Grey's Anatomy Universe Wiki
Grey's Anatomy Universe Wiki

Any first year med student knows that an increased heart rate is a sign of trouble. A racing heart can indicate anything from a panic disorder to something much, much more serious. A heart that flutters, or one that skips a beat, could be a sign of secret affliction or it could indicate romance which is the biggest trouble of all. It seems we have no control what so ever over our own hearts. Condition can change without warning. Romance can make the heart pound just like panic can. And panic can make it stop cold in your chest. It’s no wonder doctors spend so much time to keep the heart stable, to keep it slow, steady, regular to stop the heart from pounding out of your chest from the dread of something terrible or the anticipation of something else entirely.

Beat Your Heart Out is the fourteenth episode of the fifth season and the 92nd overall episode of Grey's Anatomy.

Short Summary[]

Izzie has the interns do a barrage of tests on her to find out what's wrong with her. While the Chief tries to get Bailey to stay in general surgery, Dr. Dixon and Dr. Robbins both tell her that she is really meant for peds. Lexie decides she wants to go public with Mark, withholding everything from him until he does, and Arizona kisses Callie. Knowing that Meredith is ready for marriage, Derek gets ready to propose, but his plans for a grand gesture are interrupted.

Full Summary[]

Izzie's in the clinic, trying to draw her own blood. The interns enter for their shift there and they complain about it. Izzie comes out from behind the curtains and greets them.

Cristina enters an on-call room and wakes up Owen. She apologizes and wants to leave, but he says she has to sleep since she's been at the hospital all night. He gets paged. He says she should wear her hair up more, so he can see the back of her neck, which he likes. He leaves the room and she touches her neck.

Lexie and Mark get off an elevator together. Meredith catches up with Cristina, who tells Meredith about her encounter with Owen.

Callie asks Lexie how it's going. Lexie enthusiastically talks about how good Mark is, and not just in bed. Callie doesn't want to hear it, but Lexie wants to talk and she's the only one who knows about them. Callie says alone people don't like to hear about together people, even they're alone by choice.

Meredith asks Cristina to proofread a journal for Ellis for any signs of her romance with Richard since she doesn't want to read that.

Mark sees Derek's ring for Meredith. Derek says he has to find the exact right time so Meredith won't run off. Owen joins them and he disappears into an exam room with Mark, who wants to make it quick. They come out soon after and Mark zips his pants. It's looking good.

Lexie joins Meredith in the ambulance bay. Meredith asks what's up between her and Mark, as she's been on his service all week. Lexie says she has an interest in plastics. The ambulance arrives. The patient's wife is panicking. She ran over her husband with their car. She tries to calm herself down but faints as her husband's taken inside.

Jen blames her pregnant brain. Callie says her husband has an inferior shoulder dislocation and some associated fractures. The neuro exams look good. They'll also have to debride his burns in surgery. The baby is kicking like crazy.

Meredith has to get Jen's blood pressure down before it affects the baby. Derek says it's a nice couple, they'd have nice kids. Meredith says not as cute as theirs.

Bailey's taken three days of vacation. Richard understands Jackson wasn't an easy case. He's promoting her and he needs another attending in general surgery, and he's submitting her for the board. She can start in July when her residency is over. He heard she was tired of general, but she says it sounds great after the dying kid. He says he's waiting for the board's approval. In the meanwhile, Virginia Dixon has requested her today.

Cristina is talking to patients about how to handle Dr. Dixon. She's amazing in the OR. Virginia walks in with Bailey. The patient is a young girl named Stacy, which Bailey doesn't seem to like.

Down in the ER, a man and his wife are refusing interns and residents. They approach Richard, as they want a grown-up. Warren and Rachel explain they were trying something new, which they read about in a magazine to re-ignite their nights. They did number 9. Richard, Alex, and Ryan look at it and tell Rachel they'll get her in a gown, but they clarify Warren's the patient. Richard tells him to take a seat while waiting, but Warren prefers to stand.

Callie wants to reduce Rob's shoulder before surgery. Lexie and Meredith are worried about Jen's placental blood flow. They have to keep her calm. Jen's okay, though. Rob tells the doctors that cheeseburgers calm Jen down.

While Virginia is talking to Stacy's parents about the surgery, Bailey tells Cristina she's walking out the second it starts to look like Stacy's going to die. Bailey explains to Stacy they'll fix the part of her heart that pumps blood to the lungs, which should be easy to fix. Bailey compliments Stacy's socks, which have soccer balls on them. Stacy's the best on her soccer team, and she wonders when she'll be able to play again. Bailey says they'll have to see.

