"Didn’t We Almost Have It All"
Written by Tony Phelan and Joan Rater; directed by Rob Corn

Meredith Webber voices over that being the chief of surgery is about responsibility; every patient in the hospital is the chief’s patient. As Webber helps tend to Adele in the ER (see “Testing 1-2-3”), Burke, Addison, Joe, and Walter arrive with Rina. Webber voices over that the chief of surgery needs to be able to tell a patient’s family that he or she did everything possible to save the patient. Addison tries to send Walter and Joe to the waiting room, but they want to stay with Rina. Webber continues that the chief has to sacrifice his or her own family in order to take care of other people’s families. Back at Cristina’s bachelorette party, Callie writes Cristina’s vows on her hand while Izzie encourages her to just speak from the heart. Cristina replies that the heart is an organ that pumps blood but doesn’t speak. “Well, you’re all ‘glass half empty,’” Izzie remarks. Cristina thinks she’ll like being married, but she finds the wedding itself ridiculous. Everyone except Cristina is paged, and Meredith asks Cristina if she’s ready to get married because Meredith needs her to walk down the aisle. She sees it as a sign that people like the two of them can be happy - Burke and Cristina getting married gives Meredith hope. Cristina promises that she can do this. Derek and Mark return to the hospital and learn from Bailey that the fourth climber has been found alive. The two men wonder what happened on the mountain to result in Lonnie winding up with an axe in his head. Webber asks Addison what’s wrong with Adele, but Addison won’t violate doctor-patient confidentiality until Webber reminds her that they’re still married.

Burke examines Rina, telling her that she needs surgery and will probably need to deliver her babies tonight. Rina is worried since she hasn’t chosen adoptive parents yet and still wants time to decide. Joe assures her that she doesn’t need to make up her mind about anything yet. As the interns arrive in the ER, Burke tells Addison that Rina may have a tear in her aorta, and since most blow within 48 hours, Burke only has less than 12 hours to fix it. That means Addison has to deliver the babies first. Burke promises Cristina that he’ll be at the church in time for the wedding. Bailey arrives and assigns George to work with Derek and Mark, Izzie to work with Burke, and Alex to work with Addison. She then fills Meredith in on Adele’s case and sends her to tend to her. Cristina has come without being paged, but Bailey wants her to go home and sleep since she’s getting married in less than 12 hours. Cristina notes that Burke is getting married, too, but gets to operate. “There’s only one Preston Burke,” Bailey points out. “There’s only one Cristina Yang,” Cristina replies. Bailey tells her to think of her day off as a gift, since she only gets one wedding day but will always have the chance to assist in other surgeries. She asks if Cristina would rather prep a patient or get ready for her wedding; apparently Bailey has never met Cristina. Webber meets with Mark and tells him that he never really believed Mark wanted to be chief of surgery. He thinks Mark mostly got in the race to try to beat Derek. Mark thinks he got Derek interested in the race, and Webber says Mark got everyone to fight harder. He reiterates that Mark will not be the new chief.

Derek tells Andy, Dale, and Jack that Lonnie has been found alive, then asks them what exactly happened on the mountain. They explain that they were climbing an ice wall and planned to set up their tents to wait out a storm. Lonnie wanted to go back down, and when he started going back, he pulled everyone with him, since they were all tied together. Andy claims that he swung out his axe, trying to catch it on the wall, but he accidentally hit Lonnie in the head, seemingly killing him. Adele regains consciousness and Addison tells her that Webber knows what’s going on. Adele has lost a lot of blood and may have miscarried, but Addison is able to find the baby’s heartbeat. She heads off to deliver Rina’s babies and Webber asks Adele why she didn’t tell him she was pregnant. She tells him he can leave, since he must have work to do, but he’s fine with staying with her. As Addison and Alex are discussing Rina’s surgery, a man approaches them and announces that he’s Jeff Pope and is looking for his wife, Rebecca (AKA Ava). Alex watches as the two reunite and Jeff says he never should have let Rebecca leave. Derek and Meredith run into each other and Meredith remarks that she’s heard he’s going to be Burke’s best man. She invites him to sleep over at her place after the wedding, saying that she’s feeling more like herself again. Derek announces that he met a woman at the ECB, but nothing happened; he thinks she should worry that the highlight of his week was flirting with another woman. Back in his office, Webber tells Addison that she won’t be the chief of surgery. She tells him she needs the job because she needs a reason to stay in Seattle and to get out of bed. He says that’s exactly why she’s not getting the job.

