Tainted Obligation

"We begin life with few obligations. We pledge allegiance to the flag. We swear to return our library books. But as we get older we take vows, we make promises, we get burden by commitments, to do no harm, to tell the truth and nothing but, to love and cherish till death do us part. So we just keep running up the tap until we owe everything to everybody and suddenly think … what the. The thing about being a surgeon, everybody wants a piece of you. We take one little oath, and suddenly we’re drowning in obligations. To our patients, to our colleagues, to medicine itself. So we do what any sane person would do. We run like hell from our promises, hoping they’ll be forgotten. But sooner or later, they always catch up. And sometimes you find the obligation you dread the most isn’t worth running from at all."

- Meredith Grey

 is the fourth episode of the sixth season and the 106th overall episode of Grey's Anatomy.

Short Summary
When Meredith and Lexie's father, Thatcher, returns to the hospital with a failed liver, it's up to Meredith to save his life. Meanwhile, Izzie empathizes with a patient riddled with tumors, as Mark, annoyed with Cristina's competitive zeal, tricks her into assisting on an unusual surgery.

Full Summary
Alex woke up and walked out of the trailer and screamed when he saw a bear outside. At the hospital, he told Izzie, who was proudly sporting her short hair, they had to move. She said they couldn't move because they only make $30,000 a year. (Can that be right?!). She didn't believe him about the bear, asking if he was sure it wasn't a deer instead. He wanted to move back to Meredith's, but Izzie insisted that because they were married, "this is how it's supposed to be," referring to their struggles and trying to make it on their own. She got serious for a moment and told Alex she can't move backwards after everything that's happened.

The chief pulled the staff together to tell them he basically had no answers about the merger. Cristina was itching for a surgery because she was worried only the residents with the most hours would be kept.

Lexie brought her and Meredith's dad, Thatcher, into the ER and he was acting strangely. He seemed drunk, but said he hadn't been drinking. Then he started throwing up blood all over the place. The doctors all fought over who would take his case. Lexie tried to assure Meredith that Thatcher wasn't drunk, but Meredith said nothing.

Sloan was looking at an elderly man who had a growth in his back, but the man said he was interested in having a penile enlargement. He said he was seeing "a new gal from the east wing" at his nursing home and he didn't want to disappoint her. Best line in quite a while was when the man told Sloan, "Let me tell you about the Golden Years, doc. There's just got to be more to life than eating pudding and watching 'CSI.'" Then he asked Sloan to give him "a working Johnson."

Hunt had a surgery and told Cristina and Izzie about it. Izzie jumped at the chance, and Hunt told Cristina that he wanted Izzie on it because she has a soft touch.

Meredith realized that Thatcher was in the final stages of liver failure and was going to need a transplant. Thatcher couldn't get a donor liver because the hospital board's policy said an alcoholic had to be sober a year before qualifying. Lexie volunteered to give up a piece of her liver.

Callie was struggling over whether to ask the chief for her job back. The alternative was moving to Cleveland.

Sloan told Lexie she couldn't just go off making decisions about donating a part of her liver without talking to him. "He's my dad," she said, before Sloan walked away.

Izzie was treating a guy with cancer whose girlfriend said they'd been together for eight years and still weren't married. The man said he got distracted by cancer. When his girlfriend left, he told Izzie he already had the ring and was waiting for the right time. He said he was hiding the ring in the container for his mouth guard.

The children of Sloan's elderly patient were trying to talk him out of the penile implant surgery. He said that he and his wife saved for years for that "rainy day". She died before they had a chance to spend the money on something fun. His daughter-in-law suggested that he might want that money to go toward his granddaughter's college fund. He said that she wasn't smart enough to go to college. Cristina, meanwhile, was waiting at the surgery board for something to do. Meredith came over to talk to Cristina about Thatcher and was pretty flip about the possibility that he might already be dead.

In surgery, Hunt told Izzie their patient's cancer was too advanced to be removed. She wanted to save him, but Hunt told her "sometimes you have to know when to say when."

Meredith went to find out about Thatcher and found out Lexie wasn't a match. She didn't offer to find out whether she might be a match before leaving. Cristina and Alex suggested that Meredith get tested. Then they noticed a tick on Alex's neck and he freaked out. He was tired of living in a trailer in the woods with ticks and bears and no real plumbing. (The toilet empties into a bucket under the trailer. Eww.)

