Take the Lead

is the third episode of the eighth season and the 151st overall episode of Grey's Anatomy.
==Short Summary==
The Chief makes a career-changing decision that shocks Seattle Grace Mercy West Hospital. Cristina and Owen try to find normalcy in their relationship. April continues to struggle in her new role and the 5th year residents are given their first solo surgeries, only to find out that even the most routine procedures aren't always easy.
==Full Summary==
A nurse writes Grey, M. on the surgical board. She's going to be the lead surgeon.
In a meeting with all attendings, Richard tells them that as of today, the fifth years rotate in as lead surgeons. "We've alerted the morgue," Callie jokes. He tells the attendings they need to observe and only help when they really have to. Bailey supports this, and tells the others to let the residents sink a little before they help them swim. Richard takes the floor again and says he officially resigned as Chief of Surgery. He will stay on staff, but now turns the meeting over to the new Chief: Owen Hunt. Owen stands up and says he gets it's a surprise for all them. He tells them he'll appreciate their help and patience over the next few days. Owen wants to talk about their call schedules, but Arizona interrupts him and asks what happened. Derek asks Richard if the Board forced him to step down, but Richard doesn't answer. Teddy smiles and compliments Owen with his new job. Bailey in particular is more than just surprised, she's shocked.
Meredith and Cristina walk down the hallway. The former still hasn't heard about Zola, but she's clipping her first aneurysm today. Cristina has a valve replacement. Teddy has to shut up and watch. She hopes she gets a good OR. Alex comes over and asks if it's up yet. Not yet, they say. He also asks about Zola. Cristina and Alex are surprised Meredith's first completely solo surgery is so difficult. They meet Jackson and April, who tells them they're putting it up right now. Before Jackson can ask, Meredith says she hasn't heard about Zola. They walk to the OR board, where a nurse is writing down their surgeries. Cristina is happy, she's in OR 3. Alex has a bowel resection. He switched at the last minute with a peds case, which April says he can't just do. Jackson has a plastics case. Cristina makes a comment about the Gunther spending time on boob jobs, but he says he's changing a kid's life today, whereas April is just fixing a bum knee. April reminds them that they also have to teach skills labs from now on. She made up a schedule for the month, which is up on the board in her office. "In your what?" Meredith asks.
They all enter April's office. "When did we get this?" Cristina asks, but April reminds her it's for the Chief Resident. There's a good couch and a fridge. On the board, there's the schedule for the skills labs. Each of them has been given one skills lab to teach. Cristina can't today because of her mitral valve replacement. April suggests she switch one of the others, but they all have their surgeries. April says she divided it up fairly, but Jackson reminds her that every surgery they do this year could come up at the oral boards. "And they love picking the crappy outcomes," Alex says. Cristina adds that this year could decide which fellowship she gets. It's not just life or death. It's their careers. Meredith proposes that the one with the worst outcome today teaches the skills lab all month. All but April agree when Jackson shows them the email about Webber stepping down. They all look at Meredith until Jackson mentions Owen is now the Chief. Cristina is just as surprised as the others.
In the research room, Derek reads a message on his phone. He grabs a box as Richard walks in, asking if he heard about his Alzheimer's trial from the FDA. They're sending it to Phoenix. Derek was blacklisted. He may never do another trial again. He puts all his research material into the box. Richard says he was blacklisted too. Derek questions why Richard did this to himself. Richard ignores this and asks him about Zola, but Derek hasn't heard anything.
Cristina doesn't understand why Owen didn't tell her about the Chief job. She and Meredith question if it might have anything to do with the abortion, about which he hasn't said a thing. They haven't talked about it, at all. Just as Cristina starts saying that's bad, they bump into Owen. Meredith leaves, and he confirms he really is the Chief now. Webber talked to him about it last night and this morning she was already gone, so he couldn't tell her earlier. They share an awkward conversation and agree to have dinner sometime to celebrate. They can't tonight, as Cristina's procedure takes at least 7 hours. She congratulates and hugs him as he leaves. Meredith watched from a distance and agreed that that was bad.
Alex asks April for an intern to assist on his bowel resection, but everyone is booked. Arizona comes rolling towards him and says she saw he traded her esophageal atresia surgery for the bowel resection. While saying this, she acts as if she falls asleep. "Sorry, I was trying to say Webber's bowel resection, but then I fall asleep!" she says. She knows he wants good outcomes for his boards, but he'll low-ball himself out of the fellowship if he continues this. April asks if that's really the case, or if he's just doing it because of the bet. He says to just find him an intern. Webber comes over, asking if he's ready. He replies Kepner's having trouble getting it staffed. Richard doesn't want to postpone the surgery, as he's been treating the patient for years. She'll find someone, even if she has to do it herself.
