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As interns, we know what we want, to become surgeons. And we'll do anything to get there. Suffer through killer exam, endure one-hundred hour weeks, stand for hours on end in operating rooms, you name it, we'll do it. The tough part, though, is reconciling this huge thing we want to be surgeons with everything else we want. Too often, the thing you want most is the one thing you can’t have. Desire leaves us heartbroken, it wears us out. Desire can wreck your life. But as tough as wanting something can be, the people who suffer the most are those who don’t know what they want.

Desire is the twenty-first episode of the third season and the 57th overall episode of Grey's Anatomy.

Short Summary[]

The Chairman of Seattle Grace's board of directors is admitted and all the attendings vie for his favor, Izzie and George keep getting confronted by the results of infidelity, and Preston presses Cristina for a decision.

Full Summary[]

The interns are studying together for upcoming intern exam and quizzing each other at Cristina's apartment. They take turns sitting in the answer chair while Burke cuts a cake. He needs Cristina to try a bite. She does, but she doesn't really comment on the taste. She's more concerned about whether or not George used Callie's legendary flash cards. Burke brings up another slice of a different cake, but she says she loves all the cakes and has him break the tie between her and Alex.

Meredith catches up with Derek as they enter the hospital. She hasn't seen him in days. He can stop with the not hovering. She has come to realize it was sweet of him to worry over her. She has decided she will communicate better from now, which she demonstrates by talking him through her morning.

Mark and Addison get on an elevator. He reminds her there's still only 28 days to go before they can get together. She'll be more enthusiastic when they actually cross the finish line. He just needed to make sure she hadn't lost interest in the project, which she hasn't.

Burke has set up all different cakes with place cards in a conference room. The bakery needs a decision by tomorrow. He leaves the interns to taste. Meredith thinks she should bring Derek a piece like a good girlfriend would. Cristina forbids George from eating until he brings them Callie's cards. Bailey comes in and tells them they need to study for their intern exams in 2 weeks, so there's no scrubbing in today. She tells them their assignments and leaves with a whole cake. Everybody leaves but Izzie and George. They say they have moved on and that it's brought them closer as friends.

Richard tells Bailey that Larry Jennings checked into the hospital, which his secretary told him was about something that needed the utmost discretion. Larry broke off his vacation for this. He wants Bailey to run point. The clinic can survive without her for a day. She wonders whom to delegate to. Sydney Heron then appears to answer Richard's page. Bailey is not pleased.

Alex walks into Ava's room. She's been wondering when she'd see him again. She realized she yelled at the wrong person, but she notices he's not interested in being friends anymore. She tells him about Addison's bet with Mark and their entire history. She has excellent hearing, so she's up to date on all the gossip. She advises Alex to move on Addison fast if he wants to beat Sloan.

Richard tells Bailey that Larry is the one who decides who becomes Chief, so the attendings will be all over him. Moments later, they encounter the attendings all yelling for his attention. Bailey makes acquaintance with Celeste, Larry's assistant. Richard instructs the attendings to go, but they state they will come back anyway.

Richard and the attendings enter Larry's room. He wonders what happened to discretion. Richard says they're all here to see if they can help. Larry pulls down his pants and says whoever fixes this gets his vote. And no, those are not grapefruits. Addison says her services won't be needed and leaves.

Bailey examines Larry. He has suprapubic tenderness. He hasn't taken a leak in three days. The attendings make some suggestions. Larry says he was doing a two-week raft ride down the Amazon. Richard asks Bailey to get Fischer from Urology for a suprapubic cath and to order an ultrasound. Richard asks Larry if he's called Nancy. He doesn't want to worry her. He wasn't taking the trip with her.

Alex finds Addison debating which cake to taste. He informs her that Ava has a high blood pressure, so he ordered tests for pre-eclampsia. The baby's fine, but Ava has edema. Addison tells him to get Ava on a mag and hydralazine. He suggests an epidural to get the blood pressure down, but wonders if he's going overboard. She wishes she had someone who cared that much about her blood pressure. She takes a bite from a cake. He hears she will have someone in 28 days.

