In which we see a series of broken hearts.

Don’t be fooled by all the hot shoes and the great sex and the no parents anywhere telling you what to do. Adulthood is responsibility.

No “previously” again, so we dive straight in with Meredith ruminating on how scary adulthood is, which looks to be our theme for the week. Adulthood isn’t all fun and games, the responsibilities are myriad, and Meredith is facing up to a big one a lot younger than most people have to. Her mother’s Alzheimer’s is advancing, rapidly. The limited powers she granted her lawyer aren’t going to be enough forever. While Ellis is still lucid enough to consent, everything has to be signed over to Meredith, who responds with a faintly comical “me?” when told.

She asks the question that makes sense to her – is there someone else it would make more sense to hand this off to? Unfortunately, the answer is no (with some guilt tripping thrown in by whoever this staff member is). What would be signed over is complete power over her mother, from finances and assets to healthcare. Meredith is the only person who should really have that.

The meeting has caused Meredith to miss her only opportunity to get any sleep, and so she hasn’t slept for over 48 hours when she goes into surgery with Burke. Meredith is literally holding a human heart in her hand, but she’s so tired, she nods off for a second. Her hand slips off the heart, but the surgery is done. Up in the gallery, George is jealous; Yang is pretending not to be. Izzie walks in talking about needing more ice and chips, and they begin discussing the rapidly expanding guest list for a “small meet the boyfriend cocktail thing” that evening. It has turned into a full-blown party. Izzie promises to let Meredith know about it; George, Christina and we in the audience are skeptical.

While the gallery crew try to keep Alex from finding out about said party, the patient on the table below isn’t coming back from her surgery. Her heart should be beating, and it isn’t. Meredith is looking panicked, but the patient comes back up. It’s only then, as they hand over to another team to close and finish, that she looks down and sees that her fingernail has popped through her glove.

Shepherd accosts her in the corridor, while George (sensing something going on between the two) hangs around like a bad smell. But McDreamy is McPuzzled, as Meredith is far from effusive about the experience, responding in monosyllables. Once alone in an elevator with George, she comes clean. Her fingernail sliced through the glove; she could’ve punctured the heart. George then proceeds to give her absolutely awful advice. For anyone considering a career in medicine, I have it on good authority that if there’s a chance you fucked up and could’ve punctured a major organ, you don’t just assume everything is fine and tell no one! Cue titles!

Patient roundup! Other than heart lady, we go to Webber and Bailey, who are quizzing George on their patient (Mrs Drake, AKA lung lady). He actually seems competent for once, but Grey’s Anatomy can’t resist a bit of an anti-smoking PSA. Hey, those things really will kill you! The patient needs surgery, so he’ll be talking her through it and prepping her for the OR. Alex has a patient with severe back pain, and also serious track marks. He wants to refer to a drug addiction program and discharge. Shepherd disagrees – first off, you treat the man’s pain. Then you discharge. He might be an addict, he might be faking the pain, but you still have to treat it, and he gives Alex orders to that effect.

George talks to his patient and can’t resist prodding her about smoking, despite being asked not to by the Chief. She insists she already quit smoking, and he reassures her that he can see on the X-rays that the pain she is feeling is very much real. Contrary to the advice he gives Meredith, he professes to be a straight shooter, winning her over. Her operation is her best bet, even though they said the same thing about the last one.

Meredith heads in to check on Mrs Patterson (heart lady). She’s not doing as well as they’d like, but she’s still going strong. We meet Izzie’s patient, Mr Steadman, who is suffering from a bowel obstruction and can’t be discharged until he poops. While everyone else looks like they’re keyed in on our main theme of adulthood and responsibility, Izzie’s on a different track. Can a surgeon have it all? Will her main priority always be her patient over her personal life?

Burke is handing Yang coffee, and we’re all confused! Is this an attempt to move slowly so as not to spook her? There has been tension there. Sandra Oh does an incredible job of expressing incredulity with her entire face, until Burke is forced to explain that it’s just coffee. He’s not particularly convincing, but she accepts his explanation, and he awkwardly flees the scene. Sans coffee, which she drinks; he backpedals to make sure she took it with her. This is definitely some weird form of courtship in motion!

Cut to Mrs Drake’s surgery. They’ve got the scopes inside and Bailey is explaining the procedure when Webber asks her to check the screens. There’s some sort of weird mass, he is prodding with the scope – whatever it is, it’s serious enough to get them to change to an open procedure and get in there immediately. The issue with her lungs now, it turns out, wasn’t smoking, or a bullae. Five years ago, the surgeon who operated on her at Seattle Grace left a towel inside her. “Something careless this way comes.”

Following the fact that this is an obvious disaster, Christina is put on research – find out everything she can about the surgery five years ago. George meanwhile is asked to stay with the patient. She seems to like him. Bailey asks if she is invited to the party. George says yes, because he is George. Bailey is amused. Yang is incredulous AND exasperated. All round over the top emotions, and we love to see it.

