"A Hard Day’s Night"
Written by Shonda Rhimes; directed by Peter Horton

In her opening weekly voiceover, Meredith Grey (Ellen Pompeo) talks about “the game” and how some people have what it takes to play while others don’t. Her mother had what it takes, but Meredith considers herself screwed. She means that literally, actually, as she’s waking up naked on a couch with a guy on the floor whose name she doesn’t know. It’s Derek Shepherd (Patrick Dempsey), and Meredith wants him to leave so she won’t be late for her first day of work. He asks her if she lives in the house they’re in; she says it’s her mother’s, but Meredith moved here from Boston a couple of weeks ago and plans to sell it. She tells Derek they don’t have to exchange names and information, she’ll just go upstairs and take a shower, and when she comes back down, he’ll be gone. He introduces himself anyway. Later, Meredith heads to work at Seattle Grace Hospital, where she and her fellow interns are lectured by the chief of surgery, Richard Webber (James Pickens, Jr.), about the game and how difficult it will be. “Like I said, I’m screwed,” Meredith voices over. In the locker room, Meredith notes to another intern, Cristina Yang (Sandra Oh), that out of the group of 20, only six of them are women. Cristina replies that she’s heard one of them is a model. They note that they’ve both been assigned to the same resident, Bailey (AKA the Nazi), as has an intern named George O’Malley (T.R. Knight). He remembers Cristina from the intern mixer, but his memory of how she was dressed kind of makes her think he’s gay.

The three spot Miranda Bailey (Chandra Wilson) and are surprised that she doesn’t look anything like a Nazi. They meet Izzie Stevens (Katherine Heigl), who thinks Bailey might turn out to be nice. Cristina correctly pegs her as the model. Bailey shares her rules, which start off with not sucking up because she already hates everyone. The second rule is to answer every page with a run. This is the first hour of their 48-hour shift, and as interns, they’re at the bottom of the surgical food chain. They’ll have to do anything that’s asked of them and work every second night without complaining. The third rule is not to wake Bailey if she’s sleeping unless someone is dying. Rule number four is that if the patient is dead when Bailey gets there, not only will the intern have killed someone, but Bailey will have been awakened for no good reason. Meredith notes that Bailey only gave them four rules, but she said there were five. The fifth is that when Bailey moves, everyone moves. On the roof, Bailey and her interns receive a 15-year-old patient named Katie who has been having seizures. Izzie gives her medication to stop her seizing just as Dr. Preston Burke (Isaiah Washington) enters and orders every test possible. Izzie is disappointed to be assigned to do rectal exams while Cristina, Meredith, and George get to work on Katie.

Cristina stops by an OR where Bailey is operating and tells her that Katie’s tests don’t show anything to explain her seizures. She’s also heard that every year, the attending on call picks an intern to do a procedure during his or her first shift. Bailey just sends her away. Meanwhile, George tends to a patient who doesn’t quite get his humor. Katie tells Meredith that she’s upset to be missing a pageant, Spokane Teen Miss. She notes that Meredith seems lost and asks if she’s new. Izzie does her rectal exams while George accidentally hurts a patient while giving an injection. Burke arrives and sends him away. Katie complains about Meredith’s incompetence, noting that the last time she was at the hospital, for a twisted ankle sustained when she was performing rhythmic gymnastics, the nurse who tended to her wasn’t this clueless. “You and I are going to have so much fun together,” Burke tells George. At hour seven, The interns meet up in the cafeteria, where Izzie is unable to eat after performing so many rectal exams. She thinks Bailey hates her, but George says he’s in a worse position because Bailey is a resident but he already has an attending hating him. Cristina announces that Meredith is “inbred,” as her mother is Ellis Grey, creator of the Grey method and one of the first hotshot female surgeons. Cristina would love to be Ellis and thinks she just needs one surgery to get head. Meredith joins the group and complains about Katie.

