Renegades. Rule breakers. Gangsters with scalpels. This is the way we like to think of ourselves. It makes us feel badass, sexy. Problem is, it's not exactly true. At heart, we're rule followers, sheep. We don't break protocol. We follow it to a T. Because if we don't follow protocol, our patients die. And then we're no longer badass. We're just bad. It's every doctor's dilemma. Do you play it safe and follow protocol or take a risk and invent a new one? There can be reward in risk. There can also be fallout. Still, you need to buck the system every once in a while. Bet big. And when you get the results you want, there's no better feeling in the world. But when you don't?

This is How We Do It is the seventeenth episode of the seventh season and the 143rd overall episode of Grey's Anatomy.

Short Summary[edit | edit source]

Richard is desperate for Derek and Meredith to accept Adele into their Alzheimer's trial, but will Adele stand in her own way? Meanwhile Mark and Arizona have conflicting ideas of the kind of baby shower Callie wants, Teddy is freaked out when Henry has another health complication -- leaving them both a little exposed -- and the competitiveness among the residents for the Chief Resident position is amplified when Richard receives the green light for his diabetes clinical trial.

Full Summary[edit | edit source]

Jackson finds Lexie in the laundry room. He takes off his shirt and asks her to wash that, too. They start kissing until April comes in. She asks if there's any place they don't do it. She walks off. Realizing they should probably go upstairs, Jackson puts Lexie on top of the washing machine and they continue to make out.

Bailey finds a trailer in her parking spot at the hospital. Alex is living in it because he wants to be Chief Resident and this way, he's at the hospital first. She throws her keys at him and asks her to move her car after he's moved his trailer.

Meredith and Derek are examining Adele, who asks when they're getting married for real. She insists this is not Alzheimer's. She knows from her experience as a nurse that 20% of the patients diagnosed with Alzheimer's have something else.

Meredith tells Richard it's not uncommon for patients to need time to come to terms with their diagnosis. Her mother needed it, too. Richard needs Derek to include Adele in his trial, but Derek says they need her consent, and the trial, including the waiting list, is full. Richard knows that, but he also knows Derek will do whatever he can to help his wife.

Lucy tells Callie that everything's looking great. Mark tries a trick to get Lucy to reveal the sex, but Callie and Arizona have decided they don't want to know. Lucy asks Callie if she's okay because her blood pressure is borderline. Callie says she's excited for the babyshower. She's bought gifts for every pregnant nurse and now it's finally her turn. Arizona forgot to invite Lucy, so she does it now.

Bailey finds Cristina, April, Jackson, and Alex waiting outside the men's room. Teddy and Owen inform her that the Chief is in there. His trial funding came through this morning and they all want on it. Richard comes out and each resident tries to get his attention. He says he hasn't made his decision yet and walks off. Bailey tells them to impress the Chief surgically. Avery's with her today.

Cristina approaches Owen and brings up he seems to be close to Richard. Owen says he's not getting in the middle of it, but he tells her she's beautiful. She asks him to compliment her brain instead of her looks.

Derek enters Sonya's room. She's ready. Derek meets Tarik, her son. Tarik moved back from London after he heard his mother got accepted into the trial. Meredith tells Sonya the three words she has to remember: truck, cabin, spoon. Meredith asks her what she did for Thanksgiving last year. She says she was in London with Tarik and his boyfriend Gavin, but Tarik says that was three years ago before they broke up. Sonya tells Tarik to call Gavin, but Tarik says they're not getting back together. Meredith continues her tests.

Bailey and Jackson enter Clara's room. Clara had a tumor removed 8 weeks ago. Clara's husband Sean interrupts Jackson's presentation of the case. He can't hear this kid anymore. He wants answers from a real doctor. Bailey knows it's frustrating. Sean says his kids are living with his parents and he barely survived that house, and now he's inflicting it upon his kids. Bailey says diabetes is a bear of an illness. She removed the tumor, but they knew it would be difficult to get Clara's insulin levels on track. Sean says that's not good enough. Bailey says they are doing everything. Nurse Eli says Clara made it further than they all expected. The surgery itself was a gamble and Clara made it through it. If Clara can do that, she can do anything.

