That’s pretty much the entire theory behind medical school, internship, and residency. If you survive it you get to be a doctor. They cram you full of information, facts, figures, and formulas. They set you lose on patients. They have you work thirty-six hour shifts and if you survive that, and if your patients survive that, for years and years on end, you get to be a doctor.

Does it work? He doesn’t know that it has ever been done any other way. Dr. Burke went through it. Dr. Burke was strong. He was as strong as they came. But was it because of the medical school system?

He didn’t know.

He did know a thing or two about disease, though… he knew that being weakened by one left you more susceptible to another. He knew that innocent little things like a simple infection could pose major problems if surviving a bout with tuberculosis left your body resistant to medication.

But he couldn’t let himself think too much about it. He had to get through his residency. He had to become a doctor… and if the schedule he was killing himself to keep wasn’t making him stronger… he didn’t even want to think about it.

It’s taken me a long time to realize this, but comfort is Izzie. When I got to Seattle Grace I was lost. The residency program is tough. You don’t sleep. You eat crap. You have no idea what you’re doing, but being new and scared doesn’t change the fact that people’s lives depend on you, literally. It’s a lot to take.

So, you do what you can to get by. You study harder than you ever dreamed in medical school. You learn to subsist on 15 minutes of sleep every two days. And you form a family with the only people in the world who know what you’re going through, your fellow interns.

So I formed a family with Meredith and Izzie and a little bit Cristina. And it is good knowing I have those people to count on, knowing that they’ll count on me when they need to. In that group of people everybody has their roles. Some are wanted, some aren’t.

But Izzie is comfort. After a terrible shift, Izzie bakes. Sometimes there are dozens and dozens of cookies. When I hit rock bottom, Izzie is always there to listen. Even when it’s annoying, when she’s heard it a thousand times before, when it is putting her in the middle… she listens. She always listens.

She isn’t perfect. She hates my girlfriend. She can be combative when she’s angry. She gets too emotionally involved with patients. But isn’t that what makes her such a good friend?

When she needed help, there wasn’t any choice. It was for Izzie. She’d do the same for me, she’d do the same for any of us. She wouldn’t blink. She’d just help.

So I did. We all did. It could have been our careers. But it was for Izzie. And then she quit.

I can’t imagine coming back to Seattle Grace tomorrow or the day after or the day after that without Izzie. I don’t know who is going to go look at the babies with me after a bad shift, or who is going to have a dozen cookies waiting for me when I’ve lost a patient. The idea of going through this program without her is terrifying… I hope she doesn’t leave Seattle. I hope she doesn’t leave the house.

It’s Meredith. Although, one thinks of the “one that got away” as some big epic relationship. Ours was not.

In fact, I’m not really sure it is fair to even call it “ours”. It was a year of unrequited lust and one terrible, terrible, terrible night of terribleness.

Can she be the one that got away if I never had her in the first place?

I don’t like to talk about it. I don’t like to think about it. I wish that it had never happened.

But if it hadn’t happened, I’d still be wishing that it was going to happen. I’d still be in love with Meredith. I’d be moping around the hospital hoping that she’d notice me.

The sex and the crying… most humiliating experience ever… but it’s over.

There is no romantic notion that next time it will be better.

It won’t be.

There is no next time.

There will be no next time.

And that, that is a very good thing.

What was my childhood ambition? At what age?

When I was five I wanted to be a fireman. I was going to wear a big helmet and get a Dalmatian named Red.

Until I was seven I wanted to drive a big truck like my dad. Each of my brothers and I celebrated the completion of our first year of school with a short run in my father’s truck. Jerry and Ronny both got their trips before mine. When they got back they seemed older, taller, more worldly somehow. And I wanted in on that action.

When my turn finally came, it was awesome. Best overnight trip, ever.

Most of my friends went camping at Lake Quinault that summer, but I slept in the cab of an 18 wheeler. How cool is that? At the truck stops the waitresses made a big fuss and my dad let me get a sundae even though I hadn’t finished my hamburger.

The life of a trucker could not be better.

But my enthusiasm quickly waned. The next year and for several years after that, the summer runs got progressively longer. The longer the run, the less thrilling it was.

A truck stop meal, best thing ever. A truck stop meal every day for a week, not so much.

Sleeping in the cab stops being fun when I grew too tall to stretch out.

Days of watching the trees zip by and the road disappearing behind us only served remind me how little my father and I had to say one another. I couldn’t talk about sports and cars. He couldn’t talk about Avogadro’s number and Newton’s third law.

Trucking didn’t turn out to be my thing. But to this day a weekend trip around the loop and a hot fudge sundae in Moclips, nothing gets better than that

I am George O’Malley. I am a doctor. I am a surgeon. I save lives. I am a god.

Or at least that’s what I expected.

