We Are Never Ever Getting Back Together

"Sometimes you just need to get out of town. Get a new perspective. But you can't always see that you need a new perspective, because you, well, need a new perspective to be able to see that. It's complicated. Open your eyes. What do you see? More possibilities? Does your new view give you more help? That's the goal. Sometimes your shifting perspective just makes you see what you've lost."

- Meredith Grey

 is the 22nd episode of the tenth season and the 218th overall episode of Grey's Anatomy.

Short Summary
Cristina looks to Meredith for advice as she assesses her future at the hospital. Derek and Amelia work together on a difficult surgery involving conjoined twins. Meanwhile, Jo is spread too thin when she tries to work on several cases at once and Stephanie realizes the truth about Bailey’s bubble boy case.

Full Summary
Cristina is walking down a hallway and she meets Owen on the stairs of the main hall. He tells her Cleveland Clinic wants know if she's available for central paper day. She asks if the winner of the Harper Avery Award wasn' available. He says the loss doesn't define her. In that case, she wants him to stop trying to get her to go somewhere to get over it. He replies that Zurich has been calling three times a day, wanting Cristina to come and give a presentation. He says the past year has been all about the conduit trial, so he wants her to let herself be flown, first class, and take time to figure out what she wants next. She knows what she wants next: to get this board meeting over with.

They walk into a conference, where everyone but Jackson has been waiting for them. Richard says this is everybody and asks Owen to shut the door. Callie asks about Jackson, but Richard says they can go ahead without him and then gives the word to Owen. He tells them that Dr. Russell, Cristina's boss, is leaving the hospital. He assured Owen four times it had nothing to do with the Harper Avery situation, which, Richard says, means it has everything to do with that. Arizona doesn't know which situation and Meredith informs her no doctor of this hospital will ever win a Harper Avery Award. Owen says Richard thinks they should appeal. Cristina realizes this means that she should appeal and humiliate herself. "This is not about you, Yang," Richard says. This is about the hospital getting more money for research and attracting more surgeons, as they're already losing top talent. Derek says Russell is a loss, but he's no Cristina Yang. Arizona says Cristina Yang can't be Cristina Yang if they're losing research funding. Callie thinks about people with track records and Meredith adds people with Harper Averies. Derek agrees appealing isn't the worst decision in the world and they all look at Cristina, who simply walks out. Meredith goes after her.

Meredith and Cristina get on an elevator. Cristina wants one day where she's not reminded about the Harper Avery. Now that the hospital is in danger of losing grants, she doesn't understand how the nomination could cost her grants. "Did everyone forget that I put a printed conduit in a kid and it worked?" she asks. Meredith says there are guys in Zurich didn't forget. She reminds Cristina they want her to come and speak about it. It's a free trip and it's only an hour of talking for five days in the Swiss Alps. Cristina says everyone will think that she's running away, but Meredith says that everyone here is angry for her and supports her. Cristina wants everybody to stop thinking of the hospital like a big family, as it's a business thing. Catherine Avery made a business decision and Cristina's moved on now. She wants everyone else to do too.

April is having an ultrasound with Jackson by her side. The obstetrician points at the little blueberry they've been waiting for. "Or not?" she asks when she sees their faces. She asks if the pregnancy wasn't the idea and they don't give a clear answer, leading her to ask if they're looking to terminate. They both say not. She gives April a picture of the baby and tells her to get dressed and come meet her in her office when she's done. April asks Jackson if he wants to terminate, but he repeats no. He wants them to be happy about this, which she is.

Amelia and Derek are walking front of an army of residents. He tells them that the Coopers have chosen to do the surgery here because they've done a lot of them, somewhat becoming good at it. This time, it's a little bit tricky because the brain is involved. The walk towards two girls, who are followed by a man with a suitcase. Derek asks Amelia if she's ready for this, and she says yes for the third time. He says it's a really big surgery, but she states that he asked her to do it and that it's too late if he's having second thoughts now. They meet with the girls, who turn out to be conjoined twins, who are only sharing a brain. "You must be Annie and Liz?" he asks the girls. "Nothing gets past you, huh?" Annie asks. Liz warns her to be nice, but Annie says it's unlikely he'll confuse them with other patients. The man is the girls' pediatrician, but for record, Liz says, they're 25 and he's longer their doctor. Their mother died a few years ago and since then he's really been there for them. Derek introduces himself as Dr. Shepherd, and so Amelia, explaining they're siblings. "Goodlooking doctors run in the family," she says. Derek introduces the residents as some of the roughly 40 people who will be working on them, so he's not telling them their names as they don't have to remember. Annie suggest he does the tell the names, so she and Liz can compare how much they remember after surgery, so they know if he cut through their memory center.

