Grey's Anatomy

Season 4 Episode 1

A Change Is Gonna Come

Aired Thursday 8:00 PM Sep 27, 2007 on ABC
out of 10
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Episode Summary

Entering their first year as residents, Meredith Grey, Cristina Yang, Izzie Stevens and Alex Karev now have interns of their own to mentor. The interns are welcomed by new chief resident Callie. Among the new interns are George, forced to repeat his internship after failing his exams, and Lexie Grey, Meredith's half-sister. Many new interns will be introduced in this season premiere. And they'll have their hands full when a three-car accident sends multiple casualties pouring into Seattle Grace. Some of the doctors need to deal with their new stressed out interns. A young boy brings his bleeding deer to the hospital in the hope a doctor will save her. Cristina searches for Burke. Richard resumes his post as chief of surgery. Derek and Meredith reach an impasse. Bailey wrestles with things at the hospital not turning out like she thought they would.moreless

Who was the Episode MVP ?

  • What was that?

    Last night the S4 premiere of Grey's aired here, and one word would describe what I felt about this episode: disappointment. Frustration would also sum it up for me. If you compare this episode to one from S2 or S1 then you'll see just how crappy it was. Aargh, I can't vent how much I hated this episode! Just to rant here is a short list of the characters that annoyed me the most:

    1. Lexie: Me, me, me, me, me. Okay, we get it, your Meredith's sister, but did you have to bombard her with this information as she was trying to get a critical patient into the ER? Oh yes you had to didn't you? I can tell you are going to annoy me so much. :(

    2. George: Get over yourself, your pathetic lovelife and just freakin' do your job. Stop complaining that you have to repeat your intern year and deal with it, it happens, and perhaps you should've concentrated more on studying than Izzie or Callie, or choosing between Izzie and Callie. :roll:

    3. Izzie: Where to begin? You need to get over this disgusting obsession with George and concentrate on getting your interns to pay you some respect, and your hardly going to achieve that by treating a deer, what a ridiculous storyline. :roll:

    However, it wasn't all bad IMO. I loved, loved, loved Bailey and Cristina in this episode. I loved how Bailey kind of took a stand to Callie by showing her weaknesses and also siding with Alex. Cristina is definitely the new Nazi, bravo to her, I enjoyed her authority over Lexie and setting her straight. Bravo to Sandra Oh for that performance too!

    The absences of Addison and Burke are felt terribly in this episode, I am really going to miss my Addie, but not to worry, I shall be watching Private Practice when it airs here.

    Oh, and what a terrible ending...moreless
  • A new set of interns arrives at Seattle Grace Hospital.

    This episode proved that this show plans on growing bigger as the years pass.

    Bailey's "Residents" give HER SPEECH to their interns, which includes Meredith's step sister Lexie. George starts the first day of his internship, again. Lexie introduces herself to Meredith and then runs into Dr. Shepherd (the guy in the bar). A dead guy breathes and has to have surgery. The only thing holding his head on his shoulders is skin. His wife and two children come to see him before surgery. One Blink is yes, two is no, and three blinks means I Love You. His daughter leans over so he can see her and blinks three times. Izzy saves the life of a deer for a little boy. Meredith and Derek break up. Then kiss and have break up sex. George tells Izzy he loves her.moreless
  • This season premiere was good, we get to see changes (nwe people, looks, relationships), still is not good enough. Grey's Anatomy is getting further and further from the previous seasons (and that's no good)moreless

    I am from Latin America and I waited exactly 5 months to watch this episode. It was good, but not good enough, and this series is in a rut (if we are taking into consideration the last episodes of season 3, that were worse than the rest of the series).

    This rewiev has two parts: good and bad things.

    Good things are: the deer drama, Christina's performance and George's confesion at the end of the episode, Izzie's lesson to their interns

    Bad things are: everybody being (or trying to be) nazis (that wasn't necesary and certainly that isn't like most of them), some new looks, MerDer break up scene, Callie suffering and LEXIE GREY (:@).


