It's intense, what happens in the O.R. when lives are on the line and you're poking at brains like they're silly putty. You form a bond with the surgeons right next to you. An unbreakable, indescribable bond. It's intimate, being tied together like that. Whether you like it or not, whether you like them or not, you become family. The ties that binds us are sometimes impossible to explain. They connect us even after it seems like the ties should be broken. Some bonds defy distance and time and logic; Because some ties are simply... meant to be.

These Ties That Bind is the eighth episode of the fifth season and the 86th overall episode of Grey's Anatomy.

Short Summary[edit | edit source]

An old friend of Meredith by the name of Sadie appears and causes some tension with Cristina. Bailey attempts to woo a cardiothoracic surgeon Virginia Dixon, Callie breaks down crying. Izzie confides in a patient about Denny and Cristina become suspicious about some of the interns.

Full Summary[edit | edit source]

Izzie finds the sweater she knit for Denny in her closet and smells it.

Callie is in bed by herself, staring at the empty spot.

Cristina barges into Meredith and Derek's bedroom with coffee. She gives Meredith coffee and informs her that Hahn is gone. She doesn't know why, but she's gone. Derek says too bad, because she was really talented. He figures they weren't talking to him and gets out of bed.

Downstairs, he opens the door for a woman who keeps knocking. She asks if Grey is home. She runs in and yells for "Death".

She runs into Meredith's bedroom and hugs her. Cristina gets pushed aside as Sadie sits down in bed in between them. Meredith seems happy to see her and she compliments Meredith on her boyfriend. She introduces herself as Sadie to Cristina. Meredith and Sadie laugh.

In the kitchen, Cristina tells Derek that Meredith and Sadie went backpacking through Europe together. Sadie just kicked her out of the bed. Derek knows the feeling. Cristina wonders how good a friend Sadie is, as Meredith never mentioned her. Derek says they're close enough to kick them both out of bed. He welcomes her to his world.

On their way to the hospital, Sadie says Meredith is the reason she went to med school. Sadie postponed her residency to work in the morgue, but she got bored there. Meredith can't believe she's here. They pass Izzie, who's just standing in front of the entrance. Alex knows she felt bad because Hahn's case brought up Denny, but it's in the past. Izzie says he doesn't understand. He says he might if she talks to him, but she doesn't want to. He says he'll see her inside.

Izzie enters the hospital, and Denny walks with her. He says she looks good, but tired. She tries to pretend he's not there.

Cristina notices Lexie's arm is in pain and notices there are band-aids on her arm. Cristina can't have a wounded intern now that there's a solo surgery at play, so she sends Lexie off to plastics. Alex comes over and asks what she knows about a heart surgeon named Dixon. Cristina knows she's good. Dixon is coming in today and Alex is on her case. Cristina wonders why she's not.

Derek asks Meredith why Sadie calls her Death, but Meredith says the adventures of Death & Die are better left untold. Cristina joins them and speaks in code. Meredith translates for Derek that Lexie may be a cutter and that they don't know why Hahn left. Derek asks what she's going to do about Lexie. Lexie is her family, so she should do something. She doesn't understand why.

In the ambulance bay, Owen helps Cristina tie her gown. Callie joins them. A victim with crush injuries is a couple minutes out. Callie doesn't want to talk about Hahn. She wants a patient that takes all day to fix so she doesn't have to talk about Hahn. The rig arrives and paramedic Nicole informs them they pulled the man out of a working garbage truck. The man is impaled on himself. Callie is happy.

Meredith joins them in the trauma room. Cristina is getting no pulse. They suspect the man was sleeping in a dumpster. Sadie comes in, but Cristina asks her to stay back. Cristina says breath sounds are good and equal on both sides. Owen paged Derek and Mark. Even Owen has never seen anything like this, so he wants their help.

Richard needs Bailey to be his ambassador today, show Dixon what Seattle Grace is all about. Richard tells her she's different, so Bailey has to woo her. Alex doesn't want another crazy woman in his life, but Bailey says they have to impress her anyway. Izzie brings by the chart for Dixon's patient. She is excited, but Alex tells her not to as Dixon's off. Dixon arrives and shakes Bailey's hand, saying she brought her own lab coat since she's here to perform a heart transplant. She talks about the procedure. Richard introduces himself and instructs Alex and Izzie to get the latest charts and prep the patient. Richard shows Virginia around and Bailey admits she's off.

