jamespickensjr greysanatomy s6 290 'Grey's Anatomy': Chaos + a mistake = tragedyTonight’s “Grey’s Anatomy” was all about perspective — what happened during the treatment of a patient who should have made it, from the point of view of every doctor who worked on her.

And to drive the point home, the story unfolded through the “Rashomon”-like recollections of the entire team, colored by their panic, confusion, bewilderment, and fear. Compelling, if not exactly a crowd pleaser. Amid the chaos, however, one thing became perfectly clear: The Chief is utterly falling down on the job. More on that in a minute.

Seattle Grace is hit with mass casualties from a hotel fire — several burn victims, a chest wound (a guy with a fire ax sticking out of his chest) and a firefighter who fell from a ladder and sustained multiple injuries. But the central case is a woman named Kathy Becker, a young mom with a 5-year-old son who, despite some pretty serious burns on her leg and less serious burns on her chest, seems to be on her way to recovery. The problem is that there’s no one doctor looking after her, and through the course of the night she’s passed from pillar to post with no one overseeing her care.

April and Reed, two of the Mercy West residents, conduct the initial exam of mother and son, and everything seems all right. Then Sloan and Lexie take over care of the second-degree burns on her leg. Then in comes a 16-year-old burn victim who’s really in a bad way, and they have to attend to him — though Lexie really wrestles with her emotions watching this kid suffer. Then Reed gets pulled away to help Callie with the firefighter, who seems to be in pretty bad shape. April gets distracted by the insane sight of a patient coming in with a fire ax sticking out of his chest — a situation made worse when Charles, who gave blood that day, passes out and dislodges the ax, sending a huge spray of blood all over everything.

sandraoh greysanatomy s6 290 'Grey's Anatomy': Chaos + a mistake = tragedyCristina orders some morphine to help Mrs. Becker, who’s been complaining of pain. She ends up suffering from a collapsed lung, which Lexie, who had to leave her patient’s room because she was so upset, tries to fix with a chest tube. Which she nearly screws up because she’s distracted, and Avery helps her out by pounding Mrs. Becker’s chest and relieving the pressure. The patient is stable, and for a minute we’re distracted by Arizona yelling at Lexie to pull it together — great stuff from Jessica Capshaw — and Alex frantically trying to reach Izzie, who’s been gone for a week, while having to stitch up the forehead cut of Charles, a.k.a. “Nosedive.” Nice.

Mrs. Becker’s having awful trouble breathing, and Alex has to perform an emergency cricothyrotomy to be able to open her airway. Then she starts to slide, wiith high carbon monoxide levels and labs all over the place before she begins bleeding out. At this point pretty much every doctor is working on her — Cristina, Alex, Charles, Avery, Reed, and April — but they lose her. Then it hits Reed: In her initial examination of Mrs. Becker, April was distracted and skipped checking her airway. Had she done so, she would have found soot and would have intubated the patient right away. One simple mistake led to a horrible end.

April gets fired, and even though all of the residents from both hospitals have been running around competitive and terrified, most of her Mercy West colleagues aren’t exactly sympathetic. Cristina pulls a season one “that’s one of us in there” moment and admonishes everyone, quite rightly saying that it could have been any of them, but their patients didn’t die.  

patrickdempsey greysanatomy s6 290 'Grey's Anatomy': Chaos + a mistake = tragedyIn the end, though, Derek totally wins this episode by putting the blame for the mistake on whom it belongs: the Chief. Derek says he found the trauma room in chaos, with too many doctors who don’t know each other and don’t trust each other — and that’s the system that’s been in place since the merger. The Chief needs to take another look at who’s responsible, Derek says. Can I get an Amen?

There’s a legendary former editor of the Washington Post, Ben Bradlee, who was famous for running a newsroom fueled by “creative tension” — pitting reporters against one another and letting them compete for stories. But it’s one thing to run a newsroom that way; a hospital is a different story. No one dies if something’s screwed up on the front page. We can only hope someone steps in and fixes this, because not only does it make for bad fake medicine, it’s also not that interesting to watch over the long haul, even if it is true to life.

Some other thoughts:

  • Lexie was brilliant tonight. Chyler Leigh gets better and better, and watching her try to cope with her emotions and an angry Arizona before pulling it together was great stuff.
  • I liked that for once Meredith was in the dark about the situation, waiting to be discharged to go home. It was a nice reminder that not everything happens downstairs.
  • And as annoying as the us-vs.-them thing is getting, I’m glad we’re finally getting to know some of the Mercy West residents, since they’re supposed to be able to help sustain our interest in the show over the long haul.
  • It was great to get back to the medicine for an episode, without too much personal life backstory (Alex trying to contact Izzie notwithstanding).

What did you think? Did you find the storytelling an interesting departure from the norm, or was it jumbled and confusing for you? How long do you think it will take before Assistant Director Skinner — I mean, Larry Jennings from the hospital board — to finally take some action against the Chief? And how brilliant is the nickname “Nosedive”?

Posted by:Lisa Todorovich