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Almost Grown

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They train doctors slowly. They watch us practice on frogs and pigs and dead people and then live people. They drill us relentlessly. They raise us like children and eventually they take a cold hard boot and kick us out of the nest. We all want to grow up. We're desperate to get there. Grab all the opportunities we can to live. We're so busy trying to get out of that nest, we don't think about the fact that it's going to be cold out there. Really freaking cold. Because growing up sometimes means leaving people behind. And by the time we stand on our own two feet, we're standing there alone.

Almost Grown is the fifth episode of the seventh season and the 131st overall episode of Grey's Anatomy.

Short SummaryEdit

As part of their training, the Chief puts Seattle Grace’s residents — including Meredith, Cristina, April and Jackson — in charge; meanwhile, Derek, Callie, Owen and the other attending surgeons compete for a million-dollar grant.

Full SummaryEdit

Richard is in the residents lounge as all the residents are getting ready for work. Richard says he has great faith in them, and he knows what they can do. Today, the training wheels are coming off for the residents.

Richard tells the attendings the same thing. He has a one million dollar surplus, and one department gets it. He knows what departments need, but he wants to know what they want. He'll keep the residents busy, so they can put their best foot forward.

The fourth-year residents will be allowed to wear navy scrubs for the day. They will be attendings, and only cry for help unless they're in over their head. Since Lexie is a third-year, it's a regular day for her. Lexie will consider herself Chief Resident, then, but Alex says it just makes her their scut monkey. Cristina is just staring at the scrubs. Meredith says the attendings will still be around.

The attendings watch the residents in the navy scrubs. Richard assures them it's a good idea, and a part of the training process. The residents pick up charts at the nurses station and start fooling around a little. Richard then decides it's better to start praying to God. Callie asks how late they are pitching. Richard says they can decide the order themselves. He loves a good dog fight. Callie talks to Richard how intimidating he can be, which freaks Teddy out. Bailey looks at her and a laughing Callie says she loves a good dog fight, too.

Alex and Mark are on their way to a patient who's in for a breast reduction. They enter the room, and Alex greets the woman. He says he can work with her breasts, but Arizona, who's sitting in the room as well, says she's not the patient. The woman then knocks on the bathroom door and asks her child to come out. Surprisingly, a boy with breasts comes out and greets the doctor.

Jackson, Meredith, and Derek are in Ellie's room. Ellie has severe headaches and ringing in her ears, which is caused by a build-up of fluid in her skull, so they'll place a shunt to drain the fluid. Joanne, Ellie's wife, hopes Derek is doing the surgery, not the other two. Derek says they are very talented, and he'll observe. Joanne says no to that. Derek says they have to let them operate on their own. Ellie is okay with being a teaching subject. Derek says he'll monitor them closely. Joanne's a teacher, so Ellie asks her to let the kids learn. Joanne says Ellie's been her life for 40 years.

Derek has decided to watch Jackson and Meredith in the skills lab before choosing who gets to operate. Jackson doesn't think it's fair he has to compete against Derek's wife.

Arizona doesn't like plastic surgeries on minors, especially performed by Alex. Mark tends to agree to the last part. Callie comes over and says Alex is fine. They just rather worry over Alex than their presentations. Arizona says she's not worried, as she has the tiny humans. Callie thinks she's going to cry because the Chief is intimidating. Arizona says no, but she leaves. Mark knows Callie just psyched her out. Callie needs the money, and peds already has what they need. Mark wants the money. Callie laughs and says he never prepares for anything, and his charm and looks won't help him now.

April presents the case of Roy Henley, who can't breathe properly. He thinks he needs new lungs. Teddy asks Cristina to talk. She says they'll run tests. April asks if Roy's daughter is here, as she's his emergency contact. Roy didn't want to trouble her. He doesn't need a chaperone. April says it might be time to trouble his daughter, as he has a serious condition.

