We've all heard the same. It's one of those things we've learned in seventh grade science class. Adapt or die. Adapting isn't easy, though. You have to fight your competition, fend off their attacks, and sometimes, you have to kill. You do what you need to do to survive. Adapt or die. As many times as we've heard it, the lesson doesn't get easier. Problem is we're human. We want more than just to survive. We want love. We want success. We want to be the best that we can be. So we fight like hell to get those things. Anything else feels like death.

I Will Survive is the twenty-first episode of the seventh season and the 147th overall episode of Grey's Anatomy.

Short SummaryEdit

Personal and work pressures are adding up and have Meredith visibly on edge, Owen conducts formal interviews for the Chief Resident position, Cristina grows increasingly defiant, Alex and Lucy's undefined relationship gets tested, and Jackson suddenly backs out of the Webber's diabetes trial.

Full SummaryEdit

Cristina is denying Owen sex. She thinks he has to be impartial for choosing Chief Resident. The final interviews are today and coincidentally she is on his service today. Since she can’t show off her skills to Teddy, she’s gonna show off to Owen. Therefore, he can’t see her as his desirable wife, but as a focused, organized, efficient and deserving resident. She gets out of bed to take a shower.

Meredith enters the kitchen and finds Alex eating some pizza. She asks if he has his interview with Owen today. He does. She asks if he’s going to say anything about her. He thought she’d wish him good luck, but he guesses it’s every man for himself now.

Lexie and Jackson are brushing their teeth. She tells him to brag about his trial to Owen, because it’s so good it’s gonna win every award. Also, he was instrumental in getting it approved for phase 1 human testing. He doesn’t seem enthusiastic about that.

Alex enters his room, where Lucy just found out she got the job at Baylor over 50 other applicants. She’s not sure she’s gonna take it, because it’s in Texas and there are a lot of factors to consider. Alex tells her it’s what she wanted. She was thinking about sticking around for another year. That way, he’d have a friend left if he wins Chief Resident. He says they all get it’s a competition, nothing personal. Sometimes, you just gotta be a shark. He congratulates her and leaves for work.

Meredith joins Derek in Zola’s room. She’s nervous about their meeting with the social worker because nothing in her life prepared her for this. She doesn’t know anything about being a good mother. He gives her the baby. Arizona comes in and tells them that Zola is doing great. Arizona will operate on the uncomplicated hernia today. Zola is fussy and Arizona suggests they use the pacifier to calm her down. Arizona will call them when she’s ready to go. Derek leaves Zola with Meredith, who’s holding a book titled “Your Baby’s First Year”.

Bailey takes Abena out of the hospital. After spending a month there, she can finally go home. Alex brings them some extra hydroxyurea and a toy bear for Abena. He tells her to take the meds because they’ll help her sickle cell symptoms and make attacks less severe. She thinks him. Lebo, Abena’s sister, has to take the meds, too. He also reminds them to get monitored at the hospital. Lebo’s in pain as they hug, and she falls down before she can board the shuttle.

Henry and Teddy are out for a run. They are discussing Andrew. Teddy tells him about Andrew’s job offer and that he asked her to move to Germany with him. She thinks it could turn into something between them. Teddy says she has too many obligations here, including Henry. Her moving might cause insurance problems, so they’d have to sort it out.

Lucy joins Alex, Bailey, and Arizona. They are doing an ultrasound on Lebo. They find blood in the left lower quadrant. Arizona asks why she didn’t tell them about her pregnancy. Lebo says she wouldn’t be allowed to fly if she did, and she needed to be here for her sister. Lucy says the fetus is really small for 32 weeks. Arizona says they need a CT to locate the source of the bleeding. Lucy will meet them in surgery. Lebo’s blood pressure drops, so they skip the CT and go to the OR right away.

April is talking to Owen about the checklist she developed for patient clipboards. She shows Owen how the checklist works for a patient who coughed up blood. Next up is doing a bronchoscopy to rule out cancer. The patient’s wife just heard cancer and she’s worried. Cristina comes over to report to Owen. Owen says next up is taking Raul Aranda to his bronchoscopy. April says the protocol requires to page Dr. Altman. April shows Cristina her checklist. April leaves to show Owen the OR checklist, while Cristina checks off some boxes and tells Raul that she’ll be taking him to his bronchoscopy.

