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No one believes that their life will turn out just kind of okay. We all think we are going to be great. And from the day we decide to be surgeons, we are filled with expectation. Expectations of the trails we will blaze, the people we will help, the difference we will make. Great expectations of who we will be, where we will go. And then we get there. We all think we're going to be great and we feel a little bit robbed when our expectations aren't met. But sometimes our expectations sell us short. Sometimes the expected simply pales in comparison to the unexpected. You got to wonder why we cling to our expectations, because the expected is just what keeps us steady. Standing. Still. The expected's just the beginning, the unexpected is what changes our lives.

Great Expectations is the thirteenth episode of the third season and the 49th overall episode of Grey's Anatomy.

Short Summary[]

George's grief begins to prove too much for Callie and even Izzie, who starts baking, but only a little. Cristina and Burke's continued silence proves for an interesting dinner party with Derek and Meredith and the Chief makes an announcement that sends the attendings running for answers; meanwhile, Bailey wants to start her own project, and uses the attendings current state in her favor. Two staff members at the hospital get proposals.

Full Summary[]

Bailey stands frozen in front of the OR board.

Derek and Meredith are at a dinner party at Burke's. Cristina is sitting on the counter eating cornflakes while Burke serves chicken to the guests. Meredith asks if Cristina would like some. Burke says there's only enough for three. She tells Burke he needs to feed Cristina. One of them really has to start talking to the other one. Burke wants to enjoy the dinner party. Derek heard from one of the scrub nurses that Richard is retiring, but he thought it was just a rumor. Burke says it's true. Cristina says he was in the running, but took himself out, which is apparently her fault. Burke avoids the topic and asks who wants dessert.

Before bed, Derek is obsessing over Richard passing him over for the promotion. Meredith is worrying over Burke and Cristina's relationship.

Izzie baked for George, but instead Callie comes running out of his room. George is grieving by having lots and lots of sex and she can't take it anymore. She feels horrible for George, but this needs to stop. As she quickly gets dressed, she puts Izzie on Georgewatch 2007. Izzie objects, but Callie quickly runs off. A naked George opens the door to his room. Izzie is surprised by the view and asks if he's hungry.

Alex catches up with Addison at the hospital. He thinks she's been avoiding him, which she refutes. He walks off. Addison and Callie cross paths. Addison confesses she kissed Karev, while Callie says George has turned into a sex machine.

Izzie enters the locker room and tells the other interns they need to do something about George. Meredith is tired because Derek kept her up ranting all night. She also says Cristina and Burke are still not talking. Cristina explains that would mean Burke wins, and she won't allow that since she is right. She doesn't know what's up with Alex. Alex says he's good. Izzie lists her own recent problems and says she needs one of them to pull him- or herself together to help her. George then enters and asks if anyone's seen Callie. Bailey comes in and tells the inters they are on their own today because she has important things to do today. If they face troubles, they have to ask themselves "What Would Bailey Do?" Izzie wonders what is wrong with everyone.

Izzie and George are walking down the hallway. She mentions perpetual sex is not a stage of grief, but denial is. They arrive in the ER and Izzie asks Addison if she thinks sex counts as denial. Addison asks what they know. George replies that there's an OB/GYN patient they need to see.

Derek and Bailey catch up with Richard as he gets on an elevator to go to a meeting. They both need to talk to him, but only Bailey can promise she'll keep it short. She gets on the elevator and the doors close in Derek's face. She tells Richard she wants to open a free clinic. She has done research. Richard says there a lot of hoops to jump through. Bailey asks if he'll consider this if she gets the okay from all department heads. He agrees to that, but still wonders why she's interested since it's not surgery-related.

Addison, George, and Izzie are with Jillian. Her friend and colleague Rachel says she basically had to drag Jillian in. Addison would like one of the interns to do the exam. Jillian consents. Addison picks Izzie. Izzie gets ready while Rachel insists on staying. She and Jillian were born two days apart and they do everything together. Cradle to grave. Izzie asks Addison to have a look. Addison is alarmed. Jillian urges George to also have a look so he can learn. Rachel thinks Jillian's pregnant, but Jillian says she's not.

Outside the exam room, George tells Izzie he could see the naked tumor with the naked eye. Rachel exits the room and asks if Jillian has cancer. If she does, they need to tell her here and now so they can avoid crying. George tells her to call Jillian's parents. Rachel says they both left home when they were 16 and they haven't spoken since. She's Jillian's family. She refuses to contact Jillian's parents and forbids the doctors to do it.

