- In his new role as Chief, Derek restores the hospital lecture series, and several attendings present to the group pivotal surgical cases from their pasts: Bailey reflects on how shy she was as an intern until getting advice from Webber, Callie looks back on a polio case, and Richard recalls a case in which he and Ellis worked on a patient diagnosed with AIDS, known in 1982 as GRID.—ABC Publicity
- The chief opened the night talking about the many surgery residents he's seen in his time who get addicted to surgery. Callie was throwing up at the thought of speaking at "lecture day" and said that she hated Derek. The chief, who wasn't narrating, but speaking at an AA meeting. He said he "broke" instead of becoming a better doctor and a stronger person, and he hurt people and "scared the hell out of myself."
"I am 45 days sober today," he said. "I am Richard, and I am a grateful and recovering alcoholic."
The chief met with Derek, who said he still needed the board's approval to rehire him. Derek said he could offer the (former) chief a job as an attending general surgeon. Richard turned him down and walked out. Derek chased him down and said that he'd brought back lecture day and asked him if he'd like to speak.
"I understand if you don't want to come back," Derek told him. "But if you're really going to leave this place, don't leave it the way you did. Give one last lecture."
Derek kicked off lecture day, talking to a group of seemingly bored doctors, and he introduced Dr. Bailey. Cristina was messing with some thread in her hand and Bailey tossed a candy at her that hit her in the head.
Bailey started talking about 2003, "I'm three days into my intern year."
Flash back to the chief asking a group of interns about a patient. Bailey was hiding behind the group and mumbling the answers to all the chief's questions. She introduced herself to a resident as "Mandy." The resident was annoyed with Bailey and told her to draw the patient's blood.
Back to the lecture day, Callie shook nervously as she tried to set up her laptop to display pictures on the overhead screen. The crowd laughed when a photo of her and Arizona hugging came up. Callie read slowly and quietly about a patient she had in her third year as a resident. The patient had severely deformed legs.
Back at lecture day, the chief took the stage and told the group they wouldn't realize how much they learn from each other. He talked about when he was a resident in 1982. He watched Dr. Ellis Grey save a man and she served as his colleague on "the case that changed my life." He told all the doctors to look around and said, "the biggest influences on your life are sitting next to you right now."
"This is gonna get more interesting," Cristina whispered to Meredith.
"Yeah," Meredith said.
The chief went on to talk about how Ellis Grey was brilliant but was cast off because she was a woman. They paired up to figure out what was wrong with their patient, who'd come in for a hernia operation and was getting sicker by the minute.
In Callie's flashback, her patient had come in for a club foot repair and Callie confessed to the chief that she told the man he'd be able to walk again. The chief was upset by this and told her she'd live or die by that case, because it would determine her fate at Seattle Grace.
The chief's flashback, meanwhile, showed him and Ellis pondering theories about their patient before sneaking into an on-call room and doing it just like today's "Grey's" doctors do.
Bailey went on to talk about her intern experience, pointing out that patient history is critical. Bailey made the mean resident, Dr Baylow, look bad in surgery when she mentioned to the chief that their patient was vegan, which explained some dietary issue.
The chief went on to talk about how he and Ellis used tissue sample tests to discover their patient had a rare fungus. In the flashback, he and Ellis asked him questions about trips out of the country or whether he lived near birds. He said they asked his girlfriend to leave the room because they were going to bring up some uncomfortable questions: namely, they were going to probe the possibility that he might have "GRID," which was Gay-Related Immune Deficiency in 1982, now known as AIDS. The patient was insulted by the question and wanted to leave and threatened to tell their bosses he wanted to sue for slander.
The chief talked about how rare the disease was at the time, and very few cases had been detected. Even their attending didn't know how to handle it at the time, and was upset with Richard and Ellis' hypothesis. He put them on probation.
Callie's flashback patient was getting unstable after she'd been working for eight hours. Alex, who was in surgery with her (and had passed himself off as the infamous intern who saved a man by pumping his heart in the elevator, which was really George), asked her if she wanted the patient to walk or to keep breathing.
Bailey said her patient, Alicia, came back a month later with symptoms consistent with appendicitis. It became Bailey's first surgery. When she cut the patient open, she and the chief found a perfectly healthy appendix. During the surgery, the chief looked up and saw Dr Baylow glaring down at Bailey from the gallery. He told Bailey that surgery was for sharks and that she couldn't continue to be a quiet little minnow.
Callie fumbled through her lecture and talked about what happened next, but she forgot where to take the story from there. Alex leaned forward from the lecture crowd and said, "That's when we saw the dude do the thing with his foot." Callie then flashed back to where she was telling the patient she could do more surgery, but he wiggled his toes and said he wanted to walk and stand straight up, and he believed she could finish the job.
