Psychologists believe that every aspect of our lives, all our thought processes and behavior patterns, are the direct result of our relationship to our parents. That every relationship that we have is really just another version of that first relationship. It's just us trying over and over again to get it right. It's the most important job in the world. You probably should need a license to do it, but then most of us wouldn't even pass the written exam. Some people are naturals. They were born to do it. Some have other gifts. But the good news is biology dictates you don't have to do it alone. You can waste your whole life wondering, but the only way to find out what kind of parent you'd be is to finally stop talking about it and just do it.

Sympathy for the Parents is the nineteenth episode of the sixth season and the 121st overall episode of Grey's Anatomy.

Short SummaryEdit

When Alex's younger brother, Aaron, shows up at Seattle Grace-Mercy West with a hernia, it's up to Alex to get Bailey's approval for his pro bono surgery. Matters are further complicated when Aaron discloses that his family has not heard from Alex since he arrived in Seattle, and parts of Alex's past long kept secret are revealed to his friends and fellow doctors.

Full SummaryEdit

In the morning, Derek is staring thoughtfully at Meredith. He thinks about how pretty she is and how pretty their children will be. Meredith is surprised he's talking about multiple children. He wants to start with one and see how it goes. She asks if he wants to start making children. He dodges and says he just said she's pretty. He kisses her.

Owen and Cristina are lying awake next to each other, too, but they're not talking at all. Cristina asks if he's talked to Dr. Wyatt, but he doesn't want to talk about it and disappears into the bathroom.

Meredith walks into the bathroom where Alex is showering. As Izzie is not here and she has a thing, she needs Alex to be a girl for her. She tells him that Derek wants children. He asks if she wants children. Meredith says she had the worst mother in the world, so she'd be the worst mother in the world. Alex then tells Meredith that Izzie sent him divorce papers. Derek comes in, surprised to see Meredith in there, and tells Alex there's a guy downstairs claiming he's Alex's brother. He asks if he should send the dude up here, since this is where Alex appears to be receiving his visitors. Meredith tells Derek to tell the guy to wait and after Derek leaves, she asks Alex if he has a brother. Alex nods and wonders what he's doing here.

Aaron is in the kitchen, telling Lexie and Derek about Amber, his and Alex's younger sister, as Alex and Meredith come in. Alex greets his brother, but he doesn't seem too happy about his presence. Lexie defends Aaron, but Meredith tells her she's gonna be late for pre-rounds so Lexie leaves. Derek and Meredith hear from Aaron that Alex hasn't been home in 7 years. Meredith subtly gets Derek to leave too and introduces herself to Aaron. Aaron then says he's not just here to say hi. He lifts up his shirt, revealing a big bump, and asks if he should be worried about this.

Mark and Callie are getting coffee at a coffee cart and Mark tells Callie that he and Teddy had sex. There's an awkward moment between Callie and Arizona, so the latter acts very enthusiastic about pound cake, which she buys from the cart. Arizona walks off and Mark hopes that pound cake was a dirty metaphor, or else he just witnessed the most boring conversation ever. Callie says they're talking about pound cake because she wants a baby and Arizona doesn't and they're not talking about that. Mark asks how long that is gonna go on. Callie changes the subject and asks about the sex with Teddy. He happily says it was mindblowing.

Teddy is telling Arizona the exact same time on the elevator. Owen gets on and they greet him. He remains silent until getting off on the next floor. Arizona says he's always so grumpy. Teddy says he's going through something that Cristina doesn't get, because she couldn't possibly get it, whereas Teddy totally gets it, but she can't be there for him. That's hard, but she's seeing Mark.

Mrs. and Mr. Clark tell Lexie, Richard, and April that she fainted in the store. The doctors discuss the case. Dr. Swender did a biopsy, which showed that the cancer had come back. She told them that the surgeons might be able to get it out. Richard says he may not be able to go in as deeply as he has to, but he promises to try as much as he can. The Clarks say that they appreciate that and Mrs. Clark comforts her sad husband.

