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

My mother used to say that for a surgeon, a day without death is a rare gift. Every day we face death. Every day we lose life. And every day, we're hoping for a stay of execution. We're attached to death. Chained, like prisoners. Captives.

Freedom, Part 1 is the first part of the season four finale and the 77th overall episode of Grey's Anatomy.

Short Summary[]

A surgical team battles the clock as they try to save a boy encased in cement, Alex's situation with an ever-disintegrating Ava brings back painful memories that interfere with his judgment, Derek and Meredith have one last chance at their clinical trial.

Full Summary[]

Multiple shots of patients dying as Meredith and Derek continue their trial. The bottle of champagne is still in the fridge, shown as they take turns opening it for other things. Derek is growing increasingly frustrated.

Meredith is in therapy, talking about the day her mother tried to kill herself. She made Meredith promise not to call 911, then sliced her wrists with a scalpel. Her doctor says it's okay to talk about it, Meredith says it's not. She had to wait until her mother was passed out to call 911 or else she would get in trouble. 

Cristina and Meredith are in bed together and Meredith trying to cheer Cristina up. Dancing it out and tequila are shut down, though Cristina appears to think over the idea of mocking Meredith and calling her names. Finally, Meredith offers her the sparkle pager. She knows Cristina is really sad because she never asked for it, and therefore she deserves it. Cristina finally looks excited at the idea and says if she was the kissing type, she'd kiss Meredith.

Webber, Sloan, and Derek are standing on Derek's land, talking about how people can't change. Mark says he tries and it didn't work; Webber says he didn't have to, Adele still forgave him. They have to be the men they are, while Derek smirks. He reminds them that Sloan is the man who slept with his wife and Webber is the man who lived on his land for six months, but he's not judging them. He tells them he's selling the land because a man can change.

Alex is in the kitchen, cooking breakfast for an upset and depressed Rebecca. Izzie is concerned, telling Alex that Rebecca doesn't look good, but he brushes her off. He coaxes her into eating some eggs, taking the day off work to stay home and watch movies with her and getting Izzie to cover his patients for him.

At the hospital, George finds Bailey and tells her that according to the Chief, she's not spending enough hours in the OR between her chief resident work and the clinic. In order to sit for her boards, she needs to spend an additional 15-20 hours a week in the OR, which seems to overwhelm her. She shushes George, saying she's trying to see something. Izzie jogs up to them, telling Bailey she's really worried about the Alex situation. Izzie thinks the whole thing is weird and sad and only Bailey can fix it. George tells Izzie that Bailey is trying to see something and she finally says she's trying to see the bigger picture, walking away looking determined.

Mark and Callie are in the on-call room having sex, while he narrates a very involved fantasy starring the two of them and Erica. Both seem to be into it, but Callie is distracted by her pager and, while telling Mark that he's a very good boy, a trauma is coming their way and they need to speed things up.

Meredith is instructing her interns as Izzie and George find her and catch her up on Alex and Rebecca. Midway through it, a very cheerful Cristina comes in, showing off her sparkle pager. Now she won't have to beg for time from Hahn and Izzie is upset that she didn't get it. George pipes up that it's non-transferable, but Cristina shuts him down. He gloats that he doesn't need a fancy pager when he works directly for the chief before scurrying off to answer a page. Izzie tries to refocus Meredith back onto the Rebecca situation, but is turned down when Meredith says she doesn't have time for crazy.

Izzie gets paged for a trauma, but Cristina steals it using the power of the sparkle pager. Izzie tries to argue, but Bailey shoos her off to cover the pit and Alex's post-ops. Erica, Mark, and Callie join them creating an awkward moment where Mark teases her about looking all "hot and bothered", and she stutters off an excuse that it's a really big trauma. Bailey tells her she's acting like she's never seen a really big trauma before, but as they turn the corner, the looks on all their faces tell us it's something new and different. We see a teenage boy, completely encased in cement from the neck down.

Callie is interviewing the boy's "friends" about what happened, and they admit to daring him to lay in a vat of cement in the middle of the night. They mock and laugh at him, and Callie is clearly pissed off that they let the guy just stay there before finally calling the police. 

Derek is showing Rose his work, trying to explain what the trials are doing. She tells him that when she said they should spend more time together, she meant the movies. Meredith comes in with the charts for patients 12 and 13, Jeremy and Beth. Derek looks them over, commenting that they're young. Telling Rose goodbye, Derek and Meredith go to meet their patients.

