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Perfect Little Accident

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Perfect Little Accident
Season 6, episode 16
6x16-29
Arizona befriends Teddy.
Episode Information
Airdate

March 4, 2010

Written by

Peter Nowalk

Directed by

Bill D'Elia

Episode Guide
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The Time Warp

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Push

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Surgeons are detail-oriented. We like statistics and checklists and operating procedures. Our patients live because we enjoy following the steps but as much as we love to always rely on the numbers, the plan we also know that some of the greatest medical discoveries have happened by accident. Mold: Penicilin. Poisonous tree bark: a cure for Malaria, a little blue pill for high blood pressure, impotence be damned. It’s hard for us to accept that it’s not always the hard work or attention to detail that will get us the answers we are looking for. Sometimes we just have to sit back, relax and wait for happy accident. No matter how many plans we make or steps we follow, we never know how our day is going to end up. We’d prefer to know, of course, what curveballs will be thrown our way. It’s the accidents that always turn out to be the most interesting parts of our day, of life. The people we never expected to show up, the turn of events we never would have chose for ourselves. All of a sudden you find yourself somewhere you never expected to be and it's nice, or it takes some getting used to. Still, you know you’ll find yourself appreciating it somewhere down the line. So you go to sleep each night thinking about tomorrow, going over your plans, preparing the lists, and hoping that whatever accidents come your way will be happy ones.

Perfect Little Accident is the sixteenth episode of the sixth season and the 118th overall episode of Grey's Anatomy.

Short SummaryEdit

When famous surgeon Dr. Harper Avery is rushed to Seattle Grace Mercy West Hospital, the staff is surprised to discover that one of their own is related to this legend, and his unorthodox request for his surgery causes tensions between Derek and Richard. Meanwhile, Callie and Arizona try to help Teddy and Sloan move on from their pasts and find greener pastures.

Full Summary Edit

A naked Lexie is on Alex's bed, waiting for him to come in. She tries several positions and when she finally finds the right one, Derek comes in to talk to Alex. Lexie quickly covers up and as Derek walks off, Meredith tells Lexie that Alex left 10 minutes ago. Lexie confesses they've been sleeping together ever since Meredith caught them the first time. Meredith wants to make sure that Lexie doesn't have feelings for Alex, because emotionally, he's like her three years ago. Lexie assures her there are no feelings involved, but Meredith doesn't believe that. "Your heart lives in your vagina," Meredith says, to which Lexie objects.

Derek enters the hospital and finds a small group of people listening to the door of a supply closet. Derek walks in, only to find Mark in a very compromising position with a drug rep. He sighs and leaves the room.

Cristina enthusiastically tells Owen about a surgery she did with Teddy as they're on their way to work. Owen finds a little weird to hear that she and Teddy are friends now. Cristina tells him that he can be Teddy's friend too. She never asked him not to be, he decided that all on his own. He thanks and kisses her as Charles comes running out of the ER. He paged Owen, as there's a trauma coming in. The paramedic unloads the patient, but she slips due to the wet ground and the gurney falls to the ground, with the patient on it.

Cristina and Charles are bickering over who gets to assist Owen. Gary from the legal department needs one of them to make a statement about the fall. Since Cristina is not wearing scrubs and Charles is, she has to give the statement.

Teddy stares at Owen as he works on the patient and she doesn't pay attention when Arizona comes over to talk about a patient. Arizona manages to get her attention by saying that she noticed at Christmas that there's something going on between Owen and her, and Arizona likes to fix people. Teddy begins to deny it, but Arizona tells her not to, as she'd be lying. As to the fixing, Arizona declares that Teddy is going to be friends with her, as she thinks Teddy needs a friend that is not Owen. She assures Teddy that she's an awesome friend and gets her to say yes to a girls night. Arizona then gets back to the patient she was talking about earlier, who needs a lung transplant. Alex overhears them talking and asks if he can scrub in, but Arizona doesn't allow him. Ever since she heard that he slept with Callie, she's been wanting to hit him with a brick. She tells him to run away before she can find a brick and as she and Teddy walk off, she asks her new friend not to judge her for that.