Alex drops Jo off at work in his fancy new car. Jo is late and tired and says they can't stay up till three anymore to talk about how much he loves his new job. "That's not all we were doing," Alex smilingly says. She kisses him and says she misses having him around. He says she can always call him if she needs help. That's not why she misses him and she asks why she'd need help. He said if she does, and she says she is perfectly capable of making medical decisions without the help of her boyfriend. He says she's getting weird and tells her to get out of the car before she escalates.

Amelia and Derek show the resident the most complex brain scans they will ever see, those of the Cooper twins. Amelia tells them that the women share brain matter, and seperating them will be more complicated because there's only sagittal sinus that delivers blood supply to the brain. First, they need to decide which lucky twin will get keep to keep that, and the other one gets a graft. "Dr. Grey and Dr. Webber..." Derek says.

"... will harvest the saphenous vein," Webber tells the residents, now in another room. Meredith says the saphenous vein will be used as the new sagittal sinus. "Meanwhile Dr. Torres will...," Meredith says.

"...be making a mold of the cranial bone flap, so then we'll be able to replace the missing part of the skull..." Callie says in another room, showing a model of the crane.

"...which we will cover with a flap for now, but I'll place skin expanders so we'll be able to fully cover the defect," Jackson adds while showing the residents a model of the skull.

Derek finishes the explanation by saying they need to move quickly and meticulously to turn one brain into two with the least amount of defecits. Derek asks the residents to let him now if one of them doesn't feel up for the challenge, as he needs each and every one of them to be fully confident in the OR.

Jo walks into Braden's room and tells the parents she's on Bialey's service today. The parents tell her Bailey has been avoiding them since they refused to let her put HIV in their son. Jo starts explaining it's not really HIV. Teresa says she knows, but they stuck to their guns and now Braden is doing better. Jo says Braden's numbers are good, so Bailey will maybe graduate him with solid food. David wants her to tell Bailey they're just glad Braden is doing better and that they're not mad at her.

Cristina finds Sabine in a lounge, pressing a pillow against her chest. It was Frankie's pillow. Sabine feels guilty about biting off the head of an orderly who wanted to take away the pillow, but Cristina tells her not to worry about it. While Sabine says the orderly was very friendly to their family, Cristina sits down next to her and says she's discharging all of them. Link is on the transplant list and he can wait for a heart at home and Ivy is doing better. She should recover in her own bedroom. Sabine is relieved that they can go home. Cristina says her family needs to heal after the pain they've been through and they can't do that at the hospital.

At the airport, the airline clerk is finishing up Cristina's order for a round trip ticket and he asks the destination to complete it. "Zurich," she says. He fills in the information.

In Zurich, Cristina is leaving Meredith a message while enjoying breakfast. She dives into the huge bed and starts talking about her time at the hotel.

Meredith is listening to Cristina's message. She rightfully predicts Cristina won't be able to get the chocolates Meredith asked for, as Cristina was too busy sleeping and she has to fly home pretty soon after her lecture. Meredith predicts Cristina will get them at the airport, which is what Cristina then suggests to do at the end of message. Meredith hangs up the phone and walks into the Cooper twins' room. Stephanie is ready for the ultrasound so they can decide which saphenous vein they'll harvest. She does an ultrasound on Liz's body and Annie says it's cold. They explain they share some of the sensory cortex. The twins and their former pediatrican talk about their life how it used to be and how it will be after surgery. They can't believe they'll be doing things on their own. Annie is thinking about their mom, and so is Liz because they're sharing a brain. Their mother always sad it was too dangerous to seperate them, but a cardiac defect has changed the situation. Their bodies won't sustain the situation much longer if they don't get seperated, meaning they'd die if they wouldn't do the surgery.

