hey! that almost looks like Seattle in that window!

For this week’s episode of Grey’s Anatomy (previously [mb]), we open on the “Emerald City Bar.” Brain tumor Joe’s Bar. Apparently it’s everyone favorite bar in “Seattle” because it’s the only bar set they could afford to build. And luckily, everyone is there, including a recovering shaved headed Joe back to work just few days post-surgery. Dr. Nazi is yawning into her drink, surrounded by peanut shells. Alex is playing darts in a grunge era Seattle flannel shirt. This bar really does have everything! peanuts, darts, and easy interns!

Our heroes, George, Meredith, and Isabel are crowded around a small table chatting about Sandra Oh and her nerves of steel. Incidentally, the producers have become more and more tricky with the voiceover business, mixing it in with the dialogue and not starting it right at the beginning. But here is is, today’s episode theme, voiceover style, “the key to surviving a surgical internship is denial, we deny that we’re tired, we deny that we’re scared, we deny how badly we want to succeed, and most importantly we deny that we’re in denial.”

After the jump, we see how all of this denial plays out: See Sandra Oh’s dramatic recovery, more from Mother Grey, an old patient that proves that the Nazi really does have a heart, even smartypants missionaries get the blues, and plenty of that Addison-Dempsey-Grey love triangle that keeps you tuned in every week.

While all of this denial talk is in the air, the interns are talking about how Sandra Oh will be fine. Isabel goes on and on about how cold she seems and how weird it is that she’s acting fine after losing a baby and a fallopian tube, but George says that she’s hard core. And that this proves that she’s going to make a great surgeon because if you show no weakness you make it to the top. This is maybe one of the smarter things that George has said in a long time.

“We only see what we want to see and believe what we want to believe. And it works. We lie to ourselves so much that after a while the lies start to seem like the truth.” Cue Patrick Dempsey enters the bar (natch) to chat up Bailey. “We deny so much that we can’t recognize the truth right in front of our faces.” Mistakenly, he thinks that she’ll care that since both his girlfriend and his wife kissed him on the same day everything is going to be fine. Of course the Nazi doesn’t care and lets him know that he’s so damn stupid.

Cut to the morning after at Seattle Grace Hospital. Bailey is leading her charges on their morning rounds, and warning them that they’re short staffed (because of the baby and the fallopian tube, etc.) and she has a feeling that it’s going to be “one of those days.” If there’s one thing the writers of this show love, it’s the foreshadowing; so we know to believe her. She also tells Alex to see the Chief by the end of the day. George wonders if he also gave the Chief Syphilis.

Case numero uno brings the merry band of interns into an already crowded room where a blond haired woman is enchanting the hospital staff with tales of missionary life. Everyone but Bailey is charmed; so she chases them out to move things along. This woman’s name was given to her by Nepalese villagers, she’s been passing out and having heart palpitations and has a history of rheumatic fever. When the interns are quizzed about the causes of ventricular arrythmia, no one seems to know what to say. This is until Sandra Oh staggers through the door, still wearing her little open backed hospital gown, but with the right answer (valvular disease, mitral valve prolapse, stimulants, drugs, metabolic abnormalities). Bailey shoos her hack to her room, providing Alex with an opportunity to comment on her nice panties. Always the professionals, they snicker as she limps away angrily.

Back in her hospital room, Sandra Oh is summarizing her chart and making a case for her readiness to go back to work (she’s case #2 on today’s rounds). However, the nurse said that she had a fever, which George seems to think won’t impair her ability to do her job. In the corner, we meet the mother figure, who snipes about there being more to life than surgery and her career. Despite her pleas about her fitness to resume surgical intern duties, Bailey reminds her that she’s a patient this week so that she can be a doctor next week. As the group exits, Grey tells her pal that she needs time to heal. Once again Sandra Oh asserts that she’s healed. This, naturally is going to be proven false. Throughout the episode, Sandra Oh does a good job of looking kind of shaky even though she’s pretending to be fine. Tick tock.

On to case #3 (all this before the credits!), which is George’s chance to present the case of de-tumorized Mother Grey, who once again, doesn’t want her daughter in the room. Meredith exits and runs into Patrick Dempsey in the hallway of frequent and awkward meetings and tells him that she doesn’t need “complicated” in her life, reminding him that he has a wife. Dempsey tries to smooth things over by reporting that Addison is leaving Seattle since there’s no reason at all for her to stay any longer. Right. Per her custom, the dark lord Satan appears within seconds of her name being spoken aloud and asks to join the conversation, making a hilarious joke about threesomes (that we already saw on the promos about 100 times).

