Diagnosis: Reality Check

By Brianne Moore

Partnership, that’s what this week seemed to be about. Some pairings worked out, and one, rather spectacularly, crumbled.

Let’s get the good stuff out of the way first. Derek’s annoying younger sister, Amelia, bounces into the hospital with a complicated gliosarcoma (a rare type of brain cancer) case and a sympathy-inducing picture of the patient’s kid, to remind everyone what’s at stake if they fail, as if they didn’t always know that. Also—what is it with this woman always showing up with brain tumor gifts for her big brother? Where does she keep finding them? Does she troll whatever hospital she works in for crazy cases? It’s a little creepy. Anyway, Derek takes one look and says he can’t help the woman, then takes off because he’s upset with Amelia for some reason, so Amelia and Lexie spend the day practicing the surgery, and eventually Derek comes around and helps her out and it looks like everything will be OK. Partnership established!

Elsewhere, Meredith’s helping Callie out with a man who got his hand stuck in a meat grinder. In return for helping Meredith study for her boards, Callie makes her take the lead on the case, and they manage to save the hand and do some cool surgery where they replace one of his missing fingers with his second toe.

Karev’s got one of the interns helping him study for his boards, and she spends the day dutifully quizzing him, even though he can’t even be bothered to learn her name. But then she starts getting dizzy and nauseous in the OR and has just enough time to tell him she’s 24 weeks pregnant before she passes out. After she regains consciousness, Alex asks her a few more questions about her symptoms—which included heartburn, shortness of breath, and some chest tightness—and realizes she’s having a heart attack. An important lesson during American Heart Month: heart attack symptoms in women tend to be very different from the “classical” symptoms men exhibit, so many women don’t get help until it’s too late. Stay vigilant, and go see your doctor if you’re not feeling well, ladies! Turns out poor Intern Morgan’s attack was due to acute spontaneous coronary dissection, a rare condition in which a tear develops in the coronary artery. She’s rushed to surgery, the baby’s delivered early and tended by Arizona and Alex, and everyone seems to come out fine in the end. And Alex finally learns the poor girl’s name.

Now for the downer part of the episode: Cristina and Owen spend the whole day with perhaps the world’s least effective counselor (did he say a single word before the last seconds of the episode? I don’t think so.) After finally being called out on the unfairness of acting like he was ok with Cristina’s decision and then throwing it in her face in front of all their friends after four months, Owen spent the time spewing both complete nonsense (“Meredith’s your best friend, and she has a baby, so you should have a baby now.” Say what?) and downright selfish, misogynist sludge that left me literally staring at my TV openmouthed. The moment he condescendingly informed Cristina that she’ll want a baby, because every woman wants a baby, and not wanting a baby is just not something that exists, he lost me completely. I have no idea whether we’re supposed to actively hate him now, or if this is what the writers actually believe, but either way, it’s incredibly disturbing. This is not 1952. A woman’s entire purpose in life is not wrapped up in her reproductive abilities. Some women, as Cristina rightly points out, just don’t want to be mothers and there is absolutely nothing wrong with that. Not everyone is cut out for motherhood, and I’m grateful to the people who understand that and don’t have kids just because it’s “the thing to do.” Far too many people who shouldn’t be having children have them, and that causes a lot of problems.

This partnership is falling apart. I really don’t see how it can be saved. As I mentioned in an earlier post, this is not an area you can really compromise on. You either have a baby or you don’t. It pains me to say it, because I like these characters and think they have great chemistry, but where can you go from here? Nowhere. If Owen wants kids so bad, he’ll have to go find someone who knows she wants them too, and that person is not Cristina.

How did you feel, readers? Was Owen out of line? Is there any way to save the relationship? And do you think Karev might eventually make a play for Intern Morgan once she’s back on her feet? Share your thoughts in the comments below.

