Great surgeons aren't made, they're born. It takes gestation, incubation, sacrifice. A lot of sacrifice. But after all the blood and guts and gooey stuff is washed away, that surgeon you've become? Totally worth it. Giving birth may be all intense and magical and stuff, but the act itself is not exactly pleasant. But it's also a beginning of something incredible, something new, something unpredictable, something true, something worth loving, something worth missing, something that will change your life forever.

Piece of My Heart is the thirteenth episode of the fourth season and the 74th overall episode of Grey's Anatomy.

Short SummaryEdit

Addison returns to Seattle Grace for a surgery and discovers a lot has changed since she departed for her new life in L.A. Derek and Meredith's clinical trial has an uneasy start and Callie becomes defensive when Addison suggests there may be more than friendship between her and Erica.

Full SummaryEdit

Addison is standing in front of Seattle Grace Hospital. Bailey appears and welcomes her back, but Addison reminds her she's just here for a surgery. Bailey gives her the chart, labs, and her badge. They used her old picture, making Addison feel like she never left. Richard comes over and hugs her. He says the surgery is gonna make her come back. Addison claims things haven't changed and tells Richard she's not back.

Erica and Callie get off the elevator, talking about sunrise yoga. Cristina comes over with the 3-D ultrasound and fetal MRIs for today's patient. Cristina suggests Hahn let her scrub in, but Erica just asks for the films. She and Callie then walk off.

It's the first day of Meredith's trial. Izzie says nobody cares about her trial, but she admits she's jealous. Cristina complains about Hahn not talking to her. Izzie says Hahn enjoyed talking to her. Cristina bounces back that at least she's not spending all her time in the clinic. Izzie likes the clinic, it's her happy place. Cristina asks Meredith to use the sparkle pager to get her on Hahn's service. Meredith says she has no time for the sparkle pager today because of her trial and she thinks that if Izzie and Cristina take a moment, they can be happy that she's found her path to medical history. She walks off and Cristina and Izzie both say they're not happy for her.

Meredith talks to Derek about their patient's condition. Derek says he doesn't want her to get emotionally involved or to get her hopes up, but Meredith says her hopes are not up. She and Derek shake hands and Derek asks for the chart. Addison comes over and greets them. She hugs Meredith and says it's great to see them. She says she loves Los Angeles. She uses the hug to point out that she's grown, and she can be happy for them, the happy couple. Addison feels really good. Addison walks off to go save a life. Meredith and Derek are all but a happy couple and part ways.

Addison finds Mark in his skin lab. She came to check on her patient's skin flap. He's grown actual skin from stem cells, like God. He says they can lock the door and tear one off for old time's sake. Addison says everything is exactly the same here. He's horny because the nurses are shutting him down. Addison says it's an amazing skin flap and walks out.

Izzie's interns are bored in the clinic. They're here to learn bedside manner, she says. They can't learn that in the pit, so they have to suck it up. They go to see the first patient, a woman who thinks she's pregnant. As Izzie says they'll get a test, one of her interns can't hide his boredom. Izzie closes the curtain and asks her interns what's wrong with them. She then smells scotch. They're hungover because George had a party. Izzie didn't know about that.

Meredith tells her interns they're about to experience medical history, so they should take in the moment. Derek comes over and tells them that the patient may be inappropriately emotional, so they shouldn't take it personally. It's the tumor talking. Derek greets Phillip and thanks him for agreeing to be part of the trial. Jennifer is hopeful, but Phillip just thinks he's got nothing to lose. Meredith explains they're going to inject a live virus into the tumor. They can't take it out, so they want to reduce it from within. George presents the case, but Phillip gestures him to come closer. George does so, and Phillip starts to describe his wife's great body. Jennifer explains he's been picking out new husbands for her, but Phillip screams he wasn't talking to her. Meredith reminds Jennifer it's just the tumor talking. Phillip asks George if he's single.