Alex and Meredith are in the waiting room. The bump is an umbilical hernia, which requires surgery, so Aaron needs to fill in some paperwork. Aaron says he can't, because he's not insured. Meredith suggests Alex ask Bailey to do it pro bono, but Alex doesn't want to. Cristina comes over, surprised to hear that Alex has a brother. Aaron introduces himself to Cristina, who wonders why Alex can't be as nice as his brother. Cristina then takes Meredith aside and tells her Owen is in his dark place and he's not talking about it. Meredith says Derek asked her to have a baby, making Cristina conclude that men are stupid. She then gets paged to the pit.

A group of doctors are waiting in the ambulance, where the ambulance is accompanied by quite a police escort. The patient is a police officer who got shot. Officer Gina Thompson says she's not injured that bad and says they should see the other guys. Callie sees three other patients being taken into the ER. Thompson took them down by herself, as a girl's gotta do what a girl's gotta do.

Teddy, Owen, Cristina, Callie, and Jackson are working on Gina in the trauma room as her husband comes in. Gina assures Jimmy that she's fine and then sees lieutenant Moore, who appears to be angry that she didn't wait for back-up. Gina says she went in because she heard a shot. Moore says she risked her life in doing so. Gina reminds him she took down three men by herself, which Moore replies she got herself suspended for. It's going to the review board and she'll be lucky to have a job by the end of the day. Gina panics and wants to get up, but she's bleeding into her chest so the doctors order everyone to get out. They urge Gina to stay calm and breathe.

Lexie, Richard, and April are operating on Alison Clark. Webber says he's going to resect the visible tumor and then sees that April's looking up to the gallery, where Derek is standing. April didn't expect to see the Chief there, but she guesses it's his job to observe and evaluate. Webber tells her that she's in his OR, so the only one observing and evaluating her is him. She understands and apologizes. They continue operating, but April is obviously still distracted with Derek being up there.

Alex finds Bailey playing with her son in the daycare and tells her about his brother. She sees where this is going and asks her son if she should make Alex's brother better. Alex thinks she doesn't want to and offers to schedule her surgeries for an entire month. She agrees and waves him goodbye with Tuck, telling Tuck that she would've done it anyway.

Lexie finds Gary Clark in the waiting room and tells him that his wife was a trooper in surgery. They got all of the tumor with good margins. He's extremely relieved and gets a little emotional. He says his wife told him to man up about this. Lexie says he's doing just fine and offers to go see Alison.

Meredith and Bailey are examining Aaron, who tells him that Karevs are tough because of the years they spent in foster care. They are surprised to hear that and Aaron says that Alex had like 17 foster homes in 5 years. He tells them about their difficult family situation. Alex got moved around a lot because he was a rough kid if you didn't know him, so people didn't want to keep him. Then he ended up in juvie at the age of 11 or 12 because he had to steal food, as their mother forgot to buy it sometimes. Alex comes in to talk to Bailey about a patient and figures out Aaron's been talking about his past. He tells Aaron to shut it, but Bailey sends him off, wanting to hear more. 

Gina is explaining to a colleague why she went in as Callie and Cristina come in to get her to surgery. Gina wants to wait until she's finished with her statement. Her husband hates that keeping her job is more important to her. She's been saying for 7 years that they're gonna settle down and have kids once she gets promoted to detective, but every time she's close to a promotion, she goes and do something stupid. He's not gonna stand here and watch her die. He wants a long life with her.

Richard is checking on Alison, who's not reacting. April tried to take her off the vent, but put her back on it when she realized Alison wasn't breathing on herself. Richard says she may have stroked out and orders a CT and an EEG. As he's instructing her, Lexie comes in with Gary. He thanks Richard for getting the entire tumor, but he's surprised to find that she's not awake yet. April leaves the room.

Derek is studying Alison's scans with April by his side. Alison's had a massive hemorrhage. Meredith comes in, amazed by the bleed. He says she looks even better in scrubs, which makes April look disappointed, and Meredith asks him what he's going to do about the stroke. He can't do anything. He and Meredith go off to have a cup of coffee. 

