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Grey’s anatomy S6 E4 “Tainted Obligation”

Alex wakes up in the trailer and it doesn’t seem to be a good day for him. The trailer is messy and he can’t find a towel after showering. The coffee machine breaks down and there’s no water left to rinse his mouth after brushing his teeth, so he has to do that with leftover beer. He leaves the trailer, only to find a bear on the deck, making him scream loudly. He quickly gets back inside.


In the ER, Izzie, who’s dealing with a patient, thinks he saw something else. He only got to the car by throwing a raw steak and running for his life. Izzie’s been marinating that steak for 3 days. He says they have to move. Izzie says they barely make 30 grand a year and they might be left unemployed after the merger. Alex proposes to move back to Meredith’s. Izzie says they’re married now and this is how it’s supposed to be: them making a life for themselves. She enjoys waking up in the forest. She loves it at Meredith’s, but moving back in would feel like moving backwards and she doesn’t want to do that after all they’ve been through. She needs to move forward.

In a staff meeting with his attendings, Richard tells them that he knows its’ been difficult, but he can’t give them answers. Not just yet. Derek whispers to Mark that Richard only called them down here to make himself feel better. Richard says the Mercy West staff will arrive in 3 days and when they do, there will be more cutbacks and layoffs. He needs each and every one of them to be leaders and he will answer their questions when he can. While everyone starts asking questions, Derek takes a danish.

Cristina and Meredith have been looking for surgeries, but there aren’t any. Cristina’s barely had 100 OR hours and she thinks they’ll keep the residents with the most hours. She pulls aside a curtain, finding Steve tending to a diabetic ulcer. She loses interest when he tells her it’s not down to the bone. She calls herself expired meat. Meredith is calmer, but Cristina points out she hasn’t been kicked off two services in one month. Meredith is scrubbing in with Derek later on. Moving on the next curtain, Cristina finds Izzie bandaging up a patient. She walks off when she claims that she just wanted to make sure everything is running smoothly. Izzie follows her and tells that she’s on Hunt’s service, so anything surgical that comes in is hers.

Lexie comes into the ER with Thatcher, who’s not looking good. The neighbors informed Lexie that he wasn’t getting his mail. He heard Meredith got married on a post-it. Cristina wants to go to give them family time, but Lexie says there’s something wrong and she doesn’t know what it is. Meredith asks if she picked him off the floor of a bar, because that might be a clue. Thatcher swears he hasn’t been drinking and then suddenly throws up blood all over Meredith’s shoes. Cristina comments that that could be surgical.

Bailey is taking care of Thatcher with Izzie, Alex, and Cristina fighting each other to assist her. Bailey chooses Alex. As Izzie and Cristina walk off, Lexie tells Meredith that their father made amends: he’s not drunk. Meredith walks off without replying.

Mark is taking off a growth on an elderly man’s back, with his son and daughter-in-law watching. They are very concerned about him living in the nursing home. He wants coffee, but a second cup isn’t good for his heart. Irene, the daughter-in-law, suggests in a over articulating way that they get him a cup of decaf coffee. He thanks her but reminds her that he’s just old, not demented. Irene and Tom leave and Irving tells Mark he’s really here for AMS700, the penile implant. Mark says therapy is usually the first step in treating erectile dysfunction, but Irving took those pills years ago and they didn’t work. Then his wife died and he gave up. But now he’s seeing this girl from the east wing who’s younger and he doesn’t want to disappoint. Mark understands, but it’s a surgical procedure, so there’s a certain risk given his age. He’s tired of hearing about his age and tells Mark about the golden days.

Cristina compliments Izzie’s hair. Izzie says she’s really tweaking and asks how long it’s been since Cristina cut. Over a week. Owen comes over and updates her on one of his patients, on whose case she can scrub in. Izzie is ready and takes the chart, with Owen denying Cristina who keeps repeating that she’s ready too. She blurts out that he knows she needs surgery, but he says that she knows he doesn’t play favorites. He noticed people have been afraid to work with Izzie and that’s not right, because she’s a good surgeon who has a light touch with her patients. Cristina claims she can be nice and have a light touch too, but he kind of disagrees.

Meredith tells Derek her father is dead, because throwing up blood and disorientation usually mean end stage liver failure. Which means he’s either dead or he needs a transplant. She hopes he’s not a candidate because then he’ll be in the hospital for months. Alex comes over. Meredith figures he needs a transplant.

