An adorable baby has gone into the foster system that Drs. Shepherd and Grey wanted to prevent for her, but Grey’s leads off by talking about leadership. Leadership? Not to be found in the bickering couple who seem to love arguing more than each other. Not for Dr. Kepner, who is trying to find her feet as Chief Resident. We’ll get into leadership among the fifth-year residents in a minute, but again, who wants to discuss such things when baby Zola is gone? Spoilers from here on out!
But it’s the start of including those fifth-years in the surgical rotation, heading their own surgical procedures. As Dr. Yang says, “Now it’s not just life and death, it’s our careers.” Wouldn’t want to miss one’s first aneurysm clip procedure! We do get indications that the Post-It couple that could have called many times to see when or if the baby will be coming back to them. Guess this part of the adoption proceedings wasn’t part of the whole “Get Your African Baby Today!” lecture by Madonna and Angelina Jolie. In the hallway, one by one Meredith’s colleagues ask her if there’s any news. This is the classic “tell, don’t show” writing strategy. Because first, there’s big, big news to present to the characters and the audience:
The Chief is stepping down. He resigns his post to the slack-jawed surgical staff, and at the back of the room/other head of the table, Dr. Miranda Bailey shoots daggers at Dr. Hunt, the just-proclaimed new chief of surgery. Okay, not daggers. Ninja throwing stars, laced with an untraceable poison, because that’s how Bailey rolls. We get a quick pan of everyone else’s expressions, and it’s clear that most blame Meredith for ruining the Chief’s career. More on this in the last few minutes of the episode.
Just as the news sinks in, the residents are off to see which juicy surgery assignments they’ve received. Avery gets a cleft palate repair, Cristina a mitral valve procedure, Karev a compromised bowel, Grey the aforementioned aneurism, and in another kick to her pride, Kepner gets a knee replacement, but she winds up having to assist Karev because she couldn’t find an intern to do it. Not only that, but she winds up having to share her chief resident’s office with the others because they descend on her carefully appointed space like carrion to easy prey. To rub salt in her wound, none of them agree to split their teaching time fairly, the way April had organized. Whoever has the worst surgical outcome will do all of the skill training for the month. Of course they’re not interested in fairness, April! This is the gang that stole a heart for Denny, that willingly wrecked a clinical trial to get a new treatment to a person they knew, that browbeat patients whenever they think they have a superior moral position.
By the way, that “Gunther exercise” last week proved nothing, as they all continue not to listen to each other. But then comes the news that Dr. Webber has resigned and Dr. Hunt is the new chief of surgery. It’s like a tennis match in head-twisting: first the gang looks at Meredith and then over to Cristina. Oh, what tangled webs residents and doctors weave. Except when they don’t know they’ve woven them, because Cristina looks very confused about the news.
Webber walks up to Shepherd in a small office filled with magical, technicolor binders. Shepherd complains again that he’s been blacklisted from ever doing a clinical trial again. How long has it been now? Quit your kvetching, already! Almost as a snappy comeback Webber says he has been, too, and now we’re in the pity party olympics. Question: How many physicians don’t give a fig about clinical trials in the US? Answer: Many. But the crux of the scene comes when Webber tells McDreamy to stop being so angry at Meredith. This, like last week, confuses me—why does it take third parties to get the people in the relationships to shift or not be so stubborn? Why don’t these ideas happen in the relationships themselves?
Speaking of relationships, it’s clear that Owen and Cristina haven’t talked about her terminated pregnancy since it occurred. This seems to have stopped them from talking about much else. But not knowing about his promotion? He explains that he was just offered the job last night, and he didn’t see her that morning. Well, they should celebrate, offers Yang. Yes! Okay! We are having an awkward conversation about ourselves! Meredith watches the exchange and tells Cristina afterward that whoa, they really need to talk. Something one presumes Meredith would also like to do with her spouse, but well, he’s not a talker, apparently. Seven seasons of him ranting to Meredith and now he’s gone all taciturn.
