<P> Several actors and members of the production team have been awarded for their work on the show during the season . At the 60th Primetime Emmy Awards on September 21, 2008, Sandra Oh was nominated for her performance as Cristina Yang in the episode "The Becoming", whereas Chandra Wilson received a nomination for her portrayal of Miranda Bailey in "Lay Your Hands on Me", both for the Outstanding Supporting Actress in a Drama Series . Katherine Heigl who portrayed Izzie Stevens declined to put her name forward for consideration at the Emmy Awards, claiming that she had been given insufficient material on the series to warrant a nomination . Diahann Carroll was nominated for Outstanding Guest Actress in a Drama Series for her portrayal of Jane Burke in "Love / Addiction". The make - up team, consisting of Norman T. Leavitt, Brigitte Bugayong, Thomas R. Burman and Bari Dreiband - Burman, was nominated for both Best Prosthetic Make - Up in "Forever Young" and Best Non-Prosthetic Make - Up in "Crash Into Me". Sara Ramirez's portrayal of Callie Torres was positively reviewed, resulting in her receiving a nomination at the 2008 American Latino Media Arts Awards . At the 65th Golden Globe Awards in January 13, 2008, the series was nominated for Best Drama Television Series, whereas Katherine Heigl's individual performance resulted in a nomination for Best Supporting Actress in a Television Series . At the 40th National Association for the Advancement of Colored People Image Awards, Chandra Wilson won Outstanding Actress in a Drama Series, where Shonda Rhimes was awarded at the Outstanding Writing in a Dramatic Series category, for "Freedom". James Pickens, Jr. also received a nomination for his performance as Richard Webber at the Outstanding Supporting Actor in a Drama Series category . At the 2008 Prism Awards, Justin Chambers was nominated for Performance in a Drama Series Episode, whereas Elizabeth Reaser received a nomination for Performance in a Drama Multi-Episode Storyline . At the Teen Choice Awards in 2008, Patrick Dempsey and Katherine Heigl were nominated for Choice Television Actor and Actress . </P> <P> The season was the second to air in the Thursday night time slot, at 9: 00 ET, after it was moved at the beginning of the third season, following two seasons in the Sunday night timeslot, as a lead - out to Desperate Housewives, which aired at 9: 00 ET for its entire run . The season aired as a lead - out to Ugly Betty, then in its second season, which aired on Thursday nights at 8: 00 ET . Grey's Anatomy averaged 15.92 million viewers in its fourth season, ranking tenth in viewership . The highest - rated episode of the season was the season premiere, with 20.93 million viewers tuning in and a 7.3 rating, ranking the third for the week . The episode showed a decrease in ratings compared to the previous season premiere, which had almost five more million viewers tuning in and a 9.0 rating . The season premiere also attracted less viewers than the previous season finale, which was watched by 22.57 million viewers, and received an 8.0 rating Although "A Change is Gonna Come" attracted more viewers than Desperate Housewives's "Now You Know", which was watched by 19.32 million viewers, received a 6.7 rating and ranked fourth in the week, the episode was outperformed by CSI: Crime Scene Investigation's "Dead Doll", which aired in the same hour and ranked first in the week, with 25.22 million viewers tuning in and an 8.8 rating . The lowest - rated episode was the ninth, watched by 14.11 million viewers and ranked fourteenth in the week, with a 4.9 rating, seeing a sudden decrease, after the previous episode, the second most - watched in the season, which attracted 19.61 million viewers and received a 6.8 rating . "Crash Into Me: Part 1" was outperformed in the time slot by CSI: Crime Scene Investigation's "You Kill Me", the Thanksgiving special episode which attracted 14.75 million viewers and received a 5.2 rating, ranking eleventh in the week . The season finale was watched by 18.09 million viewers, being the first - season finale of Grey's Anatomy to attract less than 20 million viewers . It was ranked fifth in the week, and received a 6.3 rating . There was a significant decrease in the number of viewers, compared to the previous season finale, which