Burke and Derek scrub up together and Derek says that Burke is lucky to have someone who’s willing to commit to him. Mark joins them and asks Derek if he’s up to the challenge of being Burke’s best man. Callie catches Bailey looking at a bulletin board and tells her the chief resident hasn’t been posted yet. Bailey denies that that’s what she was looking for, then admits it was. Callie spots George passing by and starts babbling about being out of control and liking her life the way it is. She then tells him that she has no desire to have a baby, but for some reason it’s all she can think about. Instead of talking about having a child, George just tells her that there’s a guy with an axe in his head, which is obviously the current priority. Adele again tells Webber he can leave, but he wants to tend to her. He also claims that he doesn’t need to know who the baby’s father is. Meredith arrives, followed by Patricia, who wants to know what Webber wants to do about the chief announcement. Webber heads off to take care of that while Adele tells Meredith that they met a long time ago, when Meredith was a child, and Adele always paid attention to Meredith so she didn’t have to see Webber flirting with Ellis. She’s sorry that Meredith lost her mother but glad that Meredith turned out so well. Meredith apologizes for the role Ellis played in Adele’s life, but Adele says it’s not Meredith’s fault. “You get married at 25, thinking this is it, happily ever after,” Adele says. “Maybe there is no happily ever after.”

Jane helps Cristina get ready for the wedding, loaning her a choker that women in the Burke family always wear to get married. She says that if Cristina wears it, it’ll be like she’s officially a Burke. Jane apologizes for misjudging Cristina and thinking she was selfish, but now that Cristina is giving in to Burke’s plans for their wedding, Jane thinks she’s showing more flexibility. She then asks what Cristina is planning to do about her eyebrows. Addison begins to deliver Rina’s babies, asking Alex how Rebecca and Jeff’s reunion went. He says that Jeff cried but Rebecca looked bored, probably because she’s not sure if she wants to stay with him. Izzie thinks they should stay together, since they took vows to do so, and “you don’t mess with vows.” Rina starts flatlining, so Addison hurries to deliver the twins. George assists Derek as he operates on Lonnie, lamenting that the man just wanted to climb a mountain but wound up getting axed. Derek says that Lonnie shouldn’t have turned back, since he was supposed to stick with his group. George thinks that he had the right to back out since he was panicking. “You chose to climb a mountain,” Derek says. “You can’t change your mind in the middle of the climb.” They turn their attentions to the axe, and Derek says that the wound should be shallow and show some tearing. It’s not and it doesn’t, indicating that the axe may not have been inserted accidentally. Burke is the next to stop by Webber’s office, and he learns that he’s not going to be chief because he made bad calls when he was dealing with his tremors. Webber wants to give him the job, but Burke needs to learn that he’s not perfect and he doesn’t know everything. Burke just says that he has a wedding to get to.

After Rina’s successful delivery, Addison and Burke congratulate each other and he keeps working on Rina. He admits to her and Izzie that he’s nervous about his vows, so Addison suggests that he try them out on everyone in the room. The vows talk about how Burke could promise to always be there for Cristina, but he won’t because those kind of vows are for optimistic couples, and that’s not them. He’s not hopeful or optimistic - he’s steady and sure. He knows about hearts because he deals with them on a daily basis, and he’s sure that Cristina is the one for him and that his heart beats for her. He promises that he’ll put his heart in her hands. Addison tells him that, speaking for every woman in the room, he should dump Cristina and marry Addison instead. George finds Callie sleeping in the on-call room and tells her that if she really wants to have a baby, he’s in. Alex heads to the NICU and finds Jeff with his daughter, whom he thinks looks like Rebecca. He tells Alex that he tried to give Rebecca space, and Alex blasts him for not looking for her after the ferryboat crash. Jeff says that Rebecca left him because they’d had a fight about him not understanding how unhappy she was. He didn’t look for her when she disappears, but he thinks it’s worse that he didn’t see her when she was with him. Alex says that even with her face broken, she was beautiful. “I love her. You know?” Jeff says. Cristina finds Meredith working at a nurses’ station and tries to get her attention as Meredith talks about Derek meeting another woman. Cristina announces that this is about her right now - Jane has taken her eyebrows, and now she’s a Burke.

