.
"Like it's uncommon around here to be a doctor's-" George starts.
"No, I mean royally inbred. Her mother is Ellis Grey."
"Shut up, the Ellis Grey?" Izzie asks.
"Who is Ellis Grey?" George asks confusion displayed across his features.
Izzie, Cristina and Evi laugh at George.
"The Grey method?"
"Where'd you go to med school, Mexico?" Cristina says towards George.
"She was one of the first big chick surgeons, she practically invented the abdominal-" Izzie begins.
"She's a living legend, she won the Harper Avery. Twice." Evi interjects.
"So, I didn't know one thing." George complains.
"Talk about parental pressure." Evi says taking a bite out of her salad.
"I would kill to have Ellis Grey as a mother." Cristina says right as Meredith joins them at the table. "I would kill to be Ellis Grey, I just need one good surgery."
"Katie Bryce is a pain in the ass. If I hadn't taken the Hippocratic oath, I'd Kevorkian her with my bare hands." Meredith says sitting down.
"What?" She asks when she notices everyone is staring at her.
"Good afternoon interns," Burke begins as he approaches their table.
"It's posted, but I thought I'd share the good news personally. As you know, the honor of performing the first surgery is reserved for the intern that shows the most promise. As I'm running the OR today, I get to make that choice."
He slaps his hand on George's back.
"George O'Malley. You'll scrub in for an appendectomy this afternoon. Congratulations."
"Me?" George says in disbelief.
"Enjoy." Burke then leaves the table and nobody speaks for a few moments. Evi takes a tentative bite out of her salad.
"Did he say me?" George asks in disbelief.
•.
"Katie, honey, mom and dad are here." Katie's mother says as she enters the room with her husband in tow.
"They gave her a sedative for the CT scan, so she's a little groggy." Evi says to Katie's parents.
"Will she be all right?" Her mother asks stroking her daughter hair.
"Our doctor at home said she might need an operation, is that true?" Her father asks turning to the two girls.
"What kind of operation?" Katie's mother asks.
"She's, um, well,-" Meredith stutters trying to find the answers.
"you know what," Evi interrupts. "We aren't doctors- I-I mean we are doctors we just aren't Katie's doctors. We will go get Katie's doctor for you." Evi says rapidly before leading Meredith out of the room.
"What?" Bailey asks the two interns when they run into her in the hall.
"Katie's parents have questions. Do you talk to them, or do I ask Burke?" Meredith asks holding the door open.
"No, Burke's off the case, Katie belongs to the new attending now, Dr. Shepherd, he's over there." Bailey points to another attending down the hall who was talking to a group of other doctors.
Meredith and Evi walk away from Bailey and in the direction of the attending.
"Should I talk to him? Or you?" Evi asks Meredith as they slowly walk away from the door, not yet seeing the face of him.
"We can talk to him together." Meredith suggests.
Evi looks at her unsure. "Maybe it'll be better if just one of us talked to him." She tries again wanting to avoid the stammering mess that took place in Katie's room.
"Or neither of us talk to him." Meredith says once she gets a glimpse of his face. She gently grabs Evi's arm pulling her back through the door.
"Wha-?" Evi asks as Meredith rapidly pulls Evi back through the door and around the corner.
"Meredith, Can I talk to you for a second?" Derek asks jogging around the corner. He grabs Meredith's elbow pulling her away from Evi and into the empty stairwell.
"Actually, I was-" Meredith tries to object.
Evi looks around the hall in shock wandering if anyone saw that before quickly moving towards the stairwell door. She grabs the handle and ducks low under the glass before cracking the door so she can hear.
"Dr. Shepherd," Meredith begins.
"Dr. Shepherd? This morning it was Derek, now it's Dr. Shepherd?" Derek asks amused making Evi lightly gasp from behind the door.
"Dr. Shepherd, we should pretend it never happened." Meredith continues.
"What never happened?" Derek asks amused. "You sleeping with me last night? Or you kicking me out this morning?" He continues. Evi's eyes widen in surprise. "Because both are fond memories I'd like to hold on to."
"No, there will be no memories." Meredith denies. "I'm not the girl in the bar anymore, and you're not the guy."
