"Oh, the Guilt"
Written by Zoanne Clack, Tony Phelan, and Joan Rater; directed by Jeff Melman

Meredith voices over about the Hippocratic Oath and how doing harm leads to guilt as Izzie cooks breakfast. Meredith is about to return to work for the first time since her appendectomy (see “What I Am”). Izzie tries to convince Meredith and George that she’s okay, reminding them that she’s a millionaire now (see “What I Am”), and debates opening a bed and breakfast. She adds that she’s going to the hospital to clean out her locker. She accidentally spills orange juice on her check and George freaks out. Meredith tells Izzie to take the check to the bank since she’s nervous having it around the house, but Izzie wants to clean out her locker first. She keeps repeating that she’s fine, saying that Denny wanted her to have the money because he loved her. In the locker room, George and Meredith tell Cristina and Alex about Izzie’s weirdness. Cristina would use the $8.7 million to buy her own hospital full of sick people. Izzie is in the locker room and tells everyone to stop talking about her; she’s fine and Meredith is the one with problems. She points out that Meredith hasn’t told Derek that she’s dumped Finn yet. George thinks she’s scared, but Meredith says that Derek walked away, which might be a good thing. He has a lot to deal with already, what with Addison and Mark being at Seattle Grace, and she doesn’t want to make him feel guilty. She says she’s being an adult, then tries to change the subject back to Izzie’s check. She voices over that guilt always goes along with insecurity and doubt.

In her hotel room, Callie’s cell phone rings but she ignores it, knowing George is calling her. She’s in bed with Mark, who thinks she looks guilty. Back at the hospital, Bailey tells the interns that there’s a morbidity and mortality conference in a few minutes that they all need to attend. Cristina tells Alex and George to get seats while she and Meredith get some snacks. Bailey chats with a patient, Mrs. Niles, who’s there for a mastectomy. She’s there with her husband and baby, Gus, who she complains hasn’t been eating since she had to stop nursing. Bailey suggests that they put sugar water on the nipple of the bottle. Meredith can’t believe Mrs. Niles has breast cancer at such a young age. Alex notes that she probably thought the lump in her breast was a milk gland; he’s learned things like this from being on Addison’s service. Cristina reminds the others that they need to get to the M&M. After she gets the snacks, she runs into Burke, who’s surprised that she’s getting munchies for the M&M. She asks if he needs her help in any surgeries, but he doesn’t. George finds Callie and asks her to sit with him and the interns, but she’s distant and not interested. George complains to the other interns that she’s trying to make him feel guilty for leaving her the other night to go be with Izzie. He announces that he’s not going to apologize anymore. Webber begins the M&M, then turns it over to Burke. The interns quickly realize that the patient the M&M is about is Denny. “8 million could get us on a plane to somewhere far, far away,” Cristina notes.

In the locker room, Izzie finds her stethoscope and uses it to listen to her own heart. Back at the M&M, Burke goes over the details, telling everyone that Denny’s official cause of death was a stroke. A doctor named Savoy challenges this, noting that everyone knows Denny’s LVAD was cut (see “17 Seconds”). “I’m going to my happy place,” George says. Savoy thinks that Bailey should be the one giving the details, since Burke was in the ER at the time, having been shot, and Bailey was the senior physician on the case. Bailey decides it’s time to step up and takes over answering questions. Savoy thinks that Bailey’s recent childbirth caused sleep deprivation, which along with her hormone swings caused some problems with her judgment. Bailey says that she sleeps fine, but Savoy replies that if he’d lost a patient because he made bad decisions, he wouldn’t be sleeping that easily. Webber tries to get him to stop placing blame since they’re there to learn from their mistakes. Savoy says that Bailey hasn’t admitted to making any mistakes. Cristina and Meredith think he should just kill Bailey since it would be a lot more humane than what he’s putting her through. Savoy accuses Bailey of letting her interns run wild in the hospital; she reminds him that there were shootings and the ER was chaotic. He points out that it’s always chaotic, then asks if she paged her interns. She did, but they didn’t answer, so Savoy wonders if they don’t respect Bailey’s authority. Alex stands up to defend Bailey, and when he sits down, everyone notices that Izzie is standing in the back of the room.