Bailey is examining the boy in the concrete and the paramedic keeps asking what she wants to do, wants them to do. She finally snaps, saying that she doesn't know, and the boy starts to cry. He's terrified and Bailey immediately tries to calm him, explaining that she's never seen this before but that they're going to figure it out. She tells him she never makes promises about life, but that she promises him she will save him. 

Derek and Meredith meet Beth first, who's paralyzed on the right side of her body. She teases Derek, calling him the "Seattle Grace Brain Butcher". She's in good spirits, but her parents are more concerned. They ask about the treatment, the safety of it. While Meredith and Derek admit it hasn't worked before, Beth is optimistic that she'll be the first and help make medical history. As she says that, a voice tells her "Not if I beat you to it". Jeremy is in the doorway and Beth lights up as he tells her she never called. Meredith asks if they know each other, and her answer is given as the two kiss. 

In the hallway, Beth's parents tell the doctors how the two met last year, and that Jeremy must have been the one to tell Beth about the trials. While they like Jeremy, they're more worried about Beth and the effects this could have on her. They don't want her getting so attached to someone who might die. They fear that if Jeremy were to die, Beth would lose her fight, her will to live.

Webber walks into the room where the boy in the cement is, seeing all the EMT's standing around. He wonders why no one is doing anything, and he is informed that they were told not to. He sees his people in the next room, fighting over what's most important to save first. Callie says limbs, Bailey about abdominal crush injuries, Sloan about third degree burns, and Erica about the heart and lungs. No one can agree what to treat first. They all talk over each other as Webber tries to figure out where to start.

In Webber's office, George is finding a binder to help with information about cement toxicity. He sees a drawer marked "Resident Files" and opens it, seeing the names of his former interns on the files inside. He shuts it quickly, making sure no on sees him, and flees.

The attendings are still arguing, and when Cristina tries to chime in, Hahn shuts her down. The bickering resumes before the Chief finally shuts them down, saying they have only four to six hours before the kid dies. They need to work as a team to save the boy, Andrew, before it's too late.

Rose is looking at a chart as Meredith comes over, causing Rose to drop the papers to the floor. They both bend down to clean them up and Rose confesses she's intimidated by Meredith, by the legend of Derek and Meredith. When Meredith denies there's any legend, Rose tells her that Derek is selling his land for her. Meredith is surprised and tells Rose there isn't a legend.

At the house, Alex comes back in to sit next to Rebecca on the couch. He asks what he missed in the movie and she starts crying. He thinks it's about the movie, but she tells him she wet her pants. Alex tells her it's okay, and she promises to do better. He tells her she's doing fine, kissing her forehead, before taking her to clean up.

Beth and Jeremy are catching up and she brings up a friend from their support group. He tells her she's passed, talking about how she deteriorated in the end, the pain was unbearable. Beth's mom looks concerned as he goes on. Beth tells him they'll never have to worry about that because the surgery will work and, if it doesn't, at least they'll die quick. Beth's mom interrupts, talking about how she talked to Meredith about changing Beth's room, something with more sun. Beth looks at her mom, telling her the room is fine and it's right near Jeremy. Meredith says she checked and there are no more private rooms available. Beth mouths a "thank you" to her. She tries to get her mom to leave so she and Jeremy can have some privacy, and as they start to argue, Jeremy starts seizing. 

In his room, awake, Jeremy is more concerned with Beth than himself. She assures him Beth is okay as George enters. The Chief needs to see her and he's been put on her rotation today. Meredith asks him to run some labs before smiling and walking away.

The residents are working on Andrew, slowly chipping away at the concrete and asking for people to explain what they're doing. He tells them that he's normally the smart one, not the guy who'd jump into a tub of cement because of a girl. Callie asks if it's the same girl who came in with them and he says yes, that the guys dared him and she was watching. He didn't want Lola to think he was a wimp. He compares himself to Han Solo, earning a blank look from Bailey as he explains the reference. 

Meredith finds Richard. The group overseeing the trials has informed him that they get one more chance. If they try the surgery and the patient dies, it's over and they'll be shut down. They have until midnight. There will be no second chances.

Back in therapy, Meredith's doctor tells her she's really angry at Webber. She's reliving it as she opens up in therapy, she's mad at her mother, the Chief, herself. The shrink says that her mother didn't really want to die, Meredith asserts she did. She tells Meredith the answer is right in front of her, she just needs to see it.

Meredith finds Derek, informing him that this is their last chance. He tells her to discharge Beth, but Meredith insists they can do both surgeries today. He asks her if they've gone too far, lost too many lives. He wants to know if this is about his ego, but she tells him it's not. Derek agrees to bend the rules and do both before their midnight deadline, Meredith says she'll clear it with the Chief.

