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Being chief is about responsibility. Every single surgical patient in a hospital is your patient. Whether you're the one who cut them open or not. The scalpel stops with you. You need to be able to look at her family. And to tell them your team did everything they could to save someone's child. Their husband, their wife, you get caught up. Taking care about the people´s families. And responsibility... it makes you... you take care of other people's families. And you sacrifice your own.

Didn't We Almost Have It All? is the twenty-fifth and final episode of the third season and the 61st overall episode of Grey's Anatomy.

Short SummaryEdit

The wedding day arrives, and Cristina desperately needs something to take her mind off it, the fourth climber is found and his condition doesn't match the other climbers' stories, and Adele's condition brings a change for Richard.

Full SummaryEdit

In his office, Richard tells someone that being Chief means responsibility. Every surgical patient in the hospital is your patient. You get caught up taking care of other people's families, which means you have to sacrifice your own. Richard has Adele admitted in the ER and orders fluids. At the same time, Addison and Burke arrive with Rina. Walter and Joe refuse to leave her side as they start working on her. Addison then sees Adele on the gurney in the trauma room and goes to check on her. Richard tells her he found her. She has lost a lot of blood. He asks why Adele was here.

While Callie is writing the vows on Cristina's hand, Izzie is making Meredith a wedding dress and bouquet out of toilet paper. Cristina still thinks the wedding is ridiculous. They all get paged except Cristina. While Cristina helps Meredith to get out of the toilet paper dress, Meredith tells Cristina she's going to walk down that aisle no matter what happens. Her marrying Burke is a sign that people like them can be happy. Cristina assures her she can do this.

Bailey tells Derek and Mark that they found the fourth climber, whose vitals have stabilized. They haven't done a CT yet. She shows them the climber and the ax in his head. Mark wonders what happened on that mountain.

Richard expresses worry that Adele may have uteran cancer, but Addison tells him about the fender bender. Richard says he's still legally married, so he had the right to know. Addison then tells him about Adele's pregnancy, so this may be a miscarriage.

Rina tells Burke her chest pains started yesterday around 3 o'clock. Burke promises to explain everything later, but they need to take her up to the surgical floor right now. Rina says she needs time to decide about the babies, but Joe tells her she doesn't have to decide right now. All she has to worry about is herself.

The interns arrive in the ER. Burke suspects Rina has a tear in her aorta. They have less than 12 hours to save it. Addison needs to take the babies out if they want to save Rina. Burke promises Cristina he'll make it to the chapel in time. Bailey then tells Alex, Izzie, and George who they are assisting and assigns Meredith to Adele. Cristina asks who she's with, but Bailey reminds her she's getting married. While the patients are rushed to surgery, Bailey tells Cristina that giving her a day off is kindness, so she should enjoy it. Bailey then leaves to scrub in.

In his office, Richard tells Mark that he always got the impression that he only entered the race because of some unfinished business with Derek. Mark was in it to win. He made everyone fight for the position, but he won't become the next Chief.

Derek tells the other three climbers that the fourth man was found alive. He asks what happened. Jack says they were halfway up this ice wall on their way to a ledge, where they planned on setting up their tents to wait out the storm. Lonnie wanted to go down and started freaking out and climbing down. They were all tied together and suddenly they were falling. Andy tried to catch a rock with his ax, but he accidentally clipped Lonnie in the back of his head. They thought he was dead. It was an accident.

Adele regains consciousness. Addison tells him that Richard knows and tells her to prepare herself. She does an ultrasound and finds a heartbeat, although it's a little slower than she'd like. They might be able to make it stronger with fluids and a transfusion. Addison has to leave for surgery, but she'll come back the minute she's done. Once they are alone, Richard asks why she didn't tell him. Adele points out he wouldn't exactly have congratulated her. She thinks he has work to do, but he stays right by her side.

Alex briefs Addison that the peds residents on call will be in the OR for Rina's babies. A man comes up to Addison. He introduces himself as Jeff Pope, Rebecca's husband.

Cristina is lying in bed at home and stares at the wedding dress.

Jeff appears in the doorway of Rebecca's hospital room. She turns around and greets him. He walks up to her and kisses her forehead. He apologizes. He shouldn't have let her go and he never will again.