Callie's looking at the scans of her patient. His femur is in pieces, except the part stuck in his torso. Callie can't save the leg. Derek says C-spine is clear. They can't get a CT because of the way the man is impaled. Callie says they have a limited window. Mark says they can't do anything before the femur is dislodged from the clavicle. The doctors stabilize the man and start to dislodge the femur. The man wakes up just as they release the femur, and he screams in pain. They give him morphine and apply pressure to control the bleed.

Owen asks the man to calm down. The man yells they're hurting him. Owen instructs everyone to take their hands off the man. The man says his name is Timothy Miller. He wants to walk again, but Derek says their primary concern now is to keep him alive.

Bailey shows Dixon the cardiac wing. Dixon talks about the first successful heart transplant. Alex tells Dixon that Izzie is prepping the patient and gives her the patient history. He had had a heart transplant before, but the heart was too small, so they piggybacked it to his own heart. Dixon doesn't want him to use the colloquial name for the procedure. Bailey suggests they go meet the patient.

Izzie is talking to the patient. His previous donor heart came from a girl who was hit by a car while hitchhiking, and now he sees hitchhikers everywhere when he's driving around. Denny tells Izzie not to buy that. Clay says his people, the Navajo tribe, never touch the dead people, so it's weird to have a part of a dead body sewn into his own. His friends follow the old ways and he should have listened when they told him not to do this. He doesn't want the new heart either. He just wants them to take it out. Denny yells at him to take the heart. Dixon comes in. She heard the patient doesn't want the donor heart. She asks if he's aware he'll live a short life attached to a machine if he does not accept the heart. The other doctors are surprised to hear how direct she is.

The interns are practicing stitches on each other. Lexie says they have to focus on the goal: scrubbing in with their resident if they are rewarded the solo surgery. George comes in to ask someone to run his labs. George wonders what they're doing. Lexie tells him to go find his own hangout and throws him out.

Timothy says walking is how he survives, so he's dead if he can't walk. He talks about his daily path. He's homeless, so he can't not walk. He only wants surgery if it's going to make him walk. They can't promise that. Owen says the surgery is off, then.

Clay appreciates Virginia's advice, but he won't follow it. Izzie understands he rather live a short life than a long and haunted one. She's not saying she agrees. Denny says it's a good idea to keep her mouth shut. Clay wonders what happens to his current heart. Virginia says it'll end up on medical waste. He wants it back for ritual. Dixon says there are rules that don't allow it. Bailey suggests a compromise: he can get the old heart, if he allows them to put the new one in. Clay says he'd still be haunted, just by a new ghost. Dixon says there are rules and laws, so it won't happen.

Derek can't believe Owen's just walking away. They're packing the wound, which Derek and Mark think is not enough. Owen doesn't want to hear how to run things in his ER. Derek says they don't just patch patients up, they save their lives. If Owen can't handle that, he should return to the desert and let them to do their jobs. Derek asks Callie to find a way to build the man some legs.

Callie says the right femur, hip and half of the pelvis is toast, but with some pins and plates and viable bone fragments, she may be able to do something. Sadie thinks it's wild. Mark says it's a lot of hardware and the guy just needs a whole new leg. Callie says she may be able to pull it off if she sorts out the puzzle, like Lincoln Logs. Callie asks them to grab every piece of titanium they can find.

Bailey asks Richard to declare a rule that says to respect their patient's beliefs. He thinks it's common courtesy, but Bailey explains Dixon doesn't do common courtesy, just rules. The rule is the only way to keep the patient and Dixon happy and save the patient's life. Not to mention, it wouldn't woo Dixon. The Chief declares it a rule and Bailey thanks him.

Cristina introduces herself to Dixon. She's looking forward to anything Dixon has to offer her. Dixon asks if the other residents are off the case. They aren't, so Dixon wonders why Cristina is talking to her. Cristina leaves.

