Chapter 14
Mark: "Hey, Torres. Do you know anything about putting together cribs?"
Callie: "You bought a crib?"
Mark: "Well, Sloan's coming home tonight, and I got it put together, but it wobbles. And it can't wobble. Now will you take a look at it?"
Callie: "You're like a sweet, nerdy dad now. I don't even recognize you."
Mark: "Well...who's she?" he asks motioning to a woman standing next to a nurses desk with curly hair
Callie: "I don't know." she shrugs
Mark: "I may be a dad, but I am a single dad. Excuse me."
Callie: "Okay. Now...now I recognize you."
Mark: "It must, uh, suck to work on Valentine's day. I don't believe we've met. Aah!" he takes a step back when Sky turns around and rolls her eyes "You curled your hair?!"
Sky: "No. I woke up late and didn't have time after my show-wait so the only time I can get you to talk to me is when you think I'm someone else and you hit on me?!"
Mark: "No, no. I pretty much knew it was you." he shakes his head
Sky: "Pathetic. Really pathetic." she nods her head as she walks away
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Sky: "Restaurant roof collapse" she informs Owen, Derek, Meredith, and Cristina when they enter the ER "Yeah, so far...a penetrating abdominal injury, a sucking chest wound and a massive head wound. Also, there's an open fracture on the way. Do you want me-"
April: "Dr. Shepherd."
Derel: "Oh, you're still here?"
April: "If you're here, I'm here. There's an Osha investigator waiting in the lobby, and there's also two tv crews who are asking for a statement. I told 'em to wait for you. They're setting up outside."
Sky: "We cleared the O.R. board, also, I paged Bailey, Nelson, Altman, Hagan and Sloan."
April: "As soon as I have all of the numbers, I'll..."
Sky: "Do you want to get anybody else?" the two talk at the same time and begin to overwhelm him a little
Derek: "Stop. Who do I see first?"
Sky: "Skull fracture, trauma 1." she points to the room
April: "The Osha guy."
Derek: "Chart, please." he says when he comes into the trauma room
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Owen: "Try to get as many people as possible off the backboards. Clear C-spines clinically, but if you're not sure, wait for x-ray no matter how backed up they are."
Bailey: "Hey, hold the elevator."
Woman: "I got it!"
Man: "Trauma 4 is open."
Bailey: "Okay, uh, bring the chart, please."
Woman: "Right away."
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Paramedic: "Watch it! Coming through!"
Jackson: "I got the arm."
Sky: "What do you got?"
Paramedic: "Traumatic amputation through the left distal humerus. Bleeding controlled through pressure. Got 10 of morphine. Vital signs are stable."
Sky: "Okay, let's get him in trauma 3, put him on a monitor. Push two of o-neg. Grey, Avery, you're with me."
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Sky: "Okay, I need another 4x4. Okay, dress him. I'm gonna take another look at the arm. This wound's completely macerated and contaminated. Why wasn't this guy brought in first?"
Jackson: "He was lying in dirty dishwater for a while before they found him."
Frankie: "They forgot I was back there."
Lexie: "No, I'm..."
Frankie: "It's all right. I'm not...I'm not too big on talking to people, and...nobody talks to me much back there. They just, you know, bring me the dishes. I lost my arm. I don't want to have one arm. I don't want to be a freak. I...I don't like people staring at me."
Lexie: "We're gonna do everything that we can."
Frankie: "Please."
Sky: "Okay, Frankie, I'll take you up to surgery now. We're gonna try and reattach the arm, okay? We have an open O.R. I'll prep him, work on the stump. You debride the arm, tag the vessels, and get it up to me as soon as you can, okay?"
Lexie: "Okay."
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Mark: "Dr. Rivers." he greets her when he comes into the OR
Sky: "Dr. Sloan. You finally talking to me or you wanna practice some of your pickup lines for when you flirt with someone other than me?" she gives him a fake smile before her mask
Mark: "About that. I-"
Sky: "Don't worry about it" she shakes her head "Wouldn't be me if I didn't make a remark about it."
Mark: "Right." he sighs before moving over to look at the arm
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Lexie: "We saved the arm. We saved it. We're ready."
Sky: "It's gonna have to be an amputation."
Lexie: "What?"
Sky: "There's too much devascularized tissue, too much contamination."
Mark: "Or we can push antibiotics and let the stump heal, but by that time..."
Sky: "The arm will be dead. Page me when he's awake. I'll tell him."
Lexie: "They...they can't just leave it behind. We could move it somewhere else, attach it to a healthy zone." she whispers to Jackson
Jackson: "Don't tell me, mouse."
Lexie: "I'm...I'm just saying..." he pushes her forward a little "Temporary ectopic replantation! Well, you have...you have to keep the arm alive until the stump heals."
Mark: "Yes, but in cases involving the elbow it's extreme. He'll lose range of motion, grip failure..."
Lexie: "He'll keep his arm. He deserves extreme measures. If the arm is still viable, you can't just let it die."
Sky: "Has that ever been done before, above the elbow?"