Sloan's patient got all philosophical about why he wanted his penile enlargement surgery, telling Sloan about how one day he'd be old and realize that all the milestones in life were behind him; that he'd had a bunch of "yesterdays" and no "tomorrows." He said he hadn't wanted to make love to a woman since his wife died, but then one day he played bingo with Marion and he just knew.

Lexie asked Bailey to lie to the board on behalf of her dad so he could get a liver, but Bailey said she had 15 patients on the waiting list who didn't drink themselves into liver failure so she wasn't going to lie.

Callie and Arizona sat and ate lunch outside on a beautiful Seattle day and Callie started listing off the reasons she was going to give the chief for why she should have her job back. Arizona didn't want to talk about it, she just wanted Callie to ask and deal with whatever the answer might be.

Derek told Meredith she didn't owe her father anything. Lexie came in and said she was afraid she'd be fired because she's done "a lot of dumb things today," including pulling Meredith's medical file to see if she was the right blood type. Lexie gave Meredith a speech about how she didn't have to do anything for Thatcher, but she asked Meredith to give her her dad. "I know he's not your dad," Lexie told Meredith, "but somehow, you have his blood and I don't. So I'm asking you, give me my dad."

Meredith said nothing and went to talk to Thatcher. She just told him they found a match. Then she matter-of-factly said it was her. He told her he was a drunk and didn't want to let her put him back together after he'd broken himself. He said he couldn't accept her offer.

Izzie and Hunt's cancer patient's girlfriend wanted to know what else they could do. Izzie couldn't stand it and asked Hunt to talk outside. She went through more procedures they could try. Hunt said the guy had incurable cancer, but Izzie said the guy deserved a chance -- the same chance she had.

Meredith told Alex she was "off the hook" because Thatcher didn't want her liver. He told her to try again. Derek kept walking by and seeing Meredith struggle with her decision, but he wouldn't say anything. When Cristina went to approach Meredith, Derek stopped her.

Sloan told his elderly patient's adult children that he was cleared for surgery. They said they would take him out of his nursing home if he went through with the surgery because it was causing him to make rash decisions, like sneaking into a younger woman's room and spending his savings on a penile implant. But he didn't want to leave the home. Sloan finally jumped in and said, "All he wants is a woody." He also noted, for the record, that there was nothing wrong with dating a younger woman. "It keeps you young and that's my professional opinion," he said.

The chief and Thatcher had a heart to heart about how Thatcher got to where he was -- a drunk with a failing liver. The chief told Thatcher he couldn't undo what he did, but he should take the second chance that Meredith was offering. "I took her childhood," Thatcher said. "I can't take any more from her." Then he asked the chief to take care of his girls, saying, "You owe me at least that."

Izzie was excited that Hunt listened to her about trying another procedure on the cancer patient. She thanked Alex for being understanding about continuing to live in the trailer.

Meredith told Thatcher that she was only offering her liver because it would break Lexie if she lost him. But she said that if they got through this, "the door would be open" for them to get to know each other.

Sloan was telling Derek and Hunt about the penile enlargement surgery when Cristina walked by and overheard the conversation about a risky, high-tech procedure. She jumped in without knowing what it was and volunteered to help out. She headed straight to the patient's room and read the chart, which was when she discovered it was a penile implant surgery. She'd shown up just in time to shave him.

Meredith was being wheeled into surgery to give up part of her liver and told Cristina, "At least you don't have to be laid up in bed for the next month." (And that, friends, is how TV writers handle an actress' maternity leave). Bailey wheeled Meredith into the OR, with Derek by her side.

Izzie's cancer patient said he didn't want to saddle his girlfriend down with a sick husband. Then he said, "What the hell? It might just be part of the package."

Bailey prepared to cut into Meredith and told her not to "pull anything funny" on her surgery.

Cristina was in her surgery and squeezed the patient's scrotum, as her job required.

