Everyone’s favorite bitter, neurotic doctors  are back, and even though there were some just downright silly notes in tonight’s Grey’s Anatomy, one thing was absolutely obvious: Shonda Rhimes was having an absolute blast with this episode. It played with a lot of the rumors and assumptions resulting from last season’s finale, tweaking expectations with a big fat "nyah nyah."

Spoilers ahead, but no happily ever after…

We begin back in the field where we ended last season, with Meredith waiting for Derek to return from breaking up with Rose. Hysterical, she finds him at the hospital — he’s been in a horrible car accident, and he doesn’t make it. Psych — it’s a dream. That’s rumor/theory number one tossed by the wayside.

Then there’s the business about the rankings. Now I think I know what it’s like to work in a college admissions office when the U.S. News college rankings come out. Everyone’s gathered around a computer, anxiously awaiting the rankings of teaching hospitals — and no one seems to think that Bailey can hit the refresh button properly. Seattle Grace ends up dropping — from the top to…. number 12. Ouch. And it sends this crowd of competitive whackjobs spinning. A near-constant indignant mutter of "Number 12! Huh!" issues from practically all of them. Hahn’s overwhelmed with insecurity about her bad teaching style and sets out to pretty much badger everyone about how she can become a better teacher. Remember that episode a couple of seasons back, when Callie was living in the hospital basement, and she gave George a speech about how she was the weird kid at the back of the class who eats her hair? Hahn is so clearly the other weird kid who eats her hair. It’s borderline offputting, but oddly endearing. Speaking of the weird kids, Hahn and Callie run into one another, and awkwardness immediately ensues.

We also learn, through meaningful, soulful, longing looks when George isn’t looking that Lexie is in love with him. It leads to some outstanding teasing from Sloan, who challenges Lexie to tell George how she feels after she pleads with Sloan to be nicer to him because he’s on edge getting ready to retake the intern test. Before this, however, Lexie inadvertently hears Meredith, in mid-babble about how she wants to ask Derek to move in with her but doesn’t know if she should yet is leaning into the wind and feeling the fear (oh boy) say that she slept with George. Which sends the wide-eyed Grey into mild shock.

Determined to get a random trauma that didn’t go to Mercy West (the 12 ranking has stripped Seattle Grace’s status as a number-one trauma center), Bailey, Izzie, Meredith and Alex wait in vain in the ambulance bay. And then a smashed-up limousine careens  in at top speed, containing three women of a certain age in ballgowns, cradling the very badly injured limo driver. Sarah Beth (Bernadette Peters — looking absolutely gorgeous, by the way), Anna (Kathy Baker, also fabulous) and Betty (Mariette Hartley, equally terrific) were traveling separately from their husbands on their way to a ball — it’s snowing outside — when the accident occurred. Betty’s dazed and disoriented — she asks every 30 seconds what’s going on, unable to recall what happened.

As the story of the women and their husbands unfolds — all happily married, all together for many years, Meredith takes inspiration. "They’ve been with the same men for years, and they’re happy," she tells Cristina. "They did it, and I can do it." And heavens, you want to believe her. Then they find out that the men were also in an accident, and that they’re all seriously injured — and Bailey and Cristina convince them to insist that they be brought to Seattle Grace, effectively poaching the trauma cases. The ambulance arrives, and Sarah Beth’s husband has been treated at the scene by an army trauma surgeon who performed a tracheotomy using a pen. Now, it seems to me I’ve seen that on other shows (at least once on M*A*S*H), but all of the docs seem so awed by it that I realize it really does kick ass. The surgeon, Maj. Owen Hunt (Kevin McKidd) was in the car behind the limo, and even though he hurt his leg getting to them, he got it done. This of course immediately turns our girl Cristina on, even though she semi-fights admitting it. Sandra Oh plays it terrifically well, flustered but having a great time in spite of herself. And you can practically smell the phermones.

As the team begins to work on the men, we learn that Betty’s husband has a skull fracture, a possible aortic tear and a host of other very serious injuries, and Anna’s husband has injured his spine and can’t feel his legs. We also learn that Anna has been sleeping with Sarah Beth’s husband. There goes the idea of happily ever after. But as Meredith reminds us at the beginning, that phrase is bogus and fairy tales don’t come true.

