Izzie goes after her tumor, George makes a life-altering decision, and Meredith and Derek pledge to stay together in the season finale

By Jennifer Armstrong
Updated May 15, 2009 at 04:00 PM EDT
Scott Garfield/ABC

Tonight may have marked the most emotionally loaded episode of Grey’s Anatomy ever, for a zillion reasons. It has been a tough year — quite frankly, an uneven year, even for diehard fans. Guest stars have flitted in and out, more unreliable than a 23-year-old boyfriend. Ghosts have shown up, more reliable than a call from Mom on Sunday night. But most importantly, at least for this episode, rumors have flown about everything from who might be staying together (Cristina and Owen?) to who might be leaving the show for good (George? Izzie?). We knew Bailey would leave her hubby; we guessed Mer and Der might finally tie the knot. In the end, this two-hour finale didn’t quite answer every question — um, actually it left a few really, really dangling, in a way that flustered me almost as much as Lost’s cliffhanger last night. (Anyone else suffering a massive pop cultural hangover right now? Or was that just the glass of red wine that was medically necessary to get me through all of this?) Herein, the answers — insofar as we know — to the biggest Grey’s questions of the day:

WHO IS JACOB? AND HOW DID HE MANAGE TO BEAT DANNY GOKEY? AND WHY AM I SO DAMN HAPPY ABOUT THAT?

Oh, sorry. Let me start again. One last swig of wine. (It was only one glass. I’m fine.)

WHAT’S TO BECOME OF CRISTINA AND OWEN?

Friday Night Lights‘ own Matt Saracen (i.e. Zach Gilford) — who melts me wherever he shows up — managed to inadvertently fluster Seattle Grace’s It-Emo Couple of the moment as a soldier who couldn’t move his leg without massive pain. Not that it’s hard to fluster them. He really didn’t have to go to nerve-damage lengths. Regardless, he wanted Callie to cut his leg off so he could get a prosthetic and return to battle — and that prompted Owen to think he, too, should return to Iraq, as he felt his work wasn’t done there. ”I could use your support,” he said when he told Cristina. ”You don’t have it,” she snapped.

Later, she explained, slightly more lovingly, ”I don’t want you to die.” And that’s when he turned around, asking her to come with him to resolve his unfinished business…with his mom, whom he hadn’t even told he was back from Iraq. (And she was played by the lovely Debra Mooney of Everwood. Because apparently it was all-stars-of-my-favorite-shows-ever night on Grey’s Anatomy. Yeah, there were more. Lots more.) After the visit, he reported to Cristina that he’d slept without nightmares…and good lord, even their quick kisses in the hospital hallway are hot. More wine please.

Naturally they ended up back in that steamer/propeller room that is their special place, where Sandra Oh gave the best line reading ever for ”I love you.” The best I can approximate it in print is ”I …love…you…?” But that’s not even close. You watched it. You know what I’m talking about. ”I said I love you,” she continued incredulously. Me, Cristina Yang.… It’s like you come here, and you pull out my icicle, and you make me love you. I don’t want…it’s like I can’t breathe without you.” You said it, sister. His answer: ”All you have to do is say yes.” We’ll get to her answer in a bit.

IS BAILEY GOING TO DO ANYTHING ABOUT HER FAILING MARRIAGE?

It started with an 8-year-old neuroblastoma patient. (It’s a kind of cancer kids get where tumors form outside their cranium.) Arizona wanted Bailey to scrub in. ”That depends,” Bailey quipped. ”Got any more dying children you want me to become overly attached to before they expire?” The Chief saw her weakness and tried to beckon her back to general surgery with a new fancy surgery machine thing. Cool move: She was visibly thrilled, even making light saber noises as she tried it out. Arizona broke down in front of the Chief and cried — cried! — blathering something about this being how she reacts when authority figures make her mad. I was glad Callie wasn’t around to see it. ”It’s wrong and mean to use a robot to lure Bailey back into general surgery,” she said. Is it, though?

NEXT: Izzie’s decision

But then Arizona lured her with something even better — she showed her the happy kid post-successful-surgery. Bailey even brought a bummed-out Kimberly Elise and Callie with her to ”see the joy.” Then Arizona officially dropped the news on Bailey that she’d gotten the coveted peds fellowship, but Bailey still didn’t seem happy. Finally, she revealed that her husband had told her he’d divorce her if she signed up for yet another two years of training. She’d be leaving him just for making the threat — but because she was going to be a single mom, she didn’t think it was the right time to take on a new specialty. ”What Tucker’s facing isn’t scary,” she said as she cried — and we don’t see Bailey cry often — to the Chief. ”He’s just weak.”

DID DEREK GET THAT HAIRCUT FOR THEIR WEDDING?