Alex bumps into Addison and she hugs him after they greet each other. He's on her service. He then sees Ava get off the elevator and tells Addison he'll catch up with her in a moment. Ava says she needed to see him in person. She blurts out she's pregnant. She has to blurt, as he never has time to talk. He asks if she's keeping it or having an abortion. She's surprised by that direct question. He says he has a really big case and walks off.

A group of doctors has gathered in a conference room to talk about the case, a baby's heart that's growing outside of his body. It's rare and only a handful has survived. Addison has seen a case like this before, but then the baby squeezed his own heart and died. Erica says she and Addison have a lot to do, but they're both up for it. Mark reminds everyone that he grew a skin flap.

Izzie paged George to the clinic and all the interns greet him enthusiastically. Izzie imitates them and tells George she spent her night on Google. George says the party was spontaneous and the interns keep doing this thing where they say "coded". George explains it's this thing they came up with last night. Lexie comes over and informs George they're all set for tonight. Izzie asks what's that about. Lexie says the interns are having a darts tournament at Joe's. Izzie says she loves darts. She wants to come as well. Lexie and George walk off and she tells him he so coded.

Bailey and Addison are in the conference room. Addison finds it strangely comforting that everything has stayed the same. She says that in L.A., they talk, but in Seattle, there's this strange culture of wordlessness where she's supposed to suss what one's feeling by the slight raise of an eyebrow, or the beginnings of a frown, so she asks if Miranda doesn't just want to see what's going on. Bailey says a lot has changed and Addison asks for an example. Bailey says that the clinic is making money. The Chief's wife left him. Meredith and Derek broke up and she... Addison interrupts her as she can't believe Meredith and Derek broke up. Bailey says a lot has changed.

The doctors have gathered in the baby's mother's room. The father says their baby is unique. He's proud that his son is one of a kind. Richard says the surgery will take place in two ORs. Addison and Alex will deliver the baby and Bailey will stay behind to close Nikki's incision. Addison will take the baby to the second OR, where Hahn will concern herself with the heart and Addison will fix the baby's intestinal problem. Bailey explains they found a slight defect on the baby's diaphragm. Nikki wishes she could keep the baby inside her to protect him, but Will says their love will protect him.

Outside the room, Alex says he wanted to punch the guy. Cristina tells Erica that hippies are annoying. Erica tells her to go away. Addison smiles and Callie comes over. Callie mentions Addison is great and Erica agrees. Callie asks Addison what Erica has said. Erica asks if Addison knows Callie's divorced. Addison is surprised, but Erica and Callie say it's the best thing that could have happened. Callie and Erica walk off together, laughing, with Addison watching them.

Meredith is checking up on Phillip. He's doing worse since the last check-up. Meredith tells Jennifer she's been strong. Phillip tells Meredith that if she really wants to help, she should bring in single men for Jennifer. Jennifer tells him to stop, but he gets mad and says she's a waitress without prospects who has to learn to use her ass to catch a new guy before he bites the dust. Jennifer has to remind herself it's just the tumor talking. Phillip starts laughing again. Jennifer thinks it's because it's funny for him to picture her with another guy. Phillip says it's not that, he's just blind. He keeps on laughing.

Derek is checking on Phillip. He's really blind. Derek tells him the tumor is invading the optic nerve, so they might need to consider to do the surgery today. Phillip asks Meredith if she thinks Derek is attractive enough for his wife. Jennifer leaves the room as Phillip starts laughing again.

Meredith follows Jennifer outside. Jennifer says her husband is probably gonna die today and all he can do is fix her up with other men. She knows it's the tumor talking, but if he dies, her last memory is going to be of her husband calling her a piece of ass. Jennifer goes back into the room as Derek comes out of the room. Meredith tells him she's not involved and not getting her hopes up. He doesn't seem to believe her.

