Derek's funk over losing a patient and being sued tests Meredith's staying power, while Izzie has to face the reality of her medical situation

By Jennifer Armstrong
Updated March 13, 2009 at 04:00 PM EDT
Credit: Ron Tom/ABC

I cried tonight, and that is how I like it. Grey’s Anatomy was back in full, moody force — I’d even go so far as to say the best it’s been this season. Every show’s got to have highs and lows and middles, of course, but there’s been an abnormal amount of dipping below the axis this season. But this great wallow of an episode hit its emotional highs — that’s when Grey’s is at its best, when its wonderfully sad — with no trick guest stars, no random new docs (except Jim! but I love Jim!)…just our trusty core cast (which is big enough, thanks) and some decent, but not-too-distracting, patient stories.

Let us count the downers that elevated tonight’s installment:

Depressed Derek What do we think about this, Grey’s fans? I went into this episode dreading Derek’s descent after watching him talk on The View about how awesome it was that he was getting to actually act within actual story lines that did not strictly involve him wooing a crazy commitmentphobe. I thought I liked my McDreamy McSane and McTogether. But I started to turn around on that from the very first scene, when he was moping on the sofa eating cereal out of the box — though, admittedly, my positive feelings sprouted mainly from his wild depression hair. And his casual depression sweater. What I’m saying is Depressed Derek is hot. In fact, he seemed to be taking style cues from a fair number of men I’ve dated, which helped explain some things.

Sick Izzie I felt totally opposite about knowing we were likely to finally diagnose Izzie’s terminal whatever this week: Psyched. And in this case, the story line delivered. I’ll even go one step farther: It exceeded my expectations. I liked Dying Izzie. Way more than I’ve ever liked Living Izzie. Starting with her newfound penchant for gleefully imagining those she cares about carrying on without her, from Alex becoming a distinguished doctor with salt and pepper hair to Mer and Cristina bantering in the nursing home. (Cristina: ”If you have a problem, you don’t ignore it.” Meredith: ”Sometimes if you have to pee and ignore it, it does go away.”) Incidentally, Alex started proving her fantasy right immediately by sticking to his risky diagnosis of a teen girl who’d been having seizures mid-band march, and saving her life because of it. Upbeat Alex — also hot.

The Sucktastic Interns The worst intern class in medical history, on the other hand, at least finally served a narrative purpose when Izzie pretended to be teaching them with a fake case — ”Patient X” — when she was really making them diagnose her. I personally wouldn’t go this route, since I would want, I don’t know, a correct diagnosis — and I’d also like to learn what was wrong with me from people with a soul. But it’s a TV show, so I’ll go with it, and God knows she was doing the rest of the hospital a service by occupying the idiots. (T.R. Knight sighting of the week: George asking Izzie about Patient X before the interns pulled her away for a diagnosis!) They did, however, get it right (presumably), even if it did take a while. Patient X, they said, has metastatic melanoma (which, incidentally, is very bad indeed and happens to be related to how we’re killing the earth and should wear a lot of sunscreen) that’s spread to her liver and brain. (That also makes that mole check she got last episode make more sense.) Now to the important part: With chemo and radiation, she likely has only a few months to live; the survival rate is 5 percent. As one insensitive intern quipped, ”girl’s pretty much toast.” That didn’t make the next part — where another insensitive intern asked, ”what’s our prize?” — go over very well. ”The prize is you didn’t screw up this time,” Izzie snapped. ”You are doctors. That is the prize.”

In fact, as a side note, I have to say that after witnessing the incredible job security at Seattle Grace, I’m considering becoming an intern there; it seems like the only place in the world right now where you can repeatedly screw up and fail to show up without worrying for your very livelihood. Even when Derek walked out of the hospital while the Chief begged him to do surgery, the Chief only half threatened him with being fired. Which brings us to….

NEXT: The chief gets a dressing down…by two women

Jim the Neurosurgeon How heartbreaking is this guy? We’ve never seen him before, but apparently he’s the second-string Derek who gets to do surgery only when Derek isn’t around. Lucky for him, Derek was refusing to come to work since he killed Jen the pregnant aneurism patient and got sued for it. Go Jim.

The Cancer Siblings Two sisters and a brother came in to get their stomachs removed because most people in their family die of this horrible genetic cancer deal. Whatever. The important thing is that the brother was the delicious Michael Rady — that is, Kostas from Sisterhood of the Traveling Pants, Max from Greek, and now, the lead in The CW’s increasingly intriguing Melrose Place remake. Anyway, he didn’t want to get the operation because, honestly, it did sound like it’d suck as much as you think it would not to have a stomach. So his one sister had hers removed and it turned out she did have cancer, so the other one…oh, who cares? How cute is he gonna be on Melrose? With Ashlee Simpson-Wentz! Okay, sorry, back on track: The oldest sister — the one with cancer — actually did have a pretty great insight that lit something up in Meredith when she said, ”You don’t leave the people you love alone.”

That turned out to be the theme of the night — not letting people’s icy-cool exteriors stop you from giving them a piece of your mind or heart. Miranda, fed up with the Chief sniping at her under pressure, called Adele in to give him a talking to, which she did. ”Hospital or playground, Richard?” she demanded before turning her scolding on Miranda: ”You’re no better, tattling on a man to his wife.” But then Miranda gave him some good advice after dressing him down for scoffing at her ”soft” choice to go into peds: ”Maybe you need a little soft.” Lexie, meanwhile, seemed like she may — or may not — have wisened up to the fact that Izzie had a personal stake in Patient X. ”Screw the odds,” she said, then brought up her own mother’s demise: ”People die of the hiccups.” Alex, on a lifesaving high, begged Izzie to get back to surgery. ”I don’t want to be the future of this hospital if you’re not with me,” he gushed. Cristina assured Hunt she didn’t mind his post-traumatic nightmares: ”It’s gonna take more than a bad dream to scare me off.” Izzie chose Cristina as her first post-diagnosis confidante because, ”You’re a robot. You can take it.”

Callie and Arizona finally made a date. But — awww — Mark still turned Neurosurgeon Jim down for an after-work drink.

Which left only Dark & Twisty Derek to attend to. The Chief took Miranda’s advice and went ”soft,” begging Meredith to get Derek to come back to work — he even dropped Derek’s planned engagement on her. ”He’s planning to propose,” he said. ”He’s been carrying around a big ring for weeks. That’s not a man who wants to be left alone.” She took that to heart and tracked Derek down at his trailer, where he was smashing beer cans with a baseball bat and being generally snarly. I couldn’t have been more proud of a character than when she took all his abuse, about how damaged and awful and commitmentphobic she is — ”There’s no fixing you. You’re a lemon.” — and simply told him she’d be there for him no matter what.

Yep, I was crying. Grey’s was back, cancer, heartbreak, more cancer and all.

What did you think of dark-and-twisty Grey’s? Do you like your Derek depressed and your Izzie sick? What can we do to get rid of these interns? Or do they deserve a reprieve for diagnosing Izzie? Will you miss Jim the Neurosurgeon when he’s gone?

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