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The fifth season of Grey's Anatomy opens with a traditional Meredith voice over - and a dream sequence of Derek dying under the knife.
Fortunately, in real life, everybody's angst-ridden romantic plot lines were actually pretty minor this week - a change of pace from past years!
Meredith Grey spends much of the episode second guessing everything about her relationship with Derek because that's just how she do.
Cristina, having had her ear talked off all night, finally snaps and tells her that they'll just break up like they always do.
Meredith then plunges into an existential crisis and agonizing over whether or not Cristina really meant that, and what she's supposed to do about Der. There was another terrible dream - or maybe just fantasy? - sequence in which Meredith and Cristina grow old together for some reason.
Another Grey's Anatomy fake-out moment comes when Rose starts acting like a jerk in the O.R. (Derek has dumped her, a scene we don't even see happen, but is referenced by Dr. Shepherd), then he confronts her about her antics, and she says she is carrying Derek's child ... NOT!
Rose does stab Derek - deliberately or otherwise - in the hand by the end of the episode, having him a surgical knife blade-first, not handle-first. She is certainly bitter, and we're glad she's not going to be around.
Cristina Yang meets Dr. Owen Hunt, an Army trauma surgeon who trach'ed a guy on the side of the road with a ballpoint pen. That's the way to Yang's heart right there! Cristina flirts with Dr. Hunt even as she dresses his (self-administered) staples without anesthetic. Something says he'll be back.
Lexie spends most of the show sticking up for George (who she has apparently fallen head over heels in love with) to Mark and being pestered by McSteamy to admit her feelings to George, which even Mark has figured out.
In the end, though, the two get closer - just as friends, in his eyes - but she wimps out and can't do it, continuing to allow the man to win her heart without even letting him know.
Callie and Erica are awkward around each other following their hook-up at the end of last season, but when they are finally forced to confront it, they learn that neither one of them has been interested in - or kissed - a woman before. They are both "virgins" of the girl-kissing sort. Neat!
Izzie and Alex, meanwhile, look to be beating up. They spend serious time flirting with one another. Izzie mentions to Meredith that he's changed - nothing specific about the crying incident over Rebecca, just that he is actually a very good man. Alex hears about this from Meredith and reverts quickly to his old ways, treating Izzie poorly thereafter. Sad.
At the end of the episode, Izzie sees Alex bring home some girl and start making out with her. She daydreams about seeing Denny again and we get to lay eyes on the handsome, late heart patient one last time.
Throughout the night is the recurring theme of failure and reality checks - the doctors find out that they've dropped from being one of the top-ranked teaching hospitals in the nation, and a level one trauma center, to being ranked the #12 teaching hospital and a level two trauma center.
The Chief? Far from pleased.
He insists that every patient is saved, and Dr. Bailey is willing to spend the night in the ambulance bay hoping that someone has serious injuries so bad that they're brought to Seattle Grace instead of Mercy West - now the level one trauma center that's closer. These are desperate times.
Dr. Hahn also questions her own teaching technique throughout, and we get to learn a bit about how the rest of the attendings do it.
The patients that do arrive amid the black ice / snow storm are a limo full of three women and their driver who were in a car accident. Their husbands were in a separate accident. After being coerced by Bailey, they insist be sent to Seattle Grace. She stole patients from Mercy West! Awesome.
The women are all okay, except for one who received such head injuries and her memory is resetting every 30 seconds. Their limo driver dies and their husbands are very seriously injured, though - including the one that got ballpoint penned by Dr. Hunt.
It comes out that one of the husbands lost his job months ago and, instead of telling his wife, told her best friend and had an affair with her.
Predictably, Meredith saw this as a sign that maybe she shouldn't be with Derek, because after 40 years of marriage, if that can't make you commit, what can? Izzie countered that it's about the man, not the time period. Denny was a good man, Derek was a good man, even Alex is - the innocent comment which started that whole regression on his part.
Ultimately, the woman with the resetting memory can't be cured, while her husband dies, causing the Chief to throw another fit and put everyone on notice that next day, he'll be overhauling the entire program.
Much more to come. For now, discuss in our Grey's Anatomy forum!