| Episode |
Title |
Written by |
Directed by |
Premiere |
| 4-01 (62) |
"A Change Is Gonna Come" |
Shonda Rhimes |
Rob Corn |
September 27, 2007 |
| Having just returned from her honeymoon with Meredith, Cristina searches for Burke, but he is nowhere to be found. Meredith, Cristina, Izzie and Alex spend their first day as residents with their own groups of interns. Among the interns are George, repeating his intern year after failing his exams, and Lexie Grey, Meredith's half-sister whom she has never met. Now that Derek's relationship with Meredith has reached an emotional impasse, he looks to his fellow doctors for friendship; Bailey wrestles with her place within the hospital now that her former interns report to new Chief Resident Callie; and Richard resumes his position as Chief of Surgery. |
| 4-02 (63) |
"Love/Addiction" |
Debora Cahn |
James Frawley |
October 4, 2007 |
| The residents and interns treat the victims of a massive explosion at an apartment building, while Alex investigates the cause of the accident, Mama Burke returns to collect her son's things just as Cristina trades her wedding presents in exchange for surgeries, Lexie tries to have a heart-to-heart with an unwilling Meredith, and while Callie is overwhelmed with her duties as Chief Resident, Bailey searches for an outlet for her pent-up leadership skills. |
| 4-03 (64) |
"Let the Truth Sting" |
Mark Wilding |
Dan Minahan |
October 11, 2007 |
| Meredith reluctantly helps Lexie with her first surgical procedure, while Lexie helps keep George's "repeater" status a secret from their fellow interns. |
| 4-04 (65) |
"The Heart of the Matter" |
Allan Heinberg |
Randy Zisk |
October 18, 2007 |
| Izzie confides in Alex about George and the reaction is not what she expected, the Chief's niece returns to the hospital where she once had her prom, and Derek teaches Cristina how to be a better resident to her interns. |
| 4-05 (66) |
"Haunt You Every Day" |
Krista Vernoff |
Bethany Rooney |
October 25, 2007 |
| Halloween is full of surprises for the Seattle Grace doctors when Ava makes an unexpected visit to see Alex, Meredith thinks her deceased mother is haunting her, and Callie reveals George and Izzie's affair to their fellow doctors. |
| 4-06 (67) |
"Kung Fu Fighting" |
Stacy McKee |
Tom Verica |
November 1, 2007 |
| With his marriage in trouble, the Chief turns to his fellow male surgeons for a "gentlemen's evening," Cristina and Izzie heatedly compete for the same surgery, and the doctors treat two injured finalists from a promotional wedding competition. |
| 4-07 (68) |
"Physical Attraction, Chemical Reaction" |
Tony Phelan and Joan Rater |
Jeff Melman |
November 8, 2007 |
| George and Izzie's romantic chemistry is put to the test, Mark develops a crush on a fellow surgeon, and Callie's role as Chief Resident is in jeopardy. |
| 4-08 (69) |
"Forever Young" |
Mark Wilding |
Rob Corn |
November 15, 2007 |
| A schoolbus crash floods Seattle Grace with teenagers, Derek goes out on a date with a fellow doctor, and Meredith sees her father for the first time since her stepmother's death. |
| 4-09 (70) |
"Crash Into Me, Part 1" |
Shonda Rhimes and Krista Vernoff |
Michael Grossman and Jessica Yu |
November 22, 2007 |
| Part one of a two-part episode. An ambulance crash endangers the lives of the paramedics involved, as Meredith and the Chief work on-site to save them, Bailey treats a patient who refuses her help, and Ava returns for Alex and meets his other girlfriend in the process. |
| 4-10 (71) |
"Crash Into Me, Part 2" |
Shonda Rhimes and Krista Vernoff |
Jessica Yu |
December 6, 2007 |
| Part two of a two-part episode. Meredith furiously works to save the life of a paramedic trapped inside an ambulance, as her sister, Lexie, holds the life of a patient in her hands, and Derek must rely on the help of a nurse to save a patient's life. |
| 4-11 (72) |
"Lay Your Hands On Me" |
Allan Heinberg |
John Terlesky |
January 10, 2008 |
| Bailey's family faces a medical trauma just as her marriage is falling apart, George receives a very unexpected visit from his mother, and a faith healer wishes to forgo traditional surgery. |
| 4-12 (73) |
"Where the Wild Things Are" |
Zoanne Clack |
Rob Corn |
April 24, 2008 |
| Six weeks have passed since Derek started dating Rose, and the new residents are competing in a surgical contest. George and Lexie move into their new apartment while Callie and Erica continue their friendship. |