Meredith is waiting for her patient's wife. She's arranging something to make sure her kids get squared away somewhere. With a drawing, Meredith explains how she'll approach and clip the aneurysm. The patient wants to know how they're sure the blood supply has been tied off by the clip. Meredith replies she'll puncture the dome of the aneurysm with a needle. If there's a tiny amount of blood, they know it was successful. If not, the aneurysm possibly bursts and he may die. He asks how many surgeries like this she's done. Derek is listening from the doorway how Meredith confesses it'll be her first. This doesn't comfort the patient, but Derek comes in and says Meredith is the best. Plus, he'll be there all the time. They have no more questions.
Meredith leaves the room and thanks Derek for backing her up. Derek checks his phone, but nothing from the social worker. Derek thinks Zola won't come back because they haven't heard anything by now. Meredith wants to call again, but Derek says they've already called too much. Meredith questions what'll happen if they don't get Zola back. She asks if he wants to be together. He simply tells her to focus on the surgery.
Cristina lets one of the three interns in the room present - Ruth Bennet, the mitral valve placement. Teddy is watching her. They did all the tests, but turns out none of them touched the patient's abdomen. Cristina says palpating comes before the labs and tests. "Basics, people, fundamentals!" she says as she feels herself. She is all about not skipping steps. The patient experiences more pain as Cristina lifts her hand from her abdomen. Cristina orders the interns to take the patient for triple-contrast CT. "Try not to get lost," she tells them as she gives them the chart.
Arizona watches how Jackson convinces a mother that surgery is the best option for her baby. By operating now, his maxilla will have a good chance of forming properly. The mother asks if he'll have a scar. He will have a little one, but Jackson will hide it in the contour of his lip. Over time, it'll fade altogether. Jackson picks up the baby and tells him to wait with his mommy while he gets things set up. He'll see them again in the afternoon.
He leaves the room and Arizona tells him he did excellent. He explained it, answered her questions and eased her fears. Mark Sloan is gonna do the surgery though, because Jackson's plan includes the risk of the baby's lip shortening over time. For the kid's sake, Sloan's gotta do it. Jackson says it's his procedure. She apologizes, but not this time.
April presents Sam Kenton's case, the patient needing a bowel resection. His son Jason is playing his "nursemaid", but Sam thinks he should go to school. Jason says it's only one semester. His father has to think about the money he's saving him. He and his father start joking and Kepner joins in, but Alex interrupts and asks her to just give him the bullet. She does.
Arizona, Bailey, and Teddy are in the lounge talking about Richard stepping down after 11 years as Richard comes in. They greet him. He's carrying his lunch and opens the fridge. He asks if everybody has a spot, but anywhere is fine. He puts his lunch in the fridge and tells it he'll see it again that afternoon. He wishes them all an excellent day. He is already having one. Teddy says he's trying so hard, while Arizona finds it odd he talked to his sandwich. Bailey can't stand it anymore and leaves.
Callie is walking with Owen. April comes over with a bottle of scotch that Larry Jennings sent him. He tells her to put it somewhere. She tells Callie she has to push her meniscus repair to tomorrow as she has a skills lab to teach. Owen tells her she needs to delegate. She tried, but he reminds her she just needs to give orders. Leadership is not about making friends. In that case, she's doing it right. "Very chiefy," Callie compliments him. Bailey comes over, snappingly asking for her call schedule. He said he'd distribute them, but he didn't. He stumbles she'll get it. "Way less chiefy there," Callie says. He asks her what he did to her. She's just hating him because she was Richard's right hand man. She'd hate anyone in his position. Callie knows it's not about making friends, but makes him question if he really wants Bailey as his enemy.
Cristina comes carrying Ruth's scans to Teddy. The interns missed the fact that she has appendicitis. Cristina will transfer Ruth to general surgery for an appendectomy. Teddy proposes Cristina does it. They have to monitor her anyway, and because of the COPD, she has to have an open appy. If Cristina does it, she gains a procedure. Cristina says it's a very basic procedure, but Teddy reminds her she loves the basics and is all about the fundamentals.