    A)Deer drama/Izzie: Izzie tried to play a role that is very different from her, the nazi and teacher role. This is why their interns were so bored to death. When she tried to save the deer she was trying to show something about her, that she never looses hope. This lesson was really important, and she, sadly, had to take care of bad interns. This is a good start, and she's not a bad teacher.

    B)Cristina: her new look, and her nazi attitude was great! She and Alex are nazis, they have it on their blood, and the rest does not. We get to see her human side and I loved what she says to the man in surgery. C) "I love you too": finally, I was waiting for that! It was a good thing, he said how he had been feeling since the beginning of this story.

    2 (Bad thigs).

    A) Nazis: Only Alex and Cris were true nazis. Izzie? It doesn't fit for her, and Meredith probably realised, and what she did was cool: she was so herself when she said "but sleep alone, but not with attendings, it's not a good idea" or something like that. Not everybody can act like nazis.

    B) Looks: Callie seemed a book, Alex a porn star (of a really cheap movie), Cristina a box fighter. I liked Mark's hair.

    C) MerDer break up scene: I really don't understand where such drama and problems come from. They're meant to be togheter, and they're always fighting, but I don't know why!

    When this started in 03x19 and in 03x20 I really didn't understand what was goin' on. They shouldn't have had that break up sex, because it means that there are posibilities to believe in that relationship, or that they gonna have a hard time from that moment on... They should have broken up and go to their own places (and take a cold shower).

    D)Lexie Grey: She was annoying from the very beginning. She kinda interrupted everything they were doing to see her. Okay, she's your sister...but you're in a hospital! Please back off! They were only two moments when I liked her: was when she talks to George, but at the end of the conversation, and in the lockers when she talks about bringing that baby to the world. The rest was...annoying.

    All in all, it was just and Ok episode. I hope everything gets better soon!moreless
  • Season 4 Premiere where everyone deals with the aftermath of what happened in the season 3 finale.

    I seriously don't even know why I watch this show. I hate Izzie, like I really hate her character. I also hate George. I strongly dislike Meredith, oh so sad, she's damaged. She's also 30 and needs to deal with it already. Derek was once a hot doctor and now is a whiny baby. I like Christina and did really feel bad for her about Burke leaving. I like Karev well enough although I don't think they give him quite enough screen time and obviously I love Bailey. I think I watch this show because it is addictive but I felt as though the season premiere was kind of a let down overall. I will obviously continue to watch because, like I said, I can't stop myself, but overall I think the quality was subpar.moreless
  • Lexie is Cristina's intern, George is Meredith's intern. Alex misses Rebecca and Cristina misses Burke. Callie struggles as Chief Resident whilst Bailey is still dealing with not getting the job. Meredith and Derek are broken up but not broken up...moreless

    I waited (along with many of us out there) for months on end for this premiere and I must say, it fulfilled my expectations just fine. I only started watching Grey's like 4 months ago and I finished the first 3 seasons in a grand total of 2 weeks. As for this premiere, I'm glad it's going down the road that makes it less dark and twisty and depressing than Season 3 was. There were plenty of classic Grey's funny moments. The whole deer debacle made me laugh. Personally I'm not a huge fan of Gizzie; I liked them better as best friends. I'm not big on George with Callie either though. I think George should stay single for a while though I have a feeling something may happen between him and Lexie.