Izzie's intern Gabriella tells Izzie she has trouble finding a heartbeat on an ultrasound. Izzie says that happens when you have scotch for dinner and goes to see the patient, who turns out to Ava/Rebecca. Rebecca says she didn't want an ultrasound, she just wanted something for the morning sickness. Rebecca says she's pregnant for five weeks. Izzie says an ultrasound can be hard to read then and says they'll run a blood sample to make sure everything is on track. Rebecca asks Izzie if she knows when Alex will be out of surgery as she wants to say hi. Izzie is not sure he's in surgery yet.

Addison is on the bridge with Derek, confronting him about his break-up with Meredith. Derek says they're doing a clinical trial together if that makes Addison feel better. Addison reminds him she hugged Meredith. She wonders what the hell happened, but he doesn't want to say. She asks about the trial. He says he's just killing people for sports now. He's just groping around in the dark, hoping to do the right thing, while Meredith is expecting greatness. Addison asks him what he's doing. He says he's seeing someone else, and she's lovely.

Alex was paged to the residents' locker room by Rebecca. He says she has to stop as he has a big case. She says she's just as scared as he is. He says he's not scared. He says she doesn't want him. He won't be good at it. She has a husband and he doesn't have to know the baby is his. She asks him to get over himself and talk to her so they can figure it out together. He says he has to go and leaves.

Addison explains to Nikki where they'll make the incisions. Nikki asks about the risks again, but Will says they can't think about those, as they are going to have a healthy, strong, and happy baby. Alex bluntly tells them that the chances are that the baby's gonna need a lot more than just heart surgery. Hoping that it all goes away won't help. Bailey calls Alex's name.

Alex is defending himself outside the room, saying he was just trying to prepare the parents. The baby's going to be screwed up because his crazy parents think loving each other is just enough to raise a sick baby. Will is not prepared. Bailey tells him to stuff all his feelings back in. Addison notes it's interesting advice, but Bailey tells her not to start on her.

Callie walks up to Addison for lunch, but Cristina stops Callie to tell her Hahn is no longer welcome at the apartment. Hahn is unfair to her and won't teach her, while she could have gone to any other hospital to get taught. Callie says Erica is a good listener. She may come off harsh at first, but she's got a really good heart. Cristina should tell her how she feels. Callie sits down with Addison as Cristina says she doesn't speak girl. Callie tells Addison she lives with Yang now. Addison asks if Callie is speaking the vagina monologues now. She's all for it and Erica seems great. Callie can't believe Addison thinks she and Erica are a couple. She laughs awkwardly and says it's insane. Callie likes penis and she says Addison has been living in L.A. for too long.

George is looking for a table in the cafeteria. Izzie waves at him, but Lexie stops him and tells him that people are ready to drop out of the tournament as they don't want to play with Izzie, their boss. George says he can't take back the invitation.

George sits down at Izzie's table, and Izzie asks if Lexie was making more plans. Cristina sits down with them and says she cares, so she wants to know about their feelings. She thinks Alex looks thoughtful, so she asks about his thoughts. Alex doesn't react, so she asks Izzie instead. Izzie is worried because Alex's girlfriend keeps showing up. Alex says she's not his girlfriend. Izzie knows they had sex, but Alex says she's married. Cristina asks if that hurts his heart. Meredith wonders what's going on with her. Cristina confesses she's trying to speak girl. Izzie tries to use the coding slang, but George says she totally coded when she tried. The residents don't laugh and Izzie gets mad. She says she actually cares about patient care and leaves. Cristina needs the sparkle pager to get on Hahn's service and tries to take it from Meredith as Callie comes over. She wants to know if people ever think that Meredith and Cristina are a couple. They say no, because they screw boys like whores on tequila. And then they either try to marry them or drown ourselves, Cristina adds. Cristina tells Callie to make Erica let her scrub in or she's kicking Callie out of the apartment.

Izzie finds the couple from earlier today and informs them they're indeed pregnant. She wants to give them prenatal vitamins, but the woman says they need to schedule an abortion. Izzie says she's sorry, but she says they might want to wait a few days before making the decisions. Sarah says there's no decision to be made as she's HIV positive. The condom broke. Freddie got tested already, but so far he's fine. Sarah wants to get this over with and she wants to know if they can take care of it today. Izzie will see what they can set up.