Here, the estranged husband and wife do their husband and wife bickering, about her being both the devil and an adulterous bitch. Addison still thinks there’s a case for forgiveness, given that they used to be bestest friends before the whole affair business. Dempsey tells her that things change (when you sleep with your husband’s best friend, for instance). With this, Addison hands her husband a stack of divorce papers claiming that she’ll sign them if he does. But before she goes (and before he “immediately” signs off), she says that even if she is Satan she might also still be the love of his life. This comment brings back to old perplexed face from the last episode. As AddiSatan hops in the elevator; Dempsey leans into the wall, and Meredith looks on from the stairway. Really, this hospital was designed with maximum sight-lines in mind, wasn’t it?

– the opening credits roll –

And we’re back. And so is one of those pans of Seattle that we’ve come to know and miss. This one involves some water and the space needle, two top Seattle attractions.

With the tourism board appeased, the action returns to Sandra Oh scribbling away in her own chart. Chief Wannabe #2 busts in to remind her that she’s a patient, and asks over and over how she’s doing. Because he appreciates the seriousness. She is of course, doing “fine.” CW#2 interjects that he had a right to know (about being her baby daddy). She snaps that now he knows, but it’s over and there’s nothing left to say.

At this point, Mother Oh returns to sort of flirt with Chief Wannabe #2. She lets him know that she’s been remarried ever since her daughter was knee high to a grasshopper. She asks her daughter why she doesn’t ever bring home a man as good looking as him. Oh, if you only knew the half of it, Mother Oh! She complains to wonder what she did to raise such an unpleasant girl? As he exits, Sandra Oh tells her mom that it was her boss that she was just annoying! Mom thinks that she should lighten up.

In the hallway, Isabel is trying to ask Alex out. After a bit of cute banter, he asks her out for a date where she’ll wear something gorgeous and he’ll pay for food. She accepts, and both seem to agree that this is a good thing.

After all of this, we meet the last case of the episode, Jerimiah (Little Man) Tate, who happens to be one of Bailey’s first patient from her intern days. She messed something up that kept him in the hospital for a month, and they’ve been buddies ever since. Meredith is amazed to hear that he’s a twenty-six-year-old with cystic fibrosis, a mega fundraiser, who does triathalons. Despite his amazing health, he’s in enough pain that he’s being kept up all night, is having seizures, and can’t make it to the gym. Pancreatitis is to blame, but he hasn’t called his parents because he only likes to bother them when he’s been fixed-up. As they exit, Meredith wonders how he stays so positive under such grim circumstances. Bailey tells her that denial works for him. Nice to know that everyone is in on knowing the episode theme in advance.

We cut to Alex shopping through charts. When he sees one for a gun shot wound, he freaks out because trauma hasn’t been called. This is quickly explained as the patient appears to be very comfortably slumped in the waiting area reading some sort of hunting magazine.

Back in the Oh Recovery Room, Mother Oh is painting her daughter’s toenails and chatting about her home redecorating exploits. When Sandra begs for a change of subject, Mom asks about the baby’s father and if the relationship was just about sex. This is enough to cause Sandra Oh to beg for just 20 minutes of alone time, but Mom won’t let up, complaining that the daughter that she raised would appreciate help, given her very busy Beverly Hills life. With this, Sandra Oh asks her mom to run out for a “mocha latte.” And not nonfat, a fat one. God knows how far she’ll have to go to find someone who will give her one without cracking up. If this show does one thing well, it’s in picking its stupid terms and sticking with them since episode two [mb].

And we’re back to Alex and the mysterious gunshot wound. You know, I could just consolidate everyone’s cases, but that really would rob you of the attention defecit disorder style that results from splitting an hour into six commercial-maximizing chunks. Anyway, the guy doesn’t especially look like he’s taken a bullet to the head. The flannel-clad floppy haired middle aged patient insists that (1) he was shot, (2) he shot himself cleaning his gun, (3) that it was a mistake, not a suicide, (4) that he really was shot despite the only evidence being a weird purplish mark on his forehead.

Meanwhile, Sandra Oh has escaped from her room to pick through a rack of charts until a nurse busts her for being off her I.V. and out of bed. She concedes to sitting in a wheelchair, but the nurse promises to tell her intern on her. Sandra doesn’t seem very frightened by the wrath of Meredith Grey.

