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Grey's Anatomy season 4

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This article contains summaries for the fourth season of the American medical drama television series Grey's Anatomy; the season began on September 27, 2007.

The original U.S. and Canada airdates are listed here for each episode.

No. Episode title Original airdate
1 A Change Is Gonna Come September 27, 2007
2 Love/Addiction October 4, 2007
3 Let the Truth Sting October 11, 2007
4 The Heart of the Matter October 18, 2007
5 Haunt You Every Day October 25, 2007
6 Kung Fu Fighting November 1, 2007
7 Physical Attraction, Chemical Reaction November 8, 2007
8 Forever Young November 15, 2007
9 Crash Into Me, Part 1 November 22, 2007
10 Crash Into Me, Part 2 December 6, 2007
11 Lay Your Hands On Me January 10, 2008

A Change Is Gonna Come

Summary

Entering their first year as residents, Meredith Grey, Cristina Yang, Izzie Stevens and Alex Karev now have their own interns to mentor. Having failed his intern exams as a result of Izzie's admission that she is in love with him combined with Callie's insistence the two have a baby, George O'Malley is forced to repeat his internship under Meredith. Frustrated at his lack of progress, he immerses himself in self-pity, directing his anger mainly at Callie Torres.

Meanwhile, Callie has difficulties reining in the new residents, who keep trying to undermine her authority as the new Chief Resident. A bitter Miranda Bailey does nothing to help Callie control them and refuses to talk to the Chief about his decision to pick Callie over her. A three-car pileup sends several casualties to the hospital, and the new residents get ready to receive them with their interns in tow. Lexie Grey, Meredith’s half-sister and one of Cristina’s interns, chooses this inopportune moment to introduce herself to Meredith.

Later, Lexie apologizes to Meredith for her inappropriate timing just as Derek arrives to talk to Meredith about the status of their relationship. Derek recognizes Lexie as “the girl from the bar” which disgusts Meredith because she was the original “girl from the bar.” Meanwhile, Izzie confronts George for avoiding her after she confessed her love for him, but he brushes her off.

Derek Shepherd, lonely after both Addison Montgomery and Preston Burke leave Seattle Grace, turns to Bailey and the Chief for company, only to be rejected. He in turn rejects Mark Sloan's offer for company. However, Mark eventually confesses that he came to Seattle not to retrieve Addison, but to get Derek back as his friend.

Cristina’s patient from the three-car pile up was pronounced dead on arrival, but miraculously rises from the dead. The X-ray reveals that he has been internally decapitated, but Derek promises to reconnect his spine. Cristina, not having seen Burke since the wedding, asks Derek where he is, and learns that Burke had tendered his resignation two weeks ago (the actor who portrayed Dr. Burke, Isiah Washington, was not tendered a new contract due to a dispute with the rest of the cast over comments made about TR Knight). The patient starts to move during the reattachment surgery, putting himself in severe danger. Cristina urges him to stop moving because he cannot just abandon his family. Derek manages to reattach the patient’s spine, to his family’s relief.

Meredith treats a pregnant woman from the accident whose arm had been severed. Mark manages to reattach her arm, but during surgery she goes into labor and George successfully delivers the baby, impressing all the other interns. However, he considers this beneath him and is hardly excited about it. Lexie tells him that he is not the only one whose life is not going according to plan, and urges him to take pride in delivering the baby.

The last ambulance brings in Joey, a middle-aged man with a shattered knee. Alex wants to get off the case because it is not surgical, but Callie pulls rank on him and forces him to stay on the case. Unbeknownst to the doctors, Joey suffers from pica and sneaks several medical instruments into his mouth. Joey subsequently develops complications from all the foreign objects in his stomach, and Alex immediately sends for Bailey to operate. Furious at not being informed, Callie reprimands Alex, only to be told by Bailey that Alex’s quick thinking saved Joey’s life.

Izzie, unable to procure a patient, goes around begging the other doctors to let her in on their cases. Her interns, aware of her history, are hardly impressed and label her a “dud”. Their impression of her worsens when she promises a little boy to treat the deer that caused the accident. She manages to shock the deer back to life, and tells her interns to adjust their expectations because they are stuck with her whether they like it or not. Furthermore, she informs them that she also has to adjust her own expectations since she is stuck with the “duds”.

As the day comes to an end, Alex confides to Cristina about missing Ava/Rebecca, and she replies saying she misses Burke. Meredith confirms to Derek that they have indeed broken up, but agrees to a breakup kiss, which leads to breakup sex. Back at Izzie’s house, George shows up and tells her that he loves her, too.

Music

Love/Addiction

Summary

Meredith and Derek come to an arrangement where only sex and mockery is involved, because they are the only parts of their relationship that works. Hence, Meredith refuses to let Derek sleep-over or ask her out for lunch dates, and asks him to meet her for sex at eight that evening.

Meanwhile, Cristina decides to trade all her wedding gifts for professional gain. To her shock, Mama Burke arrives shortly after to see her. Flustered, Cristina sends Meredith to get rid of her and Meredith gets chastised by Mama Burke for making the "It's over. It's so over." speech back at the wedding. A horrified Meredith flees the awkward scene, but not before being tasked to tell Cristina that Mama Burke will continue to wait for her. Later, Derek goes up to Mama Burke and asks about Burke. She asks him whether Cristina really loved Burke and he replies saying she loved him the best way she knew how. Mama Burke tells him that he is an honorable man, but only if he knows how to walk away when he is taking less than he deserves.

George finally admits to Izzie that he loves her, confessing that on hindsight, he thinks that his marriage to Callie is a mistake. He promises Izzie to tell Callie that their marriage is over. However, before he gets a chance to tell her, several victims of a gas explosion at an apartment building arrive at the hospital.

The Chief, Derek and Cristina tend to Marla, one of the casualties, who sustained severe injures to her abdomen. Marla's husband is fine, although their one-year-old son cannot seem to stop crying. Callie then assigns Alex to the crying baby. Two other men, Archie and Clark, were also caught in the explosion and sustained burns.

Bailey asks Callie for a resident to oversee her clinic while she works on Clark, but Callie cannot release any residents and instead offers as many interns as she wants. However, Bailey is horrified with the ineptitude of the interns assigned to the clinic, one of whom is Lexie. Behind Callie's back, she begs Meredith to oversee the interns at her clinic. A delighted Lexie is pleased at the opportunity to bond with Meredith, but Meredith is less than thrilled. After Lexie's repeated attempts to bond, Meredith tells her that she is not interested in knowing her because their father chose Lexie over her, causing her to have abandonment issues and crippling her ability to pursue a healthy relationship with Derek.