Derek finds Cristina and asks if she talked about the ring. Cristina hasn't, but she makes sure he'd know that Meredith would hate a big, romantic, McDreamy thing. She built him a house of candles because he likes it, but she doesn't.

Meredith asks Cristina about the journal. Cristina says it's hot, like a Victorian romance novel. It's all stolen glances now, but she'll let Meredith know when they actually do it. She walks off. Owen joins Cristina and they walk down the hall together, their hands almost touching. After a little stroke, Owen walks off. Cristina smiles.

Mark spills to Richard that Derek's proposing to Meredith. Richard's happy to hear that and asks how he's going to do it. Derek doesn't know yet. Mark also tells Owen, who congratulates him. Owen's not the guy to ask when and how to do it. As Meredith walks by, Derek diverts the conversation to medicine. Derek asks Mark not to tell anyone else.

The interns are laughing about Warren's case. Alex tells them to stop as the patient can see them. Richard comes over, but they can't stop giggling. Richard will teach them how to be professional. Richard walks up to Warren and says they'll perform a sigmoidoscopy to remove the foreign object from his rectum, followed by manual extraction.

In the clinic, Sadie's trying to find a vein on Lorraine, but she's not doing well. Izzie comes over and has Sadie practice on her. Izzie asks Sadie to also run her blood. She asks the other interns to come see her before they run any other procedures today. 

Callie and Mark are operating on Rob. Callie asks Mark if he's ready to get back on the horse now that Hunt cleared him. Mark thinks he has to break up with Lexie. Before Callie can ask, Meredith comes in. She was stuck taking care of the wife, who's stressed out. There's a huge subclavian bleed. Mark asks to have Owen paged.

Lexie's on the phone with the OR from Jen's room. The nurse informs her it's not looking good. Jen, meanwhile, is enjoying her cheeseburger. Lexie hangs up and Jen asks what they said. Lexie says it's taking a little longer than expected. Jen's heart rate goes up, but Lexie assures her it's going great. Jen calms down as Lexie explains it's good they're taking their time. Jen's pressure is way down, Lexie says. Jen suddenly has a seizure.

Bailey gets paged. She gathers herself before going to Stacy's room.

In Stacy's room, Cristina informs her that Stacy's tamponading. Bailey gets gloved and explains to Stacy she'll be okay. Cristina handles the ultrasound while Stacy's moaning in pain. Bailey inserts the needle, which relieves Stacy's pain.

Arizona tells Dixon and Bailey that Stacy's pulmonary pressures are high. She's got cor pulmonale. Dixon says Cristina is getting an OR. Arizona asks Bailey to let her know how the surgery went. Bailey tells her to stay. She's not scrubbing in on this one. Arizona says she can handle this surgery. Bailey knows that, but what she can't handle is the feeling of another kid slipping away. Arizona reminds her they saved Jackson. Kids are resilient. Arizona is sure Bailey wants to be there when they fix Stacy and give her the rest of her life.

Owen's doing his best to stabilize Rob. His pressure goes up. Callie thanks him as Lexie comes in to inform Meredith that Jen had a seizure. Meredith leaves the OR with Lexie. Callie tells Mark he's an idiot. Mark says Derek is proposing, so that makes Lexie Derek's little sister. Callie says she's celibate. She's lonely, so she knows he should let himself be happy instead of wondering what's right before he finds himself alone.

Izzie is teaching Sadie how to do an X-ray with herself as the patient, saying she has to do one later on a patient who supposedly just has the flu. Izzie says they need to do it to rule out pneumonia. Sadie tells Izzie to lay still and does the X-ray.

Richard asks Derek if he's gonna do a grand gesture. Richard says he has to do it, as it has an influence on their entire marriage. He has to go all out. Richard gives him some extreme options as Meredith comes over. She needs a consult. Richard returns to Warren.

Derek examines Jen, who sees the ring box in his pocket. As she asks what that is, Derek sends out Meredith to go set up an MRI for Jen. Once Meredith's gone, Derek explains to Jen the ring is for Meredith. Lexie is surprised, too. Jen asks when he's gonna do it. Jen says a grand gesture isn't needed. Rob proposed to her in the supermarket as they met there for the first time. Jen asks if she should be scared. He says no, and asks her the same. She says no, too.

Dixon is operating. She can repair the VSD, but this heart is one the most diseased she's ever seen. Without a heart-lung transplant, she's going to die. Bailey steps away from the table and leaves the room while gasping for air.