By Brianne Moore

Warning: This post contains spoilers

The soap bubbles keep pouring forth, don’t they? Fast on the heels of last week’s amnesia and missing heir storyline, we have a miraculous recovery, a mysterious death by poison, and a convenient outbreak of a deadly disease.

First up—ding, dong, the witch is dead! Say farewell to Vera Bates, a cartoon villain if ever I saw one. She’s shuffled off the mortal coil with the help of arsenic, and she’s in good company: arsenic was so popular as a poison amongst the upper classes for centuries it was known as “inheritance powder,” given its ability to speed up the inheritance of impatient heirs. George III, a member of the Medici family, and Napoleon are all believed to have been poisoned with arsenic at one point. For years it worked well because it was odorless and left no traces in the body. It has such a terrible reputation we’re still terrified of it, even today. It fell from grace after the Marsh Test was invented in 1836 and led to a break in the famous LaFarge poisoning case in 1840. Symptoms of arsenic poisoning include headaches, confusion, diarrhea, drowsiness, convulsions, vomiting, muscle cramps, hair loss, and finally coma and death. So the question is: was Vera murdered, or did she commit suicide? Only time will tell.

Of course, the big news is Matthew’s Miraculous Recovery (soap opera plot #8,479—suddenly reversed paralysis!) His sudden tingle at the end of the last episode was a sign of things to come, and come they did as he managed to leap to his feet to keep his beloved Lavinia from taking a tumble. Never mind the man’s been in a wheelchair for over a year and his muscles would most certainly have seriously atrophied—he’s walking again! It’s a miracle! Naturally, Dr. Clarkson is summoned and puts it all down to a case of spinal shock. This is a bit of a problem, because spinal shock, though it does often cause below-the-waist paralysis for a while, typically wears off within 4-6 weeks. Only in extremely rare cases does it take a few months. Matthew was injured more than a year ago. Methinks the author failed to do the research on this one.

The most disturbing aspect, though, is everyone’s cavalier attitude toward the doctor, even after he tells them that a specialist believed it was spinal shock all along, but Clarkson withheld the information because he was so sure he was right and didn’t want to be proven wrong. That sort of arrogance and condescension is astonishing and alarming, and brings up a lot of other questions. What else has he been ignoring because he’s so certain his diagnosis is right? Why didn’t he mention this other diagnosis when Matthew told him he was feeling tingling in his legs (Clarkson outrageously just told him it was all in his head, despite this other diagnosis)? Why on earth did the specialist never speak to Matthew or a member of his family directly about any of this? Why does everyone just shake Clarkson’s hand and invite him to dinner instead of firing him on the spot? Seriously, this man’s a lousy doctor with a terrible bedside manner. He’s proven in the past that he’s not exactly up on the latest treatments; nor is he all that interested in furthering his own education. This man is bad, bad news and an object lesson in why it’s a good idea to check out your medical records yourself, if possible.

But before long all that’s forgotten as history intrudes on Downton with the arrival of the Spanish Influenza Pandemic (which had nothing to do with Spain at all), even though by this point in time the pandemic was largely winding down (it officially died off by December 1920, but most of the later cases were in far-flung areas where it took a while for the disease to arrive). The 1918 pandemic was particularly devastating: it’s estimated that between 50 and 100 million people died worldwide, and some 500 million (27% of the world’s population at the time) were infected. The virus—a form of H1N1 we’re all too familiar with today—would present with typical flu symptoms—fever, headache, nausea, fatigue, before  patients experience a cytokine storm in which their bodies’ immune systems overreact and attack the body. This might explain why most victims were young and generally healthy people, as opposed to the very old, young, and sick who were often felled in flu pandemics.

Though it was winding down, World War I played its part in the spread of the disease. The first victim was believed to be Albert Gitchell, a company cook at Fort Riley, Kansas. His illness spread quickly through the camp, and soldiers on their way to the front carried it with them. The mortality rate from the flu is not known, but it may have killed more than the Black Death in the 14^th century, and it’s become known as the Greatest Medical Holocaust in History. Around 28% of the population of the United States was infected, and 500,000 to 675,000 died. Britain lost as many as 250,000 of its citizens. India was the hardest hit—17 million people died of influenza there. Most of the deaths were not due to the influenza itself but because of bacterial pneumonia, a secondary infection related to the flu. That explains Lavinia’s rally and sudden decline.

