In which we enjoy the delights of psychically-enhanced cupcakes.
“Eventually, you grow up. One day, you open your eyes, and the fairy tale disappears. Most people turn to the things and people they can trust. But the thing is, it’s hard to let go of that fairytale entirely.“
No previously this week, so we’re straight into domestic life in Chez Intern. Izzie is trying to figure out her mum’s cupcake recipe and has been doing a moderately insane amount of baking to test out various things to make it work, to no avail. George insists the cakes are good (Izzie scenes are all making me hungry at this point, it’s true), but she’s insistent that they’re missing something and she can’t figure out what. And she absolutely refuses to call her mother to ask. Meredith wants to spend the night at Derek’s, partly so she can snoop through his stuff, and also because she isn’t convinced that he has one.
Shepherd has spent enough time at the House of Interns that they now know his breakfast habits – he’s been there a week solid. Also, ew, muesli. This isn’t just a jokey thing, I suspect the lack of things she knows about him is going to bite them this episode by the way they’re teeing it up against the voiceover about Prince Charming being a fairytale, even though you keep hoping.
Following the pregnancy tests at the end of the last episode we get confirmation that Christina is pregnant, and she’s planning to exercise her legal right to choose not to be. They’re trying to sort a time for her to come in when the doctor proffers other options, but Christina has zero interest in them. She’s getting an abortion on the 16th.
Cut to Devo, our young patient who you might recognise as the Potential Slayer Amanda from Buffy the Vampire Slayer Season 7 (spoiler: not the last Buffy alum we’ll see on the show). She’s being treated by Alex and Burke after she wouldn’t stop bleeding after a root canal. She had an infection and a fever, the infection has been treated but she still has a heart murmur. Devo is a snarky delight, annoyed by her name (“my parents did too much blow”), her parents and having to be there. She prefers the name Esther, and after some initial mocking of her long long skirt, reveals herself to be an orthodox Jew. Either way, Burke and Karev are tasked with finding out what’s up with her.
Over in Insensitivity Corner, Christina and Meredith are loudly discussing the case of a patient who was committed to Psych. More specifically, they’re arguing that Psych are trying to a dump this patient on them, whereas the very annoying doctor from Psych is insistent that what the guy is having are seizures. It should be noted that the patient can indeed hear them at all times. He’s a study in creepy, and he definitely IS having seizures… but he may also be seeing the future, correctly predicting a patient “checking out” on the fourth floor. Cheery stuff, then. Cue titles!
Meredith is grilling Derek on his life, in that she’d like to know ANYTHING about him other than the fact that he’s from New York and likes ferry boats. Who are his friends? Where does he live? Any information besides the size of his… scrub caps. He’s reluctant to provide any information and yeah, it’s shady as hell. He says she’ll find these things out in time, but until she does, she’s instituting a sex ban. Which I actually think is reasonable – you should know more than a person’s shoe size if they’re frequently inside both you and your house.
I will just note though it’s not like she’s clued him in on the whole thing with her mother, so, she’s not entirely devoid of secret squirrels.
Our young Jewish patient, who we’ll call Esther rather than Devo for the avoidance of confusion, needs a heart valve replacement, for reasons they haven’t explained but I assume is due to the heart murmur. She also has a condition called von Willebrand disease, which is a clotting disorder. That means she can’t have a mechanical valve, so Burke is recommending a porcine valve. Yep, that’s porcine as in pork. We the audience can predict a problem coming.
Bailey and Izzie are performing a biopsy on a patient, who is awake and commenting on the idea that there’s a psychic in the hospital, who correctly predicted a death. Man, gossip travels fast in this hospital! Bailey shuts it down, but not before Izzie can helpfully note that the ICU is on the fourth floor, and people die all the time there. Definitely a great thing to say to a patient you’re currently cutting into, Izzie, well done! She definitely has a bug up her ass about psychic guy though.
Derek has a patient who appears to be having some sort of neural/spinal thing going on. He’s in a C collar, and can’t feel his legs below the thigh or wiggle his toes. What’s worse – he COULD wiggle his toes about 10 minutes previously. Whatever is happening is progressing, and quickly. There’s no evidence of damage on the spinal X-rays, but he did take a small fall while rock climbing. Derek clearly has no idea what’s up with him, so he’s sending him for an MRI, along with Meredith who he has randomly decided is with him for this patient, like that’s not a weird abuse of power.
We’ve gone from Insensitivity Corner to Incompetency Corner, where George is showing off his inability to perform under pressure. The patient needs intubation, and it’s a tricky one. Karev offers to step in and do it, but George is insistent he can do it. Needless to say, he can’t, and Burke has to step in and complete it after our bumbling intern threads the tube down his oesophagus instead of his trachea. Whoops. Burke does take the time to give a quick refresher lesson though, so hopefully it sinks in!