Derek is in his office with Mark. He understands that Mark is sad about Sloan being gone, but he can't go around screwing drug reps to make himself feel better. As Mark is about to leave, Richard appears in the doorway. Mark welcomes him back. Richard gives Derek the urine sample that he had to drop off for the drug testing. Derek wants to make sure that Richard has a good first day back, so Richard asks for a low-stress day with a light schedule. Derek agrees to that and the two shake hands.

Unlike Gary, Cristina is done with the statement. The paramedics bring in an older man, with Jackson by his side. The man wants to go despite his abdominal pain, which caused him to pass out. Cristina completely ignores Jackson and takes on the case. She tells the man that she's a very good surgeon, but he replies that his grandson is too. As doctors can't treat family members, she continues her exam and names a possible diagnoses. The patient shoots it down and says that apparantly he's a better doctor than she is. He introduces himself as Dr. Harper Avery, which leaves Cristina speechless, as it's Harper Avery as in the Harper Avery Award. She is shocked that Jackson is Harper Avery's grandson.

Cristina tells Meredith that she misdiagnosed Harper Avery, fearing it killed her chance of ever winning a Harper Avery Award. Meredith appears not to care that much. Lexie joins them, having heard about Harper Avery. Meredith blurts out to Cristina that Derek walked in on Lexie naked this morning in Alex's bed. She wants to cheer Cristina up. Like Meredith did, Cristina tells Lexie that she can't have feelings for Karev, as he's like Meredith three years ago. Lexie again says she doesn't have feelings for Karev, but Cristina, too, thinks that Lexie's heart lives in her vagina. Lexie walks off angrily as Derek joins them. He thinks it's cool that Jackson is Harper Avery's grandson, but Cristina thinks Jackson is just an entitled brat with a good bloodline. Meredith says it's not Jackson's fault that he's related to Harper Avery. "Whatever, Ellis Grey's daughter," Cristina says before walking off. Derek asks Meredith if he looks good, as he's about to meet Harper Avery. Meredith can't believe he's so excited for that, as she finds Harper Avery is just a guy who happens to have an award named after him. Derek sees through her and knows that she wants to meet him too.

Cristina checks up on Owen and Charles and their patient. Charles asks her for a hand. She happily tells him to watch and learn.

Callie and Alex's patient is screaming at her daughter, who's screaming right back. She explains her mother is almost deaf but refuses to accept that, thus refusing to learn sign language or get a hearing aid. Callie and Alex discuss what's going on with the patient and decide they need to get Mark and Derek. The patient also needs knee surgery, meaning she'll be off her feet for a few weeks. Kathy and her mother keep on bickering.

Harper Avery, lying only a few beds away, asks if it's him or if the women really are annoying. Bailey promises him to get him up to his own room as soon as possible. Harper asks Derek if he's the Shepherd from the clinical trial on the gliomas. Derek affirms, which has Harper question why he's there. All he needs is an experienced surgeon. He asks for Dr. Grey. Meredith says that's her, but he meant her mother. He didn't know that Ellis passed away. He then asks for Richard Webber, but Derek says he's not available today. Owen is about to take his patient up to the ER, but the patient seizes and is heavily bleeding, so they take him back to the trauma room. Realizing it's gonna be hectic, Derek decides to page Richard anyway.

Richard informs Harper Avery on what's going on. Scans indicate that he has an obstruction, so it's good that Jackson brought him straight in. As Richard says Bailey can operate to fix it, Harper starts guessing who Richard slept with to be asked to give up the Chief job. Derek saves Richard and says that Richard wanted to focus on his research. At least he'll be free to do his surgery then, Harper says, but Derek says that Bailey is more than capable. No offense, Harper says, but he wants Webber. He also requests that he be awake during the surgery so he can watch. So much for the low stress day, Richard concludes.