Jo finds Bailey and tells her that the Morrises think she's avoiding them. Bailey denies this and Jo says the parents are thrilled because Braden is doing better. Jo says his T cell count is 500, which lights up Bailey's face. Jo asks about solid food and Bailey says he can have whatever he wants. She wants Jo to get a full set of labs. Bailey walks off and Owen tells Jo he wants her to place a central line on one of his patients. Jo wants to do it right away, but Arizona stops her. She wants Jo to remove a JP drain and to put in a feeding tube on two of her patients. Arizona asks if they make tiny humans wait for things like drain removals and feeding tubes, to which Jo replies they don't. Arizona leaves and Jo takes a breath.

Derek tells the residents he will be in charge of twin A while Amy will take care of twin B. "Dr. Shepherd," Amelia corrects him. Amy makes her sounds like some sorority girl tagging along on his brain surgery, while in fact, she's his co-surgeon. Derek checks with the other surgeons if the roles are clear. They're all ready. "All right. See everybody in surgery," Derek says. While the residents leave the room, Richard tells them all to get something to eat. Derek wants to go over all of it once more with his sister. Before they do so, Amelia asks Meredith to get her an energy bar. Meredith assures Amelia that Derek thinks she's great, so she has no idea why he's treating her like she's... "Incomptetent," Amelia finishes her sentence. Because he's twin A, always is, always will be, which makes her twin B, Amelia answers the questions.

In the ER, April gives Arizona the chart of Rainbow Williams, a kid who needs an abdominal exam to rule out appendiciitis. Arizona decides to add Rainbow to her list of baby names, right after Buba, Tulio, and Agamemnon. Since Callie keeps shooting down the cute names that she suggests, she decided to hide the cute ones in a sea of terrible ones. April admires that she and Callie are so excited while they're not even pregnant yet. "Imagine how insufferable I'll be when there's an actual baby to talk about," a smiling Arizona says.

Cristina is answering questions about her conduit in Zurich. Suddenly, a familiar voice asks a question. It came from a man sitting in the dark of the lecture room. She answers it while the man gets up and starts walking down towards the stage. He keeps asking questions, which she easily answers. While asking a last question about a result of her conduit, the man steps into the light. It's Preston Burke. Cristina answers the questions, adding they were very surprised about the test results, but seemingly also talking about seeing him again. "Fascinating," Burke says, and then thanks her. Everyone applauds for her while she shares a look with Burke.

After the lecture, Cristina is talking to a doctor who wants the data of her initial patients. She advises him to mail her, while the doctor thanks Burke for having brought Cristina to the institute. While everyone leaves, Cristina says she thought it was someone named Weiss who arranged the lecture for her. Weiss is one of his staff, whom he used as he didn't think she'd responds to an invite coming from him, giving the circumstances of their last interaction. "Me in a white dress and you fleeing the state," Cristina summarizes. He says the follow-up to that is delicate. She asks why she's here. Because he wanted to talk to her about her unpublished details of her protocol. She can't believe he brought her 6000 miles to talk about that, but he replies it is his hospital after all. While she packs up her stuff, he says he wants to return the favor by showing her what he's been working on. She can scrub in on his surgery this afternoon. She says she has to make phone call. He'll catch up with her later then, but tells her to say hello to Meredith for him before leaving the room.

Owen sits down with Meredith in the cafetaria. She's listening to her voice mail, as she and Cristina keep missing each other. Owen asks if she's having a good time. Her speech went well, Meredith says. She then hears that Burke is back and she can't believe her ears when she hears this. Owen asks what it is, but she lies and says that Cristina got a standing ovation. Owen knew the trip would be great for her while Cristina's message asks Meredith to call her back.

At another table, Stephanie and Shane are helping Leah to practice burring holes in a skull, as Shepherd chose her to do that part of the surgery. Last time Leah burred, she burred into the table, which makes her doubt herself. Stephanie asks Jo how the scutt work is, and Jo replies she's actually killing it. Meanwhile, Leah drills through the skull into the ketchup packages they place in the skull, meaning she would've killed the patient if it were real. Leah wants to give up, but Shane says it was only her first one so she now knows how hard she has to go. He hands her the drill and she tries again.

April and Jackson are also having lunch together. She's kinda shocked that the first option tossed on the table for a pregnant woman with mixed feelings is termination, but he says the OB was just doing her job. She wants him to be on her side, which he claims he is. He just doesn't think they need to vilify the OB for one comment. April doesn't want to fight, so she suggests Phoebe as a baby name. He thinks Phoebe Freebie sounds slutty, but says it's cute when he sees her disappointed face. Jackson then walks up to Dr. Webber to talk about the board meeting he pulled off without him.

