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Something's Gotta Give

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The human body is a highly pressurized system. The blood pressure measures the force of blood, pulsating through the arteries. It's important to keep this pressure regulated. Low or inadequate pressure can cause weakness or failure. It's when the pressure gets too high... that problems really occur. If the pressure continues to increase, a closer examination is called for... Because it's the best indicator that something is going terribly wrong. Every pressurized system needs a relief valve. There has to be a way to reduce the stress, the tension, before it becomes too much to bear. There has to be a way to find relief, because if the pressure doesn't find a way out... it'll make one. It will explode. It's the pressure we put on ourselves... that's the hardest to bear. The pressure to be better than we are. The pressure to be better than we think we can be. It never ever lets up. It just builds and builds and builds.

Something's Gotta Give is the eighth episode of the seventh season and the 134th overall episode of Grey's Anatomy.

Short SummaryEdit

Top security measures go into place as a team of doctors, led by the Chief, try to save the life of a major political figure from the Middle East. Meanwhile, Cristina decides to finally decorate her new place and throw a housewarming party, and Alex shows up late from a weekend getaway to his first day of rounds with the new Pediatrics Attending, Dr. Robert Stark.

Full SummaryEdit

Cristina is sitting on the floor in her new house, surrounded by boxes.

Alex is swearing next to his smoking car, 48 miles out of Seattle.

Teddy is giving a presentation in the lecture room about Roy's case. In the audience, Jackson is worried that nobody wants to work with him anymore. He's not on anybody's service. April says it must be an oversight. Jackson says he's screwed up a lot lately. Meredith's done with his whining and tells him to just ask around and get on someone's service. A smelly Alex joins them and they wonder where he's been this weekend, but he says what happened in Vegas. He's on Stark's service with April. Stark is the new peds guy. Teddy brings up Cristina. A doctor in the audience has some questions about her choices, and wonders why she's not here. Teddy says she quit the program. Mark is surprised and stands up to discuss that. Richard gets a call and leaves the room. Derek asks why Teddy decided to leave Cristina in charge of a critical patient. Mark turns to Meredith to find out what Cristina said exactly. Meredith says they haven't spoken about it and points everyone back to Teddy. Mark decides to call Callie. Derek again asks Teddy why she put Cristina under such pressure. Teddy says Roy was stable when she left and she could not have foreseen the complications. She wonders if this is a patient presentation or a postmortem on Dr. Yang.

Callie lies down on the bed in a messy hotel room. Her phone rings. She picks up once she finds it and greets Mark. She claims she was on her way out. "She what?!" Callie says.

Owen doesn't know what came over Derek. Teddy asks how Cristina is doing. Owen says it's like nothing's changed, except that she goes blank whenever he brings up work. Richard comes over and asks the two of them to meet him in the VIP wing for an emergent patient. He tells Owen he has to send a letter to the American Board of Surgery to let them know that Cristina has left the program. He asks if there's any reason why he should hold off on that. Teddy asks for a little more time. He says okay.

Jackson is still looking for an attending to work with. He asks April who she's with. She replies Karev, then corrects herself. Jackson and Lexie warn her not to go there. Alex is not the guy for her. Lexie walks off and Jackson looks after her. He decides to go find Bailey as he hasn't blown things with her yet.

Callie has entered Cristina's house and finds Cristina dancing around. She has trouble getting Cristina's attention as Cristina can't hear her through the music. Cristina finally spots her and wonders what she's doing here. Callie says she's not going back to work until next week. She heard from Mark that Cristina quit. Cristina puts her earphones back in and starts dancing again. Cristina says she was unpacking, but she didn't enjoy it. She asks what Callie's doing now that she's free. Callie says she was thinking about getting a haircut as a radical change. While Callie rambles about that maybe not being a good idea, Cristina cuts a chunk of her hair. "Let's make lemonade," she says.

While Alex and April are checking on a kid, the kid's roommate keeps shooting Alex with little balls from a toy gun. Alex yells at the kid to knock it off. At that time, Stark comes in. He says Alex missed rouns this morning and now he finds him yelling at his patients. Alex says he's feeling very sick today. Stark checks him with a thermometer and says hangovers are not contagious, so he says Alex will work today. He asks Alex to prep his baby patient for the liver transplant. After being hit by another ball, Alex takes the gun away.

