What a Difference a Day Makes

"You never know the biggest day of your life is going to be the biggest. The days you think are going to be big ones, they are never as big as you make them out to be in your head. It’s the regular days, the ones that start out normal. Those are the days that end up being the biggest. And today was the wedding. It was beautiful. Perfect. You never know the biggest day of your life is the biggest day, not until it’s happening. You don’t recognize the biggest day of your life, not until you’re right in the middle of it. The day you commit to something or someone. The day you get your heart broken. The day you meet your soul mate. The day you realize there’s not enough time because you wanna live forever. Those are the biggest days. The perfect days. You know, it was a beautiful day."

- Izzie Stevens

 is the twenty-second episode of the fifth season and the 100th overall episode of Grey's Anatomy.

Short Summary
The 100th episode! Meredith and Derek prepare for their wedding for later that day. Izzie starts to see Denny again, Arizona and Callie have relationship issues and Owen refuses to give up on George as a few graduation students are admitted.

Full Summary
Meredith and Derek are at the church and extremely excited. At Seattle Grace, Callie wakes up and complains to Cristina that she has to pick up extra shifts in the ER since she has no money because her father cut her off. Also, she had a date with Arizona the night before at a fancy restaurant she can no longer afford and then she bailed to go to work. Cristina slept at the hospital too and is quite cranky.



In her room Izzie is extremely excited for the wedding and she and Bailey high-five. She tells Bailey she feels fine and that she must go to the wedding but Alex is concerned that her blood pressure isn't where it should be. Once they both leave the room, Izzie notices that her hair is starting to fall out. Then, Denny shows up again, causing Izzie much distress as she asks him to leave. She realizes there must be another tumor in her brain.

Alex and George are assigned to the pit, but Callie tells them they can relax because there's nothing to do and that its a slow day. Soon, a phone call comes in from an ambulance carrying bloody trauma victims. The patients are a group of college students who were on their way to their graduation but were in a terrible car accident. The surgeons scramble to deal with the carnage. Hunt finds Cristina and he tells her that it was the blades of the ceiling fan above her bed that triggered his PTSD episode, as it reminded him subconsciously of the helicopter blades in Iraq. He goes to hold her hand, but she abruptly leaves. He soon joins the rest of the team in the ER. Alex's treats the valedictorian of the class, named Becca Wells. All she ever did was study, and her life was supposed to begin today ... after she graduated from college. Cristina's patient was driving, and he asks about his girlfriend. He says she was sitting in the backseat, and when he turned around to tell her something, she was gone.



Izzie soon pages Derek and tells him about the new visions of Denny, Derek knows what it means and orders another MRI scan. Richard pages Meredith to him about a wedding present. He tells her that it is really Derek's present to her, but he has to oversee it. Meredith explains that she doesn't want any gifts, but when Richard says that the present is actually an inflamed colon, and assigns her to her first solo surgery, she smiles and agrees.

When David, George's first trauma patient dies George gives up but Owen convinces him that he can't save everyone in his line of work, and you have to move on to save the people you can, and go where you are needed. Arizona interrupts Callie's hectic day in the pit, asking what's up. They had gone to a great four-star restaurant, and it was supposed to be so romantic, but all Callie did was order a salad and bail. Too busy, Callie barely answers and runs off to yell at some paramedics instead. In her room Bailey tries to convince Izzie to stay positive as she gets her ready for the MRI, but Izzie is convinced it's another tumor. Izzie then sees that Denny is standing right behind Bailey.

Becca, Alex's patient, continues to talk. She tells him about how she should have slept with David when she had the chance, but now he's dead and she can't. Cristina's patient also starts talking. He explains that he separated from his girlfriend for some reason, and he knew that their relationship wouldn't last, even though he loves her. George starts work on another patient who is bleeding so much that there's no way to save him. After he dies, George is so disgruntled that he asks Hunt to pull him from the pit but Owen refuses. Another patient is brought in, practically cut in half, her guts literally are spilling out. She's D.O.A. and the girlfriend of Cristina's patient, who sees her. When he realizes his girlfriend is dead, he starts coding.



Richard scrubs in on Meredith's surgery which both surprises and annoys her slightly as it is supposed to be her solo-surgery. He gets very parental, commending her on things and being subtly critical here and there as well. Mark soon enters the OR to tell Meredith that she better not leave Derek because he doesn't want to have to be Derek's best man a third time.

In the ER, Arizona confronts Callie again and asks to know why Callie was so tired after their date, yet she has all this energy to be working the ER. Callie says she rallied because she just loves the pit but Arizona realizes she is lying and suggests that maybe they were just having a fling and it had done its course and lots of other women are lining up for heer anyway, Callie says maybe, shocked, Arizona walks away.



Izzie, Bailey, and Derek can't see anything in Izzie's brain scans, but Izzie knows that she wouldn't be seeing Denny unless there were something. Derek gets the idea to hook her brain up to a monitoring device so that if she gets another hallucination, they'll be able to pinpoint where it is. Alex's patient Becca continues to distress, so he suggests that she give him her valedictory speech since she worked so hard on it. As she does, we see all of her friends being zipped into body bags in a poignant montage.

