"A Change is Gonna Come"
Written by Shonda Rhimes; directed by Rob Corn

Meredith voices over that change is always inevitable in medicine because new treatments and techniques are always coming about. George and the new interns enter the locker room as Meredith voices over, “We either adapt to change or we get left behind.” Cristina, Izzie, Alex, and Meredith greet their interns by giving them the rules Bailey gave her and her fellow interns on their first day (see “A Hard Day’s Night”). Meredith tells her interns (including George) about the on-call room and advises them not to sleep with any attendings. In Intern Alley, the now-residents meet up and complain about the experience; only Alex likes having interns and thinks he’s the new Nazi. George pops in to talk to Meredith and Izzie tries to ask him about his summer vacation. She complains that she was alone for much of it because Meredith and Cristina went on Cristina and Burke’s honeymoon together (see “Didn’t We Almost Have It All”), and Alex drove out to see Rebecca (though he didn’t actually get there). George ignores Izzie, asking again to talk to Meredith. Some other interns appear and the residents chase them off. George decides to go with them, since he’s an intern, too. Cristina wonders if he’s going to mope around like this all year, adding that he needs to learn how to cope. Meredith changes the subject by asking if Cristina has seen Burke. She hasn’t, and Meredith hasn’t seen Derek either. Izzie says that if they’re both fine with not seeing their significant others since the non-wedding, they’re “either incredibly healthy or completely messed up.”

Derek chats with Bailey about the residents, who she notes are no longer her responsibility since they’re not interns anymore. He confides that he’s supposed to tell Cristina about “the Burke thing” and doesn’t know how to break the news to her. Bailey encourages him to be honest. He asks her to get a drink after work, and she guesses that he’s asked her because he has no one else to talk to - Addison and Burke are gone, and he and Meredith “aren’t smelling each other in the elevators anymore.” Derek tries to disprove her theory by asking Webber to get a drink, but Webber, of course, doesn’t drink. He also wants to talk to Bailey about choosing Callie as chief resident, but Bailey doesn’t want to discuss it. Mark approaches, having heard about a possible drink, but Derek denies that that was the topic of any conversation. In the ER, Webber announces that a bunch of victims of a car accident are being brought in, so everyone needs to help out. Callie asks if there’s anything she can do as chief resident. Webber tells her to make sure the residents run the traumas, then wonders where said residents are. Callie says she paged them, and Bailey notes that whenever she paged the interns, they would always come running. After Webber walks away, Callie chastises Bailey for saying that in front of Webber. Bailey points out that she asked, then calls her “boss.” In the hall outside the ER, Meredith spots Derek, and Cristina is confused not to see Burke anywhere nearby.

Callie blasts the residents for not coming sooner, then tells them to delegate responsibilities to their interns. Cristina assigns her interns (including Lexie) numbers instead of names so she doesn’t have to remember who they are. Meredith sends George to wait for the ambulances, taking the rest of her group with her. Alex tells his interns to stay out of the way while Izzie encourages hers to ask questions if they have any. As she walks off, she overhears them talking about how disappointed they are to be stuck with the resident who was put on probation for killing someone. George and Lexis run into each other at the ambulance bay and she promises not to tell anyone that he’s repeating his internship. She asks if he knows who Meredith is and he says he hasn’t told her Lexie is her sister yet. Lexie asks for information on her sister, noting that Thatcher won’t tell her anything about Meredith. Before George can answer, Bailey and the other residents arrive, followed by the ambulances. Cristina’s patient is actually DOA and she just has to declare him dead; she’s disappointed that she doesn’t get to do anything else. Bailey and Meredith’s patient is a pregnant woman named Nancy whose arm has been amputated. Callie’s patient is a man named Joey, who has a knee injury and is hungry. Cristina pronounces her guy dead, but just then he takes a breath. Lexie finds Meredith, now knowing who she is, and announces that she’s her sister.

In Nancy’s trauma room, Meredith tells George that Lexie is her sister, and George admits that he already knew. Izzie brings her interns by and begs Meredith to let her help out. Mark comes in to tend to Nancy and says that she has a good chance of recovery, as long as they can reattach her arm, which has yet to be found. Nancy says that her baby has no father, so she really needs her arm to be able to take care of him. Callie and Alex tend to Joey, whose knee injury isn’t too serious but whose hunger leads him to eat some cotton balls. Izzie introduces her interns to Cristina, then asks her if she can help out, confiding that she thinks her interns hate her. Cristina doesn’t care - her patient came back to life, which makes him a zombie, and she wants her zombie all to herself. Lexie comes in and tells Cristina she was gone longer than planned because she met her sister. Cristina is surprised that Lexie is Meredith’s sister, but she’s more concerned with her patient, who has a problem she needs Derek to look at. Derek is currently talking to Meredith, who’s looking for Nancy’s severed arm. Lexie approaches to talk to Meredith and Derek remembers meeting her at the ECB (see “Testing 1-2-3”). “I’m the girl from the bar,” Meredith points out, leaving. Derek is stunned to learn that Meredith and Lexie are sisters. Callie and George meet up and she tries to make him feel better about being an intern again, reminding him that he’s way ahead of the rest of the group. She comments that they might see him as the daddy intern, which makes him panic over the possibility that Callie is pregnant (which she’s not).

