State of Love and Trust

"We ask a lot of our patients. We put them to sleep. Cut them open. Poke around in their brain and guts with sharp instruments. We ask for their blind trust. Irony is, trust is hard for surgeons, because we're trained from day one that we can't trust anyone but ourselves. The only instincts you can count on are your own. The only skills you can count on are your own. Until one day, you leave the classroom and step into the O.R. You're surrounded by others, a team of others. A team that you have to rely on whether you trust them or not."

- Derek Shepherd

 is the thirteenth episode of the sixth season and the 115th overall episode of Grey's Anatomy.

Short Summary
As Derek begins his role as interim chief, he faces a potential lawsuit when Bailey and Meredith's patient awakens from anesthesia mid-surgery. Meanwhile, Teddy refuses to place Cristina on her service, as Arizona tests Alex out in Pediatrics, and Mark refuses to speak to a heartbroken Lexie

Full Summary
Derek was narrating, so you know something big was going down. He talked about how doctors ask for patients' blind trust. He was worried the staff would be mad at him for stabbing the chief in the back and taking his job. Meanwhile, rumors were swirling about changes at the hospital.

Meredith and Bailey were having trouble with a patient and couldn't figure out why her heart rate was through the roof. She was awake -- while her abdomen was cut wide open and her intestines were hanging out.

Everyone was waiting for Derek to make a big speech. He stepped up to the top of the stairs wearing a shirt and tie under his white coat. He announced he'd been appointed the new interim chief of surgery. The doctors were looking for clues in his speech, wondering whether he was hinting about getting rid of Mercy West people. While Derek was talking, the chief walked in and Derek fumbled a bit, but finished as the chief walked away.

Teddy asked Avery to work with her, and Arizona asked Alex to work with her. Avery mocked Alex about working in peds. Lexie asked Sloan about Little Sloan, but he ignored her.

Jennings asked the chief to agree to early retirement. Derek wanted the chief to sign a contract volunteering himself into rehab, and said he'd have a job waiting when he got out -- "pending board approval," Jennings added. The chief said he needed time to think and Derek asked him if he was considering quitting. Derek was called away to Meredith and Bailey's patient. He said that with any hope at all she might not remember having woken up during surgery.

They went in to talk to the patient and told her the tumor was removed. She was shaken and asked them about when she woke up and could feel them tearing up her insides and she could smell her burning flesh. Apparently, she didn't forget.

Bailey was worried they were getting sued, and she argued with the anesthesiologist about how she expected him to stay focused on his job and he failed.

Alex and Arizona worked with a teenage boy named Brad, who said he was having pain in the morning and at other times. His dad thought he was faking to try to get out of school. Brad insisted he wasn't faking it.

Cristina asked Teddy why she wasn't on her service and if she could be the next day, or the day after that. Teddy just said, "I can't today," and walked away.

Bailey and Meredith went in to see their patient, and she was still traumatized, refusing to let Bailey touch her and going into some kind of shock that caused her stitches to bleed. Meredith stepped in to take care of the problem while Bailey stepped back and walked her through it.

Lexie complained to Callie about Sloan not talking to her. Then Callie let it slip that Sloan slept with Addison more than once. Arizona and Alex couldn't see anything wrong with Brad's CT scans and wondered what they were missing. Alex had a theory that would require exploratory surgery to prove.

Cristina and Hunt met up in the ventilation room and did it.

Derek saw the chief sitting alone over the blank contracts and told him he should sign the papers and go to rehab. A shouting match ensued. Derek told the chief he did what he had to do. Derek admitted to the chief that he wanted the job, but he didn't want to end the chief's career. More doctors circled around the room. Meredith burst in and told Derek and Richard to stop fighting. Derek left and told everyone to go back to work.

The anesthesiologist told Bailey that some tests showed their patient had a condition they couldn't have known about that caused her to metabolize the drugs too fast. Bailey still worried about the patient and was upset that she couldn't help her because she couldn't touch her.

