Get Up, Stand Up

"Failure is an inevitability. Every scientist was told no, over and over. The ones we remember, the ones who changed our lives: the Curies, the Salks, the Barnards. They're the ones who wouldn't take no for an answer. Failure is inevitable. Unavoidable. But failure should never get the less for it. You have to never take no for an answer and take what's coming to you. Never give in. Never give up. Stand up. Stand up and take it."

- Meredith Grey

 is the twelfth episode and mid-season finale of the tenth season and the 208th overall episode of Grey's Anatomy.

Short Summary
On the day of April’s wedding, the Grey Sloan Memorial doctors are all preoccupied with their own drama. Meredith and Cristina continue to argue about their research and careers, Bailey comes clean to Ben about her feelings regarding him moving back to Seattle, and Shane puts himself in a risky situation. Meanwhile, Derek gets a phone call that will change his life.

Full Summary
Cristina is giving a press conference about the treatment for baby Nathan. A photographer is taking pictures, but she doesn't seem to be able to find the right words. She says that even though the risks were extremely high, that couldn't have been the reason not to try it. She looks at Meredith and then doesn't know what to say anymore at all. Owen covers his microphone and asks if she's okay. Crisitina affirms and then tells the reporters, that she's cautiously optimistic that Nathan's vitals will stay good. If that's true, they can call the procedure a success. Shane then takes her microphone and tells the reporters that Dr. Yang did a home run and that Nathan is thriving. These words make the reports more enthusiastic than Cristina's words did, and they applaud. Meredith claps too with a wry face, and leaves the room.

Meredith closes the body bag with the dead sheep in it. She tells Stephanie they'll print another portal vein and perform tests on that, so they can look for material that will hold up better. "So we go back to the drawing board?" Stephanie asks, and Meredith confirms.

Bailey and Ben are watching the OR board, and Richard joins them. Bailey notices his name is on a colectomy, and he says it's a little surgery to get his feet wet. Ben says he'll miss April's wedding, which is part of Richard's plan. He scheduled the surgery while everyone was gone, as he didn't want to make a big fuzz. Ben asks Bailey if her surgery will be done in time, and she confirms. He kisses her and walks off. Richard says that he's proud of her because the medication helped her to start operating again. "I don't wanna make a big fuzz," she says.

Cristina, Owen, and Shane walk down the hallway, with Shane saying he thinks the press conference went well. Cristina throws him off of her service, suspecting he's over his hours and saying he should take a day off. Shane asks why, and she replies he doesn't know when to keep his mouth shut. Shane starts defending his actions, but she says she's not comfortable with him speaking for her, especially with this case. Owen says that Ross said what needed to be said, because she herself wasn't comfortable up there at all. Shane shows Cristina on the tablet that he's only at 68 hours for the week. Owen tells her they're for an interview in conference room C, and walks off. Cristina then tells Shane she's worried about him, and she's not the only one. Shane asks if his work is bad, but she says his work is great. "You're gonna burn yourself out," she says. He thinks she wants to "work off some tension", but Cristina pushes away his hand, saying they're not doing that anymore. He says she shouldn't be afraid that he thinks it's more than just sex, as he knows it's just that. "It's you who needs to relax," Cristina says, and he assures her he's fine and asks her not to shut him out. "Ross, go home," she says and walks off.

Callie and Derek are talking about the receptor field of the sensors, when Owen comes in, telling Derek that Kleiss neuroscience will be at the hospital in 20 minutes. Derek says he can't, as he has to take Bailey to a music class, and Callie asks what's going on. Derek says they want to talk to him about a research thing, and Owen clarifies that it's the presidential initiative on brain mapping. Callie says Derek's brain is hers, as they're starting fase 2 of their own research. Derek says he'll brush them off, but Owen says he has to say yes. He also asks them if they'll be at Kepner's wedding, and they confirm.

Leah tells Jo and Stephanie she won't be going to the wedding as she prefers to be in the OR with Bailey, now that she's finally operating again. She also says that she doesn't want to feel like a garbage leftover thing Arizona scraped off her shoe when Arizona is looking all gorgeous at the wedding. Owen bumps into them, and asks them if they'll come. Jo and Stephanie confirm, while Leah asks if it's mandatory. Leah says that Arizona was important and that they were something, and she walks away. "Maybe they were something," Jo says, but she and Stephanie simultaneously say no.

