Beat Your Heart Out

"Any first year med student knows that an increase heart rate is a sign of trouble. A racing heart can indicate anything from a panic disorder to something much, much more serious. A heart that flutters, or one that skips a beat, could be a sign of secret affliction or it could indicate romance which is the biggest trouble of all. It seems we have no control what so ever over our own hearts. Condition can change without warning. Romance can make the heart pound just like panic can. And panic can make it stop cold in your chest. It’s no wonder doctors spend so much time to keep the heart stable, to keep it slow, steady, regular to stop the heart from pounding out of your chest from the dread of something terrible or the anticipation of something else entirely."

- Meredith Grey

 is the fourteenth episode of the fifth season and the 92nd overall episode of Grey's Anatomy.

Short Summary
Izzie has the interns do a barrage of tests on her to find out what's wrong with her. While the Chief tries to get Bailey to stay in general surgery, Dr. Dixon and Dr. Robbins both tell her that she is really meant for peds. Lexie decides she wants to go public with Mark, withholding everything from him until he does, and Arizona kisses Callie. Knowing that Meredith is ready for marriage, Derek gets ready to propose, but his plans for a grand gesture are interrupted. thumb|300px|right

Full Summary
Izzie was in the clinic pricking herself with a needle in the arm, while Meredith's voiceover was saying an increased heart rate is a sign of trouble. Cristina and Hunt then had a bit of a moment in the on-call room that resulted in him telling her she should wear her hair up more, because it shows off the back of her neck, which he likes.

Lexie started pouring out the details of her relationship with Mark to Callie, but Callie didn't want to hear it.

Meredith asked Cristina to pre-read the next part of her mother's journal because it might discuss Mer's mom's affair with the chief.

Derek carried an engagement ring and told Sloan he had to be careful with how he approached Meredith with the question. Meredith and Lexie, meanwhile, waited for an ambulance to arrive. In it was a pregnant woman (played by Jennifer Westfeldt) who'd accidentally run over her husband. She was pretty frantic about it and passed out.

Derek and Meredith talked about how they were a "nice couple" and would have "cute babies." "Yeah, but not as cute as ours," Meredith said, causing Derek to pause for a moment and give a slight smile.

The chief told Bailey he was promoting her to attending in general surgery. He was going to make the recommendation to the board. First, he said, she had to help Dr. Dixon on a case.

Bailey had just told the chief she'd rather not work on another dying child anyitme soon and she walked in to find Stacy Pollack, 9 years old, was the patient with Dr. Dixon. She had VSD.

A couple in the lobby wanted to talk to a "grown up" about a problem they were having. They tried "Number 9" in a magazine article entitled, "20 Steps to Reignite Your Night." The husband was the one "with it stuck in" him.

The pregnant woman's husband started muttering "Cheeseburgers." He said his wife was more relaxed when she had cheeseburgers.

Bailey told Cristina that if Stacy "so much as looked as if she's going to die" she'd be out of there. The girl asked Bailey how long it would be after they fixed her heart before she'd be able to play soccer again.

Cristina warned Derek not to do "some big, romantic McDreamy thing" because Meredith would hate that. He reminded her that Meredith built the house of candles, but Cristina reminded him that Meredith did that for him, not for herself. Meredith wanted an update on her mom's journal. Cristina said it was "chastely hot," and that it was all stolen glances and stuff like that. Then Hunt just happened to walk by and we were treated to the slowest minute in "Grey's Anatomy" history -- a slow walk where Hunt and Cristina were side by side with soft piano music playing in the background.

Sloan told the chief about Derek getting ready to propose to Meredith. The chief congratulated him and then Hunt came by and got in on the rumor. Derek then asked Sloan not to tell anybody else. "I thought I could trust you," Derek said.

The interns were giggling about Mr. Kramer, the patient with the mysterious "thing" lodged inside of him and Alex tried to set them straight. But he couldn't help giggling a little, too. The chief gave them a lesson in being professional.

Sadie was having trouble finding a vein in a woman's arm and Izzie came by to help. She had Izzie draw some of her own blood, then told Sadie to "go ahead and run them both" for tests. She then paused for a moment and told all the interns in the clinic to run every tests by her before doing them.

In surgery, Callie and Sloan chatted about him getting a clean bill of health from Hunt. Sloan then said he thought he'd have to break up with Lexie. Meredith walked in and the patient -- the husband of the pregnant woman. Lexie was in the woman's room on the phone with the O.R. when she heard things weren't going well with the man's surgery. She tried to assure the woman things were fine and it was just taking longer than expected. Then the woman had a seizure.

