(Meredith's house)

(Meredith is coming home to the townhouse after walking their dog, Doc. It's pouring outside)

MVO: It's an urban myth that suicide rates spike at the holidays. Turns out, they actually go down.

(Izzie is decorating a massive Christmas tree in the living room. Very, very impressive)

MVO: Experts think that people are less inclined to off themselves when surrounded by family.

(Meredith is entering the house. Doc runs into the living room and Meredith stands in the hallway astounded by the level of decorating Izzie has taken. George comes in his pajama's looking half asleep and stands next to Meredith also taken aback by the decorations)

George: Looks like Santa threw up in here.

Meredith (nods): Just... go with it. We're being supportive.

Izzie (finally notices them): Oh, hey! What do you think? (They both fake smile back) Did I go too overboard? Oh, I know, I know sometimes I can go a little overboard.

(Meredith and George speak at the same time)

George: No, we love it.

Meredith: It's great.

Izzie (big ass smile): Oh yay! I love Christmas.

Meredith: We know.

George (forced smile): Clearly.

MVO: Ironically, that same family togetherness is thought to be the reason depression rates actually do spike at the holidays.

(Izzie turns back to decorating the living room. Meredith and George give each other looks. Izzie turns around and gives the another big smile)

MVO: Yeah, okay Izzie doesn't count.

(Burke's apartment)

(Burke is sitting at the kitchen bench, reading a newspaper and drinking coffee. Cristina comes rushing in dressed ready to go work and heads to grab coffee to go. She smiles at Burke and instantly stops when she sees a tiny little undecorated Christmas tree standing on the coffee table. She gives Burke a look. He turns and sees what she's giving him the look for)

Burke: I ... thought you might like to help me decorate it tonight. Mark our first Christmas together.

Cristina (pours coffee into her mug): I'm Jewish.

(Burke takes a large swallow of his coffee)

Burke: Seriously?

Cristina: My Step-father. Saul Rubenstein.

(She grabs her keys and heads to the door)

Burke: Oh right. Right.

(She leaves the apartment)

Burke: Right.

(He looks slightly off put and looks back at his Christmas tree)

(SGH)

(Bailey is looking quite pregnant walking down a hallway. She's taking a few deep breaths. Meredith, George, Izzie, Cristina and Alex tailing follow her a few feet behind her)

George (to Meredith): Look at her belly. She's almost as wide as she is tall.

(Izzie grins at this)

Meredith: Are her ankles swollen? Is that why she's waddling?

Izzie: What's gonna happen to us when she goes on leave?

Cristina: Leave? She's going on leave?

Meredith: What do you think happens when people push babies out of their vaginas?

George (chuckles): Do you think we're gonna get a new resident?

Cristina: What?

Alex: Nah. Probably just let us all walk around unattended. See how much damage we can do.

(They stop walking as Bailey has stopped at a nurse's station still a few feet away.)

Izzie: Yeah, well you would know. (Izzie rounds to the front, suddenly smiling) Hey you guys, we should all get together and get Bailey a Christmas gift for the baby. Or we could um organize some sort of secret Santa thing.

Cristina (looks less than impressed): Ok, listen Tiny Tim you can take ---

(Meredith and George move quickly to block Cristina and interrupt her loudly)

George: Sounds great.

Meredith: Secret Santa sounds great Izzie.

Izzie (smiles): Ok.

(She turns around and starts heading off to Bailey. George and Meredith turn to face Cristina. Cristina has a 'what the hell' look on her face)

Meredith: We're being supportive.

(They are all walking down another hall but this time Meredith is the one lagging. Derek is close behind and calls out to her)

Derek (solemn): Hey.

(Meredith stops and waits for him)

Meredith: Hey. You ok? You seem ...

Derek: Yeah. (He sighs) You know ... Holidays.

Meredith: Oh, yeah. I do know.

Derek: Hmm.

(She walks off)

(Tim Epstein's patient room. He is a new patient. His wife is sitting on a chair nearby and his 3 young boisterous kids are playing around the room. Derek is in there and Bailey and her interns walk in)

Meredith: Tim Epstein, 38. Fell off the roof of his house.

Tim: I was stringing Hanumas lights and ah a shingle came loose.

Izzie: Hanumas?

Tim: Hanumas. Chrismakkuh. We ah go all out.

Izzie (broad smile): Awesome.

Mrs. Epstein: He fell 12 feet.

Tim: Ah good news is my head broke my fall.

(One of his daughters flings a rubber lizard which smacks Derek's face)

Meredith: Ah there are no visible deformities but he's definitely having some focal left arm weakness.

Mrs. Epstein: He'll probably be fine. He's always been a little hard-headed.

(Mr. Epstein chuckles but quickly moans slightly in pain)

Derek: Does your head hurt when you laugh?

Tim: Is that a bad thing?

Derek: Do you wanna follow my finger with your eyes, please?

(He moves his finger from side to side in front of Mr. Epstein's face. Mr. Epstein's son, Jake jumps of his bed and jumps onto the adjacent one and sits up in front of Bailey)

Jake: I know karate.

Bailey: Mmm Hmm. (He whacks the jug sitting on the table which Izzie quickly removes) Ah.

(Bailey moves quickly away to where Mrs. Epstein is sitting)

Bailey: You know your husband might need a little ah quiet so there's a cafeteria right down the hall ...

Tim (interrupts): No, no, no. Let them stay. Pain or no I don't want to miss out on the holidays with my kids.

Derek: Who would like to take ah Mr. Epstein down for a CT?

(Only Izzie puts her hand up very eagerly)

Derek: Stevens it is.

(Patient's room with a young woman named Nadia Shelton lying in bed. She is surrounded by various family members who are speaking loudly. Nadia looks exasperated but is quiet. George walks in with her chart. The chief walks also walks in up to her bed. And Bailey, Alex, Meredith and Cristina follow)

George: Ah, Nadia Shelton. 41. Scheduled for excision of her gastric ulcer.

(He hands the chart over to Richard)

Nadia's mother: Lot of good it's done us. She's been scheduled for three days.

Nadia: Mom. It's not his fault.

Jimmy (her husband): Everyday, she gets rescheduled for some emergencies.