Alex approaches Stark and asks if he needs help. He's free because Arizona has her baby shower. Stark says he still doesn't like him. Alex sticks around as April comes over to discuss their cases. She assures Stark they're still on for tonight, 7 o'clock. Stark walks off and Alex comes over. He's impressed that April's screwing her way to the top. April says they are not dating, they're just hanging out as friends. Naked friends, Alex says.

Teddy was paged to the trauma room for a jogger found unconscious on the street. She finds Cristina shocking Henry with the paddles.

Teddy can't believe Henry went for a run when he was having chest pains. Teddy orders more morphine. He wonders if this is a heart attack. Teddy says they still need to run more tests.

Bailey is talking to Richard about Clara. She thinks she'd be a good candidate for his trial, but Richard is still waiting for FDA approval. Bailey just wants Clara to be the first on his list so she and Sean have something to look forward to. Jackson suggests they file for an emergency waiver, but Bailey says Richard will lose everything in case it goes wrong. Jackson informs Richard about Clara's children. A nurse informs Richard that Teddy needs him. Richard says he'll call the FDA and asks Jackson to go talk to the patient.

Meredith and Cristina carry a table into the doctor's lounge for the shower. Mark wants it for the scrapbook station. Callie wanted them to go all out: scrapbooking, a onesie decorating station, and games. Arizona doesn't like it. Callie comes in and notices the tension between Arizona and Mark. Arizona asks Callie if she wants a scrapbook station. Callie says of course.

Outside Sonya's room, Meredith overhears Tarik talking on the phone with Gavin. Gavin wants to quit his job and move to the US, but Tarik refuses to let him do that. He hangs up and explains he's keeping it from his mother because it's all too complicated for her to handle. Meredith asks if they are together. For the trial, they require that the caretaker is a full-time residents of the state of Washington. Tarik knows that. Meredith says it's a big commitment and it can get overwhelming. Tarik should let them know if there's a chance he's moving back to London. Tarik says his mother stood by him when he came out and that's a very big deal. His mother lost everything for him so this is the least he can do for her. 

Bailey and Jackson explain to Clara that they would insert a device with islet cells into her body, which will produce insulin like a pancreas. They are contacting the FDA to get approval. Eli asks what the risks are, figuring they are pretty serious because the FDA hasn't approved it yet. Bailey says she was getting to the risks. There's a risk of bleeding, low platelet counts, and stress on the liver. However, this is the best option for Clara, given that they did everything else. Clara asks if they can have some more time.

Outside the room, Bailey calls Eli on what he pulled in there. She was getting to the risks and he made it seem like she was hiding something. He undermined her. Eli says he was just asking a question they didn't dare to ask. He thinks it's part of his job to make sure that patients know what highly experimental procedures they're signing up for. Bailey thinks that is her job given she is performing those procedures. He refuses to follow the doctor/nurse protocol if it hurts the patient.

April paged Stark to inform him she has too much patients to make dinner in time. He says they can skip dinner and he invites her to his home to eat there and watch a movie. April sees the smirk on Alex's face. Stark asks Alex to help April out with her cases. Stark walks off and Alex tells April that the only way she'll get to see that movie is if it's projected on his bedroom ceiling.

Cristina tells Teddy the tests showed it's very unlikely that Henry had a heart attack. They are doing a CT angio to rule out dissection or aneurysm. Richard asks Teddy if she wants to transfer the case considering their personal relationship. Teddy says it's just a business arrangement. 

Teddy goes to check on Henry in the scanner. The pain killers have finally kicked in. He's been thinking and he thinks he knows why her dates have gone so horribly bad lately. It's because he's not the guy she's dating. She's his hot wife and he wants them to be together. She is gorgeous. He could look into her eyes his whole life. Richard and Cristina can hear everything from the booth.

Richard tells Teddy it's clearly more than a business arrangement. Teddy says she doesn't feel that way. The scans come up and they see a mass near his heart. Teddy wants to remove it right away. Richard is not sure he should allow her to operate on Henry. Cristina says she can do it. She nailed a similar surgery last month. Richard says Yang will do it and Teddy can supervise. Richard leaves and Cristina tells Teddy at least she gets to stay in the OR this way.