Bailey's 9-year-old patient was in serious pain and Bailey had to use a massive syringe to relieve some of the pressure. Arizona came in and confirmed the diagnosis on Stacy and Dr. Dixon said she'd need surgery. Bailey told Arizona she should stay because she was sure she'd be scrubbing in on another child's surgery. She didn't want the burden of another child's life in her hands. Arizona gave Bailey a pep talk about how she could hand Stacy the rest of her life.

Sloan told Callie that if Lexie because Derek's sister, he wouldn't be able to stay with her. Callie was sick of hearing about it because she's "celibate." She told Sloan celibacy is lonely and he should just let himself be happy before he finds himself alone.

Izzie walked Sadie through a chest X-ray, which she had done on herself.

The chief wanted to know from Derek how he was going to propose. He encouraged Derek to go for the grand gesture. Meredith walked up and the conversation ended awkwardly. Derek was doing a quick exam on Jen Harmon, the pregnant woman, and she noticed the ring case in his pocket and said, "What's that?" Derek asked Meredith to leave the room, then told Mrs. Harmon and Lexie he was going to propose. She said her husband proposed in a grocery store because that was where he first saw her.

In surgery, Bailey was shaken up by Dr. Dixon's analysis of Stacy's heart being one of the most diseased she'd ever seen. She said that without a heart and lung transplant, she would die.

Dixon told Stacy's parents the news while Bailey spent some time in the hospital's day care area playing with her son.

Izzie was talking the interns through giving her an MRI when George walked in and mocked her, calling her a crazy person who was giving herself expensive tests for no reason. He said she'd eventually lose her job.

Meredith told Lexie and Cristina -- as they walked with Jen -- about Derek's odd behavior, noting that it started when she brought up having babies. She wondered if Derek didn't want babies with her. Lexie and Jen both told her that wasn't true. Before her MRI, Jen told Derek that if he was going to propose, she should do it soon. "She's really freaking out," she said.

At lunch, the residents and the interns laughed about the list of 20 things from the magazine. Meredith said she would try 15 and Izzie and George quickly said, "Don't try 15!" Izzie said she would try 16, prompting her and Alex to get up together and leave. "Don't do 16 too fast," Lexie said. "You can get hurt -- badly -- I've heard."

Cristina turned to Meredith and said, "You know who likes a good 12?" Then she tapped Meredith's mom's journal.

Bailey came to Stacy's parents and tried to give them an option that wouldn't confine her to a bed. She said they could give Stacy a backpack with a device that would administer her medicine until she got a heart. Dr. Dixon didn't seem comfortable with this plan. She said they should have discussed that option earlier. The family was so excited, they started thanking the doctors and the mother hugged Dr. Dixon, which sent her into a shouting fit -- a symptom of her Aspberger's.

Dixon went into a bit of shock and needed to be hugged to calm her nervous system.

Jen, the pregnant woman, was diagnosed with a brain aneurysm. Derek told her they would operate on it the next day, after her husband recovered from the complications of his surgery. She didn't know about any complications and got upset with Lexie for lying to her. Meredith told her she needed to stay calm, but Jen said she couldn't because they just her she has a "time bomb" in her head.

The chief, Alex and an intern finished up the extraction of whatever was in Mr. Kramer's hindquarters. It sounded metallic as it was dropped into a tray. Mr. Kramer regretted trying to spice things up, but the chief said he and his wife were doing just fine, "bending over backwards" to try things that would make the other happy. Afterward, the chief let himself share in some laughs about saying "bending over backwards."

Sadie brought Izzie the results of her blood test and told her she was anemic. Izzie was relieved, but then when she got the real patient's test results, she saw that the woman had cancer.

Lexie told Sloan she didn't want to keep secrets. "We're having a relationship," she told him, and said she needed to be in it in front of Meredith and Derek. "If we can't do that, then I can't do this," she said, before walking out.

Cristina and Hunt were having another one of their slow-motion, piano-music-playing moments as they walked toward each other. But Hunt was distracted when he saw a blond woman in the hallway and he told Cristina to leave him alone. He freaked out and Cristina "applied pressure to his nervous system" (she hugged him) to calm him down.

Dr. Dixon told Bailey that everything she does -- the way she handles pediatric patients -- indicates that she's not a general surgeon, she's a pediatric surgeon.

Meredith confronted Derek and asked him to tell her if she didn't want babies with her "crappy DNA." He said he does, but he had to go.