In the ER, Arizona asks Alex how his dad is. He's told all the nurses Alex is his son, showing he's really proud. "Don't know, don't care," Alex says, as they suddenly hear a car and panicking voices outside. They rush outside, where a father takes his severly hurt son out of his car. They yell to hold him still and Arizona yells for a gurney. The boy got trapped under a wheel, and the father confirms to Arizona that the boy moved since. The kid's name is Cody, the dad tells them, and they take Cody to the Lodox. The father says that he called ambulance, but he decided to take Cody to the hospital himself as it was taking too long. Arizona does a neuro exam, but nothing happens. She wants to check again if Cody moved before, and the father affirms. Alex and Arizona give each other a look, and Arizona asks the father to step back and she closes the door.

Owen comes in the research lab and tells Meredith that a photographer would like some pictures of the 3-D printer. "Where do you want us?" Meredith asks, when the photographer and Cristina come in. Owen then says it's actually for the Nathan Glazier case, and Meredith objects that the printer is now printing her work. Owen says it's fine as no one would know, but Cristina says they can come back when she sees Meredith's face. Meredith and Stephanie walk off anyway, and before walking out, Meredith angrily looks at Cristina, who's posing next to the printer. The photographer says it's perfect and takes pictures.

Alex looks at Cody's scans and diagnoses a burst fracture at C6. Arizona tells to page Torres while doing an echo, concluding there's a lot of the blood in the belly, so he needs to go to the OR right away. Alex says the father should've waited for the ambulance, as he now probably paralized his kid by bringing him to the hospital himself. Arizona says they don't know that for sure and that he should go see his long lost father, as she'd have a billion questions. She says she'll page him when she needs him. They leave, and she tells the father that they're going to operate and that Cody's neck is broken. "He can move right? He was moving!" the father says, and Alex wants to tell him of the possible paralysis, but Arizona cuts him off.

April gets out of the elevator. Her hair is in curlers, and she bumps into Jackson, who comments on her current look. She tells him she's hunting bridesmaids, and he asks if that's a farm tradition. April ignores his question and asks if he's going to be there. He asks if she wants him to be there, which she does, so he tells her he will. Jackson wants to hug her, but she doesn't want to mess up her hair, and she walks off to find her bridesmaids.

Leah presents a case and thinks the number of 312 past surgeries isn't correct, though Elliot, the patient, says it is. He started with debulking the tumors when he was 4 years old, but they keep on recurring, so they need to be lasered out over and over again. Leah says that must be rough, but Elliot says he's used to it. His parents bought a house near the hospital to be close. Bailey then proposes to custom design a drug to stop the growth in her genome lab, which would mean no surgeries ever again. "Oh my God!" Elliot says happily. Leah says the same, though irritated.

Outside the room, Leah apologizes when Bailey asks her if she thinks Elliot hasn't had enough surgery. Bailey wants to go open her lab, when Leah stands up for herself and says that she hasn't had enough surgery because she waited and waited for Bailey to get back in the OR. "I'm here to study surgery and I'm being left behind and I deserve better than this!" she yells. She apologizes to Bailey again when she says her face, but Bailey says that she needs to do the procedure on Elliot once more to get the samples she needs. "And you will perform it, beginning to end," Bailey says, and tells her to prep Elliot.

Jackson and Stephanie are in a patient's room. Stephanie is checking on the man's throat, and the wife apologizes for his nasty breath. Jackson explains that this is because the muscles in his esophagus are working against each other instead of working together. The esophagus wall forms a sack, which is where his food is being kept, causing the bad breath. Jackson explains the fix, and the wife asks if they have anything to worry about. Jackson names the risks, including a small risk of damage to the vocal chord nerves. If that happens, he won't be able to speak anymore. Dalton then blurts out that his wife has a cute butt, as he doesn't want anything to be left unsaid in case he'll end up unable to speak ever again after the surgery. He also confesses he never really liked her brother, and the wife jokingly asks how soon they can put him under.

April finds Cristina, of whom photographers are taking pictures. April pulls her with her, and Cristina asks if she's bailing on her wedding. April denies this, and says she needs Cristina to come with her.

Derek, Owen and baby Bailey are in the conference room listening to the explanation of the Kleiss neuroscience guys. They were mandated by the president to create a map of the human brain, and the first step for that is developing the technology. The sensors Derek developed for his research are the most responsive, which is why they want him to consult on their project. Derek apologizes, but says his project with Dr. Torres is time consuming enough as it is. They shove a paper onto the table with his reward for just consulting from a long distance, but Derek refuses to turn it around as it's not about the money. One of the suits then asks to watch their promo movie, and Owen says Derek will as he puts out the lights.