It’s way shorter. His grey streak is nearly invisible. I am sad on all counts. I am comforting myself that it will grow out during the summer and all will be well by the time we return. I am sure this will be the only thing I could possibly be left wondering about with regards to ‘Grey’s Anatomy’ over the summer, right?

WILL IZZIE KICK CANCER?

Okay, let’s get to one of the biggies now. Derek wanted to perform surgery to get Izzie’s new tumor out, the one little risk being that it could kill her memory off. That doctor played by Kimberly Elise (her name’s Dr. Swender, but who knew that?) touted other therapies as possibly just as effective with less risk. Derek administered a truly fascinating memory test (I was a psych minor, bear with me) wherein he shut down the part of her brain she could lose to see what the worst-case scenario might look like — and, well, she not only lost all memory of flashcards, she couldn’t identify the people she loved nor even talk. So that would be a really bad worst case. (But you want acting to do, you got acting to do, Katherine Heigl. And you did it well.) That gave Meredith flashbacks to her Alzheimer’s-stricken mom, and she demanded Izzie not undergo the surgery. Meanwhile, Alex begged Derek for answers: ”She’s the one good thing that ever happened to me.” Derek said if it were him, he’d ask Meredith to have the surgery.

As Izzie wavered, she visited Kimberly Elise’s patient who’d recovered from the same kind of tumors just fine without surgery — and she was played by Paris Gellar of Gilmore Girls (Liza Weil)! ”I have really long conversations with dead people,” Izzie explained to Paris of her own hallucinations, thus making me wonder if a sizable number of prime-time television characters (The Ghost Whisperer, Medium) are secretly suffering from brain tumors. Still, she decided that if Paris could live without surgery, so could she.

That didn’t sit well with Derek, especially when he found out Cristina and Meredith had helped talk her out of it. When Meredith told him, ”My mother disappeared right in front of me,” he responded, hilariously unaware of what hospital he works in, ”Don’t make this personal.” I even wondered for a second if he wasn’t making it a little personal when he ordered her, ”Now as my resident, go back there and change it.” Would he really say that to a resident who wasn’t his fiancée? I’m not sure.

But there were far, far more things to worry about in this episode, starting with the fact that Paris was crashing while Izzie sat with her. She never recovered, and would be stuck on a ventilator, likely for the rest of her life. For the first time, I truly believed Izzie would likely leave the show. I mean, would they really have a character as a vegetable for the better part of next season? No. So she’d either have to die or pull off what was starting to look like an extremely miraculous recovery.

Izzie must’ve been thinking along the same lines, because she paged George, and it made me happy to see someone acknowledge his character’s existence and significance. ”You know what to do,” he said, wisely. ”You’re just scared to do it. This back and forth is just fear.” (True, incidentally, in almost any situation in life in which you’re wavering.) She decided to go forward with surgery — and sign a DNR so she wouldn’t hijack next season as a vegetable. Noble.

NEXT: Izzie’s making memories

But she got through it, and she even woke up not too long afterwards! ”I have a headache,” were her first words. Derek informed her that he’d gotten the tumor out. She appeared to know what was going on, who everyone was, and even how to talk medical. ”You are a great surgeon,” she teased Derek, ”but I really thought I was gonna be a turnip.” Then bad things started happening — she didn’t remember how the surgery had gone, even though he’d just told her. She kept asking every few minutes. Her short-term memory was shot. Alex had to write everything on little notes all over her bed just so she’d remember it. He relentlessly quizzed her in hopes of making something stick. ”Her future is on me,” he snapped to Derek.

Reading his frustration, Izzie finally urged Alex to ”go ahead, get it off your chest, because it’s not like I’m going to remember in five minutes.”

And he did: ”Okay, I’m not the one with a carrot for a brain, but I’m married to it because of some crock of a wedding that we walked into, and only because the two of us thought you’d be dead within a week. You made me promise you that you wouldn’t live like this. So now what the hell am I supposed to do? Smother you with a pillow? Shoot you up with an overdose of morphine? Not really psyched about that. Leave you? Because I’m not really psyched about that either. So I guess I’m kinda screwed, right? I mean not as bad as you, but not a freakin’ walk in the park either. I’m sorry Iz.”

”No, I told you to get it off your chest,” she replied. ”You did.”

”Did you forget yet?”

”Nope.”

But minutes later she still remembered. And then she still remembered. And then she told Cristina about it.

WILL MER AND DER EVER MAKE IT OFFICIAL AFTER GIVING THEIR WEDDING TO ALEX AND IZZIE LAST WEEK?

Appropriately enough, Alex and Izzie’s tearful pre-surgery showdown over whether she should stick with her DNR — he was worried it would make him do something crazy like ”cut LVAD wires,” but she didn’t want to live comatose in a hospital — inspired Derek and Meredith to move forward with their nuptials. ”Let’s go to city hall tomorrow,” Meredith said next to Izzie’s gurney. ”I don’t want to spend another day not being married to you.”

