Stairway to Heaven

is the thirteenth episode of the fifth season and the 91st overall episode of Grey's Anatomy.
==Short Summary==
Meredith and Miranda each cross a line, William Dunn regrets his decision and Izzie finally confronts what Denny's appearance means.
==Full Summary==
Izzie is brushing her teeth before going to bed. She sees Denny in the mirror, but ignores him and leaves the bathroom.
William's still banging his head on the frame of the bed. His bandage is getting bloody.
Meredith ignores the loudly beeping monitor at the nurses' station.
In the kitchen, Denny watches Izzie practice stitches on a tomato.
Blood leaks from under William's bandage. He stops banging his head.
Sadie asks Meredith if she's coming to William's room. Meredith says the nurses will come get them if it's bad. Nurse Tyler comes over and informs them he's seizing. Sadie asks if they can go now. Meredith tells Sadie to go find something else to do.
In his room, William is seizing.
Izzie can't sleep as Denny's still with her. She wonders why he's still here. He says he's there for her, but she disagrees. She says they broke up, and he has to go. She turns off the light and tries to fall asleep.
Melinda is with her son and Bailey. Alex called UNOS, and Jackson is on top of the list. Bailey assures Melinda they're doing everything they can. Bailey gets paged.
Bailey enters William's room, where Meredith has changed his bandage. She gave William lorazepam for the seizure. She has refused to page Derek as William doesn't want her to. William states that Derek is terribly unpleasant. Meredith says William's a match for Jackson. Bailey wants to get Shepherd in for William's bleed, but Meredith stresses he's gonna die anyway. William presumes the boy wants to live, and he has organs for the boy. He's ready to die.
Lexie and Mark enter an on-call room.
Outside the room, Meredith tells Bailey she knows it's wrong on so many levels, but there's nothing in any book on how to deal with this situation. Bailey knows what to do: what's best for her patient. She suggests Meredith do the same to keep William alive. They're doctors, not executioners.
The interns Steve, Ryan, and Dani are listening outside of the on-call room where Lexie and Mark are obviously not sleeping. Suddenly, Mark screams, and the interns run off.
Mark is screaming in pain. Lexie says it's bent in the middle. She thinks she broke his penis. Mark yells for her to go get Torres.
Owen's asleep in Cristina's bed as she looks on. He awakens when he hears her leave the room.
Bailey tells Alex and Izzie they have to care for Jackson all day. His brain's going to swell and they can't stop that, but they can try like hell to slow it down. Denny tells Izzie she doesn't have time for anyone else. Richard comes over and asks how many hours they have. She says 16 hours, tops. Arizona says there's a liver dialysis machine downstairs for a clinical trial that may buy Jackson more time. Bailey tells Alex to go get the machine. Bailey badly wants off this case. She doesn't want to be there to see when Jackson dies. Arizona asks when she last slept. Bailey assures her she's fine.
Derek kisses Meredith in a conference room. He's happy to see her. She's been here all night. He asks about William. Meredith says he'll be gone soon. Derek happily tells her his mother liked her, and thinks she's good for him. Bailey sees Derek leaving the room, smiling. She looks at Meredith when she comes out, too. She suspects Meredith didn't tell Derek the truth about William.
Lexie finally finds Torres. She paged her 911 for Sloan, who's badly injured. He may have broken a bone. She broke his bone. Callie thinks she's kidding, but soon realizes it's serious.
Owen finds Cristina in a supply closet. He wants to apologize for last night. Normally, if he's showering with a woman, he does it without clothes, and if he ends up in her bed, he doesn't pass out. She says it's okay, but it's not. She doesn't think he has to talk about it.
William says it's getting harder to breathe. Meredith says he can stop at any time. She asks if he wants her to page Dr. Shepherd. William knows he's her boyfriend. The man has very good taste, he says. Right now, William can only think about lemons. When his grandfather was dying, he said he smelled lemons. That was all he could talk about. He keeps waiting to smell them, but he doesn't. His grandfather was a known liar, so maybe that's why. He's sure he doesn't want her to page Shepherd.