Mark orders Meredith and Alex to look after his patient with grade 3 decubitus. They need to debride the wounds, change the dressing, and reposition the man every 2 hours. Meredith says that'll keep them busy all day. Mark likes the nurses, so as a going-away gift, he will spare them. He's going to do one more rhinoplasty before leaving the city.

Bailey comes up to Derek and brings up her project. She asks for his support. Derek says there are a lot components to think of, which is a Chief's job, and apparently he's not cut out for that. So she's going to have to take it to somebody else.

Cristina is working with Callie. They talk about George's sex drive. Cristina points out they're not friends. Callie then realizes she doesn't like Cristina. They walk up to the patient, Steve Beck, who dislocated his right patella due to a fall while running a marathon. Steve was told he blacked out. Callie distracts the patient by asking about his day and reduces the patella. She asks Cristina to get a patellar brace, run labs, and get post-reduction films. She advises Steve to skip the race next time he has a cold.

Izzie checks with George if he's okay working on a cancer case. They run into Callie, who immediately flees. Izzie distracts George by mentioning she's here to talk, because all the sex is breaking his girlfriend's vagina. George then sees an Amish couple entering the ER. They walk up to them and ask if they need help. Their daughter is here, Jillian Miller.

Rachel and Jillian are talking about how they'll make sure Jillian gets her chemo, if she needs it. Rachel can switch shifts to drive her. Jillian's parents then enter, which angers Rachel. Jillian appears to be happy to see them and says it's okay. Rachel tells them, in their language, that they don't need them. Addison comes in and confirms it's cancer. They need to perform a radical hysterectomy to make sure they remove the entire tumor. Mrs. Miller asks how it got so bad. Rachel wants them to leave since she thinks they are only here to take Jillian home with them. Jillian tells her parents they should go as it was a mistake coming here, though she admits it pains her to say it.

Meredith asks Mark why he's quitting, from one dirty mistress to another. He admits he hates it here. He hates the rain and Addison and Derek are unforgiving. His non-binding verbal agreement with Richard is not a problem. Meredith then breaks the news to him that Richard is stepping down.

Derek finds Addison and asks her what he used as bait to get her to join the staff. She was promised the foremost neonatal unit west of Manhattan. Derek asks if a promotion to Chief was mentioned. It wasn't. He refuses to elaborate and walks off. Alex comes over and she tries to leave, causing him to loudly say he'd like to talk about the kissing. Embarrassed, she walks off.

Meredith and Alex are working on the decubitus as Cristina complains about her boring patient. She wishes he would at least have a fracture. Burke comes in and asks if anyone's available to assist on a truncus arteriosus surgery. Both Meredith and Alex volunteer, but none of them can describe the condition. It pains Cristina to remain quiet. Burke mentions it'll be years before they got another case like this and leaves. Cristina can't believe they didn't know the answer. Meredith points out Cristina could've been in on the case if it weren't for her immense pride.

Derek gets ready to scrub. Burke apologizes that he had to find out about the Chief thing that way. Burke says that was the thing that caused him not to see anyone about his hand. He was stuck. Derek says nothing's holding him back now. Burke says he couldn't take the job, even if Richard offered it to him, because it wouldn't feel right. Derek says whether something's right or not doesn't seem to matter much these days.

Cristina tells Steve that he's severly dehydrated, causing his muscles to break down a bit. They need to see if the fluids they administered are doing what they are supposed to do before they send him home. He asks if his knee's going to be okay. He needs to be ready to win the next marathon. He mentions his legs hurt. She pulls back the sheet, revealing they are severely swollen. She asks a nurse to get Callie.

They rush him to procedure room, where Callie is waiting for them. Steve has severe compartment syndrome since there are no detectable pulsations in his legs. Callie tells Cristina to mirror precisely what she's doing. She tells Steve it's going to hurt, but he needs to keep his legs still if he wants to keep them. They then perform fasciotomies on both legs.

Richard comes in and asks what happened. Callie updates him. From the EKG, it looks like Steve had a recent MI due to the hypokalemia. The meds Callie gave for that don't seem to work. Richard notes his kidneys are failing and wonders why this is happening so fast. Callie then remembers Steve took aspirin for his cold, which accelerates the process of muscle katabolism. The toxins are causing his system to crash. Richard orders to get Steve to an OR right now so they can put in a dialysis catheter. 

Izzie asks George if he wants to grab lunch. He wanted to lunch with Callie. Izzie then sees Jillian's parents are still in the waiting room. George leaves to go find Callie.