April is examining a sleeping Sam. Jason asks her about the bathroom part of the recovery. He wants to do anything his father needs, but he wants to be prepared. There are a couple of possible outcomes, all depending on what Karev finds during surgery. She proposes she goes to get him so he can explain. Jason finds Karev seems a little douchey, but April says he's very good. He can be a little douchey, but he can be a good guy. And he's a good surgeon.
Richard finds Meredith, who apologizes for everything. She didn't mean for any of this to happen. He knows what she wanted to do, he came to wish her good luck for her first surgery. She's trying to figure out which clip to use, but he says she can't know before she sees the aneurysm, as every aneurysm is different. She'll know what to do when she sees it. Richard says a resident's first aneurysm is a big deal. He says Derek'll lead the whole OR in a round of applause. Meredith doubts he'll do that today. Richard asks if they're all right. He asks because if she can't communicate with her attending, she has no business being in that OR, no matter how prepared she is. Meredith says they're fine.
Alex is practicing on a pig. Cristina comes in, saying she needs his pig to remember how to do an open appendectomy. They doubt if a pig even has an appendix. Meredith comes in, asking if anyone wants an aneurysm. Cristina hasn't thought about an appy in three years. Meredith will do anything to trade, but they decline. An aneurysm is like defusing a bomb that can explode with a wrong move. Meredith is more worried about Derek exploding. Jackson comes in, wanting the pig too, the head specifically. He doesn't want to trade either. April comes in, wanting to talk to Alex. They all ask her if a pig has an appendix. She doesn't know. She left her skills lab to let them practice whip stitches. Alex tells her to close the door and turn out the lights. She does so. He injected fluorescein dye into the bowels and that makes every viable part of it glow under UV light. Meredith leaves for her aneurysm, and Cristina goes to the skills lab. Jackson can have the pig's head. April asks Alex to go talk to Jason, but he replies he's busy. She'll have to talk to him herself.
Cristina enters the skills lab, asking those who know how to do an open appendectomy to show hands. They all do, including Cristina herself.
Owen gives Bailey her call schedule and apologizes for the delay. He made sure she got the time she needs for her trial. "You telling me I don't manage my time well?" she asks him. He just wanted to make sure her research gets the time it needs. "Oh, you telling me how to use my time?" she asks now. Not at all, she just has to forget he mentioned it. "Oh, now I don't get the time?" is her reply. She can just do what she wants, he says and sighs after she left.
April is erasing the meniscus repair from the OR board, but Callie tells her to leave it up as she'll do it herself. Now April loses a procedure. April thinks this is worse than being an intern. Callie agrees, as she did it once. April asks how she got people to listen to her, but Callie says she didn't. She sucked at it. She tells April it's not about making friends, but it is about getting them on her side. She wants to be the person they come to, not the one they run from. Callie compliments the little contest, get them competing for good outcomes as they thrive on competition. Either way, the patient wins. "It wasn't your idea, was it?" Callie asks. April shakes her head. Callie says not to give up. She'll be great. Or maybe she won't. Callie herself never was.
Jackson performed the procedure on the pig that Arizona wanted Mark to perform on the baby. Arizona compliments the result, saying the pig is now more attractive than the average pig. Jackson thinks he's ready and deserves it. Arizona agrees. "You go, Gunther," she says.
The interns are walking Cristina through the open appendectomy. She's acting as if it's a test for them. None of them knows what to do after having cross-clamped the appendix at the base, neither does Cristina. However, she tells the interns they should know this. Cristina imitates a beeping monitor and tells the intern the patient died. The intern she just interrogated starts crying, and Cristina picks her next victim.
Outside the OR, Cristina is walking herself through the procedure. She and Meredith are preparing for their surgeries. Owen comes over and Cristina tells him her mitral valve turned into an appy. Owen asks if she'll be home tonight then. She will, so they start talking about what they'll pick up. They both want to let the other one choose. Meredith interrupts and says Chinese is great. Owen wishes them both good luck and leaves. Meredith says they need to talk about the abortion because now they're just acting like bad roommates. Cristina doesn't know how to bring it up and doubts if there's even anything to talk about, as it's done. But it's not, Meredith says. They have surgery now, and they tell each other not to screw up.