Lexie presents the case of Elliot Meyer, who suffers from pulmonary fibrosis, which developed as a side effect of the radiation he received to cure his cancer. Jill is scared and snaps at them. Elliot apologizes for that. Teddy straight-out tells him that he's a high-risk candidate for the transplant, because the immunosuppressants he'd be on would make it likely for the cancer to come back. There are just way more patients on the list that are lower risk. Jill thinks he deserves lungs after all he's been through, but Teddy has to follow the rules the transplant board set out. 

Outside the room, Lexie asks Teddy if she's looked at research about ex vivo transplants. Cristina explains that's a procedure where they take damaged donor lungs that would normally be thrown away and repair them on bypass. Teddy guesses that she wants on her service to make up for the fact that she humiliated herself in front of Harper Avery, which she heard from Lexie. Since her other patient gorked before they could operate, she's free. Teddy is not sure they should do the ex vivo transplant, as it's only been done before on patient who were in much better shape. Cristina knows, but this is a hardcore procedure that might draw Harper Avery's attention. Teddy pretends she doesn't care about awards, but Cristina knows she does. As Teddy walks off, Lexie once again assures Cristina that she doesn't have feelings for Alex. Cristina doesn't care.

Jackson and Meredith are waiting outside Harper's room. Jackson sees that Harper is giving Richard and Derek his "wonders of medicine" speech, which he always said at the family dinner table.

Inside the room, Harper is trying to convince Richard and Derek to agree to his request to stay awake during the surgery. As Derek refuses, Richard says they can do it. Harper says he likes Richard's spirit and tells Derek to take note to how a Chief does things.

Outside the room, Derek tells Richard he can't sign off, as he is supposed to look out for Richard. Richard, however, really wants to, so Derek agrees to authorize the awake surgery.

Mark and a nurse leave a supply closet. Callie sees them and tells Mark he hasn't exactly made progress dealing with Sloan's departure. Callie asks him to come see her patient.

Callie and Mark join Derek and Alex in the CT booth. Mark aggressively throws Alex out. Callie explains to Derek that Mark is acting out because he can't deal with the real human emotions he's feeling. Derek doesn't like the fact that Mark is sleeping with nurses now, but Pam Nelson's scans come up as they start discussing Mark's behavior. Mark can tell by seeing the scans that Pam is deaf, because she has abnormal bone growth in the middle ear. He can remove it and restore her hearing.

Jackson, Meredith, and Richard are operating on Harper, who asks Meredith if she'd be studying at a less qualified hospital if her mother were still working here, to avoid the advantages of her legacy. Jackson and Richard quickly start talking about medicine so Meredith doesn't have to answer.

In the gallery, Lexie and Cristina wonder why Jackson and Meredith got to scrub in. Alex asks Lexie if she wants to "go grab a bite", but she claims she isn't hungry. Charles comes in and Cristina asks if he shouldn't be learning to be a surgeon somewhere, since he let her daredevil die. Charles says he didn't; he preserved the patient's heart function and now he's an organ donor. Cristina has an idea and leaves as Derek enters.

Down in the OR, the blood pressure drops as there's a bleeding. 

Callie and Mark inform Kathy that her mother doesn't have to be deaf. Mark can do the surgery right after Callie operates on the knee. Pam asks what's going on as sparks start to fly between Kathy and Mark. As Kathy informs her mother, Callie warns Mark not to sleep with her. Mark then has to explain things to Pam, who doesn't believe her daughter.

In the OR, Jackson thinks they should put Harper under, but Harper refuses that. Richard finds the bleeding and stops it, stabilizing the heart rate. Richard asks Bokhee for silk, but Harper tells him to use chromic. Jackson concludes his grandfather is fine.

Lexie was paged to an OR, where Cristina is all set up to perform an ex vivo transplant. Since her daredevil was a match and the transplant team rejected the lungs, she redirected the lungs to medical research. As Cristina gets Lexie up to speed about what they're going to do, Charles watches them from the hall.

