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Adrift and at Peace

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The first 24 hours after surgery are critical. Every breath you take, every fluid you make is meticulously recorded and analyzed. Celebrated or mourned. But what about the next 24 hours? What happens when that first day turns to two and weeks turn into months? What happens when the immediate danger has passed, when the machines are disconnected and the teams of doctors and nurses are gone? Surgery is when you get saved. But post-op, after surgery, is when you heal. But what if you don't? The goal of any surgery is total recovery, to come out better than you were before. Some patients heal quickly and feel immediate relief. For others the healing happens gradually. And it's not until months or even years later that you realize you don't hurt anymore. So the challenge after any surgery is to be patient. But if you can make it through the first weeks and months, if you believe that healing is possible, then you can get your life back. But that's a big if.

Adrift and at Peace is the tenth episode and mid-season finale of the seventh season and the 136th overall episode of Grey's Anatomy.

Short SummaryEdit

Despite Meredith's objections to the idea, a concerned Derek takes Cristina on a fishing trip in order to get away from it all, while Teddy, feeling directionless without Cristina, directs all of her efforts and compassion towards a dying patient who lacks the proper insurance to seek medical treatment.

Full SummaryEdit

Derek is packing his stuff as Meredith wonders whose idea it was to go fishing with Cristina. Derek says Owen didn't want to leave Cristina alone and he had a fishing trip planned, so he invited her. Meredith says Cristina doesn't do wilderness where there are no bathrooms. Derek knows Meredith is concerned for Cristina, but there's nothing else they can do for her now. She doubts that fishing will get Cristina back to work. Derek says they're not trying to get her back to work, they're just making sure she's okay. Meredith thinks Cristina won't be okay until she's back at work. She thinks Cristina won't show up, but at that moment, the doorbell rings.

Callie and Mark are showering. He suggests some shower sex, but she declines. The sex makes her sad, because it makes her miss Arizona. He gets it. He also misses Lexie and says he was thinking about her last night while they were doing it. This upsets Callie and she throws him out of the shower.

Owen helps Derek to carry stuff to his car, leaving Meredith and Cristina by themselves. After some silence, Meredith says there are no bathrooms out there. Cristina knows. She walks out. Meredith sighs.

Jackson, April, and Lexie are admiring Richard and Bailey as they are removing a gallbladder through the patient's mouth. Bailey asks them if they want to do one of these. She's having a contest. Each of them will develop a different protocol aimed at trying to eliminate fistulas. The one whose protocol leads to the fewest post-op fistulas, will be awarded with this surgery. The residents leave to go start their research. Richard tells Bailey she's a genius.

Teddy joins Owen and Meredith on the elevator. She asks about Cristina. Meredith says she's fishing. Teddy wonders why. Meredith tells her to ask Owen. Meredith and Owen get off the elevator. A patient asks Teddy how he looks, because he's going to propose to his girlfriend. Teddy smiles and says she'd be a fool to say no. She wishes him good luck.

Alex asks Mark and Callie if he can work with one of them since Stark doesn't want to work with him. Callie suggests heartlessness may be a peds thing. They bash Arizona for leaving them (with Stark). They walk off and Mark approaches Lexie to tell her he misses her. He asks if she's seeing someone. She says she's busy with trying to prevent her patient from developing a fistula. He repeats he misses her.

Owen joins Meredith out in the ambulance bay. Meredith is still pissed at him for sending Cristina out while she should be here, at the hospital. The ambulance arrives with Trina Paiz, who's got a lacerated ear. She fell 100 feet into a ravine, but her husband broke her fall. Jason Paiz is in the second ambulance. As Meredith takes Trina inside, she hopes her husband's okay.

Meredith asks Trina some questions. They were hiking at a mountain and they wanted pictures so they handed their camera to some guy and they posed and kissed, and suddenly, she was looking up the sky and she was on top of Jason. She says Jason can't die.