Callie's shower has begun. Mark tells Arizona that Callie is traditional so this whole 3 parents thing is a lot for her. That's why he figured the bigger the shower, the better. Arizona says he's not the Callie whisperer. Also, every woman who's ever had a pregnant friend hates babyshowers. The only one who's not normal here is Mark for acting like he's enjoying this. Callie then calls out that it's Arizona's turn to play the game. Arizona puts a balloon under her scrub top to simulate a pregnant belly per Mark's idea, sighs, and then gets ready to play a game.

Mark joins Lexie at the scrapbooking station. He's glad she came. Lexie says she's happy for him, and she's seeing someone else. Mark is surprised but says that's good for her. He asks if he knows the guy. Lexie says she should go and leaves.

Alex is stuffing food in all his pockets. Lucy catches him and says this is extreme. Alex says he doesn't have time to shop now that he's moved into his own place. However, he mentions she must like him since she chose him to talk to out of the all the people that are there are the shower. Lucy says he was in her way as she wanted to get some food. He asks her to admit she finds him charming. She grabs some food and walks off.

Alex joins Lexie, Meredith, April, and Cristina at the onesie decorating station. Lexie thinks Stark is gay because it's been a month since he started hanging out with April and no straight guy waits that long before making a move. Alex wishes Stark was into him so he could get in on his cool surgeries. April says Stark is actually really interesting once you get to know him. Alex mentions April is taking her clothes off for Stark tonight. Meredith says that happens when you go to his place to watch a movie. April loudly says she's not taking her pants off for Stark, drawing people's attention. Meredith's onesie has an abstract design that makes people wonder if she's still blind. Alex has drawn scrubs on his onesie. Jackson comes over and whispers something in Lexie's ear. She says she will come for a consult, but April says they are not fooling anyone. Mark overhears this and watches Jackson and Lexie leave together.

Richard asks Derek for a favor. He wants Derek to call his guy from the FDA and asks him to rush Richard's request for an emergency waiver. Derek doubts he'll have more influence than the Chief of Surgery. Richard says they both know there are always ways to work the system. Derek repeats he can't include Adele in his trial. He loves Adele, but pulling a patient off the waiting list can compromise the whole trial and get him blacklisted by the FDA. Richard says Adele has no future without this. Bailey comes in and says that he needs to come for Clara.

They enter Clara's room. Clara's in a hypoglycemic coma. Her sats plummet and Jackson gets ready to intubate. Richard tells Sean that if they are going to do this islet cell transplant, they need to do it now. All they need is his consent. Sean gives his consent. Bailey reminds Richard the FDA hasn't given them the waiver. He knows, but without this, Clara will die.

Teddy explains to Henry that Cristina has to operate because they are technically married. Henry is a little flattered that they're worried about Teddy's feelings getting in the way. Teddy ignores his comment and says she'll be in the OR to supervise. Henry thinks Teddy's into him. Cristina ignores that comment.

Lucy asks Meredith if her friendship with Alex is real. Meredith says yes. It surprises Lucy, because Meredith doesn't seem like the type of girl to put up with his neanderthal thing. She wonders what she's missing. Meredith says she's missing a lot. He had a girl go crazy on him, his wife almost died and she then walked out on him, and then he was shot and almost bled to death. He's been through a lot. The neanderthal thing is just a well executed act.

In the OR, Jackson says they are ready for the implant. A nurse says there's still no news from the FDA. Bailey thinks they should wait. Richard says Clara will only get worse. Bailey thinks Richard is doing this to prove a point to Shepherd. Richard assures her he's doing this for his patient. He asks for the device and places it in Clara's abdomen.

Tarik tells Meredith and Derek that he left his phone in his mother's room. Gavin called and she picked up. He begs them not to let her do this. They enter Sonya's room and find her packing her stuff. She says she's not doing the trial. She's going home so Tarik can go back to London. Derek says there won't be another opportunity like this. Tarik thinks this is just the Alzheimer's talking, but Sonya proves she's lucid. She found out that Tarik only broke up with Gavin last week when she got accepted into the trial. That makes her very proud because she raised a good son, but he needs to be with Gavin in London.