attracted almost four more million viewers and received an 8.0 rating . </P> <Table> <Tr> <Th> No . overall </Th> <Th> No. in season </Th> <Th> Title </Th> <Th> Directed by </Th> <Th> Written by </Th> <Th> Original air date </Th> <Th> U.S. viewers (millions) </Th> </Tr> <Tr> <Th> 62 </Th> <Td> </Td> <Td> "A Change Is Gonna Come" </Td> <Td> Rob Corn </Td> <Td> Shonda Rhimes </Td> <Td> September 27, 2007 (2007 - 09 - 27) </Td> <Td> 20.93 </Td> </Tr> <Tr> <Td_colspan="7"> Having just returned from her honeymoon with Meredith, Cristina searches for Burke, but he is 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 . The residents and interns have to deal with the victims of a multi-car pile - up, including a man who came to life, a pregnant woman who lost an arm, and a man with a compulsive desire to eat . Izzie attracts her interns' ire by having them treat a deer . Now that Derek's relationship with Meredith has reached an emotional impasse, he looks to his fellow doctors for friendship . Webber resumes his position as Chief of Surgery . Bailey wrestles with her place within the hospital now that her former interns report to new Chief Resident Callie, who struggles with her new position . </Td> </Tr> <Tr> <Th> 63 </Th> <Td> </Td> <Td> "Love / Addiction" </Td> <Td> James Frawley </Td> <Td> Debora Cahn </Td> <Td> October 4, 2007 (2007 - 10 - 04) </Td> <Td> 18.51 </Td> </Tr> <Tr> <Td_colspan="7"> An apartment explosion inundates the ER with patients, and Alex jeopardizes a family when he realizes the cause of the accident . Meanwhile, Meredith intrigues Derek with an "S&M" (sex and mockery) approach on their relationship, and Derek gets the wrong idea . Cristina begins giving her wedding gifts to her colleagues in exchange for surgeries . Mama Burke returns to collect Burke's things, and gives judgement and advice to the doctors . George decides to break up with Callie after realizing that he has feelings for Izzie, but Izzie stops him when she has to work with Callie, and sees how she's struggling . Callie clashes with Bailey after she sends Meredith to the clinic after becoming annoyed with Lexie and another intern . Meredith rebuffs Lexie's attempts to get to know her . Webber begins delegating in a bid to get back with Adele . </Td> </Tr> <Tr> <Th> 64 </Th> <Td> </Td> <Td> "Let the Truth Sting" </Td> <Td> Daniel Minahan </Td> <Td> Mark Wilding </Td> <Td> October 11, 2007 (2007 - 10 - 11) </Td> <Td> 19.04 </Td> </Tr> <Tr> <Td_colspan="7"> When the "really old guy" awakens from his coma, Izzie becomes aggravated with him over his attempts to end his life . Izzie puts pressure on George to end things with Callie . Callie and George find themselves both very tense in their hotel room . Bailey confronts Callie over the amount of effort that she is putting in as Chief Resident . Meredith and Lexie's rocky relationship continues because of Meredith's teaching technique, but Bailey intervenes in order to help Lexie develop . Cristina begins faking sadness to get more surgeries . Alex gets a new intern, Norman, and is forced to do a procedure he's unfamiliar with on a patient when Derek becomes unavailable . Mark and Webber attempt a surgery neither has performed before, and Derek has to remind them of the risk they took . Alex tells the other interns that George is repeating his internship . </Td> </Tr> <Tr> <Th> 65 </Th> <Td> </Td> <Td> "The Heart of the Matter" </Td> <Td> Randall Zisk </Td> <Td> Allan Heinberg </Td> <Td> October 18, 2007 (2007 - 10 - 18) </Td> <Td> 18.04 </Td> </Tr> <Tr> <Td_colspan="7"> Meredith agrees to go away with Derek for the weekend, but has to take Norman off of Alex . However, Derek realizes that he and Meredith want different things, and considers ending their relationship . Meredith gets annoyed at Norman after his error leads to them telling the wrong patient that she's dying . Callie forgives George for sleeping with Izzie . Lexie stands up to Cristina, and Derek criticizes her teaching style . George desperately tries to find Izzie before Callie can, while Izzie admits to Alex that she slept with George . Derek, Cristina and Lexie treat a college football player who faces paralysis, whose dad is still heavily critical of him . Bailey and Callie have to deal with a patient who wants to leave the hospital as quickly as possible