Meredith catches up with Derek. She heard he's best man and she is maid of honor. She tells him she's herself again and she wants him to sleep over again. He tells her he met a woman last night at Joe's. Nothing happened, but he noticed she was pretty. Meredith asks if she should be worried. He thinks she should be worried over the fact that the flirting was the highlight of his week.

Addison was just told that she won't become the Chief. She doesn't understand why. She needs a reason to stay here and to get up in the morning. She needs to wake up and not care that she's 39 and alone. Richard says that's the reason. If you need a job to give you a new life, you need to get the job or a new life.

Derek and Burke are scrubbing in. If all goes well, Burke will be out of here in 4 hours. Derek tells Burke he's a lucky man. Cristina is present and ready to commit. Burke asks Derek if he isn't lucky, but Mark comes in before he can answer. Mark says he was an excellent best man. Derek says worst case scenario, he'll sleep with Cristina in 10 years.

Callie notices Bailey hovering around the bulletin board and tells her that Chief Resident hasn't been posted yet. George walks by.

Callie follows George and closes the door. She has a crazy thing to say. She's saying it against her will because she loves her life as it is. She doesn't want to house a human in her body for 9 months and then push it out and raise it, but she actually does. The thoughts are interfering with her surgeries. It's hormonal and horrible, but she does want a baby. George says there's a guy with an ax in his head. Callie tells him he can run, which he does.

Adele tells Richard he can go, but he stays. She knows he wants to go and start bossing people around. He makes her take her pill. He can boss from his chair. She says he can ask. Richard says it's not his place to know whose baby it is. Meredith comes in to inform Adele that her room is ready. Patricia comes in to ask Richard what he wants to do about the Chief of Surgery announcement. He promises Adele he'll be right back and leaves. Adele tells Meredith they met when she was a little girl. Richard always flirted with her mother and she didn't want to see that, so Adele watched Meredith. She turned out well. She's sorry about Ellis. Meredith says she is, too. Adele says it wasn't her fault. Maybe it's no one's. They got married at 25 and they thought they were in the happily ever after part, but maybe there is no such thing. Jane Burke compliments Cristina on the choker necklace around her neck. Cristina says it's really beautiful, but she doesn't know if it's her. Jane says five generations of Burke women wore it on their wedding day. It's a way of becoming a Burke. Jane admits she misjudged Cristina. She deemed her to be selfish, but she has been flexible about things that are most important to him. Jane then asks her what she was planning to do about her eyebrows. Cristina replies nothing, which is not what Jane wanted to hear.

In the OR, Addison asks Alex about Rebecca's reunion. He replies he cried while she looked bored. He shares that Rebecca may not stay with him. Izzie says it's not complicated. You don't mess with vows. Married is married, game freaking over. Rina's pressure drops. Addison needs two minutes to get the baby out. Izzie starts compressions while Addison takes the babies out.

George and Derek are about to start operating on Lonnie. George feels for him, but Derek says you don't move against the group. George thinks you have a right to change your mind if you're scared, but Derek disagrees. If you choose to climb a mountain, you can't turn back halfway. Derek expects some tearing and a shallow wound given the way the ax ended up in Lonnie's skull, but he needs to pull harder than expected to get it out and there is no tearing. It doesn't make sense. Derek thinks the ax didn't go in by accident.

Richard tells Burke that he holds him to a higher standard and he let him down this year. Being Chief means making tough calls and one of the toughest is admitting when you're in over your head. Burke didn't do that. He is one of the best men he knows and he knows a lot, but he's not perfect and he doesn't know everything. He wants to give him the job, but he can't. Burke leaves the office, only saying that he has a wedding to get to.

Addison returns to Burke's OR and tells him the babies are doing great. He managed to stabilize Rina. They might get him to the church in time. He's more excited than nervous, although he's not sure about his vows. Addison suggests he practice now. He recites his vows, which say he won't promise her the usual things. Those are for optimistic and hopeful couples. He is not optimistic or hopeful. He is sure and steady. He is a heart man. She is his partner, his lover, and his very best friend. His heart beats for her. And on this day, he promises her to lay his heart in the palm of her hands. He promises her himself. Addison jokes he should dump Cristina and marry her. Izzie is moved as well.

George wakes Callie in an on-call room. He asks if she really wants children, because they could do it. She is relieved. They share a kiss.

