While the wedding takes center stage, the hospital remains in chaos due to a tragic car crash involving college students on their way to graduation.
: Alex delivers a powerful, spontaneous speech adapted from a valedictorian's graduation address, promising to be accountable to Izzie through any future challenges. Medical Drama and Character Growth [S5E22] What a Difference a Day Makes
: Rhimes described the episode as the moment Meredith evolved from a "dark and twisty" girl into an "extraordinary" woman capable of choosing happiness. While the wedding takes center stage, the hospital
In , the Season 5, Episode 22 milestone titled " What a Difference a Day Makes " is a landmark 100th episode that originally aired on May 7, 2009. It is widely celebrated for its emotional depth, shifting from a planned grand wedding for Meredith and Derek to a poignant ceremony for Izzie Stevens and Alex Karev. The Unexpected Wedding In , the Season 5, Episode 22 milestone
: To promote the 100th episode, ABC created a real wedding website for Meredith and Derek that fans could actually visit and RSVP to.
: As a wedding gift, Derek gives Meredith her first solo surgery—a successful colon surgery overseen by Richard Webber.
: Creator Shonda Rhimes noted that Denny's appearance in this episode was meant to represent "Death," which is why he wore black and spoke sparingly compared to previous appearances.