Addison and Derek meet with a lawyer in order to tie up all the loose ends in their property distribution. Derek decides that Addison should have Mark, but she claims she doesn’t want him. The lawyer says that they’ll split all of their assets down the middle, but they need to figure out who gets what real estate. Derek announces that Addison can have everything except his trailer and land in Seattle. That means she’s getting both their brownstone in New York and their house in the Hamptons. He wants to take responsibility for the failure of the marriage since he thinks his affair with Meredith was the final straw. Addison points out that she had an affair with Mark; Derek says that it was a one-night stand. She starts to respond and he tells her that while she made a mistake, he and Meredith had a relationship. At the hospital, the interns catch up to Izzie, who still maintains that she’s fine. George tells her she has to stick around the hospital all day or he’ll call her mother to come stay with her. She tries to call his bluff but he starts to dial and she agrees to stay in the locker room. As she leaves, she spots Burke. Webber and Bailey join the other interns, wanting to know why Izzie showed up. Alex defensively says that he had nothing to do with it - he had nothing to do with anything that’s happened. George offers to stay with Izzie all day, which Webber okays. He, Meredith, and Cristina tell Bailey that they’re sorry about the way she was treated during the M&M. She tells them they’re not allowed to apologize and feel better about the situation, and neither does she.

Bailey runs into Savoy, who tells her that his comments at the M&M weren’t meant to be personal. Mr. Niles joins them and tells Bailey that she must be a baby whisperer because her sugar-water trick worked. He offers to let her hold Gus, but Bailey thinks Savoy will believe she’s not that tough anymore, so she says no. Mr. Niles then asks Bailey to talk to his wife, since she’s panicking about the mastectomy and considering not having it after all. Bailey tells him that it’s not her job to talk Mrs. Niles into anything. She says she’ll send Mark up to talk to Mrs. Niles about her reconstructive options after her surgery. Burke tracks down Webber and tries to talk to him about being at the top of his game. He seems to be about to admit that he has a tremor, but Webber tells him he needs to be an authority figure and an example of what everyone else should be. Derek and Meredith run into each other and they share a couple of moments before Addison pages Meredith. When Meredith meets up with her, Addison reveals that she’s no longer Dr. Montgomery-Shepherd but is back to being Dr. Montgomery because the divorce has just been finalized. She then informs Meredith that their patient, Sonya, has been brought in with a foreign object stuck inside her. They soon learn that her ex-husband Adam is the foreign object. Apparently Adam has recently acquired a piercing that’s caught on something. The two explain that though they’ve been divorced for five years and Sonya is remarried, they both sell real estate and see each other a lot (and do other things to each other a lot).

Cristina finds Burke in a conference room and he admits that he started to tell Webber about his tremor but couldn’t go through with it. She promises to be there for him if he needs her in surgery. He tells her that he’s not sure what he’s going to do; for now, it’s paperwork. Izzie complains to George that everything thinks she’s crazy and needs to have her hand held. George thinks they should talk about what she plans to do with her check. They get to Adam and Sonya’s room and are shocked to see the two of them in such a compromising position. Izzie starts babbling about how Addison is rich and asks if she ever feels guilty about it. She adds that she doesn’t feel like she can talk to her friends about being rich because they’re all poor. Addison tells her to deposit the check first and the guilt will work itself out. Derek finds Meredith looking at an x-ray and she asks him if it looks blurry. She tells him it’s of a divorced couple, then segues into letting him know that she knows he and Addison are divorced now. Derek just says it was time, then asks after Finn. Meredith replies that he’s fine. Mark talks to Mrs. Niles about her reconstructive options, but she doesn’t care what kind of breast implants she gets. Mr. Niles says he doesn’t either, and Alex speaks up that he should. Mr. Niles finds Bailey and asks her what’s wrong with his wife, since she won’t talk to him or hold Gus. Bailey offers to schedule a psych consult, but Mr. Niles just wants someone to tell his wife that she has to have the mastectomy.

As Meredith takes another x-ray of a fighting Adam and Sonya, their teenaged daughter Jennifer walks in and sees them together. Sonya tells Jennifer that she’s old enough to know that her parents have sex and also make mistakes. Jennifer says she’s actually being a slut and not setting a very good example for her. Addison interrupts the conversation to announce that Adam’s piercing has hooked onto Sonya’s IUD, which has dislodged from her uterus and is now embedded in the wall of her vagina. “Did she say piercing?” Jennifer exclaims. Later, Mark catches up to Addison and asks her who got the brownstone in the settlement. She tells him it’s none of his business, but he just wants to know who he can ask about getting back the bike he left in the basement. She tells him she got the brownstone and he’ll get his bike back when he leaves Seattle. Mark is surprised that Derek took the house in the Hamptons, then realizes that Addison got both houses. “He still doesn’t know the whole story, does he?” he asks. He guesses that as long as Addison keeps quiet, she gets to be the good guy while Mark is the bad guy who seduced Addison just for the heck of it. At lunch, Izzie announces that she wants to buy something for Bailey and Burke, though she’s not sure what she would get Burke. George mentions that Burke likes jazz, but now that Izzie is a multi-millionaire, she wants to get him something big. Meredith suggests a house in the Bahamas and Alex suggests an actual island in the Bahamas. Cristina reminds him that he’s an intern and would never have time to go there, but he says he’d quit. She says he wouldn’t, since he’s a surgeon and it’s what he does. She thinks this might have offended Izzie, but Izzie is not a surgeon and is still fine.

