Grey's Anatomy Recap: Before and Aftershocks -- Plus Your First Look at Burke's Return

Grey's Anatomy Season 10In this week’s action-packed Grey’s Anatomy, Derek’s sister shows up on his and Mer’s doorstep to find out what it takes to be… well, them; Richard surprises Catherine in Boston, then gets a surprise of his own; Alex decides whether he’s really going to join Dr. Butthole’s practice; and Cristina is dealt a blow that stings even worse than her Harper Avery loss. Told ya it was action-packed! Read on, and I’ll fill in the blanks.

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TWISTED SISTER | Early on in “Change of Heart,” Amelia arrives at Casa MerDer and reveals that she has gotten engaged to James. “Neat,” says Derek more or less. “Wanna baby sit?” With Zola and Bailey now taken care of for the day, Derek is able to schedule a romantic date with Mer in the OR. (Later, they also manage to squeeze in a conjugal visit in an on-call room.) But, before the Shepherds can consider moving Amelia in to be their nanny, they come home to find her a hot mess. “Our children,” Mer suggests to Derek, “broke your sister.” Amelia can’t do what MerDer do, can’t have what they have, she sobs. One day of trying, and she’s a wreck. Hey, nobody ever said it was easy being the McDreamys!

PREGNANT PAUSE | April spends most of the episode crying in surgery or driving everyone crazy by telling and retelling the story of her Big Fight with Jackson. But when she and her husband finally wind up back at their place together long enough to talk, she blurts out why she can’t just table her concerns about how they’ll raise their hypothetical children – it’s because they’re not hypothetical anymore. She’s expecting!

NEAR MRS. | Though Richard promises Catherine a romantic evening, she assumes he only flew to see her to ask why Cristina wasn’t given the Harper Avery that she so richly deserved. Which, come to think of it, is a good question. “She could never win that award,” Catherine explains, because she works for a hospital that the Harper Avery Foundation owns. Hell, Cristina did win, Catherine adds – she had the votes! But, for political reasons, she couldn’t take home the prize. Horrified, Richard admits the real reason he came all the way to Boston – he was going to propose. Operative word: was.

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HEART TO HEART | Meanwhile, at Grey Sloan, Cristina’s already thrown herself back into her work, and not a moment too soon. While she’s performing a transplant on Frankie with what turns out to be a “lemon heart,” as Alex puts it, Ivy takes a turn for the worse. Another ticker is located – and flown in by Alex and Arizona – but, rather than give it to Frankie, Cristina elects to give it to Ivy, who has a better chance of survival. (In fact, Ivy does pull through. Frankie, on the other hand… not so much.) Afterward, Owen finds Cristina in her scrubs in the shower. She did everything right, she says. She even made the impossible decision that the girls’ parents wouldn’t. And yet… “What’s the point,” she asks, “of anything?” In response, Owen tells her what Richard just told him – that she actually won the Harper Avery. Off this, she goes marching out into the night, sopping wet but newly determined. (To do what, exactly, we don’t yet. But determined for sure.)

IN SHORT | While Alex assumes that Arizona took him with her to pick up what turns out to be Ivy’s new heart in order to convince him not to go into private practice, he’s wrong – she doesn’t try to talk him into staying at Grey Sloan at all, she just wants one last memory of working with him. (It’s actually pretty sweet.) Just as Jackson is planning to cut funding for one (or some) of the doctors’ research, Bubble Boy’s mom freaks out and decides to discontinue Bailey’s experimental treatment. (Mind you, Bailey does still have the signed consent forms.) And finally, Leah panics during surgery, likely offering more foreshadowing of how she’ll be written off.

Okay, your turn. What did you think of the episode? Did you predict that April was pregnant? Hit the comments! (And if you missed the promo for next week’s big Burke/Cristina reunion, we’ve got you covered below!)