"Into You Like a Train"
Written by Krista Vernoff; directed by Jeff Melman

Meredith is still drinking tequila at the ECB (see “Bring the Pain”), wondering if she really told Derek to pick her. Joe thinks it’s romantic, but Meredith says it’s as horrifying as “Carrie at the prom with the pig’s blood.” Meanwhile, Izzie, Cristina, and George wonder how long Meredith is supposed to wait for Derek to show up. Meredith hears Cristina call the situation pathetic and chastises her friends for talking about her behind her back. As the pagers of all the medical personnel in the bar go off, they all see a news report about a massive train wreck and have to head back to Seattle Grace. Joe tells Meredith to stay and have coffee, since she’s in no shape to take care of patients. (Also, he wants to know what happens with her and Derek.) She goes off with the others, saying that maybe it’s for the best and she doesn’t want to know. “That’s the stupidest thing I’ve ever heard,” Joe says. On the way to the hospital, Meredith voices over that people either love surprises or don’t. She doesn’t. Derek finally shows up at the ECB and Joe tells him he’s late. Meredith’s voiceover continues that surgeons don’t like surprises because they like to be in control and not get sued. Then she wonders if she’s rambling.

The interns start getting ready to receive traumas as Alex notes that Izzie has started talking to him again. She feels bad because he froze in the elevator and didn’t perform the surgery George is getting all the credit for (see “Bring the Pain”). Bailey arrives, still dressed for her interrupted date with her husband, and Meredith admits that she’s drunk. Bailey tells her to stay out of the way for now while she gives out assignments to everyone else. Though the interns are tired from already working that day, as soon as they hit the ER and see all of the people there, they’re no longer tired. Addison asks Bailey for an intern for a patient who’s burned and in the third trimester of her pregnancy; Bailey assigns Izzie to work with her. A scrub nurse spots Meredith and tells her that Joe said to say that McSteamy showed up. She corrects him, saying it’s McDreamy (McSteamy won’t show up until “Yesterday”), but the nurse is pretty sure Joe called him McSteamy. “Does that mean he picked her?” George asks. “If it does, I just lost 50 bucks,” Cristina replies. A paramedic suddenly runs in with a leg, which Cristina tells George she wants. Luckily for her, Bailey lets her take the case of a man whose leg has been severed. Webber is with the patient and asks Derek to finally clear him for surgery, which Derek does.

As Derek walks past Meredith, he nods at her; she and George both notice but can’t interpret it. Meredith voices over that whoever said “what you don’t know can’t hurt you” is an idiot because “not knowing is the worst feeling in the world.” As two patients are wheeled in with a metal pole sticking through their abdomens, Meredith amends that to, “Okay, fine. Maybe it’s the second worst.” Burke and Bailey get information on the two patients as Meredith studies them and confirms with one, Bonnie, that this is the craziest thing she’s ever seen. Bonnie asks Burke if he’s planning to pull out the pole anytime soon, but he tells her that they have to wait and see what’s going on with her and the other patient, Tom, internally. Bonnie asks for a breath mint (for her, not Tom). George is assigned to the case, and he tells Meredith that “this never would have happened before the elevator.” Bailey tells Alex to do stitches in the ER, since he appears to be afraid of scalpels now. She then tells Meredith to get a banana bag IV and give herself fluids until she sobers up. Meredith asks why she shouldn’t just go home, but Bailey says if she’s not leaving, no one’s leaving. She’s also upset that she didn’t get to finish her lobster at her ten-year anniversary dinner.

On the way to the x-ray lab, Bonnie and Tom tell George that her fiancé and his wife have already been called. The two are surprisingly good-natured about their strange situation and having to be thrown together so quickly. George is able to cut in line for x-rays as the other doctors figure his case his more important than any of theirs. Addison and Izzie tend to their pregnant patient, Brooke, who starts having contractions. Addison announces that she needs a C-section because she’s in no condition to deliver her baby naturally. Brooke first wants to call a lawyer and write out a will, since she doesn’t have one and there’s no father. In the ER, Alex sutures a woman named Mary whose annoying friend Yvonne won’t stop talking about the train wreck on her cell phone. Alex takes Mary off for x-rays, concerned that she might have internal bleeding, and Yvonne tries to stop him, since he looks too young to be a doctor. Fortunately for Alex, she quickly gets distracted by another phone call. Izzie finds Meredith trying to insert an IV into her own arm and gives her some help. Meredith wonders if Addison is acting happy because she got Derek, but Izzie says she’s a little busy taking care of people.