Izzie asks Meredith if she’s told Derek about her breakup with Finn yet, but Meredith says she’s giving him time. Izzie says that’s stupid. George replies that what’s really stupid is carrying around a check for $8 million. “I’m fine. The check is fine. We’re all fine, okay?” Izzie replies. Later, Meredith works on paperwork with a quiet Callie nearby. “I slept with another guy. Do I tell George?” Callie asks. “I broke up with Finn. Do I tell Derek?” Meredith replies. After a moment, Meredith decides not to tell Derek, but Callie decides she needs to talk to George. As Mr. Niles tries and fails to reach out to his wife, Webber pulls Bailey away from their doorway and tells her that some of the hits she took at the M&M were justified and some weren’t. “Compassion and empathy are a big part of the job,” he says. “I don’t care what Savoy said, and I know I haven’t always been supportive, but being a parent makes you a better doctor.” Burke continues his paperwork, trying to control another tremor. Izzie stops by to tell him about the check and keeps saying that she’s fine. He gives her every reason why they’re all not fine. She tells her that even though he’s her boss, she considers him her friend, and she never wanted anyone to get hurt. Now she knows there’s nothing she can do to take back what happened. “You quit,” Burke reminds her. “You quit being a surgeon. You have two good hands and you aren’t using them. Feel guilty about that.”

Addison, Meredith, and Cristina take more films of Sonya and Adam, having to change their positions to get a better image. Webber stops by, having heard about the situation, and declares that he’s already seen enough. As the two are pulled apart, Adam starts convulsing and Cristina worries that he’s having an orgasm. He’s actually having a heart attack, and Cristina takes a moment to be relieved before calling a code. Webber announces that Adam needs surgery, but the cardiologist on call is already in surgery, so Webber asks for Burke. Cristina tries to stop Webber from getting him, but there’s nothing she can do. As they scrub in, Burke tells Cristina to stand on his right side in the OR, and if he starts to tremor during the procedure, she’ll take over and do the sutures they’ve practiced together. She worries that one of the scrub nurses will notice. Burke tells her that he can walk away and not do the operation, but Adam will die, so he needs to try. Cristina, however, doesn’t have to participate. She replies that she’s his intern and will be on his right side. In the OR, she keeps her word and Burke starts the surgery. Addison tells Sonya that they’ll keep her updated on Adam’s condition, then reminds her that she’ll need to use another form of birth control now that her IUD is out. Sonya doesn’t think she’ll be having sex any time soon because she’s going to tell her current husband that she’s been sleeping with her ex. She says that she felt guilty the first time it happened but she didn’t say anything because she was sure it wouldn’t happen again. It kept happening and eventually the guilt went away. Now she needs to tell her husband because she thinks the truth needs to come out.

Burke runs into a little trouble during the surgery and Cristina notices. She asks if she can practice her running whipstitch and he steps aside to let her. The other interns watch from the gallery, impressed that Cristina is getting to do something so advanced. George laments the fact that Cristina gets sex and perks while he gets nothing. Meredith tells him to just apologize to Callie again, but he doesn’t think he should take relationship advice from her. Izzie is mesmerized by the procedure and repeats that Cristina is doing a running whipstitch on a heart. Bailey stops by Mrs. Niles’ room and tells her that after a long day at work, she heads home just wanting to see her baby. Mrs. Niles thinks Bailey is going to tell her to fight the cancer so she won’t miss out on the joys of motherhood. Bailey ignores her and continues that when she gets home, the baby is usually crying and she realizes how tired she is and starts to resent the baby’s presence in her house. She’ll pick a fight with her husband, then complain about other things, then finally blame the baby. Bailey continues that if Mrs. Niles hadn’t been breastfeeding, she wouldn’t have though the lump on her breast was a clogged milk duct and she would have been diagnosed sooner. The cancer wouldn’t have progressed this far and she wouldn’t have to be in the hospital making this decision. Mrs. Niles asks what kind of mother blames her own baby for her cancer. “A mother who is human. A mother who is overwhelmed,” Bailey replies. Mrs. Niles wonders if she shouldn’t just give up now, since Gus won’t have to miss her if she were to die while he was so young. “This is when I tell you to fight the cancer so you don’t miss out on the joys of motherhood,” Bailey says.