While scrubbing in, April tells Alex the family history of their patient. Alex questions why she's telling him. She reminds him talking to patients is his job. They're more than just easy "A"'s or a way to win a bet. It's his job. He says it's not anymore. He has to open up the patient and fix it, because there's no one who'll do it if he can't do it. It's all on him. So he can spend them talking to the patient or spend it figuring out what to do once he opens up the patient. April understands he's really nervous, which is why he didn't want to work on a kid today. He'll be fine, he's ready. Richard comes in and asks Alex if he'll be finishing his book in there. If he can keep reading, this means that Alex is not screwing up. "Will I finish this book today?" he asks. Alex says he will.
Meredith and Derek are scrubbing in too. He asks her about the pre-op scans, which she already looked over. He tells her to look again, but she replies he should do the surgery because they're not a team right now. Derek asks a couple of questions, which she can all answer. He says she's ready. They enter the OR.
So do April and Alex. They both go stand on the same side of the table. As the lead surgeon, Alex should be on the other side. "You practiced it the other way, didn't you?" she asks. She's right. Richard asks if there's a problem, but Alex says there isn't.
Cristina is performing the appy. Teddy wants her to tell her about every little thing she's doing, as that never gets old. So Cristina does.
Jackson is about to start operating. Arizona is standing by his side and starts talking about how you get worried about screwing up your kid when you have one. She wants him to know that he's determining the rest of this kid's life, if he'll be laughed at and cries at his school picture every year. Today, he will decide whom he goes to the prom with and whom he'll marry. Or if he dies all alone, unattractive and unloved. Jackson hesitates. "Did you want me to call Sloan?" Arizona asks.
In her OR, Meredith has isolated the aneurysm. She takes an angled 7mm clip. Derek wants her to use a smaller straight clip, but she says no. Derek says they only have one shot at this and repeats to take another clip. There's a risk she'll hit one of the perforators, but not if she looks where she's going. "Put the clip down!" Derek says.
Cristina tells Teddy she's isolated the appendix and is now cross-clamping it at the base. "What are you doing now?" Teddy asks, but Cristina can't remember the next step. There's the reason Teddy has her doing all this.
All the patient's bowels are exposed. The anastomosis is holding, Alex says. He reruns the bowels to check for necrotic tissue. He starts doing so and finds there's a large part of the bowel that's black.
Cristina is trying to come up with the next step. Teddy is asking her why she should let her replace a mitral valve when she can't even remember how to do an appy. "Please, shut up!" Cristina says.
Alex doesn't know which part of the bowel is viable. Dr. Knox injects the fluorescein dye. He asks to kills the light and takes the UV light. Only a small part of the bowel is viable.
Derek tells Meredith to use the 5mm clip. Meredith asks him to trust her, but he says he's done it hundreds of times. Meredith doesn't listen to him and clips the aneurysm with the 7mm clip. "Dammit!" he yells.
Meredith asks for the needle and a retractor. She pricks the aneurysm and the clip holds, meaning she did it right. She continues operating.
April tells Alex there's not enough viable bowel left.
Cristina confesses she can't remember the next step. She might want to remember this next time she's screaming at an intern for skipping the fundamentals. Cristina asks Teddy to finish the surgery. "Take your time, it'll come back," Teddy says. Cristina says it won't. She could stand here all day. Cristina watches Teddy, who keeps her eyes fixed on the appendix. She realizes Teddy doesn't know how to do it either. Nurse Linda steps in and tells them what to do. "Right," they both say. Cristina is going to finish the surgery now.
Mark has finished the surgery on the baby. He tells Jackson there's no shame. He's still the goober. "Gunther," Jackson corrects him.
Alex realizes that if he closes the patient, he'll die of sepsis. He asks Richard if he can revascularize. He could also find the clot, do a transverse arteriotomy and bypass the vessels. No, he realizes he can't, as there's too much dead bowel. He can maybe put him on a transplant list? Alex starts panicking and turns to Richard for advice. Richard doesn't answer, puts on his glasses and takes his book. Alex tells April they'll just close.
A nurse erases Jackson's name from the board. Jackson is watching how the mother of the baby thanks Mark.
Now Cristina's name is erased. Cristina and Teddy leave the scrub room. They promise each other not to ever speak of this. Nurse Linda leaves the OR, gives them a look and shakes her head. Teddy wishes her a good night and both she and Cristina go their separate ways.
Alex's name is erased now. Alex is watching Jason in the waiting room. April offers to talk to him, but Alex wants to do it himself. She tells him he did everything he could. Jason won't understand that, but April does. Alex needs to understand that himself as well. Alex walks up to Jason.