Richard asks George to talk to the nurses to find out if any patient is O+ and/or brain dead. Then he has to cross-match those folks for Jackson. He has to be gentle, and non-coercive though. George understands.
Derek shows Cristina the ring, which was his mother's. Derek wants to know if Meredith's gonna like the ring or if he should have the setting replaced with something more modern. Cristina says it's not her job. He asks her to stop the fighting with Meredith because when he proposes, Meredith's gonna need someone to freak out to. Cristina says he should ask someone else.
Izzie asks Melinda if she's had time to eat because she needs her strength. Izzie says she'll stay with Jackson. Melinda leaves and Izzie sees Denny again. Denny asks her if she believes in heaven. Izzie guesses so. Denny thought maybe this was heaven, getting to be with her. Now, he's not so sure. Maybe it's hell. He's here for her. She knows that by now. She chose Alex and she's sorry about that. Denny asks if it doesn't tell her anything that he's still here despite that. Denny says she can't pick Alex as he's here for her. He wants her to be happy, and he'd leave if he could. He doesn't want to stay here when she wants another man. He can't go because she won't listen to him. He's here for her. She asks what that means. He tells her to figure it out.
At a nurses station, Meredith wants to ask Cristina something, but decides against it. Cristina asks if she monitored the serial killer last night. Meredith says she's got it covered. Suspicious, Cristina leaves to go check on William.
She examines him and wants to page Shepherd. Meredith says that if they let William die here, they can give his organs to Jackson. Derek won't allow it, so she didn't page him. She knows Cristina thinks this is wrong, but she asks Cristina to let her do this. William asks them to page him. He doesn't want to die. Cristina calls a code, tells a nurse to 911 page Shepherd.
Arizona is guiding Izzie as she's placing a catheter. Denny, meanwhile, keeps talking about visiting the Grand Canyon and the Great Wall of China. His point is that he has other things he wants to do, but she won't listen to him. Izzie is distracted and doesn't hear Arizona's words. "Would you just tell me already!" she yells to Denny. Arizona tells her to take a break.
The interns are gossiping about Mark's broken penis. Lexie is mortified. Sadie asks her if it was Torres. Lexie says it's nobody's business. If she did know it, Lexie wouldn't tell her, as they aren't friends after the incident with the appendixes.
Derek wants William in the OR in 20 minutes. He turns to Meredith and says she should have paged him, and told him the truth a long time ago. Meredith says she followed William's wishes. Derek affirms that William doesn't get wishes. He's a monster who targets young women. He says William's been preying on her since he got here. Meredith insists she made a decision as his doctor. Derek says it was the wrong one. She has to scrub in and watch him try to undo what she did.
Alex tells Arizona that Jackson's ICP won't come down. Melinda frantically tells her son it's not time to go yet. He has to stay here with her.
Bailey is distraught while walking down a hallway when she sees they're taking William to surgery.
Callie has called in Owen, who confirms Mark has a penile fracture. Owen's done operations like this before. They have to get in now, or Mark risks permanent damage. Lexie comes in, but Mark says he doesn't want her to see him like this. He begs her to leave. She leaves.
Richard asks George what he's got. George says the guy's a match, but he's not a donor and that they're about to unplug him.
Bailey gathers herself, and then enters Derek's OR. She says she needs Derek to stop operating. This man is trying to kill himself, and god forgive her, she needs Derek to let him.
Derek tells Bailey she has to leave. Bailey says in 5 days, William will die and his organs will be buried with him. That's a crime against life. It's only 5 days and William doesn't want them anyway. Derek reminds her of their oath to do no harm. She knows, but right now, that oath makes no sense. She asks Derek to stop. Derek says that if he stops, it's the same as sticking his scalpel into the man's brain. He asks if that's what she wants. She says yes.