Speaking of the Greys, Mother Grey is in her room, flipping through charts. She demands test results from George. Today it seems that old man Alzheimer’s is causing her to believe that George is her intern and not her husband. Because the case is no longer surgical, George wants to hand her off to someone else, but the Chief is counting on him to provide stability. His complaints of unfairness falls on deaf ears, as the chief tells him to get moving and placate the patient.

Our return to Miss Nepal comes via Sandra Oh wheeling in to find her taking a pill. Or, the Pill. The use of birth control pills wasn’t in her chart, but Sandra Oh isn’t her doctor. Isabel arrives, and agrees that Oh should go back to bed. After all, this patient is some sort of neuropharmacologist who knows what she’s doing. The interns engage in a bit of bickering while the patient collapses onto the floor. Before the Code Blue team can arrive, Isabel brings the patient back to the land of the living with a firm smack to the chest. With the emergency averted, Sandra Oh rolls off with the chart in hand.

– act 2 —
Act two opens with Bailey and Grey (the younger) looking at some serious looking charts in the room of many light boxes. A lot of medical terms are thrown around, all of which mean that the CF marathoner might need surgery. But with his lungs, Bailey is reluctant to cut. She says that she’s a twenty-six-year-old survivor and she’s not willing to lose him. Conveniently enough the AddiSatan enters to offer her services. She saw a similar surgery one time. You know how it goes. Meredith gets all up in her grill, asking why a pediatric surgeon is stepping in instead of going back to Manhattan. Grey is surprised to find that the Dark Lord happens to have done two years of cystic fibrosis genetic research; so she’s seen it all and is willing to help. Bailey seems to like this patient and would be honored to have her assistance.

When Meredith and Dempsey cross paths, she freaks out a little bit about Addison still being in town. But he tells her about the divorce papers: all he needs to do is sign and he’s / we’re free. There’s no reason not to sign them, he just needs to read them over to be sure. Yeah, or maybe get a lawyer of his own?

As Mr. GSW is climbing into a CT machine, Alex and the tech talk about how he thinks the guy has a mental defect, not a bullet in his skull. Enter Mrs. GSW, who wants to know if her husband is O.K. (she believes him).

Back in the elevator of conflict, Dempsey meets up with Bailey and asks why she accepted a consult from his wife. He wonders whether she did it simply to drive him crazy. They don’t call her the Nazi for taking other people’s crap; so Bailey halts the elevator to chew out Dempsey for being so goddamn self-centered. She wants to save a patient that she cares about. Furthermore, he put himself between to very fine women and although he’s looking for a way out, she’s not going to help. Take that.

Miss Nepal continues to baffle her doctors. Isabel tells Chief Wannabe #2 that the labs look fine and that “another doctor” made a big deal of it. When he finds out that this other doctor was Sandra Oh, he seems quietly pleased by her interference. The patient is full of suggestions about her palpitations, and questions her doctors’ plan to evaluate with ultrasound instead of just skipping straight to the pacemaker.

Ah, the abandoned hallway of intern chatter is back. Meredith and Sandra Oh are chatting about their respective problems. Oh agrees that AddiSatan is peeing all over Grey’s territory. For her part, Meredith thinks it’s odd that her friend is more obsessed with the mysteries of Miss Nepal’s chart given her loss of a baby, boyfriend, and fallopian tube all in one week. Sandra counters that she just doesn’t want to spend time with her mother in a room with one window, and Meredith understands the feeling. Both wonder if they’re like their moms.

Speaking of mothers, Mother Grey has gone missing, much to George’s chagrin. She turns up in the CT room just as Alex finds that there is in fact a bullet in Mr. GSW’s brain. Mother Grey confirms his diagnosis and chides them for not getting the patient into surgery A.S.A.P..

– act 3 —

When we return, Mother Grey is walking Alex through the CT scan and surgical plan. Patrick Dempsey enters, followed by George, who takes her back upstairs.

Elsewhere, Bailey tells CF guy that it looks like they’re going to have to take out his pancreas. Addison chimes in to tell him that he’s going into multi-system organ failure; so he’ll die if they don’t do surgery. If they do operate, he still might die. He says that surviving 26 years with CF is awesome. Grabbing Bailey’s hand, he continues to say that if he gets lucky (and survives), that’s great; if he doesn’t it’s been sweet. This kind of optimism doesn’t bode well for his prognosis.