Elsewhere, George is performing a CT scan on Clark when he goes into cardiac arrest from withdrawal. George single-handedly revives him, and Callie finds out that Bailey had undermined her authority by sending Meredith to run her clinic.

Mark, Callie and Izzie work together to treat Archie, and Izzie realizes that George cannot tell Callie that he wants to end their marriage as Callie is her boss. Telling Callie about the both of them would only ruin Izzie's career, so she urges George to at least wait a while before telling her. However, George decides otherwise when Clark subsequently dies from heart failure.

Alex finds nothing physically wrong with the baby, but the baby still won't stop crying. Suspicious, he smells something odd on the infant's skin and orders a toxicology test. The results show that the baby is on methamphetamine because the couple had been running a meth lab at home. The Chief delegates Callie to take charge of the meth lab situation, in a bid to patch things up with Adele. Callie orders Alex to inform the authorities and let them handle the situation. Later, the father yells at the baby to stop crying and Alex confronts him about the meth, causing him to punch Alex out and take the baby away.

The Chief admonishes Callie for letting the meth lab situation spiral out of control. An overwhelmed Callie rushes to find the missing baby, and Mark offers to lend her a listening ear. She confesses that she thinks George is cheating on her, and Mark urges her to talk to George instead of letting it destroy her career. George finds her and initiates their interrupted talk from earlier, but she begs him not to say anything tonight. He agrees.

Derek finds the missing father and baby, who is unconscious from a stroke, and rushes him into the surgery. In the gallery, Alex tells Bailey that she can yell at him if she wanted to. She tells him it is not her job anymore, and admonishes him fiercely all the same. He thanks her and she thanks him for letting her release all her pent-up anger.

After the baby's successful surgery, Mark asks Derek out for a drink and Derek admits that he has a problem. He sends Mark to decline Meredith's rendezvous at eight, and Meredith begins heading for home. However, unable to overcome his addiction to her, he goes up to her anyway and leaves with her.

Cristina eventually goes up to meet Mama Burke, who is not there to scold her. Mama asks for Burke's apartment key to take back some of his things and the diamond choker she lent to her for the wedding. Mama Burke tells Cristina that although she loved Burke very much, she loved being a surgeon even more. Hence, she is sorry that Cristina lost the man she loved, but she is more sorry that she lost an excellent teacher, who could have helped her become a brilliant heart surgeon. She evens tells her that if she (Mrs. Burke) had been born at a different time, she could have been a lot more like Cristina. Cristina asks if Burke will ever come back, to which Mama replies, "Remember you're a strong woman." Cristina then asks Mama Burke to take back all the wedding gifts and she later returns to her apartment devoid of all the wedding gifts and Burke's things.

Music

Let the Truth Sting

Summary

Alex is surprised to overhear the new interns waxing lyrical over George’s stellar performance, and finds out from Lexie that they are in the dark about his "repeater" status.

The Chief and Mark treat a chatty woman, Connie, who has advanced tongue cancer, but the surgery will leave her unable to talk. The Chief and Mark decide to try out a cutting-edge hemiglossectomy and tongue tissue transplant that could retain Connie’s ability to talk, partly in a bid to prove that they are not over the hill just yet.

Cristina figures out that Meredith and Derek are still maintaining their sexual relationship, and is upset that Meredith thinks she is too weak and fragile after the Burke situation to handle the truth. Hence, Cristina decides to get back at her by acting uncharacteristically upset and playing on Meredith’s pity, in order to get Meredith to give her surgeries. Meredith falls for it, trading her hemiglossectomy for Cristina’s interns.

Meredith arrives at the pit, and supervises Lexie on giving an intubating procedure on a DOA. Lexie blows up at Meredith when she feels that Meredith is not trying her best to save the patient, and Meredith retaliates by sending her to the clinic to help Bailey. When Lexie emotionally requests that Bailey allow her to work away from Meredith, Bailey confronts Meredith about allowing the grudge against her father to impede her duty to teach the interns. Once Meredith learns that Lexie is under the belief that Meredith hated her mother the way she did her father, Meredith brings her the hospital report on her mother's death and explains to her how her mother died. She also admits that she was rather fond of Lexie’s mother. Meredith then discovers that Cristina has been faking to get her surgeries, and tells Cristina that she wants to stay up all night talking about her feelings, which causes Cristina to cave and admit she was faking.

Meanwhile, Alex is assigned a new intern, Dr. Norman Shales, who happens to be an old man and former pharmacist. When a teenager, Hunter, comes in with what his mother terms signs of obvious drug abuse, Alex is reserved, but Norman quickly agrees with the mother’s intuition. When the toxicology report comes back negative, Norman tells the mother that it is natural for teenagers to act reticent and rebellious, having raised four kids himself. However, when Hunter develops neurological symptoms and spouts random words without meaning to (for example; Hunter remarks "You have apple hair, I threw a pancake in a river, a PANCAKE!" stating afterwards that he was trying to say he wanted to go home), it becomes clear that Norman’s diagnosis is wrong.

While Izzie brings her interns on rounds, the "Really Old Guy" in whose room the ex-interns used to eat lunch, wakes up from his year-long coma. It turns out that he knows everything about them as he was only "semi-comatose". Remarkably astute, he raises doubts in Izzie’s mind when he notes that married men always tell other women that they would leave their wives but never really do. He announces that today will be the day he dies, and attempts to pull out the wires attached to his body. Although no damage was done, Really Old Guy goes into cardiac arrest anyway, and has to be resuscitated. He then decides to leave the hospital against medical advice, and Izzie tries to stop him. She confesses that she needs him to stay because she needs his company and advice, but finds out that he had already passed on.

The tongue surgery the Chief and Mark are performing runs into complications when they do not know how to proceed, and Derek has to be brought in to continue the surgery. Meanwhile, Hunter collapses after he suffers from a brain herniation, but Derek is unable to assist immediately and informs Alex how to drain the fluid behind Hunter’s eye to save his life. However, Norman inadvertently gets in Alex’s way, causing Alex to yell at him to get out of the way. When Alex apologises to Norman for yelling at him, Bailey quickly chastises him because Alex’s actions were wholly appropriate and Norman was in his way of saving the patient’s life. Bailey reminds him that there is a "pecking order" for a reason and that he needs to be tougher. Also, Derek manages to finish the tongue surgery and criticizes the Chief and Mark for performing a surgery they were unsure of how to perform.

