Equal parts bizarre and transcendent, “The Room Where It Happens” is Grey’s Anatomy unlike we’ve ever seen in 277 (!) episodes. Truth be told, I’m going to have to watch it a second time to fully appreciate all of its nuance and complexity and develop a more fully formed opinion. In the meantime, here are my immediate impressions of an episode that was, in many ways, more like theater than television – an episode in which the professional and the personal became intertwined as four surgeons worked to save a life.

We’re Gonna Play A Game

Grey’s Anatomy is all about the OR. It’s the training ground. It’s the arena. It’s where the game is played. In the opening montage, the table is set as the operating room is prepped for battle. Then the players step out onto the field. Meredith, Owen, and Stephanie (all overworked and exhausted before they begin this middle-of-the-night surgery) are joined by Richard who is fresh off a nap, willing to help and raring to go. GA regularly features a large ensemble cast but this episode is only about this quartet of doctors trying to save the life of a John Doe who was in a car accident.

Richard, apparently taking in mind the techniques offered by Eliza Minnick in the last episode, attempts to humanize the patient on the table. He suggests the surgeons play a game: give the patient a name and then imagine that person’s life. In short, make the patient a person, not just a “bag of organs” on the OR table. “Brandon” becomes “Joanie” who becomes “Gail” – an African American middle-aged woman who seems to be from an earlier time. She plays the cello and speaks, sometimes to Richard in what looks like her home, other times directly from the operating table (’cause that’s not weird at all).  Meredith did say in the opening voice over that lack of sleep can make you see things that aren’t there, but this seems like more than just an hallucination. Does Richard know Gail? More on that later.

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This Guy Isn’t Me

For me, the best part of the episode was meeting, after a fashion, Owen’s sister, Megan Hunt. Presumed dead after her helicopter disappeared when she, Owen, and Nathan were all serving in the Army, Megan (or at least Owen’s hybrid memory/fantasy of her) relates to her brother as only a sister can. She calls Owen out on, well, everything. His relationship to their parents. His choking of Cristina. His problematic new marriage to Amelia. We first “see” Megan and Owen as they operate in an Army surgical tent. She probes him about his guilt, insisting that it’s okay that he’s treating Nathan a bit better now, despite Nathan cheating on her. 

Soon, they segue to the present day OR where Megan sizes up Meredith, speculating that Owen had an affair with her! Of course not, Owen scoffs. They’re just friends. Still, Megan counters, Owen should have married Meredith. At least then he’d have children. Ouch! Owen snaps that he never wanted to marry Meredith. Eventually, things come back around to the patient. Owen’s already tried one work around for the guy’s shredded liver. It’s not working. Owen won’t quit because you don’t stop until you have the final answer about Megan your patient. Until you know if she’s he’s saved or dead. Megan reminds Owen that she’s not on the table and tells him to do what he knows he needs to do. Hunt agrees with an earlier suggestion that Richard made. They should remove the patient’s liver entirely and try to get him an emergency liver transplant. At this point Meredith is astounded and speechless. More on that later. 

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If You Have Something To Say, Speak Up!

Stephanie, a senior resident in a surgery with three excellent but strong-willed Attendings, is struggling to make herself heard. Coming to her aide is a younger version of herself. We learned last season that Stephanie spent her childhood in hospitals getting treated for sickle cell. That girl read a lot and learned a lot. That girl, now all grown up, realizes that their patient is rejecting platelets because of a rare medical condition. That girl, now the best resident in her year, summons the courage to insist that Grey, Hunt, and Webber stop arguing and listen to her! That girl buys John Doe Brandon Joanie Gail time.

Her Husband Never Came Home

Soon, a staff member comes into the OR with a message: John Doe might have a name. There is a woman at the hospital who says that her husband never came home after work. Could the patient be her husband, Carl? Long story short, it is Derek Carl and Meredith (who’s been really cranky all night anyway due to long shifts and sick children) is triggered. Someone needs to tell the family what is happening. Then Meredith flashes back to telling Zola and Bailey when Derek died after his own car accident. It’s soooo sad! And when Meredith imagines Derek in his scrubs and ferry boat scrub cap flashing his McDreamy smile? Well, I was never a hardcore Meredith/Derek shipper, but holy cow! That was moving!

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You’ve Saved Her About A Thousand Times

So…a liver transplant isn’t going to happen for Carl, but Meredith – thinking outside the box – realizes that there is another way! Since Owen removed Carl’s liver, the surgeons can get to the still healthy part of it that would have been inaccessible inside of his body. They do a partial transplant (which is a real thing) and save Carl’s life! Somewhere along the way, Meredith realizes that Richard knows “Gail.” And indeed he does. Or he did. Gail was his mother who died of pancreatic cancer when she was 46 and he was only ten. Richard confesses to Meredith that when he was training as a surgeon, the students were taught to focus on the medicine rather than the patients. But Richard didn’t want to be numb to the people he was saving. And he didn’t want to let his mother’s death turn him into a robot. “I started changing the rules and it made me a better surgeon.” 

So what do you think? Will Richard keep getting to be a great surgeon or will he become collateral damage in the hospital’s acquisition of Eliza? Will Owen finally accept that Megan is gone or will he search for definitive proof? Will Meredith be able to truly move on from Derek’s death, perhaps with Nathan? Will Stephanie ever get a story line worthy of her potential? Hit the comments!

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Memorable Moments and Quotes

Meredith: “How long have you been here?”

Owen: “What day is it?”

Owen (about Richard): “What’s he doing?”

Meredith: “He likes to teach. When he’s pissed, he really likes to teach.”

Richard: “We’ve got three attendings here. And a senior resident. We need to discuss the options.”

Meredith: “No! We don’t!”

Richard: “Why not?”

Meredith: “Because you also have the Chief of General Surgery in here, Dr. Webber. And I outrank you.”

Megan: “Maybe if you ask nicely someone with bring it to you.”

Owen: “I already did. And I shouldn’t have to ask twice.”

Megan: “Dad would say that. Oh god! You turned into Dad!”

Megan (to Owen): “You’re the one who brought me here and you usually only bring me around when you feel guilty.”

Meredith (to Owen): “Do not make that cut!”

[Owen makes the cut as Meredith glares at him.]

Owen: “Basin. Clips, please, Boki.”

Richard: “Since when have I taught you to stand around and play it safe?”

Meredith: “You taught me to Do No Harm!”

Meredith: “Someone should go talk to the family. Someone needs to tell them what is happening and prepare them for what is about to happen.”

Meredith: “They can’t fix him.”

Zola: “Then you should go in there and fix him.”

Meredith: “Zola…”

Zola: “You fix everyone.”

Meredith: “I can’t fix him.”

Zola: “Why?”

Meredith: “I can’t fix him. Because no one can fix him. Because he’s dead. Daddy died.”

Meredith (to Richard): “Sorry for the things I said.”

Grey’s Anatomy airs Thursdays at 8/7c on ABC. Want more news? Like the BuddyTV Grey’s Anatomy Facebook page.

(Image courtesy of ABC)

Janalen Samson

Contributing Writer, BuddyTV