Recent research into the pandemic has found evidence the virus originated in poultry and swine used for food at Fort Riley.  Despite extensive research, however, the 1918 pandemic remains, largely, a mystery. Still, the horrors of it have remained in human memory, so every time a new influenza strain rears its head, people start to panic. Luckily, we’re a bit better equipped to diagnose and handle a massive outbreak than people were in 1918.

It’s Valentine’s Day at Seattle Grace Mercy West, and while some couples are trying to escape for some romantic alone time, others can barely stand to be in the same room together. And since it’s a holiday, there’s a superabundance of crazy cases (or, as Kepner calls them, Valentraumas) to check in with throughout the episode.

For excitement, a delivery van driven by an exhausted florist drives right through the front of the ER, and Teddy, Hunt, and Cristina all end up operating on the driver. It’s the most awkward surgery imaginable, since Teddy’s not speaking to Hunt, and Hunt’s not speaking to Christina. They all glare down a fellow resident who cheerfully asks them what their Valentine’s Day plans are. Later, Hunt bluntly informs Cristina that he’s moving out, and I have to say, Sandra Oh absolutely kills this scene as her face registers grief, acceptance, and disappointment as she tries to keep herself from falling to pieces, all in about two seconds. Hunt fails to notice and instead goes off to bury the hatchet with Teddy, who informs him, in no uncertain terms, that she absolutely hates him for keeping Henry’s death from her until her surgery was over. Can these two relationships be saved?

Meredith and Bailey have a woman who’s been having blinding headaches and seizures for weeks, putting her at risk of brain damage. Meredith realizes the woman’s got hemolytic anemia, a rare disorder in which red blood cells are destroyed faster than they can be replaced, indicating an autoimmune problem. The body’s either attacking itself because of a teratoma on her lung or a microscopic tumor on one of her ovaries. Removing the lung mass does nothing, so they have to go on faith and remove her ovaries. Turns out, they were right and there is something on her ovary, so the seizures finally stop.

The Obnoxious Patient of the Week award goes to the woman whose boyfriend gets hit by a car while chasing her down. Why was she running away? He failed to propose. And even as he’s wheeled into the hospital, she continues haranguing him in the most shrill way imaginable. We later learn that they’ve been dating for eight years and she’s been all but begging him to propose for most of their time together. Oh, Obnoxious Lady. I know breaking up is really, really hard to do, but if you’ve been with someone that long and made it very clear you want something more out of the relationship and nothing more has been forthcoming, it’s seriously time to think about moving on. And not moving on in the direction of moving traffic. Of course, the joke’s on her (sort of, tragically) because he was trying to propose—the locket he gave her had a “will you marry me” message inside, which she never finds, because he dies of internal bleeding. This also gets the award for Most Depressing Storyline of the Week. It does, however, spur Lexie to decide admit her feelings for Mark, but when she goes to his apartment to talk to him, she finds Avery already there, cooking dinner and getting help studying for his boards, so the three end up having Valentine’s dinner together.

Cutest patient? A 10-year-old girl named Clementine who comes in with her equally adorable valentine, Nico, who mistakenly gave her a peanut cluster that gives her an allergic reaction. The little boy and his mom stay with Clem until her high-strung mother forces them to leave. Even then, Clem’s valentine won’t go until Alex offers to deliver a message to Clem on Nico’s behalf when she wakes up. The letter he sends her is perhaps the most adorable thing I’ve seen on this show since little Zola in her birthday outfit. Ahh, young love!

