Jackson Avery is the grandson of Harper Avery, one of the most famous surgeons in the country and the namesake of the prestigious Harper Avery Award. He grew up hearing about the nobility of being a surgeon at his grandfather's dinner table, which inspired him to become a surgeon. His family never pushed him academically because he was 'just the pretty one', so he pushed himself. Avery is initially a surgical resident at Mercy West Hospital. He joins the staff at Seattle Grace Mercy West after the merger of the two hospitals. Avery's grandfather tries to convince him to take a position at Massachusetts General Hospital when he is admitted to Seattle Grace, but Avery refuses. In the aftermath of a hospital shooting, Avery's sleep is disturbed and he and April move into fellow resident Meredith Grey's house. Avery displays an interest in Meredith's sister, Lexie Grey and they start a relationship. Avery starts working with chief of plastic surgery Mark Sloan despite Sloan having been in a relationship with Lexie. However, Lexie cannot stand the fact that the two of them are working together, and when she later shows that she still has feelings for Sloan, Avery breaks up with her.