Cristina was limping around the hospital and said she "got a burn." She admitted they were on her butt. She showed Meredith, who wondered how it happened. Cristina admitted she was having sex with Owen, and said he was "being very caveman-like." Alex and Lexie pulled back a curtain to see Cristina in a compromising position, with her butt exposed while Meredith was treating her burn. Meredith had to go and asked Lexie to finish. Lexie then got sad because she used to get sex injuries with Sloan.

Teddy tried to talk to Hunt in the hallway and he blew her off. Avery organized Teddy's charts in a way that wasn't the way Cristina does it, but she said it would be fine.

Alex told Brad's father about the exploratory surgery and the dad shouted about how it was ridiculous and a waste of money. Arizona told Alex to advocate for his patient, so Alex did. He told the dad that if he took the chance of Brad not needing the procedure done, the results could be disastrous. So if the dad thought he was faking, that was fine. "How sure are you?" Alex asked.

Bailey went to her patient and told her she needed a second surgery. The patient said "it was like being in a coffin" because she couldn't talk or move. The patient asked Meredith to do it. She remembered Meredith was there, and was calm and kind. She insisted, even though Meredith said Bailey was far more experienced.

Derek, Sloan and Hunt had a little powwow in Derek's new office, giving each other a hard time over everything from the chief's dismissal (and Derek's role in it, which he wouldn't talk about), Sloan sleeping with Addison, and Hunt having a hickey. Hunt admitted that he and Cristina have been "getting along."

Meredith went to talk to the chief, who was still sitting in the conference room, and told her Bailey was letting her do the post-op bleeder surgery, and asked if she was capable of doing it. He said nothing. Meredith also told the chief that she knew he was thinking about quitting. He still said nothing. "I think if my mother were here to see this, she would kick your ass for even considering it," Meredith said. He still said nothing.

Alex's exploratory surgery revealed nothing.

Bailey told Meredith she wouldn't let her do the surgery if she didn't believe she could handle it.

Alex was tending to Brad when his parents walked in and he had to explain that Brad became unstable during surgery and had to have a chest tube put in. Reed came into the room and noticed a lot of blood in the tube while Alex was talking to the parents. Alex got a scalpel and cut into the boy, all the while his father was shouting, "Get away from our son."

Alex managed to stop the bleeding and Teddy came in to wheel the boy to an O.R. Then she paged Cristina, who was getting it on with Hunt. He was annoyed that she wanted to answer the page. He wanted her to stay with him. She did.

Teddy was operating and Avery offered to help, but Teddy seemed to be waiting for Cristina. She finally let Avery in.

Back in Meredith's surgery, Bailey and the anesthesiologist got a mild flirtation thing going on.

Callie went to Sloan and told him that Lexie had some good points, but he was still upset that she'd dumped him.

Bailey told Derek the patient was all good, but the lawyer was still there. She told Derek that nine out of 10 times you could avoid a lawsuit by apologizing. She said that was what Webber would do.

Teddy was angry with Cristina for not answering her page. Hunt jumped in and said it wasn't Cristina's fault and that he had detained her for a "trauma thing." Teddy got even more upset that it was the first time Hunt had talked to her all day, and she walked away. Cristina was upset with him, too, asking, "What are you trying to do to me?"

Arizona and Alex explained to Brad's parents that his heart ruptured. They were upset that their son was hooked up to some tubes, but Alex jumped in and said that if he'd been at home when his aorta ruptured he'd be dead. "Think about how much school he'd be missing then, huh?" Alex said before Arizona pulled him back.

Bailey went into the conference room where the chief was sitting. He asked her to go away. She told him he couldn't sit there. He said that if he signed the papers it'd be like saying Derek and Jennings were right, then he told Bailey they want him to say he's an alcoholic.

"Well, are you an alcoholic?" she asked.

"Yes," he said. "But if I sign these papers, then I have to stop drinking and go to rehab. And I don't think I'm ready for that. Drinking feels a little bit like all I have now."

She told him to go get better and be the man that she's always known him to be. "Be the chief," she said.

Arizona told Alex he couldn't get emotional if he was going to work in peds. She told him not to judge parents. He could advocate for the kids, but couldn't berate terrified parents. She told him to go apologize, then told him he saved that kid's life today.

"How'd it feel?" she asked.

"It feels great," he said.

"Hard core, right?" she said. "Welcome to peds."