Beth is asking about Jeremy and Meredith assures her that he's okay. He's better than stable, he's calling Meredith the Angel of Death. Beth insists on seeing him, but her parents tell her she needs to rest. If she's having this surgery today then they want to spent all the time they can with her. Beth confesses she and Jeremy are the last two left alive from their support group, looking dejected. 

Lexie finds George doing research, asking if he knows where Cristina is. He tells her about Cement Boy and when she gets excited, tells her they don't want interns in there. They agree to a two-minute complaint session and George rants about all his "supposed" power. He should be able to do more, but he's stuck running labs and doing research in the hope someone asks him a question. He has fake power. George can go into Webber's office at any time, he could look at the confidential files, but the Chief knows he won't because George only has fake powers. He says what would make him feel better was knowing there was a point to all this.

Andrew, Cement Boy, keeps talking about his death. Bailey tells him everyone makes mistakes, not just stupid pieces like this. He starts freaking out again, but Bailey calms him down but telling him than Han Solo wasn't a loser, naming all the awesome things he did in Star Wars. The residents and attendings look on, amused, and Bailey admits that she likes sci-fi, asking if anyone has a problem with that. They all say no, quickly getting back to work. Andrew smiles at her.

Beth is trying to escape her room. She's dragging herself down the hall on her one good leg when Derek spots her. She says that her parents left and she just wants to see Jeremy. She doesn't want the seizure to be the last memory she has of him. Back in her room, Meredith is helping her get ready. Beth asks if she and Jeremy can be alone alone. The two had planned on waiting until they were tumor free to have sex for the first time, but now with the surgeries looming, she wants to move it up. Derek says it won't kill them, and Beth asks if he and Meredith have "done it", causing Meredith to get flustered. Beth asks about what it was like, and they say it can be magical with the right person.

Rebecca is in the shower as Alex goes to get her clean clothes. When she doesn't respond, he goes to check on her. She's sitting in the tub, water coming down on her. She wants to understand what happened, repeating over and over that she was pregnant. Alex climbs in with her, trying to comfort her. He tells her she was just confused, it'll be okay. 

At the hospital, Jeremy and Beth finally get their moments alone together while Derek and Meredith guard the door. Derek jokes that they're pimps, laughing. Meredith talks about how it's all new and fresh and exciting while Derek confesses he prefers the old, bodies you know. Beth's mom comes up to them, panicked because Beth isn't in her room. Meredith covers, saying an intern has taken her for a pre-op MRI. She takes them to a conference room for paperwork while Derek keeps standing guard.

Andrew is getting worse and Callie is concerned about the pressure building in his leg. Cristina is inserting something into him, but before she can finish Erica tells her to stop. She wants to check her work before it gets sewn into place, much to the resident's annoyance. Richard himself is confused, as it should be something easy for Cristina to do and Hann, as a teacher, should know it. Callie realized she'll need to do something drastic in order to save the leg, cutting it open to release the pressure as Andrew looks on. 

Lexie is sneaking around the Chief's office as Izzie turns the corner. Trying to play cool, she asks the resident what's up and Izzie rants about Cristina stealing her trauma and Alex not answering his phone before stalking off. Lexie pops open the office door and creeps in.

Beth and Jeremy are basking in their afterglow when Derek and Meredith come to take him down to the OR. He tells Beth he'll see her after, but Meredith points out he won't be awake before they take Beth. He amends his promise to seeing her after her surgery. Just as he's about to go, Beth pulls him back. She asks what happens if one of them dies, he promises neither will. She tells him that he made her life better, brighter, and Jeremy cuts her off. He tells her they're not finished yet because he's not finished loving her. They share a final kiss before she tells him to go. As they take Jeremy away, Beth looks at Derek and tells him not to kill Jeremy.

In the OR, Meredith is trying to be optimistic and asks him about selling the land. Derek says he's trying to move forward, and Meredith replies so is she.

George is paged to a supply closet where he finds Lexie, the residents files spread open before her. He panics, saying they have to get them back to the Chief's office ASAP. She says she read them all, she couldn't stop, and the information is burned into her brain. George claims he doesn't want to know, but Lexie stops him and tells him he failed the intern exam by a single point.

The residents and some of the attendings are taking a break from Andrew, grabbing some water. Bailey can't stop watching, there's something they're forgetting. Callie says the OR is booked, they're ready. Bailey is still going over all of it, trying to figure out what's missing. She finally realizes it's the hydration, they've been feeding him fluids for four hours and his bladder could explode.