| 4-13 (74) |
"Piece of My Heart" |
Stacy McKee |
Mark Tinker |
May 1, 2008 |
| Addison returns to Seattle Grace to perform an operation and is surprised by all the changes in the lives of her former co-workers; Derek and Meredith's clinical trial has its first patient; Rebecca returns with shocking news for Alex. |
| 4-14 (75) |
"The Becoming" |
Tony Phelan and Joan Rater |
Julie Ann Robinson |
May 8, 2008 |
| A "date and tell" policy is instated at Seattle Grace after the nurses object to Mark's trysts, Cristina has to face her feelings for Burke and Meredith and Derek admit a gay veteran soldier into their clinical trial. |
| 4-15 (76) |
"Losing My Mind" |
Debora Cahn |
James Frawley |
May 15, 2008 |
| Dr. Wyatt refuses to let Meredith give up on therapy, Alex learns the truth about Rebecca's medical condition, the Chief insists that Erica perform a risky surgery on his mentor, and after receiving news of Burke, Cristina continues to do things contrary to her nature, going so far as cleaning her always-messy apartment. |
| 4-16 (77) |
"Freedom, Part 1" |
Shonda Rhimes |
Rob Corn |
May 22, 2008 |
| Part one of a two-hour season finale. Meredith and Derek work on their last patient in their clinical trial, as the other surgeons try desperately to free a boy from a hardening block of cement. Izzie helps Alex care for Rebecca, and Lexie discovers important information about George's intern status. Callie confronts her feelings about Erica. |
| 4-17 (78) |
"Freedom, Part 2" |
Shonda Rhimes |
Rob Corn |
May 22, 2008 |
| Part two of a two-hour season finale. Meredith and Derek work on their last patient in their clinical trial, as the other surgeons try desperately to free a boy from a hardening block of cement. Izzie helps Alex care for Rebecca, and Lexie discovers important information about George's intern status. Callie confronts her feelings about Erica. |
| Episode |
Title |
Written by |
Directed by |
Premiere |
| 5-01 (79) |
"Dream a Little Dream of Me, Part 1" |
Shonda Rhimes |
Rob Corn |
September 25, 2008 |
| A military doctor piques Cristina's interest -- and she helps him -- and he helps her when she gets stabbed by an icicle. Meredith and Derek attempt to work on their "happily ever after", and the attendings are stressed over Seattle Grace's ranking of #12. |
| 5-02 (80) |
"Dream a Little Dream of Me, Part 2" |
Shonda Rhimes |
Rob Corn |
September 25, 2008 |
| Alex is offended when Izzie talks about how great a man Alex is to Meredith. Derek is stabbed with the scalpel in the palm of his hand by Rose, while the Chief is stunned over Mercy West's increase in the number of patients, a deadly ice storm ravages Seattle. |
| 5-03 (81) |
"Here Comes the Flood" |
Krista Vernoff |
Michael Pressman |
October 9, 2008 |
| A plumbing leak causes a flood at Seattle Grace, as the Chief tries to implement new teaching policies and George retakes his intern exam. Derek tries to move Izzie and Alex out of Meredith's house. |
| 5-04 (82) |
"Brave New World" |
Debora Cahn |
Eric Stoltz |
October 16, 2008 |
| Meredith freaks out when Derek discovers her mother's old diary in the house, Callie frets as she prepares for her first official date with Erica, and Cristina stumbles into a part of the hospital that neither she nor her fellow residents have seen before. |
| 5-05 (83) |
"There's No 'I' in Team" |
Jenna Bans |
Randy Zisk |
October 23, 2008 |
| Bailey heads up a team of surgeons performing a "domino procedure" in which each surgery hinges on the one preceding it. Derek gets sole credit for the brain tumor study he did with Meredith. Lexie goes to great lengths to have George notice her romantically, and Sloan counsels a desperate Callie on the ways of love. |
| 5-06 (84) |
"Life During Wartime" |
Mark Wilding |
Jim Frawley |
October 30, 2008 |
| To help Bailey become the best general surgeon at Seattle Grace, the Chief gives her new power, new responsibility, and the challenge of removing a young girl's inoperable tumor. The new head of trauma, Owen Hunt, challenges both the attending doctor's methods and the residents' surgical abilities. |
| 5-07 (85) |
"Rise Up" |
William Harper |
Joanna Kerns |
November 6, 2008 |