Richard: Yeah well we're very, very sorry for the inconvenience.

Nadia's Mother: Inconvenience? You watch your child spend 3 days in pain and then come and talk to me about inconvenience.

Richard: We get a lot of trauma cases at the holidays. Your daughter's ulcer is serious but it's not critical.

Ernie (Nadia's father, pointing to the tv that is on loud): Is that? Is that the news?

Jimmy: Are you saying that my wife is not important? Is that what he's saying? Is that what I hear.

(Everyone starts talking loudly and all at once)

Richard: Alright! Uh, Dr. O'Malley prep Mrs. Shelton for her ulcer excision which will happen this morning!

(He leaves)

Nadia's Mother: Thank you! Ernie, Ernie! I am so happy! We're going to go the Needle!

(Everybody leaves aside from George. Nadia is left looking a little unsure)

(Bailey, Cristina, Meredith and Alex are walking down a hospital hallway)

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

(Burke who walks down the hallway up to Bailey and the gang, interrupts)

Burke: Dr. Bailey, UNOS just called. They have a donor heart for a patient of mine.

(Cristina, Alex and Meredith jump at this)

Cristina: I'm free. I'm totally free right.

Alex: I can totally do this.

Meredith: I'm free.

Alex: I'm available.

(Bailey gives Alex and Meredith scolding looks)

Bailey: No you're not! You're covering the pit. (she turns to Cristina) Yang, it's yours.

Cristina: Thank you.

Bailey: Pit!

(Alex and Meredith wander off down the hallway)

Alex: Damn. Heart transplant. Would've liked to have seen that.

Meredith: There's always tomorrow.

Alex: Yeah, well maybe for you.

Meredith: Meaning?

Alex: I re-take the boards tomorrow. Pretty sure I'm gonna fail. Which makes today my last day here and I get to spend it doing stitches in the pit.

(He walks into the male's toilets)

(Burke and Cristina are walking down a hallway. Cristina is taking notes)

Burke: So when does Hanukkah fall this year?

(Cristina looks up surprised)

Cristina: Uh, no idea.

Burke: Oh. Well if there any more traditions you want me to be aware of ...

Cristina (interrupts): Oh no Burke seriously, I haven't observed religious holidays since I was old enough to know better.

(Burke looks off put by this and Cristina walks off)

(Burke and Cristina are entering a patient's room. This is the heart transplant patient, a small young black boy named Justin. His mother is there with him)

Burke: Good morning Justin. Marion.

Marion: Morning.

Justin: Hi Dr. Burke.

Burke: I'm here with good news. Great news.

Marion (smiles): You don't mean that ...

Burke: UNOS called. We have a heart.

(Marion smiles and chuckles happily)

Burke: I'll operate this morning.

Marion: You hear that baby? Santa Claus is bringing you a new heart for Christmas.

Justin (looks annoyed and turns to Burke): Tell that fat ass to give it to someone else. I don't want it.

(Burke and Marion look uncomfortable at this while Cristina just looks on amused)

Marion: Sorry Dr. Burke, he's tired today.

Justin: I'm tired everyday. I hate Christmas everyday. And I rather not have another stupid operation.

Burke: Justin, I know surgery can be frightening but you need this heart. You've worn out your last one.

Cristina: His last one?

Burke: Justin had a heart transplant as a baby but his heart hasn't aged as well as he has. You understand that Justin? Your heart just can't keep up with you anymore. You need a new one.

Justin: I don't care. I don't want it.

Burke: Can you tell me why not?

(Justin just looks down. Burke looks at Marion for answers but she is silent)

(Bailey is walking down the OR hallway up to Richard who's standing in front of an OR board)

Richard: Anxiety attacks, aneurysms and ulcers.

Bailey: Huh. Must be December.

(Patricia, Richard's assistant walks up to them)

Patricia: Chief, Adele just called.

Richard: Tell her I'm in ...

Patricia (cuts off Richard): 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" (Bailey grins madly) and then she started to use a great many words that I don't feel comfortable repeating.

Richard: I have 7 surgeons on vacation.

Patricia: And there was something about divorce.

(Richard contemplates this grudgingly)

Richard (to Bailey): You'll have to cover my ulcer excision.

Bailey: Yes, sir.

(Richard starts walking down the hallway with Patricia)

Richard: Woman is unreasonable! When did watching a 6 year old dressed up like a wiseman ...

(His voice trails off as he gets further away from Bailey who looks tiredly with her arms cradling her head at the O.R board)

(Meredith and Alex are at the emergency doors outside leading to the pit. An ambulance officer pulls down a man lying on a gurney)

Paramedic: Male. 44. Had a gastric by-pass. 3 weeks post-op. Reported extreme pain when we found him. Said something about fruitcake.

(Meredith checks the patient)

Meredith: Must've torn his abdomen wide open. (She turns back to Alex) You're going to have to fight me for this one.

Alex: He's all yours. My parting gift.

(He walks away despondent. Meredith just looks after him)

(Derek and Addison are walking down a hallway. Addison is excitedly looking through a Christmas catalogue while Derek walks beside her looking less than enthused)

Addison: Ok for your mom, I got a lamb's wool blanket, hand made in Edinburgh. It's soft, comfortable and says don't hate me for hurting your son except with fabric.

Derek (tiredly): Addie, you know my mom loves you.

Addison: No, she used to love me. I got a lot of ground to make up for with these gifts. (she holds the catalogue to Derek) So what do you think? Plain or plaid?

Derek: Uh I dunno, whatever you know.

Addison: But you love Christmas shopping.

Derek: I'm just really not in the mood for it right now, ok?

Addison: Ok well how about French food and Scottish catalogues tonight around 9?

Derek: Uh, um I guess that depends what time I get out of here ...

(Izzie who is scanning the hallway a few feet away and is obviously looking for someone calls out)

Izzie: Dr. Shepherd!

Derek: What?

Izzie: I have Tim Epstein's CT scans back.

Derek: Ah good.

(He quickly walks away from Addison and over to Izzie eager to get away from the situation. Addison stops smiling and looks on disappointed)

Derek: What do you think?

Izzie: It's not great

Derek: Oh no that's not great at all.

