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Greg Laswell – Off I Go Lyrics 13 years ago
The subject of the song could be metafor for balloon(s).

Loose ends, they tangle down
And then take flight

Helium balloons have 'Loose ends' aka strings tangling down and they take flight.

But never tie me down
Never tie me down.

This can have multiple meanings. One being don't tie down balloons, or they cannot take flight. And secondly don't tie a balloon down on being able to take flight (they often don't take off at all and just fall to the ground).

Combining these two meanings: Don't tie me down on taking flight (don't expect me to) or I wont be able to go.

Off I go.
Where I fall
Is where I land.

The balloon(s) go up in the air. And will eventually land where they fall.

TL;DR
This song seems to be about a metaphoric balloon, it accepts that fate will decide where he ends up but doesn't want his fate to be kept tied down.

I don't know how this matches with the Grey's Anatomy episode as I haven't seen it.

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