Being chief is about responsibility. Every single surgical patient in a hospital is your patient. Whether you're the one who cut them open or not. The scalpel stops with you. You need to be able to look at her family. And to tell them your team did everything they could to save someone's child. Their husband, their wife, you get caught up. Taking care about the people´s families. And responsibility... it makes you... you take care of other people's families. And you sacrifice your own.

Didn't We Almost Have It All? is the twenty-fifth and final episode of the third season and the 61st overall episode of Grey's Anatomy.

Short SummaryEdit

The wedding day arrives, and Cristina desperately needs something to take her mind off it, the fourth climber is found and his condition doesn't match the other climbers' stories, and Adele's condition brings a change for Richard.

Full SummaryEdit

Episode in detail.


  • Meredith Grey
  • Cristina Yang
  • Izzie Stevens
  • Alex Karev
  • George O'Malley
  • Miranda Bailey
  • Richard Webber
  • Addison Montgomery
  • Callie Torres
  • Mark Sloan
  • Preston Burke
  • Derek Shepherd
  • Jane Doe/Rebecca Pope/Ava
  • Jeff Pope
  • Lexie Grey
  • Joe
  • Helen Rubenstein
  • Rina
  • Jack Vaughan
  • Andy
  • Walter (left, with Joe)
  • Dale
  • Patricia
  • Adele Webber
  • Jane Burke
  • Intern #1
  • Intern #2 (front, in pink)
  • Intern #3
  • Intern #4 (left, with Intern #1)
  • Andy's Lawyer

Main CastEdit

Guest StarsEdit


Medical NotesEdit

Adele WebberEdit

  • Diagnosis:
    • Miscarriage
    • Placental abruption
  • Treatment:
    • Dilation and curettage

Adele had vaginal bleeding. Addison did an ultrasound and found a fetal heartbeat, but it was slow. She gave fluids and they waited for the heartbeat to return to normal. When she became unstable later, she was taken to the OR for a D&C.


  • Diagnosis:
    • Pregnancy
    • Aortic dissection
  • Treatment:
    • C-section delivery
    • Surgery

Rina was admitted to the hospital after passing out with extreme chest pain. Burke diagnosed her with a dissecting aorta. They got her into surgery, but she quickly flatlined, so Addison had to deliver both babies quickly so Burke could operate on her heart. She woke up after surgery and was fine.


  • Diagnosis:
    • Head trauma
  • Treatment:
    • Surgery

Lonnie was brought into the ER with an axe in his head. Derek took him into surgery to remove the axe and repair the damage.

Jack VaughanEdit

  • Diagnosis:
  • Doctors:
  • Treatment:

Jack was still in the hospital recovering from his injuries.

Andy MeltzerEdit

  • Diagnosis:
  • Treatment:

Andy was still in the hospital recovering from his injuries. Derek said his post-op x-rays looked good and he would be released.

Dale WinickEdit

  • Diagnosis:
  • Doctors:
  • Treatment:

Dale was still in the hospital recovering from his injuries.

Bailey's PatientEdit

  • Diagnosis:
  • Treatment:
    • Surgery

Cristina did the first incision on a patient who needed surgery before Bailey took over.

Rebecca PopeEdit

  • Diagnosis:
  • Doctors:
  • Treatment:

Rebecca and her daughter were both discharged to go home.