Yang has our Seizure Seer solo now that Meredith has been pulled away, and is sufficiently annoyed at him that she actually hisses at one point. He thinks it’s hot, rather than a fire-able offence. She is able to show him that he has brain activity consistent with epilepsy – not visions, just seizures. Unsurprisingly he is not convinced of this fact. As she tells him she wants to order an MRI, he goes ahead and has a seizure… and then somehow knows she’s pregnant. Alright, so officially getting spooky! He also tells her she “can’t run away from it”, which is just… what?
Christina can’t leave quick enough, and she wants off this patient, yesterday. Izzie reckons she “knows the type”, clearly some history there explaining the bug up her ass, and (with some bribery thrown in) the two get Bailey to agree to switch their assignments. Christina’s new assignment is the biopsy patient from earlier, who it turns out has breast cancer. Oh, also she’s pregnant. Out of the frying pan, Yang…
Our favourite Neurologist and his favourite intern/sex partner/person not to tell intimate details of his life to are looking at the MRI for the paralysis patient, and are surprised to find precisely no physical reason for his symptoms. Well, Derek is surprised. Grey is snippy and flippant, and resumes harassing him for details about himself. She throws a series of questions at him, receiving just one answer – he has no grandparents. He refuses to answer by way of just walking out, advising her to “lighten up” as he does. Thin ice, my friend, thin ice.
Over to our pregnant patient with breast cancer, and treatment options are being discussed. The best option – for the health and survival of the mother – is surgery, chemotherapy, radiation AND drugs. Very much the “kill it with fire” approach. The worst part of this is that the cancer is highly invasive and hormones during pregnancy will only make it develop quicker. There’s no way this treatment is compatible with the survival of her baby. Christina delivers this like a robot, much to Bailey’s disappointment. Bailey lays it out – a decision has to be made. Met with bluntness from the patient, she offers it in return – yes, it’s a case of the baby’s life, or the mother’s.
Back to our mystery paralysis patient, and his symptoms are worsening. He now can’t move his legs at all, and the paralysis is moving very quickly. Meredith is probing, looking for psychological reasons that may be responsible for this. It could be psychosomatic, and Derek is considering it, but skeptical. At that point everyone’s favourite psychic enters the cubicle – no wonder everyone in the hospital is bloody talking about him – to let the guy know that “it’s not in his head”. More scans coming for this patient, but is it all in his head? TBC.
I have to do a quick PSA before the next block. The storyline about the transplantation of a porcine heart valve into a Jewish patient being considered not kosher was widely panned by Orthodox Jewish organisations in America when the episode came out. It seems a better conclusion to this would have been to have her actually call a rabbi, who would’ve explained that it’s fine. However, Grey’s opted for the dramatic (as you’ll see later on). I’m not Jewish and I’m not going to try and explain it, but I will link to this article which does a great job of demystifying it! And now, back to our recap!
Esther’s parents are talking to her about the porcine valve replacement, and she is having none of it. As far as she’s concerned, her parents might just as well have asked her to eat a beef, cheese, bacon and prawn sandwich. We get into the root of her disagreement with her parents – they’re reform Jews who aren’t particularly observant or knowledgeable about the Torah (sidenote: Alex Karev mumbling trying to list the Passover plagues is particularly amusing background during this scene). Burke tries to convince her, but she’s not budging. She wants a different procedure, and she doesn’t care what it is – they’ll have to work it out.
Psychic man is getting an MRI and attempting to flirt with Izzie. He really is delusional. He does however manage to hit the nail on the head – he’s looking at her, but all he wants is a cupcake. And then he goes on to describe pretty much exactly the ones she made that morning! Alright so let’s just accept he is somehow psychic, I think we’re going to have to roll with that one. She’s convinced there’s another explanation – she has chocolate on her still, or someone told him about them. Either way, she’s out to prove him a fraud.
The interns have gathered for a quick (and apparently unappetising) bite of lunch. Meredith is grossed out by the food and hightails it while Karev pauses to needle George about failing to intubate the patient earlier. George begins a rant about how he could’ve managed it, only for Christina to cut him off. He needs to get laid. There’s a cute nurse over there, ask her out. The subtext: please for the love of God go stop bothering us all. Karev suggests he goes to see the psychic, which in turn sets Izzie off. With just Izzie and George left, he again suggests she call her mother – it’s her mum’s birthday, after all. But Izzie won’t, for reasons still unknown.
