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‘Grey's Anatomy’ 10x21: A pregnancy, a proposal, a resignation and a revelation

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As with all the episode titles on “Grey’s Anatomy,” episode 10x21 “Change of Heart” had multiple meanings. The most obvious dealt with one available heart and two sibling transplant patients but other changes of heart happened, too. As recounted in the April 24 recap on Hypable, very few were left untouched by the end of the episode. If you haven’t seen the episode yet, there are spoilers ahead.

Following Cristina’s loss at the Harper Avery Awards, Meredith is bitter on her friend’s behalf. She and Owen are worried when Cristina drops below the radar and disappears. Meredith lashes out at April because she’s an Avery by marriage.

Derek is surprised but delighted when his sister Amelia arrives unexpectedly. She’s freaking out because she’s now engaged and not sure she can handle the kind of life Meredith and Derek have built. She wants to see what it’s like so Derek leaves the kids with her and trots merrily off to work where he and Meredith have a date in the OR with a shared surgery.

April is still a houseguest at Callie and Arizona’s place following the fight she and Jackson had. As the couple tries to lan their upcoming pregnancy, April butts in and it becomes obvious she has over-stayed her welcome. At work, April continued to irritate others with her obsessing over the fight. When she confides her fear that she and Jackson may never get past this to Owen, he makes her feel better.

Cristina turns up at the hospital and takes over the heart surgery on one of the siblings she has been treating. The surgery doesn’t go well and there are complications. The new heart is failing but UNOS has found another.

Alex and Arizona leave to retrieve the heart. He tells her that he is thinking of leaving the hospital for private practice. On the plane ride, he grows defensive when he thinks she is going to try and talk him out of it. He feels badly when she explains she was simply reminiscing because she knows he needs to go and she will miss him.

Richard surprises Catherin when he shows up in Boston unexpectedly. She thinks he came to probe her about why Cristina didn’t win but he insists that isn’t the reason. After much discussion, she finally tells him Cristina’s research was the best. She even had enough votes to win. She was never going to win, though, because the foundation owns the hospital Cristina works for.

Furious, Richard accuses Catherine of exploiting Cristina for publicity. She denies this but reminds him there wouldn’t even be a hospital if she and her foundation hadn’t stepped in and bought it. He then tells her the real reason he came to Boston was to propose marriage to her. He produces a ring, leaves it on her desk and then leaves without waiting for an answer. It is unclear if he still intends to marry her after what feels like a betrayal.

Cristina is forced to choose which of the sisters to give the new heart to. The other sister dies and the parents blame her. Owen goes in search of her after hearing what happened and finds her fully clothed, standing in a shower. She isn’t upset about her decision making. She just wonders after doing everything right, “What’s the point?” Owen, trying to console her, tells her the news he learned from Richard. She should have won the Harper Avery award. She pushes past him and walks out of the hospital with a look that implies she is just done. Done with what remains to be seen.

At a hospital board meeting, Jackson asks the board to review the list of ongoing research projects at the hospital. The Harper Avery Foundation wants the hospital to cut operating costs and if the board can’t decide which project to cut, the foundation will. Since Derek, Callie and Meredith all have projects on the list and none of them seem upset when they see it, it must be Bailey’s project that is getting cut though no one says so yet.

Just then Alex interrupts to give the board the news that he has decided to go into private practice as soon as his fellowship is over. He gives his notice and later at home, he and Jo celebrate. He will still have surgical rights at the hospital so he will undoubtedly still be around. That is unless he has a change of heart and stays anyway.

Bailey’s bubble boy is getting worse. The parents are stressed and scared. The boy’s mother talks with the mom of the heart-transplant siblings and afterward, has a change of heart about letting Bailey use her experimental HIV treatment> Though she signed most of the consent forms, she tells the doctors they cannot go forward.

Later, after everyone has left, a desperate Bailey stands outside the boy’s room. She is holding the IV bag with the experimental treatment. Will she go ahead with the treatment? She has the forms in hand but she also knows the mother expressly forbid it. Oh, Bailey, be careful!

April returns to her apartment to get her iPod. Jackson apologizes and wants to work through their problems. He explains that at their cores, they share the same values. She can’t get past his views on her beliefs and mentions the kids they might one day have. He asks if they can just skip the hypothetical kids for now and she says, no, because she’s pregnant. A big game changer there!

Alex is leaving the hospital. April is pregnant and separated from Jackson. Webber proposed to Catherine and then left her. Cristina has left the hospital. Bailey is poised to make a tragic mistake.

What do you think will happen next? With all of this going on, we’ll also be contending with the return of Burke next week in “We Are Never Ever Getting Back Together.”

Grey’s Anatomy” airs on Thursdays on ABC.

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