Alex enters his father's room, where Jo is doing exercices with James. Alex asks her to leave them alone, so she leaves the room. Alex asks him how it's possible that he forgot his family. James says he just made a mess of everything by taking more and more drugs, but he says he remembers him though. He says Alex used to laugh in his sleep when he was around 4 years old. "You were a happy kid. I guess I fixed that, huh?" James asks. Alex starts telling he remembered when his dad took him to the fair. James says that was a night his mother had a meltdown, and wants to start talking about how difficult Alex's mother was, but Alex cuts him off by asking about his other family. Jimmy says he left things better with them, and he might be able to go back, as the other wife wasn't as crazy like his mother. Alex says he has to stop bad talking his mother, and he starts listing what he did when his father left their family. Jimmy says he did the best he could, and Alex says that his best is worthless then. "I was the dad! I was the kid, but I was the dad! You were nothing, you were gone! You were worthlesd!" he yells. Jo comes and tells him to walk away.

Arizona is operating on Cody. Callie says she has to work fast if they even want a shot at avoiding paralysis. Arizona says she's a genius, and Callie agrees to this. She says that she and Derek are starting fase 2 of their research, which is tactile pressure feedback. "Awesome! Good for you!" Arizona says, and Callie replies that it's also good for Arizona because the goal is to give her a prosthetic leg that's as sensitive and responsive as the leg she lost. She tells to prep the neck while she goes scrubbing. Alex comes in, and ignores Arizona's question about his dad.

April enters Meredith's lab. "Oh God, are you making a break for it?! Don't worry, I know what to do!" Meredith says. April wonders why everyone thinks she's running. She drags Meredith along with her and says that Meredith bailed on every single fitting for the bridesmaid dress. She opens a door, revealing she brought the seamstress to the hospital. Cristina is in there, while the seamstress's team is working on her dress. "You guys are supposed to be doing this stuff for me!" April says as she closes the door. While Meredith undresses to put on the dress, she asks Cristina what happened at the press conference. Cristina says she doesn't know what's keeping the kid alive. The conduit failed, and somehow she managed to fix it, but it's like slapping the side of the TV. Meredith asks if she didn't mention it to anyone, and Cristina replies she had no one to mention it to. Meredith then says that Cristina was right when she said that they were in different places. "I may overreach and have something to prove, but I will never be as arrogant as you are," Meredith says. "You know what, Meredith? Go to hell," Cristina says, adding she won't be taking more crap.

The promo video has finished. Derek says he's overextended. Owen is pushy to agree to consult on the project, and the suits assure it's just a few visits in a few months. Derek says they're actually doing it all wrong, and he explains how they should approach it by explaining how the brain works when we kiss want to kiss someone. One of them gets it, and Derek leaves in silence as they're starting to get it.

Dalton Marks is making more confessions to his wife while they take him up to the OR. He also sings their song. Jackson reminds them that the risk of damage to the vocal chords is small, and the wife begs them to cut them anyway. Dalton whispers something into his wife's ear, and she kisses him goodbye.

Leah is pulling off the procedure and she apologizes to Bailey once again. Bailey says it got her what she wanted, and that she was right that she hadn't been teaching lately. "Never be afraid to stand up for yourself. Just be sure you're right when you do," Bailey says. This makes Leah realizes that she has to stand up for what she deserves. "That's so incredibly true!" she says. "I know, I said it," Bailey says.

Meredith and Cristina are still fighting over their careers. Cristina says she never said Meredith was a terrible doctor, while Meredith did tell her she was a terrible person over and over because she disagreed with Meredith, because she is focused on her work and because she doesn't want a baby. Cristina is half naked while she asks Meredith when she became such a monster to her. Suddenly, Shane comes in. Cristina says that she told him to go home, but he interrupts her and says that she is in consideration for this year's Harper Avery Award. He gives her the printed email and leaves.

In surgery, Callie asks Arizona if she's going to wear her high heel leg, though she thinks it's better not to as it always gets sour after a while, and the wedding is on a farm so it'll be muddy. "I'll be fine," Arizona says. Alex asks if the kid is paralyzed, but Callie says it's too soon to tell. Alex asks if she's going to tell the dad that, and Arizona updates her that the spinal injury was likely caused by the father transporting the child, and Callie says that people should wait for the ambulance. Arizona defends the father, saying that he didn't know he was actually hurting his kid even more. "Sometimes we try to make things better and we have actually no idea that we're actually causing more pain," Arizona says, and then tells Alex they won't tell the dad.