Shepherd is roaming the halls only to hear someone yelling out in pain – he looks in and it’s back pain guy, screaming out in agony. He strides off to find Karev, and tells him that when he gives him instructions, he is to follow them. No judgement. Alex tries to fight back, pointing out that the guy is a serial drug user who has been to several hospital, but Derek explains that the patient’s pain is real – he has a serious back condition. He may be addicted to the painkillers he uses to manage the pain, but it’s pain nonetheless. Karev is dispatched to actually go do his job for once.

George is talking to Mrs Drake, who is awake but disoriented. Webber has been to see her and told her that someone left a towel in here. Again, this is the adult thing to do – own up to the patient, take responsibility and apologise. George agrees with her – it wasn’t right for someone to do that to her. She’s hurting, both physically and emotionally, from this discovery. Broken heart counter: 1

Meanwhile, in a dusty file room not very far away, Christina discovers the careless surgeon in question was none other than Preston Burke. That’s a transgression all the coffee in the world can’t wash away. She takes the information to Bailey, who basically tells her to sit on it while they work it out, and you can see Yang’s unease with this. Her instinct is to get this into the hands of the correct authority, and she doesn’t know Bailey well enough yet to trust that it won’t be swept under the carpet.

Speaking of consequences – Meredith is looking ever-more tired while trying to dodge hers. Shepherd comes over to check if she’s okay, and offers an alternative to the party that he’s not supposed to know about, dinner. But there’s no time to answer, because she gets paged to Mrs Patterson’s bedside. The patient is suddenly deteriorating, and knowing that this could be the key to working out the issue, Meredith does the adult thing in a juvenile manner. She blurts out the truth about the glove and the potential that she perforated the heart to Dr Burke. Unfortunately, she does it right in front of the patient’s husband. Broken heart counter: 2

In the OR, Burke is yelling at Meredith for the manner in which she first didn’t, and then later did, confess. She’s not the main cause, as it turns out. Just as they’re ascertaining that, Webber walks in. He’s pissed, the patient’s husband is pissed, and he wants answers the following morning. He walks out muttering about “people poking holes in hearts and leaving towels in patients”, which is fair. Meredith is given her marching orders – go speak to the husband and work out what on earth happened. Otherwise, she could well be out of the program.

The interns gather to discuss Meredith being potentially fired, the party, and how they are just workaholics with god complexes. Meredith makes arrangements for her mother to sign everything over, the tail end of which Derek overhears. Ducking his questions about the phone call and the heart surgery, she asks him two in return – when did they become adults, and how can she make it stop?

Our other sexually-tense pairing, Christina and Burke, are in a small space together and I swear you can see the temperature drop about 10 degrees. She knows he was responsible for leaving that towel inside a patient. He has no idea that she knows, in fact, we’re not even sure he knows.

Mr Patterson is outside, on the phone to his lawyer when Meredith approaches. He’s been advised not to say anything to her; she needs information from him in order to treat his wife. The difficulty is that anything she says now is being treated as blaming his wife – he won’t be convinced that it isn’t her fault, and her trying to get information out of him just makes him mad. His wife was in the best shape of her life having lost a 100lb (around 7st, or 45kg) in the last year. He’s done, and storms off.

We check in on our “minor” patients – Karev’s drug addict guy, Jerry, is now ready to be discharged. Shepherd gives the order, despite the guy’s outrage. He’s being referred on to rehab, and he will get no more drugs from Seattle Grace today. Izzie is busy not discharging her bowel obstruction patient when she’s asked to run the discharge for Jerry too. She asks George to go sign for the beer at the house, and discovers that Meredith has gone. There’s no time to tell her how big this party has gotten. Obviously given she handles social situations so well, they’re not worried at all…

We cut to the home her mother is in. Meredith and a whole team of people have shown up to sort the transfer of her mother’s estate to herself. Unfortunately, Ellis isn’t lucid, and there’s nothing that can be done. Meredith is understandably angry about the circumstances – this was put off way too long, and no one called out that this would need to be done until now, when it’s difficult to do it. Blowing up at the various people who have assembled is probably unhelpful, but I hope at least felt good.

Back at the hospital, Yang sees Burke being informed that he was the surgeon who left a towel inside Mrs Drake. She sees what looks very much like a cover-up in progress, with Burke demanding the whole file be handed over by Bailey. Given it’s a historical file it’s likely not digitised, and this may well be the only copy that implicates him. He could destroy or amend the record to absolve himself of guilt in these circumstances, and Bailey does seem reluctant to hand it over, but does. Yang is facing her own dilemma about responsibility – if she sees her immediate superiors potentially covering something up, should she go above them and report it? How sure does she need to be before she does so?

Bailey and Yang are both at the party, and Christina gathers the courage to ask Bailey what happens now with regards to Burke. Bailey tells her it’s handled, and to drop the subject – this smells more and more like a cover up, and Christina is clearly unhappy about it.

Jerry the drug addict is being discharged and struggling against it. In light of his behaviour, Izzie decides to call the Psych department, at which point Jerry starts trying to high-tail it out of the hospital. He gets about 3 metres and round a corner before colliding at speed with a nurse and cracking his head off the floor, hard. It’s a brain bleed, which means surgery – Derek asks her if she wants in and she abandons all possibility of meeting her boyfriend at the party, electing to do the surgery. She can’t have it all, and she is just a workaholic with a god complex. But she gets to operate on a brain. Silver linings.

