Everybody’s favorite dysfunctional medical drama is back for a fourth season. Grey’s Anatomy opens with a beautiful dawn rising over the Seattle skyline and, of course, the Space Needle. It is 17 days after Cristina Yang’s disastrous wedding from last season’s finale. Burke left her at the altar, so she and Meredith went to Hawaii on what was supposed to be Yang’s and Burke’s honeymoon. Alex took off in search of Ava, née Rebecca, and to grow a goatee. He didn’t do a good job of either, however. He didn’t see Rebecca, and the mustache of his goatee doesn’t connect with the chin part. Izzie and George were the only ones who stayed at the hospital, but George managed to avoid Izzie the entire time.

Today is the first day of not being interns anymore for everyone except for George, who must repeat his intern year because he failed his Step 3 exam. All the new residents have a group of interns of their very own to boss around. George is in Meredith’s group. They all do their best impressions of Miranda “the Nazi” Bailey, but I think Cristina’s is the best. One of Cristina’s interns is Lexie Grey, half-sister to Meredith, who flirted with Derek at the bar in last season’s finale. Izzie’s interns clearly do not respect her because of the Denny incident from two seasons ago, but it’s really quite ridiculous that Izzie has any interns at all. She was put on probation for a significant portion of her internship, and the bright lights running Seattle Grace thought fit to promote her along with everyone else? I think not.

It is also Callie’s first day of being chief resident. Bailey is pissed off at Chief Webber for passing her over for that position, and extends her pissiness to Callie as well. But she should really be pissed off at herself because she is still a resident. Normally, being chief resident means an additional year on top of the normal duration of residency. So if Bailey did not get it, she should be off somewhere else practicing medicine or doing a fellowship, not sticking around to be a resident for another year.

Because Burke has been written off the show, and Addison has her own show over at Private Practice, Derek is left friendless. He asks Miranda Bailey if she would like to have a drink with him after work. Naturally, she turns him down and mocks that he has no friends. Sloan overhears the talk about having drinks and tries to invite himself along, but Derek has the emotional maturity of a first grader, so he gives him the cold shoulder.

There was a multiple car accident, so the victims are being rushed to the hospital. Some guy hit a deer, another guy hit the first guy, and a pregnant woman hit the guy who hit the first guy. All the residents get their interns together to meet the ambulances. Lexie spots Meredith and picks the chaotic ambulance scene to introduce herself as her sister. Verbal diarrhea must run strong in the Grey family, because Lexie’s got it bad.

Alex gets a patient named Joey who seems alright but is so hungry that he swipes cotton swaps to eat. Alex and Callie bicker so much that they don’t notice Joey’s strange behavior. Meredith’s patient is the very pregnant woman whose right arm was severed right below the shoulder from the crash. Cristina’s patient gets the award for the episode’s most outlandish patient. The paramedics who brought him in thought he was dead, but as soon as Cristina called his time of death, he woke up. She takes him in to be x-rayed and finds out that his skull has been severed from his spinal cord and his head is only being held together by skin and muscle. Yeah, on anything except Grey’s Anatomy, that would be called intractable death syndrome.

Derek, Meredith and Lexie have an awkward encounter in the hallway. First of several, I would imagine. He recognizes Meredith 2.0 as the girl from the bar, but then the original Meredith indignantly says, “I’m the girl from the bar!” The whole conversation is very Shonda Rhimes—cutesy repetition of some kind of catch phrase. I’m not sure that I like it.

George, meanwhile, is moping, and will continue to mope for the rest of the episode, about having to repeat his intern year all over again. Should have thought of that when he was studying. Callie tries to reassure him that he will be a rockstar intern, and accidentally slips that she might be pregnant. He does not react well to this, saying only that he’s had a bad month.

Some guy and his young son have found the pregnant lady’s detached arm and brings it to the hospital. The boy, who has blood on his shirt, is carrying on about someone in the car who’s barely alive and in need of saving. Izzie hops to and makes her interns follow suit. Turns out, it’s the deer that caused the accident that is outside, in the back of the man’s pickup truck.

Meredith’s patient doesn’t have family nearby and she is having her baby alone, so she would really like her arm to be reattached. Oh, please, I can already see where this is going. I can see already that this season of Grey’s Anatomy will continue to bring us medical cases that are so blatantly about the doctors’ pathetic lives. See, Meredith doesn’t have any family either. And she may or may not have broken up with Derek, so how could she possibly keep going with her Derek, her arm? Luckily for the pregnant lady and for Meredith, Sloan says that he can reattach it.

