"Begin the Begin"
Written by Kip Koenig; directed by Jessica Yu

Izzie hides in the bathroom and is quickly joined by George, who is trying to get away from Doc. Meredith voices over about fresh starts and getting a new one each January. Izzie tells George that she’s thinking of coloring her hair, and he tells her he wants to get his cut. Meredith quiets Doc and is surprised to see George and Izzie trying to avoid him; they tell her that he’s turned into a monster. Derek returns to the trailer after fishing, and Addison is not pleased to see his catch. She starts yelling about how she hates the trailer. Webber visits Ellis at her nursing home, and she talks about how loud they were in bed in the on-call room. She thinks they’re still residents. Meredith’s voiceover continues that it’s hard to take chances and put the past behind you. In the scrub room, Burke asks Cristina if she’s ever going to give him his answer about moving in with him (see “Much Too Much”). She doesn’t have an answer, so he asks her what she was planning to do about the baby (see “Make Me Lose Control”). Webber lectures a bunch of doctors about the mistakes made the year before and how fatigue played a large role. Therefore, no one can work more than 80 hours a week. George is glad to have a chance at having a life. Meredith gets to leave until noon, so she runs off before Webber can change his mind. However, the nurses are now going to have to work more hours, so Webber wants the doctors to be nice to them.

Izzie makes a crack to Alex about keeping the nurses happy, then apologizes, remembering that her New Year’s resolution is to let it go. She asks him how his boards went; he says he thinks he did well but won’t know the results for a few days. Cristina observes a surgery Burke is performing but he won’t let her get too close. Webber ducks in and tells Burke that they have a heart for a patient of his, Denny Duquette. Burke can’t go to Idaho to get the heart, so he suggests that Webber send Bailey instead. Webber spots Cristina and tells her she has to leave the OR because she’s over her 80-hour limit for the week. Bailey, Izzie, Alex, and George visit Denny (Jeffrey Dean Morgan), who immediately starts flirting with Izzie. He’s happy to hear that Izzie will be taking part in his surgery. Alex, however, isn’t thrilled. Outside the room, Alex cracks that Denny is trying to get some sex even though he’s almost dead. Izzie thinks Denny is just trying to be nice. Bailey complains about the 80-hour-work-week regulations, noting that that wasn’t around when she was an intern, and the more hours she worked, the more she learned. George thinks the regulation is good for her because she’s about to have a baby. Bailey asks if she’s saying he looks tired; he starts babbling about how she glows. Bailey sends him off to work with Addison, then sends Alex to the pit, even though he and Izzie agree that she glows.

Addison and George’s patient is Bex, a preteen girl who has an enlarged pelvic lymph node. As George examines her, he sees some scars on her arm. Alex’s patient, Mauer, has a bezoar, a lump of foreign matter in his abdomen. His wife Audrey announces that he’s a writer suffering for his art - he ate his own novel because it wasn’t good. George gives Addison Bex’s labs and says that her hormone levels are strange. Addison wonders if she’s on birth control and tells him to talk to her without her parents around. As Webber enlists Derek to help him with something, George chats with Bex, who admits that she’s been taking birth control but hasn’t been having sex. She took the pills to make her breasts grow so she could feel like a normal person. Derek and Meredith wind up in an elevator together and she tells him that she got a dog. She adds that she’s over him, and though he first claims to also be over her, he admits that he’s not. Addison joins them and Meredith quickly takes off so Derek and Addison can argue about her hatred of the trailer and his announcement that he loves Meredith (see “Grandma Got Run Over by a Reindeer”). Addison notes that before he said “loved” in the past tense, and now he’s saying “loves” in the present tense. Alex gets ready to take Mauer to surgery, but Mauer is suddenly sweating a lot. He tells Alex that he ate the book to literally put it behind him.

Cristina spots Bailey leaving for Idaho and tries to butter her up so she can tag along. Addison and George perform an ultrasound on Bex, after which George wonders why a talented artist like Bex would want to cut herself. She tells him about the comic book she wrote about herself and her friend Jen; Jen now has a boyfriend, so Bex is alone. George admits that he wasn’t too popular in high school - he was secretary and treasurer of the Dungeons and Dragons Club. He was also a mathlete and won a blue ribbon in his Biology Club for dissecting a fetal pig better than anyone else. He encourages Bex to look forward to college and finding her place in the real world. Izzie stops by to see Denny, who wants to ask her a personal question. They banter a little and Denny asks if she’s seeing Alex. Izzie says no, and Denny is happy that he won’t have to fight for her. He teases that she’s in love with him and that he doesn’t blame her, since he’s hot. At home, Meredith does laundry and tells Doc that she’s literally washed the past away. Addison shows George the results of Bex’s biopsy - her ovary is really a testis because she’s a hermaphrodite. On their flight to Idaho, Bailey awakens and catches Cristina staring at her pregnant belly. Back at Seattle Grace, George, Addison, and Raj tell Bex’s parents about her condition. Addison suggests that the family go to therapy together because they may have a big adjustment to make - Bex may decide that she’d rather be a boy than a girl.