    Meredith and Derek..what can I say. I can't wait for next week to see how their relationship plays out, I love their chemistry and I don't think they'll break up for real...I hope not. I'm looking forward to this season, I have a feeling it's going to be more laid back and relaxed than last season. Going back to how it used to be in the first two seasons :)moreless
Ellen Pompeo

Ellen Pompeo

Dr. Meredith Grey

Sandra Oh

Sandra Oh

Dr. Cristina Yang

Katherine Heigl

Katherine Heigl

Dr. Isobel "Izzie" Stevens

Justin Chambers

Justin Chambers

Dr. Alex Karev

T.R. Knight

T.R. Knight

Dr. George O'Malley

Chandra Wilson

Chandra Wilson

Dr. Miranda Bailey

Mark Pellegrino

Mark Pellegrino


Guest Star

Sandra Thigpen

Sandra Thigpen


Guest Star

Stephanie Childers

Stephanie Childers

Nancy Walters

Guest Star

Candice Afia

Candice Afia

Intern Laura

Recurring Role

Amrapali Ambegaokar

Amrapali Ambegaokar

Intern Dani

Recurring Role

Tymberlee Hill

Tymberlee Hill

Intern Claire

Recurring Role

Trivia, Notes, Quotes and Allusions


  • TRIVIA (1)

    • A fake deer was used for all the scenes when the injured deer was lying motionless in the truck. However, they used a real animal for the brief shot of the deer standing up, magically recovered. According to associate producer Karin Gleason, Katherine Heigl (Izzie) had to sit in the truck for hours while filming, waiting for the deer to be "in the mood" and stand up for them. Heigl passed the time by reading a book, and when the deer finally jumped up unexpectedly, Heigl was ready with her character's shocked and happy reaction. Gleason has stated previously that she was very impressed with the actress's patience and performance in this scene.

  • QUOTES (30)

    • Meredith: I...uhm....
      Derek: You're not ready for this.
      Meredith: No.
      Derek: I asked for too much.
      Meredith: I think so.
      Derek: So, this is it?
      Meredith: Yeah.
      Derek: We're breaking up?
      Meredith: We're breaking up.
      Derek (walks to Meredith): We're broken up.
      Meredith: It's done. (they start kissing)
      Derek: Break-up kiss.
      Meredith: Break-up kiss.
      Derek (removes his jacket): And some break-up sex.
      Meredith: Yeah, break-up sex.

    • Callie: What? You wanna humiliate me some more? 'Cause I get it. I suck. I suck at my job, I suck as a wife, I suck all around, so... go ahead, humiliate me some more, please.
      Bailey: Hope tomorrow's better.

    • Alex: I filled this entire bag with coins from my patients stomach today.
      Cristina: No kiddin'.
      Alex (long pause): I miss Rebecca.
      Cristina (long pause): I miss Burke.
      Alex (holds up the bag of coins): You want some money? (Cristina smiles)

    • Cristina (to her interns): I have five rules. Memorize them. Rule number one, don't bother sucking up. I already hate you, that's not gonna change.
      Izzie: Traumas protocol, phone lists, pagers. The nurses will page you, you answer every page at a run. A run. That's rule number two. (notices the interns are not following her) You're supposed to follow me.
      Alex: Your first shift starts now and lasts 36 hours. You're grunts, nobodies, the bottom of the surgical food chain. You run labs, write orders, work every second night until you drop. And you don't complain.
      Meredith: On call rooms. Sleep when you can, where you can. You know, but not with anybody. Not attendings, especially not attendings. Sleeping with attendings, not a good idea. Where was I?
      George: Er, rule number three. If you're sleeping, do not wake you unless the patient is actually dying.
      Cristina: The dying patient better not be dead when I get there, because not only will you have killed someone, you will have woken me for no good reason. Are we clear? (Lexie raises her hand) Yes?
      Lexie: That was four rules. You said five.
      Cristina: Rule number five. When I move, you move. (awkward pause as nobody moves) Go! (Cristina's interns scramble off)

    • Richard: Now, whether you like it or not. You and I are gonna have to talk.
      Bailey: Chief...
      Richard: I know that you're angry and disappointed.
      Bailey: No, I'm not angry, I'm not disappointed. I'm speechless, I don't wanna talk because I'm speechless. It makes me speechless to realize that, you didn't think... I would've made an excellent Chief Resident.
      Richard: And you're right. You would've made an excellent Chief Resident, but you'll make an even more excellent surgeon. You belong in the OR, Bailey. Focus on honing those skills, not on how well you can juggle schedules, or fill out paper work. Believe me I know. You'll thank me for this one day.
      Bailey: Not today.