A man named Chris enters the ER with his son Michael and announces that he’s found an arm. Meredith takes it while Michael encourages his father to tell her that there’s an injured “she” in their truck. Izzie sets her interns in motion and they head out to the truck, where they find the injured deer that caused the car accident. The deer opens her eyes and looks at Izzie, who eventually decides that it’s her responsibility to take care of the animal. The interns aren’t thrilled about having to help her out. Derek examines Cristina’s patient, Henry, and tells her that he’s basically been internally decapitated. 90 percent of people in that situation die in the field, and Derek has never seen any of the other 10 percent live. Derek and Henry develop a method of communication using blinks, which lets Derek know that Henry has a family. Derek tells Cristina to contact them and find out if Henry is an organ donor. Callie joins Alex, who wants a patient other than Joey, since he doesn’t need surgery. Callie won’t budge, so Alex threatens to go to Bailey. Of course, he can’t, since Callie is in charge of him now. Meredith tells Nancy that her arm has been found and Mark is checking to see if it can be reattached. Nancy tells her she wanted a child and was tired of waiting to find the right guy, a no-no in her family, so she’s alone and worried about having to raise a child with only one arm. Fortunately, Mark thinks they’ll be able to successfully reattach the arm.

Izzie tends to the dear while Chris tells her that Michael is old enough to understand that she doesn’t have to save an animal. The interns also see this endeavor as a waste of time. Chris tells Michael that they’ll take the deer home and eat her; he needs to understand that people eat animals, they don’t save them. He wants Michael to learn to “grow up and face things.” Izzie announces that she’s helping Bambi, not Michael or Chris, and keeps working. Cristina finds Meredith cleaning up Nancy’s arm and notes that she still hasn’t seen Burke around the hospital. She claims that she won’t care if she never sees him again. Meredith confides that she and Derek ran into each other, and he seems to know Lexie. Izzie enters and shares that her interns think she’s a loser, partially because she’s working to save a deer. Alex joins the group to complain about Callie not letting him find a patient who actually needs surgery. George enters next and Cristina tries to invite him into the conversation, but he just wants to tell Meredith that Mark is ready for the arm. After he leaves, Meredith says that George is being a jerk, but Izzie blames herself. Alex thinks George should be happy because some of the interns are hot. Izzie and Cristina remind him that George is married, but Alex keeps talking about the interns, saying that Lexie is especially hot. “Get out before I hurt you,” Meredith replies. Alex announces that he’s going over Callie’s head to Bailey, and though Cristina reminds him that Callie is over Bailey’s head, Meredith notes that “spiritually, Bailey’s over everyone’s head.”

In the ambulance bay, Webber tries again to talk to Bailey, who changes the subject by asking about Adele. Webber says she’s good, then admits that she hasn’t let him move back home yet and isn’t actually talking to him. He tries to turn the discussion back to the chief residency, but since he’s not ordering her to talk to him, Bailey decides she doesn’t have to stick around. At the nurses’ station, Derek asks Cristina out for a drink; she says she won’t go because she doesn’t like him. He asks after Meredith, who Cristina says is fine, as usual: “We’re fine people, we do fine, we’re fine.” She asks about Burke and Derek has to tell her that Burke resigned two weeks ago. Cristina claims to be fine, of course. Alex teases Izzie about looking up information on the deer’s circulatory system on the Internet, then asks Bailey if she has any operations he can assist with. She reminds him that Callie is in charge of that sort of thing now. Callie arrives and sends Alex off, then says she doesn’t know how Bailey managed to keep control over her interns and get them to show her respect. Izzie asks Bailey if she knows anything about deer. Bailey responds that Izzie’s not her intern and the whole situation is none of her business anymore. Henry’s wife and children arrive and Cristina warns that this could be the last time they see him alive. They go in to see Henry, who communicates with blinks. He blinks three times and his wife interprets that to mean that he’s saying he loves them. As Derek arrives to take Henry to surgery, the family leaves, but Henry’s daughter soon returns to blink three times at her father.

Izzie tracks George down in a stairwell and confronts him for avoiding her. She’s upset that she confessed her love for him and he didn’t respond. He tells her he’s been there all along, in the same exact place he was last year, and is freaking out. She tells him they’re all freaking out, including her, since she’s now in charge of interns and is trying to save Bambi. George thinks “Bambi” means him, but she tells him she’s talking about herself - she’s alone in the forest and her mother’s been shot by a hunter, and she wants to know where George is. Mark and Derek meet up in the scrub room and Mark tries again to get himself invited out for a drink. He thinks Derek needs a friend because things aren’t going well with Meredith. Derek tells him that Meredith has “a right to be damaged” because of the way her parents were, adding that it’s a big step for them to be together. She wants to have a relationship but doesn’t know how to make it work, but it’s not her fault. Derek tells Mark never to talk to him about Meredith again because he doesn’t know what he’s talking about. Later, Meredith and Mark prepare for Nancy’s surgery, but she’s anxious about having to go through everything alone. Meredith tells her she’s being brave, adding that “it’s much better to be alone and feel like a success than to be in a relationship and feel like a failure all the time.” She advises Nancy to let them take care of her arm and they’ll deal with everything else later.