Richard, Teddy, and Owen arrive at the VIP wing. They're greeted by Ronald Dace from the State Department, who asks them to limit the wing to essential personnel only because no one can know this man was hospitalized, or that he's in the country. The see the patient on a gurney, surrounded by security guards, one of whom is speaking Arabic on the phone. As Owen and Teddy shock the Emir with paddles, Ronald says it would be great from a global perspective if the man didn't die.

As Owen's shocking the man again in his room, Teddy finds all of the man's records are in Arabic. Donald tells her and Richard that the Emir's car was hit when he was leaving the meeting. Richard asks what he's doing in Seattle. Donald says he wasn't. Teddy knows the Emir's people are supposed to see their first election, but if he dies, Al Qaida will move and their secret meeting will have been for nothing. Donald knows about Teddy's work in the army. Donald says the best outcome here is if they stabilize the Emir and put him on a plane home. Teddy says the best outcome actually is saving the man.

In the Emir's room, Aasif tells the doctors about the pills the Emir's on. He was also hospitalized last year because he was overworked. He says the Emir is everything to him, so he begs them to save him. Teddy promises to do everything they can. Emir goes into V-fib and they shock him again.

Alex and April are talking to the baby's parents, who insist they call the baby by her name, Lisa, as they read it helps the surgeons bond with the patient. The father asks if Stark will split the liver in situ, as they read that that gives better results than ex vivo. April says they'll find out for them.

Alex walks up to Stark and asks him to come talk to the parents, but Stark wants to go check on the harvest team. He says the parents have spent too much time consulting Dr. Internet and asks Alex to just hold their hand and tell them Stark's busy getting their baby a liver. Alex says the baby's name is Lisa.

Bailey is brushing off Jackson as she can't use him today. She's stopped by a security guard at the door to the VIP wing. She says Chief Webber paged her in there. She asks who's in there. Jackson is curious, too. Richard comes out and asks Bailey to take his patients today as he's busy. He asks her to specifically keep an eye out for Louise Cortez, who was readmitted after surgery for chronic pancreatitis. Her CT showed a pancreatic fistula. As Richard goes back inside, Bailey tells Jackson she can use him now.

Derek tells Lexie he can't use her today as the craniotomy was rescheduled. He closes the door on her and goes back to kissing his wife. He says they have to make time for this. Meredith feels like she has to call Cristina, but Derek says she did nothing wrong, despite what Cristina says. There's another knock on the door. It's a security guard looking for Meredith. Derek closes the door and asks Meredith what she did.

Cristina is cutting Callie's hair. Callie is curious to see the result. Callie says she needs to throw a housewarming party so she has some pressure to get this place ready. Cristina likes that idea and goes to grab her phone to text everyone to invite them over tonight. Callie has taken a mirror and is shocked to see her hair. She says she looks injured and wonders if Cristina's ever even cut hair. Cristina says she can't believe Callie let her do that. She says they'll go to the mall to fix it.

Owen shocks the Emir again. They need to take him to the cath lab. Teddy's going to insert a pacemaker and asks Meredith, who just arrived, for a pacemaker kit. Teddy gets the text from Cristina and tells Owen that that's a good sign. Teddy says it's an opportunity for them to talk to her as she can't leave her own party. Donald urges the doctors to do a little less party planning. Meredith says Cristina doesn't need to talk to Meredith. She needs to give Cristina some space. Owen says they don't have the time as she'll be locked out of the program forever. He doesn't think that's what Cristina really wants. He asks if Meredith thinks so, too.

Bailey is in Louise's room and explains to her what a fistula is. They've put in a drain to drain the fluid that's leaking from her pancreas because of it. Jackson informs Bailey that the OR is ready for her. Bailey tells Louise they'll get her back home in no time.

Outside the room, Bailey tells Jackson he can't scrub in with her now because he has to monitor the fluid. If it changes or color, or if Louise's temperature changes one digit, he has to page her because it could mean a serious complication. She goes to her OR.