Callie finds Hahn and asks her to put Cristina on her service as a favor. Erica agrees to but only if Callie buys them drinks at Joe's tonight. Callie agrees.

Izzie is eating potato chips at the nurses station. Addison comes over and Izzie asks her for a favor. She wants Addison to talk to her patient. Izzie explains the case of the pregnant HIV positive woman. Addison says she doesn't have to terminate, but she doesn't work here anymore so she can't talk to the patient. If she still worked here, she would be performing surgery after surgery and maybe even get back together with her husband, who's apparently back on the market. That would be simpler than the messy single life she's currently living. Her point is that she no longer works here, so Izzie has to pull her face out of the potato chips bag and go tend to her patients herself. Addison says Izzie's a fighter and she wondered what happened. Izzie says she lost a lot of fights. Addison tells her it's time to get back up. She has to be the change that she wants to see in the world. Addison walks off with the potato chips. Izzie can't believe she just quoted Gandhi to her.

Alex says it's time to take Nikki, who's sleeping, to the OR. Will says he's not an idiot. They overheard him before. He knows it can be bad, but he prefers to have hope and not focus on all the bad.

Derek enters Phillip's room. Phillip hates being blind as he wants to see Jennifer. Derek says it's a risky surgery and says Phillip could also wait with the surgery and spend a few more weeks with Jennifer. Phillip says the one thing he truly can't stand about all this is that he has to leave Jennifer behind. He wants her to be all right when he's gone. Derek says he has to tell her that before he goes into surgery.

Meredith finds Katharine Wyatt. She wants to say that Derek obviously doesn't know her at all. He's the one who's emotionally involved, because anyone who knows her knows that she's not a hopeful person. The trial is her baby and she didn't enter it without knowing how hard it was going to be. No wonder they didn't work out. Meredith leaves for her surgery. Katharine asks if it's the surgery with no hope. Meredith tells her to shut up.

In the OR, Addison asks her colleagues about the new woman Derek is dating, calling her the unlucky McRebound. She laughs, but no one else does. She can't believe the Mc-thing is over now too, but Bailey says it's the woman handing her the instruments. Addison greets Rose, who tells her shortly about her dates with Derek. He's a good guy. She gives Addison her scalpel.

Freddie is delighted to hear that they can have a healthy baby. Izzie explains that with the proper prenatal treatment, the risks to their baby are substantially reduced. Sarah is mad. She didn't ask for this, she asked Izzie to schedule an abortion. Izzie got his hopes up and this is not okay. Sarah has learned how to deal with her HIV, but she won't do that to a baby. She won't put her baby through that. She tells Izzie to go schedule the abortion and then requests another doctor. Izzie silently leaves.

Derek and Meredith are taking Phillip to surgery. Jennifer is walkign behind them. Derek reminds Phillip what they talked about. Phillip tells Jennifer he wants her to try to find somebody, because he doesn't want her to be alone. Jennifer is moved and says she'll try. Phillip hopes he'll make it. Jennifer kisses him. He laughs as they take him to the OR.

Addison delivers Nikki and Will's baby. Bailey notices Nikki is hemorrhaging as Alex informs them the baby's membrane is intact. Bailey needs another set of hands and Addison jumps in to help. The uterus isn't contracting.

Alex is taking the baby to the other OR. He tells Richard that Addison stayed with the mom. Alex takes the baby into Hahn's OR.

Izzie is talking to George. She thinks she's been hiding in the clinic because she screwed up so much at work. George tells her she can't come to play darts with them, because she's a resident and he's trying to embrace what he has, and he has friends who don't want to get drunk with their boss. She should get that. Izzie says she needs to do something and walks off.