Bailey’s long day of surgery has ruined her chances of making it to dinner with Dr. Ben, but Ben’s not only awesome, he proves he understands Bailey really, really well and planned for just this situation by having the fancy dinner brought to the hospital. He even knows to request extra bread topping on her mac and cheese. Ben’s a serious keeper, and Bailey knows it.

And it’s not just because he’s sweet and handsome, it’s because he actually understands his partner and has reconciled himself with her choices. Hunt hasn’t managed to do the same, which is the tragedy in his and Cristina’s relationship. In fact, his behavior towards her proves he doesn’t really know her at all—Cristina has always made it very clear that she’s not interested in being a mother. It’s just not her. Him thinking that she should change in such an important and fundamental way just because this is something he wants strikes me as being selfish. Compromise is important, but we’re not talking about choosing a movie or a new couch, it’s a child. And frankly, the way he seemed to support her decision—even accompanying her to her procedure and holding her hand throughout—only to throw it back in her face and hold an extreme grudge now, weeks later, is pretty horrible. Is it realistic to have fallout from a situation like this? Yes, of course, but don’t act like you’re ok with what happened and then do a 180 and destroy your marriage. It’s called counseling, folks. It would probably be a good idea to look into it.

But maybe not all hope is lost: Cristina finally tracks Hunt down to the steam turbine room he visits to think and begs him not to hate her. Maybe these two crazy kids can work it out after all. Or, at least maybe they’ll be able to start speaking to each other again. We can hope!

Happy Valentine’s day, everyone!

By Brianne Moore

Downton has always been a bit soapy, but this week they ran right into General Hospital territory with the horribly-burned-returned-from-the-dead-heir-with-amnesia storyline. Is the Canadian Patient really long-lost Patrick Crawley? Who knows? After watching this, what I was wondering was: does amnesia really exist? Is this guy’s story even plausible?

Turns out, it is (at least, as far as the amnesia goes. His story had a lot of other holes in it, which I won’t go into). Dissociative amnesia typically occurs when someone’s been through a particularly stressful or traumatic event (like, say, being unexpectedly plunged into 28-degree water with 1500 of your fellow cruise passengers in the middle of the night). The result is gaps in memory involving the event itself or even longer periods of time. Eventually the memories can resurface, as they allegedly did with Patrick/Peter here. Considering the trauma link and the fact the memories resurfaced (if this is, indeed Patrick we’re dealing with), dissociative amnesia is most likely what he had, although it’s possible he got a whack on the head during the sinking and had simple amnesia, which is usually the result of disease or injury to the brain.

Unfortunately for (maybe) Patrick, most of the treatments for dissociative amnesia (psychotherapy, cognitive therapy, medication, clinical hypnosis) were either in their infancies or didn’t exist at all in the early 20^th century. So it is likely that he would have continued to struggle with this memory loss for quite some time before something brought his past back to him.

Elsewhere at Downton, Matthew’s clearly deeply depressed about his injury (not an uncommon result with this sort of injury). As with Patrick’s amnesia, there was little help for depression in 1919; you just had to stiff-upper-lip it and muddle through. But at least he’s got Mary by his side to help him out and, thanks to Carlisle, Lavinia too!

By Brianne Moore

Today the folks at Seattle Grace Mercy West decided to play a little game of “what if?” and who hasn’t played that at least once in their lives? In this case, making a few ‘different choices’ as Meredith puts it makes everyone’s lives drastically different. Meredith, for instance, has been raised in a stable household by her mom (who does not have Alzheimer’s and is the chief of surgery) and her stepfather, Richard. The lack of a scarring childhood has turned Meredith into the kind of pink-wearing, glossy-haired girly girl who would squeal over her new engagement ring with BFF April Kepner. And who’s the lucky man? Alex, whose different choices include unfortunate hipster glasses and an obnoxiously cheerleader-y attitude. Cristina’s still a misanthropic rock star, so she’s not too different, though she has terrible hair and everyone hates her for apparently driving Burke away. She and Meredith do not get along.