Alex is making sandwiches for him and Rebecca, slicing a tomato when Izzie calls. He steps away to talk to her, leaving Rebecca alone in the kitchen. Izzie claims she cares, but Alex tells her she's just butting in. Suddenly he stops, calling Rebecca's name before the phone goes dead.

The OR is quiet as Derek calls Jeremy's time of death.  Alex turns to the kitchen, dropping his phone as he calls Rebecca's name one more time. Derek and Meredith walk into Beth's room, and she tells them not to say anything. She knows Jeremy is gone. Back in the kitchen, we see a bloody knife fall from Rebecca's hand. Meredith tries to tell Beth she's sorry, but Beth just yells at her to not say anything, breaking down as her parents try to comfort her.

Derek takes the bottle of champage from the fridge and throws it in the trash. 


Main Cast[]

Guest Stars[]


Medical Notes[]

Trial Patients[]

  • Diagnosis:
    • Malignant glioma
  • Treatment:
    • Clinical trial
    • Surgery

Derek and Meredith lost three more trial patients. One was pronounced dead at 11:53, another was pronounced dead at 18:36 and the last was pronounced dead at 15:52

Meredith Grey[]

  • Diagnosis:
  • Treatment:
    • Talk therapy

Meredith had another session with Dr. Wyatt, in which she told the story of how her mother tried to kill herself.

Rebecca Pope[]

  • Diagnosis:
    • Acute stress disorder
    • Slit wrists
  • Treatment:

Rebecca was still staying with Alex, who was trying to take care of her by himself. She later cut her wrists while he wasn't looking.

Andrew Langston[]

  • Diagnosis:
    • Crush injuries
    • Third-degree burns
    • Chest injuries
    • Broken bones
  • Treatment:
    • Vinegar
    • Fasciotomy
    • Fluids

Andrew, 19, came into the hospital encased in cement. He had jumped in wet cement on a dare and had to be blasted out of it. He had burns from the cement and it was also dehydrating him, so they started an IV to give him fluids. Callie believed that if they didn't get in soon, he'd lose both of his legs and his right arm, but Bailey was more concerned about his liver. Mark was concerned about his burns. Erica told them that as soon as his circulation opened up, the toxins that had built up would stop his heart. They needed to work together to create a plan. They rescue workers chipped away at the cement as the doctors tried to stabilize him. Mark put vinegar on his skin to minimize the burns. Callie had to do a fasciotomy on his leg to relieve the pressure and restore blood flow. Erica inserted a balloon to open up his circulation. They realized that they had been continuously hydrating him without him being able to urinate, so they had to put in a catheter to relieve the pressure so his bladder wouldn't explode.

Beth Monroe[]

  • Diagnosis:
    • Malignant glioma
    • Right side paralysis
  • Treatment:
    • Chemotherapy
    • Radiation
    • Clinical trial

Beth was a patient in Derek and Meredith's clinical trial. She'd had chemo and radiation previous to treat her tumor. Her right side was paralyzed because of the tumor.

Jeremy West[]

  • Diagnosis:
    • Malignant glioma
    • Seizure
  • Treatment:
    • Chemotherapy
    • Radiation
    • Clinical trial
    • Surgery

Jeremy was a patient in Derek and Meredith's trial. He had previously had chemo and radiation to treat his tumor. Before his surgery, he had a seizure and his surgery was moved up. He went into surgery, but he was pronounced dead in the OR at 11:47.


  • Diagnosis:
    • Brain tumor
  • Doctors:
  • Treatment:
    • Radiation

Jeremy told Beth about a woman named Carrie from their support group who had tried radiation one last time, but who died.