Jackson is trying to get to Dalton's esophagus through his mouth, but it's not working so he decides to go in through the neck. While the nurses prepare the OR for that procedure, Jackson and Stephanie think about what he whispered to his wife before surgery. They agree there's not much that they wouldn't say to each other. "Right? How do you get to that point?" Stephanie asks. Jackson says that there's nothing he wouldn't say to her, but Stephanie doubts that and says they're nowhere at that point. "You shed. You shed hair and you shed bras," Jackson then says. They discuss this, and then Stephanie says he has an angry face. She says he should smile more, as he has a beautiful smile. Stephanie then says that she think Dalton said he loved Karen. "Maybe. Say it loud and go from there," Jackson says, and explains that it's something Mark Sloan told him. While Bokhee tells them the patient is ready, Jackson continues. "You love somebody, you tell them, even if you're scared it'll cause problems or burn your life to the ground. Say it loud and go from there," he says. Stephanie says it's nice, while Jackson starts cutting.

As April's walks into the ER, Matthew is busy rolling a gurney outside. They see each other and quickly go stand back-to-back against a wall. They ask each other what they're doing here, and Matthew says he's working on their wedding day so he can take time off for after the wedding. April is disappointed that he saw her before the wedding, but Matthew says he didn't see her dress nor her hair. "Did you have a really big hat on?" he asks her, and April starts saying that it's bad luck. They take each other's hand, and Matthew says it's good that he saw her now, because if he'd see her for the first time today at the wedding, he'd be reminded of how much he didn't deserve her. "I'm glad I saw you like this, because I'm gonna see you like this a lot more than I'm going to see you like that for the rest of our lives. And I love you like this," he says. April says she loves him too, and reminds him not to forget black socks, but he doesn't answer. She looks at the other side of the wall, but he has disappeared.

Alex is explaining to the father that the paralysis could recede with time, and if not, they're looking at paralysis. The dad realizes it's his fault, as Cody was still moving before he transported him. Alex says it's not his fault, as he was just trying to help his kid. The father breaks down.

Jackson tells Karen that even though they had to go in surgically, everything went fine, so Dalton will have a fresh breath. Stephanie notices Dalton is waking up and Karen greets him. However, something's wrong with him and Jackson tells Stephanie to page Shepherd while he examines Dalton's pupils.

Meredith says that can compete as a mother and as a surgeon, but that Cristina thinks she just can't compete against her. Cristina says she can't indeed, because her career is all she does. She tells Meredith not to whine about regretting her decision to start a family. Meredith asks if she thinks she regrets her family, but Cristina says it's more the feeling of feeling left behind. "It sucks for you, but no one forced you out of the game!" Cristina says. Meredith yells she's not out of the game, she just won't sabotage her friends to winning. "Oh, is that what I did?" Cristina asks. "That's what sharks do. You called it our first day," Meredith says, and Cristina says she recalls that she was talking about Meredith back then. "How long have you been sleeping with Shane?" Meredith asks her then, leaving Cristina speechless. "He blushes at an exposed ankle, he saw you in your underwear and he didn't bat an eye," Meredith explains while putting her scrubs back on. Cristina says it's none of her business, and Meredith says Shane is just hooking up with the best teacher so he can get whatever he needs, just like Cristina did throughout med school and intern year. "Congratulations, you've become the thing you worshipped," she says as she leaves the room. "And you became the thing we laughed at!" Cristina says.

Alex walks into his dad's room. His dad says he's sorry, but Alex says he doesn't have to be. "It's like you said, you did your best and I turned out alright," he says. Jimmy thanks him, and says he just wants his family again. Alex says that they're not family and that he, his siblings and his mother are alright because he left them. He adds that if he would have stayed, Alex would probably have followed in his footsteps. "You left us, thank God, so you can stop beating yourself up," he says, and proposes to fix things with his kid in Florida. "Good luck with that. Goodbye, Jimmy," Alex says, and he holds out his hand. Jimmy takes it and holds it, until Alex pulls his hand back and walks out of the room.