On his way to surgery, Mauer tells Alex that his mouth feels like it’s on pins and needles. Audrey notes that he did eat a novel, and that the more he ate, the weirder her acted. Izzie visits Denny again and he tells her he’s been waiting for his heart transplant for a long time. He’s worried that something will go wrong, but she assures him that Burke is a great doctor. Burke stops by for a visit and tells Denny that they’ll start the procedure before Bailey gets back with the heart. After he leaves, Denny and Izzie quietly celebrate the fact that Denny is getting a new heart. Bex’s parents tell George and Addison that they’re not sure they should tell her about her condition because they don’t think she’ll be able to handle it. “You can’t not tell her who she is,” George argues. However, Bex’s parents also think that her male genitalia should be removed when she has surgery to remove the tumor in her abdomen. Since Bex has always said that she wants to be normal, her parents want to do whatever’s necessary to make that happen. Addison refuses to perform the surgery if Bex isn’t aware of what’s happening. George tells Bex’s parents that she’ll learn the truth one day and they should decide how they want her to find out. Meredith goes to visit Ellis and is surprised to find Derek there. He tells her that there’s a clinical trial she’s a candidate for, but Meredith doesn’t want her mother’s final days ruined by tests. She adds that Derek should go home to his wife, who probably doesn’t know where he is right now.

Burke calls Bailey as she’s getting the donor heart, and Cristina gestures to Bailey to make sure she doesn’t let Burke know she’s there. Burke doesn’t like the way the doctors at the other hospital are treating the heart, so he gives Bailey some orders to give them. He then goes to see Denny, who makes sure Izzie will be there when he undergoes surgery. Meredith heads back to the hospital, having run out of things to do with her free time, and George asks her when would have been a good time to find out about Addison. He thinks Bex needs to know what’s going on with her so that she can make a fresh start and move forward one way or another. In Mauer’s surgery, Alex tells Webber that Mauer was acting strangely, but Webber doesn’t think anything of it. He says that Mauer obviously needs a plan B since being a writer isn’t working out for him. Alex knows how he feels, since he’s not completely sure he passed his boards. “Right now, today, you’re still here,” Webber reminds him. George talks to Bex, who wants to know what everyone’s keeping from her, and when her parents and Addison arrive, George asks if he’s supposed to keep lying. Addison sends him out of the room, but first Bex wants to hear the news from him. Instead, her parents tell her what’s going on. Outside, Bex’s parents blast George for his behavior, telling him that she’s their daughter and it was their responsibility to decide how her life would be affected.

Alex visits Mauer after his operation and is surprised to find him saying odd things. Derek returns to the hospital and tells Webber that he visited Ellis as he requested. She’s a candidate for the experimental program, but enrolling her requires Meredith’s permission. Derek thinks Webber should be the one to approach Meredith because there’s baggage between him and Meredith, whereas Webber is just trying to help an old friend. Webber finds Alex, who tells him that it looks like Mauer has mercury poisoning from the paper he ate. In Idaho, Bailey determines that the heart might not be viable and asks Cristina to call Burke. Cristina reluctantly does so and Burke blasts her for breaking the rules. However, when Webber approaches Burke, Burke keeps quiet about Cristina and just asks for the news on the heart. Later, Webber approaches Meredith and tells her that Derek look into the experimental program as a favor to him. Meredith still doesn’t want to let Ellis be enrolled. Webber says that the treatment won’t cure Ellis, but it might improve the days she has left. Alex checks on Mauer, who asks if Alex knows what it’s like to be a failure. (Of course, he does.) Mauer has also decided that it may be time for a plan B after all. Alex tells him that doctors make mistakes that kill people, and though everyone has setbacks, he’s still a doctor and Mauer is still a writer: “We don’t have a plan B.” Fortunately, this time around Alex has found a treatment for Mauer, and he earns Webber’s praise.

On the flight back to Seattle, Cristina tells Bailey that the 80-hour regulation protects the weak and levels the playing field, which is both unfair and dangerous. Bailey thinks she’s really thinking about her own baby. She admits that when she first found out she was pregnant, she thought about not keeping the baby because even though she and her husband had been trying for one for so long, her job prohibits her from having much time for her family. But one night she realized that she could do this, even if she’s not sure how she can: “You do what you can, when you can, while you can. And when you can’t, you can’t.” Izzie returns to Denny’s room and he realizes that he’s not getting the heart after all. George stops by to see Bex, who thanks him for making her parents tell her the truth. She then asks him to bring her some scissors. As Meredith voices over about finding the end of the old and the beginning of the new, Meredith asks Derek to tell her about the program, Izzie says good night to Denny, and Bex’s mother takes over for George as he cuts Bex’s hair like a boy’s. At the trailer, Addison asks Derek if she’s supposed to wait until his feelings for Meredith pass. He says that would be good and she tells him she still hates the trailer. In the parking lot, Cristina tells Burke that she wasn’t going to keep the baby; he’s not mad, he just wanted to know. At home, Meredith joins in Izzie and George’s annoyance with Doc and they hang out in the bathroom, eating pizza together.

WELCOME TO SEATTLE GRACE: Denny

THE TITLE IS A SONG BY…: REM

MEMORABLE QUOTES: “There is a land called Passive-Agressiva and you are their queen.” - Derek to Addison

Denny: “Can I ask you something personal?”
Izzie: “If I say no?”
Denny: “I’ll hold my breath, which will stop my heart, killing me. You’re right here; you’ll be charged with murder. Lifetime in prison loved by a big old girl named Hildi.”
Izzie: “So my choices are homicide charges or inappropriate personal questions from a patient.”
Denny: “I know, kinda sucks.”


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