Bailey goes to Callie and admits that she had difficulties grasping with the "pecking order" and not being number one anymore. She makes amends with Callie and agrees to help her and work together in the future.

Unable to contain the truth anymore, Alex cruelly informs the interns that George's "skills" are a result of failing a previous internship, which he had been trying to hide. George then returns home and confesses to Callie that he slept with Izzie.

Music

The Heart of the Matter

Summary

Callie tells George she forgives him for sleeping with Izzie. Not expecting Callie's forgiveness, he rushes up and down the hospital looking for Izzie before Callie finds her. Despite his efforts, Callie finds Izzie before he does and arranges a meeting at noon in the cafeteria. Izzie's interns, who overhear the confrontation, misinterpret Callie and Izzie's meeting and the news of a fight spreads throughout the hospital. Izzie approaches Alex for help, should things get out of hand, and tells him about her affair with George. Alex is disgusted at her indiscretion. Meanwhile, Callie arrives at the cafeteria to talk, but realizes that the entire hospital gathered to watch her "fight" with Izzie. Humiliated, Callie leaves without saying anything.

The Chief's wife, Adele, rushes their niece, Camille, to the hospital after she stops breathing. Diagnosed with ovarian cancer at 14, the cancer has now spread to Camille's chest, lungs and throat. Camille begs the Chief to let her go home and die, but Adele wants him to convince her to undergo treatment. The Chief ultimately lets Camille decide how she wants to lead her life, straining his relationship with Adele even further.

Derek asks Meredith out on a weekend get-away for 48 uninterrupted hours of sex, but she has to find someone to cover her duties. Alex agrees to cover for her, but in exchange, she has to take his old intern, Norman, for the day. Meredith teaches Norman the protocol on how to tell patients they are dying, but he ends up telling the wrong patient, Mrs. Bitzer, who came in to have a mole removal. The situation turns worse when they find out they made a mistake and that she has already left the hospital. Norman manages to get her back to the hospital, but Mrs. Bitzer had already quit her job, dumped her boyfriend and purchased a one-way ticket to Iceland. Fortunately, the hospital lawyers manage to convince her to accept compensation and Mrs. Bitzer leaves happily.

Derek, Cristina and Lexie tend to a football player who sustained a cervical fracture during a game. The patient needs to be attached to a traction halo to realign his spine, but his harsh and over-critical father makes the process more difficult than it already is. Derek and Lexie bond over the one thing they have in common - Meredith. Cristina tries to stop their blooming friendship and is extremely harsh on Lexie. However, Derek tells Cristina that until she becomes a better resident and teacher, she will not scrub in on any of his surgeries. During the surgery, Derek lets Lexie perform a cauterization, but she starts to panic. Cristina steps in to teach and guide Lexie, and Derek lets her participate in the surgery.

Bailey, George and Callie treat a woman who injured her ankle while running on a treadmill, who despite her injury, wants to get back to her exercise regime as soon as possible. The woman is losing weight for her boyfriend, who told his girlfriend they'd move in together once she loses 40 pounds, while he would quit smoking for her. He is appalled that the doctors want her to gain weight before they operate, in an attempt to prevent her bones from continuing to be so fragile. Fresh from the wounds of George's confession, Callie is distracted at work, something which does not escape Bailey's eyes. Meanwhile, the woman's condition deteriorates after she starts vomiting blood, and the doctors find she is bleeding from a duodenal ulcer, and this coupled with her anorexia causes her to die on the operating table. Callie confronts the boyfriend, and Bailey and George have to keep her from losing control. Afterwards, George tells Callie that she cannot just forgive him because what he did was unforgivable, and she admits that she does not forgive him.

Guilt-stricken, Izzie later apologizes to Callie, but Callie refuses to let her seek forgiveness, calling her a "traitorous bitch". Alex also chastizes Izzie for telling him that she was not ready for a relationship after Denny, but cheapened all that when she had an affair with George, and proceeded to tell Alex as if he were one of her "chick friends". Back at home, Izzie cries on her bed. Alex comes in and gives her a box of tissues, gruffly telling her to "keep it down".

After spending the day with Lexie, Derek decides to call off the get-away with Meredith. Meredith is about to put the blame on Lexie, but Derek stops her, saying that all they talked about were the things that Meredith does not want him to say. She denies this, and he tells her that he wants to marry her and have children, among other things, and that him saying all this makes her want to flee. Derek does not want 48 uninterrupted hours, only a lifetime, and he is prepared to wait for her to be ready for that, but what happens if someone comes along who wants the same things as he does?

Music

Haunt You Every Day

Summary

It's Halloween and Meredith is convinced her mother's ashes are haunting her after having morbid and disturbing dreams, so she brings them to the hospital in a bid to deal with her own mummy issues. Meanwhile, Adele has filed for divorce, and after the Chief discovers that Cristina is putting Burke's apartment up for rent, he decides to move into Burke's apartment.

Callie announces George and Izzie's affair to the other doctors' shock. While Meredith says she is happy for them, Cristina, like Alex, does not support the affair.

Meredith meets a boy who wants Mark to do a pro bono surgery to fix his ears, which lack the pinna of normal ears. Mark is more than happy to help him, but his lack of social capital with the other hospital staff prevents him from putting together a surgical team to operate on the boy. Meredith then decides to capitalize on her mother's social capital to make the boy's ear surgery happen. She goes around the hospital with the boy trick or treating for ears, to canvass support for his surgery.

Norman is feeling under the weather and asks Alex if he could take the day off. After he receives an unexpected visit from his former patient, Rebecca Pope, he sends Norman away and begins making out with her. The two head for an on-call room where Rebecca wants to talk to Alex about their situation. She calls him "chicken" for not giving her a reason to stay when she was leaving, and for not coming for her after she left. Alex promises her to talk later, and they proceed to have sex. After sleeping together, Alex confesses that he has not been sleeping well ever since Rebecca left the hospital. Rebecca tells him that she wraps her baby daughter in her shirt to get her to sleep.

