Meredith offers to run the ER for a night, and we get to spend an hour with her in almost real time to see just how action-packed an hour in the ER can be. Most of the doctors and patients alike are all trying to get done and leave so that they can make it to a big UW basketball game, this includes Meredith's first patient who comes in with mild chest pain and wants to leave so he can take his son to the game with tickets he gave the kid for his birthday. If you think this sounds unfortunately ominous, it is -- his x-rays keep coming back looking not quite right so she sends him for a CT, where he winds up coding while in the machine because he has a ruptured aorta. It's something that's almost never caught and even when it is, it's still fatal more times than not. Teddy happened to still be at the hospital even though she was trying to leave on a date, so she and Mere rush the guy to surgery, but he winds up dying anyway. Meredith then hears his cell phone ringing and answers so that she can break the news to his family. Teddy has a much lighter evening of it and winds up going on her date, though not without Henry's trying to dissuade her first. He had shown up unexpectedly for a test of some sort and wound up killing time chatting with said date, and as Teddy is about to leave he warns her that the guy seems kind of like a poncey loser. Teddy ultimately decides to go anyway but seems (at least from the glance she shoots Henry as she gets on the elevator) to at least realize that things might not be so cut-and-dried with her insurance-only husband.
Another patient who wants to get to the game is a really drunk dude who walks in to the ER with a knife sticking out of his head. He and his equally drunk buddy had gotten into a bar brawl which resulted in the knifing, but are so drunk that they just find the situation hilarious and hope that it doesn't make them late to the game. Against all odds, the knife didn't hit anything important, and while the doctors are gathered trying to figure out the best way to get it out of his head, the dudes decide to take matters into their own hands, literally, and the friend winds up just pulling the knife out. The guy is fine (and both are still very drunk), and he decides to leave against medical advice so that they can still make tipoff.
Alex and Lucy are continuing their strange little mating dance from last week where they insult but gaze at each other. Lucy's tune changes, though, when she finds out that Alex has floor seats to the game and she agrees to help Alex clean up a bunch of his charts so he can get there on time. She then manages to get him to invite her and ditch Avery but she isn't even free -- she just wanted to see if she could get him to ask her. Ultimately Alex doesn't even wind up going either; one of the waiting patients in the ER is a little boy who broke his leg and needs two casts put on, and he and his parents have been waiting all day for an open OR for the procedure. Alex gives both tickets to Avery so that he can do the casts, so Avery invites Lexie to go to the game with him and she happily accepts.
In the middle of all of the medicine, Cristina tells Meredith that Callie asked her to be the baby's godmother. Meredith gets really weird about it and then finally admits to Cristina that she feels like if Cristina accepts, it means she thinks Mere is never going to have a baby of her own to godparent. Cristina of course doesn't mean that at all, and deep down Meredith knows it, but she feels the way she feels and so Cristina decides to pass on Callie's offer. Mere's also a little bit extra emotional because she and Derek have stepped up the fertility drugs to the point where Derek is having to give her injections, one of which he gives her in the middle of her hour. When they try to slip into the on-call room to do it, Derek walks in on Bailey and Eli getting busy though he doesn't admit to Mere who and what he saw. Bailey had repeatedly turned down Eli's requests for some in-hospital nookie but finally gave in -- Derek's busting them appears to cause her to strengthen her resolve never to try sex in the workplace again.
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As evening descends on Seattle, Meredith's voiceover asks how much we can accomplish in an hour and throws out suggestions including running errands and sitting in traffic. If you're in L.A., you can do that last one for far longer than an hour if you want to. To illustrate an hour we see sped-up footage of doctors and nurses working away in the ER, and then we see the clock tick over to 6:00 PM. Mere explains that in medicine they have a term called "golden hour" which refers to the magic window that determines whether a patient lives or dies.
As the 6:00 hour begins, Mere writes some things up on the patient board. Since this is done in real time we're treated to a bit of filler at a few different points during the episode. Cristina is kicking back at the desk eating potato chips and declares that she's not going to help out since she just finished four back-to-back surgeries and this is the first time she's sat down or eaten all day. She also reminds Meredith that she got herself into this situation since Mere volunteered to help run the ER. Mere gives some people some directions and then explains to us/Cristina that she thinks this will make her look like a good candidate for Chief Resident. She's totally giggly and smiley and Cristina notes this suspiciously; Mere explains that she's on fertility drugs and therefore full of extra hormones that are currently making her attitude and her boobs extra perky. Cristina then delicately tells Mere that Callie mentioned "a thing" but she's interrupted by Lexie, who has a patient with a migraine ready for discharge. Mere makes sure she ran all of the appropriate tests and Lexie assures her that she did, and comments that the most interesting thing about his case is his horrifying girlfriend from hell. They all turn and stare at a redhead busy talking on the phone next to the poor guy. Mere signs off on the paperwork and Cristina tries to pick up where she was interrupted but they are then interrupted by Arizona and Owen who have patients. Mere, though, seems to be doing a great job wrangling everybody. Once those interruptions are through, Cristina finally admits that Callie asked her to be the baby's godmother. Meredith's not happy about it and asks if she said no, and says that Cristina has to say no like it's the most logical thing in the world. Cristina's taken aback but Mere heads off to meet a new patient so they can't discuss it yet.
Her patient is Oliver, a good-looking businessman who is on his phone, explaining to his wife that his coworkers overreacted when they heard he was having chest pain, and he's that it's just indigestion. Nurse Tyler is around as Mere's right hand man this hour and he removes electrodes from Oliver's chest as Oliver tells his wife to have their son put on his basketball jersey, and he'll be home soon. He's hot, nice, and has a kid waiting on him? I smell doom for poor Oliver. He actually apologizes to Mere for talking on his phone, and that gesture just insures that something horrible is going to happen. He's supposed to be taking his 9-year-old, basketball-crazy son to the University of Washington basketball game that night with tickets he got the kid for his birthday. He had some chest pain but insists he's feeling better, though Mere realizes this might be his way of trying to get out earlier. Meredith assures him that she will try and get him checked out and through his tests as quickly as possible, and while he's visibly disappointed he grudgingly understands that she can't just take chest pain lightly.