Alex drags Addison into a supply closet. She kissed him and she's been avoiding him ever since. He thinks she's doing that because she thinks he's now pining after her, but he asks if it's occurred to her he just might not be interested. He doesn't want to be another intern sleeping with an attending. He kissed her back because she's his boss. He would really like to scrub in with her, which won't happen if she's avoiding him, so she just needs to accept it's happened and move on.

Derek runs into Mark. He's heard that Mark is leaving. He was going to ask Mark to scrub in on his peripheral nerve reconstruction. Mark says it's not his last day and he'd love to scrub in. Mark says he's not leaving anymore. He's heard about the race for Chief from Meredith. He tells Derek he'll see him at the finish line.

Callie and Cristina are scrubbing in. Cristina compliments Callie's work on the legs. Cristina now asks why Callie asked if she was concerned about George. Callie says he doesn't talk about anything. Cristina thinks talking is overrated. Callie knows what's going on between her and Burke. That's the last thing George talked to her about. She tells Cristina silence is overrated.

Izzie's checking up on Jillian while Rachel is out making phone calls. Izzie says her parents are still here. She knows Jillian called them and since they had to fly in, she guesses she did so yesterday or the day before. Jillian admits she did. She went to the ER and was told to go see an oncologist a while ago, but she was working three jobs at the time and she couldn't even afford her rent. But now she got scared, and she called her parents. Izzie asks why she sent them away. Jillian says Rachel left the community after she was baptized, meaning she's shunned. Jillian couldn't let her go by herself, but she's not shunned since she left before her baptism. She can go back. She admits she's thought about it. If she's dying, she wants an Amish funeral. The community is her home. But she promised Rachel from cradle to grave.

Addison, Izzie, George, and Bailey are operating on Jillian. Her kind of tumor is preventable and treatable if caught on time. Bailey takes this as an opportunity to talk to Addison about her plans for the free clinic. Her goal is prevent unnecessary surgeries and deaths. She needs the support, but Addison doesn't really pay attention to her. The tumor has invaded into the bladder, which means Jillian's stage IV. They need to close her up. An emotional George quickly leaves the OR as it reminds him of his father.

Izzie sees Jillian's parents in the hallway.

Richard, Cristina, and Bailey are putting in the dialysis catheter. Steve ran 12 miles before passing out, but he must have felt dizzy for a few miles before he did. He should have stopped running. Cristina understands Steve was in it to win. She compares it to the surgical program. Richard says it's a long race and by the time she's done with it, she'll just be happy to have made it to the finish line.

Derek finds Meredith and yells at her for giving Mark a reason to stay.

Bailey is talking to Burke about her clinic. She only needs a few hours of extra commitment per week, but he says he can't deal with any more distractions now. Bailey says he owes her. When he had that tremor, he cut her out of his surgeries and made her doubt herself. Burke says she needs someone who can provide leadership and direction to the project, but that's not him. She says that's just what he believes.

Izzie checks up on Jillian in the ICU. Rachel says she didn't really understand what Dr. Montgomery was saying earlier. Izzie says Jillian will go through a lot and it's late so her condition will get worse. Rachel asks if Izzie can give her names so she can be ready to do this right. Izzie tells Rachel she can't be everything. Jillian's parents are here and they love her, and Jillian wants to go home. She reveals Jillian called her parents. Rachel brings up their promise. Izzie says the best thing for her to do might be to let Jillian go.

Burke and Addison are hanging around the Chief's office. They both want to speak to him. Derek joins the group. He knows why they're there. Addison is offended Derek assumed the competition would just be between him and Burke. Mark comes over. Shortly afterwards, Richard comes up and they all start bickering for his attention. Mark confesses they all want to be Chief. Richard has had a perfect day. He told the board about his retiring, he saved a life, and now he's going to see his wife. And now they are ruining it by being vultures. Bailey has overheard the conversation and she's shocked. He tells her he's stepping down as soon as they find a replacement for him. He doesn't know when that will be, because at this point, he doesn't see any frontrunners.

Bailey follows Richard and yells at him for sending her on this wild goose chase instead of telling her the truth. Richard says one of the attendings may be Chief in a month so she needs their support. Also, he confides in her they'll only hold the position until she is ready for it. It's who she is. The wild goose chase was him trying to get her into the habit of doing things without him.

The attendings are sitting on the catwalk as they discuss the Chief stepping down. They all agree Mark won't be the new Chief. Bailey comes up and hands each of them a letter of support for her clinic and instructs them to sign them. They wonder why she wants it so bad. She wants and needs something more. She needs a reason to believe medicine can not only save lives, but change lives. She needs to believe in something the way she used to believe in all of them. Also, pioneering this will look very good on their resume. They all sign their letter. She walks off as Derek comments the Nazi is back.