Jeff is holding his daughter in the nursery. He tells Alex she looks like what Rebecca used to look like. Jeff thinks Rebecca needs some space. Alex says the ferry crash was on the news. He wonders why he didn't look for her. Jeff says he thought she had left him. They had a fight that night. She tried to tell him how unhappy she was and he shut her down. He didn't look for her but what's worse is that he didn't see her when she was there, either. He can't imagine what it's been like for her with a broken face. Alex says she was beautiful. Jeff tells Alex he loves Rebecca.

Cristina appears behind Meredith while carrying her wedding dress. Meredith, while working on the computer, tells her that Derek told her about a girl he flirted with. Cristina says this is really, really about her now. Meredith turns around and sees Cristina's eyebrows are gone. Cristina says she is a Burke now.

Derek updates the climbers that Lonnie is stable, but he sustained significant damage. Jack asks when he'll wake up, but Derek is not sure they want him to. He then shares that he knows the ax was put in Lonnie's head deliberately. He wants to give them another opportunity to tell him the truth. Andy wants to start talking, but Jack shuts him up. Derek leaves to update Lonnie's family, leaving the climbers to talk to the cops.

Bailey is staring at the announcement that has been posted. The Chief Resident is Callie. Meredith and Cristina appear behind her. Meredith says Cristina really needs to cut somebody open after being called a Burke and having her eyebrows taken. Bailey tells her to go home and do getting married things. Cristina says she's standing here with no dignity left. She feels like somebodye else. She wonders if Bailey knows what that's like. Bailey says she does.

Addison rushes into Adele's room. Adele started cramping and became diaphoretic. Addison has a nurse alert an OB for a possible D&C due to an incomplete miscarriage. She thinks Adele may have a placental abruption due to the trauma. She rushes her to an OR.

Patricia leads Derek into Richard's office. Derek tells Richard he doesn't have to do this today, but Richard disagrees.

Richard is pacing outside the OR wing. Addison comes out and tells him that Adele went into early DIC. She tried everything, but pregnancy at 52 is dangerous. Richard rushes to the OR and is relieved to find that Adele is still alive. He asks if she wants him to call someone, like the father of the baby. Adele says he doesn't know. She misjudged him. She thought he would go running for the hills, but he turns out to be a better man than she thought. The baby was Richard's. It was a boy. He gets emotional and lets his head rest on her body. She caresses him.

Derek enters Burke's OR with another surgeon and his him take over the closure for Burke, so he can make it to his wedding in time.

After having allowed her to slice the patient open, Bailey makes Cristina leave. Meredith has to encourage her and remind her she can do this.

Izzie finds George getting dressed for the wedding in the intern locker room. She checks if they are alone and then assists him with his tie. She tells him she's an optimist. She's hopeful. Because she's his best friend and loves him, she will do everything to support him and make his marriage work if that's what he wants. She also has to say that she is in love with him. She can't promise a future or perfection, because who knows what will happen, but in her heart, she is sure. She hopes he is in love with her, too. He stares at her without saying anything. The other interns come in. They only have 30 minutes to get to the wedding.

Derek checks on Andy, who's doing well. His lawyer is present. Andy says they thought Lonnie wouldn't make it after the fall and he was in a lot of pain, so he picked up the ax and tried to put him out of his misery. He would do it again. Lonnie is his friend.

Izzie is fixing Cristina's eyebrows. She allows Alex to borrow deodorant from her locker. They are almost ready to go. Patricia comes in with the results of their intern exams. She hands out the envelopes. Izzie, Alex, Cristina, and Meredith all say they passed. Izzie asks George, who says he passed, too. He says he'll talk to her at the church. Derek comes in as they all leave. Meredith stays behind. Derek closes the door.

Alex appears in Rebecca's room. She compliments his looks. He tells her he passed his exam. She's happy for him. She tells him that she and baby were discharged. He's a bit surprised. She says every department has signed off. He keeps objecting a bit. She closes the door and tells him she has every reason to go. Jeff is good and he's the father of her child. The minute he gets back from buying a car seat. Medically, there is no need for her to stay. He starts checking her chart. Rebecca can't believe it. She wants him to give her a real reason to stay. Jeff is a decent guy, but she's not sure if she's still Rebecca. Alex knew who she was even when she couldn't speak. She's more herself as Ava than she will ever be as Rebecca. She will go back to her life as Rebecca unless Alex gives her a reason to stay. He walks up to her and tells her to stick with the decent guy. She cries and he leaves.