Izzie enters the room where Sarah and Freddie are waiting. Izzie orders her interns to come in and listen and learn. Sarah thinks Izzie disapproves and that she wants to push some kind of agenda. Izzie says no. If Sarah wants an abortion because she wants to, that's her choice. But, if she wants an abortion because she thinks that's what medicine is telling her to do, it's between her and Izzie. Izzie was ineffectional and unclear. Izzie wasn't telling her there's some chance her baby might not be sick. There's a 98% chance that the baby is perfectly healthy. Sarah stammers she can't do this. Izzie understands she gave up on having children a long time ago and she understands it's difficult to readjust her thinking so quickly, but if Sarah takes her meds responsibly, this is her chance to be a mother. Sarah repeats the odds and hugs Freddie, who thanks Izzie. Izzie's interns are impressed.

Erica tells Alex they need Addison here now. Alex says she'll be here. They're about to lose the baby. Cristina asks what she should do. Hahn tells her to massage the heart. Cristina does so and she can feel it getting stronger. The heart rate stabilizes. Alex says he gave the baby meds. Erica says he did a good job and tells Cristina to step back now.

Derek is operating with Meredith. It's the moment of truth as they're about to inject the virus.

Mark places his skin graft over the baby's exposed heart.

The monitor is beeping and Meredith says there's complete heart block. The injection went into the intra-arterial, Derek says. Phillip doesn't respond to the meds.

Addison and Bailey have managed to control the bleeding. Addison quickly leaves.

Mark and Erica have finished up. Mark admires his own work, making Erica shake her head as Addison walks in. Erica informs her she was able to reduce the heart almost all the way into the pericardial space. The heart is beating and everything is looking perfect. Alex is staring at the baby intensely.

Phillip has died. Derek says the treatment failed on their first patient and tells Meredith to call it. She says time of death 19:33. They sigh.

Bailey is scrubbing out. Addison comes in to inform her that the baby didn't have any further complications, just as the parents suspected. Bailey says the mom's okay too. It was a good day. Addison says Miranda seems sad. Bailey says she can't share or catch up with Addison, because if she did and told her that Tucker moved out and that she hasn't slept alone in 12 years, if she told her that her heart hurts so much sometimes that she wants to rip out of her chest, she would fall apart and she doesn't have time to fall apart. She's happy to see Addison, but she wishes Addison would go away so the choice of talking and falling apart would go away. Addison remains silent.

Meredith watches Derek deliver the bad news to Jennifer and comfort her.

Meredith tells Derek she got her hopes up. He did as well. She tells him it was a pleasure to work with him today. They shake hands, share a look and he walks off.

Addison confesses to Richard that she's missed this. He says he can have her back at work here by tomorrow. Addison says she needed to come back to see that it was right to leave. He needs to fill her position. Izzie walks by and tells Addison she was so Gandhi today. She kicked Gandhi's ass. Addison laughs and explains to Richard it's an L.A. thing.

Izzie is waiting for lab results as she sees George. She asks if he isn't late for his party. He says he'd rather hang out with her. Izzie gets that he wants to hang out with the interns and tell him to go. George says that whenever says something funny, he always looks around to see if she thinks it's funny too, even when she's not there. She tells him to go. He leaves.

Derek ends up on an elevator with Meredith, Addison, and Rose. On the next stop, Mark gets on as well. He laughs and says Derek probably wishes he took the stairs. Derek affirms.

Addison, Callie, and Erica are having drinks at Joe's. They're talking and Callie wants to say what Addison thought, but then Erica stops her to remove a hair that got caught in her lip gloss. Mark comes over to ask if anyone wants to dance with him. Callie gets up and starts dancing. Cristina comes over to their table and asks if Erica doesn't like Asian people. She wonders why Erica won't teach her. Erica says she's not without skill or talent, so Cristina has to stop looking for approval. She won't tell her what a good little girl she is. It won't make her better at her job. Cristina walks off and Addison says Erica was hard on Cristina. Erica says Cristina reminds her of herself. Addison and Erica watch Callie and they agree she's beautiful.

Callie asks Mark if he wants to get out of here. He agrees and they leave.