Mark: "I don't know, but it could be done. You could implant onto the epigastric and the, uh, vena commitante. Give you a few days for the stump to heal."
Sky: "I've never done one."
Mark: "Neither have I."
Lexie: "So? After today, you can't say that anymore. Okay, come on. I told him that we would do everything we could. Do everything that we can."
Sky: "I'll call Shepherd and let him know. Grey, Avery, get ready to scrub in. We're gonna be a while. Nice one." she nods at Lexie impressed
Jackson: "Okay, that? Not mousy."
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Mark: "Look I'm sorry about before." he says as they scrub in for the surgery
Sky: "Mark it's not a big deal. Really. It got you to talk to me." she chuckles a little
Mark: "Yeah...I'm sorry about the way I've been acting these past few days."
Sky: "It's okay. Guess you were entitled to a few immature days."
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Frankie: "You couldn't do it?" he asks when he wakes up
Lexie: "Actually, we could. But, um, you need to prepare yourself. We needed to take some extraordinary measures."
Sky: "Your arm needed a blood supply to keep it alive until we could reattach it, so we had to relocate it to where we could get one."
Frankie: "Is that my arm?! What did you do? Why would you do this to me? What did you do to me?"
Lexie: "It's...it's only temporary. Okay, it...it...just for a few days. Frankie, this is what you wanted. You...you wanted your arm."
Frankie: "In the right place! I said I didn't want to be a freak. You shoulda left me like I was!"
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Frankie: "All those people out there, they just want to stare at me." he looks out his room when he sees a few people standing outside his room
Lexie: "They do. The doctors want to see you. They want to ask you questions because you're very rare...and special. And there might be press, and there's a personal injury lawyer floating around somewhere that thinks that restaurant might owe you a lot of money."
Frankie: "How much money?"
Lexie: "Sometimes change is good, right?"
Frankie: "Oh."
Chapter 15
Derek: "Good morning."
Audience: "Good morning."
Derek: "Good morning, everybody. Good morning. I'm excited. Are you excited? This is a, uh, teaching hospital. We learn a lot by doing. We can also learn...we should also learn...from other people's experiences. Their losses will save you losses. Their mistakes will save you mistakes. Their victories will inspire yours. Let's pay close attention. This is gonna be good. Dr. Miranda Bailey."
Man: "Whoo!"
Bailey: "Good morning, everyone."
Audience: "Good morning."
Cristina: "Ow." she exclaims when she gets hit in the head with something and the others chuckle
Bailey: "Morning, Dr. Yang."
Cristina: "What the..."
Bailey: "If I have to stand here, you have to listen. Eyes forward. Answer a question right, you get a chocolate. Doze off, you get beaned in the face, ask Dr. Yang. My aim is exceptional. 2003...I'm three days into my intern year."
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Sky: "Is she shaking?" she whispers to Arizona as they watch Callie setting up her presentaion
Arizona: "Huh?" she looks at Sky who points to Callie "Oh. She's just a little nervous. Not a fan of public speaking."
Sky: "Got it."
Callie: "Oh. No, no, no. That's not the right..." she stutters when she tries to get her presentation up and a picture of herself and Arizona come on the screen making others chuckle "Um...okay. Beautiful" she puts a picture of broken legs and feet "Um...in my third year as a resident, I was-" she nervously says
Man: "Can't hear you!"
Woman: "Speak louder, please!"
Callie: "In my third year as a resident, I...was presented with a patient named Sunder...Atluri, a 28-year-old grad...student from India."
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Richard: "Um...good...good morning. Once upon a time...long before I was chief of surgery, even before I was an attending, I was a resident right here at Seattle Grace, just like you. You learn from everything in your residency...the patients, the nurses, the attendings. But you don't realize how much you learn from each other. 1982...you were all in diapers...Dr. Ellis Grey...two time Harper Avery award winner and my colleague on this case...a case that changed my life. Look around. The biggest influences in your life are sitting next to you right now. The late Dr. Ellis Grey was known as a groundbreaker, a lion. She was the best this hospital or most hospitals had ever seen. But back then, she was known as "sugar" or "nurse" or nothing at all."
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Callie: "Oh, crap. Oh, come on. Oh, come on. Come on. Come on, come on, come on." she stutters as she drops her cards and works quicke to pick them up
Arizona: "Just talk." she blurts out
Callie: "Hmm?"
Arizona: "Just...tell us what happened."
Callie: "Okay. Um...there was, uh, this patient. He wanted to get his clubfoot fixed. But I had a different idea."
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Bailey: "Single most important step...in the treatment process...anyone?"
Jackson: "Physical exam."
Bailey: "No. No chocolate for you."
Cristina: "Lab and radiology evaluation."
Bailey: "Uh, oh, come on, people. Now you're embarrassing me."
Lexie: "Patient history."
Bailey: "Thank you. Catch."