Meredith checks in the other trauma room where Owen informs her that Jason's abdomen is distended. He has a lot of internal bleedings. His blood pressure drops so they rush him to an OR. Trina watches them roll Jason past the window.

In the OR, Owen says there's no time to scrub. He and Meredith get gowned and gloved while Jason's prepared for surgery. He hopes no one is wearing new shoes. He makes a cut and a lot of blood poors from the incision onto the ground.

Owen tells Meredith that the suctioning is too slow. She'll have to use her hands to scoop the blood out. There's holes everywhere so he decides to clamp the aorta at the hiatus until the pressure goes back up. He's gotten multiple units of blood. Owen says they need to stop the bleeding for a better visualization. He needs a lot of lap pads.

Out at the lake, Cristina suggests to mount the rod holders mid-ship, so they can reach the rods from either end of the boat. She did some research after he called her last night. He says it's a great idea. She can't help but making more suggestions.

Callie and Alex are doing a consult on Ron, who needs a hip replacement. His wife Sheila says their daughter's an orthodontist so the doctors know they have medical people in the family. Callie talks about her new minimally invasive technique. Alex explains the technique. She can fit him in this afternoon and have him walking out of there by the end of the week. Sheila wonders why she has an opening if she's so good. Callie says she's coming off some leave so her schedule's still flexible. Also, she's the only one in the north-west doing minimally invasive hip replacements. Sheila wants a second opinion.

Alex and Callie leave the room. She tells him to give Dan Miller a call. Ron and Sheila will hear about his 6 week recovery period and they'll come running back to her in no time. She tells him to keep the opening in her schedule for Ron.

Lexie asks nurse Eli if he's sent her patient's pancreatic fluid to the lab. Eli didn't, because he wanted to let the patient rest after a bad night. Jackson walks by with his patient, 3 days post-op and no fistula. Mrs. Kay wants to go back to bed, but he says another round. April comes over. Lexie says she added another to her drug regimen. April asks her if she's still sticking to her list. Lexie says yes. April walks off and Lexie tells Eli that her patient probably can't sleep at night because Eli lets him sleep during the day. She tells Eli to get the fluid sample now.

Teddy encounters the man from the elevator at a nurses station. He tells her it didn't go well, but he admits he proposed for the wrong reasons. He liked the girl, but what he liked most was her insurance. He capped out his insurance about three surgeries ago. Teddy takes his chart. He suffers from Von Hippel-Lindau disease and has been hospitalized 200 days over the last 3 years. Richard is his surgeon, but he discharged him today. Teddy says they won't throw him out on the street because he has a dangerous tumor on his adrenal gland. She'll see what she can do. He says he can't afford her fee.

Mark is tending to Trina's ear. She talks about how they got together. He's a really good kisser.

Meredith says Jason's blood pressure still isn't what it should be. Owen thinks there's a liver bleed and decides to go for the Pringle maneuver. They find the vena cava is torn. Owen says the injury is too severe. The pressure continues to drup. Meredith asks what his plan his, because he has to have one. Owen comes up with a long shot. They can crack his chest and put in a shunt to bypass the blood flow to the heart so they have time to make the repair. Also, Meredith can't talk like that to him in his OR.

Out on the lake, Cristina wants Derek to quiz her on fishing gear names. Derek reminds her fishing is supposed to be quiet. He decides this is a good spot. She asks if it's typical to go for hours without a bite. Derek says fishing is unpredictable. Cristina still thinks they need to move the boat to actually catch a fish. Derek tells her to stop thinking and refuses to try it her way. She has trouble turning her mind off.

Teddy is trying to convince Richard to operate on Henry pro bono, but Richard says the hospital can't pay for the long-term care he needs. His hands are tight. Teddy says she's seen him bend the rules and suggests he'd do this for Derek or Bailey. Teddy clarifies Cristina is fishing today, which is partly her fault, so she wants to do something good. Richard decides to set up a meeting with the review board.