Arizona, as she was last week, is right in Alex’s corner. But she’s none too pleased that he turned down her surgery for a bowel resection. Someone should tell Arizona that Alex doesn’t like patients who make him feel mushy inside. But why is Arizona having mini-sleep episodes? Since it serves no other purpose in the scene, I can only imagine that we’ll be seeing more of Dr. Sleepy in sweeps week. Instead she thinks that he wanted to go for the easier procedure, because apparently word has gotten around that the residents have all made a bet on surgical outcomes. Hospitals really are a microcosm of society, see.
News alert: people can now talk on cell phones in the hospital. I thought there was a danger of lighting oxygen tanks or interfering with heart-monitoring telemetry, but maybe it was all bullhockey. Anyway, Grey consults with her patient after his wife wrangles the kids on the phone, and they’re on the same page with her until she mentions it’s her first aneurysm clip. And out from the shadows, a.k.a. Derek’s natural state, comes Dr. Shepherd to relay that Grey is the best and they’re going to be fine. Does he really feel that way? If not, when did he get good with lying to patients? Out in the hall, Meredith thanks him for his support and asks if he’s heard from the social worker. No, so it doesn’t look good for us, he says. The question comes up: If they don’t get baby Zola back, will they stay together as a couple? Naturally, Derek punts the question and grumbles away down the hall.
The surgeries proceed differently than we might expect: Arizona so unsettles Dr. Avery about fixing the baby’s cleft palate that he backs down from even performing the surgery himself, and McSteamy steps in. Yang gets moved onto an appendectomy by Teddy, who really wants her to get back to basics before tackling anything glorious like a 7-hour mitral valve replacement. Unfortunately, neither of them can remember what to do once the infected appendix is ready to cut. Good thing there’s a nurse on hand to lay out the steps for them and relay their failure to the rest of the hospital staff. Karev’s bowel resection goes horribly, because there is no bowel left to save, so he has to close up and tell the patient’s brother that septic shock will soon take over. As for Grey’s aneurysm? Clipped and contained, but not before an in-OR fight with Derek about which clip to use. And whereas Derek has in the past started a kumbaya applause line for his fifth-year surgeons, this time the clapping begins from everyone else in the OR, with Shephard putting his hands together maybe three times at the end. So Karev would have won the ignoble skills training award except for the fact that Avery didn’t even press a 10-blade to skin. So Avery will get all of the skills labs work for the month.
The good news on Yang getting stuck with a shorter surgery is that she and Owen finally have a chance to move past the awkwardness of her reproductive choice, back at home, over celebratory Chinese food. I love how we’ve only seen any of these people cook a meal half a dozen times in the whole series, and usually for some holiday.
Speaking of feeling better, Callie is on hand to tell April that being chief resident sucks, and sometimes people don’t get any better at it. She’s always got the realistic, depressing angle on things. But wow, woman can sing. Maybe she should have sung the bad news to Kepner.
Dr. Bailey’s flying sharp weapons continue, as she asks Dr. Hunt when exactly she will be getting her call sheet from him. He clearly fears Bailey, as he should. Later, when he asks if she’s angry at him, she gives him another dose of her serious hostility, and keeps a straight face when she says she’s not angry at him. It takes a quiet elevator and Dr. Webber to get her to admit that she is pissed. He explains: I appreciate what Meredith did for Adele, and I want to have more time with her while it can still be quality time. Why hasn’t everyone figured this out? Why is it easier to just be angry at Meredith? Okay, Bailey says. But it’s going to take me a while. Maybe Eli could help her with that, I wonder.
Back at Mer-Der’s no longer shared residence, Derek finally opens his douchey perfect mouth and admits that he can’t trust Meredith. She asks again if they should stay together. Why is she asking? Don’t you have your own opinion, Grey? She crosses her arms and asks why he’s staying.
“Because of that,” he says, pointing like he’s the key witness in a murder trial. The damn Post-It! He made a commitment, see. I read that Mexico City is considering fixed-term marriage licenses. I don’t suppose Shepherd would want to go for one of those. No, he’d rather stay married and embittered.
Trust issues what they are, Mer-Der agrees not to work together anymore. So there’s no sense here that Derek is damaging Meredith’s career after she damaged his? But they think they should raise a child together?
I might call that social worker myself, and I know she doesn’t even exist.
Trans/plant/portation 
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