Meredith tells Derek he should just end it if he wants to see other women. Derek says he can't. He does love her. She is the love of his life, so he can't leave her. But she's constantly leaving him. She walks away and comes back when she wants. She doesn't do that to her friends. So he's asking her. If she doesn't see a future for them, she has to end it because he can't. He's in it. She just says she has to go and make sure Cristina gets down that aisle. He says they should get going, then.

The church is filling up with people. Derek and Burke are standing at the altar. Burke notices that Derek is looking weird and tells him not to worry about the Chief thing. Derek says Richard didn't pick him. Burke says they all assumed it was him. Derek says it's not. He then admits he and Meredith may not make it. He wants it more than she does, but today is about Burke. Burke says he truly is a great best man.

Cristina comes out of her bridal suite all dressed up. Her mother tells her she's proud. She always feared Cristina was too emotionally stunted to settle down. Meredith tells Cristina that she can do this.

Alex sits down with Addison. She wasn't sure whose side she should sit on. He says he just sat down next to the hottest chick in the room. He suggests they ditch the reception, but she tells him to stop it. She knows he doesn't want her. He wants Ava. Alex says she's Rebecca now and he barely knows her. Addison makes him look at her. Alex sucks to her, but they don't get unlimited chances to get the things they want. Nothing is worse than missing an opportunity that could have changed your life. No matter what her name is, she will always be Ava to him.

George finds Bailey sitting on a bench outside the ER. Bailey tells George she's so sorry. He doesn't know what to do. Bailey says you have two options when you fail your intern test: you can walk away from surgery, or you can repeat his internship. George says he can't repeat his internship. An ambulance arrive. George sits down. She tears up and asks if she failed him. He firmly says no. He failed her. She touches his arm.

Izzie is peaking into the church. Alex walks out and complimenting Cristina in her dress. Izzie tries to ask him if he's seen George, but he's already left. Callie tells her that George will be late. They had an emotional day. Callie says she was named Chief Resident and they decided to get a baby. Izzie does her best to be happy for her. The music starts playing for Cristina to walk down the aisle. Meredith checks if she has everything. Cristina then realizes that she washed the vows off her hand when she scrubbed in. She starts panicking.

Her panicking noises can be heard inside the church. Burke remains calm. He knew Cristina would need a little push.

Cristina starts pacing. There are no vows in her head. Meredith says it's going to be okay, but Cristina needs to hear something else. She needs to hear what she would say to Meredith if their roles were reversed. Meredith tells her to stop whining. She will go down that aisle, even if she has to kick her ass every step of the way. They need her to get her happy ending. Cristina says she's ready.

At that exact moment, the doubts get to Burke. He goes to check on her with everyone staring at him as he makes his way to the double doors. He makes a decision right before walking through those doors.

Cristina tells Burke she's fine. She'll be right behind him. Burke says he's sorry. She assures him she can do this. He says she doesn't want to do this. He's up there waiting for her to come down the aisle, knowing that she doesn't want to but she'll do it because she loves him. If he loved her, not the woman that he hopes she'll become, he wouldn't be up there waiting for her. He would be letting her go. Cristina stresses that she's ready. She really thinks she wants this. He wishes she didn't think. He wishes that she knew.

The doors open. Meredith starts walking down the aisle while Callie and Izzie stay behind. She walks up to the altar. She announces it's over. Everyone can go home. She repeats it's over, and quietly adds "so over" for Derek. Everyone stares at her as she makes her way to the exit.

Joe and Walter are holding their twins in Rina's room. Richard and Adele watch them from outside the room. They hold hands.

Alex arrives at Rebecca's room, but she has already left. He's too late.

Cristina is standing in her living room, still wearing in her wedding dress. Meredith comes in. Cristina tells her that Burke is gone. She points out Burke's favorite things are gone. He's gone. She says she's free. Dammit, she says. She breaks down and yells at Meredith to take off the choker. She does so and then fetches scissors to cut Cristina out of her wedding dress while Cristina herself gasps for air. Meredith holds her tight while she cries.

Izzie has stayed behind at the church. She is sitting on a bench while Callie watches her.