In a corner of the bar, George is having fun with his new friends.

The lab technician gives Izzie Rebecca's test results, but Izzie doesn't think they're right.

Addison is about to leave the bar as she has to catch her plane, but not before talking to Meredith. She's very zen now, but she wants to kick Meredith's ass so badly that it's killing her. She can't believe that Meredith is letting him get away with Rose. Addison leaves Meredith to think about that.

The technician says the results are right, so it turns out Rebecca is not pregnant.

Alex is in his bedroom with Rebecca. He touches her belly.


  • Meredith Grey
  • Cristina Yang
  • Izzie Stevens
  • Alex Karev
  • George O'Malley
  • Miranda Bailey
  • Richard Webber
  • Callie Torres
  • Mark Sloan
  • Lexie Grey
  • Erica Hahn
  • Derek Shepherd
  • Addison Montgomery
  • Katharine Wyatt
  • Rebecca Pope
  • Jennifer Robinson
  • Nurse Rose
  • Sarah
  • Freddie
  • Phillip Robinson
  • Will
  • Nikki
  • Lab Tech Jeffrey
  • Intern Graziella (left)
  • Intern Claire (left)
  • Intern Leo Byrider
  • Intern Lucy (left)
  • Intern Megan (right)
  • Intern Mitch (right)

Main CastEdit

Special Guest StarEdit

Guest StarsEdit


Medical NotesEdit

Baby JonesEdit

  • Diagnosis:
    • Ectopia cordis
  • Treatment:
    • Surgery

Addison came back to Seattle to work on the case of Nikki, 25, a mother who was 35 weeks pregnant pregnant with a baby whose heart was growing outside his chest. They also believed he had a diaphragmatic hernia, so they prepared to operate on that as well. He was delivered via c-section and Erica worked on his heart, pushing it back in his chest and covering the gap with a skin graft Mark had grown with the baby's own stem cells. They were able to put his heart almost all the way back into his chest and there was no hernia.


  • Diagnosis:
    • HIV
    • Pregnancy
  • Treatment:
    • Antiretrovirals

Sarah, who was HIV+, believed that she might be pregnant. When her suspicions were confirmed, she said she needed to terminate because she believed that she could pass HIV to her baby easily. When she was informed that she had a high probability of having an HIV- baby if she took her antiretrovirals dutifully, she decided to continue the pregnancy.

Phillip RobinsonEdit

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

Phillip's tumor had grown and he started to become very aggressive. He was also losing his vision. He was the first patient to participate in Derek and Meredith's clinical trial, which involved injecting live virus into the tumor to shrink it. Before his surgery, he went completely blind. Because of that, his surgery was moved up. They took him in, but he coded in the OR and was pronounced dead at 19:33.

Rebecca PopeEdit

  • Diagnosis:
    • Hysterical pregnancy
  • Treatment:

Rebecca came to the hospital and told Alex she was pregnant. However, it turned out that it was a hysterical pregnancy.

Nikki JonesEdit

  • Diagnosis:
    • Pregnancy
    • Hemorrhage
  • Treatment:
    • C-section delivery

Addison did a c-section to deliver Nikki's baby so the baby could have surgery. During the delivery, she hemorrhaged, but they were able to stop the bleeding and close.

Meredith GreyEdit

  • Diagnosis:
  • Treatment:
    • Talk therapy

Meredith had a quick session with Dr. Wyatt before the first clinical trial surgery.