Derek tells Andy, Jack, and Dale that Lonnie is stable but has some serious damage. Jack asks if he’s going to regain consciousness and Derek wonders if the three want him to. He gives them another chance to tell him what really happened on the mountain. Andy starts to talk but Jack shuts him up. “Is that how you let him talk to you at 14,000 feet?” Derek asks, telling the guys that they get to talk to the police next. Meredith and Cristina approach Bailey, who has just read Webber’s announcement that Callie is the new chief resident. Meredith says that Cristina really needs to cut something, since she has no eyebrows and is about to become a Burke. Bailey says no until Cristina tells her that she has no dignity left and doesn’t feel like a surgeon, but she still is one. “Do you know what it’s like, not to feel like yourself?” she asks. Addison rushes to Adele’s room, where Adele is having cramps and may be experiencing placental abruption. Addison rushes her to the OR, and the scene switches to Webber’s office, where he’s about to meet with Derek. Then Webber is in a waiting room and Addison tells him that she tried everything but couldn’t save… Webber runs off to see Adele before Addison can finish. In the OR, he first thinks Adele is dead, but she’s just asleep. He asks if she wants to call the baby’s father, but she says he didn’t even know she was pregnant. She’s realized that she may have misjudged him; she thought he would run away when he found out about the baby, but now she knows he’s the sort of person to get over his initial judgments. Webber realizes that he was the father, and she tells him the baby was a boy.

Derek heads to Rina’s OR to kick Burke out so he can make his wedding. In another OR, Bailey lets Cristina make a single cut before sending her off to the church. Izzie finds George in the locker room and paraphrases Burke’s vows, telling him she’s an optimist, hopeful, and unsure, but if he wants to be with Callie, she’ll be supportive because she’s his best friend. But because she’s his best friend, she also wants him to know that she’s in love with him. He doesn’t respond. The other interns arrive to get ready to head to the church. Derek stops by Andy’s room, where Andy is meeting with his lawyer. Andy tells Derek not to judge him because he wasn’t on the mountain. He confesses to putting the axe in Lonnie’s head to put him out of his misery, since they all thought he was going to die. If they were back on the mountain, Andy would do the same thing again because he’s Lonnie’s friend. As the interns get ready for the wedding (and Izzie fixes Cristina’s eyebrows), Patricia arrives to hand out the results of their intern exams. All of the interns report that they passed. Derek arrives to speak to Meredith as everyone else leaves. Alex stops in to see Rebecca and let her know that he passed his exam. She has news of her own - she and the baby have been discharged. She has every reason to go home with Jeff, and even though she’s scared and everything is moving quickly, Jeff is a good guy and her baby’s father. Medically, Rebecca has no reason to stay, and obviously she wants Alex to give her another kind of reason to stay, but he doesn’t get it. She tells him that Jeff sees her as Rebecca, but she’s not sure that’s who she is anymore. In fact, she was more herself when she was Ava, and Alex was the one who named her. Alex won’t give her a reason to stay and tells her to go with the decent guy.

In the locker room, Meredith tells Derek that if he wants to break up with her for another woman, he should just do it, but he shouldn’t tell her when he meets other women. He says he can’t, then tries to get her to understand that she’s the love of his life and he can’t leave her: “But you’re constantly leaving me. You walk away when you want, you come back when you want. Not everyone, not your friends, but you leave me. So I’m asking you, if you don’t see a future for us, if you aren’t in this…please, please just end it, because I can’t. I’m in it. Put me out of my misery.” Meredith says she can’t deal with this right now, since Cristina is about to get married and she needs to make sure her best friend gets down the aisle. Later, Derek asks Burke if he needs anything (a mint or a getaway car), and Burke tells him he’s not upset about “the chief thing.” Derek reveals that Webber didn’t choose him as chief of surgery, and the two men aren’t sure who he chose instead. Derek admits that he and Meredith might not make it, and he thinks he wants the relationship more than she does. Then he changes the subject back to Burke, and Burke says that Derek really is a good best man. Meredith is relieved to find Cristina still in the church, getting ready for the wedding. Helen tells her daughter that she’s proud and always thought Cristina was “too emotionally stunted to settle down.” Meredith assures Cristina that she can do this.