Cristina asks Callie what happened to Hahn because she really needs Hahn back. Callie says Hahn is not coming back, because they had a fight. Cristina says she and Meredith work together despite having fights, and it's not like Hahn was her girlfriend. Callie remains silent, and Cristina realizes she was. Callie says they hadn't figured it completely out. Cristina wonders if she's a lesbian now. Callie says whatever it was, is over now. Mark tells Cristina that Callie is fine and asks her to leave Callie alone.

Meredith tells Derek she hit the titanium motherload, just as Lexie walks by. Derek encourages her to talk to her sister. Meredith runs after her and asks her if everything's okay. Lexie asks if she's asking as her superior, but Meredith says she's asking her somewhat related person. She wonders if Lexie's channeling her tragic pain into self-mutilation. Lexie denies it. Mark comes over and asks Little Grey if she's in for Callie's surgery. Lexie says she's in.

Owen swings by Timothy's room. Timothy wants to die in peace. Owen says his vitals are slipping, which is not good. Owen imagines he's been through worse. Timothy says he's not a tragic hero with a secret past. Owen says he has a story, like everyone else. Timothy says he took a turn with his life and he couldn't connect. Timothy said he had lost.

In the basement, Lexie tells the other interns they have to shut this down for a while. She says she was accused of being a secret cutter, and Sadie tells her to wear long sleeves. While Sadie's all over the secret intern society, Lexie still thinks they need to take fewer risks. Sadie gets she can only learn so much by being careful. Sadie takes off her top and cuts herself on the back with a scalpel. She asks who wants to stitch her up and everyone but Lexie volunteers.

Derek and Meredith are getting lunch and he asks her about "Death & Die" again. Meredith says no and asks Derek to tell Mark to keep his little Sloan out of Little Grey. Derek thinks she meant her little Grey when she really just meant Lexie. Meredith tells him that the last thing Lexie needs is him getting all manwhore over her. Derek will see what he can do.

Mark finds Callie. Mark asks her if Hahn said goodbye. Callie says no. He asks if she's okay. She asks if she looks like she's okay and Mark says she looks great. Callie says she's okay then.

Izzie is talking to Clay about 9-day ritual do undo haunting. Denny can't believe they're going to waste time on this. Clay wonders why she's so interested. Izzie asks if ghosts can do things, make things happen in her life. Izzie's had cases that really reminded off her dead fiancé and she wonders if he could be doing that to her. Clay asks if her ghost is here right now, because he doesn't want her on his surgery if he is. He doesn't need extra ghosts in his OR.

Derek tells Timothy he's slowly bleeding to death. He explains to Owen he wants to know if Timothy's suicidal or just defeated. Owen knows Timothy's a fighter as he survived in the streets. He's not lucky, but smart to have taken care of himself on his own. Refusing surgery is not smart. Derek says there's a rehab close to here. Medicare will take care of him with food and a bed. Owen asks him to let them operate. They'll figure the rest out.

Bailey, Alex, and Dixon are operating. Alex says Dixon works fast. Bailey brings up the rule about respecting beliefs. It's the Chief's rule. Dixon asks Alex to make sure that they follow the Chief's rule and return the heart to the patient after the surgery. She'll go back to work.

Izzie's sitting in the gallery. Denny asks her questions about the procedure, but she's decided to give him the silent treatment. In that case, Denny will just be quiet. He says the surgery is disgusting. Denny says she's acting like she doesn't want him to be here. Izzie says she'd have given everything to see him again after he died, but seeing him and knowing she can't touch him is hurting her. Denny says she can touch him. She says he is not real, so that means she's sick. She decides he's not real. He says he's as real as she is. He asks her to touch him. She refuses and asks why he's here. He says he's here for her.

Down in the OR, they have seperated the donor's heart. Clay's heart starts beating on its own, which shouldn't be happening. Virginia starts panicking about that.

Callie has never done a leg reconstruction like this. Lexie is taking care of lacs. Mark compliments her technique.

Clay was just told his heart is working on itself, so if it stays like this, he doesn't need no more machines. Virginia has never seen this. She thinks the heart repaired itself during the six years it was able to rest. Clay says science is belief too. He believes in more than what he can see and touch.