Derek talked to the doctors again at the end of the day to apologize for getting off on the wrong foot. He said he didn't expect to have their trust right away, but they should know they have his. He then told all the doctors he was neither for nor against the merger and that each of them had a clean slate.

Then he hired back a couple of the doctors who were let go because of the budget cuts. He said there'd be cuts down the road, but they deserved a fighting chance.

Sloan and Lexie ended up in the same elevator and said nothing to each other while Lexie just started crying and walked out.

Cristina came home to find Hunt in her living room. He said he was trying to understand her, and she said he was trying to screw her into submission. He brought up Burke and asked about the engagement, and she refused to share that story. He said she wasn't giving him anything back in the relationship.

"I'm trying to love you," he said. "Why won't you let me?"

Then she started talking about Burke. She said "he took something from me. He took little pieces of me. And I let him." She said he wanted her to be something she wasn't and she made herself into something she never wanted to be. She told him about getting left at the altar despite all that.

"I lost myself somehow," she said. "But I'm finally me again."

She said she loved Hunt more than she loved Burke and that it scared the crap out of her, "because when you asked me to ignore Teddy's page, you took a piece of me, and I let you, and that will never happen again."

Derek sat in his new office and the chief walked in and handed him the papers. Derek said thank you, then he said, "I'm sorry." The chief walked out.

Main Cast

 * Ellen Pompeo as Dr. Meredith Grey
 * Sandra Oh as Dr. Cristina Yang
 * Katherine Heigl as Dr. Izzie Stevens (credit only)
 * 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

 * Kim Raver as Dr. Teddy Altman
 * Mitch Pileggi as Larry Jennings
 * Robert Baker as Dr. Charles Percy
 * Sarah Drew as Dr. April Kepner
 * Jesse Williams as Dr. Jackson Avery
 * Nora Zehetner as Dr. Reed Adamson
 * Jason George as Dr. Ben Warren
 * Spencer Garrett as Jim Walker
 * Chastity Dotson as Leslie Wilson

Co-Starring

 * Julie Lancaster as Dina
 * Corey Mendell Parker as Brian Wilson
 * Cody Christian as Brad Walker
 * Molly Kidder as Intern Megan
 * Kate Anthony as Nurse Kate
 * Joshua Wolf Coleman as Lawyer

Notes and Trivia
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 * This episode's title originated from the song State of Love and Trust, originally sung by Pearl Jam.
 * This episode scored 12.55 million viewers.
 * Jason George makes his first appearance as Ben Warren.

Quotes

 * Alex: What'd she say?
 * Jackson: That you're the best babysitter in the hospital.
 * Alex: Shut up.
 * Arizona: You don't think Peds is hardcore? Cause you can say that to my face Avery.
 * Jackson: (clears throat) No, Ma'am.
 * Arizona: Mm-hmm. Don't let the roller skates fool you. Peds is nothing but hardcore.


 * Cristina: Please don't cry on my ass.


 * Cristina: (to Owen) Burke was- He took something from me. He took little pieces of me, little pieces over time, so small I didn't even notice, you know? He wanted me to be something I wasn't, and I made myself into what he wanted. One day I was me Cristina Yang, and then suddenly I was lying for him, and jeopardizing my career, and agreeing to be married and wearing a ring, and being a bride. Until I was standing there in a wedding dress with no eyebrows, and I wasn't Cristina Yang anymore. And even then, I would've married him. I would have. I lost myself for a long time. And now that I'm finally me again, I can't. I love you. I love you more than I loved Burke. I love you. And that scares the crap out of me because when you asked me to ignore Teddy's page, you took a piece of me, and I let you. And that will never happen again.


 * Derek: Hi. I know it's been a long day, and you're all anxious to get home. But I feel like we got off on the wrong foot this morning. I don't expect to win your trust overnight. But I want each of you to know you have mine. Which is why I felt it was important to personally come in here and apologize. I am neither pro nor anti merger. From this point on, everyone has a clean slate. I am not focused on the past. I'm looking to the future to all the promise this hospital has to offer. I plan to honor Richard Webber and his legacy, not undo it, which is why I'm both humbled and honored to be your new Chief of Surgery.