hypotension treatment

Many trials and many deaths have followed Meredith Grey and Derek Shepard in their clinical trials. On top of it all, Meredith is really putting her best efforts into therapy - trying to get "whole" again. She admits to the therapist that she actually witnessed her mother's death. She watched as her mother took a scalpel and slit her wrists on their kitchen floor. Her mother told her not to help her, so Meredith waited until after she passed out before calling the police, for fear she'd get into trouble. She had saved her life, but her mother didn't want to live.

Back in the hospital with Derek, the two doctors go in to meet their next brain tumor patient for their study, a young woman with her parents. Soon after, their other patient, a young man about the same age appears at the door. Evidently the two young patients know eachother - and quite well. The young man comes and greets her with a kiss while the parents look uncomfortable. Evidently the two met at another hospital while having treatments done. They've fallen in love and the parents are concerned because they don't want their daughter to fall in love with someone who may die. their fear is that she won't fight to stay alive. When the mother confronts Meredith about finding another room for her daughter, Meredith lies and says there are no other private rooms available. The young man, who is visiting, starts seizing and Meredith rushes to help him.

Meredith, then, runs into Nurse Rose out at the nurses station and Rose drops a file on the floor. As she helps pick it up, rose tells her, "You intimidate me a little, not that you're an intimidating person, it's just that the legend of you and Derek, it's intimidating." She also happens to mention that Derek is selling his land - the land that he has blueprints to make a house with Meredith on, he's selling it. Meredith looks at her and tells her assuringly, "There's no legend." The flustered Rose is a little consoled.

George O'Malley tells Meredith that Chief Webber needs to meet with her or Derek and she says she'll talk to him. When she finds him he tells her that after 11 deaths, they're shutting down the clinical trial at midnight. He tells her they can do one more patient today, and that's all. then we're back to therapy to discuss her mother's death. Meredith insists she's not mad about the whole thing, the Chief did what he had to do and her mother did what she had to do. Then who is she angry with, the therapist asks, but Meredith doesn't know. "You're angry with the chief, you're angry with your mother, you're angry with yourself. . .the answers are right in front of you." She's reliving them every day in this hospital.

She meets up with Derek to tell him about today being the last chance. She suggests they try to get both in before the midnight deadline put on them. Derek asks her, "Are we going too far here. . . these are people's lives. . . is my ego too big here?" "Your ego is just the right size," she tells him, "We can do two." "Two patients," Derek ponders, "bends the rules without breaking them, you'll clear it with Chief?" "Yah."

As they walk past the young woman patient's room where she's trying to walk without the use of her left side. They help her into a wheelchair and she tells them she just wanted to see Jeremy (the other patient) one more time before he went to surgery. They help get her read and she tells them that she wants to "BE" with him, you know, "be" with him. Then she asks, "You've done it before, right?" Caught off guard, Derek says, "With each other?" and Meredith says, "Well, he's done it and I've done it. . ." "Is it magical," the young woman asks. Derek says, "Yes," Meredith says, "It can be," then Derek finishes, "with the right person" and he glances at Meredith as only McDreamy can. The next thing you know, the two are standing in front of the patients closed door, keeping watch. Derek says, "I've never in my life got a patient laid, much less two patients." "It's really sweet," Meredith tells him, "they're so in love . . . it's all new and fresh and exciting." Derek admits,"i've never been a fan of new. I like to know the person- their body, what makes them moan. . ." Then the worried parents appear asking where their daughter is. Derek fumbles for words, but Meredith is quickly able to give them an excuse and whisks them away for some more paperwork to be done.

Back in the patient's room Derek and Meredith ask how it went. The young man says, "It was amazing." Then it's time for him to go into surgery and the two start saying their goodbyes. The young woman tells him, "You changed my life, Jeremy, you made it better, you made it brighter, full of joy and if I die. . ." she breaks off and he finishes, "Don't you dare die! We're not finished yet. I'm not finished loving you." And then he's off to his surgery. While prepping in the O.R. Meredith asks Derek, "Can't you feel it? The majesty of life-saving?" "When did you become an optimist," he asks her. "Selling your land?" she asks knowingly. "Trying to move forward, " is Derek's reply. The go into the surgery ont he young man, but they lose him. Derek is really upset and storms out of the O.R. He throws their victory champagne in the trash. They go to talk to the young woman about her surgery. Derek doesn't want to do it anymore, but Meredith explains how they've learned from Jeremy's surgery and have adjusted accordingly. The mother says that she wants to take thier daughter home because she doesn't want to lose her. The patient tells her, "you won't [lose me] because I'm not finished. . ." and she insists on the surgery. She knows she'll die anyways eventually. "Please do the surgery today," she begs Derek. Once they leave the patient's room Derek is really upset, though. He is mad at Meredith for pushing her into the surgery. "We can't do it, she's a kid," Derek tells her. "She's a kid who's gonna die without the surgery," Meredith retorts. "She'll die with the surgery," Derek says, " That's what you and I do together. We kill things over and over and over again. We've killed 12 people and now because of you, I will kill a thirteenth. When this surgery is over, we're done. I don't want to work with you, I don't want to see you, I don't want to talk to you. We're done." And he leaves Meredith standing there alone.