Dixon explains to Stacy's parents that her heart is too diseased to repair. She needs a transplant, which may take years. The parents break down in each other's arms. Dixon asks Cristina where Bailey is.

Bailey is playing with her son in daycare. She watches as a mother comes to pick up her daughter and puts the backpack on her daughter's back.

Izzie's in the CT scanner and asks her interns through the intercom what they see. George comes into the room and says he sees a crazy person doing expensive tests for no reason, which can get her expelled. Izzie asks her interns to kick George out.

Meredith's walking with Lexie and Cristina as they transport Jen. Meredith tells them that she mentioned kids this morning and now Derek is acting weird around her. Maybe he doesn't want her babies. Lexie says it's not that, and Jen backs her up. 

Jen is all set for her MRI. As Meredith leaves the room, Jen tells Derek to do it soon, as Meredith's freaking out. Derek thanks her and activates the scanner.

The interns and residents are passing Warren's magazine over lunch. Sadie likes almost all the numbers. Meredith would want to try 15, but Izzie and George simultaneously tell her not to. Alex and Izzie leave to go do 16, but Lexie warns them not to do it too fast. Cristina tells Meredith that her mother likes a 12.

Cristina walks up to Owen and asks if he's on call too, tonight. He is. She smiles and pulls her hair together as she walks off.

Dixon tells Stacy's parents that it would be fatal if she missed one dose of her meds. The father is worried she has to live in a bed for years, but Bailey comes in with a backpack and says there's another way. Bailey explains the backpack can contain a portable pump that'll deliver her meds, so Stacy can live a relatively normal life. Dixon freaks out and says they should have discussed it earlier, in private. Dixon starts shaking as the parents thank her. The mother hugs her. Dixon screams and leaves the room.

Bailey finds Dixon as she's crying and tightly pulling her lab coat around her body. Dixon says there was too much in the room to handle. Bailey wants to leave her alone, but Dixon needs pressure. She needs her nervous system suppressed. Tight pressure across large areas on her body helps her to calm down. Bailey needs to hold her. Bailey does so, which helps, but Dixon needs a bigger person. Cristina comes in and Bailey instructs her to hold Dixon, too.

Jen has a brain aneurysm. All her symptoms were thought to be from the pregnancy, but the seizure made it clear. They can fix it in the morning when Rob's recovered from the complications. Jen didn't know about the complications. Lexie explains she didn't want to worry her earlier, but he is fine. Meredith tells Jen she has to stay calm, but Jen can't stay calm.

Cristina and Bailey are still holding Dixon. Dixon explains cows are also squeezed tightly in a chute before being slaughtered, as it calms them down. Those principles also apply to people like her. A hugging machine slows her heart. Cristina wants to stop, but Dixon tells her not to.

Richard removes the foreign object from Warren's rectum and puts it in a bowl. Warren thanks him. He won't spice things up ever again. Alex says it was good that he tried. Richard says bending over backwards to find new ways to make each other happy might just make you see you're doing just fine.

Ryan. Richard, and Alex are scrubbing out. Alex laughs at "bending over backwards". Richard and Ryan start laughing, too.

Dixon tells Cristina and Bailey they can let her go now.

Sadie finds Izzie. She has Izzie's blood test results. Izzie's anemic. Izzie looks at the results and tells Sadie her face told her she was going to die. Controlling your face is part of patient care. Izzie says anemic is no big deal. She's relieved. Izzie asks about Lorraine. Her results aren't good. Her LDH is off the charts, which indicates cancer. Izzie tells Sadie to call oncology. Izzie says they'll tell her together.

Lexie meets Mark in an on-call room. Lexie says she doesn't want to keep secrets. She's been keeping secrets all day, and the Mark secret is giving her high blood pressure. They're having a relationship and she needs to be in it in front of her sister and Derek. If she can't do that, then she can't do this.

Cristina and Owen smile at each other from both ends of a hallway and start walking towards each other, until Owen sees a woman get off the elevator behind Cristina. He recognizes her and runs off.

Owen's shaking and panicking in a trauma room. Cristina comes in. He says he just saw someone he knew. He can't do this. Cristina holds him like she held Dixon to calm him down. She explains he'll feel calmer soon. He gasps for air but calms down.

Bailey apologizes to Dixon for her outburst. Dixon says pediatric surgeons always break protocol. Bailey says she's not a pediatric surgeon. Dixon says she touches the child when she speaks to her, explains conditions to the child, reacts as if it were her own child, and breaks protocols, which always happens in pediatrics, where protocols are always evolving. Bailey's not a general surgeon. She is a pediatric surgeon. Arizona smiles.