Richard is talking to a patient's wife. He says he needs her husband's organs. Kelly tells him to get out. Her husband was healthy two days ago, and he put his head through a windshield. And now she has to unplug him. He's her love. He's the person who's supposed to hold her hand when things go bad, but now he gets to go to heaven. She can't take anymore, so she asks Richard to go. No more cutting into her husband.
Izzie walks back into Jackson's room. She's been out for a while. Alex asks if it was about Denny. She says she doesn't know. Alex tells Izzie how bad this is. Alex says even Bailey can't stay and watch, and Izzie's wasting time talking to a dead guy. She has to be a doctor here to help save Jackson, and save the dead guy talk for home. Jackson is deteriorating. Izzie goes to check with UNOS again. Arizona hopes that Bailey's having better luck, whatever she's doing.
Cristina asks if she should put in a subdural drain as William's bleeding through his craniectomy. Derek says that's Bailey's call. Bailey says no. Derek asks Bailey if he's a surgeon or an executioner. Everybody's looking at her. She decides he's a surgeon. She leaves the room ashamed of her actions.
Richard tells Kelly her husband can't take his liver with him to heaven, or his bowels, or his kidneys. These organs are good because he was a young and healthy man. He knows it's not what she wants to be thinking about right now.
Steve, Pierce, Dani, and Ryan are wondering who broke Mark's penis as they watch Callie and Owen repair it. They can't even imagine the muscle it takes to break a penis. Lexie yells to shut up about it. Ryan concludes she knows something. They suspect it was Lexie, but Sadie saves her and says it was her. She does this "twist and shout" thing that blows most guys' minds, but apparently she twisted too far. She smiles at Lexie, who secretly smiles back.
Izzie talks to Denny in an X-Ray booth. She affirms that she can feel him and smell him. She's thinking maybe he's not dead. Maybe her seeing his death was the crazy part of her, and not this. He must still be alive. He says that's not it. She asks if he's a ghost or a dream. He tells her that she's a doctor, and to think like a scientist. Izzie says scientists believe what they can feel and see. She slaps his face. She felt his face in her hand. She kisses him, and feels his lips. Those are facts. She tearfully asks what's happening. She says she's scared. They hug.
Bailey gathers herself before entering Jackson's room. In there, Arizona and Alex tilt the bed in an attempt to get his ICP down. Bailey tells Melinda to step back. Izzie takes her outside the room while Melinda tearfully begs to stay.
Derek and Cristina have finished stopping the bleeds. Meredith says it's a waste. Derek says saving a life is never a waste.
Melinda says Jackson's just a little boy. He's never even learned to ride a bike. Izzie says medical miracles happen every day. Melinda says she has to be with her son, as he's never been anywhere without her. Izzie says she's here for her son, even though she's not with him. She then remembers Denny telling her he's here for her. As Izzie realizes what it means, Alex comes to take Melinda back inside.
Inside Jackson's room, Bailey says Jackson's fading fast, and it's time to hold Jackson and help him go. The doctors make room as Melinda holds her son and says goodbye. Melinda tells him he can go. That it's okay, and Mommy won't be mad. Richard bursts in and exclaims that they have organs. Jackson starts crashing. Bailey starts CPR, and Richard tells them to get him to the OR fast. In the OR, Richard removes Kelly's husband's intestines. Alex takes them to Jackson.
In the waiting room, George has Kelly sign the consent forms as Melinda paces and cries.
Arizona and Bailey check for black spots. It looks clean. Jackson codes. They pack his abdomen and ask for a crash cart.
Izzie runs out into the ambulance bay as she gasps for air. Heaven or hell, she says. Denny's here for her. Izzie gets it. Denny says he loved her so much that when he got to come back for her, he thought she was his heaven. But maybe, he's her hell. Izzie says she's sick, and instead of telling her in order to save her life, he kept quiet. She yells that she hates him. Denny says he didn't know there was a chance. Medical miracles happen, she said so herself. Izzie tells Denny to leave. Denny says he can go now that she knows, but it's her choice. If he goes, he doesn't know if he can come back. She says she chooses heaven. She chooses life. She tells Denny to go. Denny really hopes this is heaven. She asks what he's waiting for. He kisses her one last time and disappears.