On the attendings’ side: Callie is, rather inexplicably, head of cardio, wife of Hunt, and mother to a passel of kids. Hunt’s trying (poorly) to hide his PTSD from everyone; Derek and Addison are still miserably married and she’s pregnant—but not with his baby; Bailey is completely unable to stand up for herself or speak up under any circumstances, even allowing Ellis to steal her whipple surgery; and Sloan is nowhere to be found until the very end of the episode, when he brings in Lexie after she ODs.

Yes, that’s right, Lexie’s probably the most drastically different of all, having been rewritten as a junkie who’s overdosed so many times she’s basically destroyed her heart. This isn’t really a matter of different choices so much as a complete character 180. Going from perky surgeon to thieving, angry junkie, even after you lose both parents? That’s quite a leap.

The episode was more about fantasy and less about the cases: Ellis had her whipple, which goes poorly because the patient has a history of deep vein thrombosis, rendering the vein she wanted to use for the procedure unusable. Derek and Addison argue their way through a surgery on a newborn with a neck tumor, and Cristina and Meredith clash over a heart patient whom they’re both operating on because Callie has absolutely no spine at all and refused to just assign one of them to the case. The girls later bond while shocking Lexie’s heart, though, and Cristina teaches Meredith the fine art of taking a tequila shot, which I’m pretty sure even a well-adjusted Meredith would have learned in college, or at least somewhere else before she hit her late 20’s.

Despite these different paths, some characters just can’t help but come together in the end. Meredith and Cristina, Cristina and Hunt, Callie and Arizona. And although this alternate universe isn’t great—aside from everything else, Ellis is still cold, self-centered, and unloving, her joyless rule over the hospital illustrated by the dull, gray scrubs everyone wears (heh, get it? Ellis Grey, gray scrubs?)—there’s still some good amidst the bad: the horrible hospital shooting apparently never happened, probably because Ellis managed to deflect the bullets with her many Harper Avery awards.

It’s a fun game to play, What If (although I thought it made for a less-than-exciting episode that did nothing to advance any of the plot). Have you ever played it? How do you think your life would be different if you’d made a few different choices?

By Brianne Moore

All right, show of hands: how many of you saw the word “goner” stamped on William’s forehead as soon as he started talking about joining up last season? I know I sure did. I did not, however, anticipate his deathbed marriage to Daisy or Matthew’s less deadly but very devastating injury.

Yes, the day some (many?) of us saw coming has come—William is Downton’s big war casualty, and that makes me sad, because he’s one of the few characters I’ve consistently liked and supported throughout the series. But he was just too nice, and not the romantic lead or the villain, so as soon as that bomb blast sent him and Matthew flying, I knew it was just a matter of time.

The blast left William with massive internal injuries, particularly to his lungs (suggesting possible poison gas exposure, which was being used more and more by this point in the war). Bleeding around the lungs (hemothorax) is one of the deadliest types of internal injuries, and something that was probably close to impossible to treat in 1918 (if not flat-out impossible). Poor William.

And poor Matthew, too. The same blast that numbered William’s days injured Matthew’s spine. As Nurse Sybil points out, such a vague diagnosis can mean almost anything, but in Matthew’s case, it apparently means he’ll never walk again or be able to consummate his future marriage to his fiancée, Lavinia. Poor Matthew, and poor Lavinia.

If there’s any silver lining to all these tragedies, it’s that they brought out the best in many of the other characters. The normally class-conscious dowager countess wasted no time throwing her weight around in order to bring William home so he could pass away peacefully in familiar surroundings. She even convinced the reluctant vicar to perform the wedding ceremony and put on a happy face for William’s father, quietly telling the others it was probably best to give him time to come to terms with the inevitable. She turned out to be right about that.

Even Edith and Mary, the two less pleasant Crawley sisters, step up and take their caregiving duties seriously. Mary exhibits a maturity we’ve hardly seen from her until now as she soothes and looks after Matthew and comforts Lavinia, and Edith, who’s really blossomed since Downton became a convalescent hospital, tends sweetly to William and, like her grandmother, pretends to remain optimistic about his condition to make things easier for him.