    • Lexie (looking at the babies): It's like a cute festival in here.
      George: I delievered that one an hour ago.
      Lexie: Oh, my god. Why aren't you like jumping up and down?
      George: I've done this before. This is deja-vu.
      Lexie: Uh.. you know, you didn't pass your intern test, it happens. It's nobodies fault, right?
      George: Yeah, it's nobodies fault. Except that Callie gave Cristina the study cards and Meredith didn't write anything down and Cristina was planning a wedding and Izzie... Izzie just had to... You know, I'm responsible, I've always been the responsible one, I'm not saying 'what about me', I'm not saying 'when do I get what I want', when do I get to be somebody other than the guy who repeats his intern year, I'm not sayin' that but...
      Lexie: ... But what about you?
      George: Yeah!
      Lexie: I didn't plan on being here. I was all set for an internship at Mass Gen., and then my mother gets the hiccups and I'm at a funeral. You know, we all have problems. Moms die, and dad's drink so much that they don't even know what year they're in and sisters... I didn't even know that there was a Meredith Grey until a coupla months ago. And she -- she doesn't even wanna talk to me. I don't-- I don't want to be here. I'd give anything to not be here. No, to have my life work out the way that I planned and to even have time to ask 'what about me'. So you change, you get over it. (pauses) I'm here now. And you... you delievered a baby today. So, stop feeling sorry for yourself.
      George (pauses): You... are kind of awesome.

    • Izzie: George, why are you avoiding me?
      George: I'm on my way to surgery.
      Izzie: No, I don't mean right now. Not right now. Not one word? In 17 days. I tell you that I love you, and not one word? For 17 days? Where have you been?
      George: I've been right here. Exactly where I was a year ago! I'm sorry-- I'm sorry. I'm freakin' out. I'm an intern again.
      Izzie: Yeah, we're all freakin' out. We're all freakin' out. I'm in charge of a group of interns who think I'm crazy and I might actually be crazy because day one of me being in charge, and I'm obsessed with rescuing bambi. We're all freaking out.
      George: Since when did you start calling me bambi?
      Izzie: What? I'm not calling you bambi.
      George: I - I understand. I - I expect it from Cristina or -- or Alex, but --
      Izzie: I'm bambi! I'm bambi, George. If anyone in this situation is a sad little cartoon character, it's me. I'm all alone in the forest, all alone in the forest, George. And my mother's been shot by a hunter and where are you? Where the hell are you?
      George: I'm on my way to surgery. (leaves)

    • Callie (about Alex): I don't know how you did it.
      Bailey: Did what?
      Callie: Get him to listen to you. To give you some respect. (Callie leaves, Izzie smirks)
      Izzie: Hey, Dr. Bailey, you wouldn't happen to know anything about a... the anatomy of a deer, would you?
      Bailey: Not my intern. Not my business. Not anymore. (walks away)

    • Richard: Hey, Dr. Bailey, how're things going?
      Bailey: I wouldn't know. Ask Dr. Torres.
      Richard: Miranda...
      Bailey: I don't want to talk.
      Richard: Miranda, it is not like you not to want to talk.
      Bailey: Fine. How's your wife?
      Richard (pauses): She's -- she's good. I haven't moved back in yet. She hasn't let me move back in yet. Not taking my calls. Wait, that's not what I wanna talk to you about. I wanna talk about Chief Resident. Now, we're gonna have this conversation.
      Bailey: Are you ordering me to stand here and talk to you about this, Chief?
      Richard: No, I'm not ordering you but I thought--
      Bailey: Okay, goodbye, sir. (walks off)