Back in therapy, Meredith is asked to recall what her mother's last words were to her. "She told me to be extraordinary. She said that she had failed, but that I should be extraordinary, that I shouldn't depend on anyone. 'Be an extraordinary woman, Meredith.'" So she became a surgeon just like her mother. The therapist insists that Meredith's mother was not really wanting to die and that Meredith has all the tools necessary to figure it out on her own. "You need to work this through, Meredith. I promise you that when you do, you'll be glad."

Getting ready for the next surgery, Derek is talking with Rose when she tells him,"I liked you better when you were saying boring science stuff." He starts, "I'm never good enough. No matter what I say or what I do. I never wanted to do this. This clinical trial is making me a failure. I fail her over and over and over." Rose corrects him, "You mean 'them.' When you say 'her' you mean 'them,' the patients?" and she leaves the room. He goes in to the patient and tells her, "You don't have to do this." The patient teasingly says, "Come on, what are you scared?" "Yes" he tells her very matter-of-factly. The patient gets serious, too, "Me too, so lets just leap, okay?" "Okay"

Meanwhile Chief is looking at the O.R. schedule and realizes that Derek has two surgeries scheduled. Evidently Meredith hasn't cleared it with him, but back after the surgery, the patient is still alive and Meredith and Derek are there. Derek decides to stay and monitor her. Meredith goes home and finds blood in the kitchen, which can only be stirring up bad memories (read about Alex and Ava next). She begins scrubbing. . . and scrubbing. . .

The next day, the Chief confronts Meredith about the two surgeries. She tries to blow him off and he gets firm, "Is that how you talk to the Chief?" "My mother tried to kill herself after you left, did you know that? Did you know that?" Chief is totally caught off guard, "I didn't know that, I'm sorry, I didn't know. . ." She interrupts, "She was a brilliant surgeon, how could you do that to her? She was a talented, gifted, extraordinary surgeon. . ." but suddenly she stops as if she's finally realized everything. She goes to her therapist and announces, "She didn't want to die - she was a talented extraordinary surgeon, she didn't want to die. If she had wanted to die she would have cut her carotid artery, she would have died in seconds. . ." "What did she want," the therapist asks. "She wanted Richard to come back for her." "And why didn't he come back" "Well, because he never knew about it and she was too stubborn to ask." "So what does that mean?" Meredith looks puzzled then says, "Well that part I don't know, could you just tell me for once." In the therapists wisdom, she says, "I can. It means that you are a gifted, talented, extraordinary surgeon, but the difference is that you can learn from her mistakes." And now Meredith understands, her mother wasn't talking about surgery at all.

She goes to check on her patient who seems to be doing well. She's looking at the scans of the girl's brain tumor with Rose. As she measures one from before the surgery and the one from today, she realizes that the tumor has, in fact, shrunk. The two are excited and Meredith tells Rose, "You have to tell Derek." Rose says, "No, you have to tell Derek, its the kind of news he'd want to hear from you. Congratulations on your major medical breakthrough. It's the stuff of legends." Meredith goes to find Derek.

Meanwhile, Derek is outside the patients room and sees her parents crying. He rushes in to find that the patient is alright and actually waking up. He smiles and leaves to go pull the champagne out of the trash and is looking for Meredith.