Izzie, George and Lexie go to the ambulance bay to receive their patient, only to discover that the patient is already dead from a brain haemorrhage when a brick went through her windshield. George and Lexie are stunned to find out that the patient was the daughter of a man awaiting a heart transplant at Seattle Grace. Because the daughter was an organ donor, the man could receive his own daughter's heart which would be a very good match. However, the devastated man does not want his daughter's heart in him, as it would haunt him for the rest of his life. George reveals how he would have given his father his own heart if it would have saved his life, telling the man that his daughter would have wanted the same thing. The man eventually agrees to receive his daughter's heart.

The Chief brings Erica Hahn to the hospital to harvest the dead woman's heart. Cristina and Izzie both fight over working with her, but Erica picks Izzie because she feels Cristina sleeps with her mentors like Preston Burke and Colin Marlowe to get surgeries. This drives a wedge between Izzie and a bitter Cristina, who already strongly disapproves of Izzie's affair with George. Cristina subsequently goes up to Erica and tells her that she did not sleep her way to the top and was only attracted to the talent that resembles her own. She tells her off for being inappropriate and unprofessional, only to have the Chief walk in on them to announce Erica's new position as Seattle Grace's head of cardiothorastic surgery. Not entirely overjoyed at this turn of events, Cristina tells the Chief that he cannot have her apartment.

A man suffering from somatoparaphrenia, misdiagnosed as body dysmorphic disorder wants Bailey to amputate his foot because it does not belong to him. She sends him away with anti-anxiety medication and heads for the ER to treat the victims of Seattle's annual chainsaw pumpkin-carving contest. Bailey treats a man who sliced off his finger accidentally with a chainsaw, when her patient discovers that his chainsaw is missing. She realizes too late where the saw might have gone, and finds her previous patient severing his leg with the stolen saw. During the man's amputation, Callie and Cristina bond over their failed relationships, only to be interrupted when Norman collapses from a stroke.

Rebecca wants to talk to Alex, but he gets called away after Norman has a stroke. He promises to return after dealing with Norman and leaves, but not before Rebecca tells him to not "chicken out". After Norman's surgery, Alex apologizes to him for not listening to him. Norman confesses he wanted to go to psychiatry but there was a little voice telling him to choose surgery. On hindsight, he realizes that the voice was probably his late wife wanting him to be surrounded by world-class surgeons when he suffered from a stroke. Now that the worst is over, he tells Alex that he will transfer to psychiatry. Alex returns to the on-call room and finds it empty save for Rebecca's shirt, which she left on the pillow for him.

Because Bailey agreed to help the earless boy do the pro bono surgery, she misses her son's first Halloween and quarrels with her husband over it. Meanwhile, after denying the Chief her apartment, Cristina lets Callie move in with her, on the condition that she does not clean up after her.

Lexie and the earless boy each draw from their own experiences and separately offer Meredith suggestions as to what she could do with her mother's ashes. This inspires Meredith to wash Ellis' remains down the surgery room's sink as she feels that this is where Ellis would want to be. The Chief walks in on her and helps her let go.

Music

Kung Fu Fighting

Summary

Frustrated at her own inability to pursue a healthy relationship with Derek, Meredith turns to Cristina for help with her severe abandonment issues, stemming from her dysfunctional relationship with her various family members. She concludes that the more available Derek gets, the more she pulls away.

Two brides-to-be are brought in after they severely injure each other, while competing in a store contest. Both Jackie, who dislocated her shoulder, and Helena, who has part of her scalp ripped out and a nasal fracture, are holding onto a wedding dress because the first person who lets go relinquishes a $100,000 wedding package. Jackie's shoulder needs immediate surgery, but Callie is unable to convince either party to let go until Mark suggests using George as a proxy for Jackie. Meanwhile, Alex finds Lexie doing charts in a closet to avoid being bullied by Cristina, and invites her to participate in Jackie's surgery.

Helena passes out and is rushed into surgery. Elsewhere, Jackie asks if she won after learning that Helena passed out while holding the dress. Appalled at her lack of empathy and priorities, Callie chastizes her for fighting so hard for a wedding when it is the marriage she should be fighting hard for. Subsequently, while chancing upon George in a hallway, Callie tells him that she has to and will let go of him. Back at Helena's room, George tells a happy Helena that she won after he had to let go of the dress to catch her after she passed out.

Sally, a skydiving instructor, brings Rick to the ER after he fell 12,000 feet after his parachute fails to open. To the doctors' amazement and Cristina's disappointment, he only needs an appendectomy after sustaining a haematoma in his appendix. After the residents watch his skydiving accident video, Meredith discovers that Rick is in love with Sally. Drawing from her near-death drowning in the Puget Sound, she tells him that the clarity he is feeling after his close call with death goes away, and urges him to confess his true feelings for Sally before the clarity and bravado subsides. This causes Meredith to realize that she needs the security that she feels during the few moments after sleeping with Derek, and is afraid that progressing their relationship beyond break-up sex will take that away from her.

Mr. Arnold, an avid birdwatcher, is in for heart surgery, but complications arise after he is discovered to have malignant hyperthermia. Cristina discovers a method to operate on Mr. Arnold without the need for anaesthesia, but Dr. Hahn is determined to stonewall Cristina's fervour attempts to get into cardiothoracic surgeries, and picks Izzie to scrub in with her after Izzie convinces Mr. Arnold to go through with the surgery.

However, Izzie is nervous that she would not be able to live up to "hardcore Cristina", but George encourages her to just be "hardcore Izzie". As Mr. Arnold is extremely anxious at the prospect of being awake during his heart surgery, Izzie decides to place herself in Mr. Arnold's shoes, adjusting monitors away and preparing a picture of his dream bird, the ivory billed woodpecker, to allay his fears. During the surgery, Mr. Arnold panics after realizing the entire observation gallery is looking at him. Izzie manages to get him to calm down by getting him to determine what birds the doctors in the gallery would be.

After moving out of the hotel, the Chief moves into a trailer next to Derek's. He proposes a "gentleman's evening" to take their minds off their relationship problems. A confused Derek invites Mark along, while Dr. Hahn finds out about their "gentleman's evening". She lambasts the Chief for being sexist after only inviting the male attendings and he is forced to bring her along to their gathering. The four doctors end up playing Monopoly on Derek's piece of Bainbridge Island land.

