This week, the staff of Seattle Grace is haunted — by their pasts, their recent pasts, their choices, their possibilities, their anxieties, their fantasies, and their realities. Whaaat, you may ask? Angst on Grey’s Anatomy? Why yes! And then some.

Spoilers and therapist-style tough-love insights ahead…

First ghost: Preston Burke. He’s won the presigious Harper Avery award, and the newspaper article about it is posted on the bulletin board. Despite her friends’ efforts to block the clip from her view, Cristina greets the news with a pained look and a quiet "Good for him."

Second ghost: Derek Shepherd. Meredith’s in therapy, confessing that every time she sees Derek she thinks about kissing him, which definitely complicates surgery. She wants some therapy tools so she can move on. Remind yourself of the reality, her therapist says. So Meredith keeps repeating to herself, "He’s with Rose." Of course she’s fooling herself. But the veneer of this new semi self-aware Meredith is appealing; she’s doing just enough navel-gazing to try to understand herself, yet isn’t quite so twisted up in her own angst. I’m confident that this Meredith will be shot to hell by the season finale, but with each episode, there’s new hope. And Ellen Pompeo plays this high-wire act beautifully — there’s emotion on her face and a quiet empathy with patients.

As an aside here, I seriously want Amy Madigan to be my therapist. It doesn’t matter that she’s not a therapist. I just think she’s cool. And I’d love to see more of her on the show — she’s like a much-needed Greek Chorus. Who’s just a little bit cranky.

Third ghost: Meredith and Derek’s clinical trial patient is a soldier, Darren, who’s done two tours of duty in Afghanistan (played by Benny Ciaramello, a.k.a. Santiago Herrera on Friday Night Lights). Todd, one of his platoon buddies shows up, having been called by his father. Darren’s embarrassed that his friend was summoned, and the quiet looks they give one another clearly convey something more to their relationship. They share a passionate kiss when no one’s in the room but Meredith, and the look on her face illustrates exactly what I was thinking watching that: Who wouldn’t want to be kissed that way? The don’t-ask-don’t-tell policy and Darren’s father keep him from being open about who he is, and it’s clearly anguishing.

Fourth ghost
: Callie and Sloan. Callie’s clearly not terribly proud of her, ahem, activities, but she’s got something to prove. And Sloan? Well, let’s just say sometimes reputations are deserved. Which he finds out when the nurses boycott his surgeries because of his, ahem, behavior toward them.

Fifth ghost: Rebecca. She wasn’t even in this episode, but her presence is still keenly felt. Alex’s sense of obligation to her and their baby, coupled with his conflicting feelings about it, have him reeling a little bit. He asks Izzie to ask Meredith if Rebecca can move into the house for a couple of weeks until they can get enough money together for a deposit on their own place. Rebecca’s haunting Izzie too — Izzie knows she’s not pregnant, but she can’t tell (the look on Bailey’s face when Izzie asks her about the ethics of telling test results to a patient’s friend if the patient can’t be reached — particularly frozen on my DVR — is priceless). And she’s unsuccessfully trying to be a voice of reason for Alex.

Sixth ghost:
Adele. The nurses have sent a union rep to mediate the situation with the Sloan boycott, and it turns out to be Adele — whom the Chief immediately sets out to impress by trying to prove to her that he’s changed. It’s great to see more Loretta Devine — Eli Stone only wrapped up a couple of weeks ago, but I think I missed her. To protect the hospital from possible future litigation, the board is requiring any hospital employee who has a sexual relationship with another employee to register it. Nothing like the policing of consenting adults to make you want to go to work. The Chief appoints George his intern and makes him do his dirty work in collecting the forms. Hijinks ensue.

Meanwhile, Hahn’s patient is a young mother suffering from cardiomyopathy (the same ailment that felled Denny Duquette), who’s in a bubble to protect her from infection while she awaits a new heart. She’s been in isolation for eight weeks, and she’s panicking. Her inability to have physical human contact with her loved ones — to hug her kids or kiss her husband — has driven her to the brink, and she’s hysterical. Hahn finally gets her to calm down enough to tell her that they have a heart for her. I dare you to watch this scene without tearing up. This poor woman’s desperation is absolutely wrenching. Christina, rather than just stand around and not get to do anything, elects to go to the morgue and harvest cadaver hearts for Hahn’s research.

Burke turns out to be a ghost for Hahn too — Erica bitterly complains about the men’s club that his award is, and asks Callie to have drinks with her so they can trash-talk Burke. She declines. Later, Hahn tries to engage a silent Cristina in a conversation about his award, thinking that they finally have something in common. No response from Cristina.

Sloan, chafing over his surgeries being cancelled because no nurses will work with him, appeals to Rose, who won’t give him the time of day, much less talk to her colleagues on his behalf. They banter a little bit and she holds the line, and then Sloan, like a complete idiot (McIdiot?) walks right into a lawsuit: “I hate women like you. You string guys along acting like sex is some prize, when really you’re just afraid that once you give it up, he’ll lose interest.”  1. That was horribly ugly. 2. The look on her face is a gut punch. I know we’re not supposed to like Rose, that she’s an impediment to Meredith and Derek getting back together, etc., but both the writers and Lauren Stamile’s performance make her pretty darn likable. Whatever you think about her and Derek, you have to admit that she’s cool.

Back in Darren’s room, he talks to Meredith about his situation with Todd, and that he knew what he signed on for when he joined the military ("You keep your personal life separate from your work life. I just never thought I’d meet my personal life at work."). This is one of those episodes where the patients say out loud all the things that the doctors are thinking, or their remarks strike right at the heart of the situations they’re facing. I tend to think it’s a hit-or-miss approach, but tonight it works. Could be Ellen Pompeo, whose performance really works.