Meredith is at Derek's property, but he's not there. Derek goes to Meredith's house to find an empty house. Derek finds himself back at his trailer and something bright catches his eye out on his property. He sees Meredith out there with hundreds of candles lit. She's muttering, "Stupid, corny, idiotic, I can't believe I did this - stupid loser, son of a, I could be home instead of. . ." "Meredith," he says. "Where have you been," she yells, "I've been here waiting and waiting for you and I did this stupid thing and I was just going to tell you that," and she starts pointing at the shapes of the candles where she's mapped out their house together, "this over here is our kitchen, and this is our living room and over there, that's where our kids could play. I had this whole thing about how I was gonna build us a house, but I don't build houses because I'm a surgeon and now I'm here, feeling like a lame a** loser. I got all 'whole' and 'healed' and you don't show and now its all ruined because you took so long to come home and I couldn't even find that bottle of champagne," Derek holds it up smiling, not even caring that she's yelling at him, and asks, "Where's our bedroom?" She continues, "I'm still mad at you and I don't know if I can trust you. I want to but I don't know if I do, so I'm just going to try and trust you because I believe we can be extraordinary together rather than ordinary apart. . ." but she can't finish because he's kissing her. Then Derek tells her, " I have to go." Why? " In order to kiss you how I want to kiss, the way I want to kiss you, in order to do more than kiss you, I need to speak to Rose. I want my conscience clear so I can do more than kiss you. Stay here, don't move, wait for me." And he leaves her there standing in the field of candles to wait. . .

. . . until next season.

more from this episode. . .

Alex Karev starts the day with asking Izzie Stevens to cover for him. He's not going to work, he's going to stay home and watch movies with Ava. Izzie immediately goes to Bailey for advice, but Bailey is too busy trying to "see something." She's trying to see the bigger picture. Despite her attempts to ask others, everyone just seems too busy to help Izzie with her "problem."

Meanwhile, back at home, Alex sits down next to Ava on the couch and asks her to catch him up on what he missed of the movie. She hasn't the faintest idea what has happened and says, "I think I wet my pants." Alex is caught off guard, but says, "It's okay," Ava tells him, "I'll do better, I promise," and they leave to go get her cleaned up. While she's cleaning up in the shower, she huddles down in the bath and curls up in a ball. Realizing something is wrong, Alex gets in (clothes on and all) to get in and help comfort her. She doesn't understand what has happened and how she wasn't pregnant. Alex again tells her, "it's okay" and that she just got confused.

Back at Seattle Grace, Izzie Stevens calls Karev to see how things are going at home with Ava. They were just making sandwiches for lunch and he's yelling at Izzie for being in his business. Then he suddenly leaves the phone to attend to Ava leaving Izzie clueless as to what is happening on the other end. The next thing we know, Alex has Ava in the E.R. She had slit her wrists with a knife he'd left in the kitchen to get the phone. Izzie realizes that things are much worse than she thought. After lying about the injuries and cussing Izzie out of the room, Izzie finally gets a moment with Miranda Bailey. She quickly gives a synopsis of what's going on. Miranda tells her that its no different than other patients, she is the physician, Alex is just the loved one and, " C'mon, you know what to do. It's just hard to do it." Izzie, defeated says, "Okay, I'll try." Bailey tells her, "No, you don't have to try. You're a doctor, trained by me with all the skills God gave you. You have everything you need," and sends her off to take care of it.

Izzie musters the strength and brings the psychiatrist to meet with Ava. She pulls Alex over in private to discuss the matter further. "What did I tell you? " Alex says accusingly. Izzie (thankfully with much more backbone than she's had lately) tells him, "She's my patient. I decide her treatment plan. I am not releasing her without a consult. If you try to take her out of this hospital without my okay, I will call the police and have you arrested." Thinking he's calling her bluff, Alex says "You can't have me arrested," but Izzie's not backing down. "Try me." "Look, Izz, you're worried, I understand, but you're being a little unreasonable. I got this." Izzie explains that he can't handle it. "Are you going to bodily restrain me," Alex asks. "If I have to . . . Are you going to hit a woman?" "If I have to," Alex answers. The tension continues to rise until Alex finally says, "Look, I can take care of her, I've done this before. She's just going through a rough patch alright? I can feed her and I can change her and I can bathe her and I can watch her until the bad patch is over. I can take care of her. Look, I took care of my mom and I can take care of her. . .but I was a kid then and now I'm a man so I'll be better at it. I have done this before." Izzie finally gives in and says, "Stop, you don't have to say anymore."

Alex is forced to face the reality in front of him. He finally calls Ava's husband. He tells Alex that he left Ava 2 months ago and took the baby. She has "underlying borderline personality disorder" and with the accident, the problem is getting worse. He goes to talk to Ava abaout it and tells her, "you need help Rebecca and I can't give it to you." She explains, " I wanted to be better for you. I know how hard it is for you to trust people and I wanted to be there for you. I'm sorry." "It's okay," he tells her, "you tried."