William wakes up after surgery. Meredith is checking up on him. William says he was playing her. Derek was right. He wanted to destroy her career. He wanted to be here to see the fall-out. Meredith says he was scared, she would've been too. William says it'd be good to have a friendly face in the crowd when they execute him.
Owen finds Cristina, and says he planned the whole evening, a real date. He was gonna take her to the west point lighthouse, and they were gonna watch the northern lights together. He'd like another chance. She says he's got some big problems. He admits he does. He asks if she'll go out with him anyway. She says yes.
Lexie visits Mark in his room. She refuses to go away. It's Lexie, not Little Grey. She's sorry she broke him, and that he's humiliated, but she's not going anywhere. She's got a friend who's guarding the door and since no one's gonna come in, she's gonna climb into bed with him and strokes his hair, because that's what she likes to have done for her when she's hurt. She then does so.
Outside the room, Sadie is standing guard and smiling.
Bailey and Richard are watching Jackson and Melinda, who are sleeping. It's unsure if Jackson will even wake up as he might have brain damage. Bailey confesses she crossed a line today. Richard says he did, too. Bailey starts crying and Richard comforts her.
Izzie's still in the ambulance bay, lost in her thoughts.
William's led to the execution table. He looks at the audience, and sees Meredith sitting in the back. He smiles, and is then strapped to the table. Now, he can smell lemons. He watches Meredith as the buzzer goes off, and the injections start. William's eyes close as he dies.
Jackson's eyes open. He asks for water. Melinda joyously kisses him on his forehead. Arizona and Bailey are profoundly relieved.
Meredith leaves the facility. Derek's waiting for her outside, leaning against the car. She's crying. She knows he doesn't understand her. She doesn't even understand herself. She wanted to show him compassion. That's why she went. It was horrible. Derek holds her, and says it's okay.
Cristina opens the door. Derek says Meredith's in the car outside, and she won't stop crying. She snidely asks if he proposed. He explains Meredith went to William's execution.
Outside, Cristina gets into the car as Derek sits down on a bench, and watches them talk.
==Cast==
513MeredithGrey.png|Meredith Grey
513CristinaYang.png|Cristina Yang
513IzzieStevens.png|Izzie Stevens
513AlexKarev.png|Alex Karev
513GeorgeO'Malley.png|George O'Malley
513MirandaBailey.png|Miranda Bailey
513RichardWebber.png|Richard Webber
513CallieTorres.png|Callie Torres
513MarkSloan.png|Mark Sloan
513LexieGrey.png|Lexie Grey
513DerekShepherd.png|Derek Shepherd
513DennyDuquette.png|Denny Duquette
513OwenHunt.png|Owen Hunt
513WilliamDunn.png|William Dunn
513ArizonaRobbins.png|Arizona Robbins
513MelindaPrescott.png|Melinda Prescott
513Kelly.png|Kelly
513RyanSpalding.png|Ryan Spalding
513SadieHarris.png|Sadie Harris
513JacksonPrescott.png|Jackson Prescott
513NurseTyler.png|Nurse
513InternSteve.png|Intern Steve
513InternDani.png|Intern Dani
513InternPierce.png|Intern Pierce Halley (right)
===Main Cast===
*Ellen Pompeo as Dr. Meredith Grey
*Sandra Oh as Dr. Cristina Yang
*Katherine Heigl as Dr. Izzie Stevens
*Justin Chambers as Dr. Alex Karev
*T.R. Knight as Dr. George O'Malley
*Chandra Wilson as Dr. Miranda Bailey
*James Pickens, Jr. as Dr. Richard Webber
*Sara Ramírez as Dr. Callie Torres
*Eric Dane as Dr. Mark Sloan
*Chyler Leigh as Dr. Lexie Grey
*Patrick Dempsey as Dr. Derek Shepherd