In the OR, Meredith is closing the patient's wound. As Derek doesn't do it, the anesthesiologist starts the applause. Soon, the whole OR joins him. Even Derek, albeit with an angry look on his face. Lastly, Meredith's name is erased as well.
Cristina and Meredith are sitting on April's couch. They both don't want to go home. Meredith tells Cristina she really has to talk to Owen about the abortion and that she might come over later that evening. "That would be great," Cristina says. "No, actually, that would be bad, because that would mean my marriage is over," Meredith replies. April gives them something to drink as Alex comes in. Jackson asks who lost the bet. Not Meredith, as she perfectly diffused her bomb. Cristina says her appy was flawless. Except it was finished by a nurse, Jackson says. He also says Alex's guy didn't wake up due to septic shock. They don't understand how he screwed up a bowel resection. Jackson says it's Alex who'll have to teach the skills lab. April defends Alex and says Jackson never even touched his patient as Mark did the whole procedure. "What does "between you and me" mean?" Jackson asks. April goes on and says it looks to her like he's losing by forfeit. Jackson doesn't think that's fair. They agree to have a rematch the next day. And the next day, and so on, but Jackson still has to teach the skills labs this week.
Bailey is about to leave the hospital. Owen asks her to hold up. He tells her he learned in the army that a leader is only as good as the people around him. She's one of the best people on this team so he wants to know if he has her on his side. Richard overhears how Bailey asks if he needs her to like him. He says it's not that, but is left speechless. He tells her to carry on.
She walks to the elevator, where Richard tells her she should be mad at him if she wants to be mad at someone. She's not mad at him. "Everybody knows who to be mad at," she says. He says the only thing did was give him some more time to spend with his wife. He's happy and he would like her to be happy for him too. She'll try. They get on the elevator, and she adds he's gonna have to give her a while. He'll wait.
Cristina and Owen are finishing dinner. Owen says he's been feeling terrible. He means it. Cristina asks if he wants to talk about it. He doesn't say anything as he gets up and walks to the bathroom. Cristina hears him throwing up. He asks if she had the spring rolls.
Derek walks into the kitchen, where Meredith is sorting the laundry. She tells him they never should've been in that OR together today, as they're not a team. Not anywhere. Before they get a phone call about Zola, they need to figure out of they can be one, if they can be together. Now is the time to say how he feels. He can say whatever he wants, she assures him he can deal with the consequences. He blurts out she's never accepted a consequence in her entire life and that she's never suffered one bit since she switched the envelopes, while those around her lost their jobs and reputations. She says she lost Zola. "So did I!" he yells. She does things, she just dives into things without knowing how deep the water is or whom she's gonna land on. She knows she messed up, but this all happened before Zola was even in the picture. She thinks she's changed, but he thinks she can't change. He reminds her she stole the baby. She told him already why she did. She asks if he needs her to tell him that she's sorry. "I need you to be sorry," he says.
The discussion moves to the bedroom. She tells him she's sorry. He says she did it again in the OR today. She had a successful surgery, but refused to listen to him. Meredith yells that she didn't need to. She knew what she was doing and she was right. The problem was that he just couldn't trust her. "Why should I ever trust you?" he asks. She destroyed his trial and Richard's career and set back his and her own career. "Then why are you with me?" she asks. He points at the post-it on the wall. "Because of that! Because I meant that!" he yells. He promised he wouldn't run and would love her, even when he hates her. He's trying, but she makes it so hard. Meredith understands, but doesn't want him to keep the promise when he doesn't want to and not if he can't trust her with their daughter. He does trust her with Zola. He knows she took her to protect her, and that she altered the trial for Richard and Adele. She stood in front of a bullet for him. He knows why she does all of that. It's what he loves and hates about her.
He lies down. Meredith watches Zola's empty crib. She realizes he just can't trust her at work. He can't. Meredith thinks it's easy then. They just stop working together. She's off his service, that's her consequence. If they want to stay together, with or without Zola, they just can't work together.
Owen and Cristina are sitting on the bathroom floor. They agree never to order from that Chinese again. Owen wants to go to bed, but Cristina insists the bathroom floor feels good. She lies her head on his lap.
Meredith and Derek are lying in bed next to each other, their hands very close. The camera pans out to the empty crib.
