'Grey's Anatomy': Show some respect

We've always known that the interns and residents at Seattle Grace are immature and self-involved, in addition to being talented, but this week's Grey's Anatomy really drove that point home. And it also showed very clearly what kind of toll that an odd turn of writing can have on a character.

Ghostly apparitions of spoilers follow...

First, let me say a word about Brooke Smith, who it was announced this week is leaving the show. I think she's a wonderful actor, and I'm glad that she gets so much work so we can all see her more often. Regardless of the reasons for her departure, she created a memorable character who, while consistently tough, demanding, talented, and often overly critical, had a vulnerable side as well, and even though I didn't totally buy Callica as a couple, the way she let those vulnerabilities come through kept me interested in watching her from week to week. I'll be interested to see how that storyline gets wrapped up.

This week, the residents learn that one of them will be awarded the opportunity to perform a solo surgery, which of course appeals to all of their worst competitive impulses as they seem to go numb to the idea of treating people and appear to be motivated only by what visceral experience they can wring out of working with patients and positioning themselves to win that surgery. It ain't pretty. And when viewed up against some examples of genuine compassion and respect in patient treatment, it's clearer than ever what separates those who are teaching from those who are being taught.

Stolen heart: The central case this week belongs to Hahn -- a guy named Mike, who's suffering from the same kind of heart condition that Denny Duquette suffered from. He narrowly missed out on a transplant a couple of years back. And it dawns on Izzie: he's the guy who was supposed to get the heart that she made sure Denny got. They're going to do a procedure that will buy him some time until he can get another transplant, injecting ethanol directly into his heart, incinerating the tissue in the damaged ventricle that's making it hard for him to get oxygen. And he has to be awake for it.

This case really begins to haunt Izzie -- the guy's in Denny's old room, and she begins to see Denny walking the halls. In surgery, Hahn designates Izzie to talk the poor guy through the procedure, to help him focus and to get through it. But she freezes, seeing Denny, and bolts from the OR. Meredith explains to a furious Hahn a little bit about the history of this patient and with Denny. Hahn goes to Callie, who fills her in on Izzie's relationship with Denny, the cut wire, the disciplinary action, and what it cost Izzie. Then, fuming, she barges into the Chief's office, demanding to know what kind of hospital he's running, and an impressive screaming match ensues between the two of them. Hahn demands an ethics investigation, and the Chief shuts her down.

Meanwhile, Izzie's guilt is killing her. She hides from Hahn and from everyone else, but when she goes to face the music and talk to the guy, Hahn insists that she be there if there's a second procedure, and promises that Izzie will get the blame if Mike dies as well. At first he refuses to go through it again, telling Izzie that his wife will get over it. But Izzie emphatically warns, no she won't -- she won't get over it, she won't move on. She'll be haunted. And Mike decides to go through it again.

Izzie keeps seeing visions of Denny, but during the next procedure, she eventually pulls it together enough to help Mike get through it. And predictably, just when she thinks the visions have disappeared, there Denny is again. In a really moving scene in the lockeroom, she talks to him, begging him to go away because she's over him. But he comes back, a reminder that she hasn't moved on. Katherine Heigl does some wonderful work in these scenes -- her emotion is genuine, her confusion seems real, and again she chooses to pull it back a little.

The puzzling part is Hahn. She's always been a tough-as-nails character, but when she tells Callie she intends to report the Denny/Mike case to UNOS, costing the hospital its transplant certification, she seems to have crossed a line into being so hell-bent on revenge that she's blinded to having any compassion. On principle, she's dead right -- what happened was horrible, and she's passionately advocating for her patient. But there's an edge to the way her scenes are written that borders on hysteria and makes it impossible for a viewer to side with her.

Callie is incredulous -- even though she has no particular love for Izzie, she thinks the situation has been handled appropriately. "There is no gray area here," Erica insists. "You can't kind of think this is OK. You can't kind of side with Izzie Stevens. And you can't kind of be a lesbian." Yes I can, Callie replies, and Hahn, appalled, walks away saying she doesn't know Callie at all.

