If/Then

"The baby you have is the baby you were destined to have. It was meant to be. That's what all the adoption people tell you, anyway. I'd like to think it's true. But everything else in the world seems so completely random. What if, one little thing, I said, or did could have made it all fall apart? What if I'd chosen another life for myself, or another person? We might have never found each other. What if I'd been raised differently? What if my mother had never been sick? What if I'd actually had a good father? What if? What if?...What..if? Your life is a gift. Accept it. No matter how screwed up or painful it seems to be. Some things are going to work out as if they were destined to happen. As if they were just meant to be."

- Meredith Grey

'''As Meredith puts Zola to bed and falls asleep, she begins to wonder -- what if her mother had never had Alzheimer's and she'd had loving, supportive parents? The reverberations of a happy Meredith Grey change the world of Seattle Grace as we know it. What if she had never met Derek in that bar and he had never separated from Addison? What if Callie and Owen had become a couple long before she met Arizona? And what if Bailey never evolved from the meek intern she once was?'''

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Full Summary
Thinking that everything in the world seems "so completely random," Meredith is in a "what if..." kind of mood. We see how her life and everyone at the hospital's lives are now, and Meredith falls asleep.

Meredith wakes up in a new "what if...?" word, in which she's wearing pink and living with her mother and "dad," who's actually Dr. Webber.

At Seattle Grace, we see plenty of familiar faces -- Bailey's in her intern-era dreadlocks, Derek and Addison seem happy and Addison's pregnant, Arizona is looking kind of edgy, Callie wheels in twin sons in a stroller and has a young girl with her -- and Owen is their dad. Ellis walks in as chief of staff, and she's being congratulated on her third Harper Avery Award. She's giving the surgeons a hard time for not doing enough. Callie and Arizona are arguing over a risky and innovative procedure being done on a patient. Bailey shyly presents what she's working on for the day -- an extended whipple -- and Ellis takes it from her.

Meredith shows April an engagement ring, but we don't know who it's from. Meredith tells April that she'll find someone, and mentions that Charles is really into her. Then we see Charles -- the Mercy West doctor who came over in the merger and was killed in the big shooting incident. Cristina walks into the locker room and everyone goes silent. Alex walks in and gives a peppy talk to the others. Then we see that he is the one who's engaged to Meredith.

After the staff meeting, Addison and Callie talk about Owen and Callie says she thinks they're "over it." She's referring to Owen's PTSD from Iraq, and Callie mentioned that some guys Owen Skypes with are helping him cope -- especially one named Teddy.

Webber gives Derek a pep talk and encourages him to pursue a clinical trial he's been talking about. Meredith and Derek end up waiting for an elevator next to each other, and Derek doesn't talk to her.

A tattooed young woman who's overdosed is wheeled in. It's Lexie.

Ellis tells the press to observe her surgery. Meredith asks if she can scrub in, but Ellis tells her to go work on a heart surgery. Alex learns from Bailey that Ellis has taken their whipple, and he tries to cheer the timid Bailey up.

Avery meets with Lexie, who gives her name as Lucille Ball. When Avery tells Lexie she's at Seattle Grace, she sighs.

Arizona and Callie check on their lung patient, who seems to have encountered some kind of problem with the risky treatment Callie has started, but everyone is happy when the boy starts breathing better than he should. Arizona gives Callie a hug, which gives Callie a moment of pause.

Bailey is trying to explain to her patient why she won't be doing the surgery, and that Ellis will be doing it instead. Alex tells them it's a "huge upgrade," and says it's like they've been driving a Civic and now they're getting a Jaguar. Ellis walks in and hurriedly explains the procedure she'll be doing before rushing out the door -- but not before Alex asks for and receives permission to scrub in. Bailey looks at the chart and leaves the room.

Cristina tells Lexie she's going to need some complicated procedure because of all the cocaine she's enjoyed. After Cristina leaves, Lexie tells Avery that both of her parents are dead. Her mother had "some stomach thing" and her father killed himself. She then admits she has a half-sister who works at the hospital, but they've never met and she doesn't think Meredith would want to.