Since it's been three hours, Alex thinks Ron and Sheila won't call. Callie thinks that they'll call. She believes that sometimes people make sane decisions. Not all people are evil and leaving her in airports. Her phone rings.

The shunt is in. Owen will lift the liver so Meredith can reach the tear. She can sew. He reminds her to stitch slow and steady.

April, Jackson, and Lexie sit down for lunch. Nurse Eli comes over to inform April that one of her patients came into the ER with a fistula. April rushes out. Jackson tells Lexie it's just the two of them now. Lexie tells Eli she needs another sample of her patient's fluid, but Eli says that'll be hard because he took the drain out as it was preventing the patient from sleeping comfortably. Lexie says they have to put it back in, but he refuses to until Bailey says it has to be done. Lexie says she'll do it herself, but he refuses to let her touch the patient. She may have her little list, but he has 12 years of experience that tell him that putting the drain back in now will increase the risk of infection. This hospital is his home and residents are like guests, coming and going, and Lexie is no longer welcome.

Lexie paged Mark to the ICU. She needs him to go talk to Eli because he really hates her. Mark only agrees to do it if she will meet him at Joe's tonight for a drink. Lexie calls him unbelievable. He says that's why she loves him. Lexie says they both know they don't work together. Just one drink, he says. She agrees to one drink. Mark then sees it's Eli and goes into the ICU. He tells Eli he knows better than to mess with him on his turf, so he asks Eli to just play along as if they're having a discussion. He says Lexie will go out with him if Mark would talk to him. Eli asks what's in it for him. Mark offers him tickets for the Seahawks with parking. Eli raises his voice and says he refuses to put the drain back in until Bailey tells him to. Per Mark's request, he adds that he doesn't care that Lexie is the best resident Mark's ever seen. Mark leaves the ICU and tells Lexie he did what he could. Lexie is frustrated because he didn't really do anything. Mark says he'll see her at 9 and walks off. Jackson comes over and Lexie asks him to interrupt her drink with Mark with an emergency. Jackson says there will be an actual emergency if Lexie doesn't put the drain back into her patient.

A nurse tells Owen about his messages, but there's none from Cristina. He gets ready to lift up the liver.

Sheila and Ron have decided that they're going with Callie because Miller can't fit Ron in until in 3 weeks. Callie says she's booked for the 2 o'clock slot. She says she might be able to push things around. She and Alex take a look at her schedule. She says she'll just operate Ron and risk being late for her award dinner. She's sick of those dinners anyway. Ron thanks her.

Lexie and Bailey enter the ICU. Bailey asks why he removed the drain. She says she has to put it back in now. Eli says the patient wasn't sleeping. Bailey says this protocol is not just for him. Eli says he does patients, not protocols. He hates complications as much as she does, which is why he tries to prevent them. He knows Bailey is happy when he's working and not just because of his pretty face. He is good at his job.

Meredith says she can throw in another stitch, but Owen says no. Meredith says there's not as much blood in the field as before so she thinks the patient can handle. She does the stitch against Owen's orders. The patient is fine, but he throws her out of his OR.

Meredith is on the phone with Derek. She tells him she got thrown out of the OR. She's sick of this, of Cristina not talking to her and them pretending to be friends. She asks him to put Cristina on the phone.

Derek is pretending to be talking to Dr. Keller and hangs up, but Cristina knows it was Meredith. Suddenly, Cristina has a bite. Derek tells her to remain calm but she's over the moon. He tells her to let the fish run a little so it can tire itself out. They start reeling it in and cheer.

In the OR, Callie says Alex is good. In a year, everybody will want this surgery but there's only one her, unless there's another her. She can make Alex another her.