While operating on Gina, Owen pulls out a bullet that he recognizes as a devestator. Teddy explains this means they have to be careful, as they're sharp as schrapnel and explode on impact. Callie and Cristina are amazed by Gina's career. Cristina hates how Gina's husband wants her to settle down and have babies. Teddy says you just don't have kids if you're facing mortar fire every day. Teddy explains she never had children because of residency, then Iraq, and now she's waiting for the right guy. Cristina is surprised that she wants kids. Callie asks if she doesn't. Cristina asks if Callie's met her; of course not. Teddy and Owen share a look as Cristina says she thinks she feels the bullet, right next to the heart. There's some bleeding, but she's got it. Just as Owen yells no, blood flies into their faces. Cristina asks what happened. Essentially, Owen says, she fired a bullet into their patient's chest. He gives her a really angry look.

Meredith is showing Aaron his scans on the computer at the nurses station. Arizona comes over, wanting to use the computer. Meredith introduces her to Aaron and Arizona asks why she didn't see him at the wedding, but then she remembers it was the last minute switch thing. Aaron asks what wedding. Arizona notices what she's set in motion and goes off to use another computer. Aaron is mad that Alex got married without even calling them, but Lexie explains it was a spur of the moment thing because of the cancer. Aaron thinks Alex has cancer, but Lexie clarifies it's Alex's wife Izzie who has the cancer. Meredith knows Lexie is making it all worse as she says Izzie is not really his wife anymore. She left, and then she came back, but then he didn't think it was the right thing and... Meredith makes Lexie stop talking.

Teddy says there's shrapnel everywhere. Cristina swears she only went for the bleeding and didn't touch the bullet. Owen says that when your commanding officer tells you to stand down, you stand down. Cristina says she's not in the army, but Owen reminds her that he and Teddy are her superiors. He starts speeching on the impact of devestator bullets. Callie says she would've done the exact same thing. Teddy says there's no use to this as the damage's been done, and she needs Yang's assistance to fix it.

Aaron tells Alex he can't believe that Alex didn't tell them about his marriage. Meredith explains that Aaron found out by accident. Alex says he didn't tell Aaron because he knew Aaron would make a big deal out of it. Because it is, Aaron says, and then he walked out on his wife. Alex says it was the other way around. Aaron says their mom will go off her meds when she finds out, but Alex tells Aaron not to tell her then. He tells Aaron to leave after his surgery. Aaron says he'll just leave without his surgery then. Alex tries to stop him, but Aaron says he doesn't need Alex. First he walks out on his family, and then on his wife. Like father like son. An enraged Alex throws him into a wall, resulting a big fight between the two brothers.

Bailey breaks up the fight as Aaron yells this proves Alex really turned into their dad. Meredith tells Alex to walk away and she asks Lexie to give him some space. Bailey requests a gurney for Aaron.

Gary is devestated to hear that his wife's coma is irreversible. Lexie explains that there's minimal brain activity. Gary thinks that means there's hope as there's still a little activity and her heart is pumping, but April clarifies that that is because the machine is breathing for her. Once they turn it off, the heart won't get the oxygen it needs. Gary wonders why they'd turn it off. Richard says that the advanced directive his wife signed specifically requested no mechanical ventilation. Gary says she filled that out three years ago when the cancer was first diagnosed and she only had 6 months to live. Then Alison held on for another three years. He's convinced she'll come back from this too, but Richard says they legally don't have another choice. Richard says his wife made the choice three years ago, and Gary lashes out at Lexie for telling him earlier the surgery went fine. He says she's a useless child, not a doctor, and he's done talking to all of them. 

Right before being put under, Aaron tells Meredith and Bailey that Alex protected him his whole life, kicking his dad's ass so hard that he never came back. Aaron thought that was for him, but now he's thinking maybe Alex just likes throwing punches. Meredith says she likes him, but she won't allow him to talk about Alex that way. Aaron is then put under. Once he's under, Bailey confesses she's impressed that Alex managed to become a doctor with a crack pot mom and a drug addict father.

Richard finds Lexie and tells her they're meeting with Gary Clark in Derek's office in five minutes. Mark overheard this, so Lexie explains what happened. She knows she's supposed to toughen up and not care, but she doesn't know how to do that. Mark says it's the hardest past of the job. Even he's still learning how to do it.

In the OR, Gina's blood pressure continues to bottom out. Jackson finds another bleeder in the retroperitoneum. Owen passive-agressively says they might have found it earlier if they hadn't been distracted by the shrapnel earlier. Teddy tells him this is not the moment. 

