Hope for the Hopeless

""There's nothing else we can do for you." These are the last words a surgeon wants to tell a patient. Giving up doesn't come easy to us, so we do everything in our power not to. For surgeons "lost cause" just means "try a little harder". When do you throw in the towel, admit that the lost cause is sometimes just that. There comes a point when it becomes too much, when we get too tired to fight anymore. So we give up. That's when the real work begins, to find hope where there seems to be absolutely none at all."

- Meredith Grey

 is the twelfth episode of the eighth season and the 160th overall episode of Grey's Anatomy.

Short Summary
Richard performs his 10,000th surgery on a pair of bickering sisters who come into the hospital for a liver transplant; Derek and Lexie take on a neuroblastoma case that has been previously deemed inoperable; Teddy and Cristina cross the line when they go against Owen's orders and try to steal a case from Alex and Dr. McQueen; Ellis Grey's shadow looms as Meredith searches for a specialty; meanwhile Adele is brought into the hospital after she is found wandering the streets.

Full Summary
Derek and Lexie are pondering a case that eight surgeons around the country have said is inoperable. Derek proposes they flip a coin: heads they do it, tails they don't. He says it's a "gut check," he gets a feeling when the coin is in the air how it he wants it to land.

At the house, Alex has a strange woman in the kitchen. April thinks she and Avery need to move. Sloan's girlfriend, Julia, tells him she loves him and he gives her a "see ya," which Callie takes to mean he's refusing to say "I love you, too," because he heard Lexie and Avery broke up and he thinks he might still have a chance.

Webber shows up excited about his 10,000th surgery, which is happening that day. He claims he doesn't want it to be a big deal, but asks Bailey if anything is planned to mark the occasion. She tells him about an elaborate plan that includes cake and confetti.

Hunt gets on Meredith's case about not having picked a speciality yet. He says she's drowning. He suggests general surgery, saying that with her mother's legacy she could be a natural.

Nurses bring Teddy food, which she thanks them for but admits to Cristina that she doesn't get it. Hunt shows up and Teddy doesn't want to talk to him.

Teddy jumps in on a patient who has a part of a wrought-iron fence sticking out of his chest, but Hunt orders her off the case because she's been working too long and it's her day off. Teddy first ignores him, but then leaves without acknowledging him.

The mother of Derek and Lexie's patient tells Derek she knows how dangerous the surgery could be, but wants to know whether he's willing to do it. He tells her there's a 5 percent chance the surgery will work, and she's willing to take the chance. One wrinkle, though, is that her son, who's 11, doesn't know he might die. He thinks he's at the hospital for a backache. "A very bad backache," she says.

Meredith talks to Bailey about Hunt's suggestion that she do general surgery. Bailey dismisses any concern Meredith has, saying that it's in Meredith's genes and makes perfect sense. They meet Webber's patients -- two bickering sisters, one of whom is giving her liver to the other. The donor sister is making a big issue of how she's risking her life to help her sister.

Cristina doesn't want Meredith to pick cardio, because it's hers. Alex shows Cristina an X-ray from the wrought-iron fence patient and says the man's heart is "the size of a football." Cristina and Teddy hatch a plan, and Cristina goes in when no one is around and talks to the patient's wife about how good of a doctor Teddy is and she'd assumed Teddy would be on the case.

The bickering sisters are at it again, with the donor making an issue of how she's missing a beach vacation with her family to save her sister's life. The ill sister says she'll never ask her for anything again. The arguing continues until the sick sister coughs up blood.

Bailey tells the woman to try not to get worked up for the next couple of hours before her surgery. She's refusing to take her sister's liver now, but the doctors convince her she has to do it.

As Lexie preps him for a scan, the 11-year-old boy asks Lexie if his tumor has grown more. Lexie is surprised he knows, but he says he overheard doctors at the last hospital talking about it. He doesn't want his mom to know that he knows his situation because that's the only thing that's making her happy. He asks Lexie if she thinks he's going to die, and she tells him her mom could not have picked a better doctor for him. He asks Lexie to promise she won't tell his mom that she knows about his tumor.

