"Grandma Got Run Over by a Reindeer"
Written by Krista Vernoff; directed by Peter Horton

As she voices over about the increase of suicides around the holidays being a myth, Meredith returns home from walking Doc (see “Owner of a Lonely Heart”) to find Izzie decorating a huge Christmas tree. “Looks like Santa threw up in here,” George remarks. Izzie wonders if she’s going overboard, but Meredith and George want to be supportive and tell her it looks great. Cristina rushes around Burke’s apartment, getting ready for work, but stops when she notices a little Christmas tree on the coffee table. He wants to decorate it together that night, but Cristina tells him she’s Jewish (her stepfather, after all, is Saul Rubenstein). On their rounds, the interns whisper about how big Bailey has gotten, and what might happen when she goes on maternity leave. Izzie suggests that they get Bailey a Christmas gift or organize a Secret Santa exchange. Cristina starts to shoot down her idea, but Meredith and George quickly shut her up and tell Izzie that Secret Santa sounds like a great idea. Derek and Meredith say hi to each other and Meredith notes that Derek doesn’t look very happy; he just doesn’t have much holiday spirit. The group heads off to see their first patient, Tim, who has a wife and three kids and has had their giant Christmas/Hanukkah celebration interrupted by a head injury. Bailey suggests that Tim’s wife take their kids out of the room so he can have some quiet, but Tim wants them around so they don’t miss the holidays together.

The next patient is Nadia, whose family is pretty much the opposite of Tim’s - they complain about everything while Nadia takes everything in stride. Her mother is especially upset that Nadia hasn’t had surgery for an ulcer yet because her case isn’t as critical as the other patients the surgeons have been tending to. Webber gets so fed up with their arguing that he tells George to take Nadia for surgery later in the morning. Burke tells Bailey that a heart has been made available for a transplant patient of his, so Bailey assigns Cristina to work with him. As they head to the pit, Alex tells Meredith that he’s retaking his board exams the next day, so this could possibly be his last day as an intern. Burke asks Cristina about Hanukkah, but she tells him she hasn’t celebrated a religious holiday since she was “old enough to know better.” They meet up with their patient, a boy named Justin whose mother, Marian, is a lot happier than he is to hear that there’s a heart available for him. In fact, Justin doesn’t want the heart at all. Patricia tracks down Webber, who’s with Bailey, and gives him a message from Adele reminding him to be at their niece’s pageant on time or she’s filing for divorce. Webber hands over Nadia’s surgery to Bailey and complains about having to watch “a six-year-old dressed up like a wise man.” In the pit, Meredith is surprised to not have to fight Alex for a good surgical case.

Addison looks through a catalogue, telling Derek what she’s picked out to buy for people, but he still doesn’t care about the holidays. Izzie saves him by brining him Tim’s CT scans, which don’t show them anything good. George examines Nadia, who is ready for the surgery and aware of what it entails since she’s had three bleeding ulcers in the last five years. As Alex studies in Intern Alley, Meredith tells Bailey about her patient and Bailey tells George they’ll have to bump back Nadia’s operation. Instead of scrubbing in, Meredith gets permission from Bailey to go help Alex study for his boards. Justin keeps complaining about his surgery even as he’s about to receive anesthesia, so Cristina reminds him that until he’s 18, his mother gets to call the shots. Justin says his mother is a liar because she said his new heart came from Santa. Cristina notes that he could make a run for it, but he probably wouldn’t get very far. Burke enters and Justin asks him to give the heart to someone else if he doesn’t survive the surgery. Derek and Izzie go to Tim’s room, where he and his kids are reading the Hanukkah story. They tell him that he has a subdural hematoma and needs surgery. Tim’s wife tells their kids that the fact that Tim’s doctor’s name is Shepherd must be a sign from God. During Justin’s surgery, Cristina tells Burke that she understands why he’s so upset - his mother never listens to him. Burke thinks Justin is depressed, and if he doesn’t want to live, he might not. Cristina mocks him, asking if he believes in Santa, and Burke kicks her out of the OR.