The doctors leave the room. Teddy wants the residents to decide if he's a transplant candidate. April thinks there's nothing else they can do. Cristina says she doesn't know. April asks if they convene a panel, as Roy will need to approved before getting on the list. Cristina couldn't say if they need to. April wants to convene the panel. Teddy asks then what. April will order the tests and leaves. Teddy then talks to Cristina, who says she's trying, but taking point is not her thing now. Teddy is not asking her to step into an OR, but she needs to participate. They are at a crossroads where she either gets in the game or goes home.

Teddy is with the Chief for her presentation. She wants to make this hospital the hospital that makes heart surgey obsolete. She wants to set up a project with stem cells to regenerate hearts. Richard says stem cell research is cutting edge in every field of medicine, so why cardio? Teddy says cardio and neuro are what puts this hospital on the map. Teddy says he can't give this money to neuro, because that's not really a department. It's just one strong player. Shepherd is very appealing, and he's great, but is he really cultivating talent and teaching residents? Maybe Shepherd doesn't like competiton, as he also tried to fire her. She's not holding much of a grudge, though. She then realizes she should've stuck to her notes.

Cristina's with Meredith and Jackson in the skills lab. Meredith and Jackson are practicing on eggs. They have to keep the membrane intact, but they can break the shell. Jackson swears and throws his egg away. Meredith feels kind of bad for him. Cristina says she shouldn't be in charge, but Meredith advises her to get through the day. Lexie comes in, blowing Jackson's concentration, to update Meredith. Lexie is taking over their duties but she doesn't mind. She was born for this kind of day.

Alex is marking incision lines on Seth's body. His mother jumps in and stops him. She wants him to wait a couple of years, as apparently he still can't make the right decision now that he's 13. You can't just cut of the parts of your body that you don't like. Seth's father has the exact same chest and nobody has a problem with it. She leaves to call her husband and Seth tells Alex they really pick on him because of his breasts. He's going to high school next year and he wants to be normal so he can start over.

Roy wonders why they can't just skip the panel. April says not everyone is a viable candidate. Roy wants to know what Sourpuss thinks. Cristina says that's just her face. She couldn't say if he'll pass the panel. Roy bets the doctors's fathers are really proud. April says hers really was over the moon, but Cristina stays silent.

Alex leaves Seth's room and Mark is mad that Seth's mother wants to cancel the surgery. Arizona reminds Alex that a big part of peds is parent management. Alex says he's taking care of it.

Lexie checks up on Megan Waylon. Megan keeps texting as she's waiting for doctor Torres. Lexie looks super busy, so she doesn't inspire confidence. She thinks Lexie doesn't know her case. Lexie has memorized her chart and proves she does know Meg's case. Meg's boyfriend agrees Lexie is good.

Owen is talking to Richard. He wants every doctor to have trauma training. 11 people died in the shooting and 3 of them could have been saved. Bailey did everything she was trained to do to save Charles Percy, but she couldn't to an OR, so he died. A doctor with trauma training would have known an alternative escape route. Like Bailey, 90% of their doctors lack trauma training. They failed one of their own doctors, and Owen doesn't want to face that ever again. He asks if Richard does.

Mark wants to expand the burn unit at the hospital, and become a renowned center for reconstructive cosmetic surgery. Richard is not enthusiastic about two new subspecialties. Mark says the cosmetic surgery will fund the burn unit. Richard says it's ambitious and a lot for one million dollar. Mark says he's not seeing anyone or sleeping with anyone, so he has a lot of energy to use. Mark's excited. Richard tells him to leave.

Alex is talking to Seth's mother. She wants to hear from Drs. Robbins and Sloan and refuses to listen to Alex.

April tells Cristina about Roy's lab results. It looks really bad, and immunosuppressives could kill him after the surgery, but without a transplant, he'll die too. April asks Cristina's opinion, but Cristina doesn't know. April decides to figure out what Teddy thinks and just say that at the panel. She can't believe Cristina actually doesn't care.

Teddy, Callie, Mark, and Arizona are having lunch and talking about meeting the Chief. Alex comes over and tells Mark and Arizona Seth's mother wants to talk to them. Arizona has to leave for her meeting. Callie gives her tissues, just in case. Mark tells Callie she has a sickness.