April and Avery are talking about moving out. Alex walks in on the conversation and says he's in, but April doesn't want to live with him. Alex asks Avery if he'll move in with him, but Avery doesn't want to give up April's cooking and cleaning. Meredith comes into the break room and scours Teddy's "widow casseroles," because she needs food for Zola's party.

Callie and Arizona try to talk Sloan into telling Julia he loves her. Teddy walks in on the conversation and Sloan leaves.

Webber starts the liver transplant -- his 10,000th surgery -- and several nurses stand around and applaud as he gets going. A few minutes later, a woman brings Adele into the hospital, saying she found Adele walking the street trying to get to the hospital -- which is seven miles from her home. April tries for a moment to figure out what to do, and in that time Adele disappears.

April quickly finds Adele in the empty office that used to be his, and she's convinced he finally left her. She breaks down and April tries to comfort her.

In surgery, Bailey plays up for Meredith all the appealing aspects of being a general surgeon.

Lexie goes to get her 11-year-old patient, whose mom starts crying when he's about to head out for surgery.

Hunt tries to talk to Teddy, who ignores him and then shouts at him when he tries to grab her arm as she walks away.

Derek and Lexie start the surgery, and Derek asks Lexie to walk him through what he should do. She's unsure at first, but then lays out a plan that Derek seems happy with.

April takes Adele to the gallery where she can see that Webber hasn't left her and is in surgery, but when Adele sees Meredith next to him she thinks it's Ellis Grey and goes into a tirade through the intercom about how he'd promise her he wouldn't work with Ellis again and questioning Meredith (who she's calling Ellis) about what kind of woman she'd have to be to break up a marriage. Meredith offers to scrub out, but Webber tells her he needs the extra hands. Adele continues to shout and Meredith suggests to him that he share with her a happy memory, which used to work with her mom. Webber starts singing "My Funny Valentine," which turns into a duet, all through the intercom. Webber reminds her about their wedding day, when they played that song. April cries at all this. Webber tells Adele he loves her, then turns to Meredith and asks her to tell Bailey to cancel the party.

Lexie runs through three more possible approaches for Derek, each of which he says will kill the boy. He's convinced there's no longer any chance the boy will survive, saying he thinks they have to close up. Lexie tells Derek that the boy knows about his tumor and that she promised him they would try to fix it. Derek tells Lexie to leave the O.R. After she does, he tells the nurse it's time to close up.

Hunt goes to what was supposed to be Webber's party and sees Alex serving up a piece of cake, instead of being in the wrought-iron fence guy's surgery. Alex says Teddy and Cristina took that, much to Hunt's surprise.

Derek is cleaning up and Lexie says he has to tell the boy about the tumor. Derek says they can't. It's his mother's decision. Lexie thinks the mother will continue to lie to her son and tell him it went fine, rather than telling him he's going to die in three months.

Hunt finds Teddy and Cristina doing the surgery. He's upset, but Cristina says the surgery is complicated so they should discuss it all later. He wants to see them afterward.

The 11-year-old boy's mother is tearfully telling him they can go on some of the trips they've been wanting to take because there will be no more surgeries. Derek and Lexie watch this, and the boy turns to Derek and says, "You didn't do it."

"What?" Derek asks. The boy says Derek told him after the surgery he'd be stuck in there for a few weeks. Derek tells him that sometimes when the doctors "get in there, things change -- that's why you get to home." The boy's mother tells him he's going to be OK, and he tells her she's going to be OK, too. He tells her he's "going to be with dad in heaven." She cries.

After the surgery, the sisters continue to argue. Meredith finally has to put them both in a timeout.

Teddy offers to stay the night with the wrought-iron fence patient, eating her "widow casserole" and feeling sorry for herself. Cristina heads off to Zola's birthday party.

Meredith finds Webber at the party, who says Adele insisted he attend. April asks Alex for money for the deposit on a new place. Alex is surprised she wants him to move in with her and Avery, and she seems to be, as well, but it's all going to work out.

Derek and Meredith agree to scrap Zola's name off the cake -- after taking a picture of it -- and decide to let Webber blow out the candle in honor of his 10,000th surgery.