When Meredith told Cristina she and Derek were getting married the next day, they refused to get too sappy, but they did have a sweet exchange in which Cristina gave her some Post-Its and a pen that all somehow represented the ”old, new, borrowed, blue” adage. Later, Cristina wondered aloud if maybe things were a little too hectic — what with the cancer and the patients and the rest of the stuff we’ll get to in a minute — to sneak off for a wedding. ”It doesn’t seem like the day for it,” she said. But Meredith still refused to wait another second to show Derek how much he meant to her. Or to show her best friend how much she meant to her. ”I love you, Cristina Yang.” Cristina quipped, ”You have changed.” But then Cristina initiated the hug, showing Meredith wasn’t the only one.

We’ll get to whether Mer and Der really made it in a bit. But it’s also important to note, before things get too heavy, that Sloan decided to buy a house and asked Lexie to move in. She told him she would — in maybe like five years. He was crushed. He’s buying a house anyway. We are proud of the progress he has made. Gold stars for many heretofore emotionally immature adults this week.

NEXT: In the army now

WHAT WILL BECOME OF GEORGE, GIVEN RUMORS THAT T.R. KNIGHT IS LEAVING THE SHOW?

Phew. This is a big one.

So Matt Saracen-as-soldier convinced Callie to take his leg off even though it was still technically healthy — because it was the only way for him to get back to fighting in Iraq. He said his fellow soldiers in the trenches were his ”real family”: ”Whatever we got into, we got in it together. I’ve tried fitting in here, I’ve tried being a regular person. I tried getting a job but there aren’t any.” It worked on Callie, and it worked on George, apparently, too.

Because George decided to enlist in the Army. He told Bailey first: ”I think eventually you’re gonna be proud,” he said, ”but before that you’re gonna be like, ‘What did you do?”’ (The line was funnier with him doing the Bailey voice.) He was right, she was like that — and as news spread among Seattle Gracers, reaction was mixed. Some were proud of him, but many — mostly his closest friends — were like, ”What did you do?” (Arizona and Callie even fought over it for a bit before Arizona revealed that her brother was killed in Iraq ”because there weren’t enough doctors.”) An ”intervention” was organized for 6 p.m. when he’d scrub out of his last surgery and leave for the night. ”He’s the guy who gets killed cleaning his own gun,” Cristina said. With love. I think.

AND HOW DID THIS ALL TURN OUT?

The doctors got distracted from pretty much everything when an unidentified guy came in basically in bloody pulp form after being dragged by a bus for half a block. He’d jumped out in front of it to save a girl played by Shannon Lucio (Lindsay from The O.C.!) from being hit. His skull was smashed in so badly that somehow drilling into it was a good thing, though I couldn’t really watch that. Shannon lingered whenever she could, convinced ”that is my prince in that bed.”

Clearly it was not becoming any easier for Derek and Meredith to end their day with a wedding. ”I wanna check on Izzie,” Derek told Meredith in the locker room. ”Maybe we can do that first and then go get married after.” Meredith replied, ”We can’t because we have the George intervention after that.” But she still wanted to do the wedding. ”There is no other day,” she said. ”Every day is like this.” Then they decided to write their vows to each other right there. On the Post-Its, with the pen that Cristina gave her. They vowed to love each other even when they hate each other, not to run away from each other no matter what, to take care of each other when they’re ”old and smelly and senile.” I’m about as sappy as Cristina and Meredith, but even I found it absolutely adorable. They signed their vows. I cried.

But, really, that was just the beginning of the waterworks. Once Izzie seemed to be remembering things again, Cristina remembered what Owen had said to her in the propeller room place, and she ran off to find him and say ”yes.”

Before we could be too happy about that, though, Izzie coded. Which was particularly bad because she’d signed the DNR. But Alex demanded a crash cart, and eventually the Chief broke the DNR to try to revive her. That was the last we’d know of her for this episode.

When the docs started looking for George for the ”intervention,” the Chief said George had never scrubbed in — he’d left to spend the day with his mom. So Meredith went back to check on the bus accident victim, who’d been trying to tell her something by spelling it out on her hand with his finger. He couldn’t quite do it earlier, but he finally did this time: ”007.” George’s nickname.

Meredith ran to tell everyone. But that was the last we’d see of him until next season (except for a shot of him and Izzie in a Grey’s version of the afterlife, with him in an Army uniform and her in her “prom” dress).

Cliffhangers are a bitch.

What did you think, Grey’s watchers? Was this the most emotionally loaded finale ever? Were you happy to see Cristina and Owen moving forward? Did Bailey do the right thing by leaving her husband? Did Mer-Der’s ”wedding” live up to your expectations? Did you like Derek’s haircut?

Oh, right, one other thing: Will Izzie and George live or die? How did you feel about the George twist? What did you think of leaving it unresolved?

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