The chief talked about how he and Ellis thought they were done when their patient refused treatment. In the flashback, they were flirting a bit when Thatcher walked in with a toddler-aged Meredith who wanted to show her mom her new doll (Anatomy Jane which we saw in the Life During Wartime episode in season five). Ellis didn't have time and got back to work. Their "GRID" patient was back with Kaposis Sarcoma on his face. He apologized to them as all the other doctors and nurses stood a significant distance away with surgical masks covering their faces. "Please help me," he told them.
Bailey went on to talk about how important it was to be an advocate for your patient. In the flashback, Dr Baylow told Bailey she was referring the patient to Psych because she was depressed, but Bailey disagreed with the course of action and suggested testing for lupus, lead poisoning or hemochromotosis, and Dr Baylow said they wouldn't spend thousands of dollars on tests when all the patient needed was an antidepresant. When the chief also disagreed with Dr Baylow's plans, she told him they would test for the things Bailey suggested, only she presented the tests as her own idea.
Ellis and Richard went over their patient's scans and they wanted to operate, but their attending refused, saying the man was a lost cause because he had AIDS. Richard said they took an oath to heal the sick and the attending told him that "10 years ago you wouldn't have even been allowed in this program."
Callie said she'd hit a wall with her patient, and Alex said that he gave her a rousing pep talk. In the flashback, Alex continued to tell Callie that he was the one who'd saved the man in the elevator. "What if I'd given up?" he said.
Bailey went on to say her patient tested negative for every test she could think of. She said she went to the library and hit the books hard. But in the flashback, she was at Joe's bar crying about how she was raised to be polite and didn't think she was a minnow.
The chief said he and Ellis were arrogant and had more to prove, so they went ahead with the surgery on their own. Their patient knew that the other doctors were scared of him, and he cried as he talked about how he was scared, too. They asked him to let them operate on what they could, in case there was "a cure for this tomorrow or next week."
Callie talked about researching and practicing for the next surgery on the club foot patient. When the patient crashed, Callie urged everyone not to panic and she told Alex to take the scalpel and do what he did in the elevator. It was in that heated moment that he had to admit, "I'm not the heart in the elevator guy, it was O'Malley."
She told him to get it together and take the scalpel.
The chief said they knew what they were doing was dangerous because at that time nobody knew how the disease could spread. But as they prepped for surgery, something else was on his mind. He told Ellis they had to stop living lies and end their affair. She said their marriages were the lies and that what they were doing together was right. She told him to leave Adele and she'd leave Thatcher. He said he couldn't and she couldn't either, because she had a daughter. Ellis headed into surgery, but Richard told her she didn't have to go into the O.R. because she had Meredith to think about. But Ellis said the fact that she gave birth to a child didn't make her inept.
Bailey said her patient was sent home again, but she returned a few months later. Alicia was about to be taken to the O.R. for another exploratory surgery, but Bailey noticed something and canceled her resident's surgery. In a standoff with Dr. Baylow, Bailey started yelling about how Baylow hadn't learned anything about the patient and ended her tirade by calling her a "supercilious fool." The chief called Bailey into his office.
Alex encouraged Callie to show the before-and-after X-rays of their patient's foot. She did, and there was applause. Callie said they celebrated that night, and in the flashback we saw her and Alex getting it on. Back in the lecture, Arizona was a bit uncomfortable.
The chief had Bailey in his office and pretended to yell at her while Dr. Baylow and her friends looked on. He said he had to make sure that his doctors were treated with respect. At the same time, he gave Bailey credit for catching the problem and told her she was going to make a hell of a surgeon.
Back at the lecture, the chief said their patient survived the surgery but came back eight months later with pneumonia and died a week after that. The chief said he lost the sense that he was a superhero. He reminded the doctors to remember the physician's oath they took when they graduated med school, "because it is too easy to lose your way."
Then he raised his right hand and gave the oath as we saw a montage of Callie's patient, Bailey's patient as they were cured and his and Ellis' patient as he died.
The crowd gave Richard a standing ovation and Bailey was moved to tears.
That night, Derek told Richard that the job offer still stands and urged him to think about it.
"We'll see," Richard said, pretty much to himself, as Derek and Meredith walked out.
We went back to a flashback of Ellis and Richard at the bar, toasting to their dead patient. Ellis told Richard he couldn't toast to a dead Irishman with a soda pop, and she ordered him a vodka. She told him it was time to act like a grown up.
He said he couldn't leave Adele, and Ellis said, "We'll see."
Richard grabbed the vodka and took a sip.
Contribute to this page
Suggest an edit or add missing content