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
 * Kevin McKidd as Dr. Owen Hunt
 * Jessica Capshaw as Dr. Arizona Robbins
 * Sarah Drew as Dr. April Kepner
 * Jesse Williams as Dr. Jackson Avery
 * Camilla Luddington as Dr. Jo Wilson
 * Gaius Charles as Dr. Shane Ross
 * Jerrika Hinton as Dr. Stephanie Edwards
 * Tessa Ferrer as Dr. Leah Murphy
 * Patrick Dempsey as Dr. Derek Shepherd

Guest Stars

 * Isaiah Washington as Dr. Preston Burke
 * Caterina Scorsone as Dr. Amelia Shepherd
 * Holmes Osborne as Dr. Kenzie
 * Mark Adair-Rios as David Morris
 * Rebecca Field as Sabine McNeil
 * Bresha Webb as Teresa Morris

Co-Starring

 * Alexis Stier as Annie Cooper
 * Megan Stier as Liz Cooper
 * Dar Dixon as Dr. Krogan
 * Shannon Welles as Babs Martin
 * Brooke Baumer as Obstetrician
 * Payton Silver as Dr. Knox
 * Maria Elena Maglaris as Nurse Maria
 * Brian Chin as Airline Clerk
 * Armani Jackson as Braden Morris

April Kepner

 * Diagnosis:
 * Pregnancy


 * Doctors:
 * Unnamed Obstetrician


 * Treatment:

April got a vaginal ultrasound, allowing her and Jackson to see the baby.

Annie Cooper

 * Diagnosis:
 * High output cardiac failure


 * Doctors:
 * Derek Shepherd (neurosurgeon)
 * Amelia Shepherd (neurosurgeon)
 * Callie Torres (orthopedic surgeon)
 * Jackson Avery (plastic surgeon)
 * Meredith Grey (general surgeon)
 * Richard Webber (general surgeon)
 * Leah Murphy (surgical resident)
 * Stephanie Edwards (surgical resident)
 * Shane Ross (surgical resident)


 * Treatment:
 * Separation Surgery

Annie and her sister, Liz, were at the hospital to be separated. They shared a sagittal sinus, meaning the doctors had to choose who would get the native one and who would get a grafted one from the saphenous vein. They also shared part of the sensory cortex, so they could feel what is happening to each others' bodies. Their mother was against their separation, but it became necessary because, since their blood supplies overlapped, Liz's heart was doing more work than Annie's, causing high output cardiac failure, which would kill both of them if they weren't separated. Annie was designated twin B for the surgery, meaning they determined that Liz had a better chance of survival. While in surgery, Liz developed a clot, flipping their status and making Annie Twin A. They rushed the physical separation and Amelia took Annie to another OR while Derek attempted to save Liz. He was unsuccessful and Liz was left brain dead. Annie, who was doing well after surgery, decided to withdraw care and she died.

Liz Cooper

 * Diagnosis:
 * High output cardiac failure


 * Doctors:
 * Derek Shepherd (neurosurgeon)
 * Amelia Shepherd (neurosurgeon)
 * Callie Torres (orthopedic surgeon)
 * Jackson Avery (plastic surgeon)
 * Richard Webber (general surgeon)
 * Leah Murphy (surgical resident)
 * Stephanie Edwards (surgical resident)
 * Shane Ross (surgical resident)


 * Treatment:

Liz and her sister, Annie, were at the hospital to be separated. They shared a sagittal sinus, meaning the doctors had to choose who would get the native one and who would get a grafted one from the saphenous vein. They also shared part of the sensory cortex, so they could feel what is happening to each others' bodies. Their mother was against their separation, but it became necessary because, since their blood supplies overlapped, Liz's heart was doing more work than Annie's, causing high output cardiac failure, which would kill both of them if they weren't separated. Liz was designated Twin A for the sugary, meaning they determined she had a better chance for survival than her sister. Liz developed a clot in her brain during the surgery, which flipped their statuses, making Annie Twin A. They rushed the physical separation and Amelia took Annie to another OR while Derek attempted to save Liz. However, he was unable to do so and Liz was left brain dead. Annie decided to withdraw care and she died.