==Cast==
803MeredithGrey.png|Meredith Grey
803CristinaYang.png|Cristina Yang
803AlexKarev.png|Alex Karev
803MirandaBailey.png|Miranda Bailey
803RichardWebber.png|Richard Webber
803CallieTorres.png|Callie Torres
803MarkSloan.png|Mark Sloan
803OwenHunt.png|Owen Hunt
803ArizonaRobbins.png|Arizona Robbins
803TeddyAltman.png|Teddy Altman
803AprilKepner.png|April Kepner
803JacksonAvery.png|Jackson Avery
803DerekShepherd.png|Derek Shepherd
803RobColvin.png|Rob Colvin
803LindsayColvin.png|Lindsay Colvin
803RuthBennet.png|Ruth Bennet
803SamKenton.png|Sam Kenton
803JasonKenton.png|Jason Kenton
803Marlene.png|Marlene
803InternLogan.png|Intern Logan
803Intern2.png|Intern #2
803Intern3.png|Intern #3
===Main Cast===
*Ellen Pompeo as Dr. Meredith Grey
*Sandra Oh as Dr. Cristina Yang
*Justin Chambers as Dr. Alex Karev
*Chandra Wilson as Dr. Miranda Bailey
*James Pickens, Jr. as Dr. Richard Webber
*Sara Ramírez as Dr. Callie Torres
*Eric Dane as Dr. Mark Sloan
*Chyler Leigh as Dr. Lexie Grey (credit only)
*Kevin McKidd as Dr. Owen Hunt
*Jessica Capshaw as Dr. Arizona Robbins
*Kim Raver as Dr. Teddy Altman
*Sarah Drew as Dr. April Kepner
*Jesse Williams as Dr. Jackson Avery
*Patrick Dempsey as Dr. Derek Shepherd
===Co-Starring===
*Ken Weiler as Rob
*Jessica Anne Bogart as Lindsay
*Karly Rothenberg as Ruth Bennet
*Christopher Carrington as Sam
*Lawrence Adimora as Jason
*Sabrina Perez as Marlene
*Jon Schmidt as Intern Logan
*Luke Diliberto as Intern #2
*Andrea Savopolos as Intern #3
==Medical Notes==
===Ruth Bennet===
*Diagnosis:
**Appendicitis
**Chronic obstructive pulmonary disease
*Doctors:
**Teddy Altman (cardiothoracic surgeon)
**Cristina Yang (surgical resident)
**Logan (surgical intern)
**Two other unnamed interns
*Treatment:
**Mitral valve replacement
**Appendectomy
Ruth, 50, was in the hospital for a mitral valve replacement. However, she experienced stomach pain overnight that was diagnosed as appendicitis. Teddy had Cristina operate to remove her appendix in an open procedure. In surgery, Cristina couldn't remember the steps to an appendectomy and quickly figured out that Teddy couldn't either. With the help of one of the scrub nurses, Cristina was able to finish the surgery.
===Peds Patient===
*Diagnosis:
**Cleft lip
*Doctors:
**Arizona Robbins (pediatric surgeon)
**Mark Sloan (plastic surgeon)
**Jackson Avery (surgical resident)
*Treatment:
**Cheiloplasty
**Millard rotation
Jackson was scheduled to operate on an infant with a cleft lip. However, after Arizona expressed doubt about the surgical plan he presented, he decided she'd have Mark operate instead. Jackson then practiced the technique Arizona wanted. Despite this, in the OR, Jackson stepped back and Mark Sloan ultimately operated. The procedure went well and the patient's mother was pleased with the result.
===S. Jaffe===
*Diagnosis:
*Doctors:
**Callie Torres (orthopedic surgeon)
**April Kepner (surgical resident)
*Treatment:
**Arthroscopy
**Meniscus repair
April was meant to do an arthroscopy and meniscus repair on the first day the fifth years were rotating in as lead surgeons. However, since she had to teach skills lab and assist Alex in his surgery, Callie took over for her.
===Arizona's Patient===
*Diagnosis:
**Esophageal atresia
*Doctors:
**Arizona Robbins (pediatric surgeon)
**Alex Karev (surgical resident)
*Treatment:
**Surgery
Arizona had a three month old patient who had esophageal atresia. Alex was supposed to operate, but he traded for a bowel resection.