A true marriage: A smaller but rather extraordinary storyline brings a woman named Rosie (Bonnie Bartlett) to Derek and Bailey. She has a brain tumor, the type of which is prone to bleeding. Derek tries to warn her off, but she consents, including signing a Do Not Resuscitate order. She and her husband bid one another farewell as they always do when she goes in for a surgery, and then they say hello again when she wakes up. Derek and Bailey marvel at the couple's closeness and the strength of their bond -- Bailey's in marriage counseling and Derek tried it and failed with Addison. They're both touched and a little awed by this couple.

But the surgery doesn't go well. The tumor bleeds, and Rosie doesn't regain consciousness. Ed, her husband, at first doesn't understand why no one's moving to help her -- and then the impact of the DNR order sets in. It's absolutely heartbreaking to see this man watch the love of his life slip away, and even more so when he begins CPR compressions that keep her heart beating. Derek and Bailey let it go on for a while, then Bailey takes over for him. Eventually, Derek takes over and is the one who stops, finally letting her go. It's beautifully played; the two doctors are the picture of compassion -- we all can only hope to have physicians who are half as skilled and warm-hearted help us through such an awful thing.

Extreme trauma: Which brings us to the case that could really use more compassion. A trauma comes in -- a man who's been beaten to the point of unrecognizability. The Chief has asked Dr. Hunt for input on the residents he's sizing up for the solo surgery, and while he watches Cristina efficiently handle the trauma, Hunt is horrified when she sends Lexie to the morgue for unclaimed body papers, and generally treats Lexie like crap. Hunt gives a little of the same right back to her, astonished and dismayed that she's planning for this guy's death while he's trying to save him.

In the process of treating this patient, Hunt comes in contact with Callie, who overshares (as usual) about her own experiences with the residents at Seattle Grace. And the attitude among Cristina, Karev, and Lexie is focused on procedure and the competition, which appalls Hunt. You're vultures, he tells them. You have no sense, no decency, and no respect. Later he tells the chief that his residents are undisciplined, inarticulate, and more interested in their personal crap than anything else -- and he may need to leave because of it.

In the end, Cristina finds an upset Hunt and tells him that the patient's wife has identified him. Have you found out his name, so he can become a person to you? he asks. Then one of those extraordinary Grey's exchanges happens -- she lets her armor slip a little, and talks about how being in the car accident that killed her father when she was 9 has affected her and shaped her as a surgeon. And the patient's name is Tom. See, we knew that Cristina was deeper and more personally motivated than she seemed. And to his credit, Hunt finds a way to look at her with new eyes, and a little admiration.

Learning experience: For a teaching hospital, the general level of knowledge among the residents and interns seems lacking. They have another skills lab, using a robot mannequin, which George ends up slaving over for the whole episode. But Cristina's interns are reduced to practicing putting IVs in on one another -- and because she never gets to do procedures, Lexie has no idea how to put in the chest tube that the beating victim needs. On her trip to the morgue, Lexie lays claim to several unclaimed bodies to use for practice -- which the interns and our residents readily embrace. Later, Bailey finds their practice workshop, and carefully and angrily reminds Lexie and Alex that these unclaimed bodies are people -- they were loved, and they were somebody's somebody, and it's their job as doctors to claim them and treat them with the respect they deserve. Go Bailey, go.

Mer and Der: Once again we see what looks almost like a healthy relationship between Derek and Meredith -- except that he's not getting a ton of sleep because as they devour her mother's journals Cristina keeps calling Meredith in the middle of the night and they commence talking about the diaries like they're the latest installment of the Twilight series.

Derek becomes convinced that Cristina needs a distraction, and asks Sloan to sleep with her. Sloan commences to hit on Cristina repeatedly -- and all of his advances sail over her indifferent head. I'd really like to see Sloan get a meaty storyline at some point. I suspect that Eric Dane can do a lot more than stand around, look hot, and deliver lines in a smarmy/dirty way, and it'd be nice to see what he could do. The best part, however, comes when Meredith and Cristina give Derek the business for trying to push that, ahem, alliance. It's good to see the ladies laughing a bit, and to see Meredith adjusting to living with and learning from, rather than competing with, her mother's ghost.

What did you think? Will you miss Brooke Smith? Are you glad that the Hahn/Callie storyline has been shelved? And will most of these doctors get to a point where they're grown up enough to be compassionate, or would that be the end of the show?

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