    • Callie: Hey, there you are. I missed you this morning.
      George: Yeah, I didn't wanna be late for my second first day as an intern.
      Callie: Maybe you can look at it like this, you have one up on everyone. You're gonna be like the rockstar intern.
      George: Yeah, I'm sure that's how everyone's gonna see me when they find out.
      Callie: Or maybe, they'll see you as the daddy intern.
      George: What? What did you just say?
      Callie: I'm not pregnant. I mean... I might be pregnant. My boobs are a little sore so... (George looks speechless) Hey, I'm trying to cheer you up, here George. This is-- I mean, if I am knocked up, that's a good thing, right?
      George: Callie, I'm just a little distracted. I mean, I'm havin' a bad day.
      Callie: Okay, you're having a bad month.
      George: Okay, yeah. I'm havin' a bad month. (leaves)
      Callie: Love you.

    • Derek: Hey, how are you?
      Meredith: I have a patient with a severed arm and no one seems to be able to find it. Have you seen it?
      Derek: Your severed arm? No, I haven't seen a severed arm. Meredith--
      Lexie (walks up): Hey, um, I'm so sorry about before, I was just so nervous about meeting you. Don't block the ER doors, I know that now.
      Derek: You're the girl from the bar.
      Lexie: Sorry?
      Derek: The girl from the bar.
      Lexie: Oh, my god. Yeah. Oh, my god. Yeah.
      Derek: Yeah.
      Lexie: Oh, my god. You work here?
      Derek: Yeah, I do.
      Meredith: Girl from the bar? I'm the girl from the bar. (Meredith walks away)
      Lexie: She hates me. My sister hates me.
      Derek: Meredith is your sister?
      Lexie: My half sister.

    • Izzie (to her interns): So, this is Cristina, Dr. Yang.
      Cristina: Yep, saving lives and taking names.
      Izzie (whispering to Cristina): All these interns and nothing to do. And I think that I'm a really bad teacher and they hate me. And now I'm a fraud, so any chance you wanna let me on this?
      Cristina: Izzie, this guy was dead, and now he's undead, so that kinda makes him like a zombie. And my personal zombie, so no you can't get in on this. Now you can go be a (loudly) fraud, somewhere else.
      Izzie: I don't like you.

    • Mark (to Izzie): You wanna rub up against me, you're gonna have to buy me a drink first.

    • Meredith: You see that girl out there? The dopey, wide-eyed one? Apparentally, we're related.
      George: Oh, you met Lexie?
      Meredith: So, you knew. You knew about it and didn't tell me.
      George: Kinda had a lot going on.

    • Cristina: Oh, crap, why'd you get me all excited with the sirens for a dead guy? (to interns) Who wants to see a dead guy?

    • Cristina (to her interns): Okay, one and two, go get stat packs. Three and four, go wait for the ambulances.
      Meredith (laughs): One and two?
      Cristina: Oh, no, I can't remember their names.
      George (raises his hand): I don't respond to being called a number.

    • Callie: Is there anything I -- I should do, sir?
      Richard: Save lives.
      Callie: No, I - I mean as a Chief Resident, sir.
      Richard: Make sure your residents run their tramuas. It's their first day on their own. (looks around) Where... are the residents that you've assigned to this ER?
      : Oh... I -- I, uh, I-- I paged them. I paged them. Bailey?
      : What?
      : Uh, I paged Grey, Stevens, Yang and Karev, but they're not here yet.
      : When I page them they come runnin'.
      : Get it together, Torres. (leaves)
      : Okay, you did not have to say that in front of the Chief.
      : You asked ... boss.

    • Richard: You're avoiding me, we need to talk.
      Bailey: About you choosing Dr. Torres over me to be your Chief Resident? Respectfully, no, we are not going to talk about that.