Derek's on his way out. Meredith asks him to wait so she can come with, but he says he has to work. Meredith says he's been asking like a basket case since she dropped the baby comment. If he doesn't want babies with her and her crappy DNA, he should just say so. Derek says he wants her crappy babies. He doesn't want to eat with her now, though. He leaves.

Arizona joins Bailey as she's watching Stacy and her parents. Bailey uses a bedazzler to make the backpack pretty for Stacy. Arizona says Dixon was right. Bailey belongs in peds. Bailey says her own baby almost died and her friends saved his life. She stood outside the room, feeling useless and helpless. When her son didn't die, she knew she never wanted to be near that feeling again. So, she thinks that makes her unsuitable for peds. Arizona says that makes her uniquely qualified.

Lexie sits down with Callie at Joe's. Lexie wonders if Mark will tell Derek. Callie says he will if he's not an idiot. Lexie asks if she's okay. Callie gets up and walks into the bathroom. Arizona is sitting at the bar, too.

Meredith walks into an on-call room. Cristina is lying on the bed, with Owen sleeping on her. She herself is reading Ellis's journal. Cristina says she's just staying here. Cristina tells her he's planning to propose. "What?" Meredith asks. Cristina then pretends Ellis wrote about Richard wanting to leave Adele and propose to her, but she thinks Richard never did. Meredith says that's sad. "Is it?" Cristina says. "Or romantic," Meredith says. She leaves.

Arizona enters the bathroom, where Callie is wiping her tears in front of the mirror. Arizona recognizes her from the hospital and introduces herself. Callie pretends she's fine. Arizona says people talk at the hospital, so she knows things about Callie. The talk is terrific. People really like her. Some of them really like her. She sees Callie looks upset, so Arizona thought she should know the talk is good, so when she's over being upset, there will be people lining up for her. Callie laughs and asks if she can give her some names. Arizona leans in and kisses her. "I think you'll know," Arizona says. They smile and Arizona leaves.

Mark and Derek are lighting candles in Meredith and Derek's bedroom. There's a heart made out of rose petals on the bed, bouquets of roses everywhere in the room, and a giant teddy bear. Derek says Meredith will hate this. He's a cliché. Mark says clichés became clichés because they work. Mark says it's great when you feel so strongly about someone. Derek laughs and says he shouldn't talk like that. Mark congratulates him and leaves. Derek's phone rings. It's Addison. He asks what happened.

Izzie's in the clinic by herself, busy with paperwork and lab results. Alex comes in. She puts the papers in a drawer and leaves with Alex.

Cristina is still reading with Owen sleeping on her chest.

At home, Meredith enters her bedroom. Derek, the roses, the candles, and the teddy bear are all gone. She lies down on the bed and finds a rose petal under her pillow.


Main Cast[]

Guest Stars[]


Medical Notes[]

Mark Sloan[]

  • Diagnosis:
  • Treatment:

Mark had a post-op visit for his penis. Owen cleared him.

Rob Harmon[]

  • Diagnosis:
    • Inferior shoulder dislocation
    • Associated fractures
    • Burns
  • Treatment:
    • Surgical reduction
    • Burn debridement

Rob was hit by a car driven by his wife. His shoulder was injured. They took him into surgery to reduce the dislocation and debride his burns. In surgery, he started bleeding extensively, but they were able to stabilize him.

Jen Harmon[]

  • Diagnosis:
    • Pregnancy
    • Pregnancy-induced hypertension
    • Seizure
    • Aneurysm
  • Treatment:

Jen came into the ER with her husband after she hit him with a car. She passed out in the ambulance bay and so she was taken to be examined. Her pregnancy was keeping her blood pressure up. Her pressure went down, but then she seized. After her seizure, they ran an MRI which revealed an aneurysm. They planned surgery to clip her aneurysm.

Stacy Pollock[]

  • Diagnosis:
    • Ventricular septal defect
    • Pulmonary hypertension
    • Left ventricular hypertrophy
    • Cardiac tamponade
    • Cor pulmonale
    • Eisenmenger's complex
  • Treatment:
    • Pericardiocentesis
    • Transcatheter closure
    • IV medication

Stacy, 9, had secondary pulmonary hypertension due to a VSD. Dixon planned a transcatheter closure to repair the septal defect. She developed cardiac tamponade and they did pericardiocentesis. She had developed cor pulmonale, so they moved her surgery up. In surgery, Dixon discovered Eisenmenger's complex. She repaired the VSD but said Stacy's heart was too diseased and she needed a heart-lung transplant. Until she got one, she needed IV medication every three minutes. A missed dose would be fatal. Bailey had the idea to have her wear a backpack, which would administer her medication and allow her to leave the hospital.