Izzie wants to have sex with George and they decide to meet after work for their date. However, both of them are too exhausted after their long day at work, which deeply upsets Izzie as she wanted their night to be special and memorable. They decide to postpone their perfect night to another day.

Lexie approaches Alex afterwards and asks about his evening plans. He tells her in all honesty that he is not looking for a relationship because he is bad at them and is still hung up on someone. Therefore, the only thing she will get from him is nothing else but sex. Nevertheless, she takes him up on his offer and they get it on back at his place. Meredith chances upon them in the hallway, and slams the door on the shocked Lexie.

Music

Physical Attraction, Chemical Reaction

Summary

George and Izzie try to recreate their magical sex from before, and after a few very disastrous attempts, realize that they have zero romantic chemistry regardless of their love. On the other hand, Derek and Meredith are brimming with chemistry, but Derek needs more than just sex from her. Meanwhile, the Chief constantly gets Derek to pick up his drycleaning for him, and the two have been spending evenings together having dinner and a movie, leading Mark to tease him about being the Chief's new girlfriend.

Meredith forbids Alex to sleep with Lexie over at her place. When Lexie goes to Meredith's place looking for Alex for drinks, Meredith tells her to get her own friends and stop living in her life. This leads Alex to revoke from Lexie his offer of sex because he does not want to get involved in the sisters' issues and take sides.

Callie has difficulties coping with the administrative responsibilities of being the Chief Resident. She gets Bailey to cover her duties for her, while she scrubs in for her back-to-back surgeries.

George treats a young boy who swallowed a marble in order to get his constantly bickering parents to get a divorce. When the boy's plan fails, he swallows more so that he can get his parents to take him seriously. However, the marbles he thought he swallowed were actually magnets, which are causing severe intestinal damage as they move towards each other. The boy's operation turns out well, and the incident spurs his mother to consider getting a divorce.

Alex's patient, Jerry, has no bowel movement in the past five days despite his successful bowel resection, and is extremely grumpy. Meanwhile, Izzie has to follow up on an annoying woman, who came in for a facelift. Alex and Izzie are unable to tolerate their patients any further, and Bailey who has to cover for Callie, suggests putting both patients in the same room so that they can irritate each other, forcing them to concentrate on getting better and leaving. However instead of irritating each other, they hit it off so well that Alex and Izzie walk in on them having sex. Alex is amused, but Izzie is jealous that even the two patients have chemistry.

Cristina gets Callie to schedule her as Erica's resident for the week, but not wanting Cristina on her service, Erica takes Meredith off Mark's service for herself. Mark is turned on by her sassiness. Bailey, using Callie's position as Chief Resident, urges Cristina to find another specialty, and orders her to the ER.

There, Cristina tends to a woman who fell down the stairs while carrying her adopted baby. She sends Lexie off with the baby, and the relieved mother suddenly faints from her extensive internal injuries. Erica arrives and takes over, evicting Cristina off yet another cardiothoracic case. This forces Cristina to try orthopaedics with Callie, which does nothing but remind her how much she misses the finesse of heart surgery.

The baby is fine apart from a minor brain contusion, but his father is too worried about his wife to care about the baby, with whom he has yet to bond. The father confesses to Lexie that he would give up the baby if his wife dies, because he cannot raise the baby alone.

Lexie sits outside the OR with the father, and Meredith comes up to update him on his wife's progress. Meredith tells him that he probably knows more about the baby that he thinks, leading him to tell them all the things he knows about the baby to show how little he knows. Before going back to the OR, Meredith reminds him that he knows five things about the baby that no one else knows. Despite Erica and Meredith's efforts, the man's wife dies. Although devastated, the man returns to the nursery to pick up his baby daughter, telling Lexie that he remembered a sixth thing – that the baby hates riding in the car seat. He decides to name the baby Keisha because that's what his wife wanted to name her.

An inspired Lexie goes up to Meredith and tells her five things about herself, so that Meredith would find it a little harder to hate her. Later at Joe's bar, Lexie gets drunk and falls asleep, while Alex tells Meredith that he broke things off with Lexie. Grateful, Meredith tells a confused Alex to take her sister home. While walking Lexie home, they meet her clearly drunk father, Thatcher Grey, who is on his way to buy more alcohol. Alex offers to get it for him to irritate him, so that he would not drive in his intoxicated state. Pissed off, Thatcher goes back to the house, and Lexie begs Alex not to tell Meredith about what he saw.

Mark goes up to Erica and tries to hit on her. She shoots him down, telling him that the only reason that he is attracted to her is because she is not interested in him.

The Chief confronts Bailey about all of Callie's supposed arrangements like urging Cristina to find another specialty and putting two patients in the same room against protocol. She tries to cover for Callie, but the truth comes out anyway. The Chief fires Callie from her position as Chief Resident, giving it to a relieved Bailey, who breaks down and hugs him.

George and Izzie have sex one more time, and agree that it was the best sex they have ever had. A few moments later, they call each other's bluff.

Music

Forever Young

Summary

Derek goes on a date with Sydney, to Meredith's disappointment. Meanwhile, things have gotten extremely uncomfortable between George and Izzie after their disastrous sex, leading them to act awkwardly around each other. Rumors about their breaking-up spread throughout Seattle Grace, and eventually find its way to Callie, who is happy about it.

Bailey, the new Chief Resident, manages to get Cristina onto Erica's service. However, Cristina tries too hard to impress Erica, who is irritated by her overzealousness. Callie advises Cristina to stop brown nosing and back off, or she might just blow her only chance.

A schoolbus accident floods the ER with injured teenagers. Their driver, Marcus King, is also sent in for some superficial injuries. He used to attend high school with Bailey, and she used to and still is harboring a crush on him. Capitalizing on her infatuation, he manipulates her into stitching his arm and filling out his students' patient forms for him. George discovers that Marcus has an irregular heartbeat, and Bailey sends him to get Erica, who diagnoses him as having mild atrial fibrillation. Erica also notes that if Bailey was not acting like a "blithering idiot", she could have diagnosed and treated him appropriately herself.

Marcus’ condition suddenly deteriorates and has to be rushed into surgery. Bailey tells Erica that she could have ordered further tests, but Erica in turn tells her that she could have ordered the tests herself if she was not busy flirting with Marcus. Meanwhile, Cristina decides to skip Marcus' surgery to avoid being a brown noser, and is excited when Erica finally pages her in the midst of the surgery to get her to run an errand.