    • Derek: Hmm, your interns are back from holiday today.
      Bailey: Not my interns. They're residents. I am free.
      Derek: Well, the point is... Dr. Yang, the Burke thing, she doesn't know and I'm supposed to tell her. Burke asked me to tell her. (sighs) Any thoughts?
      Bailey: Honestly always works best.
      Derek: Well, that's true. Hey, do you wanna get together for a drink after work tonight?
      Bailey: Why?
      Derek: Well, I don't know, I just thought it might be a good idea to get together and...
      Bailey: Oh, you don't have anybody to talk to.
      Derek: No, I have people to talk to.
      Bailey: Addison is gone. Burke isn't around. And you and Grey aren't smelling each other in the elevators anymore.
      Derek: I have people to talk to.
      Bailey: Who?
      Derek (looks around): The chief, I have the chief to talk to. Hey, Chief, you wanna get together for a drink after work?
      Richard: I don't drink.

    • Izzie: How's your vacation?
      George: Um.. fine. Meredith can we uh..
      Izzie: 'Cause mine was... I didn't do much. Hung out alone. For 17 days... which... is the last time that I saw you... The day of Cristina's wedding. Which was... (Cristina gives her a look) Well, then Mer and Cristina went on Cristina's honeymoon without me.
      Alex: Girl on girl honeymoon. (laughs)
      Izzie: And then Alex took a roadtrip to see Ava... without me.
      Alex: I didn't go see Ava. Her name is Rebecca and I didn't go see her, I just drove in that direction.
      Cristina: Why is everyone so tingly and hurt? I mean I was the one who was left at the altar. (Meredith and Izzie look at her) I'm fine, by the way, I honeymooned in Hawaii and I snorkled.

    • (About the interns)
      Cristina: I hate them.
      Meredith: Oh, you do not hate them, you hate you.
      Izzie: That was hideous, I feel like a fraud.
      Alex: I rocked it. I think I'm the new nazi.
      Cristina: Oh, you are not the new nazi.

    • Guy Intern (about Izzie): I heard that she like freaked out and killed a guy.
      Girl Intern: Great, we got stuck with a dud.

    • Cristina (about George being an intern again): Hey, is this how it's gonna be all year, because bambi has got to deal.
      Izzie: Hey, at least he came back.
      Meredith: Yeah, at least he came back.
      Alex: Dude, he failed his exam and got left back in kidnegarden.
      Izzie: He won't even look at me.
      Meredith: Have you seen Burke?
      Cristina: No. Have you seen Derek?
      Meredith: No.
      Izzie: Wait, you haven't seen either of them since the wedding?
      Meredith and Cristina: Nope.
      Izzie: And you're all fine?
      Meredith and Cristina: Yep.
      Izzie: Wow. You're either incredible healthy or completely messed up.

    • Izzie (to her new interns): I know you didn't wake up this morning expecting this was how your first day was gonna go. You thought you'd get to re-attach an arm or observe brain surgery; instead you helped save the life of a deer. You can bitch and complain about it, or you can adjust your expectations. Cause like it or not, you are stuck with me and I'm the kind of doctor who lets a little kid convince her she can do the impossible. Oh! Plus, when I woke up this morning, I thought today was gonna go a lot differently too. I thought I was gonna get the good interns instead I get stuck with the duds. So I have to adjust my expectations as well.

    • (Derek sees Mark and begins to walk away)
      Mark: I'm the one that can use a friend. (Derek pauses) I said, that you could use a friend, I can use a friend.
      Derek: Look Mark, I know..
      Mark: I didn't come to Seattle for Addison. I didn't come to Seattle to be chief. I came to Seattle for you. (Derek gives him a look) Okay, I came to Seattle to get you back. (Mark and Derek share an awkward pause) I know I want to take it back, but I already said it. So... (laughs)
      Derek: Yeah, (smiles) Maybe, we should have a drink.
      Mark: We could.
      Derek: Yeah, not today. (Mark smiles)

    • Mark: I really am up for a drink, you know if you need to talk.
      Derek: What would I need to talk about?
      Mark: Meredith. You were lucky, man. That girl jerked you around.
      Derek: You have no idea what you're talking about.
      Mark: Hey, I'm just... seem like you can use a friend right about now.
      Derek: Meredith's mother never wanted her and her father was never man enough to hang around. She has a right to be damaged and us, together? It's a big step for her. Her best friend gets left at the altar, and all she sees now is things like this, they don't work. She panics. She wants this, she doesn't know how to have it. And you know what? It's not her fault. So don't ever talk to me about Meredith Grey again because you do not know what you are talking about. And I don't want a friend. (leaves)