At the end of the day Bailey comes to Izzie to ask how everything went. "Awful." Miranda Bailey hands her the keys to the clinic and Izzie asks why. "I'm not giving you the keys to the clinic, I'm giving you the clinic. I've seen the bigger picture. I love the clinic, I love what it means, I love what it is, but I don't love it as much as I love surgery, I don't love it as much as being chief resident, i don't love it as much as my husband and child. Now I've seen the bigger picture and I can't do everything and have everything so I have to let some pieces go - this piece- this is your piece. I've watched you earn this piece the hard way, the awful way, knowing that I can give the clinic to someone like you. You have grown into a fine doctor, Izzie Stevens." "Thank you," are the only words Izzie can muster. "The Denny Duquette Memorial Clinic is in your hands - Make me proud!"

Back at home Alex is very torn up. Izzie walks to him, "I'm sorry," she says. "Not whatever, I'm sorry about Rebecca (Ava) and your mom. I'm sorry." Alex leans over and starts kissing her and begging, "Please, just this one time, just for this one night, please, please." But Izzie's not sure how to react. She pulls away, kisses him back a little, then pulls away and holds his sobbing head against her chest. What a day it has been for these two.

more from this episode. . .

George O'Malley continues at a run this episode. Going all over, doing the Chief's business, when he finds himself looking through Chiefs office and he stumbles upon the files of all the residents in the hospital. He looks for a moment longingly, then he gets back to what he's doing. Later, he is venting to Lexie Grey (who has given him temporary permission to complain although he promised to stop), about how he has "supposedly has all this power. . .fake power" and happens to mention that he has access to all the files, but he can't look at the files because he hasn't really got the power. The next thing you know, Lexie has paged him to a supply room where she's hiding out with all the resident files laid out in front of her. George quickly starts picking them all back up while she explains that she's already read them all and that she has a photographic memory and they are burned onto her brain. She blurts out, "George, you failed the intern exams by one point. . .1 point!" As they try to get them all back in the office, Lexie starts spewing out all the new information she's acquired. "Cristina is dyslexic, but she got straight A's all during med school and she has a PhD. It's pretty amazing - 8 letters of recommendation in her file. Izzie went to college at night, it took her 6 years to graduate and she volunteered as a candy striper, patients wrote her letters of rec. And Alex, he wrote this essay to get in - this moving, beautiful essay about how his grades weren't that good during med school because he suffered from testicular cancer. He said he lost a ball, but I've seen him naked, he has two mangerines, George, 2 pouch potatoes - he lied, he's a liar." George interrupts, "Stop telling me information I don't want to know." She continues, "One point, how can they keep you back for one point." "Just forget about it," George tells her. "Photographic memory. . .I can't," says a naive Lexie.

Lexie tries to confront George about it again later, but now he's upset. "You didn't do me a favor," he tells her,"you just made it clear that I'm still me - the 'almost guy.' All that separates me from my class is one point. One point! I mean I'd be okay if it was 50 points or 1 points, but one? That means it was right there in my hand and I let it slip away. I didn't want to know that. Do you get that? That knowing if I had just checked A instead of B then. . . that one point separates me from freedom. I've been running my tail off, busting my a** to make up for one lousy point, proving. . .you didn't do me a favor. Don't kid yourself." He walks away, but she doesn't let him drop the whole thing. She finds him again, "You had 14 letters of recommendation. Cristina had 8, Mer had 4, Izzie had 10, but you had 14 and the words that they used to describe you - nobody had recommendations like yours. People said the others were 'smart' that they were 'hard workers' they said that they were 'good,' but your letters, they said you were 'great.' They spoke of your kindness, your attention to detail, they talked about how hard you try, that you never give up. They painted a picture of the kind of doctor that I hope to become. It was an honor to read those letters because now I know that what separates you from the others isn't one stupid point. What separates you from the others is greatness, so don't you dare let one point hold you back.

