Grey's Anatomy: Season 4
Episode 1

Synopsis:

Christina, back from her honeymoon trip, searches in vain for Burke; Meredith, Cristina, Izzie and Alex spend their first day as residents with their own groups of interns.

(From ABC)
Having just returned from her honeymoon with Meredith, Cristina searches for Burke, but he's nowhere to be found. Meredith, Cristina, Izzie and Alex spend their first day as residents with their own groups of interns - among the interns are George, repeating his intern year after failing his exams, and Lexie Grey, Meredith's half-sister whom she has never met. Now that Derek's relationship with Meredith has reached an emotional impasse, he looks to his fellow doctors for friendship; Bailey wrestles with her place within the hospital now that her former interns report to new Chief Resident Callie; and Richard resumes his position as Chief of Surgery.

Neither Cristina or Meredith have heard from her exes since the wedding, and they don't seem overly concerned, which astounds Izzie, who is counting every day since she last spoke to George. George asks to talk to Meredith but before he can get her alone, the rest of the new interns show up in the hall and are shooed off by the residents. George gives up and joins the interns. Cristina nicknames him "Bambi," saying he needs to learn how to deal with his new situation.

George complains to Callie about being an intern again and she tries to reassure him by saying he's going to be the "rock star" intern. When that fails to cheer him up, she suggests maybe they'll see him as the "daddy" intern. He's rattled rather than pleased by the suggestion that she might be pregnant.

Miranda is still bitter over being passed over for Chief Resident. Without Burke or Meredith to hang out with, Derek asks Miranda out for a drink after work and she turns him down, as does the Chief.

A multi-car pileup is en route to the hospital, proving Callie's first responsibility as Chief Resident. The residents she paged are MIA and Miranda drily notes that when she paged them, they always came running. The Chief tells Callie to "get it together."

The residents instruct their interns and Izzie overhears hers saying they know her history and lamenting that they got stuck with "the dud."

The first ambulance from the multi-car accident arrives with a DOA and Cristina pulls back the sheet to show the interns their first "dead guy." The second ambulance contains a pregnant woman whose arm has been severed and the third one holds a heavyset man with a knee injury who surprises everyone by asking for something to eat.

Lexie introduces herself to Meredith, who is stunned to learn that she has another half sister. Derek approaches Meredith, just as Lexie comes up to apologize for botching her introduction. Derek recognizes Lexie as "the girl from the bar," and Meredith gives him a disgusted look and says, "I'm the girl from the bar" and walks off. Lexie frets that Meredith has another reason to hate her now.

Cristina asks Derek if Burke is off today and he reluctantly informs her that Burke turned in his resignation two weeks ago.

Cristina is pronouncing time of death for the dead man when he starts to breathe! He's been internally decapitated -- the only thing holding his head on is his skin. Derek assures him he'll try to reconnect his spine. Cristina tells the wife that if he moves even a fraction of an inch, he could die and that this may be the last time she sees her husband alive. During surgery, the patient starts to move and Cristina orders him stay still, saying he can't abandon his family like that. Miraculously, he pulls through.

The pregnant woman says she really needs her arm since her baby has no father. Mark orders Meredith to find the severed arm.

A young boy and his father come running into the E.R. carrying the arm and the boy begs Izzie to help him with another patient who's in the truck. Izzie -- who's had nothing for her interns to do yet -- rallies her group and follows the boy outside, where she is speechless to discover that her new patient is the deer that caused the accident. When the deer opens its eyes and looks at her, she agrees to try to save it, to the dismay of her interns, who think she's crazy. The father insists there's no point in saving an animal that they'd usually be eating. Izzie is horrified at the father's attitude and insists that she's going to save "Bambi."

George and Izzie meet in the stairwell and she accuses him of avoiding her since she told him that she loves him. She says she's busy trying to save Bambi and he misunderstands, thinking she's using the same nickname Cristina has for him. Izzie insists that she's Bambi -- alone and scared -- and George tells her he's needed in surgery.

Mark informs Nancy, the pregnant woman, that he can reattach her arm. During the procedure, she goes into labor and George delivers the baby.

Alex is upset that Callie won't let him switch to a surgical case. Callie is furious that she wasn't notified when the man with the knee injury ends up in emergency surgery --- turns out he's got a mania for eating random objects and now he has a perforated stomach. Miranda insists that Alex did the right thing by rushing him to surgery and there wasn't time to inform her. Richard tells Miranda that the reason he didn't name her as Chief Resident was because he thinks she's better as a surgeon than juggling paperwork.

Mark wants to take Derek up on the offer for a drink, saying he thinks he could use a friend. When Mark slams Meredith, Derek defends her, saying he doesn't blame her for running after seeing that Cristina was left at the altar. Mark insists that he didn't come to Seattle for Addison, he came to patch things up with Derek. "Maybe we should have a drink," Derek smiles, "but not today."

Izzie manages to bring the deer back to life and then informs her interns that they have to be ready for anything, even something like this. She announces that they're stuck with her and she's sorry she's stuck with them since they're all obviously "duds."

When George isn't ecstatic over delivering the baby, Lexie lectures him that he should be, and tells him he's not the only one whose life hasn't gone according to plan. The other interns are impressed by George delivering a baby on his "first day" and he slowly warms to their praise.

Alex confides to Cristina that he misses Rebecca and she says she misses Burke.

Callie is depressed over how the residents don't respect or listen to her and invites Miranda to tell her how terrible she is at her job. "Hope tomorrow is better," is all Miranda says.

Meredith tells Derek it's over but she agrees to a breakup kiss, and then to breakup sex.

George shows up at Izzie's house and tells her, "I love you too."