Meredith races down to the morgue to see Cristina after Lexie tells her Cristina’s singing — "Like a Virgin," in fact. Stop singing, she says. You’ll win your own award. You saved Burke’s career. But cristina only stops warbling when Meredith tells her she’s in therapy, and that she’s way more screwed up than Cristina. Ah, the comfort of kindred travelers on Dysfunction Highway.

The sex police investigation goes a little bit awry when the Chief exempts Bailey from having to participate. Clearly he’s trying to be respectful, but Bailey, bless her, takes offense. Later, weighed down by the reality of her crumbled marriage, she does two (hysterically funny) things. First, she fills out a form, naming all of the interns and Derek — and lays into the Chief with a speech that is sad, angry and poignant but never for a second makes you feel sorry for her (it’s the genius of Chandra Wilson). Who is he to decide that it would be so absurd for her to attract someone’s attention and have a sexual relationship with a co-worker? Her hurt is palpable, but her dignity remains absolutely intact — and she smacks him with it. Literally.

Second, Bailey gathers all the nurses together and weighs in on the Sloan boycott. "This man is a whore. He has always been a whore, will probably always be a whore. But that’s not a secret; he’s not keeping it hidden. You all knew who he was before you got involved with him. … He’s nasty. But he’s a doctor here, and a pretty good one. So let us all close our knees and get back to our jobs so he can get back to his job and help the people that really need it." All hail, Bailey!

Derek and Meredith’s surgery requires then to work perfectly in sync, and it looks as though their feelings are anything but dead, judging from the way they look at each other in the OR. But Meredith turns down his offer to help her monitor their recovering patient, and sends him off with Rose. Later, when Darren crashes and dies after the virus they injected into the tumor becomes encephalitis, he tries to comfort her and brings in a bottle of champagne. They will succeed in saving someone, he says, and when they do, they will celebrate with this champagne.

Over in her isolated room, the heart patient in the bubble suffers a collapsed lung, and Karev breaks the sterile environment to put in a tube and reinflate it — meaning that even though he saved her life, she’ll still be waiting for a heart. But they put her kids in scrubs and masks, and now the time in isolation seems a little bit less like purgatory. And Alex defends his decision to be with Rebecca and take responsibility for the situation to Izzie, who’s been gently trying to get him to rethink his plans.

In fairness, Izzie really wasn’t in this episode very much, so there’s not a lot to judge for the Izzie Annoying Scale. But for her earnest efforts to try to make Alex see the light, and for the not-overblown way she tried to work it out (and gave George a hard time for being the Chief’s lackey), I’m giving her a 1. With a plea to the writers to keep working on crawling back from the place where this character started the season.

One by one, people begin to free themselves of their ghosts — some voluntarily and some by force. The Chief and Adele go home together. Bailey offers some encouraging words to Izzie after Izzie admits she kept her patient’s test results private. Bailey works on coping with the fact that her husband is out on a date.

It’s also a great night for speeches. Besides Bailey, there’s tremendous stuff from Hahn, who confesses to Callie that she has trouble making friends, and that she’s angry at Callie for being one of those girls who drops her friend when she has a boyfriend — or "a thing," as she calls Sloan. Later at Joe’s, Callie admits that she’s been bugged by Addison’s assumption that they’re a couple, which causes them both to end up laughing, and then looking away in uncomfortable silence.

There’s also Cristina, who I’d like to see come back to the forefront with a major storyline so Sandra Oh could get some more screen time — she does great stuff with what she’s given here. Cristina didn’t turn in her form, even though Burke is no longer at the hospital. And it’s the second time in a day that the Chief gets a verbal walloping from one of his doctors: "Burke is not here. He’s gone — and he’s the better for it. He’s winning the harper avery award and he’s being celebrated all over the world. That’s not difficult. He’s out there. And I’m here. Where everything is the same. I still live in his apartment, I walk the halls of this hospital, I even wear the same scrubs — and even that’s not difficult. This is where I choose to be. But sir, when his hand was shaking, I performed his surgeries. I kept his secrets, I nursed his pride. You know it, and I know it, and he knows it. He knows it. And yet nowhere in that newspaper article does my name appear. I am the unseen hand to his brilliance. Wipes away a tear. And yet while everything is the same it’s very very different. Now I’m lucky if I get to hold a clamp. Hahn treats me like … I was his hand. And now I’m a ghost. That’s not difficult. It’s unbearable. I know everybody is proud of him. But I’m not. And I do not wish him well."

In the elevator, a bewildered Sloan tells Derek about Bailey’s defense of him — and how what she came up with is that he’s a whore. Derek, meanwhile, slept with Rose, and he thought about Meredith the whole time. "Who’s the bigger whore?" he asks.

And finally, there’s Meredith’s therapist, who essentially hits her upside the head with the obvious. She’s kidding herself. Her patient’s story is a metaphor for her own life — he dies alone while the love of his life is literally in the next room. She’s frightened, and that fear is what’s keeping her from being with the love of her life, and what’s keeping her alone. Now she’s got to figure it out. And in this season at least, she’s got two more episodes to do it.

What did you think? Will Meredith begin to make the connections she so clearly needs to make? Did you think Cristina was about to quit in that speech to the Chief? Do you hope they wrap up the Karev-Rebecca distraction by the season finale? And shouldn’t the adorable Tuck be in every episode?

Posted by:Lisa Todorovich