Owen and Teddy end up charting near each other. After some small talk about their days, Owen invites her to dinner sometime. Owen runs off when he gets paged as Charles comes over to talk to Teddy. He says he understands that she likes Yang with all of her magical heart skills, but the lungs they're transplanting belonged to a patient of his and he'd like to turn the patient's death into something meaningful. Teddy interrupts him and asks what lungs.

In the OR, Teddy yells at Cristina for what she did. Besides all the money it costs, no one at this hospital has ever done an ex vivo transplant. Teddy realizes Cristina did all this for Harper Avery and says that Cristina's priorities are off. As they start discussing awards and their consequences, Lexie brings to their attention that the lungs are viable.

Teddy explains to Elliot and Jill how risky the ex vivo transplant would be. Jill doesn't want him to get hand-me-down lungs, but Elliot says he's tired of fighting. He wants to accept the lungs. Elliot asks Arizona if it's the best option, but since she's not his surgeon in this case, she directs him to Dr. Altman. She says it's his only shot. Jill doesn't like it, but she decides to support her brother in his decision to accept the lung. 

As Alex and Callie are just about done with their knee operation, Mark comes and starts yelling at Alex to leave. Callie tells him he's out of line, but Alex decides to go anyway. Callie tells Mark he's pathetic. She says Sloan and the baby being gone gives him two options: he can grown up and find a woman to love and get a baby, or he can be the ass attending who abuses residents and screws anything.

A bunch of residents, including Alex and Charles, are trying to convince Jackson to introduce them to his grandfather. Jackson send them all off and stays behind with Meredith. He tells her he hates it when people find out he's related to Harper Avery. Also, his grandfather is not an easy person to be related to. They then get a 911 page to his room.

They rush into his room, but turns out he only paged them because they didn't get to finish their talk. This time, he wants to know if she'd turn down a spot at the best hospital in the country or not. Jackson explains that his grandfather saved him a spot at Mass Gen. He was visiting Seattle to try to convince Jackson once again to take the job, but Jackson once again firmly refuses. Harper snaps that only he knows when he's said enough, and as Jackson's only living grandfather, he has something more to say. Today, he realized his time is coming. Suddenly, he goes into V-tech. 

Derek explains to Harper that the CT showed that there's a complication, so Richard has to take him back to the OR. Harper once again would like to stay awake as clearly, a mistake's been made, and he's not ready to let that happen again. However, this time, Derek says they're gonna do it by his rules: Harper will go under general anesthesia and Jackson will sit in the waiting room. If Harper refuses, Derek will declare him unable to make decisions regarding his own care. "That is how a Chief does things, take note," Derek says before leaving.

Richard follows Derek and asks him to let Bailey operate. What's happened, his possible mistake, makes him want to drink again instead of operating. Derek says that Bailey will only assist. Two months ago, Richard wouldn't have told him he wanted to drink: he just would've had one. He assures Richard that he can do it.

Mark understands how Kathy is feeling now that she no longer has to take care of her mother. Kathy says she's not gonna miss taking care of her mother, as she wasted years of her life doing so. Now, she can do anything: get her own place, and have men over. "I was taking care of you, you little tramp," Pam says as she wakes up. Also, she took Kathy in when she had no place to go after her divorce. Pam didn't need Kathy to take care of her, but Pam let her because that way, she was caring for her daughter. Pam and Kathy cheer as they realize Pam can hear. Kathy officially declares that she's moving out and they laugh.

Teddy is struggling to put the lungs inside Elliot's chest, because the tissue is falling apart. This is why she hates awards. It makes them more competitive instead of better. As Teddy continues trashing awards, Cristina suggests she could do an interposition vein graft. Teddy decides not to, but she could do a pericardial patch, using his pericardium to do the repair. If they hurry, they still have enough to save the lungs.