A sad episode, to be sure, though it was nice to see a few characters start to shine. It’ll be interesting to see where the Matthew story goes—if the heir can’t have an heir himself, would that be a reason to destroy the entail once and for all? Or would that just be the end of Downton as a private house (which is probably inevitable anyway—few large estates remained private homes after World War II)? Or is a miraculous cure on the horizon? What do you think? Share your comments (and your favorite quotes from the Dowager Countess!) in the comments below.

By Brianne Moore

As if to make up for last week, some of the docs were extra cuddly and sympathetic this week. Meredith and Derek are happily planning adorable Zola’s adorable birthday party, while also dealing with some hospital-related issues in mature and reasonable ways. Meredith is the only fifth year not to declare a specialty yet, and she’s being heavily pressured by just about everyone to pick general surgery, because that’s what her mother did and, apparently, that means it’s in her blood. I personally don’t think a family legacy (particularly any legacy of Ellis Grey’s) is a reason to pick a medical specialty, and apparently Meredith agrees with me. She refuses to be bullied and remains undecided.

Derek has this week’s sad case: an 11-year-old with a passion for historical battles and a neuroblastoma that eight other doctors have deemed hopeless. Derek agrees to operate, but before he meets his patient, the boy’s mother warns him not to mention the kid’s cancer. Apparently, she’s been lying to her son for ages, telling him he’s just got a bad backache, because she doesn’t want to upset him. Understandable, but the kid’s condition has reached a point where he’ll only have months to live if his surgery’s unsuccessful, which is the point you’d think you’d want to give someone a head’s up so they can prepare themselves. And it turns out the kid’s not an idiot and knows all about the tumor, but he doesn’t want his mom to know he knows because he thinks it’ll upset her. It’s so tragic to hear such a young child talk about protecting a parent in that way, and this is not a situation where keeping secrets is a good thing, because it’s just increasing everyone’s stress. When the surgery’s unsuccessful, he finally comes clean with his mom about what he knows, and she cries, of course, but it seems to clear the air somewhat. Hopefully the poor kid’s last months will be a little more honest.

Speaking of honesty…

Teddy, fueled by grief and a lot of “sad widow casseroles” is on a non-stop surgery tear, and Cristina’s only too happy to come along for the ride. They’ve been at it more than two days straight, and finally Hunt—perhaps the world’s most ineffective chief of surgery—tracks them down and orders them to go home and rest, because they’re now actually a liability. Do they? Of course not. Instead, they scheme and snag a cool surgery from one of the other docs, and when Hunt finds out, there’s a huge blow-up between him and Cristina at Zola’s party, during which he reveals that he’s not at all over the fact that Cristina terminated her pregnancy. Things are not looking good at all for these two, which makes me sad.

Doing better at the whole marriage thing is—perhaps surprisingly—Richard. His wife, Adele, whose Alzheimer’s has clearly advanced considerably, shows up at the hospital demanding to see him, while he’s in the middle of his 10,000^th surgery (a liver transplant on a pair of…shall we say, colorful sisters). He’s clearly stepped up to the caregiver plate with her, and with some help from Meredith, he manages to talk Adele down from her hysteria without missing a beat in his surgery. Talk about multitasking. And his way of grounding Adele—singing “My Funny Valentine,” which is what they danced to at their wedding, was really, really sweet.

What did you think, readers? Are Cristina and Owen doomed? Would it have been better if the mother and son had been honest with each other? Was that one liver transplant sister one of the most hateful patients in the history of Grey’s? Share your thoughts in the comments below.