Derek explains to Karen that Dalton had a major stroke, that dislodged a blood cloth in the carotid during surgery. He says it's a rare outcome for any surgery, and that they'll persue any avenue to rehabilitation, but he's afraid they can't fix it. He walks out of the room, and Karen asks Jackson if Dalton is awake, but can't speak. Jackson confirms this, but he says they'll do everything they can. He says he's sorry, and Karen starts talking to her husband. She asks if Dalton can hear her, but Jackson says they can't be sure of that. She then sings their song, just like he did before going into surgery.

Outside the room, Stephanie asks if it was something they did, but Jackson says it was totally unforeseen. He's beating himself up though, and Stephanie wants to say she loves him, but she only says "I l...", and says it was nothing.

In the ER, Jo asks Leah to cover her patients as she isn't going to the wedding. Leah says she is going, as she's going to stand up for what she deserves. She plans to stand up in front of everyone and tell Arizona how she feels, so Arizona will be forced to deal with it. "And I sound crazy! And this the thing, the thing I do!" Leah realizes, and Jo says it is. Leah hugs her and thanks her for not letting her do that, and she says she'll cover her patiens. Jo walks away, and Leah suddenly realizes she's already at the allowed 80 hours for the week. "I can fix that," Shane says. He's drinking an energy drink again, takes the tablet and explains how to change the hours manually. "You do this?" Leah asks, and Shane says he can't believe she doesn't. He walks away, and Leah asks herself when he sleeps.

Derek, who's dressed up for the wedding, tells Owen that Avery's stroke patient is under his care now. He asks Owen, who's still in his Chief outfit, if he's going to the wedding himself, as he's been yelling at people all day to go. Owen says he's going to change and get Emma, and then asks Derek if saying no the the Kleiss guys wasn't enough for him, so he had to drag down everything they're doing. Derek says he wants to help them, but it's just bad timing as he wants to keep his focus in the hospital to turn it into innovativation home. Derek gets into the elevator, but Owen holds it. He tells Derek that if the president asks you to serve, you serve. Derek says that this isn't like Owen's calling was. "This is about guys just trying to score some government money and stacking the deck with my name," he says. "I appreciate how you feel, I do, but this isn't that," Derek says. Owen lets go of the elevator door.

Callie and Arizona arrive at the wedding. Callie says she wants to have a toast to celebrate fase 2 of the research after the ceremony is over. Callie says it's Arizona's research too, as she inspired her to do it, and she wouldn't be doing it without her. Arizona starts crying, and lies to Callie that it's the wedding gets to her.

In front of the barn where the ceremony is going to take place, there's table with little boxes and mints that say "mint to be". There's a sign asking the guests to open the boxes when the happy couple shares their first kiss. Stephanie and Jackson get to the table, and Stephanie says the mints are cute. Jackson takes on of the boxes and already opens it, just as Stephanie says they're not supposed to open them yet. A butterfly comes out of the box. "Nice, you just ruined Kepner's wedding," Stephanie jokes, and they go inside.

Bailey and Ben get to the table, where Bailey tells Ben that she can cure Elliot medically if she spends a few weeks in her lab. Ben asks what's going on with her: giving surgeries to residents, spending time in the lab where she first hid when she got the infection. Bailey asks what he's saying, and he confesses he's afraid she's going to quit surgery. Bailey then says that while they're on the subject, it's time to talk about why he quit surgery. He says he wants to be with his family, and says that they wouldn't have got the OCD thing under control if he hadn't been there. Bailey then points out that her symptoms got worse when he showed up having quit his job. "So that's what we're saying?" he asks, but Bailey says the thing is about to start so they go inside.

Leah and Ruth enter Jimmy's room, where he is deteriorating. Ruth puts on an oxygen masks, while Leah diagnosis him with an MI. She asks for an ECG and a crash cart.

In April's dressing room, Arizona tells April she looks beautiful. She breaks down crying, and April says it's sweet, and asks her if she can get it together. Arizona then says that it's driving her crazy how Callie is trying to forgive her and take care of her. April says she thought that's what Arizona wanted, and Arizona says it is, but she wants to fix the relationship that she broke. Callie on the other hand wants to fix Arizona, which is why she cheated. Lauren was attracted to her, and she never knew Arizona before the accident. Callie makes her feel that she's not enough, and she knows it's unfair to Callie as it's not her fault. She says she hates feeling this way. "Callie is trying to fix everything and I'm finally feeling okay the way that I am now, and I'm not sure Callie will ever make me feel that way," Arizona says as she starts crying even more. April hugs her. "I'm so sorry you have to go through all this... Today," April says. Meredith then comes in.