| The Chief announces to the residents that a solo surgery will be awarded, and the news sends them into a competitive frenzy. Meanwhile Derek turns to Bailey for advice when he feels Cristina is interfering in his relationship with Meredith, and another dark day in Izzie's career rises when Erica discovers a shocking connection between her and a longtime patient. |
| 5-08 (86) |
"These Ties That Bind" |
Stacy McKee |
Eric Stoltz |
November 13, 2008 |
| One of Meredith's oldest friends, Sadie, becomes an intern at Seattle Grace, but Mer's friends are less than welcoming to her. Lexie leads her fellow interns in secretive, unorthodox surgical training sessions; and a new surgeon, Virginia Dixon, brings rules and order to the OR. |
| 5-09 (87) |
"In the Midnight Hour" |
Tony Phelan and Joan Rater |
Tom Verica |
November 20, 2008 |
| Meredith, Cristina and Bailey come to Lexie and Sadie's rescue when a not-so-routine surgery goes horribly wrong, as Owen and Derek treat a man seriously injured while sleepwalking and Mark comforts the sleepwalker's distraught daughter and has feelings for Lexie. |
| 5-10 (88) |
"All by Myself" |
Peter Nowalk |
Arlene Sanford |
December 4, 2008 |
| Cristina is awarded the first solo surgery among the residents, but she has to relinquish it and choose her replacement; Mark performs a cutting-edge procedure to restore a patient's speech, impressing Lexie in the process; and Callie cannot figure out if Sadie is flirting with her or just being friendly. |
| 5-11 (89) |
"Wish You Were Here" |
Debora Cahn |
Rob Corn |
January 8, 2009 |
| Bailey teams with Seattle Grace's new pediatric surgeon, Dr. Arizona Robbins, to save the life of a young patient near and dear to her heart, as the admittance of a death row inmate at the hospital stirs anger in Derek and further erodes Meredith and Cristina's friendship; meanwhile, Callie and Sloan work as a team to fight their respective attractions to Sadie and Lexie, and Izzie tells Alex that she is seeing Denny. |
| 5-12 (90) |
"Sympathy for the Devil" |
Jenna Bans |
Jeannot Szwarc |
January 15, 2009 |
| Derek's mother, Carolyn (Tyne Daly), makes a surprise visit to Seattle and meets Meredith for the first time, as Mark tries to conceal his relationship with Lexie from her as well; meanwhile, death row inmate William wishes to donate his organs to Bailey and Arizona's patient, as Owen and Cristina try to go on their first date. |
| 5-13 (91) |
"Stairway to Heaven" |
Mark Wilding |
Allison Liddi |
January 22, 2009 |
| Bailey grows desperate as a patient's condition becomes more and more dire. Everyone in the hospital is stepping up to try to find the boy a new organ donor, including Meredith, who considers a death row patient's wish to die before execution. Meanwhile, an injury leaves Mark in a compromising position in the on-call room and Cristina awkwardly avoids Owen. Izzie is still struggling with Denny as he is constantly reminding her "He is there for her". Izzie has an emotional blow out with Denny and soon understands what he is trying to tell her. She finally comes to the realization that Denny is not here "for her" in the emotional sense, which leaves Izzie reeling when she soon discovers that she is sick. Jeffrey Dean Morgan Guest stars. |
| 5-14 (92) |
"Beat Your Heart Out" |
William Harper |
Julie Anne Robinson |
February 5, 2009 |
| Now that Derek has the engagement ring, he searches for the perfect way to propose to Meredith, as Lexie demands that Mark go public with their relationship, and Bailey, encouraged by her work on recent cases and by Dr. Dixon, considers a new direction for her medical career. Dr. Dixon suggests that Dr. Bailey will make a good pediatric surgeon. Derek finally decides to propose to Meredith. Addison calls Derek, and Derek decides to postpone the proposal. Cross-over with Private Practice |
| 5-15 (93) |
"Before and After" |
Tony Phelan and Joan Rater |
Dan Attias |
February 12, 2009 |
| Addison, Naomi and Sam rush the ailing Archer to Seattle Grace and reunite with old friends Derek and Mark to help save his life; meanwhile, Izzie employs her fellow doctors in a medical game designed to help teach the interns, and Owen runs into a significant someone from his past. Cross-over with Private Practice. Kate Walsh returns and from Private Practice, Audra McDonald and Taye Diggs guest star. |
| 5-16 (94) |
"An Honest Mistake" |
Peter Nowalk |
Randy Zisk |
