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

 is the thirteenth episode of the eighth season and the 161st overall episode of Grey's Anatomy.

Short Summary
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?

Full Summary
Episode in detail.

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 (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 Montgomery-Shepherd

Guest Stars

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

Notes and Trivia
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 * This episode's title originated from the song If/Then, originally sung by Ras Kass.
 * This episode scored 9.71 million viewers.
 * It is an alternate reality episode.

Character changes:


 * Derek Shepherd is very sad and miserable and still married to Addison, never had a relationship with Meredith; his nickname is McDreary instead of McDreamy, and he's professionally stuck, unwilling to teach, publish, or be creative. He is also known as Bad Shepherd.
 * Meredith Grey is a lot happier, had 2 loving parents, adopted the surname Webber, is engaged to Alex, and hates Cristina as she follows cardiothoracics too.
 * Cristina Yang has straight hair and is very bitter towards the others, except Owen. Also, since Meredith and Derek never were in a relationship, she was the only intern sleeping with an attending, which makes the others very cruel towards her.
 * Alex Karev a lot nicer person, wears glasses, and is the current chief resident and is most likely pursuing general surgery as he and Bailey work very closely together.
 * Ellis Grey does not have Alzheimer's, is with Richard, and is a loving mother and also is the chief of surgery and chief of staff.
 * Richard Webber chose Ellis over Adele and became Meredith's father. His leader traits were overshadowed by Ellis'.
 * Addison Forbes Montgomery is still with Derek, though is pregnant with Mark's baby, and still works at Seattle Grace Hospital as both neonatal and OB/GYN-perinatal chief. She is known as Good Shepherd among the residents.
 * Owen Hunt married Callie, had 3 children with her, and still shows anger management issues due to postraumatic stress.
 * Callie Torres married Owen instead of Arizona, chose cardiothoracic surgery instead of orthopedic surgery as suggested by Ellis, and apparently never faced her lesbian self.
 * Arizona Robbins did not marry Callie and apparently barely knows her.
 * Miranda Bailey is still shy and has zero confidence in herself from not having Richard teach her. Alex is the one who reinforces her self-esteem every now and then. She also has her intern-year dreadlocks.
 * Lexie Grey is a drug addict with tattoos and never went into medical school. She stated that both Thatcher and Susan are dead. She knows about Meredith but has never met her.
 * Mark Sloan does not work at Seattle Grace.
 * April Kepner is Meredith's best friend, her person, and had a casual fling with Alex. Instead of focusing on neurosurgery or trauma surgery as her focus, April seems to be focused on OB/GYN and/or neonatal surgery.
 * Jackson Avery may not have followed plastic surgery as Mark doesn't work in the hospital. It is suggested he follows trauma surgery as a specialty.
 * Charles Percy was not shot and is alive and is in love with April.

Missing characters:


 * Teddy Altman is still in Iraq.
 * George O'Malley ran away after failing intern exam; it's assumed that he is alive.
 * Izzie Stevens was fired for cutting Denny's LVAD wire after Meredith told her mother.
 * Reed Adamson was possibly fired during the merger and it is to assumed she was never shot and is still alive.
 * Preston Burke left Washington State after his relationship with Cristina, reason unknown.
 * Neither Zola Grey Shepherd nor Sofia Robbin Sloan Torres exists in this reality.
 * Erica Hahn is not mentioned.

Hospital changes:
 * Rather than merging, Seattle Grace Hospital merely absorbed Mercy West Medical Center, and Ellis planned on absorbing Seattle Presbyterian Hospital, as well.
 * Instead of the blue color scheme, the surgical staff wears a gray color scheme, with light gray for the surgical residents, and dark gray for surgical attendings.
 * Scrub caps are no longer personalized; instead they match the color of the surgical gown, which is purple.
 * Scrub shirts worn by men are of a v-neck style, while the women wear an a-neck style.
 * Surgical masks are no longer tied behind the head; instead, they loop behind the ears, similar to the surgical masks at St. Ambrose Hospital.
 * Department chiefs and/or senior attendings do not wear scrubs when outside the OR; instead they wear dress clothes with their lab coat.
 * SGH's insignia is more intricate, adding a shield, stepped-formatting with the font, and laurels.

Quotes

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


 * Charles: 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.


 * Jackson: Lucy … you got some splainin' to do.