Derek and Addison run into each other and he tells her he likes that they can be civilized around each other. “It wasn’t a one-night stand,” she announces, revealing that she thought she was in love with Mark, and after Derek came to Seattle, they lived together for two months. She wanted to believe that their relationship would work out and that she hadn’t thrown her marriage and life away for a fling. Of course, Mark isn’t faithful either and Addison caught him with someone else, and then Webber asked her to come to Seattle. Addison says that she and Derek are both equally responsible for the failure of their marriage, so Derek should get the brownstone. Derek replies that all he wants is Seattle, and to never see Addison again. He then runs into Meredith on an elevator and she decides that it’s time to tell him that she broke up with Finn. “Okay,” is all he says, confusing her. Burke and Cristina tell Jennifer that Adam’s surgery went well and he should be fine. Meredith voices over about how we all do harm. Izzie finds Webber and tells him that she has millions of dollars and can do anything she wants, but all she wants is to do a running whipstitch. Webber confides in her about losing a patient his first year as an intern, but instead of quitting, he kept working and never made the same mistake. If he’d quit, he would have only remembered the life that had been lost, but now he gets to remember all the lives he’s saved. Meredith voices over that even when we try to help, we do harm.

Mark finds Derek and tells him he knows he’s thinking that he wasted a year trying to make up with Addison when he could have been with Meredith. The two of them could be happy right now because he and Meredith could have had a real chance. Mark says he thought Derek should know the truth about him and Addison because he’s Derek’s friend. Derek makes it clear they’re not friends anymore. Meredith voices over that with harm comes guilt, which is entirely up to us. Savoy spots Bailey with Gus (whose parents are now more pleasant with each other) and asks if she’s babysitting. She tells him that being emotionally involved is part of her job. Alex joins Bailey and tells her that he didn’t do anything with regards to Izzie. She knows, since he’s been saying that all along, but he means that Izzie told him what she was going to do to Denny, but he kept quiet because he didn’t want to get involved. He wants Bailey to know that she wasn’t the only person who didn’t stop Izzie. Bailey just thanks him. As Meredith voices over about having a choice, George brings Callie food and video games, but she tells him that when she told him the other night she was done trying to compete, that meant she wanted to stop seeing him. He thinks he would have noticed that, but she says he didn’t, and that’s the reason she broke up with him. Addison lies in bed with Mark, who tells her that at least she doesn’t have to feel guilty anymore. Meredith voices over that we can either let guilt get us back into the behavior that got us in trouble, or we can learn from the guilt and move on. Izzie puts the check on the fridge with a magnet and tells Meredith and George she’s not depositing it until she figures out what good she can do with it.


MEMORABLE QUOTES: “That’s 8 million. $8 million does not like to have juice spilled on it.” - George

Lawyer: “Derek says that neither of you brought your assets into the marriage.”
Addison: “Well, I had my trust fund. And a sparkling personality. And the futon couch.”
Derek: “Yes, Addison had a very ugly, very heavy futon couch.”
Addison: “What happened to that couch?”
Derek: “We gave it to Mark. She can have him.”

Izzie: “Are those people having sex?”
Addison: “They were having sex; now they’re just fighting.”

Izzie: “I have money now, and I don’t really feel like I did anything to deserve it. And I can’t talk to my friends about it cause they’re all so poor.”
George: “Standing right here, Izzie.”

“You guys are so paying for my therapy. And my rent. And my new car.” - Jennifer to Adam and Sonya

Izzie: “I’m fine. Really, I am, I’m fine. Everyone thinks I’m not but…I’m fine.”
Burke: “You’re fine. I’m fine. Everything’s fine.”
Izzie: “So….”
Burke: “I got shot. I got shot because I was coming back to the hospital to check on Denny. Because you asked me to. I’m not fine. Denny asked you to marry him and now he’s dead. You’re not fine. Don’t come in here and…just…we’re not fine.”

“That’s right, I’m babysitting. I’m being all unprofessional and emotionally involved while my patient and her husband are having a moment together. You might want you leave right now. I feel a rush of hormones coming on. There’s no telling what I might do.” - Bailey to Savoy

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