===Sam Kenton===
*Diagnosis:
**Chronic mesenteric ischemia
*Doctors:
**Richard Webber (general surgeon)
**Alex Karev (surgical resident)
**April Kepner (surgical resident)
*Treatment:
**Exploratory laparotomy
Sam, 55, was a long-time patient of Richard Webber. He was in for his third surgery. Alex used a procedure that would allow the viable portions of bowel to glow in surgery. However, while he was operating, he discovered that very little of the bowel was viable and he'd be unable to resect any part of Sam's bowel. He had to close and inform Sam's son that Sam would die of sepsis.
===Rob Colvin===
*Diagnosis:
**Aneurysm
*Doctors:
**Meredith Grey (surgical resident)
**Derek Shepherd (neurosurgeon)
*Treatment:
**Aneurysm clipping
Meredith clipped the aneurysm of Rob Colvin in surgery. Despite disagreeing with Derek about which clip to use in surgery, Meredith successfully clipped the aneurysm.
==Music==
Song 	Performer 	Scene
"Don't Stop (Color on The Walls)" 	Foster The People 	
*A nurse fills in the OR board.
*During a meeting, attendings are informed that fifth year residents will rotate in as lead surgeons.
*Richard tells his attendings he resigns as Chief, with Owen taking over his position.
*Teddy is the only one enthusiastic about the change.
"Each Other Brother" 	Mozella feat. Tim Myers	
*Alex is operating on a pig.
*The other residents come in, complaining about their solo surgeries.
*Alex shows off his fluorescein dye.
"Lost and Found" 	Katie Herzig 	
*The residents are performing their procedures, their names being removed from the OR board when finished.
*Teddy and Cristina do not remember how to do an appendectomy, so a scrub nurse has to tell them.
*Alex panics, but Richard refuses to step in.
*Jackson watches his patient's mother thank Mark.
*Teddy and Cristina feel ashamed.
*April encourages Alex before he talks to the patient's family.
*Meredith gets applause when she's done.
"Nothing But Time" 	Opus Orange 	
*The residents discuss their days and problems.
*Jackson loses their competition.
*April finds her groove as Chief Resident.
*Bailey is not planning to be nice to Owen. 
*Richard tells her she needs to be happy for him instead of angry at Meredith, but that'll take time for her.
"Rain (Setting Out in The Leaf Boat)"	The Innocence Mission 	
*Derek and Meredith fight about his trust in her.
*Meredith decides never being on his service again is the consequence for what she did.
*Cristina and Owen are sick in the bathroom.
*Meredith and Derek lie down in silence, the camera panning towards Zola's empty crib.
"Don't Stop (Color on the Walls)" - Foster the People
"Each Other Brother" - Mozella feat. Tim Myers
"Lost and Found" - Katie Herzig
"Nothing But Time" - Opus Orange
"Rain (Setting Out in the Leaf Boat)" - The Innocence Mission
==Notes and Trivia==
thumb|300px|right
*The episode's title originated from the song Take the Lead, originally sung by Bone Thugs-N-Harmony.
*This episode scored 10.20 million viewers.https://archive.today/20120721180113/http://tvbythenumbers.zap2it.com/2011/09/30/thursday-final-ratings-x-factor-the-big-bang-theory-greys-anatomy-the-office-the-secret-circle-mentalist-adjusted-up/105546/
*The residents wonder if a pig has an appendix. The answer, which is not given in the episode, is that pigs do not have one.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458388/
*Richard Webber is seen wearing his "Chief of Surgery" coat throughout the episode while he officially resigned at the beginning of the episode.
*This is the only episode during Chyler Leigh's time as a series regular where she did not appear as Lexie Grey.
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==Gallery==
===Episode Stills===
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==Quotes==
:Meredith: We should never have been in that OR together today.
:Derek: What do you mean?
:Meredith: We're not a team, anywhere. And when we get Zola back, before we get that phone call, we need to figure out if we can be one, if we can even be together, so, now's the time to say how you feel
:Derek: I can't, I'm gonna say things that are, uh--
:Meredith: Oh, Derek, just say it. Whatever it is, we can deal with it. I can accept the consequences
:Derek: Meredith, you have never accepted a consequence in your life. Since the moment you switched those files, you haven't suffered one bit... While those around you have lost their jobs and lost their reputations.
:Meredith: And I lost Zola.
:Derek: So did I! Because yo do things without a thought, you just dive in and never give a damn how deep the water is or who you're gonna land on.
:Meredith: I know I messed up. But all of this happened before Zola was even in the picture. Don't you think I've changed?
:Derek: I don't think you can change. You stole the baby, Meredith.
:Meredith: Oh, I told you why I did that. What do you need for me to say, "I'm sorry"?