(Nadia Shelton's room. Her annoying family is still there. George is in there)

Jimmy (holds a catalogue up to Nadia): Honey-bunny what do you think of this scooter?

George: Ah I need to take her blood pressure.

(Josh, Nadia's son is playing his gameboy loudly while his Grandfather, Ernie yells at him. Mrs. Shelton also starts speaking loudly. Nadia just looks upset)

George (tries to talk to Nadia): Any questions about the surgery?

Jimmy: Apart from when you're actually going to do it.

George: We're doing it now.

Jimmy: Good.

Nadia (to George quietly): I'm sorry.

Jimmy: Don't apologize.

George: Do you have any questions?

Nadia: No. I've had 3 bleeding ulcers in the last 5 years.

Jimmy: Yeah, I hope you read the chart.

George: Yes.

Jimmy: Good.

(Alex is studying on a hospital bed in the abandoned hallway hangout)

(Meredith enters the Scrubs room adjacent to an O.R. Bailey and George are in there preparing for Nadia's surgery)

Meredith: Dr. Bailey, gastric perforation just came in.

Bailey: Damn. (George has look that says this can't be happening) Uh, um alright. (She pats George) Take Mrs. Shelton back to her room.

George: Seriously?

Bailey: Do I look like I'm kidding? Tell her we'll get to her this afternoon. (George heads into the O.R annoyed) Grey call the E.R, tell them to send him up and then scrub in.

(Meredith nods)

Meredith: Ah, Alex Karev failed his boards and he's re-taking them tomorrow. He can't study for a practical by himself. If he fails again he's out.

Bailey: Ok, go.

(Meredith runs off. Bailey presses the intercom button and speaks into the O.R)

Bailey: O'Malley.

George: Yeah?

Bailey: After you drop her off, get back here and scrub in.

George: Alright.

Bailey: Ok.

(O.R where Justin is lying on a table ready for surgery. The anesthesiologist is trying to put the mask on Justin to put him to sleep)

Anesthesiologist: Okay, Justin ...

Justin: No, I told you I don't want the heart. Why are you doing this?

(Cristina who is in there walks up)

Cristina: Cause you need it. And until you're 18 your mother calls all the shots.

Justin: My mother is a liar. You heard her. She said the heart came from Santa Claus. She shouldn't get to decide anything.

Cristina: Yeah, well you could make a run for it but the heart you have won't get you very far.

(Burke enters the OR)

Burke: Are we ready?

Anesthesiologist: Just about.

Burke (to Justin): How bout you buddy? Are you ready?

Justin: If I die in this surgery can you give this heart to some other kid?

Burke: Not gonna happen Justin. Not on my watch.

(The anesthesiologist puts the mask on Justin)

Anesthesiologist: Here we go.

(Justin falls to sleep)

(Mr. Epstein's Room. His two young daughters, one named Leah are sitting on his bed with him; Mrs. Epstein & Jake are lying down on an empty bed next to them)

Daughter: And it was only one day of oil.

Tim: And then what happened?

Leah: It lasted 8 whole days and nights!

Daughter: And it was a miracle!

Jake: I wanted to say that part!

(Izzie and Derek knock and enter the room)

Izzie: Mr. Epstein, I'm sorry to interrupt. You remember Dr. Shepherd?

Derek: Um, should we talk more privately?

Mrs. Epstein (shakes her head): Just tell us, is it bad?

Derek: The fall has caused a subdural hematoma.

Leah: I don't even know what that means.

Derek: That means your dad ... his brain is bleeding.

Leah (looks down upset): Great.

Derek: Look, there are some risks to the surgery, it has to happen before the bleeding gets worse.

Mrs. Epstein: What kind of risks?

Derek: The bleed is uh in an area of the brain that controls the um speech and the motor control.

Jake: We don't need operation, ok?

Tim: You know, Jake I think we do.

(Derek shakes his head to Izzie)

Mrs. Epstein (to Jake): Hey honey, you know something else?

Jake: What?

Mrs. Epstein: We have a doctor named Shepherd.

Tim: Shepherd. Is that a sign from God or what?

(Derek looks a little weirded out by that comment. Izzie just smiles at him)

(OR with Justin's surgery. Dr. Burke and Cristina are there performing the surgery. Burke has finished placing the transplant into Justin)

Burke: Look at that. Beautiful fit. Now all we have to do is to figure out why he is so angry.

Cristina: If I had that mother I'd be angry too. (A nurse passes a surgical tool to Burke) Actually I do have that mother.

Burke: His mother is not the problem here. She loves him, she never leaves.

Cristina: She also never listens. She doesn't know him.

Burke: Justin's depressed. You heard him. He doesn't want to live. I just hope he changes his mind before it's too late.

Cristina: Uh what do you mean too late?

Burke: With all medical realities being equal, why does one patient live and another dies? I believe there's a mind-body-spirit connection. And if Justin really doesn't want this heart, his body will reject it.

Cristina: Ok, let me get this straight. You don't just celebrate Christmas, you actually believe in Santa Claus?

(The scrub nurses and interns watching all look amused at this and give each other looks)

Burke: Dr. Yang, go and schedule a psychiatric consult for our patient.

Cristina: We're, we're not done here.

Burke: You are.

(The scrub nurses and interns again give each other looks. Cristina sighs and moves away from the operating table)

(Deserted hallway, hospital hangout. Meredith is lying on a bed, pretending to be a patient while Alex paces up and down hall walking by the bed)

Meredith (in a creepy old woman's voice): I don't know. It hurts here and here and back here.

(Alex stops walking in front of the bed)

Alex: Any chance you got hit by a truck and forgot about it?

(Meredith sits up and speaks normally)

Meredith: You're judged on bedside manner Alex. I wouldn't be surprised that's why you failed the last time.

Alex: Could you be any more patronizing? I didn't ask for your help.

Meredith: Enough with the ego! You big baby! I gave up a surgery for this! (she lies back down and goes back to creepy old woman's voice) Now like I said, it hurts here, and here and back here. Oh and this morning I noticed my poop was a funny grayish color.

(Alex looks less than amused)

(Bailey and George are in the OR, operating on the gastric perforation guy)

George: Wow, that's all you can save of his stomach.