Derek's in the skills lab, counting down the seconds for Meredith and Jackson. Meredith's scraped her initials in the scale without rupturing the membrane. Jackson did his whole name. Meredith says Jackson conned her as he went through two dozen eggs and let her think she didn't have to practice. Derek tells Jackson he has the surgery.

Arizona finishes up her presentation. Even the smallest change could improve a lot of lives. Richard calls her presentation compelling and focused. Arizona figures he expected she was going to cry. Arizona thinks they should wipe the crying thing from their memories. She's got it under control. The fact that her colleagues think she'll burst out in tears during an important professional meeting makes her want to punch someone, and she's learned to punch hard and effectively. She then suggests they return to the sweet, little children.

Owen tells Cristina she looks good in the navy scrubs. Cristina says her patient deserves a doctor. She's doing what she's expected to do. Owen has an idea. He suggests they go into the alley and let her kick his ass. She smiles. He knew she was in there somewhere. He says they'll get to go home together, no matter if the day ends well or badly.

Arizona and Mark are sitting down with Seth's mother for Seth's discharge. Alex comes over and admits 13 is young, but Seth won't grow out of it. He has breasts, and it could wait until he's older, but there's no reason he has to suffer schoolyard crap in high school. If she wants Seth to be a man, she should let him make his own decisions.

Lexie was paged to Megan's room. Megan's sight is blurry and the left side of her body tingles. Lexie examines her and says she'll order a head CT and page neuro.

Derek tells Jackson he'll be on his own. He may have hussled Meredith, but this is not a game. Jackson takes the drill and start working as a nurse informs Derek that Lexie repeatedly paged him for a consult. Derek sends Meredith to go check it out.

Cristina is watching Roy from outside his room. April comes over and says cardiothoracic is not her thing. She's sure she'll humiliate someone today. Cristina says Roy was admitted two days ago. Teddy could have convened a panel yesterday ago, but she didn't. If April says that, everyone will be fine, except for Roy, who'll die.

Meredith enters Megan's room and sends Megan's boyfriend to the waiting room. Lexie updates Meredith on her case. Meredith asks if Megan is on blood thinners. Lexie says yes. Meredith says Megan's got a brain bleed and orders an OR. Lexie wonders how she could've missed this. Meredith says she did everything right, and says they'll page Derek 911.

A nurse informs Derek they paged him again. Jackson is almost there, but then swears. Derek takes his place and starts fixing the damage Jackson did.

Callie concludes her presentation by saying the future of ortho is in xenografting. Richard was hoping for something more inspirational, like Arizona. Callie says Arizona is nicer than her and she's patient, and a better lesbian, and Callie is just always a little bit left out. She doesn't thinks she needs to apologize for her sexual history with men. Richard asks if Callie wants the money just so the playing field of their relationship is evened out. Callie says also for the xenografting. Richard walks out.

Cristina is examining Roy. Roy asks if Cristina's authistic as she's smart but not communicative. Roy says his daughter is the same way. He contacted his daughter, but she's not coming. He explains they lost contact after she sided with her mother in the divorce. He hates that, but life goes on. April comes in to inform Cristina that the panel is gathering. Cristina says she'll be right there. Roy hopes he'll get the lungs, because he wants to live.

Jackson asks Derek if there's anything he can do, but Derek just snaps back at him. Meredith calls Derek to tell him about Megan. Derek tells her he won't be there for a while, so she'll need to take care of it by herself. She can take point.

Meredith gets ready and asks for the scalpel.

Alex is about to cut into Seth's chest. After Arizona reminds him the patient is a child, Mark decides to encourage Alex instead of breaking him down. Alex asks for the 10-blade and to starts to cut around a nipple.

Meredith removes part of Megan's skull.

Jackson looks on as Derek works on their patient.

Alex excises the glandular tissue as Mark and Arizona watch. Arizona nods her head.

Joanne, Seth's mother, and Megan's boyfriend are sitting in the waiting room.