In Intern Alley, Meredith pretends to be a patient to help Alex work on his diagnosing and bedside manner. He doesn’t want her help, but she tells him to drop the ego because she gave up a surgery to help him. In surgery, George cracks a joke about Alex and Bailey admonishes him, saying that even if he doesn’t like Alex, he has to be on his side because people in their profession can make fatal mistakes at any time. Izzie and Derek operate on Tim, and while Izzie is appreciative of Tim’s family’s holiday spirit, Derek thinks it’s too much. He tells her that neurosurgeons are the busiest around the holidays because people fall while putting up lights or drive drunk and get into accidents. Cristina finds Alex and Meredith in Intern Alley, where Meredith announces that Alex failed his boards. She gets paged and heads off, telling Cristina to take her place as Alex’s helper. Alex doesn’t want Cristina’s help either, but she tells him that if he wants to be a doctor, he should put his pride aside. Meredith brings Bailey another surgical case, which means Nadia can’t have her surgery until the next day. Her family isn’t happy about it. George finds Alex giving Cristina a fake breast exam and asks if Izzie and Burke know what they’re doing. Cristina fills him in, then heads off to answer a page, making George take her place. In Justin’s room, Burke chastises Cristina for embarrassing him in his own OR and equating his spirituality with a children’s belief. She tells him that science is the one thing they have in common, but now she finds out he’s spiritual.

Tim’s family goes to see him after his surgery, but now he’s not so much full of the holiday spirit. In fact, now he’s acting completely different from the way he did before. “You stupid Shepherd! You broke my daddy’s brain!” Tim’s son yells at Derek. Izzie wonders how Tim’s personality could change so drastically, and she suspects it might be because Derek was so anti-holiday during the operation. Tim’s brain was exposed and vulnerable, and Derek was spewing a lot of “anti-holiday venom.” Cristina finds Marian decorating a tree in Justin’s room and tells her trees aren’t allowed in that area of the hospital. Marian isn’t sure why Justin has been so down recently, but she thinks the family’s priest will be able to talk to him. Cristina notes that Justin doesn’t like Christmas much; Marian says it’s her job to protect his innocence, and this could be his last Christmas. Justin wakes up and says that she said that last year. Marian happily says that Santa brought Justin back to her. Annoyed, Cristina grabs the tree and takes it out of the room. As Bailey and Meredith operate together, Bailey has to pause a moment to fight off some nausea. She tells Meredith that ordinarily she can block everything else out while she’s operating, but it’s not that easy when you’re sharing your body with another person. She sends Meredith to go get her a strawberry milkshake.

Izzie catches George helping Alex and George tells her what’s going on. He runs off after Izzie and the two of them run into Cristina and Meredith, that latter of whom tells Izzie that they’ve been so supportive of her holiday mania because of Alex. Meredith says Alex is like dirty Uncle Sal - they don’t like him but invite him to family gatherings because he’s family. Meredith has no family left other than the interns, so she’d like Izzie to apply some of the holiday spirit she keeps talking about to her relationship with Alex. George is paged to Nadia’s room, where he finds her vomiting blood. The good news is that now she finally gets to have surgery. Bailey will have to perform it, since Webber isn’t there, and she enlists Meredith and George to help. Derek and Izzie study Tim’s CT scans, spotting an intracerebral bleed which they can fix with another operation. As Derek heads off, Addison spots Izzie and tries to get her attention, but Izzie ignores her, still mad about the Emily situation (see “Owner of a Lonely Heart”). Derek ignores her, too, but accidentally, as he’s busy looking at Tim’s scans. He tells Addison that he can’t go Christmas shopping with her, and she wonders why he’s been so down recently. Derek gives Tim the news that he needs more surgery, but Tim isn’t thrilled about his treatment so far. His wife tells Derek that this isn’t like him. She’d like Derek to treat this situation as seriously as he would treat cancer because it feels that serious to her.