Shane is in the room, and he plans to operate on Jimmy. Leah says that she only paged him to get Yang, who's Jimmy's doctor. Shane says that Yang is at the wedding, and he's here now. Shane says he knows what he's doing, as he treated Jimmy before. "Then find Russell, or page the on-call doctor," Leah says, but Shane doesn't listen and tells Ruth to have an OR cleared so they can perform a sternotomy. Ruth agrees with Leah that they should wait for an attending. "You wanna wait? We'll wait, then you can explain to the attending how this man died because you wouldn't let me help him! Is that what you wanna do?" Shane asks.

Arizona and Meredith are taking care of April's veil. "Yang forgot, I knew one of you would forget," April says, as Cristina comes in too. "Oh, thank you! I knew you'd make it!" she says and she starts explaining what she wants them to do. Cristina doesn't listen, and she asks Meredith how she dares to say that she hasn't change. "I don't have to justify my choices to you, not one!" Meredith says. "How dare you say that I am the same person I was when I got here? Before I knew Burke, and Owen, and you?" Cristina asks. "Your life looks different because it's filled with houses and husbands and kids and mine looks the same, but I'm not. I've changed. I'm doing this alone, and that's... That's just as hard as what you're doing. But I thought I would at least have you," Cristina says. Meredith then confesses that she's so jealous of Cristina that she wants to set things on fire. "You did what I tried to do and I couldn't! And you didn't even know how you did it! You have nothing but time and focus! You're not who we were when we got here, you are who we both set out to be!" she says. "And you are something we never saw coming. You are as good a mother as you are a surgeon, and I'm happy for you, but we are growing apart," Cristina says. Meredith says she knows, and doesn't want to compete with her. "But I do, because we're supposed to push each other and make each other better, forever, since the day we met. Right?" Meredith asks, and Cristina agrees. They want to keep talking, but April yells to shut up. "Today is not the day! You two, superneat that you're working your crap out, but not today! And you, you know what, stop talking about adultery on my wedding day because it is my wedding day! I should be feeling very special right now, I should be flumpsed and fluffed up and checked over and handed tissues and told not to cry with joy. So, you know what, stop thinking about you and you make me feel special!" The bridesmaids nod, and Meredith points at the tissue box. Cristina grabs it, and asks if April wants a tissue. Meanwhile, the others start taking care of her.

Leah and Shane are operating on Jimmy. The pericardium bursts, and they're starting to lose control. They need  to put him and bypass, but Shane is confident that he can stitch, and he yells at Bokhee to give him the things he needs. While the heart is tearing, he keeps on yelling he can fix it. Leah tells a nurse to find anyone who can help them.

Leah tries to convince Shane to just put on pressure on the heart to keep it from tearing further until there's someone who can help them, but Shane insists he can fix it. Leah tells to get back and get his hands out of Jimmy's chest. She puts her hands in the chest too, but Shane takes them out. "I got it, I got her!" he yells. He's totally lost it. Leah runs away.

The bridesmaids and April are ready. They open the door, and they see Owen and Derek standing in front of it. Meredith and Derek go to talk on their own, while April is happy that the Chief came to her wedding. "Of course, the whole hospital is practically here," he says, which surprised April. Owen tells her she is very well liked, and she starts crying. She says that if it weren't for him, none of this would be happening to her. Owen says she deserves all of it, and says she looks beautiful.

Meredith asks how the kids are, and Derek says Zola cried because she couldn't come with. Meredith says she's spoiled by having him around so much, and she thanks him for giving her the time she needs for her research. She knows he's turning down a lot of stuff to make sure she gets the time she needs. "It's my pleasure," he says, and they kiss.

Outside the barn, Jo is waiting for Alex. He appears and kisses her, and says that they are the only family they need. "We'll be together forever, right? You and me? And if we have kids, we'll be great. I'll be a great dad, and you'll be great and it'll be just us. We won't need anybody else, okay?" he says, and Jo agrees. They share a passionate kiss.

Leah finds Richard preparing for his surgery, and yells that he needs to help them.