Roy is coughing in his bed.

Bailey's surprised to see Kepner will lead the transplant panel. Teddy says Cristina's been useless, not noticing Cristina is standing against a closed door.

Meredith stops a bleeder in Megan's brain as Derek comes in. Meredith says she's got it under control. She can finish. Derek smiles.

Derek tells Richard he wants to find a cure for Alzheimer's. The one million dollar will be a start. He wants to start a clinical trial. He tells Richard about Meredith's perfect solo craniotomy. She's got her mother's talent and looks, so it's possible she has her mother's disease as well. Ellis was young when it started. Derek's starting to fear Meredith will get it, too. He's worried every time she can't find her keys or forgets something. Once he gets started with the million dollars, investors will start throwing money at him for the same reason he'll throw everything he has at the trial: everybody knows someone who can get or has Alzheimer's. Breakthroughs don't happen because of the medicine, they happen because someone is scared to death to stop trying.

Seth wakes up in his room and he's delighted he doesn't have boobs anymore. His mother is crying. Alex explains to Seth she's just happy he's okay. Alex and Seth bump fists.

April explains to the panel that Roy's only hope is a lung transplant, but Roy's got fungal pneumonia and his liver enzymes are worrying, and he's on his way to kidney failure. The immunosuppressives could kill him, so she thinks Roy doesn't belong on the list. Richard asks why she convened the panel, then. April says she thought he was a candidate at first, but it became glaring the more she looked at it. Also, new facts came to light. The patient has no support system as his daughter's estranged. In the back of the room, Cristina mumbles that's not a reason. Teddy turns to Cristina, who says the support system is just one factor. Roy's borderline. The creatinin isn't critically low, and his pneumonia is treatable. Cristina says she's been in 27 transplant surgeries, and every time, the patient's will to try is just as telling. She thinks getting Roy new lungs won't be a waste, because he'll live. She knows it.

Jackson watches Joanne talk to Ellie. He asks Derek what he's supposed to say. Derek says mistakes happen all the time. Their job is to tell Ellie and Joanne the surgery was a success, because it was. Ellie is delighted as the ringing's gone. She says the kid did good, and Derek affirms. Joanne admits she was wrong and hugs Jackson. 

April calls out Cristina for turning on her in front of the panel. Cristina says she didn't plan it. They're both not used to failing. Cristina approaches Teddy and she says she knows Teddy thinks recommending Roy was the wrong idea, but she disagrees. Teddy says in cases like this, the right decision is to make a decision. Cristina argued for her opinion, and the panel voted to put Roy on the list. She says Cristina was a doctor today.

Richard enters the conference room for his meeting with Bailey. She has a list of broken machines in the basement that they can repair with the money, and they might have enough money left for a night nurse. Richard can't believe that's her idea. The assignment was inspiration, and good ideas. Bailey says she'd like to go to Paris, but she's not sitting around planning a trip. She's a mother and what she needs to do is her laundry, get her kid to school, and put food on the table. She can do a big presentation about changing the face of medicine, but you can't do that with a million dollars. Bailey says she's just realistic. They need to fix the medicine they already have. Let's go to the grocery store instead of Paris. Also, she knows he doesn't have a million dollars. Richard says things may be different around here in the next few weeks.

Cristina enters Roy's room with a small smile on her face. Roy says he can't call her Sourpuss anymore. She needs to draw some blood.

The fourth-year residents are changing back into their own clothes. Lexie is sleeping on a bench in the dressing room.

Richard congratulates Owen. Callie walks off angrily, Arizona and Bailey smile at him, Mark just stares at him, and Teddy is visibly disappointed, but smiles when she notices Owen's looking at her. Derek also seems disappointed.

Meredith is looking for her keys in her bag. Derek tells her they're in her hands. He looks worried as they enter the house, and close the front door behind them.

