A lot happens in this episode of Grey’s Anatomy. Seriously. This episode finally advances many of the plots that have been unfolding, painfully slowly, throughout this season. I almost wish that this one episode could have taken the place of the months of filler that we have been getting, but I suppose that would be asking too much of the writers.
Anyway, back to tonight. There’s a big, huge, career-making surgery going on. Sloan (Eric Dane) is actually going to transplant a guy’s face. The patient’s name is David Young, but all the doctors call him Blowhole behind his back. Much of his face is pretty much gone. He has a big hole where his nose should be, and he has no skin around his mouth. He looks like Harvey Two-Face. Mark is going to attempt a 70 percent transplant of his face. Alex (Justin Chambers) gets to work with Hunt (Kevin McKidd) on the face donor. Izzie and Lexie are also on this case. Because Derek is still holed up, drunk, at his trailer, and many of the other residents and attendings are on the face transplant case, Bailey wants Meredith and George to basically run the rest of the surgical department and babysit the interns.
Cristina (Sandra Oh) has a lot of things on her mind because she was just awarded her first solo surgery (operating on a hernia), and she still has to deal with the bombshell that Izzie (Katherine Heigl) dropped on her at the end of last week’s Grey’s Anatomy, that she is dying of skin cancer that has spread to her liver and brain. Cristina is so busy trying to get Izzie an appointment with a surgical oncologist, that she doesn’t have time to deal with her hernia patient, who is played by Emily Kuroda from Gilmore Girls! It’s MamaKim back on my TV!
Alex and the interns rudely refer to Blowhole by his nickname, and because Izzie is about to become a patient herself, she bristles at their insensitivity. She yells at the interns at every chance she gets.
Bailey (Chandra Wilson) sends Callie out to the woods to see if she can get Derek to come back to work. Callie heads over to the trailer and finds Derek gulping down cheap cans of beer early in the morning, drowning his sorrows. Callie (Sara Ramirez) tries to get him the pep talk about how to get back on your saddle after you lose a patient, but Derek (Patrick Dempsey) asks her how she can live with herself after killing a patient. Instead of cheering him up, she starts drinking with him. I guess she didn’t learn how to live with himself.
Cristina barely listens to Meredith venting about not knowing whether she and Derek are still a couple after he threw away her engagement ring in the woods in last week’s episode. But Cristina isn’t preoccupied enough to dish about her chaste relationship with Hunt. She’s not really sure if it’s a relationship, and she describes it as “friends with benefits, without the benefits.” They’ve kissed a couple of times, but they haven’t actually done the big wumpity-wump.
To add to everything else going on tonight, there’s a D-story about some intern drama. Two of the male interns look like they belong to Fight Club or something. One has a black eye, and the other one has a big, bloody gash on his arm. They are clearly fighting over a female intern who can’t stop crying. Meredith, Cristina, and George (T.R. Knight) decide to just ignore all the interns, even though there is clearly something going on because they have too much to deal with.
Izzie instructs Blowhole to blow into a device that will help keep his lungs active, which prompts one of her interns to snicker about the word “blow.” Izzie orders this intern outside and unleashes her fury at him for mocking the patient to his face. Sloan deems Izzie’s behavior unprofessional enough to ban her from the OR during the transplant. George notices all of this and tries to tell Meredith that something is wrong with Izzie, but Meredith doesn’t want to add resident drama to the already existing intern drama, which they are continuing to try to ignore until Bailey is all, “Nuh-uh. You better do something about those interns.” Right at that moment, the female intern runs away from Arm Gash Intern, who yells, “I love you, Megan!” while running into and knocking down a patient in the process. Do we need any more proof of why you should never want to be treated at Seattle Grace?
Meredith and George lay down the law to Girl Intern and Arm Gash Intern. They try to explain, but Meredith doesn’t want to hear the story. She just wants them not to talk or even look at each other.
Since Callie is now MIA along with Derek, Bailey sends Hunt to go drive to the woods to bring both of them back. (She’s kind of worried that they may be lying dead in a ditch, or at the mercy of a serial killer – these are just the thoughts that are coming to her head. She likes daytime TV. And, I just lost a little respect for Bailey.) Hunt tries to tell her that he doesn’t want to go, but he soon learns that it is not a good idea to sass back to Bailey. She gives him a Glare of Death, and he crumbles immediately.
Blowhole will need people to help him after his transplant. He doesn’t have any family or real friends, but he has met a bunch of people online in an orchid lovers’ chat room with whom he has become close. He hasn’t met them in real life yet, but they are supposed to be flying out to Seattle to be his support system after the surgery. However, they surprise him by coming early. He freaks out and yells at them to leave because he didn’t want them to see him with his old freak face.
Cristina tells Izzie at lunch that she booked her an appointment which is scheduled 15 minutes from now, but Izzie doesn’t want to go to it. The rest of the residents sit down at the table with them, so they switch to talking in code: Izzie has been backed up for weeks so Cristina booked her an appointment for an enema. There’s much discussion of enemas, but George, the astute one, figures out that enema must be code for something. Izzie abruptly leaves the table.