In the OR, Bailey keeps exploring for the source of the bleed. Suddenly, they found a baby tangled up in Lebo’s intestines.

Lucy is freeing the baby from the abdomen. It’s very rare for a baby to be carried to term outside the uterus, but sometimes it happens that the egg finds another place to implant. It’s often missed on ultrasounds. Alex takes the baby to get it checked out. They find the placenta is the cause of the blood and move quickly to stop it. Meanwhile, Alex manages to get the baby to cry.

Henry is talking to Richard about possibly getting on his trial. The fact that he’s married to Teddy probably excludes him. Henry says Teddy still sees him as a patient. He’d like to get his own insurance and he’d need a job for that, and then it would be helpful not to get have a diabetic shock every 5 minutes.

Callie tells Owen it’s her first day back and she needs to remember why she loves being a surgeon. She needs a nice surgery. There’s a baby crying in the background and Callie says it really sounds like her. She turns around and sees Mark with Sofia. He’s taken care of Sofia all day and he needed some adult contact. Callie needs Mark to take the baby from her arms. Owen comes over and tells Callie a motor cycle crashed, so she’s in luck.

Arizona managed to get rid of the all the adhesions, and they managed to remove the placenta. Alex comes in and tells them the baby is doing good. Lebo’s going to be just fine. Alex wonders if they’ll get the right care in Africa. Arizona suggests he go to Africa. They are looking for someone who’s single and has three years of experience to fill Arizona’s position at the Namboze Clinic. They’ve been coordinating with Alex so they know him. It’s perfect. Lucy says it’s pretty far to go for a follow-up appointment.

Jackson meets with Richard, who asks him to screen Henry’s file. Jackson says he needs to step away from the trial. Richard doesn’t know why he’d do that because Jackson’s been a big part of it. Jackson says he feels like he should focus on surgery now.

Meredith’s waiting for her interview with Owen. Alex’s interview has just ended. He comes out of the conference room and tells Meredith he didn’t say anything. He suggests she tell him herself if she’s so worried before it comes out. It’s time for Meredith’s interview.

Cristina is doing the bronchoscopy. The result is surprising. A nurse asks if they should call Dr. Altman, but Cristina says no.

Cristina informs Raul and his family that there’s a tree growing in his lung. He probably inhaled a seedling and somehow it took root and started growing. It somehow adapted to the environment. Cristina says he’ll be fine after a small surgery. April comes in to ask Cristina for a word. Raul’s son Miguel tells April she was wrong, so she’s a bad doctor.

Outside the room, April yells at Cristina for hijacking this patient and disregarding the checklist. Cristina tells her about the tree. She’s going to take it out herself. It’s like a biopsy. April says that procedure needs to be supervised. Cristina tells April she’ll put in a good word with Owen for her if April helps her.

Richard finds Henry and tells him that it looks like he’s a good candidate medically, but he still has some reservations. He’s then greeted by Andrew Perkins, who’s here for his lunchdate with Dr. Altman. Teddy comes over and introduces Andrew to Henry, who rolls with being Teddy’s diabetes friend. Richard tells Teddy that Henry’s going to be on his trial. Teddy and Andrew leave after she congratulates Henry. Richard says he’s up against Andrew Perkins, and he has a thing for underdogs. He’s a like a professional knight in shining armor, so Henry will need all the help he can get.

Lucy leaves Lebo’s room and overhears Alex on the phone with Namboze. He asks for a few days to think about it. She asks if he’s gonna go. He doesn’t know yet. There’d be amazing surgeries. After his project, he can’t imagine going back to being just a resident. If he gets Chief Resident, he has a reason to stay, but otherwise, there’s nothing keeping him here. He asks her what she thinks. She says that doesn’t matter.

Cristina helps Meredith to come up with ways to turn questions about negative parts of her life into positive points. If the social worker asks about asking a shooter to shoot her, she should change the subject.