Bailey: Yup. Eating is what this man lives for. We should put him out of his misery.

George: Paging, Dr. Karevian.

(Everybody in the OR laughs except Bailey)

Bailey: What did you just say?

George: Just, it's a joke. Kevorkian, karevian. (Bailey just stares at him) Alex Karev.

Bailey: I get the joke. I just don't think it's funny. (She holds up a scalpel) 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. You don't have to like Alex, you don't have to care about him, but you damn well have to be on his side.

(George just stands there, looking sufficiently told-off)

(Derek is in the OR with Izzie, just starting to operate on Mr. Epstein)

Izzie: What a great family. Hanumas. Chrismakkuh. And how cute are those kids?

Derek (sarcastic): Really Dr. Stevens. Chrismakkuh.

Izzie: I think it's sweet.

Derek: Do you happen to know what time of year neurosurgeon's are the busiest Dr. Stevens?

Izzie: No, there's a time of year?

Derek: Well there's no hard or fast rule but brain injuries tend to pile up around the holidays. Like our friend here. Folks fall of their roofs while they string up lights or they go skating for the first time in a decade, break their heads open. (Izzie looks slightly ill at this and looks worse by the time he stops talking) And every year people drive through blizzards to get to parties where the kiss germ-infected strangers under poisonous mistletoe and then they get so drunk they smash their heads against their windshield on their way home. Like I said, there's no hard or fast rule.

(Deserted /closed down hallway. Alex is pushing against Meredith's stomach)

Alex: Does this hurt, Mrs. Grey?

Meredith (old voice): Yes Doctor.

Alex (reaches under her back): How bout here, does it hurt here?

Meredith: Yes it does.

(Cristina walks in to the hallway and stops when she sees the previous scenario before her. Her mouth hangs open in shock)

Cristina: Okay, seriously if you're that lonely there are excellent vibrators. I can give you a catalogue.

Meredith (normal voice): He failed his medical boards. I'm helping him study.

Cristina (walks up to them): You failed your practical?

Alex: Glad to know you can keep a secret, Grey.

Meredith: I kept your secret; it didn't do you any good. He needs our help.

Cristina: Oh, you're not serious.

Meredith: What if it were you?

Cristina: It wouldn't be.

Meredith: But what if it were?

Cristina: It wouldn't be.

(Meredith gets paged. She gets up off the bed)

Meredith: I have to go. Be a patient. Do it for me.

Cristina: Fine, but when Tiny Tim goes all Norman Bates on us, I'm blaming you.

(Meredith walks to the end of the hall and calls out)

Meredith: Diagnosis?

Alex: Gall-stones.

Meredith (thumbs up): Yes!

(She leaves. Cristina sits on the bed Meredith just vacated and sighs)

Cristina: I'm a 55 year old man. I'm nauseous and I can't stop throwing up.

Alex: Forget it alright, I didn't ask for anybody's help.

Cristina: Okay Evil Spawn, you can nurse your pride; key word being nurse or you can pass your test and be a doctor. Up to you.

Alex (sighs and stands in front of her): Any abdominal pain?

Cristina: Yes from my giant fat belly all the way to my back. Oh and I'm drunk. Hiccup, hiccup.

(Meredith is entering the scrub wash room with a chart. George is already in there as is Bailey who's sitting down and eating a chocolate bar)

Meredith (hands Bailey the chart): I got another one for you.

Bailey: He tried to gift wrap a 70-inch TV for his wife?

George: Hernia?

Meredith: Strangulated. Pretty ugly.

Bailey: And you just know the wife just hates TV. Grey is that other project covered.

Meredith: I think so.

Bailey: Then scrub in. O'Malley, go tell Nadia Shelton she's off the schedule until tomorrow.

(George looks upset at this)

(Nadia Shelton's room where her boisterous, noisy family are still being annoying and creating a huge racket)

Jimmy (shocked): Till tomorrow?

Nadia: Another day is not gonna kill me Jimmy.

George: I promise tomorrow for sure.

Nadia's Mother (outraged): Today was for sure!

Ernie: What's he saying?

Nadia's Mother (yells): He's saying they can't operate until tomorrow!

Ernie (yells): Outrageous!

(There's all this loud talk and yelling. George looks annoyed)

George (speaks to Josh playing the really loud gameboy): Could you please turn that down your mother needs to rest.

Josh: Who are you? My Dad?

George: Sir, could you please tell your son---

Jimmy: Don't talk to me about my son. Who the hell do you think you are?

George: Sorry. I'm really sorry. (Mrs. Shelton and Mr. Shelton are still yelling loudly) I just think your wife should rest ...

(Nadia looks grateful at the attempt but the noise of the family is just too loud)

Nadia's Mother: You people, you have ruined everything.

George: I am very sorry.

(George just leaves the room)

(Deserted hallway where Alex is now what it looks like feeling up Cristina. Or at the very least groping her boob. Cristina backs up)

Cristina: Okay the way you're grabbing me now, that's assault.

(She grabs his hand, flattens his palm and uses the tips of his fingers to press against her chest)

Cristina: This is an exam. Pat, pat, pat.

(George comes into the hallway and looks dumbfounded)

George: What? What the hell? (loud) Does Izzie know? Does Burke know about this?

Cristina: Un-bunch your panties, George. We're helping Alex study. (to Alex) Do it.

George: I can't hear you when his hand is on your boob.

Cristina: Take your hand off my boob, Alex.

(Alex removes his hand)

George: Thank you. (he walks up to them) Study for what?

Alex: Shut it, Yang.

Cristina: Alex failed his boards.

George: Seriously?

Alex: I failed one part of one board. That's it.

George: Still...that's pretty embarrassing.

Cristina (She gets paged): Eh, he's all yours Georgie! Do your worst.

(She gets up and leaves)

George: You're not giving me a rectal. Do not ask me to cough.

(Cristina is walking up a nurse's station outside Justin's room where Dr. Burke is standing after Justin's surgery looking over a patient chart)

Cristina: You paged me? (She peers into Justin's room)

Burke: I didn't see a psych consult scheduled here.

Cristina: Ah I couldn't get one. I tried to but they told me to come back in January.