Justin tells his priest that he didn’t deserve a new heart; he also doesn’t believe in God and doesn’t think God sent him the heart. His mother has been telling him that the heart came from Santa, but he heard the nurses talking and knows that it really came from another kid - another child had to die so Justin could live. After Justin outgrew his other transplanted heart, Marian had to pray for another child to die so her son could get a new heart. Suddenly Justin codes and Cristina rushes to revive him. She tells Burke that they need to put him back on the transplant list because he got a bad heart, but Burke says he has to fight for it and decide whether he wants to live or not. She’s desperate to find something else medically that they can do to help. “The way you’re feeling right now is why I have to believe in something bigger than me. Because if I didn’t, that powerlessness would eat me alive,” Burke says. As Derek and Izzie operate on Tim again, Derek requests that Christmas music be played in the OR, telling Izzie that she’s right about never being able to tell what can penetrate the psyche. Bailey, George, and Meredith operate on Nadia as George wonders why he didn’t just throw her family out of her room. Bailey suddenly announces, “Do not kick me,” telling her baby he can’t kick her while she’s working. After Tim’s surgery, Izzie wakes Alex up in Intern Alley and pretends to be a sick farmer in order to help him study. He asks her why she’d help him and she says it’s what Jesus would do.

Cristina visits Justin and tells him that she doesn’t believe in Santa or God either, but she does believe in medicine, and it’s a medical miracle that he’s still alive. She thinks he needs to choose to live, and when he’s older, he can become a doctor and learn how to perform heart transplants that don’t require someone to die. Or he can live to raise kids who don’t believe in Santa and tick off his mom. Either way, Justin needs to live because “dying really isn’t the best revenge.” Bailey and George go to see Nadia’s family in the waiting room, and though they’re happy that she’s okay, Nadia’s mother is furious with the doctors for almost letting her daughter die because they pushed her surgery back so many times. George finally stands up to her, telling her to shut up already, then forbidding the family from seeing Nadia so she can finally get some peace and quiet for once. As Izzie’s fake examination continues, she starts crying but tries to pretend that it’s part of her character’s condition. Meredith and Derek run into each other and wish each other a Merry Christmas. Derek then heads to the ECB, where he meets up with Addison and tells her that Tim’s second surgery was successful. He then adds that he fell in love with Meredith, and that doesn’t change just because he got back together with Addison. As Meredith voices over about choosing your own family, Cristina arrives at Burke’s and sees that not only has he decorated the tree, he’s set up a menorah. She tells him that Justin is doing better and Burke wonders what got through to him. Meredith, Izzie, and George lie down under their tree and look up at the lights with Doc as Meredith voices over, “There’s the school of thought that says the family you’re born into is simply a starting point. They feed you and clothe you and take care of you until you’re ready to go out into the world and find your tribe.”

THE TITLE IS A SONG BY…: Randy Brooks

MEMORABLE QUOTES: “Grey, Karev, cover the pit. You can expect all sorts of holiday idiocy, so that is my gift to you.” - Bailey

Marian: “Santa Claus is bringing you a new heart for Christmas.”
Justin: “Tell that fat-a%$ to give it to someone else.”

Patricia: “Chief, Adele just called.”
Richard: “Tell her I’m in--.”
Patricia: “She knows you’re not in surgery and she said to tell you, quote, ‘We are going to our niece’s school pageant this morning. You have known about it for months, and after what you pulled on Thanksgiving,’ and then she started to use a great many words that I don’t feel comfortable repeating.”

“For your mom, I got a lambswool blanket, handmade in Edinburgh. It’s soft, comfortable, and says ‘don’t hate me for hurting your son,’ except with fabric.” - Addison to Derek

Meredith: (as a patient) “It hurts here and here and back here.”
Alex: “Any chance you got hit by a truck and forgot about it?”

“You see this, O’Malley? I make one mistake with this scalpel and this man’s dead. My husband, he makes mistakes at his job all the time. As far as I know he’s never killed anyone. But I have and you will, and Alex did. He made a math mistake and a man died for it. Run that past your accountant. See how he’d feel if every mistake he made, someone ended up dead.” - Bailey

“I can’t hear you when his hand is on your boob.” - George to Cristina

Izzie: “He trusted you to be his…Shepherd.”
Derek: “Dr. Stevens, you should be a little embarrassed.”
Izzie: “I am.”
Derek: “Good.”

Alex: “Why would you want to help me after what I did?”
Izzie: “Because it’s what Jesus would freaking do!”


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