Cristina is ready to resect the tumor. Cristina is all over it, but Teddy's on her back. She gets the tumor, but his blood pressure suddenly rises. Teddy urges her to check for residual tumor and keeps asking Cristina to talk to her. Cristina tells her to stop acting like a scared wife. She takes out the residual tumor and apologizes to Teddy. Teddy says it's okay and thanks her.

Derek finds Richard, who tells him he just did his first surgery without FDA approval. He doesn't care that he may get blacklisted, because he saved a life. Derek tells him someone dropped out of his trial.

Adele is in Richard's office. They need to do some tests to see if she meets the criteria for the trial. She refuses to let Derek drill into her skull. Richard says they have no time to waste. She has Alzheimer's and they have to treat it right now. He begs her to take the test. She agrees to it. She says she's going to pass so Richard will see she's healthy. They are going to grow old together.

Arizona and Mark are cleaning up after the shower. Arizona is looking for the gift list and now they're gonna have to write vague thank you notes because they don't know who gave them what. Callie comes in and Mark tells her that Arizona lost the list. Arizona admits she sucks at this and congratulates Mark for being a better woman. Callie says it's okay and asks Mark to give them a minute. He walks out and Callie tells Arizona there's one more gift left. Callie gives her a gift. She booked them a B&B and they leave in the morning. It's an olive branch because she knows how annoying she must be to Arizona right now. Callie's always wanted a kid. This is her dream and she gets to be out of her mind about it, but she's not discounting Arizona's need to vomit over her insanity. So, they're going to the B&B.

Meredith is conducting the test on Adele. She remembers correctly what she and Richard did last Thanksgiving.

April and Alex are updating Stark on his patients. Upon finding out Alex handled one case mostly by himself, Stark says he'll go to check Alex's work. April tells Robert to just thank Alex instead. Stark does so and tells Alex to go away. April then apologizes to Stark for using his first name. He says it's okay. He liked it, actually. April says she can't make it tonight. She makes up an excuse about wanting to stay late to prove she's Chief Resident material. He understands why she's hesitant, but he hoped she wouldn't use work as an excuse not to spend time with him. She says she enjoys spending time with him, but she thinks of him more as a friend. He says he never wanted to be just friends.

Derek tells Adele she needed to get a score of 26 or below to fit the criteria for the trial. Richard wants to know her score. She scored a 27. Contrary to Richard, Adele is delighted. She says she's not sick. Richard tells her she has Alzheimer's. It just hasn't progressed enough to get her into the trial. Adele still thinks she's fine and asks Meredith to back her up. Meredith says she couldn't remember spoon. It took her a while to find the word "stethoscope". Also, she knows they didn't take their honeymoon to Hawaii. They stayed in Seattle because Richard had to work. Adele says she's just a resident. She calls them all obsessed. She may have gotten a few answers wrong, but it's normal to forget things at her age. She says it's not fair. She and Richard were finally happy, loving each other they should have for all those years, and now she gets Alzheimer's?! She asks Richard not to look at her like she's damaged goods. She's still here. She's still herself. Maybe she won't be here much longer, but she is here right now. She's so scared. She breaks down and Richard comforts her. Richard tells Adele he's not going anywhere.

Bailey enters Richard's office and tells him that the device is working. Clara is doing well. Richard tells her the FDA gave them their waiver. Jackson just heard about that and mentions something about Chief Resident, but Bailey closes the door on him. Bailey tells Richard he needs to pick someone, because the residents are going crazy. Bailey knows Richard has his trial and problems at home, so maybe someone else can pick the Chief Resident for him. She refuses to do it because she raised those babies. Bailey congratules him on his surgery and leaves.

Teddy tells Henry he's gonna be okay. Henry brings up what he said about her eyes earlier. Teddy tells him he has to stop flirting. He's not sorry. He meant what he said. Teddy gets that it's a great story if they were to fall in love. She'd be lying to say that it's never crossed her mind, but she just doesn't feel it. It's not real. It's just a good story. He asks what's wrong with a good story. She says she's sorry and walks out.

Meredith finds Derek, who tells her he hasn't called the waiting list yet. He wants Adele on the trial. Meredith says the one point could ruin it for everyone else. She urges Derek to call someone from the waiting list.