===Special Guest Star===
*Jeffrey Dean Morgan as Denny Duquette
===Guest Stars===
*Kevin McKidd as Dr. Owen Hunt
*Eric Stoltz as William Dunn
*Jessica Capshaw as Dr. Arizona Robbins
*Samantha Mathis as Melinda Prescott
*Amy Sloan as Kelly
*Brandon Scott as Dr. Ryan Spalding
*Melissa George as Dr. Sadie Harris
===Co-Starring===
*Aaron Refvem as Jackson
*Moe Irvin as Nurse
*Mark Saul as Intern Steve
*Molly Kidder as Intern Megan
*Candice Afia as Intern Laura
*Amrapali Ambegaokar as Intern Dani
*Tymberlee Chanel as Intern Claire
*Gloria Garayua as Intern Graciella
*Joseph Williamson as Intern Pierce
*Winston Story as Intern Leo
==Medical Notes==
===William Dunn===
*Diagnosis:
**Seizure
*Doctors:
**Derek Shepherd (neurosurgeon)
**Miranda Bailey (surgical resident)
**Meredith Grey (surgical resident)
**Cristina Yang (surgical resident)
**Sadie Harris (surgical intern)
*Treatment:
**Lorazepam
**Surgery
William rammed his head into his hospital bed in order to make it bleed so he could become brain dead. He started seizing, so Meredith gave him lorazepam. William was conscious afterward. After a while, he said it was getting harder to breathe. Meredith offered to page Derek, but he declined. Then he later told Cristina that he didn't want to die, so she paged Derek, who rushed William into surgery. In surgery, Bailey came to ask Derek to allow William to die so that Jackson Prescott could get his organs. However, she recanted and Derek finished fixing William's brain. He was stable after his surgery and was able to be discharged back to death row, where he was then executed.
===Jackson Prescott===
*Diagnosis:
**Cirrhosis
**Short gut syndrome
*Doctors:
**Arizona Robbins (pediatric surgeon)
**Miranda Bailey (surgical resident)
**Alex Karev (surgical resident)
**Izzie Stevens (surgical resident)
*Treatment:
**Liver dialysis
**Liver transplant
**Intestine transplant
Jackson was still in the hospital waiting for a liver and intestine transplant. His ammonia levels were rising despite the shunt. They brought a liver dialysis machine from where GI was using it for a clinical trial to give him a little extra time. He continued to decline despite everything they were doing. They eventually believed he was going to die, so they told his mother to hold him to help him go. Just as she did that, Richard came in and said they had organs for him. They took him into surgery where they transplanted his new organs. He coded during the transplant, but was stabled afterward and later woke up asking for water.
===Mark Sloan===
*Diagnosis:
**Penile fracture
*Doctors:
**Owen Hunt (trauma surgeon)
**Callie Torres (orthopedic surgery resident)
*Treatment:
**Surgery
Mark broke his penis while having sex with Lexie. Owen operated to fix it.
===Matthew===
*Diagnosis:
**Brain death
*Doctors:
**Richard Webber (general surgeon)
**George O'Malley (surgical resident)
**Graciella Guzman (surgical intern)
*Treatment:
**Organ harvest
Matthew was pronounced brain dead after being in a car accident. After being asked, his wife agreed to donate his organs to Jackson Prescott.
==Music==
Song 	Performer 	Scene
"Birds" 	Emilíana Torrini	
*Izzie takes Melinda out of Jackson's room.
*Cristina and Derek operate and save William.
*Izzie tells Melinda to hope for a miracle, and by talking to her, she realizes what Denny meant by "I'm here for you".
*Alex calls Melinda back into the room. It's time to say goodbye. While she's saying goodbye, Richard comes in to say they found organs.
*They start moving Jackson to the OR.
"Blindsided" 	Bon Iver 	
*The doctors start performing the transplant.