In the woods, Hunt does his best to tell Derek that everyone loses patients, and you just have to get back in. But Derek throws back in his face that Hunt is dead inside; otherwise he would be feeling like complete crap. Hunt can’t argue with that, so cracks open a can of beer and joins the mopers. Who drinks cans of beer, anyway?
Cristina is furious when she learns that Izzie blew off her appointment with the surgical oncologist. Izzie says emotionally that everyone – the interns, even Alex – has been calling the face transplant guy Blowhole. She’s worried about what everyone will call her once she becomes the patient, Swiss Cheese For Brains? Cristina says, “No, that’s awkward and long. Blowhole’s pithy.” Izzie doesn’t want to be a patient and have her brain and internal organs hacked up and cut out. And besides, even if she does get surgery, she still only has a five percent chance of survival. Cristina demands to know why Izzie even told her about it if she isn’t going to let her help her. Izzie just tells her to keep her mouth shut and forget about it.
Mark tells Blowhole that they can’t go ahead with the transplant because the ethics board won’t approve it if he doesn’t have a group of people willing to be his support system. Blowhole doesn’t want to ask his orchid-loving friends back because he doesn’t want them to cringe when they look at his freak face. Lexie (Chyler Leigh) assures him that not one of them cringed or looked away. She steals away and calls the friends back to the room. They are awesome friends, even if they had only just met Blowhole a few minutes ago. They don’t think he’s ugly at all, and rather, compare him to some kind of orchid species. One of the friends, a kind, elderly black woman, kisses him on the cheek. Izzie is touched, watching all this display of devotion from friends.
George and Meredith play good cop and bad cop, respectively, with one of the interns, making him spill the story of what’s going on. Apparently, Girl Intern was with one of the Boy Interns but then broke up. While they were broken up, she slept with another Boy Intern, and the whole thing came to light when somebody “‘Replied All” to an email. George and Meredith get glassy-eyed when their snitch starts spewing Gen Y-isms about texting and “like” a lot.
Bailey confesses to Richard (James Pickens Jr.) that she lost Callie and Hunt after sending them to retrieve Derek. So Richard drives out to the woods to lay the smackdown on all of them. He yells at Derek that people die, and human mortality is not on them. Derek spits back that a pregnant woman came in for a routine surgery that he botched, and that is on him. He also tells Richard that because he sent Meredith to the trailer expecting an engagement ring, he ruined Derek’s life. Richard follows Derek into the trailer and yells that he’s been where Derek is right now. He’ll need a friend when he comes out of that hole he’s dug himself into. Derek finally calms down and laments that he doesn’t know how to get Meredith back. Richard reminds him that Adele took him back after knowing about his years-long affair, so he can find a way to get Meredith back.
The face transplant surgery is underway. Sloan lets Lexie help him put the new face on the patient. Upstairs in the gallery, they see and hear the interns snickering because they think that Lexie is trading sexual favors for surgical ones.
Meredith and George round up the three troublemaker interns in the bathroom. Meredith tells them all never to behave this way within the four walls of the hospital every again. She tells Boy 1 to get his gross, oozy black eye taken care of. She tells Boy 2 to get his unsanitary, bloody arm gash taken care of in the pit. She tells Girl to go to OB because she’s pregnant (she just peed on a stick). Sup Dawg. I herd u didn’t like forming babby. George is impressed with how Meredith took control of the situation and exerted her authority.
Right before Cristina’s first solo surgery, right before MamaKim is put under, MamaKim asks Cristina for reassurance that she’s going to be fine because she is really scared about the surgery. Cristina finally shows some empathy and assures her that the surgery is important to her and she will be very well taken care of. This affects her, so right before she asks for the scalpel, she tells Alex and Bailey, and everyone present that Izzie has stage 4 melanoma that has spread to her brain, liver, and skin. She is resisting treatment and likely has only months to live. Oh my God, y’all, I totes teared up during this scene. Sandra is killing me here, and so is Alex, with just his eyes.
The face transplant went extremely well. Dave, who is no longer a Blowhole, wants to see his new face, and Sloan says that although his face is still swollen and bruised, he can take a sneak peek at his face.
At the end of their shift, Cristina finds Izzie sitting outside in the rain. She tells her that she told Bailey and Alex. She says emotionally that she wants Izzie to fight. Sandra and Katherine both are making me bawl like a baby.
Lexie kisses Mark in front of the interns. She explains that despite what the interns think, he is not taking advantage of her, and she’s not using him. They are beautiful, just like Blowhole and orchids, and they can adapt to a hostile environment.
Derek finally calls Meredith, who shows up at the trailer. He tells her he loves her and asks if she can love him even if he isn’t a surgeon. She says no because he is one of about 20 people in the whole world who can save Izzie’s life, and she can’t respect someone who would walk away from that. She hands him an envelope containing all of Izzie’s scans and leaves.
As Meredith voiceovers about mortality and borrowed time and whether it’s worthwhile to make friends when everyone dies, all of Izzie’s friends gather around her and help her into a hospital bed. Derek decides that he wants to be a surgeon after all and starts poring over Izzie’s brain scans. And I look for a tissue. There’s something in my eye.