Cristina ends up on an elevator with Alex, who says chicks suck. He says Arizona offered her the job, and Lucy got all pissed. Cristina says she obviously has feelings for her, but he’s all dead inside. Cristina tells him to take the job in Africa because he’d be amazing. He thinks she just wants him out of the Chief Resident competition.

Lexie walks with Cristina and asks what the thing is about women falling for men with babies. They’ve passed Mark on their way to the nurses station and he’s surrounded by women admiring his baby. Cristina tells her that she’s the only one looking at Mark instead of the baby. Lexie scoffs and walks off.

April walks with Cristina and tells her she booked an OR. Cristina says she hasn’t had sex in three days and it’s giving her super powers. Now she gets why April is so organized. She hasn’t felt like herself in a long time because she’s banned from cardio, but now she’s finally feeling like herself again. She needed this. April is surprised that Cristina is treating her like a friend. They walk into Raul’s room, where Teddy is explaining the surgery to Raul. Richard is with Teddy and he appears to be mad at Cristina. April apologizes to Cristina, but she needed this, too.

Raul wonders why Cristina isn’t doing the surgery. Richard says Teddy has experience with complex cases like this. Raul says he’s seen three doctors before and they couldn’t help him. And then finally, Cristina finds the tree in his lungs. So, he’d like to stick with her.

Owen is interviewing Jackson. He wonders what Jackson, as possible Chief Resident, would say to a resident who wants to drop out of a clinical trial. Jackson would urge him to think it through, but he’d respect his decision. Owen says Jackson has a history of quitting when things get tough. Maybe it’s because he’s not used to work hard or because he’s afraid of success, but Jackson’s making a mistake here. Jackson disagrees.

Richard asks Teddy if Cristina can perform the surgery. Teddy says she can, but she does not like it. Cristina went behind her back to spite her. Cristina says Teddy gave her no choice. Teddy can’t believe Richard is going to reward Cristina while she should be punished for insubordination. Richard says he won’t take out disciplinary actions on the patient. Teddy will observe and April will assist. Case closed. Richard tells Cristina he’ll make sure Owen considers this in his evaluation for Chief Resident.

Meredith and Derek are peeking into Arizona’s OR while she’s operating on Zola. Meredith is worried because a lot of things could go wrong, but Derek tells her things will be fine. Meredith’s afraid that they will find better parents for Zola, because residents are not ideal mothers. So, she needs Derek to stop seeing things will be fine. He tells her things are gonna go they way they go.

Lexie finds a dark room to look at her scans, but Mark is sitting in there. It’s the only place that Sofia will sleep. He says he’ll get out of her way, but Lexie tells him to stay. She takes the opportunity to take a look at Sofia. She and Mark stare at each other for a while. She tells him she’s happy for him, because he seems really happy. He says he is, because he has everything he’s ever wanted. Almost. She takes her scans and leaves the room.

Cristina takes out the tree. She and April look at it for a while. Cristina says it managed to survive in a hostile environment and she looks at Teddy in the gallery. She decides she’s gonna keep the tree. April objects as protocol dictates it needs to go to pathology. April knows people hate rules, and the people who enforce them are annoying as are the rules, but they are there for a reason. Cristina says it’s fine to send it to pathology. She tells April she won’t become Chief Resident, no matter how many boxes she checks.

Arizona is looking at Abena and Lebo. Alex approaches her and tells her about his treatment. She asks if he’s going to do Africa. He says he’s not sure. Arizona asks if he’s in love with Lucy. He says it’s new. Arizona doesn’t want her recommended person to pull an Arizona and run away to the girl he left behind. She tells him to be sure, or he’ll have her to answer to.

Mark joins Derek outside Zola’s room. He thinks Derek wanted to get this baby because he saw how good Mark looked with a baby. Derek laughs. Mark asks about Zola’s condition. Derek says she’s feeding again, so that’s good. Mark uses a silly voice to talk to Sofia. Derek hopes he’ll get to use that voice too, because they are dealing with the international adoption agencies and they don’t just give out the kind of waiver that he and Meredith need. Mark says he and Meredith will make good parents and the agencies will see that. Mark is sure Derek will be okay.

