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These Ties That Bind

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These Ties That Bind
Season 5, episode 8
An old friend of Meredith is now an intern at Seattle Grace.
Episode Information

November 13, 2008

Written by

Stacy McKee

Directed by

Eric Stoltz

Episode Guide

Rise Up


In the Midnight Hour

It's intense, what happens in the O.R. when lives are on the line. And you're poking at brains like they're silly putty. You form a bond with the surgeons right next to you. An unbreakable, indescribable bond. It's intimate, being tied together like that. Whether you like it or not, whether you like them or not, you become family. The ties that binds us are sometimes impossible to explain. They connect us even after it seems like the ties should be broken. Some bonds defy distance and time and logic; Because some ties are simply... meant to be.

These Ties That Bind is the eighth episode of the fifth season and the 86th overall episode of Grey's Anatomy.

Short SummaryEdit

An old friend of Meredith by the name of Sadie appears and causes some tension with Cristina. Bailey attempts to woo a cardiothoracic surgeon Virginia Dixon, Callie breaks down crying. Izzie confides in a patient about Denny and Cristina become suspicious about some of the interns.

Full SummaryEdit

Izzie goes into her closet and pulls her knit sweater that she made for Denny. Cristina walks into Meredith's bedroom waking her and Derek up. She tells Meredith that Dr. Hahn is gone and Derek leaves the bedroom. He walks downstairs with a knock at the door. Sadie, a friend of Meredith ask if she's home and she runs upstairs calling her Death. They both are exciting at seeing each other, while Cristina is wondering who she is. Cristina is downstairs in the kitchen with Derek and telling him that she doesn't like getting kicked out of the bed. He said the feeling is the same being that Cristina did the same thing to him.

Meredith, Derek, Cristiana, Alex, and Sadie are walking towards the hospital where Izzie is standing outside the hospital. Alex wonders if she will be coming in and notices it's the same situation because of Denny. Izzie gets upset letting him know he doesn't know what is really going on. Alex leaves and she follows, when she enters the hospital she sees Denny again talking to her.

Cristina bumps into Lexie and sees that she had a few bandages on her arms and wants to know what is that. Lexie lies and says that it's because of her cat then switches and tells her that it is her hairbrush. Cristina sends her to plastic, because she doesn't want her acting weird that will endanger her getting the first solo surgery.

Alex tells Cristina if she knows who Dr. Virginia Dixon is and she is impressed with the name. He is on Dr. Dixon's service in doing a piggyback heart transplant and wants to know why she isn't on that case too.

Derek wants to know from Meredith where the names Death and Die come from and she doesn't tell. Cristina comes by to let her know that Lexie might be a secret cutter and leaves. He wants to know if Meredith will do anything about Lexie's problem to see if it really is true and that she can help her out if she is.

Cristina is waiting out in the ambulance bay with Owen. When Callie comes out, she wants to know why Dr. Hahn left and Callie just wants to be in an all-day surgery fixing bones. A guy name Mr. Miller comes out of the ambulance completely pretzels due to being crushed by the garbage truck. They bring him in and Owen asks Mark and Derek for consults.

Richard warns Miranda about Dr. Dixon's weird interactions and must woo her in order for the hospital to be in good standing. Izzie comes in and is continuing to see Denny and Alex ask her is she is okay. Richard lets them know that Dr. Dixon is here. She talks and leaves; Miranda agrees that she is a little off.

The doctors are trying to unpretzel Mr. Miller and suddenly he wakes up and screams. He tells the doctors to don't touch him and Owen orders everyone to let go. Owen talks to Mr. Miller and he wants to make sure the doctors do everything to save his leg.

Clay, the person for the piggyback heart transplant tells Izzie that he has been seeing hitchhikers all the time due to the heart that he was given before. Denny is there as well and continues to talk to her. Clay then says he doesn't want another heart.

Lexie and a group of interns are doing procedures on each other. George walks in and needs someone doing labs and Lexie kicks him out, he leaves.

Mr. Miller tells the doctors that he is homeless and wants them to save his legs because he needs to walk. Mark tells him that his conditions are critical and needs to get him to surgery. The doctors can't give him an answer about his legs so he refused the surgery because all he cares is about his legs.

Miranda tells Clay some solutions about the surgery and Dr. Dixon tells them no because there are rules and walks off.

Derek and Mark lets Owen know that they do not leave a patient to die and if he wants to do that he should go back to the desert. Callie comes up with solutions to save his leg by giving him a new set of legs like something similar to lincoln logs. She orders everyone to get lots of titanium that is in the hospital.

Miranda wants Richard to declare a rule that the hospital must respect all spiritual beliefs of the patients but it is common courtesy. She lets him know that Dr. Dixon doesn't do common courtesy and Richard says out loud that it is a rule and she leaves.

Cristina introduces herself to Dr. Dixon but she doesn't want to talk to her. She goes to see Callie and wants to know why Dr. Hahn left, and Callie lets her know that she was her girlfriend. Mark lets her know that she is okay and to leave her alone.

Meredith brings in a cart of titanium while she talks to Lexie about her secret cutting. She lets her know that she is not cutting herself. Mark calls for Lexie if she wants to watch Callie's procedure and she says yes. He informs that she will call Lexie, Little Grey and Meredith, Big Grey in order to tell them apart.

Owen has a brief conversation with Mr. Miller.