Sad though it was, we all knew Lang wouldn’t be long for the Downton world. As I predicted last week, the arrival of so many convalescent soldiers pushed the shell-shocked valet right over the edge, inducing increased clumsiness, night terrors, and finally a full-on public breakdown. Tragically for Lang, PTSD was poorly understood at the time and virtually untreated (too bad   canine therapy was many decades in the future—Isis the Downton dog would have been perfect). Like many others in his situation, he was sent on his way with a good reference and two months’ wages to face a highly uncertain future—the vast majority of those with PTSD are suceptible to other psychiatric disorders, including major depression, and are more likely to engage in risky health behaviors such as alcohol and drug abuse. Hopefully Lang will manage to pull himself together and live a semi-normal life; I doubt we’ll ever get a difinitive answer regarding his future.

While we’re on the subject of mental health issues—what’s up with O’Brien? This woman’s all over the map, showing kindness and sympathy for Lang but none for other soldiers, holding a grudge against Bates for absolutely no reason at all, manipulating her mistress at every turn. Does she have some sort of personality disorder, another mental health issue or is she just a rather poorly written character? I’d love to have your thoughts.

In other news, Branson the revolutionary chauffeur who sets many a heart aflutter (including the fetching Lady Sybil’s) finds out his own heart is keeping him out of the service: he has a heart murmur. More specifically, he has mitral valve prolapse, a condition in which the mitral valve fails to close properly. It usually isn’t serious, although in some rare cases it can lead to infective endocarditis or mitral regurgitation, which are worth worrying about. Of course, if he finally manages to win over Lady Sybil, he’ll have a nurse around the house to keep an eye on his health!

By Brianne Moore

Grey’s Anatomy has never tried to be all that realistic in its depiction of the workings of a major metro hospital. We’re used to seeing characters act in ways that would almost certainly get them fired and would probably result in their licenses being revoked in the real world. That sort of thing is usually dismissed because it’s the younger docs doing it, and they don’t know any better. But tonight, it was the senior surgeons—almost every single one of them—who were behaving selfishly, childishly, cruelly and in a manner so unprofessional and counterproductive to what they’re supposed to be doing (healing and teaching) that I actually walked away from my TV sort of stunned. What happened here?

The big case of the week is the separation of two conjoined twins—Andi and Brandi (with names like those, I wasn’t surprised the parents looked like they walked out of an episode of 16 and Pregnant). The complex surgery requires multiple teams and many hours, and it’s being insanely, obnoxiously micromanaged by Robbins, who meddles and stresses so much I can’t believe anyone got anything done. Alex was all gung-ho to assist with one of the more complex parts of the procedure, but then Richard plays him like a fiddle, manipulating his way into Alex’s place on the surgery. Really mature, Richard. And to think I used to like our ex-chief.

A few of our docs are forced to miss out on the groundbreaking surgery, for various awful reasons. Bailey, who’s back together with cute anesthesiologist Ben, is getting some serious pressure from him to move in together, even though they’ve only been back together for two weeks. He absolutely refuses to accept her (reasonable, in my opinion) reluctance to shack up and won’t stop pressuring her even during surgery, so she pulls Meredith in to act stupid and serve as a buffer. How grown up, and how marvelous of Bailey to keep Meredith out of a major surgery because Bailey can’t assert herself enough to tell Ben to be professional for a few hours and stop bugging her while she’s trying to save a life. What happened to the no-nonsense Bailey of earlier seasons? I really miss her sometimes.

Cristina’s also not operating on the twins because she’s in surgery with Teddy. Not operating, though. Teddy’s forcing Cristina to go through Henry’s unsuccessful surgery step by step over and over again. And she’s been doing this all day every day for two whole weeks.

For me, this was the most galling part of the episode. First, as coping/grieving mechanisms go, this is particularly toxic. Even poor Kepner, who’s made to listen to this day in and day out can’t take it anymore. Cristina’s in full-on surgical robot mode, even when Teddy calls her decisions into doubt, but this has to be wearing on her. My question is: why has this been allowed to happen? What hospital on earth would allow a surgeon to keep another surgeon hostage for psychological torture purposes? She’s actively keeping Cristina out of surgeries, which is not OK at all, and abusing her. Why hasn’t Hunt stepped in? It’s not like this is a secret—everyone knows what’s going on. It’s completely nuts and so, so wrong.