George and Izzie are seeing James Benton in the clinic. He has had a running nose for weeks now and it won't go away. There's this girl he's been seeing and they are supposed to seal the deal, but he can't do that with the running nose. Izzie thinks she'll be able to deal, but he talks about how strong the attraction is. Izzie cuts him off and says they get it.

Meredith is quizzing Cristina, who's still eying Callie for the cards. Cristina gets up and walks up to Callie. She invites Callie to come taste the cakes, but Callie simply tells her she's not getting her cards and walks off.

George finds Bailey, who asks him how Sydney's doing. George was hoping for something more. Celeste comes up and privately tells Bailey she thinks she needs to get tested. Whatever Larry has, she probably has it as well. Bailey has George page Addison.

Izzie quickly tells Sydney that she's discharging James as she's busy studying per Bailey's instructions. Sydney says she's running the clinic today. Opening a clinic as power play for Chief Resident is all well and good, but Chief Resident is about patient care. Sydney wants to improve James' care, so she has Izzie do a nasal lavage.

In an exam room, Celeste tells Addison and George that she and Larry are in love. The fact that he's married is a small price to pay for their kind of love. They must think she's terrible, but they say they are not judging. Celeste knows she should leave, but it's rare to find someone you can work and play with it. How wrong can that be?

Larry asks Richard what they're going to do next. Richard says next up is an ultrasound and X-ray. Larry wants Richard because he is the best surgeon in this place, or at least he used to be. Richard asks what the problem is. Larry wonders what happened to make Richard lose his desire. Richard says there are other things in life. Larry has to skinny dip in the Amazon to get that kind of thrill. Richard refuses to be browbeaten into keeping his job. When Larry appointed him, he was hungry and the man, but now he's a politician who hands things off. If that's the doctor he has become as well, maybe it is best if he stepped down after all.

Bailey finds Cristina and Meredith and tells them they have need all hands on deck for the board chairman's penis. She briefs them on the case. They have to take the VIPenis for the X-ray and ultrasound.

The male attendings are all looking for possible causes for Larry's problem. Mark delivers Meredith's message that she'll be in the X-ray viewing room to study Larry's scans. Derek says that's good to know. He explains to Burke that Meredith is communicating just when he needs time to think. Derek says he needs time to think about everything. Burke says he needs to be explicit with Cristina, or else there wouldn't be a wedding. It's never easy.

Callie and Addison talk outside Ava's room. Callie says she caught George in a lie the other day. It's probably nothing. Callie asks Addison about her man whore. He's reformed for now, but she thinks he'll never turn into what she wants, which is the whole thing. She wants someone stable who barbecues and teaches kids to play catch. It also doesn't explain why she's been looking at Alex like he's a puppy chew toy. Callie suggests she go there, but Addison says he's not the whole thing either. And he's young. Callie says guys like Alex mess around in their twenties, but then they pack it in and teach kids to play catch. Addison thinks she needs to stop thinking about both men. Callie says she needs to stop thinking about Izzie, but Addison tells her there's generally a reason when you obsess about something like that.

Bailey wonders why Izzie is doing a nasal lavage. Sydney comes up and tells Bailey they really turned this place around. Sydney says four visits in one month is suspicious. She understands Bailey is protecting her turf, but this is about the patient. James lies down on his pillow as they argue. Bailey says they need the bed for the 16 waiting patients and goes to tell James they are discharging him, but she then gets a good look at the fluid coming out of James' nose. She quietly tells Izzie to order a head CT. It's definitely not a cold.

Derek joins Cristina, Meredith, Mark, and Burke in the X-ray viewing room. They study the scans and see what looks like a skeleton and barbs. It looks like a tiny catfish. Richard comes in and says it's close, but it's actually a candiru fish. Cristina acts enthusiastic upon hearing the guy has the penis fish.