George is clearing out his locker. The new interns arrive. They are happy to be there. They then notice George. The group leaves to check out the cafeteria, but one woman stays behind. It's the woman Derek flirted with at the bar. She asks George if he has any advice. He says no, but then tells her to learn how to perform an appendectomy before her first day. She asks if he's leaving. He says yes. She wonders if he got a better offer, but he says it's just life. She wishes him good luck. They exchange names. Hers is Lexie Grey. She turns around and leaves the room while George realizes who she is.

Richard congratulates someone in his office. It's Derek. Derek says he's not the best man for this job. Richard is. A good Chief learns from his mistakes and Derek is still working on that. He knows Richard would do it all differently if he had to do it all over again, so Derek tells Richard that is what he should do. 

Richard is looking out the window of his office, watching over his hospital.

CastEdit

  • Meredith Grey
  • Cristina Yang
  • Izzie Stevens
  • Alex Karev
  • George O'Malley
  • Miranda Bailey
  • Richard Webber
  • Addison Montgomery
  • Callie Torres
  • Mark Sloan
  • Preston Burke
  • Derek Shepherd
  • Jane Doe/Rebecca Pope/Ava
  • Jeff Pope
  • Lexie Grey
  • Joe
  • Helen Rubenstein
  • Rina
  • Jack Vaughan
  • Andy
  • Walter (left, with Joe)
  • Dale
  • Patricia Murphy
  • Adele Webber
  • Jane Burke
  • Intern #1
  • Intern #2 (front, in pink)
  • Intern #3
  • Intern #4 (left, with Intern #1)
  • Andy's Lawyer

Main CastEdit

Guest StarsEdit

Co-StarringEdit

Medical NotesEdit

Adele WebberEdit

  • Diagnosis:
    • Miscarriage
    • Placental abruption
  • Treatment:
    • Dilation and curettage

Adele had vaginal bleeding. Addison did an ultrasound and found a fetal heartbeat, but it was slow. She gave fluids and they waited for the heartbeat to return to normal. When she became unstable later, she was taken to the OR for a D&C.

RinaEdit

  • Diagnosis:
    • Pregnancy
    • Aortic dissection
  • Treatment:
    • C-section delivery
    • Surgery

Rina was admitted to the hospital after passing out with extreme chest pain. Burke diagnosed her with a dissecting aorta. They got her into surgery, but she quickly flatlined, so Addison had to deliver both babies quickly so Burke could operate on her heart. She woke up after surgery and was fine.

LonnieEdit

  • Diagnosis:
    • Head trauma
  • Treatment:
    • Surgery

Lonnie was brought into the ER with an axe in his head. Derek took him into surgery to remove the axe and repair the damage.

Jack VaughanEdit

  • Diagnosis:
  • Doctors:
  • Treatment:

Jack was still in the hospital recovering from his injuries.

Andy MeltzerEdit

  • Diagnosis:
  • Treatment:

Andy was still in the hospital recovering from his injuries. Derek said his post-op x-rays looked good and he would be released.

Dale WinickEdit

  • Diagnosis:
  • Doctors:
  • Treatment:

Dale was still in the hospital recovering from his injuries.

Bailey's PatientEdit

  • Diagnosis:
  • Treatment:
    • Surgery

Cristina did the first incision on a patient who needed surgery before Bailey took over.

Rebecca PopeEdit

  • Diagnosis:
  • Doctors:
  • Treatment:

Rebecca and her daughter were both discharged to go home.