After his surgery, instead of being grateful, he asks Bailey if she could help him finish up his patient forms for him. George overhears all this and urges Bailey to go back and give Marcus a long speech, but she cannot bring herself to do it. Bailey takes out her anger on Derek for Marcus' shabby treatment towards her, despite how successful she is now. Derek assures her that he was not as popular in school as she thinks because he was a band geek just like her, saying that he would be honored to take her to homecoming.

One of the accident victims, a pom squad captain, is devastated to find out that not only is her face covered in lacerations, she also fractured her leg and cracked her coccyx. The girl thinks her life is over because she has lost her captaincy. However, Callie tells her that sometimes being a captain is not all that great as it is mostly about organizing crap, and now the girl can go back to doing the thing she loves.

Meanwhile, Derek, Izzie and Lexie treat a boy, who has a pencil impaled in his eye. A social outcast, the patient only has his best friend, Marisa, by his side. In the OR, Derek remarks that at least things will be better for the boy once he leaves school and all the different cliques behind. One of the scrub nurses, Rose, scoffs at Derek saying that the hospital has not come as far clique-wise as he might think. Derek manages to remove the pencil, but the boy's brain continues to swell, putting him in a permanent coma. After Marisa asks Derek for an update, Derek tells her about the boy’s condition and she breaks down in tears. Izzie tries to comfort Marisa, but she tells her that she would never understand being a prom queen and all, leading Izzie to relate how she was not a prom queen, but "the girl in cheap clothes from the trailer park who got pregnant". Marisa apologizes for jumping to conclusions, but Izzie tells her it’s okay because she knows what it feels like to lose a best friend.

Alex gets paged by one of his interns to deal with a drunk Thatcher Grey, who keeps hollering for Meredith. The Chief asks him to keep Thatcher's appearance from Meredith and get Lexie to deal with him instead. However, Alex is unable to even broach the topic of her father with Lexie, and flat out tells Meredith about Thatcher. To her surprise, her father is filled with remorse for blaming her for Susan Grey's death and for being absent for most of her life. He also apologizes for his excessive drinking, saying that today was his late wife's birthday.

Meredith tells Lexie it must be difficult for her as today was her mother's birthday, and urges her to take better care of Thatcher. Furious, Lexie retaliates by telling Meredith how Thatcher is a horrible drunk and to him, every day is Susan's birthday. She also relates how his remorse is due to his drunken state, and he did not mean anything he told Meredith. The Chief witnesses all this and consoles Meredith.

Back home, George and Izzie tell each other that they miss being each other's best friend. At Joe's bar, Sydney decides to dump Derek as she thinks that Derek is not ready to meet all of her needs, and they part amicably. The amused Derek goes up to Meredith and they both decide to leave together, but not before smiling at Rose as he leaves.

Music

Crash Into Me, Part 1

Summary

Meredith resolves to let Derek know that she does not want him to continue dating other people, but when it comes to actually telling him, she chickens out. Meanwhile, Bailey's husband, Tucker, is unhappy that she is not at home most of the time, leaving him to constantly take care of their son. He wants to have a talk with her, and she decides to meet him for lunch to have the talk.

Lexie is still mad at Alex for not keeping his promise to not let Meredith know about Thatcher's alcoholism, so he kisses her to appease her. Meanwhile, Mark has a patient, Nick, who is recovering from having a large carotid body tumor removed from his neck. However, the surgery has left his carotid artery exposed and extremely susceptible to rupturing at any time. Lexie checks on Nick as he flirts with her, saying that his ex-girlfriend left him recently. She tells him that she is already seeing someone, a nice guy who is disguised as a jerk, referring to Alex.

An ambulance brings in a heart patient with a sternal infection, causing both Cristina and Izzie to fight over who gets the patient and get on Erica's service. While they are arguing, Meredith realizes that an incoming ambulance is careening out of control and yells at them to bring the patient away. The residents manage to move out of the way just before the ambulance crashes into the other one, causing the latter vehicle to flip over several times, trapping its two paramedic occupants, Ray and Stan, inside.

Both paramedics are suspended upside-down in the ambulance, but Stan's condition is worse than Ray's. The Chief realizes that Stan is going to die from excessive bleeding once they extract him from the vehicle, so when Stan requests for his wife, who works at Seattle Grace, he immediately sends Meredith to get her. After Stan's wife arrives to see her husband, the two trapped paramedics are prepared to be extracted from the wreckage. During the extraction, Stan realizes an oxygen regulator is embedded in Ray's back, and orders Meredith to halt the extraction. The Chief calls Stan a hero for saving Ray's life, but Stan has already passed on. An ultrasound has to be performed on Ray to determine the extent of his injuries, and Meredith decides to crawl into the wreckage to do it, but Ray is now close to passing out.

A piece of flying shrapnel lodges itself in the heart patient's femur and they rush him inside the hospital. Cristina and Izzie fight for Erica's affection, but Erica eventually picks Cristina, telling Izzie to go to Callie to work on removing the shrapnel. Meanwhile, Erica requests Mark's help to remove the patient's infected sternum, and he tries to get a date with her, but is shot down yet again.

Bailey rushes to the other ambulance to find two other injured paramedics, Shane and Mary. Mary had a seizure while driving into the ambulance bay and crashed her vehicle to the other ambulance. Although Shane sustained internal abdominal injuries, he refuses to let Bailey treat him, insisting on a male doctor. But when he also refuses to let the Chief treat him, it becomes clear that what he wants is a white doctor. Determined not to give him want he wants, Bailey gets Erica to give her Cristina, who is not entirely happy about being pulled off Erica's service. Also not entirely happy is Shane, who does not get a white doctor like he wanted.

Cristina pulls back his shirt to examine him and discovers a large swastika tattooed on his stomach. She reveals that her stepfather's parents were killed in Auschwitz, but Bailey tells her that they can rise above and do the surgery. However, Shane refuses to sign his consent forms unless a white doctor is observing, and Bailey is forced to get Derek to lend her George. Tucker pages Bailey in the midst of the surgery, looking for her for their lunch talk, but she is unable to leave the OR.