Meredith enters the OR, where nurses are cleaning up, and she asks Owen to talk. He asks the nurses to give them the room. Meredith says they both knew she could do that stitch, and he'd let everybody else do it. But because she questioned how he handled Cristina, he chose to slap her down to show everyone who's boss. Owen says he thinks she's reckless and he can't have that in his OR. He also does not want that around his wife who's struggling to just hold on. Meredith says Cristina is struggling to hold on because he married her and let it be okay for her to fall apart completely. She wonders what Cristina is gonna when she comes back from her fishing trip. Everybody will be working, except for Cristina. Owen says Cristina has the right to figure that out herself. Meredith says she knows Cristina. She needs to work because surgery is who they are. Owen says Meredith told a gunman to shoot her. She's fearless in the wrong way. Most people are like Cristina, afraid, so what Cristina needs is not what Meredith needs. Cristina is not her.

Jackson, April, Lexie, and Bailey are going over patient files of patients with post-op complications. Bailey sees there's a pattern. It's always day 3. Bailey takes deep breaths and leaves the room.

Teddy and Richard are meeting with someone from the review board. Their solution is a medicalert bracelet. Teddy says Henry will be dead by the time he arrives in the hospital when he has a hypertensive crisis. Bailey comes in and says that if they remove the drain on 3 instead of day 5, they can reduce the formation of fistulas by 30%. She explains she figured that out because of Eli. She leaves her files for Richard to look at and only then sees that she disturbed a meeting. She introduces herself as Dr. Bailey, the doctor who cured fistulas. She leaves.

On the dock, Cristina's fish is being weighed. It's 28 pounds. It's one of the biggest they've had this year. They're going to take a picture of Cristina with her fish. Cristina picks up her fish. The fisherman says it's something to catch a fish that big on a first day. Derek affirms Cristina is something. The fisherman tells Cristina to smile. She lets it all sink in and starts crying. Derek tells the fisherman to take the picture now. He takes the picture and gives it to Derek, who smiles at a crying Cristina.

Meredith rolls Trina into Jason's room. Owen says the next 24 hours are crucial. They're gonna focus on getting him through the night. Meredith says Jason is still there despite all the machines and damage. Trina takes his hand.

Callie invites Alex to come drink with her, but he declines. Turns out that Stark hated his new assistant more than he hated Alex, so Alex can assist him now. Callie does not like hearing that and tells Alex to walk away. When he's gone, she tells herself she's still awesome.

Richard tells Henry that he's set him up for their free clinic. He gives Henry his card and tells him to call him if he needs anything at all. Teddy appears in the doorway as Richard leaves. Teddy comes in and apologizes for not being able to do more. Henry says he's good for a while. Teddy wishes him good luck, but then says she has great medical insurance. She's saying that she'll marry him. Henry says that is generous, but he can't accept. Teddy says she took an oath. She can't leave him now any more than she could leave him bleeding out in the street. He says this absurd and that she'll regret it in the morning. Teddy says he doesn't have to die, because she can help him. She'll marry.

Bailey tells Eli that she wants all drains removed on day 3 unless she tells him otherwise. She asks if he knows what he did. He asks if she wants to go out with him sometime. She agrees to it because he gave her day 3. He says also because he's handsome.

Lexie meets up with Mark at the bar. As she walked here, she realized this is unfair to the two of them. Nothing's changed between them. They're still in different places in their lives. He cuts her off by kissing her. Jackson comes in and says that Bailey paged him, but she asks him to deal with by himself. He leaves and Lexie kisses Mark again.

Cristina comes home with 21 pounds of trout. Owen asks her how it was. She says it was good. She puts her picture on the fridge.

Derek and Meredith are in bed. She asks if he thinks Cristina will be okay. He thinks so. She asks if she's gonna be a surgeon. He honestly doesn't know.

Callie's cooking when there's a knock on the door. Callie thinks it's Mark who forgot his keys. She opens up and sees it's Arizona. She tells Callie to picture this. She's in Africa and everything is going great and the people are nice and the work feels amazing, but she's crying constantly and this guy finally asks her what's wrong. She says she really misses her girlfriend and he asks her if they should replace her so she can go back. She opens her mouth to say no, but what comes out is yes. So they did, and Arizona came back. She tells Callie she looks pretty. Callie says nothing and closes the door on her.