Lexie tells the interns to stop doing procedures on each other because people are getting suspicious. Sadie tells her to wear long sleeves. She offers herself and cuts the back of her shoulder, while Lexie looks worried.

Derek still wants to know where the name Death and Die comes from. Meredith doesn't answer and tells him to tell Mark to stop hitting on Lexie.

Mark wants to know if Dr. Hahn said goodbye to Callie. Callie said no and that she is still okay and walks off.

Clay tells Izzie that it is a 9-day ritual to stop hauntings. She lets him know that if hauntings can go away and he asks for Izzie to not be in the surgery because he doesn't want extra ghosts with him.

Derek comes in and talks to Mr. Miller to ascertain if he is suicidal or not. Mr. Miller tells them he is a fighter. Derek and Owen convince him that they will help him after his surgery.

Dr. Dixon is operating on Clay. Miranda tells Dr. Dixon that there is rule that Clay will be allowed to keep his old heart and she says okay while continuing on operating on him. Izzie is up at the gallery carrying on a conversation with Denny. She tells him that he is hurting her all the time and notices that she might be sick because he is not real. When Dr. Dixon takes out the donor heart, his own heart begins beating with everyone's shock.

Owen, Derek, Mark, Meredith, Callie, and Lexie are operating on Mr. Miller. Mark praises Lexie's work.

Clay's doctors tell him that he won't be needed an L-Vad wire because he now has his heart. Clay tells himself that he is not haunted anymore.

Mark praises Lexie's work again and Richard thanks Cristina for her teaching. He lets her know that if she continues this kind of teaching, the first solo surgery could be hers.

At the O.R. table, Mr. Miller died on the table and Owen calls time of death. Callie cries and Owen orders everyone else to clear out the O.R. while Mark stays.

Miranda and Dr. Dixon are in the elevator and tells her that she like the heart because it has rules and it is comforting. She tells her she has Asperger's syndrome. She walks out and tells Miranda she doesn't like Seattle Grace Hospital.

Derek tells Mark for Little Mark to stay away from Little Grey and he says that is inaccurate and he is Big Mark.

Izzie tells Denny that she is ready to let go and says goodbye him.

Cristina goes to the interns and tells them not to practice on themselves and must shut it down now.

Alex sees Izzie in the closet holding Denny's sweater and to have him help her. She asks Alex to burn the sweater for her.

Callie, Mark and Cristina are at Joe's bar.

Meredith and Derek are reading in bed and he wants her to tell the story about Sadie. She agrees.

Cristina catches up with Owen and he gets a bit antsy but then grabs in and kisses her.

Alex is burning the sweater at the fireplace while Izzie goes to her bedroom and still sees Denny. She tells him he is not real and Denny asks for her to touch him. She touches her heart and he assures her that he is real. She cries happily and kisses Denny.


  • Meredith Grey
  • Cristina Yang
  • Izzie Stevens
  • Alex Karev
  • George O'Malley
  • Miranda Bailey
  • Richard Webber
  • Callie Torres
  • Mark Sloan
  • Lexie Grey
  • Derek Shepherd
  • Denny Duquette
  • Owen Hunt
  • Sadie Harris
  • Clay Bedonie
  • Timothy Miller
  • Ryan Spalding
  • Virginia Dixon
  • Intern Graciella
  • Intern Steve
  • Intern Leo Byrider
  • Jill the Paramedic

Main CastEdit

Special Guest StarEdit

Guest StarsEdit


Medical NotesEdit

Clay BedonieEdit

  • Diagnosis:
  • Treatment:
    • Surgery

Clay was in the hospital for a heterotopic heart transplant. He'd had a transplant six years prior, but that heart needed to be replaced again. However, Clay believed he was haunted by his first heart and said he didn't want the surgery. In surgery, they removed the previously piggybacked heart and were shocked when his heart started beating on its own. They believed the six years of rest provided by the other heart gave his own heart time to repair itself.

Timothy MillerEdit

  • Diagnosis:
    • Crush injuries
    • Open fractures
    • Open femur fracture
    • Posterior hip dislocation
  • Treatment:
    • Surgery

Timothy came into the ER after being crushed in a garbage truck. He was impaled upon himself due to his open femur fracture. Since they couldn't proceed without freeing his leg, they did that first, which caused him to wake up. Callie didn't believe his leg could be saved, but when he insisted that he needed it, Callie developed a plan to replace his bones with titanium rods. He agreed to the surgery and they took him in, but they were unable to keep him alive long enough for Callie to replace his leg bones and he was pronounced dead in the OR.


Song Performer Scene
"The Uniform" The Flying Tourbillon Orchestra
"Ah, Ah, Ah" The Coral Sea
"It's a Funny Thing" Jets Overhead
"Falling for You" Seabird
"Trouble is a Friend" Lenka
  • Callie, Mark, and Cristina at Joe's
  • Cristina and Owen kiss outside the bar

Notes and TriviaEdit



  • This episode's title originated from the song These Ties That Bind, originally sung by RJ Cowdery.
  • This episode scored 15.59 million viewers.


Episode StillsEdit

Behind the ScenesEdit


Izzie: I said goodbye. I burned the sweater!
Denny: Yeah, thanks for that, by the way. I loved that sweater. You made me that sweater. Izzie... stop freaking out.
Izzie: You're not real. You're not real.
Denny: Hey, I told you.
Izzie: You're not real! You're not real! You're not real!
Denny: Look at me. Touch me. (Izzie touches Denny's chest) See? Told you I was real.

See AlsoEdit

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

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