Bailey tells Thatcher he has end stage cirrhosis. They can treat the symptoms, but a transplant is the only thing that’ll save his life. Lexie questions how this could’ve happened so fast. Alex rightfully suggests gin. And scotch, Thatcher adds. He asks what the next step is. Richard says there is a rule from the transplant board here: an alcoholic has to be sober for at least a year before he can get on the list. He’s only at 90 days. Lexie says she’ll get tested today. They only take part of the liver and it regenerates. Thatcher says he can’t ask something like that because it’s major surgery. She points out he’s not asking and she’s willing to do it for her father. Meanwhile, Meredith rolls her eyes.

Callie is following Arizona, asking her to act like the Chief so she can practice asking him to give her her job back. Arizona says Callie’s been saying she was gonna do it for days now. Callie says it’s not easy asking your job back when you told your boss to go screw himself in front of his entire hospital. She thinks being a surgeon may be overrated. She could be happy doing lots of other things. Arizona says she doesn’t want Callie to move to Cleveland to be a surgeon, which gives Callie the courage to do it. She then gets a page, so she’ll have to come back later.

Mark is surprised to see Lexie coming in on her day off. She updates him on the situation. Mark stops Steve from drawing blood as he wants to overthink and talk about it, but she doesn’t want. She doesn’t want to include him in the decision because he’s her father and she feels she has to do this, whereas Mark things he has to be part of the decision because he’s her boyfriend. As Steve continues, Mark walks off.

Izzie shares a few “insider tricks” with her patient and his wife. She informs them on the disease she’s had and tells the wife she might want to leave because she has to do a rectal exam. The “wife” says she’s not his wife yet, although she’d like to be. He uses the cancer as an excuse, but when his girlfriend’s gone, he says he’s got a ring at home. He’s just waiting for the right moment.

Mark is explaining the penile implant to Irving, with Irene and Tom thinking it’s a ridiculous idea. Tom and Irene try to talk his dad out of it. Irene says he might want to spend his savings on sending his granddaughter to college, but Irving replies that even though he loves her, they should stop pretending she’s gonna go to college. It’s his money and he wants to spend it on the implant. He’d been saving with his deceased wife for their entire lives and then she died before they could spend it. Mark interrupts and says they still need to run tests, because the surgery might not even be an option.

At the OR board, Cristina starts flirting with Dr. Nelson in order to get in on his surgery. He heard she was hardcore into cardio. “I can be hardcore into anything you want,” she says as Owen appears in front of her. Nelson sees him and walks off. Cristina tells Owen he forced her into doing this. Meredith comes over and tells Cristina that her father needs a transplant. She didn’t volunteer because she doesn’t consider him to be family. She gets a page and thinks he may be dead by now.

Izzie and Owen have opened up their patient and turns it out it’s worse than expected. He doesn’t know how to fix it. She tries to talk him into trying it, but he decides not to try it.

Meredith meets with Bailey, Lexie, and Richard and is informed that Lexie wasn’t a match. Her other sister is not an option either. Richard tells her they called her down here just to keep her informed. She thanks them for that and leaves to go prep for her surgery.

The residents are having lunch in a lab in order to hide from Lexie’s big sad “I’m not a match”-eyes. Alex and Cristina are disappointed because they won’t get to do the transplant then. Izzie asks Meredith if she’s gonna get tested, but Meredith refuses because she barely knows the guy. Alex and Cristina suggest she get tested so they might get to do the surgery after all. Izzie tells Alex he has some dirt on his neck, but it turns out to be a tick. They all back away as he yells to get it off.

Irving tells Mark he really needs the surgery; it’s not just vanity. Mark says the woman will understand that he can’t perform sexually anymore, but Irving says he’s still young. One day, all the milestones he’s always looked forward to, will all be behind him. You only have a bunch of yesterdays and very little tomorrows. He’s never wanted to have sex again after his wife died and then one day, they sat him down with Marion at the bingo table. Then he knew that she was his “tomorrow”.

Lexie leaves her sleeping father and walks up to Dr. Bailey, asking her to lie to the transplant board by saying Thatcher’s been sober for a year. They trust her, they’ll listen to her, and then he can get on the list. However, Bailey replies she has 15 other people waiting for a liver transplant. 15 patient in an untenable situation, none of whom drank themselves into it, so no, she won’t lie.

While Cristina removes the tick from Alex’s neck, he is complaining about life in the trailer. He’s done with it and wants to tell Izzie they’re moving back to Meredith’s. Cristina says they can’t do that, because that’s not how it works. She’s been through hell and she’s not okay yet, so he needs to give her time. Since she saved Izzie’s life, she doesn’t want it to suck.

While having lunch in the park, Arizona talks about the Seattle weather. Callie takes a list with 50 reasons to hire her out of her bag, which she’s going to read to the Chief. As she starts reading, Arizona packs her lunch. She lost her favorite scrub nurse yesterday. It is terrible in the OR without her, so she was looking forward to 30 minutes in the park with her girlfriend because the merger thing is important to all of them. Callie apologizes for being so all about having the Chief hire her back. Arizona says he’ll either say yes or no, but then they’ll know.