  • Meredith Grey
  • Cristina Yang
  • Alex Karev
  • Miranda Bailey
  • Richard Webber
  • Callie Torres
  • Mark Sloan
  • Lexie Grey
  • Owen Hunt
  • Arizona Robbins
  • Teddy Altman
  • April Kepner
  • Jackson Avery
  • Derek Shepherd
  • Henry Burton
  • Eli Lloyd
  • Trina Paiz
  • Sheila Cherkovsky
  • Ron Cherkovsky
  • Adriana Kay and Jackson Avery
  • Marina Worker
  • Wayne Sheehan
  • Paramedic Nicole
  • Paramedic #1
  • Dr. Knox
  • OR Nurse
  • ER Nurse (right)
  • Fisherman #1 and #2 (in the back)

Main CastEdit

Guest StarsEdit


Medical NotesEdit

Bailey's PatientEdit

  • Diagnosis:
  • Treatment:
    • Gallbladder removal

Bailey performed a gallbladder removal through a patient's mouth.

Andrew RabbEdit

  • Diagnosis:
    • Pancreatic tumor
  • Treatment:
    • Tumor removal

Andrew had had a tumor removed three days before and Lexie was monitoring him in the hopes that he wouldn't develop a fistula. When Lexie figured out that Eli had removed his drain, she demanded that he get it put back in. He refused. But Bailey ultimately connected that his patients, who had their drains removed the third day after surgery, had lower fistula rates.

Trina PaizEdit

  • Diagnosis:
    • Lacerated ear
  • Treatment:

Trina, 27, fell 100 feet into a ravine onto her husband. She was pulled out and taken to the ER where her only complaint was a lacerated ear. Mark came in while her husband was in the OR and fixed her ear.

Jason PaizEdit

  • Diagnosis:
    • Internal bleeding
  • Treatment:
    • Surgery

Jason, 27, was brought to the ER after his wife fell 100 feet and landed on him. His abdomen was distended and he was bleeding internally. He was taken immediately into surgery. In surgery, Owen believed that the injury in his abdomen was a lethal injury, but he ultimately figured out a solution that would give them the time to repair the damage. After surgery, his wife came in to see him and was informed that things were still tenuous.

Ron CherkovskyEdit

  • Diagnosis:
    • Bone spurs
  • Treatment:
    • Minimally invasive hip replacement

Ron needed a hip replacement. He had a consult with Callie, who said she could do a minimal invasive one later that afternoon and he'd be walking out of the hospital by the end of the week. He was hesitant to agree, but after a consult with another orthopedic surgeon, he came back to Callie and had her replace his hip.

Adriana KayEdit

  • Diagnosis:
  • Treatment:

Three days post-op, Adriana was still fistula free.

Henry BurtonEdit

  • Diagnosis:
    • Von Hippel-Lindau Disease
    • Adrenal tumor
  • Treatment:
    • Alpha blockers

Henry was in the hospital with a tumor on his adrenal gland, but he was uninsured, so he was being discharged. Teddy looked at his chart and said she'd talked to Richard about him. When a committee decided just to give him a medic alert bracelet and discharge him, Richard prescribed alpha blockers and went to send him on his way. Teddy came in and offered to marry him in order for him to be covered by her medical insurance.

Miss HathawayEdit

  • Diagnosis:
  • Treatment:
    • Fistula
    • Septic shock

April's patient came into the ER three days after being discharged with a fistula. She was in septic shock and was taken into surgery.

Stark's PatientEdit

  • Diagnosis:
    • Midgut volvulus
  • Treatment:
    • Surgery

Alex assisted Stark in surgery on a midgut volvulus.