Burke arrives and says that he has the honor of picking an intern to join him in the OR. It’s George, and he gets to help with an appendectomy this afternoon. George is shocked, as is Bailey, who later tells Burke that George barely made the cut into the program and isn’t the best choice. Burke says George is his guy, and Bailey notes that every year Burke picks someone to torture more than the others. Burke does so in order to make the others fall into line. Bailey understands and respects this, but she doesn’t think George will be able to handle the pressure. Katie’s parents arrive and Meredith asks Bailey if she should get Burke to answer their questions. Bailey tells her Dr. Shepherd is taking over the case. Meredith is shocked to realize that Derek was the guy in her house that morning. Derek pulls Meredith aside and she tells him that they should pretend what happened the night before didn’t happen. He tells her she took advantage of him and asks if she wants to do so again on Friday. Meredith says no, since she’s an intern and he’s her attending. As George prepares for surgery, some other interns wonder if he’ll faint, cry, screw up, and/or have a total meltdown. Meredith bets $50 that he pulls it off, then blasts the others for not being loyal while one of their own becomes the first to perform surgery. Cristina speaks up that she bets $75 that George can’t even ID the appendix.

The surgery begins and Burke quiets the interns watching in the gallery. Cristina comments that Burke is trouble. The surgery starts out well, but George accidentally rips the patient’s secum and is unable to figure out how to fix the problem. Cristina notes that George is choking, but Meredith quietly encourages him to get it together. Burke quickly takes over and kicks George out. An intern named Alex Karev (Justin Chambers) calls George 007; Meredith explains to Izzie that it means George has a license to kill. At hour 19, the interns hang out in empty beds in a corridor (hereafter known as Intern Alley and George asks if everyone is calling him 007. Meredith and Izzie try to make him feel better by saying that no one’s talking about him. Meredith gets a page to tend to Katie and rushes off. George laments not going into geriatrics, a specialty where he wouldn’t be reprimanded for killing patients. Meredith reaches Katie’s room and sees that her patient is fine, just bored. “I’m not a cruise director,” Meredith points out. Katie wants to see her pageant on TV but hers doesn’t get cable. Meredith tells her to get some sleep and let her take care of people who are actually sick. Elsewhere, Izzie tells a nurse that a patient needs a central line but she doesn’t know how to start one. She ends up having to wake up Bailey, who is less than thrilled, especially since the patient isn’t dying.

Overnight, as Izzie, Cristina, and George work exhaustedly, Alex insults a nurse, then introduces himself to Meredith. She tries to give him advice but he thinks she’s a nurse, too. Meredith gets another page for Katie and takes her time getting to the girl’s room. Alex asks George if Meredith is single; George says he doesn’t know and they’re just friends. As Meredith approaches Katie’s room, she sees a bunch of nurses going in and realizes that there’s actually something wrong. Meredith can’t figure out what to do to stop Katie’s seizures, so she tells the nurses to page Derek. Katie has to be resuscitated, and when Derek arrives, he blasts Meredith for not paying enough attention to her. Bailey arrives and also blasts Meredith, telling her that if one of her patients dies, it makes Bailey look bad. Meredith just heads outside and throws up, then swears Cristina to secrecy. At hour 24, Derek admits to Katie’s parents that they’re not sure what’s wrong with her, but at least their daughter is stable. Katie’s father complains that Seattle Grace is supposed to be the best in Washington, so the doctors shouldn’t be saying that they don’t know what’s wrong. He demands another doctor. Burke tells a patient about the bypass surgery he’s about to undergo. George assures the patient and his wife that everything will be fine.

Cristina practices her suturing on a banana, hoping to wake up her brain. George laughs at her but stops when she calls him 007. He doesn’t really care, since he just comforted some people and gets to hang out in the OR. Derek greets the interns and announces that he’s going to ask them for some help in figuring out what’s wrong with Katie. Whoever can find the diagnosis first gets to assist in her surgery. A nurse asks Alex to reevaluate one of his patients, but he wants to take time to figure out what’s wrong with Katie instead. Cristina asks Meredith to work with her, since Meredith has been on Katie’s case from the start. Meredith agrees but says she doesn’t want in on the surgery since she doesn’t want to spend more time with Derek. They do some studying in the library and Cristina asks why Meredith doesn’t want to spend time with Derek. After making her promise not to react, Meredith admits that they slept together. Cristina immediately goes back to the case, then asks if Derek was good. Meredith thinks it’s sad that Katie could die before she reaches her full potential. She shares that Katie’s pageant talent is rhythmic gymnastics, then remembers something and takes off. The two find Derek and tell him that Katie fell while practicing and could have burst an aneurysm. Derek notes that there’s a one-in-a-million chance of that happening, but he agrees that that’s enough of a possibility that they should check it out.