CastEdit

  • 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
  • Roy Henley
  • Megan Waylon
  • Joanne
  • Ellie Ratigan
  • Trey
  • Mindy Gruberman
  • Seth Gruberman
  • O.R. Nurse (right)

Main CastEdit

Guest StarsEdit

Co-StarringEdit

Medical NotesEdit

Seth GrubermanEdit

  • Diagnosis:
    • Gynecomastia
  • Treatment:
    • Breast reduction

Seth, 13, was born with gynecomastia. At the age of 13, his parents agreed to allow him to have breast reduction surgery. However, once at the hospital, his mother tried to back out. Alex Karev managed to talk her into allowing Seth to have the surgery, saying it would improve the quality of his life because he wouldn't be teased at school anymore. The surgery went well and Seth woke up after surgery pleased with the results.

Ellie RatiganEdit

  • Diagnosis:
    • Fluid buildup under the skull
  • Treatment:
    • Surgery

Ellie came to the hospital with headaches and ringing in her ears. She was informed that it was caused by a buildup of fluid in her skull. They scheduled a shunt insertion. Her wife was worried about a resident operating, but Ellie said they needed to learn and agreed to let them operate. Jackson was selected to operate. However, in surgery, he caused additional bleeding. Derek had to step in and fix it. However, he was able to stop the bleeding and Ellie woke up after surgery and said that the ringing had stopped.

Roy HenleyEdit

  • Diagnosis:
    • End stage pulmonary hypertension
    • Fungal pneumonia
  • Treatment:

Roy, 57, had been admitted two days prior with severe wheezing from pulmonary hypertension. He had previously been told by a doctor that he'd eventually need a lung transplant, but at the time, he was too healthy. He believed the time had come for the transplant. Labs revealed fungal pneumonia and signs that he was developing kidney failure. April decided to convene a panel to decide whether or not Roy would be put on the transplant list. While presenting to the panel, April decided not to recommend Roy for a transplant. However, Cristina stepped in and said that despite his poor support system, Roy had the will to live necessary to make the transplant worth it. The panel voted to put Roy on the transplant list.

Megan WaylonEdit

  • Diagnosis:
    • Tibial-plateau fracture
    • Subdural hematoma
  • Treatment:
    • Elevation
    • Percutaneous screw fixture
    • Craniotomy

Meg, 28, was injured in a motorcycle accident. She had knee surgery to repair the damage. Lexie came in to check on her after surgery so she could adjust her pain medication. Meg later developed a headache and her vision went blurry. Then her left side starting tingling. A CT revealed that she had developed a brain bleed due to the blood thinners she was given to prevent DVT after her knee surgery. Lexie paged for a neuro consult. Derek was busy, so he sent Meredith to take the consult. Meredith ended up taking Meg into surgery to repair the bleed.

MusicEdit

Song Performer Scene
"On The Sly" The Bamboos feat. Kylie Audist
"You Always Make Me Smile" Kyle Andrew
"Look Alive" Wait.Think.Fast.
"Head Or Your Heart" Mat Kearney

Notes and TriviaEdit

Grey's Anatomy 700:31

Grey's Anatomy 7.05 Almost Grown Promo

  • This episode's title originated from the song Almost Grown, originally sung by Chuck Berry.
  • This episode scored 10.97 million viewers.
  • All fourth year surgical residents wore navy "attending" scrubs for this episode. It marks the first time they are seen wearing these scrubs, except for April, who wore them in Sanctuary and Death and All His Friends.
  • Goof: Derek Shepherd can be seen wearing his "Chief of Surgery" lab coat in several scenes, despite no longer holding the position.

GalleryEdit

Episode StillsEdit

QuotesEdit

Owen: I like the dark new scrubs on you. You look good. Are you okay?
Cristina: My patient deserves a doctor.
Owen: You don't have to cut, no one's asked you to...
Cristina: I know what's being asked of me and I'm doing it.

Lexie: Did you just stop that bleeder?
Meredith: Uh-huh.
Lexie: How did you even know to do that?
Derek: Okay. Sorry I'm late.
Meredith: That's okay. Lexie made a good call. I've got it under control.
Derek: What do we got?
Meredith: Let me finish, Derek. I got this.
Derek: Yes, you do.