Song Performer Scene
"It's Christmas Time" Jules Larson
"Merry Xmas" Basement Apartment
"Nun Gimmel Heh Shin" The Lee Vees
"O Come All Ye Faithful" Ashton Allen
"The First Snowflake" Boy Least Likely To
"Silent Night" Low

Notes and TriviaEdit

Grey's Anatomy 7x10 - Adrift and at Peace - Promo00:31

Grey's Anatomy 7x10 - Adrift and at Peace - Promo

Grey's Anatomy 7x10 Promo00:31

Grey's Anatomy 7x10 Promo

  • This episode's title originated from the song Adrift And At Peace, originally recorded by Nine Inch Nails.
  • This episode scored 11.02 million viewers.
  • The scenes of Derek and Cristina fishing were filmed at the Big Bear Lake in California.


Episode StillsEdit


Callie: I am stubbornly choosing to believe that not all people are evil and bad and leave me at airports.

Owen: Do you want to know what I think? I think you are reckless. I think you are reckless with your own life and today you were reckless with a patient's life. I don't care who you are. I don't want that in my OR, and I don't want that around my wife who is struggling just to hold on.
Meredith: Your wife is struggling just to hold on because you married her and let it be OK for her to completely fall apart.
Owen: You are fearless, and I don't mean that in a good way. Most people don't tell the guy with the gun to shoot them. Most people are like Cristina. Most people are afraid. So what she needs isn't what you need. She isn't you, Meredith.

Meredith: I knew what I was doing. I knew I could do that second stitch, you knew I could do that second stitch and it were anyone else, you would have let them do it. But because I question how you handle Cristina, you chose to slap me down and let everyone know who's boss.
Owen: Do you want to know what I think? I think you are reckless. I think you are reckless with your own life and today you were reckless with a patient's life. I don't care who you are. I don't want that in my OR and I don't want that around my wife who is struggling just to hold on.
Meredith: Your wife is struggling just to hold on because you married her and let it be okay for her to completely fall apart. What is Cristina gonna do when she gets back from her fishing trip tonight? Tomorrow? Next week? Next month? Next year? Because we'll all be here working, and Cristina will be... Where?
Owen: I don't know. I don't know, but she has the right to figure that out.
Meredith: You don't know. Well, I know. Because I know Cristina Yang and she needs to work because surgery is who we are.
Owen: You told the guy with the gun to shoot you. That is who you are.
Meredith: What the hell does that have to do …?
Owen: You are fearless, and I don't mean that in a good way. Most people don't tell the guy with the gun to shoot them. Most people are like Cristina. Most people are afraid. So what she needs isn't what you need. … She isn't you, Meredith.

Arizona: You look really pretty.

Teddy: I have great medical insurance.
Henry: Way to kick a guy when he's down.
Teddy: I'm... I'm saying... I'm saying that I'll marry you.
Henry: Uh, that's a really generous offer, but I can't.
Teddy: I'm a doctor. I took an oath, and I can't leave you now anymore than I could leave you bleeding out in the street.

April: Sparkle... that was the name of my pony.

Teddy: Cristina Yang is fishing today. She is one of the most talented surgical residents I have ever seen and she is fishing instead of operating, and that is partly my fault. I just want to do something good today. Make it up, pay it forward, whatever you want to call it. I just need to do some good.

Cristina: Is this typical? I mean to go for hours without a bite?
Derek: Well, the only thing predictable about fishing is that it's unpredictable.
Cristina: Wow, that's deep.
Derek: Yeah, why don't you ponder that for a while. Quietly.
Cristina: I can't stop. I can't turn my mind off.

Miranda: You want to do one of these?
Lexie: Is that a trick question?
Miranda: The trick is, how bad do you want it?
Lexie: Um, when I was little, I wanted a pony ... Like, really, really wanted a pony. This feels a little bit like that.

April: When I was little, I wanted a pony too, and you know what happened? I, uh, worked really hard, and I got one.

See AlsoEdit

A complete overview of this episode's crew can be found here.

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