Meanwhile at the wedding, Arizona walks down the aisle. At the altar, Mattew, Drew, Nicole and Matthew's other groomsmaids are waiting. Arizona shares a lovely look with Callie, but this causes Arizona to almost start crying again. Meredith follows, and shares a look with her husband. Lastly, there is Cristina, who is being looked at angrily by April's sisters. They take their places, and the guests get up when April and her dad appear. April and Matthew also share a look, and she smiles beautifully.

Richard enters the OR, where he finds Ross staring at Jimmy's chest. He tells Leah to get rescrubbed, and he asks Shane what they got. "I did this," Shane says, with his scrubs covered in blood and his hands resting on Jimmy's chest. "So I hear there's a tear in the right ventricle?" Richard asks. "It's my fault," Shane says, and we then see flashbacks of Shane sending Heather to the basement and finding her there, electrocuted. Richard concludes they need bypass and he asks Shane what he thinks.

April's dad walks her down the aisle. Everyone admiringly looks at her. April takes her place at the altar.

Richard tries to get his hands into Jimmy's chest, but Shane blocks the chest with his hands. Richard calmly says that Shane needs to take some rest, but Shane doesn't want to. "When I come back, she'll be dead. It's my fault, I sent her to the basement," he says, while there's a flashback of Heather on the operating table. Richard manages to convince him to look at him. "I got her, she's going to be fine. Go get some rest," Richard says, and Shane leaves. He starts operating and yells to page someone from cardio.

The ceremony has started. Drew talks about committing love to one another and asks the guests to pray together. Derek gets a phone call, and stands up and walks away to answer it. A female voice says that there is a call for him that seems important, so she'll put him through. A male voice then asks him to please hold for the President of the United States. While Drew talks some more about committing love, Arizona and Callie share a look, causing Arizona to tear up again, and Cristina glances at Emma and Owen. Derek sits back down, and seems a little shaken up. He smiles at Meredith when she looks at him.

A trail of blood spatters lead to the elevator, where Shane just stands completely motionless.

In surgery, Richard starts heart massage on Jimmy.

Drew asks the guests if they will support the marriage. Everyone but Jackson says "I do". Jackson turns to Stephanie and says he's sorry. He then stands up, like Meredith tells in her voice-over, but sits back down when he notices everyone is staring at him and that Drew stopped talking. Everyone is surprised by his actions, Stephanie in particular. As the ceremony goes on, he gets back up again. He tells her he loves everything about her, even the things he doesn't like, and that he wants her with him. "I love you, and I think that you love me too. Do you?" he asks. Everyone is shocked by his words, and Alex rolls his eyes. April is speechless, and everyone looks at her. She gasps.

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

 * James Remar as James Evans
 * Jason George as Dr. Ben Warren
 * Justin Bruening as Matthew Taylor
 * Marguerite Moreau as Dr. Emma Marling
 * Benjamin King as Dalton Marks
 * JD Cullum as Kleiss Neuroscience Guy #1
 * Alina Phelan as Karen Marks
 * Jonathan Nichols as Cody's Father
 * Elizabeth Bond as Kimmie Kepner
 * Grace Bannon as Alice Kepner
 * Emily Happe as Libby Kepner

Co-Starring

 * Sean Abbott as Reverend Drew
 * Nick Jaine as Tim
 * Nicole Cummins as Paramedic Nicole
 * Teresa Huang as Nurse Ruth
 * Tatiana Chekhova as Seamstress
 * Bryce Lee Townsend as Elliot Hooks
 * Amber Friendly as Photographer
 * Kathy An as OR Nurse
 * Joyce Thi Brew as Circ Nurse

Uncredited

 * Charles Drew as Joe Kepner

Cody

 * Diagnosis:
 * Abdominal Bleeding
 * Burst Fracture at C6
 * Doctors:
 * Arizona Robbins (pediatric surgeon)
 * Callie Torres (orthopedic surgeon)
 * Alex Karev (pediatric surgeon)
 * Treatment:
 * Surgery
 * Spinal Fusion

Cody was driving a tractor when he hit a bump, fell off, and the tractor ran over him. His father called an ambulance, but when Cody lost consciousness, his father panicked and brought Cody to the hospital by himself. When he arrived at the hospital, he had hyporeflexia, absent response to tapping of the tendon. The doctors determined that his neck had been broken and when his father moved him, his neck was damaged, potentially paralyzing him. After surgery, there was still no nerve response, which may indicate that the paralysis is permanent.