Izzie and Hunt's patient had some kind of problem and they lost him. Izzie was stunned. Hunt was upset because their patient had a couple of months to stay with his girlfriend and they took that away. He told Izzie he shouldn't have listened to her. He said she wasn't ready to be back at work. "You beat the odds, you were that one in a million," he said, "but you can't be a doctor and a patient in here. You have to choose."

Sloan's patient came out of surgery well and his Marion came to his room to see him.

Cristina went to the chief and said her hands should be doing serious surgeries. She couldn't get on good cases because there was no good cardiothoracic attending. She told him he should cut her because without a cardiothoracic attending, she couldn't get what she needed from the hospital. She left and the chief said nothing.

Izzie went to her patient's girlfriend and told her she should open the case where he kept his mouthguard.

Callie walked into the chief's office and he was lamenting the fact that he might now be the villain in the process of repairing the hospital he'd broken. "This must be so hard for you," Callie told him. He thanked her. She was about to ask for her job back, but stopped herself. Nonetheless, the chief told her to go to HR and tell them she's an attending surgeon at Seattle Grace Hospital and she wanted a new badge.

The next morning, Izzie was leaving for work as Alex still slept. Alex jumped up when he heard Izzie scream and the bear roar. Izzie ran back into the trailer and said that they had to move.

Derek watched from afar as Lexie slept with her head on Meredith's arm as Meredith was recovering from giving up her liver. Voiceover Meredith talked about how "sometimes the obligation you dread the most isn't worth running from at all," as Lexie poured her a cup of water.

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
 * 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
 * Patrick Dempsey as Dr. Derek Shepherd

Guest Stars

 * Jeff Perry as Thatcher Grey
 * Ralph Waite as Irving Waller
 * Tom Amandes as Charlie Waller
 * Isabella Hofmann as Irene Waller
 * Jocko Sims as Randy
 * Kristen Ariza as Angela

Co-Starring

 * Mark Saul as Dr. Steve Mostow
 * Phil Abrams as Dr. Jim Nelson
 * Payton Silver as Dr. Knox
 * Ursula Whittaker as Angry Attending #1

Notes and Trivia
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 * This episode's title originated from the song , originally sung by REM.
 * This episode scored 14.13 million viewers.
 * One day has passed since the previous episode, as Arizona mentioned she had lost her favorite scrub nurse the previous day. At the end of the previous episode, several people were fired as part of the first set of cutbacks.

Quotes

 * Bailey: I had five interns. Four of you have been on this table. One of you has cancer, one of you died. You better not pull anything funny on me, Grey.


 * Lexie (to Meredith): I didn’t want to do this, I didn’t want to have to come to you for anything, ever. So I thought if I looked up your blood type, and it was the wrong one, then that would be it. Then I could just stop thinking about it. But I cant, because you have his blood. And I know that he’s not your dad, I know that he was never there for you and I would never ask you to give him anything he doesn’t deserve a thing from you, he doesn’t. But he’s, he’s going to die Meredith. And so I’m asking you to give something to me. I’m asking, I am asking you to give me my dad, because as crappy as he was to you, god, he was wonderful to me. He never missed a single dance recital, he was there at my 5th grade graduation, What is that? That’s not even real. I know he’s not your dad, I know that. But somehow you have his blood, and I don’t. So I’m asking you, give me my dad.


 * (Lexie just walked into the ER with Thatcher)
 * Lexie: I don't know what's wrong with him!
 * Meredith: Did you pick him up off the floor in a bar, Leixe? That might be a clue.


 * Cristina: Sir.
 * Richard: Now is not the time, Yang.
 * Cristina: I have good hands. They're fast, they're dextrous, they were made to throw ties and do complex procedures. These hands were made for surgery. Today, they should have been deep inside a heart, saving a life. Instead they removed a thick and pumped a penis.
 * Richard: What's your point?
 * Cristina: My point? You know what, you should cut me.
 * Richard: What?
 * Cristina: From the program. You have to make more cuts and I should go, 'cause if you can't give me a brilliant cardiothoracic attending who's willing to teach me, then I can't get what I need from this hospital. Everyone is scared of loosing their job and so am I, but if I can't learn, if I can't use my gift, then... I... Well, I guess that scares me more. That's my point, Sir.


 * Thatcher: The Chief always pays such close attention to his patients - or is it just the ones whose wives he's had an affair with?