In the OR, Stark finds there is not enough room in the peritoneal cavity for the liver. The monitor beeps and Stark uses a sponge to take pressure of the vessels. Stark says they're done and explains to Alex and April that they can't close up the baby. They'll just have to wait for the swelling to go down, which happens regularly when adult livers are used. He leaves the OR and Alex and April doubt if it'll work. It'll take forever for the liver to shrink if it does at all, and there's the risk of infection. They agree it's not a solution.

At the mall, Cristina and Callie are in a furniture store. Callie finds it weird that Cristina is not talking to Meredith, but soon diverts to Arizona. She says she was cooler when she was single. Cristina points out she was hardly ever single. Callie laughs. She's excited to spend time on her own. A store employee comes over and Cristina orders an entire room.

Stark tells Lisa's parents that everything's looking good. He says they'll let them know when they can see her, which will be when the swelling comes down. The parents thank Stark and he walks off.

Alex and April follow him, not believing that that's all he's gonna tell them. Stark says he doesn't want to make them more worried than they already are. Alex blurts out he thinks Stark is not worried enough. Stark asks him for a better solution, but Alex can't give him one. Stark tells him to go do his post-ops.

In the cafeteria over lunch, Alex keeps shooting the other residents with the toy gun. Jackson is complaining to April about Bailey hating him now, too. Lexie has been enjoying her easy day. Meredith comes over, followed by a security guard. Lexie asks if she's going to Cristina's tonight, but Meredith doesn't know yet. Alex takes one of the balls from the toy gun and runs off. The security guard scrapes his throat to inform Meredith it's time to go back. As they're walking off, Lexie hits his back with a ball.

Teddy and Owen are talking to the group of people who came in with the Emir. They stabilized the Emir with a balloon pump, but Teddy will have to perform open-heart surgery to repair a tear. The Arabic people want the best doctors in the country. Donald suggest they take the Emir back to their country, then. Teddy understands all of their concerns, but they all want to see the Emir live. Teddy says they're out of time, which means they're out of options. She's all they got, but if they knew her better, they'd be pretty glad. They are going to operate and they'll keep them updated. As they leave, Aasif stops Meredith and tells her she can't let them operate. He whispers the reason into her ear.

Derek has joined the Emir's medical team. Aasif tells them the Emir was diagnosed with an aneurysm in his left temporal lobe. The Emir's pupil's blown, so they took a scan to see if it ruptured. Aasif swore he wouldn't tell anyone until after the election and he's still not sure he should've told it now. Meredith says he was trying to save the Emir's life. Aasif says the Emir is trying to save 7 million lives, because the elections will prevent them from living a life filled with fear for extremists. The Emir risks his life every time he sets foot out of his door. Meredith says the Emir will understand Aasif was just trying to protect him.

The scans are up, and they reveal the aneurysm has ruptured. Derek is not surprised, given the fact that Teddy shocked him 7 times and gave him blood thinners. Teddy says she could not have seen this coming. Derek says she's been saying that a lot today. They're gonna have to work simultaneously to save the Emir.

Derek and Meredith are scrubbing in. Meredith tells him they're all going to Cristina's party to talk to her. She asks him to come as he quitted once and then came back. He refuses to and tells Owen and Teddy it's a bad idea as they walk in.

April finds Alex sterilizing a ball from the gun. Stark comes in, too. He says he has found a solution for Lisa's liver. The ping pong ball has the perfect shape to keep the liver from pressing on the vessels. It's made out of celluloid so it won't break down like a sponge and there's little risk of infection. Stark says he left Alex to do his post-ops and now he's playing with balls. He contemplates going to Richard to talk about him. He leaves.

Callie's in the hairdresser's chair. She wants something dangerous and unpredictable. A waiting Cristina is eating frozen yoghurt and observing people. Mall people are so relaxed, she finds. She leaves to get a pretzel.

Bailey finds Jackson and asks her how their patient is. Jackson says there's no change. She leaves for her next surgery and he's disappointed he can't scrub in. 