Eli approaches Bailey as she's on her way home. He heard the patient is doing well. If she admits he was right, they can kiss and make up. She refuses to do that. Eli says they are outside of the hospital. In the hospital, she's the man, but here, he's the man and he's gonna take her to his bed and show her what kind of man he is. He asks if that protocol suits her. She says yes. He says good, leans in and kisses her. He tells her to come to his place in 15 minutes.

Lucy finds Alex sitting outside his trailer, his new place. He offers her some food from the shower, but she'll settle for a beer. He gives her one and she sits down with him. She knows he was waiting for her because he finds her charming and hot, and now he's stuttering because she intimidates him. That explains why he hasn't made a move this whole time. Now, he's forcing her to do it. She leans in and kisses him.

April walks into the living room with popcorn, only to find Jackson and Lexie making out on the couch. She makes room for herself and the couch and tells them to go upstairs, to a room with a door that locks. She keeps turning up the volume of the television to get them to leave. She's watching From Here to Eternity, the movie she was going to see at Stark's place.

Owen comes home and Cristina got them pizza, in honor of her rocking her surgery today. If Webber doesn't pick her as Chief Resident, he's an idiot. Owen tells Cristina that Richard asked him to take over picking the Chief Resident. She says that's awesome, but then realizes it sucks. He can't pick her because everyone will say he just picked her because she's his wife. As she freaks out, Owen enjoys a slice of pizza.

Meredith and Derek are making out in bed.

Arizona and Callie are on their way to the B&B. Callie, in the passenger seat, keeps getting texts from Mark. He's freaking out because he found out about Lexie and Jackson. Arizona takes Callie's phone and throws it onto the backseat. She says this is time for them. Callie unbuckles her seatbelt to grab her phone because she wants to call Mark. She tells Arizona that this is jealousy. She's jealous of Mark. Callie tells her to get over it. Arizona says it's not surprising considering Mark gets most of Callie, while Arizona only gets the gay Callie, which is only about 20 minutes a night if Callie doesn't feel too fat to let Arizona touch her. Callie says she's doing her best to make sure everyone's happy and she doesn't know what else she can do. She'll do whatever makes Arizona happy. Arizona thinks about that. She turns to Callie and asks her to marry her. She means it. She loves Callie more than anything. She wants more. She wants commitment. She repeats her question. They look at each other until Callie looks at the road and gasps. Arizona does, too, and there are sounds from a car crash as the screen fades to white.

Cast[edit | edit source]

Main Cast[edit | edit source]

Guest Stars[edit | edit source]

Co-Starring[edit | edit source]

Medical Notes[edit | edit source]

Adele Webber[edit | edit source]

  • Diagnosis:
    • Alzheimer's disease
  • Treatment:

Adele had been diagnosed with early-onset Alzheimer's disease. Webber insisted that Derek put her on his trial. Derek said it was full, but when a spot opened up, he tested Adele. Unfortunately, she didn't meet the criteria.

Callie Torres[edit | edit source]

  • Diagnosis:
    • Pregnancy
  • Treatment:
    • Pre-natal care

Callie was 23.5 weeks pregnant and had an ultrasound.

Sonya Amin[edit | edit source]

  • Diagnosis:
    • Alzheimer's disease
  • Treatment:

Sonya was a patient on Derek's Alzheimer's trial. However, she dropped out so that her son could move back to London to be with his boyfriend.

Clara Greene[edit | edit source]

  • Diagnosis:
    • Type-1 Diabetes
    • Tumor
  • Treatment:
    • Tumor resection
    • Islet cell device

Clara, 42, had had a tumor removed eight weeks prior. She was having trouble healing and getting her insulin levels stabilized afterward. Bailey proposed her as a candidate for Webber's diabetes trial. They applied for an emergency waiver to implant the device. When she went into a hypoglycemic coma, they took her to surgery to implant the device before getting the waiver. The waiver came through after the surgery had been completed, when Clara was stable.

Miss O'Connor[edit | edit source]

  • Diagnosis:
  • Treatment:
    • Re-casting

Miss O'Connor was re-casted by April.

Jason Cook[edit | edit source]

  • Diagnosis:
  • Treatment:

Stark said that he had already changed Jason's drain.

