"(As We Know It)"
Written by Shonda Rhimes; directed by Peter Horton

Meredith voices over that in hospitals, they say that people know they’re going to die. Bailey fights off contractions, Derek operates on Tucker, Addison sits by herself in a lounge, Alex and Izzie hold each other post-coitus, and Meredith freaks out (see “It’s the End of the World”), voicing over, “If you knew this was your last day on Earth, how would you want to spend it?” A now-dressed Izzie and Alex catch up with George, who tells them that something happened in James’ OR and now Hannah is missing. Webber passes by and says that the quiet board is to blame. Burke and Derek run into each other (still addressing each other by their last names) and Derek updates Burke on Tucker’s surgery. They note that they’re both stupid for not evacuating and state that they should have chosen different professions. Derek says he doesn’t want to be the guy who kills Bailey’s husband, but Burke trumps him by saying that he doesn’t want to be the guy who kills everyone in the hospital. Dylan suits Cristina and Meredith up with flak jackets, Cristina and Dylan both chastising Meredith for making a stupid decision. Meredith reminds Cristina of the feeling she had that morning that she might die today. Burke returns and tries to kick Cristina out, but she won’t leave until he tells her that he won’t be able to concentrate with her in the room. Cristina tells Meredith to run if she needs to.

George, Izzie, and Alex hang out in the locker room, the guys talking about how things seem different now that they know Meredith could die. Izzie starts laughing, admitting that she always has inappropriate reactions to serious situations. Alex wonders if they should call Meredith’s family, but George notes that they’re her family. Cristina heads back to Tucker’s OR to continue to help Derek, but she declines to tell him that Meredith has taken Hannah’s place with James. Addison tries to calm Webber, but George tells them that it’s a day to be scared. Addison notes that if Bailey stops pushing, she’s going to need a C-section, but Webber can’t give her an OR. Addison says that if they don’t get access to one, the baby will die. As Debbie brings Webber some blueprints, Izzie and Alex start making out again in a closet. She admits that she was jealous of Meredith for getting a good surgery, and now she’s upset about that. In James’ OR, Meredith asks Burke if this is the strangest thing that’s ever happened in one of his ORs. Burke confirms that it is, and Meredith says that’s good because she’s competitive. “All the best surgeons are,” he replies. George tells Bailey that Addison is trying to get her an OR at another hospital, but Bailey still wants to go home. George won’t help her, so she yells at him to get out.

Mindy finds Webber looking at the blueprints and asks him to tell her what could happen to her husband. All he’ll say is that James could bleed to death if they don’t operate soon. Dylan arrives and tells Webber that as long as they’re not interrupted, they could have the bomb out of James in ten minutes. Webber tells him that in the OR, patients receive general anesthesia as well as oxygen. They’ve turned off the oxygen in James’ OR, but the OR is over the main oxygen line of the OR floor. In the closet, Alex and Izzie finish up another round of sex and he tries to assure her that everything will be okay. She tells him that she needs to find something to do that will be helpful. Burke and Dylan have a whispered conversation in the doorway of the OR, and Meredith asks them to tell her what’s going on since she’s not a patient. They tell her about the oxygen line and she realizes that if the bomb explodes over the line, the whole hospital could blow up. Izzie and Alex go to Webber to ask if they can help, arriving just in time for him to have what appears to be a heart attack. Dylan tells Burke and Meredith that they’ll have to move James to another OR, but Meredith points out that she’s not even allowed to move her fingers because the bomb could go off. Dylan tells them it’s the safest option. Alex and Izzie tend to Webber, whose EKG is normal, and he’s about to go back to his job when Adele (see “Enough is Enough (No More Tears)”) shows up and forces him to stay in bed.