In surgery, Owen informs Derek that time has now become a factor in getting Cristina back. Derek still says an intervention is not a good idea. Teddy says it's not intervention. The patient goes into V-fib. They have to shock him, but Derek is not done yet. He clears after a couple of seconds and they shock him, which returns the sinus rhythm.

Alex has some questions about Stark's charts, but a nurse informs him that Stark went back into surgery with Lisa.

Alex enters the OR gallery and finds Stark operating with Richard and April. Stark is using the ping pong ball and Richard is enthusiastic about it. April asks Stark whose idea it was originally. Stark says they'll wait to see if it works first, but Richard seems to get what's happened.

Jackson walks into Louise's room, only to find her delirious. He thinks she's in shock. He then sees the fluid has changed color. He asks a nurse to call Bailey now.

Bailey's on the phone with Jackson. She tells him she's almost done with her surgery. He can go ahead and take her to an OR to open her up already.

Jackson is waiting for Bailey, but there's no word from her. He asks for a 10-blade and starts to cut.

Teddy says a bypass would work better, but that would prevent Derek from working. He needs them to stop working. Teddy can't do anything as she's trying to do a coronary graft on a hemorrhaging heart. Derek tells her to work faster. Teddy is done with his criticism. This is not her fault. She tried everything she could for Cristina. She wanted to help her student. Derek says they all failed and now it's time to back off. Owen says he won't give up on Cristina. Meredith says they all have the same goal. Derek finishes up. He apologizes. He has a personal stake in this. He wouldn't be standing here if it weren't for Cristina. Meredith says they can't do nothing.

Bailey rushes to Louise's OR, only to find Jackson calling time of death. He says this is not his fault as pancreatic fistulas always happen. He did not screw this up and he did his best. Bailey asks him to step out of her OR.

In the now-furnitured firehouse, Cristina is drinking while Callie's finishing up everything for the party. Derek arrives. He's too early for the party. He's not here to tell Cristina to come back, but he says a bunch of people are coming to do that.

April finds Alex in an on-call room and says Stark was horrible, trying to take all the credit. Lisa is doing fine. April wants to go talk to Richard, because it's unfair. Alex did everything right all day and Richard should know that. He doesn't deserve this. April wanted him to know that she knows that. He leans in and kisses her. He takes off her scrub top. She brings up this is her first time, but she doesn't want to stop. They proceed, but she asks him to go a little slower. He says they can screw if she wants to, but she won't hold her virgin hand and walk her through it. He can't take care of everybody. He storms out of the room.

Teddy finds the Emir's room all cleared out. Donald appears and says the Emir's being transported across the country, but he promises he's well taken care of. Donald says she did a great job. He hung around to thank her. It was nice meeting her. They shake hands. She'd say the same, but he was never here. He smiles and walks off.

The party at Cristina's house has begun. Jackson's drinking in the kitchen. Mark welcomes Meredith, Teddy, and Owen, and then hands the hosting duties over to Owen since he actually lives here. Mark hasn't seen Cristina, but he goes to ask Callie if she knows where Cristina is. Callie is drunk and asks Mark if she can move in with him until she can get the subletter out of her place so she can start over. They can be single together. He consents and compliments her hair.

April arrives at the party and apologizes to Owen for not bringing a gift. She starts crying and Jackson takes her to quiet place to talk. Owen shouts to ask if anyone's seen Cristina.

Up on the roof, Derek and Cristina are drinking. Derek advises her to keep the original oak floors. She has no other choice because the building's historic. He, on the other hand, is building a house from scratch, so he can choose floors he actually likes.

Alex looks on as Lisa's parents are watching their baby girl.

Bailey tells Richard she did everything she could. Richard says there's nothing she or Avery could have done. Bailey wonders why there are so many fistulas after pancreatic surgeries, even if your surgery went flawless. Fistulas appear in 20% of patients. She wants to find a way to bring that number down. After a string of losses, she could use a win. Yang was the one she didn't have to worry about. He knows. He tells her to look into it and let him know how he can help. Bailey asks if she can have Avery, because he was great today. Richard tells Bailey about Alex's save today.