    • Derek: Do you wanna have a drink later?
      Cristina: A what?
      Derek: A drink. Gimme one reason why we can't hang out.
      Cristina: I don't like you.
      Derek: You don't like me because of Meredith?
      Cristina: I don't like you because you're you.
      Derek: Hmm. How is Meredith by the way? Is she okay?
      Cristina: She's fine.
      Derek: She's always fine. That's her problem.
      Cristina: We're fine people... We do fine. We're fine. (pauses) How's Dr. Burke? I haven't seen him around today, is he off today?
      Derek (pauses): Dr. Burke handed in his letter of resignation two weeks ago. He wanted me to tell you.
      Cristina: He's g-gone?
      Derek: Sorry.
      Cristina: Oh, don't be. I'm...
      Derek: ... Fine?
      Cristina: Yep.

    • Cristina: Still no sign of Burke. Ooh, you got a severed arm.
      Meredith: My arm. Mine. Get away from it.
      Cristina: Maybe he's not on today.
      Meredith: Maybe you should just see him and get it over with.
      Cristina: No, no, no. If I never see him again, I won't care.
      Meredith: Well, I've seen Derek and Derek has seen me.
      Cristina: And?
      Meredith: And plus he seems to know Lexie.
      Cristina: And?
      Meredith: More akward. Your intern is my half sister, how weird is that?
      Izzie (walks in): Well, I'm trying to save Bambi and my interns think that I'm a loser. Ooh, severed arm.
      Alex (walks in): Callie's a bitch.
      Izzie: Word.
      Alex: She won't lemme off my patient. There's nothing wrong with him except he's a nut job. Severed arm.
      Izzie: Anyone know anything about deer?
      Alex: Tastes good.
      Izzie: Evil.
      Cristina (to George, who just walked in): Oh, George! Severed arm. Plus, Meredith's half sister is my intern, Izzie is playing Doctor Doolittle... oh and Alex hates your wife.
      George: Dr. Sloan is ready for the arm. (leaves)
      Meredith: I'll say it. George is being an ass.
      Izzie: It's my fault. I said some things and now he's not talking to me.
      Alex: I don't know what he's got to complain about, those new chick interns are hot.
      Meredith: He's married, Alex.
      Izzie: Yeah, he's married.
      Alex: You know who's seriously hot? That Lexie girl. (Cristina laughs)
      Meredith: Get out before I hurt you.
      Alex: I'm going over Callie's head to Bailey.
      Cristina: Uh, Callie is over Bailey's head...
      Meredith: Spiritually, Bailey's over everyone's head.

    • Meredith (closing voiceover): Change… We don't like it. We fear it. But we can't stop it from coming. We either adapt to change, or we get left behind. It hurts to grow. Anybody who tells you it doesn't is lying. But here's the truth; sometimes the more things change, the more they stay the same. And sometimes… oh, sometimes change is good… sometimes change… is everything.

    • Meredith (opening voiceover): In the practice of medicine, change is inevitable. New surgical techniques are created, procedures are updated, level of expertise increase. Innovation is everything. Nothing remains the same for long. We either adapt to change… or… we get left behind.

  • NOTES (4)

    • This episode takes place 17 days after the previous episode: Didn't We Almost Have It All?