Braden Morris

 * Diagnosis:
 * SCID


 * Doctors:
 * Miranda Bailey (general surgeon)
 * Stephanie Edwards (surgical resident)
 * Jo Wilson (surgical resident)


 * Treatment:
 * Gene therapy

Miranda Bailey administered the gene therapy treatment, despite Braden's parents withdrawing consent. Braden recovered from his illness quickly and had more than 500 T-cells. Bailey allowed him to go back to solid food and order more labs.

Ivy McNeil

 * Diagnosis:


 * Doctors:
 * Cristina Yang (cardiothoracic surgeon)


 * Treatment:

Cristina discharged Ivy to recover at home.

Lincoln McNeil

 * Diagnosis:


 * Doctors:
 * Cristina Yang (cardiothoracic surgeon)


 * Treatment:

Cristina discharged Link to wait for his heart transplant at home.

Babs Martin

 * Diagnosis:
 * Posterior wall perforation
 * Subclavian bleed


 * Doctors:
 * Owen Hunt (trauma surgeon)
 * Jo Wilson (surgical resident)


 * Treatment:
 * Central line
 * Colectomy
 * Venous repair

Babs was in the hospital for a colectomy, for which she needed a central line. Jo went to insert one, but the wire snagged. Jo tried tugging harder to force it out, which caused tearing. Jo ordered an x-ray to see the damage, but she left to attend to another patient and while she was gone, the nurse paged Owen with the results of the x-ray because he was the attending on the case. Owen had taken Babs into surgery for an emergency venous repair and her colectomy was postponed.

Patient in 3922

 * Diagnosis:


 * Doctors:
 * Arizona Robbins (pediatric surgeon)
 * Jo Wilson (surgical resident)


 * Treatment:
 * Drain removal

The child in room 3922 needed her JP drain removed.

Demon Child

 * Diagnosis:


 * Doctors:
 * Arizona Robbins (pediatric surgeon)
 * Jo Wilson (surgical resident)


 * Treatment:
 * Feeding tube

A patient Arizona described as "delightful, but demon-like" needed a new feeding tube.

Raynbow Williams

 * Diagnosis:


 * Doctors:
 * Arizona Robbins (pediatric surgeon)
 * April Kepner (trauma surgeon)


 * Treatment:

Raynbow was in the ER and needed an abdominal exam to rule out appendicitis.

Burke's Patient

 * Diagnosis:


 * Doctors:
 * Preston Burke (cardiothoracic surgeon)
 * Cristina Yang (cardiothoracic surgeon)


 * Treatment:
 * Transcatheter aortic valve replacement

Burke and Cristina operated on a man with an irregularly shaped valve. They used hologram technology to show them the anatomy of his heart as they operated, even allowing them to see inside to access risks before actually cutting.

Notes and Trivia

 * This episode's title originated from the song , originally sung by Taylor Swift.
 * This episode scored 8.81 million viewers.
 * Preston Burke returns to the series after six seasons. His last appearance was in the season three finale.
 * Didn't We Almost Have It All? aired again right before this episode was broadcast to give viewers a chance to relive Burke's last appearance.
 * The song used in the promo for this episode is "This Life" by The Afters.
 * The episode contains a lot of references or similarities to earlier episode with Burke:
 * In surgery, Burke is wearing the lucky scrub cap he took with him when he left Cristina.
 * A cover of the song "Like a Virgin" is used in this episode. The original version of the song was sung by Cristina after she found out Burke won the Harper Avery without mentioning her name in the article.
 * In this episode, they meet in professional circumstances (at the lecture) and after he brings her a coffee, things get personal between them. This is similar to how their relationship started. They met at work and they got romantically involved after he brought her coffee.
 * Jeff Russell resigning from his position as Chief of Cardiothoracic Surgery is reminiscent of Burke leaving.
 * Meredith lists that Burke took pieces from Cristina, which Cristina said to Owen once herself, that they took her eyebrows

Quotes

 * Cristina: You don't know me anymore. I see that your life has moved on, and i want that you know that mine too.
 * Preston: You're right. I don't know you. But I know that you've become a magnificent surgeon. You became everything I dreamed for you. You should be in a place like this. You should consider it.