Burke: You disrespected me. You mocked me in my OR. That can't happen.

Cristina: I wa ... It won't happen again.

Burke: You equated my spirituality with a belief in Santa Claus.

Cristina: Burke, science is the one thing. You know it's the one thing we have in common. I'm an intern and you're not. I'm a slob and you're not. I say I want to keep our relationship private and you go and tell the Chief of Surgery and you asked me to move in with you and now you're religious.

Burke: Spiritual. There's a difference.

Cristina (shakes her head): Well not to me. ... I don't know what we're doing.

Burke (looks angry): Well right now we're working. Page me if he spikes a fever. (Cristina shakes her head in dismay that Burke is ignoring what she's saying) Tell Mrs. Davidson to hire a private therapist or priest, anyone Justin will talk to.

(He slides the chart over to her and walks away)

(Izzie is walking down the hallway, where she finds Mrs. Epstein with her three kids sitting on some chairs)

Izzie: Mrs. Epstein?

Mrs. Epstein: Oh (she stands up and walks to Izzie) How is he?

Izzie: He's gonna be fine. He's still a little groggy.

(Jake interrupts)

Jake: My Dad wants to see me now, ok?

Izzie (smiles): Ok.

(She starts walking down the way she came and the family follow to Mr. Epstein's room. They stop at the doorway)

Mrs. Epstein: It's ok guys. Daddy's ok.

(One of the daughter's runs into the room and jumps onto the bed)

Daughter: Daddy, daddy. I could kiss it better Daddy.

Tim (to his wife): Jillian I have a headache.

(Mrs. Epstein nods)

Leah: I'll sing for you Daddy.

Tim: No.

Leah (sings): Dashing through the snow ...

Tim: No!

Leah (continues): ... on a one-horse open sleigh ...

Tim: Leah. Damn it Leah shut up! (Leah stops and immediately starts crying) I can't stand that insipid song!

Mrs. Epstein: Tim!

Tim: Just get out!

(Derek walks in)

Tim (yelling): Get out! Get the hell out of here, all of you!

Jake (upset): You stupid Shepherd! You broke my Dad's brain!

(Izzie and Derek are walking down a hallway)

Izzie: How did that happen? I mean his personality ... you didn't go anywhere near the frontal lobe.

Derek: Well the CT might've missed something. Or a personality change could be a reaction from the anesthesia wearing off. Could be the pain.

Izzie: He was in pain before the surgery.

(Derek heads into a stair well)

Derek: Watch him for a couple of hours, if he doesn't improve get a new CT.

(Derek starts walking down the stairs)

Izzie (gets a look on her face): Ok.

(Derek catches the look and walks back quickly)

Derek: Dr. Stevens?

Izzie: You had his brain open. Literally open. He was laying there unconscious and vulnerable and ...

Derek: You think I poisoned him with my anti-holiday venom.

Izzie: Well you're the one that's always saying that there's a lot about the brain that we don't know. How do you know that your words didn't speak to him on some unconscious level? I mean he trusted you to be his ... Shepherd.

(Izzie seems surprised at her own choice of words)

Derek: Dr. Stevens, you should be a little embarrassed.

Izzie (nods): I am.

Derek: Good.

(He walks down the stairs and Izzie leaves back the way they came)

(Justin's room, where his mother is decorating his room with Christmas decorations and a Christmas tree. Cristina walks in)

Cristina: Oh this is the CCU. There are no trees allowed in the CCU.

Mariann: I know, it's never really been enforced, so ... (Cristina looks off-put at this) How's he doing?

(Cristina walks up to Justin's bed)

Cristina: Ah surgery went smoothly but it's too soon to tell.

Mariann: He's really a good boy you know. You just met him at a difficult time. He's been down. I don't know why. (Cristina checks Justin's heart with a stethoscope) But Father Michael will be able to talk to him.

Cristina: No offense but uh your son doesn't seem to be a fan of the holidays. He doesn't believe in Santa.

Mariann: Yes well a mother's job is to protect her child's innocence. And this Christmas could be his last time, so.

Justin: That's what you said last year. And the year before that.

(Justin gives Cristina a look)

Mariann: Oh my baby, you're awake. You look great. My big, strong boy. Santa brought you back to me.

(Cristina looks thoroughly annoyed now and unplugs the Christmas tree lights and starts wheeling out the tree of the room)

Mariann: What are you doing?

Cristina: Sorry. CCU regulations.

(Operating room with Bailey and Meredith, operating on the strangulated guy)

Meredith: Are we using mesh?

Bailey: Yes, the conjoined tendon is ... (She pulls away suddenly from the surgery and puts the surgical tools down and moans) Mmm Hmmm Mmm.

Meredith: Dr. Bailey?

Bailey (raises her hand to silence Meredith): Just wouldn't want to throw up in the body cavity.

Nurse: Dr. Bailey, are you all right?

Meredith: Do you need ...?

Bailey: I just need a minute Grey. Oh when you operate the rest of the world goes away. Hunger, thirst, pain. You don't feel it in the OR. But it's not that way when you're sharing you're body with another person. Ok.

(She turns back to the surgery and starts again)

Meredith: Are you sure you don't want me to find someone to take over for you?

Bailey: What I want you to find me is a strawberry milkshake. Extra thick.

(The operating staff look amused at this)

Meredith: Seriously?

Bailey (nods): Yeah, nausea. Comes with the hunger, Grey. Go.

(Meredith leaves the operating table)

(George is sitting on the hospital bed in the abandoned hallway with Alex sitting next to him, 'examining' him. George is talking in the most horrible ghetto voice ever. It's hilarious)

George: My throat, it's like wicked sore yo. (Gestures to his face) Plus I've got all these like sick breakout's, right.

Alex: Dude seriously.

(George instantly stops smiling, stands up and starts walking away)

Alex: Alright, alright, sit down, sit down.

(George moves back and sits down. Alex stands up)

Alex: Open up your mouth. I'd like to inspect your tonsils.

(George opens his mouth and sticks out his tongue. Alex gets a tongue presser and a flashlight to examine his throat. Izzie comes into the hallway and looks stunned at what she's seeing)

Izzie: What's wrong with you are you sick?