Jackson sits down in the waiting room, where Jill is waiting too.

In surgery, Richard and Bailey find out what caused Harper to go into shock. They explain to Meredith that Harper is allergic to the chromic suture. He didn't know himself, as he always wore gloves during his own surgeries. Richard can't help but smile. 

Teddy and Cristina finish up in the OR. They take Elliot off bypass and wait for the lungs to start working.

Teddy, Cristina, and Lexie inform Jill that Elliot will be fine. She's extremely relieved and they take her up to Elliot's room. Meredith comes over and tells Jackson that the shock was due to an allergic reaction to the suture. So, it was Harper's own fault, which Jackson kind of likes. Meredith understands how he feels, putting up walls and avoiding him. It was the same way with her mother. However, if her mother would be upstairs in a room right now, Meredith would want to go make things right. She definitely would want to learn from her mother. She points out Jackson can still do that.

Lexie finds Alex in the residents lounge and tells him she saved a life by suggesting an awesome experimental procedure. Alex ignores this and asks her if she told Sloan they were together. He doesn't want her to go tell her ex that they're together to make him jealous, but Lexie says she did no such thing. Alex doesn't believe her, but Lexie insists that for once in her life, she's doing something that's only for her. This is all about not feeling, so if he can't handle being used for sex, she'll go find a guy who can. He's all about not feeling and suggests they go not have feelings somewhere.

Teddy and Arizona watch Owen approach. Arizona tells her it's not a good thing to cancel plans with new friends, but Teddy promises she'll meet her in 15 minutes. Owen tells Teddy he heard about the transplant. Teddy says Cristina was amazing, but she doesn't want him to tell her. He asks if she wants to go grab a beer, but she rejects as she has a planned ladies night. She says goodbye and leaves. He smilingly stares after her.

Mark approaches Alex, who immediately says that Lexie is not his girlfriend. Mark interrupts him and says he will stop yelling at him. However, at that point, Lexie walks out of the on-call room Alex just left. Alex and Lexie have a guilty look on their face as Mark sighs and shakes his head.

As Richard is giving Harper post-op care, Harper asks him about his research. Richard says he put it on the shelf years ago as he got preoccupied. Harper tells him it put him on his award shortlist multiple times, so it might be time to dust it off. Jackson comes in and says he wants to introduce him to some friends. Cristina, Lexie, Charles, and Alex come in. Cristina is so happy to meet him and takes a selfie with her idol. The rest introduces themselves.

While playing mini basketball, Owen, Derek, and Mark talk about their days. Mark admits he slept with his patient's daughter just now, but he promised to never do it again. Richard appears, so Derek throws Owen and Mark out. They wish Richard a good night. Richard tells Derek that peeing in a cup was humiliating, so he overstepped by agreeing to the awake surgery, because he needed someting not to feel humiliating. Derek totally undertands. Tomorrow, there's another day, he says. Richard takes a mini basketball, and unlike the other guys earlier, manages to score.

The women have gathered on the baseball field. Arizona is not happy that she lost the vote, but everyone else is having fun. Bailey misses the ball. Cristina tells Meredith that she's in love with Teddy. Meredith says she's like Lexie with the inappropriate feelings for inappropriate people. "What can I say? My heart lives in my scalpel," Cristina says. This time, Bailey manages to hit the ball. Cristina says it'll feel amazing, but Teddy, stating she's a badass chick, knows what it feels like. Teddy shows off by hitting the ball, making it fly across the field. The others cheer.

Cast Edit

  • Meredith Grey
  • Cristina Yang
  • Alex Karev
  • Miranda Bailey
  • Richard Webber
  • Callie Torres
  • Mark Sloan
  • Lexie Grey
  • Owen Hunt
  • Arizona Robbins
  • Derek Shepherd
  • Teddy Altman
  • Pam Nelson
  • Harper Avery
  • Charles Percy
  • Jackson Avery
  • Elliott Meyer
  • Kathy Nelson
  • Jill Meyer
  • Hospital Lawyer Gary
  • Pharmaceutical Rep
  • Paramedic

Main CastEdit

Guest StarsEdit

Co-StarringEdit

Medical NotesEdit

Teddy's PatientEdit

  • Diagnosis:
  • Treatment:
    • Surgery

Cristina told Owen about a surgery she did with Teddy.

