'Grey's Anatomy': Izzie's surgery, Owen lashes out -- and a ring

Tonight was not your average episode of "Grey's Anatomy" -- which you could tell from the opening moment, when Alex and not Meredith did the voiceover. But while everyone waited for Izzie to go into -- and then out of -- surgery, and while saw in an up-close and horrifying way what PTSD can do to someone, you couldn't help but come away with one thought: You need your people.

Even if you think you're not ready to handle these spoilers, I know you can...

No one quite knows how to handle Izzie as a patient. Alex, Cristina and Meredith are trying to sort through their conflicting instincts to be both doctor and friend. George is beside himself and putting some distance between him and Izzie, because he feels as though he's been the last to know anything, and blown off when he tried to talk to Izzie about what was wrong. Outside Izzie's room before rounds, Bailey makes it clear to Grey, Yang and Karev that when they go into Izzie's room, they have to do it as her friends, because she'll be surrounded by doctors and she'll need them.

But their discomfort, agitation  and helplessness is palpable, and they're only too eager to go off and be doctors when she tells them to go and save lives. Derek's the surgeon, and before he goes to the hospital he show's up at Meredith's with his bag -- and the ring. And she turns him down. Not like this, she says -- it's your first day back, and this has to be about Izzie. I cannot believe that this is Meredith, but she's amazing. During rounds we meet Izzie's oncologist, who is bossy and abrasive, so of course she's clearly the best, and she pretty much gives everyone in the room what for -- including Izzie. She passionlessly tells Izzie about the three surgeries in four weeks that she's scheduled for, including harvesting as many healthy eggs as possible before Izzie undergoes radiation. The will find more cancer that's spread, she says, and the aggressive and harsh treatment that they're going with is going to be tough.

Everyone has their role here. Cristina's being exceptionally watchful and working with the oncologist. Meredith's trying to be there for everyone. Alex is struggling to be brave -- and "answers the call" when the chief asks him for a specimen because Izzie's eggs have a better chance of surviving frozen if they're embryos. George is hiding on Callie's service. Callie's feeling guilty that she used to wish Izzie would die. And Bailey's taking care of Izzie. And if I were sick, the person I'd want looking out for me is Bailey -- so amen for that. Bailey is particularly brilliant when she quizzes Izzie about the surgery Bailey has coming up that afternoon, because she doesn't want Izzie getting rusty, since she'll need her skills when she's teaching a year from now. When Izzie asks if Bailey really thinks she'll be here a year from now, Bailey firmly and unhesitatingly replies, "Yes I do."

Derek's nervous -- really nervous. And before he goes into the OR, he asks Meredith to marry him again. She says no -- not if committing to him so he can do the surgery will make it OK if Izzie dies. "I love you. You can do this. I know you can," she says. Rock on, Meredith. Before she goes under anesthesia, Izzie tells Bailey that if something goes wrong, the scarf she's been knitting in her room -- which she had time to finish since her friends didn't visit -- is for Bailey. During the surgery -- as Derek works his way through, with the oncologist second-guessing his every decision until he finally fights back -- even the no-good-very-bad interns assemble in the hallway to wait.

In the end, Derek was able to take out all of the tumor. Izzie will recover, and her post-surgery CT is clean. Bailey takes the opportunity to dress down Alex, Cristina and Meredith for not going to see her. But for now, at least -- chastised, battered and freaked out, there's hope. And on this front, Izzie's OK. Now, on to the next thing.

Another wonderful side effect: Derek seems to have gotten his mojo back. How he commandeered an elevator for long enough to turn it into a consult room displaying the files and scans of all the patients he and Meredith have saved, I don't know. But it's a really sweet way of walking through their relationship, to show her how he's known she's the right person for him -- and a way for him to show that he's coming out the other side. And he tells her he wants to spend the rest of his life with her. She answers the same -- no asking, no accepting, just equals coming together. Ladies and gentlemen, we have an engagement.

But the day started a whole lot worse than it ended. Hunt stayed at Cristina's, and she awakens in the middle of the night to find him choking her, looking as though he's in a sleepwalking trance. Callie finally makes it into the room and snaps him out of it, but not before Cristina's hurt and bruised, Hunt is scratched, and everyone is shocked, scared and freaked out. Callie calls Meredith over, and between the two of them they're clearly wary and terrified for Cristina. But Hunt, who obviously was in the grip of something else, is really worried about Cristina, who ends up assuring him and everyone else that it's OK, he was asleep, and she's fine.

Like the good friend she is, Meredith doesn't let it lie. But Cristina isn't the sort to do anything she doesn't think she can handle -- and she tells Hunt so, as he's trying to break up with her. "Let me decide what I can handle," she says, as he pleads with her, worrying about what could have happened. Later Hunt freezes up on the roof when a chopper brings a trauma patient in, and Derek immediately spots what's going on. He talks to Hunt about a trial studying the brains of PTSD patients, and getting them some help, but Hunt snaps that he, the kettle, is not the one with the problem, pot.

There are really some beautiful moments between Sandra Oh and Kevin McKidd in this episode, particularly when they finally sleep together in the on-call room (I mean really -- wowza). And when it turns out that Cristina can't handle being with him, because she's afraid to fall asleep. Hunt goes to Derek and agrees to get treatment.

Some other thoughts:

• A minimum of Mark and Lexie this week, which is fine -- excellent call not to force it. But the case of the dying old lady and her nephews and niece fit into the rest of the episode with a nice touch. They weren't vultures and they didn't want her to die. And they showed up -- they were her people.
• Also a really nice performance from Justin Chambers, who I've always thought was just a little too smarmy for his own good. He did great, heartfelt stuff in his scene with Meredith, talking about how he should've known something was up, and being anguished over the idea that this isn't how he and Izzie should be making a baby.
• I watched live without the benefit of a DVR this week, so I didn't count them, but heavens there were a lot of commercial breaks this week -- at least four in the first 30 minutes, and that seems conservative. I get that a barn-burner episode would generate a whole lotta ad sales, but holy moly -- was anyone else put off?

What did you think? Were you expecting bad news for Izzie? What did you think of the Der-Mer proposal? And did you find the idea of trauma being an agent that propels you forward in life rather than drags you down as intriguing as I did?

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