Henry Burton[edit | edit source]

  • Diagnosis:
    • Tumor
  • Treatment:
    • Tumor resection

Henry was jogging when he collapsed. He had severe chest pain. A scan revealed a mass near his heart. Due to Teddy's personal relationship with him, Cristina operated to remove the mass. Despite a complication, he came through the surgery.

Master Rodriguez[edit | edit source]

  • Diagnosis:
    • Incarcerated incisional hernia
  • Treatment:
    • Hernia reduction

April and Alex did conscious sedation to reduce a hernia.

Music[edit | edit source]

Song Performer Scene
"Rumour Has It" Adele
  • Jackson and Lexie make out in the laundry room and April asks if there's any place they don't do it.
  • Dr. Bailey tells Alex to get the trailer out of her parking space.
  • Adele is examined by Meredith and Derek.
"Out of Style, Out of Touch" Eulogies
  • Callie and Arizona's baby shower
"Little Marriage" Lia Ices
  • Adele reacts to her Alzheimer's test results.
"Middle Distance Runner" Sea Wolf
  • Teddy and Henry discuss their relationship.
"Someone Like You" Adele
  • Alex finally wins with Lucy, and they kiss.
  • April kicks Jackson and Lexie off the couch, and watches From Here to Eternity by herself.
  • Owen tells Cristina that he's been chosen to pick Chief Resident.
  • Callie and Arizona argue in the car, right before the car crashes.

Notes and Trivia[edit | edit source]


Grey's Anatomy S7 March Promo

  • This episode's title originated from the song This Is How We Do It, originally sung by Montell Jordan.
  • This episode scored 10.28 million viewers.
  • April watches From Here to Eternity.
  • While many people have lived in Derek's trailer, this is the first time that the trailer itself has been moved.
  • This is one of the few episodes where the ending title card has a white blackground as it's normally black. The opening title card is white as well, making it one of the few (if not only) episodes where both title cards have the same color.
  • For the onesie decorating station, Sandra Oh, Justin Chambers, and Ellen Pompeo were given crafting supplies and they went to town. Ellen created the abstract design herself, as did Sandra with her heart design. Justin had to create a scrubs design according to the script, but he created how he was going to do it himself.

Gallery[edit | edit source]

Episode Stills[edit | edit source]

Quotes[edit | edit source]

Bailey: Stalking a man while he's in the restroom.
Jackson: I'd clean the restroom if he'd let me on his trial.
Cristina: I'd live in it.

Mark: How's the size?

Owen: You're beautiful.
Cristina: Screw beautiful. I'm brilliant! If you want to appease me, compliment my brain.

Henry: I've been thinking lately, and I think... Um...I think I've figured it out, why all of your dates go so bad, so, so bad, laughably bad, and it's not your fault. It's mine, because I'm not the guy on them with you.

Meredith: I can't get over the fact that you know what onesie-decorating is.
Mark: I've been boning up. That's what you do for the people you love.
Arizona: Oh, bite me, Mark.

Lucy: So this Karev guy, you're actually friends with him? That's real?
Meredith: Yeah. Why?
Lucy: Uh, just it surprises me, is all. I mean, you don't seem like the type of girl to put up with his whole neanderthal thing, so tell me. What am I missing?
Meredith: You're missing a lot. He had a girl go crazy on him. His wife almost died, and then she walked out on him. And then he was shot and almost bled to death in an elevator. He's been through a lot. So the neanderthal thing is just... It is an act. A well-executed one.

Callie: I'm extending an olive branch here. Because I know how annoying I must be to you right now. But since I was four and I got that doll that crap its pants for Christmas, I wanted a kid because, other than cracking bones, this baby's my dream. And I get to be insanely out of my mind happy for my dream, but I'm not discounting your need to vomit over my insanity...

Adele: Don't look at me like that, like I'm damaged good. I'm still me. I'm still here.

Teddy: It's not real. It's just a good story.
Henry: What's so wrong with a good story?

Eli: Inside the hospital you're the man. That's the protocol, but outside I'm the man. I am the man. Me. Now you can call me cro magnon or old fashion, but that's not going to stop me from taking you home to my bed tonight and showing you what kind of man I am. Now how's that? Does that protocol suit you?

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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