(Alex stops examining him)

George: Fake sick.

(Izzie just looks confused)

Alex: I failed my practical board exam. O'Malley's helping me study.

Izzie: You failed your ... (to George) You're helping him?

George: Just to study. Nothing else.

Alex: Izzie.

Izzie: No, you don't get to say my name (she points her finger at George angry) and you are unbelievable!

(Izzie storms off. George gets up and starts chasing after her but turns back to Alex)

George: Ah! I was doing mono, the whole fever and glands thing. The acne was just part of the whole teenager thing.

(George sprints off after Izzie)

(Izzie is walking up the stairs leading away from the hangout and starts walking down a hallway. George is close behind her.)

George: Izzie would you wait.

Izzie (yells): I say I like the guy and you can't stop hating him. And as soon...

George (interrupts): Izzie.

Izzie (yells): ...as he screws me over...

George: Izzie!

Izzie: You're his new best friend!

George: He failed his boards. This is important.

Izzie: He cheated on me.

Meredith (walks up behind them with the milkshake for Bailey): Busted?

George: Yeah. I'm busted.

Meredith: His exam is tomorrow.

Izzie (even more angry): You're in on this too? He cheated on me! God!

Cristina (walking down hall opposite from them with a Christmas tree): Oh, I told you she'd find out.

Izzie: Oh, of course you're in on it.

George: She let him touch her boobs!

(Cristina hits George with the Christmas tree)

Izzie: He cheated on me with George's skanky syph nurse!

George: That is just plain rude!

Meredith: We know! He cheated on you! That's why we let you turn the living room into Santa's freaking Village.

Izzie: What?

Meredith: We're not big on holidays you know that. But we're trying to be supportive because you are having a hard time. But right now, Alex, he's having a harder time.

Izzie: Why does everyone care what kinda time Alex is having?

Meredith: Because he's dirty Uncle Sal.

(Both George and Cristina turn around and give Meredith weird looks)

George: Sorry?

Cristina: Huh?

Meredith: He's dirty Uncle Sal. The one who embarrasses everyone at family reunions and who can't be left alone with the teenage girls but you invite him to the picnic anyway.

Cristina: Sorry. What?

George: I'm still lost.

Meredith: I have a mother who doesn't recognize me. As far as family goes, this hospital, you guys are it. So, I know you're pissed at Alex but maybe you could try and help him anyway. Sorta like in the spirit of this holiday you keep shoving down everybody's throats.

(Izzie shakes her head and walks off. Meredith also walks off in the opposite direction)

Cristina: You.

George: What?

Cristina: Boob!

(Cristina walks off and George's pager goes off)

(George rushes into Nadia Shelton's room, where Nadia is sitting up vomiting blood into a bucket. Her family are going nuts)

Jimmy (yelling): Somebody do something! Doctor get in here now!

(Everybody is talking and yelling at once. George rushes up to Nadia)

George (to Nadia): Nadia we're taking you to surgery.

(Nadia nods and George turns to the nurse holding the bucket)

George: Prep her now!

(The nurse nods and George rushes out of the room)

(Meredith is walking down the hallway with the strawberry milkshake. She enters the scrub room where Bailey is sitting waiting. Meredith hands her the shake)

Bailey: It's about time.

Meredith: Sorry, I got side-tracked.

(Bailey takes off the top of the milkshake and just drinks it directly from the cup. George rushes into the room)

George: Nadia Shelton's ulcer perforated. She's vomiting blood by the pint.

Bailey: Is the Chief back?

Meredith: I didn't see him.

George (shakes his head): No.

Bailey (frustrated): All right uh both of you scrub in. I'm gonna need all the help I can get.

(She starts drinking massive gulps of her milkshake not stopping as Meredith and George start scrubbing up)

(Derek and Izzie are in the CT viewing room looking at the images on the screen as Mr. Epstein lies in the CT machine)

Derek: Well, there it is. Left side of his frontal lobe. (to Izzie) Now why didn't we see that before?

Izzie: Intra-cerebral bleeds can have a delayed presentation.

Derek: Right. (to CT tech) You wanna get him out of there?

(CT tech nods and heads out of the viewing room)

Derek: Ah just prep an OR. I'm gonna talk to his wife.

(Izzie nods and heads out as well. Addison comes and stands at the doorway.)

Addison: Dr. Stevens.

(Izzie ignores her and continues out the door)

Addison (calls out): Nice talking to you. (to Derek) Think she'll ever talk to me again? (Derek is silent, staring at the CT screen) Am I invisible? I'm feeling strangely invisible. (Derek is still silent) Also inaudible.

Derek: What?

(Addison walks into the room and stands over Derek's shoulder)

Addison: Another surgery? So I guess dinner-shopping is out.

Derek: Yeah, it's not gonna happen tonight. (Addison nods) Sorry.

Addison: No, you're not. I'm just trying to figure out why you're not. It's Christmas Derek.

Derek: Yeah. I know.

(He stands up and starts heading out of the room)

Addison: It's our season. What's going on? Are you mad? Are you depressed? What?

Derek: No. Mr. Epstein here is depressed. He's bleeding from his frontal lobe. Everything's fine. We're fine Addie. You know just, I'll see you at home, ok?

(He heads off, leaving Addison looking upset)

(Mr. Epstein's room where he's lying down on his bed. His wife is standing beside his bedside looking upset. Derek is standing at the foot of the bed)

Derek: You need second surgery, Mr. Epstein. Frontal lobe is difficult. We may be able to improve things but ah you should be prepared for the possibility that things could get worse.

Tim (anger in voice): That's great. That's just great. I am so glad we came to this hospital so I could be treated by a bunch of quacks who don't know their asses from the inside of my skull!

(Mrs. Epstein looks apologetically at Derek. Derek gestures at her to talk outside the room. They walk out into the hallway)

Mrs. Epstein: This isn't my husband. This is not my husband. He doesn't speak to me this way. He doesn't speak to anyone this way.

Derek: I know this is difficult Mrs. Epstein but the important thing right now is that we stop the bleeding.