Derek and Webber operate on the guy with the severed leg as Cristina cleans off the leg so they can reattach it. Derek’s pager goes off, but he doesn’t want to leave because he doesn’t want Webber to operate alone. Webber sends him away, then asks for an update on the leg. Cristina has to tell him that the leg is a left one, but the patient is missing his right one. Webber angrily sends her off to find the correct leg. As Meredith looks on, Burke, Bailey, and George study Bonnie and Tom’s x-rays and see that one of Bonnie’s vertebra is crushed. Derek arrives and sees that the pole is also going through her aorta. There’s no way to operate without separating Bonnie and Tom, but if they move the pole, they’ll both bleed to death. Burke wonders if they can’t just move one of the patients off the pole, then move it slowly from the other, repairing the damage as they go. Of course, this means they have to pick one patient to move. Burke notes that Bonnie’s injuries are so severe that she has little chance of surviving, but Tom has a shot of living. Derek counters that because Bonnie’s are so bad, they should move Tom and give Bonnie a better chance to survive. Meredith points out that either way, someone won’t live. So how do they chose who lives and who dies?

Derek heads off to examine Tom and Bonnie before he makes a decision about who to remove from the pole. He starts to talk to Meredith, but Bailey tells him that she needs a blood-alcohol test before she can practice medicine. Meredith does her own sobriety test and Bailey asks her if she’s regretting her last shooter. Cristina searches an ambulance for the leg, asking a paramedic about the patient she brought in. The paramedic takes offense, saying that doctors think all EMTs look alike. She adds that a lot of people were decapitated in the train wreck, so Cristina’s patient is pretty lucky to only be missing a leg. In the ER, Alex tends to another patient, a pregnant woman named Jana, who wants to know where her friend (who’s also pregnant) might be. Indeed, her friend is Brooke, and Jana heads off looking for her with Alex chasing after her. George takes blood for Meredith’s BAC and admits that he’s “strung out on the scalpel” after the elevator surgery. He asks about Derek, but Meredith still can’t read him. George thinks it’s amazing that she’s even giving him a chance, and adds that he’s crazy if he doesn’t pick Meredith. Cristina passes by looking for the leg, and Meredith comments, “How weird is this job?”

Jana finds Brooke and the two friends reunite as Addison chastises Alex for letting Jana walk around without making sure she was okay first. She shoos him away, then complains to Izzie about his irresponsibility, but Izzie defends him. Derek examines Bonnie (who says that he’s cute and therefore gets to call her by her first name) and determines that she has no feeling in her legs. Tom does, which makes him happy. He asks if they’re going to survive, and Derek promises to do everything possible for them. Cristina brings a leg to the OR and hands it over to Webber, who immediately notices that it’s a woman’s leg, so it’s obviously not their patient’s. Burke, Bailey, Derek, and George reconvene to discuss Bonnie and Tom. They finally decide that Tom’s odds are better, so Bonnie should be the one to be moved. George sadly notes that Bonnie is sitting and cracking jokes - how are they supposed to tell her she’s going to die? In the ER, Yvonne complains to Alex about the wait, then takes yet another phone call. Cristina calls someone at the site of the wreck and asks him or her to sift through the wreckage to look for a leg. Her request doesn’t go over well. Burke arrives, having been paged by Cristina, and she asks him to help her find the leg because she’s afraid if she can’t find it, she’s out of the intern program. Since he’s her boyfriend, she wants his help. He replies that when they’re working, he’s not her boyfriend.