Ava is not a fan of the epidural because now she can't sit up. She's missing the Seattle Grace show. Alex says he can't stay mad at her. Ava asks if he made his move on the redhead, because she has an update. Before she can share it, she starts seizing. He yells to have Addison paged.

The doctors deliver the news to Larry. They explain that the candiru fish is attracted to urine and has been known to swim up the stream of urine. It's rare, but it happens. The fish is now stuck in the prostatic urethra and is causing an obstruction there. They need to remove it before it causes sepsis.

Addison and Alex are moving Ava to the OR. Her blood pressure shot up and the baby is in distress. The epidural didn't help. Addison says it will for the delivery, which is the only way they can lower the blood pressure and reduce the swelling in her brain. Addison assures her the survival rate at 30 weeks is extremely high. Ava tells Alex she's not ready to do this by herself, but he tells her she's not.

Derek joins Bailey and Izzie to look at James Benton's scans. Bailey tells him about the halo sign and runny nose. The labs are still in the works, but as far as she can tell, James is leaking spinal fluid through his nose. He looks at the scans and says it's a brain herniation. He has Bailey book an OR. Izzie will have watch from the gallery so she can study. Bailey is scrubbing in, because she can't not scrub in after having sent the guy home three times.

Addison and Alex deliver Ava's daughter. They quickly hand the baby off and rush to stop a bleeding. Ava wonders what's going on and tries to get Alex to tell her what's going on. She thinks she's going to die. Alex walks up to her head and tells her to look at him. He assures her she won't die and neither will her baby. He has her calm down by focusing on her breathing. Addison is impressed.

George finds Celeste and tells her she has no STD. Celeste doesn't appear to be happy. She keeps telling herself she's fine, but the truth is she probably won't be fine until she doesn't care anymore whether he's fine or not. Larry's wife Nancy then arrives. George tells her they are prepping Larry for surgery. Nancy has Celeste go and move her car from the no-parking zone she left it in.

The interns are studying together. Meredith thinks what happened to Larry is instant karma for cheating on his wife. She herself had months of pain and self-loathing when Addison showed up, as well as a crazy ranting mother and a near-drowning. Cristina says she has cheated on her boyfriend and she's fine. She doubts she's the only one. Izzie freezes. George brings the conversation back to the cakes. Cristina needs them to pick since she really doesn't care. She and Meredith leave for Larry's surgery. Meredith asks them to brief Derek about her lunch if they see him. Izzie apologizes for freezing, but George shuts her up by shoving cake into her mouth. Callie watches it happen through a window.

Addison asks Alex if she has another Denny Duquette situation on her hands. She's never seen him so attentive to a patient. He says it's his job to be nothing but over-prepared when he works with a surgeon like him. She then kisses him and they enter an on-call room, where they start undressing.

Cristina approaches Callie and once again asks for the cards, this time pleading that women have to stick together. Callie says she'll just give them to George and he can decide if he'll share. Cristina says he'll just share with Izzie since they are an exclusive little unit. Callie then tells Cristina where she can find the cards.

Addison and Alex awkwardly bump into one another as they leave the on-call room. She checks if they're good, which they are, and then they go their separate ways. Mark has seen it all.

Callie gets on an elevator with Izzie and tells her not to talk. She knows it's unfair and that there's nothing going on between her and George. George is her best friend and he gets her and needs her, but Callie wants him to get her and need her. She can't compete with Izzie, so she's asking her to give her her husband back.

Larry is being operated on, but the forceps aren't enough. They get another instrument. Meredith and Cristina arrive late. Mark is also distracted. Richard asks to have Bailey paged. Larry starts having arrhythmias. Richard says they need to open Larry up since the scope isn't working.