As for Mr. GSW, Dempsey wants to call in a psych consult. As the doctors question their patient and his wife, it turns out the the wife was “in the next room” when it happened. She claims to have not called 911 because her husband was unconscious for only a short time. But Alex is calling in the cops, since it’s the law for gun violence cases. I don’t know whether this is true or if he decides to call them in just because the couple’s story is so fishy and it’s clear that the wife was involved.

Back in the abandoned hallway, Oh is still reviewing Miss Nepal’s chart, trying to figure out what’s up with the crazy symptoms. George drops in to complain about being assigned to nanny duty. After all, he’s a surgeon! a cutter! (but not like that, I hope) He doesn’t want to get fake labs for a fake surgeon! With that, Oh realizes that the patient is faking her illness. She manages to run off to meet Isabel (who confirms that the labs look normal) to tell her that the missionary probably has Munchausen’s and is secretly ingesting pills to induce symptoms. Conveniently, Chief Wannabe #2 walks up just in time to overhear the theory.

With Mr. GSW’s surgery booked, he and the wife are talking in hushed tones. He forgives her! He cheated! He doesn’t get to play martyr! She shot him! Hmm, this cheating / martyr dialogue is sounding recycled from a previous episode, isn’t it?

We return to Oh pitching her theory: Miss Nepal loves hospitals, the staff is like her family, she can’t allow her actual family to take care of her. Hmm, projecting much? AND, Miss Nepal is actually a pharmacy tech and not a PhD. Thus, she’s a big liar. Throughout the explanation, the almost Baby Daddy Chief Wannabe #2 interjects that they need to talk and the he knows a bit about being lied to. Oh insists that they aren’t in a relationship since he broke things off. Duh.

– act 4 –

As Mr. GSW is being wheeling off to surgery, Patrick Dempsey introduces Mrs. GSW to the police. AddiSatan chimes in that there’s nothing like a domestic dispute to liven up a pre-op. While her colleague is making fun of other patients, Bailey is getting CF boy to sign consent and a DNR order (no exceptional lifesaving measures). The ominousness gets thicker, as the usually headstrong patient thinks that maybe it’s time to call his parents. But Bailey says that he can call them himself when he gets out of surgery.

Meanwhile, Mother Grey is on the loose again. George and the male nurse panic a bit, with George repeating over and over that he’s a surgeon. Just keep telling yourself that O’Malley.

As Chief Wannabe #2 and Isabel are examining Miss Nepal, the syphilitic nurse discovers that the patient has blue urine, confirming Sandra Oh’s diagnosis of fakery.

Cutting back to the case of the missing Mother Grey, George and the Chief are walking and talking in hot pursuit. The chief is angry that George turned his back on her for five minutes, since he told him to give Mother Grey his full attention. The Chief dismisses George to find a more fun surgery while he takes care of finding the lost patient.

It seems that the whole point of Mr. GSW is to allow Patrick Dempsey to reflect on his failed marriage. In an O.R., he and Alex are digging the bullet out of the guy’s skull. Alex thinks they should give the guy a spine for taking his wife’s gunplay abuse. But Dempsey isn’t so sure, relationships are built on sacrifice and sometimes a bullet is worth it. The plot thickens . . .

In the room of scrub sinks, the Chief finds Mother Grey cleaning her nails in preparation for a non-existent surgery. She’s very happy to see him. So happy that she wants to make out. After a longish kiss, the Chief delicately pushes her away. It’s at this point that Mother Grey realizes that maybe she isn’t supposed to he here. Gently, he tells her that she isn’t and offers to take her back to her room. It seems like the bit of misplaced romance was enough to turn her from overconfident surgeon back into a confused and sad Alzheimer’s patient again. Poor Mother Grey.

In the O.R. with CF guy, things aren’t looking good. Addison says that his organs are shutting down and the machines are making unpleasant beeps.

Does anyone think that there are too many cases per episode? Because we immediately cut back to the case of the Miss Nepal and her blue urine. Chief Wannabe #2 and Isabel tell her that they discovered her experiments with antitryptaline. She claims that she didn’t do this to herself, but CW#2 says that the patient is trying to deceive them, manufacturing things that aren’t there, wasting time and resources. Once again, patient symptoms conveniently mirror doctor drama. Miss Nepal’s problem is in her head and she’s banished the the psych ward.

When we get back to doomed CF boy, Bailey is still trying to bring him back (probably against the DNR wishes) with a lot of chest compressions. Grey temporarily takes over, but Addison says that there’s no blood in his intestines and everyone else sort of stops working on trying to save him, which surprises Bailey. Soon enough, there’s that really bad flatlining sound. Bailey does a good job of conveying being shocked and crushed through a surgical mask, calling the time of death and promptly exiting.

