As I type this I heave a heavy sigh. I had thought that, just for one series, we might be able to see Derek and Meredith be happy. Well, not happy maybe, but together without either one of them having any major breakdowns. I don't mind if one of them gets shot or run over maybe but I am tired of the dark and twisty.
With that little rant out of the way I'll get on the episode itself. Despite the above I actually thought it was very good. The tension between Addison and Derek throughout could have been cut with a knife. The central plot to this episode was gripping and I empathized with the characters, both the doctors and the patients, the entire way through. Everyone knows what it's like to make a mistake that can't be fixed no matter how hard you try and this episode brought that feeling to new melodramatic heights. To have the wonderful Kate Walsh return for this and the previous episode as Addison was brilliant. The friendly bickering between Alex and Meredith brought a little lightness to quite a hard hitting story line.
However, while the main plot was good, the side plots in this episode suffered slightly as a result. Izzie was wandering around shouting at interns, Christina was being rude, George was being anxious and Bailey was annoyed at the Chief. The supporting cast were reduced to caricatures of themselves for the duration of the episode but, though I've heard some people say they hate it, Bailey's new hair is fierce.
All together it was a good installment, but the side plots could have been written much better. With such a dour ending, I predict much more dark and twisty-ness to come. I just hope they do it well.