Derek is operating on James with Bailey by his side. She's beating herself up for having missed it, but Derek says it presented like a cold. She gets paged to the Chief's OR. George sits down with Izzie up in the gallery. He tries to make conversation, but she cuts him off so she can concentrate. He asks about her problem. She tells him he is. He's her penis fish. He's crawled in and latched on and she can't move or talk or think without feeling like something's eating at her insides. He wonders what happened to them being fine. She says maybe they are not and leaves.

Bailey comes in as Richard continues to have trouble with the barbs. They are going to have to cut out the fish. Fischer will repair the bladder. Burke informs them Larry's heart can't take much more. Richard finally removes the fish, which horrifies everyone present.

Mark and Meredith end up in the scrub room. He proposes a real meeting of the dirty mistress club, figuring something's wrong between her and Derek like there always is. He backs away and tells her about his thing with Addison. Addison doesn't want him. Meredith says revenge sex is not the answer. He has to be an adult.

Ava thanks Alex for what he did in the OR and tells him he and Addison make a good team. He tells her not to tell Sloan, but Ava says that's not happening because Addison wants someone who's committed. Alex says that's not him, but Ava disagrees. He's a decent guy, whether he wants to admit it or not.

George informs Nancy that everything went well. She asks him to also tell Celeste, because she doesn't have it in her to deal with her husband's girlfriend. She says the wife always knows.

Celeste enters Larry's room. She gives George the number of Larry's personal physician, who wants a copy of the records. She tells Larry she's rescheduled all his meetings except one difficult conference call, but she's sure Danny can handle it. She has asked him to step in until Larry has found someone else. She leaves the room, ignoring his pleas to talk. Nancy, while continuing to flip through her magazine, tells a confused Larry that Celeste just left him. She then tells him goodbye and leaves as well.

Burke finds Izzie devouring what's left of the cakes. She needs a vault because the cake isn't cutting it. She tells him she was with a married man, George. He takes a fork and starts eating, too. He talks about his ideas for the cake. He's thought a lot about it, about the whole day, with Cristina. Izzie understands. She tells him the red velvet's the winner.

Meredith enters the trailer. She apologizes to Derek for having made light of things today. She starts to undress in the bedroom. He watches her.

Addison runs into Mark and asks if they can get a drink to talk. Mark knows she doesn't want to get a drink with him. He's not what she's looking for. He tells her he slept with someone. Once a manwhore, always a manwhore.

Richard finds Bailey eagerly working on the OR board. He tells her to go home to her family. She has to accept there are days where she can't do it all. She has to delegate. She thinks she did that today, but he points out she did all the work anyway. She tells him he can say he's moving on all he wants, but she doubts it's true. He tells her that if she doesn't slow down, she might end up without a family to go home to.

Derek and Meredith are in bed together. She tells him he does not look happy, which is not good for her ego. She's not convinced when he tells her he's fine. She says she should not have accused him of hovering, but now she's here, available and communicating and doing his favorite things. He recalls the day she came out of the water. He spent an hour of his life breathing for her. He loves her and he wants her, but she didn't swim while she knows how to. He doesn't know if he can or wants to keep trying to breathe for her. She thinks it's time for her to go.

Cristina is studying with Callie's cards while Burke rubs her feet. He asks if she picked a cake. She says she liked the red one. He starts kissing her. She puts the cards away and they proceed to make out.

George and Izzie are watching James from outside his room. His girlfriend is with him. Izzie doesn't know how they can work together and be friends and act like it's all okay. George says there's an open spot at Mercy West. He's going to call and ask for a transfer.

Addison passes by Alex on her way out. She asks if he wants to accompany her to Joe's, but he has to study for his test. She proposes to quiz him in her hotel room. Alex tells her she's not his girlfriend. Today was awesome, but he's busy with his work. He doesn't have time for this. She leaves him to study.

Addison then walks out of the hospital and turns around for a brief moment to look at the building. Meanwhile, Meredith's voice over says that the people who suffer most are those who don't know what they want.


Main Cast[]

Guest Stars[]


Medical Notes[]


  • Diagnosis:
  • Doctors:
  • Treatment:
    • Hemiglossectomy

Meredith mentioned a patient having a hemiglossectomy.