Denny eventually appears to Izzie, and Derek finds where hallucinatory neurons are firing in her brain. The part of the brain is the other temporal lobe, and the tumor was too small to pick up on an MRI.



Bailey wants to know how they can take it out, but Derek says that there's nothing they can do. He tells Bailey that he likes Izzie and he wishes there was something he could do, after a few moments Bailey comes up with an idea. Callie sleeps peacefully but is siddenly awoken by Arizona, Callie finally confesses that her behavior was due to the fact that she is broke and can't afford fancy four-star restaurants anymore because her father cleaned out her bank account and disowned her. Arizona says that she doesn't care, and they can stay in and eat pizza. After Meredith's surgery, Richard tells her Ellis would have been very proud to watch her do her first solo surgery.

George is down on himself as all the patients he treated died and the only one who survived was the one he didn't treat. Hunt tries to pump up George's deflated ego, saying that because George treated the other five, that allowed Hunt to go and save the sixth. He says that trauma is a team sport and he's a hero too. Lexie cries as she treats the sixth patient who survived.

Meredith tells Derek excitedly about her first solo surgery, and that she is having a great wedding day. Derek asks Meredith if she wants to make the day even better. After talking with Derek Meredith finds Alex outside. He just heard that Izzie has another tumor, and he's afraid that she might die on him. Meredith shares Bailey's idea with him.



In her room Izzie asks Bailey anxiously if she can still go to the wedding because her tumor isn't going anywhere, Bailey tells her that she can but continues to wait at the door until Meredith appears. Meredith tells Izzie that the dress isn't her and that the wedding is not for her but Izzie thinks Meredith is just having pre-wedding jitters and convinces her that Derek loves her and she has to get married. Alex appears at the door and she sees him in his suit and realizes that Meredith is giving the wedding to her.



At the church, Izzie is in a dress and asks Cristina to be the maid of honor for trying to save her life when she told her about the cancer. Alex in turn asks Meredith to be his best man. The wedding begins and Izzie walks down the aisle with George by her side. Izzie worries when she realizes she has no vows but Alex jumps in and recites a version of Becca's valedictory speech about this being the beginning of his life, the day he becomes accountable to someone other than himself. As Izzie and Alex kiss, everyone gets teary-eyed.

Back at the hospital, Alex tucks Izzie into bed again. He takes the flowers out of her hair and some of her hair comes out with it. He assures her that she doesn't need her hair and that she would still look great without it. She should even shave it all off. After the wedding, Callie and Arizona have their night and eat pizza, Cristina takes down her ceiling fan, and Meredith and Derek lie by the fire. In bed, Izzie again has a scarf on her head. She has been talking to Denny and asks him to go now because she wants to be alone with her husband. Alex walks in and asks why she's wearing the scarf. She takes it off to reveal she is bald. Alex says My wife is so hot and Izzie smiles.

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

Special Guest Star

 * Jeffrey Dean Morgan as Denny Duquette

Guest Stars

 * Jessica Capshaw as Dr. Arizona Robbins
 * Amy Gumenick as Becca Wells
 * Roberto Urbina as Jordan

Co-Starring

 * Robin Gwynne as Becca's Mom
 * Trent Gill as David
 * Mark Saul as Intern Steve
 * Molly Kidder as Intern Megan
 * Candice Afia as Intern Laura
 * Mickey Maxwell as Minister
 * Amrapali Ambegaokar as Intern Dani
 * Tymberlee Chanel as Intern Claire
 * Winston Story as Intern Leo
 * Joseph Williamson as Intern Pierce
 * Payton Silver as Dr. Knox
 * Wayne Lopez as Paramedic #1
 * Shi Ne Nielson as Paramedic #2
 * Mac Brandt as Paramedic #3
 * Tim Chiou as Paramedic #4

Uncredited

 * Jennifer Couch as Dana

Izzie Stevens

 * Diagnosis:
 * Stage IV metastatic melanoma
 * Brain tumor


 * Doctors:
 * Derek Shepherd (neurosurgeon)
 * Miranda Bailey (surgical resident)


 * Treatment:

Izzie was still in the hospital for her cancer treatment. She was off the IL-2 and her incisions from surgery had healed well, but her hair started to fall out and she started seeing Denny again, meaning she had another brain met. Derek ordered another MI to find it so he could remove it. The MRI didn't show anything, so they planned to use brain mapping to find the tumor. It worked and Derek located the tumor. It was very small and Derek didn't believe he'd be able to remove it.

Owen Hunt

 * Diagnosis:
 * PSTD


 * Doctors:
 * Katharine Wyatt (psychiatrist)


 * Treatment:
 * Talk therapy

Owen told Cristina that things were going well with his shrink.

David Simons

 * Diagnosis:
 * Chest contusions
 * Cardiac contusion


 * Doctors:
 * Callie Torres (orthopedic surgery resident)
 * Alex Karev (surgical resident)
 * George O'Malley (surgical resident)
 * Lexie Grey (surgical intern)


 * Treatment:

David, 22, came into the ER after the SUV he was driving was hit by a semi. He had chest contusions, but his vitals were stable. In the ER, he coded and they were able to resuscitate him. Despite that, he had multiple arrythmias, so George suspected cardiac contusion. He coded again. George put in a chest tube, but there was no blood. George tried CPR for 20 minutes before Owen told him it was over. He was pronounced dead at 9:24.