Christina’s breast cancer patient is talking at her about the pregnancy dilemma, which you can imagine Christina REALLY wants to hear about. Lol, JK – Christina has her resting “robot” face on while taking blood. The patient is 47 and pregnant via natural means which yes, is sort of a miracle. They’d given up on having a kid after years of trying, but then one magical evening… you get the idea. The patients wants validation as to why this decision is not an easy one, but she’ll not get that from Yang. There’s no dilemma or sympathy as far as Christina’s concerned – have the baby and you’ll definitely die while the baby is very young, have the treatment and you’ll probably live. It’s that simple.
Our paralysis patient has now lost all feeling in his hands; things are getting dicier. With the rate of progression, Derek makes a gut call – he’s going to operate. He’s convinced there’s a clot in there somewhere and he will find it. Meredith is incredulous. Derek’s whole reasoning is that he’s trusting his instincts – “sometimes you gotta take a chance to save a life”. The subtext has all the subtlety of a brick – she needs to take a chance on him. Excuse me, I need a moment to recover from being hit over the head with that so hard.
It’s patient round-up time! Esther is deteriorating fast, and Alex can’t talk her into the porcine valve. She does talk him through the pull of Orthodoxy for her though – it’s a contrast to the vapid, sex-obsessed youth culture of today. Which, sure, I guess. Have you noticed how good he is with patients who are kids though? It’s a nice change. Our psychic patient has an AVM (blood vessel malformation in the brain) which needs surgery. Izzie is basically like “give me the tools we will do it now” but Bailey slows her down – protocol, etc. Still, he is getting the surgery. Bailey takes a moment to call her out on getting too involved with her patients, which is a very fair criticism.
Derek and Meredith are starting their operation on spine guy, but not without some misgivings from Meredith. There’s no proof there’s anything there TO remove. But Derek has a 10+ years of experience in the field and he’s convinced it’s a spinal haematoma – left untreated it will likely kill the patient. Meredith does get time in to utter a “wow” at seeing her first spine. Decidedly not “wow”-ing, though, is Christina’s patient. She’s clearly upset, but has elected to terminate the pregnancy and get the treatment. Bailey talks Christina through the abortion procedure, clearly upset on behalf of the patient.
Karev is in research mode, which I never thought I’d see. George asks how an asshole like Karev manages to get laid, which is a fair question (let’s be real – it’s because he’s pretty). After finding what he was looking for – a bovine xenograph – he gives George advice which basically amounts to “stop overthinking about it and just ask them out”. Which is actually good advice, so fair one. George just looks puzzled, which is also fair, because Karev wraps it in a weird boxing analogy before declaring himself “the Ali of this place”.
We’re back with Esther, and Karev walks in like the cat who just discovered a rare surgical alternative to the porcine valve replacement. Esther is praying, which naturally he takes time to mock, because while good with kids he is in fact still an asshole. Thank God Esther isn’t taking any of his crap. Karev takes the time to loudly announce this new surgical alternative to Esther and her parents, which thrills them. Unfortunately Burke walks in partway through, and promptly takes Alex outside to verbally flagellate him. Hey, maybe tell the doctor in question what experimental and new procedure you’d like to suggest, rather than just announce it to the patients as The Plan! He’s off the case, because he’s an idiot.
Over to psychic guy, who needs to sign the consent forms for his surgery. He’s reluctant to get the surgery, though. She explains the risks, but also states clearly that his visions are definitely seizures. He questions how sure she is about that, and she hits back trying to prove him a fraud, again, talking about methods he could use to read people. She accuses him of not only knowing he’s having seizures, but milking it. For what gain, Iz? He’s blithely unconcerned by her certainty, anyway, calling her “cricket”, which throws her for a loop. Spooky spooky.
Christina comes back to perform a pelvic exam ahead of the abortion, only to be met by a patient who appears to be about 20 times happier than she was a brief time ago. She’s changed her mind. No treatment, she’s having the baby. Christina tries to talk her out of it, but the lady’s not for turning. After all, there’s no guarantee she’ll survive even if she has the treatment. Christina wants to call a psych consult, but is told not to bother. The patient knows what she’s doing and what she wants – this way, she gets to be fat, and happy, and have a baby. Christina tries to tell her that if she wants to live, she needs the procedure, but the patient is clear – this is exactly what living is, to her. *sniff*
Burke and Christina touch base in an on-call room. She’s exhausted, and he’s stressed. The bovine valve surgery is much more complicated and he doesn’t know what to do. She brings him right back down to earth though – there are solutions, people he can consult, help he can get. This is solveable. The subtext – that her problems, and the problems of her patient, maybe aren’t, he’s completely oblivious to, because she hasn’t told him she’s pregnant.