Derek and George discover that the reason Mary had a seizure was because of a tumor in her brain, and the doctors have to perform a craniotomy on her to remove it. However during the surgery, the stereotactic computer malfunctions, leaving the probe in Mary's brain with no way to remove it.

As Alex prepares to scrub in on the heart patient with Mark, he sees Rebecca in the hallway looking for him. She asks him out for coffee, but he has to turn her down for the heart surgery, and she asks him to sneak her into the OR gallery so that she can watch his surgery. During the surgery, Lexie enters the gallery and sits next to Rebecca. The two make small talk and Lexie discovers that Alex is also seeing Rebecca. Furious, she goes back to check on Nick, who observes her unhappiness. Lexie tells him that her nice guy boyfriend disguised as a jerk turned out to be a jerk, and Nick tries to cheer her up by suggesting ways she could take revenge. However, Nick's carotid artery suddenly bursts, spraying blood all over Lexie.

Music

Crash Into Me, Part 2

Summary

Lexie manages to stop Nick's carotid artery bleed, but with both hands on Nick's artery, she is unable to call for help. After some difficulty, she manages to get Nick to call the nurses' station to declare a code blue and to page Mark and Cristina.

Derek and Rose are still in the middle of their own medical crisis when the stereotactic computer malfunctions, leaving the probe in Mary's exposed brain. However, the technician is in Spokane, which is five hours away. The probe cannot be removed without the computer's navigation system, and leaving the probe in Mary's brain for too long will cause it to swell. Rose, having spent three semesters in computer science at University of California, Santa Cruz, offers to fix the computer. Having no better alternative, Derek reluctantly takes her up on her offer.

Rose needs to reconnect the wires in the machine, but she is having difficulties because her hands are shaking. Derek volunteers to help her as his hands are much steadier than hers. Rose manages to fix the computer and Derek is able to resume the surgery. After the surgery, Derek and Rose trade compliments and Derek then leans in and they kiss.

Having finished Shane's surgery, Bailey is getting ready to rush off to meet her husband for their lunch talk, which she is already late for. Complications arise before she can leave, forcing her to stay behind to tend to Shane. She gets George to explain to her husband that he would have to wait a little longer, but Tucker gets George to tell Bailey that he is tired of her choosing everything over their marriage and his marriage to her is over. Bailey and Tucker use George to communicate between each other, but their marriage is falling apart by the minute. Tired of waiting, Tucker leaves before Bailey is done with her surgery.

Bailey is finishing the surgery and decides that she has to reposition the incisions so that it approximates more accurately, leaving Shane’s Swastika tattoo unrecognisable. After Shane's surgery, Cristina goes up to Bailey and tells her off for not using her for her surgical skills but for the color of her skin.

Meredith crawls into the ambulance with an ultrasound to determine the extent of Ray's injuries, and the Chief discovers that Ray's pericardium is filled with blood. Erica and Izzie are almost finished with their heart surgery with Mark and Alex, and get called away to tend to Ray in the ambulance bay. Mark and Alex are also finishing up, and Mark spots Rebecca in the gallery. He confronts Alex about her presence there, but before he can get an explanation, Cristina bursts into the OR to get Mark to tend to Nick. Mark gets Alex to finish up the surgery and immediately free up the OR so that Nick can be brought in and operated on. However, as Alex is finishing the procedure, the patient's heart graft blows.

Mark arrives and realizes that Nick's bleeding has stopped, albeit temporarily. There is a chance that the bleeding will start again, so he gets Cristina and Lexie to bring Nick down to the OR he just freed up. However, he gets called back to the OR to repair the heart graft. Meanwhile, Nick starts bleeding again, so Cristina and Lexie rush him to the OR, only to find that it is still occupied by Mark and Erica's patient. Mark gets them to get Nick into a sterile procedure room immediately. Although Mark rushes to operate on Nick, he codes and flatlines.

Izzie seeks Erica's permission to update their patient's family about his condition, but Erica tells her that if she wants to be a surgeon and not a social worker, she can wait till the crisis is over before updating the family. They reach the ambulance bay and Erica guides Meredith on how to drain Ray's blood-filled pericardium. However, Erica's insensitive description of the procedure scares Ray, and Meredith tells her to shut up. Ray is frightened by the procedure, but the Chief tells him it is good to be scared because it means that he has something to lose. Meredith manages to successfully drain the blood, and Ray is evacuated from the ambulance wreck.

Izzie tries to get an OR for Ray's surgery, but is told by the nurse that all the ORs are fully booked. The heart patient's wife goes up to Izzie and asks for updates, but Izzie admits that she has no idea because she left the surgery halfway. She gets rebuked by the wife for not giving her the updates like she promised. Izzie visits the patient after his surgery, but gets coldly brushed off by his wife.

Meanwhile, Stan's wife goes up to Meredith to get her to tell Ray that she is sorry but she cannot stay. Meredith tells her that she thinks it is better to have someone, even if it is the most painful thing a person has to do. Meredith later goes up to Derek and tells him that she does not want him dating other people. She tells him she is scared to want him, but wants him anyway because her fear means she has something to lose, and she is scared to lose him. He starts to reply, but she stops him, saying he can tell her tomorrow.

Rebecca wants to talk to Alex, but he tells her that there is nothing to talk about because she is playing dress-up. He reminds her about her husband and baby daughter and tells her about his relationship with Lexie. Alex tells her to be honest with herself and stop pretending to be someone she is not, getting her to admit that she is not here to talk to him. After getting it off his chest, he kisses her and they proceed to have sex.

Lexie is devastated after Nick's death, but Cristina tells her that she was brave, but to have Lexie say that she has no one. Meanwhile, Mark is also despondent about Nick's death and is moping in the lounge with Callie and Erica. Erica invites the two of them for a drink, even though Mark cannot promise that he would not hit on her.

Cristina brings alcohol and Lexie to Meredith's place, to her surprise and chagrin. Cristina explains that Lexie has no one, and Meredith reluctantly agrees to drink with her sister. Izzie realizes that she cannot be as cold and hardcore as Cristina or Erica. George tells her that it is a good thing. They admit their love for each other, but the timing of their relationship was not right. They go downstairs to find Meredith, Cristina and Lexie wildly dancing with each other. Irritated, Izzie begins to walk away when Meredith invites her to join in. Izzie asks George if he wants to dance, and they join the dance party.