Daredevil PatientEdit

  • Diagnosis:
    • Closed head wound
    • Penetrating neck wound
    • Multiple blunt traumas
    • Seizure
  • Treatment:
    • Ativan
    • Organ harvest

A 41 year old came in after a motorcycle accident. He had a closed head wound, penetrating neck wound, and multiple blunt traumas. While they were taking him into the hospital, the gurney tipped on its side. He was taken into the ER. They went to take him into surgery, but he started bleeding out. He later had a seizure. However, they were able to preserve his heart function so that his organs could be donated.

Elliott MeyerEdit

  • Diagnosis:
    • Lymphoma
    • Pulmonary fibrosis
  • Treatment:
    • Ex-vivo lung transplant
    • Pericardial patch

Elliott was in the hospital waiting for a lung transplant. He'd had leukemia and lymphoma and when the lymphoma went into remission, he developed pulmonary fibrosis as a side effect of his treatment. He was considered very high-risk for a lung transplant. However, Lexie suggested a way to take discarded lungs and make them viable again. She and Cristina did it in secret, but Teddy agreed to transplant the lungs once they were deemed viable for transplant. Elliott's sister was reluctant to allow them to do the transplant with previously discarded lungs, but the transplant ultimately went forward. The transplant was difficult, but Teddy was able to complete the transplant by using a pericardial patch.

Harper AveryEdit

  • Diagnosis:
    • Bowel obstruction
    • Chromic allergy
  • Treatment:
    • Surgery

Dr. Avery came into the ER after passing out in a restaurant. He also had abdominal pain. They diagnosed an obstruction and took him into surgery, for which he requested to be awake. When they stitched him up, he insisted on chromic sutures. Later, he became unstable and had to be taken back into surgery. This reaction happened because he was allergic to chromic sutures. They repaired the damage and he was stable after the surgery.

Pam NelsonEdit

  • Diagnosis:
    • Hematoma
    • Rupture knee tendon
    • Otosclerosis
  • Treatment:
    • Knee surgery
    • Ear surgery

Pam was in a car accident. She was almost completely deaf, which she refused to acknowledge or treat. She had a ruptured tendon in her knee and a hematoma on her temporal area. They ran a head an face CT and Mark noticed that she had otosclerosis and said he could fix it. Mark operated after Callie operated to fix her knee. After surgery, she was awake and able to hear normally.

Music Edit

Song Performer Scene
"Trick Pony" Charlotte Gainsbourg
"Slippin'" Quadron
"You Can Keep 'Em" Ali Harter
"From the Woods!" James Vincent McMorrow
"Die Young" The Sweet Serenades
"Untitled No. 3" Ali Harter
"Diane" Mike Doughty

Notes and Trivia Edit

Grey's Anatomy 6x16 Promo00:32

Grey's Anatomy 6x16 Promo

  • This episode's title originated from the song Perfect Little Accident, originally sung by Saturday Morning Soundtrack.
  • This episode scored 11.83 million viewers.
  • Cristina misdiagnoses Harper Avery in front of Harper Avery and she believes this ruined the chances of her one day winning the Harper Avery Award. Four years later, she will be the first doctor of the hospital in Seattle to be nominated for the Award ever since Erica Hahn and Burke were.

Gallery Edit

Episode StillsEdit

Quotes Edit

Cristina: I'm in love with Teddy. I love her.
Meredith: You're like Lexie with the inappropriate feelings for inappropriate people.
Cristina: What can I say? My heart lives in my scalpel.

See AlsoEdit

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

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