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Richard: "We're not allowed to beat you with sticks. So we punish you with scut" he says making everybody chuckle "We do it today, and they did it back in my day. Dr. Grey and I did mountains of scut. Testing tissue samples was boring. But it's how we found out our patient had a fungus called cryptococcus. We asked his girlfriend to step out...because we knew we were gonna have to ask some pretty uncomfortable questions. We suspected he might have GRID. Does anyone know what GRID is?"
Sky: "AIDS." she raises her hand
Richard: "That's right. But in 1982, it was known as...gay-related immune deficiency? This was early 1982. We hadn't seen a case in Washington state, ever. San Francisco only had five cases. We didn't know what it was, and because it was isolated to the gay community, the government wasn't funding research. Does anyone know when the HIV retrovirus was finally discovered?"
Cristina: "Uh, 1983, but there wasn't a test for it until '85."
Richard: "That's right. It was so new that even our attending didn't know how to handle it."
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Bailey: "Successes or failures...which teaches you more?"
Jackson: "Failures."
Bailey: "Yeah, but that was a gimmie. Don't get too cocky. The patient was discharged, and a month later, she was back in the ER in the middle of the night. She had right lower quadrant pain, fever, vomiting...symptoms consistent with?"
Meredith: "Appendicitis."
Bailey: "Aha. You get a chocolate, 'cause that's what I thought. But don't eat it yet. Pay attention. I diagnosed Alicia with appendicitis. And Dr. Webber decided that that appy was going to be my first solo surgery."
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Callie: "I didn't want to close, but...we had to. So...we took the...patient to surgery again, and...wait, no. Hang on."
Arizona: "You were there. Help her."
Alex: "That's when we saw the dude do the thing with his foot. You know..."
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Richard: "No surgeon likes giving up on a patient. Dr. Grey and I liked it even less than most. But when a patient refuses treatment, you're done. I mean, we were done. Well, that's what we thought anyhow."
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Bailey: "A healthy appendix...the third surgery for this patient with unrelenting abdominal pain, fatigue and muscle pain. Now what?"
Cristina: "Test for zebras. Um, uncommon diseases."
Bailey: "Okay."
Meredith: "Do an ANA for lupus."
Bailey: "Lupus. Yeah."
Jackson: "Whoa, what about lead? You test for lead?"
Bailey: "Good, good. See? Sometimes I...it's not easy. Sometimes you have to be your patient's advocate and push to get things done."
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Callie: "We'd hit a wall. And, um..."
Alex: "We planned a number of procedures."
Callie: "But, um...uh, but then..."
Alex: "Then I gave you that rousing pep talk." the audience chuckles
Callie: "You know what? You totally did."
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Meredith: "What was the result? Did she test positive for hemochromatosis?"
Bailey: "Nope."
Cristina: "Uh, what about lime disease?"
Bailey: "Lime disease-negative. Celiac disease-negative. Every test I could think of-negative. So I did what I've told you all to do when you get stuck. I went to the library and I hit the books. I hit 'em hard."
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Richard: "Hell, we weren't noble. We were just more arrogant than the rest and had more to prove."
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Callie: "We spent days trying to make things right, trying to figure out the best strategy. So we, uh, we researched and, uh, practiced and practiced, and...eventually, we were ready." she sits on the edge of the stage and starts to become more comfortable
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Richard: "We knew what we were doing was risky. These days we know that AIDS transmission requires exchanges of bodily fluids. But back then we had no idea. Can you get it from casual contact, from the air, from surgery? No idea."
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Bailey: "All my research didn't help. Dr. Baylow sent the patient home. So I thought she'd won. I thought, you know, maybe I wasn't cut out for this game. But a couple of months later..."
Lexie: "So you canceled your resident's surgery? Isn't that a little bold?"
Cristina: "Well, she was worried about adhesions, right? Give me candy." she stands up and holds her arms out ready to catch the candy and people laugh at her
Bailey: "No adhesions. No candy. And it wasn't bold, Grey, it was stupid. But in this case, it was also necessary."
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Callie: "We did a series of shorter surgeries so his lungs and heart could withstand the anesthesia. It was grueling for the patient, but worth it in the end."
Alex: "Show 'em the x-rays."
Callie: "Oh, yeah. So cool. Okay, um...these are the before. And these are the after."
Audience: "Wow. Yeah." they clap for her
Callie: "Um...yeah, it was...it was amazing. I mean, after the final surgery, we were just...and, uh, we celebrated that night. Man, did we ever celebrate." they cheer for her again and Arizona turns to give Alex a look and makes him back up into his chair
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Bailey: "I knew I was in big trouble."
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Richard: "Well, the patient survived the surgery. But eight months later, he came back with PCP pneumonia. He died a week later. Dr. Grey and I...well, um...I won't speak for her. But I lost the sense that I was a superhero. And I really started to think of how dangerous it all was. It changes you...this work. Your patients, your colleagues...you change each other. You don't ever think you'll lose your way. But what happens in this hospital...just remember why you came here. You said it the day you graduated from med school. You took the physician's oath. Remember it. Tape it to your locker, to your bathroom mirror...cause it is too easy to lose your way" he holds his hand up "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 factor 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." he finishes and they all stand up and clap for him