Mrs. Epstein (trying not to cry): He's the love of my life. And I know that you have a lot of other patients and you do a lot of other surgeries but he's the love of (she lets out a sob) my life. Because I just, I just need your word that you treat this change in my husband's personality as seriously as you would a fatal cancer. Because that's the way it feels to me and my kids. We were happy. We were a happy family. It just ... if you could just fix it (she takes Derek's hand in hers) ... just fix it.

Derek: Mrs. Epstein, I'm going to do everything in my power, all right? Ok?

(Mrs. Epstein nods)

(Cristina is standing at the nurse's station outside Justin's room watching Justin talk to a priest in the room and his mom sitting at his bedside)

Justin: I didn't want it. I already got one new heart. I didn't deserve another one.

Father Michael: Justin, you don't have to feel guilty about having a new heart. God wants you to live. That's why he sent you the heart.

Justin: I'm not stupid, ok? God didn't send me the heart and there's no such thing as God.

Marion (shocked): Justin!

Father Michael: Marion. Marion, it's all right.

Justin: The heart I have now, my mom told me the heart came from Santa. (Cristina walks in and check's Justin's vitals) I thought elves made it in their factory or whatever. But that's not true, is it?

Father Michael: No it isn't.

Justin: Yeah. I heard the nurses talking. Where it really came from is some other kid. Some other kid had to die so I could live.

Marion (crying): Oh Justin, baby.

(She sits on the bid. Cristina walks out of the room)

Justin: And then I outgrew that kid's heart. So for the last two years my mom has been praying that another kid would die for me. (to his mother) That's what you pray for all the time, isn't it mom? (Marion just looks down and doesn't answer) That's what she prayed for father. How does God feel about that?

(Justin closes his eyes)

Father Michael: Justin.

Marion: Justin.

(Justin's monitor starts beeping rapidly. Cristina hears the beeping)

Marion (shaking Justin): Justin baby? Wake up Justin! (she calls out) Nurse! Oh please no.

(Cristina rushes in)

Cristina: Move please. (yells and moves Marion out of the way) Move please!

Marion: No, no, no, God please.

Cristina: Code blue! (She starts prepping Justin) Just stay back!

Marion: Justin baby I'm right here. Please Justin I love you!

(Nurses rush in. Cristina lowers Justin's bed, as a team brings in the crash cart)

Cristina: Please shut her up!

Nurse: He's in V-FIB.

Cristina: Charge the paddle to 100.

Nurse: Charged.

Cristina: Clear.

(Cristina places the paddles on Justin and shocks his heart. Immediately the heart monitor starts beeping normally and Justin coughs awake. Cristina looks relieved while Justin just looks upset)

(Burke and Cristina are walking out of Justin's room and down a hospital hallway)

Cristina: Ok we need to get him back on the donor's list. It's a bad heart.

Burke: It's not a bad heart.

Cristina: Well can you get him back on the list?

Burke: He's waited two years for this heart. He has to fight for it. He has to decide he wants to live.

Cristina (frustrated): Ok, medically speaking is there anything else we haven't done?

Burke: 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.

(He walks up the stairwell, leaving Cristina standing there)

(OR where Derek and Izzie are operating on Mr. Epstein again)

Derek: Drill please.

Izzie: Any danger of two craniotomy's in one day?

Derek: No more than with one.

(He starts drilling)

Derek: Is there any music?

Nurse: Any requests?

Derek (looking at Izzie): Christmas carols. Or Hanukkah. Is there such a thing as Hanukkah carols? (The bars of a Hanukkah song start) The brain is a mysterious thing Dr. Stevens. You never know what may penetrate the psyche.

(Izzie looks like she's smiling through her scrubs mask)

(O.R where Nadia is being operated on. Bailey is being fed a drink by a scrubs nurse, while George and Meredith stand near the operating table, holding clamps and stuff in Nadia's body cavity)

George: Oh, look at that.

Meredith: Kissing ulcers. One's perfed and the other one's bleeding.

George: Two ulcers. Not surprised by the family. I should've thrown them out. Why didn't I throw them out? That's what I should've done. But no I didn't.

(Bailey turns back to the operating table, scrub mask in place and everything)

Bailey: Stop whining O'Malley, you had your chance; you didn't take it. Move on.

George: Right, sorry.

Bailey: Do not kick me.

George: Excuse me?

Bailey: Are you kicking me under the table O'Malley?

George (shocked): No!

Bailey: Then clearly I wasn't talking to you! ... Uh! Eh! (she backs away from the operating table) You can not kick me while I'm doing my job.

(Bailey is pressing against her pregnant belly. Everyone just stares at her amazed)

Bailey: Thank you.

(She steps back up to the operating table)

(Izzie is walking down the abandoned hospital hangout. Alex is lying down on a hospital bed asleep with textbooks surrounding him. Izzie walks up to him and slaps him)

Izzie: Wake up.

(Alex sits up groggy)

Izzie: God, no wonder you failed your boards. What do you expect to learn this stuff by osmosis?

Alex (sleepy): What are you doing here?

Izzie (crosses her arms in front of her): I'm a farmer, ok? I've been drooling, puking and crapping in my pants.

Alex: You came here to help me study?

Izzie (annoyed): Well I'm not actually crapping my pants now, am I?

Alex: Why would you want to help me after what I did?

(Izzie is silent for a moment, shaking with anger)

Izzie (yells): Because it's what Jesus would freaking do!

(Cristina is standing in Justin's room by his bedside. She looks over to his mother who is fast asleep near the door. She then takes a seat and sits next to Justin. She leans forward)

Cristina: You know I don't believe in Santa either Justin or God. (Justin looks over at her slowly) I believe in medicine. And it's a medical miracle you're alive. With the heart you had, you should've, you should've died after two weeks after you were born. Except some surgeon figured out a way to give you someone else's heart which is, is so much cooler than Santa. ... So I'm just saying ... ... I think you should decide to live. ... Live so you can become a doctor and you can find a way to do heart transplants without someone having to die. Or live so you can grow up so you can have kids and you know what raise them not to believe in Santa. And that, that would piss your mom off. (Justin smiles) Just decide to live because in your case dying really isn't the best revenge.

(Cristina leans back into her chair)

(Hospital waiting room, where Nadia Shelton's family sit waiting. Bailey and George walk up to them. Mrs. Shelton and Jimmy stand up immediately)

Jimmy: How is she?

