The first 48-hour shift for the surgical residents is chronicled in the series pilot, in which Meredith meets surgeon Derek Shepherd before she discovers he's her boss. She also has trouble with her first case, a teenage girl who's having seizures. And George tries his hand at an appendectomy.
While Meredith decides who gets to move into her house, she must also deal with the grisly souvenir of a patient's brutal rape. And her visit to the nursery leads to a conflict with a pediatric intern. Meanwhile, Cristina and Alex develop their bedside manners, in a manner of speaking; George has a depressing day overseeing codes; Izzie runs into a language barrier with one of her patients; and Burke finds out why Webber hired Derek.
A daredevil bicycle-messenger race leaves in its wake (and in the ER) an array of patients, including a banged-up cyclist who hits on Meredith and a brain-dead hit-and-run victim. The tragedy this man represents gets to Izzie. But who'll get his liver? One possibility is an older gay cancer patient (Keith David), who likes to flirt with George, who doesn't know how to handle it. Meanwhile, the cyclist isn't the only guy hitting on Meredith: Derek just won't let up. Viper: Callum Blue.
While Izzie deals with the fallout from a racy magazine spread, Cristina pushes for aggressive treatment for a cancer patient (Anna Maria Horsford) who happens to be Meredith's mother's long-time scrub nurse, and Meredith and Shepherd treat a man who accidentally shot nails into his head.
While Izzie's planning a party (and treating a patient with an obstructed bowel), Meredith assists in a heart operation---and does something she shouldn't. George's patient is an ex-smoker (Kathryn Joosten) with emphysema and Alex's is a young man (Brent Sexton) who says he has back pain. He's addicted to painkillers and Alex doesn't like that one bit. Hank: Jonathan Scarfe. Mr. Patterson: Barry Shabaka Henley.
The doctors treat a woman (Alex S. Alexander) with a 65-pound tumor and a man (Bruce Weitz) with Parkinson's disease. Also, Meredith's relationship (if that's what it is) with Shepherd gets her in trouble with Bailey, while George ponders asking Meredith for a date, and Izzie has her own affair of the heart. Annie's Mom: Jane Galloway Heitz. Mr. Levangie's Daughter: Lara Phillips.
Someone's been sleeping in Meredith's bed again, and when roomies Izzie and George find out who it is, they're not at all happy. But George is assuaged when Shepherd picks him to assist in a tricky and unusual brain operation on a 2-year-old girl. Meanwhile, Izzie must perform a bronchoscopy on a guy who swallowed his girlfriend's car keys. On purpose. And Alex, a former college wrestler, meets another ex-grappler in the clinic. The guy had asked a friend to shoot him because “I like the scars.”
Shepherd's tight-lipped about himself to Meredith, which adds to the tension between them when they disagree about a mountain climber with an unexplained paralysis. Meanwhile, a psychiatric patient with seemingly psychic powers psychs out Izzie; a pregnant woman with breast cancer befuddles Cristina; George meets his match when he has to intubate a patient; and Burke tells an Orthodox Jewish teenager with a heart defect that only a pig valve can save her.
Webber has eyesight problems, George gets a girlfriend (and a rash) and Meredith gets a surprise. Meanwhile, Burke's best friend (Wayne Wilderson) is a patient at Seattle Grace. And Izzie and Cristina must perform an unpleasant procedure they've never done before on an alcoholic. Addison: Kate Walsh.