Alex tells Meredith that Addison yelled at him and is “Satan’s whore.” When she finds out that Alex didn’t yell back, Meredith tells him he’s lost his mojo. Alex complains about how George had one good day and is a hero, but Alex had one off day and is a joke. Meredith asks why he didn’t kiss Izzie, but Alex doesn’t want to talk about it. Cristina approaches just long enough to complain that her career could be over just because of a leg. “I hope you find your mojo, Alex,” Meredith tells him. “I find you disturbing without it.” He agrees. Derek, George, Bailey, and Burke go to tell Tom and Bonnie what’s going on. Tom wants to be the one who’s removed from the pole, but Burke tells him he’s not as injured as Bonnie. Tom laments that it’s not fair; Bonnie points out that it’s not fair either way. She asks if her fiancé has arrived yet, but she’s almost glad he hasn’t because that would make things harder. As Addison and Izzie tend to Brooke, Patricia arrives with forms for her to sign indicating that if anything happens to her, Jana will have custody of her baby. Izzie thinks the two women are lovers, but they’re just best friends who used the same sperm donor so their kids could be brother and sister and also have two parents. Jana’s water suddenly breaks.

Back in the ER, Alex tends to Mary again as Yvonne appears to sleep nearby. However, when her phone rings, she doesn’t answer it and Alex quickly sees that she’s unconscious. He tries to revive her but it’s too late - she’s been bleeding internally for hours and is dead. Brooke wants to stay with Jana while they deliver their babies, but she has to be taken for her C-section. Brooke asks Izzie to stay with Jana instead, and Izzie agrees. Alex beats himself up over Yvonne’s death, but his day looks up when a paramedic brings him the leg Cristina has been looking for. Cristina heads back to the OR to give Webber the news that she couldn’t find it, but Alex is already there and gets both the glory for bringing the leg and the opportunity to assist. As Bonnie and Tom are prepped for surgery, she asks him if he believes in Heaven. He does, and she wants to. Just before they’re anesthetized, Bonnie tells Derek what she wants him to say to her fiancé when he arrives. As Bailey, Burke, and George scrub in for the surgery, Meredith tells Bailey that she’s sober and Bailey allows her to join them. Meredith and Derek wind up alone in the scrub room together, and he tells her that he stopped by the ECB. It takes her a minute to realize that he’s decided to stay with Addison. Before they can continue their conversation, Bonnie starts crashing and the group has to begin the operation.

Throughout the hospital, Bonnie and Tom undergo surgery, Izzie delivers Jana’s baby, and Brooke undergoes her C-section. After Bonnie is removed from the pole, the doctors move over to tend to Tom, except for Meredith, who says that they can’t just abandon Bonnie. She tries to revive her but Bailey has to tell her that there was never anything they could do. Addison meets up with Izzie back in the maternity ward and they share the news that Brooke, Jana, and their babies are all okay. Addison asks Izzie if she’s made up her mind whether she’s going to hate her or not. She adds that if Izzie doesn’t hate her, she’s willing to teach her about neonatology, since Izzie shows a gift for it. Derek talks to Bonnie’s fiancé, telling him what Bonnie asked him to say: “If love were enough, that she’d still be here with you.” As Meredith voices over about surgeons needing to know things, Webber congratulates Alex on his good work in the OR, Brooke and Jana happily spend time with their babies and each other, and Burke tells Tom’s wife that he’s doing well. Bailey and Derek wind up in an elevator together, and Bailey stops the elevator so Derek can cry for a few moments. Meredith voices over that while surgeons have to be in the know, humans are sometimes better off not knowing, because in the dark, there’s both fear and hope. As Addison and Derek leave the hospital together, the interns meet up in the locker room, preparing to go right back on duty after their long night.

THE TITLE IS A SONG BY…: The Psychedelic Furs

MEMORABLE QUOTES: Webber: “Can you get out of my way?”
Derek: “Fine. But I’m coming with you.” (Webber gives him a look) “Or I’m fired. Up to you.”

Izzie: “What’re you doing?”
Meredith: “Trying to insert my banana bag. Which sounds vaguely dirty, but it isn’t.”

Burke: “Cristina, when we’re on duty, I can’t be your boyfriend.”
Cristina: “Okay. So, uh, when we’re on duty, I can have sex with someone else?”

Meredith: “Dude, you lost your mojo.”
Alex: “Excuse you?”
Meredith: “I was trying to talk boy.”

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