  • Diagnosis:
    • Pregnancy
    • Pre-eclampsia
    • Fetal edema
    • Seizure
  • Treatment:
    • Epidural
    • C-section delivery

Ava developed pre-eclampsia and her baby had edema. She was given an epidural in an attempt to stabilize her, but she had a seizure, so they rushed her into the OR for an emergency c-section even though she was only 30 weeks.

Lawrence Jennings[]

  • Diagnosis:
    • Foreign object in urethra
  • Treatment:
    • Surgical extraction

Larry came in with swollen testicles. They determined the cause to be a small fish lodged in his urethra. They attempted to remove the fish without opening him up, but when he became unstable, they had to open him up to remove it. The urologist then said he'd repair Larry's bladder. Larry was stable and awake after surgery.

James Benton[]

  • Diagnosis:
    • Brain herniation
  • Treatment:
    • Nasal lavage
    • Surgery

James came into the clinic with what he thought was a cold that had been dragging on. Izzie planned to discharge him, but Sydney ordered her to do nasal lavage. Bailey then tried again to discharge him, but she noticed a halo sign on the pillow where he had his head. She ordered a CT. The MRI showed that he was leaking spinal fluid through his nose due to a brain herniation. He had surgery to repair the defect.

Celeste Newman[]

  • Diagnosis:
  • Treatment:
    • STD panel

Celeste, concerned that she might have contracted some sort of disease from Lawrence Jennings, asked to be tested. Her results all came back negative.

Baby Girl[]

  • Diagnosis:
  • Treatment:

Addison delivered Ava's baby and she had some problems after birth, but she was stable later.


Song Performer Scene
"The Secrets of Amanda Prines" The Reddmen
  • The interns study for their intern exam. Burke interrupts to make Cristina taste wedding cakes.
"Better Off" Let's Go Sailing
  • Ava listens in while Addison and Callie talk about their love lives.
  • Addison says that Callie's instincts about George and Izzie might be correct.
"Again & Again" The Bird and the Bee
  • The interns talk about Larry while trying wedding cakes.
  • Meredith and Alex leave and Callie sees Izzie and George through the window, furthering her suspicion.
  • Addison confronts Alex.
"Nausea" Beck
  • Callie tells Izzie to give her her husband back.
  • Larry has surgery to remove the candiru fish.
  • Richard has someone page Bailey when he starts to decline. They're forced to open.
  • Derek operates with Bailey's help until Bailey gets paged away.
  • George comes to sit next to Izzie in the gallery, but Izzie brushes him off and then leaves.
"How Am I Doing" Anna Waronker
  • Meredith leaves Derek's trailer.
  • Cristina is studying with Callie's cards and tells Burke she picked the same cake he liked.
  • He tries to pull the card away from her and starts kissing her.
  • Izzie and George watch a patient with his girlfriend.
  • Izzie's not sure how to act like everything's okay. George says he's applying for a transfer to Mercy West.
  • Addison offers to get a drink with Alex and help his study for his exam, but he turns her down.
  • Addison leaves the hospital alone.

Notes and Trivia[]

  • This episode's title originated from the song Desire, originally sung by U2.
  • This episode scored 20.08 million viewers.
  • The season 3 extended DVD-box includes an audio commentary on this episode by Sandra Oh.


Episode Stills[]


Bailey: I know I said you two could use the day to study but we got an all hands on deck situation.
Cristina: A bad car accident?
Meredith: Multiple gunshot wounds?
Bailey: A penis. The chairman of the board's penis.
Meredith: What's wrong with it?
Bailey: His testicles are swollen, which is the understatement of the year.
Cristina: Fantastic! How much? No, uh, you know what? Don't tell me. Let it be a surprise.
Bailey: Look, you and Grey can take him for his ultrasound and his x-ray.
Cristina: The VIPenis.

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.