Meredith is meeting with the social worker. She asks Meredith what it’s like to have a mother as a surgeon. Meredith says you definitely get to be independent, but she wouldn’t raise Zola the way her mother raised her. Janet asks her to talk about Zola. Meredith talks about Zola’s medical history and her surgery today. In surgery, Zola’s heart went back to sinus rhythm on its own, and Meredith was fascinated by that. She then realized that’s not what Janet meant. She mentions Zola is also very cute and sweet. Meredith thinks she’s not doing very well. Janet says she doesn’t have an agenda, she’s just trying to get a sense of who Meredith is. Meredith says she’s a good surgeon and she wants to be a great mother. She admits she doesn’t know much about that, but she’s willing to learn. She’ll do whatever it takes. Janet says good mothers brag about their children, and Meredith did that. Meredith knew where Zola was every second and she appreciates that Meredith shared that with her.

Cristina has her interview with Owen. She says she was showing initiative today. Owen says that doesn’t give her the right to pretend to be an attending. Cristina didn’t, she just didn’t need an attending. Teddy is doing a disservice to her education, so she took matter into her own hands. The patient is doing fine. If today didn’t show her qualities for Chief Resident, she doesn’t know what can. Owen tells her she won’t be Chief Resident. Owen says she never had the qualifications. Chief Resident is more than a resume boost. It’s managing scheduled, overseeing interns, and working within the system. That’s never been Cristina. Cristina says Owen is screwing with her career. Owen says that anything that keeps Cristina from being a surgeon will kill her. She’s not made for the job. It’d make her resent it and work against it until she fails. She has to be excellent at what she is.

Alex finds Lucy and tells her he’s not going to Africa. She has something to say of her own, but he keeps going on. He can finish his residency and then they can go to Africa together. She was right this morning. Lucy is a factor for him and he should’ve said that sooner. Alex always thinks of himself as single because whenever he thinks of a future with someone, he gets kicked in the teeth. So, he stopped looking, but he sees one with her now. She tells him to stop. He was right this morning. Career comes first. So, she took the job. Not at Baylor, at Namboze Clinic. He can’t believe she took his job. Like he said, it’s not personal. Sometimes, you have to be a shark.

Alex sits down with Cristina at the bar. He tells her about Lucy. You open yourself up to someone and then this happens. April joins them. April says there are rules for a reason. She got fired when a woman died because she missed one little step. If you follow the protocols, people live. April knows she won’t be Chief Resident, but the checklists work.

Owen finds Jackson and says that it was so stupid of Jackson to step away from the trial that he started thinking the trial was flawed. So, he looked into it. The methodology is the kind of stuff that wins big awards, like the Harper Avery. Owen realized that Jackson dropped out because he knew that if his name was on it, he’d ruin the Chief’s chances to win the Harper Avery. Owen respects that he doesn’t want to succeed on his name, but he should never let it hold him back.

Henry finds Teddy and tells her he got his old job back after he told them about the trial. That means he’s gonna have his own insurance in a couple of months. Henry wants to ask her something about their situation, but Andrew calls for Teddy from the other end of the hall. She tells Andrew she’ll be right there. Teddy says they’re going out to dinner to celebrate what they decided over lunch. She’s going to Germany with him. Henry says that’s good news, too. He’s going to be fine, which brings him back to his question. He wants a divorce. She’s surprised, but sure. She says he doesn’t need her anymore. She has to go now.

Callie and Arizona are ready to go home. Mark gives Sofia back to Callie, who talks to Sofia about her day. They all leave together.

Lexie is watching them from a distance. Jackson shows up and asks if she’s staring at Sloan again. She says she was staring at the baby. She asks about his interview. He says he’s out. It’s a long story, but he’s fine with it. He has her and he needs nothing else. They leave together.

Meredith picks up Zola from her crib and tells her she’s hoping to become her mother.