:Derek: I need you to be sorry!
:Meredith: Of course, I'm sorry!
:Derek: You did it again today in the OR!
:Meredith: I had a successful surgery today.
:Derek: You refused to listen to me!
:Meredith: I didn't listen to you because I didn't need to listen to you. I knew what I was doing and I was right. You just couldn’t trust me.
:Derek: Why should I ever trust you? Why should I trust you? You ended my trial, you set back my career, you nearly ended your own, you destroyed Richard’s. I have no reason to trust you!
:Meredith: Well, then, why are you with me?
:Derek: (points to its post-it) Because of that! Because I meant that! I promised I wouldn’t run. I promised I would love you.
:Meredith: Even when you hate me.
:Derek: Even when I hate you. I’m trying, Meredith. I am trying, but you make it so damn hard.
:Meredith: I understand, and I don’t want you to keep the promise, not if you don’t want to, and not if you can’t trust me with our daughter.
:Derek: I do, I trust you with Zola.
:Meredith: Well, you just said—
:Derek: That’s not what I said. I know that you took her to protect her, I know you altered the trial for Adele and for Richard. You stood in front of a bullet for me. I know why you do all of it. It’s what I love about you.
:Meredith: And what you hate about me.
:Derek: Yeah!
:Meredith: So, you can't trust me at work.
:Derek: No
:Meredith: Well, that's easy then. (pauses) So, we just don't work together.
:Derek: So what are you saying?
:Meredith: I'm off your service. That's my consequence. If we want to stay together, with or without Zola, we just can't work together.
----
:(Owen, the new Chief, runs up to Bailey, who's about to leave the hospital.)
:Owen: Dr. Bailey! Hold up please! I learned in the army that a leader is only as good as the people around him. Now, you are one of the best people on this team and I just wanna make sure that I have you on my side.
:Bailey: Have I done something wrong?
:Owen: No.
:Bailey: Is there something in my job performance that prompts you to ask me this?
:Owen: Not... No.
:Bailey: Or do you just need me to like you?
:Owen: It's not that!
:Bailey: Are you sure?
:Owen (He is astonished and doesn't know what to say anymore.): Carry on, Dr. Bailey.
----
:Richard: (to Derek who is packing files in a box) That Alzheimer's trial? Heard from the FDA?
:Derek: I'm sending it to Phoenix. Carl Baumann is taking over. I'm blacklisted. I may never do another clinical trial ever again.
:Richard: I've been blacklisted, too.
:Derek: And now you're gonna let them fire you.
:Richard: I fired myself.
:Derek: It was one thing taking the blame for Meredith and losing the trial, but why are you doing this to yourself?
:Richard: You know, I came to ask if you heard anything about your little girl.
:Derek: No, I have not. This isn't right.
:Richard: Hope you hear soon.
----
:Owen: Dr. Bailey, your call schedule. Sorry it was so, uh...
:Bailey: Uh-huh.
:Owen: So, Bailey, I know you've take over Dr. Webber's islet cell trial, and I wanted to offer you some protected time for your research. I can reduce your OR schedule, lighten your teaching load, make sure you get that time that you need. How does that sound?
:Bailey: You telling me I don't manage my time well?
:Owen: No. No. No. No, No. I- Uhhh, I...I just wanted to make sure that your research got the time and...
:Bailey: Oh, you're telling me how to use my time?
:Owen: N-Not at all. I wouldn't. I just- I'm sorry. Just forget I mentioned...
:Bailey: Oh, now I don't get the time?
:Owen: No, you do, you do. You can just do what... (Bailey scoffs and walks off)
----
:Richard: Effective at 9:00 a.m. this morning, I have resigned as Chief of Surgery at Seattle Grace Mercy West hospital. I will stay on the surgical staff and I will turn this meeting over to the new Chief of Surgery, Dr. Owen Hunt.
:Owen: (stands up): Thanks, Dr. Webber. I know this comes as a surprise to you too and I appreciate over the next couple of days your help and your patience. So, I have your call schedules, but I can have them…
:Arizona: Wait, what happened?
:Mark: Why did it happen?
:Derek: (quietly, to Richard) Is this the Board? Are they forcing you to step down?
:Teddy: Hunt. You're the new Chief of Surgery. Nice!
==See Also==
de:Führungskrise
fr:Prendre la main
Category:All Episodes
Category:GA Episodes
Category:GA S8 Episodes