George talks to Addison about Bailey, wondering if they can drug her or have her declared temporarily insane. Addison snaps at him, saying that she’s doing everything she can and isn’t just sitting down because she’s lazy. She adds that everyone is doing his or her best but George is just standing around and asking stupid questions. George runs off and runs into Hannah, who’s hiding in a stairwell. Cristina ducks out of Tucker’s surgery when she spots Dylan, Meredith, and two other bomb squad guys slowly moving James’ gurney down a hallway. Dylan tells Meredith that when the time comes, she needs to wrap her hand around the bomb and slowly pull it out, making sure it keep it level. They each confirm that they don’t like the other very much. As they move, they don’t realize that they’re approaching a raised strip in the hallway. Cristina appears and Meredith tells her what’s going on as Dylan yells at her to leave. Meredith asks Cristina to distract her, so she says that Burke said he loves her the night before when he thought she was asleep. “Mind your own business,” she tells Dylan. Meredith asks if Cristina is going to tell Burke she loves him, but she doesn’t think she has to, since Burke doesn’t know that she heard him. “Besides, he might blow up,” she notes. The gurney comes to the strip and the group carefully moves it over without any problems.

In the pit, George tends to Hannah, who asks how Meredith is doing. She’s happy to hear that Meredith is still alive. George tells her that Milton was a coward for leaving her, but Hannah says she’s a coward for running away. She says people always think they’ll react differently to a situation like this, but as a paramedic, she was supposed to stay and help, not run away and hide in a stairwell. Alex gets Webber’s test results back and tells Izzie that he had a panic attack, not a heart attack. Izzie gives Alex the job of giving him the news since she already had sex with him. As George watches, Addison returns to Bailey’s room and tells her it’s time to push. Bailey refuses, so Addison threatens to tell Webber they need an OR. George enters and chastises Bailey for acting like this - she’s Bailey, and she never hides from a fight. There are a lot of things they can’t control, but this is something they can do. He gets into bed behind her as Addison prepares to deliver the baby. In the new OR, Burke and Meredith get ready for surgery, going over the steps again with Dylan. Burke asks Meredith if she’s ready, but she notes that she doesn’t really have a choice. Cristina returns to Tucker’s ER and finally tells Derek that Meredith has taken Hannah’s place. Before he can react, Tucker flatlines.

As Derek and Cristina work to revive Tucker, Dylan tells Meredith that it’s time for her to remove the bomb. She tells him that George and Izzie shouldn’t have to move out of her house. George helps Bailey as Derek and Cristina keep working on Tucker. Meredith cries and tells Dylan and Burke to leave because she can’t do this. Dylan tells Meredith to look straight at him and pretend that instead of being the jerk who’s been yelling at her all day, he’s someone else. She pictures him as Derek, giving us the first scene of “It’s the End of the World.” Derek tells Meredith that she can do this, and the scene fades back to reality with Meredith starting to pull out the bomb. Bailey and George take a break, but Bailey isn’t happy that George is able to see literally everything that’s happening in a mirror. As they continue, Tucker keeps flatlining and it looks like he’s not going to make it. Derek suddenly slams his fist into Tucker’s chest, making his heart beat again. Meredith pulls out the bomb and carefully hands it to Dylan, who praises her, then walks out of the OR with it. She follows him out and watches him start to hand the bomb off to another member of the squad. This means she’s watching when the bomb explodes and Dylan turns into pink mist.

Not sure what’s going on, Webber convinces Adele to let him go, and he heads out to the hall to wait for whoever’s coming up on an elevator. It’s Burke and Derek, who are now calling each other by their first names. Burke assures Mindy that James will be okay, telling her that it’s partly thanks to Hannah. “Where is she?” Derek asks Webber, who blasts him for being a cowboy, then tells him Addison is okay. Adele realizes that Addison wasn’t the “she” Derek was referring to. That “she” is with Izzie and Cristina, who are helping her into a shower, just like in George’s dream at the beginning of “It’s the End of the World.” This time he doesn’t find it quite as sexy. At Burke’s apartment later that night, Cristina whispers an “I love you, too” to her sleeping boyfriend. Bailey introduces Tucker to their son, William George Bailey-Jones. Derek goes to Meredith’s house, noting that she almost died today, and she tells him that she can’t remember their last kiss. He tells her he’s glad she’s alive, then describes the circumstances of their last kiss to her. After he leaves, she voices over again, “If this was your last day on Earth, how would you want to spend it?”

THE TITLE IS A SONG BY…: REM

MEMORABLE QUOTES: Alex: “The chief had an anxiety attack. Who’s gonna tell him?”
Izzie: “Um, I gave you sex in a linen closet. You tell him.”

“Stop looking at my va-jay-jay!” - Bailey to George


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