Meredith and Derek are looking at their patient’s scans. She assures him she’s up for it and says everyone’s been looking at her like she owes her father something, but she still thinks he’s the bad guy. He supports her in this and walks out. Moments later, Lexie walks in, holding Meredith’s medical files. She didn’t want to do this, or come to her for anything, ever. So she thought that if it was the wrong blood type, she could just stop thinking about it. But she can’t, because Meredith has his blood type. She knows he’s not her father and that he was never there for her, and she knows Thatcher doesn’t deserve anything from Meredith, but he is gonna die. So Lexie asks Meredith to give something to her. She’s asking Meredith to give her her dad, because as crappy as he was to Meredith, he was wonderful to her. From the scanner room, Derek watches the two of them and shares a look with his wife. Meredith overthinks the matter.

Meredith tells Thatcher they have found a match, so they’ll schedule the transplant for tonight. He stammers he thought he wasn’t eligible for the list. It’s not from the list, she clarifies, it’s her. They’re an ideal match. He says he broke himself, so he won’t let her put him back together. He’s already put her through enough. It’s a generous offer, but he can’t accept it.

Angela, their patient’s wife, thinks there must be something else Izzie and Owen can do. She questions what kind of doctors they are to just send Randy home to die when they were just starting to build a life together. The couple’s discussion clearly moves Izzie and she asks Owen to speak with him outside.

Outside the room, Izzie suggests ball-tipped electrosurgery. Owen refuses. The cancer is incurable, so he won’t put the man through an excruciatingly painful surgery with only a 13% survival rate. Izzie objects she only had 5%. She’s living with incurable cancer and the only reason that she’s standing here is because no one ever said to her that they did everything they could. She’s alive because people fought for her, including Cristina. Randy deserves the chance to fight. If he doesn’t want to, fine, she’ll shut up about it, but he deserves a chance. Owen walks back into the room.

Meredith says she did the right thing. Alex thinks she has to go back into her father’s room. He’s the sick one, so she has to try again to make him accept her offer.

Derek sees Meredith pacing in an empty hallway and watches her from a distance. Cristina wants to go talk to her, but he stops her so Meredith won’t know they’re there. They watch her as she is making up her mind.

Mark tells Tom and Irene that Irving’s been cleared for surgery. Irving is sure he wants to go through with it, but Tom says that if he does, they’re taking him out of the home and have him move back in with them because the home is making him do irrational things for a man his age. Mark interrupts and says that all Irving wants is an erection. God forbid Tom is Irving’s age and his children won’t let him have one. Irving’s spent his entire life taking care of Tom, and now that he needs something, Tom is throwing it in his face. Also, there’s nothing wrong with dating a younger woman because it keeps you young.

Richard is checking up on Thatcher, who asks him if the Chief always pays such good attention to his patients, or only the ones whose wives he had an affair with. He immediately apologizes for that and questions how he ended up here. Richard understands and talks out of experience how it happened. Meredith is offering him a second chance. If he wants to live, he has to accept the liver. Thatcher says he took her childhood, so he can’t take any more from her. Thatcher tells Richard to take care of his girls, because he owes him at least that.

Izzie tells Alex that Owen listened to her about their cancer patient. Before she goes to scrub in, she apologizes for the whole tick thing, but he claims he’s fine.

Derek is still watching Meredith, who suddenly gets up from the gurney and determindly walks off.


Meredith walks into Thatcher’s room and says she only remembers that he’s the guy who used to pour her cereal in the morning. That’s all she remembers. He’s not her father and if he’d die, it probably wouldn’t change her life that much. But it would change Lexie’s. It would break her. And Meredith won’t let him do that. She doesn’t know what it’s like to have a father, but she does know what it’s like to have a sister. And it’s good. If they get through this, then the door will be open for the two of them to get to know each other. The door is open, she repeats before walking out.

In a conference room, Mark, Derek, and Owen are discussing the implant surgery. Mark says its high risk and high technology. Cristina overhears and wants in on the surgery without knowing what it is. Mark, Derek and Owen discuss if Cristina is able to handle it. Cristina interrupts and says she can handle it. Mark tells her where the pre-op patient is. She thanks him and walks off. Owen agrees that it was kind of worth it while Mark and Derek laugh.

Cristina walks into Irving’s room and tells the present resident to beat it as Sloan wants her on this. She takes the chart and then reads he’s in for a penile implant surgery. Irving says the resident was just going to shave him. An awkward Cristina then sees the shaving gear.