Becca Wells

 * Diagnosis:
 * Stomach herniation
 * Lacerated diaphragm


 * Doctors:
 * Owen Hunt (trauma surgeon)
 * Alex Karev (surgical resident)
 * Lexie Grey (surgical intern)


 * Treatment:
 * Central line
 * Surgery

Becca, 21, was brought to the ER after the SUV she was in was hit by a semi. She had some shortness of breath, but no hemothorax or pneumothorax, so they sent her for a CT and some x-rays. Her scans revealed a herniating stomach and a laceration on her diaphragm. She was told she'd be having surgery soon. At the end of the day, she was stable.

Jordan

 * Diagnosis:


 * Doctors:
 * Owen Hunt (trauma surgeon)
 * Cristina Yang (surgical resident)


 * Treatment:

Jordan, 22, was brought to the ER after the SUV he was in was hit by a semi. He was stable and was ready to be taken to CT. When he saw his girlfriend, Dana, dead, he coded and was unable to be resuscitated. He was pronounced dead at 13:02.

Derek's Patient

 * Diagnosis:


 * Doctors:
 * Derek Shepherd (neurosurgeon)


 * Treatment:
 * Craniotomy

Derek told Izzie that he had a craniotomy to get to.

Meredith's Patient

 * Diagnosis:


 * Doctors:
 * Meredith Grey (surgical resident)
 * Richard Webber (general surgeon)


 * Treatment:
 * Colectomy

As her wedding present, Meredith got her first solo surgery, a colectomy. The surgery went well.

Arizona's Patients

 * Diagnosis:


 * Doctors:
 * Arizona Robbins (pediatric surgeon)


 * Treatment:

Arizona mentioned having four back-to-back surgeries and a kid on life support.

Pete

 * Diagnosis:
 * Chest wound
 * Pericardial effusion


 * Doctors:
 * George O'Malley (surgical resident)
 * Lexie Grey (surgical intern)


 * Treatment:

Pete was brought into the ER after the SUV he was in was hit by a semi. He had a severe chest wound and pericardial effusion. George tried to remove all the blood, but he was unable to resuscitate and Pete was pronounced dead in the ER.

Michelle

 * Diagnosis:


 * Doctors:
 * Owen Hunt (trauma surgeon)


 * Treatment:

Michelle was brought into the ER after the SUV she was in was hit by a semi.

Dana

 * Diagnosis:


 * Doctors:
 * George O'Malley (surgical resident)


 * Treatment:

Dana was brought to the ER after the SUV she was in was hit by a semi. She was pronounced dead on arrival at 10:45.

Notes and Trivia

 * This episode's title originated from the song , originally sung by Dinah Washington.
 * This episode scored 15.33 million viewers.
 * This is the 100th episode of Grey's Anatomy.
 * It was mentioned that there were eight kids piled into a single SUV. However, only six (David, Becca, Jordan, Michelle, Dana, and Pete) were seen or mentioned. It's unknown if this was a mistake or if the other two passengers were just not featured.

Quotes

 * Meredith: Just a normal day.
 * Derek: Normal day. Going to work.
 * Meredith: Just a normal day, that ends in a ceremony in a churchy church.
 * Derek: This has nothing to do with us, we're just the bride and groom.


 * Callie: No! We are closed to trauma! Because we have trauma coming out of our butts! Oh, well have a nice day to you too! [sees Arizona] Oh, for the love of...
 * Arizona: So the ER is fun, but I'm not. You can get enough of me? Is that what you are saying? I mean, do you just want to just end this? Because there are women that are lining up for me. I'm hot.


 * Minister: Dearly beloved. We are gathered here today to celebrate the wedding of Alexander Michael Karev and Isobel Katherine Stevens. This is a sacred right. An ancient right. As Isobel and Alex prepare to join their lives, it is important to understand that everyone present has played a part in shaping their lives. And, will continue to play a vital role in their continuing future. And thus, we are here not only to witness their vows to each other, but to bestow upon them our blessing. And, now the couple will read their vows.
 * Izzie: Oh, we didn't write anything.
 * Alex: No, wait. I have something I wanna say. Today's the day my life begins. All my life I've been just me. Just a smart mouth kid. Today I become a man. Today I become a husband. Today I become accountable to someone other than myself. Today I become accountable to you. To our future. To all the possibilities that a marriage has to offer. Together, no matter what happens, I'll be ready. For anything. For everything. To take on life, to take on love. To take on possibility and responsibility. Today Izzie Stevens, our life together begins. And I for one can't wait.
 * Izzie: I love you. (kisses him)
 * Minister: Ahem, not yet!
 * Alex: Hurry up!
 * Minister: By the power vested in me, by god and the state of Washington, I now pronounce you husband and wife.
 * Izzie: Now?
 * Minister: Now.
 * (Izzie and Alex kiss.)