Back at Joe’s, Cristina tells Alex that it’s going to be Meredith. It doesn’t mean that you’re a bad doctor if you don’t get chosen. It just means you don’t fit the bill because you’re better at other things. Like, Alex is so good with the kids, but Meredith is organized and people trust and like her. She’s a natural. Cristina advises Alex to go and steal his job back. He should go to Africa, because that’s what he’s good at. Owen comes in. He tells Cristina he knows she’s mad. She turns around and kisses him. He wasn’t expecting that. She says she’s going to be an excellent surgeon, and she’s going to be excellent in bed tonight. She leaves. Owen wishes Alex a good night. However, before Owen can leave, Alex blurts out that Meredith messed with the Alzheimer’s trial.


  • Meredith Grey
  • Cristina Yang
  • Alex Karev
  • Miranda Bailey
  • Richard Webber
  • Callie Torres and Owen Hunt
  • Mark Sloan
  • Lexie Grey
  • Owen Hunt
  • Arizona Robbins
  • Teddy Altman
  • April Kepner
  • Jackson Avery
  • Derek Shepherd
  • Lucy Fields
  • Andrew Perkins
  • Raul Aranda
  • Henry Burton
  • Annette Aranda
  • Miguel Aranda
  • Bronchoscopy Nurse
  • Lebo
  • Abena
  • Janet Meyers

Main CastEdit

Guest StarsEdit


Medical NotesEdit

Zola LimbaniEdit

  • Diagnosis:
    • Spina bifida
    • Hydrocephalus
    • Hernia
  • Treatment:
    • Hernia repair

Zola was set to have surgery to repair a hernia. Arizona took her in and operated and post-op, she was doing well.


  • Diagnosis:
    • Sickle-cell anemia
  • Treatment:
    • Hydroxyurea

Abena was being discharged to go home. She'd been in the hospital for a month. She had sickle-cell anemia and was given medicine to continue to treat it at home.


  • Diagnosis:
    • Pregnancy
    • Sickle-cell anemia
    • Placental rupture
  • Treatment:
    • Hydroxyurea
    • C-section delivery

Lebo, 17, was leaving the hospital with her sister, Abena, when she collapsed in pain. She was pregnant and hadn't told them and had a syncopal episode. She had blood in her abdomen from what they believed to be a splenic rupture, so they took her into surgery. In surgery, they found no rupture on the spleen, but because of the scarring on her fallopian tubes, the baby implanted outside her uterus and was tangled in her intestines. Lucy quickly delivered him and they determined that the bleeding was from her placenta. After her surgery, she was stable.

Raul ArandaEdit

  • Diagnosis:
    • Foreign body in lung
  • Treatment:
    • Bronchoscopy
    • Thoracotomy
    • Surgical extraction

Raul was in the hospital for coughing up blood. He'd seen three doctors for the coughing before coming into the hospital once the blood started. April scheduled tests to rule out cancer as the cause. When he was taken into bronchoscopy, Cristina found a small tree growing in his lung. She took him into surgery to remove it.

Henry BurtonEdit

  • Diagnosis:
    • Diabetes
  • Treatment:
    • Islet cell trial

Richard allowed Henry to join his islet cell trial to treat his diabetes.

Callie's PatientEdit

  • Diagnosis:
  • Treatment:

A patient was brought into the ER after a motorcycle crash to be treated by Callie.

Lebo's BabyEdit

  • Diagnosis:
  • Treatment:

Lebo's baby was doing well after birth. Alex suspected that he likely had sickle-cell anemia like his mother. Alex later said he was a little smushed, but doing well.