February 19, 2009 |
| Derek's confidence is shaken like never before as he faces off with Addison over what course is best for their dying pregnant patient; Cristina calls the abilities of a renowned surgeon into question after she botches a standard procedure; and Bailey, who has decided to pursue a fellowship in Pediatric Surgery, is appalled by the Chief's less-than-stellar recommendation letter. Cross-over with Private Practice |
| 5-17 (95) |
"I Will Follow You Into the Dark" |
Jenna Bans |
Rob Corn |
March 12, 2009 |
| Izzie walks the interns through diagnosing Patient X after receiving her troubling test results. Bailey and Meredith perform a surgery where they remove a woman's stomach to protect her from a very invasive form of stomach cancer that runs in her family. Hunt and Karev treat a high school marching band player with seizures. Shepherd has to come to grips with killing one of his patients. Cristina receives some disturbing news from one of her colleagues. |
| 5-18 (96) |
"Stand By Me" |
Zoanne Clack |
Jessica Yu |
March 19, 2009 |
| After his fellow surgeons try and fail to bring Derek back to work, Meredith must summon the strength to convince him. Meanwhile the hospital is abuzz as Mark attempts a rare face transplant surgery. Cristina, at last awarded her first solo surgery, is more focused on the needs of her friends, and Izzie does her best to keep her medical condition a secret. |
| 5-19 (97) |
"Elevator Love Letter" |
Stacy McKee |
Ed Ornelas |
March 26, 2009 |
| All eyes are on Derek as he is set to perform his first surgery after his breakdown; attention is also set on Izzie, whose medical condition requires her to undergo a difficult surgery; and Owen has another PTSD episode that injures Cristina and traumatizes both of them, throwing the future of their relationship into question. Derek proposes to Meredith in the elevator. |
| 5-20 (98) |
"Sweet Surrender" |
Sonay Washington |
Tony Phelan |
April 23, 2009 |
| As she endures aggressive treatment for her cancer, Izzie throws herself into planning Derek and Meredith's wedding, Callie introduces Arizona as her girlfriend to her disapproving father, George excels in a trauma emergency when Alex freezes, and Owen seeks help with his PTSD. Meanwhile, Baily learns of the heart-wrenching practices in peds. |
| 5-21 (99) |
"No Good at Saying Sorry (One More Chance)" |
Krista Vernoff |
Tom Verica |
April 30, 2009 |
| As preparations continue for Meredith and Derek's wedding, Izzie receives a surprise hospital visit from her handful-of-a-mother, Robbie. Meanwhile, a newly sober Thatcher visits his daughters, Meredith and Lexie, in order to make amends, and the Chief and Meredith bitterly fight over a controversial medical case. |
| 5-22 (100) |
"What a Difference a Day Makes" |
Shonda Rhimes |
Rob Corn |
May 7, 2009 |
| 100th Episode: As Meredith, Derek and all of their friends prepare for the big wedding, a group of college students, injured in a car crash as they were heading to their graduation ceremony, is admitted to the ER. Meanwhile, Izzie fears the worst when she begins experiencing familiar symptoms. |
| 5-23 (101) |
"Here's to the Future" |
Allan Heinberg |
Bill D’Elia |
May 14, 2009 |
| Izzie spends time with a fellow cancer patient and contemplates whether or not to undergo a risky surgery, as Mark is ready to take his relationship with Lexie to the next level. A patient makes Owen reassess his place at Seattle Grace and Izzie's surgery to remove the brain tumor could have dire consequences. |
| 5-24 (102) |
"Now or Never" |
Debora Cahn |
Rob Corn |
May 14, 2009 |
| Season Finale: George delivers stunning news to Bailey, sending shock-waves throughout the hospital, and Izzie’s friends await her recovery from surgery. Meanwhile Bailey is surprisingly displeased after being accepted into the pediatric fellowship program. The doctors focus on the victim of a near-fatal traffic accident who is disfigured and unable to speak. Meredith discovers it's George, who was hit by a bus while saving the woman who accompanied him to the hospital. Izzie recovers her memory and tells Alex that she loves him before losing consciousness. The episode ends with both George and Izzie flatlining and meeting up with each other in a heaven-like scene, with no definite indication of whether either or both are dead or alive. |
