Now or Never (Grey's Anatomy)

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"Now or Never"
Grey's Anatomy episode
George Uniform.jpg
George O'Malley (TR Knight) appears in a dream of Izzie Stevens (Katherine Heigl) after she flatlines. He is in his army uniform.
Episode no. Season 5
Episode 24
Directed by Rob Corn
Written by Debora Cahn
Original air date May 14, 2009 (2009-05-14)
Episode chronology
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Grey's Anatomy (season 5)
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"Now or Never" is the twenty-fourth episode and the season finale of the fifth season of the American television medical drama, Grey's Anatomy and the show's 102nd episode overall. Written by Debora Cahn and directed by Rob Corn, the episode was originally broadcast on the American Broadcasting Company (ABC) in the United States on May 14, 2009. The initial airing was viewed by 17.12 million viewers and garnered a 6.2/17 Nielsen rating/share in the 18–49 demographic. The episode marked the last appearance of series regular T.R. Knight who played Dr. George O'Malley who got into an accident during the episode and dies in the season 6 premier.

In the episode Cristina Yang (Sandra Oh), Alex Karev (Justin Chambers), George O'Malley (T.R. Knight), and Meredith Grey (Ellen Pompeo) are all sleeping and waiting for Izzie Stevens (Katherine Heigl) to wake up after the surgery. Derek Shepherd (Patrick Dempsey) comes up with an alternative treatment plan for Izzie, Miranda Bailey (Chandra Wilson) confronts Chief's Richard Webber (James Pickens Jr.) and Arizona Robbins (Jessica Capshaw), about the peds fellowship program. Yang deals with her relationship with Owen Hunt (Kevin McKidd) who helps George with career advice. The episode also focuses on Meredith and Derek's post-it wedding.


Cristina is still deliberating reconciling her relationship with Owen, however has not completely forgiven him. Owen stops to tell her how well his therapy is going and how much progress is being made, but Cristina cuts him off by asking if he's told her about not visiting his mother even though she lives only a few miles away.

Derek has formed a plan to remove Izzie's brain tumor, but it will require removing a part of her brain, which could leave her without any memory. Izzie tries to get the others to decide, but they only offer to support her no matter what. However, they later decided to find out more information from outside sources. To see the worst possible outcome of the surgery, the doctors agree to run a test. Not only can Izzie not remember the cards, she also can't remember who anybody is or even how to speak. This terrifies Meredith, who tells Izzie that she cannot possibly have the surgery. Izzie eventually decides to have the surgery, but signs a DNR to avoid becoming a vegetable. Alex predictably panics about the idea of living without Izzie.

A young army vet comes to Owen and, by extension, George and Callie to help him with his leg. Nobody can figure out what's wrong with his leg and thus can't fix it, he just wants it cut off so he can get a prosthetic leg and go back to war. Owen is ready to do it, but Callie is totally against cutting off a perfectly healthy leg. Cristina sees Owen hug George and asks what's wrong. Owen tells her that George has an announcement that's his own to make, but that Owen is ecstatic that he actually slept without any nightmares.

The Chief calls Bailey into his office with Arizona to tell her that she's received the Pediatric Fellowship. Rather than being excited, Bailey looks like she's about to cry and walks away. Bailey tells Arizona and the Chief that her husband gave her an ultimatum the night before - if she takes the fellowship, he's divorcing her. She plans on leaving him, because there is no place for ultimatums in a marriage, but doesn't think she can do the fellowship as a single mother. Instead, she's decided to stay in General Surgery and maybe become the Attending. Meredith and Derek have decided not to wait any longer to get married and just go to City Hall that evening, but later realize that there's just no time. Instead, Derek writes their vows down on a post-it note that they both sign and then stick in their locker.