so she can continue training to earn the approval of her boyfriend, and Callie takes her personal issues out on him when the patient dies . Webber's niece ends up back in the hospital, and Webber is disheartened when she admits that she doesn't want further cancer treatment . </Td> </Tr> <Tr> <Th> 66 </Th> <Td> 5 </Td> <Td> "Haunt You Every Day" </Td> <Td> Bethany Rooney </Td> <Td> Krista Vernoff </Td> <Td> October 25, 2007 (2007 - 10 - 25) </Td> <Td> 18.17 </Td> </Tr> <Tr> <Td_colspan="7"> A nightmare brings Meredith to remove her mother's ashes from her closet . She ends up putting her mother at rest in an operating theatre sink . Meredith also forms an alliance with a little boy to grant him the ears he needs via pro-bono surgery . Alex ignores Norman feeling unwell, which culminates with Norman suffering a stroke . A busy day in the ER results in a man who is convinced that his foot doesn't belong to him trying to remove it with a chainsaw from a jack - o - lantern competition . A heart transplant patient has to face a difficult decision when his daughter is in an accident and rendered brain dead, meaning that her heart has become available to him . Rebecca seeks out Alex . Erica Hahn is invited to perform a heart transplant, and clashes with Cristina . Callie reveals George's affair with Izzie to the hospital . Callie and Cristina bond over their failed relationships, prompting Cristina to invite Callie to move in . </Td> </Tr> <Tr> <Th> 67 </Th> <Td> 6 </Td> <Td> "Kung Fu Fighting" </Td> <Td> Tom Verica </Td> <Td> Stacy McKee </Td> <Td> November 1, 2007 (2007 - 11 - 01) </Td> <Td> 19.31 </Td> </Tr> <Tr> <Td_colspan="7"> Webber organizes a gentleman's evening, leaving Derek and Mark dumbfounded, and curious to determine what it really is . Two brides - to - be fight over a dress from a bridal store competition, and this complicates treatment, as neither will release the dress . The doctors treat a parachutist who fell 12,000 feet without a parachute . Callie searches for a way to torture George whilst trying to cope with the stress from her Chief Resident position and impending divorce . Meredith tries getting Cristina to diagnose her personal problems . Izzie prepares to sleep with George for the first time in their new relationship . Erica excludes Cristina from cardio service, which drives Cristina insane and desperate, especially when Erica has Izzie scrub in on an awake open - heart surgery . Alex takes pity on Lexie when he catches her charting in a cupboard, and they eventually sleep together . </Td> </Tr> <Tr> <Th> 68 </Th> <Td> 7 </Td> <Td> "Physical Attraction, Chemical Reaction" </Td> <Td> Jeff Melman </Td> <Td> Tony Phelan & Joan Rater </Td> <Td> November 8, 2007 (2007 - 11 - 08) </Td> <Td> 19.50 </Td> </Tr> <Tr> <Td_colspan="7"> Izzie and George's new - founded relationship results in bad sex . Callie shirks her Chief Resident responsibilities and the position is taken away from her, with Bailey as the humble replacement . Meredith continues to struggle with her relationship with Lexie . Cristina is annoyed when Erica swaps her with Meredith, and is then told by Bailey to look for a different specialty . Cristina's woes are worsened when Erica and Meredith take her patient off of her . Both Izzie and Alex have to deal with patients that are annoying them, and get unexpected results when they put them in the same room . George and Bailey operate on an eight - year - old who has taken drastic action following his parents' marital difficulties . Derek finds himself doing chores for Webber, who doesn't know how to be on his own . </Td> </Tr> <Tr> <Th> 69 </Th> <Td> 8 </Td> <Td> "Forever Young" </Td> <Td> Rob Corn </Td> <Td> Mark Wilding </Td> <Td> November 15, 2007 (2007 - 11 - 15) </Td> <Td> 19.61 </Td> </Tr> <Tr> <Td_colspan="7"> A bus crash involving high school students causes the doctors to reminisce about their times in high school . Bailey sets out her rules as Chief Resident . A tense confrontation between Lexie and Meredith brings Meredith to feel guilty . Callie gives Cristina some tips to get on Erica's good side when she notices Cristina trying to impress her . An old flame of Bailey's emotional when he arrives in the ER, and Bailey and Erica clash over how she is with him . Izzie bonds with a teenager, while Derek treats her