'Grey's Anatomy': A morbidly obese patient, and a lawsuit for Derek

The doctors of "Grey's Anatomy" could certainly use some sensitivity training, and when a nearly 700-pound patient finds himself in the emergency room with all kinds of problems, it's good that they at least had the lecture.

The big case: The reason that Bailey put everyone through sensitivity training (Reaction. Obeservation. Communication.) becomes apparent when Bobby, the patient, has to be brought to the hospital in a truck. He's got stomach pains and cracks jokes as everyone struggles to maintain a passive face in an attempt to be deferential. Which is a struggle when his petite wife, Melissa, shows up, clearly extremely concerned and very much in love with her husband.

Upon examination, it turns out that Bobby's got some pretty awful sores -- what's actually happened is that he has a deep tissue infection under the skin, and it's gone through layer upon layer of fat. He's in rough shape -- made rougher by the fact that he hasn't walked in a year. That becomes a problem when he attempts to walk from the portable bed onto a gurney, and his ankles break after four steps. It's heartbreaking, because he's clearly a good guy and is trying to ingratiate himself with everyone. He's self-aware, and just seems to be trying not to be Mr. Morose. His wife explains that he was laid off from his job five years ago, and gave up looking for a new job after two years of no success. He gave up, and gained the weight. But now she's pregnant, and wanted to make sure he was getting the care he needs.

Bailey throws resident after resident off the case after they say the slightest thing that would be considered inappropriate based on the morning's training (some more than others, and I never hate seeing that obnoxious Charles guy booted out of any room). Mark and Owen want to operate, and Richard is advocating for it, but given the literal mountain of already existing and potential problems Bobby's facing, his prognosis for even surviving surgery isn't good. He doesn't want the surgery, saying that his child would be better off not to have him as a father.

Melissa gets frustrated with all of the doctors and their serious faces, particularly after she overhears Meredith and Cristina in the cafeteria speculating on the logistics of her getting pregnant. She reads Alex the riot act, telling him how disgusted she is that everyone there is only making her husband feel worse. So Alex, still semi-reeling over getting served divorce papers, goes in and jokes a little with Bobby -- and then tells him that he needs to get it together and have the surgery so at least his wife will think he tried.

In surgery, it turns out that the problem began with diverticulitis, and the infection spread. Things look like they're going south fast, but in the end Bobby pulls through. And he realizes that he's got to change his life because there's really no other alternative.

Derek's deposition: Derek, meanwhile, is being deposed in a wrongful death lawsuit against him and Seattle Grace. Mrs. Clark, his patient from a few weeks back, suffered brain damage during her cancer operation, and her advance directive said that she was not to be put on life support. Legally, Derek had no choice, but Mr. Clark was understandably crushed about losing his wife of 32 years. And he wants Derek to answer for the decision that he later admits took less than a minute to make.

Derek's clearly upset by the lawsuit and by Mr. Clark's presence in the deposition, and on his way in he mentions to Meredith that Owen hadn't exactly lobbied for Teddy. Meredith gives Owen the hairy eyeball, and wants to tell Cristina what he did. Owen goes after Derek for betraying his confidence, and Derek feels put in a terrible position, either not being able to tell Meredith anything or not being able to trust her not to whip out that hairy eyeball.

Derek keeps getting called out of the deposition to attend to patients, and being on edge really affects his manner and his decisions. Initially, he's against Bobby's surgery, saying that there's no point in them devoting time and resources to take care of a man who's not taking care of himself. Richard wisely steps in and tells Derek that it's the job talking, not the situation, and the fact that he sees potential lawsuits at every turn rather than patients is clouding his judgment.

Thankfully, at the end he gets to see Bobby survive, and he manages not to say anything when Mr. Clark calls him a coward and a murderer. The guy needed to vent, and Derek heeded the hospital lawyer's advice to let him do so. He also backed away from being angry at Meredith, and ended up hitting golfballs up on the roof with Mark.

Christina's heart patient: Christina and Avery are working with Teddy after getting thrown off of Bobby's case, and their patient is a woman who came in at the insistence of her 9-year-old daughter, Kelly, feeling awful and vomiting. Turns out she's having a heart attack, and unfortunately she and Kelly are in Seattle on a trip, due to return home to Miami the next day. While Avery and Teddy take care of the mother, Cristina gets a chance to put her sensitivity training to use (it takes her a while, but she comes around) by watching Kelly.

Things get scary when the mother needs emergency surgery, and Kelly and Cristina discuss what's happening over a game of cards. Kelly's scared about her mom dying, and Cristina explains that if in fact that happens, she'll feel like it's her fault. But it's not, and she did everything she could. Cristina explains to Kelly that she's speaking from experience, from when her dad got sick was killed in car accident when she was a kid (she omits the death part). She does an amazing job, both during the conversation and afterwards, after the patient has died and she needs to go and compose herself. It's wonderful watching Sandra Oh get a chance to do something more interesting, because she doesn't get that chance often enough. This case and spending time with Kelly has brought Cristina's father's death back to the surface for her, and she finally breaks down crying on Owen's shoulder. 

Callie and Arizona: Callie's extremely attractive cyclist patient, whose knee got really messed up when a car hit her, is doing some full-court flirting. And Callie's giving it back -- which both Charles and Lexie proceed to tease her about. After her surgery, the patient gives Callie her digits -- writing them on her hand with a Sharpie, no less -- and though Callie has no intention of calling her, she has to tell Arizona about it, since the number's still on her hand. I love you, she tells Arizona, but I keep wondering if this other woman will want kids some day. Arizona tells Callie she doesn't want to be the reason she sacrifices having children. They're basically at a standstill, and clearly the relationship is ending. Both Sara Ramirez and Jessica Capshaw did a lovely job of bringing their relationship to a close with respect and sadness, and it feels real. I like them together, but this isn't the kind of thing you can talk someone into.

Alex and Lexie: Alex deliberates a little, then signs the divorce papers after Bobby pulls through surgery. He plants a big wet kiss on Lexie, and they head home. One thing ends, another thing starts in earnest.

Some odds and ends:

• How much do we love Avery? He seems to have found a way to bond -- or at least get along with -- the Seattle Grace folks, and he's smart and sensitive without being too goopy. Clearly he's the top of the heap when it comes to the people who came from Mercy West.
• On one hand, it's less fun when either Charles or Reed show up -- and both of them were in this episode. On the other hand, Charles wasn't around much and Reed didn't say anything, so that was a plus. Though the preview for next week leads me to believe that we're going to be seeing, ahem, a lot more of her. Eesh.
• All I could think of when watching Mark and Derek hit golf balls from the roof was that I hope no one got clocked in the head down on the street. Seriously, you guys are doctors. What up, fellas?

What did you think? Did you cheer for Bobby's wife when she chewed out Alex and the others? Isn't it still astonishing to see Derek and Meredith settle disagreements calmly? Are you sad about Callie and Arizona? Or surprised that Cristina was vulnerable?

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