Over at the house, Meredith is faced with trying to find and murder Izzie Stevens, or join the party. Christina is drinking to avoid her own moral dilemma, and Meredith elects to join her, swigging straight tequila, dancing it out on a table, and dragging George up there with them to enjoy themselves. Izzie and Alex are having similar amounts of (much more sober) fun in surgery. Alex even shares some personal history about himself – his father was an addict, and that’s where his antipathy towards addicts comes from.

Meredith, Christina and George are playing strip… something, when in walks the boyfriend. Dr Stevens is, of course, assisting with a brain surgery. She’s not there, and the truth is that the hospital owns them 99% of the time. He goes to collect her from the hospital. They chat, but ultimately, it’s not working. He needs her to be available, and she just can’t be. That final “I’ll call you” sounds a lot like “I won’t call you”, let’s be honest. Iz turns back around and goes back to look after her patient. Broken heart counter: 3

Meredith is dancing on her own outside her house, tequila in hand, when Derek spots her while leaning against his car outside. She’s drunk enough to finally give in to what she wants, and uses the somewhat corny line, “take me for a ride, Derek”. They do just that in his car, still parked right outside her house, and are (presumably) post-coitally congratulating themselves on being excellent at sneaking around when there’s a tap on the window. It’s Bailey, asking them to move the car; they’re blocking her in. And boy, is she pissed. Their faces fall, as they realised they’re officially rumbled.

It’s the next day now! George is fetching Meredith coffee, strolling through the aftermath of what used to be a house but is now a pretty good visual representation of the state of Meredith’s career OR Izzie’s love life (take your pick). Izzie comes home, greeting the scene with a reasonable amount of horror. Meredith is too hungover to hate Izzie right this second, and also she has that meeting with the Chief in an hour. Izzie apologises, but does manage to clue into the fact that losing 100lb in a year is rapid weight loss that could lead to an overall reduction in muscle mass.

Straight cut to the meeting at the hospital. Meredith is fighting her corner, and Burke is backing her up. She did wrong, she acknowledges that, but the history is significant. The patient was functionally anorexic, despite still being overweight. While Meredith did cause a small puncture, the fact that it then tore open was due to the health of the patient, turning what was a minor injury that may even have healed on its own, into a serious health emergency. On the other side from Meredith and Burke is someone from Legal, who is recommending Meredith be fired – by not reporting the incident when it occurred, the hospital could be left liable.

Burke is losing this fight – so he pulls out his trump card, and owns up to the fact that he left the towel inside Mrs Drake five years ago. Unlike him, Meredith reported it, later than she should have, but she still did, and knowing what the potential consequences could be. Burke didn’t report his misgivings, and as a result, Mrs Drake has been in unnecessary pain and suffering for five years. Doctors have to be able to own up without fear of being fired.

Unfortunately once you get past the age of braces and training bras, responsibility doesn’t go away. It can’t be avoided. Either someone makes us face it, or we suffer the consequences.

Final round up, and it’s a very quick-fire sequence. Meredith gets one month probation, and we see Bailey level with Yang. Burke was always going to come clean, it was just a question of timing it. Ellis signs over her estate, as various professionals look on. Karev offers Jerry a chance at rehab. We see Burke go and apologise to Mrs Drake (who I still hope sues the hospital for five years of pain and suffering). Derek and Bailey share a moment on the stairs, and she is clearly unhappy with him. Izzie’s bowel obstruction guy gets out! The big moment here is Christina and Burke hooking up – her trust in him is now confirmed, and they have sex in an on-call room. We finish with Christina, George and Meredith cleaning up her house, to which I can only say – good luck!

Sum it up

I mean, this is a strong episode. Themes of adulthood and responsibility twined really well with the patient stories and led to some real character and storyline development as well as foreshadowing potential storylines to come (there’s no way Bailey knows about Derek/Meredith and does nothing about it). They teased Christina/Burke for a couple of episodes before it happened, so we saw it coming, although it was a bit quick by my lights. We also get some more insight into Bailey – we doubted her for a minute in the middle there, but she really came through. We’ve all felt overwhelmed and afraid by adulthood, and it turns out surgeons are no different, although they should all be being sued for medical malpractice right now. The only low point for me is that neither Christina nor George cottoned on to the disconnect between the advice they gave Meredith against owning up, and the feelings they had about what Burke did to Mrs Drake. Clearly some more learning still to be done. Overall rating: 8/10

Hero of the Episode: Meredith, who at least tried to do right by her patient.

Zero of the Episode: Actually tricky one to decide, because neither Alex nor George really deserved it for once. I think it’s going to Burke, because that woman had a towel in her lung for five damn years.

Literally Incredible: Burke should be suspended and be being sued to within an inch of his life, and I don’t believe anyone who tells me otherwise.

Did you like this episode? Hate it? Just want to tell me how much my writing sucks? Leave a comment below with your rating and what you thought overall! Alternatively, you can let me know on Twitter!