"This can't exist, you know that, right?" Meredith asks.
"You took advantage of me and now you want me to forget about it," Derek begins.
"I did not take-"
"I was drunk, vulnerable, and good-looking, and you took advantage." He finishes.
"Okay, I was the one who was drunk," Meredith says with a smile. "And you're not that good looking."
"Maybe not today." He says moving around her. Evi peaks inside the hall through her crack in the door. "Last night, last night I was very good-looking. I had my red shirt on, my good-looking shirt, you took advantage."
"You want to take advantage again? Say Friday night?" Derek proposes.
"No. You're an attending. And I'm your intern. Stop looking at me like that." Meredith says.
"Like what?" Derek asks.
"Like you've seen me naked." She says. Derek smirks at her. "Dr. Shepherd. This is inappropriate. Has that ever occurred to you?" Meredith says before turning to leave from the door she entered, making Evi quickly scramble back to her original spot in the hall.
•.
All of the interns gathered in the gallery above the OR, George was to be doing the procedure in.
"He's going to faint."
"He's a fainter."
"Nah, code brown. Right in his pants." The interns in the gallery muse.
"He's all about the flops, he's going to sweat himself unsterile."
"Ten bucks says he messes up the McBird."
"Twenty says he cries." Cristina joins in.
"I'll put twenty on a total meltdown."
"Fifty says he pulls the whole thing off." Meredith says, as everyone looks at her.
"Seventy-five says he can't even ID the appendix." Evi says after a moment of silence, and Meredith looks at her with a look of disbelief.
"I'll take that action." Izzie says and the other interns agree.
"Okay, O'Malley, let's see what you can do." Burke says.
"Here it comes." Meredith says as Evi moves to the edge of her seat.
"Scalpel." George says.
As the nurse hands George the scalpel everyone in the gallery cheers.
Burke gives them a sign and a slight glare to be quiet.
"That Burke, he's trouble." Cristina jokes, making everyone laugh.
The beginning of the surgery goes smoothly, George gets through the peritoneum and then moved on to getting the appendix out. Once its out Burke begins instructing him on how to finish the procedure.
"He's choking." Cristina says when George hesitates.
"Come on, George." Meredith mumbles.
"Today. Pull your balls out of your back pocket, let's go. What are you waiting for, suction?"
"Getting too low folks.." a nurse informs.
"Get out of the way. Pansy-ass idiot. Get him out of here. Suction. Clamp." Burke pushes George out of the way of the patient and takes his spot.
"007." An intern says.
"007, yep." Another intern agrees.
"What's 007 mean?" Evi asks Meredith quietly.
"Licensed to kill." Meredith informs her.
•.•
"They're calling me 007, aren't they?" George asks, as they sit on gurneys in the basement.
"No one's calling you 007." Izzie and Meredith try.
"I was on the elevator and Murphy whispered 007."
"Oh, how many times do we have go through this, George, five, ten? Give me a number or else I'm going to hit you." Cristina states.
"Murphy whispered 007 and everyone laughed."
"He wasn't talking about you." Izzie says.
"You sure?"
"Would we lie to you?" Evi tries.
"Yes."
"007 is a state of mind." Cristina says.
"So says the girl who finished at the top of her class at Stanford."
"Oh man. It's 911 for Katie Bryce. We gotta go." Meredith says as her and Evi's pager rings.
"Maybe I should've gone into geriatrics. No one minds when you kill an old person." George complains.
•.
"Took you long enough." Katie says as Meredith and Evi get to her room.
"You're okay? The nurse paged us 911."
"I had to go all Exorcist to get her to even pick up the phone."
"Wait. There's nothing wrong with you?" Evi asks.
"I'm bored."
"You little...We're not a cruise director." Meredith says.
"You don't have to wig out. The pageant's supposed to be on cable, but this crappy hospital doesn't get the channel. If that cow Kylie Wood is gonna walk off with my crown, I have to see it. Can you call someone?"
"Okay. This is an actual hospital. There are sick people here. Go to sleep, and stop wasting our time."
"But I can't sleep. My head's all full."
"That's called thinking. Go with it."
•.
