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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 Summary

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 Summary

Episode in detail.

Cast

Main Cast

Guest Stars

Co-Starring

Medical Notes

Adele Webber

  • 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.

Rina

  • 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.

Lonnie

  • 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 Vaughan

  • Diagnosis:
  • Doctors:
  • Treatment:

Jack was still in the hospital recovering from his injuries.

Andy Meltzer

  • 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 Winick

  • Diagnosis:
  • Doctors:
  • Treatment:

Dale was still in the hospital recovering from his injuries.

Bailey's Patient

  • Diagnosis:
  • Treatment:
    • Surgery

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

Rebecca Pope

  • Diagnosis:
  • Doctors:
  • Treatment:

Rebecca and her daughter were both discharged to go home.

Music

Song Performer Scene
"Roboxula" The Jealous Girlfriends
"Falling or Flying" Grace Potter
"Hold You In My Arms" Ray LaMontagne
  • Burke saying his vows in the OR
"Closer" Coburn
  • Izzie tells george she is in love with him
"Within You" Ray LaMontagne
"Eulogy" The Hereafter
"Explosions" The Mary Onettes
"Keep Breathing" Ingrid Michaelson
  • Meredith informs the wedding guests that the wedding isn't going to happen.
  • Adele and Richard watch Joe and Walter hold their new babies.
  • Alex comes looking for Ava/Rebecca, but she is already gone.
  • Meredith comes into Burke's apartment and finds Cristina, who says he's gone and she is free.
  • Callie watches Izzie sit in the chapel.
  • George meets Lexie.
  • Richard informs Derek that he will be chief and Derek declines.

Notes and Trivia

  • 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 alter, 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 Isaiah Washington's last appearance as a main character on the show as Dr. Preston Burke until his return in Season 10, Episode 22, We Are Never Ever Getting Back Together. To remind viewers what happened, this episode was aired again in prime time right before that episode.
  • Kate Walsh's last appearance as a series regular.
  • Chyler Leigh's first credited appearance 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.

Gallery

Episode Stills

Behind the Scenes

Quotes

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 Also

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

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