"Elevator Love Letter" is the nineteenth episode of the fifth season of Grey's Anatomy and the 97th produced episode of the series. It is also the 125th produced episode of the Grey's Anatomy franchise. It was broadcast on March 26, 2009.
All eyes are on Derek when he returns to work to perform surgery on Izzie and he finds himself questioning if he's ready to enter the O.R again while the residents do their best to comfort Izzie on her first day as a patient in the hospital. Alex struggles to be there for Izzie in her time of need and George is crushed to learn that he was the last to learn of her ailment. Owen's nightmare becomes near catastrophic for Cristina and leaves them both traumatized.
- "Surgerons are all messed up. We're butches. Messed up, knife-happy butchers. We cut people up and we move on, patients die on our watch and we move on. We cause trauma, we suffer trauma. We don't have time to worry about how all the blood and death and crap makes us feel."
- "It doesn't matter how tough we are, trauma always leaves a scar. It follows us home, it changes our lives. Trauma messes everybody up but maybe that's the point. All the pain and the fear and the crap. Maybe going through all that is what keeps us going forward, it's what pushes us. Maybe we have to get a little messed up, before we can step up."
- "Little Peices" - Gomez
- "The Weight Of Us" - Sanders Bohlke
- "That Home" - The Cinematic Orchestra
- "Rise Up" - Ben Lee
- "With The Notes In My Ears " - Peter Broderick
- "We Do What We Want To " - O+S
This episodes' title references the song Elevator Love Letter, originally sung by Stars
- Alex narrates the voiceover for episode.