The Chief shakes things up with his new teaching protocol, Derek's douchebag tendencies begin to manifest once again, Meredith dumps her psychologist and struggles with a decision between her friends and her boyfriend, and George finally gets to take his residency test again. All in all, an exciting episode! Lots of what I love about Grey's Anatomy and very little of what I hate.
Meredith fires her therapist, figuring that her emotional progress and relative happiness means that she's healed. Dr. Wyatt disagrees, but Meredith ain't hearing it.
Izzy gets out of the shower and finds Derek casing out her room to turn into his new study in the expectation that she and Alex will be moving out "soon". All three confront Meredith - all wondering why she hasn't mentioned the moving out.
Everyone gathers into the Auditorium to hear the Chief's announcement of the new teaching protocol at the hospital, each point of which is illustrated with a scene of implementation.
Yang rattles up a bunch of medical gobbledygook - which Sandra Oh probably just pulled out of her ass - that apparently pertains to a patient's cardiac problem. Hahn is suitably impressed and invites Yang to scrub in, but the chief assigns Alex to help Hahn instead as his voice over announces that first through third year residents will not be permitted to focus on an individual discipline and will have to have a general focus instead.
The patient, now Alex's, mourns his lack of luck in general and the fact that everything seems to break around him, including the wheelchair that Alex is trying to push him in. When Alex goes to find a new wheelchair, the patient decides to just walk and slips in a puddle from the leaking ceiling. The chief orders a CT scan, but the ceiling leaks onto the machine and the patient is left in darkness. Afterwards, the patient considers not even having the cardiac surgery that he came for, fearing that his string of bad luck will mean that the wound will get infected or something worse. Alex decides to sit down to have a bitching contest with the man and finally insists that the man's luck has got to turn eventually and that he needs to find something or someone to live for in the meantime, while surreptitiously staring at Izzie. Awww, he still loves her; he's just too much of a douche to admit it!
Yang is assigned to work with Derek on a migraine patient instead of Meredith as The Chief announces that personal relationships, loyalties, and favorites will no longer be a factor. Attendings must spread their wealth of knowledge equally among the residents and interns.
The Chief also wants a renewed focus on bedside manner and the camera focuses on Alex and Izzy in turn when the chief mentions that there needs to be work on furthering compassion while others need to regain their clinical detachment.
Izzy gets a further smackdown when she's pulled from the case of a cancer patient who loves Izzy and is replaced with Meredith.
Attendings and Residents are reminded that the performance of their interns and residents, respectively, reflects on them.
Callie has outed herself and Hahn to Sloan, who has started teasing Hahn about it. Hahn is less than pleased that anyone knows her private business, especially Sloan, but Callie finally lays down the law that Sloan is her friend and she needs to be able to talk to her friends, even if Hahn isn't fond of them. In the end, Hahn agrees to back off.
Meredith's patient's sister is being driven by her sister's obsession over her cancer and begs Meredith to talk to her about anything but her illness. Meredith relents and begins whining to her patient about her roommates vs. McShitbag dilemma. In surgery, Bailey finds that the patient's tumor is far more advanced than they initially thought, growing around a major artery and making it inoperable. The patient tries to put on a brave face, but when she guesses that Meredith is considering choosing the roommates over Derek, she begins to bemoan the unfairness of Meredith throwing away a hot guy when she is dying. Eventually, that leads her to cry over the unfairness over her dying.
George is finally getting his chance to retake the residency exam and is just about to start when the ceiling begins leaking onto his test. George tries to find a new, dry room to take his test in when the chief asks him to help out. George begins to refuse, but ultimately agrees to be the Chief's Intern for one more day.
The maintenance supervisor wants to shut off the water in order to fix the leak, and Bailey suggests shutting down the Surgery Wing until the leak can be fixed, but the Chief is still letting his complex about dropping in the national rankings get in the way of his common sense and refuses.
Lil' Grey is helping Yang and Derek with their migraine patient and tries to tell them about an article that she remembers reading that might provide a clue to the patient's problem, but both blow her off and tell her to go check the patient's test results. On the way, she runs into Sloan and, since the research she remembers involves Ear, Nose, and Throat doctors, she tells him about the article. Sloan decides to check the patient out and examines the man, discovering that Lexie totally called it. As a reward, Sloan offers to let her scrub in on the surgery, but she refuses, deciding to help George and the Chief instead.
The leaks get steadily worse throughout the day before becoming a full fledged flood and raining down on Alex's patient in the middle of surgery. While making sure that the wound area has been cleared of any debris from the flood, Alex discovers a malignant tumor on the man's pancreas. After testing the tumor, they find that the cancer was stage 1, a point at which it's virtually impossible to diagnose pancreatic cancer. Alex explains that by the time pancreatic cancer is usually discovered, it's advanced to the point that it's a virtual death sentence. In a sense, the flood saved the man's life. The man realizes that his luck has finally turned and has a new lease on life.
Once the man was almost killed by the flood three times and several others' lives were endangered, the Chief finally pulls his head out of his ass and shuts down the surgery wing, sending the patients to other hospitals. Bailey agrees not to gloat, but looks like she wants to smack the Chief upside his stubborn head.
Yang finds Meredith's psychologist and begs her to tell Meredith that she needs to keep going to therapy. Yang rattles off all of her opinions on what the shrink needs to tell Meredith and why she doesn't think that Meredith and Derek will work out, but the psychologist only says that it must be hard for Yang to lose Meredith. Yang tells her that she's a crappy shrink and storms out. Meredith does finally run into her psychologist, though, and the shrink convinces her that she's not quite done, even though she has made quite a bit of progress.
At the end of the day, Meredith tells Derek that Izzie and Alex are her family and she's not throwing them out. Derek wants to talk about it again later, but agrees for now. I almost feel bad for calling him McShitbag earlier, but that was still an awful douche-y way to go about things at the beginning of the episode.
Once everyone has finally gone home and the patients have been transferred, The Chief and George find a quiet room so George can take his test. The Chief acts as the proctor, saying George has more than earned his chance.
This was a very good, very packed episode. So packed, in fact, that I don't really think I did it all justice. I felt like it had everything that I love about the series and very little of what I hate. For the first time in awhile, I got to see why these people all care about eachother so much.