Richard drops by in the OR. Callie says she's still hours away, but she thinks she'll be able to pull it off. Mark says Lexie can out-pulley stitch Shepherd. Lexie is flattered. Richard compliments Lexie and Cristina on her teaching. If she keeps teaching like that, she'll be his one to watch for the solo surgery. Cristina thanks him. The patient goes into V-fib. They debrillate him.

Clay thanks Izzie. She asks what he does with the haunted piece. His tribe's medicine men will burn it. He's not allowed to touch it. They burn everything that belongs to the dead, as the spirit of the dead can cling to any of it. Clay asks if she still has anything of her ghost.

Owen calls time of death on Timothy. Callie says she built his bones from scratch. She didn't try, she did it. She did her part. The rest of them were supposed to keep him alive. She starts crying. She made his bones. Cristina says she'll help Callie clean up. Mark says they got it. Owen orders everyone to clear out. Callie turns to Mark for comfort.

Bailey tells Dixon she did an excellent job today, following the rules. Dixon says she only has one area of interest: the human heart. She likes its predictability and its rules. Every part has its function and movement. She thinks the color is comforting. Dixon asks if Bailey is familiar with Asperger's syndrome. Bailey says it is significantly impairing during social situations and realizes why Dixon is asking her that. Dixon knows when she's being manipulated and being made fun of. She doesn't like this hospital at all. She gets off the elevator.

Derek tells Mark that Meredith is concerned that Lexie is fragile, so Mark should keep his little Sloan out of her. Mark is offended by the word little.

Izzie is heading home. Denny appears to her at the entrance. Izzie says she'll always love him as he owns a piece of her, so even though he'll be gone, he won't ever be forgotten. She's sorry they never got their chance at a life together. She's trying to let him go so his soul can be at peace. He says he has peace. He's here for her. Izzie says goodbye.

Cristina finds Lexie in the intern locker room and looks at her and the other interns's arms. Cristina says she can barely do the parallel pulley stitch herself, so she certainly did not teach Lexie. She tells them to shut down whatever they're doing. Practicing on themselves is insane.

Alex is looking for Izzie. She's standing in front of her closet, holding the sweater. Alex tells her he sees her. He's seen her all day. He's seen her struggling. He wants to help her. He can help her, whatever it is. He asks her to let him. Izzie gives him the sweater and asks him to burn it for her.

At Joe's, Callie tells Mark and Cristina she hates how hard it is. People work their way into your lives and you get attached to them, so they're all you can think about. Mark looks at Lexie as she enters the bar and says he knows the feeling. Callie leaves to get another round. Cristina looks at Owen, who's sitting at the bar.

Derek asks Meredith to tell him the stories of her and Sadie. Meredith says they're ancient history and ridiculous. Derek says what is ridiculous is one man telling another to keep his penis out of a woman. Meredith is happy to hear it. Derek did it for Meredith, because it was nice to see her come up for her sister. So, she owes him a story. Meredith agrees to tell one, but only if he promises to never tell anyone.

Cristina runs after Owen as he leaves the bar. She tries to take his arm, but he pulls away. Cristina tells him she's sorry they lost the patient. Owen doesn't need her to be sorry, and closes in on her until her back's against the wall. He looks at her for a moment and starts kissing her passionately. He breaks off the kiss after a while, looks into her eyes and lets her go.

Izzie watches as Alex puts the sweater in the fire.

While Meredith's voice over talks about ties that bind people defying time, space, and logic, Izzie enters her bedroom. She closes her eyes and leans against the door. When she opens her eyes, she's startled to see Denny sitting on the bed. Izzie says she said goodbye and burned the sweater. Denny says he loved the sweater. Izzie starts freaking out and starts repeating he's not real. Denny asks her to look at him. She turns around. He asks her to touch him. She puts her hand on his chest and he puts his hand over hers. He told her he was real. She can't believe it. He leans in and kisses her. While Meredith's voice over says some ties are just meant to be, Izzie answers the kiss.