Meredith and Derek are still searching for the clot in paralysis guy’s spine, but can’t find it. It’s been four hours and still nothing. Meredith suggests maybe it’s a different spinal cord injury, but Derek is insistent – there’s a clot. As they’re talking, the patient begins to deteriorate, and this is more urgent than ever. Also urgent is the patient George gets pulled in to help with by the cute redhead nurse from earlier. She needs intubation! He’s on it, follow’s Burke’s advice from earlier, and (with Burke looking on through a window), nails it first time (and impresses the nurse!). Nice work, George!
Clearly inspired by the way he taught George, Burke grabs Karev and tells him he’s scrubbing in, although he’s not forgiven for being a blockhead. He’s also responsible for getting Esther a rabbi to bless her before surgery. You have to ask if one’s already in the building and working his mojo on Derek’s patient, because he has just found the mystery clot! Meredith is astounded and probably a little bit turned on. We get a nice graphic close up for some reason. Derek is exuberant, and rightly so. The patient will hopefully be fine. He also wants to talk about their relationship – specifically, he wants to actually call it a “relationship”. He wants her to believe that, but she tells him to show her something to make her believe.
Christina and our breast cancer patient have one final chat when she drops off the discharge papers. She tries to get Christina to understand the decision she’s making, but she doesn’t, at all. This patient is willing to die for the sake of her unborn child. Christina is not. On the flip side of the “choosing to live” coin, our psychic guy is finally convinced he’s having seizures – and he’s convinced he just saw that “it’s about to be over”. This finally elicits some sympathy for him from Izzie, who reassures him that they know what they’re doing – he’s going to live. But it’s not living he’s worried about; he thinks he’s going to lose his visions. Fully softened, Izzie tells him that if they’re real, he has to believe he’ll still have them after surgery. The main thing is that he does decide to have the surgery, and live.
Esther is being blessed by a rabbi in the OR, before being put under. There’s another surgeon attending via videolink who is an expert in bovine valve replacements, so Burke clearly took Christina’s advice! Hurray. After this (we assume) the interns gather in what I’m naming the Bed Corridor to discuss their day. Meredith is beating herself up over trying to talk Derek out of the clot surgery, which prompts Karev to tell her she basically tried to kill the guy (and Christina to call HIM an ass, because of course). George strolls in announcing he has a hot date, presumably with the nurse! That was quick. Even quicker – he grabs a condom from Alex in anticipation.
Izzie gets round to discussing psychic guy, who has had his surgery. After some discussion about whether or not he was psychic, she finally open up about her backstory and why he bothered her so much. We were fairly sure she didn’t come from money, but she’s actually from a trailer park, waiting tables to put herself through college. Except her mum was always calling high-tariff psychic lines, so all the money went to paying off those bills. Hence, leaving at 18, modelling to pay for school, and never looking back. Psychic guy has said things, though, that have challenged her scepticism, and made her wonder.
“It’s not so important that it’s happy ever after. Just that it’s happy right now.
We’re into wrap-up mode now, and spinal guy is recovering! His wife and kids are there with him, and he’s starting to regain sensation. He can even move a finger now! That’s awesome. He thanks her for believing in him, which I reckon makes her feel about 18 different types of garbage. Psychic guy tells Izzie the secret to her mum’s cupcakes! Christina sees her patient leave. Esther asks Alex if her heart beats, or moos, which made me properly laugh. Izzie finally calls her mum – “cricket”, as it turns out, was her mum’s nickname for her. Derek takes Meredith to see where he lives, which turns out to be a trailer in a huge plot of land he owns, and finally volunteers a load of information about himself. Irish heritage, four sisters, 9 nieces, 5 nephews, favourite colour, hobby, the works. She’s happy. Sex, we presume, finally ensues.
Sum it up
Right. One of the weaker episodes this one. Thematically vague and doesn’t really move the story along. Everyone was on a different plotline and they didn’t tie together well. Individually the patient stories were… okay, I guess? Spinal guy was just a McGuffin. Psychic guy was interesting but has basically established that in the universe of the show psychic people do exist – there was no ambiguity left. Christina’s patient was an interesting contrast considering the pregnancy, but she had no business being that much of a bitch to her. Esther was great as a character, but inaccurate (see earlier PSA). Meredith’s point about not knowing enough about Derek rings true, but should’ve been handled better by them. Learning about Izzie’s background was the main highlight; Alex just demonstrated that he’s a blockhead, repeatedly, and I’m unconvinced by George “moving on”. Overall rating: 6/10
Hero of the Episode: None of them. But if I’m forced to pick one? Burke, for teaching George to intubate and agreeing to perform the bovine valve transplant despite Alex being an idiot.
Zero of the Episode: Probably Christina. No treating patients like crap. Bad, Christina, bad.
Literally Incredible: The whole porcine valves aren’t kosher thing, which turns out to be quite literally not credible. Deary me.
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