Alex arrives at the party and sees April talking to Jackson. Jackson angrily walks up to him. Alex asks to let him talk to April, but Jackson punches him in the face repeatedly. Owen and Mark pull Jackson off Alex and Callie and Meredith stop Alex from attacking Jackson by taking him outside.

Lexie is putting ice on Jackson's hand in the kitchen. He wonders if it was hard for Cristina to quit. Lexie says Jackson won't quit. He says April's the only friend he's got left here. Lexie tells him not to be stupid.

Outside, Meredith's putting on Alex's face. She wonders why he did what he did with April, knowing she's a virgin. Meredith says he should've gone back to Vegas if he was just after sex. He says he wasn't in Vegas. He was in Iowa. He went home. His brother Aaron got diagnosed schizophrenic, like their mother. They figured that out when he tried to kill their sister Amber, who's only 16 years old. Their mother didn't do anything because she was off her meds. So, he had to go to Iowa for Aaron's commitment hearing. Meredith says it's good that he was there. He says he wasn't really there. He shortly visited his sister in the hospital, shoved some pills down his mother's throat, and signed his brother into a nut house and got out as soon as he could. He's the ass who can't stand to be there.

Up on the roof, Cristina says she has to go down to the party. Derek says he should go. He asks her if she's good, or if she wants to talk about something else. She asks what they're doing for bathroom tiles in their house. They sit back down as he starts talking.

CastEdit

  • Meredith Grey
  • Cristina Yang
  • Alex Karev
  • Miranda Bailey
  • Richard Webber
  • Callie Torres
  • Mark Sloan
  • Lexie Grey
  • Owen Hunt
  • Teddy Altman
  • April Kepner
  • Jackson Avery
  • Derek Shepherd
  • Robert Stark
  • Ronald Dace
  • Aasif
  • Louise Cortez
  • Arab Translator
  • ND Doctor (front)
  • Diplomatic Security Guard
  • Leanne Collis
  • Martin Collis
  • Emir's Aid 1
  • Aide
  • Sales Clerk
  • Emir's Chief of Staff
  • Callie Torres and Hairstylist
  • VIP Nurse Ruth (center)
  • Peds Nurse Carol
  • Secret Service Agent
  • Boy

Main CastEdit

Guest StarsEdit

Co-StarringEdit

Medical NotesEdit

KidEdit

  • Diagnosis:
  • Doctors:
  • Treatment:

Alex took the temperature of a kid. He was afebrile.

Lisa CollisEdit

  • Diagnosis:
    • Biliary atresia
  • Treatment:
    • Liver transplant

A liver became available for Lisa Collis, an infant. Because the donor was an adult, the liver was split between Lisa and another patient. When Stark went to implant the liver, it didn't fit into her abdomen and was compressing her hepatic artery. Stark put a sponge in to relieve the pressure and wrapped her abdomen. The hope was that the swelling would go down and they'd be able to fit the rest of her liver inside her body. However, a sponge was not an ideal solution as it would start to break down, possibly leading to liver death. Alex had the idea to use a ping-pong ball instead of a sponge, as it wouldn't break down and it could be left in her body, as her liver would just grow around it. Stark initially rejected Alex's idea and chastised him for thinking of that rather than doing Stark's post-ops. However, Stark took Lisa back into surgery and placed the ping-pong ball.

The EmirEdit

  • Diagnosis:
    • Coronary artery dissection
    • Cerebral aneurysm
  • Treatment:
    • Balloon pump
    • Surgery

The Emir was in a car accident after leaving a meeting. As no one was supposed to know that he was in the country, he was kept in the VIP treatment area of the hospital, isolated from other patients and non-essential doctors. Aasif gave the doctors his medical history as they worked as his medical records were all in Arabic. The Emir had a tear in his coronary artery and Teddy had to do open-heart surgery to fix it. When Aasif told Meredith that the Emir had been diagnosed with an unruptured cerebral aneurysm in his left temporal lobe, Derek was called in. By then, he had a blown pupil. Scans revealed that his aneurysm had blown and his brain was bleeding. He was taken into surgery so Teddy could fix his heart and Derek could fix his brain. When Teddy went to check on him after his surgery, she found that he'd already been put on a plane back home.