George spends the whole night in the cement patient's room monitoring his status, to which Chief Richard Webber tells him, "good job." George has something else to say about it. "It's not a good job, its not a good job for me, sitting by his bedside recording urine output and giving anti-anxiety meds all night. Its not a good job for me - running labs for Meredith Grey. That's not a good job for me. It's not a good job for me because I'm better that that and you know I'm better that that. Maybe if I wasn't good at my job or maybe if I had struggled and was lagging behind. My personality, I'm not Karev, I'm not Yang, I'm not Meredith, I'm not hardened, I get that, I get it, I don't have the personality of a surgeon. Maybe that's why you made the mistake of not thinking that I deserve a second chance when everyone else around here has gotten one, but sir, it is a mistake because I'm excellent, I'm excellent at my job and I did fail my test, but I deserve a second chance." Chief looks at him thoughtfully for a moment then agrees, "Okay, you can retake the test." George is elated and when he finally goes home to Lexie, in his excitement, he gives her a kiss. He moves on to continue to celebrate with alcohol and Lexie touches her lips softly realizing what she just received from him. Maybe there's love to come for these two? But as with all the plots we've now begun, we must all wait until next season. . .

more from this episode . . .

Meredith Grey, who is so put out by the therapists past comments from the last episode, goes into the office to demand her file. The therapist tells her she's quitting just like everything else in her life that she's been quitting on. Shortly after she sees Derek Shepard about the next clinical trial patient and he suggests that if she's overwhelmed she can take a break. "I'm not a quitter! I don't need you rescuing me, lets just do this."

Rose walks up to Shepard saying, "Okay, the sex, I thought it was mind-blowing myself, but I get the impression that you had a really bad time. . . Why are you avoiding me?" He tries to blow it off, but the fact remains that he hasn't called her since then.

Back in the patient's room, Derek and Meredith are asked if they can hold off the surgery until 3pm when the patient says that the love of her life, Andre is to arrive. But later in the hallway, the patient's sister tells the two that she thinks it's a delusion. The patient has never really found love before, no one has ever seen him or know anything about him, but still the patient has a "Fairy tale" type story of how the two met. She lost her shoe on the way back on the cruise ship and left it behind for fear of missing the ship. The mysterious Andre brings it to her and they had an amazing time together. Now she's considering canceling the surgery to spend her last few months with him. Meredith isn't buying this stuff and when she asks Derek if he's talked to the patient yet, she is upset that he's giving her until 3pm to wait for her mystery man. After all "She found a way to have real love," according to Derek. Meredith assures him, "Of course she did because that's where love exists - in delusional fantasies. Real love isn't like that." "Good to know," answers Derek before walking away.

In the midst of it all, Meredith is still trying to get her file away from the therapist. She even follows her to the bathroom, but while they're arguing over "quitting" Lexie Grey barges in. "I forgive you. I forgive you for treating me like crap and I forgive you for letting your friend treat me like crap. I don't know how you get up in the morning, I honestly don't. Our dad abandoned you and your mom by all accounts was the meanest person ever and you can't let Derek love you and it all really, really sucks, but ever since I knew you existed I had this fantasy about my big sister and you have failed on every occasion to live up to that fantasy, but I still love you whether you're capable of letting me or not, so I forgive you." And she's gone as quick as she came, but of course the therapist heard the whole thing. They agree to meet at 2 o'clock for a session.

Again the therapy session ends with Meredith upset. She questions why the therapist would think she is suicidal and when she will give up on that idea. The therapist tells her "When you start acting like you want to be alive . . .You seem to stand on [the line between life and death] and wait for a strong wind to sway you one way or the other. You're careless with your life. . .probably because your mother told you you were a waste of space on this planet. The problem is you believe her." "Don't you ever talk about my mother." Meredith storms out. . . again.

Back with the patient, Derek and Meredith are waiting for the love of her life to arrive. Three o'clock comes and goes, four. . .five and still no sign of him. So they finally go into surgery. Of course, then in the middle of the surgery, Meredith is informed by a nurse that he just arrived. The injection is already done, the patient goes into distress, resulting in swelling of the brain. Derek now has the bad news to inform the loved ones that the patient will never wake up again. Its too much for Meredith, she begins to cry and quietly leaves the room.

Derek meets up with Rose, who is upset with him. "Derek, we spent the night together," she tells him," and then you vanished. Now I wish that I was secure enough to handle that without a bruised ego and a lot of processed sugar, but I'm not." "Wait!" he tells her, "Can't we just make this easier. . .I've done complicated. i don't want to do that again. Can't this just be easy. . . Fun. We don't need that 'fairy tale' thing right now. We just need happy." That seems to work for her and they leave hand-in-hand. It appears that Meredith is not the only one to change expectations to make it work.

Finally Meredith steps into the therapists office after she's been crying and hesitantly says, "My mother tried to kill herself when I was a kid. After the love of her life disappeared. I never told that to anyone before. You think I'm broken, fix me because I'm no quitter. Let's go." And so it ends with a new round of growing for Meredith next week.

more from this episode. . .