    • International Titles:
      Czech Republic: Měním se, tedy jsme (I am Changing Anyway I Am)
      Slovakia: Čas zmien (Time of Changes)

    • Original International Air Dates:
      Italy: Monday, December 10, 2007 on Foxlife
      Portugal: Thursday, December 20, 2007 on Foxlife
      Australia: Sunday, February 10, 2008 on Channel 7
      Latin America: Monday, February 11, 2008 on Sony Entertainment Television
      Sweden: Wednesday, February 13, 2008 on Kanal 5
      Germany: Wednesday, February 13, 2008 on ProSieben
      The Netherlands: Monday, March 10, 2008 on Net 5
      Croatia: Monday, March 17, 2008 on RTL TV
      Czech Republic: May 11, 2008 on Prima
      Norway: Tuesday, August 26, 2008 on TV2
      United Kingdom: Wednesday, September 17, 2008 on Living
      Romania: Tuesday, October 7, 2008 on TVR1
      Thailand: Tuesday, October 21, 2008 on Star World

    • Music Featured In This Episode:
      1. Breathe In, Breathe Out by Mat Kearney
      2. Oversleeping by I'm From Barcelona
      3. Knock 'Em Out by Lily Allen
      4. 23 by Blonde Redhead
      5. Reasons To Love You by Meiko
      6. To Build A Home by Cinematic Orchestra


    • Cristina (to her interns): I have five rules. Memorize them. Rule number one, don't bother sucking up. I already hate you, that's not gonna change.
      Izzie: Traumas protocol, phone lists, pagers. The nurses will page you, you answer every page at a run. A run. That's rule number two. (notices the interns are not following her) You're supposed to follow me.
      Alex: Your first shift starts now and lasts 36 hours. You're grunts, nobodies, the bottom of the surgical food chain. You run labs, write orders, work every second night until you drop. And you don't complain.
      Meredith: On call rooms. Sleep when you can, where you can. You know, but not with anybody. Not attendings, especially not attendings. Sleeping with attendings, not a good idea. Where was I?
      George: Er, rule number three. If you're sleeping, do not wake you unless the patient is actually dying.
      Cristina: The dying patient better not be dead when I get there, because not only will you have killed someone, you will have woken me for no good reason. Are we clear? (Lexie raises her hand) Yes?
      Lexie: That was four rules. You said five.
      Cristina: Rule number five. When I move, you move. (awkward pause as nobody moves) Go! (Cristina's interns scramble off)

      This is a reference to the very first episode, "A Hard Day's Night" in which Bailey tells Izzie, Meredith, Cristina, and George the same thing. And Lexie, does what Meredith did.

      (From "A Hard Day's Night")
      Bailey: I have five rules. Memorize them. Rule number one, don't bother sucking up. I already hate you, that's not gonna change. Trauma protocol, phone list, pagers, nurses will page you. You will answer every page at a run. A run! That's rule number two. Your first shift starts now and lasts 48 hours. You're interns, grunts, nobodies, bottom of the surgical food chain. You run labs, run orders, work every second night until you drop, and don't complain. On-call rooms. Attendings hog them. Sleep when you can where you can, which brings me to rule number three. If I'm sleeping, don't wake me unless your patient is dying. Rule number four: the dying patient better not be dead when I get there. Not only will you have killed someone, you would have woke me for no good reason. We clear? (Meredith raises her hand) Yes?
      Meredith: You said five rules. That was only four.
      Bailey: Rule number five: When I move, you move. (looks at pager and starts running)

    • Izzie: I'm not doing it for him I'm helping Bambi.

      Bambi the animated story (1942 movie) of Bambi, a young deer hailed as the 'Prince of the Forest' at his birth. As Bambi grows, he makes friends with the other animals of the forest, learns the skills needed to survive, and even finds love. One day, however, the hunters come, and Bambi must learn to be as brave as his father if he is to lead the other deer to safety

    • Episode Title: A Change is Gonna Come

      The title of this episode is a reference to the song A Change is Gonna Come by Otis Redding. This is also a song by Sam Cooke, released in 1965. and a song by Leela James, released on her album A Change is Gonna Come in 2005.

    • Cristina: Izzie is playing Doctor Doolittle...

      Doctor Doolittle is a 1998 movie about a doctor that can understand animals. In it stars Eddie Murphy and Peter Boyle.