MusicEdit

Song Performer Scene
"Roboxulla" The Jealous Girlfriends
  • Meredith, Cristina, Callie, and Izzie have a bachelorette party.
  • They all get paged to the hospital except Cristina.
  • Meredith tells Cristina she needs Cristina to walk down the aisle, which will prove to her that people like them can be happy.
"Falling or Flying" Grace Potter
  • Cristina looks at her wedding dress.
  • Jeff comes into the room to see Rebecca. He hugs her, but she looks over his shoulder at Alex.
  • Derek rushes to surgery while Meredith talks to him about them. He says he met a woman.
"Hold You In My Arms" Ray LaMontagne
  • Burke practice his vows in the OR.
  • The others agree the vows are good.
  • George tells Callie they can have a baby if she wants one.
  • Jeff holds his daughter and Alex asks why he didn't come looking for Rebecca.
"Closer" Coburn
  • Derek comes in to take Burke to the wedding.
  • Cristina makes her cut and then leaves the OR.
  • Izzie tells George she's in love with him and gives him a choice between her and Callie.
  • The other interns come in in a rush while George says nothing.
"Within You" Ray LaMontagne
  • George tells Izzie he'll talk to her at the church.
  • Derek comes in to talk to Meredith.
  • Alex goes to see Rebecca on his way out. She's been discharged. She tells Alex to give her a reason to stay. He tells her to stay with Jeff.
  • Derek and Meredith talk and he says she's always leaving him and he can't take it anymore. He asks her to end it.
"Eulogy" The Hereafter
  • Helen cries when she sees Cristina in her wedding dress.
  • Alex sits next to Addison and says he wants her, but she convinces him he wants Ava.
  • George talks to Bailey about failing his exam and what happens next.
"Explosions" The Mary Onettes
  • Cristina prepares to walk in as Burke walks back down the aisle and opens the door.
"Keep Breathing" Ingrid Michaelson
  • Meredith walks up to the altar and tells everyone to go because it's over.
  • Joe and Walter hold their babies while Richard and Adele watch through the window.
  • Alex goes to talk to Rebecca, but she's already gone.
  • Meredith finds Cristina in her apartment, where Burke's treasured things are all done.
  • Cristina says she's free. Meredith cuts her out of the dress and holds her while she cries.
  • Callie watches Izzie sit in a pew in the empty church.
  • George cleans out his locker as the new interns come in.
  • The last intern asks him if he has any advice. He tells her to learn an appendectomy start to finish before her first day.
  • She tells him she's Lexie Grey, Meredith's sister.
  • Richard congratulates Derek, saying he'll make a good chief, but Derek says Richard's the best man for the job.

Notes and TriviaEdit

Grey's Anatomy 3x25 Promo - Didn't We Almost Have It All

Grey's Anatomy 3x25 Promo - Didn't We Almost Have It All

  • This episode's title originated from the song Didn't We Almost Have It All?, originally sung by Whitney Houston.
  • It also refers to how Burke left Cristina at the altar, meaning they didn't have it all.
  • This episode scored 22.57 million viewers.
  • The wedding scenes were filmed at the First Baptist Church of Los Angeles.
  • This episode marks the final appearances of Kate Walsh and Isaiah Washington to appear as Addison Montgomery and Preston Burke respectively, as series regulars.
  • This episode also marks the the first credited appearance of Chyler Leigh as Lexie Grey. She first appeared in the previous episode, Testing 1-2-3 as a stranger in Joe's bar talking to Derek, but she was not named and thus was uncredited. 
  • Richard tells Addison she either needs a new job or a new life; yet, when she chooses to move to Los Angeles to work at a private practice, he's opposed to her decisions and asks her numerous times to stay or come back.

GalleryEdit

Episode StillsEdit

Behind the ScenesEdit

QuotesEdit

Burke: Cristina; I could promise to hold you, and to cherish you. I could promise to be there in sickness and in health. I could say 'til death do us part, but I won't. Those vows are for optimistic couples, the ones full of hope. And I do not stand here on my wedding day optimistic or full of hope.
Addison: Okay, um...
Burke: I am not optimistic, I am not. I am sure. I am steady. And I know I am a heart man, take them apart, put them back together. I hold them in my hands. I am a heart man. So this, I am sure. You are my partner, my lover, my very best friend. My heart, my heart, beats for you. And on this day, the day of our wedding, I promise you this. I promise you to lay my heart in the palm of your hands. I promise you, me. Too trite? Because I can rewrite it...
Izzie: No. No. It's...
Addison: I think I speak for every woman here when I say... dump her. Dump Yang and marry me.

(standing in the living room in Burke's apartment with Meredith)
Cristina: He's gone.
Meredith Grey: I... I don't think he's gone. His stuff is still here...
Cristina: No. His trumpet was here. His entire Eugene Foote collection, vinyls and CDs. (walking over to the bedroom) His grandmother's picture was by the bed. His luckiest scrub cap was hanging on the door. He's gone. I'm... I'm free. Dammit. Dammit. Dammit!
(Cristina breaks down.)


See AlsoEdit

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

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

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