The doctors are forced to make life-altering decisions, and Cristina learns why she lost the Harper Avery

By Samantha Highfill
Updated April 25, 2014 at 07:11 AM EDT
Kelsey McNeal/ABC

Cristina’s last episodes have me on edge, because every time she makes a move, I’m over-analyzing. Did she just walk out of the hospital for the last time? Is she done being a surgeon? And no, I didn’t watch the preview for next week, which I’m sure would answer these questions, but I’d rather just hash out my feelings here with you guys. Sound good? Let’s do it!

Immediately following last week’s Harper Avery ceremony, Meredith and Owen boarded a plane back to Seattle without Cristina, who apparently had reacted to her shocking loss with four simple words: “That’s how it goes.” Meredith, on the other hand, had many, many words to say about Cristina’s loss, including that she had been robbed, that all members of the Avery family suck — even Kepner, who was an Avery by association. And don’t let me forget the moment when Meredith called the doctor who won “Dr. Nobody Sucks a Lot.” Hey, I didn’t say she was throwing around good insults, just lots and lots of them.

Back in Seattle, Derek was on his way out the door when his sister Amelia stopped by! They hadn’t talked for two months — and we hadn’t seen her since Private Practice! — but she wanted to tell him that she and James had gotten engaged. And for those of you who don’t know, James is adorable, and this is good news. Yes, he has good hair. No, it’s not as good as the Shepherd hair genes, but Amelia can help with that. Regardless, she stopped by to check out what the married-with-kids life looked like, because getting engaged did nothing but freak her out. Was she ready to handle the domestic side of life? Well, she was going to get her first taste of it right now, because Derek left her with two kids for an entire day, which was a lot to put on one person, McDreamy. You should’ve known better.

Over at casa Calzona, April was busy borrowing toothpaste and injecting her opinion into other people’s business, to which Callie’s response was very reminiscent of Bailey’s “Stop looking at my vajayjay!” Only Callie’s comment was, “Get out of my vagina.” I guess you cut right to the point after two nights of Kepner constantly talking about her marital problems. I’m betting Callie really would’ve liked to have stayed at Alex’s house, where he and Jo were implementing a strictly no talking, more sex policy. And it seemed to be working — Alex was offered the private practice gig and had until the end of the day to decide.

At the hospital, difficult decisions were the theme of the day. Avery was having to evaluate the many research projects, because the foundation decided that they needed to do a little trimming. And of course, that put Derek, Callie, Meredith, Cristina, and Bailey all on the chopping block. Add that to the fact that Cristina was clearly robbed, and it was not a good week to be an Avery. But it was an even worse week to be a member of the heart family. Frankie got a crappy heart, Link was still on a heart pump, and Ivy was going into full rejection. It was a good thing Cristina — who gave some crap line about how it “was an honor just to be nominated — had returned home.

NEXT: Don’t do it, Bailey!

On a trip to get another heart for Frankie, which happened freakishly fast, Karev and Arizona discussed his new private practice offer. He spent the entire plane ride waiting for her to talk him out of it before talking over her. Although, I will give him props for this line: “Can we not talk about the last time you were on a plane?” Well done, writers! But as Karev explained, he had already stayed at the hospital for Arizona once, and it was time he did something for himself. And surprisingly, she agreed. She would miss him, but he needed to do what’s best for him. Plus, he’ll still have hospital privileges, so we’ll still see him around. By episode’s end, he’d given his notice to the board … and I’m still sorting through my feelings about it.

Also dealing with a difficult decision was Bailey, whose research was put under a microscope when Jackson pointed out that she didn’t have any hard evidence proving that it worked. And when Bubble Boy’s mom started chatting with Heart family’s mom, it only freaked her out. She told Bailey that they were no longer allowed to inject her son with the enzyme (and therefore HIV), despite his worsening condition. Little did she realize that she’d already signed the consent form, which Bailey was keeping in her pocket. Correct me if I’m wrong — which is highly possible — but with her signature, it wouldn’t be illegal for Bailey to move forward, it would just be awful and morally reprehensible and scarring, right? Sounds like it’s right up our alley then!