*George has Kelly sign the consent form.
*Jackson codes.
*Izzie confronts Denny about after her realization. She yells at him for not telling her she's sick and tells him to go. She chooses heaven and life.
*They kiss one last time before he disappears.
"Drifting Further Away"	Powderfinger 	
*A relieved Bailey cries in Jackson's room.
*Izzie stands frozen in the ambulance bay.
*William Dunn walks to his execution. He spots Meredith in the audience.
*William looks at Meredith as he's executed.
*Jackson wakes up.
*Derek's waiting for Meredith, who starts crying. She doesn't understand herself.
*Derek goes to Cristina and tells her Meredith won't stop crying.
*Cristina goes to talk to Meredith in the car.
"Birds" - Emilíana Torrini
"Blindsided" - Bon Iver
"Drifting Further Away" - Powderfinger
==Notes and Trivia==
thumb|300px|right
*This episode's title originated from the song Stairway to Heaven, originally sung by Led Zeppelin.
*This episode scored 14.25 million viewers.https://web.archive.org/web/20090418015151/http://tvbythenumbers.com/2009/01/23/thursday-ratings-cbscsi-capture-viewers-abcgreys-anatomy-win-demo-adults/11387
==Gallery==
===Episode Stills===
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==Quotes==
:Izzie: Heaven or hell?
:Denny: Yes.
:Izzie: You're here for me.
:Denny: Yes.
:Izzie: No. You're not here for me. You're here FOR me. You're here for me.
:Denny: I loved you so much. I loved you so much that when I got to come back for you, I thought... you were my heaven. But maybe... maybe I'm your hell.
:Izzie: I'm sick. I'm sick, aren't I? And instead of telling me... instead of telling me to save my life - you son of a bitch! You selfish son of a bitch. I hate you! I hate you!
:Denny: I didn't know that there was a chance. Miracles happen. Medical miracles happen every day. You said it! You said that!
:Izzie: Leave! Leave.
:Denny: I can go now... because you know. But it's your choice. You get to choose. But, Iz, If I go... I don't know... I don't know if I can come back. If I go...
:Izzie: In the choice between heaven and hell, I choose heaven. I choose life. Go. Get out of here! Go out get of here! Go.
:Denny: I really hope this is heaven.
:Izzie: Go. What are you waiting for?
:Denny: This.
:(Denny kisses Izzie.)
----
:Mark: Little Grey.
:Lexie: It's not Little Grey. It's Lexie. And I'm sorry that I broke... that I hurt you. And I'm sorry that you're humiliated. But I'm not going anywhere. I've got a friend who is guarding the door. A good friend. And since no-one is going to be coming in, I'm now going to climb into bed with you and stroke your hair. Because that's what I like to have done for me, when I'm hurt.
----
:Cristina: You've got some problems. You've got some big problems.
:Owen: Yeah. Yeah, I do. Will, you go out with me anyway?
:Cristina: Yes.
----
:Owen: I planned the whole evening, last night. A real date. It was a clear night, one of the five Seattle gets all year. I was going to take you to the West Point Lighthouse and we were going to watch the Northern Lights together. I'd like another chance. I want you to give me another chance.
----
:Derek: It's your call, Dr. Bailey. It's up to you. Am I an executioner? Or am I a surgeon?
----
:Owen: Yeah, that's a penile fracture.
:Mark: Oh, I'm going to kill myself.
----
:Miranda: Karev, go and get the machine.
:Alex: What if it's already hooked up to somebody?
:Arizona: If that somebody has more than 16 hours to live, then we'll unhook him.
----
:Meredith: I know you don't understand me. I don't understand me. I wanted to show him compassion. That's why I went. That's the reason. And it was horrible... it was horrible.
:Derek: It's okay.
==See Also==
de:Zwischen Himmel und Hölle
fr:Le paradis ou l'enfer
Category:All Episodes
Category:GA Episodes
Category:GA S5 Episodes