Rachel is with Jillian as she wakes up. Rachel tells Jillian to go home. It's a big deal for her parents to have come here. Jillian doesn't want to leave Rachel. Rachel tells her not to worry about her. She'll be okay here in the 21st century. She won't take no for an answer. They hug and then Jillian's parents come in. Mrs. Miller breaks the rules as she tells Rachel she will tell her parents that she's well and happy, and grown into a fine woman. Rachel hugs her and then leaves the room. Izzie has overheard the conversation from outside the room.

Richard shows up at his home with flowers for Adele. He tells her he has retired. He's relieved, actually. Adele says when she didn't have any more time to wait, she meant it. That was months ago. He then realizes there's another man in his house. She apologizes and closes the door on him.

Izzie joins George in a conference room. She says she's sorry. George wonders what's wrong if the sex makes him feel better. She asks if he does feel better. He recalls her lying on the bathroom floor. He tells her she can't help him. She realizes she has to let him go. She hugs him and tells him life is short and it sucks. He should go be with Callie if that makes him happy. He hugs her back and leaves the room. Bailey comes in and asks Izzie if she's going to be okay. Izzie supposes she will and asks Bailey about the clinic. Since she got her signatures, she states the Seattle Grace Free Clinic will exist. Izzie then replies, calling it the Denny Duquette Memorial Clinic. She has 8 million dollars.

Derek finds Meredith in her bedroom. He knows he was a jerk, but that doesn't mean she can stop talking to him. This is him saying sorry. He yelled at her for no reason and walked away, so she's surprised he showed up. He wonders why he wouldn't show up. He says this is how fighting works. You fight and you apologize. She asks how she's supposed to know that. She's never done this before. He tells her she can always expect him to show up, even if one of them yells. She's happy to hear that. They share a kiss and hug. She tells him he's going to make an excellent Chief.

Addison crosses paths with Alex, but he ignores her until she addresses him. She has an emergent ovarian torsion and invites him to scrub in. He accepts.

In their apartment, Cristina tells Burke she really believed what she did was right. She'd find it patronizing if he forgave her, because that would mean he thinks what she did was wrong. She tells him she's in this for the long haul and to finish the race. If that means she doesn't win this, then that's fine. She's talking first so he wins. Burke then asks her to marry him.

George shows up at Callie's hotel room. She tells him no more sex. He tells her he's felt awful since his father's death and he still can't believe it's real. But every time he looks at Callie, he feels better. That shocks him, but it's true. He doesn't need more than a piece of him. It'd be the best thing if he could have all of her. He loves her. He gets down on one knee and asks her to marry him.

Since both Callie and Cristina are too shocked to respond, George and Burke repeat their question.


Main Cast[]

Guest Stars[]


Medical Notes[]

Jillian Miller[]

  • Diagnosis:
    • Human papilloma virus
    • Stage IV cervical cancer
  • Treatment:
    • Surgery

Jillian, 23, came into the hospital and a pelvic exam revealed a cervical tumor large enough to be seen with the naked eye. The cancer appeared to be localized, so Addison told her they'd do a radical hysterectomy, which they hoped would be curative. She revealed that she had been told previously to see an oncologist, but she couldn't afford it, so she didn't. When they took her into surgery, they determined that the tumor had invaded her bladder, so they closed her up and told her there was nothing they could do surgically. She decided to go back home and die Amish.


  • Diagnosis:
    • Decubitus ulcers
  • Treatment:
    • Debridement

Jim was semi-comatose and had bed sores. He needed debridement, dressing changes, and to be repositioned every two hours.

Mark's Patient[]

  • Diagnosis:
  • Treatment:
    • Rhinoplasty

Mark told Meredith and Alex he was doing one last rhinoplasty.

Steve Beck[]

  • Diagnosis:
    • Right patella dislocation
    • Severe dehydration
    • Compartment syndrome
    • Kidney failure
  • Treatment:
    • Reduction
    • Bracing
    • Fluids
    • Fasciotomy
    • Dialysis

Steve, 32, passed out while running a marathon and dislocated his knee. In the ER, Callie reduced his knee and told Cristina to brace it and run post-reduction films. And Callie told him to skip the race next time he had a cold. He was given fluids when labs revealed severe dehydration. Cristina said his knee looked fine and said he might need some physical therapy. However, he said that his leg hurt and when she examined them, she saw extreme swelling in both legs. He had no pulse in either leg, so they had to do bilateral fasciotomies to relieve the pressure. He also showed signs of a recent heart attack. His kidneys were also failing. Callie put together that the aspirin had accelerated his symptoms. Richard took him to an OR to insert a dialysis catheter to filter the toxins out of his body.