But present-day impossible decisions weren’t the only thing on the agenda. There was also that previous decision. You know, the one where Cristina didn’t win the Harper Avery? Richard surprised Catherine with a visit across the country so that they could spend a little post-awards weekend together, but Catherine immediately jumped to the conclusion that Richard wanted to talk about why Yang didn’t win. That actually wasn’t his intention, but once she said it, he couldn’t help but get involved. None of the other contestants even compared to Yang. So why didn’t she win? The simple answer: Politics. The Harper Avery Foundation co-owns Grey Sloan Memorial Hospital, where Yang works, which means that she could never have won that award. And nobody from the hospital ever will, Richard pointed out.

Things only got worse when Catherine threw her $24 million in Richard’s face and then admitted that Yang did have the votes to win. The award technically was hers. And in that moment, Richard revealed why he’d really come to visit Catherine. He was going to propose. But after realizing what Catherine had done, he left the ring on her desk and walked out the door. Unimportant, totally shallow thought: Do we think the ring lived up to Catherine’s standards? I mean, did you see her office?

In the episode’s most adorable moment, Meredith and Derek finally got to spend some alone time together. He scheduled them a joint surgery, they had a little “dessert” in an on-call room, and they pondered what life would be like if Amelia came to stay with them in their extra room and helped take care of the kids more often. Too bad that dream was shut down as soon as they got home to a disaster of a dream house. The kids were asleep, but they’d taken Amelia down with them. As Meredith put it, “The children broke your sister.” I will say that, in general, I really enjoyed Amelia on Private Practice, and I always enjoy watching Derek be a protective big brother, so I’m all about Amelia sticking around for a bit.

You know who can go, though? Freaking Leah. All she did this episode was panic, sort of help Cristina on a surgery, and then somehow need a pep talk when a patient that she barely had any involvement with died. I realize how cold that probably made me sound just then, but I trust you all to see through it. I just never liked her character and am glad that both she and Shane — which hurts me to say (sorry Smash!) — won’t last much longer.

NEXT: Somebody’s pregnant!

And speaking of things that won’t last much longer, Jackson and April once again had a little chat about religion. Despite Owen telling April that religion would not be the “pick-up truck” that runs over their relationship, April couldn’t stop thinking about Jackson’s face when she’d talk to their kids about religion. He had a great line about, “If you believe in God, then you believe he made me.” He reminded her that they share core values, but when she brought up kids again, he was done discussing hypothetical children. Too bad they’re not hypothetical anymore, Jackson! April’s pregnant! So will she and Callie actually be belly buddies, now?!

Alright, let’s get to what was arguably the toughest decision of the episode with Cristina. When Karev and Arizona went to get Frankie another heart, Ivy’s condition worsened, and Cristina went to the parents with a proposal. Ivy was also a match for Frankie’s new heart, and Ivy was also a better candidate for success. Cristina said they could put Frankie on an artificial heart for now if they wanted to give the heart to Ivy, but the parents couldn’t pick. Sophie’s choice is quite literally the worst thing ever, so you couldn’t blame them. They trusted Yang to make the decision, and she did.

Yang gave the heart to Ivy, and the transplant went beautifully. Frankie, however, died when they attempted to fit her with an artificial heart. And cue the equally heartbreaking and infuriating “We trusted you!” speech from the grief-stricken parents.

After the surgery, Richard found Hunt to fill him in on what he’d learned before Hunt found Cristina in the shower, not unlike what happened with Mer after the bomb exploded in season 2. Fully clothed, standing in the shower, Cristina said she knew it was an impossible decision, but she also knew that she’d made the right call. But this was about the Harper Avery. “I did everything exactly as I was supposed to. I did it perfectly,” she said. “What’s the point, Owen? What’s the point of anything?” And in that moment, he decided to tell her what he had just learned. She had won the award. She had the most votes. The politics had screwed her. She’d never stood a chance.

And as Meredith’s voiceover talked about how “Once you’ve decided, you can’t ever go back,” Cristina walked out of the doors of the hospital. Somebody tell me what she’s going to do!! She’s obviously not headed to Meredith’s to dance it out, and I’m scared.

But what did you all think of the episode? Are you down for some more Amelia next week? How do you feel about Alex’s private practice decision? And what the heck comes next for Cristina? Sound off below!

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