Cristina enters the scrub room and as soon as she does, Owen finishes up and walks out. As Cristina starts scrubbing out, Teddy comes in. She says it was their fault, as they sometimes forget civilians don't understand their language. Cristina says it's not the first time Owen's been like that. Teddy says he's been through so much, but Cristina says he's not talking about it, ever. Teddy says he can't. She can't do it at most times either, and Owen even had it much worse than she did. Has it worse. He's triggered and his triggers might never go away, but they might in time. Teddy suggests Cristina gives him that time, because he is in love with her. He just needs time. Cristina says he needs therapy, but Teddy says Owen won't go if she keeps telling him to go. She should just tell him how she feels.

In a lounge, Callie asks Bailey when's the best time to have kids. Never, Bailey says. She lists all the negative sides of having children. Then she tells Callie a sweet anecdote of Tuck's from this morning, when he finally learned to pronounce the k right. It made her feel an incredible joy. She replies to Callie's question that if she waits for the right time to have kids, she's never going to have kids.

As Alex is filling out the OR board, Meredith tells him that Aaron's surgery went great. He'll wake up in a couple of minutes, in case Alex wants to go visit him.

Derek tells Gary he's sorry for his loss, but Gary says she's not dead yet. She could still wake up, he says. Derek tells him that's not going to happen. Derek and Richard tell him what will happen if they keep her on the vent. It won't be a life for either of them, and that's why his wife signed the directive. Gary tells him not to talk for his wife. Derek says the ethics committee reviewed the case, and they're bound by law to obey her wishes. Gary says they're killing his wife by unplugging her. Derek apologizes and tells him to take all the time he needs to call his family to come say goodbye. Gary says there's no family to call. It's just them. Lexie sees that April is staring at Derek. April can't handle the situation anymore and walks out, with Lexie following her.

Lexie says that she knows what April feels for Derek, who by the way is her sister's husband. April apologizes. She's never felt like this before and promises that Lexie won't ever see it again. She begs Lexie to forget it. Lexie yells that this day sucks and walks off.

Alex is charting by his brother's bedside. Aaron says he doesn't have to be here. Alex says he's just making sure Aaron doesn't croak. Aaron tells Alex he was a better parent than their mom and dad put together. Every day, he feels bad for Amber, having only him as a brother and not Alex. He asks what happened to Alex. Alex says he sends them money every month and meds to their mother. If Alex comes back home, that'll all stop. He's this close to becoming a real surgeon, so he can't stop. Aaron tells Alex that Amber turned out okay. Alex says Aaron turned out okay too. Aaron says he's sorry for what happened with Izzie. Alex thanks him for that and walks out.

Owen tells Gina that they repaired the damage. Gina thanks them, not knowing what to say. Callie then says there were complications because of the abdominal bleedings, involving the uterine artery. They were able to stop the bleed, but in order to do that, they had to remove her uterus. Jimmy and Gina are devestated to hear they can't have kids anymore. Callie is really sorry for them. Jimmy comforts his wife.

Gary is holding his wife's hand. Richard, Lexie, and April have gathered outside the room. Richard tells Lexie to see it through this time. She goes in and as Richard encourages her, she apologizes to Gary. He says he keeps telling himself there's a chance she's gonna wake up. He asks if, once they turn off the vent, there's a very small chance that she'll start breathing again. As Alison always said, miracles do happen. He begs her to wake up. Lexie apologizes once again and turns off the vent. He continues to beg his wife to wake up as Lexie starts crying too.

Derek joins Richard in front of Alison's room. Richard asks if Derek was checking up on him in the gallery, but Derek says he was just observing. That's the closest he gets to an OR these days. Richard believes him. He says that Gary and Alison were married for 32 years. Derek assures him there's nothing he could have done, and suggests he go home to his wife, just like he's going to do. He walks past April, who still stares at him.

Cristina and Callie assure Gina that she can go back to work soon, but she and Jimmy discussed it. She's quitting. She realized it's just a job. She loves it, but she loves him too. They might adopt. Lieutenant Moore comes in. He says he did the best he could with the review board, and he happily tells her that they want her back on the job. Her colleagues come in to welcome her back on the job. Gina's amazed, contrary to her husband. Callie sees the disappointed look on his face.