Evi walks into Katie's chaotic room leisurely with a cereal bar, having been paged 911 by the nurses, she abruptly stops when she sees what's going on; Katie is having a seizure and Meredith is telling the nurses what to do in a panic.
"Phenobarbital, load her with Phenobarbital." She says quickly.
"Pheno's in." A nurse says.
"No change."
"You paged Dr. Shepherd?" Meredith asks almost in a daze.
"Heart's stopped!"
"Code blue, code blue! Code blue, code blue!"
They pull out the defibrillators and try to hand them to Meredith but she's still dazed so Evi takes them. "Charge pulse of two hundred." She orders.
"Charged. Clear."
Evi shocks her.
"Still defib. Nothing."
"Charging. 19 seconds."
Nothing.
"Charge to 300!"
"300. Anything? 27 seconds."
Nothing.
"Charge to 360!"
"Nothing. Come on, Katie." Evi curses.
"49 seconds."
"At 60 seconds you're supposed to admit her-"
"Charge again!" Meredith demands.
"Charge again!"
"Anything?"
Katies BP and rhythm starts to go back up.
"I see sinus rhythm."
"Blood pressure's coming up."
"All right now. Pressure's returning. Grid's coming back..."
"What the hell happened?" Derek asks looking between the two girls as he enters the room.
"She had a seizure, and-" Evi tries.
"A seizure?"
"her heart stopped." Meredith completes.
"You were supposed to be monitoring her"
"We checked on her and she-" Evi says.
"I got it. Just - just - go." He tells the two girls.
"You get a 911, you page me immediately, not in the five minutes it takes you to get to the emergency, immediately, you are on my team and if somebody dies it's my ass, you hear me, Grey and Jensen?" Bailey says as the two girls walk the opposite way.
"Meredith? Evi?" Cristina asks.
•.•
"What are you doing?" Evi asks Cristina.
"I'm suturing a banana, with the vain hope that it wakes up my brain."
"Good luck with that."
George laughs.
"What're you smiling at, 007?" She snaps which makes George stop laughing.
"I'm sorry, I get mean when I'm tired."
"You know what? I don't care. I comforted a family, and I get to hang out in the OR today. All is well."
"Does anybody know why we're here?" Evi asks the same time Shepherd walks in.
"Well good morning. I'm going to do something pretty rare for a surgeon, I'm going to ask interns for help. I've got this kid, Katie Bryce. Right now, she's a mystery. She doesn't respond to her meds. Labs are clean, scans are pure, but she's having seizures. Grand mal seizures with no visible cause. She's a ticking clock. She's going to die, if I don't make a diagnosis. Which is where you come in. I can't do it alone. I need your extra minds, extra eyes, I need you to play detective, I need you to find out why Katie is having seizures. I know you're tired, you're busy, you've got more work than you could possibly handle. I understand. So, I'm going to give you an incentive. Whoever finds the answer rides with me. Katie needs surgery. You get to do what no interns get to do. Scrub in to assist on an advanced procedure. Dr Bailey's going to hand you Katie's chart. The clock is ticking fast, people. If we're going to save Katie's life, we have to do it soon." He says, looking around the room.
•.•
"Hey, I want in on Shepherd's surgery. You've been the interns on Katie since the start. You guys want to work together? We find the answer, we have a chance of scrubbing in."
"I'll work with you, but I don't want in on the surgery. You guys can have it." Meredith says.
"Are you kidding me? It's the biggest opportunity any intern will ever get."
"I don't want to spend any more time with Shepherd than I have to."
"If we find the answer, the surgery's yours. Do you want to work together or not?"
"Deal."
"I'm in."
•
"Well, she doesn't have anoxia, chronic renal failure or acidosis. It's not a tumor because her CT's clean." Cristina starts.
"Are you seriously not going to tell us why you won't work with Shepherd?" Cristina asks Meredith. Evi bites the inside of her lip not wanting to give Meredith away.
"No. What about infection?"
"No. There's no white count, she has no ceteal lesions, no fevers, nothing in her spinal tap, just tell us." Evi says feigning oblivion.
"You can't comment, make a face, or react in any way."
"Okay."
"We slept together."
Evi and Cristina both make impassive faces.
Evi clears her throat. " What about an aneurysm?"
