The doctors of “Grey’s Anatomy” are constantly dealing with medical mysteries, relationship woes and workplace politics — and in “It Only Gets Worse” (Feb. 17) it’s that last one that takes over.

Not that all the other issues go away — ther are still complicated surgeries to deal with, the struggle for time management as a parent, or just finding time for those we love in all the frenzy. But the intra-office drama at Grey-Sloan Memorial has snowballed into a full blown civil war… And everyone — especially the patients — are suffering for it.

The aptly titled episode also underscores what happens if Meredith Grey (Ellen Pompeo) is not around: It’s a total disaster. There’s no “Grey’s Anatomy” without Grey, and that’s never been more apparent than right now.

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Ever since Derek’s (Patrick Dempsey) death, Grey’s completed the journey toward fearless mother and surgeon. The show occasionally winks at the fact, as it did this week, that the woman has been through everything… And as the titular star of the show  somehow survived it all. Some of the best moments in Season 13 are when Grey mentions a particular dreadful memory — like how she never talked to Derek about her third pregnancy because he was already dead when she found out — with the ease of someone trying to remember what they ate for lunch last week.

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While admittedly dark and twisty, Grey’s unwavering confidence in her abilities, along with her incredible life experiences, makes her an incredible Chief of General Surgery. She’s tough but compassionate, and stays cool in circumstances that would make even the most brilliant doctor freak out.

So yeah, it makes sense how quickly the castle falls apart without its queen. Bailey (Chandra Wilson) and Webber (James Pickens Jr.) spend the entirety of Dr. Ben Warren’s (Jason George) first unassisted surgery arguing in a total battle of the egos — then, Ben storms off angrily after he’s done — not because he wasn’t getting attention or accolades, nor because his fellow Attendings are calling him the First Lady: Ben loves his wife very much and he can take the ribbing, but when Bailey’s continuously making unpopular (and possibly terrible) decisions as Chief, that reflect on him — and acts so unprofessionally, during her husband’s thrilling first surgery — he’s understandably pissed.

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When Bailey finally asks which side he’s on — hers or Webber’s — Ben can’t answer. He’s in the precarious position of needing to stand by his wife, but deep down disagrees with what she’s doing. It’s a mess on every level: Ethics, conflicts of interest, seniority and relationships are all at odds.

The ongoing, constantly developing divide between Webber’s Army and Team Minnick is not what what most of us would’ve predicted. Catherine Avery (Debbie Allen), Webber’s wife, is Minnick’s (Marika Dominczyk) number one supporter. And now that she’s getting her bearings as the interim Chief of General Surgery, April is feeling the Minnick plan… While Jackson, her ex-husband and co-parent — and Catherine’s devoted son — is staunchly standing by Webber.

sarah drew jesse williams greys anatomy gif me and you Everythings falling apart without Meredith as the great Grey Sloan civil war escalates

Arizona (Jessica Capshaw) is a wild card: She is Webber’s person, obviously — but after Dr. Edwards (Jerrika Hinton) loses a patient to Minnick’s grand experiments, and discovers Minnick’s never lost a kid in all her years of medicine, Arizona is forced to take the high road and show her compassion. Not because she has a crush — but because this a pivotal moment in a doctor’s career requires immediate TLC, for seasoned Minnick just as much as Edwards, and Arizona Robbins is not a person who can stand by, doing nothing, in the face of that agony.

“Grey’s” has spent numerous episodes covering all the different aspects of the horror that is telling a patient’s family their loved one has died, doctors’ various ways of dealing with the guilt, the constant questioning whether they could’ve done something different — Edwards’ breakdown with a sweet Dr. Webber (a great teacher, as he doesn’t really need to remind us all the time since it’s obvious) is a stellar example, this week — but we’ve never seen a doctor deal with it so late in their career.

It’s a unique circumstance that shows us a different side to Minnick, as much as we hate being led to water like that… Although we wonder if it’s not part of the reason she’s so cavalier about her methods? Could this be a shift in her approach, moving forward?

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Arizona’s merely doing her job, taking Minnick under her wing during this tough situation. But when Edwards — Minnick’s main champion and supporter — definitely has a change of heart once the woman who’s supposed to be her adviser falls apart. If she survives this one, it’ll be with Webber’s help, and that is every bit as important and foundational as Robbins, and the rest of the Attendings, keep saying it is.

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The hospital obviously could benefit from finding a balance between Webber and Minnick’s methods — but having two heads for the Residents Program is an unacceptable solution for both parties. It’s all or nothing. None of the compromises or sniping have worked, and we’ve finally reached the boiling point. We don’t remember having seen this many intense head-butting scenes in a row, in all our years watching the show — pretty relentless, to be honest — and that seems to indicate just how badly things are out of whack.

They’re all driven by ego and competition, of course, but that’s never been such a problem. The amount of drive and confidence needed to become a successful doctor is also their Achilles heel, and it’s only their bond and connections — working as a team and a family — that keeps stuff like this from happening.

Meanwhile, the ladies at the top — Bailey and Catherine — are getting lonelier and lonelier, as everyone finds new ways to undermine their authority and they find new ways to establish their boundaries against it: It’s a crucially important story in a lot of ways, but it’s also so hard to watch. They only want Grey-Sloan to be wonderful again, to reestablish the hospital as one of the best training programs in the world — but without compromise, and especially without Grey, things can indeed only get worse.

“Grey’s Anatomy” airs on Thursday nights at 8 p.m. ET/PT on ABC.

Posted by:Emily Bicks

Freelance writer in LA. Sometimes, I'm on camera. And sometimes I'm not. Twitter: @missbicks