Meredith comes home, finding Alex on the couch, eating cereal. She sits down with him and he says Aaron went back to Iowa. Meredith wants him to know he's nothing like his father. He says she's nothing like her mother. They share some cereal and he tells her she's good, so she's gonna be a good mom. They watch some TV.

Callie is reading on her bed as Arizona comes out of the bathroom, using moisturizer on her skin. She starts making small talk about it, but Callie interrupts her and repeats she wants a baby. She can't have small talk anymore, because she knows Arizona doesn't want a baby. Arizona says they're gonna talk about it then, but they both find it difficult too.

Owen is cooking dinner as Cristina comes home. She sees he's baking bread as he brings up that she said that she doesn't want kids. She then sees the sausages and she says they're burning. He says they're fine, but she insists they're burning and takes them off the stove. He angrily takes the pan out of her hands and throws it into the sink. As he turns to her to apologize, she backs away in fear. He concludes she's scared of him. She says she doesn't want to be. He realizes he has to go back to Dr. Wyatt. She takes his hand and says it's okay.

Derek and Meredith are in bed. He says he doesn't want her to be alone when something happens to him. She says they would make pretty babies. He's glad to hear she's thinking about it and kisses her. He moves closer to start practicing to make babies.

Mark is licking chocolate off of Teddy's back and says she tastes great. She says she's really enjoying herself with him, but she needs to be honest about something. He says she doesn't have to be if she's honestly enjoying herself. That she is. That's as honest as she has to be right now, he says. He tells her to move over so he can lick chocolate off her belly button. She turns over and they kiss as the bell rings repeatedly. Mark says he'll go get rid of them. He opens the door. It's Sloan. She's heavily breathing and says the baby's coming.


  • Meredith Grey
  • Cristina Yang
  • Alex Karev
  • Miranda Bailey
  • Richard Webber
  • Callie Torres
  • Mark Sloan
  • Lexie Grey
  • Owen Hunt
  • Arizona Robbins
  • Teddy Altman
  • Derek Shepherd
  • Gary Clark
  • April Kepner
  • Jackson Avery
  • Gina Thompson
  • Sloan Riley
  • Aaron Karev
  • Jimmy Thompson
  • Alison Clark
  • Lt. Josh Moore
  • Paramedic Jill (center)

Main CastEdit

Guest StarsEdit


Medical NotesEdit

Aaron KarevEdit

  • Diagnosis:
    • Umbilical hernia
  • Treatment:
    • Hernia repair

Aaron came to the hospital with a hernia. Bailey operated to repair it. The defect was large, but she used mesh to bridge the gap and Aaron was fine afterward.

Alison ClarkEdit

  • Diagnosis:
    • Anemia
    • Internal bleeding
    • Abdominal tumor
    • Acute hemorrhagic stroke
    • Temporal hemorrhage
    • Brain death
  • Treatment:
    • Surgery
    • Mechanical ventilation

Alison came into the hospital after fainting at the grocery store. She was anemic, so they said she had internal bleeding, which was coming from her tumor. They thought they might be able to remove the tumor with surgery, but there was a chance it wouldn't work. They removed all the tumor with good margins, but before she woke up, she had a stroke. They got a CT and a consult. She had a massive hemorrhage in her temporal lobe and there was nothing they could do. She had minimal brain activity. As her advanced medical directive said no mechanical ventilation, they turned the ventilator off and allowed her to die.

Gina ThompsonEdit

  • Diagnosis:
    • Gun shot wounds
    • Bowel injuries
    • Liver laceration
    • Fractured hip
    • Lung injury
  • Treatment:
    • Chest tube
    • Surgery
    • Hysterectomy

Gina, 34, came into the hospital with multiple gun shot wounds. One was in her leg and injured her femur. She also had bleeding in her chest, so they put in a chest tube. In surgery, they found a piece of a bullet and Owen said it was a devastator. Cristina found another bullet and it exploded and did more damage. Her liver was lacerated and they repaired it, but there was still bleeding. They found that the source of the bleeding was her uterine artery. They had to remove her uterus in order to save her life. She was stable and awake after surgery.

Sloan RileyEdit

  • Diagnosis:
    • Pregnancy
  • Doctors:
  • Treatment:

Sloan came to Mark's door in labor.


