'Grey's Anatomy': Derek's the new chief

Derek's taken over as Chief on "Grey's Anatomy," but what's gone wrong with Seattle Grace clearly can't be fixed in one day. But with Bailey's difficult patient (and what looks like a new love interest), Alex rocking in peds, Mark and Lexie still estranged and the Owen-Christina-Teddy web getting more tangled, it sure was interesting watching him try to sort it all out.

Chief Shepherd vs. Chief Webber: The hospital board has appointed Derek the interim Chief, and it's gotten ugly. They've presented Chief Webber with a choice: either quit and walk away, surrendering your medical license, or go to rehab and come back to your job if the board approves. It's obviously an emotional choice for the Chief, given that he sits in the conference room all day staring at the papers, letting everyone in the hospital know what's going on. And he's so angry at Derek he can barely see straight -- which allowed James Pickens Jr. to do a fantastic snarl throughout the episode.

Derek's understandably nervous about the new gig, and everyone's talking because no one really knows anything. Which is why his initial speech to the staff goes over kind of like a lead balloon and why he should've closed the door to the conference room before giving everyone in the hallway a front-row seat to his yelling match with the Chief.

And typical of Seattle Grace, there's already a huge mess for him to cope with on day one. Dr. Bailey's patient wakes up on the table during surgery, and the terrified patient is confronted with Bailey yelling at the anesthesiologist and Meredith trying to soothe the patient back to sleep. Consequently, the utterly traumatized patient doesn't want Bailey anywhere near her, and when she requires another surgery she insists that Meredith do it.

Meanwhile, Bailey unloads on the "gas man" (Jason George, a.k.a. Keith on "Eli Stone"), who came from Mercy West and who she doesn't hesitate to accuse of negligence. It turns out that the patient has a condition that allows her to metabolize the anesthetic faster than normal, and there's no way they could have known this beforehand. So Bailey both has to eat a bit of crow and also seems to engage in a bit of flirting. I love Bailey, I love Chandra Wilson, and it would be awesome to see her get a little action.

Ultimately, a freaked and frustrated Bailey realizes that what the patient wanted to hear more than anything was an apology for what went wrong, and after successfully mentoring Meredith through the surgery, she counsels Derek to do the same -- to apologize to the patient, and to apologize and start over with the staff. Which he does, insisting that he wants to honor the legacy of Richard Webber and start fresh -- which means hiring back some of the laid-off staff. In the end, Chief Webber makes his decision as well, deciding, after a terrific pep talk from Bailey (who urges him to man up and be the man she knows he is), to go to rehab.

Arizona and Alex: Arizona's working with Alex, and this week their case is a teenage boy with intermittent stomach pain. His unsympathetic father thinks he's just faking it, and they end up doing exploratory surgery to try to figure out what's wrong. While the kid is in intensive care, his father lays into Alex with another harangue about how much this is costing him when he starts bleeding hugely from his chest tube. It turns out to be an aortic dissection (which I totally called about 90 seconds before they figured it out), and Teddy gets called into surgery. More on Teddy in a minute, but in the end the kid is going to recover and Alex takes the idea of advocating for his patient to a new level, essentially berating the father until Arizona pulls him away and counsels him to knock it off. But all in all, Alex is a rock star on the peds rotation, and Arizona is an interesting mentor for him.

Cristina and Owen and Teddy: Owen's still smarting from learning that Cristina would've agreed to give him to Teddy to keep her from leaving, and while he refuses to speak to Teddy, he does all kinds of letting his body talk with Cristina. They're, ahem, intimate all over the place (not quite Cinemax after dark, but not too far off -- wowza), to the point where Cristina ends up with butt burns from a session in the boiler room. It's "Grey's Anatomy" -- of course there's going to be some kind of weird injury.  

Meanwhile, Teddy decides to use Avery on her service rather than Cristina, except for when she really needs her in the kid's surgery -- and at Owen's urging not to leave him, Cristina uncharacteristically ignores her page. Owen tries to throw himself on the grenade for her, but it gets infinitely more interesting in the end, when they really get down to what's going on. She accuses him of trying to subdue and control her with sex, and he despairs that she doesn't give any of herself to him, so he can't know her. He didn't know, for example, about her engagement to Burke until it came out in a conversation with Derek and Mark. She insists that Burke isn't relevant to their relationship, and finally breaks down and explains that that relationship took pieces of her away as she tried to be what he wanted her to be. She's terrified that it'll happen again, just as she's getting herself back, and confesses that when he persuaded her not to answer her page, he took a piece of her away. It's a really lovely bit of acting from Sandra Oh, and I remain completely pulling for this relationship. It was fabulous to see Cristina vulnerable, but on her own terms.

Lexie and Mark: Not all that much happening on the Lexie and Mark front this week, he's still upset she slept with Alex after breaking up with him, even though he was off sleeping with Addison. She tried to talk to him, he ignored her utterly. In frustration she turned to Callie and explained her side, Callie talked to Mark and he warned her not to take Lexie's side, and in his defense, it is more complicated than just a bruised ego. Mark's venting over the situation brought no sympathy from Derek, for obvious reasons. The best part was the shot of Mark in bed with Callie and Arizona ("This isn't going to work for me."), which completely echoed the Season 1 scenes of George lying in bed with Meredith and Izzie. In the end, Lexie got incredibly upset when she ended up having to be on an elevator with Mark, and she ran off sobbing. My money's on them getting back together within the next three episodes.

Totally unrelated note: I love that this week's episode title, "State of Love and Trust," is taken from a Pearl Jam song.


What did you think? What's your take on Chief Derek? Were you surprised at how Chief Webber's decision came down? Are you rooting for Owen and Cristina -- or better yet, Bailey and the gas man?