Derek, searching desperately for any kind of friend, asks Cristina to have a drink after work. Cristina, who rocks, says no because she doesn’t like him, and then asks him where Burke is. Derek tells her that Burke turned in his letter of resignation two weeks ago and is now gone. As is her nature, she doesn’t show any emotion until he walks away.

In spite of the rolling eyes of her interns, Izzie decides to save the deer because she wants to help the little boy believe that everything is going to be okay. See how the deer case is just like her? She told George that she loved her, and he ignored her for 17 days afterwards, so she needs to believe is going to work out. That’s why she is wasting the hospital’s resources by saving Bambi’s life, which he tells George about when she runs into him in the stairwell. Only George thinks she’s calling him Bambi, like Cristina does. Instead of clarifying that she’s treating an actual deer, she makes up some stuff about how she‘s Bambi and she needs to save herself.

Cristina’s patient’s wife and two children have come to the hospital. He tells them through a blinking that he loves them. This guy’s case parallels Cristina’s life because Burke once told her that he loved her and is also black, just like her patient.

Sloan finds Derek and asks him if he still wants to have a drink, since Derek is Meredith-less now. Derek gets all snippy and defends her to Sloan, saying that she is damaged because her mother didn’t want her and her father left her and her best friend was left at the altar, so of course, she is wary of all relationships. Finally, Derek understands her, but why can’t he understand her when he’s actually talking to her?

Alex’s patient has eaten almost everything he can get his hands on, including clamps and scissors. How this escaped every single person attending to him is beyond me. The clamps and scissors have obviously done bad things to his insides, and Alex finally notices. He tells his interns to page Bailey. Callie, however, is furious to learn that Alex paged Bailey instead of her. A little while later, Chief Webber comes into the OR to talk to Bailey about the chief resident position. He tells her that he didn’t choose her because he wants her to hone her skill as a surgeon instead of wasting her time doing administrative tasks. He says that she will thank him some day for this, but she says that it won’t be today.

In another OR, Sloan is in the process of reattaching the pregnant lady’s arm when she goes into labor. It is all happening so fast that there is no time to call an OB-GYN consult, so George jumps in to deliver the baby.
Derek’s patient is not properly anesthetized and begins to move around on the table. Any movement can cause death, so the doctors scramble to increase the anesthesia. While this is going on, Cristina tells him that he cannot move, that he told his family that he loves them so he cannot leave them. She is really talking to Burke in absentia. We find out a bit later that they do indeed save him, against all odds.

George is outside of the hospital nursery looking at the baby he just delivered. Lexie joins him and is really impressed to hear that he delivered the baby on his first day as an intern. He bitterly tells her that it’s not is first day and is pissed off that he has to do it all over again. He launches into a big, whiny “What about me?” speech. Lexie counters that she didn’t want to come to Seattle for her residency. She was all set to go to Mass General (only she calls it Mass “Gen,” which nobody ever does), but her mother died and her father is too drunk to know what year it is, and the sister that she didn’t know she had won’t acknowledge her existence. So she doesn’t have time to ask “What about me?” and tells George to stop feeling sorry for himself. He tells her that she is kind of awesome, which she completely agrees with.

Sloan finds Derek in the hallway again and explains that he, Sloan, is the one who needs a friend. He came to Seattle, not because of Addison, but because he wanted to get Derek back. They share an awkward, homoerotic giggle, but Derek decides to continue being an ass and walks away.

In the intern locker room, Lexie has spread the word that George delivered a baby on his very first day as an intern. She emphasizes that it was his very first day as an intern, indicating that the other interns don’t know that he had to repeat his internship. I find this very hard to believe. Everybody knows that gossip runs rampant at the hospital. The Grey’s Anatomy writers are asking us too much of us with this one.

At the end of the day, with the rain pouring on the windows of the basement hangout, Alex and Cristina admit to each other that they miss Ava and Burke, respectively. Bailey sees Callie moping outside and offers her a few curt words of encouragement.

Meanwhile, Meredith emerges from the elevator onto the bridge to find Lexie on her left and Derek on her right, each calling out to her. Please, this “Meredith must choose” schtick is getting old. Thankfully, we don’t have to wait months to find the answer, as she chooses Derek after only a small hesitation. They go to a call room and decide that they have to break up. They immediately share a break up kiss, which leads to break up sex, so who knows if they’re actually broken up.

George shows up at Izzie’s door and says, “I love you.” And at that, millions of Gizzie haters nationwide look around the house frantically for some sturdy rope or some sharp razor blades. I thought the nauseating Gizzie business was supposed to be over! I really cannot take a whole season of this.

-Debbie Chang, BuddyTV Staff Writer
(Image courtesy of ABC)

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Staff Writer, BuddyTV