Kathy Baker, however, infuses her character with a lot of sympathy, and when she explains to Meredith how it is she ended up in this mess, sleeping with her best friend’s husband, it’s with a sad, almost astonished quality."You think it’ll always be amazing, you think you’ll always feel this kind of love," she says. "And I do love Phil — but I just… little pieces of you get chipped away by another person, and you shave little pieces of yourself away so you fit together. And one day you look up and you don’t even know who you are."

My question is, why do people keep saying things like this to poor Meredith? Can’t she just get a break, find a head space she can live in, and be allowed to stay there for 15 freakin’ minutes? Yeah, she’s twitchy and neurotic (that word again) and she has no concept of how to relate to others in a healthy way. But as self-involved as she is now, she’s loads better than she was early on. Can we start a Leave Meredith Alone club?

The number 12 ranking makes the Chief doubly determined to go the extra mile and save these patients, no matter how long the shot is. Which keeps Derek in surgery for hours with multiple patients, assisted by an openly hostile Rose. Sloan explains it to him as her delayed rage after he broke up with her, and urges him to break up with her professionally as well. The fact that delayed rage seems like an unheard-of concept to Derek is just not plausible; this is the guy who kept punishing Addison for months. He gets rage. But my larger problem with this part is Rose. I realize emotions get the better of people, but she seems almost delighted at sticking it to Derek at work. Case in point: the conversation in the hallway when she tells him, "I’m carrying your child. (pause) Gotcha!" (That’s rumor/theory number two by the wayside.) Props to Lauren Stamile for playing Rose with spunk — her scoffing at his suggestion that she should get control of herself or find another service almost pulses with a kind of light menace. But she’s at work, and her work reputation is so important. Why would she jeopardize that? It doesn’t make sense. They weren’t together that long. Ultimately, she ends up accidentally slicing his hand with a scalpel in surgery (I’m giving her the benefit of the doubt), and, embarrassed, ends up transferring to a different service in the end.

Anna’s husband, Phil, and his spinal injury provide another nugget of conflict. Maj. Hunt suggests that therapeutic hypothermia might be effective in preserving his ability to walk. Derek rules it out, but the suggestion captivates Callie. Hunt is kind of amazing on this front — the only one not afflicted with crippling insecurity, he seems to practically mesmerize everyone around him. I mean, he’s sexy too, but it’s clear that that’s not the primary attraction. There’s also Hunt’s tough-guy side — he staples his own wound together, unnumbed, which practically drives Cristina out of her mind.

That damn ranking comes into play again during surgery on Betty’s critically wounded husband. Hahn’s still exploring teaching methods, and the Chief asks Cristina to stitch the guy’s renal artery. She makes a mess of it, even though she’s done the stitch lots of times before in cardio surgery, leading Hahn to make the excellent observation that part of the problem with the ranking could be that interns are allowed to log too much specialty surgery time at the expense of general-surgery knowledge.

Separately, Alex is on the case trying to solve the problem of medical insurance for Sarah Beth and her husband. It’s due to run out at midnight, and when she calls the insurance and credit card companies, they tell her everything’s been cancelled. At first I took this to be a sign that her husband was leaving her and taking everything with him, but the truth was that he lost his job and was too ashamed to tell her. She ultimately finds out about his affair with Anna, and has some incredibly affecting scenes as a woman trying to cope with all of the shocks she’s being dealt in a day. Her anger and hurt ends up turning to resolve, and Bernadette Peters plays it exceptionally well.

Meanwhile, the move-in-or-not-move-in question is driving Meredith nuts, and she returns to it incessantly, like a scab she’s unable to leave alone to heal. I wish I could say I didn’t understand that kind of obsessiveness. "He’s got fishing gear. And boots. And hair products. And I don’t have room for any of that stuff. And he talks. He’s chatty," she says to Cristina. "We’ll build a house on his land which will be our land. Dr. Mrs. Shepherd. And you know what comes after that don’t you? Babies. His babies. And they’ll have perfect hair. And they’ll be chatty. I’ll have five. Chatty. Children. And have a chatty husband. In our house in the wilderness. And then I’ll start sleeping with your husband."
Finally, Cristina turns on her as any good friend or just plain sane person would, and tells her to shut up. She’s heard enough, and she can’t take it any more. Moving in would be a huge mistake, and as a couple they will not work. She stalks away, and promptly slips and falls on the ice. Before Meredith can help her up, a giant icicle breaks free from the roof and impales her. Perfect. Then she has a hallucination/flash of her and Meredith as old ladies, bickering together. It’s gratuitous and silly. But Old Lady Cristina eating cereal out of a box is admittedly pretty funny. Then, like an angel in camouflage, Maj. Hunt shows up, scoops Cristina up and takes her inside. And proceeds to argue with her about how to treat the injury.