Song Performer Scene
"Roboxulla" The Jealous Girlfriends
  • Meredith, Cristina, Callie, and Izzie have a bachelorette party.
  • They all get paged to the hospital except Cristina.
  • Meredith tells Cristina she needs Cristina to walk down the aisle, which will prove to her that people like them can be happy.
"Falling or Flying" Grace Potter
  • Cristina looks at her wedding dress.
  • Jeff comes into the room to see Rebecca. He hugs her, but she looks over his shoulder at Alex.
  • Derek rushes to surgery while Meredith talks to him about them. He says he met a woman.
"Hold You In My Arms" Ray LaMontagne
  • Burke practice his vows in the OR.
  • The others agree the vows are good.
  • George tells Callie they can have a baby if she wants one.
  • Jeff holds his daughter and Alex asks why he didn't come looking for Rebecca.
"Closer" Coburn
  • Derek comes in to take Burke to the wedding.
  • Cristina makes her cut and then leaves the OR.
  • Izzie tells George she's in love with him and gives him a choice between her and Callie.
  • The other interns come in in a rush while George says nothing.
"Within You" Ray LaMontagne
  • George tells Izzie he'll talk to her at the church.
  • Derek comes in to talk to Meredith.
  • Alex goes to see Rebecca on his way out. She's been discharged. She tells Alex to give her a reason to stay. He tells her to stay with Jeff.
  • Derek and Meredith talk and he says she's always leaving him and he can't take it anymore. He asks her to end it.
"Eulogy" The Hereafter
  • Helen cries when she sees Cristina in her wedding dress.
  • Alex sits next to Addison and says he wants her, but she convinces him he wants Ava.
  • George talks to Bailey about failing his exam and what happens next.
"Explosions" The Mary Onettes
  • Cristina prepares to walk in as Burke walks back down the aisle and opens the door.
"Keep Breathing" Ingrid Michaelson
  • Meredith walks up to the altar and tells everyone to go because it's over.
  • Joe and Walter hold their babies while Richard and Adele watch through the window.
  • Alex goes to talk to Rebecca, but she's already gone.
  • Meredith finds Cristina in her apartment, where Burke's treasured things are all done.
  • Cristina says she's free. Meredith cuts her out of the dress and holds her while she cries.
  • Callie watches Izzie sit in a pew in the empty church.
  • George cleans out his locker as the new interns come in.
  • The last intern asks him if he has any advice. He tells her to learn an appendectomy start to finish before her first day.
  • She tells him she's Lexie Grey, Meredith's sister.
  • Richard congratulates Derek, saying he'll make a good chief, but Derek says Richard's the best man for the job.

Notes and TriviaEdit

Grey's Anatomy 3x25 Promo - Didn't We Almost Have It All

Grey's Anatomy 3x25 Promo - Didn't We Almost Have It All

  • This episode's title originated from the song Didn't We Almost Have It All?, originally sung by Whitney Houston.
  • It also refers to how Burke left Cristina at the altar, meaning they didn't have it all.
  • This episode scored 22.57 million viewers.
  • The wedding scenes were filmed at the First Baptist Church of Los Angeles.
  • This episode marks the final appearances of Kate Walsh and Isaiah Washington to appear as Addison Montgomery and Preston Burke respectively, as series regulars.
  • This episode also marks the the first credited appearance of Chyler Leigh as Lexie Grey. She first appeared in the previous episode, Testing 1-2-3 as a stranger in Joe's bar talking to Derek, but she was not named and thus was uncredited. 
  • Richard tells Addison she either needs a new job or a new life; yet, when she chooses to move to Los Angeles to work at a private practice, he's opposed to her decisions and asks her numerous times to stay or come back.


Episode StillsEdit

Behind the ScenesEdit


Burke: Cristina; I could promise to hold you, and to cherish you. I could promise to be there in sickness and in health. I could say 'til death do us part, but I won't. Those vows are for optimistic couples, the ones full of hope. And I do not stand here on my wedding day optimistic or full of hope.
Addison: Okay, um...
Burke: I am not optimistic, I am not. I am sure. I am steady. And I know I am a heart man, take them apart, put them back together. I hold them in my hands. I am a heart man. So this, I am sure. You are my partner, my lover, my very best friend. My heart, my heart, beats for you. And on this day, the day of our wedding, I promise you this. I promise you to lay my heart in the palm of your hands. I promise you, me. Too trite? Because I can rewrite it...
Izzie: No. No. It's...
Addison: I think I speak for every woman here when I say... dump her. Dump Yang and marry me.

(standing in the living room in Burke's apartment with Meredith)
Cristina: He's gone.
Meredith Grey: I... I don't think he's gone. His stuff is still here...
Cristina: No. His trumpet was here. His entire Eugene Foote collection, vinyls and CDs. (walking over to the bedroom) His grandmother's picture was by the bed. His luckiest scrub cap was hanging on the door. He's gone. I'm... I'm free. Dammit. Dammit. Dammit!
(Cristina breaks down.)

See AlsoEdit

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

The Grey Matter blog post on this episode can be found here.