best friend, who got a pencil jammed in his eye socket in the crash . Mark and Callie have to deal with a victim who wants perfection from them . The news about Izzie and George's relationship problems travels fast around the hospital, and they worsen after Izzie catches wind of people gossiping about them . Thatcher Grey injures himself and requests to be treated by Meredith . Derek meets a nurse, Rose, who appears to be interested in him . </Td> </Tr> <Tr> <Th> 70 </Th> <Td> 9 </Td> <Td> "Crash Into Me (Part 1)" </Td> <Td> Michael Grossman </Td> <Td> Shonda Rhimes & Krista Vernoff </Td> <Td> November 22, 2007 (2007 - 11 - 22) </Td> <Td> 14.11 </Td> </Tr> <Tr> <Td_colspan="7"> An ambulance crash makes for a hectic day at Seattle Grace, when Meredith and Webber have to comfort the paramedics trapped inside one of the ambulances . A wounded paramedic creates an uproar in the ER over his tattoo, offending Bailey . As she operates on him she has the other doctors swear not to use her alias anymore . Derek and George treat the driver who caused the accident, and find a brain tumor . Derek and Rose get to know each other better . Bailey faces relationship troubles over how much time she spends at the hospital . Callie, Mark and Erica have to operate on a heart patient who was injured in the crash . Lexie becomes attached to a patient (Seth Green), who has a major artery exposed following the removal of a tumor . Rebecca returns and Lexie finds out Alex has been seeing them both . </Td> </Tr> <Tr> <Th> 71 </Th> <Td> 10 </Td> <Td> "Crash Into Me (Part 2)" </Td> <Td> Jessica Yu </Td> <Td> Shonda Rhimes & Krista Vernoff </Td> <Td> December 6, 2007 (2007 - 12 - 06) </Td> <Td> 17.78 </Td> </Tr> <Tr> <Td_colspan="7"> Meredith works to save the life of a paramedic, after his colleague died . Meredith asks Derek not to see other people after taking inspiration from some advice Webber gave a patient . Derek has to rely on Rose after the camera monitor breaks during the middle of a surgery, which leads to the pair sharing a kiss . Alex is suspended for a week for sneaking Rebecca in to observe a surgery . Izzie realizes that she is not cut out for cardio surgery . Tensions between Bailey and Tucker reach a breaking point . Cristina takes pity on Lexie, after her actions lead to the death of a patient . </Td> </Tr> <Tr> <Th> 72 </Th> <Td> 11 </Td> <Td> "Lay Your Hands on Me" </Td> <Td> John Terlesky </Td> <Td> Allan Heinberg </Td> <Td> January 10, 2008 (2008 - 01 - 10) </Td> <Td> 17.68 </Td> </Tr> <Tr> <Td_colspan="7"> When Bailey's son, Tuck, is at Seattle Grace following a bookshelf falling on him, she starts to feel that she might be a bad mother . Tucker and Bailey separate . The return of George's mother brings Callie and George together once more, and his relationship with Izzie has failed . Izzie and Cristina continue their rivalry, and Izzie later admits to Alex that it is based on jealousy . A healer with "powers" at Seattle Grace makes the doctors question science and faith . Meredith discovers Rose and Derek have kissed, which leads to them breaking up . Lexie suffers an allergic reaction after Meredith makes her breakfast . </Td> </Tr> <Tr> <Th> 73 </Th> <Td> 12 </Td> <Td> "Where the Wild Things Are" </Td> <Td> Rob Corn </Td> <Td> Zoanne Clack </Td> <Td> April 24, 2008 (2008 - 04 - 24) </Td> <Td> 16.37 </Td> </Tr> <Tr> <Td_colspan="7"> Six weeks have passed since Derek started dating Rose, and the new residents are competing in a surgical contest . Meredith wins, giving her the power to take the other residents' surgeries . Izzie treats a man with a swollen ankle who collapsed, as she believes that he has a mystery illness . The doctors treat a family who were all victims of a bear attack . Meredith thinks that one of the victims might be suffering from a neurological disorder, but she is brushed off by others who think she's just trying to get an opportunity to be with Derek . George and Lexie have moved into their new apartment and Lexie begins stealing stuff from the hospital to furnish it . Callie and Erica continue their friendship . Meredith suggests a neurological clinical trial . </Td> </Tr> <Tr> <Th> 74 </Th> <Td> 13 </Td> <Td> "Piece of My Heart" </Td> <Td> Mark Tinker </Td> <Td> Stacy McKee </Td> <Td> May 1, 2008 (2008 - 05 - 01) </Td> <Td> 15.31 </Td> </Tr> <Tr> <Td_colspan="7"> Addison Montgomery visits Seattle Grace from California and she is recapped by the doctors on what has happened in her absence . She suspects that Callie might be having feelings for Erica . The surgeons deal with a mother whose baby's heart has developed outside of his chest, and Mark becomes a bit too pompous when he feels like he is God . Izzie is jealous that George is developing a good relationship with his fellow interns . Rebecca reveals she is pregnant . Izzie is shocked when her pregnant patient wants an abortion, but both eventually regain their ability to fight . Meredith is conerned after the patient in her clinical trial goes blind . Erica finally tells Cristina why she won't teach her . </Td> </Tr> <Tr> <Th> 75 </Th> <Td> 14 </Td> <Td> "The Becoming" </Td> <Td> Julie Anne Robinson </Td> <Td> Tony Phelan & Joan Rater </Td> <Td> May 8, 2008 (2008 - 05 - 08) </Td> <Td> 16.03 </Td> </Tr> <Tr> <Td_colspan="7"> A "date and tell" policy is instated at Seattle Grace after the nurses object to Mark's trysts, causing everybody in the hospital to have to register their relations with one another . Lexie is concerned to find out Alex forgot to register their night together . Webber comes face to face with Adele again . News of Burke winning an award reaches the hospital, unsettling both Cristina and Erica . Callie starts having sex with Mark to avoid Erica . Meredith and Derek admit a gay veteran soldier into their clinical trial . George is given the title' Intern to the Chief' . Alex starts moonlighting at Joe's, so he can get money for a house for him and Rebecca . Meredith's therapist gets tough . </Td> </Tr> <Tr> <Th> 76 </Th> <Td> 15 </Td> <Td> "Losing My Mind" </Td> <Td> James Frawley </Td> <Td> Debora Cahn </Td> <Td> May 15, 2008 (2008 - 05 - 15) </Td> <Td> 15.55 </Td> </Tr> <Tr> <Td_colspan="7"> Meredith's therapy leads herself to question her past . Derek and Meredith's are at loggerheads when a patient in their clinical trial wants to delay treatment to wait for her boyfriend, whom her sister insists doesn't exist . Callie begins to wonder if she is straight or lesbian, and she tries to avoid the topic . Mark tries shaking off his "whore" image, by trying to get emotional with Callie . Webber's mentor arrives at the hospital requiring treatment, but Erica is reluctant to operate on a legend . Cristina is lashing out, and eventually Lexie bites back . Izzie tries to tell Alex that Rebecca is not pregnant . </Td> </Tr> <Tr> <Th> 77 78 </Th> <Td> 16 17 </Td> <Td> "Freedom" </Td> <Td> Rob Corn </Td> <Td> Shonda Rhimes </Td> <Td> May 22, 2008 (2008 - 05 - 22) </Td> <Td> 18.09 </Td> </Tr> <Tr> <Td_colspan="7"> A surgical team battles the clock as they try to save a boy encased in cement . Alex's situation with an ever - disintegrating Rebecca brings back painful memories that interfere with his judgment . Derek and Meredith have one last chance at their clinical trial . The parents of one of the patients want Derek and Meredith to move the other patient in the trial elsewhere . Lexie looks at the residents' case files . Meredith gives the "sparkle pager" to Cristina, to help her cope with her depression . Derek and Meredith's relationship becomes more fractured as Meredith tries to push for the surviving patient to have the clinical trial . However, when the trial has a positive outcome, Derek and Meredith decide to restart their relationship . Izzie is concerned when Alex tries to treat Rebecca after she slit her wrists . After Bailey sees Izzie struggling, she gives her the clinic . Mark ends his relationship with Callie, which leads to Erica and Callie kissing . Webber prepares to win back Adele, and move back in with her . A boy trapped in cement after a dare has placed his health at risk, leading the doctors at Seattle Grace to sympathize and ease his pains . Cristina takes the lead in surgery . George confronts Webber, and is allowed to retake the internship test . George later kisses Lexie in joy, but is unaware that she is harboring feelings for him . </Td> </Tr> </Table> <Tr> <Th> No . overall </Th> <Th> No. in season </Th> <Th> Title </Th> <Th> Directed by </Th> <Th> Written by </Th> <Th> Original air date </Th> <Th> U.S. viewers (millions) </Th> </Tr>

When does derek and meredith get back together season 4