Meredith, of course, uses this time when Cristina is immobile to bug her about whether or not she meant it when she said Meredith and Derek won’t work. Cristina pretends to be flummoxed as to why Meredith cares what she thinks. (As if she doesn’t know. She’s her person.) Later, after a chest X-ray shows she’s fine, Hunt yanks out the icicle, stitches the wound, and (of course) makes out with Cristina. Their chemistry is nice — lots of energy, and he seems to be the kind of guy who can challenge her properly. So suck on that, Preston Burke.

Trying to do something about the health insurance, Alex talks to Bailey about getting Sarah Beth’s husband into surgery before the insurance expires. But no dice — for now. Meredith makes the mistake of teasing Alex about his softer side, which Izzie had earlier attested to — remarking that he’s grown into a good guy who’s opening up. But he’s still sensitive about the Rebecca incident, and defensive. Which makes him mean — unnecessarily so — to Izzie. "I’m hoping that I wait long enough you’ll become as annoyed with the sound of your voice as I am and just shut up," he snaps at her. Now, I’m no Izzie fan, but that’s a little extreme.

Callie, having talked the Chief and the paralyzed patient into the hypothermia procedure, against Derek’s advice (which makes for a great squinty-eyed-glare exchange between Derek and the Chief), totally freezes up (pardon the pun) when things start to go wrong. Not knowing what to do seems very un-Callie-like, and Hahn, bless her, is able to get her to calm down and focus and get through it. Which in turn makes Hahn psyched that she was actually able to be a teacher.

So. A tally of the damages: Betty’s memory doesn’t get better, even after surgery. Her husband dies. Sarah Beth forgives her husband, whose vocal chords were slashed during the accident and won’t speak again. Anna’s husband, Phil, ends up able to wiggle his toes. Lexie can’t quite get up the nerve to tell George how she feels, but they talk about his episode with Meredith — and George proves to be clear-eyed and properly self-aware about it. Meredith and Derek start packing him up to move in with her. Callie confesses to Hahn that she’s not an experimenter, but their kiss was an experiment that seemed to work. Hahn confesses that Callie’s the only woman she’s ever kissed, and it’s freaking her out too. That’s rumor/theory number three out the window.

The Chief does a little checking on Hunt, finds out he’s got a great reputation, and offers him a job. Now, does it seem a little inconsistent for the Chief, who’s been thrown into a tailspin about the number 12 ranking, to (a) essentially give privileges to a stranger to practice in his hospital, and (b) offer him a job? I hope we see more of Hunt, but that was weird.

And in the midst of Meredith and Cristina wrapping up their "you’re my person, of course what you think matters" conversation, we’re thrown an interesting curve. From the hallway, Izzie spots Alex making out with some random girl in his room, and flashes on a vision of Denny — getting to actually see and talk to him on Prom Night. It’s well done, and is all the more satisfying because it wasn’t explained to death. Katherine Heigl plays it very nicely — quiet and with soul, rather than over-emoting, and I hope it portends of things to come. I’d like to see an Izzie storyline that doesn’t have her shrieking or being overbearing, but dealing with something of her own.

In the end, it all comes back to the ranking. The Chief calls a meeting of the troops, chastising them for sloppiness, for resting on their laurels, for failing to take risks and use their skills. Shoddy teaching makes for shoddy surgeons, he says, and they’ve failed. And now, things are going to change. The bar’s been raised. Consider yourself on notice. Hearing that, it’s almost impossible to avoid a little shiver of anticipation for what this season will bring.

What did you think? Did it feel like two hours to you? Did you hate Lexie’s "But what if he doesn’t like me back?" whine? Are you looking forward to seeing what "raising the bar" means this season?

Posted by:Lisa Todorovich