Alex sits with Addison in the church, and they discuss which side to sit on when they know both the bride and groom. He asks her out for a drink and she says that he doesn’t want her, he wants Rebecca. He tries to wave this away and she tells him he sucks and can’t let a possibly life-changing opportunity get away. Even though Rebecca is Rebecca now, she’ll always be Ava to Alex. George finds Bailey at the hospital, both of them having decided to skip the wedding, and asks her what he should do now that he’s failed his intern exam. She tells him his two options are to stop his journey to become a surgeon altogether or repeat his intern year. “Did I fail you, George?” she asks. “No, I failed you,” he replies. On his way out of the church, Alex chats with Cristina, Callie, and Izzie, who wonders if George has arrived yet. Callie tells her that George might be late because they had an emotional day and are now trying to have a baby. As the wedding march begins playing, Cristina realizes that when she scrubbed in for her one cut, she washed her vows off of her hand. Inside Derek wonders what’s going on and Burke notes that “Cristina wouldn’t be Cristina if she didn’t need a little push.” In the hallway, Cristina panics over not knowing her vows and begs Meredith to say something helpful. “Stop whining,” Meredith replies. “This is your wedding day. You will go down that aisle and you will get married. If I have to kick your a%$ every step of the way to get you there, you will walk down the aisle. You will get married. Do you hear me, Cristina? We need this. We need you to get your happy ending.”

Cristina is finally ready to go in, but when Burke comes out to talk to her, he tells her it’s not going to happen because she doesn’t really want to do this. He knew she didn’t want to come down the aisle but that she would come anyway because she loves him. He also knew that if he loved the woman she really is, not the woman he wants her to be, he would let her go. Cristina says she’s ready and she thinks she really wants this, and Burke replies that he wishes she knew she wanted this. Meredith winds up heading into the chapel and telling everyone that the wedding is off. At the hospital, Joe and Walter hold their new babies as Webber and Adele watch, smiling. Alex rushes back to Rebecca’s room, but she’s already gone. Meredith finds Cristina crying in her apartment - Burke is gone, and Cristina is free. The concept makes her cry and hyperventilate, so Meredith cuts her out of her wedding dress and holds her. Back at the chapel, Callie watches as Izzie cries in a pew. George packs up his locker as the new batch of interns enters to check the place out. One of them is the woman Derek met at the ECB the night before. The interns ask George for advice and he suggests that they learn to do an appendectomy from start to finish before their first day. As the others leave, the woman from the bar stays back and asks if George is leaving. She wishes him luck and he introduces himself. She tells him she’s Lexie Grey and he quickly realizes that she’s Meredith’s sister. Back in Webber and Derek’s meeting, Webber tells Derek he’s chosen him to be the chief of surgery. Derek says he’s not the best man for the job - Webber is. “A good chief learns from his mistakes,” Derek explains, and he’s still working on that, but he knows if Webber had the chance to do it over again, he’d do things differently. “Go ahead. Do it all over again,” Derek says. “Be the best man.”

THE TITLE IS A SONG BY…: Whitney Houston

MEMORABLE QUOTES: “If you need a job to give you a life, you either need a new job or a new life.” - Webber

Mark: “I was an excellent best man.”
Derek: (to Burke) “You know, the worst-case scenario is I sleep with your wife in ten years.”

Rebecca: “My teeth got a blessing from…wait, I can say this…prosthodontics.”
Alex: “Yeah, but there’s still your memory….”
Rebecca: “You know how I know my memory’s fine? Because I can say ‘prosthodontics.’”

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