Back to the babies: they’re separated just fine, but they only have three kidneys between them, and the twin that only gets one has it fail on her. Oddly, nobody knows what to do, until Alex suggests they get a kidney from the other twin, who’s a perfect donor. While everyone scurries to do that, Richard apologizes to Alex for stealing his place in the surgery…and then proceeds to manipulate him into generously allowing the former chief to do the kidney implant. Mid-surgery, Richard starts bragging about how he worked Alex, unnecessarily humiliating the young surgeon. Afterwards, Alex reminds Richard that this is a teaching hospital, and manipulating your way onto surgeries is not a teachable moment. Richard insists that it is, because it taught Alex never to give up his spot on a groundbreaking surgery again. I think it just taught him not to trust Richard, who’s a devious, childish, selfish jerk. I found it particularly sad that he did this to Alex, who’s been so damaged throughout his life that he already has major trust issues. But apparently we were just supposed to laugh this off.

The only docs I didn’t hate by the end of the hour were Meredith and Derek, who are just loving being parents to the impossibly adorable baby Zola. Might I suggest the new parents take a look at our Baby App?

Who do you think behaved the worst this hour? Robbins with her meddling, Hunt for not stepping in when necessary, Bailey for using Meredith, or Teddy for torturing Cristina? Share your thoughts in the comments below.

By Brianne Moore

Those of you who watch Masterpiece Classic know that the second season of the much-loved Downton Abbey started up last night, and it was a doozy of an episode. Hardly surprising, considering the season takes place during World War I (and starts off at the Battle of the Somme, one of the most devastating and costly engagements of the entire war). With a war on, characters off fighting (or getting ready to go) and youngest daughter Sybil taking up nursing, there are bound to be some interesting and sometimes heartbreaking medical cases coming across our screens over the next few weeks.

In our first episode, we got to see some of the more common and highly devastating effects of being at war: shell shock (now more commonly referred to as PTSD) and depression. Lang, the new valet, arrives at Downton a bit jumpy, and we quickly learn that he’s been invalided out of the service, even though he doesn’t look like he’s been wounded. His anxiety, difficulty concentrating, and flashbacks to his time in the trenches are all classic symptoms of PTSD, and with the house preparing to turn itself into a convalescent hospital for returning wounded soldiers, we can be sure Lang’s condition will only deteriorate. Lang is hardly alone—many soldiers develop PTSD after being in combat (more than half of all Vietnam veterans experienced symptoms)—but the disorder wasn’t actually identified and named until the Vietnam War era. Soldiers like Lang were considered “shell shocked” and just urged to rest for a bit. For someone in his social position, however, a period of rest isn’t necessarily an option—after all, one has to eat and have a roof over one’s head.

Even sadder than Lang’s story was that of Lieutenant Courtney, the blinded soldier being treated in the local hospital. He’s so pitiful he even makes the hateful former footman Thomas grow a bit of a heart. His blindness is the result of the use of new chemical weapons during the war: chlorine, and later mustard gas. These gasses not only caused blindness (both temporary and permanent); they also severely damaged the lungs, caused internal bleeding and blistered the skin. The young lieutenant, faced with a very different life from the one he’d planned, is also suffering from severe depression. Like Lang, he’s not alone—depression currently affects one in 10 Americans—but like so many things, it was poorly understood during this period, and effective treatments were virtually nonexistent. The doctor’s advice that the young man chin up and make the best of his situation was about the best they could do. Tragically, this advice did nothing to help the young soldier, who like many depressed people was struggling with thoughts of suicide.

Nowadays, depression is far better understood, and a wide range of treatments are available (the same holds true for blindness as well), but it never hurts to brush up on some of the warning signs of depression so someone can intervene before it’s too late.

Are you watching Downton Abbey? How do you feel about the season so far? Discuss your thoughts in the comments below.