Lexie: Where's Shepherd? I paged Shepherd.
Meredith: You got me.
Lexie: Okay, um, she's--she's post-op day two from a tibial plateau fracture. She...she was fine all day, fine, and then ten minutes ago, she started complaining of headache, blurred vision, and tingling on the left side of her body. I..I ordered a stat head C.T. I cannot believe you are the neuro consult.
Meredith: Is she on blood thinners?
Lexie: Yes, for D.V.T. prophylaxis.
Meredith: She's got a brain bleed. Let's book an O.R.
Lexie: H-How didn't I see this coming?
Meredith: Did you check her platelets?
Lexie: Yes.
Meredith: And everything normal?
Lexie: Until now, yes.
Meredith: Okay, well, you checked her platelets, you got a C.T., you called neuro. You did everything right. The only thing you're doing wrong is standing around talking about it, wasting time, while we should be getting her to the O.R.
Lexie: You totally sounded like an attending.
Meredith: Right?

Richard: (to Bailey) All right, talk to me.
Miranda: There is a broken CT machine in the basement, next to it is a broken argon lasor and a broken fluroscope. I think the million dollars could repair all three of them, and it might even be enough left over to put a new nurse on the night shift. Which is what our patient's really need.
Richard: That's it? That's what you've got for me? That's your best idea? This assignment couldn't have been clearer, inspiration. Good 'ol fashioned competition, not you coming in here and tellin' me I need to fix what's old and broken.
Bailey: Um, I would love to go to Paris, but you don't see me sitting around planning my Parisian vacation. It sounds nice, but I am a mother and what I really need to do is … get my kid to preschool, get the laundry done, put food on the table. All right, I could do a big tap dance here about how I'm going to change the face of medicine with a million dollars. But, come on, you can't do anything with a million dollars. A million dollars is nothing. That's a dream. This is real life. Preschool, laundry, food. I'm realistic. (scoffs) Change the face of medicine, we need to fix the medicine that we already have. We need a new night nurse, we need these broken machines repaired. Let's not go to Paris. Let's go to the grocery store, Chief. And while we're being honest, why are you wasting our time with this exercise anyway? When you and I both know you don't have a million dollars.
Richard" Well, things may be a little different around here in the next few weeks.

Derek: I'm gonna find a cure for Alzheimer's.
Webber: The cure for Alzheimer's with a million dollars?
Derek: With a million dollars, it's a start.
Webber: You're talking about a clinical trial? A clinical surgical trial?
Derek: Yes.
Webber: Start up costs alone, never mind the FDA, Derek, it's just...
Derek: Today I watched Meredith perform an emergency craniotomy by herself. She was perfect. She's got her mother's talent. She's got her mother's looks, Richard. What if she has her mother's disease? Ellis was young when it started. Every time Meredith forgets her keys, or asks what day of the week it is, I... when that millon dollars runs out, investors will throw money my way for the same reason I'm gonna throw everything I got at this trial. Because their dad has it or their wife. Breakthroughs don't happen because of the medicine. Real breakthroughs happen because someone is scared to death to stop trying.

Owen: Every doctor in this hospital needs trauma and training. Disaster training.
Webber: You've got a strong department.
Owen: No, not just my staff. Everyone. … Eleven people died in that shooting. Eight of them never had a chance, but the other three … could have been saved. Charles Percy had a gunshot wound to the abodmen. Miranda Bailey did everything that she was trained to do. She gave him fluids, controlled the bleeding, applied pressure, then she tried to get him to an OR. But she couldn't. And so he died. Now, a doctor with disaster training would have been able to assess that environment and worked quickly and would've known an alternative escape route. Dr. Bailey was not trained to do that and neither are 90 percent of the doctors on your staff. … And she'll remember him dying in her arms for the rest of her life … and I'll remember it. And you'll remember that we could have saved him. We failed her. We failed Charles Percy, one of our own doctors. I can't face that. (sighs) I can't face that ever again. Can you?

See AlsoEdit

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

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