Meredith, Cristina, and Derek check some films and discover that Katie has a subarachnoid hemorrhage and is bleeding into her brain. Derek heads off to tell Katie’s parents that she needs surgery, but Cristina reminds him that he said someone could help with the surgery. Derek chooses Meredith, which upsets Cristina. Burke finishes his surgery and tells George that he couldn’t save the patient because he had too much heart damage. George is upset, since he told the man’s wife he would be fine. This angers Burke, who says the only person who can make promises to patients is God, who hasn’t been seen with a scalpel lately. He instructs George to tell the patient’s wife that her husband died. In Intern Alley, Izzie tries to comfort Cristina, who doesn’t want to hear it. Meredith shows up and offers to tell Derek to pick Cristina for the surgery instead. Cristina refuses her charity and tells her that if she wants to be a shark, she should be one. “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,” she says. “You know, some of us have to earn what we get.” George tells Burke’s patient’s wife that he died; she tells him to go away. Derek shaves Katie’s head before her surgery and tells Meredith he promised to make her look cool. Meredith asks if he chose her for the surgery because they slept together. Derek says yes, then admits he was kidding. Meredith tells him to choose Cristina instead, but Derek says Meredith is Katie’s doctor. Plus, she saved her on her first day. She needs to take her shot despite her history with Derek.

Meredith and George talk about the jobs they should have pursued rather than being surgeons. Alex talks with Webber about a patient; Alex is unable to answer some pop-quiz questions without his notes. Meredith, however, is, so Webber replaces Alex with her. He also recognizes her as her mother’s daughter. Meredith winds up performing Katie’s surgery with Derek as she voices over, “I can't think of any one reason why I want to be a surgeon. But I can think of a thousand reasons why I should quit. They make it hard on purpose. There are lives in our hands. There comes a moment when it's more than just a game. And you either take that step forward, or turn around and walk away. I could quit. But here's the thing: I love the playing field.” Meanwhile, Izzie has to wake Bailey again and Cristina watches Meredith in action. Afterwards, she tells Meredith that it was a good surgery. At hour 48, Cristina and Meredith decide not to make a big deal out of apologizing and making up. As Cristina heads off to sleep, Derek finds Meredith and she tells him how great the surgery was. Meredith, Izzie, Cristina, and George leave the hospital together and Meredith heads off to see her mother, Ellis (Kate Burton). She tells her that the interns are great and she’s decided not to sell the house after all. Ellis asks Meredith if she’s a doctor, noting that she thinks she used to be one. Meredith tells her she used to be a surgeon.

WELCOME TO SEATTLE GRACE: Meredith, Derek, Webber, Cristina, George, Bailey, Izzie, Burke, Alex, Ellis


MEMORABLE QUOTES: “Rule number one, don’t bother sucking up. I already hate you. That’s not gonna change.” - Bailey

Meredith: “Dr. Shepherd, we should pretend it never happened.”
Derek: “What never happened, you sleeping with me last night? Or you throwing me out this morning? Because both are fond memories I’d like to hold onto.”
Meredith: “No. There will be no memories. I’m not the girl in the bar anymore, and you’re not the guy. This can’t exist. You get that, right?”
Derek: “You took advantage of me and now you want to forget about it.”
Meredith: “I did not take --.”
Derek: “I was drunk, vulnerable, and good-looking, and you took advantage.”
Meredith: “Okay, I was the one who was drunk, and you are not that good-looking.”
Derek: “Well, maybe not today. Last night, last night I was very good-looking. I had my red shirt on, my good-looking shirt. You took advantage.”
Meredith: “I did not take --.”
Derek: “You want to take advantage again? Say Friday night?”
Meredith: “No. You’re an attending. And I’m your intern. Stop looking at me like that.”
Derek: “Like what?”
Meredith: “Like you’ve seen me naked.”

Katie: “I can’t sleep. My head’s all full.”
Meredith: “That’s called thinking. Go with it.”

Cristina: “Katie competes in beauty pageants--.”
Derek: “I know that, but we have to save her life anyway.”

Cristina: “You should get some sleep. You look like crap.”
Meredith: “I look better than you.”
Cristina: “It’s not possible.”

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