Cast[edit | edit source]

Main Cast[edit | edit source]

Special Guest Star[edit | edit source]

Guest Stars[edit | edit source]

Co-Starring[edit | edit source]

Medical Notes[edit | edit source]

Clay Bedonie[edit | edit source]

  • Diagnosis:
    • Heart failure
  • Treatment:
    • Surgery

Clay was in the hospital for a heterotopic heart transplant. He'd had a transplant six years prior, but that heart needed to be replaced again. However, Clay believed he was haunted by his first heart and said he didn't want the surgery. In surgery, they removed the previously piggybacked heart and were shocked when his heart started beating on its own. They believed the six years of rest provided by the other heart gave his own heart time to repair itself.

Timothy Miller[edit | edit source]

  • Diagnosis:
    • Crush injuries
    • Open fractures
    • Open femur fracture
    • Posterior hip dislocation
  • Treatment:
    • Surgery

Timothy came into the ER after being crushed in a garbage truck. He was impaled upon himself due to his open femur fracture. Since they couldn't proceed without freeing his leg, they did that first, which caused him to wake up. Callie didn't believe his leg could be saved, but when he insisted that he needed it, Callie developed a plan to replace his bones with titanium rods. He agreed to the surgery and they took him in, but they were unable to keep him alive long enough for Callie to replace his leg bones and he was pronounced dead in the OR.

Music[edit | edit source]

Song Performer Scene
"The Uniform" The Flying Tourbillon Orchestra
  • Izzie smells Denny's sweater.
  • Callie looks at the empty pillow in her bed.
  • Cristina joins Meredith and Derek in bed and tells them Erica is gone.
  • Sadie appears at the front door and goes upstairs to find Meredith, kicking Cristina out of bed.
  • Cristina complains to Derek about Sadie.
  • They all go to the hospital together.
"Falling for You" Seabird
  • Richard compliments Cristina's teaching.
  • Timothy deteriorates.
  • Izzie gives Clay his old donor heart and they talk about burning stuff from a ghost.
  • Timothy dies and Callie is frustrated that her colleagues didn't succeed at keeping him alive long enough for the legs she build.
"Trouble is a Friend" Lenka
  • Alex tells Izzie he's seen her struggling and offers to help out. She asks him to burn Denny's sweater.
  • Callie, Mark, and Cristina have drinks at Joe's.
  • Meredith tells Derek a Sadie story.
  • Cristina and Owen kiss outside the bar.
  • Alex burns Denny's sweater.
  • Denny is waiting for Izzie in her room. She touches him and is convinced he's real. They kiss.

Notes and Trivia[edit | edit source]



  • This episode's title originated from the song These Ties That Bind, originally sung by RJ Cowdery.
  • This episode scored 15.59 million viewers.

Gallery[edit | edit source]

Episode Stills[edit | edit source]

Behind the Scenes[edit | edit source]

Quotes[edit | edit source]

Cristina: Pedia's julienning her scrawny little chicken arms and still no word on what made H hitch a ride with the flying monkeys. Later!

Izzie: I said goodbye. I burned the sweater!
Denny: Yeah, thanks for that, by the way. I loved that sweater. You made me that sweater. Izzie... stop freaking out.
Izzie: You're not real. You're not real.
Denny: Hey, I told you.
Izzie: You're not real! You're not real! You're not real!
Denny: Look at me. Touch me. (Izzie touches Denny's chest) See? Told you I was real.

Cristina: Wait, so are you a lesbian now?
Mark: I dunno... Maybe you were a "once-bian."
Callie: Or a twice-bian. Whatever. It's over.

Cristina: Apparently they went backpacking around Europe together or something. Before med school. You know that woman all but kicked me out of the bed?
Derek: Terrible.
Cristina: And "deth" ... Meredith's name's not "deth." It's Mer!
Derek: I really feel for you.
Cristina: I mean she's never even mentioned this woman. How good a friend could she be?
Derek: Good enough to kick us both out of bed.

Derek: We save lives here. We don't just patch up patients and leave them to die. If you can't handle that, go back to the desert, and leave us here. To do our jobs.

Sadie: This woman is the reason I went to medical school in the first place. I figured if a slacker like 'Deth could be-
Cristina: Mer.
Sadie: ...slicing people open then I could too!
Derek: Meredith's not a slacker.
Sadie: Oh, I could tell you some stories...
Meredith: But you won't.

See Also[edit | edit source]

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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