Burke's Patient[]

  • Diagnosis:
    • Truncus arteriosus
  • Treatment:
    • Surgery

Burke asked Meredith or Alex to scrub in with him, but only if they accurately described the condition, which neither of them could do.

Derek's Patient[]

  • Diagnosis:
  • Treatment:
    • Peripheral nerve reconstruction

Derek asked Mark to scrub in on a peripheral nerve reconstruction with him.


Song Performer Scene
"Enchantment" Lily Frost
  • Burke, Derek, and Meredith have a dinner party while Cristina sits on the counter and eats cereal.
  • Meredith tries to end the silence between Burke and Cristina.
  • They talk about Richard wanting Burke to be Chief.
"Ships" Umbrellas
  • Izzie watches Jillian's parents pray.
  • Richard, Callie, and Cristina talk about competitiveness while they operate.
  • Derek is upset with Meredith for telling Mark about the Chief retiring.
  • Burke tells Bailey he can't commit to tie in her clinic. She says he owes her.
  • He doesn't feel he's a leader anymore.
"Love Show" Skye
  • Derek tells Meredith he's always going to show up. She says he'll make an excellent chief.
  • Addison invites Alex to scrub in on a surgery.
  • Cristina breaks the silence and talks to Burke, saying she's in it for the long haul.
  • Burke asks her to marry him.
  • George goes to Callie's hotel room and proposes to her.

Notes and Trivia[]

  • This episode's title originated from the song Great Expectations, originally sung by KISS.
  • This episode scored 21.50 million viewers.
  • Callie places Izzie on "Georgewatch 2007", making the year 2007.


Episode Stills[]


(Izzie knocks on George's bedroom door)
Izzie: George, can I come in? I made you some cookies and brownies and muffins, of course, I always make muffins.
Callie: (comes out from room) Thank God you're here. I can't take it anymore. Three times already tonight, and he's getting ready for a fourth.
Izzie: What are you talking about? Oh. Oh, eew.
Callie: No, no I get it, you're crying, you're depressed and I know we all deal in different ways, but this is not grieving, this is my legs being bent in ways my legs do not go. A-And I know, I know his dad died, and I get it, I feel horrible for him.
Izzie: (laughs) I can give you guys some privacy, I can go far far away...
Callie: (cuts her off, whispers) No no! No! No! You stay. You take over for me, okay?
Izzie: Callie Torres!
Callie: No! I don't- Not like that, I mean. I am giving him to you. You are now officially on George Watch 2007, OK, you are his friend. Yay! And I need a break. I need to heal. I need to heal.
Izzie: No! No! What am I supposed to do?
Callie: I need to heal. I need to heal. Please, I need to heal.
George: Callie?
Callie: (after she and Izzie both freeze at George's call) Thank you, goodbye. (flees)
Izzie: No, Callie!
George: (coming out from room, naked) What is taking you so- (Izzie stares at George and he realizes, and hides behind the door) Oh!
Izzie: (averts her eyes and stifling a smile) Er- s-she had to go. Are you hungry?

Cristina: I was right. I swear I really believe what I did was right. I don't want you to forgive me. Frankly, I'd find it patronizing if you did. Because... while I know I was right, you think I'm wrong. Which doesn't matter...because... I'm in this. I'm in this for the long haul. And I'm in this to finish the race. So if that means I don't win this one, then fine. I don't win. You win. I'm talking. See? I'm talking first. You win.
Burke: Marry me. Marry me, Cristina Yang.

George: I don't want to waste another minute.
Callie: I can't have sex with you again, George. Ok? I can't- I just- I- Enough with the sex.
George: Since my dad died, I feel like someone ripped out my stomach, filled the hole with asphalt. I laugh every time I remember I'm never going to talk to him again because it just sounds like the stupidest thing I've ever heard. I can't believe it's real. But every time I look at you- I feel better. It shocks me. It knocks my wind out, but it's true. I don't have to have sex with you, I'd be happy just look at you from across the room. And even that, anything, any piece of you. And, hopefully, all of you... that'd be the best thing. Because I love you.
Callie: George.
George: (gets on one knee) Marry me? Will you marry me?

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.