– act 5 –
As we enter the final act, we find Bailey furiously scrubbing her hands as dead CF boy is wrapped up in a white sheet and wheeled out of the O.R. and down to the morgue. Addison and Grey enter and exchange sad looks with Bailey, who leaves the room. With the company reduced to the Dempsey lovers, AddiSatan speechifies about how “it’s hard to accept the end when you’re too close.” As she showily puts her giant diamond wedding band back on her finger, she continues to say, “I don’t want someone who doesn’t want me, but if there’s the slightest chance that he does, I’m not leaving Seattle.” I think that we all sympathize a little with people who will take any excuse to stay in our fair city, don’t we?

More Mr. GSW as exposition on relationship drama. Post-surgery he explains that he cheated, and that she was drunk. Alex thinks he should be grateful that the police arrested her. But he isn’t — “there’s nothing to make you feel as stupid as cheating on the woman you love.” Isabel and Alex exchange some sort of meaningful glance here.

Back in Oh’s room, she and her mother are fighting about how she should be in bed. She claims that her brain and body are fine and that she’s not the sort of person who needs her mother to take care of her. Isabel interrupts their fighting to tell Sandra Oh that she was right about the Miss Nepal. For a minute, this news seems to make Sandra Oh really happy. Until it doesn’t. Repeating “I was right”, she disintegrates into a sobbing mess and Isabel looks scared.

In another hospital corridor, the Chief catches up with Alex to mention that the intern took his clinicals late and the he got a phone call. Alex looks scared, his sordid past has caught up with him and he didn’t pass the tests. The Chief says that Alex is still an M.D., and that he has four months to re-take the exams. In a forgiving mood, the Chief adds that one misstep doesn’t end your career. Alex wonders what happens if he doesn’t pass on the second try. Apparently the forgiveness induced by his reminder of his affair with Mother Grey isn’t infinite — the Chief says that if Alex fails again he won’t be a resident at Seattle Grace. Failure is not an option.

Next, we find Desmpsey at a big table staring at the divorce papers and playing with a pen. It sort of looks like he’s thinking about signing on the dotted line, but he doesn’t actually do it.
Meredith tries to come to the rescue in the room of the weeping Sandra Oh, where Isabel and George cower out of reach, looking frightened. Helpfully, George suggests that Oh take a drink of water lest she dehydrate. Mother Oh gloats that she knew that her daughter would break sooner or later, that it was only a matter of time. Meredith tries to approach her friend, but the other interns warn her of the dangers of contact. Sandra Oh, freaking out, begs them to sedate her since she can’t stop crying.

that cardboardy cityscape was actually just a photo.

And it’s voiceover time. “Sometimes reality has a way of sneaking up and biting us in the ass. When the dam bursts all you can do is swim . . . the world of pretend is a cage, not a cocoon.” (cut to the Chief and George locking Mother Grey to her bed with fluffy handcuffs) “we are tired, we are scared . . . denying it doesn’t change the truth” (Bailey making the sad phone call to CF’s parents. Hey! look at that cardboardy skyline! And Mount Rainier is visible at night! [Ed: it's a giant poster, not fake outside. --oops. I just assumed that she wouldn't be using a cell phone in a hospital]) (Return to Oh’s room, where she’s curled up on her bed thumbsucking, while her mom is furiously palm piloting. Chief Wannabe #2 enters, wearing his after work yellow turtleneck, white blazer combo. Mother Oh tells him that her daughter doesn’t want to be touched. But he climbs into the hospital bed and they get all cuddly and sad.) “Sooner of later we have to put aside our denial and face the world head on, guns blazing” (Alex enters Seattle’s only bar to find Isabel looking great, as promised. He avoids her kiss and asks if she’s ready to go. Obviously nervous about his potential impending failure, he tells her that they should attend to their dinner reservations.)

And the voiceover ends with the cliche we’ve all been waiting for, “Denial isn’t just a river in Egypt, it’s a freaking ocean.” (Meredith and Patrick Dempsey also meet at a bar, where the divorce papers fall to the floor, and she sees that they’re unsigned.) “So how do we keep from drowning in it?”

The End. As promised, all about the dark side of denial. Now buy the soundtrack and stay tuned for KOMO’s fourth installation in turning the cast’s visit to Seattle into a “news story” about how much they like the town and how much the director of the Washington Sate Ferries loves the show. No wonder, with all of that “ferry boat” love in the air. (Next episode [mb])