Song Performer Scene
"See What You Feel" Katalyst
  • Addison returns to Seattle Grace. She's greeted by Bailey and the Chief.
"Money" Greenskeepers
  • George is torn between Lexie and Izzie in the cafeteria.
  • Lexie tells George that people will refuse to come if Izzie comes to the tournament.
  • Cristina sits down and says she cares and wants to talk.
  • Cristina tries to get the sparkle pager from Meredith.
  • Callie asks them if they were ever mistaken for a couple.
  • Cristina tells Callie to get Erica to let her scrub in or she has to move out.
"Distance" Neverending White Lights
  • Phillip is being wheeled to surgery. He tells Jennifer he doesn't want to leave her alone.
  • Addison does the c-section and the mom starts coding while Alex works on the baby.
"Five More Minutes" Meaghan Smith
  • Sarah and her husband hug.
  • Erica is operating and asks for Addison. Cristina offers to step in to help.
  • Erica allows it, but has Cristina step back as soon as the crisis has passed.
  • Derek prepares for the injection.
  • Mark places the skin flap.
  • The virus injection went into the wrong place.
  • Nikki's bleeding is controlled, so Addison leaves.
  • The baby's heart is now in his chest.
  • Phillip is dead.
"Buildings and Moutains" Republic Tigers
  • Addison sits with Bailey.
  • Derek consoles Jennifer while Meredith watches.
  • Meredith and Derek admit they got their hopes up. They agree it was a pleasure working together.
  • Addison says she needed it come back to know it was right to leave.
  • Izzie tells Addison she was Gandhi.
  • George walks toward Izzie.
"Little Bit of Feel Good" Jamie Lidell
  • Callie, Addison, and Erica are getting drinks together.
  • Callie gets up to dance with Mark.
  • Cristina asks Erica if she's racist. Erica says Cristina should stop seeking Erica's approval.
  • Erica and Addison watch Callie dance and Erica says she's beautiful.
  • Callie asks Mark to leave with her and he does.
  • George laughs with the other interns.
  • Izzie gets Rebecca's labs and sees that she's not pregnant.
  • Addison tells Meredith not to let Derek go before leaving.
  • Alex puts his hand on Rebecca's belly.

Notes and TriviaEdit

Grey's Anatomy 4x13 Pieces Of My Heart Promo

Grey's Anatomy 4x13 Pieces Of My Heart Promo

  • This episode's title originated from the song Piece Of My Heart, originally sung by Erma Franklin.
  • This episode scored 15.31 million viewers.
  • This is Addison's first appearance since the season three finale Didn't We Almost Have It All? and her first return to Seattle Grace since she resigned in the Private Practice episode In Which We Meet Addison, a Nice Girl From Somewhere Else. It is believed a guest appearance was scheduled for Kate Walsh due to the fact that no more episodes of Private Practice's first season were made after the Writer's Guild Strike.
  • The plot revolving around Sarah wanting to have her pregnancy terminated because she was HIV positive was actually a social expirement. It was influenced by The Kaiser Foundation in an effort to help change people's common misconceptions regarding HIV, and to educate them further about the disease itself.


Episode StillsEdit

Behind the ScenesEdit


Callie: Did anyone ever think you two were a couple?
Meredith: No because we screw boys like whores on tequila.
Cristina: And then we either try to marry them or drown ourselves.

(Derek is riding in the elevator with Meredith, Addison and Rose.)
Mark: (to Derek) Bet you're wishing you took the stairs right about now...

Meredith: Hey, you're leaving already?
Addison: I have a plane to catch... I walk on the beach now, I buy Aromatherapy candles, I'm very zen, but I want to kick your ass so badly right now it is killing me.
Meredith: Excuse me?
Addison: I'm talking about Derek. Derek Christopher Shepherd. Are you letting him get away? Because I swear to God Meredith, if you let him ride off into the sunset with that doe-eyed little thing...

Addison: Hey, look, I hugged you there! Did you see how I hugged you? You stole my husband from me and I hugged you! I've grown, I have, and I can be happy for the happy couple!

Addison: So, who's the new mystery woman that Derek's dating? Who is the unlucky McRebound? (laughs, while nobody answers) What? Is the whole Mc-thing over now? I'm sure things haven't changed that much around here.
Miranda: Addison, the woman standing immediately to your right, the one handing you the surgical instruments.
Rose: Hey.
Addison: Hey!
Rose: Six dates, heavy petting, lots of tongue. Good guy.

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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