Warren Kramer[]

  • Diagnosis:
    • Foreign body in rectum
  • Treatment:
    • Sigmoidoscopy
    • Manual extraction

Warren was injured while having sex. He had a foreign body stuck in his rectum. They planned to do a sigmoidoscopy and then manually extract it.


  • Diagnosis:
    • Cancer
  • Treatment:

Lorraine was in the clinic. They drew blood for tests. Her test results indicated cancer, so they consulted oncology and started a workup.

Izzie Stevens[]

  • Diagnosis:
    • Anemia
  • Treatment:

Izzie had the interns run tests on her while also running them on patients. It revealed anemia.


Song Performer Scene
"Stuck To You" Nikka Costa
  • Izzie tries to draw her own blood.
  • The interns enter the clinic and complain about their clinic shift.
  • Cristina accidentally wakes up Owen. He gets paged and tells her to wear her hair up more.
  • Mark and Lexie come into the hospital together.
  • Meredith and Cristina talk about Owen.
  • Lexie talks to Callie about Mark.
  • Meredith asks Cristina to proofread Ellis's journals.
  • Mark sees Derek is carrying a ring around.
  • Owen checks on Mark's penis.
"Transmission" Panda Transport
  • Bailey spends time with little Tuck in daycare.
  • Izzie is in the scanner. George interrupts, but Izzie asks her interns to kick him out.
  • Meredith talks to Cristina and Lexie about Derek while Jen listens in.
"These Streets" Trolle Sievenhaar
  • The residents and interns discuss sex positions that are in a magazine.
  • Cristina goes to talk to Owen and starts to put her hair up.
"Re: Stacks" Bon Iver
  • Jen wants her surgery now.
  • Cristina and Bailey hug Dixon.
  • Richard, Alex, and Ryan perform the extraction.
  • They laugh about it while scrubbing out.
"Halo" Kate Havnevik
  • Arizona tells Bailey she's qualified to be a peds surgeon.
  • Lexie sits down with Callie at the bar.
  • Meredith walks in on Cristina reading a journal while Owen's sleeping on her. Cristina talks to her about Richard and Ellis's affair.
"Never Want To Say It's Love" Dido
  • Arizona and Callie share a kiss.
  • Mark and Derek are preparing Meredith and Derek's bedroom for Derek's proposal. Mark talks about true love.
  • Derek receives a call from Addison.
  • Izzie reads her lab results and leaves with Alex.
  • Meredith lies down on her bed and finds a single rose petal under her pillow.

Notes and Trivia[]


Grey's Anatomy 5x14 Promo

  • This episode's title originated from the song Beat Your Heart Out, originally sung by The Distillers.
  • This episode scored 15.20 million viewers.
  • This episode leads into the Private Practice episode Acceptance and runs in parallel to the episode.
  • This is the start of the Grey's Anatomy-Private Practice crossover.
  • This episode features the first meeting and first kiss of future wives Callie Torres and Arizona Robbins.
  • This episode introduces Callie with bangs in her hair.
  • This episode marks the addition of Kevin McKidd to the main cast.
  • This episode is the last appearance of Mary McDonnell as Dr. Virginia Dixon.


Episode Stills[]


Derek: Addison? What happened?

Callie: Alone people don't like to hear about the together people, okay? Even if the alone people are alone by choice. It's just sort of mean. It's sort of like bringing a 6-pack to an AA meeting.

Meredith: How is it? The journal? Is it gross. Were they naked?
Cristina: No, not yet. It's kind of ... hot, actually, but chastely hot.

Izzie: You want to take narrow slices with the scan so you get a more comprehensive look. What do you see?
George: I see a crazy person taking expensive tests for no reason and, oh, I see the Chief finding out and expelling the crazy person. And then I see joblessness, homelessness and depression. It does not look good, Izzie.

Meredith: You have been acting like a basket case ever since I dropped that stupid little comment about babies. And I'm glad I dropped it, because if you don't want babies, or you don't want babies with me and my crappy DNA... just say so! You don't have to avoid me. You don't have to make up lame excuses about work.
Derek: Meredith, I want your crappy babies.

See Also[]

A complete overview of this episode's crew can be found here.

The Grey Matter blog post on this episode can be found here.