Nadia's Mother: Is she gonna be alright?

Bailey: She lost a lot of blood but we were able to replace it and repair the tear. She's gonna require several days of observation but she should have a full recovery.

Jimmy: Oh thank god.

(Bailey is smiling as she starts to leave)

Nadia's Mother: Thank god is right 'cause we're certainly not going to thank you!

(Bailey stops smiling and stands where she is)

Nadia's Mother: We should sue you for all your worth! We sat here and sat here and sat here and sat here and sat here ...

Bailey (whispers to George): You wanna help me out?

Nadia's Mother: And watched you take patient after patient after ...

George: Really?

Bailey: Yeah. You got your second chance. Just don't screw it up.

Nadia's Mother: You made my daughter wait for 3 whole days for her operation! I should sue you and this whole damn hospital!

(The rest of the family walks up to them)

George: Ok, yeah you could sue us or you could just consider the possibility of just shutting the hell up.

Nadia's Mother: What did you say to me? (to Ernie) Did you hear what he said to me?

Ernie: I heard him.

Josh: You can't talk to an old lady like that.

Nadia's Mother: Where is my daughter? I'd like to see her.

George: Well you can't. I'm her doctor and she is my patient and this is a hospital which is the kinda place where people could generally use a little peace and quiet. So no right now you can't see her. And I'm not saying this just because you threatened to sue Dr. Bailey who spent the last several hours saving your daughter's life (The family look outraged at this, while Bailey just looks smug) saving your wife's life. I'm saying this because she is my patient and she is in the recovery wing of this hospital trying to recover! And visiting hours are over! So goodnight! (a little calmer) and Merry Christmas.

(He walks off, leaving the family looking shell-shocked)

Bailey: Interns. Too emotional. Oh, apologies.

(She also walks off)

(Hospital hangout where Izzie is sitting on the hospital bed and Alex is standing in front of her)

Alex: Uh, is the nausea constant or intermittent?

Izzie: Constant.

Alex: When, when did it first start?

Izzie: After I worked in the fields all day.

Alex: Do you have any allergies you're aware of?

(Izzie's struggling really hard not to cry. Her eyes are filled with tears)

Izzie (tears in her voice, she shakes her head): No.

(Alex moves to sit next to Izzie as she starts crying now freely)

Alex: Izzie, ... I never wanted to hurt you.

Izzie (crying): You didn't hurt me. I don't even know you. I'm a farmer!

Alex: You, you're still the patient?

Izzie (still crying but indignant): What does it look like?

Alex: It's organophosphates. (Izzie nods) Pesticide poisoning. Crying is a symptom, that's it right?

Izzie (nods and continues to cry): Right.

(Meredith is walking down the hospital hallway dressed to go home. She smiles when she sees Bailey fast asleep dressed to go home on an empty gurney)

(Meredith is still inside the hospital but at the foyer entrance about to walk out. Derek also dressed to go home, walks out of the elevator and sees her)

Derek: Hey.

(Meredith closes her eyes and stops walking. She turns and faces Derek)

Meredith: Hey.

(She starts again heading out of the hospital)

Derek: You, ok?

Meredith: Yeah, yeah. You know, holidays.

Derek: Yeah. I do know.

(They head outside into the night)

Meredith: Merry Christmas.

Derek: Merry Christmas.

(They part ways)

(Derek enters Joe's bar. He walks up to the bar where Joe is standing)

Joe: Hey.

Derek: Merry Christmas Joe.

Joe: Merry Christmas. (He pours Derek a drink) Double scotch. Single malt.

Derek: You're a good man.

(He takes the drink)

Addison: Hey, Dr. Shepherd.

(Derek turns and sees Addison sitting at a bar table with catalogues and her own drink. She smiles at him. He lifts up his drink and toasts it at her)

Derek: Dr. Shepherd.

(He takes a sip and makes his way over to the table)

Addison : So? How's Mr. Epstein's frontal lobe?

Derek: He woke up smiling.

Addison: Congratulations.

Derek: Thank you. What are you drinking?

Addison (chuckles): It's ah hot buttered rum. It's delicious.

Derek (smiling): It's Dickensian.

Addison: Ah no, yeah, well it is Christmas.

Derek: Hmm.

Addison: Christmas Derek. We love Christmas. At least we used to.

Derek: Yeah. ... Christmas makes you want to be with people you love. ( Addison looks up at this) ... I'm not saying this to hurt you or because I want to leave you. Because I don't. (Addison looks confused) Meredith wasn't a fling. (Addison sits back instantly on guard) She wasn't revenge. I fell in love with her. That doesn't go away because I decided to stay with you.

(He sits down next to her while Addison contemplates what he has just said)

MVO: There's an old proverb that says you can't choose your family.

(Cristina arrives home to Burke's apartment. She places her bag down on a table as well as her keys. She stops when she sees the little Christmas tree Burke had this morning all decorated and lit up.)

MVO: You take what the fates hand you...

(She smiles when she sees an 8-candle Hanukkah set sitting on the window sill. She looks into the bed room and sees Burke half lying-half sitting on the bed reading a book.)

MVO: ...and like them or not, love them or not, understand them or not ...

(Cristina is now dressed for bed and she climbs in next to Burke)

Cristina: Justin took a turn. His fever's down and his BP is up.

(She cuddles up into Burke)

Burke (knowingly): I wonder what got through to him.

Cristina: I don't know.

MVO: ...you cope.

(Townhouse where Izzie is lying down on the floor with her head under the Christmas tree. The tree is all lit up and flashing. Meredith walks into the room)

Meredith: Pretty.

Izzie: Yeah.

(Meredith lies down next to Izzie)

MVO: Then there's the school of thought that says the family you're born into is simply a starting point.

(George now comes to the living room and looks at the two confused)

George: What are we doing?

Izzie: Lights.

(George sets down his coffee mug and runs quickly into the room and lies down next to Meredith and also begins staring at the lights)

MVO: They feed you and clothe you and take care of you until your ready to go out into the world.

(Doc barks once and enters the room and sits down next to George)

MVO: ...and find your tribe.

(The camera pans up the tree and fades out)