Song Performer Scene
"Second Chance" Peter Bjorn and John
  • Cristina denies Owen sex.
  • Alex says he won't tell Owen about Meredith.
  • Jackson and Lexie brush their teeth as they discuss the diabetes trial winning awards.
  • Lucy tells Alex about the job at Baylor.
"Come Home" Yael Naim
  • Meredith asks Cristina for advice for her meeting with the social worker.
  • Cristina tells Alex that Lucy loves him and advises him to take the job in Africa.
  • Lexie complains to Cristina about guys with babies making women go crazy.
  • Cristina tells April about her super powers.
  • She discovers April tattled on her.
"Entwined" Tim Myers
  • Derek tells Meredith everything will go as it goes.
  • Lexie and Mark talk about Sofia and that he's happy. He says he has almost everything he wants.
"The Night Will Always Win" Elbow
  • During her interview with Owen, Cristina finds out she won't be the Chief Resident because the job doesn't fit her.
  • Alex tells Lucy she's a factor for him, only to find out that she stole his job at the Namboze Clinic.
"I've Got a Feeling" Calahan
  • Alex, Cristina, and April have a drink at Joe's.
  • April insists that checklists work.
"Love More" Sharon Van Etten
  • Henry informs Teddy he got his old job back and asks for a divorce. She leaves with Andrew.
  • Lexie watches Mark, Callie, and Arizona leave the hospital with Sofia.
  • Jackson tells Lexie about his day and they leave together.
  • Meredith spends time with Zola.
  • Cristina tells Alex that it's gonna be Meredith.
  • Owen joins them and Cristina kisses him.
  • Alex tells Owen about Meredith's tampering.

Notes and TriviaEdit

Grey's Anatomy 7x21 PROMO

Grey's Anatomy 7x21 PROMO

  • This episode's title originated from the song I Will Survive, originally sung by Gloria Gaynor.
  • This episode scored 9.63 million viewers.
  • In one of many Season 7 references to plane crashes, April's strategy for becoming Chief Resident involves implementing checklists such as those pilots check to avoid any accident. It is not known if these references are meant to foreshadow the events of the Season 8 finale or if they're merely coincidental.
  • Towards the end of the episode, Alex is sitting at the bar next to Cristina and yells to the bartender, "Calahan, take a double whiskey!" The song playing in the background is "I've Got a Feeling" by Calahan.


Episode StillsEdit

Behind the ScenesEdit


Meredith: I'm a surgeon and I'm a good surgeon and I want to be a good mother. Honestly, I don't know much about it, but I'm ready to learn and I'm a fast learner. And I will do whatever it takes to be a good mom.

April: I missed a little step, one simple step. When we follow the protocols we don't skip steps. People live, simple as that. You know you're right. I probably won't be chief resident, but the checklists work. You can't tell me they don't.

Owen: It's what you are, just be excellent at what you are.

Meredith: Okay, what if the social worker wants to ask me about the time I spent sleeping around Europe?
Cristina: Oh, that's easy. You were absorbing other cultures.
Meredith: Okay, and what about the fact that my mother had early onset Alzheimer's and may have passed the gene on to me?
Cristina: It makes you more appreciative of the gift of life.
Meredith: I put my hand on a bomb in a body. She could think that was...
Cristina: Suicidal? No, it was brave.
Meredith: I told a shooter to shoot me.
Cristina: Change the subject.

Cristina: You know it's gonna be Mer, right? It doesn't mean that you're a bad surgeon or a bad doctor. Some people just don't fit the bill. They're just better at other things. Like you and those kids. I mean, you're good at that. But between you and Mer... She's organized, people like her, people trust her. She's a natural.
Alex: People trust her.
Cristina: I'm just saying. Go steal your job back. I mean, go to Africa. That's what you're good at. Go do what you're good at.

Mark: I fed her. I changed her diaper. Prettiest poop you ever saw.

Owen: Chief resident is more than just a resume boost. It's managing schedules, overseing interns, pushing papers, working within the system. That isn't you. It's never been you.
Cristina: You know, I'm protesting this. You are screwing with my career.
Owen: And it will kill you. You're a surgeon and anything that keeps you from being a surgeon will hurt you and it will make you crazy. We saw it today. You're not built for this job. You will hate it and you will resent it. And you will fight against it until you fail. So, just... be a surgeon. It's what you are. You know, just be excellent at what you are.

Lexie: What is it about guy's with babies that makes women go crazy? I mean, it's like when you're at the park and you see a guy with a puppy. Now, normally, you wouldn't even notice the guy, but then he's laughing, and the puppy's crawling all over him, and he's tickling the puppy's little puppy belly, and you're thinking, I wouldn't mind spending the rest of my life with that guy. What is that?
Cristina: Oh, everybody's looking at the baby, no one's looking at Mark. Except you.

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.

Community content is available under CC-BY-SA unless otherwise noted.