Tainted Obligation

Dr. Alex Karev (Justin Chambers) leaves his trailer for work, as he approaches a bear growling outside. He wants to move back to Dr. Meredith Grey (Ellen Pompeo)'s house, but Dr. Izzie Stevens (Katherine Heigl) insists that they must go forward in life. Dr. Lexie Grey (Chyler Leigh) brings her father, Thatcher Grey (Jeff Perry), who is vomiting blood, into the emergency room, and Dr. Miranda Bailey (Chandra Wilson) treats him. Dr. Mark Sloan (Eric Dane) admits an elderly patient, Irving Waller (Ralph Waite), with skin growths, who later reveals that he wants a penile implant, to which he receives. It is revealed that Thatcher needs a liver transplantation, and Stevens is assigned to a cancerous patient, Randy (Jocko Sims), by Dr. Owen Hunt (Kevin McKidd). Dr. Callie Torres (Sara Ramirez) wants to ask the chief of surgery Dr. Richard Webber (James Pickens, Jr.) for a job as an attending surgeon, but is nervous that he will reject her, and goes out to lunch with her girlfriend Dr. Arizona Robbins (Jessica Capshaw).

Dr. Cristina Yang (Sandra Oh) is fearful that she will be cut from the hospital's staff, so she tries to get her name on the surgical board. Stevens and Hunt operate on Randy, and it is revealed that he is terminal. Lexie wants to donate her liver to Thatcher, but she is not a viable candidate, so she asks Meredith to do it, who subsequently agrees. Randy and his wife are dismayed with the outcome of the surgery, and Stevens proposes a plan to Hunt on how they can save him. Hunt agrees, but when the surgery suffers complications, the patient is pronounced dead, and Hunt condemns Stevens. Meredith undergoes the surgery, and it is a success for both her and Thatcher. Yang confronts Webber, and tells him that if a cardiothoracic surgeon is not hired, she should be cut from the program. At the conclusion of the episode, Stevens sees the bear, and ultimately agrees that she and Karev need to relocate, out of the forest.

The episode put an emphasis on the development of Ellen Pompeo's character.

The episode was written by Jenna Bans and directed by Tom Verica. Edward Ornelas edited the episode, and Donald Lee Harris served as production designer.[1] The episode's title refers to the song "Tainted Obligation", by American alternative rock group Community Trolls. Featured music includes The Voluntary Butler Scheme's "Trading Things In" and Dragonette's "Come On Be Good".[2] Pompeo was pregnant during the episode, so the filming crew had to work around it.[3] In the episode, Lexie advocated for Meredith to donate her liver, because she was unable to. Bans commented on this: "It was REALLY easy for me to understand Lexie in this episode – 'cause that's how I imagine she grew up with [her mother] and Thatcher. There was taco night, and movie night, and if she had homework issues, one of them was always around to help. So now that her Dad needs some of her liver, recovering alcoholic or not, she’s gonna do it. She's not even thinking about the Chief's upcoming merger – and the fact that recovering from a major surgery will put her on the bench, out of the game, for at least a month. Lexie doesn't blink, because family isn't an obligation to her like it is for a lot of people - it's a gift."[3] The scene in which Meredith offers her liver to Thatcher was originally intended to rekindle their relationship. Bans later changed this, following a request from Pompeo, and offered her insight:

"I thought I wrote a reconciliation story – between Mer and her father. I thought I wrote the episode that was going to put all the bad blood behind them for good. And it did, in a way – Mer tells Thatcher the door is open, which is pretty huge. And though it was incredibly hard for her to work up the courage to say that to him, she knew it was the only thing that would let him – or alleviate his guilt enough - to allow her to save his life. But something happened in this story during the shooting process. It changed – subtly, but substantially. Here's how it started -- Ellen Pompeo came to me on the first day of shooting and wanting to change that speech she gives to Thatcher. She wanted to add a simple line, to have Mer say 'I want you to do this for her.' Because for Ellen, this story wasn't a Mer/Thatcher reconciliation story – it was a Mer/Lexie story. It was a story about these two women, who have done this awkward dance around each other for two seasons now, finally becoming sisters. Ellen insisted that her main reason for doing what she does, for being completely vulnerable in front of the man who has hurt her in more ways than we can count at this point, was Lexie. She was doing it for Lexie."

— Jenna Bans, Grey Matter[3]

Bans called Waller getting a new penis the most emotional scene she had to write, adding: "I loved this story because I hate the idea that once you're old, your life is over. I hate when people treat their aging parents like old furniture they want to get rid of but have to find a place for so they stick 'em in the corner and forget about them."[3] Bans also commented on Heigl's character's storyline, writing: "Poor Izzie. The girl's living with cancer, lost her best friend, impulsively got married and dragged her husband away to live in the woods. That takes a lot out of a person. I need to seriously recover on the couch for an hour after I go to the grocery store – I can't imagine the emotional and physical fatigue Izzie must be feeling right now. I think by the end of this episode, after Owen tells her that channeling her experience as a patient at Seattle Grace is undermining her strength as a doctor at Seattle Grace – she's wondering if she made a mistake. She's wondering if Alex and Derek and now Owen might be right – that she came back to work too soon. That she's not emotionally ready to be cutting into people yet. Because I think every doctor wants to believe all their terminal patients can be Izzie – but the odds tell another story."[3]

• "Tainted Obligation" at ABC.com
• "Tainted Obligation" at TV.com
• "Tainted Obligation" at IMDb