I was fifteen the first time I met a surgeon. It was right here in this very hospital. I was sitting in those chairs trying to focus on some morning show. Jerry and Ronny sat to my left trying to shoot paper footballs off their knees. My mother sat to my right neither knitting nor reading but nervously switching between her yarn and her book.

My father who drove an 18 wheeler 2500 miles a week for twenty years and he never had a problem. The accident that puts him in the hospital? It happened two miles from our house in the family station wagon.

We were all at the hospital before they finished his initial exam. The doctor who came to brief us talked some foreign language about his injuries. It was all vague, rushed, and grave.

Five hours after my mother signed the papers and they wheeled my father off to the operating room we knew little more than we had before.

And there I sat in the middle of it all, powerless. Powerless to calm my mother, tame my brothers, or fix my father. And in walks this man in a white coat and the whole room takes a breath at once. The nurse nods to our family and the people around us and everything else in the room melts away. All that is left is my mother, my brothers, and this guy who holds our father’s fate, our whole family’s fate, in his hands.

He breaks a smile and we can breathe. And in that moment, I know. This is who I’m going to be when I grow up. And it is what gets me through high school, college, medical school, and this damned program… I’m the guy with the white coat.

But I’m not. I’m just George.

They’d been lying in bed together when Callie asked him what he was missing most at that very moment. At the time he’d had a hard time coming up with an answer. He was in bed with a beautiful naked woman, he had 5 hours before he had to be at work, and his commute to work consisted of a couple of flights of stairs. At that moment, his life was pretty much perfect.

She’d been insistent. And he’d resisted. She told him it was important and he’d shrugged it off. Sleep was already starting to overtake his body and work was just five hours away.

The next morning as he put on his scrubs and his coat she’d asked again, and again as sat down next to her for lunch. She kept insisting that it was important. He kept praying for his pager to go off. Fortunately it did.

He didn’t want to do this kind of soul searching. He didn’t want to know that he wasn’t over Meredith. He didn’t want to find out that what he missed most was something that he could never have. He didn’t want to know that what he missed most was a life that wasn’t the one he was living. He didn’t want to know that he’d be happier working at his brother’s dry cleaner.

But the more he feared this little game the more he knew he needed to play it. The more he tried not to think about his deepest desire the more he couldn’t think about anything else.

He went to the only quiet place he could think of, a between floors landing, in a deserted stairwell in the east wing of the hospital. Nobody ever used the stairs at Seattle Grace. He sat down and closed his eyes and tried to imagine the thing that would fill the emptiest part of him.

Meredith? No… it wasn’t. And it surprised him. He felt like he’d never be over it. But maybe he was. Or maybe not. He missed her. He’d missed her since she left. He’d missed her even more when he moved out of the house. But it wasn’t so much her that he missed. He missed that environment. He missed breaking bread with people who knew exactly who he was without even knowing him. He missed Izzie baking at all hours of the night. He missed the constant chatter of Meredith and Izzie and sometimes Christina as he tried to sleep at night. He missed having people who knew when he’d had a really bad day, who cared.

Was it a perfect living situation? No. He resented being treated like one of the girls. He had mixed feelings about a group of women commandeering his bed whenever they felt like it, especially since all they ever wanted to do was sleep.

But he got from them what he missed growing up with his brothers. They were always close like that. They made up stupid games. They stayed up all night talking about cars and girls and blowing things up. They looked out for each other. But he never felt in.

These women weren’t his sisters. He didn’t think of them as sisters. He wished they didn’t think he was there little brother… but in a way they were his family. And that’s what he wanted. He wanted his family. He wanted his home.

George O'Malley
Grey's Anatomy
566

Describe your biggest failure? George rolls his eyes when he reads the questions. He could just imagine what Dr. Bailey would say if he wrote his real answer to that question. Her head would explode. But he’s got 10 minutes before he’s expected back on call. 10 minutes isn’t long enough for a real nap.

Well, I’m pretty sure the hospital malpractice people wouldn’t like us surgeons discussing our failures in a public forum like this. Lawsuits are messy and expensive and I really don’t want to get kicked out of the program. Getting kicked out of the program means moving back home and working for my brother at the dry cleaners. That cannot happen!

When I was 13 I thought the biggest failure of my life would be the time I tried to ask Cindy McGrady out for a slice of pizza. I spent a whole week trying out witty phrases to say to impress her. But when I finally worked up the nerve to talk to her, to try to talk to her, I just stuttered and stammered for fifteen or twenty seconds before turning around and walking away. I thought that would be the biggest romantic failure in my life.

I was wrong. When I was 17, I got this idea to use my position as a math tutor to make a girl fall madly in love with me. Don’t laugh! It worked on Saved By The Bell. When Carrie Bishop asked to come to my house to study, I knew that it was all falling into place. But by the time I worked up the courage to talk about anything other than SOHCAHTOA, Carrie already had a date with my brother. That failure was humiliating. It was still humiliating three years later, when the story was told twice during their wedding reception.