Song Performer Scene
"You're Not Stubborn" Two Door Cinema Club
  • Derek tells Meredith she's pretty and says their babies will be pretty.
  • Cristina tries to talk to Owen about seeing Dr. Wyatt. He gets up and leaves.
  • Meredith talks to Alex while he's in the shower about Derek wanting a baby.
  • Alex says Izzie sent the divorce papers.
  • Derek comes in and tells Alex his brother is there.
"Remember Us" Aqualung feat. Sara Bareilles
  • The doctors tell Gina they had to remove her uterus.
  • Gary sits by his wife's bedside. It's time to turn off her machines.
  • Gary is upset as Lexie turns off the machines.
"I Found You" Luluc
  • Alex tells Meredith she'd be a good mom.
  • Arizona puts on lotion after her shower and makes mindless chitchat.
  • Callie says she wants to have a baby and they can't keep avoiding talking about it.
  • Owen is making food and gets angry when Cristina points out that he's burned something.
  • Cristina flinches away from him, making him realize he needs to go back to Wyatt.
  • Derek tells Meredith he doesn't want her to be alone if something happens to him.
  • They agree to think about it and start to practice.
  • Mark and Teddy are having sex when the doorbell rings and keeps ringing.
  • It's Sloan and she's in labor.

Notes and TriviaEdit

Grey's Anatomy 6x19

Grey's Anatomy 6x19

  • This episode's title originated from the song Sympathy for the Parents, originally sung by Marilyn Manson.
  • This episode scored 9.87 million viewers, the first time in the show's history that an episode failed to top 10 million viewers.
  • Kim Raver (Teddy Altman) is added to the credits as a main cast member as of this episode, whereas this is also the first episode not to credit Katherine Heigl anymore.
  • The divorce papers Izzie sent Alex were drafted on March 30, 2010. This means that this episode takes place in early April.
  • The episode sets up and foreshadows the shooting that befalls Seattle Grace Mercy West Hospital at the end of the sixth season.
    • Mr. and Mrs. Clark are introduced, setting up Gary Clark's rage that leads to the shooting.
    • While Callie is in the OR in a surgery on the policewoman, she remarks, "Could you imagine going to work everyday knowing you're going to end up on the wrong side of a gun?" Assuming that the finale shooting had already been outlined with the introduction of Mr. Clark, this line could have been added to foreshadow events to come.
    • There's also a patient who has 4 gun shot wounds.


Episode StillsEdit


Meredith: Well, you're looking all thoughtful.
Derek: I was just thinking of how pretty you are. (Meredith smiles) And how pretty our children will be. (Meredith's smile fades)
Meredith: Children? Like, multiple?
Derek: Child. Let's just start with one and see how it goes.
Meredith: You wanna start?
Derek: I'm just sayin' you're pretty. That's all I'm saying.

Meredith: Alex? So, okay, Izzie's not here and Cristina's not answering her phone and I have a thing, so I need you to be a girl for me.
Alex: What'd he do? You want me to kick his ass?
Meredith: He wants me to have a baby.
Alex: So you do want me to kick his ass?
Meredith: Alex.
Alex: Do you wanna have a baby?
Meredith: A baby doesn't want me. I had the worst mother in the world. I would be the worst mother in the world.
Alex: Izzie wants a divorce. She sent the papers. The official papers.
Meredith: You want me to kick her ass?
Derek (walks in): Hey, Alex... (sees Meredith) Hey.
Meredith: He's being a girl for me.
Alex: Dude, it's true.
Derek: Right. There's a guy downstrairs who says he's your brother. Do you want me to send him up here to the bathroom since this seems to be where you receive your visitors?

Cristina: Owen's still in his dark place and he's still not talking. So I turned off my cell in case he wanted to say something, which he didn't. I hate men. They're stupid.
Meredith: Derek asked me to have a baby with him this morning.
Cristina: Really stupid.

Derek: If anything should happen to me, I don't want you to just be you.
Meredith: Well we would make pretty babies.
Derek: So you're thinking about it?
Meredith: Oh, I'm thinking about it.

Owen: You scared of me?
Cristina: I don't want to be.

Miranda: If you are going to wait for the perfect time to have kids, you're never going to have kids.

Cristina: You want to have kids?
Callie: You don't?
Cristina: Have you met me? No!

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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