Callie and Arizona give Sloan a hard time in front of Julia -- using the word "love" around her as much as possible. She goes to get a drink and Sloan tells them to stop. He says he's "not there yet," and wants to take it slow. He says he rushed it with Addison, "tried to force Lexie to be a grandmother," and he's not doing that again.

Hunt arrives and sees Cristina talking to Zola about how big the heart was she operated on, and he looks upset.

Derek sees Lexie, who's looking bummed. He tells her "they're not called 'lost causes' because they're fun." He offers to flip the coin over whether she'll keep doing lost causes or "the fun stuff." She catches the coin in mid-flight, insisting that she's in.

Cristina apologizes to Hunt, and he asks if she's sorry she did it or that he's upset. She doesn't respond. He tells Cristina that Teddy never came to find him after the surgery, and Cristina say Teddy is tired. Hunt says he's taking Cristina off Teddy's service permanently, and that he's not sure what Teddy will do without Cristina as her "security blanket."

"Absolutely not," Cristina tells him. She repeats it. Hunt says she should be thanking him because he could have fired them both. Cristina tells Hunt he has "no idea what's going on here."

"You made me operate on her husband, and now he's dead," she says. "She gets whatever she wants. Do you understand? Anything she wants from me -- ever."

Meredith tells Webber she's still not sure about general surgery because everyone keeps comparing her to her mother. Webber tells her that she's nothing like her mother, but she has a tremendous gift and she shouldn't waste it.

Hunt tells Cristina it was "an impossible situation," and she says it was his call to have Cristina operate on Henry and tell her who was on the table, and then had Cristina lie to Teddy. She tells him those are the big decisions and consequences he has to live with if he wants to be chief. It turns into a bigger argument about how it's "always" been about Cristina -- "You get whatever you want all the time," he says.

Webber is in the living room taking everyone down memory lane, telling everyone about his first surgery, but Hunt and Cristina's yelling in the kitchen distracts everyone.

Cristina claims "it was one surgery," but Hunt says it's not about one surgery. It's about the life he envisioned for himself. She asks him to try and forget it, but he shouts, "You killed our baby -- you don't ever forget that."

The entire house falls silent.

Main Cast

 * Ellen Pompeo as Dr. Meredith Grey
 * Sandra Oh as Dr. Cristina Yang
 * Justin Chambers as Dr. Alex Karev
 * Chandra Wilson as Dr. Miranda Bailey
 * James Pickens, Jr. as Dr. Richard Webber
 * Sara Ramírez as Dr. Callie Torres
 * Eric Dane as Dr. Mark Sloan
 * Chyler Leigh as Dr. Lexie Grey
 * Kevin McKidd as Dr. Owen Hunt
 * Jessica Capshaw as Dr. Arizona Robbins
 * Kim Raver as Dr. Teddy Altman
 * Sarah Drew as Dr. April Kepner
 * Jesse Williams as Dr. Jackson Avery
 * Patrick Dempsey as Dr. Derek Shepherd

Guest Stars

 * Loretta Devine as Adele Webber
 * Holley Fain as Dr. Julia Canner
 * Cheryl White as Mrs. Connors
 * Ryan Wynott as Wes Connors
 * Nia Vardalos as Karen
 * Peri Gilpin as Marcy

Co-Starring

 * Stacie Greenwell as Mrs. Vanderburg
 * Jes Macallan as Hillary
 * Kathy Jensen as Shannon
 * Leith Burke as Dr. McQueen
 * Rachel Andersen as Nurse Carol
 * Ray Singh as Nurse Howard

Notes and Trivia
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 * This episode's title originated from the song Hope for the Hopeless, originally sung by A Fine Frenzy.
 * This episode scored 9.42 million viewers.

Quotes

 * Cristina: What about Ortho? Callie would be a great mentor.
 * Meredith: Bones?
 * Cristina: Oncology.
 * Meredith: Depressing.
 * Cristina: Trauma.
 * Meredith: I've had enough trauma for one lifetime.


 * Alex: Don't worry, Yang. I'll send you pics from the surgery.


 * Owen (to Cristina): You... killed our baby!! You don't ever forget that!