Alex goes back to see Joey and realizes that a bunch of his supplies are gone. Joey suddenly starts choking and Alex determines that he has a foreign-body obstruction. He calls for someone to page Bailey. Back at the truck, Chris tries to teach Michael about the joys of eating animals. He thinks Michael is being “childish and ridiculous” (which means, by extension, Izzie is being childish and ridiculous), but Izzie thinks it’s not childish to keep hoping - it’s actually difficult. She thinks Michael needs to believe that “some things can work out for the best.” Izzie shocks the deer, stabilizing her heart and making her stand up. Mark and Meredith operate on Nancy, and George notes that she’s having contractions. There’s no time to get anyone from obstetrics into the OR, so George delivers the baby. Derek and Cristina operate on Henry, with help from Lexie, who notes that he’s moving because his anesthesia is too light. Cristina ducks under the table and tells Henry he has to stay still because he can’t leave the people who love him. Callie heads to Joey’s OR, where Alex and Bailey are operating, and complains that no one told her what was going on. Bailey tells her that Alex thought quickly and saved Joey’s life. Callie demands a fully dictated chart from Alex before he leaves for the night. As Bailey and Alex start pulling things (such as coins) out of Joey, Webber joins them. Bailey obviously still doesn’t want to talk to him about the chief residency.

Lexie and George stand outside the nursery together and he tells her that he just delivered a baby. She wonders why he’s not more excited, and he notes that he’s done this before. She tries to comfort him by telling him that it wasn’t his fault he didn’t pass the intern exam. George complains that everyone else was busy or had other things going on, and yet he was the one who failed. He doesn’t want to complain or wonder why he’s the one who has to go through this, but he does want to get what he wants for once. Lexie tells him that she didn’t plan on coming to Seattle Grace; she was planning on working at Massachusetts General, but then her mother died (see “The Other Side of This Life”) and all of a sudden she was in Seattle. She tells him that everyone has problems (and she has a lot of them, what with her mom dying, her father drinking a lot, and suddenly working with her half sister), and she would give anything not to be there, but she also hasn’t had her life work out the way she’d planned. “So you…you change. You…you get over it,” Lexie says. She adds that George needs to stop feeling sorry for himself because he just delivered a baby. “You…are kind of awesome,” he tells her. Back in Joey’s OR, Webber sends Alex to talk to psych, then notes that Bailey has nowhere to hide from him anymore. He says he knows she’s angry and disappointed, but Bailey denies that, saying that she’s just speechless to think that Webber wouldn’t consider her a good candidate for chief resident. He tells her that she would have been great, but she’s a better surgeon, and she needs to work on honing those skills rather than worrying about the administrative end. He thinks she’ll thank him one day. “But not today,” Bailey replies.

At the OR board, Mark tells Derek that he’s the one who actually needs a friend. He adds that he didn’t come to Seattle for Addison or to be the chief - he came for Derek because he wanted to get him back. After the awkwardness of Mark sounding like he’s in love with Derek, Derek relents that they should have a drink sometime…but “not today.” In the parking lot, Izzie tells her interns that when they woke up, they probably didn’t expect their first day to go like this. They can complain about it or they can change their expectations, because no matter what, they’re stuck with Izzie, and she’s the sort of doctor who lets kids talk her into doing something impossible. She adds that when she woke up, she thought the day would go differently, too, and she definitely didn’t expect stuck with the dud interns. As Henry’s family goes in to see him after his successful surgery, George meets up with the other interns in the locker room and they express their awe over him delivering a baby on his supposed first day. Lexie makes it clear that she’s going to play along. Alex encounters Cristina in Intern Alley, where he admits that he misses Rebecca and she admits that she misses Burke. Meredith voices over about change as Bailey passes Callie on her way out of the hospital. Callie asks Bailey if she wants to humiliate her more, since she sucks as chief resident, but Bailey just says she hopes tomorrow is better. Meredith runs into both Lexie and Derek and chooses to talk to Derek in the on-call room. They decide to break up…but first, break-up sex! As Meredith voices over that sometimes change is good, George goes to her house and tells Izzie that he’s in love with her, too.


MEMORABLE QUOTES: Izzie: “So…I have these interns and nothing to do. And, uh, I think I’m a really bad teacher. And I think they hate me. And now I’m a fraud. So any chance you wanna let me in on this? Please.”
Cristina: “Izzie, this guy was dead, and now he’s undead. So that kinda makes him like a zombie. My personal zombie. So no, you can’t get in on this. Now go be a…fraud somewhere else.”
Izzie: “I don’t like you.”
Cristina: “Mm-hmm.”

Izzie: “Does anybody know anything about deer?”
Alex: “They taste good.”
Izzie: “Evil.”

Derek: “Give me one reason why we can’t hang out.”
Cristina: “I don’t like you.”

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