"No blood on the CT, and no headaches."
"Okay. There's no drug use, uh, no pregnancy, no trauma...was he good? I mean, he looks like he would be, was it any good?" Cristina inputs.
"What are the answers? What if no one comes up with anything?" Evi wonders out loud.
"You mean if she dies?"
"Yeah."
"This is gonna sound really bad, but I really wanted that surgery." Cristina says.
"She's just never going to get the chance to turn into a person. The sum total of her existence will be almost winning Miss Teen whatever. You know what her pageant talent is?"
"They have talent?" Cristina says and Evi snickers.
"Rhythmic gymnastics." They all laugh.
"Oh, come on." Evi laughs.
"What is rhythmic gymnastics? I don't know - I can't even say it, I don't know what it is."
Evi goes still.
"Get up. Come on!" Evi ushers the two girls.
•.•
"the only thing she could possibly need is a - Oh, oh, Dr. Shepherd! Just one moment, um, uh, Katie competes in beauty pageants-" Cristina starts.
"I know that, but we have to save her life anyway." He says stepping into the elevator.
"Okay, she has no headaches, no neck pain, her CT's clean, there's no medical proof of an aneurysm-" Evi continues.
"Right."
"but what if she has an aneurysm anyway?" Meredith finishes.
"There are no indicators."
"Ah, but she twisted her ankle, a few weeks ago when she was practicing for the pageant-" Cristina picks up.
"Look, I appreciate you're trying to help, but-"
"This is not helping!" A random doctor in the elevator says when Derek shoves his hands between the door again.
"She fell. When she twisted her ankle, she fell." Evi says.
"It was no big deal, not even a bump on the head, you know she got right back up, iced her ankle and everything was fine, it was a fall so minor her doctor didn't even think to mention it when I was taking her history, but she did fall." Cristina says.
"Well, you know the chances that a minor fall could burst an aneurysm, one in a million! Literally." Shepherd shoots them down.
The elevator door is allowed to close. Meredith, Cristina and Evi sigh and turn away. The elevator dings and Derek steps out. They turn back.
"Let's go." He says, brushing past them.
"Where?" Cristina questions.
"To find out if Katie's one in a million."
•.•
"I'll be damned."
The four of them were standing around Katie's scans.
"There it is,"
"It's minor, but it's there. It's a cerebachnoid hemorrhage. She's bleeding into her brain."
"She could've gone her entire life without it ever being a problem. One tap in the right spot-" Derek starts as the four walk out of the CT room.
"And it explodes." Evi finishes.
"Exactly. Now I have to fix it. You three did great work. Love to stay and kiss your asses, but I gotta tell Katie's parents she's having surgery. Katie Bryce's chart, please."
"Here you go." The nurse says.
"Oh, and Dr Shepherd, you said that you'd pick someone to scrub in if we helped." Cristina reminds.
"Oh, yes, right. Um, I'm sorry I can't take all three of you, it's going to be a full house. Meredith, I'll see you in OR."
Evi and Cristina both share a look with each other and Meredith before walking off in different directions.
"Evi! Cristina!" She calls but they ignore her.
•.•
"Izzie." Evi says.
Evi, Izzie, and Cristina were back in the basement laying across the gurneys.
"Maybe Meredith couldn't-"
"Izzie!" Cristina cuts of her rant.
Meredith turns the corner and speaks, "I'll tell him I changed my mind, you can-"
"No, no, don't do us any favors. It's fine." Evi cuts her off.
"Cristina, Evi-"
"You know what, you did a cutthroat thing, deal with it. Don't come to me for absolution, you want to be a shark, be a shark." Cristina spits.
"I'm not-"
"yes you are. Only it makes you feel all bad in your warm gooey places. No, screw you. I don't get picked for surgeries because I slept with my boss, and I didn't get into med school because I have a famous mother. You know, some of us have to earn what we get." Cristina finishes.
Meredith stares at the woman before walking off from the area.
Evi sits beside Meredith and Cristina.
"We don't have to do that thing where I say something, and then you say something, and then somebody cries, and there's like a moment..." she says.
"Yuck."
"Good."
"You should get some sleep. You look like crap." Evi says before waking to change.
•.•