The whole point of the episode is what would have happened if Ellis never had Alzheimer's. It's pretty clear that the people who should have ended up together by relationship or by friendship still ended up together. That's the beauty of this episode. Meredith was still "damaged" by having a "Christina" as a mom but she ended up with a father (Richard) who basically protected her and put a band aid on that fact.
Obviously I thought about this so much but that's because I'm such a fan of Shondas work. She still stayed true to characters (Alex using Mer to advance his career, April having no spine but also using Mer, Jackson having those soulful eyes and not seeing Lexie as a lost cause). I'm also very sick with the flu so I do have a bit of free time on my hands to reflect in my feverish disposition.
Merediths character was shaped on her experience of not having a sympathetic mother and an absent father. In this reality it made her focus on pleasing her mom and stepfather Richard which caused her to not care about her fellow intern classmates Izzy and George when they had failed at being interns. They also failed because Bailey was a good teacher so without Miranda Bailey instilling the fear of God or going to bat for them, the class was unable to bond and look out for each other.
I loved this episode. I could see how all of this came about if Ellis did not have Alzheimer's. I mean its clear that Derek was lured to Seattle because of his talent and Addison followed to save their marriage. Derek still would have walked in on Addison and Mark but because he didnt have true love Meredith was forcing him to make a choice or basically being the better choice he opted to "make his marriage work" without ever really forgiving Addie for sleeping with her best friend. It clearly shows that Meredith was able to fare well not having the reminder that Thatcher was an awful dad and because of this Thatcher never tried to overcompensate for his shortcomings and killed himself when Susan died of the hiccups. Thus never pushing Lexie to try hard to succeed and having her cure her "illness" of being Lexipedia.
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