The failure to ask out women seems to be the unifying thread in my life. I couldn’t talk to women when I was 13 and I don’t do much better now. The thing is, though, now that I’ve had the other kind of failure, the kind of failure I can’t talk about for fear that the lawyers will come to help me clean out my locker, all the fear of humiliating myself in front of girl… it doesn’t seem that bad.

George is still thinking about this revelation five minutes later when he notices a nurse named Brenda smiling shyly at him from the nurses station. He’s never met Brenda but Olivia mentioned she’d been asking about him since he walked the picket line. He takes a deep breath. I can do this,he tells himself as he walks towards her. I’m a funny guy. I’m a doctor. I can talk to this woman!

She smiles.

He takes a deep breath.

“Hi George,” she looks up at him expectantly.

He opens his mouth, I can do this!

No sound comes out, Or not.

Superstition.

I am a doctor. I’ve been to college and medical school. I know emphatically that wearing green socks does not make a patient live longer. Touching the door jam on the way out of the OR will not ward off post-operative infections. I know that anything I have ever done to lose or save a patient had a lot to do with medical science. I’d like to think it had something to do with my skill as a surgeon. It had nothing to do with what side of the bed I got out of this morning.

Or maybe it did. Well, really it has nothing to do with what side of the bed I got up on. But if a patient believes that they have a better chance of coming out of surgery alive if their husband wears a pin that their granddaughter made for them, then who am I to argue. It can’t make them worse. And maybe focusing on dumb little superstitious things gives them something to think about that is less scary than whatever is wrong with them. Being less scared can only help the healing process.

So if a patient tells me they need me to wear all green under my scrubs, call me Kermit.

2005 in a nutshell:

I got a surgical internship at Seattle Grace Hospital. My first day, I find out I’ve been assigned to a woman affectionately known as the Nazi.

I’ve had to tell people that their loved one didn’t make it off the table. They say it gets easier. But it hasn’t this year. It’s always hard to look into their eyes afterwards and see that pain. I walk into that room and they look up at me with so much hope and then their whole world shatters and it happens in an instant. I’m supposed to be a healer but there is no healing for that.

I had sex with exactly one woman exactly one time and got an STD.

I killed a poor defenseless turkey and spent two hours of quality time removing buckshot from my father’s ass. That is a lot of time spent looking at an ass. It’s a lot of time wondering if that’s your ass 30 years from now.

Trying to avoid having my ass become that ass, I went to a gym, pulled a hamstring, and got mocked for weeks about walking like a gay John Wayne.

I got stuck in an elevator with a patient who needed emergency surgery. They really should work out some kind of system where patients who need emergency surgery don’t have to be transported by elevator. It should be something failure proof, a dumbwaiter on manual pulleys, a hydraulic lift system… but they haven’t worked out those kinks yet and the elevator stops and I’m there and Alex is there and that’s it. That’s all there is. The whole internship system is set up so you don’t ever do anything without somebody there holding your hand but the elevator breaks and you can’t just tell the dying guy to cut it out until the elevator is fixed. Believe me, I tried.

I cracked his chest open and used my finger to patch a hole in his heart.

Best year ever!

What I regret not saying:

It isn’t what most people think it will be. It isn’t, “Meredith, I love you.” He does love her. He did love her…did, does… he isn’t sure anymore. But even if he is certain that she is the love of his life, not telling her is not his biggest regret.

No, his biggest regret is not telling her that she’s better than McDreamy, that Izzie is better than Alex. He works with the strongest, smartest, most beautiful women in the world and most of the time he thinks they know it. But it doesn’t matter. They still fall for the married guys, the cheating guys. And then they cry, and stuff themselves with ice cream and vodka and cry some more. And for what? These guys aren’t worth their tears. They aren’t worth anything.

So, McDreamy is still in love with Meredith? Maybe. You would certainly think so from the looks they pass each other when they think nobody is watching. But what does that prove? He still picked his wife. He still picked somebody who wasn’t Meredith! next time he picks Meredith? Then what happens the next time and the time after that?

She doesn’t need that guy. Izzie doesn’t need Alex. They don’t need men who will hurt them. They’ve got enough going on. The men they let into their lives need to be ones who will pick them every time. Guys who will remember to set the alarm when they’ve got an early shift. Guys who will talk to them. Guys who will say, “I’ve failed my boards and I need help”… or “no, as a matter of fact, I’m not single.” They need guys who will, upon occasion, walk up to the counter and plop a box of Tampax on the counter! Because that is what real men do. They swallow their pride and support their partner, every time. And in turn that guy, whoever that guy is, gets to be picked by them every time. And that guy, he’s the luckiest guy in the world.

That’s what he wishes he could say.