Elliot Hooks

 * Diagnosis:
 * Bronchial Tumors
 * Doctors:
 * Miranda Bailey (general surgeon)
 * Leah Murphy (surgical resident)
 * Treatment:
 * Tumor Debulking
 * Custom Drug (planned)

Elliot started treatment when he was four for his bronchial tumors. Since then, he has had 312 surgeries. His growths keep recurring, compromising his breathing, so they have to be debulked every 7-10 days. Rather than continue this treatment plan, Dr. Bailey suggested that she try to culture his tumor cells in a lab and customize a drug to stop the growth. Since that wouldn't be an immediate possibility, Dr. Bailey allowed Dr. Murphy to do his final debulking.

Dalton Marks

 * Diagnosis:
 * Zenker's Diverticulum
 * Stroke
 * Doctors:
 * Jackson Avery (plastic surgeon)
 * Stephanie Edwards (surgical resident)
 * Derek Shepherd (neurosurgeon)
 * Treatment:
 * Surgery

During surgery, Jackson discovered that he couldn't get access with the scope, so he went in surgically. The procedure was successful, but Dalton had a post-op stroke, leaving him unable to speak or move, despite being awake.

James Evans

 * Diagnosis:
 * Drug Addiction
 * Myocardial Infarction
 * Acute Mitral Regurgitation
 * Doctors:
 * Jo Wilson (surgical resident)
 * Shane Ross (surgical resident)
 * Leah Murphy (surgical resident)
 * Richard Webber (general surgeon)
 * Treatment:
 * Sternotomy

James Evans suffered an MI which was found to the the result of acute mitral regurgitation. Shane discovered that and went to take him into surgery, despite the protests of Nurse Ruth and Leah, who wanted him to call Jeff Russell or page the on-call doctor. There was a ventricular perforation in surgery which caused a lot of bleeding in the chest. Leah suggested that they put him on bypass to fix it. But Shane had seen Dr. Yang repair it without bypass, so he tried to do that, despite Bokhee also suggesting bypass. The tearing continued. Leah turned to a scrub nurse and told her to call for help. When Leah tried to take over and hold pressure while they waited for help, Shane snapped and said, "Don't touch her!" Leah then ran to get help herself. The first person she finds is Dr. Webber, who immediately steps up to help. Shane has completely stopped at this point and is mentally reliving what happened with Heather. Webber tries to get Shane to snap out of it. Webber eventually gets Shane to leave him so he can operate.

Notes and Trivia

 * This episode's title originated from the song Get Up, Stand Up, originally sung by Bob Marley.
 * This episode scored 8.36 million viewers.
 * This episode is the mid-season finale of the tenth season, and thereby ended with different clliffhangers:
 * Has Cristina received a nomination for the Harper Avery Award? If she has, will she win?
 * Has Bailey decided to forget about surgery and focus on working in the lab?
 * Will Leah and Richard be able to revive Jimmy?
 * Why was Derek called by the president, and what did he tell him?
 * What will happen to Shane?
 * Will Meredith and Cristina become each other's persons again, or will they stay colleagues only?
 * How will April react to Jackson's confession?
 * Shane Ross finally comes clean to Webber about having sent Heather to the basement instead of having gone himself.
 * Emma Marling, Libby Kepner, Alice Kepner and Kimmie Kepner all make an appearance, though they have no lines.
 * Bokhee has a few lines in this episode, making this one of the very few episode where she speaks.
 * Richard Webber finally operates again. It's been since Perfect Storm that he has been in the OR (not counting the times he was being operated on as a patient). This makes him the main character who hasn't operated on anyone for the most episode in a row.
 * When Jackson confesses his love for April, he says "I want you with me". Curiously, that's the title of the episode in which he told her he didn't want to get together with her because she was just too scared of her real relationship with Matthew.
 * The way Shane walks out of the OR and into the elevator with his scrubs covered in blood is reminiscent of Cristina walking out of Burke's in From a Whisper to a Scream.
 * During the surgery, we see flashbacks from Seal Our Fate and I Want You With Me including Heather Brooks.
 * Curiously, April and Matthew met in Walking on a Dream, twelfth episode of the ninth season, and now, exactly one season later, they get married.
 * Both Cristina and Mer were previously shown with large curlers on their wedding days. Meredith also showed up at the hospital with them in, even though she was ultimately not the bride at the wedding.
 * April mentioned how she wanted the Mint To Be mint boxes and the butterflies at her wedding when she thought she was pregnant. The butterflies were also referenced when Jackson said they could get married.