Meanwhile, a man is brought in who pushed a woman out of the way of a bus and was subsequently run over by the bus and dragged half a block. The girl he saved keeps checking on him and calling him "her hero" and "Prince Charming" and similar names. Every time Meredith is talking to him, he tries to trace letters in her hands. She hands him a pen and paper, but he's too weak to hold the pen and passes out. Finally, she follows what he's writing - "O" "O" "7", or 007, George's nickname since his initial horrible surgery in season one. Meredith realizes that patient is George. She runs to tell the other doctors and they rush him into surgery to save him, but he dies on the table.

Izzie survived the surgery. When Derek examines her, she seems to have retained her memory and is in good health. She's super excited when Derek tells her that he got the entire tumor, but five minutes later asks how the surgery went. It quickly becomes apparent that she has no short term memory at all. Alex gets obsessed and starts drilling her to improve her memory, but it doesn't seem to work. Twenty minutes later, when Yang comes into check Izzie's stats, she vents to Yang about the things Alex says. It takes them a few minutes, but they realize that Izzie's memory is back. Alex comes rushing in and hugs Izzie and everyone's happy and then Izzie flatlines.

Alex tries to do CPR and save her while everyone else tries to remind him of the DNR, but he doesn't listen. Finally the Chief says screw it and calls for the defibrillator. While they're trying to restart Izzie's heart, she has a vision of getting into the elevator again with her "prom dress" on. When the elevators open, it's not Denny waiting, but George in an Army uniform.


News of Knight's possible exit was first reported by Entertainment Weekly. The reports said, "T.R. Knight, who has played lovable intern George O'Malley since the show's debut, has asked producers to write him off the hit medical drama. " The finale had the highly publicized exit for T.R. Knight with numerous rumors surfacing around the actor's exit. Fans were shocked when Knight made the surprising decision to leave Grey's Anatomy the hit medical drama that launched him to fame.[1]

Original cast member T.R. Knight made his last appearance as George O'Malley in the episode.

Reports became public that Knight had not been attending table-reads for upcoming episodes or that he had walked off the set and cleaned out his dressing room are inaccurate, a rep for Knight told People."He has been there every day. He was at a table read yesterday. He hasn't said goodbye to anyone." The rep had no further comment on his possible exit." The site further reported that Knight was still upset about former cast member Isaiah Washington's alleged use of a homophobic slur about him in an argument with co-star Patrick Dempsey, which prompted Knight to reveal he was gay, and which some felt series creator Shonda Rhimes took too long to rectify with Washington's dismissal, but a source familiar with Grey's said the speculations were false.[2]

While Knight doesn't specifically fault Rhimes for how the situation was handled behind the scenes, he says the exec producer was among those who tried to discourage him from coming out: "I think she was concerned about having my statement come out so close to the [initial] event." Rhimes denied this, "I said, 'If you want to come out, that's awesome. We'll totally support that.' And then he went away, thought about it, and came back and said, 'I'm going to make this statement.' I remember saying to [fellow executive producer] Betsy Beers, 'This is our proudest day here. T.R. got to come out, and I got to say to him that it wouldn't affect his character'. The idea that a gay actor can't play a straight man is insulting."[3]

Creator Shonda Rhimes gave exclusive interview to Michael Ausiello of Entertainment Weekly on May 15, 2009 and talked about Knight’s alleged unhappiness. About his character's absence from the season and the final scene between George O'Malley and the show's protagonist Meredith Grey Rhimes said -

When asked of TR asked to be released from his contract, Rhimes said, "I absolutely am not going to talk about any private conversations I had with the actors. I feel like that invades their privacy." and added, " I think that there have been lots of rumors about TR, but TR’s never said anything. Take from it what you will."[4]

Later, in an exclusive interview with EW, the actor revealed what led him to his decision. Due to what he called a gradual "breakdown of communication" between himself and exec producer Rhimes, the actor chose not to ask his boss what was going on with his character. He added "My five-year experience proved to me that I could not trust any answer that was given [about George]," he explains. "And with respect, I'm going to leave it at that." He also added that knows he's taking a risk walking away from his top 10 show and $14 million contract. "From an outsider's perspective, I get the [impression that] 'He's just a spoiled actor...he doesn't know how good he has it,'" he says. "There are a lot of people who would like to be in my position. But in the end, I need to be fulfilled in my work." [5]


Chandra Wilson was deemed as the best actress among the entire ensemble cast.

