'Grey's Anatomy' Season 4 Synopsis of Main Themes

See How Season 4 Fares for Meredith and Friends

Grey's Anatomy Season 4

Grey's Anatomy season 4 begins with our doctors returning from vacation after 17 days. As usual, all of the medical storylines are mixed with a myriad of personal connections, love triangles, family drama, and surprises.

Grey's Anatomy Season 4: Main Themes

With standout episodes such as "Forever Young" and "Lay Your Hands on Me", season four seems to have taken advantage of the writers' strike that took place halfway through the season. As stated by creator Shonda Rimes, the direction of the show was reexamined during the strike, creating the perfect opportunity to start fresh and make for a better second half of the season. Read below for some of the major themes:

First Year Residents

Meredith, Cristina, Alex, and Izzie are now first-year residents with interns of their own. George failed his intern exam by one point and is repeating his intern year.

We don't see much of Meredith's interns, other than George. After a while, George becomes the chief's personal intern. At first, George feels the power, but he soon realizes that it's not any power because no one respects him. He pleads his case to the chief to let him retake his intern exam and the chief agrees.

Cristina treats her interns like they are burdens. She even calls them by number instead of name. Cristina's most interesting intern is Lexie Grey, Thatcher's youngest daughter. She really wants to get to know Meredith and at first, Meredith is resistant and doesn't consider her family, but soon comes around.

Alex has one intern who is considerably older than him, Norman. Norman tries to be hip and fit in with the young interns, but finds a different specialty after suffering a heart attack.

Izzie's interns think she is crazy, especially after she saves a deer who had been hit by a car.

Chief Resident

Bailey is upset when Callie is made Chief Resident. Callie is not good at the position and Bailey helps her. The chief notices and fires Callie, making Bailey Chief Resident. Bailey decides that she has too many responsibilities and so she hands the clinic over to Izzie.


Meredith and Derek are no longer a couple but sleep together often. Derek wants more, but Meredith can't give that to him and they stop sleeping together. Derek begins dating one of the nurses, Rose, and Meredith is jealous. Meredith takes a leap of faith and gets back together with Derek.

Cristina has not dated since Burke left her at the altar. She is extremely upset when Burke wins the Harper Avery award and doesn't even mention her help.

George and Izzie try a romantic relationship once George breaks off his marriage with Callie. George and Izzie have no sexual chemistry. George and Lexie get an apartment together. George has no idea that Lexie wants to be more than friends.

Alex begins taking care of Rebecca, who is completely out of it after she learns she is not pregnant. She believes she was pregnant with Alex's baby, but labs prove that she had not been pregnant, but she just can't accept it. Alex tries to take care of her but has to put her in a home.

Richard and Adele sleep together and eventually Richard moves back in with her.

Bailey and Tucker cannot seem to make their marriage work.

Mark teases Callie about being attracted to Hahn and it freaks Callie out, until one day, she kisses Hahn.

Closure for Meredith

Meredith feels she's being haunted by her dead mother, so she takes the run to work. She ends up dumping the ashes down the sink drain in the scrub room with Webber's help. She sees a therapist and speaks of her mother trying to commit suicide, but realizes that if her mother really wanted to commit suicide she would have cut her carotid, not her wrists.

Thatcher tells Meredith he's proud of her, but Meredith later learns that he speaks to Lexie in the same drunken way he'd spoken to Meredith, so Meredith knows not to believe him.

The Clinical Trial

Meredith does research on a clinical trial and asks Derek to be the neurologist. After losing 11 patients they are about to be shut down. Patients 12 and 13 are teenagers who are in love with each other. They lose number 12 but are able to save number 13.

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