S4 E13 Piece of My Heart

05/01/08 | TV-14 | CC

Dr. Addison Montgomery returns to discover things are a little different at Seattle Grace and yet some things never change.

We were totally jazzed to see Kate Walsh take a break from her Private Practice to make a triumphant return to Seattle Grace. Yes, Addison is back, even though she tells everyone she’s not. Her expertise is needed for a rare prenatal surgery. An unborn baby’s heart is growing outside of his body. Addison will deliver the baby while Erica works on the heart. Alex, Mark, Bailey and the Chief also pitch in.

The baby’s surgery is risky. Alex is angered by the optimistic parents, feeling they may be unprepared. His attitude worsens when Rebecca/Ava shows up announcing she’s pregnant. Izzie examines her in the clinic. The tests results show Rebecca’s not pregnant (Ava either). You think Izzie will tell Alex? Sometimes that whole doctor-patient confidentiality thing is really annoying.

Cristina cons Callie into convincing Erica she should assist on the fetal surgery. The baby is delivered. Alex takes him to Hahn while Addison stays behind to help Bailey stabilize the hemorrhaging mom. Erica tells Alex they could lose the baby if Addison doesn’t get there soon. Cristina jumps in to massage the newborn’s heart. When the baby stabilizes, Hahn still won’t acknowledge Cristina. She later tells her to stop seeking her approval. Think that’ll happen?

Baby day continues as Izzie informs a couple they are expecting. The news devastates them. The woman is HIV-positive and wants an abortion. Izzie tells them they can still have the baby. Dad is overjoyed but mom is furious. She just doesn’t want to take a chance on infecting the baby. A disheartened Izzie backs off.

George adds salt to Izzie’s wounds by breaking news that the interns don’t want to hang with her outside the hospital because she’s their boss. Izzie realizes she hasn’t been doing the boss thing to the best of her abilities. She grabs her interns and marches back to the HIV-positive woman’s room. Izzie makes a forceful, convincing argument by stating there’s a great chance the baby will be healthy if they take the proper precautions. The couple is overjoyed by this new information. We’re happy, too. It’s always nice to see Izzie step up her game.

Derek and Meredith begin their clinical trial with the tumor patient from the last episode (“Where the Wild Things Are”). Der warns Mer not to get her hopes up because what they’re doing is experimental. But it’s Derek who gets emotionally involved when he encourages his erratic/abusive patient to let his wife know that the reason he’s been trying to set her up with a new guy is because he doesn’t want to leave her alone. Sadly, the patient dies on the operating table. At least his wife’s last memory of him will now be a fond one.

Addison gets up to speed on some of the changes that have occurred since she’s been away. The laundry list of breakups includes Bailey and her husband as well as Callie and George. Addison wonders if Callie and Erica are a couple. This freaks Callie out. So much so that she goes home with McSteamy. Hey, there are worse ways to deal with a sudden bout of self-doubt!

The most surprising breakup, of course, is the Mer-Der debacle. Derek gets trapped in the elevator with Meredith, Addison and Rose at the same time. We were busting. Mark is highly amused, too. He taunts Derek by saying, “I bet you wish you’d taken the stairs right about now.” At Joe’s, Addison tells Meredith, “I want to kick your ass so badly right now.” At first we didn’t understand why but then Addison explains it’s for letting Derek get away.

Despite the Chief’s offer to hire her back, Addison leaves Seattle to return to her new life in Santa Monica. Yes, things change.

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