The episode was originally broadcast on the American Broadcasting Company (ABC) in the United States on May 14, 2009. The initial airing was viewed by 17.12 million viewers and garnered a 6.2/17 Nielsen rating/share in the 18–49 demographic.[6]

The episode was generally well received among television critics. IGN Entertainment called the season and the finale a return to form for the show adding, "The season proved to be an overall success, bringing the show closer to the well-balanced mix of emotion and drama – albeit of the primetime soap variety – that characterized its first two seasons. Hopefully, the sixth season will continue to build upon this foundation while better planning its arcs so that everything feels more cohesive. Otherwise, a return to form for a show that had seemingly flatlined."[7]

PopSugar wrote, "George might be dying! Izzie might be dying! As the episode fades to black, the two of them are meeting — in an elevator, natch — with Izzie in her pink prom dress and George in his army uniform, while back on earth, their colleagues try furiously to save them. I suppose those of us who wanted answers about whether Katherine Heigl and T.R. Knight are leaving are out of luck — but wow, what an ending." Speaking of Meredith and Derek's wedding the site wrote, "I'm curious to know how the hardcore Mer-Der fans take this, but I thought the whole act was touching (not to mention their actual vows: to love each other even when they hate each other, to never walk out even when they're smelly and senile). Probably they should get around to having an actual legal marriage one of these days, but for now, that post-it is enough for me." The site also lauded Kevin McKidd and Sandra Oh saying, "every scene with Cristina and Owen feels so tense I can barely breathe."[8]

Alan Sepinwall also gave a positive review and wrote, "Great use of the core cast, particularly the Owen Hunt/Cristina Yang scenes in the first hour and the Alex Karev/Izzie Stevens scenes in both (regardless of my lack of surprise, Justin Chambers and Katherine Heigl were both great). Chandra Wilson continued to stand tall above the rest of the cast with the Bailey scenes in both episodes, particularly her crying in front of the Chief. And Meredith and Derek getting "married" via Post-It note was so perfect for their characters." He added, "I wish I was able to go into this one pristine, but I wasn't, and I still liked a lot of it. During those fallow periods in the middle of the last few seasons, people kept asking me why I was still watching and/or blogging about Grey's Anatomy. This last batch of episodes is why. This show is a free-swinging power hitter. When it swings and misses, it looks horrendous. But when it connects with the pitch it wants, all you can do is sit back and admire it."[9]


  1. ^ Ausiello, By Michael. "T.R. Knight reveals why he left 'Grey's Anatomy' -". Retrieved 2017-03-21. 
  2. ^ "T.R. Knight Asks to Leave Grey's Anatomy". 2008-12-09. Retrieved 2017-03-21. 
  3. ^ Ausiello, By Michael. "T.R. Knight reveals why he left 'Grey's Anatomy' -". Retrieved 2017-03-21. 
  4. ^ "". Retrieved 2017-03-21. 
  5. ^ "T.R. Knight Asks to Leave Grey's Anatomy". 2008-12-09. Retrieved 2017-03-21. 
  6. ^ "TV By The Numbers by". TV By The Numbers by Retrieved 2017-03-21. 
  7. ^ Monfette, Chris (2009-05-29). "Grey's Anatomy: Season 5 Review". IGN. Retrieved 2017-03-21. 
  8. ^ Entertainment. "Grey's Anatomy Rundown: Episode 23, "Here's to the Future," and Episode 24, "Now or Never"". POPSUGAR Entertainment. Retrieved 2017-03-21. 
  9. ^ "Grey's Anatomy, "Here's to Future Days"/"Now Or Never": A shocking finale?". Retrieved 2017-03-21. 

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