Song Performer Scene
"Death and All His Friends" Coldplay
  • Meredith sees the champagne still in the fridge.
  • Several more trial patients die.
  • Meredith talks about her mother's suicide attempt.
  • Meredith tries to cheer Cristina up. She ends up giving Cristina the sparkle pager.
  • Richard, Derek, and Mark look out over the city and talk about their relationships.
  • Derek tells them he's selling his land.
"Mercy" Duffy
  • Callie and Mark have sex. Mark tells a fantasy of her and Erica.
  • Callie's getting paged, so she tells Mark to hurry.
  • Meredith has the interns sorting papers for the trial.
  • Izzie talks to Meredith about Alex and Rebecca.
  • Cristina comes by and gloats about the sparkle pager.
  • George insists that he doesn't need the sparkle pager because he works for the Chief.
  • Meredith tells Izzie to work it out for herself.
"Heavy Eyes" The Rosewood Thieves
  • Richard tells Meredith they get one last patient before getting shut down.
  • Wyatt tells Meredith she's angry with Richard and her mother didn't really want to kill herself.
  • Meredith tells Derek about the IRB and convinces him to do both Jeremy and Beth's.
  • Meredith tends to Beth and Beth asks about Jeremy. Beth's parents don't want her to visit him.
"Dream" Priscilla Ahn
  • Alex holds Rebecca in the shower.
  • Jeremy and Beth have sex while Derek and Meredith watch the door.
  • Beth's parents are worried about her, but Meredith says she's getting an MRI and takes them to do paperwork.
"Giving Up" Ingrid Michaelson
  • Jeremy dies in surgery.
  • Alex calls out Rebecca's name and drops the phone.
  • Derek and Meredith tell Beth that Jeremy died.
  • Rebecca has cut her wrists.
  • Beth cries over Jeremy.
  • Derek takes the bottle of champagne and throws it in the trash.

Notes and Trivia[]


Grey's Anatomy 4x16 Freedom Promo

  • This episode's title originated from the song Freedom, originally sung by The Isley Brothers.
  • This episode scored 18.09 million viewers.
  • Shonda Rhimes originally wanted this episode to be called Prisoners of the Rock or something similar.
  • Goof: When George sneaks a peek at the residents' file cabinet in Webber's office, Meredith, Alex, and Cristina are incorrectly filed with the "First Year" group, instead of the "Second Year" group. It could be explained by the fact that it's the residents file cabinet, so the interns may not be included there. However, this would contradict the way that the years of residency are usually counted.
  • Bailey mentions Han and Leia having twin Jedi children while she is talking about Star Wars; this is a reference to Jacen and Jaina Solo in the extended universe featured in the novels and comic books that followed the films - when Lucasfilm was bought out by Disney and they decided to continue the film series, the extended universe became non-canon and instead became an alternate universe.
  • There was no separate Grey Matter blog post made for this episode, but there is one for the second part.


Episode Stills[]


George: I have all this power! Supposedly. I supposedly am imbued with power of being the chief's intern. But there's a cement boy, and I'm stuck in here, running labs, researching effects of cement on the body in the vain hopes somebody asks me a question. I'm not in with the cement boy because, even though I have all this power, I can't use it because it's not real power.
Lexie: It's fake power?
George: Fake power. I can go into the chief's office whenever I want. You know what he has in there? Files. Confidential on every resident in this hospital. And I'm just allowed in, and he's not worried because he knows and I know that I don't have any real power. I don't have the power to look at them!
Lexie: Make you feel better if you could?
George: Know what would make me feel better? If I feel like there was a reason for this, that there was a point.

Meredith: Hey.
Rose: You intimidate me. I mean, you're not intimidating, but like, the legend of Meredith and Derek, it's... it's intimidating.
Meredith: There's no legend.
Rose: He's selling his land because of you. There's a legend.
Meredith: Derek's selling his land?
Rose: He doesn't say it's because of you, but he was making plans to build a house when the two of you were together, and now - I'm not trying to - I just really like him. And you, you intimidate me.
Meredith: There's no legend.
Rose: Okay.

Beth: I mean, you've done it, right?
Derek: With each other?
Meredith: He... I've... He's done it and um, I've done it, yeah.
Beth: What's it like? Is it magical?
Derek: Yes.
Meredith: Can be.
Derek: With the right person. (smiles at Meredith)

Meredith: Do you want the sparkle pager?
Cristina: That's not funny.
Meredith: You're sad. Actually sad. Do you know how I know it's the right thing to do to give you the sparkle pager? Because you're so sad, you're not even asking me for it. Shiny, shiny pager with lots of shiny, shiny surgeries.
Cristina: If I were the kind of person who kissed people, I would kiss you.

Andrew: I'm a loser.
Miranda: Andrew. Hey, hey, listen to me. Han Solo is not a loser. Han Solo got encased in carbonite, and... and that was a big mess, but that's not what he's remembered for. He's remembered as the guy who made the kessel run in less than 12 parsecs and who braved the subzero temperatures of the ice planet hoth in order to save someone he cared about from the big, ugly wampa. He is remembered as the guy who swooped down at the last minute, blasted Darth Vader out of the sky so that Luke could use the Force and... and destroy the damn "Death Star," okay? Princess Leia saved him from the carbonite. and they fell in love and they saved the universe and had twin Jedi babies that went on to save the universe again. Right? Now that's the whole picture. The carbonite, it was just a piece, okay?

See Also[]

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