Music

Lay Your Hands On Me

Derek shows Meredith the building plans for their dream house on the mountains, but she does not share his enthusiasm. Derek notices this and changes the topic to the breakfast Meredith is attempting to cook. To his surprise, Meredith reveals that the reason she was cooking breakfast was to do something nice for her half-sister, Lexie. Meanwhile, Lexie wakes up on the sofa downstairs and heads off to eat breakfast. She bumps into Alex in the hallway and confronts him about his girlfriend, Ava. Alex guesses that she returned to her husband, and denies that Ava was his girlfriend. In the kitchen, Lexie learns that Meredith specially prepared breakfast for her, and proceeds to eat the avocado omelette Meredith cooked. Later, George finds her rummaging through the medical cart for epinephrine because of her allergic reaction to eggs and her inability to decline Meredith’s kind gesture.

Derek walks up to Rose, and tells her that he is with Meredith and has to see it through. Rose replies saying that it is okay, as they only shared a kiss. Derek tries to avoid her, but she tells him not to because they can still be professional about it, and are still friends. However, George overhears their entire conversation.

Derek tries to bring up the issue of his dream house with Meredith, but realizes Meredith is still not ready to further progress their relationship, despite what she says. Meredith tells George about how scared she is that Derek wants a future with her, but he tells her not to worry because all that happened between Derek and Rose was just a kiss. Meredith confronts Derek about Rose, saying that she cannot trust him. He replies saying that she cannot trust anyone, and keeps finding reasons not to trust him. They break up.

Bailey and her husband’s relationship is still strained, after Bailey stood him up for their lunch talk the previous day. Tucker decides to initiate a conversation about their family just as she is about to leave for work, but Bailey brushes him off and leaves mid-conversation.

Meanwhile, Cristina tries to get Izzie to back off from Erica’s cardio-thoracic patient, Elizabeth Archer. However, Izzie tells a disbelieving Cristina that she is no longer interested in cardio-thoracic surgeries. Erica, intent on not picking Cristina, asks Alex to be on Elizabeth’s case. Alex happily accepts as Cristina protests, but is silenced when Erica points out that Cristina did not realize that Elizabeth has disappeared from her room.

Bailey and Cristina finds Elizabeth putting her hands over a coding patient’s chest, and stabilizes his ventricular tachycardia. She tells the surprised doctors that she is an holistic healer, before collapsing into Cristina’s arms. Erica warns Elizabeth that her coronary artery dissection could cause her to go into cardiac arrest at any time, and urges her to consent to surgery. Elizabeth wants someone to explain to her in detail what the surgery entails, and refuses to undergo surgery until she exhausts all other non-surgical options.

Alex returns to talk Elizabeth through her surgery, and meets her own team of healers. He is completely sceptical, and tries unsuccessfully to get her to agree to the surgery. Elizabeth tells him that he has a darkness in his throat chakra where his voice should be, because he was hurt so badly in the past that he does not talk about it. He sometimes hurts people because he wants to spread the hurt around. She reveals that Alex was a sweet boy with a beautiful heart, but he is not a good man. Elizabeth tries to ask about his past, but he avoids her question.

Bailey ignores her husband’s multiple calls to her, and goes to attend to a page. She goes to the ER only to find out that the page was from her husband, because their baby, Tuck, was crushed by a falling bookcase. Bailey and her husband bicker as she tries to examine baby Tuck with the other doctors.

Mrs. O’Malley makes a surprise visit to the hospital, and shows a stunned Callie all the baby outfits she knitted for them. Furious, Callie confronts George about not telling his mother about their divorce. But before George can track down his mother, Mrs. O’Malley bumps into Izzie, who unwittingly tells her everything that happened since her last visit. Mrs. O’Malley is appalled to hear Izzie telling her about the breakdown of George’s marriage due to their drunken one-night stand and subsequent affair, as well as George failing his intern exams.

Now extremely upset, Mrs. O’Malley talks to George about what she just learned from Izzie. She tells him that they are Catholic, and do not believe in adultery and divorce because marriage is for life. She insists that he goes to confession and marriage counselling with Callie. However, before she can make him agree, he leaves after getting paged about Bailey’s baby.

Tuck has severe internal injuries with ruptured and displaced organs, making his surgery extremely risky. Bailey barges into the OR to see her baby, but Erica halts the surgery and demands that she leaves. Cristina offers to help Bailey hold Tuck’s hand, and Bailey leaves reluctantly. Derek finds a near-hysterical Bailey trying to recall the chain of events that led to her son’s accident. He pulls her in for a hug and consoles her.

Back in the OR, Erica offers to let Cristina do the final cut, but she declines and continues to hold Tuck’s hand. His surgery is successful, but Tuck is still unable to breathe on his own. Bailey and her husband watch over their baby in the ICU. She reaches out to hold her husband’s hand, but he pulls away.

Alex asks Izzie for updates on Bailey’s baby, as she confesses how she is at a loss of how to help, unlike Cristina, who would always know what to do. Izzie is envious that Cristina knows what she wants and has unwavering faith in her skill.

Bailey decides to bring Elizabeth in to help her son. She gets Bailey to hold hands with her husband and focus on their love for Tuck, because the energy in the room is not healing.

Callie sees Mrs. O’Malley again, and the two talk about God and marriage. Callie tells her that she loved being an O’Malley. At night, George finds his mother knitting for baby Tuck. George is sorry for disappointing his mother, but she tells him that he disappointed himself. She asks whether he is going for counselling, but he declines saying it would just hurt everyone more. She then asks him to move back home, and he refuses her offer because he feels that it is time he starts taking care of himself.

Meanwhile, Tucker panics when baby Tuck starts to choke, but Bailey is overjoyed because it means Tuck is starting to breathe on his own. Alex then brings Izzie to Elizabeth’s room, and gets her to talk Elizabeth through the surgery because she is like an optimist, unlike him. He leaves her to do her explanation, but not before telling her that “Yang’s got nothing on you”.

Erica goes up to Mark and tells him that he is too pretty, and if they were not working together, they would probably be together. Unfortunately for Mark, they are working together, and Erica tells him that she has to separate her personal and professional life in order to do her job. She heads out to Joe’s bar with Callie, and brushes off Mark’s request to join them.

Derek asks Rose out to dinner, while Meredith goes to look at baby Tuck. She asks Bailey about her husband, and learns that he would be moving out and moving into a hotel.

Music

References

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