While wheeling Meredith to the OR, Cristina tells her about her surgery, which she’s not at all happy with. Meredith replies that she at last won’t have to lie in bed for a month. She wants Cristina to tell her all the gossip about the Mercy Westers. Meredith asks if she’s stupid for doing this. No, Cristina thinks it’s great that she’s saving her dad’s life. Derek comes over too. Bailey appears and notices Meredith’s support group, but this is not how she’s gonna operate. She asks if she needs to find Cristina something to do, but Cristina is good with her penis. Derek insists on sitting by his wife’s head.

While he’s on the OR table, Randy tells Izzie he’s not just been waiting for the right moment to propose. Izzie figures he’s been waiting for remission. She’s right. He didn’t want to settle Angela with a sick husband, but now it looks like that might just be part of the package. So he won’t waste another moment. “You shouldn’t,” Izzie says, after which Randy is put under.

Meanwhile, Meredith’s been put under too. Right before making the first cut, Bailey tells her that she had 5 interns. Four of them have been on this table. One of them has cancer, one of them died. So Meredith better not pull anything funny on her. She shares a look with Derek and then cuts.

Owen and Izzie are opening Randy back up.

The penile implant surgery is almost finished. As the senior resident on the case, Mark wants Cristina to test the apparatus, though he would understand if she wanted to pass. She notices the men in the room are having pleasure and decides not to pass. This might be a joke to all of them, but she does her job. She squeezes the scrotum and they see the implant works.

Bailey takes out part of Meredith’s liver, which is then brought to Richard and Alex’s OR. They have opened up Thatcher. While Randy’s condition deteriorates, the same happens to Thatcher. Alex says they really can’t kill Thatcher, but Richard is already aware of that. In both ORs, they struggle to keep their patients alive.

Bailey finds Lexie sleeping against Mark’s chest in the waiting room. He doesn’t want to wake her if it’s bad news. “Wake her,” Bailey says, so he does.

Owen and Izzie’s patient didn’t make it. Owen stares at Izzie, who seems to be feeling guilty, before he angrily leaves.

Owen and Izzie are on the elevator together. Owen says they just took a couple of months away from Randy and Angela. Izzie says it’s her fault, but Owen says it’s his. It was the wrong call and he should’ve known and taught better. She was one in the million and now she wants to believe. He was wrong to do the surgery and to put her on the case, because she’s not ready. She beat the odds, but she can’t be a patient and a doctor in here. She has to choose. He gets off the elevator and Izzie witnesses how he delivers the bad news to Angela.

Irving wakes up after the surgery. Mark informs him it went good. Tom walks in with Marion and Irving introduces her.

A seemingly dejected Richard is splashing water in his face in the scrub room. Cristina walks in to talk to him. Even though he says it’s not the time, she says she has good hands, fast and dexterous. They were made for surgery. Today, they should have been deep inside a heart saving a life, but they were removing a tick and pumping a penis. Her point is that he should cut her from the program. Because if he can’t find her a brilliant cardiothoracic attending who’s willing to teach her, then she can’t get what she needs from this hospital. Everyone is scared of losing their job and so is she, but if she can’t learn or use her gift… That scares her more.

Izzie walks up to Angela, who’s still sitting in the waiting room with Randy’s belongings. She tells her she should open the case where he kept his mouth guard. Izzie says she’s very sorry for her loss and walks off, not being able to see Angela’s tears.

Callie pulls herself together before walking into the conference room to talk to Richard. She notices he’s down and asks if he’s okay. He responds that he has responsibilities to make this hospital the best medical facility it can be. To repair what he’s broken, even if it was 20 years ago. If he’s now the bad guy here, so be it. Callie realizes this must be hard for him. He thanks her. She tries to tell him she was gonna ask for her job back, but decides not to. However, before she can walk out, he tells her to go see HR tomorrow and tell them that she’s an attending surgeon at Seattle Grace Hospital and that she wants a new badge. And she can take some of the danishes home, because they’ll go to waste if she doesn’t. He walks out, leaving a smiling Callie.

Izzie is preparing for work, cautiously not to wake up Alex. She walks out of the trailer, screams and runs back inside while a bear growls outside. Alex, awake now, is happy to see that she now realizes that he was right. She wants to move.


Derek watches a sleeping Meredith in her room. Lexie is sleeping on Meredith’s lap. Meredith wakes up, which also causes Lexie to wake up. Lexie wants to make Meredith comfortable and tells her she’s been moving between her and their father’s room. Thatcher is doing fine. Good, Meredith says. She points out that Lexie is leaning on her IV. Lexie pours her sister a glass of water while Meredith rests.

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