Addison and Derek work together on a newborn baby that has a tumor. It seems Derek and Addison aren't getting as long as swimmingly as it previously appeared.

Meredith as a heart-to-heart with Webber.

The lunchtime banter includes Meredith, Alex, Avery and April -- all watching Cristina eat alone. They talk about how Cristina screwed an attending -- Preston Burke. They also refer to Izzie, whose Denny story seems complete, but it ended with Meredith turning Izzie in. Alex also mentions in passing that O'Malley "failed his intern exam and was never seen again."

Bailey is telling Callie she's concerned with the approach Ellis is going to take on her patient, but Callie is focused on Arizona having lunch with another female doctor. Bailey says that doctor is in ortho, and Callie says she should have stayed ortho, but "when Ellis Grey says you're good for cardio..." Meredith shows up and asks Callie if she can scrub in on her heart surgery. Callie first says no, but Meredith notes that her mom suggested she ask, and Callie suggests that she and Cristina split it.

Avery finds Lexie packing up to leave, and when she recites the heart procedure step by step he's impressed enough to suggest that she go to medical school and try to turn her life around. She cries.

Cristina sees Meredith's name (M. Webber, by the way) on the board next hers for the heart surgery and goes rushing into the on-call room -- where she finds Alex and April kissing. She chuckles and leaves.

Alex tells Cristina that if she says anything to Meredith, he'll make sure she never gets another surgery. Cristina tells Alex to change the board, but he says Callie changed it in the first place.

In surgery, Addison and Derek are having a personal conversation about how he's never home, stays in "that stupid trailer" on his land and planning a house he's never going to build.

Bailey is worried that the veins Ellis is planning to graft aren't suitable. Alex tells Bailey to tell Ellis herself, but Bailey can't bring herself to do it.

Cristina goes to complain to Owen, all the while Avery is trying to get Cristina to give Lexie a pacemaker. Owen gets upset with all the commotion and puts his fist through a window. Cristina helps bandage him up, then leaves for surgery. She says she thought his situation was supposed to be getting better, and he asks her not to tell his wife.

In surgery, Alex tells Ellis he's thinking of having his wedding with Meredith in Hawaii, but Ellis insists on doing it locally and Alex agrees. Ellis then sees the problem with the veins that Bailey was worried about and panics. She asks Alex if he knew about it and he says nothing. She says she wants Bailey in the room immediately.

Cristina and Meredith argue over which approach to take with their shared heart surgery. Meanwhile, Owen tells Avery that someone made off with a bunch of drugs from the hospital and the dispensary was accessed with his ID card. Avery realizes he's missing it and goes to find Lexie, who is gone.

Ellis is upset with Bailey for not having told her about the veins. Alex then nicks the carotid artery while suturing the patient up, and Ellis -- looking up at all the press in the gallery -- says they're trying to kill her.

Addison and Derek argue some more and Addison says she can only hope Derek is more interested in being home when the baby comes. She then asks him if he even wanted a baby with her. She asks him if he loves her, and he can't look her in the eye.

Cristina and Meredith bicker again when something goes wrong in their surgery, and despite Callie telling them to use Meredith's approach, Cristina jumps in and fixes the problem her way.

Ellis goes off on Derek, saying that Addison threatened to quit and that they can't bring their personal business into the hospital. She also tells Derek he's been a disappointment every since he arrived at the hospital and he needs to get it together. He says the residents have a nickname for him and it isn't flattering, but she does say what it is.

Meredith and Cristina fight again in the locker room, with Cristina saying that Callie only took Meredith's side because she's the chief's little girl. Meredith says they'd all be working under Preston Burke, but Cristina "screwed" everyone out of that opportunity. Cristina tells Meredith that since she's getting personal, she should ask what "Prince Charming and the Virgin Mary" do in Alex's office (referring to Alex and April). Alex tries to play it off, but April starts crying and Meredith leaves.

