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Moody Lighting And Artsy Staging Give New Meaning To The Term 'Operating Theater' On Grey's Anatomy

Four doctors, one complicated surgery, and a series of imaginary visitations results in a valuable lesson learned.

When this episode cold-opened on the hospital staff prepping an operating room in tight focus, I didn't think anything of it. As it progressed with Meredith, Stephanie, and Owen grousing about their exhaustion as they furiously begin cutting and pasting in the body cavity of their patient, I was mildly intrigued. But when Richard arrived and started reminiscing rather irrelevantly about old surgeries, I became confused, and by the time the body on the table morphed from a white man to a black woman who appeared stage right under a spotlight playing a cello, a lightbulb went off. Ah! This is a Very Special Episode. It is an episode of Grey's thematically created as a stage production. So we are going to be treated to a "the more you know" moment.

Stephanie, Meredith, and Owen are focused on saving a shredded liver and a kidney that is basically "broken in half." They are sleep-deprived, cranky, and arguing about the best options. But the well-rested and chipper Richard is disturbed by their impersonality toward the man on the table. "You are treating this patient like a sack of organs on a table." He chides them and then pushes them to play an imagination game. Imagine the person instead of the body. Since they have no identification for him yet, create a background, a family, a job. "He is no longer a John Doe. Give him a name." They're reluctant to play along, so Richard gives their John Doe the name "Gail." Gail is a wife, a mother, and a cellist.

I can't help but draw the conclusion that Richard is still reeling from his encounter with the annoying Dr. Minnick from last week because this Richard feels unfamiliar. He feels like someone who is trying on a persona like a new suit. Or rather, a person who may have gone looking and found his old self in the back of a closet and is surprised at how well he fits.

But Meredith and Owen continue to disagree. Meredith wants to close the patient up and take him to ICU. Owen wants to continue. Richard is drawn into their fight and suggests a call to UNOS for a transplant. Meredith is adamantly against that. Basically Meredith views any heroic measures as kinda hopeless here. She is impatient and shrill and reminds Richard that she outranks him: "If you are not on board feel free to leave." This too feels very un-Meredith to me. Would Meredith really just give up on a guy so she can go home and sleep?

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It's here that we get the first visit from an imaginary friend. Owen is transported back to a surgery in the field as his dead sister Meghan goads him into admitting he also liked to humanize his patients just as Richard suggests. Everyone else in the present operation is frozen in time and shrouded in shadow, as a brightly lit Meghan weaves among them continuing to prod Owen until he shouts at her and she disappears. But her ghostly presence has energized him and he agrees with Richard that a transplant is the way to go. He removes the liver, much to Meredith's dismayed anger.

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As the bickering around her continues, it is Stephanie's turn for an imaginary visitation: the younger version of herself. Stephanie has an idea about why the patient continues to bleed when he shouldn't be, but no one is listening. She keeps trying, but the other doctors disregard her. Young Stephanie reminds older Stephanie that in order to be heard she needs to "speak up!" Finally, she does, raising her voice and telling them to all shut the hell up. They are shocked. It is actually rather glorious to see the outrage on their faces as the lowly resident snaps at them. Her younger self smiles encouragingly.

It isn't until a nurse breathlessly comes in to inform them they may have discovered their John Doe's name that Meredith's moment arrives, and it feels like the point of this exercise in operational theater has also finally arrived. The man's name is Carl and he has a wife and two children.

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Suddenly the doors of an ER appear in a tight spotlight and Zola and Bailey are sitting at a table coloring and waiting. It is clear this is the night Derek died in a car accident, much like their patient Carl on table. And this is the moment where Meredith has to tell her children about their father. A moment we'd never seen before.

"You should go in and fix him," Zola tells a heartbroken Meredith. "You fix everyone." A look dawns on Meredith's face as her surgical mask reappears around her neck and she returns to Carl's surgery. Earlier she had just wanted to pack him off to ICU where it was "better for him to die" there than on the table. But now he's more than just a shredded liver.

"Gail was your mother." Meredith tells Richard as she now understands the point of Richard's humanization game. His mother died of pancreatic cancer after a surgery that could not save her. Once he realized that he'd felt nothing after informing a family a patient had died, he decided he could no longer consider the bodies in front of him as anonymous.

Given the recent emphasis on Grey's as a teaching hospital, it's clear that it's not only the residents who could benefit from more instruction. This is Owen's lesson in understanding that not everything presents as a trauma, Stephanie's lesson in assertiveness, and most importantly, Meredith's lesson in better doctoring.

That final lesson is driven home with a brief visit from Derek, wearing the same scrub cap, saying only "Hi," but with a big smile of approval on his face.

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