Louise CortezEdit

  • Diagnosis:
    • Chronic pancreatitis
    • Pancreatic fistula
    • Ruptured splenic artery
  • Treatment:
    • Drain
    • Surgery

Mrs. Cortez was re-admitted to the hospital after having surgery on her pancreas. She was discovered to have a pancreatic fistula. Richard inserted a drain to remove the pancreatic fluid. She had a minor fever, so Jackson was assigned to watch her very closely. When she became unstable, Jackson was told to take her into an OR and open her back up. By the time Bailey arrived to help, Jackson was calling time of death.

Aaron KarevEdit

  • Diagnosis:
    • Schizophrenia
  • Doctors:
  • Treatment:

Alex mentioned that his brother, Aaron, had been diagnosed with schizophrenia like their mother has. He tried to kill their younger sister with a knife. Alex had to go to a hearing to have his brother committed.

MusicEdit

Song Performer Scene
"Gone Man" Eels
"Dead Disco" Metric
"Dreamer" K'naan
"Shouldn't Have Loved" Azure Ray
"Could It Be" Mackintosh Braun
"Sing Me To Sleep" Fran Healy feat. Neko Case

Notes and TriviaEdit

Grey's Anatomy 700:32

Grey's Anatomy 7.08 Something's Gotta Give - Trailer

  • This episode's title originated from the song Something's Gotta Give, originally sung by Sammy Davis, Jr..
  • This episode scored 11.13 million viewers.
  • This is the first episode not to feature Jessica Capshaw since she was made a series regular at the start of Season 6.
  • This episode marks Nurse Carol's first appearance.

GalleryEdit

Episode StillsEdit

Behind the ScenesEdit

QuotesEdit

Meredith: (to Alex) You smell like you're sweating booze, where have you been?
Jackson: I want the weekend you had.
Alex: Well, what happens in Vegas, you know? Hey, who's Stark? I'm supposed to be on Stark's service today.
April: Oh, me, too. He's the new peds attending. Since Robbins left.
Alex: Crap. I can't handle a bunch of sick kids today, I can't do it.

April: (about Jackson) He thinks no one wants to work with him.
Lexie: Are they saying that or are you saying that?
Jackson: (to April) Who are you with again?
April: Karev. Uh... I mean, Stark.
Jackson: No, you meant Karev. And, you don't wanna go there.
April: You don't know where I'm going.
Lexie: He's right. You don't wanna go there.
April: I'm.. I'm not going anywhere.
Lexie: He's not the guy for you, okay? Trust me. And don't be paranoid, trust me on that, too.
(walks off; Jackson watches her go)
April: Ooh, but it's okay for you to go there.
Jackson: I'm a guy. I live there.

Robert Stark: (to Alex) So, you must be Dr. Karev. You missed my rounds today.
Alex: Uh, sorry. I had car trouble.
Robert Stark: Ah, well, there's a classic. So, what you're here just kinda yell at my patients and...
Alex: I'm sorry. Look, uh, Dr. Stark, I'm feeling very sick today so I think that since you know, you have Kepner...
Robert Stark: Well, let's see here. No fever, you don't seem to be vomiting, you retaining control of your bowels?
April: Ew.
Alex: Yes.
Robert Stark: Well, since hangovers are not contagious, I'd say you're working.

Meredith: The last thing that Cristina wants is to talk to me. We just have to give her some space.
Owen: We don't have time to give her space. She'll be locked out of this program, and I do not believe that is what she wants. I mean, you think that's what she wants? (Meredith is silent) I'm asking you, Grey.

Miranda: I could use a win, that's all. Yang. Yang was the one I didn't have to worry about.
Richard: I know. I know.

(Cristina impulsively cuts off part of Callie's hair. Callie takes a mirror.)
Callie: Look at my hair!
Cristina: Yeah, I sorta can't believe you let me do that.
Callie: Cristina!
Cristina: That's okay. We'll go to the mall. You might want a hat.

See AlsoEdit

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

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