Callie and Arizona rejoice over their patient's progress and decide they should celebrate with a drink. When Callie's kids show up, they decide they'll have that drink "someday."

Meredith is sobbing in Webber's arms. Ellis walks in and tells Meredith she shouldn't have let Cristina show her up in her O.R. Meredith says she shouldn't have been in there because she wasn't prepared, and she only went in because Ellis pushed her. Meredith leaves and Ellis breaks down in Webber's arms next, telling him she wants him fire Bailey because she made her look like an idiot.

Owen finds Cristina and thanks her. Cristina suggests that he tell Callie that he needs help, but he's worried Callie will take the kids away. Callie and the kids show up and when Callie asks what happened to his hand, Owen says a junkie patient pushed him into a tray of instruments.

A man walks into the hospital carrying Lexie, who's unconscious. The man is Sloan.

Lexie's heart beat returns after some work from the doctors. Sloan then asks where Shepherd is, and someone asks him, "Which one?"

Derek, meanwhile, is giving Addison a speech in her office about how he also hopes everything will get better with the baby comes. Addison shakes her head and says, "It's not your baby." Sloan then walks out of a restroom.

Meredith finds Cristina and Avery still trying to revive Lexie. Meredith suggests they crack her chest and try to save her that way (which is the approach Cristina wanted to use in their earlier surgery).

Bailey finds Alex crying in the elevator because he had a chance to be better, but he screwed it up. Bailey tells him she just got fired, but she isn't crying in an elevator.

Meredith and Cristina work together to save Lexie, and we next see them at the bar celebrating. Meredith fumbles through a shot of tequila. Cristina leaves and Meredith finds herself alone at the bar -- for just a moment. Derek is sitting nearby and asks what the nickname is that the residents have for him. She says it's McDreary. He thinks that's apt, and Meredith tries to cheer him up. She says that this night, he doesn't have to be a world-class surgeon, he can just be a guy in a bar -- and he says she's just a girl in a bar. They get more drinks, and, as Voiceover Meredith says that things can work out as if they were just meant to be.

Music

 * "Portions for Foxes" - Rilo Kiley
 * "Ruby Blue" - Roisin Murphy
 * "Flowers Bloom" - High Highs
 * "Girl, You Shout!" - Dressy Bessy
 * "Fools in Love" - Inara George
 * "Into the Fire" - Thirteen Senses
 * "You Wouldn't Like Me" - Tegan and Sara

This episode's title originated from the song , originally sung by Ras Kass.

Quotes

 * Meredith: [to Cristina] We'd all be working under Preston Burke right now, but you screwed us out of it. Literally!


 * Charles Percy: Shoot me now.


 * Meredith: So how about tonight, you're not McDreary? You're just a guy in a bar.
 * Derek: And you're just a girl in a bar?
 * Meredith: I am. And I drink tequila.

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 Ramirez as Dr. Calliope 'Callie' Torres
 * Eric Dane as Dr. Mark Sloan
 * Chyler Leigh as Dr. Alexandra 'Lexie' Grey
 * Kevin McKidd as Dr. Owen Hunt
 * Jessica Capshaw as Dr. Arizona Robbins
 * Kim Raver as Dr. Teddy Altman (credit only)
 * Sarah Drew as Dr. April Kepner
 * Jesse Williams as Dr. Jackson Avery
 * Patrick Dempsey as Dr. Derek Shepherd

Special Guest Star

 * Kate Walsh as Dr. Addison Forbes Montgomery-Shepherd

Guest stars

 * Loretta Devine as Adele Webber
 * Robert Baker as Dr. Charles Percy
 * Kate Burton as Dr. Ellis Grey

Co-Starring

 * Kevin Brief as Barry
 * Marilyn McIntyre as Jill
 * Nicole DuPort as Theresa
 * Sonya Leslie as Rita
 * Nicole Cummins as Paramedic
 * Teresa Huang as Nurse
 * Kayla Madison as Allegra
 * Bryson Thomas as Riley