So, where to begin? Meredith Grey was not in this episode. Neither was Alex Karev. I think that's got to be a first. Also a first? An episode in which romantic shenanigans took a complete backseat to the practice of medicine and the training of surgeons. Yep. You read that right. There were no hookups. There were no supply closet trysts. There were no professions of love. "It Only Gets Much Worse" was all about the medicine as the theme of "firsts" came to the fore: first day on the job, first lead surgery, first loss of a patient. At the center of it all was the tug of war between old and new, attendings and residents, Webber and
Minnick Bailey. This week the gloves came off and there were casualties.
It's April's first day as Interim Chief of General Surgery and things are not off to a good start. Staff members (aka non-primary cast members) keep asking for Dr. Grey and look skeptical when April assures them that she is now in charge. Phase Two (residents take the lead, attendings assist) of Dr. Minnick's teaching is underway, which leads to an immediate confrontation with Richard in which April practically begs him to work with Ben Warren. Colleagues (Maggie!), friends (Arizona!) and ex-husband/Harriet's daddy (Jackson!) all consider her a traitor for taking the job and "turning" on Richard.
The icing on the cake, however, is Lynne, a patient of Meredith's, who is understandably upset when Dr. Grey is unavailable to perform her surgery. Meredith found her cancer and had a plan. Now Lynne's stuck with "Dr. Not Grey" and makes her displeasure very clear. To her credit, April tries to rise above the fray. Maggie is undermining her at every turn and the patient has complications in surgery (of course), but Kepner is managing to stay professional, until she's told that Meredith is nicer than April. Kepner's not having it. More complications come up and Lynne needs another surgery stat. Maggie, whose loyalty to Richard I can appreciate, but who is also being really awful to April, gets kicked out of the scrub room by a "badass" Kepner. She fixes the complications and removes the tumor.
At the end of the day, April, stung by Jackson's insinuation that she was chosen for the job because she could be controlled and not because she earned it, has a clarifying conversation with Catherine Avery (herself having a bad day because Richard finally pieced together that it was she, not Bailey, who started this whole Minnick ball rolling). April insists that she's not anti-Richard or pro-Eliza. She feels the whole fiasco is bigger than she, bigger than them, bigger than politics. She took the job because someone needed to do it and it was a good opportunity. Catherine gets it. Jackson's name and wealth have always provided him with a "safety net." He's worked hard and earned his reputation, but never had to scrape or worry or fight the way she and April have. They go out to celebrate April's new job.
Mr. Bailey and his Chief Wife
Ben Warren is caught between a rock and a hard place. As a resident, he benefits from Eliza's program and can't wait to try his wings as a solo surgeon. But from his former life as an anesthesiologist, he's buddies with all of the attendings who are warring with Eliza. Add to that his marriage to Bailey, and Warren's in a no-win situation, which somehow gets worse during his own solo procedure. Miranda decides (against Ben's wishes) that she will "observe" and she and Richard get into it, tensions finally reaching the boiling point.
Turns out that Richard was present for Miranda's first solo surgery (during which the dulcet tones of "MMMBop" played in the background). Richard's disappointed and disgusted to report that somewhere down this road, "Dr. Bailey forgot that I know how to teach!" As for Ben, he finally calls them on their poor behavior, saying that he only gets one "first" lead surgery and they took all the joy out of it for him. Richard later rails at Catherine that he's always been a "fine" surgeon but an "excellent" teacher. Today he not only failed, but Bailey, his protegee and favorite student, has become his adversary.
Mama's Got Surgery
Meanwhile, Stephanie is gleeful and gloating about her chance for her first lead surgery. When one patient dies, she and Minnick go "trolling" in the ER to pick up a new "start to finish" patient. They poach a patient (from an irate Leah Murphy) - a young boy, Matty, who has gallstones even though he's only nine. But the removal is a routine, simple surgery. What could go wrong?
Arizona insists on being present in the procedure, arguing that residents shouldn't get to solo for the first time with minimal supervision when the patient is a child. Minnick, cocky and sure of both herself and her training program, condescends to let Robbins in the room, as long as she only observes. Things go well until they don't. Before we know it, Matty is bleeding out and then dead. Stephanie and Eliza both flee.
Arizona finds Eliza and starts to ream her out for abandoning her resident, but stops short when Eliza reveals that she's never lost a child patient before. Not in her residency or her fellowship. Certainly not in her specialty area of sports-medicine and orthopedics, where she operates on injured athletes and elderly patients needing new knees and hips. Arizona is immediate compassionate and guides Eliza through the crisis...and there are more
anvils hints of a burgeoning relationship between them.
Stephanie, meanwhile, runs straight to Richard who - as ever - knows just what to say. He talks Stephanie down from the ledge and assures her that these things do happen. Step-by-step, calm and reassuring, the master teacher helps his student. The juxtapostion of Stephanie's hug with Richard now with her hugging Eliza earlier in the episode is powerful and startling. Stephanie asks Richard what comes next. When Arizona and Eliza go to break the news to the child's parents, Stephanie and Richard are already in the room.
Memorable Moments and Quotes
Fun Fact: four series' regular were absent this episode - Meredith, Alex, Amelia, and Andrew
April: "I'm doing my job. This is my job, Maggie. Someone has to act like an adult."
Cafeteria Scene! #ThrowbackThursday
Owen (who's trying to remain neutral in the conflict): "What I'm saying is, Chief gives an order, you follow the order. You try to make it work."
Nathan: "Spoken like a true soldier."
Arizona: "Spoken like a former chief!"
Jackson: "WTH are you supposed to do when you're completely against the order you've been given?"
Owen: "That's called a coup."
Nathan: "Frowned upon but sometimes very necessary!"
All that talk of Switzerland! Anyone else keep thinking about Cristina Yang?
Richard (to Catherine): "Bailey was my favorite student. I brought her in as an intern. I saw her all the way through to chief. She was my 'start to finish.' And you turned her against me."
Arizona (to Eliza): "You are the attending. This is your loss. You take the hit. Because if you put it on her, she might quit. She might think that she can't survive it. So you show her that she can."
Richard (to Stephanie): "You lost. It's not your fault you lost. Every good surgeon does. It might be your worst, but it won't be your last."
(Image courtesy of ABC)