Arizona told Bailey that Dixon was right about her being a pediatric surgeon. Bailey said the fact that she panicked about Jackson's surgery made her unqualified for pediatric surgery. Arizona said that makes her "uniquely qualified" for pediatric surgery.

Cristina was staying overnight in the on-call room with Hunt laying in her arms. "He's planning to propose," Cristina said. She said it was the chief she was talking about. He had told Meredith's mom he was going to leave his wife and come propose, "but I don't think he ever did."

"That's said," Meredith said. "Or romantic."

At the bar, Arizona walked into the restroom and found Callie. She said "people talk," and said she "knows things" about Callie. She told Callie that when she was done being upset "there will be people lining up for you." Callie asked her for some names, but Arizona didn't say anything. Instead, she leaned in and kissed Callie. Then, she giggled and walked out.

Back at the house, Derek was filling his and Meredith's bedroom with roses and candles. He worried it was cliche.

Sloan told Derek "it's great, isn't it. When you feel so strongly for someone and it isn't about the sex. It is. It's true."

Derek laughed and told Sloan, "You shouldn't talk like that."

Derek's phone rang after Sloan walked out. He answered, "Addison? What happened?"

Izzie was back at the hospital going through some files and smiling. Cristina laid in the on-call room bed, reading the journal.

Meredith came home as her voiceover talked about keeping heart rates slow, steady and regular, "to stop the heart from pounding out of your chest, from the dread of something terrible, or the anticipation..." she said as she walked into her bedroom, which was suddenly not filled with flowers. "... of something else entirely.

Meredith found a single rose pedal still left under the bed and looked at it, somewhat suspiciously.

Main Cast

 * Ellen Pompeo as Dr. Meredith Grey
 * Sandra Oh as Dr. Cristina Yang
 * Katherine Heigl as Dr. Izzie Stevens
 * Justin Chambers as Dr. Alex Karev
 * T.R. Knight as Dr. George O'Malley
 * 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
 * Patrick Dempsey as Dr. Derek Shepherd

Guest Stars

 * Jessica Capshaw as Dr. Arizona Robbins
 * Jennifer Westfeldt as Jen Harmon
 * Ben Shenkman as Rob Harmon
 * Peter Mackenzie as Warren Kramer
 * Laura Allen as Beth Whitman
 * Brandon Scott as Dr. Ryan Spalding
 * Melissa George as Dr. Sadie Harris
 * Mary McDonnell as Dr. Virginia Dixon

Co-Starring

 * Susan Merson as Lorraine
 * Eric Payne as Dan
 * Martha Boles as Lisa
 * Lori Harmon as Rachel
 * Jamey Dettman as Stacy Pollock
 * Mark Saul as Intern Steve
 * Molly Kidder as Intern Megan
 * Joseph Williamson as Intern Pierce
 * Winston Story as Intern Leo
 * Kate Anthony as Nurse

Notes and Trivia

 * This episode's title originated from the song Beat Your Heart Out, originally sung by The Distillers.
 * This episode scored 15.20 million viewers.
 * This episode leads into the Private Practice episode Acceptance, and runs in parallel to the episode.
 * This is the start of the Grey's Anatomy-Private Practice crossover.
 * This episode features the first meeting and first kiss of future wives Callie Torres and Arizona Robbins.
 * This episode introduces Callie with bangs in her hair.

Quotes

 * Derek: Addison? What happened?


 * Derek: She said a thing about babies. Like babies are a totally ordinary idea. She's not afraid, she's ready.
 * Mark: When are you gonna do it?
 * Richard: Do what?
 * Mark: Shepherd's proposing.
 * Richard: No kidding? Outstanding! How're you gonna do it?
 * Derek: I don't know. Just decided.
 * Owen: Morning.
 * Mark: Shepherd's proposing.
 * Owen: Congratulations, that's a big step.
 * Derek: Thank you very much. (to Mark) You just gonna tell everybody now?
 * Mark: You need advice. Hunt, you ever proposed before?
 * Owen: Uh sorry I'm...not the guy to ask. When are you gonna do it?
 * (Meredith approaches)
 * Derek: Well more importantly how am I gonna do it?
 * Mark: (sees Meredith, coughs) So, what do you use, like a twist drill for that?
 * (Richard leaves)
 * Derek: Well not if you don't want a partial, pridal hematoma!
 * (Derek, Mark and Owen do big fake laugh.)
 * Meredith: (confused) Hi... (walks away)


 * Callie: Alone people don't like to hear about the together people...It's just sort of mean. It's sort of like bringing a 6-pack to an AA meeting.